American Journal of Nursing 2000 February Volume 100, Issue 2

106^th Congress

Patient Protections Top Legislative Agenda.

As the second session of the 106th Congress convened the last week in January, health care continued to be among the issues ripest for political debate and legislative action. The ANA will capitalize on this and continue to advocate protecting nurses and their patients.

Protecting Patients

The November 1999 report on medical errors of the Institute of Medicine (IOM) received substantial attention in the media and among policymakers. (See “Workplace Rights” in this issue for more specifics on the report, To Err Is Human: Building a Safer Health System.) Within a week of the report’s release, current ANA President Mary E. Foley, MS, RN, testified before a Senate Committee chaired by Senator Arlen Specter (R-PA) about the relationship between staffing decisions and patient safety.

“No system can succeed, no matter how brilliant, if there aren’t qualified staff to implement it,” said Foley. “Until health care administrators and the public focus on reducing system problems that contribute to clinical errors, shared accountability for systems improvement in health care cannot be achieved.”

Congress is expected to debate the issue of medical mistakes vigorously. In fact, in December, Senator Edward Kennedy (D-MA) announced he intended to introduce legislation requiring all hospitals to notify state governments of mistakes causing serious injury or death, and creating a Center for Patient Safety within the Department of Health and Human Services (HHS). The IOM report recommended both ideas.

Growing consumer demand for this and other information about the health care system may also force Congress to consider more closely the Patient Safety Act (HR 1288/S 966). The act would require health care institutions to disclose specific staffing and outcomes information, to provide whistleblower protections for nurses, and to consider the effects on community health care before approving hospital mergers and acquisitions. The Patient Safety Act has been introduced in the last three Congresses.

Managed care reform legislation—known as the Patient’s Bill of Rights—will move into a conference committee early this year to reconcile the versions passed by the House and Senate in 1999. The ANA supports the bipartisan Norwood-Dingell measure passed by the House because it’s enforceable and comprehensive, holds health plans legally accountable for harmful decisions they make, and protects nurses who advocate for their patients.

Congress is also expected to consider legislation protecting health care privacy and confidentiality, because HHS, which has issued proposed regulation, has limited legal authority. For instance, the HHS proposal addresses only electronic records and doesn’t provide consumers the right to sue for damages in egregious cases of privacy invasion.

Advocating for Nurses

The bipartisan effort in the Senate to advance needlestick protection legislation is encouraging. A bipartisan bill was introduced in the House in May 1999, and the issue has garnered support in the Senate as Senators James Jeffords (R-VT) and Kennedy have agreed to make it a priority in 2000.

The ANA will also continue to work toward expanding Medicaid reimbursement to all advanced practice registered nurses. Currently, federal law mandates reimbursement only for pediatric and family nurse practitioners and for certified nurse-midwives.

In addition, the ANA will seek appropriate funding levels for the Nurse Education Act, the National Institute of Nursing Research, and labor programs, including the Occupational Safety and Health Administration.

To let your member of Congress know where you stand on the issues, contact the U.S. Capitol Switchboard at (202) 224-3121. For more information on the ANA’s legislative activity and how you can be more politically active, go to the “Legislative Branch” at www.nursingworld.org

 

Key AA Issues for Congress in 2000

Managed Care Reform Patient Safety Act Needlestick Protection Medicaid Reimbursement Funding for Nurse Education and Research Whistleblower Protection Patient Privacy and Confidentiality Medical Errors and Staffing