Governmental Affairs

2007-2008 Legislative Program

I. Consumer Advocacy and Health Promotion

NYSNA monitors and supports state and federal legislative proposals to:

A. Promote Access to Quality Health Care for All People

1. Advocate the establishment of a national health system to meet the health needs of all people.
2. Promote initiatives at the state level to meet the health needs of all New Yorkers, including prescribed medications and supplies, regardless of ability to pay.
3. Advocate strategies to promote a continuum of health care including preventive, primary, long term care and end of life care, including a smooth transition among the various levels of care on the health care continuum.
4. Support funding for research that examines the effectiveness of health care financing policies in order to promote quality outcomes, effective health care delivery systems and a positive nursing care environment.
5. Promote access to quality health care that includes appropriate alternative and complementary modalities.
6. Promote legislation to eliminate anti-competitive and discriminatory barriers to services provided by professional nurses.
7. Promote consumers' opportunities to choose nurse providers within managed care or health care networks.
8. Advocate access to full range of reproductive services for all persons.
9. Promote the development of coordinated networks of services planned and provided by state agencies to ensure outreach to and accessibility by consumers.
10. Support efforts to establish an authoritative external appeal process with clinical peer utilization review to assure access to quality health and nursing services.
11. Support efforts to immunize appropriately and decrease barriers to immunization.
12. Promote legislation to assure that individuals without health benefits are able to purchase affordable comprehensive health insurance.
13. Support efforts to provide HIV and communicable disease counseling and testing at all health encounters.
14. Support state DOH funding of all types of confidential HIV testing at all county health departments in New York State.

B. Protect the Health of Vulnerable Populations

1. Those in Need of Economic Security
   
   1. Promote continuation of Social Security as a social insurance program for covered populations.
   2. Support efforts that reduce the growing disparity between the wealthy and the poor.
   3. Support initiatives to assure that all workers receive adequate wages to raise households out of poverty.
      
2. Affected by HIV Epidemic
   
   1. Support funding for increased HIV primary care, prevention and educational programs.
   2. Support AIDS centers and treatment initiatives.
   3. Monitor attempts to require mandatory HIV testing. Support programs of voluntary, confidential testing and the continuance of free, publicly funded anonymous testing.
      
3. The Homeless
   
   1. Support programs that provide comprehensive, coordinated health and social services at the community level.
   2. Encourage legislative initiatives to expand available and affordable housing.
      
4. Those Who Need Long Term Care
   
   1. Support adequate funding for community-based and institutional long-term care services for all ages.
   2. Support efforts to develop affordable long-term care insurance.
   3. Support efforts to utilize nurses as care providers and case managers in facilities, agencies, and programs delivering long term care services.
   4. Promote adequate nursing staffing patterns to ensure safe long-term care.
      
5. Those Who Need Child Care
   
   1. Promote access to quality, affordable day care for all families.
   2. Support medical and family leave legislation that mandates the continuation of health care benefits.
   3. Support efforts to utilize appropriate personnel in the delivery of health care by child care centers and providers.
      
6. Children and Adolescents
   
   1. Support efforts to prevent violence, suicide, substance abuse, teenage pregnancy, and sexually transmitted diseases.
   2. Support efforts to utilize registered nurses as providers and supervisors of mandated school health services.
   3. Advocate expanded school health services to include health promotion, health counseling, and care for acute and chronic illness.
   4. Support initiatives that promote coordination of school-based and school-linked health care services.
      
7. Disabled Infants and Children
   
   1. Advocate nursing assessment for all children prior to admission into special education programs.
   2. Support appropriate nurse/child staffing ratio to assure safe care.
   3. Promote access to quality Early Intervention Programs.
      
8. Those who Need Mental Health Care
   
   1. Support prevention in high-risk groups such as children in inner cities and rural areas, persons who are homeless, members of culturally diverse populations, the elderly and healthcare personnel.
   2. Support efforts to develop mental health services and continuity of care to ensure appropriate placement in the least restrictive environment.\
   3. Advocate for the inclusion of mental health benefits as equal with other health benefits and resources to ensure appropriate services for persons with a primary or secondary diagnosis of mental illness or multiple diagnoses.
      
9. Those Who Need Care for Misuse of Alcohol and Other Drugs
   
   1. Support prevention in high-risk groups such as school age children, adolescents, the elderly and healthcare personnel.
      Support prevention in high-risk groups such as school age children, adolescents, the elderly and healthcare personnel.
   2. Support education and rehabilitation programs to reduce alcohol and other drug use and abuse.
   3. Promote the development of coordinated networks of services to provide comprehensive treatment.
   4. Advocate for the inclusion of insurance benefits equal with all other illnesses for alcoholism and drug addiction.
   5. Support appropriate interventions to meet individual needs of family members.
   6. Support the expansion of state-funded inpatient and outpatient treatment programs for alcoholism and drug addiction.

C. Promote Enhancement of Public Health Systems

1. Restore and strengthen the statewide public health infrastructure.
2. Promote public healthcare planning that takes into account the need for culturally sensitive care for diverse populations.
3. Advocate registered nurse involvement in all public health efforts.
4. Support appropriate resources for disaster preparedness and response to terrorism across the state, including nurses in planning and deployment activities, ensuring that funding sources do not drain basic public health services.
5. Support emergency preparedness network development and coordination at the national, state and local level.
6. Advocate a health system that promotes health and prevents disease and injury.
7. Promote insurance coverage for preventive health care services.

D. Support the Rights of All Individuals

1. Promote passage of the Equal Rights Amendment.
2. Support programs to protect and support survivors of all forms of violence, abuse and neglect.
3. Support efforts to prevent all forms of violence, abuse and neglect through public education and prevention programs.
4. Advocate measures directed at reducing gun violence.
5. Protect the right of individuals to make informed choices about all aspects of their health care.
6. Advocate removal of barriers to the delivery of appropriate care, including pain management.
7. Defend the right of all individuals to be protected from unsafe health care providers.
8. Oppose any attempts to substitute unlicensed personnel for health professionals.
9. Support efforts to provide equality in health care for women.
10. Oppose regulatory reform initiatives that dilute clients' rights.
11. Support measures that prevent hate crimes.
12. Promote efforts to ensure confidentiality of private information.
13. Promote efforts to prevent discrimination.

E. Foster Pay Equity and Comparable Worth

1. Support efforts to improve the economic status of women.
2. Support efforts to guarantee pay equity for women.
3. Encourage the implementation of a fair, adequate and portable retirement plan for all health care workers.

F. Protect the Environment

1. Promote a safe global ecosystem through adequate waste management including medical waste and nuclear waste.
2. Support environmental reclamation programs.
3. Support legislation to protect the land, air and water.
4. Support legislation to protect the public from environmental health hazards.

II. Educational System for Nursing

NYSNA monitors and supports state and federal legislative proposals to:

1. Promote Access To Nursing Education Within Institutions of Higher Learning
   
   1. Advocate funding to support public and private baccalaureate nursing education programs.
   2. Support initiatives to eliminate barriers to educational mobility in nursing.
   3. Advance efforts to meet the critical need to recruit and retain qualified and culturally diverse nursing faculty.
      
2. Support Initiatives to Meet the Future Needs for Registered Professional Nurses
   
   1. Promote educational opportunities for nurses to acquire skills to work in the health care system.
   2. Advance efforts to meet the projected need for nurses with baccalaureate and graduate education.
   3. Advocate funding to enhance retention and recruitment of diverse groups into undergraduate and graduate education.
   4. Advocate appropriate support services to enable students to successfully complete nursing education programs and secure licensure.
   5. Promote opportunities for appropriate precepting and mentoring of nurses.
   6. Support funding for a positive nursing image campaign especially to young people who are yet to make career decisions.
   7. Advocate for a school finance system that ensures students are provided with educational resources to prepare them for higher learning.
   8. Support ongoing research development that informs and improves nursing education and ensures an educational system responsive to change.
      
3. Initiate legislation that establishes the baccalaureate as entry into professional nursing practice, including provision for “grandparenting.”

III. Environment in Which Nursing Is Practiced

NYSNA monitors and supports state and federal legislative proposals to:

1. Promote Professional Practice
   
   1. Advocate the dissemination of facility specific information on RN staffing and nurse-sensitive patient outcome data so consumers can make judgments about the quality of care available at different healthcare organizations.
   2. Develop incentives to promote professional practice in all settings in which health care is delivered.
   3. Support public recognition of nurses as independent health care providers with a legal scope of practice that fully entitles them to render and be reimbursed for services.
   4. Support direct access to nurses in advanced practice including nurse practitioners, nurse-anesthetists, nurse midwives and clinical nurse specialists.
   5. Obtain mandatory third-party reimbursement benefit for registered professional nurses from all payer sources. Include psychiatric nurses in all sections of insurance law where specific psychiatric/mental health providers are identified.
   6. Oppose inappropriate restructuring plans and staffing mixes that jeopardize the quality of care.
   7. Define the appropriate utilization of unlicensed personnel to ensure that they are assistive to nurses rather than replacements for RNs.
   8. Advocate resources to ensure an adequate supply of licensed nurses.
   9. Evaluate regulatory reform proposals to determine their effect on nursing practice and the quality of health care.
   10. Support efforts to enable school nurses to practice to the full extent permitted under the Nurse Practice Act.
   11. Support nursing research to promote and advance nursing expertise in patient care delivery.
   12. Advocate mandatory continuing education utilizing nationally accepted standards for nursing education to maintain nurses' positions as knowledgeable health care providers.
   13. Support strategies to enable health care providers in rural areas to attain and maintain the specialized knowledge needed to address rural health problems.
   14. Repeal the exemption clause in the Nurse Practice Act that permits unlicensed personnel to practice professional and practical nursing in institutions under the jurisdiction of the Office of Mental Health and the Office of Mental Retardation and Developmental Disabilities.
   15. Advocate the modification of home care licensure requirements to remove restrictions that discriminate against registered professional nurses in private practice.
   16. Support appropriate utilization of licensees providing telehealth services in a way that prevents illegal interstate practice.
   17. Support efforts that recognize the appropriate role of the RN in the emergency medical services system without requiring compliance with duplicative credentialing processes.
   18. Promote legislation that ensures safe staffing in all settings based on ANA’s Principles for Nurse Staffing.
   19. Support legislation to ensure safe staffing ratios in hospitals and nursing homes.
   20. Promote legislation prohibiting employers from mandating nurses to work overtime except in defined emergencies.
   21. Support efforts to reduce duplicative and voluminous paper and documentation requirements in health care, particularly in home care and nursing homes.
   22. Support efforts to ensure that future RNs attain the baccalaureate degree in nursing.
   23. Support career advancement pathways that enable diploma and associate degree registered nurses to attain a baccalaureate degree in nursing.
       
2. Protect the Public through Upholding the Nurse Practice Act
   
   1. Ensure that only licensed nurses practice nursing.
   2. Oppose any effort to institute waiver of licensure.
   3. Oppose the mutual recognition model and interstate compact for multistate licensure.
   4. Oppose vigorously any effort that suggests, implies, or requires physician supervision of professional nursing practice or any other attempt to weaken the RN’s independent practice, autonomy, client advocacy and responsibility for the delivery of nursing care.
   5. Advocate prosecution of unlicensed individuals illegally practicing nursing.
   6. Ensure that the standards in the American Nurses Association's Code of Ethics for Nurses are reflected in any substantial revision of the Nurse Practice Act.
   7. Provide leadership in shaping amendments to the Nurse Practice Act to protect the practice of nursing by:
      
      1. Reaffirming the statutory recognition of all nurses by protecting the title nurse and creating statutory recognition for registered nurses in advanced practice by protecting their titles.
      2. Assuring that all RNs have non-pharmacological prescriptive authority to order laboratory tests, assistive devices, and other interventions as part of a nursing care plan and provide pharmacological prescriptive authority for any RN in advanced practice.
      3. Repealing outdated exemption clauses and preventing the enactment of any additional exempt clause proposals without our leadership.
      4. Opposing proposals that would require nurses in advanced practice to attain a second license, while supporting professional certification.
         
   8. Advocate that all relevant laws are consistent with the provisions of the Nurse Practice Act.
      
3. Protect Employee Rights and Safety
   
   1. Support efforts to improve the economic status of workers.
   2. Support legislation to clarify labor law provisions to protect the rights of nurses to join together collectively for purposes of labor representation.
   3. Advocate the development of state and local community conversion plans to address changes in hospital services, retraining of hospital employees, and retaining jobs in the community.
   4. Support legislation to assure pre-notification to employees of closures or mergers of health care facilities and to provide continuation of health and pension benefits for employees.
   5. Protect the rights of workers during health industry restructuring and financial realignment.
   6. Promote labor laws that protect employees.
   7. Evaluate legislation regarding drug testing in the workplace.
   8. Maintain the right of all individuals to be protected from sexual harassment in the workplace.
   9. Support efforts to strengthen whistleblower protections.
   10. Support efforts to ban permanent replacement of workers engaged in a legal strike.
   11. Support initiatives to create and maintain jobs for the New York state workforce.
   12. Monitor legislation addressing HIV testing. Support programs designed to effectively protect the public and recognize the rights of workers.
   13. Support unemployment insurance and worker's compensation systems with adequate funding and fair distribution of benefits.
   14. Support initiatives that eliminate or minimize occupational health, safety hazards and violence in the workplace.
   15. Promote inclusion of domestic partners of covered workers in insurance and pension benefits.
   16. Promote development and implementation of an appropriate ergonomics standard to ensure the health and safety of the health care workforce and clients.
   17. Advocate for appropriate compensation for healthcare workers who become injured/disabled in conjunction with participation in emergency response activities.
   18. Support efforts to ensure a minimum of time and a half-hourly wage for overtime work.
       
4. Maintain Liability Insurance
   
   1. Support legislation that maintains affordable and available liability insurance for nurses.
   2. Support tort reform proposals that promote comprehensive service networks designed to identify and provide services for all infants and children with neurological and developmental impairments.
   3. Support efforts to maintain an individual's rights to seek redress for wrongs while controlling any exorbitant increases in the cost of professional liability insurance.

IV. Government Accountability for Health Care Policy and Assuring Quality of Care

NYSNA monitors and supports state and federal legislative proposals to:

1. Provide Adequate Funding for Health Care
   
   1. Advocate a state budget that meets the physical and mental health needs of the frail, the elderly, the young, the disabled, and the medically indigent.
   2. Advocate strong rules regarding conflict of interest, accountability, and public participation to protect the public interest as healthcare delivery systems and financing mechanisms change.
   3. Oppose initiatives to authorize investor owned for-profit corporations to own or operate hospitals and nursing homes in New York State.
   4. Advocate the equitable distribution of the state's resources to provide incentives for nursing research, evidence-based practice and nursing clinical initiatives to meet the health needs of New Yorkers.
   5. Promote utilization of quality outcomes, including nursing measures of quality to support decision-making that does not rely solely on economics.
   6. Support adequate reimbursement for health care facilities to meet rising personnel costs of providing health care.
   7. Promote adequate reimbursement for health care facilities to provide adequate funding for nursing services.
   8. Support funding for inpatient hospitalization for those patients in need of intensive psychiatric treatment and for sufficient community-based services for those individuals who are most appropriately treated in the community.
   9. Advocate reimbursement for the provision of nursing care to all school children, including handicapped children.
      
2. Support Initiatives to Reform the State Budget
   
   1. Advocate reform of the state budget process to assure public accountability and participation.
   2. Oppose any efforts to establish state fee structures that are inequitable.
   3. Promote a tax code that assures that those most able to pay contribute a fair share and those least able to pay are taxed proportionately less.
   4. Support efforts to reform the structure of the tax code system so that it captures revenue proportionate to the growth of wealth in the state.
   5. Promote utilization of appropriate health care personnel through adequate funding of initiatives to deter illegal unlicensed practice.
   6. Oppose any efforts to allow special revenue from professional licensure/registration fees/surcharge to be used for purposes other than professional governance.
      
3. Promote Election Process Responsive to Citizens
   
   1. Advocate reform of the election law to make it easier for individuals to register and vote.
   2. Promote election law reforms that enable qualified candidates to secure a place on the ballot.
   3. Advocate campaign financing reform efforts to provide a more level playing field for all candidates including challengers.
   4. Promote mechanisms for small contributors to balance the influence of large contributors in supporting political candidates.

This is an illustrative, but not exhaustive, list of issues that the New York State Nurses Association will address to advance the cause of nursing and promote the health and welfare of all New Yorkers.

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