AARP believes that every American deserves a highly skilled nurse when and where nursing skills are needed. A richly skilled, effectively integrated nursing workforce — with enough professionals to meet the need — is essential to delivering high-quality health care.
For more information on nursing issues and how they impact your health care, visit the Center to Champion Nursing in America, an initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation.
NURSING WATCHDOG
AARP members are watching for policy solutions and legislation that would fully realize nurses' potential contribution to a patient-centered, transformed health care system in the following areas:
Removing Barriers to Practice: Modernize outdate policies (public and private) and change state and federal laws and regulations to allow nurses to practice to the full extent of their education and training.
Patient-Centered Transformed Health Care System: Advances and contributions to the research, advocacy and communications strategies through the national network of professional and health care related stakeholders.
Advancing Nursing Education: Federal and state policies to increase the educational level of nurses through an improved education system that promotes seamless academic progression.
Nurses Leading Change and Advancing Health: Federal and state policy making bodies include nurses on advisory committees, commissions, and boards.
Providing the Nurses We Need
Nurses are central to consumers’ good health, especially within a changing health care system. They are positioned across the health care system to provide high quality health care, increase access to health care services, and keep costs down. Yet, as our population ages and requires more complex health care, we’re facing a shortage of nurses – 260,000 over the next 15 years.
To ensure Americans have a nurse, with the right skills, when and where they need one, Congress should: 1) modernize Medicare nursing education payments to help produce more advanced practice nurses; 2) establish a reliable, dedicated source of funding for nursing education capacity; and 3) remove federal legislative and regulatory barriers that prevent advanced practice registered nurses from fully using their skills to provide services within Federal health programs.
DOCUMENTS RELATED TO NURSING AND HEALTH CARE
The Center to Champion Nursing in America contributed to a comment letter AARP submitted to the Centers for Medicare and Medicaid Services (CMS) regarding increased Medicaid payment rates for primary care providers. The letter encouraged CMS to include advanced practice registered nurses and physician assistants, who currently provide primary care services across the country, as providers eligible for these increased payments. (June 11, 2011)
AARP Connecticut submitted testimony in support of Senate Bill 414, which allows Advanced Practice Registered Nurses (APRNs) to sign forms to authorize needed health care services. This bill would increase consumers’ access to support services by allowing APRNs to sign, certify or give an authorization where a physician is allowed or required to do so.
AARP Louisiana offered support for House Bill 951, which proposed to remove a mandatory collaborative practice agreement between physicians and nurse practitioners who practice in medically underserved areas, thereby increasing consumers’ access to health care.
AARP Missouri submitted testimony in support of Senate Bill 679, which proposes to increase consumers’ access to health care by removing the mandated collaborative agreement between physicians and advanced practice registered nurses and instead would allow a written protocol or a standing order.
AARP and members of the Nursing Community sent a letter to the Federal Trade Commission expressing support of their efforts to promote competition, access, and choice in health care through opinions on proposed regulations and legislation affecting Advanced Practice Registered Nurses’ scope of practice.
AARP Virginia submitted a letter in support of a Virginia Department of Health Professions’ study regarding scope of practice for nurse practitioners, the elimination of barriers to practice, and health care access for consumers.
AARP submitted a letter to Members of Congress expressing serious concerns with the House Reconciliation proposal pursuant to the Fiscal Year 2013, including provisions affecting state health insurance exchanges, Medicaid and CHIP provisions, and the repeal of the prevention and public health fund.
Along with partnering national nursing organizations, AARP sent a letter thanking CMS Acting Administrator Marilyn Tavenner for her leadership on the recently-released Graduate Nurse Education (GNE) Demonstration solicitation. The letter also requested a 30-day extension of the proposal deadline to allow additional time for questions and clarification.
AARP applauds Medicare Graduate Nurse Education Demonstration. In a statement released earlier this week, AARP applauded the CMS Innovations Center's recent release a request for proposals to implement an initiative to produce more advanced practice nurses (APRNs). The Medicare Graduate Nurse Education demonstration program, established by the Affordable Care Act (ACA), will provide $200 million over four years to create partnerships between hospitals, schools of nursing and community-based providers such as community health centers, and will help to incentivize the production of more highly skilled nurses.
AARP Comments to Marilyn Tavenner, Acting Administrator for the Centers for Medicare & Medicaid Services, about the proposed rule on “Reform of Hospital and Critical Access Hospital Conditions of Participation.” AARP recommended that the proposed regulation be modified to clearly state that APRNs be eligible for clinical privileges, admitting privileges, and medical staff membership including voting privileges and that hospital policies assure that the process for making these decisions are transparent, objective and timely. (See PPI publication Removing Barriers to APRN Care: Hospital Privileges for more information). (December 21, 2011)
AARP responded to a Request for Information from the Centers for Medicare and Medicaid Services (CMS), and encouraged clear communication, delivery reform, patient engagement, and quality care measures in the development of ACOs. In this letter, AARP also encouraged CMS to adopt the Institute of Medicine’s definition of “primary care” so that practices led by Advanced Practice Registered Nurses (APRNs) and Nurse-Managed Health Centers can participate in ACOs. (December 3, 2011)
AARP New York letter to the Co-chairs, Workforce Flexibility/Change of Scope of Practice Work Group recommending the removal of scope-of-practice barriers for advanced practice registered nurses (APRNs) in New York state. (December 2, 2011)
In a June 2011 comment letter to CMS, AARP expressed concern at the exclusion of Federally-Qualified Health Centers, Rural Health Centers, and nurse-led medical/health homes as eligible providers and suppliers in ACOs, since each of these entities provides primary care, particularly to medically underserved populations. (June 6, 2011)
AARP Comments on the proposed statement of antitrust enforcement policy regarding Accountable Care Organizations participating in the Medicare shared savings program (“Proposed Statement”). (May 31, 2011)
AARP Comments to Don Berwick, CMS Administrator, about the proposed rule regarding the Face-to-Face Requirements for Medicaid Home Health Services.
The law requires that a physician, nurse practitioner, clinical nurse specialist, certified nurse-midwife, or a physician assistant have a face-to-face encounter with the individual before a physician certifies the individual’s need for home health services. AARP pointed out that this is an extra step for patients whose primary care provider is an advanced practice registered nurse (APRN), leading to increased costs and delays in accessing home health care. AARP believes that APRNs should not just conduct the face-to-face encounter, but be able to order (certify) home health services (i.e. sign the forms authorizing services). AARP has consistently supported legislation that would allow APRNs to certify patients for home health services. (September 12, 2011)
A Letter of Endorsement: AARP Supports Home Health Care Planning Improvement Act (H.R. 2267), co-sponsored by Representative Allyson Y. Schwartz (D-PA).
A Letter of Endorsement: AARP Supports Home Health Care Planning Improvement Act (H.R. 2267), co-sponsored by Representative Greg Walden (R-OR).
A Letter of Endorsement: AARP supports Home Health Care Planning Improvement Act of 2011, co-sponsored by Senator Susan M. Collins (R-ME).
A Letter of Endorsement: AARP supports Home Health Care Planning Improvement Act of 2011, co-sponsored by Senator Kent Conrad (D-ND).
Letter to CMS: AARP outlines its priorities related to Accountable Care Organizations, including ensuring that nurse-led practices and nurse-managed health clinics are considered providers within ACOs and ensuring that accurate outcomes data is captured, including for care provided by advanced practice registered nurses.
Statement from Nancy LeaMond: AARP Urges Bi-Partisan Support for Home Health Companion Bills
A Letter of Endorsement: AARP supports Home Health Care Planning Improvement Act of 2010, sponsored by Representative Allyson Y. Schwartz (D-PA 13)
A Letter of Endorsement: AARP supports Home Health Care Planning Improvement Act of 2010, sponsored by Senator Susan M. Collins (R-ME)
Statement from Susan Reinhard: AARP Applauds HHS Investments in Primary Care
Statement from Susan Reinhard: AARP Applauds Medicare Graduate Nursing Education
Nursing Related Provisions in Health Care Reform Legislation: A Chart
Statement from Susan Reinhard: AARP Supports Senate bill to expand number of Advanced Practice Registered Nurse
A Letter of Endorsement: AARP, nursing organizations support Capps bill to increase funding for nursing training
Statement from Susan Reinhard: AARP applauds House bill to modernize Medicare funding for nursing education
Letter to House Representative: AARP applauds Rep. Lois Capps' leadership on health and nursing issues
NURSING and the ECONOMIC STIMULUS
AARP advocated for additional funding for nursing education in the American Recovery and Reinvestment Act of 2009. Here are some related materials:
Overview of 2010 HHS Appropriations for Nursing Education: House and Senate Appropriations Committees Approve Spending Bills
Fact Sheet: Putting Nurses to Work in the Economic Recovery Package: Option for Consideration
Letter from the CCNA: Congress Considers Major Investment in Nursing Education as Part of Economic Recovery
Letter from the CCNA: President Obama Signs the Reinvestment Act of 2009; Represents a Major Investment for Nursing Education
Letter to the HRSA: AARP's letter the Health Resources and Services Administration urging the use of ARRA funds for nursing workforce development
OTHER LEGISLATIVE ACTIVITIES
Letters to FTC from Congress:
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