ENA Washington Update

June 15, 2019

ENA Government Relations
gov@ena.org

Day on the Hill 2019 Sees Largest Attendance Yet

On May 21 and 22, ENA members traveled to the nation's capital under sunny skies to participate in what has become an annual tradition for the organization - Day on the Hill. ENA's premier advocacy event, it has built on the success of the past few years, with this year seeing the largest attendance thus far, at 165. More than 40 percent of attendees indicating it was their first time advocating in Washington for ENA.

Day on the Hill includes a day of training and educational sessions that this year included in-person remarks by Congressman Joe Courtney (D-CT) and a special video greeting from Senator Tammy Baldwin (D-WI), both of whom are sponsors of the Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1309/S. 851) in the House and Senate, respectively. The program also included a lunch speaker, political commentator AB Stoddard, who is the Associate Editor of Real Clear Politics, as well as breakout sessions where attendees could organize and prepare for their meetings the following day.

On May 22, ENA advocates traveled to Capitol Hill to meet with their elected representatives and senators. Forty-six states were proudly represented this year. Throughout the day, attendees met with more than 150 congressional offices to advance priority legislation related to workplace violence and improving emergency care for children.

PAHPA Clears Congress, Enacts MISSION ZERO Program

On June 4, the House of Representatives cleared a bill to reauthorize programs contained within the Pandemic and All-Hazards Preparedness Act, a bill originally passed to help the nation deal with varying types disasters - from hurricanes and earthquakes, to terrorist attacks and outbreaks of infectious disease. Also contained within this version of the legislation were provisions to enact the MISSION ZERO program, an ENA-supported measure and Day on the Hill priority 'ask' in 2017 and 2018. The movement of the legislation marks the end of a tumultuous process which saw the bill delayed for months because of a disagreement between two senators.

The MISSION ZERO program, originally contained in legislation introduced in 2016 by Representatives Michael Burgess (R-TX) and Gene Green (D-TX), is an innovative military/civilian trauma exchange program. It will allow military trauma teams and providers to embed with civilian trauma centers, providing opportunities to remain sharp while not deployed and to allow the transfer of knowledge between both sectors. Military health care professionals have, over the past two decades, become proficient in treating traumatic battlefield injuries, skills that could prove extremely useful in the private sector as emergency departments face levels of violence and trauma once reserved for the battlefield. PAHPA was originally passed in the Senate on May 16 and is expected to be signed into law by the president.

House Committee Advances Workplace Violence Bill

On June 11, the House Education and Labor Committee voted to advance the Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1309) on a 26-18 vote. Congress is now one step closer towards enacting a bill which would require health care and social service employers nationwide to take steps to protect their employees from violence. Similar bills have previously been passed in a handful of states to address the epidemic of violence plaguing these sectors, however this bill would mark the first national standard related to workplace violence in health care. The next stop for this ENA-supported bill is most likely the House floor, where it would likely pass.

H.R. 1309 was an ENA priority during the most recent Day on the Hill in May. ENA members participated in over 300 meetings with Senate and House office and were instrumental in increasing congressional support and cosponsors for this important workplace safety legislation.

Surprise Medical Billing Talks Continue in House

The House of Representatives has jumped on the surprise medical billing issue with recent hearings before the subcommittees on Health in both the Ways and Means and Energy and Commerce committees. But while the issue is strongly bipartisan and the Senate has taken the lead on the issue, the ultimate fix seems elusive. Surprise medical bills are sent to insured patients who are serviced by an out-of-network provider, often during an emergency. Sometimes the patients are cared for at an in-service hospital, but an anesthesiologist or other medical provider is not participating provider in the patient's medical plan.

One sticking point that came up in both House hearings was who was going to take the hit to help consumers, providers or insurers. Legislative proposals in both chambers would prohibit balance billing, where a consumer is sent a bill for the difference between what their insurer will pay and what an out-of-network provider will change for their services. That's the approach taken by Sens. Bill Cassidy (R-LA) and Maggie Hassan (D-NH) in S. 1531, the STOP Surprise Medical Bills Act of 2019, as well as Energy & Commerce Chairman Frank Pallone (D-NJ) and Ranking Member Greg Walden's (R-OR) No Surprises Act, although at this time, the latter bill has not yet been introduced. With both sides of the aisle looking for a win in this area, this issue should heat up right along with the rest of the summer.

Oregon Approves Workplace Violence Prevention Bill

On June 11, Oregon Gov. Kate Brown signed into law a workplace violence prevention bill, after securing near unanimous support in both the Oregon House of Representatives and Senate. Around 30 states have passed laws making assaults on healthcare workers a felony, but only a handful of states have passed laws requiring hospitals to take proactive steps to protect employees from violence. The Oregon bill, SB 823, requires healthcare employers to conduct comprehensive security and safety evaluations with respect to workplace violence, which could lead to the development of an assault prevention and protection program. It requires Oregon's Department of Consumer and Businesses Services to provide legislators with a full report on workplace violence in 2022.

The bill also makes it illegal for employers to retaliate against employees who report incidents of violence in good faith. Oregon ENA actively supported passage of SB 823, with Oregon ENA President Krista Espenship and Government Affairs Chair Bill Schueler providing in-person testimony during Senate and House committee proceedings.

Federal Advocacy Update: ENA Priority Legislation

Here you will find monthly updates on the status of bills that are of priority concern or focus for ENA. Links below will take you to the find more information on a piece of legislation. Updates are in red.

Bipartisan Background Checks Act of 2019

H.R. 8

Synopsis: H.R. 8 would require under federal law that most transfers of firearms be supported by a background check. This legislation takes steps to effectively close the "gun show loophole" that currently allows the transfer of firearms between individuals without a background check.

Status: H.R. 8 was passed in the House of Representatives on February 27 by a 240-190 margin. It now awaits action in the Senate.

Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 (PAHPA)

H.R. 269

S. 1379

Synopsis: H.R. 269/ S. 1379 reauthorizes critical federal programs to support the nation's efforts to prepare for, and respond to, large scale emergencies- whether intentional, accidental or natural. This version of PAHPA also includes provisions to enact the MISSION ZERO grant programs, which would enable military trauma teams and providers to provide trauma care and other acute care services at civilian trauma centers.

Status: H.R. 269 was passed in the House of Representatives on January 8, 2019 by a 401-17 margin. It currently awaits action in the Senate. S. 1379 was passed by voice vote in the Senate on May 16, 2019. It was subsequently passed by the House of Representatives on June 4, 2019. It currently awaits action by the president.

Poison Center Network Enhancement Act of 2019

H.R. 501

S. 1199

Synopsis: The 55 poison control centers of the United States provide free, 24-hour advice to anyone in the 50 states and territories. Nurses at the bedside even utilize the poison control hotline in the care and treatment of patients. H.R. 501 would reauthorize funding for the poison control centers as well as the national poison control hotline.

Status: H.R. 501 was passed by voice vote in the House of Representatives on February 25, 2019. It now awaits action in the Senate. S. 1199 was introduced on April 11, 2019 by Sen. Patty Murray (D-WA) and currently awaits action in the Senate.

Title VIII Nursing Workforce Reauthorization Act of 2019

H.R. 728

S. 1399

Synopsis: Title VIII of the Public Health Service Act includes programs to develop and sustain the nursing workforce through grants and other opportunities. These programs help recruit, retain and advance the education of nursing professionals. Title VIII scholarships, as well as loan repayment and grant programs support more than 60,000 nurses and nursing students each year at all levels of nursing education and help support academic nursing institutions and health care facilities.

Status: H.R. 728 was introduced on January 23, 2019 by Rep. David Joyce (R-OH) and currently awaits consideration in the House of Representatives. S. 1399 was introduced on May 9, 2019 by Sens. Jeff Merkley (D-OR) and Richard Burr (R-NC) and currently awaits action in the Senate.

Emergency Medical Services for Children Program Reauthorization Act of 2019

H.R. 776

S. 1173

Synopsis: The Emergency Medical Services for Children (EMSC) program has for more than 30 years supported projects that improved or expanded emergency care for children who need treatment for traumatic or life-threatening illnesses or injuries. In addition to providing funding to all 50 states, the EMSC program also supports the Pediatric Emergency Care Applied Research Network, the only federally-funded multi-institutional network for research in pediatric emergency care.

Status: H.R. 776 was introduced on January 24, 2019 by Rep. Peter King (R-NY) and currently awaits action in the House of Representatives. S. 1173 was introduced on April 11, 2019 by Sen. Robert Casey (D-PA) and currently awaits action in the Senate.

Workplace Violence Prevention for Health Care and Social Service Workers Act of 2019

H.R. 1309

S. 851

Synopsis: Workplace violence against health care workers, including emergency nurses, has reached epidemic proportions. One-third of emergency nurses surveyed reported considering leaving nursing as a profession because of workplace violence. This bill would compel OSHA to implement a national standard for health care and social service employers, requiring them to take certain steps to protect and support workers before, during and after an assault.

Status: H.R. 1309 was introduced on February 19, 2019 by Rep. Joe Courtney (D-CT). It was advanced by the House Education and Labor Committee on a 26-18 vote on June 11, 2019. It currently awaits further action in the House of Representatives. S. 851 was introduced on March 14, 2019 by Sen. Tammy Baldwin (D-WI). It currently awaits action in the Senate.

Survivors' Access to Supportive Care Act of 2019

H.R. 1082

S. 402

Synopsis: Survivors of sexual assault seeking care in an emergency department are a vulnerable population with specific medical and emotional needs. Sexual Assault Nurse Examiners (SANE) are highly-trained registered nurses uniquely qualified to provide this care, having completed specialized education and clinical training for patients who have experienced sexual assault. S. 402, also known as SASCA, seeks to improve care for this population. Among other things, SASCA would support the development of training materials and protocols to improve care for survivors.

Status: S. 402 was introduced on February 7, 2019 by Sen. Patty Murray (D-WA) and currently awaits action in the Senate. H.R. 1082 was introduced on February 7, 2019 by Rep. Pramila Jayapal (D-WA) and currently awaits action in the House of Representatives.

ENA Government Relations

gov@ena.org