Policy Updates

Exciting advancements are happening across our region related to healthy work environments and addressing workplace violence, nurse staffing, and the nursing and healthcare workforce, spanning across all three pillars of ONL's 2023 Policy Platform and Multi-State Agenda. ONL is working to position nurse leaders to advance policy through their spheres of influence and collaborative relationships.

Here are the latest policy updates we have to share (Last updated as of March 30, 2023).

Workplace Violence in CT, MA, and VT

Legislation related to preventing workplace violence in healthcare has been introduced in multiple ONL member states. While the proposed legislation is different in each state, there are common threads across states.

CONNECTICUT

Process: Nancy LaMonica, VP and CNO at Bristol Hospital, collaborated with Senator Henri Martin drafting, filing, and now championing a bill to address healthcare worker safety in a bill introduced as An Act Ensuring the Safety of Health Care Workers. The content of this bill has been integrated into Senate Bill 14, An Act Improving the Safety of Health Care Providers and Patients. As of March 29th, this bill was favorably reported out of the Public Health Committee.

Bristol Health provides testimonyActions: Nancy LaMonica and colleagues from Bristol Hospital testified at a March 15th hearing (click here for press coverage and video). ONL submitted written testimony in support, as did the CT Hospital Association and the National Association of Social Worker, CT Chapter. ONL Government Affairs State Rep. Jeannette Bronsord has been working closely with nursing and specialty organizations to advance their understanding of this important work.

Content: The Connecticut bill has four main components:

  • Commissioner of Public Health issues public service announcements raising awareness of the issues surrounding the mistreatment of health care workers and encouraging public civility in the health care setting
  • Add hospital security to the definitions of "health care employee" for the purpose of allowing assault charges for assaults against hospital security under section 53a-167c of the general statutes
  • Require the Secretary of the Office of Policy and Management to create and fund a grant program whereby Connecticut hospitals may apply for grants to secure hospital entrances and public spaces to provide for the safety of hospital health care workers
  • Allow hospitals to create policies relative to patient conduct that would, in certain instances related to health care worker safety, allow hospitals to require patients receive nonemergency health care in a different location.

MASSACHUSETTS

Process: The Massachusetts Health and Hospital Association hosted their Annual Meeting last week. During the meeting, they released a United Code of Conduct, and a first-of-its-kind report on workplace violence in Massachusetts: “Workplace Violence at Massachusetts Healthcare Facilities.”

Additionally, H.2362/S.970 An Act Requiring Health Care Facilities to Develop & Implement Programs to Prevent Workplace Violence addresses three key areas:

  • increasing penalties for those, of sound mind and with intention, who attempt to harm a health care provider
  • improve treatment placement for patients in acute behavioral health, mental health, or substance use disorder crisis who may behave violently without intention
  • ensuring workplace violence prevention plans are not discriminatory toward patients or visitors who may be at risk of being profiled due to sociodemographic characteristics, diagnoses, etc.

VERMONT

Process: In February, Sen. Dick Sears and Sen. Ginny Lyons held a joint hearing to hear from health care providers on Senate Bill 36 An Act Relating To Permitting An Arrest Without A Warrant For Assaults And Threats Against Health Care Workers And Disorderly Conduct At Health Care Facilities and workplace violence. ONL Government Affairs State Rep. Carol Conroy attended the hearing and has played a key role in advancing strategic collaborations in the state. Additionally, Vermont has launched a PSA campaign over television and radio media to raise awareness of workplace violence in healthcare environments (*note similarity to CT bill).

Content: Senate Bill 36 proposes to permit a law enforcement officer to arrest a person without a warrant if the officer has probable cause to believe the person (1) assaulted or threatened a health care worker at a health care facility or (2) engaged in disorderly conduct that interfered with the provision of medically necessary health care services in a health care facility.

Nurse Staffing in CT and MA

Legislation addressing nurse-to-patient ratios has been filed in Massachusetts and Connecticut.

CONNECTICUT

The Connecticut Bill: (S. 1067 An Act Concerning Minimum Staffing Levels For Nurses) is very prescriptive and contains exact ratios for different units.

ONL members testified in opposition to the bill, both in-person and through written testimony. Written testimony can be viewed here. ONL submitted written testimony in opposition, as did the CT Hospital Association. ANA of CT (CT Nurses Association) submitted written testimony in opposition and focused on enhancing current legislation, such as strengthening hospital staffing committees.

Despite these significant efforts, this bill was reported out of committee favorably. Efforts will continue to educate legislators about the significant unintended consequences associated with this proposal.

MASSACHUSETTS

The Massachusetts Bill (H. 2491/S.1660 An Act Promoting Patient Safety and Equitable Access to Care) directs the Department of Public Health to conduct a process of collecting input after which they would set ratios.

Nursing and Healthcare Workforce

NURSE LICENSURE COMPACT - RHODE ISLAND

Ara Millette provides testimony on NLC

We are cautiously optimistic that the NLC is gaining support in Rhode Island. Last legislative session in Rhode Island, The House of Representatives set up a Study Commission on Nurse Licensure Compact (NLC). ONL Government Affairs RI State Representative and committee member Ara Millette is representing ONL on the study commission and ONL Government Affairs committee member Cynthia Danner is also around the table representing her health system.

At a hearing on March 7th, both Ara (pictured) and Cynthia testified in support of HB 5737 An Act Relating to Business and Professions - Nurse Licensure Compact, while ONL submitted written testimony in support. The bill is currently in special legislative commission, with bills introduced in both the House and the Senate.

GRADUATE NURSE STATUS - MASSACHUSETTS, RHODE ISLAND, VERMONT

We're also watching bills in Massachusetts, Rhode Island, and Vermont that relate to graduate nurse status.

In Massachusetts, the Graduate Nurse Status (GNS) is currently active, however it is due to sunset in June 2023. However, language passed in the March 2022 Supplemental Budget (Section 31) extends GNS use to 180 days after the termination of the public health emergency declared on May 28, 2021. The Healey-Driscoll administration has announced that the public health emergency will end on May 11, 2023, effectively making the sunset date for the GNS November 11, 2023. The Massachusetts Health and Hospital Association has filed a bill to make Graduate Nurse Status permanent.

In Rhode Island, we're watching SB 0284: Relating to Businesses and Professions - Nurses. ONL members are testifying in support of this bill that, if passed, would allow nurses to practice ahead of NCLEX. This is scheduled for the House floor this week.

In Vermont, discussions are on-going exploring risks and benefits associated with allowing nurses to practice prior to passing NCLEX (graduate nurse practice) in the state.

NURSING ASSISTANT PIPELINE REGULATIONS - SUCCESS IN RHODE ISLAND!

A related success story out of Rhode Island is that the state successfully amended nursing assistant licensure regulations in February to allow alternate testing administrators, thereby addressing bottlenecks in the CNA pipeline (especially related to hands-on testing requirements).

This issue is also relevant in VT and MA and relates to CMS regulations at the national level. Leaders in VT and MA, as well as at AONL are looking into how to address federal regulations and states’ interpretations of these regulations.

 

If you have any questions or would like to talk about ways to get involved, please email Ashley Waddell at [email protected].

 

 

 Patient Care LinkAmerican Organization for Nurse Leadership