WVNA Member Notice – Open Comments on 2024 WVNA Health Policy and Legislative Statement

Dear WVNA Member,

Please find the proposed changes for the 2024 WVNA Health Policy and Legislative position statement for your review. We will ratify this statement at the 2023 WVNA Fall Conference and Membership Assembly on Saturday, September 30, 2023. Please submit your recommended changes to WVNA CEO Julie Huron at  julie@wvnurses.org or to President Wilson at joycewilsonfnp@gmail.com by 5 pm on Thursday, September 28, 2023.

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WVNA Member Notice –

Open Comments on 2024 WVNA Health Policy and Legislative Statement

 

The goal of West Virginia Nurses Association (WVNA) is to support enactment and implementation of policy that will benefit the health and welfare of all citizens. The WVNA strives to provide information, advocacy, representation and protection for the state’s professional nurses. As part of the American Nurses Association (ANA), the organization establishes policies and goals for the profession that form the basis for nursing’s contribution to the advancement of health care policy.

1. PROFESSIONAL ISSUES

WVNA supports regulatory legislation that:

• Assures the West Virginia RN Board of Examiners for Registered Professional Nurses (WVRNB) retains authority and autonomy to regulate the nursing profession with a culture that is fair, just, collaborative and adherent to fiduciary responsibilities;
• Supports the implementation of the National Academy of Medicine (NAM) Institute of Medicine (IOM) The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity, Leading Change, Advancing Health recommendations (IOM, 2010; National Academy of Medicine, 2021 2015);
• Recognizes the full scope of practice and autonomy of nurses RNs as established by professional licensure and delineated by professional organizations;
• Promotes APRNs (certified registered nurse anesthetists, certified nurse

practitioners, certified nurse-midwives, and clinical nurse specialists) as licensed independent practitioners, promotes full compensation for APRNs, prevents professional liability carriers from limiting coverage or restricting the full APRN scope of practice, prevents restraint of trade through collaborative requirements, and supports the APRN Compact to facilitate interstate practice does not endorse the current version of the APRN Compact ACNM, 2011; NCSBN, 2014 2020);

• Supports APRNs in the autonomous management of opioid use disorder, including medically assisted treatments and therapies;

1. Improves health care access through modernizing statutory language, eliminating restrictions in nursing practice and prescriptive authority (AANP, 2015 2020);
2. Promotes the use of appropriate scientifically correct and inclusive terminology in proposed legislation and health policy;
3. Promote full practice authority for APRNs within their educational standards of practice., specific to the national credentialing standards. (NCSBN, 2012).

WVNA supports workplace initiatives that:

• Uphold individual nurses’ right to make moral-ethical decisions (ANA Code of Ethics, 2015);
• Supports safe staffing initiatives determined by nurses, that take into account patient acuity and that maximize standard quality outcomes;
• Recognize the RN as a the coordinator for patient care;
• Provide flexible work schedules that lessen the risk of fatigue-related errors;
• Prohibit mandatory overtime. forced overtime and fairly compensate RNs and other health care providers utilizing traditional payment scales for overtime hours (ANA Code of Ethics, 2015);
• Fairly compensate nurses using traditional payment scales for regular and overtime hours.
• Improve patient and staff nurse safety with education, supplied devices, and personal equipment to protect the patient and nurse staff from adverse events; injury and infection;
• Standardize policies and procedures, equipment and medication delivery systems, including but not limited to information technology, to provide seamless care across the health care landscape to rural populations (e.g., telehealth);
• Support unrestricted use of titles appropriate to educational degrees and credentials (e.g., doctor of nursing practice, DNP);
• Disseminate education to each nurse regarding prevention, treatment, and recovery for nurses with substance use or mental health disorders; through the alternative to discipline program (WV RESTORE).

1. HEALTH CARE DELIVERY

WVNA supports a health care delivery system that:

• Encourages a culture of health through education, public awareness and the full impact of the media;
• Support Healthy People 2030 objectives that include: health conditions, health behaviors, populations, settings and systems, social determents of health. Actively addresses leading health indicators including physical activity, responsible sexual behavior, maternal health, oral health, mental health, environmental quality, immunization, social determinants, access to health services, and prevention of substance abuse, obesity, tobacco use, injury and violence, and racial disparities in health (Healthy People 2030, 2021 2020, 2015);
• Supports patient safety though adequate staffing patterns with RN supervision and appropriate delegation of licensed and unlicensed assistive nursing personnel;
• Assures compliance with WV Code: “The legislature finds that regulation should be imposed on an occupation or profession only when necessary for the protection of public health and safety” (WV Code, Chapter 30-1A-1);
• Promotes nurses practicing to the full extent of their education and competency. Modernizes state regulations to eliminate barriers to health care and those that have anticompetitive effects with no contribution to the health and safety of the public (NAM, 2021; FTC, 2012 IOM, 2010; FTC, 2012);
• Provides interprofessional person-centered care, employs evidence-based practice, applies quality improvement, and utilizes informatics (NAM, 2021 IOM, 2010; NAM, 2015);
• Facilitates antibiotic stewardship by all who administer, receive, or prescribe antibiotics. Antimicrobial medications have transformed health care, but 20-50% are unnecessary or inappropriate. Patients exposed to unnecessary antibiotics are at risk for adverse events with no benefit, and can exacerbate antibiotic resistance, one of the most serious and growing threats to public health (CDC, 2021 2014; National Quality Forum, 2016; WV DHHR, 2017; ANA, 2017);
• Encourages the expansion of nurse-led models of care;
• Improving timing for access to care for patients for primary care services.

WVNA supports public policies that:

• Promote equal access to quality, comprehensive health care for all West Virginians;
• Promote a commitment to the principle that all persons are entitled to affordable, readily accessible, high-quality health services (AHRQ, 2008; ACA, 2010);
• Promote reimbursement parity for all health services, including but not limited to medications, complementary care, reproductive services, and mental health services (ACA, 2010);
• Assure that quality supportive/palliative end-of-life care is accessible to all people, including effective symptom control, and psychosocial and spiritual support;
• Maintain current West Virginia immunization standards and strongly recommend ongoing immunization guideline modifications as outlined by the U.S. Centers for Disease Control (CDC, 2017);
• Encourage senior West Virginians to maintain active, healthy, and independent lifestyles. Promote access to quality in-home long term or intermediate care when desired and needed;
• Identify, report, and prevent elder abuse and neglect, including physical, mental, and financial abuse, and provide victim support (WV State Auditor’s Office, 2012);
• Eradicate prescription drug abuse, reduce inappropriate prescribing and dispensing, and reduce opiate use and abuse in WV (WVNA, Opiate Reduction Act 2018, WV Office of the Attorney General, 2021 2016).
• Eliminates the flow of illegal drugs into the state (DEA, 2018).
• Support the safe, regulated legal prescribing of therapeutic marijuana and complementary therapies by all prescribing providers, as appropriate (ANA, 2016);
• Recognize the importance of patient confidentiality, given the impact of social media and technology on professional practice (WVNA, ANA, 2012).
• Eradicate HIV/AIDS through harm reduction strategies, increased screening, and expanded early treatment including the use of PrEP in primary care settings for persons at high risk (HIV.gov, 2019).
• Protects consumers from surprise billing and provides transparency in drug pricing.
• Include best practices in harm reduction services for persons suffering from substance use disorder.
• Achieve statewide broadband coverage.

WVNA supports school health initiatives that:

• Support a minimum of one certified school nurse in every WV public school building to promote health and wellness; manage students with acute and chronic diseases; provide drug prevention education and referrals; administer stock naloxone and epinephrine; and provide mental health services, support, and referrals to ensure an educated and healthy workforce for economic growth and development in WV (American Academy of Pediatrics Policy Statement, 2016);
• Support the need for safe administration of insulin at school for students with diabetes – only a certified school nurse, registered nurse, licensed practical nurse, parent/guardian, trained parent designee (not employed by the board of education), and/or student may legally administer insulin in the school setting (WVASN and WVCOSN Position Papers, 2014);
• Promote the coordination and linkage of students to a health home including oral health through the certified school nurse;
• Promote the role of the certified school nurse in the enrollment of children and families in comprehensive insurance programs which include oral health;
• Recognize the certified school nurse as the coordinator of health care intervention with the authority to make appropriate health care task delegations and assignments within the educational setting and the nurse’s scope and ability;
• Promote collaboration between the certified school nurse and school-based clinics for health promotion and disease management. (A certified school nurse covers all children enrolled in public school; the school-based clinic provides care only to established patients);
• Recognize the certified school nurse as the professional who ensures quality health care instruction for pre-K through 12th grade students, including comprehensive, age-appropriate human sexuality education, as well as in asthma and diabetes care (WVDE School Nurse Needs Assessment, 2010);
• Support certified school nurses’ pay parity within educational funding formula for teachers;
• Promote the community school concept, which coordinates programs and services to support healthy lifestyles for students, staff, parents, and the community which each school serves (Communities in Schools; Coalition for Community Schools; CDC Whole School, Whole Community, Whole Child, etc.).
• Recognize the long-term health impacts of childhood trauma and link students to trauma informed care and programs to build and support resilience.

1. PATIENT RIGHTS

WVNA supports patients’ rights to:

• Health care as a basic human right;
• Safe, error-free health care environments;
• Transparent information about nurse staffing patterns and quality patient outcome benchmarks at health facilities (CMS Rules, 2014);
• Receive health care provided by nursing personnel consistent with their level of acuity;
• Privacy and confidentiality;
• Informed decision making about personal health, including end-of-life care and reproductive health services, without coercion;
• Information about all treatment options, including the comparative risks and benefits, at the appropriate literacy level;
• Designate APRNs as their primary Licensed Independent Provider (LIP) of healthcare.

1. NURSING RETENTION AND RECRUITMENT

WVNA supports strategies for retention and recruitment, including:

• Practices that promote a safe, professional work environment with shared nurse governance;
• Funding for undergraduate and graduate education for nurses, educational opportunities for faculty, and nursing workforce redevelopment programs (ANA, 2023 2010);
• Economic Improving incentives for nurse educators and preceptors who provide clinical supervision to the next generation of clinicians (RWJF, 2017);
• Leveraging Modernizing policy to ensure that all nurses may practice to the full extent of their education, training, and certification (namely, to remove collaborative requirements, restrictive prescribing formularies, and restrictive signatory authority);
• Reimbursement parity for APRN services;
• Peer monitoring and counseling that is confidential and compassionate to protect the public and promote retention of recovering nurses in the workforce (ANA, 2010; WV Restore, 2015);
• Recognizes and appreciates Elevates the role of the professional nurse related to quality of care, patient outcomes, organizational and financial stability.

 

1. SOCIAL ISSUES

WVNA supports the following:

• Education focusing on social justice issues;
• Legislation focused on prevention of violence and bullying, particularly the protection of vulnerable populations in all venues, including social media;
• Initiatives to eradicate human trafficking;
• Initiatives to screen for, educate about, and reduce public health risks, including but not limited to unclean air and water, harmful additives and toxins, drug and alcohol impairment, distracted driving, sexually transmitted infections, HIV/AIDs, sports injuries, gun violence, and ATV/motorcycle helmet use;
• Access to programs that identify and treat post-concussive head injuries from sports and other causes (CDC, 2015);
• Access to trauma informed care, mental health services, and programs addressing post-traumatic stress disorder (PTSD);
• Public disclosure of and education about environmental health risks in homes, and in work, school, and other public settings (ANA, 2010);
• Adequate funding and public policy to provide smoking and vaping prevention, cessation, and educational programs to eliminate tobacco use and environmental exposure;
• Education regarding the health benefits of breastfeeding and chest feeding (WVNA, WABA Baby-Friendly USA, 2016);
• Ongoing recognition and support of WV nurse veterans and all veterans;
• Programs developed to identify and treat the high incidence of post-traumatic stress disorder (PTSD) and post-concussive head injuries in the post-war veteran population (e.g., traumatic brain injury) (AANP, 2012);
• Programs developed to identify and treat the high incidents of military sexual trauma (MST) and of suicide in the military population;
• Access to mental health services for all veterans and families with supportive opportunities for the highest quality of independent living (AANP, 2012);
• Addressing the high incidence of suicide, substance abuse and low availability of quality mental health services (e.g., integrating mental and physical health services, telehealth, substance abuse treatment) (WV Perinatal Partnership, 2015);
• Engaging community members and health professionals in disaster threat preparedness efforts (WVREDI, 2015);
• A realistic living minimum wage; Programs that address social determinants of health and enhance health equity; including economic stability, health care access and quality, social and community context, education access and quality, and neighborhood and built environment (HP 2030);
• Eradication of prescription drug abuse, inappropriate prescribing and dispensing, and reduced opiate use and abuse in WV (WVNA, WV Office of the Attorney General, 2016);
• The fundamental principle of respect for the inherent dignity, worth, unique attributes, and human rights of all individuals (ANA, 2015);
• Increase visibility and contribution of nurses in local, state, national and international leadership roles, including service on hospital boards and health related commissions;
• Full staffing of sexual assault nurse examiners (SANE) at hospitals across the state.