In the Trenches at the Texas Legislature
Thursday, April 4, 2019
Posted by: Roy Muyinza
By: Andrew Cates, JD
Director of Government Affairs, General Counsel, Texas Nurses Association
We’re right at the halfway point in the 86th Legislative Session and the capitol is finally in full swing. This session, TNA has a number of priority bills as well as a number of budget initiatives. And we need your help to make this session successful!
The Big Bills
HB 1146 by Rep. Donna Howard — Awaiting hearing in House Public Health Committee
In 2015, TNA worked with Rep. Donna Howard to pass a study bill on workplace violence against nurses. The study polled health care practice sites as well as nurses themselves, and it showed that 1 in 2 nurses reported an incident of violence in the workplace at some point in their career. Freestanding emergency centers and long-term care sites were the most prevalent settings of workplace violence in the study and the least likely to have protections in place for nurses.
TNA worked with Rep. Howard once again to file landmark legislation on workplace violence. This bill includes additional reporting requirements and audits for practice sites, training requirements for workplace staff, and mental health services for nurses who experience violence in the workplace.
After working with stakeholders, we anticipate having little to no opposition by the time the bill is heard in committee. If passed, this will be a huge win for TNA and all healthcare workers across the state!
HB 2410 by Rep. Stephanie Klick — Awaiting hearing in House Public Health Committee
Currently, in order to call safe harbor, a nurse must stop what they are doing and fill out a form to document the issue and their objection to it. Based on calls received by nurses at TNA, we understand that this is not a viable option in emergency situations where immediate care is needed.
This bill would allow nurses to orally request peer review by notifying a supervisor if the nurse is unable to complete the peer review request form due to immediate patient care needs.
TNA worked with the Texas Hospital Association on favorable language to ensure THA is comfortable with the bill. We should have no or little opposition when heard by the committee.
HB 2980 by Rep. Donna Howard — Awaiting hearing in House Higher Education Committee
This bill includes a budget rider to appropriate $13.75M to the GNE innovation grant program as well as any money that is returned to the Higher Education Coordinating Board from the Nursing Shortage Reduction Program.
One of the largest barriers to training nurses is a lack of available clinical space. Too frequently, nursing schools must refuse applicants, and health care facilities limit the number of available clinical slots due to high demand.
HB 2980 creates a new innovative grant program, administered by the the Higher Education Coordinating Board, to award grant funds for pioneering approaches to increasing the availability of clinical education practice sites for graduate nurses.
HB 1401 by Rep. Donna Howard — Awaiting hearing in House Appropriations Committee
The funds from the permanent tobacco fund dedicated for health-related programs are crucial for nursing education in Texas to meet the needs of Texas’ rapidly growing population. Texas patients need qualified Texas nurses. Fiscal support of nursing education is a common-sense measure to accomplish this goal and maintain a healthy Texas.
The current statute is set to expire in 2019.This bill extends the current dedication of funds for nursing education programs to 2023.
Grants from the fund go to programs that prepare students for RN licensure, as well as higher nursing education pursuits and programs that employ innovative approaches to recruiting and retaining students and qualified nursing faculty.
HB 3111 by Rep. Stephanie Klick — Awaiting hearing in House Human Services Committee
A 2016 joint study by the Texas Department of State Health Services and the Texas Center for Nursing Workforce Studies determinedthe state will be 60,000 nurses short of demand by 2030. That same study showed demand for nurses in long-term care settings such as nursing homes will double by 2030.
HB 3111 begins to address the shortage by establishing a loan repayment program for RNs who meet certain criteria, including full-time employment by a long-term care facility for at least one year. This bill includes a $4 million appropriation in the budget for operation of this new program.
SB 358 by Sen. Chuy Hinojosa — Awaiting hearing in Senate Higher Education Committee
Last session, TNA successfully fought to create a $3 million line item in the state budget to fund the Nursing Faculty Loan Repayment Program. This program provides loan repayment assistance to nurses who choose to leave the care setting and go into faculty positions at nursing schools.
TNA, with Sen. Hinojosa’s help, put forth SB 358 to increase funding and expand funding to more nurses by allowing part-time faculty to apply for loan repayment awards. Texas has seen a trend in full-time vs. part-time nursing faculty positions converging over time. This is a common-sense solution to a growing nursing shortage problem. SB 358 includes a budget rider to increase the appropriation from $3 million per biennium to $10 million per biennium.
HB 1792 by Rep. Stephanie Klick — Subcommittee action pending in House Public Health Subcommittee on Health Professions
TNA supports full practice authority for all advanced practice registered nurses. Currently, Texas laws prevent APRNs from providing health care to the full extent of their licensure and training.
APRNs must sign a delegation agreement with a collaborating physician in order to practice, even though that physician is not required to be on site or see any of the APRN’s patients. This delegation agreement adds to health care bureaucracy and red tape, reduces time spent with patients and increases costs for businesses and providers.
Twenty-four states, the VA and all branches of the military have repealed these laws to expand access to care to patients. Texas should do the same.
Nursing Shortage Reduction Program – TNA works each session to ensure that the NSRP is adequately funded in the state budget. Last legislative session, the program was cut by 40% along with a number of other programs in order to balance the budget. This session, we hope to restore those cuts and make the program operate more efficiently to maximize its impact across the state.
How to Help
As you can see, we are very busy at the capitol this Spring and, as always, we will need your help to make it successful as we close out the final 60 days of session. Here are a few ways you can help us make an impact at the capitol:
- Check your email and make sure that TNA and our Action Alerts are whitelisted. We send out periodic action alerts to our members to send their legislators emails, calls and tweets in support of our bills. As our bills start getting set for hearings, we will utilize these action alerts more and more, so make sure that the following email addresses are whitelisted so they don’t go to spam – email@example.com, firstname.lastname@example.org, email@example.com
- Make sure to follow @TexasNursesAssn and @TXNursesLege on Twitter. We regularly post on twitter about the capitol and issues we support. Make sure to get a twitter account and follow our activity and be sure to engage with us there, too, through comments and retweets! Twitter is also a great way to keep up with legislators.
- Use the legislative action center, under the Policy tab at texasnurses.org. All of our possible action alerts live here on our website. You can go to take action on any bill in the action center at any time. Your voice needs to be heard, so please go to our page today and take action.
- Join Capitol Corps and keep YOUR state legislators informed of current nursing issues. Be the legislative liaison between your TNA Government Affairs Committee (GAC) representative and the lawmakers who represent your region. Don’t worry, we have plenty of resources to help you hone your grassroots advocacy skills, and TNA’s GAC members and Government Affairs staff are always available to answer questions and ensure you’re well-equipped to discuss issues of importance. Send an email to firstname.lastname@example.org.
- Invest in the TEXAS NURSE PAC to support state lawmakers who support Texas nurses. TEXAS NURSE PAC uses the contributions it receives from nurses of all scopes of practice, to invest in candidates and lawmakers of both parties that deserve the endorsement and financial support of nurses. For Texas nurses to empower the profession, we MUST support state legislators who understand the value of the nursing perspective when making decisions about state health care. Invest in the future of the nursing profession in Texas. Invest in the TEXAS NURSE PAC.