Legislative Platform

ACCESS TO QUALITY HEALTH CARE

Goal: Promote access to quality health care services for all Missourians; the role of nurses as qualified providers of health care services including prescriptive services; and access to all nursing care services with emphasis on adequacy and appropriateness of nurse staffing as provided in the American Nurses Association’s Staffing Principles.

MONA supports:

• Utilization of nursing-sensitive quality indicators for improved health care outcomes
• Quality, affordable, accessible, and equitable health care, including mental health care
• Direct access by consumers to services of registered nurses
• Safe, quality, health care for vulnerable populations, including victims of domestic violence, pregnant women, children, individuals with HIV/AIDS, the elderly, and the disabled
• Substance abuse education and treatment
• Evidence-based health education for all
• Primary health care provided by advanced practice nurses
• Maternity, neonatal and well-woman care provided by Certified Nurse Midwives (advanced practice nurses certified by the American College of Nurse-Midwives)

MONA opposes:

• The introduction, by other professions, of health care personnel who perform nursing functions
• Limiting access to quality health care to any Missourians

ETHICS AND HUMAN RIGHTS

Goal: Promote individuals having the right to make decisions that affect themselves and their significant others. Assure the basic right of all people to equality and dignity under the law regardless of age, color, creed, disability, gender, health status, health practices and behaviors, nationality, race, religion, or sexual orientation.

MONA supports:

• Consumer participation in health care decision making
• Health care surrogate and durable power of attorney for health care decisions when an individual is incapacitated
• A person’s right to dignity in all stages of the health care continuum
• The rights of victims in cases of abuse and provision of needed care for those individuals
• Adequate palliative care for persons with terminal illnesses and appropriate pain management for all persons

MONA opposes:

• All forms of participation by nurses in capital punishment by whatever means, whether under civil or military legal authority
• Disparity based on age, color, creed, disability, gender, health status, health practices and behaviors, nationality, race, religion or sexual orientation

  HEALTH CARE FINANCING

Goal: Promote federal, state, and local governments’ work to provide a stable source of funding to meet the public’s health care needs, including direct remuneration for services provided by registered nurses.

MONA supports:

• Funding to provide health care, mental health services, food, and shelter to persons in need
• Recognition of nursing’s unique role in the delivery of comprehensive and cost-effective quality care
• Federally-mandated reimbursement for advanced practice nurses
• Ensuring funding for state health plans, public health and public health nursing services
• An affordable health care system that is monitored to ensure that quality of care, quality of life and patient safety are not compromised
• Administrative reforms to reduce health care costs
• A public health system that remains prepared for disasters, pandemics and other statewide emergencies by being appropriately funded, staffed, and educated
• Leadership in developing solutions to the shortage of registered nurses
• Leadership in developing solutions to the shortage of qualified nurse faculty
• Use of evidence-based cost-containment incentives in the health care delivery system that do not compromise quality of care and that:
• Apply to all providers, payers and vendors
• Are based on continued review of the appropriateness of health care services
• Serve to eliminate significant waste and inefficiency

MONA opposes:

• Health care coverage that would limit access based on the ability to pay
• Reimbursement models for registered nurses’ services that are not fair and equitable
• Duplication of health care services in geographic areas that are adequately served

  NURSING EDUCATION, PRACTICE, AND LICENSURE

Goal: Promote the delivery of quality nursing care by appropriately educated and licensed nurses in order to protect the patient and the integrity of the nursing profession.

 MONA supports:

• Enhancement of educational mobility and seamless academic progression
• Allocation of Health Professional Nursing Student Loans on the basis of workforce need
• Public awareness of the importance of accreditation of schools of nursing by a national nursing accrediting body
• Accountability of registered nurses for nursing practice and all personnel who provide nursing care
• Preservation and protection of the practice of registered nursing in all practice settings
• Protection of registered nurses’ rights to practice to the full scope of their education and licensure
• Full practice authority for advanced practice registered nurses, including plenary prescriptive authority
• All registered nurses in all workplaces identifying themselves to all persons as registered nurses and in any written communication in the workplace
• Cooperation with other organizations and professions to promote the practice and roles of advanced practice nurses
• Affordable professional liability insurance for all registered nurses
• Safe staffing to ensure safe & quality patient care
• Lifelong learning for all nurses
• Mechanisms that would recognize and expand nursing practice
• The development of a centralized national database on nursing licensure and discipline while safeguarding the access and security of the information that will be collected
• The interstate Nurse Licensure Compact

MONA opposes:

• The substitution of registered nurses with lesser qualified patient care personnel
• Recruitment of foreign-educated nurses in the absence of meaningful workplace reform

WORKPLACE ADVOCACY

Goal: Promote and protect the economic and employment rights of registered nurses.

MONA supports:

• The rights of nurses to organize and bargain collectively
• Protection of nurses from arbitrary and discriminatory actions by employers
• Providing nurses with a means of communication and collective action regarding conditions of employment
• The negotiation and enforcement of contracts or agreements governing rates of compensation, hours and other conditions of employment so quality nursing services are available to the public
• RN staffing standards that ensure quality patient care
• No-fault error reporting
• Protection from retribution for nurses reporting unsafe or unethical patient and work conditions
• Adequate rest and number of hours between shifts to prevent medical errors
• Strategies to reduce medical errors
• Mandated speech or silence in the nurse-patient relationship

MONA opposes:

• The use of mandatory overtime
• The use of ratios to determine safe staffing policies

OCCUPATIONAL, ENVIRONMENTAL, & PUBLIC HEALTH HAZARDS

Goal: Promote the development and enforcement of standards that protect the environment, public health and the workplace.

MONA supports:

• Resources to increase the capacity of nurses to prepare and respond to disasters (emergency and disaster preparedness)
• Assurance of safe water, air, and food supply
• A unified effort against smoking and substance abuse
• Protection of the public and health care providers from environmental and occupational health hazards, including environmental and medical waste
• Personnel policies that address all aspects of pathogen exposure in the workplace according to OSHA standards and reflect the most current scientific and epidemiological knowledge, while incorporating sound principles of supervision and management
• A confidential post-exposure program to assure employees receive accurate information, guidance, reassurance, and supportive care in accordance with OSHA standards
• Clean indoor air legislation
• Promotion of health and safety programs in the workplace including ergonomics, safe patient handling, infection control, and prevention of workplace violence and work-related accidents
• Appropriate access to substance abuse treatment for impaired nurses
• Bans on texting while driving
• Laws currently in place to protect safe workplace environments