1. An Overview of
Legislation and Regulation
Chapter 65 & 66

2. Influencing the Introduction of a Bill
Nurses can influence as constituents and as members of
professional organizations that lobby congress.
Organized groups such as the ANA, AACN, CNA
What can nurses do?

3. Committee Action
Centers for policy making at federal and
state levels
Conflicting points of view discussed and
legislation refined or amended
Organization, consensus building, and
time
15% of bills that go through committees
are reported out to the House or Senate

4. Conference Committee
A type of joint committee
(House and Senate)
Work together to address
differences

5. Ways a committee can handle a bill
Approve a bill with or without
amendments
Rewrite or revise a bill, and report it out
to the full House or Senate
Report it unfavorable (i.e., allow the bill to
be considered by the full House or
Senate, but with a recommendation that
it be rejected)
Take no action, which kills the bill

6. Authorization and Appropriation Process
Important for nurses to be familiar with this process
Nurse Education Act
Scholarships for the Disadvantaged Students
National Institutes of Nursing Research

7. Authorization and Appropriation Process
Two Step Process
1. Authorization Bill
* Establishes the purpose of and sets guidelines
for the program
* Legal authority
2. Appropriation Bill
* Allows an agency or program to
spend money

8. Committee Procedures
Three Standard Steps
1. Hearings
2. Mark-ups
3. Reports

9. Presidential Appointments
Approved by the Senate
Described in the U.S. Constitution Supreme Court Nominees
High-level positions
Ambassadors
Federal Judges
U.S. Attorneys
U.S. Marshalls

10. Regulatory Process
Major role is to interpret the laws
Important for nurses to influence the
regulatory process
Regulations have a direct impact on
nurses’ work and professional life

11. Sources of Regulation Affecting Nursing Practice
Nursing Boards
Authority through state laws
What is determined at the state level?
Initial qualifications for licensure
Continuing educational requirements
Disciplinary procedures
Complaint resolution processes
Professional misconduct
Mandatory reporting requirements
Specific scopes of practice

12. Sources of Regulation Affecting Nursing Practice
Health and Human Services
HHS Regulations
Civil Rights, Privacy, Food and Drug Safety,
MCR/MCD programs, health care fraud,
medical research, technology standards,
and tribal matters
Umbrella organization for...
CMS, FDA, CDC, and OCR

13. Sources of Regulation Affecting Nursing Practice
Centers for Medicare and Medicaid
Government health insurance
Medicare versus Medicaid
Office of Inspector General
List of Excluded Individuals/Entities

14. Sources of Regulation Affecting Nursing Practice
The Joint Commission
Compliance with MCR/MCD
Standards
Goal

15. Sources of Regulation Affecting Nursing Practice
Federal, State, and Local Law
Public Health Codes
Emergency preparedness
Communicable diseases
Environmental controls
Utilization of health care facilities
Staff credentials and competency
Policies and procedures
Sanitation, Housing, Childhood nutrition
Mental health issues, Food safety
Other elements related to nursing care

16. Sources of Regulation Affecting Nursing Practice
Organizational Policy
Nurse responsibility
Practice Standards
Standardization and Consistency
Failure to follow

17. Scope of Practice
Scope of practice has evolved and expanded
Issues with scope of practice
Medical societies challenging BON
Actions by the AMA and degrading terms