The Oregon Nurses Association is Oregon’s oldest and largest union and professional association for nurses. ONA is proud to represent more than 14,000 Oregon nurses. From school-based health centers and emergency rooms, to public health departments and nurse practitioner-run clinics, ONA members are on the front lines of our health care system. ONA works to support policies that ensure the best working conditions for nurses, the best health care for our patients and equality for all. ONA’s Cabinet on Health Policy has identified the following as legislative priorities for the 2017 legislative session.
Top Priorities for ONA Members
Oregon currently ranks 50th in the nation in corporate taxes. As a result, many Oregonians do not have access to affordable health care and our classrooms are among the most crowded in the nation. A no-new-revenue 2017-2019 budget will require the legislature to cut an additional $1.8 billion from current service levels (Co-Chairs’ Existing Resources Budget Framework, 2017 – 2019). These cuts will result in hundreds of thousands more Oregonians losing health care coverage and require drastic cuts in nurse-lead public health and safety net programs. ONA members believe cuts to these vital programs are unacceptable, especially while Oregon has the lowest corporate tax. We are committed to working with the legislature to find a solution to our state’s revenue challenges and pass a budget that invests in Oregonians’ health, education, and safety.
Employer Health Care Accountability
The Affordable Care Act set a standard for what an affordable, employment-based health care plan must look like. Unfortunately, employers have tried to avoid ACA penalties by reducing wages, hours worked, or both so that workers are no longer full-time, full-year employees. This loophole shifts the cost to Oregon taxpayers to subsidize health-care costs for low-wage employees. As long as we have an employer-based health care system, ONA recommends greater accountability for employers to provide affordable, quality health care to their employees, or pay a fine to the state to recuperate the cost of state-subsidized health care.
High Cost Prescription Drugs
Prescription drug prices are the fastest growing part of the health care system, meaning that it is increasingly challenging for our patients to receive the treatment they need. Between 2008 and 2015 the price of brand-name drugs in the US increased by 164 percent (Tough Pill to Swallow- The High Price of Prescription Drugs in the US, Institute for Health and Socio-Economic Policy, September 27, 2016). ONA recommends increased price transparency through requiring pharmaceutical manufactures to report and justify their costs, increased accountability for prices that exceed a fair rate of return, advanced notice to consumers prior to a price increase and a cap on prescription drug co-pays for consumers.
Nurse Faculty Loan Repayment Program
Oregon is facing a nurse workforce shortage in the next decade. In 2015, Oregon associate and baccalaureate nursing programs received 7,031 applications for 1,610 available seats, turning away many qualified candidates, due in large part to a lack of nurse faculty (Data from the Oregon Center for Nursing). Oregon’s Nurse Faculty Loan Repayment Program can help address this issue by helping to offset education costs for nurse educators, making it more realistic for nurses to pursue a career in education. ONA’s recommends allocating $350,000 for Oregon’s Nurse Faculty Loan Repayment program to provide loan repayment for approximately 10 nurse faculty.
Improving Access to School Nurses
Oregon falls significantly short of the federal and state recommended ratio of one school nurse for every 750 students (2009 Oregon legislation [HB 2693], the National Association of School Nurses, Healthy People 2020, American Academy of Pediatrics, and the Robert Wood Johnson Foundation recommend a 1:750 ratio). Although many of the children who need and receive care from school nurses are enrolled in the Oregon Health Plan, few schools have the infrastructure to bill Medicaid for the services provided to students. ONA recommends increased investment in school infrastructure to bill Medicaid to help support the costs of school nurses and expand access to care.
Nurses who have spent their careers in public service are part of the Public Employee Retirement System. As PERS recipients, ONA members want to do their part to be part of creating a fair and balanced, long-term solution for Oregon’s unfunded liability, and remain dedicated to ensuring the system is secure for every worker. ONA members believe any proposed PERS reforms should not shift the burden of paying the state’s bill to current employees.
Nurse Practitioner Barriers
In Oregon, Nurse Practitioners have earned broad authority, practicing independently in both primary and some specialty care. However, arbitrary barriers to NP practice still exist in statute and create access to care issues for many patients. ONA has made a long-term commitment to work with the legislature to ensure statutory language is provider neutral and inclusive when appropriate, and to remove existing barriers to NP practice.
Tobacco and Nicotine Control
Every year, over 7,000 Oregonians die as a result of tobacco use and we spend over $1.4 billion on tobacco related medical care annually (Oregon Tobacco Fact Sheet, 2014. Oregon Health Authority Public Health Division Tobacco Prevention and Education). ONA proposes several solutions to help address this problem, including increasing the tax on tobacco products and creating a tax for e-cigarettes, implementing a robust tobacco retail licensure system to ensure proper enforcement of existing tobacco control laws, and raising the age of tobacco purchase and use to 21.
Hospital Community Benefit
As part of remaining tax-exempt, hospitals are required to provide and report on investments in “community benefit.” Community benefit is currently defined as programs that provide treatment or promote health, including free or discounted health services, research, and community-building activities. ONA recommends the requirements for hospitals’ community benefit be more specific to ensure that the greatest community needs are being addressed.