2021 Legislative Priorities

Download THA 2021 Legislative Priorities Overview

Nursing Graduate Licensure
SB1267 by Sen. Shane Reeves (R-Murfreesboro) / HB1353 by Rep. Kevin Vaughan (R-Collierville)

  • An executive order first signed by Governor Bill Lee in spring 2020 allows graduates of accredited nursing programs who have not yet taken the National Council Licensure Examination (NCLEX) to begin practice under the supervision of a licensed registered nurse (RN) while awaiting testing and licensure.
  • While the executive order has been helpful during the pandemic, this policy has practical workforce implications for hospitals beyond the current crisis. By employing new nurses sooner, hospitals can more readily address the ongoing nursing shortage, which has persisted through the pandemic and is expected to continue.
  • The legislation will allow for more efficient onboarding of nurse graduates to employment in healthcare facilities. As drafted, the bill will allow a nursing graduate to engage in the practice of professional nursing without a license for 120 days from the date of authorization to take the NCLEX-RN examination, all while working under the supervision of a licensed RN.
  • Eligible nursing graduates are those who hold a diploma or degree from an approved nursing school and have received authorization to take the NCLEX-RN examination. While this bill would permit eligible graduates to voluntarily begin practice as they await examination and licensure, it does not require it.
  • By enabling immediate practice with proper supervision from experienced nurses, nurse graduates are able to complete the orientation and training process at the hospital and are better prepared for full practice upon licensure.

Hospital Assessment
SB123 Sen. Ferrell Haile (R-Gallatin) / HB181 Rep. Patsy Hazelwood (R-Signal Mountain)

  • The annual, voluntary hospital assessment again will be part of THA’s legislative agenda in 2021. The assessment generates $602 million in state dollars, which with a federal match, totals $1.7 billion for the TennCare program.
  • These dollars fund a number of proposed state budget cuts dating back to 2010, which maintain a host of benefits for TennCare enrollees and avoid significant reductions in provider reimbursement.
  • The proceeds from the assessment prevent a number of reductions from taking effect, including a 7 percent reduction in reimbursement for services provided by health professionals and limits on patient hospitalizations, outpatient visits and physician office procedures.

Certificate of Need
SB1281 by Sen. Shane Reeves (R-Murfreesboro) / HB948 by Rep. Clark Boyd (R-Lebanon)

  • A major issue left unresolved in 2020, certificate of need (CON) reform again is a priority for lawmakers. In addition, the Health Services and Development Agency (HSDA) – which oversees the CON program – is up for sunset in 2021 and its extension is essential to the survival of the program.
  • While hospitals understand the desire for CON reform and know support exists among legislators for such legislation, THA believes some parts of the program must be maintained.
  • Hospitals are unique in the healthcare system in that they are the only providers that treat every patient who comes through the door, regardless of ability to pay. Elimination of certain CON requirements would give an unfair competitive advantage to non-hospital providers, such as outpatient diagnostic centers (ODCs) and ambulatory surgery centers (ASCs), which are not subject to the same federal requirements as hospitals.
  • The impact of the COVID-19 pandemic has placed hospitals in an even more precarious position. THA believes now is the wrong time to take a gamble with the viability of the most visible and most critical component of the healthcare system in Tennessee. CON requirements for non-hospital providers must be maintained.
  • However, THA’s Board of Directors is prepared to support CON reform legislation that makes a number of significant CON reforms without deregulating non-hospital providers, along with a three-year extension of the Health Services and Development Agency (HSDA) and no additional changes to the CON program during that time.

If you have questions, contact Joe Burchfield at 615-401-7472.