How the CARES Act and Other COVID-19 Laws Affect Nursing and Health Care
Like cancer, viruses know no political parties, no country boundaries, and no personal attributes. As the COVID-19 coronavirus spread in an infectious wave across the earth in record time, it decimated economies and devastated populations. To defend their countries against an invisible enemy, governments around the world stepped in with unprecedented command.
In a rare display of bipartisanship, the U.S. Congress immediately and decisively responded (https://www.speaker.gov/newsroom/4420-0) to the public health and national economic collapse. In March, it passed three incredible pieces of legislation with an astronomical price tag, reaching more than $2.5 trillion, including grants, loans, and direct payments.
The Coronavirus Preparedness and Response Supplemental Appropriations Act of (https://www.congress.gov/bill/116th-congress/house-bill/6074/text) 2020 (H.R. 6074) passed the House and Senate with near unanimous support, and the president signed it into law (https://www.whitehouse.gov/briefings-statements/remarks-president-trump-signing-h-r-748-cares-act/) on March 6. It provided $8.3 billion in emergency funding to several federal agencies (the Centers for Disease Control and Prevention [CDC] received $2 billion, National Institutes of Health [NIH] $836 million, and U.S. Food and Drug Administration $61 million) for research and development for vaccines, diagnostics, technology, and medical devices (U.S. House of Representatives, 2020b).
The Families First Coronavirus Response Act of 2020 (https://www.congress.gov/bill/116th-congress/house-bill/6201/text) (H.R. 6201), for a total allocation of $3.5 billion, was signed into law on March 18 and contained sections to address the virus’s spread, paid sick leave, insurance coverage for virus testing, nutrition assistance, and unemployment benefits. It also included funding to the Department of Health and Human Services (HHS) for COVID-19 healthcare-related assistance programming at $1 billion, to the Veterans Administration at $60 million, and to the Department of Agriculture to directly pay for federal programs related to detection, diagnosis, and testing for COVID-19 at $400 million (U.S. House of Representatives, 2020c).
The Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 (https://www.congress.gov/bill/116th-congress/senate-bill/3548/text) (S. 3548) was signed into law on March 27 as a $2 trillion economic relief and public health emergency assistance package. Of that, $1 billion is designated for personal protective equipment, $415 million for research and development of vaccines and antivirals, $80 million for a pandemic response accountability committee, $45 billion for the Federal Emergency Management Agency’s Disaster Relief Fund, $4.3 billion to CDC for COVID-19–related activities, $1 billion to NIH to support research, and $200 million to the Centers for Medicare and Medicaid Services (CMS) for nursing homes and community responses (U.S. Senate, 2020).
On April 23, a fourth bill for $484 billion was passed to buttress the previous legislation and promote a fiscal stimulus through the coming weeks. The Paycheck Protection Program and Health Care Enhancement Act of 2020 (https://www.congress.gov/bill/116th-congress/house-bill/266/text) (H.R. 266) provided funding for small business loans, $75 billion to HHS to reimburse hospitals for COVID-19–related expenses and lost revenue, and $25 billion to expand COVID-19 testing, bringing the total federal response to the pandemic up to $2.8 trillion—the largest emergency relief investment in modern U.S. history (U.S. House of Representatives, 2020a).
What This Means for Nurses
The bills also contained regulatory changes that affected healthcare providers. Through CMS, nurses specifically were granted waivers (https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf) to help care for patients during COVID-19, including:
- Nursing services requirements were created for nursing staff to develop and keep current a nursing care plan for each patient, intended to allow nurses to increase time in clinical care and remove patient needs.
- Certain staffing requirements were increased for nurse practitioners (NPs) and certified nurse midwifes to furnish patient care services at least 50% of the time.
- Requirements for physician supervision of NPs were modified—but limited by state law—to allow NPs to take a larger scope-of-practice role to fill staff shortages during COVID-19.
Nurses, who are on the front lines of the pandemic, are earning their top spot as the most trusted profession for two decades. Their commitment to patients, practices, and peers is unsurpassed. ONSs health policy advocacy ensures that oncology nurses have a voice in health care and patient safety. For more information or to get involved in ONS’s advocacy work, visit ons.org.