CEO of Texas Nurses Association outlines legislative priorities

Lifting barriers to nursing practice, funding nurse education, ensuring paid sick time off — these are all top priorities for the Texas Nurses Association (TNA), according to the organization’s CEO Cindy Zolnierek, PhD. In a Facebook Live video, Zolnierek gave an overview of the legislation TNA is supporting and what she hopes to see accomplished in the upcoming legislative session.


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She said TNA’s Policy Council has been working on legislation for the past year in anticipation of this session. The organization also consulted with the Nursing Legislative Agenda Coalition, made up of over 20 nursing organizations, she said.

One of TNA’s top goals is to remove barriers to Advanced Practice Registered Nurse (APRN) practice, Zolnierek said. Since Gov. Greg Abbott’s waivers have not been as effective as they might have been due to the state’s nursing delegation rules, it has been difficult for APRNs to come from other states to practice in Texas, she explained. TNA also wants to remove barriers that prevent MPRNs from ordering VME and delivering homecare.

Another priority for TNA is increasing access to telehealth and telemedicine, she said.

“We might have thought previously that patients wouldn’t be receptive [of telemedicine],” Zolnierek said. “We found quite the opposite, and we found that it’s made a big impact on the quality of care, because individuals have greater access. Those that may be disadvantaged in some ways or have difficulty finding child care, transportation, time off from work…are now much more able to access health and medical services via telehealth and telemedicine.”

TNA hopes to see legislation that continues to lift barriers and ensure pay parity for telehealth services, she said.

Ensuring paid sick leave for nurses who test positive for COVID-19 is critical, Zolnierek said. This manifests itself in the prefiled HB 396 (a “presumption bill”). 

“We call it a ‘presumption bill’ because it will ‘assume’ that if you are in a clinical setting and you contract COVID, it is from your clinical work and you should be able to access benefits, including pay, for being away from work,” she said. “That is a very important bill for our health care workforce, and for nurses specifically.”

Sponsored by Rep. Joe Moody, this legislation would ensure COVID-19-positive nurses have time to recover without having to use PTO or be unpaid.

Zolnierek is also pushing for increased resources for nursing education. According to her, the state was originally projected to be 57,000 RNs short by 2032 — this number is only worsened by COVID-19. One way to do this is to maintain the Nursing Faculty Loan Repayment Program, which encourages nurses to become faculty members by helping pay back their student loans. Zolnierek said Texas should also add more flexibility to the program to allow more nurses to access it.

Increasing funding for school nurses is another priority for TNA, Zolnierek said. She said the Texas Center for Nursing Workforce Studies plans to survey school nurses to collect workforce details, such as the total number of school nurses in Texas.. It is costly to get a nurse in every school, and difficult to pull from education funds to pay for school nurses, she added.

However, there are areas the state can draw from to ensure sufficient school nurse funding, according to Zolnierek.

“There is money being left on the table,” she said. “There are Medicaid funds that we could access if the state worked to pass a particular waiver. So we are working very closely with the school nurses to get that waver passed, to be able to pull money down from the federal government to fund the services that school nurses provide.”

Zolnierek also wants to fully fund the Texas Board of Nursing’s appropriations request. This is the request the board makes to the Legislature every year to receive funds for their work. These funds are essential to ensuring nurses can do their work and process new nursing licensure applications, Zolnierek said.

The organization is also pushing to fully fund the Texas Peer Assistance Program for Nurses (TPAPN). This program would increase resources for nurses who are experiencing PTSD and need continued support. Nurses also sometimes relapse when they are experiencing PTSD, Zolnierek said.

Zolnierek acknowledged that, given the Legislature is convening in the middle of the COVID-19 pandemic, it is uncertain how lawmakers plan to meet. This might also mean less bills will be passed than normal, she said. Nonetheless, TNA will pursue these legislative goals this session, which will benefit nurses and the health care workforce as a whole, according to Zolnierek.

“We’ll be very busy this legislative session, and even though we expect the legislature to have a very narrow focus in terms of the bills they want to focus on, we believe nursing will be front and center,” she said. “We have been identified as the most trusted profession, we are in the spotlight with the work that all of you [nurses] are doing at the bedside, so I think that the legislators will be very interested in hearing from nurses and wanting to understand what our needs are and how they can support us.”

Zolnierek said nurses can get involved in influencing legislation by joining TNA for Texas Nurse Day at the Capitol on Feb. 8th, as well as attending TNA’s weekly regional interactive panel events in which nurses can interact with the legislators who represent them.