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Update from "The Hill"

Posted By Dena Cochran, Monday, February 12, 2018

Good Day to Everyone,


I just received this for the AWHONN Office of Government Affairs.


The Senate passed (71-28HR 1892, the Bipartisan Budget Act of 2018, a continuing resolutionIn addition to temporarily funding the government, the bill includes full fiscal year 2018 defense funding, and raises for two years the caps on defense and nondefense discretionary spending set by the Budget Control Act of 2011.  It included a five-year reauthorization of the Maternal, Infant, and Early Childhood Home Visiting program at current funding levels and extends the recent six-year reauthorization of the Children’s Health Insurance Program for an additional four years. It reauthorized for two years the community health centers grants, the National Health Service Corps and Teaching Health Centers. It appropriates $6 billion to address the opioid epidemic. Additionally, the bill delays cuts to Medicaid disproportionate share hospital payments for fiscal years 2018 and 2019. 


However, the bill cut the Prevention and Public Health Fund by $1.35 billion over 10 years.


The Pain-Capable Unborn Child Protection Act (S.2311) failed a cloture vote (51-46) in the Senate on January 29. The House companion bill, HR 36, passed in October. Both bills would have made it a crime to perform or attempt an abortion after 20 weeks of pregnancy. 


Following a missed November deadline to announce the Title X family planning grants application process and states currently receiving Title X grants facing running out of money, the Department of Health and Human Services announced there would be no "gaps in service” and that the Department is committed to the program even though federal grant money is expected to run out at the end of March according to the Associated Press.

Title X provides comprehensive family planning and related preventive health services to low-income women and men. 


Last Wednesday, the Senate confirmed Brett Giroir, MD as the new Assistant Secretary for Health at the HHS. He will also serve as Medical Director in the Regular Corps of the U.S. Public Health Service. Giroir has previously served in academic and government positions.


Respectfully Submitted,

Dena Cochran

AWHONN Illinois Section

Legislative Coordinator

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January AWHONN Updates from "The Hill"

Posted By Dena Cochran, Monday, January 8, 2018

The Updates:

Budget and Appropriations

  • The Federal Government didn’t shut down right before Christmas. On the last day of the previous continuing resolution to fund the government, both chambers of Congress passed, and then President Donald Trump signed into law, another continuing resolution to fund the government through January 19.
  • The continuing resolution provides temporary funding of $2.85 billion for the Children's Health Insurance Program and $550 million for community health centers, lasting through March 31. In children’s advocacy group First Focus’ ( analyses, the CHIP funding extension may not be enough to carry states through March. The extension is paid for, in part, by a $750 million cut to the Prevention and Public Health Fund beginning with a $100 million cut in Fiscal Year 2019. Authorization for mandatory funding for CHIP expired on September 30.
  • House Speaker Paul Ryan (R-WI-1), Senate Majority Leader Mitch McConnell (R-KY), House Minority Leader Nancy Pelosi (D-CA-12), Senate Minority Leader Chuck Schumer (D-NY), Office of Management and Budget Director Mick Mulvaney and White House Director of Legislative Affairs Marc Short have been negotiating over the budget. Various news outlets have reported that negotiations include terms on raising spending caps on defense and non-defense programs, reauthorizing CHIP and community health centers, additional disaster relief for hurricane and wildfire victims, and a deal to fix the Deferred Action for Childhood Arrivals for young undocumented immigrants. Congress is widely expected to pass another continuing resolution to allow appropriators time to finalize Fiscal Year 2018 appropriations bills. Fiscal Year 2018 began on October 1.


  • Talking Points Memo has reported that Sen. Susan Collins (R-ME) said she hopes a pair of bills to stabilize the Patient Protection and Affordable Care Act exchanges will pass and be implemented before 2019, despite opposition to both measures from members of the House Republican majority that kept them from being taken up at the end of 2017. One bill, known as Alexander-Murray, after its bipartisan Senate authors, would restore government subsidies to insurance companies, known as cost sharing reduction payments, which the current administration cut off in 2017. The other bill would send states $500 million in 2018 to set up a reinsurance or high-risk pool program, and then $5 billion a year for 2019 and 2020.
  • Reuters reported that the Centers for Medicare and Medicaid Services has reported that 8.7 million people signed up for Patient Protection and Affordable Care Act plans for 2018 after a shortened enrollment period, slightly lower than the 8.8 million figures given earlier in December. The revision was due to some customers' late cancellations.
  • Reuters has also reported that two judges have blocked the Trump administration from enforcing new rules that allow businesses or nonprofits to obtain exemptions on moral or religious grounds for a requirement to provide insurance that covers birth control. The action by a US district judge in California comes after a similar ruling from a federal judge in Philadelphia.

AWHONN Ohio Section Representative to Serve on LARC Advisory Committee


The Ohio Colleges of Medicine Government Resource Center, under contract with the Ohio Department of Health, has invited the AWHONN Ohio Section to designate a representative to serve on an advisory committee to work on a project related to long-acting reversible contraception (LARC). This work is in response to the passage of Senate Bill 332, which calls for collaboration with Ohio health professional training programs to develop and implement appropriate curricula in those schools and programs designed to prepare primary and women's health care physicians, advanced practice registered nurses, and physician assistants to provide patient counseling on efficacy-based contraceptives, including LARC devices.  Congratulations to the Ohio Section for being called on to share your expertise!

Shaping public policy doesn’t just happen in Congress or state legislatures. There are many opportunities to influence laws and regulations such as by serving on commissions and advisory committees.


Maternal Mortality Awareness Day in New Jersey


Robyn D’Oria, AWHONN New Jersey Section chair and CEO of Central Jersey Family Health Consortium, has shared with me that due to legislation passed in 2017, January 23 will now be the annual Maternal Health Awareness Day in New Jersey.  Maternal Health Awareness Day honors women who have suffered or died as a result of pregnancy or childbirth. Rutgers Robert Wood Johnson Medical School has created an online publicity kit to raise awareness about maternal mortality and morbidity and promote women’s health. 


Health and Humans Service Secretary Nomination Hearing Set For Tuesday


Alex Azar, JD, who has already been questioned by the Senate Health, Education, Labor and Pensions Committee, will have a hearing before the Senate Finance Committee tomorrow. In his first hearing, Azar said that as Secretary, his priorities would be curbing rising drug prices, making health care more affordable and the opioid epidemic. His nomination will be sent to the Senate floor for a vote if the Finance Committee votes to do so.


Seven Words You Can Never Say on Television


The Washington Post reported in December that the Department of Health and Human Services had issued a directive to employees to avoid certain words when preparing requests for next year's budget. The words to avoid are “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based.” The document was distributed to budget offices in the department's operating divisions, including the Centers for Disease Control and Prevention, National Institutes of Health and the Food and Drug Administration.

In response to a letter from House Labor, Health and Human Services, Education, and Related Agencies subcommittee Ranking Member Rosa DeLauro (D-CT- 3), Centers for Disease Control and Prevention Director Brenda Fitzgerald shared a copy of a relevant section from the budget style guide. The enclosure notes:

The Department of Health and Human Services provided general guidance to its operating divisions on the development of Congressional Justifications to facilitate consistency across the wide-ranging budget formulation process. This budget guidance is not official Administration policy and did not come from the Office of Management and Budget. While discussions regarding the budget process are protected because of their deliberative nature, we provide below and excerpt from that guidance. As this excerpt makes clear, there are no "banned" words. These are merely suggestions of what terms to use and what often overused words should be avoided.

See Director Fitzgerald's letter and excerpted HHS style guidance here.

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Posted By Dena Cochran, Wednesday, December 13, 2017

Write to your US Representative to urge them to cosponsor the Addiction Treatment Access Improvement Act, which would significantly expand access to medication-assisted treatment for opioid use disorder, particularly among vulnerable populations such as pregnant women and postpartum mothers struggling with addiction. If you haven’t already written to your US representative about this bill, you can use AWHONN’s Legislative Action Center to do so.


Speak Up!

Dena Cochran

AWHONN Illinois Legislative Coordinator

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October AWHONN updates from "The Hill"

Posted By Dena Cochran, Wednesday, October 11, 2017
Updated: Wednesday, October 11, 2017

Illinois AWHONN Members and Potential Members,


I have attached communication from "The Hill" that I would like to share with you.  I would also like to remind everyone that if you have the opportunity to write or speak to your elected officials, your stories are very impactful.


In case you are unaware, the maternal mortality crisis in the U.S. (the highest in the developed world) has caught the mainstream media eye and is making daytime talk shows.  I have attached a webinar - America's High Maternal Mortality and What Can Be Done - with panel members - Dr. Elliot Main from CMQCC, Eugene Declercq from Boston University and Nina Martin, a reporter and editor specializing in women's legal and health issues.


AWHONN is advocating for the companion bills HR 1318, the Preventing Maternal Deaths Act and S 1112, the Maternal Health Accountability Act, which would help states establish or improve their maternal mortality review committees to examine maternal death cases and identify locally relevant ways to prevent future deaths.


Respectfully submitted,

Dena Cochran, MSN, RNC-OB, CLC

Illinois AWHONN Legislative Coordinator

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September AWHONN Updates from "The Hill"

Posted By Dena Cochran, Tuesday, September 26, 2017

Good Morning Illinois AWHONN Members and Potential Members,


I have received communication from "The Hill" that I would like to share with you.


With appropriations bills needing passes, debt ceilings, emergency spending for hurricane relief and insurers plans for participation in the health insurance exchanges for 2018, there is a lot going on which only behooves us to keep an eye on what is important to us at AWHONN.


AWHONN monitors legislation and advocates for public policies that advance the association's mission "to improve and promote the health of women and newborns and to strengthen the nursing profession." 


You can read AWHONN’s 2017 Federal Legislative and Policy Agenda online.


Find Your Legislator


Find Your Representative


Respectfully Submitted,

Dena Cochran, MSN, RNC-OB, CLC

Illinois AWHONN Legislative Coordinator







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Staying in the loop with Illinois ACOG

Posted By Dena Cochran, Wednesday, August 30, 2017

Successful 2017 Lobby Day and Eventful Legislative Session in Illinois Section

Maura Quinlan, MD, Illinois Legislative Chair


In April, we met with Illinois legislators to provide an ob-gyn perspective and scientific evidence for bills that would affect our patients. Join us next spring for 2018 lobby day!


2017 Illinois Section Lobby Day


2017 Legislative Year


HB 5576 Contraceptive Coverage Bill

  • Became law January 1
  • Illinois is now one of four states (including California, Maryland, and Vermont) to enact statutes codifying the Affordable Care Act's contraception mandate into state law and expand on the federal law's requirements
  • If the Affordable Care Act is repealed, insurance will continue to cover women's contraception in Illinois without additional co-pays

SB 1564 Health Care Right of Conscience Act Amendment

  • Became law January 1
  • Providers and facilities with religious objections must inform patients about the standard of care and have protocols in place to ensure patients have information about other provider options

HB 2617 Fertility Preservation Bill

  • Still in committee, not yet voted on by the whole House
  • The first piece of legislation to come from Illinois section
  • Would require health insurance to cover fertility preservation services when a necessary medical treatment may cause iatrogenic infertility
  • Recent Chicago Tribune letter to the editor regarding the bill

HB 40 Reproductive Choice

  • Passed the Illinois House and Senate, awaiting Governor Bruce Rauner's signature
  • Would ensure that abortion remains legal in Illinois if Roe v. Wade is overturned

HB 274 Pharmacist Prescribing Hormonal Contraception

  • Opposed by ACOG
  • Would allow pharmacists to prescribe hormonal contraception
  • Is still a barrier to access for women—ACOG supports true over-the-counter access.

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Illinois Legislative Update

Posted By Dena Cochran, Wednesday, August 30, 2017
Updated: Wednesday, August 30, 2017

Legislation That Impacts Women, Low-Wage Workers, and Students

Federal legislation designed to improve the lives of women and all low-wage workers, including bills that would raise the minimum wage and mandate paid sick leave, has repeatedly been introduced in Congress over the last seven years. Unfortunately,each of these bills has stalled. In the face of federal inaction, advocates have pressed for change at the state and local level. This issue of WomanView is focused on state legislation that impacts the lives of all Illinoisans, particularly women, low-wage workers, and students of all ages.

The following are just some of the bills that passed both the House and the Senate of the Illinois General Assembly, and have either been signed by the Governor and are now law, or are awaiting action by the Governor—either his signature to make the bill law, or his veto.


Strengthening Equal Pay Act protections. Women and people of color deserve equal pay for substantially similar work compared to their white male counterparts. HB 2462 would strengthen the Illinois Equal Pay Act of 2003 by banning employers from asking job applicants and their current and former employers about their salary history. Since women and people of color are too often paid less than white men, using salary history to inform future salaries only exacerbates the wage gap.

Posting of county and local prevailing wage schedule. Illinois’ Prevailing Wage Act governs the wages that a contractor or subcontractor is required to pay to all laborers, workers, and mechanics who perform work on public works projects. Wage standards like the prevailing wage are an important tool for promoting good jobs and boosting consumer spending to stimulate the local economy. HB 3044 amends the Prevailing Wage Act to require the Illinois Department of Labor to publish the annual prevailing wage in each county in the state on August 15 of each year. The Department already collects this data, but does not post it online currently. HB 3120 would allow a public body that has ascertained the prevailing rate of wages for that body to satisfy publication requirements by posting a notice of the prevailing wage to the public body’s website.

Raising the state minimum wage to $15 per hour. Nearly 40% of workers in Illinois—most of whom are women and many of whom are single mothers—stand to receive a raise if the minimum wage is raised in the state. SB 81 amends Illinois’ Minimum Wage Law to phase in increases to the state minimum wage, starting January 1, 2018, that would reach $15 per hour on January 1, 2022. This increase would not apply to workers under the age of 18 who have worked less than 650 hours for their employer; the minimum wage for these workers will reach only $12 per hour on January 1, 2022. In addition, SB 81 provides a tax credit for employers with 50 or fewer employees to lessen their burden of the increased minimum wage. And the tipped minimum wage would remain at 60% of the state minimum wage, which would be $9 when the state minimum wage is $15.

Removing barriers to professional licensure and certification to those with criminal records. Professional licenses, such as those for hairdressers, are out of reach for individuals with criminal records. This arbitrary barrier prevents many individuals from supporting themselves and their families. SB 1688 amends the Department of Professional Regulation Law of the Civil Administrative Code, the Criminal Identification Act, and other Acts to require the Department of Professional Regulation (DPR) to consider certain mitigating factors for some applicants for licenses, certificates, and registrations. The bill would eliminate “lack of moral character” as a reason for denying such an application, a constant issue for people with criminal records. In addition, if an individual has a criminal record, the type of conviction must be considered by the DPR, and can be a mitigating factor if the conviction will not impair the ability of the applicant to engage in the practice for which the license, certificate, or registration is sought. As a result, more people with criminal records will have the ability to obtain licensure and secure gainful employment.

Protecting religious practices in the workplace. A worker’s religion and religious practices should not inhibit that worker’s ability to find or retain employment. SB 1697 amends the Illinois Human Rights Act by providing that employers may not, as a condition of obtaining or retaining employment, impose any term or condition that requires a person to violate their deeply held religious practice, including the wearing of any attire, clothing, or facial hair in accordance with the requirements of their religion. The law does not apply when dress codes or grooming policies are related to workplace safety or food sanitation.


High school police training program. HB 243 amends the School Code to create the Police Training Academy Job Training and Scholarship Fund. School districts with at least one high school in counties with more than 175,000 residents would be allowed to establish job training programs with local police or sheriff’s offices. These programs, funded in part from a newly created fund, would provide police academy training to current high school students in order to create a stream of recruits for law enforcement offices. The bill also amends the Higher Education Student Assistance Act to create a scholarship for students who have completed the job training program, been accepted into a public institution of higher learning in the state, and meet certain other requirements.

Enabling schools to help students and their families in need. Students and their families need safe, stable, and secure housing to be independent and successful. HB 261 amends the School Code as well as the Education for Homeless Children Act to strengthen the ability of school districts to assist students and their families in times of great need. The bill would allow school districts to act to prevent children from becoming homeless by paying rent, mortgage, or other overdue bills that, if left unpaid, would result in the loss of housing for the student.

Preventing preschool children from being expelled. A child’s education, starting with preschool, is crucial to later academic, economic, and social success. HB 2663 amends the School Code to prevent students from being expelled from their preschool. Provisions have also been added to provide options for children and schools in severe cases where the well-being of children is at risk.

Dual enrollment in high school and community college. HB 2794 amends the School Code to require school boards in districts with a high school to inform all 11th and 12th grade students of dual enrollment and dual credit opportunities at public community colleges for qualified students.

Study of the early childhood workforce. HB 3167 amends the Public Aid Code to require the Illinois Department of Human Services (IDHS) to conduct a study of the early childhood workforce once every three years. The study shall describe the professional development system for the early childhood workforce, determine compensation levels required to attract and retain a high-quality workforce, and make recommendations to foster career advancement pathways. IDHS will use this information to set base payment rates for state-funded providers.

SNAP benefits (food stamps) for college students. Nearly half of college students have reported experiencing food insecurity, and 22% said they have had to skip meals. HB 3211 amends the Public Aid Code to extend SNAP eligibility to certain low-income adult students in career and technical education (CTE) certificate or degree programs at a community college. The bill also establishes a process by which the Illinois Student Assistance Commission will identify and notify students who may be eligible for SNAP. The bill is expected to improve the lives of more than 40,000 students at community colleges across the state.

State school report cards to include attendance rates. SB 1532 amends the School Code to require school report cards to include the average daily attendance of the school as well as other school characteristics and student demographics, including the average teaching experience of school teaching staff, the percentage of English learners in the student body, the racial/ethnic breakdown of students, and the percentage of low-income students. Separately, the average daily attendance of students with individualized education programs and students who have 504 plans shall be disaggregated.

For more information, please contact Wendy Pollack, director, Women’s Law and Policy Project, Sargent Shriver National Center on Poverty Law.

Vol. 21, Issue 2
August 11, 2017


Respectfully Submitted,

Dena Cochran

Illinois AWHONN Legislative Coordinator

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August AWHONN Legislation Updates from "THE HILL"

Posted By Dena Cochran, Monday, August 28, 2017

AWHONN Legislation Updates from “THE HILL”

The US Breastfeeding Committee is comprised of representatives from relevant government departments, non-governmental organizations, and health professional associations. AWHONN is a national nonprofit member. The convening coincided with World Breastfeeding Week (August 1 through 7) and National Breastfeeding Month. The convening was followed by a lobby day on Capitol Hill. We discussed the impact of breastfeeding on infant health and the opportunities for federal policy to better enable breastfeeding.

With the House and the Senate both taking off the month of August, there is not much on which to update you. The next update will be around Monday, September 11.

Senate Takes Most of August off After All

Both chambers plan to reconvene on September 5, the day after Labor Day.

Members of Congress typically use this time to make themselves available to their constituents by holding public town hall meetings. Look on your representative’s and senator’s websites for times, dates and locations. This is a good opportunity to check in with your elected officials. You can find directories on their websites online at and

Use this opportunity to ask your Members of Congress about his or her plans for the future of healthcare reform. Always mention that you are a nurse and share your insights on the impact that federal health law and programs have on your community. We would love to hear what your elected official and fellow constituents have to say. Please send me your feedback at .

Since my last missive, the Senate took a series of votes on amendments to the Better Care Reconciliation Act, which is the Senate companion bill to the House-passed HR 1628 American Health Care Act.  The House and Senate bills would repeal major portions of the 2010 Patient Protection and Affordable Care Act. The votes on amendments were test votes on possible content for the final bill. Senate Majority Leader Mitch McConnell abandoned further effort to find enough votes to pass the bill after the final amendment vote failed in the early morning hours of Friday, July 28.

Senate Health, Education, Labor and Pensions Chairman Lamar Alexander (R-TN) and ranking member Patty Murray (D-WA) are cooperating on a health insurance market stabilization bill. They plan to hold committee hearings beginning in September when the Senate returns from recess.

The Obama administration had been making cost-sharing reduction payments to insurance companies that sell individual plans to keep down coverage costs for low-income people. President Donald Trump has repeatedly threatened to withhold the payments. Many insurance companies have indicated their reliance on the stabilization payments for participating in the individual market. There are already 19 counties at risk of having no insurer willing to sell PPACA coverage for 2018. The bipartisan legislation Alexander and Murray are working on would be written to address the needs of counties without participating insurers.

Budget and Appropriations
CQ has reported that the House is preparing a 12-bill omnibus for consideration when they return from recess. Four appropriations bills have already been passed by the House. Combining the four House-passed bills with the remaining 8 would create a single package of bills that the Senate could vote upon, potentially speeding along the usual budget and appropriations process. CQ also reported that the measure could come to the floor as early as the first week of September. The Federal Government’s fiscal year ends on September 30. If spending bills aren’t passed before then, Congress will have to pass a continuing resolution to keep the government operating.

Debt Ceiling
The Treasury Department estimates that the Federal Government will hit the debt ceiling around September 30 and therefore not have authorization to borrow and spend until Congress raises the limit. Office of Management and Budget Director Mick Mulvaney and Treasury Secretary Steve Mnuchin have both urged Congress to pass a debt limit increase without tying it to making budget cuts. The process of setting the debt ceiling is separate and distinct from the budget process, and raising the debt ceiling neither directly increases nor decreases the budget deficit. Nonetheless, approaching the debt limit has in some past years prompted a debate or even a standoff over the budget between Congress and the President.

The Senate confirmed four of President Donald Trump's Department of Health and Human Services nominees on August 3. Amongst them were Jerome Adams, MD, MPH as Surgeon General and Elinore McCance-Katz, MD as HHS Assistant Secretary for Mental Health and Substance Use. Adams had most recently been Indiana State Health Commissioner, a position he was appointed to by former Indiana Governor Mike Pence. Adams is an anesthesiologist and an assistant professor at the Indiana University School of Medicine. Prior to assuming her current role, McCance-Katz was the chief medical officer for the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals and a professor at the Alpert Medical School at Brown University.         


Dena Cochran, MSN, RNC-OB, CLC

Illinois AWHONN Legislative Coordinator

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AWHONN Legislation Updates from "THE HILL"

Posted By Dena Cochran, Friday, August 25, 2017
Updated: Friday, August 25, 2017

Good Afternoon,


I am your ILLINOIS AWHONN Legislative Coordinator and would love to hear from you.  I'm just getting started so if you have questions/comments/ideas, please let me know.


Dena Cochran, MSN, RNC-OB, CLC

Illinois AWHONN Legislative Coordinator

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Free Webinar: Working Across Sectors to Reduce Maternal Mortality

Posted By Lori Folken, Friday, August 11, 2017


Hi everyone,


Mona received this flyer and wanted to share. See the attachment.




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