Dear NPWH,

The past four months have been incredibly active with advocacy efforts and representing certified WHNPs and AAPs in women's and gender-related healthcare and NPWH.

NPWH collaborates with like-minded organizations to amplify the collective voice of the 13,000 certified WHNPs in the U.S. NPWH is committed to increasing inclusivity, diversity, and equity in our organization, the WHNP profession, the women's and gender-related healthcare field, and beyond.

We participate in signing letters to endorse research funding, government programs, and targeted initiatives that support the needs of women's health nurse practitioners, CNMs, and nurse practitioners and the individuals they serve.

Sign-on letters: 26

Amicus briefs: 2

Between January and April 30, 2024, NPWH has participated in numerous joint letters with allied organizations on various women's and gender-related healthcare issues:

• One significant collaboration involved joining forces with esteemed healthcare associations and organizations, including the National Women's Law Center, National Black Women's Reproductive Justice Agenda, National Asian American Women's Forum, and National Latina Institute for Reproductive Justice, in a compelling amicus brief urging the U.S. Supreme Court to uphold the federal Emergency Medical Treatment and Labor Act (EMTALA) requirement to stabilize abortion healthcare. EMTALA ensures equitable access to emergency healthcare, including for pregnant patients in labor and those facing other emergency conditions.

• Additionally, NPWH partnered with the American Academy of Physician Associates (AAPA), the Association of PAs in Obstetrics and Gynecology (APAOG), and the American College of Nurse-Midwives (ACNM) in filing an amicus brief with the United States Supreme Court regarding the case U.S. Food and Drug Administration v. Alliance for Hippocratic Medicine, which addresses the use of mifepristone, an FDA-approved drug.

Furthermore, we have actively participated in events and calls to represent our organization, the WHNP-BC profession, and access to healthcare, including:



• "The Power of Research: The Need for Gender Equity," hosted by Maria Shriver, Women's Alzheimer's Movement (WAM), in collaboration with the Cleveland Clinic and Society for Women's Health Research. This event highlighted the importance of gender equity in medical research and recognized First Lady Dr. Jill Biden for her role in launching the White House Women's Health Research Initiative.
• Engagement with White House representatives from the White House Women's Health Research Initiative, where we introduced our organization and the WHNP profession, emphasizing our wide scope of practice and areas of specialization. Of particular interest to the White House is the role of WHNPs in the perimenopause and menopause space.
• Last month, I attended a rally at the U.S. Supreme Court to support EMTALA. I joined healthcare professionals from around the country who also affirm that the federal Emergency Medical Treatment and Labor Act (EMTALA) requires stabilizing abortion healthcare. EMTALA has been a cornerstone of ensuring equitable access to emergency healthcare for all individuals, encompassing pregnant patients in labor, those facing emergency conditions unrelated to labor, and individuals requiring emergency treatment to prevent pregnancy loss.
• NPWH attended the National Abortion Federation annual meeting held in April and reconnected with many advanced practice providers who provide abortion care. It was one of the largest meetings in the history of the organization and the primary venue for the presentation of the latest research, innovations, and policies that affect abortion care provision around the world. NPWH's Reproductive Healthcare Policy

Outlined in our newsletter are key highlights of our advocacy endeavors. Stay tuned for the upcoming launch of Advocacy Bundles, designed to equip you with essential information to bolster your advocacy efforts at both the state and federal levels, as well as within your hospital and with your employers, concerning the scope of practice of the certified WHNP.

Your feedback has been instrumental in identifying this need, and we're diligently collaborating with our committees and staff to develop these resources for you. If you are active in advocacy efforts related to the profession, women's or gender-related health, please share your story with me. We want to highlight the work of our members across the country.

If you are a company who is interested in exploring NPWH's advocacy efforts relating to our Advocacy Policy, please contact me.

With warm regards,

Heather L. Maurer, MA, CAE

Chief Executive Officer

The National Association of Nurse Practitioners in Women's Health

www.npwh.org

hmaurer@npwh.org

P.S. Follow me on my professional Instagram. IG: @heatherlmaurer

Amicus Brief: Amicus Brief to Protect WHNP-BC, CNM, Physician Associates (PAs) and Advanced Practice Practitioner Practice

On February 22, 2024, the National Association of Nurse Practitioners in Women’s Health (NPWH) joined the American Academy of Physician Associates (AAPA), the Association of PAs in Obstetrics and Gynecology (APAOG), and the American College of Nurse-Midwives (ACNM), in filing an amicus brief in the United States Supreme Court (SCOTUS) following a decision from the United States Court of Appeals for the Fifth Circuit. The case, U.S. Food and Drug Administration v. Alliance for Hippocratic Medicine, concerns mifepristone, a drug the FDA first approved in 2000 as safe and effective for patient use. The Fifth Circuit opinion held that the FDA’s 2016 rule changes allowing qualified “nonphysicians” (including registered nurses, certified nurse midwives, physician assistants/associates, collectively “APCs”) to be certified independent prescribers of mifepristone should be enjoined. If the Supreme Court affirms the Fifth Circuit’s decision, APCs could be prohibited from prescribing mifepristone. Read more.

February 2024 – NPWH Director of Policy Sue Kendig, JD, WHNP-BC, attended a meeting with the CDC's Surveillance for Emerging Threats to Mothers and Babies Network (SETNET). NPWH was proud to join our women's health colleagues in providing input to the CDC SETNET team in addressing future threats to mothers' and babies' health through surveillance, access to meaningful data and collaboration.

In photo: Becky Abbott, Director of Government Relations, Society For Maternal Fetal Med Sue Kendig, Michelle Munroe, CNM, DNP, FACNM, American College of Nurse-Midwives Jennifer WIlliams, Centers for Disease Control and Prevention.

Sue Kendig also toured the CDC Emergency Operations Center along with colleagues from ACNM Michelle Munroe, CNM, DNP, FACNM, and AWHONN Karen Crowley, DNP, APRN-BC, WHNP, ANP, CNE.

They met with representatives from the CDC Nurses Workgroup: CAPT Jenny Williams, PhD, MSN, MPH, FNP-B,C FAANP; LCDR Stephen Perez, PhD, RN, ACRN, CRNP, and co-chair of the CNWG Partnerships Committee; Erin Whitehouse, PhD, MPH, RN, and immediate past president of the CNWG; and CDR Shauna Mettee Zarecki, MSN, MPH, RN, GCEM, NHDP-BC, past president of the CNWG and co-chair of the CNWG Partnerships Committee.

NPWH signed a letter of support for the Credit for Caring Act, sponsored by the AARP, which would create a new, non-refundable federal tax credit for eligible working family caregivers to help address the financial challenges of caregiving.

In February 2024, NPWH released a statement opposing the Alabama Supreme Court's ruling to legally designate frozen embryos as children. "The Alabama Supreme Court's decision is met with opposition from the National Association of Nurse Practitioners in Women’s Health (NPWH),” stated NPWH President Komkwuan P. Paruchabutr, DNP, WHNP-BC, FNP-BC, CNM, FACNM. "This decision opens practitioners and those families seeking IVF healthcare to potential legal prosecution. While it's imperative to handle frozen embryos with care, labeling them as children is both scientifically flawed and misinformed. This ruling, reminiscent of Roe v. Wade, raises grave concerns among prospective parents and medical professionals alike.”

On February 28, 2024, NPWH participated in a Roundtable on Congenital Syphilis with National Provider Organizations by the U.S. Department of Health and Human Services (HHS) Assistant Secretary for Health ADM Rachel L. Levine and other healthcare associations to discuss efforts to protect the health of our nation’s patients and their babies. This meeting built upon a series of conversations and engagements to respond to the U.S. syphilis and congenital syphilis epidemic.

During the roundtable, members of the Task Force highlighted the important work being done by the Biden-Harris Administration to improve access to care, advocate for syphilis testing whenever indicated, innovate screening and testing methods of intervention, initiate syphilis treatment immediately, foster an environment of open communication, and further connect organizations to available HHS resources.

ADM Levine emphasized syphilis has reemerged as a major public health concern and the critical role health care providers play in reversing this alarming trend. NPWH will be partnering with HHS and other women’s healthcare associations to provide updated CE opportunities on congenital syphilis.

March 2024 – NPWH signed a letter of support regarding Change Healthcare, which was was subject to a cyberattack in late February, which led to a significant impact on health care operations across the country. Payments to hospitals, physicians, pharmacists, and other health care providers across the country were disrupted. Change Healthcare, which is owned by UnitedHealth Group, processes 15 billion health care transactions annually and is involved in one in every three patient records. Change Healthcare provided resources for providers as well as a letter to providers.

April 2024 – NPWH joined a formidable amicus brief, Idaho v. United States, with the National Women’s Law Center, National Black Women’s Reproductive Justice Agenda, National Asian American Women’s Forum, National Latina Institute for Reproductive Justice, and 98 esteemed healthcare associations and organizations calling on the U.S. Supreme Court to affirm that the federal Emergency Medical Treatment and Labor Act (EMTALA) requires stabilizing abortion healthcare. EMTALA has been a cornerstone of ensuring equitable access to emergency healthcare for all individuals, encompassing pregnant patients in labor, those facing emergency conditions unrelated to labor, and individuals requiring emergency treatment to prevent pregnancy loss.

The brief argues that a decision that EMTALA no longer preempts state abortion bans during pregnancy-related emergencies will only compound the existing maternal morbidity and mortality crisis in the U.S. 

On April 24, 2024, the U.S. Supreme Court heard oral arguments for the consolidated case (Idaho v. United States and Moyle v. United States) challenging decades of legal precedent of providing emergency care for pregnant people as protected under EMTALA. NPWH CEO Heather Maurer was among many activists outside the Supreme Court that day in support of EMTALA.

Ahead of the final ruling in June, the Supreme Court appeared to be split – a decision NPWH hopes the justices can avoid in favor of keeping the life-saving protections of EMTALA. Read more about the case here and read NPWH's statement here.

The American Nurses Association (ANA) submitted a sign-on letter, with the support of numerous nursing affiliates and partner associations (including NPWH), to leaders of the Occupational Safety and Health Administration (OSHA) urging them to immediately release their proposed workplace prevention standard. April is Workplace Violence Prevention Awareness Month, and ANA continues to raise awareness and inspire action through its advocacy and policy work. As workplace violence continues to spike across the country, ANA is gathering voices from across the nursing profession and country to push OSHA to finish this critical work and implement a national standard that comprehensive workplace violence prevention programs in all settings of care. Read More.

On April 22, 2024, the Biden-Harris Administration, through the Office for Civil Rights at the U.S. Department of Health and Human Services (HHS) announced a Final Rule, entitled HIPAA Privacy Rule to Support Reproductive Health Care Privacy. The Final Rule strengthens the Health Insurance Portability Act of 1996 (HIPAA) Privacy Rule by prohibiting the disclosure of protected health information (PHI) related to lawful reproductive health care in certain circumstances.

HHS is issuing this Final Rule after hearing from communities that changes were needed to better protect patient confidentiality and prevent medical records from being used against people for providing or obtaining lawful reproductive health care. This Final Rule will bolster patient-provider confidentiality and help promote trust and open communication between individuals and their health care providers or health plans, which is essential for high-quality health care. Read more.

On April 29, the 4th Circuit Court of Appeals in Richmond, Va., issued its decision about two cases, thus mandating that state health insurance plans must provide coverage for gender-affirming care in North Carolina and West Virginia. One case was brought forth by North Carolina transgender state employees and their dependents who were unable to get coverage for gender-affirming care. The other lawsuit came from West Virginia residents who are transgender and on Medicaid. In an 8-6 decision, the majority of the 4th circuit decided that the patients were entitled to health insurance coverage for their care. Judge Roger Gregory, who wrote the majority opinion, called the denial of coverage "obviously discriminatory."

Bipartisan Lawmakers Introduce Bill to Boost Research Into Menopause

The Washington Post (5/2, Diamond) reports congressional leaders on Thursday unveiled “a $275 million bill to boost federal research, physician training and public awareness about menopause, [in] a campaign led by prominent female lawmakers and boosted by the star power of actor Halle Berry.” The bipartisan bill, Advancing Menopause Care and Mid-Life Women’s Health Act, “would authorize $125 million in menopause-related research grants through the National Institutes of Health, create a $50 million public awareness campaign about the condition, fund $50 million in additional training for health workers and provide $50 million to improve diagnosis and treatment of chronic conditions affecting women at midlife.” 

Call to Action: Contact your federal congressional representatives and ask them to sign and support this bill.

White House Initiative on Women's Health Research

The goal of the initiative: "to fundamentally change how our nation approaches and funds women’s health research."

"Research on women’s health has always been underfunded, many medical studies have focused on men and left women out, many of the medicine dosages, treatments, medical school textbooks, are based on men and their bodies – and that information doesn’t always apply to women. There are big gaps in research on diseases and conditions that only affect women, that disproportionately affect women, or that affect women and men differently." Dr. Jill Biden, U.S. First Lady, said.

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