Health Policy Agenda - NAPNAP

Health Policy Agenda

Health Policy Agenda Framework

The National Association of Pediatric Nurse Practitioners (NAPNAP) Health Policy Agenda is based on four health policy priorities: (1) health care access and quality, (2) social determinants of health, (3) pediatric-focused advanced practice registered nurse (APRN) practice and (4) pediatric-focused APRN advocacy, and rooted in an unwavering commitment to diversity, equity and inclusion for all children, families and pediatric health care providers.

Priority #1: Health Care Access & Quality: All children and adolescents must have access to comprehensive, continuous, coordinated, compassionate, culturally inclusive, family-centered, affordable, evidence-based, quality health care, across all care settings and specialties, including telemedicine and mental and behavioral health care.

  • Goal: Improve access to quality pediatric health care including comprehensive primary, chronic, acute and specialty care services for all children and adolescents.
  • Strategies:
    • Maintain comprehensive funding for the Children’s Health Insurance Program (CHIP) and Medicaid programs.
    • Improve access to Medicaid coverage for children, adolescents and families via improved access to Medicaid coverage and implementation of the Immigrant Children’s Health Insurance Improvement (ICHIA) options in all states.
    • Eliminate disparities in health care costs related to insurance coverage, inadequacy of benefits and out of pocket expenses for pharmaceuticals and durable medical equipment.
    • Expand developmental, behavioral and mental health services for children and families as integral to comprehensive pediatric health care, including those services provided in school-based health settings.
    • Advance access to quality care in alternative settings, including home health, hospice, school-based, rural and community health programs and via telemedicine.
    • Prioritize development of comprehensive quality health indicators focused on the care of children and families.

Priority #2: Social Determinants of Health: All children and adolescents must have access to healthy nutrition, safe environments, quality education and opportunities and communities free of racism and violence in order to be well and thrive.

  • Goal: Optimize Child and Adolescent Health by advancing public health and policy initiatives that address social determinants of health.
  • Strategies:
    • Advocate for health policy related to emergency preparedness for national and global health care crises, including the ongoing COVID-19 pandemic, ensuring pediatric needs are addressed in treatment development and response.
    • Optimize nutrition and physical activity for children and adolescents, focusing on breastfeeding promotion, reducing food insecurity and preventing childhood obesity.
    • Increase access to comprehensive, evidence-based and integrated services to optimize childhood development and mental and behavioral health.
    • Support injury prevention and harm reduction initiatives focusing on the leading causes of childhood illness, injury, adverse childhood experiences, maltreatment and violence against children, including gun violence prevention.
    • Develop resources and ensure comprehensive health care access for marginalized populations including children in sex and labor trafficking, those impacted by the opioid epidemic, LGBTQIA youth, youth experiencing homelessness, children in foster care and detention centers and refugee, undocumented and unaccompanied migrant and immigrant children.
    • Advance environmental health and safety for all children and families with a focus on climate justice and access to safe housing, clean water, air and healthy communities.
    • Promote awareness of the need for pediatric data disaggregation to highlight existing disparities in child health outcomes and promote targeted interventions to improve health equity among children.
    • Promote evidence-based education and timely, equitable access to complete immunization.

Priority #3: Pediatric-Focused APRN Practice: Barriers to care provided by pediatric-focused APRNs must be eliminated in all practice settings to maximize health care access for all children, adolescents and families.

  • Goal: Promote access to a pediatric-focused APRN workforce that reflects the diversity of children across the nation.
  • Strategies:
    • Recognize pediatric-focused APRNs who provide primary care as primary care providers by all entities.
    • Acknowledge pediatric-focused APRNs as full partners and leaders in innovative models of care such as Accountable Care Organizations (ACOs) and health care homes.
    • Promote comprehensive, transparent reimbursement and appropriate attribution for care by government and commercial payors through the elimination of “incident-to” billing and use of National Provider Identification numbers to document the role of pediatric-focused APRNs in care delivery.
    • Include pediatric-focused APRNs as eligible participants and essential partners in any federal grant programs piloting innovative models of care, including health information technology initiatives.
    • Increase funding for and maintenance of self-contained, independent, comprehensive pediatric clinical and didactic education for nurses of all education levels.
    • Advocate for increased funding for nursing workforce development programs to meet pandemic related demand for growth with a particular focus on ensuring funding for the development of the pediatric nursing workforce.
    • Encourage strategies to retain pediatric-focused NP workforce members through professional advancement and recognition.
    • Advocate for national standardization of pediatric-focused APRN practice across states in alignment with the APRN Consensus Model to eliminate arbitrary, costly, unsupported and time-limited barriers preventing children from full and direct access to high-quality, affordable care provided by pediatric APRNs who are able to practice to the full scope of their education and training.
    • Prioritize diversification in nursing and pediatric-focused APRN training, education, scholarship and employment.
    • Promote programs that enable work-based employee support including early referral programs for crisis management, mentoring and coaching, and voluntary employee assistance support for nurses experiencing burnout and mental health and overall wellness concerns related to the effects of the COVID-19 pandemic.

Priority #4: Pediatric-Focused APRN Advocacy: National and grassroots advocacy by pediatric-focused APRNs is essential and should be supported to advance vital pediatric health policy initiatives.

  • Goal: Position pediatric-focused APRNs as recognized child health policy leaders and advocates at federal, state and local levels.
  • Strategies:
    • Empower participation in federal, regional, state and local child health advocacy initiatives, including congressional meetings, legislative days and calls to action, through ongoing member, chapter and special interest group training, mentorship and support.
    • Engage association members and leaders in child health advocacy through use of varied political, technological and e-communication platforms, maximizing both impact and reach.
    • Identify, develop and deploy a high-quality network of pediatric-focused APRN advocacy leaders to represent the association on national, regional and state child health and health policy task forces, advisory panels and committees.
    • Collaborate with academic leaders to develop innovative programs of pediatric specialty and education that broaden advocacy initiatives.
    • Educate policy makers and the public about the expertise of pediatric-focused APRNs.
    • Seek state and national media opportunities for pediatric-focused APRN leadership to communicate with the public about priority child health policy initiatives.
    • Build relationships with community partners and other key stakeholders to promote the role of pediatric-focused APRNs advancing child health.

Foundation: Diversity, Equity and Inclusion: The National Association of Pediatric Nurse Practitioners is committed to achieving diversity, equity and inclusion for all by advancing essential and urgent health and public policy change. NAPNAP will actively oppose any health-related or adjacent policy initiatives that discriminate against children, families, health care workers and/or communities on the basis of race, age, ethnicity, nationality, religion, gender, sexual orientation, socioeconomic status or otherwise.


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