The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)

Be sure to add a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.

Part 1: Legislation Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. Be sure to address the following:

  • Determine the legislative intent of the bill you have reviewed.
  • Identify the proponents/opponents of the bill.
  • Identify the target populations addressed by the bill.
  • Where in the process is the bill currently? Is it in hearings or committees?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:

  • Advocate a position for the bill you selected and write testimony in support of your position.
  • Explain how the social determinants of income, age, education, or gender affect this legislation.
  • Describe how you would address the opponent to your position. Be specific and provide examples.
  • At least 2 outside resources and 2-3 course specific resources are used.



Legislation Grid Template

Nurses encounter events and situations that influence their participation and involvement in advocacy roles so that they can impact the development and implementation of policies, regulations and laws associated with and aimed at improving health aspects like care delivery (Taylor et al., 2021). Nurses do this by participating in policymaking and lobbying to ensure that patients get quality care (Milstead et al., 2019). The essence of this paper is to review a selected health-related bill in Congress to determine its intent, target population and provide an advocacy statement or testimony related to nursing.

Health-related Bill NamePreventing Maternal Deaths Reauthorization Act of 2023  
Bill NumberH.R. 3838
DescriptionThe bill wants to amend title III of the Public Health Services act with the aim of reauthorizing federal government to support states in their efforts to save and sustain the health of mothers before, during and after pregnancy (, 2023).
Federal or State?Federal
Legislative IntentThe bill seeks to eliminate maternal health disparities and improve outcomes for pregnancy-related and pregnancy-associated deaths. The bill focuses on identifying solutions to enhance quality of care and outcomes for mothers during this time (, 2023).
Proponents/ OpponentsProponents: mothers and expectant mothers, healthcare providers, social workers, and health department
Opponents: Health insurance companies, conservative legislators within state legislatures based on their party affiliations.
Target PopulationExpectant mothers, mothers during delivery, and postpartum mothers.  
Status of the bill (Is it in hearings or committees?)Ordered reported and awaiting consideration after being sent to the House and Senate as a whole bill.  
General Notes/Comments    The bill is critical for maternal health since the U.S. lags behind its peers with one of the highest infant mortality rates due to disparities that affect health populations, especially low-income and racial minorities. The bill is a critical part of improving efforts to reduce and prevent high rates of infant mortality in the country. Having assumed a bipartisan sponsorship in Congress, the bill has increased chances of passing and being enacted to save and sustain expectant mothers, those recently delivered, and those experiencing postpartum period.

Part 2: Legislation Testimony/Advocacy Statement

The U.S. continues to have one of the highest maternal mortality rates among its peers from the Organization for Economic Co-operation and Development (OECD). The Centers for Disease Control and Prevention (CDC) (2023) asserts that the U.S. maternal mortality rates stand at 23.8 per 100,000 live births. The rate increases based on racial composition with African Americans registering over 55.3 per 100,000 live births. These high rates mean that expectant mothers and those delivering are not safe (Jang et al., 2022). The disparities in maternal health requires interventions like the proposed bills which will compel both state and federal governments to enact measures aimed at reducing and preventing mortality rates.


Maternal mortality impacts American women irrespective of their background (Hill et al., 2022). Pregnant women risk experiencing complications like preterm labor, infections, gestational diabetes and even fatality because of their condition. Again, among those who survive the pregnancy period and childbirth, close to 50,000 experience life-threatening pregnancy associated complications or severe maternal morbidity (SMM). Therefore, as core part of healthcare provision, nurses advocate for the enactment of such measures to improve the safety and quality of care offered to the expectant women and those delivering and even during the postpartum period to prevent and reduce any complications that may arise (Milstead et al., 2019). This bill will help reduce these complications and deaths that arise from pregnancy.


Social determinants of income, age, education and gender may affect this legislation since those impacted most by the disparities are racial minorities, especially African American women. The passage of this bill will ensure that these women get access to healthcare resources to reduce their susceptibility to complications (Taylor et al., 2019). For instance, this bill addresses states to implement measures to increase resources and access aimed at lowering any possible complication during pregnancy, delivery, and at postpartum period.

Opponents of the bill should consider the negative effects of these complications and the need to save and sustain the lives of these women. Again, it would be critical to consider the benefits of reducing and preventing maternal mortality to the overall cost burden of healthcare. Therefore, opponents should focus on the effects of the bill in mitigating costs and improving quality of care offered to the patients.


Health-related bills in Congress focus on improving care delivery. As such, nurses should advocate for these legislations to improve different aspects of care provision like accessibility and quality. The legislative intent of this bill is to reduce maternal mortality and improve the overall care delivery for the targeted population.


Centers for Disease Control and Prevention (2023 March 16). Maternal Mortality

Rates in the United States, 2021. (2023). H.R. 3838: Preventing Maternal Deaths Reauthorization Act

            of 2023.

Hill, L., Artiga, S. & Ranji, U. (2022 Nov 01).  Racial Disparities in Maternal and

Infant Health: Current Status and Efforts to Address Them.

Jang, C. J., & Lee, H. C. (2022). A review of racial disparities in infant mortality in

            the US. Children, 9(2), 257. DOI: 10.3390/children9020257

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide

            (6th ed.). Jones & Bartlett Learning.

Singh, G. K., & Stella, M. Y. (2019). Infant mortality in the United States, 1915-

2017: large social inequalities have persisted for over a century. International Journal of Maternal and Child Health and AIDS, 8(1), 19. DOI: 10.21106/ijma.271

Taylor, J., Novoa, C., Hamm, K. & Phadke, S. (2019) May 2). Eliminating Racial

Disparities in Maternal and Infant Mortality: A Comprehensive Policy Blueprint

Legislation Grid Template

As important healthcare providers, nurses encounter situations that implore them to take actions and participate in activities or initiatives aimed at improving access to affordable quality care for different health populations. As patient advocates, nurses seek to impact policies, laws, and regulations that affect healthcare issues of interest (Milstead et al., 2019). Through the undertaking, they help patients attain better outcomes by offering inputs on how such policies should be developed for effective implementation in clinical settings and nursing practice (Walden University, 2018). The purpose of this legislation grid and testimony or advocacy statement is to discuss and advocate a proposed bill on healthcare that will enhance quality of care.

Part 1: Legislation Grid

Health-related Bill Name  Special Diabetes Program Reauthorization Act of 2023
Bill NumberS.1855
DescriptionThe Special Diabetes Program Reauthorization Act of 2023 is proposed legislation that aims at having continued funding for a key federal diabetes research program which is set to expire in September, 2023. The legislation reauthorizes funding for the program that focuses on type 1 diabetes research for another five years to allow scientists at the National Institutes of Health to continue their ongoing efforts to get new approaches to treating, preventing and curing the disease (Collins, 2023). The legislation, if enacted, would offer the program $150 million each year for the program. According to the National Institute of Diabetes and Digestive and Kidney Diseases, the special diabetes program aims at researching about the prevention and cure of type 1 diabetes (, 2023). Therefore, this bill expands the mandate for more research on the condition to develop innovative and unique treatment options for the condition that affects millions of Americans.
Federal or State?Federal
Legislative IntentThe legislative intent of the bill is to reauthorize funding for special diabetes program for Type 1 Diabetes as well as the special diabetes program Indians. The Act would not only reauthorize but also strengthen critical research on type 1 diabetes and develop new critical treatment, education, and prevention initiatives for populations considered as at high risk (, 2023). These include Native Americans and Alaska Native communities who have high rates of Type 2 diabetes than the national average.
Proponents/ OpponentsProponents: Proponents of the bill include the sponsors, Senior Senator Susan Collins and the cosponsors Senator Jeanne Shaheen who are co-chairs of the Senate Diabetes Caucus. The bill is also supported by the National Council of Urban Indian Health (2023).
Opponents: The bill does not have any known opponents as it is considered a bipartisan legislation supported by Congressional members from the two dominant parties and even independents.    
Target PopulationThe bill targets populations that are susceptible to getting diabetes type 1 that may lead to type 2 diabetes like the native Indians and Alaska Natives. The bill also targets research facilities like the National Institutes of Health. The increase in allocations means that more individuals can benefit from the research on interventions, education programs and awareness about type 1 diabetes.
Status of the bill (Is it in hearings or committees?)The committee assigned to the bill sent it to both House and Senate as whole to consider it by June 15, 2023. The committee had passed the bill paving way for its return to the Senate and the House for debate as whole and after that taking of a vote on it.
General Notes/Comments    The Special Diabetes Reauthorization Program Act 2023 is a critical piece of legislation that would improve care provision for the targeted population through effective research initiatives (DeGette, 2023). The bill is important in improving the overall health outcomes for those populations and individuals who are at increased risk for type 1 diabetes.

Part 2: Legislation Testimony/Advocacy Statement

The Special Diabetes Program Reauthorization Act of 2023 is a core proposed legislation that would help fight the increasing cases of type 1 diabetes, especially among the Native communities and minorities who bear the greatest risk for the condition. Existing evidence shows that the Type 1 Diabetes Research and the Special Diabetes Program for Indians (SDPI) has been significant in creating meaningful resources and research milestones to develop cures and prevention initiatives for individuals with Type 1 diabetes, including Native Americans and Alaska Natives. Imperatively, if not extended, the two programs will expire and increase the risk of diabetes, not just among the communities but even the nation and pile pressure and strain on the current resources. As such, this bill is essential in helping mitigate such situations now and in the future.

Social determinants of health (SDOH) are conditions that one is born and lives in which affect their access to health. These include income, education, age, and gender among others. These SDOHs affect the legislation as they imply that only those individuals with access to better health care based on income can have better treatment interventions (Milstead et al., 2019). These determinants also affect access to information and use of the information to make informed and better choices.

Currently, the bill has no known opposition as it is a bipartisan approach to dealing with the issue of diabetes as a public health concern. However, it is essential to emphasize that the bill will offer immense benefits to patients and the targeted communities through better interventions, especially prevention of the disease. As such, all should support the bill because of its benefits to public health discourse and patients. 


Legislations are essential in improving healthcare outcomes. Nurses as patient advocates should support such legislations so that they can improve the quality of care delivery for their patients. The proposed bill will ensure that more people can access treatment and preventive care against diabetes.


Collins, S. (2023 June 15). Collins’ Bipartisan Bill to Support Type 1 Diabetes

Research and Combat Type 2 Diabetes Advances Senate Committee.

DeGette, D. (2023 April 11). DeGette, Bilirakis introduce legislation to continue

funding key diabetes research program. (2023). S. 1855: Special Diabetes Program Reauthorization Act of


National Council of Urban Health for Indians (2023 June 10). Senate Committee

Passes Bipartisan Bill to Reauthorize the Special Diabetes Program for Indians, Marking First Increase in Nearly Two Decades.

National Institute of Diabetes and Digestive and Kidney Diseases (2023). About

the Special Diabetes Program.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide

          (6th ed.). Jones & Bartlett Learning.

Walden University, LLC. (Producer). (2018). Introduction to Health Policy and

          Law with Joel Teitelbaum [Video file]. Baltimore, MD: Author.



Nurses experience events and situations that motivate them to assume the advocacy role in hopes of influencing policies, regulations, and laws related to healthcare and care provision. To do so, they have to enter into the less familiar political and policy making spheres to demonstrate their interests by evaluating proposed bills and their overall effects on the target health population, the nursing professional and the healthcare industry. The essence of this assignment is to review a selected health-related bill that has been proposed in Congress and complete the Legislation Grid Template to determine its intent, proponents and opponents, the target population and issue an advocacy statement or testimony.

Health-related Bill NameMobile Health Record Act of 2019  
Bill NumberH.R.1390
DescriptionMobile Health Record Act of 2019 was introduced in the house on February 27 2019 and was sponsored by Susan Brook, the house representative from the fifth Congressional District in Indiana. The bill’s co-sponsors include Yvettte Clarke the New York representative of 9th Congressional District, Levine, Mike from California, Schweikert, David from Arizona and Gottheimer, Josh from New Jersey. The bill requires the Centers of Medicare and Medicaid Services (CMS) to create a program which facilitates Medicare enrollees to link their claims data using trusted applications, services and research programs. The bill also requires enrollees to access information using a mobile health record application of their choice and one approved by the CMS and meets the specified requirements. The CMS must make such information accessible to such applications as stipulated by the current Blue Button 2.0 program. The proposed legislation also mandates federal payments to states that opt to develop or purchase similar applications for the enrollees.    
Federal or State?Federal
Legislative IntentThe legislative intents of the bill are to amend the Social Security Act with the objective of providing benefits from part A or part B of the Medicare programs. These include individuals who enrollee in state programs under Medicaid. These people will be empowered through the bill to access personal medical data that include prescriptions, diagnosis, providers and tests using mobile health records application of their choice.  
Proponents/ OpponentsProponents: Proponents of the bill include the representatives introducing and supporting it, healthcare providers like nurses and physicians, software development companies and startups, and Centers for Medicare and Medicaid Services (CMS).  
Opponents: Opponents may include insurance companies that have always have the monopoly to offer consultancy services to the beneficiaries.  
Target PopulationBeneficiaries of both Medicare and Medicaid  
Status of the bill (Is it in hearings or committees?)The bill was introduced in Congress in 2019 and later referred to the respective Committee on Energy and Commerce. The bill is currently in the Committee of Ways and Means’ subcommittee on Health. The bill has received substantial amount of coverage but it is still new and at committee stage.    
General Notes/Comments    The need to expand access to health care, especially for older Americans and individuals with chronic conditions is essential as the country continues to battle pandemics like the Coronavirus disease of 2019. The use of health information technology models like mobile health is expanding access, particularly to underserved and susceptible populations. Therefore, the bill seeks to enhance access to information and allow individuals to have effective management and involvement in their health decisions (Bouayad et al., 2017). By allowing Medicaid and Medicare beneficiaries to access personal health information through mobile applications, the bill expands care and individual autonomy to make decisions.

Part 2: Legislation Testimony/Advocacy Statement

Access to healthcare remains one of the fundamental goals of different administrations, particularly at this time when the country and the world are battling a resurgence in COVID-19 cases due to the Delta variant. The cost of healthcare continues to rise, particularly for those from low-income households and neighborhood and racial minorities. Initiating different interventions like the introduction of Mobile Health Records Act of 2019 will ensure that these people can access healthcare at affordable cost. The act aims at enhance access to care information at a personal level by leveraging novice technology. In their study, Dameff et al. (2019) advance that the use of mobile health records platforms has the capability to enhance health delivery and outcomes. The authors emphasize the need to embrace health information technology models to enhance overall care delivery, particularly access to personal record records.

The main concern should be on whether the model through the provision of access to personal health information can improve care outcomes that the minimal cost while maintaining service quality of care (Snezana et al., 2020). It is important to understand that the advent of electronic health records together with increased use of Internet platforms and smart technologies have enabled seamless flow of critical clinical information among care organizations and providers (Harahap et al., 2021). Imperatively, if the same can be attained at a personal level, it will enhance patient involvement in decision making concerning their care plans and interventions.

The approach will also enhance individuals’ ability to make informed choices concerning the use of healthcare services. Opposition to this Act can only arise due to unproven status of such applications in improving access and quality of care (Niazkhani et al., 2020). Such positions can be addressed by looking at the success of models like electronic health records, the use of telehealth and telemedicine and even artificial intelligence in care provision and reducing the cost of healthcare.


The Mobile Health Records Act of 2019 is a mobile version of EHRs and should be passed and enacted into law to enhance access to care and reduce the overall costs. The use of such technologies will also enhance patients’ participation in their treatment plans and interventions and allow them to make better informed choices and decisions.


Bouayad, L., Ialynytchev, A., & Padmanabhan, B. (2017). Patient health record

systems scope and functionalities: Literature review and future directions. Journal of Medical Internet Research, 19(11), e388.

doi: 10.2196/jmir.8073.

Congress.GOV. (2021). H.R.1390 – Mobile Health Record Act of 2019.

Dameff, C., Clay, B., Longhurst, C. A. (2019). Personal Health Records: More

            Promising in the Smartphone Era? JAMA, 321(4):339-340.

doi: 10.1001/jama.2018.20434.

Harahap, N. C., Handayani, P. W., & Hidayanto, A. N. (2021). Functionalities and

Issues in the Implementation of Personal Health Records: Systematic Review. Journal of medical Internet research, 23(7), e26236.

 doi: 10.2196/26236

Niazkhani, Z., Toni, E., Cheshmekaboodi, M., Georgiou, A., & Pirnejad, H.

(2020). Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review. BMC medical informatics and decision making, 20(1), 1-36.

doi: 10.1186/s12911-020-01159-1

Snezana, S., Kilintzis, V., Jakimovski, B., Jolevski, I., Beredimas, N., Mourouzis,

A., … & Trajkovik, V. (2020, September). Cloud Based Personal Health Records Data Exchange in the Age of IoT: The Cross4all Project. In International Conference on ICT Innovations (pp. 28-41). Springer, Cham.