VA Employee Fairness Act: 7 Things to Know

Gayle Morris, MSN
Updated November 10, 2022
    The VA Employee Fairness Act affects the nursing profession and patient outcomes in the VA system. Understand the facts and how to help.
    Featured ImageCredit: Getty Images
    • The VA Employee Fairness Act gives nurses and doctors in the VA healthcare system the right to collective bargaining and to report potentially deadly policies without fear of discipline or retaliation.
    • The bill is currently in the House of Representatives where it has acquired over 200 cosponsors and needs to be passed before moving to the Senate.
    • If the bill makes it to the Senate, it will be a historic advancement for legislation that gives VA nurses collective bargaining rights.

    Did you know that Veterans Affairs (VA) nurses do not have the same collective bargaining rights as nurses in public or private hospitals? This has significantly affected patient care and working conditions for the staff. During the COVID-19 pandemic, conditions in the workplace slipped even further.

    Although VA nurses can demonstrate after work or on their lunch break, employers are not obligated to listen to or address the grievances. The VA Employee Fairness Act can help change this and improve conditions for nurses and patients.

    However, there is a short time line to accomplish the goal. Discover how you can help.

    1 | What Is the VA Employee Fairness Act?

    On March 16, 2021, the VA Employee Fairness Act was introduced to the House by House Committee on Veterans’ Affairs Chairman Mark Takano (D-Calif.) and Senator Sherrod Brown (D-Ohio). It is meant to level the playing field, so nurses, doctors, dentists, and physician assistants in the VA healthcare system can have the same workplace rights that other federal employees have.

    “The nurses, physicians, dentists, physician assistants, and other healthcare workers at our nation’s VA medical centers, many of whom are veterans themselves, are the best at what they do,” said Senator Brown in a press release. “Expanding the right to collectively bargain is one of the most important tools we can use to empower these workers and ensure they have a voice in the workplace.”

    The VA Employee Fairness Act ensures that health professions have the same collective bargaining rights other federal employees have had since 1991. Under Section 7422 of Title 38, healthcare providers have been exempt from this right on any matter that affects professional conduct or competence, compensation, or peer review.

    Title 38 Section 7422 addresses collective bargaining for healthcare providers in the federal healthcare system. The section is not specific but instead gives authority to the current Veterans Affairs Secretary to interpret the language. It states that “professional conduct or competence” means direct patient care or clinical competence.

    One problem that nurses in the VA system have had to contend with is the broad interpretation of the code taken by the secretary. Government Executive reports this has included “declaring proficiency ratings and cash awards nonnegotiable.” The American Federation of Government Employees (AFGE) had proposed provisions like retention incentives but were told those were nonnegotiable.

    2 | What’s the Time Line?

    In May 2021, the House Veterans Affairs Committee voted to send the bill to the floor. However, there has not been any further action since then. So far, there are more than 200 bipartisan cosponsors in the House.

    The leaders from two federal employee unions issued statements in September 2022, calling for the bill to be called up and passed by House members. The AFGE and the National Federation of Federal Employees (NFFE) together represent over 800,000 federal employees.

    Experts estimate the successful passage of the VA Employee Fairness Act has a limited time line. The current Congress has a break during midterm elections and then ends at the end of the year. Bills not passed before Congress ends in December 2022 must be reintroduced in the new Congress the following year.

    The concern is that Republicans have historically been opposed to the VA Employee Fairness Act. Experts estimate that if Republicans gain control of Congress after the midterm elections, it could push this legislation back at least another two years.

    3 | Can You Put This Into Context?

    Currently, VA nurses do not have the same rights to strike and engage in collective bargaining as private-sector nurses. Government and nurse unions, including the NFFE, AFGE, and the National Nurses United (NNU) have banded together to push for a vote on this legislation.

    The House Veterans Affairs Committee advanced the VA Employee Fairness Act to the floor in May 2021, but there has been no movement since then. Support within Congress for the bill has slowly gained traction. Advocates are waiting for the bill to receive 218 cosponsors.

    If the bill makes it to the Senate, it will be the first time any legislation that gives VA nurses collective bargaining rights progresses this far in the legislative process.

    4 | What Happens If It Passes?

    If the VA Employee Fairness Act is passed, it would give healthcare workers, including nurses, nurse practitioners, physicians, and physician assistants, full collective bargaining rights. This would allow them to negotiate for better working conditions, compensation, and patient care decisions.

    Alma Lee is the president of AFGE’s National VA Council. In a press release, she called the hardworking healthcare providers in the VA healthcare system “our nation’s heroes.”

    “For decades, the VA has been chronically understaffed, losing medical professionals to private sector practices that provide better working conditions and competitive salaries,” she said. “To ensure our VA is fully equipped to serve our veterans, it is critical that all VA workers have a voice on the job, regardless of their job title.”

    The NFFE national president, Randy Erwin, acknowledges that VA nurses may report inefficiencies or potentially deadly policies, but not without fear of discipline or retaliation. The VA Employee Fairness Act would protect healthcare providers from oversight authorities.

    “VA healthcare professionals are the best in the business because they understand the complex and unique needs of our nation’s veterans. The VA is not the place to suppress whistleblower laws or the professional opinions of those responsible for providing treatment and healthcare at the VA,” he said in a press release.

    5 | What This Means for Nurses

    In addition to giving nurses an avenue to express their concerns over working conditions, compensation, or patient care outcomes, it is a critical vehicle to recruit and retain top nursing talent within the VA hospital system.

    The VA is currently strained with low staffing levels and funding issues. Erwin believes the VA Employee Fairness Act will give frontline workers a voice and help hospitals fill thousands of vacant positions. High-quality nursing staff want the ability to contribute ideas and constructive criticism that affects their working conditions and patient outcomes.

    Ensuring an avenue that allows collective bargaining may increase the number of qualified applicants who are hired and remain employed within the VA healthcare system and improve patient care.

    6 | How the VA Employee Fairness Act Would Impact Patients

    Passing the act and allowing collective bargaining and protection of VA healthcare employees also would benefit the patients. Research published in 2016 showed that successfully unionized hospitals outperformed nonunion hospitals in 12 of 13 factors.

    According to research, the largest performance changes are experienced in the first year the hospital was unionized, and the largest impact is felt in patients with pulmonary failures, metabolic dysfunction, and central nervous system disorders. These improvements range from 15% to 60%.

    Patient advocacy requires nurses to speak up to management without fear of repercussions. Nurses must be able to resolve disputes over issues that could endanger patient safety, such as safe nurse-to-patient ratios, insufficient supplies, or nurses with inadequate training.

    7 | How Can You Help?

    The VA Employee Fairness Act must pass the House before being considered by the Senate. Nurses can contact their representatives in the federal House of Representatives to encourage them to support the bill being brought to the floor.

    Nurses can also preemptively contact their Senators. After the act has passed the House, the Senate must bring it to the floor quickly and vote to pass it before Congress adjourns in December. You might choose to write an email or call their office.

    You can find the contact information for your House representative by scrolling to your state and choosing the representative from your district. Their phone number and committee assignments are listed. If you aren’t sure of your district, you can also search by zip code.

    Two Senators represent each state. You’ll find their contact information by searching your state from the drop-down menu. You’ll have their address, phone number, committee assignments, and a link to their website.

    Nurses can support VA nurses by voicing their support of this act directly to your representatives.