Bipartisan, MOAA-supported legislation that would allow military treatment facilities (MTFs) to retain experienced civilian nurses is one step closer to becoming law with its inclusion in the Senate version of the FY 2025 National Defense Authorization Act (NDAA). The provision is also part of the House-passed NDAA, increasing the likelihood it will be included in the final bill.

The legislation, which was introduced as a standalone bill in November as the Retain Educated Workers and Registered Nurses Developing (REWARD) Experience Act, would let MTF hiring managers waive certain regulations that drive many providers out of MTFs when they obtain a higher nursing degree.

The REWARD Act supports an updated strategy aimed at stabilizing the military health system (MHS). The deputy secretary of defense signed a memo Dec. 6 requiring the MHS add capacity to reattract patients and beneficiaries, improve access to care in military hospitals and clinics, and increase opportunities to sustain military clinical readiness for medical forces. 

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The memo addressed the dual mission of the MHS: providing medically ready forces while simultaneously delivering quality care to beneficiaries. As the memo states, doing so effectively “requires a stable, predictable workforce sufficiently staffed, trained, and routinely available to provide health care to our beneficiaries.”

Meeting the Staffing Mission

Both MHS and civilian medical centers across the U.S. have been plagued with staffing challenges since the COVID pandemic, which led to many nurses leaving clinical roles.

Further issues stemmed from the congressionally directed MHS reorganization shifting authority, direction, and control of all MTFs to the Defense Health Agency.

The transition has been characterized as “the largest reorganization and transformation in DoD since the establishment of the Air Force in 1947,” according to a Defense.gov article announcing the stabilization strategy.

How the Legislation Helps MTFs Retain Experienced Nurses

An example under the current system: A licensed practical nurse (LPN) starts in the federal General Schedule (GS) system at an MTF and earns a diploma or bachelor’s degree in nursing while working. By the time the nurse graduates, they have been promoted to a GS-6 position.

If that nurse wants to move into a registered nurse (RN) role, they would only be qualified for a GS-5 position because they don’t meet the requirement for qualifying experience in an equivalent position. They would effectively be taking a pay cut for increased responsibility within an institution they are already likely more well-equipped to support than an outside hire with more experience.

NDAA language from the REWARD Act would allow hiring managers to waive this requirement, giving them a path to retain skilled personnel.

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MOAA appreciates the REWARD Act addressing civilian staffing challenges, and we thank the lawmakers who have led this effort on Capitol Hill, including Sens. Patty Murray (D-Wash.) and Ted Budd (R-N.C.), and Rep. Marilyn Strickland (D-Wash.).

Keep up with the latest on this issue and others included in ongoing NDAA discussions by visiting MOAA’s Advocacy News page.