Adelita Grijalva

Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2025

This bill requires hospitals to implement and submit to the Department of Health and Human Services (HHS) a staffing plan that complies with specified minimum nurse-to-patient ratios by unit. Hospitals must post a notice regarding nurse-to-patient ratios in each unit and maintain records of actual ratios for each shift in each unit. The bill also requires hospitals to follow certain procedures regarding how ratios are determined, and other staff are prohibited from performing nurse functions unless specifically authorized within a state's scope of practice rules.

HHS must adjust Medicare payments to hospitals to cover additional costs attributable to compliance with these ratios.

Nurses may object to, or refuse to participate in, an assignment if it would violate minimum ratios or if they are not prepared by education or experience to fulfill the assignment without compromising the safety of a patient or jeopardizing their nurse's license. Hospitals may not (1) take adverse actions against a nurse based on the nurse's reasonable refusal to accept an assignment; or (2) discriminate against individuals for good faith complaints relating to the care, services, or conditions of the hospital or related facilities. HHS may impose civil monetary penalties on hospitals violating the ratio requirements and must publish the names of such hospitals.

The bill provides stipends to the nurse workforce loan repayment and scholarship program and expands the nurse retention grant program to include nurse preceptorship and mentorship projects.

Infant Formula Safety Modernization Act of 2026

This bill directs the Food and Drug Administration (FDA) to expand requirements for the testing of infant formula and formula manufacturing facilities for pathogens and microorganisms.

Current regulations generally require manufacturers to test finished formula products for Cronobacter and Salmonella. The FDA tests manufacturing facilities for these contaminants in regular inspections, but manufacturers are not required to test their own facilities.

Within 90 days of the bill's enactment, the FDA must issue a final rule requiring manufacturers to test their facilities and finished formula products for certain pathogens and microorganisms, including Clostridium botulinum (which causes botulism). These regulations must include a recommended frequency for facilities testing, including requirements for testing different areas based on their proximity to formula products.

Manufacturers must notify the FDA within one business day of any positive result for one of the specified pathogens or microorganisms in a finished formula product, even if the product is still in the manufacturer’s possession. (Currently, notice is required only if the affected product has left the manufacturer’s facilities.) Manufacturers must also retain records of any positive result (from a test of formula or facilities).

The FDA must notify Congress within one business day of

• receiving notice of a positive test result for a finished formula product, or

• recommending official corrective action to address the findings of a facility inspection.

Finally, the regulations must explicitly require the FDA to enforce consistent inspection and compliance standards for all formula products, including imported products.

Public Health Nursing Act

This bill establishes a grant program within the Department of Health and Human Services to support a public health nursing workforce in state, territorial, and local public health departments.

This joint resolution redesignates the memorial to Robert. E. Lee in Arlington National Cemetery as the Arlington House National Historic Site.

Equal Access to Justice for Victims of Gun Violence Act of 2025

This bill removes limitations on the civil liability of gun manufacturers and the disclosure of gun trace data in civil actions.

Specifically, the bill repeals the Protection of Lawful Commerce in Arms Act, which prohibits civil actions against a firearm or ammunition manufacturer, seller, importer, dealer, or trade association for damages resulting from the criminal or unlawful misuse of a firearm.

Additionally, the bill states that firearms trace data maintained by the Bureau of Alcohol, Tobacco, Firearms and Explosives is not immune from legal process. Such data is subject to discovery; is admissible as evidence; and may be used, relied on, or disclosed in a civil action or administrative proceeding.

Alternatives to Prevent Addiction In the Nation Act or the Alternatives to PAIN Act

This bill reduces cost-sharing and prohibits the imposition of certain utilization requirements under the Medicare prescription drug benefit for certain non-opioid pain management drugs.

Specifically, the bill requires such drugs to be covered without a deductible and to be placed on the lowest cost-sharing tier (if any). The bill also prohibits the imposition of prior authorization requirements (i.e., requiring prior approval from a plan) or step therapy requirements (i.e., requiring the use of alternative drugs before a drug is covered under a plan) with respect to such drugs.