Oregon’s First Black LGBTQ+ Nurse Lawmaker Is Passing Historic Laws for Nurses
"We have the power to change laws when we show up in the halls of power," Nelson says.
One of the many challenges facing the nursing industry is the inability for nursing care to be recognized as a billable service. Whereas everything from a single box of tissues to an ibuprofen tablet is billable during a hospital stay, nursing care is not. The skilled and professional work that nurses provide is lumped into a hospital stay, much like Jello or housekeeping.
Not only does the lack of billable nursing care affect the complicated finances of healthcare delivery, but it holds the nursing profession back as well. If nursing care is, on paper, equivalent to hospital jello, the entire nursing profession is reduced. Many nurses have been fighting to change the way the system works, and one such nurse, Travis Nelson BSN, RN, BC- Portland, Oregon, who just happens to be the State Representative House Dist. 44, North and NE Portland, saw major success in leading Oregon to become the first state in the country to allow nurses to bill Medicaid directly for care management services.
It's a small step in a long journey of change, but Nelson is up for the challenge. Here's more on what the State Representative is working on, why he is fighting AI on behalf of human nurses, and what he hopes to accomplish in the future.
The Long Game
Nelson is no stranger to playing the long game in politics because his journey into nursing was also a long and winding one.
"Nursing was a journey for me," he describes.
While Nelson explains that he initially thought he wanted to become a teacher, he switched to nursing and worked towards his goal of earning his Bachelor of Science in Nursing for an impressive 10 years, working full-time while he went to school. I got my first AA in 2003, my LPN in 2004, my ADN in 2005, and my BSN in 2010," he says.
Just as his political journey is varied, so too was Nelson's time as a nurse. He worked everywhere from Med-Surg to Critical Care to Case Management and also served as the charge nurse for an inpatient rehab unit.
He tells Nurse.org that he enjoyed his time on the rehab unit the most because it allowed him the most time with patients and provided the reward of seeing them improve over the course of their stay. "Many times, patients would come in on a stretcher and be discharged walking out of the building on their own," he recalls.
As his nursing care progressed, Nelson got involved with the nursing union, where he slowly uncovered his passion for politics. What started with simple candidate interviews and going door-to-door campaigning for pro-nursing candidates eventually ended up going to DC for President Obama’s inauguration in 2009, a moment he says "really kicked off" his involvement.
"I just kept volunteering and running for things," Nelson describes. "Next thing you know, I was a top campaign volunteer for multiple candidates. That led to me getting more involved in the state Democratic Party and then the DNC, before assuming public office."
Political Work
Today, Nelson is proud to serve as Oregon's first-ever Black LGBTQIA+ member in the state legislature. He was elected to the House of Representatives in January 2022, representing House District 44, and tells Nurse.org that his work as a state representative falls into three buckets: healthcare, worker rights, and equity work.
His official state biography speaks to his work ethic and proud history as a nurse and the grandson of Louisiana sharecroppers. He also shares with Nurse.org that he feels it's an "honor" to serve as the state's first Black openly LGBTQIA+ member.
"Only a handful of openly LGBTQ Black legislators have ever served in the entire country," he notes. "I take being the first in Oregon seriously and am doing what I can to ensure that the capital in Salem is a place where all are welcome to serve, regardless of race or sexual orientation."
Nelson is also a member of the Sierra Club, American Nurses Association, Oregon Coalition of Black Trade Unionists, the NAACP, and a former Vice President of the Oregon Nurses Association.
His involvement in both politics and nursing associations has been pivotal for much of the legislative efforts Nelson has worked on. For instance, he tells Nurse.org that both the passage of the Medicaid bill and his in-progress bill banning AI from labeling assistive technology as "nurses" were derived from his work with the American Nurses Association.
"There is a lot of crossover in nursing and politics," Nelson notes. "Both professions put problem-solving to the forefront. Being a nurse honed my communication skills and prepared me for the collaborative spirit needed in politics."
While both bills are awaiting final rulemaking to be signed into law, Nelson is hopeful that they will both support the future of the nursing profession for the better. For instance, he's passionate about preventing AI companies at the legal level from attempting to label their technology as "nurses."
"The bottom line is we want to reserve nursing titles for humans and not non-human entities," he says firmly. "Nurses go to school, get trained, take boards, and may provide a wide range of care that AI doesn’t do. I am glad that this bill has been sent to the governor. I look forward to her signing it into law."
The legislation allowing nurses to bill Medicaid directly for their services is also not finalized yet, but it's another action Nelson is proud to be a part of. He views the legislation as another piece of the autonomous puzzle for nurses that will ultimately improve patient care.
"Rulemaking is pending, but I see nurses being able to bill for care coordination independently instead of having an MD, PA, or ARNP be the middle person," he describes. "My hope is that there will be an improvement in patient outcomes."
Looking Toward the Future
Nelson's 2025 legislation session came to a close on July 1, with many successful bills under his belt that are now officially on their way to the governor to be signed. In addition to the Medicaid and AI bills, his other initiatives included legislation that aims to:
- Improve newborn screening
- Protect healthcare workers from workplace violence with prevention requirements
- Invests in behavioral health workers and safety
- Ensure only a Registered Nurse can supervise other nurses in a school setting (Hannah's Law)
- Improves sickle cell hospital protocols
- Improve child welfare data reporting
His legislative efforts directly show the impact that having a nurse working for you in the political scene can make. How many politicians would sponsor bills dedicated to things like school nurse supervision or newborn screening without the knowledge of a nurse? Nelson is proud of the crossover his careers provide, primarily for the changes they are able to make for patients and families.
"Whether it was serving as VP of the Oregon Nurses Association, working for the Washington State Nurses Association, or serving in the Oregon legislature, it has been an honor to advocate for nurses and patients in a meaningful way," he says. "In my very first long session, I was a chief sponsor of the bill that made Oregon the only state in the nation to put nurse-to-patient ratios in statute. That’s the kind of impact nurses can have when we run for office!"
As Nelson looks forward to some much-deserved downtime—"I can't wait to get more time in my vegetable and flower garden!" the gardening enthusiast gushes—he also tells Nurse.org that he's looking forward to getting back to work with the Washington State Nurses Association as well.
He also encourages his fellow nurses and nursing students to get involved at the political level, whether it's at a small level or a larger platform. "Get involved in your union or state professional association—go to political townhalls, run for office, or establish relationships with your local elected officials!" he says.
Nelson is a believer that nurses have the power to change the future because they are the voice and hands that people trust.
"Nurses have an incredibly strong voice when they use it," he notes. "It is no accident that nurses have been the most trusted professionals for more than 20 years. People love and respect nurses, and we have the power to change laws when we show up in the halls of power."
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