Appropriations Watch: Fiscal Year 2020

The Committee for a Responsible Federal Budget tracks appropriations legislation as it progresses from committee to the House and Senate floor, and to the President's desk to be signed into law. The 2020 fiscal year began on October 1, 2019. A continuing resolution (CR) funds the government through November 21. The House and Senate are expected to use the next few weeks to continue negotiations on full appropriations for the rest of FY 2020.

Additional information can be obtained at https://www.crfb.org/blogs/appropriations-watch-fy-2020.

How Private Equity Helps Increase Health Care Prices

During the past decade, private equity and venture capital firms have ramped up their investment in health care, buying up everything from physician practices and health technology start-ups to addiction treatment facilities. An essay from the Commonwealth Fund argues that investors will benefit most if they add true value to the U.S. health system. 

The essay can be obtained at https://hbr.org/2019/10/the-role-of-private-equity-in-driving-up-health-care-prices.

RWJ Fellows Program Applications Due Next Week

Applications to become one of six Robert Wood Johnson Foundation Fellows are due next week. The Fellowship provides up to $165,000 for a midcareer health professional to work in federal health policy issues in Washington, DC beginning on September 1, 2020.  

The application can be found here
More information about the RWJ Fellows program can be found here

House Passes the EMPOWER for Health Act to Reauthorize Title VII Workforce Programs and New Diversity Grants

On Monday the U.S. House of Representatives passed H.R. 2781, the Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 by voice vote. The bill, which reauthorizes Title VII HRSA health professions workforce programs including the Geriatrics Workforce Enhancement Program and Geriatric Academic Career Awards, also includes the Allied Health Workforce Diversity Act, which authorizes funding for a new grant program to increase educational opportunities in the professions of physical therapy, occupational therapy, audiology, and speech-language pathology.

Rep. Bobby L. Rush (D-IL), said, “I am pleased that the underlying bill includes my legislation: the Allied Health Workforce Diversity Act. The current lack of diversity in the Allied Health industry is shocking.  Many patients of color, whether they are seeking physical therapy, occupational therapy, or similar forms of health care, are unable to be find a provider who is a person of color, and research has shown us that this lack of diversity leads to worse healthcare results for these patients…My amendment will only serve to strengthen the EMPOWER for Health Act by authorizing the necessary funding to diversify allied healthcare providers, ultimately leading to better outcomes for all patients.”

ASAHP is grateful towards the U.S. House of Representatives, including key leaders on this bill such as Rep. Frank Pallone, Rep. Greg Walden, Rep. Bobby L. Rush, Rep. Jan Schakowsky, Rep. Michael C. Burgess, M.D., and Rep. McMorris Rodgers. The EMPOWER for Health Act was introduced in May and passed the Energy and Commerce Committee unanimously in July. The Senate has yet to move forward with their Title VII reauthorization and Allied Health Workforce Diversity Act bills.

H.R. 2781 may be accessed here: https://docs.house.gov/billsthisweek/20191028/BILLS-116hr2781-SUS.pdf

A press release from Rep. Bobby L. Rush may be accessed here: https://rush.house.gov/media-center/press-releases/rush-legislation-to-diversify-allied-healthcare-providers-passes-house-0

A press release from Rep. Jan Schakowsky may be accessed here: https://schakowsky.house.gov/press-releases/house-passes-schakowsky-burgess-empower-for-health-act/

A press release from Rep. Burgess, M.D., may be accessed here: https://burgess.house.gov/blog/?postid=402229

A press release from Rep. McMorris Rodgers may be accessed here: https://mcmorris.house.gov/mcmorris-rodgerss-allied-health-workforce-diversity-act-passes-house/

Open Enrollment For Individual Health Insurance Market Begins November 1

Consumers in many states who would like to learn about 2020 individual market health plans, prices and quality rating information now can do so. Open enrollment through the federally facilitated exchange and most state exchanges will become available on November 1, 2019 and end on December 15 of this year.  

More information can be obtained at www.HealthCare.gov.

Potential For Public Plans To Reduce Premiums Of Competing Insurers

Considerable interest exists in making a public option available in the Affordable Care Act (ACA) non-group marketplaces. A report from the Urban Institute analyzes commercial insurers’ experiences competing in marketplaces with managed-care organizations, which, prior to ACA implementation, only offered coverage within public programs (either Medicaid only or Medicaid and Medicare). 

The report can be obtained at https://www.urban.org/sites/default/files/publication/101221/is_there_potential_for_a_public_option_to_reduce_premiums_of_competing_i_1.pdf.

2020 ASAHP Leadership Development Program Now Accepting Applications

In 2005, the Association’s Board of Directors approved the creation of a leadership development program aimed at individuals in ASAHP member institutions. The eighth iteration of this offering will occur in 2020 with Part I scheduled for May 15-16 in Columbus, Ohio. Part II will take place in Long Beach California on October 26-27 immediately prior to the 2020 Annual Conference, which is on October 28-30.

Individuals who are accepted for the program also will be expected to register and participate in the Annual Conference and pay the full registration costs for that meeting.

The program will feature outstanding guest speakers who possess significant expertise and experience in various aspects of higher education administration. The period between May and October will be devoted to a combination of team projects. Participants will have the opportunity to pursue issues of interest while also developing personal leadership skills.

· No fewer than 10 and not more than 16 participants will be selected. Normally, no more than one person will be chosen from any single member institution.

· Eligible applicants: Priority will be given to department chairpersons/directors, associate/assistant deans, and new deans (appointed within the previous 24 months at the time of applying). Others would be considered based on space availability. Self-nominations are permissible.

· The registration fee for each participant is $1,500. Expenses for lodging, travel, conference registration, and meals will be the responsibility of either the individual participant or the institution.  

· Applications must be submitted electronically by November 30, 2019 to jacoby@asahp.org  

The application form may be found here.  Participants will be notified of their selection in January 2020.

How Measures Are Brought to the Floor Of The U.S. Senate

A new report from the Congressional Research Service (CRS) describes two basic methods the Senate uses to bring legislation to the floor for consideration: (1) The Senate, at the majority leader’s request, grants unanimous consent to take up a matter or (2) it agrees to his motion to proceed to consider it.  

The report can be obtained at https://fas.org/sgp/crs/misc/RS20668.pdf.

The Pathways to Health Careers Act of 2019 Advances in House

Today, the House Ways and Means Committee advanced, as amended, H.R. 3398, The Pathways to Health Careers Act of 2019, by a vote of 24-16. The bill, which House Democrats introduced earlier this year, reauthorizes the Health Profession Opportunity Grant (HPOG) program at significantly increased funding levels and greatly expands opportunities for individuals to develop the education and skills required to enter a host of allied health professions and nursing, particularly for low income individuals. 

Committee Chairman Richard E. Neal (D-MA), said, “this legislation will make the Health Profession Opportunity Grant program, which has a proven track record of success, available to workers in all 50 states, tribal communities, and the U.S. territories. Not only do HPOGs help struggling Americans get good jobs, they also strategically address our country’s health worker shortage.”

ASAHP worked closely with House Committee staff in support of this legislation.

Chairman Neal’s Opening Statement may be accessed here.

Chairman Neal’s statement upon passage may be accessed here.

H.R. 3398 may be accessed here

HPOG Fact Sheet may be accessed here.

Impact Of Medicare For America On The Employer Market And Health Spending

The Medicare for America Act of 2019 (H.R. 2452) was introduced into the House of Representatives on May 1, 2019. If enacted, this legislation automatically would enroll much of the U.S. population into a single federal comprehensive health insurance program. A study by KNG Health Consulting estimates that it would result in nearly one in four workers previously offered employer-sponsored insurance losing access to it by 2023 and one in three by 2032. 

The report can be obtained at https://www.aha.org/system/files/2019-03/the-impact-of-medicare-X-choice-final-report-2019.pdf.

 

HPNEC Hill Briefing on HRSA Workforce Development

The Health Professions and Nursing Education Coalition (HPNEC), of which ASAHP is a member, will be holding a hill briefing on Wednesday, October 30, from 12-1 pm in 485 Russell Senate Office Building,  titled “HRSA Workforce Development: Innovating our Health Care Pipeline, Training, Delivery Systems”. The briefing, which aims to educate congressional staffers, will include the following speakers:

• Ellen Flaherty, PhD, MSN, APRN, Assistant Professor of Medicine, Geisel School of Medicine, Co-Director, Dartmouth Centers for Health and Aging, Dartmouth-Hitchcock Medical Center

• Marja Hurley, M.D, Professor of Medicine and Orthopedic Surgery, Associate Dean Department of Health Career Opportunity Programs, Founding Director, Aetna Health Professions Partnership Initiative, University of Connecticut Health Center

• Lepaine Sharp-McHenry, DNP, RN, FACDONA, Dean of the College of Natural, Behavioral, and Health Sciences, Simmons University

More information can be found here.

Guidelines Updated To Prevent Infections In Health Care Personnel

The Centers for Disease Control and Prevention on October 18 released an update to its 1998 guidelines to prevent and control infection in the health care workplace, including special considerations associated with emergency response personnel and the Americans with Disabilities Act. Intended for health care leaders and staff who address workplace health and safety, the updated guidelines apply to a broader range of health care settings, including hospital-based, long-term care, and outpatient settings.  

The update can be obtained at https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/exec-summary.html?deliveryName=USCDC_425-DHQP-DM11130.

House Democrats Introduce HEA Reauthorization Bill

Chairman Bobby Scott just released a detailed fact sheet and title by title summaries for his HEA reauthorization bill, the College Affordability Act. He will be doing a press conference with Speaker Pelosi this afternoon at 3:30PM. Please find links below.

House Education & Labor Press Release

The College Affordability Act - Fact Sheet

The College Affordability Act - Title by Title

CAA At a Glance -- SKILLED WORKFORCE

CAA At a Glance -- QUALITY

CAA At A Glance -- LOANS

CAA At A Glance -- EQUITY

CAA At A Glance -- COST

Department of Veterans Affairs Long Standing Workforce Problems

A report from the Government Accountability Office (GAO) indicates that turnover in key occupations threatens VA’s ability to deliver on its mission. Specifically, about a third of VA’s workers in 2017—including many senior leaders—would be eligible to retire by 2022. Some allied health professions are mentioned as being mission-critical occupations and clinical occupations. 

The report can be obtained at https://www.gao.gov/assets/710/702032.pdf.

Creating A Diverse Student Success Infrastructure

A new report from the American Council on Education (ACE) shares a road map for institutions to create and implement a systemic approach to student success for a diverse student population, including cross-functional collaboration and shared, equity-minded leadership. 

The report can be obtained at https://www.acenet.edu/Documents/Creating-a-Diverse-Student-Success-Infrastructure.pdf.

Unsupported Drug Price Increases

Net price increases for seven drugs raised U.S. drug spending by $5.1 billion between 2017 and 2018 without evidence of improved safety or effectiveness, according to the first annual report by the Institute for Clinical and Economic Review on the costliest U.S. drug price increases unsupported by clinical evidence. For example, the average U.S. price for Humira, a drug used to treat chronic illnesses such as rheumatoid arthritis and ulcerative colitis, increased 15.9% over the period after accounting for rebates and other concessions, which increased spending on the drug by an additional $1.86 billion. 

The report can be obtained at https://icer-review.org/wp-content/uploads/2019/01/ICER_UPI_Final_Report_and_Assessment_100819_Final.pdf.

Pre-Existing Condition Prevalence For Individuals And Families

An estimated 27% of adults under age 65, or 53.8 million, had a preexisting health condition in 2018, according to a study released by the Kaiser Family Foundation. State estimates range from 22% in Colorado to 37% in West Virginia, based on 2018 data from the National Health Interview Survey.   

The study can be obtained at https://www.kff.org/health-reform/issue-brief/pre-existing-condition-prevalence-for-individuals-and-families/?utm_campaign=KFF-2019-Health-Reform&utm_source=hs_email&utm_medium=email&utm_content=2&_hsenc=p2ANqtz-_WXUXBNGEfmzYezTz9s3OXrJwZIuaZver07OJKagAYpQn_OR2E2MVPuVDPAwicDqGDNCM2qeBnVKZF4bc9vQn6DsRNaw&_hsmi=2.

ASAHP and Other Health Organizations Send Amicus Brief to the United States Supreme Court in Support of DACA recipients

On November 12th, the Supreme Court will hear oral arguments in the Department of Homeland Security v. Regents of the University of California case challenging the rescission by the Trump Administration of the Deferred Action for Childhood Arrivals (DACA) program.

ASAHP, along with 32 other health and higher education associations, sent an Amicus Brief in support of the DACA program and its students and practitioners in health related professions. Please find a link to the Amicus Brief here.

 

Funding To Improve Social Determinants Of Health

The GrantWatch column in the September 2019 issue of the journal Health Affairs describes funding by foundations that addresses either of two social risk factors: food insecurity and inadequate housing. Examples are provided of endeavors that obtained financial support. 

The article can be obtained at https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2019.01013.