Gainful Employment Rule And Student Loan Repayment

A brief from the Urban Institute estimates loan repayment rates in the Biden administration’s new income-driven repayment (IDR) plan before and after the gainful employment (GE) rule goes into effect. 

The brief can be obtained at https://www.urban.org/sites/default/files/2023-07/How%20the%20Gainful%20Employment%20Rule%20Will%20Affect%20Student%20Loan%20Repayment.pdf.

Senate Appropriations Committee Advances FY 24 Labor-HHS-Education Spending Bill

The Senate Appropriations Committee marked up its Labor-HHS-Education bill earlier today, which was approved by a bipartisan vote of 26-2. It provides $224.4 billion overall for programs within its jurisdiction, a 1% cut below current levels and in stark contrast to the 28% overall cut proposed in the House version of the bill. The Senate Labor-HHS-Education bill includes $79.6 billion in discretionary funding for the Department of Education and $117.0 billion in discretionary funding for the Department of Health and Human Services. The bipartisan Senate markup includes a $250 increase for the maximum Pell Grant.

“The bill provides $35 million more for the Mental Health Block Grant over fiscal year 2023 and includes $172 million for the Behavioral Health Workforce Education and Training Program, a $19 million increase over fiscal year 2023, to expand community-based clinical training and for repayment of education loans for individuals working in either a Mental Health Professional Shortage Area or where the overdose death rate exceeds the national average. Additionally, the bill provides $400 million for Certified Community Behavioral Health Clinics, a $15 million increase over fiscal year 2023, and an $18 million increase over fiscal year 2023 for the 988 Suicide Prevention Lifeline, building on the nearly $400 million increase in fiscal year 2023. The bill also includes over $100 million in investments within the Department of Education to address the shortage of school-based mental health professionals in our nation’s K-12 schools.”

“The bill protects essential funding to address public health threats, improve health care access and affordability, and strengthen the health care workforce. This includes: $1.86 billion for Community Health Centers, including $55 million for school-based health centers; $1.4 billion for Health Professions Workforce Development; $1.2 billion for the core Maternal and Child Health programs; $341 million for the Improving Maternal Health Initiative to combat the unacceptable levels of maternal mortality; and $4.1 billion for the Centers for Medicare and Medicaid’s administrative needs.”

In her opening remarks, Ranking Member Collins noted that the bill “invests in workforce training, including funding to increase the number of geriatric health professionals…[and] provides significant resources for substance abuse prevention and treatment programs and mental health programs.” Her press release noted the inclusion of “$302.5 million for Title VIII Nursing Workforce programs, an increase of $2 million above the FY23 enacted level, $48.2 million for HRSA Geriatric workforce education programs, which include the Geriatrics Workforce Enhancement Program and Geriatric Academic Career Awards, and $172 million for Behavioral Health Workforce Education and Training, an increase of $19 million above the FY 23 enacted level.”

The Senate Labor-HHS-Education bill text is here, report is here, summary is here, and resource page which should be updated by the Committee with further details is here. Sen. Murray’s remarks are here and a joint statement from Chair Murray and Ranking Member Collins is here.

Congress is leaving town for an extended summer recess with the Senate returning to session on September 5 and the House not slated back until September 12. That leaves only eleven legislative days with both chambers in session before the end of the fiscal year, with none of the twelve appropriations bills having been enacted, foreshadowing a busy September.

2023 ASAHP Regional Summit Recap

The Association of Schools Advancing Health Professions hosted its 4th Annual ASAHP Regional Summit hosted by ASAHP’s Interprofessional Committee This year’s theme focused on “Joining Forces to Build a Resilient, Collaborative and Practice-Ready Healthcare Workforce” and sought to promote dialogue between academic institutions and their health care industry partners to improve collaboration and enhance health outcomes.

ACE Holds Forum on Proposed Distance Education, State Authorization Regulations

On Tuesday, ACE, in collaboration with the Presidents Forum, hosted an in-person event on Capitol Hill to examine the Department of Education’s (ED) draft regulations regarding distance education and state authorization. Panelist’s explored how ED’s proposed rules to upend the current state reciprocity agreement would create challenges for institutions offering distance education courses and their students, while also discussing a better way forward.

More details may be accessed here.

New America Webinar on Protecting Racial Equity in Higher Education

On Tuesday, July 18, New America will host a webinar entitled, “From Enrollment to College Completion: What Can Federal Policymakers Do to Protect Racial Equity in Higher Education?”. The event will consist of two panel discussions with affirmative action experts and students.

More details, including a registration link, are available here.

House Advances FY 24 Labor-HHS-Education Funding Bill

The House Labor-HHS-Education Appropriations Subcommittee marked up its FY 24 funding bill last week, passing it along party lines. The overall funding level for the bill is 29% below the FY 23 level. Amendments to the bill were held off until full Committee markup, which may be held next week, though it has not yet been announced. The Department of Education would receive a 28% overall cut. The House Appropriations bills have $119 billion less than the spending caps agreed to earlier this year in the bipartisan debt limit agreement. However, successful House-Senate negotiations later this year will require compromise and the support of moderates in both parties to achieve enough votes for final passage. The Senate Labor-HHS-Education bill is expected to be marked up in Subcommittee on July 27th. After next week, the House is scheduled to be on recess for five weeks and the Senate is scheduled to be on recess for six weeks.

Bill text and the House Republican summary may be accessed here. The House Democratic summary may be accessed here.

 

Protecting Consumers And Lowering Health Care Costs

A new report from the U.S. Department of Health and Human Services (HHS), announced actions to protect consumers from junk health plans, surprise medical bills, and excess costs that lead to medical debt.  

More information is available at https://www.cms.gov/newsroom/press-releases/hhs-announces-actions-protect-consumers-and-lower-health-care-costs.

Upcoming Webinar: Innovative Clinical Fieldwork: Thinking out of the box

This webinar hosted by ASAHP’s Clinical Education Committee on Thursday, July 13 at 2:30pm ET will highlight innovative clinical experiences developed to promote Occupational Therapy & Physical Therapy students’ readiness for professional practice, general considerations for establishing and implementing role emergent/community-based intra and interprofessional clinical experiences, & the benefits of these experiences from the academic program, supervisor, and student perspective. 

Aims of presentation:

  1. Provide suggestions of some innovative clinical opportunities and some general considerations when programs when establishing and implementing role emergent/community-based immersive clinical experiences. 

  2. Consider ways to enhance Intra & interprofessional opportunities for collaboration during clinical field experiences. 

  3. Identify some of the benefits of creating innovative/role emergent community-based clinical/fieldwork programs from the perspective of the academic program, clinical field instructors, and from a former OT student.

 

Jeanne Coviello:
Jeanne Coviello has over 35 years' experience as an OT. She is one of two, Academic Fieldwork Coordinators and an Assistant Professor for Temple University’s OT program. Jeanne is an active member of both AOTA and POTA. Professional activities include scholarly publications and presentations at state, national, and international conferences. She has served as a board committee member for the AOTA Test Prep Product. She has extensive experience working in adult rehabilitation settings, both at staff and clinical management levels. Jeanne earned her OTD in 2018 from Thomas Jefferson University. Her research interests include students' development of clinical & professional reasoning during Level II fieldwork and intraprofessional collaborative (OT & OT Assistant) learning. 

Jessica Dunn:
Dr. Dunn is currently the Director of Clinical Education at Seton Hall University in Nutley, NJ. She joined the faculty in 2021 and currently teaches within her specialty area. As a physical therapist with 23 years of experience in the post-acute environment, Dr. Dunn has been a leader and advocate for students in this clinical setting. Jessica served as Clinical Director for Powerback Rehab and was instrumental in creating a vision and structure for the student program in the ever-changing post-acute environment. Not only has she developed several resources to support clinical instructors with student orientation and supervisory responsibilities, she put systems in place to ensure an organized, challenging and fulfilling student education experience. In addition, she has personally guided countless clinical instructors and students work through supervisory and/or performance challenges during the experience.

Lina-Maria Garcia:
Dr. Lina-Maria Garcia, OTD, OTR/L, is an occupational therapist and assistant professor of instruction in Temple University's doctoral OT program. Though originally from Queens, NY and Lynn, MA, she earned her Bachelor's in psychology (LaSalle University), Master's in occupational therapy (University of the Sciences), and clinical Doctorate in occupational (Temple University), as a Philadelphia native. Prior to her current role, Lina worked alongside Temple students as an OT FW level 1 preceptor and level 2 Fieldwork Supervisor for community settings, supporting programming through consultation and design services. Additionally, she worked in skilled nursing facilities (SNFs) in Cincinnati, Ohio, serving an adult population with a range of psychiatric diagnoses, history of drug and alcohol abuse, and people affected by homelessness and social instability. In her 11 years as a practicing clinician, Lina has worked as both a staff and travel OT in home health and long-term care settings in Philadelphia, Boston, Los Angeles, and Cincinnati. She is a board member for Ladies of Leadership, Cincinnati, where she was a 4-year mentor to underserved youth and continues to support mentor onboarding efforts and curriculum development using an OT lens.

Annmarie Murphy:
Dr. AnnMarie Murphy is an Occupational Therapist with advanced training and certification from the Sensory Treatment and Research (STAR) Institute, specializing in the evaluation and treatment of Sensory Processing Disorder. AnnMarie holds a Master of Science in Occupational Therapy from American International College as well as a Doctorate in Occupational Therapy from Temple University. AnnMarie's primary research area is on the impact of sensory processing on chronic conditions. AnnMarie is on the research team at Great Kids, working on the validity and reliability of the Sensory Emotion Engagement Framework to gain insight and understanding of the relationship among sensory processing and social emotional challenges. She is an Adjunct at Temple University and Level II fieldwork supervisor. 

White House Announces New Actions to Provide Debt Relief and Support for Student Loan Borrowers

This afternoon, after the Supreme Court struck down the Biden Administration’s student loan debt forgiveness plan, the Administration announced new actions to provide debt relief and support for student loan borrowers. The Secretary of Education initiated a rulemaking process aimed at opening an alternative path to debt relief, using the Secretary’s authority under the Higher Education Act. The notice announces a virtual public hearing from 10am to noon and 1 to 4pm on July 18 and solicits written comments from stakeholders on topics to consider.

Also, today the Department of Education finalized the Saving on a Valuable Education (SAVE) plan, ensuring that borrowers will be able to take advantage of this plan this summer—before loan payments are due. Many borrowers will not have to make monthly payments under this plan. Those that do will save more than $1,000 a year.

In addition, the Department is instituting a 12-month “on-ramp” to repayment, running from October 1, 2023 to September 30, 2024, so that financially vulnerable borrowers who miss monthly payments during this period are not considered delinquent, reported to credit bureaus, placed in default, or referred to debt collection agencies.

The White House fact sheet may be accessed here. The Department of Education’s notice of its intent to establish a negotiated rulemaking committee, using the Secretary of Education’s authority under the Higher Education Act, may be accessed here.

Supreme Court Strikes Down Administration's Student Loan Debt Forgiveness Plan

Today, the Supreme Court issued its 6-3 decision striking down the Administration’s student loan debt forgiveness plan. President Biden’s initiative would have forgiven up to $20,000 in federal student loan debt for more than 40 million Americans. Advocates for student debt relief are calling on the White House to create an alternative plan using different legal authority, such as through the Higher Education Act.

The Supreme Court ruled the State of Missouri has standing to bring its case forward as it created MOHELA, which is “an instrumentality of the State of Missouri” and would face a direct injury if the student loan forgiveness moved forward, losing $44 million in fees.

The Court found that the Department relied on the HEROES Act to “waive or modify” exist­ing statutory or regulatory provisions applicable to financial assis­tance programs under the HEA, allowing the Secretary to provide loan forgiveness under certain circumstances, but the Secretary exceeded his authority by rewriting that statute to the extent of canceling $430 billion of student loan principal.  

The opinion was written by Chief Justice Roberts who highlighted the major questions doctrine – whether it is Congress or a federal agency that has the power to offer a student loan forgiveness program, stating that if Congress wants to give an administrative agency the power to make “decisions of vast economic and political significance,” it must say so clearly. But here there is no authorization, much less clear authorization, for this program.

The opinion may be accessed here. A statement from President Biden may be accessed here.

Supreme Court Rejects Affirmative Action

The Supreme Court rejected, along ideological lines, the admissions systems used by Harvard University and the University of North Carolina at Chapel Hill. The White House said the Department of Education and Department of Justice will provide resources to colleges and universities addressing lawful admissions practices within the next 45 days. Last summer, ASAHP joined the Association of American Medical Colleges and 45 health professional and educational organizations in an amicus curiae brief submitted to the U.S. Supreme Court in support of the limited consideration of an applicant’s racial or ethnic background or experiences in higher education admissions.

An article by Inside Higher Ed may be accessed here. A White House Fact Sheet may be accessed here.

University of Arkansas at Fayetteville Dissolves DEI Office, Reallocates Staff and Resources

The University of Arkansas at Fayetteville dissolved its DEI office, retaining staff and resources but reallocating them to other offices, primarily in human resources and student success. Inside Higher Ed examines the University’s move and reactions.

The article may be accessed here.

Critical Access Hospitals

According to a report this month from the Government Accountability Office (GAO), small "critical access" hospitals often are the only source of health care in rural communities. While they provide emergency mental health care, only some provide other in- and outpatient psychiatric care. Medicare generally pays these hospitals at cost, but most inpatient psychiatric services aren't eligible for cost-based payment.  

The report can be obtained at https://www.gao.gov/assets/gao-23-105950.pdf.

ASAHP Comments on the Department of Education’s Proposed Rulemaking

Comments on the Department of Education's proposed regulations covering state authorization, gainful employment, ability to benefit, and more were due on Tuesday, June 20. ASAHP submitted comments as well as joined a joint-comment letter led by the American Council on Education (ACE). ASAHP called on the Department of Education to withdraw its proposed regulations language that institutions must meet all state consumer protection laws related to closure, recruitment, and misrepresentations out of concern the language could significantly increase compliance burdens, decrease access to postsecondary education and clinical rotations, and result in the dismantling of current reciprocity agreements which have benefitted ASAHP institutional members. ASAHP also expressed concern regarding a potential unintended consequence of the proposed language that requires an institution to provide students with accessible clinical opportunities.

ASAHP’s comments may be accessed here, and the joint comment letter led by ACE may be accessed here.

ASAHP Clinical Education Committee Seeking Graduate Student Project Coordinator

ASAHP’s Clinical Education Committee is looking for a project coordinator . The Project Coordinator will participate in all ASAHP Clinical Education Committee activities, including monthly conference calls and delegated Task Force / ASAHP meetings. The Project Coordinator will work with Committee members to support their objectives and assist with meeting goals of the Committee.

The hours are flexible and generally 2 to 4 hours per week. Applicants must be a graduate student at an ASAHP member institution. Students are paid by the hour.

Interested students can apply here.

State Authorization, Gainful Employment, Ability To Benefit Comments Due Tuesday

Comments on the Department of Education's proposed regulations covering state authorization, gainful employment, ability to benefit, and more are due no later than Tuesday, June 20. There is concern that, as written, there could be a significant impact on reciprocity for State Authorization Reciprocity Agreements (SARA)-participating institutions and SARA member states. Also, Section §668.16(r) addresses Administrative Capability-Accessible Clinical or Externship Opportunities. The National Council for State Authorization Reciprocity Agreements (NC-SARA) has posted its comment letter here, and maintains a call-to-action page here which should be helpful to institutions when preparing their own comments.

Comments may be submitted here.

House Committee Hearing on Postsecondary Education

On Wednesday, the House Education and the Workforce Committee’s Subcommittee on Higher Education and Workforce Development held a hearing on “Postsecondary Innovation: Preparing Today’s Students for Tomorrow’s Opportunities”. Issues discussed included dual enrollment, competency based education, online education, and financial aid. Dr. Tim Renick, Executive Director, National Institute for Student Success, Georgia State University and a speaker at ASAHP’s 2018 conference, was one of the four witnesses.

Our memo on the hearing may be accessed here.

Factors Driving Physician Practice Acquisition

Escalating costs associated with managing their own practice coupled with burdensome insurer policies and regulatory requirements are some factors driving physicians to seek employment in other practice settings, according to a new report released by the American Hospital Association. 

The report can be obtained at https://www.aha.org/system/files/media/file/2023/06/fact-sheet-examining-the-real-factors-driving-physician-practice-acquisition.pdf.