On Thursday evening, the Senate approved the ACEP-supported "Dr. Lorna Breen Health Care Provider Protection Act" (H.R. 1667) by voice vote. The Senate had previously passed its own version of the bill in early August 2021, but a few minor changes were made to that text during the House legislative process, which required the Senate to vote on the House-passed bill one final time. The bill now heads to President Biden to sign it into law.
ACEP is grateful for the leadership of the original sponsors of the legislation, lead sponsor Sen. Tim Kaine (D-VA), Sen. Todd Young (R-IN), Sen. Jack Reed (D-RI), and Sen. Bill Cassidy, M.D. (R-LA), and lead sponsor Representative Susan Wild (D-PA), Rep. David McKinley (R-WV), Rep. Raja Krishnamoorthi (D-IL), Rep. Fred Upton (R-MI), Rep. Judy Chu (D-CA), Rep. Morgan Griffith (R-VA), Rep. Haley Stevens (D-MI), and Rep. John Katko (R-NY) who committed to prioritizing care for health professionals that courageously put the needs of patients first.
H.R. 1667 is named in honor of Lorna Breen, MD, FACEP, an ACEP member who died by suicide in April 2020 after being overwhelmed by the influx of COVID-19 cases in New York City. Dr. Breen's death directly led to ACEP's work with Sen. Kaine to develop this legislation honoring Dr. Breen, which seeks to provide mental health and substance-use disorder support for physicians and other health care providers and to address the stigma of receiving such help. Sen. Kaine also spoke directly to hundreds of emergency physicians during the 2021 Leadership & Advocacy Conference (LAC) about the importance of strengthening mental health resources and access for health care professionals providing care in response to the COVID-19 pandemic.
From its inception to final passage, ACEP has been deeply involved in advancing this much-needed legislation. From helping to inform and develop the legislative language, hundreds of meetings with legislators during LAC21 and persistent grassroots outreach by ACEP members, this legislative victory is a testament to the effective advocacy efforts and voice of emergency medicine. Just prior to its passage, the legislation had 167 bi-partisan co-sponsors in the House of Representatives and 29 in the Senate.
The "Dr. Lorna Breen Health Care Provider Protection Act" provided the framework for ACEP's successful efforts to secure $140 million in funding for the bill in 2021 as part of the American Rescue Plan.
Dr. Lorna Breen
In addition to providing direction to HRSA about how the grant programs should be conducted and overseen, H.R. 1667 will:
Require HHS to disseminate best practices to prevent suicide and improve mental health and resiliency among health care providers;
Establish a national awareness campaign to encourage health care providers to seek support and treatment for mental/behavioral health concerns;
Award grants or contracts to promote mental health among health care professionals; and
Support mental/behavioral health training for health care students, residents, or other health care professionals.
Above all, this legislative accomplishment for emergency medicine honors Dr. Breen's legacy and her memory, taking a critical step forward to ensure health care workers have access to the mental health resources and services they need and deserve.
On Wednesday, the Senate successfully confirmed Robert Califf, MD, as Commissioner of the U.S. Food and Drug Administration (FDA) in a narrow 50-46 vote. Califf's confirmation finally ensures a permanent leader for the FDA after more than a year without one, clearing the way for the Biden Administration to more effectively implement its health care priorities.
The confirmation vote was closer than President Biden and Senate Majority Leader Chuck Schumer (D-NY) had hoped or anticipated, as several Democrats had noted their opposition to the nomination weeks ago. Ultimately, Sens. Bernie Sanders (I-VT), Richard Blumenthal (D-CT), Maggie Hassan (D-NH), Joe Manchin (D-WV), and Ed Markey (D-MA) voted against Califf's confirmation. On the Republican side, Sens. Mitt Romney (R-UT), Roy Blunt (R-MO), Richard Burr (R-NC), Lisa Murkowski (R-AK), Susan Collins (R-ME), and Pat Toomey (R-PA) voted in support of Dr. Califf.
On Wednesday, Senators Jacky Rosen (D-NV) and John Boozman (R-AR), introduced the bipartisan "Resident Education Deferred Interest (REDI) Act" (S. 3658). This ACEP-supported legislation would allow medical and dental residents to pause their federal student loan interest accrual and principal loan repayments until their residencies or internships are complete.
The legislation is aimed at reducing some of the barriers facing medical professionals who wish to serve in rural or underserved communities, especially as communities throughout the country continue to weather the challenges of persistent health care provider shortages. The bipartisan House companion bill was introduced in June 2021 by Reps. Brian Babin, DDS (R-TX) and Chrissy Houlahan (D-PA).
Also on Wednesday, Senators Richard Durbin (D-IL) and Rob Portman (R-OH) introduced the ACEP-supported "Post-Disaster Mental Health Response Act." This legislation extends the Federal Emergency Management Agency's (FEMA's) existing technical assistance and reimbursement to help provide mental health services during Emergency Declarations.
FEMA's Crisis Counseling Assistance and Training Program (CCP) provides guidance, tools, best practices, and funding to state and local governments to help communities recover from the mental health impacts of disasters. However, the program is only available for Major Disaster Declarations, and not smaller-scale crises that receive Emergency Declarations. This bill will help ensure that these critical mental health resources are available to communities that receive an Emergency Declaration as well. The House companion legislation (H.R. 5703) was introduced by Reps. Ayanna Pressley (D-MA), David McKinley (R-WV), Dina Titus (D-NV), and Peter Meijer (R-MI).
On Thursday evening, the Senate passed a short-term continuing resolution (CR) to keep the government funded. The short-term CR kicks the funding deadline out to March 11, giving congressional appropriators some breathing room as they continue working toward an agreement on an omnibus appropriations measure for the remainder of FY22.
Given the previous CR was set to expire on Friday, it may have looked like Congress was nearing a potential government shutdown - but both Republicans and Democrats had signaled that shutdown was not a possibility, mainly because both parties are hoping to avoid a self-inflicted, politically damaging crisis as the midterm elections come up.
Meanwhile, appropriators continue working on a compromise and have recently signaled some encouraging movement, but it remains to be seen if an omnibus package can be successfully put together in the next three weeks. ACEP continues monitoring these negotiations and pushing for emergency medicine priorities to be funded in any appropriations measures moving forward.
This week, the Centers for Disease Control and Prevention (CDC) released a draft revised guideline to the 2016 opioid prescribing guideline. and is seeking feedback from the public on its recommendations on prescribing opioids for the treatment of both chronic and acute pain.
Read this week's Regs & Eggs blog to find out more about the CDC's long, drawn-out process for updating the opioid prescribing guideline and what specific recommendations made their way into the draft revised guideline.
On Thursday, CMS released a Request for Information (RFI) on Medicaid and Children's Health Insurance Program (CHIP) issues related to health care access, such as enrolling in and maintaining coverage, accessing health care services and supports, and ensuring adequate provider payment rates to encourage provider availability and quality. CMS states that feedback obtained from the RFI will help the agency better understand Medicaid and CHIP beneficiaries' barriers to enrolling in and maintaining coverage and accessing needed health care services and support.
The RFI is open for a 60-day public comment period, and ACEP plans on providing a comprehensive response in the coming weeks.
The eyes of the nation, or at least the house of medicine, maintain their gaze upon South Dakota, where the legislators of the Mount Rushmore state continue to consider SB134, legislation that would gut existing supervisory requirements for physician assistants, replacing them with language that would provide a track for independent PA practice after only 6 months of collaborative practice with a physician or qualified PA.
Since passing out of committee, planned votes for the bill on the floor of the Senate have been delayed twice, with it now being slated for consideration on Tuesday, February 22. Additionally, the sponsor has reportedly been working on amendments in an effort to gain the votes needed for passage, but the bill remains unacceptable to physicians.
All of which is to say that the bill is now in trouble, but opponents should not let their guard down. ACEP has created a link to assist members with contacting their state senator about the bill.
Additionally, AMA Scope of Practice Partnership staff has provided a list of Twitter handles that might be used to register your position on this bill. That information is being passed on along with a reminder to be nice while also being clear:
