Governmental Affairs

ASPAN Governmental Affairs Update March 2002

H.R. 3487/S. 1864 "THE NURSE REINVESTMENT ACT" 

·                     On December 20, 2001, both the House of Representatives and the Senate passed the Nurse Reinvestment Act

·                     The bills differ in some respects but both would authorize loan repayment programs and scholarships for nursing students, and public service annoucncements to encourage more people to enter the nursing profession

·                     *****Congress has failed to take action to merge and enact the Nurse Reinvestment Act---the longer this action is delayed, the more likely the bill will be lost among other Congressional priorites-----please urge Congress to make the final push to enact this bill-----NOW IS THE TIME TO CONTACT YOUR CONGRESSMEN!!!*****

·                     For a full summary of the 2 bills and a side by side comparison of the differences, go to www.nursingworld.org

 

 

American Nurses Associtation (ANA) 2002 Biennial Convention 

·                     June 29-July 2, 2002

·                     Philadelphia, PA

·                     "Nurses Care For America"

·                     www.nursingworld.org or 800-274-4ANA

 

CRNAs/Physician Supervision 

·                     On March 14, Idaho Governor Dirk Kempthorne (R) told the Centers for Medicare and Medicaid Services (CMS) that Idaho is opting out of the requirement that CRNAs be supervised by physicians

·                     Idaho is the 3rd state to take advantage of this provision (Iowa and Nebraska were the first two)

 

Interstate Nurse Bill

 

·                     Tennessee has joined this compact--legislation passed both their houses without a single no vote

·                     This compact, which was created in 1998, was designed by the National Council of State Boards of Nursing to ease shortages of nurses and make it easier for states to share information on disciplinary actions

·                     Other states in the compact:  NC, UT, MD, TX, WI, SD, NE, IA, DE, ME, ID, ND, AZ

·                     www.knoxnews.com

 

Medical Reserve Corps

 

·                     During the State of the Union address, President Bush launched USA Freedom Corps

·                     The goal of the above initiative is to provide opportunites and create incentives for Americans to become involved in serving their communities and country through volunteering

·                     Specific to health care providers is the community-based Medical Reserve Corps (now under development)

·                     The objective of the above is to harness the strength of healthcare professionals to augment local health care capacity during an emergency

·                     This project is being managed under the auspices of the Federal Emergency Management Agency (FEMA) and the Department of Health and Human Services (HHS)

·                     The website for additional info regarding US Freedom Corps is www.usafreedomcorps.gov

·                     For additional info specific to the Medical Reserve Corps, go to www.citizencorps.gov/medical.html

·                     www.nursingworld.org

·                     LET'S ROLL!

 

2000 National Sample Survey of Registered Nurses

 

·                     HHS Secretary Tommy Thompson released the final report of this survey

·                     The release was timed with the launch of a campaign to encourage school children to consider careers in nursing and the health professions

·                     The nursing survey (the most extensive and comprehensive statistical resource on RNs with current licenses to practice in the US) suggests that too few  young people are choosing careers in nursing and the average age of RNs has increased substantially

·                     "Kids Into Health Careers" is the educational campaign designed to attract more children to careers in nursing and the health professions

·                     www.aamc.org/advocacy/washhigh

·                     www.bhpr.hrsa.gov/healthworkforce/rnsurvey

·                     www.bhpr.hrsa.gov/kidscareers/

 

JCAHO "Speak Up" Program

 

·                     This program encourages patients to become active, involved, and informed participants on the health care team

·                     These efforts are supported by the CMS

·                     JCAHO President stated, "Everyone has a role to play in preventing health care errors.  Physicians, health care executives, nurses, and other health care workers are already working hard to address this on-going problem.  It is now time for patients themselves to become part of this effort."

·                     Consumers can download a "Speak Up" brochure that provides specific guidance to patients to help them make their care safe by visiting the JCAHO website, www.jcaho.org

·                     The brochure is also available by calling JCAHO's Customer Service Center at 630-792-5800

·                     ANA President Mary Foley adds, "In addition to encouraging patients to 'speak up,' it is also our hope that Congress will 'speak out' on behalf of patients and nurses by passing much-needed legislation in this area.  It is time for Congress to pass the Nurse Reinvestment Act, which would offer grants and other funding for educating students and promoting the profession; the Safe Nursing and Patient Care Act, which would impose restrictions on mandatory overtime; and  the Patient Safety Act, which would require health care institutions to disclose information on staffing levels, staff mix, and patient outcomes.  It is only through these and similar government initiatives that we will achieve true safety and quality-of-care for patients and a safe and professional work environment for nurses."

·                     www.nursingworld.org

 

On The Hill/Appointments

 

·                     John Sullivan (R-OK) was elected January 8 in a special election to replace Representative Steve Largent (R-OK) who retired on February 15 to run for Governor

·                     Sullivan (sworn in as the newest member of the House of Representatives on February 27) has served in the OK House of Representatives since 1995 

·                     The Senate confirmed on March 15 the nomination of Sally Stroup as Assistant Secretary for Postsecondary Education at the Department of Education

·                     Stroup is best known for her tenure as the top aide to former House Committee on Education and the Workforce Chairman William Goodling (R-PA) from 1995-2001

 

 

·                     On March 14, Representative Ernie Fletcher (R-KY) was named to the House Committee on Energy and Commerce, taking the seat vacated by Steve Largent (R-OK), who retired in February

·                     Dr. Fletcher (a family practitioner) is 1 of 8 physicians in the House of Representatives

·                     Because the Energy and Commerce Committee is considered an "exclusive" committee, Dr. Fletcher is required to give up his seats on the Agriculture, Budget and Education, and the Workforce committees

·                     On March 26, President Bush announced his intention to nominate Elias Zerhouni, MD to be Director of the National Institutes of Health (NIH)

·                     This position requires confirmation by the Senate

·                     Dr. Zerhouni currently serves as executive vice dean and chair of the Department of Radiology and Radiological Science at Johns Hopkins University School of Medicine 

·                     Also on March 26, President Bush announced his intention to nominate Richard Carmona, MD to be Surgeon General

·                     This position also requires confirmation by the Senate

·                     Dr. Carmona is currently clinical professor of Surgery, Public Health, and Family and Community Medicine at the University of Arizona, as well as chairman of the State of Arizona Southern Regional Emergency Medical System

·                     His background includes:

·                     High School dropout

·                     RN

·                     Green Beret in Vietnam

·                     Police Officer and SWAT team member

·                     Listed as one of the nation's "Top Cops" by the National Association of Police Organizations

·                     Physician of the Year in Pima County, AZ in 1993 

 

·                     On March 22, the Senate confirmed the nomination of Robert Roswell, MD to be Under Secretary for Health at the Department of Veterans Affairs (VA), where he will be responsible for overseeing the Veterans Health Administration

·                     Dr. Roswell has served since 1995 as director of the VA Sunshine Healthcare Network (VISN 8) which covers FL and Puerto Rico 

·                     HHS Secretary Tommy Thompson announced on March 6 that Elizabeth James Duke, PhD has been appointed to serve as administrator of the Health Resources and Services Administration (HRSA)

·                     Dr. Duke has been acting administrator of the agency since March 2001

·                     HRSA (second largest Public Health Service agency) administers the National Health Service Corps, the Title VII and VIII health professions programs, the Community Health Centers, and the Ryan White AIDS programs 

·                     On March 22, Tommy Thompson appointed Carolyn Clancy, MD as acting director of the Agency for Healthcare Research and Quality (AHRQ)

·                     Since 1997, Dr. Clancy has directed AHRQ's Center for Outcomes and Effectiveness Research (COER), which conducts and supports studies of the outcomes and effectiveness of diagnostic, therapeutic, and preventive health care services and procedures 

·                     www.aamc.org/advocacy/washhigh 

·                     John Combes, MD and a physician executive for both American Hospital Association (AHA) and the Hospital and Healthsystem Association of PA, has been selected to serve on the Steering Committee of the Patient Safety Research Coordinating Center (PSRCC)

·                     PSRCC selected 13 members to the committee from a nomination list of 32--3 of them are nurses

·                     The new steering committee members are:

·                     Nancy Donaldson, RN (University of California-San Francisco)

·                     Christine Kovner, RN (New York University)

·                     Pamela Mitchell, RN (University of Washington)

·                     Andrew Brown, MD (University of Mississippi Medical Center)

·                     Pascale Carayon (University of Wisconsin-Madison)

·                     Victoria Fraser, MD (Washington University School of Medicine)

·                     Harold Kaplan, MD (Columbia University)

·                     Kate Lapane (Brown University)

·                     Richard Lilford (University of Birmingham, UK)

·                     Joseph Ouslander, MD (Wesley Woods Center of Emory University)

·                     Richard Platt, MD (Harvard Medical School)

·                     Nancy Ridley (Massachusetts Department of Public Health)

·                     Eric Thomas, MD (University of Texas-Houston Medical School)

·                     www.ahanews.com

 

Bush Administration Proposes Cuts To Medicare Payments To Hospitals

 

·                     The Bush administration has recommended reducing hospital payments below market-basket levels in order to help the government keep the Medicare program budget-neutral while it increases payments to doctors

·                     HHS Secretary Tommy Thompson and Office of Management and Budget Director Mitchell Daniels wrote in a letter to the House Ways and Means Committee, "Reasonable and modest limits on hospital market basket updates would appear to provide adequate reimbursement for hospitals."

·                     www.ahanews.com

 

Bush Seeks To Revise Patient Privacy

 

·                     Doctors and hospitals could disclose private information about patients and provide medical services without prior consent under proposed Bush administration revisions to Clinton-era patient privacy rules

·                     The changes would also give parents greater access to their children's medical records, including information about abortions, drug treatment, and other sensitive services

·                     The changes are scheduled to take effect in April 2003--they would continue the status quo because consent forms are not now required but would have been under the Clinton administration version being revised

·                     The rules prohibit health care providers from disclosing patient information for reasons unrelated to health services and establish civil and criminal penalties for violators--they give patients the right to inspect and copy their records and to ask for corrections

·                     Health care providers welcomed many of the changes, including scrapping of consent forms

·                     Privacy advocates were unhappy about the consent forms and the elimination of some privacy rights for minors, including teenagers who may seek abortions, drug treatment, or other medical care

·                     Both the Clinton and the Bush versions of the privacy rule allow minors to keep privacy rights if specified under state law--absent at state law, both would allow doctors to disclose information to parents

·                     The regulations clarify that personal information cannot be sold or given drug companies or others that want to market a product or service without patient permission

·                     The revised rules are subject to a 30-day public comment period before becoming final

·                     www.hhs.gov/news/press/2002pres

·                     www.nurses.com

 

Bills/Resolutions Updates

 

The Senate Shays-Meehan-McCain-Feingold Bill Has PASSED

 

·                     This campaign finance reform bill passed 60 yeas to 40 neas

·                     Carolyn Jefferson-Jenkins, President of the League of Women Voters of the US, stated, " The League calls on President Bush to sign this bill and hand the reins of our political system back to its rightful owners-the American voters."  

·                     www.lwv.org

 

President Submits $27 Billion Supplemental Appropriations Bill

 

·                     On March 21 President Bush submitted to Congress his proposal for $27 billion in emergency supplemental FY 2002 spending

·                     The request contains significant funding for the war on terror ($14 billion), homeland security ($5.2 billion), international assistance and embassy protection ($1.7billion), economic recovery and assistance to dislocated workers ($750 million), and assistance to New York ($5.5 billion)

·                     The request also includes $240 million in non-emergency spending that is offset by recissions in other programs

·                     www.aamc.org/advocacy/washhigh

 

House Panel Approves FY 2003 Spending Plan

 

·                     Following the President's lead, the House Budget Committee on March 13 passed an FY 2003 budget resolution that focuses heavily on defense and homeland security and provides a less than inflation increase for domestic discretionary programs

·                     The budget doubles funding for homeland security to $38 billion, including $5.9 billion to counter bioterrorism

·                     The budget has only a $2.6 billion increase in overall discretionary health spending

·                     The budget includes a reserve fund for Medicare reform and prescription drugs that provides $5 billion in FY 2003 and $350 billion over 10 years

·                     The committee rejected a number of amendments by Democrats, including proposals to increase funding for education and prescription drugs

·                     www.aamc.org/advocacy/washhigh

 

H.R. 3966 "Genomic Science and Technology Innovation Act of 2002"

 

Sponsor:  Representative Lynn Rivers (D-MI)

Introduced:  3-14-02

Latest Major Action:  On 3-14-02 referred to House Science Committee and House Judiciary Committee

 

·                     This bill would require the White House Office of Science and Technology Policy to conduct a study on the impact of federal policies, including intellectual property policies, on the innovation process for genomic technologies

·                     There is no companion bill in the Senate

·                     www.thomas.loc.gov

·                     www.aamc.org/advocacy/washhigh

 

 

H.R. 3967 "Genomic Research and Diagnostic Accessibility Act of 2002" 

Sponsor:  Representative Lynn Rivers (D-MI)

Introduced:  3-14-02

Latest Major Action:  Referred to the House Judiciary Committee

 

·                     This bill would permit scientists to use patented genetic sequence information  for non-commercial research and permit physicians to perform genetic diagnostic and other testing without infringing on a gene patient

·                     Would require public disclosure of genomic sequence information contained within a patent application when federal funds were used in the development of the invention

·                     There is no companion bill in the Senate

·                     www.thomas.loc.gov

·                     www.aamc.org/advocacy/washhigh

 

H.CON.RES. 353 "Establishing the congressional budget for the United States Government for fiscal year 2003 and setting forth appropriate budgetary levels for each of fiscal years 2004 through 2007"

 

Sponsor:  Representative Jim Nussle

Introduced: 3-15-02

Latest Major Action:  On 3-21-02 received in the Senate and referred to the Committee on the Budget

 

·                     The House passed this budget resolution by a largely party line vote of 221 to 209

·                     The Senate Budget Committee approved its version of the budget on March 21

·                     During deliberations on the budget March 21, the Senate Committee adopted by voice vote an amendment by Senators Hiliary Clinton (D-NY) and Tim Johnson (D-ND) that provides a "Sense of the Senate" that the Congress should "Provide sufficient resources to ensure beneficiary access to high-quality health services provided by home health agencies, skilled nursing facilities, physicians, and hospitals, including rural, teaching, community, and safety net hospitals that serve communities across the nation."

·                     The amendment's findings specifically note the inadequate reimbursements and severe capacity strains on teaching hospitals

·                     www.thomas.loc.gov

·                     www.aamc.org/advocacy/washhigh

 

S. 1976 "National Cancer Act of 2002" 

Sponsor:  Senator Dianne Feinstein (D-CA)

Introduced:  2-28-02

Latest Major Action:  On 2-28-02 read twice and referred to the Committee on Health, Education, Labor, and Pensions

 

·                     Senator Feinstein introduced this legislation to create what she describes as "a new comprehensive national battle plan to modernize and re-energize the nation's war on cancer"

·                     This bill is cosponsored by a bipartisan group of 29 other senators

·                     It would update the National Cancer Act of 1971 and would:

·                     Authorize increased funding for the National Cancer Institute through FY 2007

·                     Provide $100 million a year for 5 years in grants and other incentives for translational cancer research

·                     Authorize a loan repayment program for health professionals who spend at least 3 years doing cancer research and increase postdoctoral salaries over 5 years beyond the current salary level of $28,000

·                     Provide tax and marketing incentives to encourage pharmaceutical companies to produce "orphan drugs," or drugs targeted to small patient populations

·                     Require meaningful regulation of the content of tobacco products by the FDA and their marketing to children

·                     Require all insurers to pay for cancer screenings, smoking cessation, nutritional counseling, and genetic testing (among people with demonstrated risk)

·                     Provide $250 million for the CDC's Breast and Cervical Cancer Screening Program for low-income women

·                     Provide $50 million to create a demonstration program to expand the CDS's program to include screening for colorectal cancer

·                     www.thomas.loc.gov

·                     www.aamc.org/advocacy/washhigh

 

H.R. 3882 "Preserving Patient Access to Physicians Act of 2002" 

Sponsor:  Representative Nancy Johnson (R-Connecticut)

Introduced:  3-6-02

Latest Major Action:  On 3-6-02 referred to House Energy and Commerce Committee and House Ways and Means Committee

 

·                     Representative Johnson is the House Ways and Means Health Subcommittee Chairman

·                     This bill would reform the system used to calculate the Medicare physician payment update

·                     It would repeal the current sustainable growth rate (SGR) methodology and replace it with a formula that bases the update on estimated changes in input prices for the coming year, less an adjustment for growth in multifactor productivity

·                     It directs the Medicare Payment Advisory Commission (MedPAC) to evaluate (by specialty) the impact of refinements to the practice expense component of physician payments

·                     Last fall, the Senate and House introduced bills (S. 1707/H.R. 3351) that would reduce the 2002 cut from minus 5.4% to minus 0.9% and require MedPAC to develop a replacement for the SGR--both bills have significant support (73 cosponsors in the Senate and 331 in the House)

·                     www.thomas.loc.gov

·                     www.aamc.org/advocacy/washhigh