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NIWI Speaker
-
Representative Lois Capps, RN was the guest speaker at the Nurses in
Washington Roundtable hosted by the Nurse in Washington Interns (NIWI)
-
Representative Capps’ topic: “Beyond the Nurse Reinvestment Act” and
her efforts to form a Nursing Caucus in the House of Representatives
New Duty Hours for
Residents
-
On
February 11, 2003
the Accreditation Council for Graduate Medical Education (ACGME) board
approved new duty hours requirements that go into effect
on July 1, 2003
-
In
addition to existing requirements that all programs provide residents
one 24-hr day free every 7 days, and that residents be on call no more
than 1 night in 3, both averaged over 4 weeks, the following become part
of the requirements:
-
A
maximum of 80 hours per week averaged over 4 weeks
-
10 hours off for rest and personal activities between duty periods and
after call
-
24 hours maximum continuous on-site duty with up to 6 additional hours
permitted for patient transfer and other activities to be defined
-
No new patients after 24 hours of continuous duty
-
Resident time spent in the hospital during at-home call is counted
toward the 80 hrs
-
In-house “moonlighting” is counted toward the 80 hrs
-
Program directors and faculty must adopt policies to prevent and
counteract effects of fatigue
-
Duty hours are to be monitored by the program and sponsor
-
www.aamc.org/advocacy/library/washhigh
Nurse Reinvestment
Act Funding Update
-
From the HRSA Section of the Conference Report on the FY 2003
Appropriations Bill—within the funding for health professionals
training, $113,502,000 is provided for nurse training programs
-
The
conferees have relabeled “Basic Nurse Education and Practice” the “Nurse
Education, Practice, and Retention Grants” and relabeled the “Loan
Repayment Program” the “Loan Repayment and Scholarship Program”
-
PLEASE DON’T FORGET TO GET THOSE
THANK YOU LETTERS OUT TO OUR FRIENDS IN THE SENATE AND THE HOUSE WHO
MADE THIS POSSIBLE!!
-
ANSR’s goal is to increase the amount dramatically in FY 2004 (we had to
get our foot in the door first)
On-Line Quality
Measures Warehouse
-
On
February 20 the Agency for Healthcare Research and Quality (AHRQ)
announced the launch of its Web-based National Quality Measures
Clearinghouse (NQMC)
-
This will contain the most current evidence-based quality measures and
measure sets available to evaluate and improve the quality of health
care
-
The
site can be searched by measures that target a particular disease or
condition, treatment, age range, gender, vulnerable population, or
setting of care
-
Measures to be considered for inclusion in the NQMC can be submitted on
an ongoing basis but must meet a set of published criteria
-
If
interested, contact
info@qualitymeasures.ahrq.gov
-
www.aamc.org/advocacy/library/washhigh
Project BioShield
-
The
Department of Health and Human Services (HHS), in cooperation with the
Department of Homeland Security, is bringing together the resources of
the US government in an innovative effort to develop defenses against
bioterror before they are ever needed
-
“By
bringing researchers, medical experts, and the biomedical industry
together in a new and focused way, our nation can achieve the same kind
of treatment breakthroughs for bio-terrorism and other threats that have
significantly reduced the threat of heart disease, cancer, and many
other serious illnesses,” Secretary Thompson said
-
BioShield was announced by President Bush in his State of the Union
address on
January 28, 2003
-
The
project’s 3 major goals:
-
Ensure resources to develop next-generation countermeasures
-
Create a special secure spending authority to pay for the delivery
of “next-generation” medical countermeasures
-
Over the next 10 years almost $6 billion will be available to
purchase new countermeasures for smallpox, anthrax, botulinum toxin
-
Additional funds will be available to produce and purchase
countermeasures for other dangerous agents, such as Ebola and
plague, once safe and effective treatments are developed
-
Expand research and development
-
Make promising treatments available quickly for emergencies
§
The
Food and Drug Administration (FDA) would have the ability to make new and
promising treatments under development available quickly in emergency
situations—potentially saving many more lives than treatments otherwise
available today
New Freedom
Initiative
-
2
years ago President Bush launched the New Freedom Initiative which is
aimed at eliminating the many barriers that unnecessarily hinder
Americans with disabilities
-
In
the past 2 years there has been significant progress—President Bush
requested a thorough inventory of federal rules and policies that impact
on those with disabilities, with recommendations for change
-
An
HHS report included more than 400 recommendations for improvement
-
An
Office of Disability in the HHS Secretary’s office was created to
coordinate activities
-
Through HHS’s Office for Civil Rights, work is being done to help bring
about fulfillment of the Supreme Court’s Olmstead decision in a
productive and responsible manner
-
Under Olmstead, state programs must move effectively toward serving
those with disabilities in home and community-based settings wherever
possible, instead of requiring those with disabilities to be confined to
nursing homes or other institutions in order to receive assistance
-
An
important feature of the President’s new proposal to improve Medicaid
includes more flexibility to provide home and community-based care for
those with disabilities
-
www.hhs.gov/news
HIPPA Update
-
Under the security standards, health insurers, certain health care
providers and health care clearinghouses must establish procedures and
mechanisms to protect the confidentiality, integrity, and availability
of electronic protected health information
-
The
rule requires covered entities to implement administrative, physical and
technical safeguards to protect electronic protected health information
in their care
-
The
security standards work in concert with the final privacy standards
adopted by HHS last year and scheduled to take effect for most covered
entities on April 14
-
The
2 sets of standards use many of the same terms and definitions in order
to make it easier for covered entities to comply
-
Most covered entities will have 2 full years—until April 21, 2005—to
comply with the standards (small health plans will have an additional
year to comply, as HIPPA requires)
-
In
a separate final regulation, HHS adopted modifications to the
transaction standards, which health plans, certain health care providers
and health care clearinghouses by law must use for electronic health
care transactions—covered entities must comply with these modified
transaction standards by October 16, 2003
-
HHS
worked extensively with the Designated Standards Maintenance
Organizations (DSMOs) to revise the proposed changes to the standards,
as required by Congress as part of HIPPA
-
Major provisions of the final rule include:
-
Repealing the National Drug Code (NDC) as the standard medical data
code set for reporting drugs and biologics in all non-retail pharmacy
transactions
-
Adopting the proposed Addenda to the implementation guides with some
technical revisions based upon comments received and consultation with
the DSMOs
-
For retail pharmacy transactions:
-
Adopting the National Council for Prescription Drug Programs (NCPDP)
Batch Version 1.1 to support the Telecommunications Version 5.1
-
Adopting the Accredited Standards Committee (ASC) X12N 835 as the
standard for payment and remittance advice and the NCPDP
Telecommunications Version 5.1 and NCPDP Batch Version 1.1
Implementation Guides as the standard for the referral certification
and authorization transaction
-
Continuing the use of the NDC code set for the reporting of drugs
and biologics
-
CMS
is responsible for implementing and enforcing the security standards,
the transaction standards and other HIPPA administrative simplification
provisions, except for the privacy standards
-
HHS’s Office for Civil Rights is responsible for implementing and
enforcing the privacy rule
-
The
complete text of both final rules, the full text of the Addenda to the
transaction modifications rule, and HIPPA standards information are
available at the CMS website:
www.cms.hhs.gov/hipaa2
Safer Smallpox
Vaccines
-
HHS
Secretary Thompson announced on February 25 the award of 2 contracts
totaling up to $20 million in first-year funding to develop safer
smallpox vaccines
-
The
3-year contracts were awarded to Bavarian Nordic A/S of Copenhagen,
Denmark, and Acambis Inc. of
Cambridge,
MA
-
The
National Institute of Allergy and Infectious Diseases (NIAID) will
administer the contracts
-
Thompson stated, “To protect ourselves from the remote but extremely
grave threat of a deliberate release of smallpox virus, we need a
vaccine that can be safely given to all Americans, including individuals
with weakened immune systems, children and pregnant women. The new
contracts will help us meet this need by accelerating research on
second-generation smallpox vaccines.”
-
Acambis and Bavarian Nordic will develop, manufacture and conduct safety
trials of modified vaccinia virus Ankara (MVA) vaccine candidates
-
Vaccinia virus, a close relative of smallpox virus, is used in
traditional smallpox vaccines
-
A
live, replicating virus, vaccinia can cause side effects, which on rare
occasions can be serious and potentially life-threatening
-
Pregnant women and people with compromised immune systems cannot receive
the current smallpox vaccine at all
-
MVA
is a strain of vaccinia that cannot replicate inside human cells and
therefore cannot cause dispersed infection
-
An
MVA-based vaccine given to more than 120,000 people during the smallpox
eradication campaign in
Germany
in the 1970s had an excellent safety record
-
When smallpox was declared eradicated in 1980, however, the need for
smallpox vaccines vanished, and research on MVA for that purpose ended
-
www.hhs.gov/news
Disease Management
Demonstration Projects
-
During testimony on February 27 before the Senate Finance Committee, HHS
Secretary Thompson announced plans to improve the quality and efficiency
of Medicare services through capitated disease management demonstration
projects
-
The
projects will provide coordinated multispecialty disease management
programs for Medicare beneficiaries with chronic conditions such as
congestive heart disease and diabetes
-
Patients currently enrolled in the Medicare fee-for-service program may
elect to participate in the demonstrations
-
The
projects will be overseen by CMS and will run for 3 years
-
Under the demonstration, providers will receive a capitated payment for
all Medicare-covered Part A and Part B services—the payment will reflect
the complicated health status of enrolled beneficiaries
-
www.aamc.org/advocacy/library/washhigh
HHS FY 2004
Priorities
-
During a February 26 House Budget Committee hearing on the
Administration’s FY 2004 HHS budget proposal, Secretary Thompson
identified some of his priorities for the coming year
-
His
first priority was to work with Congress to develop a plan to cover the
uninsured
-
Thompson also hoped to redirect a portion of fraud and abuse funding to
providers who purchased technology that reduced medical errors and
improved the quality of patient care
-
Included among his other priorities were medical liability reform and a
new process to select Medicare contractors
-
Thompson has placed particular emphasis on outlining the
Administration’s new state option for Medicaid financing and explaining
their opposition to temporary increases in the Federal Medical
Assistance Percentage (the federal “Medicaid match”)
-
www.aamc.org/advocacy/library/washhigh
Positions/Appointments
ASH to Step Down
-
On
February 5, HHS Assistant Secretary for Health (ASH) Eve Slater, MD,
announced her intention to resign from her position in order to “pursue
other opportunities”
-
Dr.
Slater has served as the ASH since President Bush nominated her in
October 2001
-
Surgeon General Richard Carmona, MD will serve as acting ASH while a
search for a successor takes place
Clancy Appointed to Head AHRQ
-
On
February 5, HHS Secretary Thompson announced the appointment of Carolyn
M. Clancy, MD as director of the Agency for Healthcare Research and
Quality (AHRQ)
-
Dr.
Clancy has been acting director since March 2002 when former director
John Eisenberg, MD, MBA passed away
-
Prior to serving as acting director, Dr. Clancy was director of AHRQ’s
Center for Outcomes and Effectiveness Research and director of the
Center for Primary Care Research
-
AHRQ is the lead federal agency responsible for supporting research
designed to improve the quality of healthcare, reduce its cost, improve
patient safety, decrease medical errors and broaden access to essential
services
-
www.aamc.org/advocacy/library/washhigh
Bills/Resolutions
Update
H.R. 663 “Patient Safety and Quality Improvement Act”
Sponsor: Representative Michael Bilirakis
Introduced: 2-11-03
Latest Major Action: On 2-12-03 was unanimously passed by the House
Energy and Commerce Committee
Summary:
-
Amends the Public Health Service Act to make “patient safety work
product” privileged information
-
Defines “patient safety work product” as a record concerning patient
information either reported to a patient safety organization by a health
care provider (doctor, hospital, etc) or created by a patient safety
organization
-
Defines a “patient safety organization” as an organization, certified
under this Act, that collects such information with the goal of
improving patient safety and the quality of health care delivery
-
Imposes a civil penalty on providers who violate the privileged status
of patient safety work product
-
Directs the Secretary of HHS to establish and maintain a database to
receive relevant nonidentifiable patient safety work product,
consistent, if practicable, with the administrative simplification
provisions of the Social Security Act
-
Permits the Secretary to provide to patient safety organizations and to
States technical assistance with reporting systems for health care
errors
-
Directs the Secretary to establish a process for the Secretary or
another approved Federal or State governmental organization to certify
patient safety organizations
-
Requires the Secretary to develop or adopt voluntary national standards
promoting the interoperability of information technology systems
involved with health care delivery
-
Requires the Secretary to issue and periodically revise regulations
requiring the manufacturer of any drug or biological product that is
subject to regulation by the FDA, or the packager or labeler of such a
product, to include a unique product identifier on the packaging
-
Simply, this act would create a voluntary and confidential medical
errors reporting system
-
The
medical errors information would be stored in a national database for
use in patient safety and quality improvement research
-
The
Committee passed similar legislation last year, but could not achieve a
legislative compromise with the Ways and Means Committee, which also
passed a patient safety bill
-
www.thomas.loc.gov
-
www.aamc.org/advocacy/library/washhigh
H.R. 810 “Medicare Regulatory and Contracting Reform Act (MRCRA) ”
Sponsors: Rep Nancy Johnson (R-CT) (House Ways and Means Health
Subcommittee Chair)
Rep Pete Stark (D-CA) (Ranking Member)
Introduced: 2-13-03
Latest Major Action: On 2-13-03 referred to the House Committee on Ways
and Means and to the House Committee on Energy and Commerce
-
This bipartisan legislation was reintroduced to reduce the regulatory
and paperwork burden currently imposed on Medicare providers
-
This new act is based on a similar bill that was introduced by Johnson
and Stark in August 2001 (H.R. 2768)
-
At
the end of 2001, the House unanimously passed a modified version (H.R.
3391)
-
Most of the provisions were also included in the 2002 comprehensive
House Medicare package (H.R. 4954) that passed the House in June of 2002
-
Among the reforms outlined are new provider rights related to
overpayments/audits, a competitive process for selecting Medicare
contractors, and newly created “ombudsmen” to assist providers in
resolving grievances or obtaining information
-
The
legislation creates a Technical Advisory Group to review Emergency
Medical Treatment and Active Labor Act (EMTALA) regulations and advise
the HHS Secretary accordingly
-
MRCRA would allow treating physicians to determine whether EMTALA-related
Medicare services are “reasonable and necessary” based on the
information available at the time the care was provided and requires
pilot testing of new E&M guidelines before implementation
-
www.thomas.loc.gov
-
www.aamc.org/advocacy/library/washhigh
H.R. 534 “Human Cloning Prohibition Act of 2003”
Sponsors: Representatives Dave Weldon (R-FL) and Bart Stupak (D-MI)
Introduced: 2-5-03
Latest Major Action: On 2-27-03 was passed by House by a vote of 241-155
Summary:
-
performing or attempting to perform human cloning
-
participating in such an attempt
-
shipping or receiving an embryo produced by human cloning or any
product derived from such embryo
-
importing such an embryo or derived product
-
Sets forth criminal and civil penalties
-
Provides that nothing in this Act restricts areas of scientific research
not specifically prohibited above, including research in the use of
nuclear transfer or other cloning techniques to produce molecules, DNA,
cells other than human embryos, tissues, organs, plants, or animals
other than humans
S.
245 “Human Cloning Prohibition Act of 2003”
Sponsor: Senator Sam Brownback (R-KS)
Introduced: 1-29-03
Latest Major Action: On 1-29-03 referred to Senate Health, Education,
Labor, and Pensions Committee (has not gathered a filibuster-proof
majority)
Summary:
-
performing or attempting to perform human cloning
-
participating in such an attempt
-
shipping or receiving an embryo produced by human cloning or any
product derived from such an embryo
-
importing such an embryo
-
Sets forth criminal and civil penalties
-
Provides that nothing in this Act restricts areas of scientific research
not specifically prohibited above, including research in the use of
nuclear transfer or other cloning techniques to produce molecules, DNA,
cells other than human embryos, tissues, organs, plants, or animals
other than humans
-
Directs the General Accounting Office to assess the need for amendment
of such prohibition, including through:
-
a
discussion of new developments, the need for somatic cell transfer to
produce medical advances, current public attitudes and prevailing
ethical views concerning its use, and potential legal implications of
somatic cell transfer research
-
a
review of any technological developments that may require technical
changes to such prohibition
-
www.thomas.loc.gov
S.
303 “Human Cloning Ban and Stem Cell Research Protection Act of 2003”
Sponsors: Senators: Orrin Hatch (R-UT)
Dianne Feinstein (D-CA)
Arlen Specter (R-PA)
Edward Kennedy (D-MA)
Tom Harkin (D-IA)
Zell
Miller (D-GA)
Introduced: 2-5-03
Latest Major Action: On 2-5-03 was referred to House Judiciary Committee
-
The
bill makes it a crime, punishable by up to 10 years in prison and fines
of $1 million or 3 times any profits made, whichever is greater, on any
person who clones or attempts to clone a human being
-
The
bill permits nuclear transplantation to be conducted on unfertilized
eggs for up to 14 days, under strict ethical and federal regulation
-
The
bill requires that all egg donation be voluntary, prohibits large
payments to women to induce egg donations, and prohibits the purchase or
sale of unfertilized eggs, including eggs that have undergone nuclear
transplantation
-
The
bill also requires informed consent by egg donors, review of any nuclear
transplantation research by an ethics board and safety, and mandates
privacy protections
-
The
exportation of eggs that have undergone nuclear transplantation to any
foreign country that does not ban human cloning also is prohibited
-
The
Association of American Medical Colleges (AAMC) has endorsed this bill
-
AAMC President Jordan J. Cohen, MD stated in a letter to Senator Hatch,
“We recognize the significant ethical issues that are raised about
embryonic stem cell research and we respect the view of those who oppose
such research, including some in our own medical school community.
However, we are persuaded otherwise by what we believe is an equally
compelling ethical consideration, namely, the unique potential afforded
by embryonic stem cells, to alleviate human suffering and enhance the
quality of human life.”
-
www.aamc.org/advocacy/library/washhigh
H.R. 5 “Help Efficient Accessible, Low-Cost, Timely Health Care Act of
2003” (HEALTH Act)
Sponsor: Representative James Greenwood (R-PA)
Introduced: 2-5-03
Latest Major Action: On 3-6-03 ordered to be reported (amended) by voice
vote
Summary:
-
Makes changes to the health care liability system, including
compensation for injured patients and other issues arising out of health
care law suits
-
Requires a suit to be brought within 3 years of the date of injury or
one year after the claimant discovers or should have discovered the
injury, whichever occurs first (specifies exceptions when a suit may be
brought later than 3 years after the date of injury)
-
Sets forth requirements and permissible recovery amounts for
compensating patient injury, including:
§
the
full amount of economic loss without limitation
§
noneconomic damages as specified
§
a
fair share rule
-
Requires the court to supervise payment-of-damage arrangements, limiting
contingency fees
-
Permits the introduction of evidence of collateral source benefits,
except that this section shall not apply to provisions of the Social
Security Act pertaining to State plans for medical assistance and
Medicare as secondary payer
-
Limits the availability of punitive damages, requiring clear and
convincing evidence of malicious intent to injure or a deliberate
failure to avoid substantially certain, unnecessary injury
-
Prohibits their award for products that comply with FDA standards,
except if the manufacturer or distributor of a particular medical
product or the supplier of a component or raw material of such a product
causes harm by failing to comply with a specific requirement of the
Federal Food, Drug and Cosmetic Act
-
Authorizes periodic payment of future damages to claimants
-
Excludes suits for vaccine-related death or injury from the requirements
of this Act if otherwise covered under the National Vaccine Injury
Compensation Program
-
Preempts State law unless such law imposes greater protections for
health care providers and organizations from liability, loss, or damages
-
Expresses the sense of Congress that a health insurer should be liable
for damages for harm caused when it makes a decision as to what care is
medically necessary and appropriate
-
www.thomas.loc.gov
-
At
a February 10 field hearing of the House Energy and Commerce
Subcommittee on Oversight and Investigations in
Langhorne,
PA, Thomas Nasca, MD (Dean of Jefferson Medical College at Thomas
Jefferson University) provided testimony that addressed the major impact
of rising malpractice premiums on the missions of medical schools and
teaching hospitals
-
Using Jefferson Medical College as an example, Dr Nasca (also President
of Thomas Jefferson University Physicians) warned that their education,
research, and patient care missions are “in jeopardy of disruption due
to the recent, unprecedented increases in cost for medical liability
insurance”
-
Nasca added that academic medicine could be “disintegrating” because
rising premiums demand that academic centers divert funding and time
away from education and research activities
-
Dr
Nasca reported, for example, that physicians have been forced to
increase their clinical work and decrease their teaching activities to
generate the additional revenue needed to cover malpractice premium
increases
-
This shift of responsibilities has negatively affected faculty morale
-
Dr
Nasca reported that when frustrated physicians ultimately decide to
leave, it is increasingly difficult to recruit replacements because
faculty practices can no longer assure a balance of clinical
responsibilities and time for education and research
-
H.R. 5 is similar to legislation that Rep Greenwood had sponsored, and
the House had ultimately passed, in 2002
-
Simply, the bill would:
§
Establish a statute of limitations for filing claims
§
Cap
non-economic and punitive damages
§
Establish joint and several liability guidelines to assure physicians pay
only their “fair share” of damages
§
Limit
attorneys’ contingency fees
§
Prohibit “double recoveries” by plaintiffs (may not collect amounts
already paid by their health plan)
·
www.aamc.org/advocacy/library/washhigh
Senators and Malpractice Crisis
-
The
debate over malpractice liability reform continued at a February 12
joint hearing of the Senate Health, Education, Labor, and Pensions
Committee and Senate Judiciary Committee
-
This hearing indicated a growing bipartisan concern that rising
malpractice premiums are restricting patient access to care
-
The
access issue was addressed in several testimonies, including one offered
by the wife of a man who had to wait hours before a neurosurgeon was
found to treat his life-threatening head injury—according to her
testimony, the neurosurgeons in the area had moved away because they
could no longer afford their malpractice insurance premiums
-
The
testimony of an obstetrician/gynecologist from Las Vegas who recently
moved to
Maine
because of premium increases also addressed access problems—despite
having 8,000 active patients, he could not sell his well-respected
12-year practice because of
Nevada’s
malpractice premium levels
-
While there was bipartisan agreement on the impact of rising malpractice
premiums, the Committee members remained divided over how to address the
problem
-
Senators Edward Kennedy (D-MA), Christopher Dodd (D-CT), and Richard
Durbin (D-IL) were among those who held the insurance industry
accountable—they blamed premium increases on poor financial management
and an exemption from anti-trust regulations, and called for increased
oversight and investigations of the industry
-
While several senators suggested capping awards and limiting an
attorney’s contingency fees as proposed in the HEALTH Act, others
including Hilary Clinton (D-NY) proposed the creation of a funding pool
that high-risk specialists could draw from to pay part of their premiums
-
Senator John Edwards (D-NC) criticized President Bush for claiming that
too many frivolous lawsuits go to court—he explained that attorneys
invest a great deal of time and money in defending their cases and
subsequently would never take on a case that had no merit and would fail
in court
-
Senator John Ensign (R-NV) and witness Jay Angoff, an attorney who
specializes in malpractice issues, felt that pre-trial screening
procedures (“affidavits of merit”) would prevent frivolous lawsuits from
consuming unnecessary resources and contributing to the rise in
malpractice premiums
-
Several states, including NC and TX already require some type of
affidavit of merit
-
www.aamc.org/advocacy/library/washhigh
H.J.Res. 2 “Consolidated Appropriations Resolution, 2003”
Sponsor: Representative C.W. Bill Young
Introduced: 1-7-03
Latest Major Action: On 2-13 Senate agreed to conference report by yea-nay
vote 76-20,
House agreed by 338-83
-
House and Senate leaders reached agreement on an omnibus $397.4 billion
spending package that encompasses the 11 unfinished appropriations bills
-
Most programs will be subject to an across-the-board cut of 0.65%
-
The
bill completes the doubling of the NIH budget, restores cuts to the
Title VII Health Professions programs, and provides increased Medicare
payments to physicians and rural hospitals
-
Within the Labor-HHS portion of the bill, the omnibus package includes
$27.3 billion for the NIH (16.2% increase) which completes the 5 year
effort to double the agency’s budget
-
The omnibus bill provides $424
million (9.3% increase) for the Title VII and VIII health professions
and nursing programs, including funding for portions of the new Nurse
Reinvestment Act
-
The
Title VII health professions programs are allotted $310.5 million (5.2%
increase)
-
The
National Health Service Corps (NHSC) is appropriated $172.2 million
(15.6% increase)
-
AHRQ receives $303.7 million (1% increase)—this
includes $55 million directed to research on reducing medical errors
-
Physicians and some hospitals will see an increase of 1.6% for Medicare
payments from April 1 to September 30, 2003 (there was an expected 4.4%
cut)—however Medicare Education and
Medicaid
Disproportionate Share Hospital payments were not included in the final
bill
-
www.aamc.org/advocacy/library/washhigh
H.R. 865 “Smallpox Vaccine and Compensation and Safety Act”
Sponsors: Representatives: Henry Waxman (D-CA)
Sherrod
Brown (D-OH)
Lois Capps (D-CA)
Edward Markey (D-MA)
Introduced: 2-13-03
Latest Major Action: On 2-26-03 referred to House Subcommittee on Health
-
This bill would address many unresolved issues surrounding President
Bush’s plan to vaccinate 500,000 health care workers against smallpox
-
The
bill would offer education, medical screening and surveillance to health
care workers who volunteer for the smallpox vaccine
-
The
legislation would provide medical care and a no-fault compensation fund
for anyone harmed by the vaccine—assistance would be administered
through state grants
-
www.thomas.loc.gov
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-
Meantime, the Bush Administration also said it is finalizing a proposal
to extend to volunteers who experience adverse effects following
smallpox vaccinations
-
The
coverage may also extend to volunteers’ families and patients who are
exposed to the vaccine
-
In
addition, the Administration is expected to add provisions further
protecting vaccine manufacturers from lawsuits
-
A
similar proposal is being considered in the Senate, but a bipartisan
agreement has not yet been reached
-
The
Administration’s voluntary vaccination initiative (underway since
January 24, 2003) has received harsh criticism from ANA, as well as
hospitals, public health officials and other organizations representing
health care workers for failing to address potential safety and
liability concerns
-
ANA
has written letters to President Bush and HHS Secretary Thompson
expressing reservations about the vaccination plan, citing concerns over
unnecessary health risks to nurses and their patients and unanswered
questions regarding potential liability issues
S.
373 “Safe Nursing and Patient Care Act of 2003”
Sponsor: Senators Edward Kennedy (D-MA) and John Kerry (D-MA)
Introduced: 2-12-03
Latest Major Action: On 2-12-03 referred to Senate Finance Committee
Summary:
-
Amends title XVIII (Medicare) of the Social Security Act to place
limitations on mandatory overtime for nurses, protect nurses against
retaliation in any manner with respect to any aspect of employment, and
provide for civil money penalties for violations of such provisions
-
Directs the HHS Secretary to study and report to Congress on standards
to establish for the maximum number of hours that a nurse may work
without compromising the safety of their patients
-
Requires the Director of the Office of Management and Budget to study
and report to Congress on the extent to which federally operated medical
facilities have in effect practices and policies with respect to
overtime requirements for nurses that are inconsistent with the overtime
requirements added by this Act
-
www.thomas.loc.gov
H.R. 745 “Safe Nursing and Patient Care Act of 2003”
Sponsors: Representatives Pete Stark (D-CA) and Steven LaTourette (R-OH)
Introduced:
2-12-03
Latest Major Action: On
2-26-03 Referred to House Health
Subcommittee
Summary:
-
The
above acts would:
-
Prohibit health care facilities that receive Medicare funding from
requiring an RN or LPN to work beyond an agreed to, predetermined,
regularly scheduled shift—in no instance could a nurse be required to
work more than 12 hours in a 24-hour period or for more than 80 hours
in a 2-week period (a provision that would prevent an institution from
altering shift schedules in a way that would undermine the law)
-
Include nondiscrimination protections for nurses who refuse overtime
and for nurses who provide information and/or cooperate with
investigations about the use of overtime
-
Include an exception in the case of a declared national, state, or
local emergency—such an emergency would be in response to an
unpredictable disaster, not in response to a staffing deficiency
resulting from management practices
-
Provide for a study by the HHS on the maximum number of hours that may
be worked by a nurse without compromising patient safety
-
The
ANA has long warned that mandatory overtime is dangerous for patients
and nurses, and that the practice has been driving nurses away from the
profession, thus exacerbating an emerging nursing shortage that is
expected to worsen dramatically over the next 10 years
-
By
using health care law to address the problem, Congress is recognizing
that mandatory overtime is a health care crisis that must be addressed
if patients are to receive safe and effective care
-
www.nursingworld.org/pressrel
H.R. 934 “The Teacher and Nurse Support Act of 2003”
Sponsor: Representative Carolyn McCarthy
Introduced:
2-26-03
Latest Major Action: On
2-26-03 was referred to House
Education and the Workforce Committee
-
The
Americans for Nursing Shortage Relief (ANSR) is supporting this bill
-
This bill will reduce the loan burden of individuals who agree to either
work full-time in the clinical setting as an RN or agree to teach
full-time as members of nursing faculty in accredited schools of nursing
-
The
bill addresses the most critical aspects of the shortage by providing
loan forgiveness to nurses trained through all accredited programs to
include diploma, associate degree, and baccalaureate and graduate-level
education
-
As part of ANSR, ASPAN has signed on
to a letter that will be sent to Representative McCarthy endorsing this
legislation
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