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Governmental Affairs Update
August - December 2004
Gena Near, BSN, RN, CPAN
Governmental Affairs
Committee Chair
ANSR Update
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Held a
successful congressional briefing in September 2 days after the
long August recess
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The
event attracted Hill staff from the Senate and House, nurses
from the community, representatives from ANSR organizations (ASPAN
sponsored the event), and nurses that work in a variety of
federal agencies and the military
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There were over 100 people present
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The
message of the need for adequately prepared faculty and the
numbers of students that were unable to enter programs as a
result came through loud and clear
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The
speakers worked hard to reinforce the need for funding this
important aspect of Title VIII
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There were 4 reporters present
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ASPAN
signed onto a letter supporting H.R. 4231, the “Department of
Veterans Affairs Nurse Recruitment and Retention Act of 2004”
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As a
result of our conference call on October 21, we are proceeding
with plans for an ANSR congressional reception to welcome new and
old Members of Congress and their Health Legislative Assistants
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This
reception will be held on Tuesday, March 1, 2005 in the Cannon
House Office Building from 5:30 to 7:30 PM (I plan to represent
ASPAN there)
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ASPAN will be listed in the program
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ANSR
will be presenting their first ANSR Alliance Public Service
Award:
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Plans are for a 2 hour evening reception for approximately 250
people
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On
November 18 a number of ANSR organizations met via conference call
to discuss the FY 2006 nursing appropriations funding request with
a number of the APRN groups (all of which are ANSR organizations)
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During the course of the discussion, the groups on the call all
agreed that their organizations were interested in pursing an
adjusted $205 million for the FY 2006 appropriations funding
level
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The
inflation factor that was agreed to by the groups was health
care inflation, which is reported at 7.3% by CMS (Centers for
Medicare and Medicaid Services)
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This
would be a $220 million funding level
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There was some discussion about COLA (cost of living adjustment
inflation factor) that the Federal government uses for its
Federal employee salaries—for FY 2006 this rate is 3.5% which
would provide a $212 funding level
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The
groups on the call support the $220 level
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On
November 29 a conference call was held among a number of nursing
organizations to discuss the FY 2006 nursing education
appropriations number
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The
next conference call is planned for January 6 to discuss the
following:
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ANSR
FY 2006 appropriations amount
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ANSR
letter re appropriations testimony
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ANSR
reception
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ANSR
consensus statement review for 109th Congress
ON THE HILL
2004 ELECTION OVERVIEW
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The US
will remain in Republican control
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In
addition to President Bush gaining a second term, the GOP
increased their advantage in both the Senate and House
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In the
Senate, Republicans picked up 6 new seats and lost 2, and will
hold a 55 to 44 margin, with one Independent, in the 109th
Congress
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Republicans picked up 4 more seats in the House to hold a 231 to
201 margin, with one Independent and 3 seats undecided
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The
109th Congress will have 3 new physicians:
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Senator-elect Tom Coburn (R-OK), a family physician
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Representative-elect Tom Price (R-GA), a surgeon
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Representative-elect Joe Schwarz (R-MI), an otolaryngologist
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This
brings the total number of physicians in Congress to 11
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The
Senate has 9 new members:
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Republicans:
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Richard Burr (NC)
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Tom Coburn (OK)
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Jim DeMint (SC)
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Johnny Isakson (GA)
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Mel Martinez (FL)
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John Thune (SD)
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David Vitter (LA)
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Democrats:
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Barack Obama (IL)
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Ken Salazar (CO)
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6 of
the new Senators have experience in the House:
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Burr
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DeMint
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Isakson
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Vitter
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Coburn
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Thune
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Term
limits that Republicans imposed on themselves in 1997 and revised
last year mean that at least 8 Senate committees will get new
leaders:
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Thad
Cochran (R-Miss) is slated to take over Appropriations Committee
from Ted Stevens (R-AL), who will move to chair the Commerce,
Science and Transportation Committee
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Larry Craig (R-ID) will chair the Veterans’ Affairs Committee,
which is currently led by Arlen Specter (R-PA), who is in line
to take over the Judiciary Committee
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Retiring Budget Committee Chair Don Nickles (R-OK) is likely to
be replaced by either Judd Gregg (R-NH) or Wayne Allard (R-CO)
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If
Senator Gregg takes over Budget, he may be replaced as Chairman
of the Health, Education, Labor and Pensions (HELP) Committee by
Michael Enzi (R-WY), who is next in line behind Gregg and Senate
Majority Leader Bill Frist (R-TN)
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In the
House, Appropriations Committee Chair C.W. Bill Young (R-FL) is
term limited, and will be succeeded by one of three current
subcommittee chairs:
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Ralph Regula (R-OH)
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Jerry Lewis (R-CA)
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Harold Rogers (R-KY)
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James
Walsh (R-NY) also must give up his chairmanship of the House
VA-HUD Appropriations Subcommittee
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Both
the House Energy and Commerce Committee and the Ways and Means
Committee will lose key members:
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Representatives Burr, Greenwood, and John were members of the
Health Subcommittee
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The
Ways and Means Committee loses the number two Republican on the
committee, Phil Crane (IL) , as well as Michael Collins (R-GA),
Jennifer Dunn (R-WA), Amo Houghton (R-NY), Scott McInnis (R-CO),
Jerry Kleczka (D-WI), and Max Sandlin (D-TX)
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Representatives Crane, Dunn, and Kleczka served on the Ways and
Means Health Subcommittee
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www.aamc.org/advocacy/library/washhigh
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There
was reelection of 3 nurses to the House of Representatives:
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Eddie Bernice Johnson, RN (D-TX)
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Carolyn McCarthy, LPN (D-NY)
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Lois
Capps, RN (D-CA)
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Key
races were won in the Senate who have a strong background in
promoting health care and nursing issues:
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Numerous proponents of health care also were elected to the House
and include:
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www.nursingworld.org
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President Bush will submit his FY 2006 budget to Congress in
February 2005
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Some
of the health issues likely to arise in the 109th
Congress:
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Medicare
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Medical Malpractice
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Prescription Drug Importation
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Stem
Cell Research
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Coverage of the Uninsured
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Medicaid Reform
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Patient Safety
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Health Information Technology
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Telehealth
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FDA
Regulation of Tobacco
“EARLY OFFERS” PILOT
PROGRAM TO SPEED COMPENSATION TO INJURED PATIENTS, HELP REDUCE
MEDICAL COSTS
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HHS
Secretary Thompson announced on September 21 an “Early Offers”
pilot program aimed at encouraging settlements of patients
claiming to have been injured by medical mistakes and controlling
health care costs by providing fair and prompt compensation
without time-consuming and expensive litigation
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Secretary Thompson said the program is another way to combat the
medical liability crisis that is contributing to the rising cost
of health care and driving doctors out of their practices
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The
Secretary said the initiative could serve as a national model for
resolving medical liability cases in a more efficient manner
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The
early offers pilot program applies to claims made against the
Department of Health and Human Services by patients who are
treated by employees of federally funded community health centers
overseen by HHS’ Health Resources and Services Administration or
by patients who receive service through Indian Health Service
(HIS) programs—participation by any injured patient is voluntary
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www.hhs.gov
GRANTS.GOV REACHES 1,000
APPLICATIONS MARK
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HHS
Secretary Thompson announced on September 17 that “Grants.gov,”
the single secure Web site to find and apply for US Government
grants, has received its 1,000th electronic grant
application, a milestone indicating the shift from a slower,
paper-based grant application process is well underway
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Managed by HHS, Grants.gov is 1 of 24 E-government initiatives
operating under the governance of the Office of Management and
Budget (OMB), and is 1 of only 2 E-government initiatives to
successfully meet OMB’s operational goals earlier this year
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The
award-winning, free Web site centralizes grant information and
electronic applications for more than 900 grant programs from all
26 federal grant-making agencies, making it easier to find and
apply for over $360 billion in annual grant funds available across
the federal government
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User
satisfaction is driving the site’s growth—more than 1,000 grant
applicants chose Grants.gov over a paper-based grant application
process
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Federal agencies are currently posting nearly 1,400 active grant
opportunities, which are accessible through the Grants.gov “Find
Grant Opportunities” feature
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Grants.gov is the single Web site unifying federal grants—through
this site, state, local, and tribal governments, colleges and
universities, non-profits, research institutions, and other
organizations can access, find, and apply for grants from more
than 900 grant programs representing over $360 billion in annual
grant funds offered by the 26 federal grant-making agencies
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Grants.gov is a collaborative effort led by HHS
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Collaborative partners include: Departments of Agriculture,
Commerce, Defense, Education, Homeland Security, Housing and Urban
Development, Justice, Labor and Transportation, Environmental
Protection Agency, National Endowment for the Humanities, and the
National Science Foundation
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www.grants.gov
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www.hhs.gov
DRUG DISCOUNT CARDS
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HHS
Secretary Thompson announced on September 22 that nearly 2 million
low-income Americans on Medicare will soon be automatically
eligible for prescription discounts through the Medicare Drug
Discount card and qualify for an additional $1,200 in savings over
the next 14 months
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Letters will go to people who receive state help to pay Medicare
premiums in what are known as Medicare Savings Programs (Qualified
Medicare Beneficiary, Specified Low-income Medicare Beneficiary,
and Qualifying Individual)
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The
potential credit is $600 per year between now and the end of 2005
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Any
portion of the credit that is unused at the end of 2004 can be
carried over into 2005
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Beneficiaries needed to sign up by December 31, 2004 to be
eligible for the credit
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Beneficiaries who received letters can call 1-800-MEDICARE or
visit
www.medicare.gov to see if their favorite pharmacy takes the
card they received and what discounts are available on the drugs
they take
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Medicare beneficiaries who do not receive prescription drug
coverage through Medicaid are eligible for a Medicare-approved
drug discount card
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In
addition, Medicare beneficiaries whose annual incomes are below
$12,569 for singles and $16,862 for married couples are eligible
for the $600 credit
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www.hhs.gov
HHS ANNOUNCES REGIONS TO
ADMINISTER NEW MEDICARE PRESCRIPTION DRUG BENEFIT AND MEDICARE
ADVANTAGE PROGRAM
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On
December 6 HHS (Health and Human Services) Secretary Thompson
announced that Medicare is taking another step in bringing more
choices, better benefits, and more savings to millions of Medicare
beneficiaries by establishing the regions for prescription drug
plans and Medicare Advantage Preferred Provider Organizations (PPOs)
health plans beginning in 2006
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To
help ensure that all Medicare beneficiaries have the opportunity
to take advantage of the Medicare prescription drug benefit, the
Centers for Medicare & Medicaid Services (CMS) established 26
regions for Medicare Advantage Preferred Provider Organizations
and 34 regions for prescription drug plans
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Beginning in 2006, Medicare beneficiaries will be able to receive
drug coverage through a prescription drug plan, if they wish to
remain in traditional fee-for-service Medicare, or through a
Medicare health plan
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In
either case, Medicare pays about 75% of the beneficiary’s premium
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Beneficiaries who are enrolled in an employer-sponsored plan will
be able to remain in that plan if they wish
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CMS
considered the following factors in setting up Medicare Advantage
regions:
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Many
of the same factors went into defining Prescription Drug Plan (PDP)
regions
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www.hhs.gov
BIODEFENSE CONTRACTS FOR
VACCINE DEVELOPMENT
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HHS
Secretary Thompson announced on October 7 four new contracts
totaling more than $232 million to fund development of new
vaccines against 3 potential agents of bioterrorism:
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Smallpox
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Plague
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Tularemia
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The
National Institute of Allergy and Infectious Diseases (NIAID),
part of the National Institutes of Health (NIH), will administer
the contracts
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The
smallpox awards continue advanced development work that began in
February 2003 on 2 modified Vaccinia Ankara (MVA) vaccine
candidates
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The
tularemia and plague awards will fund early-stage product
development of the respective vaccines, which will include dosage
formulation, pilot batch production, and initial clinical
assessment
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All 4
contracts are for purchases of vaccine lots intended for research
use
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Any
future purchases of additional vaccines for stockpiling in the
event of an emergency will depend on the results of the research
currently underway
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NIAID
awarded 2 contracts totaling up to $177 million for advanced
development of MVA vaccines against smallpox
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The
3-year contracts were awarded to Bavarian Nordic A/S of
Copenhagen, Denmark, and Acambis, Inc, of Cambridge, MA, and
Cambridge, England
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MVA is
a highly weakened form of the vaccinia virus that cannot replicate
in human cells
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For
the plague vaccine, NIAID awarded a contract to Avecia
Biotechnology, Ltd, of Manchester, England
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The
3-year, $50.7 million contract covers the manufacture of a new
plague vaccine as well as animal testing and initial human
trials
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There is currently no licensed plague vaccine, and the pneumonic
form of the disease (which affects the lungs and can spread from
person to person through the air) is nearly always fatal unless
antibiotic treatment is started within 24 hours of infection
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NIAID
also modified an existing contract with DynPort Vaccine Company
LLC of Frederick, MD, to include the manufacture of a pilot batch
of live, attenuated tularemia vaccine
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The
3-year, $4.5 million contract modification also covers stability
testing of the vaccine
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Tularemia is a highly infectious bacterial disease most often
transmitted by ticks and insects
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In
humans, illness is characterized by intermittent fever,
headache, and swelling of the lymph nodes
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This
live, attenuated vaccine contains a weakened form of the
tularemia bacterium, enabling the immune system to recognize and
produce neutralizing antibodies against the bacterium if it is
encountered again
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NIAID
is a component of NIH
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NIAID
supports basic and applied research to prevent, diagnose, and
treat infectious diseases such as HIV/AIDS and other sexually
transmitted infections, influenza, tuberculosis, malaria, and
illness from potential agents of bioterrorism
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NIAID
also supports research on transplantation and immune-related
illnesses, including autoimmune disorders, asthma, and allergies
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www.hhs.gov
JCR PUBLISHES GUIDES TO
IMPROVING PATIENT CARE
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On
December 6, 2004 Joint Commission Resources (JCR) announced the
publication of 2 new books to help hospitals provide safe, high
quality care:
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Issues in Provision of Care, Treatment, and Services for
Hospitals
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Issues in Human Resources for Hospitals
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Other
JCR books:
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Overcoming Performance Measurement Challenges for Hospitals
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Cost-Effective Performance Improvement in Hospitals
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Meeting JCAHO’s Infection Control Requirements: A Priority
Focus Area
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Infection Control Issues in the Environment of Care
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To
order: 877-223-6866 or
www.jcrinc.com
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www.jcaho.org
US PLEDGES 20 MILLION
DOSES OF SMALLPOX VACCINE TO GLOBAL STOCKPILE
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HHS
Secretary Thompson announced that the US is pledging 20 million
doses of smallpox vaccine to the global stockpile managed by the
World Health Organization (WHO)
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The US
is by far the largest contribution to date to the global stockpile
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Canada,
France, Germany, and the UK have made pledges to the stockpile
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At a
2003 Ministerial Meeting of the Global Health Security Initiative
(GHSI), the US encouraged its international partners to develop
the WHO Smallpox Vaccine Bank, which would consist of a physical
stockpile in Geneva and a virtual global stockpile of pledged
vaccine stocks from around the world
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This
vaccine stockpile could quickly dispatch vaccine to any country
that might be experiencing an outbreak of smallpox
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Founded after 9-11-01, the GHSI brings together the health
ministers of Canada, France, Germany, Italy, Japan, Mexico, the
UK, and the US plus the Health Commissioner of the European Union
and the Director-General of the WHO—it was formed to promote
collaboration in preparedness and response planning for public
health emergencies and potential bioterrorists attacks
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www.hhs.gov
HHS BUYS NEW ANTHRAX
VACCINE FOR STOCKPILE
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HHS
Secretary Thompson announced that HHS has awarded a contract for
$877.5 million to VaxGen, Inc. to manufacture and deliver 75
million doses of a new anthrax vaccine
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The
full supply of the vaccine will be added to the Strategic National
Stockpile and would be used to protect the public against a
terrorist attack in which anthrax spores were released
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This
award represents the first contract under the Project BioShield, a
new program intended to accelerate the development, purchase, and
availability of medical countermeasures for biological, chemical,
radiological, and nuclear threats
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President Bush introduced Project BioShield in his 2003 State of
the Union address
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Congress passed the Project BioShield Act of 2004 and the
President signed it into law on July 21, 2004
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HHS’
Office of Public Health Emergency Preparedness, which oversees the
research and procurement efforts under the Project BioShield
program, will manage this new anthrax vaccine contract
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www.hhs.gov
HHS NEWS
*****HHS Secretary
Tommy Thompson announced on December 3 his resignation, stating
“after nearly 40 years of public service, it is time
for me and my family to move onto the next chapter in our
life.”*****
HHS AWARDS $139 MILLION
TO DRIVE ADOPTION OF HEALTH INFORMATION TECHNOLOGY
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On
October 13, 2004 HHS announced $139 million in grants and
contracts to promote the use of health information technology
(HIT)
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Awarded through HHS’ Agency for Healthcare Research and Quality (AHRQ),
this multi-year program builds on President Bush’s initiative to
use HIT to improve the nation’s health care system
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These
awards will provide insight into how best to use health
information technologies to improve patient safety by reducing
medication errors; increasing the use of shared health information
between providers, laboratories, pharmacies, and patients; helping
to insure safer patient transitions between health care settings,
including hospitals, doctors’ offices, and nursing homes; and
reducing duplicative and unnecessary testing
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The
$139 million will be used in the following ways:
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President Bush in April called for electronic health records for
most Americans within 10 years
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An
executive order provided for the establishment of the office of
the “National Coordinator for Health Information Technology” and
in May, Secretary Thompson appointed Dr. Brailer to the new
position
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www.ahrq.gov
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www.hhs.gov
JCAHO UPDATE
Continuous Access to PPR in 2005
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Beginning January 18, 2005, JCAHO will provide all accredited
organizations with continuous access to the Periodic Performance
Review (PPR) software via the Extranet
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Continuous access will assist organizations in using the PPR tool
as part of the organization’s ongoing management strategy as well
as help organizations prepare for the future requirement to update
the PPR annually (effective 1-1-06)
Recognition of Exemplary Organ Donation Rates
Jayco
Extranet Security Enhancements
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New
security enhancements have been made to the JCAHO’s “Jayco”
extranet site
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Beginning in October, as accredited organizations log into their
“Jayco” site, they will be prompted to migrate to the new system
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Through the new system, staff members who are listed on the
Organization Contact page on the “Jayco” site and who provide an
email address will be given their own login and password, rather
than sharing one password throughout the organization
New
Campaign Offers Steps to Prevent Infections
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JCAHO,
in collaboration with the American Hospital Association,
Association for Professionals in Infection Control and
Epidemiology, CDC, Infectious Diseases Society of America, and
Society for Healthcare Epidemiology of America, on October 20
urged Americans to take appropriate steps to reduce the likelihood
of becoming ill
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The
national campaign to help Americans fight the spread of infection
in health care settings and in the community, and contain
contagious diseases like the common cold, strep throat, and
influenza, coincided with National Infection Control Week, October
18-22
Call
for Codman Award Applications
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JCAHO
is now accepting applications for the 9th annual Ernest
A. Codman Award
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The
deadline for submitting an application for the award is February
14, 2005
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For
2005, JCAHO-accredited Disease Specific Care Certification
programs are now eligible to apply for the Codman Award
JCAHO
Participating in Development of Surgical Care Improvement Project
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The
Surgical Care Improvement Project (SCIP) is a national partnership
of organizations committed to improving the safety of surgical
care through the reduction of post-operative complications
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In
summer 2005, the SCIP partnership will launch a collaborative,
multiyear national campaign to substantially reduce surgical
mortality and morbidity in 4 target areas:
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The
goal is to reduce nationally the incidence of surgical
complications by 25% by the year 2010
JCAHO, CMS to Make Common Performance Measures Identical
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JCAHO
and the Centers for Medicare and Medicaid Services (CMS) announced
the signing of an agreement to work together incompletely aligning
current and future common Hospital Quality Measures in their
condition-specific performance measure sets
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The
current Hospital Quality Measures are included in the Joint
Commission’s ORYX Core Measures and CMS’ 7th Scope of
Work Quality of Care Measures on heart attack, heart failure,
pneumonia, and surgical infection prevention
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CMS
and JCAHO released and made available on their websites a common
measures specification manual, which includes a data dictionary,
measure information forms, algorithms, and other technical support
information
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This
single common measures manual for hospital quality measures is
effective with January 2005 hospital discharges
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While
containing documentation on the identical measures, the single
manual also contains measures and operational processes unique to
each entity—for example, the acute myocardial infarction (AMI)
section of the manual contains the common identical measures, as
well as 2 CMS test measures and the JCAHO AMI mortality measure
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JCAHO
and CMS have signed an agreement to continue to work together to
assure alignment into the future for common Hospital Quality
Measures in their condition-specific performance measure sets
New
Health Care Information Technology Work Group
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For
2005, a new Health Care Information Technology Strategic Issues
Work Group (SIWG) will be formed
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This
SIWG will identify opportunities for JCAHO to contribute to the
rapid adoption of a national health care information technology
infrastructure that includes an electronic medical record
NURSES TOP LIST IN
HONESTY AND ETHICS AGAIN IN GALLUP POLL
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The
Gallop Organization’s annual poll on professional honesty and
ethical standards ranked nurses number one
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Nurses
have topped the list every year, except one (firefighters in 2001)
since they were added to the survey in 1999
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www.nursingworld.org
ANA PRESIDENT BLAKENEY
TO SERVE ON IOM PANEL
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American Nurses Association (ANA) President Barbara Blakeney, MS,
RN has been invited by the Institute of Medicine (IOM) to serve on
a committee that will assess the current and future border
quarantine functions and structure
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The
study (sponsored by the Centers for Disease Control and Prevention
(CDC)) will focus on:
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the
role of US quarantine stations as a public health intervention
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the
role federal agencies (such as Customs & Border Protection,
Immigration and Customs Enforcement, US Department of
Agriculture and US Fish and Wildlife Service) will play in
working with the CDC’s Division of Global Migration and
Quarantine at ports of entry
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the
role state and local health departments will play, such as
disease surveillance and medical assessment and follow-up of
newly arriving immigrants and refugees
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the
appropriate types and number of health care professionals to
staff quarantine sections
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The
IOM is a nonprofit organization under the auspices of the National
Academies of Science, specifically created to serve as adviser to
the nation to improve health by providing unbiased,
evidence-based, authoritative advice concerning health and science
policy to policy-makers, professionals, leaders in every sector of
society and the public at large
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To be
asked to serve on an IOM board is a high honor; Blakeney is the
first sitting president of ANA to serve on such a panel
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www.nursingworld.org
ANA PRESIDENT BLAKENEY
SPEAKS OUT ON WORKPLACE VIOLENCE AT NIOSH CONFERENCE
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On
November 17, 2004, ANA President Blakeney represented Nursing on a
panel of national leaders during the National Institute for
Occupational Safety and Health (NIOSH) conference titled,
“Partnering in Workplace Violence Prevention: Translating
Research to Practice” in Baltimore, MD
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The
goal of the conference was to identify successful workplace
violence prevention strategies, barriers to program
implementation, research and information dissemination gaps, and
roles for national agencies and organizations
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NIOSH
info can be accessed at:
www.cdc.gov/niosh/injury/traumaviolence.html
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www.nursingworld.org
ICN RELEASES PUBLICATION
ON GLOBAL NURSING SHORTAGE
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The
International Council of Nurses (ICN), the Florence Nightingale
International Foundation (FNIF), and the Burdett Trust for Nursing
released The Global Shortage of Registered Nurses: An Overview
of Issues and Actions
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The
document provides a global overview of the nursing workforce, it:
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The
full document may be found at:
www.icn.ch/global/shortage.pdf (large pdf file; 62 pages)
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