Washington Highlights: February
15, 2008
Contents
Prior Issues
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AAMC, GAO Testify on Future Health Care Workforce,
Title VII
Director of the AAMC Center for Workforce Studies Edward S. Salsberg,
M.P.A, Feb. 12 testified
before the Senate Committee on Health, Education, Labor, and Pensions
(HELP) in a roundtable hearing "Addressing Healthcare Workforce
Issues for the Future," including health professions shortages,
maldistribution, and diversity. Chaired by Sen. Bernie Sanders (I-Vt.),
the hearing coincided with the release of a Government Accountability
Office (GAO) report
that predicts "an ongoing decline in the nation's financial
support for primary care medicine" and an "over reliance
on specialty care services at the expense of primary care."
Testifying for GAO, Health Care Director A. Bruce Steinwald, called
for greater "accountability" for the $8 billion federal
investment in Medicare Direct Graduate Medical Education (DGME)
and Indirect Medical Education (IME) payments.
In his statement, Mr. Salsberg outlined how the nation's medical
schools and teaching hospitals are attempting to avert a physician
shortage as well as the challenges they face. HELP Chair Ted Kennedy
(D-Mass.) joined Senators Sanders, Lisa Murkowski (R-Alaska), Patty
Murray (D-Wash.), and Sherrod Brown (D-Ohio) in criticizing the
President's FY 2009 proposal to eliminate funding for the Title
VII health professions programs [see Washington
Highlights,
Feb. 8], and the panel of non-governmental witnesses overwhelmingly
agreed that increased support for the programs is necessary. Senators
Sanders and Murkowski also described the need to double the National
Health Service Corps (NHSC), a recommendation the AAMC proposed
in its 2006 Statement
on the Physician Workforce. Mr. Salsberg urged the committee
to strengthen these proven programs as it considers ways to address
workforce distribution.
Also among the panel of 9 witnesses were John E. Maupin, Jr., D.D.S.,
M.B.A., president of Morehouse School of Medicine, and Kevin Grumbach,
M.D., director of the University of California, San Francisco (UCSF)
Center for California Health Workforce Studies and professor and
chair of the UCSF Department of Family and Community Medicine. A
full witness list and summaries of each panelist's testimony are
available on the HELP
website.
Marcia Brand, Ph.D., associate administrator for the Health Resources
and Services Administration (HRSA) Bureau of Health Professions,
submitted written testimony for the record.
Information:
Tannaz Rasouli, Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
House, Senate VA Committees Examine President's
FY 2009 Budget
The House Committee on Veterans Affairs Feb. 8 and the Senate Committee
on Veterans Affairs Feb. 13 held hearings on the President's FY
2009 budget proposal for the Department of Veterans Affairs (VA).
The President's budget proposes $442 million for VA Medical and
Prosthetics Research, a $38 million (7.9 percent) decrease from
FY 2008 [see Washington Highlights,
Feb. 8].
Secretary of VA James B. Peake, M.D.; VA Undersecretary for Health
Michael J. Kussman, M.D.; and representatives of the Independent
Budget veterans service organizations testified at both hearings.
During the House hearing,
Rep. Shelley Berkley (D-Nev.) brought attention to the cut proposed
for VA research last year in the President's FY 2008 budget. She
questioned why the Administration saw fit to cut VA research again
in FY 2009, when Congress had restored the FY 2008 proposed cuts
and approved a $68 million increase in the final omnibus appropriations.
Rep. Vic Snyder (D-Ark.) also questioned the Administration's estimate
of other federal contributions to VA research, such as from the
National Institutes of Health (NIH). He noted that the Administration
estimated $769 million in the FY 2008 budget request, but the VA
only received $708 million for that fiscal year. In FY 2009, the
President's budget estimates $751 million from other federal resources
despite freezing the NIH budget.
At the Senate hearing,
VA Committee Chair Daniel Akaka (D-Hawaii) and Senators Patty Murray
(D-Wash.) and Richard Burr (R-N.C.) all expressed dismay about the
proposed cut in the VA research appropriation and questioned the
wisdom of cutting research and development at this time. The VA
representatives responded that the Administration's request was
consistent with previous budget proposals.
The Friends of VA Medical Care and Health Research (FOVA) coalition
submitted statements
for the record to the VA committees. For FY 2009, FOVA recommends
$555 million for VA Medical and Prosthetic Research and $45 million
for VA research facilities improvements under the minor construction
account. The AAMC is a member of the FOVA executive committee.
Information:
Matthew Shick, Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 828-0525
HHS Issues Patient Safety Proposed Rule
The Department of Health and Human Services (HHS) Feb. 11 released
the proposed
rule to establish a network of Patient Safety Organizations
(PSOs) designed to collect patient safety data from hospitals and,
in return, provide data, expertise and recommendations on how to
implement strategies to reduce errors and adverse events. The rule
implements the Patient Safety and Quality Improvement Act of
2005 (P.L.
109-41), which is intended to help address the barriers in analyzing
and implementing patient safety improvement strategies nationwide.
The PSOs will be designed not only to assist hospitals, but also
to aggregate patient safety data on a national level to identify
and eliminate systemic errors across the health care system.
To increase participation in the program, as well as offer protection
for the providers, the rule establishes confidentiality and privilege
protections for the data submitted to the PSOs. Data prepared and
submitted to the PSOs will be considered "patient safety work
product" and therefore privileged. The data and information
available at the PSO will not be released with few exceptions as
stated by law.
The Secretary of HHS will work with the private sector to develop
common formats and definitions for hospitals to provide their data
to allow for national aggregation. A National Quality Forum (NQF)
process allowing for multi-stakeholder involvement and input will
handle the initial formats and definitions. In the future, NQF will
allow for periodic review and comment on the common formats.
Various types of organizations can become a PSO; however, organizations
will need to complete a certification process through the Agency
for Healthcare Research and Quality (AHRQ) that requires documentation
of the organization's ability to meet 8 patient safety activities,
including: the collection and analysis of patient safety work product,
the development and dissemination of information with respect to
improving patient safety, operation of a patient safety evaluation
system and appropriate security measures to preserve confidentiality
of patient safety work product.
Participation in this program is voluntary. However, with the confidentiality
protections and the opportunity for hospitals to receive input on
how to handle their patient safety issues, it is anticipated that
participation will be high after the initial start up period.
AHRQ will accept comments on the proposed rule until April 14,
2008.
Information:
Jennifer Faerberg, Director, GME Track/Health Care Quality Liaison
AAMC Division of Health Care Affairs
jfaerberg@aamc.org
(202) 862-6221
On the Hill
Rep. Tom Lantos (D-Calif.) died Feb. 11, one month after announcing
he had been diagnosed with esophageal cancer. The 14-term lawmaker
served as Chair of the House Foreign Affairs Committee and as the
second-ranking Democrat on the Oversight and Government Reform Committee.
Calif. Gov. Arnold Schwarzenegger (R) has scheduled for April 8
a special election to choose a successor.
Rep. Darlene Hooley (D-Ore.) announced Feb. 7 that she will not
seek a 7th term this November. Rep. Hooley, who holds seats on the
House Committees on the Budget; Energy and Commerce; and Science
and Technology, also serves as House Senior Whip.
Rep. John Shadegg (R-Ariz.) announced Feb. 11 that he will retire
at the end of his current (7th) term. He currently serves on the
House Energy and Commerce Committee and the Select Committee on
Energy Independence and Global Warming.
The Republican Steering Committee Feb. 14 selected Rep. Jo Bonner
(R-Ala.) to serve on the House Appropriations Committee. Rep. Bonner
will fill the seat vacated when former Rep. Roger Wicker (R-Miss.)
was appointed to the Senate. The GOP conference must vote on the
Steering Committee's decision for final approval.
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