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Category: Health/Medical

Possible New Funding to Train Primary Care Physicians

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On Tuesday, President Obama will release his FY2015 budget request to Congress. We learned yesterday – while we were on Capitol Hill advocated for more Graduate Medical Education funding to train primary care physicians – that the President’s budget proposal will include:

• $5.23 billion over 10 years to train 13,000 primary care residents in high-need communities, and in team-based care, such as an accountable care organization.

• Higher payments to Medicaid providers, including physician assistants and nurse practitioners, by one year at a cost of about $5.44 billion.

• $3.95 billion over the next six years in the National Health Services Corps to support growing the program from 8,900 primary care providers in 2013 to at least 15,000 annually starting in the 2015 fiscal year.

The proposal will also address a shortage of mental health providers by offering new residency opportunities for psychiatrists, psychiatric nurse practitioners, and other mental health providers as part of the team-based approach.

We look forward to seeing more details next week, but this is the first encouraging news in a long while related to training more primary care physicians.

July Federal Update

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FY14 APPROPRIATIONS

The path to enacting FY14 appropriations measures is paved with legislative friction as Congress is showing no signs of undoing the sequester and the House and Senate chambers are working on vastly different overall budget numbers. At this point, there are three budgets — House, Senate, and White House — all of which assume no sequestration, but include different ways to account for the cuts in later years.

The House is advancing its FY14 appropriations bills at a $967 billion overall spending cap, while the Senate is working with a $1.058 trillion cap, which does not take into account the sequester. Ironically, both the House and Senate plans would trigger a new round of across-the-board spending reductions under sequestration because they violate the caps set by the 2011 Budget Control Act (PL 111-25). But the House GOP plan busts the caps in defense and other security measures while the Senate is expected to bust the caps in both defense and non-defense (domestic) bills. All of this is leading to a big fight on spending, which will certainly culminate in a continuing resolution (CR) before the federal fiscal year ends September 30th. Continue reading “July Federal Update”

Senate Proposes Increase for NIH

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Earlier today the Senate Labor, Health and Human Services, Education (L-HHS-ED) Appropriations Subcommittee approved by voice vote an FY14 bill that provides $164.33 billion in discretionary funding for programs under its jurisdiction, $7.8 billion higher than FY13 and above the budget caps established in the Budget Control Act.  No amendments were offered during the subcommittee markup. As you know, the House is advancing its appropriations bills at a $967 billion overall spending cap, while the Senate is working with a $1.058 trillion cap, which does not take into account the sequester. The House allocation for their Labor-HHS bill is much less than the Senate allocation, at only $121.8 billion.

A summary of the bill is up on the Senate Appropriations committee website. A few funding levels highlighted by the subcommittee include:

National Institutes of Health: The bill provides $30.955 billion, an increase of $307 million, to fund biomedical research at the 27 Institutes and Centers that comprise NIH. This level will allow NIH to allocate $40 million for the new Brain Research through Application of Innovative Neurotechnologies (BRAIN) Initiative. Other relevant NIH sections include:

  • Alzheimer’s Disease: The bill includes an $84 million increase for the National Institute on Aging, the NIH Institute with the primary responsibility for preventing, treating, and curing Alzheimer’s disease. The bill also includes $20 million for a new Alzheimer’s Disease Initiative that will strengthen dementia-capable long-term services and supports, assist caregivers of individuals with Alzheimer’s disease, and train healthcare providers on how to recognize the signs and symptoms of Alzheimer’s and manage the disease.
  • Public Access to Federally Funded Research: Four years ago, Congress required NIH to improve the public’s ability to access taxpayer-funded research by means of an online NIH repository. This effort has been highly successful. The bill includes a new provision that extends the requirement to other agencies funded in the bill.
  • Accelerating Cures: The bill includes $50 million, five times the FY13 level, for the Cures Acceleration Network, an NIH initiative intended to help speed the translation and application of discoveries that have shown signs of success at the laboratory level but have not advanced far enough to attract significant investments from the private sector.

Centers for Disease Control: The bill includes a program level of $7.023 billion, $475.6 million above FY13. The bill includes $5.8 billion in Budget Authority. Within the CDC appropriation, $20 million is included for the Advanced Molecular Detection and Response to Infectious Disease Outbreak initiative. The Education and Research Centers/AFF Program (NIOSH) is funded at $24.226 million, the same as the FY13 level. We have not seen the report accompanying the bill yet, but understand that the AFF Program is also funded at the FY13 enacted level.

Pell Grants:  The bill maintains the discretionary portion of the maximum Pell grant award level at $4,860 for the 2014/2015 school year but combined with the mandatory funding the maximum award will rise by $140 to $5,785.

Because the House of Representatives has yet to mark up its L-HHS-ED bill, it is impossible to provide a direct comparison. However, the House allocation is $121.8 billion, or 25.9 percent lower than the Senate level. The full Senate Appropriations Committee will consider the L-HHS-ED bill on Thursday morning. We will pass along additional information about what is included in the bill once it is available.

House GOP Proposes Austere FY14 Appropriations Plan

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Late yesterday, the House Republicans released new spending targets for FY14 appropriations bills. Under the GOP numbers, the Labor-HHS-ED bill will face a nearly 20 percent reduction on top of the cuts already made in the March 1st sequestration order. These programs would be capped at $121.8 billion — or about $28 billion below the best available estimates for post-sequestration appropriations. This represents $42 billion, or 26 percent, below what was enacted in FY10. House Appropriations Committee Chairman Hal Rogers (R-KY) appears to be scaling back spending for these programs, as well as for transportation, housing, environmental, and natural resources programs, in order to provide significant increases for a few of the 12 annual bills this summer. For example, Pentagon spending would rise to $512.5 billion, a roughly 6 percent increase over the reduced levels allowed under sequestration. We expect similar increases for Military-VA and Homeland Security.

Meanwhile, Senate Appropriations Committee Chairwoman Barbara Mikulski (D-MD), whose state is home to the NIH, pledged to work with the top senators on the Labor-HHS-ED subcommittee to ensure they get an appropriate allocation to fund these programs. The Democrat said she is “worried about the sequester’s effect on the people who work at NIH as well as extramural programs such as those run by universities.” Senator Richard Shelby (R-AL), the top Republican on the full committee, said he would work with Mikulski to try to increase funding for NIH in the face of the sequester. Other Senators also pledged their support for NIH funding, including Senators Tom Harkin (D-IA) and Jerry Moran (R-KS) – top ranking members of the Senate Health, Education, Labor, and Pensions (HELP) Committee. But despite the bipartisan support, there are still concerns that GOP priorities would prevent Congress from giving NIH the necessary funding resources.

The Office of Federal Relations continues to remind the Washington state delegation about the substantial fiscal impact NIH grant funding has on our economy. Please contact us if you have information that will help inform Members of Congress about the importance of NIH funding.

HRSA Announces Funding to Help Veterans Pursue Nursing

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Accredited nursing schools and health care facilities can apply through June 7 for up to $350,000 a year in funding to increase veterans’ enrollment in baccalaureate nursing programs, and explore ways to award academic credit for prior military health care experience or training, the Health Resources and Services administration announced today. The agency expects to award up to nine four-year cooperative agreements. The funding was announced at a White House Forum on Military Credentialing and Licensing.