Health Policy Digest for July 2020

House HHS Appropriations Bill Released
On July 13, the House Appropriations Committee passed its bill funding the Departments of Labor, Health and Human Services, and Education for fiscal year (FY) 2021. Highlights from the allocations include $78.6 million for advanced education nursing, $45.9 million for nursing education, practice, and retention, $5 million for the Nurse Practitioner Optional Fellowship Program, $20.3 million for nursing workforce diversity, $91.6 million for NURSE Corps scholarship and loan repayment, and $28.5 million for the Nursing Faculty Loan Program. The House is expected to vote on the bill by the end of July, though the Senate has not yet advanced their bills for FY 2021 government funding. Read the Committee-approved bill text and the Committee report.

On June 22, the Nursing Community Coalition (NCC)—of which ARN is a member—submitted letters to House and Senate leadership of the Labor, Health and Human Services, Education, and related agencies subcommittees on appropriations. These letters reiterated NCC's requests for additional funding in FY 2021 for Title VIII Nursing Workforce Development Programs ($278 million) and the National Institute of Nursing Research ($182 million). Read the letters here and here.

On July 1, Dr. Francis Collins, director of the National Institutes of Health (NIH), announced that Dr. Shannon Zenk, currently a nursing collegiate professor at the University of Illinois at Chicago, will become the next director of the National Institute on Nursing Research (NINR). Dr. Tara Schwetz, who has been serving as the NINR acting director since January 2020, will return full-time to her role as NIH associate deputy director. Read the NIH announcement on Dr. Zenk's selection here.

On July 15, the Coalition to Preserve Rehabilitation (CPR)—of which ARN is a member—submitted a letter to Congress requesting that the next COVID-19 legislative package include a "reset" of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act. The IMPACT Act, enacted in 2014, requires that Centers for Medicare and Medicaid Services (CMS) work to implement a unified payment system for all four settings of post-acute care (SNFs, IRFs, HHAs, and LTCHs). Due to the recent implementation of new individual payment systems and policies in PAC settings and the ongoing impact of the COVID-19 pandemic, CPR and other stakeholders have requested that Congress reset the timeline of the IMPACT Act and reevaluate whether a unified PAC payment system is appropriate for beneficiaries in need of post-acute care.

On June 16, the American Nurses Association (ANA) sent two letters to the Trump administration outlining recommendations for COVID-19 relief. One letter to CMS identified emergency flexibilities that should be made permanent, including telehealth flexibilities, and expanded scope of Medicare practice for advanced practice registered nurses (APRNs). The second letter, sent to the Occupational Safety and Health Administration (OSHA), urged the Department of Labor to restore standards for the provision of personal protective equipment in healthcare workplaces. Read the letter to CMS and the letter to OSHA.

On July 15, NCC sent a letter to CMS Administrator Seema Verma requesting that the agency make permanent a set of temporary regulatory waivers enacted during the COVID-19 public health emergency. Among these requests, NCC asked CMS to extend the waiver of the Medicare requirement that patients be under the care of a physician, permanently allow nurse practitioners and clinical nurse specialists to perform mandatory patient visits in skilled nursing facilities, and continue to expand flexibility for telehealth. Read the letter to CMS.

On July 9, the American Medical Rehabilitation Providers Association (AMRPA) and the American Academy of Physical Medicine and Rehabilitation (AAPM&R) hosted a virtual congressional briefing on the medical rehabilitation needs of recovering COVID-19 patients. Physician and hospital executive leaders from both organizations shared their experience with the COVID-19 pandemic and outlined policy recommendations to address the ongoing needs of rehabilitation patients, providers, and facilities. The recorded briefing is available to the public (password: 3F*^81vg).

On July 8, former Vice President Joe Biden's presidential campaign released a series of recommendations developed by the Biden-Sanders Unity Task Force, including a set of policies to improve access to and quality of health care. Among the recommendations are proposed policies to reauthorize the National Health Service Corps, double the public health workforce through expanded training and credentialing, and increase funding for Title VIII nursing workforce programs. View the recommendations.

On July 4, President Trump signed legislation extending the Paycheck Protection Program, implemented under the CARES Act in March to provide loans to small businesses to keep employees on payroll. The program, which was scheduled to expire on June 30, is now authorized to provide additional loans through August 8.

If you haven't already, we recommend that you visit ARN's COVID-19 Resource page on the ARN website for the latest information and resources for rehabilitation nurses.

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