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House Passes Mental Health Reform Bill

The U.S. House of Representatives recently passed the Helping Families in Mental Health Crisis Act (H.R. 2646) with overwhelming bipartisan support (422-2) after it was unanimously reported out of the House Energy and Commerce Committee. The legislation, introduced by Rep. Tim Murphy (R-PA), represents a significant overhaul of U.S. mental health treatment policy.

If enacted, the bill would create the Office of Assistant Secretary for Mental Health and Substance Abuse Disorders within the U.S. Department of Health and Human Services (HHS). This Assistant Secretary would assume responsibility over the Substance Abuse and Mental Health Services Administration and would also serve as a member of the Health Resources and Services Administration’s Council on Graduate Medical Education, an advisory body which provides recommendations to Congress and the Secretary of HHS regarding physician workforce and education. The budget-neutral bill also authorizes new prevention and treatment programs; reauthorizes existing ones - like a program to train clinicians how to better share information under the Health Insurance Portability and Accountability Act; authorizes grants for community treatment centers; and clarifies privacy regulations. Additionally, the bill codifies a recent federal rule that eases restrictions on Medicaid payments to mental health facilities. Specifically, it allows Medicaid to pay private managed care plans for patients who stay at these hospitals for fewer than 15 days.

Earlier this year, the Senate Health, Education, Labor and Pensions (HELP) Committee approved its measure, which is similar to the House bill. HELP Chairman Lamar Alexander (R-TN) expects the Senate will take up its measure in September when Congress returns from August recess, but the bill is stalled for now over gun background check legislation.

House and Senate Appropriations Committees Approve Labor-HHS-Ed Bills

Appropriations Committees in the House and Senate have each passed a Labor, Health and Human Services, Education (Labor-HHS-Ed) funding bill for fiscal year (FY) 2017. Senate appropriators approved their measure in June, and their counterparts on the House Appropriations Committee passed their bill in July. The House bill provides $161.6 billion in discretionary funding. The committee passed the bill by a vote of 31-19, mostly along party lines. This represents the second year in a row that the House Appropriations committee has passed a Labor-HHS-Ed appropriations bill and the first time in seven years that the Senate Appropriations Committee has passed one with bipartisan support. Highlights of interest in the House bill to osteopathic medical education include:
  • $33.3 billion for the National Institutes of Health, a $1.25 billion increase over the current funding level.
  • $280.24 million for the Agency for Healthcare Research and Quality, a $54 million cut from current level.
  • $7.8 billion for the Centers for Disease Control and Prevention (CDC).
  • $500 million, for CDC, Substance Abuse and Mental Health Services Administration (SAMHSA), and Health Resources and Services Administration (HRSA) programs targeted to combat opioid abuse, an increase of $126 million over current levels.
  • $294.2 million for HRSA Title VII Health Professions and Education Training Programs, a 12.1 percent increase above FY16 levels; this funding is inclusive of the HRSA Behavioral Health Workforce Education and Training Program that was transferred from SAMHSA.
  • $169.5 million for Rural Health Care Programs, an increase of $20 million above FY16. The bill focuses resources toward efforts and programs to help rural communities, such as telehealth.
  • $160 million for Preventive Health and Health Services Block Grant (Prevent Block Grant), which is level with FY16 funding.
  • The Administration proposed to eliminate this program.
  • The Health Careers Opportunity Program was eliminated in both the House and Senate bills.
  • $30.25 million for the Area Health Education Centers Program, which is level with FY16 funding.
  • $21.7 million for the Centers of Excellence Program, which is level with FY16 funding.
  • $46 million for the Scholarships for Disadvantaged Students Program, a $1 million increase from FY16.
  • $38.7 million for Geriatrics Programs, which is level with FY16 funding.

Additionally, the FY17 House Labor-HHS-Ed appropriations bill funds the U.S. Department of Education at $66.8 billion, $1.5 billion less than FY16.

In addition to the funding provisions, the House bill also contains a number of policy riders that are expected to be vetoed by the President, including defunding the implementation of the Affordable Care Act; prohibiting the implementation of the overtime rule recently issued by the Department of Labor; and defunding title IX family planning programs. Furthermore, the bill includes language which prevents the CDC from researching the public health implications of gun violence. Several of these provisions are nonstarters for Democrats and will likely be stripped from any funding bill that ultimately passes.

It is expected that neither chamber will bring a Labor-HHS-Ed funding bill up for a vote. The Senate bill differs significantly from the House version, and the two versions will have to be reconciled in conference, which is unlikely due to the limited legislative business days left this year. Congress must pass the appropriations bills or a continuing resolution (CR) to fund the federal government by September 30, 2016, the end of the federal government’s FY, or the government will shut down. It is expected that they will pass a CR to allow time to consider an omnibus bill, which would most likely include all FY17 appropriations bills.

House Passes Bipartisan Bill to Simplify Student Aid Application Process

On July 11, 2016, the U.S. House of Representatives passed H.R. 5528, Simplifying the Application for Student Aid Act by voice vote. Representatives Joe Heck (R-NV), Phil Roe (R-TN), Jared Polis (D-CO), and Mark Pocan (D-WI) were original sponsors of this bipartisan legislation. The bill is now in the Senate and was referred to the Committee on Health, Education, Labor, and Pensions for consideration.

The House Education and Workforce Committee continues its work on reauthorizing the Higher Education Act (HEA), and has recently passed other higher education bills, which will most likely become part of a larger HEA bill.

The House bill includes the following provisions:

  • Allows students to use data from two years prior to the date of application when filling out the Free Application for Federal Student Aid (FAFSA), a process known as prior-prior year (PPY).
  • Requires the U.S. Department of Education to simplify the process for applicants importing their available income data through the Internal Revenue Service. It also requires making the FAFSA available on a mobile application.
  • Provides student aid administrators more time to verify financial aid applicants’ income. The legislation would also allow student aid administrators to determine the maximum Pell Grant award earlier and provide students with immediate and accurate aid information.

With limited legislative business days left in the 114th Congress, a full HEA reauthorization is extremely unlikely this year, but is expected to be taken up next year in the new Congress.

AACOM Participates in First Coalition for Health Funding Public Health Fair on Capitol Hill

On Wednesday, July 13, 2016, AACOM participated in the 2016 Coalition for Health Funding (CHF) Public Health Fair on Capitol Hill. The CHF, an alliance of over 90 nonprofit health organizations fighting to protect investments in the public health continuum, held their first ever health fair in coordination with the Public Health Caucus to elevate the conversation around public health on Capitol Hill. AACOM is a long-time member of the CHF.

At the national event, AACOM highlighted the role of the ED to MED campaign in working to improve public health by strengthening the future physician pipeline, as well as providing information about the importance of mental health support for our nation’s medical students, residents, and physicians. AACOM also stressed its advocacy on other key policy issues on graduate medical education and support for funding of key physician workforce programs.

For more information about AACOM’s role at the CHF Public Health Fair, visit our Storify from the event.

U.S. Department of Education Announces New Student Loan Servicing Standards

The U.S. Department of Education (USDE) has recently announced a series of enhanced protections and customer service standards that will guide the future of federal student loan servicing practices. Ted Mitchell, the Under Secretary of Education, USDE, outlined these policies in a memorandum to the Office of Federal Student Aid (FSA) that is responsible for implementing the strategy to strengthen student loan servicing during the current procurement process. The USDE developed these guidelines in coordination with the U.S. Department of the Treasury and the Consumer Financial Protection Bureau.

Expanding on the agencies' joint principles and efforts to identify and incorporate student loan best practices, this joint endeavor will drive the USDE's ongoing contracting process to select new vendors to implement its vision for a new loan servicing system. The USDE policy memorandum provides direction in five specific areas: economic Incentives; accurate and actionable information; consistency; accountability; and transparency. According to the USDE, the goal of the new loan servicing system is to make it easier for borrowers to manage and repay their loans and enable any borrower to use a single web portal to access information, make payments, apply for benefits, and manage their account. Once created, multiple loan servicing vendors or customer service providers will plug into the platform. USDE plans to award the new vendor contracts by the end of the year.

Additionally, the USDE is enhancing its own oversight of financial institutions and exploring ways to ensure borrowers protect themselves against improper practices. On July 1, 2016, fulfilling one of the primary objectives of President Obama’s 2015 Student Aid Bill of Rights, the USDE launched the FSA Feedback System. Using this online portal, federal student aid customers may submit complaints, provide feedback, and report allegations of suspicious activity regarding their experience with federal student aid programs.

AACOM and its Council of Student Financial Aid Administrators Participate in NASFAA Conference

In July, the National Association of Financial Aid Administrators (NASFAA) held its national conference in Washington, D.C. AACOM Government Relations staff and members of its Council of Student Financial Aid Administrators (CSFAA) from the nation’s osteopathic medical schools participated in the conference. The CSFAA also held its in-person annual meeting during the conference.

Conference speakers included Representatives John Kline (R-MN) and Bobby Scott (D-VA), the Chairman and Ranking Member of the House Committee on Education and the Workforce, which has jurisdiction over the reauthorization of the Higher Education Act (HEA). The House leaders spoke to attendees about the ongoing work to reauthorize the HEA and the committee’s priorities for this year, and potential priorities in the next Congress. Chairman Kline, who is retiring this year, noted that while full reauthorization was “extremely unlikely” before the end of this Congress, it remains a priority. The House recently passed five smaller measures to address issues in higher education, including three bills that solidify the use of prior-prior year (PPY) income data on the Free Application for Federal Student Aid (FAFSA); require annual loan counseling; and develop a new online consumer information tool.

Conference participants were able to attend numerous policy sessions such as federal town halls, an HEA preview with congressional staff, and discussions on the VA and graduate and professional schools.

Additionally, Undersecretary of Education Ted Mitchell and Department of Education staff provided a federal update. They highlighted several initiatives at the Department, including the borrower defense regulation, the state authorization proposed rule, FAFSA, and the use of PPY income data.

HHS Releases List of Health Professional Shortage Areas

On July 1, 2016, the U.S. Department of Health and Human Services (HHS) officially published its updated list of designated primary medical care, mental health, and dental health professional shortage areas (HPSAs) as of May 13, 2016. As a substantial number of designation and withdrawal requests come from the Primary Care Office in state health departments and are reviewed and updated as necessary annually by HHS’ Health Resources and Service Administration (HRSA), the list highlights provider shortages by demography, geography, and institution, identifying areas in which National Health Service Corps (NHSC) professionals may serve, and entities that include clinical training sites in HPSAs that may receive priority for HRSA residency training program grants. To locate NHSC approved sites with eligible HPSAs and the corresponding HPSA scores for use in the NHSC programs, individuals should refer to the NHSC Jobs Center.

Please note: HPSAs are updated frequently based on the identification of new areas, population groups, facilities and sites that meet the eligibility criteria or that no longer meet eligibility criteria and/or are being replaced by another type of designation. As such, additional HPSAs may have been designated since the July 1st announcement. These newly designated HPSAs will be included in the next publication of the HPSA list and are currently included in the daily updates posted on the HRSA Data Warehouse using the HPSA Find resource.

For further information regarding shortage designation, please visit the HRSA Shortage Designation website.

Inside OME Header
July/August 2016
Vol. 10, No. 6