What You Need to Know

The continuing resolution (CR) signed by the President on September 27 extended Congress’ deadline to negotiate and pass its 12 appropriations bills to November 21. This week, the U.S. House of Representatives plans to introduce a new CR that would avert a federal government shutdown and further extend Congress’ deadline to December 20. However, congressional negotiations have largely been hindered over disagreements concerning funding for domestic programs and the border wall. The White House has indicated that the stopgap spending bill must include border wall funding to be signed into law. Many education and health programs critical to osteopathic medical education (OME), which were unaffected by last year’s shutdown, could face funding lapses this year if an agreement is not reached. Additionally, without further bipartisan funding negotiations, short-term funding for mandatory programs such as the Teaching Health Center Graduate Medical Education (THCGME) Program and community health centers could also lapse. AACOM will continue monitoring developments on the appropriations process as the current CR’s deadline approaches this Thursday.

As a note, our next issue of the Washington Insider will be sent on Tuesday, December 3.

Wishing you a happy Thanksgiving holiday,

AACOM Office of Government Relations

On The Hill

AACOM Joins Friends of HRSA Letter to Congress in Support of FY20 HRSA Funding

AACOM joined more than 50 national organizations in a letter to House and Senate Appropriations leadership, requesting a minimum of $7.32 billion in fiscal year (FY) 2020 discretionary funding for the Health Resources and Services Administration (HRSA). HRSA is an essential component of the nation’s health care system and a national leader in improving the health of Americans. HRSA addresses the supply, distribution, and diversity of health professionals; supports training in contemporary practices; and provides quality health services to the nation’s most vulnerable and underserved populations. AACOM is a member of Friends of HRSA, a nonpartisan coalition of nearly 170 national organizations representing public health and health care professionals, academicians, and consumers invested in HRSA’s mission to improve health and achieve health equity.

House to Consider Stopgap Funding This Week

This week, the House is scheduled to consider a CR to fund the federal government until December 20, buying time for Congress to continue negotiating FY20 spending bills before the current CR expires on November 21. Separately, short-term mandatory funding for several important health care programs, including the THCGME Program, is also set to expire.

House and Senate leadership are working to avoid a government shutdown, but disagreements over border wall funding and increases in domestic spending continue to complicate congressional negotiations. The Senate must pass the remaining eight of 12 spending measures, and the House its remaining two, before conference negotiations can begin between the two chambers. AACOM will continue to advocate for programs of importance to OME as Congress progresses through the FY20 appropriations process.

Senate Budget Committee Advances Bill to Reform Budget Process

On November 6, the Senate Budget Committee advanced a bipartisan bill, the Bipartisan Congressional Budget Reform Act (S. 2765), to overhaul the federal budget process. Among other reforms, the bill would maintain annual appropriations but replace the current procedure with a two-year budget resolution, the blueprint for spending and taxes. The proposal follows previous efforts to reform the budget process, including last year’s Joint Budget and Appropriations Process Reform Committee, which disbanded in December 2018 after failing to reach a bipartisan consensus to approve its own recommended set of proposals to overhaul the federal budget and appropriations process. It is not yet clear whether the Bipartisan Congressional Budget Reform Act will gain more bipartisan support, despite growing frustration over government shutdowns, repeated delays in passing appropriations bills on time, and a growing federal debt.

Advocacy

AACOM Launches New Campaign to Promote Osteopathic Recognition

AACOM has launched a new campaign, Osteopathic Recognition Matters: Programs for Optimal Patient Care, to promote and help educate the OME community about the benefits of graduate medical education (GME) programs with Osteopathic Recognition (OR). OR programs provide a complete and rigorous education by focusing on the principles and practice of osteopathic medicine. AACOM’s OR Matters campaign will help medical students connect with GME programs where they can build upon their skills and interest in osteopathic medicine, and help program directors attract high-quality, best-fit candidates dedicated to osteopathic principles.

In early 2014, AACOM, the American Osteopathic Association, and the Accreditation Council for Graduate Medical Education (ACGME) agreed to transition to a single GME accreditation system by July 2020. The new single GME system allows graduates of allopathic and osteopathic medical schools to complete their residency and/or fellowship education in ACGME-accredited programs. As the completion of the transition to single GME accreditation approaches, AACOM’s OR Matters campaign provides helpful, timely information and resources to ensure the OME community is well-served by this new system. As always, AACOM remains committed to advocating to expand GME programs and funding to help ensure today’s osteopathic medical students receive the training they need to meet our country’s growing health care demands and challenges, and we look forward to building upon these efforts to further support our community. Learn more.

Medical Resident Inspires ED to MED Community to Make Advocacy a Lifelong Commitment

Third-year OB/GYN resident Harika Kantamneni, DO, first became passionate about advocacy early in her medical school career. This interest developed and grew during her time with AACOM’s Office of Government Relations in Washington, DC, as an Osteopathic Health Policy Intern. Supporting efforts that impact the OME community gave Harika a unique perspective on the importance of consistently advocating and building relationships with policy leaders. These tools now help Harika advocate for her patients and share her expertise with Members of Congress. Learn more in Harika’s ED to MED guest blog post.

Reminder: Apply for AACOM’s Osteopathic Health Policy Internship

Develop an understanding of federal health care and higher education policy, participate in the legislative and regulatory process, and hone your life-long advocacy skills during this eight-week internship! Interns support AACOM’s Office of Government Relations in Washington, DC by attending Capitol Hill hearings and briefings, researching federal policy issues impacting OME, and more. Applications are due on Friday, January 24, 2020. Apply today.

#COMDAY19: Raising Our Voices for the Future Health Care Workforce

ED to MED thanks the many grassroots advocates who took action on Capitol Hill and social media to urge Members of Congress to support the future physician and broader health care workforce during COM Day and Virtual Hill Day 2019. View the ED to MED blog to revisit highlights from our advocates and their Members of Congress on #COMDAY19.

Administration and Federal Agencies

Apply by this Thursday for the NHSC S2S Loan Repayment Program

Osteopathic medical students are strongly encouraged to apply for HRSA's National Health Service Corps (NHSC) Students to Service Loan Repayment Program (S2S LRP). The S2S LRP provides up to $120,000 in loan repayment assistance to medical or dental students in their final year of school in exchange for a commitment to provide primary health care services in eligible health professional shortage areas with the greatest needs. The NHSC is seeking applicants who are interested in serving communities with limited access to health care and providing care through their initial service commitment and beyond. Applications are due by 7:30 PM ET this Thursday, November 21. This NHSC loan repayment option is a particularly good opportunity because of its exclusive availability to a small cohort and higher acceptance rate compared to other programs. Learn more.

ED Publishes Accreditation Final Rule

On November 1, the U.S. Department of Education (ED) published a final rule on accreditation and state authorization based on the consensus-backed language of the 2019 Negotiated Rulemaking sessions. The new regulations—entitled Student Assistance General Provisions, The Secretary's Recognition of Accrediting Agencies, The Secretary's Recognition Procedures for State Agencies—reform procedures governing the recognition of accrediting agencies and their operations in overseeing higher education institutions, among other revisions. In promulgating the final rule, ED seeks to increase flexibility, promote innovation, and increase competition among accrediting agencies. The new regulations have an effective date of July 1, 2020. AACOM continues to thoroughly assess the rule for provisions of interest and importance to the OME community.

U.S. Supreme Court Hears Oral Arguments on Termination of DACA

Last week, the U.S. Supreme Court heard oral arguments on three consolidated cases challenging the Administration’s 2017 termination of the Deferred Action for Childhood Arrivals (DACA) program. In briefs filed with the Court, the attorneys general of several states and the University of Southern California, among others, argued that termination of the program violated the Administrative Procedure Act and the rights of DACA recipients. In response, the U.S. Department of Homeland Security (DHS) argued that the DACA program implemented under the Obama Administration was an illegal exercise of DHS’s executive authority and that its decision to rescind the program was not reviewable by the Court. The Court will consider whether DHS’s decision to end the DACA program is judicially reviewable and, if so, whether rescission of the program was lawful. A decision by the Court is expected by the summer of 2020.

Stephen Hahn Nominated as FDA Commissioner

President Trump recently announced his intent to nominate Stephen Hahn, MD, to serve as Commissioner of the Food and Drug Administration (FDA). Dr. Hahn, a radiation oncologist who specializes in treating lung cancer and sarcoma, is currently the Chief Medical Executive of the University of Texas MD Anderson Cancer Center in Houston, Texas, and previously served as the Center’s Chief Operating Officer. ADM Brett P. Giroir, MD, Assistant Secretary for Health at the U.S. Department of Health and Human Services (HHS), will oversee the FDA until Dr. Hahn is confirmed by the U.S. Senate. The Senate Committee on Health, Education, Labor, and Pensions will hold a hearing to consider his nomination on November 20.

Featured Federal Resources and COM Engagement

U.S. Rep. Cleaver, II Discusses Health Care at KCU Roundtable: U.S. Representative Emanuel Cleaver, II (D-MO), recently visited Kansas City University (KCU) to discuss health care issues with Marc Hahn, DO, KCU President and CEO, KCU administrators, and students. The roundtable discussion focused on Medicaid expansion, patient access to health care, especially in underserved locations, basic civility in our culture, and student debt. Rep. Cleaver, II, a proponent of student debt relief, remarked, “Student debt is simply a problem we have to solve.” While KCU students, and graduate students as a whole, have very low student loan default rates, heavy debt burdens can be a stressful start to a medical career. Learn more about Rep. Cleaver, II’s visit, and for those interested in advocating to help address graduate student debt issues, consider joining AACOM’s ED to MED campaign.

UIWSOM Student Accepted into NHSC Scholarship Program: Steven Rodriguez, a member of the Incarnate Word School of Osteopathic Medicine’s Class of 2021, has been accepted into the NHSC Scholarship Program (SP). The NHSC SP awards scholarships to students pursuing eligible primary care health professions training. In return, scholars commit to providing primary care health services in Health Professional Shortage Areas. Scholarship recipients commit to a minimum of two years of full-time service in exchange for a full year of scholarship support. “Coming from an underserved area and my research in health disparities has motivated me to work with and provide holistic care to individuals from underserved communities,” says Steven. “I am honored to be accepted into the NHSC SP and be provided with the support and opportunity to do so.” Learn more about the program.

HHS Celebrates National Rural Health Day: November 21 is National Rural Health Day! Started in 2010 to collectively recognize the contributions occurring in rural communities to address the unique health care challenges of rural areas, the 2019 celebration is marked by a week of events and programming, beginning today, November 18. Nearly 20 percent of the nation’s population lives in rural areas, and throughout this event, seminars, innovations, toolkits, and online collaborations will be highlighted as resources to advance rural health care. Notable planned programming includes a keynote from HHS Deputy Secretary Eric Hargan, a roundtable about the importance of rural health, and a discussion with the filmmakers of an award-winning documentary, The Providers. Learn more.

AHRQ Releases Playbook for Medication-Assisted Treatment: The Agency for Healthcare Research and Quality has developed an interactive, web-based tool for rural primary care providers on Medication-Assisted Treatment (MAT), an approach to treating opioid use disorder. As MAT use grows in primary care practices, this Playbook offers important resources. Learn more.