National Dialogue on Equity and Health Moving the Health Equity Agenda Forward In a Changing Political Environment

Transcription

1 National Dialogue on Equity and Health Moving the Health Equity Agenda Forward In a Changing Political Environment November 30, 2010 Sponsored by: National Health Equity Coalition Moderator: Brian D. Smedley, PhD, Joint Center for Political and Economic Studies

2 Agenda Welcome Brian D. Smedley, PhD,Moderator Moving the Health Equity Agenda Forward In a Changing Political Environment Congresswoman Donna M. Christensen Questions and Answers Health Equity in Health Reform Daniel Dawes, JD Questions and Answers Open Mic Closing Remarks Brian Smedley, PhD.

3 National Health Equity Coalition Policy and advocacy network committed to the elimination of racial/ethnic health disparities through a health equity policy lens. Mobilized and sponsored by the National REACH Coalition to Eliminate Health Disparities. Designed to link the advocacy work in Washington with the policy and advocacy activities taking place in communities across the country.

4 National Health Equity Dialogue Series Seeks to create a national network for information exchange and build cross sector support for the full spectrum of federal polices that shape and define the socioeconomic opportunities and the health of communities and racial/ethnic minority populations.

5 Overview of Webinar Format Please note all participants are in listen-only mode. Post questions in the chat box at any time during the webinar. We will provide them to the panelists for discussion during the ending Q&A portion.

6 Moderator* & Panelists Brian D. Smedley, PhD Vice President and Director of Health Policy Institute Joint Center for Political & Economic Studies Washington, DC Daniel Dawes, Esq. Federal Affairs and Grassroots Manager Premier Healthcare Alliance Washington, DC

7 Moving the Health Equity Agenda Forward In a Changing Political Environment Congresswoman Donna M. Christensen United States Virgin Islands Delegate to Congress (D- VI)

8 Health Equity in Health Reform Eliminating Health Disparities 8

9 expand health insurance coverage for almost 32 million individuals who are uninsured or underinsured, transform the delivery of care from treating sickness to preventing illness and promoting wellness, strengthen protections for the approximately 57 million people who have a pre-existing condition by prohibiting discrimination based on their health status, ensure that we have a more robust data collection and reporting system to track the disparities in health status and health care services, increase the diversity, cultural, and linguistic competence of health services providers improve the quality and cultural competence of care individuals especially vulnerable individuals - receive from health care providers, prioritize the reduction of health disparities in research, and provide grant opportunities to develop programs to reduce the gap in health status and health care between vulnerable populations and the general population 9

10 10 Mandatory versus Discretionary Funding

11 Title Section Info Funding Level Community Health Centers Sec (Reconciliation) Sec $11B in new dedicated funding over the period FY 2011 to FY $9.5B for operations and $1.5B for construction. The CHC Trust Fund is in addition to existing discretionary funding. Operation funding amounts were changed in reconciliation. However, construction amount remained same as in base text. (A) $1,000,000, ; (B) $1,200,000, ; (C) $1,500,000, ; (D) $2,200,000, ; and (E) $3,600,000, ; National Health Service Corp. Sec $1.5 billion in new, dedicated funding for the National Health Service Corps. The National Health Service Corps Trust Fund is in addition to existing discretionary funding. School Based Health Centers (construction) Maternal, Infant and Early Childhood Home Visiting programs Sec (a) Sec Creates a grant program for the establishment of SBHCs. Grant funds would be used only for construction and equipment. Requires Secretary to give preference to facilities that serve a large population of children eligible for the Medicaid and CHIP programs. Appropriates a total of $200M over the period FY 2010 to FY Appropriates a total of $1.5B over the period FY 2010 to FY (A) $290,000, ; (B) $295,000, ; (C) $300,000, ; (D) $305,000, ; and (E) $310,000, (A) $50,000, ; (B) $50,000, ; (C) $50,000, ; and (D) $50,000, ; (A) $100,000, ; (B) $250,000, ; (C) $350,000, ; (D) $400,000, ; and (E) $400,000,

12 Title Section Info Funding Level Community Prevention and Public Health Fund Personal Responsibility Education Demonstration Projects to Address Health Professions Workforce Needs Sec Sec Sec Establishes a Prevention and Public Health Investment Fund to provide for expanded and sustained national investment in prevention and public health programs. Total of $15B for FY (program authorized in perpetuity). Provides support for programs to educate adolescents on the prevention of pregnancy and sexually transmitted infections. Entities targeting services to highrisk, vulnerable, and culturally underrepresented youth populations are given priority for funding. Appropriates a total of $75,000,000 for each of fiscal years 2010 through Establishes a demonstration project for low-income individuals to attain education and training for high-growth occupations in the health care sector. Appropriates a total of $410M over period FY 2010-FY (A)FY 2010, $500,000,000; (B) FY 2011, $750,000,000; (C) FY 2012, $1,000,000,000; (D) FY 2013, $1,250,000,000; (E) FY 2014, $1,500,000,000; and (F) FY 2015, and each fiscal year thereafter, $2,000,000,000. (A) FY 2010, $75,000,000; (B) FY 2011, $75,000,000; (C) FY 2012, $75,000,000; (D) FY 2013, $75,000,000;and (E) FY 2014, $75,000,000; Appropriates a total of $410M over period FY 2010-FY

13 Title Section Description Funding Level Nurse-Managed Health Centers Sec Authorizes a federal nurse managed health clinic program which serves disadvantaged communities. School Based Health Centers (operations) Understanding Health Disparities: Data Collection and Analysis Community Transformation Grants Sec (b) Sec Sec There are authorized to be appropriated $50,000,000 for the fiscal year 2010 and SSAN for each of the fiscal years 2011 through Creates a grant program for the establishment of SBHCs. Funds can be used for both operations and construction. Authorizes Secretary to give preference to applicants who demonstrate ability to serve communities with specified barriers to access. Improves federal data collection efforts by ensuring that federal health care programs collect and report data on race, ethnicity, sex, primary language, and disability status. Please note, there is a notwithstanding clause which states that data may not be collected under this section unless funds are directly appropriated for such purposes in an appropriation act. Provides grants to State and local governmental agencies and community based organizations for evidence based community preventive hea lth activities to achieve a number of goals, including reducing health disparities. (A)FY 2010, $50,000,000; (B) FY 2011, SSAN; (C) FY 2012, SSAN; (D) FY 2013, SSAN; and (E) FY 2014, SSAN; Authorizes SSAN for FY FY Authorizes SSAN for FY Funding amt and level not specified. 13

14 Title Section Info Funding Level Grants to Promote Community Health Workers Oral Healthcare Prevention Activities Community Preventive Services Task Force Sec Sec Sec Provides grants to community health workers who serve as liaisons between communities and health care agencies and provide culturally and linguisticallyappropriate services. Establishes an Oral Healthcare Prevention Education Campaign with targeted activities for special populations conducted in a culturally and linguistically appropriate manner. These populations include racial and ethnic minorities and individuals with disabilities. Establishes an independent Community Preventive Services Task Force to conduct rigorous, systematic reviews of existing science and recommend the adoption of proven and effective services. The Task Force topic areas for review will include those related to specific age groups and health disparities among sub-populations and age groups. Offices of Minority Health Sec Establishes individual Offices of Minority Health within six agencies (HRSA, CDC, FDA, CMS, AHRQ and SAMHSA). Redesignates the on Minority Health and Health Disparities as the National Institute on Minority Health and Health Disparities. Promoting Diversity of the Health Workforce Sec Authorizes $60,000,000 for fiscal year 2010 and such SSAN for each of the fiscal years 2011 through Authorizes SSAN for FY FY Authorizes SSAN for FY FY Authorizes SSAN Secretary must allocate funds from each Agency s budget to establish a Center. (A)FY 2010, $60,000,000; (B) FY 2011, SSAN; (C) FY 2012, SSAN; (D) FY 2013, SSAN; and (E) FY 2014, SSAN;

15 Title Section Info Funding Level Training in Cultural Competency, Prevention, Public Health, and Aptitude Working with Individuals with Disabilities Sec Provides support for development of model curricula in cultural competency and related training. Authorizes SSAN for FY 2010 to FY Promoting Diversity in the Workforce: Sec Provides support for (1) pipeline programs for the health professionals that assist in recruitment and retention of underrepresented minorities and individuals from disadvantaged backgrounds; (2) loan repayment programs for faculty from disadvantaged backgrounds; and (3) institutions that train nurses to increase diversity among these professionals, including support for bridge or degree completion programs. (a) Loan Repayment and Fellowship Regarding Faculty Positions Changes the loan amount for faculty positions from $20,000 to $30,000 per year. (b) Scholarships for Disadvantaged Students There is authorized to be appropriated $51,000,000 for FY 2010, and SSAN for FY FY (c) Reauthorization for Loan Repayments and Fellowships Regarding Faculty Positions There is authorized to be appropriated $25M over FY 2010 to FY (d) Reauthorization for Educational Assistance in the Health Professions Regarding Individuals from a Disadvantaged Background. There is authorized to be appropriated $60,000,000 for fiscal year 2010 and SSAN for fiscal years 2011 through Alterative Dental Health Provider Models Sec Creates new demonstration program, which will award grants to 15 eligible entities, to test different dental health care provider models that will promote access to oral health services in underserved communities. There is authorized to be appropriated SSAN 15 SSAN

16 Senate: 53 Dems/47 GOP House: 242 GOP/191 Dems Things to note about the 112 th Congress: Nearly two dozen clinicians, mostly GOP, including 7 new physicians The Tea Party claims five Senators, and 40 House members One fifth of new Congress will be freshmen, approximately 90 new members in the House, 16 new Senators Large number of conservative/moderate Dems lost re-election bid: Of the 54 House Blue Dogs, 22 lost/of the 34 Democrats who opposed ACA, 21 lost 16

17 State District Candidate Party Specialty Virgin Islands -- Rep. Donna Christensen, MD* Democrat Family Medicine Washington 7 Rep. Jim McDermott, MD* Democrat Psychiatry Wisconsin 8 Rep. Steve Kagen, MD* Democrat Allergy/Immunology Georgia 6 Rep. Tom Price, MD* Republican Orthopedic Surgery Georgia 10 Rep. Paul Broun, MD* Republican Family Medicine Georgia 11 Rep. Phil Gingrey, MD* Republican OB/GYN Indiana 8 Larry Bucshon, MD Republican Thoracic Surgery Louisiana 7 Rep. Charles Boustany, MD* Republican Cardio-Thoracic Surgery Louisiana 4 Rep. John Fleming, MD* Republican Family Medicine Louisiana 6 Rep. Bill Cassidy, MD* Republican Gastroenterology Maryland 1 Andy Harris, MD Republican Anesthesiology Michigan 1 Dan Benishek, MD Republican Surgeon Nevada 3 Joe Heck, DO Republican Emergency Medicine New York 19 Nan Hayworth, MD Republican Ophthalmology Tennesee 4 Scott DesJarlais, MD Republican Family Medicine Tennessee 1 Rep. David Phil Roe, MD* Republican OB/GYN Texas 14 Rep. Ron Paul, MD* Republican OB/GYN Texas 26 Rep. Michael Burgess, MD* Republican OB/GYN * Incumbent Defeated 17

18 Republican Strategies Repeal and Replace Revising Specific Pieces of the Law Appropriations Intense Oversight W&M, E&C, E&L, and O&I Overturn Regulations 18

19 Democrats Response Regulators Veto power Hearings 19

20 Individual Mandate Medicaid expansion IPAB Comparative Effectiveness Research Center for Medicare and Medicaid Innovation Non-Profit Tax Exempt Hospitals Data Collection 20

21 Prevention and Public Health Fund Stricter abortion language CLASS ACT long-term disability insurance program Pricing Transparency as a way to keep costs down Medical Malpractice Reform 21

22 Thank you! For more information, please contact Daniel E. Dawes, J.D. 22

23 Q&A Please submit all questions via GoTo Webinar s Questions Section.

24 National Health Equity Coalition Thank you & happy holidays!