September 10, 2018

What You Need to Know

As Congress returns to Washington, DC following its August recess, we are excited for AACOM’s upcoming 2018 COM Day on Capitol Hill, which will take place on September 27. Participants will meet with their elected officials in Washington to emphasize the importance of federal financial aid programs and health care workforce funding to the osteopathic medical education (OME) community, and advocates from across the country will simultaneously raise their voices on social media during our Virtual Hill Day. Leading up to the event, AACOM’s ED to MED campaign is launching an Advocacy Challenge to increase awareness about the importance of investing in the future health care workforce, build momentum, and impact meaningful change. Register today for ED to MED campaign emails to ensure you receive the Advocacy Challenge messages beginning Wednesday.

In the meantime, Congress is striving to pass its fiscal year (FY) 2019 spending bills before September 30 to avert a federal government shutdown and moving forward on a heavy legislative agenda to include a stalled opioid package with a limited number of days left in session before the midterm elections.

Pamela Murphy
Senior Vice President of Government Relations

On The Hill

FY19 Appropriations Update

On August 23, the Senate passed an $857 billion spending package deal for both Defense and Labor, Health, Human Services, and Education (LHHS) funding. The U.S. Department of Health and Human Services would receive a $2.3 billion boost, and the U.S. Department of Education (USDE) would receive a $541 million boost. This legislation also includes $334 million for the Agency for Healthcare and Research, for which AACOM has been strongly advocating. Although the House of Representatives has not yet taken up its version of the LHHS spending bill, the chamber has agreed to go to conference with the Senate on the combined Defense/LHHS appropriations bill. The Senate is expected to name conferees shortly. Congress must pass the appropriations bills or a continuing resolution by September 30.

AACOM Supports Advancing Medical Resident Training in Community Hospitals Act of 2018

U.S. Representative Josh Gottheimer (D-NJ) recently introduced H.R. 6056, the Advancing Medical Resident Training in Community Hospitals Act of 2018, which would provide a technical fix to a Centers for Medicare & Medicaid (CMS) rule that would allow residents who have graduated from established medical schools to continue their training in nearby hospitals. H.R. 6056, similar to H.R. 284 and H.R.4552, introduced by Representatives Elise Stefanik (R-NY) and Mike Gallagher (R-WI), respectively, differs slightly in that it would increase the eligibility criteria, allowing more programs permission to create new caps and establish new per-resident amounts.

AACOM Joins Letter to House and Senate Appropriators Supporting IHS

As a member of the American Indians and Alaska Native Health Partners, AACOM joined 11 other national health organizations asking the House and Senate Appropriations Interior Subcommittees to provide robust funding for the Indian Health Service (IHS) for the FY19 Interior Appropriations bill. Full funding for IHS would increase the number of health care providers who work in Indian country and fund scholarships for American Indian and Alaskan Native students, aiming to improve health care access for American Indians and Alaskan Natives.

House Democrats Introduce Aim Higher Act

On July 24, led by U.S. Representative Bobby Scott (D-VA), Ranking Member of the House Education and the Workforce Committee, Democrats introduced H.R. 6543, the Aim Higher Act, to reauthorize the Higher Education Act (HEA). Last updated in 2008, the HEA governs the nation’s higher education and federal financial aid programs. This legislation was introduced in response to the Republican-led Promoting Real Opportunity, Success and Prosperity through Education Reform Act, introduced by Committee Chair Virginia Foxx (R-NC) and Brett Guthrie (R-KY) late last year.

Among other provisions, the Aim Higher Act would allow physicians working at non-profit hospitals or other health care facilities in states that prohibit the direct hiring of these individuals to have their loans forgiven through the Public Service Loan Forgiveness Program, revive the Perkins Loan Program, and preserve graduate student participation in Federal Work-Study. If Democrats succeed in taking back the majority in the House of Representatives following the midterm elections, this bill could serve as a blueprint for future legislation. Learn more.

Supreme Court Pick Appears Before Senate Judiciary Committee

On September 4, the Senate Judiciary Committee began its week-long confirmation hearing for Brett Kavanaugh, JD, President Trump’s nominee for Associate Justice for the U.S. Supreme Court, following Justice Anthony Kennedy’s retirement announcement earlier this year.

Noise around Kavanaugh’s confirmation hearing has been especially contentious as Democrats have accused the White House and Republicans of refusing to release tens of thousands of documents from Kavanaugh’s time as a Bush-era White House lawyer. Judge Kavanaugh currently serves on the U.S. Court of Appeals for the Tenth Circuit, to which he was appointed by President George W. Bush. If confirmed, Kavanaugh would assume the seat vacated by Associate Justice Anthony Kennedy, reinstating the nine-member court’s conservative majority.

Advocacy

Take the #E2MChallenge

On September 27, AACOM’s Board of Deans, osteopathic medical students, and other advocates will convene in Washington, DC to meet with lawmakers to raise awareness about the importance of federal financial aid programs and graduate medical education funding. Advocates will also speak out on social media in support of these programs during our Virtual Hill Day, using the #COMDAY18 hashtag. Leading up to #COMDAY18 and Virtual Hill Day, ED to MED is calling on advocates to step up and take the #E2MChallenge! Join us by registering to receive ED to MED emails and check your inbox on September 12 for the first Advocacy Challenge message, and be sure to follow @ed2med on Twitter to engage with Advocacy Challenge posts.

Campus Ambassadors Spread the Word about ED to MED

Annie Phung and Amanda Nguyen, second-year GA-PCOM students, raise awareness of the ED to MED campaign on campus.

With fall approaching and osteopathic medical students returning to campus, ED to MED Campus Ambassadors have been educating their classmates on the policy issues important to their futures and encouraging them to advocate for change. Learn about their outreach and get inspired about ways you can engage students on your own campus.

AACOM Participates in Advocacy Summit

Last month, Mary-Lynn Bender, AACOM’s Senior Director of Congressional and Public Relations, presented on a panel discussion during this year’s annual Buzz Advocacy Summit in Annapolis, MD, with representatives from the National Transportation Safety Board, American Academy of Neurology, and McKesson. Panelists addressed questions about coalition building and outlined strategies they employ to forge strong alliances, discourage disruption, and direct groups’ focus to achieve common goals. Created in 2016, the summit brings together industry practitioners with a demonstrated passion for public affairs and advocacy and features speakers from outside the industry to offer new and unique perspectives. This year’s theme was “Authentic Voices, Meaningful Data,” and session topics ranged from exploring the role of social media and utilization of visual data in advocacy to mobilizing advocacy around elections and tracking metrics to cultivate advocacy champions.

Administration and Federal Agencies

AACOM Comments on USDE 2018 Borrower Defense to Repayment NPRM

AACOM recently submitted comments to the USDE on its notice of proposed rulemaking (NPRM) to rewrite Borrower Defense to Repayment (BDR) regulations and establish a federal standard and a process for adjudicating claims submitted by federal student loan borrowers who may be eligible for loan forgiveness if their school violated certain laws. AACOM’s comments express support for the USDE’s decision to remove a provision originally included in the 2016 BDR regulations that did not account for the unique characteristics of medical education and would have negatively impacted for-profit member institutions. The USDE will review public comments and prepare the final regulation with the intent to publish by November 1.

USDE Announces Intent to Establish Negotiated Rulemaking Committee

The USDE has announced its intent to establish a negotiated rulemaking committee to review topics including state authorization, accreditation, the eligibility of faith-based entities to participate in Title IV aid, the definition of the term “credit hour,” and other issues. In addition, the USDE is holding a series of public hearings in September to receive feedback on the proposed rulemaking agenda and topics for the committee. Committee activity and negotiations are expected to begin in early 2019. AACOM will provide updates as the regulatory process moves forward and actively seek opportunities to engage with the USDE to ensure that osteopathic medical schools and the students they train are well-served by Title IV financial aid programs and regulations.

USDE Proposes to Rescind Gainful Employment Regulations

On August 14, the USDE published its NPRM that would rescind regulations governing gainful employment (GE). Implemented in 2015, the GE regulations particularly impact for-profit institutions and require that students receive the proper training to be gainfully employed upon graduation with a reasonable amount of student debt that does not lead to default on their student loans. According to the NPRM, the Department intends to update its College Scorecard or a similar web tool to include program-level data for all schools accepting federal funds. Earlier this year, the USDE’s negotiated rulemaking committee on GE did not reach consensus, which resulted in the USDE drafting its own proposal. AACOM continues to review the NPRM and will submit comments on behalf of the OME community.

CMS Releases FY19 IPPS Final Rule

The CMS recently released its final rule for the FY19 Medicare Hospital Inpatient Prospective Payment System and Long Term Acute Care Hospital Prospective Payment System. AACOM provided comments to CMS on the proposed rule earlier this year on the provision that would enable new urban teaching hospitals to loan medical residency slots to other new urban teaching hospitals beginning July 1, 2019, through June 30, 2020. The final rule includes this provision and provides additional clarification regarding the term “new urban teaching hospital” as it relates to this section.

Featured Federal Resources and COM Engagement 

HRSA Funding Awarded to ATSU-SOMA: The Health Resources and Services Administration (HRSA) recently awarded A.T. Still University School of Osteopathic Medicine in Arizona a $1.9 million grant to strengthen the primary care workforce. This grant, distributed over five years, will create a primary care fellowship program for physicians and physicians' assistants to integrate health science and community-based research to create better primary care health care professions. Learn more.

HRSA Unveils New Open Data Website: HRSA has launched a new website showcasing important data, maps, and dashboards related to the agency’s health care programs, including grants, loan, and scholarship programs. Previously known as the HRSA Data Warehouse, the new resource integrates with external sources such as the U.S. Census Bureau and enables users to download and compare data for research and analysis, create custom maps, and more. Learn more.

Marian University Awarded First NIH Grant to Study Rosacea: The Marian University College of Osteopathic Medicine (MU-COM) received a grant for more than $300,000 to research rosacea. The funding is the university’s first from the National Institutes of Health (NIH). “To be awarded funding from the NIH acknowledges that an innovative and meritorious proposal has been vetted through a rigorous peer-review process and judged to be among the best-of-the-best grant submissions,” Donald Sefcik, DO, MBA, Dean of MU-COM and Vice President of Health Professions, said. Learn more.

VCOM-Auburn Researcher Secures First NIH Grant for Auburn Campus: Edward Via College of Osteopathic Medicine-Auburn (VCOM-Auburn) researcher Wei Liu, PhD, Associate Professor for Biomedical Affairs and Research, recently received notice of an NIH grant award to examine the biomechanical effects of tai chi exercise in knee osteoarthritis patient populations while promoting a complementary medicine integrative health approach. The five-year $825,000 grant has been funded through the NIH National Center for Complementary and Integrative Health. This is the largest single research grant to date for VCOM-Auburn campus researchers and the first NIH grant for the three-year-old campus. Learn more.

VCOM-Carolinas Awarded Grant for Primary Care Training and Enhancement Fellowship Program: Ron Januchowski, DO, Associate Dean for Curriculum, Assessment, and Medical Education at Edward Via College of Osteopathic Medicine-Carolinas, has been awarded a Primary Care Training and Enhancement grant from HRSA. The grant is for five years and is in the amount of $1.95 million. The VCOM Fellowship for Primary Care Transformation Leaders Program aims to strengthen the primary care physician workforce in community-based health centers in medically underserved areas. The program’s goals include improved patient outcomes and increased physician recruitment to rural Community Health Centers. Learn more.

Governor Bryant Cites Importance of WCUCOM at Health Care Summit: On August 18, Mississippi employers and health care and industry partners attended the 2018 Governor’s Health Care Economic Development Summit to discuss innovations in health care as a driver of economic strategy and impact. Governor Phil Bryant spoke about how new medical education institutions, such as the William Carey University College of Osteopathic Medicine (WCUCOM), help improve the state’s economic landscape. WCUCOM Dean James Turner, DO, MPH, moderated a panel discussion on collaborative workforce and workforce readiness. Ben Carson, MD, the U.S. Secretary of Housing and Urban Development, also provided remarks. Learn more.

U.S. Representative George Holding Visits CUSOM:

From left to right: Dusty Barbour, Clinical Simulation Technician, CUSOM; Rep. Holding (R-NC); Brian Mann, Director of Simulation Education, CUSOM; David Tolentino, DO, Associate Dean for Clinical Affairs, CUSOM; Nancy Lawrence, Chief of Operations, CUSOM

Campbell University Jerry M. Wallace School of Osteopathic Medicine (CUSOM) hosted U.S. Representative George Holding and his staff on August 14 to tour the Leon Levine Hall of Medical Sciences, which consists of approximately 96,500 square feet and is designed to accommodate future leaders in the medical field through forms of interactive, hands-on learning environments that simulate realistic clinical experiences. Rep. Holding was able to take part in a virtual reality demonstration that incorporated use of HoloLens headsets. CUSOM is the first school in the nation to utilize this innovative technology in its curriculum. Congressman Holding represents North Carolina’s 2nd District.

Governor Northam Speaks with LUCOM Students about Opioid Crisis:

Virginia Governor Ralph Northam addressing LUCOM students during his Medical Grand Rounds Tour about the opioid crisis in Virginia.

Liberty University College of Osteopathic Medicine students heard from Virginia Governor Ralph Northam on September 5 about ways in which future physicians can lead the way in stopping opioid addiction. The governor’s visit to Liberty’s Center for Medical and Health Sciences was part of a lecture tour to all medical schools in the Commonwealth. Gov. Northam introduced Ryan Hall of Covington, VA, a 25-year-old recovering heroin addict, to lead a discussion from a patient’s perspective. Hall was a prominent high school athlete until a serious football injury led him to be placed on heavy pain killers, which started him down the path to addiction. First-year student Rachel Zielinski said the lecture was a great experience, especially in the early stages of her medical career. A former EMT, Zielinski said she saw firsthand how deadly addiction can be. “We got to hear from the patient’s perspective about how we can do better,” she said. “The opioid crisis isn’t something that’s just happening in Virginia. It’s something that is happening everywhere. Hearing Ryan’s story just reminded me that we can prevent (addiction) at the prescription stage.” Learn more.

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