Third Act – back to life
Deal or no? It’s October
Don’t count out zombies
Point of personal privilege (by Catherine Liao)
Our office has seen significant changes over the last year, and at long last our new team is in place. I am pleased to introduce new Directors of Government Relations Julie Rose and James Tucker, both of whom started earlier this year shortly before the pandemic began. They individually bring deep policy and DC experience to our team and manage an extensive legislative portfolio divided by various issue areas. Julie and James will continue to promote the missions of patient care, education, research, and community health at Duke Health among federal policymakers.
I am also so pleased to welcome Brian Lee as our team’s new Business Manager. He will oversee the office’s overall administrative management, including the coordination of a variety of business related functions such as finance, budget, payroll, space and facilities planning, and policy interpretation and reporting.
I want to recognize the retirement of long-time Business Manager Julie Gay, who retired on September 30 after nearly 40 years of service to Duke. She was instrumental in the success of our office and in particular the development of the Project Medical Education (PME) program. Since she assisted in launching the program more than 20 years ago, there have been nearly 250 PME programs across more than 50 institutions showcasing the value of medical education, training, and research. Her work to build this program, which is now an institution within the Association of American Medical Colleges (AAMC), has led to countless members of Congress and their staff learning about the multiple missions of medical schools and teaching hospitals.
Thank you, dear readers, for your support and interest in our office! Never hesitate to let us know how we can be helpful to you.
For now, FY 2021 will look a lot like FY 2020
This week the Senate passed a continuing resolution (CR) to keep the federal government funded at FY 2020 spending levels through December 11. The CR, signed by President Trump and cleared by the House last week, helps Congress avoid the threat of a government shutdown before the November elections.
The spending agreement also includes additional funding for nutrition assistance, aid to farmers, temporary extensions of a number of expiring Medicare “extenders,” a delay in cuts to Medicaid Disproportionate Share Hospital (DSH) payments, an extension of the payment period and reduction in the recoupment percentage for payments made under the Medicare Accelerated and Advance Payment Programs during the public health emergency, and an extension of funding for multiyear research grants supported by the National Institutes of Health (NIH) that were interrupted in FY 2020 by COVID-19.
How Congress decides to address long-term plans for FY 2021 federal spending will likely depend on the outcome of the elections and the appetite of policymakers to reach a broader deal ahead of the new year.
New life for a COVID relief deal?
As part of a final effort to reach a deal on the next round of COVID-19 relief and stimulus legislation, House Speaker Nancy Pelosi (D-CA) unveiled a scaled back version of the HEROES Act (H.R. 6800) first passed by the House on May 15. The $2.2 trillion proposal retains many elements from the original HEROES Act, including $4.7 billion for the NIH, as well as $2.9 billion for the National Science Foundation (NSF), a temporary increase in Federal Medical Assistance Percentage (FMAP) payments to state Medicaid programs, and additional support for small businesses and the airline industry.
The effort has helped to revitalize negotiations with Treasury Secretary Steven Mnuchin this week with both sides indicating they may be inching closer to an agreement. The House passed, largely along party lines, the revised proposal Thursday evening. The symbolic vote puts down a new marker for House Democrats and provides cover for vulnerable incumbents if talks break down again with the White House.
However, it is unclear whether Senate Republicans would support any deal before November in excess of $1 trillion. Senate Majority Leader Mitch McConnell (R-KY), who has not been directly involved in current negotiations, characterized the two sides as progressing but still very far apart.
Duke Health Government Relations continues to advocate for $26 billion to support the research enterprise and greater certainty for the future of expanded telehealth policies in any COVID-19 relief and stimulus agreement.
Energy and Commerce Subcommittee hearing includes Founding Director of the Duke-Margolis Center for Health Policy
This week the House Energy and Commerce Subcommittee on Oversight and Investigations held a hearing entitled “Pathway to a Vaccine: Ensuring a Safe and Effective Vaccine People Will Trust.” Dr. Mark McClellan, Founding Director, Duke-Margolis Center for Health Policy at Duke University and former Commissioner of the Food and Drug Administration, was among the expert of witnesses at the hearing. In her opening statement, Subcommittee Chair Diana DeGette (D-CO) expressed concern about the public’s trust in a future COVID-19 vaccine, but stated that she was hopeful that the hearing’s experts could help guide us on ways to ensure that the public has full confidence in a COVID-19 vaccine once it is made available.
Homeland Security issues proposed rule change for F and J visas
On September 25, the Department of Homeland Security issued a notice of proposed rulemaking to change visa policies for F and J visa holders. Under the current rules, F and J visa holders may remain in the United States until the completion of their degree, a policy known as “duration of status.” The proposed rule would change “duration of status” to a “fixed duration,” meaning that these visa holders would be required to petition for extensions after certain periods of time. While only a proposal at this time that is subject to an open comment period and mandatory review before implementation, it has been met with strong opposition from academic institutions across the country, including Duke.
Duke Health Government Relations will support our colleagues on the campus-side government relations team and leadership who are preparing formal comments to oppose the proposed rule and will communicate our concerns with the NC Congressional delegation. We will continue to monitor this issue closely.
AAMC issues statement on Executive Order “Combating Race and Sex Stereotyping”
The Association of American Medical Colleges (AAMC) issued a statement on September 24 noting that it is “concerned and alarmed” by the details of an Executive Order issued by President Trump on September 22 that is designed to “combat offensive and anti-American race and sex stereotyping and scapegoating.”
The order is intended to apply to all federal contractors, subcontractors, agencies, the uniformed services, and certain federal grant recipients. It requires agencies, for contracts awarded after November 21, 2020, to include a clause that prohibits a contractor from providing workplace training that “inculcates in its employees any form of race or sex stereotyping or any form of race or sex scapegoating.”
While acknowledging that the order includes some elements of near universal agreement, AAMC stated that the Administration’s policy demonstrates a “misunderstanding of most diversity and inclusion training programs,” later adding that “AAMC, and the academic medical institutions that comprise our membership, are committed to being diverse, inclusive, equitable, and anti-racist organizations.”
Legal challenges to prevent enforcement are anticipated. Duke Health Government Relations will continue to monitor this issue and provide updates as appropriate.