February 28, 2024
February 2024 – Health Advocate Insights
February 29, 2024
Health Advocate Insights #2
Welcome to the second edition of the Social Mission Alliance’s Health Advocate Insights where we examine and report on the most recent developments in health workforce and education issues! As we continue to champion social mission across the health professions, we are constantly reminded of the vital role that K-12 and postsecondary institutions play in furthering our goals of equity. For that reason, this edition highlights important developments in both health professions training and issues impacting the postsecondary education space. As healthcare advocates, we are constantly reminded of the interconnectedness between community health and the health workforce. For all the difficult defeats that the health equity movement has suffered, we are excited to see the federal government and states continue the important work of increasing access to care, supporting clinicians, and ensuring that the next generation of students have access to the services they need to support their communities in the way they deserve.
To that end, we are excited to highlight the important work of the American Association of University Professors (AAUP) and their newly formed Center for the Defense of Academic Freedom. Sponsored by a $1.5 million grant from the Mellon Foundation, the Center for the Defense of Academic Freedom aims to fight back against the assault on higher education and academic freedom. The center will “bring together higher education and academic freedom experts…to develop a comprehensive understanding of the scope and nature of political interference in higher education and develop means of countering this assault.” The center will also create a database of the institutions, donors, politicians, and political operatives that are responsible for these attacks. The timing of this center comes shortly after the release of the 2023 results of the annual Academic Freedom Index which indicated that the US experienced one of the sharpest declines in academic freedom over the past decade with a particularly pronounced decline in the past three years. These findings underscore the important work that the AAUP and the Center for the Defense of Academic Freedom will have ahead of them. Onto the news!
What's going on in Washington, DC?
During the Trump administration, the Department of Health and Human Services (HHS) revised the right of conscience rules to allow the agency to deny funding to healthcare providers who retaliated against employees who cited religious or moral issues to providing care to certain patients. Critics of the Trump-era rule argued that it was a method to indirectly target providers who supplied reproductive health, gender-affirming, and other necessary care. The Biden administration recently rescinded the provisions that would deny such funding to providers, among other changes. Speaking to the change, HHS Office of Civil Rights Director Melanie Fontes noted that “protecting conscience rights and ensuring access to health care are critically important, no matter who you are, where you live, who you love, or your faith and conscience. Our office has statutory mandates to protect people across the country and takes this responsibility very seriously…We are proud of today’s rule, which advances conscience protections, access to health care, and puts our health care system on notice that we will enforce the law. As a law enforcement agency, we are committed to this work.” This change is part of a broader effort initiated by Executive Order 13985 to advance support of underserved communities through the federal government.
In Congress, bipartisan legislation has been introduced that would add 1,000 new Medicare-sponsored residency positions over five years for hospitals that currently have or are developing residency programs in addiction medicine, addiction psychiatry, or pain management. The Substance Use Disorder Workforce Act would split the residencies equally between hospitals with existing residency programs and those that are currently establishing a program. With polling data indicating that 83% of the nation’s behavioral health providers believe that without any policy change, provider’s won’t be able to meet the demand for SUD care and will face elevated burnout, the potential passage of this bill could help remedy the dangers of a workforce shortage. Already, the American Association of Medicine Colleges, American Hospital Association, and the American Osteopathic Academy of Addiction Medicine have come out in support of the bill.
Elsewhere in the House of Representatives, legislation has been introduced that would add additional legal penalties for individuals who knowingly and intentionally assault or intimidate employees of medical facilities. Under the bill, an incident of assault could lead to up to 10 years in prison while an incident that involves a dangerous weapon or during periods of an emergency declaration could lead to up to 20 years in prison. The bill also establishes a grant program for hospital workforce safety and security. Noting the rise in violence against healthcare workers, bill sponsor and physician Representative Larry Mucshon (R-Ind-08) stated “The rapid uptick in violence against our nation’s healthcare professionals is negatively impacting their ability to provide quality care for their patients and is worsening levels of stress and burnout. The SAVE Act will put in place legal protections to help deter violence inside our nation’s hospitals and keep these vital institutions safe and secure for patients and healthcare professionals.” Data from the National Institute for Occupational Safety and Health (NIOSH) indicate that nursing and personal care facility workers faced assaults at a rate of 21.8 per 10,000 full-time workers in 2020. Other studies have found even higher rates for other years and smaller geographic areas.
What's going on in the states?
Dental and oral health legislation has made a notable resurgence over the past month. In Wisconsin, Governor Evers signed a bill that would allow for the licensure of dental therapists within the state. Previous proposals in the state were met with opposition from the Wisconsin Dental Association however, the advocacy group dropped its opposition after the new legislation included requirements that dental therapists graduate from accredited programs and that they practice under a dentist’s supervision. Over in West Virginia, a bill passed the State Senate which increase scope of practice for dental hygienists to also provide tobacco cessation education while the Virginia State House is considering a bill that would allow dentists and dental hygienists to practice across multiple states through the Dental and Dental Hygienist Compact.
In Colorado, lawmakers announced a pair of bills that would address the growing need to treat mental health issues among the state’s rural areas. The first bill would create an agricultural and rural community behavioral health liaison that would engage in community outreach to educate communities about behavioral health issues facing farmers, ranchers, and others involved in agriculture. It would also create a grant program to support initiatives that address root causes of behavioral health issues in rural communities and increase access to behavioral health services. The second bill would create a suicide prevention program for agricultural workers. According to data from the CDC, rural suicides increased by 48% from 2000 to 2018. In Colorado, individuals employed in agriculture, forestry, and hunting industries have the highest suicide rate of any industry underscoring the importance of ensuring adequate behavioral health support.
The state of New York recently received approval for an 1115 waiver that would strengthen access to primary and behavioral healthcare services. The demonstration would establish a base rate for safety net hospitals located in underserved communities; enhance access to coordinated treatment for SUD; and make long-term investments in the state’s health workforce. The latter includes expanding career pathways for front-line health and social care professions including training in culturally appropriate services, loan repayment programs for certain health workforce professions that practice in underserved communities, and increased Medicaid reimbursement rates.
What else are we reading?
What can you act on today?
As we navigate the ever-evolving landscape of state and federal policies, it’s clear our mission is more important than ever. We look forward to your continued support and involvement in our journey to build a more equitable and inclusive health workforce. Together we can drive meaningful change for our communities and the future of healthcare.
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