September 2024 – Health Advocate Insights

September, 2024
Health Advocate Insights
This past month saw record donations made to several of the nation’s top historically black medical schools. A gift from the Bloomberg Philanthropies, the donations included $175 million to Meharry Medical College, Morehouse School of Medicine, and Howard University College of Medicine, as well as $75 million to Charles R. Drew University of Medicine and Science. Responding to the donation, Howard University President Dr. Ben Vinson lll noted that “this is a transformational gift, not only for its impact on cultivating the next generation of health professionals but for its visionary investments in the intergenerational wealth and health of our medical students and the communities they serve.” This set of donations comes on the heels of another Bloomberg Philanthropy sponsored donation to Johns Hopkins University Medical School, allowing them to provide free tuition to most students.

What's going on in Washington, DC?
With the presidential Democratic ticket now finalized, a potential Democratic healthcare platform is becoming more clear. Minnesota Governor Tim Walz, Vice President Harris’s choice for running mate, has a record as governor not unlike that of the current administration. Under his leadership, his state invested $93 million into mental health infrastructure including increased hospital bed capacity and mobile crisis units, as well as grants and loan forgiveness for mental health practitioners. During his tenure, he also oversaw significant increases in private health plan sign ups through the state’s private health insurance marketplace, MNsure, suggesting that a focus on enhancing ACA marketplaces may be a centerpiece of a Harris-Walz healthcare platform.
On the agency side, the Center for Medicare and Medicaid Services (CMS) released a final rule implementing Section 4122 of the Consolidated Appropriations Act which provides funding for a minimum of 200 new residency positions in 2026 with the requirement that at least 100 of the new positions be distributed to psychiatry or psychiatry subspecialty positions. According to the initial bill text, at least 10% of the new residency positions should be located at either rural hospitals, those located in a health professional shortage area (HPSA), or hospitals in states with candidate status from LCME.
Elsewhere, conservative advocates have pushed back against Biden administration efforts to encourage voter registration in healthcare settings. The Heritage Foundation recently released a white paper arguing that Executive Order 14019, which directs federal agencies to use their resources to encourage voter registration, could “cause members of the public who interact with federal agencies to feel intimidated and coerced.” Specifically citing HHS’s efforts to encourage federal health centers to engage in voter registration activities, the paper argues that these efforts encourage “health care providers to take advantage of their sensitive fiduciary relationship with vulnerable individuals who are suffering from medical and health problems to “assist” them to register and vote, enabling providers to persuade vulnerable patients who are dependent on them to vote in ways that advantage particular issues and particular candidates.” Considering the Heritage Foundation’s close relationship to conservative lawmakers and advocacy groups, it is possible that the ideas posed in this paper constitute a reflection of future direct advocacy efforts against voter registration efforts in healthcare settings.

Cover of Wisconsin’s Task force on the Healthcare Workforce Report
What's going on in the states?
Wisconsin Governor Tony Evers’ Task Force on Health Workforce recently released its recommendations for addressing the state’s health workforce challenges. The task force, which was established in early 2024, is made up of a 25 member group of cabinet officials and healthcare experts and is led by the states’ Lieutenant Governor Sara Rodriguez, a nurse herself. The report recommends increased support for health professions faculty including expansion of incentive programs to become a faculty member at health professions’ schools, providing additional training and funding for the states’ health worker apprenticeship program, and increasing access to K-12 student science programs intended to prepare students to enter health workforce positions early on in their careers. The report also recommends several initiatives to improve recruitment and retention, including increased Medicaid reimbursement for doulas, community health workers, peer specialists, and other community-based providers. While some of the programs and policies would require legislative approval, such as Medicaid expansion, others can and will likely be approved through the Governors’ executive power.
At the same time, the Illinois state legislature introduced a bill to revamp the state’s new higher education funding model. Based on a report released by the Commission on Equitable University Funding, the Adequacy and Equity formula is designed to reduce underfunding by not just accounting for the size of an institution but also the sociodemographic diversity of the student body which experts have suggested will benefit minority-serving institutions. While this approach would help to address underfunding of many of the state’s higher education institutions, critics have noted that it would require an additional $1.4 billion in appropriations over the next fifteen years. That number stands in stark contrast to the current version of the bill which only increases annual appropriations by $135 million.
At the same time, the Illinois state legislature introduced a bill to revamp the state’s new higher education funding model. Based on a report released by the Commission on Equitable University Funding, the Adequacy and Equity formula is designed to reduce underfunding by not just accounting for the size of an institution but also the sociodemographic diversity of the student body which experts have suggested will benefit minority-serving institutions. While this approach would help to address underfunding of many of the state’s higher education institutions, critics have noted that it would require an additional $1.4 billion in appropriations over the next fifteen years. That number stands in stark contrast to the current version of the bill which only increases annual appropriations by $135 million.
What else are we reading?
- Project 2025: Assessing the Impact on the Healthcare Workforce
- California is giving schools more homework: Build housing for teachers
- Boston U Grad Worker Strike Now Longest in a Decade
- Confronting the Bully: New North Carolina Medicaid Program Gets Hospitals to Forgive and Prevent Medical Debt
- Mass General Brigham Doctors Rally for Better Wages in Boston
What can you act on today?
- Promote the Social Mission Metrics Survey (SMMI) at your institution – For the first time in 5 years, all U.S. based medical schools have the opportunity to participate in the Social Mission Metrics Self-Assessment, a free tool for schools to evaluate their performance on activities related to social mission. The intent of this tool is to provide schools with an honest evaluation of their social mission, highlight the areas needed for improvement, and provide actionable resources that will lead to positive change.
- Sign up for the Health Advocate Insights Newsletter – Are you passionate about the intersection between social mission and health professions advocacy? We invite you to spread the word about SMA’s quarterly advocacy newsletter to your colleagues. Stay informed about the most recent developments, challenges, and successes in state and federal policy, as well as national advocacy efforts. Together, let’s amplify our voices and create a healthier, more equitable health workforce community!
- Become Part of the 2024-2025 Community Health Center Climate Action Incubator – The Medical Society Consortium on Climate and Health (MSCCH) and the National Association of Community Health Centers (NACHC) are pleased to invite applicants with a passion for making a difference on climate and health to join the 2024-2025 Community Health Center Climate Action Incubator. The goal of this project is to enable participants to hone their leadership skills in making effective climate action and decarbonization proposals at their own health centers. Specifically, the program is designed to deepen participants’ knowledge and improve their advocacy and communication skills through peer-to-peer learning.
- Watch the Revisions to the Federal Standards for Race and Ethnicity Data Collection Webinar – During the webinar, experts from the State Health Access Data Assistance Center (SHADAC) and Health Equity Solutions reviewed the new OMB standards for race and ethnicity data collection, described the history of federally-defined race and ethnicity data collection standards, and highlighted the motivations for the revisions. The webinar also featured a discussion of the implications for health equity and provided guidance for implementing the standards in partnership with key stakeholders.
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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