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Latest News: Public Health News

Congress Passes $2 Trillion Stimulus Package

Friday, March 27, 2020  
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This week, Congress continued its focus on responding to the novel coronavirus (COVID-19) outbreak, providing additional aid to support both the public health and health care aspects of the pandemic, while providing additional support for the nation as a whole during this economic downturn. On Thursday, the Senate passed a $2 trillion emergency supplemental funding bill (H.R. 748), the third phase of disaster response, to address COVID-19. The funding bill includes resources for local communities on the frontlines of the epidemic and assists with resources to hospitals overwhelmed by the crisis. It also contains financial support to individuals and families hurt by the economic impact of the pandemic. The bill passed the Senate unanimously (96-0). The House is expected to pass the bill this afternoon. You can see an summary of the entire bill here, key provisions for local health departments include:

CDC and health departments: $4.3 billion in additional funding for FY2020, with $1.5 billion of that guaranteed for state and local health departments, and $125 million for tribal health departments, to be used by September 2024. The bill guarantees that grants will include at least 100% of the funding level for public health emergency preparedness (PHEP) in FY2019, but that the dollars can flow through another mechanism. (The first tranche of federal dollars went out to states, territories, and 6 directly funded cities through their crisis NOFO.) The federal grants may be used for surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications and other preparedness and response activities. The bill also includes $500 million through September 2024 for public health data surveillance and analytics infrastructure modernization grants to CDC and state, local, tribal, territorial health departments, a key NACCHO priority. Additionally, $300 million to replenish the Infectious Disease Rapid Response Reserve Fund.

FEMA and local governments: $150 billion for state, and local governments is included to cover costs incurred between after March 1 until December 30, 2020 that were not accounted for during the enactment of state, local, or tribal or government budgets. $45 billion is included for the Federal Emergency Management Agency to support immediate needs of state, local, tribal, and territorial governments. Reimbursable activities include medical response, PPE, National Guard deployment, and other critical services. The bill also contains $15.5 billion to bolster the Supplemental Nutrition Assistance Program to accommodate increased need for food stamps due to the pandemic.

ASPR and health care: $27 billion for the Biomedical Advanced Research and Development Authority (BARDA) under the Assistant Secretary for Preparedness and Response (ASPR), including $3.5 billion for manufacturing, production and purchase of Medical Countermeasures (MCMs) such as vaccines, therapeutics and diagnostics. The Strategic National Stockpile is slated to receive $16 billion and the Hospital Preparedness Program will receive $250 million, nearly double the annual appropriations for the program. Notably, the final package did not include a provision that had been floated to remove the Centers for Disease Control and Prevention (CDC) from collaboration with the Office of the Assistant Secretary for Preparedness and Response (ASPR) on the management of the Strategic National Stockpile. NACCHO helped lead a stakeholder letter opposed to that change.


Health Resources and Services Administration: $90 million for the Ryan White HIV/AIDS programs and $185 to support rural critical access hospitals, rural tribal health and telehealth programs, and poison control centers. The bill also reauthorizes HRSA grant programs that promote the use of telehealth technologies for health care delivery, education, and health information services and provides $1.32 billion for community health centers.

Other provisions:

Congress also included an overhaul of the federal regulation of Over-the-Counter drugs, which will provide the agency with additional resources to strengthen oversight of these products. NACCHO supported this policy improvement.

It also included a change to federal privacy restrictions on substance use treatment records known as 42 CFR Part 2 that gained attention during the opioid misuse crisis. The rule requires explicit patient consent each time the treatment records are shared with anyone, and also bars law enforcement from using the records for investigations. The change allows patients to consent to their records being shared inside the health care system and puts the documentation under HIPAA, the landmark medical privacy law. Patients can still revoke their consent, and the legislation contains anti-discrimination provisions and restrictions on law enforcement use of the records. Health groups have pressed for the change to 42 CFR Part 2 in order to bolster data collection efforts and to allow sharing between providers in order to curb the opioid epidemic.

 

NACCHO sent out a press releaseapplauding the bill.NACCHO advocated with partners for public health needs to be addressed in this package and continues to push for sustained funding for public health infrastructure and workforce in future funding packages. (See media clips and letters below.)

 

USDA Announces Child Nutrition Waivers

The US Department of Agriculture (USDA) issued three additional waiversthat states can opt into to ensure meal access for children during the COVID-19 outbreak. One would allow parents or guardians to pick up meals for their children to limit potential exposure for children to the virus. The second would waive the requirements to serve meals that meet meal pattern requirements and the third would waive the deadlines for the Community Eligibility Provisionfrom April 15 to June 15.

 

EPA Announces Enforcement Discretion During COVID-19 The Environmental Protection Agency (EPA) released updated guidance on limitations and suspension of some activities of the Enforcement and Compliance Assurance Program during the COVID-19 outbreak. The policy encourages compliance with policies already in place; however, the outbreak may affect facility operations and the availability of key staff and contractors and the ability of laboratories to timely analyze samples and provide results. As a result, there may be constraints on the ability of a facility or laboratory to carry out certain activities required by federal environmental permits, regulations, and statutes. These consequences may affect reporting obligations and milestones set forth in settlements and consent decrees.

 

Senators Request Justice Department Release Vulnerable Inmates

On Monday, 14 Senators sent a bipartisan letterto the Justice Department, which oversees the federal prison system, asking that it make full use of its power to release elderly, terminally ill, and low-risk inmates to home confinement. The Senators write that the Federal Bureau of Prisons COVID-19 Action Plan does not include any measures to protect vulnerable staff or inmates during the crisis. The letter requests that terminally ill non-violent offenders over the age of 60 who have served 2/3 of their sentence be transferred to their homes for detention.