CSWE Health Care Reform Update

11/3/2009

Congress has been making a significant push over the last several weeks to move health care reform legislation. Last week, the House unveiled its re-worked bill, the Affordable Health Care for America Act (H.R. 3962). This bill is the product of negotiations between the three House committees responsible for crafting health care legislation – Energy and Commerce, Education and Labor, and Ways and Means. You will recall that these three committee introduced joint health care reform legislation earlier in the year (H.R. 3200). The new bill is meant to replace that earlier version and is the result of the last several months worth of debate and compromise.

On the Senate side, the two committees responsible for crafting health reform legislation – the Health, Education, Labor and Pensions (HELP) Committee (S. 1679) and the Finance Committee (S. 1796) – have drafted their own respective bills, which were recently merged into one Senate package. Senate Majority Leader Harry Reid (D-NV) is currently reviewing the legislation and devising his strategy for incorporating the so-called “public option” and getting the bill to the Senate floor. The text of the hybrid Senate bill is not yet available.

House Speaker Nancy Pelosi (D-CA) has expressed her interest in bringing the House bill to the floor for a vote prior to the Thanksgiving break. Floor debate could start as early as this week. The ultimate plan for House and Senate Democrats is to complete work on health care reform and have a bill on President Obama’s desk by Christmas. However, as we near the end of the year, accomplishing such a feat becomes increasingly challenging. House and Senate leaders have expressed their intention to keep House Members and Senators working as late as December 18 (in a “normal” Congressional cycle, Congress would have already adjourned for the year), including shortened holiday breaks (such as an abbreviated Veterans Day break) as well as potential weekend sessions in order to complete work on health care reform this year.

As reported in previous updates, the Council on Social Work Education (CSWE) has been very active in engaging with Congress on health care reform. CSWE has been closely tracking and informing the debate to ensure that social work and social work education, training and research have a place in the next-generation health care enterprise. Below is an update on some of the favorable provisions within the current House and Senate health care bills that are of particular interest to CSWE.

Affordable Health Care for America Act (H.R. 3962), Revised House Bill as of October 29, 2009

  • Mental and Behavioral Health Training Program, which would award grants to accredited health professions schools, including social work, to plan, develop, operate, or participate in a training program that promotes interdisciplinary training and coordination of delivery of care across settings. The program would also provide financial assistance to health professionals in the form of traineeships or fellowships.
  • Grants for cultural and linguistic competency training for health professionals, which may be awarded to an accredited health professions school.
  • An Innovations in Interdisciplinary Care Training Program, which would include grants to accredited health professions schools to test, develop and evaluate training programs promoting interdisciplinary and team-based models of care.
  • Advisory Committee on Health Workforce Evaluation and Assessment, which would assess the adequacy and appropriateness of the health care workforce and make recommendations to the federal government.
  • National Center for Health Workforce Analysis, which would gather data to evaluate the effectiveness of federal workforce programs. A website would be established to serve as a comprehensive source of information on the health care labor market and training, including data on salary, training requirements and average graduate loan debt.
  • Community Living Assistance Services and Supports (CLASS) Act, a bill developed by the late-Senator Ted Kennedy (D-MA), which would create a national insurance trust (cash benefit) to help those with disabilities obtain services and support and have more choices and opportunities in how and where they choose to live.

Affordable Health Choices Act (S. 1679), Senate HELP Committee as of September 17, 2009

It is unclear at this time whether these provisions have been included in the recently-merged HELP and Finance Committee bill.

  • Mental and Behavioral Health Education and Training Grants, which would award grants to institutions of higher education to support the recruitment of students in baccalaureate, master’s, and doctoral degree programs of social work, as well as the development of faculty in social work. It stipulates accreditation by CSWE among its eligibility requirements.
  • A demonstration program to integrate quality improvement and patient safety training into clinical education, for which schools of social work would be eligible to participate in the development of curricula.
  • A Pediatric Specialty Loan Repayment Program, which would provide loan repayment in exchange for 2 years of full time service in providing pediatric medical subspecialty, pediatric surgical specialty, or child and adolescent mental and behavioral health care.
  • A Public Health Workforce Loan Repayment Program, which would provide loan repayment in exchange for 3 years of full time service in a Federal, State, local, or tribal public health agency
  • National Center for Health Care Workforce Analysis, which would be tasked with analyzing the needs of the health care workforce.
  • Community Living Assistance Services and Supports (CLASS) Act, a bill developed by the late-Senator Ted Kennedy (D-MA), which would create a national insurance trust (cash benefit) to help those with disabilities obtain services and support and have more choices and opportunities in how and where they choose to live.
  • Enhancement to existing health professions programs, such as the National Health Service Corps, geriatric education and training programs, and mental and behavioral health education and training grants.
  • Grants to states to establish Community Health Teams, which may include social work.

America’s Healthy Future Act (S. 1796), Senate Finance Committee as of October 21, 2009

It is unclear at this time whether these provisions have been included in the recently-merged HELP and Finance Committee bill.

  • Workforce Advisory Committee, which would be comprised of external stakeholders and representatives of health professions, higher education institutions, public health experts, insurers, and others. The Committee would develop a national workforce strategy, which would touch on recruitment, training and retention needs of the health workforce.
  • Demonstration grants to provide aid and support services to low-income individuals to obtain education and training for occupations in the health care field.
  • Provisions requiring federally-funded surveys to collect data on racial and ethnic subgroups in order to compare health disparities populations.

Looking Ahead

Before health care reform legislation can become law, the House and Senate will have to reconcile the differences between their respective proposals. CSWE will continue to engage with Congress toward ensuring that the positive provisions outlined above are included in the final bill. To view CSWE’s recent activities, including correspondence to Congressional Committees and Obama Administration officials, please visit CSWE’s Public Policy Web page.

If you have any questions about this or any other CSWE Public Policy activity, please do not hesitate to contact Wendy Naus at wendy@lewis-burke.com.

Contact: Wendy Naus