Category: Opioids Addiction

A Budget to Nowhere

  

 

The good news is that the budget unveiled Monday by the Trump administration is dead on arrival. The two-year agreement reached by Congress last week makes this budget even less relevant than most presidential budgets, and more importantly the congressional spending deal funds a number of crucial health programs that were in danger of losing funds. The bad news is that the President’s budget seeks to normalize policy proposals that would either cripple or eliminate altogether a number of crucial federal programs that provide critical aid for nurses and their patients.

Nursing Workforce Development Programs covered under Title VIII of the Public Health Service Act would be particularly hard hit, with cuts of almost 65% at a time when nurses nationwide desperately need this funding to continue providing quality care. The budget slashes $145 billion overall, eliminating all but one program under Title VIII (the NURSE Corps Loan Repayment and Scholarship Program, which would be funded at $83 million). As a result of this drastic and misguided approach, the Nursing Community Coalition (of which ANA is a member) announced their strong opposition earlier today.

Even when the President’s budget takes one step forward by allocating new funds, it simultaneously takes two steps back, as with funding to combat the opioid crisis. While the budget proposal would allocate $13 billion, experts estimate that at least $32 billion is needed to address this lethal epidemic. This new funding would also come at the expense of the Centers for Disease Control and Prevention (CDC), which would lose $1 billion and suffer particularly deep cuts to programs aimed at reducing chronic disease, bolstering public health preparedness, and overseeing occupational safety and health.

Perhaps most alarmingly, the budget embraces the approach of the already-rejected Graham-Cassidy legislation to repeal and replace the Affordable Care Act. This approach would implement massive cuts to Medicaid and eliminate its state-based expansion (which 33 states to date have chosen to embrace). It would also end the subsidies that help a vast majority of Americans who obtained health coverage under the ACA-implemented marketplace pay for their premiums.

Rather than promoting a misguided and out-of-touch budget, ANA urges the administration to instead focus on more pressing priorities, including helping Congress reach an agreement on those affected by the Deferred Action for Childhood Arrivals (DACA) program, as well as efforts to stabilize the health insurance marketplace following the repeal of the individual mandate late last year. Too many of the ideas included in this budget have been rejected by bipartisan congressional majorities. Like those ideas, this budget should similarly be put aside.

Congress Passes Bipartisan Spending Measure with Funding for Critical Health Programs

  

Following a brief, overnight government shutdown, President Trump this morning signed a spending measure and continuing resolution which reopens the government and provides funding through March 23rd while setting broad spending levels through FY 2019. The measure provides roughly $500 billion in additional funding over the next two years, including roughly $140 billion in additional non-defense domestic spending, a similar increase in defense spending, and roughly $90 billion in federal relief funding for Puerto Rico, the U.S. Virgin Islands, Texas, and Florida, which were pummeled by devastating hurricanes last summer, and for those impacted by the California wildfires. The bill also waives the debt ceiling until March 1, 2019.

Crucially, the spending bill provides additional funding for some of the nation’s most important public health programs. It provides $7 billion in funding for the nation’s 2,600 community health centers, which provided care to 26.5 million Americans in 2016; this was a critical need and the $7 billion in this bill represents roughly 2 years of federal funding for the nation’s centers.

The spending measure also extends the Children’s Health Insurance Program (CHIP) for another 4 years, meaning that the program will now be fully funded at the federal level for 10 years. CHIP provides healthcare coverage for roughly nine million American children and is a critical provider of healthcare services. The measure also provides an additional $2 billion in funding to the Department of Veterans’ Affairs to better manage their health system and prevents automatic cuts to Medicare and Medicaid, while eliminating the Independent Payment Advisory Board (IPAB). The measure critically provides $6 billion in funding over the next two FYs to fight the opioid epidemic.

With a large portion of the nation’s fiscal policy taken care of, the House and Senate have now cleared their plates to work on a solution to the Deferred Action for Childhood Arrivals Program, better known as DACA. The Trump administration plans on ending the DACA Program on March 5th, giving Congress roughly four weeks to come up with a solution to shield hundreds of thousands of young immigrants from deportation. ANA supports the DACA program and urges the House and Senate to quickly come to an agreement to keep these young Americans in the country. The Senate has already taken up a measure this morning to begin debate on the fate of DACA; ANA will continue to monitor this important issue.

We applaud Congress for coming to a bipartisan, long-term spending deal which ensures that several of the nation’s most important healthcare programs receive long-term funding. CHIP, the nation’s community health centers, and the VA all provide critical healthcare access to some of the nation’s most vulnerable populations, and Congress should be commended for recognizing their importance.

ANA also applauds Congress for providing additional funding to areas hit hard by this summer’s devastating hurricanes and by the wildfires in California; the American Nurses Foundation teamed with the Texas Nurses Association in August to raise donations for victims, and numerous nurses went down to Texas, Florida, and the Caribbean to help out. The spending measure signed into law this morning, however, only provides funding for the government through March 23rd; until then, members of Congress will continue to work to hammer out appropriations for federal agencies and programs for the remainder of FY 2018 and FY 2019. We strongly urge you to make your voices heard and let your member of Congress know that funding for the nation’s healthcare programs is critical to the overall health of the nation.

Photo Credit: Tom Brenner/The New York Times

Nurses work to stem the opioid crisis

  

Nurses see firsthand the devastating effects of the opioid crisis on their patients, communities, and perhaps even themselves or their families. ANA members have been forthcoming in their stories about access, treatment, and the pain they have dealt with each and every day working to fight this crisis. That’s why many are cheering the Trump administration’s work on the crisis, with the First Lady leading the administrative efforts for declaring it a national emergency, as nurses team with emergency responders, policymakers, law enforcement, and other stakeholders in the fight to turn the tide on the devastating effects of opioid abuse in local communities.

The statistics are sobering: 64,000 Americans lost their lives to drug misuse in 2016. The number of people misusing prescription opioids in 2015 is even more alarming, 12.5 million people. There is hope—however, a comprehensive approach is needed from the ground level all the way up through state and federal governments in order to address the crisis. ANA supports nurses who are facing this crisis head on through targeted continuing education, support of federal legislation that supports nurses to practice to the full extent of their training and education, and supporting/advocating for policies that allow APRNs to prescribe medication assisted therapy, which has proven effective in stemming substance use disorder.

Within the walls of Congress, there are currently over a hundred of bills aimed at addressing varying aspects of the opioid crisis. Two in particular are at top of ANAs priorities for opioid legislation. In the Senate ANA has signed on to support is Combating the Opioid Epidemic Act, introduced by Bob Casey (D-PA) and Ed Markey (D-MA). In the House, Reps. Paul Tonko (D-NY) and Ben Ray Luján (D-NM) introduced H.R. 3692, the Addiction Treatment Access Improvement Act with support from ANA and our nursing partners. The latter bill aims to build on the Comprehensive Addiction and Recovery Act in order to allow clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists to practice to the full extent of their training and education in prescribing buprenorphine.

Buprenorphine, however, is just one piece of the puzzle in treating opioid dependency. As with all medications used in Medication Assisted Therapies (MAT), it is just one part of a comprehensive treatment plan that includes addressing the underlying issues through counseling and participation in social support programs. Nurses play a primary role in comprehensive treatment plans and will continue to be integral in treating the most vulnerable populations throughout the country. ANA urges you to continue to voice your support in this fight by contacting your representatives and asking them to support H.R. 3692.