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December 2015
The Comprehensive Justice and Mental Health Act of 2015 (S.993) will amend the Omnibus Crime Control and Safe Streets Act enabling the Attorney General to grant funding for eligible entities which aim to collaboratively map and implement programs for mentally ill inmates both during and after time in jail or prison.
The Attorney General is now authorized to award grants for:
Collaborative programs which coordinate and implement community-based crisis services.
Enhancement of correctional facility capabilities to provide the clinical, medical, and social needs of inmates including appropriate mental health and substance abuse treatment.
Development of comprehensive training programs, protocols, and systems for law enforcement, mental health, substance abuse, housing, corrections, and emergency medical service personnel to provide coordinated assistance to individuals with unique needs.
In the United States, prisons house 10 times more mentally ill individuals than psychiatric hospitals. In 44 states and the District of Columbia, the largest prison of the state held more people with serious mental illnesses than the largest psychiatric hospital of the state, as of May 2015. This bill was created in an effort to reduce the number of people incarcerated and increase the number of people treated for mental illnesses. This bill aims to develop a better understanding of the flow of individuals with mental illnesses through the criminal justice system by identifying opportunities for improved responses to the mentally ill and creating post-prison resources to reduce repeated offenses. Introduced: 04/16/15 Passed by Senate: 12/10/15
The Minority Diabetes Initiative Act (H.R. 4209) will amend the Public Health Service Act to authorize grants to physicians and community-based organizations for a variety of diabetes-related health services including public education on diabetes prevention and control, and routine health care for diabetic patients, eye care, foot care and treatment for kidney disease and other complications of diabetes. Diabetes can lead to serious complications including high blood pressure, heart disease, stroke, blindness, kidney disease, nerve damage, lower-limb amputations, or even death. Diabetes is the 7th leading cause of death in the U.S. and disproportionately affects racial and economically disadvantaged minority groups in America. African-Americans, Hispanics, Native Americans, Pacific Islanders and Asians have a 50-100% higher prevalence of diabetes, as well as a higher rate of complications or death from diabetes than White Americans. By improving funding for minority health initiatives, diseases such as diabetes which disproportionately affect minorities could steadily decrease in prevalence. Introduced: 12/10/15
TheFixing America's Surface Transportation (FAST) Act (H.R. 22) was signed into law December 4, 2015 by President Obama. The FAST Act is a five-year, $305 billion reauthorization of federal surface transportation policy. The law includes increased funding for bicycling and pedestrian projects ($850 million per year by 2018 and through 2020) such as “Safe Routes to Schools” and the first-ever federal “Complete Streets” language. Public health advocates, including Trust for America's Health (TFAH), are encouraged to work with federal and state partners to learn more about the next steps for implementation and how transportation policy can help promote healthier communities.
Introduced: 01/06/2015 Signed into Law: 12/04/2015
Public Health Implications of the Regulation of Marijuana Decriminalization of marijuana has been supported by many health equity advocates because of disparities in law enforcement and imprisonment for marijuana possession among racial and ethnic groups. Of the 8.2 million marijuana arrests between 2001 and 2010, 88% were for minor possession. Despite roughly equal usage rates, Blacks are 3.73 times more likely than whites to be arrested for marijuana. Within Pennsylvania, that rate rose to 7.5 in 2010.=. Nationwide, the arrest data revealed one consistent trend: significant racial bias. Disproportionate arrests force specific groups of people into the criminal justice system and those with convictions have a significantly harder time finding employment, enrolling in education institutions, obtaining access to health insurance, and ultimately, providing for their families. This creates a ripple effect in minority households for generations leading to cyclical impoverishment, poor health, and lack of access to opportunities.
In the age of mass incarceration, or "targeted" incarceration, a term used by Dr. Marc Lamont Hill to emphasize racial inequality in our judicial system, steps are being taken to decrease the number of non-violent minorities arrested for marijuana possession.
Presidential candidate, Senator Bernie Sanders proposed the Ending Marijuana Prohibition Act of 2015 (S.2237). This bill will repeal all federal penalties for possessing and growing marijuana by removing references to "marijuana" from the Controlled Substances Act. However, transporting marijuana from places where it is illegal to places where it is legal would still be prohibited and subject to penalties of fines and/or imprisonment up to one year. A similar proposed bill, the Regulate Marijuana Like Alcohol Act (H.R. 1013), will decriminalize marijuana at the federal level and allow states to establish their own laws. Both bills could have a significant impact on how many people, specifically those of color, are arrested for possession of marijuana. This change in language and shift of responsibility from the federal level to state governments could reduce the number of African Americans, and other ethnic minorities, incarcerated and improve access to vital resources for health and success.
November 2015
The Reducing Gun Violence in Our Neighborhoods Act (H.R. 3830) aims to reduce gun violence, increase mental health counseling, and enhance tracking of lost and stolen firearms. The bill proposes a $100 tax on the sale of any firearm and mandates the Treasury of the US to create a 'Gun Violence Reduction and Mental Health Counseling Trust Fund' for community mental health services and crime control services.The bill also calls for a national standard for passive identification capability meaning that every firearm would be equipped with a form of technology that enables it to be identified by a mobile or fixed reading device. Failure to report the loss or theft of a firearm would result in a $10,000 fine per unreported firearm.
Another bill introduced to congress (H.R. 3411) aims at enforcing criminal background checks for every firearm sale. The bill also requires that any individual prohibited from purchasing a firearm is listed in the National Instant Criminal Background Check System, including individuals who have been “adjudicated as a mental defective.”
The two bills are a step towards limiting the prevalence of guns in hopes that this will reduce gun violence in communities overall. The requirement of mental health counseling and denying the sale of firearms to individuals who have a history of struggling with mental health illnesses will increase the importance and credibility of proper mental health. Introduced: 7/29/15 (H.R. 3411) & 10/26/15 (H.R. 3830)
The Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015 will repeal the requirement imposed by the Fair Labor Standards Act of 1938, requiring certain employers to automatically enroll employees into a health plan. The bill will eliminate the requirement for individuals to maintain minimum essential health care coverage. The bill will also terminate funding for the Prevention and Public Health Fund, which provides funding for programs aimed at improving the public’s health and reducing the overall healthcare costs. For one, year no federal money can be paid to entities such as the Planned Parenthood Federation of America and other tax-exempt organizations that provide similar services.
By limiting funding to organizations such as Planned Parenthood, many individuals would be losing access to a number of preventative health services. Terminating the Prevention Fund has serious negative implications to public health as this fund has invested in a multitude of evidence-based intervention programs and research involving tobacco prevention, immunizations and screenings, public health workforce training and much more.
The Women’s Public Health and Safety Act will amend Medicaid to modify the requirements for a state plan for medical assistance. Currently, any individual that requires medical assistance may receive services from any entity, institution, agency or person qualified to do so. Under this new bill, states will be able to choose whether or not to deny services provided by certain entities to eligible individuals based on the individual’s or entity’s involvement with abortions.
By limiting services from any health care providers who offers abortions, this act would limit a range of other family planning and women’s health resources to Medicaid receiving individuals.
Introduced: 9/11/15 Passed by House: 9/29/15
The Community-Based Gang Intervention Act responds to the growing burden of gang violence by providing grant monies and outlining parameters for effective community-based interventions. The United States has only 5 percent of the world’s population, but 25 percent of the world’s prisoners.With increased prison costs, vital social programs and services such as education, job creation, housing, and healthcare are being cut or eliminated to maintain the prison industry.
The most recent data reveals that in 1998, states spent nearly $4,200,000,000 on “juvenile justice” related programs. Of those expenditures only 8.4 percent went towards delinquency prevention. This bill supports developing a comprehensive violence reduction strategy, acknowledging and addressing larger, entrenched social conditions and issues such as poverty, homelessness, inadequate educational systems, and limited economic opportunities that give rise to gangs and gang violence.
This act offers holistic and comprehensive support for the variety of community-based gang intervention activities that focus on and engage active and former gang members, their close associates, and gang members in and returning from confinement. This act provides definitions of terms and services related to community-based gang intervention to ensure that funding for such intervention is utilized in a cost-effective manner and that community-based agencies are held accountable for providing holistic, integrated intervention services.
Introduced: 10/15/15
The Protecting our Infants Act of 2015 requires the federal Agency for Healthcare Research and Quality to report on prenatal opioid abuse (abuse of opioid drugs during pregnancy) and neonatal abstinence syndrome (the symptoms of withdrawal in a newborn). The report must include:
assessment of existing research on neonatal abstinence syndrome
evaluation of the causes and barriers to treatment of opioid use disorders among women of reproductive age
evaluation of treatment for pregnant women with opioid use disorders and infants with neonatal abstinence syndrome
recommendations on preventing, identifying, and treating opioid dependency in women and neonatal abstinence syndrome
The Department of Health and Human Services must review its activities related to prenatal opioid use and neonatal abstinence syndrome and develop a strategy to address gaps in research and programs. The Centers for Disease Control and Prevention must provide technical assistance to states to improve neonatal abstinence syndrome surveillance and make surveillance data publicly available. Introduced: 3/15/15 Passed by Senate: 10/22/15
October 2015
Feature: Reconciliation Bills Threaten Public Health Infrastructure Despite continuing political tension, Congress averted a government shutdown by passing a short-term Continuing Resolution (CR) on September 30th, signed by President Obama before budgets for federal agencies were scheduled to deplete. This temporary resolution will extend funding for the majority of federal agencies to continue daily operation until December 11th 2015. The CR did not include any provisions or language related to defunding Planned Parenthood or the Patient Protection and Affordable Care Act (ACA), also known as Obamacare. However, multiple Public Health priorities are being targeted for budget cuts in the reconciliation process.
On September 29th and 30th, the House of Representatives' Ways and Means Committee, Energy and Commerce Committee, and Education and Workforce Committee, separately, passed reconciliation bills. Collectively, these bills will repeal several major factors of the Affordable Care Act, defund Planned Parenthood for one year, and fully cut the Prevention and Public Health fund. This will not only terminate vital heath care services in almost 700 clinics across the nation which specifically serve disadvantaged Americans, but also place an excess service burden on Community Health Centers which will receive redirected funds and patients from the possible dismantling of Planned Parenthood. All three reconciliation bills will be reviewed and compiled by the House Budget Committee then sent to President Obama, whom has threatened to veto the bill. Congress has roughly two months to collaborate and create a budget for fiscal year 2016, or we face the threat of another government shutdown.
UPDATE: Medicaid Expansion 2015 In states that have expansion packages, Medicaid coverage will be available for adults based on income alone compared to non-expansion states in which income, household size, disability, family status, and other factors affect eligibility. Expansion of Medicaid now allows people with annual incomes below 138% of the federal poverty level health care coverage regardless of other factors. This population typically consists of low-income able-bodied parents, low-income adults without children, and many low-income individuals with chronic mental illnesses and/or disabilities who struggle to maintain well-paid jobs but did not meet previous disability standards for Medicaid.
According to the Medicaid Enrollment & Spending Growth report released by the Kaiser Commission on Medicaid and the Uninsured, enrollment increased across all 50 states and the District of Columbia by an average 13.8% in the 2015 fiscal year. The 31 states that opted to expand Medicaid under the Affordable Care Act saw an average 18% increase in enrollment and in spending within 2015, the first full year of the expansion. Some financial analysts have equated the Medicaid enrollment spikes to those normally seen in tough economic times. Find out more about Medicaid Expansion and what it means for you!
EPA Sets New National Air Quality Standard at a Lower Level The Clean Power Act mandates that the U.S. Environmental Protection Agency (EPA) sets the national air quality standards for ozone pollution. On October 1st, the EPA officially lowered the standard, previously set at 75 parts per billion (ppb) to 70 ppb. The APHA had called for a stricter standard, based on scientific evidence presented by the EPA Integrated Science Assessment, the Health Risk and Exposure Assessment and the Policy Assessment, which showed that 60 ppb would be the ideal level for the health of the population. Nonetheless, this new standard will protect many people, particularly at-risk populations such as children, those with lung diseases including asthma, and older people. Additionally, it will also improve the health of trees, plants and ecosystems, making the outdoors a safer place to be.
Pennsylvania House of Representatives Proposes Bill to Regulate Unfair Practices of PBMs Pharmacy Benefit Managers (PBMs) are in charge of processing and paying prescription drug claims and act as liaisons between payers and pharmacies. These PBMs manage pharmacy benefits for nearly 95% of Americans. In Pennsylvania, PBMs do not have to register with any state entity. Because of this lack of accountability, there is no standard for determining the maximum allowable costs (MACs) of products and many PBMs engage in unfair auditing practices. MACs establish the unit price for the products sold to pharmacies. Lack of regulation of MACs means that PBMs can set and alter prices for drugs as they choose, resulting in high costs to pharmacies and in turn, patients.
The Pennsylvania House of Representatives has proposed two bills, HB946 and HB947, that would alleviate these disparities. The first bill would require all PBMs to register with the Department of Health and provide pharmacies with how MACs are determined and established to increase accountability. The second bill would create the Pharmacy Audit Integrity Act, which would regulate auditing practices among pharmacies. PBMs would be required to provide sufficient notice to pharmacies prior to audits, and only audits that follow Federal and Commonwealth of Pennsylvania procedures can be conducted. Increased monitoring and strict enforcement of these laws will ensure that drug costs will be lowered to the public, making it more accessible for people to receive the medication they require for temporary and chronic health conditions.
September 2015
Feature: Congress Spending Bills Threaten Public Health Infrastructure Every year, Congress must pass bills that appropriate money for all discretionary government spending by the end of September. The House and Senate adjourned for their summer recess this year without sending any of the spending bills to President Obama. With only twelve working days scheduled in the month of September, Congress will likely have to pass a continuing resolution until the new spending bills can be agreed upon. A continuing resolution would prevent a government shut down by allowing funds to be appropriated as they had in the previous fiscal year for a designated period of time.
While bills from all sectors have an impact on public health, there are certain bills that will have a more immediate and direct impact on the state of public health. One of these is the labor-HHS-appropriations bill, which designates funding for public health infrastructure. The House version of the bill would increase the Center for Disease Control and Prevention's (CDC) overall funding while cutting important programs within the agency, including the Climate and Health Program and the Environmental Health Tracking Program. It would also cut funding for the Health Resources and Services Administration (HRSA) and eliminate all funding for the Title X family planning program and the Agency for Healthcare Research and Quality (AHRQ). If passed, the Senate bill would cut overall funding for CDC, HRSA and AHRQ while also eliminating CDC's Partnerships to Improve Community Health and Racial and Ethnic Approaches to Community Health Programs.
The Clean Power Plan aims to reduce carbon pollution from power plants by 32% by year 2030 Power plants are the largest source of carbon emissions in the world and are the largest contributors to climate change. Climate change is inextricably tied to public health because the harmful effects of climate change, including air pollution, have increased the cases of asthma, injury, and cardiovascular disease. The Clean Power Plan is projected to prevent 3,600 premature deaths in the United States, 90,000 asthma attacks among children, and 300,000 missed days of school and work. The Clean Power Plan was initially proposed in 2014, but the final rule was added in August of 2015. The plan specifies standards for existing power plants, but states will have the ability to develop plans tailored to their specific needs.