HEALTH CARE BRIEFING: Biden Eyes Mandatory Nursing Home Staffing

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President Joe Biden will announce plans to impose mandatory minimum staffing requirements for nursing homes during his State of the Union address today, according to a White House fact sheet.

In addition, Biden will ask Congress for nearly $500 million—a 24% increase—to fund expanded health and safety inspections at nursing homes. And Biden plans to increase penalties for poor-performing facilities, the fact sheet says.

The staffing initiative comes amid the Covid-19 pandemic, which has fueled the worst staffing crisis the nursing home industry has ever experienced. More than 201,000 residents and staffers have died from Covid-19 in nursing homes and other long-term care facilities, according to the Kaiser Family Foundation.

In 2001, the Centers for Medicare & Medicaid Services issued a report to Congress that recommended a minimum standard of 4.1 hours of nursing time per resident each day. A recent analysis by the National Consumer Voice for Quality Long-Term Care found that few states meet those guidelines today.

“The Biden Administration has taken a giant step toward treating nursing home residents with the respect, care and dignity they deserve,” Lori Smetanka, executive director of the group, wrote in a statement yesterday. “The Administration’s plan will address inadequate staffing that has plagued nursing homes for decades.”

The White House announcement comes as several states, including New York and Rhode Island, have paused implementation of new state nursing home staffing requirements—and Florida is considering legislation that would roll back staffing requirements, said Smetanka. “From our perspective, that’s going in the wrong direction,” she said of the three states, whereas the reforms the Biden administration is pushing “will literally save lives.” Read more from Tony Pugh.

  • Biden built his five-decade political career around his foreign policy expertise and deft touch with everyday Americans, qualities that polls show many voters now doubt. He’ll need to rediscover both of those traits today in his first State of the Union speech, as the U.S. and its allies step up pressure on Russia over Ukraine. Biden must also persuade skeptical voters that he can lead the country out of its pandemic doldrums after key pillars of his economic plan collapsed and inflation spiked. Jenny Leonard, Nick Wadhams and Nancy Cook preview the themes to watch for in tonight’s speech.
  • Meanwhile, Brian Monahan, the Capitol’s attending physician, announced last weekend that masks would no longer be required on the House floor, including for tonight’s State of the Union address. It follows new guidance from the Centers for Disease Control and Prevention, which lifts most pandemic restrictions for regions seeing low transmission rates and a drop in hospitalizations. Yesterday, the White House followed suit, dropping its mask mandate on the complex. Madison Muller has more.

Also Happening on the Hill

Abortion Rights Bill, in Rare Stand-Alone Vote, Stalls in Senate: Legislation to safeguard the right to abortion services in the U.S. fell short in a procedural vote yesterday, leaving the politically fraught dispute largely in the hands of the judiciary. Abortion rights supporters say just getting a vote in the Senate is historic and shows that Congress can’t sit quietly as the Supreme Court signaled it may erode almost a half-century of protections for abortion access. The vote itself is meant to remind Americans that their lawmakers could move to enshrine the right to access to abortion, advocates argue.

“Now they’ll know that Congress can do something,” said Nancy Northup, CEO for the Center for Reproductive Rights. Congress annually debates whether federal funding should be available to organizations that offer abortion services. Yesterday’s vote was the first time the Senate has voted on a stand-alone bill to codify abortion rights, Northup said.

The House-passed bill (H.R. 3755) to codify the high court’s landmark 1973 Roe v. Wade decision and create a federal right to abortion was blocked on a 46-48 Senate vote; 60 votes were needed to advance. Senate Democrats also say the vote is meant to highlight who among them backs abortion rights, and who does not. “This vote will be a rallying cry in November,” Sen. Richard Blumenthal (D-Conn.) said. Read more from Alex Ruoff.

Rare Disease Advocates Urge for Early Patient Input in Research: Early patient engagement should be a federal requirement for drugmakers looking to launch clinical trials on rare disease treatments, medical researchers and patient advocates said. Both the Food and Drug Administration and Congress could act to ensure patient voices are a key component of the R&D process, the advocates argued in a webinar held in honor of World Rare Disease Day. Early input before a trial—instead of just during or after—can help ensure researchers use effective biomarkers to measure a potential treatment’s results. Celine Castrnuovo has more.

Advocacy Group Seeks $17 Billion to Fight Covid Worldwide: Health and anti-poverty advocates from The ONE Campaign will meet virtually with lawmakers “to urge them to support at least $17 billion to fight COVID-19 globally,” according to a statement from the group. The activists will also ask for Congress’s support for a $2 billion yearly commitment from the U.S. “to fight global HIV-AIDS, tuberculosis, and malaria,” they said. “The US has been ahead of other governments in the race against COVID but we remain a distant second to the virus itself.” Read their statement here.

What Else to Know Today

Ukraine War Threatens to Stymie Covid Vaccination Efforts: The humanitarian crisis spurred by the war in Ukraine threatens to worsen the spread of Covid-19 and hamper vaccination efforts across Europe, health security and human rights analysts said. The European Union is preparing for an outflow of at least one million refugees following Russian’s invasion of Ukraine late last week. An exodus of just 10% of Ukraine’s 44 million residents would put huge pressure on neighboring countries’ ability to offer essential health services like primary care, childhood screenings, and vaccines, Jeannie Baumann and Ian Lopez report.

West Coast Ends Mask Mandates in Schools: California, Oregon, and Washington will no longer require masks in classrooms after the end of next week, as plunging Covid-19 case rates across the West Coast accelerate efforts to return to something like normal life. The three states will shift to recommending masks in schools and child-care facilities, rather than mandating them, after March 11, according to a statement yesterday. Oregon and Washington will lift mask rules for most other indoor settings then as well. California had let its indoor mask rules expire earlier this month. Read more from David R. Baker.

FDA Reviews Limits on Gay Men From Donating Blood: The Food and Drug Administration is reviewing whether safety data supports revising its current three-month deferral policy for blood donations from males who have sex with males, an agency official said. The spokesperson told Bloomberg Law that the agency is reviewing blood donor safety data as nationwide blood supply shortages have forced the agency to rethink decades-long restrictions on gay and bisexual men. The update comes as lawmakers push the FDA to replace the blanket deferral with an individual risk assessment. Celine Castronuovo has more.

U.S. Birth Rate Seen Returning to Pre-Covid Level: U.S. birth rates are still declining, but not nearly as severely as in the depths of the pandemic, suggesting Americans are more comfortable having children as Covid-19 cases drop. The number of births for the first half of 2021 declined by 2%, the same as the decrease observed for the first half of 2020, according to data from the National Center for Health Statistics. That’s less than half of the drop seen in the second half of 2020. “This difference between patterns seen for the first six months of 2021 and earlier years suggests that the magnitude of the downward trend seen in the second half of 2020 and January of 2021 may have begun to wane and declines in the number of births may be returning to pre-pandemic levels,” according to the report released today. Read more from Alex Tanzi.

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