Legislative Update 10/25/2021: National Mental Health Emergency, Vaccine Mandates, and Pediatric Vaccine Availability

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This is the legislative update for October 25, 2021. View all updates here.



The October 25, 2021 legislative update includes highlights from both federal and state legislatures.

Federal Updates

#SoundTheAlarm4Kids

Last week, the Children’s Hospital Association (CHA), the American Academy of Pediatrics (AAP), and the American Academy of Child and Adolescent Psychiatry (AACAP) declared a national mental health emergency for children and teens.

The “Sound The Alarm For Kids” initiative calls attention to staggering statistics and spokespeople to generate awareness of the mental health crisis faced by children across the nation.

Children’s Hospital & Medical Center (Children’s) is directing members of Congress, state legislators, stakeholders, and the public to learn more about the initiative through the #SoundTheAlarm4Kids communications campaign which runs through the end of the year.

Children’s is committed to pediatric mental health needs and has two major funding requests before lawmakers to impose a new level of care and insert opportunities for early intervention and prevention.

Coverage of the national emergency so far includes stories in ABC News, The Hill, and U.S. News and World Report. We look forward to seeing continued activity on social media — and beyond — to generate awareness.

COVID-19 Vaccine Rollout For Children

Last week saw big news from the White House as they plan to roll out the COVID-19 vaccine for roughly 28 million children ages 5 to 11.

The Food and Drug Administration (FDA) will sign off prior to the Centers for Disease Control (CDC) advisory panel meetings on November 2 and 3. Within hours of this approval, vaccines will begin going out to providers across the country — along with the smaller needles needed for injecting young children. According to the Biden administration, the United States has purchased 65 million doses of the Pfizer pediatric shot.

For full protection, the vaccine requires:

  • Two doses — spaced three weeks apart
  • A two-week wait following the second dose

This means that the first children in line for the pediatric vaccine will be fully covered by Christmas.

Alongside the pediatric vaccine rollout, the White House is also preparing a stepped-up campaign to educate parents and children about the safety of the shots and the ease of getting them. As has been the case for adult vaccinations, the administration believes trusted messengers — educators, doctors, and community leaders — will be vital to encouraging vaccinations.

In Congress

Both the House and Senate are in session this week and have a handful of looming deadlines ahead of the Thanksgiving holiday.

The House is expected to vote on the Build Back Better Bill this week, which has been significantly pared down to gain bipartisan support. One of the primary changes made to decrease the overall price tag is cutting down on the longevity of funding. The Children’s Health Insurance Program (CHIP) permanency could face significant challenges in the final package.

Also included in this Reconciliation bill is:

  • 12 months of continuous Medicaid coverage for children and new mothers
  • A boost of $250 million for Children’s Hospital Graduate Medical Education (CHGME) funding

Along with our #SoundtheAlarm4Kids campaign, we continue to ask our members of Congress to support pediatric mental health initiatives in the Reconciliation bill or FY 2022 spending bill that include provisions for the following pieces of legislation:

  • The Children’s Mental Health Infrastructure Act of 2021 (H.R. 4943) would provide $2 billion a year for 5 years for grants to children’s hospitals for increasing their capacity to provide pediatric mental health services.
  • The Helping Kids Cope Act of 2021 (H.R. 4944) would provide $500 million a year for 5 years to support grants to children’s hospitals and other providers to support pediatric behavioral health care integration and coordination. The bill would also provide $100 million annually for 5 years for grants to children’s hospitals and other providers to support workforce training for a range of pediatric behavioral health professionals.

State Updates

Nebraska Department Of Health And Human Services (DHHS)

Last Friday, October 22, Dr. Bridget Norton testified on behalf of Children’s in support of the Respiratory Therapy (RT) 407 Credentialing Review with the Nebraska Department of Health and Human Services (DHHS). This is a preliminary process required when any scope of practice decisions must be made by the Legislature.

Our due diligence and collaboration with the RT Association of Nebraska have ensured there are no known opponents to our request to change the RT scope of practice.

The new scope of practice for respiratory therapists would include their ability to receive extracorporeal membrane oxygenation (ECMO) certification and administer this form of life support.

ECMO uses a pump and an artificial lung to circulate blood back into the bloodstream of a child who has severe breathing or heart problems. It can be used to support children who are waiting for heart or lung transplants, or who are recovering from heart surgery.

Dr. Norton did an exceptional job putting the technical review committee at ease with the proposed changes to the RT scope of practice, and explained the extensive training and ongoing education needed to receive ECMO certification.

One term we seek to strike from the existing score is “aerosolized medications.” This will serve to make it clear that respiratory therapists with ECMO training are the best standard of care for ECMO circuit management.

There will be 3 to 4 hearings in total before the DHHS committee provides a recommendation or approval of our request. That request will then need to be written into a legislative bill and introduced in January.

It is unlikely these hearings will conclude in time for the upcoming legislative session; however, we still have the blessing of the RT Board of Health at DHHS that says it is critical to allow RTs with ECMO training to sit the pump as this process unfolds.

The next 407 credentialing review hearings are scheduled for:

  • November 19, 2021 at 1 p.m
  • January 11, 2022 at 9:30 a.m.

Vaccine Mandates And Republican Pushback

The federal government recently imposed a directive requiring all employers with 100 or more employees to get vaccinated or opt for regular testing. Last Friday, Nebraska’s Attorney General Doug Peterson announced he is exploring whether these mandates are enforceable and/or lawful along with other Republican states.

Meanwhile, Senator Ben Hansen (R-Dist. 16, Blair) and Senator Robert Clements (R-Dist. 2, Elmwood) are circulating a petition calling on their fellow senators to support a special legislative session aimed at prohibiting businesses, schools, and the government from imposing a vaccine mandate on employees and consumers in Nebraska.

Currently, 26 state senators have signed on to support the Governor initiating a legislative session, but 33 votes are required — and will be difficult to attain.

We are heavily monitoring the possibility of a special session and will be tracking leftover legislation from last year containing similar language (LB643). The bill remains in committee and could be viable for debate as early as mid-January 2022.

More than ever — especially ahead of the vaccine rollout for children ages 5 to 11 — Children’s needs to continue to endorse and sponsor positive vaccination campaigns throughout the community.

Changes In Hospital Capacity Dashboard Reporting

Governor Pete Ricketts announced that updates to the Nebraska Hospital Capacity Dashboard will return to a weekly schedule as long as COVID-19 hospitalizations remain below the 10% capacity threshold.

Dr. Chris Maloney sent a letter to Dr. Gary Anthone last week outlining the importance of the daily COVID updates, but our attempts were not successful with the Administration.

The next update to the dashboard will occur on Wednesday, October 27. The Nebraska Hospital Capacity Dashboard will subsequently be updated once per week on Wednesdays and will no longer include demographic data and county-specific statistics.

Directed Health Measure Rescinded Ahead of October 31 Timeline

Ricketts has rescinded the Directed Health Measure (DHM) that had temporarily suspended inpatient Class D and Class E elective surgeries for all Acute Care, Critical Care, and Children’s Hospitals in Nebraska. Class D and Class E elective surgeries have resumed as of October 22, 2021 — earlier than Ricketts’ initial October 31 extension.

(Sources: CHA, Congress.gov, Nebraska Legislature, World-Herald, Peetz & Co.)

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