Legislative Update 11/22/21: Provider Relief Fund Expansion, PATCH Act, and Nebraska Legislature

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This is the legislative update for November 22, 2021. View all updates here.



The November 22, 2021 legislative update includes highlights from both federal and state legislatures.

Federal Updates

The Future Of The Provider Relief Fund

Last week, Iowa Representative Cindy Axne (R-IA3) introduced bipartisan legislation that would ensure remaining Provider Relief Fund (PRF) dollars are distributed to healthcare providers seeking support from recent COVID-19 surges.

In March 2020, Congress created the PRF as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act to reimburse healthcare providers for expenses or lost revenue attributable to the COVID-19 pandemic — so far appropriating over $178 billion for the PRF.

However, the PRF distribution process has faced its own challenges, including changing guidance, confusing tax information, and burdensome restrictions — not to mention children’s hospitals were largely excluded from PRF funds until the third portion of funding was released.

Additionally, no PRF dollars have been issued to compensate providers for expenses associated with the Delta variant surge of COVID-19 over the summer.

In response, the Provider Relief Fund Improvement Act would require Health and Human Services (HHS) to:

  • Distribute remaining PRF dollars by March 31, 2022
  • Relieve the bureaucratic burdens associated with shifting reporting deadlines
  • Allow PRF recipients to spend their awards on investments in the workplace, employee safety, and mental health support

These provisions would give much-needed certainty to US healthcare providers about forthcoming distribution timelines, as well as renewed flexibility in how they can use this funding.

The Importance Of The PATCH Act

Children’s is also discussing the importance of the Pediatric Access to Critical Health Care (PATCH) Act — a $6 billion investment over 10 years for national pediatric investments.

Under the PATCH Act, these investments would:

  • Add flexible critical care capacity: The PATCH Act would dedicate funding — combined with matching requirements — for the replacement or addition of up to 4,000 hospital beds across the country.
  • Strengthen the workforce: New investments would address pediatric workforce issues, recognizing the difference between adult and pediatric providers. It would also help address increased work stress and burnout in healthcare — which is already a major challenge to recruitment and retention.
  • Support telehealth technology and cybersecurity: Ongoing cyber threats have revealed the critical need to build strong defenses that protect the privacy and safety of patients and their health information. PATCH Act investments would enable providers to virtually connect families with high-quality, safe, and equitable healthcare.

The Modified Build Back Better Act

This week, the House passed a modified version of the Build Back Better Act (H.R. 5376), an omnibus bill (Translation:packages of policy changes and budget measures bundled together) being considered under the streamlined process of reconciliation.

Among its many provisions, the $1.75 trillion social spending package includes:

The bill — which is being considered under reconciliation procedures — is expected to face scrutiny in the Senate and will likely undergo more significant changes in the coming weeks.

However, there will be limited activity this week, as the Senate and House are home for Thanksgiving. Their work will be cut out for them upon their return as they face a budget deadline on December 3 and must decide whether or not to raise the debt ceiling by December 15.

State Updates

Nebraska Legislature

The Nebraska Child Health and Education Alliance (NCHEA) is hosting a virtual lunch and learn on Tuesday, December 8 at 12 p.m. (CST). The virtual event will call attention to pediatric mental health statistics, concerns, and solutions.

With a legislative session just around the corner, we are targeting all local, state, and federal lawmakers with a call to action to address the mental health crisis in children, including Children’s two proposals.

Liz Lyons is chair of the alliance that is comprised of healthcare providers, child advocates, and schools and will be moderating the event. Mike Vance will be the keynote address as he presents mental health data and solutions on behalf of Children’s.

Nebraska Department Of Health And Human Services (DHHS)

Last Friday, Dr. Bridget Norton participated in the second technical review committee hearing for the Respiratory Therapy (RT) 407 Credentialing Review.

This process was initiated by Children’s and the RT Association of Nebraska with the intent to broaden the scope of the language in the RT licensure to enable respiratory therapists to receive their extracorporeal membrane oxygenation (ECMO) certification.

The second hearing was efficient, and it quickly ended with resounding support from the ad hoc committee. The next hearing on January 11 will be the third and final public hearing. This hearing will be followed by the committee’s debrief and recommendation review — which is typically scheduled for a later date after these internal discussions.

While we have their overall support, it is unlikely we will have a bill this legislative session due to timing. We have the opportunity to continue to allow respiratory therapists with ECMO training to sit the ECMO pump in the meantime.

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

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