123: Territories Visit Capitol Hill

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Tuesday, February 22nd, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

ASTHO members are focused on Washington, D.C. this week, discussing public health policy and meeting with key members of Congress. The annual Washington Week event allows state and territorial health officials the chance to collaborate on key federal issues and share their views with Capitol Hill. In today's morning conversation, ASTHO's Alex Wheatley tells us how the organization's territorial members are getting ready for tomorrow's Hill Day meetings.

How are ASTHO members from the territories planning to advocate during Hill Day tomorrow?

ALEX WHEATLEY:

So, among ASTHO's members, we have five territories and three Freely Associated States. These island jurisdictions have challenges and opportunities that, in many ways, differ from those of the states. So, we've crafted a number of Washington Week sessions to help address these unique needs; specifically, we have five meetings on the agenda this week with key committees on the Hill and our DC-based federal agency partners.

I'm excited. We have six representatives joining us virtually, and two island representatives that have flown into DC—CEO Esther Muña made the trip from Saipan, and Dr. Mellado is coming in from Puerto Rico.

JOHNSON:

How are you prepping them for their meetings?

WHEATLEY:

The ASTHO team's been working behind the scenes for a couple of weeks to set up all of our Washington Week events. Last week, we had our final meeting with our island area members to discuss key strategies and talking points for each of the five meetings. I think everyone's ready, and I know I'm excited for the conversations.

JOHNSON:

Well, let's talk about those conversations for a moment.

What is the message to lawmakers if you are representing a territory or a freely associated state?

WHEATLEY:

Absolutely. So, we have two key priorities for Washington Week: our members from the territories and Freely Associated States are focusing on Medicaid parity for the territories and renegotiated compacts of free association, or COFA. Both of these issues are at critical stages on the Hill, and while both appear to be enjoying bipartisan support right now, the path forward is complicated; so, now is really an opportune moment for policy makers and federal agency partners to hear directly from health officials about their experiences and about the urgent need for solutions.

In terms of Medicaid, our efforts focus on the need for a permanent and equitable solution for the territories. Medicaid programs in the territories have been underfunded compared to states; and while current stop-gap measures have enhanced the amount of funding currently available to the jurisdictions, this patchwork approach has really made it difficult for territories to do any kind of effective long-term planning. They really need a permanent fix, and that's what we're focusing on.

In terms of COFA, I think it's helpful to back up and actually share some history. So, COFA are the public laws that tie the Freely Associated States to the United States. Baked into these laws are significant amounts of direct financial assistance for health system development in the islands. However, some of that financial assistance is slated to expire next year without a great replacement funding source. If the funding were allowed to expire, it would really undermine and disrupt health service delivery in the Freely Associated States. It also impacts other states and territories with large Freely Associated State migrant populations. So, negotiations to renew and extend that funding have stalled; so our members' message for lawmakers this year is really sort of the urgent need for a solution there.

More broadly, our members also want to use this moment to assess the progress made over the last 40 years of compact assistance and to use this moment to really optimize federal government support for the region, sort of optimizing how we can create comprehensive and vibrant systems of care to help rectify some of these jurisdictions' disproportionate health burdens. I'd say they're both health equity issues at the end of the day.

JOHNSON:

ASTHO is monitoring the Senate's work on new pandemic-related legislation; the Prevent Pandemics Act could debut in committee as early as March.

ASTHO's Carolyn McCoy says ASTHO is offering input as the bill is being written.

CAROLYN MCCOY:

One of the areas that we're keeping an eye on is the proposal for a comprehensive review of the COVID-19 response, and they propose the establishment of a task force that can review what happened from A to Z of the response and provide a report.

JOHNSON:

National stockpiles of ventilators and PPE drew widespread attention in the early days of the pandemic. McCoy says:

MCCOY:

There's a proposal included in this discussion draft for improvements made to state stockpiles and the federal strategic national stockpile. So, ASTHO had some keen interest in that and the idea of how Congress would implement state-level stockpiles.

JOHNSON:

Also today, McCoy's colleague analyst Devon Page offers his take on the latest Hill actions in a blog article posted as Congress was passing another continuing resolution to avoid a holiday weekend government shutdown. You can read his assessment using the link in the show notes.

Following up on a story from last week, the Community COVID Coalition has a link to its latest webinar supporting its campaign to increase COVID-19 vaccination rates among key populations. The event is set for this Thursday, February 24th, at 4:00 PM Eastern time. The panel will discuss ways to leverage immunization manager and community-based organization partnerships. The link to register is in the show notes.

Finally, ASTHO's popular COVID vaccine comparison chart has been updated. As always, you can find it using the link in the show notes.

That'll do it for today's newscast. We are back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.