583: Infectious Disease Docs Wanted, Congress Grapples With Funding Deadline

ROBERT JOHNSON: 

This is the award-winning Public Health Review Morning Edition for Friday, January 19, 2024. I'm Robert Johnson. Now, today's news from the Association of State and Territorial Health Officials.

RAUL RUIZ: 

Infectious disease doctors are the cornerstone of our strong public health response in a pandemic and they help promote our understanding of the risks new threats pose.

JOHNSON: 

But the problem, according to Congressman and doctor Raul Ruiz from California, is there aren't enough doctors trained to deal with infectious diseases, let alone respond to another pandemic event.

RUIZ: 

We're having a growing population with more and more threats of infectious diseases due to a host of reasons, including climate change. And at the same time, we're decreasing in the number of infectious disease specialists, and that will hamper our ability not only to identify novel threats when they arise, but also to track and contain them.

JOHNSON: 

Congressman Ruiz is an emergency room physician who was on the front lines during the H1N1 pandemic. He says there are things public health leaders can do to help address the concern.

RUIZ: 

They should work with their local medical schools and residency programs to collaborate with, you know, public, private, or state and federal partnerships to create more GME slots, meaning graduate medical education slots, or residency training programs for infectious disease.

JOHNSON: 

And what about Congress?

RUIZ: 

Congress needs to work with CMS to modify the physician fee schedule to ensure ID physicians are reimbursed for the additional services they take on as part of coordinating the responses to outbreaks when they arise.

JOHNSON: 

Congressman Ruiz also wants to invest in student loan programs to get more people in the pipeline. He writes about the crisis in an article for STAT Online. You can read it using the link in the show notes.

It's a busy end to the week on Capitol Hill. ASTHO's Carolyn Mullen is here to tell us all about it in her latest View from Washington, D.C. report.

Carolyn Mullen, good to see you here on this very chilly Friday morning. How are you doing today?

CAROLYN MULLEN: 

I'm really good. I actually like the cold. It makes me feel alive. So, I'm celebrating all the snow that we're getting here in Washington, D.C.

JOHNSON: 

Definitely outside on Capitol Hill they're shoveling snow right now. But inside the building, they're punting on federal spending. Can you give us an update? Yes,

MULLEN: 

One of Congress's favorite activities is punting. So, they will be punting on federal funding yet again, this time in the form of a continuing resolution, and it's a laddered approach. Part of the continuing resolution will extend through March 1 for WIC and FDA. And the other part will extend funding for HHS and other mandatory programs through March 8. Congress is currently considering that legislation. If they do not approve it, there'll be a partial government shutdown on January 19 for WIC and FDA programs. But we expect it will get approved sometime over this weekend.

JOHNSON: 

What do ASTHO members then need to keep in mind about all of this? Is there anything new to worry about this time around?

MULLEN: 

There's nothing new to worry about right now. It's keeping funding levels at current levels. It just creates a lot of stress in the field; unable to implement new programs, just oscillating from extension to extension to extension. It would be nice to be able to implement programs with certainty. And when Congress does this, it just adds a lot of uncertainty and confusion for our members, but no new information yet. But stay tuned: March and April, there will be a lot of things happening.

JOHNSON: 

What do you think will be happening with the federal budget process over the next eight to 12 weeks?

MULLEN: 

So, right after the New Year, Speaker Johnson and Senator Schumer announced a bipartisan budget deal and included in this budget deal was recisions of about $6 billion for COVID money, this is unobligated COVID resources. So, in the next couple of weeks, we will see if that deal holds. The House Freedom Caucus has given Speaker Johnson a lot of headaches saying, "We do not support this deal. We want you to back away from it." Speaker Johnson said, "No, I'm not backing away from it." But if this COVID recisions comes to light, it could result in some contracts being delayed on the public health side just as the federal government tries to figure out what unobligated COVID resources they have. Moreover, we're watching the budget in April. In current law, there's a sequester order. A sequester order is very different from recisions. It would hit all programs, projects, and activities with an automatic, across-the-board cut. The White House issued guidance to agencies saying, "Hey, this could come, please don't operate any differently." And we don't know the across-the-board percent cut that could happen in April, but it could be around 1% and as high as 9%. In the middle of the fiscal year, that would be pretty unfortunate and devastating for a lot of public health programs, but a lot of uncertainty in the budget right now. We're continuing to monitor it and stay tuned for View from Washington as we update as all this drama unfolds in the next couple of weeks.

JOHNSON: 

Carolyn Mullen, we appreciate as always having you here on the newscast with us on Fridays and we hope that you have an awesome weekend.

CAROLYN MULLEN: 

Yes, thanks so much, Robert.

JOHNSON: 

Also today, get legislative and policy updates from the ASTHO government affairs team by signing up for Legislative Alert emails. There's a link in the show notes.

Finally, this morning, many states allow pharmacists to prescribe contraception, but more training and partnerships are needed to improve uptake. O'Keyla Cooper has more.

O'KEYLA COOPER: 

ASTHO's Contraception Access Learning Community is hosting a virtual webinar on pharmacist-prescribed contraception implementation on January 30 from 2 to 3:30 p.m. ET focusing on clinical training and workforce engagement. The webinar, facilitated by Birth Control Pharmacist, emphasizes the importance of evidence-based training and strategic relationship building for maximizing policy impact. Register now via the link in the show notes.

JOHNSON: 

Before we go, a reminder to follow this newscast on your podcast player so you don't miss a single report. You also want to be sure to connect with ASTHO on social media. We are on LinkedIn, Twitter, and Facebook.

That'll do it for today. We're back Monday morning with more ASTHO news and information. I'm Robert Johnson. You're listening to the award-winning Public Health Review Morning Edition. Have a great weekend.