Differing House and Senate Budget Resolutions Raise Questions About Restoration of Title VII Geriatric Health Professions Funding

As Congress focuses on crafting a 2007 budget, major differences between the Senate and House budget resolutions—their spending “blueprints” for next year—raise questions about future funding for Title VII geriatric health professions programs.

In a 218 to 210 vote May 18, the House approved a $2.7 trillion 2007 budget resolution that stays within President Bush’s proposed $873 billion limit in discretionary spending, but excludes the cuts in Medicare, Medicaid, and other entitlement programs included in the President’s $2.77 trillion spending plan. Although the House resolution did not include a commitment, sought by moderate House Republicans, to add $3.1 billion for education, health, and labor programs, it did include a statement that these programs should receive an additional $3.1 billion—if cuts could be made elsewhere. Medicare, Medicaid, and other programs for low-income Americans would not be cut to make up the $3.1 billion difference, said Rep. Michael Castle (R-DE), a moderate.

The Senate’s $2.8 trillion budget resolution, approved in March, includes $7 billion more for health and education than the President has proposed. The extra $7 billion would restore health and education allocations to 2005 levels, making restoration of Title VII geriatric health professions funds a possibility.

It’s unclear, however, how the House and Senate will ultimately reconcile differences between their spending blueprints, and, as a result, the fate of Title VII funding—the only Federal funding for geriatrics training—remains undecided.

Congress’ decision last December to eliminate 2006 funding for Title VII geriatric health professions programs has already had devastating effects on geriatrics training, according to a recent AGS survey of more than 140 directors of geriatric academic programs. Title VII funds for geriatrics, which totaled $31.5 million in 2005, supported three crucial initiatives: geriatric faculty fellowships for physicians and other health professionals; Geriatric Academic Career Awards (GACAs) for geriatricians pursuing careers in academic medicine; and the nation’s 50 Geriatric Education Centers (GECs), which train primary care doctors, nurses, and other healthcare providers. Program Directors surveyed reported that they had been able to find replacement funds to support fewer than 12% of their GACA awardees and fellows. Loss of funds for GECs will also limit geriatrics training in the community, they reported. Since December, the American Geriatrics Society has been making a concerted, multifaceted effort to restore these funds in 2007.

Medicare Prescription Drug Plan’s Initial Enrollment Deadline Marked by Rush to Join Plans, Uncertainty Over Penalties for Enrolling Late

More than 600,000 beneficiaries phoned Medicare’s toll-free Medicare prescription drug plan call center on May 15, the last day to enroll in a drug plan without incurring a scheduled 7% premium increase. Just hours after the initial enrollment deadline passed, however, members of the Senate and House announced that they would try to eliminate the penalty. “It’s time to cut seniors a little slack,” said Sen. Max Baucus (D-MT), the Senate Finance Committee’s leading Democrat, who, with committee Chair Charles E. Grassley (R-IA), is spearheading the Senate effort to waive the penalty for those who sign up by the end of this year. House Ways and Means Health Subcommittee Chairwoman Nancy L. Johnson (R-CT) announced that she would introduce similar legislation.

The Centers for Medicare & Medicaid Services (CMS) earlier waived late penalties for certain low-income beneficiaries through 2006, but said waiving the penalties for all beneficiaries would require legislative action.

Beneficiaries can opt to sign up via phone, at enrollment centers, online, or via mail. An estimated 9 million beneficiaries have done so voluntarily, according to The New York Times. Another 5.9 million low-income beneficiaries have been automatically enrolled by the government.

Just weeks before the May 15 deadline, the Administration changed policy to protect beneficiaries in drug plans against loss of coverage of drugs they are currently taking. Under the revised policy, insurers who eliminate drugs from their formularies, or introduce new restrictions on their use, must exempt beneficiaries in their plans who are already taking the medications.

HHS Issues Checklist to Help Medical Offices and Clinics Prepare for Potential Influenza Pandemic

In light of concerns about avian flu, the Department of Health and Human Services (DHHS) recently developed a checklist to help medical offices and clinics prepare for a potential influenza pandemic. “The ability of medical offices and ambulatory clinics to monitor illness in surrounding communities and in their own patients will be crucial to the success of dealing with a pandemic,” DHHS Secretary Mike Leavitt stated. “Identifying strengths and weaknesses in their organizations now and building community contacts in advance will provide a strategic advantage if a pandemic influenza strikes.”

The checklist recommends:
• incorporating pandemic influenza preparedness into emergency management planning;
• having a plan for surveillance and detection of pandemic influenza in the population the office or clinic serves;
• drafting a communication plan that identifies key public health and other contacts;
• providing education and training to ensure that all staff understand the implications of and control measures for pandemic influenza;
• developing a plan for triage and management of patients during a pandemic;
• developing an infection control plan;
• developing a vaccination and antiviral medication plan.

The complete checklist is available at http://www.pandemicflu.gov/ plan/medical.html.