Worker safety

The co-chairs of the Congressional Mental Health Caucus will host a briefing Wednesday for staffers who have questions about mental illness in the wake of the Jan. 8 shooting of Rep. Gabrille Giffords (D-Ariz.).

The prime suspect, Jared Lee Loughner, is widely believed to suffer from a mental illness.

The briefing is hosted by Reps. Grace Napolitano (D-Calif.) and Tim Murphy (R-Pa.), who co-founded the caucus in 2003. The week after the shooting, Napolitano told The Hill that she wanted to host a briefing on mental-health danger signs because staffers are often on the receiving end of threats or disturbing remarks but don't always know which to take seriously.

"In the wake of the shooting in Tucson, Arizona, many congressional staff are concerned about mental health and mental illness and their work as staff," reads a memo from Napolitano's office to congressional staffers  "While stressing the importance of not increasing stigma against the mentally ill, who are not more likely to be violent than the general population, the Congressional Mental Health Caucus will provide a panel of experts to take questions and discuss what resources are available to staff members if they do feel threatened."

Invited panelists include Daniel Dodgen, the director of the Office for At Risk Individuals, Behavioral Health, and Human Services Coordination at HHS; William Hudock of the Substance Abuse and Mental Health Services Administration; and Pete Earley, a representative from the Capitol Police.

The hour-long briefing has been scheduled for 2 p.m. in 2103 Rayburn House Office Building.

A U.S. Supreme Court ruling Tuesday that medical residents are workers, not students, is rekindling debate over the length of their shifts.

"The U.S. Supreme Court's ruling Tuesday that resident physicians are properly deemed workers — not students — for purposes of paying Social Security taxes further bolsters the case that residents should also have other protections afforded to workers," Sidney Wolfe, director of Public Citizen's Health Research Group, said in a statement. "This includes a good night's sleep."

Public Citizen is part of a coalition of consumer and labor advocates that has been petitioning the Occupational Safety and Health Administration (OSHA) to assume jurisdiction over the work hours of physician residents — and to put strict limits on what those hours can be. 

The groups — which include the Service Employees International Union and the American Medical Student Association — say the rules established by the Accreditation Council for Graduate Medical Education (ACGME) that currently monitors residents' work hours don't go far enough to ensure the safety of residents and the patients they see.

Newly proposed ACGME standards, for instance, would still allow interns to work 20 consecutive 16-hour shifts, the critics argue.

Among the reforms, the petitioners want OSHA:

• To cap the workweek at 80 hours "without averaging." (ACGME limits the workweek to 80 hours — averaged over four weeks.)

• To establish a limit on single shifts of 16 consecutive hours. (ACGME set the maximum shift at 24 hours, while also allowing an additional six hours of educational activities. That, the groups write, "has been universally interpreted as a 30-hour shift.")

• To require at least one full day off per week, without averaging. (ACGME allows one day off per week, averaged over four weeks.)

• To limit the frequency of in-hospital on-call duty to once every three nights, without averaging. (ACGME has the same limit, averaged over four weeks.).

Welcome to The Hill's evening roundup of the day's health policy news and advance look at tomorrow's schedule.

Wednesday’s health news:

Congress approve 9/11 benefits: A $4.3 billion bill providing health benefits and compensation to Ground Zero first-responders passed through Congress Wednesday afternoon after Senate Democrats struck a last-minute deal with Sen. Tom Coburn (R-Okla.), who had been blocking the bill. Failure to pass the bill Wednesday would have doomed it in the lame duck, and its chances next year were thought to be slim in a Republican-controlled House. http://bit.ly/gBRRPB

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Oklahoma City firefighters are pressuring their senator to drop his opposition to a bill that would provide health benefits and compensation to Ground Zero first responders.

The firefighters association, recalling its own tragic day in 1995 when an Oklahoma City federal building was bombed, urged its senators to support a bill that provides $6.2 billion to workers who got sick at the Ground Zero site in the aftermath of the Sept. 11 terrorist attacks.

With both chambers hoping to wrap up the lame-duck session Wednesday, supporters of the bill are pleading with Sen. Tom Coburn (R-Okla.) to allow the vote to proceed. Coburn said Tuesday that he has concerns with the bill and wants it to go through the committee process next year.

"We're going to have to come back and fix it," Coburn told Fox News on Tuesday, "and we're going to waste a whole bunch more money and not fix the real problem, which is taking care of those people who are so desperately dependent on it."

The Oklahoma City firefighters said the Senate shouldn't delay the bill.

"It has been almost 10 years since that tragic day, and firefighters, police officers and those who worked on the pile remain without adequate health monitoring and care," they said. "It is a national disgrace."

House Majority Leader Steny Hoyer (D-Md.) said Tuesday that members of the lower chamber will stay in Washington on Wednesday to pass the bill if it gets through the Senate.

With the Senate expected to pass the legislation Wednesday, House members will stay in town for the vote.

Sens. Chuck Schumer and Kirsten Gillibrand announced Sunday they have struck a deal on one of the last lame-duck items.

Welcome to The Hill's evening roundup of the day's health policy news and advance look at tomorrow's schedule.

Thursday’s health news:

GOP blocks 9/11 health benefits: Senate Republicans filibustered legislation to monitor and treat first responders and emergency workers who suffered illnesses related to the Sept. 11, 2001, terrorist attacks.The cloture vote on the $7.4 billion bill failed 57-42, making it less likely the Senate will approve the measure before the end of Congress's lame-duck session.

The bill’s passage was in doubt for many months and, in the end, no Senate Republican voted to save the bill. Even before the cloture vote failed, dozens of members signed a letter urging Speaker Nancy Pelosi (D-Calif.) to include the bill in legislation extending the Bush tax cuts.

"We feel that we must seize every opportunity possible to ensure that this bill become law," the members wrote. http://bit.ly/fKsw57

Congress passes doc fix: One day after the Senate approved the yearlong "doc fix" by unanimous consent, the House of Representatives approved the deal, 409-2, to avoid a scheduled 25 percent cut in Medicare physician payments.

The paid-for, $19.2 billion bill now goes to President Obama’s desk, one day after he voiced his support for the agreement, even though it borrows from healthcare reform funding.

This marks the fifth time Congress has enacted a stopgap measure in the past year to avoid rate cuts to Medicare doctors. Obama and physician groups have urged Congress to come up with a more permanent fix to the rate formula next year. http://bit.ly/eggCa1

HHS Secretary approves: Health and Human Services Secretary Kathleen Sebelius hailed the doc fix in a Thursday afternoon statement, but said more work needs to be done. “I look forward to working with the new Congress on a permanent solution to fix Medicare’s physician payment system once and for all,” she said.

Mini-meds forced to come clean: Health insurers offering so-called "mini med" plans must notify customers in plain language and within 60 days that their insurance plans offer extremely limited benefits, according to new HHS guidance. However, more than 200 plans have already been exempted from annual coverage dollar limits required by the healthcare reform law.
   
Sen. Jay Rockefeller (D-W.Va.), Congress’s biggest critic of the mini-med plans, said the guidance will provide some help to consumers.

"These 'mini med' policies have gaping holes in coverage and do not help with serious health problems," he said in a statement. "I am encouraged by HHS taking this step to begin to improve consumer protections as we transition to a fully reformed insurance market in 2014." http://bit.ly/gRszFU

GOP senator says CR funds reform: Sen. Tom Coburn (R-Okla.) criticized the continuing resolution to fund the government through next year as a “Trojan horse” for funding the healthcare reform law. Coburn said the CR includes funding for a number of provisions in the law, and he urged other members who campaigned on defunding healthcare reform to oppose the measure. http://bit.ly/hG15OO

Rising hospital costs: Transaction prices for a day in a California hospital paid by private insurers jumped more than 150 percent over the past 10 years, according to a new America’s Health Insurance Plans (AHIP) report. Meanwhile, the same report found that hospital prices for common hospital services increased about 10 percent above the rate of inflation in Oregon from 2005 to 2009.

AHIP chief executive Karen Ignagni told reporters Thursday that the report shows that costly services, and not insurers, are driving up healthcare spending.

“We are 4 percent of total healthcare expenses,” Ignagni said. “You don’t need to have a degree in advanced mathematics to say, 'what about the other 96?' ”

Tobacco smoke an 'immediate' danger: Exposure to tobacco smoke, even occasional smoking or secondhand smoke, inflicts immediate damage to a person’s body that can cause serious illness or death, according to a new surgeon general's report. Even brief exposure to secondhand smoke can cause cardiovascular disease and trigger a heart attack, the report said.

Quitting smoking has become harder than ever because today’s cigarettes deliver nicotine more quickly and efficiently than in the past, according to the report. http://bit.ly/i2ymH2

States' rights bill introduced: Sen. Roger Wicker (R-Miss.) introduced a bill that would allow state officials to challenge federal regulations before they go into effect. Wicker said the bill was inspired by the new healthcare reform law.

The Restoring the 10th Amendment Act would allow certain state officials to file a legal brief challenging the constitutionality of proposed regulations during the comment period. Wicker said he introduced the legislation to start drumming up support for the next Congress. http://bit.ly/eQkWdI

R-E-C-A-L-L: Johnson & Johnson announced a voluntary recall of three Rolaids products after customers complained about the presence of metal and wood particles. J&J’s pharmacy division, McNeil Consumer Healthcare, announced the recall for Rolaids Extra Strength Softchews, Rolaids Extra Strength Plus Gas Softchews and Rolaids Multi-Symptom Plus Anti-Gas Softchews. This is just the latest in a chain of recalls for J&J, whose safety protocols are being investigated by the House Committee on Oversight and Government Reform.

On the agenda for Friday:

Lessons for healthcare reform: The National Academy for State Health Policy will host a discussion panel on the Robert Wood Johnson Foundation's Maximizing Enrollment for Kids national program. http://bit.ly/hUsG6P

Innovative healthcare: The Hope Street Group will host a discussion panel on the Using Open Innovation to Reinvent Primary Care project. http://bit.ly/fDo06M

Around the Web: 

Searching for influence: Five major health insurers are trying to build their own Washington-based lobby shop, according to NPR and Kaiser Health News. http://n.pr/dE3o25

Florida challenges reform: The Florida Senate revived a proposed constitutional amendment that would block a healthcare reform provision requiring individuals to buy health insurance. http://bit.ly/efSD1v

Failing grades for women's health: The United States has missed almost every goal to improve women’s health over the past decade, The New York Times reports. http://nyti.ms/eLbYOE

Younger people in nursing homes: People ages 31 to 64 account for 14 percent of the nation’s nursing home population, up from 10 percent a decade ago, NPR reports. http://n.pr/dPMIi3

Higher mortality rate at for-profit dialysis chains: Patients treated at dialysis clinics in the largest for-profit chains have a higher risk of death than those at the largest nonprofit chains, ProPublica reports. http://bit.ly/fvIja0

Defending healthcare reform: The New York Times profiles the Justice Department lawyer responsible for defending healthcare reform. http://nyti.ms/e4suDQ

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A vote to quash the filibuster failed by a vote of 57 to 42, dampening chances for this year.

Senate Majority Leader Harry Reid (D-Nev.) said he will try to end debate Monday on a bill providing healthcare benefits and compensation to sick Ground Zero workers.

Reid said he will file cloture on the motion to proceed with the James Zadroga 9/11 Health and Compensation Act, which will provide $7.4 billion over the next 10 years to first responders to the site of the Sept. 11 terrorist attacks in New York City.

The Senate would need just one Republican to vote for cloture to bring the bill to a final vote.

The three co-authors of a compensation bill for victims of 9/11 want federal regulators to develop autopsy guidelines for people who were exposed to toxins after the terrorist attack in New York City.

The National Institute for Occupational Safety and Health began working on such guidelines several years ago, but they were never completed. In a letter this week to NIOSH Director John Howard, Democratic Reps. Carolyn Maloney and Jerrold Nadler and Republican Rep. Peter King urge the agency to "develop autopsy guidelines that would help to better understand the causes of the illnesses being experienced by World Trade Center responders and survivors."

"Setting guidelines for autopsies for those who were exposed to toxins at Ground Zero," they write, "could help to better understand the effects of 9/11 exposures both for that individual and for the larger affected group."

The three New York lawmakers are co-sponsors of the James Zadroga 9/11 Health and Compensation Act, which guarantees healthcare for first responders to the site of the Sept. 11, 2001, attacks in New York City. It cleared the House 268 to 160 in September but has yet to come before the Senate.