Billions of federal dollars to bolster public health services nationwide may not have a lasting impact when the cash pool dwindles, officials worry.
President Joe Biden has outlined a plan to create thousands of new public health jobs, a vision Democrats sought to realize as part of the US bailout (Public Law 117-2) signed into law last year . The administration last May pledged to spend $7.4 billion of the law to hire new public health workers. Most of the money, $4.4 billion, was intended to expand state and local health services.
But health services must compete with hospitals and other private companies for high-demand workers like nurses and epidemiologists. And they often offer less money for tougher jobs — and those that may disappear in a year or two, according to public health officials. This raises fears that many of these departments will end up where they were before 2020: understaffed and unprepared for a pandemic.
“The problem we face is not so much the number of dollars we see today as sustainability,” said Umair Shah, Washington state health secretary. What the public health sphere needs is a long-term vow from Congress to expand its workforce, officials say.
Public health services were already shrinking as the Covid-19 pandemic approached: There were 91,540 full-time positions in state health agencies in 2019, down from 101,619 in 2012, a drop of nearly 10%, according to data from the Association of State and Territorial Health Officials. Since then, health services have been strained to track the spread of Covid-19 and distribute vaccines to protect people against the virus. This shortage has made it difficult for health agencies to properly assess the number of people with the virus and has complicated response times.
An analysis by the de Beaumont Foundation, which advocates for a broader public health system, recommended the federal government fund 80,000 new public health jobs to prepare for the next pandemic. Alex Ruoff has more.
It’s happening on the Hill
Biogen Battle plans changes for fast FDA approvals: Lawmakers could revamp the FDA’s fast-track process used to approve Biogen’s drug to treat Alzheimer’s disease under unavoidable legislation to reauthorize agency user fees. The House is considering a proposed renewal of the Prescription Drug User Fees Act, which allows the Food and Drug Administration to collect fees from brand name drug companies to help fund the agency’s operations. Lawmakers spent much of the first hearing on the issue focusing on Aduhelm’s endorsement that prompted extensive scrutiny of the fast-track program.
At the heart of the Aduhelm controversy was the FDA’s decision to bring the drug to market based on questionable evidence and against the recommendation of its scientific advisory board. The expedited approval mechanism is not directly tied to tariffs that the FDA negotiates with industry, but the PDUFA often includes policy endorsements that go beyond user fees. Possible changes may include improving the clinical trial endpoints used under expedited approval.
The House Energy and Commerce Committee is planning additional hearings on PDUFA next month, ahead of the Sept. 30 reauthorization deadline. Céline Castronuovo and Jeannie Baumann have more.
Republicans call on Biden to end the emergency: Top House Energy and Commerce Committee Republican Cathy McMorrisRodgers (R-Wash.) And more than 70 House Republicans have urged Biden and the Department of Health and Human Services “to accept that COVID-19 has become endemic, to recognize that the current brutal government interventions are doing more harm than good and immediately begin the process of resolving the public health emergency. This may have significant ramifications, such as loosening federal authority over vaccination mandates. Read their letter here.
- At the same time, the Federation of American Hospitals called for an extension of the public health emergency after its current expiry date in April. The FAH has also called for a minimum of 60 days notice before the Biden administration ends the PHE designation. In a letter to HHS Secretary Xavier Becerra, the FAH cited the “lasting damage, unpredictable nature, and threat of new variants that may rapidly emerge” of Covid-19 in its extension request. Read the letter here.
Biden and Becerra will speak to community health centers: Biden and Becerra will deliver virtual remarks today to leaders of community health centers across the country during the National Association of Community Health Centers’ 2022 Virtual Policy and Issues (P&I) Forum. Thousands of professionals from community health centers, which help provide primary care to nearly 29 million patients a year, are expected to join, according to a statement.
Also from NACHC ahead of a Senate hearing on labor shortages in the health care industry, the group unveiled a report calling for federal investments and policy changes. Read it here.
Senate floor: Senate Majority Leader chuck schumer (DN.Y.) has called for closure of Robert McKinnon Califf’s nomination for Food and Drug Administration commissioner at the Department of Health and Human Services and votes on the nominee are expected to take place as early as tomorrow.
White House switches to deficit reduction to get Manchin’s vote: The White House plans to rework Biden’s economic and social spending plan to emphasize deficit reduction in a bid to win the senator’s support. Joe Manchin (DW.Va.) said a person familiar with the administration’s discussions. Leading congressional Democrats have also been discussing adding deficit-cutting measures in recent days. While the Biden administration insisted the president’s agenda would be fully paid for, Manchin blocked the $2 trillion package of climate, fiscal and social spending initiatives, citing concern over the effect on the federal debt as well as on inflation. Learn more about Jennifer Epstein, Erik Wasson and Laura Davison.
The coronavirus pandemic
FDA delays meeting on Pfizer Shot for Young Children: Federal health officials have postponed a key meeting on Pfizer’s Covid-19 vaccine for children under 5, after the drugmaker said it had new data to add to its vaccine request . The FDA Vaccine Advisory Committee had planned to consider a two-dose schedule of the vaccine. The delay is to allow the company and its partner BioNTech to gather and evaluate more information about the impacts of a third dose, FDA officials said in a statement, another roller coaster diversion. for parents wishing to have their children vaccinated in the middle of the tip of the omicron. John Lauerman has more.
Sotomayor dismisses New York school workers over vaccine rule: U.S. Supreme Court Justice Sonia Sotomayor declined to intervene on behalf of 15 people who said they were about to be fired from their jobs as employees of a New York school. York because they refused to be vaccinated against Covid-19. Sotomayor, who handles emergency affairs from New York, rejected the group’s demands to stop the city from firing people who claim a religious objection to being shot. She made no further comment and opted not to refer the case to the full court, suggesting she did not view the case as a close call. Read more from Greg Stohr.
Biden vaccine mandate for stranded entrepreneurs in Arizona: An Arizona judge has issued final judgment in a challenge to Biden’s executive order requiring vaccinations on federal contractors, shielding state employees and companies doing business with the government from the rule. Judge Michael Liburdi of the U.S. District Court for the District of Arizona in Phoenix last week granted a permanent injunction against the executive order, after a previous January order that temporarily blocked its application and did not define its full scope. Erin Mulvaney has more.
What else to know today
J&J launches lawsuit over bankruptcy strategy: Johnson & Johnson’s controversial bankruptcy strategy, which has come under intense scrutiny by Congress, faces a new trial today, with the consumer products giant set to argue that settling billions of dollars in talc-related liabilities in a single case is better for cancer victims than fighting thousands of individual claims. A week-long hearing begins today to decide whether J&J wrongfully manipulated the bankruptcy system by placing a unit in Chapter 11 only to force a negotiated end to more than 38,000 lawsuits. Read more from Steven Church.
Fentanyl teen deaths soar: Overdose deaths linked to synthetic opioids like fentanyl have tripled among teens and quintupled among black teens in the past two years, according to interim data from the Centers for Disease Control and Prevention. The nonprofit group Families Against Fentanyl compiled the data from the CDC, which said the 2021 numbers are incomplete because overdose deaths have a six-month lag in reporting time. Margaret Warner of the CDC’s National Center for Health Statistics said that given the spike in drug use during the pandemic, it’s likely that the number of deaths in 2021 will only increase.
It’s on Congress’s radar, too: During a Senate Finance Committee hearing last week on youth mental health during the pandemic, the senator. Mike Crapo (R-Idaho) cited a “skyrocketing increase” in teen overdose deaths. Learn more about Madison Muller and Ella Ceron.
To contact the reporter on this story: Brandon Lee in washington at [email protected]