Schedule Note: There will be no digest next Monday, August 22^nd. The digest will return on Monday August 29^th.

WHITE HOUSE:

With Congress wrapping up the legislative session (more below), the White House focused on the President signing several pieces of legislation (such as the CHIPS Act), announcing more investment in high-speed internet, this time for tribal communities, and the announcement of 166 federal grants, totaling nearly $2.2 billion dollars, for road infrastructure projects (you can find the full list of projects here (PDF), if you’re interested). One item of note:

• The President signed the PACT Act, a bill that significantly expands healthcare coverage, including nursing home care, for veterans impacted by toxic exposure. As nearly 80% of veterans with a toxic exposure claim had been denied VA benefits, the bill will likely help more veterans receive the coverage they deserve. The bill had significant bipartisan support, although it got caught in some political intrigue before passing. You can access a copy of the bill here (PDF). For those of you who work with veterans, the VA has created a central resource page to help navigate the new benefits. They also have a one-page factsheet (PDF) with an overview of the program.

CONGRESS:

We mentioned last week that the Senate was in the final stage of approval for the “The Inflation Reduction Act of 2022”, the party-line bill passed using Reconciliation, which they ended up passing on Monday. As expected, the House passed the bill Friday, sending it to the President’s desk where he is expected to sign it in short order. While we covered the major points last week, three useful

explainers:

• Kuno Bell posted a guide to several of the major tax components of the Inflation Reduction Act right here at the z-INTEL Community.

• The Hill has a comprehensive overview of the entire bill, broken down by sector (I.e., healthcare, environment, etc.).

• The Kaiser Family Foundation created a slideshow that provides an overview of the Medicare Part D drug provisions in the bill. You can download the full presentation here (PowerPoint).

In terms of schedule, Congress is now out of town until after Labor Day.

With the Congressional session now in the rear-view mirror, and on the heels of the Democrats most successful legislative two-week span since the 2020 election, a few items of note on the elections front:

• 538’s election forecast tool has moved significantly in favor the Democrats holding on to the Senate, although the House remains likely to flip to the GOP. As the tool is based on recent polling data, it remains to be seen what the impact will be as we get closer to November.

• In Wisconsin, Speaker Robin Vos held on to his seat in a heated Republican primary against an opponent who received an endorsement from Former President Trump.

• It would appear that the conventional wisdom that we’d have fewer competitive races this cycle as a result of gerrymandering and redistricting is wrong.

The Congressional Research Service, a non-partisan policy institute that is part of the Library of Congress, provided two interesting, and potentially valuable, reports this week.

• A comprehensive guide (PDF) for all the different tools available to track the spending on Covid-19 by the federal government over the last two years.

• A comprehensive guide (PDF) to the new ARPA-H agency, including several of their policy goals. Back in March, at the behest of the President, Congress created a new federal agency within HHS called ARPA-H. The goal is to build an agency dedicated to funding “risky” and innovative healthcare research, similar to the highly successful DARPA (military research) and ARPA-E (energy research) federal research programs. For those of our readers involved with cutting edge biomedical projects, it’s worthwhile to monitor ARPA-H as there may be funding and grants available.

AGENCIES:

HHS announced the release of nearly $60 million in funding to strengthen the healthcare workforce, specifically in rural areas, through a variety of federal programs. The full list, broken down by state, is available here.

As CMS continues to work on their approach to the minimum staffing study, they announced that they would be conducting around 65 site visits to facilities around the country to gather data.

LEGAL:

Two notes on the legal front – please share with your legal advisors for specific impact:

• A federal appeals court ruled (registration required) that the PREP Act doesn’t provide immunity to a nursing home as a defense against a Covid-19 lawsuit. You can access the full decision here (PDF).

• NY consolidated all pending Covid lawsuits under one roof to determine the extent of protection that the state’s liability shield provides to facilities.

OTHER:

• If you missed the Zimmetwood conference this past week, Skilled Nursing News has a summary of z-INTEL Cofounder Marc Zimmet’s keynote address. The key takeaway: We need to develop a more consistent approach to SNF funding that recognizes the inherent differences that exist from location to location and reduces the fractured and inconsistent regulatory requirements.

• One suggestion to deal with the staffing crisis is to allow the federal Public Service Loan Forgiveness program to include frontline healthcare workers. On Friday, Health Affairs (a widely read blog on healthcare policy), advocated for Congress to support the effort.

• An important op-ed from the Baltimore Sun calling for a return to normalcy and loosening of the ongoing covid restrictions governing nursing homes. Especially with the CDC relaxing guidelines in non-healthcare settings, and recognizing that Covid is here to stay, this is an important public policy argument to make.

• Politico pointed out that since government rate setters use lagging data to set medical prices, healthcare providers, like SNF’s, are often forced to bear the burden of inflation and other market forces.

• Politico also took a long look at homes for the developmentally disabled and the impact the staffing shortage is having there.

• The Economist had an interesting look (registration required) at the senior care systems in other countries, including Denmark, which is seen as a bellwether for how to take care of the elderly and the staffing challenges that they are facing.

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