NAEMSP Advocacy

Advocates for Emergency Medical Services (AEMS) began as a coalition of major EMS organizations that was founded October 22, 2002, dedicated to promoting, educating and increasing awareness among decision-makers in Washington on issues affecting EMS providers. AEMS supported all providers of EMS, whether they were fire, hospital, volunteer, third service, or nongovernmental based, by monitoring and influencing legislation and regulatory activity involving EMS and raising awareness among lawmakers on issues of importance to EMS. Beginning in 2015, Advocates for EMS became part of NAEMSP and is no longer working as a coalition. Please contact the NAEMSP Advocacy Committee if you have questions.
 


On Thursday, January 21, 2021, President Biden unveiled his National Strategy for the COVID-19 Response and Pandemic Preparedness and took executive actions (EOs) to implement the effort. The EOs were aimed at: 

  1. Ramping up COVID-19 testing and vaccines and establish a COVID-19 Pandemic Testing Board;
  2. Directing  agencies to use the Defense Production Act to compel companies to make supplies needed to combat the pandemic;
  3. Expanding public health workforce and clinical care capacity;
  4. Improving access to affordable care and ensuring COVID-19 testing is free, including for uninsured individuals;
  5. Protecting workers through revised employer guidance and increased enforcement efforts;
  6. Fully reimbursing states for National Guard personnel and emergency supplies (through September 30, 2021); and
  7. Addressing inequities, including across racial, ethnic, and rural/urban lines. 
The text of the EOs can be found here.
 
The strategy highlights President Biden’s EOs creating a COVID-19 Response Office responsible for coordinating the pandemic response across all federal departments and agencies, filling supply shortfalls by invoking the Defense Production Act, increasing emergency funding to states, and bolstering the Federal Emergency Management Agency (FEMA) response. Additionally, the strategy seeks to address COVID-19 disparities by creating a COVID-19 Health Equity Task Force. The strategy outlines the membership, including a chair (Dr. Marcella Nunez-Smith) and up to 20 members appointed by the President from sectors outside the federal government. The Task Force will provide recommendations to the President to mitigate the health inequities caused or exacerbated by the COVID-19 pandemic and prevent such inequities in the future. This includes recommendations for how COVID-19 resources should be allocated in light of disparities, recommendations for COVID-19 relief funding distribution in a manner that advances equity, and recommendations regarding effective, culturally aligned communication, messaging, and outreach to communities of color and other underserved populations. The Task Force will also outline data collection requirements to address data shortfalls related to adequately tracking inequities.
 
The plan also directs the Department of Health and Human Services (HHS) to conduct a national vaccination campaign to promote vaccine trust among communities of color and other underserved populations and engage with leaders in those communities. Further, the plan directs the White House Office of Science and Technology Policy (OSTP) to develop a plan for advancing innovation in public health data and analytics in the U.S.
 
To execute the National Strategy, President Biden established the Coordinator of the COVID-19 Response and Counselor to the President position (Jeff Zients). The President has said he plans to issue new EOs every weekday in January, focusing each day on different policy areas with healthcare as the focus on January 28, as noted in the e-mail below.  We also anticipate a “Buy American” EO  to be released on January 25.
 
The White House also issued a regulatory freeze memo that directs the withdrawal of certain Trump Administration regulations that were not yet published.  Specifically, the memo asks the executive agencies to immediately: 
  1. Propose or issue no rule in any manner until a department or agency head appointed or designated by President Biden reviews and approves the rule;
  2. Withdraw any rules that have already been sent to the Office of the Federal Register (OFR) for publication but which have not yet been published;
  3. Consider postponing by 60 days the effective date of any such rules already sent to OFR for publication (or otherwise issued) but which have not yet taken effect, “for the purpose of reviewing any questions of fact, law, and policy the rules may raise;” and
  4. Following the 60-day freeze, for those rules that raise substantial questions of fact, law, or policy, consult with the director of the Office of Management and Budget (OMB) and take further appropriate action in consultation with the OMB Director. 
The memo also suggests that during the 60-day date delay, agencies should consider opening a 30-day comment period to let interested parties provide input on “issues of fact, law, and policy raised by those rules.” Agencies also should consider any pending petitions that ask for those rules to be reconsidered.  The Administration already paused a final rule that would require health centers funded under section 330(e) of the Public Health Service Act to provide access to insulin and injectable epinephrine. We expect to see more of these announcements in the coming weeks.
 
Notably, Biden’s first- and second-day actions are on top of the plans his team released last week, including a $415 billion COVID-19 plan that will require Congress’s approval.
 
Regarding health appointments,  Biden has tapped Norris Cochran to serve as acting HHS secretary until the permanent secretary is confirmed and Liz Richter to serve as acting CMS Administrator until a permanent administrator is confirmed.  Additionally, the following will serve in temporary roles at HHS - 
  1. Dan Barry to serve as acting HHS general counsel;
  2. Nikki Bratcher-Bowman to serve as HHS' acting assistant secretary;
  3. Felicia Collins to serve as HHS' acting assistant secretary for health;
  4. Robinsue Frohboese to serve as acting director of HHS' Office for Civil Rights; and
  5. Christi Grimm to temporarily serve as acting HHS inspector general. 

In addition, Biden has appointed Sean McCluskie to serve as HHS' permanent chief of staff. McCluskie has long served as an aide to Becerra. Biden also appointed Micky Tripathi as HHS' national Coordinator for health IT, which does not require the Senate's confirmation.  See more information here on acting leadership and HHS appointments.
 
Finally, of note, Representative Brett Guthrie (R-KY) will replace Representative Michael Burgess (R-TX) as Ranking Member of the House Energy and Commerce Health Subcommittee.   Regarding Senate leadership positions, the Senate is operating on the organizing resolution from the last Congress, when the GOP was in the majority. Until a power-sharing agreement is reached, Republicans will continue to chair committees, and new members cannot be added.

- update provided by Holland & Knight
 


 

DEA Ruling - Protecting Access to Emergency Medications Act of 2017


NAEMSP won a hard fought victory for our membership in 2016 (2017), by lobbying for and achieving passage of the "Protecting Access to Emergency Medications Act of 2017", a bill that addressed significant hazards for EMS practice and controlled substances. The much-anticipated DEA rules package for the application of the Bill have finally been published in the federal register for public comment that ends on 12/4/20.  We encourage our members and their respective agency leadership to visit the document and submit concerns prior to Dec. 4, 2020.

Summary:
The "Protecting Patient Access to Emergency Medications Act of 2017," (hereafter the "Act") which became law on November 17, 2017, amended the Controlled Substances Act to allow for a new registration category for emergency medical services agencies that handle controlled substances. It also established standards for registering emergency medical services agencies, and set forth new requirements for delivery, storage, and recordkeeping related to their handling of controlled substances. In addition, the Act allows emergency medical services professionals to administer controlled substances outside the physical presence of a medical director or authorizing medical professional pursuant to a valid standing or verbal order. The Drug Enforcement Administration proposes to amend its regulations to make them consistent with the Act and to otherwise implement its requirements.

Comments:
Electronic comments must be submitted, and written comments must be postmarked, on or before Dec. 4, 2020. Commenters should be aware that the electronic Federal Docket Management System will not accept comments after 11:59 p.m. Eastern Time on the last day of the comment period.
All comments concerning collections of information under the Paperwork Reduction Act must be submitted to the Office of Management and Budget (OMB) on or before Dec. 4, 2020.

Read the full information here:
https://beta.regulations.gov/document/DEA-2020-0029-0001

COVID-19


Lawmakers can only make educated decisions when those in the field inform them of what is going on.

Click here for a message from our partners at Holland & Knight, released Thursday, March 19.

Click here for NAEMSP's COVID-19 Resources.
Click here for CMS's latest guidance on EMTALA.
 

2020 Government Relations Academy (GRA)


Unfortunately, due to COVID-19, the 2020 Government Relations Academy has been canceled.


 

Current Issues


NAEMSP ADDRESSES DRUG SHORTAGE ISSUES AMIDST LEGISLATIVE ACTION AROUND THE OPIOID EPIDEMIC

July 9, 2018
Following meetings with Holland & Knight staff on behalf of NAEMSP, as well as other public health groups engaged on drug shortage issues, the sponsors of the Opioid Quota Reform Act (S. 2535) inserted important language into the bill that would give the Attorney General the authority to specifically consider drug shortages when modifying production quotas so as not to adversely affect providers’ access to these important drugs.

Click here for more information

NAEMSP introduces NAEMSP PAC

Click here to donate to the NAEMSP PAC or download the PAC Donation Form.


EMS Physicians gather on Capitol Hill to Address

Critical Drug Shortages Affecting Patient Care

WASHINGTON, DC (April 16, 2018) – Members of the National Association of EMS Physicians (NAEMSP) gathered in Washington, D.C. last week to advocate for issues affecting quality out-of-hospital emergency medical care, including ongoing drug shortages affecting EMS providers.

Click here for more information.


BIPARTISAN BILL PREVENTING DELAYED EMERGENCY MEDICAL CARE SIGNED INTO LAW

EMS Physicians Applaud the Signing of the Protecting Patient Access to Emergency Medications Act WASHINGTON, DC (November 20, 2017) – The National Association of EMS Physicians (NAEMSP) applauds the signing into law of the Protecting Patient Access to Emergency Medications Act (H.R. 304), which unanimously passed the House of Representatives in January and the Senate in October. The bill reestablishes the ability of emergency medical care providers, such as paramedics, to administer certain life-saving medications to critical patients without unnecessary delay, which was put in question by recent U.S. Drug Enforcement Agency (DEA) regulatory deliberations. It also strengthens DEA oversight of emergency medical services (EMS).

Click here for more information.


EMS PHYSICIANS FLY-IN TO TALK MEDICAL CARE ACCESS & QUALITY

NAEMSP Members Discuss Senate Bill Reintroduction, Bestow EMS Award to Congressman

WASHINGTON, DC (April 25, 2017) – Members of the National Association of EMS Physicians (NAEMSP) gather in Washington, D.C. this week to advocate for the Protecting Patient Access to Emergency Medications Act (H.R. 304), and other issues affecting access to and quality of out-of-hospital emergency medical care, such as EMS payment reform.

Click here for the full press release.


CBO RELEASES SCORE OF ACA REPEAL AND REPLACE LEGISLATION

The Congressional Budget Office (CBO) has just released its score of the ACA repeal and replace legislation, the American Health Care Act, currently moving through the House of Representatives and scheduled to be marked up by the House Budget Committee on Wednesday. The score estimates that if the legislation is enacted there would be 14 million more people uninsured in 2018 as compared to current law, increasing to 24 million in 2026.

House Ways and Means and Energy and Commerce Committees Unveil ACA Repeal/Replace Bill

AHA Timeline


The "Protecting Patient Access to Emergency Medications Act of 2016" (H.R. 304) Grassroots Advocacy (formerly H.R. 4365)

HR 304 passed the House on 1/9/2017! Next stop - the Senate!

Click here for a summary (posted 6/1/2016)

Click here for section by section (posted 6/1/2016)


NAEMSP Members Descend Upon Capitol Hill

(April 20, 2016) NAEMSP members participated in EMS On The Hill Day to advocate for several legislative initiatives including support for H.R. 4365, Protecting Patient Access to Emergency Medicine Act of 2016. H.R. 4365 will clarify that the current practice of physician Medical Directors overseeing care provided by paramedics and other emergency practitioners via "standing orders" is statutorily allowed and protected.

In preparation for the Hill Day, NAEMSP members participated in Holland & Knight's Government Relations Academy, which gave them the tools to successfully advocate for this vital legislation. NAEMSP members sharpened and refined their advocacy skills, and gained new ideas and knowledge from the Academy speakers. Attendees heard from Preston Bell who serves as a top aide to the bill's chief sponsor, Representative Richard Hudson (R-NC-6), and they had a dialogue with former Congressman Jim Davis and former Chief Counsel for the House Judiciary Committee (Subcommittee on Constitution) Kathryn Lehman. They also had the opportunity to learn about the reimbursement landscape from Brett Baker from the Senate Finance Committee.

NAEMSP and our coalition partners have been working with Representative Hudson's office to craft this legislation and gain support from additional Members of Congress. H.R. 4365 had six original sponsors when it was introduced in January 2016. Today, as a result of NAEMSP advocacy efforts – including the recent Hill Day – the bill has 67 cosponsors, which consist of 43 Republicans and 24 Democrats representing multiple regions of the country. Since the Hill Day, 26 Members of Congress have cosponsored H.R. 4365 and we anticipate that more Members of Congress will offer their support.

NAEMSP and our coalition partners have been working diligently to secure a hearing on the bill. Accordingly, we anticipate a hearing in mid-May. We are also solidifying Senate sponsors and anticipate introduction of companion legislation in the Senate soon.

Background: The "Protecting Patient Access to Emergency Medications Act of 2016" (H.R. 4365), sponsored by Rep. Richard Hudson (R-NC), will allow EMS agencies to continue using standing orders from their medical director to administer approved medications to their patients under the Drug Enforcement Administration (DEA). For background, a one page-summary and section-by-section are included in the toolkit.

Now that the bill has been introduced, we need all NAEMSP members to reach out to their Members of Congress in the House of Representatives and urge them to co-sponsor our bill. Note we will engage in Senate outreach once a companion bill is introduced.

When a Member of Congress cosponsors a bill, it publicly shows their support for the bill. With thousands of bills being introduced each year, bills with many cosponsors are more likely to make it to the next phase of the process.

The importance of grassroots initiatives cannot be overstated. A well-organized and informed grassroots advocacy effort can effectively convey the importance and urgency of an issue to policymakers. We need you to join us in carrying the message to your lawmakers. They need to hear from folks on the ground in their districts!

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