FEDERAL HEALTH UPDATE
July 18, 2008Produced by Kate Connelly Theroux in collaboration with the Institute of Federal Health Care (IFHC) To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. Sponsored by
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Congressional Schedule
On June 27, the nonprofit Institute of Federal Health Care convened a roundtable discussion involving representatives from federal programs, congressional staff, professional associations, and private-sector organizations. The discussion produced substantial information and numerous ideas as to how the Department of Defense and CDC can work together more effectively to address the important issue of STIs. The summary of the roundtable discussion is available and it can also be viewed at the Institute of Federal Health Care Web site.
Officials from DoD, VA, federal and local government joined in a ceremonial ribbon-cutting and groundbreaking to complete a $16-million parking and infrastructure project and to mark the beginning of construction of a $71-million, four-story addition to the existing North Chicago VA Medical Center. Naval Health Clinic Great Lakes is gradually merging operations with the existing VA staff and facilities. This will provide a full range of modernized medical and support resources for patients while at the same time eliminating costly duplications that exist between the two nearby medical facilities. More than 400 veterans, active-duty service members, hospital staff and family members attended the ceremony. NAVFAC Midwest is in charge of constructing the facility, which will be the first to use a completely integrated VA/Navy staff to treat recruits, active-duty service members, retirees, family members and veterans. Integration will be complete in 2010, and the new care center, named in honor of Navy retiree and commander of Apollo 13 Capt. James A. Lovell, is expected to save approximately $160 million over the projected 40-year life span of the facility. www.navy.mil/local/navfachq
Upon completion in 2011, the joint campus, led by tri-service leadership, will centralize all Army, Navy and Air Force basic and specialty enlisted medical training at Fort Sam Houston, Texas. Fort Sam Houston will gain five instructional facilities, six dormitories, an Air Force and Navy headquarters building, dining facility, gym and lighted troop walks. The six existing Army Medical Department Center and School buildings will become part of the training campus. Several units will then join the AMEDDC&S here to include the 882nd Training Group, Sheppard Air Force Base, Wichita Falls, Texas; the Naval Schools of Health Sciences in San Diego and Portsmouth, Va.; the Naval Hospital Corps School in Great Lakes, Ill.; and the enlisted medical training mission at Walter Reed Army Medical Center, Washington, D.C. METC’s average daily student load is projected to be more than 9,000 and the support staff nearly 4,000. The nearly $1 billion project, directed by Base Realignment and Closure 2005 legislation, is the largest economic development project that has occurred in San Antonio to date. http://www.health.mil/Press/Release.aspx?ID=279
A pioneer in the field of cardiac surgery, DeBakey is credited with developing mobile Army surgical hospitals during World War II, which became the foundation for bringing specialized medical care closer to troops on the battlefield and, thereby, dramatically reducing combat deaths. In the late 1940s, he was instrumental in establishing the VA facility in his hometown of Houston as one of the premier medical facilities in the country. In December 2003, President Bush signed into law a measure naming VA’s Houston medical center after DeBakey. This April, VA named a conference room in the Department’s headquarters after DeBakey and Congress awarded him the Congressional Gold Medal, one of the nation’s highest awards for civilian service.
VA already has services for women patients equal to those men receive, but Peake acknowledged that the VA needs to expand its women-centric focus to initiate new programs that meet the needs of women veterans. Peake announced formation of a work group to focus on women’s needs in prosthetics and rehabilitation; hiring women’s advocates in VA medical centers; developing quality measurements specifically for women patients; purchasing more state-of-the-art; specialized women’s health care equipment; and expanding medical education in women’s health for VA care providers. In addition, VA recently established a work group whose goal is to ensure every female veteran enrolled in VA care has a women’s health primary care provider, especially to meet gender-specific needs. The conference focused on how to ensure VA meets women-specific health needs and how to inform more women veterans of their VA benefits. It was the fourth women’s summit, which VA holds every four years. Summit co-sponsors included the American Legion Auxiliary, AMVETS, Disabled American Veterans and Veterans of Foreign Wars. Other assisting veterans groups included the Blinded Veterans Association, Military Officers Association of America, Paralyzed Veterans of America, the American Legion, Vietnam Veterans of America and TriWest. http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1525
The event is open to recently injured veterans who have spinal cord injuries, traumatic brain injuries, certain neurological conditions, amputations, other mobility impairments or post-traumatic stress disorder. For many injured veterans, this event will provide a first exposure to recreational sports and other activities after being injured. The National Veterans Summer Sports Clinic will take place Sept. 28 through Oct. 3 at several venues in the San Diego area. Events include sailing, cycling, surfing, kayaking and track and field events. Admission for the public is free. Sea World and the San Diego Marriott Hotel and Marina will be the site of the opening and closing ceremonies along with some of the week’s events. Other events will be held at the U.S. Olympic Training Center in Chula Vista, Kellogg Park in La Jolla Shores, the Embarcadero Marina Park and the Mission Bay Yacht Club. Recreational sports can be an important part of the therapy for many disabilities. VA is a recognized leader in rehabilitation, with therapeutic programs available at VA health care facilities across the nation. The event will become the fifth national rehabilitation event offered by VA to promote the healing of body, mind and spirit, joining the National Disabled Veterans Winter Sports Clinic, the National Veterans Wheelchair Games, the National Veterans Golden Age Games and the National Veterans Creative Arts Festival. The VA San Diego Healthcare System is hosting the 2008 Summer Sports Clinic. Specific event activities offered will change each year. For more information about the National Veterans Summer Sports Clinic or to volunteer during the week, visit the clinic Web site at www.summersportsclinic.va.gov. http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1528
Effective immediately, VA will now process applications received through its on-line application Web site, VONAPP, without the claimant's signature. The electronic application will be sufficient authentication of the claimant’s application for benefits. Normal development procedures and rules of evidence will still apply to all VONAPP applications. VONAPP (www.va.gov/onlineapps.htm) is a Web-based system that benefits both internal and external users. Veterans, survivors and other claimants seeking compensation, pension, education, or vocational rehabilitation benefits can apply electronically without the constraints of location, postage cost, and time delays in mail delivery. VONAPP reduces the number of incomplete applications received by VA, decreasing the need for additional development by VA claims processors. The on-line application also provides a link to apply for VA health care benefits and much more. More than 3.7 million veterans and beneficiaries receive compensation and pension benefits from VA and approximately 523,000 students receive education benefits. Approximately 90,000 disabled veterans participate in VA’s Vocational Rehabilitation and Employment program. http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1529
This coveted distinction is the result of the H&HN’s Most Wired Survey and Benchmarking Study, which promotes the effective use of information technology in achieving clinical and operational excellence. Areas surveyed included business processes, customer service, safety and quality, workforce management and public safety and quality. DCVAMC was also recognized as a finalist in the Most Wired Innovator category with a separate submission describing The Provider Hand-off Tool. The Provider Hand-off Tool serves as a vital communication tool for ensuring safety when patients are transferred — at shift changes and other times — among various providers. This graphic interface in the Medical Center’s electronic health record system (EHR) helps prevent miscommunication and medical mishaps and ultimately improves patient safety. DCVAMC’s submission was chosen by an independent panel selected by the editors of H&HN which evaluated submissions based on: universality and achievement of stated business objective; creativity and uniqueness of concept; impact on the organization; scope of the solution; and the stage of implementation. The Washington DC VA Medical Center was previously recognized as a “Most Wired” hospital in 1999, 2004 and 2006.
The first initiative is a pilot project the U.S. Food and Drug Administration (FDA) is undertaking, in collaboration with its counterparts in the European Union and Australia, to plan, allocate for and conduct inspections of drug-manufacturing facilities. The project will initially focus on makers of active pharmaceutical ingredients. If successful, this program could expand to include other types of manufacturing facilities. The novel collaboration will allow the FDA to more fully take advantage of information gathered by trusted inspection and regulatory systems in other countries. The second initiative is a third-party certification pilot program involving aqua-cultured (farm-raised) shrimp. The FDA is seeking the participation of certification bodies that currently certify foreign processors of aqua-cultured shrimp for compliance with the FDA’s seafood regulations. The project is designed to help the FDA learn how to evaluate third-party certification programs and implement them in the field —a key part of leveraging the additional resources of the private sector and other regulators. Additional information about import safety initiatives is available at www.importsafety.gov.
AHRQ and AARP also released an accompanying wall chart, the Staying Healthy at 50+ timeline, that provides information about recommended preventive services and can be posted in both clinical and community settings. These three publications Men: Stay Healthy at 50+, Checklists for Your Health; Women: Stay Healthy at 50+, Checklists for Your Health; and the Staying Healthy at 50+ timeline show at a glance the evidence-based recommendations from the U.S. Preventive Services Task Force regarding screening tests, preventive medicines and healthy lifestyle behaviors for people 50 and older. Checklists for Health, available in English and Spanish, are brochures that adults can take along to medical appointments and are designed to help patients and clinicians engage in discussions about necessary preventive screening tests. Unlike diagnostic tests, which clinicians order when they suspect someone has a disease, screening tests help check for problems before symptoms are apparent. Patients can use the checklists to record their screening test history and plan follow-up medical appointments. Both checklists also provide tips about other things to do to stay healthy, such as eating a healthy diet and exercising. The Staying Healthy at 50+ timeline displays the Task Force's recommendations for preventive care for men and women age 50 and older in a wall chart, and it is designed to be posted in places such as clinicians' offices, senior centers, fitness centers, pharmacies and other public locations. The Task Force is the leading independent panel of experts in prevention and primary care. The Task Force, which is supported by AHRQ, conducts rigorous, impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening, counseling and preventive medications. Its recommendations are considered the gold standard for clinical preventive services. http://www.ahrq.gov/news/press/pr2008/ppip50pr.htm
The report evaluates the three-year pilot program, which began in California, Florida and New York in 2005 and expanded to Arizona, Massachusetts and South Carolina in July 2007. The funds returned to the Medicare Trust Funds occurred after taking into account the dollars repaid to health care providers, the money overturned on appeal and the costs of operating the RAC demonstration program. Of the overpayments, 85 percent were collected from inpatient hospital providers, and the other principal collections were 6 percent from inpatient rehabilitation facilities and 4 percent from outpatient hospital providers. CMS has begun the expansion process by initiating a competition for four permanent RACs after the pilot program ended in March 2008. The RAC program was created by the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) to find and correct improper Medicare payments paid to health care providers participating in fee-for-service Medicare. Medicare processes more than 1.2 billion Medicare claims annually, submitted by more than one million health care providers, including hospitals, skilled nursing facilities, physicians and medical equipment suppliers. Errors in claims submitted by these health care providers for services provided to Medicare beneficiaries can account for billions of dollars in improper payments each year. The permanent RAC demonstration is a key tool that CMS will use to ensure that payments to health care providers are accurate and proper and that the number of errors in Medicare claims continues to decline. The RAC demonstration, authorized in the MMA, was required by Congress to be a permanent part of Medicare in the Tax Relief and Healthcare Act of 2006. The law states the national program must be implemented by Jan. 1, 2010. CMS NR 07-11-2008
Over the past two years, genome-wide association studies (GWAS) have allowed researchers to uncover more than 300 novel genetic variants associated with common diseases. However, the discovery of genetic variants through GWAS research represents just the first step in the challenging process of piecing together the complex biological picture of common diseases. To help speed the process, NHGRI is supporting new research in existing large epidemiology studies, all with a rich range of measures of health and potential disease, and many with long-term follow-up. The focus of the new research is on how genetic variants initially identified through GWAS research are related to a person's biological and physical characteristics, such as weight, cholesterol levels, blood sugar levels or bone density. Scientists will also examine how non-genetic factors, such as diet, medications and smoking, may interact with genetic factors or each other to influence health outcomes. The information generated by this program will help guide other genomic and epidemiologic studies by defining the potentially wide-ranging effects of genetic differences among people. Additionally, it will lay the groundwork for laboratory experiments in cultured cells and other model systems to identify the precise biological mechanism affected by each genetic variant and how it interacts with other biological and environmental factors. Such information is vital to developing more individualized ways of preventing, diagnosing and treating common diseases. A coordinating center will also be established to facilitate data access and analysis tools for the research community. The principal investigator of the coordinating center is Tara Matise, Ph.D., University of Rutgers Busch campus, Piscataway, N.J. The center will receive approximately $3.1 million over four years. The coordinating center is being co-funded by the National Institute of Mental Health, which will contribute approximately $1.2 million over four years. To view the list of the NHGRI grantees, along with their estimated funding levels over four years, and the cohorts involved, please visit http://www.genome.gov/27527085
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If you need further information on any of the items in the Federal Health Update, please contact Kate Connelly Theroux at (703) 447-3257 or by e-mail at katetheroux@fedhealthinst.org. To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. To unsubscribe, please send an email to newsletter@fedhealthinst.org with UNSUBSCRIBE as the subject. Back issues availiable at Federal Health Update Archives. |
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