Seeking to Grow Market Share?

Get a FREE assessment of your CDH products —
a $3,000 value.
LEARN HOW >

HHS partners to develop first intranasal treatment for cyanide poisoning

HHS Gov News - September 18, 2017

The first intranasal (nose spray) treatment for the life-threatening effects of cyanide poisoning will be developed under an agreement between the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR) and Emergent BioSolutions of Gaithersburg, Maryland. Cyanide could be used as a chemical weapon against the United States.

“Cyanide is easily obtained, and exposure to high levels of the chemical can cause death within minutes,” explained Rick Bright, Ph.D., director of the Biomedical Advanced Research and Development Authority (BARDA), a component of ASPR. “All currently approved cyanide antidotes are administered intravenously, which takes time, training, and medical resources. To save lives, first responders need a treatment they can administer easily within seconds in the field.”

Under the 17-month, $12.7 million agreement announced today, Emergent will develop an intranasal, stabilized form of Isoamyl Nitrite. Amyl Nitrite traditionally has been used to treat angina pectoris, severe chest pain caused by an inadequate supply of oxygen-rich blood to the heart.

Studies have shown Amyl Nitrite to be an effective treatment for cyanide poisoning, although the drug is not approved by the U.S. Food and Drug Administration specifically for this use. The company will develop a reformulated active ingredient, isoamyl nitrite, along with an intranasal delivery device, with the goal of gaining FDA approval. The contract can be extended up to a total of approximately $63 million over 5 years.

As a BARDA partner, Emergent will conduct nonclinical and clinical safety and efficacy studies; manufacturing activities; all associated regulatory, quality assurance, management work, and administrative activities necessary prior to the initiation of a Phase 3 (large) clinical study.

Development of this new drug is part of BARDA’s efforts to develop medical products and procedures to protect health and save lives in terrorist attacks, including those using chemical warfare agents like cyanide. Cyanide was used in World War I as a chemical weapon, in World War II concentration camps, and most recently this past spring in the Syrian Civil War.

These treatments are among the post-exposure treatments and non-pharmaceutical interventions BARDA and its private partners are developing to counter the health effects of chemical exposure. Products include novel and repurposed therapeutics, and decontamination for treatment of exposure to any of four classes of chemical agents.

BARDA continues to seek proposals for the development of effective products to treat injuries caused by chemical agents, including new products and new indications for products already in clinical use. The products must be easy to use in a mass casualty situation and safe and effective for all segments of the population. Proposals are accepted through the Broad Agency Announcement BARDA-CBRN-BAA-16-100-SOL-00001 at the Federal Business Opportunities website, www.fbo.gov.

The project announced today is part of BARDA’s integrated portfolio for the advanced research and development, innovation, acquisition, and manufacturing of medical countermeasures – vaccines, drugs, therapeutics, diagnostic tools, and non-pharmaceutical products for public health emergency threats. These threats include chemical, biological, radiological, and nuclear agents, pandemic influenza, and emerging infectious diseases.

ASPR leads HHS in preparing the nation to respond to and recover from adverse health effects of emergencies, supporting communities’ ability to withstand adversity, strengthening health and response systems, and enhancing national health security. HHS is the principal federal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.

To learn more about preparedness, response and recovery from the health impacts of disasters, visit the HHS public health and medical emergency website, www.phe.gov. For more information about advanced research and development of medical countermeasures, visit www.medicalcountermeasures.gov.

El ultimátum de Trump a los “soñadores” impacta en la industria de la salud

Kaiser Health News:Marketplace - September 18, 2017

Yuriana Aguilar estuvo en los titulares el año pasado cuando se convirtió en la primera estudiante inmigrante indocumentada en obtener un doctorado de la Universidad de California-Merced.

Ahora está en medio de su beca postdoctoral en la Universidad Rush en Chicago, investigando formas de ayudar a prevenir el paro cardíaco súbito, una de las principales causas de muerte en los Estados Unidos.

La joven fue capaz de obtener esta beca sólo por su participación en el programa federal de Acción Diferida para los Llegados en la Infancia (DACA), que permite a los jóvenes que fueron traídos de niños los Estados Unidos sin la documentación apropiada, quedarse y trabajar aquí.

Aguilar, de 27 años, nació en México y llegó con su familia a Fresno, California, a los 5 años.

Pero su investigación podría detenerse si la administración del presidente Donald Trump mantiene su promesa de poner fin al programa DACA.

Use Nuestro ContenidoEste contenido puede usarse de manera gratuita (detalles).

Es irónico “que mi investigación podría eventualmente ayudar a salvar las vidas de las personas que están alterando mi vida”, dijo, refiriéndose a los miembros del Congreso, muchos de los cuales están en una edad en que la que el riesgo de enfermedad cardíaca es mayor.

“Pediría al Congreso que mirara… cuánto hemos logrado en estos últimos cinco años”, dijo Aguilar. “No estamos tomando el trabajo de nadie, simplemente estamos llenando las lagunas”.

Aguilar es una de los 220.000 beneficiarios de DACA en California, el grupo más grande del país. A nivel nacional, hay cerca de 800.000 niños y adultos jóvenes con DACA, un estatus que les ofrece protección temporal contra la deportación y la posibilidad de recibir permisos de trabajo. El ex presidente Barack Obama estableció el programa en 2012 a través de una orden ejecutiva.

No hay estadísticas firmes que demuestren cuántos de estos inmigrantes, conocidos como “soñadores”, trabajan en el sector de la salud, pero los líderes de la industria han sugerido que la terminación de DACA podría tener un impacto significativo, especialmente entre los estudiantes de medicina y asistentes de salud en el hogar.

“Las implicaciones de esta acción para los estudiantes de medicina, los médicos residentes y los investigadores con el estatus de DACA son graves, e interferirán con su capacidad para completar su formación y contribuir de manera significativa a la salud de la nación”, declaró la Asociación de Colegios Médicos Americanos (AAMC) a través de un comunicado.

Robert Espinoza, vicepresidente de políticas de PHI, un grupo de defensa de la atención médica a largo plazo, dijo que la terminación del programa podría tener consecuencias importantes para la fuerza laboral en salud. “Cuanto más amenace la administración a los inmigrantes y a sus familias y comunidades, más se está amenazando al suministro de mano de obra”, agregó.

El 5 de septiembre, el fiscal general Jeff Sessions anunció que el presidente Trump cancelaría la orden ejecutiva que creó DACA. La administración dijo que no cree que Obama tuviera la autoridad para establecer el programa, y que anticipa demandas de los estados.

La administración está brindando un período de gracia de seis meses antes de que estas protecciones terminen, dándole tiempo al Congreso para aprobar una legislación para tratar el estatus legal de los soñadores. Trump y legisladores demócratas han acordado trabajar en un plan para ampliar el programa DACA, pero hay pocos detalles, y los conservadores ya han planteado preocupaciones.

El lunes 18 de septiembre, varios beneficiarios de DACA demandaron a Trump por su decisión de poner fin al programa, con el respaldo de eminencias legales, entre ellos el profesor de derecho de Harvard, Laurence Tribe, y el decano de la facultad de derecho de la Universidad de California-Berkeley, Erwin Chemerinsky.

Uno de los demandantes, un inmigrante que llegó de niño desde Tailandia, ahora es un estudiante de cuarto año de medicina en la Universidad de California-San Francisco quien teme que poner fin a DACA también podría poner fin a su “sueño de convertirse en médico y proporcionar atención a las comunidades marginadas y desamparadas”, según indica el texto de la demanda.

Cerca de 20 estados y el sistema de la Universidad de California ya han presentado desafíos legales.

Los graduados de medicina nacidos en el extranjero tienden a trabajar en áreas desatendidas, dijo Matthew Shick, director de relaciones gubernamentales y asuntos regulatorios de la AAMC. La eliminación de DACA podría romper una conexión vital entre médicos y poblaciones que necesitan desesperadamente atención médica, apuntó.

Karla Ornelas es una estudiante de tercer año de medicina en la Universidad de California-Davis, y beneficiaria de DACA. Su meta es convertirse en médica de familia y volver al Valle Central. (Cortesía de Karla Ornelas)

Karla Ornelas planea convertirse en médica de medicina familiar y trabajar en el Valle Central de California, donde hay una gran necesidad de médicos, especialmente bilingües.

Ornelas, de 20 años, es licenciada en psicología y biología en la Universidad de California-Davis. Nació en México y llegó a los Estados Unidos a los 9 años.

La joven recientemente acompañó a su madre a una cita médica, como siempre lo hace, para traducir. Su madre tenía preguntas sobre los resultados de laboratorio, y como las decía en español y Ornelas las traducía al inglés, el médico se impacientó, les dijo que dejaran de hacer preguntas y que salieran del consultorio, contó Ornelas.

“Mi mamá quería llorar, y yo estaba sorprendida”, dijo Ornelas, quien creció en Turlock, California. “Fue entonces cuando me di cuenta de que no era sólo mi mamá, era toda una comunidad que confiaba en este médico para su atención médica”.

No está claro si hay soñadores que practican la medicina, dada la edad del grupo demográfico. Se les exigió tener menos de 31 años en el momento de la orden ejecutiva de Obama, dijo Kurt Mosley, vicepresidente de alianzas estratégicas de Merritt Hawkins, una empresa de reclutamiento de médicos.

Pero 65 soñadores fueron matriculados en escuelas de medicina en toda la nación durante el último año académico, dijo Shick.

“Suena como un pequeño número”, dijo, “pero están tratando entre 1.000 y 2.000 pacientes”.

La terminación de DACA también podría afectar la capacidad del país para atender a los pacientes de una manera culturalmente sensible, dijo Mosley. Las estadísticas apuntan a la necesidad: se espera que las minorías constituyan la mayoría de la población estadounidense para 2044, según la Oficina del Censo de los Estados Unidos. Para 2060, se espera que los hispanos, que constituyen la mayor parte de los soñadores, representen casi el 29% de la población.

“Somos una nación de diversidad, y nuestra fuerza de trabajo debe reflejar eso”, dijo Mosley. “Y [la disolución del DACA] es un paso atrás”.

Jennifer Rodríguez, de 28 años, dijo que frecuentemente ve la necesidad de mano de obra multicultural en un centro de atención psiquiátrica en Elkhart, Indiana, donde trabaja como asistente administrativa.

Los clientes latinos a menudo se acercan a ella para pedir ayuda, reconociendo una cara amistosa y preguntándole en cortadas palabras en inglés, si ella habla español.

Interpretar para los clientes no está dentro de sus tareas, y su jefe a veces le dice que diga que no, cuando la ve abrumada de trabajo.

“Pero nunca le haría eso a mi gente”, dijo Rodríguez, quien llegó a Goshen, Indiana, desde México, cuando tenía 3 años, y no recuerda su lugar de nacimiento.

“Esto es todo lo que sabemos, y sólo queremos ser ciudadanos productivos”, dijo. “Es hiriente que yo considere que éste es mi hogar, pero para otras personas soy ilegal”.

Esta historia fue producida por Kaiser Health News, que publica California Healthline, un servicio editorialmente independiente de la California Health Care Foundation.

Trump’s Deadline On ‘Dreamers’ Reverberates Through Health Industries

Kaiser Health News:Marketplace - September 18, 2017

Karla Ornelas said she has “always had the idea of being a doctor, I’ve never seen myself doing anything else.” The third-year pre-medical student at the University of California-Davis said she plans to become a family medicine physician and work in California’s Central Valley, where there is a great need for doctors and especially bilingual doctors.

But that dream could be uprooted if the Trump administration goes forward with its plan to end the Deferred Action for Childhood Arrivals (DACA) program, which allows young people brought to the U.S. by their parents without proper documentation to stay and work here. Ornelas, 20, was born in Mexico and came arrived to the U.S. at age 9.

Across the country, Jennifer Rodriguez, 28, faces the same problem. Rodriguez, who works at a psychiatric care facility in Elkhart, Ind., as an administrative assistant, arrived in Goshen, Ind., from Mexico when she was 3, with no recollection of her birthplace and no documents to prove she belonged in the nation she  calls home. Now she is worried that she will be able to stay.

“It’s hurtful that I consider this my home, yet to other people I am an illegal,” she said.

This KHN story also ran in USA Today. It can be republished for free (details).

In 2012, President Barack Obama established the DACA policy that gave a group of about 800,000 children and young adults freedom from concerns about being deported and the opportunity to earn a living.

On Sept. 5, Attorney General Jeff Sessions announced that President Donald Trump would cancel Obama’s executive order that set up DACA. Explaining the decision, the administration said that it did not believe Obama had the authority to set up the program and that it anticipated lawsuits from states seeking to end the program.

The administration is providing a six-month grace period until these protections end, giving Congress time to pass legislation to address the legal status of these immigrants, known as “Dreamers.”  Trump and Democratic lawmakers have agreed to work on a plan to extend the DACA program, but there are few details and conservatives have raised concerns.

There are no firm statistics showing how many Dreamers work in the health care sector, but industry leaders suggested that DACA’s end could have an impact, especially among medical students and home health aides.

Multiple health care groups denounced the administration’s move. A statement released by the Association of American Medical Colleges (AAMC) said its members are “extremely dismayed” by the decision.

“Even with the ‘wind down process’ described by the administration, the implications of this action for medical students, medical residents, and researchers with DACA status are serious, and will interfere with their ability to complete their training and contribute meaningfully to the health of the nation,” the group wrote.

The American Medical Association (AMA) said the administration’s announcement “could have severe consequences for many in the health care workforce, impacting patients and our nation’s health care system.” It urged Congress to pass a permanent solution.

“The more the administration threatens immigrants and their families and their communities,” said Robert Espinoza, vice president of policy at PHI, a long-term care advocacy group, “the more we threaten that workforce supply.”

One segment of the health care workforce that could be affected are medical students.

Students and residents may have to cut their training short, the AAMC said, and researchers may have to leave the country before completing their experiments. Foreign-born and international medical graduates also tend to work in underserved areas, said Matthew Shick, director of government relations and regulatory affairs at AAMC. Phasing out DACA could also sever a lifeline connection between doctors and populations in sore need of health care.

Karla Ornelas is a third-year pre-medical student at the University of California-Davis who registered for the DACA program. Her goal is to become a family medicine physician and return to the Central Valley. (Courtesy of Karla Ornelas)

Ornelas, whose family settled in Turlock, Calif., feels that need. For example, she said she accompanied her mother to a doctor’s appointment, as she usually does to help translate. Her mother, she said, had questions about lab results, and as her mother asked in Spanish and Ornelas repeated in English, the doctor grew impatient, told them to stop asking questions and walked out of the room.

“My mom wanted to cry, and I was shocked,” Ornelas said. “That’s when I realized that it wasn’t just my mom, it was an entire community that was relying on this doctor for health care.”

Sixty-five Dreamers were enrolled in medical schools across the nation during the last academic year, Shick said.

“It sounds like a small number,” he said, “but they’re treating anywhere between 1,000 and 2,000 patients in their clinical panel.”

Those medical students are needed to serve neglected communities as well as to alleviate the shortage of doctors. The AAMC projects a shortage of between 40,800 and 104,900 physicians by 2030. More than 43,000 of the empty slots are for primary care physicians.

Kurt Mosley, vice president of strategic alliances for Merritt Hawkins, a physician recruitment company, said he is unsure if there are any Dreamers practicing medicine given that group’s age (recipients were required to be younger than 31 at the time of the executive order).

DACA’s end could also have a large impact on the country’s ability to care for patients in a culturally sensitive manner, he said. And statistics point to the need — minorities are expected to constitute the majority of the U.S. population by 2044, according to the U.S. Census Bureau. By 2060, Hispanics — who make up the bulk of Dreamers — are expected to account for nearly29 percent of the U.S. population.

“You know we’re a nation of diversity, and our workforce should reflect that,” Mosley said. “And [dissolving DACA] is a step backwards.” Health care already relies on immigrants to fill the ranks. Over a fifth of Dreamers work in the health care or education industries, according to a 2016 survey by groups including the National Immigration Law Center and the Center for American Progress. Moreover, based on a separate 2015 survey by the immigrant advocacy organization United We Dream, nearly 23 percent want to pursue a career in health care.

Another sector of the workforce that heavily relies on foreign-born employees is direct care, which includes nurse aides, home health aides and personal care assistants. According to Espinoza, one-quarter of all employees are immigrants.

As the population ages, those jobs will continue to be in high demand. It’s hard to tell whether the vacancies that may be created by immigrants forced out of their jobs could be filled by the remaining population, he said.

“What our sector needs most is care,” Espinoza said. “And these kinds of federal decisions impede that — it impedes our ability to provide care.”

Rodriguez said she sees that need at her job often. The Latino clients frequently approach her for help, she said, recognizing a friendly face and asking in bits of broken English whether their native Spanish is familiar to her.

Interpreting for clients doesn’t fall under her job description, and her boss sometimes tells her to say no when she’s overwhelmed.

“But I would never do that to my people,” Rodriguez said. She wants to stay in the country and continue her work and life here.

Without DACA, Rodriguez said, she would have trouble caring for her family. She has two daughters and just purchased a home.

She is married to an American citizen, so she has petitioned for residency. However, the application is still being processed, she said, which means she relies on DACA to stay employed and keep her driver’s license. Many of her family members also depend on the program for legal protection, and she said she is worried what will happen to them.

Rodriguez identifies herself as a Mexican-American who considers Indiana home.

“This is all we know, and we just want to be productive citizens,” she said. “That’s all.”

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Without Price Breaks, Rural Hospitals Struggle To Stock Costly, Lifesaving Drugs

Kaiser Health News:HealthReform - September 18, 2017

MOUNTAIN VIEW, Ark. — Hospital pharmacist Mandy Langston remembers when Lulabelle Berry arrived at Stone County Medical Center’s emergency department last year.

Berry couldn’t talk. Her face was drooping on one side. Her eyes couldn’t focus.

“She was basically unresponsive,” Langston recalls.

Berry, 78, was having a severe ischemic stroke. Each passing second made brain damage more likely. So, Langston reached for the clot-busting drug Activase, which must be given within a few hours to work.

“If we don’t keep this drug [in stock], people will die,” Langston said.

Berry survived. But Langston fears others could die because of an unintended bias against rural hospitals built into the U.S. health law. An obscure Obamacare provision forces rural hospitals like Langston’s to pay full price for drugs that many bigger hospitals buy at deeply discounted rates.

For example, Langston’s 25-bed hospital pays $8,010 for a single dose of Activase — up nearly 200 percent from $2,708 a decade ago. Yet, just 36 miles down the road, a bigger regional hospital gets an 80 percent discount on the same drug.

This KHN story also ran on NPR. It can be republished for free (details).

White River Medical Center, a 235-bed facility in Batesville, Ark., buys Activase for about $1,600 per dose. White River participates in a federal drug discount program Congress approved in the early 1990s. The program offers significant price breaks on thousands of drugs to hospitals that primarily serve low-income patients. One federal report found the average discount ranged from 20 to 50 percent, though as illustrated with Activase, it can be much higher.

Rural hospitals have long wanted to be part of the so-called 340B program, too, but were blocked from participating until the Affordable Care Act of 2010. That historic health law added rural hospitals to the overall program. But, unlike bigger hospitals, rural hospitals can’t get discounts on expensive drugs that treat rare diseases because of a last-minute exclusion written into the ACA.

That seemingly minor detail in the law has left rural hospital pharmacists and health care workers struggling to keep medicines in stock, and wondering if they will be able to adequately care for patients.

Arkansas, for example, is in the “stroke belt,” where medical staff depend on Activase to help them battle one of the highest rates of stroke deaths in the country. When Langston went to restock Activase this year, it was so expensive she left a reorder unfilled for more than week, anxiously keeping only one dose of the clot-busting drug on hand.

“Usually strokes come in clusters,” Langston said. “I didn’t want two people to come in and we were going to [have to] choose which one we were going to treat.”

In Atlantic, Iowa, pharmacy director Crystal Starlin sparingly stocks oncology drugs at Cass County Memorial Hospital. Newly diagnosed cancer patients might have to wait a couple of days to start treatment.

“We just can’t keep the extra [drugs] on hand,” Starlin said.

In Vermont, North Country Hospital closed its infusion center this spring due to the soaring cost of medicines.

“That was one area we could not afford to be in,” said chief executive Claudio Fort. North Country is the only hospital in a two-county region along the Canadian border and its roughly dozen active chemotherapy patients now must drive 45 minutes away for treatment.

The rare-disease exclusion was not publicly debated before being added into the ACA. Rather, it was tucked into the law at the very end of the process. How it wound up in the law is a bit of a mystery.

Former PhRMA chief executive Billy Tauzin said he doesn’t recall negotiating the exclusion. But, he said, the industry has consistently raised concerns about the drug discount program’s reach.

“It’s a question of how deeply you can afford to discount drugs that are expensive,” said Tauzin, who abruptly stepped down just before the ACA passed.

After the health law passed, PhRMA battled for years — in federal court — to keep rural hospitals from getting discounts on rare-disease drugs.

Congressman Peter Welch, a Democrat from Vermont who represents North Country, said it is clear whom the law hurts and helps.

“The pharma lobbyists pay attention, and their lawyers pay attention to the fine print,” Welch said. The pharmaceutical industry changes that fine print … [and] many legislators don’t even realize [that it] will have this adverse impact on hospitals in their communities.”

The rare-disease exclusion means that certain types of hospitals — including critical access, sole community and rural referral centers — cannot get discounts on rare-disease drugs, or on drugs that are “designated” to treat a rare disease. (Rare-disease drugs are also known as orphan drugs, which is a federally approved category of drugs that treat a disease affecting fewer than 200,000 people. Often, they carry price tags of up to $100,000 a year or more.)

The Food and Drug Administration gives the designation as a first step when it agrees with a drugmaker’s request to study whether a drug can be used to treat a specific rare disease. This can happen even if a drug is already FDA-approved and on the market for use in treating a common condition. The next step — the ability to market the medicine as an orphan drug — comes once research confirms that the drug is safe and effective in treating a specific, less common condition.

The popular clot-buster Activase has not won final approval to treat a rare disease but, on two separate occasions in 2003 and 2014, the FDA has given it the orphan designation while research is ongoing.

About 450 orphan drugs have been approved by the FDA. But thousands of drugs are “designated” and more are identified every week.

The list includes generic drugs such as the hormone melatonin and the autoimmune drug abatacept. In other words, medicines used to treat everything from sleep troubles to arthritis have ended up “designated.”

The small town of Mountain View, Ark., known for its crafts and music scene, is about two hours north of Little Rock and nestled in the rolling Ozarks. Arkansas’ mountainous terrain makes it essential for local hospitals to stock lifesaving stroke drugs. The state reports some of the nation’s highest rates of stroke deaths. (Sarah Jane Tribble/KHN)

Some drugmakers, such as Janssen Pharmaceuticals, have voluntarily offered discounts to rural hospitals on all of their orphan drugs including Remicade, whether they’re approved or designated. In contrast, drugmaker Genentech sent letters to rural hospitals on Jan. 1 listing dozens of drugs that would not qualify for discounts, including Activase and cancer drug Avastin.

Susan Willson, a Genentech spokeswoman, said the company is “deeply committed to ensuring that people have access to the medicines they need.” But, she added, the company believes the federal drug discount program has “grown well beyond its original intent.”

Several federal reports in recent years from the Medicare advisory board, as well as the Government Accountability Office and the Office of Inspector General, have evaluated the federal drug discount program’s growth. About 40 percent of U.S. hospitals now participate in the program and House Republicans held a hearing this summer questioning the program’s growth.

But for Dana Smith, director of pharmacy at Dallas County Medical Center in Fordyce, Ark., the discount program’s growth and problems are a separate issue.

“Basically, Genentech is saying to me that rural health care and the patients in rural America are not as important as patients in urban areas,” Smith said, adding the pharmaceutical industry “knows we have less manpower to fight them.”

Back at Stone County, emergency room medical director Dr. Barry Pierce paused one recent afternoon at the nursing station and recalled those tense days with just one dose of Activase. Stone County now keeps two doses of the stroke drug on hand.

Pierce noted that Stone County is at least 45 minutes away from the next nearest hospital and, echoing Langston’s concern, he said: “If we don’t have the drugs we need, people will die.”

KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

HHS activates program to reimburse hospitals caring for patients evacuated following Hurricane Irma

HHS Gov News - September 17, 2017

As part of the Trump Administration’s government-wide efforts to provide relief to those affected by Hurricane Irma, the U.S. Department of Health and Human Services (HHS) activated a program to help hospitals and medical facilities providing care to people affected by Irma. This is the first time HHS has activated the program in response to a natural disaster since a devastating earthquake hit Haiti in 2010.

The program, called the National Disaster Medical System (NDMS) Definitive Care Reimbursement Program, reimburses medical facilities and hospitals for the definitive medical care costs of patients medically evacuated following disasters. These patients are directed to NDMS-designated hospitals and medical facilities and tracked through Federal Coordinating Centers managed by the Departments of Veterans Affairs and Defense.

“Hurricane Irma significantly affected access to medical care in the areas hardest hit by the storm, and patients who need care in these impacted areas must rely on facilities in areas spared by the storm,” said HHS Assistant Secretary for Preparedness and Response Robert Kadlec, M.D. “We are activating NDMS’ Definitive Care Reimbursement Program to ensure that the medical facilities and hospitals accepting these patients will be reimbursed for the vital care they are providing.”

The program, overseen by HHS ASPR, covers medical care provided to people who are injured or became ill as a result of natural disasters if medical care is no longer available in their local area after the disaster. Covered services include medically necessary hospital care, which can extend beyond the typical 30-day stay, as well as home care, rehabilitation, physical therapy and primary care.

Approximately 85 patients will be covered under the NDMS definitive care program in eligible medical facilities in Puerto Rico. These patients were medically evacuated to Puerto Rico from the U.S. Virgin Islands utilizing resources available through the U.S. Department of Defense and Federal Emergency Management Agency’s national ambulance contract.

Facilities receive reimbursement up to 110 percent of the Medicare rate for participating in the program or a comparable rate if the Medicare rate is unavailable. The facilities must make available up to 25 beds for NDMS patients. More than 1,900 hospitals across the country participate in NDMS’ Definitive Care Reimbursement Program.

In addition to the definitive care program, NDMS provides medical professional who can assist state and local medical professionals in impacted areas. Approximately 5,000 medical, public health, and emergency management professionals comprise the NDMS and are organized into more than 70 response teams. They hail from communities nationwide and serve as intermittent federal government employees in a coordinated federal response.

HHS remains committed to meeting the medical and public health needs of communities across the southeast impacted by Hurricane Irma. Health tips for clean up after the hurricane are available at www.phe.gov/irma.

Critical updates also are available at:

About ASPR:

ASPR leads the nation in preventing, preparing for, and responding to the adverse health effects of public health emergencies and disasters. The HHS division focuses on preparedness planning and response; building federal emergency medical operational capabilities; countermeasures research, advance development, and procurement; and grants to strengthen the capabilities of hospitals and health care systems in public health emergencies and medical disasters.

HHS commits $144.1 million in additional funding for opioid crisis

HHS Gov News - September 15, 2017

The U.S. Department of Health and Human Services has awarded an additional $144.1 million in grants to prevent and treat opioid addiction in support of President Trump’s commitment to combat the opioid crisis. The grants will be administered by the Substance Abuse and Mental Health Services Administration (SAMHSA).

“Those supporting prevention, treatment, and recovery efforts in our local communities are heroes in our nation’s battle against the opioid crisis,” said HHS Secretary Tom Price, M.D. “On our nationwide listening tour, we have heard how critical federal resources can empower their efforts to meet the challenges of substance abuse and addiction, especially with the opioid crisis. These grants will help expand treatment and recovery services to pregnant and postpartum women who are struggling with substance abuse, train our first responders to effectively use overdose reversing drugs, improve access to medication-assisted treatment, and increase long term recovery services. Together, we can heal communities and save lives.”

According to SAMHSA’s National Survey on Drug Use and Health, in 2016 an estimated 11.8 million people misused opioids in the past year, including prescription pain relievers and heroin.  Preliminary data from the Centers for Disease Control and Prevention for 2016 suggests the number of drug overdose deaths, most of them due to opioids will likely top 60,000.

“Opioid use disorders continue to plague our nation,” said Dr. Elinore McCance-Katz, Assistant Secretary for Mental Health and Substance Use. “These funds will support and expand prevention, treatment and recovery services in America’s communities.” 

The first four of the six grant programs listed below were authorized in the Comprehensive Addiction and Recovery Act (CARA) of 2016, (P.L. 114-198). CARA authorized funding to fight the opioid epidemic through prevention, treatment, recovery, overdose reversal, and other efforts. The fifth grant program listed, Medication Assisted Treatment (MAT), received an increase in funding for opioids in the fiscal year 2017 Omnibus Appropriations bill.

SAMHSA is issuing the funding through the six grant programs listed below in the following amounts:

  • First Responders – Comprehensive Addiction and Recovery Act - $44.7 million. The purpose of this program is to provide training and medication for emergency treatment of opioid overdose. https://www.samhsa.gov/grants/awards/2017/SP-17-005
  • State Pilot Grant for Treatment of Pregnant and Postpartum Women - Comprehensive Addiction and Recovery Act - $9.8 million. The purpose of the program is to support family-based services for pregnant and postpartum women with a primary diagnosis of a substance use disorder, including opioid use disorders. https://www.samhsa.gov/grants/awards/2017/TI-17-016
  • Building Communities of Recovery - Comprehensive Addiction and Recovery Act - $4.6 million. The purpose of this program is to increase the availability of long-term recovery support for substance abuse and addiction. https://www.samhsa.gov/grants/awards/2017/TI-17-015
  • Improving Access to Overdose Treatment - Comprehensive Addiction and Recovery Act - $1 million. The purpose of this program is to expand access to FDA-approved drugs or devices for emergency treatment of opioid overdose. https://www.samhsa.gov/grants/awards/2017/SP-17-006
  • Targeted Capacity Expansion:  Medication Assisted Treatment (MAT) – Prescription Drug and Opioid Addiction - $35 million. The purpose of this program is to expand access to medication-assisted treatment for persons with an opioid use disorder seeking treatment. https://www.samhsa.gov/grants/awards/2017/TI-17-017
  • Services Grant Program for Residential Treatment for Pregnant and Postpartum Women - $49 million. The purpose of this program is to expand services for women and their children in residential substance abuse treatment facilities, among other services. https://www.samhsa.gov/grants/awards/2017/TI-17-007

The funding will be distributed to 58 recipients, including states, cities, healthcare providers and community organizations. The funds will be awarded for three to five years, subject to availability and depending on the program.

Earlier this year, HHS Secretary Price outlined five strategies to provide the Department with a comprehensive framework to combat the ongoing opioid crisis: improving access to prevention, treatment, and recovery services, including the full range of MAT; targeting the availability and distribution of overdose-reversing drugs; strengthening public health data and reporting; supporting cutting-edge research on pain and addiction; and advancing the practice of pain management.

These awards follow a separate award of $485 million in grants in April 2017 – provided by the 21st Century Cures Act – to all 50 states, the District of Columbia, four U.S. territories, and the free associated states of Palau and Micronesia by SAMHSA for opioid abuse prevention, treatment, and recovery. 

 

Pages