Monday, March 27, 2023

Congress is working on legislation to address children’s mental health crisis


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Today’s edition: President Biden will convene a roundtable on baby formula. The federal health department establishes a new environmental justice office. Sen. Joe Manchin (D-W.Va.) reiterates support for Democrats’ prescription drug pricing measures. But first … 

Lawmakers are under pressure to address the pandemic’s toll on child mental health

Roughly 7 in 10 public schools are reporting a rise in students seeking mental health services since the beginning of the pandemic, according to new federal data. But just over half of all schools were able to effectively provide services to all students in need. 

It’s yet another statistic in a growing body of research on the mental health crisis among America’s youth. Research suggests mental health was already declining among American kids before the pandemic, and the suspension of in-person school combined with economic instability, grief and social isolation during the pandemic are believed to have further worsened the problem.

The Biden administration and Congress are working on policies that could help curb the mental health challenges children face and offer them the support they need. Lawmakers and federal officials have homed in on youth mental health as an area ripe for bipartisan compromise as the pandemic’s emotional toll spurs calls for action.

The Senate Finance Committee is crafting a mental health package focused on five main areas, including boosting care for children and strengthening the workforce. It’s possible the panel may release more discussion drafts of some of the components — such as provisions focused on youth — before the July 4 recess. A broader package may be marked up before the August recess, according to Senate aides.

Earlier this month, the House Energy and Commerce Committee advanced a mental health package that includes resources for kids. Other key health panels are also eyeing measures attempting to strengthen care for youth, and the Biden administration is pushing its own proposals. 

One key point we heard yesterday in interviews with advocates and lawmakers … “To be effective, we’ve got to go to where kids are with mental health, emotional health resources, and that means going into the schools,” Rep. Kathy Castor (D-Fla.), the co-chair of the congressional Children’s Health Care Caucus, told The Health 202. 

A trio of groups — the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association — have gone as far as to declare a national state of emergency in children’s mental health. 

Advocates point to the need for more mental health professionals working in the nation’s schools. That aligns with a proposal from the Biden administration to allocate $1 billion to help double the number of school counselors, nurses and other workers in schools over the next decade. The funding ask was tucked into the White House’s fiscal year 2023 budget request, though such proposals are just mere wish lists on Capitol Hill, which holds the power of the purse. 

“Schools offer such a unique opportunity for early identification, prevention and intervention services for kids where they already are,” said Jennifer Snow, the national director of government relations, policy and advocacy at the National Alliance on Mental Illness.

Here’s the latest: The report released yesterday from a wing of the Department of Education showed schools are struggling to meet rising mental health needs.

“The results come as an enormously stressful school year draws to a close,” The Post’s Laura Meckler writes. “They add to the evidence that the pandemic is leaving this generation of students with significant mental health challenges.” 

Other surveys have documented a steep decline among youth. Yet, some of the trend lines suggest concerns about adolescent mental health were also rising before the pandemic.

  • Between 2009 and 2019, the percentage of teens who reported having “persistent feelings of sadness or hopelessness” rose from 26 percent to nearly 37 percent.
  • Last year, the figure increased to 44 percent, our colleague Moriah Balingit wrote earlier this year.

Researchers have proposed various theories about why the numbers have increased. According to a Surgeon General’s report from December, those include the growing use of digital media, limited access to mental health care, rising income inequality, racism and a rise in the willingness to openly discuss mental health concerns. 

White House prescriptions

On tap today: President Biden will convene a roundtable with HHS Secretary Xavier Becerra, Surgeon General Vivek Murthy and manufacturers of infant formula to receive updates on ramping up the nation’s formula supply amid ongoing shortages. This includes top executives at Reckitt, Gerber, Perrigo Company, ByHeart and Bubs Australia, per a White House official.

HHS establishes new Office of Environmental Justice

The Department of Health and Human Services is establishing an Office of Environmental Justice to tackle health inequities among disadvantaged communities and vulnerable populations facing pollution and other environmental health issues, the Biden administration announced yesterday. 

The details: The new office — which will be couched within the Office of Climate Change and Health Equity — will develop and implement a department-wide strategy on environmental justice and health and coordinate annual HHS environmental justice reports, among other tasks. The new office is seeking public comment due June 18 on a draft outline of its strategy and implementation plan. 

Sharunda Buchanan, a former official at the Centers for Disease Control and Prevention specializing in environmental health issues, will serve as interim director of the new hub.

Brenda Mallory, chair of the White House Council on Environmental Quality:

Manchin doubles down on calls for drug pricing legislation — though he has held up Democrats’ broader bill

All eyes on Manchin: Sen. Joe Manchin (D-W.Va.) reiterated his support for Democrats’ push to lower prescription drug costs yesterday, going as far to say “If we do nothing else this year — and I think we will do a lot — this has to be done,” the Charleston Gazette-Mail’s Caity Coyne reports. 

Manchin has consistently supported allowing Medicare to negotiate drug prices, and said any pared-down version of a social spending package should include Democrats’ drug pricing deal at the center. But he’s been the main holdup to passing a broader economic package in the Senate, which some were quick to point out on social media. 

The West Virginia lawmaker met with AARP representatives yesterday to discuss congressional action to lower prescription drug costs, a policy area Manchin said he believes could see completed legislation “before November.” 

“Every senator in the country has the same concerns, there’s no reason we can’t get this done,” Manchin said.

Following the AARP event Tuesday, Manchin took to Twitter to call for lower drug prices: 

But his comments made waves among some other Democrats, who pointed out his opposition to Build Back Better — which included the party’s signature drug pricing package. Here’s Rep. Ilhan Omar (D-Minn.): 

AMA pushes against bill to require opioid addiction training for doctors

In a move seemingly at odds with its past recommendations and calls to action, the nation’s largest physician lobbying group said it would not support a bill requiring doctors be trained on treating people with opioid use disorder, Stat’s Nicholas Florko reports. 

While the American Medical Association is a powerful lobbying group in Washington, it remains unclear how much of an impact its opposition will have on the bill, which has otherwise received bipartisan support. 

The details: The bill would require physicians complete a one-time, eight-hour training course on treating patients with opioid and other substance use disorders as a condition of being able to prescribe controlled substances. It has the support of nearly every group that focuses on addiction treatment

  • Key context: The Medication Access and Training Expansion Act comes as a “direct response to surveys that have shown doctors are uninterested in treating addiction, harbor stereotypes about people seeking treatment, or are unaware of treatment options for the condition,” Nicholas writes.

In a letter to lawmakers, the AMA wrote that the trade group doesn’t back the bill, and also thought it wouldn’t make a difference. “A one-time training mandate for substance use disorders, no matter how well-intentioned, will not have a meaningful impact on reducing drug-related overdose,” the May letter states. 

  • The group also said much of its resistance stems from the organization’s long-standing opposition to lawmakers imposing federal mandates on practicing medicine, which is typically regulated by states.

Andrew Kolodny, medical director of opioid policy research at the Heller School for Social Policy and Management:

  • The Pandemic Response Accountability Committee, which oversees federal pandemic relief spending, is asking Congress to give the inspectors general more authority to go after fraud in covid-19 relief programs, the Associated Press reports.
  • In Washington state: Fourteen health insurers filed an average requested rate increase of 7.16 percent for the state’s 2023 individual health insurance market. Final decisions will be made in the fall.
  • A new study published in JAMA Internal Medicine found that pulse oximeter measurements among Black, Hispanic and Asian covid-19 patients were less accurate than measurements for their White peers. Researchers believe the discrepancy may have led some patients of color with severe disease to receive delayed or be denied treatment despite having oxygen levels low enough to warrant it, the Wall Street Journal reports.

Omicron was deadlier for seniors than Delta

Yes, the delta variant of the coronavirus was more likely than the omicron variant to cause serious illness among the general population. However, among those 65 and older, omicron was more deadly, the New York Times notes.

“Almost as many Americans 65 and older died in four months of the Omicron surge as did in six months of the Delta wave, even though the Delta variant, for any one person, tended to cause more severe illness,” Benjamin Mueller and Eleanor Lutz write.

And even with the effective vaccines, age is still a massive risk factor in whether someone will become seriously ill or die.

  • “This is not simply a pandemic of the unvaccinated,” said Boston University’s Andrew Stokes told Benjamin and Eleanor. “There’s still exceptionally high risk among older adults, even those with primary vaccine series.”

Politics and Pandemic Fatigue Doom California’s Covid Vaccine Mandates (By Rachel Bluth | Kaiser Health News)

The Doctor Prescribed an Obesity Drug. Her Insurer Called It ‘Vanity.’ (By Gina Kolata | The New York Times)

Abortion Opponents Take Political Risks by Dropping Exceptions for Rape, Incest, and the Mother’s Life (By Julie Rovner, Kaiser Health News)

Thanks for reading! See y’all tomorrow.

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