Published 7/1/2018
Elizabeth Fassbender, Esq.; Jordan Vivian

Senate Addresses Preparedness for Public Health Threats

On May 25, the Senate Health, Education, Labor, and Pensions (HELP) Committee approved legislation to reauthorize the Pandemic and All-Hazards Preparedness Act of 2006. The reauthorization legislation, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI), was introduced by Sen. Richard M. Burr (R-N.C.) and cosponsored by Sens. Lamar Alexander (R-Tenn.), HELP Committee chairman; Bob Casey (D-Pa.); and Patty Murray (D-Wash.), HELP Committee ranking Democratic member. According to the legislators, PAHPAI will improve the nation’s ability to prepare for and respond to public health threats.

Additionally, the bill seeks to update programs within the original legislative framework to address 21st-century issues such as Ebola, Zika, and the recent destructive hurricane season.

“We must be vigilant in our efforts to prepare for and respond to the very real threats our nation faces,” said Sen. Burr. “Fostering and leveraging innovative technologies to improve our preparedness and response capabilities will encourage a nimble and flexible response to new and changing public health threats affecting our national security.”

“The recent resurgence of Ebola in the Congo should serve as a stark reminder that the threats we are working to address in this bill aren’t hypothetical,” said Sen. Murray.

Before the bill’s passage, AAOS and the Orthopaedic Trauma Association (OTA) sent a joint letter to Congress that offered additional policy considerations. The groups noted that orthopaedic surgeons receive training in trauma and critical care and provide life- and limb-saving care in emergency situations around the country and the world.

In particular, AAOS and OTA urged inclusion of H.R. 1876, the Good Samaritan Health Professionals Act of 2017, which helps protect healthcare professionals who volunteer their services when a major emergency arises. Both groups have continually advocated for this legislation to provide clear liability protections to licensed healthcare professionals who volunteer healthcare services to victims during a declared national disaster. Notably, the legislation respects existing medical liability laws and does not protect providers in cases of willful or criminal misconduct, gross negligence, or reckless misconduct. The House Energy and Commerce Committee reported the bill by voice vote on Feb. 14.

“Recent federally declared disasters have highlighted the need for medical professionals who wish to assist those affected and that they not be turned away or limited in the scope of their assistance due to a potential medical liability lawsuit,” stated AAOS and OTA in a letter to the committee regarding the Good Samaritan bill. “While current state and federal laws provide some level of liability protections for licensed healthcare professionals, this legislation would fill remaining gaps and ensure that vital healthcare services—often provided by medical volunteers—remain available, all while respecting existing medical liability laws in individual states.”

Although the committee-passed PAHPAI bill does not include the Good Samaritan legislation in full, it does include some encouraging provisions.

Additionally, Sen. Alexander stated that he will continue to work with Sen. Bill Cassidy (R-La.) and Rep. Marsha Blackburn (R-Tenn.) to improve provisions in the current legislation, including expanding the protections to more disasters and making it easier for medical professionals to register as volunteers. AAOS fellows continued to advocate for this when they met with their Congressional representatives during the National Orthopaedic Leadership Conference in Washington, D.C., in June.

Importantly, the PAHPAI bill does include the AAOS- and OTA-endorsed MISSION ZERO Act (H.R. 880), authored by Rep. Michael Burgess, MD (R-Texas). This legislation establishes a grant program for trauma centers to bring military trauma specialists to civilian hospitals. It was passed by voice vote in the House of Representatives on Feb. 26 and referred to the Senate HELP Committee.

“MISSION Zero requires the Office of the Assistant Secretary for Preparedness and Response within the Department of Defense to award grants that would enable military trauma care providers and trauma teams to provide trauma care and related acute care at civilian trauma centers,” stated AAOS and OTA in a letter to the Senate committee. “These funds will be used to train and incorporate military trauma care providers into the trauma center and may be used to cover expenditures for malpractice insurance, office space, information technology, specialty education and supervision, trauma programs, and state license fees. … With the drawdown of U.S. troops from Afghanistan and Iraq, the nation once again has an opportunity to benefit from the lessons learned about trauma care during the past 17 years of war and ensure that civilian trauma centers are staffed and ready in case of any mass casualty event.”

PAHPAI was advanced by the Senate HELP Committee on June 18, but has not yet received a vote in either the full Senate or House of Representatives. The current authorization expires on Sept. 30 and both chambers are expected to complete work on the legislation before that date.

Elizabeth Fassbender, Esq., is the former communications manager in the AAOS Office of Government Relations (OGR). Jordan Vivian is manager of government relations in the AAOS OGR. He can be reached at vivian@aaos.org.