106th Congress Has Many Health Care Issues on Agenda

Dennis Hastert (R-Ill.), slated to be the new Speaker of the House, has been a key player in health care issues. In the last Congress, he chaired the House Republican Health Care Task Force and was instrumental in the development of patient protection legislation. Many anticipate that he will focus on health issues as he moves into his new position. Charles Norwood (R-Ga.) has already reintroduced his patient protection bill, and other members are expressing interest in revisiting the issue. With polls indicating that the public's concerns about managed care have not been mitigated in the months since the election and with reports of significant premium increases for health plans, Congress is likely to focus on the issue early in the session. Confidentiality legislation also will be on the agenda, with a mandate in the Health Insurance Portability and Accountability Act of 1996 calling for legislation to be passed by August 1999, or the Secretary of Health and Human Services will be required to issue regulations.

Early reports about the Administration's budget proposal indicate cuts in spending for many discretionary health programs, including support for family practice training. Groups potentially impacted by proposed reductions already are contacting members of the appropriations committees to urge support for their programs. Additionally, the Medicare Bipartisan Commission is expected to release its recommendations for reform of the Medicare program in March, an issue that will be hotly debated in Congress.

National Guideline Clearinghouse Is Launched on the Internet

At a press briefing in January in Washington, D.C., the National Guideline Clearinghouse (NGC), an Internet-based repository for clinical practice guidelines and related materials, was unveiled. The Internet address for the clearinghouse is http://www.guideline.gov. The NGC, developed by the Agency for Health Care Policy and Research (AHCPR) in partnership with the American Medical Association (AMA) and the American Association of Health Plans (AAHP), is an electronic database that will expand access to evidence-based clinical practice guidelines for all health care professionals and the general public. The AHCPR, the AMA and the AAHP have been working together since 1997 to develop the clearinghouse.

To be included in the NGC, guidelines must meet specified inclusion criteria. The following elements will be available with the full text of each guideline: a standardized abstract with information about the guideline; a comparison of guidelines that cover similar topic areas; and topic-related electronic mail groups in which registered users may exchange information about the guidelines. More information about the NGC can be obtained on the Web site of the AHCPR at http://www.ahcpr.gov/ or by contacting Jean Slutsky, NGC project officer; telephone: 301-594-4015; fax: 301-594-4027; e-mail: jslutsky@ahcpr.gov.

HHS Awards $479 Million in Grants for HIV/AIDS Care and Support Services

Health and Human Services Secretary Donna Shalala has announced awards of $479 million in grants to 50 metropolitan areas to fund primary health care and support services for low-income individuals with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Funded under Title 1 of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, the metropolitan areas receive these awards based on the number of people in the areas living with HIV disease. “These grants place funds where they are needed most, so that hard-hit communities can provide people affected with HIV/AIDS the crucial services they need,” said Secretary Shalala.

Awards to metropolitan areas are determined by formulas set in law. To qualify for Title I funding, an eligible metropolitan area must have a population of at least 500,000 and have reported more than 2,000 AIDS cases in the past five years. Cities receiving grants include Houston (nearly $16 million), Chicago (just over $18 million), Miami, Fla., (just over $21 million), Los Angeles (nearly $34 million), San Francisco (just over $36 million) and New York City (almost $97 million).

Leadership Centers Are Established by the PHS Office on Women's Health

The U.S. Public Health Service's Office on Women's Health (PHS OWH) has established four national Centers of Leadership in Academic Medicine that will become model projects to promote gender equity in medicine and leadership advancement of junior faculty. Approximately $300,000 was awarded to the centers, which are located at Allegheny University of the Health Sciences, Philadelphia; East Carolina University School of Medicine, Greenville, N.C.; Meharry Medical College, Nashville, Tenn.; and University of California, San Diego School of Medicine. After a nationwide solicitation, these centers were chosen on the basis of their potential capacity for implementing recommendations developed by the National Task Force on Mentoring for Female Health Care Professionals, convened by the PHS OWH to eliminate career barriers traditionally faced by women in medicine.

AAFP Policy Center Reissues Call for Input from Family Physicians

In the December 1998 “Newsletter,” Larry A. Green, M.D., director of the new American Academy of Family Physician's (AAFP's) Center for Policy Studies in Family Practice and Primary Care, requested input from practicing family physicians about what they consider the most important policy issues facing family physicians. Because of intermittent technical difficulties with the center's e-mail system, suggestions sent via e-mail may not have been received by Dr. Green. Dr. Green is requesting that any e-mail correspondence sent during December and early January be resent. The e-mail address is lgreen@aafp.org. If you have ideas or suggestions that could help focus the efforts of the new policy center, please e-mail Dr. Green or write Larry A. Green, M.D., AAFP, 2021 Massachusetts Ave., NW, Washington, DC 20036-1011.