WASHINGTON – U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) issued a statement today after the Senate approved a bipartisan emergency funding bill to combat the coronavirus (COVID-19) on a 96-1 vote:

“We are pleased that Congress quickly passed this important coronavirus response package on a bipartisan basis, and with sufficient funding to meet the threat posed by the COVID-19 outbreak. While the Trump Administration's initial $1.25 billion request fell far short of what state and federal agencies need to combat the spread of coronavirus, this $8.3 billion package will immediately direct needed resources to Virginia and other states – including funding for diagnostic testing, vaccine development, and additional resources for state and local responders who are on the front lines of a potential pandemic,” said the Senators. “This legislation is about making sure costs don't get in the way of a strong response to the threat posed by the coronavirus. Once it is signed into law, the Commonwealth will immediately receive $13.3 million in federal funding to help cover the costs of preparations for this public health emergency.”

“With the President's signature, state and local agencies in Virginia will be able to apply for further federal funds to reimburse for the costs of detecting, tracking and controlling the spread of the virus. While Virginia is fortunate that we have not experienced an outbreak, this bill sets aside $350 million that will be available to local authorities if our region does get hit. It also provides $500 million for masks, medication, protective equipment, and other much-needed medical supplies that can be distributed directly to hospitals and local health care providers. We are committed to working with federal, state and local health officials to make sure the Commonwealth is getting the federal support it needs to prepare for coronavirus, and we encourage all Virginians to follow the guidance of public health professionals to protect against its spread,” concluded the Senators.

The legislation also includes language based on Sen. Warner’s CONNECT for Health Act of 2019, which reduces restrictions on the use of telehealth for public health emergency response, as well as $500 million to facilitate its implementation.

Earlier today, the Sens. Warner and Kaine wrote to the leadership of the Virginia Chamber of Commerce encouraging the organization's member businesses to commit that workers will not be penalized for following recommended health procedures to protect the public from further spread of the coronavirus. Sen. Warner also led a group of 14 Senators in urging major U.S. employers to make the same commitment. 

In a letter sent yesterday, the Senators urged health insurers and federal and state officials to eliminate cost burdens that could disincentivize people with coronavirus symptoms from seeking testing and treatment for the contagious illness. In a separate letter, the Senators called on the Trump Administration to end efforts to undermine the Affordable Care Act that could jeopardize America's coronavirus response.

These letters represent the latest in a series of efforts by the Senators to push for a robust response to the threat of coronavirus. In January, Sens. Warner and Kaine asked the Administration to redirect available public health funds to combat the virus and to inform Congress of any additional resources needed to respond to the coronavirus. Earlier this week, in a letter to Vice President Mike Pence – who has been tasked with coordinating the federal government’s coronavirus response – Sen. Warner expressed concern over how the U.S. government has mobilized to combat the outbreak of coronavirus and urged the Vice President to devote the resources, expertise, and manpower needed to prevent this virus from spreading while also improving the government’s communication with Congress and the American public. This week, Sen. Kaine joined letters calling on Secretary of Education Betsy DeVos and Secretary of Labor Eugene Scalia to provide details on their Departments’ plans for preparedness and response efforts to protect the safety and health of students, teachers, school staff, and workers in light of the emerging threat of the novel coronavirus.

The House of Representatives passed this coronavirus response package yesterday by a 415-2 vote. With Senate approval, the bill now heads to the President's desk, and President Trump has announced he intends to sign it into law.

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WASHINGTON – Today, in a letter to Vice President Mike Pence, U.S. Sen. Mark R. Warner (D-VA) expressed concern over how the U.S. government has mobilized to combat the outbreak of coronavirus (COVID-19), including how the Administration is communicating with state, local and federal officials, and Americans impacted by the virus. In his letter, Sen. Warner urged the Vice President to devote the resources, expertise and manpower needed to prevent this virus from spreading while also improving the government’s communication with Congress and the American public.     

“I am concerned that the Administration’s response to date has not been aggressive enough to effectively combat the virus and fails to underscore the threat posed by this virus,” wrote Sen. Warner. “I have been deeply frustrated with the U.S. government’s communication with Congress, my constituents and their family members impacted by the virus, and the American people more broadly.  I understand that individuals at the State Department, including in embassies around the world, the CDC and other federal agencies, have been working around the clock.  Yet despite this flurry of efforts, the U.S. government has not established an effective communication plan that tracks specific cases and communicates out guidance to individuals, their family members and Congressional offices working to get them help.  Nor has it effectively pushed back on disinformation around the coronavirus or given adequate information to the American public.”

“Since the outbreak of the coronavirus, I have been in frequent communication with a number of Virginians, who were traveling in Asia and were unable to return home,” he continued. “The U.S. government’s task force was unable to provide these folks with basic information on a timely basis about what they could expect for the next 24 hours and how they could be medically cleared.  Questions such as where they would sleep the following night, whether they should book a hotel or flight, and how they could be reunited with their spouses in country, went unanswered for far too long.  In addition, my office, despite repeated outreach to numerous government entities, struggled to get the basic information these constituents needed.  This process was opaque, time-consuming and ultimately unsatisfactory for my constituents.  We must do better.  We need to put better systems in place, especially as the virus continues to spread.”

To date, coronavirus has sickened more than 90,000 people around the world, killing more than 3,000 individuals. In the U.S., 88 cases of the virus have been confirmed and there have been two fatalities.

In his letter, Sen. Warner also emphasized the need for a government response that includes, at a minimum, a request for emergency funds from Congress, and an established communications strategy to ensure that government officials and the American public have the latest information they need to remain prepared and safe.

In January, Sen. Warner asked the Administration to redirect available public health funds to combat the virus and to inform Congress of any additional resources that are needed. The Administration has since requested $2.5 billion in emergency funds – an amount far below what most public health experts believe is needed to adequately prepare and respond to the virus. Congressional appropriators from both parties are currently working to negotiate and draft an emergency funding package to combat the coronavirus, which the Senate is expected to take up in the coming days.

A copy of the letter is available here and below.

Vice President Mike Pence

The White House

Office of the Vice President

1600 Pennsylvania Avenue, N.W.

Washington, D.C. 20500

Dear Vice President Pence:

I am writing to convey my concerns over how the U.S. government has mobilized to combat the novel coronavirus (COVID-19), including how the Administration is communicating with state, local and federal officials responding to the virus and Americans at large impacted by the virus.  As you take over the leadership of the U.S. government’s response to the coronavirus, I ask that you devote the resources, expertise and manpower needed to prevent this virus from spreading and that you improve the U.S. government’s communication with Congress and the American public.  

As you well know, the novel coronavirus has sickened more than 90,000 people around the world, and killed more than 3,000 people to date.  While there have only been 88 confirmed cases in the U.S. and two fatalities, the Centers for Disease Control (CDC) has stated that the virus is expected to spread within the U.S.  I am concerned that the Administration’s response to date has not been aggressive enough to effectively combat the virus and fails to underscore the threat posed by this virus. 

Earlier this month, I wrote to the Administration asking them to redirect available public health funds to combat this virus and to inform my colleagues and me of any additional resources that are needed.  This week, the Trump Administration asked Congress for only $2.5 billion dollars in order to contain the coronavirus and to try to prevent it from spreading in the U.S.  A number of independent public health experts have expressed concern that this amount will not be enough to effectively prepare, and both Republican and Democratic Members of the House and Senate have publically agreed this request is likely insufficient.

In addition, I have been deeply frustrated with the U.S. government’s communication with Congress, my constituents and their family members impacted by the virus, and the American people more broadly.  I understand that individuals at the State Department, including in embassies around the world, the CDC and other federal agencies, have been working around the clock.  Yet despite this flurry of efforts, the U.S. government has not established an effective communication plan that tracks specific cases and communicates out guidance to individuals, their family members and Congressional offices working to get them help.  Nor has it effectively pushed back on disinformation around the coronavirus or given adequate information to the American public. 

For example, since the outbreak of the coronavirus, I have been in frequent communication with a number of Virginians, who were traveling in Asia and were unable to return home.  The U.S. government’s task force was unable to provide these folks with basic information on a timely basis about what they could expect for the next 24 hours and how they could be medically cleared.  Questions such as where they would sleep the following night, whether they should book a hotel or flight, and how they could be reunited with their spouses in country, went unanswered for far too long.  In addition, my office, despite repeated outreach to numerous government entities, struggled to get the basic information these constituents needed.  This process was opaque, time-consuming and ultimately unsatisfactory for my constituents.  We must do better.  We need to put better systems in place, especially as the virus continues to spread.

I urge you to prioritize implementing an effective and reliable mobilization effort to support our nation’s response to the threat of coronavirus.  This response – at minimum – should include an emergency appropriations request to Congress with sufficient funding levels based upon recommendations from public health experts on the front lines of this outbreak.  In addition, I urge you to establish an organized and reliable communications strategy that ensures state, local and federal officials and the American public have the most up-to-date information they need to remain prepared and safe.  Thank you in advance for you attention to this letter, and I look forward to working together on this critical issue moving forward.

Sincerely,

MARK R. WARNER

cc:       

Secretary Alex Azar

Secretary Mike Pompeo

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) addressed the coronavirus (COVID-19) outbreak and what it means for individuals in the Commonwealth of Virginia.

Specifically, Sen. Warner expressed concern with the Trump Administration’s response to the outbreak, and stressed the need for a more aggressive response in order to effectively combat the coronavirus. He also encouraged Virginians to heed instructions from the Centers for Disease Control (CDC) and directed Virginians to the CDC website for the most up-to-date information.

A transcript of his remarks is available below:  

“Hello, I’m Virginia Senator Mark Warner. Today, I’d like to talk to you about the coronavirus outbreak and what it means for the Commonwealth.

“As folks may know, coronavirus has sickened more than 82,000 people around the world. Almost three thousand people have died – now, mostly all in China. In the United States, there have been sixty confirmed cases – none of which are currently in the Commonwealth. However, the Center for Disease Control – CDC – has stated that the virus is expected spread within the U.S. on some level.

“My office has been in regular contact with officials on the ground in Virginia. Our priority is to make sure they have the resources they need and are fully prepared to respond to any potential cases of coronavirus in the Commonwealth. In addition, I’ve been closely tracking the actions of the Trump Administration and working with federal officials to make sure they’re taking this threat seriously.

“Earlier this month, I wrote to the Administration asking them to redirect available public health funds to combat this virus and to inform me and my fellow Senators of any additional resources they may need. This week the Trump Administration asked Congress for $2.5 billion dollars in order to contain the coronavirus and to try to prevent it from spreading in the U.S.

“I am reviewing this request, but frankly, based upon the initial feedback of public health experts, I am concerned that the Administration’s response to date may not be aggressive enough to effectively combat the virus. I’m also concerned that we will need a more robust response – particularly in funding – if we are going to be fully prepared.

“I plan to continue working with folks in the Commonwealth and at the federal level to ensure the health and safety of all our fellow Virginians. In the meantime, I urge all Virginians to heed CDC advice, including travel advisories and tips on how to keep your family safe. For more information, visit www.CDC.gov. We will get through this. Thanks so much.”

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) released the following statement on President Trump's State of the Union address:

"Rather than taking this evening as an opportunity to attempt to unify a deeply divided nation, President Trump instead delivered a State of the Union address that seemed focused solely on rallying his own political supporters behind him. 

"I'm especially stunned that the President walked into the House chamber tonight and declared that he wants to protect Americans with preexisting health conditions, despite the fact that he has spent three years undermining the Affordable Care Act, putting those protections at risk for the more than 3 million Virginians who have a preexisting condition. 

"If the President really means what he says about protecting people with preexisting conditions, he should immediately direct the Department of Justice to reverse its support for a lawsuit designed to take down the health care law in its entirety, and instead work with Democrats to lower health care and prescription drug costs and end surprise medical billing." 

Sen. Warner, a longtime champion of access to health care, has been outspoken about the Trump Administration’s effort to overturn the Affordable Care Act in court. Last year, he introduced legislation to allow Virginia, and any other states that expanded Medicaid after the 2014 deadline, to receive the same federal matching funds as states that expanded earlier under the terms of the Affordable Care Act. According to the Virginia Hospital & Healthcare Association, this bill would save Virginia’s hospitals an estimated $300 million per year in the first three years of implementation. 

Additionally, in October, Sen. Warner forced a Senate vote on a Congressional Review Act (CRA) resolution that would have overturned a Trump Administration waiver rule that destabilizes the nation’s health insurance market and weakens protections for 3 million Virginians with preexisting conditions.  

In his speech tonight, President Trump called on Congress to pass legislation to lower prescription drug prices. The Senate Finance Committee, of which Sen. Warner is a member, in a bipartisan 19-9 vote last year approved legislation that would help address the rising cost of prescription drugs by taking on industry price hikes and protecting seniors with the highest out-of-pocket costs. However, despite support from Republican Committee Chairman Chuck Grassley (R-IA), whom the President named as a partner on the issue in tonight's address, the Senate Majority Leader has declined to bring the bill to the full Senate floor for a vote.

In Congress, Sen. Warner has long pushed for policy changes to help lower prescription drug costs for Virginia seniors and families. Last year, Sen. Warner re-introduced legislation to allow Medicare to negotiate prescription drug prices—a move that would cut costs for nearly 43 million seniors enrolled in Medicare Part D.

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) announced that he will be inviting a Medicaid recipient and health care advocate from Chesapeake, Va. as his guest to the President’s State of the Union address on Tuesday evening. Terry “Bean” White, who lost his private insurance in 2008 when severe arthritis forced him to give up his job in the Newport News shipyards, is one of nearly 400,000 Virginians who gained coverage under Virginia’s Medicaid expansion and who are in danger of losing their health care coverage if the Trump Administration is successful in its effort to overturn the Affordable Care Act (ACA) in court.

Mr. White, who has congestive heart failure and has been previously treated for prostate cancer, became eligible for coverage after the Commonwealth expanded Medicaid at the beginning of last year – a move that was made possible under the ACA. Prior to that, Mr. White incurred an enormous amount of medical debt and had no choice but to move in with his sister, her daughter, and her two-year-old granddaughter.

“Despite the Trump Administration’s best efforts to dismantle our nation’s health care law, people like Mr. White are proof that Obamacare is working for Americans, and that Medicaid expansion is thriving in Virginia,” said Sen. Warner. “Bean was a hard worker who lost his health insurance through no fault of his own and soon found himself drowning in health care debt – all while struggling to manage his medical conditions. Thankfully, he was able to access coverage after Virginia voted to expand Medicaid under the ACA. But now, under the Republican-backed lawsuit that seeks to wipe out our nation’s health law, hundreds of thousands of Virginians like Bean are at risk of losing the coverage that in many cases keeps them alive and stands between them and bankruptcy. I hope that his presence will serve as a reminder of the potentially devastating consequences if the Trump Administration’s shameful lawsuit succeeds in overturning the health care law Congress passed back in 2010.”

“It is an honor to be invited to the State of the Union and I would like to thank Senator Warner,” said Mr. White. “The senator understands that without the ACA some of us, like myself, wouldn't be here. I am diabetic and recently survived prostate cancer. If it weren’t for Medicaid expansion, I would pay about $7,000 a month in medication costs.”

In December, the Fifth Circuit Court of Appeals struck down the individual mandate as unconstitutional and remanded the Texas vs. United States lawsuit to the lower court, instructing it to rule on which parts of the ACA should be eliminated. If the President’s lawsuit is successful, more than 20 million Americans and nearly 400,000 Virginians could lose their health coverage, with costs going up for millions.

In Virginia, Medicaid expansion made more than 400,000 Virginians like Mr. White eligible for low- or no-cost health care coverage. As of January 2020, more than 375,000 people have actually enrolled in the program. Prior to this expansion, these individuals fell into a “coverage gap” due to incomes that were too high to be eligible for Medicaid, but too low to receive tax credits to purchase affordable coverage in the health care marketplace.

Sen. Warner has been a champion of health care access for all Virginians amid this Administration’s relentless efforts to dismantle our nation’s health care law in Congress and now in court. Last week, Sen. Warner denounced a new plan by the Trump Administration to allow and incentivize states to cut Medicaid funding, thereby undermining Medicaid’s critical financing structure and putting care for vulnerable Americans on the chopping block. Last year, Sen. Warner introduced legislation to allow Virginia, and any other states that expanded Medicaid after the 2014 deadline, to receive the same federal matching funds as states that expanded earlier under the terms of the Affordable Care Act. According to the Virginia Hospital & Healthcare Association, this bill would save Virginia’s hospitals an estimated $300 million per year in the first three years of implementation. Additionally, in October, Sen. Warner forced a Senate vote on a Congressional Review Act (CRA) resolution that would have overturned a Trump Administration waiver rule that destabilizes the nation’s health insurance market and weakens protections for three million Virginians with preexisting conditions.  

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WASHINGTON – A bipartisan bill introduced by U.S. Sens. Mark R. Warner (D-VA) and John Boozman (R-AR) to help address the alarming rate of veteran suicide is one step closer to becoming law. Today, the Senate Veterans Affairs Committee included language from the Senators’ IMPROVE Well-Being for Veterans Act as a provision in a comprehensive bill that expands veterans’ access to mental health services. The legislation unanimously passed the committee and now awaits consideration by the full Senate.

“Our nation’s veterans have faithfully served our country, and they deserve to know that, as they face the invisible wounds of war, we will do everything we can to make sure they receive the help they need. Currently, we are facing an alarming rate of suicide deaths among our veteran population and we’ve got to make tackling this issue a priority. With today’s markup of our bill, we are one step closer to making sure veterans get the services and resources they need,” said Sen. Warner.

“This is a great step in the right direction to getting our veterans the resources, services and care they need. Coordinating and sharing information between the VA and veteran-serving organizations that have the common goal to save lives will have a positive impact,” said Sen. Boozman.

 The IMPROVE Well-Being for Veterans Act creates a new grant program to enable the Department of Veterans Affairs (VA) to conduct additional outreach through veteran-serving non-profits in addition to state and local organizations. Additionally, the bipartisan bill enhances coordination and planning of veteran mental health and suicide prevention services and would better measure the effectiveness of these programs in order to reduce the alarming number of veteran suicides.

The VA estimates that around 20 veterans die by suicide each day. That number has unfortunately remained roughly unchanged despite drastic increases in funding. Over the last ten years, Congress has more than tripled the VA’s funding for suicide prevention efforts to $222 million.

Only six of those 20 veterans were receiving healthcare services from the VA before their death. That’s why Sens. Warner and Boozman are empowering the VA to share information with veteran-serving non-profits and requiring it to develop a tool to monitor progress so that resources can be concentrated on successful programs.

The IMPROVE Well-Being for Veterans Act was introduced in June 2019. Days later, VA Secretary Robert Wilkie called the bill “key” to unlocking the veteran suicide crisis at a committee hearing.

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA) expressed concern with repeated delays by the Drug Enforcement Administration (DEA) that are preventing providers from being able to properly treat their patients via telehealth. In a letter, Sen. Warner urged the DEA Acting Administrator to finalize a long-delayed rule that will ensure providers can successfully use telehealth to treat individuals with substance use disorders.

“Providers across the country have been frustrated in their inability to provide adequate care as they wait for Congressionally-mandated guidance from your agency to clarify the process whereby health care professionals can legally use telehealth to better treat patients suffering from substance use disorder,” wrote Sen. Warner. “The DEA’s failure to promulgate the rule has meant that – despite Congress’ best efforts – many patients suffering from substance use disorders remain unable to access treatment via telehealth. These patients cannot afford to wait and we are concerned the DEA is standing in the way of treatment for individuals that cannot access a provider in person – particularly those in rural and underserved areas.”

“The opioid and addiction epidemic has devastated communities nationwide, with a particularly devastating impact on rural and medically underserved areas,” he continued. “Expanding telehealth services to individuals suffering from substance use disorder can bridge the distance between patients and care and ensure increased access to services they need.”

In order to crack down on the online proliferation of dangerous controlled substances online, the Ryan Haight Act of 2008 prohibited the delivery, distribution, or dispensing of a controlled substance by means of the internet without a prior in-person exam. However, this prevented providers from properly using telehealth to treat individuals – particularly those in rural communities who rely on this service to obtain timely access to health care.

Sen. Warner helped draft and pass the Senate’s comprehensive substance abuse treatment bill, which included a provision directing the Department of Justice, in consultation with the Department of Health and Human Services, to create a process for exempting certain health care providers for the purpose of providing telehealth services for substance use disorder. In addition – that legislation included four other provisions led by Sen. Warner that use telehealth to expand access to treatment for individuals suffering from substance use disorder. The bipartisan legislation was signed into law in 2018; however, the Attorney General failed to finalize a rule by the October 2019 deadline. For provisions of this legislation to be most effective, the DEA must complete its rulemaking process.

In the letter to Acting Administrator Uttam Dhillon, Sen. Warner emphasized the wide disparity in opioid deaths between urban communities and rural communities, which have a 45 percent higher rate of deaths by opioids. Sen. Warner also requested that the DEA provide an explanation if it does not intend to promulgate rulemaking on this issue in a timely manner.

A copy of the letter can be found here and below.

Mr. Uttam Dhillon

Acting Administrator

Drug Enforcement Administration (DEA)

U.S. Department of Justice

800 K Street NW Suite 500

Washington, D.C. 20001

Acting Administrator Dhillon,

I am writing regarding the Drug Enforcement Agency’s (DEA) implementation of critical provisions in the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (Ryan Haight Act) (Public Law 91-513) and the recently passed SUPPORT for Patients and Communities Act (SUPPORT Act) (Public Law 115-271) that ensure individuals with substance use disorders can successfully access medical treatment via telehealth.

As you likely know – the Ryan Haight Act prohibits the delivery, distribution, or dispensing of a controlled substance online without first conducting an in-person exam. The intent of this law is to prevent illegitimate entities from selling dangerous controlled substances online while maintaining the ability for legitimate healthcare providers to treat patients in need.

The Ryan Haight Act also directed the DEA to promulgate rules exempting certain health care professionals from this requirement with the goal of ensuring patients have access to care via telehealth. However, in the 10 years since passage, the DEA has not promulgated rules to this effect. Congress further expressed its intent in passing the SUPPORT Act in 2018, which allows Medicare-eligible individuals suffering from substance use disorder to be diagnosed and treated via telehealth. The SUPPORT Act – similar to the Ryan Haight Act – mandated rulemaking by October 2019. Another deadline that has been missed.

Providers across the country have been frustrated in their inability to provide adequate care as they wait for Congressionally-mandated guidance from your agency to clarify the process whereby health care professionals can legally use telehealth to better treat patients suffering from substance use disorder. The DEA’s failure to promulgate the rule has meant that – despite Congress’ best efforts – many patients suffering from substance use disorders remain unable to access treatment via telehealth. These patients cannot afford to wait and we are concerned the DEA is standing in the way of treatment for individuals that cannot access a provider in person – particularly those in rural and underserved areas.

The opioid and addiction epidemic has devastated communities nationwide, with a particularly devastating impact on rural and medically underserved areas. According to the Centers for Disease Control and Prevention (CDC), there were more than 70,000 overdose deaths in 2017 – a 9.6 percent increase from 2016.   Furthermore, the CDC cites opioid deaths as 45% higher in rural areas, compared to urban communities. 

Expanding telehealth services to individuals suffering from substance use disorder can bridge the distance between patients and care and ensure increased access to services they need.

As detailed above, Congress passed the SUPPORT Act in 2018 and instructed the Attorney General – in consultation with the Department of Health and Human Services (HHS) – to promulgate rules on health care professional exemptions for prescribing controlled substances via telemedicine. This rule will ensure providers can successfully use telehealth to treat patients with substance use disorders. HHS has previously published suggestions on the potential uses of telehealth to diagnose and treat substance use disorder, but until the DEA takes action, providers will continue to face significant barriers in using telehealth to treat patients with substance use disorders. 

I strongly urge the DEA to promulgate rulemaking on this issue as soon as possible so that patients suffering from substance use disorders can receive the care they need. Furthermore, I ask that if you do not intend to promulgate this rule in a timely manner you respond in writing with an explanation of your decision. Thank you for your consideration of this request and I look forward to your response.

Sincerely,

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WASHINGTON – U.S. Sen. Mark R. Warner (D-VA) released the following statement after the Fifth Circuit Court of Appeals ruled the individual mandate of the Affordable Care Act (ACA) unconstitutional, sending the case back to the lower courts:

“Despite the millions of Americans who have gained health care coverage thanks to the Affordable Care Act and the critical protections for individuals with pre-existing conditions, Republicans remain determined to throw out our existing health care system with no viable options to replace it.

“The uncertainty created by this court ruling and the repeated attacks on our nation’s health care laws place essential health care coverage for American families in serious jeopardy. As I have said before – the Trump Administration and Republicans in Congress should be working in a bipartisan fashion to strengthen existing law, not engaging in misguided attempts to take away people’s health care.

“Should Republicans succeed in their campaign of health care sabotage, millions of Americans would be without insurance, have higher costs, and have fewer protections. In light of this ruling – I remain committed to strengthening our health care law and will do everything I can to protect it.”

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WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA) and Tim Scott (R-SC) introduced the Ensuring Seniors Access to Quality Care Act to help senior living facilities caring for aging adults to better screen, hire, and retain quality staff. The Ensuring Seniors Access to Quality Care Act would provide nursing home operators with access to the National Practitioner Data Bank (NPDB) – an existing national criminal background check system – a move that would give employers greater ability to screen and vet potential employees to ensure that caregivers do not have a history that would endanger the seniors under their care.

“Anyone with a loved one in a senior living facility should have the peace of mind of knowing that they are receiving care from compassionate, dependable, and well-qualified staff as they live out their golden years,” said Sen. Warner. “This bipartisan legislation will help provide these facilities with the tools they need to hire experienced staff and to continue to meet the demands of high quality care without losing staffing levels.”

Our senior citizens, and their families, know the importance of having well-qualified, compassionate and trustworthy caregivers in senior living facilities,” said Sen. Scott. “The Ensuring Seniors Access to Quality Care Act will help these facilities more efficiently hire the best candidates, and, in turn, provide better care for seniors everywhere.” 

Currently, senior living facilities are not authorized to use the NPDB and instead must rely on state-level criminal background checks that can often omit key details about an employee’s background.

Additionally, the bipartisan legislation amends overly restrictive regulations that bar certain senior living facilities from conducting training programs for in-house Certified Nurse Assistants (CNAs) – individuals who assist patients with their daily activities – for a two-year period after a care facility is found to have deficiencies, such as poor conditions or patient safety violations. Under existing regulations by the Centers for Medicare and Medicaid Services (CMS), senior living facilities that receive a civil monetary penalty (CMP) over $10,000 are automatically prohibited from conducting CNA staff training programs for a period of two years.

According to the Bureau of Labor and Statistics, the need for nursing assistants to care for the growing aging population is projected to rise 9 percent from 2018 to 2028. With this growing need for caregivers, in-house CNA education at senior living facilities often helps meet the need for CNAs. But with the existing two-year lockout period, it can make it more difficult for senior care facilities to properly train new employees and retrain existing employees. Research by CMS also indicates that there is a direct correlation between facilities that are staffed adequately and the high-quality care they provide.

Specifically, the legislation would allow senior living facilities to reinstate its CNA training program if:

• The facility has corrected the deficiency for which the CMP was assessed;
• The deficiency for which the CMP was assessed did not result in an immediate risk to patient safety and is not the result of patient harm resulting from abuse or neglect;
• And the facility has not received a repeat deficiency related to direct patient harm in the preceding two year period.

“CNAs are essential to the quality care provided in long term care facilities. In addition, the jobs provided by nursing homes and assisted living communities are important to many communities, especially rural areas, where they are often a major employer,” said Mark Parkinson, President and CEO of the American Health Care Association/National Center for Assisted Living. “This bill does two important things. First, it will help ensure that long term care providers have the ability to provide training programs for CNAs. Just as important, it will allow skilled nursing facilities access to the National Practitioner Data Bank, providing a better way to conduct background checks on potential employees. We applaud Senator Warner and Senator Scott for taking this important step to address the worker recruitment and retention challenges facing providers.”

“Workforce development is crucial to our members’ ability to provide top-notch care. The loss of nurse aide training authority is an obstacle to quality improvement for nursing homes, and particularly when increased staffing levels are needed,” said Katie Smith Sloan, President and CEO, LeadingAge. “We have for years advocated for changes to the training lockout mandated under the Nursing Home Reform Act of 1987. This legislation, like similar legislation in the House (H.R. 4468), offers a much-needed solution to help alleviate the severe workforce shortage in long term care. CNAs, who provide direct care to residents, are the backbone of every nursing homes’ team.”

“LeadingAge Virginia applauds Senators Mark Warner and Tim Scott for introducing legislation that will enable training of certified nursing assistants (CNAs). Under federal law, nursing homes are inspected annually and fines are assessed for any deficiencies in compliance with federal regulations. If these fines exceed a certain level, a nursing home automatically loses its authority to train CNAs for two years,” said Melissa Andrews, President and CEO of LeadingAge Virginia. “This ‘CNA Training Lockout’ runs counter to a nursing home’s ability to provide the highest quality of care and we appreciate the Senators for introducing legislation to overcome this barrier.”

“Having started my career in long term care as a nursing assistant, I know how critical they are to providing direct care to thousands of patients and residents every day. Ending the CNA training lockout will have a tremendously positive impact on our ability to train more caregivers to work in our nursing homes,” said David Tucker, Chairman of Virginia Health Care Association – Virginia Center for Assisted Living (VHCA-VCAL) and President and COO of Commonwealth Care of Roanoke.

“Westminster Canterbury Richmond believes that a qualified workforce is crucial for the overall success of a nursing home to provide the highest quality of care. The training lockout is an obstacle to achieving this goal, and we believe this legislation is a positive step forward,” said John Burns, President and CEO of Westminster Canterbury Richmond, and a member of the LeadingAge Virginia Board of Directors.

“At a time where we need more individuals to choose the important and meaningful work of service to older adults throughout this country, limiting the ability to train future generations of care workers is not the answer,” said Rob Liebreich, President and CEO, Goodwin House Incorporated.

“Having access to the National Practitioner Data Bank would be extremely beneficial for us. It would help prevent bad actors from hopping from state to state,” said Melissa Green, Chief Clinical Officer of Trio Health Care, LLC, Hot Springs, VA and a nursing home operator who has facilities close to neighboring states. She cites an incident when it was revealed that an employee had stolen an identity to work as a nurse—without access to the NPDB there was no way to know the actual nurse’s identity was stolen even though the nursing home completed the required background checks.

“Because of the CNA training lockout, we’ve reduced the number of qualified CNAs entering in the workforce, which has had a trickle-down effect on a facility the size of ours,” said Keith Denson, Administrator, Snyder Nursing Home, Inc., Salem, VA. “If we’re not training our people to take care of our unique and wonderful residents, who will do it? Training programs in the community lack the continuity of care and the CNA to resident experience that provider programs offer. I am very appreciative of the trust Sen. Warner has in our ability to train our staff to take care of our residents.”

Sen. Warner has been a longtime advocate of improving long-term care for seniors. In 2000, Sen. Warner’s mother was diagnosed with Alzheimer’s, passing away in 2010 after battling the disease. Her diagnosis and the family’s subsequent struggle to find qualified care and support resources inspired Sen. Warner to launch SeniorNavigator.com, an online information and referral network for older Virginians and their caregivers. In the Senate, Sen. Warner serves as a Co-Chair of the Alzheimer’s Caucus and has helped lead efforts to secure robust funding for Alzheimer’s research, prevention, and treatment. He’s also introduced bipartisan legislation designed to give people with serious illnesses new tools to plan for their care, and empower them to have those choices honored. Sen. Warner has also sponsored legislation that allows seniors with multiple chronic conditions to receive enhanced care in their homes – an effort to decrease hospital readmissions – and expand telehealth services for seniors to increase access to primary care services in rural communities. The Senate unanimously passed this bill in September of 2017, and the bill was signed into law in 2018.

The text of the Ensuring Seniors Access to Quality Care Act is available here.

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WASHINGTON – Today, U.S. Sens. Mark Warner and Tim Kaine (both D-VA) applauded $299,456 in federal funding from the Office of National Drug Control Policy (ONDCP) for Virginia Tech to conduct research on community-based ways to combat the opioid epidemic and facilitate cooperation between law enforcement and public health agencies. The grant was awarded through the ONDCP’s Combating Opioid Overdose through Community-Level Intervention (COOCLI) grant program.

“Communities throughout the Commonwealth and across the country continue to feel the devastating effects of the opioid epidemic, which is why we’re so glad to see this federal funding go towards conducting potentially lifesaving research at Virginia Tech,” said the Senators. “We’re proud to know that with this grant, the Commonwealth will continue to play a vital role in making sure that our nation is better prepared to mitigate this crisis and fight opioid addiction.”

In 2018, the Virginia Department of Health estimated that 1,059 people died in Virginia as a result of a fentanyl, heroin, or prescription opioid overdose. Fatal drug overdoses are now the leading cause of accidental death in the United States, surpassing car accidents and gun violence.

Grants issued under the COOCLI program support efforts to: 1) undertake research activities that entail implementing and evaluating community-based efforts to fight the opioid overdose epidemic; and 2) support and promote the partnership of law enforcement and public health agencies, whose collaboration is critical to reducing overdose and other harms of opioid abuse.

Sens. Warner and Kaine have long advocated for increased federal funding to combat the opioid epidemic in Virginia. Last year, the Senators successfully passed a bipartisan bill to help communities across Virginia by improving opioid treatment and recovery efforts and providing new tools for law enforcement. Additionally, in 2016, Sens. Warner and Kaine successfully advocated for the inclusion of several Virginia counties into the High Intensity Drug Trafficking Area (HIDTA) program.

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA), Vice Chairman of the Senate Intelligence Committee and co-founder of the Senate Cybersecurity Caucus, wrote to the Department of Health and Human Services (HHS) regarding a proposed rule by the Centers for Medicare and Medicaid Services (CMS) that would require CMS-funded health plans (including ACA marketplace plans) to allow patients to access their personal health information electronically through third-party consumer applications. In his letter, Sen. Warner urged HHS to include clear standards and defined controls for accessing patient data in order to address the potential for misuse of these interoperability features.

“In just the last three years, technology providers and policymakers have been unable to anticipate – or preemptively address – the misuse of consumer technology which has had profound impacts across our society and economy. As I have stated repeatedly, third-party data stewardship is a critical component of information security, and a failure to ensure robust requirements and controls are in place is often the cause of the most devastating breaches of sensitive personal information,” wrote Sen. Warner. “It is critical that there are proper safeguards are in place to protect patient privacy and sensitive health information. Moreover, there should be more work done by HHS to facilitate greater access to, and transfer of, electronic health information that does not inadvertently enable dominant IT providers to leverage their control over user data outside of the health care context into nascent markets for personalized health products.”

“Across all sectors – including health care – innovative products and services, increasingly dependent upon machine learning, rely on user data as the single most important productive input to innovation and customization. Importantly, however, any approach must balance innovation and ease of access with privacy, security, and a commitment to robust competition. Further, any effort must ensure that such access redounds to the benefit of patients – and that data, once shared with new providers, is not commercialized in ways that benefit those providers without direct benefits or compensation to users,” he continued. “As CMS and HHS move forward with this needed rule – I urge you to include clear standards and defined controls for all stakeholders that ensure third party software applications accessing patient data through APIs are effectively protecting patient information and that patients are appropriately (and routinely) informed, in clear and particularized ways, how their data is used.”

Under the proposed Interoperability and Patient Access rule, CMS would require Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance Program (CHIP) Fee-for-Service (FFS) programs, Medicaid managed care plans, CHIP managed care entities, and qualified health plans (QHPs) on the federally-facilitated exchanges (FFEs) to allow patients to access their personal health information electronically through open application programing interfaces (APIs). APIs would allow third-party software applications to connect to, process, and make the data available to patients.

In the letter, Sen. Warner emphasized the importance of allowing patients to easily access their health information. He also noted the similarities between the proposed rule and the ACCESS Act – bipartisan legislation introduced by Sen. Warner that would promote market-based competition among social media platforms by requiring the largest social media companies to make user data portable, and their services interoperable, with other platforms. The ACCESS Act would also allow users to designate a trusted third-party service to manage their privacy and account settings, if they so choose. Additionally, Sen. Warner urged that, at a minimum, the final rule include the following standards:

• Patient Access to Data – A guarantee that patients will have ready access to their personal health data and an ability to regularly monitor and ensure the accuracy of such information. Patients should be informed of all commercial uses of their data, including any third parties their data has been shared with (even if it has alleged to have been anonymized). Patients should also have the right to withhold consent for their data to be shared with third parties, or used in new ways without their consent. Patients should also reserve the right to have third party users dispose of their data upon request.
• Adequate Privacy and Security Safeguards – Ensure participating stakeholders can adequately safeguard patient information by using existing best practices for secure storage and complying with applicable breach notification requirements. Moreover, HHS must work with the FTC and state attorneys general to develop mechanisms to report, supervise, and prosecute privacy and security lapses.
• Documentation of the open API specifications and required security controls – Provide clear attestation of the open API specifications as defined for patient data, the security requirements and controls imposed on healthcare providers, and the third-party platform obligations in managing patient data. 
• Patient Consent and Terms of Use – CMS and HHS should work proactively with the patient, provider and payer community to ensure users have informed proactive consent when user data is shared with a third party. In addition – there should be clear protections in place to ensure third party vendors use patient data solely for purposes in which the patient has expressly given informed proactive consent, including cases where patient information may be sold, and that patients retain the right to direct any party that has acquired their data to delete it upon request. Further, those accessing patient data should be prohibited from conditioning continued access on agreement by the patient to share their data with third parties. 

Sen. Warner has been a longtime critic of poor cybersecurity practices that compromise Americans’ personal information. Last week, Sen. Warner raised concern with HSS’ failure to act, following a mass exposure of sensitive medical images and information by health organizations. In September, he wrote to TridentUSA Health Services to inquire about the company’s data security practices, following reports that a company affiliate exposed medical data belonging to millions of Americans. Earlier that month, Sen. Warner demanded answers from U.S. Customs and Border Protection (CBP) and South Korean company Suprema HQ, following separate incidents that affected both entities and exposed the personal, permanently identifiable data of many Americans. Sen. Warner has introduced legislation to empower state and local government to counter cyberattacks, and to increase cybersecurity among public companies.

The letter text can be found below and a PDF is available here.

The Honorable Alex M. Azar II

Department of Health and Human Services

Office of the Secretary

200 Independence Avenue, S.W.

Washington, D.C. 20201

Dear Secretary Azar:

I am writing regarding the proposed rule from the Center for Medicare and Medicaid Services (CMS) on Interoperability and Patient Access that would enable third party consumer applications to access sensitive patient and health plan data through application programming interfaces (APIs) [1]. I share the goals of advancing interoperability in patient health information and believe that – implemented appropriately – this proposal could represent a significant step in that direction. However, I urge CMS to take additional steps to address the potential for misuse of these features in developing the rules around APIs. In just the last three years, technology providers and policymakers have been unable to anticipate – or preemptively address – the misuse of consumer technology which has had profound impacts across our society and economy. As I have stated repeatedly, third-party data stewardship is a critical component of information security, and a failure to ensure robust requirements and controls are in place is often the cause of the most devastating breaches of sensitive personal information.

Congress passed the 21st Century Cures Act (P.L. 114-255) with a key objective of improving the protected exchange of electronic health records across the care continuum. Notably, Section 4003 and 4004 included specific provisions to establish a trusted health information exchange framework and reduce information blocking; it stated that there should be regulation over unreasonable practices to interfere with, prevent, or materially discourage access, exchange, or use of a patient’s electronic health records. While your agency has taken substantial steps to implement fundamental aspects of this legislation, it is critical that there are proper safeguards are in place to protect patient privacy and sensitive health information. Moreover, there should be more work done by HHS to facilitate greater access to, and transfer of, electronic health information that does not inadvertently enable dominant IT providers to leverage their control over user data outside of the health care context into nascent markets for personalized health products.

In your proposed rule CMS would specifically require Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance Program (CHIP) Fee-for-Service (FFS) programs, Medicaid managed care plans, CHIP managed care entities, and qualified health plans (QHPs) on the federally-facilitated exchanges (FFEs) to allow patients to access their personal health information electronically through an open application programming interface (API). Data should be made available through an API so that third party software applications can connect to, process, and make the data available to patients.

I agree that patients should have an ability to easily acquire their health information. The rule is in many ways consistent with bipartisan legislation I have introduced in Congress – the Augmenting Compatibility and Competition by Enabling Service Switching (ACCESS) Act, which requires our nation’s largest social media companies to make user data portable, and make their services interoperable with other platforms.

Common to both my bill and the proposed rule is a recognition that consumers should have a right to possess their data – and share it with authorized third parties that will protect it. Both proposals also seek to address the control over consumer data that incumbents wield, often to the detriment of new, innovative providers. Across all sectors – including health care – innovative products and services, increasingly dependent upon machine learning, rely on user data as the single most important productive input to innovation and customization. Importantly, however, any approach must balance innovation and ease of access with privacy, security, and a commitment to robust competition. Further, any effort must ensure that such access redounds to the benefit of patients – and that data, once shared with new providers, is not commercialized in ways that benefit those providers without direct benefits or compensation to users.

 As CMS and HHS move forward with this needed rule – I urge you to include clear standards and defined controls for all stakeholders that ensure third party software applications accessing patient data through APIs are effectively protecting patient information and that patients are appropriately (and routinely) informed, in clear and particularized ways, how their data is used. Such standards in a final rule should include at a minimum:

• Patient Access to Data – A guarantee that patients will have ready access to their personal health data and an ability to regularly monitor and ensure the accuracy of such information. Patients should be informed of all commercial uses of their data, including any third parties their data has been shared with (even if it has alleged to have been anonymized). Patients should also have the right to withhold consent for their data to be shared with third parties, or used in new ways without their consent. Patients should also reserve the right to have third party users dispose of their data upon request.
• Adequate Privacy and Security Safeguards – Ensure participating stakeholders can adequately safeguard patient information by using existing best practices for secure storage and complying with applicable breach notification requirements. Moreover, HHS must work with the FTC and state attorneys general to develop mechanisms to report, supervise, and prosecute privacy and security lapses.
• Documentation of the open API specifications and required security controls – Provide clear attestation of the open API specifications as defined for patient data, the security requirements and controls imposed on healthcare providers, and the third-party platform obligations in managing patient data. 
• Patient Consent and Terms of Use – CMS and HHS should work proactively with the patient, provider and payer community to ensure users have informed proactive consent when user data is shared with a third party. In addition – there should be clear protections in place to ensure third party vendors use patient data solely for purposes in which the patient has expressly given informed proactive consent, including cases where patient information may be sold, and that patients retain the right to direct any party that has acquired their data to delete it upon request. Further, those accessing patient data should be prohibited from conditioning continued access on agreement by the patient to share their data with third parties. 

Thank you for your consideration your commitment to advancing interoperability to improve patient care. I believe the outline I have shared would strengthen and ensure the rule achieves its intended purpose.  It is my hope and belief that we can achieve both a higher level of interoperability and patient access to their data, as well as, strong protections for that information. I look forward to continued work with you on this important issue and our shared goals.

Sincerely,

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WASHINGTON — Today, U.S. Sen. Mark R. Warner (D-VA) met with David Collins, the new Director of the Hampton VA Medical Center, at Sen. Warner’s office in Washington, D.C.

In the meeting, Sen. Warner and Director Collins discussed staffing challenges and shortages at the Hampton VA Medical Center and how these factors may have contributed to the problems raised last month by an Inspector General report related to managing and tracking supplies. Additionally, they spoke about suicide prevention efforts and strategies for reducing wait times for medical services, including primary care and mental health care. During the meeting, Sen. Warner also reiterated his commitment to increasing access for one of the fastest growing veterans populations in the nation and pushing for the completion of a new VA Community Based Outpatient Clinic in South Hampton Roads.

“Our veterans have sacrificed so much for the nation – the least we can do is to make sure they get top-notch medical care once they are back home,” said Sen. Warner. “I am committed to working with Director Collins to help mitigate the challenges at Hampton VA Medical Center. But the VA also needs more capacity in the Hampton region to meet the growing demands of our veteran population. While we may have cleared the last Congressional hurdle for approving the new clinic lease prospectus in South Hampton Roads, our work is not done until this clinic is fully-functional and serving our veterans.”

Sen. Warner has been a longtime advocate of improving care for veterans in the Commonwealth. In 2017, he successfully pushed for Congress to approve overdue medical leases on 28 major Veteran’s Affairs (VA) facilities, including one in Hampton Roads, which is projected to ease the workload at the Hampton VA Medical Center, and another in Fredericksburg. Since then, Sen. Warner has pushed to get these facilities up and running by pressuring the GSA and the VA to move these projects forward, pushing the Office of Management and Budget (OMB) to sign off on these clinics’ lease prospectuses, and successfully urging the Senate Committee on Environment and Public Works (EPW) to bring up the prospectuses for approval.

Sen. Warner has also long fought to reduce wait times for veterans in Hampton Roads. In 2015, confronted with wait times that were three times the national average, Sen. Warner successfully urged the VA to send down a team of experts to try to address the problem. He also succeeded in getting the Northern Virginia Technology Council to issue a free report, detailing how to reduce wait times.

Director Collins, who was appointed director of the Hampton VA Medical Center in August of 2019, is a 28-year Veteran of the Navy Medical Service Corps, whose recent appointments include service as the Executive Assistant to the Navy Surgeon General, Commanding Officer of the Jacksonville Naval Hospital, and Chief Operating Officer of the Naval Hospital in Bremerton, Washington. He also spent time as the Executive Officer for NATO’s Multinational Medical Unit in Afghanistan, demonstrating an ability to relate to other military Veterans with a similar background. He is a current resident of the Hampton and Chesapeake Community.

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