Capitol Hill Visits Produce Results, Affirm Commitments
Seven members of the House of Representatives signed on as cosponsors of the Pharmacy and Medically Underserved Areas Enhancement Act during or after ASHP’s September 16 Legislative Day campaign on Capitol Hill, according to Congress.gov.
The total number of cosponsors of the legislation, also known as H.R. 592, was 203 this morning.
Among the 101 ASHP members who visited the Washington, D.C., offices of federal lawmakers on Legislative Day were 9 who were not participants in ASHP’s policy-recommending meetings and came on their own initiative.
Scott Knoer, chief pharmacy officer at Cleveland Clinic, said his trip's top goal was to speak about H.R. 592 with two legislators whom he had identified as likely cosponsors: Ohio’s Robert E. Latta and Florida's Debbie Wasserman Schultz, whose district is the site of Cleveland Clinic Florida—Weston.
Knoer said he had initially approached Wasserman Schultz about the bill in August, when he had wrangled a seat at his employer's table for the speech the congresswoman gave at the City Club of Cleveland.
Wasserman Schultz, chair of the Democratic National Committee, was in town for the first Republican presidential debate.
“I hit her up there for the first time about provider status,” Knoer said.
He then had the same Cleveland Clinic government relations person who arranged his City Club seat make an appointment with Wasserman Schultz’s D.C. office for September 16.
Unbeknownst to Knoer, a group of ASHP members from Florida had the appointment slot before him.
Soon into his conversation with the congresswoman’s aide, she told him that the people who had just left the office were pharmacists who spoke about the bill.
Knoer said he took advantage of the Florida pharmacists laying the groundwork and jumped to the “meat” of his message.
“One of the things I said is, ‘I would assume, based on what I know of the congresswoman, that this [bill] would be something that she would probably be interested in to help expand access” to healthcare services for her medically underserved constituents.
The aide agreed with him, he said.
And the next morning, he received an e-mail informing him that the congresswoman had signed on as a cosponsor.
James A. Trovato of Baltimore had a similarly successful meeting with a legislator’s aide.
The University of Maryland associate professor and oncology specialist said he drove 45 minutes to D.C. for the day because he’s “passionate about provider status” and believes the current legislation has a real chance of being passed by Congress.
At Representative C.A. Dutch Ruppersberger’s office, as at the other legislators' offices Trovato visited, the discussion centered on the Pharmacy and Medically Underserved Areas Enhancement Act, he said.
Trovato was part of a group that met with Walter Gonzales, Ruppersberger’s deputy chief of staff.
“The first thing out of the staffer's mouth was, ‘How come were not on that bill? Well, we'll put him on the bill today.’”
And they did. Ruppersberger is among the three legislators who signed on as cosponsors on Wednesday.
Trovato said he suspects that the pharmacists presence in Ruppersberger's office served as a reminder for the staff to take the action necessary for the congressman to cosponsor the bill.
Tom Johnson, assistant vice president of hospital pharmacy for South Dakota–based Avera Health, said he had a positive feeling after talking with Senator John Thune and two legislative aides.
By attending the South Dakota Sunrise Coffee, a somewhat-regular Wednesday constituent event, Johnson said he had the opportunity to personally thank Senator Mike Rounds for cosponsoring S. 314, the companion bill to H.R. 592, and also speak with Thune and his aides.
“They told me that their health policy fellow is currently writing a memo for the senator to review,” Johnson said. “So I'm hopeful that they'll take a look at it and let me know what his vote would be on Senate bill 314.”
Rounds and Representative Kristi Noem—two thirds of South Dakota's congressional contingent—are already cosponsors of the Pharmacy and Medically Underserved Areas Enhancement Act.
Johnson made the trip to D.C., he said, partly because of the importance of maintaining a physical presence.
"It's always good to continue to build good relationships, and it's good to ensure that you're top of mind," he said. "Just because they've signed on doesn't mean that it's an absolute lock. Other people may have other opinions. You want to make sure that they understand that you're a resource that can be helpful to them as we go through the legislative process."
Like Trovato, pharmacy director Casey Dugan came to D.C. because he believes the act has better momentum than previous bills on provider status for pharmacists.
Dugan, with Children's Hospital Colorado, in Aurora, said staffers for Senator Michael F. Bennet and Representative Diana DeGette had a misconception about the legislation's effect on pharmacists' scope of practice.
At both congressional offices, Dugan said, he and ASHP Federal Regulatory Affairs Director Christopher Topoleski explained that the legislation does not expand pharmacists' scope of practice, which remains a state-determined issue.
This misconception, along with the misperception that the legislation would take away responsibilities from physicians, also arose during the Maryland pharmacists' meeting in the office of Representative John P. Sarbanes, Trovato said.
Trovato said he emphasized the legislation's application to medically underserved areas and detailed his experience in a community-based oncology practice where some patients don't have a primary care physician. He explained that pharmacists are well equipped to "step up and take care of these patients."
Dugan started his visits at a constituent coffee with Senator Cory Gardner.
“I got a chance to thank him for his support on cosponsoring S. 314,” Dugan said.
And then, when they finished talking, Dugan said, Gardner's legislative assistant on health issues, Alison Toal, invited him to meet with her for 30 minutes later in the morning.
"Since Senator Gardner was already a cosponsor of the bill, she just wanted to pick my brain on other items," Dugan said.
Those other issues, he said, were the 340B Drug Pricing Program, sterile compounding, and drug shortages.
“At that point, I made clear that I'm speaking on my behalf, as a representative of Children’s Hospital, and not necessarily for ASHP, because the questions were more aligned that way,” he said.
Dugan said he explained how the 340B program enables his hospital, which Toal had toured two weeks earlier, to expand its care to indigent pediatric populations in the facility's seven-state region.
The 340B program was also on the minds of Thune and a health staffer in Noem's office, Johnson said.
Avera Health participates in the program, he said, and is reviewing the “mega-guidance” recently proposed by the Health Resources and Services Administration.
Thune and Noem’s office, Johnson said, asked to be copied on Avera Health's comments regarding the omnibus guidance so that the legislators understand "where our health system is coming from."
Also in D.C. solely to visit their legislators’ offices on Wednesday were Deborah Brown of Florida, Michael Goldenhorn of Maryland, John Hertig of Indiana, Felicity Homsted of Maine, and Kristine Willett of New Hampshire.