5/28/2002, Government Affairs Update - Almanac, Vol. 48, No. 35

Government Affairs Update

Federal Relations | Commonwealth Relations | City & Community Relations

Federal Relations

New Border Security Legislation

On May 14, President Bush signed into law the Enhanced Border Security and Visa Entry Reform Act of 2002, which contains several provisions that are relevant to higher education. The new law requires student visa applicants to provide additional information on their applications including the names and addresses of spouse, children, parents, and siblings; contacts within the country of residence who can verify personal information; and previous work history.

The measure requires the State Department and Immigration and Naturalization Service (INS) to notify institutions when students have been issued visas, and when these individuals enter the United States. Institutions will be required to notify INS within 30 days if a student visa holder fails to enroll. The Department of Education will also be required to conduct regular reviews of institutions certified to receive foreign students, to ensure that the institutions are in compliance with recordkeeping and reporting requirements.

Much of the compliance with this law will be dependent on the Student and Exchange Visitor Information System (SEVIS), which INS expects to be operational this fall. SEVIS is a nationwide electronic tracking system for foreign students. The INS recently published implementation regulations for SEVIS, which require that all higher education institutions use the system by January 2003.

Sensitive Areas of Study

Bush Administration officials recently announced plans to implement a Presidential Directive related to access by international students to education and training in "sensitive areas of study." The stated objective is to create a system that balances scientific freedom and progress with national security.

The plan focuses on creation of a new governmental entity to provide an additional level of review for all student visas and visas for postdoctoral students and researchers. The new mechanism will be called Interagency Panel on Advancing Science and Security (IPASS).

Visa applications will be flagged for IPASS review if certain criteria are met during the regular review process. These criterion include: being citizens of countries that are determined as suspicious or dangerous, having past training in certain scientific areas, and applying for study in areas that are "sensitive" and "uniquely available in the United States." The Administration has not yet determined which countries will raise red flags, and has not yet defined which areas of study will be identified as "sensitive."

After IPASS has completed its review of visa applicants, the findings and recommendations will be forwarded to either the INS or the State Department, depending on the circumstances, for further action. IPASS is expected to review about 2,000 applications per year. There is no timetable for implementation of IPASS.

IPASS will, under certain circumstances, review current visa holders under the same procedures. This review will occur when students apply for a change in status, or if irregularities or concerns are brought to light through the Student Exchange Visitor Information System (SEVIS) electronic tracking system for foreign students. The parameters will be slightly different for graduate and undergraduate study.

Changes in Student Visa Processing

Over the past months, the Department of State has implemented new policies that affect the processing of student visas. Please keep these in mind for students for the coming academic year.

Rats, Mice, and Birds

The farm bill signed by President Bush on May 13 permanently excludes rats, mice, and birds from oversight under the Animal Welfare Act (AWA). This development is a victory for the research community, which has fought back efforts to include rats, mice, and birds under the AWA that resulted from a lawsuit against the United States Department of Agriculture (USDA). This provision will retain the 30-year policy of excluding rats, mice and birds from USDA regulation and will prevent the implementation of additional, burdensome paperwork requirements at our nation's biomedical research facilities. The cost of this inclusion was expected to exceed $100 million per year.

Bioterrorism Legislation

Before adjourning for Memorial Day recess, Congress approved bioterrorism legislation that would give universities more responsibility for guarding biological agents used in research. This legislation is intended to address tracking of individuals who are working with potentially dangerous biological materials.

The new bioterrorism bill requires that every university and laboratory working with biological material that could be used to pose a public health threat--"select agents"--would be required to register with the U.S. Department of Health and Human Services (HHS) or the U.S. Department of Agriculture (USDA). Under current law, only laboratories that send or receive "select agents" must register. In addition, the legislation would impose new steps designed to limit access to 42 biological agents including anthrax, the Ebola virus, and smallpox.

The bill would prohibit scientists from countries that are considered state sponsors of terrorism (including Iraq and Iran) and any individuals with criminal records from handling "select agents." It would also implement a government-run screening process for all scientists handling "select agents." However, the legislation specifically states that any researchers who are in the midst of a project will be permitted to continue their work while the government performs its background checks. For new hires, individuals will not be able to begin work until the background screening is complete.

The background check process will work as follows: universities will submit names of researchers studying "select agents" to the Department of Health and Human Services. Names of individuals doing research on plant and animal pathogens will be submitted to the Department of Agriculture. The U.S. Attorney General's Office will then conduct the necessary background checks.

The legislation includes an appeal process if the government denies approval to a researcher. It also has a provision that would allow scientists to work on "select agents" without being screened in the case of an emergency.

The measure represents a compromise between earlier versions that had passed the House and the Senate. President Bush is expected to sign the bill shortly. Thereafter, HHS and the USDA will publish for comment the implementing regulations. The higher education community will work closely with these departments on the implementation process. We will keep the University community apprised of the details as soon as they are available.

For further information pertaining to these or other federal relations issues, please contact Melissa Peerless at peerless@pobox.upenn.edu or (215) 898-1532.

Federal Relations | Commonwealth Relations | City & Community Relations

Commonwealth Relations

Medical Liability Reform

On March 14, House Bill 1802 -- Medical Liability Reform was passed by unanimous vote in the Senate and with only one negative vote in the House. The final bill was an amended version of the reform bill approved by the House and sent to the Senate on February 13. The bill was subsequently signed into law by the Governor on March 20 as Act 13 of 2002.

HB 1802 incorporates a number of limited tort reform measures. A new provision bars causes of action seven years from the occurrence of the event, with exceptions for minors and certain other circumstances. There are new expert witness qualification requirements. The collateral source rule that had prevented offsets to damages for medical expense and lost earning recoveries by plaintiffs from third parties has been eliminated. There are now periodic payments for future medical expenses over $100,000. There is a new requirement that trial courts must consider motions challenging a verdict as excessive to evaluate its impact on availability or access to health care in the community. The ostensible agency rule has been modified setting a higher standard when hospitals can be held responsible for the acts of non-employed physicians. Finally, HB 1802 creates a committee to study jurisdiction/change of venue issues with recommendations to be made by September 2002.

HB 1802 also contains a number of measures relating to the Medical Professional Liability Catastrophe Loss (CAT) Fund. The Fund is transferred to the Insurance Department and the Department is required to contract with a third party administrator to manage settlement of the remaining cases. There is a reduction in Fund coverage from $700,000 to $500,000 effective January 1, 2003 with a reduction in provider coverage to $1 million per occurrence/$3 million aggregate ($4 million for hospitals). The Fund will be phased out over the next seven years with changes to the levels of primary coverage physicians will have to obtain increasing to $1 million effective January 1, 2009. The Insurance Commissioner can suspend the phase-out if there is not available medical liability coverage in the commercial market. Experience ratings will be used for providers to increase the relative level of surcharges for providers with multiple paid claims from the Fund. The Fund surcharge is capped, in the aggregate, at 95% of the 2001 surcharge for 2002 and at 90% for 2003 and 2004. Starting in 2004 and continuing for 10 years, $37 million from the Auto CAT Fund will be used to reduce Fund liabilities, reducing the level of the surcharge. The Auto CAT Fund dollars will be allocated in a manner such that 50% will be used to reduce surcharges for hospitals and at-risk specialists (surgeons, obstetricians, etc.) with the result that the surcharge reduction for those "at risk" providers will be significantly more than for all other providers.

There are new professional board reporting requirements relating to complaints and disciplinary actions against physicians, midwives and podiatrists, including mandatory reports from the CAT Fund on any providers with more than three paid claims from the Fund. There will be increased fines for professional practice act violations as well as new continuing education requirements for providers.

HB 1802 establishes a new 11-member Patient Safety Authority appointed by the Governor and the Legislature and chaired by the Physician General to be funded by facility license surcharges (up to $5 million in total expenses). The legislation requires reporting to the Authority by hospitals, birthing centers and ambulatory care facilities (ACFs) of serious events (occurrences that are undesirable and result in death or injury that require additional medical care) and incidents (occurrences that are undesirable that could have resulted in injury). HB 1802 permits anonymous reports to be made to the Authority and for the Authority to investigate reports if not satisfied with the report from the providers. A medical facility can be fined up to $1,000 per day for failure to report. Hospitals, birthing centers and ASFs are required to develop patient safety plans (to be approved by the Department of Health) for the purpose of improving "the health and safety" of patients and the bill requires the establishment of a patient safety committee and the appointment of a patient safety officer. Of great import to providers, HB 1802 protects the confidentiality of information generated to comply with the new patient safety requirements, except original source documents (e.g., medical records). Also, HB 1802 requires the Insurance Department to establish a patient safety discount for those providers that adopt measures that reduce medical errors and improve patient safety.

The University of Pennsylvania Health System, along with other providers in the Commonwealth, continue to experience extraordinarily high medical liability costs. Some private practice physicians, especially in certain subspecialties, have not been able to obtain commercial coverage at any price. It remains to be seen whether HB 1802 will have any significant immediate or long-term effect on the cost of medical professional liability coverage or access to that coverage. The Health System and the University will continue to work as an institution and through various advocacy coalitions to address unresolved medical malpractice issues and the overall health care delivery system and economic stability of hospitals and health systems.

Federal Relations | Commonwealth Relations | City & Community Relations

City and Community Relations

Walnut West Library

The first phase of the City of Philadelphia's $3 million Walnut West Library renovation project is currently underway. The building design restores the original 40th Street entrance as well as the skylights, and provides a modern, state-of-the-art public library facility for West Philadelphia. Throughout the summer, the demolition phase of the project will move forward, allowing for the removal of materials from the interior of the building. By mid-August, the building will be secured while the design is finalized. The one-year construction phase is scheduled to begin in December 2002. Councilwoman Jannie Blackwell, the Friends of the Walnut West Library, and the University City Historical Society, who worked passionately to champion this project, expect the renovated facility to reopen in early 2004.

Drawings are on display at the library branch at 3927 Walnut Street. Please note that the Friends of Walnut West Library will now hold their Friday afternoon book sales on the lawn between DuBois House and the library building while construction activity is underway.

City Year Day of Service

The culminating event of City Year's week-long convention, Cyzygy '02, (see details in this issue) will be a high-impact day of community service to be run at nine different schools and day care centers throughout West Philadelphia. The "City Year Day of Service", on Saturday, June 8, will tap the power of the entire City Year national network to revitalize communities through projects at the following schools: Lea Elementary, West Philadelphia High, The Penn-Assisted School, Parent-Infant Center, University City High, Drew Elementary, The Walnut Center, Powel Elementary, and McMichael Elementary. The projects were designed in partnership with principals, students and other community organizations at each of these locations. It is estimated that these efforts will impact the lives of over 7,000 children.

City Year is looking to engage members of the West Philadelphia community in working with its "corps members" during planned service activities. These activities include: