Integrative efforts on Capitol Hill push inclusion in COVID-19 policy
My work in integrative health has spanned 40 years beginning in the 1970s when “alternative medicine” was the only terminology available. Like many integrative practitioners, my professional and personal identity has been largely focused on being a healer and I believed that identity was incompatible with the less savory world of politics and healthcare policy. My commitment to practicing integrative healing, in an often-hostile professional environment, felt like my best contribution to be an agent of systemic change.
Over time, I began questioning my own dogma and felt the need to find broader platforms to bring about change and began piloting interprofessional team-based integrative health models focused on demonstrating improved health outcomes and cost savings. Now, after four decades, I concede that change has been too slow.
The final straw for me came last year after our eight-year integrative pilot program ran out of money. I resolved that, to effect faster change, my identity needed to embrace policy and politics, too. Now, more than ever, I’m hoping you as practitioners will consider doing the same.
Paradoxically, amid the biggest worldwide health crisis in our lifetimes, we have a window of opportunity to affect healthcare policy in accelerated ways that weren’t possible even a month ago. Legislators’ eyes and ears are suddenly open to their constituents in ways they weren’t under “normal” circumstances. Barriers to change in healthcare, that might have taken years, have shifted overnight, as with, for example, telehealth.
Our integrative health footprint is not a small one in the overall healthcare landscape. The conventional landscape is one that has preferentially favored acute, invasive, high-tech, reactive care over preventing chronic disease, lifestyle change, health creation, resilience, and wellness. The current systems’ deficiencies are being spotlighted, and our opportunity to establish a legitimate place in the emergency relief legislation is here. Establishing a seat at the table now allows for additional dialogue and opportunity later.
The Integrative Health Policy Consortium (IHPC), a nonprofit organization aimed at eliminating barriers to integrative, patient-centered care, has urgently mobilized its collective policy expertise to address the immediate needs of the integrative health community brought on by the novel coronavirus (COVID-19) pandemic. Many of integrative medicine professions were left out of the initial healthcare relief legislation. Longstanding inequities and discrimination in reimbursement and recognition by insurance plans became glaring, but with crisis comes opportunity.
In response, the IHPC’s Capitol Outreach team, led by Tracy Bowen, executive director of the IHPC, prepared several COVID-19 related letters to the House and Senate leadership addressing these inequities and omissions. The integrative healthcare community needs to make its voice heard, cement our presence in the legislation, and highlight our value both as separate healing disciplines and collectively as an industry. Consider the IHPC alone represents 26 organizations and more than 650,000 state licensed or nationally certified healthcare professionals and academic, research, clinical, and public education organizations who help generate annually nearly $27 billion in the United States economy.
Below are excerpts from the IHPC’s letters to both the House and Senate leadership, which can be found in full on the IHPC website:
IHPC’S Request Letter COVID-19 Stimulus 4
Dear Speaker Pelosi and Minority Leader McCarthy,
…We are pleased you intend to introduce a fourth COVID-19 economic relief package that will focus on meeting the needs of health care professionals. Despite the ambitious reach of the CARES Act, its provisions could be strengthened by including thousands of integrative health professionals and their patients, who are being adversely affected by the COVID-19 pandemic. Many integrative professionals are treating patients during this public health crisis; however, their practices have been devastated by the crisis, rendering them unable to deliver necessary care and services and support their livelihoods.
As you and your colleagues craft a fourth COVID-19 relief package, we respectfully ask that you consider including the following provisions to address the immediate needs of integrative health care professionals.
Provide direct economic relief to all state-licensed and/or nationally certified Integrative Health Care providers, their small businesses, students and Institutions.
Insert “state-licensed and/or nationally certified” when referring to “Health Care Professionals” in all sections of Stimulus or Recovery Acts. Without this phrase many integrative health providers are not included.
Allocate $500 million in micro-grant support for the integrative health professionals who are state-licensed and/or nationally certified providers of integrative and whole person health care services to ensure these providers remain part of the workforce during this national emergency.
Include any integrative health professional associations, nonprofits and other tax-exempt organizations, and their workers for support within any federal aid packages or supplemental appropriations measures, as many have been and will be harmed by event cancellations due to quarantining, social distancing and other public health measures.
Expand HRSA’s National Health Service Corps to include integrative health professionals who are state licensed and/or nationally certified providers.
Expand Medicare coverage through CMS for all integrative health providers who are state-licensed and/or nationally certified. Currently most of our providers are not included.
Expand telehealth coverage for services by all integrative health providers who are state-licensed and/or nationally certified.
Allocate immune/respiratory research support of $20 million be directed at the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (and other institutes and centers, including NIA, NHLBI, and NCI) and of $20 million be directed to the Department of Defense, Defense Threat Reduction Agency (DTRA).
COVID-19 Phase 3.5 Stimulus (submitted)
Dear Majority Leader McConnell, Minority Leader Schumer, Speaker Pelosi, and Minority Leader McCarthy,
“…Our members have been adversely affected by the extreme economic fallout instigated by the COVID-19 pandemic. The Paycheck Protection Program (PPP) created by the CARES legislation is benefitting our members. However, they are experiencing delays and are concerned about its future liquidity. We endorse your efforts to boost funding for this program as well as to expand funding for hospitals and, hopefully, other health care providers, immediately. In previous communications (IHPC Stimulus #4 letter) and in coordination with members of the House Integrative Health and Wellness Caucus, we have expressed our community’s needs. Respectfully, we urge you to consider our requests as you work on the current and future COVID relief packages. We simply ask that every health care profession be treated equally in all of the COVID-19 response and recovery programs, from PPP to student loan forgiveness, to telehealth and Medicare, to small business loans.”
The above letters are valuable but, not effective unless your voices as practitioners, your emails, your letters, and your phone calls to your state representatives multiply that impact exponentially as voting constituents of your districts. Below is part of an action alert for you to use in your district with your representative:
Dear Representative _____,
I am your constituent and an integrative health care professional who practices [insert name of profession] in your district. While I am pleased that Congress and the Administration worked together to enact the Coronavirus Aid, Relief and Economic Security (CARES) Act (P.L. 116-136), the bill did NOT address many of the unmet needs of the integrative health care community.
On April 2, the Integrative Health Policy Consortium (www.ihpc.org) sent Speaker Pelosi this letter outlining five proposed recommendations that would help health care professionals, such as myself, recover from the devastating economic fallout caused by the current pandemic and improve our ability to deliver effective, immediate care to our patients.
I urge you to contact Speaker of the House Nancy Pelosi and House Minority Leader Kevin McCarthy and ask that the following provisions be included in the next coronavirus relief package:
Provide direct economic relief to all state-licensed and/or nationally certified Integrative Health Care providers, their small businesses, students and Institutions by using the inclusive term “state-licensed and/or nationally certified” when referring to “Health Care Professionals” in all sections of stimulus or recovery acts.
Expand HRSA’s National Health Service Corps to include integrative health professionals who are state licensed and/or nationally certified providers.
Expand Medicare coverage through CMS for all integrative health providers who are state-licensed and/or nationally certified.
Expand telehealth coverage for services by all integrative health providers who are state-licensed and/or nationally certified.
Provide $20 million in support of immune/respiratory research through the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health and $20 million for similar research at the Department of Defense, Defense Threat Reduction Agency (DTRA).
Thank you for considering my request and for your leadership during this challenging time in our nation’s history. Please do not hesitate to contact me if I can be of assistance to you and your staff.
Sincerely,
Name
Title
Contact information (email and phone)
The interdependence of all our citizen’s collective health and wellness is palpable. We cannot ignore the impact of social determinants of health and the need for a proactive, health-focused, approach to population health and wellness during the COVID-19 crisis. There is no better time to build on the existing infrastructure to make the shift from the artificial distinction between integrative health and comprehensive healthcare. Federal agencies like the U.S. Department of Veterans Affairs are already leading the way with their whole-health programs. We hope you will join the IHPC and integrative healthcare community by adding your voice.
Editor’s note: David Fogel, MD is the chief executive officer and co-founder of CHI Health Care and and at-large board of director and co-chair of the Policy Committee for the IHPC. This article is sponsored by the IHPC.
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