[House Report 117-213]
[From the U.S. Government Publishing Office]
117th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 117-213
======================================================================
DR. LORNA BREEN HEALTH CARE PROVIDER PROTECTION ACT
_______
December 8, 2021.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Pallone, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 1667]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 1667) to address behavioral health and well-
being among health care professionals, having considered the
same, reports favorably thereon with an amendment and
recommends that the bill as amended do pass.
CONTENTS
Page
I. Purpose and Summary..............................................3
II. Background and Need for the Legislation..........................4
III. Committee Hearings...............................................5
IV. Committee Consideration..........................................5
V. Committee Votes..................................................5
VI. Oversight Findings...............................................6
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures6
VIII.Federal Mandates Statement.......................................6
IX. Statement of General Performance Goals and Objectives............6
X. Duplication of Federal Programs..................................6
XI. Committee Cost Estimate..........................................6
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits......6
XIII.Advisory Committee Statement.....................................7
XIV. Applicability to Legislative Branch..............................7
XV. Section-by-Section Analysis of the Legislation...................7
XVI. Changes in Existing Law Made by the Bill, as Reported............9
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Dr. Lorna Breen Health Care Provider
Protection Act''.
SEC. 2. DISSEMINATION OF BEST PRACTICES.
Not later than 2 years after the date of the enactment of this Act,
the Secretary of Health and Human Services (referred to in this Act as
the ``Secretary'') shall identify and disseminate evidence-based or
evidence-informed best practices for preventing suicide and improving
mental health and resiliency among health care professionals, and for
training health care professionals in appropriate strategies to promote
their mental health. Such best practices shall include recommendations
related to preventing suicide and improving mental health and
resiliency among health care professionals.
SEC. 3. EDUCATION AND AWARENESS INITIATIVE ENCOURAGING USE OF MENTAL
HEALTH AND SUBSTANCE USE DISORDER SERVICES BY
HEALTH CARE PROFESSIONALS.
(a) In General.--The Secretary, in consultation with relevant
stakeholders, including medical professional associations, shall
establish a national evidence-based or evidence-informed education and
awareness initiative--
(1) to encourage health care professionals to seek support
and care for their mental health or substance use concerns, to
help such professionals identify risk factors associated with
suicide and mental health conditions, and to help such
professionals learn how best to respond to such risks, with the
goal of preventing suicide, mental health conditions, and
substance use disorders; and
(2) to address stigma associated with seeking mental health
and substance use disorder services.
(b) Reporting.--Not later than 2 years after the date of enactment of
this Act, the Secretary shall provide to the Committee on Health,
Education, Labor, and Pensions of the Senate and the Committee on
Energy and Commerce of the House of Representatives an update on the
activities and outcomes of the initiative under subsection (a),
including a description of quantitative and qualitative metrics used to
evaluate such activities and outcomes.
(c) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $10,000,000 for each of fiscal
years 2022 through 2024.
SEC. 4. PROGRAMS TO PROMOTE MENTAL HEALTH AMONG THE HEALTH PROFESSIONAL
WORKFORCE.
Subpart I of part E of title VII of the Public Health Service Act (42
U.S.C.. 294n et seq.) is amended by adding at the end the following:
``SEC. 764. PROGRAMS TO PROMOTE MENTAL HEALTH AMONG THE HEALTH
PROFESSIONAL WORKFORCE.
``(a) Programs to Promote Mental Health Among Health Care
Professionals.--
``(1) In general.--The Secretary shall award grants or
contracts to health care entities, including entities that
provide health care services, such as hospitals, community
health centers, and rural health clinics, or to medical
professional associations, to establish or enhance evidence-
based or evidence-informed programs dedicated to improving
mental health and resiliency for health care professionals.
``(2) Use of funds.--An eligible entity receiving a grant or
contract under this subsection shall use funds received through
the grant or contract to implement a new program or enhance an
existing program to promote mental health among health care
professionals, which may include--
``(A) improving awareness among health care
professionals about risk factors for, and signs of,
suicide and mental health or substance use disorders,
in accordance with evidence-based or evidence-informed
practices;
``(B) establishing new, or enhancing existing,
evidence-based or evidence-informed programs for
preventing suicide and improving mental health and
resiliency among health care professionals;
``(C) establishing new, or enhancing existing, peer-
support programs among health care professionals; or
``(D) providing mental health care, follow-up
services and care, or referral for such services and
care, as appropriate.
``(3) Priority.--In awarding grants and contracts under this
subsection, the Secretary shall give priority to eligible
entities in health professional shortage areas or rural areas.
``(b) Training Grants.--The Secretary may establish a program to
award grants to health professions schools, academic health centers,
State or local governments, Indian Tribes or Tribal organizations, or
other appropriate public or private nonprofit entities (or consortia of
entities, including entities promoting multidisciplinary approaches) to
support the training of health care students, residents, or health care
professionals in evidence-based or evidence-informed strategies to
address mental and substance use disorders and improve mental health
and resiliency among health care professionals.
``(c) Grant Terms.--A grant or contract awarded under subsection (a)
or (b) shall be for a period of 3 years.
``(d) Application Submission.--An entity seeking a grant or contract
under subsection (a) or (b) shall submit an application to the
Secretary at such time, in such manner, and accompanied by such
information as the Secretary may require.
``(e) Reporting.--An entity awarded a grant or contract under
subsection (a) or (b) shall periodically submit to the Secretary a
report evaluating the activities supported by the grant or contract.
``(f) Authorization of Appropriations.--To carry out this section and
section 5 of the Dr. Lorna Breen Health Care Provider Protection Act,
there are authorized to be appropriated $35,000,000 for each of fiscal
years 2022 through 2024.''.
SEC. 5. REVIEW WITH RESPECT TO HEALTH CARE PROFESSIONAL MENTAL HEALTH
AND RESILIENCY.
(a) In General.--Not later than 3 years after the date of enactment
of this Act, the Secretary, in consultation with relevant stakeholders,
shall--
(1) conduct a review on improving health care professional
mental health and the outcomes of programs authorized under
this Act; and
(2) submit a report to the Congress on the results of such
review.
(b) Considerations.--The review under subsection (a) shall take into
account--
(1) the prevalence and severity of mental health conditions
among health professionals, and factors that contribute to
those mental health conditions;
(2) barriers to seeking and accessing mental health care for
health care professionals, which may include consideration of
stigma and licensing concerns, and actions taken by State
licensing boards, schools for health professionals, health care
professional training associations, hospital associations, or
other organizations, as appropriate, to address such barriers;
(3) the impact of the COVID-19 public health emergency on the
mental health of health care professionals and lessons learned
for future public health emergencies;
(4) factors that promote mental health and resiliency among
health care professionals, including programs or strategies to
strengthen mental health and resiliency among health care
professionals; and
(5) the efficacy of health professional training programs
that promote resiliency and improve mental health.
(c) Recommendations.--The review under subsection (a), as
appropriate, shall identify best practices related to, and make
recommendations to address--
(1) improving mental health and resiliency among health care
professionals;
(2) removing barriers to mental health care for health care
professionals; and
(3) strategies to promote resiliency among health care
professionals in health care settings.
SEC. 6. GAO REPORT.
Not later than 4 years after the date of enactment of this Act, the
Comptroller General of the United States shall submit to the Congress a
report on the extent to which Federal substance use disorder and mental
health grant programs address the prevalence and severity of mental
health conditions and substance use disorders among health
professionals. Such report shall--
(1) include an analysis of available evidence and data
related to such conditions and programs; and
(2) assess whether there are duplicative goals and objectives
among such grant programs.
I. Purpose and Summary
H.R. 1667, the ``Dr. Lorna Breen Health Care Provider
Protection Act,'' requires the Department of Health and Human
Services (HHS) to establish grant programs and conduct
activities intended to address the behavioral health and well-
being among health care professionals. Among other things, HHS
would be required to award grants for relevant mental and
behavioral health training for health care students, residents,
or professionals and to support mental health and behavioral
health needs among health care providers; conduct a campaign to
encourage health care providers to seek support and treatment
for mental and behavioral health concerns; and disseminate best
practices to prevent suicide and improve mental health and
resiliency among health care providers. The legislation also
requires HHS to study, develop, and submit policy
recommendations to Congress on policies to improve health care
professional mental health and prevent burnout. Finally, the
legislation requires a Government Accountability Office (GAO)
study on how federal substance use disorder (SUD) and mental
health grant programs address mental health conditions and SUDs
among health care professionals and identify any duplication of
work amongst agencies.
II. Background and Need for Legislation
The coronavirus disease of 2019 (COVID-19) pandemic has
compounded the stress and burnout experienced by health care
workers working in an already emotionally demanding field.\1\ A
recent American Medical Association survey of over 20,000
medical professionals found that 38 percent of respondents were
experiencing anxiety and depression, and 49 percent had
burnout.\2\ Another survey from the Kaiser Family Foundation
and the Washington Post found that a majority of frontline
health care workers (62 percent) say that worry or stress
related to COVID-19 had a negative impact on their mental
health.\3\ The same survey found that only 13 percent of health
care workers reported receiving mental health services. An
additional 18 percent surveyed said that although they thought
they needed them, they did not seek out these services, citing
busy schedules, embarrassment or fear, professional
repercussions and financial concerns.\4\
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\1\Gemma Seda-Gombau et al., Impact of the COVID-19 Pandemic on
Burnout in Primary Care Physicians in Catalonia, U.S. National Library
of Medicine, National Institutes of Health (https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC8431168/) (Sep. 2021).
\2\American Medical Association, Half of health workers report
burnout amid COVID-19 (www.ama-assn.org/practice-management/physician-
health/half-health-workers-report-burnout-amid-covid-19) (July 20,
2021).
\3\Kaiser Family Foundation, KFF/The Washington Post Frontline
Health Care Workers Survey (www.kff.org/report-section/kff-the-
washington-post-frontline-health-care-workers-survey-toll-of-
the-pandemic/?utm_campaign=KFF-2021-polling-
surveys&utm_medium=email&_hsmi=2&_
hsenc=p2ANqtz-
_O1wzC3EysCZIKW0kCMDZpbV6oLd5xwx4CIkuyY3sw3HY_IWeElYAKCkK_
a7ODLB801Vx8g9u2oXcvko8YvTVJhgmDoQ&utm_content=2&utm_source=hs_email)
(Apr. 6, 2021).
\4\Id.
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The American Rescue Plan (ARP) which included funding for
grants to medical providers to promote mental health among
their health professional workforce as well as for an education
and awareness campaign encouraging healthy work conditions and
greater use of mental health and SUD services by health care
providers.\5\ H.R. 1667 would authorize the funding provided in
ARP in order to provide sustained and predictable programming
to support the behavioral health and well-being among health
care providers through the establishment of programs that offer
behavioral health services for front-line health care workers,
the authorization of studies and recommendations about
strategies to address provider burnout and facilitate
resiliency, and the creation of a public awareness campaign
encouraging health care workers to seek assistance when needed.
This legislation is named for Dr. Lorna M. Breen, the medical
director of the emergency department at New York-Presbyterian
Allen Hospital, who died of suicide in April 2020.
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\5\American Rescue Plan Act of 2021, Pub. L. No 117-2.
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III. Committee Hearings
For the purposes of section 3(c) of rule XIII of the Rules
of the House of Representatives, the following hearing was used
to develop or consider H.R. 1667:
The Subcommittee on Health held a legislative hearing on
October 26, 2021, entitled ``Caring for America: Legislation to
Support Patients, Caregivers, and Providers.'' The Subcommittee
received testimony from the following witnesses:
Corey Feist, Founder, Dr. Lorna Breen Foundation;
Lisa Macon Harrison, M.P.H., President, National
Association of County and City Health Officials
(NACCHO);
Brooks A. Keel, Ph.D., President, Augusta University;
Alan Levine, Executive Chairman, President, and CEO,
Ballad Health;
Jeanne Marrazzo, M.D., Board Member, Infectious
Disease Society of America (IDSA), Infectious Disease
Division Chief, University of Alabama at Birmingham;
Stephanie Monroe, J.D., Director, Equity and Access,
UsAgainstAlzheimer's, Executive Director,
AfricanAmericans AgainstAlzheimer's; and
Victoria Garcia Wilburn, D.H.Sc., O.T.R., F.A.O.T.A.,
Assistant Professor, Occupational Therapy, IUPUI School
of Health & Human Sciences.
IV. Committee Consideration
H.R. 1667, the ``Dr. Lorna Breen Health Care Provider
Protection Act,'' was introduced on March 8, 2021, by
Representative Susan Wild (D-PA) and 14 original cosponsors and
referred to the Committee on Energy and Commerce. Subsequently,
on March 9, 2021, the bill was referred to the Subcommittee on
Health.
On November 4, 2021, the Subcommittee on Health met in open
markup session, pursuant to notice, to consider H.R. 1667 and
eight other bills. During consideration of the bill, an
amendment in the nature of a substitute (AINS) offered by
Representative Griffith (R-VA) was agreed to by a voice vote.
Upon conclusion of consideration of the bill, the Subcommittee
on Health agreed to report the bill favorably to the full
Committee, amended, by a voice vote.
On November 17, 2021, the full Committee met in open markup
session, pursuant to notice, to consider H.R. 1193 and 11 other
bills. No amendments were offered during consideration of the
bill. Upon conclusion of consideration of the bill, the full
Committee agreed to a motion on final passage offered by
Representative Pallone (D-NJ), Chairman of the Committee, to
order H.R. 1193 reported favorably to the House, as amended, by
a voice vote.
V. Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list each record vote
on the motion to report legislation and amendments thereto. The
Committee advises that there were no record votes taken on H.R.
1667, including a motion by Mr. Pallone ordering H.R. 1667
favorably reported to the House, as amended.
VI. Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1)
of rule X of the Rules of the House of Representatives, the
oversight findings and recommendations of the Committee are
reflected in the descriptive portion of the report.
VII. New Budget Authority, Entitlement Authority, and
Tax Expenditures
Pursuant to 3(c)(2) of rule XIII of the Rules of the House
of Representatives, the Committee adopts as its own the
estimate of new budget authority, entitlement authority, or tax
expenditures or revenues contained in the cost estimate
prepared by the Director of the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974.
The Committee has requested but not received from the
Director of the Congressional Budget Office a statement as to
whether this bill contains any new budget authority, spending
authority, credit authority, or an increase or decrease in
revenues or tax expenditures.
VIII. Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
IX. Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to reduce
and prevent suicide, burnout, and mental and behavioral health
conditions among health care professionals and to provide
resources to support health care entities to offer assistance
to address these needs.
X. Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 1667 is known to be duplicative of another Federal
program, including any program that was included in a report to
Congress pursuant to section 21 of Public Law 111-139 or the
most recent Catalog of Federal Domestic Assistance.
XI. Committee Cost Estimate
Pursuant to clause 3(d)(1) of rule XIII, the Committee
adopts as its own the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
XII. Earmarks, Limited Tax Benefits, and Limited
Tariff Benefits
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 1667 contains no earmarks, limited
tax benefits, or limited tariff benefits.
XIII. Advisory Committee Statement
No advisory committee within the meaning of section 5(b) of
the Federal Advisory Committee Act was created by this
legislation.
XIV. Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
XV. Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 designates that the short title may be cited as
the ``Dr. Lorna Breen Health Care Provider Protection Act.''
Sec. 2. Dissemination of best practices
Section 2 requires the Secretary of HHS, two years after
enactment of the legislation, to identify and disseminate
evidence-based or evidence-informed best practices and
recommendations for preventing suicide and improving mental
health and resiliency among health care professionals, and for
training health care professionals in appropriate strategies to
promote their mental health.
Sec. 3. Education and awareness initiative encouraging use of mental
health and substance use disorder services by health care
professionals
Section 3 requires the Secretary of HHS, in consultation
with relevant stakeholders, to establish a national evidence-
based or evidence-informed awareness initiative. The initiative
shall (1) encourage health care professionals to seek support
and care for their mental health or substance use concerns, to
help such professionals identify risk factors associated with
suicide and mental health conditions, and to help such
professionals learn how best to respond to such risks, with the
goal of preventing suicide, mental health conditions, and SUDs,
and (2) to address stigma associated with seeking mental health
and SUD services. Section 3 also requires the Secretary of HHS
to provide an update on the activities and outcomes of the
initiative to the Senate Committee on Health, Education, Labor,
and Pensions and the House Committee on Energy and Commerce no
later than two years after enactment. Section 3 authorizes $10
million for each of fiscal years 2022 through 2024 to carry out
the activities outlined in this section.
Sec. 4. Programs to promote mental health among the heath professional
workforce
Section 4 amends the Public Health Service Act to establish
programming to promote mental health among the health
professional workforce, by authorizing $35 million for each of
fiscal years 2022 through 2024 for the Secretary of HHS to
award grants or contracts to health care entities such as
hospitals, community health centers, and rural health clinics,
or to medical professional associations, to establish or
enhance evidence-based or evidence-informed programs dedicated
to improving mental health and resiliency for health care
professionals. Eligible entities receiving a grant or contract
shall use funds to implement a new program or enhance an
existing program to promote mental health among health care
professionals, which may include improving awareness among
health professionals about risk factors and signs of suicide
and mental health or SUD; establishing new or enhancing
existing peer-support programs; and, providing mental health
care, follow-up services and care, or referrals for such
services or care. The Secretary of HHS must also prioritize
eligible entities in areas with health professional shortages
or rural areas. The Secretary may also establish a program to
award grants to health professions schools, academic health
centers, state or local governments, Indian Tribes or tribal
organizations or other appropriate public or private nonprofit
entities to support training for health care students,
residents, or health care professionals to address mental
health and SUD and improve mental health and resiliency among
health care professionals. Grants or contracts shall be for a
period of three years, and entities receiving grants or
contracts shall submit a report evaluating the activities
supported by the grant or contract.
Sec. 5. Review with respect to health care professional mental health
and resiliency
Section 5 directs the Secretary of HHS, in consultation
with stakeholders, to conduct a review on improving health care
professional mental health and the outcomes of programs
authorized under this legislation, and submit a report to
Congress on the results of this review no later than three
years after enactment. This review should take into account (1)
the prevalence and severity of mental health conditions for
health care professionals and factors that contribute to those
conditions, (2) barriers to seeking and accessing mental health
care for health care professionals, which may include
consideration of stigma and licensing concerns, and actions
taken by State licensing boards, schools for health
professionals, health care professional training associations,
hospital associations, or other organizations, as appropriate,
to address such barriers, (3) the impact of the COVID-19 public
health emergency on the mental health of health care
professionals and lessons learned for future public health
emergencies, (4) factors that promote mental health resiliency
among health care professionals, including programs or
strategies to strengthen mental health and resiliency among
health care professionals and (5) the efficacy of health
professional training programs that promote resiliency and
improve mental health. This review, as appropriate, shall
identify best practices and make recommendations to address (1)
improving mental health and resiliency among health care
professionals, (2) removing barriers to mental health care for
health care professionals, and (3) strategies to promote
resiliency among health care professionals in health care
settings.
Sec 6. GAO report
Section 6 requires GAO, no later than four years after
enactment, to submit a report to Congress on the extent to
which federal SUD and mental health programs address the
prevalence and severity of mental health conditions and SUDs
among health care professionals. The report shall include an
analysis of available evidence and data related to such
conditions and programs and assess whether there are
duplicative goals and objective among such grant programs.
XVI. Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italics and existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
SEC. 764. PROGRAMS TO PROMOTE MENTAL HEALTH AMONG THE HEALTH
PROFESSIONAL WORKFORCE.
(a) Programs to Promote Mental Health Among Health Care
Professionals.--
(1) In general.--The Secretary shall award grants or
contracts to health care entities, including entities
that provide health care services, such as hospitals,
community health centers, and rural health clinics, or
to medical professional associations, to establish or
enhance evidence-based or evidence-informed programs
dedicated to improving mental health and resiliency for
health care professionals.
(2) Use of funds.--An eligible entity receiving a
grant or contract under this subsection shall use funds
received through the grant or contract to implement a
new program or enhance an existing program to promote
mental health among health care professionals, which
may include--
(A) improving awareness among health care
professionals about risk factors for, and signs
of, suicide and mental health or substance use
disorders, in accordance with evidence-based or
evidence-informed practices;
(B) establishing new, or enhancing existing,
evidence-based or evidence-informed programs
for preventing suicide and improving mental
health and resiliency among health care
professionals;
(C) establishing new, or enhancing existing,
peer-support programs among health care
professionals; or
(D) providing mental health care, follow-up
services and care, or referral for such
services and care, as appropriate.
(3) Priority.--In awarding grants and contracts under
this subsection, the Secretary shall give priority to
eligible entities in health professional shortage areas
or rural areas.
(b) Training Grants.--The Secretary may establish a program
to award grants to health professions schools, academic health
centers, State or local governments, Indian Tribes or Tribal
organizations, or other appropriate public or private nonprofit
entities (or consortia of entities, including entities
promoting multidisciplinary approaches) to support the training
of health care students, residents, or health care
professionals in evidence-based or evidence-informed strategies
to address mental and substance use disorders and improve
mental health and resiliency among health care professionals.
(c) Grant Terms.--A grant or contract awarded under
subsection (a) or (b) shall be for a period of 3 years.
(d) Application Submission.--An entity seeking a grant or
contract under subsection (a) or (b) shall submit an
application to the Secretary at such time, in such manner, and
accompanied by such information as the Secretary may require.
(e) Reporting.--An entity awarded a grant or contract under
subsection (a) or (b) shall periodically submit to the
Secretary a report evaluating the activities supported by the
grant or contract.
(f) Authorization of Appropriations.--To carry out this
section and section 5 of the Dr. Lorna Breen Health Care
Provider Protection Act, there are authorized to be
appropriated $35,000,000 for each of fiscal years 2022 through
2024.
* * * * * * *
[all]