Keep the Public Health Commissioned Corps robust

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Elizabeth Newman
Elizabeth Newman

A challenge for long-term care providers right now is figuring out what to expend mental energy on when it comes to news and policy reform. This isn't a question of one's political beliefs, but an acknowledgement that for every small victory or piece of positive news for the sector, such as a push for more Alzheimer's funding, there are national stories sucking a lot of oxygen out of the room.

That means that smaller health stories, such as a proposal to slash funding for public health professionals who respond to disasters, are drowned out.

Last week the Office of Management and Budget proposed to cut the size of the U.S. Public Health Service Commissioned Corps from the current 6,500 officers to — at most — 4,000 officers, The Washington Post reports. The thought is that these officers are more expensive than civilians, even though it's unclear how much money would be saved.

Why does this matter to you? While you may have been lucky enough to avoid a public health disaster in your neck of the woods, the Corps is made up of doctors, nurses, and other professionals who work in their day-to-day lives in the government, at places such as the Centers for Disease Control and Prevention. But when disaster strikes, they are dispatched to help.

The Corps is under the Department of Health and Human Services, and members receive military pay and wear uniforms. They leave their jobs and regular lives during disease outbreaks or natural disasters. More than 1,460 officers, for example, were sent to help those affected by hurricanes Harvey, Irma and Maria, a spokeswoman told the Post. In 2014, hundreds were sent to respond to a humanitarian crisis involving migrant children, such as medical screenings. Officers are responding to the current nightmare involving children being separated from their parents at the border. The goal is for them to respond to vulnerable populations, and many put in 14-hour days to help, one source noted.

One could make the argument that the Trump administration promised to slash federal government, and this proposal is a part of that. But it's questionable whether there's solid math behind the assertion that this proposal would save money. For example, the proposal cites a two-decade old Government Accountability Study as part of its rationale and wants many of the Corps slots to be filled by civilians. That appears not to take into account something long-term term care operators are intimately familiar with, which is overtime.

An analysis found that commissioned officers could be more expensive than civil servants but the comparison isn't apples to apples because of overtime hours. For example, if we look at FEMA, the government paid civil servants close to three million hours in overtime at a total of $124 million for work during last year's hurricanes. Corps members, on the other hand, aren't punching a clock when an elderly hurricane victim shows up needing medical assistance.

It's true the Corps members receive military benefits — by law, they are considered veterans — but these are people who wanted to serve their country in the best way they could and, as one source noted, chose the public sector over far more lucrative private gigs. Not all of us are made for active combat, but I find it reassuring that there are medical professionals who believe government can be a help, not a hindrance.

That help has never been more needed for those running skilled nursing facilities. Of course, the Corps is small enough that many administrators may never come across it. And I'm well aware that in the number of issues you may want to talk to your representatives about, this may not be the hill you want to die on. But I would posit that a place to start is a) knowing this Corps exists b) asking whether it's a good idea to trim back a program that may end up costing the government more money in the long run and c) whether this is one more whack at a healthcare industry already under siege.  

This may not be a situation where people are outraged, but it should be a proposal that receives the scrutiny it deserves.

Follow Senior Editor Elizabeth Newman @TigerELN.

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.