Health leaders watch budget

Proposal’s local impact considered

Congressional Republicans’ plans to change health insurance law have faltered, but President Donald Trump’s proposed federal budget could still affect public health programs in Northwest Arkansas and around the country.

Web watch

Read President Donald Trump’s budget proposal online at www.nwadg.com/docum….

The budget proposal released this month would add to some programs, such as new federal disease-response money and beefing up the Department of Veterans Affairs’ budget for veteran health care. It would also take away, cutting almost $6 billion from medical research grants and eliminating other programs.

Congress hasn’t yet taken up the budget and is free to accept all of the proposal or none, but the proposal gives an idea of the president’s priorities and offers a starting point for the multistep budgeting process.

“To keep Americans safe, we have made the tough choices that have been put off for too long,” Trump wrote in the budget summary made public March 16. “But we have also made the necessary investments that are long overdue.”

TIGHTENING HERE

On the chopping side, the proposal eliminates about $400 million in health professional and nursing training, some of which has gone to local institutions. The University of Arkansas and the University of Arkansas for Medical Sciences together received about $2.6 million in 2015 to train more nurse practitioners, for example.

The budget also shaves about 3 percent from the U.S. Department of Agriculture’s Women, Infants and Children program budget, which gives vouchers for certain foods and education for low-income pregnant women, recent mothers and their children up to 5 years old. Arkansas’ Department of Health runs the program for 76,000 people in the state each month, mostly children. The figure includes 25,000 people in Northwest Arkansas.

A larger cut would go to the National Institutes of Health, which give grants for research in cancer, Alzheimer’s disease and other health concerns. The $5.8 billion drop represents a fraction of 1 percent of all federal spending, but an 18 percent cut for the institutes.

The institutes sent millions of dollars to Arkansas this year, mostly to the medical sciences university for research into the causes of Alzheimer’s disease-related loss of memory and thinking abilities or how the environment affects children’s health, for instance. Chancellor Dan Rahn called the grants highly competitive but essential to work that isn’t immediately bankable for private business.

“Very important research is funded by private companies, but basic research, game-changing research really, needs public funding,” he said, adding grants often lead to spin-off patents and companies, encourage young students to get into research or propel projects to the point that other support can take over.

“They’re all part of developing a community of science,” he said. “That’s really important.”

Green Technologies, a small fabrication company in West Fork that works for startups in the Arkansas Research and Technology Park in Fayetteville, received an institute award of about $1 million.

The company is using the money to develop safer wheelchairs, owner Steve Green said. He’s hired three others with the grant to create a mechanical system that can safely stop a chair from rolling backward when needed but doesn’t let loose immediately when it’s switched off. Green said he hopes to license the system to chair manufacturers after the grant wraps up in about a year.

SFC Fluidics, a company at the technology park, is using multiple grants that totaled about $1 million last year to develop smaller, more convenient and user-friendly pumps for controlled amounts of insulin or other medications that can be implanted or worn on the skin as a patch, said Ashley Shemain, vice president of business development. The company has refined the concepts and hopes to move to a second phase of grants to commercialize them, he said.

“It’s not easy money,” Green said of the grants, adding review boards of industry professionals for every application are “very skeptical” and turn down most requests. “They want the potential of significant innovation.”

The Trump administration’s explanations for all of its suggested cuts fall along three main lines, saying the affected programs are redundant, haven’t shown they achieve results, or can or should be covered by local governments and the private sector. The health institutes will focus on “the highest priority research and training activities,” the proposal states.

Arkansas Republicans have praised the idea of limiting federal spending and waste but have voiced concern over specific cuts in the budget, including a provision to eliminate the Delta Regional Authority that, among other things, encourages foreign-born doctors to practice in rural east Arkansas.

“President Trump’s budget blueprint highlights his continued dedication to reversing the liberal legacy of the Obama administration and ensuring America’s fiscal responsibility,” Rep. Steve Womack, who’s on the House of Representatives Appropriations Committee, said in a statement.

“My colleagues and I will work hard to make the tough but necessary decisions on how to rebuild our military while appropriately funding the nondefense discretionary programs on which so many Americans rely.”

EXPANDING THERE

Several programs would see a boost under the Trump proposal. It would create a new federal emergency fund to respond to disease outbreaks, though it doesn’t say how much should go to the fund. A new $500 million block grant to states would come from the Centers for Disease Control and Prevention.

The centers granted more than $30 million within Arkansas last year, most of it to the Health Department for prevention efforts for cancer, diabetes and HIV and for immunization, according to the centers’ online data. The centers also have assisted in the response and study of Arkansas’ continuing mumps outbreak this year and last.

A substantial increase is coming to the Department of Veterans Affairs for its veteran services in mental health, primary care and other specialties. Trump would add $4.6 billion “to improve patient access and timeliness of medical care services,” an increase for the department’s budget of about 6 percent.

About 54,000 veterans get health care at the Veterans Health Care System of the Ozarks, which has its main campus in Fayetteville and outpatient clinics in Northwest Arkansas, Oklahoma and Missouri.

Veterans systems in recent years have been criticized for wait times weeks or months long, but the Ozarks system reported 98 percent of its appointments are scheduled within a month, 2 points higher than the national number, according to the latest data from January. The average wait time for primary care or mental health appointments is about a day, a third of the national average.

“It’s fantastic,” Justin Lee, a 40-year-old single father and Air Force veteran in Fayetteville, said about the system. A routine checkup can still take weeks to schedule, he said, but when he thought he was having heart problems, he got in immediately.

“Once you get in, they take good care of you,” he said.

Trump also proposed extending the program that allows some veterans to get private care without charge if they’re a certain distance from a veteran clinic or need a service it doesn’t offer. It’s set to expire in August.

Bryan Matthews, the system’s medical center director, said the center had shortened its wait times in recent years by adding weekend clinics and a call center for questions and appointments by phone and by allowing appointments for specialty care without going to a primary care physician first, among other changes.

The system is adding a 20-bed mental health and substance abuse inpatient facility that should open late this year, so veterans in need of it don’t have to go to Little Rock. New clinics are coming to Springfield and Joplin in Missouri.

The veterans department in a statement said the budget request “fulfills the president’s commitment to our nation’s veterans,” but Matthews also said the system is doing well.

“This has been a good budget year, and I can say that we have all of the money we need to do the things we need to care for veterans,” he said.

Dan Holtmeyer can be reached at dholtmeyer@nwadg.com and on Twitter @NWADanH.

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