Helping Kids Cope Act

Substance Use Disorder Workforce, including scholarship opportunities Substance Use Disorder Treatment and Recovery Loan Repayment Program Reauthorization (H.R.3073/S.1452) Community Mental Wellness and Resilience Act (H.R.2412) Helping Kids Cope Act (H.R.3713) Mental Health Services for Students Act (H.R.4851) 9-8-8 Implementation Act of 2023 (H.R.4950) IMPROVE Addiction Care Act (H.R. 4531/ S.3393) Support for Patients and Communities Reauthorization Act (H.R. 773/S.3165) Homelessness and Behavioral Health Care Coordination Act of 2023 Issues surrounding 9-8-8 georouting (H.R.7536/S.3085) Preventing Adverse Childhood Experiences (PACE) Act (H.R.7212/S.2733) Providing Empathetic and Effective Recovery (PEER) Support Act Issues surrounding ACO flex model Issues surrounding Mental Health Parity and Addiction Equity Act rules (H.R. 8375) Strengthening Our Pediatric Mental Health Workforce Act (H.R. 8376) Latino Youth MH Empowerment Act (H.R. 8377) Youth Suicide Prevention Research Act (H.R. 8680) Community Mental Wellness Worker Training Act (H.R. 9581) STAR Plus Scholarship Act Issues surrounding health workforce education scholarship and loan programs S.Res.769 - A resolution recognizing the importance of mental health for youth in the United States, and expressing the pressing need for awareness and support for mental health care for children and adolescents (H.R.10047) Closing the Substance Use Care Gap Act (H.R.10445) Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 (H.R.10545) American Relief Act, 2025 (H.R.10515) American Relief Act, 2025

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support funding for the CHGME program, opposition to proposals that would limit access to the 340B program, opposition to site neutral payments, including Section 404 in the recent Energy & Commerce markup, and support for H.R. 4758 and its companion S. 2372, the Accelerating Kids Access to Care Act; The Helping Kids Cope Act (H.R. 2412); The Early Action and Responsiveness Lifts Youth (EARLY) Minds Act (H.R. 7808); The Stabilization to Prevent (STOP) Suicide Act (H.R. 9577); The Prevention Services for Youth Act (S. 4811); The Prevention Services for Youth Act (S. 4811); The Strengthening Supports for Youth Act (S. 4812)

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support funding for the CHGME program, opposition to proposals that would limit access to the 340B program, opposition to site neutral payments, including Section 404 in the recent Energy & Commerce markup, and support for H.R. 4758 and its companion S. 2372, the Accelerating Kids Access to Care Act; The Helping Kids Cope Act (H.R. 2412); The Early Action and Responsiveness Lifts Youth (EARLY) Minds Act (H.R. 7808); The Stabilization to Prevent (STOP) Suicide Act (H.R. 9577); The Prevention Services for Youth Act (S. 4811); The Prevention Services for Youth Act (S. 4811); The Strengthening Supports for Youth Act (S. 4812)

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

CONNECT for Health Act of 2023 (H.R. 4189 / S. 2106), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2023 (H.R. 3432), all provisions related to ensuring coverage of mental health services furnished through telehealth. Modernizing Opioid Treatment Access Act of 2023 (H.R. 1359/S. 644), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 988 Implementation Act (H.R. 4851), all provisions related to authorizing and growing funding and support for the 988 suicide and crisis lifeline Protecting Kids on Social Media Act (H.R. 6149/S.1291), all provisions related to authorizing certain safeguards to protect mental health for children when using social media platforms Ryan Haight Act, all provisions related to the extension of COVID-19 telemedicine flexibilities for prescription of controlled medication The PEER Mental Health Act of 2023 (H.R. 2642 / S.3498), all provisions related to award grants to build capacity for peer support programs for individuals experiencing mental health and substance use challenges Helping Kids Cope Act of 2023 (H.R. 2412), all provisions related to awarding grants to build the capacity of the pediatric behavioral health services Strengthening Community Care Act of 2023 (H.R. 2559) all provisions related to reauthorization of the Community Health Center Fund for three years, ending in 2026. Improving Access to Mental Health Act (H.R.1638 / S.838), all provisions related to the incentivizing of mental health professionals to practice in Mental Health Professional Shortage areas. SUPPORT for Patients and Communities Reauthorization Act (H.R. 4531/S. 3393) all provisions relating to the continued bolstered funding for substance use disorder treatment and recovery. Local 9-8-8 Response Act (H.R. 4974 / S. 3444), all provisions relating to the continued bolstering of 9-8-8 crisis services and requiring that 9-8-8 calls be routed to their nearest call center as opposed to the call center matching the area code of the phone originating the call. CONNECT Act (H.R. 6928), all provisions related to awarding grants to certain crisis centers for providing follow-up care to individuals who receive suicide prevention and crisis intervention services. Improving Mental Health and Wellness in Schools Act (H.R.3331/ S.754), all provisions related to expanding mental health education and health promotion in existing school education programs Kickstarting Innovative Demonstrations Supporting Health Act (H.R.3805/ S.1769), all provisions relating to improving the health and wellbeing of children by addressing nonmedical factors that determine health outcomes. Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act (S.1378), all provisions related to incentivizing primary care to implement integrated care models to improve access to behavioral health care treatments. Better Mental Health Care for Americans Act (S.923), all provisions relating to parity enforcement and improving access to mental health care for Medicare and Medicaid beneficiaries. Mental Health Student Loan Forgiveness Act (H.R. 4933/S. 462), all provisions relating to expanding the Substance Use Disorder Treatment and Recovery Loan Repayment Program and expanding eligibility to include individuals who agree to work in mental health professional shortage areas for a period of time. Resident Physician Shortage Reduction Act (H.R.2389/ S.1302), all provisions relating to adding additional residency positions for improved access to behavioral health care in physician shortage areas as defined by SAMHSA Stop Overdose in Schools Act (H.R.5652), all provisions related to setting aside funds for opioid reversal agent administration training for schools and the expansion of opioid education programs in education. Mental Health Infrastructure Improvement Act of 2023 (H.R.5804), all provisions relating to authorizing the Secretary of Health and Human Services to make loans and loan guarantees for the betterment of pediatric and adult mental health and substance use treatment facilities. Advancing Lifesaving Efforts with Rapid Test strips for Communities Act ALERT Communities Act (S.2919), all provisions related to expanding access to fentanyl and xylazine test strips. H.R. 7545, all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. STAR Plus Scholarship Act (H.R. 9851), all provisions related to creating a scholarship program for substance use treatment providers. Community Mental Wellness Worker Training Act (H.R. 8680), all provisions related to creating a grant program for behavioral health organizations to train mental wellness workers in communities. Elementary and Secondary School Counseling Act (H.R. 8524/S. 4407), all provisions related to establishing five-year renewable grant programs to help elementary and secondary schools to hire additional school-based mental health providers such as counselors, psychologists and social workers. Kid PROOF Act of 2023 (H.R. 6663/S. 3364), all provisions related to allowing health care providers to purchase and distribute lethal means safety supplies for children at risk of overdose or suicide. Telehealth Access for Tribal Communities Act of 2024 (H.R. 9271), all sections related to expanding telehealth access for tribal communities. Campus Prevention and Recovery Services for Students Act of 2024 (H.R. 9214), all provisions related to helping higher education institutions implement programs to prevent alcohol and substance misuse on campus and support those with substance use disorders. Recognizing the Role of Direct Support Professionals Act (H.R. 2941/S. 1332), all provisions related to requiring the Office of Management and Budget to establish a separate category within the Standard Occupational Classification system for direct support professionals for data reporting purposes. American Relief Act (H.R. 10545), all provisions relating to extension of Medicare telehealth flexibilities. SAMHSA Notice of CCBHC-E Data Collection, submitted comment to SAMHSA regarding the request for clearance for eleven data collection instruments and forms related to the implementation and impact studies to be conducted as part of an evaluation of the 2022 CCBHC-Expansion grant cohorts. SAMHSA Notice of Patient-Level Data Collection, submitted comment SAMHSA regarding the proposed SAMHSA Unified Client-level Performance Reporting Tool (SUPRT) to modify the existing Center for Substance Abuse Treatment (CSAT) and Center for Mental Health Services (CMHS) Client-Level Performance Instruments into a streamlined, multi-component SAMHSA Client-Level Performance Tool. CMS Draft FAQ on Provider Enrollment and TPL for Dual Eligibles, submitted comment on CMSs draft FAQ related to providing services for dual eligible individuals. SAMHSA Crisis definitions and guidelines draft documents, submitted comments on SAMHSAs drafted coordinated crisis care services definitions and guidelines. SAMHSA Satellite Definition, submitted comment on SAMHSAs proposed update to Satellite Facility for purposes of CCBHC payment exclusion.

Client expense: $112,806 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, SENATE

CONNECT for Health Act of 2023 (H.R. 4189 / S. 2106), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2023 (H.R. 3432), all provisions related to ensuring coverage of mental health services furnished through telehealth. Modernizing Opioid Treatment Access Act of 2023 (H.R. 1359/S. 644), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 988 Implementation Act (H.R. 4851), all provisions related to authorizing and growing funding and support for the 988 suicide and crisis lifeline Protecting Kids on Social Media Act (H.R. 6149/S.1291), all provisions related to authorizing certain safeguards to protect mental health for children when using social media platforms Ryan Haight Act, all provisions related to the extension of COVID-19 telemedicine flexibilities for prescription of controlled medication The PEER Mental Health Act of 2023 (H.R. 2642 / S.3498), all provisions related to award grants to build capacity for peer support programs for individuals experiencing mental health and substance use challenges Helping Kids Cope Act of 2023 (H.R. 2412), all provisions related to awarding grants to build the capacity of the pediatric behavioral health services Strengthening Community Care Act of 2023 (H.R. 2559) all provisions related to reauthorization of the Community Health Center Fund for three years, ending in 2026. Improving Access to Mental Health Act (H.R.1638 / S.838), all provisions related to the incentivizing of mental health professionals to practice in Mental Health Professional Shortage areas. SUPPORT for Patients and Communities Reauthorization Act (H.R. 4531/S. 3393) all provisions relating to the continued bolstered funding for substance use disorder treatment and recovery. Local 9-8-8 Response Act (H.R. 4974 / S. 3444), all provisions relating to the continued bolstering of 9-8-8 crisis services and requiring that 9-8-8 calls be routed to their nearest call center as opposed to the call center matching the area code of the phone originating the call. CONNECT Act (H.R. 6928), all provisions related to awarding grants to certain crisis centers for providing follow-up care to individuals who receive suicide prevention and crisis intervention services. Improving Mental Health and Wellness in Schools Act (H.R.3331/ S.754), all provisions related to expanding mental health education and health promotion in existing school education programs Kickstarting Innovative Demonstrations Supporting Health Act (H.R.3805/ S.1769), all provisions relating to improving the health and wellbeing of children by addressing nonmedical factors that determine health outcomes. Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act (S.1378), all provisions related to incentivizing primary care to implement integrated care models to improve access to behavioral health care treatments. Better Mental Health Care for Americans Act (S.923), all provisions relating to parity enforcement and improving access to mental health care for Medicare and Medicaid beneficiaries. Mental Health Student Loan Forgiveness Act (H.R. 4933/S. 462), all provisions relating to expanding the Substance Use Disorder Treatment and Recovery Loan Repayment Program and expanding eligibility to include individuals who agree to work in mental health professional shortage areas for a period of time. Resident Physician Shortage Reduction Act (H.R.2389/ S.1302), all provisions relating to adding additional residency positions for improved access to behavioral health care in physician shortage areas as defined by SAMHSA Stop Overdose in Schools Act (H.R.5652), all provisions related to setting aside funds for opioid reversal agent administration training for schools and the expansion of opioid education programs in education. Mental Health Infrastructure Improvement Act of 2023 (H.R.5804), all provisions relating to authorizing the Secretary of Health and Human Services to make loans and loan guarantees for the betterment of pediatric and adult mental health and substance use treatment facilities. Advancing Lifesaving Efforts with Rapid Test strips for Communities Act ALERT Communities Act (S.2919), all provisions related to expanding access to fentanyl and xylazine test strips. H.R. 7545, all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. STAR Plus Scholarship Act (H.R. 9851), all provisions related to creating a scholarship program for substance use treatment providers. Community Mental Wellness Worker Training Act (H.R. 8680), all provisions related to creating a grant program for behavioral health organizations to train mental wellness workers in communities. Elementary and Secondary School Counseling Act (H.R. 8524/S. 4407), all provisions related to establishing five-year renewable grant programs to help elementary and secondary schools to hire additional school-based mental health providers such as counselors, psychologists and social workers. Kid PROOF Act of 2023 (H.R. 6663/S. 3364), all provisions related to allowing health care providers to purchase and distribute lethal means safety supplies for children at risk of overdose or suicide. Telehealth Access for Tribal Communities Act of 2024 (H.R. 9271), all sections related to expanding telehealth access for tribal communities. Campus Prevention and Recovery Services for Students Act of 2024 (H.R. 9214), all provisions related to helping higher education institutions implement programs to prevent alcohol and substance misuse on campus and support those with substance use disorders. Recognizing the Role of Direct Support Professionals Act (H.R. 2941/S. 1332), all provisions related to requiring the Office of Management and Budget to establish a separate category within the Standard Occupational Classification system for direct support professionals for data reporting purposes. 2025 Medicare Physician Fee Schedule Proposed Rule, submitted comments to the administration regarding proposed provisions related to mental health and substance use services under Medicare. 2025 Outpatient Prospective Payment System Proposed Rule, submitted comments to the administration regarding proposed provisions related to mental health and substance use services. Congressional RFI on Pay PCP Act, submitted comment in response to request for comment from Senators Cassidy and Whitehouse regarding Medicare primary care provider payment and the importance of integration with behavioral health care. Marijuana Rescheduling Proposed Rule, submitted comment to the DEA in response to the proposed rule recognizing the importance of research, substance use prevention, and access to care. Standard Occupational Classification (SOC) 2028 Update, signed on to an organization sign-on letter regarding peer support specialists under the OMB SOC manual update.

Client expense: $154,891 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Boston Children's Hospital focuses on pediatric workforce education, public health and medical research policy issues impacting children. In the 118th Congress, we have advocated for the reauthorization of and funding through the appropriations process for the Children's Hospital Graduate Medical Education program (CHGME). We have also discussed the escalating mental and behavioral health challenges among youth and policy solutions in the areas of the pediatric mental health delivery system, workforce and infrastructure. Advocacy pertaining to youth and adolescent mental and behavioral health issues has included the introduction of legislative proposals such as the Helping Kids Cope Act (H.R. 2412) and the EARLY MINDS Act (H.R. 7808).

Client expense: $80,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Issues regarding childrens health care coverage and access to care under Medicaid, CHIP, the Exchanges, and private insurance Issues regarding the annual Notice of Benefit and Payment Parameters for the Exchanges and private insurance Issues regarding childrens and mothers health specifically continuous eligibility for children in Medicaid and CHIP, CHIP permanency Issues regarding childrens mental health and the national emergency in childrens mental health, including mental health parity, the mental health workforce and related access issues. Issue regarding Medicaid supplemental payments and directed payments Issues related to Health Information Technology, interoperability, information blocking, and cybersecurity Issues regarding the importance of Medicaid to children, including military and veteran families  Issues regarding Medicaid support for providers caring for children on Medicaid, including DSH payments Issues regarding Children's Hospitals Graduate Medical Education (CHGME) program and funding Issues related to 340B Drug Pricing Program, prescription drug pricing, drug shortages, high-cost drugs/therapies and pharmaceutical supply chain, including H.R. 3290 Issues related to pediatric workforce, Medicare GME, the Pediatric Specialty Loan Repayment Program, and Title VII and VIII Issues regarding Organ Procurement and Transplantation Network Issues regarding site neutrality and price transparency in health care  Issues regarding pediatric pandemic and disaster preparedness and response and emergency preparedness Issues regarding food security and nutrition Issues regarding drugs and medical device shortages and high costs Issues related to the regulation of laboratory-developed tests Issues regarding prescribing of drugs via telehealth Issues related to mental health services in schools Issues related to pediatric cancer and the Moonshot Issues regarding Artificial Intelligence (AI) Issues regarding oversight and implementation of EPSDT H.R. 2412 The Helping Kids Cope Act S.2372/HR. 4758 - Accelerating Kids Access to Care Act  H.R. 1397, Telehealth Improvement for Kids Essential Services (TIKES) Act H.R. 7623/ S. 3967, Telehealth Modernization Act Issues involving Site Neutral payment legislation, including H.R. 3281 and H.R. 3561 S. 1774/H.R. 3761 the Assist Act H.R. 2584/S.2768, Safety form Violence for Healthcare employees (Save) Act S. 1409, Kids Online Safety Act H.R. 6663/S. 3364, Kid PROOF Act of 2023 H.R. 6664 Innovation for Pediatric Drugs Act of 2023 H.R. 7808, the Early Action and Responsiveness Lifts Youth (EARLY) Minds Act H.R. 6960 Emergency Medical Services for Children Reauthorization Act of 2024 H.R. 3391 Gabriella Miller Kids First Research Act 2.0 H.R. 6963 Pediatric Cancer Drug Supply Act H.R. 3433/ S. 2897, Give Kids A Chance Act H.R. 7384, Creating Hope Reauthorization Act. H.R. 6664/S. 4905, Innovation in Pediatric Drugs Act H.R: 4714: Pediatricians Accelerate Childhood Therapies Act of 2023 S. 0251 340B PATIENTS Act of 2024 H.R. 9577 Stabilization to Prevent (STOP) Suicide Act.

Client expense: $1,170,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

Reproductive health, physician-patient relationship, and EMTALA issues Emergency department boarding Drug shortages Health care consolidation H.R.1694-Emergency Care Improvement Act, to permanently allow for coverage under Medicare and Medicaid of services that are provided by freestanding emergency centers. H.R.2412-Helping Kids Cope Act, to provide grants to improve mental health access for children and reduce pediatric emergency department boarding H.R. 2416-To reauthorize the MISSION ZERO military-civilian partnership for trauma readiness H.R. 2940-PASTEUR Act of 2023, to incentivize new antimicrobial development H.R.4941-Providing Access to Treatment and Housing Act H.R 5414-Improving Mental Health Access from the Emergency Department Act, to establish grants for emergency departments and hospitals to help improve care and care coordination for patients with acute psychiatric care needs H.R.5804-Mental Health Infrastructure Improvement Act of 2023, to provide loans and grants to improve mental health treatment and substance use disorder treatment facilities H.R.6960-Emergency Medical Services for Children Reauthorization Act of 2024, to reauthorize the EMSC program H.R. 6992-Mapping Americas Pharmaceutical Supply Act, to map the U.S. pharmaceutical supply chain to identify vulnerabilities and other security threats H.R. 7153-Dr. Lorna Breen Health Care Provider Protection Act, to reauthorize programs to improve mental health access for health care providers S. 1346-Improving Mental Health Access from the Emergency Department Act, to establish grants for emergency departments and hospitals to help improve care and care coordination for patients with acute psychiatric care needs S. 1355- PASTEUR Act of 2023, to incentivize new antimicrobial development S. 1447-Bipartisan Solution to Cyclical Violence Act of 2023, to establish a grant program to support trauma center violence intervention and violence prevention programs S. 2586-Drug Shortages Prevention and Quality Improvement Act S. 2364-Mapping Americas Pharmaceutical Supply Act, to map the U.S. pharmaceutical supply chain to identify vulnerabilities and other security threats S.3679-Dr. Lorna Breen Health Care Provider Protection Act, to reauthorize programs to improve mental health access for health care providers S.3765-Emergency Medical Services for Children Reauthorization Act of 2024, to reauthorize the EMSC program

Client expense: $428,634 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied in favor of legislation to ensure that uncompensated care pool days can be included in the medicaid fraction of the medicare DSH %. In the FY 2024 IPPS CMS changed a rule that would prevent these days from being included. Discussed this solution with members/staff of the following offices: Buchanan (FL), Luna, Bilirakis, Lee (FL), Castor, Rubio, Scott, Soto, Franklin. Advocated on behalf of the At-HOME Services Act (S. 3756, H.R.7742). To expand hospital-at-home waiver to include observation patients for medicare payment. Ongoing conversations with Senator Rubio's office, Congresswoman Castor's office, and Congressman Buchanan's office in advancing At-HOME Services Act. Commented on the following proposed rules out of CMS: -CY 2025 Home Health Prospective Payment System Proposed Rule Fact Sheet (CMS-1803-P) -CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule (CMS 1809-P) -CY 2025 Medicare Physician Fee Schedule Proposed Rule (CMS-1807-P)-Medicare Shared Savings Program Proposals. Sent a letter to the following offices in support of the bills listed below. -Reps. Bilirakis, Buchanan, Castor, Donalds, Dunn, Franklin, Frost, Lee, Luna, Soto, Steube -Sens. Rubio and Scott -Legislation: HR 4286, HR 6693, HR 4363, S 2213, HR 4531, HR 2412, HR 7742, S 3756

Client expense: $211,558 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Educate policymakers about policies to support children mental health care needs, including H.R.2412, the Helping Kids Cope Act and H.R.7808, Early Minds Act; support funding for CHGME; monitor House and Senate work on pediatric and adolescent mental health; discuss the impact of pediatric workforce and drug/supply shortages and its impact on child health; educate policymakers on Children's Hospitals Graduate Medical Education (CHGME); monitor issues related to lab-developed tests; monitor AI and health care technology privacy; monitor policies related to the 340B program.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Substance Use Disorder Workforce, including scholarship opportunities Substance Use Disorder Treatment and Recovery Loan Repayment Program Reauthorization (H.R.3073/S.1452) Community Mental Wellness and Resilience Act (H.R.2412) Helping Kids Cope Act (H.R.3713) Mental Health Services for Students Act (H.R.4851) 9-8-8 Implementation Act of 2023 (H.R.4950) IMPROVE Addiction Care Act (H.R. 4531/ S.3393) Support for Patients and Communities Reauthorization Act (H.R. 773/S.3165) Homelessness and Behavioral Health Care Coordination Act of 2023 Issues surrounding 9-8-8 georouting (H.R.7536/S.3085) Preventing Adverse Childhood Experiences (PACE) Act (H.R.7212/S.2733) Providing Empathetic and Effective Recovery (PEER) Support Act Issues surrounding ACO flex model Issues surrounding Mental Health Parity and Addiction Equity Act rules (H.R. 8375) Strengthening Our Pediatric Mental Health Workforce Act (H.R. 8376) Latino Youth MH Empowerment Act (H.R. 8377) Youth Suicide Prevention Research Act (H.R. 8680) Community Mental Wellness Worker Training Act (H.R. 9581) STAR Plus Scholarship Act Issues surrounding health workforce education scholarship and loan programs S.Res.769 - A resolution recognizing the importance of mental health for youth in the United States, and expressing the pressing need for awareness and support for mental health care for children and adolescents

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 462 Mental Health Professionals Workforce Shortage Loan Repayment Act: increasing the mental health workforce HR 1423 911 Community Crisis Responders Act- Increasing the number of unarmed mental health crisis response teams S 853 & HR 1639 VA Zero Suicide Demonstration Project Act of 2023: Resources to end veteran suicide S. 923 Better Mental Health Care for Americans Act- Enforcing and Strengthening the Mental Health Parity Law S. 652 & H.R.2630 Safe Step Act -Creates an exception to medication step-therapy protocol HR 1201 Increasing Behavioral Health Treatment Act: ending the IMD exclusion HR 498 988 Lifeline Cybersecurity Responsibility Act: protecting the 9-8-8 Suicide & Crisis Lifeline from cybersecurity threats HR 3011 To Establish a taskforce at the DOD on Mental Health: To help promote the mental health of service members. S. 923 Better Mental Health Care for Americans Act: Provisions to enforce mental health parity, end ghost networks, and improve mental health care. H.R. 3432 & S.3651 Telemental Health Care Access Act: Making it easier for individuals to access telemental health services. HR 3548 S 1700 Pursuing Equity in Mental Health Care Act: Providing mental health resources to historically underserved communities HR 3850 The Pride in Mental Health Care Act: Mental health resources for LGBTQI+ youth HR 824: the Telehealth Benefit Expansion for Workers Act of 2023: Expands telehealth options for certain workers without the protections of the ACA. HR 4531 & S. 3393 The Support for Patients and Communities Reauthorization Act: Reauthorization of numerous SUD & MH programs from the original SUPPORT Act. HR 2412 Helping Kids Cope Act: Increasing access to pediatric behavioral health service at children's hospitals S 1452 HR 3073 Community Mental Wellness and Resilience Act: Provides technical and financial support for community resilience program Stating our support for the Office of Recovery at the Substance Abuse and Mental Health Services Administration (SAMHSA) S. 24444 H.R. 4830: The Attain Mental Health Act: To create an online dashboards to list available mental health grants H.R. 4851: The 988 Implementation Act: To increase resources for 988 and mental health crisis response H.R. 5804: Mental Health Infrastructure Improvement Act: Loan guarantees for the construction or renovation of pediatric or adult mental health treatment facilities H.R. 485 Protecting Health Care for all Patients Act: prohibits a health care programs from using prices that are based on quality-adjusted life years S. 1378 Complete Care Act: Incentivizes primary care providers to include behavioral health providers in their practice S.1769/H.R.3805: Kids Health Act of 2023: Promoting the whole child health model H.R.6663/S.3364 Kid Proof Act: Preventing youth suicide and overdoses * S. 3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023: Reauthorization of existing Mental Health and SUD programs S.3453 - Peer-to-Peer Mental Health Support Act: Enhancing Peer support services in our nation's schools H.R.5594 - Enhancing the Community Health Workforce Act: Using community health workers to enhance mental health. S. 2733 & H.R. 7212 PEER Support Act- addresses the behavioral health workforce shortages through support for peer support specialists H.R. 7069 Peer Support for Firefighters Act: To increase mental health resources to firefighters H.R. 7140 Mental Health Transparency Act: To require the disclose of percentage of in-network participation for certain provider types H.R. 7924 To amend the Higher Education Act of 1965 to support graduate programs in mental and behavioral health professions at minority-serving institutions and for other purposes: To help increase the diversity of the mental health workforce. H.R. 7153 & S.3679 Dr. Lorna Breen Health Care Act: To provide mental health resources for health care providers H.R. 6982 & S.3579: The Gambling Addiction, Recovery, Investment, and Treatment (GRIT) Act: Federal funds to research gambling addiction and treatment H.R. 4880 PACE Act: the ability to waive sovereign immunity in certain circumstances where jurisdictions prohibit monetary bail H.R. 6928 Connect Act: grants to certain crisis centers for providing follow-up care to individuals who receive suicide prevention and crisis intervention services. H.R. 8377 Youth Suicide Prevention Research Act: Research to decrease youth suicide H.R. 8375 Strengthening our Pediatric Mental Health Workforce: Using Medicaid and CHIP to increase pediatric mental and behavioral health opportunities H.R. 8376 Latino Youth Mental Health Empowerment Act: Awareness campaign regarding Latino youth mental health H.Res 385/S.Res 205: Supporting the designation of May 10, 2023, as "National Asian American, Native Hawaiian, and Pacific Islander Mental Health Day: Raising MH awareness in AANHPI communities H.R. 7808 Early Minds Act: Supporting funding for early interventions and prevention mental health services. H.R. 8680 To authorize the Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, to award grants to train community mental wellness workers: To increase the mental health workforce S. 5112 Crisis Care Access Act: Payment for crisis stabilization services S. 4812 Strengthen Supourt for Youth Act: Funding for research on youth mental health S.4835/H.R.9133 The Primary and Behavioral Health Care Access Act: Access to mental health care without cost sharing. H.R.3432/S.3651 The Telemental Health Care Access Act: ensuring coverage of telemental health H.R.9422 The Recovery Act: Increase substance use disorder access to care in Medicaid H.R. 9581: STAR Plus Scholarship Act: Increasing the mental health workforce H.R. 9577 Stop Suicide Act: Increase mental health stabilization services H.R. 9796 CHIERS Act: Transportation services for those with SUD S.5182 UNDERSTAND Health Act: Data on social determents of health Support for the Centers for Medicare and Medicaid to strengthen maternal health care proposals in the CY 25 hospital outpatient prospective payment system proposed rule. Support for the Centers for Medicare and Medicaid to finalize CY 25 Medicare outpatient prospective payment system proposals rule to improve access to Medicare for people on parole, probation, and other status groups Support for CMS to cover digital Mental health treatment the CY 2025 Physician fee schedule proposed rule Support for the final rule to strengthen the mental health parity enforcement provisions of the federal Mental Health and Addiction Equity Act.

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), President of the U.S., SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Lobbying Issues Description: Budget and appropriations for public health, disease and injury prevention, including obesity and related diseases; pandemics and emerging infectious diseases; physical activity; public health preparedness; nutrition programs; environmental health; health equity; community-based public health interventions; public health infrastructure and workforce; and substance misuse/behavioral health issues. Specific Legislation: 1.Preventing Adverse Childhood Experiences Act (S. 3085) 2.Mental Health Services for Students Act (S. 1884/H.R. 3713) 3.Helping Kids Cope Act (H.R. 2412) 4.Advancing Student Services in Schools Today Act (S. 1774/H.R. 3761) 5.Student Mental Health Rights Act (H.R. 3726) 6.Pursuing Equity in Mental Health Act (S. 1700/H.R. 3548) 7.RISE from Trauma Act (S. 1426) 8.Better Mental Health Care for Americans Act (S. 923) 9.Reentry Act (S. 1165/H.R. 2400) 10.FY 2024 Labor, HHS, Education and Related Agencies Appropriations 11.FY 2025 Labor, HHS, Education and Related Agencies Appropriations 12.Farm Bill 13.Improving Social Determinants of Health Act (H.R. 4781/S. 3847) 14.Health Equity and Accountability Act of 2024 (H.R. 9161/S.4773) 15.Social Determinants Accelerator Act (Not yet introduced) 16.The UNDERSTAND Act (S. 5182) 17.SNAP Nutrition Security Act of 2023 (S.2326/ H.R.4909) 18.SWEET Act (Not yet introduced) 19.OH SNAP, Close the Fruit and Vegetable Gap Act of 2023 (S. 2015/ H.R. 4149) 20.FY 2026 Labor, HHS, Education and Related Agencies Appropriations 21.The TRUTH in Labeling Act (H.R.6766/ S.3512) 22.Personal Health Investment Today (PHIT) Act (Not yet introduced) 23.Child Nutrition Reauthorization 24.Whole Milk for Healthy Kids Act of 2023 (H.R. 1147/ S. 1957) 25.Promoting Physical Activity for Americans Act (S.397) 26.CDC Oral Health Reauthorization Act (Not yet introduced) 27.GusNIP Expansion Act of 2023 (H.R. 4856) 28.Senior Hunger Prevention Act of 2023 (S. 1036/ H.R. 3474) 29.Black Maternal Health Momnibus Act (H.R. 3305/S. 1606) 30.Older Americans Act (Not yet introduced) 31.Protecting the Health of Americas Older Adults Act (Not yet introduced) 32.REAADI Act (S. 1049) 33.Improving Data in Public Health Act (H.R. 3791) 34.Pandemic and All-Hazards Preparedness Act Reauthorization (H.R. 4420, H.R. 4421) 35.Public Health Infrastructure Saves Lives Act (S. 1995) 36.BIO Early Warning Act (Not yet introduced) 37.The Support for Patients and Communities Reauthorization Act (H.R. 4531) 38.The PEER Support Act (S. 2733/H.R. 7212) 39.The Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (S. 1378) 40.The Barriers to Suicide Act (H.R. 3759) 41.The 9-8-8 Implementation Act (H.R. 4851) 42.Influenza Act (H.R. 5846) 43.Bipartisan Primary Care and Health Workforce Act (S. 2840) 44.National Defense Authorization Act (S. 2226) 45.A resolution declaring racism a public health crisis (S. Res 319) 46.Preventing Maternal Deaths Reauthorization Act of 2023 (S. 2415) 47.Continuity in Necessary Evaluative Crisis Treatment (CONNECT) Act (H.R. 6928) 48.Local 988 Response Act (S. 3444) 49.Better Mental Health Care, Lower Drug Cost, and Extenders Act (S. 3430) 50.Lead-Safe Housing for Kids Act (Not yet introduced) 51.The Medicaid Bump Act (S. 3921/H.R. 4892) 52.The Kid PROOF Act (S. 3364/H.R. 6663) 53.EARLY Minds Act (H.R. 7808) 54.Campus Prevention and Recovery Services for Students Act (H.R. 9214) 55.Stabilization to Prevent (STOP) Suicide Act (H.R. 9577) 56.FY 2025 Interior, Environment and Related Agencies Appropriations 57.American Family Act (H.R. 3899) 58.H.Res.1375 - Recognizing the threat of extreme weather to children's health and well-being, and expressing the sense of Congress that solutions must be rapidly and equitably developed and deployed to address the unique vulnerabilities and needs of children. House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, White House Domestic Policy Council, HHS, CDC, FDA, CMS, OMB, NIH, USDA, HRSA, SAMHSA, and Federal Communications Commission (FCC).

Client expense: $41,497 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Lobbying Issues Description: Budget and appropriations for public health, disease and injury prevention, including obesity and related diseases; pandemics and emerging infectious diseases; physical activity; public health preparedness; nutrition programs; environmental health; health equity; community-based public health interventions; public health infrastructure and workforce; and substance misuse/behavioral health issues. Specific Legislation: 1.Preventing Adverse Childhood Experiences Act (S. 3085) 2.Mental Health Services for Students Act (S. 1884/H.R. 3713) 3.Helping Kids Cope Act (H.R. 2412) 4.Advancing Student Services in Schools Today Act (S. 1774/H.R. 3761) 5.Student Mental Health Rights Act (H.R. 3726) 6.Pursuing Equity in Mental Health Act (S. 1700/H.R. 3548) 7.RISE from Trauma Act (S. 1426) 8.Better Mental Health Care for Americans Act (S. 923) 9.Reentry Act (S. 1165/H.R. 2400) 10.FY 2024 Labor, HHS, Education and Related Agencies Appropriations 11.FY 2025 Labor, HHS, Education and Related Agencies Appropriations 12.Farm Bill 13.Improving Social Determinants of Health Act (H.R. 4781/S. 3847) 14.Social Determinants Accelerator Act (Not yet introduced) 15.SNAP Nutrition Security Act of 2023 (S.2326/ H.R.4909) 16.SWEET Act (Not yet introduced) 17.OH SNAP, Close the Fruit and Vegetable Gap Act of 2023 (S. 2015/ H.R. 4149) 18.Personal Health Investment Today (PHIT) Act (Not yet introduced) 19.Child Nutrition Reauthorization 20.Whole Milk for Healthy Kids Act of 2023 (H.R. 1147/ S. 1957) 21.Promoting Physical Activity for Americans Act (S.397) 22.CDC Oral Health Reauthorization Act (Not yet introduced) 23.GusNIP Expansion Act of 2023 (H.R. 4856) 24.Senior Hunger Prevention Act of 2023 (S. 1036/ H.R. 3474) 25.Black Maternal Health Momnibus Act (H.R. 3305/S. 1606) 26.Older Americans Act (Not yet introduced) 27.Protecting the Health of Americas Older Adults Act (Not yet introduced) 28.REAADI Act (S. 1049) 29.Improving Data in Public Health Act (H.R. 3791) 30.Pandemic and All-Hazards Preparedness Act Reauthorization (H.R. 4420, H.R. 4421) 31.Public Health Infrastructure Saves Lives Act (S. 1995) 32.BIO Early Warning Act (Not yet introduced) 33.The Support for Patients and Communities Reauthorization Act (H.R. 4531) 34.The PEER Support Act (S. 2733/H.R. 7212) 35.The Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (S. 1378) 36.The Barriers to Suicide Act (H.R. 3759) 37.The 9-8-8 Implementation Act (H.R. 4851) 38.Influenza Act (H.R. 5846) 39.Bipartisan Primary Care and Health Workforce Act (S. 2840) 40.National Defense Authorization Act (S. 2226) 41.A resolution declaring racism a public health crisis (S. Res 319) 42.Preventing Maternal Deaths Reauthorization Act of 2023 (S. 2415) 43.Continuity in Necessary Evaluative Crisis Treatment (CONNECT) Act (H.R. 6928) 44.Local 988 Response Act (S. 3444) 45.Better Mental Health Care, Lower Drug Cost, and Extenders Act (S. 3430) 46.Lead-Safe Housing for Kids Act (Not yet introduced) 47.The Medicaid Bump Act (S. 3921/H.R. 4892) 48.The Kid PROOF Act (S. 3364/H.R. 6663) 49.FY 2025 Interior, Environment and Related Agencies Appropriations 50.EARLY Minds Act (H.R. 7808) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, White House Domestic Policy Council, HHS, CDC, FDA, CMS, OMB, NIH, USDA, HRSA, SAMHSA, and Federal Communications Commission (FCC).

Client expense: $47,102 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Issues regarding childrens health care coverage and access to care under Medicaid, CHIP, the Exchanges, and private insurance Issues regarding the annual Notice of Benefit and Payment Parameters for the Exchanges and private insurance H.R. 2412 The Helping Kids Cope Act S.2372/HR. 4758 - Accelerating Kids Access to Care Act  Issues regarding childrens and mothers health specifically continuous eligibility for children in Medicaid and CHIP, CHIP permanency Issues regarding childrens mental health and the national emergency in childrens mental health, including mental health parity, the mental health workforce and related access issues. Issue regarding Medicaid supplemental payments and directed payments Issues related to Health Information Technology, interoperability, information blocking, and cybersecurity Pediatric Access to Critical Healthcare (PATCH) Act, and issues regarding pediatric health care infrastructure and capacity  Issues regarding the importance of Medicaid to children, including military and veteran families  Issues regarding Medicaid support for providers caring for children on Medicaid, including DSH payments Issues regarding Children's Hospitals Graduate Medical Education (CHGME) program and funding Issues related to 340B Drug Pricing Program, prescription drug pricing, drug shortages, high-cost drugs/therapies and pharmaceutical supply chain, including H.R. 3290 Issues related to pediatric workforce, Medicare GME, the Pediatric Specialty Loan Repayment Program, and Title VII and VIII Issues regarding Organ Procurement and Transplantation Network S. 3029/H.R. 6085 PREEMIE Reauthorization Act Issues regarding the Medicaid unwinding Issues regarding surprise billing, bad debt, and price transparency in health care  Issues regarding pediatric pandemic and disaster preparedness and response and emergency preparedness Issues regarding food security and nutrition Issues regarding drugs and medical device shortages and high costs Issues related to the regulation of laboratory developed tests Issues regarding prescribing of drugs via telehealth Issues related to mental health services in schools Issues related to pediatric cancer and the Moonshot Issues regarding Artificial Intelligence (AI) H.R. 1117, Advancing Safe Medications for Moms and Babies Act of 2023 H.R. 4189, CONNECT for Health Act H.R. 1110, KEEP Telehealth Options Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issues regarding the Public Health Emergency Unwinding Issues involving Site Neutral payment legislation, including H.R. 3281 and H.R. 3561 S. 1884/H.R. 3713, Mental Health Services for Students Act H.R. 2389, The Resident Shortage Reduction Act S. 1774/H.R. 3761 the Assist Act H.R. 2665, Supporting Safety Net Hospitals Act H.R. 2584/S.2768, Safety form Violence for Healthcare employees (Save) Act H.R. 3046, Medical Student Education Authorization Act S. 2556, Improving CARE for Youth Act S. 2647/H.R. 5012, SHINE for Autumn Act of 2023 S. 923/H.R. 4933, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023 S. 2362/H.R. 3008, Drug Shortage Prevention Act of 2023 S. 1409, Kids Online Safety Act S. 1769/H.R. 3805, the Kickstarting Innovative Demonstrations Supporting (KIDS) Health Act. H.R. 5804, Mental Health Infrastructure Improvement Act H.R. 5976 /S. 3060 Youth Mental Health Research Act S. 3364, Kid PROOF Act of 2023 H.R. 6664 Innovation for Pediatric Drugs Act of 2023 H.R. 7808, the Early Action and Responsiveness Lifts Youth (EARLY) Minds Act H.R. 7153/S. 3679 Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. 3757 Congenital Heart Futures Reauthorization Act of 2024 H.R. 6960 Emergency Medical Services for Children Reauthorization Act of 2024 H.R. 3391 Gabriella Miller Kids First Research Act 2.0 H.R. 6963 Pediatric Cancer Drug Supply Act H.R. 3433/ S. 2897, Give Kids A Chance Act H.R. 7384, Creating Hope Reauthorization Act. H.R. 6664, Innovation in Pediatric Drugs Act S. 4298: Esthers Law Issues regarding oversight and implementation of EPSDT

Client expense: $1,550,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

Boston Children's Hospital focuses on pediatric workforce education, and public health issues impacting children. In the 118th Congress, we have advocated for the reauthorization of and funding through the appropriations process for the Children's Hospital Graduate Medical Education program (CHGME). We have also discussed the escalating mental and behavioral health challenges among youth and policy solutions in the areas of the pediatric mental health delivery system, workforce and infrastructure. Advocacy pertaining to youth and adolescent mental and behavioral health issues has included discussion of the reintroduction of legislative proposals such as: the Childrens Mental Health Infrastructure Act; the Helping Kids Cope Act (H.R. 2412); the Health Care Capacity for Pediatric Mental Health Act; the Kids Mental Health Now Act.

Client expense: $110,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Educate policymakers about policies to support children mental health care needs, including H.R.2412, the Helping Kids Cope Act; support funding for CHGME; discuss the impact of pediatric workforce and drug/supply shortages and its impact on child health. Monitor issues related to lab-developed tests; discuss policies related to children's mental health, including in H.R.7808, EARLY Minds Act; monitor policy related to AI and privacy; discuss policies related to TRICARE.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for Pediatric Specialty Loan Repayment Program (PSLRP) and adoption of application selection criteria that ensures providers with high graduate debt can benefit equally from this important program. Gun safety legislation - support for HR 6663/S 3365 - The KID Proof Act, and support for an appropriations request to fund research on firearm morbidity and mortality prevention at CDC, NIH, and NIJ. Funding for Childrens Hospital Graduate Medical Education (CHGME) in the FY 2025 budget act. Support for Mental health legislation - HR 7808 - The Early Minds Act, and HR 2412 - The Helping Kids Cope Act. Support for legislation to improve access to specialty care for kids - S. 2372/HR 4758 - Accelerating Kids Access to Care Act. Opposition Medi-Cal cite neutral payments as a budget pay-for.

Client expense: $40,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Support for Pediatric Specialty Loan Repayment Program (PSLRP) and adoption of application selection criteria that ensures providers with high graduate debt can benefit equally from this important program. Gun safety legislation - support for HR 6663/S 3365 - The KID Proof Act, and support for an appropriations request to fund research on firearm morbidity and mortality prevention at CDC, NIH, and NIJ. Funding for Childrens Hospital Graduate Medical Education (CHGME) in the FY 2025 budget act. Support for Mental health legislation - HR 7808 - The Early Minds Act, and HR 2412 - The Helping Kids Cope Act. Support for legislation to improve access to specialty care for kids - S. 2372/HR 4758 - Accelerating Kids Access to Care Act. Opposition Medi-Cal cite neutral payments as a budget pay-for.

Client expense: $40,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

Reproductive health, physician-patient relationship, and EMTALA issues Emergency department boarding Drug shortages Health care consolidation H.R.1694-Emergency Care Improvement Act, to permanently allow for coverage under Medicare and Medicaid of services that are provided by freestanding emergency centers. H.R.2412-Helping Kids Cope Act, to provide grants to improve mental health access for children and reduce pediatric emergency department boarding H.R. 2416-To reauthorize the MISSION ZERO military-civilian partnership for trauma readiness H.R. 2940-PASTEUR Act of 2023, to incentivize new antimicrobial development H.R.4941-Providing Access to Treatment and Housing Act H.R 5414-Improving Mental Health Access from the Emergency Department Act, to establish grants for emergency departments and hospitals to help improve care and care coordination for patients with acute psychiatric care needs H.R.5804-Mental Health Infrastructure Improvement Act of 2023, to provide loans and grants to improve mental health treatment and substance use disorder treatment facilities H.R.6960-Emergency Medical Services for Children Reauthorization Act of 2024, to reauthorize the EMSC program H.R. 6992-Mapping Americas Pharmaceutical Supply Act, to map the U.S. pharmaceutical supply chain to identify vulnerabilities and other security threats H.R. 7153-Dr. Lorna Breen Health Care Provider Protection Act, to reauthorize programs to improve mental health access for health care providers S. 1346-Improving Mental Health Access from the Emergency Department Act, to establish grants for emergency departments and hospitals to help improve care and care coordination for patients with acute psychiatric care needs S. 1355- PASTEUR Act of 2023, to incentivize new antimicrobial development S. 1447-Bipartisan Solution to Cyclical Violence Act of 2023, to establish a grant program to support trauma center violence intervention and violence prevention programs S. 2586-Drug Shortages Prevention and Quality Improvement Act S. 2364-Mapping Americas Pharmaceutical Supply Act, to map the U.S. pharmaceutical supply chain to identify vulnerabilities and other security threats S.3679-Dr. Lorna Breen Health Care Provider Protection Act, to reauthorize programs to improve mental health access for health care providers S.3765-Emergency Medical Services for Children Reauthorization Act of 2024, to reauthorize the EMSC program

Client expense: $509,774 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 462 Mental Health Professionals Workforce Shortage Loan Repayment Act: increasing the mental health workforce HR 1423 911 Community Crisis Responders Act- Increasing the number of unarmed mental health crisis response teams S 853 & HR 1639 VA Zero Suicide Demonstration Project Act of 2023: Resources to end veteran suicide S. 923 Better Mental Health Care for Americans Act- Enforcing and Strengthening the Mental Health Parity Law S. 652 & H.R.2630 Safe Step Act -Creates an exception to medication step-therapy protocol HR 1201 Increasing Behavioral Health Treatment Act: ending the IMD exclusion HR 498 988 Lifeline Cybersecurity Responsibility Act: protecting the 9-8-8 Suicide & Crisis Lifeline from cybersecurity threats HR 3011 To Establish a taskforce at the DOD on Mental Health: To help promote the mental health of service members. S. 923 Better Mental Health Care for Americans Act: Provisions to enforce mental health parity, end ghost networks, and improve mental health care. H.R. 3432 & S.3651 Telemental Health Care Access Act: Making it easier for individuals to access telemental health services. HR 3548 S 1700 Pursuing Equity in Mental Health Care Act: Providing mental health resources to historically underserved communities HR 3850 The Pride in Mental Health Care Act: Mental health resources for LGBTQI+ youth HR 824: the Telehealth Benefit Expansion for Workers Act of 2023: Expands telehealth options for certain workers without the protections of the ACA. HR 4531 & S. 3393 The Support for Patients and Communities Reauthorization Act: Reauthorization of numerous SUD & MH programs from the original SUPPORT Act. HR 2412 Helping Kids Cope Act: Increasing access to pediatric behavioral health service at children's hospitals S 1452 HR 3073 Community Mental Wellness and Resilience Act: Provides technical and financial support for community resilience program Stating our support for the Office of Recovery at the Substance Abuse and Mental Health Services Administration (SAMHSA) S. 24444 H.R. 4830: The Attain Mental Health Act: To create an online dashboards to list available mental health grants H.R. 4851: The 988 Implementation Act: To increase resources for 988 and mental health crisis response H.R. 5804: Mental Health Infrastructure Improvement Act: Loan guarantees for the construction or renovation of pediatric or adult mental health treatment facilities H.R. 485 Protecting Health Care for all Patients Act: prohibits a health care programs from using prices that are based on quality-adjusted life years S. 1378 Complete Care Act: Incentivizes primary care providers to include behavioral health providers in their practice S.1769/H.R.3805: Kids Health Act of 2023: Promoting the whole child health model H.R.6663/S.3364 Kid Proof Act: Preventing youth suicide and overdoses * S. 3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023: Reauthorization of existing Mental Health and SUD programs S.3453 - Peer-to-Peer Mental Health Support Act: Enhancing Peer support services in our nation's schools H.R.5594 - Enhancing the Community Health Workforce Act: Using community health workers to enhance mental health. S. 2733 & H.R. 7212 PEER Support Act- addresses the behavioral health workforce shortages through support for peer support specialists H.R. 7069 Peer Support for Firefighters Act: To increase mental health resources to fire fighters H.R. 7140 Mental Health Transparency Act: To require the disclose of percentage of in-network participation for certain provider types H.R. 7924 To amend the Higher Education Act of 1965 to support graduate programs in mental and behavioral health professions at minority-serving institutions and for other purposes: To help increase the diversity of the mental health workforce. H.R. 7153 & S.3679 Dr. Lorna Breen Health Care Act: To provide mental health resources for health care providers H.R. 6982 & S.3579: The Gambling Addiction, Recovery, Investment, and Treatment (GRIT) Act: Federal funds to research gambling addiction and treatment H.R. 4880 PACE Act: the ability to waive sovereign immunity in certain circumstances where jurisdictions prohibit monetary bail H.R. 6928 Connect Act: grants to certain crisis centers for providing follow-up care to individuals who receive suicide prevention and crisis intervention services. H.R. 8377 Youth Suicide Prevention Research Act: Research to decrease youth suicide H.R. 8375 Strengthening our Pediatric Mental Health Workforce: Using Medicaid and CHIP to increase pediatric mental and behavioral health opportunities H.R. 8376 Latino Youth Mental Health Empowerment Act: Awareness campaign regarding Latino youth mental health H.Res 385/S.Res 205: Supporting the designation of May 10, 2023, as "National Asian American, Native Hawaiian, and Pacific Islander Mental Health Day: Raising MH awareness in AANHPI communities H.R. 7808 Early Minds Act: Supporting funding for early interventions and prevention mental health services. H.R. 8680 To authorize the Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, to award grants to train community mental wellness workers: To increase the mental health workforce

Client expense: $20,000 · Firm income: Not reported

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), President of the U.S., SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

H.R. 4714 & S. 2345, The Pediatricians Accelerate Childhood Therapies (PACT) Act H.R. 3226 & S.1573, The PREEMIE Reauthorization Act H.R. 3838 & S.2415, Preventing Maternal Deaths Reauthorization Act of 2023 H.R.7087 & S.3641, MOMS Who Serve Act H.R. 3312 & S. 1602, Moms Matter Act H.R. 5378, Lower Costs, More Transparency Act (hospital & 340B provisions) SUSTAIN 340B Act - Senate discussion draft H.R 7635, 340B PATIENTS Act H.R. 7808, Early Action and Responsiveness Lifts Youth (EARLY) Minds Act H.R. 2439 & S. 1135, Ally's Act H.R. 7542 & S. 3864, Stop CMV Act H.R. 7379, Patient Matching and Transparency in Certified Health IT (MATCH IT) Act H.R. 6664, Innovation in Pediatric Drug Act of 2023 H.R. 5012 & S. 2647, SHINE for Autumn Act H.R. 2412, Helping Kids Cope Act

Client expense: $190,219 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Children's mental health; child and adolescent psychiatry workforce & health care workforce shortage; H.R.1202/S. 704, Resident Education Deferred Interest (REDI) Act; H.R. 4933/S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023; H.R. 2412, Helping Kids Cope Act; H.R. 3548, Pursuing Equity in Mental Health Act; S. 923, Better Mental Health Care for Americans Act; Stimulant drug shortage; H.R. 8375, Strengthening Our Pediatric Mental Health Workforce Act; H.R. 8377, Youth Suicide Prevention Research Act

Client expense: $75,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Substance Use Disorder Workforce, including scholarship opportunities Substance Use Disorder Treatment and Recovery Loan Repayment Program Reauthorization (H.R.3073/S.1452) Community Mental Wellness and Resilience Act (H.R.2412) Helping Kids Cope Act (H.R.3713) Mental Health Services for Students Act (H.R.4851) 9-8-8 Implementation Act of 2023 (H.R.4950) IMPROVE Addiction Care Act (H.R. 4531/ S.3393) Support for Patients and Communities Reauthorization Act (H.R. 773/S.3165) Homelessness and Behavioral Health Care Coordination Act of 2023 Issues surrounding 9-8-8 georouting (H.R.7536/S.3085) Preventing Adverse Childhood Experiences (PACE) Act (H.R.7212/S.2733) Providing Empathetic and Effective Recovery (PEER) Support Act Issues surrounding ACO flex model Issues surrounding Mental Health Parity and Addiction Equity Act rules (H.R. 8375) Strengthening Our Pediatric Mental Health Workforce Act (H.R. 8376) Latino Youth MH Empowerment Act (H.R. 8377) Youth Suicide Prevention Research Act (H.R. 8680) Community Mental Wellness Worker Training Act

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

CONNECT for Health Act of 2023 (H.R. 4189 / S. 2106), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2023 (H.R. 3432), all provisions related to ensuring coverage of mental health services furnished through telehealth. Modernizing Opioid Treatment Access Act of 2023 (H.R. 1359/S. 644), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 988 Implementation Act (H.R. 4851), all provisions related to authorizing and growing funding and support for the 988 suicide and crisis lifeline Protecting Kids on Social Media Act (H.R. 6149/S.1291), all provisions related to authorizing certain safeguards to protect mental health for children when using social media platforms Ryan Haight Act, all provisions related to the extension of COVID-19 telemedicine flexibilities for prescription of controlled medication The PEER Mental Health Act of 2023 (H.R. 2642 / S.3498), all provisions related to award grants to build capacity for peer support programs for individuals experiencing mental health and substance use challenges Helping Kids Cope Act of 2023 (H.R. 2412), all provisions related to awarding grants to build the capacity of the pediatric behavioral health services Strengthening Community Care Act of 2023 (H.R. 2559) all provisions related to reauthorization of the Community Health Center Fund for three years, ending in 2026. Improving Access to Mental Health Act (H.R.1638 / S.838), all provisions related to the incentivizing of mental health professionals to practice in Mental Health Professional Shortage areas. SUPPORT for Patients and Communities Reauthorization Act (H.R. 4531/S. 3393) all provisions relating to the continued bolstered funding for substance use disorder treatment and recovery. Local 9-8-8 Response Act (H.R. 4974 / S. 3444), all provisions relating to the continued bolstering of 9-8-8 crisis services and requiring that 9-8-8 calls be routed to their nearest call center as opposed to the call center matching the area code of the phone originating the call. CONNECT Act (H.R. 6928), all provisions related to awarding grants to certain crisis centers for providing follow-up care to individuals who receive suicide prevention and crisis intervention services. Improving Mental Health and Wellness in Schools Act (H.R.3331/ S.754), all provisions related to expanding mental health education and health promotion in existing school education programs Kickstarting Innovative Demonstrations Supporting Health Act (H.R.3805/ S.1769), all provisions relating to improving the health and wellbeing of children by addressing nonmedical factors that determine health outcomes. Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act (S.1378), all provisions related to incentivizing primary care to implement integrated care models to improve access to behavioral health care treatments. Better Mental Health Care for Americans Act (S.923), all provisions relating to parity enforcement and improving access to mental health care for Medicare and Medicaid beneficiaries. Mental Health Student Loan Forgiveness Act (H.R. 4933/S. 462), all provisions relating to expanding the Substance Use Disorder Treatment and Recovery Loan Repayment Program and expanding eligibility to include individuals who agree to work in mental health professional shortage areas for a period of time. Resident Physician Shortage Reduction Act (H.R.2389/ S.1302), all provisions relating to adding additional residency positions for improved access to behavioral health care in physician shortage areas as defined by SAMHSA Stop Overdose in Schools Act (H.R.5652), all provisions related to setting aside funds for opioid reversal agent administration training for schools and the expansion of opioid education programs in education. Mental Health Infrastructure Improvement Act of 2023 (H.R.5804), all provisions relating to authorizing the Secretary of Health and Human Services to make loans and loan guarantees for the betterment of pediatric and adult mental health and substance use treatment facilities. Advancing Lifesaving Efforts with Rapid Test strips for Communities Act ALERT Communities Act (S.2919), all provisions related to expanding access to fentanyl and xylazine test strips. H.R. 7545, all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes.

Client expense: $149,440 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Womens Health Protection Act Mental Health Workforce Shortages Meeting with various administrative agencies on expanding access to mental health care in rural areas Forthcoming House bill on capital investments in rural mental health Federal policies affecting access to contingency management services for substance use disorders H. R. 498 / S.1493, 9-8-8 Lifeline Cybersecurity Responsibility Act H.R. 501 Block, Report, And Suspend Suspicious Shipments Act H.R. 773/S. 3165, Homelessness and Behavioral Health Care Coordination Act of 2023 H.R. 1359/S. 644 Modernizing Opioid Treatment Access Act H.R. 1423 911 Community Crisis Responders Act of 2023 H.R. 1502 Comprehensive Opioid Recovery Centers Reauthorization Act of 2023 H.R. 2400 The Reentry Act H.R. 2474 - The Strengthening Medicare for Patients and Providers Act H.R.2577/S.1137,DHS Suicide Prevention and Resiliency for Law Enforcement Act H.R. 3074/S. 971 The Due Process Continuity of Care Act HR 3305 Black Maternal Health Momnibus Act H.R. 3375 STOP Fentanyl Overdoses Act H.R. 3548 Pursuing Equity in Mental Health Act H.R. 3752 Parity Enforcement Act of 2023 H.R. 3759 Barriers to Suicide Act of 2023 H.R. 3850/S.3949 Pride in Mental Health Act H.R.4310/S.2233, Youth Poisoning Protection Act H.R. 4531 / S. 2433, SUPPORT for Patients and Communities Reauthorization Act of 2023 H.R. 4851, 9-8-8 Implementation Act of 2023 H.R. 4884 /S. 2476 Mental Health for Latinos Act of 2023 H.R.4974, Local 988 Response Act H.R. 5866, Substance Use Disorder and Family Engagement (SAFE) in Recovery Act H.R. 6284/S. 3260 Improving Measurements for Loneliness and Isolation Act of 2023 H.R. 6475 Health Disparity Zones Act of 2023 H.R.6928 CONNECT Act of 2024 H.R. 7301 Certified Community Behavioral Health Clinic Expansion Act of 2024 H.R. 8390 Mental Health and MAMA Act of 2024 H.R. 8503 Integrated Care for Dual Eligibles S.669/H.R. 8458 Increasing Mental Health Options Act of 2023 S. 923 Better Mental Health Care for Americans Act S. 1378/ H.R 5819 COMPLETE Care Act S. 1426/H.R. 4541 Rise from Trauma Act S.2350, National Strategy for Social Connection Act Reintroduction of The Behavioral Health Coverage Transparency Act Reintroduction of The Parity Enforcement Act of 2023 H.R. 5804, The Mental Health Infrastructure Improvement Act Reintroduction of The Comprehensive Addiction Resources Emergency Act Reintroduction of The Stop Online Suicide Assistance Forums Act S.2511, the ADAPT Act S. 2688 / H.R. 5116, the Behavioral Health IT Coordination Act S. 2733, PEER Support Act Response to Senator Bill Cassidy Request for Information re: patient data privacy Federal policies affecting the use of contingency management services for the treatment of stimulant use disorders H.R. 7808, EARLY Minds Act H.R. 6407 / S. 3297, Medical Nutrition Therapy Act S.3364, Kids Providing Resources for Optimal Outcomes Against Fatalities Act of 2024 (KID Proof Act) S.3085, Preventing Adverse Childhood Experiences Act (PACE Act) S. 3393 SUPPORT for Patients and Communities Reauthorization Act S.3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S.3498 Promoting Effective and Empowering Recovery Services in Medicare Act of 2023S. 3557 Public Health Impact of Opioid Drugs S. 3769, Alternative Pathways to Child Abuse Prevention Act S. 4312 United States Senate Commission on Mental Health Act of 2024 S. 4338 Pay PCPs Act of 2024 Dear Colleague letter to CMS re: coverage of digital therapeutics Reauthorization of the Older Americans Act Elder Justice Act Title IV-B of the Social Security Act H.R. 7432, Sickle Cell Comprehensive Care Act H.R. 3432/S. 3651, Telemental Health Care Access Act Congressional briefing on telehealth and H.R. 3432 Congressional briefing on caregiving and mental health Congressional Briefing on A Population Health Approach to Youth Substance Use Disorder Prevention Congressional Briefing on Caucus on the Commission on the Social Status of Black Men and Boys Mental Health Parity Final Rule Meeting with the Tri-Departments (DOL, HHS and Treasury) H.R. 2412, Helping Kids Cope Act H.R 3312, S. 1602, Moms Matter Act

Client expense: $500,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Faith-Based & Community Initiatives, Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of

Reproductive health, physician-patient relationship, and EMTALA issues Emergency department boarding Drug shortages Health care consolidation H.R.1694-Emergency Care Improvement Act, to permanently allow for coverage under Medicare and Medicaid of services that are provided by freestanding emergency centers. H.R.2412-Helping Kids Cope Act, to provide grants to improve mental health access for children and reduce pediatric emergency department boarding H.R. 2416-To reauthorize the MISSION ZERO military-civilian partnership for trauma readiness H.R. 2940-PASTEUR Act of 2023, to incentivize new antimicrobial development H.R.4941-Providing Access to Treatment and Housing Act H.R 5414-Improving Mental Health Access from the Emergency Department Act, to establish grants for emergency departments and hospitals to help improve care and care coordination for patients with acute psychiatric care needs H.R.5804-Mental Health Infrastructure Improvement Act of 2023, to provide loans and grants to improve mental health treatment and substance use disorder treatment facilities H.R.6960-Emergency Medical Services for Children Reauthorization Act of 2024, to reauthorize the EMSC program H.R. 7153-Dr. Lorna Breen Health Care Provider Protection Act, to reauthorize programs to improve mental health access for health care providers S. 1346-Improving Mental Health Access from the Emergency Department Act, to establish grants for emergency departments and hospitals to help improve care and care coordination for patients with acute psychiatric care needs S. 1355- PASTEUR Act of 2023, to incentivize new antimicrobial development S. 1447-Bipartisan Solution to Cyclical Violence Act of 2023, to establish a grant program to support trauma center violence intervention and violence prevention programs S. 2586-Drug Shortages Prevention and Quality Improvement Act S.3679-Dr. Lorna Breen Health Care Provider Protection Act, to reauthorize programs to improve mental health access for health care providers S.3765-Emergency Medical Services for Children Reauthorization Act of 2024, to reauthorize the EMSC program

Client expense: $417,727 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Boston Children's Hospital focuses on pediatric workforce education, and public health issues impacting children. In the 118th Congress, we have advocated for the reauthorization of and funding through the appropriations process for the Children's Hospital Graduate Medical Education program (CHGME). We have also discussed the escalating mental and behavioral health challenges among youth and policy solutions in the areas of the pediatric mental health delivery system, workforce and infrastructure. Advocacy pertaining to youth and adolescent mental and behavioral health issues has included discussion of the reintroduction of legislative proposals such as: the Childrens Mental Health Infrastructure Act; the Helping Kids Cope Act (H.R. 2412); the Health Care Capacity for Pediatric Mental Health Act; the Kids Mental Health Now Act.

Client expense: $180,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Lobbying Issues Description: Budget and appropriations for public health, disease and injury prevention, including obesity and related diseases; pandemics and emerging infectious diseases; physical activity; public health preparedness; nutrition programs; environmental health; health equity; community-based public health interventions; public health infrastructure and workforce; and substance misuse/behavioral health issues. Specific Legislation: 1.Preventing Adverse Childhood Experiences Act (S. 3085) 2.Mental Health Services for Students Act (S. 1884/H.R. 3713) 3.Helping Kids Cope Act (H.R. 2412) 4.Advancing Student Services in Schools Today Act (S. 1774/H.R. 3761) 5.Student Mental Health Rights Act (H.R. 3726) 6.Pursuing Equity in Mental Health Act (S. 1700/H.R. 3548) 7.RISE from Trauma Act (S. 1426) 8.Better Mental Health Care for Americans Act (S. 923) 9.Reentry Act (S. 1165/H.R. 2400) 10.FY 2024 Labor, HHS, Education and Related Agencies Appropriations 11.FY 2025 Labor, HHS, Education and Related Agencies Appropriations 12.2023 Farm Bill 13.Improving Social Determinants of Health Act (H.R. 4781/S. 3847) 14.Social Determinants Accelerator Act (Not yet introduced) 15.SNAP Nutrition Security Act of 2023 (S.2326/ H.R.4909) 16.SWEET Act (Not yet introduced) 17.OH SNAP, Close the Fruit and Vegetable Gap Act of 2023 (S. 2015/ H.R. 4149) 18.Child Nutrition Reauthorization 19.While Milk for Healthy Kids Act of 2023 (H.R. 1147/ S. 1957) 20.Promoting Physical Activity for Americans Act (S.397) 21.Halt Obesity in America Act (Not yet introduced) 22.CDC Oral Health Reauthorization Act (Not yet introduced) 23.GusNIP Expansion Act of 2023 (H.R. 4856) 24.Senior Hunger Prevention Act of 2023 (S. 1036/ H.R. 3474) 25.Black Maternal Health Momnibus Act (H.R. 3305/S. 1606) 26.Older Americans Act (Not yet introduced) 27.Protecting the Health of Americas Older Adults Act (Not yet introduced) 28.REAADI Act (S. 1049) 29.Improving Data in Public Health Act (H.R. 3791) 30.Pandemic and All-Hazards Preparedness Act Reauthorization (H.R. 4420, H.R. 4421) 31.Public Health Infrastructure Saves Lives Act (S. 1995) 32.BIO Early Warning Act (Not yet introduced) 33.The Support for Patients and Communities Reauthorization Act (H.R. 4531) 34.The PEER Support Act (S. 2733/H.R. 7212) 35.The Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (S. 1378) 36.The Barriers to Suicide Act (H.R. 3759) 37.The 9-8-8 Implementation Act (H.R. 4851) 38.Influenza Act (H.R. 5846) 39.Bipartisan Primary Care and Health Workforce Act (S. 2840) 40.National Defense Authorization Act (S. 2226) 41.Tobacco Tax Equity Act of 2023 (S.2929/ H.R. 5715) 42.A resolution declaring racism a public health crisis (S. Res 319) 43.Preventing Maternal Deaths Reauthorization Act of 2023 (S. 2415) 44.Continuity in Necessary Evaluative Crisis Treatment (CONNECT) Act (H.R. 6928) 45.Local 988 Response Act (S. 3444) 46.Better Mental Health Care, Lower Drug Cost, and Extenders Act (S. 3430) 47.Lead-Safe Housing for Kids Act (Not yet introduced) 48.The Medicaid Bump Act (S. 3921) 49.The Kid PROOF Act (S. 3364/H.R. 6663) 50.FY 2025 Interior, Environment and Related Agencies Appropriations House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, White House Domestic Policy Council, HHS, CDC, FDA, CMS, OMB, NIH, USDA, HRSA, SAMHSA, and Federal Communications Commission (FCC).

Client expense: $44,194 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Discussion with OMB/OIRA regarding OSHA Occupational Exposure to COVID-19 in Healthcare Settings Final Rule; Discussion with FDA Drug Shortage expert regarding Inflation Reduction Act Provisions that could impact duration of shortages; Discussion with ASPR Hospital Preparedness Program Staff about speaking at a meeting regarding HPP issues; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Inpatient Prospective Payment System/Long Term Care Hospital Proposed Rule; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Medicare Advantage Final Rule; Hill outreach about reducing hospital workplace violence; Hill outreach about the benefits of hospital mergers and acquisitions; Statement to the U.S. Senate Committee on Health, Education, Labor, and Pensions, Examining Health Care Workforce Shortages: Where Do We Go from Here?; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an RFI on the drivers of health care workforce shortages; Support S.1110, Rural Hospitals Support Act, a bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support H.R. 1110, Telehealth Option Act, a bill to direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Childrens Health Insurance programs during the COVID-19 emergency; Feedback on the Connect for Health Act; AHA provided feedback on the creating opportunities new for necessary and effective care technologies (CONNECT) Act; False Claims Act Case AHA Provides Statement for House Hearing on Price Transparency, Competition; Oppose H.R.977/S.470 Patient Access Higher Quality Health Care Act, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support S.940, The Rural America Health Corps Act A bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Support the Conrad State 30 and Physician Access Reauthorization Act that would allow international doctors trained in the United States to remain in the country if they practice in areas experiencing medical shortages; Letter to CMS regarding intent to issue staffing mandates for nursing homes and urged CMS and policy makers to focus on efforts that will bolster our workforce; Support HR 2389/ S 1302, Resident Physician Shortage Reduction Act of 2023, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Support HR 2411/ S 1150, National Nursing Workforce Center Act of 2023, a bill to amend the Public Health Service Act to support and stabilize the existing nursing workforce, establish programs to increase the number of nurses; Support HR 2534, Preserving Rules Ordered for The Entities Covered Through 340B Act of 2023 or the PROTECT 340B Act of 2023, a bill to amend title XXVII of the Public Health Service Act to ensure the equitable treatment of covered entities and pharmacies participating in the 340B drug discount program; Support HR 2559, Strengthening Community Care Act of 2023, a bill to extend funding for community health centers and the National Health Service Corp; Statement to the House Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing titled, Competition and Transparency: The Pathway Forward for a Stronger Health Care Market highlighting that mergers and acquisitions can be a helpful tool for many hospitals and pushing back against site-neutral payment policies; Letter urging Congress to continue to protect this critical program and oppose efforts to cut its benefits, which would result in reduced access to quality care for the patients and communities served by 340B hospitals; Statement to Subcommittee on Health of the Committee on Energy and Commerce on its hearing Examining Existing Federal Programs to Build a Stronger Health Workforce and Improve Primary Care; Support S 1447, Bipartisan Solution to Cyclical Violence Act of 2023, a bill to amend the Public Health Service Act to establish a grant program supporting trauma center violence intervention and violence prevention programs, and for other purposes; Support HR 3046/ S 1403, Medical Student Education Authorization Act of 2023, a bill to amend the Public Health Service Act to establish a grant program to award grants to accredited public institutions of higher education, and for other purposes; Concerns with HR 2691, Transparent Prices Required to Inform Consumer and Employers Act or the Transparent PRICE Act, a bill to promote hospital and insurer price transparency; Letter strongly opposing the draft bills, which would create additional site-neutral payment cuts and threaten access to care, especially in rural and other vulnerable communities; Comment letter to the Office of Civil Rights on its HIPAA Privacy Rule to Support Reproductive Health Care Privacy and concerns the guidance is too broad and will result in significant adverse consequences for hospitals, patients and the public at large; Statement to SFC for the hearing on Consolidation and Corporate Ownership in Health Care: Trends and Impacts on Access, Quality, and Costs; Comment letters to CMS on their Inpatient and Long-term Care Facility Prospective Payment System FY 2024 proposed rule; Letter to reauthorize key programs within the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018, supporting policies that will reduce barriers to receiving and administering behavioral health care by improving payment policies, reducing unnecessary regulatory and administrative burden, and strengthening the behavioral health workforce; Comment letter on the Environmental Protection Agencys (EPA) proposed standards for the use of ethylene oxide (EtO) to sterilize medical devices urge caution and thoughtfulness in EPAs approach to avoid disrupting health care delivery through the unintentional fracturing of the already fragile medical device supply chain; Comment on Energy and Commerce Committee Chair Rodgers drug shortages discussion draft; Support S. 2364 Mapping Americas Pharmaceutical Supply Act A bill to map the United States pharmaceutical supply chain and use data analytics to identify supply chain vulnerabilities and other national security threats; Support S. 2510 RAPID Reserve Act A bill to improve supply chain resiliency for critical drug products with vulnerable supply chains and ensure that reserves of critical drugs and active pharmaceutical ingredients are maintained to prevent supply disruptions in the event of drug shortages or public health emergencies; Support S. 1961, Pharmaceutical Supply Chain Risk Assessment Act of 2023, A bill to require an interagency risk assessment of the pharmaceutical supply chain to identify and mitigate health and national security risks, and for other purposes; support the Drug Shortage Prevention Act that will help pave the way for additional improvements to the U.S. drug supply chain, which will, in turn, improve patient access and care; Support S.1636/H.R. 3440 Protecting Rural Telehealth Access Act A bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program. Drug Shortages RFI Letter to the U.S. Senate Committee on Finance in response to a Request For Information on drug shortages; Support H.R. 4713 Rural Hospital Technical Assistance Program Act A letter to support HR 4713, the Rural Hospital Technical Assistant Program Act. A bill to make permanent a program that provides technical assistance for rural hospitals to help prevent closures; Verbal Support Train More Nurse Act, It instructs HHS and DOL to conduct a joint review of all grant programs supporting the nursing workforce and coming up with recommendations to Congress within a year on how to change the programs to increase nurse faculty, provide pathways for those who want to become nurse faculty, and increase the nursing pipeline for both RNs and LPNs; Support H.R.2412 Helping Kids Cope Act To amend the Public Health Service Act to authorize grants to increase national capacity to provide pediatric behavioral health services at childrens hospitals and through community-based providers to improve childrens access to care; and to authorize grants to begin to address large numbers of children boarding in emergency departments, to support the pediatric behavioral health workforce, and for other purposes; Meeting with OMB to discuss Proposed Minimum Staffing Requirements for Long-term Care Facilities; Meeting with OMB to discuss FY 2024 IPPS and LTCH Final Rule; Meeting with Senate Finance Committee regarding the FY 2024 LTCH Final Rule; A letter to comment on ways to improve access to care in rural and underserved areas ensuring that Americans in these rural and underserved areas have high-quality, affordable health care; Support S. 2016/ H.R. 4189, CONNECT for Health Act of 2023, a bill to support to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; A letter to the Department of Veterans Affairs (VA) expressing significant concerns about Cotivitis audit and appeals process, including its inadequate appeals procedures, the scope of audits being performed and the untenable timelines that are being executed; Support S. 3211/ H.R. 6205, Healthcare Workforce Resilience Act, a bill to support Healthcare Workforce Resilience Act to enhance our Nations nurse and physician workforce by recapturing unused immigrant visas; Support for Reauthorization of PAPHA, The Pandemic and All-Hazards Preparedness Act (PAHPA), To amend the Public Health Service Act to reauthorize certain programs with respect to public health security and all-hazards preparedness and response related to the Administration for Strategic Preparedness and Response and certain programs with respect to public health security and all-hazards preparedness and response related to the Centers for Disease Control and Prevention, and for other purposes; Support H.R. 6430, Rural Community Hospitals (ARCH) Act, a bill to support the Assistance for Rural Community Hospitals (ARCH) Act; To support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges, Congress established the Medicare- dependent Hospital (MDH) program in 1987, allowing eligible hospitals to receive the sum of their prospective payment system (PPS) payment rate, plus three- quarters of the amount by which their cost per discharge exceeds the PPS rate; Support H.R. 4531/ S.3393, Patients and Communities Reauthorization Act, a bill to reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment, and for other purposes; A letter to the FDA on its laboratory developed tests (LDTs) proposed rule urging the agency to not apply its device regulations to hospital and health system LDTs because they are not devices; rather, they are diagnostic tools developed and used in the context of patient care. Instead, we urged the FDA to continue to apply its enforcement discretion to hospital and health system LDTs; Submit Statement to the Committee on Energy and Commerce Subcommittee on Health hearing, Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care to share the hospital fields comments on proposed regulations for minimum staffing standards for LTC facilities and their potential impact on access to care; Concern H.R. 5378 Lower Costs, More Transparency Act, A bill to promotes price transparency in the health care sector, and for other purposes; Hill Briefing on SAVE Act, Support S. 2768 / H.R. 2584, The Safety from Violence for Healthcare Employees (SAVE) Act, A bill to protect hospital personnel from violence, and for other purposes; Health Care Spending in the United States: Unsustainable for Patients, Employers, and Taxpayers; Statement to the House Committee on Energy and Commerce Subcommittee on Health regarding the topic of national health expenditures, The Independent Dispute Resolution Process (IDR), To comment on the proposed rule related to the operations of the Independent Dispute Resolution Process (IDR) established by the No Surprises Act (NSA); Examining Chronic Drug Shortages in the United States, Statement to the House Committee on Ways and Means regarding the important topic of drug shortages in the United States; Support H.R. 6205 / S. 3211, Healthcare Workforce Resilience Act, A bill to reauthorize title II of the Higher Education Act of 1965, and for other purposes; H.R. 7513; Protecting Americas Seniors Access to Care, Statement to the House Committee on Ways and Means regarding Protecting Americas Seniors Access to Care to prohibit the Secretary of Health and Human Services from finalizing a proposed rule regarding minimum staffing for nursing facilities, and to establish an advisory panel on the skilled nursing facility workforce; Enhancing Access to Care at Home in Rural and Underserved Communities, Statement to the House Committee on Ways and Means on how telehealth flexibilities, the hospital-at-home (H@H) program and home health agencies have expanded access to care for patients in their homes and the need for these programs to continue; The recent cyberattack on Change Healthcare, Letter to House and Senate leadership requesting assistance for hospitals impacted by the cyberattack; The recent cyberattack on Change Healthcare, Letter to Senate Finance Committee leadership to share concerns regarding the Administrations proposal to penalize hospitals that do not meet certain cybersecurity requirements; Support S. 3779 / H.R. 7265, Child Suicide Prevention and Lethal Means Safety Act, A bill authorizing the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Evaluating Approaches to Diagnostic Test Regulation and the Impact of FDAs Proposed Rule.", Statement to the House Committee on Energy and Commerce Subcommittee on Health on the impact of the Food and Drug Administrations (FDA) proposed regulation of diagnostic tests; Senate RFI on the SUSTAIN 340B Act Draft, A letter to provide feedback on the Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future of (SUSTAIN) 340B Act bipartisan discussion draft and accompanying request for information on the 340B Drug Pricing Program; Access to Health Care in America: Ensuring Resilient Emergency Medical Care, Statement to the House Committee on Ways and Means on access to emergency medical services in rural areas; Support H.R. 7623, Telehealth Modernization Act, A bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program; House RFI on strengthening ERISA, A letter to provide feedback on an RFI from the House Education and Workforce Committee on ways to strengthen and improve ERISA, Addressing drug shortagesAHAs statement for record to Ways and Means committee hearing on Examining Chronic Drug Shortages in the United States, Statement commenting on the impact of the FDAs proposed regulation of laboratory developed tests (LDTs), AHAs statement for the record to Energy and Commerce Subcommittee on Health on "Evaluating Approaches to Diagnostic Test Regulation and the Impact of FDAs Proposed Rule.", Response to RFI on oversight and regulation of LDTs, Response to Sen. Cassidy, Ranking Member of HELP Committee on his RFI seeking feedback on the FDAs proposed regulation of hospital LDTs, OMB meeting, including FDA officials, on the FDAs rulemaking on the regulation of hospital LDTs as medical devicesOMB/FDA; Support S 3679 / H.R. 7153, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, A bill to reauthorize the Dr. Lorna Breen Health Care Provider Protection Act, and for other purposes, Support S. 1110, the Rural Hospital Support Act, A bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support HR 1565, Critical Access Hospital Relief Act of 2023, A bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services.

Client expense: $6,010,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE

Issues regarding childrens health care coverage and access to care under Medicaid, CHIP, the Exchanges, and private insurance Issues regarding the annual Notice of Benefit and Payment Parameters for the Exchanges and private insurance Issues regarding the implementation of the ACE Kids Act  H.R. 2412 The Helping Kids Cope Act S.2372/HR. 4758 - Accelerating Kids Access to Care Act  Issues regarding childrens and mothers health specifically continuous eligibility for children in Medicaid and CHIP, CHIP permanency Issues regarding childrens mental health and the national emergency in childrens mental health, including mental health parity, the mental health workforce and related access issues. Issue regarding Medicaid supplemental payments and directed payments Issues related to Health Information Technology, interoperability, information blocking, and cybersecurity Pediatric Access to Critical Healthcare (PATCH) Act, and issues regarding pediatric health care infrastructure and capacity  Issues regarding the importance of Medicaid to children, including military and veteran families  Issues regarding Medicaid support for providers caring for children on Medicaid, including DSH payments FY 2024 and FY 2025 Senate and House Labor-HHS appropriations provisions - Children's Hospitals Graduate Medical Education (CHGME) program funding   Issues regarding Children's Hospitals Graduate Medical Education (CHGME) program reauthorization Issues related to 340B Drug Pricing Program, prescription drug pricing, drug shortages, high-cost drugs/therapies and pharmaceutical supply chain, including H.R. 3290 Issues related to pediatric workforce and the Pediatric Specialty Loan Repayment Program S. 3029/H.R. 6085 PREEMIE Reauthorization Act Issues regarding the Medicaid unwinding Issues regarding surprise billing, bad debt, and price transparency in health care  Issues regarding pediatric pandemic and disaster preparedness and response and emergency preparedness Issues regarding food security and nutrition Issues regarding drugs and medical device shortages and high costs Issues related to the regulation of laboratory-developed tests Issues regarding prescribing of drugs via telehealth Issues related to mental health services in schools Issues related to pediatric cancer and the Moonshot H.R. 1117, Advancing Safe Medications for Moms and Babies Act of 2023 H.R. 4189, CONNECT for Health Act H.R. 1110, KEEP Telehealth Options Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issues regarding the Public Health Emergency Unwinding Issues involving Site Neutral payment legislation, including H.R. 3281 and H.R. 3561 S. 1884/H.R. 3713, Mental Health Services for Students Act The Pursuing Equity in Mental Health America Act H.R. 2389, The Resident Shortage Reduction Act S. 1774/H.R. 3761 the Assist Act H.R. 3633, the Prevent HPV Cancers Act H.R. 2665, Supporting Safety Net Hospitals Act H.R. 2584/S.2768, Safety form Violence for Healthcare employees (Save) Act S. 923, Better Mental Health Care for Americans Act H.R. 3046, Medical Student Education Authorization Act S. 2556, Improving CARE for Youth Act S. 2647/H.R. 5012, SHINE for Autumn Act of 2023 S. 923/H.R. 4933, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023 S.2476/H.R. 4884, Mental Health for Latinos Act of 2023 S. 2362/H.R. 3008, Drug Shortage Prevention Act of 2023 H.R. 3759, Barriers to Suicide Act of 2023 S. 1409, Kids Online Safety Act S. 1769/H.R. 3805, the Kickstarting Innovative Demonstrations Supporting (KIDS) Health Act. H.R. 5804, Mental Health Infrastructure Improvement Act H.R. 5976 /S. 3060 Youth Mental Health Research Act S. 3364, Kid PROOF Act of 2023 H.R. 6664 Innovation for Pediatric Drugs Act of 2023 H.R. 7808, the Early Action and Responsiveness Lifts Youth (EARLY) Minds Act H.R. 7153/S. 3679 Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. 3757 Congenital Heart Futures Reauthorization Act of 2024 H.R. 6960 Emergency Medical Services for Children Reauthorization Act of 2024 H.R. 3391 Gabriella Miller Kids First Research Act 2.0 H.R. 6963 Pediatric Cancer Drug Supply Act H.R. 3433/ S. 2897, Give Kids A Chance Act S. 2560 Long COVID Support Act H.R. 7384, Creating Hope Reauthorization Act. H.R. 6664, Innovation in Pediatric Drugs Act

Client expense: $1,400,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Natl Oceanic & Atmospheric Administration (NOAA), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

Children's mental health Child and adolescent psychiatry workforce & health care workforce shortage HR1202/S704, Resident Education Deferred Interest (REDI) Act HR4933/S462, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023 HR2412, Helping Kids Cope Act HR3548, Pursuing Equity in Mental Health Act S. 923, Better Mental Health Care for Americans Act Stimulant drug shortage

Client expense: $75,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Educate policymakers about policies to support children mental health care needs, including H.R.2412, the Helping Kids Cope Act; support funding for CHGME; monitor House and Senate work on pediatric and adolescent mental health. Advocate for childrens issues in S.2333, the Pandemic and All Hazards Preparedness Act; discuss the impact of pediatric workforce and drug/supply shortages and its impact on child health. Monitor issues related to lab-developed tests.

Client expense: Not reported · Firm income: $90,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Substance Use Disorder Workforce Substance Use Disorder Treatment and Recovery Loan Repayment Program Reauthorization (H.R.3073/S.1452) Community Mental Wellness and Resilience Act (H.R.2412) Helping Kids Cope Act (H.R.3713) Mental Health Services for Students Act (H.R.4851) 9-8-8 Implementation Act of 2023 (H.R.4950) IMPROVE Addiction Care Act (H.R. 4531/ S.3393) Support for Patients and Communities Reauthorization Act (H.R. 773/S.3165) Homelessness and Behavioral Health Care Coordination Act of 2023 Issues surrounding 9-8-8 georouting (H.R.7536/S.3085) Preventing Adverse Childhood Experiences (PACE) Act (H.R.7212/S.2733) Providing Empathetic and Effective Recovery (PEER) Support Act

Client expense: Not reported · Firm income: $30,000

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S 462 Mental Health Professionals Workforce Shortage Loan Repayment Act: increasing the mental health workforce HR 1423 911 Community Crisis Responders Act- Increasing the number of unarmed mental health crisis response teams S 853 & HR 1639 VA Zero Suicide Demonstration Project Act of 2023: Resources to end veteran suicide S. 923 Better Mental Health Care for Americans Act- Enforcing and Strengthening the Mental Health Parity Law S. 652 & H.R.2630 Safe Step Act -Creates an exception to medication step-therapy protocol HR 1201 Increasing Behavioral Health Treatment Act: ending the IMD exclusion HR 498 988 Lifeline Cybersecurity Responsibility Act: protecting the 9-8-8 Suicide & Crisis Lifeline from cybersecurity threats HR 3011 To Establish a taskforce at the DOD on Mental Health: To help promote the mental health of service members. S. 923 Better Mental Health Care for Americans Act: Provisions to enforce mental health parity, end ghost networks, and improve mental health care. H.R. 3432 & S.3651 Telemental Health Care Access Act: Making it easier for individuals to access telemental health services. HR 3548 S 1700 Pursuing Equity in Mental Health Care Act: Providing mental health resources to historically underserved communities HR 3850 The Pride in Mental Health Care Act: Mental health resources for LGBTQI+ youth HR 824: the Telehealth Benefit Expansion for Workers Act of 2023: Expands telehealth options for certain workers without the protections of the ACA. HR 4531 & S. 3393 The Support for Patients and Communities Reauthorization Act: Reauthorization of numerous SUD & MH programs from the original SUPPORT Act. HR 2412 Helping Kids Cope Act: Increasing access to pediatric behavioral health service at children's hospitals S 1452 HR 3073 Community Mental Wellness and Resilience Act: Provides technical and financial support for community resilience program Stating our support for the Office of Recovery at the Substance Abuse and Mental Health Services Administration (SAMHSA) S. 24444 H.R. 4830: The Attain Mental Health Act: To create an online dashboards to list available mental health grants H.R. 4851: The 988 Implementation Act: To increase resources for 988 and mental health crisis response H.R. 5804: Mental Health Infrastructure Improvement Act: Loan guarantees for the construction or renovation of pediatric or adult mental health treatment facilities H.R. 485 Protecting Health Care for all Patients Act: prohibits a health care programs from using prices that are based on quality-adjusted life years S. 1378 Complete Care Act: Incentivizes primary care providers to include behavioral health providers in their practice S.1769/H.R.3805: Kids Health Act of 2023: Promoting the whole child health model H.R.6663/S.3364 Kid Proof Act: Preventing youth suicide and overdoses * S. 3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023: Reauthorization of existing Mental Health and SUD programs S.3453 - Peer-to-Peer Mental Health Support Act: Enhancing Peer support services in our nation's schools H.R.5594 - Enhancing the Community Health Workforce Act: Using community health workers to enhance mental health. S. 2733 & H.R. 7212 PEER Support Act- addresses the behavioral health workforce shortages through support for peer support specialists H.R. 7069 Peer Support for Firefighters Act: To increase mental health resources to fire fighters H.R. 7140 Mental Health Transparency Act: To require the disclose of percentage of in-network participation for certain provider types H.R. 7924 To amend the Higher Education Act of 1965 to support graduate programs in mental and behavioral health professions at minority-serving institutions and for other purposes: To help increase the diversity of the mental health workforce. H.R. 7153 & S.3679 Dr. Lorna Breen Health Care Act: To provide mental health resources for health care providers H.R. 6982 & S.3579: The Gambling Addiction, Recovery, Investment, and Treatment (GRIT) Act: Federal funds to research gambling addiction and treatment H.R. 4880 PACE Act: the ability to waive sovereign immunity in certain circumstances where jurisdictions prohibit monetary bail H.R. 6928 Connect Act: grants to certain crisis centers for providing follow-up care to individuals who receive suicide prevention and crisis intervention services.

Client expense: $10,000 · Firm income: Not reported

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), President of the U.S., SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Womens Health Protection Act Mental Health Workforce Shortages Coding and reimbursement for digital therapeutics devices (DTx) and services furnished via DTx Meeting with various administrative agencies on expanding access to mental health care in rural areas Forthcoming House bill on capital investments in rural mental health Federal policies affecting access to contingency management services for substance use disorders H. R. 498 / S.1493, 9-8-8 Lifeline Cybersecurity Responsibility Act H.R. 501 Block, Report, And Suspend Suspicious Shipments Act H.R. 773/S. 3165, Homelessness and Behavioral Health Care Coordination Act of 2023 H.R. 824, Telehealth Benefit Expansion for Workers Act H.R. 1359/S. 644 Modernizing Opioid Treatment Access Act H.R. 1423 911 Community Crisis Responders Act of 2023 H.R. 1502 Comprehensive Opioid Recovery Centers Reauthorization Act of 2023 H.R. 2400 The Reentry Act H.R. 2474 - The Strengthening Medicare for Patients and Providers Act H.R.2577/S.1137,DHS Suicide Prevention and Resiliency for Law Enforcement Act H.R. 3074/S. 971 The Due Process Continuity of Care Act HR 3305 Black Maternal Health Momnibus Act H.R. 3375 STOP Fentanyl Overdoses Act H.R. 3432/S. 3651 Telemental Health Care Access Act H.R. 3548 Pursuing Equity in Mental Health Act H.R. 3752 Parity Enforcement Act of 2023 H.R. 3759 Barriers to Suicide Act of 2023 H.R. 3850/S.3949 Pride in Mental Health Act H.R.4310/S.2233, Youth Poisoning Protection Act H.R. 4531 / S. 2433, SUPPORT for Patients and Communities Reauthorization Act of 2023 H.R. 4851, 9-8-8 Implementation Act of 2023 H.R. 4892, Medicaid Bump Act H.R. 4884 /S. 2476 Mental Health for Latinos Act of 2023 H.R.4974, Local 988 Response Act H.R. 5866, Substance Use Disorder and Family Engagement (SAFE) in Recovery Act H.R. 6284/S. 3260 Improving Measurements for Loneliness and Isolation Act of 2023 H.R. 6475 Health Disparity Zones Act of 2023 H.R.6928 CONNECT Act of 2024 S.669 Increasing Mental Health Options Act of 2023 S. 923 Better Mental Health Care for Americans Act S. 1378/ H.R 5819 COMPLETE Care Act S. 1426/H.R. 4541 Rise from Trauma Act S. 1736, Farmers First Act S. 2016 / H.R. 4189, CONNECT for Health Act S.2350, National Strategy for Social Connection Act Reintroduction of The Behavioral Health Coverage Transparency Act Reintroduction of The Parity Enforcement Act of 2023 H.R. 5804, The Mental Health Infrastructure Improvement Act Reintroduction of The Comprehensive Addiction Resources Emergency Act Reintroduction of The Stop Online Suicide Assistance Forums Act S.2511, the ADAPT Act S. 2688 / H.R. 5116, the Behavioral Health IT Coordination Act S. 2733, PEER Support Act H.R. 4736, the Investing in Rural America Act Response to Senator Bill Cassidy Request for Information re: patient data privacy Federal policies affecting the use of contingency management services for the treatment of stimulant use disorders H.R. 7808, EARLY Minds Act H.R. 6524 / S. 1077, Home-Based Telemental Health Care Act H.R. 6407 / S. 3297, Medical Nutrition Therapy Act S.3364, Kids Providing Resources for Optimal Outcomes Against Fatalities Act of 2024 (KID Proof Act) S.3085, Preventing Adverse Childhood Experiences Act (PACE Act) S. 3393 SUPPORT for Patients and Communities Reauthorization Act S.3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S.3498 Promoting Effective and Empowering Recovery Services in Medicare Act of 2023S. 3557 Public Health Impact of Opioid Drugs S. 3769, Alternative Pathways to Child Abuse Prevention Act H.R. 6487, No Fees for EFTs Act H.R. 3730/S. 198, Rural Health Clinic Burden Reduction Act H.R. 6407/S. 3297, Medical Nutrition Therapy Act Coalition letter to CMS opposing inclusion of HR 824 in funding package Meeting with CMS CIIO Office re: future rulemaking under the No Surprises Act Meeting with CMS and House/Senate offices re: coverage of digital therapeutics Reauthorization of the Older Americans Act Elder Justice Act Title IV-B of the Social Security Act H.R. 2762, the Tribal Family Fairness Act H.R. 3461, the Strengthening Tribal Families Act H.R. 2412, Helping Kids Cope Act H.R 3312, S. 1602, Moms Matter Act

Client expense: $400,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Faith-Based & Community Initiatives, Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of

CONNECT for Health Act of 2023 (H.R. 4189 / S. 2106), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2023 (H.R. 3432), all provisions related to ensuring coverage of mental health services furnished through telehealth. Modernizing Opioid Treatment Access Act of 2023 (H.R. 1359/S. 644), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 988 Implementation Act (H.R. 4851), all provisions related to authorizing and growing funding and support for the 988 suicide and crisis lifeline Protecting Kids on Social Media Act (H.R. 6149/S.1291), all provisions related to authorizing certain safeguards to protect mental health for children when using social media platforms Ryan Haight Act, all provisions related to the extension of COVID-19 telemedicine flexibilities for prescription of controlled medication The PEER Mental Health Act of 2023 (H.R. 2642 / S.3498), all provisions related to award grants to build capacity for peer support programs for individuals experiencing mental health and substance use challenges Helping Kids Cope Act of 2023 (H.R. 2412), all provisions related to awarding grants to build the capacity of the pediatric behavioral health services Strengthening Community Care Act of 2023 (H.R. 2559) all provisions related to reauthorization of the Community Health Center Fund for three years, ending in 2026. Improving Access to Mental Health Act (H.R.1638 / S.838), all provisions related to the incentivizing of mental health professionals to practice in Mental Health Professional Shortage areas. SUPPORT for Patients and Communities Reauthorization Act (H.R. 4531/S. 3393) all provisions relating to the continued bolstered funding for substance use disorder treatment and recovery. Local 9-8-8 Response Act (H.R. 4974 / S. 3444), all provisions relating to the continued bolstering of 9-8-8 crisis services and requiring that 9-8-8 calls be routed to their nearest call center as opposed to the call center matching the area code of the phone originating the call. CONNECT Act (H.R. 6928), all provisions related to awarding grants to certain crisis centers for providing follow-up care to individuals who receive suicide prevention and crisis intervention services. Improving Mental Health and Wellness in Schools Act (H.R.3331/ S.754), all provisions related to expanding mental health education and health promotion in existing school education programs Kickstarting Innovative Demonstrations Supporting Health Act (H.R.3805/ S.1769), all provisions relating to improving the health and wellbeing of children by addressing nonmedical factors that determine health outcomes. Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act (S.1378), all provisions related to incentivizing primary care to implement integrated care models to improve access to behavioral health care treatments. Better Mental Health Care for Americans Act (S.923), all provisions relating to parity enforcement and improving access to mental health care for Medicare and Medicaid beneficiaries. Mental Health Student Loan Forgiveness Act (H.R. 4933/S. 462), all provisions relating to expanding the Substance Use Disorder Treatment and Recovery Loan Repayment Program and expanding eligibility to include individuals who agree to work in mental health professional shortage areas for a period of time. Resident Physician Shortage Reduction Act (H.R.2389/ S.1302), all provisions relating to adding additional residency positions for improved access to behavioral health care in physician shortage areas as defined by SAMHSA Stop Overdose in Schools Act (H.R.5652), all provisions related to setting aside funds for opioid reversal agent administration training for schools and the expansion of opioid education programs in education. Mental Health Infrastructure Improvement Act of 2023 (H.R.5804), all provisions relating to authorizing the Secretary of Health and Human Services to make loans and loan guarantees for the betterment of pediatric and adult mental health and substance use treatment facilities. Advancing Lifesaving Efforts with Rapid Test strips for Communities Act ALERT Communities Act (S.2919), all provisions related to expanding access to fentanyl and xylazine test strips. H.R. 7545, all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes.

Client expense: $140,770 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Medicaid program reforms, including telemedicine and prior authorization issues Section 340B Drug Pricing program, including H.R. 5378 (Lower Costs, More Transparency Act), Section 202 Drug pricing reforms generally Juvenile mental and behavioral health legislation generally "Food as medicine" nutrition programs generally Medicaid Disproportionate Share Hospital payments Advanced Research Projects Agency-Health program generally H.R. 3884 (Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act of 2023), all provisions H.R. 3391 (Gabriella Miller Kids First Research Act 2.0), all provisions H.R. 3887 (Children's Hospital GME Support Reauthorization Act of 2023), all provisions Implementation of Pediatric Specialty Loan Repayment Program Medicare "site neutral" payment policy generally, including H.R. 5378 (Lower Costs, More Transparency Act), Section 203 Pediatric cancer research generally Pediatric access to cell and gene therapies generally H.R. 4822 (Health Care Price Transparency Act of 2023), all provisions H.R. 4714 / S. 2345 (Pediatricians Accelerate Childhood Therapies (PACT) Act), all provisions H.R. 2412 (Helping Kids Cope Act), all provisions H.R. 5976 / S. 3060 (Youth Mental Health Research Act), all provisions S. 2556 (Improving Coordination and Access to Resources Equitably (CARE) for Youth Act), all provisions

Client expense: $180,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Reproductive health, physician-patient relationship, and EMTALA issues Emergency department boarding Drug shortages Health care consolidation H.R.1694-Emergency Care Improvement Act, to permanently allow for coverage under Medicare and Medicaid of services that are provided by freestanding emergency centers. H.R.2412-Helping Kids Cope Act, to provide grants to improve mental health access for children and reduce pediatric emergency department boarding H.R. 2416-To reauthorize the MISSION ZERO military-civilian partnership for trauma readiness H.R. 2940-PASTEUR Act of 2023, to incentivize new antimicrobial development H.R.4941-Providing Access to Treatment and Housing Act H.R 5414-Improving Mental Health Access from the Emergency Department Act H.R.5804-Mental Health Infrastructure Improvement Act of 2023, to provide loans and grants to improve mental health treatment and substance use disorder treatment facilities S. 1346-Improving Mental Health Access from the Emergency Department Act S. 1355- PASTEUR Act of 2023, to incentivize new antimicrobial development S. 1447-Bipartisan Solution to Cyclical Violence Act of 2023, to establish a grant program to support trauma center violence intervention and violence prevention programs S. 2586-Drug Shortages Prevention and Quality Improvement Act

Client expense: $499,399 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Reproductive health, physician-patient relationship, and EMTALA issues Emergency department boarding Drug shortages Health care consolidation H.R.1694-Emergency Care Improvement Act, to permanently allow for coverage under Medicare and Medicaid of services that are provided by freestanding emergency centers. H.R.2412-Helping Kids Cope Act, to provide grants to improve mental health access for children and reduce pediatric emergency department boarding H.R. 2416-To reauthorize the MISSION ZERO military-civilian partnership for trauma readiness H.R. 2940-PASTEUR Act of 2023, to incentivize new antimicrobial development H.R.4941-Providing Access to Treatment and Housing Act H.R 5414-Improving Mental Health Access from the Emergency Department Act S. 1346-Improving Mental Health Access from the Emergency Department Act S. 1355- PASTEUR Act of 2023, to incentivize new antimicrobial development S. 1447-Bipartisan Solution to Cyclical Violence Act of 2023, to establish a grant program to support trauma center violence intervention and violence prevention programs S. 2586-Drug Shortages Prevention and Quality Improvement Act

Client expense: $352,268 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for HR 2412, the Helping Kids Cope Act, which would take important steps to address the children's mental health crisis through the creation of three new HRSA grant programs designed to reach children and pediatric behavioral health providers. Sought support for HR 4758/S 2372, the Accelerating Kids Access to Care Act, which would streamline Medicaid provider enrollment when a child needs to travel to another state for care. Responded to congressional inquiries regarding gender affirming care.

Client expense: $100,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Boston Children's Hospital focuses on pediatric workforce education, and public health issues impacting children. In the 118th Congress, we have advocated for the reauthorization of and funding through the appropriations process for the Children's Hospital Graduate Medical Education program (CHGME). We have also discussed the escalating mental and behavioral health challenges among youth and policy solutions in the areas of the pediatric mental health delivery system, workforce and infrastructure. Advocacy pertaining to youth and adolescent mental and behavioral health issues has included discussion of the reintroduction of legislative proposals such as: the Childrens Mental Health Infrastructure Act; the Helping Kids Cope Act (H.R. 2412); the Health Care Capacity for Pediatric Mental Health Act; the Kids Mental Health Now Act.

Client expense: $80,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Issues regarding childrens health care coverage and access to care under Medicaid, CHIP, the Exchanges, and private insurance Issues regarding the annual Notice of Benefit and Payment Parameters for the Exchanges and private insurance Issues regarding the implementation of the ACE Kids Act H.R. 2412 The Helping Kids Cope Act S.2372/HR. 4758 - Accelerating Kids Access to Care Act Issues regarding childrens and mothers health specifically continuous eligibility for children in Medicaid and CHIP, CHIP permanency Issues regarding childrens mental health and the national emergency in childrens mental health, including mental health parity, the mental health workforce and related access issues. Issue regarding Medicaid supplemental payments and directed payments Issues related to Health Information Technology, interoperability and information blocking Pediatric Access to Critical Healthcare (PATCH) Act, and issues regarding pediatric health care infrastructure and capacity Issues regarding the importance of Medicaid to children, including military and veteran families Issues regarding Medicaid support for providers caring for children on Medicaid, including DSH payments FY 2023 and FY 2024 Senate and House Labor-HHS appropriations provisions - Children's Hospitals Graduate Medical Education (CHGME) program funding Issues regarding Children's Hospitals Graduate Medical Education (CHGME) program reauthorization Issues related to 340B Drug Pricing Program, prescription drug pricing, drug shortages, high-cost drugs/therapies and pharmaceutical supply chain, including H.R. 3290 Issues related to pediatric workforce and the Pediatric Specialty Loan Repayment Program S. 3029/H.R. 6085 PREEMIE Reauthorization Act Issues regarding the Medicaid unwinding and impact of the pandemic, increased FMAP funding, and the impact of COVID-19 on childrens hospitals and children, the pediatric supply chain, and pediatric residency programs Issues regarding COVID-19 vaccination efforts for children Issues regarding surprise billing, bad debt, and price transparency in health care Issues regarding the Public Health Emergency and response on RSV/flu Issues regarding the reauthorization of the Pandemic and All-Hazards Preparedness Act and emergency preparedness Issues related to Emergency Medical Services for Children reauthorization Issues regarding food security and nutrition Issues regarding drugs and medical device shortages and high costs VALID Act/laboratory developed tests Issues regarding the uptake of childhood vaccines Issues regarding prescribing drugs via telehealth H.R. 1117, Advancing Safe Medications for Moms and Babies Act of 2023 Issues regarding the Public Health Emergency Unwinding Issues involving Site Neutral payment legislation, including H.R. 3281 and H.R. 3561 S. 1884/H.R. 3713, Mental Health Services for Students Act The Pursuing Equity in Mental Health America Act H.R. 2389, The Resident Shortage Reduction Act S. 1774/H.R. 3761 the Assist Act H.R. 3633, the Prevent HPV Cancers Act H.R. 2665, Supporting Safety Net Hospitals Act H.R. 2584/S.2768, Safety form Violence for Healthcare employees (Save) Act S. 923, Better Mental Health Care for Americans Act H.R. 3046, Medical Student Education Authorization Act S. 2556, Improving CARE for Youth Act S. 2647/H.R. 5012, SHINE for Autumn Act of 2023 S. 923/H.R. 4933, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023 S.2476/H.R. 4884, Mental Health for Latinos Act of 2023 S. 2362/H.R. 3008, Drug Shortage Prevention Act of 2023 H.R. 3759, Barriers to Suicide Act of 2023 S. 1409, Kids Online Safety Act S. 1769/H.R. 3805, the Kickstarting Innovative Demonstrations Supporting (KIDS) Health Act. H.R. 5804, Mental Health Infrastructure Improvement Act H.R. 5976 /S. 3060 Youth Mental Health Research Act S. 3364, Kid PROOF Act of 2023

Client expense: $2,640,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Natl Oceanic & Atmospheric Administration (NOAA), SENATE, Treasury, Dept of

Discussion with OMB/OIRA regarding OSHA Occupational Exposure to COVID-19 in Healthcare Settings Final Rule; Discussion with FDA Drug Shortage expert regarding Inflation Reduction Act Provisions that could impact duration of shortages; Discussion with ASPR Hospital Preparedness Program Staff about speaking at a meeting regarding HPP issues; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Inpatient Prospective Payment System/Long Term Care Hospital Proposed Rule; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Medicare Advantage Final Rule; Hill outreach about reducing hospital workplace violence; Hill outreach about the benefits of hospital mergers and acquisitions; Hill outreach about the anticompetitive behaviors of travel nurse staffing agencies; Statement to the U.S. Senate Committee on Health, Education, Labor, and Pensions, Examining Health Care Workforce Shortages: Where Do We Go from Here?; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an Request For Information on the reauthorization of the Pandemic and All-Hazards Preparedness Act; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an RFI on the drivers of health care workforce shortages; Support S.1110, Rural Hospitals Support Act, a bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support H.R. 1110Telehealth Option Act, a bill to direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Childrens Health Insurance programs during the COVID-19 emergency; Feedback on the Connect for Health Act; AHA provided feedback on the creating opportunities new for necessary and effective care technologies (CONNECT) Act; False Claims Act Case AHA Provides Statement for House Hearing on Price Transparency, Competition; Oppose H.R.977/S.470 Patient Access Higher Quality Health Care Act, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support S.940, The Rural America Health Corps Act A bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Support the Conrad State 30 and Physician Access Reauthorization Act that would allow international doctors trained in the United States to remain in the country if they practice in areas experiencing medical shortages; Letter to CMS regarding intent to issue staffing mandates for nursing homes and urged CMS and policy makers to focus on efforts that will bolster our workforce; Support HR 2389/ S 1302, Resident Physician Shortage Reduction Act of 2023, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Support HR 2411/ S 1150, National Nursing Workforce Center Act of 2023, a bill to amend the Public Health Service Act to support and stabilize the existing nursing workforce, establish programs to increase the number of nurses; Support HR 2534, Preserving Rules Ordered for The Entities Covered Through 340B Act of 2023 or the PROTECT 340B Act of 2023, a bill to amend title XXVII of the Public Health Service Act to ensure the equitable treatment of covered entities and pharmacies participating in the 340B drug discount program; Support HR 2559, Strengthening Community Care Act of 2023, a bill to extend funding for community health centers and the National Health Service Corp; Support HR 2584/S.2768, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purpose; Statement to the House Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing titled, Competition and Transparency: The Pathway Forward for a Stronger Health Care Market highlighting that mergers and acquisitions can be a helpful tool for many hospitals and pushing back against site-neutral payment policies; Letter urging Congress to continue to protect this critical program and oppose efforts to cut its benefits, which would result in reduced access to quality care for the patients and communities served by 340B hospitals; Statement to Subcommittee on Health of the Committee on Energy and Commerce on its hearing Examining Existing Federal Programs to Build a Stronger Health Workforce and Improve Primary Care; Support S 1447, Bipartisan Solution to Cyclical Violence Act of 2023, a bill to amend the Public Health Service Act to establish a grant program supporting trauma center violence intervention and violence prevention programs, and for other purposes; Support HR 3046/ S 1403, Medical Student Education Authorization Act of 2023, a bill to amend the Public Health Service Act to establish a grant program to award grants to accredited public institutions of higher education, and for other purposes; Concerns with HR 2691, Transparent Prices Required to Inform Consumer and Employers Act or the Transparent PRICE Act, a bill to promote hospital and insurer price transparency; Letter strongly opposing the draft bills, which would create additional site-neutral payment cuts and threaten access to care, especially in rural and other vulnerable communities; Comment letter to the Office of Civil Rights on its HIPAA Privacy Rule to Support Reproductive Health Care Privacy and concerns the guidance is too broad and will result in significant adverse consequences for hospitals, patients and the public at large; Statement to SFC for the hearing on Consolidation and Corporate Ownership in Health Care: Trends and Impacts on Access, Quality, and Costs; Comment letters to CMS on their Inpatient and Long-term Care Facility Prospective Payment System FY 2024 proposed rule; Letter to reauthorize key programs within the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018, we encourage you to consider policies that will reduce barriers to receiving and administering behavioral health care by improving payment policies, reducing unnecessary regulatory and administrative burden, and strengthening the behavioral health workforce; Comment letter on the Environmental Protection Agencys (EPA) proposed standards for the use of ethylene oxide (EtO) to sterilize medical devices urge caution and thoughtfulness in EPAs approach to avoid disrupting health care delivery through the unintentional fracturing of the already fragile medical device supply chain; Hill briefing, Site-neutral Payment Proposals Would Jeopardize Access to Care for Patients and Communities; Comment on Energy and Commerce Committee Chair Rodgers drug shortages discussion draft; Support S. 2364 Mapping Americas Pharmaceutical Supply Act A bill to map the United States pharmaceutical supply chain and use data analytics to identify supply chain vulnerabilities and other national security threats; Support S. 2510 RAPID Reserve Act A bill to improve supply chain resiliency for critical drug products with vulnerable supply chains and ensure that reserves of critical drugs and active pharmaceutical ingredients are maintained to prevent supply disruptions in the event of drug shortages or public health emergencies; Support S. 1961Pharmaceutical Supply Chain Risk Assessment Act of 2023A bill to require an interagency risk assessment of the pharmaceutical supply chain to identify and mitigate health and national security risks, and for other purposes; Drug Shortage Prevention Act Letter to express support for the Drug Shortage Prevention Act that will help pave the way for additional improvements to the U.S. drug supply chain, which will, in turn, improve patient access and care; Bipartisan request for information on the critically important 340B Drug Pricing Program Letter on the savings 340B hospitals achieve through purchasing certain outpatient drugs at a discount allow them to provide a range of programs and services that directly benefit their patients; Support S.1636/H.R. 3440 Protecting Rural Telehealth Access Act A bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program. Drug Shortages RFI Letter to the U.S. Senate Committee on Energy and Commerce and Finance in response to a Request For Information on drug shortages; Support H.R. 4713 Rural Hospital Technical Assistance Program Act A letter to support HR 4713, the Rural Hospital Technical Assistant Program Act. A bill to make permanent a program that provides technical assistance for rural hospitals to help prevent closures; Verbal Support Train More Nurse Act It instructs HHS and DOL to conduct a joint review of all grant programs supporting the nursing workforce and coming up with recommendations to Congress within a year on how to change the programs to increase nurse faculty, provide pathways for those who want to become nurse faculty, and increase the nursing pipeline for both RNs and LPNs; Support H.R.2412 Helping Kids Cope Act To amend the Public Health Service Act to authorize grants to increase national capacity to provide pediatric behavioral health services at childrens hospitals and through community-based providers to improve childrens access to care; and to authorize grants to begin to address large numbers of children boarding in emergency departments, to support the pediatric behavioral health workforce, and for other purposes; Meeting with OMB to discuss Proposed Minimum Staffing Requirements for Long-term Care Facilities; Meeting with OMB to discuss FY 2024 IPPS and LTCH Final Rule; Meeting with Senate Finance Committee regarding the FY 2024 LTCH Final Rule; A letter to comment on ways to improve access to care in rural and underserved areas ensuring that Americans in these rural and underserved areas have high-quality, affordable health care; Support S. 2016/ H.R. 4189, CONNECT for Health Act of 2023, a bill to support to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; A letter to the Department of Veterans Affairs (VA) expressing significant concerns about Cotivitis audit and appeals process, including its inadequate appeals procedures, the scope of audits being performed and the untenable timelines that are being executed; Support S. 3211/ H.R. 6205, Healthcare Workforce Resilience Act, a bill to support Healthcare Workforce Resilience Act to enhance our Nations nurse and physician workforce by recapturing unused immigrant visas; Support for Reauthorization of PAPHA, The Pandemic and All-Hazards Preparedness Act (PAHPA), To amend the Public Health Service Act to reauthorize certain programs with respect to public health security and all-hazards preparedness and response related to the Administration for Strategic Preparedness and Response and certain programs with respect to public health security and all-hazards preparedness and response related to the Centers for Disease Control and Prevention, and for other purposes; Support H.R. 6430, Rural Community Hospitals (ARCH) Act, a bill to support the Assistance for Rural Community Hospitals (ARCH) Act; To support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges, Congress established the Medicare- dependent Hospital (MDH) program in 1987, allowing eligible hospitals to receive the sum of their prospective payment system (PPS) payment rate, plus three- quarters of the amount by which their cost per discharge exceeds the PPS rate; Support H.R. 4531/ S.3393, Patients and Communities Reauthorization Act, a bill to reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment, and for other purposes; A letter to the FDA on its laboratory developed tests (LDTs) proposed rule urging the agency to not apply its device regulations to hospital and health system LDTs because they are not devices; rather, they are diagnostic tools developed and used in the context of patient care. Instead, we urged the FDA to continue to apply its enforcement discretion to hospital and health system LDTs; Submit Statement to the Committee on Energy and Commerce Subcommittee on Health hearing, Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care to share the hospital fields comments on proposed regulations for minimum staffing standards for LTC facilities and their potential impact on access to care.

Client expense: $8,090,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE