00:00Back now, recognize the new Vice Chair of the Health Subcommittee, Ms. Harshbarger of Tennessee.
00:06Thank you, Chairman Griffith. I appreciate that, and it's an honor to be the Vice Chair.
00:11You know, it's the first reauthorization of a MUFU, and it's important that we get it right.
00:17And we've made a lot of progress in the first five years of this, but I don't think we've
00:22realized the full potential of what Congress set out to achieve on behalf of consumers with this.
00:28And so we need to work through that to improve the regulatory certainty and minimize regulatory
00:34burdens where possible. And I've got a lot more questions for you. But anyway, we'll start with
00:40Dr. Chin. I represent a very rural area in East Tennessee, and I also co-chair the bipartisan,
00:47Congressional Bipartisan Rural Health Caucus. And we continue to hear that patients in rural areas
00:53have a much harder time accessing quality health care services, which is often due to a lack
00:58of providers in the immediate area. And we need to ensure that taxpayer resources are reaching
01:04the communities that need it most. And the term disadvantage is used throughout Title VII and
01:10Title VIII of the Public Health Service Act. And my question is, how does the Secretary define
01:17such a term?
01:18Dr. Chin. The definition that we use in our programs often is directed by statute. And if
01:27there's a particular program that you're interested in, we can follow up with you afterwards with
01:30the specifics.
01:32Dr. Chin. Okay. Do one. Okay. Mr. Morris. I joined Representative Emanuel Cleaver to introduce
01:45bipartisan legislation to expand the scope of rural health grants to include mobile integrated
01:50health and community paramedic grantees, enabling Americans in rural communities to receive centralized
01:58mobile and preventative care through local paramedics. And it's an increasingly popular
02:04initiative in health care known as community paramedic. Currently, EMS is considered a service
02:10provider of transportation. However, EMS has progressed over the years to become a crucial
02:15part of a health care system. And what are your thoughts on reform of the current EMS system?
02:21And does HRSA see the value of community paramedic as a part of the future of EMS and health care
02:26as a whole?
02:27Dr. Thank you for the question. Yeah, the use of community paramedic in mobile integrated
02:33care has been growing for the last 10 years. And it's another example, I think, of the creativity
02:39that rural communities can bring to this. I think what spurred its creation was you had EMTs and
02:45paramedics with downtime between calls. And somebody had the idea that they could go do blood pressure
02:50checks or home visits. And it extended a somewhat constrained workforce. So I think it's worked well.
02:56We funded a number of those programs through the rural health outreach over the years. And I'm sure we're
03:01going to continue to fund them because they really do work. I think the larger challenges are how to
03:07sustain them. There are some pathways forward where it might work well in a value-based care system.
03:13But we're also in a fee-for-service system. So part of the challenge is figuring out the best way to
03:18cover those services.
03:19Dr. Yeah. We're looking at a lot of different ways to pay for different services. Telemedicine is another.
03:24So, you know, they fundamentally believe in the right care at the right place at the right time. And that
03:30mentality means that the emergency department isn't always the best place for that patient. And often
03:37those patients can be treated in place or via telehealth. Do you see how that's not only good
03:42for the patients, but also for really the financial portfolio of the healthcare system as a whole?
03:48Dr. Corrigan-Couray, independent pharmacies are the bedrock of our communities. And can you tell us how
03:57CDER is operationalizing the OTC-ACNU pathway in order to expand the role of consumer health products
04:04and helping consumers manage their health?
04:06Dr. Sure. You're referring to our additional condition of use, which is a PDUFA program.
04:12Dr. Yeah.
04:13Dr. Yes. What we're, you know, there's some lots of flexibility in operationalizing. You know,
04:18a company will come in and they will establish that the usual sort of drug facts label is not
04:24sufficient for selection. And then there'll be another condition of use that will be put on,
04:31whether that would be, you know, going to a website, whether you could have something within a pharmacy,
04:37you know, some questions, electronic kind of questions, but something that you would have to
04:42satisfy that condition of use before you access the product. And we really think that this is going
04:47to be key to getting more of those products that we just can't, you know, get that self-selection
04:52through the label and perhaps for chronic diseases. And so we'll be working with companies
04:57on how to innovate in this area.
04:59Dr. Okay. That's very, very good. As a pharmacist, that makes me feel good.
05:02And then there's certain things that should be kept behind the counter,
05:04but we'll talk about that later. Thank you. And I yield back.
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