The country had a great day yesterday, inspired by the inauguration. Now it's time to get to work.
The House Ways and Means Committee Healthcare IT Bill includes language chartering two new Federal Advisory Committees - the HIT Policy Committee and the HIT Standards Committee.
What is a Federal Advisory Committee?
The Federal Advisory Committee Act became law in 1972 and is the legal foundation defining how Federal Advisory Committees operate. Characteristics of a Federal Advisory Committee include:
Open and Inclusive
Such regulations shall provide that -
(A) no member of any advisory committee or of the staff of any advisory committee shall receive compensation at a rate in excess of the rate specified for GS-18 of the General Schedule under section 5332 of title 5, United States Code;
(B) such members, while engaged in the performance of their duties away from their homes or regular places of business, may be allowed travel expenses, including per diem in lieu of subsistence, as authorized by section 5703 of title 5, United States Code, for persons employed intermittently in the Government service; and
(C) such members -
(i) who are blind or deaf or who otherwise qualify as handicapped individuals (within the meaning of section 501 of the Rehabilitation Act of 1973 (29 U.S.C. 794)), and
(ii) who do not otherwise qualify for assistance under section 3102 of title 5, United States Code, by reason of being an employee of an agency (within the meaning of section 3102(a)(1) of such title 5), may be provided services pursuant to section 3102 of such title 5 while in performance of their advisory committee duties.
(2) Nothing in this subsection shall prevent -
(A) an individual who (without regard to his service with an advisory committee) is a full-time employee of the United States, or
(B) an individual who immediately before his service with an advisory committee was such an employee, from receiving compensation at the rate at which he otherwise would be compensated (or was compensated) as a full-time employee of the United States.
(e) The Administrator shall include in budget recommendations a summary of the amounts he deems necessary for the expenses of advisory committees, including the expenses for publication of reports where appropriate.
Governance
a) No advisory committee shall be established unless such establishment is -
(1) specifically authorized by statute or by the President; or
(2) determined as a matter of formal record, by the head of the agency involved after consultation with the Administrator, with timely notice published in the Federal Register, to be in the public interest in connection with the performance of duties imposed on that agency by law.
(b) Unless otherwise specifically provided by statute or Presidential directive, advisory committees shall be utilized solely for advisory functions. Determinations of action to be taken and policy to be expressed with respect to matters upon which an advisory committee reports or makes recommendations shall be made solely by the President or an officer of the Federal Government.
(c) No advisory committee shall meet or take any action until an advisory committee charter has been filed with
(1) the Administrator, in the case of Presidential advisory committees, or
(2) with the head of the agency to whom any advisory committee reports and with the standing committees of the Senate and of the House of Representatives having legislative jurisdiction of such agency. Such charter shall contain the following information:
(A) the committee's official designation;
(B) the committee's objectives and the scope of its activity;
(C) the period of time necessary for the committee to carry out its purposes;
(D) the agency or official to whom the committee reports;
(E) the agency responsible for providing the necessary support for the committee;
(F) a description of the duties for which the committee is responsible, and, if such duties are not solely advisory, a specification of the authority for such functions;
(G) the estimated annual operating costs in dollars and man-years for such committee;
(H) the estimated number and frequency of committee meetings;
(I) the committee's termination date, if less than two years from the date of the committee's establishment; and
(J) the date the charter is filed.
A copy of any such charter shall also be furnished to the Library of Congress.
Transparency
Sec. 10. Advisory committee procedures; meetings; notice, publication in Federal Register; regulations; minutes; certification; annual report; Federal officer or employee, attendance
-STATUTE-
(a)(1) Each advisory committee meeting shall be open to the public.
(2) Except when the President determines otherwise for reasons of national security, timely notice of each such meeting shall be published in the Federal Register, and the Administrator shall prescribe regulations to provide for other types of public notice to insure that all interested persons are notified of such meeting prior thereto.
(3) Interested persons shall be permitted to attend, appear before, or file statements with any advisory committee, subject to such reasonable rules or regulations as the Administrator may prescribe.
(b) Subject to section 552 of title 5, United States Code, the records, reports, transcripts, minutes, appendixes, working papers, drafts, studies, agenda, or other documents which were made available to or prepared for or by each advisory committee shall be available for public inspection and copying at a single location in the offices of the advisory committee or the agency to which the advisory committee reports until the advisory committee ceases to exist.
(c) Detailed minutes of each meeting of each advisory committee shall be kept and shall contain a record of the persons present, a complete and accurate description of matters discussed and conclusions reached, and copies of all reports received, issued, or approved by the advisory committee. The accuracy of all minutes shall be certified to by the chairman of the advisory committee.
(d) Subsections (a)(1) and (a)(3) of this section shall not apply to any portion of an advisory committee meeting where the President, or the head of the agency to which the advisory committee reports, determines that such portion of such meeting may be closed to the public in accordance with subsection (c) of section 552b of title 5, United States Code. Any such determination shall be in writing and shall contain the reasons for such determination. If such a determination is made, the advisory committee shall issue a report at least annually setting forth a summary of its activities and such related matters as would be informative to the public consistent with the policy of section 552(b) of title 5, United States Code.
(e) There shall be designated an officer or employee of the Federal Government to chair or attend each meeting of each advisory committee. The officer or employee so designated is authorized, whenever he determines it to be in the public interest, to adjourn any such meeting. No advisory committee shall conduct any meeting in the absence of that officer or employee.
(f) Advisory committees shall not hold any meetings except at the call of, or with the advance approval of, a designated officer or employee of the Federal Government, and in the case of advisory committees (other than Presidential advisory committees), with an agenda approved by such officer or employee.
Termination, Renewal, Timeframe
Sec. 14. Termination of advisory committees; renewal; continuation
-STATUTE-
(a)(1) Each advisory committee which is in existence on the effective date of this Act shall terminate not later than the expiration of the two-year period following such effective date unless -
(A) in the case of an advisory committee established by the President or an officer of the Federal Government, such advisory committee is renewed by the President or that officer by appropriate action prior to the expiration of such two-year period; or
(B) in the case of an advisory committee established by an Act of Congress, its duration is otherwise provided for by law.
(2) Each advisory committee established after such effective date shall terminate not later than the expiration of the two-year period beginning on the date of its establishment unless -
(A) in the case of an advisory committee established by the President or an officer of the Federal Government such advisory committee is renewed by the President or such officer by appropriate action prior to the end of such period; or
(B) in the case of an advisory committee established by an Act of Congress, its duration is otherwise provided for by law.
(b)(1) Upon the renewal of any advisory committee, such advisory committee shall file a charter in accordance with section 9(c).
(2) Any advisory committee established by an Act of Congress shall file a charter in accordance with such section upon the expiration of each successive two-year period following the date of enactment of the Act establishing such advisory committee.
(3) No advisory committee required under this subsection to file a charter shall take any action (other than preparation and filing of such charter) prior to the date on which such charter is filed.
(c) Any advisory committee which is renewed by the President or any officer of the Federal Government may be continued only for successive two-year periods by appropriate action taken by the President or such officer prior to the date on which such advisory committee would otherwise terminate.
I serve on the Social Security Administration Future Systems Tecnology Federal Advisory Committee. All meetings must be open to the public and published in Federal Register. All members have to be vetted by the Federal government and members are actually federal government employees on the days their group meets. The most challenging requirement is the comprehensive financial disclosures that members must do. FACA rules are set by Federal law and very exacting to ensure that there is transparency.
I am speaking with many stakeholders about the impact of this FACA construct and the proposed Standards and Policy Committees on CCHIT, HITSP, NeHC (the AHIC Successor), HISPC, ONC and all the work we've done for the past 3 years. More to come!
Any thoughts as to whether the dollars allocated to ambulatory healthcare IT will (or ought to) be distributed directly to physicians' practices? Or, alternatively, via larger aggregators such as large hospitals systems as a means of promoting interoperability and data sharing?
ReplyDeleteCurrent organizations staffed and led by volunteers, like NEHC, HITSP, and CCHIT as they are today, wouldn't meet the requirements for a FAC. There's a tradeoff between "getting things done expeditiously" vs "drowning in red tape" so do you think that the FAC idea is a good vehicle to advance interoperability? If the FACs exist in ADDITION TO the current organizations, then would they bringing value commensurate with the extra cost? If they REPLACE some of the current organizations, will progress be lost? I look forward to your future posts.
ReplyDeleteDavid - these are exactly the questions I am exploring right now. As I talk to all the stakeholders inside and outside of government, I'll post the answers.
ReplyDeleteNice write up in Nextgov. I sure hope the message sinks in with Washington about not entertaining trying to institute a national EHR program, it would be a disaster and re-inventing the wheel, and we don't have the time for that as well.
ReplyDeleteAfter what I read about the White House technology that was left today, I was not shocked but rather amazed at it shows the resistance to adapt new technology at the very top level, sad.
I posted today about my old EMR I wrote years ago to try and make a point too about how thing have changed so much, and one of my somewhat satiric posts about "It's for those guys over there, I don't do digital notes" has been getting a lot of reads!
Be the jet and bring a fleet of jets with you!
Nice write up in Nextgov. I sure hope the message sinks in with Washington about not entertaining trying to institute a national EHR program, it would be a disaster and re-inventing the wheel, and we don't have the time for that as well.
ReplyDeleteAfter what I read about the White House technology that was left today, I was not shocked but rather amazed at it shows the resistance to adapt new technology at the very top level, sad.
Recep Deniz MD
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