GOP proposal seeks to require EpiPens in New Hampshire schools
The New Hampshire Senate is set to vote Thursday on a bill to require that schools maintain a supply of epinephrine, which is used to treat allergic reactions.
House Bill 677 requires New Hampshire schools to have epinephrine injectors, commonly known by the brand name EpiPen, or nasal epinephrine spray, and it requires that a nurse or at least one 'assistive personnel' be on site to administer the epinephrine at the school during school hours. The bill gives nurses and school staff five days to replace the epinephrine after it's used.
Rep. Mike Drago, the Raymond Republican who sponsored the bill, said there are at least two programs that offer epinephrine to schools for free. Epinephrine manufacturers Viatris and ARS Pharmaceuticals both advertise such programs on their websites. Lawmakers plan to rely on these programs to make this proposal possible.
'In reality, we're putting EpiPens in every single school at no cost,' Drago, who has a child with a nut allergy, said in an April Senate hearing. 'And potentially saving lives.'
Under state law, schools are allowed to maintain a supply of and use epinephrine. This bill, if enacted, would require them to do so.
The House previously approved the legislation in an April voice vote, and it received the unanimous recommendation of the Senate Education Committee earlier this month. The bill is co-sponsored by a group of mostly Republicans but has bipartisan support.
Some lawmakers expressed concerns about creating a mandate without establishing a funding source in the budget and relying on outside programs to provide the epinephrine for free.
Sen. Debra Altschiller, a Stratham Democrat, commended Drago at the April hearing for raising the issue, but said she's concerned 'the state would rely on a program that's at the discretion of a pharmaceutical company.'
'It exists today,' Altschiller said. 'It might not exist tomorrow. And to require a specific product be carried in the school at the expense of the school is where I have significant problems.'
She noted epinephrine is 'wildly expensive' and called this an 'unfunded mandate.'
Drago said he doubts these programs will ever disappear.
Still, to address these concerns, the Senate Education Committee proposed an amendment that establishes a state fund to help schools pay for epinephrine. Though it doesn't appropriate any money to that fund, the amendment creates a mechanism for the state to accept gifts from organizations besides the pharmaceutical companies.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Forbes
5 hours ago
- Forbes
Oregon's Bold Stand Against Private Equity In Healthcare: What's Next?
Private Equity Has Skyrocketed In Healthcare Complex economic forces shape the U.S. healthcare landscape, with private equity (PE) firms promising efficiency and growth in the medical sector while simultaneously sparking debate. On June 9, 2025, Oregon Governor Tina Kotek signed Senate Bill 951 (SB 951) into law, representing the most recent and stringent legislative effort to restrict private equity investment in healthcare. What does the rise of private equity mean for healthcare? What will be the impact of Oregon's new law? What are the perspectives of investors and physicians regarding private equity in healthcare? The Rise Of Private Equity In U.S. Healthcare PE refers to investments made by firms or individuals in private companies with the goal of enhancing their value and selling them for a profit. These investments often involve significant control over the company's operations and strategic decisions, typically funded through a combination of investor capital and borrowed funds. In healthcare, the funding structure tends to rely more heavily on borrowed funds. In essence and in broad generalization, PE firms identify a business, believe they can operate it more efficiently, and aim to sell it for a profit. This trend reflects the increasing financialization of medical care. In healthcare, PE investments span a wide range of entities, including hospitals, physician groups, medical practices, fertility clinics, cosmetic clinics, imaging centers and ambulatory surgical centers. PE firms now own 460 hospitals, a 25-fold increase over the past twenty years. From 2010 to 2020, private equity deals in healthcare surged by over 250%. This growth is understandable. Healthcare processes often suffer from significant inefficiencies, and investors view the sector as an attractive opportunity due to its size, valuable fixed assets, and stable demand, which is largely independent of traditional market dynamics. "Private equity has revolutionized the engineering space, and it's clear what's been happening in healthcare isn't working. Private equity rewards high performing entities. Why wouldn't medicine want to lean into that?" says Michael Tobias, Founder Principal New York Engineers and shareholder Eaglestone Private Equity when interviewed for this article. This surge aligns with PE's standard approach: acquiring potentially undervalued assets, streamlining operations for short-term profits, and exiting within 3–7 years through sales or initial public offerings (IPOs). This strategy involves taking on immediate financial risk in pursuit of high returns. In healthcare, PE firms have traditionally focused on consolidating high-margin specialties such as dermatology, ophthalmology, and emergency medicine but are now expanding into more diverse areas of care delivery, including neurosurgery. Why Are Physicians Turning To Private Equity? In certain medical circles, surgeons in the latter half of their careers—typically with 15–20 years of practice—view private equity (PE) as an attractive exit strategy. The costs of operating a medical practice continue to rise steadily, driven by expenses such as staffing, equipment, and regulatory compliance. Meanwhile, reimbursement rates to physicians from insurers, including Medicare and private payers, are consistently declining. Private equity offers a way to mitigate these financial risks and exit the market with significant compensation for the assets built over years of practice. This approach can be highly lucrative for senior shareholders within a group practice. However, it may pose challenges for younger partners, who might face exclusion from the deal or diminished roles post-acquisition. What Are The Risk Of Private Equity In Healthcare? Private equity (PE) firms traditionally target high-margin specialties and procedures in healthcare. A leading article in JAMA reported that, following PE acquisition of hospitals, patient safety incidents increased significantly: a 27.3% rise in falls, a 37.7% increase in central line-associated bloodstream infections, and a doubling of surgical site infections. These outcomes occurred despite hospitals treating younger and more financially secure patients. Concerns arise that these issues stem from PE strategies, such as cost-cutting, staff reductions, and deferred investments, which are often implemented to manage debt. How Is Oregon Limiting Private Equity In Healthcare Senate Bill 951 (SB 951) establishes the most comprehensive state-level barriers to private equity (PE) in healthcare, strengthening the corporate practice of medicine (CPOM) doctrine, which prohibits non-physicians from owning or controlling medical practices. Historically, this doctrine was underenforced. The law targets the common structure used by PE for investment, focusing on management service organizations (MSOs) rather than direct PE ownership. MSOs typically handle administrative tasks such as billing and IT, but their contracts often enable indirect operational control. SB 951 closes these loopholes by prohibiting MSOs from interfering in clinical decisions, capping their fees at fair market value, and banning non-compete, nondisclosure, and nondisparagement agreements that restrict physicians or their interactions with patients. SB 951 prohibits PE participation in clinical operations, including hiring, firing, work schedules, compensation, coding decisions, clinical policies, billing collections, pricing, contract negotiations, and, most critically, setting clinical staffing levels and patient interaction time. This legislation essentially undermines the operational influence of PE investments in healthcare. Nationwide Ramifications of Oregon's New Law Oregon's Senate Bill 951 (SB 951) establishes the most stringent state-level restrictions on private equity (PE) in healthcare. Investors must comply with new regulations in a phased approach, with full compliance required by January 2029. Other states may follow Oregon's lead and adopt similar legislation. Recent high-profile health system bankruptcies, some of which involve PE-backed entities, have fueled momentum to strengthen regulations on the corporate practice of medicine in states like California. 'We're at an inflection point in this country when it comes to the corporatization of healthcare,' said House Majority Leader Ben Bowman (D-Tigard, Metzger, S Beaverton), who introduced the bill. 'With the passage of this bill, every Oregonian will know that decisions in exam rooms are being made by doctors, not corporate executives.' What Do Surgeons Have to Say About Private Equity In Healthcare? Brian Gantwerker, MD, a private-practice neurosurgeon in Santa Monica, CA, offers a nuanced perspective on PE in healthcare. "I believe private equity is a good thing in terms of commerce and goods and services outside of the medical field. The main issue is of course that private equity job is to purchase assets load them up with a lot of debt and then sell them off the commoditization of healthcare. Private equity as it is now represents a pump and dump scheme. I think it is possible to have private equity involved in a responsible way where the assets are purchased as part of an agreement with healthcare leaders in their community, and there are certain guidelines that they have to abide by such as keeping it open up to a minimum of five years and knowing and announcing when sale of assets will occur at least 6 to 12 months in advance of that transaction occurring. That way, if things fall through or if the clinic or entity fail, the community will be deprived of that service, but in a way that other services might be set up in advance to help catch those critical patients that may fall through the cracks. Responsible capitalism is possible. When it comes to patients, that must be our north star." John Abrahams, MD, a neurosurgeon at New York Brain & Spine, authored the leading paper on private equity in neurosurgery, published in The Journal of Neurosurgery. He expresses a more pessimistic view when quoted for this article: 'I don't see any benefit in the short or long term.' Dr. Abrahams argues that expected benefits, such as economies of scale, fail to materialize. Private equity (PE) firms often struggle to negotiate better insurance rates due to insufficient outcome data, and growth through acquisitions tends to diminish practice valuation. The risks are clear to practicing surgeons: PE firms impose management fees and may require surgeons to assume debt. In his defining article, Dr. Abrahams writes, 'Private practice neurosurgery is in serious trouble. Recent reports do not support its survival, and as costs increase while reimbursements decrease, new solutions and business models need to be developed. Successful business models need to be shared at a national level so we can all learn the difficult lessons at once and grow with the new knowledge gained. Private equity is not the solution for healthcare, and if you want to learn more about its perils, read the book These Are the Plunderers: How Private Equity Runs—and Wrecks—America by Gretchen Morgenson and Joshua Rosner. It describes in detail how private equity ruins companies in general, as well as gives some examples of failure in healthcare.' What's Next for Private Equity in Healthcare? The Deeper Question Oregon's SB 951, by reinforcing the corporate practice of medicine doctrine, establishes regulatory guardrails to protect the patient-physician trust, potentially curbing excesses while sparking broader debates about the limits of state oversight in complex systems. Caution is always warranted with government intervention, as overly prescriptive laws risk unintended consequences, stifling the entrepreneurial spirit that could address healthcare's inefficiencies and echoing Hayek's warnings against the hubris of centrally planned economies. At its core, the fundamental question persists: Are we content to entrust the stewardship of healthcare—our vital guardian of life and dignity—to entities such as government bureaucracies or distant investors chasing the scraps of crony capitalism, whose contributions and ownership may be mere abstractions. Or, perhaps more appropriately, we should steer reform toward those directly providing and receiving care.
USA Today
8 hours ago
- USA Today
A farewell to Ozzy, Coke's sugar high, another vaccine shake-up: The week in review
RFK shakes up vaccines again Health Secretary Robert F. Kennedy Jr. took another step toward overhauling the nation's vaccine policy when he approved the removal of thimerosal, a mercury-based preservative, from all flu vaccines despite widespread agreement in the medical community that the preservative is safe. Kennedy signed off on a recommendation from the Advisory Committee on Immunization Practices, a panel he replaced with his own appointed members in June, to stop distributing vaccines containing thimerosal, which has long been targeted by anti-vaccine groups. An operatic honor for Melania Republican lawmakers are working on a Kennedy Center production of their own: renaming the center's Opera House to the 'First Lady Melania Trump Opera House.' The House Appropriations Committee, whose spending bill funds the iconic performing arts venue in Washington, voted 33-25 for the change. Lawmakers have already agreed to spend $256.7 million on improvements to the center sought by President Donald Trump, who ousted much of the Kennedy Center's board after he took office and appointed himself chairman. He has criticized some of the center's performances and said in one visit that he 'never liked 'Hamilton' very much.' A sweet twist to the Cola wars Cane sugar: It's the real thing. A Coca-Cola made with cane sugar − not high-fructose corn syrup − is coming to the United States this fall, the company announced, just like the Coke you find overseas, including Mexico. (The long-running debate over which tastes better, U.S. Coke or Mexican Coke, has been a fierce one). The news doesn't come as a compete surprise; President Donald Trump had made a case for cane sugar Coke on social media in mid-July − 'You'll see. It's just better!' Also, not to be outdone, Pepsi announced it is launching Pepsi Prebiotic Cola this fall, in Original Cola and Cherry Vanilla, containing 5 grams of cane sugar and 3 grams of prebiotic fiber. Ozzy Osbourne, the 'Prince of Darkness,' is dead The heavy metal world has lost one of its most beloved characters, Ozzy Osbourne, at age 76, only weeks after reuniting with his original band, Black Sabbath, in England for a farewell show. Osbourne, who was infamous for his hard living (and for biting the head off a bat), exploded into stardom in a solo career and later branched into reality TV with MTV's 'The Osbournes' in the early 2000s. In 2020, he revealed he had Parkinson's disease. In a just-announced new memoir, 'Last Rites,' arriving Oct. 7, Osbourne says: 'Look, if it ends tomorrow, I can't complain. I've been all around the world. … I've done good, and I've done bad. But right now, I'm not ready to go anywhere.' Remembering Ozzy Osbourne: Life on the 'Crazy Train': The metal icon through the years All bets for 2026 are on Scottie Scheffler Scottie Scheffler, fresh off a dominating win at the British Open July 20, is at the top of his game, and you can expect he'll be there for awhile. Scheffler, 29, who also captured the PGA Championship in May and now needs only a U.S. Open victory to enter the elite group of golfers who have won the sport's grand slam of all four major championships, is now the odds-on favorite to win every major in 2026, according to BetMGM. Declared the gaming venture's Matt Wall: 'The comparisons with Tiger Woods certainly don't look out of place right now.' − Compiled by Robert Abitbol
10 hours ago
As ADA turns 35, groups fighting for disability rights could see funds slashed
TOPEKA, Kan. -- Nancy Jensen believes she'd still be living in an abusive group home if it wasn't shut down in 2004 with the help of the Disability Rights Center of Kansas, which for decades has received federal money to look out for Americans with disabilities. But the flow of funding under the Trump administration is now in question, disability rights groups nationwide say, dampening their mood as Saturday marks the 35th anniversary of the landmark Americans with Disabilities Act. Federal dollars pay for much of their work, including helping people who seek government-funded services and lawsuits now pushing Iowa and Texas toward better community services. Documents outlining President Donald Trump's budget proposals show they would zero out funds earmarked for three grants to disability rights centers and slash funding for a fourth. Congress' first discussion of them, by the Senate Appropriations Committee, is set for Thursday, but the centers fear losing more than 60% of their federal dollars. The threat of cuts comes as the groups expect more demand for help after Republicans' tax and budget law complicated Medicaid health coverage with a new work-reporting requirement. There's also the sting of the timing: this year is the 50th anniversary of another federal law that created the network of state groups to protect people with disabilities, and Trump's proposals represent the largest potential cuts in that half-century, advocates said. The groups are authorized to make unannounced visits to group homes and interview residents alone. 'You're going to have lots of people with disabilities lost,' said Jensen, now president of Colorado's advisory council for federal funding of efforts to protect people with mental illnesses. She worries people with disabilities will have 'no backstop' for fighting housing discrimination or seeking services at school or accommodations at work. The potential budget savings are a shaving of copper from each federal tax penny. The groups receive not quite $180 million a year — versus $1.8 trillion in discretionary spending. The president's Office of Management and Budget didn't respond to an email seeking a response to the disability rights groups' criticism. But in budget documents, the administration argued its proposals would give states needed flexibility. The U.S. Department of Education said earmarking funds for disability rights centers created an unnecessary administrative burden for states. Trump's top budget adviser, Russell Vought, told senators in a letter that a review of 2025 spending showed too much went to 'niche' groups outside government. 'We also considered, for each program, whether the governmental service provided could be provided better by State or local governments (if provided at all),' Vought wrote. Disability rights advocates doubt that state protection and advocacy groups — known as P&As — would see any dollar not specifically earmarked for them. They sue states, so the advocates don't want states deciding whether their work gets funded. The 1975 federal law setting up P&As declared them independent of the states, and newer laws reinforced that. 'We do need an independent system that can hold them and other wrongdoers accountable,' said Rocky Nichols, the Kansas center's executive director. Nichols' center has helped Matthew Hull for years with getting the state to cover services, and Hull hopes to find a job. He uses a wheelchair; a Medicaid-provided nurse helps him run errands. 'I need to be able to do that so I can keep my strength up,' he said, adding that activity preserves his health. Medicaid applicants often had a difficult time working through its rules even before the tax and budget law's recent changes, said Sean Jackson, Disability Rights Texas' executive director. With fewer dollars, he said, 'As cases are coming into us, we're going to have to take less cases.' The Texas group receives money from a legal aid foundation and other sources, but federal funds still are 68% of its dollars. The Kansas center and Disability Rights Iowa rely entirely on federal funds. 'For the majority it would probably be 85% or higher,' said Marlene Sallo, executive director of the National Disability Rights Network, which represents P&As. The Trump administration's proposals suggest it wants to shut down P&As, said Steven Schwartz, who founded the Center for Public Representation, a Massachusetts-based organization that works with them on lawsuits. Federal funding meant a call in 2009 to Disability Rights Iowa launched an immediate investigation of a program employing men with developmental disabilities in a turkey processing plant. Authorities said they lived in a dangerous, bug-infested bunkhouse and were financially exploited. Without the dollars, executive director Catherine Johnson said, 'That's maybe not something we could have done.' The Kansas center's private interview in 2004 with one of Jensen's fellow residents eventually led to long federal prison sentences for the couple operating the Kaufman House, a home for people with mental illnesses about 25 miles (40 kilometers) north of Wichita. And it wasn't until Disability Rights Iowa filed a federal lawsuit in 2023 that the state agreed to draft a plan to provide community services for children with severe mental and behavioral needs. For 15 years, Schwartz's group and Disability Rights Texas have pursued a federal lawsuit alleging Texas warehouses several thousand people with intellectual and developmental disabilities in nursing homes without adequate services. Texas put at least three men in homes after they'd worked in the Iowa turkey plant. Last month, a federal judge ordered work to start on a plan to end the 'severe and ongoing' problems. Schwartz said Disability Rights Texas did interviews and gathered documents crucial to the case. 'There are no better eyes or ears,' he said.
