Baldwin, Collins, Rosen, Murkowski Lead Bipartisan Legislation to Grow and Support the Infectious Disease and Pandemic Preparedness Workforce

Washington, D.C. – Today, Senators Tammy Baldwin (D-WI), Susan Collins (R-ME), Jacky Rosen (D-NV) and Lisa Murkowski (R-AK) introduced the Bolstering Infectious Outbreak (BIO) Preparedness Workforce Act to address retention and recruitment issues facing vital clinicians and public health professionals and better prepare the American health care system for future public health emergencies. The bipartisan legislation would establish a new student loan repayment program for infectious disease (ID) clinicians and other public health preparedness and response professionals who work in health care settings.

The COVID-19 pandemic has exposed gaps and weaknesses in our nation’s preparedness for public health emergencies related to infectious disease outbreaks, including insufficient workforce capacity focused on outbreak preparedness and response in health care settings. Prolonged, significant additional work (including both direct patient care and system-focused preparedness and response activities) in an environment of health risks, uncertainty, and overwhelming loss of patient lives has contributed to severe burnout among physicians, nurses, laboratory professionals and others. This has led some to consider early retirement, exacerbating existing workforce concerns and threatening the future of this critical workforce. These issues have been apparent for ID specialists who provide direct clinical care and often serve as leaders of health facility preparedness and response teams, as well as for related health care professionals who conduct bio-preparedness activities focused on facility- and community-wide preparedness and response. These activities include conducting antibiotic stewardship, outbreak and surge capacity planning, collaborating with local public health officials, and purchasing and managing personal protective equipment and medical countermeasures. And further, the ID provider workforce was facing significant strain even before the pandemic. A June 2020 study in the Annals of Internal Medicine, authored by now-Director of the Centers for Disease Control and Prevention (CDC) Rochelle Walensky, MD, MPH, found that 208 million Americans live in areas with little or no access to an ID provider. In 2020, only 75 percent of infectious diseases training programs were able to fill all their slots, in part due to significantly lower salaries for ID providers than nearly all other specialties, including general internal medicine. Given that the average medical student debt is over $200,000, the ID specialty and related bio-preparedness work are a financially infeasible choice for many.

The bipartisan BIO Preparedness Workforce Act would establish a new student loan repayment program for infectious disease clinicians and bio-preparedness health care professionals including physicians, clinical pharmacists, physician assistants, and advanced practice registered nurses. For each year of service, qualified individuals may receive up to $50,000, up to a total of $150,000 in loan repayment, with $50 million authorized for the program.

“The COVID-19 pandemic put a major strain on our health care system, especially among our infectious diseases clinical workforce and public health professionals who specialize in bio-preparedness. This bipartisan legislation will strengthen our workforce to help get through this pandemic, and make sure we are better prepared for future public health emergencies,” said Senator Baldwin. “We need to use all the tools in the tool box to be better prepared, and that starts with making sure we support and grow our infectious disease and pandemic preparedness workforce.”

“We need to encourage students to pursue careers in health care and eliminate barriers to getting this vital training -- such as nursing faculty shortages or financial disincentives to pursuing certain specialties,” said Senator Collins.  “The ongoing public health emergency has underscored the importance of investing in a robust medical workforce.  Our bipartisan bill would establish a new student loan repayment program for infectious disease professionals, attracting more students to this critical field and helping our nation prepare for future crises.”

 “For nearly two years, the pandemic has put unprecedented demands on our health care system, and has been particularly challenging for medical professionals in the infectious disease and public health fields,” said Senator Rosen. “This bipartisan legislation will help address ongoing retention and recruitment issues that have been exacerbated by COVID-19, leading to a shortage of clinicians and public health professionals. We must ensure Nevada’s health care system has the workforce needed to continue fighting this pandemic while preparing for future public health emergencies, and this bill is an important next step.”  

“Even before COVID-19, Alaska’s healthcare workforce was strained and understaffed. The pandemic has only exacerbated that challenge. From infectious disease doctors to the technicians in our laboratories, it is crucial that we have a strong infectious disease workforce in Alaska and across the country. By establishing a new loan repayment program at HRSA for these workers, we will ensure that if faced with another challenge like COVID, communities will be adequately staffed and capable of responding,” said Senator Murkowski.

The BIO Preparedness Workforce Act is supported by Johns Hopkins Center for Health Security, Infectious Diseases Society of America, American Medical Association, American Hospital Association, American Association of Medical Colleges, National Rural Health Association, Association for Clinical Microbiology, American Society for Microbiology, American Dental Association, Association of Professionals in Infection Prevention and Epidemiology, HIV Medicine Association, AIDS Institute, AIDS United, American Academy of HIV Medicine, American College of Clinical Pharmacy, American Institute of Dental Public Health, Association of Nurses in AIDS Care, GLMA: Health Professionals Advancing LGBTQ Equality, American Association for the Study of Liver Disease, Society for Health Care Epidemiology, American Society for Clinical Laboratory Science, American Society for Clinical Pathology, HIV Dental Alliance, HIV + Hepatitis Policy Institute, National Hispanic Medical Association, National Medical Association, National Virus Hepatitis Roundtable, National Working Positive Coalition, Latino Commission on AIDS, National Black Gay Men’s Advocacy Coalition, Pediatric Infectious Diseases Society, Physician Assistant Education Association, Ryan White Medical Providers Coalition, Society of Infectious Diseases Pharmacists, University of Wisconsin Health System, University of Wisconsin School of Medicine and Public Health, Vivent Health, Wisconsin Medical Society, and the Wisconsin Hospital Association.

“The COVID-19 pandemic has dramatically highlighted the importance of having a robust health workforce of infectious disease and bio preparedness professionals. Congress can play an essential role in providing investment and incentives needed by young professionals to choose these careers,” said Dr. Eric Toner, senior scholar at the Johns Hopkins Center for Health Security. “The proposed legislation by Senators Baldwin and Collins will make it possible for many more health care professionals to pursue careers in these vital fields.”

“The American Medical Association appreciates Sens. Baldwin and Collins for introducing legislation that would help address critical physician shortages and strengthen our nation’s preparedness for public health emergencies,” said Gerald A. Harmon, MD, President of the American Medical Association. “We need additional programs for physician student loan forgiveness to ensure that we have an adequate physician staff and a prepared health care professional workforce that can protect us against health emergencies we encounter in the future.”

“The American Hospital Association (AHA) thanks Senators Baldwin, Collins, Rosen and Murkowski for leading this important bipartisan effort to support the infectious disease and outbreak preparedness workforce, including those in America’s hospitals and health systems,” said Stacey Hughes, Executive Vice President of AHA. “This legislation will also help attract new workers to these critical professions, including by incentivizing them to practice in areas with workforce shortages and in communities dealing with sustained hardship. We look forward to working with the sponsors to move this bill forward.”

“The National Rural Health Association (NRHA) applauds Senators Baldwin and Collins for introducing the BIO Preparedness Workforce Act. Currently, 208 million Americans live in areas with little or no access to an infectious disease (ID) physician, and the distribution of ID physicians is geographically skewed including in our rural communities,” Alan Morgan, Chief Executive Officer of the National Rural Health Association. “NRHA believes passing the BIO Preparedness Workforce Act will increase access to ID physicians in rural areas of our country, something that has been proven necessary during the ongoing COVID-19 pandemic.”

“The COVID-19 pandemic has underscored that the bio-preparedness and infectious diseases workforce is essential to our national security and well-being. But our workforce is under enormous strain, and we don’t have the personnel we need to prepare for future public health emergencies and respond to immediate threats,” said Daniel P. McQuillen, MD, President of the Infectious Diseases Society of America. “As one example, 208 million Americans live in areas with little or no access to an infectious diseases physician, as crushing student debt drives many new physicians to much more lucrative specialties. Loan repayment will help ensure that the infectious diseases specialty is a financially feasible choice for physicians and other health care professionals. The Infectious Diseases Society of America (IDSA) is proud to support the BIO Preparedness Workforce Act, and commends Senators Baldwin and Collins for their leadership.”

We have an urgent need for a stronger and broader infectious diseases workforce to address ongoing public health threats, including antimicrobial resistance, the worsening HIV and viral hepatitis epidemics nationwide and in my home state of West Virginia, and other infections associated with the injection drug epidemic,” said Judith Feinberg, MD, former Chair of the HIV Medicine Association. “By offering loan repayment to ID healthcare professionals— including doctors, infection control nurses and other healthcare professionals-- the BIO Preparedness Workforce Act will provide much needed support to improve health equity by drawing these professionals to underserved rural areas in West Virginia and across the country. HIVMA applauds Senators Tammy Baldwin and Susan Collins for their leadership in sponsoring this bipartisan legislation.”

“The COVID-19 public health emergency continues to show us the critical importance of public health preparedness. Supporting our health care workforce – particularly those working in infectious disease care and bio-preparedness – is key to managing future outbreaks,” said Dr. Nasia Safdar, Professor of Medicine and Associate Dean for Clinical Trials at the UW School of Medicine and Public Health. “This bill takes an important step in supporting that workforce by providing the financial tools to make these professions more accessible and incentivizing more to get involved in these crucial specialties.”

“The COVID-19 pandemic has shown that while Wisconsin physicians and their health care teams are willing to work extraordinarily hard to fight the virus, we need more professionals in this critical area of medicine,” said Alicia Arnold, MD, President of the Wisconsin Medical Society. “The Wisconsin Medical Society is pleased to support Senator Tammy Baldwin’s proposal to bolster the physician and health care pipeline by incentivizing careers in bio-preparedness and infectious diseases. Wisconsin’s physicians urge Congress to pass the bill so we can help prepare for future pandemic challenges.”

“WHA appreciates Senator Baldwin’s leadership in introducing legislation supporting our infectious disease and emergency planning workforce,” said Ann Zenk, Vice President of Workforce & Clinical Practice at the Wisconsin Hospital Association. “Hospitals have experienced many significant challenges throughout this COVID-19 pandemic. Workforce challenges continue to be at the top of the list and this legislation would help bolster their emergency preparedness and infectious disease planning operations.”

In addition to Baldwin, Collins, Rosen and Murkowski, the bipartisan legislation has been cosponsored by Kirsten Gillibrand (D-NY) and Ben Cardin (D-MD).

The full text of the Bolstering Infectious Outbreak (BIO) Preparedness Workforce Act can be found here.