APIC Testifies Before HICPAC on Mandatory Reporting Issue

WASHINGTON, D.C. -- The following statement is the testimony of Denise Graham, manager of government affairs for the Association for Professionals in Infection Control and Epidemiology (APIC), before the Healthcare Infection Control Practices Advisory Committee (HICPAC) of the Centers for Disease Control and Prevention (CDC).

Good day Chairman Brennan, members of HICPAC, and distinguished guests. Thank you for allowing me the time to speak before you today.

I am here today as a representative for the Association for Professionals in Infection Control and Epidemiology (APIC) located in Washington, DC. While I am not a clinician, I am fortunate to have had numerous members share their visions of what they see coming out of this extremely important effort. Although new as the manager of government relations for APIC, my background includes over 10 years of government relations experience with a strong emphasis on health policy. My extensive

experience consists of working on the inside of government serving as the legislative aide to five state representatives, and then as the legislative aide and researcher to the Senate Minority Whip in the Connecticut General Assembly.

To this end, I come before you today from the perspective of a legislative staffer. As you are all aware, most state legislatures meet for only part of the year, every year. Legislators have limited time to review the reams of documents delivered to them and rely heavily upon their staffers to supply them with pertinent information. In fact, legislators can drown in the amount of information being delivered to them yet are expected to be experts in a variety of issues. As such, legislators prefer not to start from

scratch whenever possible and are more apt to take the easy route by referring to another states statute.

Having worked alongside other legislative staffers, committee consultants, legislative analysts, and members of state agencies, I learned that when policy makers review bill proposals, they generally consider the following criteria:

1. Is the issue a significant one currently facing the state government and its citizens?

2. Does the issue have national or regional significance? Have other states similar in size considered this issue? If yes, compare and contrast to our proposal.

3. Is the information being presented offering an innovative approach to address the issue? Does it provide meaningful results?

4. Does it accomplish its stated goals?

5. Does the proposal represent a practical approach to the problem?

6. Does the proposal represent a comprehensive approach to the problem or is it tied to a narrow approach that may have limited relevance?

7. Is the structure of the proposal logically consistent?

8. Are the language and style of the proposal clear, unambiguous, and easily understood by a layperson?

When applying the above criteria, we are concerned that the Sept. 10, 2004 HICPAC guidance document will not provide the answers to these necessary questions. While we commend all of you for the hours and obvious scholarship you have put into creating this document, we are extremely concerned about it not providing the proper deliverables for one of the major targets of the intended audience the policymakers. We have listened to the debate on the public conference calls and appreciate you are already grappling with the complexities of the issue. That very complexity demands an effort to present a sharp, clear document that gets the attention of legislators and staffers first. Otherwise they may never see and use the scientific evidence that is so critical to support CDC/HICPACs recommendations.

Currently, there are five states requiring mandatory reporting legislation and a host of other states considering it for their 2005 legislative sessions. As noted earlier, we are concerned that states may never consider the HICPAC document if it remains too technical or appears to be an academic treatise that does not attempt to speak their language.

Thank you for allowing me the time to come before you today.

Source: APIC