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About AHCJ: General News

AHCJ leaders hold series of media access meetings with government officials Date: 03/15/11

AHCJ representatives held a series of meetings in Washington, D.C., last week to press for government openness at the state and federal levels.

AHCJ President Charles Ornstein and board member Felice Freyer (chair of the organization's Right to Know Committee) met with representatives of the Health and Human Services Department, the Food and Drug Administration and the Centers for Medicare & Medicaid Services, as well as 12 newly appointed state health directors organized by the Association of State and Territorial Health Officials.

The federal officials professed a commitment to openness, within limits, and promise to look into specific requests to further that goal. The state health officials, who heard a panel presentation about working effectively with reporters, were receptive and eager to talk with AHCJ about building relationships at the state level.

Department of Health and Human Services

Ornstein and Freyer met with Richard Sorian, HHS assistant secretary of public affairs, along with Christian J. Stenrud and Dori Salcido, both deputy assistant secretaries for public affairs at HHS, on Tuesday. They described AHCJ members' continuing frustrations getting timely responses to inquiries and arranging interviews with experts.

Though he could not provide numbers, Sorian said HHS faces a growing volume of media inquiries because more reporters are covering health care, and the federal health-care law has intensified interest.  Asked how his office triages calls, he said the speed of the response is based on the reporter's deadline, not the publication. He urged reporters to provide a clear description of what they need and when their deadline is.

Sorian said that every media request to any division of HHS, no matter how minor, requires approval by his office. "We don't want to micromanage, but we do need to know about that," he said. Sometimes questions pertain to more than one HHS division, lawsuits, political issues or involve higher-level discussions about the agency's official positions. But he said requests "almost always are approved." When they're not, Sorian said, it's because the department doesn't have a position (such as when asked to comment on a letter not yet received) or the question involves another jurisdiction. For example, the Treasury Department must answer questions about the tax provisions of the health care law and flexible spending accounts.  

Sorian said he receives a daily media report from each division of HHS listing stories that mention the agency. But he said there is no central tracking of media calls and no aggregate statistics for number of calls, response times or trends over time.

Both Sorian and Stenrud said that scientists and others making presentations at medical meetings or congressional hearings are free to answer reporters' questions when approached afterward. Asked about the availability of subject-matter experts for interviews at other times, Stenrud said press officers work hard to arrange such interviews, but that experts are busy and scheduling can be difficult. Some experts do not consider doing media interviews an important part of their job, but the press office urges them to do so, Stenrud said.

At the end of the meeting, Ornstein and Freyer asked Sorian to write policies and procedures for dealing with the press, create a system for tracking media calls, and provide a list of senior press officers to whom reporters can appeal when having trouble getting a timely response. They will follow up with him later this month.

That evening, Sorian, Stenrud and the top press officers of several HHS agencies attended a meeting of AHCJ's Washington, D.C., chapter. The meeting was an off-the-record exchange. Members attending affirmed the same frustrations and concerns expressed earlier in the day.

Food and Drug Administration

On Wednesday morning, Freyer and Kathryn Foxhall, a freelance writer and member of AHCJ's Right to Know Committee, met with top press officials of the FDA, an agency that, based on anecdotes, has been a source of frustration for many reporters.

Beth Martino, associate commissioner for external affairs, said, "I feel the number of complaints about responsiveness have declined." She noted that vacancies have recently been filled and her office is fully staffed and better able to respond. When told that reporters sometimes simply cannot get an answer, she said, "We're not hearing that."

She encouraged reporters who are not getting timely responses to contact one of the four officials at the meeting:

"I guarantee we'll call you back," Scott said.

"We are striving to be as helpful as we can," Martino said. "We do have a duty to explain what we're doing."

But there are some circumstances when the FDA simply cannot comment, Martino said. When the agency is evaluating a drug, a public comment "isn't in the best interest of the regulatory process," she said.  The agency needs to maintain an objective stance while still in the evaluation phase of a product, she explained.

Martino said there is no rule requiring FDA employees and experts to obtain permission from the press office before speaking with the media.  She does encourage employees to refer inquiries to the press office, and many employees are uncomfortable talking with the media without guidance, Martino said. But there is no prohibition on direct contact, she said.

The press office gets about 40 to 50 inquiries a day, and 10 to 15 result in interviews with a subject matter expert, according to Scott.

Martino said that not all media requests to the FDA must be cleared by the HHS press office. Straightforward factual questions are handled directly by press officers within the division. Only when an issue is controversial, concerns a policy matter, or involves another HHS division does the question require clearance from HHS, she said.

The group also discussed the recent controversy concerning FDA policy on embargoes. In January, when announcing new policies on medical-device approvals, FDA press officers barred reporters from seeking comment from experts and commentators before the embargo lifted. AHCJ argued that such restrictions defeat the purpose of embargoes, and wrote to Martino urging her to abandon that approach.

Martino said that she has been evaluating FDA's an embargo policy and asking other organizations about theirs. When FDA has a new regulatory action, it often involves lengthy documents, and an embargo gives reporters time to digest that information. But once they start sharing it with others, word could get out prematurely, which can affect financial markets, she said. While reporters are bound by the embargo's terms, the people they talk with are not.

Martino said she would respond to AHCJ about embargoes within the next few weeks.

Centers for Medicare & Medicaid Services

Ornstein met with Don Berwick, CMS administrator, to encourage the agency to post hospital inspection reports online and to release to the media details of bids and compensation for individual insurance plans participating in Medicare Parts C and D (Medicare Advantage and prescription drug plans). Such information is not currently released, and AHCJ would like to see it become public. Berwick said he would look into the requests.

State health officials

Ornstein, Freyer and Rose Hoban, a North Carolina Public Radio reporter and member of AHCJ's Right to Know Committee, told a dozen newly appointed state health directors that openness was essential to maintaining the public's trust. In a panel presentation that was part of a training session for new health directors, each gave examples of successful and unsuccessful media interactions, showing how secrecy can backfire. 

The session was an outgrowth of a promising new relationship between AHCJ and the Association of State and Territorial Health Officials. The two groups are working on draft guidelines for reporting deaths in a public health crisis. Those attending included the top health officials from New York, New Jersey, Connecticut, Illinois, New Mexico and elsewhere.