Western Occupational & Environmental Medical Association

WOEMA's Legislative and Advocacy Agenda

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Approved by the WOEMA Board of Directors, April 2010

The Western Occupational and Environmental Medical Association (WOEMA) is an organization of about 600 member physicians and other health care specialists who champion the health and safety of workers, workplaces, and the environment. WOEMA a regional component of the American College of Occupational and Environmental Medicine (ACOEM), our national medical association headquartered near Chicago, Illinois.

In addition to its educational and service functions, WOEMA is dedicated to legislative and regulatory advocacy in our five member states (Arizona, California, Hawaii, Nevada, and Utah). We recognize that more effective laws and regulations are needed in a number of areas related to occupational and environmental health. We also seek stronger ties with other relevant public health and medical associations, in order to promote occupational and environmental issues of common concern. In particular, we are dedicated to the following advocacy goals:

1. The delivery of high quality Occupational Medicine services to workers, consistent with the use of evidence based Practice Guidelines. In particular, WOEMA seeks the adoption of the ACOEM Practice Guidelines, or other comparable quality guidelines, in all of our member states.

2. Availability of quality affordable healthcare for America's workers. WOEMA believes that all American workers should have access to quality affordable health care, as an essential prerequisite for achieving broad public health goals and to assure a healthy and productive workforce.

3. A requirement for the near universal availability of workplace preventive services, as provided by Occupational Health physicians and other qualified medical providers. In particular, we stand for policies that will encourage employers, medical insurers, and other payers to reimburse physicians and other health care professionals for providing high quality preventive services in workplaces.

4. Improved OSHA Standards (both Federal and state OHSA programs) aimed at safety and preventive planning in workplaces. In particular, we believe that an improved OSHA Hazard Communication Standard should be promulgated, requiring the preparation of even more effective Injury and Illness Prevention Programs (as currently required in California by Cal-OSHA) in nearly all workplaces, and requiring the involvement of physicians in many circumstances.

5. Enhanced funding for Graduate Medical Education in the field of Occupational and Environmental Medicine. We believe that the current supply of Occupational Medicine residents in our member states should be increased to assure a supply of Occupational Medicine specialists roughly equivalent to one Occupational Medicine Physician per 10,000 - 50,000 population, within the next ten years, essentially representing a ten-fold increase from current levels. Such funding could be achieved by ramping up funding currently provided in California to the Centers for Occupational and Environmental Health (COEH's), or comparable increases in funding currently provided by NIOSH to the ERCs (Education and Research Centers).

6. Adoption of public policies, including tax incentives or other initiatives, to encourage the widespread adoption of Health and Productivity Management (HPM) Programs in workplaces. Examples of successful HPM Programs can be found on the ACOEM website (www.ACOEM.org). Such programs deserve much wider adoption as an established way to improve both the health and the productivity of the American workforce in a cost-effective manner.

7. Promotion of land use policies, chemical and technology policies, and community planning practices to promote a healthful and sustainable built environment. WOEMA is aware that in this time of change, with recent broadening of national awareness about the scope of public health and more careful attention to the environmental impacts of advancing technologies, cradle-to-grave environmental assessments should be part of nearly all land use planning decisions.

8. Support of environmental initiatives to decrease the release of greenhouse gases, and to monitor indicators of the effects of global climate change.

9. Adoption of effective incentives for the adoption of electronic medical records in Occupational Medicine practice. We are aware that such incentives would have to be carefully crafted, to be consistent with comparable incentives currently offered to physicians through the American Recovery and Reinvestment Act (ARRA, 2009), and consistent with the needs of the Medical Home.

10. Revision of the OSHA Standards (both Federal and state) for occupational lead exposure. WOEMA recognizes that the current Standards for occupational lead exposure have failed to take account of recent scientific advances, and fail to protect lead-exposed workers from the toxic effects of lead. WOEMA supports improved Standards to keep work blood lead levels below 20 mcg / 100 gm. [Medical Guidelines for the Lead Exposed Worker]

11. Adoption of equitable fee schedules for primary care Occupational Medicine practice, coupled with payment mechanisms that reward medical quality. WOEMA is aware that current Workers' Compensation fee schedules in California are very low (49th out of the 50 states) and that fee schedules in some other jurisdictions are also inappropriately low, and are not designed to reward quality practice, including high quality disability management. WOEMA supports the adoption of fee schedules that take account of well established data on the extra clinical and administrative work required to care for sick and injured workers under Workers' Compensation.

12. Appropriate Medical Credentialing - WOEMA remains vigilant to assure that Occupational Medicine services are delivered by qualified individuals. In particular, we believe that the full scope of Occupational Medicine practice is best done by physicians with appropriate training and experience, with an appropriately different permitted scope of practice for other health professionals. We also believe that credentialing practices in hospitals and other regulated institutions should recognize Occupational Medicine as a distinct specialty, with specialty-based credentialing and privileging requirements.