Policy Resolution HHS-25-04

WHEREAS, Black Americans disproportionately face barriers to healthcare as a result of historic and systemic racism;

WHEREAS, factors attributing to this include segregation and redlining which have caused certain minority populations to live further away from accessible care, and often in a designated Health Professional Shortage Area (HPSA);

WHEREAS, Black Americans are more likely to live in HPSAs, resulting in difficulty engaging with the healthcare system according to the Health Resources and Service Administration;

WHEREAS, limited access to healthcare over time has led to Black Americans experiencing higher uninsured rates, a 70 percent higher rate than Whites, lower health literacy, and a distrust of the healthcare system due to inadequate and negative experiences according to the Center on Budget and Policy Priorities;

WHEREAS, Black Americans experience a higher rate of chronic disease compared to the rate of White adults, including a higher rate of diabetes, adult and child asthma, and coronary heart disease according to the CDC;

WHEREAS, properly managing a chronic disease can be exacerbated due to a lack of healthcare and medication adherence;

WHEREAS, Black Americans are more likely to be in pharmacy deserts, and pharmacy deserts are more likely to be in low-income Black neighborhoods than in low-income White neighborhoods, resulting in difficulty filling prescriptions and remaining adherent to a prescription regimen;

WHEREAS, natural disasters and severe weather incidents disproportionately impact areas that already face major barriers to care, namely hurricanes, tropical storms, and flooding in the South and Southeast United States, wildfires and earthquakes in the West, and tornadoes and winter storms throughout the Midwest;

WHEREAS, natural disasters and severe weather incidents severely impact access to necessary medications and medical supplies for the continuing treatment of chronic diseases and treatment of injured persons;

WHEREAS, the COVID-19 pandemic and subsequent drug shortages demonstrated the need for state-managed essential medicine buffer inventory, and the importance of improving state buffer stock management throughout the United States, specifically in the event of a crisis;

WHEREAS, there is unclear statutory authority for shortages which creates difficulties in management during crisis and the development of sustainable funding mechanisms;

WHEREAS, state-managed essential medicine reserves have a stronger ability of ensuring equitable access than provider-managed buffer stock, as they can incorporate the appropriate equity plans into distribution processes rather than focusing solely on serving their own patients and communities;

WHEREAS, previous strategic national essential medicine reserve attempts have not consistently included lower-resourced urban and rural local health departments, safety-net hospitals and community organizations, which would help promote effective distribution of medical countermeasures to ensure essential medicine buffer inventory needs are tailored for emergency preparedness strategies to serve these diverse communities;

WHEREAS, state-managed essential medicine reserves can be a factor in helping to ensure that there is an equitable approach for vulnerable regions, communities, and facilities serving Black populations and other communities of color who are medically underserved to have access to medications and medical supplies in case of a natural disaster or public health emergency;

WHEREAS, compared to traditional buffer stock endeavors, one option for consideration should be virtually sequestered buffer stock managed by a distribution vendor which allows distribution centers to reserve medications in a manner that protects against expiration of products physically warehoused and managed by the State;

WHEREAS, a virtually sequestered product, state-managed essential medicine reserves protect against natural disasters directly impacting the physical site of a state essential medicine buffer inventory or warehouse; and

WHEREAS, equity must be a driving factor for states to develop essential medicine reserves, as state-managed buffer stock can be better equipped to handle their state’s individual vulnerable regions and communities.

THEREFORE, BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) supports legislation that creates or supports state-managed buffer stock of essential medicines for emergency use;

BE IT FURTHER RESOLVED, that such state-managed essential medicine buffer inventories should be available in the case of natural disaster, emergency declaration, alleviate supply chain issues, or major public health event;

BE IT FURTHER RESOLVED, that such state-managed essential medicine buffer inventories should be deployed in the event of a natural disaster or public health emergency when needed to equitably address the needs of all residents of the state, prioritizing those that are most impacted by the triggering event and least able to secure necessary medicines via other means; and

BE IT FINALLY RESOLVED, that medicines included in such state-managed buffer stocks should be prioritized for which interruption of a prescribed treatment regimen would be the most impactful to the patient in addition to medications most commonly needed for direct crisis response.

• Resolution ID: HHS-25-04
• Sponsored by: Sen. Raumesh Akbari (TN)
• Policy Committee: Health and Human Services (HHS)