Mark DeSaulnier

Saving the Civil Service Act

This bill generally prohibits changes to the classification of positions in the competitive service and excepted service unless certain conditions are met. (Competitive service positions are subject to competitive examination while excepted service positions are appointed under one of five schedules. Competitive service positions have notice and appeal requirements for adverse actions that are not applicable to most excepted positions, including those of a confidential, policy-determining, policy-making, or policy-advocating character under Schedule C.)

On October 21, 2020, President Donald Trump issued an executive order that placed executive agency positions that are of a confidential, policy-determining, policy-making, or policy-advocating character, and that are not normally subject to change as a result of a presidential transition, under a new Schedule F in the excepted service. The order was subsequently revoked by President Joe Biden.

The bill prohibits executive agency positions in the competitive service from being placed in the excepted service, unless such positions are placed in a schedule in the excepted service as in effect on September 30, 2020. The bill also prohibits positions in the excepted service from being placed in any schedule other than the aforementioned schedules.

Additionally, agencies may not (1) transfer occupied positions from the competitive or excepted service into Schedule C without the consent of the Office of Personnel Management, or (2) transfer employees in the excepted service to another schedule or transfer employees in the competitive service to the excepted service without employee consent.

This resolution reaffirms the U.S. commitment to protect the safety, health, and well-being of refugees and asylum seekers. The resolution calls upon the Department of State, the Department of Homeland Security, the Department of Health and Human Services, and the U.S. Mission to the United Nations to partner with the international community to solve existing conflicts, prevent new conflicts from emerging, and tackle the root causes of involuntary migration.

Conrad State 30 and Physician Access Reauthorization Act

This bill modifies the Conrad 30 Waiver program, which incentivizes qualified foreign physicians to serve in underserved communities. It also extends statutory authority for the program for three years from this bill's enactment.

Individuals coming to the United States under a J-1 nonimmigrant visa to receive medical training typically must leave the country and reside for two years abroad before being eligible to apply for an immigrant visa or permanent residence. The Conrad program waives this requirement for individuals who meet certain qualifications, including serving for a number of years at a health care facility in an underserved area.

The bill increases the number of waivers that a state may obtain each fiscal year from 30 to 35 if a certain number of waivers were used the previous year, and provides for further adjustments depending on demand.

A physician may be employed at an academic medical center to meet the Conrad program's employment requirements if the physician's work is in the public interest, even if the medical center is not in an underserved area.

Employment contracts for physicians under the Conrad program shall contain certain information, such as the maximum number of on-call hours per week the physician shall have to work.

Certain physicians (along with the physician's spouse and children) shall be exempt from the direct annual numerical limits on immigration, including those physicians that have met certain requirements related to visas for physicians to serve in underserved areas.

Alternatives to Prevent Addiction In the Nation Act or the Alternatives to PAIN Act

This bill reduces cost-sharing and prohibits the imposition of certain utilization requirements under the Medicare prescription drug benefit for certain non-opioid pain management drugs.

Specifically, the bill requires such drugs to be covered without a deductible and to be placed on the lowest cost-sharing tier (if any). The bill also prohibits the imposition of prior authorization requirements (i.e., requiring prior approval from a plan) or step therapy requirements (i.e., requiring the use of alternative drugs before a drug is covered under a plan) with respect to such drugs.