Five years to the week after Dr. Lorna Breen died by suicide, her brother-in-law could be found walking the halls of Congress trying to persuade lawmakers to renew the law named in her honor, which sought to aid healthcare workers struggling with mental health.
Congress allowed the Dr. Lorna Breen Health Care Provider Protection Act of 2021 to expire at the end of 2024 when they bowed to pressure from Elon Musk and then-President-elect Donald Trump to kill a healthcare package that included an extension of the grant program.
Related: CDC launches initiative to reduce healthcare worker burnout
The Breen Act cost a relatively modest $45 million a year from 2022 to 2024 and supported healthcare providers developing effective means to help workers deal with mental stresses and free them from requirements to disclose when they receive mental healthcare, which could jeopardize their careers.
Corey Feist, who is married to Breen's sister, Jennifer Breen Feist, hopes the latest budget battles roiling Capitol Hill don't sink the measure again.
Feist, CEO of the Dr. Lorna Breen Heroes Foundation, visited congressional offices last week to offer some encouragement. One of his final stops was Rep. Dr. Andy Harris (R-Md.), the chair of the conservative Freedom Caucus and among the louder champions in Washington of cutting healthcare spending. That opinion didn't apply to the Breen Act, however, Feist learned.
"The meeting went well. The meeting went exceptionally well, and that's our common experience. Our consistent experience is exactly what we just had," Feist said.
Indeed, no lawmakers have publicly signaled opposition to renewing the Breen Act.
But given the uncertain, chaotic nature of Congress, that's no guarantee the bill will make it through the sausage grinder that is the legislative process. Sen. Tim Kaine (D-Va.) introduced a measure to reauthorize the Breen Act in January and Rep. Debbie Dingell (D-Mich.) followed in February. Each bill has a small number of cosponsors from both parties.
Some Democratic champions are hopeful, but still angry the law was not renewed in December. Instead, it and numerous other bipartisan health policies were scuttled after Musk posted on his social media platform X that Congress should scrap the legislation, a sentiment Trump soon echoed.
"These things should have all passed at the end of last year. And Elon Musk killed it," said Rep. Dr. Kim Schrier (D-Wash.).
Feist, the former CEO of Charlottesville-based University of Virginia Physicians Group, is just one of the advocates pushing to ensure Congress acts this time.
Dr. Randy Pilgrim, enterprise chief medical officer at the Atlanta-based medical practice SCP Health, has also been reaching out to lawmakers. He is acutely aware that Capitol Hill is especially fraught for any bill these days. He feels that way even though he believes the prospects are good, especially since he thinks it aligns with Health and Human Services Secretary Robert F. Kennedy Jr.'s "Make America Healthy Again" agenda.
"I don't think it'll ever get through with no problems," Pilgrim said. "But I do know there's enough commitment behind this, and frankly, there's enough rationale for it. If you can't stand for this, what do you stand for?"
The support existed last year, as well. Rep. Buddy Carter (R-Ga.) has been a vocal proponent, and this year is the chair of the Energy and Commerce Committee's Health Subcommittee, which has jurisdiction over the bill.
When his subcommittee unanimously passed the measure in March 2024, Carter hailed it as a "landmark" law that only scratched the surface of what doctors, nurses and other clinicians need. "The Lorna Breen Act is the lifeline for health workers," he said at the time.
Carter said recently that while lawmakers are focused on other issues at the moment, the Breen Act will be renewed. "It will be alright," he said.
Shortly before her death in Charlottesville on April 26, 2020, and less than a day after recovering from COVID-19, Breen resumed her 12-hour shifts as emergency department director at NewYork–Presbyterian's Allen Hospital in New York City. At that time, she told Jennifer Breen Feist and Corey Feist that she feared seeking help for exhaustion and depression because it could end her career, Feist said.
Pilgrim and SCP Health's chief wellness officer, Dr. Bentley Tate, said the three-year effort had an outsize impact helping health systems deal with mental illness and substance abuse among medical professionals. More than half state credentialing bodies now ask doctors questions about their own health that are more targeted, and less apt to spark fears over losing licenses because of temporary struggles.
Breen Act grants to 45 health systems helped the Dr. Lorna Breen Heroes Foundation develop a roadmap to create working environments that help both patients and clinicians, Feist said. "We need to redesign the coal mine so it doesn't kill the canaries," he said.
"When healthcare workers come to you and say, 'We're burning out and you need to change this operational environment,' that can seem like an incredibly daunting task," Feist said. "They just are kind of lost in the sea."
The Breen Act lapsing threatens the progress made so far and makes further efforts more difficult, which puts physicians at risk, Tate said.
"It needs to continue. It has really been expansive in its effectiveness," Tate said. "Though only about 1% of hospital systems, from my research, have been directly impacted with dollars across the country, the healthcare system has greatly benefited from the attention."
The University of Utah Health Resiliency Center in Salt Lake City received Breen Act funding to develop methods to help providers deal with debilitating struggles and train others to teach those methods. There is still a lot of research to be done to establish the best ways to help healthcare workers and to create conditions to reduce stress in the first place, said Dr. Amy Locke, the center's executive director.
Health systems and other participants that conduct this research typically finance programs for their workforces with their own money, but most rely on grant money to design the interventions, Locke said. That funding dried up at the end of the year.
"If you're actively investigating what works and what doesn't, then you'll get further than if you're kind of guessing," Locke said. "Exactly what interventions and in what dose and with what frequency is still a bit of guesswork for most places. We have some data, for sure, but there's so much more we need to know and understand to be maximally effective."
Feist said the relatively small amount of funding involved was critical, since small initiatives tend to be vulnerable to budget cuts.
"What you find is these types of programs get to be the first ones cut, and we, once again, ask the workforce to be more resilient," Feist said. "The workforce believes that word now is a four letter word — 'resilient.' They don't want to be asked to be more resilient."
A Breen Act renewal would pass on its own if Congress brought it to a vote, Pilgrim said. Short of that, congressional aides who spoke on background said a likely vehicle may be something considered must-pass, such as government funding.
As lawmakers juggle multiple challenges, they should consider how important it would be to them and their constituents to have better functioning healthcare workers in their districts' medical institutions, Pilgrim said.
"I would say to every congressperson: If you want the healthcare system to be there for you, make sure your doctors are healthy when they're there for you," Pilgrim said.
