Slides - Washington State Hospital Association
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The 2014 State Legislative Session Washington State Hospital Association Presenters Cassie Sauer Claudia Sanders Mary Kay Clunies-Ross SVP, Advocacy & Government Affairs SVP, Policy Development VP, Communications & Public Affairs Washington State Hospital Association Session Overview • Short session • New leadership (4/5 of key players) • Majority Coalition – interesting political dynamics • Even with complicated political dynamics, some great steps forward and no steps backward for hospitals Washington State Hospital Association The Budget Mental Health Funding Hospital Owned Clinics Medicaid Outreach Maintain Primary Care Rates Washington State Hospital Association State Budget Overview • Non-budget session – House and Senate differed on willingness to spend • Revenue forecast was better, but not great • Supreme Court reiterated mandate for more education funding, days before session began • Budget gaps filled with marijuana tax revenue • No capital budget Washington State Hospital Association Mental Health Funding Bad news: No capital funding Good news: $17.7 million for mental health services • $4.5 million for non-Medicaid backfill – Includes Institutes for Mental Disease • Funding for 3 new Evaluation and Treatment centers • PACT teams for those at high risk for rehospitalizations • Recovery services for those returning to the community Washington State Hospital Association Hospital-Owned Clinics WSHA Goal: Preserve Medicaid funding for hospitalowned clinics Proposed cut would have limited access to primary and specialty care for Medicaid enrollees Result: • No cut • HCA will study/make recommendations for reducing payment rates • Could have big impacts on patients’ access to care Washington State Hospital Association Bills Enacted Emergency Credentialing Grace Period Notification Behavioral Health Integration Health Care Innovation Safety Net Assessment Fix Confidentiality Training for PHDs Washington State Hospital Association HB 2692: Support Emergency Credentialing WSHA Goal: Allow for emergency credentialing for out-of-state health care workers and provide immunity for health care workers in emergencies Result: HB 2692 passed with emergency credentialing provision Future: Continue to work on provider immunity Washington State Hospital Association SB 6103: Support Notification for Delinquent Exchange Premiums WSHA Goal: Minimize confusion regarding payment for care delivered during 3 month grace period • Insurers responsible for first month of coverage, but can deny payment in second and third month • Providers must be notified that patient has not paid premium Result: SB 6013 passed Washington State Hospital Association SB 6312: Support Integration of Behavioral Health WSHA Goal: Support patient-centered integration of state purchased mental health, chemical dependency, and medical services • Task force to make recommendations • Goal of full integration by 2020 through managed care plans • CON waiver for conversion of hospital beds to psychiatric care Result: SB 6312 passed by legislature Washington State Hospital Association Support Innovation and Transparency WSHA Goals: Support reform that does not create barriers to care or innovation; Support access to cost and quality data and common performance measures Result: HB 2572 and SB 6228 passed Savings: $2.8 million 2014-2015 And $57 million 2015-2017 Washington State Hospital Association HB 2572: Communities of Health • A regionally based voluntary collaborative • Broad membership including hospitals • No identified boundaries or specified number of collaboratives • Grants for two pilots Washington State Hospital Association HB 2572: Physician Extension Program • Aimed to help primary care and behavioral health providers – Better coordinate care – Become patient centered medical homes Washington State Hospital Association HB 2572: All Payer Claims Database • Office of Financial Management establishes statewide database, with lead organization • Mandates data from Medicaid/public employees • Advisory committees include hospitals • Protects confidentiality but allows for access • Comparisons must account for differences in acuity, impact of uninsured and government patients and teaching expenses Washington State Hospital Association HB 2572 and SB 6228: Common Performance Measures • New state committee; members include WSHA representative • Measures determined by January 2015: – Prevention and screening – Management of chronic care – Key health outcomes – Care coordination and patient safety – Preventive, acute, and chronic conditions Washington State Hospital Association SB 6228: Transparency Tools • Better information tools for consumers, including about hospital cost and quality for both inpatient and outpatient care • Thank you for posting links to WSHA transparency site on your website! Washington State Hospital Association SB 6570: Hospital Safety Net Assessment Technical Fix WSHA Goal: Fix assessment technical and timing issues to allow approval by Centers for Medicare and Medicaid Services • • • • Bill enacted as WSHA wanted State expects approval shortly Did not change ratcheting schedule More information soon Washington State Hospital Association SB 6265: Confidentiality • Heighten protections of CHARS data • Fixes provisions about accounting for mental health disclosures • Urge Governor to sign! Washington State Hospital Association Public Hospital Districts AWPHD Goal: Increase access to training regarding the Public Records Act, Open Public Meetings Act, and records retention • Bill proposed to provide consistent, accessible training Result: SB 5964 passed AWPHD Goal: Increase transparency without jeopardizing Board ability to conduct business • Bill clarifies that posting agendas in advance of meeting does not prevent later agenda changes Result: HB 2105 passed by legislature Washington State Hospital Association Bills Not Enacted Telemedicine Staffing Mandates Federal Basic Health Suspect and Inmate Care Medical Records Payment Rates Breastfeeding Public Hospital Districts Washington State Hospital Association Telemedicine WSHA Goal: Assure payment for services provided using telemedicine technology • Passed House 98-0 • Unfounded concerns about “webcam abortions” killed the bill in the Senate Result: HB 1448 not enacted Washington State Hospital Association Staffing Mandates WSHA Goal: Defeat unworkable nurse staffing legislation that endangers patients Nursing union proposals: – Nurse staffing ratios – Uninterrupted meal and rest breaks – Overtime/on-call restrictions Result: We defeated all these bills, again Future: These bills will be back, again Washington State Hospital Association Careful Evaluation of Federal Basic Health WSHA Goal: Delay creation of new program without more complete analysis of impacts • ACA allows Federal Basic Health for those with incomes slightly above Medicaid • Concern regarding lack of data supporting program and potential costs to state and providers Result: Bill to create program not enacted Future: Track issues of affordability Washington State Hospital Association Suspect and Inmate Care WSHA Goals: • Defeat attempts to limit payment to no more than Medicaid • Protect staff and patients by requiring adequate law enforcement guarding of patients who are suspected or convicted of a violent or sexual crime Result: Neither issue was enacted, but important stakeholder conversations have begun Washington State Hospital Association Medical Records Requests WSHA Goal: Ensure hospitals can charge the same rates for electronic and paper medical record requests • Bill proposed to mandate that hospitals respond to medical record requests in electronic form and cap record fees at $20 Result: HB 2074 was modified to be acceptable, but was not enacted Washington State Hospital Association Support Breastfeeding WSHA Goal: Support breastfeeding as a strategy to improve infant health and reduce childhood obesity Result: HB 2329, SB 6298 defeated Future: Work on voluntary efforts Washington State Hospital Association Public Hospital Districts – Good Results AWPHD Goal: Maintain local decision-making and affiliations • Bill prohibited district boards from delegating certain management functions-- affiliations virtually impossible Result: SB 6425 defeated Washington State Hospital Association Public Hospital Districts – Good Results for Bills Targeted at Large Districts AWPHD Goal: Ensure larger public hospital districts may elect at-large commissioners Result: SB 6004 defeated AWPHD Goal: Defend hospital districts from unduly burdensome personal income reporting requirements Result: SB 6348 defeated Washington State Hospital Association Public Hospital Districts – Disappointing Results AWPHD Goal: Allow public hospital districts to recover costs relating to public records requests for commercial purposes Result: HB 1037 died Washington State Hospital Association Policy Work Before 2015 Session • • • • Nurse staffing Transparency and Innovation Future of Certificate of Need Mental health funding and integration • Enrollment and expansion Washington State Hospital Association Washington Hospital PAC Building Relationships Electing Champions for Hospitals Unifying Hospitals’ Political Voice www.wsha.org/whpac.cfm Washington State Hospital Association Thank You! We couldn’t do it without you! Thank you for your good work! Washington State Hospital Association Questions? Comments? Cassie Sauer Senior Vice President, Advocacy & Government Affairs cassies@wsha.org 206/216-2538 Washington State Hospital Association
