April 5, 2013

Legislative Notes for ASHNHA members; compiled from hearings, reports, news accounts and good old fashioned face to face discussion in the Capital City

New Draft of Capital Budget Released in the Senate

Sen. Kevin Meyer (R-Anchorage) led the Senate Finance Committee through passage of this year’s capital budget.  Senator Meyer warned that this capital budget would be significantly smaller than the 2013 capital budget.  In fact, upon reviewing the bill before the committee, Sen. Meyer stated, “I think I’ve made everyone equally mad so I think it’s a pretty good budget.”  
The health projects are few and far between compared to last year. In this version of the legislation, Ketchikan Medical Center is slated to receive $10 million (out of a requested $20 million) for their remodel project.  Other projects in this version include funding for deferred maintenance in the Pioneer Homes, a re-appropriation of up to $2 million for the Hoonah Health Center, and money for the electronic information health exchange. 
Here is a breakdown by House District of where the money is going:

We thank Yuri Morgan of Anderson Group for this help in tracking Capitol projects.

The capital budget is on the Senate floor today and will be passed to the House for their consideration.  This is usually one of the last pieces of legislation to pass before adjournment. Thoughts are that the House will add almost $100 million.

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Just a Few Days Left….But Wait… it Will Continue

Today is day 82 of the 90 day session.  As the energy builds toward adjournment , most (me included) are looking forward to returning to the normal pace of our regular jobs. 
However, in the Capitol building, House Finance Committee members are planning for summer meetings on the Health and Social Services budget. According to sources in the Capitol, the House Finance Committee staff is preparing an agenda for the DHSS subcommittee interim hearings.  The goal is to help the House Finance Committee make better decisions about the FY 15 budget. We hear the current plan of the Chair Mark Neuman is for the subcommittee (i.e. the whole Finance Committee) to meet from 9am-4pm daily the third week of every month, beginning in June. We are looking for a schedule to be released prior to adjournment on April 14.
Likewise, Senate Finance Co-Chair Pete Kelly has called for budget subcommittee work during the summer. “Nothing is off the table for discussion,” he told the press. Reportedly Senator Olson is not interested in holding interim meetings, but may change his mind after the session clears his mind.

House Joint Resolution 14 Moves Out Of House HSS Committee

After a brief hearing, HJR 14 moved out of the HSS Committee.  As you will recall from last week’s addition, this resolution, sponsored by Rep. Bill Stoltze (R-Wasilla), calls on the Governor and Congress to delay the implementation of the Affordable Care Act  until it can be determined that there is no negative impact on small business.
The resolution is now in House Rules awaiting scheduling to the House floor for a vote.  That could happen this week.

Testimony against ACA by Dr. Farr

Dr. IIona Farr, an Anchorage physician flew to Juneau this week to present invited testimony in front of the House HSS committee. Dr. Farr registered her deep opposition to all components of the Affordable Care Act.  She estimated in her presentation that up to 60% of providers would retire or opt out of Medicare and Medicaid in the next three years due to the law. Dr. Farr does not take Medicare assignment.   
She spoke to a fairly poorly attended committee meeting, as there are a lot of competing priorities this time of year. One representative on the Committee—Representative Ben Nageak, Barrow, expressed dismay at her comments as being very negative and requested that the Committee hear a more balanced view.  He then left the hearing to further express his displeasure.  Dr. Farr also distributed a letter to legislators starting with this paragraph, “Please do not expand Medicaid….”.  You can read the letter and view the powerpoint here.

Bill to Mandate Newborn Screening for Heart Defects on the Move

A bill to ensure all newborns are screened for congenital heart defects is poised for passage at the end of the session.  Most hospitals in Alaska are routinely providing the test within 24 hours of birth. The test is done with pulse oximetry—a quick, painless bedside test that determines the amount of oxygen in the blood and the pulse rate.
Low levels of oxygen in the blood can be a sign of a critical congenital heart defect. Once identified, babies with critical congential health defects can be seen by pediatric cardiologists or appropriate specialists.  
The Senate draft  version of the bill,  sponsored by Senator Peter Micciche, would also mandate the test be administered by birthing centers and at home births.  The responsibility would be on the attending provider to ensure the test is conducted and reported to the State.
Work is being done now to eliminate the need for a fiscal note or expense for the bill, so it can avoid a finance referral.  If there are no funds appropriated, the State may not be able to provide an analysis of the mandated reports—although that is not entirely determined at this point.
The ASHNHA legislative committee reviewed the bill this week and expressed support because virtually all birthing hospitals are already performing the test as a best practice or working toward that goal.  The committee did have some deep concerns about providers needing to report to the State if the information was not going to be analyzed or used for public health reasons. We are working on this area.
In Alaska, between 1996 and 2002, cardiovascular birth defects were the most frequently reported congenital anomalies, affecting about 2% of the 11,000 deliveries per year, or 220 babies annually.  

Legislative Hearings for the Week of April 8th to 14th

Reminder:  The Legislature is now under the 24-hour rule that allows the scheduling of bills to happen much faster. 
Tuesday, April 9th @ 3:00pm House HSS Committee – HB 184 Newborn Screening for Heart Defects

DHSS Announces New Director of the Alaska Pioneer Homes Division

This week, Dep. Commissioner Craig Christenson announced G. Ken Truitt as director of the Alaska Pioneer Homes division, effective April 16, 2013.

Mr. Truitt is an attorney who brings expertise in a variety of health care areas including Medicare, Medicaid, privacy, licensing, scope of practice, accreditation, anti-fraud as well as employment and labor law.
Most recently, Mr. Truitt is legislative aide and general legal counsel for Sen. Fred Dyson. He starts his new responsibilities right after the legislative session.
Previously, he served the SouthEast Alaska Regional Health Consortium as general counsel and interim president/chief executive officer. He served the State of Alaska as an assistant attorney general for nearly a decade from 1995-2004. He also has experience as a private attorney with Birch, Horton, Bittner & Cherot. Mr. Truitt is a member of the Alaska Bar Association.

Merger Talks Between PeaceHealth and Catholic Health Initiatives End

Catholic Health Initiatives (CHI) has suspended merger discussions with PeaceHealth ending a potential deal to create an integrated health system in the Pacific Northwest.  The two Catholic systems had signed a nonbinding agreement last August.  The deal would have combined seven CHI hospitals with PeaceHealth’s eight medical centers.  The merger was supposed to be completed before June 30, 2013.
While it appears that neither party was able to develop an integrated model, they remain engaged in exploring other opportunities to work together.
You can read the entire story from here by clicking here.

CNO Committee and CFO Collaborative Joint Meeting April 18-19, 2013 – Anchorage

ASHNHA is facilitating a dynamic event for hospital CNOs and CFOs. The first event of its kind will focus on communication between Finance and Nursing. Make sure you’re registered by clicking here.
We have a full two days of education and networking planned including a dinner and panel discussion on Thursday April 18. Below is information on a few of the presenters.
Day Egusquiza will present “Mastering the Chaos -Documentation to Support Billable Services” along with a breakout session on ICD-10 impacts to the revenue cycle. Ms. Egusquiza is a nationally recognized speaker on continuous quality improvement (CQI), benchmarking, redesigning, reimbursement systems and implementing an operational focus of compliance – both in hospitals and practices.
Terry Kiss, RN, MS, MSSW, CCRN, CMSRN Fairbanks Memorial Hospital will share and discuss best practices to improve outcomes and efficiency through collaboration between Finance and Nursing. Ms. Kiss is director, medical unit-2South of Alaska-based Fairbanks Memorial Hospital, where she worked as a staff nurse in the ICU from 1987 to 2011. She was an assistant professor at the University of Alaska School of Nursing from 2002 to 2010 and a certified flight nurse for Fairbanks-based Critical Care Air Ambulance, Guardian Flight, Inc., from 1998 to 2005.

Sheela Tallman, Senior Manager of Legislative Policy for Premera Blue Cross, will be speaking to the CFO group and sharing the latest updates on Health Care Reform. Ms. Tallman is responsible for managing the tracking and analysis of federal and state legislation in Washington, Oregon, and Alaska.
Jennifer Bundy-Cobb, Vice President and Senior Employee Advisor for the Wilson Agency will also present on the health exchange in Alaska.
Click here for meeting locations and the full agenda.
Hotel rooms are still available at the Sheraton Downtown for a discounted rate of $91/night. Call 907-276-8700 and mention "ASHNHA." If you have any questions, please contact Connie at 907-646-1444 or

Dynamic Speakers lined up for Nome Annual Meeting

The ASHNHA annual meeting in Nome is scheduled for September 11-13, 2013. Registration for the conference should be available on-line in 2-3 weeks.  Our speaker line up is beginning to take shape. We are finding that speakers are very interested in coming to Nome, Alaska for a once in a lifetime visit.
Former Governor of Mississippi Ronnie Musgrove is fulfilling a lifetime dream of visiting Alaska and speaking at our conference. Ronnie Musgrove has been appointed by Secretary Sebelius as the Chair of the National Committee on Rural  Health and Human Services- the committee that advises the Department on rural matters. The Committee is staffed by Tom Morris, the head of HRSA’s office of rural health policy.  Governor Musgrove has a keen interest in rural health from the bayous to the tundra.

During Ronnie Musgrove's tenure as Governor of Mississippi, he helped create more than 52,000 new jobs, brought more than $14 billion in new investments to the state, invested in creating rural jobs, and brought Nissan to Mississippi, which was the largest economic development project in state history.

Governor Musgrove’s dedication to providing quality public education and creating economic opportunity for all Mississippians has received national attention. His history-making efforts in providing health insurance for children (from under 1,000 to over 60,000), expanding civil defense, and working with the Mississippi National Guard. Having received many accolades, he is the recipient of a Distinguished Service Award from the National Guard Bureau in Washington, D.C.

Timothy McDonald, MD JD, is a physician-attorney who has been involved in quality and patient safety efforts at the University of Illinois Hospital and Health Sciences System as the Chief Safety and Risk Officer for Health Affairs.
His focus has been on the principled approach to quality, medical liability and patient harm with an emphasis on the robust reporting of patient safety events, near misses and unsafe conditions. He has helped pioneer the hospital’s learner reporting process as a means of engaging learners from all professions and all specialties in safety and quality education.
Dr. McDonald’s approach to patient harm also includes a commitment to communicate within the health care team and with patients and families throughout the therapeutic relationship. It also involves a promise to investigate and work to create systems improvement following the detailed analysis of harm or near miss events or other gaps in Quality metrics.
His federally funded research has focused on all of these domains and their impact on improving the quality of care while mitigating medical liability issues, including the establishment of teaching methodologies for all levels and professions in health care. 
He is an engaging speaker and we look forward to hosting him in Nome.

Value Based Purchasers Try Again

The ASHNHA team has again done a scientific analysis of ice thickness and weather patterns in Nenana and have carefully filled out our tickets for the Nenana Ice Classic. We are proudly known as the Value Based Purchasers.  The lottery contest has been going on for nearly 100 years and the proceeds are split between the winners and the City of Nenana for community projects.  Last year there was a single winner who won a record jackpot of $350,000, but most years the prize is split several ways. 

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