March 29, 2013

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

Session Swings into High Gear

Today is the 75th day of the 90 day session.  Adjournment of the regular session is 16 days away.  With the operating budget passing in both houses, a conference committee of three House and three Senate members will now be appointed.  As soon as that happens, which is expected by mid-week, bills can be heard and moved at 24 hour notice instead of five days.

Capitol insiders say the House committees will close down bill hearings by the end of next week, except for Finance.

No sign of a capital budget yet. Since he is producing the bill, Senator Kevin Meyer’s office is ground central for those hoping their project makes it in the first draft.  Rumors abound that the capital budget will be the smallest we have seen in many, many years.

In House HSS, one of the last bills to be heard will be a recently released House Joint Resolution 14 which 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 measure is sponsored by Representative Bill Stoltze and a few others, including Tammie Wilson of Fairbanks. Word is the measure is being supported and pushed by the National Federation of Independent Business (NFIB). NFIB was a party to the lawsuit to strike down the law at the Supreme Court.  The hearing is on Tuesday, April 2nd at 3pm.  On Thursday April 4th, the Committee is also slated to hear from Anchorage physician IIona Farr, a vocal critic of the law. 

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Long Term Care Strategic Planning Resumes

The State re-energized their long term care planning effort this week.  Rather than do more studies, they plan to review the mountains of material commissioned over the last several years and work with stakeholders to come up with new strategies.   The State hired the consulting firm of Agnew Beck of Anchorage to lead a comprehensive effort in 2011.  However, the process got bogged down in improvement reforms that were needed in the Division of Senior Disabilities and Services. Director Duane Mayes split the process in two pieces with an immediate focus on short term improvements to waiver and other services.  Now the longer term will be the focus – led by new Office of Rate Review Chief Jared Kosin and assisted by Margaret Brodie, Director Medicaid Services, and Duane Mayes.
In the materials issued for the kick off meeting, the focus is on the coming “silver tsunami” and the actions needed to meet new demands.  Nursing Homes and Assisted Living fit in the continuum but are not the major focus of the effort right now.
There are some interesting materials generated for the meeting – a few of which we highlight here. These graphs show skilled nursing patients now account for 2% of all Alaskans receiving LTC services and account for about 20% of the spending. Personal Care and Waiver services far outpace institutional care in cost and growth.

Karen Perdue and Laurie Dotas attended the meeting and will track the issue for ASHNHA, with assistance from Dennis Murray, Ruth Johnson, and the LTC Committee.

U.S. Senate Spending Plan Keeps Healthcare Sequester Cuts

The 2% sequester cuts have been incorporated in the US Senate spending plan adopted last week. This means the cuts, which were supposed to be temporary, will be incorporated into spending through September 30th.   In addition to the 2% cut to Medicare reimbursements, $1 billion slated for implementing health insurance exchanges and other provisions of the Patient Protection and Affordable Care Act were eliminated.  It is unclear whether or not these cuts will affect the timing for implementation of the health insurance exchanges.

You can read the entire article from by clicking here.

SEARHC CEO Clement says Sequestration is the “New Normal.”

Last week, in an interview with Sitka public radio station KCAW, SEARHC CEO Charles Clement stated sequestration was forcing their organization to make $3.5 million in cuts. This week specific program cuts were announced. On April 30, SEARHC will be closing the Bill Brady Healing Center, an adult residential drug and alcohol treatment program. The closure will make up a little over 40% of the cuts caused by sequestration. The Community Health Aide Training Program is also being suspended through October 1. Clement says the organization has dealt with short-term funding problems before. But he calls sequestration “the new normal.” To read more about the story see the following links:

ASHNHA President Annie Holt Honored by Anchorage Chamber

More than 650 people packed the sold out luncheon on Monday to honor this year's Anchorage ATHENA Society inductees. Among the ten women honored at the ceremony was Annie Holt, CEO of Alaska Regional Hospital, our ASHNHA Board Chair.
From left to right Vic Rosenbaum, Alaska Regional COO; Annie Holt, CEO; Linda Doughty, CNO; Karen Perdue, ASHNHA CEO

Annie joins a list of distinguished Alaskan women who have been inducted into Alaska’s version of the International Society dedicated to encouraging the potential of women as valued members and leaders of the business community through scholarships and mentoring opportunities.

Annie was honored for her work as a business leader and also for her work in supporting juvenile diabetes awareness.  Annie is a Type I diabetic who has managed her condition throughout her lifetime.  Helvi Sandvik, CEO of NANA Corporation was the overall winner of the ATHENA award. 

States Urged to Expand Medicaid with Private Insurance

President Obama’s administration is working with Ohio and Arkansas to allow those states to use federal Medicaid money to pay premiums for commercial insurance that will be sold through insurance exchanges. Other Republicans in states who previously opposed the Medicaid Expansion (Florida, Louisiana, Pennsylvania, and Texas) have now expressed interest in this option.

This could be good news for Alaska as this is one idea that Commissioner Streur and Governor Parnell have expressed interest in.

You can read the entire article from the New York Times here by clicking here.

PhRMA Comes Out in Opposition to House Bill 53       

At the House Health and Social Services Committee meeting yesterday on HB 53 (opiate consultation requirement) Pharmaceutical Research and Manufacturers of America (PhRMA) submitted testimony opposing the legislation. PhRMA told the committee it would, “create an undue burden on Alaskans who need pain treatment.”  In addition, PhRMA believes the legislation will interfere with the relationship between the patient and primary care provider.

Under this legislation, patients who are dispensed 120 milligrams of morphine equivalent dose or more of an opiate in a day for six weeks must consult with a pain management specialist.  PhRMA said that requiring a third party or “gatekeeper” to prescribe medications at a certain dose would create a barrier between the patient and their provider.  

This was the second hearing for the bill and the committee did adopt another committee substitute for the legislation but did not move the bill from committee.  Considering we are less than three weeks from adjournment, it is unlikely that HB 53 will gain any momentum this year but will be an issue for review next year.

To review the bill click here.

Ombudsman Bill Viewed by Some as a Power Grab

This is the time of year when obscure bills begin to move and big things that look insignificant can get momentum. SB 72 gives the State Ombudsman new authorities to investigate more state agencies and its contractors or grantees. One very controversial part of the bill gives them authority to investigate the Alaska Bar Association (I see a lawsuit coming). More relevant to ASHNHA is the language to investigate juvenile treatment or residential treatment facilities and State of Alaska grantees.

North Star Behavioral Health CEO Dr. Andy Mayo wrote in opposition to section 12 of the bill that residential treatment facilities serving children and juveniles already have numerous oversights including State of Alaska Licensing, JCAHO, CMS and a whole lot more.

The Ombudsman Office says as government services are outsourced and new mechanisms to deliver State services are set-up, they need this authority to investigate complaints.

The Ombudsman Office is a creation of the Legislature in the 70’s to give the ordinary citizen a chance to get an objective review of how they are treated by government.
The bill will be sent to a subcommittee for further work over the interim.

You can view the legislation by clicking here.

Bitter Pill

You’ve probably read or heard about the March 4 TIME magazine piece “Bitter Pill” by Steven Brill focused on the health care system.

AHA has created some documents and a webpage to provide clarity on a number of statements in the article and offered responses to some inaccurate or misleading statements.
You might find this information helpful when talking to Board or community members who read the article.
Click here to visit the AHA Setting the Record Straight webpage.

Don't Miss Out on the CNO Committee and CFO Collaborative Joint Meeting
April 18-19, 2013 – Anchorage

Meeting Location:   Alaska Regional Medical Plaza, 1200 Airport Heights Dr, Classrooms 1 & 2

Time:  8:30 am - 4:30 pm: An evening networking dinner is planned for Thursday.

The first day will feature a joint meeting with CNOs and CFOs focused on improving collaboration between clinical and financial staff in hospitals and will address areas of mutual interest.  The second day will provide an opportunity for CFOs and CNOs to meet separately for networking and discussion of common issues.
Click here for more information on the agenda.

There is no charge to attend this meeting, but registration is requested. Travel funds will be available for ASHNHA Small/Rural Hospital CNOs and CFOs to attend (2 people from each small hospital). Travel assistance must be requested by April 5, 2013.
Click here to register for the event.

Hotel: Residence Inn Marriott at 1025 E 35th Ave (907)-563-9844. Make a reservation by April 1st and mention “ASHNHA” for a discounted rate of $109 for studio or $119 for 1 bedroom.

For more information contact or call ASHNHA at 907-586-1790.

Legislative Hearings for April 1st –April 7th

Tuesday, April 2nd @ 3:00pm – House HSS Committee – HJR 14 – Delay Implementing Affordable Care Act
Thursday, April 4th @ 3:00pm – House HSS Committee – Presentation by Kathryn Craft, Project Coordinator – Alaska Health Workforce & Presentation by Dr. Ilona Farr on the Affordable Care Act

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