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February 1, 2013

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

Welcome to ASHNHA's Legislative Notes


ASHNHA is trying a new email format for our Legislative Notes this year. Please remember to click "display all images" for the best viewing. If you would like to print this newsletter you may wish to view it in your browser. If you have any trouble printing or viewing this newsletter please contact debbie@ashnha.com or 907-586-1790. Let us know if you would like a pdf version of the newsletter emailed to you for easy printing.

Medicaid Budget Drops Again


Usually the Medicaid program takes from the state treasury, but yesterday we observed the rare sight of DHSS turning Medicaid money back to the state coffers.

Governor Parnell submitted his supplemental appropriations bill this week seeking an actual decrease in state spending in this fiscal year—due to Medicaid savings.  The Administration reduced the state’s contribution to the FY2013 Medicaid budget by $25 million in general funds—which translates to roughly $50 million in actual health care service. The Governor attributed the savings to “in large part the success of certain cost containment measures implemented upon the recommendation of the Medicaid Task Force.”

The $25 million was quickly reprogrammed into a wide variety of unanticipated costs for anything from wildfire suppression, litigation costs, unexpected Pioneer Home costs, and indigent burials.

DHHS Announces new Deputy Commissioner for Medicaid and Health Care Policy


Craig J. Christenson, DPM, CEM, has been appointed as Deputy Commissioner for Medicaid and Health Care Policy effective Feb. 1, 2013.  Dr. Christenson replaces Kimberli Poppe-Smart, who relocated out of state in December 2012.

In an announcement to DHHS staff, Bill Streur stated, “Dr. Christenson’s extensive background in health care and emergency management will be a great asset to our department as we face the challenging and changing environment of health care.”
 
Most recently, Dr. Christenson was the Commander (Vice President for Clinical Operations) of the 673rd Medical Operations Squadron at Joint Base Elmendorf-Richardson in Anchorage. While in that role, he assessed health care needs and expectations, providing strategic guidance and planning to ensure a comprehensive system of outpatient health services.  Previous to his JBER assignment, Dr. Christenson was Branch Chief/Medical Planner for the U.S. Northern Command (NORAD) at Fort Sam Houston, San Antonio, Texas. Dr. Christenson holds a doctorate in podiatric medicine from Pennsylvania College of Podiatric Medicine, and a bachelor’s degree in biology from Washington and Jefferson College. He is a licensed podiatrist in Alaska and is board certified in podiatric surgery.

Plans Set for ASHNHA Winter Legislative Fly-in


We are putting the final touches on the agenda for the ASHNHA Winter meeting February 18-19 in Juneau.  The agenda is packed with updates from the Capitol including information from:
  • Dinner speech with Senator Kevin Meyer, Co Chair of Senate Finance
  • Commissioner of DHSS William Streur          
  • A deep dive into recent reports issued on the Medicaid Expansion in Alaska
  • A review of selected issues in the state’s Medicaid program by Director of Health Care Services Margaret Brodie
  • An update on Background Checks by Director Brodie and Jane Urbanovsky
  • Analysis and review of State Active and Retiree claim trends by Commissioner Becky Hultberg and her staff
  • A first review of the financing plan for Alaska’s health information exchange.
All this is interspersed with visits to Legislators and an Executive Committee meeting with Governor Parnell and a House HSS overview.

If you haven’t made your plans to come, there is still time. We have a few hotel rooms left at the Baranof.  If you are interested in attending, contact Geoff Bullock in the Juneau office at 586-1790 or consult@gci.net.

Check Out the New Alaska Legislature App


Smartphone users might want to download the new free Alaska Legislative app (available through the iTunes app store - search for "The Alaska Legislature").  The app will show you all committee meetings including links to meeting documents, status of moving bills, and other useful information.  You can even watch live web streams on your phone. 

Senate HSS Committee Organized


The Senate Health and Social Services Committee has a new crop of members this year.  Like their House counterpart, the Senate HSS committee is usually the first committee that hears any legislation pertaining to health care.  Thus the path for any Medicaid expansion, or other Affordable Health Care Act components that need legislation starts here.  Currently the committee has only one bill in committee.
 
The Senate HSS committee has a new chairman, Sen. Bert Stedman (R-Sitka).  He replaces longtime committee member Sen. Betty Davis (D-Anchorage) who served as chairman since 2007.  Last session Sen. Stedman was co-chair of the Senate Finance Committee.

In a recent visit with Senator Stedman, he told ASHNHA he does not plan a lot of overviews and committee activity not related to Legislation.  And since this is—so far- a very light year for health care bills—the committees calendar is currently empty.  No hearings have yet been scheduled in Senate HSS. Today, the Committee was referred one assignment by the Senate President- review the reappointment of Paula Easley and Russ Webb to the Alaska Mental Health Trust Authority. 

In addition to Sen. Stedman other majority members include Sen. Kevin Meyer (R-Anchorage), Sen. Pete Kelly (R-Fairbanks), and Sen. Peter Micciche (R-Soldotna).  The minority committee member is Sen. Johnny Ellils (D-Anchorage).
 
When it does meet, the Senate HSS committee meets on Mondays, Wednesdays, and Thursdays beginning at 1:30pm.  

House HSS Committee Up and Running


The House Health and Social Services Committee is up and running for the 2013 session.  This committee is usually the first committee that hears any legislation pertaining to health care.  Currently the committee has five pieces of legislation under review.
 
The committee has a new chairman, Rep. Pete Higgins (R-Fairbanks) who replaces Rep. Wes Keller (R-Wasilla).  Rep. Higgins was elected to the House for the first time last fall.  Rep. Keller remains on the committee as vice-chairman. 

Representative Higgins is a practicing dentist with clinics in Fairbanks, Anchorage and the Valley. He is very knowledgeable about health care financing, and health care in general. He has invited ASHNHA to give an overview of hospital issues to the Committee.
 
In addition to Rep. Higgins and Rep. Keller other majority members of the committee are Rep. Ben Nageak (D-Barrow), Rep. Lance Pruitt (R-Anchorage), Rep. Lora Reinbold (R-Eagle River), and Rep. Paul Seaton (R-Homer).  The minority committee member is Rep. Geran Tarr (D-Anchorage).
 
The House HSS committee meets throughout the session on Tuesdays, Thursdays, and Saturdays beginning at 3pm.

Legislative Hearings February 4th to February 8th


Monday, February 4th  @ 8:30am – House Health & Social Services Finance Subcommittee – Meeting cancelled

Monday, February 4th @ 1:30pm – House Finance Committee – Presentation by Department of Administration Commissioner Becky Hultberg and Department of Health and Social Services Commissioner Bill Streur:  Healthcare Cost Containment

Wednesday, February 6th @ 8:30am - House Health & Social Services Finance Subcommittee – Juvenile Justice

Thursday, February 7th @ 8:00am – Senate Health & Social Services Finance Subcommittee – Department Overview

Thursday, February 7th @ 9:00am – Joint House and Senate State Affairs – Employee Health Plan Overview Presentation by Department of Administration Deputy Commissioner Curtis Thayer

DHSS Budget Facts


During FY 2005-2012:
  • Growth of DHSS budget:  $1 billion in federal and state
  • Growth of Medicaid budget: $360 million
  • Growth of State Funds:  $717 million or 119%
  • Growth of Behavioral Health grants:  99%-- $47 million
  • Growth of Public Health Grants: 200%

Foster G. McGaw Prize – AK Hospitals Step Right Up


Alaska hospitals are invited and encouraged to apply for the Foster G. McGaw prize.
 
The Prize honors health delivery organizations (hospitals, health systems, integrated networks, or self-defined community partnerships) that have demonstrated exceptional commitment to community service.
 
The winner of the Foster G. McGaw Prize will receive $100,000, a trophy, recognition at a special awards ceremony. Up to three finalists will each receive $10,000 and be mentioned in AHA NewsH&HN (Hospitals & Health Networks), and other health care publications.  The recognition and visibility as a winner/finalist goes a long way toward establishing the credibility of rural hospitals for community service. In 2010, Wrangell Medical Center was a finalist for this award. 
 
More information available on the AHA web site or contact AHA Member Relations at 312-422-3932
 
Please let ASHNHA know if you are interested in applying.  Applications must be received in the Prize office by close of business on April 5, 2013.

Dave Cote Presents on Pioneer Homes


Director of the Pioneer Home System, Dave Cote, gave a presentation on the Pioneer Homes to the House Finance Budget Subcommittee on January 28, 2013. As usual, legislators expressed a strong interest in the operations of the Pioneer Home System and Director Dave Cote provided in depth and knowledgeable answers.
 
Link to Pioneer Home Presentation

Here are some highlights from Dave’s presentation:
  • The six Pioneer Homes served 579 Alaska seniors during FY2012.
  • The average age of a Pioneer Home resident is 86 and has been increasing.
  • Rates charged to residents are considerably below cost: Level I care is $2,350, Level II is $4,260, and Level III is $6,170.
  • The change in the level of service provided to Pioneer Home residents over the past eleven years is significant.  Those residents requiring the highest level of service, Level III, increased from 38 to 55 percent, while those requiring Level 1 care decreased from 24 to 12 percent.
  • As of September 30, 2012, there were 356 Alaskans on the active waiting list, 3,706 on the inactive waiting list.  During the past year, the number of applicants on the active wait list increased by 16 and the number on the inactive wait list increased by 427.  During the year, the Pioneer Homes admitted 123 new residents.  
 
The total budget of the Alaska Pioneer Home system is $61.4 million from all sources, of this 35.7 million is unrestricted general funds.  The Pioneer Homes are not requesting an increase in the operating budget for FY14.
 
Dave Cote spoke of the need for Alaska and the Pioneer Homes to think differently about how to meet the needs of the growing numbers of seniors in Alaska and how to meet the needs of those waiting for Pioneer Home Services. The subcommittee asked a variety of questions about waiting lists, occupancy rates, and the decrease in Level I care. 
 
The following are tables and charts provided as part of the presentation.  Additional information can be found in the full presentation on-line.

Active Wait List
The number of applicants on the active wait list increased over the past number of years, due in part to outreach by both management at the division level and the individual Pioneer Home administrators. The number of seniors on the Pioneer Homes active wait lists over the years is shown in the table and graph below.



Pioneer Homes Occupancy
The table below shows the September 30, 2012 occupancy figures for each of the five Pioneer Homes and the Alaska Veterans and Pioneer Home located in Palmer by level of service. 



Pioneer Homes at a Crossroads

Both Commissioner Streur and Dave Cote described a need to think new and differently about how the Pioneer Home system and other providers can meet the future needs of the elderly in Alaska as the elderly population grows.  “The Pioneer Homes are at a crossroads” said Streur. He suggested it might be time to look at other ways to provide services to seniors.
 
Rep Mia Costello asked if the division is working on such a plan.  Cote said the administration, legislature and the private sector must all step up to figure how to meet the need. He also said the Pioneer Home Advisory Board has been vocal about what should happen with the system.
 
Cote said the division commissioned two studies on the future of the homes. One study conducted by Information Insights in 2009 suggested the state add 726 beds in 10 unit facilities. The second study, prepared by an architectural firm, proposed a 10 year plan to add 200-500 beds by adding on to existing homes.  Both studies can be found on the Divisions’ website, under reports or click these links:

http://dhss.alaska.gov/daph/Documents/docs/plan.pdf
http://dhss.alaska.gov/daph/Documents/docs/LookingForward2010.pdf

Cost is a big issue in any future planning, said the Commissioner. He said the State cannot continue to add beds to a “structure that is pricing itself out of the assisted living market.”—due to rising acuity.  He said there were several options discussed at a recent senior housing summit in Anchorage. One idea discussed was a government-private partnership, where the Pioneer Homes would oversee facilities that private entities constructed and operated. 
 
Both Representative Neuman and Austerman called for such a plan and the Commissioner said he would try to deliver one by the end of the session.
 
Not discussed at the hearing but useful to such analysis is the Long Term Care analysis the Department awarded to consulting firm Agnew Beck recently.  More on that as we learn about it.

 

SEARHC Purchases Sitka Medical Center


In January, SEARHC announced purchase of Sitka Medical Center, a private medical clinic founded in 1982. According to an article published by Raven Radio - KCAW, the clinic will operate in the same way, just with a new owner. “It’s the same clinic, the same providers, the same employees, and there’s no reason for the patients – or the employees – to note any change in the day-to-day operations,” said Dr. Robert Hunter, one of the clinic’s original founders.

SEARHC stated care will be provided to both SEARHC beneficiaries and non-beneficiaries. The purchase was characterized as a continuation of services for the patients of Sitka Medical Center. To read the full article, click here.

KAREN PERDUE
President / CEO
IN SESSION
426 Main Street
Juneau, AK 99801
907.586.1790
----
1049 W 5th Ave, Ste 100
Anchorage, AK 99501
907.646.1444

EMAIL
karen@ashnha.com

ASHNHA’s Office Looking Good For 2013


The ASHNHA office in Juneau is looking good after several deferred maintenance projects were completed last fall.  In addition to the drainage issues on the outside of the building, the inside of the building sports a new furnace, water heater, new carpet and fresh paint.  
 
New furniture was brought in to make several work stations and give the interior a more ‘professional’ look. From the reviews of people who have come to the office, it appears we have reached that goal.  Here is a picture of the outer office with two work-stations showing the new furniture, paint and carpet. Thanks ASHNHA Board!
 

Blood Bank of Alaska Building New Facility


One prominent health care project that was given Governor Parnell’s blessing in this year’s capital budget is a new facility for the Alaska Blood Bank in Anchorage.

The $7 million he inserted in his budget adds to $19.2 million already appropriated for the project by the State.
 
The Blood Bank of Alaska supplies blood and blood products to more than 200 communities across Alaska and 21 medical centers including Alaska’s private, tribal and military hospitals.
 
“Along with the Governor’s appropriation for a new building, the Alaska State Legislature has also been very generous and supportive of the new facility,” said Bob Scanlon, Blood Bank of Alaska’s new CEO. “Their commitment ensures that Alaskans are served by a modern blood bank that will be a strong part of the state’s emergency preparedness plan.”
 
The new 57,000 sq. ft. building will improve the blood bank’s operating efficiencies and infrastructure statewide. Located adjacent to Alaska Regional Hospital at the corner of DeBarr and Airport Heights, the facility will consolidate satellite blood collections and warehouse offices.
 
“Our goals are to ensure high quality blood products to our state hospitals and to serve their needs. The hospitals are where the rubber meets the road. We need to supply them with the blood they need so that blood is leveraged in the saving of lives. The new building will offer us capabilities that we don’t currently have,” explained Scanlon.

“The building will be strategically located in Anchorage so the Blood Bank can respond to the state’s largest hospitals along with having access to outlying hospitals,” added Scanlon, whose organization taps blood from 700 donors a week in several sites across Alaska. “We need to be prepared for a disaster or a state of emergency and ready to respond when the hospitals and the people of Alaska turn to us.”

The Blood Bank of Alaska is an Associate member of ASHNHA.

Bob Scanlon Takes Reins of the Blood Bank of Alaska


Bob Scanlon took the reins of the Blood Bank of Alaska in the Spring of 2012, and he brings decades of experience in health care from the lower 48.
 
Prior to his position as the Blood Bank’s CEO, Scanlon worked as the Executive Director of Humphrey’s Diabetes Center and as the Area Director of Manufacturing for American Red Cross’ Biomedical Services for the Western United States.
 
Born in Illinois, Scanlon’s family lived all over the country due to his father’s work in the federal government. With an undergraduate degree from Portland State University and an MBA from Northwest Nazarene University in Idaho, Scanlon settled in Boise, Idaho.
 
An active Rotarian, Scanlon also served as an Infantry Officer in the United States Marine Corp in Honduras, Panama, Desert Shield, and Desert Storm. While in the service, Scanlon got his first taste of Alaska in the late 1980’s during a layover on his way to Okinawa.
 
“I had the opportunity to see a little bit of Alaska at that time and really liked it,” said Scanlon. “I liked what I saw and the people that I met. It just felt right and since then, I’ve always wanted to come to Alaska.”
 
Now that he’s landed in the Last Frontier, Scanlon and his wife along with two of their four sons are settling into their new home while the other boys attend college in the Lower 48.  “My wife and family adore Alaska as much as I do. I’m glad we eventually got up here.”
 
It seems like for Scanlon, the combination of his new position and answering his own personal call of the wild is the perfect fusion of career and location – a good mixture for breaking new ground for him and the Blood Bank.  
 

Healthy Alaskans 2020: Your Input Needed



Healthy Alaskans 2020 is a statewide initiative with the goal of identifying 25 leading health indicators, or measurements, to guide health efforts in Alaska over the next decade. Your input is needed to help achieve the vision: "Healthy Alaskans in Healthy Communities."
 
This survey is the second in the year-long process to gather input about health priorities that are important to Alaskans. Results from Survey One helped to identify 71 potential leading health indicators. 
 
This survey will help to further narrow the potential leading health indicators down to 25.
 
Take the Survey

Alaska Perioperative Nursing Consortium Training


ASHNHA is conducting an evaluation of the Alaska Perioperative Nursing Consortium (APNC) training after two cohorts have graduated. To get the best and most complete review we turned again to Tracey Jones and Diana Frawley, leaders of the NorthWest Perioperative Consortium,  to conduct the evaluation. The nurses met with members of Alaska’s consortium during a visit this week.  Their report will be completed by April 15. 

The visit was a great opportunity to assess the success the program has had for participating hospitals.  Without exception, consortium members indicated that the project has either greatly reduced their need for travelers or substantially reduced it.  That has been one of the principle goals.
 
 
To date, twenty-five Nurse-Residents have completed the training.  The next cohort will begin on February 25.  It is expected that Providence Kodiak, SEARHC and YKHC will have Nurse Residents in addition to PAMC, AK Regional, ANMC and FMH.  If your facility is interested in joining the consortium, please contact Dennis at 907-646-1444 or dennis@ashnha.com
Photo: left to right it is Gary Shaw, Tracey Jones, Laura Mullin (surgery manager) and Diana Frawley

Odds Are Good


I’m sure you’ve heard the classic Alaska saying—the odds are good, but the goods are odd—referring to the ratio and quality of the eligible male pool in Alaska.  For the first time in history, it appears Alaska no longer holds the record as the state with more young men than women.  Wyoming has surpassed Alaska in the percentage of single people who are men, with North Dakota closing in on Alaska pretty rapidly. That still leaves Alaska’s ratio 58% men to women in the 18-34 category.  No comment on the quality (goods are odd) metric.


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