OHA Advocacy Network

Advocacy Report • Friday, September 22, 2006

State Rules and Regulations Update

Did you know? OHA has compiled information about draft rules and proposed regulations.

To access this directory, click here.

OHIO DEPARTMENT OF HEALTH

Attorney General Files Revised Rules with JCARR, Public Hearings Begin
In early September, Attorney General Jim Petro filed rules with the Joint Committee on Agency Rule Review (JCARR) that would require hospitals to register and annually file their IRS Form 990 with the attorney general’s (AG) office. The AG’s office reported it received written comments from numerous groups, including OHA, many of which expressed concerns with certain provisions of the proposed rules, which originally were extremely broad and burdensome. On Aug. 30, a small group representing charitable organizations and attorneys, including OHA, met again with the AG's staff to refine a few outstanding technical issues. At that time, the AG’s staff expressed appreciation for the many technical comments, shared a new draft of the rules, committed to make a few more changes and stated their intention to go forward with the rules.

All of OHA’s material concerns with the rules have been addressed and the rule now contains only a few substantive provisions, including:

Charitable hospitals and other charitable health care organizations such as nonprofit HMOs will be required to file a one-time registration statement with the AG’s office. The statement requests only basic information about the organization.
A charitable advisory council is established to advise the AG on various issues, including governance, administration and model policies. Hospitals will have a designated seat on the council.

Before the official advisory council is formed, the Attorney General wants the OHA to be represented on an ad hoc advisory group, which is being created immediately. The filing with JCARR begins a rule review process that dictates public hearings, the first scheduled for Oct. 10, with the rules being final in early November. View a full news release at www.ag.state.oh.us/press/06/09/pr060906.asp. (Mary Gallagher, maryg@ohanet.org)

Draft Rules Begin Implementation of Public Disclosure Legislation
The Ohio Department of Health (ODH) recently released two sets of draft rules to begin implementation of House Bill 197, legislation requiring hospitals to report additional pricing and quality information to ODH.

The first set deals with the specific quality measures that hospitals will begin submitting in April 2007, as required by the new law, including:

pediatric quality measures for iatrogenic pneumothorax and for post-operative respiratory failure, as endorsed by the Agency for Healthcare Research and Quality;
pneumonia measures for pneumococcal vaccination and for blood culture before initial antibiotic, as publicly reported by the Centers for Medicare and Medicaid Services;
acute myocardial infarction measures for aspirin at arrival and for beta blocker at arrival, as publicly reported by the Joint Commission on Accreditation of Healthcare Organizations;
measures for heart assessment and for angiotensin converting ventricular systolic dysfunction as endorsed by the National Quality Forum.

The second set of rules deal with the format in which hospitals will submit average charges and volume for their top 60 outpatient procedures.

OHA is reviewing the draft rules, available at www.odh.ohio.gov/rules/drafts/3701-14.aspx, and will submit comments to the department by the Oct. 5 deadline. The department has indicated the rules should take effect by early February, giving hospitals two months to submit the additional quality and pricing information. OHA will contact hospitals in the coming weeks to assist them in meeting the new disclosure requirements, similar to OHA’s previous efforts to comply with state and federal reporting requirements. (Jeff Klingler, jeffk@ohanet.org; Mary Drake, maryd@ohanet.org)

ODH Adds Two Disorders to Mandatory Newborn Screening List
The Ohio Department of Health (ODH) in late August announced it will begin tests for cystic fibrosis and carnitine uptake defect, which have been added to its list of disorders for mandatory newborn screenings. This addition will bring the number of disorders screened in Ohio to 32 per infant.

With no known cure but improving treatments, cystic fibrosis entails abnormally thick respiratory secretions that can lead to other problems such as infertility and poor food absorption and affects 2,000 white newborns but is less common in other races. Carnitine uptake defect is a rare disorder that impairs the body’s ability to metabolize fatty acids.

The total newborn screening fee for each newborn screening test kit will increase because of the additional tests from $45.16 to $55.16. Hospitals are required to pay the fee for each newborn as well as cover the expense of the health care workers who explain the procedure to mothers and obtain the blood samples to send to ODH’s public health lab. While hospitals object to such unfunded mandates, they strongly support early detection through newborn screening. (Rick Sites, ricks@ohanet.org)

January 1 – July 31, 2006 Clostridium Difficile Report Released
The Ohio Department of Health has released the July report for clostridium difficile (C. diff). The report lists rates of clostridium difficile cases for hospitals for each month between January and July. ODH also released a Frequently Asked Questions (FAQ) document regarding the C. diff rate reports.

The goals of this reporting system are to better determine the extent of health care-associated C. diff infection in Ohio and to establish facility-level baseline C. diff activity to enable identification of unusual disease activity and reporting of disease outbreaks.

Ohio hospitals and long-term care facilities should make certain they are using the correct form when reporting their C. diff and patient day numbers. The form can be found at www.ohanet.org/advocacy/state/issues/resources/reportform.doc.

Read more on this disease and see the recently released interim report for hospitals for January through July 2006 at www.odh.ohio.gov/alerts/cdiff1.aspx. View ODH’s FAQ document on OHA’s Web site at www.ohanet.org/advocacy/state/resources/FAQ.doc. For more information about C. diff reporting visit www.ohanet.org/advocacy/state/issues/cdiff.htm. (Rick Sites, ricks@ohanet.org)

Other Updates from the Ohio Department of Health (ODH):

Birth Defects Registry - While reporting birth defects is a statutory mandate in Ohio, ODH has taken a slow and deliberate course in bringing hospitals into the mandatory reporting process. Sixteen hospitals in four counties are now reporting certain birth defects, and ODH has worked carefully with each hospital to reduce obstacles. At a recent meeting of its Birth Defects Advisory Council, ODH said it would not add additional hospitals until late this year or next year. Early findings show that 62 percent of birth defects involve cardiovascular impairments, followed by 13 percent involving genitourinary defects. More than 90 percent of the reports have come from children’s hospitals, where children with birth defects are referred.
Tuberculosis Guidelines - ODH has filed a director’s rule regard the Centers for Disease Control and Prevention (CDC) Tuberculosis (TB) guidelines, which will be the subject of a hearing on Sept. 27 at 10 a.m. at ODH offices in Columbus. The proposed rule updates the requirement that hospitals with bone marrow transplant, cardiac catheterization, open heart surgery, obstetric and newborn care, pediatric intensive care, linear accelerator/cobalt radiation/gamma knife, pediatric cardiac catheterization, or pediatric cardiovascular surgery comply with the 2005 CDC TB guidelines. OHA supports this change, which updates the current rule reference to the 1994 CDC TB guidelines.

PUBLIC HEALTH COUNCIL

Public Health Council Announces 2007 Meeting Dates

The Public Health Council had released its meeting dates for 2007 as follows:

January 18

March 8

May 3

June 28

August 9

September 27

November 15

All meetings are held in the 8^th floor conference room at the Ohio Department of Heath (ODH) offices located at 246 North High Street in downtown Columbus. The role of the council is to adopt, amend or rescind regulations related to public health—although some statutes provide for rule adoption by ODH without the involvement of the council. Hearings regarding such rules are held before the council on the above dates unless a special meeting is called. The council consists of seven individuals appointed by the governor. More information about the council is posted at http://www.odh.state.oh.us/rules/publicHealthCouncil/publicHealthCouncil.aspx.

Other Updates from the Public Health Council

· During the Aug. 17, 2006 Public Health Council meeting, hearings were held for rules involving radiation protection standards as well as radioactive materials packaging and transportation—and there were no witnesses. See OHA’s rules and regulations status sheet for the citations. New business included existing Bureau of Children with Medical Handicaps (BCMH) rules that were filed with no change since ODH expects the outcome of the BCMH study committee will require some rule changes. Another item under new business involved the proposed rescission of a rule requiring filing of an abortion form. The language of the form is now in a new statute at RC 3701.79 and ODH no longer is authorized to issue a form.

· Gov. Bob Taft appointed Dr. Rosemary Chaudry to the Public Health Council. Dr. Chaudry is an Assistant Professor of Clinical Nursing at the Ohio State University.

OHA Advocacy “In the Know”

2006 OHA Hospital Law Handbook Available

OHA’s 2006 Hospital Law Handbook, a collection of select Ohio statutes and regulations that pertain to health care, is now available for purchase. At a cost of $75 plus $7 shipping for OHA member hospitals, the handbook features information on the following topics: medical liability and peer review; mental health; minors, birth and abortion; environmental provisions; infectious diseases and public health issues; vital statistics; death and dying; physicians and nurses; and mandatory reporting. The 800-page compendium is 10 percent longer and about 25 percent revised as compared to the 2005 edition—examples of new sections include county hospitals, the new physician assistant and quality measure statutes, and all tort reform statutes. This resource provides an organized source of actual statutory and regulatory text as of June 30, 2006, with a detailed table of contents and index. It is not intended to provide legal advice or substitute for hospital legal counsel. For more information or to order a copy of the 2006 OHA Law Handbook, contact Rhonda Major-Mack at 614.221.7614 or rhondam@ohanet.org.

Not a Member of the Advocacy Network?

Being a member of the OHA Advocacy Network provides you access to information on government activity and assists the hospital industry in sending unified messages to elected officials. If you are not a current member, you can easily join on-line. Join today to start reaping the benefits of being a member of the OHA Advocacy Network.

The OHA Advocacy Network is a service of the Ohio Hospital Association, 155 E. Broad St., Columbus, OH 43215-3620, 614-221-7614, 614-221-4771 (fax)

Visit us on the Web at: www.ohanet.org

Direct questions on OHA’s advocacy agenda to:

Bridget Gargan, Vice President, State Policy & Advocacy (bridgetg@ohanet.org)

Jeff Klingler, Director, State Policy & Advocacy (jeffk@ohanet.org)

Jean Scholz, RN, Director, Health Policy (jeans@ohanet.org)

Rick Sites, General Counsel (ricks@ohanet.org)

Stacey Conrad, Specialist, State Policy & Advocacy (staceyc@ohanet.org)

Jonathan Archey, Manager, Federal Relations (jonathana@ohanet.org)

Laura Landis, Executive Assistant, State Policy & Advocacy (laural@ohanet.org)