OHA Advocacy Network

Advocacy Report • Monday, April 23, 2007

Budget Sub Bill Expected by Week’s End

House Finance & Appropriations Committee continues to deliberate on the biennium budget, HB 119, and is expected to have a sub bill prepared by the end of the week. The committee is slated to meet Saturday, Sunday and Monday to finalize their version of the bill before it moves to the House floor for a vote. After the bill passes the House, it will move onto Senate Finance & Financial Institutions Committee, which has released their hearing schedule for biennium budget.

OHA has heard House support for the provider update, providing all hospitals to receive a 3.3 percent Medicaid update starting Jan. 1, 2008, and a 2.9 percent update in 2009. Provisions that appear to be vulnerable include the expansion of Medicaid eligibility for parents earning up to 100 percent of the federal poverty line and children in families between 300 and 500 percent of the federal poverty line.

OHA is strongly encouraging hospitals, particularly critical access hospitals, trauma centers and hospitals that provide rural OB services, to continue to voice their support for OHA-proposed health care provisions in the budget using the template letter available in the “Take Action” section at http://www.ohanet.org/advocacy/state/default.htm. Talking points on the 2008-2009 budgets are also available to OHA members. (Bridget Gargan, bridgetg@ohanet.org)

Hearings Begin on 24/7 ER Legislation

Last week, Senate Health, Human Services & Aging Committee heard testimony from several hospital representatives in support of SB 120, legislation that would require all Ohio hospitals to operate 24/7 emergency departments. Bill sponsor, Sen. David Goodman (R-Columbus), told the committee the legislation's purpose is to more clearly define the term hospital in the Ohio Revised Code, a definition needed because throughout Ohio there are facilities that claim to be hospitals, but do not offer all the services that people typically expect of hospitals. Sen. Goodman explained to the committee that the legislation would require facilities established after Aug. 8, 2006 to maintain an emergency department 24 hours a day, seven days a week and require that clinical activities in the emergency department be supervised by a qualified medical staff member and that there be medical, nursing, and professional staffing adequate in number to meet the written policies of and the anticipated clinical needs of the hospital. It would also require that the emergency department be readily accessible to those who require service.

Jim Pancoast, president and CEO of Good Samaritan Hospital and Health Center in Dayton, told the committee the legislation would help level the competitive playing field between community hospitals and for-profit limited service hospitals. He noted that healthy competition brings higher quality and lower prices to the market – but the danger emerges when limited-service hospitals offer only the more profitable services and community hospitals struggle to continue meeting the community need for lower-margin services. He also voiced concern about the conflict of interest when physician investors have a financial incentive to take less complex and more profitable cases to their own facility.

John W. Zeiger, an officer of the OhioHealth Board of Trustees, urged the Health Committee to require that all hospitals share the community burden of uncompensated care by providing emergency room services. He also states that a staffed emergency room in all hospitals is in best interest of patients when routine surgeries become emergency situations.

Bryan Bucklew, president and CEO of the Greater Dayton Area Hospital Association, told the committee legislative action would help address hospitals’ concerns because limited-service hospitals would likely strive to meet the new definition of hospital to maintain reimbursement from government programs.

Opponent testimony will be heard this Wednesday in Senate Health, Human Services & Aging Committee. For more information on SB 120, or to track its progress, visit http://www.ohanet.org/advocacy/state/issues/limitedservicehospitals.htm. (Bridget Gargan, bridgetg@ohanet.org; Reed Fraley, reedf@ohanet.org)

Healthcare Access and Affordability Committee Looks at Consumers

Last week’s hearing in House Healthcare Access and Affordability Committee focused on consumer issues. Committee members heard from AARP national coordinator JoAnn Lamphere, who discussed the association’s “Divided We Fail” intiative to address the issues based on five priniciples which include all Americans have a right to affordable, high-quality health care when they need it; financing of health care should be fair; policies and technologies that save health care costs and improve quality should be part of all health care reform; individuals should take personal responsibility for their health by educating themselves and taking preventative measures to guard against illness and disease; and persons of any age who have a disability should have a full array of services available to them. The committee also heard from Universal Health Care Action Network of Ohio (UHCAN) executive director Cathy Levine on the role of consumer advocacy groups in the healthcare debate and outlined what she described as the “crisis” in Ohio health care complied by too many people without coverage, benefit cuts, lack of prevention focus, skyrocketing costs, and declining quality. Ms. Levine also informed the committee on statistics of Ohio’s uninsured. Finally, Col Owens, senior attorney for Legal Aid Society of Southwest Ohio, addressed the committee discussing the Ohio Healthy Workers concept, a proposed new insurance product for Ohio’s small employers and the self-employed who are without coverage to secure insurance for their employees and themselves. Mr. Owens explained that the plan would be: available to all employees regardless of income and family makeup; modeled on the Medicaid benefits package and reimbursement rates; administratively similar and based on a large pool; marketed by insurance companies and/or HMOs that serve the Covered Families and Children category; provided by employers who can’t afford and do not offer employer-sponsored insurance; made available only to employees without insurance for certain period or to those facing large premium increases (Bridget Gargan, bridgetg@ohanet.org; Jeff Klingler, jeffk@ohanet.org).

Foundation Supports Nutrition & Physical Fitness Legislation

OHA’s Foundation for Healthy Communities last week voted to support legislation to designate May as Nutrition and Physical Fitness Month in Ohio. HB 105, sponsored by Rep. Ted Celeste (D-Columbus), is pending in the House State Government & Elections Committee. In his sponsor testimony, Rep. Celeste noted rising levels of adult and childhood obesity and the increasingly sedentary habits of the entire population. He stressed that not only would passage of the legislation improve the health of Ohioans, it would save the state money in health care dollars. A companion bill in the Senate, SB 93 sponsored by Sen. Dale Miller (D-Cleveland), has passed the Senate Health Committee and will now go to the full Senate for passage. (Stacey Conrad, staceyc@ohanet.org)

Medical Records Legislation Receives First Hearing

Rep. Peter Ujvagi gave sponsor testimony on HB 122 in House Health Committee Wednesday. The legislation would clarify that health care providers should provide one copy of a patient’s medical records to a patient or patient representative without charge when the record is requested to support a disability claim.

OHA has been involved for many years with the issues of medical records and copying charges. In 2000 legislation was enacted outlining the maximum fees which hospitals and other providers could charge for copying records. It also contained a number of circumstances for which hospitals must provide free copies, including if the record was requested by the patient or the patient’s representative to support a disability claim. Since the enactment of this legislation, some revisions have occurred to the medical records statute, and those revisions inadvertently eliminated a patient’s attorney from the definition of a patient’s representative. OHA is supportive of the bill, and will be working with Rep. Ujvagi on the legislation. (Jeff Klingler, jeffk@ohanet.org)

Shaken Baby Legislation Introduced

Sen. Steve Stivers (R-Columbus) this week introduced legislation to establish the Shaken Baby Syndrome Education Program. SB 144 would require the Director of Health to convene a group of experts, who will assist the department in developing education materials on the issue of Shaken Baby Syndrome. The department will make the materials available on its Website, where child birth educators, pediatricians and obstetricians, hospitals and child care centers would download and make them available to expecting or new parents.

The bill also requires the Department of Job and Family Services to record in the statewide automated child welfare information system whether a reported case of child abuse involved shaken baby syndrome. OHA has been working with Sen. Stivers the past six months in the drafting of the legislation and is supportive. (Jeff Klingler, jeffk@ohanet.org)

Security Systems Bill Wide Reaching

House Commerce and Labor Committee conducted its third hearing this week on HB 41, legislation requiring individuals who sell, install, repair, monitor or test security systems to be registered through the Ohio Department of Commerce. The legislation, sponsored by Rep. Joseph Uecker (R-Loveland), would establish by rule the fees and other requirements needed to obtain the registration. OHA has raised concerns with the legislation as it would require any hospital employee who monitors or tests security systems to be registered with and pay a fee to the state and appears to be an unnecessary and overly burdensome requirement. OHA is meeting with the bill’s sponsor next week to discuss possible solutions to hospitals’ concerns. (Jeff Klingler, jeffk@ohanet.org)

OSMA Health Insurance Bill Receives Sponsor Testimony

Legislation introduced at the request of Ohio physicians received its first hearing last week in House Commerce & Labor Committee. HB 125 would establish certain uniform contract provisions between health care providers and third-party payers, establish standardized credentialing, and require third-party payers to provide to health care providers specified information concerning enrollees. Bill sponsor Rep. Matt Huffman testified that the legislation is designed to bring more balance, uniformity and clarity to Ohio's healthcare system. He explained the bill deals with three important issues - multiple, complex managed care contracts that must be updated on a regular basis; redundant annual credentialing processes; and the absence of comprehensive, real-time health insurance information on patients at the time services are provided. Supporters of the bill include the Ohio State Medical Association, the Ohio Osteopathic Association, the Ohio Chiropractic Association, the Ohio Dental Association, the Ohio Optometric Association, the Ohio Pharmacists Association, the Ohio Podiatric Medical Association and the Ohio Psychological Association. The committee is expected to have additional hearings on the bill over the next two months, with a possible vote being taken in late June.

OHA has discussed the legislation with the association’s Finance Committee, which was general supportive of the bill. Staff will next process it with the CEO Committee on Advocacy and Policy next month. (Jeff Klingler, jeffk@ohanet.org)

BWC Budget Bill Heads for Vote; Hospital Safe Lifting Proposal Expected to be Included

As the House Insurance Committee prepares for a vote this week on legislation enacting the two-year budget for the Ohio Bureau of Workers Compensation, language is being proposed to assist hospitals in purchasing safe lifting equipment, which in turn will help create a safer work environment for health care personnel.

In 2005, the legislature established within the Bureau a fund to assist nursing homes in purchasing, improving, installing or erecting equipment in order to facilitate a “no manual lifting” environment in the facility. OHA is advocating adding hospitals to the program as well.

Health care personnel regularly lift patients in hospital settings. Accordingly, nurse aides, orderlies and attendants are ranked first and registered nurses are ranked sixth by the U.S. Bureau of Labor Statistics in a list of at-risk occupations for strains and sprains. An aging nursing workforce and an increasingly heavier patient population is likely to exacerbate this problem in the future. It is for these reasons OHA supports proposed language to the BWC budget extending the existing safe lifting equipment program to Ohio’s hospitals.

The bill, House Bill 100, sponsored by Rep. Tom Brinkman (R-Cincinnati), is scheduled for a committee vote on Tuesday. (Jeff Klingler, jeffk@ohanet.org).

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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)