OHA Advocacy Network

Advocacy Report • Friday, April 18, 2008

Action for next week…

Wednesday

HB 320 – Booster Seats: House Infrastructure, Homeland Security & Veterans Affairs Committee, Room 114 at 2:30 pm (All testimony, Possible vote)

SB 279 – Medical Board: Senate Health, Human Services & Aging Committee, South Hearing Room at 2:30 pm (All testimony, Possible vote)

SB 304 – Infant Surrenders: Senate Health, Human Services & Aging Committee, South Hearing Room at 2:30 pm (All testimony, Possible vote)

HB 331 – Maternity Licensure: Senate Health, Human Services & Aging Committee, South Hearing Room at 2:30 pm (All testimony)

SB 301 – Pathology Services: Senate Health, Human Services & Aging Committee, South Hearing Room at 2:30 pm (All testimony)

HB 346 – Nurse Staffing: Senate Health, Human Services & Aging Committee, South Hearing Room at 2:30 pm (Proponent testimony)

HB 493 – Pathology Services: House Health Committee, Room 17 at 4 pm (All testimony)

HB 398 – Radiologist Assistants: House Health Committee, Room 17 at 4 pm (All testimony)

HB 503 – Psychologist Licensure: House Health Committee, Room 17 @ 4 pm (All testimony)

Thursday

HB 456 – Health Care Reform: House Healthcare Access & Affordability, Room 17 @ 10 am (Use of Federal 340b Programs and Statewide Purchasing Pharmaceutical Benefit)

Radiologist Assistants Licensure Approved by Senate Health

The Senate Health, Human Services & Aging Committee Wednesday passed a substitute version of Senate Bill 229, legislation that would create licensure requirements for radiologist assistants and also authorize a licensed radiologist assistant to perform certain radiologic procedures under the direct supervision of a physician specializing in radiology. Committee Chairman Kevin Coughlin (R-Cuyahoga Falls) said the sub bill would

Transfer the regulation of radiologist assistants from ODH to the State Medical Board and allow the board six months to adopt rules and implement the program.

Require applicants hold credentials from the National Registry of Radiologic Technologists.

Permit assistants to perform procedures not listed in the bill if they are authorized in the board's rules.

Limit assistants' authority to administer drugs to those that are directly related to the radiological procedure being performed.

Chairman Coughlin added that the measure would create a distinction between on-site supervision at the same location and direct supervision within actual sight of the physician. Under the bill, onsite supervision would apply in most cases, while direct supervision would be required for procedures performed when the patient is under high levels of sedation or analgesia.

OHA processed the bill with the OHA Quality Improvement and Accreditation Committee, which evaluated it against the OHA Principles for Licensing Healthcare Workers. While the committee did not oppose the concept of the bill, as it is not a new licensure requirement but rather expands the scope of practice of an existing licensed professional (similar to recent legislation regarding physician assistants and advance practice nurses), it did raise numerous quality concerns, especially with provisions requiring the Ohio Department of Health to serve as the regulatory entity overseeing radiology assistants rather than the State Medical Board. OHA participated in numerous meetings on the legislation, and all of the OHA Quality Committee’s concerns have been addressed in the new version of the legislation. (Jeff Klingler, jeffk@ohanet.org)

Senate Health Hears Nurse Staffing Proposal

Rep. Jim Hughes gave sponsor testimony this week on House Bill 346, a proposal regarding hospital nurse staffing plans that is supported by OHA, the Ohio Nurses Association (ONA) and the Ohio Organization for Nurse Executives (OONE). Hughes told the Senate Health, Human Services & Aging Committee that the staffing plans must involve input from all types of nurses providing direct care in the hospital. The bill would create a mechanism to obtain input from nurses in all patient care units. The nursing care committee would evaluate the hospitals' current plan, taking into consideration patient acuity, complexity of care, discharges, transfers, and other patient needs and recommend minimum nurse staffing levels for all units, he said.

OHA is currently meeting with members of the committee to seek support for the proposal, and is preparing proponent testimony, which is to be offered next Wednesday. To learn more about the nurse staffing issue visit OHA’s state health care issues Web site. (Jeff Klingler, jeffk@ohanet.org; Jean Scholz, jeans@ohanet.org)

Senate Committee Hears Hospital Support for Maternity Licensure Revisions

Legislation that would provide much-needed revisions to Ohio’s maternity licensure statute this week received proponent testimony from hospital representatives in the Senate Health, Human Services and Aging Committee. Kleia Luckner, administrative director for women’s services at The Toledo Hospital, told the committee that the legislation would allow caregivers to spend more time with patients and in clinical care activities by reducing the time spent meeting outdated licensure requirements. She also praised the bill for setting standards of care that are evidence-based, current and non-duplicative. She said the bill provides care standards that are comprehensive and sensitive enough to reflect the needs of The Toledo Hospital, an urban hospital that delivers over 4,300 mothers a year, as well as Fulton County Hospital, a rural hospital in northwest Ohio that delivers 339 mothers a year. She also supported the bill’s creation of an Advisory Council to address the many individual Ohio Department of Health (ODH) programs pertaining to newborn health.

Judy Gilliam, associate executive director at The Ohio State University Hospital/Ross Heart Hospital, testified that House Bill 331, sponsored by Sen. Mark Wagoner (R-Toledo), is the result of collaboration between the OHA Maternity Licensure Task Force and ODH. She noted that the bill combines the two current sets of requirements to reduce regulatory burden and confusion, lower costs and enhance maternal and newborn care in Ohio. "This legislation will help hospitals and ODH minimize regulatory burdens, maximize efficiency, contain cost, and enhance patient care," she said.

The bill, which unanimously passed the House before moving to the Senate, would impact the 121 active hospital maternity units and three functional maternity homes in Ohio. (Bridget Gargan, bridgetg@ohanet.org)

OHA Member Bulletin Now Available on Healthcare Simplification Act

On June 25, House Bill 125 will take effect, implementing a number of managed care contracting reforms and bringing more uniformity to the contracting process.

Significant provisions of the legislation include:

Requirements for the Department of Insurance to prescribe the standardized credentialing application form to be used by contracting entities;
Time requirements during which a contracting entity must complete the credentialing process or face penalties;
Requirements that health care contracts include a summary disclosure form that includes the compensation or payment terms and other specified information;
Prohibitions on contracting entities from requiring providers to provide services for all products as well as from requiring that providers accept any future product offering that the entity makes;
Limited conditions under which contracting entities may sell, rent or give a third party the entity's rights to a participating provider's services;
Prohibitions on contracting entities from offering to a provider (other than a hospital) a health care contract that includes a most favored nation clause. No health care contract with a hospital may be entered into or amended at the insistence of a contracting entity to include a most favored nation clause for two years.
Creation of an advisory committee to study and recommend mechanisms that will enable providers to send to and receive from payers sufficient information to enable a provider to determine the enrollee's eligibility for services covered by the payer.

The bill was heavily negotiated with participation by legislators and interested parties, including OHA, physicians, health plans and employer groups and went through many versions between its introduction last year and enactment. OHA supports the bill and will continue advocating for stronger most favored nation clause statutes. A detailed analysis of the bill’s provisions is available at http://www.ohanet.org/Bulletins/2008/08-003.htm. (Jeff Klingler, jeffk@ohanet.org; Mary Gallagher, maryg@ohanet.org)

Healthcare Access & Affordability Committee Hears Dentistry Testimony

Defining roles in public dentistry was the focus of the last Healthcare Access & Affordability Committee hearing. House Bill 456, sponsored by committee chairman Jim Raussen (R-Springdale), proposes a new law to permit a dental hygienist to enter into a collaboration agreement with a dentist employed by, or under contract with, a public health facility to provide certain services at these facilities without the dentist being physically present at and without prior examination by the dentist. The legislation also requires a collaborative agreement, including limits to the number of agreements and processes for termination, and it governs the conditions under which a dental hygienist may practice under a collaboration agreement.

At the hearing, Mark Siegal, chief of the Department of Health's Bureau of Oral Health Services, told the committee that 4.25 million Ohioans, or 38%, lack dental coverage. "A lot of times there's a disconnect between oral health care and the rest of the body," he said, noting oral disease has been associated with other serious health problems, such as heart and lung disease, stroke, diabetes, and premature births. Community dental programs are an important part of increasing access to health care, he said. Lawrence Hill, executive director of the CincySmiles Foundation, testified that dental hygienists' training is more than sufficient to allow them to practice in the community, as proposed in the legislation. Jed Jacobson, senior vice president and chief science officer for Delta Dental of Ohio, offered testimony on the Healthy Kids Dental initiative in Michigan, a privately administered program that has been steadily improving access to dental care for children enrolled in Medicaid since its inception in 2000.

OHA supports this provision as improving access to proper dental care will help keep people out of the emergency department. Preventive dental care will help people avoid potentially significant systemic and expensive infections. (Bridget Gargan, bridgetg@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, Manager, State Policy & Advocacy (staceyc@ohanet.org)

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

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