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Monday, May 19, 2003
New Standard to Address ED Overcrowding
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is asking hospitals to review a new proposed standard to address emergency department (ED) overcrowding. Hospitals are asked to review the standards online at www.jcaho.org under “Latest From JCAHO” and complete the survey by June 2. Hospitals are asked to also e-mail a copy of the comments to Rosalie Weakland at OHA at rosaliew@ohanet.org or fax to 614.221.4771.

Overcrowding in EDs increases the risk for patient safety and health care quality problems and, in the extreme, may prevent access to essential services for critically ill or injured patients. While a number of the contributing factors to this problem are beyond the control of hospitals, there are steps that hospitals can and should take to anticipate and prevent ED overcrowding. The potential management responsibilities of hospital leaders in addressing this issue are the focus of the proposed standards.

Tuesday, May 20, 2003
OHA Supports Limits on Uninsured Motorist Statute
OHA yesterday filed friend of the court briefs for two Ohio Supreme Court cases dealing with liability coverage of uninsured and underinsured motorists. OHA joined several other trade associations in asking the court to limit the application of a line of decisions from a previous case, Scott-Pontzer v. Liberty Mutual. In that line of cases, Ohio's statutory requirement that automobile liability insurance policies must include uninsured and underinsured coverage was greatly expanded to require business liability insurance to cover injuries of employee family members driving personal vehicles for non-business purposes.

In the first case, Shaw v. State Farm Insurance Co., the court of appeals required University Hospitals' excess insurance policy to pay on a pro rata basis, dollar for dollar, with the plaintiff’s personal automobile insurance policy for injuries caused to an employee of the hospital. The employee was driving his own vehicle for non-business purposes at the time of the accident. The court of appeals’ ruling would cause the excess insurer to pay twenty times more than the plaintiff's insurer for a loss not contemplated by either insurer when the policy was purchased.

The second case, Tucker v. Wilson, focuses on whether certain self-insured businesses, including some hospitals, are subject to Scott-Pontzer. The court of appeals ruled that a business is not exempt from Scott-Pontzer under certain circumstances where it uses a "fronting" insurance company as part of its self-insurance mechanism. (Rick Sites, ricks@ohanet.org)

Wednesday, May 21, 2003
Hospital Rep Encourages Medicaid Relief
Alan Channing, president and CEO of St. Vincent Charity Hospital in Cleveland, testified to the Ohio Senate Finance Committee on the importance of implementing an inflationary update for Medicaid outpatient hospital services.

Channing acknowledged the difficult position of the legislature in balancing the budget but emphasized the losses hospitals incur in charity care and care for patients in a Medicaid program that currently does not meet costs. The state has proposed a freeze on the Medicaid inflationary update and the federal program that helps to reimburse hospitals for uncompensated care covered only $330 million of a $710 million price tag in 2002 and the allotment will decrease by nearly $50 million this year. Channing encouraged legislators to consider an inflationary update for outpatient hospital services as a cost-effective fix, updating a rate that has been adjusted only once since 1991 and requiring only $24 million in state GRF. He also asked the committee to preserve expanded eligibility, noting that increasing Medicaid funding and expanding eligibility help protect community assets and Ohio’s health care system during this time of recession.

OHA is asking member hospitals to contact Sen. Randy Gardner at 614.466.8060 to voice support for the outpatient update by Friday, May 23. More information on the importance of the Medicaid problem to more than 1.5 million Ohioans and Ohio’s hospitals and economy, visit www.ohanet.org/medicaid/. (Bridget Gargan, bridgetg@ohanet.org)

Licensure Bill Heads to House
The House Commerce and Labor Committee passed legislation yesterday requiring home medical equipment (HME) providers to be licensed by the Ohio Respiratory Care Board despite OHA's request to exempt providers who are accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

Kelly Friar, Vice President of Care Continuum Businesses, Mount Carmel Health System, Columbus, testified on behalf of OHA. Friar told the committee additional regulation of HME providers that are JCAHO-accredited is unnecessary because quality standards required by JCAHO and other requirements of various state and federal regulatory agencies ensure that home care patients have access to high quality equipment and services. After a short discussion about the resulting increases on licensing fees of non-accredited providers by exempting JCAHO-accredited facilities, the committee voted to table the amendment, resulting in a bill as passed by the committee that would require all HME providers, including all HME entities owned or operated by hospitals, to be licensed by the state even though most are accredited.

House Bill 105, introduced by Rep. Thom Collier (R-Mt. Vernon), now heads to the full House of Representatives. Friar’s testimony is online at www.ohanet.org/advocacy/state/issues/default.htm#hme. (Jeff Klingler, jeffk@ohanet.org)

Thursday, May 22, 2003
OHA Offers Labor Law Resources
Many OHA members are currently subscribed to the OHA Labor Law and Contract Program, a service aimed at providing hospitals with up-to-date information on Ohio health care labor relations and employment law issues. For those members who currently participate, the time has come to renew subscriptions, and hospitals not taking part are encouraged to explore whether the program holds benefits for their workforce strategies.

OHA and the law firm Jones, Day, Reavis & Pogue collaborate to offer ongoing information on labor union activity, legal developments and labor contract terms to hospitals that have unionized work forces, or that may be a future target of organizing efforts. The annual subscription fee of $300 enables a hospital to access the OHA/Jones Web-based searchable collective bargaining agreement database with current Ohio hospital labor contracts, attend two OHA labor and employment workshops, receive a $50 discount on participation in the OHA Salary Survey and access the latest news on employment and labor issues through a page on OHA’s Web site.

For subscribers, a labor relations workshop will be held June 9 from 1-4 p.m. at the Greater Columbus Convention Center. Visit www.ohanet.org under “What’s New” for registration materials. For more information, contact Jean Scholz at jeans@ohanet.org or Debbie Wolfe at debbiew@ohanet.org or 614.221.7614.

Friday, May 23, 2003
Hospital Costs vs. Reimbursement: A Continuing Challenge
Ohio’s hospitals are waging a constant war to maintain a level of funding that allows them to offer quality services to their communities while continuing to improve and better meet their patients’ needs. Alongside rising costs and losses on Medicaid and uninsured patients, Ohio’s Medicare reimbursement margin has also followed a downward trend, falling from 8.8 percent in 1997 to less than one percent in 2001. With Ohio’s Medicare reimbursement just covering costs statewide, and 69 percent of Ohio’s hospitals not receiving full reimbursement for their costs, hospitals have little leeway to endure further decreases or shift money based on areas of greatest need.

Medicare reimbursement, or lack thereof, has significant impact on the hospital revenue in Ohio considering that on any given day 40 percent or more of the patients in Ohio’s hospitals are Medicare patients. As hospitals’ costs threaten to overcome their level of reimbursement, many facilities could be forced to reduce services, lay off staff or forego efforts to improve quality, modernize equipment or expand programs to meet growing needs.

OHA and the American Hospital Association continue to work with Congress as it debates various Medicare reform proposals this year to ensure hospitals are more adequately reimbursed for services provided to our communities’ elderly and disabled. Hospitals are simply not able to absorb ever-growing Medicare costs on top of the price of maintaining quality facilities, covering Medicaid costs, providing charitable care and working to ensure access to quality care for all Ohioans. For more information, see OHA May Healthbeat at www.ohanet.org/healthbeat/.

Former Mercy President Dies After Battle with ALS
M. Julia Hanser, past president and CEO of Mercy Health Partners of Southwest Ohio, former OHA Board member and long-time health care leader, died Thursday from ALS (Lou Gehrig's disease). She was 61.

During her career at Mercy Health Partners, Hanser integrated four Mercy hospitals and other health care delivery sites into one integrated health care system. She spearheaded the addition of two Centers for Health and Wellness, HealthPlex fitness facilities, auditoriums and offices for physicians. Also under her leadership, two Franciscan hospitals and three senior retirement communities joined Mercy Health Partners.

Arrangements are being handled by the Kolkmeyer-Helmcamp-Orians Funeral Home, 221 North Franklin, Delphos, Ohio. Visitation will be 2-8 p.m. Sunday, May 25. Mass of Christian Burial will be at 11 a.m., Monday, May 26, at St. John Church, 331 E. 2nd St., Delphos, Ohio.

The family has requested memorials go to the M. Julia Hanser Fund for Women at: Healing Connections, 1601 Madison Road, Cincinnati, Ohio 45206. For more information contact Karen Kuhn at Mercy Health Partners at 513.603.8850.