OHA HEALTH e-NEWS Plus

Monday, February 4, 2008
President’s Budget a Step in the Wrong Direction
President Bush today released a budget proposal that includes $182 billion in Medicare reductions and $17.4 billion in Medicaid reductions over 5 years. These cutbacks would fall on top of a continued freeze in Medicaid reimbursement at the state level, creating dangerous shortfalls in Medicaid and Medicare reimbursement to hospitals; Ohio’s hospitals lost more than $320 million caring for Medicaid patients in 2005 and nearly $400 million providing services to Medicare patients.

Proposed reductions include:
► $64 billion through a three-year freeze and subsequent reduction in hospitals’ inpatient and outpatient Medicare updates
► $20.7 billion through a two-year 30% reduction in payments to Medicare disproportionate share hospitals
► Reduction in payments to physicians and home health agencies
► Reduction in reimbursement for medical education programs
► $433 million in cuts to the Centers for Disease Control and Prevention and $1 billion in cuts to the Health Resources and Services Administration (HRSA)

Freezing or reducing payments to health care providers hampers hospitals’ ability to provide care and prepare for the future needs of their patients, especially during a time when the economy is struggling and the population is aging. OHA is analyzing the estimated impact the president’s proposal could have on Ohio hospitals and will provide additional information to members and Ohio’s congressional delegation. (Jonathan Archey, jonathana@ohanet.org)

Tuesday, February 5, 2008
Resources Help Hospitals Prepare for Patient Safety Week
OHA encourages hospitals to start planning now for National Patient Safety Week March 2-8. Events can be built around the 2008 Ohio theme Band Together Through Communication for Patient Safety. The Ohio Patient Safety Institute (OPSI) offers resources to support hospital patient safety initiatives for each day of patient safety week:

Monday – Standardized Wrist Bands
Download a toolkit, posters, a PowerPoint presentation, a news release template and additional information on the standardization of wrist band colors.

Tuesday – OPSI phone conference series
Communication has been identified as a critical aspect of ensuring the health and safety of patients. Promote and register for a once-a-month phone series on high stakes communication.

Wednesday – Medication Safety
Download or order medication safety brochures, which are also available in low-literacy and Spanish. Check out other resources such as medication cards and a brown bag toolkit.

Thursday – Ohio Surgical Verification Protocol
Download this protocol to protect against wrong site, wrong procedure, wrong person surgery or procedure.

Friday – Ohio Patient Safety Institute Web site/Available Resources

Keep track of the latest events and resources in patient safety by visiting the OPSI Web site often. Share this site with other associates who work with patient safety issues. (Rosalie Weakland, rosaliew@ohanet.org)

2008 Federal Poverty Guidelines Released
The 2008 federal poverty income guidelines were published in the Federal Register Jan. 23. The guidelines took effect on the date of publication for the Hospital Care Assurance Program (HCAP), meaning HCAP eligibility for admissions or dates-of-service on and after Jan. 23 should be based on the 2008 guidelines. The new Finance Web page on OHA’s Web site includes a link to the guidelines and additional information on the guidelines. (Charles Cataline, charlesc@ohanet.org)

Wednesday, February 6, 2008
Hospital Rep Urges Passage of Energy Bill
A hospital representative testified yesterday before the House Public Utilities Committee in support of the electric restructuring bill, Senate Bill 221. John L. D’Angelo, director of health system facility management for the Cleveland Clinic, told the committee that energy makes up 50 percent of his facilities’ operating costs, averaging around $40 million annually and directly affecting the affordability of health care for the communities they serve. D’Angelo testified that SB 221, sponsored by Robert Schuler (R-Cincinnati), would create a viable energy framework to serve as a catalyst for Ohio’s economic and environmental health. He noted that affordable and reliable energy are crucial not only to health care consumers, but to all consumers. Without the passage of legislation such as SB 221, electric rates after this year are expected to increase, with the potential to jump dramatically as in states with deregulated electric rates. A House version of the legislation is expected to be introduced in the near future.

OHA is a member of the Ohio Coalition for Affordable Power (OCAP), which supports SB 221. OCAP advocates for a framework to ensure affordable and reliable power. For more information, visit OHA’s energy Web page. (Bridget Gargan, bridgetg@ohanet.org; Rick Sites, ricks@ohanet.org)

Strickland to Focus on Jobs, Education
Gov. Ted Strickland focused mainly on job creation and education in his second state of state address today. As part of his $1.7 billion “Building Ohio Jobs” plan, Strickland will direct $200 million to biomedicine, specifically cardiovascular products. Other investments include renewable energy sources, roads and bridges and the Clean Ohio Fund.

Strickland also called on lawmakers to protect jobs by taking action immediately on an energy bill that would re-regulate the state's market for electricity. OHA supports the bill, Senate Bill 221, as a way to stabilize energy rates and provide reliable energy to Ohio consumers and business, including hospitals.

The governor’s plans for higher education include a guarantee that every Ohioan can receive an associate’s or bachelor’s degree at a college or university within 30 miles from his or her home.

The full state of the state transcript is available on OHA’s Web site at www.ohanet.org/advocacy/state/resources/stricklandstateofstate08.pdf. (Bridget Gargan, bridgetg@ohanet.org)

Flu Activity on the Rise in Ohio
The Centers for Disease Control and Prevention is reporting an uptick in the flu activity in Ohio. Hospitals that reach capacity due to flu may request Centers for Medicare & Medicaid Services (CMS) approval to place patients in prospective payment system exempt beds (rehabilitation, psychiatric, ambulatory surgery center beds). OHA is aware of two hospitals that recently made such a request. Hospitals needing a waiver should contact Illia Villanueva, Region 5 CMS NonLongterm Care Branch Chief, at 315.353.3756 or illia.villanueva@cms.hhs.gov. Please also send a notice to OHA’s Rick Sites at ricks@ohanet.org or Carol Jacobson at carolj@ohanet.org to help OHA monitor the regional and statewide situation and determine whether a public health emergency exists.

Visit OHA’s flu and pneumococcal Web page or monitor flu activity through the Centers for Disease Control & Prevention Web site. (Rick Sites, ricks@ohanet.org)

Thursday, February 7, 2008
State Health Care Reform Bill Receives First Hearing
Rep. Jim Raussen (R-Springdale) offered sponsor testimony on House Bill 456, also called Ohio C.A.R.E., in the House Healthcare Access and Affordability Committee Wednesday. Raussen noted, “This bill was and is a work in progress, a starting point. Most likely there will be some changes as we go deeper into some of these issues. I am not naïve to know that the task that lies before us is a difficult one.”

Raussen, who also chairs the committee, outlined his strategy for processing the bill. Hearings for the legislation will be scheduled according to four issue groups. Group one includes pricing standards for food in schools; nursing instructor salaries; tax credits on self-employed returns, and changing eligibility for dependent coverage on family policies. Group two includes use of federal prescription drug pricing programs; public dentistry; defining charitable care, and government tax credits for individuals and families. Group three includes statewide purchasing pharmaceutical benefit; assignment of benefits for emergency care; BWC discounts for businesses, and re-insure for chronic and pre-existing conditions. Group four includes role of health information technology; Medicaid managed care and contracting with hospitals, and miscellaneous other topics. Raussen did not present a timeline for hearings although he intends to start with group one and conclude with group four.

HB 456 contains numerous provisions which impact the OHA membership including:

Requiring tax-exempt hospitals with Medicaid utilization rates under 35% annually to publish the cost of charity care provided and property and sales tax savings.
Requiring non-disproportionate share hospitals (DSH) to contract with every Medicaid managed care organization (MCO) in their region to be eligible for Hospital Care Assurance Program (HCAP) funds.
Requiring DSH hospitals to contract with every Medicaid MCO in their region to be eligible for more than the minimum HCAP funds.
Requiring ambulatory surgical facilities to annually report certain data to the Director of Health.
Offering discounts on Bureau of Workers’ Compensation premiums for employers who offer health and wellness programs.
Creating a pilot program and advisory board with OHA representation to explore health information technology.
Increasing compensation for nursing instructors.

OHA is working to identify areas of support and issues of opposition in the bill. OHA will actively engage members, hospitals and legislators in a dialogue on the issues impacting hospitals. (Bridget Gargan, bridgetg@ohanet.org)

OHA-Backed Nurse Staffing Bill Receives Unanimous Committee Approval
A House panel Wednesday unanimously approved legislation requiring hospitals to establish evidence-based nurse staffing plans after soliciting and considering input from direct-care nurses. Supported by OHA as “common sense” nurse staffing legislation, House Bill 346, sponsored by Rep. Jim Hughes (R-Columbus):

Requires hospitals to create a hospital-wide nursing care committee, which is charged with developing recommendations for a written nursing care staffing plan guiding the assignment of nurses. Direct care nurses representing all types of nursing services offered by the hospital will serve on the committee as will the hospital’s chief nursing officer.
Requires hospitals to create a staffing plan, giving significant regard to the committee recommendations. The nursing services staffing plan, which must be consistent with current governmental and private accreditation standards, must then be provided to all staff nurses free of charge and to other requestors at a nominal charge.

Before receiving a vote in the House Health Committee, changes to the bill were adopted including:

Licensed Practical Nurses would be required to be included in hospital staffing plans for those hospitals that employ LPNs;
When establishing their staffing plans, hospitals must consider the amount of time needed by nurses for patient education;
A requirement that the nursing care committee recommendations be available to anyone requesting was deleted from the bill, while maintaining the requirement that the staffing plan be provided free of charge to the hospital's nursing staff and others upon request for a nominal charge.

Grace Wakulchik, vice president of patient services and chief nursing officer at Akron Children’s Hospital, reiterated the support for the bill by OHA and the Ohio Organization of Nurse Executives, an OHA-affiliated society representing more than 500 nurse leaders in the state. She said the bill would go far to ensure that all Ohio hospitals solicit input from direct care nurses when making staffing decisions while, at the same time, ensuring that hospitals are considering evidence-based, quality standards when establishing nursing plans. She added that the bill furthers hospitals' efforts towards transparency in health care by requiring staffing plans be made available to those who request it and it holds hospitals accountable to patients and communities that appropriate nurse staffing is being provided to meet health care needs. Walkulchik’s testimony can be viewed at http://www.ohanet.org/advocacy/state/issues/testimony/hb346wakulchik020608.pdf

The bill must be approved by the full House of Representatives before being considered by the Ohio Senate. (Jeff Klingler, jeffk@oha.net)

Awards Deadline MONDAY
Hospitals have until Monday, Feb. 11 to submit nominations for OHA’s 2008 Health Care Leadership Awards or Albert E. Dyckes Health Care Worker of the Year Award. Nominations must be made electronically using an official nomination form – one form for the Health Care Worker of the Year Award and a separate form for the eight Health Care Leadership Awards – to awards@ohanet.org by Feb. 11. Health Care Worker of the Year nominations received by Feb. 11 will receive TWO BONUS POINTS. The final deadline for the Health Care Worker of the Year Award is March 10. Health Care Leadership Award nominations will not be accepted after Feb. 11. Find more information and download the nomination forms at www.ohanet.org/annualmeeting/Awards/. All honorees will be celebrated as part of OHA’s Annual Meeting June 9-11 at the Hilton Columbus at Easton. (Tiffany Himmelreich, tiffanyh@ohanet.org)

Friday, February 8, 2008
New OHA Service Can Help Hospitals Simplify Revenue Cycles
OHA this week announced a new partnership between HTP Inc and OHA Solutions that will provide the technology for hospitals to find coverage for those patients that have it, maximize reimbursement from patients who can pay and find financial assistance for patients who can't. The new model offer hospitals enhanced opportunities to:

minimize bad debt
maximize patient charity qualification
streamline patient financial assistance
initiate financial planning for the insured underinsured and uninsured
maximize and increase net revenue
receive special OHA member discounted pricing for these services
earn a 5 to 10 times return on their investment.

OHA sent more information to hospital chief financial officers by e-mail this week.

To schedule a demonstration or to purchase any OHA Solutions products, contact Dan Paoletti at danp@ohanet.org or 614.221.7614 ext. 154 or contact HTP directly at 888.487.8010 x2246 or webinfo@htp-inc.com. Learn more about this partnership at www.htp-inc.com and learn more about OHA Solutions and the products it offers to Ohio’s hospitals at www.ohasolutions.com. (Dan Paoletti, danp@ohanet.org)