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Washington State Hospital Association
Presenters
Cassie SauerSVP, Advocacy & Government Affairs
Claudia SandersSVP, Policy Development
Mary Kay Clunies-RossVP, Communications & Public Affairs
Washington State Hospital Association
Session Overview• Short session• New leadership (4/5 of key players)• Majority Coalition – interesting political
dynamics• Even with complicated political dynamics, some
great steps forward and no steps backward for hospitals
Washington State Hospital Association
The Budget
Mental Health Funding Hospital Owned Clinics
Medicaid Outreach Maintain Primary Care Rates
Washington State Hospital Association
State BudgetOverview• Non-budget session – House and Senate
differed on willingness to spend• Revenue forecast was better, but not great• Supreme Court reiterated mandate for more
education funding, days before session began• Budget gaps filled with marijuana tax revenue• No capital budget
Washington State Hospital Association
Mental Health Funding
Bad news: No capital funding Good news: $17.7 million for mental health services• $4.5 million for non-Medicaid backfill– Includes Institutes for Mental Disease
• Funding for 3 new Evaluation and Treatment centers• PACT teams for those at high risk for rehospitalizations• Recovery services for those returning to the community
Washington State Hospital Association
Hospital-Owned ClinicsWSHA Goal: Preserve Medicaid funding for hospital-owned clinicsProposed cut would have limited access to primary and specialty care for Medicaid enrollees
Result: • No cut• HCA will study/make recommendations for reducing
payment rates • Could have big impacts on patients’ access to care
Washington State Hospital Association
Bills Enacted
Emergency Credentialing Grace Period Notification
Behavioral Health Integration Health Care Innovation
Safety Net Assessment Fix Confidentiality
Training for PHDs
Washington State Hospital Association
HB 2692: Support Emergency Credentialing
WSHA Goal: Allow for emergency credentialing for out-of-state health care workers and provide immunity for health care workers in emergencies
Result: HB 2692 passed with emergency credentialing provision
Future: Continue to work on provider immunity
Washington State Hospital Association
SB 6103: Support Notification for Delinquent Exchange Premiums
WSHA Goal: Minimize confusion regarding payment for care delivered during 3 month grace period • Insurers responsible for first month of coverage, but
can deny payment in second and third month• Providers must be notified that patient has not paid
premium
Result: SB 6013 passed
Washington State Hospital Association
SB 6312: Support Integration of Behavioral Health
WSHA Goal: Support patient-centered integration of state purchased mental health, chemical dependency, and medical services • Task force to make recommendations• Goal of full integration by 2020 through managed
care plans• CON waiver for conversion of hospital beds to
psychiatric care
Result: SB 6312 passed by legislature
Washington State Hospital Association
Support Innovation and Transparency
WSHA Goals: Support reform that does not create barriers to care or innovation; Support access to cost and quality data and common performance measuresResult: HB 2572 and SB 6228 passed Savings: $2.8 million 2014-2015 And $57 million 2015-2017
Washington State Hospital Association
HB 2572: Communities of Health
• A regionally based voluntary collaborative• Broad membership including hospitals• No identified boundaries or specified number
of collaboratives• Grants for two pilots
Washington State Hospital Association
HB 2572: Physician Extension Program
• Aimed to help primary care and behavioral health providers– Better coordinate care– Become patient centered
medical homes
Washington State Hospital Association
HB 2572: All Payer Claims Database
• Office of Financial Management establishes statewide database, with lead organization
• Mandates data from Medicaid/public employees
• Advisory committees include hospitals• Protects confidentiality but allows for access• Comparisons must account for differences in
acuity, impact of uninsured and government patients and teaching expenses
Washington State Hospital Association
HB 2572 and SB 6228: Common Performance Measures
• New state committee; members include WSHA representative
• Measures determined by January 2015:– Prevention and screening– Management of chronic care– Key health outcomes– Care coordination and patient safety– Preventive, acute, and chronic conditions
Washington State Hospital Association
SB 6228: Transparency Tools
• Better information tools for consumers, including about hospital cost and quality for both inpatient and outpatient care
• Thank you for posting links to WSHA transparency site on your website!
Washington State Hospital Association
SB 6570: Hospital Safety Net Assessment Technical Fix
WSHA Goal: Fix assessment technical and timing issues to allow approval by Centers for Medicare and Medicaid Services• Bill enacted as WSHA wanted• State expects approval shortly• Did not change ratcheting schedule• More information soon
Washington State Hospital Association
SB 6265: Confidentiality
• Heighten protections of CHARS data• Fixes provisions about accounting for mental
health disclosures• Urge Governor to sign!
Washington State Hospital Association
Public Hospital Districts
AWPHD Goal: Increase access to training regarding the Public Records Act, Open Public Meetings Act, and records retention• Bill proposed to provide consistent, accessible training Result: SB 5964 passed
AWPHD Goal: Increase transparency without jeopardizing Board ability to conduct business
• Bill clarifies that posting agendas in advance of meeting does not prevent later agenda changes
Result: HB 2105 passed by legislature
Washington State Hospital Association
Bills Not Enacted
Telemedicine Staffing Mandates
Federal Basic Health Suspect and Inmate Care
Medical Records Payment Rates Breastfeeding
Public Hospital Districts
Washington State Hospital Association
Telemedicine
WSHA Goal: Assure payment for services provided using telemedicine technology• Passed House 98-0 • Unfounded concerns about
“webcam abortions” killed the bill in the Senate
Result: HB 1448 not enacted
Washington State Hospital Association
Staffing MandatesWSHA Goal: Defeat unworkable nurse staffing legislation that endangers patients
Nursing union proposals:– Nurse staffing ratios– Uninterrupted meal and rest breaks– Overtime/on-call restrictions
Result: We defeated all these bills, againFuture: These bills will be back, again
Washington State Hospital Association
Careful Evaluation of Federal Basic Health
WSHA Goal: Delay creation of new program without more complete analysis of impacts • ACA allows Federal Basic Health for those with incomes
slightly above Medicaid• Concern regarding lack of data supporting program
and potential costs to state and providersResult: Bill to create program not enactedFuture: Track issues of affordability
Washington State Hospital Association
Suspect and Inmate CareWSHA Goals: • Defeat attempts to limit payment to no more than
Medicaid • Protect staff and patients by requiring adequate
law enforcement guarding of patients who are suspected or convicted of a violent or sexual crime
Result: Neither issue was enacted, but important stakeholder conversations have begun
Washington State Hospital Association
Medical Records RequestsWSHA Goal: Ensure hospitals can charge the same rates for electronic and paper medical record requests • Bill proposed to mandate that hospitals respond to
medical record requests in electronic form and cap record fees at $20
Result: HB 2074 was modified to be acceptable, but was not enacted
Washington State Hospital Association
Support Breastfeeding
WSHA Goal: Support breastfeeding as a strategy to improve infant health and reduce childhood obesity
Result: HB 2329, SB 6298 defeatedFuture: Work on voluntary efforts
Washington State Hospital Association
Public Hospital Districts – Good ResultsAWPHD Goal: Maintain local decision-making and affiliations• Bill prohibited district boards from delegating certain
management functions-- affiliations virtually impossible
Result: SB 6425 defeated
Washington State Hospital Association
Public Hospital Districts – Good Results for Bills Targeted at Large Districts
AWPHD Goal: Ensure larger public hospital districts may elect at-large commissioners
Result: SB 6004 defeated
AWPHD Goal: Defend hospital districts from unduly burdensome personal income reporting requirementsResult: SB 6348 defeated
Washington State Hospital Association
Public Hospital Districts – Disappointing Results
AWPHD Goal: Allow public hospital districts to recover costs relating to public records requests for commercial purposesResult: HB 1037 died
Washington State Hospital Association
Policy Work Before 2015 Session
• Nurse staffing• Transparency and Innovation• Future of Certificate of Need• Mental health funding and
integration• Enrollment and expansion
Washington State Hospital Association
Washington Hospital PAC
Building RelationshipsElecting Champions for HospitalsUnifying Hospitals’ Political Voice
www.wsha.org/whpac.cfm
Washington State Hospital Association
Thank You!
We couldn’t do it without you!
Thank you for your good work!
Washington State Hospital Association
Questions? Comments?
Cassie SauerSenior Vice President, Advocacy & Government Affairs
[email protected] 206/216-2538