Slides - Washington State Hospital Association

The 2014
State Legislative Session
Washington State Hospital Association
Cassie Sauer
Claudia Sanders
Mary Kay Clunies-Ross
SVP, Advocacy &
Government Affairs
SVP, Policy
VP, Communications &
Public Affairs
Washington State Hospital Association
Session Overview
• Short session
• New leadership (4/5 of key players)
• Majority Coalition – interesting political
• 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 Budget
• 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
Washington State Hospital Association
Hospital-Owned Clinics
WSHA Goal: Preserve Medicaid funding for hospitalowned clinics
Proposed cut would have limited access to primary and
specialty care for Medicaid enrollees
• 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
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
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
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
Result: 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
• 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
• 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
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 Mandates
WSHA 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, again
Future: 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 providers
Result: Bill to create program
not enacted
Future: Track issues of affordability
Washington State Hospital Association
Suspect and Inmate Care
WSHA 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
Result: Neither issue was
enacted, but important stakeholder
conversations have begun
Washington State Hospital Association
Medical Records Requests
WSHA 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
Future: Work on voluntary
Washington State Hospital Association
Public Hospital Districts – Good Results
AWPHD Goal: Maintain local decision-making and
• Bill prohibited district boards from delegating certain
management functions-- affiliations virtually
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 requirements
Result: 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
Result: 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
• Enrollment and expansion
Washington State Hospital Association
Washington Hospital PAC
Building Relationships
Electing Champions for Hospitals
Unifying Hospitals’ Political Voice
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 Sauer
Senior Vice President, Advocacy & Government Affairs
[email protected]  206/216-2538
Washington State Hospital Association

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