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The 2014 State Legislative Session. Presenters. Cassie Sauer SVP, Advocacy & Government Affairs. Claudia Sanders SVP, Policy Development. Mary Kay Clunies-Ross VP, Communications & Public Affairs. Webcast Outline. Introduction State Health Care Environment

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Presentation Transcript

The 2014

State Legislative Session


Cassie Sauer

SVP, Advocacy & Government Affairs

Claudia Sanders

SVP, Policy Development

Mary Kay Clunies-Ross

VP, Communications & Public Affairs

webcast outline
Webcast Outline


State Health Care Environment

State Legislative Environment


Short Session

WSHA Agenda: Improving Quality, Increasing Access



Going Forward

state health care environment improving quality increasing access
State Health Care Environment: Improving Quality, Increasing Access
  • Implementing ACA
  • Promises and challenges of population health
  • Changing payment models = uncertain sustainability
  • Some hospitals are in severe economic crisis
  • Innovative patient safety work: voluntary, collaborative, successful, national leadership
washington state government
Washington State Government

Jay Inslee




major leadership changes
Major Leadership Changes

New Republican New Democrat Leaders Leaders

Returning Leader

Speaker Chopp

Gov. Inslee

Rep. Kristiansen

Sen. Tom

Sen. Nelson

Sen. Schoesler

wsha policy priorities
WSHA Policy Priorities
  • Support Telemedicine
  • Support Health Care Reform, Monitor Legislation
  • Support Transparency Goals, Monitor Legislation
  • Oppose Staffing Mandates
  • Collect Mental Health Data
  • Support Suspect and Inmate Guarding
  • Support Crisis Standards of Care
  • Ensure Hospital Flexibility for Partnerships
  • Fix Provider Liability under ACA
  • Delay Federal Basic Health
  • Encourage Breastfeeding
support telemedicine hb 1448
Support: TelemedicineHB 1448
  • Telehealth is when physicians use video technology to provide services
  • Good way to deliver dermatology, mental health, post-surgery monitoring and others
  • Goal is to assure payment for services provided using telehealth technology
  • Does not expand services beyond those already covered by patient’s insurance policy
support health care reform monitor legislation
Support Health Care Reform: Monitor Legislation
  • State Health Care Innovation Plan - good goals:
    • efficient, high-quality care
    • care coordination
    • prevention
    • improved population health
  • WSHA supports reform that:
    • protects patient and provider choices
    • builds on existing local networks of care
    • takes into account changing payment models
    • does not create barriers to innovation
  • Concerns:
    • Accountable Communities of Health
support transparency goals monitor legislation
Support Transparency Goals; Monitor Legislation

State reform plan relies on transparency of cost and quality

Creates an all claims payer database with negotiated prices

WSHA supports with concerns about accuracy of information, access to data and governance oversight

wsha transparency website www wsha org transparency cfm
WSHA Transparency
  • Compare hospitals charges
  • Look for these buttons on the websites of Washington hospitals
oppose staffing mandates hb 1095 hb 1152 hb 1153
Oppose Staffing MandatesHB 1095, HB 1152, HB 1153
  • Staffing mandates undermine nurse-staffing committees and do not consider patient need
  • Nurse staffing committees are goodmodel for joint decision-making
    • Ratios: not shown to increase safety
    • Uninterrupted meal, rest breaks: takes away nurse choices on best time to break
    • Overtime/on-call restrictions: lead to necessary treatments being delayed
hospital leadership on nurse staffing
Hospital Leadership on Nurse Staffing
  • Hospital leaders are encouraged to ask themselves tough questions, including:
    • How is your nurse staffing committee functioning?
    • Do you use overtime or mandatory call? How much?
    • What are the longest shifts people work?
    • Are your staff getting their breaks?
  • We have asked DOH to step up enforcement
support suspect and inmate guarding sb 5968
Support: Suspect and Inmate GuardingSB 5968
  • There are increasing incidences of violent suspect or inmate injuring staff and patients
  • SB 5968 would require that all law enforcement agencies provide security when patient has history or suspicion of violent or sexual crimes
support c risis standards of care
Support: Crisis Standards of Care
  • For disasters that are declared by the Governor or local government executive, legal protections will help health care providers get to work faster
  • When the normal amount of resources are not available to meet the need, providers cannot deliver the same kind of care
ensure hospital flexibility to form partnerships
Ensure Hospital Flexibility to Form Partnerships
  • Certificate of Need is a long, expensive, unpredictable process, and the wrong process
  • Increased review under new rules will slow hospitals’ ability to form partnerships necessary to maintain or expand basic services
  • Other possibilities:
    • Conscience clauses
    • Provider freedom
    • Maternity services definition
fix provider liability under aca
Fix Provider Liability Under ACA
  • Act allows three months coverage if premiums unpaid
  • Insurers responsible for first month
  • Providers responsible for care in second and third month
  • WSHA supports WSMA fix
delay federal basic health
Delay: Federal Basic Health
  • ACA allows Federal Basic Health for those with incomes slightly above Medicaid
  • Premium share lower than in Exchange
  • Concerns:
    • Not enough enrollment data to know whether a new program is needed
    • State must pay start-up costs and would be responsible for ongoing, overall costs
    • Providers would receive Medicaid-like rates
support breastfeeding
Support Breastfeeding
  • Partnership with Governor and Department of Health
  • Strategy to reduce childhood obesity
  • Support a new recognition program for high-performing hospitals
budget priorities
Budget Priorities


  • Meant to make minor adjustments to biennial budget
  • Supreme Court unfavorably reviewed education plan
  • Revenue forecast likely better, but not great

Budget Priorities

  • Mental Health Funding
  • Medicaid Outreach
  • Increased Dollars for PrimaryCare Support
support mental health funding
Support Mental Health Funding
  • 2013 had improvements
    • Increased capacity in state hospitals
    • Changes to Involuntary Treatment Act, new resources
    • State task force
    • Capital budget funding + regulatory relief
  • Years of cuts in recession still left big hole
  • Ongoing concerns about viability of Institutes for Mental Disease
mental health 20 million plus federal matching funds
Mental Health:$20 million plus federal matching funds
  • Budget goals:
    • Stability of Institutes for Mental Disease
    • Additional capital dollars to expand inpatient options
    • Additional inpatient capacity at Western State Hospital
    • Funding for new evaluation and treatment centers
    • Funding for improvement of case management for high-risk individuals
medicaid outreach 1 1 million plus federal matching funds
Medicaid Outreach$1.1 million plus federal matching funds
  • WSHA supports Governor’s budget request for funding to focus on potential Medicaid enrollees
    • Medicaid Newly Eligible Adults: 121,258
    • Medicaid Previously Eligible but not Enrolled: 55,807
    • Medicaid Redeterminations (Previously Covered):156,206
  • Targeted outreach effort is needed
maintain primary care rates 24 million plus 24 million federal matching funds
Maintain Primary Care Rates$24 million plus $24 million federal matching funds
  • Support WSMA’s efforts to retain Medicare payment rates for Medicaid enrollees
  • Access to primary care physicians is essential for improving population health, especially for new Medicaid enrollees
heading into session www wsha org policyadvocacy cfm
Heading Into
  • Stay informed
    • Inside Olympia, Weekly Report
    • Bulletins and Calls to Action
    • Policy and Advocacy Website
      • Priorities
      • Issue Briefs
  • Stay connected
    • Feel free to contact Cassie, Claudia, or policy directors if you have questions or experiences you’d like to share
washington hospital pac
Washington Hospital PAC

Building Relationships

Electing Champions for Hospitals

Unifying Hospitals’ Political Voice

thank you
Thank You!

Your advocacy with your legislators, your testimony, your connections with local leaders and media, and your contributions to the PAC are essential to our success.

Please keep up

the good work!

thank you questions comments

Thank You!Questions? Comments?

Cassie Sauer

Senior Vice President, Advocacy & Government Affairs 206/216-2538