DEPARTMENT OF HEALTH AFFAIRS CATHOLIC CONFERENCE OF OHIO 2004 LEGISLATIVE GOALS

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1 DEPARTMENT OF HEALTH AFFAIRS CATHOLIC CONFERENCE OF OHIO 2004 LEGISLATIVE GOALS State Legislative Summary The Catholic Conference of Ohio will work to maintain the general goals of Ohio s hospital community by adhering as closely as possible to the approved goals of the Ohio Hospital Association (OHA) keeping in mind if issues are not supported by the overall Catholic hospital community. If this is the case, the Catholic Conference will not take a position on the issue. Adequate Funding is Available for Health Care Medicaid Reimbursement A new Medicaid study committee with strong private sector influences will study all aspects of the Medicaid program in With current economic conditions and an ongoing emphasis on reducing state spending, Ohio s Medicaid funding is vulnerable. Maintaining adequate reimbursement and preventing cuts to hospital reimbursement will remain a priority. OHA will work to halt implementation of any pilot projects for the Managed Care for Aged, Blind and Disabled population that are inconsistent with OHA Board Policy. Credentialing/Physician Relations In 2003, OHA worked at the state and federal levels to stop the proliferation of physician-owned hospitals. In November, Congress passed legislation that stopped the building of new physicianowned hospitals for 18 months. Working through a Board-appointed task force, OHA will seek to successfully position full-service community hospitals for possible state or federal legislative action when the moratorium on new physician-owned specialty hospitals expires in the summer of Mammography The legislature enacted a mandate for mammography in Since that time, the $85 cap reimbursement has not been modified. OHA will work to enact legislation to increase reimbursement for mammography services. Tax Code A ballot initiative to repeal the one-cent sales tax increase will promote a healthy debate on fiscal issues in the legislature. The OHA Board voted to oppose the repeal of the one-cent sales tax. If the tax is repealed, OHA will work to safeguard hospital reimbursement and Medicaid enrollment. Bond Issue Ohio hospital systems could benefit from updates in current law regarding the method by which hospitals acquire bonds. OHA will seek enactment of legislation streamlining the process to acquire bonds. 1

2 Energy Costs Hospitals use substantial amounts of energy, and energy costs are affected in part by regulations promulgated by the Public Utility Commission of Ohio (PUCO). The PUCO will continue to define the parameters and process of utility and energy supplier behavior through its regulatory process. OHA participation in the formal PUCO rulemaking process on utility issues impacting hospitals will continue. Legislative Mandates Legislation has been introduced requiring hospitals to provide minimal levels of charity care and certain education programs to patients. OHA opposes such legislative mandates, as hospitals need flexibility in choosing which services are most needed in their communities. OHA will work to defeat any legislative unfunded mandates on hospitals. Ohio Hospitals Attract and Retain Talented and Dedicated Employees and Medical Staff Medical Malpractice Insurance Crisis Although important tort reform was enacted in 2003, civil justice reform will not be complete until legislation is enacted reducing pre-judgment interest, reforming Ohio s ostensible agency doctrine as applicable to hospitals, and capping punitive damages. The Ohio Department of Insurance will receive support from OHA for its initiative to permit reactivation of a Medial Liability Underwriting Association in the event the Ohio commercial market collapses. Collaborating with interested parties, OHA will work to formulate an affordable Patient Compensation Fund proposal. OHA will evaluate the need for amendment of the state constitution, as may be required to create a patient compensation fund and uphold damage caps. The Ohio Patient Safety Institute will continue to develop patient safety materials for use in doctors offices, hospitals and patients homes and will assess the types and levels of computerized technology implemented in hospitals statewide. Initiating a campaign to influence public opinion, OHA will strive to educate voters on the importance of the Ohio Supreme Court regarding key health care issues, especially how the court can impact the medical professional liability insurance crisis and access to health care services. OHA will seek legislative opportunities to exempt hospitals from Ohio s Consumer Sales Practices Act. 2

3 Licensure Barriers Each session, legislation is introduced that would license new types of health care workers, services and facilities. To protect patients, hospitals must ensure their staffs are fully competent and prepared to perform the duties they are assigned. Hospitals must also ensure the services they provide meet quality standards. Referring to its Principles for Licensure of Health Care Workers, OHA will review proposed legislation regarding physician assistants and other emerging professionals requesting new or revised legislative and regulatory scope of practice. Every Ohioan Has Appropriate Access to Health Care Medicaid Eligibility In 2003 the governor proposed slashing 50,000 working poor adults from the Medicaid program. OHA and the Family Coverage Coalition successfully collaborated to prevent these drastic cuts in enrollment. With the potential repeal of the one-cent sales tax these benefits are vulnerable. OHA will work to defeat proposals to rollback eligibility for low-income families with Healthy Start/Healthy Families Medicaid coverage. Initiatives to Cover the Uninsured With an ailing economy yet to heal, the number of Ohio residents without health insurance continues to grow. In addition to supporting proposals to expand Medicaid eligibility, OHÅ will pursue initiatives to help more Ohioans access private sector health insurance coverage. Efforts to enact an affordable insurance product for small businesses and low-income Ohioans will be supported by OHA. OHA will support High Risk Pool legislation consistent with OHA policies and principles. Ohio Hospitals lead the Way in a Quest to Create Healthy and Prosperous Communities Hospitals as Economic Catalyst Working to actively demonstrate the community benefit of hospitals, OHA will strive to ensure legislators, public officials and Ohioans recognize and appreciate the value of their community hospitals when making public policy decisions. Emergency Preparedness OHA will work to obtain continued federal dollars through contract or grants awarded by the Ohio Department of Health, HRSA, or others, increasing the flow of state and federal dollars to hospitals to offset the expenses incurred for enhanced emergency preparedness. OHA will finalize regional mass casualty plans in the event of terrorism or other catastrophic events. 3

4 Pollution Prevention Hospitals have complex waste streams involving infectious, hazardous, radioactive, solid, recyclable, and confidential materials many of which are strictly regulated. Mandating a onesize-fits-all approach is unnecessarily expensive as shown by Ohio s antiquated infectious waste statutes. Efforts to mandate additional hospital pollution prevention efforts such as elimination of mercury and reduction of waste stream volume will be opposed by OHA in favor of voluntary efforts. OHA will seek an enactment of revised infectious waste statutes to be consistent with accepted infection control science and practices. OHIO Medical Malpractice/Tort Reform Focus of OHA State Advocacy Agenda As state lawmakers continue to hear from hospitals and physicians about the medical malpractice crisis, a number of bills have been proposed to help resolve the problem. The following is a summary of state legislation dealing with the medical malpractice insurance crisis. Senators Propose Freezing Med Mal Rates Legislation was recently introduced imposing a one-year moratorium on increases in medical malpractice insurance premiums. Senate Bill 204, sponsored by Sen. Kirk Schuring (R-Canton), has already received opposition by Ohio Department of Insurance Director Ann Womer Benjamin, who has said it could undermine the stability of the already-tenuous market in Ohio. A similar idea had been kicked around by Sen. Scott Oelslagaer (R-Canton), who proposes prohibiting medical malpractice insurers from increasing premiums by more than 5% over the prior year and requiring every malpractice insurance policy be issued for at least five years. Oelslager is considering the ideas after hearing from Stark County physicians that a medical malpractice insurance crisis exists in Ohio. He has asked the Commission on Medical Malpractice, a legislative study panel created last session in a bill placing caps on the amount juries could award in malpractice lawsuits, to consider the measures to help alleviate the problem. Oelslagaer has also asked the panel to: Study legislation that would require insurance companies to rate physicians on a completely individual basis. We need to align what physicians pay for premiums more closely with their actual individual performance and activity. Study transactional costs. It seems unfair that even when claims against a doctor are dismissed that they are still taken into account by insurance companies, which leads to an increase in doctors premiums Study the geographic boundaries that dictate what insurance companies charge doctors for their premiums. The high premiums Stark County doctors pay may not represent their claim history but reflect that they are in the same region as Cuyahoga County. Therefore, their premiums may not accurately represent the claims records they have. 4

5 Lawmakers Look at Medical Malpractice Problem From Many Approaches Many other bills have been introduced this session looking at the medical malpractice crises. Senate Bill 80, Sponsored by Sen. Steve Stivers (R-Columbus), is a business-backed comprehensive tort reform bill that would establish a punitive damage cap benefiting hospitals. SB 80 is pending in the House Judiciary Committee. OHA Position: Support House Bill 38, sponsored by Rep. John Willamowski (R-Lima), would create a civil cause of action for injunctive relief and damages under the Deceptive Trade Practices Law against a person who performs a service without a required license, certificate, permit, or registration. A substitute version of the bill passed the House in January and was approved by the Senate on May 25. OHA Position: Monitor House Bill 215, sponsored by Rep. Jean Schmidt (R-Loveland), would allow either party to a medical claim to require the claim to be reviewed by a medical review panel prior to proceeding in court. OHA supports the concept behind the legislation. H.B. 215 was approved by the House in early May and by the Senate in late May. OHA Position: Support House Bill 238, sponsored by Rep. Larry Flowers (R-Canal Winchester), would create a patient compensation fund to pay for catastrophic medical malpractice judgments and settlements. HB 238 has received no hearings and is pending in the House Civil and Commercial Law Committee. OHA Position: Monitor House Bill 282, sponsored by Rep. Larry Flowers (R-Canal Winchester), allows the director of the Ohio Department of Insurance to form by regulation a Medical Liability Underwriting Association that would issue medical liability insurance policies to eligible providers who had been declined by two admitted carriers. It would address only availability, not affordability of coverage. HB 282 was approved by the House in January, the Senate in February and became law on April 12, OHA Position: Support Legislature Has Enacted OHA-Backed Medical Malpractice Bills State lawmakers have enacted a number of bills in 2004 to help alleviate the medical malpractice problems in Ohio. Senate Bill 86, sponsored by Sen. Steve Stivers (R-Columbus), was signed by Governor Taft in December and became effective April 13, SB 86 expands qualified immunity for doctors providing services on a voluntary basis, such as care for uninsured patients. OHA Focuses Nurse Overtime Debate Around Safe Staffing Principles OHA staff continues meeting with members of the House Health and Family Services Committee on legislation prohibiting hospitals from requiring overtime of their nurses. The association s advocacy message is now augmented with a focus on Principles for Safe Nurse Staffing, a white paper developed by the Ohio Organization for Nurse Executives (OONE) and approved last month by the OHA Board. 5

6 In meetings with legislators, OHA has reiterated the position of the OHA Board and OONE Board members that nurse-staffing legislation is redundant, and therefore, unnecessary because of the multitude of standards required by the Joint Commission, Medicare and other regulatory entities. Concealed Carry Resource Page OHA added a section to its Web site to assist hospitals in understanding and implementing the recently passed concealed carry legislation, which took effect April 7, The legislation permits hospitals and other private entities to determine whether to allow concealed handguns in their facilities. OHA s site, contains a message board so hospitals can share tips and strategies used in banning weapons in their facilities. The Web site also includes a link to the bill and its analysis, an OHA bulletin with information on prohibiting weapons at their facilities, information on other states concealed carry laws and a list of Representatives and Senators that voted for or against the legislation. Catholic Hospital Alert Issues of medical/moral significance will probably surface in the Ohio Legislature for the fall session. Discussions are underway for action on a bill to revise Ohio s organ donation law and several legislators have drafts regarding banning cloning, but allowing for stem cell research! Abortifacient drug prescription practices are expected to receive attention in the Fall. The Catholic Conference of Ohio is planning a medical/moral committee meeting for later this year and we will be requesting attendance from all Catholic hospital ethicists and medical/moral personnel representing these hospitals. Any questions regarding this communiqué please contact Timothy Pond, Director of Department of Health Affairs, Catholic Conference of Ohio at On behalf of Ohio s Catholic Bishops we wish you a prosperous year in fulfillment of the mission of the Catholic Church in Ohio. 6