Safety Net MeetingApril 22, 2008

Utah Legislative Update

Deb Wynkoop

UHA

Political Environment

Political Environment

Political Environment

Political Environment

3 sitting senators attempting to be Pres 21 GOP senators up for re-election vs. 12 Dems 25 GOP and 2 Dem House members retiring 51- 49 margin in Senate with Dem majority Historically low congressional approval rating November 4, 2008

What We KnowWhat We Know

Political Environment

Economy/economic stimulus will dominate President’s budget slashes Medicare Short legislative year Lame duck administration

Key markersMay 25: MedicaidJune 30: Medicare

Endgame

Political Environment

Roadways vs. roadblocksImpact of presidential nominees on

process

What We Don’t KnowWhat We Don’t Know

Utah State Budget Overview

Legislator’s allocated $775 million in new funds for 2008-2009

$441 million prioritized for new school funding

$100 million for future public education$72 million for public safety, for

corrections, UHP officers, county jails and new prison in Gunnison.

Utah State Budget Overview

$60 million to the state’s rainy day funds$18 million in tax cuts for self employed

families who purchase own health ins.$14 million for Medicaid needs$12 million for Higher Education

Health and Human Services

FY 2009 appropriated budget is $66,929,500 over the 2008 budget

2.6% increaseGeneral Fund increased by $28,078,200

or 4.3%

Major Funding Initiatives

Provider Contract COLAs of 3% based on operating budget

Federal Medical Assistance Rate Change funded

Medicaid Inflation/Provider Reimbursement Rates increased 2-3%

Inpatient Hospital increase 2.7%Outpatient Hospital increase 3.3%

Major Funding Initiatives

Baby Watch Early Intervention reallocation for 6% provider rates and 5% caseloads

Immunization funding for underinsured children one time $500,000

Medicaid adult dental servicesCommunity Health Centers one-time GF

for grants to serve medically uninsuredMedicaid funding decrease utilization

Budget Policy Initiatives

HB 326 Children’s Health Insurance Program – Open Enrollment $2,700,000 on going GF for the FY 2010 base with non-lapsing appropriation

HB 133 – Health System Reform - $615,000 on going and $882,000 one-time GF. Creates a multi-agency strategic reform plan & 11 member task force

Budget Policy Initiatives

HB 133 provides funding to encourage standard electronic medical records

Additional partnerships to work on health care reform – UHA Health Care Coalition

Members appointed – Sen.Killpack, Knudson, Bell and Davis

Rep. David Clark, Barrus, Daw, Newbold, Painter, Litvak and Biskupsi

Failed Bills

HB 168- Health Insurance Market – Allowed insurance companies to offer products without state minimum mandates

HB 491 – Health Plan Exemption for Selected Requirements

Issues may be discussed in the Health Care Task Force

Workforce Budgets

Nurse education funding with Utah hospitals paying match $2 million ongoing

Health care initiative $900,000 to Dixie and SLCC for health care workforce

Medical Education Council $220,000 GF to replace dedicated credits lost

Other UHA Bills of Interest

HB 121 – County Charges to Incarcerated Persons requires all counties to pay Medicaid rate to hospitals and PEHP rates plus 35% to physicians w/o a contract for services to county inmates

HB 47 – Standards for Exchange of Electronic Health Information. Establishes statewide standards

Other UHA Bills of Interest

H.B. 140- Child Restraint Device Amendments – children under 8 in child seats

H.B. 268- Health Facility Committee Membership – adds a hospital affiliated outpatient ASC member

HB 74 – Medicaid 340B Drug Pricing Program – Requires UDOH to explore expanding the program

UHA Tracking

HB 82 – Notice of Changes to State Medicaid Plan – Requires UDOH to notify the legislature when changes are made

HB 277 – Pandemic Preparedness Amendments – provides immunity in disasters for use of a building for vaccine distribution

HB 366- Medicaid Long Term Care Amendments – changes bed banking and limits growth without UDOH oversight

UHA Tracking

HB 399 – Medication Aide Certified Amendments – ongoing certification by DOPL for medication aides.

SB 66 – Uniform Emergency Volunteer Health Practitioners Act – Outside volunteer registration in response to a declared emergency

SB 93 – Licensed Direct Entry Midwife – defines normal birth, clarifies client transfer requirements for hospitalization

UHA Tracking

SB 97 – Immigration Task ForceSB99 Amendments to Sales and Use Tax

for Prosthetic Devices – tax exemption for prosthetic devices

SB 146 – Amendment to Uniform Anatomical Gift Act – coordinates directions from a pt. under an advanced directive to declare to make a gift

UHA Tracking

SB 161 – Advance Health Care Directive – Describes standards surrogates use when making a health care decision, modifies the POLST form

Training is available from the Utah Bar.

2008 State Elections

Senate Leadership Will Have Some New Faces Next Year

The most influential Senators in the Utah Legislature are resigning, signaling a changing of the guard. Senate Majority Whip, Davis County's Dan Eastman, the Rules Committee Chairman, Senator Bill Hickman, and Minority Leader Mike Dimitrich

Senate President John Valentine isn't worried.

Questions?

Deb Wynkoop

UHA, Utah Hospitals & Health Systems Assn

801-486-9915