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May 20, 2009 News Headlines

State Legislative Update

Legislative activities are picking up in the State Senate and Assembly as committees consider various proposals of interest to health care providers. Two particular proposals of interest moved to the next stage of the legislative process this week:

  • Family Health Care Decisions Act (A.7729, Gottfried/S.3164, Duane). This legislation would establish procedures for making medical treatment decisions on behalf of individuals who lack the capacity to make decisions for themselves. The issue has been deliberated in the Legislature for 17 years and, for the first time, was reported yesterday by the Senate Health Committee to the Codes Committee; the Assembly Health Committee moved the bill to the Codes Committee last week. HANYS strongly supports this bill, which addresses gaps in the current system by better protecting the rights of incapacitated patients and sparing family members the nightmare of helplessly watching their loved one’s health care wishes go unfulfilled. HANYS issued a press release urging the Legislature to pass the bill.
  • Transitional Care Unit Demonstration Program (S.3532, Foley/A.3144, Eddington). This bill would expand the transitional care unit (TCU) demonstration program enacted in 2005 to allow the Commissioner of Health to approve ten hospitals to operate TCUs. The current demonstration program is restricted to five hospitals. HANYS supports this legislation, as early results of the demonstration show that TCUs can improve access to care, quality, and patient outcomes, and decrease hospitalizations, thereby providing value in the provision of post-acute care for elderly patients. This bill was approved by the Senate Health Committee and referred to the Senate Finance Committee for consideration. The Assembly has already passed this bill.

In other legislative action, the following bills were considered in legislative committees last week:

  • Hospital Staffing Ratios (A.2264, Gottfried/A.3843, Duane). This bill would create direct care nurse-to-patient staffing ratios in hospitals and establish extensive new requirements relating to internal committee structures and reporting, among other changes. HANYS continues to strongly oppose legislative proposals that create nurse staffing ratios and has expressed this opposition in meetings with lawmakers and legislative staff. This proposal was approved by the Assembly Health Committee and referred to the Codes committee for consideration. The Senate companion bill is currently in the Health Committee.
  • Nursing Home Staffing Ratios (A.1718, Gottfried). This bill would create specific nursing home staffing ratios for nurses, other licensed personnel, and nurses aides. The proposal would also establish an advisory council on nursing home staffing to make recommendations to the Governor, and require public disclosure by each nursing home of its staffing levels. HANYS opposes this legislation and has expressed opposition to lawmakers and legislative staff. This bill was approved by the Assembly Health Committee and referred to the Ways and Means Committee for consideration.
  • Safe Patient Handling Demonstration Program Extension (A.8045, Gunther/S.5006, Duane). This bill extends for two years the safe patient handling demonstration program that was authorized in 2005 and extended for two additional years in 2007. The goal of the demonstration program is to study evidenced-based data to design best practices for safe patient handling programs. This proposal would extend the demonstration until 2011. The Assembly Health Committee approved the bill and referred it to the Ways and Means Committee for consideration. The Senate companion bill is currently in the Health Committee.
  • Immunization of LTC Workers (S.3256, Duane)/A.8133, Gottfried). This bill would require all personnel in long-term care facilities to receive annual influenza vaccinations, except in the case of a vaccine shortage. The bill would also remove the current requirement of employees to receive vaccination against pneumococcal disease. The Senate Codes Committee acted on the legislation last week and it is now under review by the Finance Committee; the companion legislation is being considered by the Assembly Health Committee.
  • Nurse Protection (S.4018, Hassell-Thompson/A.3103, Koon). This bill amends the penal law regarding the assault of emergency medical professionals, to add registered nurses and licensed practical nurses, and provides for a class C felony for physical injury to them. HANYS supports this legislation. This legislation was approved by the Senate Codes Committee and is on the Senate calendar. The Assembly companion bill is in the Codes Committee.

HANYS will continue to update the membership as proposals of interest are considered by the Legislature.

Senate Panel Considers Policy Options to Finance Health Reform

Earlier this week, the U.S. Senate Finance Committee released a policy paper on options for financing comprehensive health care reform. This is the third and final policy options paper to be released by the Committee as it works to draft comprehensive health reform legislation. Committee Chairman Max Baucus (D-MT) said he wants the Committee to complete the legislation next month. The other policy options papers cover delivery system reform and expanding coverage.

The financing document contains policy options that would seek to fund a portion of health reform through reductions in Medicare and Medicaid payments, such as through update reductions and cuts to Graduate Medical Education and Disproportionate Share Hospital payment levels. The document does not contain details that would enable an impact analysis to be conducted. HANYS is weighing in strongly with Senate Finance Committee member Senator Charles Schumer (D-NY) against reductions that would put New York hospitals and health systems at risk. Senator Schumer has long been a champion of the state’s hospitals and health systems.

In addition to Medicare and Medicaid changes, the financing document considers a number of health-related and non health-related tax options to help fund comprehensive health care reform. The Committee is meeting behind closed doors today to discuss all policy options contained in the financing document. Contact: Susan Van Meter

HHS Issues Plans to Implement HIT Provisions of ARRA

The U.S. Department of Health and Human Services (HHS) has released two documents describing plans for implementing the health information technology (HIT) provisions of the American Recovery and Reinvestment Act (ARRA). While the documents lack key details such as the definition of “meaningful use” of HIT, they provide a timeline and general overview of HHS’ plans.

The first document provides implementation plans for the HIT provisions of ARRA that directed $2 billion to be allocated, in part, to states for the establishment of HIT grant and loan programs, and to entities that will become regional extension centers. The document also provides a timeline and plans to fund and implement ARRA privacy, security, and standards provisions.

The second document highlights HHS’ plans for implementing the temporary Medicare and Medicaid HIT incentive payments authorized by ARRA to hospitals and non hospital-based physicians that are considered “meaningful users” of “certified” electronic health records (EHRs).

HANYS summarized the Medicare and Medicaid payment incentive provisions of ARRA for members. Contact: Susan Van Meter

299 Cases of Swine Flu Confirmed in New York State

As of today, the Department of Health (DOH) is reporting 299 confirmed cases of novel influenza A H1N1 (swine flu) infections in New York State. This total represents 201 cases in New York City and 98 cases outside of New York City. Total laboratory-confirmed cases by county and New York City are posted daily on the DOH Web site.

The New York City Department of Health and Mental Hygiene (DOHMH) is reporting increased levels of influenza in many parts of New York City, and evidence suggests that the novel influenza A H1N1 is causing a large proportion of the city’s current flu cases. Except in special circumstances, DOHMH does not test people with flu to determine which type they may have.

DOH and DOHMH continue to update their guidance for hospitals. Below are links to the most current New York State updates.

  • DOH: Health Advisory: Update #4, issued May 7, replaces all previously released H1N1 virus health advisories. This guidance is intended for providers seeing patients outside of New York City.
  • DOHMH: Health Alert #17, issued May 12, provides an epidemiologic update on the outbreak in New York City, revised reporting requirements, revised guidance on diagnostic testing, revised guidance on antiviral treatment for influenza and febrile respiratory illness, and updated guidance on antiviral prophylaxis for exposures to influenza and febrile respiratory illness.
  • DOHMH: Novel H1N1 Influenza Q&A for Healthcare Providers

Health Provider Network (HPN) coordinators and others responsible for responding to Health Emergency Reporting Data System surveys should ensure that their information in the DOH Communication Directory is up to date. HANYS urges hospitals to regularly check HPN for additional information. Contact: Christopher Smith

Mandatory Flu Vaccines for Health Care Personnel on Agenda for SHRPC Committee

A proposed regulation that would require annual influenza vaccines for all health care personnel in hospitals will be discussed at tomorrow’s Codes Committee of the State Hospital Review and Planning Council (SHRPC). The rule would also apply to employees of diagnostic and treatment centers, certified home health agencies, long-term home health care programs, acquired immune deficiency syndrome home care programs, licensed home care services agencies, and hospices.

The regulation is still in draft form and has not yet been published for comment in the State Register. The draft is available for members to review on HANYS’ Web site. A separate proposal that would require mandatory flu vaccines for personnel working in nursing homes is currently under consideration in the State Legislature.

Under the proposed regulation, hospitals and other covered health care facilities would have to provide or arrange for the influenza vaccinations at no cost to their employees. Personnel covered under the new rule would include employees, members of the medical staff, contract staff, students, and volunteers.

Health care staff could choose to receive the vaccine elsewhere, but would have to provide documentation to the facility. Exceptions would only be granted where the vaccine is medically contraindicated. The new requirement would add the flu vaccine to the list of required immunizations already mandatory for health care personnel.

According to Department of Health (DOH) data, more than 5,000 employees in hospitals and nursing homes were sickened by either suspected or confirmed nosocomial flu infections over the period from 2000-2007. More than 19,000 residents and patients of nursing homes and hospitals had confirmed or suspected nosocomial flu over the same period. Influenza is the sixth leading cause of death in the United States, killing an average of 36,000 Americans each year.

Because of the dynamic situation with the H1N1 flu virus, and the uncertainty over the possibility of a combined flu vaccine being available in time for the next flu season, it was not immediately clear how the new strain of flu virus would impact this proposal and the timeline for implementation. The state has the authority to fast-track regulations under certain conditions in an emergency. HANYS will provide additional information after this week’s SHRPC meetings. Contact: Karen Roach