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For the week ending February 14, 2003
| H.128, Certificate of Need (CON)/Hospital Budgets The members of the House Health and Welfare Committee continued to take testimony this week regarding H.128, the CON bill. Spencer Knapp and Theresa Alberghini-DiPalma of Fletcher Allen Health Care testified on Wednesday. Knapp told the committee that what happened at Fletcher Allen was a "failure in leadership and not a failure of the CON process." He then outlined in detail many steps that FAHC is taking “to get things right.” Alberghini-DiPalma reviewed the goals of the 1996 legislation that created the Department of Banking, Insurance, Securities and Health Care Administration (BISHCA), the public oversight commission and the current process for reviewing hospital budgets and CONs and contrasted it with the system that existed prior to 1996. Bea Grause, President and CEO of VAHHS, testified on Thursday. Grause testified about the four-part proposal that VAHHS’s Board adopted to reform the CON/budget process, namely: participation in a national hospital quality reporting initiative, a 3-year community needs assessment and accountability report, financial and efficiency benchmarks that address issues related to accountability and hospital spending, and VAHHS’s proposal to reform the CON process. Anne Cramer, legal counsel for VAHHS, testified after Grause regarding the history of the CON process. Tom Huebner, President of Rutland Regional Medical Center, testified on Friday. Huebner discussed how RRMC’s current CON project for a new emergency department and boiler system is on schedule and on budget. He also discussed RRMC’s governance structure and its formal community assessment process as well as benchmarks used by the hospital to report on such things as quality and financial strength. On Tuesday, February 18th, members of the House Health and Welfare Committee are going to discuss H.128, and what sections they want to continue working on. Early indications are that they will narrow the scope of H.128 significantly. Next week VAHHS has arranged the following witnesses: Tuesday, 2/18 - John Nicholls, Trustee, Central Vermont Hospital; Weds. 2/19 - Joe Woodin, President of Gifford Medical Center; and Friday, 2/21 Patricia Burnham and Laurel Stanley, Trustees, Northeastern Vermont Regional Hospital. Department of Health FY 04 Budget This week the Commissioner of the Department of Health, Jan Carney, testified before the House Health and Welfare Committee regarding her department’s FY 04 proposed budget. Significantly for hospitals, Carney is proposing to cut tobacco control programs by $2.2 million or 57 percent. This cut includes a $431,105 or 37 percent cut in smoking cessation programs, primarily aimed at youth cessation. Early reports from the department are that this cut will not affect the smoking cessation programs operated by hospitals. Some of the $2.2 million in tobacco funds that are cut are directed towards Governor Douglas’s so-called “D.E.T.E.R” program (Drug Education, Treatment, Enforcement and Rehabilitation), including new funding for a second methadone clinic in Vermont. Health Department Bioterrorism Preparedness and Response Project The Vermont Department of Health received a $6.3 million grant from the Centers for Disease Control and Prevention (CDC) to ensure that Vermont’s overall public health system is able to effectively respond to bioterrorism, infectious disease outbreaks or other threats and emergencies. Activities to be funded include: preparedness planning and readiness assessment, designing systems for surveillance and epidemiology capacity, ensuring core diagnostic capabilities in state public health laboratories, establishing a network for exchange of information over the Internet, improving communication capabilities for dissemination of information to citizens and ensuring training needs of health professionals. The grant is funded through August 2003. Nursing Home Inflation factor and Bed Tax Update The Commissioner of the Department of Aging and Disabilities, Patrick Flood, told us this week that he has set aside $3.1 million in the FY 04 budget to fund the inflation factor for nursing homes. The department plans to raise the nursing home bed tax by a total of $600,000 to fund slightly less than half of the $3.1 inflation factor. Funding for the other half of the inflation factor will likely be paid for with state general fund dollars. S.17, Abuse of Vulnerable Adults This week the Senate Judiciary Committee voted unanimously to advance
S.17, a bill that proposes to increase the criminal penalties for abuse
of vulnerable adults in nursing homes and hospitals. The bill will be
up for action on the Senate floor next week. The committee made significant
changes to the bill since it was introduced earlier this year. After VAHHS
and others objected, the committee removed the section of the bill that
proposed to institute criminal penalties against a board of directors
or a “high managerial agent” of a facility, revised the “neglect”
section, and revised the ‘abuse by restraint” section. While
VAHHS made progress on the “Abuse by Restraint” section, the
Association continues to oppose it. The text of the bill appears on the
Senate Calendar for Feb. 14, 2003. Here is a link to that calendar. S.76, Medical Marijuana This week the Senate Judiciary Committee started to take testimony regarding
S.76, a bill related to the use of medical marijuana. This bill proposes
to exempt seriously ill people from prosecution for using medical marijuana
under a physician’s supervision. The bill does not prohibit the
use of medical marijuana in nursing homes or hospitals and raises questions
about such use. The Senate Judiciary Committee will continue taking testimony
regarding this bill February 20th and 21st. Here is a link to the text
to the most recent draft of the bill as approved by the Senate Health
and Welfare Committee. Commissioner John Crowley Testifies This week John Crowley, the newly appointed Commissioner of the Department of Banking, Insurance, Securities and Health Care Administration (BISHCA), testified before the Senate Health and Welfare Committee. Commissioner Crowley said that personally (and not on behalf of Governor Douglas) he believes that community hospitals are one of the greatest assets in the communities they serve. According to Crowley, the Douglas Administration is going to propose increasing the jurisdictional thresholds for CONs and a 3-track CON review process, including an expedited review for replacement of equipment or small projects. Crowley was somewhat vague on the specifics of the Douglas proposal. Public Hearing on FY 04 Budget The House Appropriations Committee will hold a public hearing on the FY 04 budget on Friday, February 21, 2003, from 9-12 noon and 1:30 to 3:30 pm in Room 11 at the State House. Tort Reform – Panel Discussion Scheduled February 20, 2003, 6:30 to 9 pm Last week we reported that the Senate and House Judiciary Committees
were planning to hold a public hearing on the issue of tort reform, including
medical malpractice. Plans changed somewhat and this event is now going
to be a Panel Discussion sponsored by the Vermont Bar Association, from
6:30 to 9 pm on Thursday, February 20, 2003, in Room 11 at the State House. |