IHA Legislative Update - Feb 6, 2009

The most recent IHA Legislative Update is cut and pasted below (with some minor formatting changes). Items of particular interest to hospital quality professionals are colored in orange.

Deadlines Approaching; Workforce Bills Move Forward
Although conference committee work does not begin until late April, critical deadlines are approaching. Bills must be heard and pass out of committee by Feb.19. The surviving bills then must be amended and voted on by the full House and Senate by Feb. 24 and 25, respectively. Bills that don't make it through this process will be considered "dead." Of course, to keep things interesting, there are always opportunities to revive dead legislation, but these instances are limited.

Various bills addressing workforce issues are moving forward this session. Legislation includes:

Professional Licensing Matters: HB 1573, authored by Peggy Welch (D-Bloomington), addresses various professional licensing matters. The bill currently contains language that will grant physician assistants (PAs) more autonomy and somewhat expand their scope of practice. Among other changes, it would add PAs to the list of providers that can refer patients to occupational and physical therapists. It would also eliminate the current limit on the number of PAs that a physician may supervise and significantly changes the supervisory agreement. The bill is set for a hearing during next weeks' House Public Health Committee.

Home Health Care Wages and Benefits: HB 1028, authored by Rep. John Day (D-Indianapolis), would require home health care agencies to report annually wages, benefits, travel time and mileage, and other detailed information. This legislation is backed by the SEIU, which is concerned about the level of compensation for certain home health care workers. However, IHA’s government relations team has communicated to lawmakers that hospital-employed home health care workers are generally more highly-compensated than their non-hospital employed counterparts. Hospitals have been exempted from any new requirements.

Attracting Primary Care Physicians for Shortage Areas: HB 1138, authored by Rep. Scott Reske (D-Pendleton), passed out of the Public Health Committee this week. It defines primary care as family practice, obstetrics and gynecology, pediatrics, and internal medicine. The bill creates a loan forgiveness program for Indiana physicians who practice in these areas. A similar loan forgiveness program is included in HB 1210 (Public Psychiatry Development Program) authored by Rep. Charlie Brown (D-Gary). This bill is designed to increase the number of psychiatrists, psychologists, and psychiatric nurses practicing in Indiana, especially in the public sector.

Surgical Technologists and Nurse Circulators: HB 1593, authored by Rep. Chuck Moseley (D-Portage), presents some concerns for hospitals. The bill would require hospitals to employ only surgical technicians certified by a private, national accrediting agency (with some exceptions and a provision “grandfathering” those currently working as surgical technicians). This requirement would also extend to surgery centers and other health facilities.

Language in the legislation would also require nurse circulators to be present for the “duration” of surgical procedures. There are other issues that need clarification if this bill moves forward. The bill has passed out of the Public Health Committee, but Chairman Charlie Brown has asked IHA to work with the surgical technicians’ representatives to resolve other outstanding issues.

Trauma Funding Bill Passes First Test
This week, HB 1215, authored by Rep. Charlie Brown (D-Gary), was endorsed by the House Ways and Means Committee by a vote of 21-3. Before the vote, an amendment was approved that would reduce the amount of projected funding. The Legislative Services Agency had estimated that the introduced version of the bill would generate $16 million annually based on increased fees for motor vehicle violations, registrations, and driver's licenses. In its current form, the bill would only generate dollars for trauma centers through increased penalties for motor vehicle violations. HB 1215 could move to the House floor as early as next week for purposes of amendment by the full body.

FSSA Halts Welfare Modernization Rollout
FSSA Secretary Anne Murphy has halted any further rollout of the state's privatized, automated welfare intake system until agency officials are sure it can handle the additional volume. This decision comes at a time when lawmakers have introduced bills to slow down the initiative and fine-tune the new system which has met criticism. Since the rollout began 15 months ago, some have complained of lost documents, revoked benefits, lengthy hold times, and other problems.

State Revenue Falls Short; FSSA Asked to Make Cuts
The State Budget Agency has published the most recent monthly revenue report which can be viewed here: http://www.in.gov/sba/2485.htm.

Total tax collections for January were $142.2 million, well below a forecast that was made just a few weeks ago. The "Big Three"-- sales tax, individual income tax, and corporate income tax all fell below projected levels. For the first time in recent memory, this revenue report was posted along with a special commentary written by State Budget Director Chris Ruhl. His memo raises the very real possibility of additional state cost containment measures, and FSSA is specifically mentioned:

"Given the possibility of further revenue shortfalls, the Governor has directed us to assemble options for additional contingency measures. These generally include additional reductions in base spending, transferring unused balances in dedicated funds to the general fund, and renegotiating contracts and leases to generate cost savings. The Family and Social Services Administration has been asked to continue to generate other cost savings ideas in both Medicaid and other welfare programs they operate while preserving services."