Minnesota Hospital Association


May 15, 2017

MHA Newsline: May 15, 2017

In this issue 

Pathologists, radiologists from Hennepin County Medical Center staff annual North Minneapolis See, Test and Treat event

Since 2006, Hennepin County Medical Center’s Clinical Laboratory and Radiology departments have taken part in an annual “See, Test and Treat” event held at NorthPoint Health & Wellness Center in Minneapolis. The three-day See, Test and Treat program provides free cervical and breast cancer screening, diagnosis and follow-up for uninsured and underinsured women – all in one visit.   

The one-stop model removes barriers that often prevent access to timely disease screening and follow-up, such as lack of child care and transportation. During the event, women received a pelvic exam and Pap test to screen for cervical cancer, as well as a mammogram for detection of breast cancer performed by HCMC’s Mobile Mammography unit. Pathologists and radiologists interpreted the results and explained them to patients, as well as provided follow-up information and treatment.   

“This is an outstanding community event that provides access to screenings that can save lives,” said Dr. Bradley Linzie, chief of lab medicine and pathology at HCMC, who read Pap tests at the event. “I want to recognize my HCMC colleagues in Pathology and Radiology for their continued support for this event that gives back to the community.”   

Visit the MHA website to learn more and read the full 2016 Community Benefit Reportreturn to top   

Updated measles information and resources available

MHA partnered with the Metro Health and Medical Preparedness Coalition and Children’s Hospitals and Clinics of Minnesota on May 12 to host a statewide clinical call on Minnesota’s measles outbreak. Patsy Stinchfield, senior director of infection control, Children’s Hospitals and Clinics of Minnesota, moderated the call and shared Children’s experience related to the clinical picture of measles cases; screening processes; diagnosis, care, and treatment of potential measles exposures and positive cases; and visitor guidelines. Call replay is available online.   

Children’s has developed a measles toolkit for health professionals that includes front-line screening resources, triage and testing processes, a clinical decision tree and examples of signage for emergency department and clinic lobbies.   

Health care professionals should continue to follow the Minnesota Department of Health’s (MDH) measles outbreak vaccination guidance and continually work to minimize the risk of measles transmission in health care settings. Additional questions regarding measles should be directed to MDH’s vaccine-preventable disease section at 651-201-5414. return to top   

New FBI ransomware guidance issued; web conference on ransomware to be held May 25

On May 12, institutions around the world, including National Health Service (NHS) hospitals across England, were struck by ransomware attacks disabling computers and phone lines. Hospitals were forced to cancel surgeries and discourage any but the sickest patients from visiting emergency rooms. More information on these attacks can be found in articles from the Daily Mail, Telegraph and the Sun. The FBI issued new guidance on the attack on May 13. For more information, contact Mark Sonneborn, vice president of health information and analytics, who is MHA’s point person on this issue.   

A web conference update on ransomware, “Ransomware in 2017: The New Threat of Hacking Medical Devices,” will be held Thursday, May 25, from 12:30 to 2 p.m. To register for the conference, download the web conference brochure here.   

According to a report released by the Poneman Institute earlier this year, 90 percent of health care organizations suffer data breaches. Close to 45 percent of all data breaches in the industry are due to criminal activity such as nation-state cyber espionage units; ransomware; malicious insiders; and physical theft of patient information, clinical research and pharmaceutical formulations.   

This up-date-date web conference will examine recent ransomware occurrences across both hospital software and devices, review how they happened and give you steps to take to lessen the chance that one of the new types of ransomware attacking your institution. return to top   

Nurse staffing legislation introduced

Last week, a Minnesota Nurses Association (MNA) supported mandated nurse staffing legislation was introduced in the Senate and House. The bill (SF 2382/HF 2650) was introduced too late in the session to receive a policy hearing, but it will carry over to the 2018 session.   

The bill includes many elements of bills previously introduced by the Minnesota Nurses Association (MNA). It requires hospitals to provide direct-care registered nurse staffing at minimum levels specified for each hospital unit; requires reporting of shift-level staffing levels by MHA and to the Commissioner of Health; requires the staffing plan to have consent of union representatives; forms new patient safety committees in hospitals; gives direct care RNs the ability to close units and close the hospital to new admissions; and says that hospitals cannot lay off other positions to meet the staffing ratio.   

Hospitals and nurses share the same goal – delivering high-quality, safe patient care. Minnesota’s hospitals and health systems believe that staffing decisions are best made at local hospitals by health care professionals closest to the bedside. Teamwork is critical to a strong safety culture. Nurses, physicians, pharmacists, therapists and staff from all disciplines work together to support a culture of safety.   

Minnesota legislators in 2013 rejected the idea of a government-imposed mandate. Instead, a compromise was reached among legislators, MHA and MNA to provide for greater transparency and reporting of nurse staffing levels in Minnesota hospitals.   

More information is available on MHA’s website. Additional resources for MHA members are available on the Member Center. For assistance accessing the Member Center, contact Ashley Beno, member services and communications specialist, 651-603-3545. return to top   

MHA members urged to apply for new MCHA board

The Minnesota Comprehensive Health Association, which oversaw Minnesota’s high-risk pool prior to the Affordable Care Act implementation, is regulated by the Minnesota Department of Commerce and is guided by a board of directors. HF 5/SF 720, which created a new Minnesota reinsurance program, requires that the board be made up of 13 members, two of which must be selected by the commissioner of human services. One of the positions must represent hospitals and one of the positions must represent health care providers. Applications for these two board positions are being accepted until June 6 at 5 p.m. Interested individuals can apply through the secretary of state’s website by selecting the Boards and Commissions tab and clicking on the MN Comprehensive Health Association Board of Directors link.    

With questions, contact Krista O’Connor, project lead, Minnesota Department of Human Services, 651-431-7297. return to top   

Governor vetoes HHS omnibus budget bill

Gov. Dayton vetoed the health and human services omnibus budget bill last week. In his veto message, the governor raised concerns about the proposed cut of $505 million, saying that this was “reckless” at a time when the state has a significant budget surplus and “when we are facing serious uncertainty about future federal health care funding.” Legislative leaders and the governor are expected to resume budget negotiations again this week. MHA is hopeful that negotiations will address some of the concerns raised by the governor without re-opening the funding provisions that were contained in this conference committee bill (SF 800).   

Hospital leaders are reminded to continue with their legislative messaging against health care provider rate cuts this session. The legislative session ends on Monday, May 22, at midnight. A special session of the legislature may be needed if budget bills are not completed by that time.   

Governor signs children’s hospitals alternative payment legislation
Last week, the governor signed legislation to allow the Department of Human Services (DHS) to develop a revised payment methodology for children’s hospitals to address action by the Centers for Medicare and Medicaid Services (CMS) that may result in Children's Hospitals and Clinics and Gillette Children’s Specialty Healthcare losing all of their DSH funding. This substitute payment methodology will continue to recognize the unique situation of children’s hospitals and, like DSH funding, is intended to offset the substantial losses associated with caring for a disproportionate share of Medicaid and uninsured patients.   

With questions, contact Mary Krinkie, vice president of government relations, MHA, 651-659-1465, or Kristin Loncorich, director of state government relations, MHA, 651-603-3526.   

Advocacy resources
Visit the MHA Member Center for legislative resources. If you have questions about your legislative advocacy efforts, please contact MHA’s grassroots coordinator, Karin Johnson.  

Session bill tracker
For a complete list of 2017 legislative bills MHA is tracking, visit the MHA Member Center. For assistance accessing the Member Center, contact Ashley Beno, member services and communications specialist, 651-603-3545. return to top  

MHA, hospital leaders meet with Sens. Klobuchar and Franken

MHA members and staff traveled to Washington, D.C., for the American Hospital Association annual conference and to meet with Sens. Klobuchar and Franken and staff for Reps. Walz, Lewis, Paulsen, McCollum, Emmer, Peterson and Nolan.   

Members shared the potential impact of the American Health Care Act (AHCA) on Minnesota and on their specific hospitals. They shared that MHA maintains its position of opposing the AHCA and will continue to advocate for meaningful insurance coverage for all Minnesotans; coverage of pre-existing conditions and all essential health care services; and for enhanced public health insurance program payments to providers to cover costs associated with caring for public program participants.   

In addition to expressing concerns with the AHCA, members discussed the importance of the 340B Drug Discount Program, adequate Medicare payments for telehealth services, graduate medical education payments and the challenges facing rural health care providers, including the physician supervision requirements, 96-hour rule and maintaining an adequate rural health care workforce.   

MHA staff, key stakeholders discuss importance of medical assistance with Rep. Emmer
In partnership with National Alliance on Mental Illness (NAMI) Minnesota, Kristin Loncorich, director of state government relations, MHA, and Briana Nord Parish, policy analyst, MHA, on May 10 met with Rep. Emmer to discuss the potential impact of the American Health Care Act (AHCA) on Medicaid and mental health care. Other meeting participants included the Arc Minnesota, Mn Teen Challenge, Care Providers of Minnesota and Lutheran Social Services. MHA will continue to partner with various stakeholders to advocate for health coverage for all Minnesotans.   

MHA shared hospital-specific concerns with the AHCA’s Medicaid provisions, including the repeal of the Medicaid expansion; the repeal of the presumptive eligibility determination, which will prohibit hospitals from temporarily and immediately enrolling patients in Medicaid if it appears they are eligible; and the shortening of the Medicaid eligibility look-back period from three months to one month. These provisions will likely lead to an increase in hospital uncompensated care. MHA and NAMI also highlighted the unique collaboration between Minnesota’s mental health community and hospitals to provide innovative mental health services.   

During the meeting, Rep. Emmer stressed that House passage of the AHCA was just the beginning of the process to replace the Affordable Care Act (ACA). He expressed frustration with the lack of consensus within the Republican conference and the lack of bipartisanship to address the ACA’s shortcomings. Additionally, Rep. Emmer told the group that although the media focus has been on insurance coverage of pre-existing conditions and the ACA’s mandated essential health benefit set, representatives and senators continue to negotiate the ACHA’s Medicaid provisions, which are expected to change in the Senate legislation. He noted there are a handful of Republican senators whose top issue is protecting their states’ Medicaid expansion population. Rep. Emmer asked for continued input on the impact of the AHCA and any modifications made by the Senate, but did not commit to changing his position of supporting the AHCA.    

AHCA moves to Senate for consideration
The Senate Affordable Care Act (ACA) repeal and replace legislation is expected to differ significantly from the House-passed American Health Care Act (AHCA). Senate Republican leadership said they will overhaul the House-passed bill or draft their own version. Possible Senate modifications include tying the tax credits to buy insurance to income, not just age as in the House bill; changing the Medicaid reform provisions to lessen their impact on expansion states; removing the provisions defunding Planned Parenthood; and modifying or removing the provisions giving states more authority over whether to cover the essential health benefits set, which may violate reconciliation’s rules for consideration.   

In addition to a 13-Senator working group, Sen. Rob Portman (R-OH) is also working with Sens. Susan Collins (R-ME) and Bill Cassidy (R-LA) to engage a separate group of senators focused on Medicaid reform and patient protections. Earlier this year, Sens. Collins and Cassidy introduced the Patient Freedom Act, which would allow states to keep the ACA or implement an alternative market-based system that provides states with more flexibility while still ensuring those with pre-existing conditions are protected.   

The Congressional Budget Office (CBO) announced it will release its estimated cost and impact on coverage of the AHCA the week of May 22.   

With questions, contact Briana Nord Parish, policy analyst, MHA, 651-603-3498, or Ben Peltier, vice president of legal and federal affairs, MHA, 651-603-3513. return to top