Minnesota Hospital Association


February 02, 2015

MHA Newsline: Feb. 2, 2015

In this issue 

Allina Health creates community solutions to improve health

Despite having access to world-class medical care right in their “backyard,” many residents of South Minneapolis experience poor health outcomes. Allina Health’s Backyard Initiative goes beyond medical care to improve health by empowering residents to strengthen their own health.   

The Backyard Initiative includes 12 Citizen Health Action teams (CHATs), each of which receives between $5,000 and $25,000 per year to develop and manage community-led health improvement projects. More than 6,600 community members participated in CHAT activities during 2013, with 175 residents actively leading CHATs – this means that approximately 15 percent of residents participated in the Backyard Initiative. One example of a CHAT accomplishment is the Growing in the Backyard program, which has distributed 6,000 pounds of vegetables to 2,500 community members.   

For more examples of how hospitals are reaching beyond their four walls to their communities through outreach and wellness programs, read the 2014 Community Benefit Report.  return to top    

Budget hearings begin  

Gov. Dayton released his proposed budget for the 2016-17 biennium last week and hearings begin this week.   

The House Health and Human Services Finance Division passed and amended a deficiency funding bill (H.F. 264) authored by Rep. Jim Knoblach (R-St. Cloud) that includes funding for the Minnesota Department of Health, $2 million included for hospitals designated as Ebola treatment centers and EMS providers. This legislation will be heard in the Senate Finance committee on Monday, Feb. 2. Gov. Dayton also included this request in his proposed budget.   

The Senate Health, Human Services and Housing Policy committee passed a bill for increased loan forgiveness grants for health care providers (S.F. 3) authored by Sen. Greg Clausen (DFL-Apple Valley). Its House companion, H.F. 211, is scheduled to be heard in the House Health and Human Services Reform committee on Tuesday, Feb. 3.   

Upcoming hearings of interest  
On Monday and Tuesday, the Senate Health and Human Services Finance Division will hear public testimony on the Governor’s proposed budget. Lawrence Massa, MHA president and CEO will testify along with several MHA members.   

On Monday, Feb. 2 at noon, the Senate Health, Human Services and Housing policy committee will hold a hearing on several ambulance and EMS related bills; S.F. 379, S.F. 233, S.F. 307 and S.F. 175 are included on the schedule.   

On Tuesday, Feb. 3 at 2:45 p.m., the House Health and Human Services reform committee will hear a proposal to add funding to the loan forgiveness program for health care professionals (H.F. 211), authored by Rep. Debra Kiel (R-rookston).   

On Wednesday, Feb. 4 the House Health and Human Services reform committee will hear the House companions to the ambulance and EMS related legislation considered by the Senate on Monday.    

Bills of interest introduced this week include  
H.F. 380, authored by Rep. Joe Schomacker (R-Luverne), would increase payment rates for rural special transportation services.   

For a complete list of 2015 legislative bills MHA is tracking, visit the Member Center. For assistance accessing the Member Center, please contact Ashley Gauster, MHA member services and communications specialist, 651-603-3545.  return to top   

Health care items included in Governor’s budget

$66.1 million for MinnesotaCare changes
The Governor’s proposed budget addresses the ongoing sustainability of the Health Care Access Fund (HCAF) through a combination of increased cost-sharing and modest premium increases for MinnesotaCare enrollees. These changes, which are projected to total $65.4 million are intended to address a projected deficit in the HCAF in FY2017.  The MinnesotaCare program serves approximately 85,000 low income residents who earn between 138-200 percent of the federal poverty guidelines.   

In addition, the proposed budget includes several recommended changes to ensure the MinnesotaCare program complies with federal regulations related to the Basic Health Plan (BHP). One change is to exempt people with income below 35 percent of federal poverty from premiums. Other recommendations would clarify income and household composition rules, align renewal periods and permit a long grace period for enrollees not paying their premiums. Together, these recommendations would cost an additional $700,000.   

$5.2 million for hospital inpatient payment changes
The Minnesota Department of Human Services (DHS) is developing an updated Medical Assistance inpatient hospital payment system. State law requires the new system to rebase payment rates in a cost-neutral fashion and to be ICD-10 compliant.   DHS plans to create a cost-based system for Critical Access Hospitals (CAHs) similar to Medicare. According to its early analysis, however, reimbursement rates for CAHs might fall well below those of other hospitals unless supplemental funding is provided. Therefore, the governor’s proposed budget calls for a small increase in state funding to avoid those unintended consequences of the rebasing effort.   

In addition, the proposed budget includes a recommendation to remove the payment cap on vaginal and C-section deliveries, and to align disproportionate share hospital (DSH) payments with state and federal policy objectives.   

MHA is working with DHS to organize a webinar or conference call on Friday, Feb. 6 for members to learn more about the rebasing process and better understand the projected payments for Prospective Payment System hospitals. Once DHS has more details regarding its CAH payment methodology, MHA will look to convene another similar webinar. Information regarding the dates and times of these webinars will be sent to MHA members via email.   

For more information, contact Joe Schindler, MHA vice president of finance, 651-659-1415.  return to top   

Governor proposes substantial investments in mental health

Gov. Dayton’s proposed budget includes more than $45 million in new spending to strengthen Minnesota’s mental health system. Improving access to mental health services is one of the Minnesota Hospital Association’s (MHA) highest priorities for this legislative session.   

The governor’s budget proposes the following key funding items: 

  • $2.173 million for behavioral health homes, which provide coordinated care to people with serious mental illnesses. The BHH program will also draw down a 90 percent match in federal Medicaid funds. 
  • $4.6 million for mental health crisis services, which include creating a single crisis phone line, increasing reimbursement rates for crisis services and expanding 24/7 availability across the state. 
  • $2.59 million for three new state operated Intensive Residential Treatment Services (IRTS) that serve people with complex conditions, including behaviors that are aggressive. 
  • $5.51 million in grant funding to stabilize intensive residential treatment and crisis providers pending a more thorough revamping of their payment rates. 
  •  $1.32 million to expand the number and improve the quality of Assertive Community Treatment (ACT) teams, including a forensic team for people leaving the corrections system. 
  • $6.62 million for Psychiatric Residential Treatment Facilities (PRTFs) to provide 150 beds in new models of residential care for children and adolescents with serious mental illnesses, as well as extended-stay contracts with community hospitals for 30 beds for inpatient child and adolescent mental health treatment. 

In addition to supporting many aspects of the governor’s mental health proposals, MHA is advocating to expand and improve payment for telehealth services, as well as address the 48 hour law that prioritizes people under commitment and in jail for admission to state facilities over people under commitment and in a community hospital.   

MHA continues to evaluate the proposals contained in the governor’s budget to gauge their potential impact on patients, communities and the hospitals and health systems that care for them. For example, MHA is looking to the potential repercussions of closing the Child and Adolescent Behavioral Health Services (CABHS) program in Willmar and treatment facilities for people with the dual diagnoses of mental illness and chemical dependency.   

For more information, contact Jen McNertney, MHA policy analyst, 651-659-1405.  return to top   

Legislation introduced to provide flexibility in meeting meaningful use requirements

Federal legislation would give hospitals and eligible professionals more flexibility in meeting meaningful use requirements for electronic health records (EHRs) in Fiscal Year 2015.   

The Flexibility in Health IT Reporting (Flex-IT) Act (H.R. 270), would shorten the 2015 reporting period to 90 days from the current 365 days for Medicare and Medicaid EHR Incentive Program participants using the 2014 Edition Certified EHR. Without this change, the vast majority of hospitals are required to meet all Stage 2 requirements starting on Oct 1, 2014, and maintain compliance through Sept. 30, 2015.   

Nationally, hospitals continue to be challenged with the current regulatory timeline for EHR delivery, installation and implementation. Without relief from the full year of use and reporting requirement, hospitals could face financial penalties despite their best efforts at compliance.   

This legislation is supported by MHA and the American Hospital Association. MHA has reached out to our House members asking them to sign onto the bill.   

For more information, contact Ann Gibson, MHA vice president of federal relations and workforce, 651-603-3527.  return to top   

MHA members encouraged to attend AHA annual meeting, May 3-6 in Washington D.C.

MHA will coordinate visits with the Minnesota congressional delegation  
This spring, Congress addresses issues and deadlines including the debt ceiling and the Medicare Sustainable Growth Rate formula. MHA members’ help is needed to deliver a unified message on these budget issues during the American Hospital Association (AHA) annual meeting in Washington, D.C., May 3-6.   

AHA will host a strong line-up of speakers who will address the most immediate and long term issues facing hospitals and health systems, and with approximately 1,500 attendees in attendance this is a unique opportunity to network with peers across the country. In addition, MHA staff will schedule congressional office visits and help prepare MHA members for those visits during a special briefing.   

To register for the meeting, visit aha.org. About a week prior to the annual meeting, MHA will send participants additional information on special “Minnesota-only” events.   

For more information, contact Ann Gibson, MHA vice president of federal relations and workforce, 651-603-3527.  return to top   

CMS seeking documentation of eligibility from CAHs

The American Hospital Association (AHA) alerted critical access hospitals (CAHs) that the Centers for Medicare and Medicaid Services (CMS) is sending letters asking for information related to each hospital’s eligibility for the CAH program. The CMS letters are expected to request documentation that might include the CAH’s distance from another hospital, the number of inpatient beds in use or its designation as a necessary provider by the state. According to the AHA special bulletin, CMS is making the request in anticipation of an upcoming “recertification or re-accreditation” process.    

The Minnesota Hospital Association (MHA) is concerned about CMS’s underlying purpose for this request. Minnesota is home to 79 CAHs that provide access to care in rural communities throughout the state. MHA and AHA are working together to learn more.   

AHA expects that CMS will require CAHs to provide the requested documentation within 15 days of receiving the letter, but hospitals can receive an extension, if necessary, by contacting Rosemary Robinson, CMS, 404-562-7405.   

For more information about the CAH program or previous federal proposals to reduce the number of CAHs, contact Ann Gibson, MHA vice president of federal relations and workforce, 651-603-3527.  return to top    

Sexton to promote professional resiliency at MHA Healthcare Leadership Institute

J. Bryan Sexton, Duke University professor and director of patient safety for the Duke University Health System, will present a special all-day session on professional resiliency on Thursday, March 5 at the MHA Healthcare Leadership Institute.   

The session, Essentials for Enhancing Professional Resiliency, is sponsored by MMIC Group and will provide participants with real-time feedback on the essentials of professional resiliency. Participants will leave with specific instructions and tools to promote their own resilience and well-being along with an understanding of how to help their employees and physicians in their own fatigue management.    

Dr. Sexton has captured the wisdom of frontline caregivers through rigorous assessment of safety culture and teamwork. His research instruments have been used around the world in more than 2,500 hospitals in 20 countries.   

The conference will be held March 4-6 at the Crowne Plaza Minneapolis West in Plymouth. For more information or to register download the conference brochure or visit the MHA website.   

The deadline for accommodations at the Crowne Plaza is Tuesday, Feb. 10 so be sure to reserve your room right away by clicking here or calling (763) 559-6600. Be sure to mention you are with the MHA Leadership Institute.  return to top   

Federal health IT coordinator sets 2017 goal for interoperability

The Office of the National Coordinator for Health Information Technology (ONC) recently released a 10-year roadmap on how to improve interoperability in electronic health-record systems. The report calls for most providers to be able to use their systems to send, receive and use a common set of electronic clinical information by the end of 2017. The plan is open for public comment through April 3.   

On the state level, Minnesota has had a mandate for all providers to have interoperable electronic health records by 2015. While the Minnesota mandate does not include penalties for non-compliance, at the federal level there is the possibility of penalties for failing to meet meaningful use requirements. While this report sets a goal of 2017, it does not set a timeline for penalties to begin.   

Accompanying the plan is a 13-page “advisory” to the health IT community on what the ONC sees as the best available healthcare information exchange standards and implementation specifications to facilitate health data information exchange. The ONC intends to keep the list updated periodically.   

The ONC's interoperability roadmap calls for a public-private partnership to create a “governance framework” for health information exchange. It also calls for more work to be done developing and harmonizing interoperability standards “that will allow us to facilitate the sharing without a whole lot of extra effort,” ONC director Karen DeSalvo said.   

For more information, contact Mark Sonneborn, MHA vice president of information services, 651-659-1423.  return to top   

AHA now accepting applications for Foster G. McGaw Prize

The Foster G. McGaw Prize honors health delivery organizations that have distinguished themselves through efforts to improve the health and well-being of those in their communities with an exceptional commitment to community service. Any health care delivery organization (hospitals, health systems, integrated networks or self-defined community partnerships) are eligible to apply.   

Applicants must demonstrate they meet criteria in the following categories: leadership, commitment, partnerships, breadth and depth of initiatives, and community involvement.   

Recipients of the award will receive recognition in the form of cash prize and acknowledgement with a trophy, special awards ceremony at the AHA Annual Meeting and coverage in health care publications.   

All MHA members are encouraged to apply; applications are due April 3, 2015.   

More information, including the Call for Entries brochure, application and examples of past award winners can be found herereturn to top