1. Safety Net Meeting April 22, 2008 Utah Legislative Update Deb Wynkoop UHA

2. Political Environment

5. 3 sitting senators attempting to be Pres 21 GOP senators up for re-election vs. 12 Dems 25 GOP and 2 Dem House members retiring 51- 49 margin in Senate with Dem majority Historically low congressional approval rating November 4, 2008 What We Know

6. Political Environment Economy/economic stimulus will dominate President’s budget slashes Medicare Short legislative year Lame duck administration Key markers  May 25: Medicaid  June 30: Medicare Endgame

7. Political Environment Roadways vs. roadblocks Impact of presidential nominees on process What We Don’t Know

8. Utah State Budget Overview Legislator’s allocated $775 million in new funds for 2008-2009 $441 million prioritized for new school funding $100 million for future public education $72 million for public safety, for corrections, UHP officers, county jails and new prison in Gunnison.

9. Utah State Budget Overview $60 million to the state’s rainy day funds $18 million in tax cuts for self employed families who purchase own health ins. $14 million for Medicaid needs $12 million for Higher Education

10. Health and Human Services FY 2009 appropriated budget is $66,929,500 over the 2008 budget 2.6% increase General Fund increased by $28,078,200 or 4.3%

11. Major Funding Initiatives Provider Contract COLAs of 3% based on operating budget Federal Medical Assistance Rate Change funded Medicaid Inflation/Provider Reimbursement Rates increased 2-3% Inpatient Hospital increase 2.7% Outpatient Hospital increase 3.3%

12. Major Funding Initiatives Baby Watch Early Intervention reallocation for 6% provider rates and 5% caseloads Immunization funding for underinsured children one time $500,000 Medicaid adult dental services Community Health Centers one-time GF for grants to serve medically uninsured Medicaid funding decrease utilization

13. Budget Policy Initiatives HB 326 Children’s Health Insurance Program – Open Enrollment $2,700,000 on going GF for the FY 2010 base with non-lapsing appropriation HB 133 – Health System Reform - $615,000 on going and $882,000 one-time GF. Creates a multi-agency strategic reform plan & 11 member task force

14. Budget Policy Initiatives HB 133 provides funding to encourage standard electronic medical records Additional partnerships to work on health care reform – UHA Health Care Coalition Members appointed – Sen.Killpack, Knudson, Bell and Davis Rep. David Clark, Barrus, Daw, Newbold, Painter, Litvak and Biskupsi

15. Failed Bills HB 168- Health Insurance Market – Allowed insurance companies to offer products without state minimum mandates HB 491 – Health Plan Exemption for Selected Requirements Issues may be discussed in the Health Care Task Force

16. Workforce Budgets Nurse education funding with Utah hospitals paying match $2 million ongoing Health care initiative $900,000 to Dixie and SLCC for health care workforce Medical Education Council $220,000 GF to replace dedicated credits lost

17. Other UHA Bills of Interest HB 121 – County Charges to Incarcerated Persons requires all counties to pay Medicaid rate to hospitals and PEHP rates plus 35% to physicians w/o a contract for services to county inmates HB 47 – Standards for Exchange of Electronic Health Information. Establishes statewide standards

18. Other UHA Bills of Interest H.B. 140- Child Restraint Device Amendments – children under 8 in child seats H.B. 268- Health Facility Committee Membership – adds a hospital affiliated outpatient ASC member HB 74 – Medicaid 340B Drug Pricing Program – Requires UDOH to explore expanding the program

19. UHA Tracking HB 82 – Notice of Changes to State Medicaid Plan – Requires UDOH to notify the legislature when changes are made HB 277 – Pandemic Preparedness Amendments – provides immunity in disasters for use of a building for vaccine distribution HB 366- Medicaid Long Term Care Amendments – changes bed banking and limits growth without UDOH oversight

20. UHA Tracking HB 399 – Medication Aide Certified Amendments – ongoing certification by DOPL for medication aides. SB 66 – Uniform Emergency Volunteer Health Practitioners Act – Outside volunteer registration in response to a declared emergency SB 93 – Licensed Direct Entry Midwife – defines normal birth, clarifies client transfer requirements for hospitalization

21. UHA Tracking SB 97 – Immigration Task Force SB99 Amendments to Sales and Use Tax for Prosthetic Devices – tax exemption for prosthetic devices SB 146 – Amendment to Uniform Anatomical Gift Act – coordinates directions from a pt. under an advanced directive to declare to make a gift

22. UHA Tracking SB 161 – Advance Health Care Directive – Describes standards surrogates use when making a health care decision, modifies the POLST form Training is available from the Utah Bar.

23. 2008 State Elections Senate Leadership Will Have Some New Faces Next Year The most influential Senators in the Utah Legislature are resigning, signaling a changing of the guard. Senate Majority Whip, Davis County's Dan Eastman, the Rules Committee Chairman, Senator Bill Hickman, and Minority Leader Mike Dimitrich Senate President John Valentine isn't worried.

24. Questions? Deb Wynkoop UHA, Utah Hospitals & Health Systems Assn 801-486-9915