Governmental AffairsASPAN Governmental Affairs Update July/August 2002ANA 2002 House of
Delegates Actions
Visit
www.nursingworld.org for more info and to apply!! National Patient Safety Goals ·
JCAHO’s Board of
Commissioners has approved for implementation effective January 1, 2003
a set of 6 National Patient Safety Goals representing 11 recommendations
for improving the safety of patient care in health care organizations: ·
Improve the accuracy of patient identification ·
Use at least 2 patient
identifiers (neither to be the patient’s room number) whenever taking
blood samples or administering medications or blood products ·
Prior to the start of any
surgical or invasive procedure, conduct a final verification process,
such as a “time-out” to confirm the correct patient, procedure, and
site, using active—not passive—communication techniques ·
Improve the effectiveness of communication among caregivers ·
Implement a process for
taking verbal or telephone orders that require a verification
“read-back” of the complete order by the person receiving the order ·
Standardize the
abbreviations, acronyms, and symbols used throughout the organization,
including a list of abbreviations, acronyms, and symbols not to use ·
Improve the safety of using high-alert medications ·
Remove concentrated
electrolytes from patient care units ·
Standardize and limit the
number of drug concentrations available in the organization ·
Eliminate wrong-site, wrong-patient, wrong-procedure surgery ·
Create and use a preoperative
verification process, such as a checklist, to confirm that appropriate
documents are available ·
Implement a process to mark
the surgical site and involve the patient in the marking process ·
Improve the safety of using infusion pumps ·
Ensure free-flow protection
on all general-use and PCA IV infusion pumps used ·
Improve the effectiveness of clinical alarm systems ·
Implement regular preventive
maintenance and testing of alarm systems ·
Assure that alarms are
activated with appropriate settings and are sufficiently audible with
respect to distances and competing noise within the unit Nursing Shortage Reports ·
The ANA commends JCAHO for
its focus on the nursing shortage in its report, Health
Care at the Crossroads: Strategies
for Addressing the Evolving Nursing Crisis ·
JCAHO’s report reaffirms
several of the findings and recommendations that the nursing community
issued in its own report, Nursing’s
Agenda for the Future ·
The above details nursing’s
strategic plan to address the complex, interrelated factors that have
created the growing shortage of nurses ·
Nursing leaders will advance
this plan to stakeholders outside of nursing, including policy-makers,
consumers, purchasers, and other health care providers at a “Call to
the Nation” planned for 2003 ·
“Health care facilities
with the Magnet designation have been proven to improve patient care
delivery and nurse retention,” ANA President Barbara A. Blakeney, MS,
APRN, BC, ANP stated ·
Blakeney continued,
“Research projects have suggested that Magnet facilities have lower
mortality rates and shorter lengths of stay for patients, increased
career satisfaction for nurses, and increased RN retention and
recruitment rates” ·
Nursing’s Agenda for the Future
is available from the ANA at www.nursingworld.org/naf ·
Health Care at the Crossroads:
Strategies for Addressing the Evolving Nursing Crisis may be obtained by contacting JCAHO at: 630-792-5175 New CDC Appointments ·
Tommy Thompson (Secretary of
HHS) announced the appointments of: ·
Julie L. Gerberding, MD, MPH
as director of the Centers for Disease Control and Prevention (CDC) and
Administrator of the Agency for Toxic Substances and Disease Registry (ATSDR) ·
Jerome M. Hauer, MPH as
acting Assistant Secretary for Public Health Emergency
Preparedness—this is a new position created by the bioterrorism
legislation signed into law by President Bush on June 12 ·
www.aamc.org/advocacy/library/washhigh Committee Approves Surgeon General Nomination ·
The Senate Health, Education,
Labor, and Pensions Committee July 17 approved the nomination of Richard
Carmona, MD to be Surgeon General ·
Dr Carmona was nominated by
the president March 26 and his confirmation hearing was held July 9 ·
The full Senate on July 23
confirmed him to be the next Surgeon General ·
www.aamc.org/advocacy/library/washhigh On The Hill ·
Congressman Virgil Goode (R-VA)
officially joined the Republican Party on August 1 (he became an
Independent in January 2000 after serving as a Democrat since 1997) ·
Representative James Traficant (D-OH) was
expelled from the House of Representatives July 24 by a vote of 420-1
following his conviction on federal bribery, tax evasion, and
racketeering charges in April and a subsequent recommendation for
expulsion by the House Committee on Official Conduct (Ethics Committee) ·
The party breakdown in the House is now 223
Republicans, 210 Democrats, 1 Independent, and 1 vacancy ·
www.aamc.org/advocacy/library/washhigh 7 ·
The Medical Payment Advisory
Commission (MedPAC) has named Mark Miller, PhD as its new Executive
Director ·
Dr Miller is currently
assistant director of health and human resources at the Congressional
Budget Office (CBO) ·
Dr Miller will begin at
MedPAC in the fall ·
www.aamc.org/advocacy/library/washhigh Born To Be Wild??? ·
HHS Secretary Tommy Thompson
was formally inducted into the Sturgis Motorcycle Museum Hall of Fame in
South Dakota on August 7 ·
“For somebody who rides
motorcycles, it’s quite a thrill to be honored by your peers,” said
Thompson ·
Thompson started riding hogs
10 years ago when he was governor of Wisconsin, the home state of the
Harley-Davidson company ·
Thompson further stated,
“I’m secretary of health. I
wear a helmet. I don’t smoke. And
I’m on a diet.” HRSA Awards States Grant Money ·
HHS’ Health Resources and
Services Administration (HRSA) has awarded grants to 11 states and one
territory to help them develop plans to provide affordable health care
to the uninsured: ·
Alabama ·
Georgia ·
Hawaii ·
Indiana ·
Maine ·
Maryland ·
Montana ·
New Jersey ·
South Carolina ·
The Virgin Islands ·
West Virginia ·
Wyoming ·
Each of the above 11 received
one-year grants because they had either a low percentage of uninsured
residents or possess “the ability to significantly reduce the number
of uninsured" ·
The grants will enable the
states to study ways to provide health coverage to the uninsured through
programs similar to already existing federal or state health plans ·
At the conclusion of the
one-year term, each state will submit a report to the HHS secretary that
“identifies the characteristics of the uninsured within its state and
proposals for providing them with affordable health insurance
coverage” HRSA’s Report on the Nursing ShortageOn The Hill ·
The report, “Projected
Supply, Demand, and Shortages of Registered Nurses:
2000-2020” by the National Center for Health Workforce
Analysis, DHHS was released on July 30, 2002 ·
To read full report, go to:
http://bhpr.hrsa.gov/healthworkforce/rnproject/report.htm Cloning ·
The Council on Bioethics (appointed by President Bush as part of
his stem cell research funding decision last August and chaired by Leon
Kass, MD, PhD) issued its cloning report on July 11 ·
The 18 member panel is unanimous in its opposition to reproductive
cloning, but split on somatic cell nuclear transfer (SCNT) research, or
“therapeutic cloning” ·
It was expected that the panel would overwhelmingly advise making
SCNT research illegal—but the panel had only 10 votes in favor of a
4-year moratorium on such research, 7 members recommended allowing SCNT
research to go forward, and 1 member abstained from making any
recommendation ·
There
is no legislation pending in Congress to impose a moratorium on SCNT
research ·
www.amc.org/advocacy/library/washhigh NIH
Finalizes “Just in Time” ·
NIH published in the August 7 Federal Register a notice
amending the Public Health Service (PHS) Policy on Humane Care
and Use of Laboratory Animals to permit institutions with PHS Animal
Welfare Assurances to submit verification of Institutional Animal Care
and Use Committee (IACUC) approval for competing applications subsequent
to peer review but prior to award ·
A revision permits institutions to submit IACUC verification for
competing application subsequent to peer review but prior to award ·
This concept is often referred to as “just in time” ·
This change in PHS Policy is effective as of September 1, 2002 (for
all applications submitted for the May-June 2003 Advisory Council dates) ·
www.aamc.org/advocacy/library/washhigh Senate
Panel Completes NIH Doubling ·
On July 18 the Senate Labor-HHS-Education Appropriations Committee
approved an FY 2003 spending bill that completes the doubling of the NIH
budget in 5 years and provides substantial growth for education programs ·
Overall the bill appropriates $136.6 billion—a
7% increase over last year—in discretionary funding for the
departments of HHS, Education, and Labor ·
For the Agency for Healthcare Research and Quality (AHRQ), the bill
provides $308.6 million (2.8% increase over FY 2002 and $56.9 million
more than the President’s budget) ·
This includes a $5 million set-aside for bioterrorism and $5
million for patient safety ·
The bill also eliminates the proposed $10 million transfer from
AHRQ to the Census ·
In this bill, AHRQ would be completely funded with budget authority ·
The Committee’s mark provided $189.4 million for the National
Health Service Corps (an increase of 30.2% over the current year and the
same level as recommended by the President) ·
www.aamc.org/advocacy/library/washhigh Medicare
Final Inpatient Rule ·
On August 1 The Centers for Medicare and Medicaid Services (CMS)
published its federal fiscal year 2003 Medicare
inpatient prospective payment system final rule ·
CMS rescinded a policy suggested in the proposed rule to expand its
post-acute transfer policy from the current 10 DRGs to all DRGs ·
Under the policy, hospitals discharging patients associated with
one of the 10 DRGs to a post-acute facility prior to the corresponding
average LOS would receive less than the full DRG payment ·
If CMS’ proposal to expand this policy had been implemented, it
would have meant almost $2 billion less in Medicare payments to
hospitals ·
CMS did not back off its decision to increase the outlier threshold
by 60% ·
Under the final rule, the federal FY 2003 outlier threshold will be
$33,560 (up from $21,025 in federal FY 2002) ·
The final rule also implements an update to the standardized
payment amount of 2.95%--this reflects a market basket increase of3.5%,
less 0.55 percentage points (as specified in current law) ·
In legislation passed recently by the House of Representatives
(HR4954), the federal FY 2003 update would equal the full market basket
increase (the Senate has yet to act on similar legislative proposals) ·
CMS proposed a number of changes to the provider-based criteria
that must be met for an entity to bill under the Medicare outpatient
prospective payment system ·
CMS decided not to increase the labor-related share of DRG payments
that is adjusted by the hospital wage index, as had been proposed ·
www.aamc.org/advocacy/library/washhigh Bills/Resolutions
Update H.R.
3487/S.1864 “Nurse Reinvestment Act” ·
On July 22, both the House and Senate passed the final version to
address the nursing shortage ·
House and Senate negotiators reached an agreement on a single,
uniform measure that establishes new programs including scholarships,
loan repayments, public service announcements, retention grants (best
practices-Magnet), career ladders, geriatric training grants, and loan
cancellation for nursing faculty ·
On August 1, President Bush signed the Nurse Reinvestment Act into
law—became Public Law
No: 107-205 ·
ANA President Barbara Blakeney, MS, APRN, BC, ANP was among the
congressional and other national leaders who joined the president for a
signing ceremony in the Oval Office at the White House ·
It
is essential that we take the time to thank Members of Congress for
their attention and action on this important issue—this is a perfect
opportunity to express gratitude to your Senators and Representative ·
****This act does not allocate any funding for the new programs, so
Congress will have to appropriate the money separately—Members
of Congress need to hear from nurses
about the importance of providing adequate FY 2003 funding for
the new legislation**** ·
Please
take the time to send a message to both of your Senators and your
Representative to express your appreciation to them for their support
and urge them to provide adequate funding for implementation of the
“Nurse Reinvestment Act” ·
Go to www.congress.org
to contact them by email ·
www.aamc.org/advocacy/library/washhigh H.R.4954
“Medicare Modernization and Prescription Drug Act of 2002” Sponsor: Representative Nancy L. Johnson Introduced:
June 18, 2002 Latest
Major Action: on July 27,
passed by the House Summary:
go to www.thomas.loc.gov ·
Under this legislation, the portion of a hospital’s resident
limit that is being “unused” would be redistributed to teaching
hospitals seeking to increase their resident limits ·
The slots that would be redistributed would be eligible for direct
graduate medical education (DGME) payments, but not indirect medical
education (IME) payments ·
The Congressional Budget Office (CBO) has scored the provision at
$1 billion over 10 years ·
www.aamc.org/advocacy/library/washhigh S.
812 “Greater Access to Affordable Pharmaceuticals Act of 2001” Sponsor:
Senator Charles E. Schumer Introduced:
May 1, 2001 Latest
Major Action: Passed/agreed
to in Senate Summary:
Allows a drug to be considered a bioequivalent to a listed drug
if the effects of such drug and the listed drug do not show a
significant difference based on certain tests or studies.
Sets forth requirements concerning the filing of a citizen
petition review. H.R.
1862 “Greater Access to Affordable Pharmaceuticals Act of 2001” Sponsor:
Representative Sherrod Brown Introduced:
May 16, 2001 Latest
Major Action: On June 1,
2001 referred to Subcommittee on Health ·
S.812 amends the federal
Food, Drug, and Cosmetic Act to provide greater access to affordable
pharmaceuticals through increased access to generics ·
The bill is being used as a
base legislative vehicle for Senators to offer competing amendments to
expand the prescription drug benefit under Medicare ·
Amendments to increase
Medicare provider payments for hospitals, physicians, and other
providers may be offered as well ·
www.aamc.org/advocacy/library/washhigh H.R. 4600 “Help Efficient, Accessible,
Low Cost, Timely Healthcare Act” (HEALTH Act) Sponsor: Representative
James C. Greenwood Introduced: April 25,
2002 Latest Major Action: On
May 6, 2002, referred to Subcommittee on Health ·
Due to last minute scheduling
changes by the House Judiciary Committee, mark-up of this bill has been
postponed until after the August recess (the committee had originally
scheduled a mark-up for July 23) ·
Department of HHS Secretary
Tommy Thompson released a report on July 24 that blames excessive
litigation for rapidly increasing malpractice insurance premiums ·
The report, Confronting the New Health Care
Crisis: Improving Health
Care Quality and Lowering Costs by Fixing Our Medical Liability System,
maintains that excessive litigation also drives increases in health
insurance costs and discourages providers from sharing medical errors
data that could improve the quality of patient care ·
www.aamc.org/advocacy/library/washhigh S. 2793 “Help Efficient, Accessible,
Low Cost, Timely Health Care (HEALTH) Act of 2002” Sponsor: Senator John
E. Ensign (R-NV) Introduced: July 25,
2002 Latest Major Action: Referred
to Committee on the Judiciary H.R. 5253 “Medical Liability Insurance
Crisis Response Act of 2002” Sponsor: Representative Max Sandlin (D-TX) Introduced: July 26,
2002 Latest Major Action: Referred
to Committees on Judiciary, Energy and Commerce, Ways and Means, and
Education in the Workforce ·
S. 2793 caps awards for
non-economic damages at $250,000, disallows joint and several liability,
and limits attorneys’ contingency fees ·
Also caps awards for punitive
damages, permits payment of large awards over time, establishes statues
of limitations, and addresses collateral source benefits ·
H.R. 5253 permits the
application of anti-trust laws to the malpractice insurance industry,
mandates guaranteed renewals and coverage for physicians with zero
claims over the past 3 years, and forces any company that discontinues
its malpractice product in a certain market to discontinue all lines of
business in that market ·
The above also mandates
mediation before any action goes to trial ·
The bill includes provisions
that address the nursing shortage and establish “prompt-pay”
guidelines/penalties for group health plans ·
With one exception (allowing
payments of large awards over time), H.R. 5253 does not include any of
the provider protections contained in H.R. 4600 ·
www.aamc.org/advocacy/library/washhigh H.R. 5005 “Homeland Security Act of
2002” Sponsor: Representative
Richard K. Armey Introduced: June 24,
2002 Latest Major Action: On
July 26 the House resolved into Committee of the Whole House on the
state of the Union for further consideration S. 2452 “National Homeland Security and
Combating Terrorism Act of 2002” Sponsor: Senator
Joseph I. Lieberman Introduced: May 2,
2002 Latest Major Action: on
June 24 Senate preparation for floor—placed on Senate Legislative
Calendar under General Orders ·
These largely mirror the
president’s proposal for the new department ·
www.aamc.org/advocacy/library/washhigh Appropriations
Committee ·
When Congress returns to Washington following Labor Day, it will
face the ritual September rush to complete the 13 appropriations bills
before the October 1 start of the federal fiscal year ·
The Senate Appropriations Committee has cleared all 13 spending
bills, but only 3 have been approved on the Senate floor ·
The House has passed 5 bills, but 7 have not even been considered
at the subcommittee level ·
www.aamc.org/advocacy/library/washhigh
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