Government Affairs Update and Training Webinar for Chapter Legislative Representatives

Transcription

1 Government Affairs Update and Training Webinar for Chapter Legislative Representatives February 26, 2015 Lisa Tomlinson, Vice President of Government Affairs and Practice Guidance Nancy Hailpern, Director, Regulatory Affairs Laura Evans, Legislative Affairs Representative 1

2 Objectives Provide overview and training on the role of CLRs Provide updates on: Federal Legislative Issues Federal Regulatory issues State Legislative Issues APIC Overview 2

3 Vision: Healthcare without infection Mission: Create a safer world through prevention of infection Strategic Goals 2020 Patient Safety: Demonstrate and support effective infection prevention and control as a key component of patient safety. Strategic Goals Implementation Science: Promote and facilitate the development and implementation of scientific research to prevent infection. IP Competencies and Certification: Define, develop, strengthen, and sustain competencies of the IP across the career span and support board certification in infection prevention and control (CIC ) to obtain widespread adoption. Advocacy: Influence and facilitate legislative, accreditation, and regulatory agenda for infection prevention with consumers, policy makers, health care leaders, and personnel across the care continuum. Data Standardization: Promote and advocate for standardized, quality and comparable HAI data. APIC Advocacy Team 3

4 APIC Government Affairs Team Staff Primary Role: background in government affairs and advocacy Chapters (CLRS) Public Policy Committee (PPC) Primary Role: clinical background with volunteer public policy experience Chapter Legislative Representatives (CLRs): clinical and chapter/local volunteer experience APIC Staff APIC Policy Influence Public Policy Committee 2015 Public Policy Committee Committee Chair Annemarie Flood RN, BSN, MPH, CIC Committee Vice Chair D. Kirk Huslage RN, BSN, MSPH, CIC Members Rebecca Fitzpatrick DNP, RN, CIC Patrick Kleinkort RN, BSN, MHA, CIC Mary Alice Lavin RN, MJ, CIC Rosie Lozano MPH, CIC C. Nancy O Connor MBSA, BSN, RN, CIC Tarry Samsel BSN, RNC, CIC Mary Virgallito RN, MSN, CIC Senior Advisor Susan Dolan RN, MS, CIC 4

5 2015 Chapter Legislative Representatives Rebecca Stockwell Mary-Lark Dupont Mary Alice Lavin Patricia Marquez Angela Gerken Stephanie Kreiling Cindy York Joanne Holman Diane Bennett Carol Ward Maribeth Coluni George Allen Mary Shanks Sharon Bradley Christine Kettunen Joan Bartholomew Pongpetch Hansrisuk Rosie Lozano Katie Cary Emily Mills Amy Nichols Jan Ratterree Janet Suttmiller Sharon Berry Erica Disharoon Patti Steger Amy Jablonowski Paula Lister Kerry Flint Nancy Barrett Susan Slavish Sarah Tice Sheila Fletcher Arlene Brumbach Stephanie Lambert Kelley Garner Kitti Flood Karla Walsh Suzanne Mamrose-Hunt Abby Kengersky Barbara Roman Patrick Kleinkort Valerie Henderson Shilla Patel Beth Goodall M. Jeanne Cummings Larry Krebsbach Michelle Kaiser Paul Thomas Dr. Patti Grota Casey Landholt Kymberly Lengyel Cathy Stampfli Rhonda Reed Amanda Valyko Tonya Anderson Romero Tarry Samsel Helen Garcia Melissa Allen Carolyn Cooper Katherine Ward Susan Cramer Linda Johnson Linda Goddard Donita Gorman Ashlie Milford Barbara Brenchley Vivian Nutsch Carol Wilkie Virginia Swindle Connie Bush Janet Bacon Troy Cutler Charlotte Wheeler Tobin Johnson DeeAnn Vaage Caroline Taylor CLR Roles and Responsibilities 5

6 CLRs: Chapter Legislative Representative Roles and Responsibilities Must be knowledgeable about APIC policy positions. Have an interest in and be willing to develop expertise in the legislative process and on federal and state legislative and regulatory issues. Serve as the primary contact between the chapter and APIC staff on public policy issues. Provide public policy reports at all chapter meetings. Mobilize chapter members to respond to issues, when requested by APIC staff, and provide necessary follow up to both chapter members and staff. Respond to APIC Action Alerts, notices, and other communication in a timely manner. Share major outcomes of chapter grassroots efforts with APIC. Communication Tips 6

7 What is APIC? APIC, founded in 1972, is an international organization of more than 15,000 members. APIC is the leading provider of infection prevention resources through education, training, government advocacy, and implementation of research. APIC members represent healthcare facilities including hospitals, outpatient surgery centers, long-term or specialty care facilities, and home care groups as well as industry, and local and state health departments. Many members serve on committees or boards of national organizations to influence improvements in patient safety in all healthcare settings. Who are Infection Preventionists? Policymakers may be familiar with infection prevention, but may not realize that there is a person whose job it is to prevent healthcareassociated infections (HAIs). Effectively communicating who infection preventionists (IPs) are will help policymakers understand the many hats that IPs wear on the job. IPs are professionals who dedicate their careers to preventing HAIs. These professionals play a significant role in: Developing proven policies to ensure a safe environment for patients. Ensuring compliance with standards and regulations designed to protect patients and healthcare workers. Tracking and monitoring activities to identify HAIs and other infectious agents. Acting as leaders in emergency preparedness to be ready for events such as an influenza pandemic or acts of bioterrorism. Leading and participating in healthcare quality improvement efforts. Educating the public and healthcare personnel about infectious diseases and how to limit their spread. Reporting communicable diseases to the CDC. 7

8 Frequently Asked Questions? Communicating with Policymakers These images from APIC s Infection Prevention and You campaign are a perfect example of the level of communication a policymaker may be able to process. 8

9 Poll Question Which of the following APIC resources are you familiar with? (Check all that apply) Legislative Information and Toolkit 9

10 State Key Contacts Included in each CLR training manual is a list of key contacts within each state that a chapter covers. For example, the CLR manual for APIC Chapter 123 Intermountain Region will contain key contacts for Idaho, Montana, Oregon, Nevada, Washington and Utah. Each list of key contacts includes the mailing address and phone number for the Governor, Lt. Governor (if applicable) and U.S. Senators. Instructions are provided for each CLR to locate their U.S. Representative, State Representative, and State Senator. The VIP Advocacy Toolkit The toolkit includes: Tips for planning a legislative visit Tips for deciding which legislators to meet with Tips for preparing materials Sample planning timeline Sample meeting request letters Sample talking points Sample follow-up letters 10

11 Primary CLR Resources Take Action APIC Action Alerts will be posted here. Find Elected Officials based on zip code. View current State legislation here. Subscribe to the VIP Action E-list. 11

12 Regulations This is a library of a wide range of Public Policy resources. For example: Proposed Federal regulations APIC comments on federal regulations Final Federal regulations Interactive State Legislative Map This is where you can check for legislative updates for specific states and/or by issues we follow Options: click on a specific issue choose a state from the pulldown menu click on a specific state on the map 12

13 How to Read State Summaries Link to read bill itself Summary provided by APIC s vendor Summary added by APIC Bill Status Public Policy Action E-List To sign up for the Action E- List, visit the Public Policy Overview page of the APIC website. Within the what s new page explanation, there is a link to join the Action E- List. The link will open a webpage that allows a user to enter basic information before joining the Action E-List. Additional APIC information is helpful but not required. Managing your Action E- List subscription is also available at this site. 13

14 CLR Community on MyAPIC The library can be used to share documents and contains previous CLR presentations. This is where members can post questions, share experiences and discuss regulatory/legislative issues. Events can be posted here. Announcements will be posted here. Additional Public Policy Resources 14

15 Additional Public Policy Resources What s New Page Presentation-Ready Maps CRE HAI MRSA Long-term Care Ambulatory Care Accessing APIC Regulatory Comments Public Policy Position Statements Chapter Presentation Slides 15

16 VIP Chapter Presentation Slides latest addition to APIC Government Affairs resources for CLRs intended for CLR to present Public Policy Information to chapter (approximately slides) federal issues issues under Public Policy Committee review available in the document section of the MyAPIC CLR community store in the CLR manual under Chapter Presentation Slides Federal Regulations 16

17 Key Federal Legislative Actions on HAIs Deficit Reduction Act Enacted HAC Policy to impact 2008 payment Uses funding as incentive for quality improvement House Committee and GAO Issues Report on Need for HAI Coordination 2009 American Recovery and Reinvestment Act (ARRA) Grants to States for HAI Coordinators and activities Omnibus Appropriations Act States to develop HAI Plans (or lose block grant funds) National Action Plan to Prevent HAIs Response to Congressional Hearing and GAO report Plan to better coordinate federal HAI activities 2010 Affordable Care Act (Obamacare) Required HAI reporting as part of healthcare quality improvement programs CMS Hospital Quality Improvement Programs Hospital-Acquired Conditions (HAC)/ Present on Admission (POA) indicators Hospital Inpatient Quality Reporting (IQR) Program Hospital Value-Based Purchasing (VBP) Program HAC Reduction Program (coming in FY 2015) 17

18 Hospital-Acquired Conditions (HAC) Non-reimbursement policy Non-reimbursement policy (impacted payment in beginning October 2008) Prohibits reimbursement of designated HACs that were not present on admission HAI-HACs include vascular catheter-associated infections; CAUTI; and SSIs following coronary artery bypass graft, certain orthopedic procedures, bariatric surgery for obesity and cardiac implantable electronic device HACs identified through claims data Reporting Federal HAI Reporting to NHSN for CMS Quality Reporting Programs CLABSI Acute Care ICUs (Jan.) CAUTI Acute Care ICUs (except NICUs) (Jan.) CAUTI LTCH, IRF, Cancer Hospitals (Oct) SSI Colon Surgeries and Abdominal Hyst. Acute Care (Jan) Dialysis Events ESRD (Jan) CLABSI LTCH, Cancer Hospitals (Oct) C. Diff Acute Care (Jan.) MRSA Bacteremia Acute Care (Jan.) HCP Influenza Vaccination Acute Care (Jan.) HCP Influenza Vaccination LTCH (Jan.) HCP Influenza Vaccination ASCs/Hosp. Outpt. Depts. (Oct.) SSI Cancer Hospitals (Jan.) HCP Influenza Vaccination IRF (Oct.) CLABSI Acute Care Med, Surg, Med/Surg Units (Jan.) CAUTI Acute Care Med, Surg, Med/Surg Units (Jan.) MRSA Bacteremia LTCH (Jan.), IRF (Jan.) C. Diff LTCH (Jan.), IRF (Jan.) HCP Influenza Vaccination Inpt. Psych. Fac. (Oct.) VAE LTCH (Jan.) Payment

19 Hospital Value-Based Purchasing (VBP) Program Total Performance Score determined by hospital s achievement and improvement compared to a 9-month baseline period Established by the Affordable Care Act as incentive program to improve quality of healthcare. FY 2013 first year of payment adjustments under the VBP program FY 2015 first year NHSN-reported HAIs included in VBP program Hospital-Acquired Condition (HAC) Reduction Program Penalty for poor performance Hospitals that rank in the lowest-performing quartile of HACs receive a 1% penalty Payment adjustment to account for HACs with discharges beginning October 1, 2014 (FY 2015) Total HAC score based on measures in 2 domains: Domain 1 includes certain AHRQ Patient Safety Indicators (determined by claims data) Domain 2 consists of HAI measures reported through NHSN 19

20 Acute Care Payment Program Measures CLABSI (ICU) NHSN reporting began 2011 CMS payment for reporting began FY 2013 Added to VBP beginning with FY 2015 payment Added to HAC Reduction Program beginning FY 2015 CLABSI (medical, surgical, med/surg wards) NHSN reporting begin 2015 CMS payment for reporting begin FY 2017 Acute Care Payment Program Measures CAUTI (ICU) NHSN reporting began 2012 CMS payment for reporting began FY 2014 Added to VBP beginning with FY 2016 payment Added to HAC Reduction Program beginning FY 2015 CAUTI (medical, surgical, med/surg wards) NHSN reporting began 2015 CMS payment for reporting begin FY

21 Acute Care Payment Program Measures Surgical Site Infection following colon surgery/ abdominal hysterectomy NHSN reporting began 2012 CMS payment for reporting began FY 2014 Added to VBP FY 2016 payment Added to HAC Reduction Program FY 2016 payment MRSA Bacteremia LabID Event NHSN reporting began 2013 CMS payment for reporting began FY 2015 Added to VBP FY 2017 payment Added to HAC Reduction Program FY 2017 payment Acute Care Payment Program Measures C. difficile Infection LabID Event NHSN reporting began 2013 CMS payment for reporting began FY 2015 Added to VBP FY 2017 Added to HAC Reduction program FY 2017 HCP Influenza Vaccination NHSN reporting began 2013 CMS payment for reporting began FY 2015 Later revised to coincide with flu season data collection October 1 March 31; single report to NHSN by May 15 of year season ends 21

22 Quality Programs Outside of Acute Care PPS-Exempt Cancer Hospital Quality Reporting Program (PCHQRP) CLABSI (2012), CAUTI (2012), SSI -COLO, AB/HYST (2014) Long-Term Care Hospital Quality Reporting Program (LTCQRP) CLABSI (2012), CAUTI (2012), HCP flu vaccination (2013), MRSA (2015), C.diff. (2015), VAE (coming 2016) End-Stage Renal Disease (ESRD) Quality Incentive Program BSI in outpatient hemodialysis, HCP flu vaccination ( flu season) Hospital Outpatient Quality Reporting Program HCP flu vaccination ( flu season) Ambulatory Surgical Center Quality Reporting Program (ASCQRP) HCP flu vaccination ( flu season) Inpatient Rehabilitation Facility (IRF) Quality Reporting Program CAUTI (2012), HCP flu vaccination (2014), MRSA (2015), C.diff (2015) Inpatient Psychiatric Facility (IPF) Quality Reporting Program HCP flu vaccination ( flu season) Other Agencies Regulating Infection Prevention CDC Focus: Evidence-based guidelines for infection prevention and control practice OSHA Focus: Worker safety Examples: Bloodborne Pathogens Standard, Respiratory Protection Standard, considering possible Infectious Disease Standard FDA Focus: Regulation of drugs; medical devices; human blood, tissue and cell products EPA Focus: Regulation of disinfectants and sterilants; medical waste incinerators State and local health departments 22

23 Federal Legislation Funding for federal programs Centers for Disease Control and Prevention (CDC) $32 million for NHSN and the Prevention Epicenters Program $30 million for Advanced Molecular Detection (AMD) and response to infectious diseases program $500 million Core Infectious Diseases, which would include funding for: HAIs Antimicrobial Resistance Emerging Infections Program (EIP) $264 million Antibiotic Resistance Solutions initiative Agency for Healthcare Research and Quality (AHRQ) $10 million for HAI research grants $4 million for HAI contracts including the Comprehensive Unit-Based Safety Program (CUSP) National Institutes of Health (NIH) $4.6 billion for the National Institute of Allergy and Infectious Diseases (NIAID) antibacterial and related diagnostics efforts 23

24 Antibiotic resistance Federal antibiotic resistance initiatives include: Antibiotic Resistance Solutions Initiative Would establish State AR Prevention programs Would create new AR isolate bank and network of regional laboratories Would provide real-time data on antibiotic use and resistance trends using NHSN 21 st Century Cures legislation Would allow a limited population approval pathway for antibacterial drugs Would provide for higher Medicare reimbursement of certain antibiotic drugs State Legislation 24

25 Pending state legislation Immunization WV HB 2556 and SB 286 Would allow medical and personal exemptions from mandatory immunizations for school children. MN HF 393 and SF 380 Would require education from a physician on the risks and benefits of vaccination prior to receiving an exemption from school immunizations requirements. Quarantine NM SB 362 Would establish protocols for the New Mexico Department of Health to place individuals under quarantine. TX SB Would allow the Governor to declare a state of infectious disease emergency and establishes procedures for the Texas Department of State Health Services to place individuals under quarantine. MN HF 22 Would establish financial protections for individuals under quarantine, including requiring the state/employer to cover any lost income. Malpractice NY AB 1124 Would allow an individual who contracts an HAI to bring a cause of action for injuries suffered as a result of the infection pursuant to the statute of limitations. Looking ahead: NHSN State Competition The NHSN competition is on! APIC is supporting the President s budget request of $32 million for NHSN and the Prevention EpiCenters. APIC will soon be asking members to send a letter to Members of Congress supporting funding for NHSN and other federal infection prevention programs. The state with the highest percentage of letters sent will win a prize! Alert your chapter today! 25

26 Questions? Lisa Tomlinson, MA, Vice President of Government Affairs and Practice Guidance Overall government affairs and practice guidance strategy Nancy Hailpern, Director of Regulatory Affairs Federal regulatory issues HAI reporting at the federal level Laura Evans, Legislative Affairs Representative Federal and state legislation Legislative maps When in doubt, 26