2013 North Dakota Legisla4ve Update: What Does it Mean for Rural Health? June 27, Brad Gibbens, Deputy Director and Assistant Professor

Transcription

1 2013 Nrth Dakta Legisla4ve Update: What Des it Mean fr Rural Health? June 27, 2013 Brad Gibbens, Deputy Directr and Assistant Prfessr

2 Established in 1980, at The University f Nrth Dakta (UND) Schl f Medicine and Health Sciences in Grand Frks, ND One f the cuntry s mst experienced state rural health ffices UND Center f Excellence in Research, Schlarship, and CreaMve AcMvity Hme t seven namnal prgrams Recipient f the UND Award fr Departmental Excellence in Research Fcus n EducaMng and Infrming Plicy Research and EvaluaMn Wrking with CmmuniMes American Indians Health Wrkfrce Hspitals and FaciliMes ruralhealth.und.edu 2

3 Lngest sessin in histry full 80 Passed 475 bills Big Time Mney fr a Small State Largest state budget in histry - $14 billin (abut $10 B mre than 2003) $6.9 B in apprpria4ns (up 31%) $2.3 B fr rads and infrastructure $515 M in water and fld prjects Sales revenue is number ne surce f state revenue fllwed by il, incme, and prperty $1.1 billin in aid t western ND $1.1 billin in prperty tax, sales, persnal & crp. incme tax relief Department f Health budget - $44 m (was $33) Legacy Fund (can t spend un4l 2017) ver $1 B (riginal es4mate was $600 m) 3

4 Nrth Dakta Rural Health Asscia4n Significant amunt f legisla4n imprtant t rural health was tracked (hspital, public health, health technlgy, lng term care, mental/ behaviral health, insurance, tribal health, human services, nursing, ral health, pediatrics, pharmacy, general health plicy, and wrkfrce) Rebecca, Kylie, Nikki, Jdy, Twyla, Kris4ne, Lyneee, and Brad n CRH Plicy Cmm. Wrked with NDRHA Plicy Cmmieee Issued a weekly reprt that updated bill status 4

5 Key Legisla4n HB 1362 Medicaid Expansin Effec4ve January 1, 2014, expands up t 138% f FPL fr peple 18-62, add 20-32,000 Nrth Daktans t health insurance SB 2187 Medical Facility Infrastructure Lan Prgram - $50 M revlving lan fund with $ frm Bank f ND (culd expand t $100 M frm anther surce) pririty t CAHs, 1% lw interest lans HB 1358 Oil and Gas bill with numerus effrts t add- n fr CAHs can t d Bad Debt s, $9.6 millin grant prgram that can be used n smware t check credit wrthiness il prducing cun4es can t result in having a psi4ve margin 5

6 Key Legislatin HB Expanded service payments fr elderly and disabled rebase RHC t the Medicare rate fr Medicaid payments increase payments t rural clinics by abut $1.4 M als preserve cst based fr lab and x- ray s abut $1.3 M fr CAHs HB 1135 Dental Care $100,000 fr dental care service grant t rganiza4n that will prvide dental care services t lw incme and underserved children SB 2031 Tribal Health - create public health districts exclusively within the barder f a reserva4n Failed 6

7 Key Legisla4n HB 1443 Diabetes cllabra4n between NDDHS, NDDH, Indian Affairs Cmmissin, and PERS t iden4fy gals and benchmarks and individual agency plans t reduce the incidence f diabetes, imprve diabetes care, and cntrl cmplica4ns. Shw financial impact f diabetes, and cnsider future budget items HB 1360 PACE Extends Prgram fr All- Inclusive Care fr the Elderly which is available in Dickinsn and Bismarck and expand t Mint, Farg, Garrisn, Hazen, Bwman, and Lamure helps t keep elderly in their hmes 7

8 Key Legislatin SB 2030 Public Health Netwrks new defini4n t be 2 units serving minimum pp. f 15,000 t prvide cre PH ac4vi4es r 3 PH units (n pp min) $700,000 (cap f $250,000 per netwrk) HB DHS Budget included $320,000 fr TBI Resurce Facilita4n 8

9 Key Legisla4n SB 2172 Newbrn screening all newbrns delivered at a hspital birthing center will be screened fr cngenital heart defects thrugh pulse ximetry HB 1175 STEMI/Heart Systems f Care Adds acute cardivascular system t trauma and strke systems fr cn4nued wrk fr enhancing acute heart events, emergency respnse systems, hspital designa4n and registry SB 2004 Health Department Budget Expanded strke funding ($383,000 includes supprt fr CAH Quality Netwrk technical supprt, 2 addi4nal speech aphasia pilt prgrams, public educa4n n calling 911, and EMS/Hspital Training) STEMI/ Cmmunity Paramedicine.5FTE psi4n 9

10 Fr the Future 41 interim studies apprved (ut f 69) Cmprehensive f care fr individuals with brain injuries (including veterans) ND health care system needs and challenges, implemen4ng Healthy ND, examining Medicaid refrm, feasibility f develping a plan fr a private health care mdel that will cmply with federal health refrm Study health care refrm p4ns, including the implementa4n f the federal Affrdable Care Act if the federal law remains in effect and state alterna4ves fr state- based health care refrm if the federal law is repealed Study the affects f the ACA including alterna4ves t the law and the Medicaid expansin 10

11 Fr the Future Study hw t imprve access t dental care (including feasibility f mid- level prviders) Study behaviral health needs fr yuth and adults Study current state and federal benefits t veterans (including incme and prperty taxes) Study cmprehensive statewide tbacc preven4n and cntrl plan Study hme and cmmunity- based services including the need t expand Medicaid waiver t cver 24 hur emergency assistance, adult cmpanin service, behaviral prgramming, chre services, and thers Study feasibility and desirability f cmmunity paramedics prviding addi4nal clinical and public health services, par4cularly in rural areas 11

12 Fr the Future Maximum state cntribu4n fr state emplyee health benefits Study the intellectual prperty plicies and prcedures at the research universi4es Statewide childcare services Grwth in prperty tax (par4cularly whether the level f tax relief t taxpayers is cmmensurate t level f state funds t the pli4cal subdivisins) Rejected a study f the western ND man camps 12

13 Cntact us fr mre infrmatin! 501 Nrth Clumbia Rad, Stp 9037 Grand Frks, Nrth Dakta ruralhealth.und.edu 13