A Report of the 2011 General Assembly Session

1. A Report ofthe 2011 General Assembly Session Mr. Mark Rubin, JD Executive Director of Government Relations for VCU and VCUHS

2. The 2011 Session • A “Short Session” of 45 days – amendments to the biennial budget offered by the Governor and General Assembly • Overtones of upcoming elections and redistricting prevalent in some legislation • McDonnell Administration is focused on efforts to continue to create jobs and improve the Commonwealth’s economy • Federal money from the American Recovery and Reinvestment Act (stimulus funds) set to expire June 30, 2011 2011 Session Statistics 2882 Bills and 810 Resolutions Introduced 757 Bills Approved 4Bills Vetoed – 2 vetoes sustained VCU tracked 309+ Bills Government Relations V i r g i n i a C o m m o n w e a l t h U n iv e r s i t y a n d V C U H e a l t h S y s t e m

3. Higher Education Budget Summary • Restoration of $17M tuition revenue withheld in introduced budget • $5M to Massey Cancer Center for research • will augment private funds raised to treat more patients and conduct more research/clinical trials • will help achieve NCI Comprehensive Cancer Center designation • Maintained $3M for transfer of parking lot/slave burial ground to the City of Richmond Government Relations V i r g i n i a C o m m o n w e a l t h U n iv e r s i t y a n d V C U H e a l t h S y s t e m

4. Higher Education Budget Summary (Cont.) • Other Budget Items to Note: • 5% salary increase; offset by 5% VRS contribution • No change for ORP participants • $1.55M for financial aid • $1.7M for base adequacy adjustments • Secured administrative approval of $42M for General Classroom Building Government Relations V i r g i n i a C o m m o n w e a l t h U n iv e r s i t y a n d V C U H e a l t h S y s t e m

5. Higher Education Legislation Higher Ed Operating --Virginia Higher Education Opportunity Act – HB 2510, SB 1459 --Virginia Research and Technology Investment Program – HB 2324, SB 1485 --Six Year Capital Outlay Plan – HB 2328 Academic Standards --American Sign Language – HB 1435 --Cambridge College Programme – HB 1910

6. Higher Education Funding Model The Framework for Future Funding:  • Basic operations and instruction (E&G)  • Each Virginia undergraduate student actually enrolled  • Need-based financial aid  • Support for targeted financial incentives

7. State Inspector General • HB 2076 (Landes) and SB 1477 (Stosch) • The bill establishes the Office of the State Inspector General to investigate complaints alleging fraud, waste, abuse, or corruption by a state agency or non-state agency or their officers and employees. • The bill also authorizes the State Inspector General to examine the management and operation of state agencies. • The bill consolidates the offices of inspector general of the Departments of Behavioral Health and Developmental Services, Corrections, Juvenile Justice, and Transportation and the Department of the State Internal Auditor into this new office, and adds responsibility for the Tobacco Indemnification and Revitalization Commission. • The Governor, on or before December 31, 2011, shall, in consultation with impacted stakeholders, complete a plan for the coordination and oversight of the internal audit programs with the new Office of the State Inspector General. • The bill has a delayed effective date of July 1, 2012.

8. Health Budget Summary Restoration of Some Impending Reductions to Medicaid Program The 2010-2011 Biennium Budget included multiple reductions of Medicaid providers reimbursement rates. In June 2011, the following reductions were to be implemented: • 4% cut to providers • 4% cut of hospital inpatient rates • 4% reduction to hospital and outpatient hospital rates • 4% cut of reimbursement for dental care • Elimination of podiatry services for Medicaid patients • $7.1 reduction for indigent care at state teaching hospitals The General Assembly and the Governor approved to FULLY RESTORED the following cuts: • 4% cut to providers • 4% cut of hospital inpatient rates • 4% cut of reimbursement for dental care • Elimination of podiatry services for Medicaid patients The General Assembly did NOT RESTORE the following cuts • 4% reduction to hospital and outpatient hospital rates • $7.1 reduction for indigent care at state teaching hospitals Government Relations V i r g i n i a C o m m o n w e a l t h U n iv e r s i t y a n d V C U H e a l t h S y s t e m

9. Health Budget Summary (Cont.) • Other Budget Items to Note: • $30.0 million dedicated to Virginia’s Behavioral Health and Developmental Services Trust Fund • This funding will be used to transition individuals in training centers to community based settings. • Created in response to a Department of Justice report that recommended Medicare not pay for services provided by Hancock Geriatric Treatment Center. Payment for Medicare services provided was restored in March. • $34.5 million for intellectual disability and developmental disability waivers and to restore providers’ reimbursement rates for services administered to these patients. Government Relations V i r g i n i a C o m m o n w e a l t h U n iv e r s i t y a n d V C U H e a l t h S y s t e m

10. Health Budget Summary (Cont.) • Trauma Fund • Language was amended in the state budget to ensure payments to the trauma fund would not be reduced due to the collection of fees from those found guilty of a DUI, which were delayed due to court proceedings. • AIDS Drug Assistance Program • Governor McDonnell had included $3.6 million in state monies to address a shortfall in funding for the AIDS Drug Assistance Program (ADAP). • The program provides assistance with premiums and/or free medication to low income and uninsured AIDS patients. • The General Assembly reduced this amount to $2.6 million in 2012. The Department of Health is helping patients enroll in patient assistance programs offered by pharmaceutical companies to help pay for all non – HIV related medications that they will no longer purchase for patients. Government Relations V i r g i n i a C o m m o n w e a l t h U n iv e r s i t y a n d V C U H e a l t h S y s t e m

11. Health Legislation • Medical Malpractice and Peer Review Legislation • Medical Malpractice bills - HB 1459 and SB 771 • Stakeholders including the Medical Society of Virginia, the Virginia Hospital & Healthcare Association and Virginia Trial Lawyers Association agreed to legislative language that would increase the annual cap on the amount that could be recovered by the claimant of a medical malpractice suit. • Cap increases from $2 million to $2.05 million on July 1, 2012 • Cap will continue to increase by $50,000 annually until July 1, 2031 • General Assembly approves bills by large margins • Peer Review bills – HB 2373 and SB 1469 • This bill states that the communications of providers involved in a peer review case are privileged and protected from disclosure in court proceedings. • Approved by the General Assembly by large margins • Signed by the Governor • Governor McDonnell vetoes the Medical Malpractice bills • Argues Virginia has the highest medical malpractice cap in the nation • Believes that increasing the cap will not reduce the costs of healthcare • States he will not abandon promises made during his campaign for Governor to veto any legislation increasing the cap • General Assembly overturns the Governor’s veto

12. Additional Health Legislation • HB 1535 – Military experience accepted for licensure requirements • Requires the Boards of Medicine and Nursing to accept military training and practical experience for the didactic and clinical training required for licensure of a RN, LPN, respiratory therapist, occupational therapist, radiologist assistants and techs and nurses aides. • HB 1690 – Increases penalties for assaulting a healthcare provider in an Emergency Room • Patients who assault a health care provider in the emergency room will be charged at a minimum with a Class 1 misdemeanor and sentenced to serve at least 2 days in jail. • HB 1836 – Hospitals must provide mothers with a blood spot containing DNA of infant • Hospitals will have to provide mothers with a sample of blood from an infant born at the hospital. The DNA in the blood can be used to identify a child who is abducted or killed. • HB 1968 – Document requiring signature of physician deemed to include physician assistant • Whenever a law or regulation requires a signature of a physician it shall be deemed to include the signature of a physician assistant. • HB 2037 – Use of the title Social Worker • A person not licensed by the Board of Social Work cannot use the title “Social Worker”. There is an exemption for federally required and defined social workers in nursing homes and hospices. This law goes into effect July 2013. • SB 1117 – Nurse Practitioners and Physician Assistants permitted to Sign Death Certificates • This bill allows supervised nurse practitioners and physician assistants to determine the cause of death and sign a death certificate as long as they have access to the descendant's medical history and death is due to natural causes. Government Relations V i r g i n i a C o m m o n w e a l t h U n iv e r s i t y a n d V C U H e a l t h S y s t e m

13. Other Reoccurring Health Bills • Abortion Legislation • SB 924 – The bill as written required the Board of Health to create regulations for minimum standards for hospitals and nursing homes for infection prevention, disaster preparedness and facility security. • An amendment was added to require that facilities, in which five or more trimester abortions per month are performed, be classified as a hospital and subject to the requirements. The amendments also requires the Board of Health create these regulations within 280 days of enactment. • The Board of Health will make the proposed regulations public and vote on them in September. • HB 2434 – Under the federal Affordable Care Act the states had the option of creating a state based Exchange or could become a part of the federal Exchange. This bill which was passed by the General Assembly created a Virginia Health Benefits Exchange. • Governor McDonnell added an amendment to the bill that stated that insurance plans offered through the Exchange would be prohibited from covering abortions except when the pregnancy is the result of alleged rape, incest or when the life of the mother is endangered. • Insurance Coverage for Autism Spectrum Disorder • HB 1475 and SB 823 – The bills require health insurance companies provide up to $35,000 of insurance coverage annually for the diagnosis and treatment of autism spectrum disorder for children ages 2 – 6 years old. • Scope of Practice Legislation • No changes in 2011 • MSV and Virginia Nurses Association continue to discuss a compromise for expanding the scope of practice for nurse practitioners • Increase of Medicaid Eligibility Rates - FAILED • Legislation to increase the income requirements for eligibility for FAMIS from 200% to 225% of the federal poverty level failed. Government Relations V i r g i n i a C o m m o n w e a l t h U n iv e r s i t y a n d V C U H e a l t h S y s t e m

14. Your Legislative Concerns • We are here to advocate for you • The 2012 Legislative Agenda • Agenda for the legislative session is created in the Summer • Advance concerns or issues through your respective vice president for consideration • Become involved in the legislative process Government Relations V i r g i n i a C o m m o n w e a l t h U n iv e r s i t y a n d V C U H e a l t h S y s t e m

15. Office of Government Relations Website and Legislative Updates • Highlights of federal, state legislative and political news sent weekly • State and federal legislation being monitored is listed on the VCU Office of Government Relations website http://www.govrel.vcu.edu// Contact Us: (804) 828-1235 or govrel@vcu.edu Government Relations V i r g i n i a C o m m o n w e a l t h U n iv e r s i t y a n d V C U H e a l t h S y s t e m