Government Liaison Report CLSA Annual Meeting – Fairbanks, Alaska Submitted April 19, 2013

1. Legislative Symposium March 18 - 19 2013 Washington D.C. Government Liaison Report CLSA Annual Meeting – Fairbanks, Alaska Submitted April 19, 2013 David M. Pierce

2. Legislative Symposium ReviewObjectives • Following this presentation participants will be able to: • describe the Legislative Symposium process • discuss three current areas of legislative concern to the laboratory community • relate the national legislative concerns to the issues facing clinical laboratories in Alaska

4. Why Have a Legislative Symposium? • Discuss laboratory organizations viewpoints on current healthcare issues • Describe the elements of a congressional office and how to effectively communicate with congressional staffers • Present laboratory organizations concerns to Congressional representatives in a clear, concise and educated manner • Present the concerns of the laboratory community particularly as they apply to Alaska

5. Alaska’s Congressional Delegation Senator Senator Representative Mark Begich Lisa Murkowski Don Young

6. Pre-visit instruction • Judy Yost (CLIA Office) presented a comprehensive update on CLIA issues • Thorough overviews to each of the legislative and regulatory issues were presented with emphasis on the potential impact to the laboratory industry • Participants had an opportunity to role-play a visit which was very helpful to put us at ease during the actual visit.

8. Concerns of the Laboratory Community • Laboratory professionals the impact of clinical laboratory services on the costs of healthcare • We need to tell our story • What we do • Laboratory professionals add value to healthcare • 70% of medical decision decisions are based on laboratory data • Downstream costs are reduced because of the value of the clinical laboratory • Who are we • We all have different experiences • Tell your story and make it personal

9. Concerns of the Laboratory Community • Clinical Laboratory payment cuts are arbitrary and don’t produce true cost savings. • Cuts in laboratory fees jeopardize our ability to continue to provide safe, effective and efficient laboratory services which ultimately increases costs for non-laboratory services • The cost for patient isolation is much greater than MRSA screening by PCR • Laboratory testing reduces hospital re-admission rates • Laboratory reimbursements total 2% of all Medicare costs but labs have absorbed 40% payment cuts in real dollars (not inflation adjusted) even though the cost of providing services has doubled since 1984 • We are doing more with less but have reached our capacity. • Fees in rural areas ( e.g. Alaska) need to reflect actual costs • Laboratories are struggling to hire qualified staff

11. Concerns of the Laboratory Community • Reauthorization of the workforce investment act • 40% of lab workforce will retire within 10 years and the laboratory community will need 11,000 new workers annually through 2018; fewer than 5000 graduates per year • In reauthorizing the workforce Investment Act congress should • Include provisions that make institutions of higher learning partners in job creation initiatives • Make public institutions of higher learning automatically eligible as job-training providers • Designate medical laboratory personnel education programs as preferred programs • Small hospitals and clinics in Alaska face critical shortages and are paying much higher labor costs for per diem techs

12. Visits to Congressional Offices • Alaska CLSA members in attendance were: David Pierce Shellie Smith and Shannon Billings • All members of the Alaska delegation from CLSA were able to visit congressional staffers in Senators Murkowski and Begich’s offices. Shannon and Shellie visited Representative Young’s office • We had pleasant visits with the Congressional staffers as we discussed the concerns of the national lab organizations and impressed upon them the concerns specific to Alaskans

13. Russell Senate Office Building

14. Hart Senate Office Building

15. Rayburn House Office Building

16. How to make your voice heard • What do our congressional delegates want to hear? • Let them know that they are YOUR representatives • They don’t pay much attention if you are not a constituent • Be clear, concise and considerate • Tell them what you want – no complaints • Phone calls are logged – when a “critical mass” is reached, the aide responsible gets a memo. • No mass mailings

18. Visits to Congressional Offices Conclusions: • The aides were cordial and demonstrated serious interest in the laboratory community’s concerns: we received assurance that our message would be relayed to each of the Congressmen • There was considerable interest in the length of time for medical laboratory training programs - all three aides asked that particular question. • The time and money used to bring the laboratory’s concerns to the forefront are efforts well spent – a legitimate voice in our nation’s capitol will ensure the viability of the clinical laboratory as a profession of merit.

19. The End