Bon Secours Health System (Virginia)
2008 Virginia State Legislative Priorities

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Access
Bon Secours Health System in Virginia (Richmond & Hampton Roads) SUPPORTS those initiatives of the Governor’s Health Care Reform Commission with regard to access, specifically those initiatives included by the Governor in his proposed 2008- 2010 biennial budget.

• The “VirginiaShare” Health Insurance Program will expand access to health insurance coverage for low income families who work for small businesses with 50 or fewer employees and who earn 200% or less of the Federal Poverty Level (FPL); the program — which will be a pilot — will expand coverage to only about 5,000 of Virginia’s one million uninsured persons, but is a step in the right direction. The state will cover one-third of the premiums (up to $75 a month) for participating
  individuals; the individual and his employer will each cover half of the remaining premium amount. (Cost: $7.7 million/biennium)
  
  
• Additional Funding for Community-Based Safety Net Providers will provide funding for operating costs, expanded access, and better care coordination, to the Virginia Healthcare Foundation, Virginia Association of Free Clinics. ($10 million over the biennium)
  
  
• Funding to Expand Eligibility for Prenatal Coverage will increase eligibility from 185% of the Federal Poverty Level to 200%. This will provide coverage to an additional 400 low income pregnant women a year under the FAMIS MOMS program. (Cost: $2.6 million GF, $4.8 million NGF over the biennium)
  
  
• Support for the Virginia Breast and Cervical Cancer Early Detection Program (VABCCEDP): Also known as “Every Woman’s Life”; provides free screenings and diagnostic testing for breast and cervical cancer for uninsured women. Program funding would increase by $300,000 in FY 2010; screenings and tests would be provided to more than one thousand uninsured women, aged 18-44.

Bon Secours also SUPPORTS increased funding to cover enrollment, utilization
and inflation growth in baseline Medicaid and FAMIS programs ($371.3 Million GF; $414.4 Million NGF over the biennium). Bon Secours — while not actively seeking increases in Medicaid provider payment rates — nevertheless urges the Governor and the General Assembly to at the very least maintain existing reimbursement rates.

Mental Health
Bon Secours Health System in Virginia is in general agreement with the Governor and the Virginia Tech Review Panel that changes must be made in a number of the state’s mental health laws and processes. Specifically, we SUPPORT:

• Extension of Emergency Custody Orders to Eight Hours (VT Panel recommendation IV-13)
  
  
• Requiring the Independent Evaluator of a Temporary Detention Order Patient to be Available During a Hearing. Bon Secours does NOT support a requirement that the treating physician be in attendance since the court hearing often occurs before the treating physician has evaluated the patient, and because the treating physician’s presence could potentially compromise a future therapeutic relationship
  with the patient. (VT Panel recommendation IV-20)
  
  
• Changing the Criteria for Emergency Custody and Temporary Detention from the “Imminent Danger” terminology to: “substantial likelihood that in the near future he will (a) cause serious physical harm to himself or to another person, as evidenced by recent behavior causing, attempting, or threatening such harm, or (b) suffer serious harm due to substantial deterioration of his capacity to protect himself from such harm or provide for his basic human needs.” (VT Panel recommendation IV-15)
  
  
• Explicitly authorizing the Disclosure of Information Between Providers in order to Deliver, Coordinate or Monitor Treatment, and between Providers and the Courts to Monitor and Report on Service Delivery and Compliance with Treatment. (VT Panel recommendation V- 22, 24)

Quality and Prevention
Bon Secours supports a package of proposals to: streamline the state’s Medicaid program through (given adequate funding) use of electronic health benefit cards, increased use of electronic medical records, and a web-based claims submission system; and to provide incentives through higher Medicaid reimbursement rates to hospitals which develop primary care facilities on their
campuses. Bon Secours Maryview Medical Center in Portsmouth has established a clinic for uninsured adults adjacent to the hospital’s Emergency Department. Bon Secours supports legislation to further the Quality and Patient Safety Improvement efforts of hospitals by protecting Incident Reports and other peer review materials from being classified as “medical documents” by the courts and entered into evidence in civil cases. Such use of these documents will have a chilling effect on the willingness of physicians and other staff to participate in open, frank and honest discussion of ways to improve quality and safety. Only through candid clinical discussion can patient safety and quality be improved.

Bon Secours supports the recommendation of the Governor’s Health Care Reform Commission to amend the Virginia Clean Indoor Air Act to prohibit smoking in all indoor areas of restaurants. Studies of secondhand tobacco smoke have found that it contains at least 250 toxic chemicals, 50 of which have been demonstrated to cause cancer. According to the Centers for Disease Control & Prevention, secondhand (or sidestream) tobacco smoke accounts for more than three-thousand lung cancer deaths a year among non-smokers, and causes the hospitalization of between 7500 and 15,000 infants and toddlers every year. Nonsmokers subjected to secondhand smoke at home and in the workplace increase their risk of developing heart disease by 25-30% and lung cancer by 20-30%. In 2005, fully $400 million of the Virginia Medicaid budget went to treat diseases caused by tobacco use.

Workforce
Bon Secours supports legislation to establish and fund a Health Care Workforce Data Center charged with improving data collection, monitoring trends, and measuring the health care workforce in the state (estimated annual cost: $600,000). Virginia is already experiencing a critical shortage of registered nurses, physicians, and other health care professionals. The situation will become progressively worse without vigorous intervention by state government. Projections indicate that by 2020 Virginia will be short 1500 physicians and 22,600 registered nurses.

Other Key Issues
Bon Secours SUPPORTS preservation of the $2 million cap on non-economic
damages in medical malpractice cases. A cap has been shown to limit premium increases, control bad faith or frivolous claims, and protect physician supply and access to care.

Bon Secours SUPPORTS continued voluntary participation by hospitals and health systems in the Virginia Birth-Related Neurological Injury Compensation Program.

Bon Secours SUPPORTS additional study of the feasibility of integration of
acute and long term care through the introduction of a managed care system
into long term care in Virginia. There has been no adequate review of the potential adverse impact on nursing homes in the Commonwealth.

Bon Secours SUPPORTS preservation of the state’s Certificate of Public Need
(COPN) program. As we have contended many times before, major changes to
the COPN program — or elimination of the program — should occur only in the
context of a process of responsible deregulation which protects the health care
safety net in Virginia and those providers who make up most of that safety net the state’s not-for-profit community hospitals and teaching hospitals.

Bon Secours SUPPORTS reasonable and humane efforts to deal with the
problem of illegal immigration; however, we believe that nothing positive is
achieved by either demonizing illegal immigrants — who after all are also God’s
children — or acting on emotion rather than on facts. Bon Secours also opposes efforts to deliberately punish children for the mistakes of their parents.

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