Last week, state legislative leaders announced their agreement, in concept, on the fiscal year (FY) 2011 budget and indicated the budget could be completed by the end of this week. This follows a recent proposal to solve the FY 2010 budget deficit.

The agreement to balance the FY 2011 budget includes a 3 percent cut to all government departments, which was proposed earlier this year, and an early retirement package offered to state workers that is designed to save an additional $60 million. The Michigan Department of Community Health (MDCH) budget target has been set at $2.4 billion, which is approximately $50 million less than Gov. Jennifer Granholm's executive budget recommendation in February. While there is agreement on the $2.4 billion expenditure target, the MDCH Budget Conference Committee - led by MDCH Appropriations Subcommittee Chairs Sen. Roger Kahn (R-Saginaw Twp.) and Rep. Gary McDowell (D-Rudyard) - will determine specifically where the $50 million will be removed from the MDCH budget.

Although both the House and Senate budget proposals contain some positive provisions for the healthcare community, it remains critical that hospital members and healthcare advocates contact members of the MDCH Budget Conference Committee and urge them to:

• Claim all federal assistance related to Medicaid for its budget.
• Support the language that directs the MDCH to base funding on costs for hospital outpatient Medicaid services provided in the state's small and rural hospitals.
• Maintain eligibility for all currently covered Medicaid populations.
• Restore optional adult dental and podiatric Medicaid services.
• Reject language that would use the number of hours to determine whether hospital admission is an inpatient stay.

The state constitution requires the Legislature to complete all budget action by Sept. 30, which leaves less than three weeks to sign a balanced FY 2011 budget into law. While some conference committees have been scheduled to meet, the MDCH Budget Conference Committee has yet to set a meeting date. The MHA will provide more information as it becomes available, and questions on the budget should be directed to Chris Mitchell at the MHA.

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With less than eight weeks until the Nov. 2 general election, campaign activity across the state has kicked into high gear. At recent conventions, both the Republican and Democratic state parties nominated their final slate of candidates for statewide offices, including lieutenant governor, attorney general, secretary of state and Michigan Supreme Court. A complete listing of candidates for statewide, congressional, Supreme Court and state House and Senate offices is available online.

The 2010 general election is absolutely critical to Michigan hospitals and the patients and communities they serve. Issues of considerable importance to hospitals likely to be addressed over the next few years in Congress, the state Legislature and the Supreme Court include medical malpractice, tort reform, hospital nonprofit status, union/labor matters and implementation issues for national healthcare reform.

As healthcare advocates, the active participation of hospital personnel is essential to help elect the best candidates for healthcare in Lansing and Washington, DC. Comprehensive election candidate information and recommended campaign activities for MHA members can be found at the MHA election website. The MHA is also requesting member assistance to help defeat Proposal 1, a measure that would needlessly cost taxpayers $45 million.

As they engage and support candidates, MHA members should keep in mind that any such action must be carried out in an individual capacity and not on behalf of, or as a representative of, a hospital or health system. Information on election activities and 501(c)(3) hospitals is provided on the MHA website to help ensure compliance with Internal Revenue Service regulations in this regard. Members with questions should contact David Finkbeiner at the MHA.

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U.S. Rep. John Dingell (D-Trenton) recently introduced H.R. 6095, a bill to amend the Social Security Act's Medicare provisions to preserve integrated care for durable medical equipment (DME) programs. Under current law, the U.S. Department of Health & Human Services must implement a national competitive bidding program for the purchase of DME for Medicare beneficiaries. This mandate directly conflicts with the integration of healthcare promoted by current market forces and required by the Affordable Care Act; resulting in a division of care among various DME contractors that undermines efforts to provide hospital-based DME equipment and services in a timely and efficient manner. Recognizing that coordinating the supply and delivery of DME avoids extra days in the hospital and improves patient outcomes, H.R. 6095 would exempt these programs and supplies from the competitive bidding process.

Dingell introduced the bill at the request of an informal coalition that includes several Michigan hospital-based DME providers. Working over the past three years, the coalition consists of more than 60 hospitals and health systems in 22 states that have developed their own DME and other post-acute-care services as a way to improve quality and safety for patients, while controlling costs.

MHA members are encouraged to ask their U.S. representative to co-sponsor H.R. 6095. For more information, contact Laura Appel at the MHA.

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The MHA, three of its member organizations, and an MHA-member hospital affiliate are among the country's top 100 healthcare employers as determined by Modern Healthcare magazine. Joining the MHA on the list are Allegan General Hospital, Chelsea Community Hospital, HHA Services of St. Clair Shores, and McLaren Health Plan of Flint.

The Modern Healthcare Best Places to Work in Healthcare 2010 award is based on a judging system that is weighted 25 percent on an organization's nomination and 75 percent on its employees' survey results, making the award significantly representative of staff sentiment. An awards ceremony will take place Oct. 18 in Dallas, where specific rankings of all winning employers will be announced.

MHA President Spencer Johnson commented on the recognition, saying, "Perhaps most important is the knowledge that MHA employees derive great satisfaction from their careers, ensuring that the work we do for Michigan hospitals is inspired, creative and outcome-oriented. I am very proud of all we have accomplished and look forward to continuing our award-winning corporate culture."

This honor continues an MHA tradition that emphasizes the link between employee satisfaction and productivity. In 2009, the MHA accepted an award from the Alfred P. Sloan Foundation for Business Excellence in Workplace Flexibility. For more information, contact Nancy McKeague at the MHA.

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The MHA Health Foundation Governance Leadership Forum, scheduled for Oct. 24 and 25, is Michigan's most comprehensive healthcare governance and leadership conference, offering innovative approaches to becoming a more engaged, informed and vital organization and board. An early registration discount is available through Sept. 20.

This year's conference, titled Integrating the Pieces of healthcare Reform, outlines how to restructure systems, partnerships and clinical care based on the immediate or near-immediate healthcare reform initiatives. Specific topics include clinical variation and its impact on cost, trends on physician employment and assumption of risk, and evaluating the accountable care organization model as a solution for healthcare delivery in a changing industry. The forum will take place at The Inn at St. John's in Plymouth. For details on the Governance Leadership Forum or opportunities to sponsor the event, contact Erin Steward at the MHA.  

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At least 16 billion injections are given globally every year and, according to the World Health Organization, unsafe injection practices account for many new cases of infectious disease. These statistics have drawn the attention of the Centers for Medicare & Medicaid Services, which has received a $50 million grant to enforce infection control standards. The MHA Health Foundation webinar Ensuring Injection Safety and Infection Control will help hospitals evaluate where improvements can be made in their injection policies using the injection practice guidelines of the Centers for Disease Control & Prevention, The Joint Commission and others. The webinar is scheduled from 10 to 11:30 a.m. Nov. 4 and has a connection fee of $195 per MHA-member organization. For more information or to register, contact Leigh Anne Jewison at the MHA.

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The Medical Services Administration (MSA) will distribute $69 million in fee-for-service graduate medical education (GME) payments to Michigan's teaching hospitals on Sept. 30 for fiscal year 2010. Also on that date, the MSA will distribute disproportionate share hospital (DSH) payments to eligible hospitals for both the $45 million DSH pool and the tax-funded $60 million outpatient uncompensated care DSH pool, with corresponding tax invoices distributed shortly thereafter. Although DSH payment amounts for individual hospitals have not yet been finalized, the MSA will distribute correspondence to hospitals regarding their DSH payment amounts prior to Sept. 30. Members with questions should contact Vickie Seal at the MHA.
 

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Smart	Harding

George Smart recently joined Alpena Regional Medical Center as chief financial officer (CFO). Smart has more than 20 years of financial healthcare experience and has served as vice president of Finance and System Operations at Zeeland Community Hospital and assistant CFO at Otsego Memorial Hospital, Gaylord.

Ed Harding has been named president and chief executive officer (CEO) of Bay Area Medical Center, Marinette, WI, and is expected to begin his new duties in December. Harding previously served as president and CEO at Columbus Community Hospital in Columbus, WI; vice president of Planning, Marketing and Professional Services for Mercy Medical Center in Clinton, IA; and director of Strategic Planning at Mount Carmel Health, Columbus, OH.

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• The Hospital Affiliated Legislative Officers will meet from 8:30 to 9:30 a.m. Tuesday at the MHA Capitol Advocacy Center, Lansing. Participants will receive a state budget update and discuss legislation pending before the general election. For more information, contact David Finkbeiner at the MHA.

• The MHA Board of Trustees will meet from 9 a.m. to 12:30 p.m. Wednesday at MHA headquarters, Lansing. Attendees will examine and discuss election-year strategies and establish an MHA work plan for the 2010-2011 program year. For more information, contact David Seaman at the MHA.

• The MHA Health Foundation webinar The Final Meaningful Use Rules: Moving from Paper to Portal will be held from 11 a.m. to 12:30 p.m. Thursday. This webinar will clarify hospitals' electronic health record goals and outcomes based on the federal government's rules and regulations. For more information, contact Leigh Anne Jewison at the MHA.

• The early registration discount ends Friday for the eight upcoming Michigan Department of Community Health (MDCH) 2010 Fall Regional Immunization Conferences and the limited number of seats are quickly being reserved. Available throughout the state during October and November, the conferences will provide updates on vaccines and vaccine-preventable diseases, discuss communication strategies to quell misinformation about vaccines, and feature a panel of experts to answer participants' questions. For more information, contact Rosemary Franklin at the MDCH.

• The application period for the 2011 National Healthcare Quality Award is open through Oct. 27, with Intent to Apply forms due by Oct. 15. Presented by the National Quality Forum (NQF), the award recognizes exceptional organizational leadership and innovation to achieve national goals for quality improvement. The 2011 award jurors will focus on clinical integration, care coordination, and the ability to achieve the best outcomes at the most affordable cost. As a member of the NQF, the MHA Keystone Center for Patient Safety & Quality encourages Michigan hospitals to submit an application for this prestigious award. Three Michigan hospitals/health systems have won the award since it was created in 1993.