Democratic Caucus Releases Budget Proposal

This morning, House and Senate Democratic lawmakers released a FY 2017 budget proposal that closes the estimated $930 million budget deficit.  The plan does not accept the Governor’s elimination of all funding of supplemental payments to hospitals.  However, it does not fully fund the inpatient supplemental payments as proposed by the House and Senate Republicans in their FY 2017 budget proposal, released on Tuesday.  The Democrats’ plan funds hospital inpatient supplemental payments in the amount of $138 million.

CTNewsJunkie is reporting that the Administration has responded to the proposal, with Governor Malloy’s spokesman Devon Puglia saying “…the Governor has serious concerns about this proposal, and he could not support or sign it in its current form… It relies on hundreds of millions of dollars in one-time revenues and unrealistic savings targets.”

Other healthcare and social service cuts of note in the Democrats’ plan include reductions to:

  • The cost-of-living increase for private not-for-profit social service providers.
  • Rates paid to nursing homes – a reduction of $5.25 million.
  • Payments to home health agencies for administering medication to patients – a reduction of $5.25 million.

Also, the plan eliminates the proposed exemption from the hospital tax for Day Kimball and Milford Hospitals.

Reacting to the Democrats' budget proposal, Republican leaders stated that the budget does not solve the state’s budget problem or make positive long-term structural changes.

All caucuses and the Administration await final consensus revenue estimates, which are expected to increase the FY 2017 budget deficit by another approximately $200 million.


Connecticut Hospital Day Secures More Support for HB 5588

Representatives from a broad spectrum of Connecticut’s hospitals came to the Capitol on Wednesday, April 27, to make a request to lawmakers from their districts: Please support us.

The face-to-face meetings, which largely occurred outside the halls of the House and Senate, served two significant purposes.  First, they reminded legislators of the stakes for hospitals as the General Assembly goes into its final week of the session with the 2017 budget still unresolved and, second, they allowed hospitals to urge support for HB 5588, An Act Concerning The Timing of Payments From Supplemental Inpatient Payment Pools For Short-Term General Hospitals.

A priority bill for hospitals, HB 5588 would require the state to make quarterly payments to hospitals that include the federal share and require that the money appropriated to the payment pools not be used for any other purposes.  It would also allow a hospital to offset tax payments if the Department of Social Services does not make payments to the hospital as outlined in the bill.

CHA has been working to secure as many co-sponsors as possible for HB 5588, which has already been approved unanimously by the Human Services and Finance, Revenue and Bonding Committees, and Wednesday’s efforts by hospitals furthered that goal considerably.  As of publication, the bill had 138 bipartisan co-sponsors from both chambers.  The bill now heads back to the House.

Hospital officials said they were impressed by how receptive their lawmakers were to hearing about HB 5588 and gratified that so many of them agreed on the spot to co-sponsor the legislation.

“They were very supportive,” said Stuart G. Marcus, MD, President and CEO of St. Vincent’s Medical Center.  “It was a nice surprise to find how receptive they were to our message.”

R. Christopher Hartley, Senior Vice President, Trinity Health-New England, Inc., said attendees from Johnson Memorial Hospital and Saint Francis Hospital and Medical Center had “positive and constructive conversations” with lawmakers on Wednesday, a point that was reinforced by Johnson Memorial Hospital President and CEO, Stuart Rosenberg.

“I thought it was very productive.  We had several meetings with legislators in which they agreed to sign on as co-sponsors,” said Mr. Rosenberg.

Also in attendance at Hospital Day were representatives from Bristol Hospital, Day Kimball Hospital, Eastern Connecticut Health Network, Hartford HealthCare, The Charlotte Hungerford Hospital, Middlesex Hospital, Saint Mary’s Hospital, Western Connecticut Health Network, and Yale New Haven Health System.



Opioid Abuse Bill Approved by House of Representatives

On Monday, April 25, the House of Representatives unanimously passed landmark legislation, House Bill 5053, An Act Increasing Access To Overdose Reversal Drugs, that addresses opioid abuse by limiting initial prescriptions for opioids to a seven-day supply in most cases, and requiring first responders to carry Narcan, an overdose-reversing drug.  CHA supports this measure.

The bill would also strengthen the state's electronic prescription monitoring effort to prevent doctor shopping, a practice employed by addicts to secure multiple prescriptions for drugs.  It now moves to the Senate for consideration.

Governor Dannel Malloy applauded the vote on Monday.

“This vote is another step forward in our efforts to ensure that those who need help get it, and I am optimistic that the Senate will swiftly approve the bill so I can sign it into law," Governor Malloy said.  "It is critical that we continue to combat this problem, which is having a nationwide impact.  We must keep moving forward and must keep tackling this critical issue."

The Governor thanked the co-chairpersons of the Public Health Committee, State Senator Terry Gerratana (D-New Britain), and State Representative Matthew Ritter (D-Hartford), as well as State Representative Sean Scanlon (D-Guilford) and State Representative Theresa Conroy (D-Seymour) for their input in crafting the legislation, in addition to the bipartisan membership of the House who supported the bill.


House And Senate Meet in Session

The Connecticut House of Representatives and State Senate met several days this week to pass legislation. 

On Monday, April 25, the House debated and voted on HB 5053, An Act Increasing Access To Overdose Reversal Drugs, a bill supported by CHA and described in the previous story.  The bill was transmitted to the Senate for further action.

The Senate was not in session on Monday, April 25.

On Tuesday, April 26, the House debated and voted on HB 5451, An Act Concerning The Department Of Public Health's Recommendations For Various Revisions To The Office Of Health Care Access Statutes.  HB 5451 makes several changes to the Office of Health Care Access (OHCA) statutes.  The bill was amended by deleting sections 3, 4 and 12.  Sections 3 and 4 would have made changes to the CON law relating to the replacement of certain imaging equipment.  Section 12 would have significantly lowered the standard by which OHCA may impose a civil penalty for failure to file seek CON approval as required by section 19a-638.

Also on Tuesday, the Senate took action on SB 67, An Act Concerning The Authority And Responsibilities Of Advanced Practice Registered Nurses.  Among other provisions, SB 67 would allow advanced practice registered nurses (APRNs) to certify, sign, or otherwise document medical information that currently requires a physician's signature, certification, or documentation, including: certifying a patient for medical marijuana use (except for glaucoma); issuing “do not resuscitate” orders; certifying a disability to cancel a health club contract; and certifying a disability or illness for continuing education waivers or extensions for various health professions.  SB 67 was transmitted to the House for further action.

On Wednesday, April 27, the Senate took action on SB 351, An Act Concerning Matters Affecting Physicians And Hospitals.  CHA has concerns with SB 351, which makes several changes to the laws impacting hospitals, healthcare, and physicians including limiting non-compete clauses in physician contracts.  SB 351 was transmitted to the House for further action


GOP Caucus Releases Budget Proposal

On Monday, April 25, House and Senate Republican lawmakers released a FY 2017 budget proposal that closes the estimated $930 million budget deficit.  The plan does not carry forward into FY 2017 the $90 million cut imposed in the December 2015 Deficit Mitigation Plan. 

In addition to restoring funds to hospitals, the GOP proposal recommends separating supplemental payments for hospitals and Federally Qualified Health Centers (FQHCs) from the Medicaid line item, thus limiting the exposure hospitals would have in any future rescissions imposed by the governor.

Generally, the Republican budget proposal would:

  • Maintain Governor Malloy's $281.1 million savings in personnel services.
  • Implement legislative givebacks, including salary reductions and elimination of legislative mailing privileges.
  • Reduce annual bonding levels.
  • Impose wage freezes for all state employees.
  • Centralize state legal staff.
  • Privatize group homes.
  • Eliminate public financing for political campaigns.
  • Increase employee healthcare contributions to 20 percent, as well as increase copays for non-union state employees.
  • Include cuts to administrative, non-service accounts by 12 percent, for a total savings of $157.5 million.

Links to additional GOP budget documents can be found here:
Pathway to Sustainability Summary
Pathway to Sustainability (long-form)
PowerPoint Presentation


Hospitals Participate in Donate Life Month

Connecticut hospitals are honoring National Donate Life Month, celebrated each year in April.  Throughout the month, hospitals across the state, working with Organ Procurement Organizations (OPOs), have been holding activities and programs highlighting the importance of organ and tissue donations, as well as honoring donors and transplant recipients.  Here are some of the activities happening in hospitals this month:

In celebration of Donate Life Month and to help raise awareness of the importance of organ donation, ECHN and LifeChoice Donor Services held ceremonial flags raisings to honor those who have given the gift of organ, eye, and tissue donation on April 25 at Manchester Memorial Hospital, and April 27 at Rockville General Hospital.  Also, ECHN has put together a team that will participate in LifeChoice Donor Services’ third Annual Blue and Green 5K and 2 Mile Walk, which will be held on Saturday, April 30, 2016, in Windsor.

Middlesex Hospital held a ceremonial flag raising with LifeChoice Donor services on April 6.  There were four tissue donors at Middlesex Hospital last year.  The ceremony honored and celebrated the lives of those who had given the gift of life, their families, and the hospital’s staff for their ongoing support of the program.

Donate Life Month at Saint Francis Hospital and Medical Center was celebrated in several ways.  On Wednesday, April 20, LifeChoice Donor Services hosted a donor designation station/information table with a cupcake giveaway.  The cupcakes were decorated with sunflower and Donate Life sticks.  The hospital also held its monthly flag raising in honor of Organ, Eye, and Tissue Donors that afternoon.  Teams from Saint Francis and Johnson Memorial Medical Center will participate in the Blue and Green 5K and 2 Mile Walk in Windsor.  Finally, National Healthcare Decisions Day was marked with a donor designation station in the hospital's main entrance.

Saint Mary’s Hospital in Waterbury is displaying the Donate Life New England flag outside the hospital for the month of April. The flag is regularly flown whenever an organ donation occurs.  On April 14, Saint Mary’s welcomed Cheryl Edwards, RN, MSN, CCRN, CPTC, Regional Team Lead for Connecticut and Senior Donation Coordinator, New England Organ Bank, who greeted patients, staff, and visitors in the Main Lobby.  Cheryl offered information about organ donation and invited people to register as organ, eye, and tissue donors.  In addition, Saint Mary’s is displaying the sunflower-inspired art for 2016 National Donate Life Month on table tent cards, posters, and digital signs throughout the hospital.

Waterbury Hospital’s month-long celebration of National Donate Life Month showcased various perspectives of those touched by donation and transplantation.  The activities included in-service training in the ED by a representative of the New England Organ Bank (NEOB) and an organ recipient, flying the Donate Life flag outside the hospital for the month of April, and hosting NEOB representatives outside the café on April 19 and 20 to talk about and encourage organ donation.  In 2015, Waterbury Hospital had a total of three organ donors and 24 tissue donors.

Yale-New Haven Hospital hosted numerous events marking National Donate Life Month, including a Celebration of Life on April 5 that included a Yale-New Haven Hospital heart transplant and ventricular assist device (VAD) patients, multiple organ donation awareness days, a National Donate Life Blue and Green Day on April 15, an organ donor educational program on April 21, a patient and donor stories program, the presentation of the Workplace Partnership for Life Award from New England Donor Bank on April 28, and the April 30 showing of the film, “The Wish – A Story of Hope, Faith and Generosity,” sponsored by Heart and Vascular Center and Yale-New Haven Transplantation Center.  In addition, Yale-New Haven Hospital partnered with NBC Connecticut to promote organ donor awareness and registration.  NBC Connecticut interviewed Dr. David Mulligan, Section Chief of Yale-New Haven Transplantation Center, about the transplant center and the need for organ donors.  The show aired on April 15, National Donate Life Day.


Special Election Held: Democrats Retain Waterbury-Based Seat

Democrat Geraldo Reyes Jr. beat  Republican Raymond Work in a Special Election held in Waterbury on Tuesday, April 26.  A long-time community activist and former mayoral aide, Rep. Reyes beat Mr. Work by a vote of 960 to 289.  The Special Election was held to fill the vacated Waterbury-based seat created when former State Representative Victor Cuevas stepped down mid-session.  On Thursday, April 28, Mr. Reyes was sworn into office by House Speaker Brendan Sharkey.  

Shortly after being sworn in, Rep. Reyes took action to protect hospitals by becoming a co-sponsor of HB 5588, An Act Concerning The Timing Of Payments From Supplemental Inpatient Payment Pools For Short-Term General Hospitals.

Democrats now hold 87 seats, and Republicans hold 64 seats in the House.   The 75th House District seat covers Waterbury’s South End.



Education Updates

Preparing for Accountable Health Communities–Addressing the Social Determinants of Health
Wednesday, May 4, 2016
9:00 a.m. - 3:30 p.m.
View Brochure | Event Registration

Many patients and families who seek medical care in our hospitals and healthcare systems face daunting challenges in their personal lives.  Food insecurity, housing insecurity, economic challenges, and other socially-determined factors negatively affect health outcomes and make it difficult for patients to engage successfully in their treatment.  A growing and consistent body of evidence makes it clear that interventions exist to meet these challenges, improve health, and reduce costs of care.

Healthcare delivery system leaders and clinicians have long recognized the impact of social factors on health, and that addressing patients’ social needs can be extremely complex.  Yet, clear signals from CMS and other payers increasingly require healthcare providers to plan to address this issue.  CHA is pleased to announce it is working with Health Leads, a company founded more than 20 years ago to address social determinants of health, real time, at the point of care.

Please join us for a full-day educational forum designed to develop the strategy and resources your organization needs to connect patients with community-based resources that can improve their health and reduce unnecessary healthcare utilization.


Transitioning From Staff to Management: What’s Next?
Thursday, May 5, 2016
8:30 a.m. - 3:30 p.m.
View Brochure | Event Registration

Whether recently assigned to the role of manager or a seasoned veteran, it is important to determine how well your problem solving, critical thinking, and decision making skills are keeping pace with the ever-changing healthcare environment.  For those who attended “Staff to Management: Starting the Transition” in September 2015 or March 2016, this is the second course in the two-part program and provides additional development for all managers who want to continually improve their skills.

Continuing education credits are offered for this session.  See the brochure for details.


HEN 2.0 – Reducing Adverse Drug Events: Strategies to Accelerate Improvement Webinar - Insulin Safety
Thursday, May 5, 2016
1:00 p.m. - 2:30 p.m.
Event Registration

Reducing Adverse Drug Events is a topic area for focused improvement efforts nationally.  Join Frank Federico, IHI, as he reviews key strategies proven to assist hospitals in managing their high-risk medication safety programs related to opioid, insulin, and anticoagulation usage. 

The program is being presented as part of the Partnership for Patients HEN 2.0 educational series.


Leading in a VUCA Environment
Friday, May 6, 2016
9:00 a.m. - 3:00 p.m.
View Brochure | Event Registration

The scope and pace of change in healthcare is unrelenting.  VUCA is an acronym that describes an environment that is Volatile, Uncertain, Complex, and Ambiguous—a military term that was created during the Cold War and reused during the Middle East conflicts.  Healthcare fits the description perfectly—and as the landscape continues to evolve, learning the strategies and principles of VUCA Leadership will enhance focus and agility.  This workshop will blend didactic and experiential material, giving leaders practical tools to engage their employees in shaping organizational culture and achieving outcomes that drive operational excellence.

Continuing education credits are offered for this session.  See the brochure for details.


Cyber Resilience Workshop 
Tuesday, May 10, 2016
12:30 p.m. - 4:00 p.m.
View Brochure | Event Registration

In partnership with the Department of Homeland Security, CHA is pleased to offer the Cyber Resilience Workshop.  The session is designed to introduce cyber security stakeholders and practitioners to cyber resilience concepts and to build capability and capacity across key performance areas related to cyber security, IT operations, and business continuity within critical services.  The workshop is targeted to executive and operations managers within critical infrastructure (public and private) sectors, and will result in tangible, useful “take-away” information related to risk-based decision-making and security planning for critical IT services underpinning core operations.

This half-day session allows participants to practice—via scenarios, activities, and templates—process improvement, and to demonstrate capability-building over and above the mere production of improved IT security controls and countermeasures.  Attendees will also gain an awareness of modern cyber security threats and current trends in the context of protecting and sustaining IT services related to core business functions and mission objectives.  Participants will leave with greater awareness of decision criteria for cyber incidents, vulnerabilities, and business continuity applications.


Using High Reliability to Improve the Patients' Experience 
Friday, May 20, 2016
Morning Session: 9:00 a.m. - 12:15 p.m.
Event Registration

Afternoon Session: 1:00 p.m. - 4:15 p.m.
Event Registration

This program focuses on highly reliable staff behaviors that enhance patient satisfaction and HCAHPS scores.  Lynn Pierce of HPI, an alumna of Baptist Hospital in Pensacola, FL (home of the 2003 Malcolm Baldrige Quality Award), will be back as the instructor.  Medicine, Nursing, and Quality continuing education credits are offered for these sessions.  


CHA Nurse Preceptorship Program
Monday, May 23, 2016
8:30 a.m.- 3:45 p.m.
View Brochure | Event Registration

Supporting and strengthening the work of nurse preceptors is critical to the development of new nurses and retention of the highly skilled staff registered nurses who teach them at the bedside.

CHA’s Nurse Preceptorship Program has routinely received positive feedback, featuring a curriculum developed by a team of educators from hospitals and schools of nursing, and designed to provide core content that is foundational for the role of nurse preceptor.  This one-day program includes presentations and interactive sessions that cover topics such as roles and responsibilities, characteristics of a professional role model, basics of teaching and learning, tools and strategies for effective communication, principles of constructive feedback delivery, and evaluating competence.  The Nurse Preceptorship Program will serve to start new nurse preceptors off with critical information and also may be of interest to nurse preceptors that have not had this content, or would like to be refreshed on these concepts.

Continuing education credits are offered for this session.  See the brochure for details.


HRO Cause Analysis - Two-Day Training
Wednesday, May 25, 2016
Thursday, May 26, 2016
8:30 a.m. - 4:30 p.m.
Event Registration

Cause analysis teaches staff how to evaluate events, patterns of events, and causes of events, and then helps staff ascertain how to implement solutions.  The sessions are for quality staff, safety staff, risk management staff, and other staff that respond to events.  Medicine, Nursing, and Quality continuing education credits are offered for these sessions.


HRO Train-the-Trainer
Thursday, June 2, 2016
9:00 a.m. - 4:15 p.m.
Event Registration

Train the Trainer is the model for sharing high reliability training with the rest of the staff.  The scripted training requires an enthusiastic participant who is willing to make time to train others within the organization.  Other hospitals in Connecticut have trained educators, front-line managers, and senior leaders, including the CEO, as part of their training contingent.  Train the Trainer sessions are for hospitals and ambulatory practices.  Medicine, Nursing, Quality, and Radiology continuing education credits are offered for these sessions.


HRO Rounding to Influence
Friday, June 3, 2016
9:00 a.m. - 12:15 p.m.
Event Registration

The program teaches leaders how to go out on the units to coach, mentor, and sustain high reliability habits and practices.  Medicine, Nursing, and Quality continuing education credits are offered for this session.


HRO Problem Solving with the Top 10
Friday, June 3, 2016
1:00 p.m. - 4:15 p.m.
Event Registration

When issues are identified in Safety Huddle, how do you solve them and maintain the other projects you are doing?  Problem Solving with the Top 10 is a tool for prioritizing and implementing projects without losing sight of the core value of safety.  Medicine, Nursing, and Quality continuing education credits are offered for these sessions.