January 19, 2004

MHA's Monday Executive Briefing
January 19, 2004

In this week's edition...
- State News -
1. Your help needed for grassroots advocacy
2. Survey: Corruption rate tops in Mississippi
3. House, Senate make committee assignments
4. President Bush recess appoints Judge Charles Pickering
5.Barbour's name to remain with his former Washingtonlobbying firm
6. Musgrove returns to alma mater to teach
7. Senator aims to file a new voter ID bill
8.Governor Barbour’s Inaugural Address
- National News -
9. Bush looking at new health care initiative
10. Clinton to file EHR bill
11. CMS updates quality officials on reporting initiatives
12. Congress set to reconvene Jan. 20, budget delivery expected Feb. 2
13. MedPAC backs full-inflation update in 2005
14. AHA summary compares presidential candidates' health coverage proposals
15. Survey: Congressional impasse puts employee pension plans at risk

- State News -

1. Your help needed for grassroots advocacy
  In the past two years, MHA has depended heavily upon our e-mail network to transmit urgent information on key advocacy issues. This grassroots network is an important component of MHA’s advocacy program. In order to get ready for the 2004 legislative session, we need the name, title and e-mail addresses of the staff that you consider key contacts at your hospital. We also have issue-specific lists for CEOs, CFOs, CNOs and DONs, executive staff, human resources, purchasing/materials management, risk management, human resources, marketing and public relations, hospice and home care, facility managers, behavioral health and health care educators. Please send us the information on employees in your hospital you would like to add to those e-mail lists.(It makes a powerful impact on legislators and their decisions when a major issue is up for a vote and the legislator hears resoundingly from those affected.)
   In addition to expanding our grassroots network with hospital staff members, MHA is making a special effort to include hospital trustees in our network. Hospital trustees are effective advocates because they are perceived as working only for the good of their community when talking to an elected official about a hospital issue. They are a valuable addition to our grassroots team and  it is important that we make every effort to get trustees involved. If possible, please nominate at least two trustees from your Board who would be interested in staying informed on important issues and would be willing to make contact with an elected official at a critical time.
   For more information or to send your list of names, contact Shawn Lea at by phone at (601) 368-3237, by fax at (601) 368-3200 or by e-mail at slea@mhanet.org .

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2. Survey: Corruption rate tops in Mississippi
    Mississippihas the highest corruption rate in the country, or at least, the highest rate of crooked officials who get caught. More Mississippipublic officials have been convicted on federal corruption charges per capita over the past decade than any other state, according to the Washington-based newsletter Corporate Crime Reporter.
   The survey - Public Corruption in the United States- was released Friday. It found federal prosecutors convicted 215 Mississippipublic officials from 1993-2002, at a rate of 7.48 per 100,000 people. Corporate Crime Reporter editor Russell Mokhiber said the survey wasn't an absolute indicator - public officials who don't get caught don't show up. Also, states with small populations may find their rankings skewed upward, he said. The survey is meant to spur debate and discussion about public corruption in the United States, Mokhiber said.
   North Dakotawas the survey's second-most corrupt state with a rate of 7.09, and Louisianawas third at 7.05. The least corrupt states, according to the survey, were Nebraska, Oregonand New Hampshire. Four Southern states - Mississippi, Louisiana, Kentuckyand Florida- ranked in the survey's top 10.

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3. House, Senate make committee assignments
   In making the all-important committee assignments recently, both Republican Lt. Gov. Amy Tuck, the Senate's presiding officer, and House Speaker Billy McCoy, D-Rienzi, remained bipartisan but placed members of their own party - and philosophy - in key positions. The committee chairs and the make-up of the committees are key to whether legislation is passed. A chairman can kill legislation by not calling it up or the chamber's presiding officer can kill legislation by sending it to a committee where he or she knows the majority of the members oppose it.
   During the previous term in the House, Republicans chaired seven of the 30 standing committees. This term, McCoy has created six new standing committees, and Republicans gained one chairmanship. Additional joint (House-Senate) committees exist but are generally less influential or have rotating chairs.
   On the Senate side, Republicans chaired 11 of the standing committees during the previous term but will chair 13 this time around. In the 52-member Senate more than half the members are chairmen and there are not enough Republicans to chair all of the committees. Democrats hold either 29 or 30 of the 52 seats - depending on the outcome of a contested seat in HindsCounty.
   In the   five major committees - Appropriations, Ways Means in the House or Finance in the Senate, Education, Public Health and Judiciary A - Republicans hold four of those posts in the Senate and Democrats hold all of those chairs in the House. African-Americans hold two of those five committee chairs in the House, including a money committee for the first time since the 19th century. In the Senate, blacks, who held two of those five committee chairs during the previous term, hold none this time.
   The Senate Judiciary Committee was split into two bodies this session, with Tuck picking Sen. Gray Tollison, D-Oxford, to head Judiciary B and Sen. Charlie Ross, R-Brandon, Judiciary A. Tuck said she wanted the 21-member Judiciary Committee split into two 15-member committees to ease the work load.
   Judiciary A is the committee that probably will consider proposals to change the civil justice system. In the House, McCoy has appointed Ed Blackmon, D-Canton, who is considered one of the leading trial attorneys in the state.
   McCoy in general has said that he wants to give the laws passed during a 2002 special session time to work before making any additional major changes in the civil justice system. But McCoy has formed a special committee - co-chaired by Blackmon and Public Health Committee Chairman Steve Holland, D-Plantersville, to look into the problems doctors are having obtaining medical malpractice insurance.
   A list of all committee members in both the Senate and the House can be found here.

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4. President Bush recess appoints Judge Charles Pickering
    On Jan. 16, President George W. Bush recess appointed US District Judge Charles Pickering of Mississippito the Fifth Circuit Court of Appeals. Bush's installation of Pickering, whose home is near Laurel, avoids the Senate confirmation process. Such appointments are valid until the next Congress takes office, in this case in January 2005. The 5th Circuit handles appeals from Mississippi, Texasand Louisiana, and the federal judges on that circuit have been trailblazers on desegregation and voting rights in the past. Read Bush’s statement on the appointment here.

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5.Barbour's name to remain with his former Washingtonlobbying firm
   Gov. Haley Barbour says he sees no conflict with his name remaining on a Washingtonlobbying firm while he serves in elected office. Barbour said he resigned as president and CEO of Barbour Griffith & Rogers on Tuesday when he took his oath as Mississippi's 63rd governor. His last name, however, remains as part of the company.
  Barbour said the firm - one of Washington's most influential Republican-run lobbying groups - was sold in 1999, and the name Barbour Griffith & Rogers was part of the sale. Barbour Griffith & Rogers is owned by the Interpublic Group of Companies Inc., a publicly traded company that's one of the world's largest advertising and marketing firms. Barbour said he did not receive a severance package when he gave up his titles of president and CEO, and he has no ownership or stock in the company he helped found in 1991.
    Mississippi Ethics Commission director Scott Rankin said state ethics laws cover businesses owned by elected officials. He said such businesses cannot be contractors, subcontractors or vendors with the state, except under limited circumstances. Rankin said state ethics laws also prohibit elected officials from using their position for financial gain for themselves or their relatives.
  Barbour, 56, said he has put all his personal investments into a blind trust to be administered by a lifelong friend, Bank of Yazoo City President Griffin Norquist. Barbour said the blind trust he established is modeled after those used by federal officials.Barbour said he has retained part ownership in a Washingtonsteak house, the Caucus Room. That investment, like his others, will be managed by Norquist. Barbour said he was not active in Barbour Griffith & Rogers most of last year while he was campaigning but he had kept the titles of chairman and CEO because that's what his partners, Lanny Griffith and Ed Rogers, wanted.
   Barbour Griffith & Rogers represents such high-profile clients as Brown & Williamson Corp., Delta Air Lines, Lockheed Martin and Pfizer Inc. Barbour Griffith & Rogers also lists the Universityof Mississippi and the Universityof Southern Mississippias clients.

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6. Musgrove returns to alma mater to teach
   Former Gov. Ronnie Musgrove has decided to return to his alma mater, this time as a distinguished visiting lecturer. Musgrove will be lecturing in various political science classes at the Universityof Mississippithis spring. Musgrove told the Associated Press that he won't teach full time, but only a couple of classes while attending to "some other work." Musgrove received his business degree at UM in 1978, and then continued to receive his law degree in 1981.

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7. Senator aims to file a new voter ID bill
   Mississippi voters should be required to show some form of identification, such as a driver's license, passport or Social Security card, when they go to the polls, said state Sen. Mike Chaney.  Chaney, R-Vicksburg, last week filed a bill that would require voters to produce one of 13 forms of ID. He will be reviving the controversial issue of voter identification, which has broken down largely along racial lines. If voters fail to produce one of the forms of ID, they could proceed to the polls if they are recognized by an election manager. Currently, no ID is required.
  But black lawmakers have railed against the proposal, saying such a requirement would intimidate older, black voters who lived through the poll tax. State Rep. Chuck Espy, D-Clarksdale, an opponent, said he would be more amenable to the measure 25 years from now, when it would not affect the oldest generation of voters, black or white.

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8.   Governor Barbour’s Inaugural Address

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- National News -

9. Bush looking at new health care initiative
    President Bush is expected to propose a healthcare initiative in his State of the Union address to help the uninsured and the underinsured, White House advisers said. It was unclear how much the initiative, to be announced in the address tomorrow, would cost at a time when Bush is under pressure because of a growing budget deficit. But White House officials have made clear that they do not want to cede the politically potent issue of healthcare to the Democratic presidential candidates, all of whom have made healthcare a centerpiece of their campaigns. "One of the main drivers of a significant section of the uninsured in Americais because of the rising costs of healthcare," a senior administration official said Friday in a briefing to reporters. "And those can be addressed from several different ways." Bush has already proposed an $89 billion, 10-year package of tax credits for the uninsured, which is many times less than the health plans of the Democrats.

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10. Clintonto file EHR bill
  Senator Hillary Rodham Clinton (D-NY) last week said she would likely introduce legislation calling for the creation of a nationwide system of electronic health records (EHR). Clintonsaid her proposal would address the expense of switching from paper-based records to EHR, according to the Associated Press (AP). If created as Clintonenvisions, the new system would enable providers and patients to view medical records and communicate with each other online. One hospital in 50 has its own EHR system, the AP quoted the Healthcare Information Management Systems Society as saying, and a few physician offices and pharmacies have their paperless systems as well. Read more about Clinton 's proposal   here.

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11. CMS updates quality officials on reporting initiatives
  In its Jan. 6 Hospital and Quality Initiatives Call, the Centers for Medicare and Medicaid Services reported that there are now close to 2,300 hospitals nationwide that have joined the American Hospital Association’s National Voluntary Reporting Initiative. In addition, approximately 800 hospitals will have updated data on their Web site by mid February.
   CMS also reported that the revised HCAHPS instrument is available for public comment, with details available   here. The Agency for Healthcare Research and Quality and CMS are providing an opportunity for hospitals, vendors and other interested parties to use the 32-item draft of the HCAHPS® instrument prior to national implementation. Additional information is available directly from AHRQ by e-mailing hospital-CAHPS@ahrq.gov.
In other reports from the call, CMS said it has posted the framework for its 8th Scope of Work. Details can be found   here. Comments should be sent to CMS at 8SOW@cms.hhs.gov.

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12. Congress set to reconvene Jan. 20, budget delivery expected Feb. 2
  Congress is expected to return to work Jan. 20 to begin the second session of the 108th Congress. One of the new session’s most anticipated developments is set for Feb. 2, when the Bush Administration is expected to deliver its fiscal year 2005 budget proposal. The talk is that the proposal will include several tax cuts, reduce the growth in biomedical research spending and offer savings incentives and tax credits to help the uninsured purchase health coverage. MHA will monitor the budget talks and report to members on key healthcare provisions.

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13. MedPAC backs full-inflation update in 2005
   A draft recommendation by the Medicare Payment Advisory Commission urges Congress to set a full-inflation update for hospital inpatient and outpatient payments in 2005. The new Medicare reform law, however, already establishes inpatient updates through 2007, setting the 2004 update at full inflation and tying updates for the remaining years to participation in a voluntary quality initiative. Hospitals that submit quality data to the CMS will receive a full-inflation inpatient update, while those that don't will receive an increase equal to inflation minus 0.4 percentage points. The Medicare law doesn't set updates for outpatient payments, except in the case of some rural facilities.

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14. AHA summary compares presidential candidates' health coverage proposals
   The AHA has published a table comparing the various health care coverage and access proposals announced by 2004 presidential candidates to date. The summary comparison can be found here.

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15. Survey: Congressional impasse puts employee pension plans at risk
   Congress' failure to pass pension reform is jeopardizing employer-sponsored pension plans, according to a recent Hewitt Associates survey of 200 large employers. More than one-third (39%) of survey respondents that offer pension and other defined benefit plans said that without congressional reform, they would freeze the plans entirely or restrict them to current employees. Only 11% said they would maintain their traditional pension plans, while the remainder said they would take a "wait-and-see approach." "This survey shines a light on the need for quick congressional action on legislation to relieve hospitals of unnecessary and artificial pension funding requirements," said Mike Rock, AHA senior associate director for legislative affairs. "Without changes, already limited hospital financial resources will be drained from important day-to-day needs, with no real benefit to the financial health of pension funds." Employers' required pension plan contributions currently are based on the 30-year Treasury bond interest rate, which has plunged to an all-time low in recent years and inflated employers' pension liabilities to levels many say are unsustainable. Though a bill passed by the House in October would replace the problematic Treasury bond rate with a corporate bond index for two years while the issue is studied, the Senate delayed action on the bill until it returns from recess Jan. 20. For a copy of the Hewitt survey, call (847) 295-5000, or e-mail infodesk@hewitt.com.

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