Committee on Health Newsletter

http://dccouncil.us/committees/committee-on-health
J U N E 2 0 1 3

Committee on Health:
Councilmember
Yvette M. Alexander,

Committee on Health Updates
Department of Health Director to Leave
Dr. Saul Levin, who has led the Department of Health (DOH) as Interim Director for the past 11 months, has given notice that his last day will be July 12. I share this news with mixed emotions. Dr. Levin arrived at DOH about a year and a half ago as the Department’s Senior Deputy Director for the Addictions Prevention Recovery Administration (APRA). Just 4 months in his tenure, Mayor Gray tapped him to become Interim Director of DOH when the Mayor appointed Dr. Mohammad Akhter, Director of DOH, to head the Health Benefit Exchange Authority, the body that is hard at work preparing the District for implementation of Health Care Reform (Obamacare). Dr. Levin tendered his resignation to accept the post that has been his dream for years. He will become the Chief Executive Officer/Medical Director of the American Psychiatric Association (APA), serving more than 36,000 psychiatrists throughout the world. During his relatively short time with us, I have grown very fond of Dr. Levin and the excellent working relationship my staff and I have enjoyed with him and the DOH team under his leadership. Dr. Levin should depart with pride at the accomplishments of DOH during his administration. Working with the Metropolitan Police Department (MPD), DOH was able to identify and respond to the growing trend of synthetic marijuana (aka “Spice” and “K2”) use among our youth. And, partnering with the federal Substance Abuse and Mental Health Services Administration launched the first in the nation synthetic marijuana public education campaign. He led the city’s response to the derecho and oversaw President Obama’s second inauguration. And, Dr. Levin has worked to ensure the smooth transition of APRA and the Department of Mental Health into the new Department of Behavioral Health. Additionally, he has engaged the faith-based community in innovative efforts in addressing the HIV/AIDS epidemic through rapid HIV testing and in outreach efforts to promote prenatal care by pregnant women,

Chairperson Rayna Smith, Committee Director Melanie Williamson, Legislative Counsel Ronald King, Senior Policy Advisor

Phone: 202-724-8170

1350 Pennsylvania Avenue, NW

Fax: 202-741-0911

Washington, DC 20004

John A. Wilson Building

Suite 115

both important undertakings, particularly in Ward 7. These are just a few highlights of the excellent work of Dr. Levin’s short tenure at DOH. We wish him the best as he departs.

United Medical Center Update: Budget and Town Hall Meeting
On May 28, 2013, the Council’s monthly Mayor-Council Breakfast took place at United Medical Center (UMC). The Mayor, members of the Council and their staff were greeted by UMC employees and Huron Healthcare, the consultant team contracted to turnaround the hospital’s severe financial situation. This meeting, entitled “Transformation Engagement,” was a project update for DC government officials. During the meeting, Huron provided the Council with UMC’s current financial performance, an explanation of the market and UMC’s position within the market, its operating assessment, and strategic next options. Some of the major facts presented by Huron are as follows:
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UMC is currently in a worse position now than it was at this point last year, by close to $8.5 million dollars and that overall expenses are about budget by 4%. Inpatient volume is below budget by 5.6%, but consistent with the same period last year. Revenue per admission and patient day has declined as a result of decline in patient acuity and payer mix. Surgery volume is extremely low; there are consecutive days with no surgeries scheduled. Emergency room volume remains strong, but very few emergency visits result in inpatient admission. UMC’s market is growing rapidly and aging but is not necessarily diversifying.

The overall conclusion of the presentation is that UMC must combine aggressive operational improvement and cost management with strategic change, and that being a part of a hospital system and partnership will be necessary moving forward. In its next steps, UMC will complete its analysis on the current state of the hospital and the community in which it resides, present options to the Steering Committee, refine its goals and strategies, and finally, present its final strategic plan to the Board for a vote on July 25. Later that evening, United Medical Center held a Town Hall Meeting at the Department of Employment Services in Ward 7, in order to hear from members of the community. This was the third town hall meeting held by the hospital, with the first two being in Ward 8, where the hospital is located. At the meeting, the moderators asked many questions to the attendees, including “What are your impressions of UMC?” “If given a choice between UMC and another hospital, where would you likely go?” “Please explain some of the experiences you’ve had at UMC – both positive and negative” and “What are some things that you would need to see improve at UMC for you to trust them as your hospital?” The crowd responded with several responses, and while a few individuals noted positive experiences at UMC, including the birth of a child or particular care for a loved one, a majority responded with criticisms. The poor critiques included lack of specialized care, poor customer service and dilapidated facilities. UMC and Huron employees took copious notes on the matter and promised the community that their voices
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have been heard and that changes would be made. Councilmember Alexander, co-sponsor of the event, explained that she “would do everything in [her] power to ensure that Huron and UMC brought the only hospital east of the river back to being the superb health care facility that residents of Ward 7 and 8 deserve.”

Committee on Health FY14 Budget
On May 6, the Committee on Health met to mark-up its Budget recommendations. While the Committee chose to accept the Mayor’s recommendations as it pertained to the Department of Behavioral Health, the Office of the Deputy Mayor for Health and Human Services, and the Not-For-Profit Hospital Corporation, it did make a few changes to the Department of Health Care Finance, the Department of Health and the Health Benefit Exchange Authority. The Mayor’s FY14 budget proposal included $265,062,274 in gross operating funds for DOH. The Committee recommended a gross operating budget of $265,714,274, which reflects a $652,000 increase from the Mayor’s FY14 proposal. This $600,000 increase is a result of $500,000 in savings realized from the Department of Health Care Finance, as well as $152,000 sent to the Department from other committees in the Council. With an increase in funds, and recognition of savings from other sources within the agency, the Committee chose to reallocate funds in the following manner: (1) Increase the budget of the HIV/AIDS, Hepatitis, STD, and TB Administration by $50,000 to address the District’s problem of mother-to-child (vertical) transmission which can occur during pregnancy, labor, delivery, or breastfeeding; (2) Increase the budget of the Community Health Administration by $850,000 to enhance the Department’s efforts in addressing the chronic illnesses asthma, diabetes, obesity, cancer, heart disease, hypertension, and kidney disease; (3) Increase the budget of the Community Health Administration by $300,000 to create a program designed to promote healthy development in girls attending public and charted schools that are located in areas of the city possessing both the highest rate of teen pregnancy, and with a high population of enrollees of state-funded health programs; (4) Increase the budget of the Community Health Administration by $100,000 to create a farmers’ market incentive program; (5) Increase the budget of the Community Health Administration by $52,000 for a school-based food pantry programs. The Committee also recommended an increase of $40,000,000 in Special Purpose Revenue funds for the Health Benefit Exchange Authority to reflect an increase in federal grants that were awarded to the Exchange. In regards to Budget Support Act recommendations, the Committee adopted those recommended by the Mayor, and also added two additional subtitles: the “Department of Health Functions Clarification Amendment Act of 2013” which provides the Department of Health with the authority to award grants to qualified community organizations who meet specific community needs, and the “Reporting Requirement Act of 2013,” which requires the Department of Behavioral Health, of Health Care Finance, of Health, and the Not For-Profit Hospital Corporation and the Deputy Mayor for Health and Human Services, to provide reports to the Committee with pertinent information that will assist the Council and the Committee in overseeing the actions of these agencies. This subtitle has no impact on existing law.

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MCO Update
On April 30, 2013, the D.C. Council approved three new contracts for Managed Care Organizations (“MCOs”) to deliver comprehensive health care services to individuals enrolled in the District’s Medicaid and Alliance programs. Two of the contracting companies, Trusted Health Plans (formerly known as Thrive Health Plan) and Amerihealth, are new to managed care in the District. These two new MCOs will replace incumbent health plans United Health Plans and Chartered Health Plans. The third new contract was awarded to Medstar Health, another incumbent company and the only incumbent MCO that will continue into the new contract period. Although it is new to the District, Amerihealth has been providing health care services for 30 years and currently operates in 12 states. It also purchased the assets of the financially troubled Chartered Health Plan on May 1, 2013, and will serve Chartered’s members until Amerihealth’s own new contract begins on July 1, 2013. Trusted Health Plans was started in 2012 by a group of managed care professionals with a plan to use innovative and unique strategies to maintain wellness and target health disparities in the District’s Medicaid and Alliance population. The company will anchor itself in Ward 7, where the vast majority of Medicaid and Alliance recipients reside. As the only company with a presence east of the river, Trusted hopes to provide unprecedented support to its members in the Ward. Members will soon receive notices that they have been auto-assigned to one of these three new health plans (Amerihealth, MedStar, or Trusted). All members currently enrolled in United Health Plans will automatically be assigned to either MedStar or Trusted. Members previously enrolled in Chartered Health Plans will remain with Amerihealth. MedStar will retain its current membership. However, all members will have 90 days from the start of the contract period on July 1, 2013, to change their membership and select a different plan. If you have questions regarding these health plans and the enrollment process, please call DC Healthy Families (202) 639-4030 or 1800-620-7802 (TDD/TTY line: (202) 639-4041).

Health Benefit Exchange Update
With federal deadlines for the District’s first Health Benefit Exchange fast approaching, Councilmember Alexander obtained the unanimous vote of her colleagues and passed an emergency health benefit exchange bill at the Council’s June 4, 2013 legislative meeting. The legislation reflects the input of dozens of stakeholders and the D.C. Health Benefit Exchange Authority Executive Board, and solidifies the final pieces of the Exchange. It clarifies a number of details for the Exchange marketplace to ensure that consumers obtain maximum choice and value from plans on the Exchange. For example, the legislation requires carriers to offer plans with bronze, silver, and gold values that are all “meaningfully different” from each other and contain benefits for mental health, substance abuse, and autism treatment.

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The D.C. Health Benefit Exchange Authority reports that four major insurance carriers will participate in the exchange and offer a combined total of nearly 300 plans. The plans and rates are currently under review by the Department of Insurance, Securities, and Banking, and, if approved, must be uploaded to the Exchange’s online system by August 1, 2013. After August 1, the system will undergo a series of tests by the federal government before it will go live for open enrollment on October 1, 2013. As Chair of the Committee on Health, Councilmember Alexander holds monthly roundtables on the implementation of the District’s Health Benefit Exchange. The next oversight roundtable will occur on Tuesday, June 25, 2013. All members of the public are encouraged to attend and testify, and can obtain more information about the roundtable by contacting the Committee on Health at 202-724-8170.

JaParker Deoni Jones Birth Certificate Equality Amendment Act of 2013
On Wednesday, June 5, 2013, the Committee on Health unanimously passed the JaParker Deoni Jones Birth Certificate Equality Amendment Act of 2013. JaParker Deoni Jones, one of our transgender neighbors, was brutally murdered while sitting at the bus stop at East Capitol Street near the intersection with Sycamore Road, NE. The murder outraged our community and brought an outpouring of support from all sectors of the public throughout the city. Bill 20-142, named in honor of Jones, amends the Vital Records Act of 1981 to require the Registrar to issue a new certificate of birth, designating a new gender for any individual who provides a written request and signed statement from a licensed health-care provider that the individual has undergone a gender transition, to require that an original certificate be sealed when a new certificate of birth is issued and to amend section 16-2501 of the District of Columbia Code to exempt an individual from the publication notification requirement for a name change that is requested in conjunction with a request to change the individual’s gender designation. Any concerns that individuals might seek gender changes for fraudulent purposes are unfounded the Social Security Administration has issued clear guidelines to prevent abuse of the changes Bill 20-142 would provide. Additionally, law enforcement agencies and the court system would have access to the sealed original birth certificates to guard against attempt at fraud.

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Recent Committee Hearings: Committee on Health
June 5: Mark-Up—JaParker Deoni Jones Amendment Act of 2013 (B20-142), Rm. 123 @ 2 p.m.

Upcoming Committee Hearings: Committee on Health
June 25: Roundtable—Health Benefit Exchange, Rm. 123 @ 11 a.m. June 28: Hearing—The Omnibus Health Regulation Amendment Act of 2013 (B20-153), Rm. 500 @ 11 a.m. July 1: Hearing—Cottage Food Amendment Act of 2013 (B20-168), Rm. 123 @ 11 a.m. July 2: Hearing—(1) Trauma Technologists Amendment Act of 2013 (B20-232) and (2) Medicaid Reimbursement for Chiropractic Services Amendment Act” and (3) Health Professional Recruitment Program Act, Rm. 123 @ 11 a.m. July 12: Hearing—(1) Prescription Drug Monitoring Program Act of 2013 (B20-127), (2)Health Services Planning Regulations Approval Resolution of 2013 (PR20-280), Rm. 120 @ 11 a.m.

Medicaid Fraud Hotline
DHCF investigates activities relating to the prevention, detection, and investigation of alleged provider and recipient fraud and/or abuse in the Medicaid program. Controlling fraud and abuse means more dollars are spent funding critically needed programs and medical procedures. If you have suspicions of Medicaid Fraud, please call 877-632-2873 or visit https://www.dcmedicaid.com/dcwebportal/nonsecure/fraudAndAbuse.

HIV—”Get Tested”
The DC Department of Health HIV/AIDS, Hepatitis, STD, and TB Administration has prepared a comprehensive and easy-to-read directory of all DC HIV/AIDS services, most are funded by the District of Columbia Government. The directory contains information ranging from HIV testing locations to medical care, medications and support services, including nutrition services and housing. Directory of HIV/AIDS Services in DC: http://haadirectory.doh.dc.gov/

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Agencies under Committee on Health Purview:
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Department of Health Department of Health Care Finance Department of Mental Health Deputy Mayor for Health and Human Services District of Columbia Health Benefit Exchange Authority Not-For-Profit Hospital Corporation, better known as United Medical Center Health Information Exchange Policy Board Advisory Committee on Acupuncture Advisory Committee on Naturopathic Medicine Advisory Committee on Physician Assistants Advisory Committee on Polysomnography Advisory Committee on Surgical Assistants Board of Allied Health Board of Behavioral Health Board of Chiropractic Board of Dentistry Board of Dietetics and Nutrition Board of Marriage and Family Therapy Board of Massage Therapy Board of Medicine Board of Nursing Board of Nursing Home Administration
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Boards, Commissions, Councils and Advisory Committees:
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Board of Occupational Therapy Board of Optometry Board of Pharmacy Board of Physical Therapy Board of Podiatry Board of Professional Counseling Board of Psychology Board of Respiratory Care Board of Social Work Board of Veterinary Examiner Committee on Metabolic Disorders Commission on HIV/AIDS Council on Physical Fitness, Health, and Nutrition Mental Health Planning Council
Metropolitan Washington Regional Ryan White Planning Council

Advisory Committee on Anesthesiologist Assistants 
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Board of Audiology and Speech-Language Pathology 
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State Rehabilitation Council Statewide Health Coordinating Council

Committee on Health Contact Information:
Rayna Smith: Committee Director, 202-741-2111, rsmith@dccouncil.us (United Medical Center, Department of Mental Health) Melanie Williamson: Legislative Counsel, 202-741-2112, mwilliamson@dccouncil.us (Department of Health Care Finance, D.C. Health Benefit Exchange Authority) Ronald King: Senior Policy Advisor, 202-741-0909, rking@dccouncil.us (Department of Health)

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