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During the session interim, the�Legislative Hotline will be distributed monthly.� In addition to state issues, we will include relevant information on federal and local affairs.� The Legislative Hotline will return to a weekly distribution when Session resumes in January of 2005.

To view the legislative information below, click on the subject of interest to go directly to that area or scroll down to view the entire document.

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FEDERAL
Bush & Kerry Offer Different Visions for Health Care

STATE
Capital Budget Efforts
Senate EHEA Committee Site Visit
Slot Machines
Delegate Pete Hammen to Discuss Med Mal with the CPA
GCPA to Attend the Maryland Association of Counties Conference

CITY
Charles Commons

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STAFF CONTACT INFORMATION

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FEDERAL ISSUES

Bush & Kerry Offer Different Visions for Health Care

Over the past few months, both the Bush and Kerry campaigns have put forth their health care plans. The following is a brief outline of their proposals to date. As the campaign progresses, we may see additional details or even changes between now and November. Both candidates� proposals contain items which would likely meet (and in some cases, have met) with significant congressional opposition.

President Bush:

Medical liability Reform

President Bush�s proposal is similar to the reforms adopted in California in the late 1980�s and calls for: a $250 thousand cap on non-economic damages; no limit on economic damages; punitive damages available only for severe cases and limited to the greater of twice economic damages or $250 thousand; the adoption of the proportional share rule (rather than joint and several liability rules); a statute of limitations of 3 years -- except for cases involving children; and permitting information sharing among providers regarding medical errors without the fear that such information will be subject to discovery during litigation.

Association Health Plans (AHPs)

This proposal would permit small employers to pool together (under the auspices of an entity like the National Federation of Independent Businesses) to offer health insurance options to their employees similar to the way large corporations and unions are currently able to do under federal law. Note that this implies a fairly substantial change from current law in that states would loose their jurisdiction over plans covering these workers.

Refundable Tax Credit and Health Savings Accounts (HSAs)

This proposal, estimated to cost $70 billion over 10 years, would make available to individuals without employer-sponsored health insurance a tax credit for the purchase of insurance. The credit would be worth up to $1,000 for individuals with incomes up to $30,000 and up to $3,000 for families with incomes up to $60,000. This proposal was included in the President�s FY 2005 budget. In addition, the proposal would permit individuals with HSAs to deduct 100% of the cost of premiums for catastrophic health care coverage.

Health Care Technology

Numerous demonstration projects are being conducted regarding the use of information technology to improve the flow of health information to reduce medical errors, provide more appropriate levels of care, and reduce liability and administrative costs. The President�s FY 2005 budget doubles the amount of funding for these projects to $100 million with the goal of having most Americans with an electronic health records within the next 10 years.

Senator Kerry:

Changes to Medicare

The Senator�s proposals with respect to the Medicare Prescription Drug program include: (i) having the drug program run by Medicare rather than private insurers; (ii) permitting the Secretary of Health and Human Services to negotiate drug prices; (iii) permitting the re-importation of pharmaceuticals from Canada and other countries; (iv) reforming the generic drug rules; (v) instituting transparency rules for Pharmacy Benefit Managers; and (iv) providing incentives to states to implement better contracting for drugs.

Changes to Medicaid

The use of block grants for the Medicaid program, which has been suggested in the past, is opposed by Senator Kerry. He would provide $25 billion in �state relief� over 2 years for: nursing home inspectors and training for health care workers; and support for paid and unpaid caregivers. In addition, Senator Kerry proposes to expand Medicaid for the disabled by creating more options for in-home and community care and has proposed that the federal government pay the full cost of the Children�s Health Insurance Program (S-CHIP) so states can expand coverage to families up to 200% of poverty and childless adults up to 100%.

Medical liability reform

Senator Kerry�s proposal includes steps to facilitate the current claims/litigation process so as to reduce malpractice premiums and supports state efforts regarding mediation and would institute a �three strikes and you�re out rule� for lawyers to limit frivolous lawsuits.

�New� Congressional Health Plan

This plan proposes $177 billion in tax credits to allow uninsured Americans to buy insurance through a process similar to that which is available to members of Congress and their staff through the federal employee health benefit plan. The purchase of this insurance would be facilitated by: (i) a 25% credit for seniors (55 to 64) with salaries below 300% of poverty; (ii) a 75% credit for �people between jobs� with salaries below 300% of poverty, (iii) up to 50% for small businesses covering low to moderate income workers and (iv) a credit for workers not otherwise covered by this new plan which would somehow limit premiums to less than 6% of income for workers below poverty phasing out to 12% for workers at 300% of poverty.

Response to the AIDS crisis

In order to address the AIDS crisis both nationally and internationally Senator Kerry proposes: increasing funding for Ryan White CARE Act and Housing Opportunities for People with Aids Act, expanding Medicaid to cover additional HIV/AIDS treatments, through the resources made available from the $25 billion in state aid discussed above, providing $30 billion to the Global Fund by 2008, increasing resources for US programs to combat tuberculosis and malaria, eliminating legislative restrictions on the use of federal funds, and working for greater debt cancellation for poor countries fighting AIDS.

STATE ISSUES

Capital Budget Efforts

As Johns Hopkins continues to build out it master plans on the Homewood and East Baltimore campuses, financing these projects will rely on a combination of institutional debt, fundraising, and state support. The Homewood master plan calls for $450 million for facilities such as Gilman Hall and the construction of new academic buildings. Meanwhile, the East Baltimore campus master plan calls for the investment of $1.2 billion to address numerous issues, including replacing outdated clinical buildings, providing state-of-the art research laboratories and modern teaching facilities, and supporting infrastructure.

During the upcoming session of the Maryland General Assembly, the Johns Hopkins Institutions will be seeking state support for three projects - $3 million for the Computational Sciences Building, $25 million over five years for the Cancer Research Building II, and $50 million over six years for the Pediatric Trauma components of the new Children�s and Maternal Hospital.

The Computational Sciences Building will support new interdisciplinary research and training activities of the faculty in the Department of Computer Science (CS), a department of the Whiting School of Engineering located on the Homewood Campus. Total project costs are estimated at $22 million: state support of $3 million will represent about 13% of project costs. The 60,000 square foot facility will be a part of the MICUA Capital Grant Program, along with projects from Loyola College, the Maryland Institute College of Art and Baltimore Hebrew University.

The 270,352 square foot Cancer Research Building II will complete the plan for Johns Hopkins Medicine to co-locate the majority of cancer related research on the East Baltimore campus. The facility will include 10 floors of office space, 5 floors of laboratories, and a basement vivarium. Total project costs are $85.9 million and the state request would represent 29%.

Johns Hopkins Children Center is home to the state�s only dedicated pediatric trauma center caring for more than 1,000 critically ill and injured children and more than 5,000 seriously injured and ill children annually. These patients come from every jurisdiction in the state. As a result of this major statewide mission, Johns Hopkins is seeking $50 million in state support to cover the costs of the pediatric trauma components of the new Children�s and Maternal Hospital. The pediatric trauma center will not be a freestanding facility or a designated floor, but for operational efficiencies will be integrated throughout the $194.5 million Children�s and Maternal Hospital. It should be noted that for the entire $1.2 billion East Baltimore master plan, Johns Hopkins is requesting $75 million or 6.3% of the total project costs.

In an effort to build state support for all of these projects, Johns Hopkins will host several site visits for various legislative committees and groups throughout the year. In addition, Johns Hopkins will present its master plans and corresponding state request before the Maryland Higher Education Commission and the Department of Budget and Management this fall.

Senate EHEA Committee Site Visit

On July 27, 2004, the Senate Education, Health & Environmental Affairs (EHEA) committee incorporated a visit to the East Baltimore campus in their Baltimore City site visit. Since the Governor has allocated funding for the pediatric trauma center in the upcoming fiscal year, the Senate committee was interested in touring the existing pediatric facilities and learning more about Johns Hopkins� plans for the State�s only designated Pediatric Trauma Center. Dr. Miller and Mr. Peterson welcomed the committee to our campus before Dr. Dover and his team conducted an extensive tour. In addition, in response to a request by the committee chair, Senator Paula Hollinger, to learn more on how our hospital is utilizing technology to improve patient safety and medical record information, the committee saw a demonstration of the new Provider Order Entry system Three additional committees of the general assembly are expected to visit our campuses later this fall.

Slot Machines

On Friday, August 6, House Speaker Michael Busch presented a bill to legalize slot machines to Governor Ehrlich. The bill will allow for 13,500 machines at Laurel Racetrack, the Maryland State Fairgrounds in Timonium, the Rocky Gap Lodge near Cumberland, along Interstate 95 in Harford County, and in Frederick and Cambridge with operator�s licenses awarded through competitive bids.

Of the money generated in the Speaker�s slots proposal, 3% of the proceeds would be designated for local development grants for the counties and Baltimore City, plus another 2% in grants for jurisdictions where slots are located. As much as $100 million would go toward increasing horse-racing purses and supporting the horse industry. For the first five years after slots is legalized, up to $40 million a year would go toward a racetrack improvement fund. The state lottery would get up to 5% to cover administrative costs for the first five years. After that time, it is anticipated that the amount needed to cover the administrative costs will decrease and the amount they receive would, therefore, be reduced accordingly. The Maryland Stadium Authority would get 5% for acquisition and construction of slots facilities. Slots operators would receive up to 25% of the proceeds, depending upon the amount of their bid. More than 50% of the proceeds would go toward K-12 public education.

The Speaker has offered to negotiate with the Governor and President Miller on all aspects of the proposal except the provision to put the bill to a referendum to be decided by the voters in the fall. That is the biggest point of contention for the Governor and Senate President who are opposed to a ballot measure. However, they have agreed to study the proposal and respond to the Speaker within two weeks. For a bill to be put on the November ballot, the members of the General Assembly would have to convene a special session and pass the bill by a 60% margin in both houses by September 8.

Delegate Pete Hammen to Discuss Med Mal with the CPA

On September 1st at 6:00 p.m. in JHOC room 2140 Delegate Pete Hammen will meet with members of the Clinical Practice Association for a discussion of medical malpractice tort reform. Delegate Pete Hammen represents the 46th Legislative District and is the Vice-Chair of the House Health and Government Operations Committee and a member of the House Workgroup on Medical Malpractice Tort Reform.

GCPA to Attend the Maryland Association of Counties Conference

The Government Relations staff for the Johns Hopkins Institutions will be exhibitors and attendees at the annual Maryland Association of Counties (MACo) Conference in Ocean City, Maryland, August 18 � 21. In keeping with the theme of the conference, �Monster Mash,� Johns Hopkins will be presenting �Weird Science,� an exhibit highlighting some of the more unique and unusual programs at the Institution. Eight programs will be displayed, including Aqua-Porons, the Facial Prosthetic Clinic, Hubble Space Telescope, the Howler Monkey Project, Forensic Nursing, Robo-Rounds, and the Mind/Brain Institute. Many divisions across the Institution have donated items to be raffled off, such as books from Johns Hopkins University Press, and props to be displayed, including a skeleton courtesy of the Anatomy Department and lab coats embroidered with �Johns Hopkins � Weird Science Division� from Procurement. If you are planning to attend the conference please visit us in booth space 210 & 211.

CITY ISSUES

Charles Commons

All regulatory approvals to commence demolition and site preparation are in place. As of early August, pre-demolition environmental remediation was underway. Demolition is expected to start in the later part of August, and the project is scheduled to be completed in the Summer of 2006 so as to accommodate the incoming students. Adjacent to the Charles Commons project, Struever Bros., Eccles & Rouse is also developing new condominiums, retail, and structured parking on the 3200 block of St. Paul Street. The two projects, which are designed to complement each other and strengthen the economic and social viability of the area, will address several important elements identified in the Commission on Undergraduate Education report (CUE), and will add many new features to Charles Village that have long been desired by JHU affiliates and nearby residents.

In order to have progressed this far in the development process, the projects required significant public zoning entitlements. To accomplish this, and to garner support within the surrounding communities, the development team convened and oversaw a community task force which met regularly over the past 18 months. The task force provided input on both the Charles Commons and 3200 block projects regarding the exterior features of the buildings, streetscape elements, and desired (and undesired) business establishments. The proactive efforts of this task force have lead to formal expressions of support for the projects by the leading community-based organizations, and the strengthening of town-gown relations. Letters, testimonials, and other actions by Homewood�s neighbors have played an important role in securing several permits and other approvals essential to the projects, including allowing larger building massing, and permitting new retail types and sizes such as the bookstore, live entertainment, restaurants, and a wine-bar. Additional information can be found at www.charlesvillageprojects.com.

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STAFF CONTACT INFORMATION
Please contact the Government Relations staff if you would like additional information. Your input assists us greatly in evaluating and formulating the position of Johns Hopkins on all legislation.

Government, Community, and Public Affairs
Johns Hopkins Institutions
901 S. Bond Street, Suite 540
Baltimore, MD 21231
phone 443-287-9900
fax 443-287-9898

FEDERAL Beth Felder	bfelder1@jhu.edu
Maggy Huson	mhuson@jhu.edu
STATE Heather Barthel	hbarthel@jhmi.edu
Sheila Higdon	shigdon@jhmi.edu
Jim Kaufman	jkaufma@jhmi.edu
Bret Schreiber	bschreiber@jhu.edu
Mickey Geisler	mgeisler@jhu.edu
Cathy Ximenez	cximenez@jhmi.edu
CITY Salem Reiner	sreiner@jhu.edu
Joseph Smith	Jsmith185@jhu.edu