Legislative Hotline
2006 SESSION OF THE
MARYLAND GENERAL ASSEMBLY
Volume 13, Number 12����������������������������������������������������������������������������������������������� April 17, 2006
The
2006 legislative Session of the Maryland General Assembly concluded at midnight
on April 10, 2006.� As the last session
prior to the upcoming primary and general elections in September and November,
it was at times a partisan and contentious 90 days.
That
being said, much was accomplished on behalf of the State of
��� Capital
���� Operating
���� Mental Health
��� Nursing Issues
���� Higher Education
���� Certificate of Need (CON)
����� Stem Cell
����� Medical
Liability
����� Trauma
����� Physician Reimbursement/Rebalancing
of Negotiating Power
����� Minority Health
Disparities
����� Health Care Workers
Shortage Task Force
����� Mental Health
Patients in Emergency Departments
���� Tax Credit
���� Eminent Domain
The
General Assembly passed a $711,157,833 capital budget ten days prior to the end
of the legislative session and sent it to Governor Ehrlich for his action by
midnight Friday, April 07, 2006.� State
law permits the Governor to sign the bill, veto it in its entirety, line item
veto, or allow it to become law without his signature. Governor Ehrlich opted
not to sign the bill, and expressed frustration with the amended bill in a
message to Senate President Mike Miller.�
The Governor indicated that his preference was to veto provisions of the
bill that amended changes to other statutes, but he was advised by the Attorney
General that that option was not available to him.� Consequently, Senate Bill 370 The
Johns
Pediatric Trauma Center������������������������������������������������������������������������������������ $15,000,000
Cardiovascular and Critical Care Adult Tower����������������������������������������������������� $12,500,000
(Note:�
an additional $5 million for the CCCAT will be funded through
�the
operating budget in FY2007, resulting in a total state commitment
of $32.5 million for the new clinical buildings
in the upcoming fiscal year)
School of Nursing/Berman Bioethics Institute����������������������������������������������������� $3,000,000
Additional major capital budget items
include:
University of
Kennedy Krieger Institute –
Developmental Disabilities
�
�
�
Kennedy
Krieger Children’s Hospital – Spinal Cord Injury Recovery
Program����� $1,000,000
�
�
�
The capital budget also includes $323
million for public school construction.
The General Assembly
approved a $29.4 billion spending plan for FY 2007, which is almost a $4
billion increase over the FY2006 budget.�
The budget does not include any new taxes or
tax cuts, but does include $870 million in rainy day funds to help balance
future budgets.� Although complete
details of the operating budget will not be available for several weeks,
following is a brief summary of items of particular significance for The Johns
Hopkins Institutions:
- Full funding of the Sellinger Aid Program, which translates to
$21 million in FY07 for Johns Hopkins; this represents an 11% increase
over FY06.�
- The Cigarette
Restitution Fund programs at Johns Hopkins were funded at their FY05
levels of $2.47 million for the cancer research grant and $1.2 million for
the public health grant.� The cancer
research grant received a 50% increase over last year’s
appropriation and the public health grant was level funded.� In addition, a deficiency appropriation
includes restoration of $600,000 of the FY06 cut for the cancer research
grant.
- $15 million for Stem
Cell Research
- A provision that freezes tuition at state
colleges for one year, as well as a two percent average raise for most
state workers with an 11.3% increase for correctional officers.�
��
The
General Assembly withheld $100,000 of the Mental Hygiene Administration’s
appropriation pending the completion of a report to the budget committees
detailing short-term and long-term solutions toward the problem of
over-utilization of emergency rooms by persons with psychiatric illness.� The report is due December 1, 2006, and must
include a clear articulation of the State versus private sector role in the
provision of acute inpatient psychiatric services.� In addition, the report must detail the
extent to which the proposed solutions are agreed to by all the appropriate
providers and regulators.
Legislation
passed which seeks to help address the nursing and nurse faculty shortages in
Two
bills passed that directly impact independent Higher Education in
Another bill
within higher education will authorize judicial review in the circuit
court of a decision by the Maryland Higher Education Commission (MHEC) regarding
the duplication of academic programs. Decisions are only subject to judicial review
when an institution of higher education has specifically
requested a determination about program duplication or has filed an objection to the
implementation of a new program based on unreasonable program duplication. The bill
clarifies that MHEC must make a determination about the duplication of academic
programs implemented after July 1, 2006, after receiving a request from a public
institution directly affected by the duplication.
On
March 29, State Superintendent Nancy Grasmick and the
State Board of Education called for an order requiring 11 schools to overhaul
their management, either by contracting with a third party or converting to
charter schools (public schools that operate independently). The State's move
to take over the 11 schools is the first such action under the No Child Left
Behind Act, a four-year-old federal law, and
Legislation
was passed changing the hospital capital expenditure threshold that requires a
CON from $1.25 million to $10 million.�
In addition, only a hospital in a county with fewer than three hospitals
must hold a public informational hearing before closing all or part of a
hospital.�
Several
pieces of legislation altering the Certificate of Need (CON) process related
particularly to open heart surgery programs were introduced, but none passed.�
The
Maryland Stem Cell Research Act of 2006 was passed by the General Assembly on
March 29 and signed by the Governor on April 6.�
It will take effect on July 1, 2006, and establishes a Commission that
will set the parameters for use of the $15 million that has been appropriated
for stem cell research in the FY2007 budget.�
The bills stipulates that the funds may be granted for either adult and
embryonic stem cell research, and it�
prohibits human cloning and the use of human oocytes
in state funded research which is to say that state funds may not be used for
research involving Somatic Cell Nuclear Transfer (SCNT), although SCNT is not
prohibited.�
Nearly
twenty pieces of legislation dealing with medical liability were introduced,
although none passed.� Companion bills
that would have established a task force on Administrative Compensation for
Birth-Related Neurological Injury failed to pass their respective chambers, as
did bills addressing expert witnesses, emergency medical care and Good
Samaritan immunity, structured payments and income tax credit for medical
malpractice insurance.� A bill that would
have rendered the expression of regret or apology inadmissible overwhelmingly
passed the House but died in the Senate.�
The trauma bill passed in the waning hours of the Legislative
Session.�� When introduced, the bill made
three changes to the current trauma program to try to get all physicians providing
trauma care included under the program: 1) it expanded the trauma reimbursement
program to 22 specialties that treat trauma patients but currently do not get
reimbursement under this program; 2) it included the three specialty trauma
centers that currently are not included in the original law; and 3) it
increased the on-call support for level two and level three trauma centers.
�
There was some reluctance in the Senate Committee to expand this program at all and there was strong
resistance to doing anything that might force them to have to increase the fee
that supports this program in the current year or the foreseeable future. The
Finance Chairman made it clear to trauma net members that there did not appear
to be a sufficient number of votes to pass the bill in the Finance committee if
there was a net annual cost in this program (despite the fact that there is a
current surplus in the Fund).��
Consequently, the bill was amended by the Finance Committee to cut the
amounts provided in the bill for Children’s Hospital (for Maryland trauma
patients) by $100,000; and to cut the four level two hospital trauma centers by
$300,000 ($75,000 each).� The Senate did
add a small one-year grant program of up to $3 million for capital equipment
for level two and three trauma hospitals, to be funded from the surplus. The
House accepted the Senate amendments.
Physician Reimbursement/Rebalancing of Negotiating
Power
Multiple
bills were introduced in an effort to shift the balance of health industry
negotiating power away from insurance carriers to a more balanced relationship
with providers and physicians.� Legislation that
prohibits insurers from including “Most Favored Nation” clauses in
provider contracts was adopted.�
Currently, Care First Blue Cross Blue Shield uses such a provision in
its provider contracts when they offer the provider a higher rate than the Care
First standard fee schedule.� ��Other bills that deal with the assurance of
network adequacy and recredentialing of health care
providers when there is a change in tax ID or employers have all also passed.� Measures that
did not pass include bills dealing with prohibiting carriers from requiring
providers to accept workers compensation cases at contract rates, assignment of
benefits, and payment of non-par providers.�
Eight
bills designed to address minority health disparities on several fronts were
introduced.� Three measures passed,
including a bill that has potential impact on the Johns Hopkins Adult Sickle Cell
Disease Program. That bill requires the Department of Health to study and make
recommendations on methods to improve the quality of health care delivery to
adults in
Health Care Workers Shortage Task Force
Legislation passed
that creates a Statewide Commission on the Shortage in the Health Care
Workforce.� The Commission will be housed
in the Department of Health and Mental Hygiene and will report its findings and
recommendations annually to the General Assembly and Governor.� The Commission is charged with the following:
�
determining
the current extent of health care workforce shortage in
�
examining
what changes are needed to enhance institutional capacity to increase student
enrollment and graduation rates, and to enhance current education and
scholarship programs,
�
examining
what changes are necessary within the health care environment to retain
workers, and
�
identifying
methods to recruit and retain health care workers.
Mental Health Patients in Emergency Departments
Although
the General Assembly deferred major initiatives regarding multiple issues
pertaining to the public mental health system pending due to a report by the
Mental Hygiene Administration, a bill that will bring some relief for mental
health patients with insurance who present to emergency departments did
pass.� That bill will accomplish the
following:
- require
private review agents that require authorization for emergency inpatient
admission for treatment of a mental, emotional or substance abuse
disorder, to make a determination within 2 hours of receipt of the
information needed to make a determination,
- allow
hospitals to refer these patients to a residential treatment center, and
- require private review agents to cover
the first 72 hours of inpatient hospitalizations for
involuntary admissions.
There were six bills introduced that sought to provide tax credit incentives for the biotechnology industry.� All failed.�
After the Supreme Court ruled that a city in
Legislation was ultimately introduced
in both chambers that sought to conclude the following: (1) a viable business
should be preserved whenever reasonably practicable and should not be acquired
by condemnation for urban renewal or economic development purposes unless other
alternatives are shown not to be practicable, and (2) when it is necessary to
acquire an existing business by condemnation, the government unit must make
every reasonable effort to ensure that the business is incorporated in the
urban renewal or economic development project at its existing location or
nearby.�� All the bills on eminent domain
failed.
STAFF CONTACT INFORMATION
Please contact Government Relations if you have concerns or would like
additional information. Your input assists us greatly in evaluating and
formulating the position of Johns Hopkins on all legislation.
Legislative Session Office
410-269-0057
fax 410-269-1574
Heather Barthel�������������������� [email protected]
Mickey Geisler��������������������� [email protected]
Jessica Hendrix������������������� [email protected]
Sheila Higdon����������������������� [email protected]
Bret Schreiber���������������������� [email protected]
Tom Lewis���������������������������� [email protected]
Nicole
Xander���������������������� [email protected]
Cathy Ximenez��������������������� [email protected]
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