Department of Legislative Services (DLS) Budget Briefing
On January 24, the Senate Budget and Taxation and the House Appropriations Committees received a fiscal briefing on the Governor�s budget from the DLS. This briefing provided some clarity on the Governor�s proposed Operating and Capital Budgets for FY 2012. You will find a summary below:

Operating Budget
The total growth in the budget is 3%. While most programs are level funded or reduced, Medicaid grows by 14.4%. This growth is driven by the discontinuation of ARRA funds and increased enrollment. A number of operating budget items are of particular interest to Johns Hopkins.

The proposed budget and the Budget Reconciliation Financing Act (BRFA) include a $250 million increase in hospital assessments over those in FY 2011. Included in the proposal are a new $200 million assessment to become permanent state law, and $50 million in additional Medicaid assessments (details unclear at this time). When added to existing assessments, the projected total is $530 million. There is also an existing assessment on hospitals that funds the Maryland Health Insurance Plan (MHIP); this is expected to remain even after implementation of federal health care reform in 2014. With the inclusion of the MHIP assessment, the total projected financial hit to hospitals is $655 million. The proposed budget also includes a 1% reduction in physician reimbursements. Also included in the reduction to hospitals is a section in the BRFA that would (1) increase the current hospital assessment cap from 3% to 6% of net revenue on a permanent basis, (2) alter graduate medical education provisions to allow pooling similar to the uncompensated care pool; and, (3) add an assessment on savings realized by averted hospital uncompensated care from the health care expansion.
We are working with the Maryland Hospital Association and key legislators to mitigate the impact of the proposals on hospitals.

Sellinger Aid was level-funded at the FY 2011 appropriation of $38.4 million (JHU received $16.6 million of those funds in FY 2011 due to enrollment growth).

The $400,000 in CRF money dedicated to Johns Hopkins for cancer research remains intact.

The Stem Cell Research program has been level funded at $12.4 million and the Biotechnology Tax Credit program is funded at $8 million.

Capital Budget
The Governor's proposed capital budget includes two major provisions for Johns Hopkins.

The final $5.5 million installment of capital funding for the New Clinical Buildings is included, which would complete the state�s $100 million capital funding commitment.

The MICUA Capital Grant program was reduced to $4 million. The MICUA Capital Grant program has traditionally been funded at close to $8 million. Johns Hopkins� Brody Learning Commons is one of the projects being funded by this program in FY 2011, and currently receives $1 million in this proposed budget. Our staff is currently working in conjunction with MICUA staff to restore this funding level.

In the coming weeks, the House and the Senate will be holding budget hearings, and are required to pass a balanced budget before the Legislature adjourns on April 11.


JHU Leadership in Annapolis

On Tuesday, January 25, Brian Gragnolati participated on an panel of hospital representatives who briefed the Senate Budget and Taxation Committee on health care reform. Hospitals were asked for their input on the impact of healthcare reform on hospitals and health systems. While funding was not the primary focus of any of the presentations, there was a consensus amongst the hospitals that adequate funding is necessary to move forward with healthcare reform. The presentations were well received by the Committee.


Provost Lloyd Minor in Annapolis

On Wednesday, January 26, despite the inclement weather, Provost Minor visited the General Assembly and met with a number of legislative leaders. Provost Minor accompanied Senator Catherine Pugh, who represents the Homewood Campus, on the State Senate Floor and was recognized by the body. The Provost met with both presiding officers, Speaker of the House Michael Busch and Senate President Thomas V. �Mike� Miller, as well as a number of other key legislators, to discuss Johns Hopkins priorities


Health Information Exchange (HIE) Briefing

On Thursday, January 27, the Health and Government Operations (HGO) Committee held a briefing on the HIE in Maryland. Dr. Rex Cowdry, Executive Director of the MHCC, and David Horrocks, President of CRISP, gave an overview of the legislation which MHCC has developed in regard to HIE, and the progress of CRISP throughout the State. Delegate Shane Pendergrass, Vice Chair of the HGO Committee, said that she would be filing the legislation developed by MHCC regarding HIE. However, she did raise a concern regarding CareFirst requiring physicians participating in their Patient Centered Medical Home to use their proprietary health information interface, and that she would like to address this issue in the legislation as well. We will be working with CRISP, MHCC, and other stakeholders to ensure that any concerns which we have will be addressed.


Necessary Care

The Health and Government Operations (HGO) committee held a briefing on overutilization of cardiac stents on January 26. The Secretary of the Department of Health and Mental Hygiene, Josh Sharfstein, indicated that there are three bills that are being discussed on this issue: (1) legislation to allow sharing of information amongst State health agencies; (2) legislation banning gifts to health care professionals (laws that have already passed in Vermont and Massachusetts are being considered for the hospital models); and (3) professional legislation to require accreditation for angioplasty. Dr. Sharfstein indicated that the professional legislation will not be sponsored by DHMH. The Maryland Hospital Association and the Maryland Health Care Commission are working on this issue.


Hospital Governance

Also on January 26, the Health and Government Operations (HGO) committee held a briefing on an update of a report on hospital governance from the Health Services Cost Review Commission (HSCRC). This report was based on a request from Chairman Hammen in FY2010 on how nonprofit hospitals are performing on best practice governance statutes. The report found that hospitals are meeting or exceeding national standards. Bob Murray, Executive Director of the HSCRC noted that the findings were based on individual hospital boards only, and that HSCRC does not have adequate information on system boards to report on how they are performing.

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BILLS INTRODUCED

General Business

SB0060 Unemployment Insurance - Administration of Claims - Changes to WithholdingStatus

This bill repeals the limitation on the number of times per benefit year a claimant for unemployment insurance benefits may change a previously elected withholding status.

Effective Date: October 1, 2011
For more information, please contact: Delora Sanchez

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General Education

HB0038 Nonpublic Schools Accepting State Funds - Bullying, Harassment, andIntimidation - Policies

This bill requires nonpublic schools that accept State funds to adopt a policy prohibiting bullying, harassment, and intimidation. Requires nonpublic schools to develop the policy in consultation with parents, students and school employees and volunteers and to publicize the policy in student handbooks, website and other locations. Provides that specified employees who report or fails to report acts of bullying, harassment, or intimidation are not civilly liable under specified circumstances.

Effective Date: July 1, 2011
For more information, please contact: Delora Sanchez

SB0041 Education - Age for Compulsory Public School Attendance - Exemptions

This bill alters the age from 16 to 17 and from 17 to 18 that a child is required to attend public school and that a parent or guardian is responsible for a child�s attendance in public school, with certain exceptions.

Effective Date: Various
For more information, please contact: Delora Sanchez

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Handgun

HB0009 Regulated Firearms - License Issued by Delaware, Pennsylvania, or Virginia -Reciprocity

This bill will make an individual�s license from Delaware, Pennsylvania, or Virginia to carry a regulated firearm, including a concealed regulated firearm valid in Maryland.

Effective Date: October 1, 2011
For more information, please contact: Delora Sanchez

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Health Care Administration

SB0051 Criminal Procedure - Criminal Injuries Compensation Board - ClaimantConfidentiality and Eligibility

This bill prohibits the disclosure of identifying information of a victim or claimant who is a victim of a sexual offense. The bill makes individuals who have ever been convicted of certain enumerated crimes ineligible to receive an award from the fund.

Effective Date: October 1, 2011
For more information, please contact: Delora Sanchez

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Health Care Facilities

HB0003 Pharmacies - Taking Back and Disposing of Unused Drugs

Requires pharmacies that have been issued a pharmacy permit to take back and dispose of unused prescription and non prescription drugs in accordance with the guidelines established by the United States Food and Drug Administration.

Effective Date: October 1, 2011
For more information, please contact: Delora Sanchez

HB0023 Freestanding Ambulatory Care Facilities - Licensing - Abortion Services

This bill alters the definition of "ambulatory surgical facility" to include abortions. This bill also alters the definition of surgical services to include instruments that are used to perform abortions. The effect of this bill is that abortion services would be subject to more stringent regulations and oversight.

Effective Date: October 1, 2011
For more information, please contact: Nicki McCann

SB0020 Health Occupations - Facilities for Dental Radiology

This bill authorizes a licensed dentist to own and operate a facility for dental radiology. If a licensed dentist evaluates the results of a dental radiograph,
a certified dental radiation technologist may staff the facility, operate equipment and practice dental radiation technology without a licensed dentist on the premises. Requires the State Board of Dental Examiners to adopt regulations.

Effective Date: October 1, 2011
For more information, please contact: Delora Sanchez

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Health Care Occupations

HB0064 State Board of Examiners of Nursing Home Administrators - Sunset Extension andProgram Evaluation

This bill continues the State Board of Examiners of Nursing Home Administrators in accordance with the Maryland Program Evaluation Act (sunset law) and requires that an evaluation of the Board be performed before July 1, 2016. This is standard Board legislation.

Effective Date: July 1, 2011
For more information, please contact: Nicki McCann

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Health Insurance/Health Care Access

HB0014 Health Insurance - Medically Underserved Areas and Populations - Reimbursementfor Covered Services Rendered by Telemedicine

This bill would require health insurance carriers and HMOs to pay for covered services rendered via telemedicine to enrollees who are located in underserved areas of the State. The rates paid to the physician would be equal to rates paid for the service if it were in person.

Effective Date: October 1, 2011
For more information, please contact: Mat Palmer

HB0015 Health Insurance - Participation in Health Insurance Systems and Plans -Freedom of Choice

This legislation outlines that a person is free to choose to purchase or not to purchase health insurance, in what ever manner that person see's fit. This is an attempt to preempt the Federal law which mandates the purchase of health insurance by all adults by 2014.

Effective Date: October 1, 2011
For more information, please contact: Mat Palmer

HB0019 Health Insurance - Coverage of In Vitro Fertilization Services

HB 19 alters the amount of time for which a couple must be infertile before they can receive in vitro fertilization services from 2 years to the definition of infertility used by the American Society of Reproductive Medicine.

Effective Date: October 1, 2011
For more information, please contact: Mat Palmer

SB0056 Health Insurance - Evaluation of Quality of Care and Performance of HealthBenefit Plans

This bill would allow the MHCC to evaluate quality and performance of Health Benefit Plans which are administered by carriers. MHCC would be required to promulgate regulations regarding the reporting requirements of carriers concerning Health Benefit Plans.

Effective Date: July 1, 2011
For more information, please contact: Mat Palmer

SB0057 Maryland Health Care Commission - Certificate of Need Requirements

This bill alters the requirements on the closure of a Health Care Facility, requiring notice of the closing 30 days prior, and a public informational hearing to be held in coordination with MHCC.

Effective Date: October 1, 2011
For more information, please contact: Mat Palmer

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Health, General/Public/Environmental

HB0001 Education - Youth Athletes - Concussions

This bill requires county boards of education and the Maryland Public Secondary Schools Athletic Association to establish guidelines and forms to educate individuals about concussions and head injuries. Requires that the information sheets be signed and returned by youth athletes and the parent or guardians of the athlete before they may practice or participate in competitions; that youth athletes must be removed from a practice or game if they are suspected of having a concussion or head injury; and the youth athlete that has suffered a head injury must meet certain requirements before returning to play.

Effective Date: October 1, 2011
For more information, please contact: Delora Sanchez

HB0004 Public Health - Containers Manufactured with Bisphenol-A - Prohibition

This bill prohibits the manufacture, sale, or distribution of cans, jars, or other containers containing a specified amount of bisphenol-A if the containers contain a liquid, food or beverage intended primarily for consumption by a child under the age of 4 years. Also prohibits the manufacture, sale, or distribution of sports water bottles containing bisphenol-A. Requires the Department of Health and Mental Hygiene to adopt regulations to enforce the restrictions on the amount of bisphenol-A on or before July 1, 2011.

Effective Date: June 1, 2011
For more information, please contact: Nicki McCann

HB0017 Department of Health and Mental Hygiene - Use of Federal Funds - Priority forMedically Underserved Areas

This bill would give priority status to underserved populations and areas of the State if DHMH receives any federal funds which are to be used for implementation of telemedicine.

Effective Date: October 1, 2011
For more information, please contact: Mat Palmer

HB0018 Health - Abortions - Reporting Requirements

This bill requires a physician that has performed an abortion in the State to report information about the abortion within 30 days to the Department of Health and Mental Hygiene. The report shall include information on any complications or injury that occurred during the abortion procedure and may not include any identifying information for the patient or physician.

Effective Date: October 1, 2011
For more information, please contact: Nicki McCann

HB0020 Health - Abortion - Transport of Patient

This bill provides that a patient may be transported across state lines if an emergency exists and the physician determines that transporting the patient is necessary to protect the life and health of the patient. The patient must be transported by ambulance.

Effective Date: October 1, 2011
For more information, please contact: Nicki McCann

HB0080 State Government - Sickle Cell Anemia Awareness Month

This bill requires the Governor to declare Septemer "Sickle Cell Anemia Awareness Month".

Effective Date: July 1, 2011
For more information, please contact: Nicki McCann

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Higher Education/Financial Aid

SB0081 Higher Education - Assistance Efforts for Family Investment Program Recipients- Repeal

This bill repeals the assistance efforts for Family Investment Program recipients.

Effective Date: June 1, 2011
For more information, please contact: Mat Palmer

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Medical Liability/Tort Reform

SB0005 Physicians - Professional Liability Insurance Coverage - Notification andPosting Requirements

This bill requires licensed physicians in the State to notify patients in writing if the physician does not carry professional liability insurance coverage or if the physician�s coverage has lapsed for any period of time and has not been renewed. The bill requires the notification to be signed by the patient at the time of his or her visit, and kept in the patient�s records. The Board of Physicians is required to create regulations for notification requirements.

Effective Date: October 1, 2011
For more information, please contact: Delora Sanchez

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Tax Policy

HB0007 Income Tax - Subtraction Modification and Tax Credit - Interest on Loans toEnterprise Zone Businesses

This bill would allow a business which is located in a designated Enterprise Zone to claim an state income tax credit of up to five perecent of any interest income earned.

Effective Date: July 1, 2011
For more information, please contact: Mat Palmer

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Video Lottery Terminals

HB0051 Video Lottery Operation Licenses - Information on Payouts

This bill would require that any payout made by VLTs above a certain threshold amount (to be determined by the Lottery Commission) should be reported to the Child Support Enforcement Administration.

Effective Date: October 1, 2011
For more information, please contact: Mat Palmer

SB0008 Table Games - Video Lottery Facilities

This bill would allow an owner of a VLT license in the State to offer Table Games (black jcak, poker, roulette, etc.)

Effective Date: July 1, 2011
For more information, please contact: Mat Palmer


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