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JOINT COMMISSION ON HEALTH CARE Patrick W. Finnerty Executive Director November 26, 2001 Richmond,...
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Transcript of JOINT COMMISSION ON HEALTH CARE Patrick W. Finnerty Executive Director November 26, 2001 Richmond,...
JOINT COMMISSION ON HEALTH CARE
Patrick W. FinnertyExecutive Director
November 26, 2001Richmond, Virginia
Joint Commission on Health Care
2Presentation Outline
Joint Commission on Health Care
2001 Legislative Studies
Probable 2002 Legislative Recommendations
Results of 2001 “Health Access Survey”
Joint Commission on Health Care
3Joint Commission on Health Care
Chairman
Senator William T. Bolling
Vice Chairman
Delegate Harvey B. Morgan
Sen. Benjamin J. Lambert, III Del. L. Preston Bryant, Jr.
Sen. Stephen H. Martin Del. Jay W. DeBoer
Sen. Linda T. Puller Del. Alan A. Diamonstein
Sen. Nick Rerras Del. Franklin P. Hall
Sen. Kenneth W. Stolle Del. Philip A. Hamilton
Sen. William C. Wampler, Jr. Del. S. Chris Jones
Del. Robert H. Brink Del. Kenneth R. Melvin
The Honorable Louis F. Rossiter (ex officio)
Joint Commission on Health Care
4
Broad Range of Issues
Joint Commission on Health Care
Health Insurance/Access for Uninsured
Medical Education
Health Care Cost & Quality
Health Workforce
Long-Term Care
Joint Commission on Health Care
5Joint Commission on Health Care
Study Requests(Bill/SJR/HJR/Budget)
Public CommentPeriod
General AssemblySession (Jan-Feb/Mar)
JCHC PolicyInitiatives
Study Reports(May-Nov)
JCHC Recommend.(Dec.)
JCHC Legislationto G. A.
Joint Commission on Health Care
6Joint Commission on Health Care
On The Internet•The JCHC web site includes meeting schedules, studies, reports, and legislation
•Interested parties can access the full text of JCHC reports and provide public comments through the Internet
•Visit the Joint Commission at: http://legis.state.va.us/jchc/jchchome.htm
•E-Mail address: [email protected]
Joint Commission on Health Care
7Presentation Outline
Joint Commission on Health Care
2001 Legislative Studies
Probable 2002 Legislative Recommendations
Results of 2001 “Health Access Survey”
Joint Commission on Health Care
82001 Legislative Studies
Long-Term Care Related Studies— Voluntary Closure of Long-Term Care Facilities (SB
845/HB1920)— Exceptions to Medicaid Reimbursement for Nursing
Facilities (SB 1249)— Long-Term Care Insurance Reforms (HB 2228)— Employment Exceptions for Nursing Facility Employees (HB
2748)— Nurse Staffing Ratios in Nursing Facilities (SB 1125/HB
2257)
Joint Commission on Health Care
92001 Legislative Studies
Virginia Medical Savings Account Program
Local Health Partnership Authorities (HB 2060)
Palliative Care Reimbursement
Multi-State Nurse Licensure Compact
Certificate of Public Need (COPN)— Follow-up to last year’s plan to phase out COPN
Joint Commission on Health Care
10Presentation Outline
Joint Commission on Health Care
2001 Legislative Studies
Probable 2002 Legislative Recommendations
Results of 2001 “Health Access Survey”
Joint Commission on Health Care
11
Probable 2002 Legislative Recommendations
Establish a state “Critical Access Hospital” program through Medicaid cost-based reimbursement
Revise Virginia Medical Savings Account Program
Revise premium rate-setting process for long-term care insurance — Implements recommendations of National Association
of Insurance Commissioners
Establish a tax credit for persons who volunteer in a long-term care facility
Joint Commission on Health Care
12
Probable 2002 Legislative Recommendations
Eliminate the local government “match” requirement for the state’s Auxiliary Grant Program— AG Program provides assistance to low-income residents
of assisted living facilities
Require state agencies conducting licensure or certification inspections of long-term care facilities to notify Adult Protective Services of any citations for adult abuse or exploitation
Extend peer review/disclosure protection to patient safety/medical errors information shared among providers and expert safety organizations
Joint Commission on Health Care
13
Probable 2002 Legislative Recommendations
Revise requirements of state’s dental scholarship to require recipients to be participating providers in Medicaid and FAMIS
Extend authorization of health care data reporting for additional 5 years to 2008
Allow part-time nursing students to be eligible for existing nurse scholarship programs
Joint Commission on Health Care
14
Probable 2002 Legislative Recommendations
Authorize Board of Dentistry to issue temporary permits to graduates of dental schools who have not yet been licensed and are practicing in Free Clinics or Community Health Centers
Authorize “general” supervision of dental hygienists— Likely will not be legislation . . . Board of Dentistry has
authority to revise supervision requirements through regulations
Numerous budget amendments also will be introduced
Joint Commission on Health Care
15Presentation Outline
Joint Commission on Health Care
2001 Legislative Studies
Probable 2002 Legislative Recommendations
Results of 2001 “Health Access Survey”
Joint Commission on Health Care
16
Virginia Health Care Foundation Sponsored 2001 Health Access Survey
Survey completed by Southeastern Institute of Research Telephone survey of 1,959 households; data on 4,801 individuals
— Findings are estimates only; statewide margin of error: 2%, others range from 2-5% unless otherwise noted
2001 survey updates data collected in 1993 and 1996 Two general types of measures are used in presentation:
— Uninsured rate: refers to the percentage of a population group that has no health insurance
For example . . . “14.9% of Virginians are uninsured” — Distribution of uninsured: refers to the percentage of the uninsured
who fall into a particular category For example . . . “20% of uninsured have income at or below the
poverty level”
Joint Commission on Health Care
17
The Uninsured Rate For All Virginians Has Increased Since 1996
14.0% 14.9%13.0%
0.0%2.0%4.0%6.0%8.0%
10.0%12.0%14.0%16.0%18.0%20.0%
1993 1996 2001
Uninsured Rate
Source: Health Access Surveys: 1993, 1996, 2001
Joint Commission on Health Care
18
Regional Uninsured Rates Range From 11% to 20%
14.9%
17.2%
13.1%11.0%
14.7%
20.4%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
State Central Eastern Northern Northwest Southwest
Source: Health Access Survey 2001
Joint Commission on Health Care
19
Number Of Uninsured Virginians Has Grown Due To Population Growth And
Increase In Uninsured Rate
1,051,000
858,000
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1996 2001
Number of Uninsured Virginians
Source: Health Access Surveys: 1996, 2001
Joint Commission on Health Care
20Number of Uninsured Persons By Region
209,652225,263
200,042
149,632
267,141
0
50,000
100,000
150,000
200,000
250,000
300,000
Central Eastern Northern Northwest Southwest
Number of Uninsured Persons
Source: Health Access Survey 2001
Joint Commission on Health Care
21
Persons At/Below 200% of Federal Poverty Level (FPL) Are Nearly Twice As
Likely To Be Uninsured
26.8%24.4%
13.6%
9.4%
14.9%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
<=100%FPL
101-200%FPL
201-300%FPL
301%+ FPL All
Source: Health Access Survey 2001
Joint Commission on Health Care
22
The Highest Uninsured Rate Is Among Young Adults
14.1%
19.7%
13.1%
1.1%
14.9%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
Age 0-17 Age 18-44 Age 45-64 Age 65+ All
Source: Health Access Survey 2001
Joint Commission on Health Care
23Uninsured Rate By Race
12.8%
20.4% 21.0%
14.9%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
White African-American
Other All
Source: Health Access Survey 2001
Note: Error margins are in the range of 2% for statewide estimate; 2-5% for African-American and White estimates; and as much as 15% for “other” category
Joint Commission on Health Care
24
Employees Of Very Small Firms Have Highest Uninsured Rate
25.1% 26.6%
13.7%
21.8%
9.1%12.9%
18.9%
13.8%10.6%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
<5 5-9 10-24 25-49 50-99 100-249
250-499
500-999
1000+
Number of Employees In Firm
Percent Uninsured
Note: Error margins are in the range of 2% for statewide estimate; 4% for firms with 1000 or more; and 8-11% for other categories
Source: Health Access Survey 2001
Joint Commission on Health Care
25Distribution of Uninsured By Race
White, 63.0%
African-American,
28.0%
Other, 9.0%
Source: Health Access Survey 2001
Joint Commission on Health Care
26Distribution of Uninsured By Income
$50,001 +, 26.0%
$30,001-$50,000,
20.0%
$20,001-$30,000, 22.0%
<$10,000, 14.0%
$10,001-$20,000, 18.0%
Source: Health Access Survey 2001
Joint Commission on Health Care
27
Persons With Higher Incomes Represent An Increasing Share Of The Uninsured
Population
0%
20%
40%
60%
80%
100%
1996 2001
<=100% FPL 101-200% FPL 201%+ FPL
34.0%
29.0%
37.0%
49.6%
30.0%
20.4%
Source: Health Access Survey 2001
Joint Commission on Health Care
28
Over Two-Thirds Of Uninsured Adults Are Employed Full-Time
Employed, Full-Time,
67.0%
Employed, Pt. Time,
10.0%
Unemployed, Looking,
6.0%
Homemaker, 10.0%
Other, 6.0%
Source: Health Access Survey 2001
Joint Commission on Health Care
29
Percent Of Uninsured Adults Who Are Employed Full-Time Has Increased
Substantially Since 1993
41.0%
57.0%
67.0%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
1993 1996 2001
Percent of Uninsured Population
Source: Health Access Survey 2001
Joint Commission on Health Care
30
Approximately 133,000 Uninsured Children (0-18) Appear To Be Eligible For
Medicaid/FAMIS
50,497
31,788
89,757
0
50,000
100,000
150,000
200,000
250,000
300,000
Number of Uninsured ChildrenBy Income
301%+ FPL201-300% FPL101-200% FPL<=100% FPL
Note: margin of error ranges from 4-11%
Estimated Total Number of Uninsured Children: 254,300
82,286132,783
Source: 2001 Health Access Survey
Joint Commission on Health Care
31
Uninsured Persons Have Less Access To Health Care
3.9%10.3%
23.1%15.9%
27.6%
55.2%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
Unable To GetNeeded Health
Care
Unable to GetPrescription Due to
Cost
Do Not Visit DentistRegularly
Insured Uninsured
Source: 2001 Health Access Survey