|
AHA News
AHA News Now
Click here to read all of the latest e-AHA news.
Don’t forget that all SSWLHC members are able to take advantage of the AHA members only site. Reference your SSWLHC member number when signing up to become a registered user. Contact lgroff@fernley.com if you do not have your five-digit member number.
Additional contents on this page:
AHA Fax Update 1/11/01
Statement of the Release of the Surgeon General's National Action Agenda for Children's Mental Health
Regulatory Advisory-OSHA Ergonomics Standards
Impact of Proposed Privacy Rules
MEDPAC STICKS WITH BIPA's PPS UPDATE
The Medicare Payment Advisory Commission (MedPAC) today said the Medicare hospital PPS inpatient update for FY 2002 included in the Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act -- market basket minus 0.55% -- is "reasonable and within the range [MedPAC] would recommend." Effective representation shown by MedPAC members Spencer Johnson, president of the Michigan Health and Hospital Association, and Floyd Loop, M.D., CEO and chairman of the Cleveland Clinic Foundation. They brought to the commission's attention the huge pressures being imposed on hospitals by labor, drug and technology costs and the costs of complying with the Health Insurance Portability and Accountability Act's patient record privacy and security requirements.
Statement on the Release of the Surgeon General’s National Action Agenda for Children’s
Mental health
Rick Pollack, Executive Vice President, American Hospital Association
Mark Covall, Executive Director, National Association of Psychiatric Health Systems
January 3, 2001
The release of the Surgeon General’s National Action Agenda for Children’s Mental Health shines a spotlight on the critical importance of mental health to the overall health and well-being of our nation’s children. As associations representing behavioral health care organizations and professionals, we applaud the leadership of the Surgeon General in helping to focus national attention on critical public health and public policy issues.
As the report documents, one in every 10 children and adolescents suffers from mental illness severe enough to cause some level of impairment. Yet, fewer than 20 percent of these youngsters receive needed treatment. For children to grow and thrive, they must have access to appropriate healthcare services, including mental health care. As a nation, we can afford no less. Recognizing problems and providing the necessary care and support as early as possible literally changes lives.
Our associations are committed to improving access, coverage, funding, and coordination of children’s mental health services. We hope – and urge – that the Surgeon General’s report will provide momentum for policymakers to eliminate discrimination for all people with mental illnesses—and particularly for children. One important step will be to provide equality between insurance coverage for mental and physical disorders – a move the Surgeon General’s report notes "is an affordable and effective objective."
As a nation, we must continually work toward overall health by devoting adequate resources to both mind and body.
Regulatory Advisory
AHA's Regulatory Advisory, a service to AHA members, will be produced whenever there is a significant regulatory development that affects the job you do in your community.
A Message to AHA Members:
Last month, the Occupational Safety and Health Administration (OSHA) issued a final ergonomics standard aimed at reducing job-related musculoskeletal disorders (MSDs). OSHA’s standard requires employers, including hospitals and other health care providers, to take specific actions to address job -related MSDs and, if they occur in the workplace, implement a broad-based ergonomics program. This standard takes effect in January 2001, and enforcement begins in October 2001.
Employers who implemented an effective ergonomics program by November 14, 2000 may be eligible to "grandfather" and continue with their program, instead of complying with the new OSHA standard, provided their program meets certain conditions.
OSHA’s ergonomics standard is very controversial and efforts are underway to get relief through the courts or Congress. It is AHA’s view that the standard is overreaching and imposes huge regulatory and financial burdens on hospitals. Furthermore, many non-work related factors may increase the likelihood of sustaining an MSD, yet the standard holds employers accountable. Lastly, the scientific community lacks consensus as to the causes and proven remedies for MSDs.
While relief efforts are underway, it is highly advisable to grandfather an eligible ergonomics program. Grandfathered programs will be exempt from numerous requirements and employers will not be required to revamp their programs. To get the benefits of the grandfather option, a formal review of the elements and effectiveness of an existing ergonomics program needs to occur before January 16, 2001.
After reviewing this advisory, check off the following items from your to-do list:
- If your facility implemented an ergonomics program before November 14, 2000, immediately take the steps required to use OSHA’s grandfather option. Be sure to document all the steps your facility takes to grandfather an ergonomics program.
- Assign a point person in your facility to be responsible for compliance with OSHA’s ergonomics standard.
- Talk to your state enforcement agency – in those states with OSHA-equivalent standards – to make sure you are also in compliance with their regulations. The AHA will keep you up-to-date regarding developments in the courts and Congress that would change implementation or enforcement of the standard, as we work with a coalition of other organizations to seek relief. In addition, the AHA will continue to advocate for payment increases to cover the dramatic costs that compliance would require. This advisory focuses on the one element of the standard requiring immediate attention – the opportunity to take advantage of the grandfathering option. Additional advisories will be sent to you in the coming months.
Rick Pollack
Executive Vice President December 19, 2000
This Regulatory Advisory is designed to inform you of the opportunity to use the grandfather option in the Occupational Safety and Health Administration’s (OSHA) final ergonomics standard, and provide the essential requirements. Additional advisories about how to comply with other parts of the standard will be sent to you in the coming months.
On November 14, OSHA issued its final ergonomics standard aimed at reducing the number and severity of musculoskeletal disorders (MSDs) caused by exposure to "risk factors" in the workplace. A risk factor is defined as force, awkward posture, repetition, vibration or contact stress.
All general industry employers covered by OSHA, including hospitals and other health care providers, are required to comply with OSHA’s ergonomics standard.
The ergonomics standard includes work-related MSD risk factors associated with injuries in the neck, shoulder, elbow, forearm, wrist, hand, abdomen (hernia only), back, knee, ankle and foot. MSDs may include muscle strains and tears, ligament sprains, joint and tendon inflammation, pinched nerves, and spinal disc degeneration. The standard does not address injuries caused by falls, slips, trips, vehicle accidents or similar accidents.
The ergonomics standard takes effect on January 16, 2001, and enforcement begins on October 15, 2001.
Employers without a grandfathered ergonomics program will be required to provide all employees, by October 15, 2001, with basic information about MSDs, how to report MSDs, and a summary of the OSHA ergonomics standard. Employers also must monitor MSD reports and, in response to certain MSD incidents, implement a comprehensive ergonomics program.
Under the standard, a comprehensive ergonomics program must include:
- Management leadership
- Employee participation
- MSD management for an employee with an MSD injury
- Job hazard analysis for specified job(s)
- Hazard reduction and control measures
- Initial training and follow-up training every three years for specified employees
- Evaluation of program effectiveness every three years
- Record-keeping
Employers who implemented an ergonomics program by November 14, 2000 may be eligible to continue with their program under the grandfather option, instead of complying with the new OSHA standard. Those who address ergonomics through their safety and health programs typically will not need to create a separate ergonomics program to qualify for the grandfather option. It is highly advisable to grandfather a program because eligible programs will be exempt from numerous requirements, and employers will not be required to revamp their program.
To qualify for grandfather status, an ergonomics program must be in written form (electronic maintenance is acceptable) and have been implemented before November 14, 2000. You must also conduct at least one formal review of the elements and effectiveness of the program before January 16, 2001. OSHA does not require employers to submit any type of material if they grandfather their ergonomics program. Employers should document every step they take to review their ergonomics program in case OSHA asks for evidence of a review in the future. An existing ergonomics program must be demonstrably effective and include six mandatory program elements:
1. Active management leadership demonstrated by an effective MSD reporting system; prompt responses to reports; clear program responsibilities; and regular communication with employees about the program.
2. Employee participation demonstrated by early reporting of MSDs; and active involvement by employees and their representatives in the implementation, evaluation and future development of the program.
3. Job hazard analysis and control demonstrated by identification, analysis and use of feasible engineering, work practice and administrative controls to control MSD hazards; or reduction of MSD hazards to specified OSHA levels (see Appendix D of the standard, available on OSHA's Web site at www.osha.gov); or reduction of MSD hazards to the extent feasible; and follow-up evaluations to ensure the effectiveness of control measures. OSHA recognizes that employers may need to prioritize the implementation of permanent controls for jobs with risk factors. Through a prioritization process, an employer may choose to temporarily implement interim controls, but is expected to institute permanent controls as soon as possible.
4. Training of managers, supervisors and employees, at no cost to the employees, on the ergonomics program and their role in it; how to recognize MSDs, and their signs and symptoms; the importance of reporting MSDs, and their signs and symptoms, early; and the identification of MSD hazards in jobs in the workplace and employer methods of control.
5. Program evaluation through regular reviews of the program's elements, effectiveness as a whole, and the identification and correction of program deficiencies. When evaluating a program's effectiveness, employers must use one or more measures, such as a reduction in the number or severity of MSDs; an increase in the number of jobs in which MSD hazards have been controlled; reductions in the number of jobs posing MSD hazards to employees; or any other measure that demonstrates program effectiveness . At least one formal review must take place before January 16, 2001.
6. Implementation of an MSD management policy by January 2002, one year after the effective date of the standard, for any employee that sustains an MSD injury. This management policy must meet specific requirements of the standard, such as free access to a health care professional, any necessary work restrictions, continued earnings and other employment rights and benefits (see paragraphs "p," "q," "r" and "s" of the standard). The AHA will provide you with an advisory about compliance with this requirement in the coming months.
OSHA’s ergonomic standard, appendices and ancillary materials, including compliance assistance materials, are available on OSHA’s Web site at www.osha.gov. If you do not have Internet access, you can get a print copy of the standard by calling OSHA at (202) 693-2116.
The AHA will keep you up-to-date regarding developments in the courts and Congress that would change implementation or enforcement of the standard. Additional advisories will be sent to you in the coming months. For more information about this standard, contact AHA’s Robyn Cooke by e-mail at rcooke@aha.org, or by phone at (202) 626-2672.
News Release
FOR IMMEDIATE RELEASE
Contact: Alicia Mitchell (202) 626-2339
COST IMPACT OF PROPOSED PRIVACY RULES DRAMATICALLY UNDERESTIMATED BY FEDERAL GOVERNMENT
New study puts hospitals’ tab at as much as $22 billion – significantly more than the cost of Y2K compliance
WASHINGTON (December 14, 2000) – A new analysis has found that the costs of complying with just some of the federal government's proposed medical privacy rules for hospitals could reach $22.5 billion over five years – far exceeding original government estimates. First Consulting Group (FCG), a multinational pharmaceutical/life sciences and health information technology services firm based in Long Beach, Calif., prepared the report at the request of the American Hospital Association (AHA).
"As guardians of patients’ personal medical information, the nation’s hospitals take privacy and security issues very seriously, and we support vigorous efforts to protect patients’ records," said AHA President Dick Davidson. "But this sweeping proposal has gone far beyond what Congress intended and has the potential to interfere with the treatment we provide patients."
In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA), which called for health plans, hospitals and clearinghouses to meet new requirements for performing electronic health care transactions, protecting the confidentiality of "individually identifiable" health information and implementing security standards that ensure medical records privacy. Proposed rules on privacy were issued last year with final regulations expected soon.
The Department of Health and Human Services’ (HHS) estimate of $3.8 billion for the entire health care field to comply with HIPAA’s privacy rules alone did not include several provisions. The AHA asked FCG to provide cost estimates for three key provisions (not included in HHS’ estimate). They include:
"Minimum necessary use" of information – Hospitals must make every reasonable effort not to use or disclose – internally or externally – more patient information than is necessary to accomplish an intended purpose. Hospitals will need to conduct a comprehensive audit of all patient data created and maintained throughout the hospital, change all internal computer systems to limit access to information, train staff in appropriate uses of patient information, and use costly audits to check compliance.
Five-year cost to hospitals: A minimum of $1.3 billion. If hospitals must invest in new information systems or substantially upgrade existing systems to come into compliance, these costs could rise to $19.8 billion.
Requirements for contracting with and monitoring business partners – Hospitals must identify all business partners who use or access the organization’s patient-identifiable information, such as physicians, insurers, clergy or state licensing boards. Hospitals must hold these business partners accountable, by written contract, for the appropriate use of that information under the privacy requirements. Hospitals estimate that they may have between 50 to 750 business partners, making monitoring compliance a hugely burdensome undertaking.
Five year cost to hospitals: $2.3 billion.
No preemption of contrary and more stringent state laws – Since HIPAA privacy requirements will not preempt state laws that conflict with the proposed federal rule and provide greater privacy protections, hospitals must implement policies and procedure that reflect these differences.
Five year cost to hospitals: $372 million.
According to FCG, the overall cost for achieving compliance with these three elements could range from $4 billion to $22.5 billion over five years, depending on the specific approach that organizations take and the effort required to bring their information systems into compliance. Ongoing costs are expected to exceed $500 million a year.
In addition, HHS’ cost estimates lack a "stated or logical source" and "grossly underestimate" the likely costs of the technical requirements, FCG noted.
"These costs are just the tip of the iceberg -- the proposal’s total impact on hospitals hasn’t been fully considered," said AHA President Davidson. "With one-third of the nation’s hospitals operating in the red and hospitals still reeling from $8 billion in Y2K costs, we need to make sure that the law’s important objectives are met while making the best use of our health care resources."
In order to reach its conclusions, FCG conducted focus groups and in-depth telephone interviews with 19 diverse hospital organizations to ascertain the likely impacts of the three components of the proposed privacy rule; determined critical tasks that a hospital is likely to undertake to achieve compliance; and built a financial model that projected the privacy rule’s expected impact on each organization.
The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which includes 5,000 hospitals, health care systems, networks, other providers of care and 37,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA Web site at www.hospitalconnect.com.
Editor’s note: Reporters can obtain a copy of the report’s executive summary or arrange an interview with the study authors by calling Jacqueline Harvey at (202) 626-2963
Return to Previous Page
|
|
