On Monday, February 10, 2009 the House of Delegates debated and amended the compromise legislation put forth by the Speaker of the House and Governor Tim Kaine (SB 1105 and HB 1703).
The amendments make the following changes:
1. Changes the enactment date of the bill from October 1, 2009 to January 1, 2010.
2. Smoking would be allowed in all outdoor areas of a restaurant
3. Smoking is permitted if the entire restaurant is reserved for a private function
4. A restaurant that wants to permit smoking has to have a separate smoking room that either has a door OR a separate ventilation system. The original language that the separate smoking room have both a door AND a separate ventilation system
5. Smoking is permitted if at any time a restaurant does not permit people under the age of 18 to enter the restaurant
The House rejected an amendment made by Delegate Tom Gear that said:
1. If the restaurant has fewer than 75 seats smoking can be permitted.
All members of the House of Delegates then formally voted on and passed the amended version of the bill on Tuesday, February 11, 2009. Below is the vote count:
61 - voted to pass the amended version of the bill
38 - voted against the amended version of the bill
Red - Republican
Blue - Democrat
Yes
Albo, Alexander, Amundson, Armstrong, BaCote, Barlow, Bell, Bouchard, Bowling, Brink, Bulova, Caputo, Carrico, Cosgrove, Cox, Crockett-Stark, Dance, Ebbin, Eisenberg, Englin, Hamilton, Herring, Howell, A.T., Hull, Iaquinto, Joannou, Johnson, Jones, Knight, Landes, Lingamfelter, Marsden, Marshall, R.G., Mathieson, May, McClellan, McQuinn, Melvin, Miller, J.H., Miller, P.J., Morgan, Morrissey, Nichols, Oder, Orrock, Phillips, Plum, Purkey, Rust, Scott, J.M., Shannon, Sickles, Spruill, Tata, Toscano, Tyler, Valentine, Vanderhye, Ward, Watts, Mr. Speaker
No
Abbitt, Athey, Byron, Cline, Cole, Fralin, Frederick, Gear, Gilbert, Griffith, Hall, Hargrove, Hogan, Hugo, Ingram, Janis, Kilgore, Lewis, Loupassi, Marshall, D.W., Massie, Merricks, Nixon, Nutter, O'Bannon, Peace, Pogge, Poindexter, Pollard, Putney, Saxman, Scott, E.T., Sherwood, Shuler, Ware, O., Ware, R.L., Wright
SB 1105 passed on a similar vote. The amended bills now go to the Senate for consideration. HB 1703 has been referred to the Senate Education and Health Committee and may be heard next week. The House amendments to SB 1105 will be considered by the full Senate.
Governor's Comments on Amendments to Compromise Bill
On Tuesday, February 10, Governor Kaine spoke to several reporters about the changes made to the compromise legislation to which he and Speaker Howell had agreed. Governor Kaine said he was not pleased with the amendments as they weakened the bill.
Below please find some of the news article that includes the Governor's comments:
Associated Press - Smoking amendments dismay Kaine
http://www.starexponent.com/cse/news/local/article/smoking_amendments_dismay_kaine/29681/
Wednesday, February 11, 2009
Urgent News for Hospital and Health Systems
Hampton Roads has been blessed with a strong economy in recent years. Shipbuilding, cargo transfer and other industries have fueled strong economic growth that has helped many in our communities. However, the effects of hard economic times are affecting the entire Commonwealth and Hampton roads especially. Cargo imports are down and the potential loss of an aircraft carrier threaten the region. More and more Virginians in the area are losing their jobs and turning to state services such as unemployment and Medicaid in order to survive. But the State is feeling the effects of the economy as well and can’t sustain its current levels of service. The Governor has proposed a budget that cuts back on all core services, but hits Medicaid funding especially hard. The Governor's budget would reduce Medicaid reimbursements from the current 75 percent of cost to 70 percent of cost for inpatient services.
And it gets worse. The Governor also offset further cuts by proposing a 30-cent tax increase on tobacco. Smoking costs Virginia's Medicaid program more than $400 million per year. The new proposal would offset that cost by raising an additional $155 million. Because Medicaid is a federal mandate, the federal government would match the state money dollar for dollar. Without the state money from the tobacco tax and the federal match, Medicaid stands to lose more than $300 million on top of what the Governor has already proposed cutting. That would drop Medicaid inpatient reimbursements down to 50 percent of cost. At 50 percent of cost, health providers in Hampton Roads would be forced to cut services and eventually lay off workers. It is estimated that more than 1,300 workers in health care and other industries across Eastern Virginia would be laid off if the tobacco tax, or its equivalent revenue, is not used to fund Medicaid. These workers are essential to providing all health care services in the area, and all Virginians would feel the effects. Please act now to tell your Hampton Roads-area legislators that Medicaid must be funded in order to preserve access to health care in Virginia.
And it gets worse. The Governor also offset further cuts by proposing a 30-cent tax increase on tobacco. Smoking costs Virginia's Medicaid program more than $400 million per year. The new proposal would offset that cost by raising an additional $155 million. Because Medicaid is a federal mandate, the federal government would match the state money dollar for dollar. Without the state money from the tobacco tax and the federal match, Medicaid stands to lose more than $300 million on top of what the Governor has already proposed cutting. That would drop Medicaid inpatient reimbursements down to 50 percent of cost. At 50 percent of cost, health providers in Hampton Roads would be forced to cut services and eventually lay off workers. It is estimated that more than 1,300 workers in health care and other industries across Eastern Virginia would be laid off if the tobacco tax, or its equivalent revenue, is not used to fund Medicaid. These workers are essential to providing all health care services in the area, and all Virginians would feel the effects. Please act now to tell your Hampton Roads-area legislators that Medicaid must be funded in order to preserve access to health care in Virginia.
Contact Your Legislators
VoterVOICE Sign-up Instructions
Your Political Participation and Grassroots Activism is our Most Effective Advocacy Tool.
VoterVoice is our online Grassroots tool that allows you to communicate directly with your legislators about issues important to hospitals and health systems.
1. Visit www.vhha.com/grassroots
2. The screen will display the following:
Advocacy & Policy
VHHA is involved at every stage in the development of the laws, regulations and guidelines that affect hospitals and health systems and their customers. We influence the laws enacted by the General Assembly each year and the regulations and guidelines developed by state agencies to implement those laws. VHHA plays a similar role at the federal level. VHHA also represents hospitals and health systems in influencing nongovernmental "regulation" such as JCAHO oversight. VHHA provides resources to assist its members in their compliance with these laws, regulations and guidelines.
Click here to sign up for VoterVOICE. Learn about current legislative and regulatory actions and how you can shape their outcomes.
HosPAC has information on VHHA's political action committee.
3. Select "Click here" to sign up for VoterVOICE
4. Select Budget 2009
5. Select TAKE ACTION--This will prompt a screen asking if you are a new user or existing user
5. Select "New User"
6. Enter business and residential information
7. VoterVOICE saves that information and matches you to your legislators
8. Current "Campaigns" will be displayed. These are our current voter voice alerts for various issues.
9. Select a campaign to Take Action
Your Political Participation and Grassroots Activism is our Most Effective Advocacy Tool.
VoterVoice is our online Grassroots tool that allows you to communicate directly with your legislators about issues important to hospitals and health systems.
1. Visit www.vhha.com/grassroots
2. The screen will display the following:
Advocacy & Policy
VHHA is involved at every stage in the development of the laws, regulations and guidelines that affect hospitals and health systems and their customers. We influence the laws enacted by the General Assembly each year and the regulations and guidelines developed by state agencies to implement those laws. VHHA plays a similar role at the federal level. VHHA also represents hospitals and health systems in influencing nongovernmental "regulation" such as JCAHO oversight. VHHA provides resources to assist its members in their compliance with these laws, regulations and guidelines.
Click here to sign up for VoterVOICE. Learn about current legislative and regulatory actions and how you can shape their outcomes.
HosPAC has information on VHHA's political action committee.
3. Select "Click here" to sign up for VoterVOICE
4. Select Budget 2009
5. Select TAKE ACTION--This will prompt a screen asking if you are a new user or existing user
5. Select "New User"
6. Enter business and residential information
7. VoterVOICE saves that information and matches you to your legislators
8. Current "Campaigns" will be displayed. These are our current voter voice alerts for various issues.
9. Select a campaign to Take Action
Children’s Hospital of The King’s Daughters
Why the Children of Hampton Roads Can’t Afford Medicaid Cuts
Children’s Hospital of The King’s Daughters, the only freestanding children’s hospital in the Commonwealth of Virginia, serves a unique role in the care of children. CHKD is centrally located in southeastern Virginia where a large and sprawling population has high concentrations of childhood cancer, sickle cell disease, fragile premature newborns, victims of abuse and neglect and children living with diabetes and asthma. CHKD turns no child away, regardless of the family’s financial situation.
As an independent hospital and as the regional referral center for all pediatric chronic conditions and traumatic injuries and illnesses, CHKD is unlike any other health care provider in Virginia. Today, one of its differences is particularly relevant: its commitment to serving the underserved within the region.
More than 50 percent of the days children spend as inpatients at CHKD are covered by Medicaid or a Medicaid HMO. In its Neonatal Intensive Care Unit, the largest segment of CHKD’s hospitalized patients, that percentage rises to 61, a figure that reflects the NICU’s status as the only unit of its kind in the greater Hampton Roads region. The Transitional Care Unit, where patients spend weeks to years before going home, is currently 100 percent Medicaid. Finally, more than half of the visits to the Emergency Room are from children relying on Medicaid.
It is important to note that at a children’s hospital, where one pound babies are as common as 100 pound children, the cost to provide care is much higher than at an adult facility: Capital expenditures for surgical equipment that can navigate microscopic newborn veins must be as available as lifts to move a 16-year-old football player onto an operating table. And, with the closure of nearly all pediatric beds at adult facilities in Hampton Roads, the region is extraordinarily reliant on CHKD.
All of these factors reveal one truth: CHKD is uniquely vulnerable to changes in reimbursement within all Medicaid programs.
While as citizens of Virginia CHKD recognizes the extreme challenges facing the state’s overall budget, it is very concerned about any reductions to Medicaid, a program that is currently unable to cover the actual costs to provide care to its population. And while CHKD’s status in caring for large numbers of Medicaid patients is recognized through disproportionate share payments, those payments still do not overcome the shortfall in reimbursements for the care it provides to children covered by Medicaid.
In 2007 CHKD lost $3.4 million dollars on Medicaid. Next year, costs alone are expected to rise by $1.5 million dollars compounding the effect of any Medicaid reductions. And this is a preliminary projection.
With rising numbers of families experiencing losses of income, jobs, their homes, retirement funds and benefits, there will surely be rising numbers of families turning to Medicaid to cover health care for their children. CHKD’s inability to cover its Medicaid costs will only escalate.
Medicaid as a safety net program will be more important than ever for the foreseeable future, yet with looming cuts to the program, the very real question for CHKD is whether it will have enough resources to maintain its full complement of services.
It is neither an exaggeration nor an overstatement to conclude that cuts to Medicaid will jeopardize CHKD’s ability to maintain its services for every sick and injured child who needs the lifesaving care and treatment that is available only at CHKD.
We appeal to you to protect CHKD as you make your extremely difficult budget decisions this year, and we thank you for your hard work on behalf of all children and all citizens of the Commonwealth.
Children’s Hospital of The King’s Daughters, the only freestanding children’s hospital in the Commonwealth of Virginia, serves a unique role in the care of children. CHKD is centrally located in southeastern Virginia where a large and sprawling population has high concentrations of childhood cancer, sickle cell disease, fragile premature newborns, victims of abuse and neglect and children living with diabetes and asthma. CHKD turns no child away, regardless of the family’s financial situation.
As an independent hospital and as the regional referral center for all pediatric chronic conditions and traumatic injuries and illnesses, CHKD is unlike any other health care provider in Virginia. Today, one of its differences is particularly relevant: its commitment to serving the underserved within the region.
More than 50 percent of the days children spend as inpatients at CHKD are covered by Medicaid or a Medicaid HMO. In its Neonatal Intensive Care Unit, the largest segment of CHKD’s hospitalized patients, that percentage rises to 61, a figure that reflects the NICU’s status as the only unit of its kind in the greater Hampton Roads region. The Transitional Care Unit, where patients spend weeks to years before going home, is currently 100 percent Medicaid. Finally, more than half of the visits to the Emergency Room are from children relying on Medicaid.
It is important to note that at a children’s hospital, where one pound babies are as common as 100 pound children, the cost to provide care is much higher than at an adult facility: Capital expenditures for surgical equipment that can navigate microscopic newborn veins must be as available as lifts to move a 16-year-old football player onto an operating table. And, with the closure of nearly all pediatric beds at adult facilities in Hampton Roads, the region is extraordinarily reliant on CHKD.
All of these factors reveal one truth: CHKD is uniquely vulnerable to changes in reimbursement within all Medicaid programs.
While as citizens of Virginia CHKD recognizes the extreme challenges facing the state’s overall budget, it is very concerned about any reductions to Medicaid, a program that is currently unable to cover the actual costs to provide care to its population. And while CHKD’s status in caring for large numbers of Medicaid patients is recognized through disproportionate share payments, those payments still do not overcome the shortfall in reimbursements for the care it provides to children covered by Medicaid.
In 2007 CHKD lost $3.4 million dollars on Medicaid. Next year, costs alone are expected to rise by $1.5 million dollars compounding the effect of any Medicaid reductions. And this is a preliminary projection.
With rising numbers of families experiencing losses of income, jobs, their homes, retirement funds and benefits, there will surely be rising numbers of families turning to Medicaid to cover health care for their children. CHKD’s inability to cover its Medicaid costs will only escalate.
Medicaid as a safety net program will be more important than ever for the foreseeable future, yet with looming cuts to the program, the very real question for CHKD is whether it will have enough resources to maintain its full complement of services.
It is neither an exaggeration nor an overstatement to conclude that cuts to Medicaid will jeopardize CHKD’s ability to maintain its services for every sick and injured child who needs the lifesaving care and treatment that is available only at CHKD.
We appeal to you to protect CHKD as you make your extremely difficult budget decisions this year, and we thank you for your hard work on behalf of all children and all citizens of the Commonwealth.
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