Transcript Public Policy Committee

APIC GC Chapter Legislative Representative
Overview
March 18, 2016
Lisa Tomlinson, Vice President of Government Affairs and Practice Guidance
Nancy Hailpern, Director, Regulatory Affairs
Laura Evans, Legislative Affairs Representative
Objectives
CLRs
• Provide updates on:
– Federal Legislative Issues
– Federal Regulatory issues
– State Legislative Issues
APIC Overview
Vision: Healthcare without infection
Mission: Create a safer world through prevention of infection
Strategic Goals 2020
Patient Safety: Demonstrate and support effective infection prevention and
control as a key component of patient safety.
Strategic Goals
Implementation Science: Promote and facilitate the development and
implementation of scientific research to prevent infection.
IP Competencies and Certification: Define, develop, strengthen, and sustain
competencies of the IP across the career span and support board certification
in infection prevention and control (CIC®) to obtain widespread adoption.
Advocacy: Influence and facilitate legislative, accreditation, and regulatory
agenda for infection prevention with consumers, policy makers, health care
leaders, and personnel across the care continuum.
Data Standardization: Promote and advocate for standardized, quality and
comparable HAI data.
APIC Advocacy Team
APIC Advocacy Triangle
APIC Government Affairs Team Staff
Primary Role:
background in government affairs
and advocacy
Chapters
(CLRS)
Public Policy Committee (PPC)
Primary Role:
clinical background with volunteer
public policy experience
Chapter Legislative Representatives (CLRs):
clinical and chapter/local volunteer experience
APIC Policy
Influence
APIC
Staff
Public
Policy
Committee
2016 Public Policy Committee
Committee Chair
D. Kirk Huslage RN, BSN, MSPH, CIC
Committee Vice Chair
Mary Alice Lavin RN, MJ, CIC
Members
Barbara Goss-Bottorff RN, MPH, MSN, CNS, CIC
Rebecca Fitzpatrick DNP, RN, CIC
Linda Johnson RN, MSN, CIC
Patrick Kleinkort RN, BSN, MHA, CIC
Rosie Lozano MPH, CIC
C. Nancy O’Connor MBSA, BSN, RN, CIC
Sarah Smathers MPH
Senior Advisor
Annemarie Flood RN, BSN, MPH, CIC
CLR Roles and Responsibilities
Legislation notification
If a bill related to
infection prevention
has been introduced in
a state represented by
your chapter, you will
receive an email that
includes:
• Link to the bill
• Synopsis of the bill
and how it relates to
infection prevention
• Link to bill sponsor
website
• Any relevant
information on the
bill and/or sponsor
What to do if you receive a legislative
notification
If you receive a legislative notification, you
should:
• Read through the entire notification and the
bill links.
• If you have any questions, email
[email protected] or call APIC staff
• Share this information with your chapter
• Your chapter should discuss if they support
the legislation or have concerns.
Please note that decisions regarding supporting or opposing legislation are made by
APIC HQ in conjunction with the Public Policy Committee and the Board of Directors.
• Contact APIC staff to discuss chapter support/concerns and next steps (such as
a support letter, or letter requesting changes to the legislation.
What to do if you are aware of legislation
that APIC hasn’t alerted you to
If you are aware of a bill but you never received a legislative
notification about it, then contact APIC staff!
Email staff or [email protected]:
• Bill information, including bill text, news articles on the bill, or
anything else that may be helpful to understanding the bill.
• Detail your concerns (or support)
Remember:
• Do not take any action on your own without contacting APIC HQ first
• When representing your APIC chapter, you must support the APIC
position
What to do if you have
questions/concerns about legislation
If you have questions/concerns
about legislation:
• Contact APIC staff to discuss
• Discuss your concerns with your
chapter members/leadership
• If you chapter has questions,
relay those questions to APIC
staff
• If you chapter has come to a
consensus on the legislation,
relay the information to APIC staff
your chapter’s lobby day
interested in having a lobby day?:
• Determine the objective of the lobby
day
• Find the best time to have the lobby
day
• Engage chapter members to
participate
http://www.apic.org/Advocacy/advocacytoolkit
Federal
Regulations
CMS hospital quality
improvement programs
• Hospital-Acquired Conditions (HAC)/ Present on
Admission (POA) indicators
• Hospital Inpatient Quality Reporting (IQR) Program
• Hospital Value-Based Purchasing (VBP) Program
• HAC Reduction Program
CMS HAI reporting requirements
for acute care hospitals
Measure
Reporting to NHSN
begin (CY)
IQR payment (FY)
VBP payment (FY)
HAC Reduction (FY)
CLABSI – ICU
CAUTI – ICU
SSI – Colo, Ab. Hyst.
2011
2012
2012
2013
2014
2014
2015
2016
2016
2015
2015
2016
MRSA Bacteremia –
FacWide LabID
2013
2015
2017
2017
C.Diff Infection –
FacWide LabID
2013
2015
2017
2017
HCP Influenza
Vaccination
CLABSI –
Med/Surg/MedSurg
2013
2015
2015
2017
2019
Baseline period
1/1/15 – 12/31/15
Performance period
1/1/17 – 12/31/17
2018
CAUTI –
Med/Surg/MedSurg
2015
2017
2019
Baseline period
1/1/15 – 12/31/15
Performance period
1/1/17 – 12/31/17
2018
HAC Reduction
Program measures
Domain 1: PSI-90 Composite
•
•
•
•
•
•
•
•
PSI-3
PSI 6
PSI-7 (CVC-related BSI rate)
PSI-8 (Postoperative hip fracture rate)
PSI-12
PSI-13 (Postoperative sepsis rate)
PSI-14 (Wound dehiscence rate)
PSI-15
Domain 2: HAI Measures
• CLABSI – ICU (FY 2015 onward)
• CAUTI – ICU (FY 2015 onward)
• SSI
• Following colon surgery (FY 2016 onward)
• Following abdominal hysterectomy (FY 2016
onward)
• MRSA Bacteremia (FY 2017 onward)
• C.diff. (FY 2017 onward)
• CLABSI – non-ICU (FY 2018 onward)
• CAUTI – non-ICU (FY 2018 onward)
Quality programs outside
of acute care
PPS-Exempt Cancer Hospital Quality Reporting Program (PCHQRP)
• CLABSI (2012), CAUTI (2012), SSI -COLO, AB/HYST (2014), HCP flu vaccination (2016-17 flu
season), MRSA (2016), C.diff (2016)
Long-Term Care Hospital Quality Reporting Program (LTCQRP)
• CLABSI (2012), CAUTI (2012), HCP flu vacc. (2013), MRSA (2015), C.diff. (2015), VAE (2016)
End-Stage Renal Disease (ESRD) Quality Incentive Program
• BSI in outpatient hemodialysis, HCP flu vaccination (2015-16 flu season)
Hospital Outpatient Quality Reporting Program
• HCP flu vaccination (2014-15 flu season)
Ambulatory Surgical Center Quality Reporting Program (ASCQRP)
• HCP flu vaccination (2014-15 flu season)
Inpatient Rehabilitation Facility (IRF) Quality Reporting Program
• CAUTI (2012), HCP flu vaccination (2014), MRSA (2015), C.diff (2015)
Inpatient Psychiatric Facility (IPF) Quality Reporting Program
• HCP flu vaccination (2015-16 flu season)
Influences on new regulations
• Improving Medicare Post-Acute Care Transformation
(IMPACT) Act of 2014
– Established standardized post-acute care assessment tool
across care settings
– So far this has influenced:
• Proposed revisions to Conditions of Participation for home
health, dialysis facilities, and long-term care facilities
• Proposed update to discharge planning requirements
• NQF care coordination measure updates
• AHRQ comparative effectiveness study on patient safety in
nursing homes
• Probably more to come
Influences on new regulations
• HHS announcement in 2015 to increase rate of
movement from Medicare payment based on fee-forservice to pay-for performance.
– Goal: by 2018, 90% of Medicare payment based on value or
quality of care.
– Likely to see this reflected in annual Medicare payment system
updates; hospital/CAH practices to promote innovation,
flexibility and improved patient care
Influences on new regulations
• Federal agency FY 2017 budget request narratives
– OSHA: FY 2017 funding to implement an infectious
disease standard; regulatory plan to introduce proposed
ID standard rule in 2016
– FDA: Priorities include:
• Compounded drug safety
• Medical device safety
• Antimicrobial use in animals
Influences on new regulations
• White House
– National Action Plan for Combatting Antibiotic-Resistant
Bacteria (2014)
– National Action Plan for Combatting Multidrug-Resistant
Tuberculosis (2015)
Other agencies impacting infection
prevention and control programs
• CDC
– Focus: Evidence-based guidelines for infection prevention and
control practice
• OSHA
– Focus: Worker safety
– Examples: Bloodborne Pathogens Standard, Respiratory Protection
Standard
• FDA
– Focus: Regulation of drugs; medical devices; human blood, tissue
and cell products
• EPA
– Focus: Regulation of disinfectants and sterilants; medical waste
incinerators
• State and local health departments
Federal
Legislation
Federal Legislation under review by the APIC
Public Policy Committee
Federal legislation under review by the APIC Public Policy
Committee:
Preventing Superbugs and Protecting Patients Act:
• Would require manufacturers of reusable medical
devices like duodenoscopes to submit proposed
cleaning instructions and validation data to FDA
before marketing the devices
• Status: APIC endorsed, currently pending in
Senate
Strategies to Address Antibiotic Resistance (STAAR)
Act:
• Would expand programs to address antibiotic
resistance
• Status: Under review by the APIC Public Policy
Committee, currently pending in Senate
Patient Safety Improvement Act of 2016:
• Would require report on HAIs and antibiotic
resistance
• Status: Under review by the APIC Public Policy
Committee, currently pending in Senate
The President’s budget request for fiscal
year 2017 federal programs
Centers for Disease Control and Prevention (CDC)
• $21 million for NHSN and the Prevention Epicenters Program
• $30 million for Advanced Molecular Detection (AMD) and response to infectious
diseases program
• $427.9 million Core Infectious Diseases, which would include funding for:
− HAIs
− Emerging Infections Program (EIP)
− $200 million Antibiotic Resistance Solutions Initiative
Agency for Healthcare Research and Quality (AHRQ)
• $34 million for HAI research
National Institutes of Health (NIH)
• $4.7 billion for the National Institute of Allergy and Infectious Diseases’ (NIAID)
antibacterial and related diagnostics efforts
State Legislation
Pending state legislation
ARIZONA
We have no Infection Prevention related legislation pending
Looking ahead: NHSN State Competition
The NHSN competition is back!
The winner of the CLR engagement contest is Troy
Cutler of the APIC 126 Pine Tree Chapter. Over 60% of
Maine’s APIC members sent a letter to Congress
supporting NHSN funding!
APIC will soon restart the competition for fiscal year
2017. The state with the highest percentage of letters
sent will win a prize!
Alert your chapter today!
Questions?
Lisa Tomlinson, MA, Vice President of Government Affairs and Practice
Guidance
[email protected]
• Overall government affairs and practice guidance strategy
Nancy Hailpern, Director of Regulatory Affairs
[email protected]
When in doubt,
• Federal regulatory issues
e-mail:
[email protected]
• HAI reporting at the federal level
Laura Evans, Legislative Affairs Representative
[email protected]
• Federal and state legislation
• Legislative maps
Cary B Heath, APIC GC Chapter Legislative Representative
[email protected]
What’s New in Public Policy?
(as of March 2016)
Olympus issues new reprocessing instructions for TJF-160 F/VF
duodenoscopes
Teva recalls Amikacin Sulfate Injection
FDA releases environmental assessment for field trial of
genetically engineered mosquitoes
FDA issues donor screening guidance to protect against Zika
transmission
Sagent recalling Fluconazole Injection
Olympus reaches settlement in criminal payment scheme
GAO report identifies patient safety implementation challenges