The National Picture of Healthcare Information Technology Blair R. Hedgepeth HIMSS Manager, Congressional Affairs

2 History of HIMSS Advocacy Initiative February 1998 – Advocacy Task Force launched by HIMSS Board under direction of Board Vice Chair (Colonel) Rosemary Nelson to explore whether HIMSS should be involved in advocacy and public policy activities – Response to HIPAA April 1998 – Advocacy Task Force report presented to HIMSS Board February 2000 – HIMSS Board of Directors approved new advocacy initiated by a narrow margin June 2002 – Dave Roberts appointed 2nd Advocacy Steering Cmte Chair July 2002 – Dave Roberts hired as Advocacy consultant on part-time basis August 2003 – Tom Leary hired as first full-time advocacy employee April 2004 – HIMSS office opened in Alexandria, VA July, 2004 – “Advocacy Committee” elevated to Steering Committee level, and renamed “Advocacy & Public Policy Steering Committee” October 2005 – Tom Keefe hired as 1st Director of State Gov’t Relations July 2006 – HIMSS advocacy budget surpasses $1M and staff at 7 FTEs plus Manager of Public Policy Communications January 2007 – HIMSS Arlington Office opens! August 2007 – Add first Manager of State Government Relations position

Dave Roberts, MPA, FHIMSS Vice President, Government Relations Tom Leary, MA, FHIMSS Senior Director, Federal Affairs Jonathan French Coordinator, Federal Affairs Blair Hedgepeth Manager, Congressional Affairs Tom Keefe, MA Senior Director, State Government Relations Arnol Simmons Coordinator, State Government Relations Meredith Taylor Manager, State Government Relations Sharolyn Hyson Manager, Public Policy Communications Maggie McNamara Coordinator, Government Relations FY08 Organizational Chart: Government Relations

The HIMSS Advocacy Team Board of Directors – Set Policy Advocacy & Public Policy Steering Committee (A&PPSC) – Make recommendations –14 voting members –5 non-voting members (EHRVA, CHIME, ME/PI TF, NACHRI and SHIRE) –5 Board Liaisons (Wade, Hansmann, Srini, Christian, and Harris) HIMSS Government Relations Roundtable (HGRR) Chapter Advocacy Liaison Roundtable (CALR) Individual members and staff (including Member Relations)

Organization Chart Government Relations Volunteer Opportunities Advocacy & Public Policy Steering Committee CHIME EHRVA ME-PI TF NACHRI SHIRE Friday Collaborative Group Congressional Caucuses Other Collaborators Task Forces: LEG./REG Review Advocacy Awards Rapid Response All other HIMSS Steering Committees Chapter Advocacy Liaison Roundtable (CALR) HIMSS Government Relations Roundtable (HGRR)

Monthly CALR Calls 3 rd Friday of every month Agenda is posted in the Share Point portal 2 nd Friday of every month Tracking the 3 levels of advocacy competency through CALRs internet connections Conduct a Pre-Advocacy Day Training via webex for CALRs (April CALR Call)

CALR Program FY 08 Revised Recognition Levels Advocate Level- Awarded to CALRs/Chapters that complete 3-5 monthly tasks during the year (including state equivalents and/or extra credit Ambassador Level- Awarded to CALRs/Chapters that complete 6-8 of our monthly tasks during the year (including state equivalents and/or extra credit) Presidential Level- Awarded to CALRs/Chapters that complete 9-12 of our monthly tasks during the year (including state equivalents and/or extra credit)

CALR Recognition Program FY chapters (90%) engaged in some measurable advocacy activity 31 Chapters (46%) achieved recognition for their advocacy work in Year One Shawna Schueller of the Minnesota Chapter received CALR of the Year Award

CALR Year One Results / Year Two Goals Year Two (2007 – 2008) 1. Increase participation / relationship-building 2A. Grow network in all existing Chapters 2B. Grow network in all existing States 2C. Grow network in key U.S. House Districts Recognition LevelActionNumber of CALRs Advocate LevelSome Measurable Advocacy Activity21 CALRs Ambassador LevelMultiple Advocacy Activities10 CALRs Presidential LevelSustained, Consistent Advocacy Activities2 CALRs Year One ( )

HIMSS CALR Geography AK - 0 HI - 1 As of 09/05/07  63 CALRs  38 States Represented  48 Congressional Districts Represented

Current Tools and Resources HIMSS Pulse on Public Policy Website Redesign Online Grants Office Fact Sheets and Position Statements Legislative Principles Knowelgis GR Tracker CRS Reports HIMSS State Dashboard Legislative Action Center Arlington office

Current Key Events Advocacy Day –Hill visits, Advocacy Awards Reception Congressional Luncheon Seminar Series U.S. Conference Caucus Events National Health IT Week HIMSS Summit Winston Ball

Current & Key Issues Federal Funding Privacy & Security Standards Integration & Interoperability Value Based Purchasing / P4P Patient Safety & Quality Outcomes Health Disparities (Rural & Underserved) Congressional Caucuses Election 2008 (Presidential, Congressional & State) AHIC Successor SCHIP Reauthorization Bi-Partisanship

Legislation Overview 84 pieces (42 House and 42 Senate) of Health IT related legislation introduced during 1 st session of 110 th Congress HIMSS supports 6 pieces of legislation: –S. Con. Res. 21 Conrad: FY08 Budget Resolution and HIT Fund (Passed) –H.Con.Res Kennedy/Murphy: Declaring National Health IT Week Resolution –S.Res Stabenow/Snowe/Whitehouse: Declaring National Health IT Week Resolution (Passed) –S Stabenow: Health Information Technology Act –H.R Gonzalez/Gingrey: National Health Information Incentive Act –H.R Gingrey: ADOPT HIT Act of 2007

Legislation Overview (Cont.) HIMSS opposes 2 pieces of legislation: –S. 73 Reid/Inouye: Registered Nurse Safe Staffing Act of 2007 –H.R Schakowsky: Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007

Legislation Overview (Cont.) HIMSS is monitoring 6 pieces of legislation –H.R Rangel: State Children’s Health Insurance Program (SCHIP) Act Reauthorization –H.R Dingell: Children’s Health and Medicare Protection (CHAMP) Act of 2007 –S Kennedy, Enzi, Clinton, and Hatch: Wired for Health Care Quality Act –S Leahy: Health Information Privacy & Security Act –H.R – Gordon: NIST Healthcare Information Enterprise Act –H.R Moore of Kansas: Independent Health Record Trust Act

What are the BIG pieces of Legislation for the Fall? S Kennedy, Enzi, Clinton, and Hatch: “Wired for Health Care Quality Act” H.R. ? -- Eshoo: Companion “Wired” Bill H.R Rangel: State Children’s Health Insurance Program (SCHIP) Act Reauthorization H.R Dingell: Children’s Health and Medicare Protection Act of 2007 H.R. 3043/S.1710: HHS Appropriations H.R – Gordon: NIST Healthcare Information Enterprise Act

S.1693: Wired for Health Care Quality Act PRIMARY CONTACTS: –David Bowen, Staff Director, HELP –Katy Barr, Professional Staff, HELP –David Schwartz, Majority Counsel, Finance –Mark Hayes, Minority Staff, Finance Trying to pass by Unanimous Consent? Jurisdictional Issues? Unfriendly Provisions?

Eshoo Companion Bill in the House No details? No known concerns over AHIC Successor Plan per Speaker’s office

SCHIP Reauthorization SCHIP vs. CHAMP President wants only $5B expansion $35 billion program congressional expansion Senate vote –Adds $35 billion to SCHIP –Also passed by House ( ) Presidential Veto?

SCHIP HIT Language Section 6 titled State Health Reform Projects –Health information technology.--With respect to health information technology, the State plan shall provide methodology for the appropriate use of health information technology to improve infrastructure, such as improving the availability of evidence-based medical and outcomes data to providers and patients, as well as other health information (such as electronic health records, electronic billing, and electronic prescribing).

FY08 HHS Appropriations Update Office of the National Coordinator –FY08 President’s Budget Request: $117M –House Approved: $61.3M –Senate Appropriations Committee Approved: $71M –HIMSS Position: Support SENATE

FY08 HHS Appropriations Update (cont.) HHS Studies (ASPE) –FY08 President’s Budget Request: $3M –House Approved: Unclear –Senate Appropriations Committee Approved: Unclear AHRQ Grants –FY08 President’s Budget Request: $45M –House Approved: $45M –Senate Appropriations Committee Approved: $44.8M

FY08 Appropriations FY08 began on October 1 House approved a Continuing Resolution ( ) continuing FY07 level of funding until Nov. 16 th Senate will also pass a CR House approved 12 appropriation bills Senate approved only 4 of 12 bills

H.R NIST Healthcare Information Enterprise Act 1) Directs the National Institutes of Standards and Technology (NIST) to establish an initiative for advancing HIT integration and allows it to assist healthcare representatives and organizations and federal agencies in developing technical roadmaps for HIT standards; (2) Requires NIST to develop or adopt existing technology-neutral guidelines and standards to enable federal agencies to effectively select and use HIT systems that are secure, interoperable, and ensure patient privacy;

H.R NIST Healthcare Information Enterprise Act 3) Requires the Department of Commerce to establish a Senior Interagency Council on Federal Healthcare Information Technology Infrastructure to coordinate the development and deployment of federal HIT systems, the associated technology transfer, and federal work with private HIT standards development organizations; (4) Requires NIST to establish a university grant program for multidisciplinary research in HIT-related fields; and (5) Directs the National High-Performance Computing Program to coordinate federal HIT R&D programs.

What is HIMSS Doing? Meeting with House/Senate HHS Appropriations aides Meeting with Eshoo staff on House companion “Wired” bill Working with Senate staff on “Wired for Health Care Quality Act –HIMSS concerns still on privacy/security Beginning meetings with House E&C and W&M health aides to assess situation Worked with House/Senate Conferees to delete Sec. 905 from H.R. 3162; support Section 501 of H.R. 976

What is HIMSS Doing? (cont.) Developing a white paper to support Senate Appropriations language for ONC Developed language to replace Sec. 905 Developing a white paper on privacy & security provisions to be included on S. 1693

Advocacy Day 2007 & 2008 HIMSS Advocacy Day Participants from 40 states 215 Meetings with Members of Congress 40 out of 50 Targets Covered HIMSS Advocacy Day 2008 Cover all 50 states Increase Coverage of Key Congressional Districts based on legislative requests Deepen and sustain relationships from Advocacy Day by feeding participants into the CALR Program Use CALR Program to provide district visibility and pressure after Advocacy Day

National Health IT Week ‘08 June 9 – 13, 2008 in Washington, DC HIMSS Summit National Advocacy Day June 11, 2008 –Washington Renaissance Hotel –Scholarships available!

Blair Hedgepeth HIMSS Manager, Congressional Affairs 4300 Wilson Blvd., Suite 250 Arlington, VA