1. Dave Dagenais, SASHE, CHFM, CHSP Steve Jalowiec, PE, CHFM

2. AdvocacyAdvocacy Professional Development NetworkingNetworking Information Resource Optimize the Health Care Physical Environment Strategic Goals: Reputation, Capacity and Regulation

3. Reputation Our members will have a reputation as highly valued professionals with a specialized body of knowledge experience and competency of strategic, operational and business value to the entire enterprise.

4. Reputation Goal Increase the recognition of our strategic value to the organization Increase the level of competency within our profession Increase our confidence in ourselves and our ability to promote ourselves Increase the awareness by C suite for the value of CHFM

5. Reputation Goal - Continued Increase the awareness of the importance of maintaining the organizations physical assets and the consequences of not maintaining our environment Increase the awareness by C suite of ASHE and local chapters Increase the number of high school graduates seeking a career path to our profession

6. Capacity Our members will be supported by a nimble association with the resources, relationships, decision systems and work processes necessary to achieve their envisioned future for the field.

7. Capacity Goal Decrease competition between national and local associations Increase the interaction and alignment of chapter and national activities Increase member awareness of the relevance and combined value of dual membership

8. Regulation Our members will work in a regularity environment characterized by good science, defensible economics, informed policymaking and clear decision authority.

9. Who Regulates Hospitals? Source: American Hospital Association http://www.aha.org/aha/trendwatch/2011/11mar-tw-costofcaring.pdf

10. Regulation Goal Increase influence on policy making Decrease the inconsistency and conflict in the development and enforcement of codes and standards Increase management awareness and appreciation of what we do Increase the use of science

11. Regulation Goal - Continued Abandon the existing system and devise one in which all codes will be based on a cost justification/benefit analysis Create unified code (one code) Decrease the number of AHJ organizations Note: Regulation Goal is Assigned to Advocacy Committee

12. ASHE Advocacy ASHE Staff Advocacy Team o Manages the day-to-day advocacy efforts o Provides support to members as needed Advocacy Committee o Supports strategic initiatives o Develops community action plans o Manages task forces projects

13. ASHE Advocacy Chapter advocacy liaison o Manages the day-to-day advocacy efforts at the chapter level o Provides information to the chapters

14. ASHE Advocacy Committee Action Plan 1 Clipping Service Scope of Work Develop process to monitor and deliver results to ASHE staff. Staff to continuously monitor results and report to ASHE Advocacy Advisory Committee and/or Members.

15. ASHE Advocacy Committee Action Plan 2 Up-to-date Codes and Standards Scope of Work ASHE had joined with TJC to pressure CMS Identify key legislative entities or individuals in D.C. Determine the interest which AHA has in assisting ASHE in the legislative effort. Contact other health care organizations and other entities with similar interests or resources. Identify conflicts within codes and standards that lead to higher costs. o Survey ASHE facility based membership o Utilize advocacy liaisons

16. ASHE Advocacy Committee Action Plan 3 Evidence Based Codes Scope of Work Develop a process that ensures that facts are checked and science is used for pending code changes Convince code making authorities to take a more rigorous approach to ensuring that only fact-based changes are made to their codes or standards. Develop a list of universities and organizations that support this initiative and are willing to provide necessary research for changes to the organizations defined by this action plan.

17. ASHE Advocacy Committee Action Plan 4 Incorporation of Commissioning Guidelines Scope of Work Create a specialty subgroup recognized by the Healthcare Guidelines Revision Committee: Incorporate the Commissioning Standards into the Healthcare Guidelines Revision Committee process as a reference Incorporation of standard into the FGI Guidelines by reference.

18. ASHE Advocacy Committee Action Plan 5 Guidelines Adoption Scope of Work Develop an action plan to encourage and educate state authorities on the benefits of adopting latest editions of the FGI Guidelines. Increased awareness by the State Authorities of the recommendations of the FGI Guideline. Promote Consistency of rules from state to state. Broaden interpretation base for review and update of both Guidelines.

20. Guideline Goals

21. ASHE Advocacy Committee Action Plan 6 Advocacy Highway Scope of Work Develop a initial meeting of the chapter advocacy liaisons to: o Inform them of the ASHE process on advocating at the national level, o Gather information from the state societies on codes and standards issues within their states or regions, and o Educate the advocacy liaisons about the One Code initiative so they can meet with state and local officials to explain the rational for making these changes. Schedule a series of quarterly conference calls to follow up on ASHE initiatives and continue to gather codes and standards information. Review success of initial face to face meeting and conference calls and develop proposal for moving forward.

22. Repaving the ASHE Advocacy Highway

23. Advocacy work affects you Ever asked yourself questions like: The code says I have to do what? Who writes these things? Do they have any idea how things work in the real work? Through the process of advocacy, ASHE members have caused obsolete standards to be replaced and performance-based standards to be adopted.

24. Poor codes cost money without improving safety ASHE estimates that the hospitals spend more than $4 billion a year because of conflicting codes and standards, overregulation, unjustified code enforcement, and misinterpretations. Even things that may seem small and not worth fighting in an individual hospital could have a profound effect nationwide.

25. Example of Poor Code Interpretation A 2010 citation from a state fire marshal required OR supply cabinets to have automatic sprinkler heads installed inside, or holes drilled in the top of the cabinet. If all states required sprinklers in OR cabinets, the estimated cost to the health care industry would exceed $425 million.

26. Example of Poor Code Interpretation CMS surveyors have cited numerous facilities for microwave ovens and toasters not listed as hospital grade – even though no hospital grade microwaves or toasters are currently available on the market. Assuming commercial-grade appliances would satisfy CMS, this interpretation could cost the health care industry $30 million.

27. Important to Share Information ASHE advocacy leaders can act to help rectify inappropriate code interpretations where appropriate. They can also use the information to make the case nationally for uniform codes and standard application. But that can only happen if ASHE advocacy leaders know about the problems. Thats why communications through the Advocacy Highway are so critical.

28. Learning from ASHE ASHE provides chapter advocacy liaisons with up- to-date information on national advocacy issues affecting health care facilities. ASHE provides resources and tools to empower chapter advocacy liaisons. Learning from liaisons ASHE wants to hear from chapter liaisons about regulatory issues affecting chapter members. ASHE will use this information, collected nationwide, to help build the case for uniformly applied and interpreted codes, which could save billions of dollars. The Highway Is a Two-Way Street

30. Repaving Work Underway ASHE advocacy leaders met in December with chapter advocacy liaisons from Gold- and Platinum-level ASHE chapters. ASHE staff and the liaisons will continue to communicate so that information moves quickly along the advocacy highway.

31. Ways Chapters Can Help Spend a few minutes of chapter meetings discussing codes and standards issues affecting your members. Report poor code interpretations or other advocacy information to ASHE through the Advocacy Highway website form: http://www.ashe.org/advocacy/highway/dhtml/ communicate.dhtml

32. Get Involved ASHE is a member-based organization: We Are ASHE. Getting involved with the code development process can impact codes and potentially save your facilities money and time. To get involved, contact o Steve Jalowiec: stevej06418@yahoo.comstevej06418@yahoo.com o Dave Dagenais: Dave.Dagenais@wdhospital.comDave.Dagenais@wdhospital.com o Chad Beebe: cbeebe.aha@gmail.comcbeebe.aha@gmail.com

33. NEHES Advocacy Efforts Advocacy Liaisons Steve Jalowiec Dave Dagenais Available to present ASHE Advocacy Highway at a chapter meetings Each state should appoint a state advocacy representative to coordinate local advocacy highway efforts. Initiate code issues and questions and send up through NEHES Advocacy Liaisons