1. Washington State Hospital Association STAT! Washington Hospitals in Crisis Preparing for the 2002 Legislative Session II NSIDENSIDE OO LYMPIALYMPIA

2. Washington State Hospital Association STAT! Washington Hospitals in Crisis Presenters Randy Revelle Taya Briley Cassie Sauer

3. Washington State Hospital Association STAT! Washington Hospitals in Crisis Purpose of the Web Conference To get WSHA, AWPHD, and STAT! members ready for the 2002 legislative session To give you the latest information To let you know WSHA and AWPHD plans and get your advice To help you know where and how to get more information

4. Washington State Hospital Association STAT! Washington Hospitals in Crisis Poll: Recent Advocacy Since the last session adjourned, have you: written a letter or e-mail, or made a phone call to a legislator? met with a legislator or staff in his or her office? had a legislator or staff visit your hospital?

5. Washington State Hospital Association STAT! Washington Hospitals in Crisis The Legislature The Governor The Budget

6. Washington State Hospital Association STAT! Washington Hospitals in Crisis Major shift since 2001 Democratic Governor One vote Democratic majority in Senate Two vote Democratic majority in House Balance of Power in Olympia

7. Washington State Hospital Association STAT! Washington Hospitals in Crisis Senate Leadership Majority Leader: Sid Snyder (D-Long Beach) Minority Leader: Jim West (R-Spokane) Ways and Means chair: Lisa Brown (D-Spokane) Ways and Means minority: Dino Rossi (R-Issaquah) Health Care chair: Pat Thibaudeau (D-Seattle) Health Care minority: Alex Deccio (R-Yakima) Senator West Senator Snyder

8. Washington State Hospital Association STAT! Washington Hospitals in Crisis House Leadership Speaker: Frank Chopp (D-Seattle) Minority Leader: Clyde Ballard (R-Wenatchee) Appropriations chair: Helen Sommers (D-Seattle) Appropriations minority: Barry Sehlin (R-Whidbey) Health Care chair: Eileen Cody (D-Seattle) Health Care minority: Tom Campbell (R-Roy) Speaker Chopp Clyde Ballard

9. Washington State Hospital Association STAT! Washington Hospitals in Crisis Every Vote Counts Votes will be close Each member has one vote Your Senators and House members are important, even if not in a leadership position Don’t know who they are? Contact Cassie Sauer, 206/216-2538 or cassies@wsha.org www.leg.wa.gov can find your district with your zip code

10. Washington State Hospital Association STAT! Washington Hospitals in Crisis Growth in State Spending: 2001 - 2003 Biennium 5.9 % 601 Spending Limit

11. Washington State Hospital Association STAT! Washington Hospitals in Crisis State Budget Challenge $21,550 $21,800 $22,050 $22,300 $22,550 $22,800 $23,050 2001-2003 2002 - 2003 changes Lost Revenue Original Budget $22.8 Billion Supplemental Budget $300 Million September forecast: $95 million decrease November forecast: $779 million decrease I-747 (property tax): $25 million decrease Federal estate tax: $20 million decrease Available Revenue $21.9 Billion K-12 growth, tort, fires, and other Millions

12. Washington State Hospital Association STAT! Washington Hospitals in Crisis Without Fixing a $1.25 Billion Hole Without Major Hospital Cuts $21,550 $21,800 $22,050 $22,300 $22,550 $22,800 $23,050 2002 - 2003 changes Lost Revenue Supplemental Budget $300 Million Available Revenue $21.9 Billion Millions Available Revenue $21.9 Billion Available Revenue $21.9 Billion $566 Million in cuts $246 in Human Services Return ferry and rail costs to transportation budget: $125 million Use of reserves: $152 million Money transfers: (ProShare, tobacco fund, etc): $252 million New revenue (lottery, taxes, etc.): $169 million

13. Washington State Hospital Association STAT! Washington Hospitals in Crisis Other Features of Governor’s Budget Proposal Delays vendor rate and state salary increases Eliminates I-695 replacement funding for local government and public health Increases state employee share of health premiums Eliminates entire programs and hundreds of jobs

14. Washington State Hospital Association STAT! Washington Hospitals in Crisis Elimination of MI, GA-U, and ADATSA Fee Increases CHIP wait list for kids BHP co-payment increases Adult dental and vision cuts Just because Governor didn’t choose them doesn’t mean they won’t reappear Not Agency Budget Cut Options Not Adopted by the Governor

15. Washington State Hospital Association STAT! Washington Hospitals in Crisis Includes $28 million to increase Medicaid payment for physicians and ambulances Medicaid outpatient rates cut Hospital rate increases delayed Nursing home rates cut Medical interpreters funding eliminated Tobacco prevention and control funds diverted Women, Infants, and Children (WIC) cut Governor’s Health Care Budget Proposals

16. Washington State Hospital Association STAT! Washington Hospitals in Crisis Questions? Press 14 on your phone

17. Washington State Hospital Association STAT! Washington Hospitals in Crisis WSHA, STAT! and AWPHD Plans and Resources

18. Washington State Hospital Association STAT! Washington Hospitals in Crisis Updated Financial Crisis Report Coming Soon

19. Washington State Hospital Association STAT! Washington Hospitals in Crisis Hospitals Still Struggling Financially 4-5% is bond raters’ healthy margin Washington Hospital Operating Margins: 1995-2000

20. Washington State Hospital Association STAT! Washington Hospitals in Crisis WSHA / AWPHD Policy Initiatives Budget AWPHD Bid Limit Workforce Commission Retroactive B&O Tax Mandatory Overtime Work Force Commission

21. Washington State Hospital Association STAT! Washington Hospitals in Crisis Retroactive B&O Tax WSHA successfully overturned Business and Occupation (B&O) tax in 2001 Governor vetoed retroactive portion Significant financial impact on hospitals WSHA trying for a new bill acceptable to the Governor or a veto override

22. Washington State Hospital Association STAT! Washington Hospitals in Crisis Work Force Commission Duties of commission: Strengthen training programs Improve image of health professions Reform regulations Streamline entry-to-practice regulations Support welfare-to-work and unemployment-to-work

23. Washington State Hospital Association STAT! Washington Hospitals in Crisis Mandatory Overtime Public relations problem Board directed new approach for WSHA Seeking compromise, a reasonable bill Goal to keep hospitals attractive as a place to work Allow for emergencies and flexibility

24. Washington State Hospital Association STAT! Washington Hospitals in Crisis AWPHD Bid Limit $5,000 limit set in 1945 requires small projects to be bid publicly Red tape, expense, and inefficiency Propose raising bid limit to $50,000 Restore flexibility for facility upgrades Promote efficient use of public funds Consistent with the original intent of the statute

25. Washington State Hospital Association STAT! Washington Hospitals in Crisis Policy/Advocacy Agenda

26. Washington State Hospital Association STAT! Washington Hospitals in Crisis Policy/Advocacy Issue Briefs

27. Washington State Hospital Association STAT! Washington Hospitals in Crisis WSHA / AWPHD Lobbyists Randy RevelleLisa ThatcherLen McComb

28. Washington State Hospital Association STAT! Washington Hospitals in Crisis Communication from WSHA Our main communication piece, coming to you weekly by e-mail: Anyone can receive -- encourage your staff, board members, and volunteers to sign up! II NSIDENSIDE OO LYMPIALYMPIA

29. Washington State Hospital Association STAT! Washington Hospitals in Crisis www.wsha.org Redesigned and Easier to Use

30. Washington State Hospital Association STAT! Washington Hospitals in Crisis www.awphd.org Redesigned and Easier to Use

31. Washington State Hospital Association STAT! Washington Hospitals in Crisis www.wastat.org

32. Washington State Hospital Association STAT! Washington Hospitals in Crisis www.leg.wa.gov

33. Washington State Hospital Association STAT! Washington Hospitals in Crisis www.access.wa.gov

34. Washington State Hospital Association STAT! Washington Hospitals in Crisis How YOU Can Help

35. Washington State Hospital Association STAT! Washington Hospitals in Crisis Message to Legislators Basic message: Hospitals are hurting financially. State government is not the biggest problem. All the pressures mean that hospitals cannot absorb any more budget cuts. We know there is a budget crunch in Olympia, but legislators cannot look to hospitals to absorb more cuts. Legislators have to look elsewhere.

36. Washington State Hospital Association STAT! Washington Hospitals in Crisis You don’t need to know all the facts and figures It’s okay to say, “I can get back to you” WSHA staff know the details We need your voice and your personal version of the story! You Don’t Need to Know Everything to Advocate Effectively

37. Washington State Hospital Association STAT! Washington Hospitals in Crisis Why We Need Your Action Legislators will be thinking about salmon, forests, transportation, education, child abuse... hundreds of topics. Make sure hospitals and health care are on their list of priorities!

38. Washington State Hospital Association STAT! Washington Hospitals in Crisis We Want Feedback! Let us know about your meetings with legislators BEFORE they happen Let us know what happened in your meetings and conversations with legislators Ask us to follow up if necessary

39. Washington State Hospital Association STAT! Washington Hospitals in Crisis Ideas for Action Call or e-mail legislators Go to Olympia to represent your hospital Arrange a meeting when legislators are home Host a dinner in Olympia with your council Educate your community; get them to speak

40. Washington State Hospital Association STAT! Washington Hospitals in Crisis Discussion / Q & A Want tips or help? Contact Cassie Sauer, 206/216-2538 or cassies@wsha.org We’re interested in your questions and comments! Press 14 on your phone to ask a question Thank you for your participation and your support!