1. Schoolhouse Rock 201: Some States are More Equal Than Others! Oregon Hospice Association PPE September 2015 Tony Kudner Program Manager, Grassroots Advocacy NHPCO Hospice Action Network

2. What I hope to cover while you’re grabbing lunch: Provide some congressional context around Jennifer Kennedy’s awesome plenary (go NHPCO!) Discuss what the legislative future might hold for hospice & palliative care Talk about Oregon’s unique and outsized role in the hospice policy process Talk about stewardship of Congressional Champions

3. Congressional Context How did we get to the new 2 tiered RHC rate? Affordable Care Act gave HHS Authority ‘…no sooner than FY2014’. What are NHPCO’s views on new payment method? What about Congress? HR 3037 and Senate Sign-On Letter January 1 could be very, very interesting.

4. Hospice Policy- What’s Next? Rollout of new payment method HR 3037, our ace in the hole A reminder about budget neutrality & the laws of unintended consequences in the out years Aforementioned MCCM New ACP Codes for Physicians Care Planning Act Hospice & Medicare Advantage

5. Hospice Policy- What’s Next? Fall Government Shutdown? The effect on hospice 2016 Presidential Circus Election Senate could also shift to Democratic control (24 Republican Senators up, many in ‘purple’ states) House stays Republican for foreseeable future NHPCO & HAN don’t endorse candidates, but will speak to national issues as appropriate

6. The Importance of Oregon, aka ‘Why Tony Took The Red-Eye’. Some states matter more than others!

7. The Importance of Oregon, aka ‘Why Tony Took The Red-Eye’. The ‘Hospice Map’

8. The Importance of Oregon, aka ‘Why Tony Took The Red-Eye’. Senator Ron Wyden Ranking Member, Senate Finance Committee Congressman Earl Blumenauer, OR-3 rd House Ways and Means Committee Both are HUGE hospice champions!

9. The Importance of Oregon, aka ‘Why Tony Took The Red-Eye’. Senator Ron Wyden Know anything about the ‘MCCM’? Thank the Senator! Congressman Earl Blumenauer, OR-3 rd Glad about ACP Codes for Physicians? Thank the Congressman!

10. The Senate Finance Committee Committees have immense control over their issue areas Government Agencies like CMS and HHS pay close attention Senator has unique ability to sway hospice policy

11. OK, so now what? Oregon has long been at the forefront of the Hospice & Palliative Care movement Senator Wyden and Congressman Blumenauer have a deep affinity for our issues We can’t take this for granted! Oregon’s hospices need to keep the entire state congressional delegation informed More than most providers, you get to start every conversation with ‘thanks!’

12. OK, so now what? HAN and OHA are here to help! Have a policy or advocacy question? Let us know. Making sure Senator & Congressman (and their staff) hear from you on a consistent basis is key. Host site visits, attend town halls, try to catch Congressman Blumenauer on the bike trails of Portland, whatever it takes!

13. Thank you for your Advocacy! Tony Kudner Program Manager, Grassroots Advocacy NHPCO Hospice Action Network akudner@nhpco.org @GrassrootsTony