The Adequacy of Your Advocacy 2018: How to Make Your Case to Legislators - Zach Shamberg, Director of Advocacy and Legislative Affairs ...
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The Adequacy of Your
Advocacy 2018:
How to Make Your Case
to Legislators
Zach Shamberg, Director of Advocacy and Legislative Affairs
Pennsylvania Health Care Association
A Legislator’s Guide to Advocacy
State Representative Warren Kampf
Represents Chester and Montgomery Counties
Why is Advocacy so important?
Campaign Intern for U.S.
My Background Senator Pat Toomey
(2010)
Campaign Manager for
State Representative
Todd Stephens
(2010 & 2012)
Chief of Staff to Rep.
Stephens (2010-12)
Director of Advocacy
and Leg. Affairs at PHCA
(2014-2018)
Male Model (briefly in 2012)
What does it mean to be a
‘Grassroots Advocate’?
YOU are on the front lines
YOU are the ‘boots on the ground’
YOU raise awareness
YOU influence Public Perception,
Policy and Regulation
Advocacy Foundations
Communication
Every avalanche starts with one snowflake
Imminence of action
Convince legislators to take action
Method of action
The simpler the better
Follow-up
This is crucial to any grassroots effort
HERE’S THE PROBLEM: Ask 10 people what the ‘cause’ is, you’ll hear 10 different answers We have to be organized We MUST have consistent messages We have to be on the same page!
Pennsylvania Politics
The Politics of Pennsylvania • Everyone has state and federal legislators who represent their facilities In Pennsylvania, there are: • 203 state Representatives • 50 state Senators • 18 U.S. Representatives (members of Congress) • 2 U.S. Senators: Pat Toomey (R) and Bob Casey (D)
Republicans vs. Democrats
Republicans hold majorities in the
state House and Senate
• 120 Republicans-81 Democrats in House
• 34 Republicans-16 Democrats in Senate
• 1 Democratic Governor: Tom Wolf
How do we balance our advocacy between
Republicans and Democrats?Mike Turzai (R) Dave Reed (R) Frank Dermody (D)
Speaker of the House House Majority Leader House Minority Leader
Joe Scarnati (R) Jake Corman (R) Jay Costa (D)
Senate President Senate Majority Leader Senate Minority LeaderGovernor Tom Wolf Emphasis on Home and Community-Based Services Implemented Managed Care (Phase I in January 2018) 4-4 on NO Increases: Governor Wolf has yet to propose an increase for nursing homes in the state budget
Gubernatorial Campaign
2018Republican Gubernatorial Candidate Paul Mango Visit to Genesis Healthcare’s Chapel Manor
Not running for reelection in 2018
Rep. William Keller (D-Philadelphia)
Rep. Mike Hanna (D-Clinton)
Rep. John Maher (R-Allegheny)
Rep. Joe Markosek (D-Allegheny)
Rep. Matthew Baker (R-Tioga)
Rep. Mark Mustio (R-Allegheny)
Rep. Flo Fabrizio (D-Erie)
Rep. Kevin Haggerty (D-Lackawanna)
Rep. C. Adam Harris (R-Juniata)
Sen. Stewart Greenleaf (R-Montgomery)
Sen. Charles McIlhinney (R-Bucks)
Rep. Ron Marsico (R-Dauphin)
Rep. Bob Godshall (R-Montgomery)
Rep. Katharine Watson (R-Bucks)
Rep. Will Tallman (R-Adams)
Rep. Harry Lewis (R-Chester)
Rep. John Taylor (R-Philadelphia)
Rep. Eli Evankovich (R-Westmoreland)Redistricting in Pennsylvania • January 22nd: the Pennsylvania Supreme Court issues an order striking down the state's congressional district map • The order set a February 15th deadline for revising the district map • Republican leaders in the legislature asked the U.S. Supreme Court to overturn the decision • The PA Supreme Court drew new maps and released them in February • State Senate and House Republican Leaders filed an appeal with the U.S. Supreme Court to stop the implementation of the new map • Petitions for Congressional candidates have begun
The ‘Old’ Congressional Map
The ‘New’ Congressional Map
State Issues affecting
our Sector
RIGHT NOWFunding Regulation Quality Care Staffing OAPSA Increased Fines/Penalties Community HealthChoices Lawsuit Abuse Reform Emphasis on Homecare
The State Budget
Budget Funding
Governor Wolf unveiled his 2018-19 budget proposal in February
Spending proposed to increase by just under $1 Billion
Incudes new investments in education at $225 Million, workforce at $50 Million,
and the opioid crisis at $31 Million
Proposes an increase of PA’s minimum wage to $12/hour
Proposes a Natural Gas extraction tax that is projected to raise $248.7 Million
Flat funding for Medicaid Long-Term Care
MDOI was removed from the budgetLawsuit Abuse Reform
Pennsylvania’s Legal Climate
Arguably the WORST in the Country
• Long-term care facilities spend more than
$100 million Medicaid dollars per year on
litigation costs
• Ranked second among all 50 states in total
medical malpractice payouts
• No correlation between quality care and
lawsuits
• Some companies are paying more on liability
and defense than FOOD for residentsRegulation
Regulation: The ‘Perfect Storm’
DOH CMPs Per Year 2014-2017 2014 $79,250.00 2015 $170,050.00 2016 $412,200.00 2017 $2,019,750.00 Total $2,664,000.00
Total Number of DOH CMPs Per Year
How Do We Combat These Challenges?
Welcoming a Legislator into Your Building
Things to Remember Tour your legislator through building Highlight practices/awards/innovations Introduce your legislator to staff Introduce him/her to residents (chances are they’ll know someone!) Ask family members to visit AL/PC Facilities: Townhall for residents Nursing Homes: Townhall for families Take time to sit with your legislator and discuss state/local issues (before or after the tour) Invite your legislator back for an event
Talking Points
State Budget
2.6% increase in the 2018-2019 budget
($44 million state dollars)
$17 million to fund the MDOI
Medicaid Shortfall:
$27.25 per day of careThe MDOI • The ‘Medicaid Access Add-On Payment’ • Has been put in Fiscal Code or Public Welfare Code bills that pass alongside State Budget • We’ve historically asked for $16 million • We’ve only ever received $8 million Money goes directly to high Medicaid facilities Must be >65% Medicaid and >85% Occupied
What would $44 million mean to you?
Or a $17 million MDOI?
• Investing in staff (is turnover a problem?)
• Investing in capital improvements (age of bldg?)
• Investing in technology (still using paper?)
• Innovation
• Quality Care
What could you do if you were
adequately funded?Lawsuit Abuse REFORM We are asking legislators to cap
punitive damages at twice the
amount of compensatory
damages
Physicians have had caps on
punitive damages since 2002
Predatory out-of-state law firms
advertise in newspapers
throughout Pennsylvania
PA’s Medicaid program spent
$104 million on liability-related
costs in 2015
Remember: YOU are
the ExpertWhat effect does this ad have on staff?
On Residents?
On Families of Residents?
How much time do you spend
preparing for a deposition, or gathering
paperwork when a lawsuit is filed?
We know how hard you
work every single day.
Out-of-state lawyers
want to put you out of
business.Regulation
What kinds of regulation do you comply with everyday?
Are fines/deficiencies a problem?National Perspective
LaShuan Bethea
Vice President, Legislative Affairs
Genesis Healthcare
ACA Repeal
Tax Reform
Medicaid Block Grants
Lawsuit Abuse ReformHow to find your Legislator • PHCA website (www.phca.org) • Advocacy Tab • Click on ‘Locate Your Legislator’ • Type in Address of Facility
How to Find 1-pagers and
talking points
• PHCA website (www.phca.org)
• Advocacy Tab
• Click on ‘Issue Briefs’
–Budget
–Tort Reform
–Quality Care
–Managed CareQuestions?
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