2012 SJH Advocacy Priorities

Annually, the St. Joseph Health identifies legislative advocacy priorities. Those priorities are selected based on anticipated federal and state legislative issues, as well as specific Advocacy criteria established and approved by the SJH Board or Trustees based on themes of social teaching.

Core issues of Catholic healthcare ministry including religious freedom and end of life care are addressed by the SJH advocacy infrastructure as needed throughout the legislative year.

Working closely with our ministries and with select national and state organizations, we establish clear annual priorities and generate local, grass roots action by providing alerts to employees and community members and then helping them contact legislators at critical points in the legislative process.

We hope you will take advantage of our interactive website to make your voices heard on critical regional and national issues including:

• Preserve and Protect the Safety Net
• Catholic Identity: Conscience Rights
• Physician Issues
• Health Care Reform: Implementation
• Childhood Nutrition & Obesity Prevention

Protect the Safety Net

State Budget deficits persist with California and Texas among the highest state deficits in the Nation. As a result State and County funding of Medicaid, SCHIP, Mental Health and numerous other safety net programs are being significantly reduced or eliminated. Among the threatened impacts in Texas are, significantly reduced UPL funding, major reduction or elimination of Trauma funding and, Medicaid provider rate reductions. In California, likely impacts include Medi-Cal provider rate reductions, new and increased co-pays for adults and children services, and increased premiums for adult and children’s coverage.

SJH will continue to focus advocacy efforts on precluding or minimizing these cuts, and supporting a balanced and equitable approach to addressing deficits. SJHS will continue to partner with other organizations in advocating for a thirty month extension of the California hospital fee, as well as addressing the threat at the Federal level where there is bi partisan support to eliminate this tax option all together. We will also work with our respective counties to ensure effective implementation of the recently approved Section 1115 waiver, and its potential for expanded health coverage in 2012 through the low income health plan (LIHP). Additionally we will monitor and engage as appropriate, the possibility of ballot initiatives in the November election, which could be hostile to Not-for-Profit hospitals.
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Catholic Ethical Integrity: Conscience Rights

The recent action by Federal HHS mandating Catholic hospitals as employers to provide to their employees insurance coverage of free access to contraception and sterilization services, has supposedly been changed by the President to relieve Catholic hospitals of this mandate and instead directing the services be provided free of charge by insurance companies. The tumult and stress caused by this regulatory action has simply added to the concern felt by Catholic hospitals regarding the need for more permanent solution to Federal Conscience Protection. Over the past three decades a number of Federal “conscience clause” actions have been enacted that were intended to protect health care providers (hospitals and individuals) from being compelled to provide abortion if doing so would violate their ethical or religious beliefs. The most recent conscience clause, enacted by Congress in 2005 is the Weldon Amendment. Every year since 2005, Weldon, has had to be re-enacted as a rider to the Labor-HHS appropriations bill. Over the past few years, particularly in California, there have been incidents of conflict around Weldon involving incorrect or narrow interpretation, and lack of enforcement.

In response to these incidents and with the intent to make Weldon permanent Federal law, the U.S. Conference of Catholic Bishops, the California Catholic Conference (of Catholic Bishops), the Alliance of Catholic Healthcare and the Catholic Healthcare Association last year introduced legislation in Congress to strengthen federal conscience rights laws. SJH will work with these and other partners to advance this legislation, and other related efforts aimed at strengthening Conscience protection.
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Physician Issues

At the heart of the new delivery system reform mandate of true clinical integration, is the necessity for hospitals and physicians to closely collaborate and align their treatment activities into patient centered care coordination. Severely outdated Corporate Practice of Medicine laws in California and Texas place both states at a distinct disadvantage in responding to the Federal mandate of clinical integration. SJH will continue to promote and support public policy and legislation that enhances opportunities for collaboration between physicians and hospitals. We will also continue to ensure that Federal and State implementation of ACO’s allows both physicians and hospitals to lead such organizations, as well as allowing for joint leadership. We will also need to continue to protect the existing Foundation model. After numerous short-term incremental approaches to resolving the major problem in Medicare reimbursement for physicians, SJHS will continue to partner with others to support a long-term solution to this problem. Protecting the Medical Injury Compensation Reform Act (MICRA) will also continue as an issue in the California legislature. Take action or learn more

Childhood Nutrition & Obesity Prevention

In support of SJH efforts to create healthiest communities, we will track federal and state legislative efforts to reduce childhood obesity and seek ways to collaborate with state and federal legislators who author such legislation. Advocate with elected officials and community leaders to raise public awareness for childhood obesity. Enhance awareness of Childhood Obesity and Prevention Week by working with elected officials and the community to promote a healthier lifestyle for children. In addition, we will continue to promote SJHS’s Healthy4Life program to insure that reducing childhood obesity is seen as an essential component to a healthy community. Take action or learn more

Health Care Reform: Implementation

SJH will continue to actively monitor the implementation of national health reform. The new law requires the federal government to issue rules and regulations that will affect all aspects of the delivery system and SJHS. Additionally, members of Congress who opposed HCR continue their vow to repeal the new law and possibly de-fund certain provisions. SJHS will monitor and track proposed changes and will engage as appropriate, consistent with the SJHS’s vision of Health Reform. We will continue to advocate regarding key issues surrounding the implementation of the new law including Medicare update rules, hospital readmissions, Value Based Purchasing, the health insurance exchange and other issues that impact our ministries and the communities we serve.. Take action or learn more