Legislature(2003 - 2004)
03/25/2004 03:04 PM House HES
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* first hearing in first committee of referral
+ teleconferenced
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+ teleconferenced
= bill was previously heard/scheduled
HB 500-MEDICAL REVIEW ORGANIZATION Number 0050 CHAIR WILSON announced that the first order of business would be HOUSE BILL NO. 500, "An Act relating to medical review organizations; and providing for an effective date." Number 0102 SARA NIELSEN, Staff to Representative Ralph Samuels, Alaska State Legislature, testified on behalf of Representative Samuels, sponsor of HB 500. She told the members that this bill adds the Joint Commission on Accreditation of Health Care Organizations (JCAHO) to the narrow definition of a review organization. She explained that the commission is an independent not-for-profit organization that evaluates 16,000 health care organizations within the United States. The board is comprised of physicians, nurses, and consumers, she added. Ms. Nielsen said that JCAHO is the nation's oldest and largest standards setting and accrediting body in the health care field, having operated for more than four decades. She emphasized the importance of including JCAHO in the review organization definition because health care facilities that provide information to the commission will have the assurance that information will be treated as confidential. Its addition to the statute will ultimately promote quality health care in Alaska, she summarized. Number 0213 SANDY SEVERSON, Administrative Director, Quality Support Services, Providence Health System, testified in support of HB 500. She told the members that she believes this legislation is necessary because JCAHO is the principal independent organization that performs accreditation of hospitals and other health care organizations throughout the United States. Recently JCAHO redesigned its survey process from a tri-annual survey to a policy of requiring hospitals and other health care organizations to complete a mid-cycle periodic performance review. The periodic performance review is a self-assessment of compliance with all applicable standards, she said. If there are areas that are found to be in non-compliance, the hospitals and health care facilities are charged to develop plans of action along with measures of success to demonstrate that the identified problem areas have been resolved when JCAHO does an on-site visit every three years, Ms. Severson explained. Number 0322 MS. SEVERSON told the members that it was the intent of JCAHO that all information developed through this process would be shared directly with them. The American Hospital Association, the American Society of Health Care Risk Management, and several state hospital associations immediately identified this approach as a significant risk management concern for health care organizations, she explained. Ms. Severson pointed out that depending on each state's statutes regarding confidentiality of quality information, and what specifically entailed a quality review organization, the information shared directly with JCAHO could be deemed discoverable and used against the health care facilities by any individual or entity requesting those results, she said. This would waive health care organizations' protection of the quality control data if the statutes do not recognize JCAHO as a quality review organization. Number 0441 MS. SEVERSON told the members that JCAHO met with concerned health care organizations, the American Hospital Association, and the American Society of Health Care Risk Management and offered the health care organizations two additional options. The first option suggested doing the self-assessment, but not submitting it to JCAHO. The drawback of this is that the organization would loose the ability to actively discuss the details of the action plan with JCAHO and get feedback from them. She explained that JCAHO takes data from participating hospitals and publishes trends in patient safety and quality of care so health care organizations can learn from each other. In order for this to work effectively it is important that all the health care organizations submit its data to them, she said. MS. SEVERSON said that the second option is to choose to not do the periodic performance review and instead do an on-site JCAHO survey. The cost of additional surveys are charged to the hospitals and will further inflate health care costs. She added that surveys also take staff time away from patient care. Ms. Severson told the members that Providence Health Systems does not believe this option is the solution. She said that it has completed the self-assessment process and has found it to be very meaningful and educational for staff. Ms. Severson shared that Providence Health Systems sought legal counsel to review the Alaska statute as it pertains to public accessibility to information reported through this process. She said its attorneys reported that under current Alaska statutes JCAHO is not considered a quality review organization; therefore, the self-assessment information could be vulnerable to discovery once it is submitted to JCAHO. She summarized that Providence Health Systems is committed to evaluating and improving the quality of health care in Alaska. It is important that this legislation be enacted to protect the quality review information, Ms. Severson stated. Number 0566 REPRESENTATIVE COGHILL commented that he understands the benefit of JCAHO. He said he believes current statute already addresses this issue and asked for clarification that additional protections are needed. Number 0615 MS. NIELSEN replied that it is important to add the commission to the statute to eliminate any uncertainty that it is not included. REPRESENTATIVE COGHILL asked if there are any other review teams that should be included. MS. NIELSEN responded that she is not aware of any; however, she told the members that the sponsor would not be opposed to including others who would want to be included in this bill. Number 0722 REPRESENTATIVE SEATON moved to report HB 500, Version A, out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HB 500 was reported out of the House Health, Education and Social Services Standing Committee.
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