Call to Order and Roll Call
The 3rd meeting of the Interim Joint Committee on Licensing and Occupations was held on Friday, August 14, 2015, at 10:00 AM, in Room 129 of the Capitol Annex. Senator John Schickel, Chair, called the meeting to order, and the secretary called the roll.
Present were:
Members: Senator John Schickel, Co-Chair; Representative Dennis Keene, Co-Chair; Senators Joe Bowen, Tom Buford, Julian M. Carroll, Denise Harper Angel, Jimmy Higdon, Paul Hornback, Ray S. Jones II, Christian McDaniel, and Dan "Malano" Seum; Representatives Tom Burch, Denver Butler, Larry Clark, Jeffery Donohue, Dennis Horlander, Joni L. Jenkins, Adam Koenig, Charles Miller, Brad Montell, David Osborne, Darryl T. Owens, Ruth Ann Palumbo, Arnold Simpson, Diane St. Onge, and Susan Westrom.
Guests: Chris Bartley, Captain, Lexington Fire Department; Joe Baer, President, Kentucky Professional Firefighters; Ronnie Day, Director, Kentucky Fire Commission; David McCrady, Battalion Chief – Retired, Owensboro Fire Department; Victor DiPilla, Vice President and CBDO, Ted Wabler, Executive Director of Strategic Development, The Christ Hospital Health Network; Henry Miller PhD, Managing Director, Berkeley Research Group.
LRC Staff: Tom Hewlett, Bryce Amburgey, Jasmine Williams, Michel Sanderson, and Susan Cunningham.
Approval of minutes for July 10, 2015 meeting.
A motion to approve the minutes of the July 10, 2015 meeting was made by Representative Simpson and seconded by Senator McDaniel. The motion was carried by voice vote.
The Christ Hospital Health Network
Victor DiPilla, Vice President and Chief Business Development Officer of the Christ Hospital Health Network, said that the hospital was founded in 1888 by Methodist missionaries with money from the Gamble family, of Proctor and Gamble fame. Due to changes in health care, the hospital has gone through changes that have brought them to the network they operate today. The mission of the Christ Hospital health network is to improve health in the community by providing exceptional outcomes, with a good patient experience. The goal of the network is to become a national leader in clinical excellence, and affordable care. The network has been rated most preferred healthcare provider in the region by the National Research Corporation for the last 19 years. Press Ganey has honored the network with a Beacon of Excellence award for patient satisfaction.
The network’s facilities perform approximately 25,150 inpatient/outpatient surgeries annually. Medical staff are offered a flexible schedule, allowing surgeons to make their own choice as to staying independent or working for the network. The service area covers south east Ohio, northern Kentucky and south west Indiana. Services offered in the clinics cover musculoskeletal, heart and vascular, oncology, specialized surgery, women’s health and comprehensive medicine. This keeps outpatient care more accessible and affordable to patients.
Fourteen percent of the network’s business thus far in 2015 has come from northern Kentucky. Because it is important to the network to provide services where patients live, there are plans to expand outpatient clinics in Fort Wright. The network also recently acquired land in Fort Mitchell at the Drawbridge Inn site. This development will bring additional outpatient services, including an emergency department with convenient access. Speaking from an economic development standpoint, there will be new jobs for the community with an expected 200 additional professional positions.
In response to a question from Representative Simpson, Mr. DiPilla said there will not be a hospital in the Fort Mitchell location. The focus of the network is to provide outpatient services with access to short-stay care to support observation. There are no plans to build a bed tower. In response to another question from Representative Simpson, he said Ohio abandoned Certificate of Need in the late 1980’s.
In response to a question from Senator Buford, Mr. DiPilla said that Medicaid is accepted at all Kentucky locations.
In response to a question from Senator McDaniel, Mr. DiPilla said the network is not subject to the provider tax that Kentucky domiciled hospitals are required to pay.
In response to a question from Representative Burch, Mr. DiPilla said although he did not have a figure to quote, the clinics have been recognized in a number of areas for clinical excellence and the hospital infection rate was extremely low.
In response to a question from Representative St. Onge, Mr. DiPilla responded that he was unsure of the exact percentage of Medicaid patients. Typically, patients are affiliated with a network physician. Therefore, if a patient required a hospitalization they would be transferred to the Mount Auburn location.
In response to a comment from Senator Schickel, Mr. DiPilla said that typically, if the care is not urgent, an indigent person would be asked to seek treatment in the clinic at the Mount Auburn location.
In response to a question from Representative Owens, Mr. DiPilla said a physician’s choice of where to send a patient is a recommendation, the patient has the ultimate choice, particularly for an elective procedure. Costs for out-of-network procedures will differ than services provided in-network.
In response to a question from Senator Seum, Mr. DiPilla said the network is pleased with the transition from CON to free market in Ohio. It is believed that competition makes for better quality of care for patients.
Firefighters’ Cancer and Workers Compensation
Chris Bartley, Captain, Lexington Fire Department, said the cancer bill has been introduced for the last five sessions. There are multiple studies to support that firefighters suffer more cancer that the general public. In 2006, the University of Cincinnati combined data from 32 studies of firefighters covering 20 different types of cancer. The risks for 10 types of cancer were significantly higher in firefighters. The National Institute for Occupational Safety and Health (NIOSH), responsible for conducting research and making recommendations for the prevention of work related injury and illness, collected information from 1950 to 2009, including 30,000 career firefighters from three major cities, also studied the issue and found that furniture that burns today is not made from natural material. Fires burn hotter, faster and release more toxins. This increases the risk for many cancers including testicular, multiple myeloma, non-Hodgkin’s lymphoma, prostate cancer, brain cancer, colon cancer, and Leukemia.
Thirty-five states have some type of cancer presumption for firefighters. Michigan and Arkansas passed bills this year. The bill introduced in the Kentucky 2015 session was restrictive in comparison to other firefighter cancer presumptive laws nationwide. The coverage expires five years after a firefighter has retired. The coverage is for both paid and volunteer firefighters. Firefighters must have been tobacco free for ten years to be covered. The coverage is for the cancers that have been scientifically linked to firefighters. This law will expire if it can no longer be financially supported by the Kentucky Fire Commission. It is estimated that the total cost to cover the workers compensation aspect is $2 million per year. Of the seven states that have presumptive coverage in place and are paying an average of one to three claims per year, there has been no increase in financial burden to the state.
Kentucky has approximately 3,700 paid firefighters and 20,000 volunteer firefighters. An evaluation by the National Council on Compensation Insurance shows negligible cost, less than three tenths of one percent of the total premium in the state. The proposed legislation would allow workers compensation to be used rather than vacation or sick time to cover leave. The Kentucky Fire Commission is paying workers compensation for 20,000 volunteer firefighters. The new legislation will bring the paid firefighters under the Fire Commission, reducing cost for cities.
David McCrady, Battalion Chief, Retired, Owensboro Fire Department, said in December of 2013 he was diagnosed with brain cancer at the age of 46. In September of 2014 he was forced to retire. The prognosis for life expectancy was three to six months. However, he has been participating in a trial cancer drug program, and it has been 20 months since his brain cancer surgery. Cancer causing agents come not just from inhaling smoke, but also comes from soot and residue left on bunker gear that has to be cleaned. Currently he participates in teaching a firefighter cancer awareness and prevention class.
In response to a question from Senator Carroll, Mr. Bartley said if the Fire Commission can no longer afford to pay claims the workers compensation payments will revert back to the cities.
In response to a question from Representative Westrom, Mr. Bartley said the International Association of Firefighters recognizes line of duty cancer deaths. Sixty percent of the names on the Fallen Fighter Memorial in Colorado are due to cancer.
In response to a question from Representative Burch, Mr. Bartley said because the session last year was 30 days long, time ran out to get the bill passed.
In response to a question from Representative Koenig, Mr. Bartley said the State Fire Commission collects a state surcharge tax to pay for the training incentive.
Representative Koenig said that the presumptive cancer bill could create a need for the administration to raise the insurance tax fee that goes to the Fire Commission to pay these costs.
In response to a question from Senator Seum, Mr. Bartley said the amount the firefighters receive from the KLEFP will not decrease if there is presumptive cancer coverage in place.
In response to a question from Representative Clark, Ronnie Day said the insurance surcharge generates approximately $60 million dollars annually for the firefighters.
Representative Butler said he felt the legislation would enhance the firefighter work place in creating a tobacco free environment. Additionally, 17,000 volunteer firefighter will become covered. The funding is from a surcharge of 1.8 percent paid on home and auto insurance policies. The split is 70 percent for police and 30 percent for firefighters. Because these funds are restricted funds, he has asked Auditor Edelen to perform an audit so that the entire amount of the funds collected can be returned to the departments.
Senator Higdon said that he was in support of the bill, but wants to better understand the payment structure.
Representative Montell said that sweeping funds should be stopped during the next session.
There being no further business to come before the committee the meeting was adjourned at 11:10 AM