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North Carolina’s hospitals weigh in

The Observer and the News and Observer of Raleigh asked officials at the North Carolina Hospital Association to share their thoughts about hospital-related legislation this year. Following are the questions and answers.

Q. What was notable about hospital-related legislation this year?

A. Hospitals had many legislative champions this year and, for the first time in recent memory, legislators who were determined to enact legislation despite information about the harmful effects it would have on the patients, communities we serve and the 192,000 hospital employees who care for them. Most notable was the legislature’s disbelief of the changing future for hospital care and finances due to the Affordable Care Act and the compounding effects of legislative decisions on that future.

Q. And overall, how do you think that legislation will affect hospitals?

A. Overall, this legislative session will significantly adversely affect hospitals by substantially reducing the resources available to care for patients and communities. This session included the largest budget cuts in history for hospitals. Hospitals will be taking $100 million in cuts from the State and face the prospect of future legislatures lowering the sales tax refund cap on nonprofits. Those cuts will force the elimination of services in some hospitals and the loss of hundreds of jobs for hospital caregivers and will threaten the degradation of both physical health for patients and economic health for many communities.

The legislation will also remind hospitals of the importance of legislative decisions on their ability to serve their communities and of the need for continued education of legislators about the effects of those decisions and the future challenges hospitals face.

Q. What was notable about the hospital’s lobbying efforts this year?

A. The involvement of thousands of hospital employees reaching out to legislators in attempts to help lawmakers understand the plight of hospitals and the impact of their decisions on the provision of care to patients was most notable. Hospitals and their employees have never been more engaged. Many legislators heard those pleas and fought for their hospitals. Sadly, many were ignored by legislators.

Q. What were some of the key ways the hospital industry tried to get its points across to lawmakers?

A. Facing about $800 million in Medicare cuts each year for the next decade under the Affordable Care Act, our field tried to help legislators understand that massive state funding cuts would devastate some hospitals. Our efforts included a letter writing campaign, greater use of social media and an advertising campaign that included television, radio and newspaper. Many hospital employees called and emailed their legislators and the governor. Over 400 hospital employees traveled to Raleigh to meet with their legislators during Hospital Advocacy Days.

Q. What was different or unusual about the NCHA’s lobbying and public information efforts this year? You previously told us a little about the "Healthy Hospitals" campaign. How effective was that?

A. We believe we have a duty to the public to ensure they are aware of the potential adverse effects on our ability to meet their needs when the legislature is making decisions that adversely affect that ability. We believe the “Healthy Hospitals” campaign helped to meet that duty by alerting the public of the challenges hospitals face in the coming years due to budget cuts. We know it motivated some to contact their legislators in support of our issues. .

Q. Hugh Tilson said the NCHA advertised in every hospital market in the state. Why did the NCHA feel it was important to do that? How much did that television advertising campaign cost?

A. The advertising served several purposes. We believe we have a duty to the public to ensure they are aware of the potential adverse effects on our ability to meet their needs when the legislature is making decisions that adversely affect that ability. Since hospitals operate throughout the state, we believed it important to inform the public throughout the state about the challenges hospitals are facing in the coming years due to funding cuts. Hospitals’ mission is to care for everyone in the community, all day, every day. The advertising was hospitals’ way of battling for the resources to fulfill that mission. The public advertising also helped build momentum for some of our other lobbying efforts. NCHA spent about $1 million on this form of lobbying. The expenditure was the highest in NCHA history.

Q. Did the NCHA or its member hospitals conduct any sort of letter-writing campaign this year? Can you tell us a little about that? How many lawmakers did the hospital representatives write to and how many pieces of mail went out?

A. We believe hospital employees and the public sent legislators about 40,000 pieces of mail as part of our campaign. The letters went to every legislator and to the governor.

Q. How much did the NCHA spend overall on lobbying this year? How does that compare to previous years?

A. NCHA has not yet computed our total lobbying expenses for the year. That report is not due to the state until next year.

Q. From the secretary of state’s web site, it looks as though the hospital association registered 12 lobbyists this year - more than in most past years. Was it a particularly busy year on the legislative front for the hospital industry? Why?

A. NCHA takes a conservative approach when determining whom to register. Most of the NCHA registered lobbyists are NCHA staff experts who interface with government on a sufficiently regular basis to register them as lobbyists. They do not, however, lobby at the legislature.

It was a particularly busy year on the legislative front. We used every resource available in attempts to let legislators know of the challenges hospitals face going forward and the impact many of their decisions would have on the care provided in hospitals and on those who provide that care. For hospitals, meeting our mission is paramount. Our lobbying efforts are, were and will be directed to ensuring hospitals have the resources to meet their missions.

Q. What else do you think it’s important for people to know about this year’s legislative efforts as they pertain to hospitals?

A. We are grateful to those legislators who heard from their community hospitals and agreed that hospitals do more than our fair share for our communities through our actions to meet our mission of caring for all in our community, all day every day. We are disappointed that some in the legislature disregarded the information we provided about the effects of the Affordable Care Act and other current challenges as we meet our mission.

The $100 million cut that this legislative session put on hospitals combined with the State’s decision to neither expand Medicaid nor provide an alternative insurance for the state’s poorest adults and the $800 million in Medicare cuts will force the elimination of services in many hospitals and the cost hundreds of hospital caregivers their jobs. These cuts will harm hospitals’ abilities to care for our patients and communities and employ those who provide that care. NCHA, its members and employees worked hard to save patients and communities from this harm.

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