February 24th, 2009

HealthPoint editor Lauren attended the Dept. of Health’s budget hearing before the House yesterday afternoon.  Here are the highlights of her notes, paraphrased from what was originally said. 

REP. CONKLIN:  As far as the stockpile for funding emergency relief, such as disease epidemics… is that funding still available?

DH:  Yes.  The anti-viral stockpile comes mostly from federal money, but is a state/federal partnership.  The DH has already purchased for the year the supplies needed.

REP. FRANKEL:  The budget reduced funding for non-preferred, he reduced funding for the Children’s Hospital of Phila., but eliminated funding for the Children’s Hospital of Pittsburgh.  Why the inequality?  I can’t understand why Philly only gets a cut, but Pitt gets eliminated.  Similarly, there were major cuts for regional cancer institutions, and the Pitt ones got the short end of the stick.  What is the rationale behind this discrepancy?

DH:  We never intended to discriminate against Pitt, which does fine work.  Philly non-preferreds got a 10% cut.  Pitt’s funding is a legislative initiative and their funding will be restored through the negotiation process.  That’s the reason for the difference.  We recommended a cut to Pitt’s funding with a restoration mid-year.

FRANKEL:  But this has been happening for years.  It’s unfair.  We hope that we can work with you to resolve this.  Similar institutions should be treated comparably.  But I will move on – to the smoking ban.  In Harrisburg, I’ve noticed that it’s being loosely interpreted… bars are creating “smoking rooms” and such.  How is this going?  Do you have the resources to enforce the ban?

DH:  A lot of restaurants have actually received fines.  DH’s approach has been to first educate businesses by distributing a toolkit on how to comply with the ban.  For the first 3 months, we focused on educating businesses and the public on the ban’s importance.  Since December, now we’ve been focused on enforcement.  We don’t have many resources, however.  We’re using contractors to enforce the ban.  We’ve set up a complaint line, which we receive many tips from.  First we give a warning letter, which usually works.  But on a second complaint, we will go out and investigate.  Finally, we will cite the business.  [DH then explains the types of business exemptions.]  We will be denying more requests for exemptions from now on.

FRANKEL:  The simple solution is to enact a full smoking ban!

REP. SCAVELLO:  As far as primary care access initiatives and Prescription for PA money goes… These programs are a big impact on the expansion of primary care.  What is their status?

DH:  They provide loan repayment to certain healthcare workers (doctors, nurses, etc.) who commit to practicing in underserved areas for a certain period of time.  Right now, a 3 year commitment will earn them up to $30K in loan repayment.  ENHANCE extends those commitments, so more time = more money.  For physicians and dentists, a 5 year commitment will earn them up to $114K.  It is the best way to insure that we have good primary care professionals in underserved areas.  Community challenge grants fund patient access to healthcare services.  They also assist clinics directly, helping them add services and equipment.  They are critical programs.

SCAVELLO:  Is our physician loan repayment program comparable to the programs run by other states?

DH:  Yes, especially with ENHANCE.  PA is very competitive.

REP. SHAPIRO:  For HIV prevention, there is federal money to be had, but certain standards have to be met by the state to get the funding.  PA has yet to meet these standards, which means we’re leaving that money on the table.  What money could we expect if we up our standards?

DH:  You’re right, we’re behind.  There are 2 federal funding sources for HIV prevention programs, and we are not eligible for either.  We want testing for HIV to become more routine in medical care.  So we should make some changes in order to receive the funding.  We would be looking at $1 million.

SHAPIRO:  How could we change the loan repayment program to bring in even more doctors and nurses?

DH:  We would have to broaden the list of types of professionals eligible for the funding, and the list of where they can practice.  We would have to change the statute.  Right now it doesn’t have the flexibility to accept OB-GYNs and other specialists, so that should be changed.

REP. SMITH:  You are cutting diabetes program funding.  But, you are keeping the same funding for hemophilia and other less prevalent diseases.  The diabetes funding would save more lives and money in the long term.  Why the discrepancy?

DH:  That funding cut doesn’t actually give direct services or treatment, so patient won’t be directly affected.  We ARE trying to prevent chronic disease, which these programs can mitigate.  We don’t fund these programs enough.  We are treating disease, not preventing it.  DH has to better identify the programs that are working, and increase funding for them.  I do want to work with you to address this issue.