March 31, 2019
Treating Trauma
Heartbreaking news out of Parkland, Fla., and Newtown, Conn., in recent weeks — in which survivors and loved ones of those affected by violence died by suicide — have put the devastating effects of trauma in the spotlight.

Maryland’s health care leaders are all too familiar with the long-term effects of violence, natural disasters, and other harrowing events. You see suffering in the community. You know that health care workers may experience serious secondary trauma while caring for patients.

Many hospitals support your communities through outreach, education, and early intervention. You also are undertaking efforts to protect, sustain and strengthen front line staff and other associates who care for traumatized patients daily.

Your Maryland Hospital Association (MHA) is here to assist you as you reimagine trauma-informed care. We established a Behavioral Health Task Force to identify and support efforts aimed at reinforcing our state’s behavioral health care continuum. Looking ahead, that dedicated group will be focusing on important issues, including stigma and screening for suicide risk.

Last year, MHA and the Maryland Nurses Association formed the Workplace Violence Prevention Steering Committee and hosted a statewide summit on workplace violence.

But, of course, there is more work to do to keep our workforce and our communities healthy and resilient.
Part of MHA’s job is to gather and disseminate best practices. I encourage you to visit our Innovations for Better Health repository to share your successes and to let us know how we can bolster your efforts.
Bob Atlas
President & CEO
Western Maryland Health System Signs Letter of Intent to
Pursue an Affiliation with UPMC
On Friday, Western Maryland Health System announced that it will pursue an affiliation agreement to integrate into the University of Pittsburgh Medical Center system. Citing opportunities to expand healthcare services to Allegany County, Md. and the surrounding areas, WMHS hopes to leverage UPMC’s clinical expertise while improving physician recruitment opportunities.
“Western Maryland Health System is working with UPMC toward a definitive agreement to affiliate, which will allow WMHS to maintain clinical excellence in western Maryland and throughout the region for years to come,” said Barry Ronan, WMHS President and CEO. “Since we became clinically affiliated with UPMC in 2018, we have a stronger clinical and operational position allowing a broad range of nationally recognized care here locally for the people of Allegany County and surrounding counties in Maryland, Pennsylvania and West Virginia.”  
Save the Date: MHA's 2019 Annual Membership Meeting
Registration is now open for your Maryland Hospital Association’s 2019 Annual Membership Meeting. An evening reception is scheduled for June 10, and the general session is scheduled for June 11, from 8:30 a.m. to 1 p.m. The keynote speaker for the event is Captain “Sully” Sullenberger, and Adam Boehler, senior adviser to the Secretary for the Centers for Medicare & Medicaid Services and Director of the Center for Medicare and Medicaid Innovation, also will be featured.
MHA Updates Physician Provider Attribution Analysis
MHA’s Medicare Performance Adjustment Work Group received an updated analysis detailing how individual physicians’ utilization is shared across hospitals. The data suggest hospitals in certain regions in Maryland might consider shared accountability under the Medicare Performance Adjustment (MPA), and, might coordinate their outreach and support to physicians in managing care. At MHA’s request, the commission extended the deadline for hospitals to review provider attribution lists under the MPA until April 12. For more information or to see the full report, contact Brett McCone , MHA Senior Vice President, Health Care Payment.
Free Training Available For Nursing Home Partners
The Centers for Medicare & Medicaid Services (CMS) is launching a free online training course in infection prevention and control for nursing home staff in the long-term care setting developed with the Centers for Disease Control and Prevention (CDC). The course information covers core activities for an infection prevention and control program, with a detailed explanation of recommended practices to prevent pathogen transmission and reduce healthcare-associated infections and antibiotic resistance in nursing homes.
Maryland General Assembly Update
As the Maryland General Assembly enters the final week of the 2019 legislative session, the state’s fiscal year 2020 operating and capital budgets were finalized last week (for more details, see the item below) and several priority bills continued progressing. Certificate of Need modernization legislation advanced by the Maryland Hospital Association passed the General Assembly, as well as legislation that includes language authorizing a hospital or health system to have a Prescription Drug Monitoring Program (PDMP) “facility” account instead of only individual prescriber accounts to improve physician workflows. Your MHA team continues to wrap up several priority issues ahead of Sine Die on April 8. For more information on bills MHA is tracking, please click here .
Maryland's Fiscal Year 2020 Budget Includes Hospital Priorities
Last week, the Maryland General Assembly finalized the state’s $46 billion fiscal year 2020 budget. Following a $268-million revenue write-down earlier this month, the Department of Legislative Services (DLS) recommended delaying the entire $40 million Medicaid Deficit Assessment reduction included in Gov. Larry Hogan’s proposed budget. The House of Delegates provided a $20 million and the Senate a $25 million reduction in their respective versions of the budget. The field ultimately secured a $25 million reduction during conference committee deliberations despite the DLS recommendation, significant revenue write-down, and an effort to provide $255 million as an initial investment for the Kirwan Commission on Education recommendations in fiscal year 2020. The final budget also includes nearly $30 million for Maryland’s two Institutions for Mental Diseases (IMDs) as well as rate increases for health care providers, including behavioral health community services in accordance with the Keep the Door Open Act of 2017. MHA secured an additional $500,000 in the capital budget for nine hospital projects that we recommended, bringing the total funding to $5.5 million in fiscal year 2020. Looking ahead, the state’s fiscal outlook is bleak beginning next year as DLS projects a $829 million structural budget deficit in fiscal year 2021.
Pilot Program Seeks to Prevent HIV in
Sexual Assault, Rape Survivors
The Maryland General Assembly on Thursday passed legislation establishing a pilot program that will provide HIV prophylaxis, free of charge to sexual assault and rape survivors. This legislation requires the state to cover the cost of providing qualifying victims with a full course of treatment and follow-up care to prevent HIV. The Maryland Hospital Association , on behalf of the hospital field, worked with the Maryland Coalition Against Sexual Assault to pass this legislation.
CRISP Hosts Informational ECIP Webinars
Current Care Redesign Program (CRP) hospitals can enroll mid-year in the Episode Care Improvement Program (ECIP) for a July 1 start. The implementation protocols for midyear enrollment into ECIP Track must be submitted to CRISP by May 1. CRISP will host informational webinars to review the details of ECIP and train representatives on available tools:

Hospital users with access to the CRISP Reporting Services (CRS) portal can access materials via the ECIP Card in CRS and recordings from the Fall 2018 ECIP Webinar series - at the bottom of the page . For questions, contact Care.Redesign@CRISPHealth.org .
Health Care By the Numbers
* Source: MHA Analysis of HSCRC’s 2017 Hospital Discharge (Revisit) Data; Patients with three or more hospital encounters including: admissions, emergency department visits, or observation stays
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