Illinois
Society for Respiratory
Care
Phone - 217-522-5558 - Fax
217-522-5557
(AN AFFILIATE OF
THE AMERICAN ASSOCIATION FOR RESPIRATORY CARE)
| View the Update from the 2011 AARC
Pact visit to Washington
THE SCOPE OF COPD IN ILLINOIS (Accessed April 2, 2011) The American Lung Association in Illinois has assessed the scope of COPD in Illinois. See the executive summary that provides a sampling of the findings for our multi-method assessment, including hospitalization and emergency department data from 2000-2009 provided by Illinois Department of Public Health Hospital Discharge Data and 2010 Health Care Effectiveness Data and Information Set (HEDIS) commercial data set. A full report will be available through the American Lung Association in Illinois next month. ¢ COPD… Not an "old man's disease"; COPD effects both middle-aged men and women. ¢ One out of three (31.7% in 2009) Illinois residents who were hospitalized for COPD were under the age of 65, making COPD an employment issue. ¢ COPD is expensive. In 2009, the average hospitalization for COPD was $24,975, excluding professional fees. ¢ In 2009, the total hospitalization charges for COPD in Illinois, excluding professional fees was over $1.1 billion. The majority of COPD hospitalizations are preventable. ¢ 80% of the $1.1 billion in charges were to Medicare or Medicaid - making COPD hospitalizations a tax payer issue. ¢ 2007 was the first year that more females were hospitalized due to COPD than males in Illinois, a rate of 14.45 females per 1,000 population versus 14.38 for males. This trend continued during 2008 and 2009. ¢ The rate of COPD hospitalizations in Illinois in 2008 was greatest in rural and urban counties, and lowest in Chicago and the Metro Collar Counties. The rate of hospitalizations in rural Illinois counties was nearly three times that of Metro Collar Counties. ¢ According to the 2010 HEDIS aggregated commercial data set (excluding Medicare and Medicaid) for Illinois showed that only 35% of Illinois residents with COPD received a spirometry test in their assessment and diagnosis of COPD. This is lower than the national average of 37.6%. There is room for improvement in utilizing this gold standard for the diagnosis and management of COPD. Spirometry is inexpensive. An office spirometer costs less than $800 and trainings are available. For two webinars on spirometry implementation and interpretation in the primary care practice, please click here. ¢ The average age for a COPD hospitalized patient is going down. Between 2000 and 2009, the average age for a hospitalized patient with COPD has declined 1.5 years; from 71.8 years to 70.3. ¢ In 2009, COPD was the PRIMARY reason for 3 percent of all hospitalizations in Illinois. Summary Chronic obstructive pulmonary disease (COPD) is no longer a disease of elderly men; increasingly, it is a disease of both middle-aged men and women. Each year, there are an average of 67,800 COPD hospitalizations in Illinois. 2007 was the first year that more females were hospitalized due to COPD than males, a rate of 14.45 females per 1000 population 45 years of age and older, versus 14.38 for males. This trend continued during 2008 and 2009. The rate of COPD diagnosis in women has caught up with the rate for men for several reasons. One reason is that women's lungs are more susceptible to developing COPD compared to men with the same exposure. However, the main reason is an increase in tobacco use by women form the 1950s through the '90s. Background information The American Lung Association in Illinois undertook this COPD surveillance study as the state's leader in COPD patient and professional education. This data will provide guidance to the goals and objectives listed in the May 2008 Illinois COPD State Plan. In addition, this data will guide the future direction of the American Lung Association in Illinois and Greater Chicago. This data has never before been available to health care and public health professionals in Illinois. As a result of this data, the American Lung Association in Illinois is forming the Illinois COPD Provider and Public Awareness Task Force. For more information or to join this task force, contact Lori Yonker at lori.yonker@lungil.org or 217-787-5864. For more information about the Scope of COPD in Illinois study, please contact Jill Heins Nesvold, director of respiratory health, at jill.heins@lungmn.org or 651-223-9578. View The American Lung Association Suumary from March 2011 AARC PACT MEETING MARCH 8-10, 2010 Once again it is time for the AARC (American Association for Respiratory Care) PACT Meeting. Last year we had over 100 RT's, several patients and completed over 300 Hill visits. Hopefully this year we will do the same. The congressional offices will certainly get a lot of education regarding lung health issues as there are visits from members of AACVPR (American Association of Cardiovascular and Pulmonary Rehab) and ACCP (American College of Chest Physicians) around this same time period of our visits.This year I will be going to DC with our current President of the ISRC, Audrea Hardwick-Williams.I have meetings in the following offices scheduled: 1. Congressman Mark Kirk 2. Congressman Peter Roskam 3. Congresswoman Jan Schakowsky 4. Congressman John Shimkus 5. Congressman Aaron Schock 6. Congresswoman Judy Biggert 7. Senator Richard Durbin I hope to have meetings scheduled with the offices of Congressman Bobby Rush and Congressman Danny Davis also. Main Issue for Support: 1. Medicare Respiratory Therapy Initiative: (HR1077/S343) Again, this will allow certain qualified respiratory therapists under Medicare B to be recognized as "physician extenders" which would give individuals living with chronic lung diseases increased access to respiratory care practitioners outside of the hospital setting. Please go to aarc.org if you wish to read more about this important Initiative for our patients and our profession. Other Issues on the Table: 1. Home Oxygen Therapy: There are currently 2 House Bills that address the provision of Home O2. HR3220 (Medicare Home Oxygen Therapy Act of 2009) would reform the current Medicare coverage and reimbursement and HR2373 (Home Oxygen Patient Protection Act of 2009) would restore the Medicare payments for Home O2 throughout the beneficiary's period of medical need. HR2372 has more co-sponsors (82) then HR3220 (2) but neither Bill has a Senate companion Bill as of yet. I have personally been to a few Support Groups in IL and am taking their concerns with me to DC. I did meet directly with Congressman Schock, along with Chapter 1 Chair and AARC IL District Rep, Donny Byrd, in the Congressman's Peoria office last summer to speak about this as several of his constituents voiced their concerns over the reimbursement changes. 2. National Coverage Determination for Pulm Rehab: I have spoken to several hospital-based Pulmonary Rehab Coordinators regarding how the changes that began January 1st are affecting program implementation. I will take their concerns with me to DC as well.We always encourage our congressional leaders to become members of the COPD Caucus. Currently, Senator Durbin is the only member from Illinois.
If anyone would like me to take their concerns to DC during this visit, please email me at lzang@pulmonaryexchange.com
I would also like to ask everyone to send in their support for the Medicare Respiratory Therapy Initiative and the Home Oxygen Therapy issues by emailing their congressional representatives. We need a lot of letters going into DC prior to our arrival!
Before I update you on the current Bills/Issues, I would like to take this opportunity to thank one of my District Reps and current ISRC Chapter 1 Chair, Donny Byrd, on setting up a meeting with his congressional representative in his District office. Due to his efforts, we were able to have a great meeting with Congressman Aaron Schock, IL-18, in Peoria this summer. I had the occasion to meet with the Congressman’s healthcare legislative aide in his DC office, but not directly with him. We understood that their District office had received phone calls from constituents regarding the changes in the provision of home oxygen therapy, so this definitely was one of the topics of discussion during our meeting. I hope that by telling you about this that everyone will realize that you can be heard! You can also meet directly with your elected officials and tell your story…your experience…and give your insight on how to make things better. Thanks Donny for your continued efforts! It has certainly been an interesting year so far for healthcare. We are all definitely working in an industry that is undergoing a lot of talk about reform, even as we have undergone changes already. Here is a highlight of some of the legislation/issues that were presented last month in the AARC Federal Government Affairs Activity Report. Medicare Respiratory Therapy Initiative - (HR1077/S343) Briefly, this legislation will allow qualified respiratory therapists to provide certain services under the “medical and other health services” benefit category under Medicare Part B. If you are not familiar with this Initiative, please go to aarc.org/Government Affairs section to gain more information.. We continue to gain co-sponsors for this legislation from across the country. As of the writing of this article, we have 23 House Co-Sponsors and 8 Senate Co-Sponsors. We do have several consumer/patient organizations that have offered their support. I personally have spoken to some local groups in IL and have been offered pledges of support by their members. We need to get some of our Illinois congressional representatives “on board” with this important legislation. I want to thank all of my colleagues who did write a letter at the ISRC Convention in May but I am asking again that you please keep the letters coming! There are a lot of issues that are being talked about with the upcoming the Healthcare Reform Packages that are being introduced on both the House and Senate side, so we want to keep our Initiative in the forefront of their minds. Outpatient Pulmonary Rehabilitation (PR) – National Coverage To update, the Bill was passed whereby CMS will make a National Coverage Determination (NCD) for the coverage of PR as a Medicare benefit. The “go live” date for this NCD is January 1, 2010. Several stakeholder groups have been involved in many meetings over the past months in an attempt to ensure that the NCD becomes a good coverage benefit for those individuals who require this benefit. The AARC has been one of those stakeholder groups. CMS has issued proposed regulations (regs) for the NCD. According to the individuals from the AARC who presented the Activity Report, “The AARC continues to work in partnership with other PR stakeholders, including the AACVPR, ATS, ACCP and NAMDRC to present a united front and unified recommendations to CMS. This joint approach has had a very positive impact on policymakers in the past and we expect speaking in one voice on the proposed regs will carry weight.” All of the PR stakeholders are currently reviewing the proposed regs and are due to send their recommendations/response by August 31st. Home Oxygen Reform Initiative There has been a move by several stakeholder organizations to work together and to send a proposed initiative to reform the current legislation for coverage of home oxygen therapy by Medicare. If you are not familiar with the current law you can gain insight into this by going to aarc.org/government affairs. In a nutshell, the stakeholders’ proposal includes asking for the elimination of oxygen from Competitive Bidding and repealing the 36 month cap. It also will include looking at other payment reform strategies and “categorizing” portability options. It is uncertain as of the writing of this article if there will be further changes in DME legislation. It is certainly an area of hot debate and scrutiny. If you have not written your congressional representatives about this issue, NOW would be a good time to do so as there is slated to be healthcare reform sooner rather then later. Oxygen on Airlines The final rule from the Department of Transportation (DOT) regarding permitting passengers with “electronic respiratory assist devices” to board the plane went into effect May 13, 2009. The devices permitted include portable oxygen concentrators (POC), respirators, ventilators and CPAP devices. The two primary conditions for use are that the devices must be tested and labeled by the manufacturer as safe for air travel and they must be able to be stored safely according to FAA rules. I would recommend that anyone using one of these devices arrange their travel plans in advance and call their airline ahead of time to obtain and follow their procedures. Medicare, Medicaid, and Maternal Child Health (MCH) Tobacco Cessation Promotion Act of 2009 – (HR 1850/S 770) This bill would create a Medicare and Medicaid benefit that would cover smoking cessation programs provided by qualified smoking cessation counselors. Senator Durbin from IL was one of the Sponsors of this legislation. If the Bill becomes enacted, the AARC would work towards the recognition of respiratory therapists as qualified professionals to provide tobacco cessation counseling. The Centers for Disease Control and Prevention (CDC) Chronic Disease COPD Program Appropriations Request According to the Activity Report, the “AARC continues to partner with the US COPD Coalition to support a public health program that would address COPD in the Chronic Disease and Health Prevention Division of the Centers for Disease Control and Prevention (CDC). We are asking that Congress fund $1 million to be directed to the CDC for a COPD Action Plan.” The AARC set for a letter writing campaign earlier this year so that we could write to our Senators to ask for their support in this effort. Due to the sustained efforts of many, CDC has named a COPD “Czar” who will look into ensuring we have better surveillance of COPD! The “Czar” will begin by looking at all the States Behavior Risk Factor Surveillance Surveys (BRFSS). In Illinois, for example, our BRFSS asks questions about tobacco use and asthma. There is no question specific to COPD. I hope that all of the above will give you some information on what is currently going on. As the IL AARC PACT Chair, I would like to thank Cheryl West (AARC Director of Government Affairs), Miriam O’Day (AARC Director of Legislative Affairs) and Anne Marie Hummel (AARC Director of Regulatory Affairs) and all of the staff at the AARC for their tireless efforts. I would also like to thank all of my colleagues in Illinois who continue to write letters and set up meetings with their congressional representatives to voice their opinions regarding the issues at hand. These are pivotal times in healthcare! We must remember that our opinions and voice matter! Please make sure you take the time to make yourself heard. Also, make sure you spread the word to others and encourage them to write. The more we all unite together as one, the louder the voice will be from Illinois on the issues. For any questions/comments, please email me at lzang@pulmonaryexchange.com Lisa M. Zaenger, RRT, RCP
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