Last year, the American College of Surgeons (ACS) implemented a new program to encourage ACS chapters to host lobby day programs at their state capitols. Endorsed by the Board of Governors and more than 27 chapters, the Board of Regents approved the proposal, which provides $50,000 over two years in grants for state chapters to organize lobby days during the 2011 and 2012 legislative sessions. Chapters were eligible to receive up to $5,000, and required to match that grant with one dollar for every two dollars received. For the 2011 legislative grant program, 10 chapters applied and received funding. In the August 2011 “Advocacy advisor” article titled “ACS State Chapter Lobby Day Program,” seven chapter lobby day programs were addressed: Connecticut, Georgia, Northern California, Indiana, Virginia, Florida, and New York.* As a follow up to that article, this wrap-up provides an overview for the remaining three 2011 chapter lobby day grant participants: Ohio, Alabama, and Massachusetts.
Ohio Chapter lobby day (May 25, 2011)
Some of the highlights of the Ohio lobby day included state representative Barbara Sears (R) leading a discussion on the state budget as well as important upcoming legislative activities that were aimed at addressing significant budget reforms. Mr. Aaron Crooks, the legislative liaison from the Office of Ohio Health Plans, a state Medicaid agency, was also present to discuss budget reform issues. Mr. Crooks encouraged chapter members to stay active in their communication with Medicaid agencies so that the state can more fully comprehend the problems facing providers.
These presentations were followed by meetings with legislators during which prominent issues, such as S.B. 129—a bill that would offer liability protection for emergency care workers—were discussed. Another important bill addressed during the meeting was S.B. 121, a bill to establish standards for physician designation by health care insurers. Physician designation is defined in the bill as a means to grade, star, tier, or make any other rating to characterize or represent assessment or measurement of a physician’s cost efficiency, quality of care, or clinical performance.
After an afternoon of successful meetings with legislators, the chapter hosted a legislative reception that was attended by a number of representatives and senators, as well as four Ohio Supreme Court Justices: Justice Terrence O’Donnell, Justice Judith Ann Lanzinger, Justice Robert Cupp, and Justice Yvette McGee Brown.
Alabama Chapter lobby day (May 31, 2011)
Mark Jackson, the director of legislative affairs for the Medical Association of the State of Alabama, led the group in meeting with legislators. Chapter members who attended the meeting met senators and representatives on the General Assembly floor and were able to observe the session as well. During the Alabama Chapter lobby day, surgeons discussed many prevalent issues that affect their ability to deliver surgical care in Alabama.
Chapter members used the ACS website, where research from the Institute of Healthcare Policy and Research is posted. This research became an integral resource for this chapter in preparing for their meetings with legislators.
The chapter focused on an overarching problem in Alabama, which is a shortage of practicing surgeons in the state. According to the most recent data available, Alabama has a population of approximately 4.7 million people and approximately 1,960 surgeons, of which only 425 are classified as general surgeons. For a population of its size, it is an accepted premise that a healthy surgeon-to-population ratio is 6/100,000.± Therefore, Alabama ideally needs to recruit 2,800 additional surgeons in order to meet that preferred ratio of surgeons to patients. Many counties in Alabama are currently without a practicing surgeon.
The Alabama Chapter acknowledged that this shortage of surgeons is exacerbated by other legislative issues that affect surgical care. Resolving some of these other issues could aid in recruiting additional surgeons. For instance, improving the surgical and community infrastructure, reforming medical liability, addressing scope-of-practice issues, offering reciprocity for volunteer emergency health care providers, addressing the legislative mandate to create a statewide trauma system, and providing reimbursement to hospitals that provide care to underinsured and uninsured patients are some of the legislative issues that can affect surgeon shortages. The surgeons of the Alabama Chapter voiced these concerns regarding patient access to surgical care in both rural and urban portions of the state, as well as the need to address and resolve these issues through legislative means.
Massachusetts Chapter lobby day (June 21, 2011)
Members and staff of the ACS Massachusetts chapter joined in the pediatric residents and fellows residency lobby day at the statehouse. The event brought out a total of 75 people with a number of prominent speakers that included John Auerbach, Commissioner of the Massachusetts Department of Public Health; State Representative Ruth Balser (D); and John Straus, MD, vice-president of medical affairs for the Massachusetts Behavioral Health Partnership. Alex Calcagno of the Massachusetts Medical Society led a participatory workshop titled How to be an Effective Lobbyist, and attorney Ed Brennan led a question-and-answer segment on legislation and lobbying. Peter Masiakos, MD, FACS, Chair of the Massachusetts Chapter Legislative Advocacy Committee, spoke on the proposed Primary Seat Belt Law, S.B. 1211/ H.B. 2401, which would allow law enforcement to pull over vehicles and give citations to drivers who are not wearing a seat belt (see related article in the February 2011 Bulletin‡). As the law currently stands, law enforcement can only pull over vehicles for other driving citations, and then issue a ticket for not wearing seat belts as a secondary offense. Moving the seat belt citation from a secondary offense to a primary offense would result in greater usage of seat belts and overall improved public safety in Massachusetts.
2012 chapter lobby days
Based on the number of chapters applying for and receiving state lobby day grants, and the excellent lobby day programs hosted by these chapters, it is clear that the first year of this two-year program was a resounding success. Looking ahead this year, the ACS State Affairs team was thrilled to receive a total of 16 grant applications. This increase in chapter applications (six additional applications compared to the program’s first year) is an example of how advocacy efforts are growing within the ACS chapters. The state chapters participating in the 2012 Lobby Day include the following: Alabama, Connecticut, Florida, Georgia, Illinois, Indiana, Kansas, Maine, Massachusetts, Michigan, North Carolina, Northern California, Ohio, Oregon, Tennessee, and Virginia.
The State Affairs staff are excited to collaborate with the 2012 recipients on their lobby day programming, as we anticipate another important and decisive year in state level policy and legislation. For more information on the legislation discussed in this article or the state lobby days described, contact Charlotte Grill at firstname.lastname@example.org.
* Grill C. Advocacy advisor: ACS state chapter lobby day program. Bull Am Coll Surg. 2011;96(8)57-58.
± Faher EP, Poley ST, Sheldon GF, Ricketts TC, Thompson KW. Shaping surgical workforce through evidence-based analyses. Bull Am Coll Surg. 2011; 96(5):37-45.
‡ Masiakos PT. Advocating for state injury prevention laws. Bull Am Coll Surg. 2011;96(2):31.