Dear Colleague:

It is my pleasure to send you the first edition of the new electronic version of GCA Connections. GCA Connections is the newsletter of the Columbia University Medical Center (CUMC) Office of Government and Community Affairs (GCA). GCA represents the interests of CUMC before the federal, state, and city governments and serves as the liaison between the Medical Center and the external community.  

GCA Connections will provide you with the latest on issues involving legislation, government, politics, and community affairs.  Please feel free to share this with any CUMC colleagues who you think might enjoy reading GCA Connections or have them contact us so that we may add them to our distribution list.

I hope you will continue to reach out to us for guidance on policy and community issues. If you have been invited to testify before Congress, the State Legislature, the City Council, or any Executive agency, or plan to meet with or lobby any senior government official or community leader, please let us know so that we may be of service. With the new lobbying laws in effect on both the federal and state levels, now more than ever, it is especially important that you inform us if you are engaging in any lobbying activities on behalf of Columbia.

I hope you enjoy GCA Connections. Please feel free to visit our web site. You may also contact us if you have questions or would like additional information on a particular matter. You may reach us at (212) 305-8060 or at cumcgca@columbia.edu.  Thank you.

Very truly yours,

Ross A. Frommer
Deputy Vice President and Associate Dean

Dean Goldman Visits Capitol Hill - Speaks with Legislators on Health Policy Issues

On July 9th, CUMC Executive Vice President and Dean Lee Goldman spent the day on Capitol Hill in Washington meeting and discussing health policy with Members of Congress and their staffs. The visit was part of the annual Associated Medical Schools (AMS) of New York annual lobby day, which saw the Deans of seven New York medical schools as well as Senior Associate Deans and government affairs representatives come together to lobby on behalf of issues of importance to New York’s medical schools.

Dean Goldman with other medical school Deans and Senator Charles Schumer

Throughout the day, Dean Goldman and the other Deans stressed the importance of increasing funding for the National Institutes of Health (NIH) and discussed efforts to prevent drastic cuts in Medicare Physician Payments. As luck would have it, while the Deans were in Washington, the Senate passed a measure to prevent cuts in Medicare spending.

The Deans as a group met with New York Senator Charles Schumer and staff from Senator Hillary Rodham Clinton, including Dr. Kathleen Klink, a CUMC faculty member from the Department of Medicine who is working for Senator Clinton as a Robert Wood Johnson Health Policy Fellow. AMS also hosted a breakfast in the Rayburn House Office Building for members of the House delegation. Congresswoman Nita Lowey and Congressman James Walsh spoke about the appropriations process and what it meant for NIH funding. Several other Members and staff attended and had a chance to share their thoughts on the issues of concern to the Deans.

Dean Goldman spent the afternoon meeting individually with Members of the New York delegation, again stressing the importance of funding NIH and taking care of the physician payment issue. He also discussed legislation that would amend the Federal False Claims Act. While aimed at preventing the waste, fraud, and abuse of federal dollars, this legislation could have severe and unintended consequences for research institutions like Columbia. Dean Goldman stressed the importance of addressing these concerns before moving forward with the legislation.

Assembly Leader Gives CDM Commencement Address

New York State Assemblyman Herman "Denny" Farrell, Jr. delivered the 2008 commencement address at the Columbia University College of Dental Medicine (CDM) graduation ceremony. First elected in 1974, Assemblyman Farrell represents the 71st district which includes much of the CUMC campus. Assemblyman Farrell has been a very strong supporter of CUMC and has helped secure funding for many CDM programs.

Assemblymember Denny Farrell delivering the CDM commencement address

Assemblyman Farrell began his remarks by thanking the students and faculty for all the good work they do to promote oral health in the community. He highlighted the mobile dental van and the clinic that CDM runs in the Edward J. Stitt Middle School, which the Assemblyman attended when he was growing up in the neighborhood.

For the first time, CUMC graduation ceremonies were held at the New Balance Track and Field Hall of Fame at the Armory. Assemblyman Farrell spoke about the history of the Armory and how it had evolved from a military installation, to a homeless shelter, to the magnificent museum and athletic facility that it is today. He noted that as a teenager, he had actually done part of his National Guard training in the very same building that the graduates were now sitting.

Assemblyman Farrell ended his remarks with some advice to the class of 2008. Referencing the movie "The Graduate", he told them to always be sure to enjoy their work and to keep doing it as long as they found it fulfilling and worthwhile.

Congress Passes Several Key Health Measures - NIH Funding Picture Looking a Little Brighter

Before adjourning in August for the district work period and for the Republican and Democratic Conventions, Congress passed legislation to preserve and strengthen Medicare and Medicaid and to increase funding for the NIH. 

The flurry of activity started in June when both the House and Senate, in a major victory for teaching hospitals, voted to prohibit the Centers for Medicare and Medicaid Services (CMS) from implementing several proposed rules, one of which would have eliminated Medicaid funding for Graduate Medical Education (GME). President George W. Bush had proposed eliminating Medicaid support for GME, but in 2007 Congress passed a one-year moratorium on implementing this policy change. That moratorium expired in May; however, a court injunction prevented the Administration from moving forward immediately. The bill language, which was included as part of the Emergency Supplemental Appropriations Bill which the President has signed into law, extends this moratorium for one more year, the hope being that the next President, whoever he may be, will choose not to implement the Medicaid GME rule.

The bill also contained a very important, although somewhat unnoticed, provision to add $150 million to the NIH budget for this year. This brings total funding for FY 2008 to $29.38 billion. Although not a huge increase, it is for the current fiscal year and follows on the roughly $300 million that was added to the NIH budget when the funding bill was originally passed in December of 2007. The supplemental also included additional money for research at the National Science Foundation, the Department of Energy, and the National Aeronautics and Space Agency.

Around the same time as Congress was finishing up work on the bill to add money to the FY 08 budget, it began work in earnest on the funding bills for FY 09, which begins October 1st, 2008. Just prior to adjourning for the 4th of July recess, both the House and Senate Appropriations Subcommittees on the Departments of Labor, Health and Human Services, Education, and Related Agencies marked up their respective funding bills for next year. The Senate increased NIH funding to $30.26 billion, 3.5% over the original FY08 funding, and the House bumped up funding 3.9% to $30.38 billion. Both these figures are less than the increase members of the patient advocacy and research communities had hoped for, but with these numbers, for the first time since FY 2003, the NIH budget would at least come close to keeping up with inflation.

There is also hope for an even further increase this year. Congress may try to pass a continuing resolution or an economic stimulus package and there is an effort to include another $500 million for the NIH in one of those bills.

Even with the GME regulation moratorium and the NIH funding increases, perhaps the biggest news of the summer may have come on the Medicare front. On July 9th the Senate adopted by voice vote a House-passed Medicare package that averted scheduled reductions in the physician payment update. CMS was set to reduce the amount Medicare pays physicians by 10.6%, with an additional 5.4% decreased planned for 2009. Together, these cuts could have reduced faculty practice revenues at Columbia by roughly $10 million next year. This bill prevents these cuts from going through and instead extends to the current .5% increase in physician payments until the end of this year and establishes a 1.1% increase for next year. 

While the measure passed without a roll call vote, the real drama took place on an earlier cloture vote. Under Senate rules, debate can not proceed unless the measure gets sixty votes. Senate Majority Leader Harry Reid (D-NV) had tried to pass this measure before the July 4th recess but could not get the votes he need to prevent a filibuster. He tried again on July 9th. In a very moving moment, Senator Edward Kennedy (D-MA), who had been home in Massachusetts receiving treatment for cancer, surprised his colleagues by flying down to Washington to vote on the measure. Senator Barak Obama (D-IL) who had missed a number of earlier votes while out on the campaign trail was also present. Nine Republicans who had previously opposed the bill voted for cloture. President Bush vetoed the measure but Congress overrode his objections. Senator John McCain (R-AZ) was not present for the vote.

The last major piece of health care business that Congress attended to before recess was reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR). Columbia has a major PEPFAR grant to conduct HIV prevention and treatment in Africa. The bill authorizes PEPFAR through 2013 and also adds Vietnam to the list of focus countries. President Bush signed the bill into law on July 30th.

Congress has a little over a week left before the scheduled September 26th adjournment date. It is highly unlikely they will complete work on the appropriations process and other key measures, so a post election session is almost a certainty, although the timing and direction of such a session will depend on the results of the Presidential and Congressional elections in November.

Governor and Legislature Agree on Deficit Reduction Plan

Responding to concerns about the economy and impending budget deficits, and making references to the Great Depression, Governor David A. Paterson called the State Legislature back to Albany on August 19th for a special emergency economic session to address New York State’s financial situation.

Prior to the session, the Governor announced that he was cutting over $630 million by administrative action from this year’s budget, but that he would need the Legislature’s help to close the projected gap. After the whole day, and late into the night session, the Governor, along with Senate Majority Leader Dean Skelos (R-Nassau County) and Assembly Speaker Sheldon Silver (D-Manhattan) announced that they had reached an agreement on a $1 billion plus, two-year savings plan that does not include any tax or fee increases. After enactment of the agreement, fiscal year 08/09 spending will now total $120.9 billion, an increase of 4.2%, which is equal to inflation.

The Governor said that this agreement was an important first step in addressing the State’s expected budget shortfalls for the upcoming years, but that more needs to be done. He noted that the, “Looming deficit we face next year will demand even more difficult choices. And given the significant, continued uncertainty within the economy, there are no guarantees that we can avoid additional current-year spending reductions if revenues plummet even further.”

The administrative savings come from instituting a hard hiring freeze and making other across the board cuts in agency spending. The spending cuts enacted by the Legislature were also varied with a large portion coming from the State and City University budgets, aid to local governments, and from Legislative member items. Health care was not spared, although, the $127 million cut in hospital and nursing home spending was not nearly as much as some had feared. There are also several million dollars in cuts to higher education spending. 

While the Governor and Legislature were able to reach an agreement on this spending reduction package, they could not come to terms on tax policy. The Governor and State Senate support a cap on increases in local property taxes while the Assembly would like to see incomes taxes raised for those earning over $1 million. Another special session may be necessary this fall to resolve this and other budget issues.

Lawmakers did agree to place a moratorium on medical malpractice liability premium increases between July 1, 2008 and June 30, 2009. This freeze gives relief to doctors in New York avoids an impeding crisis and sets the stage to discuss and address the escalating cost of Medical malpractice insurance. The legislation also prohibits the state’s Insurance Superintendent from imposing a surcharge on premiums.

Legislation that has cleared both the Senate and House Judiciary Committees is causing concerns about the effect it would have on academic medical centers. The False Claims Act Correction Act of 2008 (S. 2041 and H.R. 4854) was introduced by Senators Charles Grassley (R-IA) and Congressman Howard Berman (D-CA). The bill was intended to correct recent decisions by various federal courts that have limited the scope and application of the False Claims Act (FCA). The FCA is a tool in the government’s effort to combat waste, fraud, and abuse of federal funds and has been used quite often in cases involving hospitals and medical schools; however, the legislation in its current form could have serious and unintended consequences. 

The Senate and House bills are similar but not identical. A major concern with the Senate bill is the effect it could have on how damages are calculated. Currently, in cases involving the misuse of federally sponsored research funds, the institution that receives the grant is liable for three times the amount that was used improperly plus other costs, a significant penalty and a strong incentive for universities to prevent such misuse. The way S. 2041 could be read however, damages would no longer be treble the amount misused, but three times the amount of the whole grant, creating a potential huge liability for any medical school. For example, on a $5 million grant, if someone managed to misuse a small amount of money, $15,000, under S. 2041 as it currently stands, the grantee could be on the hook to the federal government, not for $45,000 (plus penalties) as would be true under existing law, but for up to $15 million. 

There are other concerns with both bills. Both would extend the Statute of Limitations from six to ten years and would interfere with the way the federal government and health care providers reconcile minor discrepancies in payments at the end of the year by turning every overpayment into a potential FCA case.

CUMC has been working very hard to prevent the bills from passing in their current forms. Dean Goldman has met with Senator Schumer and Congressman Jerold Nadler (D-NY), both Judiciary Committee members, to express his concerns about the bill. Other CUMC representatives, in conjunction with colleagues from Cornell and other medical schools, have met with key House and Senate staff. The Association of American Universities and the Association of American Medical Colleges have also cosigned a letter with fourteen other organizations opposing S. 2041 and H.R. 4854. The letter states that the bill would, "Dramatically expand the scope of liability under the statute, increase its financial penalties, and remove safeguards against unfounded qui tam lawsuits." The letter continues, "These amendments are unnecessary and will impose enormous burdens on non-profits, universities, hospitals, and small businesses, as well as virtually any organization that does business with the Federal government." Advocacy efforts continue in the House and Senate to ensure that any damaging FCA legislation does not pass or is at least amended in such a way as to remove the major concerns that hospitals and universities have with the bill.

On August 14th, Dean Goldman joined local Assemblyman Adriano Espaillat (D-Washington Heights) and others to announce new safety and security improvements at the 168th Street subway station. Assemblyman Espaillat was able to secure $500,000 from New York State for the project which will consist of improved lighting and added video surveillance. The 168th Street station serves the A, C, and 1 trains and is the second busiest stop in the system north of 96th Street.

Assemblyman Adriano Espaillat, Dean Goldman, and Helen Morik

Speaking at a press conference, Dean Goldman thanked Assemblyman Espaillat for making the funding possible and noted how important these planned improvements are for CUMC. Roughly half of CUMC’s employees use the subway to get to work each day.

Dean Goldman and Assemblyman Espaillat were joined by Helen Morik, Vice President of Government and Community Affairs for New York Presbyterian Hospital, Norbert Sanders, President of the Armory Foundation, and Inspector Jason Wilcox, Chief of Manhattan Transit for the New York City Police Department. All noted that this station serves a world class medical center and it should be a world class station. While more work needs to be done to make that happen, and Assemblyman Espaillat pledged to keep pushing for further improvements, these upgrades will make the station a safer and more secure place for the staff, faculty, students, patients, and visitors who use the subway.

On June 26th, 2008, Dean Goldman, Andria Castellanos, and Jeffrey Leiberman welcomed community leaders, faculty, staff, and community-based organizations at the 22nd Medical Center Neighborhood Fund (MCNF) award’s ceremony. The Neighborhood Fund awarded grants ranging from $500 to $5,000 to community-based organizations that provide an array of recreational, supportive, and educational services to residents in the Washington Heights-Inwood community. A total of over $65,000 was awarded. 

MCNF 2008 Awardees

The MCNF was founded twenty-two years ago as a joint effort of CUMC, NewYork-Presbyterian Hospital, and the New York State Psychiatric Institute. The Fund supports local non-profit organizations that offer a host of services that improve quality of life for all residents in the Washington Heights-Inwood community. The initiative is made possible by volunteerism and monetary contributions of faculty and employees of the three institutions. One hundred percent of every employee-contributed dollar goes to support community programs and services.

Each year, the MCNF presents the Donald F. Tapley Award to an organization that exceeds the expectations of the granting committee and demonstrates an extreme need for funding to continue its programming. Congratulations to this year’s Tapley award winner: The Ecumenical Food Pantry and its Executive Director, Talia Bernal-Lockspeiser.

Click below for more information:

Medical Center Neighborhood Fund

Thank you for your continued support and contribution!

Columbia University took part in a series of events sponsored by the Greater Harlem Chamber of Commerce in celebration of Harlem Week – Healthy Eating and Living Initiative. CUMC hosted a special seminar focused on mental health and oral health needs in the community. The August 9th seminar at Lerner Hall featured Drs. Stephanie LeMelle, Allan Formicola, and Mindy Fullilove along with John Palmer, Executive Director of the Harlem Hospital Center, who gave in-depth presentations on the mental health and oral health services/programs provided by Columbia. They also addressed the challenges of addressing unmet health needs in underserved communities and gave unique examples of what can be done to advance discoveries and forge best practices in the mental health and oral health fields.

Saturday, August 16th marked the official kick-off of Manhattan Borough President Scott Stringer’s Go Green Washington Heights & Inwood initiative. CUMC and over twenty community based organizations have come together to promote a greener Washington Heights and Inwood community. The event took place at J. Hood Wright Park – 173rd Street and Broadway. Go Green Washington Heights & Inwood: making Washington Heights even cooler than it already is!

Assemblymembers Adriano Espaillat and Herman D. Farrell, Jr. Manhattan Borough President Scott Stringer with community children

Over the summer, our community celebrated the sixth annual Uptown Arts Stroll.  Sponsored by CUMC and many community groups and local business, this great event showcases the talents of our local artists by displaying their work throughout the Washington Heights-Inwood community. This year, there was a special reception in honor of In the Heights, the Tony award winning musical set in our community. To learn more about artists in our community and next year’s Arts Stroll, please visit  www.artstroll.com

SAVE THE DATE

Columbia University Medical Center

Election Forum

Monday, October 20th, 2008

4:00 p.m.

Alumni Auditorium

Reception following in the Foyer

Lee Goldman, MD
Executive Vice President for Health and Biomedical
Sciences
Dean of the Faculties of Health Sciences of Medicine

Lisa Hogarty
Chief Operating Officer

Ross A. Frommer
Deputy Vice President for Government &
Community Affairs and Associate Dean

Sandra Harris
Assistant Vice President for Government &
Community Affairs

Clara N. Leon
Assistant Director for Government &
Community Affairs

Edna Velez
Department Administrator

Natalia Arias
Community Affairs Assistant

Mailing Address:
630 West 168th Street
Box 62
Phone: (212) 305-8060
Fax: (212) 342-3914
E-mail: cumcgca@columbia.edu
Web site: www.cumc.columbia.edu/dept/gc