FROM THE EXECUTIVE DIRECTOR'S CHAIR

The AWPHD Board of Directors and Finance Committee, the participants in the Nursing Home Proshare program and AWPHD staff committed significant energy over the past eight months developing a responsible approach to sustain AWPHD into the future. The plan makes significant changes to our structure and funding, but I believe every one of those changes makes the organization both stronger and more accountable to the members.

Three main points drove our work: (1) the expense of supporting AWPHD has not been equitably shared across the membership; (2) AWPHD expenses must be reduced as the gap between district expenses and district revenues (particularly revenue from DSH and Proshare payments) grows; and (3) no district should be asked to pay more in 2004 than it paid in 2003.

Equalizing the burden: the single most obvious problem with previous AWPHD budgets was their reliance on dues assessed against DSH and Proshare transactions to pay for things the whole membership uses. To fix that, we drew a bright line between expenses related to Core Services (defined as services that benefit every member) and Supplemental Expenses (expenses we incur as a result of advocacy, education and member services related to DSH and Proshare--programs that help only some members).

Core Services will cost just under $428,000 in 2004--58 percent of the total budget. For this year, we used the same dues methodology as WSHA to calculate each district's share of the total. There is significant interest on the Finance Committee to consider other methodologies in the future.

Supplemental Expenses will total just over $300,000 in 2004. The budget assumes dues assessments of just over 4 percent on each supplemental payment transaction to cover these expenses.

Cut Spending:  the 2004 AWPHD budget reduces spending by 25 percent, to just over $730,000.  The cuts mean some loss in service:  AWPHD will no longer fund one-half of Kristen Michal's position as director of federal policy and advocacy.  AWPHD will have very limited funds for federal work in 2004.

The cuts also mean new approaches to state advocacy. For five years, AWPHD has shared equally with WSHA the costs associated with having Len McComb represent our interests on budget issues in Olympia.  The new budget does not support equal cost-sharing. Len has asked to sit down after legislative session to determine what AWPHD can afford. In similar fashion, AWPHD’s ability to fund a lobbyist for policy advocacy in Olympia drops sharply in the budget.

I have worked very hard as Executive Director to make AWPHD's finances and budget as transparent to the membership as possible. It has been a tough road, at times, but I know it is the right road for us. The staff and membership owe a big debt to Jon Davis, Mike Glenn, Tom Martin, Andrew Craigie and Camille Scott.  They have put in long hours and made difficult choices to stabilize the organization. I would also be remiss if I did not note the contributions that Jeff Uyyek, Wendy Ray and Dorothy Magnusen made as we worked to solve a very tricky puzzle.

SNAPSHOTS

Those of you desiring a “cloak of anonymity” at the State Auditor's Office (SAO) when looking for guidance about a proposed activity or voicing concern over an auditing issue, should contact Dick Goldsmith at 206-216-2528. He'll be glad to act as an intermediary for you.

If you feel comfortable going directly to the SAO, there are two routes. One way is to submit your question via e-mail to the SAO's Help Desk. Go to www.sao.wa.gov, click on the Agency and Municipal Government Helpdesk button about halfway down the web page, click on the Create New Request button, and then fill in the required fields.

The second avenue is to contact Kelly Collins, who's replaced Ivan Danserau as the SAO's audit manager for public hospital districts. (Ivan's taken over the SAO's Quality Assurance program.) You can e-mail her at collinsk@sao.wa.gov or call her at 360-725-5376.

The 2004 legislative session has passed the half-way point and the AWPHD staff has reviewed 29 bills that could directly impact public hospital districts. (WSHA's Policy/Advocacy Team scrutinized another 159 bills affecting hospitals in general.) Thanks to AWPHD lobbyist Lisa Thatcher, the single bill that AWPHD tabbed as a high priority—House Bill 2490—sailed through the House on a 96-0 vote and is now awaiting a hearing in the Senate. This bill would clarify current law and allow—but not require—PHD commissioners to serve on the governing boards of PHD joint ventures. If HB 2490 is signed into law, it will cut down on the size of the governing boards of organizations such as the Rural Healthcare Quality Network and the Western Washington Rural Health Care Collaborative. Representatives Kathy Haigh (D-Shelton) and Mike Armstrong (R-Wenatchee) introduced this bill at the request of AWPHD.

AWPHD lobbyist Len McComb has been working the budgetary/fiscal issues down in Olympia. AWPHD has two budget priorities. We want to (1) increase Proshare funding for rural hospital districts with nursing homes from $6 million to $9.6 million; and (2) make sure district hospitals get an equitable share of the new Disproportionate Share Hospital funds earmarked for the state in the Medicare Drug bill last December. As this goes to print (or wherever it goes in this cyberworld), the House and Senate have just released their proposals for the state Supplemental Budget. Proshare numbers look good, but there is some work to do on the DSH front. Jeff Uyyek, Jeff Mero and Len will be working to make our case before the legislature leaves town on March 12.

Conflicts of interest and hospital drug policies will be the subjects of upcoming AWPHD educational programs. Brad Berg, AWPHD’s outside counsel and counsel to a number of PHDs around the state, will be working with Dick Goldsmith to develop the conflicts of interest presentation.  While the format for this program hasn’t been decided, it’s probably going to be aimed at both PHD commissioners and administrators/CEOs.  The drug policy program is likely to be a web cast jointly sponsored by AWPHD and WSHA.  Julie Kebler, an employment lawyer who discussed wage and hour issues at the AWPHD Administrators/ CEOs Retreat last November in Mazama, will be the prime speaker.  Julie’s a colleague of Brad’s at Foster Pepper & Shefelman PLLC in Seattle.  As the timelines and formats for these programs are established, we’ll keep you informed.

The Public Hospital District Project Review Board (Board) held its first meeting on February 6 in Olympia.  Serving as PHD representatives on the 10-person Board are Sandy Buchanan (Lincoln Hospital) and Jim Paapke (Olympic Medical Center).  Although AWPHD had been working behind the scenes since mid-summer to get the Board operational as quickly as possible, the Governor didn’t make his Board appointments until the middle of January.

At its March 1 meeting the Board is expected to formally adopt operating rules and procedures.  As soon as this occurs, we’ll notify you via the AWPHD Listserve so that PHDs seeking Board approval to use the general contractor/construction manager (GC/CM) procedure for large public works projects can obtain an application from John Van Gorkom, the executive director of the Washington Health Care Facilities Authority.  (The Authority is housing and providing administrative services for the Board.)  The Board hopes to hold its first application hearing on March 22.

The AWPHD webcast Large Public Works Projects and the GC/CM Procedure, which is located on-line at http://www.awphd.org/presentations/awphd120903/replay.htm, gives you the basic information you need about this procedure.

AWPHD is assisting the Rural Healthcare Quality Network and the Western Washington Rural Health Care Collaborative in their search for a director of Network Development and Quality Improvement.  These two organizations, composed primarily of rural PHDs, recently received Critical Access Hospital grants from the Department of Health for these activities.

Visit awphd.org to view new model documents from your peers.  We have added a model pre-employment drug testing policy and a couple of conflict of interest for board members policies (www.awphd.org/resources_modeldocs.asp).  Please remember the password is awphd.  Also, be sure to have your new commissioners check out the commissioner’s resources section at http://www.awphd.org/resources_CR.asp.  If you have items you would like to see added or suggestions for the website, please send them to Wendy Ray at wendyr@awphd.org.

PEOPLE ON THE MOVE

Dale Polla has accepted the administrator position at Okanogan Douglas County Hospital in Brewster.  Dale replaces Jerry Lane, who was interim administrator. 

Keith Mesmer has joined Klickitat Valley Health Services in Goldendale as the interim administrator. 

Lee Malott is now administrator at McKay Healthcare in Soap Lake.  Lee joins Bruce Buckles, who is now the superintendent of the district.

John Todd, MD, has taken over as interim administrator at Stevens Healthcare in Edmonds.  They are conducting a national search for a permanent CEO.

Alan MacPhee has taken the position of interim administrator at Snoqualmie Valley Hospital replacing Jeff Lyle.

UPCOMING EVENTS

17th Annual Northwest Regional Rural Health Conference
Rural Healthcare: Challenged to Respond
March 25-26 • Red Lion Hotel at the Park, Spokane
Contact: (509) 358-7640

WHF Policy Futures Conference
April 22 • Red Lion Hotel, Seattle
Contact:  Lindsey Reid  (206) 216-2517

WHF 5th Annual Heroes of Healthcare Awards
April 22 • Red Lion Hotel, Seattle
Contact:  Lindsey Reid  (206) 216-2517

WHF 10th Annual Communities Striving to Improve Health
Sharing Our Stories--Inspiring Hope
April 23 • McCaw Hall, Seattle
Contact:  Barbara Hitzl  (206) 216-2512

Association of Healthcare Administrative Assistants Conference
Riding the Wave of Innovation
April 29-30 • Bellevue Red Lion
Contact:  Linda Bradley  (503) 294-3230

AHA Annual Meeting
May 2-5 • Washington, DC
Contact:  Danie Wright  (206) 577-1845

AWPHD Membership Meeting
June 28 - 9:00-11:30 a.m. • Campbell’s Resort, Chelan
Contact:  Wendy Ray (206) 216-2516

WSHA 28th Rural Hospital Summer Workshop
June 28-30 • Campbell’s Resort, Chelan
Contact: Danie Wright  (206) 577-1845