FROM WHERE I'M SITTING...BY JEFF MERO, EXECUTIVE DIRECTOR

Thatcher and McComb Sparkle in Session's Final Hours

It's a lobbyist's worst nightmare: three hours before the deadline for voting all policy bills into law, the Republican Caucus of the State Senate adjourned for the weekend. Dozens of bills, all but delivered to the governor, were on the chopping block. For the lobbyists, it was like watching the Post Office shut down at 4 p.m. on April 15th, leaving mailboxes full of federal tax returns, the only other news being that the Post Office would not re-open until January.

At risk for hospitals in the adventure were two bills: one to bring the state's Critical Access Hospital program more in line with Medicare rules, the other allowing public hospital district commissioners to delegate their responsibility for governing the limited liability corporations to which their districts belong.

Lisa Thatcher, who lobbies policy issues for both AWPHD and the Washington State Hospital Association (WSHA), immediately went into overdrive, networking with legislators and other lobbyists to avert the loss of two months of legislative midwifery. Over the next seventy-two hours Lisa (using tricks found nowhere on my "How a Bill Becomes a Law" cheat sheet) managed to get the two bills at risk amended onto a bill that was still alive.

Meanwhile, on the budget front, Len McComb was able to deflect at least two serious efforts to reduce the amount of money district hospitals would be allowed to retain through the state's Public Hospital District Disproportionate Share (PHDDSH) program. Having worked with the Locke Administration through the fall to get a good initial "budget mark" (which means $6.6 million in new funding directly to the districts between now and June 30, 2005), Len was able to bring three King County Republican Senators into the fray on AWPHD's behalf. The result? Those Senators persuaded Republican budget writers that the Democrats' approach to this funding was the right one for them to adopt. The win means millions--literally--to you.

Those of us "near the inside" know enough to marvel at the intimate dance Len and Lisa perform with their colleagues and lawmakers daily during legislative session. Theirs is a skill set that takes years to develop and yet is always only one broken promise away from useless. They succeed because they are trusted and respected by those who matter most in Olympia. We could not be better served in AWPHD's most important work.

Dues Update

Last month I wrote about the new funding approach AWPHD's Board approved for the 2004 budget. I am pleased to share the news that, as of this writing, we have collected two-thirds of the total 2004 Core Dues. Most impressive, the funds have come in within six weeks of our initial invoice. I deeply appreciate your quick response, and am choosing to read it as a statement of your commitment to this organization's success. Listed below are those districts from whom we have received dues. From all of the staff here at AWPHD, please accept our most gracious THANK YOU!

By tracking changes in demographic data, you have a powerful tool for forecasting trends in community needs and wants--including demands for health care services. And that's a good reason for you and your district commissioners to attend AWPHD's Annual Mid-Year Meeting in Chelan on Monday, June 28th. Dr. Annabel Kirschner, the chair of Washington State University's Department of Community and Rural Sociology, will be the keynote speaker. She'll talk with you about how the demographics of Washington's rural communities are affecting local social structures.

Tim Eyman is back with yet another initiative to cut taxes. This time he's filed Initiative 864, which would reduce regular property tax levies by 25 percent starting in 2005. He has until July 2nd to get the 197,734 signatures needed to put this initiative on the November ballot.

AWPHD estimates that regular property taxes average about 5 percent of a public hospital district's revenues; consequently, passage of the initiative would result in an average decrease in revenue of around 1.25 percent. The actual impact, which depends how much of a district's revenues are derived from regular property taxes, will vary from district to district.

The state Department of Revenue has been trying to assess what passage of this initiative would mean. In late February, the department estimated that county revenues would drop by $112 million. Keep in mind, too, that impacts between counties will vary; whether county public health services are ultimately put on the chopping block is anyone's guess.

Will there be a public groundswell for this tax cut? It's difficult to know but you can be an "early warning system" for AWPHD by passing along any stories in your local paper. In the meantime, we'll continue to meet with representatives from other governmental organizations to evaluate impacts and discuss strategies. And we will, of course, update you as events unfold.

The AWPHD-WSHA webcast on drug testing has been scheduled for Tuesday, June 22 from noon to 1 p.m. Julie Kebler, an employment attorney with the Seattle firm of Foster Pepper & Shefelman, will cover such topics as whether a drug testing program is necessary, when drug testing should be conducted, drug testing standards for public hospital districts, and other considerations for creating an effective and efficient program. Although we won't send you details about this program--including how to participate--until the middle of May, we want to alert you in advance so that appropriate members of your staff can block out this time on their calendars.

Skagit County PHD # 1 cleared the first hurdle for building an addition to Skagit Valley Hospital on March 22 when the Public Hospital District Project Review Board (Board) approved its application to use the general contractor/construction manager (GC/CM) procedure. In early April, the district will hold a hearing to take public comments on its preliminary determination to use this procedure for its $75 million project, which also includes site and off-site improvements, as well as minor renovations to the existing hospital. On April 27, the electorate will vote on a bond issue to fund this project.

Skagit County PHD #1 was the first district in the state to submit an application to the Board. The Board acted swiftly, holding a hearing on the application and rendering an oral decision within a few hours.

If you're considering the GC/CM process, we suggest that you contact Diane Morton at Skagit County PHD #1 (360-428-2343 or dmorton@skagitvalleyhospital.org). She would be an invaluable resource on how to put together an application, as well as developing a presentation for the Board.

Some information gleaned from the Board's discussion of the Skagit County application that should be helpful to future applicants: (1) The Board wants to see that some members of the project management team--either on staff or as consultants--have experience working on successful GC/CM projects. (2) To obtain maximum value from this alternative contracting procedure, the GC/CM should be brought in early in the process: the farther along a district is in its planning activities, the more it will have to justify to the Board that use of the GC/CM is necessary. (3) A district needs to have an organizational structure for the project, with clear and direct lines of reporting.

Although the Board has yet to establish a web site, it has adopted most of its operating policies, procedures and guidelines. These materials, as well as application forms, are available by contacting John Van Gorkom (360-753-6185 or johnvg@whcfa.wa.gov).

AWPHD's wrap-up of the 2004 legislative session, focusing on newly-enacted laws that affect the municipal activities of PHDs, should be out shortly. As In Focus was "going to press," the Governor hadn't acted on all the bills delivered to him by the Legislature. After final word of his actions is received, we'll prepare a summary for you.

PEOPLE AND PLACES

You're invited to Ocean Beach Hospital's Open House on April 23rd to celebrate the completion of a $10 million expansion and remodeling. The Open House will run from 2 to 4 p.m. During this 16-month project, Ocean Beach's emergency room, admitting area, lab, and imaging departments were among the spaces that were expanded. Equipment also was updated, especially in the imaging departments.

Garfield County Hospital District recently completed the remodeling of its Pomeroy Medical Clinic. The result is a "more patient-friendly" space with better workflow and more visual appeal. And facility changes are just one element of the district's "Creating Home and Building Community" project. Staff also are undergoing training in communication, quality, caring and values as the district creates a patient-directed model of care "that exemplifies the very best of rural living--respect, self-sufficiency, autonomy, and neighbors supporting neighbors."

Bruce Grimshaw became chief executive officer of Dayton General Hospital on March 1st. Bruce replaces Bob Compson, who will remain at the hospital through the end of the year working on special projects.

The Rural Healthcare Quality Network LLC and the Western Washington Rural Health Care Collaborative LLC have selected Elizabeth Floersheim as their executive director. A nurse and an attorney, Elizabeth has worked with rural Washington hospitals to address quality issues and meet Critical Access Hospital requirements.

Kristen Michel, AWPHD's (and WSHA's) director of federal policy and advocacy, became a mother for the second time on March 12. The new addition is Emma Grace.

UPCOMING EVENTS

WHF Policy Futures Conference
April 22 • Red Lion Hotel, Seattle
Contact:  Barbara Hitzl  (206) 216-2512

WHF 5th Annual Heroes of Healthcare Awards
April 22 • Red Lion Hotel, Seattle
Contact: Barbara Hitzl  (206) 216-2512

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

WSHA Rural Hospital Committee
May 13 - 10:00-3:00 p.m. • WSHA Offices
Contact: Johanna Bradford (206) 216-2510

WSHA Board Meeting
May 21 - 9:00-12:00 a.m. • WSHA Offices
Contact:  Lisa Rusk (206) 577-1852

AWPHD/WSHA Drug Testing Webcast
June 22 - 12:00-1:00 p.m.
Contact:  Lisa Rusk (206) 577-1852

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

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