FROM WHERE I'M SITTING...By jeff mero, executive director

Board Approves Advocacy Reserve Policy

As I wrote last time, AWPHD's successful advocacy in the last legislative session for Disproportionate Share programs and the Nursing Home Proshare program means quite a bit more money to the districts eligible to participate in the transactions. In total, the districts will gain about $9 million over the next 12 months.

During its May 18th meeting, the AWPHD Board adopted a staff proposal to create an advocacy reserve fund to assure the organization is able to maintain its strong advocacy performance on these issues in Olympia and in Washington, D.C.

What that means for participating districts is that AWPHD will assess dues against the supplemental payments (PHD Disproportionate Share and PHD Swap in June; Proshare and Rural DSH in the Fall) at a rate of 4.3 percent. Last year's assessment rates ranged from 8-12 percent, so this is a much lower dues rate than we have assessed in the past.

Because the districts are retaining a significantly larger amount of money from the transactions, assessing dues at 4.3 percent will provide AWPHD with unanticipated revenue (about $275,000 in 2004). The funds collected will be committed to implementing the very best advocacy program we can put together to support these programs into the future.

Charity Care Skyrocketing

The first reports providing information on hospital utilization and finances for all of 2003 show a 36 percent jump in the value of charity care provided in our states' hospitals. During 2003, hospitals provided $239,335,177. In 2002, the number was $175,710,409. Charity care costs were up significantly all over the state, with the Northwest Council (80 percent increase) and the Southwest Council (70 percent increase) showing the largest jumps. The cost of care and loss of state insurance coverage for the working poor and low-income individuals and families, coupled with a sluggish economy, seem to be the main causes for the increase. Meanwhile, on the national front, Congress continues to express interest in hospital billing practices, particularly as related to pursuing bad debt. Despite the increase in charity care provided, operating margins across the state increased slightly to 3.8 percent for all of 2003.

SNAPSHOTS

In the short term, local government public education programs about the potential impacts of Initiative 864 (I-864) can be forums for eliciting views from the public about where cuts should be made if this initiative were to pass. But AWPHD sees a greater, long-term good coming from these presentations: they can be a catalyst for fostering better communications-and relations-among local governmental leaders. With up to a 25 percent cut in property tax revenues possibly looming on the horizon, each local taxing district needs to be aware of whether other districts are offering the same or similar services and, if so, how those services can be delivered more efficiently and cost-effectively. But even if I-864's cuts don't come to pass, each taxing district needs to understand that without continued communication and cooperation among its "partners," everyone is susceptible to more initiatives like I-864.

As Tim Eyman continues his attack on government through I-864, others are considering a legal attack against Initiative 747 (I-747). I-747 was Eyman's successful 2001 initiative that requires voter approval for annual local property tax increases exceeding 1 percent. (Prior to the passage of I-747, local governments were limited to a 6 percent annual increase without voter approval.)

Three public interest organizations are considering a lawsuit against this initiative, which they allege to be "unconstitutional in its entirety." Because of the funds and efforts directed towards opposing Premera's proposed conversion from a non-profit to a for-profit corporation, AWPHD's Board declined to become involved in the lawsuit. However, its action shouldn't preclude individual PHDs from signing on as plaintiffs if commissioners think that it's in the district's interest to do so. If your district would like more information about the lawsuit and possibly becoming a plaintiff, please contact Dick Goldsmith, AWPHD's director of legal services (richardg@awphd.org; (206)216-2528).

The AWPHD-WSHA web conference-To Test or Not to Test: Considerations in Establishing A Hospital Drug Testing Program-airs at noon on Tuesday, June 22nd. Whether your staff is looking at the pros and cons of putting a program in place or thinking about making changes to an established program, Julie Kebler, chair of the employment, labor and immigration law group in the Seattle office of Foster Pepper & Shefelman PLLC, will have useful information. An e-mail with instructions for participating in this web cast went out on May 21st, but if you misplaced it, please contact Wendy Ray (wendyr@awphd.org) for another copy.

AWPHD's Mid-Year Meeting opens WSHA's 28th Annual Rural Workshop (June 28-30) at Campbell's Resort in Chelan. June 11th-the registration deadline for the Rural Workshop-is days away and rooms in Chelan are getting hard to find, so don't delay any longer. The AWPHD meeting will begin at 9 a.m. and features a talk about the impact of demographics on the social structures of Washington's rural communities by noted Washington State University demographer and sociologist Annabel Kirschner.

Check with your pharmacy director to ensure that your hospital has completed the 2004 Medication Safety Self Assessment. This survey, which is part of a joint effort of the Institute for Safe Medication Practices (ISMP), the American Hospital Association and the Health Research and Education Trust to make hospital medication practices safer, was mailed out earlier this month. For questions or concerns about the survey, contact ISMP's executive director, Allen Vaida, at (215)947-7797 or avaida@ismp.org.

And here's a note for your financial staff: The state Department of Revenue is proposing to exempt prescription eyeglass frames from the state's retail sales tax. (Prescription lenses are already exempt.) This regulatory change, which would go into effect July 1, 2004, implements provisions of the national Streamlined Sales and Use Tax Agreement. The proposed revision to Section 458-20-150 of the Washington Administrative Code is available online at http://dor.wa.gov/Docs/Rules/draft/CR105_20_150.PDF

The Centers for Medicare and Medicaid Services have just issued revised EMTALA interpretive guidelines for state survey agencies. These guidelines are online at http://www.cms.hhs.gov/medicaid/survey-cert/sc0434.pdf

PEOPLE AND PLACES

Snoqualmie Valley Hospital (King County PHD No. 4) has just hired Rodger McCollum as its interim administrator. Before taking this position, Rodger was CEO of ScanQuest Imaging Center in Seattle.

The commissioners of Grant County PHD No. 1 just hired Phil Sandifer as the interim CEO/Administrator at Samaritan Healthcare in Moses Lake. Phil was the administrator at Island Hospital (Skagit County PHD No.2) before becoming a principal in The Lakes Group.

The state Department of Health has determined that Quincy Valley Medical Center (Grant County PHD No. 2) has resolved all the issues that led to the suspension of its hospital license last May. According to Administrator John Perushek, who was hired to lead Quincy back into compliance, the hospital also "did very well" in passing the Critical Access Hospital survey. Congratulations to John and his staff for the quick turn-around.

The commissioners of Jefferson County PHD No. 2 recently selected Jefferson Healthcare as the new name for the district's healthcare system. This name, which is to be officially rolled out this summer, covers the hospital, physicians' clinic, physical therapy and rehabilitation, home health and hospice, and other health-related services. (Approximately three-fourths of the district's current revenue comes from non-hospital or outpatient services.) Under development are a system logo, as well as marketing programs and collateral marketing materials.

We already told you (and sent Evergreen Healthcare our kudos), but now it's almost official. After the absentee ballots in King County PHD #2 were counted, over 65.5 percent of the voters said "yes" to the district's $120 million bond levy. The funds will be used to expand Evergreen Healthcare's Emergency Department and construct a 7-story surgery and inpatient facility.

UPCOMING EVENTS

Administrative Simplication Workshop
June 2 - 1:00-4:00 p.m. • Evergreen State College, Olympia
Contact: Lilly Anderson (206)901-6413

WHF Board Meeting
June 15 • WHF Offices, Seattle
Contact: Greg Vigdor (206)216-2521

AWPHD Project Review Board
June 21 - 11:00 a.m. • Health Care Facilities Authority, Olympia
Contact: John Van Gorkom (360)753-6185
Note: This meeting could be canceled if no PHDs have submitted applications to use the general contractor-construction manager procedure.

AWPHD/WSHA Webcast - To Test or Not to Test: Considerations in Establishing A Hospital Drug Testing Program
June 22 - 12:00-1:00 p.m. • Internet
Contact: Wendy Ray (206)216-2516

WHF Second Annual Healthy Aging Summit
June 23 • Yakima Neighborhood Health Services
Contact: Sallie Neillie (206)216-2555

AWPHD Board Meeting
June 28 - 7:30-9:00 a.m. • Campbell's Resort, Chelan
Contact: Wendy Ray (206)216-2516

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

AWPHD Finance Committee Conference Call
July 15 • 2:00-3:00 p.m.
Contact: Wendy Ray (206)216-2516

WSHA Summer Board Retreat
July 15-17 • Sun Mountain Resort, Winthrop
Contact: Lisa Rusk (206)577-1852

Take pride in your district's accomplishments and share them with your colleagues through In Focus. Send a brief article to Dick Goldsmith (richardg@awphd.org).

The deadline for the next issue of In Focus is Tuesday, June 22nd.