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

I-330 Off to a Great Start: Help Break the Gridlock!

Initiative 330 (I-330), sponsored by Doctors for Sensible Lawsuit Reform, is on the streets. Information kits have been sent to all PHD Administrators and Board Chairpersons. The I-330 campaign aims to deliver about 280,000 signatures to the Secretary of State by December 30th. From all accounts, interest is very high…a spokesperson for the sponsoring group estimates that about 50,000 names have been gathered in the first three weeks of the campaign.

I-330 would do a number of different things to address the state's medical liability insurance crisis. It would establish a sliding scale on the share of awards that attorneys can claim; set a cap on non-economic damages of between $350,000 and $1,050,000 (depending on the number of defendants); allow for periodic payments on awards over $50,000; promote arbitration and mediation as an alternative to court action; change existing provisions for joint and several liability; and limit the time for bringing suit to within three years of the occurrence of a claim.

In the meantime, the Washington State Trial Lawyers Association is not sitting still. They are collecting signatures for Initiative 336, which would seek to address the malpractice crisis by strengthening hospital reporting and enforcement procedures in an effort to make the health care system safer. The initiative would also shine a brighter light on insurance practices, calling for much closer scrutiny of rate increases.

Both sides are using paid signature gatherers.

Both AWPHD and WSHA have endorsed I-330. There will be a presentation on both initiatives during WSHA's annual meeting next week. See you there!

Primary Vote is Tough to Read

Turnout for the primary election on September 14th was higher than expected, baffling pundits who predicted voters would stay home rather than follow the restricted choices offered under the state's new system. The results, though, have provided hours of fodder for lobbyists intent on predicting the outcome of the November general election. In the race that seemed to hold the most interest for district hospitals, Cathy McMorris easily outpolled her two Republican primary opponents in the race for the seat now held by U.S. Representative George Nethercutt. McMorris has been a great friend to hospitals during her time as a state representative in Olympia.

The picture for the state legislature is murkier. Democratic analysts point to a strong showing for their candidates across the board; Republican boosters point to fewer contested races and an alleged cross-over strategy that had Republican voters choosing to vote the Democratic side of the ballot.

With just over five weeks to go, the race for Governor is tighter than many expected, with Republican candidate Dino Rossi challenging 24 years of Democratic control of the governor's mansion in Olympia.

AWPHD Steps Up To Support RHQN

The state's Rural Hospital Quality Network (RHQN) has grown quickly over the past two years, and is now made up of 33 Critical Access Hospitals (CAHs). The RHQN, supported primarily by government grant funding, offers what could become a "best practice" model for CAHs across the country.

The growth, bolstered by the recent award of a three-year, $1.5 million U.S. Public Health Service grant, has brought the normal challenges related to communication, staffing, and business plan management. In response to the growing pressures on the RHQN staff, AWPHD has agreed to take a larger role, at least temporarily, in helping insure the RHQN's performance and viability. The RHQN will pay AWPHD for all services it receives and we'll work hard to make sure RHQN members get what they expect from the network. Look for more news on the RHQN's development in your mailbox soon!

SNAPSHOTS

The September 14th special elections resulted in a sweep for public hospital districts. Voters in Skagit PHD #2 passed a $30.5 million bond issue to remodel and expand Island Hospital in Anacortes; Okanogan PHD #4 residents approved a $500,000 special levy for North Valley Hospital (Tonasket); the electorate of Garfield County PHD (Pomeroy) supported a $339,000 maintenance and operations levy; and the residents of San Juan PHD (Inter Island Medical Center, Friday Harbor) approved an emergency medical services levy. Congratulations to each of you. Obviously, your communities recognize-and appreciate-the services that you provide.

AWPHD's annual membership meeting (which is immediately before WSHA's 72nd annual meeting) will held on Thursday, October 7th. The location is the Bell Harbor International Conference Center in Seattle and the meeting will run from 8 a.m. to 9:30 a.m. Although there's no registration fee for the AWPHD meeting, there is a fee to attend WSHA activities. To get more information on the WSHA annual meeting, log on to http://www.wsha.org/meetings.htm

While winning a legal victory, Samaritan Healthcare (Grant County PHD #1) also wrote itself into the legal reports of Washington State. To boil the case down to its essence, a paramedic at Samaritan alleged to the Public Employment Relations Commission (PERC) that the hospital had discriminated against and ultimately fired the employee because of his union activities. After holding a hearing-at which witnesses testified and documentary evidence was introduced-PERC's hearing examiner concluded that Samaritan had articulated "lawful reasons" for the discharge and the union failed to meet its burden of showing that the firing "was substantially motivated" by the paramedic's exercise of his lawful rights.

The paramedic filed suit in Grant County Superior Court again alleging that his union activities resulted in his discharge. The trial court, however, ruled that this issue had already been litigated at the hearing and that the paramedic could not re-litigate it in Superior Court. The paramedic appealed this ruling to the Court of Appeals, which overturned the trial judge's determination. However, the state Supreme Court-in a 6 to 3 decision-reversed the Court of Appeals. For those of you who want to learn more, the case is Christensen v. Grant County Hospital District No. 1, Opinion No. 73772-0, filed August 26, 2004.

As you may have noticed, AWPHD's lineup of legal presentations has been temporarily delayed. The conflicts of interest presentation has been set aside as we wait for the State Auditor's Office to determine whether it approves of the methodology used by one of the commissioners at a PHD to avoid a conflict of interest. In the meantime, we'll be moving ahead early next month to develop a program with Carllene Placide from the Seattle office of Foster Pepper & Shefelman: she'll be the primary speaker on how to navigate immigration laws when hiring nurses overseas. And after the first week in November, we'll be sitting down with Doug Ross from Davis Wright Tremaine's Seattle office to plan an overview of anti-trust issues that affect PHDs. As program details are worked out, we'll keep you informed via In Focus and e-mail.

NETWORK NEWS

Editor's Note: In response to requests from AWPHD members, we're making a section of "In Focus" available to the Rural Health Quality Network (RHQN), the Western Washington Rural Health Care Collaborative (WWRHCC) and the Critical Access Hospital (CAH) Network so they can tell you about their activities.

RHQN
The RHQN marked its first anniversary in August with a successful conference in Spokane. East Adams Rural Hospital, Ritzville (Adams County PHD #2); Prosser Memorial Hospital (Prosser PHD); and Lourdes Medical Center (Pasco) are the RHQN's newest members.

WWRHCC
The WWRHCC is applying for a three-year grant from the federal Health Resources and Services Administration (HRSA) for network development. And in the next few days four of its members-Mark Reed Hospital, McCleary (Grays Harbor PHD #1); Morton General Hospital (Lewis County PHD #1); Ocean Beach Hospital, Ilwaco (Pacific County Public Healthcare Services District #3); and Willapa Harbor Hospital, South Bend (Pacific County PHD #2)-and non-member Mason General Hospital, Shelton (Mason PHD #1) will be joining together to receive Tele-health via the University of Washington

PEOPLE AND PLACES

Sharon Cox has just been appointed as the Superintendent at Klickitat County PHD #1 (Klickitat Valley Health Services, Goldendale).

UPCOMING EVENTS

AWPHD Board Meeting
October 6 - 6:00 p.m. • Dahlia Lounge, Seattle
Contact: Wendy Ray (206)216-2516

WSHA Rural Hospital Committee Meeting
October 6 - 10:00 a.m. • WSHA Offices, Seattle
Contact: Johanna Bradford (206)216-2510

PHD & WAH Workers' Compensation Board Meeting
October 6 - 6:00 p.m. • Waterfront Seafood Grill, Seattle
Contact: Anita Badri (206)216-2553

AWPHD Membership Meeting
October 7 - 8:00-9:30 am. • Bell Harbor Conference Center, Seattle
Contact: Wendy Ray (206)216-2516

WSHA Board Meeting
October 7 - 9:30-10:30 a.m. • Bell Harbor Conference Center, Seattle
Contact: Lisa Rusk (206)577-1852

WSHA Annual Meeting
October 7-8 • Bell Harbor Conference Center, Seattle
Contact: Danie Wright (206)577-1845

WSHHRA Meeting
October 21-22 • Leavenworth
Contact: Claudia Hawley (360) 427-9575

If you have an item for the next In Focus, please send it to Dick Goldsmith at richardg@awphd.org by Friday, October 22nd.

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