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

State economy slowing?

The most recent state revenue forecast, released about two weeks ago, predicts a slowdown in the state's economy during the last half of 2005 and first half of 2006 (state fiscal year 2006). The news caught some observers, at least, off guard. The state revenue picture had been improving (slowly, very slowly) for the last five quarters, and many expected the trend line to continue to inch upward. The loss comes from an anticipated decline in manufacturing jobs. Of course, the overall revenue picture masks large variations across the state--some counties have seen no rebound from losses sustained in the mid-90s (and, in a few, the bad news goes back even further). The news is important though, as legislators gear up for the annual jigsaw puzzling exercise that results in a state budget. That work will begin in earnest in March.

Lost in the noise over the tightest governor's race in the state's history is news that may be more important to building the state budget: the legislature will be organized by Democrats alone for the first time since 1988. The Democrats captured two seats in the Senate, and will have a slim majority (made slimmer by the fact that on several key issues, one or more of the Democratic senators have a history of voting with Republicans). One interesting side note: the Senate Democrats had their organizing meeting recently, and emerged with an all-female leadership group of five. On the House side, Speaker Frank Chopp (D-Seattle) will have an even larger majority than he did in the past session. Of note for public hospital districts: the balance of power has swung, ever so slightly, towards the I-5 corridor and urban Washington. Rural communities and their leaders will need to make a special effort to be heard over the noise from unions in the upcoming session.

One big issue on the table will be liability reform. At this point, it appears that both initiatives aimed at addressing the medical malpractice insurance issue will be certified and delivered for legislative review. On our side, Initiative 330, developed by the Washington State Medical Association (WSMA) and supported by AWPHD and WSHA. On the other--Initiative 336 (I-336), developed by the Washington State Trial Lawyers Association. Voters in Florida recently approved an I-336 style measure; it has medical providers "tied up in knots" according to my counterparts in the Sunshine State. The campaign effort here promises to be an expensive experience: WSMA has asked hospitals in the state to contribute about one-third of the cost of what is expected to be a $6-7 million campaign. PHDs will need to find a way to help.

We have reached the time of year when it is easy to go to work in the dark and come home in the dark. A warm fire and good company seem more important than they have for seven months. I hope you enjoy all of the wonders that come through the darkness, and that you and those you care most about travel safely and with joy through the holiday season. Thanks for all you do, each day, to keep high quality medical care there, in your community.

UPDATE: Critical Access Hospital (CAH) Financial Benchmarking Project... By jeff uyyek, director of financial policy

The CAH financial benchmarking project, co-sponsored by AWPHD and the state Department of Health, has moved into its second phase. After discussions with an advisory group of chief financial officers, we are adopting the financial indicators used by the national Flex monitoring team to measure overall financial performance. This allows for consistency and comparability with national data and also facilitates data collection, as Medicare cost reports are the source for most of the information.

In addition to overall financial performance, we will be looking at benchmarks for four departments within CAHs: laboratory, radiology, nursing home, and rural health clinics. We hope to identify differences and best practices in these departments that can be correlated to overall financial performance.

Data collection began in June with the rural health clinic survey, and is continuing with the CAH survey that was sent earlier this month. If you have not received either of these surveys, please contact me at (206)216-2867 or jeffreyu@wsha.org. We encourage you to complete both surveys as soon as possible so we can begin our analysis in December.

Results from the project will be presented at the CAH Hospital Conference, March 23, 2005, in Spokane.

SNAPSHOTS

With a ceremony on December 3rd, Whitman County PHD #1-A dedicates the Pacific Northwest's newest hospital. And with a new facility comes a new name and location: Pullman Regional Hospital, located at 835 SE Bishop Boulevard in Pullman, replaces Pullman Memorial Hospital, which abuts the Washington State University campus. The ceremony runs from 5:30-7 p.m. and will be followed by community open houses on December 4th and 5th. More information can be obtained from Matt Strange (509)336-0267, mstrange@pmh1.org.). And pictures of the new hospital will be up shortly on the district's web site: www.pullmanhospital.org. Congratulations to the district's commissioners, Administrator Scott Adams, and employees on their new home. The district's residents can't help but be appreciative and proud of everyone's efforts in making the new hospital a reality.

The November 2nd elections brought mixed results for PHDs. On the governance side, voters approved the expansion of the boards of Columbia PHD (Dayton General Hospital) and Snohomish PHD #2 (Stevens Healthcare, Edmonds) from three to five commissioners.

Fiscally, districts didn't do as well. Adams County PHD #2 (East Adams Rural Hospital, Ritzville) did get the six-year Emergency Medical Services levy it sought ($.44 per $1,000 of assessed value). Sadly, the levies proposed by Columbia PHD, Klickitat PHD #2 (Skyline Hospital, White Salmon), Grant County PHD #4 (McKay Healthcare and Rehabilitation) and Grant County PHD #5 (Mattawa Community Medical Clinic) failed to gain the votes needed.

There was good federal funding news, however, for two PHDs: Odessa Memorial Healthcare Center (Lincoln County PHD #1) and Garfield County PHD, Pomeroy. As part of the federal appropriations bill covering the Department of Labor and the Department of Health and Human Services, Odessa received $1,050,000 to modernize its Emergency Room and hospital building, as well as replace infrastructure; Garfield received $50,000 to assist in the replacement of its boiler and HVAC system.

Senator Patty Murray and Congressman George Nethercutt assisted Odessa in its efforts. Representative Nethercutt also worked on behalf of Garfield. And in a major supporting role was Kristen Michel, AWPHD's former director of federal policy and advocacy.

If your PHD sends out bulk mailings, it may want to look into reducing costs by obtaining a nonprofit mailing permit from the U.S. Postal Service. Although governmental entities generally are not eligible, they can be if their purposes meet postal service requirements (regardless of whether or not they have nonprofit status under the IRS Code). We've heard that some PHDs already have a permit. Information on this permit-which is no-cost and issued by your local post office-is available on-line at http://www.usps.com/businessmail101/resources.

NETWORK NEWS

WWRHCC

November marked the entry of Enumclaw Community Hospital into the WWRHCC.

Spence Byrum, a consultant assisting WWRHCC members with patient safety, visited Jefferson Healthcare (Jefferson Healthcare Services, Port Townsend). Spence also is working on the $1.5 million grant that the RHQN received from the Agency for Healthcare Research and Quality.

PEOPLE AND PLACES

John White, CEO at Newport Community Hospital (Pend Oreille County PHD #1), will be leaving to take over as CEO at Samaritan Healthcare (Grant County PHD #1). The "change of command" at Moses Lake will occur on January 17th. Phil Sandifer has been serving as the interim CEO during Samaritan's search.

On January 1st, Bill Russell will be the new administrator of East Adams Rural Hospital. Jerry Lane has been the interim administrator.

Gary Wangsmo has accepted the position of Chief Financial Officer at Stevens Healthcare, Edmonds. Prior to his selection, Gary was serving in this role on an interim basis.

The community of Point Roberts, Washington will be voting to create a pubic hospital district in February 2005. With a permanent population of about 1,500 (which swells another 2,500 or so in the summer), Point Roberts needs the taxing power of a district so that the Aydon Wellness Clinic-funded by a federal rural clinic startup grant-can continue to operate. Dick Goldsmith, AWPHD's director of legal services, has been working with district organizers and will be speaking at a forum for potential commissioner candidates on December 4th.

UPCOMING EVENTS

Unemployment Compensation Board Meeting
December 4- 8:00 a.m. • Coeur d'Alene Resort, Coeur d'Alene
Contact: Dale Tuvey (206)216-2532

PHD Project Review Board
December 6 - 11:00 a.m. • Conference Call
Contact: John Van Gorkam (360)753-6185

PHD & WAH Workers' Compensation Board Meeting
December 9 - 9:00 a.m. • Prime Hotel, SeaTac
Contact: Anita Badri (206)216-2553

WSHA Board Meeting
December 10 - 9:30 a.m. • WSHA Offices, Seattle
Contact: Lisa Rusk (206)577-1852

AWPHD Board Meeting
December 14 - 10:00 a.m. • AWPHD Offices, Seattle
Contact: Wendy Ray (206)216-2516

WWRHCC Member Meeting
December 16 - 10:30 a.m. • Mason General Hospital, Shelton
Contact: Elizabeth Floersheim (206)577-1851

AWPHD Board Meeting
January 12 - 12:00 a.m. • Conference Call
Contact: Wendy Ray (206)216-2516

WSHA Executive Committee
January 14 - 12;00 noon• WSHA Offices, Seattle
Contact: Lisa Rusk (206)577-1852

If you're got any items for the last In Focus of the year, please send them to Dick Goldsmith at richardg@awphd.org by is Thursday, December 23rd.

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