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

The 2005 legislative session is history. While there are significant questions about how some of the budget plans will be implemented, it appears that legislators worked hard to protect health care providers and state programs for health care. I am working with the cities and counties to make sure we have the benefit of their perspectives as we think through changes to state law that will affect local government, and hope to report to you on those in the very near future. Meanwhile….

Get ready for lots of opinions and recommendations. The cost of health care has been the focus of recent reports from the Washington Roundtable, the Washington Alliance for a Competitive Economy, and the Puget Sound Health Alliance. While there's plenty to argue about when it comes down to specific numbers (is Washington's health care more expensive than Oregon's? California's?), there is no denying the reality that our expenses are today (and have been, for a very long time) increasing more quickly than general inflation. New technology, an aging population, burdensome regulations, shortages of health care professionals, liability insurance cost increases…the list of reasons is solid and impressive. Unfortunately, none of those reasons provides employers or legislators with the money they need to keep up with the cost spiral. Health care is now one dollar of every five spent by the state, and is expected to grow nearly 11 percent in the 12 months that begin July 1. State revenues will grow five percent over the same time.

And so we will have a lot of legislative studies and initiatives over the interim. The Washington Health Care Authority (HCA) will develop a drug-purchasing consortium for state agencies. HCA will also be doing a health technology assessment pilot project, including the departments of Social and Health Services (DSHS), Labor and Industries (L&I), Corrections, and Veterans' Affairs. The aim of the pilot is to develop a joint decision process for determining whether a procedure should be covered and, if so, when. HCA will also partner with DSHS and L&I to design and implement a "pay for performance" initiative to improve outcomes and save money.

But HCA won't be the only group with work to do over this period. We can also look forward to a study to improve the equity of the medical assistance payment system for hospitals, a study of the state's Certificate of Need review program, and a study on how to best address the funding needs of local public health jurisdictions.

A campaign to protect the public image of hospitals and health care, funded by the state's public hospitals, the Washington State Hospital Association (WSHA) and AWPHD, is moving forward. The campaign's steering committee has chosen the Rockey Hill & Knowlton firm to develop the messages and strategy, which will promote a "news you can use" approach in a public media effort. The model will resonate with a public that is being asked to become more engaged and involved in their own payment and service choices. Thanks to each of you who have already contributed to the campaign. Those of you who have not yet joined the effort-and who haven't already talked to me-can look forward to a phone call.

SNAPSHOTS

Sometime after the middle of May, you'll be receiving two important documents about the recent legislative session. WSHA will be issuing its 2005 Legislative Summary, which will include narrative summaries of the victories and disappointments for AWPHD and WSHA. AWPHD also will be publishing a matrix of changes to municipal government statutes; most-if not all-of the new laws will go into effect in late July.

Because the Governor has 20 days after the Legislature adjourns to veto all or part of a bill, the fate of the bills the Legislature presented to her in the waning days of the session won't be known with certainty until May 16th.

During the WSHA Rural Hospital Summer Workshop in Chelan, AWPHD will be facilitating a meeting between representatives from the State Auditor's Office (SAO) and the major CPA firms that work with PHDs. The impetus for the meeting was the 2005 Financial Reporting Package, recently issued by the SAO. It's hoped that the meeting will be the first step in an ongoing dialogue between the SAO and PHDs to make the audit process more efficient and cost-effective for everyone involved. We'll report on that meeting in the July edition of In Focus.

AWPHD will be helping organize a conference for hospital foundations. Dave Campbell at the Samaritan Healthcare Foundation (Samaritan Healthcare, Moses Lake; Grant County PHD #1) asked AWPHD to put a conference together. To ensure that the conference addresses topics of interest to ongoing foundations (and perhaps to PHDs thinking about starting a foundation), volunteers will plan and oversee the conference, with staff support from AWPHD (primarily Beionka Moore). If you or a member of your hospital foundation's staff would like to be on the planning/steering committee, please contact Dave at dcampbell@samaritanhealthcare.com (509-764-2904). Dave hopes to form the committee shortly and we'll keep you informed of his progress.

The backdrop for a recent Washington State Supreme Court decision on public works projects was provided by a construction project at Newport Community Hospital (Pend Oreille County PHD #1). The Court ruled that a "second tier" subcontractor-one providing materials or labor and materials to a subcontractor-must comply with the notice provisions of Section 39.08.065 of the Revised Code of Washington (RCW) or else be barred from seeking recovery against the contractor's bond. Under this statutory provision, a person or entity furnishing "materials, supplies or provisions" to a subcontractor has 10 days from the first delivery to notify the contractor in writing of its actions. The Court also determined that a second tier subcontractor cannot recover against the public body's "retained percentage" unless the subcontractor meets similar notice requirements set out in RCW 60.28.015. (The "retained percentage" can be up to five percent of the contract price and is reserved to pay those who perform work or provide materials for a public works project.) The case is LRS Electric Controls, Inc. v. Hamre Construction Inc., Docket No. 75096-3, March 3, 2005.

Congratulations to Valley Medical Center (VMC) in Renton (King County PHD #1) on its successful emergency and hospital services levy. The levy will result in an additional $12 million annually ($10 million for VMC and $2 million to be shared among local fire districts). VMC needed the additional revenues because patient visits to the Emergency Room had leaped from 50,000 in 1999 to 75,000 in 2003 and were projected to top 110,000 in just five years.

According to VMC, "the enthusiastic support of the hospital's unions was considered to be a significant factor in the levy's passage." Members of Service Employees International Union District 1199 NW logged in over 200 three-hour shifts at the union's mobile phone bank to build community support for the levy.

The levy, which was VMC's first since 1978, raises the levy rate from $.09 to $.59 per $1,000 of assessed value. Although only 34.36 percent of the almost 137,000 registered voters in the district mailed in ballots, over 54% of those who voted approved the ballot measure.

PEOPLE AND PLACES

Joanne Endres, an emergency room nurse at Evergreen Healthcare in Kirkland (King County PHD # 2), was the subject of a May 2nd column in The Seattle Times for her quick response to a recent medical emergency while flying from Minneapolis to Seattle. The column is on-line at http://seattletimes.nwsource.com/html/nicolebrodeur/2002260910_brodeur03m.html.

After serving nine years as administrator of Columbia Basin Hospital in Ephrata (Grant County PHD #3), Al Beach will be retiring on May 20th.

The commissioners of Lewis County PHD #1 (Morton General Hospital) have appointed Dr. Charles Anderson, MD as the hospital's interim administrator.

Lori Daisely has been appointed as the Chief Operating Officer at Skagit Valley Hospital in Mount Vernon (Skagit County PHD #1).

NETWORK NEWS

The RHQN is almost ready to start the intervention phase of its heart failure project. The project's advisory committee has been reviewing materials and soon will meet to discuss and select those that will be distributed to the network's hospitals.

As soon as all of the network's members have submitted data on the heart failure measures, RHQN staff will aggregate the data and establish a baseline. Preliminary review of the data shows there are opportunities to make significant improvements in the overall care and discharge planning processes for patients admitted with heart failure.

After the baseline has been established, RHQN staff will assign each hospital a unique identifier and send the baseline data to all network administrators and quality improvement contacts. Each quarter, the RHQN will collect data from its members to evaluate the effectiveness of these interventions and for benchmarking purposes.

Network members and others with questions about this project should contact Jackie Huck (jackieh@awphd.org, 206-577-1821).

UPCOMING EVENTS

WHF Heroes in Health Care Awards
May 5 - 4:30 p.m. • Westin Hotel, Seattle
Contact: Heather Pitre (206)577-1848

WHF Healthy Communities Colloquium
May 6 - 9:30 a.m. • Westin Hotel, Seattle
Contact: Nikki Lac (206)216-2529

Hospital Image Campaign Steering Committee
May 9 - 10:00 a.m. • SeaTac Radisson Gateway Hotel, Seattle
Contact: Wendy Ray (206)216-2516

AWPHD Administrators Retreat
May 11-12 • Sleeping Lady Resort, Leavenworth
Contact: Beionka Moore (206)216-2530

AWPHD Board Retreat
May 12-13 • Sleeping Lady Resort, Leavenworth
Contact: Beionka Moore (206)216-2530

Wash. State Hospice & Palliative Care Organization Spring Conference
May 12-15 • DoubleTree Hotel, SeaTac
Contact: Christine Grace (425)290-8739

Western Wash. Rural Health Care Collaborative Member Meeting
May 20 • Mason General Hospital, Shelton
Contact: Elizabeth Floersheim (206)577-1851

WSHA Rural Hospital Committee
May 26 - 10:00 a.m. • SeaTac Hilton, Seattle
Contact: Melissa Waddell (206)216-2510

WSHA Board Meeting
May 27 - 9:00 a.m. • WSHA Offices, Seattle
Contact: Lisa Rusk (206)577-1852

RHQN Board Meeting
June 9 - 10:00 a.m. • WSHA Offices, Seattle
Contact: Brad Vollegraaf (206)216-2550

WSHA Strategic Planning Meeting
June 9 - 12:00 p.m. • WSHA Offices, Seattle
Contact: Lisa Rusk (206)577-1852

WSHA Executive Committee Meeting
June 10 - 9:00 a.m. • WSHA Offices, Seattle
Contact: Lisa Rusk (206)577-1852

WSHA Public Policy Advisory Group Meeting
June 17 - 10:00 a.m. • WSHA Offices, Seattle
Contact: Melissa Waddell (206)216-2510

WSHA Public Policy Committee Meeting
June 24- 10:00 a.m. • WSHA Offices
Contact: Melissa Waddell (206)216-2510

AWPHD Board Meeting
June 27 - 7:30 a.m. • Campbell's Resort, Chelan
Contact: Wendy Ray (206)216-2516

AWPHD Membership Meeting
June 27 - 9:00 a.m. • Campbell's Resort, Chelan
Contact: Wendy Ray (206)216-2516

WSHA 29th Annual Rural Hospital Summer Workshop
June 27-29 • Campbell's Resort, Chelan
Contact: Danie Wright (206)577-1845

RHQN Board Meeting
June 27 - 11:30 a.m. • Campbell's Resort, Chelan
Contact: Brad Vollegraaf (206)216-2550

The deadline for next month's In Focus is Friday, May 20th. Send articles or information to Dick Goldsmith (richardg@awphd.org, Fax: (206) 577-1897, 300 Elliott Avenue West, Suite 300, Seattle, WA 98119-4118.

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