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

What beats a full house? If you're talking about AWPHD's Administrators' Only Retreat, the answer is nothing at all! We are booked solid for next week's retreat at Cave B Inn at Sagecliffe in Quincy. I am sorry if there's anyone who was shut out. This is--by far--the strongest response we have had for this event. We'll do a little work to figure out why, and next year make sure we can accommodate all who wish to attend. I want to thank Brad Berg, Julie Kebler and their colleagues at Foster Pepper PLLC for their support, both financial and in developing much of the content we will explore. I am looking forward to seeing many of you there!

WSU's Center to Bridge the Digital Divide has just about finished phase one of their work to help AWPHD develop a proposal to create a statewide "spine" for health and medical telecommunications. This project, funded through a Flex Grant from the state's Office of Community and Rural Health, will produce a vision and plan for moving forward toward an open network that will support teleconsults, distance learning and administrative efficiencies for rural providers. We are pointing toward a meeting in mid-June, where stakeholders will come together to reach consensus on the basic values and principles that will shape the network. It is likely we will need to work with the Governor and the Legislature next year. Just what that work will entail is yet to be determined, but I suspect the plan be of interest to most rural hospitals, clinics, nursing homes and physicians as we move forward.

The Rural Healthcare Quality Network, which supports quality assurance and performance improvement at all 39 of the state's Critical Access Hospitals, will undergo a significant strategic planning effort this summer. Two years after its incorporation (first as a limited liability partnership, now as a nonprofit corporation), the Network faces a familiar but always difficult series of decisions. Grant money is beginning to diminish, and the loss of resources is pushing us toward a basic discussion about the Network's purpose. Originally conceived as an innovative approach to identify, describe and promote exemplary clinical performance in Critical Access Hospitals, the flood of new quality reporting demands and increased state scrutiny during licensure surveys are causing many to suggest it is time to "get down to basics." It promises to be a challenging discussion--one I hope will do justice both to our highest ideals and our current reality.

We now have more than half the PHDs in the state signed up as Participating Organizations in the Washington Health Foundation's "Healthiest State in the Nation" Campaign. The AWPHD Board has suggested we aim to have all of you signed on by the time we get to Chelan. If you are not yet a Participating Organization, Wendy Ray will be sending you a letter to offer her assistance in getting you signed up. If you have already signed up, congratulations on your engagement in the largest civic effort to improve health in our state's history.

Travel safely, and enjoy this spectacular time of year in our beautiful state.

SNAPSHOTS

AWPHD's web cast on the Family and Medical Leave Act (FMLA) is scheduled for Tuesday, June 20th at noon, so be sure that you and your HR staff block out time now to get more clarity on laws and regulations that employers have found vexing. Attorneys Karen Sutherland and Angela Belbeck--employment law and municipal law specialists, respectively, at the Seattle firm of Ogden Murphy Wallace--will be your "mentors." Details on the FMLA web cast will be sent to you and your HR director in the next few weeks.

Because some of the PHDs in the state don't have hospitals, we want to clarify two provisions of House (HB) Bill 2292, which was recently signed by the Governor and addresses medical liability reform:

· The notification and reporting of "adverse events" to the state Department of Health.
· The reporting of closed medical malpractice claims to the state Office of the Insurance Commissioner (OIC).

(HB 2292 was briefly noted in the Summary of Municipal Law Changes 2006 Legislative Session sent out to CEOs and Administrators earlier this month.)

Beginning June 7, 2006, only a "medical facility"-- a term that encompasses "a childbirth center, hospital, psychiatric hospital, or correctional medical facility"--is required to report an adverse event. The bill also states that "An ambulatory surgical facility shall be considered a medical facility for purposes of this chapter upon the effective date of any requirement for state registration or licensure of ambulatory surgical facilities."

In addition to making their medical staff aware of this requirement, hospital CEOs and Administrators should notify their public records officers that: (1) notices and reports of adverse events are exempt from public inspection and copying; and (2) when these notices and reports are made by or through a coordinated quality improvement program or peer review committee they are protected from disclosure by Washington state confidentiality laws.

The mandate to report closed medical malpractice claims is more sweeping in scope. Under certain circumstances, "a clinic, diagnostic center, hospital, laboratory, mental health center, nursing home, office, surgical facility, treatment facility, or similar place where a health care provider provides health care to patients, and includes entities described in RCW 7.70.020(3)" must report claims closed on or after January 1, 2008. (Note: PHDs with emergency medical services should review RCW 7.70.020(1), (2) and (3) to ascertain whether they fall under this reporting mandate.)

Usually, your insurer (or your PHD if it is self-insured) will be required to report closed claims to OIC. However, if the claim wasn't covered by the insurer or self-insurance, then the health care facility or provider must file the report. Section 202 (1)(b)(i)-(iii) lists some of the circumstances when facility or provider reporting is necessary.

To make life easier for you, here's the Internet link to HB 2292:

http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/Session%20Law%202006/2292-S2.SL.pdf

The adverse events provisions are found in Sections 105 through 112 of HB2292 and the closed medical malpractice claim provisions are in Sections 201 through 210. It's also suggested that you or your staff review HB 2292 in its entirety--most of its provisions go into effect June 7, 2006.

And here is the Internet link to RCW 7.70.020: http://apps.leg.wa.gov/RCW/default.aspx?cite=7.70.020.

Authorization for local governments to create a hospital benefit zone, which would allow the financing of public improvements such as street construction in areas where a hospital is situated, passed the Legislature in 2006. HB 2670 wasn't listed in AWPHD's Summary of Municipal Law Changes 2006 Legislative Session because it was introduced to address infrastructure needs related to the construction of St. Anthony's Hospital in Gig Harbor. However, we want to bring this very complex legislation to your attention. Although a hospital benefit zone may not be of interest to most of our members, it could provide possibilities--and opportunities--for some. We suggest that you first read the final bill report before delving into HB 2670 itself. Here are their respective Internet links:

http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bill%20Reports/House%20Final/2670-S.FBR.pdf

http://www.leg.wa.gov/pub/billinfo/2005-06/Pdf/Bills/Session%20Law%202006/2670-S.SL.pdf

For those of you wondering how the State Auditor (SA) will carry out the performance audits of state and local governments mandated last year by the passage of Initiative 900, we've got some preliminary answers. According to The First 100 Days: Progress Report on the State Auditor's Performance Audit Program issued earlier this month, health care at the state level is among the initial audits:

"Health care is among the costliest areas of state government, and it is largely administered by the Department of Social and Health Services, Department of Health and the state Health Care Authority. We believe the array of health care services administered by these agencies present major opportunities for increased efficiencies and effectiveness. We intend to conduct a comprehensive audit of health care services, including the operations of and the services administered by DSHS' Medical Assistance and Health and Rehabilitative Services administrations. We project audit work to begin by November and anticipate completion by September 2007."

Currently, PHDs are not listed among the initial local government entities targeted for performance audits. To learn more about the SA's plans, we encourage you to attend AWPHD's Mid-Year Meeting on Monday, June 26th at Campbell's Resort in Chelan. SA Brian Sonntag has been invited to be our keynote speaker so you'll receive the latest information on how performance standards for PHDs will be developed and when these audits will take place.

Rural Advocacy Days in Washington, D.C.--September 11th and 12th--is yet another event to mark down on your calendar. AWPHD members will be meeting with senators and representatives on Capitol Hill to discuss rural issues. This joint event--put on by AWPHD and the Washington State Hospital Association--is not only for CEOs and Administrators, but also for district commissioners. For more information, contact Wendy Ray at wendyr@awphd.org or (206)216-2516.

The Washington Health Foundation (WHF) has redesigned its website to keep users more informed about its "Healthiest State in the Nation" campaign. Among the new features are a scoreboard showing Washington's progress toward the 10 Million Mile Challenge and WHF's Weekly Health News Roundup, with around-the-state coverage. The website's address is www.whf.org.

PEOPLE AND PLACES

CEO Bruce Grimshaw (Columbia County Health System in Dayton) achieved "Fellow" status in the American College of Healthcare Executives (ACHE), its highest level of professional achievement. He was awarded this distinction during ACHE's annual Congress on Healthcare Leadership in March.

Terry Litke is the new CFO at Kennewick General Hospital (Kennewick PHD). His previous position was vice president of finance at Samaritan Healthcare (Grant County PHD No.1).

Russ Keefer is also joining Kennewick General Hospital as its new HR manager.

John Howrey, CFO at Quincy Medical Center (Grant County PHD No. 2), will be stepping down May 5th.

Forks Community Hospital (Clallam County PHD No. 1) has a new HR director, Geoff Roach. He has over 24 years of human resources management experience, including assignments in biomedical manufacturing and biotechnology research and development.

On May lst, ownership and operation of the Aydon Wellness Clinic in Point Roberts will be transferred to the Point Roberts PHD, which was created in February 2005. The clinic has been operating under a federal Rural Outreach Grant since its doors opened in 2002. District Superintendent Marge Biery has greatly appreciated all the assistance that AWPHD's members have given her and the district.

UPCOMING EVENTS

AWPHD Board Retreat
May 2 - 1:00 pm • Cave B Inn at SageCliff, Quincy
Contact: Beionka Moore (206)216-2530

AWPHD Administrators Only Retreat
May 2-4 • Cave B Inn at SageCliffe, Quincy
Contact: Beionka Moore (206)216-2530

RHQN Board Meeting
May 10 - 10:00 am • Conference Call
Contact: Brad Vollegraaf (206)216-2550

WSHA Hospital Governing Board Committee
May 10 - 11:00 am • WSHA Offices , Seattle
Contact: Angela Segerra (206)216-2539

WSHA Hospital Governing Board Committee Planning Retreat
May 11 - 8:00 am • Homewood Suites, Seattle
Contact: Angela Segerra (206)216-2539

WSHA Strategic Planning Committee
May 11 - 10:00 am • WSHA Offices, Seattle
Contact: Lisa Rusk (206)577-1852

WSHA Board
May 12 - 9:00 am • WSHA Offices, Seattle
Contact: Lisa Rusk (206)577-1852

4th Annual WHF Latina Health Fair
May 20 - 10:00 am • Seattle Eagles, Seattle
Contact: Giselle Zapata-Garcia (206)577-1813

WHF Annual Meeting
May 26 - 9:30 am • Museum of Flight, Seattle
Contact: Heather Pitre (206)577-1848

WSHA Patient Safety Task Force
June 5 - 5:00 pm • Washington Athletic Club, Seattle
Contact: Angela Segerra (206)216-2539

RHQN Board Meeting
June 7 - 2:00 pm • Conference Call
Contact: Brad Vollegraaf (206)216-2550

WSHA Executive & Finance Committees
June 16 - 7:30 am • WSHA Offices, Seattle
Contact: Lisa Rusk (206)577-1852

AWPHD FMLA Webcast
June 20 - 12:00 noon • Webcast
Contact: Wendy Ray (206)216-2516

AWPHD Board Meeting
June 26 - 7:30 am • Campbell's Resort, Chelan
Contact: Wendy Ray (206)216-2516

AWPHD Membership Meeting
June 26 - 9:00 am • Campbell's Resort, Chelan
Contact: Wendy Ray (206)216-2516

AWPHD SAO Committee Meeting
June 26 - 11:30 pm • Campbell's Resort, Chelan
Contact: Wendy Ray (206)216-2516

RHQN Membership Meeting
June 26 - 11:30 pm • Campbell's Resort, Chelan
Contact: Brad Vollegraaf (206)216-2550

WSHA 30th Annual Rural Hospital Summer Workshop
June 26-28 •Campbell's Resort, Chelan
Contact: Danie Wright (206)577-1845

The deadline for the next In Focus is Friday, May 26th. 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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