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

I would like to open this month by doing something I should have done at Chelan during the membership meeting--recognizing the strength and contribution of the staff here at AWPHD. I am fortunate to have such a great team to support our work, and you reap the benefits of their tremendous skills and commitment every day. Dick Goldsmith continues to provide great support to members both "on the ground"-helping answer basic questions about local government law, providing on-site education for commissioners, etc.--and at the policy level with the State Auditor's Office, the Construction Project Advisory Review Board, and the state legislature. Beionka Moore has shown tremendous growth in her time with AWPHD, and has become a real expert at organizing special member meetings (as well as keeping track of where I'm supposed to be and when). Wendy Ray has really expanded her responsibilities as the list of our activities has grown. Wendy has tracked the special payment programs for us for several years, and has worked closely with the accounting staff in Montana to make sure our budget process works smoothly, that invoices to members are accurate and timely. Wendy has also developed into an effective project manager, a skill she demonstrated most clearly last fall, working with Cassie Sauer on the Hospital Image Campaign. They deserve every bit of thanks we can dump on them!

I thought this year's Annual Mid-Year Meeting was one of the best we have had during my tenure. The presentation from the State Auditor's Office on the evolving Performance Audit function was clear, and I thought the Auditor's representative did a nice job of handling a potentially difficult topic. The recognition for John Woodall and Vince Rota for their service, through Washington Casualty Company, to the rural hospitals of the state struck a nice chord for me, and, based on the reaction of the audience, with many of you. Special thanks here to Bob Appel, who did a great job introducing John Woodall with not much in the way of lead time.

It's hard to believe it's August! This past month has been a blur of activity as a variety of state advisory committees (on Medicaid payment, technology assessment, long term care, Certificate of Need, electronic health information exchange, to name just a few) head in to the home stretch and prepare their final recommendations for consideration by the Gregoire Administration and the 2007 state legislature. There will be plenty to occupy our attention over the next few months--as if there weren't already enough!

Finally, I'd like to thank each of you for your responsiveness on our challenge to join the Washington Health Foundation's Healthiest State in the Nation campaign. As we get set for another Governor's Health Bowl, I hope you will find a few minutes to think about all the ways your work and the work of your employees contribute to the vitality of your community. We are hoping to get a couple of challenges going between a few hospital districts, or between a hospital district or two and another local system--like a school district or a county administration. If you are interested in hearing more about this opportunity, please let Wendy Ray (wendyr@awphd.org) or me (jeffm@awphd.org) know. We'll be more than glad to work with the folks at the Health Foundation to make sure it turns into as much fun as it can be!

SNAPSHOTS

The ability of PHDs to continue to use special contracting procedures for large public works projects beyond June 31, 2007 likely rides on upcoming actions of the Capital Projects Advisory Review Board (CPARB). CPARB, which the Legislature created in 2005 to review and make recommendations for changes to existing public works statutes, hopes to roll out its recommendations and proposed legislation for the general contractor-construction manager (GC/CM) and design-build statutes by the end of the summer or early fall.

Since CPARB first began its monthly meetings in September 2005, Dick Goldsmith, AWPHD's director of legal services and public policy, has been closely monitoring CPARB and actively participating in the monthly meetings of its subcommittees and task forces. Although it is still too early to determine the outcome of CPARB's deliberations, it appears that the GC/CM and design-build statutes will be extended for another six years. This extension would enable the Legislature to better evaluate whether these contracting procedures--in certain circumstances--are more beneficial to the public than the traditional "design-bid-build" process.

In addition to this extension, AWPHD has been advocating on behalf of PHDs to: (1) allow the GC/CM procedure to be used for projects that are valued at less than $5 million; (2) keep the existing PHD Project Review Board in place; (3) allow all PHDs to use the design-build procedure if their projects "qualify;" and (4) clarify and refine the existing statutory requirements for these procedures.

What CPARB ultimately will recommend is still in flux. As the deadline for final CPARB action draws near, the discussions at subcommittee and task force levels have become more heated: not only are new "actors" coming into the process at the last minute, but construction and public entity representatives are backing away from solutions that seemingly had been agreed to earlier. However, we remain optimistic. (A caveat: the Legislature isn't bound to follow CPARB's recommendations. However, it becomes more difficult for individual interest groups to tear them apart when CPARB is composed of a wide range of industry and public entity representatives who are experts in construction and have achieved consensus on improving the process for building large public works.)

Washington State legislators, regulators and their staffs again took the opportunity to see rural health care first-hand during a two-day tour of Central Washington health care facilities. Among the host facilities were AWPHD members Othello Community Hospital (Adams County PHD No. 3), Samaritan Healthcare (Grant County PHD No. 1, Moses Lake), Quincy Valley Medical Center (Grant County PHD No. 2), Columbia Basin Hospital (Grant County PHD No. 3, Ephrata), and Kittitas Valley Community Hospital (Kittitas County PHD No. 1, Ellensburg) and the Cle Elum Family Medicine Center.

Topics raised by health care providers included the difficulty of recruiting primary care physicians and specialists into rural areas; the short and long-term effects of fast-growing populations on the delivery of health care services in some rural areas; their participation in patient safety and quality initiatives; and the challenges to providing health care as bad debt and charity care rise.

The annual tour, which has been in existence for almost a decade, was the brainchild of Department of Health (DOH) Secretary Mary Selecky and House Health Care Committee Chair Eileen Cody. Participants joining them on this year's tour included Senators Linda Evans Parlette, Karen Keiser (chair of the Senate Health and Long-Term Care Committee) and Pat Thibaudeau; Representatives David Buri, Richard Curtis, Tami Green, Bill Hinkle, Jim Moeller, Dawn Morrell, and Shay Schual-Berke; Department of Health and Social Services (DSHS) Secretary Robin Arnold-Williams; staff from the House Health Care and Appropriation Committees, the Senate Health and Long-Term Care Committee, the House Democratic and Republican Caucuses, DOH, DSHS, and the Health Care Authority; and AWPHD Director of Legal Services and Public Policy Dick Goldsmith.

AWPHD efforts to improve the State Auditor's Office (SAO) process for auditing PHDs continues through collaboration between the association and the SAO. Immediately after AWPHD's Mid-Year Meeting in Chelan, the AWPHD SAO Committee (composed of financial staff from small, medium, and large PHDs and representatives from CPA firms who work with PHDs) met with SAO representatives to discuss the accomplishments of the previous year and look at other steps that can be taken to make the auditing process more efficient and cost-effective for everyone. Over the coming year, training and education within both the SAO and PHDs will be areas of focus. [Editor's Note: A summary of this SAO Committee meeting already has been sent to district CFOs. If you want a copy, please send an e-mail to Dick Goldsmith at richardg@awphd.org]

In the next few weeks, the CFO at each PHD will be asked to complete an on-line evaluation of its local SAO auditing team. The results--which will be aggregated so that the ratings and comments of individual PHDs can't be discerned--will be used by the SAO in developing a training program for new SAO personnel who will be auditing PHDs. (AWPHD also will send the aggregated evaluation results to PHD CFOs.) After the SAO puts together a potential training program, the SAO Committee will review its content and, if necessary, offer suggestions for improvement. And SAO Committee members may be volunteering to teach parts of the program.

As for ways in which PHDs can be better prepared for SAO audits, AWPHD sought the advice of the SAO. Their comments and suggestions, as well as the SAO publication Your Audit, were sent to district CFOs in a July 20th e-mail from Dick Goldsmith.

A "tip of the AWPHD hat" to attorneys Karen Sutherland and Angela Belbeck of the Seattle firm of Ogden Murphy Wallace for AWPHD's June 20th web cast--Family and Medical Leave Act (FMLA) Considerations for Employers. Participants gave excellent evaluations to their program.

PEOPLE AND PLACES

Mike Carter is the new chief executive officer at Stevens Healthcare in Edmonds (Snohomish County PHD No. 2). He comes to Stevens from Kindred Hospital in Phoenix, where he was the CEO of that 50-bed intensive care facility.

Stepping down as Stevens' CEO is Dr. John Todd. Before taking the helm there in January 2004, he was its medical director.

CPA Dave Sherwood, who has represented the Spokane office of LeMaster and Daniels on AWPHD's SAO Committee, has taken a position with an Irvine, California public accounting firm. Mike Sonner and Ralph Conner will now be the LeMaster and Daniels representatives. AWPHD greatly appreciated Dave's work on behalf of its members.

Grant County PHD No. 5 celebrated the opening of its new Mattawa County Medical Clinic with ceremonies on June 20th.

Skagit Valley Hospital (Skagit County PHD No. 1, Mount Vernon) recently assumed operations of the cancer care program at Cascade Valley Hospital (Snohomish County PHD No. 3, Arlington). Under the agreement between the two districts, the program is still housed at Cascade Valley Hospital, with Skagit Valley Hospital providing an oncologist and certified oncology nurses. This arrangement enables Cascade Valley Hospital to continue to offer outpatient oncology treatments in Arlington and allows Skagit Valley Hospital to formally expand its cancer care program.

September elections will be important for at least two PHDs in the state. Whidbey Island PHD (Whidbey General Hospital, Coupeville) will be seeking an EMS levy rate increase of 13 cents. The current EMS rate--37 cents--has been in effect since 1997. And Garfield County PHD residents will be asked to approve a $3.5 million bond levy to modernize and refurbish Garfield County Memorial Hospital in Pomeroy. If passed, the 20-year bond levy would mean a levy rate of $1.75 per $1,000 of assessed value.

THE HEALTHIEST STATE IN THE NATION (HSIN) CAMPAIGN

[Editor's Notes: In the May issue, you learned about the HSIN activities at Garfield County PHD. To find out more about their activities, go on-line to www.AccountingForHealth.org.]

This month, In Focus highlights what's been happening at the Columbia County Health System (Dayton). CEO Bruce Grimshaw, filed this report.

The Washington Health Foundation (WHF) awarded a $50,000 grant to the Columbia County Health System (Health System) to establish and evaluate a school and community wellness education campaign about the importance of developing healthy habits through exercise and nutrition. With this grant, the Health System will expand its already existing community wellness program and formalize educational materials.

The Health System's wellness initiatives began with a January 2005 challenge to determine whether the educators at the Dayton School District or the Health System's employees could walk, run, and exercise the most over a four-month period. Participants used pedometers to measure their activities each day, and the results were collected and updated weekly. Over 90 million total steps were logged, which equates to more than 30,000 miles! In the end, the Health System won by a mere 50,000 steps.

After WHF staff heard about this challenge, they showed up at the finish to award the first "Governor's Bowl" to the Health System for its great work in motivating healthy habits. And they issued a challenge of their own to the entire Dayton community: go the next step and get involved in the statewide 2005 Governor's Bowl challenge.

Dayton took this to heart, with the Health System leading more than 600 people (over 20 percent of the community) towards the statewide goal of 1,000,000 miles walked over a five-week period. Our tiny community worked hard and fared very well, finishing third out of more than 400 participating communities. And the state goal was met.

But the Health System and the Dayton community have not stopped. And Dayton is now ranked the Number 1 community in the 2006 Governor's Bowl challenge.

UPCOMING EVENTS

PHD & WAH Workers' Compensation Board Retreat
August 3-4 • Channel Lodge, LaConner
Contact: Anita Badri (206) 216-2553

Rural Hospital Committee Retreat
August 10-12 • Cave B Inn, Quincy
Contact: Melissa Waddell (206) 216-2510

AWPHD Board Meeting
August 14 - 10:00 a.m. • AWPHD Offices, Seattle
Contact: Beionka Moore (206) 216-2530

CPE Meeting
August 14 - 1:30 p.m. • AWPHD Offices, Seattle
Contact: Wendy Ray (206) 216-2516

RHQN Board Meeting
August 15 - 2:00 p.m. • Conference Call
Contact: Brad Vollegraaf (206) 216-2550

Rural Advocacy Days
September 11-12 • Washington, DC
Contact: Wendy Ray (206) 216-2516

RHQN Board Meeting
September 13 - 10:00 a.m. • Conference Call
Contact: Brad Vollegraaf (206) 216-2550

WSHA Executive & Finance Committees
September 15 - 7:30 a.m. • WSHA Offices
Contact: Lisa Rusk (206) 577-1852

WSHA Hospital Governing Boards Committee
September 15 - 8:00 a.m. • WSHA Offices
Contact: Angela Segarra (206) 216-2539

WSHA Public Policy Advisory Committee
September 20 - 10:00 a.m. • WSHA Offices
Contact: Melissa Waddell (206) 216-2510

WSHA Patient Safety Committee
September 25 - 5:00 p.m. • Washington Athletic Club
Contact: Angela Segarra (206) 216-2539

WSHA Public Policy Committee
September 29 - 10:00 a.m. • WSHA Offices
Contact: Melissa Waddell (206) 216-2510

The deadline for the next In Focus is Friday, August 25th. 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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