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A Guide To Capital Funding Options
For Public Hospital Districts, Rural Hospital And/Or Critical Access Hospitals
In Washington State
A publication funded by the Association of Washington Public Hospital
Districts and developed by consulting firms The Lakes Group and Moss Adams
LLP.
INTRODUCTION
The majority of Public Hospital Districts in the State of Washington
are, or will shortly, be in the need of capital financing to replace aging
physical plants, operating systems and clinical equipment to meet the
increasing safety and environment of care standards required by state,
federal and accrediting agencies. In additions, there is a mandate for
information systems (IS) that provide privacy (HIPAA) financial, clinical
and operational interfaces required by state and federal agencies as well
as third party payers and liability insurers. All of these requirements
are and will have a major impact on hospitals and health systems due to
the cost.
The need for capital outside of existing institutional financial reserves
to address these mandatory upgrades is additionally impacted by the continuing
decrease in third party reimbursement for clinical services and reduced
returns on investment income.
For these reasons, the Association of Washington Public Hospital Districts
leadership decided to seek assistance in developing this guide to assist
AWPHD members to find and access capital funds to replace or upgrade aging
physical plants, operating systems, clinical equipment and/or information
systems.
DISCLAIMER
Information in this resource directory has been gathered from numerous
resources and is intended to be a guide for hospitals to identify potential
sources of capital financing. These resources are listed for reference
only and are not intended as endorsement by the Association of Washington
Public Hospital Districts or the consulting firms of The Lakes Group or
Moss Adams LLP.
While this directory is as comprehensive, regarding funding mechanisms,
as the researchers could make it, it is not exhaustive, either to funding
mechanisms or funding resources. The directory includes detailed financing
information for only one or two sources for each particular type of funding
mechanism, rather than attempting to include information for every source.
If other funding mechanisms or funding sources are identified by AWPHD
members/staff, or if other financial sources feel they have been overlooked,
this information should be forwarded to the Executive Director, AWPHD
to be considered as potential addenda to this publication. There is a
blank resource template in Appendix 2 of this resource guide that can
be used to provide the information recommended for addenda to this AWPHD
publication.
It should also be noted that capital funding from state and federal government
resources is a very fluid resource. As this publication went to print,
there were some legislative actions at the federal level that focused
on assisting rural facilities to maintain financial viability and improve
physical plants and information systems. AWPHD and WSHA resources will
monitor these actions and provide timely feedback to the membership if
this legislative support becomes a reality.
This guide is intended to provide accurate information, but it should
not be used as a replacement for or override individual institutions’
financial advisors or auditing firms.
ACKNOWLEDGEMENTS
The Association of Washington Public Hospital District would like to
thank the following contributors to this publication:
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