In this issue...

Address Update Reminder
President's Message
Hunting Accidents Leads to Critical Care Transport
St. Luke's Pharmacy Manager Receives Washington State Health System Pharmacist of the Year Award
Northwest Rural Health Conference - March 15-17
Legislative News
Grant Writing Workshop

Welcome

Welcome to the January 2016 issue of the Washington Rural Health Association e-Newsletter. Inside this issue you will find news and information from the new 2015-2016 President and board of directors, members, and community partners from across the state of Washington.

If you would like to submit your own story, please click here.

The WRHA e-newsletter is a publication of Washington Rural Health Association, a not-for-profit association composed of individual and organization members who share a common interest in rural health. This e-newsletter seeks to disseminate news and information of interest to rural health professionals and stakeholders to help establish a state and national network of rural health care advocates.

WRHA Members

WRHA members include administrators, educators, students, researchers, government agencies and workers, physicians, hospitals, clinics, migrant and community clinics, public health departments, insurers, professional associations and educational institutions. If you are interested in joining or renewing your membership with WRHA click here.

ADDRESS UPDATE REMINDER

Submitted by: Kris Sterling, Office Manager, Wipfli LLP
[email protected]

**Please note: Effective 9/30/15, transition of the WRHA management included a new PO Box address and phone number. This contact information has been updated in several locations on our website, as well as directly on the internal invoices created when renewing a membership or sponsorship. Please ensure your internal AP systems have the correct address for mailing payments to the WRHA. Thank you for updating your records!!

P.O. Box 882
Spokane, WA 99210

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PRESIDENT'S MESSAGE

Submitted by: Jeffrey Johnson, WRHA President
[email protected]

It is February 2nd, and I am writing this message from Washington D.C. as I attend the annual National Rural Health Association Policy Institute meeting just a few blocks north of 1600 Pennsylvania Avenue. Ironically, it is Ground Hog’s day, today, and it seems like the message is the same as last year, well, the last few years, quite frankly. The only thing that would have made it better was if Bill Murray was the keynote speaker (he wasn’t for the record).

In all seriousness, there is a lot to think about and much work to be done to save rural health, as I listen and reflect on the speaker’s comments; the NRHA representatives, consultants, senators and congressional representatives. All of these speakers seem to be fighting for rural health, yet, yesterday, February 1, at 5 p.m., another rural hospital closed bringing the total up to 67 since 2010. I would like to believe that will be the last one this year, but I know it won’t be as hospitals, rural physicians and non-physician practitioners, and other providers continue to endure payment reductions by Medicare and Medicaid in rural America.

Rural hospitals make up nearly 30% of the acute care hospitals in the U.S., but receive less than 5% of the total Medicare payments. A recent study released by NRHA this week, indicates that nearly 1/3 (or 673) of additional rural hospitals are severely vulnerable and could close. A copy of the 2016 Rural Relevance Study is available for download at the following link:
http://info.ivantagehealth.com/2016-rural-relevance-study-request-0.

Washington rural hospitals are not exempt. Many of the items that have made hospitals vulnerable are related to payment cuts. CMS actually spends 2.5% less on rural beneficiaries than it does on urban beneficiaries. Yet, the cuts to rural providers continue. There is a solution but it will take legislation to fix this problem. Save Rural Hospitals Act (HR. 3225) is a bill that is in currently in congress and has gained momentum. This bill is not asking for more money. Instead, Save Rural Hospitals Act is simply asking to eliminate cuts such as sequestration, reversal of bad debt reimbursement, and Medicare and Medicaid disproportionate hospital payment reductions. In addition, the Bill seeks to reinstate sole community hospital “hold harmless” payments, extend Medicaid primary care payments, and permanently extend low-volume and Medicare dependent hospital payment levels, to name a few. Among other regulatory relief provisions, the Bill provides for an innovative delivery model solution that establishes a new Medicare payment model designation, the Community Outpatient Hospital (COH). Critical access hospitals and rural hospitals with 50 beds or less would be eligible for this designation. Based on a community needs assessment, COHs would provide medical services in addition to emergency and other post-acute services and, in return, would be paid 105% of reasonable cost. I encourage you to familiarize yourself with the Bill and contact your congressional representative and urge them to sign on to this important legislation.

In addition to representing Washingtonians at our Nation’s capitol, your WRHA board has had an active fall and winter season. One of our top priorities was to hire an Executive Director to help lead and execute on WRHA strategies and initiatives of understanding and promoting advocacy for rural health issues in Washington, promoting education, and providing support to improve delivery of health care in our rural communities. We are pleased to announce that we have hired Brianna Bobiak.

Brianna is a native of Washington State and is currently pursuing a Master Healthcare Administration degree at the University of Washington where she will graduate in June 2016. She has lived in both Eastern and Western Washington and has a passion for serving the underserved in rural areas. She hopes to continue to live in Washington for a long time to help rural communities become sustainable and successful. Her personal goals include; raising a family, small-scale farming, owning horses, and learning to be an expert fly fisher. We will formerly introduce her at the Annual meeting on March 16, 2016, along with our strategic plan for WRHA.

I wish to close by reminding everyone of the CAH and Northwest Rural Health Conference held in Spokane March 15-17, 2016. We are excited about partnering for the first time ever with the Rural Health Clinic Association of Washington during this event. If you have not already registered, please take time to do so. See you there!
Jeffrey M. Johnson, CPA
WRHA Board President

Washingtonians visited Washington D.C. at the annual National Rural Health Association Policy Institute February 1-4, 2016.
Pictured from left to right are: Dr. Keith Watson, President of Pacific Northwest University; Paul Babcock, Coulee Medical Center;
Rep. Cathy McMorris Rodgers; Jeff Johnson, Wipfli LLP; and Brian Gibbons, Sunnyside Community Hospital and Clinics. Not pictured, Geri Forbes, Whidbey General Hospital and Clinics.

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Hunting Accidents Leads to Critical Care Transport

Submitted by: Meagan Pierluissi
[email protected]

A gunshot wound to the foot by your dog may be one of the more surprising hunting stories someone could share. But for 41-year-old Hugo Mertens of Mesa, Wash. and his dog, Kimber, this is exactly what occurred while hunting with friends. "I've been out on the river duck hunting since I was a boy," Hugo says. "I put my gun down to reset the decoy, and my dog knocked [the gun] over. When it fell over, she stepped on the trigger and clocked me from five feet away." Hugo says he told his friends he'd been shot, and no one could believe it. Dressed in waders for hunting, Hugo was unable to fully assess how badly he was bleeding, but, he says, he could feel a massive amount of blood loss occurring. With minutes ticking by, his friends lifted him into the boat, called 911 and quickly got across the river to meet their local, volunteer first responder from Franklin County Fire District #1. Betsy, Hugo's wife, knew where he was hunting and arrived just before Northwest MedStar's critical care helicopter landed. "They were totally the nicest people," he says of the crew who worked to provide intravenous medications before lifting off. NW MedStar transported Hugo to a nearby hospital in Tri-Cities. After being assessed, Hugo was then loaded into a NW MedStar fixed-wing aircraft and flown more than 200 miles away to a Seattle medical center. While hospitalized, Hugo's foot was removed and he says, "I have nothing to complain about." The Mertens family was relieved to see their air medical transport bill for thousands cost them nothing because of their membership. "That was one huge weight we never have to worry about-ever," Hugo says of their NW MedStar membership . "We tried to be prepared for something like this- it's the cheapest assurance you'll ever buy." Fitted with a prosthetic foot, Hugo shares his story with a great sense of humor, urging everyone he sees to get a NW MedStar membership and follow safe hunting practices. Kimber, his dog, is preparing to go hunting with him again this year.

Find out more about NW MedStar's Membership Program here: https://www.nwmedstar.org/Membership

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St. Luke's Pharmacy Manager Receives Washington State Health System Pharmacist of the Year Award

Submitted by: Meagan Pierluissi
[email protected]

Pharmacy Manager Chris Greer at St. Luke's Rehabilitation Institute was awarded Washington State Health System Pharmacist of the Year by Washington State Pharmacy Association (WSPA). "Chris is an exemplary and effective leader," says Kim Ward, chief nurse executive at St. Luke's. "The award is a reflection of his passion and commitment to serving patients, teaching future pharmacists and helping others. His contributions to St. Luke's, our community and throughout the State of Washington are to be commended." Washington State Pharmacy Association annually honors the accomplishments of deserving pharmacy professionals. This award recognizes outstanding pharmacists and their service to the profession of pharmacy, specifically, hospital pharmacy. "I am very honored to receive this recognition from an organization that is so important to the profession of pharmacy in our state," says Greer. "It is evident to me that it would not be possible without the opportunity to be a part of our fantastic team of pharmacists, pharmacy technicians, nurses, therapists and medical staff here at St. Luke's." Learn more about St. Luke's at www.st-lukes.org.

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2016 Northwest Rural Health Conference

Submitted by: Pat Justice, Dept. of Health
[email protected]

I want to offer a bit of information about the 2016 Northwest Rural Health Conference on March 15-17 in Spokane at the Spokane Convention Center.

Registration is open, and the block of rooms at the Doubletree Hotel in Spokane will be held until February 15.

There are three big changes to the conference this year.

We are pleased that the Rural Health Clinic Association of WA has decided to combine their conference with our own.
We are also proud to offer the first Rural Emergency Medical Service (EMS) track at the conference.
Day one on Tuesday, March 15 has been totally redesigned. Critical Access Hospitals, Rural Health Clinics and Rural EMS will each have a track, with two offerings, so there will be six concurrent offerings. The day also has wonderful opening and closing plenaries where all attendees come together. Day 2-3 features the best abstracts pulled from a pool of over 65 submissions and more great plenaries.

Please register early and join the wonderful rural health community in our state and nearby states in March.

http://www.cm.wsu.edu/ehome/index.php?eventid=140949&

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LEGISLATIVE NEWS

Submitted by: Beionka Moore, Assoc. of WA Public Hospital Districts

Flexibility for WRHAP Critical Access Hospitals: House Bill 2450
House Health Care & Wellness Committee will hold a public hearing for House Bill 2450, which would give critical access hospitals taking part in a pilot program the ability to return to critical access status if they so choose when the pilot is complete. The pilot program will test a new payment and delivery model for Medicaid patients. There is currently a moratorium on Critical Access Hospitals under state law. This work, known as the Washington Rural Health Access Preservation (WRHAP) project, provides an opportunity for approximately a dozen of Washington’s smallest CAHs to model and test new delivery and payment innovations.

To encourage hospitals to participate and ensure stability in the local health delivery system, this new legislation will allow current CAHs the participate in the pilot program the option to return to their pre-pilot status at the conclusion of the pilot program. Similar guarantees were afforded under state law at the advent of Critical Access Hospital program.

Participate in the interstate medical licensure compact: Senate Bill 6228
Senate Health Care Committee will hold a public hearing for Senate Bill 6228. The bill seeks to have Washington State participate in a multi-state compact that would streamline physician licensure and make it easier for doctors to practice in multiple states. This would allow for better access to health care in our state, especially in border communities, and at a time when telemedicine — which allows providers to see patients virtually — becomes more prevalent. Additionally, physicians are more often getting recruited from across the country, making multi-state licensing a more common practice.

Unnecessary regulations of public hospital districts: Senate Bills 6021, 6037 and 6312
The Senate Government Operations & Security Committee held a public hearing regarding three bills that impose unnecessary restrictions on public hospital districts. These bills, would place unnecessary restrictions on public hospital districts.

Senate Bill 6021 would require that the existing affiliation between King County Public Hospital District No. 1 and University of Washington Medical Center be ratified by a vote of the people despite the fact that the agreement has been repeatedly upheld by the courts. The affiliation is already settled law, and the bill sets the precedent that affiliations of any sort might be subject to a popular vote making it difficult to build the collaborations necessary to meet patient needs.

Senate Bill 6037 would require a vote of the people for public hospital districts to enter into an affiliation in which a certain percentage of the district’s operations are contracted to another entity.

Senate Bill 6312 would require a vote of the people for public hospital districts to transfer “core legislative powers” to another agency, such as a partner hospital.

Extended stay recovery centers: Senate Bill 5453
Senate Bill 5453 proposes to allow ambulatory surgical facilities to add “recovery care centers” that would care for post-surgical patients for an extended 48 hours after surgery, in addition to the currently permitted time of 23 hours and 59 minutes.

While the bill is supposed to be aimed at serving patients for whom it is reasonable to expect an uncomplicated recovery but who need a little more time, it would instead vastly expand the types of procedures ambulatory surgical facilities may offer. A patient who needs a little more recovery time requires hours of post-surgical care, not days.

Almost three quarters of inpatient surgical stays in community hospitals are four days or less. This bill proposes to allow ambulatory surgical facilities to offer hospital-like lengths of stay without any of the corresponding hospital regulations. Ambulatory surgical facilities lack important state and federal regulations regarding quality and safety, including licensure standards and construction review.

Prescription Monitoring Program: House Bill 2730
The House Health Care & Wellness Committee will hold a public hearing on House Bill 2730, which expands access to the Prescription Monitoring Program (PMP) to all licensed providers who can prescribe legend drugs, and making it easier for providers within hospitals to access PMP data.
Prescription opioids are frequently subject to abuse, and the death rate from prescription opioid overdose in America has increased fourfold between 1999 and 2010. By 2014, opioids were killing 125 Americans per day. This bill seeks to enable more physicians to access the data to better inform them of their patients' prescription history. This bill seeks to enable more physicians to access the data to better inform them of their patients' prescription history.

Grants Training in Burien / Seattle, WA - February 16-17, 2016

The Washington State Criminal Justice Training Commission and Grant Writing USA will present a two-day grants workshop in Burien / Seattle, February 16-17, 2016. This training is for grant seekers across all disciplines. Attend this class and you'll learn how to find grants and write winning grant proposals. Beginning and experienced grant writers from city, county and state agencies as well as nonprofits, K-12, colleges and universities are encouraged to attend. Multi-enrollment discounts and discounts for Grant Writing USA returning alumni are available. Tuition payment is not required at the time of enrollment.
We are excited to offer Washington Rural Health Association members a special tuition rate of $425 which includes all class materials. Please use discount code "WASSN" to receive this $30 discount off full price at registration.   Seating is limited, online reservations are necessary.

Complete event details including learning objectives, class location, graduate testimonials and online registration are available here.

Contacts:
Kaelee DeLisle                                                                   Leanna Bidinger
Grant Writing USA                                                              WSCJTC
888.435.7281 toll free                                                          206.835.7307
[email protected]                                              [email protected]

More than 10,000 agencies across North America have turned to Grant Writing USA for grant writing and grant management training.