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Welcome to the May 2018 issue of the Washington Rural Health Association e-Newsletter. Inside this issue you will find news and information from the Executive Director 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.
Welcome to our latest WRHA e-newsletter, the third edition this year--- all of which we hope has helped to keep you informed on latest rural health care issues and available resources.
The Washington Rural Health Association’s Board has had a very active and productive first quarter. But before diving into that update, I first want to thank the conference planning committee for successful production of the 2018 NW Rural Health Conference--- a job well done!
Committee Co-Chairs are Dawn Bross, Rural Health Clinic Association of Washington and Krista Loney, Eastern Washington Area Health Education Center. Congratulations on such a successful, meaningful event and having record breaking attendance of over 480 participants. The Conference was very well organized, both logistically and in terms of its content (reports, panels, etc). On behalf of the Board and members of WRHA, thank you to committee chairs, committee members, conference support, registration management and the many organizations that contributed to this triumphant annual event. Conference evaluations are being reviewed and compiled, however feedback I’ve personally received, has reflected an overwhelming appreciation of the event.
As Executive Director, I’ve been involved in rural health issues for many years. I’m currently busy executing WRHA strategies and initiatives of understanding, while promoting advocacy and education for rural issues in Washington, and providing support to improve delivery of health care in our rural communities.
Although we continue to address rural health issues at a national level, we also continue to engage extensively at the state and local level. I am extremely passionate about sustainability and providing access to quality healthcare in rural communities. This has kept us engaged in state policy discussions on rural issues directly affecting the communities in which we reside. As an Association member, you have representation and I am proudly working on your behalf on the following committees: National Rural Health Association - Rural Health Congress, WA State Interprofessional Education Collaboration, Emergency Cardiac and Stroke Technical Advisory Committee, and WSAC Health Professional Loan Repayment Program Planning Committee.
The WRHA membership has experienced substantial growth in the past few months. We are working diligently at developing and maintaining a diverse membership that represents all rural Washingtonians. Membership has increased from 98 active profiles to 167. We have additional ways to grow, however this accomplishment is sizeable. The Association also obtained three new organizational sponsors. They all contribute to ensuring sustainability of WRHA and increased attention on rural Washington. WRHA is continuing to build a strong social media presence. We are very active on LinkedIn, Facebook, and Twitter. Our social media presence is crucial to involvement in rural conversations and making connections. This allows for increased awareness of rural health issues, relationship building and driving new membership/sponsorship growth.
Another area of focus is convening a statewide listening session with local rural healthcare leaders. We intend to be proactive on rural issues by holding this forum. Our hope is to generate an active, informed interest in rural health care issues at the local, state, and regional level that will lead to transformed, sustainable rural health delivery system. Special focus would be on identifying the current and future needs of rural Washingtonians. The Federal Reserve Bank of San Francisco has agreed to collaborate with WRHA on this event and is heavily involved in planning. We are currently considering scheduling this event in July or August 2018.
Thank you for taking time to read the WRHA e-Newsletter; I hope you found something helpful and informative. All of us at the Washington Rural Health Association welcome your feedback and urge you to contact us if you need more information. Without such dialog between the Association and its external constituencies, we cannot succeed at collaboratively strengthening and improving the health of rural communities.
Finally, please let us know of your interest in helping to make WRHA a thriving organization for the advocacy of rural healthcare in Washington. I’m excited about the progression and revitalization of the WRHA and what’s to come! Please join me and visit the Committees’ page of our website at www.waruralhealth.org/committees if you are interested in serving in some capacity.
With each publication, we would like to introduce a member of the WRHA Board of Directors. This edition features the Board of Directors Member, Shane McGuire:
Q: Please tell me your name, where you work, title, your role with WRHA and how long you have been a board member? A: Shane A. McGuire, CEO; Columbia County Health System. I am a newly elected board member.
Q: How did you first become involved with the Washington Rural Health Association? A: We are a critical access hospital and public hospital district serving a rural population of 5800 people. As an organization, we have always been a member of WRHA.
Q: There are several rural health organizations in Washington State. Why did you choose to work with WRHA? A: There are several organizations supporting rural healthcare and I actually participate with more than one. I recognize that WRHA has a growing membership and is a well-recognized voice in the industry.
Q: Why is Rural Health important to you? A: I believe that health outcomes shouldn’t be weighted by where you live. People in rural areas should have access to quality, responsive care and outcomes should be on par with our metropolitan counterparts. Our community produces wheat, barley, legumes, and more recently pulp product all of which are shipped across the nation and world. We serve a community that feeds a greater population, and it is our job to keep this population healthy!
Q: What has surprised you most about working with Washington Rural Health Association? A: Both the passion and tenacity exhibited by members; literally in the face of numerous, National hospital closures and during a period of great uncertainty, stands this group of leaders working and fighting to transform, survive, and continue serving their communities’.
Q: What is the best part of working with WRHA? A: Getting to learn from some of the most respected hospital and healthcare leaders in the State. The combined years of service included in the membership is astounding.
Q: What do you see as some of the most challenging issues facing WRHA and Rural Health in our state? A: The National trend of hospital closures combined with the rapid rate of industry consolidation.
Q: What do you wish other people knew about Washington Rural Health Association? A: I wish rural Washington community members fully understood how much work is done legislatively by WRHA in part to ensure the longevity of our most vulnerable healthcare systems.
Q: If you could change one thing about Washington Rural Health Association what would it be? A: Differentiate and distinguish it from other associations. There are likely people that feel like they already belong to a rural health association and that WRHA is redundant.
Q: Do you volunteer for any other organizations? Why do you feel it is important to volunteer? A: There were many people before me that plowed tough paths and sacrificed time and effort to which I am a benefactor of. I need to do what I can to continue that mission for the generations coming after me.
Q: How do you like to spend your time outside of work and volunteering? A: I’m pursuing a healthcare informatics degree currently and that takes up much of my spare time.
Q: What might (someone) be surprised to know about you? A: I have a Class A Commercial Drivers License and drove truck for my family’s business for a number of years.
Q: What do you think will change about Washington Rural Health Association over the next five years? A: The brand will be strengthened and refined. There will be membership challenges stemming from industry consolidation and potential health system failures or reorganizations, and these events will make our reliance on WRHA more significant.
WhidbeyHealth Medical Center had zero device related infections from urinary catheters, central lines and ventilators for the past three years. Our nurses are diligent about using proper technique with the care of these devices from insertion to discontinuation and every aspect in between and it shows. According to the Center for Disease Control (CDC), one in 25 hospitalized patients will get an infection as a result of the care they receive. An estimated 75,000 patients will die each year. Healthcare Acquired Infections (HAIs) are a threat to patient safety. Many hospitals and healthcare facilities have made the prevention and reduction of these infections a top priority. The most common infections include Catheter-Associated Urinary Tract Infections (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), and Ventilator Associated Events (VAE). Nurses are critical in keeping the patient safe from these device associated infections. Infection rates are difficult to compare as not all hospitals are the same and not all hospitals submit data to the CDC for comparison. Of those that do, the CDC shows the following rates. We are very proud to have a rate of zero since April of 2015!
The Area Health Education Center of Western Washington (AHECWW) is committed to distributing Mental Health First Aid training more broadly in the rural western Washington region. As part of that mission, AHECWW is excited to offer the opportunity for more health professionals to become instructors and increase the number of trainings available in rural areas. Health professionals are invited to apply for participation in the instructor training to take place June 6-8, 2018, at Highline College's Des Moines campus, near Seattle. Mental Health First Aid is included on Substance Abuse and Mental Health Services Administration's (SAMHSA) National Registry of Evidence Based Programs and Practices. Studies show that training in Mental Health First Aid builds confidence in helping an individual experiencing a mental health challenge, reduces negative or distancing attitudes towards individuals with mental illnesses, and increases mental health literacy; being able to identify, understand and respond to signs of mental illnesses and substance use disorders. Becoming a Mental Health First Aid instructor is a rewarding opportunity that requires a serious commitment of time, energy and creativity. Certified instructors are required to have prior experience teaching groups of adults and facilitating groups. Instructors must have knowledge of mental health and substance use issues and an understanding of the Mental Health First Aid program. Successful candidates demonstrate they have the skills to plan, publicize, and facilitate classes, as well as engage partners and find additional resources to support the program. For more information and to apply for the Instructor Certification class, go to ahecww.org/instructor-certification-for-mental-health-first-aid or e-mail [email protected].
Programs and services help prevent illness and injury, promote healthy places to live and work, provide information to help people make good health decisions and ensure our state is prepared for emergencies. To accomplish all of these, we collaborate with many partners every day. We help ensure a safer and healthier Washington by:
Working to improve health through disease and injury prevention, immunization, and newborn screening
Providing health and safety information, education and training so people can make healthy choices
Promoting a health and wellness system where we live, learn, work, play and worship
Addressing environmental health hazards associated with drinking water, food, air quality and pesticide exposure
Protecting you and your family by licensing healthcare professionals, investigating disease outbreaks and preparing for emergencies
Rural Health The Rural Health Washington State Office of Community Health Systems, Rural Health section, supports health systems planning and development in Washington’s rural and underserved communities to improve health and healthcare across the life span.
Pullman Regional Hospital, Pullman Tri-State Memorial Hospital, Clarkston
WELCOME NEW INDIVIDUAL MEMBERS
Alex Knoll, Ability App Nick Leute, Columbia Medical Associates Alan Davis, Proteus Consulting, Spokane Ron Wallin, Commissioner WhidbeyHealth, Whidbey Island Dr. Tobe Howard Harberd, Chelan
Sidney Ritter's life changed at just 18 years old as she headed home with her best friend to Spokane during holiday break at Washington State University. On this drive home the pair were involved in a tragic car accident, one that took the life of Sidney's friend on impact. Sidney was badly injured and taken by air transport to Providence Sacred Heart Medical Center. The accident left Sidney with a traumatic brain injury (TBI) and several injuries to her body. She spent 10 days in Sacred Heart's ICU, where surgery to fix a broken arm left Sidney with a steel plate from her shoulder to her elbow and 16 screws. As soon as she was able, Sidney began her rehabilitation journey with the help of therapists from St. Luke's Rehabilitation Institute, embedded as part of the Sacred Heart hospital care team. Sidney needed to relearn to walk, talk and even recognize her family again.
"When I got to St. Luke's my eyes weren't open," she says. "I couldn't walk yet, and I was in a wheelchair. I was stable enough that St. Luke's Traumatic Brain Injury unit could take me from Sacred Heart." Sidney spent 22 days at St. Luke's, the region's only Level I trauma rehabilitation hospital. She worked with a team of providers dedicated to rehabilitation - a physiatrist, psychologist and therapists ranging from physical, occupational, recreational and speech-language pathology. "I can remember meeting her within the first few hours of coming to St. Luke's," says Paul Tippetts, doctorate of physical therapy at St. Luke's. "She had a difficult time holding up her head and controlling her body posture. Her mind was going a mile a minute, yet she was pretty tired and fatigue; however, you could tell she was in there cognitively." "Sidney had to relearn how to eat, drink and swallow because she ended up needing a feeding tube for nutrition because she was unconscious so long," says Sidney's mother, Stacy Ritter. "The nutritionist and chef were great at making a menu available that she would like and regain her strength on. The nursing assistants were the consistent, compassionate ones who showed her care above what a job description states. They French braided her hair daily and rubbed her temples in the middle of the night when a migraine wouldn't subside.
Sidney says her experience with TBI was the reality that she knew she had this injury and knew the obstacles she was working to overcome like walking, talking and remembering daily functions, but she didn't understand why she couldn't do these things. "The therapists and the people who work in TBI--and probably all of St. Luke's-- don't make you feel like you're broken and needing therapy," Sidney says of her time in rehabilitation. "St. Luke's understands TBI and what the patient is working through, and gives them respect and care that we were so thankful for." After being discharged as an inpatient, Sidney continued speech and physical therapy in St. Luke's outpatient program for more than six months. Her goal: returning to WSU. "I've worked really hard and was able to return to WSU part-time in the fall of 2016, about nine months after my accident," she says. "I've got big goals." Sidney says she has dreams of majoring in microbiology and is working toward that goal. Today, Sidney experiences frequent migraines, short-term memory loss and her speech is slower than before, but, she says, she's working on that in therapy. Learn more about St. Luke's Brain Injury Program by visiting: st-lukes.org/programs-services/brain-injury-program/
SEATTLE - (April 23, 2018) - Virginia Mason Medical Center, a national leader in health care quality, safety and innovation, has started an affiliated consulting group that helps hospitals, particularly those serving rural communities, address challenges and assess opportunities in several critical areas, including C-suite staffing. Called NetworxHealth, its services include skilled guidance for boards of directors during transitions in C-level positions (e.g., chief executive officer, chief financial officer, chief nurse officer and chief operating officer). "We provide executive and management placement and consulting services for any hospital or medical center in the nation, and we have a special focus on rural and community hospitals," said Noel Rea, MBA, senior director and hospital administrator. "Rural providers have a unique role in the fabric of their communities as they serve their friends, families and neighbors. Small hospitals often are the cornerstone for the entire health delivery system in their communities. It is important to keep them vibrant, successful and independent."
NetworxHealth consultancy services also encompass management expertise in pharmacy operations, continuing medical education, financial management, supply chain efficiency, laboratory operations, group purchasing, facilities and construction project management. "We guide our clients in evaluating challenges and opportunities, and in developing locally-driven solutions and strategies that are right for their organizational goals, patients and communities," said Tammara Gibbons, Executive Director. "Our ultimate goal is to help health care organizations excel."
NetworxHealth experts are experienced health care professionals who are either working in their specialties or recently retired from successful careers. These experts, some of whom are or have been affiliated with Virginia Mason Medical Center, are available for interim and longer-term assignments as needed by their customers. "NetworxHealth is our response to independent and rural hospitals requesting support over the years," said Ken Freeman, President, Virginia Mason Health Resource Services. "We consistently hear from organizations that want a partner that understands their perspective and will be supportive of their particular needs while maintaining local control. Our team has the expertise and focus to make this happen."
Because NetworxHealth, LLC, is a wholly-owned for-profit affiliate of Virginia Mason Medical Center, its work reflects the commitment to excellence for which the medical center is known. In February, Virginia Mason was named one of the 50 best hospitals in the United States for the second straight year by Healthgrades, an online consumer resource for comprehensive information about hospitals and physicians. For more information about NetworxHealth and its services, call (206) 384-2938 or email [email protected]
The Washington Rural Health Association has been invited to participate in the e-National Institutes of Health's All of Us Research Program. We are excited to take part in this important initiative. e-National Institutes of Health's All of Us Research Program is an ambitious effort to gather data from one million or more people living in the United States to accelerate research. The program will be open to people both healthy and sick, from all communities. Unlike a single research study focused on a specific disease or population, All of Us will serve as a national resource for thousands of studies, covering a wide variety of health conditions.
All of Us is launching nationally on May 6, 2018 and Pasco is proud to be one of the launch event sites. There is an exciting program planned for the launch activities, including a half day Health and Wellness Fair. The fair will feature an interactive 'All of Us' informational booth, free health screenings, family friendly activities, and other community resources representing organizations from throughout the community. Please stop by, join us for activities and visit the WRHA booth. Say hello and learn how you can become more involved!Click on link for additional details. PRESS RELEASE.
Washington State Hospital Association is in the news: Modern Healthcare
Washington State Hospital Association was recently featured in an article in Modern Healthcare! Initiative launched in 2012 to help hospitals share information with one another — initially to create a standard set of practices to lower the frequency of unnecessary visits — has served as the basis for other programs across the country. Many of these programs have been specifically targeted at addressing health care's role in the opioid epidemic. WSHA is thankful that the work has proven helpful for communities across the country, as we all strive for better health. Read the article.
UW School of Nursing seeking rural clinical training partners
Are there providers in your organization (ARNP, MD, DO or PAs) who might be interested in precepting our advanced practice nursing students or who might be interested in learning more as they consider becoming a preceptor? There are several specialty foci in the UW DNP program including Adult Acute and Primary Care NP, Family NP, Pediatric Acute and Primary Care NP, Nurse Midwifery and Psychiatric/Mental Health NP. Our students have previous nursing experience in a variety of settings.
Students need precepted clinical experiences on a quarterly basis as part of their education. Students in the program spend four quarters in clinical placements, and one to three days per week each quarter, depending on the track and stage of their education.
The benefits to your organization can include an improved clinical experience for your patients, staff enrichment, the potential for APRN recruitment and affiliation with the highly regarded program at the University of Washington. The School of Nursing is committed to helping our advanced practice students understand the health care needs and issues in rural and medically underserved settings and make a contribution to your community. If this is an opportunity you would like to discuss further contact: Tish Parmenter BSN, MS, RN, Outreach Coordinator, Advanced Nursing Education Workforce/HRSA grant, UW School of Nursing (206) 685-9309, [email protected].
Grant Available
In support of Empire Health Foundation’s vision to transform Eastern Washington into the state’s healthiest region, Empire Health Foundation is holding an annual open request for proposals, which is called Responsive Grant Program. This program is designed to address one-time, emergent needs within our service area. Responsive Grant Program also includes a Rural Aging track for projects serving seniors living outside of Spokane County. Any nonprofit serving our region can apply for up to $15,000. Contact Information: Jeri Rathbun or Christina Kamkosi Link to website: empirehealthgrants.fluidreview.com
Employment Opportunity
Washington State Department of Health as an opening for a full-time project Health Services Consultant 4 (HSC 4), Rural Behavioral Health Consultant, in the Division of Health Systems Quality Assurance, Office of Community Health Systems. They are seeking skilled facilitator and writer to lead this important project. **Note: The Rural Behavioral Health Project and this position are currently funded through December 31, 2020. Announcement Link
Saying Farewell to Two Exceptional Health Care Leaders
Chewelah resident Gary Vaughn Peck passed away in an auto accident on April 19, 2018, four miles south of Colville. Peck was 71 and was heavily involved as the chief administrator of St. Joseph's Hospital before retiring. According to a report from the Washington State Patrol, the 2010 Subaru he was driving northbound on Highway 395 left the roadway, rolled over and landed in a creek.
Mr. Peck was a humble servant of the community with a combined 40 remarkable, challenging, and sanctifying years in hospital administration. Mr. Peck worked at Deaconess Hospital for over 20 years in administration. After his time at Deaconess, he was fortunate with an opportunity to serve in the town where he was born and raised as Chief Executive Officer (CEO) for St. Joseph’s Hospital in Chewelah. It was there that he retired after serving his community for another 20 years. There are no words to adequately describe the energy and sheer force that Gary Peck brought to every organizing effort. For decades, many of us have known that if Mr. Peck was on it, it was going to get done. Follow this link to view article in Spokesman-Review.
Also, on April 23, 2018, Lake Chelan Community Hospital & Clinics - Commissioner, Judge Tom Warren passed away at the age of 77. Tom was a tireless advocate for community health and a champion of efforts to build a new hospital in Chelan. Tom was also a member of the WSHA Rural Hospital Committee, and in 2016 he chaired the WSHA Effective Governance Task Force, which underscored the importance of good governance and identified core competencies for hospital board governance. Judge Warren retired in 2007 after more than 20 years on the bench. He was a member of Lake Chelan Rotary, and was formerly in the Wenatchee Lions Club. Judge Warren is survived by his wife Mary Ann Warren and two daughters, Amanda Froh and Katy Warren and close family friend, Deyanira Jorda Nolan.
All of us at Washington Rural Health Association extend our deepest sympathies to both families. We are heartbroken and they will be missed tremendously.
Rural opioid crisis response falls to health officials, police
Over the last decade, methamphetamine and opioid abuse in rural areas has compounded into the crisis seen today. “Honestly, most people thought heroin was a city thing,” says NRHA Board Secretary Pat Schou of the Illinois Critical Access Hospital Network, an NRHA member. “But we quickly learned that wasn’t the case. It affects everyone.” It’s had a profound effect on law enforcement and the medical community. “The type of inmates we have now is totally different, I think, from the inmates we had in the 70s,” says Christian County, Ill., Sheriff Bruce Kettelkamp. “It’s because of the mental health problems they have and the severe drug abuse problems. I think I can safely say 90 percent of the people we have are in here because of drug abuse or alcohol.” Explore rural-specific solutions to the opioid epidemic.
Kinley is a patient at the Spokane Shriner's Hospital. Like many little girls, she is a 'mommy' to her doll. Kinley's doll, Shannon (yes, we checked the spelling), happens to have exactly the same condition and story as her 'mommy'. So, yes, this is a story about a doll. 'Shannon' met with William Bronson, M.D., a pediatric orthopaedic specialist at the Spokane Shriners Hospital, because of a severe spinal curvature. Dr. Bronson wanted to try bracing to straighten the curve before looking at surgical options. So it was that the young, uh, doll was walked out of her clinic room and down the hall to the Oorthotics and Prosthetics Manager Peter Springs, who custom fit her with a specialized brace. To make the doll feel better, Peter also made a brace for Kinley so they could match! In the end, the bracing was a resounding success, reducing the curve from 42 to 19 degrees! You could tell right away that Kinley truly, genuinely loved the doll. She was so shy and quiet, we wanted to do something to make her more comfortable and help her to open up. Kinley's mom suggested we create a brace for Kinley's doll to match, which seemed like a great idea to me! She seemed to really warm up after that! Things like that are why it's so great working with kids. Kinleys mom, Amber went to Facebook with her thanks, commenting on a post that displayed her, Kinley and Shannon in a multi-generational photo. "Thank you for taking such good care of my baby and making her feel special today," wrote Amber. We assume she was referring to Kinley, who, as we mentioned, has a suspiciously similar story.
Working exclusively in the Health Insurance Portability and Accountability Act (HIPAA) Security Rule realm over the past five years has taught us that each Covered Entity approaches their security program differently. We have mentally cataloged the most common attributes in an effort to better understand how the medical community manages programmatic risk and compliance, and to positively shape our conversations as we work with rural hospitals and clinics.
These three categories are purposely broad and some organizations may fall in between:
the team prioritizes protecting protected health information (PHI) by resourcing a program with the proper people and tools to reduce the risk of an unauthorized disclosure event (i.e. PHI spillage). This organization sets milestones and establishes basic metrics to provide feedback to the program’s investment. They realize that compliance and security are not an end-state but are established and regularly maintained.
the organization is aware of HIPAA and has a broad responsibility compliancy officer assigned to oversee related (e.g. CMS reimbursement program, etc.) reporting. There may or may not be a formally designated HIPAA Security Officer and this person is most likely the information technology manager who has not completed position-commensurate HIPAA training. The team works within their limits and believes that they are mostly meeting the federal regulations’ spirit.
the decision makers are aware of HIPAA but focus their staff on providing clinical care. They may or may not report improper or unauthorized disclosure events to the Office of Civil Rights. Some individual team members are concerned that the failure to mature a compliance program will eventually impact the organization but continue their tenure because of the small number of area medical employers.
We realize that prioritizing HIPAA may be a difficult for some compliance officers and the categories presented above may appear blunt and oversimplified. Instead, the challenges of regulatory compliance are overt and require effort to demonstrate a reasonable and appropriate program. Protecting PHI is integral to modern patient care and to a rural health community’s reputation. Realizing how HIPAA is administered and acknowledging limitations, whether they be fiscal- or employee expertise-based, can frame a healthy discussion and provide productive direction that improves patient outcomes, decreases operational risk, and protects the limited financial space most rural healthcare organizations operate under.
By now, most consumers know a cyber breach could expose sensitive, protected or confidential data, including an individual’s name, a Social Security number, medical records or financial information. To maintain consumer trust, it’s imperative that organizations make protecting personal information an organizational priority. Particularly in today’s hyper competitive environment, consumers have many options, and failing to protect personal information is often enough incentive for them to take their business elsewhere.
In addition to lost business, healthcare entities face unique and additional risks from a cyber-attack. Medical records have a high value on the black market. With the average cost of a cyber-attack being about $380 per healthcare record, compared to only $141 per record in other industries1, hospitals and healthcare practices are very appealing to criminals. Given the high black-market value of the records, it should come as little surprise to learn that healthcare cyber-attacks increased 81 percent2 in 2016-2017, affecting four out of five physicians3. At the same time, ransomware attacks increased 4-fold on healthcare entities between 2014-20164.
Since no IT system is “bullet proof” and criminals are always evolving their attack strategy, it’s almost impossible to think of every preventative measure. In addition to evaluating IT systems and breach response protocols, health system Boards and C-suite executives should evaluate insurance coverage to obtain appropriate help in the event of a breach, both to cover the costs and the potential reputation consequences. For example, Beazley (Underwrites professional and management liability insurance) has an in-house unit dedicated to collaborating with insureds throughout the investigation of cyber and ransomware attacks, providing guidance and arranging breach investigation and response services5. A trusted insurance professional can help you identify the many types of breaches that can happen and write policies that cover them.
For example, while 47 percent of breaches are the result of malicious attacks6 and 28 percent are the result of health system glitches or accidents7 and another 25 percent come from internal employees or contractors8. In some policies, not all of these breaches are covered, especially if the policy has exclusions for intentional acts, in-house products, or “insured vs. insured” (exclude possible collusion between insured parties such as one executive suing another). All of these oversights can add to an already hefty price tag for a healthcare cyber-attack, which tends to cost an average of about $3.62 million per attack9, before factoring in potential fines for violations of the Health Information Portability and Accountability Act (HIPAA), litigation costs, IT forensics/upgrades and credit monitoring costs.
When most healthcare leaders think of a cyber risk, top of mind is the electronic health record (EHR), radiology or pharmacy systems. But equally important are the devices that gather data on a patient, and any means in which caregivers access the data using smartphones, tablets and mobile applications. Medical devices are also at risk for an attack, as they may not always have up-to-date software patches or written security protocols. Devices such as bedside monitoring equipment, pacemakers and insulin pumps are vulnerable, as attackers or patients may be able to alter those devices so they do not work when signaled or give non-prescribed doses.
Unless a healthcare facility or medical practice buys a separate cyber insurance, policy there is a good chance that they are either under-insured or have no real coverage. Some insurance policies add a small amount of cyber coverage, but these limits often won’t pay the printing costs of notifying the government and thousands of patients about a breach or an attack.
Since health systems cannot prevent every type of cyber event, it is imperative to discuss this issue separately with an insurance professional to make sure appropriately coverage is in place, and that the policy writer has experience managing these events in the best interests of patients. References
The Washington Rural Health Association elected new Board members at the annual membership meeting held on March 27. Join us in congratulating them and expressing gratitude for their willingness to serve. It’s an honor to welcome this esteemed group of individuals to the associations board of directors. The following individuals have been nominated, selected, and have agreed to serve a three-year term; Geri Forbes, CEO, WhidbeyHealth; Shane McGuire, CEO, Columbia County Health System; Jeannie M. Eylar, Chief Clinical Officer, Pullman Regional Hospital and finally, Nick Leute, Columbia Medical Associates, Director of Performance Improvement, Risk Management & Corporate Compliance. We look forward to their input and infusion of new ideas and concepts for the betterment of the WRHA and its members, as well as for a long healthy working association with us.
The complete list of board members and officers follows:
Elected Officers Beionka Moore – Executive Director Sandy Brecker – President, Account Executive, Premier Insurance Management Services (PIMS) – a subsidiary of Premier, Inc. Weston Davis – Immediate President, Executive Director - Rural Health, Inland Imaging, Spokane Teresa Gall – Treasurer, Controller, Tri-State Memorial Hospital, Clarkston Secretary -Vacant
Board Members Jeffrey Sund, Senior Account Manager, Nuvodia IT Solutions, Spokane Rebecca Snyders, Communications Principal Tonya Vallance, Director of Services, Douglas-Okanogan County Fire District #15, Brewster Jeffrey M. Johnson - Ex officio - Partner, WipFli LLP, Spokane
NRHA State Association Council Representatives Beionka Moore, Executive Director - Washington Rural Health Association Sandy Brecker, President - Premier Insurance Management Services (PIMS) Weston Davis, Immediate Past President - Inland Imagining
WRHA State Office of Rural Health Representatives Beionka Moore, Executive Director - Washington Rural Health Association Sandy Brecker, President - Premier Insurance Management Services (PIMS)
Northwest Rural Health Conference Planning Committee Members Beionka Moore, Washington Rural Health Association Tonya Vallance, Director of Services, Douglas-Okanogan County Fire District #15, Brewster Weston Davis, Inland Imaging, Spokane
Board Terms Expired Kim Kelley, Stroke Program Coordinator, Rural Health Section, Community Health Systems, DOH Wayne Walker, General Manager, Lifeline Ambulance, Inc. Keith Watson, President, Pacific Northwest University
The WRHA extends our sincerest gratitude to former board members for their dedication and service through-out the years! We are not saying goodbye as we know you will be involved in some capacity!
The Washington Rural Health Association is a 501(c)(3) not-for-profit organization supported by individual donors, corporations, foundations, and government grants. Donations to the WRHA go an extremely long way. Donations go directly towards helping us improve healthcare for our rural communities across the State.
Join your voice with other WRHA supporters. There are many ways to contribute: by going to our website and click on the Donate Now link, or to our Facebook page and click on the blue donate button at the top of the page. And don't forget to select WRHA as your charity of choice on Amazon Smile.
Shop HERE and Amazon will donate to Washington Rural Health Association.
DOMAIN NAME CHANGE In efforts to reestablish a presence on the internet we’ve changed the WRHA domain name from www.wrha.com to www.waruralhealth.org. To ensure you receive future emails, please add www.waruralhealth.org to your address book or safe sender list.
2018 WRHA Rural Health Awards
Each year Washington Rural Health Association honors outstanding individuals and organizations in the field of rural health who have dedicated their time and talents to improving the health and well-being of others during the year. The following are awards distributed by the Washington Rural Health Association to deserving members.
Annual awards ceremony takes place in conjunction with the Northwest Rural Health Conference. Awards were presented by association executive director, Beionka Moore. Unlike previous years WRHA received several nominations in all five categories. The following individuals were nominated, selected and were presented with an award this year:
OUTSTANDING CONTRIBUTION TO RURAL HEALTH Ron Wallin, Board Chair, WhidbeyHealth – Pictured with Geri Forbes, CEO, WhidbeyHealth
FUTURE OF RURAL HEALTH AWARD Kyrk Taylor, Washington State University, Master’s Degree in Health Policy and Administration.
LEAH LAYNE MEMORIAL HEALTH LEADERSHIP Susan M. Skillman, Deputy Director, Center for Health Workforce Studies, Associate Director, WWAMI Area Health Education Center (AHEC), Investigator, WWAMI Rural Health Research Center - University of Washington
DR. JOHN ANDERSON MEMORIAL AWARD FOR OUTSTANDING RURAL HEALTH PRACTITIONER Dr. Tobe Howard Harberd, Rural Physician in Chelan
MARY SELECKY FRIEND OF RURAL HEALTH Tammy A. Arndt, Director, Northwest TeleHealth, Inland Northwest Health Services – Pictured with former Secretary of Health Mary Selecky
Congratulations to 2018 WRHA Rural Health Award Recipients! It is the Washington Rural Health Association's immeasurable delight to celebrate and acknowledge the efforts of these focused rural health champions. Click here to view acceptance video - YouTube Channel
I have served on the board since 2015 and now as the newly elected president of which I am honored to fulfill, I have been thinking about the message I want to deliver. In a time where we see a lot of negativity all around us it is easy to get caught up in the mess. When I think about the Washington Rural Health Association, the word that comes to mind is positivity.
WRHA is an organization of individuals coming together for the collective good of rural Washington. We have grown in a positive direction hiring an Executive Director that has given a stronger voice in the legislative arena, increased our membership because the value of our organization is recognizable and helped to elevate the content, speakers and location of this years’ Northwest Rural Health Conference. In addition, we have several new members on the board representing more geographically diverse areas that will bring expertise and fresh ideas for the future direction of the WRHA.
In my career, I have been fortunate enough to get to know many of you in your communities and to hear to the challenges you face on a daily basis. Despite lack of funds or resources you hold your heads high and greet each new day with the will to keep doing what is right. CEO’s and CFO’s finding ways to keep doors open, physicians staying in rural areas to serve that population, clinics helping the needy, mobile outreach and dental services, risk managers prioritizing patient safety and first responders getting to those people in time. You are heroes because you choose to serve the people in areas where environmental and financial situations can be challenging.
I certainly am no hero, but I wanted to join the WRHA to help the true heroes, to be a part of making a difference no matter how small. I believe very strongly you can only affect change if you are a part of it. The WRHA is that positive change that continues to gain momentum and I am proud to be a part of this organization.
Caring Through Sharing: One PNWU Student's Plan to Improve Healthcare Across Rural America
Submitted by: Paul Bubluski, Marketing Coordinator Pacific Northwest University of Health Sciences [email protected]
(Yakima, WA) According to the National Institute of Health (NIH), pain affects more Americans than diabetes, heart disease and cancer combined, and stands as the most commonly cited reason for people accessing the health care system each year. The NIH also states that one in every four Americans suffers from chronic pain. It is the most common cause of long-term disability, and treatment with opioids is often viewed as one of the major contributing factors to our nation’s ongoing opioid epidemic.
As many of the factors associated with chronic pain, including obesity rates and average age, continue to rise, Americans are faced with a mounting public health issue that is expected to get worse. The devastating effects of chronic pain are visible across the United States, and especially apparent in rural communities. In places like Lincoln County, Idaho, the toll that chronic pain is having on the population is painfully obvious and explicitly crushing.
Despite its size — approximately equivalent to the entire state of Rhode Island — the expansive landscape of Lincoln County is home to only around 5,300 people, most of whom work in the farm industry. The labor-intensive and often dangerous demands of farming are complicated by our nation’s overwhelming need for health professionals in rural communities. Only about 10% of all physicians practice in rural areas despite the fact that about 20% of Americans live in those areas. This trend has played a major role in making Lincoln County -- where there is only one medical clinic -- statistically unhealthier than nearly every other community across the state of Idaho.
Third-year Pacific Northwest University osteopathic medical student Jacob Thatcher has witnessed the devastation first-hand. Six generations of Thatcher’s family have farmed the fertile lands of Idaho, and he has seen the price they’ve often paid for their hard work and dedication.
“My grandpa recounts stories of summers spent working on his cab-less tractor as young as 10 years old,” said Thatcher. “He often said, “The best equipment a man can put on his land is his shadow.”
Thatcher’s family tamed the land, where there was no such thing as a “sick day,” and pain and fatigue were part of the sacrifice to put food on the table. While today’s generation has it a bit easier — with cabbed-tractors, air-conditioning and even GPS — proof of the attrition of life on a farm is not hard to find.
“Over 60 years of hard work have taken a toll on my grandpa,” said Thatcher. “Initially, the opioids controlled my grandpa's pain enough to continue farming, but soon, it was his dependency on them that would prevent him from continuing our family tradition.”
In his first year at Pacific Northwest University of Health Sciences’ College of Osteopathic Medicine, Thatcher plunged into the pathophysiology of dopamine. As he did, his grandfather slid deeper into opioid dependency and, for the first time in six generations, everything the Thatcher family had worked for was at risk of being lost.
The family helped his grandfather to countless medical appointments, including Osteopathic Manipulative Therapy (OMT), to combat his pain, but it soon became apparent that his inability to control the pain, coupled with his hesitancy to talk about his opioid abuse, were a problem facing not only the Thatcher’s, but countless farmers throughout the region.
Determined to do something for his family and his community, Thatcher applied for, and was chosen to be a Paul Ambrose Scholar.
The Paul Ambrose Scholars Program is a cohort of students from health professional programs throughout the country with an interest in public health. Scholars arrange and complete projects which aim to achieve the goals of Healthy People 2020, the federal government's prevention agenda for building a healthier nation. Thatcher set his projects crosshairs on substance abuse.
In conjunction with the Shoshone Family Medical Center and Hazelden Betty Ford, and thanks to a grant from the Health Resources and Services Administration, the program has provided the tools to begin exploring options to improve the lives of the people in rural communities like Lincoln County. A micro-research RuralPREP grant through the University of Washington and Ohio Heritage University is helping to provide the funds necessary for the program to be successful.
“Shoshone Family Medical Center is the only clinic in the county," Thatcher explained. "Despite the challenges of running a private clinic in an underserved area, Dr. Davis has provided incredible care for his community for over 30 years. This progressive environment, coupled with provider retention issues, reimbursement cuts and an opioid epidemic, created the perfect arena to test the efficacy of Shared-Medical Appointments (SMAs) in Chronic Pain.”
Thatcher has started hosting bi-monthly SMAs to evaluate the effectiveness of treating patients with chronic pain. The appointments, which offer an innovative, interactive model to healthcare by bringing patients with common needs together with one or more health care providers, have been largely untapped in regards to treating chronic pain, explained Thatcher.
According to a meta-analysis published in the Journal of Osteopathic Medicine, S.M.A.s have been shown to be more effective than the traditional office visit at not only motivating patients, but reducing hospital admissions and emergency department visits, which is particularly crucial in rural health care settings where resources are limited, practitioners are overburdened and more health care professionals are desperately needed.
“We believe our osteopathic approach and collaboration with Hazelden Betty Ford and the Chronic Pain Association will truly benefit these patients in Shoshone and, perhaps, serve as a pilot program for other rural medical clinics around the country to mirror and adopt,” said Thatcher.
Today, Thatcher’s grandpa is improving. Though his pain is still debilitating, he has discovered alternative ways to control it. This month he will drill wheat for the 70th time.
“I believe his principle method of recovery has been connecting with another farmer with similar issues,” said Thatcher. “If all goes well, my grandpa will be farming the soil of Idaho for many years to come.
Photo Info:Jacob Thatcher, Pacific Northwest University osteopathic medical student
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The Washington Rural Health Association’s Board has had a very active and productive first quarter. But before diving into that update, I first want to thank the conference planning committee for successful production of the 2018 NW Rural Health Conference--- a job well done!
Another area of focus is convening a statewide listening session with local rural healthcare leaders. We intend to be proactive on rural issues by holding this forum. Our hope is to generate an active, informed interest in rural health care issues at the local, state, and regional level that will lead to transformed, sustainable rural health delivery system. Special focus would be on identifying the current and future needs of rural Washingtonians. The Federal Reserve Bank of San Francisco has agreed to collaborate with WRHA on this event and is heavily involved in planning. We are currently considering scheduling this event in July or August 2018.
In support of Empire Health Foundation’s vision to transform Eastern Washington into the state’s healthiest region, Empire Health Foundation is holding an annual open request for proposals, which is called Responsive Grant Program. This program is designed to address one-time, emergent needs within our service area. Responsive Grant Program also includes a Rural Aging track for projects serving seniors living outside of Spokane County. Any nonprofit serving our region can apply for up to $15,000.
Chewelah resident Gary Vaughn Peck passed away in an auto accident on April 19, 2018, four miles south of Colville. Peck was 71 and was heavily involved as the chief administrator of St. Joseph's Hospital before retiring. According to a report from the Washington State Patrol, the 2010 Subaru he was driving northbound on Highway 395 left the roadway, rolled over and landed in a creek.
Also, on April 23, 2018, Lake Chelan Community Hospital & Clinics - Commissioner, Judge Tom Warren passed away at the age of 77. Tom was a tireless advocate for community health and a champion of efforts to build a new hospital in Chelan. Tom was also a member of the WSHA Rural Hospital Committee, and in 2016 he chaired the WSHA Effective Governance Task Force, which underscored the importance of good governance and identified core competencies for hospital board governance. Judge Warren retired in 2007 after more than 20 years on the bench. He was a member of Lake Chelan Rotary, and was formerly in the Wenatchee Lions Club. Judge Warren is survived by his wife Mary Ann Warren and two daughters, Amanda Froh and Katy Warren and close family friend, Deyanira Jorda Nolan. 
The Washington Rural Health Association is a 501(c)(3) not-for-profit organization supported by individual donors, corporations, foundations, and government grants. Donations to the WRHA go an extremely long way. Donations go directly towards helping us improve healthcare for our rural communities across the State.
(Yakima, WA) According to the National Institute of Health (NIH), pain affects more Americans than diabetes, heart disease and cancer combined, and stands as the most commonly cited reason for people accessing the health care system each year. The NIH also states that one in every four Americans suffers from chronic pain. It is the most common cause of long-term disability, and treatment with opioids is often viewed as one of the major contributing factors to our nation’s ongoing opioid epidemic. 
“My grandpa recounts stories of summers spent working on his cab-less tractor as young as 10 years old,” said Thatcher. “He often said, “The best equipment a man can put on his land is his shadow.”
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