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Welcome to the November 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.
Wow…once again summer went by way too fast, and we’re knocking on the door of Thanksgiving and falling leaves already! November is here and I am reminded of your generosity and continued support of Washington Rural Health Association. It is a pleasure to work and advocate on your behalf. I appreciate the opportunities our Board of Directors and I have had, to work with you over the past few years. Thank you!
As Executive Director, one of my concerns is to ensure the Washington Rural Health Association be effective in its’ goal to help strengthen our rural healthcare system. Our Mission Statement reads as follows: Vision: To be the collective voice that strengthens rural health in Washington communities by advancing policy to promote high quality, accessible, and comprehensive health care for rural residents. Mission: WRHA mission is to collaboratively strengthen and improve the health of rural communities.
The Washington Rural Health Association was formed in 1988, an outgrowth of the developing vision of many individuals and organizations who recognized the value of uniting to support rural health care throughout the state of Washington. WRHA is a strong advocate for enhanced access, quality, and stability for rural health services.
Some of the keywords in our mission statement are “collaboratively” and “improve.” We do not see ourselves as trying to force an agenda of change on rural communities, but rather, we choose to work, as the statement says, collaboratively with individuals and organizations for the mutually attainable quality and quantity of the health care that you need.
In that vein, your Board of Directors is looking for ways to better connect with you. We want to hear from you what you need from the health care system. What’s working and what isn’t? Maybe you live in one of those communities where the healthcare system is working fine and your needs are met. Or you could be living in a place where some necessary services are lacking. We have nearly 200 members in the Association. Chances are that some of them live in your town.
In what ways can we help? We can bring your messages to state legislative and congressional members. We can communicate and work with other healthcare organizations when necessary. We can work with policymakers within state government. In short, we will stand up for you, doing our best to see that you get the health care you need when you need it.
In that spirit of collaboration, we are happy to announce that we are partnering again with the Rural Clinic Association of Washington (RHCAW), WWAMI - Area Health Education Center Program Office, The State Office of Rural Health, Washington State Department of Health (SORH/DOH) to host the Annual Northwest Rural Health Conference in 2019.
Join more than 450 rural health colleagues from Washington, Oregon, Idaho, Montana, and Alaska to share strategies, best practices, project models, innovative ideas, and success stories. This year’s conference focus is on how rural communities are navigating the changes and finding the right fit for their community through sharing proven tips, tools, methods or initiatives. Breakout session content will focus on an exchange of information about programs and innovative strategies that can be models for changing rural health and health care delivery at the state and regional levels. Hundreds of rural health professionals attend, ranging from rural health administrators, health care providers, board members, educators, state and federal staff, public health officers, researchers, information technology specialists, and more.
This largest gathering of rural health professionals in the Northwest will be at the at the Hilton Hotel & Conference Center, SeaTac, Washington, March 25-27, 2019.
Finally, your participation in our membership is paramount to our success. We strive to make a difference in your lives by making it easier, less stressful, and more noteworthy to do business with us. Your recommendation of our services to your family and friends will continue to fuel our growth and prosperity into the future. All the best to you and your families for an enjoyable fall season!
With Gratitude,
Beionka Moore, Executive Director
We’re Seeking Board Members!
On another topic, the Board of Directors currently has three unfilled positions and expects to have one more before our annual meeting in March. This leaves four opportunities for members to serve as Directors. A full complement of board members would give the Board more power and flexibility to get the job done. I invite any member who thinks they might have an interest in serving on the Board to view the structure and duties of Board members by looking at the eligibility requirements on the WRHA website at http://waruralhealth.org/bylaws. Scroll down to Article III. Submit a resume through this email address to [email protected] or mail it to Washington Rural Health Association, PO Box 882, Spokane, WA, 99210. Please include a statement about why you want to serve and what you could add to the group. We'd love your help!
Looking for Committee Members
Would you like to have a greater impact on the future of rural health and the direction of the WRHA? If so, consider joining one of WRHA’s committees. The WRHA is seeking volunteers to join the following committees:
Awards Committee – selects WRHA award winners and presents awards at the 2019 NW Rural Health Conference in March
Membership Development and Communications Committee – promotes the association to prospective members, increases awareness of WRHA, and develops member benefits. Coordinates WRHA publications including the e-newsletter, In Case You Missed It Updates and funding Opportunities
Legislative Committee – mainly active during the legislative session, this committee reviews the Bill Tracking Report, compiles a list of bills to be tracked, and works for legislative event planning
Bylaws Committee – headed by the WRHA president, this committee meets every two years to review Association bylaws
Finance Committee – assists executive director and the treasurer in developing an annual budget, review disbursements, makes recommendations to the Board, and manages additional revenue
It has been an especially important year, as we face the daunting challenges of this economic crisis. Your support and financial contribution are a great vote of confidence in our mission. As a sponsor at the PLATINUM LEVEL, you will receive thanks and recognition on WRHA website, social media outlets and at the Northwest Rural Health Conference program as well as a complimentary exhibit booth and 2 conference registrations. We look forward to seeing you there. Thanks for your consideration.
With each publication, we would like to introduce a member of the WRHA Board of Directors. This publication we would like to introduce a valuable member of the board, Deborah Watson, Pullman Regional Hospital:
1) Please tell me your name, where you work, title, your role with WRHA and how long you have been a board member: Deb Watson, Clinical Project Manager at Pullman Regional Hospital. I joined the Board in June of this year.
2) How did you first become involved with the Washington Rural Health Association? Attended several conferences in the past and was asked by former board member to consider role as board member.
3) There are several rural health organizations in Washington State. Why did you choose to work with WRHA? Asked by former board member, that I respect and admire, to consider role as board member and I'm very interested in supporting health and wellness for rural communities.
4) Why is Rural Health important to you? I’ve lived and worked in rural communities much of my life. Life in rural communities is challenging with limited resources and access to services. I’m interested in assuring that the health & wellness of rural communities thrives into the future through out-of-the-box thinking for accessing resources and services.
5) What has surprised you most about working with Washington Rural Health Association? How challenging it is for the organization to maintain a presence and call to action for rural communities.
6) What is the best part of working with WRHA? Diverse team of dedicated board members led by an outstanding executive director!
7) What do you see as some of the most challenging issues facing WRHA and Rural Health in our state? Finding new ways of collaborating with rural organizations to design/test/implement ‘out-of-the-box’ ideas to improve the health and well-being of rural communities.
8) What do you wish other people knew about Washington Rural Health Association? How passionate the organization is in their desire to make a difference for rural communities.
9) If you could change one thing about Washington Rural Health Association what would it be? Find our niche, what we do best that no other organization does.
10) Do you volunteer for any other organizations? Why do you feel it is important to volunteer? I am a co-chair for the Spokane Community Colleges Nursing Program Board and was a past member of the WSU School of Nursing Board. I am a member of NWone, eastern Washington Chapter. I feel it’s important to volunteer to support organizations doing meaningful work that benefits the underserved; to share my experiences and knowledge with organizations dedicated to making a difference in the health and wellness for all, especially for rural communities.
11) How do you like to spend your time outside of work and volunteering? I enjoy spending time with my family. My husband and I have a blended family with 5 children and 15 grandchildren. I also enjoy the outdoors: being on the lake, walking, hiking, bike riding, snowboarding as well as traveling to visit new places all over the world.
12) What might (someone) be surprised to know about you? I served in the Air Force as a Nurse Corps officer for nearly 8 years.
13) What do you think will change about Washington Rural Health Association over the next five years? Staying relevant to meet specific needs of rural communities.
Jefferson Healthcare is proud to announce Chief Administrative Officer and Chief Financial Officer Hilary Whittington, CPA, MBA has been recognized by the Puget Sound Business Journal as a "40 Under 40" award winner. This prestigious designation recognizes the 40 most "up and coming" leaders in our region. Whittington oversees the finance, ancillary and support service related departments at Jefferson Healthcare.
Whittington joined Jefferson Healthcare in 2011 as Chief Financial Officer and was promoted to Chief Administrative Officer in 2018. She led Jefferson Healthcare's financial and operational turnaround and is key member of the leadership team of one of the more dynamic rural healthcare organizations in the country. "Hilary has been instrumental in both our growth and improvement as an organization. She understands the critical role Jefferson Healthcare plays in our community and is a passionate advocate for the continued sustainability of rural healthcare.
In addition to all of this, Hilary is a delight to work with and we could not be more proud of her "40 under 40 recognition" said Mike Glenn, CEO at Jefferson Healthcare. For the past 20 years the Puget Sound Business Journal has introduced 40 of Washington's brightest and most innovative leaders of the business community. This year's class was recognized at an awards ceremony September 28, 2018.
Submitted by: Meagan Pierluissi Inland Northwest Health Services [email protected]
"It's just a small world," is a sentiment Jack Walker says of his experience at St. Luke's Rehabilitation Institute's Outpatient Cardiac Rehabilitation Program when he noticed a fellow participant looked familiar. "I went up to [Rick Stone], and he said he was one of the lead paramedics at Fire District #4 who treated me the night of my heart attack. It was comforting to see him at St. Luke's. " An avid hunter and fisherman, Jack says he had been diagnosed with bronchitis by his physician just before going out to Mt. Spokane to hunt deer one evening. After attempting to field dress the deer he shot, he says he knew he was in trouble. "I couldn't breathe and I had chest pain; then I started sweating profusely and had an upset stomach." Jack, 61 years old, drove himself down from the mountain and pulled into the nearest fire station, Spokane County Fire District #4, where Rick, a paramedic, helped Jack before the ambulance arrived, taking him to Providence Spokane Heart Institute on the Sacred Heart campus.
Jack was in a coma for 14 days at Sacred Heart before transferring to St. Luke's for cardiac rehab. "It was amazing what cardiac rehab did for me. The therapists are always looking out for you. They're looking at your heart rate and blood pressure while you exercise. Now when I go to the gym on my own, I can feel and listen to my body better. You know what your limitations are. I have a drive to stay healthy because I don't want to go through this again."
"St. Luke's was a lifesaver and the cardiac rehab program is a club where we share the same goal of getting better," Jack says. "I highly recommend St. Luke's, there's no question that's where I would go." "Rick helped save my life. That's what he does, as a paramedic, but I would bet he doesn't always get to be in class next to the guy who he helped save. It was very cool. We got to know each other a little bit. I thank him every day for being there and helping me."
"I wore my Fire District #4 jacket to rehab, and Jack saw it. I asked him if he was the hunter who suffered severe chest pains and that's how we made contact," Rick says. "Being thanked does go with the territory of being a paramedic, and Jack was quite determined to find others who helped him that night to thank them." Rick, 67 years old, was at home when he went into cardiac arrest. His wife, Carol, performed CPR while first responders were en route. Carol is also a paramedic for Spokane's AMR and was Rick's student 28 years ago. "Carol did seven to eight minutes of CPR until the fire department got here without a break," he says. "That's love. She stopped once to give me a breath, but she did straight CPR.
Something we want others to know is to learn to do compression-only CPR to the tune of 'Staying Alive;' this is what saves lives." Rick was also taken to Providence Spokane Heart Institute, where he stayed for four weeks. He then began his cardiac rehabilitation at St. Luke's with Carol by his side. "Carol has done a fantastic job of weeding out what I can and can't eat based on the nutrition education we got at rehab," Rick says. "I tell others that going to St. Luke's rehab not only helps you physically and mentally, but it also creates social bond with people in the class just like a support group," Rick says. "We all sit and talk, getting to know each other's stories.
The leadership of the program is great. They keep an eye on us, taking our vitals before, during and after each exercise session." "It's incredible stories like Jack and Rick's that really make my job come alive," says Suzanna Tarr, St. Luke's certified exercise physiologist. "Their experiences and bond make us proud to be part of their rehabilitation journeys." For more information on St. Luke's comprehensive, medically-monitored exercise and education program, please visit www.st-lukes.org or call (509) 473-6000.
Washington Rural Health Association would not be able to carry out its advocacy activities and would not be a success without the generous support you have provided us throughout. We deeply appreciate the willingness with which you have and continue to sponsor the efforts that enable us to continue our mission to help improve health for the people living in rural communities. Which will ultimately make our communities a healthier, happier place to live in. We sincerely hope that this association will be maintained and that you will continue to support us in our future endeavors. Thank you!
RETURNING PLATINUM SPONSOR Inland Northwest Health Services
Inland Northwest Health Services represents a collaborative approach to health care that is unlike any other. With forward-thinking solutions, unique partnerships and innovative technologies, we bring safer, more cost-effective and higher quality health care to Spokane, the Northwest and the nation. https://www.inhs.info
Inland Northwest Health Services 601 West 1st Ave. Spokane, WA 99201 509.232.8100
RETURNING GOLD SPONSOR Wipfli LLP
Wipfli’s health care practice serves a wide array of health care organizations nationwide, including hospitals, health systems, and senior living providers. Our team of experts uses an outside perspective coupled with insider knowledge to develop practical solutions that deliver sustainable results. Wipfli’s integrated service model incorporates reimbursement, revenue cycle, behavioral health integration, facility planning, audit/tax compliance, performance improvement, and clinical consulting to provide innovative solutions to demanding health care issues. www.wipfli.com/healthcare
WIPFLi LLP 201 W North River Drive, Suite 400 Spokane, WA 99201 509.489.4524
NEW INDIVIDUAL MEMBER
Michelle Jerome, Touchstone Health, Chelan
RETURNING ORGANIZATION MEMBERS
Columbia Basin Health Association, Othello Columbia County Health System, Dayton Inland Northwest Blood Center, Spokane Mason General Hospital and Family Clinics, Shelton MEDEX Northwest, Seattle Ocean Beach Hospital, Ilwaco Odessa Memorial Healthcare Center, Odessa Physicians Insurance, Seattle Providence Mount Carmel Hospital, Colville Shriner's Hospital for Children, Spokane Spokane Regional Health District, Spokane UW School of Medicine, Spokane Washington Academy of Family Physicians, Bellevue Washington Association of Nurse Anesthetists, Spokane Whatcom Community College, Bellingham Whitman Hospital and Medical Center, Colfax Willapa Harbor Hospital, South Bend
Wilderness Medical Staffing is a Washington owned-and-operated locum tenens company that specializes in staffing rural healthcare facilities with top-notch advanced practice providers. We work with medical providers who share our passion for rural medicine, and we work with our healthcare facilities to provide a custom staffing solution for each unique site. We exist so that you can focus on what matters: Providing excellent healthcare to your community.
Wilderness Medical Staffing services:
Top-notch locum tenens medical staffing for clinic and hospital sites across Washington
Staffing for any size healthcare facility
Staffing for both short-term and long-term assignments
Full-time staffing with rotating providers
Unique benefits of working with Wilderness Medical Staffing:
As a local company, we are completely familiar with the areas that we send practitioners to because we have worked and lived in many of these areas ourselves.
Our medical providers have extensive experience in rural and remote areas, and they are fully oriented to the particular site where they will be providing healthcare.
From Day 1 you get direct contact with a WMS Decision-Maker, who can offer immediate solutions to your staffing needs.
Most importantly, we pride ourselves on being able to practice excellence in medicine in any location, under any circumstances. Whether it’s a weekend or a year, we’ve got you covered!
JOIN US IN CELEBRATING EXCELLENCE IN RURAL HEALTH CARE Each year the 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. Previous recipients have stretched the boundaries of possibility by forging innovative programs and services, thereby making rural life healthier and more compassionate.
Consider nominating your favorite rural health individual, program, or organization to regionally honor them for contributions to rural health. Selections will be made on the basis of a 300-500-word narrative which is part of the nomination form.
The nominator of the chosen winner in each category will be notified prior to the luncheon; so that significant individuals (family members/colleagues) can be invited to the awards ceremony. The award's recipient in each category can have up to four guests free of charge. The luncheon tickets are $45 per person after the fourth guest.
The awards ceremony will take place on Tuesday, March 26th, from Noon to 1:00 PM. WRHA will accept online submissions only. Click nominate and upload supporting materials: NOMINATIONS
Webinar- Affordable Housing Basics for Washington’s Healthcare Stakeholders
The Health Care Authority is hosting a webinar for providers to learn about affordable housing development and rental resources. The goal of the webinar is to provide the health care community with an introduction to how affordable housing works so that they are equipped to develop effective partnerships with housing stakeholders. Please feel free to share this with your colleagues who may be interested in learning more about affordable housing. Webinar information: Affordable Housing Basics for Washington’s Healthcare Stakeholders November 6, 2018, 10:00 AM – 11:00 AM PST Register here
This Webinar will provide an opportunity for providers to learn about how affordable housing, including permanent supportive housing, is created in their community, and will prepare you to have informed conversations with housing stakeholders about investing in affordable and permanent supportive housing. The discussion will offer an overview of affordable housing resources available across Washington as well as discuss the complexities and challenges involved in creating these housing opportunities. Washington State Health Care Authority, Division of Policy, Planning, and Performance: [email protected]
A Rural Community Decided To Treat Its Opioid Problem Like A Natural Disaster Details the efforts of Washington's Snohomish County to address the opioid epidemic. This rural county is the first in the country to respond to the crisis like a natural disaster, inspired by their experience with responding to the 2014 landslide in Oso, Washington. Source: NPR
USDA Prioritizes Funding to Facilitate Safe Prescription Drug Disposal in Rural Communities The U.S. Department of Agriculture (USDA) announced that applications to the Solid Waste Management Grant Program which propose innovative projects to promote the safe disposal of prescription drugs in rural communities will receive priority points. Source: U.S. Department of Agriculture, Rural Development
The number of U.S. healthcare organizations actively seeking foreign-trained nurses is increasing. Healthcare administrators cite everything from bedside manner to reliability for why they're so useful; however, as The Icon Group has covered before, foreign-trained nurses arrive to the United States with an advantage before they even step into a hospital. That's because the vast majority all carry a bachelor's degree. And according to an article by Anna Louie Sussman in The Wall Street Journal, that's what nearly every nurse is going to need soon.
Anna Louie Sussman spoke with a U.S. nurse who earned her associate's degree in nursing yet cannot land a full-time role nursing despite applying to over three dozen listings. "Truthfully, an associate's program is not really going to get you anywhere anymore," said nurse Megan Goodman to Sussman in the article. According to Sussman's article, the number of nursing programs rocketed 41 percent between 2002 and 2014. During that time, the amount of new nurses ballooned about 80 percent; however, the number of nurses over 50 doubled, as many would-be retirees remained working.
This brings us to the ever-popular "silver tsunami" term used in many national nursing shortage reports. A bulk of the nursing demographic is nearing retirement "senior nurses, nurse educators, etc." and they'll need to be replaced. The Institute of Medicine recognized the problem, and in 2010, the third-party advisory group called for 80 percent of the nursing workforce to have a bachelor's degree by 2020. The goal was based on research dating to the early 2000's, research that showed how hospitals with a higher amount of nurses with a bachelor's degree scored higher on indicators of 'overall quality care.
"On top of The Institute of Medicine's advisory, The Affordable Care Act puts more focus on preventative care, which of course makes hospitals rely on nurses for more leadership and coordination skills", as the article says, that are not part of the nursing associate degree curriculum. That's why foreign-trained nurses, that we place, have made for an exceptional alternative. Facilities need flexible nurses who have the skills that a bachelor's degree curriculum demands.
One of the challenges facing a rural Health Insurance Portability and Accountability Act (HIPAA) security program may be the knowledge required to properly perform a risk analysis (i.e. a risk assessment). Complicating this challenge is a combination of inadequate Internet checklists, an obnoxious free government software program and a gaggle of “experts” who aren’t.
A risk analysis is different from the compliance assessment discussed last issue, primarily in that risk is calculated and quantified. A risk analysis should be based on a methodology (i.e. a complete approach to a process) and the framework (i.e. a flexible or incomplete approach) of the HIPAA Security Rule. The output of the risk analysis process is a list of risks, which should be cataloged into a risk register.
The biggest question that we are asked related to the risk analysis is, “…how often do I need to do one?” and the answer is that the Security Rule doesn’t provide a specific periodicity. Those rural health organizations participating in the Centers for Medicare and Medicaid Services (CMS) incentive program must have a current (i.e. same reporting period) risk analysis completed; so for this group, we recommend an annual risk analysis to protect their CMS-paid monies should an audit take place. The HIPAA Security Rule §164.308(a)(1)(ii)(A) citation requires a Covered Entity or Business Associate “…conduct an accurate and thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of electronic protected health information…”. A risk analysis is an element of an organization’s risk management program and as such, should be performed at a reasonable and appropriate duration given the size and complexity of the ePHI environment. For example, a risk analysis should be performed or updated as a new electronic health record system is implemented or following the acquisition of a new practice into a provider network.
In the next WRHA newsletter we will cover how to perform a HIPAA Security Rule based risk analysis, how to avoid some common mistakes and what to do with that risk register that was created.
The Washington Rural Health Association (WRHA) encourages rural providers and communities to join the State Office of Rural Health (WORH), the National Organization of State Offices of Rural Health (NOSORH) and other state and national rural stakeholders to “Celebrate the Power of Rural” during the annual National Rural Health Day celebration on Nov. 15.
NOSORH created National Rural Health Day as a way to showcase the good works of America’s 59.5 million rural citizens and promote the efforts of NOSORH, State Offices of Rural Health and others in addressing those concerns.
“At the same time, National Rural Health Day gives us an opportunity to raise awareness of the unique healthcare issues being faced by rural citizens, particularly a lack of health care providers and affordability issues resulting from larger percentages of uninsured and underinsured citizens and greater out-of-pocket health costs, to name a few,” said NOSORH executive director Teryl Eisinger. “And while the Affordable Care Act may make health care more affordable for rural Americans, it doesn’t necessarily make it more accessible – a lack of public transportation, fragile infrastructures, and geographic barriers also must be overcome in order to ensure that all rural safety net providers can adequately meet the basic healthcare needs of their residents.
WRHA salutes our rural providers who are truly addressing the issues of rural health by providing quality care at the right place, the right time, and for the people who need it the most. For providers considering working in a rural setting, we want them to know they are both needed and welcomed. Rural areas are great places to live, work and play. The people are warm, community-driven, caring and family-minded.
The Washington Rural Health Association is a non-profit professional membership organization. WRHA’s primary focus is to advocate for the preservation and improvement of rural health in Washington State. The WRHA mission is to collaboratively strengthen and improve the health of rural communities, by promoting access to rural health services. The WRHA accomplishes this through education, research, service, and community engagement.
For more information on WRHA services and resources, please visit www.waruralhealth.org. Additional information about National Rural Health Day can be found on the Web at www.celebratepowerofrural.org.
ELECTION DAY!
Your voice and opinions are powerful. Own it, voice it, on Tuesday, November 6.
TOGETHER OUR VOICES ARE LOUDER AND STRONGER
Join the discussion, connect with us! Share your stories and ideas, get the latest news, and act to help preserve rural health care and access in Washington state! Please head over to Facebook, Twitter or LinkedIn and look us up at WASHINGTONRURALHEALTH!
We’re Seeking Board Members! 
THANKS FOR YOUR GENEROSITY
JOIN US IN CELEBRATING EXCELLENCE IN RURAL HEALTH CARE 
The Washington Rural Health Association (WRHA) encourages rural providers and communities to join the State Office of Rural Health (WORH), the National Organization of State Offices of Rural Health (NOSORH) and other state and national rural stakeholders to “Celebrate the Power of Rural” during the annual National Rural Health Day celebration on Nov. 15.
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