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Lovell , Wyoming
May 30, 2013     Lovell Chronicle
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May 30, 2013

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16 I The Lovell Chronicle I May 30, 2013 will BY PATTI CARPENTER New programs for pa- tients and ord- able Care Act will affect the hospital district were hot topics at the North Big Horn Hospital District's regular board meeting held on Tuesday, May 21. CEO Rick Schroeder reported that the hospital has entered into an agree- ment with a firm that will provide "telepsychology" services. The services are grant funded and will al- low patients who need psy- chological services to access care through a teleconfer- encing system set up at the hospital. "Our providers are re- ally enthusiastic about this program," explained Schro- eder. "It basically provides a two-pronged approach. In cases where we have pa- tients held here on an invol- untary hold it will allow ei- ther the judge or a licensed psychologist to make deci- sions about their hold. The providers really like the idea that a trained profes- sional can prescribe ap- propriate medications for the patient and help make those decisions. "The second part of the program is to schedule a half day per month where patients can be scheduled to use the telepsychology services at the hospital. If the program gets bigger we will look at maybe making two half days available to patients." Schroeder also report- ed on the progress of the Patient Centered Medi- cal Home program. The Patient Centered Medical Home is a program that fa- cilitates partnerships be- tween individual patients, their personal physicians and, when appropriate, the patient's family. Care is fa- cilitated by registries, infor- mation technology, a health information exchange and other means to assure that patients get care when and where they need it, in an appropriate manner. "The whole thought process behind the Patient Centered Medical Home is to be proactive to our pa- tient's care, so that we are doing what we can to keep them healthy rather than just being here when they become unhealthy," ex- plained Schroeder. "An example would be diabetics, who we might discover through our data base haven't had certain tests or their feet examined in a reasonable amount of time," he said. "We would contact those people to re- mind them that they need that type of care, This will help increase the quality of the care to the patients we serve, and as they become healthier they will utilize Medicare and Medicaid less frequently, which will take some of the stress off the federal and state programs that pay for that care." Schroeder also report- ed on the community needs assessment work that is in progress. "We're moving along with that now," he said. "We've met twice now and have isolated community obesity as a target we need to work on." Schroder said a "sensi- ble nutrition" program will begin in August and a walk- ing program is expected to begin in June. The program is expect- ed to last three years and may also include a special- ist going into homes to work directly with individuals and families. The Affordable Care Act requires a community health needs assessment for three years. It's considered a long-term program and board member Bruce Wack- er pointed out that it will not conquer obesity over- night. It takes longer than three years to do something like that, he said. Schroeder also reported on the hospital's responsi- bility with regard to health insurance exchanges under the Affordable Care Act. "The exchanges are set up for people who don't have insurance, who can buy insurance through the exchange," explained Schroeder. "So far, only one company in Wyoming has signed up for the exchange. It's one of the 'blues' and they are talking about how people will be led through the process of going from no insurance, or insurance they can't afford through their employer, to buy- ing insurance through the exchange using the help of people who will act as navigators. "We're hoping to get a grant for this. If this grant doesn't work, they are tell- ing us that it will fall on the hospitals to provide the navigators. So, we're really hoping this grant will come through, so it's not another expense that we incur as a result of decisions that have been made recently." Schroeder also report- ed on the 340B drug pro- gram that he expects to "go live" on July 1. The pro- gram, which was original- ly set up by the Veteran's Administration, is now a larger government program that will allow the hospi- tal to purchase drugs at a reduced price. Lovell Drug has partnered with the hos- pital on this as the hospi- bed days were up this tal's pharmacy, month and revenue was re- "So-far7 this looks: likeported above budget. Cash it's going to be a good oppor- tunity for us," said Schroed- er. "As I learn more, I'll re- port to you on how it will work." The human resources department reported that Dr. Richard Jay has start- ed as a new provider at the hospital and that Dr. Bren- dan Fitzsimmons is expect- ed to start as a provider on July 1. Board members and staff attending the meet- ing noted they are already hearing positive feedback about Dr. Jay and the work he has performed so far at the hospital. Both nursing supervisors Tina Toner and Traci Harrison said they have heard positive feed- back from staff about work- ing with the new doctor. The hospital had a 2 percent turnover rate in personnel for the month of April. Current open posi- tions at the hospital include EMT, CNA/Elder Assistant, RN, LPN, Housekeeper, Ac- tivities Aide, Respiratory Therapist and RN Scrub Technologist. Nursing Supervisor Tina Toner reported that her staff was very busy this past month with double the swing bed use than they anticipated. Traci Harrison reported that the census is on target at the New Horizons Care Center. She noted that they have also started involve- ment in a CNA program with Northwest College in an effort to help recruit CNAs. Chief Financial Officer Richard Goertz reported a slight loss in operations last month ($21) and a year-to- date loss of $39,000. Swing on hand in the operation- al fund is around $92,000 compared to the state aver- age for hospitals, which is around $85,000. Board Chairman Bret Crosby asked Goertz if he knew yet how the Afford- able Care Act would af- fect hospital finances. Go- ertz said he plans to include about $90,000 for possible penalties in the budget re- lated to employee health benefits. He explained that it is a complicated system where the hospital may have to pay a penalty in cases where employees are not insured as required by the law. He said he hopes to have a more concrete number within a week or so but that it looks like it could cost the hospital up to $130,000. He also not- ed that the cost of hiring a navigator, should the hos- pital not get grant money for the position, is also an unknown. Schroeder explained that it is his understand- ing that anyone working for the hospital more than a certain number of hours will have to be insured at a cost of 9.5 percent of total family income or less or the hospital will be penalized because it is deemed "non- affordable" at that rate. There are further penalties if the coverage does not in- clude all that is mandated in the new law. The penal- ties could potentially reach as much as $5,000 per em- ployee if all of the require- ments are not met. Schroeder and Goetz said they thought the hos- pital's policy met most of the requirements but they could see a $3,000 per era- ployee penalty on as many as 30 employees because their salary to policy cost ratio may not meet the per- centage requirements of the law. A discussion ensued about how the penalties could be avoided but was not resolved. Goetz clari- fied that although the pen- alties could affect about 30 employees, some may be in- sured elsewhere, lessening the blow to the hospital's budget. Some of the alter- natives looked at included increasing pay and upping the percentage the hospital pays. It is unclear whether any of these ideas will real- ly help the situation. Schro- eder said the district's in- surance advisor is studying the various scenarios using a "proprietary software pro- gram" that may help find a solution to the problem. "We're just telling you what we know at this point, which is basically more than we understand at this point," said Schroeder. In other matters, the board of trustees voted to employ the services of the Studer Group. Schroeder said he is working with oth- er groups through the hospi- tal association to get a group rate that will bring down the cost of the program. Tra- ci Harrison reported that she recently attended a spe- cial training session by the Studer Group and that she thought it was very good. The firm provides manage- ment and leadership train- ing, as well as employ. ee training programs that many hospitals in the area are beginning to employ. After considerable dis- cussion the board vot- ed to try out the program, which has a money-back guarantee. OO0 Announcements For Rent POWELL: 3 BEDROOM HOUSE, all appliances included, fenced yard, quiet neighborhood, no smoking, $950/mo. Avail- able now. Call 202-0400. (43TFCT) POWELL" 2 BDRM HOUSE, washer/dryer, no pets, no smoking. 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