Bishop reports on the state of the district
by Samantha White
Harney District Hospital (HDH) Chief Executive Officer (CEO) Jim Bishop began the regularly-scheduled meeting of the Harney County Health District Board of Directors (held June 24) with a presentation detailing the district’s history. The district is celebrating its 25-year anniversary July 1.
“Elected leaders and community volunteers looked to the future and did what’s right, instead of what’s easy,” Bishop said regarding the formation of the district. “Honestly, I think they were crazy or half crazy to think they could pull this off.”
He added that the district achieved all five of the top goals that were put forward when it was founded, and he encouraged the board to continue its efforts to ensure another 25 years of success.
Bishop, who is retiring after nearly 15 years of service, provided the board with his final State of the Harney County Health District report.
He reported that there are more than 180 full and part-time positions within the district, and employment will continue to rise. For example, two new family practice doctors and their support staff are being hired. Additionally, HDH Family Care clinic will add staff to increase outreach and expand hours of operation to six full days per week. Behavioral health services will also be added to the clinic, and the district will add surgical staff as procedure numbers increase.
According to Bishop, employee surveys indicate that job satisfaction is above average. He added that employee wages and benefits exceed $1 million per month, adding significantly to the local economy.
Bishop observed slow declines in inpatient census, which he attributed to regulatory changes that promote shorter inpatient stays, as well as efforts to promote population health and reduce readmissions. However, he stated that increases in outpatient procedures “more than offset” these small declines. He also noted that there’s been an increase in Medicaid-insured and Veterans Affairs patients.
Bishop also reported that the Paragon hospital information system was installed one year ago, and, although there have been some “bumps in the road,” overall performance has been good. In fact, HDH is one of less than 20 percent of hospitals in the United States that has achieved Meaningful Use II compliance. Meaningful use sets specific objectives for using certified electronic health record technology. Hospitals and eligible professionals must achieve these objectives to qualify for incentive programs. In addition to the expected reimbursement from Centers for Medicare & Medicaid Services, HDH is qualified for a significant bonus.
Bishop wrote that, “In the 25 years of the health district’s existence, its financial health has never been better.”
He explained that, several years ago, the board and administration agreed to hold a minimum level of cash and use any excess to pay extra on the district’s higher interest, long-term debt. At least $800,000 in additional debt reduction is planned for this coming year.
Regarding the district’s future, Bishop stated that providers have embraced health care reforms, which move away from the historic procedure-based healthcare model to focus on wellness, prevention, health outcomes, and cost moderation. The district is achieving leadership in a number of areas, including patient-centered medical home status, care management, close coordination of care and follow up between HDH and the clinic, and adding behavioral health to the clinic. Bishop stated his belief that these efforts will continue to help the district obtain grants, receive fair compensation for services, and recruit and maintain providers and staff.
“I think the health district is well-positioned to move forward into this exciting and challenging future,” he concluded.
The board agreed to approve the 2015-2016 Workplan Goals, which include attracting and retaining high-quality employees, expanding services to address community needs, continuously improving district operations, strengthening the financial base, and developing excellence in reputation and service to the community.
The budget hearing was opened at the beginning of the board meeting, and budget committee chair Fred Flippence recommended approving the budget with a 4 percent price increase.
HDH Chief Financial Officer Catherine White explained that a 5 percent increase was originally proposed, but the budget committee elected to reduce the increase to 4 percent in order to keep rates as low as possible for the community. She added that each percentage point affects the budget’s bottom line by $150,000.
Board secretary Susan Doverspike noted that Rite Aid is in the process of coming on board with the 340B Drug Pricing Program, which will bring “a significant chunk of change” to the district that it’s not accustom to receiving.
She added that, prior to committing funds to the proposed clinic remodel, she’d like to pay down debt.
White said she’s working with the Bank of Eastern Oregon on lowering a loan’s interest rate from 6.75 percent to 4.5 percent, which would save approximately $600,000 over the 15 years remaining on the loan. She added that she needs the board’s approval to “get the ball rolling.”
The board agreed to authorize White to move forward with investigation to lower the interest rate.
Upon recommendation from White, the board also agreed to switch the credit card vendor from Umpqua Bank to Bank of Eastern Oregon.
After closing the hearing, the board agreed to approve the budget for fiscal year 2015-2016, as presented.
Board member Ann Vloedman abstained from voting to avoid a potential conflict, as her husband is a hospital employee.
The board also passed Resolution 2016-01 adopting the annual budget for fiscal year 2015-2016 in the total amount of $30,955,328, making appropriations, and imposing and categorizing a tax rate of $1.9314 per $1,000 of assessed value.
Board members Tim Smith and Preston Jannsen were recognized and thanked for their service on the board, as both of their terms are ending.
Both Smith and Jannsen thanked the board for the opportunity to serve. Smith also expressed his appreciation for HDH staff, especially White and Bishop.
Vloedman moved to wait another month and continue advertising efforts before filling the board’s vacant positions.
Doverspike seconded the motion, and board chair Dan Brown voted in favor of it. Smith and Jannsen abstained from voting, so the motion passed with two abstentions.
In other business, the board:
• is waiting to hear back from its attorney regarding the Harney County Health District Bylaws;
• learned from HDH Development Coordinator Denise Rose that an architecture company will be on site July 7 to look at the clinic and learn more about team-based care. However, the actual construction phase is not planned in this year’s budget;
• upon recommendation from HDH Human Resources Manager Sammie Masterson, approved Policy 915.HR.309 “Employee Vaccinations and TB Testing” and Policy 915.HR.201 “Drug Free Workplace;”
• received a report from Clinic Manager Stacie Rothwell, stating that the clinic hired Richard Friday, a behaviorist who will start July 13. She also reported that the clinic began the process of re-attesting to the Oregon Health Authority for Primary Care Medical Home designation;
• approved policies 100.115 “Special Committees,” 100.120 “Removing Board Members,” and 100.125 “Strategic Planning” without changes;
• granted medical staff privileges to Luther Hemphill, certified registered nurse anesthetist (anesthesiology); Nicholas CB Branting, MD (radiology); Henry Elder, MD (psychology); and Dr. Heidi Vanyo (family practice);
• re-appointed Laura Schaben, MD (neurology) to medical staff.
The next meeting will be held at 6 p.m. Wednesday, July 22 in the hospital board conference room.