Governing Board Letter


Vol. 32, No. 2 - June 2010

Medical Home: What Is It?

To start with, there is probably no single definition of medical home that all could accept. But, there is no denying that the topic is one of the hottest in health care circles today. There are at least three efforts in our state to create, operate, or promote the medical home concept.

  • Group Health Cooperative of Puget Sound, after a very successful trial, expanded the medical home idea to all of its 26 primary care clinics. To see greater detail and the health benefits to its members, click here (
  • Swedish Medical Center Ballard also has a medical home underway for a segment of its community. A team of care givers -- physician assistants, nurses, and physicians -- provide primary care for a panel of patients for a fixed $45 per member per month. The patients are insured through a Premera and Molina health plans. To see more, go to the Swedish-Ballard web page (
  • WSHA is participant in the Rural Health Plan Steering Committee, which came up with a practical description that may assist rural hospitals re-organize for the future. That description is:

The medical home is an approach to organizing primary care practice whereby patients have an ongoing relationship with a primary care provider and caregiver team which collectively take responsibility for providing or arranging for and coordinating all of the patient’s healthcare needs. The medical home offers comprehensive, patient-centered primary care, enhanced access, health promotion, chronic care management, and coordination of primary and specialty services. The medical home ensures that patients who need care receive the right care at the right time in the right place.

To read the entire, excellent report, click here. (Robb Menaul,

Hospitals Weather Tough Legislative Session

The 2010 Legislative Session was one of the most difficult in memory. The ongoing huge deficit dwarfed everything else. Still, WSHA’s Policy and Advocacy Team felt it was a positive session for hospitals. Among the highlights:

  • The Hospital Safety Net Assessment – This effort, developed by WSHA and passed by the legislature, over the biennium will bring in about $200 million to restore Medicaid hospital budget cuts from the 2009 session.
  • The state preserved its position as a leader in providing health insurance to targeted, needy populations. The Basic Health Plan, Apple Health for Kids, and General – Assistance Unemployable programs were saved.
  • Outside of budgetary matters, the most prominent work was the defeat of a bill to mandate hospitals to provide uninterrupted meal and rest breaks. Nurses working in hospitals played a key role in testifying and calling legislators to explain how the mandate actually worked to reduce professional judgment.

To learn more, find the legislative web cast (April 15) at WSHA’s web cast page or view/download WSHA’s written summary. (Robb Menaul,

Confused about Insurance Health Reform? Check These Sources

There is a great deal of information and disinformation circulating about the specifics of the late March passage of H.R. 4872 - the Patient Protection and Affordable Care Act. WSHA’s web site has a number of good resources, including short and long summaries and a model PowerPoint on the topic. One of the best, neutral sources of information is the Kaiser Family Foundation. Its 40 page summary is easy to read. (Robb Menaul,

Patient Safety Remains a Top Governing Board Priority

In April, more than 200 board members and executive team members attended the Fourth CEO and Trustee Patient Safety Summit. The slides and materials for the summit are available. This is a password protected page. User name is "boardmember" and password is "wsha".

The Summit also kicked-off the annual survey of board members on the progress of the safety and quality program in Washington hospitals. If you have not yet taken the survey at the Summit, online, or via hard copy, please take the survey. (Carol Wagner,

Don’t Forget the Governance Education Web Page

WSHA staff regularly adds new content to the association’s Governance Education web page. The newest Best Practice, for example, is Kadlec Health System Board of Directors’ Advocacy Committee Charter originally adopted in 2001 and updated in April 2010.

Another great source is American Hospital Association’s Center for Healthcare Governance. There are four price levels: large and small and AHA members or not.

Menaul to Retire June 30

Robb Menaul, WSHA Senior Vice President, will retire at the end of June. During his 32 ½ years at the association, he staffed the Hospital Governing Boards Committee for more than 20 years. Robb considers the Governance Education Task Force (see report) as one of the most important and fun projects he worked on. Deborah Swets will take over the responsibilities for governance education, the Hospital Governing Boards Committee, and the Governing Board Letter.

Accepting Nominations for Community Health Leadership Award

The Community Health Leadership Award was created in 1993 by WSHA’s Hospital Governing Boards Committee. This award is used to acknowledge health care organizations and their governance leadership that best serve their community’s broader health needs. In 2009 the award went to Dungeness Valley Health and Wellness Clinic, for its great work as a totally volunteer clinic in Sequim.

During the months of June, July and August the association will gather nominations. The committee will review them in September. WSHA will recognize the highest-ranked organization at WSHA’s Annual Meeting in October at the Bell Harbor International Conference Center in Seattle.

If you would like more information, contact Deborah Swets at (Jean Engler,

Coming Up. Mark Your Calendar.

  • The 34th Annual Rural Hospital Summer Workshop, June 28 – 30
  • Governing Board’s Role in Strategic Planning webcast, Sept. 23
  • WSHA biennial orientation/refresher for board members, Oct. 12
  • WSHA’s Annual Meeting, October 13 – 14

Did You Know?

  • Comparing community hospital utilization in Washington State – 1998 vs. 2008: In 1998 there were 72,056 births and 1,602,826 emergency department visits. In 2008 the numbers were 82,557 and 2,385,734, respectively. Source: AHA Hospital Statistics, 2000 and 2010 editions.
  • In 2001, WSHA worked intensively with members of the Washington State Legislature to pass legislation to provide Medicaid cost-based reimbursement for our state's Critical Access Hospitals. Still, less than half of the states provide Medicaid cost-based reimbursement.

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