TORCH Hospitals:

TORCH is bestowing specials awards on four state lawmakers for helping us in the last session. Senators Robert Duncan of Lubbock and Kel Seliger of Amarillo, as well as State Representatives Joe Heflin of Crosbyton and Garnet Coleman of Houston will be the recipients of the Texas Rural Health TORCHbearer Award for their support of rural hospitals and their efforts to enhance rural health care access.

The first award ceremony will be conducted at 11 am this morning at Covenant Hospital Plainview for Representative Heflin. He was a strong supporter of rural hospitals and worked hard on HB 1924, which was to protect rural hospitals from stricter pharmacy rules. He also worked for physician employment issue and in other areas to help Texas rural hospitals..

Here is an excerpt from the press release that has been sent out:

Texas State Representative Joe Heflin of Crosbyton was presented today with the Texas Rural Health TORCHbearer Award by the Texas Organization of Rural & Community Hospitals. Representative Heflin was recognized for his efforts in the 81st session of the Texas Legislature in support of rural hospitals and working to improve access to health care for rural Texans. The award ceremony was held at Covenant Hospital in Plainview, one of the rural hospitals in the House District #85 which is represented by Heflin.

The Texas Organization of Rural & Community Hospitals, also known as TORCH, represents more than 150 rural hospitals, including those in Heflin’s district. According to TORCH President and CEO David Pearson, “Representative Heflin is one of a few state lawmakers that went well beyond the call of duty to help rural hospitals and pressed for enhanced health care in rural areas.” Heflin is credited with working in several areas including pushing for programs to bring more doctors to rural Texas and trying to shelter rural hospitals from regulations that could add unnecessary costs for patients and local taxpayers.

Pearson added “Joe Heflin is someone who fully understands the importance of protecting our limited resources. He knows that when rural hospitals struggle, the community soon starts to feel the effects. Joe truly gets it and he makes it a personal priority to fight for rural hospitals.” TORCH bestows this special award on only a small group of deserving individuals who have sincerely demonstrated their commitment to improving rural health care.

Many rural hospitals in Texas struggle with limited resources and low patient volumes, but without them thousands of rural Texans would not have accessible health care. Don McBeath, Director of Advocacy for TORCH, said “without enthusiastic support from people like Representative Heflin, some of our rural hospitals could not survive. We truly appreciate his efforts and his willingness to fight for our rural citizens to have access to care.”

Heflin has one of the most rural districts in the Texas Legislature with 16 rural counties covering more than 15,000 square miles and spanning 243 miles north to south and 183 miles east to west. It spreads from Plainview in the panhandle, to west of San Angelo, to north of Abilene. The 85th House district has 12 hospitals, 8 of which have 25 or less beds.

Senators Duncan and Seliger, as well as Rep. Coleman will receive their awards on later dates based on scheduling.

October 22 and 23, 2009 - Hyatt Regency Hotel on the Lake - Austin, Texas

Building a winning team begins with strong leadership. The TORCH Leadership and Management Institute provides the topics and techniques you need to coach and inspire your employees to better performance. Don’t miss this opportunity to gain specific knowledge that our emerging healthcare leaders and managers need to know.

Here is our starting lineup for this year’s TORCH Leadership and Management Institute training seminar:

• Tim Durkin, CSP, Founder and President of Seneca Leadership Programs
  Bedside Matters . . . Managing the Communication of Care to Improve Your Outcomes
• Tim Wright, President and CEO of Wright Results
  Managing to Engagement: A Dozen Ways Managers Can Raise Their Employees’ Level of Engagement
• Judy Whitehouse, SPHR, President and CEO of Capital Insights
  HR Headaches Getting You Down? Here are Some “Can’t Miss” Remedies
• Tracy Wilson, Account Executive, Press Ganey Associates
  The Role of Leadership and Management in Quality Improvement and Service Recovery
• Hayden Hayden, Partner and Founder of Enlightened-Leaders, LLC
  Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior
• Kevin Reed and Jennifer Claymon, Shareholders, Davis & Wilkerson, PC
  Now, That’s Good Way to Get Yourself Sued: How Hospitals Beg for Lawsuits and How to Avoid Them
• Andrew Lasser, Dr.PH, Chairman, CEO of American University Health Care
  Thoughts from a Seasoned Pro

Watch your mail for the full brochure with complete program information and registration form. Kick off will be at 1:15 pm on October 22 with the final bell at 3:30 pm on Friday, October 23. Make hotel reservations in the TORCH room block by calling 512-477-1234 before September 30 to insure the special guest room rate of $129.00 (parking is $6.00 per day). A copy of the program flyer with a brief description of each session is available at the link below, so you may forward it to the staff members you would like to have attend this year’s event.

Remember, this is an excellent way to build morale, teamwork and retain your future managers and directors. By helping your up and coming leaders to grow in their roles as a master motivator and innovative thinker, you will be improving your hospital from the inside out. Give your best employees the tools they can use to help your hospital become leadership central on your local community. Your hospital will realize a return on this investment for many years to come. Ready, set, lead!

The TORCH Foundation and TORCH are pleased to host our 5th annual Rural Hospital Information Technology Conference on
October 20-21, 2009 at the Hyatt Regency Hotel in Austin
(map). We have an excellent program planned and invite everyone to attend this unique education event and
exhibition. Topics presented include:

• Keynote Address: Delivering on the Promise
• Rules of Engagement: Defining “Meaningful Use”
• Market Dynamics: Where Will You be in the “Buffet Line”
• Strategies to Effectively Secure, Manage and Protect Your Data
• Business Intelligence and Clinical Transformation
• Evaluation and Selection of EHRs
• Going LIVE: Achieving Successful Implementation
• The Art of the Deal: Mastering the Devil
• Technology and the Human Factor
• To Be or Not to Be: Hospital as Data Center and IT Shop
• Putting “IT” in Perspective

Plus, we have planned for an expanded tradeshow that will feature quality health IT/EHR products and solutions in the
marketplace. Also, there will be dedicated product demos to allow you the opportunity to see highlights of various EHR
systems.

Register before October 12, 2009
to receive the early-bird registration fee. Reserve your room before September 28, 2009 for the
special conference rate of $129/night (single/double).

Hope to see you all at HITCON/09! If you have questions, please contact Rose Valenzuela, Dawn Haberkorn or Quang Ngo at
(512) 873-0045, or email us at: hitconstaff@torchnet.org.

• 2009 HITCON Agenda
  [download pdf]
• 2009 HITCON Hospital Registration Form
  [download pdf]

Texas Hospitals Recognized for Quality of Care

AUSTIN, Texas–(BUSINESS WIRE)–93 Texas hospitals will receive Texas Health Care Quality Improvement Awards this year, presented by TMF Health Quality Institute. The program evaluates a hospital’s performance improvement on specific national quality measures.

“As a nonprofit consulting company focused on promoting quality health and health care, TMF is proud to recognize these hospitals for promoting quality improvement activities and their senior management for promoting a quality culture,” said Tom Manley, CEO of TMF Health Quality Institute. “Quality improvement is a complex and demanding process and we thank all of these hospitals for their commitment to improving the health of Texans and the efficiency of health care in our state.”

The Texas Health Care Quality Improvement Awards honor Texas hospitals that are performing quality initiatives aimed at improving outcomes in patient care by recognizing those hospitals that have improved their performance on specific national quality measures.

The awards acknowledge hospitals for improving care related to acute myocardial infarction or AMI (heart attack), heart failure, pneumonia and surgical care. These clinical areas have been designated as national health care priorities by the Centers for Medicare & Medicaid Services (CMS) and The Joint Commission, an independent, non-profit, standards-setting and accrediting body in health care.

A ceremony at the Hilton Austin Airport Hotel on August 27, 2009 will honor the 93 hospitals. The ceremony will feature special guest speaker Augie Garrido, University of Texas head baseball coach and the winningest coach in NCAA Division I baseball history.

Of 227 participating Texas hospitals, 27 met the criteria of the highest award, the Award of Excellence, and another 66 received the Quality Improvement Achievement Award. A list of the honored hospitals is provided below.

TMF Health Quality Institute, the Medicare quality improvement organization for Texas, established the awards program in partnership with The Texas Hospital Association, Texas Medical Association, Texas Organization of Rural & Community Hospitals and Texas Osteopathic Medical Association.

The awards recognize hospitals that are active in quality improvement and have made the required improvement on a composite scoring system, called the appropriate care measure (ACM). For acute care hospitals, the ACM consists of 24 quality indicators: eight AMI, four heart failure, seven pneumonia and five surgical care measures. Critical access hospitals have an ACM score based on 11 quality indicators: four heart failure and seven pneumonia measures.

To qualify for an award, hospitals were required to collect data on the quality indicators for four quarters beginning with the first quarter of 2008. They then implemented process changes quarterly to improve their performance and remeasured at the end of the fourth quarter 2008, to see if they had maintained or improved their performance.

To earn the Award of Excellence, a hospital had to achieve or maintain performance between 90 and 100 percent on the appropriate care measure and had to have met all other requirements. To qualify for the Quality Improvement Achievement Award, a hospital had to attain a minimum 80 percent for the appropriate care measure and meet all other requirements.

Other requirements included passing validation of three quarters of data (quarters 1-3, 2008), having mortality scores within the projected range and submitting the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) data. (Data for mortality rates and HCAHPS are not available for critical access hospitals and, therefore, were not part of the awards criteria for these hospitals.)

For more information on the awards, see the TMF Health Quality Institute awards Web site at http://award.tmfhqi.net.

About TMF

TMF Health Quality Institute is an Austin-based, nonprofit consulting company focused on promoting quality health and health care through contracts with federal, state and local governments, as well as private organizations. TMF partners with health care providers in a variety of settings to ensure that every person receives the appropriate care, every time. www.tmf.org

Documents and/or Photos available for this release:

93 Texas Hospitals Receive Award for Quality of Care

To view supporting documents and/or photos, go to www.enr-corp.com/pressroom and enter Release ID: 217208

TMF Health Quality Institute
Emilie Fennell, 512-334-1649
VP, Communications
efennell@tmf.org

It is disappointing that Governor Perry vetoed this important piece of legislation. With the addition of the amendment allowing certain rural public hospitals to employ physicians, this bill would have ensured access to physician coverage across rural Texas. Rural public hospitals in Texas find it more and more difficult to attract physicians to their communities and retain them. Many physicians entering practice today prefer an employee relationship, rather than having the responsibility and burden of setting up and managing a small business. H.B. 3485 gave rural public hospitals and physicians who want to practice in rural Texas flexibility. Having the option to employ physicians would have helped rural hospitals improve and preserve access to physicians. Without physicians, these hospitals will not continue to exist.

The Governor alleges that an amendment was added in the final days of session that was neither debated nor discussed. However, prior to concurring with all of the Senate amendments I had multiple conversations with the Governor’s office, one of them with Sen. Ken Armbrister, the Governor’s Legislative Director, as well as another member of the Governor’s staff.

To be clear - I told the Governor’s staff that the amendment in question could be removed if it created any sort of problem or if it jeopardized the passage of this important legislation. Sen. Armbrister assured me that the Governor was fine with the amendment and therefore fine with the overall bill. Tort reform groups were also contacted to assuage any concerns, with their assurances that the groups were neutral on the bill. To Sen. Armbrister’s credit, he did call today to inform me of the governor reversing his position.

The worst part is, the only losers with this veto are the people of the state of Texas and the various counties, with no gain or loss to the tort reform movement.

Aside from providing an incentive for physicians to move to rural areas, the bill contained many important policy matters related to county governance. Further information about the content of the bill will be forthcoming, for more information please do not hesitate to contact us. For additional comments on the governor’s vetoes and more information on HB 3484 please feel free contact us at (512) 463-0524.

posted by Rep. Garnet F. Coleman at 6:13 PM

TORCH/REES/THT workshop on June 18 has been postponed and will be re-scheduled for later in the year.

TORCH and The TORCH Foundation are pleased to host the 2009 Texas Critical Access Hospital Conference. Texas ranks among the top five states in the country with the most certified CAHs. These hospitals are a vital part of Texas rural safety net providers.

This is a unique time for rural healthcare, with several opportunities for significant change in the way healthcare is delivered. Federal push, particularly through the economic stimulus plan, for the adoption of certified electronic health records has generated much excitement (and uncertainty) for what this will mean for rural hospitals.

This education conference will provide you valuable information on key issues, topics, resources and strategies for Critical Access Hospitals. We encourage you to be an active participant in this exciting learning event. and to take this opportunity to interact with your peers and the presenters.

Priority registration ends June 17, 2009, so please hurry and register!

2009 Conference Agenda

2009 Conference Registration Form (Hospitals Only)

Exhibitor and Sponsor Opportunities Brochure

Exhibitor and Sponsor Registration Form

Each year we here at TORCH try to do things a little better and 2008 was no exception. The Board during its strategic planning expressed a desire to bring each of the organizations under the TORCH umbrella closer together and to communicate to the members the benefits and services that are available through both the TORCH Foundation and TORCH Management Services. These organizations grew and matured considerably over the years, but they also were seen as entities that were not closely aligned with the mission and vision of the parent association. After thoroughly considering the attributes that make each entity valuable to rural and community hospitals it was decided that the foundation and our management services company needed to be more closely associated with TORCH both administratively and from a sales and marketing perspective.

The first step in the process was the development of a trio of logos that will ensure that rural hospitals in Texas understand the close association that each of these organizations has with one another. The TORCH Foundation, which plays a major role in grant funding, program development and I.T. related services for rural hospitals, has become successful at creating common sense solution that are either subsidized or highly leveraged so that even the smallest hospitals can afford to take advantage of emerging opportunities and best-in-class technologies. TORCH Management Solutions or TMSI is a full-fledged rural hospital consulting company that provides a wide menu of services including: operational assessments and evaluation, strategic planning, executive-level searches and vendor endorsement. Now both of these companies share the TORCH logo, so that you can be sure that you will receive the same amount of care for your individual needs and quality of service that you have come to expect from TORCH.

Now, we invite you to visit our new Web sites for TORCH, TORCH Foundation and TORCH Management Services. The development of these new up-to-date online resources is a pain-staking process and it is far from over. However, you will notice right away that the goal has been to collect every available piece of relevant material for rural hospital administrators, staff and trustees and put it in one place so that you no longer have to waste valuable time searching for the information you need most. There is extensive information about the three organizations that bear the TORCH name, but also rural health policies, data and statistics to help you make a presentation, digest a rural health issue or apply for your next grant. We hope that you will all avail yourselves of this new member service. It’s been a long time coming, but we are well-prepared to soon celebrate 20-years of service to rural and community hospitals in Texas with a new look and a commitment to combining the strengths of these three great organizations.

Visit www.torchnet.org and there you will find at the very top, links to www.torchnet.org/foundation and www.torchnet.org/tmsi. Please provide us your feedback and be sure to tell us if you know of any information that would be useful to include in this new comprehensive Texas rural health resource. 

The TORCH Annual Award Luncheon is also the time during which we honor a rural hospital administrator who embodies this spirit of superior service to their local community. In recognition of three decades of service in healthcare and to rural hospitals, including CEO at Perryton, Kansas, Alaska and Oklahoma, Wally Boyd has been named the recipient of the 2009 “Gordon Russell Merit Award.” This award exists to recognize outstanding achievement by rural and community hospital administrators for their leadership and dedication to the profession. Gordon Russell, the award’s namesake, was the administrator of Hi-Plains Hospital for over 40 years and a former mayor of Hale Center, TX. Mr. Boyd was selected for his dedication to rural hospital administration, his active involvement in TORCH as a former Board Member, as well as many other civic and professional contributions.

Mr. Boyd began his career in healthcare in 1979 as Director of Support Services for the hospital in Claremore, Oklahoma. After working as the Assistant Administrator at the Children’s Medical Center in Tulsa and for the Great Plains Health Alliance, he went to Nome, Alaska to be the Director of the Norton Sound Health Corporation’s Hospital Services Division. Wally then returned to the lower 48 and became administrator of Bob Wilson Memorial Hospital  in Ulysses, KS. He then worked for the U.S. Public Health Service/Indian Health Service in Oklahoma before moving back to Perryton in 1994.Wally is a Fellow in the American College of Healthcare Executives and has both a Bachelor of History/Political Science and a Master of Public Health degree. He is a licensed minister, THIE board member, Past-president of the Northwest Texas Hospital Association and the Coalition of Health Services.

In the nomination letter by John Henderson, CEO of Childress Regional Medical Center, it was written, “Wally has accomplished what we all set out to do – he has made a difference. Over his 30 year career, he has touched countless lives through his work as a civic leader, minister, mentor and hospital CEO.” TORCH wishes to congratulate Wally Boyd on being selected as this year’s recipient of the Gordon Russell Merit Award. The honor is well deserved. TORCH would also like to thank all those who have served in leadership positions for our organization. Due to their leadership and the support of our member hospitals, healthcare continues to be a vital and viable resource for the millions of important people who live and work in rural Texas.

On April 9th, the Senate State Affairs Committee passed SB 1500 by Duncan 5 votes to 1. The lone no vote on the committee was form Dr. Bob Deuell, the Senator from Greenfield. The bill now moves to the floor of the Senate. That same day, there were 10 TORCH-Member hospitals on hand to tell their story to the Senate Intergovernmental Relations Committee. These hospitals all filed changes to their enabling legislation that would allow them to directly employ physicians. Their testimony made a tremendous impact on the members of the committee, even though the bills were left pending further discussion among the committee, bill authors, hospitals and physicians.

An ophthalmologist and Chairman of the TMA Board of Trustees, Lyle S. Thorstenson, testified in support of the prohibition against the corporate practice of medicine. In his testimony, he stressed that the doctors clinical autonomy was sacred and that this effort by hospitals to employ physicians was tantamount to practicing medicine without a license. TMA’s marketing department has recently gone full tilt in their effort to paint small rural hospitals, which have a mission to provide essential healthcare services to their community, as loaded guns. TMA’s latest message is that hospital CEOs are ready and willing to sacrifice the best interests of the patients they serve.

Texas is one of only five states that continues to explicitly define or actively enforce some form of the prohibition of the corporate practice of medicine.  However, Texas does allow private nonprofit medical schools, school districts, nonprofit health organizations certified by the Texas Medical Board, federally qualified health care centers, and migrant, community, and homeless centers to employ physicians. Additionally, the legislature has allowed approximately 10 hospital districts to change their enabling legislation to employ physicians. The state itself is allowed to employ physicians to work in state academic medical centers, state hospitals, and prisons.

Many smaller Texas communities report that the prohibition against the hiring of physicians is a significant factor contributing to the inability to recruit and retain physicians to serve in those communities. When an individual physician is required to establish a sole practitioner office that requires health insurance and retirement benefits, the cost and administrative burden can be a deterrent to agreeing to practice in a small community.

As proposed, S.B. 1500 provides that a hospital that is designed as a critical access hospital, is a sole community hospital, or is located in a county with a population of 50,000 or less is permitted to employ a physician. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 311, Health and Safety Code, by adding Subchapter E, as follows:

SUBCHAPTER E.  EMPLOYMENT OF PHYSICIANS BY CERTAIN HOSPITALS

Sec.  311.061.  APPLICABILITY OF SUBCHAPTER.  Provides that this subchapter applies only to a hospital that is designated as a critical access hospital under the authority of and in compliance with 42 U.S.C. Section 1935i-4; is a sole community hospital, as that term is defined by 42 U.S.C. Section 1395ww(d)(5)(iii); or is located in a county with a population of 50,000 or less.

Sec.  311.062.  EMPLOYMENT OF PHYSICIAN PERMITTED.  (a) Authorizes a hospital to employ a physician and retain all or part of the professional income generated by the physician for medical services provided at the hospital.

(b) Authorizes a hospital located in a county with a population of 50,000 or less to continue to employ any physicians employed by the hospital on or before the date of release of a federal decennial census that shows the county’s population exceeds 50,000.  Prohibits the hospital from employing a new physician after that date.

Sec.  311.063.  HOSPITAL POLICIES.  (a) Requires a hospital to adopt and maintain policies to ensure that a physician employed under this subchapter whose professional income is retained under Section 311.062 exercises the physician’s independent medical judgment in providing care to patients at the hospital.

(b) Requires that the policies adopted under this section include policies relating to credentialing; quality assurance; utilization review; peer review; medical decision-making; and due process.

Sec.  311.064.  CREDENTIALING AND PRIVILEGES.  (a) Provides that a physician employed by a hospital is subject to the same standards and procedures regarding credentialing, peer review, quality of care, and privileges as a physician not employed by the hospital.

(b) Requires a hospital to give equal consideration regarding the issuance of credentials and privileges to physicians employed by the hospital and physicians not employed by the hospital.

Sec.  311.065.  OTHER HOSPITAL-PHYSICIAN RELATIONSHIPS.  Prohibits this subchapter from being be construed as altering, voiding, or prohibiting any relationship between a hospital and a physician, including a contract or arrangement with an approved nonprofit health corporation that is certified under Section 162.001(b) (relating to approval and certification of certain health organizations), Occupations Code, and that holds a certificate of authority issued under Chapter 844 (Certification of Certain Nonprofit Health Corporations), Insurance Code.

Please stand by as we enter a very important phase of this process. The senate requires 22 members to agree to allow a bill to be heard on the floor. We will be asking you to canvass the members of the Senate very soon. It is imperative that we maintain 22 votes in order to move this bill to the other side of the Capitol. So prepare your talking points and we’ll let you know when we need you to begin making calls and leaving messages.