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.

El Campo Memorial Hospital recently celebrated its 30^th anniversary of providing compassionate healthcare services to the people of El Campo and Wharton County.

As the primary source of family healthcare, El Campo Memorial provides services that range from pediatrics to geriatrics as well as in- and out-patient and diagnostic procedures. Like many other rural hospitals, El Campo Memorial’s achievement was not one without challenge.  Through a public initiative to raise money for a new facility in 1979, they opened their doors to a much needed facility to replace their predecessor.

“Everyone at the hospital is excited to be celebrating this milestone,” said Steve Gularte, CEO of El Campo Memorial Hospital.  “The hospital has come a long way since its inception back in 1979.”

With this great milestone, the Texas Organization of Rural & Community Hospitals is excited to congratulate El Campo Memorial for this amazing milestone.

The Texas Organization of Rural & Community Hospitals (TORCH) has launched a revamped Web site designed to become a greater resource for current and prospective members.

The new Web site (www.torchnet.org) features a powerful design that provides visitors with quick access to the vast amounts of resources the organization provides. Additional features include an enhanced events calendar, an exclusive section for members only, RSS feeds, and more.

For advertising opportunities or information becoming a member, please call 512-873-0045.