State Crime Lab Reminder

The State Crime Laboratory (SCL) recently notified the Arkansas Hospital Association (AHA) that some hospitals are not cooperating when the SCL requests medical records.

It is extremely important that hospitals abide by Arkansas statute 12-12-311(c) which requires that "any physician, surgeon, dentist, hospital, or supplier of healthcare services shall cooperate and make available to the Executive Director of the State Crime Laboratory or his staff, the records, the reports, charts, specimens, or x-rays of the deceased as may be requested where death occurs and investigation is being conducted under the provisions of this subchapter."

The medical examiner's request for information may be made by phone or through the crime laboratory's Cause of Death form.

Study Shows Arkansans Inactive, Flabby

A new study conducted by the Arkansas Department of Health confirms at least one suspicion why the state ranks at the bottom in terms of overall health. The study, which was designed by the national Centers for Disease Control and Prevention, showed that Arkansans don't exercise enough and, as a result, are becoming sick.

It indicates that there is a lack of focus on physical fitness among the state's population, noting that only one-third of Arkansas high school students participate in physical education (PE) classes and a third of adults don't engage in some type of physical activity. Arkansas rates for students who take PE classes were better than the U.S. rate. Nationally, 20% of high school students take a PE class, but just 28% of adults report no regular exercise.

David Bazzel, chairman of the Governor's Council on Fitness, responded to the report urging that state health officials, legislators, and educators do more to emphasize physical activity. He also asked that state Department of Education officials increase the number of credit hours of gym classes that are required for graduation from high school. Currently, only one semester of gym is required in Arkansas for all four years of high school.

Governor Wants Arkansans Insured

Arkansas Governor Mike Huckabee has established a goal for his administration to get healthcare insurance coverage for all Arkansans. The governor, who already is actively supporting use of part of the state's $1.62 billion tobacco settlement fund to expand Medicaid coverage, said that his 2001 legislative agenda will include a small-business insurance bill.

Also, state Health Department director Dr. Fay Boozman said his agency has applied for a $1 million-plus grant from the federal Health Resources and Services Administration (HRSA) to pay for a study detailing an approach for the state, its employers, and residents to work together to get every Arkansan covered.

According to Boozman, the HRSA will award grants to 10 states this year for activities related to obtaining full insurance coverage. Five grants will go to states nearing the goal, while the remaining funds will be directed toward states just now beginning that quest. Grants are scheduled to be awarded in the fall. However, Governor Huckabee said his goal won't change whether the state receives the HRSA grant money or not.

PEPP Compliance Workbook

On June 7, the Arkansas Foundation for Medical Care (AFMC) PEPP team distributed copies of the Payment Error Prevention Program/Compliance Workbook to hospital compliance officers attending an Arkansas Hospital Association quarterly Compliance Forum.

This workbook was prepared by the Texas Medical Foundation, acting as the Payment Error Prevention Support Peer Review Organization (PEPSPRO), to assist PROs in the implementation of PEPP. It is an excellent resource tool for any department involved in hospital compliance. The workbook provides guidance for developing and implementing a general hospital compliance program, a coding compliance program, a claims auditing program, and a utilization management compliance program. It addresses documentation issues that affect payment and includes many tools to assist in your compliance efforts.

If you are responsible for departmental compliance, ask your hospital administrator or compliance officer to provide you with a copy of the workbook. If your hospital has not received a copy of this workbook, contact Tori Gammill at (501) 649-8501, ext. 248, to set up an appointment.

AAHT Elects Officers

The Arkansas Association of Hospital Trustees (AAHT) on May 19 elected board members for 2000-2002.

Trustees elected AAHT officers are: president—Ray Kordsmeier, Conway Regional Medical Center; president-elect—Lathan Hairston, Bradley County Medical Center, Warren; secretary-treasurer—Peggy Talkington, Saint Mary's Regional Medical Center, Russellville; and past-president—John Collier, CrossRidge Community Hospital, Wynne.

Directors elected are: Karen Clark, Baxter Regional Medical Center, Mountain Home; Alan Patteson, St. Bernards Regional Medical Center, Jonesboro; Rob Brothers, St. Mary's Hospital, Rogers; and Steve Smart, Medical Center of South Arkansas, El Dorado.

AHA Patient Safety "Talking Points"

The Arkansas Hospital Association (AHA) has developed a series of "talking points" to assist member hospitals and health systems in responding to questions that may arise over the issues of medical errors and patient safety. The "talking points" were mailed to Arkansas hospital CEOs.

In November 1999, the Institute of Medicine (IOM) issued a report concluding that hospitals and clinicians in the United States are responsible for an estimated one million preventable medical injuries and 44,000 to 98,000 deaths each year that are directly related to medical errors.

The report, To Err is Human: Building a Safer Health System, clearly indicates that most medical errors are the result of a system that relies heavily on human involvement in a process where there is a high probability for mistakes to occur. It also focused the public’s attention on the issue of patient safety and has created support by some members of Congress for legislation to require the reporting of all medical errors that occur in the nation’s hospitals.

During its May 12 meeting, the AHA board of directors discussed the patient safety issue. While the IOM report didn’t generate much media attention locally when it was released, some board members believe that patient safety will gather more interest as congressional debates about various medical error reporting bills heat up.

The board agreed that the AHA should provide some general guidelines to all member hospitals recognizing that errors sometimes occur and indicating what hospitals in the state are doing to reduce errors and improve patient safety measures.

Clinical Pastoral Education Programs Available in Arkansas

The Rev. Bill Carr, an ordained Presbyterian minister, came to the University of Arkansas for Medical Sciences in Little Rock as chaplain in 1985. Three years later, he organized the clinical pastoral education program, which had been sought by UAMS officials and many in the Little Rock religious community.

The training program was the first of its kind in Arkansas when it started in 1988. Another program exists today at Jefferson Regional Medical Center in Pine Bluff.

"It was really a partnership," Carr said. "Several denominations joined together to give financial resources and encouragement to begin the program" at UAMS. Since UAMS is a teaching center, officials decided the chaplaincy program should be a training ground as well. Some 120 students have completed the program, which is nationally accredited by the College of Pastoral Supervision and Psychotherapy and the Association for Clinical Pastoral Education.

In the program, "Students learn some psychology and theology and how it relates to human behavior. They learn about illnesses, health and how to work in an interdisciplinary way with the medical staff," said Carr. "They also learn a great deal about themselves. Personal growth goes a long way toward helping others. You have to develop your own emotional and spiritual life." Students serve as chaplains and chaplaincy interns for the hospital during their training.

Arkansas Insurance Commissioner Issues Warning

Arkansas Insurance Commissioner Mike Pickens informed members of a state House subcommittee that the state faces a healthcare crisis unless the Legislature does something to make health insurance more affordable and increase competition for the healthcare dollar.

Pickens said that 39 insurance companies have stopped doing business in Arkansas since 1998, leaving just seven or eight major health insurance carriers that write healthcare policies here. He said the reduced competition leads to higher costs, which worsens the uninsured ranks. Currently, about 400,000 working Arkansans have no health coverage.

Pickens offered several recommendations to the Insurance subcommittee of the House Insurance and Commerce Committee. They included:

• Reduce state government interference in healthcare.
• Place a moratorium on new coverage mandates.
• Allow small business in the state to ban together in purchasing pools to spread risk and increase purchasing power.
• Consider legislation to make medical savings accounts more attractive to consumers.