Thanks for AHAPAC Contributions
The following Arkansans contributed $185 or more to the Arkansas Hospital Association's Political Action Committee (AHAPAC) during 1997, thereby becoming members of the 1997 Chairman's Club:

• Robert Atkinson, Jefferson Reg. Med. Center
• Bob Bash, Booneville Community Hospital
• Patsy Beatty, Arkansas Hospital Association
• David Blackburn, Arkansas Heart Hospital
• Eddie Bradford, Northwest Ark. Rad.Therapy Inst.
• JoAnn Butler, Arkansas Hospital Association
• Roy Clinton, Trustee, Washington Reg. Med. Ctr.
• Harrison Dean, Baptist Memorial Med. Ctr.
• Lucinda DeBruce, Charter Behavioral Health Sys.
• Roger Feldt, Saline Memorial Hospital
• Alan Finley, Van Buren County Memorial Hosp.
• Lee Gentry, Lawrence Memorial Hospital
• Gary Hollis, Baptist Memorial Hosp/Blytheville
• Diana Hueter, St. Vincent Infirmary Med. Ctr.
• David Laffoon, Central Arkansas Hospital]
• Ray Montgomery, White County Medical Center
• Michael Morgan, St. Edward Mercy Med. Ctr.
• Thomas O' Neal, Bates Medical Center
• Scott Peek, Chambers Memorial Hospital
• Allen Smith, Baptist Health
• James Summersett, Conway Reg. Med. Ctr.
• Philip Walkley, Methodist Hospital of Jonesboro
• Doug Weeks, Baptist Med. Ctr/Bapt. Rehab. Inst.
  
  Thanks for AHAPAC Contributions Cont.
  The following Arkansans contributed $250 or more to the AHAPAC and the American Hospital Association Political Action Committee, thereby becoming members of the American Hospital Association PAC's 1997 Capitol Club:

• Don Adams, Arkansas Hospital Association
• Gary Bebow, White River Medical Center
• Roger Busfield, Georgetown, Texas
• Paul Cunningham, Arkansas Hospital Association
• Jeff Curtis, HSC Medical Center
• Randall Fale, St. Joseph's Regional Health Ctr.
• Joseph Fischer, BHC Pinnacle Pointe Hospital
• Patrick Flynn, Washington Regional Med. Ctr.
• Dan Gathright, Baptist Med. Center/Arkadelphia
• Gary Gray, Moore Stephens Fros
• Russell D. Harrington, Jr., Baptist Health
• W. D. Hedden, Magnolia Hospital
• Michael D. Helm, Sparks Regional Med. Ctr.
• Beth Ingram, Arkansas Hospital Association
• Randy King, Baptist Memorial Hosp/Blytheville
• Steve Lampkin, Baptist Health
• Luther Lewis, Medical Center of South Arkansas
• Jerry Mabry, National Park Medical Center
• Mike McCoy, Saint Mary's Reg. Med. Ctr.
• Ben Owens, St. Bernards Reg. Med. Ctr.
• Barry Pipkin, The BridgeWay
• Ron Rooney, Arkansas Methodist Hospital
• Stan Townsend, Stone County Medical Center
• Eugene Zuber, Newport Hospital & Clinic
  
  The following Arkansans contributed $500 to the AHAPAC and the American Hospital Association Political Action Committee, thereby becoming members of the American Hospital Association PAC's 1997 Chairman's Circle.

• Ross Hooper, Crittenden Memorial Hospital
• Phil Matthews, Arkansas Hospital Association
• C. C. McAllister, Ouachita County Medical Ctr
• Curtis Shipley, Trustee, Washington Reg. Med. Ctr.
• Jim Teeter, Arkansas Hospital Association

We hope to have a longer list in '98!

Arkansas Hospitals Meet '97 AHAPAC Goals
The Arkansas Hospital Association begins each year's AHAPAC campaign by setting a modest goal for every hospital, which is $1 per bed with a $185 minimum. Hospitals reaching their goals are:

• Arkansas Heart Hospital, Little Rock
• Arkansas Methodist Hospital, Paragould
• Baptist Medical Center, Little Rock
• Baptist Medical Center/Arkadelphia
• Baptist Memorial Hospital/Blytheville
• Baptist Memorial Hospital/Osceola
• Baptist Memorial Medical Center, NLR
• Baptist Rehabilitation Institute, Little Rock
• Bates Medical Center, Bentonvill
• BHC Pinnacle Point Hospital, Little Rock
• Booneville Community Hospital, Booneville
• Central Arkansas Hospital, Searcy
• Chambers Memorial Hospital, Danville
• Charter Behavioral Health System/LR
• Conway Regional Medical Center, Conway
• Crittenden Memorial Hospital, West Memphis
• HSC Medical Center, Malvern
• Lawrence Memorial Hospital, Walnut Ridge
• Magnolia Hospital, Magnolia
• Methodist Hospital of Jonesboro
• National Park Medical Center, Hot Springs
• Newport Hospital & Clinic, Newport
• Northwest Ark. Radiation Therapy Inst., Springdale
• Ouachita County Medical Center, Camden
• Saint Mary's Regional Med.Center, Russellville
• Saline Memorial Hospital, Benton
• St. Joseph's Regional Health Ctr., Hot Springs
• Stone County Medical Center, Mountain View
• The BridgeWay, North Little Rock
• Van Buren County Memorial Hospital
• Washington Regional Med. Center, Fayetteville
• White County Medical Center, Searcy
• White River Medical Center, Batesville

AHA Workers' Comp Dividends
Last week the Arkansas Hospital Association Workers' Compensation Self-Insured Trust (AHAWCSIT) distributed over $1.2 million in dividends to 36 hospitals that purchase their workers' compensation coverage through the Trust. Ron Rooney, chairman of the AHAWCSIT, said he feels the net expense (premium less dividends) makes workers' compensation through the Trust an outstanding buy for participating hospitals.

The Trust has distributed a total of $5.1 million in dividends to its members over the last three years. Members of the board of directors of the Trust are: Ron Rooney, chairman, Arkansas Methodist Hospital, Paragould; Jeff Curtis, HSC Medical Center, Malvern; Phil Matthews, Arkansas Hospital Association; Robby Reddish, Chicot Memorial Hospital, Lake Village; Eugene Zuber, Newport Hospital and Clinic, Newport; Tom Siemers, Rebsamen Regional Medical Center, Jacksonville; Rudy Darling, Carroll Regional Medical Center, Berryville; and Jim Summersett, Conway Regional Medical Center, Conway. Any hospital wishing to participate in the self-funded trust should contact Patsy Beatty or Phil Matthews at (501) 224-7878.

Arkansas Hospital Association Launches New Web Site
The Arkansas Hospital Association (AHA) recently launched its web site (www.arkhospitals.org) providing another medium for instantaneous communications with member hospitals. What can you find out from the AHA's website?

-- About AHA -- information about the AHA, the board of directors, the Executive Committee, the AHA staff, institutional members and affiliate groups; (you can e-mail the board, the staff, and individual hospital members from this area);
-- Governmental Issues -- state and national legislative and regulatory matters; link to members of the Arkansas Legislature and the state's congressional delegation, and e-mail members directly; and review the archive of the AHA Legislative Bulletin;
-- Publications -- peruse current and past issues of The Noteboo, Arkansas Hospitals, the Legislative Bulletin, and, The Arkansas Trustee;
-- News Flash -- late-breaking and important news for AHA members;
-- Calendar -- upcoming educational meetings and seminars, and registration information for specific events;
-- AHA Services -- products and services available to AHA members, along with a list of companies endorsed by AHA Services;
-- Links -- to many governmental and regulatory agencies, news organizations, as well as various healthcare publications;
-- Search -- input a word or phrase and search through the various information on the web page pertaining to that subject;
-- Feedback -- allows the user to provide instantaneous feedback or response to the AHA about the topic of your choice;
-- Members Only -- contains information intended for members only. Access requires a user name and password, which were communicated to hospital CEOs in a memorandum on January 13, 1998.

An Interstate Compact for Mutual Recognition of Nursing Licensure
Faith A. Fields, MSN, RN, Executive Director, Arkansas State Board of Nursing

The 1997 Delegate Assembly of the National Council of State Boards of Nursing (NCSBN) took a monumental step in the advancement of nursing regulation by adopting a recommendation endorsing an interstate compact for mutual recognition of nursing licensure. A 12-member multi-state Regulation Task Force was appointed by the NCSBN Board of Directors to identify the magnitude of the need for multi-state licensure and to make recommendations.

The NCSBN, of which the Arkansas State Board of Nursing is a member, took this step in regulatory reform to meet the needs of a changing healthcare delivery environment for the following reasons:

-- nursing practice is increasingly occurring across state lines;
-- new practice modalities and technology are raising questions regarding compliance with state licensure laws;
-- expedient access to qualified nurses is needed and expected by consumers;
-- expedient authorization to practice is expected by employers and nurses;
-- and, having to demonstrate the same licensure qualifications to multiple states for comparable authority to practice is cumbersome and expensive.

The Task Force's vision statement, "a state nursing license recognized nationally and enforced locally," means nurses could care for clients wherever they are, based on any care delivery methodology. States' rights to determine who does and does not practice would be respected.

A legal review has revealed that the simplest workable approach to multi-state regulation is a model of mutual recognition, because it is the closest model to the existing system; it reflects the legal concept of full faith and credit between U.S. jurisdictions; and it could be implemented incrementally, with states "signing on" as they are legally able. "Signing on" would be accomplished through the legislature enacting an interstate compact for nursing home licensure into law.

An interstate compact is an agreement between two or more states, established for the purpose of remedying a particular problem of multi-state concern. It is a useful tool for states to accomplish tasks that are within their realm, such as licensure, but which require a multi-state solution. Nearly 200 compacts are in existence. They govern a variety of areas, including natural resources, taxation, corrections, and health.

An example of a current interstate compact is the driver's license compact, which allows an individual to drive in a state in which he/she does not hold a license. It addresses jurisdiction, discipline, and sharing of information related to an individual licensed in one state and driving in other states.

In using this model for nursing licensure, practice across state lines is allowed, whether physical or electronic, unless the nurse is under discipline or a monitoring agreement that restricts practice. A central information system containing relevant licensure and disciplinary information would keep the nurse' s file current and accessible to boards of nursing. Disciplinary actions would be initiated by the state in which the practice violation occurred. The nurse would renew only in the state in which she/he lives. Only if the nurse moved to another state would a new license be required.

An interstate compact for mutual recognition of nursing licensure will provide a mechanism for enhancing mobility of nurses while maintaining a state-based system of licensure and discipline. Other benefits include providing a one-stop database; increasing the speed of endorsements; decreasing the number of applications to be processed; and giving a board of nursing jurisdiction over all nurses practicing in their state. Consumers will have clear recourse when they wish to report a nurse. Nurses will be able to obtain multiple licenses with decreased cost and trouble. And, most important, the consumer's access to safe and qualified nurses is expanded.

Following an informational meeting with ANA, a special meeting of the Delegate Assembly of the NCSBN was held December 14-15, 1997 in Chicago. At this time delegates, including those from Arkansas, voted to adopt this interstate compact for mutual recognition of nursing licenses. If the interstate compact is passed in the 1999 Arkansas legislative session, mutual recognition of licensure could be implemented in the year 2000 with any other state who has enacted the legislation. This will be a significant benefit for hospitals, educational programs, home health agencies, and other health related facilities employing nurses who practice across state lines.

Columbia Divesting Arkansas Hospitals
Columbia HCA Healthcare Corp. has approved an internal operating reorganization plan that will reduce its hospital holdings by more than 100 facilities, including its three remaining Arkansas hospitals. Columbia's board approved the plan effective January 1. The plan will cut the number of Columbia-owned hospitals nationwide from 340 to 232. At the same time, the company will reduce its number of ambulatory surgery centers from 148 to 115.

The reorganization plan would remove Columbia's presence in Arkansas, if carried out. Columbia DeQueen Regional Medical Center, Columbia Medical Park Hospital in Hope, and the Medical Center of South Arkansas in El Dorado are all included on a list of Columbia hospitals slated for either sale or a spin-off into a separate company. The company announced November 14 its intent to sell the operations of Columbia Doctors Hospital in Little Rock to St. Vincent Infirmary Medical Center. The three Arkansas hospitals to be divested are to be combined with 38 other Columbia hospitals in a group that could be spun-off into a separate corporation.

An analyst with Little Rock's Stephens, Inc. said the group would be viable as a stand-alone company. The remaining hospitals involved in the restructuring will be organized into two other divisions. If any spin-offs of the three divisions occur, the newly formed companies would operate independently, but would have continued access to several Columbia benefits including national purchasing agreements, information systems, and managed care contracting.

Profiling Community Health Status
Compiling original data on a community's health status isn't always the best starting point for a community health improvement group. The time and cost involved in conducting surveys and interviewing target groups can stall a health improvement effort before it gets started.

A number of local, state, and federal agencies -- as well as other organizations serving various population group -- have a wealth of resources for profiling a community's health status, risk factors, and healthcare resources, including data on population characteristics, insurance coverage information, disease rates, preventive care screens and hospital admissions.

The following list of common indicators of health status and sources for statistics was compiled by The Lewin Group, Fairfax, VA., and published in A Guide to Community Assessment Programs by Grantmakers in Health, Washington, D.C.

Health Status Indicators

• Population by age, sex, education, occupation, income/poverty status, marital status
• Population by race and ethnicity
• Unemployment rate
• Number of individuals receiving AFDC, public assistance, Medicaid, food stamps
• Population by insurance coverage status
• Potential Data Sources
• U.S. Bureau of the Census
• U.S. Bureau of the Census
• State labor department
• State human services department
• Current population survey for state-level insurance status (state health department); survey of population; data from third-party payers, employers, hospitals
• Health Status
• Mortality and morbidity rates
• Communicable disease rates (measles, mumps, tuberculosis, syphilis, gonorrhea, AIDS)
• Cancer incidence by stage of disease at diagnosis
• Disability rates
• Potential Data Source
• State health department; U.S. Department of Health and Human Services
• State health department
• Cancer registries
• Area council on aging; National Health Interview Survey; National Center for Health Statistics; disabilities advocacy groups
• Risk Factors Indicators
• Natality and infant mortality rates; teen pregnancy rate/number of illegitimate births
• Accidental injury rates by cause of injury
• Potential Data Sources
• State health department
• National Vital Statistics System; Centers for Disease Control and Prevention; hospital discharge data; state and local health departments
• Utilization of Resources and Capacity
• Admissions per 1,000 population
• Length of stay (average)
• Delivery of preventive care screens and early detection programs (e.g., mammograms)
• Potential Data Sources
• National Center for Health Statistics; National Hospital Discharge Survey and National Health Interview Survey; local hospital associations; facility data, U.S. Bureau of the Census
• Local hospital associations; facility data
• Centers for Disease Control and Prevention; National Center for Health Statistics
• Capacity Indicators
• Beds per 1,000 population
• Physicians per 1,000 population (primary care; specialty)
• Number, types, and capacity of facilities (acute care, diagnostic and treatment centers, outpatient clinics, dental services, rehabilitation, psychiatric care, nursing home, long-term care, home health agencies)
• Potential Data Sources
• American Hospital Association; facility data; U.S. Bureau of the Census
• State education department; American Medical Association; specialty medical practices; U.S. Bureau of the Census
• State health department; U.S. Department of Health and Human Services; state hospital associations; facility data

Source: A Guide to Community Health Assessment prepared by the Lewin Group for Grantmakers in Health, Washington, D.C., September 1996