AAHT Plans Spring Regional Dinner Meetings
Six years ago, the Arkansas Association of Hospital Trustees made the decision to offer a biannual series of  regional dinner meetings to be held in several locations across the state.  These meetings offer hospital trustees and CEOs an opportunity to meet other trustees from the surrounding area, discuss problems and concerns they experience, and share ideas.

The 2001 series will focus on the effects of the Balanced Budget Act  (BBA) of 1997 on Arkansas hospitals and how trustees can convey this information to the community.  

While it is true that some relief will be gained from the Medicare, Medicaid, and SCHIP Benefit Improvement and Protection Act (BIPA) of 2000, most Arkansas hospitals will never gain what was lost through the severe damage caused by the BBA.  It will take years for many hospitals to recover.  That is why it is so important that you attend one of the 2001 AAHT regional dinner meetings.

Larry Walker of Lake Oswego, Oregon, will lead the discussion at each meeting.  Now a consultant to trustee organizations and the American Hospital Association, Walker  is a former board chairman of the 107-bed Mt. Hood Medical Center in Gresham, Oregon, and director of Legacy Health System, a large Portland, Oregon healthcare system.  

He has facilitated many healthcare strategic development processes, assisting healthcare organizations ranging from small rural hospitals to metropolitan healthcare systems and physician groups.  Prior to developing The Walker Company, he published weekly newspapers and business magazines, and served on local city councils and community boards.

Each of the five regional dinner meetings will begin at 5:30 p.m. and should adjourn around 8:30.   Hospital CEOs and trustees are encouraged to attend the session nearest your hospital:

            April 3 – Holiday Inn City Center, Fort Smith

            April 4 – Fayetteville Hilton

            May 15 – Camden Country Club

            May 16 – Holiday Inn, Jonesboro

            May 17 – Conway Regional Medical Center

Registration and programming information will be mailed soon.  Call Beth Ingram at the Arkansas Hospital Association, 501-224-7878, with questions.

Arkansans to Attend AHA Annual Meeting, 
April 28 - May 1, Washington, D.C.
"Creating the Future: A New Era in Health Care for Patients, Communities, Caregivers” is the theme for the American Hospital Association’s annual membership meeting April 28 – May 1, 2001 in Washington, DC.

Arkansas hospital CEOs, administrators, and trustees will visit with Arkansas’ congressional delegation and honor the congressional aides with an appreciation/get-acquainted dinner.

Hospital trustees will have several educational opportunities to discuss trustee responsibilities in a changing environment, patient safety, and a new healthcare delivery system. The annual Capitol Club luncheon for supporters of the AHAPAC will feature the political music troupe, The Capitol Steps.

The group will also hear presentations from speakers such as ABC news correspondent Ann Compton; Judy Schneider, congressional specialist for the Library of Congress; Lou Holtz, former Arkansas Razorback and Notre Dame football coach and now head coach of the University of South Carolina; Paul Gigot, columnist for The Wall Street Journal; and Mark Shields, moderator of CNN’s The Capital Gang.

Meeting and registration information has been mailed to American Hospital Association members or you may register on-line at www.aha.org. Please fax a copy of your meeting registration form to Beth Ingram at the Arkansas Hospital Association (501-224-0519) to receive special mailings detailing Arkansas events.

Legislative Assistance Needed – Charitable Immunity in Jeopardy
The 83rd Arkansas General Assembly is in full swing at the state Capitol.  The Arkansas Hospital Association works hard to monitor the hundreds of bills that are introduced during the session that could affect healthcare and Arkansas hospitals.  From time to time, the AHA will ask for your help in supporting or defeating a bill that has been introduced.

Arkansas Senator Mike Everett has introduced SB 444, a bill that would remove the doctrine of charitable immunity from nonprofit hospitals.  The AHA asks that you review the following discussion points prepared by Lynda Johnson of the Friday, Eldredge & Clark law firm, and write your state senator TODAY opposing the bill, which will be heard in the Senate Judiciary Committee as a Special Order of Business at 10:30 a.m., February 28, in Room 171 of the Capitol:

Without Charitable Immunity, Plaintiffs may seek unlimited punitive damages from hospitals in the State of Arkansas.  Presently claims against charitable or non-profit organizations subject to Ark. Code Ann. §23-79-210 are limited to the amount of the insurance policy maintained by the organization.  This means that plaintiffs may not seek excessive punitive damages from the organizations. 

 If charitable immunity is abolished, plaintiffs may seek to recover not only the policy limits from the insurers, but may also seek to collect any excess amounts, including punitive damage awards, from the hospital.  For most hospitals in Arkansas that have been struggling due to cuts in Medicare brought about by the Balanced Budget Act of 1997, a single multimillion dollar judgement could shut its doors and further reduce the medical care available to rural Arkansans.

The Supreme Court's decision in George v. Jefferson Hospital Association did not affect a change in the manner in which charitable immunity is interpreted.  The fact that the plaintiff failed to recover in the George case was not due to the Arkansas Supreme Court's interpretation of the charitable immunity doctrine – it was due to errors on the part of the plaintiff's attorney.  

The attorney representing Ms. George filed his complaint "just within the statute of limitations" naming only the Jefferson Hospital Association, but not its insurer, St. Paul Fire and Marine Insurance Company.  When Ms. George's attorney later sought to amend his complaint to include St. Paul, this request was denied because the statute of limitations had expired.

The Arkansas Supreme Court even recognized the error on the part of Ms. George's attorney and noted that prior cases had directed an attorney how to proceed against both a hospital and its insurer when it stated:  "Appellant could have sued both initially and through alternative pleading not having jeopardized its claim against either the hospital or its insurer.  

This court's decision in Harville v. Community Methodist Hospital Assn., 302 Ark. 39, 786 S.W.2d 577 (1990) is dispositive of this issue." Even in cases where the insurer may not be known to the attorney for the plaintiff, a plaintiff may protect his rights to proceed against the insurer by naming a John Doe defendant and specifying that such defendant is the insurer of the hospital.

Senate Bill 444 would conflict with the established Arkansas Rules of Civil Procedure that apply to all forms of civil litigation.  The proposed revisions to paragraph (b)(2) of  §23-79-210 (located at lines 15 through 30 on page 2 of the Bill) would establish a procedure that is contrary to the Arkansas Rules of Civil Procedure in that it would: require notification by a charitable or non-profit organization within thirty days of being served of its intent to plead tort immunity, and require that plaintiff's counsel be notified of such information by certified mail.

Arkansas Rules of Civil Procedure:  Currently, if a charitable or non-profit organization is sued in Arkansas, the organization has twenty days in which to file an answer to the complaint. Arkansas Rules of Civil Procedure 12(a).  If SB 444 becomes law, the organization would still be required to file its answer within twenty days, but would also be required to submit a separate notice via certified mail to counsel for the plaintiffs concerning the tort immunity issue.

Currently, a plaintiff or defendant may "amend his pleadings at any time without leave of the court" unless the opposing party objects and the court determines that such amendment would unduly prejudice the opposing party.  Arkansas Rule of Civil Procedure 15(a).  

Therefore, currently, any time that charitable immunity is raised after the initial pleading is filed and such amendment would prejudice the plaintiff, the plaintiff is entitled to challenge the amendment and ask the court to strike the amendment.  

If SB 444 becomes law, no amendments would be allowed to assert charitable immunity, whether prejudice results or not.  Also, with regard to the assertion of charitable immunity, Senate Bill 444 would establish an entirely different rule which would apply only to this one type of litigation.

Arkansas Rule of Civil Procedure 5 only requires that pleadings be served on the attorneys of record via regular mail.  Therefore, if SB 444 becomes law, it will create a unique situation in this type of litigation in that the required charitable immunity notice must be sent via certified mail.

To get a copy of SB 444, go directly from the Arkansas Hospital Association's Web site, www.arkhospitals.org, click on Government Issues, then click on Arkansas General Assembly to review the bill.   Or, go directly to the information regarding the 83rd Arkansas General Assembly at www.arkleg.state.ar.us.

Going Gray
According to The Kiplinger Letter, longer lives and aging baby boomers mean more grandmas and grandpas coming.  It also means:

That a huge impact on markets, employers and culture can't be overstated. Just as the baby boom flooded maternity wards, ignited school construction and made "youth" the cultural icon of the '50s, '60s, and '70s, the senior boom of this century will shape the '10s, '20s, and '30s. The first baby boomers will celebrate their 65th birthday in 2011. The last of them in 2029.

By 2025, we will have 63 million over-65ers, nearly twice as many as today.  Roughly a fifth of the total population, same as for children 13 and under. In 1960, the heart of the baby boom, children outnumbered seniors 3 to 1.

Boomers will enjoy longer lives than their parents – 10-12 years on average. And, many baby boomers who reach age 65 are likely to live for another two decades. Most of the extra years will be healthy and active, thanks to medical advances plus more awareness about diet and exercise.

Twice as many centenarians. . .at least 250,000, up from 72,000 now. Over-85ers will climb from about 4 million to over 7 million by 2025.

Senior boom means tremendous growth for some products and services:

Money matters: financial advice and estate planning, annuities, long-term-care insurance.

Fountain-of-youth products:  hair dye, cosmetics, plastic surgery, anti-aging therapies of all sorts.

Health care: growing demand for home health care, hospices, nursing homes, pharmaceuticals, specialized medical equipment (vision aids, hearing implants, artificial joints, insulin pumps, and more).

Housing and real estate: assisted living and senior communities, remodeling services and sales agents as seniors or their heirs shed their homes.

Gerontic specialties of all sorts:  "elder" law and geriatrics, family counseling, elder-care workers, even academic gerontologists.

AHA's Committee on Governance
The American Hospital Association's (AHA) Committee on Governance is a 28-member group of people from across the country responsible for active promotion of trustee involvement in the AHA.  Twenty-six of the members are currently serving as trustees in AHA-member institutions.

According to Lanny Kope, chairman of the COG, the group has made a commitment to work on five important issues in 2001.  They are:

Patient Safety:  A major issue for trustees, the COG plans to address the broad issue of medical errors that have had such a negative impact on our health system.

Creating the Future:  The major thrust of this initiative will be to provide the AHA board with insights on ways to strengthen hospital governance, especially in entities structured through relationships rather than through ownership organizations.

Political Advocacy:  Always an important task, the political advocacy initiative will carry on its work from 2000 since it seems that politics and healthcare will be going hand-in-hand in 2001.

Trustee Education:  Starting with the AHA Annual Meeting in April, three trustee education programs will be held along with the annual trustee breakfast.

Health Care Policy:  Health care policy, as in the past, will be one of AHA's 2001 initiatives.  The input of trustees in the development of AHA policy is vital since trustees are the community representatives who bring a unique perspective to this area.

APSI Promotes Patient Safety
The Arkansas Patient Safety Initiative (APSI), a coalition of eleven healthcare organizations and advocacy groups formed last year to pursue a common goal of promoting and improving the quality of health services, will sponsor its first educational conference next month.  The Arkansas Hospital Association is a member of the group.

The conference is scheduled for Friday, March 2, at the Chenal Country Club, 10 Chenal Blvd., in Little Rock.  There is no charge for the full-day session, which will run from 9 a.m. to 4:30 p.m., but those wanting to attend need to register by calling Robin Keith at 501-649-8501, ext. 204, or emailing her at arpro.rkeith@sdps.org.

Topics on the conference agenda include major patient safety issues, the relationship between the healthcare delivery system and patient safety, prescription errors, and the ethics of disclosing medical errors.  Dr. Steve Small, director of the University of Chicago's Anesthesiology and Critical Care Safety Group, and Mary Foley, president of the American Nurses Association, are the featured speakers.

Fortune 500 Leaders Listen to Their Hunches
Every single person has experienced it – that nagging, won't -go-away inner voice that drives them to do – or say – something they may otherwise not do or say.  And nine times out of 10, people trust it. But in the board room? Or behind the CEO desk? Increasingly, the answer is "yes."

Word is out that intuition has a key role to play in decision making. Increasingly, Fortune 500 companies are offering training programs to help employees develop their intuitive abilities. Top business leaders, themselves, are learning to trust their own intuition.

Marcia Emery, Ph.D., of Berkeley, California, recently conducted an exhaustive survey of Fortune 500 executives across the country on their thoughts, attitudes and use of intuition as a business practice.  Almost all of those surveyed held the title of CEO. Half reported annual incomes of between $100,000 and $299,000; 47% cited incomes of $300,000 or higher.

"Thirty years ago, when people said the word intuition, they said it very, very quietly," says Emery. "Then, they graduated to viewing intuition as 'a woman's thing,' or 'the thing psychics do in telling your fortune.' It was seen as a gift that only a few people had. And then, in later years, it was, 'oh, intuition – that seat-of-the-pants analysis. I don't want any part of it.'

"But now, finally, intuition is being seen as an invaluable leadership trait.  Not long ago, I was excited to see the cover of Forbes magazine naming Chrysler Company of the Year because it was 'smart, disciplined and intuitive.'  It was a giant step forward."

Certainly, business leaders are acknowledging the benefits of intuition.  In Emery's survey:

Ö More than half (52%) described intuition as "having a hunch or gut feeling."

Ö Eleven percent said they "always" use their intuition in decision making; 53% said they "often" use their intuition.

Ö Ninety percent believed their intuition was "often" correct; the remaining 10% said their intuition was "sometimes" correct.

Ö Twenty-seven percent said they "often" made decisions not based on facts, while 59% said they "sometimes" did.

Ö Seventy-three percent felt they were "moderately" or "very" intuitive.

Ö Nine out of ten executives said they regretted not completely following through on an intuitive decision or idea.

"Increasingly, top leaders of organizations are finding intuition particularly useful especially when there's a high level of uncertainty," says Emery.  "There is no doubt that the tool of the 21st century is intuition." 

               reprinted from Healthcare New Jersey