Incumbent Grays Harbor Hospital District 2 commissioner Maryann Welch, who is chairman of the commission, is being challenged by Dale Hensley, a former commissioner for Fire District 2. They are seeking a six-year term. Below, the candidates respond to four questions posed by The Daily World.
Personal
Maryann Welch
Graduate Aberdeen High, Grays Harbor College, University of Washington. 25 years as the County’s Public Health & Social Services Department Director. Third generation Harborite. My husband, Jim, and I have lived in Vesta for 38 years. Hospital Board of Directors nine years, current Public Hospital District Commissioner.
Dale Hensley
I was born in Aberdeen and have lived here my entire life. I worked for Anderson/Middleton Log Division, the Aberdeen Police Department and the Grays Harbor Sheriff’s Dept. before becoming a Firefighter paramedic with the Aberdeen Fire Dept. until I retired. I worked in EMS for most of my life. I have been a commissioner serving on a junior taxing district and served 12 years.
Minutes from the district’s last meeting indicate the hospital’s net income for the year at minus $858,303. What are some of the things the district can do to reverse the losses?
Welch: 1. Achieve acceptance of the move to cost-based payments for Medicaid services provided by our Primary Care Providers – additional revenue of approximately $2 million a year.
2. Closely examine strategies to speed up the revenue stream.
3. Continued successful recruiting efforts will decrease the necessity for temporary providers – a large expenditure the past 2 years.
Hensley: On September 26, 2017, it was reported that the hospital was $1.9 million dollars in the red. I was an elected commissioner for a junior taxing district for 12 years and have never seen anything like this. The hospital needs to implement a “Budgeting, Accounting and Reporting System” (BARS) system of accountability. The hospital district is required by law to use this system. This will show the hospital and public where this money is going. Morale is low and nurses are leaving, requiring the hospital to hire “Traveler Nurses” who cost 2 to 3 times the amount of nurses who live in our area. The billing department is short 14 “Coders,” which has caused $14.5 million dollars to not be billed out. These two things need to be corrected immediately!
Do you have confidence in the current management team at the hospital? If not, what direction would you offer?
Welch: (Chief Executive Officer) Tom Jensen has used his knowledge and skills to navigate a treacherous climate for our rural health system. Receiving 125 percent of fees for services to our Medicaid population has been the most important development in our ability to avoid drastic measures to reduce services and staff. This was due to Mr. Jensen’s creativity and work with the Legislature. Currently, he and his team are working hard to achieve Primary Care cost reimbursement. These efforts and others give me confidence that we have a CEO willing to fight for the survival of our local health system and continue to come up with innovative ways to do so. Critics claim there is a lack of community participation by, or visibility of, the organization’s leaders. I have witnessed the commitment of Mr. Jensen and his team and support their concentration and focus on the crucial work of assuring continuity of services. Additionally, the hospital has been recognized with awards for outstanding services in several areas. Infection control is topnotch as compared to hospitals state and nationwide. These can only be achieved by an outstanding team of employees at every level and an effective leadership team. Yes, I have confidence in the team in place.
Hensley: I do not have full confidence in the board of commissioners (BOC) or the management team. The “Public Non-Profit 501c3 Corporation” (PNPC) made the elected BOC their board members. The elected BOC annually make themselves the “Board” for the PNCP. I believe this is a conflict of interest. Our BOC are wearing two hats. Last year the total amount of time the BOC spent on Public Hospital District meetings was 72 minutes. The longest BOC meeting for 2016 was 8 minutes. The BOC is conducting the hospital district business as the Board of Directors for the PNCP. While they may seem similar, Washington state laws are different between the two entities. The Washington State Constitution’s Article 8 section 7 prohibits a government entity from benefiting directly or indirectly from stocks and bonds. The PNCP does indeed invest in stocks and bonds. This year there was an alleged criminal activity in the finance department. While the amount taken hasn’t been released, this resulted in a $120,000 fine to the IRS. The hospital district is required by law to notify the Washington State Auditor of any type of criminal activity so they can investigate. This wasn’t done. The BOC handled this as the PNCP. The hospital belongs to the “Association of Washington Public Hospital Districts.” This organization makes training available to the commissioners. I believe the BOC needs to take advantage of this training to help the board know it roles, duties and responsibilities. The BOC is responsible to the public for the proper running of the hospital district! Three issues came up this year that should have been handled as a board. (1) The hospital’s choice to not accept Molina-Apple Health Care insurance; (2) The horrible handling of the Montesano Street improvement project in front of their clinic; (3) The recent change to a 49-bed Sole Community Hospital. The management team has shown consistency for running the hospital in the red and poor employee morale for years. The management team needs to be individually evaluated for efficiency, cost effectiveness and results. If warranted, these members need to be replaced with proven managers who have experience in public hospital districts.
3. Difficulty recruiting medical personnel, a high percentage of patients without insurance and uncertainty regarding government-funded insurance make things very difficult for rural hospitals. How does the district meet those challenges?
Welch: These are indeed big challenges! The good news is that this year has been a great one for recruiting – there are seven new providers in the community due to the efforts of the administration and the support of current medical staff. The need for Primary Care is on-going and is the priority for recruitment efforts. As I mentioned above, successful recruiting in all disciplines can have a positive impact on the budget. There remain challenges in retaining providers and planning to fill gaps left by future retirements.
Private organizations are able to restrict the number of Medicaid or Medicare patients seen. We are bound to serve everyone, regardless of their ability to pay. Generally, about 72 percent of those served are on Medicare or Medicaid. The ability to realize, and continue to be paid, the 125 percent of fees for Medicaid upon becoming a Public Hospital District, along with seeing the implementation of cost-reimbursement for Primary Care, will go a long way in meeting these challenges. Much as we’d like to have a large employer with private insurance coverage for employees land in Grays Harbor, we can’t afford to wait on or count on that happening.
Hensley: It’s difficult in hiring nurses and other employees, with the low morale of the hospital staff. Grays Harbor College has a wonderful RN program and their students train at the hospital. The hospital needs to recruit from there and other areas and rely less on traveler nurses if possible. It will be difficult to figure out what will happen with medical insurance, with the state of flux it is in. One of the problems is that insurance companies “cherry pick” the areas where they will cover. Since Grays Harbor is not on the I-5 Corridor, we do not get the same chances for insurance that others do. If this were to change, it would have to be done through the Washington State Legislature. Harbor Medical Group (a division of Community Hospital) seems to be responsible for recruiting physicians. Harbor Medical Group physicians are paid a salary, receive office space, paid staff, health insurance benefits, mal- practice insurance and other financial benefits from Grays Harbor Community Hospital. Some of these positions are necessary for the hospital. They typically are on a three-year contract with automatic renewal. With the recent budget report of being $1.9 million in the red, I don’t see how the hospital can afford more doctors in the Harbor Medical Group. I know of a physician who is in good standing who lives in the Aberdeen/Hoquiam area. He has to travel out of the area to practice family medicine. With the shortage of doctors in this area there is no reason he, or other physicians who are in good standing, should not be allowed to work here. This will bring in more revenue to the hospital. Egos and attitudes need to be put aside for the benefit of the people in our community.
4. Given those challenges, should the hospital consider partnering with a larger health care provider?
Welch: One of the benefits of remaining independent is the ability to claim 125 percent of Medicaid fees. It is doubtful that enhanced reimbursement would remain in place if another entity were to take ownership of the hospital. This is an additional revenue of $5 million to $7 million a year. I am of the opinion that most large systems are not interested in Grays Harbor due to the payor mix being so heavily weighted on the Medicaid/ Medicare side. The only way those organizations would benefit financially would be to cut local services, sending more of our residents out-of-county for their needs. At this point, it is prudent to continue to seek ways to maintain the local control that will assure the services that the community needs are provided right here at home.
Hensley: Absolutely! The taxpayers of Hospital District 2 are the owners of Grays Harbor Community Hospital. My number one goal is to assure that a quality hospital (regardless of the name) will be available to our citizens in their time of need. The Board of Commissioners is ultimately responsible for the operation of the hospital. Community Hospital saves lives! Community Hospital is one of the largest employers in our community! Community Hospital is necessary for our residents and visitors to our area!
