May 3, 2001

The View from Hospital District #1

Eric P. Jensen, Administrator

Kittitas Valley Community Hospital

Kittitas County Hospital District #1

It would be difficult to live in Kittitas County during the past two years and not be aware of the turmoil surrounding emergency care, physician practices, and health care delivery in the northwestern portion of our county that constitutes Hospital District #2.

As administrator of Kittitas Valley Community Hospital (KVCH), I and the members of our board of commissioners, have been cautious and respectful of the fact that decisions regarding the future of Hospital District #2 ultimately belong with residents of that district. It has been our approach to maintain our focus on the real issue: access to appropriate and quality health care for the citizens of Kittitas County. This approach includes consideration of the important role KVCH plays in supporting key healthcare services throughout this County. I doubt very much that the average citizen thinks about the fact that KVCH can fulfill this role only if it is financially healthy.

Hospital District #1, which operates KVCH, covers approximately two-thirds of the county. KVCH is the county’s only inpatient acute care facility and, therefore, our service area includes all of Kittitas County. In fact, twenty-eight percent of our inpatients last year live in what is typically called “Upper County”.

On April 24 the board of commissioners of Hospital District #2 decided to contract with Overlake Hospital Medical Center in Bellevue. I think that this was a decision not in the best interests of our communities. It doesn’t take much to upset the balance of health care delivery in a rural healthcare system like Kittitas County. We are all influenced by every other part of the system. As a hospital administrator in this State for the past 13 years, I have watched many urban hospital ventures in rural communities. Too often the corporate goals of these large organizations drive these ventures rather than the needs of the rural population they purport to serve. The most successful strategies were always those that involved collaboration and cooperation with the key stakeholders and healthcare providers in the rural community. It is my assessment that the process by which District #2 selected Overlake to provide interim management services fell short of these principles.

I have frequently been asked my assessment of the current situation in Upper County. To provide a little historical perspective, in 1994 a grant was received to “evaluate and implement a model of integrated /consolidated operations and service delivery” in Upper County. The grant application included both Kittitas County hospital districts and Cle Elum Family Medicine (CEFM). The study was conducted by Health Facilities Planning and Development and LaMasters and Daniel, a public accounting firm.

Recommendations from the final report, completed in March 1995, concluded that the greatest interim benefits for District #2 and CEFM could be realized by consolidating some of their services and operations. This is obviously not the direction we have seen this past year and a half. The consultants also commented that the best long-term solution for the County “may well remain full integration of the Districts” even though Commissioners from both Districts were reluctant to pursue this course of action in 1995. It has been my position that serious consideration of this strategy is a direction that the Upper County residents must initiate, not KVCH.

In the past several years, I and the staff of KVCH have offered counsel and recommendations to staff and the board of Hospital District #2. We have provided the resources of our previous chief financial officer to help Hospital District #2 develop a financial accounting system. A system that seems to have been abandoned sometime last year. As recently as last year we offered copies of a number of our policies and procedures requested by District #2. We also offered to include questions in our community survey of Upper County residents that might benefit District #2. Most recently, KVCH staff and members of KVCH’s board of commissioners have attended public meetings in Cle Elum on numerous occasions. I have been particularly impressed by the number of citizens who have become very knowledgeable and have worked diligently to find a positive solution to the problems at hand.

In early April, we were encouraged by the Citizens’ Committee to submit a proposal for an interim management agreement to help move Hospital District #2 to a more solid financial position and work toward reopening the Immediate Care Center (ICC). KVCH’s proposal to Hospital District #2 included a strong team of experienced managers to provide ongoing business office and administrative support, to assist in establishing billing, collection, and reporting systems, and to facilitate planning for restoration of ICC services. We also offered access to KVCH’s group purchasing discounts, employee skill labs and continuing education offerings. I also suggested a study, if agreeable to the District #2 commissioners, of the feasibility of establishing the Cle Elum ICC as a “provider-based clinic”. This was a promising strategy that could increase revenues to District #2. It is an option only KVCH could offer. I have felt that it was important to support this group of citizens in their efforts and be responsive to any proposals developed by them involving KVCH. I am disappointed by the lack of consideration given to their hard work by Hospital District #2 commissioners up to this point.

Kittitas County is an outstanding community, with a high quality, well-respected hospital supported by an excellent staff. We are very fortunate to also have superb physicians and emergency medical services. I am convinced that any long-term, viable solution in the Upper County must include a good working relationship with the physicians who live and practice there. It is foolish to think otherwise. The final resolution must be inclusive and reflect the best thinking of those who will be most directly affected by those decisions, including Kittitas Valley Community Hospital.