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KershawHealth to administer $750,000 AccessHealth SC grant

Will assist uninsured patients' access to healthcare

Posted: August 27, 2010 11:59 a.m.
Updated: August 30, 2010 5:00 a.m.

In the near future, low-income, uninsured residents of KershawCounty will have an easier time accessing healthcare services, thanks to a $750,000 AccessHealth SC grant recently awarded to KershawHealth by the Duke Endowment.

"This won't add to our profit, but it will benefit the county," said KershawHealth President and CEO Donnie Weeks.

According to a press release issued during the KershawHealth Board of Trustees' Aug. 23 meeting, KershawHealth will partner with the Community Medical Clinic, Sandhills Medical Foundation, ALPHA Center, S.C. Department of Mental Health and the S.C. Department of Health and Environmental Control's Kershaw County Health Department. The grant will fund efforts by the partnership to improve care coordination, enrollment in services and access to specialty care.

"This could bridge where we are today and 2014, when most of the healthcare reform changes come," Weeks said. "It will help patients in charity situations."

Weeks said Vice President Mike Bunch had been leading the effort to both obtain the grant and form the partnerships. Bunch said KershawHealth's partners have been "outstanding" to work with.

"The teamwork has been tremendous," said Bunch. "I think this will push us forward ... for years to come. The one really good thing is that it drives organizations to the table so we can look at these patients to guide them to care."

KershawHealth officials explained that AccessHealth SC's goal is to "spark sustainable health system change that provides medical 'homes' and ensures timely, affordable, high-quality healthcare services for low-income, uninsured patients."

It said the newly formed netowrk will serve as a central location for the coordination of community care and assigning of medical "homes" for patients. The idea is to reduce fragmentation and confusion for patients among agencies with different eligibility criteria and admission processes.

"The core of this is case management ... those who don't have a medical 'home' and guide them to the care they need. It will help us really start to organize how we provide care," Bunch said.

For example, Bunch said, if a patient comes into KershawHealth's emergency department, staff would know which case worker to involve.

"We need to figure out what roadblocks there are for these patients -- education, transportation," added KershawHealth Chief of Staff Todd Alderson, "and set them up with someone who can help."

Weeks said the timing of the grant award couldn't have come a better time because there are more people in need of such help than ever before.

In the press release, KershawHealth acknowledges that Kershaw County is a rural community with a limited number of healthcare providers: a free medical clinic, federally-qualified health center, local health department, medication providers and private providers in addition to the hospital itself.

"Many of our patients come to us with chronic, untreated conditions that require specialized care," Kathy Moser, a family nurse practitioner with the Community Medical Clinic said in the press release. "Having case managers who will arrange referrals to specialists, schedule appointments and coordinate care with patients will be a trememendous resource. It will help us make the most of available resources and it will allow me to spend more of my time in actual patient care.

"That benefits everyone."

According to a fact sheet handed out at the board meeting, AccessHealth SC is based out of the S.C. Hospital Association. The program provides technical assistance and shares best practices, creates networks of care, works toward sustainable health system change and creates access to care for uninsured patients. The Duke grant application included funding requests for a program leader, case mangers, IT support and part-time physician or extender.

Coupled with the AccessHealth SC announcement, Weeks led a discussion on the impact of the recently passed healthcare reform legislation. While most of the changes will hit consumers and providers in 2014, a time line Weeks handed out looked further ahead, to 2020.

"One of our biggest issues will be the daily cost of delivering healthcare," said Weeks, listing out staff salaries, regulation compliance, malpractice insurance, equipment and supplies as some of KershawHealth's biggest expenditures.

Weeks said that at a recent conference, attendees were presented a "thought-provoking" exercise: to name four things the government has a priority of "fixing." In order, they were wrapping up the war in Afghanistan, illegal immigration, reducing the debt/creating jobs and, at the bottom, protecting physicians in terms of government reimbursements.

"If that's a fact, then we have go to find a way to lower costs," Weeks said. "One way is to do things differently with our partners, including staff. We could help physicians that want to add to their practices so we can increase the number of physicians to serve the community. The hospital can with some incremental costs."

Another way to deal with the situation, said Weeks, is to collaborate -- similarly to how AccessHealth SC will work -- and form a network of physicians to deal with information technology issues.

"The government has relaxed the regulations on how to do that. I believe IT (advancements) will reduce costs for healthcare providers," said Weeks.

In the meantime, KershawHealth is still experiencing some financial pain. Trustee Scott Ziemke, in his role as finance committee chairman, reported that the healthcare system suffered an operating loss of $1.3 million in the month of July, compared to operating income of $427,000 a year ago. The total net loss for the month was $871,000, compared to net income of $467,000 in July 2009. Ziemke did note that July was a three-payroll month, adding higher salary costs for the period.

The year-to-date operating loss as of July 31 was $70,000, compared to year-to-date operating income of $2 million at the same point the year before. There was some good news: total net income for the fiscal year to date stands at $1.5 million. However, that did not compare favorably with a total net income of $3 million at that point in 2009.

Vice President and CFO Don Trippel said another factor was the fact that total inpatient and observation admissions were down 7 percent below July 2009. Surgeries were 11 percent below July 2009; deliveries, 21 percent below; emergency department visits, 5 percent below. On the plus side, total outpatient volumes were 11 percent above July 2009, and Elgin Outpatient Center volumes continue to increase.

"We are already 10 percent above last August's admissions and should be higher than July if we continue as we are for the rest of the month," said Trippel.

The finance committee reported two capital expenditures. KershawHealth is spending approximately $150,000 to upgrade cold water, hot water and hot water return pipes in the oldest parts of the facility.

"We are replacing pipes that go back in time 55 years. We are seeing leaks and ruptures," said Bunch, who later showed off a section of pipe with heavy build up inside that would restrict water flow. "It's going to be a really long project and we anticipate allocating more funds in 2011."

KershawHealth will also spend some $175,000 to replace two orthopaedic towers with cameras. Vice President and Chief Nursing Officer Gloria Keeffe said that 73 percent of the hospital's orthopaedic procedures are performed using the towers, but are not compatible with high definition upgrades KershawHealth is trying to make.

Finally, Weeks, reported that Standard & Poor's and Fitch have maintained their bond ratings for KershawHealth. He said S&P listed a good position, with more than a 50 percent share of the Kershaw County market; good operating profits; and modest debt capacity as strengths. Things to look out for included the level of KershawHealth's bad debts and charity coupled with the county's high unemployment rate.

The KershawHealth Board of Trustees meets on the fourth Monday of each month at 6 p.m., beginning with a meal, at at the Health Resource Center on Battleship Road in Camden. All meetings are open to the public.

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