& RECEIVED FOD 6 1978 Western Oregon Health Systems Agency 975 Oak Street, Suite 320 Eugene, Oregon 97401 503/484-9311 February 2, 1978 Dorothy D. Hoskin, President Western Colorado HSA Board of Directors 2525 E. 7th Street Grand Junction, CO 81501 Dear Ms. Hoskin:. Recognizing that there is an urgent need for increased funding for minimally funded health systems agencies without adversely affecting the funding of larger agencies, the Region X Association of Health Systems Agency Presidents and Executive Directors unanimously adopted the following position statement at its January 27-28, 1978 meeting: The Region X Association of HSA Presidents and Executive Directors In addition the Association feels that this amount should, in fact, be a minimum and that local monies raised by minimally funded agencies should be entitled to Federal matching funds. We hope you will support this position. Please contact me if further clarification is desired. Sincerely, Spencer D. Ralston, President Presidents and Executive Directors SDR:gp Serving the counties of Benton, Coos, Curry, Douglas, Jackson, Josephine, Lane, Lincoln, Linn, Marion, Polk, and Yamhill, RECEIVED FEB 2 1978 President James H Carison Vice President Jane Kirkpatrick, A.C.S. W Secretary Karen & Kaseborg Treasurer Dave Hoerning MEMBERS BY GEOGRAPHIC AREA Baker George Nicolescu Burns Palute Tribe Kenton Dich Umatilla and Warm Springs Tribes Emma Farrow Crook John N Say. D.M.D. Deschutes Dave Hoerning Jane Kirkpatrick, A.CSW. Don O Schuman, O D Gilliam Foster Odom Grant James H Carison Harney Dale White Hood River Jerry Routson Jefferson Herschel Read Klamath Veidon C Boge M.D David A Peterson Catherine Puri, RN. Bryant Willems Lake Robert W. Bomengen. M.D. Malheur WC Hammack Dorin Daniels, MD Morrow Warren H. McCoy Sherman Karen B. Kaseborg Umatilla Harold Delamarter Union (irace Brothers Daniel Kehr, DC Wallowa Edythe O Crane Wasco Robert L Proffitt Ralph M. Stearna Wheeler Kenna Sheen, R.N. This is a letter in support of the position paper on minimally funded rural health system agencies. Our health system agency and many of the health system agencies in Region X, HEW (Alaska, Washington, Oregon and Idaho) are minimally funded health system agencies with extraordinary time/distance problems. The travel problems resulting from our large health service areas and small population densities creates special problems for us in carrying out the requirements and intent of P.L. 93-641. Our agency, Eastern Oregon Health Systems Agency, Inc., encompasses a land mass of more than 68,000 square miles with a population of approximately 3000,000 people. It is readily apparent that our communities are widely spaced when one looks at the map of Oregon. Our HSA covers an area larger than the whole state of Washington. No community is larger than 16,500 people which means we have a great number of small communities spread out over our health service area. The size of our health service area and our minimum funding status of $175,000 has placed a substantial burden on our Agency in carrying our the functions prescribed by HEW. A specific example of one of those problems is that convening our Board, necessary committees and providing them with the necessary staff support requires that our travel budget be large. As a matter of fact our travel budget represents 25.1% of our total budget. This has placed an inordinate amount of our funds in the category of "travel" which effectively robs funds that could be used for additional personnel. We have six (6) staff persons. Four (4) are responsible for agency management and carrying out professional planning and review responsibilities and two staff persons providing secretarial and administrative support. We feel that to expect our health systems agency to perform within the same time frame and produce the same products that other agencies with considerably higher funding levels is unrealistic and results in inappropriate expectations. In addition, there were no predecessor comprehensive Page 2 health planning agencies in our health service area prior to Public Law 93-641 and the concept of a regional, comprehensive health planning is one that takes time, great care and delicacy to sell. In terms of innumerating specific successes of our Agency we feel that the very fact that we have a health system agency organized with nine (9) subarea health planning councils actively participating with us is no small success in itself. Between the 30 persons on our Board and an additional 215 or so subarea health planning council members and probably another 100 or 200 individuals who are working closely with the local health planning councils and our Board, we feel that we have a very strong, active, committed nucleus. They are adopting the concept that looking at our health care problems and needs in a systamatic, rational and thorough manner will benefit the citizens they represent. We believe that we have quite strong relationships with our 18 county courts or commissions as well as with the health care institutions in our health service area. We have completed our health system plan, are moving towards the completion of our annual implementation plan and expect to begin to do selected project and Certificate of Need reviews within the next two months. We feel strongly that if this very delicate and fragile mechanism for improving the health of citizens is to succeed we must have sufficient resources. We are encouraged by the effort of Board and staff members from the minimally funded rural HSAS coalescing around the unique problems but exciting potentials of the minimally funded and rural HSAs. Our Board of Directors have not met as a body to discuss this position paper but on behalf of the Board, I believe that the principals stated in the position paper reflect our Board's concerns and expectations about the role of our health systems agencies and the necessary resource support for them. I can not supply you with names of Board members who are able and willing to testify before committee hearings but will try to determine their availability when we meet as a Board. Thank you very much for your iniative and commitment to represent us at the hearings scheduled in Washington. If there are any questions or concerns that you have or any request for additional information, please don't hesitate to contact us at: Eastern Oregon Health Systems Agency, 1037 North 6th, Redmond, Oregon 97756, or telephone area code 503 548-5185. CC: Richard L. Brownrigg, M.D. Sincerely, དན་ས་ A Carlson James H. Carlson, President Agency We agree with the position as outlined in the position paper from your agency A copy of the 1976-77 Annual Report which includes listing of Committee Miss Mary Storm (114A W. Church St., Frederick, Md. 21701 301-662-8266) and Sincerely, Sterling & Bollinger, Side Sterling Bollinger, Sr, President CC: Senator Charles McC. Mathias, Jr. Representative Goodloe Byron Senator SCHWEIKER. Next we will hear from a panel representing the Washington Business Group on Health, Mr. Richard Martin and Mr. John Brown. We will put your full statement in the record, Mr. Martin, and you may go ahead and highlight it. STATEMENT OF RICHARD MARTIN, MANAGER, HEALTH SERVICES INDUSTRY RELATIONS, GOODYEAR TIRE AND RUBBER CO., AKRON, OHIO; JOHN BROWN, DIRECTOR OF EMPLOYEE BENEFITS, GENESCO, INC., NASHVILLE, TENN.; AND WILLIS GOLDBECK, DIRECTOR, WASHINGTON BUSINESS GROUP ON HEALTH, A PANEL Mr. MARTIN. Gentlemen, my name is Richard Martin. I am the manager of health services industry relations for Goodyear Tire and Rubber Co. in Akron, Ohio. With me today is John Brown, director of employee benefits, Genesco, Inc., in Nashville, Tenn. Also, Willis Goldbeck, director of the Washington Business Group on Health is here and would be happy to assist in responding to any questions you may have. We are representing the Washington Business Group on Health, an organization of more than 150 major employers having serious concerns for the quality and cost of health care. More specifically, we are here because we both serve with our respective health systems agencies. I am the president of the Summit-Portage County HSA in Akron, and John Brown is vice president of the Board of the Middle Tennessee HSA in Nashville. Let me state clearly that we do not, as some have recommended, seek the repeal of Public Law 93-641. Rather, we seek a strengthened and improved health-planning law. Our own experience and the position of the WBGH support the health-planning system. I want to ssure you that we do not take our position casually or base it upon naive hopes. No system which is national in scope and comprises hundreds of new organizational entities will be perfect. No matter what amendments are passed, 10 years from now those who would rather see planning fail will be able to present isolated horror storie. to support their position. We do not want to see planning fail. As business people, we have taken the position that the only responsible way to make health planning truly reflect our local needs is to make a major commitment to working within the system for its improvement and implementation. Business supports health planning for several reasons: One: If properly conducted, it is local planning. Two: The rising cost of health care, of which we are all so well aware. forces us to look inside the system for changes. This is especially true at a time when so many of our Nation's resources are increasingly limited. It is inconceivable to business people that $160 billion segment of our economy would or should be totally devoid of planning. The waste in our health system costs us billions of dollars annually which could otherwise be applied to our very real health needs. Three: As private businesses, we desire to keep our health system in the hands of the private sector to the greatest extent possible. We |