The health clinics that treat Idaho's poorest residents are hoping to convince the Legislature to make sure more low-income Idahoans can afford to see the doctor.

The proposals they presented Thursday, if adopted, could start to make a dent in the roughly 250,000 Idahoans who don't have health insurance.

The Idaho Primary Care Association pitched the rough plans to the Legislature's Health Care Task Force. The ideas were greeted with interest, along with many skeptical questions.

The community health centers want to create Medicaid-funded "primary care accounts" to get people to see their own doctor before illnesses advance too far. Plus, they want the state to help these Idahoans buy health insurance with a high deductible in case something does go wrong.

Both ideas, theoretically, could save money that's being spent from state and county coffers that pay the health bills of those who can't afford any other solution.

The Idaho Primary Care Association is made up of Terry Reilly and other health centers around the state.

These clinics provide primary care to many without Medicaid or insurance, charging a sliding scale based on the patient's income and dependents.

Many low-income people only see doctors in the emergency room, said Erwin Teuber, executive director of Terry Reilly Health Services.

That's not a "medical home," he said, because doctors don't keep records there, and they don't do the same follow-up as primary care physicians.

That's the idea behind Medicaid's "Health Connections" program, which requires most people on Medicaid to visit one doctor or clinic for all their health care needs.

Emergency room visits are far more expensive than regular trips to the doctor.

The "primary care account" would work like the health savings accounts that many insured Idahoans have, except the state would put money into the account, and the medical fees would be paid directly to the health center or clinic that treated the patient. The patients, too, would be asked to pay for part of each visit, based on what they could afford.

And even though the health insurance proposal would include a high deductible — Teuber guessed it could be about $3,000 — the plans could keep Idaho's counties from paying several thousand dollars more when an expensive health problem sends an already low-income family into indigence.

If Idahoans don't have health insurance or qualify for Medicaid, the counties can pay the medical bills they can't afford.

The task force's Co-Chairman Dean Cameron made it clear he wasn't supporting the idea so far, but he said he liked that it promoted personal responsibility — the low-income Idahoans would still have to pay some of their own money for the doctor visits, and they'd have to find and buy — with state financial help — their own insurance.

Several issues that came up were:

• Whether the proposal would work throughout the state, because not every community has close access to a  community health center.
• How the accounts would be managed, and what would happen to any money that wasn't spent at the end of the year.
• Whether the Idahoans who would qualify for the plan could ever afford a $3,000 deductible.
• Whether people would be required to be legal residents or to be working to qualify.
• And, most important, how much it would cost, and where the money would come from.

The plan laid out by Teuber was too undeveloped to know any financial impact, but Teuber said the state should be able to get a Medicaid waiver to pay for the program. That means that each $1 spent by Idaho must be matched by $3 to $4 in federal money.

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BOISE - Some of the most fragile, ill and elderly evacuees from the Gulf Coast hurricane are now resting in nursing homes and hospitals in Idaho, and beds are being readied around the state for more.

"None of these people even knew where Idaho was when we left - they just knew that they were going someplace better," said Ken Sheldon, flight paramedic and LifeFlight manager for St. Alphonsus Regional Medical Center in Boise, who helped bring 10 evacuees from the Houston Astrodome to Boise early Monday. "The state of Idaho is absolutely committed to bringing back as many people as we can," he said.

After a Nampa nursing home offered beds to hurricane victims on Friday, state Health and Welfare officials scrambled. On the Friday night of the Labor Day holiday weekend, the staff of the state's long-term care unit in Lewiston came in to work and started calling around the state "to find out what type of beds were available and where," said Health and Welfare spokesman Ross Mason. "They came up with 671 of them for skilled nursing home care."

Ten of those beds, at two Nampa nursing homes, were filled by the first planeload of evacuees, who were rolled off an Idaho National Guard C-130 cargo plane in wheelchairs at 3 a.m. Monday after a flight from Houston. Another half-dozen arrived on Tuesday afternoon from Meridian, Miss., and were headed to Boise hospitals and nursing homes.

The planes left Idaho packed with donated bottled water, Power Bars and other supplies bound for New Orleans, along with medical teams from Boise hospitals to treat the patients on their way back to the state.

"If the state of Idaho has the means to provide relief and hope to those who have been displaced, we have a duty to do it," said Gov. Dirk Kempthorne. "So far, Idaho's response to Katrina and her aftermath has been proactive and well-received."

Sheldon said he was shocked by the situation at the Astrodome, which he said rivaled Third World countries he's visited. There were just 85 showers for 24,000 people, he said, and a form of "mob rule" had erupted.

As he was putting one woman on the airplane, Sheldon said, he asked whether there was anything she needed. "She looked at me and said, 'No, sweetie pie, this is the first time I haven't been afraid in 10 days.' "

Lt. Tony Vincelli, public affairs officer for the Idaho Air National Guard, said there are no additional evacuation flights scheduled at this point, due to "some issues with getting those folks out of wherever they're being treated and getting them medically cleared to fly aboard a C-130 aircraft. We don't want to put 'em on an aircraft if that's potentially going to jeopardize their health."

But Sheldon said he and a representative of Boise's St. Luke's Regional Medical Center will be returning to the Astrodome on Thursday to stay for 10 days to two weeks, set up a triage system, and evacuate another 400 patients to Idaho.

And two Idaho National Guard C-130s will head back to Naval Air Station New Orleans today loaded with thousands of 1.5-liter bottles of Idaho water. They'll return to Boise tonight.

Kempthorne also sent five National Guard tanker trucks to the gulf region, each loaded with 2,500 gallons of gasoline to fuel police cars and ambulances.

The governor also appointed a Task Force on Refugee Resettlement to look into shelter, food, clothing, education, jobs, health care and more, for evacuees who might come to the state.

"We're really kind of just getting our arms around this whole idea and how big of a task it's going to be," said Mike Journee, press secretary to the governor. "We're considering all options that we can to help the people of the Gulf Coast."

Mason said, "We don't know, we may get five, 10, we may get several thousand. It's a real fluid situation and we just don't know what's going to happen right now."

The Federal Emergency Management Agency was so impressed with Idaho's quick job of identifying spots for nursing home patients that it called state Health and Welfare Director Karl Kurtz, who worked on the effort throughout the holiday weekend, for advice.

"They were interested in how we had responded so quickly to it," Mason said. "These are people that it's difficult to move; it's generally pretty traumatic. They're going to a whole different world -some of 'em have probably never been out of Louisiana in their life and then all of a sudden they're cast up in some place called Idaho that some of 'em may never have heard of."

The 671 identified beds are in 45 nursing homes from Sandpoint and Coeur d'Alene to Boise and Idaho Falls, Mason said.

Because nearly 85 percent of nursing home patients nationwide are on Medicaid, the program . likely will pay for their stay regardless of which state they land in.

"It's just a matter of getting them into the Idaho system," Mason said.

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"It just doesn't pay the county what it needs," said Commissioner Gary Grind-staff. "This is a one-time opportunity to meet all the needs of the community."

On Tuesday, all three commissioners signed a letter to the proposal committee that outlined the county's concerns with the proposal.

"In particular, we have continuing concerns regarding the structure of the local governance, the funding of public health care services in the county, and a reasonable compensation to the people of the county for the equity in their hospital that the county is contributing toward the new hospital," the letter said.

However, St. Luke's isn't off the county's radar just yet. The proposal committee has two weeks to respond to the commissioners' letter and if it can negotiate on those key concerns, commissioners are willing to give it another look before considering proposals from the dozen or so for-profit and nonprofit hospital networks that have sent letters of interest to the county. The ball is now back in the hospitals' court.

What's next?

"We'll cross that bridge when we get there," said Commissioner Bill Brockman.

The proposal would create a regional health care system that would also include St. Luke's facilities in Meridian and the Wood River Valley as well as its Mountain States Tumor Institute. Merger supporters had hoped commissioners would take the proposal to voters in November. Is it too late?

"It depends on how they respond to it and the legal timetable requirements," said Commissioner Tom Mikesell.

In the letter to the proposal committee, commissioners outlined a number of key areas they wanted changed in me proposal, many having to do with money and some having to do with health care.

Under Idaho law, counties are responsible for funding indigent care. Commissioners want a $750,000 cap on the county's obligation to the local hospital for indigent care. The county also wants a guarantee the system won't sue the county.

The county also wants more than the $12.5 million the proposal promised for a new special foundation to help fund and improve public health in Twin Falls 'County. Commissioners said the current proposal "does not sufficiently compensate the people of Twin Falls County for their equity in the hospital that they are contributing to the system."

Commissioners want a firm commitment from a new owner that it will preserve Canyon View Psychiatric and Addiction Services or its equivalent at current standards of program offerings, service and quality.

"Judges are begging for a place to send people for treatment for meth and alcohol addiction," Grindstaff said.

Commissioners want the county's obligation for indigent mental health care capped at $80,000 per year plus annual increases as provided by law — currently 3 percent.

Commissioners also want to see more local control. They want the local hospital board to be able to appoint its own local members without risking a system board veto; furthermore, the commissioners would like the right to appoint one member without system approval.

Hospital officials were disappointed in the commissioners' decision.

"Considering the broad level of support from community leadership, medical staff and hospital employees, we are very disappointed and surprised to learn that our proposal was not accepted," officials of the two hospitals said in a joint written statement Tuesday. "It is our position that a partnership between St. Luke's and Magic Valley Regional Medical Center, as opposed to a sale, best serves the long-term medical needs of the valley. We stand by our proposal and will continue to offer it. Any action to modify the proposal will be dictated by the decisions of our boards next week." Magic Valley Regional Chief Executive officer John Kee said the Hospital Board will discuss the issue at Monday night's board meeting.

"We'll have a chance to go through it, point by point," Kee said.

St. Luke's President and CEO Ed Dahlberg said his board will discuss it when they meet Tuesday.

"We stand by our proposal in a sense that it's a partnership." Dahlberg said. "We think our joint statement says it best and serves our interests in the long term."

Key Concerns:

• Local governance: Commissioners want the local hospital board to be able to appoint its own local members without a system board veto. Commissioners themselves also want the right to appoint one member without system approval.
• Indigent care: Commissioners want a $750,000 cap on the county's obligation to the local hospital for indigent care. The county would be willing to pay annual increases as provided by law and justified by expenditure levels and needs at the time — currently 3 percent a year.
• Litigation against the county: Currently, Magic Valley Regional is owned by the county and therefore can't sue the county. Commissioners want a guarantee the system will not sue the county at any time.
• Continue existing community reinvestment fund: The new owner must commit to keep its annual contribution to at least the current level of $200,000.
• Canyon View Psychiatric and Addiction Services: Commissioners want a firm commitment from a new owner that it will preserve Canyon View or its equivalent at current standards of program offerings, service and quality. Commissioners also want the county's obligation for indigent mental health care capped at ' $80,000 per year plus annual increases as provided by law — currently 3 percent.
• Transaction costs: The county wants to be reimbursed for all costs of the transaction, including consultants, attorneys and election costs.
• Use of existing hospital campus: The county wants to retain ownership of all real property and equipment related to current hospital operations and lease them to the new owner.
• Use of property after opening the new hospital: The current proposal would build a new, $120 million, 600,000-square-foot hospital and medical office complex most likely on the southeast corner of Pole Line and Grandview roads. Should the system continue to use the current property to provide inpatient or outpatient ^ services, the lease would continue at a proportional rental per square foot. If the system wished to use the current property for non-hospital-based purposes, such as medical space or commercial uses, the county wants to be able to lease the property at fair market value. When the system. no longer leases at least 70 percent of the property, the county wants the system to pay up to $1.5 million to raze or remodel the facility.
• Restrictions on sale: The county wants a firm commitment from the system that it will not sell Magic Valley Regional for a period of 15 years. The county wants to receive a rever-sion interest in the hospital free and clear if the system ever transfers ownership or control of the hospital. In the event of a transfer, the county wants to be able to consent to a 22 percent interest in the proceeds received by the entire system.
• Additional compensation for the New Health Initiatives Trust: The county believes the current proposal which puts $12.5 million into the fund doesn't sufficiently compensate the people of Twin Falls County for their equity in the hospital. Commissioners want the proposal committee to reconsider the amount of funding.

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TWIN FALLS — So many offers, so little consensus.

As three new proposals on the fate of the county hospital poured in recently, commissioners seemed uncertain of the board's next step.

Twin Falls County and Magic Valley Regional Medical Center board members are discussing options for the county hospital including its sale to or merger with a nonprofit entity. County commissioners initially agreed to focus solely on a potential merger with Boise-based St. Luke's Regional Medical Center before considering other offers.

However, in recent weeks, cracks appeared in the commission's united front.

On Wednesday, an offer by Sisters of Charity of Leaven-worth Health System to buy MVRMC, caught commissioner Gary Grindstaff's attention.

"I like this new proposal because it meets the hospital's needs," Grindstaff said. "It also takes care of the county's needs."

Sisters of Charity, a nonprofit based in Lenexa, Kan., submitted to the commission a written proposal on Aug. 19 to buy the hospital for $55 million.

William M. Murray, president of Sisters of Charity, visited Twin Falls on Wednesday and met with commissioners, toured the hospital and spoke with MVRMC chief executive John Kee.

"Our purpose today was sort of to put a face with a proposal," Murray said.

"We're just waiting to see where the process goes from here."

It's up to the commissioners to decide whether to consider Sisters of Charity's proposal or to continue to work with St. Luke's, which also is a nonprofit. The commission also has received two additional offers, both from for-profit entities — parties the hospital board has indicated it's not interested in working with, Grindstaff said.

Grindstaff said Sisters of Charity's proposal gives the county opportunity to offer medical services that it can't currently provide. Some of  those opportunities will come from an upfront cash offer Sisters of Charity made over and above that of St. Luke's proposal. 

"They actually met St. Luke's plus $40 million more," Grind-staff said.

Sisters of Charity also would assume approximately $24 million of the county-backed debt owed by the hospital, and it would invest $120 million over five years in new facilities for the hospital.

"There's no question that a major renovation is required," Murray said.

St. Luke's proposal includes similar offers.

'"However, Grindstaff said St. Luke's proposal does not meet the needs of the county or hospital.

"I'm ready to look at other options," Grindstaff said.

For Grindstaff, those options include not only Sisters of Charity's offer but also a potential proposal by Saint Alphonsus — owned by Trinity Health — which has expressed interest in a merger.

Grindstaff represents one vote out of three on the commission. Commissioner Bill Brockman could not be reached for comment on Wednesday. However, commissioner Tom Mikesell didn't share Grindstaff's enthusiasm for Sisters of Charity's offer.

"I think it's too vague to be attractive," Mikesell said.

For starters, Mikesell wasn't sold on the $40 million that Sisters of Charity claims to be offering over St. Luke's proposal.

"I don't think money is the solution to all of our challenges to the continued success of Magic Valley Regional Medical Center," Mikesell said.

Ultimately, Mikesell isn't ready to give up on the merger with St. Luke's. And, if the dialogue with St. Luke's breaks down, Mikesell wants the public, not the commissioners, to decide whether the hospital should be sold.

Regardless of whether commissioners determine a sale or a merger is in the hospital's future, the public has the final say.

"I think we'll only get one chance to make this happen," Mikesell said. "And, if we have any confusion to the voters, it won't happen.

"It's an extremely important issue and we need to do it right," he said.

New proposal

Sisters of Charity of Leaven-worth Health System proposal

• SCLHS proposes to buy Magic Valley Regional Medical Center for roughly $55 million.
• About $24 million in debt accumulated by county-based MVRMC would be assumed by Sisters of Charity.
• $120 million would be pledged for new facilities in the first five years under Sisters of Charity control.
• A local board of directors would lead the hospital.

About Sisters of Charity

• In 1858, Mother Xavler Ross founded Sisters of Charity in Nashville, Tenn., before moving to Kansas, where the organization founded its first hospital. The Sisters incorporated in 1972.
• The system Includes nine hospitals and four stand-alone clinics in Montana, California, Colorado and Kansas.
• The nonprofit's corporate offices are in Lenexa, Kan.
• Employees: 10,835 in 2005.
• FY 2005: 97,099 total admissions; 249,469 ER visits; 492,616 clinic visits; 940,684 outpatient visits
• Total assets: $2.78 billion as of Feb. 28.

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TWIN FALLS, Idaho — Officials with Boise-based St. Luke's Regional Medical Center say they'll build a new facility in Twin Falls even if county commissioners reject a merger proposal with the county-owned hospital.

St. Luke's President Ed Dahlberg says most local physicians are poised to join up with St. Luke's regardless of whether the merger with the county-owned Magic Valley Regional Medical Center happens.

"The medical community has made a commitment to come with us," Dahlberg said.

The county-owned hospital has been looking for a new manager since members of its hospital board voted 9-2 last year to change the hospital to a not-for-profit facility. The nonprofit St. Luke's began discussing the merger with local officials last June.

Twin Falls County has owned the hospital for 87 years, and net income rose to $7.8 million in 2004. But there has been growing concern among physicians and other health care providers over whether

Magic Valley Regional can continue to meet patient needs and make facility improvements in the face of rising costs of medicine, treatment and technology at a time when reimbursements are shrinking from government-supported insurance programs such as Medicaid and Medicare.

Twin Falls County commissioners have some concerns about the proposed merger, however. For instance, commissioners want the local hospital board to be able to appoint its own members without a system veto.

But hospital officials say an integrated health care system would require giving veto power to the medical system board.

Commissioners and the hospitals are also arguing over indigent care funding.

Commissioners first asked that the county's obligation be capped at $1.2 million plus an annual 3 percent increase, to which the hospital requested a $L5 million cap. But earlier this month, commissioners changed their request, asking for a cap of just $750,000.

County commissioners also want a promise from a new system that Canyon View Psychiatric and Addiction Services, or its equivalent, be preserved with its current program offerings unless the county consents otherwise.

Merger supporters had hoped commissioners would take the proposal to voters in November. But commission Chairman Gary Grind-staff has said he intends to look at offers from other health care networks, both nonprofit and for-profit, before making a decision on whether to take one of them to voters.

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If a group of concerned citizens gets their way, what is now a free health clinic in Rexburg may grow into a much more comprehensive community health center.

Golden Linford, a former state legislator and retired agri-businessman, says a group of volunteers is spearheading a fundraising campaign to raise seed money for the federally funded health-care project.

The fundraising group is beginning to contact individuals and businesses for donations. They hope to raise a minimum of $100,000 in pledges, cash, property or equipment to go toward establishing the center, which likely would be located in a vacant building in Rexburg. , Once the facility is in place, the federal funds would be used for operating expenses.

"We are largely looking for pledges that would be contingent on receiving the grant," Linford says.

Because the facility will be nonprofit, all donations are tax deductible. The group would like the funds raised by the end of the year and to submit the grant request next spring.

If the group is successful in raising local funds the federal government will take a serious look at helping to establish a health center that would be owned by the community.

Federal funding would come primarily from the U.S. Public Health Service.

If the community can show such a center is viable, it would be eligible for up to about $650,000 per year to help run the facility.

"If we can show we are viable, we have an excellent chance of getting the community health center in our area, says Bob Hodgen, president of the Upper Valley Free Clinic.

The center would be designed mainly for people who can't afford to pay through the traditional private health-care system. The clinic would charge the same fees as other privately run clinics, but patients would pay on a sliding fee scale depending on their income.

Nine such community health centers are located in Idaho, with the closest in Blackfoot.

The initial idea is to have the center located in Rexburg and to serve a five-county area, including Madison, Fremont, Jefferson, Teton and dark counties. The center would r be required to provide medical care (including family practice, internal medical and obstetric care), diagnostic labs, dental care, and mental heath care services.

A minimum of thee medical providers would be required, including at least one doctor and one dentist. It would be required to be open at least five days a week and to be accessible seven days a week.

Linford, who serves on the board of directors of the Upper Valley Free Clinic, sees a community health center as the answer to health care for those who can't afford health insurance.

"There are people in our community who just can't afford to go to the doctor," Linford says. "If they don't get medical attention when needed, they could slip into very expensive care and end up on the indigent rolls of the county. Money would be saved through treating illness early before it develops into a major expense."

He believes a community health center will also help to take the pressure off the local hospital and other medical providers that often lose money on unpaid and uncollectible bills.

"I've known from my legislative experience the problems with indigent care and I know through working in business how many people are uninsured," Linford says.

"President Bush's emphasis is to get community health centers into poor counties in America," he says. "These counties in the upper valley all qualify."

Hogden says poor health costs U.S. business $130 billion a year in lost productivity. "Early intervention is the primary focus of community centers," he says. "In the long run, it ends up costing the community a great deal more if people do not receive proper medical care."

Stan Stanley, a retired Rexburg citizen and member of the fundraising committee, says while the health center would be good for businesses, it's also a humanitarian concern.

"I have been very much concerned about this and have followed the free clinic's progress so I volunteered to help," he says.

Many people in the upper valley are not covered by medical insurance because they work in agriculture. It is to the benefit of these businesses that traditionally can't afford to carry insurance for their employees to have a community health center.

The free clinic in Rexburg opened in January 2001 and sees between 1,200-1500 patients a year.

Dr. Jeff Hopkin, founder and medical director of the free clinic, says six doctors take turns assisting at the free clinic. The clinic is open each Thursday from 5 p.m. until there are done seeing patients in the District 7 Health Department office on North Third East in Rexburg.

He says the clinic is held together by volunteers who include doctors, nurses, students, social workers, and others who work as receptionists, transcriptionists, translators and file clerks. The free clinic also operators on private donations, funding from three counties and donated medicines and equipment.

"Virtually anyone can come, but if they have insurance we encourage them to go elsewhere. We're very limited in what we can provide," Hodgen says.

He estimates 95 percent of the patients come from working families who do not have health insurance.

"Our problem at the free clinic is we are very limited in what we can do," he says. "We can't do serious diagnostic tests."

"The free clinic is only scratching the surface of the.) medical needs of the uninsured in the five-county area that we want to serve," Linford says,

For more information about the fund-raising effort, contact Linford at 356-7220 or Stanley at 356-0366.

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Ruby Swigert said she was concerned about an increase in hours for the EMS coordinator when revenue is less than expenses for the ambulance service. Projected income for the ambulance is $65,100, with budgeted expenses of $77,928, the largest being payroll at $32,776.

The board voted unanimously during its regular meeting to adopt the budget. The North Custer Hospital District has projected expenses of $159,814 with Income of $112,203. The Challis Area Health Center (the clinic) expects both income and expenses to be $375,301.

Veteran's help

The board unanimously approved a memorandum of understanding with the Veteran's Administration's (VA) medical center in Boise to provide psychiatric services to Custer and Lemhi county veterans half a day each week via a video phone.

In July, Dr. Larry Dewey, VA chief of psychiatry in Boise, said the VA had received a grant to provide services to about 1,600 vets in the two counties. However, only vets who have first visited Dewey in person will be eligible for the video phone appointments.

Under the agreement approved by the board, the clinic will offer an exam room for the long-distance appointments and the VA will provide $1,000 to remodel the room and $300 per month to rent it. Dr. Dewey will make four personal visits per year to the clinic.

The board also voted to get two new emergency mobile radios under the condition that a 2005 Homeland Security grant would pay the costs. The new radios will cost $2,500 apiece, one for each ambulance and be encrypted so people can't pick up transmissions on their home scanners. The last provision Is to protect patient confidentiality.

The board voted to write off 15 past due clinic accounts and one district account totaling more than $4,200 to a collection agency and to pay the current clinic and district bills of more than $11,500.

The vision thing

There was a short discussion about the meaning of a change in the clinic's vision statement before the board approved it on a 3-1 vote.

Trustee Bob Boren voted against the change, saying he thought the new wording made the clinic's mission seem broader than it needs to be, implying the clinic offers such things as dental and chiropractic services.

The new Challis Area Health Center's new vision statement says CAHC is 'To be the healthcare resource of choice for our regional community." It is meant to answer the question "where are we going?"

Boren said he thought the clinic could get by with its mission statement only and eliminate the vision. The mission says the clinic exists 'To provide quality primary healthcare to our regional community."

The board kept the old mission statement as is and adopted the new vision statement.

Brad Schipper, St. Luke's director of regional services, told Boren he Interprets the new vision statement to mean the clinic can refer patients to chiropractors, orthopedists and acupuncturists or to practitioners of other health services not offered at the clinic.

The old vision statement was a bit more complicated. It said this about the clinic's direction: 

"To meet the community's need for essential services in a cost-effective manner and raise community satisfaction by providing and improving: Healthcare support: EMS, primary . healthcare, on-site specialists on a regularly scheduled basis, hospital/tertiary care referrals. Patient financial assistance: endowment development, foundation development, grants/scholarships."

The clinic vision and mission statements had been discussed at a long-range strategic planning meeting in July. The goals and the year's accomplishments that helped meet those goals included:

• Keeping a full-time, "quality" health care provider at the clinic. The clinic now has three mid-level health care providers working at different times: Nan Cayler, Helen Wmegarner and Ken Hyatt Winegarner and Hyatt also work at the Salmon River Emergency Clinic in Stanley.
  Also, the district's contract with Dr. Richard Paris and the Halley Medical Center continued. The American Academy of Family Practitioners named Dr. Paris Family Practice Physician of the Year for 2005 and he was featured in two Reader's Digest articles.
• Improving the clinic's financial stability. The clinic's cash flow improved and the amount of money owed by patients was reduced to its lowest average in seven years. The annual audit showed the clinic's finances were in good shape. St. Luke's Hospital supported the clinic with charity care donations and helped with the Medicare cost report.
• Increasing preventative health care services. The district partnered with Beta Phi Sorority to expand the annual health fair's activities and public participation. Another site visit for the mobile mammography unit was added to meet local demand for breast cancer checks. A podiatrist began monthly visits. Mental health and social services were offered through Lemhi Valley Social Services. Motorcycle safety was offered at the clinic on some Weekends and evenings.
• Ensuring high quality basic emergency care. The clinic continued to network with St. Luke's Medical Center in Boise and the Wood River Medical Center, as well as hospitals in other communities to minimize the area's isolation and long distances to hospitals, A $489 donation from St. Luke's allowed the clinic hell-pad to be resurfaced and repainted and certified by the Federal Aviation Administration. Thompson Creek Mining Company donated $2,610 to buy new ambulance bay doors.
• Developing separate master plans for the clinic and its finances. Thanks to a $30,000 anonymous donation, the X-ray machine should be replaced with an updated model by the end of the fiscal year. St. Luke's is helping the clinic compare bids and systems.
• Increasing involvement in community economic development. The district hosted the health fair, helped the Stanley clinic during its reorganization and is involved in organizing the first statewide rural health clinic conference.

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PONDERAY — Don't let the lack of a sign at the 6,500-square foot building on Fontaine Road mislead you.

The first phase of the new Bonner Regional Community Health Center — its behavioral /mental health services and substance abuse treatment — has been up and running since Tuesday.

For hundreds of Bonner County residents suffering from depression to schizophrenia on waiting lists of providers or who lack the funds for treatment, the opening of the clinic's behavioral service is like an answered prayer.

So far, seven patients have come to see Lisa Foodim, BRCHC's licensed mental social worker, who recently received a national certification as a master addiction counselor.

"I have a feeling we will fill up quickly because there is such a huge need," said Foodim, who holds a Master's degree in social work from Arizona State University and has been practicing since 1993.
"Our goal is not to have any patients on a waiting list. I expect in six weeks we will be very busy, from walk-ins to appointments."

Currently, Foodim said the clinic has the capacity to handle about 30 to 32 patients per week.

Funded by a $650,000 grant by the U.S. Department of Health & Human Services, the non-profit clinic in the former Sandpoint Window and Doors building south of the Bonner Mall paralleling Highway 95, BRCHC is committed to treating all patients regardless of income level or lack of health insurance.

Patients can receive a discount for medical services and treatment according to their income.

One of 105 HHS new health center grants totaling $63 million, the federal funds will be a huge boost in a county where its medically-indigent needs are steadily increasing. When the clinic opens in its entirety, it will boast 15 exam rooms, a pharmacy, four board-certified family practice physicians, two mid-wives and employ 40 people.

A dentist and dental hygienist will be added to the clinic in the future.

"It's a medical center that will have a wide range of services like any other medical center provides," said Eileen Gau, BRCHC's Bonner Project Coordinator. "A federal grant contributes to this particular medical center that enables us to treat people who fall into that vulnerable population of low income, uninsured as well as under-insured.

"But our target is any patient in Bonner County."

Currently, Gau said BRCHC is waiting for its facilities developer to put the building on its construction schedule to begin necessary renovation work.

"We're going forward with the second phase of the clinic's development," she added. "We've basically broken it down into phases to keep it more manageable."

For appointments at the clinic's mental health services, call 263-7101 Monday - Friday from 8a.rn.to5p.m.

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Nearly 13 percent of people in Ada County are without insurance. More than half of those people have jobs, and that lack of insurance for the working poor causes unnecessary emergency room visits and drives up health care costs for all Idahoans, according to a study Boise State University released today.

Leaders of community health centers said the data confirmed their suspicions that most of the uninsured are the working poor.

About 252,000 people in Idaho are uninsured, but the leaders of community health centers said they have not seen county-specific data on the uninsured.

BSU conducted the study as part of a three-year Healthy Community Access Program, a $2.02 million federal grant given to the Family Medicine Residency of Idaho, a medical clinic staffed by recent medical school graduates who treat low-income and uninsured patients. The clinics sought the study to see how Ada County clinics are serving low-income and uninsured patients. The study is based on hospital data and about 14,000 surveys mailed to county residents in March.

"We saw so many gaps in the health care of these vulnerable people in Ada County," said Ted Epperly, director of the Family Medicine Residency clinics who over sees the HCAP grant. WWe wanted to do more to build up a system of care for those who don't have resources."

Epperly and others at the Family Medicine Residency applied for the HCAP grant last year to study the role of the community health clinics that treat uninsured and low-income patients. The study is just the first step in that process.

"We need to set a start point," said Epperly. The study will help the clinics assess in the future whether certain programs are succeeding in helping the uninsured and low-income residents in the county get the necessary access to health care.

Among the study findings: Uninsured residents of Ada County were four times as likely as patients with insurance to visit a hospital emergency room t get treatment for regular health services such as a sore throat.

Those unnecessary visits to the emergency room happened throughout the week at nearly all times of day.  That finding surprised leaders of the local clinics --the Family Medicine Residency, Terry Reilly Health Services and the Garden City Community Clinic — because they assumed that most unnecessary ER visits occurred on weekends and evenings when clinics are closed. They said the numbers show that clinic services need to be expanded.

"To me, it is showing that there is a significant issue with access to care," said Kari Watts, the medical director of the Garden City Community Clinic. "For some reason, whether it's people don't have insurance or they don't have a financial ability or that clinics are so busy that they can't get in on a timely basis, there are just some barriers that are there."

Watts hopes further research will examine more closely why people visit the emergency room so often.

The most common illnesses among uninsured people visiting the emergency rooms at Saint Alphonsus and St. Luke's regional medical centers were common colds and sore throats that could have been treated at a doctor's office or community clinic.

About half of the uninsured patients who visited the two hospital emergency rooms last year were diagnosed with a sore throat, cough, back pain, ear ache or dental problems like a toothache, according to the study.

Getting treatment in an emergency room for those illnesses costs about $500, when it would cost about $50 for the same treatment at the Family Medicine Residency or another clinic, said Julia Robinson, project director for the HCAP grant.

Uninsured patients often cannot pay all of their emergency room bills, so visits for non-emergency needs saddle hospitals with financial losses that drive up costs for patients who can pay their bills.

The group of clinic leaders is unveiling the study results to county and state officials and local community leaders today. Members of the HCAP grant group hope the numbers will get more money for the clinics to expand services.

"I think it is a very good tool to increase the public awareness of this problem," Watts said of the study. Watts' clinic serves uninsured patients in Garden City, which has been designated a medically underserved area by the federal government.

The study spent about $5,000 of the $2 million in grant money the group received last year. Some ways the HCAP grant group plans to spend the remaining funds:

• Conduct future studies, including a survey of patients who visit the three community clinics.
• Set up an electronic database of patient records that all three clinics can access.
• Buy new software to help low-income patients apply for prescription drug assistance programs.

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County and state government budgets are barely keeping pace with the number of uninsured residents who need help paying their medical bills.

The caseload of the uninsured handled by the Kootenai County Assistance Office increased from 523 clients last year to 610 this year, according to Maria Lewis, manager of the county's indigent fund.

Fortunately, Lewis said, the county has collected more in repayments, which is how the assistance office is able to cover its bills through this fiscal year, which ends Sept. 30.

"We spent it all," Lewis said. "There's so many uninsured people out there. Insurance is pretty spendy for the average person with a part-time or temporary job."

Her office requested the commissioners increase the indigent budget by $624,000, but the proposed county budget calls for a $200,000 increase, to $1.6 million, as of Tuesday night's budget hearing, according to David McDowell, county finance director.

Although it's not as much as Lewis wanted, McDowell noted that an increase of almost 14 percent is more than most departments are getting.

When hospital patients are indigent, and can't pay medical bills, Kootenai Medical Center refers them to county assistance. If they qualify for county assistance, the county pays up to $10,000 of their medical bills, and the state catastrophic fund covers the rest.

In response to the growing need, the Legislature approved a $3 million increase in the state catastrophic fund. Last year's $12.1 million appropriation ran out before the end of the fiscal year, forcing the state's fund manager to ask for a supplemental appropriation.

And in response to local government lobbying, the Legislature tightened the criteria for qualifying for county assistance. Now, patients have to show they cannot pay their medical bills within five years. Previously, the requirement was three years.

Despite ever-growing appropriations to help cover indigent costs, KMC still has to write off millions for charity and indigent care - about $21 million last year, said hospital CEO Joe Morris.

This year, he estimates, those unpaid bills will increase by 10 percent. To offset the increasing indigent costs, the hospital has to charge more to those patients who do pay.

"It's not fair to the hospital or patients that we cover all our indigent or uninsured costs by raising their costs," he said.

Among Idaho residents without health insurance, "80 percent are working, they're just not

covered by their employers," Morris said. "Every year we see a rising number of uninsured. ... We have to find some way for employers to cover employees." 

Private industry in Idaho is responding with some new, less-expensive options for employers. Regence Blue Shield of Idaho, for instance, is offering lower-cost coverage options for chamber of commerce members.

And Blue Cross of Idaho is working on a plan for businesses that have not been able to provide health insurance to employees for at least two years, said Jonathan Coe, executive director of the Coeur d'Alene Chamber of Commerce. Spearheading the push for more affordable insurance for employers was the Boise Chamber of Commerce, he said.

"The cost of providing insurance for employees is so expensive, that insurance providers are trying to find ways to be as creative as possible to get more people covered," Coe said. If something isn't done to expand medical coverage, he said, "the burden falls back on all of us" to pay the costs.

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In a sparsely populated, relatively close-knit county like Franklin, it's hard not to have relatives employed at the same place. Especially when its somewhere as big as the Franklin County Medical Center.

While Hospital CEO Mike Andrus emphasizes there have been no real problems caused by relatives from the same families working at FCMC, he said the board is due to consider an "Employment of Relatives" policy at its next meeting in mid-September.

The idea for such a formalized policy started with the compliance committee, which meets at least yearly. "It checks the audit, etc., to make sure we comply with rules," Andrus explained. "They (committee) set this (new policy) as a goal. There were no specific problems," he said. "A lot of relatives work here. We thought it would be a good thing to study, prepare a guide over a few months."

The policy was reviewed by the board at its meeting earlier this month and has been reviewed by the hospital's attorney.

"We recognize health care workers generally possess skills that are not (always widely) available in the community," he said. Sometimes, as with many professions, members of the same family may pursue a similar vocational path, whether it be in law enforcement or health, Andrus said.

And while the nationwide nursing shortage has not yet hit FCMC, in part due to proactive efforts by the hospital in cooperation with others, such realities of potential scarcity of skilled labor do exist, Andrus said.

Due to potentially "overriding needs, it may even facilitate hiring relatives" when they are the most qualified for certain positions, he continued.

"We want everyone to be aware that (relatives working closely) can create problems, conflicts of interest," with such a policy one way to help in managing that, Andrus said.

"There are guidelines of how to handle" potential relative-related problems in the new policy. For example, supervisors who are relatives could not set wages. "There are no glaring problems. We're not pushing this" due to that, but looking at the policy as a "proactive measure where there could be problems, and this provides procedures if difficulties come up," he said.

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Hospital Taxing District Commission Chairman Brown re-stated that the Board will present its decision about when a vote will be held on the hospital taxing district at the next regularly scheduled meeting of the Commission on Monday September 19th. Brown stated that the Commission has promised the public that a vote will be held, and that the Commission will stick to this promise; he noted that the only question is when the vote will occur. Brown also noted that the Commission has been receiving a number of comments, and that the comments have expressed views from both sides of the issue. In addition, Brown read a letter from The Hospital's Board of Trustees to the Commission. This letter stated that if the hospital taxing district were dissolved following a vote in November of 2006 after the fiscal year 2007 budget were approved, all funds would be put toward payment of the bond. The bond obligation would not be affected by a vote to dissolve the district.

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POCATELLO — Assessor Diane Bilyeu says Bannock County commissioners recently sided with large, out-of-state corporations at the expense of local taxpayers when they voted to give! GE and other companies tax.exemptions on equipment worth millions of dollars which they lease to Portneuf Medical Center.

PMC was created in 2002 when Pocatello Regional Medical Center, a corporate nonprofit hospital, merged with county-owned Bannock Regional Medical Center.

Commission Chairman Jim Guthrie said he decided to support the hospital's request after listening to arguments on all sides of the issue at the Board of Equalization meeting in July.

In an attempt to overturn the decision, Bilyeu filed an appeal in Idaho Tax Court last month. A hearing remains unscheduled. 

"Here we are trying to reduce property taxes for the citizens of Bannock County, and every time an additional exemption is granted, it shifts the bur-. den of taxes onto the county's tax payers," she said. :

The issue stems from a 2001 state tax code ruling, which makes corporate nonprofit hospitals exempt from paying taxes on leased equipment. However, Bilyeu points out that PMC is not being taxed, and furthermore, is not incorporated.

"It's a legal question," Bilyeu said. "County hospitals are exempt, but if they lease personal property from a vendor, then the vendor should pay taxes on it. Why s' .'"Id they be exempt?"^

Bilyeu said the corporations have been taxed for leased equipment in the past, and just because the hospital wants to use the 2001 law to maintain  or improve its relationship with them doesn't mean doing so is legal. She said after researching the matter the county's attorney advised commissioners not to grant the exemption, but Guthrie and Steve Hadley did so anyway.

"As an assessor, I have to go by what's in the statute," Bilyeu said. "We're talking about an appeal on $3,535,559 in property. That's big dollars."

The exemption for fiscal year 2005 would be worth about $84,000, she added.

Bilyeu said the commission's decision — which she equates to corporate welfare — sets a bad precedent for not only the county, but for the entire state. She said PMC plans to lease more than $100 million in property during the next three years, which would also be exempt if the decision stands.

PMC officials denied the hospital will lease anywhere near that amount. They did not return calls with an estimate before press time. 

Guthrie said he is not favoring the leasing companies. He said he has a responsibility to support the county hospital, which requested the exemption. Guthrie added that he and Hadley did vote against the advice of counsel, but he said counsel doesn't make decisions.

"When we went into Board of Equalization, we listened to all sides and the hospital made a good argument," he said. "If Pocatello Regional Medical Center was still in town, and the merger that created PMC had never happened, they'd get the exemption. But right across town. Bannock Regional, which was a county-owned hospital, would not."

PMC's Chief Financial Officer John Wilker acknowledges the county has taxed the leasing companies in the past, but said it hurt the hospital's relationship with them. He said the 2001 law was meant to level the playing field between corporate nonprofit hospitals and county-owned facilities, not to create a wider division between them. He said the law should not be strictly interpreted, but applied on its intent.

"I see where (Bilyeu) is coming from," Wilker said. "As an assessor, she sees the issue is to maximize tax revenue. In the past, because we didn't have the exemption, the county automatically billed the leasing companies. Then they'd come back to us and ask us to reimburse them and we told them they shouldn't have paid it in the first place."

He said the hospital requested the exemption to be a good leasing partner and a good partner for the county. He said if the exemption is not upheld by the tax court, the vendors will refuse to do business with PMC unless the hospital agrees to absorb the cost.

"In essence, the county would be taxing itself," he said.

For his part, Hadley said Bannock County Road and Bridge leases equipment from out-of-state corporations, but the county does not tax them. He said he doesn't understand why Bilyeu is singling out the hospital.

Bilyeu said her office relies on the vendors to report what equipment they are leasing in Bannock County. She said companies that lease property to any county agency or private business are required to pay taxes.

"Why would I single out the hospital," she said. "These big corporations have been paying this for years. It's not different than they've ever done."

The one dissenting commissioner, Larry Ghan, said he thinks Guthrie and Hadley should have listened to counsel and denied the exemption. He said he worries about the commission's proximity to the hospital board.

"There could be an appearance that we're not as independent as we should be," Ghan said. "It would be better if that decision was made in another venue, like the tax court."

Ghan said the county's entire tax system needs to be called into question. When asked why he voted against the hospital's request, Ghan said, "There is a clear delineation between private nonprofit hospitals and county-owned hospitals. Just because we would wish them to be similar, I don't think is a compelling case."

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GRANGEVILLE — "We have been doing some brainstorming and have come across some very good reasons for collaboration," said Syringa General Hospital administrator Jess Hawley to the the board to its regular meeting Aug. 24.

A task force has now met twice to explore a collaborative effort between SGH and St. Mary's and Clearwater Valley hospitals.

"Positive reasons for collaboration include driving down the cost of operations, expanding the scope of patient care services and the availability of grants to health care facilities that cooperate rather than compete," Hawley explained.

Medical staff from the three hospitals will meet in Kamiah Oct. 4 for the purpose of garnering information and offering feedback. The task

force will then meet again Oct. 21, and findings will be presented to the SGH trustees in early December.

"It's important for the public and the board to understand that this is not the '50s or the '60s — it's 2005 and medical care is expensive," said trustee Pat Long who sits on the task force. "We cannot bring in mental health or orthopedic personnel alone but perhaps together we could."

Long also mentioned issues such as lower liability as well as employee insurance and a combination of management skills for the proposed SGH rural health clinic.

"We do not have experience running a clinic — St. Mary's does," Long said. "That expertise could be beneficial to us."

Trustee Don Solberg asked about the time frame and wanted to make sure there would be time for public input to find out what the community thinks about a collaborative .effort.

"This is simply a chance to see what it would look like, there are no decisions being made," said Long. Anything that happens has to go through this board."

Hawley explained the task force needs to go through the process of showing detailed information to the board.

"I am for the task force looking into all this, but one thing is nagging me," said board chair Al Bolden to Long. Are you content with the pace of this?"

"No," Long shook his head. "I believe it is important to slow down the pace a bit."

"Who is setting the pace?" asked Dr. Leanne LeBlanc.

Long shrugged, "it's just that the sooner the board gets something concrete it can look at, the better."

"I love the brainstorming, I just want to make sure the public has a chance for input," Solberg reiterated.

Hawley explained the task force is simply in the process of generating information and it takes work to do so. l

"It isn't a footrace or implied commitment," Hawley said. "The board definitely controls the outcome, we're just trying to get the information to you."

In other news the board passed the hospital's $9 million budget for fiscal year 2006. A full budget appeared in last week's Free Press.

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JEROME--St. Benedicts .Family Medical Center was awarded a $1,200 grant from the Saint Alphonsus Foundation to establish an AED (automated external defibrillator) program to assist the Magic Mountain Recreation and Ski Area with  medical emergency treatment for cardiac arrest.

The new program is in conjunction with the St. Benedicts 'Emergency Department and Life Flight. St. Benedicts representatives say AED technology has advanced to the point that non-medical personnel can use the equipment simply, without intimidation, and that defibrillators are becoming standard equipment for schools, offices, stores, factories and public places.

The grant paid for one unit for the Magic Mountain recreation area, and St. Benedicts will provide training and medical oversight, said Dennis Maughan with the St. Benedicts Foundation.

St. Benedicts Emergency Department medical director, Dr. Thomas Zepeda, will coordinate defibrillator training and certification of the ski patrol and staff of the Magic Mountain resort, which is open year round, Maughan said.

The AED Program, the first of its kind at Magic Mountain, will benefit the thousands of people who use the recreation area, which is made up of more than 302,000 acres, hospital representatives say.

According to Marty Jacobs, Magic Mountain Ski Area owner, there are countless summer homes, church camps, snowmobilers, skiers, horseback riders, all-terrain vehicle enthusiasts and bike riders who use the many trails in the Sawtooth National Forest.

St. Benedicts and Saint Alphonsus are part of the Trinity Health, a hospital network.

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JEROME — Later this month, St. Benedicts Family Medical Center will begin adding an expanded occupational medicine program, pre-admitting services and an outpatient lab.

The occupational medicine program will address the needs of the employer by providing pre-employment physicals, drug screenings, hearing tests and respirator fit testing, according to a hospital news release. The program will also offer return-to-work assessments for injured employees.

The pre-admitting program will take some of the stress off surgical patients by offering them one-on-one counseling to assist them through the entire surgery process prior to the day of surgery. The counselor will walk the patient through the pre-certification process for both obstetrics and surgery. Counselors will also help patients with financial resources.

The addition will also include a full-service outpatient lab drawing facility so outpatients will no longer have to go to the hospital to have their lab work done, the news release said

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St. Luke's Regional Medical Center opened a new internal medicine clinic Monday at the corner of Cloverdale and McMillan roads.

Four doctors and a nurse practitioner work at the new clinic. St. Luke's opened its first internal medicine clinic in 1992 and now has four.

The internal medicine clinics provide subsidized treatment for Medicare patients and others who cannot afford to pay for medical treatment.

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REXBURG - While 70 percent of people surveyed say they think the overall quality of health care in eastern Idaho is good or excellent, 30 percent thought physician care and nursing care were unsatisfactory.

The overall survey showed a positive response for Madison Memorial Hospital, which commissioned it, but there were areas the hospital could improve, says Mike Cannon, a public relations professor at Brigham Young University-Idaho in Rexburg.

He wrote the survey.

According to the survey 88 percent of those who participated were very familiar or somewhat familiar with the hospital.

Eighteen percent of the people questioned said the hospital service was fair or poor, and 25 percent of those who felt that it was poor claimed that physician care was the area of service that was most unsatisfactory.

"Apparently," Cannon said tongue-in-cheek, "they enjoy the hospital, they just don't appreciate the people they have to interact

with."

Fifty-five percent of those interviewed had a member of the household hospitalized in the last two years. Of those people about 51 percent went to Madison Memorial Hospital.

Convenience was the main reason most people chose the facility, but 20 percent said they went because of physician recommendation.

About 31 people who were interviewed chose another facility. Fourteen of those said they didn't choose Madison Memorial because of inadequate specialty services. Only one said they went somewhere else for convenience. Three said Madison had a poor reputation.

The hospital board has discussed a name change when it expands and posed a question in the survey about it. Some options were Madison Regional Medical Center, Madison Medical Center, Madison Hospital and Madison County Hospital.

An overwhelming majority of the people questioned in the survey, 85 percent, said the hospital should keep its current name.

Cannon joked that the data should be ignored.

"Memorial has kind of a terminal connotation," he said. "I don't know if that should be associated with a hospital. But there is a strong sense of tradition."

A good sign for the hospital, Cannon said, is that the majority of the people, about 76 percent, support the expansion. Only 5 percent opposed it, with 19 percent of people not knowing or not caring.

One issue the hospital needs to inform the public more about, Cannon said, is that the hospital won't be using taxes to pay for the expansion. Sixty-one percent said they didn't know people wouldn't be taxed to pay for the project.

"They need to know they aren't being taxed," Cannon said. He said the hospital board should inform the public more about the revenue bonds.

Overall, Cannon said, the survey should provide some help to the board, so they can communicate with the community better. "It's certainly a favorable assessment," Cannon said.

The phone survey was conducted through the Rexburg Opinion Center. The purpose of the survey was to help the hospital to understand public opinion on the facility and the expansion project.

About 300 people, mostly in Madison County, and some from Fremont and Jefferson counties, were randomly contacted by phone for five-minute survey.

The board thanked Cannon for his work and took lots of notes on what he said.

What the survey shows

• 300 people in Madison, Fremont and Jefferson counties were interviewed by phone.
• 30 percent of people thought physician care and nursing care in eastern Idaho are unsatisfactory.
• 82 percent view Madison Memorial's service as good or excellent.
• 85 percent view Madison Memorial as their primary hospital.
• 59 percent of people learned about the expansion from newspapers.
• 76 percent of people interviewed support the expansion.

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All it takes to save a life sometimes is the right picture.

A new 64-slice computed tomography (CT) scanner at Tri-State Memorial Hospital in Clarkston produces images so crisp that radiologists can instantly diagnose heart disease and strokes.

Its three-dimensional, high-resolution, color images can be rotated on a computer screen and provide more detail than the flat, black, white and gray depiction of organs taken with traditional CT and ultrasound.

"This is a revolutionary breakthrough," says Dr. John Mannschreck, a radiologist who practices at Tri-State.

Installation of the system began last week and it's expected to be operational by mid-October.

The 64 slice refers to the number of pictures the scanner takes in a single rotation around a patient, who lies in a doughnut-shaped ring for the test. The scanner Tri-State is replacing takes eight photos.

Tri-State officials believe they're the first hospital in Washington outside Seattle to introduce the technology at a cost of $1.6 million.

"They're so expensive most hospitals don't choose to be first, but our board took a really proactive approach," says Shelley Williams, spokeswoman for Tri-State.

St. Joseph Regional Medical Center administrators hope to have one of the devices in place by December, says Tom Pfliger, assistant administrator at the hospital.

A scan can identify the source of chest pain in seconds, showing which patients need clot-busting drugs and which need to be sent to Spokane for surgery, Mannschreck says. "It allows us to see in exquisite detail the coronary arteries, which we could never see before."

Frequently it takes hours to diagnose someone with chest pain, waiting for lab results and performing a battery of tests such as a chest X-ray.

It's faster, safer, and less invasive than diagnostic cardiac catheterization, another test that provides much of the same information, say Mannschreck and Dr. Lee Gould, a Lewiston cardiologist.

Patients will save money, too. The CT scan runs about $2,000, one fifth the cost of catheterization.

But not all patients will qualify for the new CT scans. Those who are overweight or have arrhythmia will have to .undergo diagnostic cardiac catheterization.

Diagnostic cardiac catheterization checks for vessel blockages and examines how well heart valves are functioning,

During the test a catheter is inserted into the groin or arm and dyes are injected that make it easier to view vessels in the heart in X-rays.

St. Joe's began offering the catheterizations this year and has done 10 or 12 so far, Pfliger says. "We had hoped to do more. The big thing is the availability of an invasive cardiologist to do them."

But the use of 64-slice CT isn't limited to cardiac patients. ^ It also allows faster and more accurate diagnosis of strokes where blood clots block arteries to the brain. The test can pinpoint what artery is affected so physicians will know what parts of the brain are hurt, Mannschreck says.

For cancer patients, 64-slice CT provides more detailed information about the volume and dimension of a tumor.

That helps doctors know exactly how much chemotherapy or radiation will be needed for treatment. And as the therapy progresses, the test can be repeated to tell how well a tumor is responding.

"It's bright," Mannschreck says. "It's clean. It jumps right off the (screen) at you."

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By Emily Morrison

Teton Valley Hospital and Surgicenter will help bring awareness and encourage healthy habits by offering discounted mammography certificates through the annual Harvest Health Fair this October.

"We'll hand out certificates valued at $40 toward a mammogram," said Ann Loyola, public relations director for the hospital.

Certificates can be picked up during the Harvest Health Fair Saturday, October 15 at Teton Middle School from 10 a.m. until 2 p.m.

"It is so important for women to stay on schedule with their health screenings. If income or insurance are factors for not getting screened, women should know that the state of Idaho provides funding through a program called 'Women's Health Check'," Loyola said.

The third Friday in October each year is National Mammography Day, first proclaimed by President Clinton in 1993. On this day, or throughout the month, women are encouraged to make mammography appointments. This year, National Mammography Day will be celebrated on October 21. This year will mark more than 20 years that National Breast Cancer Awareness Month has educated women about early breast cancer detection, diagnosis and treatment.

All women are at risk for getting breast cancer and as a woman gets older the risk increases. Eating a healthy diet, losing excess weight, exercising regularly, reducing alcohol use, and quitting smoking are all ways a woman can help reduce her chances of breast cancer. Breast health care not only includes a healthy lifestyle, it is important to include testing within the breast care regiment. There are two different stages -of testing, screening and diagnostic. Screenings are tests such as annual mammograms that look for signs of disease in women without symptoms. Diagnostic tests such as MRIs, blood tests, and bone scans become part of the picture when breast cancer is suspected or has been diagnosed.

Teton Valley Hospital and Surgicenter is in the midst of a campaign to acquire new radiology equipment including a mammography suite that will allow them to better diagnose breast health for women.

"We're very excited to see such enthusiasm from our community for our 'Meet the Challenge' campaign to purchase a state-of-the-art mammography suite. The suite also includes a top caliber bone densometer. With the recent acquisition of a 3-D ultrasound unit, we're able to more accurately pinpoint cancers and abnormalities in breast tissue. The addition of a new mammography suite will be the crown jewel in our women's health care program," Loyola said.

The Wyoming affiliate of the Susan G. Komen Breast Cancer Foundation will host a regional breast cancer conference October 4 through 6 in Jackson. The event will be at Snake River Lodge. Topics for the conference range from screening and prevention to alternative therapies, new diagnostic approaches, and identifying available support following diagnosis. The conference is the only regional breast cancer symposium and will offer a plethora, j of information and support. The conference includes many speakers including doctors, nurses and breast cancer survivors.

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Nearing 50 years in its current location on Kaniksu Street, Boundary Community Hospital will host an open house celebration Sept. 17 from 10 a.m. to 1 p.m.

"I think that (people) will find it to be interesting," Hospital CEO Craig Johnson said. "The number of individuals who have worked at the hospital over the years, how service has changed since 1955 to 2005." ,

Photos of doctors, nurses and other staff from today and from days of yore will be prominently displayed and refreshments available.

There will also be photos of the building just before the remodeling in the early 90's and during the remodeling as well as photos of the Sept. 20 1955 dedication at the present site.

Photo sequences will move from the dedication to present day.

Tours will be available showing the hospital's newest equipment — including a 16-slice CT scanner.

"People can get an idea of what's going on at the hospital today. My staff and I have certainly found it interesting to look at old photos and remember," Johnson said.

Folks can also take tours of diagnostic rooms and the emergency room.

It's a chance to get to know

the community's hospital, he said.

Johnson wants to honor the doctors, nurses, nurses aids, dietitians and other staff who have made the hospital's growth and success possible through dedication, professionalism and teamwork.

You couldn't ask for better. We have a current great group of people," Johnson said.

"I started here in 2000 and one of the things I think that I was the luckiest at is that I inherited a group of individuals here who are extremely dedicated."

The hospital has a storied history.

According to the History of Boundary County book, the hospital was originally located where the community Restorium now stands. 

Veryl Lindsay, a nurse' back for the hospital into the 1980s, recalled in the book that the hospital was of wood construction, including floors, and its elevator was run on water pressure. To get to the second floor, a visitor would hand pull cables and a wood furnace kept the hospital warm.

Since then, the hospital's site changed and, of course, it was expanded and modernized.

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Idaho Hospital Association
PO Box 1278 - Boise, ID 83701
208-338-5100
www.teamiha.org