of Rhode Island

Hospital Association

2019 ANNUAL REPORT

Building on our successes and planning for the future was the philosophy for the Hospital Association as 2019 presented new challenges and opportunities.  With this mantra in mind, HARI has found new opportunities for innovation and collaboration over the past year which will prepare our hospitals for future changes in state and federal law. 

HARI participated with healthcare providers, consumers and insurers in developing and signing the “Compact to Reduce the Growth in Health Care Costs and Health Care Spending in Rhode Island.”  The Compact established a growth target of 3.2% per year based on Rhode Island’s Potential Growth State Product.  States around the country are following the Rhode Island commitment to “taking all reasonable and necessary steps” to keep costs below target.

HARI and its members are supporting and participating in the Rhode Island Foundation initiative to develop a long-term health plan that will ensure equitable accessible healthcare for all Rhode Islanders.  Hospitals are being challenged to address community needs.

HARI member hospitals completed and presented the 2019 Community Health Needs Assessment (CHNA) in September this year. The top needs identified were Maternal and Child Health, Behavioral Health and Chronic Disease.  Hospitals in Rhode Island are committed to ensuring health equality.  Each hospital plan is approved by their board and posted on their respective websites.  These efforts reflect long term investments that will improve healthcare for all Rhode Islanders. 

Hospitals continue to be on the front lines of Rhode Island’s Behavioral Health Crisis.  HARI has been an active participant on the Governor’s Overdose Prevention and Intervention Task Force and Governor’s Council on Behavioral Health.  HARI will continue to work with community partners and government leaders to develop long term solutions.

 In May 2018, HARI pledged to become a regional partner of the Campaign to Change Direction - an international public health initiative that aims to normalize mental health conversations through the use of a common language, known as “The Five Signs” – agitation, decline in personal care, withdrawal, change in personality, and hopelessness.

In 2019 through our partnership with the Rhode Island Department of Behavioral Health, Developmental Disabilities and Hospitals, the Rhode Island Department of Health  and the Rhode Island Regional Prevention Coalitions HARI has been able to share the Campaign to Change Direction with high school and middle school students in Kent County, Washington County, Providence County and the City of Providence.

Over the past year, HARI and its member hospitals’ continued commitment to quality improvement and patient safety is demonstrated by their participation in several HARI led patient and worker safety efforts, including:

Hospital Improvement Innovation Network (HIIN)
High Reliability Organizations (through RI Saves Lives)
Patient Care Link – Staffing Transparency
Worker Safety Initiatives

At the 2019 AHA Leadership Summit, AHA and HRET celebrated the success of the HIIN and HRO safety programs.  The Hospital Association of Rhode Island was nationally recognized in recognition of reducing hospital acquired conditions in member hospitals throughout Rhode Island.  The effort led by Jean Marie Rocha, MPH, RN, Vice President of Clinical Affairs, was also recognized by Healthcentric Advisors and the New England  IN-Patient and Family Advisory Council. 

This year HARI’s advocacy effort, led by Lisa Tomasso, Vice President of Strategy & External Affairs, produced significant successes during the Rhode Island General Assembly’s 2019 session. 

HARI worked with the Rhode Island Department of Health to secure passage of legislation creating the Maternal Mortality Review Committee. This committee will assist providers to improve maternal outcomes by identifying the actions that need to be taken to improve the health and safety of pregnant women. 

Protected our non-profit hospitals from real and personal property taxes.
Supported a state reinsurance program.
Supported resolution raising awareness around sepsis.

The General Assembly approved an FY20 budget that funded disproportionate share hospital payments and the outpatient upper payment limit.  Hospitals leveraged the licensing fee to secure an increase in Medicaid rates.  Howard Dulude, Director of Finance, and the CFO Group worked together with the Advocacy Team in this successful effort. 

Overall the budget is a $42 million improvement for hospitals from the originally proposed budget. 

The Hospital Association of Rhode Island continues to provide members with timely, relevant and concise information. Last year we reformatted HealthLink, HARI’s weekly newsletter.  This year HealthLink received a Silver Award in the electronic marketing division, at the New England Society for Healthcare Communication (NESHCO) 2019 Lamplighter Awards Gala.  In addition, during the 2019 legislative session, HARI expanded HealthLink to include a legislative edition which provides members with up to date information about the progress of health care legislation in the General Assembly. 

HARI’s Healthcare Emergency Management Director, Dawn Lewis, RN, Ph.D., continues to serve as a co-chair of the Healthcare Coalition of Rhode Island (HCRI) with the Rhode Island Department of Health (RIDOH) and continue to be a resource for hospital staff.

Resulting from a rise in the frequency of hospital emergency department diversions, RIDOH and HARI convened a work group to look for solutions.  HCRI implemented a new feature in its Hospital Capacity System that identifies hospitals’ current NEDOCS scores and displays them for situational awareness.

While HCRI remains hospital-centric, its leadership established new relationships with healthcare organizations that had not previously participated in the Coalition (e.g., homecare agencies and hospices). In so doing, HCRI continues to evolve to reflect the makeup of RI’s healthcare system. This integration allows the Coalition to assist with ensuring continuity of care for patients across the healthcare spectrum during an emergency.

HCRI conducted its annual Emergency Preparedness Conference, which provided 174 participants from the healthcare system education opportunities relevant to emergency preparedness and response.

Over the past year, several exercises were conducted that tested the ability of HCRI and its members to effectively share information with one another during large-scale incidents with healthcare facility impacts. Some of the examples included: care of a patient with Ebola, surge of hospitals during a mass casualty incident, active shooter response in a clinical setting, and evacuation of hospitals and long-term care facilities.

The Rhode Island Statewide Cancer Registry (RICR), which is housed at HARI, helps health care professionals better meet the needs of patients with cancer by collecting and maintaining data on individuals with the devasting disease. Data collected by the RICR is used by physicians to monitor treatment and continuing care of patients and by epidemiologists to track cancer activity throughout Rhode Island and the nation.  The RICR was recognized by the North American Association of Central Cancer Registries with the ‘Gold Standard’ for the twenty-first consecutive year for the accuracy and completion of data collected.  In addition, the registry was named a ‘Registry of Excellence’ by the National Program for Cancer Registries for the timeliness, completeness, and quality of data submitted.

This year, Cancer Registry Director, Nancy Lebrun, also attended the North American Association of Central Cancer Registry’s Annual Conference in Vancouver, BC in June.  Ms. Lebrun accepted the 21st certificate for Gold Standard at this meeting. 

HARI and the RICR have been awarded an additional contract this year from the Rhode Island Department of Health.  This contract modification was tailored toward the environmental impact and/or comorbidities associated with lung cancer.  The scope of work for this contract reviewed targeted communities with higher risk factors for developing lung cancer to better inform decisions on further community-level studies in Rhode Island.

HARI entered into the second year of its partnership with the Rhode Island Department of Health to provide support for the Partnership to Reduce Cancer in Rhode Island. The Partnership is a broad based coalition of community partners who have come together to provide input in the planning and implementation of programs and services around comprehensive cancer control. 

HARI has worked with the American Hospital Association and our Congressional delegation to postpone the reductions of the federal DSH funds.  A Continuing Resolution was passed on September 27, 2019 postponing the proposed reductions of the federal DSH funds until November 21, 2019.  We will work together to further postpone these cuts and to find alternative sources of federal funding to address the loss of the benefit of the Imputer Rural Floor.  

HARI is committed to advocating for Hospitals to positively influence legislative outcomes and regulatory policy through education of the public, elected officials and community partners.  We will work throughout the upcoming year to define the role of hospitals in addressing the Social Determinants of Health as we build healthier communities together.