Maricopa County Health Care System Overhaul

March 30, 2017

Transcript:

TED SIMONS: GOOD EVENING AND WELCOME TO ARIZONA HORIZON, I'M TED SIMONS. THE ARIZONA REPUBLIC REPORTS THAT AN INDEPENDENT INVESTIGATION THAT CLEARED STATE PARKS-BOARD DIRECTOR SUE BLACK OF WRONGDOING WAS CONDUCTED BY A LAW FIRM THAT'S INVOLVED WITH ADVISING THE STATE ON HOW TO HANDLE THE CLAIMS MADE AGAINST BLACK. THE REPUBLIC REPORTS THAT THE LAW FIRM, LED BY FORMER STATE REPRESENTATIVE JUSTIN PIERCE, CONDUCTED INTERVIEWS WITHOUT DISCLOSING IT'S RELATIONSHIP WITH THE STATE. BLACK IS ACCUSED OF BERATING EMPLOYEES AND GETTING DRUNK AT PUBLIC EVENTS. THE INVESTIGATION IN QUESTION FOUND NO SIGNIFICANT WRONGDOING. AND IN A REPORT RELEASED TODAY, THE NEW MARICOPA COUNTY RECORDER, ADRIAN FONTES, BLAMES HIS PREDECESSOR, HELEN PURCELL, FOR THE DECISION TO CUT THE NUMBER OF POLLING PLACES FOR LAST YEAR'S PRESIDENTIAL PRIMARY. FONTES SAYS THAT THE DECISION CAME FROM THE TOP DOWN. HE ALSO CITES OVERWORKED STAFF AND BAD COMMUNICATION FOR SOME OF THE PROBLEMS THAT LED TO LONG LINES AND LOTS OF UNHAPPY VOTERS, WHICH IN TURN LED TO FONTES DEFEATING PURCELL IN THE NOVEMBER ELECTION. THE BOARD OF MARICOPA COUNTY'S REGIONAL HEALTH-CARE SAFETY-NET SYSTEM RECENTLY MOVED TO GO AHEAD WITH A 1-BILLION REMAKE OF THE MEDICAL CENTER AND OTHER HEALTH-CARE FACILITIES. HERE TO EXPLAIN WHAT ALL THIS MEANS, ESPECIALLY IN THE WAKE OF POSSIBLE CHANGES TO THE AFFORDABLE CARE ACT, IS STEVE PURVES, PRESIDENT AND CEO OF THE MARICOPA INTEGRATED HEALTH SYSTEM, AND SUSAN GERARD, CHAIRMAN OF THE MARICOPA COUNTY HEALTH CARE DISTRICT BOARD. GOOD TO HAVE YOU BOTH HERE. BEFORE WE GET TOO FAR INTO THIS, I THINK A LOT OF PEOPLE ARE CONFUSED BY THERE MARICOPA COUNTY HEALTH CENTER AND MEDICAL CENTER. GIVE US AN EXPLANATION.

STEVE PURVES: MARICOPA HEALTH CENTER HAS BEEN SERVING THE COMMUNITY AND STATE FOR OVER 140 YEARS. WE WERE HERE BEFORE ARIZONA WAS A STATE BACK WHEN WE WERE A TERRITORY. WE HAVE ALWAYS BEEN A PUBLIC HEALTH CARE SYSTEM WHICH REALLY MEANS WE HAVE A MISSION TO SERVE EVERYBODY WITHOUT REGARD TO THEIR ABILITY TO PAY AND TO BE THAT SAFETY NET SYSTEM OF CARE FOR PEOPLE ESPECIALLY WHO FALL THROUGH THE CRACKS THAT DON'T HAVE ACCESS TO HEALTH CARE.

TED SIMONS: SO HOW DOES THE MARICOPA MEDICAL CENTER DIFFER FROM OTHER HOSPITALS IN THE AREA?

SUSAN GERARD: I THINK THE IMPORTANT THING IS WE ARE NOT JUST A MEDICAL CENTER. WE HAVE CLINICS ALL OVER THE COUNTY. WE HAVE AN HIV CLINIC, REFUGEE WOMEN'S CLINIC. WE DO A LOT OF THINGS. THE HOSPITAL ITSELF IS A SMALL PART OR IT IS A SIGNIFICANT ROLE BUT IT IS JUST IN THE MIX OF ALL THE THINGS WE DO.

TED SIMONS: SO THIS IS A NON-PROFIT HOSPITAL?

SUSAN GERARD: IT IS A PUBLIC. WE ARE A SEPARATE POLITICAL SUBDIVISION. WE ARE NOT PART OF THE COUNTY. THAT IS THE OTHER THING PEOPLE ASK.

TED SIMONS: RIGHT. SO THIS IS BASICALLY FOR EVERYONE?

STEVE PURVES: IT IS FOR EVERYONE. WE ARE OWNED BY THE PUBLIC, ACCOUNTABLE TO THE PUBLIC FOR THE OPERATION OF OUR HEALTH SYSTEM. WE ARE MORE THAN A HOSPITAL. ALTHOUGH TEACHING IN GRADUATE MEDICAL EDUCATION IS A BIG PART OF WHAT WE DO BUT WE ARE MORE THAN THAT.

TED SIMONS: $1 BILLION REMAKE OF THE HEALTH CARE SYSTEM. THE WHOLE KIT AND CABOODLE. WHERE DID THIS COME FROM?

STEVE PURVES: FORTUNATELY, OUR BOARD WENT THROUGH AN EXHAUSTIVE PROCESS AND THE BOND MADE THE DECISION IT WAS TIME TO GO TO THE VOTERS AND ASK FOR SUPPORT TO REPLACE OUR AGING TEACHING HOSPITAL AND ALL OF OUR CLINICS AND OUR BEHAVIORAL HEALTH HOSPITAL TO IMPROVE CAPACITY FOR BEHAVIORAL HEALTH, FOR EXAMPLE. SO THE VOTERS PASSED THAT BOND REFERENDUM IN NOVEMBER 14, ELECTION DAY, WHICH SET THIS INTO MOTION GIVING US THE RESOURCES TO REMAKE THE HEALTH SYSTEM.

TED SIMONS: 2014 BOND AUTHORIZATION PROVED BUT STILL A LITTLE TIME BETWEEN NOW AND THEN. FINANCES INVOLVED. WHAT WHAT HAPPENED IN BETWEEN?

SUSAN GERARD: WELL, A LOT HAS CHANGED IN THE HEALTH CARE INDUSTRY SINCE THEN EVEN. THEN, YOU KNOW, THE AFFORDABLE CARE ACT WAS JUST COMING ON BOARD AT THE TIME AND HAVING TO SEE WHAT INFLUENCE THAT HAD ON OUR VOLUMES AND EVEN THE KIND OF PEOPLE AND WHAT THE COMMUNITY NEEDS WERE. THERE HAS BEEN CHANGE IN METHODOLOGY WITH THE FEDERAL GOVERNMENT ABOUT FUNDING AND MOVING TO VALUE BASE INSTEAD OF FEE FOR SERVICE. SO THERE HAS BEEN A LOT OF CHANGES AND WE WERE HAVING FINANCIAL ISSUES THAT NO ONE ON THE BOARD FELT IT WAS APPROPRIATE FOR US TO BE SPENDING ANY MONEY UNTIL WE MADE STEVE AND HIS STAFF DID AN UNBELIEVABLE JOB TURNING US AROUND FINANCIALLY.

TED SIMONS: HOW DID YOU DO THAT?

STEVE PURVES: THROUGH A LOT OF HARD WORK. NO SINGLE THING DID IT. WE LOST A MAJOR FUNDING SOURCE IN THE SAFETY NET CARE THAT PROVIDED ABOUT $50 MILLION FOR US TO HELP US WITH THE UN-SUPPLEMENTAL CARE. WE BEGAN TO LOOK AT OUR REVENUE, EFFICIENCY OF THE OPERATIONS, HOW PEOPLE WORKED TOGETHER, LOOKING AT OUR EXPENSES, NEW WAYS OF DOING THINGS, AND IT TOOK EVERYBODY SORT OF ROLLING UP THEIR SLEEVES. AND THUS THE BOARD SAID WE ARE READY TO GO WITH THE EXPANSION.

TED SIMONS: EXPANSION INCLUDES A NEW MEDICAL CENTER, WILL IT STILL BE AT 26TH STREET AND ROOSEVELT?

SUSAN GERARD: THAT WAS PART OF THE BALLOT INITIATIVE. WE WOULD STAY IN THAT LOCATION.

TED SIMONS: OKAY AND THE BUILDING HAS BEEN THERE A WHILE DO WE NEED A BRAND NEW BUILDING THERE?

SUSAN GERARD: WE NEED A BRAND NEW BUILDING TO DO WHAT WE DO. YOU KNOW, SOME PEOPLE MIGHT SAY THAT GEOGRAPHICALLY THERE IS A CONCENTRATION IN THIS AREA BUT THAT IS JUST A REALITY. YOU ARE GOING TO BUILD THESE FACILITIES WHERE YOU HAVE THE MOST PEOPLE.

TED SIMONS: AGAIN, WAS A NEW BUILDING REQUIRED? WAS THE OLD ONE JUST NOT HOLDING UP?

STEVE PURVES: YES I WILL TELL YOU THAT BUILDING WAS PLANNED IN THE EARLY '60s. FINALLY CONSTRUCTED IN THE LATE '60s AND OPENED UP EARLY '70s. IT IS OBSOLETE BY ANY MODERN STANDARDS WE MIGHT APPLY TO OUR FACILITY TODAY.

TED SIMONS: I FIND IT INTERESTING THE PLAN CALLS FOR FEWER BEDS. IS THAT TRUE?

STEVE PURVES: CORRECT. THAT IS THE WAY HEALTH CARE IS HEADING. OUR HEALTH CARE SYSTEM IS RADICALLY DIFFERENT THAN IT WAS 20-30 YEARS AGO. WE ARE FOCUSED ON KEEPING PEOPLE OUT OF THE HOSPITAL TODAY. AS A RESULT OF THE UTILIZATION RATES ARE LOWER THAN WHAT THEY WERE. WE CONTINUE TO MAKE STRIDES KEEPING PEOPLE WELL, RATHER THAN SIMPLY TAKEN CARE OF THE SICK.

SUSAN GERARD: AND DOING THE BEHAVIORAL HEALTH IS ANOTHER TREND. YOU HAVE TO TREAT THE WHOLE PERSON.

TED SIMONS: HOW MANY HEALTH CLINICS ARE OUT THERE? WHAT KIND OF IMPROVEMENT WILL THEY SEE?

SUSAN GERARD: WE HAVE TWO THAT ARE NEW AND THE REST OF THEM ALL REALLY NEED TO BE EVEN CHANGED THEIR LOCATION BECAUSE WHERE THEY WERE BUILT THEY ARE NOT ON LIGHT RAIL, BUS LINES, THEY ARE NOT CONVENIENT. BUT THEY WILL STILL BE IN THE GAME GEOGRAPHIC AREA AND WE ARE HOPING TO COVER OTHER AREAS OF THE COUNTRY THAT WE ARE NOT RIGHT NOW, THAT HAS LARGE CONCENTRATIONS OF THE PEOPLE WE SERVE.

TED SIMONS: IT SOUNDS AS THOUGH BUILD A BEHAVIORAL HEALTH HOSPITAL. IS THAT PART OF THE PLAN? IS THERE A HOSPITAL TO THAT END NOW?

STEVE PURVES: YES. WE HAVE A FREE STANDING BEHAVIORAL HOSPITAL IN MESA CALLED DESERT VISTA. WE ALSO HAVE A BEHAVIORAL HEALTH ANNEX ON OUR CAMPUS IN ROOSEVELT. THEY ARE THE ONLY INPATIENT FACILITIES FOR THE MENTALLY ILL AND WE KNOW BEHAVIORAL HEALTH IS A MAJOR ISSUE IN OUR SOCIETY TODAY. WE DO NOT HAVE ENOUGH CAPACITY TO TREAT THAT SEGMENT OF THE POPULATION. OUR PLAN CALLS FOR CONSOLIDATING AND MAKING THOSE BEHAVORIAL HEALTH FACILITIES MORE CONVENIENT AND ACCESSIBLE, BUT ALSO HELPING THEM WORK BETTER AND INCREASE OUR CAPACITY.

SUSAN GERARD: WHAT BECOMES OF DESERT VISTA IN MESA? I THINK WE OWN THE LAND AND WE HAVE BEEN SORTING THROUGH DIFFERENT THINGS WITH THE COUNTRY BUT, YEAH, WE WILL PROBABLY SELL IT. I DON'T THINK WE WILL KEEP ANY OPERATION OUT THERE.

STEVE PURVES: THAT IS THE KIND OF DETAIL WE ARE INVOLVED WITH IN THE PLANNING PROCESS. IT IS YET TO BE DETERMINED WHAT WILL HAPPEN TO THE DESERT VISTA FACILITY. WE HAVE A CHALLENGE IN MAKING SURE WE CONTINUE TO INCREASE OUR CAPACITY BECAUSE WE DON'T WANT TO CURTAIL THAT.

TED SIMONS: CERTAIN PATIENTS DON'T LIKE CHANGE AND BEING MOVED AND THEIR FAMILIES WOULD LIKE TO KNOW WHERE THEY ARE AND KEEP THEM WHERE THEY ARE. THAT HAS TO BE A FACTOR.

SUSAN GERARD: SURE. OUR BEHAVIORAL HEALTH IS MORE SHORT TERM. AT THE STATE MENTAL HOSPITAL WHERE PEOPLE MIGHT BE FOR YEARS, WE DO THE COURT ORDERED EVALUATION AND STABILIZE PEOPLE. OURS IS NOT A LONG-TERM CARE TYPE FACILITY.

TED SIMONS: OKAY. THE NEW MEDICAL CENTER TIME TABLE. WHEN DOES IT ARISE? WE KICKED OFF THE PLANNING THIS MONTH. WE WILL BE PLANNING AND CONSTRUCTING FACILITIES OVER A SIX AND A HALF TO SEVEN YEAR PERIOD OF TIME. THE HOSPITAL IS THE MOST COMPLEX PART OF THAT. THAT WILL TAKE A LONGER TIME TO COME TO FRUITION. WE ARE LOOKING AT THE BEGINNING OF '21, BEGINNING OF '22 TO OCCUPY THE NEW HOSPITAL.

TED SIMONS: ALL SOUNDS VERY COMPLICATED AND LIKE A PLAN IS IN PLACE AND ALL SYSTEMS GO. WHAT HAPPENS IF THE AFFORDABLE CARE ACT IS REPEALED? WHAT HAPPENS IF MEDICAID IN ARIZONA TAKES A BIG SHIFT?

SUSAN GERARD: YOU KNOW, I REALLY FIND IS HARD TO BELIEVE THAT WOULD HAPPEN. IT IS JUST NOT US IN ARIZONA BUT EVERY HOSPITAL IN THE STATE, EVERY HEALTH CARE PROVIDER IN OUR STATE AND EVERY PLACE ACROSS THE COUNTRY. IF THEY MOVED TO MAKE A SERIOUS CUT IN MEDICAID, WE WOULD HAVE TO REEVALUATE WHAT WE DO.

TED SIMONS: THE ENTIRE PLAN WOULD HAVE TO BE LOOKED AT?

SUSAN GERARD: PROBABLY SO, YES.

TED SIMONS: AGREE?

STEVE PURVES: I AGREE. WE HAVE A SPECIFIC FINANCIAL PLAN GOING FORWARD AND WEATHERED GREAT CHANGE IN TERMS OF OUR FINANCIAL STATUS. THE ACA, IF ITS REPEALED WITH NOTHING REASONABLE TO REPLACE IT, WILL MAKE A SIGNIFICANT IMPACT ON OUR HOSPITAL AND EVERY OTHER HOSPITAL IN THE STATE.

TED SIMONS: WOULD IT MEAN NO NEW MEDICAL CENTER? I AM NOT SURE BUT I KNOW WE WILL NOT BE ABLE TO DO EVERYTHING WE ENVISION TO REINVENT OUR HEALTH CARE SYSTEM.

TED SIMONS: NOTHING LIKE MOVING GOAL POSTS OUT THERE. GOOD TO HAVE YOU BOTH HERE. UP NEXT ON ARIZONA HORIZON: THE FINAL-4 MEANS MORE THAN BASKETBALL TO PHOENIX.