In the area of collaboration, the work done on APC's with the assistance of GHA is great. Thanks Cal for your efforts during a busy legislative year. We will also submit an application for the Practice Management work spearheaded by committee members under Cathy Dougherty and Art Bell. An excellent effort! For Education, we are submitting the Winter Institute in Atlanta for an award. If you were able to attend, you know why. It was well organized, well attended, and well thought of. The CPAR committee never stops, and I hope will win a Yerger award for the improvements made to an already excellent program. Healthcare professionals value certification, and advancement is the way to go. Thanks to the CPAR Committee for providing a bigger path for achievement. In the area of innovation, two award applications are pending. Kathy London has given benchmarking a new perspective, and I hope developed standards of measure that can be adopted nationwide. You really made a difference! Another innovation was the education for Medicare recipients. This is one of the most important areas of outreach our Georgia Chapter has undertaken - with rave reviews. Lil Kloock and Kathy Mobley led this effort and should be proud of the results they achieved. Enhancing Communication with Managed Care Carriers was a program that should definitely win in the Communications category. Cathy Dougherty did outstanding work in strengthening alliances between providers and carriers, and as far as I am concerned, that's what it's all about! Last but not least, Glenda Bess improved member service through her work with the Corporate Compliance Survey. My thanks for all your work.

Those mentioned above will all tell you that it takes a team effort to make a difference, and our Teams have worked their hardest. There are so many of you that are worthy of mention, but it cannot be done in this tiny little space. But you know who you are, and let me assure you that we have reached our goals and achieved the results we hoped to achieve.

As the year ends, I look forward to seeing each of you at the Spring Institute. Callaway Gardens has opened the Virginia Hand Callaway Discovery Center, with a new entrance to the Gardens and an expansion that is worth visiting. I hope you will send in your registration for May 2 - 5, and plan to be there so I can personally thank each and every one of you for your contribution. I am proud to say "Georgia Chapter" has made a difference! - Thank "YOU" for a tremendous year!!!

Alexis A. Klamke

South Georgia Medical Center - Meeting the ever-increasing demand for the latest and best healthcare services

July 1, 2000, South Georgia Medical Center will celebrate 45 years of progress. Since our establishment in 1955, SGMC has grown with the region adding services and personnel to meet the ever-increasing demand for the latest and best healthcare services. Our mission is to provide quality, cost-effective, comprehensive health care within the confines of our region. We offer modern convenience, state-of-the art technology and highly skilled personnel in a friendly, caring atmosphere.

South Georgia Medical Center is located in Valdosta, the county seat of Lowndes County. Valdosta is Georgia’s tenth largest municipality. It is strategically located on Interstate Highway 75, just a few miles from the Florida border. Valdosta is a progressive city that preserves its cultural heritage; while at the same time looks toward the future. It is expected that the 2000 Census will afford Valdosta the distinction of being a metropolitan area (MA). Currently, Valdosta is one of two cities in Georgia vying for this achievement. MA status will enhance SGMC’s rate of reimbursement from Medicaid and provide other Federal financial benefits for the community.

SGMC is a full service, 335-bed, regional referral hospital that serves the acute care needs of 290,000 residents living in a 13-county medical service area of South Georgia and North Florida. Last year, over 150,000 individuals came to SGMC for health care. More than 40 percent of these patients traveled from outside Lowndes County.

Today, SGMC employs over 1,800 employees making up one of the most technically advanced workforces in our region. The hospital has an annual operating budget of approximately $120 million and is the largest civilian employer in the region with an economic impact over $300 million. SGMC is affiliated with state and national health organizations including the Georgia Hospital Association, Voluntary Hospitals of America, and American Hospital Association. The hospital is proud to continue its forty-five year history of community service by meeting area healthcare needs with no local tax support.

As one of the largest healthcare facilities south of Macon, SGMC enjoys the reputation as the region’s major referral center for patients with more serious injuries and illnesses. Over 160 highly qualified physicians with expertise in more than 25 specialties complete SGMC’s medical staff.

New service lines and facilities, such as Medical Center Home Health, The Wound Care Center, and Greenleaf Center have been added most recently to our scope of services. SGMC has plans to increase its scope of services to include the following subspecialties: open-heart surgery and treatment of advanced heart disease, neonatal/ pediatrics care facilities, endocrinology units for the treatment of gland dysfunction and disease, and facilities and resources forthe study and treatment of infectious diseases. Construction will begin before the end of the year on a new primary care clinic in south Lowndes County. A certificate of need (CON) is pending for a $5.9 million expansion of our labor, delivery and recovery areas.

The Cardiology Center at SGMC offers dedicated cardiac services for patients experiencing cardiac problems requiring immediate assessment and treatment. Plans are currently in progress for the establishment of an open-heart surgery program, which will have a major impact on SGMC. "An open-heart surgery program completes the continuum of Cardiology services offered here," explained SGMC President & CEO John S. Bowling. "Our cardiac catheterization lab, Cardiac Progressive Unit and Cardiac Intensive Care Unit are always very busy. The addition of the open-heart surgery component is very positive for our critically ill patients, our community, and a positive step forward for our hospital."

The Pearlman Comprehensive Cancer Center is nationally acclaimed for its state-of-the-art facility. Through a comprehensive team approach, physicians and cancer specialists work with patients to develop an individualized treatment plan that includes surgery, radiation therapy, chemotherapy combined with nutritional counseling, patient education, on-site laboratory and pharmacy and support groups.

The Women’s Place features complete maternity care at The Birthplace, a full range of women’s gynecological and other conventional surgeries, mammography’s, and bone density testing for osteoporosis. Educational programs also address issues women face on a daily basis.

SGMC’s distinctive 109-unit senior living community, Langdale Place, offers active, independent senior adults the perfect blend of security, comfort and convenience so that they can enjoy the carefree life that is so well deserved in one’s retirement.

On a larger scale, South Georgia Medical Center also serves as the hub of the South Georgia Health System. The health system manages and coordinates a myriad of services that go beyond the main hospital’s walls. Today, this system not only includes SGMC, but two rural community hospitals, community health clinics, a senior living facility, a skilled nursing home, a home health agency and other health-related services. The health system is comprised of these associated entities: South Georgia Health Alliance, Inc., (Hospice of South Georgia and Langdale Place); the SGMC Foundation; Louis Smith Memorial Hospital (Lakeland, GA) and Clinch Memorial Hospital (Homerville, GA).

SGMC is also a member of South Georgia Health Partners, an alliance of physician-hospital organizations (PHOs) in Moultrie, Thomasville, Tifton and Valdosta, providing managed care plans for self-insured employers. w

Article submitted by Dana Massingill

Members of HFMA: Greg Hembree, CPA, CFO; Bill Huling, CPA, Controller;

Rick Joiner, Director of Patient Financial Services

The CFO Forum committee presented "A Medicaid Update" on 12/17/99 at Clayton State College. Thirty nine attendees from providers as well as other health related service organizations took part in the interactive presentation. Lamar Blount of HMA served as the moderator and opening speaker. He shared some insights as a result of analyzing Medicaid DRG data, specifically concentrating on obstetrical services coded as DRG-372 (vaginal delivery with complicated diagnoses) and average charges per admission and length of stay variances were noted. however, of greater interest was the deviation noted at specific hospitals regarding the ratio of their DRG’s 372 and 373 as compared to state averages. For example, the state average of DRG 372 as a percentage of the sum of DRG 372 and 373 is 16%. If the hospital’s is 10%, it may indicate an opportunity to improve the adequacy of documentation and the accuracy of coding.

Conversely, if DRG 372 exceeds the state average, it may indicate over coding. Conformity to compliance standards as well as good business sense warrant review of this issue.

The next speaker was Ms. Marcine Sullivan, Health Systems Administrator for the Health Planning division which was formerly known as the State Health Planning Agency. She shared an overview of the newly created Department of Community Health (DCH). DCH insures approximately 2,000,000 individuals which includes both Medicaid and State employees and represents 30% of Georgia’s population. Their budget is currently $5 billion. Other responsibilities include planning for uninsured Georgians and administering the recent tobacco settlement fund. Changes within the Health Planning Division include updating Radiation Therapy rules, Home Health Agency rules and expediting non-clinical services CON applications (e.g. a parking garage) rather than having it go through the full ninety day cycle. Ms. Sullivan commented on other initiatives including the Healthcare Reform Package (consumer choice within managed care plans, insurance consumer advocates with regard to insurance rates and patient rights when treatment in excess of $500 is denied by insurer). Their intent is to annually review indigent care commitments beginning January of 2000 based on the 1999 Indigent Care Surveys, and to review facilities to determine if their Medicare and Medicaid volumes are below the average for their service area.

Mr. Butch Beaty, Director of the Georgia Better Healthcare (GBHC) presented information on Medicaid managed care which has linked Medicaid patients to a primary care physician (PCP) in an attempt to get patients into the physician’s office versus emergency rooms. The PCP is responsible for authorizing treatment by a specialist or for hospital services, and is paid $3 per patient per month. Patients can choose their PCP, and if they do not, are auto-assigned by a computer algorithm. This system is mandatory for about 80% of Medicaid recipients but is optional for the reminder who have both Medicaid and Medicare coverage. Overall, GBHC has resulted in a 4-5% reduction in expenditures and requires the PCP to coordinate the patient’s medical care. Additionally, Peachcare Kids is now administrated by GBHC and currently has over 50,000 members.

Jim Connelly, Director of Reimbursement Service discussed the Indigent Care Trust Fund (ICTF) and their desire to move the application process back to an earlier start date. It was also stated that premiums for Peachcare Kids to cover hospital employee’s children is an acceptable request for use of the funds required for the hospital’s primary care plan obligation of the ICTF. Finally, it is their intent to be open with calculations of each hospital’s share of the fund.

Russ Toal, Commissioner of the DCH reviewed the recent change in coverage of the state health plan and University system from the Blue Cross Prudent Buyer Program to the direct contract method for 1/1/00 - 6/30/00. The State Board of Medical Examiners is part of DCH. They have been provided with access to updated computer systems to organize their files. They also have the fifth lowest licensure fees in the country and are proposing increases to generate an additional $600,000 to be used for staff and computerization.

The Office of Rural Health and the Primary Care Office of Public Health have been transferred to the DCH and a director is being sought. It’s office will be located in a yet to be determined site in rural Georgia.

The upcoming budget contains requests for normal rate adjustments for hospitals, nursing homes and physicians. It also contains requests for increases for critical access hospitals and initiatives to address dental care and children’s health. The Medicaid eligibility standards are requested to increase from 200% to 235% of the Federal poverty guidelines for pregnant women and infants. This increase could lead to raised eligibility for Peachcare. A separate request would address coverage of family planning services for postpartum women for two years to help them make informed decisions about their next pregnancy and have a positive impact on the fairly negative infant mortality rate in Georgia. Changes in the eligibility thresholds for children to standardized 150% of the poverty guideline and coverage for aged, blind and disabled persons up to 100% of the guideline are also requested.

Mr. Toal discussed the tobacco settlement and the 14% reduction from the projected $368,000,000 payment as a result of lower tobacco usage. He anticipates that Governor Barnes will recommend to the General Assembly that they assume a lower amount and to create a reserve fund as a hedge against future reductions. It is DCH’s proposal that the settlement be used to fund the increased eligibility standards first, second for a school nurse program, and finally for the state to follow the CDC’s recommended best practices on tobacco prevention, cessation and control program. The Governor has repeatedly stated he wants one third for rural economic development.

Inside the Medicaid program, Mr. Toal stated there would be no Medicaid HMO’s by year end, increased attention to fraud and abuse, and efforts to "clean up" the ICTF process.

Submitted by Raymond C. Owings

Chief Financial Officer

Southeast Georgia Health System

On February 10, 2000, 165 CPAR graduates were honored at the 2000 Winter Institute held at The Atlanta Gwinnett Marriott Place. The day began with an educational session led by Michelle Lee, HFMA Chairperson for Membership Recruitment and Retention, entitled Behave Yourself. The graduates completed individual behavioral profiles and learned about different ways to effectively communicate. Following the educational session, a reception honoring the CPAR graduates was held. Later that evening 300 guests attended the awards banquet.

This year’s High Scorer was Jennifer "Lacy" Martin of Harkins and Henry.

Not only was she surprised by achieving this accomplishment but by the appearance of her parents. Lacy was presented roses by her parents. Mr. and Mrs. Richard Martin have been active members of the HFMA Georgia Chapter. Richard Martin was the 1985 - 1986 Georgia HFMA President.

This year’s Organizational Awards were presented to two organizations that have supported CPAR for many years. Grady Health System had 22 graduates, Harkins and Henry had 15 graduates. These organizations have key individuals who have supported all of HFMA’s programs. Larry Bradley, Senior Director of Patient Financial Services for the Grady Health System, was the 1983-1984 Georgia HFMA President. Clint Harkins of Harkins and Henry was the 1991 - 1992 Georgia HFMA President.

A special award was presented to Emily Lloyd of Bleckley Memorial Hospital as the 2000th CPAR Graduate. The CPAR program began in 1982, when a group of HFMA members recognized the need for a training and certification program for hospital business office employees. The yearly program has since expanded to include other aspects of patient accounting and is enthusiastically supported in hospitals and affiliated organizations throughout the state of Georgia. We are honored to have 2085 individuals who have gained certification through the CPAR Program.

The CPAR program only exists because of the HFMA volunteers who serve on the CPAR committee. The 1999-2000 committee volunteers were: Carmen Sessoms, CPAR, CHFP of McKesson HBOC; David Catoe, CPAR of Athens Regional Medical Center; Jesseca Edwards, CPAR of Vista Financial Services; Kimberly Farmer, CPAR of Promina Gwinnett Health System; Carol Mitchell, CPAR of Promina Gwinnett Physicians Group; Kathy Mobley, CPAR of BCBS of Georgia - Medicare Part A; Karen Newton, CPAR of The Law Offices of Harkins and Henry; Teresa Pope, CPAR of The Children’s Heart Center; Talmadge Reece, CPAR of NDC; and Mary Kay Tam of Athens Regional Medical Center.

Special thanks to the employers of our CPAR volunteers for supporting and encouraging their efforts in providing quality education for the healthcare financial associates in the State of Georgia.

Special thanks to Northside Hospital, South Georgia Medical Center, Candler Hospital, Wellstar Health System, Athens Regional Medical Center, Grady Hospital, and Houston Sports Clinic for hosting coaching and testing sessions.

Congratulations to our 165 CPAR graduates! They have the honor of being recognized as the first graduating class of the new millennium!

Brenda Carroll

Sarah Diana Fulcher

Phyllis Goodpaster

Constance Hale

Venita Harris

Rosie Jarrell

Suzannah Lipscomb

Wakesi Walton

Debra Baker

Sharon Johnson

Kamilia Parker

Latrelle Powell

Emily Lloyd

Angela Poteat

David Critz

Lori Hervol

Kathleen Lown

Renee Gordon

Kimberly Hall

Gail Jackson

Janette Newberry

Lisa Tarpley

Victoria Terrell

Tracie DeLois-Allen

Eleanor Balauitan

Tammy Barnwell

Kathy Bass

Ray Granger

Linda McClellan

Dianne McGhee

Melanie Smith

Linda Ward

Gloria Willingham

Nyocka Addison

Pamela Lawson

Cassandra Mitchell

Debra Walker

Nelson Williams

Deborah Deas

Bonnie Luker

Janice Harrington

Carla Brock

Karen Carswell

Kathryn Adams

Samuel Alexander

John Anderson

Welta Dismuke

Doreen Douglas

Gertrude Dunlap

Kimberly Favors

Curtis Frederick, Jr.

Jacquelyn Garrett

Brenda Harris

Ylinda Hyde

Ronald Jackson

Joyce Jester-Mobley

Maria Kemp

Veronica Mosley

Dorothy Murphy

Vanessa Peak

Janie Stegall

Nettie Thrash

Deborah Troup

Geraldine Williams

Nancy Williams-Moreland

Wendy Boatright

Amy Cox

Shayne Bell

Colleen Bradley

Pamela Chastain

Maggie George

Wilhelmina Hampton

Carol Hansard

Bernadette Hicks

Jennifer Martin

Linda McCain

Bo McGehee

Richard Rhine Jr.

Donna Rolin

Paula Vaughn

Zane Watkins

Vicky Wells

Angie Anderson

Kay Hamblin

Jeanine Thomas

Cheryl Logue

Penny McLendon

Marina Spelas

Brita Andrews

Cathy Brewer

Stephanie Dent

Lori Evans

Tesha Johnson

Kellye Layson

Deborah Lynch

Sharon McClain

Kim Must

Jacqueline Nobles

Monica Pope

Angelia Scott

Diane Spires

Karen Strong

Brenda Allen

Sandy Bowdre

Bonnie Fitzgerald

Doris Gaines

Martha Inglett

Addie Moore

Beverly Parker

Roxanne Pelfry-Rowe

Sandra Smith

Rebecca Brister

Erika Gruman

Connie Jones

Patricia Miles-Williams

Linda Wright

Alecia Albury

Katie Dang

Deborah Martin

Aquil Johnson

Kelly Mayo

Shakawn Kinney

Judithe Klein

Katrina Minix

Inderia Muhammad

Melissa Weller

Wendy Allen

Mila Barber

Tracey Hayward

Hattie Hill-Johnson

Kiwanis Reid

Edward Lomicka

J. Patrick Murphy

Sayler Whitten

Lisa Jenkins

Kristie Petree

Judy Buckley

Linda Walker

Sherry Dawson

Connie Easterling

Inez Mitchell

Eleanore Snow

Vicki Engle

Laurie McCullers

Tiffany Jones

Jerri Settle

Jay Potter

Ruthie Burden

Jeannett Maskell

Sandra Berryman

Cynthia Colley

Maurice Barnes

Dawn Powell

Tracie DeLois-Allen

Venita Craft

Beth Dalton

Sherry Creamer

Kelly Dunnahoo

Brenda Kelley

Jerome Piska

Joe Hall

Denise Barna

Michele Howerton

Renee Kline

Renate Ladd

Janice Raphael

Laurence Laughlin

Linda Smallwood

Melissa D’Antignac

Barbara Dymowski

Charles Fletcher

Theresa Hall

Linda Mathis

Debra Mollohan

Juan Montanez

Carol Pascarella

Caroline Smith

Teresa White

Earl Wood

Elizabeth Louise Chastain

Jared Fogg

Wyatt Friend

Lisa Hakim

Anthony Helton

Janice Matthews

Albert McRae

James Sellers

Andrew Shine

Arthur Vinson

Alice Lamb

Sandra Lott

Sade Love

Wendy Owens

Amanda Thomas Trask

Louise Truitt

LaTonia Taylor

Brian Unell

Mary Woodward

Pamela Barton-Knott

Elizabeth Crabtree

John Gallatin

Teri Anne Hartman

Lori A. Hervol

Charles Horne

Gray Johnson

David Kasdin

Allyson Keller

Mel Hope

Robert Johns

James Peterson

Tamela Putnam

Kerry Ball

Kenneth Barngrover

Lisa Conti-Bacon

Michael Coussan

Bruce Craycraft

Gary DeBouver

Fred Droms

David Esser

Carol Forsythe

Sherrie Justice

Melinda McNair

Todd Moschner

Vinnie Pandita

Paul Price

Kimberly May Skinner

Ross McCain Sloop

Eddie Phillips summed up HFMA involvement by quoting National HFMA President Dick Clark who said in his recent trip to our Atlanta Institute, "No matter how much you give, you get more back." "It’s fun!", added Eddie.

As the incoming President-Elect, Eddie has definitely given a lot to this chapter. He joined in 1988 and has only missed 2 institutes since!

His involvement has included working on and chairing various teams such as Strategic Plans, Pro Action, Managed Care, Treasurer, Secretary and Program Chairman. He has also earned both the Follmer Bronze and the Reeves Silver Awards.

Eddie said that he believes decreasing reimbursement and increasing regulatory oversight are the biggest challenges facing the healthcare industry today. In addition, HFMA as an organization is facing a static or declining membership because of industry cut backs. "To survive, we are going to have to reach out beyond traditional providers to promote membership to other groups, such as physician practices, long term care providers, and HMO’s", he stated.

This will be a busy year for Eddie as he prepares to succeed Tim Beatty as President. He will begin working on his strategic plan for 2001-2002.

Eddie has been with Ernst &Young’s Atlanta office since 1986. With a degree in accounting from The University of Alabama, he started his career in the Birmingham, Alabama office of Arthur Andersen in 1980.

Eddie has been married to wife Helen for 13 years. They have an 11 year-old son, Kevin, who is very involved in tennis, piano and voice. When he’s not spending time with the family, Ernst & Young, or HFMA, you may find Eddie working for the Athletic Booster Club of The University of Alabama or playing golf.

Program chairperson for HFMA is just one of Cynthia Perley’s many titles in life. They range from CPA to Director to Soccer Mom. Her life is full and that’s the way she likes it.

Cynthia joined HFMA in 1984 while involved in public accounting. It wasn’t until she joined DeKalb Medical Center that she became active. She has served on several teams including Education, Public Relations, CPAR, Membership Recruitment and Retention, and Pro Action. She jumped in this past year to serve as treasurer when the position became vacant. Cynthia has earned both the Follmer Bronze Award and the Reeves Silver Award.

She truly believes HFMA is a terrific organization. "You get much more out of it than you put into it. The networking opportunities are unlimited. You learn a lot and you have a lot of fun."

Cynthia also stated that the friendships she has developed through HFMA are strong.

Cynthia pointed out that involvement in HFMA can also help individuals develop career skills. "Members who are staff level in their organization do not always have the opportunity to manage and develop those skills. By becoming involved in HFMA, they can learn management skills in Teams. Working on a team or chairing a team gives you the opportunity to work with people at all levels." That type of experience can’t be bought!"

Cynthia sees the biggest challenge facing healthcare today as continually trying to provide quality service in an era of decreasing reimbursement. HFMA through its programs will continue to help organizations understand these changes and work together as efficiently as possible.

Cynthia, a graduate of the College of William and Mary in Virginia, worked for 2 small firms in public accounting before joining Emory Hospital as a financial analyst. She joined DeKalb Medical Center 16 years ago as an internal auditor and is presently Director of Materials Management. Eight years ago, she returned to school and earned a Masters of Science in Healthcare Policy and Administration from Mercer.

Cynthia, along with husband Phil, 14 year old son Mitchell, 13 year old son Adam, and 4 year old daughter Megan reside in Atlanta.

After a person sustains a brain injury, spinal injury, multiple orthopedic injuries or suffers a stroke, the family must locate services to meet his or her ongoing needs - medical rehabilitation, work re-entry services, driving evaluations, adaptive recreational opportunities, a transitional living program and multiple accessible residential options.

Augusta, GA has one answer for such needs: Walton Rehabilitation Hospital, Walton Community Services, Inc., Walton Options for Independent Living, Inc., and Walton Foundation for Independence, Inc., under the leadership of Dennis B. Skelley, President/CEO, have developed a comprehensive continuum of care to offer the health and community services that enhances the quality of life for Georgians with disabilities, in their community.

Walton Rehabilitation Hospital

Walton Rehabilitation Hospital (Walton) uses a treatment team approach to address the individual rehabilitation needs of children and adults who are recovering from catastrophic illnesses, injuries or conditions. Each team is led by a physician who is board certified in physical medicine and rehabilitation. Patients benefit from physical, occupational and speech therapists, many of whom are regionally and nationally recognized for their expertise, including a physical therapist who is certified in neurologic rehabilitation - a distinction less than 1% of all physical therapists have attained. Furthermore, a majority of Walton’s registered nursing staff has attained the Certified Rehabilitation Registered Nurse (CRRN), a designation awarded by the Association of Rehabilitation Nursing (ARN) to recognize advanced education in the field of rehabilitation nursing.

Each treatment team follows best practice protocols for the efficient treatment of numerous diagnoses, including a Center of Excellence for Brain Injury and Stroke. Walton worked with other rehabilitation hospitals in the SouthEast Rehabilitation Network, Inc.’s (SERN) Best Practice Task Force to define these best practice protocols. Patients spend a minimum of three hours a day in gyms that are superbly equipped with items many other rehabilitation providers don’t have, such as activity of daily living suites, a gait trainer, a car transfer simulator and two hydrotherapy pools.

Walton is accredited by the Joint Commission on Accreditation of Healthcare Organizations and the Commission on Accreditation of Rehabilitation Facilities in the areas of acute brain injury, community integrative/brain injury, spinal cord, chronic pain management, outpatient medical rehabilitation, and comprehensive inpatient rehabilitation to include stroke, orthopedics and cardiovascular accidents.

Walton offers outpatient physical, occupational, speech and psychological therapy, as well as physician services are offered on an outpatient basis. Specialized clinics and services offered include: wheelchair and equipment clinics; augmentative communication clinics; tone management services; driving evaluations; work and school re-entry services; aquatic exercise programs; and support groups.

Walton participates in a number of recreational opportunities for children with physical disabilities as the home to the local Winners On Wheels (WOW) program, a scouting type program for children ages 7-11 and offers a summer camp for children and teenagers with brain injuries. Walton also supports the Blaze Sports Program, a local weekly sports program for children with physical disabilities.

Walton has a number of other safety and prevention programs for both children and adults. For children, our organization is heavily involved in children’s injury prevention as the lead organization for Safe Kids of East Central Georgia, a national injury prevention program, and other school and home based programs. We also offer a special needs car safety seat loaner program and SafeSitter classes. For adults, Walton has an interactive Wellness Information Room, a Speakers Bureau and participates in numerous community health fairs.

In addition to contributing to research projects to advance physical medicine and rehabilitation, Walton is involved in assisting in the long-term needs of people with disabilities through grants and advocacy. Currently, Walton is working to secure grants for post-care items and services such as home modifications and transportation. Walton has also advocated for numerous causes including increasing Medicaid funding for Community Care Services and Independent Care Waiver (ICW) slots.

Walton Community Services, Inc., brings independence home by assisting people with physical disabilities to live as independently as possible in the community. WCS provides the following services and programs:

Opened in 1995, Walton West Transitional Living Center was the first program of its type in Georgia to help improve the person’s social, behavioral and thinking/memory skills in five basic areas: work/school activities, self-care, leisure activities, social interaction and household maintenance. Clients master skills, such as cooking, money management and shopping, needed to be successful at home, work, school and in the community.

Concerned by the lack of affordable, accessible housing in the Augusta area, Walton collaborated with the Department of Housing and Urban Development (HUD) to build and operate several residential options that were accessible, affordable, convenient, and inclusive in the community. Walton and HUD have opened four housing communities in Augusta, with two communities under construction for a total of 88 units. Other communities are in the planning stages across the CSRA.

In the early 1990s, Augusta businessman Phil Harison learned that independent and assisted living opportunities specifically for people with physical disabilities were limited. Mr. Harison approached Walton to help find a solution. The answer became Harison Heights, the only community of its kind in Georgia. The community, named in honor of Mr. Harison, provides residents with the opportunity to foster their independence, while still having the personal care needed on a daily basis.

In 1994, Walton Rehabilitation Hospital provided funding to establish a private, not for profit, nonresidential Center for Independent Living for people of all ages with all types of disabilities living in the greater CSRA. The center became separately incorporated a short time later as Walton Options for Independent Living, Inc. through grant funding to operate as a Center for Independent Living. Services provided by the center include: advocacy, information and referral, independent living skills training, peer support, home modifications, computer recycling and training, materials in alternative formats and a personal assistance services registry. Walton Options also has a Technology Demonstration Center with assistive technology information, demonstration and training.

Walton Foundation for Independence, Inc., unites the fund development efforts of Walton Rehabilitation Hospital, Walton Community Services, Inc., and Walton Options for Independent Living, Inc. The Foundation is a separatelyincorporated organization that works to obtain resources for medical care, equipment and other items needed by people with physical disabilities to live dignified, productive lives.

Article provided by Meredith Little - Marketing Department Walton Rehabilitation Hospital.

You don’t want to miss attending HFMA’s 2000 Annual National Institute (ANI), to be held June 25-29 at the Walt Disney World Dolphin and Swan, Lake Buena Vista, Florida. Just as important as the valuable education offered is the chance to interact with the "who’s who" in healthcare finance. You’ll meet people that will help you excel in your career. Discover the power of networking! This year’s ANI offers some great opportunities to rub elbows with your peers.

For first-time attendees or those who have not attended an ANI in some time, the get-acquainted session will offer a convention overview and orientation. This session will be held on Sunday, June 25, from 5 to 6 pm. Attendees will have a chance to meet others and ask questions. Networking opportunities will abound. Those who want to make the most of their ANI experience will learn tips on how to maximize participation in the ANI. In addition, there will be a chance to win valuable prizes! Attending this session can make all the difference. One of the contacts you make could be your next boss, a new mentor, or a friend for life.

Don’t miss networking at this ANI icebreaker event, which brings everyone together for fun. Attendees and their families and guests, exhibitors, sponsors, HFMA leadership, and anyone attending are invited. The event will be held on Sunday, June 25, from 6 to 9 pm in the Northern Hemisphere Ballroom at the Walt Disney World Dolphin. In the spirit of incoming National Chairman Connie Cape’s theme "Imagine the Possibilities," the theme for this function will be "Imagine-Nation." There are networking opportunities at every turn - while sampling the wide array of food and beverage, tapping your toes to the sounds of the live music, enjoying the entertainment, and much more!

The exhibit show is a networking paradise. The hall will be packed with more than 200 exhibiting companies, whose representatives will talk to you about the latest and greatest products and services affecting your job and career. Steps away in every direction are your peers, who are willing to share their experience and discuss common concerns. You will have the chance to meet HFMA’s National leadership, view HFMA on-line, and get in the Know with the HFMA Knowledge Network¨. When you are enjoying all the trade show has to offer - from the food and beverage to the Go-For-the Green golf simulator, remember everyone one around you is a valuable contact. Try to meet as many people as possible, so you return to the office with a fist full of business cards of new contacts. The trade show will be held at the Walt Disney World Dolphin. Show hours are Monday, June 26, from 12:30 to 3 pm (lunch) and from 5 to 7:30 pm (reception) and on Tuesday, June 27, from 7 to 8:30 am (continental breakfast) and from 12:30 to 2:30 pm (lunch).

• Forums Reception and Activities
• Certification Information Breakfast
• Certification Lunch
• Golf Tournament

As the 1999-00 membership renewal campaign moves into high gear after the first invoice is mailed on March 1, HFMA members across the country will be reflecting on the personal benefits they received as a result of joining HFMA. The key to a successful renewal campaign is to demonstrate to members that the benefits outweigh the cost, so they will sign up for another year.

Chapter officers can ensure that members of their chapter reap maximum benefits from HFMA membership. Here are some quick tips:

• Ask new members for their involvement on a chapter committee, task force, or project. HFMA research shows that involved members get more out of HFMA than those who do not become involved and are therefore more likely to remain members. (Refer to the list of at-risk members you received in December’s Membership Marketing Tool Kit No. 4.)
• Write a chapter newsletter article about how HFMA membership benefits members at both chapter and National levels. Personal stories from chapter members will add credibility.
• Promote HFMA products and services at chapter meetings and programs by having an information table with the latest details on HFMA resources, such as books, national education programs, Forums, and certification. Contact Richonda Platt at rplatt@hfma.org to request promotional materials geared to the audience at your event.
• Assign a "buddy" to members who are attending chapter meetings for the first time. The buddy should introduce the new member to other chapter members so he or she will feel comfortable and likely will return. In addition, chapters can begin a mentor program that partners all new members with an active member. Case studies on ongoing mentor programs are available from Chapter Relations. Contact chapter@hfma.org.
• Schedule structured networking events at meetings. People learn from other people’s experience. One easy-to-implement idea from an HFMA peer goes a long way toward membership renewal.
• Or take idea sharing a step further. At chapter meetings or in the chapter newsletter, make sharing tips and strategies an ongoing feature, especially those solutions that are the result of an HFMA experience.

Remember, start small but think big. Every time you mail a newsletter or meeting announcement, you have an excellent opportunity to remind members, "This is brought to you as a benefit of belonging to HFMA." For more information, contact Richonda Platt at (800) 252-4362, ext. 305, or rplatt@hfma.org.

Question One: What is a health care provider’s liability with respect to complying with a Request to Produce Documents that seek confidential medical records?

Question Two: What is a health care provider to do when served with a request to produce a patient’s medical records?

Recent court cases in Georgia have stated that if a party does not object to the request for the production of medical records within the ten-day time frame, the patient’s privilege is waived. In one case, neither the psychiatrist nor the patient objected to an RPD within the statutory timeframe. The psychiatrist later objected, stating that it was not in his patient’s best interest to turn over the records. The court ordered the production of the psychiatric records, citing the Georgia Code provision as support for the proposition that if no timely objection is filed, the privilege is deemed waived. While the patient’s attorney has a responsibility for objecting to these requests, their failure to do so serves to waive confidentiality. If the provider fails to object, they are subject to the same waiver. This may not be in the best interest of either the patient or the provider.

Our medical culture values the notion that full disclosure leads to maximum medical benefit. Failure to protect confidentiality by taking these rather simple steps serves to weaken that principle and compromise the effectiveness of health care in general.

Be careful.

Michael Rosetti

Feiler & Associates

The Internet has become an integral part of most businesses; however, within the tax-exempt organization arena it has also raised issues with respect to both legal and tax issues. These issues arise because of the ever-increasing free flow of information and immediate access to different organization’s fund-raising activities. Issues relating to exempt organizations that will have to be dealt with in the near future by the Treasury Department and the IRS include those related to internet advertising, internet sales, referral payments, and e-commerce activities that benefit charities. Additionally, such accessibility through the Internet can also affect those individuals and companies who donate money and time to tax-exempt organizations. While many issues relating to Internet technology have been identified, most have not been specifically addressed or clarified in publications by the Treasury and IRS.

Charity web sites have become so common that the first page of the Form 1023, Application for Recognition of Exemption, asks for an applicant’s web site address. Establishing a Web site is a convenient and cost effective way for exempt organizations to provide information about themselves to a broad audience, communicate with members, conduct research, and raise funds. Posting a web site that does these things on the Internet is not inconsistent with an exempt organization’s exempt purpose. It is the content and structure of the web site that gives rise to the tax and legal issues.

Unique to the Internet, "links" enable organizations’ web sites and their information to be quickly and easily connected. Because of this links have been a hot topic for the IRS and practitioners, however, there is only informal guidance regarding their use. Links may turn a sponsor acknowledgement into an advertisement. Acknowledgements can include the sponsor’s name or logo, but can not include quantitative or qualitative language an endorsement, or price information. Having a link to a sponsor’s web site may constitute an advertisement; thus generating unrelated business income. The style of link may also be a factor when considering whether or not establishing a link taints the sponsor acknowledgement. The IRS has indicated in recent authority that a passive link retains the character of a sponsor acknowledgement, while a moving banner in all probability would be considered an advertisement.

Exempt organizations may establish links to affiliates that may be exempted under a different Code Section or even taxable. These links may have an adverse effect on the organization’s tax-exempt status if it appears the link enables the organization to achieve purposes the exempt organization is prohibited from accomplishing directly. Organizations need to be wary of lobbying rules and limits, as well as political activity when considering linking to another organization’s web site and determining the content of their own web site. Section 501(c)(3) exempt organizations may be faced with losing their exempt status if their web site contains any amount of political campaign activity or links to a web site containing political campaign activity.

Income generated from an online shop may also give rise to unrelated business income, as well as state and local sales tax issues. The IRS will examine each item sold to determine it’s relation to the organization and how selling the item online furthers the organization’s exempt purpose.

Due to the complexity of determining the state and local tax liability of Internet sales, Congress has created a national commission to study international, state, and local taxation of electronic commerce, in addition to the Internet Tax Freedom Act, which imposes a three-year moratorium ending October 21, 2001, on any tax that discriminates against electronic commerce.

The ability to raise funds over the Internet brings about many legal concerns. Charities and charitable fundraisers are required by most states to register with state authorities before soliciting state residents for contributions. In addition, charities and charitable fundraisers soliciting over the Internet must be able to substantiate online contributions just as they substantiate other contributions. Because the IRS has not thus far confirmed whether or not substantiation by e-mail or other electronic method will satisfy the acknowledgment requirements, charities and charitable fundraisers currently should not rely exclusively on e-mail substantiation.

The deductibility of charitable contributions made online may be jeopardized by the nature of how the web site is operated. There are many web sites maintained by web site operators, where members of the public can contribute to a charity of their choice from a selection. If the web site operator is an "agent" of the charity, then the contribution will be deductible. However, if the web site operator is not an "agent" of the charity, but rather a third party, the contribution would be considered taxable income to the third party and nondeductible to the individual. Both donors and charities should carefully review and analyze the terms of the agreement between a third party web site operator and the charity to make certain the desired intentions are realized.

Online charity auctions give rise to deduction issues for donors and possible unrelated business income tax ("UBIT") to the charities. Typically a donor that donates an item to a charity to be auctioned can claim a deduction for the lesser of the item’s basis or its fair market value, and the purchaser can claim a deduction for the excess of the purchase price over the items fair market value. Online auctions, however, are often structured so that it is the donor that is auctioning the item, not the charity. In this case, the donor recognizes a gain on the sale and can only deduct the amount given to the charity and the purchaser is unable to claim a charitable contribution deduction. Charities need to determine who will run the auction, whether or not it will take place on a regular basis, and if the donated items fall under the exemption from UBIT.

The mass of legal and tax issues increases as the use of the Internet expands. The IRS and Treasury have publicized their intent to address many issues. In the meantime, organizations using the Internet need to be aware of the legal and tax issues that face them, as well as the developing authorities ruling on them.

Lane Victory works with the healthcare group at Arthur Andersen, LLP in Atlanta.