The Inside View: Summer 2009

ACHE of North Texas

THE INSIDE VIEW

Summer 2009 A Publication of the ACHE of North Texas Chapter

MAGAZINE

On The Cover J. Eric Evans Chief Operating Officer Lake Pointe Medical Center

$2.3 Billion Recovery Funds

Immunization Immunization Grant Program Section 317 Program

Biden Announces To Help Children Prevent Disease

Biomedical Researchers

Medications

Invited to Design Experiments For The International Space Station

Are You Taking Too Many Medications

Traumatic Brain Injuries Linked to Long‐Term Issues For Iraqi Veterans

Mental Health How Does It Affect You What You Can Do To Help

Knowledge . Leadership . Marketability . Relationships.

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Summer ‘09 Issue

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contents & special features northtexas.ache.org Summer 2009

The Inside View Photo Cover J. Eric Evans Chief Operating Officer Lake Pointe Medical Center

Special President Message 4

$2.3 Billion Recovery Funds

Janet D. Henderson, MHA, FACHE President, ACHE of North Texas Chapter

Biden Announces Help Children Prevent Disease

Special Regent Message 6

Is The Primary Federal Program Specifically Devoted To Child Care Services and Quality

Britt R. Berrett, FACHE President & CEO, Medical City Dallas Hospital

Immunization

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Immunization Grant Program Section 317 Program

Medications

Child Care and Development Fund

Biomedical Researchers

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Are You Taking Too Many Medications

Linked To Long‐Term Issues For Iraqi Veterans

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How Does It Affect You What Can You Do To Help

Entertainment

Traumatic Brain Injuries 10

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Invited To Design Experiments For The International Space Station

Mental Health

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Charity Among Areas Hit As Economy Forces Americans To Cut Back

2009 Event Calendar

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Upcoming events © 2009 All Rights Reserved

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Summer ‘09 Issue

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Need An Organization Join Us At ACHE of North Texas Knowledge . Leadership . Marketability . Relationships

The American College of Healthcare Executives is an international professional society of more than 30,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organiza‐ tions.

ACHE is known for its prestigious credentialing and educational programs and its annual Congress on Healthcare Leadership, which draws more than 4,000 participants each year.

ACHE is also known for its journals, the Journal of Healthcare Management and Frontiers of Health Services Management and its maga‐ zine, Healthcare Executive, as well as ground‐breaking research and career development and public policy pro‐ grams.

ACHE's publishing division, Health Administration Press, is one of the largest publishers of books and jour‐ nals on all aspects of health services management in addition to textbooks for use in college and university courses.

Through such efforts, ACHE works toward its goal of being the premier professional society for healthcare leaders by providing exceptional value to its members.

Contact our Membership Committee Co‐Chairs for more information:

Ron Coulter, FACHE Texas Health Harris Methodist Hospital‐Cleburne roncoulter@texashealth.org

Bethany Williams Perot Systems bethany.williams@ps.net

ACHE of North Texas 3001 Skyway Circle, Suite 100 . Irving, Texas 75038 p: 972.256.2291 . f: 972.570.8037 . info@northtexas.ache.org northtexas.ache.org

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Summer ‘09 Issue

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The Importance of Conferencing Knowledge A Message From The President of the ACHE of North Texas Chapter

Janet D. Henderson, MHA, FACHE

“As healthcare leaders and profession‐ als, we are charged with making sure that those in need have access to quality care. It is our responsibility to make sure that the members of our communities do not fall through the cracks.” Janet D. Henderson, MHA, FACHE

A few weeks ago, I was watching a story on “60 Minutes”. The televised news maga‐ zine had done a story on the closing of hospitals and/or clinical service departments as a result of the current recession.

The focus of the story was a medical center in Nevada that had recently closed its outpatient oncology unit leaving its cancer patients without access to care. The pa‐ tients had been notified by letter that the oncology unit was closing and that they would no longer receive services in that unit. Those most affected were the “working poor” and the unemployed. Despite having life‐threatening illnesses that required ongoing chemotherapy, they were denied care due to the hospital’s inability to keep the unit open. The very limited incomes and lack of insurance (in some cases) prevented them from accessing care at other hospitals and/or clinics.

According to the National Coalition on Health Care, there has not been any improvement in access to care, despite the fact that the U.S. spent $2.4 trillion in 2007 (16% of Gross National Product). The health care system in the U.S. continues to struggle with inefficiencies in excessive spending, in‐ flated pricing, poor management, and inappropriate care. (Reference: info@nchc.org/facts/coverage.shtml).

Although President Obama is pushing to expedite health care reform, it will not come overnight and we will continue to hear stories similar to the Nevada story.

As healthcare leaders, it is our responsibility to assure that our communities have access to care (Research shows that prevention, early intervention, and increased access to care can dramatically improve the health of individuals) as well as quality care. As leaders in the healthcare community, it is our responsibility to stay abreast of changes in health care policy at the local, state, and national levels and lead the drive to make access to care a national priority!

Janet D. Henderson, MHA, FACHE 2009 President, ACHE of North Texas Director of COPC, Parkland Health and Hospital System

If you have comments for President Janet Henderson, send them to info@northtexas.ache.org.

THE VALUE OF SPONSORSHIP

ACHE of North Texas thanks the following Corporate Sponsors for assisting the organization’s mission. By sponsoring various events throughout the year, these sponsors are provided local and national exposure with an opportunity to showcase their organization, brand, career opportunities, prod‐ ucts and services to the ACHE membership and its affiliates.

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Summer ‘09 Issue

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The Inside View Editor‐In‐Chief

Managing Director

Contributing Editors

ACHE NOTES PUBLISHING

Publishers

Production/Creative Director

Director of Editorial Research

Advertising

Subscriptions

Address All Questions and Comments To: Editorial Office c/o The Inside View ACHE of North Texas 3001 Skyway Circle, Suite 100 Irving, Texas 75038 p: 972.256.2291 f: 972.570.8037 e: info@northtexas.ache.org w: northtexas.ache.org

Janet D. Henderson, MHA, FACHE Michael Ojeda, FACHE J. Eric Evans John G. Self Brad Simmons, FACHE Gail Maxwell, FACHE Britt R. Berrett, FACHE Ron Coulter, MHSM, FACHE Beverly Dawson, RN Forney Fleming Jonni Johnson, CPSM Sandy Lutz Elizabeth McGrady, FACHE Caleb F. O’Rear, FACHE George L. Pearson, JD, FACHE Scott Schmidly, FACHE Rick L. Stevens Jania Villarroel Demetria Wilhite Bethany Williams

ACHE of North Texas info@northtexas.ache.org ACHE of North Texas Janet D. Henderson, MHA, FACHE info@northtexas.ache.org info@northtexas.ache.org

2009 Chapter Officers President Janet D. Henderson, MHA, FACHE Parkland Health & Hospital System jhende@parknet.pmh.org

President‐Elect J. Eric Evans Chair, Education Committee Lake Point Medical Center Eric.evans@tenethealth.com

Immediate Past‐President John G. Self JohnMarch Partners, Inc. jgself@johnmarch.com

Secretary Brad Simmons, FACHE Parkland Health & Hospital System bwsimm@parknet.pmh.org

Treasurer Gail Maxwell, FACHE Baylor Health Care System gailm@baylorhealth.edu

2009 Board Members‐at‐Large Britt R. Berrett, FACHE, Ex‐Officio Medical City Dallas Hospital Medical City Dallas Children’s Hospital britt.berrett@lonestarhealth.com

Ron Coulter, MHSM, FACHE Co‐Chair, Membership Committee Texas Health Harris Methodist Hospital‐Cleburne roncoulter@texashealth.org

Beverly Dawson, RN Chair, Networking Committee Elder Care LP bdawson@eldercarelp.com

Forney Fleming, Ex‐Officio Co‐Chair, Advancement Committee The University of Texas at Dallas fwfleming@gmail.com

Jonni Johnson, CPSM Co‐Chair, Sponsorship Committee RTKL Associates Inc. jwjohnson@rtkl.com

Sandy Lutz PricewaterhouseCoopers Health Research Institute sandy.lutz@us.pwc.com

Elizabeth McGrady, FACHE Chair, Advancement Committee University of Dallas elizabethmcgrady@sbcglobal.net

Michael Ojeda, MHA, FACHE Co‐Chair, Communications Committee VA North Texas Health Care System Michael.ojeda@va.gov

Caleb F. O’Rear, FACHE Co‐Chair, Sponsorship Committee Denton Regional Medical Center caleb.orear@hcahealthcare.com

George L. Pearson, JD, FACHE Co‐Chair, Education Committee Co‐Chair, Networking Committee Texas Health Resources georgepearson@texashealth.org

Scott Schmidly, FACHE Co‐Chair, Mentorship Committee Medical City Dallas Hospital Medical City Dallas Children’s Hospital scott.schmidly@hcahealthcare.com

Rick L. Stevens Chair, Mentorship Committee JPS Health Network rsteve01@jpshealth.org

Jania Villarroel Co‐Chair, Communications Committee Metropolitan Anesthesia Consultants, LLP jvillarroel@metroanesthesia.com

Demetria Wilhite, Ex‐Officio Co‐Chair, Advancement Committee The University of Texas at Arlington demetria@uta.edu.

Bethany Williams Co‐Chair, Membership Committee Perot Systems bethany.williams@ps.net

The ACHE of North Texas e‐magazine, The Inside View, is published quarterly (Spring, Summer, Fall and Winter) and includes information on the latest regulatory and legislative developments, as well as the quality‐improvement and leadership trends that are shaping and influencing the hospital and health system field. Readers get in‐depth reporting on the issues and challenges facing hospital and health system leaders today. We make it our job to tell about the great things the organization and Chapter are doing every day to ensure the health of our community.

If you have any news and updates that you want to share with other members, please e‐mail your items to info@northtexas.ache.org. Microsoft Word or compatible format is preferable. If you have a graphic or picture that you’d like to include, please send it as a separate file.

The following are the types of information that our members shared in our past ACHE of North Texas magazine: Advocacy Issues, Legislative Issues, Educational Opportunities, Awards / Achievements, Promotions (Members On the Move), Committee Updates, Journal submissions, conference submissions, and workshop participations, Sharing mentoring experiences, etc.

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A Message From The Greater DFW Regent “Attaining the tools, guidance and support you need to gain an edge in the field of health care.”

Regents Advisory Council

Ronald E. Coulter, FACHE Texas Health Harris Methodist Hospital‐Cleburne

Harvey L. Fishero, FACHE Medical Center of Plano

Brett S. McClung, FACHE Texas Health Harris Methodist Hospital Southwest FW

Troy D. Thibodeaux, FACHE East Texas Medical Center

Elmer G. Ellis, FACHE East Texas Medical Center Regional Healthcare System

Michael A. Lieb, FACHE Wadley Health System

John G. Self JohnMarch Partners, Inc.

Paula M. Zalucki, FACHE Salus Strategy Group, LLC

James C. Edmonson, RN, FACHE Medical City Dallas Hospital

During a recent hallway conversation at the 2009 ACHE Congress in Chicago, I had the opportunity to share some experiences with a colleague on the activities occurring in our region. With pride, I highlighted the tremendous collaboration and respect that is demonstrated. Further, I reflected on our ability to not only support and sustain numerous collaborative efforts but to do so in a highly competitive and dynamic environment. Where other re‐ gions are conflicted with an inability to coordinate services, share best practices, and enhance the overall care to the community served, in our region we celebrate one another’s successes and reach out to provide sup‐ port. Whether it is the hospital or industry council, or our ACHE boards, our region is famous for pulling together.

To be sure, competition is fierce from both within and without. One need only look at the proliferation of competitive health care services Britt R. Berrett, FACHE to recognize that we are all actively engaged. And this competition also President and CEO comes from outside our industry as our region has become the petri Medical City Dallas Hospital Medical City Dallas Children’s Hospital dish of every entrepreneurial idea and initiative. Perhaps health care executives are naturally competitive and welcome the chance to ex‐ plore new ideas and challenge conventional thinking. However, in our region this competition has been done with respect.

As I share with many aspiring health care professionals, today I may be competing with you and tomorrow I may be working for you. The American College of Healthcare Executives provides a forum to collaborate and coordinate. It is the professional organization that holds us to a higher standard that requires us to renew our commitment to improve the lives of those we serve in our community. . . both individually and collectively.

Thank you for being the kind of professionals that have earned national recognition for collaboration and coordination.

About Britt R. Berrett, FACHE Britt Berrett has served as president and chief executive officer of Medical City since April 2000. He oversees strategic planning and operations for both Medical City and Medical City Children’s Hospitals, guiding the hospital in its mission to be a dynamic learning healthcare organization that sets the standard of excellence for its employees, patients, physicians and commu‐ nity. While on a two‐year mission in Peru, Berrett developed a great appreciation for the role that healthcare providers can play in improving the quality of life for an entire community. It is his concern for the quality of life in the community that makes him a passionate advocate for excellence in healthcare and a perfect fit for Medical City. Prior to joining Medical City, Berrett served as chief executive officer of Sharp Chula Vista Medical Center, a 306‐bed facility located in San Diego and Daniel Freeman Memorial Hospital in Los Angeles, California. He received his bachelor's degree in finance from Brigham Young University and his master's degree in hospital administration from Washington University School of Medicine in St. Louis.

ACHE of North Texas Learn how today’s leaders are ensuring tomorrow’s solutions >> northtexas.ache.org

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Summer ‘09 Issue

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>> Local and National Political and Social Issues Affecting You

Immunization Grant Program Section 317 Program Source: U. S. Department of Health and Human Services

Immunization Grant Program

The Section 317 program provides funding for immunization operations and infrastructure necessary to implement a comprehensive immunization program at the federal, state, and local levels.

Of the $300 million in Recovery Act funds allo‐ cated to the Section 317 program, $250 million will help existing Section 317 grantees acquire and make recommended vaccines available by using $200 million of these funds for CDC‐ purchased vaccines that will be made available to states and territories.

The remaining $50 million will be used to pro‐ vide program operation grants and scientific and technical support to states and territories to deliver the vaccines and strengthen vaccina‐ tion programs.

Vaccines and Recovery Act resources will also be made available to the urban Section 317 programs in Chicago, Houston, New York City, Philadelphia and San Antonio.

An additional approximately $18 million in grants will be used to provide support to Sec‐ tion 317 grantees that demonstrate innovative approaches to increase the number of Ameri‐ cans who receive the childhood vaccine series, zoster vaccine, and influenza vaccine, and for improving reimbursement practices.

A portion of vaccine purchase may be used to

support innovative initiatives for expanding access to vaccines in schools and communities.

Applications to apply for these grants will be made available on grants.gov.

Nearly $32 million in Recovery Act funds will be used to increase information, communication and education and strengthen the evidence base for immunization. This will include activi‐ ties to increase national public awareness and knowledge about the benefits and risks of vaccines and vaccine‐preventable diseases.

Funds will also help provide tools and educa‐ tion for health care providers and to monitor and assess the impact and safety of licensed vaccines routinely recommended for use in the United States to ensure that national vaccine policy is appropriate and effective.

For more information on Section 317 as well as information on vaccine‐preventable diseases, go to http://www.cdc.gov/vaccines/

ACHE OF NORTH TEXAS COMMITTEES Communications Committee: Oversees and maintains communications among chapter members through web services, publications, electronic mail, and other delivery mechanisms to ensure effective and timely communication among the chapter members.

Educational Programming Committee: Develops, plans, and coordinates educational programs related to current and pertinent issues facing the healthcare industry. At least two ACHE cate‐ gory II educational programs shall be provided to members each calendar year. This committee will plan category I programming, using the panel dis‐ cussion format and onsite programming options. This committee will also explore establishing regional Program Councils to deliver educational pro‐ grams within the chapter’s geographic territory.

Member Services Committee: Coordinates recruitment and retention activities through the chapter’s Ambassador program.

Develops member recognition programs, promotes ACHE amongst area graduate programs, and provides career services for current and potential chapter members.

Advancement Committee: Encourages chapter affiliates to prepare for advancement to Fellow. Conducts exam preparation courses, organizes study groups as needed. Encourages existing Fellows to re‐credential.

Mentoring Committee: Oversees and coordinates the healthcare executive mentorship program, and produce an Early Careerist seminar.

Networking Committee: The Networking offers members opportunities to network with their peers. Networking opportu‐ nities include but are not limited to: 1) Bi‐monthly executive leadership breakfast meetings; and 2) Bi‐monthly social/networking events. The breakfast meetings and social events are hosted by senior executives of local healthcare facilities or health related organizations.

Sponsorship Committee: The Sponsorship Committee solicits sponsorships to support chapter events and ACHE Congress scholarships.

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>> Local and National Political and Social Issues Affecting You

ARE YOU TAKING TOO MANY MEDICATIONS?

By Allison Van Dusen, Columnist

The next time you take a peek in your friend's or neighbor's medicine cabinet, don't be surprised if it's a little crowded.

Statistics are showing that more and more Americans are taking prescription drugs, and in increasing quanti‐ ties. It's estimated, for instance, that from 1994 to 2005 the number of prescriptions purchased increased 71% (from 2.1 billion to 3.6 billion) compared with a 9% growth in the U.S. population, according to the Henry J. Kaiser Family Foundation, a nonprofit that analyzes health care issues. During roughly the same period, the average number of retail prescriptions per capita in‐ creased from 7.9 to 12.4.

Now, new research by the pharmacy benefit manager Medco Health Solutions is showing for the first time that a majority of insured Americans, 51%, took prescription drugs to treat at least one chronic health problem last year, and one‐fifth of the population used three or more chronic drug treatments. But are all of those prescriptions necessary? It's a question, experts say, that more Americans should be asking.

Prescription Nation While the Medco data shows, unsurprisingly, that seniors have the highest prevalence of chronic medication use, younger generations are catching up.

Nearly half of women ages 20‐44 are being treated for chronic conditions, in addition to one‐third of men their age. Top treatments used by the gen‐ eral public include medications for high cholesterol and high blood pressure, with use of cholesterol drugs by 20‐ to 44‐year‐old men increasing by more than 80% over the past seven years. And nearly 30% of children ages 19 and under take a chronic medication.

Continued on page 9

Building the Future

Help support the ACHE mission to advance our members and healthcare management excellence. Gain year‐round access to leaders in the industry and support ACHE, its members, and its mission by becoming a sponsor today. >> Learn more about ACHE of North Texas Sponsorships.

http://northtexas.ache.org

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>> Local and National Political and Social Issues Affecting You

ARE YOU TAKING TOO MANY MEDICATIONS?

By Allison Van Dusen, Columnist Continued from page 8

Prescription Nation While the Medco data shows, unsurprisingly, that seniors have the highest prevalence of chronic medication use, younger generations are catching up. Nearly half of women ages 20‐44 are being treated for chronic conditions, in addition to one‐third of men their age. Top treatments used by the general public include medications for high cholesterol and high blood pressure, with use of cholesterol drugs by 20 ‐ to 44‐year‐old men increasing by more than 80% over the past seven years. And nearly 30% of children ages 19 and under take a chronic medication.

The reasons why so many Americans are popping pills varies almost as widely as the types of people taking them. Americans have had an in‐ crease in the incidence of obesity, which can lead to all kinds of health problems," says Dr. Lon Castle, senior director of the department of medical and analytical affairs for Medco. "They also have a penchant for going for the quick fix. They want medications to treat their problems rather than trying diet and exercise or lifestyle changes, which might also be effective."

Direct‐to‐consumer advertising of prescription drugs, especially on TV (a legal practice for about a decade now), has convinced many Americans that they need medications to lead better lives. A 2007 UCLA study pub‐ lished in the Annals of Family Medicine, which analyzed how 38 direct‐to‐ consumer TV ads for prescription drugs attempted to influence viewers, found that 85% of the ads portrayed taking medication as a way for peo‐ ple to regain control of their lives.

And in addition to an increase in the number of drugs available to treat chronic diseases in general, recommendations from the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure in 2003 and the U.S. National Institutes of Health's Na‐ tional Cholesterol Education Program in 2001, have resulted in Americans being treated more aggressively‐‐often with multiple medications‐‐for high cholesterol and blood‐pressure levels.

Too many doctors also accept gifts from the drug industry, which can influence their decision to prescribe certain drugs, says Melody Petersen, author of the new book, Our Daily Meds. In fact, the drug industry spends nearly $19 billion per year on marketing to doctors, including free meals, drug samples, gifts and sponsorship of education programs, according to a 2006 article in the Journal of the American Medical Association.

"Doctors will tell you it isn't a problem, but studies show that even the smallest gifts can get a doctor to prescribe a drug," Petersen says. "The doctor wants to reciprocate. It's normal. If you get a gift or I get a gift, we like that person."

Taking Stock With patients heading to the doctor's office looking for a certain prescrip‐ tion and doctors under pressure to keep visits 10 to 12 minutes long in

order to see as many patients as possible, it's no wonder that so many encounters result in pharmacy runs. About 71% of all patients' walk‐in visits to doctors' offices involved drug therapy, according to the 2005 National Ambulatory Medical Care Survey, a report compiled by the Centers for Disease Control and Prevention. But while there's no ques‐ tion that some prescription drugs save lives and prevent people from developing diseases, experts say some Americans would benefit from taking stock of their medications.

"We're taking drugs we really need and we don't, but the body doesn't know the difference when it comes to side effects," says Dr. Mark H. Beers, professor of medicine at the University of Miami School of Medi‐ cine and editor‐in‐chief emeritus of Merck Manuals.

Beers points out that adherence rates tend to fall when people take multiple medications, with a dramatic fall‐off at the three‐medication mark, and that's not to mention the cost of keeping your medicine cabi‐ net full. Patients also run the risk of getting sick from any one of the drugs they're taking, drug interactions as well as a drug‐and‐disease interaction. Even taking an over‐the‐counter cold medication, for in‐ stance, can raise your blood pressure or worsen some types of glaucoma.

Have you adjusted the amount of prescription drugs you take? Weigh in. Add your thoughts in the Reader Com‐ ments section below.

Dr. Allan Sosin, an Irvine, Calif.‐based board‐certified internist and foun‐ der of the Institute for Progressive Medicine, says he's seen patients on six, seven and even 15 drugs at a time who don't realize some of their symptoms may be due to interactions. While he prescribes medications, he also spends time counseling patients on how lifestyle changes might eliminate a prescription or two.

The method is working for John Alexander, a 62‐year‐old retired teacher who turned to Sosin in January. Over the past two years, Alexander had been through six doctors, who put him on a variety of blood‐pressure medications that frequently made him feel worse and caused him to add 50 pounds to his already large frame. Sosin, Alexander says, was the first doctor to explain how shedding the pounds could improve his health.

Within months Alexander was losing weight and bringing down his blood pressure‐‐on his own.

Handling Your Health To get a handle on your prescriptions, Beers suggests sitting down with a health care provider, whether it's your doctor, a nurse or pharmacist, laying out all of the medications you're taking and asking which ones you need and which ones you might not.

A review of all of your medications should always be part of your yearly exam. "It's a matter of taking ownership of your health care and working with physicians and pharmacists to make sure you get results," says Cyn‐ thia Reilly, director of clinical standards and quality for the American Society of Health‐System Pharmacists.

Patients also should think about the vibe they're giving off in the doctor's office. If you tell your doctor about a symptom you're experiencing and don't want a pill to treat it unless it's necessary, say so.

Keep in mind, also, that your goal in examining what's in your medicine cabinet isn't necessarily lowering the numbering of prescriptions you're taking.

"It should be," Beers says, "to make sure every medication [you're] on is necessary, the best drug for what you need and the best dose."

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>> Local and National Political and Social Issues Affecting You

Traumatic Brain Injuries Linked To Long‐Term Issues For Iraqi Veterans Source: U. S. National Academies of Science

Photo By Unknown

Iraqi War Veterans and Family Members At The Mall In Washington, DC

A new report provides evidence linking trau‐ matic brain injury sustained by troops in com‐ bat in Iraq and Afghanistan to a variety of long‐ term health problems including dementia, aggression, depression and symptoms similar to those seen in Parkinson's disease.

But the Institute of Medicine committee charged with developing the report also pointed to a troubling lack of scientific data on such injuries, which are fairly recent in the history of warfare.

"The real bottom line significant finding is that there's not a good human literature on the kinds of neurotrauma seen in Iraq and Afghani‐ stan caused by blasts," said Dr. George W. Rutherford, vice chair of the department of epidemiology and biostatistics at the University of California, San Francisco, School of Medi‐ cine.

"The human literature is really about people who've had [brain injury] from car crashes or falling down stairs and, in the military, from shrapnel or gunshots. We're all worried that blast neurotrauma hasn't really made it into the human literature."

This makes it difficult, if not impossible, to anticipate and hopefully mitigate the long‐term consequences of such injuries, added Ruther‐ ford, who chaired the committee that wrote the report.

"They focused on blast‐induced neurotrauma, a blast injury that leaves the head without any external marks of even being knocked about," explained Keith Young, vice chair for research

at Texas A&M Health Science Center College of Medicine and Neuroimaging and Genetics Core Leader for the VA Center of Excellence for Research on Returning War Veterans. "The blast is so close and so large, it seems to be shaking the brain. My guess is that this causes micro‐bleeds," Young said.

The current U.S. conflicts in Afghanistan and Iraq, which have been ongoing since Oct. 7, 2001 and March 2003, respectively, differ vastly from previous combat deployments in terms of injuries sustained. They differ even from injuries seen in the 1991 war, with more deaths, multiple traumas and more traumatic brain injuries (TBI).

Blast injuries are considered the "signature" wound of the Iraq war and are largely a result of newer, more powerful explosive devices.

"One cause of the high rates of TBI is relatively simple: survival," Young said. "The reason more people are surviving is better on‐the‐scene treatment and medivacing to facilities within minutes rather than hours."

According to the Department of Defense (DOD), more than 5,500 soldiers had suffered TBIs as of January 2008, accounting for about 22 percent of all casualties, as compared with only 12 percent to 14 percent of all combat casualties during the Vietnam War.

In an effort to detail the long‐term conse‐ quences of TBI, the committee looked at al‐ most 2,000 studies on the subject.

The committee found evidence of a causal

relationship between penetrating TBI and unprovoked seizures as well as death, and between severe or moderate TBI with unpro‐ voked seizures.

There was "sufficient" evidence of an associa‐ tion between TBI and decline in neurocognitive function, long‐term unemployment and prob‐ lems with social relationships; Alzheimer's‐like dementia, endocrine dysfunction, depression, aggressive behavior, memory problems and early death.

There was "limited/suggestive" evidence of an association between moderate or severe TBI and diabetes or psychosis; and between mild TBI and visual problems, dementia, post‐ traumatic stress disorder and suicide.

"Inadequate/insufficient" evidence existed on the relationship between moderate or severe TBI and brain tumors; mild TBI and employ‐ ment and social functioning problems, bipolar disorder or attempted suicide; TBI and multiple sclerosis or amyotrophic lateral sclerosis (Lou Gehrig's disease).

The committee put forth a number of recom‐ mendations.

"Three of the recommendations are really directed towards the DOD and the VA about how to keep track of this stuff so people in the future can put registries together," Rutherford said. "Once you know that, you can start an‐ swering questions, are five of these five times as bad as one, what's the long‐term risk of any bad outcome."

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>> Local and National Political and Social Issues Affecting You

Biden Announces $2.3 Billion In Recovery Funds To Help For Children, Prevent Disease Source: U. S. National Academies of Science

“Child Care and Vaccination Programs to Benefit from Recovery Act”

Vice President Joe Biden announced the Obama Administration will make $2.3 billion available for crucial health and human services programs that help to provide care for children and prevent disease. States will receive $2 billion in Recovery Act funding to support child care for working fami‐ lies. The administration also plans to make $300 million in vaccines and grants available to ensure more underserved Americans receive the vaccines they need.

The $2 billion in Recovery Act funds for the Child Care and Development Fund will allow states across the country to support child care services for more families whose children require care while they are working, seeking employment or receiving job training or education. The funds will be used by states to provide vouchers to families for child care or to provide access to care through contracts with child care centers or invest in quality improvements. Recovery Act dollars will support a wide range of child care providers, including child care centers and home‐based programs.

“Parents are worried about finding a job or keeping the job they have

and they shouldn’t have to worry about affording quality child care,” said Vice President Biden. “Safe, affordable, high‐quality child care gives working parents the peace of mind they need to be stable, dependable employees.”

In addition to funding for child care programs, an additional $300 million in Recovery Act funding and grants will help to ensure more underserved Americans receive the vaccines they need. The Vice President’s an‐ nouncement came as Americans mark National Public Health Week.

Funded by the American Recovery and Reinvestment Act, the majority of these new resources will be used to purchase vaccines, which will be distributed through the HHS’ Centers for Disease Control and Preven‐ tion’s (CDC) Section 317 immunization program to all 50 states, several large cities, and U.S. territories. Funding will also be used to support national public information campaigns regarding vaccines and support grants to states that demonstrate innovative new ways to ensure more Americans receive the vaccines they need.

“Vaccines help keep children healthy, prevent costly stays in hospitals, and fight diseases that can lead to serious illness or death” added Biden.

“The Recovery Act will help to vaccinate more Americans, cut health care costs, improve public health and save lives.”

More information regarding the child care and vaccine programs is in‐ cluded below.

To see a list of state by state funding for child care programs, visit http:// transparency.cit.nih.gov/RecoveryGrants/grant.cfm?grant=childcare.

To see a list of state by state funding for vaccine programs, visit http:// transparency.cit.nih.gov/RecoveryGrants/grant.cfm?grant=vaccines.

Child Care and Development Fund Source: U.S. Department of Health and Human Services Child Care and Development Fund: The Child Care and Development Fund (CCDF) is the primary federal program specifically devoted to child care services and quality. It enables low‐income parents and parents receiving Temporary Assistance for Needy Families (TANF) to work or to participate in the educational or training programs they need in order to work. Funds may also be used to serve children in protective services. In addition, a portion of CCDF funds must be used to enhance child care quality and availability.

The $2 billion in Recovery Act funds for the Child Care and Development Fund will allow states across the country to support child care services for more families whose children require care while they are working, seeking employment or receiving job training or education. The funds will be used by states to provide vouchers to families for child care or to provide access to care through contracts with child care centers. Recovery Act dollars will support a wide range of child care providers, including child care centers and home‐based programs.

A portion of the funds will be used to improve overall quality and enhance infant and toddler care. For example, states may train child care providers, assist providers in meeting health and safety requirements, hire specialists specifically trained to work with infant and toddler providers, provide grants to providers to achieve higher quality and invest in other initiatives.

The new funds supplement the existing $5 billion child care subsidy program, the Child Care and Development Fund (CCDF). The Recovery Act funds will be awarded on a formula basis to states, the District of Columbia, five territories and 260 tribal grantees representing approximately 500 Indian tribes.

For more information on the Child Care and Development Fund, visit http://www.acf.hhs.gov/programs/ccb/ccdf/factsheet.htm.

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EXCERPT FROM THE NORTH TEXAS CHAPTER BYLAWS The ACHE of North Texas Board of Directors is chaired by the President and will consist of officers of the organization, eight to twelve members and designated ex‐officio members. The ex‐officio positions may be voting or non‐voting. In addition, any Regent of ACHE who is a member of the chapter and the Program Directors shall be ex‐officio, voting member of the Chapter Board.

The voting members of the Board of Directors must be Active members of the Chapter and have a current and active status in ACHE. Preference shall be given to those having Active Chapter membership for a mini‐ mum of two years. A regular term of a Board member is one year with a maximum of five consecutive years. Board Members must serve on at least one additional committee of ACHE of North Texas.

Nominees for membership on the Board of Directors shall be submitted to the Nominating Committee to the Board of Directors. Upon the rec‐ ommendation of the Nominating Committee, vacancies on the Board of Directors may be filled. Board members who are filling vacant positions shall be eligible to be nominated and elected to the immediately suc‐ ceeding full term. The Board of Directors and Officers are elected annu‐ ally at the last business meeting of the year. Elections consist of simple majority.

Anyone interested in submitting a nominee for consideration should do so by sending their resume and cover letter to the following weblink on the ACHE of North Texas Website under "Contact Us".

>> northtexas.ache.org

2008 Spring Issue: March / April / May Artwork / Materials Received Deadline: January 15, 2008 Issue Released: March 2008

2008 Summer Issue: June / July / August Artwork / Materials Received Deadline: April 15, 2008 Issue Released: June 2008

2008 Fall Issue: September / October / November Artwork / Materials Received Deadline: July 15, 2008 Issue Released: September 2008

2008 Winter Issue: December / January / February Artwork / Materials Received Deadline: October 15, 2008 Issue Released: December 2008

2009 Spring Issue: March / April / May Artwork / Materials Received Deadline: February 15, 2009 Issue Released: March 2009

2009 Summer Issue: June / July / August Artwork / Materials Received Deadline: April 15, 2009 Issue Released: June 2009

2009 Fall Issue: September / October / November Artwork / Materials Received Deadline: July 15, 2009 Issue Released: September 2009

2009 Winter Issue: December / January / February Artwork / Materials Received Deadline: October 15, 2009 Issue Released: December 2009

2008‐2009 Editorial Calendar

For advertising information or to reserve ad space, contact info@northtexas.ache.org

More information online at: northtexas.ache.org

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>> Local and National Political and Social Issues Affecting You

Biomedical Researchers Invited to Design Experiments For the International Space Station Source: U.S. Department of Health and Human Services ‐ National Institutes of Health News

Photo By NASA National Aeronautics and Space Administration

NASA Space Station

The National Institutes of Health and the National Air and Space Admini‐ stration are partnering to conduct biomedical experiments that astro‐ nauts could perform on the International Space Station.

In a notice to scientists at universities, medical centers, and companies across the United States, the NIH announced its willingness to fund highly meritorious biomedical experiments that could utilize the unique envi‐ ronment in space and produce breakthroughs to improve human health on Earth.

The International Space Station provides a special microgravity and radio‐ logical environment that Earth‐based laboratories cannot replicate. Con‐ gress, recognizing the immense promise the facility holds for American‐ led science and technology efforts, opened the U.S. portion of the Inter‐ national Space Station to other federal agencies and university and pri‐ vate sector researchers when it designated the U.S. resources as a Na‐ tional Laboratory in 2005.

The NIH solicitation is the next step in a new partnership to apply the National Laboratory to research that complements NASA’s space explora‐ tion efforts. "As the primary federal agency for conducting and support‐ ing medical research, the NIH looks forward to facilitating access to our nation’s life sciences laboratory in space," said Stephen I. Katz, M.D., Ph.D., director of the NIH’s National Institute of Arthritis and Muscu‐ loskeletal and Skin Diseases, and NIH liaison to NASA.

Already, biomedical experiments conducted on the International Space Station have addressed how bone and muscle deteriorate, how humans fight infectious disease, and how cancers grow and spread. "The ISS is an extraordinarily capable laboratory in a unique environment that has not previously been available for widespread medical research. NASA strongly supports the NIH’s leadership in this promising opportunity," said Mark Uhran, NASA’s assistant associate administrator for the Inter‐

national Space Station.

The NIH‐NASA program will encourage a new cadre of health researchers from a variety of disciplines to incorporate the space environment into their experiments, and will support them as they prepare their experi‐ ments for launch and analyze their data following a mission.

"The diversity of NIH institutes and centers that agreed to participate in the initiative underscores the promise the International Space Station holds for human health," Katz continued. "We encourage all biomedical researchers in the United States — particularly those who are interested in molecular or cellular biology, biomaterials, or telemedicine — to give serious thought to how International Space Station facilities might an‐ swer their most pressing questions about how to benefit life on Earth."

Former astronaut and Senator Harrison H. "Jack" Schmitt, who strongly supported the new partnership’s development when he was chairman of the NASA Advisory Council, applauded the initiative: "The NIH and NASA have a long history of collaboration, and this announcement builds on that foundation to leverage the American public’s investment in space‐ related health research and its implications for a much deeper under‐ standing of human physiology."

In addition to NIAMS, other sponsors of the announcement include the National Cancer Institute (NCI), the National Center for Research Re‐ sources (NCRR), the National Heart, Lung, and Blood Institute (NHLBI), the National Institute on Aging (NIA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute of Biomedical Imag‐ ing and Bioengineering (NIBIB), the National Institute of Child Health and Human Development (NICHD), and the National Institute of Neurological Disorders and Stroke (NINDS).

For more information on the NIH‐NASA partnership and the funding opportunity announcement, visit http://www.niams.nih.gov/ News_and_Events/NIH_NASA_Activities/default.asp. For more informa‐ tion on the National Laboratory at the International Space Station, visit: http://www.nasa.gov/mission_pages/station/science/nlab/.

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the Department of Health and Human Services' National Institutes of Health (NIH), is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.

For more information about NIAMS, call the information clearinghouse at 301‐495‐4484 or 877‐22‐NIAMS (free call) or visit the NIAMS Web site at http://www.niams.nih.gov.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases.

For more information about NIH and its programs, visit www.nih.gov.

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>> Local and National Political and Social Issues Affecting You

How Does Mental Health Affect Me? What You Can Do. What You Can Do To Help.

By Texas Department of Mental Health and Mental Retardation

One in four people will experience a mental health problem at some point in their lives – and they may well be one of your friends, colleagues or family members.

But do you know what to do or say? Mental health affects all of us – so we can all do something to help break down the stigma that surrounds it and help create a society where mental health problems are not hidden in shame and secrecy. Many people who experience mental health problems are unsure what to do or where to turn, and many are afraid to talk about their problems. Our Stigma Shout research showed that the overwhelming majority of people with mental health problems say the way in which family, friends, neighbors and colleagues behave around them can have a big impact on their lives. Make sure you are helping by following this advice:

What you can do: There are a lot of myths surrounding mental illness. And because of the myths it can feel like you don’t know enough to be able to help. But you don’t need to be an expert on mental health to be a friend. It’s often the everyday things that make a difference. Sometimes people feel uncomfortable with mental health problems and are frightened, as they don’t know what to do. But doing nothing, or avoiding the issue can make things worse. People with mental health problems can and do get back on their feet and lead fulfilling lives; this is even more likely with your help.

What you can do to help: Be there to talk and listen. It’s often hard to tell someone about a mental health problem because of fear of people’s reac‐ tions. So if someone talks to you, don’t brush it off, acknowledge their problem and let them know you’re there for them. Make time to stay in touch.

Call, visit or invite your friend round – carry on with whatever you normally do. Ask the person how you can help – people will want support at differ‐ ent times in different ways. Keep in mind that having a mental health problem is just one part of the person. People don’t want to be defined by their mental health problem. Think about the words you use. Words like nuttier, crazy and psycho can hurt.

Apply for Membership As an affiliate, you’ll join more than 30,000 healthcare leaders from across the country and around the world who are dedicated to improving healthcare delivery.

Choose the Membership Status that Best Suits You

APPLY FOR MEMBERSHIP TODAY!

Click on the links below to determine your eligibility or apply for membership. Note: Dues are prorated based on the month you join.

Member ‐ If you have a minimum of a bachelor's degree and a commitment to the profession of healthcare management, then you are in‐ vited to join ACHE as a member. There is no better resource to have at your fingertips than the premier organization for healthcare execu‐ tives. Annual dues are $150. If you prefer, you may be eligible for the following membership levels. Keep in mind that Faculty Associates, International Associates, and Student Associates are ineligible for Fellow status.

Faculty Associate ‐ If you maintain a full‐time position with an appointment in a graduate or undergraduate program in health services ad‐ ministration, you may be eligible for a discount on your dues. You will have access to cutting‐edge knowledge—knowledge that you can share with your students and colleagues—via ACHE's highly respected publications, ground‐breaking research, and online resources. Annual dues are $115.

International Associate ‐ If you live outside the U.S. and are not a member of the U.S. military, you may be eligible for a discount on your dues. Keep abreast of the latest trends in the healthcare field and acquire the tools you need to succeed. Annual dues are $150.

Student Associate ‐ If you are enrolled in a health services administration or related administrative program, you may be eligible for a dis‐ count on your dues. Find answers to your most pressing career questions—and gain a competitive edge—through ACHE's countless re‐ sources. Annual dues are $75.

Are you still unsure? Contact ACHE’s Customer Service Center at (312) 424‐9400 or contact@ache.org.

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>> Local and National Political and Social Issues Affecting You

Entertainment, Charity Among Areas Hit As Economy Forces Americans To Cut Back Source: Steve Yount, A. Larry Ross Communications Faith‐based Organizations May Fare Better Than Other Nonprofits

As the new year begins, Americans say they are putting the brakes on spending, including chari‐ table giving, according to a recent Wilson Re‐ search Strategies survey commissioned by Dunham+Company.

The greatest single impact of the economy on household budgets is the money being spent on entertainment ‐‐ 58 percent of respondents say they have reduced this kind of spending.

Forty percent of Americans say they have cut back or eliminated what they put into short‐ term savings accounts, and 33 percent said they had either reduced or stopped putting money into retirement accounts. Only 18 per‐ cent said their household budget had not de‐ creased. But what should be of concern to non‐ profit organizations is the impact of the econ‐ omy on charitable giving ‐‐ 43 percent of re‐ spondents said they had either reduced or stopped giving to charity.

“When you look at the data, it is clear that the failing economy has had a very real and direct impact on household budgets, and giving has not escaped that impact,” says Rick Dunham, President and CEO of Dunham+Company, which helps ministries with their fundraising, marketing and media strategies.

“There’s little doubt that most charities are in for a bit of a rough ride. However, for faith‐ based charities, I believe the picture is much

brighter. The data shows that 81 percent of those who attend religious services more than once a week intend to give the same or more to charity. This is the core donor demographic for religious charities. On average, only 67 percent of their secular counterparts indicated the same.”

The survey indicated that there will continue to be an underlying weakness to charitable giving in 2009, especially among middle class house‐ holds. Only 56 percent of Americans said they intended to give the same to charity in the coming year, with 14 percent indicating they intend to give more, and roughly one in four (27 percent) saying they intend to reduce giv‐ ing.

These findings are similar to those from a Sep‐ tember 2008 survey in which 58 percent of the respondents stated they intended to give the same to charity, 8 percent said they intended to increase their giving, and 26 percent said they intended to reduce their giving.

As mentioned earlier, of special concern in 2009 are middle‐class households. Forty‐one percent indicated they intend to reduce giving in 2009; only 27 percent of the upper class said they intended to do the same.

The breakdown of those who attend religious services more than once a week (about 27 million people) indicated they are much less likely to pull back on their giving in the coming year and do intend to keep giving. Of those surveyed, 60 percent said they intended to

Long‐Term Acute Care For Brain Injuries ‐ Resources For Vets Long‐term care brain injury rehabilitation facil‐ ity for vets with brain injuries approved a five‐ year pilot project to treat up to 25 wounded warriors and veterans with severe to moderate traumatic brain injury has been approved by the Federal government. The center is to be located in Johnstown, PA in the former Crich‐ ton Rehabilitation Center at the Hiram G. An‐ drews Center.

The center is designed to provide long term care to brain injured veterans. The center will provide high‐tech neurorehabilitation services and the latest medications, as well as nontradi‐ tional methods such as horseback riding, tai chi

and music therapy. Wounded veterans will come to Johnstown for extended care for up to a year after they have been discharged from an acute care unit.

Patients’ families will have the opportunity to stay in Johnstown or participate by teleconfer‐ ence and help with the rehabilitation. In addi‐ tion, there will be respite opportunities for family caregivers exhausted from dealing with a severely injured veteran.

Long term care in facilities with staff properly trained and equipped to provide brain injury rehabilitation services are greatl y

keep giving the same in 2009, 21 percent said they intended to give more, and only 17 per‐ cent said they intended to reduce their giving.

Regionally, the findings were consistent across the country, except with respondents living in the South, who demonstrated a slightly greater propensity to continue making charitable dona‐ tions.

“With the ongoing tremors in the economy and with households continuing to pull back on spending, charities are going to have to work that much harder to gain a share of household expenditures,” Dunham said. “While many people are indeed reducing what they spend, including their giving to charity, I believe the survey indicates the majority of Americans who do give, intend to continue giving, especially those who are active religiously. But I believe it is up to charities to make an even more effec‐ tive case for that support if they expect to weather this economic storm.”

This study was part of Wilson Research Strate‐ gies January Omnibus Study of 1,000 adults nationwide. All respondents were contacted via Random Digit Dialing methodology. Interviews were conducted via live telephone interviewer Jan. 16‐20, 2009. A sample of 1,000 has a mar‐ gin of error of +/‐3.1 percent at the 95 percent confidence level.

For more information on charitable giving during recessionary times, you can visit www.dunhamandcompany.com/economy.

needed. Those suffering from the effects of traumatic brain injury should not be forced to go into nursing homes where often little or no appropriate care is being provided.

Hopefully further centers will be approved throughout the country.

However, those considering and providing funding for future care options to those per‐ sons suffering from traumatic brain injury should understand that the final answer is not indefinite long term in patient care, but provid‐ ing sufficient resources so that these individu‐ als can return home and receive proper care and rehabilitation services within their own community. Unfortunately, all to often we have seen that individuals suffering with brain dam‐ age injuries are forced to spend their days in facilities because better home‐based alterna‐ tives simply do not exist.

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AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES

ADVANCEMENT PROCESS Strengthen Your Credentials

Go to http://www.ache.org/ABT_ACHE/regs_current.pdf for specific criteria and detail.

To Become A Member • Bachelor's or Post Baccalaureate degree and a commitment to the profession of health‐ care management

• • •

•

have five years of healthcare management experience

and at least two years of healthcare man‐ agement experience

Pay dues

•

Special categories include Student Associate, Faculty Associate and International Associ‐ ate

•

retain such status for three years, at which time said status may be renewed via the recertification process.

•

Eligibility To Sit For ACHE Exam • Master’s or other postbaccalaureate degree.

• Current healthcare management position

Submit forms

FACHE Recertification • An individual granted Fellow status may

•

To Become A Fellow • Pass the Board of Governors Examination • Be in a healthcare management position and

24 hours of continuing education since the last advancement or recertification, no less than half of which must be Category I credit.

Show evidence of participation in healthcare and community/civic affairs Submit application

• • •

Have three years tenure as an ACHE Mem‐ ber Earn 40 hours of continuing education—at least 12 of which are Category I (ACHE edu‐ cation) hours—during the five years before you become a Fellow. The remaining 28 hours can be Category I or Category II. Participate in two healthcare and two com‐ munity/civic activities during the three years before you become a Fellow.

Submit application Pay dues

• • • •

Three references from current Fellows Submit application Pay dues ACHE provides resources for the exam in‐ cluding Information Sessions, Reference Material, a Review Course, an Online Tuto‐ rial, an Online Exam Community, and an Exam Study Set. For more information go to ache.org

Note: Affiliates who were Diplomates as of December 31, 2006, have until January 1, 2010 to meet the Fellow requirements. After this date they will lose their Fellow designate status and must reapply to advance to Fellow status.

ACHE BOARD OF GOVERNORS EXAM

Advancement Seminar Presenters Paula Zalucki Dr. Michael Nowicki

Date Friday, June 5, 2009

Time 8 a.m. to 5 p.m.

Cost $50 ‐ includes breakfast and lunch

Location 8400 Data Point Drive Baptist Health System School of Professions San Antonio, Texas

See flyer and registration go here http://stc.ache.org/

Sign up for the ACHE advancement exam before June 30, and save the $200 exam registration fee. (Go to www.ache.org ) .

Below is extracted from www.ache.org:

ACHE will waive the $200 fee to take the Board of Governors Exam once your application [for advancement to Fellow] has been approved (the waiver is valid for six months). You must be an ACHE Member with at least two years of health‐ care management experience to be eligible to apply for Fellow status. All follow‐up materials (e.g. references) must be submitted by August 31 for the waiver to be valid.

NOTE: Per above ‐‐ you do not have to take the exam prior to June 30 ‐‐ or Aug 31! Contact ACHE for additional info.

See you there!

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2009 EVENT CALENDAR

>> May 5, 2009

>> May 20 and 21, 2009

>> September 17, 2009

"Current Economic Challenges" Presenters: DFW Hospital Council Time: 1:00 ‐ 3:00 p.m.

Cost: Free, Register by April 30 to attend.

Location: Las Colinas Country Club 4400 N O'Connor Blvd., Irving, TX 75062 For more information contact Gerri Wessling at info@northtexas.ache.org or 972.256.2291

Category I Education Session Presenters: ACHE of North Texas and the Fort Worth Local Program Council Co‐Champions: Tina Barker, Jonni Johnson, and Cynthia Nguyen Course Title: Physician Integration Approaches Category 1 credits: 1.5 hours

>> May 8, 2009

Category II Education Session Southwest Healthcare Transactions Conference Presenters: The Health Industry Council of the DFW Region and Renaissance American Management, Inc. Supporters: Dallas‐Fort Worth Hospital Council Location: Omni Mandalay Hotel Dallas 221 East Las Colinas Blvd., Las Colinas, TX 75039 Category II credits: 6.5 hours

ACHE Board Meeting Time: 7:30 AM Location: The Health Industry Council Conference Room 3001 Skyway Circle N., Ste. 100, Irving, TX 75038 For more information contact Gerri Wessling at info@northtexas.ache.org or 972.256.2291

Category I Education Session Presenters: ACHE of North Texas and the Fort Worth Local Program Council Co‐Champions: Mark Vaughan and Rebecca Tucker Course Title: Green Hospitals and Healthcare Category 1 credits: 1.5 hours

Category I Education Session Presenters: ACHE of North Texas and the Dallas Local Program Council Co‐Champions: Chakilla Robinson White and Mark Graban Course Title: Sustaining a Financially Vibrant Healthcare Organization Category 1 credits: 1.5 hours

>> May 13, 2009

>> July 9, 2009

>> November 13, 2009

Category I Educational Session Webinar Time: 11:00 AM to 12:30 PM Cost: $180 ACHE Affiliate and $200 Non‐Affiliate Category 1 credits: 1.5 hours Presenters: Join Rulon F. Stacey, PhD, FACHE; George E. Hayes, FACHE; and Kevin L. Unger Course Title: The PVHS Baldrige Journey: Achieving Performance Excellence ‐ The Malcolm Baldrige National Quality Award is one of the most prestig‐ ious awards given for performance excellence.

Poudre Valley Health System in Fort Collins, CO is the 2008 recipient and only the ninth hospital to receive this award. Hear how Poudre Valley achieved performance excellence, took steps to build a framework for success, and aligned the organization's culture with performance goals in quality, patient and employee satisfaction. These issues and more will be addressed during the webinar.

Registration: ache.org/webinars.

Sponsor: ACHE National

ACHE Executive Book Briefing Registration: 6:45 AM Breakfast Buffet: 7:00 AM Book Synopsis: 7:30 AM ‐ 8:05 AM Location: The Park City Club 5956 Sherry Lane, Suite 1700, Dallas, TX 75225 Cost: $25 Members $20 Students $30 Nonmem‐ bers

ACHE Board Meeting Time: 7:30 AM Location: The Health Industry Council Conference Room 3001 Skyway Circle North, Suite 100 Irving, TX 75038

>> May 15, 2009 ACHE Breakfast with the CEO Topic: "Key Nursing Issues at Arlington" Host: Dean Elizabeth Poster, PhD, RN, FAAN The University of Texas at Arlington Smart Hospital & Health System Revolutioning Healthcare Education & Training Time: 7:30 AM to 9:00 AM Location: The University of Texas at Arlington 706 W. Greek Row Dr., Arlington, TX 76019‐0400 Cost: Free Registration Deadline: Tuesday, May 12, 2009 Gerri Wessling at info@northtexas.ache.org or 972.256.2291 Parking: Trinity Lot "T". Tell the guard you are with ACHE.

>> May 19, 2009 ACHE Executive Book Briefing Featured Book: Good to Great: Why Some Compa‐ nies Make the Leap...and Other's Don't by Jim Collins Presenter: Randy Mayeux Time: Registration: 6:45 AM Breakfast Buffet: 7:00 AM Book Synopsis: 7:30 AM ‐ 8:05 AM Location: The Park City Club 5956 Sherry Lane, Suite 1700, Dallas, TX 75225 Cost: $25 Members $20 Students $30 Nonmem‐ bers Registration Deadline: Friday, May 15, 2009

>> June 18, 2009

>> October 15, 2009

>> November 17, 2009

ACHE Board Meeting Time: 7:30 AM Location: The Health Industry Council Conference Room 3001 Skyway Circle North, Ste. 100 Irving, TX 75038

ACHE Executive Book Briefing Time: Registration: 6:45 AM Breakfast Buffet: 7:00 AM Book Synopsis: 7:30 AM ‐ 8:05 AM Location: The Park City Club 5956 Sherry Lane, Suite 1700, Dallas, TX 75225 Cost: $25 Members $20 Students $30 Nonmem‐ bers

>> July 16, 2009

>> November 19, 2009

Category I Education Session Presenters: ACHE of North Texas and the Fort Worth Local Program Council Co‐Champions: Jeff Patterson and Eric Boon Course Title: Managing Your Clinical Supply Chain Category 1 credits: 1.5 hours

Category 1 Education Session Presenters: ACHE of North Texas and the Fort Worth Local Program Council Co‐Champions: Aaron Miri and Tina Barker Course Title: Service Line Development Category 1 credits: 1.5 hours

>> July 10, 2009

>> August 21, 2009 Category I Education Session Presenters: ACHE of North Texas and Arlington/ Irving Area Program Council Co‐Champions: Eric Evans and Kyllan Cody Course Title: Comprehensive Leadership for Senior Level Executives Category I credits: 6 hours

>> September 11, 2009 ACHE Board Meeting Time: 7:30 AM Location: The Health Industry Council Conference Room 3001 Skyway Circle North, Ste. 100 Irving, TX 75038

>> September 15, 2009 ACHE Executive Book Briefing Time: Registration: 6:45 AM Breakfast Buffet: 7:00 AM Book Synopsis: 7:30 AM ‐ 8:05 AM Location: The Park City Club 5956 Sherry Lane, Suite 1700, Dallas, TX 75225 Cost: $25 Members $20 Students $30 Nonmembers

2009 Educational programs and networking events are currently being planned. All members will receive notice of scheduled events via e‐mail.

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Public Policy Governance Ethics Diversity Education Research Legislative >> developing healthcare leaders one person at a time.

Inside The American College of Healthcare Executives The American College of Healthcare Executives is an international professional society of more than 30,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organizations.

ACHE is known for its prestigious credentialing and educational programs and its annual Congress on Healthcare Leadership, which draws more than 4,500 participants each year. ACHE's established network of more than 80 chapters provides access to networking, education and career development at the local level. In addition, ACHE is known for its magazine, Healthcare Executive, and its journals, the Journal of Healthcare Management and Frontiers of Health Services Management, as well as groundbreaking re‐ search and career development and public policy programs. ACHE's publishing division, Health Administra‐ tion Press, is one of the largest publishers of books and journals on all aspects of health services manage‐ ment in addition to textbooks for use in college and university courses. Through such efforts, ACHE works toward its goal of being the premier professional society for healthcare leaders by providing exceptional value to its members. Ache.org

ACHE of North Texas . 3001 Skyway Circle, Suite 100 . Irving, Texas 75038 . p: 972.256.2291 . f: 972.570.8037 . info@northtexas.ache.org . northtexas.ache.org

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