March 2015 Southern Indiana Business Source

MARCH 2015

The

Pulse of

Local Health Care INSIDE

CAREGIVER HOMES EXPANDS INTO SOUTHERN INDIANA IU SOUTHEAST NURSING PROGRAM:

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EDITOR’S MESSAGE

EDITOR

Daniel Suddeath

Bill Hanson

PUBLISHER bill.hanson@newsandtribune.com

daniel.suddeath@newsandtribune.com

Daniel Suddeath

A healthy change It appears to be safe to peek out and take a glimpse of the post-Obamacareimplementation works.

Somehow, we’ve managed to stay afloat as a nation despite the onset of the President’s widely debated Affordable Care Act. To hear some tell it during recent years, one might have thought the world would have ended by now as the result of such a dastardly plan.

In Indiana, the struggle has waged on longer than in other states, as Gov. Mike Pence, among other Republican leaders, has fought the federal government on about every health care front.

Regardless of how you feel about the federal legislation, there’s no denying thousands of Americans now have access to health care who didn’t have coverage prior to the ACA. It’s also hard to argue that health care hasn’t changed. Locally, we are witnessing our flagship hospitals, Floyd Memorial and Clark Memorial, attempt to adjust to a new marketplace.

Clark Memorial, at the time of print, was exploring adding business partners, while Floyd Memorial was embarking on a new year with an interim CEO. While the hospitals concede changes have happened, and will continue to happen, they’ve also pledged to continue to offer high-quality service in Southern Indiana.

In a time marked by uncertainty in health care, it’s good to know Floyd and Clark Counties have several medical options.

Health care is an industry, and not just one affecting nurses, doctors and other professionals in the sector.

Quality hospitals are also important tools for the community, especially as baby boomers begin to need more care.

This edition of Southern Indiana Business Source is dedicated to the local health care industry. We’ll explore our local hospitals, medical care available for the elderly and an upstart nursing program at Indiana University Southeast.

Thank you for reading, and hopefully your 2015 is productive and healthy.

EDITOR daniel.suddeath@newsandtribune.com

Mary Tuttle

ADVERTISING DIRECTOR mary.tuttle@newsandtribune.com

Stephen Allen

PRODUCTION MANAGER/DESIGNER brandi.jones@newsandtribune.com

Christopher Fryer

PHOTOGRAPHER christopher.fryer@newsandtribune.com

CONTRIBUTING WRITERS BLAYR BARNARD WENDY DANT-CHESSER VERN ESWINE MICHAEL LAMSFUSS JASON LOPP ALLEN PLATT PAUL SANDERS

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4 :: SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015

SOUTHERN INDIANA BUSINESS SOURCE 221 Spring Street Jeffersonville, IN 47130

COVER STORY

The Pulse of Local Health Care Some good, some bad, area hospitals seeing changes Clark Memorial Hospital

PAGE 16

FILE PHOTO

06 Community Development Recent news and updates

LAW TALK

10

Indiana’s Position on King v.

Burwell: Will Text or Context Reign Supreme?

DOUGLAS L. MCSWAIN & AMANDA WARFORD EDGE

10 Law Talk

Indiana’s Position on King v. Burwell: Will Text or Context Reign Supreme?

11 Labor Laws

Should Your Company Adopt a Paid Sick Leave Policy?

12 Book Review

“Take Command Lessons in Leadership: How to Be a First Responder in Business.

WYATT, TARRANT & COMBS, LLP WYATTFIRM.COM

14 Womancare

Making Your Job Work When You’re Expecting

15 Marketing

Building Brand Ambassadors makes the promise real!

28

20 Digestive Health

Work- Related Stress and Your Digestive Health

24 XXX

President Obama’s Plan for Degree Attainment and the Important Role of Community Colleges

FEATURE

PARTNERS

JUST LIKE THE REAL THING Students come out of IUS nursing simulation labs better prepared to enter the workforce SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015 :: 5

COMMUNITY DEVELOPMENT

MCNeely Stephenson law firm moves to historic Hieb Building

Service Mother Teresa was a Roman Catholic Religious Sister and missionary often praised for her philanthropic efforts.

Did you know... Mother Teresa fed the hungry by requesting leftover food from airplane stewardesses — a testament to her commitment to aid the poor?

SERVICE is one of our Core Values. We want to thank our clients for the trust and confidence you’ve placed in allowing us to serve you.

The law firm of McNeely Stephenson is pleased to announce its move to the historic Hieb Building in downtown New Albany at 318 Pearl Street. They are excited to expand their space to more fully serve their clients in their family law, elder law, and litigation practices in Indiana and Kentucky. According to Managing Partner Larry Church, this move allows McNeely Stephenson to double its space, hire new attorneys, and expand its staff. Being a full service law office founded in 1974, the firm is eager to continue to grow with the community.

Currently, McNeely Stephenson’s Southern Indiana office includes attorneys Steve Langdon, who focuses on elder law issues, Dana Eberle-Peay, who practices primarily in family law, and Larry Church, a litigator and mediator. McNeely Stephenson invites you to visit their new offices and their website at msth.com.

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Vaughan Scott, MBA Senior Vice President – Investment Officer Eric Ballenger Senior Vice President – Investment Officer Michael Grau , CFP® Vice President – Investment Officer 101 W. Spring Street, Fifth Floor - New Albany, IN 47150 Phone: 812-948-8475 Fax: 812-948-8732 www.axiomfsg.com Wells Fargo Advisors, LLC. Member SIPC

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SOUTHERN INDIANA BUSINESS SOURCE :: JANUARY 2015 :: 6

FEATURE

Caregiver Homes expands into Southern Indiana Service provides an alternate to nursing home care

BY DANIEL SUDDEATH News and Tribune :: daniel.suddeath@newsandtribune.com

J

EFFERSONVILLE — When a loved one or friend’s health declines, some would prefer to care for them at home instead of admitting them into a nursing home or medical facility.

Caregiver Homes of Indiana is giving people that option locally.

“A lot of people think if they need help with more than a few things at home they have to go to a nursing home, and that’s no longer the way it is,” said Betty Antoine, branch manager of the Caregiver Homes of Indiana office in Jeffersonville.

The company began in Massachusetts in 2007, and has offices in seven states. Caregiver Homes launched in Indiana about 16 months ago, and has more than 170 customers. The Jeffersonville branch opened last July off 10th Street.

“We’ve grown in the state of Indiana significantly in a very short period of time,” said Kelli Tungate, Indiana state director for Caregiver Homes.

The business features Structured Family Caregiving, and the program is funded through Medicaid. The business works directly with LifeSpan Resources for referral services.

The caregiver is coached by Caregiver Homes’ staff, and they submit a daily electronic note to give information about the patient. A case manager makes an in-home visit each month to check on the patient as well.

An example of someone who may find the service beneficial is the son or daughter who has had to move back home to take care of an aging parent.

“We really act as the coaches and the support system for that caregiver, who often times doesn’t have that significant support they need,” Tungate said.

She credited State Rep. Ed Clere for his work on Senate Enrolled Act 44 — a bill that cleared caregivers to receive access to health data for the patient they are treating at home. His work helped facilitate better home caregiving practices in Indiana, she said.

Through the Medicaid program, caregivers are typically paid a stipend for their work. To qualify, a patient must be Medicaid-eligible and need help with three or more daily activities such as bathing, dressing and walking.

Prospective caregivers can contact the business to learn more about eligibility. If they qualify, they’ll be referred to LifeSpan Resources.

For more information, call Caregiver Homes at 866-797-2333.

on the web • www.caregiverhomes.com

Jeffersonville Mayor Mike Moore joins staff from Caregiver Homes of Indiana during a ribbon cutting ceremony last summer. The Jeffersonville location opened in July, and the company has eight branches in Indiana.

PHOTO SUBMITTED.

“We really act as the coaches and the support system for that caregiver, who often times doesn’t have that significant support they need.”

KELLI TUNGATE, INDIANA STATE DIRECTOR FOR CAREGIVER HOMES

8 :: SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015

LAW TALK

Indiana’s Position on King v. Burwell: Will Text or Context Reign Supreme?

BY DOUGLAS L. MCSWAIN AND AMANDA WARFORD EDGE WYATT, TARRANT & COMBS, LLP :: WYATTFIRM.COM On March 4, 2015, the Supreme Court of the United States will hear oral arguments in King v. Burwell, a lawsuit attacking premium assistance tax credits under the Affordable Care Act (“ACA”) for those who live in states (like Indiana) where the only Obamacare health insurance marketplace is the federal “exchange” i.e. HealthCare.gov. Regardless of the Supreme Court’s decision in King, both Indiana residents and employers will be impacted. This article attempts to shed some light on the nature of this impact, the central tenets of the King debate and the position Indiana has taken in the matter. At the end of the day, King boils down to whether text or context will reign supreme.

7.

Background. To understand King, one must first understand how the ACA operates. The ACA grants federal tax credits, based on income level, for individual health insurance purchased in the Obamacare marketplaces, also known as “exchanges.” The taxpayer may claim these credits as subsidies, in advance of tax filing time, to assist in the payment of monthly insurance premiums that are due to the insurer of the health plan selected by the taxpayer in the exchange.

8.

There are two types of Obamacare marketplaces: state exchanges and the federal exchange. The ACA created the federal exchange for individuals who live in states that do not set up their own state exchange.

A total of 36 states, including Indiana, have not set up their own state exchange. As a result, Indiana’s taxpayers must use the federal exchange?i.e. HealthCare.gov.

9.

The King dispute exists because the ACA’s specific text authorizing the federal tax credits and permitting their use as premium subsidies states further that they are for health insurance coverage purchased in “an Exchange established by the State.” An IRS Rule, however, extends these credits to coverage purchased in any exchange?including the federal exchange, i.e. HealthCare.gov. The King challengers that by expanding the tax credits to coverage obtained on the federal exchange, the IRS Rule has improperly trig-

gered ACA mandates and penalties for millions of individuals and thousands of employers in states like Indiana that are served only

by HealthCare.gov.

10. The Challengers’ Argument. The King challengers argue that the ACA’s plain text should govern, and the IRS Rule should be invalidated. The challengers state that the ACA provides tax credits only for health coverage purchased through a state-established exchange. No tax credits can be provided for coverage purchased in the federal exchange because it was not established by any state.

Accordingly, taxpayers who live in Indiana and other federal exchange states simply cannot benefit from premium assistance tax credits. For the challengers in King, this ACA text reigns!

11. Indiana’s Position. Indiana, along with 39 of its public school corporations, has filed an amicus brief supporting the challengers’ argument. By doing so, Indiana and these schools adopt the position that Indiana’s taxpayers should not benefit from premium assistance tax credits. They argue that the decision to create a state exchange was for Indiana’s policy-makers and, by Indiana’s refusing to do so, employers in the state were spared the burden of the ACA’s employer mandate. This mandate requires every employer employing 50 or more to offer its employees minimum health coverage. If the employer does not, and any employee receives a premium assistance credit, the employer must pay a tax penalty. According to Indiana and its school corporations, the IRS Rule has the effect of negating Indiana’s decision not to create a state exchange and impermissibly subjects Indiana’s employers – including the state itself and the schools as they are employers too – to the employer mandate.

12. The Obama Administration’s Response. The Obama administration disagrees with the challengers and Indiana. It states that the ACA’s text cannot be taken out of context. According to the administration, the challengers read this provision in isolation, in spite of the law’s whole meaning and in

disregard of other ACA provisions. Instead, the context surrounding the ACA reigns!

13. In this respect, the Obama administration highlights that the ACA provides every income-eligible taxpayer the right to claim premium assistance subsidies, regardless of where he or she resides. These subsidies can only be used for “qualified” health plans that are certified to meet minimum standards. The administration argues that since “qualified” plans may be sold in any exchange, including the federal exchange, it is clear the ACA permits premium subsidies everywhere.

If the ACA’s text really forbade subsidies as the challengers argue, no reason would exist for requiring only “qualified” plans to be sold in all exchanges. This is especially true given the ACA’s broad individual mandate requiring every taxpayer to have coverage or pay a penalty. It would make little sense to subject every taxpayer in states that use the federal exchange to potential penalties, yet deprive them of premium assistance to buy coverage.

14. The Obama administration also argues that the ACA requires every state to establish an exchange, but if a state refuses to do so, the federal government must establish “such Exchange” for it. The purpose of the federal exchange, as shown by the law’s use of the word “such,” is to operate as a functional equivalent of an “Exchange established by the State.” According to the administration, to read the ACA’s text myopically as the challengers do would only propel insurance markets in states with the federal exchange into a “death spiral,” in which markets cannot attract enough healthy insureds to offset unhealthy ones. Without subsidies, too many buyers will exit the federal exchange, driving up premiums to unaffordable, unsustainable levels.

15. Outcome. No decision in the King case will be forthcoming until on or around the last day of the Supreme Court’s term, which will likely be around June 30th. While the Fourth Circuit Court of Appeals has sided with the Obama administration, it re-

10 :: SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015

continued on page 26

LABOR LAWS

Should Your Company Adopt a Paid Sick Leave Policy?

BY TODD LOGSDON & LAUREN M. CLAYCOMB FISHER & PHILLIPS, LLP :: LABORLAWYERS.COM In his State of the Union Address, President Obama encouraged Congress and the states to enact paid sick leave policies on both the national and local levels. With those remarks in mind and flu season in full swing, Indiana employers may want to know if or even how President Obama’s recent push for mandatory paid sick leave will impact them.

For the moment, Indiana employers should not be too concerned about a possible national paid sick leave law because the President’s proposed legislation is unlikely to make it through the Republican-controlled Congress. Nonetheless, the President’s plan has opened a national debate that may leave some employers wondering

if they should offer paid sick leave to their employees.

Are Indiana employers legally required to offer paid sick leave to employees?

No. Some larger employers have opted to allow their workers to earn paid sick leave, but this option is not feasible for many businesses that have smaller workforces and finite resources.

Doesn’t the Family and Medical Leave Act (FMLA) already cover leave for employees?

Yes, but only to a certain extent. The FMLA permits eligible employees to take up to 12 weeks of leave for the birth of a child or a serious health condition. The FMLA only guarantees unpaidleave and,

according to the Obama Administration, only 60% of workers are eligible for its protections. A national paid sick leave law would expand these requirements and apply to most, if not all, workers.

What would President Obama’s paid sick leave law actually do?

The details of President Obama’s paid sick leave policy can be found in the Healthy Families Act, which House Democrats introduced in the last Congress as H.R. 1286.

The Healthy Families Act allows workers employed by companies with 15 or more employees to accrue up to seven days of paid sick leave annually. Covered employees can use this time off to seek preventative care, continued on page 27

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BOOK REVIEW

“Take Command Lessons in Leadership:

How to Be a First Responder in Business

BY PAUL SANDERS

“Take Command Lessons in Leadership: How to Be a First Responder in Business”

by Jake Wood

Paul Sanders

Paul Sanders is an award-winning writer who worked for the past 10 years in the training industry with best-selling authors including Stephen Covey, Ken Blanchard and Tom Peters.

He is an adjunct professor who works with the Sullivan University Dale Carnegie Group.

With technology almost daily reinventing the ways we work, fierce global competition, and constant disruption, business is in need of a new kind of leadership: high-stakes, Take Command leadership. That is the no-holds barred premise of “Take Command Lessons in Leadership: How to Be a First Responder in Business,” by Jake Wood.

To succeed in today’s high-pressure business climate, leaders no matter what their position, experience or job title, must rise to the challenge of leadership as never before. They must prepare themselves to be what Heraclitus in 500 BC called the Warrior?the one out of 100 who brings the others home.

And while we can’t all literally be warriors, we can all be leaders, according to Wood. He poses a set of ambitious challenges to every individual: prepare yourself to fight under conditions of extreme pressure and uncertainty, learn to lead others and create the life you want for yourself.

Wood was a member of one of the Marine Corps’ most elite units, the Marine Scout Sniper Platoon. He had tours in Al Anbar Province, Iraq and Helmand Province, Afghanistan. He was named a CNN Hero for 2012 and awarded the 2011 GQ Better Men Better World Award. He was also profiled in People and Forbes magazines.

Wood has turned his experience as a Marine sniper into a management book that tells readers how to apply military leadership principles to their work in business. Wood’s firsthand experience of why having every individual be an effective leader is good for business as well as

society is both eye opening and affirming. It should encourage each of us to persevere in our own professional lives while becoming leaders for the world we want to live in.

After military service, Wood and fellow veteran William McNulty formed a non-profit organization Team Rubicon, named after the river Caesar crossed to march on Rome and known as being a point of no return. The organization unites the skills and experiences of military veterans with first responders to rapidly deploy emergency response teams. It includes nearly 20 thousand volunteer veterans and first responders.

It has conducted over 50 missions on four continents, responding to tornados, typhoons and other disasters.

Wood draws on the experience of running this organization as well as his military background in developing his principles on leadership.

He sets an urgent tone on the need for leadership. His book opens with a graphic description of a mission to aid a Platoon of Marines in Fallujah, Iraq. It is his first combat deployment and he is kneeling over the dead body of a friend and fellow Marine.

Seeing a void in leadership, Wood realizes he has to Take Command. That realization “changed the course of my life forever,” he writes.

Most of us don’t work at jobs that involve leading a battalion of Marines on the battlefield, but Wood’s point is succinct: in today’s world, we are all on the front lines. To be successful, each of us is called upon to take the first plunge into the unknown and take command.

12 :: SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015

continued on page 13

“Every profession has its front lines, whether you work on a commodities floor, or in a courtroom, or in a cubicle behind a computer,” Wood writes.

“Sure the situations aren’t exactly the same. But the principles that carry you through to success are.”

JAKE WOODS, AUTHOR OF “TAKE COMMAND LESSONS IN LEADERSHIP: HOW TO BE A FIRST RESPONDER IN BUSINESS”

“Every profession has its front lines, whether you work on a commodities floor, or in a courtroom, or in a cubicle behind a computer,” Wood writes. “Sure the situations aren’t exactly the same. But the principles that carry you through to success are.”

Wood breaks his eight Lessons in Leadership into four parts: Prepare, Analyze, Decide and Act. Each of these sections contains a principal illustrated with examples from his military background, management experience and outstanding instances of leadership in contemporary business.

The section on team building is particularly valuable. Wood takes the idea of team to another level, the High-Impact Teams (HIT). Such a team “is defined by some special internal characteristics along with some environmental ones.” It must be faced with a daunting task or high stakes opportunity. The HIT “must be foolish enough to think it can make a change, daring enough to try, and persistent enough to have a chance.” To accomplish great things, and make a great impact, you need to create a high-impact team.

The other Lessons in Leadership include

maintaining transparency, determining goals, gathering pertinent information, understanding risks and overcoming setbacks.

While such lessons may not be original, Wood’s approach creates an urgency that underscores their importance.

The ability to take charge is a fundamental issue for every successful leader?and both personal and organizational lessons must be learned to make it so. “Take Command,” gets to the heart of leadership and guides the reader to personal and organizational success.

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SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015 :: 13

WOMANCARE

Making Your Job Work When You’re Expecting

BY RONALD L. WRIGHT, MD WOMANCARE :: WOMAN-CARE.ORG

What NOT to say to a

Pregnant Co-Worker If one of your co-workers is expecting, following these simple rules can help you avoid saying something you’ll regret.

•

If you can’t say something nice, don’t say anything at all.

•

Never describe her as “big,” “huge” or “enormous.”

•

If a woman hasn’t told you she’s pregnant, don’t ask. Ever.

•

Never ask a woman if she’s having twins. Just don’t.

•

Don’t ask to touch her pregnant belly.

If you don’t normally touch your coworkers’ stomachs, this is no time to start. If she’s open to it, she’ll extend the invitation.

Many women find themselves working through a pregnancy. If you’re one of them, you want to continue to perform at a high level while taking the best possible care of yourself and your little one. Here are some tips to help you accomplish both goals.

Be careful not to over-exert yourself, which can affect your baby’s health and increase your risk of going into labor early.

Short, frequent breaks can be helpful.

If you’re able to take a short nap during lunch, you’ll be surprised at how refreshed you feel.

Watch out for stress. While every job has stress, try to remain focused on the positive and find stress relief tactics that work for you.

Wear comfortable shoes. Your feet will swell during the day, so shop for shoes in the evening to ensure a better fit. This is one time in your life when support matters more than style. And put your feet up when possible to help alleviate that swelling.

Take bathroom breaks. During the last trimester, you may feel like you’re visiting the restroom every few minutes, but not listening to your body in this regard can lead to urinary tract infections.

Eat several small meals during the day rather than three big ones, to keep your blood sugar levels consistent and help even out mood swings. Bring your own food and

14 :: SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015

continued on page 27

MARKETING

Building Brand Ambassadors makes the promise real!

BY VERN ESWINE THE MARKETING COMPANY :: MARKETINGCOMPANY .COM Building a strong brand is one thing but maintaining it is another. Too any companies want to take the easiest route in relying on just creative advertising or clever slogans.

The truth is that all of us, regardless of the type of product or service, is looking for an experience of some kind. We want to believe what the advertising promises, we want to experience the results we hear the ads say we will receive when buying this or that but all too often there is a disconnect between the communication of the promise and the actual delivery of the promise.

As a brand marketer for over thirty years we spend much of our time walking our clients through an ongoing effort in developing an internal structure that will deliver a great experience for the customer and more importantly, deliver on what they promise on a more than regular basis. This brings us to building brand ambassadors.

Brand ambassadors are first, your employees. In most cases, whether on the phone, through email or in person, your employees are the brand ambassadors of your product and service. These individuals are the ones

that will deliver on the promises you are making to your clients and customers or will fail miserably so they should be provided with everything they need on an ongoing

SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015 :: 15

continued on page 27

Vern Eswine has been involved in leadership, marketing and business consulting for more than 30 years and is president of The Marketing Company, a branding firm located on Spring Street in New Albany.

COVER

“Right now, Floyd Memorial is in a period of making sure it completely understands its next steps, and you’ll find that as we get into the summer and fall, Floyd will be very open in community a lot in terms of how we look at the future.”

DAN FAIRLEY, FLOYD MEMORIAL INTERIM CEO

Floyd Memorial Hospital PHOTO BY CHRISTOPHER FRYER

SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015 :: 16

The

pulse

local heatlh care of

Some good, some bad, area hospitals seeing changes

On the web • www.clarkmemorial.org • www.floydmemorial.com • www.kmchospital.com

BY DANIEL SUDDEATH News and Tribune daniel.suddeath@newsandtribune.com

S

OUTHERN INDIANA — Local hospitals have experienced an array of changes over the past year.

From restructuring and retooling, and in some cases, closing, medical care in Southern Indiana has seen some some swings.

Just days before this magazine was printed, it was announced that a bid to purchase St. Catherine Regional Hospital in Charles-

town had fallen apart. The emergency room at the hospital closed, and the future St. Catherine’s remained in doubt, as the hospital had already filed for bankruptcy in 2012.

St. Catherine had been in operation in Charlestown for 39 years.

Also in late February, Clark Memorial Hospital announced its intentions to form a partnership with Regional Health Network of Kentucky and Southern Indiana, which

is a joint venture of Norton Healthcare and LifePoint Hospitals.

As of press time, the Clark County Commissioners and Clark County Council still needed to approve measures to allow the deal to proceed. If approved, the deal is expected to elimnate Clark Memorial’s debt, though exact figures of the proposal weren’t made public.

Previous offers between Norton Healthcare continued on page 18

SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015 :: 17

COVER

Clark Memorial Hospital FILE PHOTO

and the Clark County commissioners and council, as reported by Matt Koesters in the News and Tribune, included a vow by the medical provider to assume Clark Memorial’s bond debt.

The bonds would remain in the hands of the county, but Norton Healthcare had pledged to pay the $52 million in debt. LifePoint’s involvement is expected to strengthen the deal.

Due to ongoing negotations involving the proposal, Clark Memorial CEO Martin Padgett was unavailable for a direct interview with Southern Indiana Business Source regarding the state of the hospital by the publishing deadline.

In a news release issued Feb. 18, he did express optimism in the Regional Health

Network plan.

“We believe we have found the right team of partners in Regional Health Network and look forward to working with the Clark County council and commissioners to explore this potential collaboration further,” he said.

Clark Memorial employs about 1.350 people.

FLOYD MEMORIAL SEEKING BROADER PRESENCE Floyd Memorial Hospital and Health Services is under the direction of interim CEO Dan Fairley, who took the place of Mark Shugarman in December. Shugarman departed New Albany for a position with Shriner’s Hospital for Children in Cincinnati.

Often rumored in recent years has been that Floyd Memorial, like other area hospitals, was up for sale. Past leadership vehemently denied the rumors, and Fairley said the hospital is focused on stengthening its relationship with the Floyd County Commissioners and Floyd County Council.

“After all, we are a hospital authority created by the state of Indiana and the county,” Fairley said.

There was some fuel behind the fire of the rumors.

Faced with budget cuts and financial shortfalls in 2014, some county leaders suggested exploring the sale of the hospital.

In September, Rialto Capital Advisors — the Florida-based company that owns Kentuckiana Medical Center in Clarksville — issued a

18 :: SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015

“We believe we have found the right team of partners in Regional Health Network and look forward to working with the Clark County council and commissioners to explore this potential collaboration further.”

MARTIN PADGETT, CLARK MEMORIAL CEO

letter to the county commissioners expressing interest in buying Floyd Memorial.

Floyd Memorial leaders said at the time they had no interest in being part of a sale, and the talk of finding a buyer for the medical provider has all but ceased by county leaders publicly in recent months.

Fairley said Floyd Memorial is looking forward to being a long-term provider in the community.

“In the last few years, like [many] community hospitals, we’ve struggled a little bit with health care reform and the Affordable Care Act, and the continuing need for health care costs to be managed better,” he said. “Floyd Memorial is emerging out of that now, and is in a period of renewal and retooling.”

Some of those new tools should be made

public by this summer, as Floyd Memorial begins to focus more on “population health,” Fairley said.

“It will look more like a community health provider,” he said.

Floyd Memorial will seek a broader presence in bigger networks across the state, as the health care model across the nation becomes less “hospital-centric,” Fairley continued.

“The hospital will be here, it will have the services it has here no doubt, and it will have some high-end specialty services that we have now, and those will be enhanced,” he said.

But outpatient and ambulatory services offered by the hospital will be distributed more into the communities through care centers under Floyd Memorial’s umbrella.

Floyd Memorial will continue to rely on

its strong network of physicians throughout the coming changes, as the hospital plans t continue growing that network as it seeks to extend deeper into other communities, Fairley said.

“Right now, Floyd Memorial is in a period of making sure it completely understands its next steps, and you’ll find that as we get into the summer and fall, Floyd will be very open in community a lot in terms of how we look at the future,” he said.

“We’re very focused on making sure we do a good job with what we have, and we’re also planning for the future and trying to respond to the things that are coming at us.”

SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015 :: 19

DIGESTIVE HEALTH

Work-Related Stress and Your Digestive Health

BY DR. JAMES C. STROBEL MD GASTROENTEROLOGY OF SOUTHERN INDIANA :: GHPSI.COM From the job candidate who feels “butterflies in her stomach” before an interview, to the decision-maker who relies on “gut feelings,” the connection between your mind and your stomach is undeniable. In fact, the stomach and intestines contain more nerve cells than your entire spinal cord.

Medical experts often refer to the “braingut axis,” the strong connection between the brain and the digestive system. We usually think about stress causing stomach distress, but it also works the other way; digestive problems can result in an increased level of stress.

Many jobs involve a certain level of stress, but some more than others. In addition, some people feel stress more acutely than others do. Here are just some of the symptoms that may indicate your stress levels are high enough to affect your digestive health: • Stiffness or tension in your muscles • Headaches • Restlessness or difficulty sleeping • Weight loss or gain • Procrastination or difficulty completing projects • Changes in alcohol or food consumption • Increased desire to be with or withdraw from others • Frequent talking or brooding about

work situations • Overwhelming sense of pressure • Difficulty relaxing • Difficulty concentrating or making decisions Stress reduction and stress management are important for everyone, but especially for those with high-stress positions. Two keys to managing stress are regular exercise and adequate sleep, both of which provide a host of other health benefits as well.

Movement — walking, running, swimming, biking — changes the balance of stress hormones in your brain and helps flush out the chemicals your body releases due to stress. Sleeping in complete darkness

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continued on page 26

HI, I’M JOE TAYLOR. Overton, Texas. What keeps me coming back to the Trail? It’s just absolutely sensational.

I have people tell me what they’ve spent playing one round at Pebble Beach and a night at the hotel, or going to Pinehurst for a couple rounds. We do the entire week, travel, hotel, green fees, good meals and everything for the price of one day at these places. And it’s absolutely a sensational place to come.

TO PLAN YOUR VISIT to Alabama’s Robert Trent Jones Golf Trail, visit rtjresorts.com or call 1.800.949.4444 today. facebook.com/rtjgolf twitter.com/rtjgolf

Twenty Under 40 2015

Deadline approaching for 20 under 40 SOUTHERN INDIANA — It’s good to be young. It’s better to be young and talented.

Southern Indiana Business Source is looking for those types of people for its annual 20 under 40 edition of the business magazine.

Nominations for the fourth-annual honor are being accepted. The best thing about the current round of nominations is SIBS has made the process much easier for those nominating candidates this year.

“Our 20 Under 40 publication is consistently one of our most popular editions,” said SIBS Editor Daniel Suddeath. “It introduces our readers to some of the most prominent young professionals in the community, and allows those being featured to garner some well-deserved praise and attention.”

Unlike past years, we are only asking

for basic information regarding nominees.

Filling out the form will take less than three minutes. To be eligible, nominees must be younger than 40 on May 1 and live or work in Clark or Floyd counties. The deadline for nominations is 5 p.m. Feb. 27. The edition will publish in April.

Nominations may be filled out at — surveymonkey.com/s/K7TXRKY “Our 20 Under 40 edition has become a keepsake for readers because it focuses on the future leaders in Clark and Floyd counties,” said SIBS and News and Tribune Publisher Bill Hanson. “We are excited to see who is nominated and eventually selected for this year’s class. They will be joining some really inspiring young people.”

If you have questions or need more information, email at bill.hanson@newsandtribune.com

SUBMIT YOUR NOMINATION: surveymonkey.com/s/K7TXRKY NOMINATION DEADLINE: Feb. 27, 5 p.m.

SCAN THIS QR CODE Scan this QR code with your smart phone for quick access to the nomination form.

SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015 :: 23

HIGHER EDUCATION

President Obama’s Plan for Degree Attainment and the Important Role of Community Colleges

BY JUSTIN M. SUER HTTPS://JUSTINSUER.WORDPRESS.COM/

GOV. HASLAM AND THE TENNESSEE PROMISE

In early February, President Obama visited Ivy Tech’s Indianapolis campus to discuss, among other things, the Obama Community College Plan. The President’s Plan has its roots in the state of Tennessee.

The Tennessee Promise “uses lottery money to pay tuition for any high school graduate to attend a two-year public college in the state.” The initiative is part of a drive by Republican Governor William E. Haslam to improve his state’s college graduation rate.

In 2010, just 32.8 percent of Tennessee’s residents had earned an Associate’s degree or higher. That ranked 40th in the United States for degree attainment. Indiana ranked 33rd with 36.1%. Haslam’s longterm goal for the state of Tennessee is 55%.

Only Massachussetts and North Dakota boast more than a 50% degree attainment.

Why is a Republican Governor from Tennessee willing to invest an estimated $35 million per year to send high school graduates to college? Haslam understands the relationship between educational attainment, earnings, and unemployment.

According to the Bureau of Labor Statistics, an individual with a Bachelor’s degree will earn 1.7 times as much as an individual with a high school diploma.

“Businesses deciding whether to locate or expand in Tennessee look for more than incentives. The single best recruiting tool for future job growth is a high quality in our work force that flows from our educational achievements,” said Haslam recently.

EDUCATIONAL ATTAINMENT IN THE UNITED STATES

While Tennessee is attempting to catch up to its competitor states, the U.S. finds itself losing ground fast to international competitors. “Americans thrived in the 20th century because we made high school free. We were ahead of the curve, but other

countries caught on,” said President Obama.

“In a 21st-century economy that rewards knowledge more than ever before, we need to up our game.”

According to the Organization for Economic Cooperation and Development, the rest of the World is quickly catching up to the United States in educational attainment. tertiaryWhy? The United States was one of just six countries that cut its public expenditure on education between 2008 and 2011. The others include Estonia, Hungary, Iceland, Italy, and the Russian Federation…hardly a group of economic overachievers.

“Raising educational attainment is not only giving countries more income but it is also creating a greater degree of social cohesion,” said OECD’s Director for Education and Skills Andreas Schleicher. “Every business transaction [is founded] on trust. Trust in institutions is vital, trust in democracies.

All of those aspects are vital for the functioning of societies.”

So, the decreased U.S. investment in education is coming home to roost. As a

result, U.S. wages remain stagnated with no imminent reversal in sight.

Obama’s plan proposes to spend $6 billion to make two years of community college free for students that meet the plan’s requirements. It requires the state to fund a portion of the overall cost.

THE ROLE OF THE PUBLIC COMMUNITY COLLEGE

Most public community colleges, in America, are built on low-cost delivery models compared to public and private four year institutions. Here are some of the differences: Community College faculty do no research. So, faculty can devote 100% of their time teaching and advising students.

Community Colleges rely more heavily on inexpensive, part-time adjunct faculty to teach courses.

Community Colleges operate in modest facilities that are less grandiose compared to most public and private four year

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continued on page 25

institutions.

Thus, public community colleges are often significantly less expensive than public or private four year institutions. In Indiana, for example, the cost of tuition at Ivy Tech Community College is less than half of the $7,050 average for colleges in Indiana. The following chart illustrates 2014 tuition levels at twenty-two Indiana colleges and universities. tuition Obama’s plan would push students that might otherwise pay out of pocket or borrow money to attend Indiana University (Northwest), for example, to attend Ivy Tech Community College for their first sixty credit hours. The student would save $12,222 over those two years and be wellpositioned to transfer to a four year institution for his/her Bachelor’s degree. Consequently, students would not have to incur such high levels of debt over the course of their degree seeking years.

Critics argue that community colleges

have high dropout rates and lack the resources to employ full-time advisors, counselors, and student mentors. They argue that Obama’s plan addresses the symptoms but not the illness. In his recent NYT Op-Ed, David Brooks argues that Obama should, instead,tackle the overwhelming need for remedial education, living expenses, and child-care.

In his commentary for Fortune, Stuart Butler of the Brookings Institution, argues that Obama’s plan represents an unwarranted subsidy for middle-income and even upper income students. “Meanwhile, many lower-income students at community colleges would still not have the money to cover the non-tuition costs, such as books, supplies and transportation – and room and board for those not living at home. These costs usually dwarf tution at a public community college,” writes Butler.

Still others point to our divided government and underscore how Congressional

approval for Obama’s Plan or something like it is utterly improbable if not impossible.

One thing is perfectly clear. Unless our state and/or federal governments can find innovative ways to accelerate high-quality degree attainment in the United States, economic growth will continue to lag behind the rest of the world and wages will remain stagnant. At least, the President has started a conversation about the need to invest in educational attainment. All stakeholders should use this opportunity to debate the issue vigorously and act to invest in a solution that positions the United States for wage growth in the 21st century.

Justin Suer is the Dean of Business and Public Services at Ivy Tech Community College in Sellersburg.

then get back into the game.

IT’S NOT WHO YOU KNOW. IT’S WHO KNOWS YOU.

SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015 :: 25

MCSWAIN AND EDGE: KING V. BURWELL continued from page 10

STROBEL: WORK-RELATED STRESS, DIGESTIVE HEALTH continued from page 20

mains to be seen how the Supreme Court will rule. If doubt lingers about how to interpret the ACA, the Obama administration’s position has another argument in its favor, based on the precedent of Chevron, U.S.A., Inc. v.

Natural Resources Defense Council (1984).

Under Chevron, any ambiguity in a statute’s meaning is resolved by deferring to the executive agency charged with the law’s regulation and enforcement. Indeed, unless the Supreme Court strikes the IRS Rule, Chevron deference could be crowned supreme, tipping the scales of justice toward context.

increases production of melatonin, which has been shown to help reduce stressinduced lesions in the GI tract.

Likewise, a healthy diet plays a big role in reducing stress levels. Stay away from simple sugars and starches like chips, cookies and ice cream, and reduce or avoid caffeine and alcohol. Instead, opt for fruits, vegetables and other high fiber foods, and complex carbohydrates.

Some tasty choices that make sense for a low-stress diet include cashews and walnuts, berries, oranges, dark chocolate and chamomile or green tea.

It’s worth pointing out how all of these approaches work together. For example, eating well and exercising help us sleep better, so one behavior aids another. Likewise, yoga, meditation, prayer and other relaxation strategies can help lower stress while yielding additional health benefits. And don’t underestimate

Douglas L. McSwain

the value of positive social interaction — quality time relaxing with family and friends.

Finally, keep in mind the relationship between stress and disorders of the digestive system. Stress can contribute to everything from heartburn to irritable bowel syndrome, but these conditions, especially when undiagnosed and untreated, can also induce stress. Talk with your doctor if you experience any ongoing symptoms related to your digestive tract.

Dr. James C. Strobel MD Gastroenterology of Southern Indiana Dr. Strobel joined GSI in July of 1997. He received his undergraduate degree from Indiana University in Bloomington, and his medical degree from Indiana University in Indianapolis, followed by a residency in Internal Medicine, three years of additional training, and a fellowship in Gastroenterology at Duke University in Durham, North Carolina.

Dr. Strobel is board certified in both Internal Medicine and Gastroenterology.

Amanda Warford Edge THIS IS AN ADVERTISEMENT

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WRIGHT: WHEN YOU’RE EXPECTING continued from page 14

EWSINE: BUILDING BRAND AMBASSADORS continued from page 15 basis to succeed in that effort. This includes ongoing support and an understanding of what they can do well and what they cannot. For instance, not everyone is a great speaker or writer, so why allow them to do this without over site or more Importantly some guide lines that will help in the delivery and confirmation that the promise you made is true? ( more on this later).

Most of us will be the judge whether we come back or not, purchase the product or service again through the personal experience we have ourselves. Providing our customers that experience also

creates our second set of brand ambassadors, our customers.

Developing a great brand can save you money, help see your company through rough economic times and overall make your corporate life more enjoyable but it takes work and effort. Make sure you are doing more than making catchy promises or winning awards with your advertising.

True brand development is successful when you deliver what you promise and for that to happen on a regular basis you need great brand ambassadors.

LOGSDON & CLAYCOMB: PAID SICK LEAVE POLICY continued from page 11 treat their own illnesses or care for sick family members. Several states and cities have enacted similar measures. Connecticut was the first state to pass a paid sick leave law in 2011. California enacted a paid sick leave law in September 2014 (even though San Francisco adopted its own policy in 2006). Other cities, including Seattle, Portland, New York City, San Diego and Newark, have also enacted paid sick leave laws.

Following in the footsteps of these local initiatives?and perhaps realizing that Republican-led Congress is not likely to pass the Healthy Families Act?the Obama Administration is actively calling on states and cities to pass their own paid sick leave laws. To that end, President Obama requested that Congress allocate more than $2.2 billion in next year’s budget to reimburse states who initiate paid sick leave programs.

Is paid sick leave a good thing for employers?

Paid sick leave laws may be beneficial for some employers.

Proponents of paid sick leave tout the benefits as including increases in productivity, boosts in employee morale and noticeable drops in absenteeism. A national paid sick leave law could also benefit employers with operations in multiple states or cities who are forced to deal with a patchwork of state and local laws establishing leave requirements.

Supporters of a national paid sick leave law also point to the laws enacted in Connecticut and California?and San Francisco in particular?as proof that such laws have little to no negative impact on the economy. Even though paid sick leave laws have been successfully implemented in these states, experts worry that the same would not be the case for states and cities that are still struggling from the recession.

Opponents of mandatory paid sick leave argue that such laws

snacks with you to work, since going out exposes your weakened immune system to a higher risk of illness or infection.

And drink plenty of water and fresh juice.

If you’re dealing with morning sickness, keep a small bottle of mouthwash and baby wipes on hand. You’ll be glad you did.

Finally, be willing to ask for help. If you need to adjust your workload or schedule to ensure your health and you have the ability to do so, consider this option. Don’t try to be superwoman. Accept help when it’s offered. And keep your doctor’s emergency number on your desk and in your bag at all times.

Ronald L. Wright, MD Attending Physician, OB/GYN WomanCare (woman-care.org) Originally from Muskegon, Michigan, Dr. Wright received his BA from Tulane University, then went on to graduate from the University of Louisville Medical School. From there, Dr. Wright completed his OB/GYN residency at the University of Texas Southwestern Medical School. From general and high-risk obstetrics to incontinence and infertility including laparoscopy, Dr. Wright provides complete care to women of all ages. He and his wife Jennifer have two children. Dr. Wright is a council member of the Christian Medical and Dental Associations, volunteers at A Woman’s Choice Resource Center and is a member of Southeast Christian Church.

would raise costs for employers.

Large employers could absorb the additional costs, but smaller businesses may find it more difficult to do so. Mandatory paid sick leave may also end up hurting workers if employers attempt to shift the cost of paying for sick days by reducing employees’ pay or cutting back on other benefits they already provide.

What does this mean for Indiana employers?

Indiana employers need not be too concerned with the President’s paid sick leave initiative, nor should they be pressured to adopt their own paid sick leave policies. Congress will probably block all legislation that mandates national paid sick leave for private employers.

So, until the Indiana legislature or city and local governments act, Indiana employers will not be required to provide paid sick leave to their workers.

Todd B. Logsdon is a Partner in the Louisville office of Fisher & Phillips LLP. He practices exclusively in the areas of labor and employment on behalf of employers, with a particular emphasis on discrimination, wage and hour issues, FMLA and OSHA issues. Todd may be contacted directly at 502-561-3971 or tlogsdon@laborlawyers.com.

Lauren M. Claycomb is an Associate in the Louisville office of Fisher & Phillips LLP. She practices exclusively in the areas of labor and employment on behalf of employers. Lauren may be contacted directly at 502-873-4002 or lclaycomb@laborlawyers.com.

SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015 :: 27

FEATURE

Jacelyn Chaisson, a junior in the nursing program at Indiana University Southeast, runs some diagnostics on a pediatric mannequin in the school's new nursing labs. Students can get experience working with a variety of different patients in all sorts of medical conditions in the labs. PHOTO BY JEROD CLAPP

Just like the real thing Students come out of IUS nursing simulation labs better prepared to enter the workforce

BY JEROD CLAPP News and Tribune :: jerod.clapp@newsandtribune.com

N

EW ALBANY — As her patient was about to give birth, Brittany Vannis kept her patient calm and aware of what was going on every step of the

way.

The lives of her patients were never really on the line, but her grade was. Behind her, a team of professors and assistants were watching

their every move through video cameras and one-way mirrors.

Vannis, a junior at Indiana University Southeast, was taking an exam in the Judge Carlton and Sue Sanders Laboratory for Nursing Education. With 12 beds in a general skills lab and more in pediatric, birthing and advanced cardiac labs.

Jacqueline Reid, interim dean of nursing, said the labs give students several advantages by the time they make it into the job market.

Unlike clinicals, students can make mistakes without risking the health, safety or lives of patients.

“But nobody’s going to get hurt if the actions are not exactly what they should be,” Reed

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A healthy job market

BY DANIEL SUDDEATH News and Tribune :: daniel.suddeath@newsandtribune.com

Faculty and assistants watch students during an exam in the maternity simulation lab at Indiana University Southeast. Professors can control the patients in the lab, their vitals and communicate to students from the assessment room. STAFF PHOTO BY JEROD CLAPP said. “And the reality is that it’s been demonstrated through research that you learn as much through an error that you’ve made as you learn from doing it wordperfect.”

The labs were dedicated to in November 2014. Students have had the ability to work in them through the fall semester, but now, Reid said they’re getting a real feel for the full potential of what they can learn.

In the labs are simulation mannequins, patients that have a variety of programmable conditions and varying degrees of realism.

The lab was partially funded through a $500,000 donation from the Sanders, as well as matching funds from the university.

In the birthing lab, professors in the observation room can set blood pressure, respiration, heart rate and other vitals for both the mother and the child. As students talk to the mother, professors can speak through the patient to give students information indicating symptoms or other complications.

Reid said along with the ability to change symptoms on the fly and test the skills of students in the labs, professors can also guarantee that students get the experiences they’ll need. While clinicals in hospitals are high-stakes and still a required portion of their curriculum, professors can’t guarantee a mother will give birth on any given day, nor can they promise students will get to work on the kinds of patients they’re learning about.

“This is augmenting their clinical experi-

ence,” Reid said. “They’ll all have one day of this and five or six days in the hospital.

It’s a very, very low ratio, less than 20 percent of the time they’re in clinicals.”

Reid said the school has invested a lot in the labs, with about $70,000 just in the simulation mannequins.

Melissa Ott, a junior in the nursing program, said she’s glad she has the opportunity to use the labs to take her learning to a different level before she finds herself working with real patients in a hospital.

“It prepares you to think ahead, you learn from the mistakes you make while you’re in a safe environment,” Ott said. “I think it’s a good preparation for us to feel a little more comfortable in ourselves and our skills.”

She said while no one wants to mess up during an exam or exercise in the labs, it helps them trace their steps to what led to the mistake and how to avoid it in their careers.

“If you make the mistake here, it’s kind of half real and half not real,” Ott said. “We think as the patient as being real, but if we mess up, it’s OK, we’re going to talk about it later, we’re going to figure out what we did wrong and what we could have done better, then we can apply it in a real situation.”

After students are finished in the lab exams, they can review the recording of their performance with professors to look at what they did right and where they could use improvement.

Tonya Broughton, assistant clinical continued on page 30

SOUTHERN INDIANA BUSINESS SOURCE :: MARCH 2015 :: 29

S

OUTHERN INDIANA — Medical professionals are charged with treating injuries, diagnosing problems and keeping people healthy, but the health care field is also critically important to the economic well being of the region.

“Since exiting the Great Recession, health care and social services has been one of the top performing sectors in Southern Indiana with respect to overall job creation,” said Uric Dufrene, professor of Finance at Indiana University Southeast.

“It is second to manufacturing in terms of overall job growth since 2009.”

In Floyd, Clark, Washington and Harrison Counties, the health care and social services sector employed just less than 12,000 people last year.

Manufacturing accounted for about 13,500 jobs in the same area in 2014.

The trend is similar statewide.

The state put out its Hoosier Hot 50 Jobs report in 2014 which examines the top employment fields currently as well as predictions for the future.

Registered nurse was the number one job on the 2014 list based on an eight-year project, as the job pays an average annual salary of $57,370, according to the Indiana Department of Workforce Development report.

Licensed practical nurse was sixth on the list, as the job pays an average annual salary of $39,900.

The list considers projected long-term growth for the positions as well as expected job openings and wages.

12,000

In Floyd, Clark, Washington and Harrison Counties, the health care and social services sector employed just less than 12,000 people last year.

FEATURE

professor, said that prepares the students better for the real world, knowing what to do step-by-step by learning through mistakes.

“The safe environment is the best place to make a mistake because you can learn what led up to that mistake,” Broughton said. “Was it the way you read the doctor’s order, the way you interpreted the communication? Where was the breakdown? So we teach them to look at the situation, assess the background and learn that making a mistake it OK. Once you can trace it back, you don’t make that mistake again.”

Broughton said it also gives some students opportunities they otherwise wouldn’t get, but it also makes them feel more comfortable when they begin course work in a hospital.

“I can see a huge difference in the students with their confidence when they walk into clinicals, especially with [obstetrics] and the guys who come through,” Broughton said. “They don’t experience that the same way because they don’t get to see all the deliveries that the females get to see. If they’re in the [emergency room] and they get a female that comes in, they’re ready. It’s not now.”

Tori Swank and Megan Quade, juniors in the nursing program at Indiana University Southeast, take an exam in the maternity simulation lab. Students have to exercise the technical aspects of working with patients, but also get graded on bedside manner.

STAFF PHOTO BY JEROD CLAPP

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