The American Lung Association is hosting a “Respiratory Rally” on Saturday.

The keynote speaker of the rally will be Len Geiger, who underwent a double lung transplant at age 43.

Geiger had the lung transplant several years after he was diagnosed with Alpha-1 antitryspin deficiency (AATD). the genetic form of Chronic Obstructive Pulmonary Disorder which can cause lung damage, emphysema and liver cirrhosis if untreated.

The Tucson Respiratory Rally, which takes place from 8 a.m. to 1 p.m. at The Hotel Arizona, 181 W. Broadway, is set up to help people learn how to better manage chronic lung disease. The event costs $10 per person.

For more information log onto www.breatheeasyaz.org/events.htm.

Coyote Trail and Rattlesnake Ridge elementary school students have organized a walkathon to benefit the Diamond Children’s Medical Center at University Medical Center.

The 3-mile walk will take place at 8 a.m. Saturday at Coyote Trail Elementary School, 8000 N. Silverbell Road.

Those who participate will walk from Coyote Trail to Rattlesnake Ridge Elementary School, 8500 N. Continental Loop Drive.

“This is a wonderful example of children making a difference,” says Vicki Began, vice president for Women and Children’s Services at UMC. “We are grateful for their hard work and dedication to help build Diamond Children’s Medical Center.”

The Diamond Children’s Medical Center is scheduled to open in 2010.

For more information, www.diamondchildrens.org.

Tucsonans are getting a noseful of plant parts as a second round of high pollen counts has hit the Old Pueblo.

Mark Sneller, owner of Aero Allergen Research and the sole pollen counter in Pima County, said the pollen counts dropped to 192 pollen grains per cubic meter of air last Friday after being in the 300s earlier in March.

But the count jumped back up to 359 Wednesday after winds blew through the area, he said.

Sneller also said that while some pollen generators such as mulberry, juniper and ash are fading away, others are just starting to bloom.

“Olive is going strong, along with ragweed and grass,” he said. “It will be quite a trying time for the next few days.”

On the Northwest Side, where there is an abundance of paloverde trees, residents may also be suffering because the trees are blooming with a vengeance.

Dr. Martin Bartels, a Tucson allergist, said he has seen an increase in the number of patients coming in to complain of allergy symptoms.

“We’re just coming into the midst of it,” Bartels said. “Patients really do need to get ready.”

He said that the allergy season appears to be lasting longer each year and that wind aggravates symptoms, especially in those who are already asthmatic or have respiratory problems.

“You probably want to be seen before you become miserable,” Bartels advised. “The better way here is to be proactive and work on prevention and you will end up on less medication in the long run. You will feel better and miss less days of work.”

The worst may be yet to come.

During the last week of April in 2008, Sneller counted 700 pollen grains per cubic meter of air. During that week the temperature was in the 90s and mesquite, palo verde, olive and ragweed caused the most problems.

“I would take off your shoes before entering your house,” Sneller said then. “Most of that stuff gets in the house by being tracked in.”

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On the Web

University of Arizona pollen calendar

http://allergy.peds.arizona.edu/southwest/calendars.html

Schwartz

A Tucson eye doctor convicted of hiring a hit man to kill his former business partner has filed a $750,000 claim against the Arizona Department of Corrections.

Bradley Schwartz’s attorney, Brick Storts, said Schwartz was attacked four times by other inmates in a one-year period while being housed in the department’s Rincon Unit, 10000 S. Wilmot Road.

That latest attack on Sept. 27 sent Schwartz to a Phoenix hospital for more than a week. His injuries included fractured eye sockets that have left him blind in one eye and a broken nose, Storts said.

“He’s got very severe, permanent injuries,” Storts said.

The claim was filed Saturday. If the DOC doesn’t settle the claim within a year, Storts said, he will file a lawsuit.

Schwartz had been placed with the general population prisoners at Rincon, some of whom had a history of assaults, the claim letter states.

General population inmates generally share cells, have a set time to congregate outside and are able to interact with each other.

Storts had sent at least three letters to the director of the unit expressing concern about Schwartz’s safety and a lack of supervision at the time of the assaults.

Schwartz was attacked in an unmonitored corridor, Storts said.

When Schwartz was released from the Maricopa Medical Center, where he received care for his injuries, including plastic surgery, he was placed in a segregated unit in Florence, Storts said. The segregated unit provides more security and less interaction with other prisoners, he said.

The Department of Corrections refused to comment on the claim.

Storts also is asking DOC to look into the actions of a doctor at St. Mary’s Hospital who Storts said refused to treat Schwartz after the September attack and sent Schwartz to the hospital in Phoenix.

“The prison cannot tolerate such breaches by treating physicians; an independent investigation of this incident is required by your department,” Schwartz’s claim states.

Any settlement money would go to Schwartz’s family, Storts said.

Schwartz was convicted of conspiracy to commit murder in the stabbing death of Dr. Brian Stidham. Schwartz was sentenced to life in prison with parole possible after 25 years. Bruce Bigger, who was found guilty of killing Stidham, was sentenced to life in prison with no possibility of parole.

Shelden Andrew Pruitt

A teenager accused of killing his 14-year-old half sister will likely spend less than a decade in prison, following a plea deal agreed upon in court Wednesday.

Pima County Superior Court spokesman David Ricker said Shelden Andrew Pruitt, 16, who had been charged with second-degree murder, pleaded to one charge of negligent homicide and one charge of child abuse.

Ricker said Pruitt can get four to eight years in prison for negligent homicide and will likely face lifetime probation on the child abuse charge.

The plea was taken in the courtroom of Judge Frank Dawley, who Ricker said questioned both the defense and prosecution attorneys extensively over the reduced charges.

Ricker said the attorneys “discussed the plea with the family and the family had agreed to it.”

Pruitt was set to go to trial in April.

On July 26, 14-year-old Alexandria Salinas was killed by a single shot to the head.

Interviews with family members shortly after the shooting revealed that Pruitt was jealous of Salinas.

Pruitt, who grew up in Colorado, came to Tucson to live with his father, Roland Salinas and stepmother, Abby Wagner, about three weeks before the shooting.

He had never lived with his father before but had visited the summer before the killing.

Salinas said he agreed to take Pruitt in after Pruitt’s mother had threatened to turn him over to the Colorado foster care system, telling him she was giving up on taking care of him, according to Citizen archives.

Ricker said the child abuse charges stem from Pruitt pulling a gun on Salinas several times prior to shooting her.

Pruitt will be sentenced April 27.

Alexandria Salinas

Roubideaux

A University of Arizona educator has been nominated to be the director of the Indian Health Service by President Obama, the White House Press Office announced Monday.

Dr. Yvette Roubideaux is an assistant professor in the department of family and community medicine in the College of Medicine.

The Indian Health Service is a federal health program that is a part of the Department of Health and Human Services and oversees health care services for the native nations.

According to the White House statement, Roubideaux has conducted extensive research on American Indian health issues, with a focus on diabetes in American Indians/Alaska Natives and American Indian health policy.

She worked previously with the Indian Health Service as a medical officer and clinical director on the San Carlos Indian Reservation and in the Gila River Indian Community.

Roubideaux, 46, is a member of the Rosebud Sioux tribe.

UA said Roubideaux was not allowed to engage in interviews during the White House selection process. She would replace Robert G. McSwain.

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Indian Health Service

www.ihs.gov

A striped skunk is shown in this undated photo by the U.S. Fish and Wildlife Service.

Pima County has had more cases of rabid animals this year than any other county, while Arizona is on track to set a record for the second consecutive year.

The Arizona Department of Health Services said 59 animals tested positive for rabies statewide this year.

Of those, 21 were in Pima County. Cochise and Coconino counties each had 13 cases.

Last year, 176 cases of rabies in animals were confirmed. The previous record of 169 cases was set in 2005.

Rabies causes acute swelling of the brain and is always fatal to untreated humans.

This year, 35 skunks, 21 foxes, one bobcat, one ringtail and one horse have tested positive for rabies, DHS said. Those animals exposed seven people and 39 pets to the viral disease.

Fifteen of the rabid skunks and six of the infected foxes were in Pima County, Pima County Health Department spokeswoman Patti Woodcock said, warning “Stay away from foxes and skunks.”

Rabid skunks are much more aggressive this season than in the past, Woodcock said.

Traditionally, skunks infected by rabies have behaved friendly or cuddly, she said. This year, they have been “charging, growling, snapping.”

“The manifestation is very different than what we were seeing in the past,” Woodcock said.

Most of the rabid skunks have been found in the northeast corner of Saguaro National Park, although the animal is common on the outskirts of the metro area, she said.

Elisabeth Lawaczeck, state public health veterinarian with DHS, said skunks live near people because of the abundance of food, but will generally stay away from humans and domestic animals.

“They’re usually not very active in the middle of the day,” she said. “Being out during the day is a sign that they are not acting normally.”

Another indicator, Lawaczeck said, is rabid or sick skunks are more likely to attack dogs or chase or bite people.

During the last stage of their sickness, rabid skunks will wobble when they walk and fall down easily, she said.

Bats traditionally account for the greatest number of rabid animals in Arizona, accounting for 89 of last year’s 176 rabid animals.

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Who to call

If you believe you or your animal has been bit by a rabid animal, call Pima Animal Care at 243-9900.

The U.S. Department of Health and Human Services has designated $2.5 million in stimulus funding for Arizona’s hospitals, one week after the Arizona Legislature restored some funds for the state’s Medicaid program.

In February, the Legislature cut $13 million from Arizona Health Care Cost Containment System funds that helped compensate hospitals for the care of uninsured patients and close the gap between the cost of caring for AHCCCS patients and AHCCCS reimbursements. The cut cost the state $26 million in federal funding because the federal government provided $2 for every $1 the state spent.

In addition, the state eliminated $7 million in AHCCCS funds for graduate medical education, which would have cost the state $14 million in federal matching funds and was predicted to eliminate more than 100 residency positions statewide.

As part of the federal stimulus package, the federal match increased to $3 for every $1 the state contributed to help pay for health care for uninsured or AHCCCS patients, so called “disproportionate share” funds.

On March 12 the state Legislature restored $8.9 million in disproportionate share funds, giving hospitals a total of $35.6 million. The state also restored $5.5 million to graduate medical education, giving hospitals $16.5 million.

The additional money made available by Health and Human Services is for hospitals receiving disproportionate share funding and it is up to the Legislature to decide if it will be used, said Laurie Liles, senior vice president of public affairs for the Arizona Hospital and Healthcare Association.

She said Arizona would also need to appropriate about $830,000 in state matching funds to get the money.

University Medical Center’s chief financial officer Kevin Burns said the restoration of funds “certainly helps.”

He said the hospital has been under a hiring freeze since the budget cuts and has been making an effort to preserve jobs.

“The hospital is bracing for whatever cuts may come in the 2010 fiscal year, which starts in July, Burns said.

“It does put a lot of pressure on what we do when the state is possibly discussing further future cuts,” he said.

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On the Web

To see a complete list of the revised disproportionate share allotments that include additional funding provided through the Recovery Act, visit www.hhs.gov/recovery/cms/dshstates.html.

Corrected version: Corrects information about Mark Goldberg. Mark D. Goldberg of Mesa signed a consent agenda item, the contents of which were not disclosed. Dr. Mark C. Goldberg of Tucson has never been the subject of an Arizona Medical Board action.

Three Tucson cardiologists have agreed to pay $355,000 in a settlement with the U.S. Department of Justice of a case involving Medicare’s physician self-referral law.

Dr. Lee Goldberg said Wednesday that he and three members of the former business, Tucson Cardiovascular Imaging, reported themselves to the federal government after learning that their business was not in compliance.

The payment is part of a settlement between Dr. Richard A. Cohn, Dr. Timothy M. Marshall and Goldberg, and the Department of Justice, the Department of Health and Human Services and the Office of Inspector General. It was signed by all parties on March 5 and stated that the doctors had 15 days from that date to pay the full amount.

In November, Dr. Mark Goldberg, Lee Goldberg’s brother, agreed to pay the federal government $135,000 for the same reason. He settled separately from his three business partners.

Lee Goldberg said the group had legal counsel that helped set up a nuclear imaging business in 2006.

“All we wanted was to make sure it was legal,” Goldberg said.

He said the nuclear imaging machinery used to look for blocked arteries is too expensive for one private practice to run on its own. The four doctors joined together to open the business.

He said somebody “looked at our business model and advised that it wasn’t compliant. . . . We were advised to self-report ourselves to the government.”

Goldberg said the business was shut down shortly thereafter.

The settlement information released by the U.S. Attorney’s Office in Arizona did not include details of the business practices or the legal violations, other than to say that the doctors were in violation of physician self-referral laws, commonly referred to as the “Stark Law,” which resulted in false claims for payment to Medicare.

None of the doctors has been previously sanctioned by the Arizona Medical Board.

Board spokesman Roger Downey said the board will investigate the doctors. He said that the board could find that the doctors committed unprofessional conduct and, at a minimum, could issue letters of reprimand.

Lee Goldberg said he is not worried about a medical board investigation because he believes the doctors did not do anything wrong and were quick to report themselves when they learned they were not in compliance with federal regulations.

El Rio Community Health Center will host its annual Cover the Uninsured Fair on March 24.

The fair provides eligibility screenings for uninsured Pima County residents. Residents can meet with representatives of a variety of health-related agencies, including Susan G. Komen for the Cure and the American Lung Association of Arizona.

Some of those agencies are expected to provide limited health screenings. El Rio will also offer free healthy food with demonstrations on portion sizes.

The fair will be from 3 to 5 p.m. at the El Pueblo Neighborhood Center, 101 W. Irvington Road.

Pima County will receive more than $13 million of the tobacco tax funds collected since an 80-cents-a-pack tax increase in 2006.

The money will go to organizations and agencies that provide services to children up to age 5, with an emphasis on groups that provide family support services and child care assistance, said Diane Umstead, First Thing First’s regional manager for southeast Arizona.

First Things First is the state organization that will distribute the tobacco tax money.

The county is divided into three regional areas: north Pima, which covers the Avra Valley and the Catalina foothills; central Pima, which is mostly made up of metro Tucson; and south Pima, which includes Ajo and Vail. Each is headed up by an 11-person volunteer council.

Central Pima will receive the largest bulk, $7.6 million. North Pima will receive $1.7 million and south Pima will get $3.8 million.

The award was announced during a Monday meeting at Pima Community College.

Umstead said organizations and agencies that serve children within the regions are encouraged to submit grant applications. She said the funds will be distributed before June 30.

Because many agencies in the area have lost funding because of state budget cuts, Umstead said she expects those organizations will want to use the grants to supplement what was eliminated.

Umstead said funds will also be used to immediately help organizations in Pima County.

She said $500,000 has been set aside to buy food boxes for the Community Food Bank and other money will be used to help families pay for child care for parents who are going to school or looking for work.

Peg Harmon, vice chairwoman of the First Things First Central Pima Regional Partnership Council, said during the Monday meeting that the county has 81,749 children age 5 and under who could benefit from the First Things First funds.

“Thirteen million dollars in comprehensive services and programs for young children also translates into an economic stimulus for our local communities,” Harmon said.

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On the Web

First Things First

www.azftf.gov

South Pima Regional Partnership Council

www.azftf.gov/RC018/Pages/default.aspx

North Pima Regional Partnership Council

www.azftf.gov/RC016/Pages/default.aspx

Central Pima Partnership Council

www.azftf.gov/RC017/Pages/default.aspx

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How to apply

All grant applications must go through the Phoenix office. Grant information may be found online at www.azftf.gov/ WhatWeDo/Funding/Pages/ RegionalGrants.aspx.

Canadian caller poses as grandchild needing cash to avoid jail term

When 74-year-old Catherine Wood got the call that her 19-year-old grandson Brandon had been arrested, she panicked.

He needed $5,000 to avoid being put in a Canadian jail or else he would be considered absent without leave from the ship where he was stationed with the U.S. Marine Corps.

The problem – Brandon was safe and sound on his ship and Wood was becoming a victim of the “grandparent scam.”

According to the Pima County Sheriff’s Department at least five elderly people in the county, including Wood and 90-year-old Leslie Lawrence, have been victimized by the scam in the past three months.

The pretend Brandon used Wood’s fears and love for her grandson, while playing off of information she unwittingly fed him, to talk her into sending money to Canada, where he said he had been arrested for a hit- and-run accident.

It was the money-transfer employee at Wal-Mart who told Wood’s husband that she didn’t feel right about sending the money, as the situation felt like a scam.

After some calls to police in Ontario, to the Marines and to her daughter, Wood was able to determine that her grandson wasn’t in Canada, although because of his deployment she couldn’t contact him directly.

Lawrence said the scammer who called him actually used his grandson’s name, Eric, when he started the phone call, which confused him.

“This kid, young fellow, was desperate,” Lawrence said. “I said your voice don’t sound right and he said ‘Well I’ve been drinking and I’m stressed.’ ”

Lawrence’s grandson works at the University of Phoenix in Maricopa County and Lawrence said he didn’t think he could be in Canada, but the desperation in the caller’s voice kept him on the line.

A “corrections officer” also got on the line and told Lawrence that his grandson had failed a sobriety test and drugs were found in the car. If the grandfather sent $2,000, the grandson wouldn’t have to stay in jail and could go home.

“He really played up ‘Don’t tell mom because I’m so embarrassed,’ ” Lawrence said. “He put it over pretty good.”

When Lawrence got off the phone, he called the real Eric’s office number and was able to track Eric down at his desk.

He said there were signs during the conversation that something was amiss, such as the caller calling him “grandfather” instead of “poppa” and not sounding like his grandson.

The scammers called Lawrence and Wood several times. One time to say they were in trouble, another time so the grandparent could talk to a corrections officer or lawyer and a third time to give an address where money needed to be sent.

When the third call came, Wood was ready. She told the scammer that the Marines were going to pay his fine and that she had a number for him to call.

“I said they are going to send the money and he hung up,” she said.

Anne Hilby, spokeswoman for the Arizona Attorney General’s Office, said the grandparent scam has been around for about five years, but has recently resurfaced in Arizona.

She advised seniors to joke around with someone who says, “It’s your favorite grandson” by asking, “Which one?” or to establish a secret code with family members that can help the victim from being scammed.

Those who believe they have been a victim of such a scam are encouraged to call the Attorney General’s Office in Tucson at 628-6504.

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Grandparent scams reported to the Pima County Sheriff’s Department

Dec. 10, 2008

Male victim received a phone call from a male pretending to be his grandson. The “grandson” said he had been involved in a collision and needed money sent to Boston, Mass. The victim sent $2,500 and then later contacted family members who advised him that he had been scammed.

Dec. 19, 2008

Male victim received a phone call from a female who identified herself as his granddaughter. The female said she had gotten into an accident and needed $2,000 to repair her vehicle in Denver. The victim sent $2,000, but later learned he had been scammed.

Feb. 25

Female victim received a call from a male who told her he was her grandson, Nathaniel. He said he had an accident in California and needed money to return home to New Mexico. The victim sent the caller, who knew personal information about her family, $2,500. The victim later learned her grandson had been working in New Mexico and was not in an accident.

March 2

Male victim Leslie Lawrence received a call from a male from Canada claiming to be his grandson, Eric. The male told the victim he was stopped by the police in Canada and that there were drugs in the vehicle. The caller asked for $2,000. Lawrence did not believe the caller was his grandson and contacted his family members who told the victim to contact law enforcement.

March 11

Female victim received a phone call from a male subject who was calling her grandma. The caller told the victim he had gotten in trouble in Canada and his car had been impounded. The caller said he needed $3,200 sent to him. The victim believed the call to be a scam and reported the information to law enforcement.

Source: Pima County Sheriff’s Department

Dannik Batiste, 8, stands in his classroom on Wednesday at Oyama Elementary School. He will be honored by the Tucson Fire Department on Thursday for saving his family after a fire started in the kitchen of its home.

Jesse Lesnewski and Dannik Batiste aren’t superheroes who can fly or bend steel, but they do know how to help in an emergency.

The two 8-year-olds are receiving hero awards Thursday. Jesse’s award is being presented by Northwest Fire Department for her quick thinking in helping her diabetic brother, Roy, 10.

Dannik will receive his from the Tucson Fire Department for rescuing his little brothers from a kitchen fire.

Jesse

When Jesse woke up Feb. 27, her brother, Roy, asked her if he had a diabetic kit.

“He knows he has a diabetic kit to keep all his things in,” she said. “I said, ‘Of course you have one.’”

The questioned worried Jesse.

“I looked at his coloring and it was way worse than the other colors that he has,” she said Wednesday.

Jesse, a second-grader at Twin Peaks Elementary School, 7995 W. Twin Peaks Road, got Roy a soda, but he only drank a little. She tried to spoon feed him chocolate syrup, but most of it got all over the bed. She tried to take his blood sugar, but he wouldn’t let her.

“I was really scared,” she said. “He was telling me, ‘Leave me alone, I don’t want you here.’ He didn’t know who his family was, who he was.”

She realized she needed more help and woke up her father, John Lesnewski.

“She woke me up and said, ‘Daddy, call 911, I woke up and tried to get Ruvie (Roy’s nickname) up and he’s not waking up, he has low blood sugar,’” Lesnewski said.

Lesnewski said he quickly checked on his son, who wasn’t cooperative and wasn’t acting like himself. He was able to check Roy’s blood sugar level, which was 28. The goal, Lesnewski said, is to have the level at 80-120 when his son wakes up in the morning.

Jesse waited outside for the paramedics, while holding her teddy bear. By the time they arrived three to four minutes later, Roy was alert and, when tested, his blood sugar level was 117.

“They asked what I did. I said ‘I didn’t do anything. My daughter did,’” Lesnewski said.

“I thought that was pretty brave because she’s never really done that before,” said Roy, who is in fifth grade at Twin Peaks.

Roy said he has been a diabetic for about a year.

Dannik

On March 8, when Dannik smelled smoke coming from his kitchen, he knew exactly what to do.

As part of his third-grade curriculum at Oyama Elementary School, 2700 S. La Cholla Blvd., he participated in Tucson Fire Department’s Adopt-a-School program, which teaches fire safety.

The program includes a practice simulation where students have to evacuate a smokey house, which is set up in the department’s Fire Safety Trailer.

On March 8, Dannik first yelled for his dad, who was taking a shower.

“I called my dad, but he didn’t hear me,” Dannik said. “I told my brothers to get out of the house.”

Dannik carried his 1-year-old brother, Demarco, while holding the hand of his 3-year-old brother, Deangelo.

Once outside he flagged down a car and got someone to call 911. He also got an adult to go in and get his dad.

When firefighters arrived, they were able to contain most of the damage to the kitchen. The fire started when a pizza box, left on the stove top, got hot.

“Dannik is a perfect example of why education/prevention is so vital to our community,” said Mandy Hart, the public education specialist who taught Dannik’s class. “I was thrilled to hear that a student knew exactly what to do.”

Jesse Lesnewski, 8, poses with her brother Roy, 10, on Wednesday at their house in Marana. Jesse will be honored by the Northwest Fire/Rescue District for saving her brother during a diabetic crisis.

Several sites across Tucson will be providing free rapid HIV testing from now until March 20.

All of the locations are offering the OraQuick ADVANCE rapid HIV test as part of National Women and Girls HIV/AID Awareness Day, on March 10, and National Native HIV/AIDS Awareness Day, on March 20. The test uses an oral swab and results are available in 20 minutes.

Free testing is available at the following locations and times:

• Tuesday: 1-4 p.m., Quincie Douglas Neighborhood Center, 1575 E. 36th St.

• Wednesday: 10 a.m. to 3 p.m. Armory Park Senior Center, 220 S. Fifth Ave.

• Friday: 9 a.m. to 3 p.m., El Pueblo Neighborhood Clinic, 101 W. Irvington Road

• Saturday: 10 a.m. to 4 p.m., Wingspan, 425 E. Seventh St.

• March 17: 9 a.m. to 1 p.m. Archer Neighborhood Center, 1665 S. La Cholla Blvd.

• March 18: 10 a.m. to 3 p.m. Northwest Neighborhood Center, 2160 N. Sixth Ave.

AHCCCS changes choke off key funds, CEOs say

Resident physicians Dr. John Clement Biboa (left), Dr. Lokesh K. Jha and Dr. Sachin Chaudhary work on cases at University Physicians Hospital.

Legislative budget cuts this fiscal year to the state’s health-care system for the poor could raise insurance premiums for the rest of us, slow or stop plans for hospital expansions or improvements, and worsen the state’s doctor shortage, administrators say.

Hospitals in the state are reeling after the Arizona Legislature cut funds last month to the Arizona Health Care Cost Containment System by:

• Eliminating $13 million in state money that compensated hospitals for the care of a large number of uninsured patients and that helped close the gap between AHCCCS’s reimbursements and the costs of caring for AHCCCS patients.

These “disproportionate share” funds became even more crucial after AHCCCS reimbursements were frozen in October even as health care costs and the number of AHCCCS patients continued to climb.

• Reducing graduate medical education funding by $7 million, which will cost the state an additional $14 million in federal matching funds and could cause elimination of more than 100 residency positions statewide.

Jim Haynes, chief financial officer for the Arizona Hospital and Healthcare Association, said he has heard the Legislature is considering reducing the AHCCCS reimbursement by 5 percent for fiscal year 2010, which begins July 1.

“I think we live in fear of next year,” said Larry Aldrich, CEO of University Physicians Healthcare, which manages University Physicians Hospital on East Ajo Way and whose physician members also staff University Medical Center.

In the meantime, hospital administrators are trying to figure out how to live without the millions of dollars in anticipated funding that was cut from this year’s budget.

“Like most hospitals, we already lose money providing care for AHCCCS patients,” said Jean Tkachyk, chief financial officer for University Physicians Hospital.

AHCCCS pays hospitals set amounts for medical procedures and services, and hospitals receive on average about 80 cents for every dollar spent on an AHCCCS patient. However, the reimbursement freeze, combined with increased costs, has brought that average down to about 77 cents for every dollar spent, UMC chief financial officer Kevin Burns said.

The AHCCCS reimbursement freeze is costing UMC more than $3.5 million this year, on top of the loss incurred because the reimbursement falls short of the cost.

At Tucson Medical Center, the reimbursement freeze, combined with the reduction in disproportionate share payments will have at least a $4.5 million impact on this year’s budget, said spokeswoman Julia Strange.

“As a nonprofit hospital, we operate at a pretty narrow margin to begin with,” she said. “When we don’t receive the revenues that we expect at whatever level, that can make a pretty profound impact.”

In addition, the number of AHCCCS patients is increasing. AHCCCS patients in Pima County increased by 8 percent in 2008. Burns at UMC said that he anticipates that number will continue to climb as laid-off workers use up their severance packages and employer-offered health benefits.

Tucson has lost nearly 10,000 jobs in the last year.

In 1999 hospitals that treated a large percentage of AHCCCS and uninsured patients began to receive disproportionate share funds from the state.

In fiscal year 2008, Carondelet Health Network received a little more than $1 million for its three hospitals – St. Joseph’s and St. Mary’s in Tucson and Holy Cross in Nogales – while UMC received about $1.5 million. Hospitals traditionally receive that money in a lump sum on the last day of the fiscal year, June 30.

“That is a direct cut,” Bill Pike, Carondelet’s director of public policy, said of the Legislature’s elimination of disproportionate share funds. “We are seeing more people who are uninsured, either because employers are cutting back on coverage and certainly with people being out of work.”

People with health insurance may end up indirectly paying for those patients.

“Hospitals will attempt to shift as much of that shortfall to private-paying patients,” said John Rivers, CEO of the Arizona Hospital and Healthcare Association. “They will see their premiums go up much more than expected.”

According to an association survey released last month, 59 percent of Arizona hospitals said there were plans to shift health-care costs to private insurance companies.

But Burns of UMC said the option of passing on the costs to insurance companies is not feasible in the current economic climate.

“Right now, when you have high unemployment, the likelihood of being able to shift that shortfall to insurers – that window is closed to me,” he said. “We’re forecasting we’ll see an increase in (AHCCCS) and an increase in the uninsured, who for a time don’t have coverage from their employer.”

Before the federal economic stimulus was passed, hospital administrators had hoped that it would compensate for some of the state’s cuts. Instead, the stimulus may have just prevented even deeper cuts.

Monica Coury, assistant director of the office of intergovernmental regulations at AHCCCS, said the 2009 budget cuts approved in February, which eliminated $500 million from social services (including the Department of Economic Security and AHCCCS), had already taken into account the estimated $500 million coming from the federal stimulus, also approved in February.

“They settled on $500 million, so it’s kind of a wash,” she said. “Without the stimulus, they would have had to cut $500 million more.”

The hospital association survey found that 45 percent of hospitals in Arizona instituted a hiring freeze in the third quarter of 2008. In January, Burns said UMC had not imposed a hiring freeze, but that had changed by March.

“Our goal is to not have any layoffs at UMC,” Burns said. “We will fight hard to protect our staff. However, you never know what can transpire.”

Strange said TMC is under a “hiring chill.”

“We do have jobs that are posted, but each one of those positions are carefully looked at,” she said

The survey also found that:

• 74 percent of participating hospitals were postponing construction and renovation projects.

• 74 percent were delaying the purchase of clinical equipment.

• 52 percent were suspending information technology improvements.

• 71 percent estimated their capital projects will be delayed for more than a year.

“We are cutting everything you can cut and delaying investments,” said Tkachyk.

Both Aldrich and Burns believe the cuts to health care will end up causing damage to Arizona’s economy.

“Health care can help keep the economy going,” Burns said. “We buy a lot of expensive, high-end equipment. The more they (the state) dampen our flow, that trickles down to the rest of the economy.”

All of Pima County hospitals reported their patient totals have stayed stable or increased over the last year.

University Physicians Hospital’s interim CEO, Peter Bryan, said cutting graduate medical education funding will hurt patients and Arizona’s economy in the long run.

“For every graduate you generate $1.3 million for the community,” he said.

The federal government has given hospitals $2 for every $1 given by the state. Cutting $7 million cost Arizona hospitals $21 million in graduate medical education funding through the end of the year. Rivers estimates that cut will eliminate 112 residency positions a year.

However, the federal stimulus increased the match from $2 to $3. During a hearing Wednesday, members of the Arizona Senate’s Healthcare and Medical Liability Reform Committee learned that if the Legislature restored only $5.5 million in graduate medical education funds, Arizona hospitals would not lose any federal funding. The Legislature has until June 30 to restore funding to programs that receive a federal match.

Tkachyk said current residents won’t be affected by the 2009 cut because hospitals make a commitment to each student. Students planning to start Arizona residencies during 2010 will be affected.

“There’s a shortage of physicians currently in Arizona,” Strange of TMC said. “Funding of graduate medical education is clearly the best path to easing that shortage. The long-term impact is we will have an even greater physician shortage.”

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ENROLLMENT

Pima County AHCCCS enrollment figures

Dec. 2008: 184,260

Dec. 2007: 174,262

Dec. 2006: 166,790

Dec. 2005: 168,419

Dec. 2004: 168,505

Dec. 2003: 153,300

Source: Arizona Health Care Cost Containment System

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DISPROPORTIONATE SHARE FUNDING

In February, the state Legislature eliminated disproportionate share money given to hospitals that take care of a large percentage of uninsured and self-pay patients. Several Pima County hospitals have been receiving this funding since 1999 and budget for it each year.

Hospital 2004 2005 2006 2007 2008

UMC $2M $1.1M $1.5M $1.3M $1.5M

TMC $1.5M $1.2M $1.2M $1.1M $1M

University Physicians $0 $868,279 $0 $2.1M $470,873

Northwest Hospital $53,765 $113,101 $144,516 $103,013 $256,324

St. Joseph’s Hospital $71,0393 $73,986 $96,033 $72,230 $172,376

St. Mary’s Hospital $315,332 $205,682 $178,383 $163,412 $636,464

Source: Arizona Hospital and Healthcare Association.

* Neither Tucson Heart Hospital nor Northwest Hospital at Oro Valley received disproportionate share money.

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BREAKING DOWN THE CUTS

How cuts will affect University Medical Center and Tucson Medical Center:

UMC

AHCCCS reimbursement freeze will eliminate $3.5 million from the 2009 budget.

The elimination of disproportionate share funding will reduce the budget by at least $1.5 million.

A reduction in graduate medical education funding will take away $3.7 million.

TMC

AHCCCS reimbursement freeze will eliminate $2.5 million from the 2009 budget.

The elimination of disproportionate share funding will reduce the budget by at least $1 million.

A reduction in graduate medical education funding will take away $1 million.