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Currents We continue to closely monitor the state budget bill in the state General Assembly as it relates to Medicaid funding. As previously communicated in Currents, the budget passed by the House of Representatives would result in a loss in state Medicaid match funds, which would have a substantial impact on MUSC.  The state Senate is now deliberating the budget bill.   Most recently, the Health Subcommittee of the Senate Finance Committee, chaired by former MUSC Board member, Senator Verne Smith, approved a 22-cent increase in state cigarette tax to provide an ongoing source of revenue for the Medicaid program. The full Senate Finance Committee will soon consider the cigarette tax.   If the Senate does not restore cuts approved by the House, the state’s total loss of Medicaid funds will be approximately $81 million in state dollars and $188 million in federal funds for a total loss of $269 million. The cuts would amount to approximately $22 million to MUSC. Our Children’s Hospital, Transplant Services and Emergency Services would be particularly hard hit.   The South Carolina Hospital Association, the governing boards of hospitals throughout the state, including the MUSC Board and other health care interest groups have been working diligently to gain support for Medicaid funding. Most recently, MUSC President Ray Greenberg wrote an article for The Post and Courier urging support for the cigarette tax.   While the Medicaid funding outlook is not good, there is reason for encouragement. South Carolina’s cigarette tax is the third lowest in the nation at 7 cents.  According to the State Budget and Control Board, each one-cent increase in cigarette tax will generate $4 million in revenue.   The results of a Medicaid cigarette tax survey are expected to be released very soon. Reportedly, the random survey, conducted by a professional firm, has indicated overwhelming support by the general public for a cigarette tax to address the Medicaid funding needs.   We are hopeful that the outlook for restoring Medicaid funds improves. It will likely be late May before this issue is fully resolved. This issue is perhaps the most visible state budget matter that will be played out in the media over the next month. We continue to hope for the best, while preparing for the worst.   Thank you very much. W. Stuart Smith Vice President for Clinical Operations and Executive Director, MUSC Medical Center   Medical Center is one of SC’s top ‘Job Creators’ MUSC Medical Center was recognized this month as one of South Carolina’s top “Job Creators” for 2001, one of 45 recipients to be recognized.   Recipients were selected by a committee comprised of members from various state agencies and our local  Workforce Investment Area board, according to Helena Bastian, director of Human Resources, who made the announcement at the April 9 communications meeting.   The Medical Center was nominated for its Clinical Associate Apprenticeship (CAA) program.  The program, established in March 2001, provides participants with both educational and clinical training as well as employment opportunities.  According to Bastian, 61 clinical associates were hired through the program in 2001.   Accepting the award from Gov. Jim Hodges on behalf of the Medical Center was Hermenia Mosley, Medical Center Human Resources recruiter, and Janice Rhodes, R.N., Education Project Nurse/CAA program manager.    The CAA program is coordinated by the Medical Center Office of Human Resources and Clinical Services Education. Rhodes coordinates the clinical aspect and Mosley coordinates the employment side.   “I am very pleased this program was recognized,” Bastian said. “It provides important training for our workforce which is a benefit to the community, the state, the Medical Center and the individual.” MUSC Patient Safety Program continues to develop Everyone has a role in patient safety —from employees and physicians, to managers, administrators, patients and family members, said Rosemary Ellis, director of Quality for the Medical Center.   Ellis, who is a regular presenter at communications meetings, is working to reinforce the message regarding employee responsibility relating to patient safety. “It’s your responsibility to report, educate and comply with policies and procedures relating to safety,” Ellis said. “You are required to report occurrences and near misses.”   Examples of near misses: A nurse almost gives the wrong amount of insulin, but double-checks to clarify that the “U” was being read as “O.” Housekeeping finds a bottle of cleaner left in the shower stall on a closed inpatient psychiatric facility.   Employee responsibility regarding patient safety includes reporting all occurrences and patient safety concerns to Risk Management at 792-8830. All environmental safety concerns should be reported to Environment of Care at 792-5176.   “Reports can be made anonymously, however, you are encouraged to identify yourself in case additional information is needed and so you can be contacted regarding findings,” Ellis said.    The major components of the MUSC Patient Safety Program include: Non-punitive reporting system Easily understood safety principles and human performance principles Training at orientation and on an ongoing basis Process redesign Proactive stance rather than reactive  The program also works to make devices as fail-safe as possible including automatic shut off heating devices, circuit breakers, ready-to-administer medications and over-write protected computer disks. Also, patients should be encouraged to be active partners in their own care. “An educated patient is a good thing,” Ellis said.   Ellis encouraged employees to think of other mistake-proofing techniques and share ideas with her office. PI and Patient Safety Information can be found on the Quality Network Web page at http://www.musc.edu/qn. Big brothers, big sisters needed Big Brothers Big Sisters of Carolina Youth Development is in need of volunteers willing to serve as friends and role models to Lowcountry children.   Lisa Robinson, director of the program, appealed to MUSC employees to “make a difference in a child’s life” by becoming a big sister or big brother. She said currently some 150 children in Berkeley, Dorchester and Charleston counties are waiting to be matched.   The program has proven results. Studies show that children who are matched are eight times less likely to be arrested and 50 percent less likely to use drugs. They are more likely to earn better grades and stay in school longer. They also get along better at home and with their peers.   Robinson thanked those in the audience who have served as a big brother or big sister, including Dave Neff, administrator for Ambulatory Care Services, who introduced Robinson.   “The main thing,” Robinson said, “is you have to have a good heart.”   Since 1979, Big Brothers Big Sisters of Carolina Youth Development, an affiliate of Big Brothers Big Sisters of America, has provided services to more than 5,000 children in the Charleston area.    For more information, contact Johnson at 266-5233. Psychiatry announces new hires, positions  Representatives from the Institute of Psychiatry (IOP) introduced two new nurse managers at the April 9 communications meeting.   Harriet Cooney, Youth Services and CDAP director, introduced Debra Davis, R.N., MSN, R.N., CFNP, as the new CDAP Services manager. Davis has been with the IOP since June 1993. She has been interim manager of CDAP Services since November 2001.   Linda Lewis, Psychiatry Access Center director, introduced Andy Atkinson as the new adult services nurse manager. Atkinson began his nursing career at the IOP on 2 North in 1995 and in 1997 became the program coordinator for the highly successful youth outpatient and partial program. He is also currently pursuing a double master’s degree in health administration and health sciences/health information administration.