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March 31
Need for more nurses growing around Valley, across nation

Yakima Herald Republic
Published March 31, 2015
By: Molly Rosbach

​Click here to view YHR article and video.​

Wit
h improved access to health care, the increasing number of aging baby boomers and retirements in the medical community, industry experts are projecting a nursing shortage that could see the United States needing anywhere from 200,000 to 1 million nurses by 2020.

The Yakima Valley’s three nursing programs are doing their best to combat that.

“The beauty of us having the nursing programs that we have in this community” — at Heritage University, Yakima Valley Community College and Washington State University — “is that people tend to stay local,” said Veronica Knudson, CEO of Yakima Regional Medical and Cardiac Center, who worked as a nurse herself for many years.

“Most people like to stay where they grew up and where they have family and friends,” she said. “If we can educate them in the same community, they’re more likely to stay here and work, and that’s really what we want: We want our staff taking care of their friends and neighbors.”

The path to nursing takes many forms. Two- and four-year degree programs, followed by nursing board exams, both turn out registered nurses (RNs), while shorter practical nursing programs, followed by a licensing exam, turn out licensed practical nurses (LPNs). Post-bachelor’s nurse practitioner programs can be at either the master’s or doctoral degree level.

Between YVCC, WSU and Heritage, the Yakima Valley’s got it all.

“The bottom line for me is, in these tough economic times, we really promote the fact that we home-grow our students and graduates, and they get jobs mostly in the Yakima area,” said Rhonda Taylor, longtime director of YVCC’s nursing program, which has about 145 students enrolled.

While students can come to YVCC, WSU or Heritage from outside the Yakima area, all three schools share the goal of producing local nurses specifically trained to address the health disparities of the Yakima community, where income and education levels directly impact access to health care.

“There is an understanding among nurse leaders around the nation that the best way to do that, instead of talking about cultural competence, is to actually change the workforce so that we include people from the communities and families that they will be competent to serve,” said Christina Nyirati, director of Heritage’s nursing program and a nurse practitioner.

Nursing programs here are diverse, reflecting the community. At YVCC, for example, Taylor said the majority of students in the latest class are people of color, about 70 percent. Cultural competence is a major part of the program.

“It’s threaded in our curriculum,” Taylor said. “Definitely with the understanding of how important it is to teach our students about, not just how to care for patients, but how to care for patients’ families and for communities.”

That bird’s-eye view of health care, looking at family units and community health as critical factors in individual health outcomes, ties in with the broader shift in health care toward preventive care and population health — which should reduce cost over time.

“I’m hoping because our graduates will have an impact on community health and preventing problems, and also at clinical reasoning, that fewer people will have to be rehospitalized, and also people will be able to go home sooner,” Nyirati said.

Heritage’s program will have eight to 12 students when it starts this fall, and will only grow to 20 or 24 in the next few years, she said.

WSU’s program admits 24 students per semester, for about a hundred undergrads at any one time, said nursing co-director Sandy Carollo. YVCC and WSU are also entering into a direct transfer agreement to enable RNs with associate degrees to get their BSN in just one year.

The nursing programs do regular outreach to area high schools to tell students about career opportunities, as well as to nurses already working in the community.

WSU has a grant to connect high school students with nursing mentors who follow them through high school and community college, and another to help practicing RNs go back and get their four-year degree. The RN grant covers about half the cost of tuition, plus books. Another grant provides some tuition help for RNs working in the community who want to go back and get their nurse practitioner degree.

The different programs are collaborative, not competitive, said WSU co-director Laura Hahn.

“I think there’s more than enough students,” she said. “Twenty years ago, it might’ve been a little different, but there’s such a need for nurses now that we’re turning applicants away.”

The programs are also all engaged with Pacific Northwest University of Health Sciences in developing interprofessional education, aiming to graduate students across many medical disciplines who are equipped to work in teams. WSU’s pharmacy school, which operates at PNWU, is involved, too.

“We’ve come together; we’re all sitting at the table together, and we’re working to meet the needs of the community,” by improving costs, overall health and access to care, Carollo said.

The biggest challenge in the Yakima area, nursing programs agree, is the limited number of clinical training spots for nursing students.

“We struggle because the hospitals are our primary partners, and they are training nursing students and all different kinds of students — medical students, physician assistants, nurse practitioners, phlebotomists, EMTs, paramedics — the list just goes on and on,” Taylor said. “The hospitals and the nurses are saying, ‘Enough! We just can’t take another student.’ ”

“You can’t grow a program if you can’t place them in good clinical sites,” she continued. “There’s no way.”

Taylor said she endorsed Heritage’s new BSN program, but with the caveat that it not add any more net nursing students to the existing number of training spots.

Nursing students do clinical rotations in nursing homes and primary care clinics, as well, but those don’t provide the high-acuity, hands-on experience students need to become competent in the fast-changing job.

Part of the demand on nurses comes from a shift to more outpatient care for conditions like diabetes, Hahn said.

“Fifteen years ago, they went to see a specialist if they were diabetic; now we have family physicians and nurse practitioners that are dealing with those issues in a community clinic,” she said. Complications from hypertension, obesity, cardiac disease and mental health issues are also commonly seen in primary care clinics.

Nursing’s other main tension right now is between two-year and four-year degree programs. At the national level, many in the nursing field are calling for the BSN to be the standard entry level for nursing, and for the profession to move away from two-year associate degrees, even though RNs all have to pass the same board exams and can carry out all the same nursing duties. Both sides of the debate feel strongly about their respective degree tracks.

But that push, combined with increasing complexity in medicine, is why Heritage is starting a BSN program, Nyirati said.

“We believed that having a baccalaureate program here would better fulfill the mission and vision of the university, for preparing nurses with a strong liberal arts background who could focus their nursing care, in addition to taking care of the individual, on the family and the community as the units of care,” she said.​

March 30
Challenges are plenty for updating a 40-year-old medical code system - from 13,000 to 68,000

​Yakima Herald Republic
March 30, 2015
By Molly Rosbach

Click here to view YHR article.​

Say you find yourself in a spacecraft, and all of a sudden, you crash and hurt yourself.

In ICD-10, there’s a code for that.

ICD-10 — the International Statistical Classification of Diseases and Related Health Problems, version 10 — is scheduled to be the new national standard for medical coding come Oct. 1, six months from now, as mandated by the Centers for Medicare and Medicaid Services, or CMS.

Medical coding is the system by which medical providers document patients’ various illnesses and injuries, and which allows them to bill specifically for office visits and procedures. Without accurate coding, they don’t receive reimbursement from Medicare or Medicaid or private insurers. Theoretically, the more detailed and specific the coding, the more providers will be properly reimbursed for patient services.

“The people who pay for health care want to be sure you’re doing the right thing, for the right reason, at the right time,” said Dr. Carl Olden, chief medical information officer at Yakima Valley Memorial Hospital and a primary care physician. “You have to tell the story in more detail. We don’t want the CliffsNotes; we actually want the novel.”

The existing coding system, ICD-9, has been in place since 1975 and contains 13,000 diagnostic billing codes.

ICD-10, adopted by many countries worldwide in the 1990s, has 68,000, more than five times as many — and that’s not counting procedure codes, for the treatment side. So obviously, it includes a lot of codes that aren’t available in ICD-9, and providers and payers alike are feeling anxious about the transition.

“It’s going to be rocky,” Olden said. “It really is an entirely different system,” with alpha-numeric codes up to seven digits long, compared to three- to five-digit codes in ICD-9.

(The Healthcare Dive, an online publication, last year posted a list of the “16 most absurd ICD-10 codes,” including, but not limited to, “Struck by duck,” “Burn due to water-skies on fire,” and “Walked into lamppost.” These are real codes.)

While the volume of codes is daunting, ICD-10 is meant to improve medical documentation and, in the long run, allow providers and payers to have a more comprehensive understanding of population health, which should in turn lead to more preventive health care and reimbursement based on providers’ ability to keep patients healthy.

Industry urges caution

ICD-10 has been delayed several times since it was first mandated by CMS in January 2009, prior to and separate from the Affordable Care Act. Most recently, it was postponed for a year last March, to 2015.

Another delay is still possible, but providers here say the October date looks solid and they’re proceeding under the assumption that Oct. 1 will be go-live day.

In fact, many local providers have been preparing and training for ICD-10 for the past few years, regardless of recurring delays.

“We’re ready to go with it,” said Dr. Mike Maples, CEO at Community Health of Central Washington. “Our concern is that the people to whom we transmit that information are not going to be ready to deal with it.”

Industry consultants are urging clinics and hospitals to build up cash reserves or lines of credit so they can sustain their practice for up to six months, in case the payers or other vendors don’t sort out their end in time.

The fear is that if providers like Community Health start billing an insurance company using ICD-10 codes, but the insurer isn’t prepared to process claims with the new codes, it will block the cash flow of reimbursement back to the provider.

A March 4 letter to CMS from the American Medical Association and 99 other groups expressed concern that recent testing showed the claims acceptance rate in Medicare would fall from 97 percent to 81 percent if ICD-10 were implemented today. The AMA has long opposed the transition to ICD-10.

“Those revenues are crucially important to supporting hospitals” and other providers, said Bob Perna, policy director at the Washington State Medical Association. “If you can’t get those to function in the near term, you could see some serious cash crunches in the provider community.”

Other anticipated costs from the new system include some lost productivity as providers struggle to incorporate the new codes into their everyday practice; lost reimbursement if they code incorrectly; and software upgrades to keep the program functioning over time.

Individual organizations’ electronic health records systems will play a big part in how easily providers make the transition; some will prove better than others at generating shortcuts or suggesting codes based on the provider’s notes, experts say.

Practice, practice, practice

At Community Health, Maples said, providers are already coding in ICD-10, with ICD-9 mirrored in the electronic health records system so the codes will automatically transition in October.

Memorial is dual-coding as well, and testing by sending ICD-10 codes to payers able to accept them, vice president and chief information officer Jeff Yamada said. Training started in earnest in January 2014. Memorial will hire extra staff to help with coding during the transition, he said, but it plans to be fully prepared for the switch.

Perna said WSMA has been holding work groups with providers and insurers to do “as much pre-planning and problem-avoidance issues as we can.”

Yakima Valley Community College’s Medical Billing and Coding program has been teaching ICD-10 alongside ICD-9 since 2012, instructor Sandy Erlewine said, and will probably continue teaching ICD-9 at least through next spring so students can still learn to handle older claims that haven’t been processed by the Oct. 1 changeover date.

The school’s Allied Health Center of Excellence offered discounted online workshops on ICD-10 in 2013 and 2014 to community members, aiming to provide the local health care workforce with more resources to prepare for the new system.

“I would say that they are in high demand,” Erlewine said, adding that the demand for certified medical coders will only grow as baby boomers age and require more health care.

Perna said small providers might face more challenges in adapting to the new system than bigger organizations, like hospitals or community clinics, that have more resources to dedicate solely to coding and billing, as well as to analyzing the vast amounts of new data they’ll have on patient populations.

However, he said, smaller offices should also have a more limited scope of codes that they’ll need for patients, whereas hospitals or multi-specialty clinics will have to be familiar with a wide range of codes.

A lot of the buzz around ICD-10 has been negative, doomsday forecasting, as providers brace for the vastly more complicated system. It’s hard to see the benefits, experts say, especially when the medical community is already weighed down with documentation requirements for things like electronic health records and patient-centered medical homes.

“I think in the future-future, it will be transformative; I think right now, everybody views it just as another change,” Yamada said. “Us that are kind of more in the industry, we can see the gradual evolution and steps moving forward, but no one has really communicated well what’s the bigger picture of this moving forward.”​

March 29
WSU coaching legend Brayton dies at 89

​Yakima Herald Republic
Published March 29, 2015
By: Roger Underwood

Click here to view YHR article.

YAKIMA, Wash. — You should have seen the look on Mel Stottlemyre’s face.

The former New York Yankees pitcher and coach, in Yakima for a Parker Youth & Sports Foundation event in 2006, had just seen Bobo Brayton enter the room. Stottlemyre hurried through a crowd, hugged Brayton, then held each of his former coach’s shoulders while looking at Brayton’s beaming countenance with sheer, unadulterated joy.

That’s the way it no doubt was for countless Washington State Cougars and others who had played for, coached with or otherwise knew the college baseball coaching legend, who died early Saturday.

He was 89.

“Bobo,” Stottlemyre said in a telephone interview, “was loved by everybody. He had a way about him. Once you knew Bobo, it’s like you’d known him all your life.”

Stottlemyre, though never a Cougar, had been a Yakima Valley College Indian with Brayton as his coach. It was here, after all, that Frederick Charles Brayton began his Hall of Fame career.

Brayton was hired at YVC in 1950 and led the baseball program through 11 years and 10 league championships before succeeding Buck Bailey at WSU in 1961.

There he coached for 33 years, and Yakima Valley products Bob Garretson Jr., Manny Perez, Dave Edler were among his players.

“I think all of us who played for him, we were all very close,” Edler, a Yakima minister, said Saturday. “It was an honor to have played for him.”

Or to have been a teammate and friend, as Tom Parry had been at Washington State before embarking on his own career as a football coach at Central Washington University and Yakima Valley Community College.

“What a guy,” said Parry, who played football with Brayton in 1947 for coach Phil Sarboe. “High energy, no BS. Tough as nails, played linebacker and fullback for us, and I was very fortunate to get to know Bobo and realize what a wonderful damned guy he was.”

Consider, then, Bill Faller, who succeeded Brayton as Yakima Valley’s baseball coach. Faller had known Brayton since the two played youth baseball together in Mount Vernon.

And unlike most, Faller affectionately referred to Brayton as “Charlie.” Brayton, meanwhile, called Faller “Willie.”

“With Charlie, he was able to go, go, go, and then he’d maybe sit down and rest his eyes for a little bit,” Faller said. “When I replaced him at YVC, the one thing he told me was to go to bed at 11 o’clock and get a good night’s sleep. To Charlie, that meant going to bed at 11 and getting up at 5 in the morning.”

Garretson, who played two years for Faller and then one for Brayton in 1964 before signing a professional contract, said, “First of all, baseball has lost a great coach and person. Bobo was unique, and he really understood his players. And he cared for them.

“He was demanding, but he was fun to play for because he knew the capabilities of his players. One of the reasons he was so successful is he put the right guys in the right spots at the right times.”

He put Perez at shortstop in 1970, and for two seasons the Highland High School graduate served as team captain while also excelling as one of the best infielders Brayton coached.

Perez had driven Faller to Pullman earlier last week to be with Brayton, who passed away at his home near Pullman.

“It’s a sad day for Cougar nation,” Perez said. “There were several of us who were with him, and we were able to hold his hand and say some personal things, and I think he was able to hear us. It was tough.

“But he was a man who meant a lot to a lot of people. Just his personality, his character, the things he taught us that transferred to the way we lived. He taught us that we were going to get knocked down, but when that happened you get back up, dust yourself off and move forward.”

As Brayton himself had, winning 1,413 games (251 at YVC, 1,162 at WSU).

At Pullman his teams won nearly 70 percent of their games, claiming 21 conference championships and making the NCAA postseason 10 times including College World Series berths in 1965 and 1976.

Stottlemyre, Edler, Ron Cey, John Olerud, Aaron Sele and another Yakiman, Scott Hatteberg, were among the major leaguers tutored by Brayton.

When he retired in 1994, Brayton’s win total ranked fourth all-time on the NCAA list. And he has since been inducted into the College Baseball Hall of Fame, State of Washington Sports Hall of Fame, Inland Empire Sports Hall of Fame, WSU Athletic Hall of Fame and YVCC Athletic Hall of Fame.

As an athlete, Brayton was a three-sport Cougar, playing football, baseball for Buck Bailey and also basketball during the 1943-44 season for Jack Friel.

He became the school’s first baseball All-American in 1947, and WSU’s baseball facility is named Bailey-Brayton Field.

Said Parry, “Bobo is right up there with Babe Hollingbery, Jack Friel and a select few others in terms of what he meant to Washington State University.”

Said Edler, “I think about coach a lot, and I still use Boboisms when I talk to people.”

Said Stottlemyre, “I had the privilege of playing for Bobo his last year at YVC, and boy, what an experience. I learned a lot from him. He was a great coach and a great teacher in a lot of different ways, and I will really miss him.”

Said Perez, “Like Bobo always said, ‘Go Cougs.’”​

March 24
Truck driving course offered through YVCC

​KIMA TV - published: March 24, 2015

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February 25
YVCC offering biology lecture series Feb 24

​Grandview Herald
February 11, 2015

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February 23
Sounds of science

​Yakima Herald Republic
February 23, 2015

Photo Gallery: Sounds of science
Click to view photos by Kaitlyn Bernauer​

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An Engineering Day for Kids was held Saturday in the HUB at Yakima Valley Community College in Yakima. The free event was put on by Yakima Valley Community College Engineering Department in partnership with the Yakima branch of the American Society of Civil Engineers.



February 22
YVCC men fall to Blue Mountain

​Yakima Herald Republic
February 22, 2015

YAKIMA, Wash. — Yakima Valley started strong but couldn’t maintain that momentum in the second half as Blue Mountain rallied for a 73-70 victory over the Yaks in an NWAC East Region men’s basketball game Saturday at Sherar Gym.

Tra Satterwhite had 19 points to lead Yakima Valley (3-9, 5-21), which built a 37-32 halftime lead. But the Yaks shot just 37 percent in the second half (13 of 35) and Blue Mountain outscored the home team 11-4 from the foul line after intermission to mount the comeback.

Demetrius Trammell added 11 points and Shawn Dobovan had 10, with both players grabbing five rebounds apiece.

One problem for Yakima Valley was that it collected just 10 assists, compared to 20 for the visitors.

Max Mueller led the Timberwolves (2-10, 6-18) with 19 points. Coleman McElroy added 16 points and Jared Schultz had 14 points and a team-best seven rebounds.

BLUE MOUNTAIN — Williams 1-1 0-0 3, Schultz 6-13 1-3 14, McElroy 4-11 4-4 16, Bell 0-2 0-0 0, Mueller 8-15 3-3 19, Rivas 0-2 0-0 0, Martin 0-0 0-0 0, Christensen 1-5 3-4 5, Wells 1-1 0-0 2, Meyers 7-11 0-0 14. Totals 28-60 11-14 73.

YAKIMA VALLEY — Clark 2-4 0-0 4, Satterwhite 9-15 1-4 19, Cleveringa 2-8 1-1 6, Gill 1-2 0-0 2, Dobovan 2-12 1-2 6, Bussey 4-6 2-2 10, Wood 3-5 0-0 8, Robbs 1-4 2-2 4, Williams 0-3 0-0 0, Trammell 3-7 2-3 11. Totals 27-66 9-14 70.

Halftime — YVCC 37, BMCC 32. 3-point goals — BMCC 6-17 (Williams 1-1, Schultz 1-2, McElroy 4-9, Mueller 0-1, Chistensen 0-1, Meyers 0-3), YVCC 7-22 (Satterwhite 0-1, Cleveringa 1-6, Dobovan 1-7, Wood 2-2, Trammell 3-6). Fouled out — None. Rebounds — BMCC 35 (Schultz 7), YVCC 40 (Bussey 5, Williams 5, Trammell 5). Assists — BMCC 20 (Schultz 4), YVCC 10 (Williams 3). Turnovers — BMCC 14, YVCC 12. Total fouls — BMCC 16, YVCC 13.​

February 22
YVCC women fall to Blue Mountain

​Yakima Herald Republic
February 22, 2015

YAKIMA, Wash. — Mar’Shay Moore scored 33 points Saturday to power Blue Mountain to a 90-77 victory over Yakima Valley in an East Region women’s game in Sherar Gym.

The Yaks, with their seventh straight loss, fell to 2-10 in the East and 5-21 overall.

Myleah Musgrave scored 16 points and Dakota Marshall had 15 for YVCC, which was without starters A.J. Yarlott, Monica Villegas and Salome Yates.

Riley Gerlinger added 21 points for the Timberwolves (8-4, 15-8).

Yakima Valley concludes its season with games Wednesday at Spokane and Saturday at home against Wenatchee Valley.

BLUE MOUNTAIN — Jada Desautel-Ootsey 5-8 0-0 10, Riley Gerlinger 8-16 5-7 21, Mar’Shay Moore 12-18 8-8 33, Chung 3-3 0-0 7, Heugly 4-12 1-2 9, Reyna 3-7 0-0 8, Gregory 1-2 0-0 2. Totals 36-66 14-17 90.

YAKIMA VALLEY — Dakota Marshall 7-11 0-0 15, Tassia Merkle 5-11 0-0 11, Myleah Musgrave 4-13 7-8 16, Malika Kasumu 5-7 0-0 10, Leilua Iosia 7-17 3-4 17, Ceja 3-7 2-2 8, Lass 0-0 0-0 0. Totals 31-66 12-14 77.

Halftime — BMCC 43-40. 3-point goals — BMCC 4-11 (Gerlinger 0-2, Moore 1-3, Reyna 2-4, Chung 1-1, Heugly 0-1); YVCC 3-4 (Marshall 1-1, Merkle 1-1, Musgrave 1-2). Fouled out — None. Rebounds — BMCC 35 (Gerlinger 7, Moore 7); YVCC 33 (Merkle 8). Assists — BMCC 15 (Desautel-Ootsey 7); YVCC 17 (Musgrave 5). Turnovers — BMCC 12, YVCC 9. Total fouls — BMCC 15, YVCC 12.​

February 21
YVCC women fall to TVCC

​Yakima Herald Republic
February 21, 2015

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February 21
YVCC men win in overtime

​Yakima Herald Republic
February 21, 2015

YAKIMA, Wash. — Demetrius Trammell and Marshaun Williams scored 15 points apiece Friday night as Yakima Valley outlasted Treasure Valley 94-88 in overtime in an East Region men’s game at Sherar Gym.

Blake Cleveringa added 12 points, Mac Wood had 11 and Tra Satterwhite 10 for YVCC, which won for the second time in three games. The Yaks are 3-8 in the region and 5-20 overall.

Thadius Galvez scored a game-high 34 points for Treasure Valley (6-5, 1-13), which trailed 47-28 at halftime.

Yakima Valley shot 57 percent during the first half but only 33 percent in the second before hitting 3 of 5 field goals and 7 of 9 free throws in overtime.

“Somehow,” YVCC coach Ray Funk, “we went from being up 19 at halftime to being down four with about four minutes left. But we came back to tie it, then had enough in overtime to win.”

The Yaks host Blue Mountain today, visit Spokane on Wednesday and then conclude their season next Saturday at home against Wenatchee Valley.

TREASURE VALLEY — Youngblood 3-8 3-3 9, Hooper 2-6 4-4 8, Brendan Guzman 4-16 6-7 15, Thadius Galvez 9-19 12-13 34, Ingram 1-8 0-0 2, Dontese Tower 5-11 9-12 20, Pennock 0-0 0-0 0, Wess 0-0 0-0 0, Alip 0-1 0-0 0. Totals 24-70 34-39 88.

YAKIMA VALLEY — Clark 4-8 0-0 9, Blake Cleveringa 3-7 4-7 12, Dobovan 2-7 2-2 8, Bussey 2-5 0-0 4, Demetrius Trammell 5-6 4-5 15, Tra Satterwhite 3-8 3-4 10, Fuller 2-4 1-2 6, Gill 0-0 0-0 0, Mac Wood 2-10 6-8 11, Robbs 2-3 0-0 4, Marshaun Williams 4-4 7-10 15. Totals 29-62 27-38 94.

Halftime — YVCC 47-28. Regulation — 80-80. 3-point goals — TVCC 6-25 (Alip 0-1, Hooper 0-3, Guzman 1-8, Tower 1-2, Galvez 4-8, Ingram 0-3); YVCC 9-24 (Clark 1-1, Satterwhite 1-3, Cleveringa 2-4, Fuller 1-2, Dobovan 2-6, Wood 1-6, Trammell 1-2). Fouled out — Hooper, Williams. Rebounds — TVCC 40 (Guzman 7); YVCC 46 (Williams 6). Assists — TVCC 6, YVCC 16 (Cleveringa 4). Turnovers — TVCC 10, YVCC 9. Total fouls — TVCC 23, YVCC 25.​


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