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CabinBusiness.com Sunday, Sept. 13, 2009

CENTRAL ARKANSAS BUSINESS NETWORK

The debate Faulkner County professionals discuss health care reform

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Dr. Alan Lucas, pediatrician and chief of staff for Conway Regional Medical Center, examines 2-weekold Ella Davenport during a check up. LIBERTY PARKS PHOTO

Health care n Vol. 3


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Table of Contents Feature:

Reforming health care .................... pages 4-5, 7

Departments: Changing ..........................................................page 8 Improving .........................................................page 10 Serving ..............................................................page 12 Sustaining .........................................................page 13 Forecasting ......................................................page 14 Growing ...........................................................page 15

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Small businesses tackle rising costs on their terms By REBECCA BROCKMAN SPECIAL TO THE LOG CABIN

Try going through downtown Conway without running into a small business. Make a list of restaurants you see on your daily commute that are owned and operated by “mom and pops.” It’s impossible to drive down Front, Main or Oak Street and not see a business that is owned by a fellow neighbor, friend or family member. Needless to say, small businesses are the nucleus of Faulkner County. Rising health care related costs bombard small businesses and word of new legislation regarding health care reform has some local places changing how they do business. Others are deeply concerned and passionate about finding answers. Greg Williams, chief financial officer for Nabholz Construction Services in Conway, said his company is skeptical when it comes to the new health care legislation. “First, there are multiple bills introduced and it is difficult to ascertain exactly what is being proposed,” Williams said. “There does not seem to be much being proposed that would actually reduce the cost of care.” Founded in 1949, Nabholz has grown to become a dominating force in the construction industry in the past 60 years. During that time, the company has made efforts to offset and lower the cost of care to their employees. In fact, three years ago, Williams said Nabholz joined a risk retention group as a different way to

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Reforming health care Health care reform has been a hotbutton topic since the presidential election, and even more so in recent months. Although several plans are still being considered by lawmakers, the Log Cabin Democrat approached several people in the health care industry about their concerns and hopes. These discussions shed light on various issues. A provider Jim Lambert, CEO of Conway Regional Medical Center, said some plans being discussed call for the proposed public rate to be based on Medicare and Medicaid rates while others leave it open for negotiation. One of his concerns is that Medicare and Medicaid do not reimburse providers enough to pay for the care, he said. One argument he heard was, “If we move (some 45 million uninsured Americans into the system), you’ll get some reimbursement where you were getting none. Will that work out? That’s a concern. That’s why we’re trying to negotiate those rates,” he added. Patient expectations have an affect on the cost of health care as well, Lambert said. “People want immediate access. ‘If I have to wait, there’s something wrong,’” he said. Access to technology and other services increases the cost, he said. Lambert continued, “The current system is not sustainable economically. I think everyone agrees the current system will potentially bankrupt the country.” Another challenge, according to

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Lambert, is a lack of patient understanding of the actual cost of health care. “Some people think it costs them $25, so they come as often as they want,” which increases the cost on the system, he said. Lambert said measures need to be taken to encourage more people to become primary physicians. “If we give 45 million people insurance, they’re going to start looking for someone to take care of them. We don’t have enough physicians today. If you increase the number, I’m not sure how they’re going to get seen, because physicians are seeing as many as they can today, at least in our community.” A doctor Dr. Alan Lucas, pediatrician and chief of staff for Conway Regional Medical Center, said one of his concerns about proposed legislation to reform the health care system is that physicians have not been involved. He said legislators have some physicians serving as academic advisers, but lawmakers have not asked physicians in the general public to be involved. “I could tell them (areas to cut costs) if they ever asked. We’re as frustrated with private insurance companies as any government plans. They need to get back to the grass roots and ask the people who do it every day, ‘What do you need.’” Lucas said there are imbalances in the rates of doctors’ reimbursements. For instance, procedures are reimbursed at a higher rate than office visits that require more cognitive skills. One simple procedure that takes very

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little time pays much more than an hour-long discussion with a parent about behavioral problems, he said. “I think there are obvious ways to save money,” he said. Another concern of Lucas’ is the issue of tort reform. Leaders have said it won’t be part of the plans now being formed, but doctors have concerns that it has an impact on the cost of health care, he said. For example, he said, doctors may order excessive testing to determine if a particular course of treatment is the right one because they are afraid of being sued. Excessive testing increases the cost on the system. Lucas said he is also concerned about whether doctors will be reimbursed at a rate that will pay their costs. “If you are reimbursed less, the only way to increase revenue is to see more patients. Most doctors are already seeing more than they are comfortable with,” meaning they do not have time to adequately discuss each patient’s illness, he said. Insurance Local State Farm agent Jay Bernard said, “I have concerns over any government program that reduces or affects free market competition. The public needs to be involved in this conversation, getting the experts from all arenas. I think a doctor has to be involved in this conversation. I’m excited that we’re trying to address it for the betterment of our country. This is a healthy discussion that I think all

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parties need to be actively involved in.” Bernard said tort reform is a concern for the insurance industry as well. “Physicians have to protect themselves. Excessive lawsuits drive the cost up for liability. We, the public, have to pay for (the cost of lawsuits to insurance companies) through our premiums,” he said. He described the “vicious cycle” as a carnival ride. “If you can only think of a Ferris wheel, and the following people are on it — the insurance companies, the doctors …” lawyers, and the public, he said. “In my opinion, the Ferris wheel is out of control,” he added. Bernard said re-educating the public about the cost of health care could help with some of the costs to the health care system. “We have trained the public that you can run to the doctor and pay $20 for a runny nose or sore throat. What we’re working on with small business owners is that philosophy — take a larger deductible. In return, you’ll have a health savings account, where this account grows tax free and is utilized for the normal doctor visit. The benefit is that you are lowering your premium cost by absorbing more of the risk.” Also, Bernard said he is concerned about how the proposed federal government plans will be paid for. “Small businesses are already paying, in my opinion, an exorbitant amount of federal tax. How are they going to pay for it without additional taxes? The government is not a business. They are not required to meet and balance budgets to stay in business. All they have to do is basically

Sarah Davenport talks to nurse Ashley Simmons at Arkansas Pediatrics of Conway. LIBERTY PARKS PHOTO

raise taxes to pay for their expense.” Cal Kellogg, chief strategy officer for Arkansas Blue Cross and Blue Shield, said, “The primary driver of the cost of health care insurance is the cost of health care itself. If you look at every dollar we collect in revenues and premiums, well over 80 percent of those end up going back to the cost of health care provided. Until you address the cost of health care, we’re never going to be able to address the cost of insurance. “We understand part of the reason for the number of uninsured people is the affordability issue, but until we tackle the main issue of what drives

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finance their health care program. In addition, they put a wellness program in place, which included hiring a full-time physician assistant to run the program. “Our wellness program has grown to not only provide traditional wellness services, but also provide limited clinical services to employees in order to lower costs and save employees time and money,� Williams said. He said the program emphasizes annual physical evaluations and improving care and lifestyle to lower claims costs over the long term. The wellness program is a simple, yet effective example of how a company can be proactive when it comes to rising health care costs. “The program has resulted in the diagnosis of previously unknown conditions, and our employees are in touch with the correct type of provider to serve their needs,� Williams said. Educating their employees about the importance of health and wellness will hopefully keep Nabholz one step ahead of the tumultuous health care reform battle. Williams believes that if new legislation results in

a significantly larger role for government in health care, there will likely be some form of rationing when it deals with the health care of Nabholz employees. On the other hand, Williams said, “If the legislation allows insurance companies and self-funded insurance plans to set premiums based on controllable risk factors, then the cost of care and the cost of insurance premiums will decrease over time as people adopt healthier lifestyles.� Besides the wellness program, Nabholz has had a flexible spending account program in place for a number of years. “Employees using this program are able to pay out of pocket medical and child care expenses with pre-tax dollars, effectively lowering costs,� said Williams. Current health care legislation concerns Williams and the Nabholz company. “We feel the current proposals will actually increase the cost to our company and our employees, because the projected cost of $1-2 trillion will have to be paid somehow. Eventually the additional cost will result in additional taxes and/or higher insurance premiums for almost everyone,� said Williams.

When asked what advice he had for other small businesses in Faulkner County who are struggling with the rising health care dilemma, Williams said, “Focus on wellness.� He pointed out that there are many high quality, low- or nocost resources available on the Internet and through other organizations. Williams stressed that if companies do decide to follow the wellness program idea and hire an outside vendor for wellness services, make sure the vendor is compensated based on the number of participating employees, not the total number of employees in the company. Ray Kordsmeier, third-generation owner of Kordsmeier Furniture in downtown Conway has found another way to handle rising health care costs. He follows a plan known as defined contribution. Because the company does not qualify for a group policy, fulltime employees shop for their own health care. Kordsmeier said this allows the employees to make decisions about what is important when it comes to health care. Once an employee chooses a plan, Kordsmeier works it out so that the bal-

ance of how much an employee earns and spends on health care is taken care of. From an employer standpoint, he is not worried about the government charging more taxes, but about “what the government is going to do to my costs.� He believes the anger seen at town hall meetings and similar events are because people don’t know what’s going on and the government is using negative talking points. “There will be a lot of changes no matter what,� said Kordsemeier. Like Williams, Kordsmeier is skeptical when it comes to new legislation. “No one really knows what the consequences are going to be. People are naturally concerned, because we don’t know.� He said no one has come out and said, “this is what we are going to do.� The unknown and avalanche of conflicting reports out of Washington seem to be a common thread in the small business and rising health care crisis. Kordsmeier said he has talked to many of his customers who are concerned about the health care legislation. Questions about retirement, business liability and the future have become part of normal conversation at his store.

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Health care reform keeps assisted living facilities in check By REBECCA BROCKMAN SPECIAL TO THE LOG CABIN

There is a growing demographic that is anxiously watching the health care reform debate. This group’s need is different from the rest. They do not have the option to return to work to receive health care benefits, or the physical ability to do so. For the thousands of individuals that depend on assisted living facilities in Faulkner County, there are professionals in the industry eyeing legislation that may affect them. People in assisted living facilities in Conway depend on assistance from Arkansas Medicaid, HUD (Housing and Urban Development) and other sources. Village Park and Independent Living Services (ILS) are two such places that cater to the citizens of our community. Tammie Lewellen, an administrator at Village Park, a licensed level II assisted living facility, said residents pay for services through private funds or Medicaid. Lewellen said right now the facility is more concerned about how the current legislation will affect their 15 employees. Village Park offers personalized assistance and compassionate care for adults and seniors who may no longer be able to live on their own, but do not need 24-hour skilled medical supervision. At ILS, they are trying to stay up to date with health care reform, while providing the best care for people in Conway. When asked what ILS has done to prepare for the changes in health care reform, Jackie Fliss, executive director of ILS, said the agency belongs to the American Network of Community Options and Resources (ANCOR) and the Development Disabilities Providers Association (DDPA). “Both organizations provide invaluable research about any proposed legislation affecting our industry,” Fliss said. ANCOR is a non-profit trade association that represents and advocates on behalf of Americans with disabilities. The second association, DDPA, is a statewide network of community programs. To educate herself, Fliss attended Congressman Vic Snyder’s health care forum held at the Statehouse Convention Center in August to learn more. Research via the Internet and news-

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up costs, we will never be able to stabilize or lower costs so that everyone can afford to have access. We’d love for everyone to have access, whether it’s through us, whether it’s through some other option already existing, but until we make it affordable, that’s going to be really tough to do.” Kellogg said he supports doing away with pre-existing conditions and making health care affordable for everyone, but individual responsibility will be key. “(The) young and healthy who would rather use their money for something else, they stay out of the pool. You end up with only the older or those who really need it. If you spread the risk out over the healthy and those who really need it, you have a much more workable situation, but it’s a temporary solution until we address the issue of cost. Costs will continue to go up, and that’s what drives the rates. Until we can address the costs, we will only have a temporary solution in terms of getting people covered.” Independent living Jackie Fliss, executive director of Independent Living Services in Conway, said she hopes affordable health care for everyone becomes a reality from the legislation being discussed. “It would help us greatly with our part-time employees. We are going to offer them a health policy, but the coverage is not extensive.” As for the agency’s consumers, Fliss said she does not know of any changes. “We’re controlled by the Centers for Medicare and Medicaid. Our funding is predominantly Medicaid. As far as I know, we have not been pulled into health care reform,” she said. Fliss added ILS is a member of nationwide and statewide associations of providers that research proposed bills, and she has not received any information on health care reform. Nursing homes Rhonda Stout, administrator of Conway Health Care and Rehabilitation, said she has seen cause for concern in a proposed bill. The America’s Affordable Health Choices Act of 2009 would cut Medicaid reimbursements significantly in long-term facilities, she said. In Arkansas alone, over a 10-year period, the cuts would mean a $370.4 million reduction in labor spending, she said. “Since labor represents 70 percent of nursing home expenses, we would be forced to look at layoffs, reducing salaries, reducing benefits. The way I see it, at the end of the day, the only

‘Until we can address the costs, we will only have a temporary solution in terms of getting people covered.’ — Cal Kellogg, chief strategy officer for Arkansas Blue Cross and Blue Shield

people we will be hurting are our seniors, because it’s their quality of care that will be affected. “It affects our seniors, but it affects our total economy because of the jobs that will be lost. My fear is that we’ll have no choice but to cut back to minimum (staffing), and we don’t staff at minimum here; we staff above. “You want to be able to provide the top quality of care. The number of staff depends on your residents’ needs. Probably 30 percent of our residents need total assistance with activities of daily living.” Vickey Kirkemier, administrator at Salem Place Nursing and Rehab Center, said she does not believe nursing homes are at great risk of losing funding. “I feel like the nursing home, and rehab portion especially, is very acces-

sible, and we’re able to do it at a fraction of the cost of other institutions. And we’re very successful with people going home. The majority go home in about 45 days. I think the success rate speaks for itself.” She said the needs of patients in nursing homes have changed over the years. Those who are fairly independent have moved to independent living facilities, leaving nursing homes serving those who need a high level of care, she said. “They may limit therapy people can have, but as long as they are receiving therapy, how could you weed out something successful and keep something that’s going to cost more money? I have more people that get rehab and go home. I really think that’s where the success is going to be.”

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The business of paying for health care

Greg J. Dunseath is a registered representative for Conway Financial Services. LIBERTY PARKS PHOTO

Greg J. Dunseath is a registered representative for Conway Financial Services.

Q A

CMYK

:How are businesses encouraging their employees to live healthier lifestyles? : Employers are trying to be more proactive, especially larger businesses. Money is still tight. Overall, the number of employees in area companies has dropped around 20 percent. However, employers are maintaining their benefits. They know how important it is for their employees, especially when times are harder. The saying still holds true, salaries attract good employees, but benefits keep them. Even with the increasing cost of providing benefits, employers know this. Some compa-

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nies encourage employees to be more proactive in being healthier with different types of incentives — extra vacation days or PTO, shorter work day during a week, or even cash. Larger businesses tend to have better cash flow to provide incentives or bring in wellness programs. One of our clients is talking about bringing in a health care provider on a Saturday to make flu shots available for employees and their families. :What about wellness programs? : Almost all carriers in Arkansas have 100 percent preventive or wellness coverage in their medical plans. In our experience, many em-

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ployees and their dependents don’t utilize this benefit to its fullest, especially men. Many women are diligent in having their routine annual exams and mammograms. This is vital and is usually covered at 100 percent. Males over 40, with this age varying within the medical community, need to begin considering routine colonoscopy. We men usually have to be persuaded to go in for this initial visit! Most carriers provide 100 percent coverage under preventive/wellness (up to their particular maximum limit) every three to five years. There are also additional wellness plans that can be added, usually with a reasonable fee. Googling wellness programs will provide employers with numerous options and ideas. :How can employers benefit from encouraging healthy living for their employees? :Employers are trying to think of ways to help, because generally a healthier employee is a happier, more productive employee. It can also

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have an affect on their bottom line. The employer is usually contributing a major portion of the employee’s premium. If an employee is healthier and not utilizing the health plan as much, it usually has a trickle-down effect — better rates for the employer! It also means lower payroll deductions for the employee. The cost of benefits has become one of the top expenditures to an employer. But it takes two to make it work! The employee has to be willing to exercise, eat healthier, stop smoking, and do things that are required for a healthier lifestyle. It is in everyone’s best interest if the employer will provide some incentives for the employee. The investment will usually come back to the employer. :Any suggestions for companies trying to get started? :Smaller employers cannot afford, nor have the space, to provide exercise equipment, so they’re doing things like encouraging walking or exercising during lunch hour and eating healthier lunches. Some employers are encouraging their employees by having company challenges, such as pro-

Q A

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CABN • Sunday, Sept. 13, 2009— 

Changing viding a positive and fun atmosphere by dividing employees into teams and challenging them with different goals; weight loss, lowering cholesterol, etc. One company brought in a consultant that had a couple of sessions talking with employees about ways to improve their health. Employers have hosted screenings in which employees can get their weight, blood pressure, cholesterol, and glucose checked. Cost is usually the biggest deterrent for employers to do anything. But if they view it as an investment, they will usually get a return on their investment in better productivity and lower cost of benefits! Being preventive is key to improving one’s health. Joining fitness centers, purchasing exercise equipment, getting friends together to walk or run are just some of the ways. There are creative programs and ideas out there. Since our agency is involved in the entire process from implementation to servicing of our clients’ benefits, we know the health and concerns of our clients. We see the medications being taken, the health issues going

on with individuals and their families, and how this affects their lifestyles and general well being. Some illnesses are genetic and cannot be eliminated or resolved. However, good habits, exercise, and using common sense about how we should take care of ourselves can often reduce the effect of some illnesses and eliminate the need for many medications, not to mention their expense. We have become a society of excessive utilization, declining health, and numerous medications, with much of it caused by obesity, high blood pressure, high cholesterol, diabetes, and stress-related issues with the medication this requires. These areas of health care can be improved with better eating habits, exercise and trying to have a healthier lifestyle. Cost of health care has become expensive and even unaffordable for some. Change starts with us. If we will do what is necessary to become a healthier society, many of the issues and related costs, in my opinion, will be resolved!


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Improving

Salem Place features luxury, comfort and care Salem Place Nursing and Rehabilitation Center is undergoing a large expansion. Salem Place provided the Log Cabin with information about some of the many services offered.

Designed with a luxurious hotel in mind, Salem Place offers more than a beautiful décor and plush furnishings. With all the comforts of home and exceptional clinical care, it is the best place for those seeking a new home or just the right environment to heal. “We have all the amenities of a luxury hotel, all the best in clinical care and all the comforts of home, all in one place,” said Vickey Kirkemier, facility administrator. Salem Place Nursing and Rehabilitation Center — a 53,000-squarefoot, modern facility — is a skilled, long-term care center licensed by the state for 118 beds. Located at 2401 Christina Lane east of Nutters Chapel Road in southern Conway, the center has a spacious lobby area complete with a fountain and a baby grand piano, and two therapeutic courtyards. The layout also provides comfortable visiting areas with a cozy atmosphere. Residents enjoy daily housekeeping and laundry services, spacious climate-controlled rooms, cable television and transportation. There is also a physician’s exam room in the facility as well as a small beauty shop. “Residents dine in a relaxed and cheerful atmosphere while enjoying a continental breakfast or buffet dining in one of our three spacious dining rooms,” Kirkemier said. Private and semi-private rooms are available. The staff plans many regular activities to give residents a variety of opportunities to meet their physical, spiritual, intellectual and emotional needs. In addition, Salem Place features state-of-the-art rehabilitation suites that offer a spa-like atmosphere with upscale bathrooms. The private suites have a contemporary, comfortable interior design, personal phones and are furnished with 32-inch flatscreen television sets. “The amenities and service are those you would find in a five-star hotel yet we provide a relaxed, homelike setting,” Kirkemier said. “Our goal is to get you home, but you won’t want to leave.” The Salem Place rehab team offers speech therapy, physical therapy

Donna Holt, head of the nursing staff at Salem Place, visits with resident Horace Rappold.

and occupational therapy. Those who seek care at the facility — from those who make a short-term, recuperative visit as well as those who now call Salem Place home — discover beautiful surroundings and a caring, professional staff. For many years, Salem Place has been recognized for quality services delivered by outstanding and compassionate health care professionals. Among its accolades: • Named one of America’s top nursing homes by the Consumer Research Council of America. • Maintains a Star Quality Rating in Conway. • Dietary manager among top three in the state by the Arkansas Healthcare Association. “I don’t think you can find anything like this facility in the state — in our building and furnishings as well as our staff,” said Kirkemier, who has worked at Salem Place since

the late 1980s. “We treat everyone like they are family,” Kirkemier said.

Salem Place accepts Medicaid, Medicare and private pay. For more information, please call (501) 327-4421.


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papers also helps ILS stay up to date on pressing health care reform related issues. “At this time, health care reform will not directly affect services to individuals with intellectual disabilities; however many of our part-time employees will benefit from health insurance,” said Fliss. ILS offers health insurance to their full-time employees. In October, limited health, life and disability plans will be offered to parttime employees. Even though current legislation wouldn’t affect individuals at ILS, there are other issues that Fliss watches carefully. The Centers for Medicare and Medicaid Services (CMS), a federal agency, has proposed a regulation that would not pay for support services if an individual were living in a provider-owned facility. Payment for services would not be rendered unless the state of Arkansas and the secretary of health and human services approved the facility. “People living in ILS group homes would be adversely affected by the proposed regulation,” said Fliss. She said a number of people believe that only facilities with four or less people would be approved on the federal level. For the past 40 years, the mission at ILS has been to help people with develop-

mental disabilities live as independently as possible within the community. ILS is a nonprofit agency that provides services to more than 200 individuals (children and adults) with intellectual disabilities. According to Fliss, the aforementioned services include housing in three apartment complexes (two in Conway and one in Greenbrier). There also three group homes and two private community homes. “Support services are provided to individuals living in ILS facilities, to those living in their own homes or those living with a family member,” said Fliss. While some individuals require as little as 15 hours per week, others require aroundthe-clock support Fliss said. “Support includes assistance with safety, shopping, money management, assistance with cooking and housework, transportation, banking, socialization and accessing services,” Fliss said. Due to her research and staying abreast of changes on the local and federal level, Fliss is prepared to react when issues arise. She suggests that other organizations and assisted living facilities “research and be as ready as possible.” During his lecture, Snyder echoed Fliss’ advice, “For those of you who say, ‘I don’t want anything to change because I like what I have,’ it is going to change.”

Stephanie Hammon puts groceries away in her apartment at Florentz Estates. Haammon has lived in the Independent Living Services apartment complex for the past two years.

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Serving

Committed to Public Health Rep. Robbie Wills, D-Conway, served as the speaker of the House during the 87th Arkansas General Assembly, which adjourned May 1.

The health care debate in Washington, D.C., and around the country has certainly captured the attention of many people in the United States. Heightened media coverage of town hall meetings and the back-and-forth debate on the issue has provided an opportunity for each of us to examine how we feel about the availability and affordability of health insurance and basic medical care. Rather than choosing sides — and there are more than two from which to chose — it may be helpful to focus on how any plan would affect the ability of the states to continue to be a positive force for the delivery of health care services to local citizens. We will be watching, of course, to see if federal health care reform intends to shift

costs to the states and further impact our ability to fund Medicare and Medicaid services. And whether or not new taxes are imposed, such as on health care premiums, which would further burden Arkansas taxpayers. Every state legislature in the nation will make itself heard on those two issues. But this summer’s focus on health care is not without its benefits. What it brings to the fore, at least in Arkansas, is a reaffirmation of our ability to positively impact health care through local initiatives. Take for instance two important laws for our state: The tobacco tax to fund a state trauma network and other health programs, and our Any Willing Provider law that has increased the availability of health care services from a wider range of physicians and hospitals. Through federal matching money for some of the programs, the tobacco tax will leverage an estimated $175

million a year for the trauma center network, community health centers, in-home care for the elderly, expansion of the ARKids First children’s health insurance program and operating costs for a Fayetteville campus of the University of Arkansas for Medical Sciences. All of these programs work to increase health care availability and quality for all Arkansans. They also keep Arkansas competitive with surrounding states by improving our quality of life, thus attracting new business, industry, retiree and tourism investment. The Any Willing Provider law, which the legislature first passed in 1995, has now, after a long legal battle, begun to work. The law requires health insurers to include any physician as an approved provider as long as the physician agrees to accept negotiated conditions. The law’s objectives are to drive down insurance premium costs,

increase patient choice and reduce travel times to health care providers. There is no question that the health care debate in Congress, across kitchen tables and in corporate boardrooms is important to the future of our country and the welfare of our families. But we in Arkansas have shown over the years an ability to creatively address our own needs and provide improved care for our citizens, while working to create an environment where preventive medicine and health education can also thrive. Arkansas is not helpless to act in our own best interest. We do have ways and means to address state and local needs in partnership with private enterprise, as well as the federal government. I have no doubt we will continue to look for and act on ways to take care of our own as the national debate continues.

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CABN • Sunday, Sept. 13, 2009— 13

Sustaining

Conway Farmers Market provides quality fresh produce, helps local economy Kami Marsh is a Faulkner County Extension Agent-Agriculture.

Do you ever wonder where the food that your families are getting comes from? Do you ever stop to think about the quality of the food that you are preparing? Would you like to be feeding your family produce that doesn’t have to travel hundreds of miles before it makes it to your dinner table? We are blessed with a great asset in our community and county, the Conway Farmers Market. This market provides a service to both the customers and the producers. Customers are able to feed their families produce that is produced locally and is of the best quality, and producers are able to make a living and sustain their family farms by selling their fresh produce. The Conway Farmers Market has been established for more than 25 years and has just recently moved to Downtown Conway. The market is comprised of 100 percent home-grown or handmade products. The

market is a well-maintained market operated for the sale of quality local farm products. High quality is the main benefit offered to the Farmers Market producers and customers. We try to offer a welcoming and friendly atmosphere to all who visit or sell at our market. The new location of the market is on Front Street, across from Simon Park. The market days are Tuesday from 7 to 11 a.m. and Saturday from 7 a.m. to noon. With the great response in customer volume this fall we foresee that we will also have a Thursday market. Even though the market is only two days a week, the benefits of a farmers market are endless! Agriculture is an everchanging world, and these changes that are happening have allowed fewer farmers with less labor requirements to produce the majority of the food and fiber in the U.S. There are many universities, extension services and the USDA doing research

on sustainable agriculture. To define sustainable agriculture you will find varying answers, however, all and all this is a process that is working with the farmers to reach goals of being responsible with the environment, remaining economically profitable and also considering the future generations. The Conway Farmers Market has a program with youth that allows youth enrolled in the 4-H Gardening project to sell their produce free of charge (there is no vendor booth fee). This is one way that they are working to ensure there is a next generation of producers and farmers at the Conway Farmers Market. ATTRA — National Sustainable Agriculture Information Services reported that research shows that farmers’ markets in

the U.S. have increased dramatically over that past two decades. This is another way in which farmers have expanded and enhanced their farm operations. Value added products assist in sustainability on the farm. These are the products that you are seeing at your local farmers markets around Arkansas. For more information on sustainable agriculture check out the following sites: ATTRA — National Sustainable Agriculture Information Services http://attra. ncat.org/ Sustainable Agriculture Research and Education http://www.sare.org/ For more information about the Conway Farmers Market, contact Kami Marsh, County Extension Agent-Agriculture at 501-329-8344 or kmarsh@uaex.edu.

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Forecasting

The changing face of the tax system Dr. Pam Spikes, CPA, is a professor of accounting at the University of Central Arkansas. Dr. Patricia Mounce, CPA, is associate professor of accounting at UCA.

Congress still has four months in which to make changes to the 2010 tax law. At this point no one knows exactly what is to come. However, we can only assume that some recent tax changes that will affect 2010 tax returns will remain as enacted. Several tax provisions affecting individual taxpayers are scheduled to expire in 2009 unless Congress acts to extend them. Common among these are the educator’s deduction, the tuition and fees deduction, and having the choice to deduct state income tax or sales tax. At risk for non-itemizers is the loss of the additional standard deduction for prop-

erty taxes and sales tax on vehicles. A major concern for many years has been the increasing number of taxpayers who, in addition to paying regular income tax, are subject to alternative minimum tax. If Congress fails to change the exemption levels, millions of additional taxpayers will find themselves incurring this penalty tax. Not all changes have negative consequences. One beneficial change for high-income taxpayers relates to Roth IRA conversions. Starting in 2010, persons with more than $100,000 modified AGI will be free to switch a traditional IRA to a Roth IRA. Tax on 2010 conversions can be spread over two years. Another positive change in the tax law is an increase in the domestic production activities deduction from six percent

to nine percent in 2010. Estate tax planning has been in somewhat of a limbo state since 2001. Since that time, exemption levels have gradually increased while tax rates have decreased. Under the current law, the estate tax will be eliminated in 2010. However, it is scheduled to reappear in 2011 at the exemption amounts and rates in effect in 2001. If it reverts back to the 2001 levels, exemptions will be reduced from $3.5 million (2009 level) to a mere $1 million (2001 level) with a maximum tax rate of 55 percent. The 2001 provision was enacted because the small exemption amount led to family members having to sell off property from family farms and closely held business in order to pay estate taxes. However, assets were passed to beneficia-

Michael C. Shock Agent

ries at a stepped-up basis equal to fair market value, thus minimizing gain upon sale. If Congress chooses to permanently eliminate the estate tax, although it sounds good, there is still a downside for beneficiaries to consider. Upon ultimate sale of an asset, gain (or loss) will be measured by the difference in proceeds and the decedent’s basis in the property. For business property that has been depreciated, this basis may be zero, creating a 100 percent gain on the sale. History has shown that Congress is unpredictable. However, one thing that is relatively certain is that Congress will make some lastminute changes. We are left to guess what impact they will have on taxpayers.

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CABN • Sunday, Sept. 13, 2009— 15

Growing

HSAs an alternative to traditional health insurance

Many financial institutions in Faulkner County offer Health Savings Accounts. Centennial Bank provided the Log Cabin with the pros and cons of HSAs.

Lately, one of the major hot button issues facing our nation is health care. There are many different options to attain health care coverage. Many believe that the only way to attain health care coverage is through their employer’s plan. However, other alternatives, such as Health Savings Accounts (HSAs), are available. According to www.hsainsider. com., a Health Savings Account is an alternative to traditional health insurance; it is a savings product that offers a different way for consumers to pay for their health care. HSAs enable you to pay for your current health expenses and save for future qualified and retiree health expenses on a tax-free basis. In order to have an HSA, you must first have a High Deductible Health Plan (HDHP). A HDHP differentiates itself from traditional health plans in that they are somewhat reversed in practice. With traditional health insurance, you pay monthly premiums and have most of your initial up front medical costs covered. With HDHPs, you are still covered, but only after a higher deductible is reached. With an HSA, you are able to save in order to help cover expenses until that deductible is reached. For those who choose the HSA option, there are several advantages that can be utilized. First, you control the money in the HSA account. You decide how to allocate and spend

the money in the account. This could mean you have the right to shop around for health care based on price and quality. There is no insurance “middle-man” to give approval for medical expenditures. Second, you have the ability to decide investment strategies to grow your HSA funds. Third, if your employer chooses to do so, they can also contribute to your HSA. Fourth, you can pay for the medical care of another family member without a tax penalty. Another benefit of an HSA is that the funds continue to grow and rollover from year to year. If you have a relatively healthy year with little deductions from the account, the remaining amount will be allowed to carry over to the following year. While there are several advantages to HSAs, there are a few potential negatives worth considering. In some ways, HSAs are unpredictable. Because you are never fully able to control your health, you might have trouble knowing just exactly much how to hold back for health care expenditures. Another negative to consider is the early withdrawal of HSA funds not designated for medical purposes will not be tax free. HSAs are available at local financial institutions and some are actually options in employers’ plans. While there is significant freedom with where and how the funds in the HSA are allocated, you have to act as the accountant by keeping records and receipts of expenditures. There are many pros and cons to weigh when thinking about opening a Health Savings Account (HSA). Is it right for you? A good tip to use would be to analyze the last several

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Bowling For Kids

Sunday - October 18 1:00 to 3:00

years of health care expenditures. From this, you should be able to get a good average of what expenses have been incurred. Were you relatively healthy or ill? Helping put together a chart of these questions will help you make the right choice when it comes to choosing the option of an HSA. For more information on HSA’s, please visit www.hsainsider. com or the Centennial Bank Web site at my100bank.com. Centennial Bank Health Savings Account (HSA) Product Features • Individual ownership with allowable authorized signers, beneficiaries, trustee, and estate accounts available. • Interest credited monthly • Available to anyone with a high deductible health plan • Unlimited transactions and check writing with no per check charges • Protects against high or unex-

pected medical bills • No monthly service charge • Contributions can be made by the individual, employer, or both • Distributions are tax-free if taken for “qualified medical expenses” • First ATM/Debit card free, which can be used for “qualified medical expenses” • Descriptive monthly statements • Free E-statements optional • Free Internet Bill Pay • Free Internet Banking • Direct deposit available Customer Benefits • Earn monthly interest on money • 24-hour banking convenience • Easy expense tracking • Less paper clutter • Receive your statements faster • Provides necessary information for tax purposes

Advice Do you get it from your accounting professional? In today’s uncertain economy, you need a trusted advisor to help you make every dollar count.

We can help you to: • Understand your financial statements and actually use them to better manage your business • Prepare documents that help create a positive impression with your bank • Plan your tax strategy early in the year and reduce your risk of audits and penalties • Handle bookkeeping, payroll tax, and sales tax to give you more time to run your business • Set up and fine tune your software if you do your own accounting.

Conway Family Bowl on OAK Street (across from Conway Commons)

Sponsors and Bowlers are needed. If you would like to bowl or to donate money to help a child in need please contact Debra at HAVEN at (501) 327-1701 for details.

Throw a strike for a worthy cause!

Allison Smith & Associates, P.A. Certified Public Accountant www.asmithcpa.com 603 Court Street, Suite 3 • Conway,Arkansas 72032 • (501) 327-1088


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Cabin Business publication, Vol. 3: Health care.

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