sional malpractice, liability and healthcare insurance costs (multiplied by however many doctors it would take to provide 24/7 professional cover, say 6 or 8) be fully reimbursed by any of the third-party payors previously mentioned. These costs alone would eat up perhaps 2 or 3 times more than the tax levy of some $743,000 annually, quoted in the Ballot measure, which taxpayers would have to raise through taxes each year. I see this initial levy authorization as simply "the foot in the door" with subsequent, annual, ballot Measures to substantially increase SHH's funding to "Save Our Hospital".


COMPARISONS WITH SEASIDE AND ASTORIA HOSPITALS

Seaside and Astoria hospitals are seeking, or now have, the designation of critical access hospital, to allow them to continue to operate as hospitals, even though they may be suffering financially by doing so. Both were, at one time, "full service" acute care hospitals with plant, operations and staffing intact. These hospitals are used in the Study to demonstrate success of a critical access hospital.

I submit that even though they may have small resident populations, the vast number of tourists who travel to those communities, not just in Summer, but to attend a variety of year-round activities also, significantly and consistently increases their market populations. This can hardly be envisioned for St. Helens, which is not a tourist destination site. Most tourism occurring in St. Helens is of the "transitional" type; the tourists are on their way to some other destination and just "passing through" or are attending to County business in the County seat. Tourism is highly unlikely to have any appreciable effect on the hospital patient load of SHH.

JOBS CREATION - OVERSTATED PROJECTIONS

The Study cites some 63 new jobs as being provided by the proposed SHH. Although I requested the staffing breakdown by job type and quantity, representatives of the Hospital Coalition have not provided those data. I am left to make my SHH staffing assumptions as if I were the Administrator.

Because of the close proximity to Legacy hospitals and the ease and speed of travel to St. Helens, the number of employees to be hired locally would be no more than 10 full-time equivalents at the minimum wage level. Legacy nursing staff would fill all the $70,000 to $80,000 R.N. jobs.

LEGACY'S ROLE IN STAFFING AND ANCILLARY SERVICES

Legacy will provide all the M.D.s and Physicians' Assistants (P.A.s) from its current complement of employee or contractor doctors and P.A.s. Similarly, Legacy's Director of Nursing would assign all R.N. Practitioners and floor R.N.s from its R.N. staff. All ancillary services' staff (Surgery, Radiology, Pharmacy and Pathological Laboratory technicians) Physical Therapists, Social Workers, etc. would all come from Legacy's present staff complement. Legacy would also provide a wide array of services from their central locations. All Administration (including Financial Management and Billing, etc.) medical records, Dietary, Central Supplies, Laundry, Pathological Laboratory, Radiological Diagnosis and Pharmacy would all be provided from Portland central facilities.

Plant and equipment maintenance would all be under Warranty Agreements with the original Contractors, Suppliers and Installers. External campus maintenance (window cleaning, parking lot and landscaping services, etc.) would all be contracted out. However, these latter would represent a very small expenditure.

HOSPITAL R.N. STAFFING CONSIDERATIONS & "RE-ENTRY" TRAINING REQUIREMENTS

With respect to the possibility of finding sufficient Registered Nurses (R.N.s) to complement the M.D. staff at SHH it is significant to note that the major hospitals in Portland are all desperate to recruit qualified R.N.s and are offering substantial recruitment "bonuses" and other inducements to attract R.N. staff. St. Helens Hospital would have to be able and willing to also compete in this market. If any R.N.s now living in St. Helens expect to find work in SHH, and who are not now employed in another hospital, or who have been away from hospital nursing for 3 years or more, the re-entry training requirements are substantial (think "start from scratch!") The State Board of Nursing (which issues license standards) has such an extensive requirement for re-entry training that the Oregon Nurses Association (the Nurses' union) would like to see significant relaxation of those requirements. However, there is no intention on the part of the State Board to do so. Additionally, there is absolutely NO reciprocity with any other State's R.N. licensees.