[Congressional Record Volume 146, Number 26 (Thursday, March 9, 2000)]
[Senate]
[Page S1387]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      RETIREMENT OF KEITH McCARTY

 Mr. BAUCUS. Mr. President, 2\1/2\ years ago, when the Balanced 
Budget Act (BBA) was enacted, few Members of Congress paid much 
attention to a small section in the BBA that created a new program for 
hospitals in frontier and rural communities.
  This program, called the Critical Access Hospital, was buried among 
hundreds of provisions affecting Medicare. Yet, in many ways, it may 
well be one of the most lasting achievements of that session of 
Congress.
  The Critical Access Hospital idea is based on a very successful 
demonstration project in Montana. This project, called the Medical 
Assistance Facility Demonstration Project, was coordinated by the 
Montana Health Research and Education Foundation (MHREF). This 
foundation is affiliated with MHA, an Association of Montana Health 
Care Providers, formerly the Montana Hospital Association.
  As is usually the case, many people can claim at least some of the 
credit for the huge success of the MAF demonstration project. But the 
person who should claim the lion's share of the credit has never chosen 
to do so. It is that person--Keith McCarty--who I would like to 
recognize today.
  Keith McCarty joined MHREF in 1989. At that time, even the concept of 
an MAF was vague. Several years earlier, a citizens' task force had 
dreamed up the idea of a limited service hospital to provide access to 
primary hospital and health care services in rural and frontier 
communities. Acting on the recommendations of the task force, the 
Montana Legislature had created a special licensure category for these 
hospitals.
  MHA, the state department of health and others seized the opportunity 
created by the Legislature and, working with the regional office of the 
Department of Health and Human Services, developed a demonstration 
project aimed at determining whether MAFs would actually work. Keith 
was hired with the unenviable task of transforming this amorphous 
concept into reality, a job few gave him much hope of performing 
successfully.
  Keith brought a broad range of skills to his job. Trained as a 
psychologist, from 1968 to 1975, he worked with the developmentally 
disabled in a variety of positions, including serving as the 
Superintendent of the Boulder, Montana School and Hospital, the state's 
school for developmentally disabled children. Beginning in 1975, he 
provided professional contract services for a wide variety of health 
care and social service organizations.
  By the time he joined MHREF, Keith was skilled at managing projects, 
preparing grant applications, coordinating and supervising grant-funded 
projects, program development and evaluation, research and data 
analysis, facilitating community decision-making and inter-agency 
cooperation. All these were skills he would use in developing the MAF 
demonstration project.
  The MAF demonstration project brought its share of challenges. Among 
Keith's toughest challenges was convincing communities that the quality 
of their health care would not decline if they converted to MAF status. 
Once beyond that hurdle, Keith worked tirelessly with the state's peer 
review organization, fiscal intermediary, facility licensure and 
certification bureau and HHS officials to remove other potential 
roadblocks.
  First one facility made the conversion, then another and before long 
there were more than twice as many as the project thought might convert 
to MAF status. I pushed for the Medicare waiver in the early 1990s, and 
the Medical Assistance Facility became a reality.
  As the demonstration neared completion, Keith worked closely with my 
staff to draft the Critical Access Hospital legislation that I 
introduced in 1997 and saw through to final passage as part of the BBA. 
His insights about how Critical Access Hospitals might function, in 
practical terms, proved invaluable. And the model embodied in the 
Balanced Budget Act of 1997 closely parallels the experience Montana's 
MAFs enjoyed.
  Keith McCarty retired on December 31, 1999. He retired only after 
ensuring that Montana's MAFs were able to seamlessly transition into 
the new Critical Access Hospital program.
  His departure from MHREF marks a fitting transition for the Critical 
Access Hospital program. Once only a dream in the minds of a few people 
in the sparsely-populated areas of central Montana, the Critical Access 
Hospital has already become an institution in many communities across 
America.
  Keith is far too modest to take credit for his labors. So, what he 
won't say, we should. Keith's efforts--and the MAF demonstration 
project--have been recognized in special awards from the National Rural 
Health Association and the American Hospital Association.
  But perhaps the most fitting tribute that can be paid is to note that 
today, in 15 communities in Montana, routine health care services are 
provided in Critical Access Hospitals. If there had been no MAF 
demonstration project, health care services in at least half of these 
towns would no longer be available.
  I want to acknowledge and thank Keith McCarty for the service he has 
provided to so many Montanans.

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