Congratulations, Grays Harbor Community Hospital. Your proposal to become a hospital district with the boundaries your administration proposed survived the gambit in front of the county commissioners and now heads to the August ballot.
The real question becomes: Will the community support it? And what kind of campaign does your organization plan to run? It could either be one of facts, plans and information or one consumed by fear mongering and threats of closure. Frankly, there’s been a lot of mixed messages that came about these past few weeks.
As Cosmopolis Mayor Vickie Raines put quite succinctly: You now have three months to sell this message and answer all of the unanswered questions.
After attending so many forums and public hearings on the issue, however, I feel a need to dispel some of the myths, rumors and innuendos being batted about.
Claim: Former Montesano mayor Dick Stone said that Summit Pacific Medical Center was too late to the game and should get out of the way and let Community Hospital gobble up its growth area. He’s not the first one that I heard say this. The truth of the matter is that Summit Pacific has been working on a plan to potentially add the Montesano area since at least 2009, if not earlier. I interviewed CEO Renée Jensen and her staff back in 2009 for an extensive profile and they laid out their plans pretty clearly — a new hospital, new clinics, potentially annexing the areas of Brady and Montesano and becoming a true East County hospital district. They’ve been doing a fine job following up on their plan, and Jensen has earned every dime of her salary gathering political and community support for the move from McCleary to Summit Pacific Medical Center. The new hospital has only been open a year and plans are in the works to upgrade the clinic in McCleary and add a clinic in Montesano. Just last month, former mayor Stone urged the Montesano City Council to put the brakes on their street repair plans and look to see what was feasible for a long-term plan. Well, Summit Pacific was taking baby steps in their own long-term strategic plan.
What would it have looked like if the old Mark Reed Hospital would have started the annexation process before its hospital was even done? I’m pretty sure the community would have screamed “money grab” and made untrue allegations that it needed Monte’s money to build the new hospital. They did all of that on their own and want to ADD services to Montesano and would like help paying for it. That seems perfectly reasonable to me. What people tend to forget is that Mark Reed was losing money, too. The entire district was on the verge of going down before then-Chief Financial Officer Ron Hulscher and Jensen got involved and started down the road of their strategic plan. Well, back to the drawing board for Summit Pacific.
Claim: Community Hospital employees say they needed to rush this process through because the governor signed a bill requiring that the hospital become a public hospital district to get more money in April and they had a May 9 deadline to get it on the August ballot. Those two facts may be true, however, local legislators had been telling hospital officials what would happen for years. All six of the legislators representing the Coastal Caucus told them this. In February, I talked to all of our legislators and published an extensive article and they each told me that they had been asking the hospital to pursue the public hospital district idea, confused as to why the hospital hadn’t talked about it. “It’s time to put it on the ballot, as soon as this November, and tell the people of Grays Harbor what’s happening,” state Rep. Brian Blake, D-Aberdeen, said. “The wait is over.”
The hospital chose to wait until the last second possible before pursuing the option. They could have conducted public forums months ago. They could have developed a strategic plan to pitch the benefits of a hospital district years ago. This was a decision the administration and their private board made, crossing their fingers that their finances would get better and the state would give them a handout without any strings attached.
However, the strings were always there. In 2013, the bill that would have given them a higher reimbursement rate without any strings attached never received a public hearing in the Legislature. And the reason was simple: There was absolutely no support for it, not even among local legislators.
“If they want our support, it is pivotal for them to be a hospital district,” said Rep. Kevin Van De Wege, D-Sequim. “It’s been more than a year now. We’ve been waiting, but they’ve always pushed it off. Time is running out. Their debt has just snowballed and they have yet to take any action to move forward to become a public hospital district. There’s no longer any excuse they can use for why they shouldn’t. They must. And the people of Grays Harbor must support them.”
“I think Kevin and I started telling them to go this direction three years ago,” said state Rep. Steve Tharinger, D-Sequim. “I understand they’d prefer to be a private non-profit, but we need to show legislators that the local community has done all it can to support the hospital and, unless they’ve gone to the voters, they haven’t done that.”
Claim: This whole matter of the public hospital district is Sen. Jim Hargrove’s fault. Absolutely false. And I’m tired of the blame being shoved by all parties at Sen. Hargrove, who was stuck in a difficult position and was unable to find any political support on the state level to hand over a check to the hospital.
“We did our best down here in Olympia; the ball is now in the communities’ court. They need to be a public hospital in order to utilize these much-needed financial resources,” Hargrove said. “I really think this is going to stabilize the financial situation for Grays Harbor Hospital, we need to make sure this important medical facility is able to serve this community for generations to come.”
The hospital had its hand out looking for $2 million per year in free money. The hospital, a private organization, is a text book example of a special interest group. Do you know how many other special interest groups had their hands out this past legislative session?
This was all at the same time that state Republicans and state Democrats were in a gridlock in figuring out how to pass their budgets. In fact, it’s the first time in at least a decade the two sides didn’t come together to approve a capital budget, which would have given money to local flood-relief projects and help many other projects. Praying for free money from the state isn’t a plan. It’s about the equivalent of praying for money to rain from the heavens. It’s not a realistic plan.
Claim: Community Hospital’s finances are readily available for anyone to view by going to the state Department of Health’s website. That’s true enough, but I’ve had quite a few people try to navigate the website and find the budgets on a year-by-year basis and have no luck. Stop sending people to a website that they can get lost at and make the financials readily available on your own website. It took a local blogger to post old finance data before we started hearing about the specifics behind the $36 million in bonds the hospital is dealing with. I spoke with hospital spokesman David Quigg about this last week and he was going to develop an action plan to make this possible.
Claim: It will take us too long to explain the hospital’s financials. Make time. On KBKW last week, a woman called in and had specific questions about the hospital’s financials. She wanted to know how much money the hospital was losing, what its budget figures were and questions about the bond. Hospital administrators told her it would take too long to explain — maybe 15 minutes of radio time — and invited her into the hospital for a sit-down. Is the hospital going to sit down with each of the thousands of people out there that may have similar questions? Probably not. The simple solution is to put the information on a readily accessible website and craft a two-page document that breaks the numbers down for the public. Besides the state Department of Health budget information, put up the current IRS tax documents, too, and help explain those numbers to the public, as well. Old IRS tax data is already floating out there.
All the people want are explanations and the truth. Bury them in truth — and do it before the hospital’s chief financial officer retires this summer. Quigg said that could be a good plan, too.
Claim: Community Hospital’s financial woes are a new development. Absolutely false. The hospital’s growing debt and declining revenue has been occurring for years. In 2010, I sat down with then-Hospital CEO John Mitchell and hospital spokeswoman Linda Brown and we talked about the hospital’s growing problem of bad debt and charity care coupled with a rise in low-income hospital users.
There had been hope that the federal Affordable Care Act may help. It still might.
But hospital officials noticed years ago that a disturbing trend was developing.
In 2007, the hospital had a little more than $1.55 million in charity care and wrote off $9.3 million in bad debt from those who refused to pay their bills or insurance that wouldn’t cover the actual expenses. Hospital officials were worried that it had grown to a combined $16.4 million by 2009.
As of last year, the charity care and combined debt had risen to $22 million — almost double what it was back in 2007.
Back in 2010, about 65 percent of the hospital’s patients were on Medicare or Medicaid — and it has just kept rising, just as hospital officials expected it would if the recession continued. The latest figures, as of last month, show that 75 percent of the hospital’s patients are on Medicare or Medicaid. That means as unemployment has continued, more and more residents have lost their private insurance and signed up for free health care. And the state refuses to cover the full costs of the expenses hospitals bear.
All of this was happening at the same time the hospital was spending millions more dollars covering for customers that won’t pay their bills or charity care for those who can’t afford it and apply for assistance.
The hospital has taken some steps over the years to reduce expenses — but not enough. For the past three years, the hospital has lost $2 million to $3 million a year.
Knowing that local legislators would not just hand over a check for more money, the hospital should have been coordinating a long-term strategic plan. As part of this plan, they could have been taking baby steps going toward a potential hospital district. They could have involved the public years ago to have a community discussion about what a public hospital district could look like. During these meetings, they could have set up goals for a potential clinic in Ocean Shores to leverage support there. As part of this planning, they could have let the folks at Summit Pacific Medical Center in on their ideas and we could have had a countywide health care plan. Instead, Community Hospital boosters sprinted forward with their hospital district petition at breakneck speeds in less than two months and did not involve Summit Pacific in their petition, and we are left with two quality hospitals with competing plans. It didn’t have to be this way.
Claim: Public Hospital Districts offer no value. Absolutely false. I have attended public hospital district meetings in East County off and on for the past few years. The meetings offer a public comment period and there are elected officials directly accountable to the voters. If you have a complaint about the quality of service at the hospital, there is a quality assurance committee. And, if you want to know if other people have the same complaint, you can file a public records request and get the information — although no private information, just the basics. For that matter, at each hospital commissioner meeting, every complaint is detailed for the commissioners in a written report. The transparency behind a public hospital district is unparalleled. Want a specific service? Lobby the hospital to provide it and, if the elected officials are worth their salt, your comments will not fall on deaf ears. Hospital patients at the old Mark Reed Hospital wanted better imaging equipment and made that desire known before the switch to the hospital in Elma. Now, the imaging equipment is first-class. That’s a direct result of administration and constituent desires. The best part of a hospital district is being able to walk into a hospital district meeting and see exactly what the hospital board is doing. I’ve never been to a board meeting of the private Community Hospital and I couldn’t tell you who the members of the board even are at this point.
Transparency is a great motivator for change.
Steven Friederich is editor of The Vidette. Contact him at firstname.lastname@example.org