HCHD board creates committee to study ETMC lease issues
Houston County Courier
By Lynda Jones
Approximately 25 to 30 citizens attended the Houston County Hospital District Board of Directors meeting at Don Rafa’s Mexican Restaurant in Crockett Tuesday, Oct. 4, but they didn’t hear much. The board normally meets in Nursing School Classroom 2 at ETMC Crockett.The meeting actually convened without most in the room being aware, and the noise level was high the first few minutes of the meeting.Board President Dr. John Stovall mentioned the noise and difficulty hearing, and Dr. Richard Kelly said, “That’s what we want.”The board was seated at a long table facing each other, with the backs of half the members facing the audience.The board conducted its business at a conversational volume, speaking to each other and making it difficult for anyone not seated at the table to hear the discussion.According to the board agenda, and discussion in previous board meetings, the board was to start reviewing its lease agreement with ETMC. The lease expires on June 30, 2015.Instead, the board appointed a committee of four to review the lease between now and the end of the year.The committee will consist of directors Deborah Blackwell, Barbara Crowson and Dr. Ray Morrison, with Dr. John Stovall, board president, serving as an “ad hoc” member. Stovall asked Blackwell to head the committee.The committee is charged with the task of reviewing the existing contract, which has been in effect since July 1, 1995, line by line, and creating an outline of what the board needs to consider when it enters into contract negotiations with ETMC.Stovall said the board’s attorney, located in Austin, advised them to create such an outline before they start working with him on the development of a new contract.During the board’s discussion, Blackwell stated, “I think we need a new lease.” She referenced the number of changes that have occurred over the years regarding the delivery of health care, and noted the changes that lie ahead due to legislation at the state and federal levels.Morrison also referenced legislative changes that will impact any agreement the board makes.“This is going to be a work in progress,” Morrison said.He said Congress will be meeting in December to address issues that will impact health care delivery.Morrison mentioned the Congressional “Super Committee”, which consists of of six Republican and six Democratic lawmakers charged with finding $1.2 trillion in cuts to the federal budget.The “Super Committee”, was formed as part of an August deal to raise the U.S. debt limit and must report a plan to Congress by the end of November.This is why the HCHD committee plans to work on its “wish list” as Crowson described the outline. The committee will give the board a monthly report.Blackwell said, “We need to make this as much a fluid document . . . .” She added, “We can’t change what legislation does.”Some board members did mention some issues important to them.Also during the discussion, Kelly said the board needs to determine what will be best for the city and what the county needs to prosper. He repeated his concern that he feels health care services in Crockett need to meet the needs of any industry that wants to come here.Morrison said ETMC honored the contract as it was written in 1994 and signed in 1995 by establishing rural indigent care clinics, and that he wants to see a continuation of those things that were established.Stovall said, “We don’t want our citizens to have to leave for services”, and cited cardiology as an example. He said his wife recently had to go out of town for surgery. He said it was very inconvenient because he had to shut down business while she was there.Blackwell asked board members to jot notes of things they want addressed to give the committee something with which to start.Kelly suggested allowing the community to submit letters of what they want.“We serve the community,” he said.In other business, Stovall said the plans for completion of the surgical suite at ETMC Crockett should be complete in about a week and a half.At the completion of the board’s business, Stovall asked if there were any comments.James Hall of Crockett addressed the board about this choice of a venue for the meeting. He said, “No one could hear you.” Hall also told board members if they had intended to interface with the public, it had failed.Hall also advised the board of meeting rooms at the Crockett Civic Center and asked the board to please make use of them.Hall also addressed the impact of federal health care issues, and said it would be extremely difficult for ETMC or anybody else to write a budget until the dust has settled (from pending litigation regarding the federal health care plan).Further, he said he hopes the board will engage more involvement from the public as it gets something drawn up.“You know a lot, but you don’t know everything,” Hall said.Stovall acknowledged the restaurant venue was not amenable for the type of meeting held Tuesday. “I had no idea this many would show up,” Stovall said.Stovall then faced the audience and recapped the action of the board.“We know there are going to be services that cannot be provided here, but there are some we do want to see,” Stovall said. “This is a start.”He also said, “We aren’t going to rush.”Daphne Hereford of Crockett also addressed the board. She reviewed figures reflecting the provision of indigent care, and referenced Page 28 (ii) of the lease agreement.In part, that page states, “. . . total indigent care rendere by Lessee at the hospital, the ADC and Rural Clinics exceeds the greater of seven percent of net patient revenues from such facilities for such Lessee fiscal year or the amount of charity care Lessee is required to render for Lessee and such faicilities to be tax-exempt under state law.”According to Hereford, ETMC provided $48,836.34 in indigent care to Houston County inmates the past two months.She stated that in 2010 ETMC was responsible for $1,873.830.47 and that charity care totaled $8,386,555.12. In 2011 (through Aug. 30), according to Hereford, ETMC was responsible for $1,288,367.96 and that charity care totaled $4,684,827.95.According to the contract, HCHD is required to pay 10 percent of its non-operating account after ETMC has paid seven percent of net patient revenues for indigent care. Hereford suggested that if the HCHD repaid ETMC the 10 percent of its non-operating account owed, then maybe ETMC could bring in some of the services the board has discussed.According to Hereford, 10 percent of the HCHD non-operating account for the year ending Sept. 30, 2010 was $289,396.79. She said 10 percent of the funds held in the non-operating account for the year ending Sept. 30, 2011 was $207,943.69. During her presentation, Stovall interrupted Hereford and asked if what she was saying was germaine to the discussion. Kelly said, “No, it’s not germaine.”Hereford responded that it was, that it goes back to Hall’s statements. She said she was just giving them information to consider as they proceed. Hereford also asked the board if, as a member of the public, was she not allowed to present her views. Stovall replied that she did have that right, and she proceeded with her presentation.Former board member Virginia Lewis reminded the board that they need to get input from the community. She also said the board needs to give information to the public.“We can improve, but you can’t improve if you don’t know what the people feel. I want the public to make those decisions, too.”Stovall suggested that the board publish an address in the Houston County Courier to which citizens can send their opinions.A woman in the audience who spoke said it isn’t necessarily the hospital’s fault that doctors do not want to come to Crockett.She explained her view that the community is not large enough to sustain many doctors’ families’ and the lifestyle they want. She referenced schools and shopping opportunities.Billy “Hollywood” Groves of Crockett also spoke, saying, “Work together. Put away the partisan bickering . . .and get it done.”The meeting was videotaped for hospitaltax.com and will be posted on that website. Hereford said hospitaltax.com will be taping future HCHD meetings as well.