Veterans Memorial Hospital holds first public meeting to discuss conversion from city to county

by Brianne Grimstad

Tuesday, September 13, Veterans Memorial Hospital (VMH) in Waukon held the first of several scheduled public forums regarding the conversion from being a city-owned hospital to county-owned. The issue will be on the upcoming November 8 general election ballot for Allamakee County residents to vote on.

VMH Administrator Michael Coyle began the meeting with a presentation answering some of the most commonly asked questions regarding the conversion. Basically, the hospital is asking voters to approve a transfer of ownership of VMH from the City of Waukon to Allamakee County. If approved, being a county-owned hospital would allow for additional resources to help ensure the sustainability of the hospital.

In the information provided by VMH, it is noted that this will allow the hospital to retain existing services like obstetrics (OB) and surgery, as well as expand on the hospital’s service line to meet the continually changing local healthcare needs for Allamakee County. For example, VMH will be opening a Mental Health and Behavioral Health Clinic October 17 of this year in an effort to meet a growing need for those services locally.

Appropriations from the County would also support infrastructure and technology updates, which Coyle said are essential to improving patient care and retaining and attracting physicians, nurses and other staff. The appropriations would also allow for an upgrade to the hospital’s Emergency Room (ER). Currently, the hospital does not receive any tax support appropriations from the City of Waukon, Coyle further explained.

The information shared at the September 13 presentation noted that, financially, the hospital has been gaining ground recently, after several years of financial instability. Coyle explained that in recent years, the decision by Mayo Health System to close its Waukon clinic and changes to healthcare, in general, have impacted healthcare needs in the area.

Coyle noted that reimbursement rates from Medicaid and Medicare have also steadily decreased, further explaining that lower reimbursement rates mean hospitals like VMH keep at a break-even point, financially, or maybe slightly better than break even. Reimbursement rates from insurance companies come in at $0.52 on the dollar and at $0.32 on the dollar from Medicaid, Coyle shared.

Conversion to a county-owned hospital will allow for appropriations from the County to the hospital. Coyle explained that small, rural hospitals still have to comply with the same requirements and regulations as larger, urban hospitals, but they have to do that without the revenue that bigger hospitals with more patient volume have. Coyle cited that since 2010, 125 rural hospitals have closed around the country, leaving that rural population with no option other than to have to travel further for healthcare.

Coyle noted that in emergency situations, time is of the essence and having to travel an hour or more to receive care can be detrimental. Financial support from the County would help Allamakee County residents be able to have access to healthcare close to home.

The question has been raised as to why VMH just doesn’t merge with another healthcare organization, and Coyle explained that as an independent hospital, VMH has the ability to quickly adapt to the healthcare needs of Allamakee County residents. If the hospital would merge with another organization, that may not be the case, depending on what the governing body of that organization feels is right. He noted that sometimes the needs of a rural area and an urban area - where many of the larger healthcare organizations smaller hospitals tend to merge with come from - can be different.

If approved, the conversion would affect the taxes of Allamakee County residents. The proposed support amount being asked for in the conversion from city to county ownership is $950,000 annually in appropriations. The example given at the September 13 forum in regard to how that funding would be generated by the County through a property tax levy was that if an Allamakee County resident had a home with a taxable value of $144,000, the tax increase resulting from the hospital’s conversion in order to provide that appropriation would be $157 per year for that homeowner, or just over $13 a month.

Of course, costs would be different for each homeowner, depending on the assessed value of homes, as well as for farmers and businesses. There will be calculators available at the public forums for those who would like to see what the tax impact would mean for them.

Coyle explained that county ownership of hospitals is common, and in Iowa those hospitals receive, on average, $1.75 million in tax support each year. The conversion for VMH would result in about half of that average appropriation amount at the $950,000 annually.

If approved, the partnership between Allamakee County and VMH would grow beyond services already in place. If approved, residents from all parts of Allamakee County would also be eligible to serve on the hospital’s board of directors, a much broader representation than its current board of trustees membership open only to residents living within Waukon. Coyle further noted there would not be a negative impact on Emergency Medical Services (EMS) within the county.

If the measure is approved, Coyle also noted that the hospital would hold annual public forums, provide an annual report and plan to form a Community Ambassador group with members from all over Allamakee County. The group would serve as a voice of the community and guide VMH in the direction of healthcare needs of Allamakee County. Updates following monthly board meetings would also continue in The Standard newspaper.

VMH is also currently one of the largest employers in Allamakee County with 250 employees. The regional impact of the hospital’s payroll is around $50 million, according to economic impact calculations. “When care stays local, so do jobs,” Coyle said.

He also noted that when there are visitors to patients in the hospital, staff does encourage those visitors to spend time in area businesses. Having services available at VMH also reduces costs and saves time for locals, who may otherwise have to travel to La Crosse, WI, Rochester, MN, Iowa City or other places for treatments and procedures.

If the conversion is not approved, Coyle admitted the hospital will still continue to operate but will face challenges, including creating enough bottom-line profit to sustain programs already being offered. He said appropriations would be essential in helping to fund specialty services, new equipment purchases, facility updates and major capital investments.

The hospital would like to be able to bring back services like chemotherapy and dialysis, with Coyle noting that having these services available close to home can make a difference in patients’ lives.

The public is encouraged to attend the forums, which will take place throughout Allamakee County through September, October and the first week of November (see specific dates on Page 4 of this edition). “We want to hear your comments and questions,” Coyle said.

He also expressed that if a group would like to schedule a meeting, VMH would be more than happy to do that. There will be information in the newspaper, on the radio and online as well, such as on the Veterans Memorial Hospital Facebook page and its website at veteransmemorialhospital/voteyes/. The site contains answers to some of the frequently asked questions (FAQs), short video testimonials and schedules of upcoming forums in Allamakee County. Questions and comments can also be submitted via the website. Anyone who has a group interested in scheduling a meeting regarding the hospital’s proposed city to county conversion is asked to contact Erin Berns at Veterans Memorial Hospital at 563-568-3411.