Board of Supervisors continues discussion on Veterans Memorial Hospital Board of Trustees; Special session scheduled for Wednesday afternoon

by Joe Moses

The Allamakee County Board of Supervisors met in regular session Monday, November 28 to address a full agenda of matters including an update relating to the Veterans Memorial Hospital City-ownership to County-ownership conversion, discussion of improvements and increased maintenance of Hickory Nut Drive, and discussion relating to the condition of Allamakee County Courthouse restrooms, among other matters.

During Public Comment, Lansing area resident Doug Mullen discussed the City-ownership to County-ownership conversion of Veterans Memorial Hospital (VMH) following the passage of Public Measure AN in the November 8 General Election. Mullen noted that he believes many who voted in favor of the conversion did so due to their perception that a vote against the measure would result in the closure of the hospital.

Mullen questioned whether the Supervisors would be managing or controlling the hospital’s budget. He recommended that the Supervisors appoint the Board of Trustees, hire and supervise the hospital’s administrators, and that three Board of Trustees members be appointed immediately by the Supervisors with four additional members to be appointed from throughout the county in the next few weeks. Mullen noted that he did not believe that districting should be put in place for the purpose of electing Board of Trustees members and that the Supervisors should have the discretion to make these appointments. Mullen added that VMH should be run by the County due to the County’s financial support through the tax levy to be implemented following the voter-approved public measure.

Gayle Decker of Waukon, a former Waukon City Council member, noted that he would like to thank the Board of Supervisors for supporting the conversion of VMH and that he stands behind that decision 100 percent. Decker recommended that the Supervisors appoint members to the Board of Trustees based upon qualifications regardless of their address within the county.

VMH CEO Michael Coyle noted that he will be providing bi-weekly updates to the Board of Supervisors moving forward and that a meeting with the Iowa Board of Management will be taking place later in the week relating to the hospital’s budgeting process. Coyle added that VMH’s budget is available to the public and viewable online. Relating to VMH Board of Trustees appointments, Coyle noted that orientation materials are being developed which will be made available for the Supervisors to review.

Decker and Coyle discussed VMH’s profitability and revenue with Coyle providing an overview of the matter. Coyle noted that VMH is a non-profit critical access hospital with a yearly break-even profit margin being a goal. Coyle added that achieving that goal is reached through operations, ideally, and is supplemented through grant funding and VMH Foundation support. Coyle advised that last year’s bottom line was inflated due to a positive IPERS adjustment, which is a variable from year to year, and that absent the IPERS adjustment VMH has been at the break-even point the last two years. He also noted financial and operational changes with the addition of services and clinics.

The meeting moved into the VMH Transition Update agenda item with Board of Supervisors Chairperson Larry Schellhammer providing information from a recent meeting with legal counsel including Allamakee County Attorney Anthony Gericke. Schellhammer summarized that contracts, titles and documentation will need to be updated to reflect the City-ownership to County-ownership transition, with the County having the same input and responsibility previously held by the City of Waukon. In response to Mullen’s earlier questions relating to the management of VMH, Schellhammer clarified that the County’s role is to appoint a Board of Trustees to provide the most inclusive and best representation possible.

Allamakee County Assessor Ann Burckart advised that property deeds associated with the hospital and clinics are under three entity names including Veterans Memorial Hospital, the Veterans Memorial Hospital Board of Trustees and the City of Waukon, with work ongoing relating to these plats. Gericke noted that with approval of the public measure by voters, the hospital, assets and liabilities have become property of Allamakee County with work delegated to Waukon’s Assistant City Attorney Kevin Stinn relating to the paperwork and transfer-related matters. Gericke noted that special attention is being paid towards the title transfer of the attached medical office building and helicopter pad, as well as tax exemption matters.

Gericke added that VMH’s legal counsel is handling the transfer of 28E agreements, with local entities, in addition, providing information to Gericke. Relating to insurance coverage and liability, Gericke noted that work is ongoing and that 125-plus vendor contracts are being updated to reflect the conversion of VMH’s ownership. He noted that there are many moving pieces to this process, something which has not taken place relating to a similar Iowa hospital in several decades so there is no real example to follow. Gericke noted that there are also some gray areas in Iowa Code relating to this type of transfer and as a result, the County will use good judgment in making the best decisions possible moving forward based upon the State Code guidance that is available.

Gericke also discussed the development of the Board of Trustees Bylaws which will need to be adopted by that board following appointment of its members. Gericke discussed Iowa Code specifying that the Supervisors will appoint five to seven Trustees to hold office until the next general election, which will take place in November 2024, with three of those Trustees elected in 2024 to have four-year terms and the remaining Board of Trustees members to have two-year terms. Gericke noted that, per Iowa Code, the Board of Trustees may reduce that board from seven to five members, if they so choose.

Coyle discussed the urgency of appointing the Board of Trustees, with expenditures above $10,000, vendor contracts and employment offers not being acted upon in the meantime without Board of Trustees approval. Decker further advised that qualified Board of Trustees are needed regardless of which Allamakee County community they may live in.

Schellhammer noted that the temporary Board of Trustees language previously approved by the Board of Supervisors is not allowable, with any appointment now being made to be permanent until the next election. Paul Whalen of New Albin expressed that this is a complex matter and questioned whether those involved in this process have done their due diligence in researching these matters.

Coyle noted that there are 42 county hospitals in Iowa, which is a majority, with healthcare being different from other industries due to reimbursement methods. Supervisor Mark Reiser motioned to table the board appointments until next week to allow for additional time in communicating with potential appointees. The motion died for lack of a second.

Supervisor Dan Byrnes motioned to meet Wednesday, November 30 at 1 p.m. relating to the discussion and consideration of appointments to the VMH Board of Trustees. The matter was approved with a second by Schellhammer, with Reiser voting against.

Allamakee County Zoning Administrator Stephanie Runkle presented information relating to plat requests relating to Larry M. and Sharon L. Snitker, Caleb M. and Danielle E. Ferring, Jerry C. Johanningmeier, and Manning Fighting Irish LLP. All four plats were approved.

The meeting moved into discussion of the condition of the Allamakee County Courthouse restrooms. Gericke noted feedback received from multiple offices relating to strong plumbing-related odors in addition to a sewage smell outside the south courthouse entrance. Gericke advised that resolving this problem may require tearing up some areas of flooring and wall space by an outside contractor in locating the issue. He further discussed carpeting that may need to be replaced within the Veterans Affairs office.

Gericke noted that a contractor on standby to assist with quarterly inspections may be advisable in addition to a committee of courthouse employees to also assist in prioritizing and scheduling painting and plumbing work. Gericke and Beyer discussed the potential use of American Rescue Plan Act (ARPA) funding with Beyer noting that this funding source requires obligations by the end of 2024 with expenditures to be made by 2026. The Supervisors were in agreement to develop a committee to include Head of Courthouse Maintenance John Roe, Reiser and a minimum of three courthouse employees with this matter to be added to the Monday, December 5 Supervisors meeting agenda and to also include discussion of ARPA funding for these repairs and improvements.

Beyer addressed the next matter relating to discussion of the need for a Governmental Accounting Standards Board (GASB) 87 Leased Asset Policy. She advised that the Department of Management has provided a sample policy detailing the leases to be recognized by the County. Beyer noted that Gericke will need to review the matter prior to official action or adoption.

The Supervisors reviewed Secondary Roads Department Transfers including $78,596.78 from the General Fund and $848,982.95 from the Rural Basic Fund. The Secondary Roads Transfers were approved as presented.

Allamakee County Engineer Brian Ridenour addressed the next matter relating to the consideration of a detour route for the Waukon Holiday Parade. Ridenour noted that the detour route would be effective from 6:30-8 p.m. Thursday, December 8. Ridenour said the detour route during this time would detour Main Street traffic to 9th Street SW to Iron Mine Drive as done in previous years for this event. The Supervisors approved the detour for the Waukon Holiday Parade.

Ridenour also introduced Travis Duehr, who was present for the next agenda item relating to the discussion and consideration of improvements and additional County maintenance of Hickory Nut Drive. Ridenour noted that Duehr has purchased property on this newly-named dead end road with plans in place to construct a combination shop and house, referred to as a shouse, to be used as a primary residence by Duehr and his wife, Mattison.

Ridenour noted the request to improve this dead end that includes approximately 2,100 feet of road, to include maintenance. He added that this road is basically a one-lane road at a 40-feet width, 17-feet shoulder to shoulder, that is graveled, with the County’s Ordinance specifying that a 66-feet width, fence to fence, is required if the County does make improvements.

Ridenour provided specifics relating to the amount of additional gravel needed to improve and widen the road surface with his recommendation for some buy-in from the Duehrs relating to this cost. Allamakee County E911 Director Chris Fee addressed questions relating to emergency services requirements pertaining to the 17-feet road width at this location.

The Supervisors were in agreement to revisit the matter in the spring with Duehr advising that no construction will take place yet this year or during the winter season.

Under Department Head Updates, Ridenour noted that Iowa River Drive (County Road A26) is open to traffic following work relating to a small bridge replacement and installation of culverts (see photo above). Ridenour added that County sand trucks were out over the weekend due to frost.

Runkle discussed that a calendar is being developed for the Board of Adjustment and the Planning and Zoning Commission relating to submission deadlines and meeting dates. She also discussed a recent Planning and Zoning meeting.

Gericke and the Supervisors discussed the potential use of outside counsel as a consultant relating to a variety of matters pertaining to the VMH ownership conversion and the Board of Trustees.

Allamakee County Solid Waste Manager Dave Mooney noted high traffic levels at the Allamakee County Recycling Center Friday and Saturday following the Thanksgiving holiday. Fee discussed an upcoming 911 Board meeting with the purchase of some new equipment to be discussed.

Allamakee County Emergency Management Coordinator Corey Snitker advised that the Courthouse/Public Buildings Security Meeting will be taking place this week. Snitker noted that the Allamakee County Public Safety Center is getting a weather station from the National Weather Service with Snitker agreeing to help with those updates. Snitker added that Hazard Mitigation Planning is going well with school districts authorizing him to work on this planning. He noted that the School Safety Initiative is moving forward with safety assessments completed at the Eastern Allamakee Community School District and at St. Patrick Schools in Waukon, with Postville and Allamakee Community School Districts to be completed this week prior to the next step in this program relating to the grant award process.

Beyer noted that a couple of election-related matters are being wrapped up. She discussed filing an accrual report with the State of Iowa, which is yet to be done, in addition to other reporting including a Tax Increment Financing (TIF) reconciliation, among others.

Prior to adjournment, the Supervisors, Beyer and Supervisor-elect Dennis Keatley held a work session to discuss Board and Commission assignments and to discuss the upcoming budget work session schedule.