Taskforce’s job is finished: Hospital ballot question now up to the voters

By Bob Steenson, bsteenson@charlescitypress.com

Members of a taskforce working to educate area residents about a county hospital question on next week’s general election ballot say they’ve done just about all they can to explain the issue.

Now they have one more message: “Please vote.”

Voters in Floyd County are being asked to decide yes or no on this question:

“Shall the Floyd County Memorial Hospital of Charles City, Iowa, organized and governed under Chapter 37 of the Code of Iowa be changed to be established and governed under Chapter 347 of the Code of Iowa?”

What’s the difference between Chapter 37 and Chapter 347? The answer isn’t “4.”

The county hospital, now operating as the Floyd County Medical Center, was originally organized as a memorial hospital under a state charter that calls for an appointed board of trustees and puts decisions about any county funding in the hands of the county board of supervisors.

Going to Chapter 347 would change the board of trustees members to elected positions, and would give that board the authority to levy property taxes.

Ron James, a member of the taskforce, a current hospital board member and former hospital chief financial officer, said the reason for the change is basically because of government cutbacks on reimbursements.

“You can cut your costs just so far, but when the payments start coming back you’ve got to do something different,” James said.

Rod Nordeng, the hospital administrator, has been speaking to many service groups, business groups and others, and his message is simple: Changes in the way the state’s Medicaid system is managed have resulted in more than $700,000 a year in reduced reimbursements.

“That was really the tipping point for us in pursuing Chapter 347,” he said.

On top of that, there has been almost a quarter million dollar reduction in the amount reimbursed annually by the state’s primary private insurer, Wellmark Blue Cross/Blue Shield, he said.

James said that people “assume when you send a bill off for $100 you’re getting $100 payment. That hasn’t happened for years.”

Heidi Worrall, another task force member, said part of the message they’ve been sharing — and also hearing from people they talk with — is how important the hospital is to the community.

“When you see the statistics of how many people access service through here, it’s just critical that the hospital is here and kept local,” she said.

Worrall said it’s also important for people to understand that, except for a $250,000 payment approved by the county board of supervisors for this fiscal year, the hospital hasn’t been receiving any county tax support.

Nordeng said that, compared with other county hospitals in the state that every year receive hundreds of thousands of dollars or more than a million dollar in taxpayer support, the Floyd County hospital has saved taxpayers millions of dollars over the years.

“And we still have a progressive medical center, debt free. We have outstanding clinical staff,” he said. “But unfortunately the tipping point was the change in the Medicaid. Other payers are also reducing, but not to the level that we experienced with that.”

Jim Moon, a member of the task force and longtime hospital board member, said he hasn’t heard much opposition to the ballot question, but people have questions about health care in general.

“I do sense that the average citizen just doesn’t understand the complexities of health care and how difficult it is to make everything work to keep all the services that need to be, you know, at our level there. It’s just hard for the average citizen to understand that,” he said.

Cheryl Erb, a task force member, said the financial aspect is frustrating. Premiums for insurance are increasing at the same time the amount insurance companies are reimbursing for health care is decreasing.

“The hospital has been successful,” Erb said. “Our clinic has been successful because they say, ‘We will be here to provide you top-notch service, top notch medical care for a price,’ and to have them not get reimbursed by any of those players is not right.”

Still, she said, “it’s our hospital. We take care of our own.”

Nordeng said, “It really is the county hospital. It’s the people’s hospital — $1.7 million in charitable care and bad debt, we don’t turn anyone away.

“We have 214 of their neighbors and relatives employed here, and it’s very important to the business community. I don’t feel you can have a vibrant community without a hospital — and a vibrant hospital,” Nordeng said. “It’s very important, otherwise you just become another rural community where things are leaving or dying off.”

The hospital is not in danger of closing, Nordeng has said, but without new financial options it may be forced to look at changes in services.

“Over the last two years 10 hospitals have discontinued delivering babies across Iowa,” he said. “If we go back, I think it’s six or eight years, the number’s closer to 42.”

Members of the group said they are optimistic they have gotten their message across and voters will mark “yes” on Tuesday, but many echoed the sentiment that people need to turn out at the polls.

Joanne Starr, a task force member, said, “I hope that’s the message that is conveyed — vote.”