BOH disdains hospital proposal on 3-2 vote
The Cherokee County Board of Health agreed Wednesday night to enter into a contract to transfer the Public Health Department services to Careage Services of Sioux City.
The approval of the Careage proposal came on a 3-2 vote, with BOH chair Tom Gary, and members Butch Sleezer and David Appleby voting for Careage Services, while BOH members Dr. Ed Burkhalter and Liz White voted to transfer the PHD services to the Cherokee Regional Medical Center.
The BOH had solicited the Careage proposal and, later, the CRMC proposal, in a scramble to relocate the PHD operations after Cherokee County severed ties with the PHD effective July 1 of this year.
Final approval by the Supervisors still remains for any 28-E Agreement contract between the BOH and Careage Services to officially transfer the PHD services. The Supervisors are on record saying that they will not approve sending county money for county health out of the county.
Citing cost-cutting due to a serious budget crunch, the Board of Supervisors in January initiated the contentious issue as the Iowa State Association of Counties (ISAC) and others have been recommending that counties get out of the health care field and cease competing with private health care providers. There is a trend statewide of counties doing just that. At last count, five Iowa counties had stopped funding Public Health altogether.
At Wednesday night's meeting in the crowded Supervisors' room at the court house, the CRMC submitted its proposal that was then aired, argued and discussed by the BOH and some others in attendance, including current PHD staffers concerned about losing their jobs.
Mysteriously, while the CRMC representatives were grilled again in public, not a single word was discussed about the Careage proposal that the BOH has had in its official possession since March 13. That proposal was submitted by Dan Myer, representing Careage Services of Sioux City. Myer was not present to field any possible questions at Wednesday's decision-making meeting.
The BOH and PHD also have refused to make public the Careage proposal to the Supervisors or the media, despite the proposal being ruled as public record by Cherokee County Attorney Jamie Bowers.
For more than a year, the PHD has been searching for a larger facility after out-growing the court house space. According to Gary, the PHD can relocate into his former clinic facility in Cherokee "For $1 per year and costs." A longtime Cherokee physician, Gary is now retired and lists his residence as Yankton, S.D.
The fact that Gary and BOH member Sleezer both live out of the county also became a hot issue in February when Dan Meloy, a Cherokee attorney and a member of the CRMC Board of Directors, cited a residency requirement in the Iowa Code for BOH members that resulted in Gary and Sleezer being dismissed from the BOH. County Attorney Bowers and the Iowa Attorney General's Office concurred with Meloy and the action was taken.
However, Gary and Sleezer appealed and, pending the outcome of the appeal in District Court, were reinstated on the BOH. There has been no time frame made public concerning when that appeal will be heard.
Following the vote, Burkhalter made a motion that the BOH keep communications open with the CRMC in the event that any problems would arise with Careage Services' handling of the PHD. Sleezer and Appleby both quickly seconded Burkhalter's motion.
Effective at the beginning of the fiscal year July 1, 2007, the county will fund $48,000 to the BOH, with $3,000 of that for BOH expenses, and the rest to the PHD.
Currently, the PHD operates with an annual budget of about $600,000, with an estimated 80-percent of that paid for by state and federal grants. According to the County Auditor's office, about $500,000 of the PHD annual budget goes for payroll and benefits for the department's 17 full- and/or part-time employees and it currently costs about $43,000 per month to operate the PHD.
The PHD generates revenues from a variety of sources, including Medicaid and Medicare, grants monies, and private pay (insurance, etc.). The PHD's total anticipated income is listed at $524,526 and its tax levy request is $72,642. As agreed to, that $72,642 will now become $48,000 on July 1 of this year.
The current year's tax asking for the PHD is more than $95,000 and the department has had to request an amendment to its tax asking the past two years due to a shortfall.
Careage Services also owns and operates Careage Hills nursing home in Cherokee.