Hospital May Escape Crippling Cuts

DAYTON - The Columbia County Health System may be facing a 10 percent cut in Medicaid reimbursement funding from the state that would reduce the hospital's budget by $55,000 to $60,000 each year.

Usually, the state gives about $38 million to critical access hospitals like Dayton's each year to fully reimburse these hospitals. Based on how much the state gives these hospitals for Medicaid, the federal government also matches some of that money.

District CEO Charlie Button said a large proposed cut last November of 76 percent of Medicaid reimbursement from the state looks as though it is off the table in this legislative session. Cutting this much of the reimbursement would have meant a $400,000 cut from the health system's budget, and Button feared last fall that cut could have closed the hospital.

"It's still sketchy," Button said of the current budget picture. "It doesn't look like it. It looks like (the reimbursement) will stay at 90 percent."

Residents and business owners in the health district flooded local legislators' mail boxes and inboxes with opposition to this large cut that may have closed the hospital in Dayton and other small hospitals in rural areas across the state.

Button said at the health system board meeting last Thursday the Democrats in the Legislature have come back to the table with a 10 percent cut, which is far better than previously proposed 76 percent cut.

The House Ways and Means Committee approved its budget plan late last Saturday, Button said, and that included the 10 percent cut. He said he did not know when the entire House would vote.

Button said he would much prefer the Legislature to cut 5 percent, leaving the health system to fill a gap of about $30,000 a year instead.

"We could live with 5 percent," Button said.

He added the 10 percent cut would not close the district's doors, but it would certainly put the district in the red each year the cut existed.

"We realize the state is in a difficult position," Button said. "But we don't have a lot of room to give. Even little cuts are hard."

The board also discussed taking a 10 percent cut for the next two years and writing into the bill that the reimbursement would be re-evaluated, if not fully re-installed, after two years.

But, Button and the board expressed concerned that if they fight the 10 percent, the Legislature may end up cutting more than that.

"If we accept part of a cut, do we fight for a temporary cut or fight for the whole (amount of reimbursement) and look at a further cut than 10 percent?" Button asked the board.

Board Member Jim Kimes said he was very concerned that fighting for 5 percent rather than 10 percent wouldn't be worth the risk of the Legislature cutting more.

Board Chairman Ted Paterson said he would much rather accept the 10 percent cut and have the Legislature look at the reimbursement in another 2 years when the economy has improved a bit.

"We can live with it, but we would like to put it back in the system," Paterson said of the cuts and the reimbursement.

The other board members unanimously agreed that they could accept the 10 percent cut if it was over only two years.

Button said he would contact the local legislators and tell them the board's preference.

Button added Monday that he hadn't yet heard the twoyear time frame proposed by any other hospital boards or the hospital association. But, he stressed this is only our health system's preference on a local level.

But because a 10 percent cut is on the table rather than a 76 percent cut, Button said that's certainly a win for critical access hospitals.

He thanked the residents of Dayton for contacting local legislators last fall and spreading the message against the cuts that might have closed the hospital. There's no need to contact legislators at this point, he added. All the community can do is continue to wait and see what the legislators pass in this session.

"Nothing is a done deal," Button said.