CCMH

Witt: Maintenance, tech among priorities

Cedar County residents will go to the polls Tuesday, Aug. 6, to vote for or against a proposed 300% property tax increase earmarked for the Cedar County Memorial Hospital. If passed, the CCMH levy will go from $0.1528 per $100 assessed valuation to $0.6112. A similar measure on the April ballot was defeated 1,022-761.

The Cedar County Republican submitted a list of questions to Jana Witt, CCMH chief executive officer, for more information about the referendum. Some responses have been edited for space and clarity.

1. Why should the voters pass the levy increase?

The fact is rural hospitals such as Cedar County Memorial Hospital save lives. Voters should support the levy to assure CCM’s continued presence in Cedar County and its ability to provide life-saving services. 

2. Do you expect this to be a one-time increase or do you foresee a need to raise it again in the future?

I believe the board had the foresight to request a sufficient increase so further increases will not be necessary. 

3. Why is the hospital financed by a levy and not some other source, like a sales tax?

State statutes dictate the type of tax the hospital must pursue, which in this case is a property tax. The hospital doesn’t have the option to pursue some other source. 

4. If passed, where will the money most likely be used?

I believe the board will primarily direct use of these funds for facility maintenance, equipment and technology needs to support current operations and services. 

5. Will the hospital improve and/or add services if the levy is passed? If so, what and how?

The purpose of this request is not to fund new services; it is to provide a reliable funding stream to help close the current funding gap and to provide resources for facility maintenance, equipment and technology needs. However, we will continue to focus efforts on determining the services residents of Cedar County need, while determining the potential utilization and feasibility of adding such services.

We realize we can’t be everything to everyone and must strategically determine what services we can offer. We do conduct a community health needs assessment every three years to assist in this planning. 

6. Is there any concern the amount of the levy increase might be too much for voters to approve?

Certainly, we have received questions about the amount of the levy increase; but keep in mind our levy rate hasn’t increased in 58 years when it was first set at $0.20 [per $100 assessed valuation] and later reduced to $0.1528 due to provisions of the Hancock Amendment. Health care in our country is growing increasingly complex with ever-expanding rules, regulations, standards and technological requirements. CCMH managed for 58 years without having to ask for additional tax support. The need for a levy increase is required now due to changes in the environment in which Critical Access Hospitals must operate.

The board of directors carefully researched and contemplated the amount of an increase to request based upon the organization’s financial need and what is common in comparable Missouri counties. 

Here are two examples from counties close to ours with levies for a Critical Access Hospital and a County Health Department. Barton County: 2018 health department levy $0.1495, 2018 hospital levy $0.4332; Total $0.5827. St. Clair County: 2018 health department levy $0.2070, 2018 hospital levy $0.4879. Total $0.6949. We are asking for a levy of $0.6112, which falls right between the two. 

7. What portion, if any, of the increase will be devoted to the Cedar County Health Department?

Our current fiscal year operating budget runs from Feb. 1, 2019, until Jan. 31, 2020.  Obviously, the current budget does not reflect the tax levy increase because the passing of the levy was an unknown at the time the budget was approved by the board of directors and will continue to be an unknown until after the Tuesday, Aug. 6, election.  Again, as addressed earlier, the funds primarily would be used for facility maintenance, equipment and technology needs throughout our organization, which includes the Cedar County Health Department. 

8. What portion will be devoted to address current hospital debt?

Currently, CCMH has just over $1.2 million of outstanding debt. The most recent available data from the 2016 Medicare HCRIS database shows the average debt of a Missouri Critical Access hospital to be $7.2 million. All of CCMH’s debt is for Meditech, our current Electronic Medical Record system as well as components interfaced with the EMR system. This debt has a payoff in less than four years. The board at this time has not determined what portion, if any, of the funds would be used to pay off current debt. 

9. What plans do you have to encourage patients outside El Dorado Springs to patronize CCMH?

We want to encourage people to patronize all of our facilities, both in El Dorado Springs and in Stockton. We believe we need to go back to the basics by making sure people realize all of the services we offer. Our marketing director, Jeanne Hoagland, is very enthusiastic about doing this through face-to-face encounters, word of mouth, and utilization of social media. We have so much to offer at CCMH and great staff members and physicians, too. We encourage people who have never visited us or who haven’t used our services in a long time to come see what all we have to offer.

CCMH staff members are required to have the same licenses and certifications as the staff members at larger hospitals. CCMH must meet standards and regulations just like any other hospital. Cedar County residents likely will save time and money by utilizing CCMH services, not to mention it helps keep the hospital and the 120+ jobs it provides in the community.

10. What happens if the levy fails again?

We will continue to try to increase utilization of our services and look for other revenue opportunities. However, like any other business, without adequate funds we may have to look at service, staff or structure reductions. We get questions and hear comments from people who are upset a service was closed or hours reduced; but the fact is we are not different from any other business in that we need customers — in our case, patients — to utilize services or we can’t financially support those services. If the community wants a service, they must utilize it.

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