Cedar County Memorial Hospital CEO Jana Witt took time over this past weekend to answer written questions from the Sun about the proposed tax levy that will be on the April ballot.
Q. How much money does the current tax rate generate?
The current tax levy generates approximately $265,000-$270,000 a year.
Q. What is the deficit in revenue monthly and/or yearly?
$1,500,000 for Fiscal Year 2019 (Feb. 1, 2018-Jan. 31, 2019)
Q. How much money will the higher tax rate generate?
We are proposing a levy of 0.6112, which would generate approximately $795,000 additional tax revenue.
Q. Do you have any idea why this has never been done before? Or has it?
According to research by Marlon Collins, Cedar County Presiding Commissioner, there has been no request or attempt to increase the hospital’s levy since it was first established at 0.2000 per one hundred dollars of assessed value on Feb. 3, 1961.
Due to provisions of the Hancock Amendment, the levy rate is currently 0.1528. The request for a levy increase is being made now due to the environment in which Cedar County Memorial Hospital and other rural Critical Access Hospitals face.
Decreased reimbursement, increases in unreimbursed medical care due in part to Missouri’s failure to expand Medicaid, and decreased patient volumes due to increased local competition from larger hospitals necessitate the need to increase the levy at this time.
Q. Will the new money go into the general fund or a special fund?
Funds generated from the increased tax levy would be placed in the general fund as has always been done with the tax revenue funds.
Q. How will the increase improve the viability of CCMH?
As with most rural Critical Access Hospitals, costs are outpacing revenues. We face growing technology and facility needs. There is much financial uncertainly for small hospitals such as ours; we need this levy to help close the funding gap and to provide funding needed to assure resources are there for facility and equipment upgrades.
Q. What are the yearly expenses of the hospital and the Health Department? How many employees does each have?
For Fiscal Year 2019 ending 01/31/19, hospital expenses were $13,500,000; and County Health Department expenses were $310,750. The hospital has 123 employees, while County Health has 5 employees.
Q. Does any other hospital in the state support both the hospital and a health department with its tax levy?
To my knowledge, there is no other hospital in Missouri that manages the Health Department in the same county. In our case, there is a single levy-not two separate levies (one for the hospital and one for county health). That single levy generates less tax revenue for the hospital and county health combined than most Missouri Critical Access Hospitals receive to operate their hospital alone.
Q. When did the Health Department begin and why? Are all hospitals required to have a health department?
The Cedar County Commission began contracting with Cedar County Memorial Hospital to provide county health services in January 1995. There is no requirement for hospitals to fill this role; it is unique to our county.
BIn 2012, we discontinued obstetrical and full-time general surgical services. We continue to provide general surgical services on a part-time basis.
Q. How does our Days Cash On Hand stack up to other area hospitals and what does that mean?
Days cash on hand is the number of days an organization can continue to pay its operating expenses given the amount of cash currently available. Cedar County Memorial Hospital has 163 days cash on hand, compared to an average of 76 days cash on hand for Missouri Critical Access Hospitals.
Q. How has the elimination of services affected other services the hospital offers? (example – Has the elimination of the OB Department cut down on children needing a pediatrician?)
I am not aware of such effects.
Q. Do you believe that there are a significant number of Cedar County residents who are getting their primary care somewhere else and why?
Due to our volume declines, it is apparent that Cedar County residents are seeking medical care elsewhere. I believe patients often don’t realize they have a choice in deciding where they want to go for services such as lab testing, radiology exams, rehabilitation services, etc. and simply go where their medical provider suggests. It is very important that Cedar County residents understand what services they can obtain at Cedar County Memorial Hospital and request that their orders for services be sent here. It is a win for everyone, providing convenience to the patient and added business to the local hospital.
Q. If this tax should pass, are there plans to add additional services that are not offered at this time? If so, what are they?
The purpose of this tax levy request is not to fund new services in the near future; it is to provide a reliable funding stream to help close the current funding gap and to provide resources for technology, equipment and facility needs. However, we will continue to focus efforts on determining the services residents of Cedar County utilize and 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.