Future of hospital up for vote

On Dec. 10, voters in Marengo County will decide how much they want to keep Whitfield Regional Hospital open and growing.

The single issue on the ballot is a 4-mill property tax. All income derived from the tax would benefit WRH. The estimated annual income, according to Sharon Hilbish, county revenue commissioner, is $950,000.

The tax vote is possible because of an Alabama constitutional amendment that allows for county commissions to call a special election to benefit only a hospital for up to 4 mills, said county attorney W.W. Dinning.

Homeowners can expect a tax increase of up to $40 per year on a house appraised at $100,000, said Hillbish.

In addition to the tax on houses, Hilbish explained that the total tax on 100 acres of average pasture land would be $48 annually, and on current use acreage, $17.72. 

“We would finally be able to have a capital plan for the hospital,” said CEO/Administrator Doug Brewer. “We’re going to be able to move the hospital along.”

Like many other rural hospitals in the nation, WRH faces mounting financial difficulties, especially with its large percentage of Medicaid patients. Many rural facilities have closed, leaving area residents with travel times of an hour or more to receive treatment.

WHR has weathered the storm better than most but still faces uphill battles to remain viable. Brewer said the hospital has had to cannibalize equipment for repairs or constrict services.

“That’s the beginning of the spiral downhill no matter what business you’re in,” said Brewer.

“There is no plan for the development of capital over the long term,” he continued. “So how do you replace 40-year-old boilers? How do you replace air handlers? How do you buy a new piece of imaging equipment to be able to stay relevant? In my opinion that’s exactly why this hospital is in the situation it’s in today.”

The most glaring of the constriction of services was the closing of the labor and delivery department in 2014 which caused considerable controversy.

If the proposed new tax is approved, however, Brewer said the hospital board has made a direct commitment to bring back L&D, probably in 2020, saving pregnant women from having to travel to Tuscaloosa or Meridian to deliver.

 “What we needed was the ability to operate a going concern. We’ve never had that,” Brewer explained. Instead of having a reliable source of funding, “It’s always been ‘Let’s go beg people for more money’.”

Passage of the property tax would provide “a long-term revenue stream that the people of Marengo County are committed to providing,” said Brewer.

With the primary intention for the use of the tax as a capital plan, it would provide a steady source of revenue enabling WRH to secure loans to improve the Emergency Department, reopen L&D and replace broken or outdated equipment.

“With a capital plan we can show the ability to pay back bonds,” said Brewer.

Top on the list of priorities, said Brewer, is the expansion of the Emergency Department which had 13,000 visits this year to the ED, a jump of 15 percent. The ED is having a hard time handling the volume.

The hospital’s boilers are 45 years old. The building needs a new roof to combat leaks, and the parking lot has to be resurfaced.

Recently a $43,000 dishwasher had to be replaced. Since there was no capital budget to handle such needs, the operations budget had to absorb it, Brewer said.

WRH is one of the few not-for-profit hospitals left that doesn’t have a strong commitment from the city and county, he went on. “It’s a viable hospital because there’s such a huge need for it.”

Except for education tax renewal, Marengo County hasn’t had a property tax hike in 40 years, said Dinning. Almost all hospitals in adjacent counties already have city and/or county taxes to benefit them.

Joining the UAB health care system has been a boon for the hospital, Brewer said. WRH has become a Level III Trauma Center and already has responded to 45 trauma victims. More than 45 Code Blue patients who came to the ED not breathing have been treated. Two of those were babies under three years of age.

Within a month of opening, the Wound Center reached the two-year goal for the number of patients. Now in place is a hospitalist program with a physician or nurse practitioner on site around the clock.

The Whit Clinic that opened in Linden in October already has shown to be cost effective, and Brewer said at least two more rural health clinics are planned.

The CEO stressed the negative economic impact to the county should WRH be forced to close, including the loss of 385 jobs. Of the employees, 80 percent live in the county with a yearly payroll of more than $15 million.

“This hospital brings $17 million each year in federal dollars. It is the only business in town that does that,” he said. “It’s not a smoke and mirrors game.” If the hospital isn’t here, the money will go somewhere else.

 “I want to tell my people how important it is” to vote for the tax, said Freddie Armstead, District 1 commissioner. It doesn’t matter if the voter owns property or not, he added.

Armstead said Alabama requires that major industries with boilers must be able to get injured employees to hospital within 10 minutes. If the hospital closes, industries such as West-Rock will be at risk.

Jason Windham, District 2 commissioner, added to Armstead’s comments.

“I’ve been a big proponent of it,” he said, especially since 100 percent or the tax revenue goes directly toward the hospital. The tax will supplement some of the losses due to indigent care, he said.

Since WRH is the second largest employer in the county, “I would be scared of what would happen” without it, he added. “It would be detrimental not only to Marengo County but the whole west Alabama area should the hospital close.”