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Court agrees to help fund ARH addition

The Letcher Fiscal Court voted after considerable discussion this week to allocate $100,000 in coal severance tax funds to Whitesburg Appalachian Regional Hospital.

The vote came during the court’s July meeting Monday after Ellen Wright, chief executive officer of the Whitesburg hospital, showed the court an architect’s drawings of a proposed women’s health center, which is part of an $8 million planned renovation to the hospital. Wright first asked that the court make an annual donation of $200,000.

The Women’s Health Center features a 1,512-foot addition to the current space on the main floor and will have 16 patient rooms, four labor and delivery rooms, and a 12- bed nursery. Whitesburg ARH had the highest rate of newborn deliveries in the ARH chain, 465 in Fiscal Year 2007, and works closely with Mountain Comprehensive Health Care and Dr. Wade Baker, an obstetrician/ gynecologist.

Dr. Baker told the court that the current delivery room at WARH still has the institutional green paint it had when the hospital was built in the 1950’s by the United Mine Workers. Baker said at that time, the expectation was for 200-300 babies per year to be born there, and that while there have been many technological changes at the hospital, the space is basically the same.

“It’s amazing we’re doing what we are with what we have,” said Baker. “That’s thanks to the greatest nursing staff I’ve ever worked with. Your help would be appreciated.”

Fifth District Magistrate Wayne Fleming said that while he would like to help with the Women’s Care the ARH chain, including the way hospital employees, who are members of the United Steel Workers, were treated during and after the recent strike. Fleming said that although he didn’t blame Wright personally, the ARH chain had not treated the union well.

“We have some great union members,” said Fleming. “Some haven’t been called back to work. I feel they have been punished and now I’m worried about the RNs (registered nurses). They will go out soon. I hope you treat them better.”

Fleming said he also had concerns about the way ARH handles its billing. He said the people who really have problems paying for health care are not so much the poor, who can qualify for Medicare, but the working poor who have no insurance at all. Fleming used the example of a friend who had lost his wife to cancer and was sued by a collection agency on ARH’s behalf soon after her death.

“I would like you to look at your billing practices, and not be so eager to turn them over to collection agencies,” said Fleming. “I’ve had a lot of people call me on your behalf. I don’t buy your indigent care statement, but it is a good thing. I still have some real bad feelings.”

In response to a question from Second District Magistrate Archie Banks, Wright told the court there are 12-14 workers who still haven’t been called back to work from the strike. She said that is partly because of union rules about bumping for jobs with seniority and partly because summer is usually a time when the hospital’s activity is at its lowest point. Wright said the Whitesburg ARH has recovered well from the strike and she hopes to be fully staffed in the fall.

Banks also said he has been to the Daniel Boone Clinic and has noticed long lines in the halls waiting to see doctors and one worker who was doing the job of three. Banks said he has a problem with that scenario. At that point, Wright told the court that the $600,000, which could be realized from the court’s donation plus a three-to-one match from the state, would be used to reimburse the chain for indigent care but it would free up other funds which could be used for the Women’s Center.

“So this money goes to Lexington,” said Fleming.

“How are we to be assured Lexington will send it back here?” asked Banks.

“Will they give you a guarantee this place (the Women’s Center) will be built?” asked Fleming. “That’s the only way I can vote for this.”

Wright said the center would be built and Judge Ward said the court would still need to think about how much help it can afford to give ARH. The annual nature of the donation came as a surprise to court members as well. Banks and Fleming both said they had thought the request was for one time and Ward said he had been under the impression it was a onetime deal which could be spread over four years.

“We thought it was $200,000 and not $200,000 a year,” said Banks. “We were looking at it as $200,000 over a four-year period.”

Joy Freeman, ARH director of Governmental Relations, told them that by virtue of an emergency regulation signed by Kentucky Governor Ernie Fletcher in 2006, the coal severance tax funds can only be used to reimburse the hospital chain for care provided to indigent patients. Wright said ARH provided $7.4 million in indigent and charity care in Whitesburg in fiscal year 2007 and $6.9 million in FY 2006. She said the state plan provides for a three-to-one match for the court’s funds, making a total of $600,000 for the chain. Wright said this would offset the cost of providing indigent care for the chain and allow other funds to be spent for the development of the Women’s Health Care Center.

Wright also said the Perry County Fiscal Court has authorized $200,000 and Harlan County has allocated $100,000. Magistrate Fleming told the court he felt they should equal Harlan County’s donation and give ARH $100,000 with the possibility of revisiting the matter again in a year. Dr. Baker said that would be a big help and they would know within a year if the Women’s Center would be built in Whitesburg.

“If there is no center by next year, you can tell them to hit the door,” said Baker. “I’ll be the first to say ARH doesn’t always keep its word.”

The court voted unanimously to allocate $100,000 in coal severance tax funds to ARH, but with a stern warning from First District Magistrate Bobby Lewis.

“You had better start treating your people better,” said Lewis.

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