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Hospital boss takes issue with criticism, vote by magistrates to deny coal tax use

Ripples from actions taken at last month’s meeting of the Letcher County Fiscal Court ran through the court’s March meeting and led to apologies and a heated exchange between a hospital executive and an elected county official.

Whitesburg Appalachian Regional Hospital Administrator Dena Sparkman attended Monday night’s meeting to address comments made by District Five Magistrate Wayne Fleming when he criticized the hospital’s billing practices during the court’s February meeting. Sparkman told the court she heard several “inaccurate comments” about the hospital while she was viewing a recording of the meeting on the county government’s cable television channel. At issue was a 3-to-3 vote that resulted in the court not recommending that the Kentucky General Assembly renew a $100,000 coal severance allocation the hospital uses to help pay for indigent care.

Sparkman said the not-forprofi t hospital has more than 400 employees in Letcher County who earn more than $11 million in salaries and benefits. She also told the court that ARH provides about $3 million annually in charitable care here and pointed to one audience member who she said had received more than $54,000 in charity care at the facility.

“Indigent care is a fancy word for charity,” said Sparkman. “ARH is a charitable facility. We always try to work to get a patient the health care they need.”

Sparkman said she took exception to a charge Magistrate Fleming made in February when he said the hospital harasses poor people for payment.

“It is always our intent to collect with compassion,” said Sparkman. “I want the public to know we are not as heartless as Mr. Fleming indicated.”

Sparkman also charged that Fleming’s vote to delete the hospital’s request for severance tax money was unethical because Fleming used his own experience with the hospital’s collection department as an example of what he termed overall harassment. She said Fleming should have abstained from voting against the appropriation.

During the February meeting, Fleming said that ARH had turned a bill for services he had received over to a collection agency before he had received the bill and that it had damaged his credit rating. Sparkman told the court that Fleming’s insurance eventually paid the bill after 18 months. Fleming said the billing dispute was between the insurance company and ARH and that he shouldn’t have been penalized because the insurance company was slow in paying.

“I don’t have a deductable,” said Fleming. “ The insurance company called the (ARH) billing office and told them I don’t have a deductable.”

Fleming told Sparkman his case is similar to others detailed in a recent Associated Press report that cited many instances nationwide where people are finding their credit rating has been lowered because of disputes over small medical bills. Fleming also told Sparkman had not been trying to disparage employees at the Whitesburg hospital.

“I’ve never spoken against your employees,” said Fleming. “And I never called anyone on your staff a jerk. After the meeting, I got 15 calls, and four from your own employees, saying you had messed over them. Every time you’ve asked us for money I voted for it and asked you to do people better. One of your employees told (Jenkins Mayor Kincer) G.C. you would take your facility out of Jenkins.”

Sparkman told Fleming she did not know why he had such negative feelings about ARH and said that although a number of her associates had said she should demand an apology she would be satisfied to have her say before the court.

“There will be no apology from me,” said Fleming.

Fleming, who represents the Jenkins area, later told Sparkman the town suffered a huge blow when the old Jenkins hospital and its emergency room were closed a few years ago. Sparkman said it wasn’t ARH’s decision to close the Jenkins facility. She that action was taken by the Jenkins hospital’s previous owner, Wellmont Health System of Kingsport, but that Wellmont’s experience had shown it is not economically feasible to operate a hospital in Jenkins because the people there won’t use it. She said ARH continues to operate a clinic in the old hospital because that is what the people have shown they will use.

“I’ve tried to take the high road — a place you might not be familtheir iar with,” Sparkman told Fleming.

At that point Judge/Executive Jim Ward weighed in.

“ARH is very important to Letcher County,” said Ward. “If I get sick I’ll have to go somewhere and I don’t want to go out of the county. I appreciate ARH and the services they provide.”

Fleming said he had never questioned the medical treatment provided at the Whitesburg hospital, adding that his problem was the way it treats people in its billing practices.

“If I get sick, I would want to go there too,” said Fleming.

Ward told the court the $100,000 was placed back into the coal severance tax allocations by the General Assembly.

In other business, the court also discussed the use of severance tax money to help fund the Esta Craft Conway domestic violence shelter in Whitesburg. Although the court did not vote to cut funding for the center in February, Magistrate Fleming and District Four Magistrate Keith Adams said they had heard rumors about the behavior of some clients living in the center and asked that a representative of the center discuss the situation with the court.

Debbie Hogg, who represents the organization that operates the center, Letcher County CARES, attended Monday’s meeting to address the court’s concerns. Hogg explained that the shelter is actually a transitional center that provides long-term housing until a client can transition into a different situation. She said stays can be two or three years and that the center emphasizes confidentiality for the safety of its clients.

Hogg said Letcher County CARES tries to maintain a disciplined program at the center while also respecting a client’s personal issues. She said the facility has served 95 families and more than 200 children, and added that men are seen in the building because it also the headquarters of the community housing service HOMES Inc. Hogg also said the building is being equipped with new locks for the back door.

Facility director Phyllis Barker later told a reporter for The Mountain Eagle that staff and volunteers had gone together to buy a grill for the clients so they could cook out with their children. She said that should put to rest questions about clients grilling outdoors.

Hogg said the facility, which is named after the mother of former Kentucky First Lady Judy Patton, is dependent on the funding from the court and from donations and other aid from hundreds of volunteers and donors. She said the program was one of the first transitional centers in the state and that surrounding counties are now modeling their own programs in the Letcher County facility.

“We have a model program that Letcher County can be proud of,” said Hogg. “If any issues arise in the future please contact Phyllis Barker or the board members. We want to clarify them.”

Fleming told Hogg there had been a lot of confusion about the facility and said he had not known it was a transitional facility. He said the presence of HOMES had also created some confusion and added that he is glad the issue has been clarified.

“I apologize to you if I said anything to make it hard to get funding,” said Fleming.

Keith Adams and District Two Magistrate Terry Adams apologized as well. Terry Adams said he had not understood the nature of the organization and Keith Adams added that a person should not listen to rumors.

In other business, Paul Nesbitt of Nesbitt Engineering, who is working with the City of Jenkins on the Payne Gap Water Project, reported that Phase I is nearly complete and showed the court a map of the entire project. Nesbitt said a memorandum of agreement has been delivered to the mayor’s office in Jenkins from Abandoned Mine Lands (AML) for $3 million to fund Phase II and the money should be available after July 1. Nesbitt said Phase II should take lines to Mayking and Phase III will tie in at Kona.

Judge Ward asked Nesbitt to look into the feasibility of extending a line from the main line to county facilities at Fishpond Lake as well. Nesbitt added that construction has gone well and that while there have been some cleanup issues, some of the contractor’s money was withheld to get the contractor’s attention. He added that he expects water should be in the Phase I lines in 60 to 90 days.

In other water-related issues, a group of residents from Mill Creek asked the court about getting lines extended from the Deane Water Improvement Project to serve their neighborhood. Although AML has agreed to fund the main Deane project, the Mill Creek area did not meet the agency’s funding requirements.

Christopher Yonts, who lives in the Shelby Fork area of Mill Creek, said the community has been left out even though the well water there has been impacted by mining and gas drilling as well as by silt from a nearby coal tipple. Yonts at one point became angry and said he felt Mill Creek residents were being “screwed.” Yonts said the coal companies and gas companies should be required to do something for the area since they had ruined the water there.

Ward told the Mill Creek residents their problem is close to being solved because he and Terry Adams had gone to Frankfort and helped persuade the General Assembly to agree to put funding in the state budget as a line item to extend lines to the community. Ward said the funding is already in place and the project will be done sometime this year.

The court also voted to use coal severance tax money to pay for tap fees for Letcher County residents who have water lines extended into their area that are not funded by AML. Under AML’s guidelines, the agency pays for the connection fee of every customer on AML-funded projects, but other funding and loan providing agencies do not. After hearing a complaint from Gary Rogers of the Letcher Fire Department, Magistrate Fleming made the motion to use coal severance tax refunds to pay the tap fees.

Ward told Fleming that using the coal severance money for tap fees will mean that the money can’t be used to extend water lines, but Fleming said it would help the Letcher County Water and Sewer District to add more paying customers. Fleming said he believes the current fee of $350 keeps many people from signing up for water although they need it. Fleming also said those residents on the lower end of the county who have signed payment agreements for tap fees but have not gotten water service should get their money back when funding becomes available.

In other business:

• The court approved the Department of Parks and Recreation’s 2012-13 budget for $110,000.

In a related matter, Parks and Recreation Director Derek Barto gave the court the first in what will be regular monthly reports on the new Letcher County Recreation Center in Whitesburg. The center has averaged a net profit of $24,000 per month since opening late last year. It has sold more than 1,400 memberships and has served elementary schools throughout the county. Barto said the facility averages holding 10 parties a week and added that he will post party times on a dry-erase board so people will know when certain parts of the center will be in use. Bowling leagues are also being formed.

• Deputy Sheriff LaShawna Frazier presented the court with the 2011 financial statement from Sheriff Danny Webb. The sheriff ’s office had gross receipts of $ 877,687.36 against total disbursements of $877,554.84 with excess receipts of $132.52.

• The court approved a $ 1,057,412 operating budget submitted for the Letcher County Jail submitted by Jailer Don McCall.

• The court voted unanimously to request multicounty severance funds with Perry County and Knott County to expand the capacity of the Carr Creek Water Treatment Plant that serves all three counties. Ward said if the plant isn’t expanded it will limit the county’s ability to expand water service.

• The court voted unanimously to approve an agreement with Knott County to allow Letcher County to maintain the Bull Creek and Elk Creek roads.

• The court voted unanimously to advertise for bids for the construction of a World War II monument in Jenkins. Magistrate Fleming praised the work of Mary Ann Mullins of Burdine, who he said had done the lion’s share of the work to make the monument a reality.

• David Narramore, chairman of the Letcher County Tourism Committee, reported that Artwalk will be held in Whitesburg on April 28 and exhibits will be open to the public beginning April 5. The gallery in the tourism building will be open from noon to 6 p.m., Thursday through Saturday. Narramore said persons wishing more information may call Pat Shelton at 606- 632-9542.

• The court was told that auditions for the Little Shepherd Outdoor Drama in Jenkins will be held at the Jenkins Public Library on March 25. It is an open casting call and all roles are open.

• Letcher Fire Chief Gary Rogers told the court that accusations he had overcharged residents of Carcassonne to haul water are not true, but added that the department has to pay for the water at the county terminal and that fuel costs have gone up. The court asked that area fire departments that haul household water should not charge more than their actual costs.

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