The Memorial Hospital is reworking its 2004 budget, which was already adopted by the hospital board, after county budget cuts stripped $50,000 from TMH coffers.
The budget was actually cut about $135,000, but the Moffat County Commission agreed to purchase an $85,000 ambulance for the hospital using grant money. The net cash impact for the hospital was $50,000.
The cuts announced Monday subtracted even more money from the already diminished county hospital funding.
TMH has received roughly the same amount of funding from the county for the past 17 years. The funds help to offset "uncompensated care" TMH delivers in Moffat County, based on a "historic covenant" between the county and TMH, according to Hospital Administrator Randy Phelps.
"The county provided us a sum of money to help us offset care provided to county residents who weren't able to pay," Phelps said. "For the last 17 years, that number has been pretty static. We haven't asked for an increase in that budgetary amount for 17 years."
In 2003, TMH received $472,000 from the county for the uncompensated care. However, TMH projects the cost for providing the charity care will reach $677,000 in 2003. Historically, the hospital has been able to offset the difference between the charity care allotment from the county and the actual cost of providing the charity care.
In October budget negotiations, TMH was warned it would likely have to shoulder an even larger portion of that burden, when commissioners told the hospital not to expect to receive the same amount of funding as in years past.
Instead of $472,000, the county told TMH to expect $419,000 due to the county financial position. TMH prepared, and adopted, a budget based on the new figure.
But when the county budget still did not come together, commissioners announced Monday they were withholding another $50,000.
It sent TMH back to the drawing board.
"We are going through and recasting our budget based on what we've learned," Phelps said.
The cuts prompted initial fears that the Moffat County Care Clinic would close. The clinic is housed in the north end of TMH. It treats indigent clients on a sliding scale.
Since 1994, the county annually has given TMH $39,600 specifically earmarked for the Care Clinic, according to Phelps.
Monday's cuts, however, eliminated that funding altogether.
Community Relations Director Pam Thompson, fearing closure of the clinic, began a frantic push to speed up a grant application that could save the clinic.
Thompson had applied to the Caring for Colorado Foundation for a two-year, $100,000 grant for the clinic.
After learning of the additional county cuts, she called Caring for Colorado to report that the future of the Care Clinic is at stake.
"The future of the clinic is contingent upon the funding we receive," Thompson said.
Sue Lyster, chairwoman of the TMH board of trustees, said she could not envision the hospital closing the Care Clinic. And Lyster was confident that by reworking the budget, the hospital could uphold its historic commitment to community-based programs.
"I think it's necessary in this community for the people who truly need it," Lyster said.
While hospital officials may see the clinic as fulfilling a mission to provide healthcare to the underserved in Moffat County, financial benefits weigh-in, too.
Healthcare officials widely agree that the Care Clinic saves the hospital money by offering preventative healthcare, in a clinic, as opposed to seeing the patients in the emergency room when the condition is much worse and the venue much more costly. Either way, the hospital absorbs the bills of those who can't pay. In that view, it makes more sense to treat the patients in the less costly and more appropriate clinic setting.
As Phelps and Chief Financial Officer Roger White take another "snapshot" of the hospital's financial position, Phelps is increasingly confident the hospital can arrange to save the Care Clinic.
It's a decision that will ultimately be made by the board, which must approve the budget and any cuts.
In the time since TMH first drafted the budget, and the announcement of the additional cuts, Dr. Michael Crane, a newly hired doctor of obstetrics and gynecology, has lead a booming practice, Phelps said.
TMH may adjust its revenue projections based on the success of Crane's practice.
Coupled with adjustments elsewhere in the budget, it may save the Care Clinic.
The issue will come before the TMH board of trustees at its meeting Dec. 30 at 7 p.m. in the basement of the Visiting Nurse Association building.
Jeremy Browning can be reached at 824-7031 or firstname.lastname@example.org