The CEO of Iron County Medical Center in Pilot Knob is counting on voters to approve a half-cent sales tax appearing on the April ballot so that the financially troubled hospital might have a chance to survive.
The half-cent sales tax would be added to a half-cent tax already in effect.
Over the last several months, CEO Joshua Gilmore has been holding town hall meetings to make people aware of the critical access hospital's dire financial straits and the work he and his staff have been doing to remedy the situation since his arrival a year ago.
In February it was Gilmore who announced that the hospital had filed for Chapter 9 bankruptcy in the hopes of stopping the financial bleeding the facility has experienced since opening in December 2006.
"I think they started out on the wrong foot because they didn't have any funds for operating when they opened the door, so they started out behind the curve and they never really caught up," he said. "What happened over time is that they got a little bit further and further behind.
"The last four years they've gotten very far behind in regard to paybacks due to Medicare based on cost report filing. The combination of the increased accounts payable, as well as the amount of paybacks that we have had led to it being harder and harder for them to make ends meet on just a regular monthly basis."
According to Gilmore this is what has led the hospital to be in the financial dilemma it finds itself in now.
"We've made a lot of improvement over the last 12 months while I've been here, but we're not where we need to be yet," he said. "To put that into perspective, fiscal year to date through January 2018, which started July 1, we had a loss of $205,000. While that's not where we want to be — that isn't sustainable, and we need to correct that — a year ago for the same time period in fiscal year 2017 through January we had a loss of just under a million dollars."
Still, despite seeing some improvement, Gilmore admits that they haven't turned the ship around yet.
"There's a variety of reasons that extend beyond just the debt, such as poor reimbursements from our payers," he said. "You know Medicare and Medicaid aren't looking to give you any extra dollars these days.
"Things are getting tighter and harder to recoup from them. We've been subject, from the Medicare side of things, to sequestration. So rather than us getting 101 percent of cost, we only get 99 percent of cost on a good day. That's for what they allow."
Gilmore noted a hospital "necessity" not reimbursable under Medicare.
"Simple things like covering the cost of maintaining telephones and televisions in patients' rooms," he said. "That's relatively a minor expense but that's industry standard. You're not going to go to a hospital anywhere and not have those things — but Medicare doesn't consider that a reimbursable cost.
"The reality is that we don't really get true cost for Medicare at the end of the day. Since that's 50 percent of my business, that makes things challenging. The best we do with Medicaid is to actually get cost, but again with them not everything is paid at that level when you look at the books at the end of the day."
That leaves the hospital's commercial payers to make up the difference between what's covered and not covered, as well as leaving them on the hook for helping the medical center make up for its bad debts and caring for indigent patients that can't afford to pay for services.
"That's not been happening," Gilmore said. "Our commercial payers have not been paying us at a level that is sufficient to make up for those gaps. I worked for about seven months after getting here to try to renegotiate contracts. I got United Healthcare to come to the table, which was a huge help, but they still weren't giving me what we knew we needed to make ends meet.
"I accepted the new contract because it was a lot better than what we were getting before, but it still is not sufficient, and I knew that, to get us where we needed to be. But it beat the alternative of continuing to take the sizable loss that we were taking at the time.
"Blue Cross was not willing to renegotiate the contract, feeling that they had already agreed to enough. It took me communicating to them through our Chapter 9 about the possibility of maybe having to terminate their contract to get them to come back to the table."
The half-cent sales tax, which would be added to a half-cent tax already in effect, could help the hospital achieve sustainability if it's passed. It will affect everyone purchasing items in the county - not just residents but those traveling through the area who make purchases as well.
"If approved, we estimate that the tax will bring in an extra $400,000 or so to help us make ends meet," Gilmore said. "We're just asking the voters to step up and help support this organization on an ongoing basis. We don't see things getting easier down the road from a reimbursement standpoint. We see things getting more challenging as we as a nation struggle with how we make health care sustainable. I think we will get there to sustainability, but I think it's going to get harder before it gets easier."
The St. Francois County Commission approved a resolution adopting an All-Hazard Mitigation Plan when it met in regular session Tuesday morning at the courthouse annex in Farmington.
Associate Commissioner Patrick Mullins explained the purpose of the resolution before the vote.
“The Southeast Missouri Regional Planning and Economic Development Commission has contracted with the State Emergency Management Agency (SEMA) to complete the five-year update to the St. Francois County Hazard Mitigation Plan,” he said. “The focus of the plan is on actions that local jurisdictions — specifically the county, cities and public school districts and college can take to mitigate against the impact of natural disasters on the public, students, infrastructure and economy.”
According to Mullins, as of Nov. 1, 2003, any Missouri county declared a federal disaster area must have an approved plan in place to be eligible for hazard mitigation grants.
“The funds may be used to fund projects that will reduce or eliminate losses from future disasters, as well as providing long-term solutions,” he said. “Some examples would be safe rooms, sirens, generators, underground electric wires and certain utility poles.”
Mullins noted that the commission has been working with SEMA since its first Southeast Missouri Region Disaster Mitigations session held in June 2010. Besides active participation in the plan’s development, the county is required to have a representative attend meetings and complete necessary documents. In addition, the county must provide its portion of the match for the grant funding development of the plan.
“In-kind matches are allowed and no out of pocket expenses are required,” Mullins said. “In-kind labor on Aug. 31, 2010 was $4,789.61 out of the $7,000 needed. The rest was made up by other local jurisdictions. Now the in-kind labor is $8,000. Time sheets will be used at the rate of $21.57 [an hour].”
After being told that the draft All-Hazard Mitigation Plan had to be adopted by the commission prior to March 26, Mullins explained that the last minute vote was caused by the Federal Emergency Management Agency (FEMA) being “bogged down” because of recent natural disasters, including Hurricane Harvey that hit Houston, Texas, and Hurricane Irma that devastated Puerto Rico.
“Nothing binds the county to this,” Mullins said. “There are no funds necessary and no commitments have to be made.”
He added that by adopting the plan he hopes the county will be able to get as many as two emergency generators — one for the courthouse and the other for the courthouse annex — with an 80/20 match grant.
In other action, commissioners opened bids for county department computers; approved a bid for box culverts; approved bids submitted through the annual bid process; received the sales tax collection report; approved the Senior Citizens Committee minutes and resolution; accepted the recommendation of the St. Francois County Sheriff’s Department to reject a bid for data storage; and approved a position change and addition in the assessor’s office.
The next regular meeting of the commission will take place at 10 a.m. March 20 on the third floor of the courthouse annex.
The Park Hills City Council met in regular session Tuesday evening to hear city reports and to approve two ordinances. Absent were Councilwoman Charlotte House and Councilman Tom Reed.
First, the council opened the floor for public comment regarding an updated city zoning map, as explained by Park Hills Community Development Director Robert Sullivan, who said the city had been working with Stan Balsman of the Southeast Missouri Regional Planning Commission.
“Some of the changes that we made, for instance, if there was a piece of property that was split in two by a zoning line for some reason, he went back and researched the ordinance to clarify where that line was supposed to be. For some reason, when they did the mapping it put a line through a piece of property and the intent was not to zone that piece of property as two different zones.”
Sullivan said the city Planning and Zoning board had approved the map and recommended passage to the council. After hearing no public opinion or questions from the council, the present councilmen approved the planning and zoning map.
Next, the council heard City Administrator Mark McFarland’s monthly report, which touched on work at the sports complex, city work and the upcoming election.
McFarland said work on the ball fields at the sports complex had been completed, with the Central School District picking up the majority of the bill as they are heavily used for school athletics. He recommended council members go to the sports complex and see the finished work.
McFarland also said he had received several calls from residents asking about why the city street sweeper had not been in use recently. He said the sweeper is winterized at the beginning of winter and is not able to be used until the weather allows, which should happen in coming weeks.
McFarland thanked Don Akers and the street department for volunteering their time to go door-to-door handing out information about the use tax issue which will be on the April ballot. The use tax will allow city taxes to be collected on purchases made over the internet, which McFarland said is vital as physical sales within city limits decline in favor of online purchases.
In committee reports, Councilman Adam Bowers requested the council’s unofficial approval to place a sign-up sheet at City Hall for residents interested in being a part of the proposed neighborhood watch program. Hearing no argument, Bowers said he would put together the sign-up sheet and get it to City Hall in coming days.
Councilman John Clark gave a report from the Public Works Committee, saying that the committee had met and tried to decide on the most pressing issues to work toward resolving.
“One thing that the committee decided in discussion with the department heads is that we’d kind of like to narrow our pretty huge list down to three, four or five things that we’d like to focus on,” Clark said.
Clark said those prioritized items for the utilities include additional sewer crossings in the Elvins area, maintenance at the water plant, water main replacements on Griffith and View Streets, and an engineering study on the flow between Division and Wood Streets.
For public works, Clark said the prioritized items include storm water issues across the city, significant work on Lower Mill Street, paving on Strickland Lane, work on the downtown municipal parking lot and senior center parking lot, LED lighting at city-maintained intersections and sidewalk work around town.
The council then briefly discussed an ordinance to raise the cost of fire tags for the fire department. A separate ordinance had been drafted and discussed by City Attorney Ed Pultz, who suggested that the council pursue a simple rate increase this year and consider a more in-depth update in the future.
The present council members voted to approve the ordinance unanimously, which raised fire tags from $35 per year to $50 per year and commercial fire tags from the determination of the fire chief to a flat rate of $100.
The council then voted to adjourn into closed session. The next meeting of the Park Hills City Council will be a March 27 work session.
A local woman is being charged in the death of her infant who died just hours after being born at her home.
Roberta Baker, 36, of Bonne Terre, is charged with a class A felony of abuse or neglect of child.
According to the probable cause statement, on Feb. 22 at 3 a.m. Baker delivered her child at her home in the 1400 block of Highway 47. Officers were called to the home at approximately 5:30 a.m. the following day in regard to an infant that was in "full arrest," or unresponsive. EMS and law enforcement personnel responded to the home.
The baby boy was taken to Parkland Hospital by ambulance and a short time later he was pronounced dead. The deputy reported that Baker initially gave conflicting statements to the responding officers as to when she gave birth.
Baker reportedly told investigators that she discovered she was pregnant approximately one month prior to giving birth to her son. She told the officers that she believed she possibly became pregnant in June.
She also said she continued to use methamphetamine throughout her pregnancy, using meth as much as twice a week. Baker submitted to a drug test following the birth of the baby and the forensic drug test report indicated that she tested positive for meth.
Baker told investigators she “Googled” how to deliver her child at home and said she weighed the baby after he was born. She said he weighed two pounds and she believed the baby was premature due to either her drug use or from smoking cigarettes.
She told investigators she had five possible due dates and that the baby was fine after the birth. She said she fed the baby boy two bottles of formula.
She said she went to sleep holding the baby in her arms and when she woke up she could tell that there was something very wrong with him. She later told officers that the baby’s skin tone was a different color and that she thought it had something to do with his circulation. She also described the baby’s eyes as dark.
Baker told officers that the reason she never sought prenatal care or medical assistance for the birth of her child was due to the fact that she was “on the run” and had warrants for her arrest.
She was taken into custody for a probation and parole warrant out of Jefferson County that morning after police were called to her house for the unresponsive infant.
The baby was deceased when ambulance personnel arrived. The body was taken to Parkland Health Center North initially, then transferred to have an autopsy performed.
The autopsy revealed that the 2.5 pound baby boy was alive after birth and had been fed at least once. It was also determined that the baby was born anywhere from 28 to 30 weeks into the pregnancy and was just a few hours old when he died.
Initially a law enforcement source close to the case said he felt Baker had intentionally killed the baby, but the autopsy revealed the newborn may have died because it was neglected and not taken care of properly.
It was also discovered during the investigation that Baker had not been to the doctor and she didn’t know how far along she was in her pregnancy.
The initial call to 911 about the infant did not come from Baker, but from another source.
Baker is being held in the St. Francois County Jail on a $500,000 bond in addition to her Jefferson County warrants.