By Mary Alice Murphy

At the work session on Aug. 16, Gila Regional Medical Center Chief Executive Officer Brian Cunningham explained why the resolution proposing a four-mill levy for the hospital was on the agenda for approval on Aug. 18.

"Three years ago, we were in the hole for $ 9 million," Cunningham said. "We recouped that the following year and continued to be in the positive for the next year. However, at the end of FY 16, we were at a negative $3.2 million. This is the most challenging environment for health care. It is a capital heavy operation. We have reinvested in IT restructuring and keeping the revenue stream going. Quality is still our major focus. The Centers for Medicare and Medicaid just gave GRMC a 4-star rating, one of only three in New Mexico, with no 5-star ratings in the state."

"Right now we have 115 days of cash, which gives us a cushion," Cunningham said. "But as we continue to bring on physician practices and equipment upgrades, that will drop. Fourteen other counties in the state support their hospitals. We want to continue to keep providing quality care to the community, and we want to continue to grow and provide services.

"We are proposing a four mill levy for the next four years," he continued. "It will be for capital equipment and infrastructure for the community. What we're attempting to do is prevent what happened in Taos, when it slid to 11 days of cash and had to do away with its ob/gyn and labor and delivery services."

He said Lea County, which has the other four-star rural hospital, has a mill levy to support its hospital.

Cunningham said the four-mill levy would provide about $3.2 million annually.

Commissioner Ron Hall and Commissioner Gabriel Ramos thanked Cunningham for talking to each commissioner separately and explaining the numbers.

Commission Chairman Brett Kasten confirmed the four-mill levy would sunset in four years. Webb said it could be renewed by another ballot initiative.

"How do we assure that the money will be spent on equipment and infrastructure?" Kasten asked.

Cunningham said he would report to the county and community monthly. "We can make it transparent. It will be easy to demonstrate."

At the regular session on Thursday, Hall commented that he wanted to make sure it would sunset in four years. Attorney Abigail Robinson said, by state statute, it could be renewed only once for a total of eight years.

Hall said he did some calculations and it "would be a healthy raise in property taxes."

Ramos said the tax was substantial, but the hospital is important to the community. "I would like to see language that if funding for the hospital comes back to 2008 levels that the levy would be abolished."

Cunningham said if the safety net care pool came back, "we would surrender it." He explained that the hospital has lost about $11 million the past year from previous levels of the safety net care pool."

Kasten asked if unfunded, uncompensated care has remained about the same. Cunningham said with expansion of Medicaid, "we have netted about $5 million."

"Government funding has been reduced by two-thirds," Kasten said. "I commend you for cutting services."

Cunningham replied that the services had not disappeared but had been shifted to community agencies.

He said that the hospital had determined that the need for equipment upgrades was about $2 million. "That doesn't address the needed expansion, which we've been talking about for 15 years. We're looking at $5 plus million over the next five years."

Hall said it was important to get the information to the citizens and asked for public forums on the issue.

Assessor Raul Turrieta at the regular session brought the numbers to the commissioners. "I create the authority for the four-mill levy and the money goes straight to the hospital. We have one of the lowest millage rates in the state and have stayed consistently as second lowest."

The levy will tax the taxable value on a home, keeping in mind that taxable value is about one-third the sale value of the property.

He cited an example of what it would cost a property owner annually for the additional levy. For a home with $100,000 taxable value, it would cost $133.33 more a year, and would bring to GRMC each year $3.3 million.

Turrieta noted that his staff was working on reappraisal for 2017.

Jeremiah Garcia, GRMC Board of Trustees Chairman, said: "We have challenged the CEO and the C-level leadership on this issue. We want you to understand that this is critical. We see a crumbling health care system across the nation, and we don't see a lot of help. Sometimes we have to take care of our own. How will we replace aging equipment, which we must, to remain current? If we do not, we are in danger of losing quality physicians. We ask you to consider supporting the levy and our hospital. We just received a four-star rating. We want to continue to give quality care to our citizens. I think we are working in the right direction."

Cunningham pointed out that the difference in the bottom line for the hospital budget has been in the amount received for uncompensated care. "Yes, we have more revenue received through expanded Medicaid, but we are still down $12 million to $13 million over what we received in the past. We exist as a county-owned hospital to serve our communities."

"It's not just hospitals across the country," Kasten said. "Shame on the state and federal governments for putting rural schools, universities, municipalities, counties, detention centers in such dire straits. We are inundated with unfunded mandates, draining our emergency funds to near emergency levels."

He noted that Senator Howie Morales told him he would be a 100 percent advocate for the four-mill levy.

"If you do not take care of yourself," Kasten said, "do not ask anyone else to do it for you."