By Mary Alice Murphy

Public input came toward the beginning of the special budget meeting held by the Gila Regional Medical Center Board of Trustees on May 22, 2017.

Chris DeBolt, who retired from Gila Regional, said: "I will continue to be at meetings that concern the hospital, because I care deeply about Gila Regional. I think what has been neglected is the voices of the patients, their families and friends. They spoke last week at the forum on the Cancer Center. I was impressed by them. They are afraid and angry."

She said the three worst words a person can hear are: You have cancer.

"I hope you are open to listening to them before you make a decision," DeBolt said.

She said the Selection Committee, of which she was a member, to choose the next chief executive officer was "a great open process."

"It seems to me to be only fair that you table the decision on the Cancer Center until the new CEO is here and learns about the situation," DeBolt continued. "I encourage the decision to be a more public and transparent process."

A review of the fiscal year 2017-18 operating and capital budget, titled: "State of New Mexico- Gila Regional Medical Center/Grant County resolution No. 2017-2," which will run from July 1, 2017-June 20, 2018, began.

Interim CEO Alfredo Ontiveros said it is a "bottom-up budget. We included directors in the process. (Controller Elizabeth) Allred and (Interim Chief Financial Officer JoBeth) Vance have been working on the process since about February."

"It is a conservative budget," he continued. "Because of timing, the new CEO coming in will have to go with this budget. I think the hospital will be able to attain this budget next year."

Vance echoed that it is a conservative budget. "Volumes remain pretty much flat, but we see increasing revenues because of the safety net care pool we will receive and based on revenue generating changes we have made. For expenses, the directors submitted them, and we tweaked them only a bit."

She said the budget expects an excess of $538,000 at the end of the fiscal year. "I think it's doable."

Trustee Tony Trujillo said he thought it important to highlight salaries and benefits, which are set to decrease about $219,000, especially on contract labor, which should see a $3.6 million decrease.

Trustee Dr. Victor Nwachuku said the expenses for Meditech 6 will begin to decrease in June, after the go live date. "Some costs will decrease and some revenues should increase."

Ontiveros warned that June might see a downturn in the revenue part, because for a period of time, tweaks would need to be made and the Meditech 6 system might not be ready to create charges. "But there should be a pick up in revenues in July, August and September."

Board Chairman Jeremiah Garcia said some back billing needs to be done and that might take a couple of months. "We will have Meditech technicians to help us with glitches."

"But I hope we won't have them long," Ontiveros said.

Garcia complimented Allred for putting much of the budget together, as she began working on it before Vance arrived.

"It was a team effort," Allred said. "We gave the directors the templates and they put in the labor to build their expenses into them. We have 70 departments and 30 directors, so it was a significant amount of work."

Trustee Mike Morones said the directors want to make sure the budget is realistic, because they are the ones that have to implement it.

Chief Nursing Officer Peggy White said: "This is the first time my directors have been able to understand the budget and have realistic expectations of the target going in."

Garcia said it was important for everyone to "have a piece of the pie. Everyone was involved. We challenged the financial department to go with as realistic a budget as possible as we right-size, especially addressing the contract labor that Mr. Trujillo has been hounding us about."

Vance said the hospital has cut back on legal and consulting fees. "We anticipate bringing in full-time employees instead of contract labor."

Ontiveros said the budget allows for continuing recruitment in surgery, ENT (ear, nose and throat), pediatrics and family practice for next year.

"We would like to recruit more, but our focus is on what brings in revenue," he said. "Even though the budget is conservative, there are still opportunities to increase revenue. As Trustees Trujillo and Morones continue to say: 'Keep an eye on expenditures.'"

Garcia also complimented the interim CEO on getting the Meditech 6 upgrade process continuing toward the go live date on June 1.

Trujillo said the team led by Ken Stone has been putting the system to the test.

Garcia said once Meditech goes live, it will communicate with other systems. "I hope there are very few glitches. We're excited. It's been a task for a couple of years, so we see light at the end of the tunnel."

"Nine days," Ontiveros chimed in.

Nwachuku asked for clarification on the projections. Vance said the projection shows an increase of $1.1 million for inpatient services and a total $3 million increase.

"Remember, this is a $200 million plus operation," Ontiveros said.

Garcia said an area in the budget talks about capital expenditures, with priorities for the first, second, third and fourth quarters.

Morones said a lot of physicians were involved in the capital part. "They want to make sure they have the tools they need for their practices."

Vance said inpatient services always come first, but facility infrastructure is important to be able to treat them. "We tried to balance it out."

Morones said the $2 million is what the operations budget can stand.

"We will have to look out throughout the year," Vance said. "Some may be looked at in next year's budget."

Ontiveros said the hospital has missed some upgrades to process payrolls. "I'd hate to see employees complaining about their checks."

He said the hospital would replace two HVAC (heating, ventilation and air-conditioning) units this year, with 10 more to go.

"I support the capital budget," Morones said. "I would love to put the $2 million into cash on hand, but we need to keep plugging away to make sure the facilities serve the community."

"If revenues increase, we may be able to look at priorities," Garcia said. "We need a little bit for emergencies."

Vance said: "If it's an emergency, we make sure we get it done."

"I think if the cash flow goes well, we can bring the issue to the board," Morones said. "We may want to pad cash in hand rather than capital."

"We will try to stay within the budget," Garcia said.

Allred pointed out that in 25 years, only one budget had been amended after the preliminary budget was approved.

Garcia said what is important is that the budget is attainable, history-based and meets needs. "The caregivers understand what they need to do to stay within the budget."

"This is what we have to work with this next year," Ontiveros said.

"We submit this to DFA and then what?" Trujillo asked.

Allred said the audit comes at the end of the year. "Each quarter we send reports, the same ones you get, to DFA. When they receive the end of year numbers, they relook at the budget after they have given us the preliminary approval."

Trujillo asked what the days in cash on hand are. He was told 69 days in cash.

Nwachuku said that was good, because earlier in the year, they feared, by this time, it might be in the 40s.

The trustees went into executive session for more discussion on the budget for about an hour.

When they came out, Morones said they had talked about strategy and long-range planning as related to the budget. He moved to approve the budget and Trujillo seconded it, and then asked why it was a resolution. Morones explained because "we have to resolve to send it to DFA."

"The directors and caregivers had input in this budget, but it still allows for about $2 million for capital infrastructure expenditures," Morones said. "I like this budget."

Garcia read the entire resolution and then called for a motion to adjourn.