Rob Austin, Moab Regional Hospital CEO

Moab Regional Hospital needs approximately $550,000 from local donors and government entities in order to receive $1,698,800 through Disproportionate Share Hospital (DSH) payments from the state.

Robb Austin, chief executive officer of Moab Regional Hospital, and Jen Sadoff, the hospital’s marketing and community relations director, requested financial support from the county council at their meeting Tuesday, Sept. 3.

DSH payments are for hospitals that serve a significant number of low-income patients. The federal money is given to states, which is then distributed to hospitals based on both need and community support.

Sadoff said that $30,000 has been donated and another $100,000 had been pledged, leaving the hospital with $420,000 to raise by the end of November in order to receive the full reimbursement.

“For every dollar that is given, we receive three dollars back. One third must come from a local source,” Sadoff said.

Until 2011, hospitals were able to provide their own seed money.

Hospital staff approached both the Moab City Council and county council for “seed” funding in 2012. In November 2012 the Grand County Council allocated $195,000 and the Moab City Council allocated $82,000 in order to pay a $277,000 payment to the State Department of Health on behalf of Moab Regional Hospital for the DSH reimbursement. Due to the city and county’s contributions, the hospital received $877,000.

The hospital received notice that due to the high volume of Medicaid patients, it was eligible for an additional $1 million in DSH funding. The hospital raised $350,000 in private donations for seed money to receive the additional $1 million.

“We did not budget money for this this year,” said council chair Gene Ciarus.

The city council also received a request for funding the seed money; but through a letter from Austin near the end of their annual budgeting process this summer.

“The requested funds had already been allocated to the USU set-aside fund, pursuant to the city council’s priorities set in their Visioning process in February,” said city manager Donna Metzler.

In joint city and county council meetings and through presentations made by a city and county health task force, there had been discussion regarding enacting a county rural health care tax that could subsidize the Canyonlands Care Center and provide seed money for the DSH reimbursement.

The county council considered placing the rural health care tax on the Nov. 5 ballot at their council meeting held Tuesday, Aug. 6. However, due to the legal opinion of county attorney Andrew Fitzgerald, the council chose not to take action.

“No motion was made due to legal review essentially stating that it would be misleading to the public to hold a special election to ask the voters about the tax prior to the State Code being amended to allow it,” said county administrator Ruth Dillon.

At this time, the state code requires the use of a county rural health tax for county-owned health facilities. Moab Regional Hospital is a private not-for-profit facility. The Canyonlands Care Center is owned by a county special service district, not the county itself.

Sadoff emphasized that the hospital provides services for low-income county residents.

“One of the things I would highlight, just last year, in 2012, we gave $4.9 million in uncompensated care,” Sadoff said.

Approximately 85-percent of the $4,901,645 of charity care and bad debt that the hospital wrote off last year was for residents of Grand County, not visitors, Sadoff said.

“Our community has a really high percentage of people on Medicaid,” Sadoff said. “I think it’s a reflection of the economy. We are definitely seeing a big increase in bad debt.”

The hospital now has an in-house Medicaid eligiblity worker and a four-person Charity Care Committee to review bills for low-income individuals and families.

According to the presentation made by Austin and Sadoff, if the hospital had not received DSH funding over the last three years, it would have had a net loss of more than $4.2 million.

“This is a critical program for our local health care system,” Austin said. “It would make us be able to meet our bond indebtedness for 2013.”

The new hospital campus on Williams Way was built through a $31 million bond through Housing and Urban Development (HUD). Austin said that the remaining balance on the bond is $28,760,000.

Council member Lynn Jackson asked if DSH funding would be available when the Affordable Health Care Act is fully implemented.

Austin said that according to conversations he has had with other hospital administrators, it may not be available after 2014.

“We may not have the ability to tap that source. It’s up to the (U.S.) Congress to pass that, but that’s what we’re hearing in hospital administrator land,” Austin said. “I’ve heard that starting in 2015, that it won’t be available anymore.”

Austin said that there is a belief that there won’t be a need for the federal government to provide DSH funding once the Affordable Health Care Act is in place.

“They believe more people will be covered and there will be less uninsured,” Austin said.

Sadoff stressed the need for county contribution.

“We’ve come to the conclusion, that short of fund raising, the county is our only option to get that funding for the 3 to 1 match,” Sadoff said. “We can’t raise $500,000 a year; that will affect other non-profits also dependent on fund raising.”

Austin referred to the upcoming deadline and how funds need to be received in time in order to receive the compensation.

“If Nov. 29 comes around and we don’t have the money, we don’t have a choice,” Austin said.

Sadoff said that the full $550,000 doesn’t need to be raised in order to receive monies.

“Whatever you can give and we can send, can still be matched,” Sadoff said. “I’m out there beating the bushes. I’ve stopped getting invited to most parties because we’re looking anywhere we can for this money. Anything you can give would be most appreciated.”