Putnam General Hospital leaders and supporters made a plea to commissioners Aug. 10 to rework the proposed 2019 budget that funds the hospital at $250,000, a $150,000 reduction from the previous fiscal year.
Going against tradition, commissioners allowed the public to speak on budget matters at the work session and Dr. Robert Betzel, who is on the PGH authority board told the BOC that the $400,000 the hospital had been receiving for the last five years covered only about two months of the write offs for indigent care and bad debts.
“In 2008 we received $542,000, which continued at $500,000 until 2013,” Dr. Betzel said noting commissioners decreased the hospital’s budget through the years instead of increasing it.
Commissioner Alan Foster agreed — calling fellow board member’s attention to the budget displayed on a large screen in front of them.
“Just about everywhere you look, it goes up a little bit as you go along and yet the hospital has been the same for five years,” Foster said.
“I don’t see the hospital being less important than what it was. It is one of our budget considerations, but it’s not less important that some of these other things like recreation, fire and courts system, it’s right up there with those so I would be opposed to seeing a reduction of budget for the hospital.”
Foster said he preferred the hospital get a small increase, suggesting $450,000 in keeping with inflation, and wanted to know from County Manager Paul Van Haute why he made the decision to cut that budget.
Van Haute said that a couple of things went into play, including a decision by Macon-Bibb County to eliminate a contribution of $471,000 to Navicent for indigent services.
Rhonda Perry, COO of Navicent Health, confirmed Macon-Bibb County officials made that decision and said Navicent was in a position where they had only 350 days cash on hand.
Van Haute said the other reason for his decision was an unsurety of PGH’s ability to continue to operate under local authority.
“I’m concerned as to the long-term viability of the hospital; we’re talking about an organization that was basically C.O.D. for supplies a couple of years ago, $2.5 million in debt three or four years ago and now $7 million in debt,” he said, noting also that he didn’t think the hospital would close, only that Navicent would operate the facility.
Van Haute also said Houston County began suing people for indigent care and as a result, indigent cost went down the following year.
“They had their wages garnished and everything else; none of these things have been discussed as a proactive management position on behalf of Navicent. So, I’m wondering if they are going to make it,” he said.
Perry advised that by law, no hospital could sue an indigent patient.
“What Houston is going after is bad debts where people have the ability to pay,” she said, noting also that PGH would endanger their tax-exempt status if they started suing for an inability to pay.
The hospital authority did submit a plan to reduce the debt it owes to Navicent.
That plan gives Navicent PGH’s $1.5 million in proceeds the rural hospital received from the Georgia Heart program, a state-instituted program allowing taxpayers who give to eligible hospitals such as PGH to receive a 100 percent tax credit for the contribution.
The debt reduction plan also calls for any surplus funds received from the Georgia Heart program to go toward operating the hospital and not to Navicent debt reduction.
“The fact that our annual funding has been decreased by almost 40 percent shows a decision on the board’s part that they may not understand the negative impact such a drastic reduction will have on our hospital’s operating budget,” Dr. Betzel said.
“The hospital’s been working diligently to utilize the Georgia Heart program. I hate to think because many have worked so hard to get so many to give that this is being used to justify our funding.”
Tom Thompson, who was appointed by Gov. Nathan Deal to serve on the state Rural Development Commission and to Putnam General’s board 18 months earlier by the BOC, said the RDC spent about half its time looking at the plight of rural Georgia healthcare.
“A lot of hospitals in the state of Georgia about the size of ours have closed. Navicent, I understand, came in to help stabilize this situation financially because they realized that our hospital is fairly unique,” Thompson said. “I would urge you to recognize that our community stands on three legs. It stands on its schools, its churches and its hospitals.”
PGH supporter, Mona Betzel, said children who grew up in the community have a relationship with the hospital whether through injuries or the loss of loved one or other ways.
“They believe in the hospital and its importance to the area,” Mrs. Betzel said, noting also, “Without a strong viable hospital, Eatonton and Putnam County cannot and will not be taken seriously as a place of location or relocation.”
PGH authority board member, Judy Fain, whose father and grandfather were doctors, told commissioners that unlike a business where the customer is required to pay for the services they receive, hospitals can’t turn patients away.
“If people come into our ER, we are bound by law to serve them and if they walk out without paying, we have to absorb that cost, year after year,” Fain said.
“Just because we provide the charitable support that we do, we need the support from the county monthly.”
Alan Horton, CEO of Putnam General, said hospitals are the only contractors in the state that are paid less than the cost of care.
“And we don’t have a way to make up for that loss without the support of our community,” he said.
After hearing from the speakers, Commissioner Trevor Addison said that in 14 years Putnam County commissioners have allotted more than $6.8 million to the hospital.
“We’re a partner,” Addison said. “I support the proposed budget, but perhaps I will try to rework some of the numbers myself, as I have told the board that I will try to do.”