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Show EDITORIAL How Are We Governed? Ninety-one percent of voters casting ballots in February said yes to the new I percent sales tax imposed to save Garfield Memorial Hospital and Clinics and the valuable service they make available to all the people of the county. Saving the jobs of those who work at the hospital would be a secondary and important natural consequence of saving the hospital and clinics BUT imposing a tax only to save their jobs andor protect their job retirement benefits would never have been justifiable. It would be the same as taxing everyone county wide to save my job or yours. However, let's look at what has happened.' Intermountain Health Care which owned and operated the hospital and clinics said it had experienced a loss of $800,000 in the past year and notified the county commission that it no longer could afford to operate at such a loss. The number-one-ranked IHC which successfully operates large hospitals offered to turn the hospital over to the county and continue to operate it for the current year while the county decided what to do about running it. The county agreed and successfully proposed the 1 percent sales tax toward its operation, and then appointed the nine-member Hospital Transition Board to look into options to continue that operation. Board members had just begun to do their job and they and the commissioners were expecting to meet with Rural Health Management Corporation (RHMC) repre-sentatives to hear their proposal when the County Commission met on Apr. 24. Instead, on that commission day, Commissioners Louise Liston and Clare Ramsay and most Transition Board members learned for the first time that RHMC had been canceled by the County Clerk Camille Moore and Commissioner Dodds. They also learned that Commissioner Maloy Dodds had with the help of a few Panguitch Hospital Transition Board members, the county clerk, and some hospital employees with a vested interest in their jobs with IHC negotiated privately with Intermountain Health Care several days earlier. In a written offer to IHC, a draft of which was submitted to IHC for their consideration before the final offer was sent, Commissioner Maloy Dodds committed not only the revenues from the hospital but also the total revenues to be generated from the new sales tax, which the county estimates at $600,000 the first full year, and the state estimates at $725,000. His letter, signed only by him, stated that IHC was the county's "only" option and that the offer was from the commissioners and the newly appointed hospital board. At the previous Transition Board meeting, IHC had indicated that it was not interested in continuing to operate the hospital and clinics and had told the Board that the county should consider working with Rural Health Management Corporation (RHMC) with whom IHC had already communicated and to whom IHC had provided information to help that management company prepare its offer to the county to be discussed at the Apr. 24 combined Commission and Transition Board meeting. It is possible that the Transition Board and all three county commissioners would have ended up with a contract with IHC AFTER they had looked at all other options as they proposed to do, and would have come up with a carefully-thought-out contract that provided protection for the county and for IHC. Commissioner Dodds could provide no specific explanation to the board as to why the course he took demanded such immediate action, except to say he felt an "urgency." One might reasonably assume that offering IHC all hospital revenues and all tax revenues appears to have made a big difference with IHC and that IHC was now pressing for a fast solution. It also apparently made a big difference with hospital employees whose jobs and whose retirement benefits are now protected from any potential uncertainties." But there are some "what ifs" the county's taxpayers may want to be asking Commissioner Dodds: What if IHC decides to close the outlying clinics or cut back on emergency room coverage anyway? What if IHC again decides they cannot hire a third physician, a move we have been told will prompt the other physicians to leave? What if no anesthesiologist or nurse anesthetist (CRNA) is hired, will the facility be forced to turn away OB patients? What if sales soar in the county and tax revenues expand beyond anticipated funds? How will IHC use those funds? What if IHC's answer to lack of revenues at the hospital is simply to cut back rather than invest and try to build up the hospital's already diminished services? What i f hospital services are fewer and revenues less and sales tax revenues increase, how will that affect the hospital and clinics and IHC's bottom line? If the county owns the hospital and all it's assets, who will maintain it, and with what funds? What if the hospital's potential primary function will be simply to serve as a clearing house to funnel patients to other IHC facilities and help keep them solvent rather than to serve the needs of county residents? What if sales in the county diminish substantially reducing tax revenues? Will those reduced revenues mean further reduced hospital services and again possible closure? Who assumes the risk? Who makes the ultimate decisions? These are the questions that have gone unanswered in Commissioner Dodds' effort to apply a "quick fix." The Transition Board and the county commissioners have a challenging job on their hands. If Commissioner Dodds' letter is allowed to stand as a valid offer from the county, both the appointed Hospital Transition Board members and all three elected commissioners will need to have some answers for the county's voters. If they allow it to stand as an offer, perhaps IHC will still negotiate a sensible contract that will allow fairness for all. But, if that happens, will everyone still wonder what other possibilities might have been available as a solution for operating the county-owned taxpayer-subsidized hospital and clinics? And we have to ask was it fear of possible change and not-fully-predictable decisions by the Transition Board and the other two commissioners that may have motivated a Panguitch commissioner, and a few board members and hospital employees to jump the gun and manipulate manipu-late a situation in their favor? And, our final question: is this county governed by three commissioners, com-missioners, or by one? |