County commissioners have given Weems Memorial Hospital CEO Mike Cooper a vote of no confidence and are considering stepping away from their management agreement with Tallahassee Memorial Hospital.

The series of votes at the Nov. 21 county meeting was triggered by a report from County Coordinator Michael Morón that Cooper had informed him Weems was in need of a cash infusion for payroll.

Morón reported that based on a conversation with Cooper the previous week, the hospital’s operating account was drawn down after payments were made to reduce the account payable balance earlier this month, and that after the Nov. 15 payroll, approximately $140,000 would remain in Weems’ account.

Morón said Cooper, who was not in attendance at the meeting. had told him more than $350,000 could be needed to meet Weems’ next three payrolls. The hospital CEO told him Weems would receive LIP/DISH funding sometime in the spring of 2018. LIP (Low income pool) and DISH (Disproportionate share) monies are state and federal health care monies reimbursed to hospitals that serve low-income patients.

Morón said Weems had received a payment of $180,000 in DISH money the week prior which was needed for accounts payable.

Morón’s report came against a backdrop of a mounting debt Weems owes to both the county’s health care trust fund coffers, as well as to Tallahassee Memorial (TMH).

In 2015 and 2016, the county advanced Weems close to $900,000 out of its health care trust fund that draw on monies from its one-cent sales tax, first enacted a decade ago. A portion of that has been repaid, so that Weems now owes the county about $690,000.

In addition, since TMH’s management agreement calls for Cooper to be one of their employees, Weems owes the Tallassee hospital at least a half-million dollars in monies TMH has advanced for Cooper’s annual salary of $150,000.

“It (the TMH debt) is somewhere between $500,000 and $650,000. It goes up and down significantly throughout the year,” Cooper said, in a telephone interview Tuesday.

The hospital’s combined debt of at least $1.2 million, on top of the fact that half of the roughly $2 million annual proceeds of the sales tax goes to Weems each year for operations, and another $120,000 to support the two clinics, concerned commissioners.

“This is about to get serious,” said Commissioner William Massey. “If (TMH) asks for their money it will interfere with us paying salaries (at Weems).”

Commissioner Noah Lockley moved, and Commissioner Cheryl Sanders seconded, to end the county’s management agreement with TMH, and in so doing end their relationship with Cooper.

“I have asked Cooper repeatedly why we have a $2 million deficit. He says things are great, but (Weems) still hasn’t paid back $285,000 from (the Health Care Trust Fund) borrowed last year,” Sanders said. “We have to say we have had enough and consider selling the hospital or whatever else we have to do. (Cooper) has been lying to me.

“We’ve got to do something better. The people deserve better. We are almost at same point we were 20 years ago and I’m concerned. We can’t continue to take money out of capital outlay. I feel like this commissioner has been lied to by Mr. Cooper,” she said.

Lockley’s motion passed 4-1, with Commissioner Ricky Jones opposed.

Alan Feifer, spokesman for the Concerned Citizens of Franklin County, said from the audience that he had been unable to obtain a financial report for Weems for September. “Somebody needs to look and see if we’ve gone over the cliff,” he said.

Feifer said that if Weems closes because it is left without a CEO, there is no longer sufficient money in the trust fund to reopen it. “We’re better off negotiating as a going concern. It’s an emergency situation (if Cooper) leaves,” he said.

Morón told commissioners that negotiations with Community Hospital Corporation (CHC), which the county hopes to bring is as a risk partner, have stalled. CHC has been communicating with County Attorney Michael Shuler.

Morón suggested commissioners, CHC and Shuler meet on Dec. 5 to discuss options, and the county attorney agreed the meeting was a good idea.

“At this time there is not a meeting of the minds. I would like to have (all five commissioners) in the room,” said Shuler, and asked commissioners to reconsider TMH termination until after the meeting with CHC.

Former County Planner Alan Pierce suggested the county give TMH 90 days to make changes to replace Cooper.

Lockley made a new motion to give TMH a 90-day warning, which passed unanimously 4-0, with Sanders having left the room.

Cooper said Tuesday that while he has not been involved in the county’s negotiations with CHC, he believes a partnership is needed if Weems is to gain sources of income..

“It operates about as well as it’s going to do for as small an operation as it is,” he said. “It’s not an expense issue, there’s got to be additional revenue streams created, and you can’t do that without the likes of CHC.”

He cited two possible additional sources, the federal government’s 340B program that offers steep drug discounts to hospitals such as Weems that serve low-income patients, as well as the creation of an adult outpatient psychiatric unit that enhances the Medicare payment for geriatric patients.

“I’ve worked on it and the stumbling block has been on getting a psychiatric partner,” Cooper said, noting that CHC might be able to help in this regard.

He said that because of the way the state directs LIP and DISH monies, Weems has to wait nine months to get a lump-sum payment, which could be about $1.2 million in the spring.

“Last year we started with less than $150,000 in the bank, and then when we got a big hunk of money we made significant payments to the county and TMH and put a significant amount in savings in anticipation,” said Cooper. “We’re almost halfway though the year, and we haven’t received any money.”

He said some money has come in following his talk with Moron, and that he had talked with him prior to that out of an abundance of caution.

“I don’t want to be an alarmist here and I do not want to not give notice to the board, but depending how things fall it could become an issue for us to meet payroll,” he said.

Cooper said the hospital covered its Dec. 1 payroll. “If I don’t get any more money at all from the state I can make it probably though January but it’s a fluid thing,” he said. “Our cash position now is much better than a couple years ago.

“It’s a cash flow issue, not an operations issue,” he said. “We have a positive cash flow.”