Stressing the need to keep a local hospital in Franklin County, the board of directors of Weems Memorial Hospital voted Tuesday morning to recommend the county commission begin talks with representatives of Tallahassee Memorial Hospital and Alliant Rural Hospital Solutions on a long-term deal to provide financial, operational and clinical oversight for the hospital.


The motion, made by board member Kristin Anderson and seconded by Duffie Harrison, made no mention, pro or con, of building a new hospital or freestanding emergency room.


Rather, it called for the county to begin negotiations on a proposal, unveiled last fall, for a five-year management proposal, developed by Louisville, Kentucky-based Alliant in conjunction with TMH.


County commissioners are expected to take up the recommendation at their meeting Thursday, April 30 at 9 a.m.


As it stands now, the TMH/Alliant deal is proposed to cost the county about $28,100 per month in the first year of the contract, and then increase to $28,500 monthly in year two, about $30,000 in year three, $30,400 per month in year four and $31,400 in year five.


The salary and benefits for the Weems CEO, who currently makes $10,000 per month, would be included in this monthly fee.


“We’ve all had ample time to study both proposals that have been submitted to us,” said Doug Creamer, chairman of the Weems board, referring to a second proposal made by Ascension Sacred Heart.


“I think today I would like for us to make a decision. We need to discuss the pro and cons and move forward,” he said.


As it turned out, there was no further discussion among the board members regarding the Ascension proposal, which calls for closing down the acute care hospital, and replacing it, somewhere in the county, with a freestanding emergency room the county would build, and Ascension would pay to outfit with equipment.


Both proposals call for retaining the hospitals’ two clinics, and beefing up specialty care, although they differ in their methods for doing so.


“I think this situation here with this pandemic shows the need to have hospital beds,” said Harrison. “We’ve increased our beds, our capacity. I just see a need for hospital beds.


“We don’t know what’s coming next,” he said. “I feel more comfortable having hospital beds.


“All the research I’ve done shows that a county with a freestanding emergency room is not looked at nearly as favorably with any corporation or companies considering moving in or investing in a county,” Harrison said. “The citizens of the county want to visit loved ones in the hospital.


“A lot of patients show up on golf carts, riding mowers or on foot,” he said. “It’s a big deal for them to come to a local hospital and visit with them.


“We should have the best small hospital in the state of Florida and the country and there’s no reason we can’t,” he said.


Harrison made sure to add that negotiations between the parties as to the terms of the partnership needs to be a part of the process, but did not specify any proposed changes.


David Walker, Weems interim CEO, said recent events have shown the need for communities to preserve their rural critical access hospitals.


“We don’t want to be forgotten here with Covid 19,” he said. “I have gotten calls from other counties that don’t have a hospital now and they wish they would have keep their hospital.


“This shows us we really need a hospital. We should have one of the best small hospitals in the area. Why can’t it be us?” he said.


The motion passed unanimously, with only board members Donnie Gay, and emergency room physician Dr. Patrick Conrad absent.


Courtney Alford, RN, who oversees the nursing staff, said the hospital has had 15 patients tested for the coronavirus, with all coming back negative.


She said the hospital has adequate reserves of personal protection equipment, and can draw on resources with emergency management and the county health department as well.


Alford said there are daily meetings with state health officials, and ongoing reports about testing and resources. “We’re continuing to push out more education for staff as it becomes available,” she said.


“It looks to me like it (testing) is going to ramp up shortly,” said Harrison.


Walker told the board that he would like to see Weems be a part of a pilot project regarding testing in poor, rural communities.


“We have a high number of underlying medical issues here anyway. That’s why testing is important,” he said.


He said the hospital has seen a steady number of emergency medical calls, but a drop in hospital and clinic visits due to patients’ reluctance to chance contracting the virus. The clinic in Carrabelle has been forced to drop its Saturday hours until further notice, after a drop in volume.


But, Walker stressed, the Weems staff is scrupulous about hygiene and CDC protocols, and that patients do not have to come into the clinic to be seen by a doctor.


“Sometimes people are afraid to come into our facility,” he said. “We want people to know it is safe.”


He said the consequence of delaying medical care, “is that when they finally come to the emergency department, they’re probably sicker than if they had come earlier.”


Richard Lewis, who heads the ambulance service, said staff does a thorough cleaning of each truck after every run.


“There’s not going to be a cross contamination between patients,” he said.


Lewis said he in discussion with a company to enable a telemedicine component to the EMS department, to better integrate the clinic, hospital and ambulance functions.


“We really want to take our services to the community, that’s huge for rural areas,” Walker said. “It means a different way to meet that need in the community.”


Walker said the ambulance service has three ventilators, and the hospital three, which is above the average for small rural hospitals. He said the seventh should arrive with a week or so.


In his finance report, Bill Storck, the hospital’s chief financial officer, said a $1.2 million accumulation of unbilled services has been whittled down to $43,000, thanks to the work of in-house staff.


Walker said about half of that had to be written off, and that of the rest, stepped-up collections will see only about one-third being received by the hospital.


Storck said the hospital has seen a rebound from a low of only six days worth of cash on hand, to 44 now, in some part due to an infusion in government monies earmarked for the COVID 19 crisis. But, he noted, revenues have dropped, and expenses increased, during the coronavirus pandemic.


“It (cash flow) is nowhere near as bad now,” he said.


“We were teetering, every hospital was,” Walker said.


Walker said he continues to explore the creation of a pharmacy kiosk in Carrabelle. “We have been in conversations with a company, we’re still looking into that,” he said.


He also said the hospital is looking into boosting its existing security camera system, and into the possibility of replacing its aging generator ahead of hurricane season.


“We have a generator at the hospital that really needs to be replaced,” Walker said. “We have an agreement now that if something goes wrong, they’ll bring us something quick and get it back up.


“Covid 19 has really pushed at the hospital to be more prepared now with hurricanes and whatever comes up,” he said.