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County backs TMH/Alliant deal

David Adlerstein
The Apalach Times

The county is moving forward with keeping its small, full-service acute care hospital in Apalachicola, after commissioners last week voted unanimously to pursue a management contract for Weems Memorial Hospital with a health care consulting firm working in collaboration with Tallahassee Memorial Hospital.

The decision to pursue talks with Louisville, Kentucky-based Alliant Rural Hospital Solutions follows on the heels of a decision to abandon, for the time being, any plans to secure a low-interest, roughly $10 million U.S. Department of Agriculture loan to build a new facility.

“This has nothing to do with any construction whatsoever at this time,” Doug Creamer, chairman of the Weems hospital board, told commissioners at the April 30 special meeting. “There’s no construction in it, no additions.”

County Coordinator Michael Morón said he had no choice but to ask the USDA to de-obligate the loan funds pending for construction of either an expansion of the existing Weems hospital in Apalachicola, or the creation of a freestanding emergency room, as envisioned in a rival proposal presented by Ascension Sacred Heart.

“Once Covid 19 set in, I called the USDA back and said there’s no way we can meet the June deadline for funds,” Morón said. “There are no funds available to build any facility at this moment. If and when we decide what we’re doing, we would then need to reapply for a loan.”

After hearing some opposition from the public in the call-ins, and discussing the matter amongst themselves, the commissioners voted to have Morón, and interim Weems CEO David Walker, open talks with Alliant.

“The question before our board was to make a determination of what health care model we wanted, of where we wanted to go with health care,” Creamer told the commissioners. “Sacred Heart presented a freestanding emergency room only. The one from Alliant maintains a hospital.

“You’ve probably heard from people in phone calls, and they would probably tell you they prefer Sacred Heart,” he said. “But they’ve always been against the hospital and want to close the hospital and that’s their right.

“The majority of citizens want Weems well-maintained, they want it well-equipped and they want a good solid health care platform in our county for our citizens,” Creamer said.

He said the TMH/Alliant deal would allow the county to continue operating its ambulance service through Weems. “With Sacred Heart you would have to develop another entity to manage the EMS department,” Creamer said. “We put a lot of hours, a lot of time in this. It’s not going to make everybody happy.”

Terms of the agreement proposed by Alliant called for a five-year deal, that would 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 earns $120,000 per year, about 25 percent less than his predecessor, would be included in this monthly fee.

“We have not agreed on any hiring or any dollar amounts at this time,” said Creamer. He said Alliant would be generating revenue for the hospital that he believed would “more than offset any cost that we incur.”

Commissioner Ricky Jones asked whether Alliant would be able to handle management without having to take additional monies from the health care trust fund.

“With any business like Alliant, the key is that whatever funding that Weems gets, Alliant should be able to operate within that,” Walker said.

While the vote was unanimous, Jones said he was concerned about the timing during looming budget difficulties, that could include hiring freezes.

“I think the timing’s wrong,” he said. “I would be more uncomfortable doing this now than in the next quarter of the year.”

Commissioner Bert Boldt said the need for hospital beds during this Covid 19 crisis influenced his decision.

“We have retained Texas A & M who came in here with three eminent health care professionals and they gave us perspective about the importance (of keeping a local hospital,” he said, “Let’s just think of this worldwide and US-wide pandemic. It’s been a huge scare and a huge census of gathering up licensed hospital beds and where they are.

“What we have here is an infrastructure of peace of mind,” Boldt said. “I believe anything we do to protect that is very important to remember and honor. The most valuable asset in this county is the health of our people.”

He said it was important the deal be “financially neutral, with us not burdened with consultant fees. We’ve been talking about hospital management and this is a time for the community of Franklin County to push for a better hospital system.”

Chairman Noah Lockley, a vocal advocate of keeping Weems in operation, said help is coming in because of the need to accommodate a possible health crisis.

“I’ve been with this hospital ever since it’s been there,” he said. “We have assistance going on all over the world. The situation were in, it’s all over the world.”

Commissioner Smokey Parrish said sustainability is the key.

“To me it is to take a step necessary to make the hospital sustainable,” he said. “If we can’t do that, how can we be building a new hospital?

“A major component of Alliant is to help us collect money that’s owed to us. If we cannot do that as a community, there’s no point even looking at building a hospital,” Parrish said. “We need help, we need help with the management of the hospital, we need help collecting dollars.

“They bring in physicians to help raise revenues,” he said. “If you’re not sustainable, you’re going down a dark hole. Am I willing to spend some money? Yes. But if it can’t work we have a whole other issue we have to deal with.

“We have to make this hospital sustainable. We cannot support it with the ad valorem tax base,” he said. “That’s why I’m all on board to help us achieve that goal, but until we reach that point I don’t think we’re going to get there.”

He also noted that the coronavirus “highlights the need to have beds in this county,” noting that a woman whose husband was to be moved to St. James Bay rehab center availed herself of Weems for his care.

“You’re moving people further away,” Parrish said. “If we didn’t have a hospital here what would we have done?”

Commissioner William Massey said “we got to try to do something to keep this one alive,” and said the organizations have credibility when ti comes to providing management assistance

“You need the expertise of these two leading organizations,” he said. “I think this is a good opportunity so we can really advance.”