Draft

July 2, 2001

The Alexander County Board of Commissioners held a special called meeting on Monday, June 2, 2001 in the Commissioners’ Room in the Alexander County Courthouse, Taylorsville, North Carolina.

Chairman David Odom called the meeting to order at 7:02 PM.

Commissioner Watts gave the invocation and Ray Warren, Sheriff, led the Pledge of Allegiance to the Flag.

Chairman Odom briefly discussed the closing of Alexander Community Hospital and recognized Commissioner Watts for an update on the closing and procedures that were being taken.

Commissioner Watts explained that he had been the contact between the Hospital Board and the Board of Commissioners for quite some time. Commissioner Watts stated that the financial status of the hospital had been an ongoing problem for several years and that several factors had contributed to the problem including Federal and State reimbursement shifts, insurance, population, and economy. Commissioner Watts stated that the Hospital Board had met on Tuesday, June 26, 2001 and unanimously voted to suspend services effective July 7, 2001 at 12:01 AM due to cash flow problems.

Commissioner Watts recognized hospital representatives and also several county department heads for an update on changes and preparations being made.

Lee Sharpe, Hospital Board, and Marie Chapman, Interim Administrator, gave an update on the status of Alexander Community Hospital. Ms. Chapman informed the Board that the hospital would close effective July 5, 2001 at 7:00 PM due to lack of staffing. The hospital will remain closed for up to 90 days and will still maintain its license and bed certification. If more time is needed, the hospital can apply for an extension.

Commissioner Harbinson asked about inpatient care. Ms. Chapman responded that no patients had been admitted since Friday, June 29, 2001. There will be no patients and no surgery will be scheduled.

Commissioner Watts asked if hospital representatives had informed the proper State agencies of the closing. Ms. Chapman responded the Division of Facilities Services had been notified as well as physicians that work in Alexander County Community Hospital clinics. The physicians will be able to continue work in the hospital clinics until the end of July. Hospital officials have been in contact with Serge Dihoff, Office of Rural Health, as well.

Commissioner Watts suggested contacting surrounding hospitals to make them aware of the closing.

Commissioner Hammer asked if any hospital staff was willing to stay on during the suspension of services. Ms. Chapman responded that some staff was going to stay including a few in the business office, medical records, and maintenance. Someone will also be in the kitchen for the next 2 weeks to provide meals for the jail.

Commissioner Harbinson asked if someone had met with hospital employees to discuss the closing, pension plans, and insurance. Ms. Chapman stated that a meeting was held on Wednesday, June 27, 2001. Ms. Chapman also noted that the Employment Security Commission would be at the hospital on Thursday, July 5, 2001 to sign employees up.

Commissioner Harbinson also asked what procedures were being taken in the direction of filing for bankruptcy. Lee Sharpe responded that no formal decision had been made but that the Hospital Board was awaiting a recommendation from an attorney.

Commissioner Harbinson mentioned the public hearing that was held in November of 1999 on county funds being used for the hospital. Approximately 200 citizens were present and all that spoke said they wanted the county to fund the hospital and do whatever it took to keep the hospital open. The hospital sent out proposals for merger or acquisition but no formal bids were received. Commissioner Harbinson felt bankruptcy would be the best position for the hospital in order to make it more appealing to another hospital for a takeover. Critical Access could also be carried over to the larger hospital which would also be a benefit to them. Commissioner Harbinson commended the Hospital Board for their hard work in trying to do all they could to keep the hospital open.

Commissioner Robertson discussed the bed certification and asked if the 15 bed limit was an average or maximum. Commissioner Watts responded the number of beds was a yearly average, which allows more flexibility for service.

Chairman Odom inquired about the attorney fee and asked if the hospital would have funds available to pay the fee. Mr. Sharpe stated that attorney fees ranged from $5,000 to $100,000. The recommendation will only cost $1,000 and the hospital has funds available for payment.

Commissioner Hammer thanked the Hospital Board and those that contributed to the hospital in years past.

Sheriff’s Department

Ray Warren, Sheriff, explained how the hospital closing would affect the Sheriff’s Department and county jail operations. Sheriff Warren explained that jail meals were provided by the hospital kitchen at $3.75 per meal. Due to the closing, the hospital has agreed to provide meals for $5.65 for the next 2 weeks. This agreement would only be temporary to allow time to explore other options. The weekly cost would jump from $2,200 to $3,322.

Sheriff Warren noted that he had contacted other jails, Meals on Wheels, and local restaurants to negotiate an agreement but nothing had been worked out. They would be required to provide meals 7 days a weeks and holidays and the food would have to meet State nutrition and temperature regulations.

Commissioner Hammer asked if it would be possible to get meals from a local restaurant 6 days a week and allow the inmates to have fast food on Sundays. Sheriff Warren responded that fast food would not comply with State and Federal nutrition regulations and that restaurants would be much more expensive. Commissioner Hammer mentioned Pat Fox in Caldwell County (Meals on Wheels) who recently purchased new kitchen equipment and suggested Sheriff Warren contact her in regard to the jail meal situation.

Sheriff Warren also noted that additional part-time deputies would be needed to make up the additional time added to calls which will total $25,584 yearly for payroll. The deputies have in the past met assault and rape victims at the hospital. Inmates were taken to the hospital for evaluations as well as mental patients. These types of situations will take longer due to a longer drive into another county to a hospital.

Sheriff Warren also stated that he would need a transport vehicle with a cage and radio to taken inmates to a hospital out-of-county. This would total approximately $2,500 for the retrofit. Sheriff Warren also noted that the hospital always took the loss of a bill not paid by an inmate examined at the hospital and felt that a hospital out-of-county would not be willing to do the same and would bill the jail, and thus, the county.

Chairman Odom asked if EMS could examine and treat inmates complaining of sickness. Sheriff Warren responded that they could to some extent but could not fully treat the inmate and may incur some liability issues.

At this time, Sheriff Warren requested permission to move forward with the temporary agreement with the hospital to provide meals to jail inmates for 2 weeks ($3,322 per week) and also to add funding to the Sheriff’s Department budget for additional part-time deputies ($25,584). The Board agreed that the Sheriff could begin using the funding in his 2001-2002 budget for the additional pay and budget amendments could be made at a later date.

Commissioner Watts made a motion to allow Sheriff Warren to move forward with the temporary agreement with the hospital for jail inmates meals at a cost of $3,322 per week and also to allow additional part-time deputies with additional pay of $25,584. Commissioner Harbinson seconded the motion. The Board voted unanimously in favor of the motion.

EMS

Nolan Jarvis, EMS Director, stated that the paramedic program would close if it didn’t have a sponsorship hospital. Frye Regional Medical Center has agreed to serve as the sponsor. Mr. Jarvis stated that he had received signed faxes of the agreement and that a hard copy was in the mail.

Mr. Jarvis stated that EMS workload would increase due to the closing of the hospital and estimated that there would be a 30 minute increase to each call since patients would have to be transported outside of the county to the nearest hospital. Mr. Jarvis explained that this could cause some problems and delays if another call comes in while an ambulance is outside of the county.

Mr. Jarvis stated that he couldn’t estimated how much increase EMS would have in calls but felt sure that they would definitely increase since some residents may not want to drive themselves to a hospital out-of-county. Mr. Jarvis requested authorization for additional part-time employees for a day-time crew. Mr. Jarvis also noted that the proposed ambulance would be a greater need now.

Commissioner Robertson asked if the Transportation Department could transport residents to hospitals out-of-county so that ambulances would not be occupied as long. Patty Foster, Transportation Director, stated that the Transportation Department could not transport the general public.

The Board agreed to allow Mr. Jarvis to form an additional day crew.

Emergency Management

Terry Foxx, Emergency Management Director, stated that he had notified the State Emergency Management Regional Office in Hickory of the hospital closing. Mr. Foxx stated that his biggest concern was the helipad and asked that the helipad remain accessible in case air care is needed.

Chairman Odom noted that each fire department had recently received a scene landing kit and soon there would be more zones in the county to land. Chairman Odom also asked if Mr. Foxx or Mr. Jarvis had AED’s equipped in their vehicles. Both responded that they did not have them in their vehicles and that they could be purchased for approximately $6,500.

Transportation Department

Patty Foster, Transportation Director, stated that the drug and alcohol testing for drivers would be affected by the closing of the hospital. Ms. Foster stated that negotiations would possibly be made with Family Care, Catawba Memorial Hospital or Iredell Memorial Hospital.

Ms. Foster also discussed in detail Commissioner Robertson’s suggestion that the Transportation Department transport residents to hospitals out-of-county and stated that they were only authorized to transport residents inside county limits and that they could not transport the general public, usually just Medicaire patients. Ms. Foster suggested that the county contact Dallas Dolle, Geri-Go-Round. Geri-Go-Round is a public access organization and is contracted through the Transportation Department.

Health Department

Leeanne Whisnant, Health Director, stated that the Health Department would need someone to perform lab work and that Labcore would be an easy transition. Labcore will cost a little more. Ms. Whisnant stated that the Health Department would be working with Family Care with radiology, chest x-rays, and mammograms. Home Health staff can perform drug tests as well as Labcore.

Fire Marshal

Russell Greene, Fire Marshal, stated that he had contacted fire department chiefs regarding the closing. EMS paramedics usually stand by at fires in case of injury. All fire chiefs told Mr. Greene that they would free up EMS from a fire as soon as possible.

Commissioner Hammer suggested that the Rescue Squad help out to free up EMS as well.

Human Resources

Jim Riley, Human Resources Director, stated that he would need someone to perform pre-employment and post accident drug testing. Mr. Riley stated that he may negotiate with Labcore but that Labcore would cost more and turnaround would not be as quick.

Mr. Riley suggested working with Priscilla Carrigan, employed with hospital.

Public Information

David Icenhour, Public Information Officer, stated that he had issued statements to local as well as surrounding newspapers and radio stations.

Commissioner Watts conveyed his appreciation to Mr. Icenhour for notifying the public.

Commissioner Robertson stated that he appreciated the efforts of the hospital board and staff as well as county department heads. Commissioner Robertson also stated that he was in hopes of a larger hospital take-over and that staff could work together cooperatively.

Commissioner Harbinson commended the Hospital Board for doing all that they could to keep the hospital as long as they did with the financial troubles they were continuously facing. Commissioner Harbinson noted a letter that was received from Serge Dihoff in January 2001 which elaborated on the efforts of the Hospital Board as well as the Board of Commissioners, a copy of which is attached at Attachment #1.

Commissioner Watts felt this was a time for people to bond together and do what they could to support future hospital services in Alexander County.

Commissioner Hammer felt that the hospital helped everyone and needed to be open. Commissioner Hammer stated that he hoped to see the hospital reopen in 90 days and thanked the Hospital Board and county staff.

Chairman Odom also thanked the Hospital Board and the Board of Commissioners. Chairman Odom also thanked the hospital doctors and staff who have remained during the past several years. Chairman Odom voiced concerns with the fact that it only takes 5 minutes to get to Alexander Community Hospital and that it may take up to 20 or 25 minutes to travel out of the county. Chairman Odom stated that he hoped a solution would be found soon.

There being no further business, Commissioner Harbinson made a motion to adjourn at 9:05 PM. Commissioner Robertson seconded the motion. The Board voted unanimously in favor of the motion.

Attachment #1 - January 2001 letter from Serge Dihoff

  David S. Odom, Chairman           Jamie C. Millsaps, Clerk to the Board