We are fortunate to live in a country where our citizenship provides us with the opportunity to vote. However, with that opportunity is also the responsibility to know what you are voting for, or against. On May 15, registered voters will have the opportunity to vote for or against dissolution of the Chase County Hospital District. If you plan to vote, do you understand what this ballot initiative is about?
We currently have two entities in Chase County with the ability to govern healthcare. One is the County Hospital, which we know as Chase County Community Hospital. Our local hospital has been governed under the County Hospital statutes since it opened in 1977. It continues to operate under these statutes today. The second entity is the Chase County Hospital District, which was brought forth two years ago by a petition resolution to create a hospital district. This resolution passed in the May 2010 primary.
Since the 2010 primary, additional information about County Hospitals and Hospital districts has been presented to the public. Registered voters concerned about the possible effect of the new Hospital District organized a petition and received the required signatures to place the issue of dissolving the Hospital District on the ballot for the 2012 Primary.
Why was the Chase County Hospital District created? The answer to that may depend on who you ask. The most common reason given was to create an elected board for Chase County Community Hospital rather than an appointed board as is required under County Hospital statutes. Some points to consider:
Point # 1 – The vote in 2010 did not create an elected board for the hospital. It created a new political subdivision with an elected board called the Chase County Hospital District. This district currently has no governance over Chase County Community Hospital.
Point # 2 – In order for the newly created Hospital District to govern Chase County Community Hospital, the hospital would have to be transferred into the hospital district. Estimates from two different legal firms have put the cost of this transfer in the range of $200,000-$400,000. The reason for this expense is that since the Hospital District will be a new owner, this transfer could require appraisals, expense for potential bond issues, new contract negotiations with vendors and employees, updating of legal documents, insurance coverage, etc. Since the Chase County Hospital District has no money, this expense would most likely be assessed to property taxes in Chase County.
Point # 3 - There are definite differences in the laws that govern a County Hospital and a Hospital District. While I will not cover all of them, there is one difference I see as a major concern: The ability of a board to lease or sell the hospital facility and property: Under County Hospital statutes, which currently govern Chase County Community Hospital, the hospital board of trustees cannot lease or sell all or substantially all of the hospital without it also being approved by the county commissioners. It would take a majority vote of both boards. (Statute 23-3504, section 3). This is based on the most recent revisions made through LB 995, which was signed into law on April 5, 2012.
Under Hospital District statutes, only a majority vote by the Hospital District board is required to lease or sell your hospital. So this means only 3 out of 5 district board members could make this decision. No one else has to approve this.
You might ask “who would want to buy a rural hospital?” There actually has been interest by corporate healthcare entities in purchasing Chase County Community Hospital. Something to consider here: Those corporate entities are not required to answer to anyone locally in terms of how they run the hospital. If the hospital is not profitable enough, they can also choose to close it without input of the local residents. It could be very similar to what happened with Heritage Nursing Home in Wauneta.
Again, with the new revision of LB 995, in the event an offer was made to purchase Chase County Community Hospital, this decision would need to be approved by two boards. If the hospital were to transfer to the Hospital district, the decision to sell the hospital would only need to be approved by the Hospital District board.
Point # 4: Appointed Board or Elected Board? This seems to be the main issue that created the situation we now have. As Americans, we believe in our right to elect officials who govern our public organizations. So is that right lost under the County Hospital structure which by statute requires an appointed board? In my opinion, not really. The current Chase County Community Hospital Board of Trustees is appointed by the county commissioners. The commissioners have legal oversight of the hospital board and the commissioners are elected by a vote of the people. A couple of sub-points:
a. If you feel the Chase County Hospital Board of Trustees is not doing an adequate job of managing the hospital, you have several options. 1) All hospital board meetings, by law, are open to the public and the public is welcome to attend and register concerns. 2) If you are not satisfied with the trustees’ response, you have the option to go to the county commissioners, who oversee the county hospital board of trustees, and register your concerns. 3) If you feel a board member or members are not doing their job, and can successfully make that case to your county commissioners, the commissioners have the right to remove any hospital board of trustee member at any time for any reason. (This based on LB 995 revisions).
b. Under the Hospital District Board, if you register a concern and are not satisfied with the response of this board, you have to wait until the next election and hope you can influence a change. The hospital district board of directors does not answer to the commissioners on matters of hospital operation.
At the beginning of this letter, I stated that we have the responsibility as voters to understand what we are voting on. We must also understand what a vote “For” and what a vote “Against” really means. The ballot relating to dissolution of the hospital district will ask the question: “Shall the Chase County Hospital District be dissolved?” A vote FOR this will dissolve the district. A vote AGAINST this initiative will retain the hospital district and keep it operational. Please note, if this initiative passes, and the hospital district is dissolved, it does not affect the operation of Chase County Community Hospital. Your local hospital and clinic will continue to operate as they have in the past, under the governance of the County Hospital statutes.
One other point of clarification I would like to make deals with the recent property tax statements. If you own property, you may have noticed a levy assigned to Chase County Hospital. The tax money collected from this is not being used for Chase County Community Hospital. This money is used to pay for expenses related to creating the new Chase County Hospital District.
If you would like to learn more about the statutes that govern County Hospitals and Hospital Districts, they can be found on the Internet at http://nebraskalegislature.gov/ and choose the link to Bills and Laws. The laws governing County Hospitals are Statutes 23-3501 through 23-3526 and 77-3442 & 77-3443. You can also look up LB 995 at this same website to see the latest changes to County Hospital Statutes as of April 5, 2012. Hospital Districts are Statutes 23-3578 through 23-3578.
Finally, I encourage you to get out and vote. I believe it is in the best interest of health care for our county to vote FOR this initiative and dissolve the Chase County Hospital District. Whether you agree or disagree with my perspectives, I hope you exercise your right and responsibility to vote.