Deal floats idea that could save rural ERs

mlee@macon.comMarch 19, 2014 

At a meeting of rural lawmakers Wednesday, Georgia Gov. Nathan Deal announced a plan to keep struggling rural ER services open.

MAGGIE LEE — mlee@macon.com

ATLANTA -- Georgia Gov. Nathan Deal has proposed changes to state hospital regulations that could help keep key emergency medical services available in rural towns like Montezuma.

“The modifications would permit rural hospitals to offer fewer services if they are in danger of closing,” the Republican governor told a bipartisan meeting of rural lawmakers in Atlanta on Wednesday. “The new rules provide a valuable option.”

Several rural Georgia hospitals have closed over the past few years, beaten down by a range of problems from a doctor shortage to Medicaid and Medicare reimbursements that don’t cover costs.

Deal’s proposal would allow rural hospitals to stay open as full-service emergency rooms that could also choose to offer services that don’t require an overnight stay, such as elective outpatient surgery, basic OB-GYN care and low-risk childbirths. Each center would have to be within 35 miles of a full-service hospital.

“Every Georgian deserves to be reasonably close to a health care provider should an emergency arise. Specifically in rural communities, facilities and specialists may not always be as near as you would like for them to be,” said Deal.

The state hospital regulators at the Department of Community Health are on board. Commissioner Clyde Reese said he’s working on calling a special board meeting as early as next week to consider the governor’s proposal, followed by a public comment period. The rules could be in his books by late May, Reese said.

The rules would be retroactive one year back from the date DCH adopts them.

Macon County will be paying attention.

Late last summer, the Flint River Community Hospital in Montezuma closed its ER.

“The (county) commissioners in that area were trying to come up with a plan to create a freestanding emergency room,” said state Rep. Patty Bentley, D-Reynolds.

If the new state rules are adopted quickly enough, Flint River may find some provision they want to use.

Democrat lawmakers applauded Deal’s announcement, especially state Sen. David Lucas of Macon. His district covers all or part of seven counties, including Hancock, which has no hospital.

“I want to thank you,” Lucas told the governor. “It shows that even though you’re on one side of the aisle, and I’m on the other side, that sometimes we can get together on things that affect everybody.”

Lucas spent the annual legislative session hammering anyone who would listen about the need for rural triage centers, but his move to create them via Senate Bill 338 went nowhere. He hammered the executive branch as well, including in a meeting with Deal last week.

“I told him he was going to be happy,” said Deal.

State Rep. Debbie Buckner, D-Junction City, said the move is a 180-degree turn from the sentiment at the beginning of the session, when a suburban Atlanta lawmaker was quoted in a media story saying some rural hospitals should close.

“We’ve got to figure out how to help them make money to stay open,” said Buckner. Besides the health care, a hospital has ripple effects in a community, she said, like creating good-paying jobs and tax receipts.

Not to mention the effects on the county’s bond rating. In many cases, counties underwrite their hospital.

Jimmy Lewis, CEO of HomeTown Health, a network of rural hospitals and health care providers, said the rules would offer hospitals a “buffet” of choices about what services to offer.

“In Georgia we’ve never had this opportunity to explore this access point,” said Lewis, and it’s not exactly clear yet what mix of services and funding would keep the centers afloat. Under the rule, hospitals and the counties that run them would get the chance to “go after how to fund it, how to fix it.”

He called the proposed rules “a phenomenal first step.”

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