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Medical Center devastated by $3 million cut from Bibb

A month after losing almost $3 million in Bibb County funding, The Medical Center of Central Georgia is in the process of figuring out how to cover the gap, probably by cutting programs and services to the poor.

The hospital traditionally receives Bibb County funds to help offset the cost of treating uninsured county residents and the “medically indigent,” people who make less than a certain income in relation to their family size. In June, the county voted to give the hospital $1 million in fiscal 2010, down from $3.9 million during the last budget year.

Medical Center CEO Don Faulk expressed frustration with the county’s funding decision.

“We were getting well over $1 million in 1978,” he said. “Based on the funding, you’d assume the county’s commitment to the medically indigent has almost been abandoned.”

Faulk said the hospital may reduce hours, services or programs that serve the poor. But he said cuts could also affect services to the insured and those who receive Medicare and Medicaid, particularly if those programs lose money. Decisions will likely be made in the next 60 days, he said.

Faulk estimated that about half the near $3 million in cuts would likely come from eliminating staff positions from shuttered programs that “are really nice to have” but not entirely necessary. He said he hopes “the vast majority” of these employees could move into other open jobs at the Medical Center.

If jobs are cut, it would be on a much smaller scale than last year’s large layoff of more than 200 employees, Faulk said. That move was part of a larger effort to cut $43 million in expenses, touted as a way to make the hospital financially viable for the next five to 10 years.

The hospital is implementing some of the changes over several years, so it budgeted for about $31 million in savings for this fiscal year, said Chief Financial Officer Rhonda Perry. She said the hospital is on target to achieve that savings.

But Faulk called the additional $3 million reduction in Bibb County funding “devastating” after the hospital’s recent deep cuts.

“We can’t simply ask paying patients to pay more,” he said. “The county is basically saying, ‘Do less,’ so we’re trying to figure out what we can cut to have the least impact. ... Maybe we’re past the point of ‘do no harm’ to ‘do the least harm possible.’ ’’

The majority of indigent care costs come from the emergency room, but the hospital cannot refuse to provide emergency care. So the Anderson Health Center, which offers walk-up primary care to low-income patients, is more likely to see cuts.

“That is a clinic most hospitals don’t offer,” Faulk said.

Over the last three years, the Medical Center already closed two neighborhood health centers that offered primary care to the poor. Those patients had the opportunity to transfer to the Anderson center, which gets about 24,000 to 30,000 visits a year, according to Faulk.

Others services that benefit the poor, which could also be affected by the cuts, are educational programs to teach people to prevent illness and control medical conditions, and free or reduced-price laboratory services for clinics in Macon that serve the poor.

Faulk said the hospital hopes to approach the county again in the coming months to ask for more support.

But Commissioners Bert Bivins, Elmo Richardson and Sam Hart said Tuesday that they didn’t see how the county could offer the hospital more funding this year.

“This year, we just ran out of choices,” Bivins said. “The Medical Center has to make choices, too. I hate that those choices affect poor people.”

Hart, chairman of the commission, said he hopes the county can continue to work with the Medical Center in future budget years to cover the funding gap.

Richardson said the county would jeopardize its fund balance by taking out money to give the hospital. That reserve, which in February was projected to drop from $31.6 million to $24.4 million by this summer, helps determine the county’s bond rating.

At a budget hearing in June, Bibb commissioners suggested that the Medical Center fill the funding gap by pulling money from its own reserve.

But because of the volatile financial markets, the hospital’s investments have fluctuated widely in value, and the hospital already had to delay some capital spending to maintain a reserve of about $400 million, which provides enough money to operate the hospital for 280 days, Perry said.

Given uncertainty about forthcoming health-care reform and the economy, the hospital’s financial adviser recommended keeping this much in reserve to maintain a good bond rating, she said.

To contact writer S. Heather Duncan, call 744-4225.

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