The town meeting held on Wednesday Oct. 30, in the Shelby High School auditorium was well attended, with over 100 people coming to hear about the Request for Proposal (RFP) in regards to Marias Medical Center, the Heritage Center and the Care Center. The point of the meeting was to share information with residents and to hear any comments or questions people may have in regards to the RFP.
“We are responsible for the financing the County,” said Commissioner Joe Pehan. “We try not to raise taxes and make sure there is enough money for all entities. When you are going in the hole every year, you start looking to see what is going on. The last time the hospital made a profit was 2011. It has been operating at a loss of $748,000 a year, which the taxpayers have been picking up. We need to do something.”
Pehan explained the Commissioners have looked into a few different options, such as the facility becoming a non-profit, and found none were feasible. It was then they decided to go forward with drafting an RFP.
Bob Olsen, senior vice president of the Montana Hospital Association, was in attendance to shed some light on the hospital situations across the state.
“This has become the lay of the land of rural healthcare,” said Olsen in regards to the RFP. “And not just in Montana, but across the country. Shelby’s situation is not unique, it’s ongoing throughout the rural U.S. and there isn’t an easy answer. Toole County is only one of four county-owned critical care facilities left in the state.”
Olsen explained how the rules county-owned hospitals receive funds starves them of revenue, mainly it is a disadvantage in how they get paid by Medicaid. Olsen shared his concern for MMC has personal meaning, as he grew up in Shelby and his mother was able to remain living in Shelby until she passed, due to the hospital here.
“I graduated from SHS, Class of 1975,” smiled Olsen. “It’s critical and crucial that every community attends to these needs and that you are making sure your hospital has the best opportunity to provide services. My mom was able to stay home, in her community, with her family friends, because of this facility. In order to allow other families to have the opportunity to leave their family members in their home, with their friends and neighbors, we need to make sure all needs in the community are met.”
MMC lawyer Stewart Kirkpatrick said the draft RFP was put out for community comment. Everyone involved wants to make sure it’s the right system for the community. He explained the draft RFP has significant commitments any entity wishing to purchase the facility would have to make to the community.
“A facility with experience can come in and take over,” said Kirkpatrick. “We are looking for a strong commitment, whoever it is must provide the current level of care, if not improve upon what is already available.”
The RFP also gives appropriate local controls over how the hospital operates and that the requirements are being followed. A board consisting of community members would be overseeing and making sure requirements are being met.
Comments and questions were accepted from those in attendance, with a few choosing to speak.
Dr. Lance Stewart inquired how long it took to put the RFP together and what other options were investigated. He was advised the RFP process started approximately three months ago.
“A non-profit by the clinic was brought up, but then was never presented to us,” said Pehan. “When doing the budget we had to make financial decisions.”
“We looked into leasing it,” added Commissioner Mary Ann Harwood. “That wasn’t going to be a good option because if it didn’t work out, then we’re right back where we started. We asked other hospitals about their management companies and the county still pays the bills. The other hospitals have said you’re better off just letting someone buy it.”
“There were multiple attempts to address options,” said Stewart. “The commissioners didn’t respond.”
“We did communicate with the clinic board and invited them to our meetings,” said Harwood. “The situation is, we cannot just give the hospital to someone. We have to make decisions that will benefit the county and we have to follow legal procedure.”
Rick Robertson, who is new to the community, said he was in attendance to find out more about what is going on here.
“People need the care,” he said. “There seems to be a lot of partners around here, other hospitals in the area, and people here seem to like folks from here to be in charge. I was wondering if you had checked in with them to see if that’s possible.”
Robertson was given a copy of the RFP and told that if any of the neighboring facilities were interested they could put in a bid and would be considered.
Shelby Mayor Gary McDermott also had a few questions in regards to the financial end of things.
“There is $1.9 million in outstanding bonds,” said McDermott. “Have the trustees been contacted to see if Toole County will still be responsible?”
McDermott was advised that Bond Counsel had been contacted and stated that those can be paid off with the change of ownership.
“The entity acquiring the facility would pay those off,” said Kirkpatrick. “There are no capital requirements in the RFP, we figure they will lay that out in the proposal and we didn’t want to limit it. We wanted to be broad and allow opportunity.”
McDermott shared he thinks there should be some capital requirements, to ensure things stay solvent.
City Attorney Bill Hunt first clarified the RFP was just an option, but one the commissioners were looking to pursue. He also commended them for getting help in writing it up.
“This is still just an option, but the way you are looking to go, correct? I think it was wise to get expertise in this matter,” said Hunt.
Hunt questioned what the service area referred to in the RFP consisted of and was advised Toole, Glacier and Liberty counties. Hunt stated he would like to see it better defined in the RFP, as it’s fairly vague. He also shared that he would like to see the board comprised of mainly Toole County residents. He also questioned the mills currently being paid towards the hospital and what would happen with them.
“When the 10 mills are paid off the county will be relieved of that,” said Pehan. “The community board will have veto power and can stop any actions they don’t agree with. The board will be selected by the commissioners and will serve for a 10-year period.”
Hunt questioned what happened if a board member could not serve the entire 10 years and was informed that a new member would then be chosen, by the commissioners and board members.
“Okay, good. The new entity should not have a say,” said Hunt before sitting back down.
Val Hardy then took a turn at the microphone. Hardy demanded to know who wrote the RFP and was told there was legal help and experts hired to help write the proposal.
“No one with money is going to take over a losing battle,” said Hardy irately. “You had someone offer to take over and do for free. How do you afford to pay $400,000 a year to Keifer? You work for us! No one is going to come in and dump money into this.”
“We all want to sustain the hospital,” said Harwood. “To make it better, to keep it. We need to work together as a community. We are giving it our best shot, this is just the tip of the iceberg. We are trying to do what is best.”
“We are trying to future- proof the hospital and secure that it stays,” added Marias Medical Center CEO William Kiefer. “There are interested entities and it is our due diligence to listen to the proposals. There will be public meetings to hear the proposals. We want to see it through and see what we get. The RFP is to protect the community, that’s why we are getting input, so we can make sure it covers all.”
With no other public comments being made the commissioners thanked everyone for attending and advised that future public meetings would be taking place and notices would be published in the Promoter and advertised on KSEN.
A copy of the RFP is available to the public in the Clerk and Recorder’s office at the courthouse and online.