The push to renovate and remodel the hospital is nearly complete, but that's just the tip of the iceberg. All that's needed now is to locate the nearly $2.7 million it will take to get the facility operational for at least 6 months. That doesn't include the furniture, fixtures and equipment at an estimated cost of $3.3 million.
"I've been saying this for years. You can get the hospital open but where is the startup money going to come from for salaries and everything else that needed to keep it running until the money starts coming in?" asked Craig McMillan, chairman of the Gadsden Hospital Inc. Board of Directors.
In order to make the picture clear, Charles Chapman, assistant to the interim county manager and employee on special assignment with the hospital, presented a PowerPoint presentation during a workshop to the Gadsden County commissioners outlining exactly what will be needed to open the hospital and operate the facility.
Using information provided by Tallahassee Memorial Hospital and Calhoun County Hospital, Chapman said the numbers reflected the estimated cost.
The TMH projection calls for operating expenses to come in at $5,260,284, while the Calhoun projection is $4,601,954.40. The major expense, according to both estimates, is in salaries and wages. TMH's estimate of $2,786,048 is $65,832.96 more than the Calhoun estimate.
In the area of staffing, TMH's estimate (for 52 full-time employees) would be $2,786,048 annually, while the Calhoun estimate, (based on 43-45 full-time employees) would be $2,127,718.40.
Commissioners said they are not in favor of using general funds.
"We don't have many sources to go to," said Commissioner Doug Croley.
If the county used the TMH model, the funding sources for the first year would come from patient services plus a rural health grant for $3,692,560, building renovation debt service from the half-cent sales tax of $578,298 and interest from the hospital trust fund of $50,000. The bottom line from all the funding sources is $4,320,858. However, TMH expects expenses to top $6.275 million for the first year.
On the other hand, the Calhoun model estimated funding at $4,105,858, while expenses came to $5,480,703.77.
"Hopefully the citizens of this county with insurance and money will support this hospital. If they don't use the hospital, it will go down quickly," said commission Chairman Eugene Lamb.
"We need to rake a step back. Let's not move as if it's a time crunch. If we rush in and get this open and it closes, it may take us 20 to 30 years to regroup," said Commissioner Gene Morgan.
He said the county has alternatives referring to the request for an extension for the license that the Legislature is expected to grant. The Agency on Health Care Administration officials, in a presentation before the board in January, said they could apply for a "fast track" license and possibly be granted a license within the next 12 months. Stepping back and looking at alternatives, Morgan said, would allow the hospital to open and stay open.
Commissioner Sherrie Taylor suggested that the county look into borrowing $5 million from the principal of the trust fund and repay it so the fund would continue to earn interest.
With no decision made at the end of a four hour meeting, the board voted to have staff research the funding that could be derived from the indigent tax, trust fund and loans through the United States Department of Agriculture's rural development program.