After two failed attempts to entice a health care provider to the county to build and operate a hospital, Valencia County commissioners sat down at a workshop with state legislators Monday morning.
The question of the hour was, “where do we go from here?”
With more than $26 million in taxpayer funds in the bank for the operation and maintenance of a hospital/24-hour emergency healthcare facility, the county commission — current and past — has struggled to get the project off the ground.
“We have tried diligently since I’ve been on this board to get this built,” said commission chairman Jhonathan Aragon. “There have been a lot of hurdles over the years.”
In 2006, an eight-year, 2.75 mill levy was approved by the voters — 14,245 in favor and 4,438 in opposition. Since then, the county has been embroiled in several lawsuits about the project.
In April 2018, finally clear of the last lawsuit, the county released a request for proposal for a health care facility. The RFP also included a subsidy to help cover the $950,000 annual health care contract for inmates housed at the county jail.
That RFP resulted in a contract with Lovelace Health Services, but it was terminated in short order. The company argued it wasn’t obligated to pay the inmate subsidy, despite offering up to $950,000 a year toward it, and the facility it wanted to build fell short of the state’s definition of what constitutes a hospital.
According to the New Mexico Department of Health regulations, a hospital is a “facility offering inpatient services, nursing, overnight care on a 24-hour basis ... for three or more separate individuals.”
Earlier this year, the commission issued a second RFP without the jail inmate subsidy, requesting a 24/7 emergency room/hospital with three beds. There were no responses.
The sticking point seems to come down to how DOH regulations define a “hospital” and what providers are willing to provide.
“It’s not just a matter of beds,” said county attorney Dave Pato. “But once you have those beds, there are other ancillary services that have to come with them, such as a full-time nutritionist, which add a lot of additional cost.”
Pato said some possible solutions would be to ask DOH to either redefine the term “hospital” or, since it doesn’t have a definition, define the county’s mill levy referendum language of “a hospital/24-hour emergency healthcare facility.”
“That is a term of art,” Pato said. “It isn’t defined anywhere.”
Another solution could be to ask the Legislature to draft a law specifically for the Valencia County mill levy that would allow it to be conveyed to a facility that wasn’t strictly a hospital as per DOH regulations.
Some of the residents at the meeting suggested a third option — give the money back.
“I know everyone keeps saying it’s impossible. It’s not,” said Meadow Lake resident Tom Mraz. “People have moved, sold property. Put that money in escrow for five or seven years, whatever is required by law. If they haven’t claimed it by then, it goes back to the general fund.
“I’d rather see a hospital than get the money back for sure, but the way it’s been going on and on ...”
Sen. Clemente Sanchez, who lives in Grants and sits on the board for Cibola General Hospital, told the commissioners not to discount the possibility of repurposing the mill levy funds to build a facility and have a county-run hospital.
Sanchez did caution that type of project would have to have buy-in from the community, including local health care providers, as well as his fellow legislators and the governor.
“Let’s not say that we can’t do something. Let’s also look at the possibility of repurposing the money,” he said. “Look at the possibility of not having to do it by statute.”
Sen. Greg Baca, who lives in Belen, said he was happy to help, but any changing of definitions would need to go to the voters.
“It would be disingenuous to change definitions without some voter approval,” Baca said. “The mill levy ... was borne from the community. Over the years, the obstacles and hurdles have caused so much time to lapse that the environment and field of play have changed.
“I like the idea of a hospital. At the end of the day, a hospital is a needed thing.”
Rep. Gayle Armstrong, a Magdalena resident, said as a member of the health and human services committee, she would be glad to ask HHS specific questions about changing definitions to be specific to the issue in Valencia County.
Aragon said he welcomed input from the legislators to help define what was needed.
“This board is dedicated to getting this done,” he said. “The sooner we pass this off the better.”
Belen City Councilor Frank Ortega urged the commissioners to look at converting the Presbyterian Urgent Care on Christopher Road back into a hospital.
“We converted a hospital into an urgent care,” Ortega said. “Why can’t we convert it back and get Presbyterian back? It still has a helipad and the ambulance entrance is in the back.
“There are lots of people who need the hospital. Put Presbyterian back like it was and subsidize it. Give the taxpayers what they paid for — not a micro hospital, not an urgent care, but a hospital.”
Rio Communities resident Abel Romero asked if the mill levy question language is bound to the DOH regulatory definition.
Pato said it was not, but the county referred to established definitions to determine what the mill levy question meant.
“The concern is the transfer of the mill levy money to something not meeting regulatory definitions,” the attorney said. “With the history of litigation, it’s out of caution we rely on (DOH) definitions.”