Potential budget cuts to Critical Access Hospitals endangers public

As part of her solution to the state’s projected budget shortfall, Governor Chris Gregoire has suggested a course of action for our state’s Critical Access Hospitals that will endanger the public health, cost the state millions in federal matching dollars, and may – in the end – result in several rural hospitals closing their doors to the public.

Let us be clear, solving our state’s budget issues will be no easy task. The lack of sound fiscal decisions made by the majority party in Olympia have combined with an international economic recession to create a serious budget shortfall that needs immediate action.

However, the governor’s proposal to cut $27 million from the state budget by eliminating cost-based payments for Critical Access Hospitals would end up doing much more harm than just what shows up on the ledger sheet.

Critical Access Hospitals are an essential component of Washington state’s health care delivery system. They are the hub for local health care services in their communities, delivering primary and preventive care, key diagnostics and laboratory services, emergency services, and recuperative care.

To qualify as “Critical Access,” the hospital must have fewer than 25 inpatient beds, serve rural areas and must meet specific distance requirements from other hospitals or have been deemed an “essential community provider” by the state Department of Health.

The “Critical Access” designation allows these 38 hospitals across the state allowable cost-based reimbursement for their Medicare and Medicaid patients. This is especially important as these hospitals tend to serve older, rural communities with lower incomes. As such, they treat a much higher ratio of Medicaid and Medicare patients and have fewer privately insured patients.

In a recent committee meeting, we heard testimony from several Critical Access Hospitals that would be severely impacted by the governor’s proposal. The services that could be eliminated or reduced because of these budget cuts include nursing home/assisted living care; orthopedic surgery; well-child care; home health care; hospice care; physical therapy; pharmacy; school health; transitional care; counseling/mental health services; ambulance services and other transportation services – just to name a handful.

But it’s not just the $27 million from the state budget that we’re talking about here. If the Legislature goes through with the governor’s proposed cuts to Critical Access Hospitals they’ll also lose millions in matching federal dollars. The total cuts to these hospitals would be end up being closer to $85 million.

This is a financial hit that, frankly, many rural Critical Access Hospitals cannot absorb. Most will have to cut major services and some will be forced to close their doors permanently, placing the health care of thousands of Washingtonians in jeopardy.

Urban hospitals will see a significant uptick in emergency room patients, Medicaid patients and uncompensated patients. The state’s entire health care system will experience sicker patients as individuals go without needed care until their sickness gets too serious to ignore.

Washington state currently benefits from a strong network of rural and urban hospitals working together to ensure appropriate care for every patient. A breakdown in the Critical Access Hospital network will impact all hospitals in our state.

We are working with our colleagues on both sides of the aisle and in both chambers of the Legislature to prioritize spending, make state government more efficient, and to implement policies that help the private sector create more jobs. The state’s budget problem must be solved quickly – but not at the expense of our state’s excellent Critical Access Hospitals.

(By Rep. Joe Schmick, R-Colfax, Rep. Jay Rodne, R-North Bend, and Rep. Shelly Short, R-Addy.)