Jay Howe
Greenfield
A major Greenfield downtown remodeling project is happening at 288 Public Square, across from Adair County’s courthouse. If one looks at the designer’s visual rendition for the project, it is indeed to be a nice enhancement for the town’s historic commercial district. The project is being professionally directed and with top-notch worker efforts.
However, isn’t there something possibly “wrong” with this “picture” of a Union County medical establishment incursion into neighboring Adair County, to be branded the “Greenfield Medical Clinic”?
Adair County, like Union County, operates its own taxpayer-funded, publicly-owned hospital and clinic system. Both systems are creations of state of Iowa Code Chapter 347, a statutory provision that does not anticipate that a publicly-owned, taxpayer-funded hospital system of one county should charge over onto the “turf” of another county with a major patient intake operation.
Is this not a misuse of Union County property tax dollars and local resources that the statute intended for dedication to facilities in the county of the tax levy? Furthermore, if such resources are geared to compete with healthcare resources of neighboring Adair County, doesn’t this contribute to the de-valuation of Adair County’s hospital and clinic institution and its citizen-taxpayer interests in such? Less revenue potential.
Adair County, population 7,541, does not possess the patient catchment territory to support activities of two robust critical care hospital and clinic endeavors. One of them, over time, will probably get into financial jeopardy of losing full general hospital status, a status which features both inpatient and outpatient offerings.
If a county healthcare system is reduced to what’s called Rural Emergency Hospital outpatient first-aid status, it is likely the community will find it difficult to recruit and retain general practice MDs, DOs and PAs to serve its basic staffing needs. Additionally, this situation will surely impact the county’s economic outlook and its institutions, and not in good ways.
Iowa Code Chapter 347.7 (1)(b) authorizes neighboring county tax-supported hospitals to cooperate and share with each other, for the benefit of each. Obviously not to erode the footing of either by predatory activity that could tip the scales to a closure or partial closure of one.
Two neighboring county-owned hospitals should be collaborating in ways that strengthen the status of both.
If the “Greenfield Medical Clinic” staff elects to utilize Adair County’s nearby hospital diagnostic and treatment services for patient cases that can be appropriately referred for such, then this kind of practice and protocol will demonstrate collaboration. It’s a scenario that sees patients well informed of their complete free choice of hospital referral options.
Referrals inordinately routed to Union County’s GRH hospital, bypassing Adair County, will demonstrate competition rather than collaboration. Is this what Iowa lawmakers had in mind when the county hospital statute was enacted?
- Jay Howe is a former Adair County hospital trustee board member and chairperson