Funding rural hospitals, education and other vital services requires prioritization in the budget | GUEST OPINION

In recent weeks, I have heard from administrators and health care workers who operate small hospitals in rural areas across the state, and from those within the 39th District, which includes United General Hospital in Sedro-Woolley, Valley General in Monroe, and Cascade Valley in Arlington. They are concerned with proposed cuts in the governor’s supplemental budget plan for reimbursement of care for Medicaid and Medicare patients.

By Rep. Dan Kristiansen • December 1, 2011 11:15 am

In recent weeks, I have heard from administrators and health care workers who operate small hospitals in rural areas across the state, and from those within the 39th District, which includes United General Hospital in Sedro-Woolley, Valley General in Monroe, and Cascade Valley in Arlington. They are concerned with proposed cuts in the governor’s supplemental budget plan for reimbursement of care for Medicaid and Medicare patients.

Many of these are small hospitals with 25 beds or less that operate in Rural Public Hospital Districts. Local taxpayers have approved these hospital taxing districts to ensure critical access to health care in Washington’s rural areas. Most of their budgets are at bare minimum and they rely on cost-based reimbursement from state and federal Medicaid/Medicare dollars. The governor’s proposal would slash $27.2 million for the remainder of the budget cycle (through June 30, 2013) from the Critical Access Hospital Program, which could affect 38 rural hospitals across the state.

An example is United General in Sedro-Woolley, whose reductions would be more than $2.3 million per year. That’s in addition to more than $4.8 million of uncompensated care provided annually by United General.

Hospital officials say if the Legislature approves these reductions, it could force many rural hospitals to curtail health services or close altogether. It would also mean the loss of jobs in rural communities where the hospital is often one of the largest employers. Additionally, closure would create an influx of patients into other hospitals without the capacity to deal with the increase. Many may end up in emergency rooms, driving up health care costs and wiping out any savings the governor would hope to achieve from her proposal.

Some are so despondent over the governor’s cuts they are willing to blindly jump into her plan to increase taxes by nearly a half-billion dollars to “buy back” these reductions. And I would suggest, that’s what the governor is counting on as she seeks voter support on the March ballot to impose the largest state sales tax increase since 1983.

I asked hospital administrators and workers, please don’t swallow that bitter pill quite yet. We can fund our rural hospitals at the present levels within existing revenue without tax increases, without these onerous cuts, and without hurting funding for education, public safety and for protection of the state’s most vulnerable citizens. It is just a matter of setting the correct priorities in the budget – something the Legislature has failed to do.

Here are some things to consider:In the remaining 19 months of the state’s fiscal calendar, state government is expected to take in nearly $2 billion more than the previous budget cycle — more than enough to cover the hospital reductions in question.While the governor is seeking to reduce education funding by another $411 million that she would “buy back” through her proposed sales tax increase, she has yet to reduce the budgets of several of her own agencies. For example, the total operating budgets of each of these departments have increased by the following amounts over the previous budget cycle:

  • Agriculture – Up 8.2 percent;
  • Natural Resources – Up 7.6 percent;
  • Ecology – Up 10 percent;
  • Department of Parks and Recreation – Up 12.2 percent;
  • andFish and Wildlife – Up 14.8 percent.

When the Legislature is cutting education (the state’s paramount duty) and slashing funding for rural hospitals, while increasing funding to save salmon and buy more park lands, I believe priorities are in the wrong order. During this special session and throughout the regular session which begins next month, I will be fighting to reset these priorities to ensure rural hospitals will not be cut short when it comes to life and death care. By establishing priorities of government and unleashing the power of the private sector to create jobs, we can balance the state budget and preserve these vital services without raising taxes on families when they can least afford it.

Rep. Dan Kristiansen, R-Snohomish, serves as chairman of the Washington House Republican Caucus and represents the 39th Legislative District. He can be contacted at 360-786-7967 or e-mail him through his website at www.houserepublicans.wa.gov/Kristiansen. His office address is: P.O. Box 40600, Olympia, WA 98504-0600.