Monroe County Commissioners approved by a 4-1 vote on Tuesday, Dec. 15 a resolution to adopt its 2021 county budget.
The total 2021 balanced budget is in the amount of just under $41.9 million, including about $33.3 million in the general fund. The remaining $8.6 million is made up of the enterprise fund (about $6 million for solid waste, water and the conference center), special revenue funds (about $2.2 million for E-911, D.A.R.E. and the C.A.R.E. Cottage) and capital projects ($400,000), which include $200,000 in information technology upgrades and $200,000 for five additional fully-equipped sheriff’s vehicles.
The operational general fund total is about $26.9 million. Of that $26.9 million, about $9.8 million is for general government, about $1.7 million is for judicial, about $9.8 million is for public safety, about $2.7 million is for public works, about $826,000 is for health and welfare, about $690,000 is for recreation, about $647,000 is for housing and development, and about $735,000 is for debt service.
The remaining approximately $6.4 million in the general fund will be used to supplement other departments, such as solid waste and water, and for additional debt service.
Commissioners previously held a required public hearing on the 2021 budget on Nov. 17.
One notable change in the 2021 budget is that Commissioners allocated $600,000 for Monroe County Hospital (MCH), down from $900,000 in the 2020 budget.
On Tuesday, four MCH staffers, including CEO Lorraine Smith, and four Hospital Authority of Monroe County members, including chairman Mac Brown, attended the Commissioners’ meeting to urge the Board to restore the $300,000 in funding that was removed from the 2021 budget.
After Brown noted that more than 8,500 patients visited MCH’s emergency room during the hospital’s 2020 fiscal year, Smith told Commissioners that largely due to the COVID-19 virus, 2020 has been an especially difficult year in health care.
“I don’t have a lot of fight left in me this year,” Smith said. “We’ve had a really difficult year across health care in general. . . After this year, if you (Board of Commissioners) can’t understand and see the value of what the hospital brings, especially to your constituents specifically in this community, then there’s nothing I’m really going to say to you up here today that’s going to change that.”
Smith said MCH continues to trend in the right direction financially but is still dependent upon the county’s annual subsidy to succeed. Smith likened the relationship to that of a parent (Monroe County) continuing to provide for his young child (MCH) until the child has reached adulthood.
District 2 Commissioner Eddie Rowland said he appreciates MCH and the service it provides to the community. However, Commissioner Rowland noted that COVID-19 has cut severely into the county’s revenues in 2020 and said other departments have been hurt too. In particular, Commissioner Rowland cited revenue decreases at the county’s conference center and recreation department countered by increased expenses in EMS and solid waste.
“You are a part of it,” Commissioner Rowland told MCH officials in terms of the county’s big-picture financial situation. “You are a part of us. And sometimes we all have to take a piece of the pie. . . We’re (Commissioners) not angry with you. We’re not upset with you. We don’t want you to fail.”
District 4 Commissioner George Emami said he’s pleased that MCH has continued to improve both financially and in its quality of care. However, Commissioner Emami said nearly every county department will have to deal with 2021 budget cuts, and MCH will be no different. He then challenged MCH leaders to continue progressing toward breaking even without a county supplement.
“We want there to be an urgency,” Commissioner Emami said. “We want there to be some tension on y’all quite frankly to get this plane off the ground. At some point the hospital needs to be viable. I personally as a taxpayer am not comfortable forever paying property taxes on my house to ensure that the hospital survives. And I feel like I speak for the majority of my district.”
District 3 Commissioner John Ambrose agreed with the other two commissioners, saying he was initially against saving the hospital four years ago but had changed his mind due to the improved service and quality at MCH. Despite that, Commissioner Ambrose reiterated 2020 was “just a bad year” in terms of the county’s financial shortfalls.
Chairman Greg Tapley asked Smith and MCH Finance Officer Judy Ware how much money the hospital has received this year from COVID-19-related payments through the federal Paycheck Protection Program (PPP), the U.S. Department of Health and Human Services (HHS), as well as the ongoing Georgia H.E.A.R.T. Program. Smith replied that MCH has received about $648,000 through PPP and about $400,000 from the H.E.A.R.T. program. Ware then added that MCH has received about $3 million through HHS but said she anticipated MCH would have to re-pay much of the $3 million because it didn’t have enough COVID-19-related expenses to justify the amount it received. Ware said the HHS funding to rural hospitals was allocated based on a previous cost report and not based on the number of COVID-19 patients the hospital had treated.
District 1 Commissioner Larry Evans said he’s been around long enough to remember when the hospital opened in 1957. Evans said MCH is fortunate to have leaders like Smith and Ware and noted the complicated nature of the hospital’s cost-based method of reimbursement.
“You’ve got to have a doctorate in nuclear physics or something to understand the accounting involved in Medicare,” Commissioner Evans said.
At the conclusion of an hour of discussion, Commissioner Rowland asked MCH leaders to provide Monroe County Finance Officer Lorri Robinson with an update of the hospital’s first quarter financial statements for FY 2021 (MCH’s fiscal year begins on Oct. 1). Chairman Tapley added that he would like to meet with MCH leaders to formulate a strategy for discussing rural hospital needs with state legislators.
When it was time to vote on the adoption of the 2021 county budget, Commissioners approved the measure by a 4-1 vote with Commissioner Evans saying he was opposed because he wants the county to restore the $300,000 in subsidized funding for MCH that was removed in this year’s budget.
Commissioner Emami said of Commissioner Evans: “I would commend Commissioner Evans. I think you’ve been a valiant champion for the hospital. And there’s no question that I think all of us want to see it succeed. And if it ever didn’t, it wouldn’t be for your passion and desire to make sure that their needs and desires are well spoken for.”
