GOODLAND CITY COMMISSION

Special Joint Commission Meeting

City Commission and Sherman County Commission with Goodland Regional Medical Center Board

August 14, 2023                                                                                                                            5:00 P.M.

Mayor Aaron Thompson called the meeting to order with Vice-Mayor J. J. Howard, Commissioner Jason Showalter and Commissioner Brook Redlin responding to roll call.  Commissioner Ann Myers was reported absent.

Sherman County Chairman Steve Evert called the meeting to order with Sherman County Commissioner Rodney Blake and Sherman County Commissioner Harvey Swager responding to roll call. 

Also present from the City were Danny Krayca – Director of Parks, Mary Volk – City Clerk, Joshua Jordan – IT Director and Kent Brown – City Manager.  Also present from Sherman County are Bret Mangan – County Attorney, Ashley Mannis – County Clerk and Eric Albright – County IT Director.  Representing Goodland Regional Medical Center (GRMC) are Craig Loveless – GRMC CEO, Breanna McEwen – GRMC Executive Assistant, Greg Cure – Board Chairman and Board members Valerie Gavin and Sabrina Thompson.  In addition, there are approximately twenty-five to thirty members present in the audience. 

Mayor Thompson led Pledge of Allegiance

DISCUSSION ITEMS

1. Direction of Goodland Regional Medical Center and Future Plans – Mayor Thompson stated, ourfirst discussion is future plans with the hospital.  Craig stated, in my monthly reports I have discussed the current status of our building and its age.  We had engineers and architects evaluate our structures.  The main building was built in 1972 with specialty clinic added in 1995 and medical clinic in 1998.  Through the course of the study the engineers and architects do a lot of work in this area.  They looked at the current structure and total building layout.  A concern is the distance from the clinic to the hospital is clear across the building.  With changes in the law, if any part of the building is changed we have to upgrade the entire building to be compliant.  There are a number of things to consider beside age.  Our boilers are fifty-one years old.  This year we have replaced an HVAC unit, rebuilt a coil in chiller system and have quotes out for a new roof.  Our concern is where to head with aging building as we will continue to have repairs show up that need addressed.  If we comply with current regulations our rooms are too small and we do not meet current code for our trauma and emergency room.  We are fine if we do not touch anything, but if we touch anything we have to bring to current code.  Do we look at a major remodel or build a new facility.  An audience member questioned how much will our taxes increase?  Craig stated, none if we use a revenue bond.  Another audience member asked, at a recent hospital meeting you closed dialysis, what other services will we lose?  Craig stated, dialysis had staffing issues, this plan does not have same issue.  An audience member asked, what is estimated cost?  Craig stated, we do not have costs at this point.  A remodel today costs about as much as building a new facility.  An audience member asked, will you check costs for both options?  Craig stated, yes but we will do a feasibility study before we proceed.  An audience member asked, how long will study take to complete?  Craig stated, not long.  An audience member asked, where will facility be built?  Craig stated, that has to be determined.  We own some neighboring lots that we would look at because it gives us direct access to Highway 27.  Another audience member asked, do you plan to add services and bring in more doctors?  Craig stated, right now we believe staffing is adequate but we are always looking for new doctors.  An audience member asked, what will you do with old building if it is outdated?  Craig stated, we have options but that has to be determined.  Mayor Thompson stated, we appreciate your questions but we are getting deeper in issue than the intention of this meeting.  Those questions should be approached to the board or a planning committee.  A member of the audience asked, we are critical access hospital now, how many rooms do we have?  Craig stated, we have twenty-five rooms but staffed for twelve.  Mayor Thompson stated, these are good concerns and need to be addressed as process continues.  Greg stated, these questions will be answered but right now we are just beginning the process.   Mayor Thompson stated, our meeting is to discuss the direction and future needs for the hospital.  This is a general meeting so we know where hospital is in process.  These are all great questions that will be answered.  An audience member stated, this meeting should let you know we do not want a decrease in services.  Craig stated, we have no intention in that.  A member of the audience asked, there is no point to remodel facility and throw good money after bad in the building?  County Commissioner Blake stated, that is exactly what we are faced with the old nursing home.  We have moved on and it is working out well.  We have to be open minded at this time as there are a lot of unanswered questions.  An audience member asked, what funding is available for hospital?  Craig stated, we are looking at FDA financing using a revenue bond.  County Commissioner Swager asked, are you asking for direction from commissions?  Craig stated, at this point we want to keep everyone informed; we are at a crossroad and would like direction.  Audience member asked, how does the feasibility study work, does it go to the public?  Craig stated, no the firm evaluates hospital finances to see if we are able to take on debt.  Under FDA rules with our critical access and Medicare status, a good portion will be reimbursed based on those programs.  An audience member stated, we just moved from Minnesota and had services there that are not offered here such as Medicare Advantage.  I would like to see the community grow.  There is a lot of negative from things that have happened in the past.  I would like to see a progressive community that is thriving.  Craig stated, that is why we are here.  The community and hospital are one, neither will survive without other.  We need to learn from past and move forward.  An audience member asked, will feasibility study consider offering dialysis services again?  Craig stated, that is not part of study but we know there is a need for the services.  An audience member stated, there are citizens that need it.  County Chairman Evert stated, we need to remember when the hospital was built we had a higher population and more students in schools.  Our community numbers have changed and we still make it work.  We have opportunities in near future but it takes time to get things to work.  We have things growing but we have to determine how to move ahead.  There is negativity but have to do what is important for community.  Sometimes regulations tie our hands.  It costs a lot of money especially today.  Craig stated, the hospital expansion in 2015 was bid at $400 per square foot but ended up being $500.  Today the estimate is $650 to $700 per square foot.  Vice-Mayor Howard stated, with prices today by the time the project is complete the cost will probably be closer to $1,000 per square foot.  Craig stated, the build America buy America rule that we have to follow drives costs up more.  It is a good rule but increases costs.  An audience member asked, what about a wellness center?  Craig stated, we have to discuss it because it does not make money so it is up to the responsible entity.  The audience member stated, I feel we can add services without touching the building.  Mayor Thompson stated, this is one of many discussions to come.  Craig stated, we have to take all things into consideration.  Mayor Thompson stated, everyone here wants the best for community which is what we are trying to do.  We are all working same direction which is the reason we are having discussion.  It is a long process and we are trying to work in the right direction.  An audience member asked, when you mentioned the financing, you said no taxes; is it a grant or what since you referred to $60,000,000 to $80,000,000 debt?  If county owned hospital how are you repaying debt?  Craig stated, that is reason we need feasibility study.  Our financial tool is a revenue bond where security of the debt is hospital revenue.  An audience member asked, does hospital generate enough money to repay debt?  Craig stated, four years ago we borrowed money to make payroll.  We have built up funds today through COVID money and some financial restructuring that was difficult at that time but we look good today.  We have to make sure we can take on debt.  An audience member asked, does study give you limit to spend or what does it consider?  Craig stated, yes, our debt capacity study shows we can handle $60,000,000 to $70,000,000 in debt.  COVID money is not considered but the study looks at our cash flow.  Greg stated, health care is constantly changing.  The hospital objective is to be transparent.  We are in preliminary stages so do not have answers to a lot of questions tonight.  County Commissioner Blake stated, ignoring the issue will not fix it.  Craig stated, we see costs to maintain building continue to escalate.  Greg stated, we are glad to be in a position we can discuss this issue.  We are sitting well compared to other hospitals.  An audience member asked, who will do study?  Craig stated, we will take bids from firms that provide service.  Vice-Mayor Howard stated, with any business there comes a time expenses outweigh costs of a new building.  Do you continue putting money into an old facility?  A new facility will be expensive but have to look at all costs to determine what is feasible.  An audience member asked, will you keep old building, you still have to fix it up?  Vice-Mayor Howard stated, you still have an old building but if you have a different use for building you can repurpose it.  Craig stated, I said no new tax and that is our intention.  Our plan is not to come to the tax payers to fund, but the community must be involved and support services.  There will be increased costs to community but have to evaluate what we need to do to proceed.  County Commissioner Swager stated, if people get service they need, they are more willing to pay.  An audience member stated, how many in this room are so secure they believe they will not need healthcare and that resources will be provided for services needed.  Mayor Thompson stated, I appreciate citizens coming out, it shows this is important to the community.  Valarie stated, our board meetings are 4^th Wednesday of each month and open to the public.  We welcome people to attend.  This will continue to be discussed with our other items.    An audience member asked, who will make final decision whether to build or remodel.  Greg stated, we have discussed options for a committee to assist with process.  We need to consider who will make up the committee.  Craig stated, I feel confident it will not be only the board and administration.  We will not make decision without community.  County Commissioner Swager stated, we assume you will proceed with study.  Craig stated, yes it is in our budget this year.  Commissioner Redlin asked, what does study cost?  Craig stated, about $70,000.  Commissioner Showalter stated, I feel good this conversation has begun, people will not come without a job.  We have economic options happening that include additional jobs, but have to make sure infrastructure and services are in place.  I am in favor of moving forward with feasibility study.  Valarie stated, when we establish committee the milestones will be available to the public.  An audience member stated, you are saying revenues from the hospital will pay the debt of the revenue bond.  Craig stated, that is our goal.  The audience member stated, if study shows hospital has revenue to meet debt but healthcare changes, revenues could drop but debt is not removed.  What is next source to pay debt?  Craig stated, revenue is the collateral.  Revenue from hospital is risk the investor is taking.  Because this would be an FDA obligation, the risk is with the FDA, so the government is assuming the risk.  FDA stands for Food and Drug Administration.  The audience member replied who is the federal government, but us.  Craig stated, that is why I want to make it clear our intention is not to increase taxes but the community has to support it.  Mayor Thompson stated, we are getting to questions where information has not been provided.  Valarie stated, we are not set on that route yet, we have to have study to determine best way to proceed.  Mayor Thompson stated, these are good questions that need to be asked but they are not there yet.  The audience member asked, have you looked at other options.  Craig stated, yes we have looked at other options but this appears to be best direction at this point

OTHER DISCUSSION ITEMS FOR CITY COMMISSION AND SHERMAN COUNTY COMMISSION

A.  Sales Tax Sunset & Start of New Sales Tax – Mayor Thompson stated, the City wanted an update on the sunset date for the sales tax bond.  We received word the new tax is in place.  Ashley stated, the tax started July 1^st and you will receive checks monthly.

• Wolak Building – Kent stated, we entered into agreement in 2012 allowing fire to occupy building with separate departments.  Now that departments merged, the building is occupied by County functions but owned by City which makes it difficult with insurance and building. City insures building and county insures equipment and contents.  Some vehicles are city and some county.  Eventually it will all be part of merged district but will take time.  Brett stated, Jake Kling, City Attorney and I have discussed that all vehicles need to be titled to county but equipment needs to be kept separate.  Kent stated, we agree but it is not in agreement so will need to amend agreement.  As far as the building, it serves the county but is city owned.  I feel the commissions need to discuss if we want to change ownership.  County Commissioner Blake stated, the county has spent quite a bit of money on the building and the merger has worked out well.  We do not know who will be occupying commission seats ten years from now.  I feel the commissions need to think about it.  Mayor Thompson stated, I feel we need to look at the agreement overall and evaluate how it is working.  The merger has gone well.  I feel we all felt things would pop up.  County Commissioner Blake stated, there was a lot of trust going into merger.  We have good EMS and fire departments.  County Commission Swager stated, I feel the city and county should think it over then meet again.  I feel county should own building.  Commissioner Showalter stated, it makes sense but I would add the caveat that if building changed hands the building name will not change as Ed Wolak gave a lot to the City.  Kent stated, another caveat since the building is in close proximity to city hall is that if county moves out of building, the City will have some input as to what building will be used for.  I would expect fire to remain in building, but one never knows. 
• Update FEMA Floodplain Map –   Kent stated, the State is working to update mapping for a number of neighboring counties.  The last update for City of Goodland was 1981.  There is no FEMA floodplain map for the county but the city map from 1981 is outdated.  It still shows the old “Y” on Highway 24, which has triggered questions.  The improvements of the retention pond may have changed flood zones in and out of city.  The State has not had a favorable response from Sherman County to update map, which is how they move project forward.  They did indicate that FEMA may not move ahead if county is not involved.  The County does not have to adopt the map but the analysis will be done.  They want local input while occurring.  Does the county have interest in having conversations with state officials to update maps?  Mapping is completed through state resources not the Division of Water Resources, but for city purposes we feel we need to update map.  County Commissioner Blake stated, the study could be done but county does not have to adopt.  Kent stated, that is my understanding.  County Commissioner Blake stated, if we adopt county map then we could require county residents to carry flood insurance on farm ground.  Kent stated, I believe it is structures not farm ground, but need clarification.  County Commissioner Blake asked, what is cost?  Kent stated, it is through the State and does not cost the community.  County Chairman Evert asked, who would county talk to about feasibility of plan and whether it is for County structures?  We need to see if County does not endorse plan can city have map updated.  Kent stated, I talked with floodplain coordinator she agreed to discuss information and address specific questions at a County meeting.  County Commissioner Blake stated, if we could get city updated without obligating farmers/ranchers in the County, I have no problem proceeding.  Kent stated, that is our goal.  County Commissioner Blake stated, please get us the state contact information to meet.  Kent stated, I will get information to Ashley.  Mayor Thompson stated, I appreciate willingness to have discussion. 

ADJOURNMENT FOR SHERMAN COUNTY COMMISSION WAS HAD ON A MOTION County Commissioner Swager seconded by County Commissioner Blake.  Motion carried by unanimous VOTE, meeting Adjourned at 6:10 p.m.

ADJOURNMENT WAS HAD ON A MOTION Commissioner Redlin seconded by Commissioner Showalter.  Motion carried by unanimous VOTE, meeting Adjourned at 6:10 p.m.

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ATTEST:                                                                               Aaron Thompson, Mayor

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Mary P. Volk, City Clerk