The Richmond Register

October 7, 2012

Health board moves to stop the bleeding

By Bill Robinson
Register Editor

RICHMOND — The  Madison County Health Department, especially the three-county home-health agency it operates, continues to be whipsawed by rising costs and declining reimbursements from Medicare and Medicaid.

MEPCO, which provides a variety of in-home health services in Madison, Estill and Powell counties, has finally had to resort to involuntary layoffs. Seven employees were told last week they they will be losing their jobs this month.

Despite cutting expenses substantially, including staff reduction through attrition, MEPCO’s income has kept falling at an even faster rate.

Fortunately, the health board socked money away during the good years. It has a reserve of more than $7 million to carrying it through the lean years, although most of that money was set aside for capital projects.

You don’t have to be a health care professional to know that bleeding must be staunched if a patient is to survive. Health department management, backed by the board, has taken that approach which MEPCO, which which was continuing to bleed money.

However, there is only so much that a local health board can do about rising costs and falling income from state and federal programs. As health board members noted last week, if recent trends continue, even its sizable surplus will last only a few years

Unlike private providers, MEPCO may not refuse service to patients who cannot guarantee payment. Also, unlike their private competitors, MEPCO is told what it must pay for state health insurance and retirement for its employees. Instead of fully funding the employee benefit programs it put in place, the General Assembly continues to push more of those costs onto local agencies. And, patients in financial need will suffer for it.

At both the state and national levels, we must decide how health care is to be provided and paid for. At the national level, the debate is confusing and unproductive. The way candidates from the two major parties portray their own plans and that of their opponents is baffling. That was evident in last week’s presidential debate. Until we can agree on what the facts are, especially the costs, we won’t resolve anything.

There are three contested legislative races in Madison County this year, and among the questions we intent to press in our interviews with candidates will be their plans for public health programs and the state retirement system.

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While they may add to the excitement and theater of politics, I don’t think hecklers, especially those who ambush their targets, add much to political discourse.

On Friday, an ambush heckler disrupted the opening of the Madison County’s Democratic Party headquarters at the conclusion of U.S. Rep. Ben Chandler’s remarks. As he appeared to video Chandler, a young man in a booming voice asked why the congressman had refused to debate his Republican opponent. Although a few in the crowd heckled the intruder, Chandler and most others ignored him.

The congressman’s colorful grandfather, Happy Chandler, was both the perpetrator and recipient of some ambush heckling during his political career.

When Happy Chandler, then governor, challenged incumbent Sen. Alben Barkely in the 1938 Democratic primary, President Franklin Roosevelt came to Kentucky to campaign for Barkley. Chandler exercised his right as governor to welcome the president upon his arrival and then remained an unwelcome guest of the entourage.

Nearly 20 years later, when Chandler again sought the governor’s chair, he told young voters to “Be like your pappy and vote for Happy.”

After Chandler was accused of taking part in an illegal duck hunt on a friend’s land, a supporter of Chandler’s primary opponent had his son put on a duck costume and run through a venue where Chandler was speaking and yell, “Happy shot my pappy.”

Such stories are good for a few laughs, but they are don’t contribute to serious political discourse or help solve problems.

Friends of Sue Hays, the first director of the Madison County Public Library, got to wish her well Saturday during a reception for her 65th birthday. Hays, who served the library for its first 25 years, is battling cancer. She moved to Shelbyville after retirement to be near her children and grandchildren, but was back in Richmond for the birthday celebration.

I was on the library board when Hays was hired. After years of contentious struggle, the Madison Fiscal Court created library taxing district in the late 1980s. The board knew it had to deliver if it was to silence library critics. We fell into good fortune when we hired Sue Hays. The county couldn’t have wished for a more a more ebullient and effective leader. The fledgling library hit the ground running and soon had some of the highest use in the state.

While Hays now faces her most difficult challenge ever, I was not surprised to see that she is still the same happy warrior who came to Madison County to start its library and left an enduring legacy.