Ark City Daily Bytes took to the streets — and the internet — this week to find out what Arkansas City thinks about the current situation involving South Central Kansas Medical Center.

The SCKMC Board of Trustees voted last month to recommend to the City Commission of Arkansas City that it approve a mail-ballot sales tax question, to be voted on by the citizens.

The hospital is facing a financial deficit that is likely to require, at a minimum, the renewal of a half-cent sales tax that will sunset in April 2019.

Ark City Daily Bytes asked a simple question of the citizens: “What would the City Commission need to do to earn your ‘yes’ vote for a new or renewed sales tax to support SCKMC?”

But unlike the question, the answers proved to be far from simple or cohesive.

Transparency

“I believe we should cut our losses, sell the hospital for what we can to a larger hospital like Wesley or Via Christi, and then implement the sales tax to cover the remainder of the loan. I believe there should be a forensic audit,” said Chris Green.

“I also think the city or the board, whoever is responsible, should see to it that the board meetings are not at 7:30 in the morning, but in the evening when more people can attend. They should also be televised and shown on the website for people to watch.”

He was asked if he thought there was a lack of transparency at the hospital.

“At 7:30 in the morning, are we hiding something? Is it convenient for any of the citizens to go and watch? Is it available on video? Is it available on the website? The city meetings are — that’s my point,” Green said.

Some SCKMC support

Some citizens showed support for the hospital because of the far-reaching benefits that the existence of a hospital can have on small communities.

“Our sales tax won’t increase because of the current half-cent drop-off. Please, everyone … vote yes. Just think, if we don’t have a hospital, we will not attract new businesses nor any new execs or new employees from existing businesses … they will choose Winfield. This will affect our schools, local businesses and our property value. Let’s at least give OUR hospital one more chance,” said Marsha Jensen.

The proposed tax question would replace the current half-cent sales tax, according to board discussion.

If it is approved with the suggested wording, there would be no increase in overall sales tax, which would remain at 9 percent within city limits.

“They have my yes vote. This hospital is vital to our community. It is a positive, even though it is in the red. We want our community to thrive, but who wants to come to a town that doesn’t even have a hospital?” said Rags Smith.

“I’d vote yes. We need to keep our community going and with services we need. They saved my life here. We do not want our community to die like other towns all over,” said Donna Colgrove.

“The hospital is an absolute necessity!!! You won’t need to worry about economic development and job growth because no industries will locate to a community without a hospital! You will get top-notch care and I’m sure will be thankful if you ever need a hospital in an emergency,” said Tyler Anstine, who recently was one of several applicants interested in filling a vacant seat on the SCKMC Board of Trustees.

Citizen concerns

However, many citizens think tax burden is too high.

“I paid $10,000 (in taxes) last month, property, sales, income, $10,000 bucks. So I don’t have a problem with our sales taxes. But our property taxes … they’ve got to give us some kind of relief. They’ve got to make it reasonable to own a business,” said Sandra Davis.

“Our two experiences out at the ER, we saw a PA, super nice guy, but (he) did not know what he was doing, at all. He diagnosed my son’s kidney stone as constipation, and my daughter’s seizure as: ‘Well, you know, sometimes you just have one.’”

Other citizens pointed toward physicians.

“If the hospital can’t make it on what they got to shut it down, no need to have to keep raising the taxes just so they can have a hospital, and maybe get doctors in the hospital that know what they are doing,” said Tiny Carter.

“Get more doctors. I think that’s what we need. … There are hardly any doctors at the clinic anymore. You can’t get any good local care. It’s not the hospital’s fault. They have state-of-the-art equipment. You don’t have the people in the positions to give the care,” said Shawnda Michelle.

Still, others want to look to management outside of Cowley County, or for improvement of operations across the board.

“I’ll vote yes for a tax increase only if it’s sold to a for-profit company that has a good track record of making money,” said Phillip Harader.

“No to more taxes. Get better at what you do, rather than increase the tax base,” said Bob Hicks.

Asking for change

Other citizens offered more direct feedback for the commission as to what would need to change for them to consider voting yes to a tax.

“Nothing, until the entire board from the top down is replaced. Show a comprehensive one year, five years and 10-year plan,” said Tammy Miller.

“Operate on or below budget for those 10 years. The first time they go one red cent over, close it down or sell it to a large hospital that had people with sense enough to run it. As long as any of the board is even associated — I mean, if they are hired to clean toilets — the answer is NO MORE TAXES. They have had every chance and they blew it.”

“Replace (the) CEO,” said Melissa Sweely Cochran.

“I really think the city needs to give up on the hospital. Their energies would be much better spent on economic/job development. The hospital never improves. More people are going to Winfield and Wichita. The billing is, and always has been, horrendous,” said Michelle Mohan.

“I do not feel this is a referendum on the staff. It is more a realistic financial decision.”

Not a simple issue

Many respondents said they realize this is not a simple issue and many factors affect SCKMC’s financial situation.

“My husband just had two trips to the ER with pneumonia. His Medicare coverage will only pay our hospital an allowed portion of the bill, and they have to accept it. Blue Cross gap insurance picks up the rest of the allowed charges,” said Evelyn Shoup.

“Medicaid is the same and Brownback chose not to have Kansas participate in the federal program. This had a direct detrimental effect on local hospitals. Simply put, they lose money through no fault of their own.”

The city is responsible for the hospital debt. The bill has to be paid one way or another. I absolutely hate the idea of more taxes, but given the choice between a continuing sales tax or increasing property tax, I would choose the sales tax,” said Dr. Nathan Niles, a local dentist.

“I firmly believe that the city should sell all non-vital property that it owns first, and apply that money towards the debt prior to any tax.”

“We will vote for the sales tax to support our hospital. When Kansas leaders realize that they need to do something about KanCare, then perhaps our hospitals will not need this kind of help,” Shoup said.

“Hospital boards and administrators must continue to be as careful as possible to manage the funds they receive from the sales tax, from Medicare, Medicaid and insurance companies. Our hospital is a vital part of our community. Help to support it.”

The problem is that hospitals are a very unique entity. They can have a plan, but it changes drastically when the fed and state change reimbursement rates at their will, Niles said.

Last year, the State of Kansas cut Medicaid reimbursements by 4%. The (Affordable Care Act) did not help the hospital either. More people had insurance, but couldn’t afford their deductible, which has to get paid first prior to insurance paying. This left the hospital with a lot of debt. Don’t get me wrong: It could and should be ran better and more efficiently, but I am not privy to all of the numbers to have an opinion on how to do it.

If the insurance companies would stop raising deductibles on insurance, more people would be less in debt and hospitals would be paid on time, said Johnny Sharp.

The problem in economy is when minimum wage or workers across the board get a raise, insurance companies raise everyone’s deductible. If the state would only contract out to insurance companies with low deductibles and write some laws forbidding enormous deductibles for middle-class citizens, we (wouldn’t) have half the problems we have with the economy.

A city divided

Some citizens showed support for the hospital staying open, without much conversation about the cost of services or the proposed sales tax.

“The hospital and (doctors) are necessary for our community. Lives would be lost without them. I never had a problem with the billing. The hospital hires lots of AC residents, too. We NEED it,” said Tina Gressel.

“Citizens fighting for the Burford. Look at it today!!! Maybe some of those citizens could get something started up for the AC hospital. We need the hospital but a better way to save it needs to be found.”

“It is easy for some to think the hospital is a waste of money until you need it!” said Randy Leach.

“I have recently seen the hospital staff and ER in action for both my daughters, granddaughter, and unfortunately for myself. The staff was professional, caring and addressed my familys needs. Paying a little extra sales tax is a very small price to pay for the service available.”

“I support the tax increase. Im on (a) fixed income and still say we need a hospital here. Winfield may be good, but time matters when your life is at stake,” said Linda Squires.

While others did not give a reason for their vote, they very clearly stated they did not want any more taxes going to support the hospital.

“They can buy my property, my parents property and my in-laws property … we will move and they can keep on destroying Ark City,” said Bruce Pendlay.

“More taxes huh?? No wonder people are packing up and leaving,” said Roman Tiger.

“NO MORE!!! We need a Robin Hood, not more excuses,” said Piper Leigh.

“Absolutely nothing. No more taxes. I will start shopping out of town if they increase again,” said Cindy Beeson.

“Nope, most citizens are on a fixed income of some sort. We are being taxed to death already,” said Carrie Mosconi.