By Mary Alice Murphy

After a great deal of public comment on two issues [which will be covered in a future article], the commissioners went into executive session to discuss the disposal of county-owned property, namely Gila Regional Medical Center.

Those who had given public input milled around the room and others in attendance the meeting left while the commissioners were out of the room.

After a relatively short session, the commissioners came back into the room and moved back into open session.

Commissioner Brett Kasten said: "I move to continue delivery of medical care at Gila Regional Medical Center as a county-owned hospital."

Cheers briefly erupted, before people realized the commissioners had to vote first.

Commissioner Harry Browne commented first.

"I've spent a lot of time in Grant County fighting wishful thinking," Browne said. He cited fighting groundwater issues with Freeport McMoRan; the Gila diversion project, where people are just hoping there will be a market for this water that is economically viable; Holloman Air Force Base, which assures us their overflights will to cause fires, and "I'm very worried that we are engaged in wishful thinking on Gila Regional Medical Center. The hospital has put a lot of eggs in the basket of someone I respect very much, Richard Stokes, and a lot of eggs in the designation of critical access, which is political and no telling how long it can last."

He said more than 120 rural hospitals have gone out of business since 2005, and more than 700 have dramatically cut services. These hospitals were disproportionately ones that were critical access hospitals in rural areas. He cited the aging infrastructure of Gila Regional, the high rates of uninsured who use the facility, insufficient patient populations and the high risk the hospital has as it serves the poor.

Browne warned that closure of the hospital for the latter population would be devastating.

"It's not often a community like this one turns down millions of dollars in cash plus future investment just to stay with an overworked and dedicated but underqualified Board of Trustees that directs an institution that is heavily disadvantaged by lack of scale in the marketplace," Browne said. "Goodness help us. We'll be needing it."

Commissioner Gabriel Ramos thanked the public for their calls, letters to the editor. "But I ask the public to stop bashing any individual. We have all put in a lot of effort as commissioners. The decision we made to look at the hospital was made as a Commission, not as individuals. We needed to react to the loss of $22 million over several years at that time. There were things we could not divulge during the RFP process. All we ever wanted to do was make sure our hospital was secure and stable in order to give the best care possible to our residents."

He said it's been a long process, but "we considered not only the county residents and hospital employees, but we also considered our family members that might need care there. We thank the Board of Trustees members for their service and pray we have made the right decision."

"We are counting on you to communicate with us and the newly formed critical thinking group," Ramos continued. "We ask that the Board of Trustees and the Commission meet together at least a couple of times a year.

"Did we make the right decision?" he asked. "Only the future will tell. We're asking all of you who spoke for the hospital to support any tax that comes up. Put your money where your mouth is. It may be the only way to support the hospital. We challenge the public when a tax issue comes up to help Gila Regional, to help the county, to help yourselves by supporting it."

Commissioner Alicia Edwards thanked everyone for the calls and emails. "I appreciate the back and forth dialogue. We initiated the process to evaluate the current financial situation at that time and the future viability of the hospital. It has not been a pretty process. Our county staff made sure it was the most comprehensive risk assessment possible. The decision does not end today but is the beginning and continues into the future."

"Remaining independent will be challenging," she continued. "No one can say no to serving on a committee. If you need a procedure, you have to choose to have it here at Gila Regional. You have spoken of your desire to have a county-owned hospital, so you must vote yes on any tax question. I would also ask that within the next 12 months, the community step up to the place and create a special hospital district. The request has to come from the community. I would like to see that."

She noted the Hospital Funding Act is a difficult legislative action to follow. "We need to undo it and create a special hospital district or 501c3. We have a monumental task in front of us and we must rise up together."

Commissioner Brett Kasten said the Gila Regional Medical Center has a lot of challenges left in front of it. "When we began the process, we thought it was circling the drain without a chance to come out of it. Kudos to the Board of Trustees, Taffy and the staff for keeping it going. You still have an unbelievable amount of challenges."

He noted one of the most vocal groups against selling the hospital was the doctors. "They were 100 percent in favor of keeping it local. I chastise them a bit for wanting to keep it local. If you want to keep the hospital local, quit sending people outside for what we can do here at Gila Regional. We need a higher use rate of the hospital. Gila Regional Medical Center is still the only county-owned hospital in the state."

"I ask the trustees to work with the commissioners and the public to continue the discussion of whether county-owned is the best governance for the hospital," Kasten continued. "We ask you to consider a special hospital district. The Board of Trustees would be elected by the public, which would allow accountability, of which there is none right now.

"Not 100 percent of the community wanted it kept local," Kasten said. "Some people were vocal the other way."

Commissioner Billy Billings agreed that time would tell if the right decision were being made.

"We are putting a lot of confidence in the administration that seems to be turning things around financially," Billings said. "We are talking financial problems here, not operations problems. The levels of service, safety and care were never problems. I look forward to an improved relationship with the Board of Trustees."

Picking up a packet, he showed a petition that he had received signed by 31 physicians, 100 percent in support of keeping the hospital local.

The vote was done individually, beginning with Browne, who said: "Aye." Ramos echoed the "Aye." Edwards, too, said "Aye," followed by Billings and Kasten also saying "Aye."

This time the applause and cheering were more prolonged at the unanimous support of the commission to keep the hospital county-owned.

Billings invited any Board of Trustee members or administrators to come forward and comment if they wished.

Board Chairman Mike Morones expressed his appreciation of the tremendous amount of work, and, "yes, bravery. You did not take the coward's approach. I applaud you for doing what you've done to make sure Grant County had good, sustainable and viable health care. I also express appreciation for the two years of education I have received as a trustee. I have done a large amount of reading, debate, discussion and discourse, especially over the last year. I have learned a lot on how to make trustees and the administration more efficient. We've learned about a lot of challenges and know it is a battle we face."

"We knew that if the vote went our way, our work begins today," Morones continued. "It will be a tremendous effort. We have to change the communication culture. We have built-in hurdles with the Hospital Funding Act, but it has sometimes been used as an excuse not to communicate. We have to create a culture through the act to provide more transparency, so that not just this Board, this administration functions at a high level, but that it is put in place, so future boards and administrations follow it. If there is a publicly diverse task force, we need to play a part in it, as does the Commission. We need to continue to look at other models, maybe a 501c3. We need to do what is important to ensure the community has great care going into the future."

He said he appreciated the opportunity "to work my tail off. I will continue to work to earn your trust and the public's trust and to feel good about what we do."

Trustee Tony Trujillo he did not want to repeat what had already been said, but "I want to put everything in perspective. Thank you for doing your due diligence. We, as trustees, learned a lot from what we had to do. I thank you for today's decision. I'll put the quality of our physicians, our caregivers, our staff and trustees ahead of anyone else. We don't win awards without them. The community support has been tremendous. We have our work cut out for us."

Trustee Jeannie Miller also thanked the commissioners for their vote. "It has been an incredible 12 months. I've just complete dmy first year. We, as a board, we all said we are ready to put our chin to the road if the vote goes our way."

To the comments about having unqualified, inexperienced trustees, she said although they may have little hospital experience, they have a broad diversity of other experience. "One of the things I hope we will do is look at how we as trustees become more knowledgeable about the hospital and learn about the turmoil of health care in the country. I praise the new administration. You teach us and help us. The administration doesn't shy away from our questions and even criticism. We just need to get our feet on the ground. We're ready to hit the ground running, and we start today."

Ed Wilmot, the most recently appointed trustee, said he would not attend his first board meeting until late next week. "I have heard a lot of credit given to Taffy (Arias, chief executive officer) and Richard (Stokes, chief financial officer), who have done an enormous job. But, also, I emphasize that it took courage for you to do what you did and look at the options. A lot of good came from your efforts. We will prove to you that we are up to the job. We have experience based on holding people accountable. Accountability is key. I believe we will be successful in communication. It will take a lot of hard work. We have to be exceptionally proud of our opportunities for the future. We'll get there."

Arias came forward. "I have felt since the moment I interviewed here, that there is a special feeling, a special ambience, a special spirituality in this community. It is an honor to live here and serve you. Thank you."

Stokes said when he arrived about five months ago, "it took me about three hours to realize the significant opportunities we have. I thank the commissioners for their job. It is our job to move this hospital to the next level. It won't be easy. It won't be great every day, but the team that Taffy has built is extraordinary. This is the fifth hospital I have worked at and this board is the most engaged I have ever worked with. They ask some hard questions. My job is to be the source of information and to create the framework so the Board of Trustees can judge what the activity we have been currently working on is and what future activity will be."

[Editor's Note: Prior to the executive session, Arias and Stokes had presented the most recent financial report. It will come in the next article. Further articles on the work and regular sessions will ensue.]