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Thursday, November 8, 2007








Board extends Ah-Gwah-Ching hospital deal
CASS COUNTY BOARD
WALKER - Cass County Board voted Tuesday to extend into 2008 agreements and ongoing work toward establishing a critical access hospital at Ah-Gwah-Ching.

After making a telephone call to Minnesota Department of Administration Tuesday morning, Administrator Robert Yochum reported the state still does not have a firm closing date for the state's Ah-Gwah-Ching in-patient program operating at the site.

The county's agreement to purchase the property states the sale closing will be Nov. 15, or 30 days after Minnesota Department of Human Services relocates its remaining programs and operations, whichever is later.

Until there is a closing date, Yochum said the county cannot seek bids for removing hazardous material from existing buildings.

He also reported estimates for that work, demolition of existing buildings and making sewer and water improvements to connect with city services are running much higher than the $4 million the Legislature has already approved. The county has used $277,599 of the $4 million so far to hire consultants to prepare cost estimates and work requirements to remove hazardous materials.

The current demolition and site preparation estimate to prepare to reuse the site is $6,767,500, so the county will need to seek additional state funding from the 2008 Legislature, Yochum said.

Chief Financial Officer Larry Wolfe reported the current cost estimate does not include any abatement for a former dumpsite on the property. The area is located north of the road running between Highways 371 and 34. Under current plans the former dumpsite would not be a part of the area proposed to be used for future county government buildings.

If that land ever were disturbed to make use of it, municipal solid waste abatement would have to be done, Wolfe said, adding the county has no insurance for such pollution abatement. Two studies have confirmed municipal solid waste on the site, he said.

Cass County will continue its agreement designating Benedictine Health Systems as lead provider. Michael Hedrix, of Benedictine Health Systems, said hospital operations will become a subdivision of Benedictine effective Jan. 1, 2008, under the name Essentia Hospitals and Clinics.

After studying expected building and operations costs, Hedrix and Critical Access Hospital Task Force Chair John Warren told the county board it appears a hospital service taxing district would need to be created in the area the hospital will serve in order to generate sufficient funds to operate a new hospital and clinic at Ah-Gwah-Ching

Hedrix said officials are looking at not only providing a hospital and clinic at Ah-Gwah-Ching, but also would like to provide full coordinated emergency medical services, including ambulance service.

He declined to say whether Essentia would own the ambulance service or whether it might be a contracted service with an ambulance provider. Benedictine Health Systems owns the ambulance service serving the hospital it owns at Duluth, but does not have any affiliation with North Memorial Ambulance, which provides services in the area around St. Joseph's Medical Center in Brainerd.

Whether there will be any hospital at Ah-Gwah-Ching still hinges on whether Congress approves a variance from federal rules prohibiting a critical access hospital within 34 miles of an existing hospital. Ah-Gwah-Ching is about 31 miles from the Park Rapids hospital.

Mike Mahoney has been lobbying Congress and tracking bills proposed to provide that variance. One passed Congress only to have President George Bush veto it. Others likely will not come up for floor votes until 2008, he said.

Mahoney said he and Yochum have been tracking revised federal rules that now include classing highways as primary or secondary. It is possible, they believe, that Highway 34 between Walker and Park Rapids might be classed as a secondary highway. In that case, the mileage requirement between the two hospital sites might be different from 34 miles and the Ah-Gwah-Ching site might qualify without special legislation for critical access designation.

Getting that designation would give the new hospital the right to bill higher amounts for services under government programs and, thus, make the difference between it being able to cover operations costs.

In related matters, Yochum reported Minnesota DNR is reviewing the county's request for utility, view, access and recreational purpose easements over the shoreline property that will go to the DNR when Cass County purchases the balance of the Ah-Gwah-Ching site.









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