How do Baptist hospitals deal with hard issues?

How do Baptist hospitals deal with hard issues?

Every day, the Baptist health systems in Alabama face unpleasant issues with which they must deal.

Perhaps it is a young woman seeking to end an unwanted pregnancy.

Maybe it is someone visiting the emergency room for a nonemergency situation because he or she lacks health care insurance.

Or it may be that the systems’ financial officers are watching the ever-shrinking Medicare reimbursement dollar and witnessing how it is affecting health care for everyone.

Yet, the systems try to handle these matters in a fashion that stays true to their mission of showing the love of Jesus Christ and giving quality care to everyone, regardless of ability to pay.

One way that it is done is through the commitment to the sanctity of life.

Quite simply stated, the facilities of Baptist Health of Montgomery do not terminate pregnancies. Should someone request an abortion, “we give them names, addresses and phone numbers of people who are available to offer that kind of counseling,” said Rick Derrick, system director of public relations and overseer of the MediCall Center.

Derrick went on to explain that the trained counselors try to help the people see that there are alternatives to terminating a pregnancy.

Baptist Health of Montgomery operates two hospitals in that city and one each in Prattville, Selma and Luverne; PriMed primary care clinics in Montgomery, Wetumpka and Prattville; three surgery centers, two nursing homes and an elderly community with 100 apartments.

In the northern and central sections of the state is Baptist Health System (BHS). That system operates 10 hospitals (in Sylacauga, Talladega, Fort Payne, Centre, Moulton, Jasper, Cullman, Alabaster and two in Birmingham) and 60 clinics, in addition to eight home health agencies, 10 fitness centers and seven long-term care facilities.

That system handles requests for abortions in a similar manner.

“Generally, that patient would be told there are other alternatives,” said Dennis Hall, president and chief executive officer of BHS. At nine of the system’s hospitals, abortions are not permitted at all, he said.

However, at the other one — Montclair Medical Center in Birmingham, a pregnancy can be terminated under certain circumstances, said William Hynson, executive vice president with BHS. A nonviable fetus and a situation in which the mother’s life is in jeopardy are two reasons an abortion would be allowed at the hospital.

But before the pregnancy could be terminated, Hynson explained, a team of physicians has to agree on the medical need. Even at that, no abortion is done after the 20th week of gestation.

Hall said an abortion also could be done in instances of rape or incest that have been investigated and documented by law enforcement agencies.

With such tight restrictions, Hall went on to say, abortions are very rare at that hospital.

“If it happened once a year,” he said, “I’d be surprised.”

Giving medical care to those who lack insurance coverage or can’t afford to pay — and giving them the same quality of care as someone who can pay — is one of the missions of the two Baptist health systems in the state.

“That is an important role we play,” said Hall.

The dollar amount for this care “is staggering,” he added.

For Baptist Health of Montgomery, it is about $7 million to $10 million a year, Derrick said. That loss is absorbed by operating revenue in such a way that patient care isn’t affected.

He explained that Baptist Health of Montgomery has a reserve only because it has been a good steward of the money it has received. “If we weren’t financially strong, we couldn’t absorb that loss.”

But he added that the operating out of the reserve money can’t go on forever.

At BHS, $44.2 million in charity care was given in the last fiscal year, Hall reported. About $45.7 million has been budgeted for this fiscal year.

The amount of bad debts — people who didn’t or couldn’t pay their bills — was about the same, he noted. The loss is absorbed generally through having enough margin from other sources, such as reimbursements from HMOs, insurance companies and Medicare.

Nonetheless, six of the 10 hospitals in the system are “in the red,” he said.

Yet, the commitment to provide health care to everyone stands firm.

BHS has two “proactively operating indigent clinics” in Birmingham for those who lack the ability to pay.

These two “referral clinics,” as they are called, are located at Princeton and Montclair. Hall said these clinics have been open “many, many years — probably nearly three decades now” and often treat patients referred there by other hospital systems in the area.

Hall also said the system’s board decided to create a “mission tithe.” This designates 10 percent of the cash reserves to improving community health issues. In the future, 10 percent of the surplus would go into this “tithe.”

What this “mission tithe” does is to award grants for projects that focus on indigent care or community health matters. These are not limited only to BHS projects, Hall stated. “It’s a pretty significant thing we’ve done.”

This effort began 18 months ago and grant requests began to be approved in the past year.

Among the grants already funded, Hall said, were cancer and heart screenings in Walker County, health promotion equipment in Shelby County and a health project on Chandler Mountain by Samford University.

To the south, Baptist Health of Montgomery and churches in that area worked together to start a free health clinic, staffed mostly by volunteers. “This has been a tremendous thing for the community,” said Derrick.

Montgomery Outreach Ministries Family Health Clinic, though, is not supported just by Baptist churches. “We want this to be a community clinic,” he explained.

Those who qualify for being seen at the clinic cannot be on Medicare or Medicaid, he added.

The clinic was the idea three years ago of the system’s former president and chief executive officer, Michael DeBoer, who died at 52 July 7 of a brain tumor, Derrick said.

The clinic grew out of the system’s involvement four years ago in an undertaking of the city government, the Army National Guard and many businesses and agencies to give free dental and medical care to more than 2,000 people in two days. Not only did the clinic visitors receive free care, but they also got a new pair of shoes and groceries, Derrick said.

“Mike’s vision for this was, ‘Why does this have to occur once every couple of years?’” Derrick continued. “Some people had never been to a doctor in 10-15 years.” In fact, a number who attended that two-day clinic were found to have significant conditions that required immediate surgery. The system donated an operating room and the doctors, their time.

“Health care is in such critical shape right now” because of the Balanced Budget Act of the Federal Government, Derrick said.

And if there isn’t some relief soon, about 14 hospitals in the state will run out of money and have to close, he added.

He pointed out that Baptist Health of Montgomery lost about $20 million from operations as of the end of the fiscal year on June 30.

The cut in Medicare reimbursements, which he said have surpassed the amount Congress had originally intended, “affects the entire health system,” even for those who have health insurance.

It means some services that were being offered will cease; equipment may not be replaced on the same schedule as before and buildings can’t be maintained as they could previously.

Even those who have insurance will not be able to receive the same quality of care as they had enjoyed before because of the cuts hospitals are having to make, Derrick said.

It also means some employees may not be replaced, Hall noted. The situation is the same at all hospitals now, he said.

Officials with both systems encourage residents of Alabama to contact their congressman and express concern about the effect these cuts in Medicare reimbursement are having on health care.

Moreover, these Medicare cuts translate into services ceasing or access to them being limited.

At BHS, these cuts are affecting programs involving patient education, screenings and transportation and those focusing on indigents and inmates.

For Baptist Health of Montgomery, a project that had assisted 18,000 in its one year of existence was cut out Aug. 1. It is one of several projects suffering the blow.

Derrick said MediCall was a medical triage call center. People could call the number and talk to a registered nurse before going to the emergency room. The R.N. would advise the best method of treatment. It might be to call 911, go to the emergency room or wait until the next day to see a physician.

However, the Medicare cuts and the losses in operating costs spelled MediCall’s demise, much to Derrick’s disappointment. “We know we saved some lives with (MediCall)” and cut down on nonemergency visits to the emergency room.