Frequently Asked Questions
Q: What is the history of the hospital project?
A: The Columbia Health District has been looking for ways to improve access to health care services since St. Helens Hospital was closed by Health and Hospital Services in 1990. The Board went to voters in 2004 and funds were approved to build a small hospital in South Columbia County. The hospital will have 12 beds with a 24/7 emergency room. Services will include radiology, CT scan, laboratory and rehabilitation services and wound care services. In the future services can be expanded to include outpatient surgery and to meet other medical needs that arise within the community, such as dialysis or chemotherapy.
Q: What progress has been made toward building a hospital in St. Helens since voter approval in 2004?
A: CHD has secured land for the hospital which has been the biggest hurdle to overcome. The property is on Millard Road, on the west side of U.S. Highway 30, close to the highway. Ethos Development is the general project manager and will manage construction and financing. Clark/Kjos architects will design the building and grounds. Michael Lilly is our real estate negotiator. We have moved our open date to late 2009.
Q: Why is land so tricky to secure?
A: The CHD Board confirmed two sites in the last year, but each one was found to be unworkable for different reasons. One had a covenant attached to the deed which would have limited the ability of the hospital to grow with the community. On the second site, when the District brought in highly sensitive seismic tests, the ground was found to vibrate slightly with passing trains, making the site unsuitable for critical medical instruments. The Board is now in negotiations on a site in the southern part of St. Helens.
Q: Can we still receive the Critical Access Hospital designation?
A: When the Board began the hospital project in 2001, we were assured that the hospital would qualify for Critical Access Hospital status, which we would apply for after the hospital opened. Since then we have learned that the Federal rules for Critical Access Hospitals have changed and we may not qualify. That affects the reimbursement the hospital receives for Medicare and Medicaid patients and impacts the bottom line. Recently we have heard that there are more changes in the CAH Federal program and we may again qualify. We are continuing to build a hospital that would qualify as a Critical Access Hospital and we will apply for the status after we open.
Q: Is the financial success of the hospital assured?
A: The Health District has two independent financial feasibility studies for the hospital. The second was commissioned after the district learned that the Critical Access Hospital program might not be available to us after we open. Both studies confirm that the project is feasible, given the size of the community, the medical needs and the size that the hospital will be. If the hospital qualifies as a Critical Access Hospital upon opening, we will be able to reduce the opening debt more quickly and could possibly add services.
Q: Who is going to run the hospital?
A: Legacy Health System was selected by the Columbia Health District Board of Directors, as the contractor to manage the day-to-day business of the hospital. The CHD will be the owner, and will ensure the hospital is locally controlled and able to respond to the needs of the community. Legacy officials meet regularly with CHD representatives and have provided valuable advice and the benefit of their experience to insure that the hospital project stays on time and on budget.
Q: How will this be different than an Urgent Care Clinic?
A: A small hospital will provide the community with an emergency room that will be open all the time, and will offer services to care for more serious injuries. This is significant because it will increase our ability to react to local emergencies at all hours of the day and night. A local 24-hour emergency room will increase ambulance availability for “life or death” situations and reduce travel time by approximately 35 minutes.
Q: Will the hospital accept all kinds of insurance?
A: The emergency room will be used by all insurance providers, who generally pay for care at the closest emergency facility. The hospital administration will work to have contracts with as many insurance providers as possible.
Q: Does the hospital have the same services as a larger Portland hospital?
A: No. Serious injuries will still go to Portland, or may be stabilized in St. Helens and then transported to a larger sister hospital. Kids with cuts, broken bones, earaches and burns can be treated. CT scans, lab, ultrasound and X-ray will be available. Seniors can be admitted for overnight observation for dizziness, pneumonia and pulmonary disease. Patients can get bandages changed, wound irrigation and fractures treated. The big benefit of a local hospital is that people can be treated in the same community they live, with their families there to provide support.
Q: Will the hospital fit the criteria to receive Medicare/Medicaid reimbursements?
A: Yes, the hospital will receive Medicare/Medicaid reimbursements whether or not it is a critical access hospital.
Q: The building site is outside the city limits. How will you access sewer and water?
A: The City of St. Helens is working with property owners to form a Limited Improvement District, and the Health District has budgeted to run sewer from U.S. 30 to the site. The hospital will annex to the city eventually. The hospital project manager for the hospital has met with the McNulty Water system supervisor and the way is clear to hook up to the system at no cost to current users.
Q: Millard Road is narrow and in desperate need of repair. Can it take the increased hospital traffic?
A: It is less than a quarter mile between U.S. 30 and the hospital site. CHD will improve the road along the hospital frontage with curbs and sidewalks.
Q: What are you doing with the tax income during this planning stage?
A: The Columbia Health District is putting the bulk of the tax revenues into a high-interest government pool until it will be needed for property purchase and construction. CHD is paying for a project manager, project coordinator, fiscal management, architects, most on a part time basis to be as economical as possible.
Q: Cost of the project has increased since voters approved the tax rate. Will voters be asked for more money?
A: CHD has hired financial consultants to make sure the project is feasible with the tax rate we have. The Board will not go back to voters for more funds.
Q: We have had so many doctors just pass through St. Helens. How are you going to maintain physician coverage?
A: We plan to contract with a physician group who would provide the 24/7 coverage. We believe that a small facility can stabilize our physician community and attract physicians to the area.
Q: Aren’t you building something completely different than the voters approved?
A: No we’re not. We’re building a hospital that will qualify as a CAH if we can receive the designation. – 24/7 Emergency Room; 12 beds instead of 15, but other than that, same size, same services.
Q: I heard that the CHD is funding public health services from the hospital fund.
A: Some Public Health employees are doing hospital planning, which is more economical than hiring new people to take on those tasks. Hospital funds support those employees’ wages and benefits for the time they are doing hospital tasks.
Q: How much is CHD paying for the property on Millard?
A: The purchase price for the new hospital property is based upon an appraisal received on October 18, 2007 and prepared by Owen Bartels and Robert L. Hickok, M.A.I. of Integra Realty Resources. Both Mr. Bartels and Mr. Hickok are certified appraisers. The appraisal was prepared for the St. Helens School District, and it conforms to the Uniform Standards of Professional Appraisal Practice.
The entire piece being conveyed from the St. Helens School District to the City of St. Helens and the Hospital was appraised by Integra at a fair market value of $1,520,000. The total property consists of 23.32 acres. There are wetlands on the property and portions of the lot that are not well suited for development because of the slope of the land and a creek, so approximately 14.77 acres are useable for development. That works out to an appraised value of $102,911 per useable acre. The hospital will be receiving 5.94 of those useable acres, which multiplies out to $611,291.34. This was rounded off to $611,294, which is the contract purchase price.
This property is very suitable for the hospital and less expensive than the other parcels that we explored earlier. For the public it has the added benefit that the purchase price will be paid to the City of St. Helens and the St. Helens School District, so the public will in effect get a double benefit. This is because the taxes will be spent to acquire the land as planned, but since the money will stay in the hands of public bodies, the money will be used again for the public's benefit by the City of St. Helens and the St. Helens School District.
Q: Is the state going to put a light in at the intersection of Hwy 30?
A: Not that we know of.
Q: Can the hospital levy more taxes without a vote of the people?
A: The Columbia Health District is the owner of the hospital. All tax levies would come from the Columbia Health District and need to be approved by the voters, just as the current tax rate was.
Q: Where is CHD going to get the money to offset the startup years before the hospital begins to break even?
A: The financial feasibility study and projection of income and expenses shows that like any new business, we will lose money for the first years. In our case, we are looking at breaking even in year six. To offset the first years we are saving our tax income in the high interest Government Pool, we are planning a Foundation giving program and the rest we will borrow up front.
Q: Does the Emergency Room require a specific ER physician to function?
A: The Columbia Health District has stated many times that it is the board’s intention to have a physician in the hospital around the clock. However, by licensure, it is not necessary to have an MD in the hospital at all times. One must be on call. If the hospital has an Emergency Room, there must be an RN on site at all time.
Q: Where will those ER physicians come from? Urgent Care has problems keeping MDs.
A: We have had an initial meeting with the group of contract physicians that provided physician coverage to the Urgent Care Clinic. We are budgeting to hire a group to provide 24/7 coverage.
Q: Will Legacy Urgent Care employees be taken straight across to the new ER or do they need to “apply for their jobs.”
A: Legacy will be providing management services and so they will have a major role in how their employees are treated. We have not gotten to the discussion of local Legacy employees who wish to work at the hospital.
Q: Will they be employees of Legacy or the Columbia Health District?
A: Our initial management document with Legacy spells out that hospital employees will work for the hospital owner, the Columbia Health District. The CEO and CFO will be employed by Legacy.
Q: It appears that payroll alone would be as much as the tax rate. How can the hospital survive?
A: The hospital will have income from services. The tax rate will pay back the loan for the construction and the start-up funds until billings cover expenses and we begin to break even.
Q: How can I get involved?
A: If you want to keep up with progress on the hospital, you can log into the web site (www.columbiarivercommunityhospital.org ) to find out dates for the meetings Columbia Health District, generally on the fourth Thursday of the month, 7 p.m. at the Columbia Learning Center Auditorium. The CHD Board hears updates at each meeting.
If you have specific questions, contact Hospital Project Coordinator Pam Powell, 503-397-4651, ext 211 or e-mail, hospitalcoalition@chdpublichealth.com.