Bid for new hospital put on hold

A grant application to purchase new ambulances for Crook County Medical Services District is moving forward, the board of trustees heard on Friday. However, things aren’t looking good for the district’s efforts to utilize that same CARES Act funding to replace or remodel the hospital.

The federal guidance on how CARES Act funding can be spent has been a source of confusion since it was first given to Wyoming. According to Kara Ellsbury, attorney for the board, a conversation with the Attorney General’s Office has shed light on whether the district should put in an application for a new hospital facility.

“They have said that the CARES Act funding that the State Lands and Investments Board (SLIB) is administrating is very clear that it does not apply for new construction, [and] that if it could apply for new construction it…truly has to be spent by year’s end,” Ellsbury said.

The lack of clarity in the instructions has caused frustration for those trying to apply for it, Ellsbury said. The Attorney General’s Office is not concerned that the money would not be properly spent, she explained, but rather that not following the guidance properly could have unintended consequences.

If it is not spent according to that guidance, there is a possibility the federal government could demand it be returned.

“The problem is the payback,” she said. “If the state has to pay it back to the federal government, how in the world are they going to claw it back from us and others?”

The application for new ambulances has been submitted to SLIB and Interim CEO Micki Lyons reported that a request for a more detailed quote has been answered. The next meeting of SLIB is on August 28. However, Ellsbury’s advice convinced the board that CCMSD will not be able to submit a second application for a new hospital building.

“What about asking for funding for the remodel?” asked Trustee Connie Lindmier.

Applying for funds to remodel the current facility has a better chance, said Ellsbury, “but the issue is still going to be, could you get a remodel done by the end of this year?”

There could be a workaround on the timing, she mused. Or, as it’s such a moving target, some new federal guidance could come out to clarify things.

“I would say that you guys could choose to put in an application and maybe something changes, and worst case it’s denied,” she said.

However, CEO Micki Lyons explained that there is a downside to putting in an application for a remodel: it would require a true cost estimate. Lyons contacted a company that creates cost estimates of this nature and ascertained that the price for an analysis would be in the region of $66,000.

While a remodel could conceivably be completed by the end of the year, she said, it would involve “a significant amount of money” for the cost estimate, which would need to be completed before the district found out if it was eligible for funding.

Additionally, the timeline would need to include this cost estimate and also the bidding process, Lyons said.

The board then considered whether or not to go ahead with the application for a new hospital on the offchance the situation may change.

“I know there’s a large number of people in the community who are very much against a hospital and a large number of people who think that we very much need one,” said Lyons, saying that this makes it difficult to offer recommendations about whether to apply.

“The timing is what people are against,” said Trustee Sandy Neiman, because of the impact the current state financial situation is having on taxes, people’s incomes and ag revenue.

An application for a new facility is complete, signed and ready to go, said Lyons, but has not been sent. Lyons explained that she had wanted to do “one thing at a time” and had thus sent in the ambulance application first, with the intention of sending the new hospital request once the district had “accomplished the first goal”.

However, on the basis that making such a request might cloud the decision of the SLIB board regarding the application for new ambulances – which, said Erickson, are an immediate need – and considering Ellsbury’s advice, the board decided it would be best not to send in that application.

“I think that right now we need to just tap the brakes,” said Chairman Mark Erickson. He noted that funding for the ambulances alone will be a big step forward for the district.

“Even that’s going to be a godsend,” said Erickson.

Trustee Connie Lindmier suggested having Ellsbury contact the Attorney General’s Office once again to ask for further guidance on applying for the remodel.

“In the long run, it would be good to have a study anyway,” she said.

Neiman wondered if it would really be money well spent. If a cost estimate is done and the district does not move ahead with an upgrade for a few years, she said, it would need to be done all over again.

Lindmier disagreed that it would be wasted money as it could guide decisions moving forward and perhaps aid in seeking other grants. Ellsbury agreed to contact the Attorney General’s Office for further guidance.