Juneau residents are expressing concerns about reducing or eliminating several programs that lose money at Bartlett Regional Hospital, including a 16-bed residential and outpatient substance abuse treatment facility that is projected to lose $800,000 next year.
The hospital’s financial condition is unhealthy, officials said at a public forum June 4, while it faces growing competition from the nonprofit SouthEast Alaska Regional Health Consortium.
About 25 people in-person and 35 online attended the first of two public forums scheduled by hospital leaders to get feedback on proposed cuts to six non-core programs including Rainforest Recovery Center, crisis observation and stabilization services, outpatient psychiatric care and hospice.
The hospital board of directors is scheduled to make recommendations about the programs at its June 25 meeting.
Bartlett has been losing about $1 million a month since the summer of 2020, hospital officials told Juneau assembly members.
Most of the money-saving options proposed by hospital officials during the past few weeks involve either reductions, finding additional funding from sources such as the City and Borough of Juneau, or having another entity take over money-losing programs.
But the numbers presented by Bartlett officials are stark, with the hospital at risk of running out of cash within three years. In addition to the six programs targeted for cuts or elimination that are losing money — and thus further putting core services at risk — the hospital is increasingly facing competition for services provided by SEARHC.
“SEARHC has, and I think uniquely in Alaska so far — decided to compete directly against the private providers that are out there, including Bartlett, but also dentists and other providers,” said Max Mertz, chair of the hospital board’s finance committee.
“And when your reimbursement rate is significantly higher than what other providers get, it creates a very uneven field,” he said, referring to the higher federal rate received by SEARHC for care it provides than what other health care operators receive.
“We are very much in danger of having a monopoly here and a lot of what we’re dealing with here is because of that,” Mertz said.
SEARHC, established in 1975 and one of the largest Native-run health organizations in the U.S., originally served only Natives at its Southeast Alaska facilities, but has expanded its patient base and operations over the years. It receives funding from the Bureau of Indian Affairs and grants as well as billing for services provided under Medicaid, Medicare and private insurance.
SEARHC several months ago opened a new, three-story facility in Juneau’s Mendenhall Valley, providing urgent care, primary care, pediatrics, behavioral health, optometry and more.
A SEARHC spokesperson did not respond to questions from the Empire on June 5.
Bartlett is owned and operated by the City and Borough of Juneau, so the option of “subsidizing” programs such as those being considered for cuts largely rests on the willingness of city leaders to provide additional funds. Mayor Beth Weldon has suggested the question might be put to voters about funding or scaling back such programs.
Some people speaking at the June 4 meeting, including current and former medical staff at the hospital, said the priority for the board should be ensuring essential services are prioritized.
“Bartlett generally needs to look at doing surgical services, doing what they do and do it well,” said Carlene Conway, who worked at Bartlett for 32 years including as its surgical services director. “Not try to branch out too many places.”
But some attendees said it’s also vital to consider what best serves the overall health needs of the community, including the programs picked up by Bartlett in recent years and now targeted for reductions.
Aaron Surma, executive director for the National Alliance on Mental Illness’ Juneau office, cited crisis services the hospital started offering in December at its new Aurora Behavioral Health Center as a high-needs service without suitable local alternatives.
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