NPR, All Things Considered | By Sarah Varney | August 19, 2010
Modoc County is in the remote northeastern corner of California. Residents there will soon vote on whether to tax themselves to save their local hospital.
Rural hospitals across the nation have struggled to stay afloat. There are, of course, fewer patients in rural areas, and many of them are on public health insurance programs that pay far less than private insurers.
Residents in Modoc County, in the remote northeastern corner of California, will soon vote on whether to tax themselves to save their local hospital.
The county has gone broke trying to keep the hospital open, and a fractious debate has erupted in this proudly conservative frontier community over the best way forward.
The hospital hallways at the Modoc Medical Center, like the nights, are quiet. It's been years since pregnant women could deliver their babies here. A surgeon comes just twice a month to do simple procedures. Even the helicopter pad is sprouting weeds.
We're in a battle right now, we don't want to go insolvent. That's not going to resolve anything. If the county goes down, the hospital goes down. If the hospital goes down, the city goes down.
- Dan Macsay, chairman of the Modoc County Board of Supervisors
But it's no exaggeration to say that the county hospital in Alturas — even with its limited services — is a lifeline to the people who live here. The closest full-service hospitals are hours away, and the nearby medical centers over the mountains are often unreachable during winter storms.
"They gotta have something," says Vicky Smith, 61, who moved to the area as a young girl. She now owns the Main Street Family Diner. "There's a lot of retired people here, a lot of 'em. And if they don't have medical, they'll have to leave.
The talk of the diner, and elsewhere in the remote Pit River Valley, is the fiscal calamity that could force the hospital to close and the county to go bankrupt.
An outside audit found that county supervisors improperly used restricted funds to bail out the hospital, which was losing millions of dollars a year. Now, the county has to pay back some $12.5 million in federal and state grants. And the hospital is on its own to make ends meet.
"It's almost living paycheck to paycheck basically," says Monica Derner, the hospital's interim chief executive. She's the seventh CEO in the past four years. "And some months are better than others. And sometimes the payables are more current than other times. And it's kind of just juggling the finances around to make it work right," she says Read more about In Rural Calif., A Debate On How To Save A Hospital