Many years ago, we were asked to volunteer as part of a Healthcare Advisory Board to St. Joseph Madison Hospital. Through that volunteer service we began to see first-hand all the issues our facility faces and after much discussion agreed— we need a new hospital. We researched our options, sought the advice of legal experts and decided our best option would be to once again ask the voters of Madison County to support this community initiative.

Recently there have been several questions raised about the upcoming election that we as Friends of Madison Hospital feel need to be addressed. There are some who feel this process has been rushed. That is simply not the case. In April of 2020 members of the Healthcare Council formed a Discernment Committee to explore our options. Through that process the Friends of Madison Hospital was born. We worked to get the petitions signed necessary to put this to a community vote and followed the legal process as laid out by the state to make this happen. We felt it was important for all of us, as a community, to have the opportunity to vote. Madison County officials did their due diligence to verify the approximately 350 signatures collected, shared information to be discussed at upcoming meeting and placed it on the ballot as requested by citizens of our county.

While to some this may seem that it happened quickly or quietly, we want to remind everyone that the issues the hospital facility faces are not news to us as a community. The voters of this county have twice before been asked to consider a hospital district. Both times that measure failed but community leaders knew then what we know now. Our building is falling apart. We are now in a much more dire situation than we were then.

So what exactly are we voting for? On the ballot will be one vote but includes four parts. 1) the creation of the Madison County Hospital District, 2) the appointment of 7 directors by the County Commissioners. After the initial appointment, those positions will be voted on by the public. 3) a tax rate not to exceed .25 cents per $100 valuation, 4) issuing a bond for the construction of a new hospital for $33 million. And yes, it is true, as we have shared recently on our information page that exemptions such as Homestead and Over 65 do not apply to a hospital district.

There have also been questions about how the new hospital should be funded and specifically why we did not propose a sales tax instead. It is possible for a county our size to consider levying a sales tax for a hospital district but there are many reason why that is not the best option:

If it were to pass we would have to first implement and then collect on those funds. It would be more than a year before we saw any of that money and still wouldn’t be nearly enough to pay for a new building. So we would have to save up enough to build a new facility. We don’t have that kind of time.

Sales taxes are based on sales. If sales go up, the money we collect is more. If they go down, the money we collect is less. It is very unlikely that a bank will lend us money based on an inconsistent revenue stream. How would we guarantee we could pay it back?

A sales tax is permanent. A bond is not. Once the bond is repaid, those fees go away. A sales tax does not. We don’t want to burden the community longer than necessary.

Perhaps 20 years ago when the facility was not so bad off we could have considered it, but we are well passed that point now. If the voters agree to move forward with the creation of the Madison County Hospital District and the bond issue, we could begin construction in early 2022.

Once the Hospital District is created the citizens of Madison County will own the hospital and the board will be responsible for overseeing health care on our behalf. If we really wanted to, we as voters could consider levying a sales tax to offset the bond debt at a later date. For now, we need to tackle the bigger issue of getting the loans to break ground.

The appointed (and later elected) hospital district board will represent us, the citizens of Madison County. It is up to them to decide who will manage the facility on our behalf and what that agreement will look like. Common Spirit, the parent company of St. Joseph Madison Hospital, has expressed interest in continuing to work with us as a county but we are not there yet. Voters must decide first.

As far as selling the old hospital land back to the County or the Madison County Hospital District, that would be up to St. Joseph, the owner, and those entities to negotiate and decide upon. Also, any rent payments would have to be negotiated by the Madison County Hospital District board members and the health care provider.

We have no doubt that you have questions. This election is a big deal and we want you to take it seriously. The Madison EDC is hosting two public meetings from 6 pm to 8 pm on Tuesday, Oct. 19 and Monday, Oct. 25 at the Kimbro Center. We invite you to join us. In the meantime you can visit our website at friendsofmadisonhospital.org or find us on Facebook at @friendsofmadisonhospital.

Sincerely,

Friends of Madison Hospital