Ownership of VMH would simply transfer from the City of Waukon to Allamakee County. The location of the facility, and current Board of Trustees, leadership team and staff would remain the same.

Additional resources are needed to ensure the sustainability of local, personalized healthcare in Allamakee County for decades to come. Converting from a city- to a county-owned hospital will allow VMH not only to retain existing programs like surgery and OB, but to expand services to meet the county’s growing healthcare needs.

County appropriations will also support critical infrastructure and technology updates. Both are essential to improving patient care, as well as retaining and attracting physicians, nurses and other staff in a highly competitive market.

Yes. During the March 21 Waukon City Council meeting, VMH received the Council’s full support to file a petition to invoke a vote for a city to county conversion.

On April 4, VMH started the petition for voter support. The petition, which requires the signatures of at least 372 eligible voters, is due to the County Board of Supervisors by Aug. 18. The Board will then submit the petition to the election commissioner to be put on the ballot for the Nov. 8 general election. 

After years of financial instability, VMH has begun to gain ground through operational improvements, expanded services and recruitment of additional providers. While strategic internal changes helped drive this success, COVID relief dollars received in 2020-2021 played a significant role in temporarily offsetting recent expenses and funding minor renovations. Those resources will be depleted by year end 2022.

The city-to-county conversion isn’t just about what has changed, such as the depletion of COVID relief dollars, it’s also in response to what has not changed.

VMH faces ongoing financial challenges—many that are unique to rural hospitals. For example, rural hospitals like VMH must comply with the same regulations and healthcare codes as larger hospitals. The difference is that large facilities profit from efficiencies of scale and high patient volume while rural hospitals that serve small communities struggle to break even on many services.

Challenges like these have caused more than 125 rural hospitals to close since 2010. Converting to a county hospital will allow VMH to build on the financial progress it’s made in recent years, while ensuring recurring financial support to keep access to quality care close to home.

As an independent hospital, VMH has the ability to quickly adapt to the changing healthcare needs of Allamakee County residents. While we will continue to work closely with larger providers like Gundersen and Mayo Clinic, we want to ensure our patients continue to receive the high level of personalized, compassionate care they have come to expect from VMH.  

A minimal tax increase has been proposed to support approximately $950 thousand in annual appropriations for VMH. For example, a resident with a home valued at $144,000 would be taxed just $157/year to help ensure the sustainability of healthcare for Allamakee County.

Funds are earmarked for critical capital investments that may include:

  • Operating Room (OR) updates and expansion: Currently, VMH has just one OR that is shared by orthopedic, ophthalmology, podiatry, OB and general surgeons, which makes OR availability very limited. The time it takes to clean the OR between each patient further limits availability. As VMH continues to recruit new specialists, an additional surgery suite will be needed to accommodate growing patient volume.
  • Emergency Room (ER) updates and expansion: With just two main ER rooms to service a growing number of patients, VMH’s Emergency Department is often full. It will be critical to expand the ER to ensure everyone has access to emergency services when they need them.
  • Infrastructure updates/renovations: The current facility is 70 years old, and it has been more than 20 years since any major renovations were made. VMH will need to make major updates in the near future, including replacing the roof and boiler, updating the HVAC and electrical systems, and purchasing a new emergency generator.

Electronic Medical Record (EMR) system: Upgrading to a user-friendly system will allow patient records to be electronically transferred quickly and easily, not only between different providers and departments, but also between different healthcare facilities. This will help save time, improve accuracy and provide a better patient experience.

It’s very common. In fact, county-owned hospitals in Iowa receive, on average, $1.75 million in tax support each year. It’s also important to know that the partnership between the county and VMH will continue to grow beyond the related services already in place. Examples include transferring of behavioral health patients and providing a county examiner and Allamakee County Public Health Services, which are already part of VMH.

None. The conversion will not affect the existing ambulance services in any way.

VMH will continue to be your hospital. Just as in the past, every decision will be made in the best interests of our patients and the communities we serve. To ensure this:

  • VMH will produce an annual Report to the Community, documenting the hospital’s activities and finances for the prior year.
  • Annual community forums will be held to provide an open exchange of information and to gain valuable input from Allamakee County residents.
  • A Community Ambassador group will be formed with members from throughout the county. This group will be the voice of the community, guiding VMH in its mission to provide an exceptional healthcare experience with compassion.
  • What if the conversion isn’t approved? Is the hospital in financial trouble?
  • Although the hospital won’t be in immediate “financial trouble,” it will face ongoing challenges to create enough bottom-line profit to sustain some existing programs. Appropriations will be essential to help fund specialty services, new equipment purchases, facility updates, and major capital investments.

To help put this in perspective … VMH is reimbursed for the healthcare services it provides. That reimbursement rate is just $.52 on the dollar from insurance companies, and only $.32 for Medicaid patients. Even though the cost of healthcare is high, low reimbursement rates keep VMH’s monthly profits at just slightly above break even. This does not leave enough funds for critical infrastructure updates, major equipment purchases, or larger facility improvements, such as roofing and electrical updates.

For example, VMH would like to bring back much-needed services like chemotherapy and dialysis. Having programs like these—close to home—can make a real difference in the lives of our patients and their families. But the reality is, we simply don’t have enough margin to fully engage the growing number of services our patients need. County appropriations will allow VMH to make critical capital investments it would be challenged to fund on its own.

Local jobs are of paramount importance for the long-term health of any community; even more so in rural America. VMH helps drive the local economy in many ways:  

  • With more than 250 employees, from clinical, administrative and IT professionals, to housekeeping, food service and maintenance staff, VMH is one of the largest employers not only in Waukon but also in the county. When care stays local, jobs do, too.
  • The regional economic impact of VMH’s payroll is approximately $50 million.

The conversion can make a big difference not only in the lives of our patients and residents of Allamakee County, but to everyone who is part of the VMH team. Appropriations will help fund critical capital investments that can improve our facility; enhance the working environment; provide access to the latest equipment and technology; increase advanced education and training opportunities; and affect the resources available to further invest in our valued staff.

The value of the fund hit a new high last year, which is great news for IPERS members—but that does not translate into direct profits for VMH. Why? Because IPERS is a prefunded retirement plan that exists exclusively to provide retirement security for employees. 

Here’s how it works. Eligible employers (like VMH) and their employees contribute to the fund. IPERS invests the contributions and holds the investment income in a trust fund for the exclusive purpose of paying benefits to members and their beneficiaries.

It’s also important to know that nothing will change if VMH becomes county-owned.