Assets and liabilities connected to Glen Rose Medical Center are no longer the concern of Somervell County. Documents finalizing the transfer of all hospital property and administrative affairs to the hospital district were signed Thursday, Aug. 1.

Meanwhile the hospital board of directors is working to nail down a budget and proposed tax rate for the coming fiscal year, which begins Oct. 1.

The county no longer has to consider alloting eight percent of its total budget for indigent healthcare funding. Those expenses will now be funded through the Somervell County Hospital District.

Michael Honea, Glen Rose Medical Center's chief financial officer, said patients who previously received healthcare assistance through the county - or others who are in need of indigent services - now apply for and obtain such services directly through the hospital.

"Applications may be picked up in the front lobby or in the emergency room waiting area," Honea said. "There will be a hospital representative available every Tuesday from 7:30 a.m. to 4:30 p.m. in the front registration area to assist with any questions regarding the application process."

With the transfer complete, the hospital district board of directors is looking toward the coming fiscal year. Honea and Ray Reynolds, medical center CEO, are working on a proposed budget, which will be presented to the board next week.

The hospital board met Aug. 6 and was presented a list of proposed projects and capital expenditures for the coming fiscal year. Projects being considered include the revamping of the hospital website to include direct access to district financials, audits and upcoming board meetings and events.

The website is currently operated off-site, but Honea suggested making website updates an internal operation. He said the preliminary cost estimate for the upgrades is $5,000.

Meanwhile, the board is considering changing the way GRMC approaches public relations and marketing. Currently, the hospital works with an outside advertising firm, but Honea suggested hiring a public relations specialist. He said it would be a full-time position with an estimated annual salary of $40,000.

Board member Angie Roberson said that individual should attend community events and meetings, serving as the face of GRMC.

"There is a void in the community," board member Walter Maynard agreed.

Other considerations include allotting an estimated $50,000 for physician recruitment.

"From my perspective, this needs to be in the budget," Reynolds said. "If we are going to grow, we need support."

When it comes to family physicians, board member and GRMC medical practitioner Dr. Karen Burroughs said there are three on staff who plan to retire over the next few years. She suggesting looking for young doctors who can "grow up here." Burroughs also said in internal medicine, Dr. Julia Hutchison is inundated with clientele and is not accepting new patients.

But board Chairman Larry Shaw said while there is a need for additional doctors, there is not currently space for a newcomer. He said modifications need to be made to current offices to accommodate a new doctor.

The board had a healthy discussion on the current contract with EmCare, which provides emergency room physicians. Due to the fact that EmCare is not a local provider, many insured patients - those on Blue Cross Blue Shied of Texas, Aetna, Cigna, Humana and United Health Care - must pay out-of-network rates when receiving emergency care.

While contract adjustments could be made to allow those patients to receive in-network coverage, the cost could be as much as an additional $200,000-$500,000 to extend benefits to consumers of each of the providers.

Under the current contact, GRMC currently subsidizes ER operations by about $360,000.

Looking at the long term, Shaw said he would prefer to see the ER become an in-house operation.

"We are not giving enough study to doing it ourselves rather than subsidizing by half a million dollars," Shaw said.

But Burroughs said running an emergency room is "ridiculously expensive," with doctors making $100-200 per hour. While a suggestion was made to use nurse practitioners under doctor supervision, Burroughs said that would be "a step back in ER management."

"We are talking about a significant figure," Shaw added. "I would like to look at a way to generate revenue. The community doesn't appreciate that we are not doing enough to keep costs down."

But Reynolds said in the case of "true emergencies," many providers will pay in-network.

The board discussed potential renovations to patient waiting areas and the Senior Care building, as well as equipment requests submitted by departmental directors. Those requests included (but were not limited to) immediate needs like a new patient call system at about $90,000, a centralized monitoring system at $75,000, updates that will soon be government mandated that relate to digital record keeping at $165,000 and new EKGs (electrocardiograms) for the surgery department and Pecan Family Clinic at $40,000 and $8,000, respectively.

The board also discussed the more than $900,000 estimated annual debt service payments that will have to be made over the next 24 years.

The board's Tuesday, Aug. 13 budget workshop will combine discussions on operations, capital expenses and the proposed tax rate. The meeting will begin at 8 a.m. in the GRMC community board room.

The agenda will be posted 72 hours prior to the meeting and can be found online at glenrosemedicalcenter.com/board-authority.cfm.