Loebsack hears concerns

Jan. 22--OSKALOOSA -- Congressman Dave Loebasck made his first visit to Mahaska County this year on Jan. 12.

Loebsack visited Mahaska Health Partnership (MHP) to visit with hospital staff and to hear their concerns, ranging from health insurance and medicaid to orphan drug legislation, veterans' care and behavioral health .

There are many issues, MHP interim CEO Chris Jepsen said.

"Probably our most pressing issue is IV fluids and medication shortages," she said. "I'm wondering if there is an opportunity to get into emergency stock situations because we are in such a crisis."

From a clinical standpoint, Jepsen said, the hospital is almost at the point where they would have to cancel elective surgeries in some cases.

MHP Chief Financial Officer Jason Feucht said the devastation that occurred when Hurricane Maria hit Puerto Rico affected manufacturers of saline solution and impacted the ability to acquire the product.

"It's salt water, basically, and everyone's having issues getting that," he said, and explained there are stockpiles of saline solution that is held in reserve for disaster recovery. "And that stuff ages and they have to throw it away. We just want to make sure if maybe a month before they throw it away, maybe they could look at it and they could disburse it to some of the hospitals."

It impacts patient care, Feucht said.

"It also impacts us financially," he said, "because there are surgeries we may have to call off because we don't have the saline solution to do them."

It is a national concern, said MHP staff members.

Loebsack said it was the first time he has heard of the issue.

"And I am not aware of any attempts to try to deal with the issue but we will do everything we can, obviously," he said. "Nothing has come across my desk yet to try to deal with this issue."

Feucht said the hospital acquires saline solution via suppliers who distribute solution based on the average used over past months. As more constraints are placed on that, the average amount continues to decrease.

"They're manufacturing only so much stuff and then they're disbursing out, so you can only get so much," he said. "There's a significantly finite amount that you can get."

Loebsack also asked MHP staff what their experience has been with Medicaid privatization.

MHP Compliance Officer Stephanie Faulkes said it has been a huge administrative burden.

"Understanding the rules, how to we do it, enrollment, co-providers along with our groups, reimbursement," she said.

Those groups, managed care organizations are not standardized and have different approaches toward billing.

Executive Director of Clinics Andrea Hagist gave an example regarding the discrepancy between what MCOs consider emergent and non-emergent.

"If you came in feeling suicidal, your visit was considered non-emergent and they wanted that money back," she said. "You had to have actually acted on it and had a suicide attempt for that visit to be deemed emergent."

Loebsack also broached the topic of mental health concerns in the community.

"This is kind of personal for me too because when I was growing up in Sioux City, my mom was a single parent with four kids and she had an 11th grade education, and she struggled with mental illness," he said. "And when Gov. Brandstead closed down Clarinda and Mount Pleasant, I got very upset because my mom spent a lot of time at Cherokee. I often say I saw things kids probably shouldn't see growing up. But it's really personal for me and that's why I've tried to take a concern, an interest in this as a congressman."

Hagist said mental healthcare is obviously underfunded.

"What you brought up about medicaid privatization was probably weighing most on my mind in terms of behavioral health," she said. Mahska county is probably lucky, she added, in terms of mental health resources available.

"We have two psychiatrists and we have a nurse practitioner. But we have been looking for a fourth provider for probably the better part of the year," she said. "It never feels like enough."

Herald Staff Writer Angie Holland can be reached at aholland@oskyherald.com and followed on Twitter @OskyAngie.

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