More than a year ago, the COVID-19 pandemic struck Northwest Missouri and the community had to react quickly. The task required not only manpower, but also heaps of cash.
Hospitals were forced to buy personal protective equipment, ventilators, supplies for testing and vaccines and also increase staffing.
Joey Austin, a spokeswoman for Mosaic Life Care, said construction that included an immediate build needed for respiratory clinics, COVID-19 overflow in the ambulance bay for COVID-19 patient capacity and adding negative pressure at the medical center was the biggest expense for the St. Joseph-based health system. At the height of the pandemic, Mosaic had more than two floors full of COVID-19 patients at its flagship location.
Austin said the hospital was well-positioned to handle the immediate financial needs of the pandemic. However, adjustments were made to ensure the hospital kept a strong financial foundation.
Losing money from elective procedures
Officials at Cameron Regional Medical Center saw millions of dollars in new expenses related to the COVID-19 pandemic and struggled when elective surgeries were cut. The hospital was able to qualify for around $4.5 million of Payment Protection Program loans as well as additional grants that totaled $11 million.
Joseph Abrutz Jr., Cameron Regional Medical Center administrator, said in April 2020 revenue was down at his facility by $7 million, and that trend continued into May and June before rising again in July. But the financial impact was still present.
“The first thing that we did in April (2020), we applied for the small business protection program and we qualified for that being a small business employer under the 500-employee threshold,” Abrutz said.
Abrutz said $4.5 million received from the payment protection program in the summer of 2020 was essential to helping the hospital stay financially sound. But now he is prepared to have to give up to $6 million back from a total of more than $11 million in grants received after he was informed that some federal funding would need to be repaid. He said the hospital still has money in reserves.
“Thank God the federal government and the presidential administration last year really thought that a priority was making sure hospitals received sufficient grants,” Abrutz said.
Abrutz said the money was definitely needed. While revenue was down, the hospital spent an additional $1.8 million in just one quarter on COVID-19-specific products.
At Mosaic Life Care, the decline in elective procedures left the hospital in a tough spot. In May 2020, News-Press NOW reported Mosaic was operating at half its usual capacity even though there was only one COVID-19 patient in the hospital. Elective procedures at that time were nonexistent.
That month, Mosaic had to cut jobs due to financial pressures. At the time, Austin said officials were not disclosing the total number of staff cuts but added there were positions available for some employees to be rehired immediately into other jobs. Along with the cuts, Mosaic implemented hiring freezes and executives took pay cuts to help the bottom line.
Mosaic Chief Medical Officer Dr. Davin Turner has described “elective” surgeries as more of quality-of-life procedures and not necessarily just cosmetic operations. He said those surgeries going away for a period of time not only put a financial strain on the hospital but also hurt the quality of life for some and created lingering problems for those who stopped receiving necessary care.
Times were tight at Mosaic as hospitalizations for COVID-19 neared 100 and staffing became an issue. During that time, Turner spoke candidly about how the hospital was struggling. He advocated continuing to do elective surgeries when COVID-19 cases were continuing to rise, as he said the procedures were essential and Mosaic could do them safely. As at the Cameron Medical Center, such procedures are a key source of income for Mosaic.
Abrutz said Cameron Regional Medical Center did not have to lay off nurses thanks to the PPP loans, which Mosaic as a bigger entity did not qualify for.
Former Missouri Department of Health and Senior Services Director Dr. Randall Williams, who recently left that post, said he believes there is an opportunity for hospitals to receive more funding. He said the state has been grateful for how hospitals have stepped up during vaccination efforts and in all COVID-related situations.
“We will be working with our hospital partners and our physician partners and our health department partners to look at helping resource them, especially since they were so great about stepping up when we needed them to,” Williams said prior to his departure from his job with the state.
Local government distributes
Outside the hospital, budgeting was happening at the county level as well. Early in the pandemic, Buchanan County commissioners received more than $10 million in federal CARES Act money and had to delegate funding around the area.
Commissioners started giving small businesses $5,000 grants and then took out a big chunk of $2.4 million for use by the St. Joseph School District. County officials also provided money to Mosaic for COVID antibody testing and later for the vaccination clinic at East Hills Shopping Center.
CARES Act top expenditures outside the school district included $1.5 million to Motorola for an emergency radio system and hospital radio systems, $493,725 to the Buchanan County Jail for quarantine cells for COVID-19, $401,472 for the Mid-Buchanan School District for COVID-19 mitigation, 369,830 to Buchanan County School District R-IV for COVID-19 mitigation, $267,450 to Missouri Western State University athletic testing, $264,455 to Mosaic for antibody testing and $250,000 to Triumph Foods for COVID-19 mitigation for employees.
Presiding Commissioner Lee Sawyer said officials had to distribute the money quickly as it was designed to be a stimulus and it wasn’t meant to stay in the county’s pocket.
“In the end, what we really had decided and talked about is how can we affect the most number of people in Buchanan County,” he said.
One of the recipients of CARES Act dollars was the St. Joseph Health Department as the demand for contact tracers became an issue. The money was used to pay the salaries of five additional contact tracers so the health department could meet the demand.
Debra Bradley, St. Joseph’s health director, said the summer and fall of 2020 required an all-hands-on-deck approach, and people were moved from different places to assist with COVID-19 tasks and handle contact tracing. The department also bought an additional refrigerator for vaccines as well as spent money on PPE.
“There were a lot of upfront costs that we didn’t anticipate ... with the combination of no revenue coming in, because even the contracts that we have, we didn’t do as much towards the contracts,” Bradley said. “When you have a person who is supposed to be doing health education to bill to a contract but they’re doing contact tracing, you can’t bill the contract because they’re not doing that job. So it’s kind of a double-edged sword that we had going on.”
Bradley said money from the CARES Act was crucial for the department and recovery is slow, but city health staff are getting back to giving a variety of immunizations, issuing death certificates, doing STD testing and providing other services that were all paused due to the pandemic.
“We want to make it through it and I feel like the CARES Act kind of gave people some hope. That (funding) was one thing I didn’t have to worry about for a while,” Bradley said.
Longtime impact from the pandemic
While a financial impact was felt by many, there is a lot gained knowledge that came from going through a pandemic, officials said.
Abrutz said staff at his medical center have learned a lot in the last year, and he is proud of how the hospital provided testing and vaccinations for more than 18 counties in Northwest Missouri. Cameron had a tent that served as a testing location for COVID-19 at the beginning of the pandemic.
While the hospital has gotten through the pandemic, Abrutz said there needs to be a change in the third-party payer system for people who cannot afford health care.
“For every bill we send out on Medicare, we receive 10 cents on the dollar ... and then there’s patients that don’t have any third-party payer program to help them,” he said. “We’re fortunate if one out of 10 people can pay their bill in full on the self-pay.”
Bradley said the health department had plans for a disaster set in place after emergency management meetings in 2001. When the COVID-19 pandemic hit, she said some of those plans held strong, but others had to be adjusted.
“This was too big for one entity, and we all know that everyone stepped up and did their part,” Bradley said. “It was a great partnership, we knew we could always call on Mosaic, or Northwest (Health Services) or anybody in the community if we needed anything.”
Bradley said she is proud overall of how the pandemic was handled by the community and said that agencies like hers now are more ready for another crisis.
“I believe we are better prepared, I believe we’ve learned a lot through this process ... we did have plans,” Bradley said. “We used to have meetings on these emergency preparedness plans weekly, then we had them monthly and then they just kind of faded away.”
A program involving the city’s homeless population is offering benefits on two fronts.
The day labor program employs homeless individuals to fix up and beautify the parks around St. Joseph. While it has the obvious benefit of making city property look better, the program also has had success at getting individuals back to earning a living.
Community Action Partnership of Greater St. Joseph’s Rachael Bittiker oversees the program. She’s the public affairs and community development director at the agency.
“Unfortunately, a lot of individuals don’t see the full picture unless you’re working daily with this population,” Bittiker said. “You have good people, you have bad people in every group of society, regardless if you’re homeless or not homeless.”
The original day labor program had a 50% success rate at getting people involved with the program employed. The newly revamped program is set to be funded for at least a year and pay participants minimum wage.
A small yellow bus with “CAP Early Head Start” written on the side arrived on Tuesday morning at Krug Park with about 15 program participants on board.
For some in the day labor program, the park holds family memories.
“It was about a month and a half ago, down there on that stage, I got his pictures taken,” program participant Tasha Aunspaugh said. “That’s the first time in a decade that I got to do that with my son, and it was wonderful.”
Aunspaugh and her husband have been staying at a homeless shelter for three weeks, and they hope to be able to leave soon, which is why they signed up for the day labor program.
Aunspaugh said they both have struggled with drug addiction in the past but added they have been clean for about two years.
“I want to have my son up here (at Krug Park) for Christmas, and I want him to know that I love him,” Aunspaugh said. “We’re going to better our lives and never go backwards.”
Aunspaugh and Misti Plott were picking up trash and using a leaf blower to clean up the sidewalks, while others were using weed cutters and clipping branches.
Plott said she’s been living on the streets for six years and has struggled with alcoholism for 23 years.
“I’m gonna stand here and tell you that I’m an alcoholic, but I’m also going to tell you that it’s been a couple of years where I’ve been doing really good,” Plott said.
Similar to Aunspaugh, Plott has fond memories of her boys at Krug Park. So much so that she said the memories are painful because she hasn’t seen her kids in a while.
She believes her youngest is set to graduate from high school this year, and she hopes to check on him.
“I just want to see him and know that he is OK,” she said.
Plott has a goal to “enter back into society” and hopefully get a place of her own. She’s thankful for CAP and the day labor program for helping her work towards that goal.
“I’m a work in progress,” Plott said.
Jason Winger makes DoorDash deliveries six days a week, but rising gas prices threaten to eat into his profits.
“It’s an extra $5 or $10 a day depending on how far you have to drive,” he said while pulling out of the Chipotle parking lot. “It keeps going up.”
At least the fuel is there when he needs it. Some are now hinting at gasoline shortages this summer as Americans hit the road after a year of lockdowns and travel restrictions.
The problem isn’t the availability of fuel but a potential lack of tanker-truck drivers for the last mile of delivery to service stations.
“As demand is starting to pick up for gasoline and travel in general, there is a chance there would be a driver shortage,” said Nick Chabarria, a spokesman at AAA’s St. Louis regional headquarters. “There’s no information right now on any specific areas that would be impacted.”
Chabarria doesn’t expect a return to 1970s-style gas lines. The United States has plenty of fuel in storage, with gasoline stocks earlier this year exceeding levels from two years ago, before the pandemic. The Energy Information Administration reports a 51% increase in gasoline demand from last year, although the agency believes it will take several years for total energy consumptions to return to 2019 levels.
All that should spell bountiful supplies and stable prices, but instead, isolated shortages were reported last month in northern Arkansas and Florida. In its latest forecast, AAA warned of possible shortages, especially in heavy tourist areas near beaches or mountain resorts.
Chabarria said it’s important to remember that any shortages would be short-lived and isolated.
“One thing to remember is it would be a logistics issue,” he said. “It wouldn’t necessarily be a gasoline supply issue. Some local stations are trying to better schedule their deliveries so they can keep up with supply.”
Ron Bachman, president of St. Joe Petroleum, said driver shortages are nothing new in the fuel industry. His company operates the Fastgas convenience stores and supplies petroleum to several Conoco and BP-branded stations.
“The Midwest has always had fuel,” he said. “ I suspect we will have fuel throughout the summer. I have no reason to believe they wouldn’t.”
Bachman believes the coastal areas would be more at risk of shortages because of higher volume.
Even if supplies are plentiful, prices are another matter. Last year’s record-low gas prices could be viewed as a hollow victory for motorists who had nowhere to go. Now, AAA is forecasting even higher fuel prices heading into Memorial Day. This past week, drivers in St. Joseph already were paying $2.69 a gallon for regular unleaded gasoline, compared to $1.50 last year at this time.
Some might point a finger at the Biden administration, which canceled the Keystone XL crude pipeline and advanced other green energy initiatives. But those steps, while controversial, would have more of a long-term consequence on prices, said Dr. Kara Grant, associate professor of economics at Missouri Western State University.
The current situation, she said, has more to do with drivers hitting the road just as OPEC and non-OPEC producers like Russia cut back on production to boost worldwide prices.
As prices continue to rise, the question heading into the summer of 2021 is how motorists will react if they get a hint of a gasoline shortage. If you think about what happened with toilet paper last year, it’s not a pleasant thought.
“It depends on how dramatic it is,” Grant said. “If they say, ‘It’s just a temporary shortage,’ then they may not change their behavior at all. If it’s dramatic, then prices are going to skyrocket. The problem is when everyone demands more of it, the prices rise.”