Director of Nursing Renee Myers opens the door to the linen supply room, nearly empty due to lack of funding at Claiborne County Hospital. (The Vicksburg Post/MELANIE DUNCAN)

[07/03/01] PORT GIBSON Almost every day, Wanda Fleming hears that her job is unnecessary.

People tell Fleming, administrator of Claiborne County Hospital since 1990, that she runs a ramshackle bandaging station, she said. It’s a place, the small hospital’s critics say, where poor people can go to get free care for coughs and scratches that a for-profit doctor wouldn’t charge much for anyway.

Fleming and Renee Myers, CCH’s director of nursing, smile when they discuss the sources of derision. Myers even thinks some of them might have a point.

But neither believes the hospital’s faults justify closing its doors, a possibility that appears more realistic every day, Fleming said, barely halfway through Claiborne County’s fiscal year. The hospital, a non-profit operation since being established in 1951, has no money in the bank with a $64,000 payroll to meet on Friday. County and hospital officials met for two hours behind closed doors Monday night to search for more funding.

“We could close tomorrow,” Fleming said early Monday afternoon. “For all we know, it could be later today.”

If Fleming’s fear is realized, Claiborne County’s 11,600 residents will lose a safeguard between serious accidents and illnesses and the better-equipped hospitals of Jackson and Vicksburg, both of which are about 30 miles away.

After their evening discussion Monday, county and hospital officials both said CCH won’t stop serving patients.

“The hospital has never closed, and it will not close now,” said Albert Butler, president of the Claiborne County Board of Supervisors.

“We can absolutely guarantee that (CCH) will stay open,” said Linda Smith, chairman of the hospital’s Board of Trustees.

Both Butler and Smith said they were trying to create a “strategic plan” to sustain CCH, but neither would elaborate.

Like other rural hospitals in the United States, CCH has had to navigate narrow financial straits since former President Clinton and Congress worked out the Balanced Budget Act of 1997. As a part of its attempt to cut federal health-care expenses, the legislation has removed about $200,000 a year for five years from CCH’s normal appropriation.

Fleming said she has heard horror stories from other rural health care managers about the human toll of hospital belt-tightening.

“Balancing the budget was a good thing, but they shouldn’t have done it on the backs of poor people,” she said. “We at this hospital are the ones who are paying for the balanced budget.”

But other factors complicate Claiborne County’s version of the dark side of fiscal discipline CCH is having to make up a Medicare overpayment of almost $200,000 that it received in 1999, and the hospital’s lack of OB/GYN facilities disqualified it last year from a Medicaid program that previously provided $300,000 annually.

Also, the Hill-Burton Act requires CCH to give free care to the poor to repay a loan it received from the federal program in the 1970s. The hospital owes about $300,000 in additional treatment, Fleming said.

All the extra costs have made it hard for Fleming to come up with the $4 million a year that it takes to keep CCH’s doors open. And even though the millions in taxes paid to the county annually since the $3 billion Grand Gulf Nuclear Station opened has made Claiborne County government among the state’s wealthiest per resident served, that hasn’t translated to dollars the hospital needs.

The hospital’s linen closet is nearly empty, and nurses paid for sheets at Dollar General last week out of their own pockets, Fleming said. Cable TV had been shut off to CCH before that.

“I’m not going to lie,” Myers said. “We’re desperate.”

It is a small hospital, Myers said, but it is important. She’s seen lifeless trauma victims revived. Some may have later died after being transferred to bigger hospitals, Myers said, but that hasn’t diminished her faith in CCH. They’re at least good for a fighting chance at life, she said.

“We only stabilize people here, but that can make all the difference in the world,” Myers said.

Doris Nash, a CCH employee since 1973, thinks county and state officials also value the function of small rural hospitals. That’s why she isn’t looking for another job.

“They’ll never be able to shut us down,” Nash said. “I don’t believe they can. It’s just too important.”