CHEYENNE — With less than three months left to spend the state’s share of federal coronavirus relief money, the president of the Wyoming Hospital Association told lawmakers Tuesday that the process for hospitals statewide to get funding has been “cumbersome” and “taken way too long.”
Through the federal CARES Act, passed in late March, Wyoming received $1.25 billion for use on expenses related to the COVID-19 pandemic. During its special session in May, the state Legislature then set up a loan program for cities, counties, hospitals and other entities to apply for loans from that pot of money.
But WHA President Eric Boley said Tuesday the state has “missed some great opportunities” to improve its health care facilities due to an application process run through the State Loan and Investment Board, which includes all five statewide elected officials.
“I don’t know if we’re going to see any relief from the deadline, but the Dec. 31 deadline created a situation where I think a lot of money is going to be returned to the feds that really could have been put to use here in our state,” Boley told members of the Legislature’s Joint Labor, Health and Social Services Interim Committee. “Our health-care facilities are aging, and our ability to treat these patients could have been enhanced and built.”
As of Sept. 30, roughly $67 million of Wyoming’s stimulus money had been allocated to boost its health-care facilities, out of a total of $105 million earmarked for them, according to the governor’s spending dashboard.
However, those figures reflect allocations, rather than money that has actually been spent. Guidance from the U.S. Department of the Treasury prohibits spending to backfill budget shortfalls, and all funds can only cover costs incurred by the end of this year.
“I think we’ve taken maybe an overly cautious approach to expanding those funds, and I think it may come back to bite us in the future,” Boley said.
Many hospitals across the state, which have been forced to change their procedures amid the pandemic, saw their revenues drop by more than 50%, Boley said, and several facilities accepted direct CARES Act distributions in the pandemic’s initial months. But rule changes from the federal Department of Health and Human Services have complicated the use of those funds.
“What we thought was money that was supposed to be used to help offset lost revenue and to make sure that hospitals and nursing homes stay viable, we now are under threat of having to return that money,” said Boley, adding hospital revenues have yet to return to pre-COVID levels.
Discussion of CARES Act funding has often included the possibility of additional federal relief being passed that loosens the rules on CARES Act spending. But after President Donald Trump told his team Tuesday to end stimulus talks with Democrats in Congress, that possibility appears to be dwindling.
In other action during Tuesday’s meeting:
Boley’s testimony came after lawmakers spent part of their meeting discussing what laws could be changed to better prepare Wyoming for the next pandemic.
The answer, at least in terms of statutory changes, was not a lot. Instead, health officials said a bigger issue has been conveying detailed information to the public.
“It’s been difficult to communicate effectively all of the nuance and detail to a wide audience, not only the contents of the public health orders, which are often changing on a two-week basis,” Department of Health Deputy Director Stefan Johansson told the committee. “It’s just difficult with something as novel and unknown as this has been to really communicate effectively on those contents.”
Kevin Bohnenblust, executive director of the Wyoming Board of Medicine, said a few proposals may be brought to improve the state’s licensing process, but he largely echoed Johansson’s sentiment.
“By and large, the board’s been very creative and very responsive, very agile in this process,” Bohnenblust said.
Bohnenblust was also asked by Sen. Anthony Bouchard, R-Cheyenne, about the board’s position on hydroxycholoroquine, an anti-malaria medicine that the president has repeatedly promoted as a treatment for COVID-19.
“What the board did was it took the position (that) we’re not going to prohibit the prescribing of hydroxychloroquine, but if you prescribe it, it needs to be appropriately done,” said Bohnenblust.
After initially granting emergency use of the drug for COVID-19 patients, the Food and Drug Administration eventually revoked its approval, warning that hydroxychloroquine can cause dangerous heart abnormalities in some people. Previously, the drug had mainly been used to treat patients with lupus and rheumatoid arthritis.
Though continuing to evaluate use of the drug on a “case-by-case basis,” Bohnenblust said the board has only gotten a handful of complaints about inappropriate uses of hydroxychloroquine since the pandemic began.
“It was all related to physicians prescribing it for themselves or their family when they were not symptomatic and didn’t have the disease, weren’t hospitalized,” Bohnenblust said. “The pharmacies were saying, ‘We’re not going to fill that, because that’s not an appropriate use,’ but no one’s been disciplined. There’s not been any kind of action taken.
“The board simply said, ‘Do this wisely. Don’t do inappropriate prescribing.’”
Tom Coulter is the Wyoming Tribune Eagle’s state government reporter. He can be reached at firstname.lastname@example.org or 307-633-3124. Follow him on Twitter at @tomcoulter_.