Emergency Surgery 

Could splitting responsibility for the Med and the Memphis City Schools be the answer to both funding crises?

Here's an interesting prescription, er, proposition.

Last week, the City Council voted to postpone allocating a much needed $2 million to the Regional Medical Center. Instead of the emergency infusion, some council members saw an opportunity for what could only be called an experimental treatment.

"What we've been talking about is switching the responsibility," said council member Shea Flinn. "If the city were to assume the responsibility for the Med, the county would be willing to assume the $50 million [for the city schools]."

In order to survive until July 1st — and the next fiscal year — the Med needs an additional $12 million now. Shelby County government already allocated $10 million in funding to the ailing hospital, and council member Joe Brown recently led a charge for the city to make up the difference.

"Without the Med, we all lose," Brown said. "You can't get shot and be taken to Methodist. You can't get shot and be taken to Baptist. You're going to have to go to the Trauma Center at the Med."

The Med sees 55,000 patients in its emergency room each year, many of them uninsured. It's facing $52 million in proposed TennCare cuts, as well as a need for an additional $20 million on top of that in annual operating expenses.

Shelby County mayor Joe Ford has said repeatedly that the Med's emergency room could shut down any day for lack of funds. And county commissioner Mike Ritz recently filed a federal civil rights complaint against the state, alleging that federal money for uncompensated care at the Med has been given to other hospitals across the state.

But Memphis city government is already undergoing budget triage, as the council struggles with where to find $50 million it promised Memphis City Schools (MCS) but didn't put into this year's budget. The situation is made even more critical by $57 million the state appellate court ruled the city owes MCS for last year, as well as education funding for the upcoming fiscal year.

It's enough to give anyone an anxiety attack. Or a tax increase.

With the county funding allocation, the Med has enough money to last until March or April. But of that $10 million from the county, almost $7 million of it will come from city taxpayers. Of the entire $12 million, should it be allocated, 75 percent of it will come from city residents, bringing up once again the council's sore point of double taxation.

"They're asking for $2 million," Flinn said. "We wouldn't do that, but if we look at the Med and we can lower the double tax burden in the city, we're getting closer to fair. If it gets us to single-source funding, if it keeps the Med open, that's a good thing."

Council member Bill Morrison also pointed out that emergency funding isn't treating the underlying cause of the problem.

"The governor expressly said he needed to see a viable plan for the Med. We don't have a viable plan by saying, 'Here's $2 million,'" Morrison said. "We can alleviate some of the double taxation and speak to the whole problem. It's not just a band-aid."

But is the swapping of the two entities realistic?

"It doesn't solve any short-term budget problems," Flinn said. "Even under the rosiest of scenarios, the city will still have a $30 million shortfall, and the county will still have a $20 million shortfall."

And with two rather large impediments to any such deal, the prognosis is grim.

"It's incumbent that the Med survive. It's not a deal we could make and then turn around and say, 'The Med's gone, y'all are stuck with schools,'" Flinn said. "If the Med's not going to be an ongoing concern, no deal works."

The second problem centers on the state funding formula for education.

The city is not the official local funder for the schools. The county is — a fact at the heart of the council's decision to cut education funding and the resulting litigation.

County education dollars are split based on average daily attendance. For roughly every three dollars it spends on the city schools, it has to give a dollar to the county schools.

If the county takes over any of the current city funding for MCS, that might mandate an additional contribution to the county schools, as well.

"That could make the numbers unworkable," Flinn said. "There's a lot of technical stuff we need to work out."

The council will resume its discussion of the Med's $2 million question Tuesday, February 23rd.

In the meantime, I'm wishing both the Med and the city schools a very speedy recovery, however it happens.

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