City Council Chairman Larry Magel held a press conference on July 13th at which representatives of Physicians Regional Hospital announced that they will be opening a Marco Island facility by the end of December, 2012. CEO Scott Campbell made the announcement that the 8,200 square foot facility will be located in the Shops of Marco (The “Big Publix” shopping center). But, the big remaining question is whether the citizens want a 24 hour a day, seven days a week walk-in clinic supported by taxpayer subsidy.
Mr. Campbell, flanked by Ken Warriner, Chief Financial Officer, Dr. David Childress, Medical Director of Emergency Services and Todd Gibson, Emergency Services Director, stated that a lease has been executed and that architectural plans are being developed. 3,500 square feet of the building will be devoted to a primary care walk-in clinic to be open 12 hours a day, seven days a week. He pointed out that of people taken to emergency rooms by ambulance or otherwise, “80% of all persons at emergency rooms are not admitted to the hospital.” In view of the fact that only 20% are admitted, a full time (24 hour, seven day) walk-in clinic arguably could reduce the strain on ambulance services. Dr. Childress stated that, “most patients [coming to the clinic] could be treated and released.”
Mr. Campbell stressed that Physicians Regional is anxious to serve Marco Island. However, the walk-in clinic is not intended to generate a profit and it could not be self-sustaining. Physicians Regional estimated that staff costs would be about $1.1 million plus $50,000 for other expenses. The hospital projects that it would receive about $400,000 in revenue. It would therefore require subsidy in the estimated amount of $750,000-$800,000 per year, although there is no clear data on the exact cost.
The City Council has also asked Naples Community Hospital to submit a proposal, but NCH has advised that it is not interested, although, “we would pleased to respond to a request for a proposal to provide additional services at the Marco Island campus.” The question of 24 hour service has festered on Marco Island for many years, although old data indicated that a 24 hour facility operated by NCH until about six years ago only served about two patients per night.
With reference to the walk-in clinic, Chairman Magel added that, “Frankly, we need it because we only have one ambulance,” but that the city is not able to get a second ambulance, even if the taxpayers are willing to pay for it. Under current rules the city cannot operate its own ambulance without Collier County approval. To date there is no indication that the County is willing to grant that approval.
According to Chairman Magel, even if the city received approval, the county could still call the ambulance off the island, and the county would receive the revenues received from patients transported off the island.
The clinic would provide 5,000 added hours of medical service to the citizens if they want it. The clinic is not intended to be a money maker but, they would have to pay for it with a tax supported subsidy. On this basis the City Council has approved a ballot question in a non-binding referendum asking voters:
“Shall the City levy an ad valorem tax for purposes of providing that the proceeds of the ad valorem tax shall be used solely to supplement the costs of maintaining and operating a 24 hour per day – 7 days per week freestanding walk-in clinic to be operated by an established full-service hospital system located in Collier County and selected by the City Council after due consideration.”
A Municipal Services Taxing Unit (MSTU) would be established to deal with the ad valorem tax if the voters approve the ballot question. The vote takes place on August 14. Even if approved it is unlikely that the clinic would be operational until 2014.