Christus St. Vincent Regional Medical Center couldn't afford to co-sponsor the Mayor's Ball, which benefits a local charity, two weeks ago.

And if things don't improve for the hospital, it might have to stop providing free dental care to Santa Fe's needy children.

And there might be "serious layoffs."

That's what Christus CEO Alex Valdez told Santa Fe County commissioners at an Oct. 25 meeting of the County Indigent Hospital and Healthcare Board.

Valdez was trying to convince the county to give the hospital more money for its supplemental Medicaid funding. Christus has widely decried as inadequate the $2 million the county contributed earlier this year for base indigent care funding.

"The impact is not only on the hospital, not only on the services we provide, but to tell the mayor 'No' was a new day for me," Valdez said.

Christus has been crying poor since the county voted earlier this year to allocate funding based on indigent health care claims, resulting in a dramatic decrease in contributions compared to previous years. On top of that, the federal government is withholding $7.3 million in Medicaid money from Christus because of draft audit findings released this spring. That audit questioned whether $23 million Christus received in fiscal year 2009 was obtained improperly [news, April 6: "Wheel of Wrongdoing?"].

Valdez cited this delay and the county's reduced contribution as key factors in the hospital's alleged penury.
"Now is the time for community leaders to shake ourselves, come around the table and say, 'What is the new day we're going to create?'" Valdez told the group.

Both County Commission Chairwoman Virginia Vigil and Commissioner Liz Stefanics balked at the notions that Christus is desperate for cash and that the county has been stingy.

"There's been a new day many times with this," Vigil said, referencing the phrase Valdez used repeatedly.

"My concern is the messages that are given that the county needs to step up to the plate," Vigil said. "The county has stepped up to the plate. We have given millions and millions of dollars…I want to make sure that message gets out there because I never hear it."

Christus didn't return a call for comment before press time.

In her comments, Stefanics referred to Christus' most recently released financial statement, which shows $21 million in revenue in FY 2009 and a $3.2 million "surplus" in Medicare money. Valdez' pay was $615,000.

"When I hear the hospital say they have money issues, I also look at the cash assets on the 990s," Stefanics said. "It kind of makes me not think the hospital is going down the tubes."

Valdez laughed.

The board voted at the meeting to authorize just a $165,000 supplemental Medicaid money contribution—money Christus won't receive right away anyway because of the audit. In total, Christus will receive approximately three times that much once it's matched with federal dollars.

"It's certainly nothing like what they want," Health Policy and Planning Commission Chairwoman Judy Williams says. "They want $5.6 million…but we have to balance various needs in the community."

In the past, commissioners have taken issue with the hospital's refusal to divulge details of its Medicaid spending. Christus won't allow a commissioner to sit in on any budget discussions. It also dragged its feet in filing the tax document that revealed its high past revenues [news, April 13: "Information, Please"].

"The county wants to know what they did with all the [Medicaid] funds they used to get," Williams says.

It doesn't help Christus' cause that it announced plans this spring to buy the private Physicians Medical Center—an estimated $9 million deal. Valdez told SFR at the time that the new site would alleviate patient crowding, but the center is a specialty surgery center primarily for elective procedures.

"I mean, where is the money for that coming from?" County Commissioner Kathy Holian says, referring to Christus' expansion.

The commission is looking into using a mill levy in the future to fund the hospital—not only to save county money, but also to take the public temperature on Christus' demands.

"It would interesting to see how the voters respond," Vigil said.