Zombies pass Sierra Vista Hospital FY2027 budget

The Sierra Vista Hospital Joint Powers Commission, in accepting and passing a one-page budget for fiscal-year 2027, was so inanimate that it made me wonder if they were zombies. 

The JPC met August 20 to, among other things, pass the 2027 fiscal-year budget, which was supposed to be turned in by July 31 to the New Mexico Department of Finance and Administration.

The JPC put off its July “annual” meeting two times, JPC member Sandy Jones pointed out at the meeting, despite the state deadline.

Jim Paxon, JPC chairperson, said they put off the annual meeting so they didn’t have to hold two meetings in one quarter. Evidently Paxon was not available, even by phone, for a July meeting. 

The JPC’s own committee rules require that they meet quarterly, but they passed a schedule that blows off the October meeting, deciding to not meet again until January. 

That shows the level of interest our elected officials have in exercising fiscal oversight over the publicly-owned Sierra Vista Hospital. 

Two boards represent the people’s interests, supposedly, in overseeing the running of and fiscal health of SVH. Paxon summarized the boards’ roles. The Governing Board oversees “day-to-day operations,” he said. “We’re policy,” Paxon said, of the JPC. 

The JPC is made up of elected officials sitting on T or C’s city commission (Rolf Hechler and Ingo Hoeppner currently), Sierra County’s county commission (Jim Paxon and Sandy Jones currently) and the Village of Williamsburg’s Trustees, (Deb Stubblefield currently). Elephant Butte used to be a hospital owner but removed itself over the last year. 

The Governing Board is composed of people selected by the county’s and municipalities’ elected officials.  

I sent in five questions two days before the meeting about the one-page budget to two of the JPC members, trying to enlist them to ask questions and get answers during the public meeting, but most of the questions went unanswered. 

This is very concerning, especially in light of the impending cuts to Medicare and Medicaid coming January 2027, which are expected to hurt rural hospitals’ ability to  operate, or even stay in existence. 

The JPC, the owners’ board, seems totally unaware of the coming threat. It also appears unaware that Governor Michelle Lujan Grisham will have saved the hospital’s bacon, if the hospital does survive, by pushing through a series of laws and policies that directs funds to rural hospitals, such as Sierra Vista Hospital. Thank goodness Lujan Grisham anticipated that Trump and his sycophantic Republicans in congress would come after Medicare and Medicaid and tried to fill in funding shortfalls. But Lujan Grisham’s tenure is nearly up and her gap-funding legislation may go with her. 

In fiscal-year 2026, Lujan Grisham pushed about $12 million extra in funding to Sierra Vista Hospital, and it appears that the fiscal-year 2027 budget relies on those same sources of funding for nearly $12. But will it happen? Based on what knowledge or estimates? The JPC didn’t ask ANY questions, so it’s unknown. 

My questions and partial answers from the JPC Aug. 20 meeting:  

1. Why is the budget one page? Where are the supporting materials on which this summary is based? Where is the capital-projects part of the budget? The one-pager is only for operations, it appears. Governing Board packets do not include the 2028-2032 Infrastructure Capital Improvements Plan, and the July 30 meeting packet does not include the budget.Therefore the public is blind about operations and capital projects. Where is the draft budget, due to the Department of Finance and Administration on July 1? The final budget was due July 31 to the DFA. So the public knows nothing until the final budget, and then only gets to see a one-pager? 

(Partial explanation: Paxon wrongly stated that both the Governing Board and JPC approve the budget–only the JPC does, as stated in its policies and procedures, ironically approved minutes before by the JPC as part of its “annual” meeting. See screen capture of the JPC’s policy section on “duties.”

Paxon went on to say that the JPC is “only supposed to look over the budget to see if it is out of wack. We’re policy, not operations. This looks reasonable to me, realizing it is a summary.” 

The budget is essentially a reflection of hospital policy, defined by Google AI as, “ A policy is an official plan, set of rules, or guiding principle adopted by a group, business, or government to decide how to handle situations and make choices.”)

2. Governing Board financial reports state that in FY2026 the 2024 Healthcare Delivery and Access Act, the 2024 Senate Bill 161, the “20 smallest rural hospitals” and “Rural Healthcare Delivery Fund” gave the hospital almost $12 million. The FY2027 budget says “other revenue” is expected to be over $11 million. Please give the breakdown of this other revenue, including amounts expected from these four funding sources. Please state what these monies can be spent on. 

3. The JPC Aug. 20 packet includes Gross Receipts Tax revenue for fiscal years 2018 through 2026, which goes to the New Mexico Finance Authority in a “direct payment,” the document states. I’m assuming this is for the newish hospital-wing loan, which yearly payment is $1.47 million. The debt is more than the $1.34 million collected in FY2026 GRT revenue. What money source paid the difference? The county charges taxpayers a 2.0 mill levy for the hospital. What was the revenue collected from the levy for the same years, FY2018 through FY2026? And is the mill levy revenue to be used only for hospital operations? Or has it gone to help pay the hospital debt? And what is the life of that debt? 

4. Elephant Butte has not been paying its GRT portion to the hospital regularly. Other months are missing, but the biggest gap is between May 2023 through Dec. 2026. What is the JPC doing about these past tax monies due?

(Paxon said the JPC and City of Elephant Butte came to an “amicable” agreement. If I heard correctly, and the audio was terrible, a contingency of Elephant Butte leaving the JPC was to pay $5,000 a month in GRT revenue. Paxon didn’t say for how long, but I assume Elephant Butte obligated itself to pay its share of GRT revenue to the hospital to pay off the debt for the newish hospital wing. That debt runs through 2046. The GRT report in the JPC Aug. 20 packet shows that Elephant Butte started paying GRT again in January, but payments vary and are under $5,000. Nothing was said about the monies due for the two and half years the city didn’t pay any GRT.)

5. What percentage of the hospital’s revenue is from Medicare? from Medicaid? Does the FY2027 budget include estimates for less Medicare and Medicaid income due to the Big Beautiful Bill? Please give FY 2026 Medicare and Medicaid percentages of revenue and actual figures. Please give FY2027 Medicare and Medicaid estimated percentages of hospital revenue and actual estimated figures.

Below, please find the JPC’s policy stating its duties, followed by a link to the one-page budget for FY2027: