First, an important fact: our hospital tax levy has remained unchanged at $2.10 per $1,000 of assessed valuation for the past 12 years. During that time, our Board of Trustees carefully reviewed the levy every single year. Our administration conducts detailed financial forecasting, and the board takes a hard, responsible look at our needs before making any decisions. We do not automatically take the maximum levy allowed, and we never have. This year the maximum levy the hospital could take is $3.00 per $1,000 of assessed valuation.

Over the past few years, the hospital has received Directed Payment Program (DPP) funds and as an organization we have been intentional and prudent with these dollars, setting them aside to help offset long overdue master facility planning projects. These include critical areas such as our ambulance garage, our Emergency Department, and the specialty clinic space within our primary care clinic. The DPP funds are going to drastically reduce or eliminate in the next few years.

As healthcare services evolve, our physical spaces must evolve as well. Remodeling is not about expansion for expansion’s sake — it is about ensuring our facilities match the services we provide and meet the needs of all the patients we serve throughout Hamilton County and surrounding communities.

Our tax levy also plays a crucial role in supporting essential services that are not reimbursed at cost.

Ambulance services are a prime example. We operate three fully equipped ambulances, staffed by highly trained EMS professionals who respond day and night to emergencies across Hamilton County and surrounding areas. When seconds matter, these ambulances become mobile emergency rooms — delivering immediate, skilled medical care that stabilizes patients before they reach the hospital. Whether responding to heart attacks, strokes, trauma, respiratory distress, farm injuries, or accidents on the highway, our EMS teams save lives every single week. Yet, despite the essential nature of this service, ambulance operations are not reimbursed at cost by insurance or government payers. The tax levy helps ensure that all three ambulances remain staffed, supplied, and ready to respond at a moment’s notice when a call for help comes in.

In addition, the levy helps offset the high cost of employee benefits of IPERS (Iowa Public Employees’ Retirement System) and insurance, which we provide to all employees and providers. It also helps cover employer’s FICA contributions. Even in these areas, we do not take the highest levy allowed. We remain disciplined and conservative because we recognize these are taxpayer dollars.

IPERS is not just a benefit — it is one of the most powerful tools we have to retain qualified, dedicated employees in Hamilton County. The hospital has a mandatory contribution of 9.44%.

As a county-owned, not-for-profit hospital, every dollar we receive is reinvested directly back into our organization — into our people, our equipment, and our facilities. We do not generate profits for shareholders; instead, we reinvest resources to maintain fair and competitive wages, provide bonuses when financially possible, and ensure we recruit and retain the skilled staff needed to care for our community.

Because our building is now 16 years old, much of our infrastructure requires significant attention — from heating and cooling systems to plumbing, electrical components, and core structural updates. Additionally, major equipment such as our MRI, mammography unit, CT scanner, and critical IT systems are reaching the end of their life cycles and will require replacement to maintain quality care and regulatory compliance. Two years ago, our master facility planning estimated over $40 million in needed updates and replacements, a number that has only grown with inflation and rising construction costs.

To maintain a strong local hospital and a responsive ambulance service, the average household contributes approximately $80 to $110 per year. That investment ensures lifesaving care close to home — care that would be far more costly, and potentially unavailable, without local support. In addition, you can see (in the pie graph); the hospital only receives 5.1% (the shaded triangle) of the entire tax authority. Only asking for 5.1% to run emergency care for our community and maintain a viable thriving hospital is a small ask.

Medicare reimburses the hospital at approximately 99% of cost, creating a negative margin for that population. Yet caring for every citizen — regardless of ability to pay — is part of our mission as a community hospital. However, healthcare is volatile. It is not like a private commercial business. Costs rise, reimbursement changes, and patient needs shift rapidly. The hospital tax levy provides stability in an otherwise uncertain environment.

Over the years, we have worked tirelessly to build a culture of kindness within Hamilton County Public Hospital d.b.a. Van Diest Medical Center — kindness toward one another as colleagues and kindness toward the patients and families we are honored to serve. Our employees consistently show up with dedication, compassion, and a deep sense of purpose. Many of them have built their careers here. They are vested — not only in IPERS, but in the communities we serve, in their relationships with patients, and in the future of local healthcare. Their commitment is the backbone of our organization.

For their sake, and for the sake of every resident who relies on us in moments of need, it is essential that our hospital remains strong and viable for many years to come. The work we do today ensures that future generations will continue to have access to the care they deserve, close to home.

I understand there is currently a petition circulating asking residents to protest the hospital tax levy. I respect the rights of citizens to ask questions and express concerns. In fact, I encourage it. We welcome open respective dialogue and community involvement. The finances of healthcare are complex, and transparency helps build trust.

There will be a public hearing prior to our Board of Trustees meeting on March 24 at 6 p.m. in the clinic boardroom. I strongly encourage citizens to attend and share their perspectives. Community support for Hamilton County Public Hospital helps ensure we can continue providing emergency care, ambulance services, inpatient and outpatient care, primary care, specialty clinics, laboratory services, radiology, rehabilitation, and many other essential healthcare services to everyone across Hamilton County and surrounding areas. Your voice matters, and we value hearing from you.

If you would like to meet with me, I am including my contact information below. I am happy to have a meeting with you. Please reach out.

Our goal is simple: to care for our employees and to care for all people in Hamilton County — responsibly, transparently, and with integrity. To achieve that goal, local tax support remains essential.

Lisa Ridge

Chief Executive Officer

Van Diest Medical Center —

Hamilton County Hospital

515-832-7700

lridge@vandiestmc.org