As tough economic times continue to besiege the state of Georgia and the nation, Georgia Gov. Sonny Perdue recently proposed legislation that would levy a fee based on a percentage of revenues generated by hospitals to offset state services budget shortfalls.

In this case, the fees proposed to be levied would go to cover a $208 million deficit faced by Medicaid and to improve trauma care in the state.

It is believed this proposal could prevent major cutbacks in Medicaid and Peach Care services and improve on trauma care throughout the state. It is estimated that nearly 700 people a year die because of spotty trauma care.

Although the proposal is still pending and under review, Medicaid cutbacks have already been recognized locally at Upson Regional Medical Center.

In 2009, the hospital is faced with a five percent reduction in Medicaid revenue that equates to a loss of nearly $300,000 without a reduction in the Medicaid patient load.

However, the hospital has prepared for this cutback by budgeting $500,000 in projected losses for the Medicaid services. If Perdue’s proposal is passed, the Medicaid losses could far exceed $500,000, said Upson Regional CEO David Castleberry.

How can the hospital overcome the burden of these projected losses?

“We’ve got to manage efficiently and we’ve got to take advantage of our group purchasing opportunities and save on supplies and capital equipment, mainly supplies since that is an operating expense,” said Castleberry on Wednesday. “We are part of a large purchasing consortium that is able to get some discounts on supplies and we have to maximize that the best we can.”

Castleberry noted that spending wisely and staffing appropriately, without compromising any patient care of any kind, are key.

“We just have to be mindful of our dollars. I’m not sure we can make up that kind of hit. That is a chunk of money.”

When asked if he anticipated any staff reductions in 2009 because of the projections, Castleberry didn’t hesitate in his answer.

“No. We don’t look to do that. Our goal is to staff efficiently and wisely and manage the staff we have to get through this without having to cut any staff.” he answered emphatically.

The heartburn over spotty trauma care is something Castleberry believes is well under control at the hospital. He pointed out that all trauma care begins in the field and he is extremely confident in the hospital’s award-winning EMS team under the direction of Richard Lee.

In fact, hospital statistics indicate the URMC EMS team has response times to calls that are at least two minutes better than the national average of nine minutes. This minutes are calculated from the time the call is received until the unit arrives on-scene.

“Our EMS team have won some state awards and their response times are second to none,” explained Castleberry. “They have a great response rate. They are at least two minutes under the state and national average. Two minutes means a lifetime to someone who is pinned in an automobile or in need of immediate medical attention.”

Castleberry, raised in Alpharetta and a graduate of Georgia State University and Brenau University in Gainesville, arrived in Thomaston on October 6, 2008, said he and his family are having a good time and really enjoy being here. Now that the “honeymoon” is over, Castleberry is looking forward to 2009.

“We’re in good shape as it stands now,” he said. “We go into 2009 solid and in good shape on our financials. We had a good year in 2008. The hospital has a long history of making good operational, strategic and financial decisions that have put us in the position we’re in now, which is a sound financial position.

“With the economy and things like they are, we’ve got to pay even closer attention to all our numbers to make sure we are diligent in spending wisely and staffing wisely.

“Every dollar we spend, we have to make sure it is the wisest way to spend that money.”

No one really knows what 2009 will bring but at URMC, one thing is certain.

David Castleberry and his hospital are prepared. Win, lose or draw.