Health, other concerns highlight Smith talks with commissioners

McCOOK, Neb. -- Discussion between Red Willow County commissioners and the community liaison for Nebraska Congressman Adrian Smith ranged from guns to hospitals during the commissioners' weekly meeting Monday morning.
Rick L. Willis told commissioners that he staffs Congressman Smith's office in Scottsbluff and comes out to the counties in the Third Congressional District to talk to commissioners and get local input for the Congressman.
The "96-hour rule" that applies to critical access hospitals (those of 25 or fewer beds) concerns Smith, according to Willis, because it makes it hard on patients -- and subsequently on their families -- who must be moved to larger hospitals if they require a stay longer than 96 hours.
Willis said that the "physician supervision" rule, which requires that a physician be on the hospital premises for all procedures, makes it difficult for rural hospitals that struggle with adequate doctor staffing. "The Congressman is working on these two laws to provide relief for rural America," Willis said.
Commissioners Earl McNutt and Vesta Dack told Willis that their health care concerns revolve around reimbursement, Medicare and Medicaid, for services provided to residents at the county-owned nursing home. Dack said that federal reimbursement hasn't kept up with the rate of inflation or the actual cost of services provided to residents.
The proposed "checkbook rule" concerning gun ownership is another concern for Congressman Smith, Willis said, explaining that the rule means that if someone can't manage his/her own money, he/she loses the ability/right to buy or own guns. "I can't always balance my checkbook," Willis said, with a wry smile.
On the subject of "the waters of the U.S.," Willis said, "Common sense would tell us it'll go away." But, McNutt said, it hasn't. The rule is meant to make it clearer which waterways and "navigable waters" the EPA and the Corps of Engineers can oversee under the 43-year-old Clean Water Act. The rule would determine whether antipollution laws are triggered if a farmer blocks a stream to make a pond for livestock, a developer fills in part of a wetland to put up a house, or an oil pipeline has to cross a creek. The rule ensures protections for tributaries that have physical signs of flowing water, even if they don't run year round, and ditches that "look and act" like tributaries.
McNutt said the law would create permitting nightmares for counties as they build, rebuild, repair or replace county roads, bridges and culverts.
Willis encouraged commissioners to remember the youths of the district and opportunities available to them through Smith's office. Smith's "Youth Advisory Council" is open to high school juniors and seniors and provides them with a forum to discuss the concerns of young people and to gain insight and involvement in government.
Willis also provided information on the Congressional Art Competition, the Congressional Award, service academy nominations, assistance with financial aid and internships.
In other action Monday morning, commissioners:
* Accepted a bid for $8,153 from Applied Connectivity Technologies of Albion for internet cabling/network in the courthouse. The base bid does not include a "sonic wall" security appliance and filtering devices that will cost less than $1,000, McNutt said.
The other bid was $13,717 from Prairie Winds PC's of McCook.
* Discussed the early-March merger of D.A. Davidson and Smith Hayes, with representatives Paul Grieger of the Omaha investment banking firm of D.A. Davidson, and Andy Snyder, now of D.A. Davidson and formerly of Lincoln-based Smith Hayes. The county has done business with both businesses, McNutt said.
Grieger told commissioners that bonds for construction at Hillcrest Nursing Home are callable in October, but that he is not proposing restructuring yet because there is no formal agreement to do so. He did say that D.A. Davidson could tailor something to the particular situation at the county-owned nursing home. Grieger said there are options they could look at and analyze, bearing in mind what's most important to the county and the nursing home.
Grieger and Snyder were to meet with the Hillcrest board of trustees this morning.