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RIVERTON — State-level negotiations to use federal CARES funds for building a proposed community hospital in Riverton emerged Monday at the Legislative Joint Appropriations Committee meeting.

“To build a fully functional hospital, which we don’t have now, and which I really think we need to have, is important to the community,” said State Sen. Eli Bebout, R-Riverton, to the committee he chairs.

The $1.25 billion CARES package now being parceled by the Wyoming Legislature is federal money earmarked to relieve citizens and governments of coronavirus-related expenditures.

After months of consideration, Bebout is presenting a plan to direct CARES money not toward pandemic-accommodative expansion of Riverton’s current hospital, SageWest Health Care, but toward a new hospital owned by the City of Riverton.

“There are several points (of the construction effort) that could be COVID-related,” he said.

Current estimates for the hospital construction and land anticipate that effort to cost up to $40 million. The ratio of that amount eligible for CARES funding is still unknown, according to Bebout and McGuffey, but will be explored in a working group of JAC members in the coming days.

For portions of the funding not necessarily COVID-related, Bebout asked Riverton Medical District leader Corte McGuffey whether the city was willing to apply for funds to back the construction effort.

“Yes. We’re working with the city of Riverton right now,” said McGuffey. “The city council and mayor are on board with what we’re doing, and will take ownership of the hospital and the land (using the grant money) — and I think that’s a pretty big commitment on their behalf.”

McGuffey would clarify in a later interview that the City has not yet completed a memorandum of understanding with the Riverton Medical District but the topic is imminent in upcoming council meetings.

Riverton Medical District is the nonprofit entity formed to coordinate hospital planning that began in 2018.

McGuffey added that the U.S. Department of Agriculture facilities funding program would be used to finance some costs.

“Our town is behind this. They know how important this is. They know how much the service levels have dropped here.”

McGuffey said Fremont County averages 1,000 medical airlifts to out-of-town hospitals per year, compared with fewer than 200 six years ago.

The Joint Appropriations Committee co-chairman, State Rep. Bob Nicholas, R-Cheyenne, asked McGuffey if a new hospital would supplant workers and underwhelm the industry.

“How many people does (SageWest) employ? How many doctors does it have on staff? What services do they not provide? What gap is this going to fill?” he asked. “You’re going to have two competing hospitals in one town — how do you deal with those issues?”

“That’s what a lot of people around the state think: that we do have a hospital here,” answered McGuffey. “But we don’t have a hospital here,” said he, referring to the cutback in services at SageWest Riverton.

He spoke of SageWest’s decision, six years ago, to consolidate many of its services into the Lander SageWest Health Care.

“Before 2014 we had over 230 employees at our hospital, and now we have under 40,” he said. “We used to have 25 doctors, and now we have under 10. The hospital here has decided not to compete. And that’s why we’ve come together to build this hospital.”

When asked how many of the county’s 1,000 annual air ambulance patients were from the Riverton side, McGuffey said it was difficult to delineate given Wyoming Department of Health aggregation policies, but he estimated about two-thirds. State Rep. Lloyd Larsen, R-Lander, countered that hospital records suggest that the two-thirds majority of air ambulance patients is actually from the Lander side. While Fremont County is an “anomaly” as far as life-flight numbers, said Larsen, “air ambulance is a real problem... throughout the state.”

McGuffey would later note that although the new hospital expects to be the first truly pandemic-ready hospital in the state and offer services missing from the area, it will be smaller than the current facility.

SageWest Riverton, said he, has about 70 beds. The new hospital would have about 20.

He said he hoped the facility would have a symbiosis with the Central Wyoming College nursing program.

“A lot of smart people have looked at this, and the viability... makes sense,” Bebout added.

State Sen. Dave Kinskey, R-Cheyenne, said the permissibility of building a new hospital with federal funds should be explored carefully.

“It’s hard for me to imagine (the federal government) taking this money back if we put it into a medical facility with some sort of colorable claim,” he said. it might be necessary for Bebout to have a conversation with United States Senator John Barrasso, R-Wyoming, to be sure of it.

“Am I out to lunch, or are the people that worry too much actually right?” added Kinskey.

The embryonic CARES allocation bill allowing a possible $250 million in grants to rural hospitals for COVID needs will specify that the money must be spent by December 2020 - a deadline imposed by the United States Congress.

Throughout legislative deliberations on how and where to spend CARES money, haste is the recurring theme. Federal relief funds not spent in 2020 could be returned to Congress.

“We’ve got five-and-a-half months left and $1.25 billion,” said Bebout when referring to CARES distribution generally.

“We need to get that money out the door. The sooner the better. (And) rural hospitals, broadband, all those are areas where we can do something.”

The rush to spend relief money comes, paradoxically, in a time when non-COVID expenditures are being cut by 10% — with another 10 percent of executive cuts under consideration — due to economic fallout created by COVID shutdowns and a minerals-industry price drop.

Beyond the governor’s mandated $250 million in immediate spending cuts, legislators are considering new revenue streams, such as the repeal of some tax exemptions, to meet the state’s biennium budget, which is projected at $1.5 billion less than anticipated in early 2020.

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