March 29, 2022 Tuesday 9:00 am
The Bourbon County Commission met in open session with all three Commissioners and
the County Clerk present.
Also present for all or some of the meeting were Clint Walker, Anne Dare, Don
Coffman, Matt Crystal, Drew Solomon, Tom Booser, Merrill Atwater, Dr. Randy
Nichols, and Mark McCoy.
Eric Bailey presented permits for Joe Kerr at Indian Rd and 195th for an entrance
culvert. The second permit is for Craw-Kan to install fiber lines in the southwest part
of the county. Clifton made a motion to approve the permits at Indian Rd & 195th and
also for Craw-Kan in the southwest area of the county. Lynne seconded. All approved.
Eric said that he received a phone call this morning regarding a utility company
cutting Maple Rd. at approximately 190th or 195th he has not seen it yet. He was not
aware of this and is going to work with them to get the appropriate permits. Eric said
that he does not think that cutting the road was the best option but he was not aware
of the project prior to them cutting the road. Eric asked that if a utility company
contacts a commissioner, then please refer them to his department so they can look
at all options and get appropriate permits. Jim said that he had a conversation several
months ago with a utility company but he said that he told them to contact Eric.
Eric said that due to the road safety plan grant received last year, TranSystems
Company is in town gathering data. Eric said that if you see vehicles with lights
driving around gathering data but those vehicles should be clearly marked.
Eric discussed the placement of a stop sign in Bronson in the area of 25th & Bay St at
the far west part of the curve. He provided maps and of the location and it was
discussed as to what the best placement would be. Jim made a motion to place a stop
sign at the intersection of Bay and the curve between 25th & Bay. This would stop the
westbound traffic on Bay Street and the sign would be placed on northwest corner of
the intersection. Clifton seconded. All approved.
Eric said that Dustin had worked diligently to find a dump truck and it paid off
because they were able to find a 2008 Sterling in Tulsa for $60,000.00 and it has the
plow attachments that they will be able to put the county plow on it. Eric said that
they finished at 267th and Arrowhead with the 36” culvert replacement so that isn’t so
narrow now. He said that they are scheduled to burn at Elm Creek Lake on Friday,
weather permitting. Eric gave an update on the windmills saying that they are still
working on the punch list that he submitted and everything is going good on finishing
up. Jim Harris asked if Eric had received information on federal funding for the year
yet. Eric said yes, but that it had been postponed. Lynne asked about the ditching on
Wagon Rd that he had received a call on. Eric said that it is on the list and they are
working as fast as they can but they also need to look at fixing cross tubes if the
ditching is going to really help anything.

Millie Lipscomb, with the Elk’s Lodge, said that with costs rising on everything, that
she was requesting a donation from the county of $750 instead of $500 that has been
donated by the county the last few years. Clifton made a motion to donate $750 to
the Elk’s Lodge for their fireworks display this year. Lynne seconded. All approved.
Ashley presented the contract with Hamlin Energy to help secure the best price for a
gas supplier since Pro Solutions is going out of business. She said that they will look
and price as well as monitor bills and recommend locking in a price or changing
suppliers. She also said that the contact is not for a specific time frame that it can be
revoked at anytime with a written letter from the county. Clifton made a motion to
allow Chairman Harris to sign the contract with Hamlin Energy. Lynne seconded. All
approved.
Clifton made a motion to amend the agenda to add mowing at 401 Woodland Hills
Blvd. Lynne seconded. All approved.
Clifton made a motion to move county counselor comments to the end of the agenda.
Lynne seconded. All approved.
Clifton said he had been asked if the bids received were apples to apple and he said
that they are not. Justin Meeks recommended rejecting all bids and rebidding it. He
said that he thinks that we should rebid with better specs. Jim agreed. Clifton made a
motion to reject the bids for mowing and rebid it with more detailed specs and to be
due back by next Tuesday’s meeting. Lynne seconded. All approved.
Clifton made a motion to go into executive session under KSA 75-4319(b)(4) to discuss
data relating to financial affairs or trade secrets of corporations, partnerships, trusts,
and individual proprietorships. The session will last for 30 minutes returning to the
commission room at 9:57 am and will include the 3 commissioners, Noble Health
representatives (Drew Solomon, Tom Boozer, and Marrill Atwater), Josh Jones, Shane
Walker, Susan Bancroft, and Justin Meeks. Lynne seconded. All approved.
Clifton made a motion to resume normal session at 9:57 am with no action. Lynne
seconded. All approved.
Clifton made a motion to move the executive session for personnel matters to next
week’s meeting. Lynne seconded. All approved.
Susan reminded everyone that the meeting next week on March 5th will be held at the
Mapleton Community Center at 6 pm and asked what the commission wanted to do
about future meetings in outside areas of the community. Jim said that he would like
to see one held at Garland and Hiatville. Lynne said he would like to see a night
meeting held here at the courthouse as well and Jim agreed. Lynne also said that if
you are going to have meetings at those locations you should probably have one at
Fulton, Hammond and even Devon. Jim said he would be in favor of trying that and

proceed based on attendance. Jim recommended that once we have been to several
remote locations for meetings, that they continue with a remote location meeting
once per quarter and an evening meeting at the courthouse every 4-6 weeks possibly.
Susan said that she would work on a schedule. Susan handed out a capital
improvements document to help department heads to understand what needs to be
taken into consideration when looking at capital projects. This also includes
personnel. If a department needed to add personnel they would have to justify the
reason for requesting.
Noble Health Presentation – Drew Solomon gave an update on the feasibility study. It
is substantially complete. There are a few items that need to be done. A lot of good
findings. Tom Booser will provide additional information. Tom is the coordinator of
the research. All of rural Kansas has a demographic trend happening. Every year 25
families leave this county. Right now 19% of the population of Bourbon County is 65+.
In 20 years 40% of the population will be 65+. This region is the least healthy in the
entire state. Kansas used to rank 9th in terms of health and has declined to 29th out of
the 50 states. Through community meetings and surveys the consensus is that we
need more healthcare. Data shows there is a very significant trend in this county.
There was substantial migration for healthcare from this area prior to the hospital
closing. Eleven million dollars per year for healthcare leaves Bourbon County for care
outside of this county. If this is going to be a sustainable hospital it must control the
out migration. It must find a way to build trust in the community and attract people
back. In this community, in this region, these hospitals carry twice the
uncompensated care burden as most rural hospitals. As the population ages, you can
see from a financial standpoint, your coverage may exceed, in terms of income from a
hospital, 40% of revenue. Medicare pays less than private insurers. Medicare
typically pays less than the cost to deliver the care. The current model of this
hospital the cost to deliver the care is higher than what the reimbursement is. Every
time you see a patient you lose money. The only way a hospital can fix that is from a
high percentage of private insured patients. If you have a large Medicare/Medicaid
population and you can control payments you have a very stable model. This is why
so many hospitals get some level of tax subsidy because there is a structural mismatch
between costs and revenue. The only way to surmount this, going forward, is to do
something different than you’re doing right now or what has been done in the past.
This is a structural problem and you have to change the approach. Part of that is
collaboration. Rural hospitals should collaborate more. This is going to require
transformation. A completely different way of behaving in regard to healthcare.
There has to be some sort of community leadership to get people to understand that
using healthcare in the region keeps it sustainable. In this region, workforce could be
the main component of whether a hospital is viable or not. There is a nursing school
in Pittsburg that graduates about 120 students per year. On average, those students
owe $25,000 which could be about 15 to 20% of your pay every month to pay off that
loan. What if there were help for these candidate nurses so they wouldn’t have that
debt. This requires community activism and some original thoughts. The former
hospital operated in a certain model allowing surgery and other things like that.
There is a merging model called a rural emergency hospital that could be an option