WinnMed Joins Five-Hospital Bid for $19.2 Million Maternal Health Grant

Decorah deserves a newsroom of its own. Help us keep it strong. DECORAH — WinnMed has joined four other Northeast Iowa hospitals in seeking $19.2 million in federal rural health funding for a regional maternal health initiative, while hospital officials say the program's rules and rapid application process can make it difficult for rural hospitals to compete for the money. WinnMed Chief Administrative Officer Steve Slessor told the hospital's Board of Trustees Wednesday that the five-hospital application was submitted shortly before the Sept. 2 meeting. The proposal covers four budget years and was submitted through Iowa's Rural Health Transformation Program. The application includes WinnMed and hospitals in Cresco, Manchester, West Union and Waukon. The hospitals are seeking funding through a "hub-and-spoke" option for rural providers. Slessor said the proposed funding would support obstetric services and additional work the hospitals could undertake with grant funding. Potential activities include additional training and collaboration with Northeast Iowa Community College, including enhanced simulation equipment. Regional Health Services of Howard County's grant writer prepared the application on behalf of the five participating organizations, with input from the hospitals. WinnMed was still waiting for a decision on the application as of Wednesday's meeting. The maternal health proposal is one of several opportunities WinnMed has pursued through the Rural Health Transformation Program, a $50 billion federal initiative created as part of legislation that also included Medicaid cuts, according to Slessor. Iowa received $209 million through the program in its first year. Slessor said the state then distributes the money through individual requests for proposals developed by the Iowa Department of Health and Human Services. The process has moved quickly. Slessor said some grant opportunities have given hospitals only a few weeks to develop major proposals. WinnMed has already received two awards through the program. The hospital received funding for a CT scanner in the first round and funding associated with the recruitment of a psychiatrist, which resulted in the hiring of Dr. Alicia Killian. Because WinnMed received awards in the first round, it was not eligible to apply for the corresponding second-round medical equipment and workforce opportunities, Slessor said. The hospital also is watching for a cardiovascular hub-and-spoke opportunity that had been expected to be released in July or August but had not been issued as of Wednesday's meeting. A school-based health services opportunity also is being considered, although the state had released only a notice of intent and not the full request for proposals. WinnMed has declined to pursue some other grant opportunities after determining they were not a good fit for the hospital. Slessor told trustees that the program has produced meaningful opportunities for WinnMed but also presents challenges. One concern is that the federal funding does not replace the financial impact of the Medicaid cuts included in the One Big Beautiful Bill Act, he said. Another concern is the amount of administrative work required by the grants. Slessor said the CT scanner award, in particular, has required significant reporting, including requests for information that hospital officials did not always see as useful. The grants also generally are intended to support new activities rather than the ongoing cost of services that rural hospitals already provide, which can create a sustainability problem, Slessor said. A grant may allow a hospital to begin a new service or activity, but the hospital can be left responsible for maintaining it after the grant ends. "That's one of the challenges," Slessor told the board, explaining that some services were not offered previously because they were not financially sustainable. The program's restrictions have also affected which projects WinnMed can pursue. For example, WinnMed could not participate in a cancer-care hub-and-spoke opportunity because of requirements involving distance from a radiation oncology hub and the ability of a hospital serving as a hub to provide radiation oncology by Jan. 1, 2027. WinnMed also could not use the program to support construction, Slessor said, which creates another limitation for proposals involving the co-location of services. The maternal health application faced a similar geographic issue. The grant rules originally required participating hospitals to meet mileage requirements involving the hub and other spokes. Manchester requested that the allowable distance be increased from 60 miles to 75 miles, and the state approved the change, allowing Manchester to participate. Slessor said state officials have emphasized the speed at which Iowa has distributed the federal money. The state also has an incentive to move quickly because money that Iowa receives but does not distribute can be returned to the federal government and potentially redistributed elsewhere. The timing has made the application process difficult for hospitals, Slessor said, particularly when large proposals require collaboration among multiple organizations. Hospital officials were advised to focus on opportunities available in the program's first year. Slessor said WinnMed does not expect another round of the same "best and brightest" medical equipment grants in the second year, although workforce grants are expected to continue annually. For WinnMed, the maternal health application represents a decision to pursue one of the opportunities officials believe fits the hospital's needs. The hospital will continue evaluating new requests for proposals as they are released, Slessor said, while deciding whether individual opportunities make sense for WinnMed and its patients. Busy day? We've got you covered. Get local news delivered to your inbox.