Polk County commissioner Tommy Melton has proposed that the county grant $285,000 to help St. Luke&squo;s Hospital expand its lucrative orthopedic services.

Commissioners met Monday in front of a packed meeting room full of St. Luke&squo;s officials and supporters.

Melton&squo;s proposal did not get a second from other commissioners, but the board agreed to send questions to St. Luke&squo;s officials and make a decision on May 4.

St. Luke&squo;s Board of Trustees Chair Susan McHugh introduced the hospital board to commissioners. Much of the presentation was on how St. Luke&squo;s is striving to reconnect with the community and rebuild a relationship with the county.

John Young, regional vice-president of Carolina Healthcare Systems, spoke about the hospital&squo;s new approach to focus on orthopedics. He reviewed the hospital&squo;s decline in inpatient acute discharges over the last few years as well as its negative operating margins. The hospital has lost money for the past five years, Young said.

Young said the hospital&squo;s &dquo;map for success&dquo; is to select a limited number of services on which to focus. He said the main focus for St. Luke&squo;s is orthopedics.

Hip and knee replacement surgery at the hospital has grown substantially over the past few years, with 24 hip and knee replacements done in 2003, 123 in 2007 and 109 in 2008.

Dr. Brian Rosenberg, St. Luke&squo;s orthopedic surgeon, was referred to on Monday as the hospital&squo;s &dquo;cash cow.&dquo;

Phase one of the hospital&39;s new plan includes &uot;removing capacity constraints&uot; for orthopedic growth, at an estimated cost of $338,000.

Phase one tactics are to expand orthopedic services, expand the hospital&squo;s office space through a glass office connector ($34,000), provide imaging connectivity to the office with a workstation ($19,350) and connectivity ($24,150), add a scheduling module ($46,500), medical/dental clearance ($18,000), customer service/public relations ($46,000) and C Arm fluoroscopy ($150,000).

Other improvements planned within the hospital with no costs associated include expanding the MRI availability and improving the hospital&squo;s discharge, lab, pre-op and operating room processes.

The county&squo;s contribution would be used for the $338,000 phase one.

The hospital has a total of $4 to $5 million of capital needs in order to effectively compete and survive, Young said.

About 15 local residents spoke in support of the hospital, stressing what a loss to the community it would be if St. Luke&squo;s one day could no longer survive.

The money the county is considering giving to the hospital is from the sale of the James Tool building, funds earmarked for economic development. Commissioner Ren´e McDermott said she supports the hospital, but wants to ensure the county&squo;s guidelines for spending the economic development dollars are adhered to in the process.

Commissioner Warren Watson also said he supports the hospital but thinks it would have been inappropriate to vote on the issue Monday night without further study.

Melton reminded commissioners that the county owns the St. Luke&squo;s building and the hospital has it leased through 2028.

&dquo;It really is an emergency,&dquo; Melton, who sits on the hospital board of trustees, said. &dquo;This has been discussed and put on the table for some time. I don&squo;t have a problem waiting, but don&squo;t let it go. Let&squo;s not wait until our hospital does close.&dquo;