The sun was shining but the people gathered outside the south Asheville community center were tense as they waited for N.C. Attorney General Josh Stein to arrive. Citizen groups from Highlands to Asheville to Burnsville and Spruce Pine were about to hear a much-anticipated announcement from Stein about the sale of non-profit Mission Health to for- profit HCA. Since Mission Health announced in March its intention to be bought by HCA, the groups have been diligently questioning how the final deal might affect the member hospitals, individuals and groups throughout the 18-county region. They have also cast a skeptical light on the make-up of the Dogwood Health Trust.
Citizens from across Western North Carolina came to hear N.C. Attorney General’s announcement about the sale of Mission Health to HCA and the changes that have been negotiated in the Asset Purchase Agreement. N.C. AG Josh Stein is pictured at the center, N.C. Sen. Terry VanDuyn is at the right, and Patrick Taylor, Mayor of Highlands, is fourth from left.
Standing behind a simple wooden podium set up at one end of a bright blue multi-purpose room, Stein assured the audience of citizens and the press that he and his staff understood that “access to healthcare is truly a life or death issue.” He prefaced his remarks by giving a special word of appreciation to the people who had written or called about their concerns and said it was “public forums which his staff attended, delegations of your folks coming to meet with me in Raleigh, 100s of letters and dozens of phone calls,” input that “shaped a fair deal for the people of Western North Carolina.”
Indeed, anxiety in the room lessened visibly as AG Stein outlined the major changes which have been negotiated in the revised asset purchase agreement. There is now a 10-year commitment to keep hospitals, including the five rural hospitals, open. The services each hospital must have are spelled out, along with provisions for charity care. Provision for an independent monitor has been added, and that person’s role will be central to assuring that the terms of the amended Asset Purchase Agreement are met. That monitor provides a safeguard should the local advisory boards wish to make changes at their facility. This gives SEARCH confidence that Blue Ridge Regional will continue serving the area for at least a decade. The revised agreement also spells out a way for the hospital to be acquired by the community if that becomes necessary or desirable. While “Save Our Hospital” asked for a different outcome, their efforts were successful in showing the concern of 4,000 local citizens who signed petitions.
The other major point that SEARCH has promoted was that the Dogwood Health Trust, the $1.5 billion foundation to be created out of the proceeds of the sale, needed to become truly representative of the people of WNC. Though the initial board members are Mission-centric and the majority of members are from Buncombe County, the revised Asset Purchase Agreement charts a route to a board composition that is independent of Mission and reflective of the demographics of the entire region.
The summary of changes to the original Asset Purchase Agreement including how the price being paid for Mission Health System was determined to be fair, and how the agreement will be monitored can be found on the SEARCH website, www.searchwnc.org.
Speaking on behalf of the leadership of SEARCH, Susan Larson expressed gratitude to Attorney General Stein and his staff for the diligence and openness they displayed during the exceedingly complicated review process. They addressed the points even-handedly and negotiated an agreement that appears to give the protections sought for rural hospitals and moves the Dogwood Health Trust towards a truly regional body that functions with transparency.
“Elected officials in Mitchell and Yancey counties acted to make this agreement as favorable as it could be for our rural area,” she said, “passing resolutions that stated clearly what needed to be strengthened in the agreement.” The Towns of Burnsville, Bakersville, Highlands and Spruce Pine and Mitchell County Board of Commissioners and Yancey County EDC all discussed and adopted resolutions which went to the Attorney General. “Those elected officials should feel gratified that their concerns were heard and acted upon in the final agreement,” said Larson. Of particular concern locally is what will happen to EMS, and in the amended agreement HCA will provide full financial support of EMS services for one year in Mitchell, Madison, and Yancey counties while an alternate solution is found.
The Mayors of Highlands and Franklin and other individuals in Macon County also made sure that questions about the hospitals in their towns were fairly addressed.
Asheville groups have played different roles in evaluating the sale. COAH (Communities for Older Adult Health) organized, with the help of SEARCH and Elder Law, the August forum about the Dogwood Health Trust. The Health Equity Coalition, a group of a dozen organizations looking at disparities in access to health care in western North Carolina, took shape to ensure that the Dogwood Health Trust board represented the diversity of the WNC population.
SEARCH worked with former Missouri Attorney General and Governor Jay Nixon, who under the sponsorship of individual and community groups, came to Asheville to lead a Listening Session and then travelled to Raleigh to meet with Attorney General Stein. Nixon has maintained his interest in the outcome and lauded the groups’ work as “democracy in action.”
The work of SEARCH is much broader than the issue of maintaining the hospital. The public is invited to attend the next SEARCH meeting, tentatively scheduled for February 12 in Spruce Pine, to celebrate and to continue the work of Sustaining Essential and Rural Community Healthcare in Mitchell and Yancey Counties and to plan how to welcome HCA to the community.