Legislative committee abandons previous suggestions, says more study needed
RALEIGH–Those expecting drama, or even debate, surrounding Mission Health System’s Certificate of Public Advantage at a state legislative meeting on Thursday morning were surely disappointed.
When the House Select Committee on the Certificate of Need Process and Related Hospital Issues Co-Chair Rep. John Torbett, R-Gaston, adjourned the meeting after about 15 minutes, murmurs of “That was it?” could be heard rising after the gavel came down from the dozens of gathered onlookers.
The committee scheduled the meeting to approve a set of recommendations to the 2012 N.C. General Assembly short session, but, instead, proposed no direct action concerning Mission Health System’s certificate, also called the COPA.
Staff attorney Sean Parker read from the committee’s official findings and recommendation, which stated, “The Committee finds that in order to effectuate the purpose of a COPA…regulatory and judicial oversight of such agreements are necessary to ensure that the benefits of cooperative agreements outweigh the disadvantages and reduction in competition resulting from such agreements.”
In other words, the committee said that before it could recommend any specific action to the General Assembly, more work and examination of the COPA needs to be done.
“I guess this meeting was prudent and to the point,” said Ron Paulus, president and CEO of Mission Health System. He and Brian Moore, director of planning and public policy at Mission, attended the meeting with other Mission delegates. Both said they were surprised at the brevity of the meeting but happy with the committee’s final recommendations.
“We appreciate the efforts of people like Representative Tim Moffitt and Senator Tom Apodaca,” said Paulus. He said many Western North Carolina representatives had a role in making sure the committee’s suggestions from last month — which included a buffer zone that would prevent Mission from offering health services within 10 miles of a competitor — were left out of the committee’s official report.
Mission: We will cooperate with state compliance review
Rowena Buffett Timms, Mission’s senior vice president of government and community relations, said that hospital representatives had 55 meetings with committee members since last month’s meeting to discuss the COPA.
“We tried to offer clarity on our issues,” said Paulus, who issued a letter to the committee on Tuesday that stated that while Mission will still seek an “eventual and appropriate termination of the 16 year old (sic) COPA, we recognize that this Committee is not the appropriate venue to do so.” [Read Paulus' complete letter below.]
Paulus’ letter also emphasized that Mission will cooperate with the N.C. Department of Health and Human Services on a compliance review performed by Dixon Hughes, an independent auditor.
Critics of Mission also claimed victory on Thursday, saying that the committee’s pithy recommendation is a sign that the debate surrounding the COPA isn’t over.
“The bottom line is that we are encouraged,” said Graham Fields, assistant to the president of Park Ridge Health and the spokesman for the WNC Community Health Care Initiative. “The process for us has revealed that the state has not provided oversight of the COPA; for us that’s clearly shown (because) it’s so rare for a committee to continue work after the session has ended.”
Fields said that the compliance audit and review from Dixon Hughes will be crucial in helping the state move forward on the COPA issue.
The state commissioned the 11-person committee last September to investigate and review North Carolina’s health-planning process, including state medical facilities and issues surrounding certificates of need.
But much of the committee’s attention has been taken by Mission’s COPA, which is the only COPA in the state and the cause of a prolonged battle in Western North Carolina between Mission Hospital and competitors Park Ridge Health and 21st Century Oncology. They say North Carolina has allowed Mission to run a veritable monopoly in Buncombe and Henderson counties for nearly 20 years.
“The committee has consistently shown a strong interest in slowing this train down,” Fields said. “We hope that Mission takes the hint and also slows down on behalf of the people of WNC.”