A recently closed hospital gets another shot at life in the state budget passed last week.
By Thomas Goldsmith, with reporting by Rose Hoban
WakeMed and Duke Lifepoint are the leading candidates to take advantage of a door opened by the completed North Carolina state budget, an opportunity to take over services at the former Franklin County regional hospital, legislators said.
Specific budget provisions have enabled state funding for 18 behavioral health beds at the facility, a provision that would allow for an emergency room, and possibly more services at the county-owned Franklin Medical Center in Louisburg, closed by Novant Health less than a year ago.
Potential bidders for the facility, which had 80 beds a decade ago, are Duke Lifepoint and WakeMed, said Sen. Ralph Hise (R-Spruce Pine), co-chair of the Senate Subcommittee on Appropriations on Health and Human Services.
WakeMed is a three-hospital, 919-bed private, not-for-profit health system based in Raleigh. Duke Lifepoint is a joint venture of Duke University Health System, in Durham, and the Brentwood, Tenn.-based health-care company LifePoint Health.
“There are two individuals being interested,” Hise said before the General Assembly adjourned. “There are two different proposals for how many beds they would use.”
WakeMed President and CEO Donald Gintzig confirmed the network’s interest in the Franklin County facility Thursday.
Under a state budget item on rural hospitals, a hospital system would be enabled to bypass the state’s certificate-of-need process to locate behavioral health beds in Louisburg. Two other rural hospitals will be able to set up new behavioral beds as well.
The beds would be part of a $18 million budget provision designed to fund new behavioral-health and substance-abuse capacity in the eastern, central and western regions of the state. Another $2 million will go toward short-term crisis centers to serve children and adolescents.
An additional section of the 2017 budget allows a hospital to start a clinic or other service — under the originating hospital’s license — in an adjoining county, if the destination county has lost its only hospital in the previous three years.
That’s exactly the situation in Franklin County. The county has sorely missed its hospital’s former emergency room, which could be replaced under the budget provision.
“I have been working collaboratively with different elected officials in Franklin County for the purpose of figuring out what to to do,” said Sen. Chad Barefoot, who represents parts of Wake and Franklin counties. “What we realized is the the state licensing laws prevented an emergency room from opening up in Franklin County.”
The budget provision does not specifically mention Franklin or Yadkin, another county with a recently closed hospital. It states that a functioning hospital in one county can set up an emergency room and then other types of services, in a facility that’s been closed in an adjoining county, if that adjoining county has been without a hospital for less than three years.
“What it does is allows the county to put out an RFP [request for proposals] to accept bids from providers who are in counties adjoining them to set up services,” Barefoot said.
If a company with a hospital licensed in Wake County, for example, added services in Franklin County, the hospital in Louisburg could continue to grow.
All new services would require approval by the Department of Health and Human Services.
“There’s a lot of concern”
Harry Foy Jr., a Franklin County commissioner from Spring Hill, said he has heard that hospital chains are showing interest in the county hospital.
“I have not heard all the details,” Foy said. “There’s a lot of concern going on in this county about this.”
In a statement, WakeMed’s Gintzig said, “WakeMed has been proud to serve the people of Franklin County for years, and we would be honored to have the opportunity to do even more in the future.
“We were eager to help when leaders from Franklin County reached out to us after Novant closed the hospital and emergency services,” he said. “We have been discussing with them opportunities to not only bring health care services back to the county, but also develop a true partnership that will meet the community’s health care needs.”
The General Assembly’s action created possibilities for WakeMed to pursue emergency and behavioral health services in Franklin County, he said.
Efforts to reach Duke Lifepoint’s corporate offices in Brentwood, Tenn., were unsuccessful Wednesday. In January, the company added Central Carolina Hospital in Sanford and Frye Regional Medical Center in Hickory to its North Carolina properties in Sylva, Clyde, Henderson, Roxboro, Rutherfordton, Bryson City and Wilson.
Money from Dix sale at work
The behavioral-health initiatives will be financed with part of Raleigh’s payment to the state for the property of the old Dorothea Dix Hospital, which closed in 2010. Sen. Tommy Tucker (R-Waxhaw) said legislators were responding to government and health-care industry concern over hospital emergency departments that have often filled to overflowing with behavioral-health patients.
“In the last decade, with the reduction in beds and the growth in the population and the requirements that are being exacerbated in the emergency rooms, the cry from the hospitals and the providers is ‘More beds, more beds, more beds’,” Tucker said.
“So we are putting money into making an effort to increase beds in the various communities.”
Advocates for people with mental illness have urged the state to spend more on community resources such as independent living arrangements and outpatient drop in centers. In some cases, support from a caseworker or other professional can allow a person with mental illness to remain successfully at home, freeing up some emergency and long-term residential space.
Speeding up the process
Placing behavioral health beds, as well as short-term crisis centers, at locations across North Carolina should help in the effort to broaden community care, Tucker said.
“We found that if we can place them more regionally around the state, that kind of parallels with community care,” he said.
Rep. Donny Lambeth (R-Winston-Salem) said the money from the Dix sale was a “big plus” in the effort to provide more resources for mental health needs. Giving exceptions from the certificate-of-need process should make the process go faster, he said.
“I think mental health was a part of the budget that came along nicely,” Lambeth said.[box style=”2″]This story was made possible by a grant from the Winston-Salem Foundation to examine issues in rural health in North Carolina. [/box]