Hawkins Commission approves resolutions opposing Ballad Health service downgrades

Jeff Bobo • Updated Dec 19, 2018 at 8:31 AM

ROGERSVILLE — Following a lengthy public hearing Monday, Hawkins County commissioners approved four resolutions opposing Ballad Health restructuring plans that will affect trauma care, Kingsport's NICU, and local cancer treatment.

Among the speakers Monday was Bristol native Dani Cook, who has been traveling the region speaking out against Ballad's proposed trauma center downgrades and NICU (neonatal intensive care unit) closures in Kingsport and Bristol.

When the plan is completed, Johnson City Medical Center will house the region’s only Level 1 trauma center and NICU, and the cancer treatment center in Allandale will be relocated to a facility near Indian Path.

Cook, like many people who spoke Monday, had a personal story of how the services that are being reduced saved the life of a family member. In her case, it was her granddaughter whose life was saved by the NICU staff at Holston Valley Medical Center.

One of her main points Monday was that the COPA (certificate of public advantage) that created Ballad Health is also an instrument that can be used to prevent service reductions and downgrades.

Through the issuance of a COPA in Tennessee and a similar document known as a cooperative agreement in Virginia, Ballad Health was formed in 2018 through the merger of Mountain States Health Alliance and Wellmont Health System.

"It's important for you to know that we're not stuck with this thing," Cook said. "If we can show them there is a severe and negative public disadvantage, then we can make them take action, and I believe that's clear from the changes that they are trying to make in our system."

She added, "You just have to hold the people who oversee (the COPA) accountable."

She noted that the state health plan requires health systems to protect and promote the health of the population.

"These changes don't do that," Cook said.

Currently, about 11 out of every 1,000 Hawkins County newborns don't survive.

"What's going to happen when they don't have a NICU that's at least a Level 2 if not a Level 3 available to them," Cook asked. "That number will go up. ... Your babies will continue to die."

Another 55 out of 1,000 Hawkins County babies are born with Neonatal Abstinence Syndrome, or drug addiction.

"They want you to take your babies all the way to Niswonger (in Johnson City)," Cook said. "Here's what I think about hospital care and health care. I think it's not about profits. It's about people. I do understand that business is business, but I believe you can save our hospitals without sacrificing the health and well-being of our communities."

On Nov. 21, Ballad officials outlined their restructuring plans for the Hawkins County Commission's Public Safety Committee.

Ballad wasn't represented at Monday's public hearing. A representative notified Public Safety Committee Chairman John Metz on Saturday that the information provided last month should give commissioners sufficient background on Ballad’s plans.

Dr. Mickey Spivey, who is an emergency medicine physician in Kingsport, said he believes Ballad's plan to downgrade the Kingsport trauma center from Level 1 to Level 3 and Bristol from Level 2 to Level 3 "is far too drastic for the safety of this region."

Spivey spoke about the "golden hour," during which the survival of trauma patients is greatly increased if they receive definitive care within that hour.

Rural trauma accounts for 60 percent of all trauma deaths, and rural road conditions, especially during inclement weather, make ground transportation less efficient in this region, Spivey noted.

"For this reason, I believe all our trauma centers are needed to ensure this timely access to definitive care," Spivey said. "Almost two-thirds of Ballad's service area is either closer to Bristol or closer to Kingsport than it is to Johnson City. I think most of us, if we were going to pick a trauma center to serve the region, we would probably pick the trauma center that was best located, most capable, providing the highest quality of care to the most people in the region."

Spivey said he believes Johnson City was chosen because combined with the regional prenatal center in Johnson City qualifies JCMC to be one of six "safety net" hospitals in Tennessee.

"What that means to Ballad is millions and millions of dollars in state funding that comes into Ballad," Spivey said. "Obviously finances are extremely important for any health care system. But so are lives."

The resolutions approved Monday by the County Commission express opposition to the downgrading of the trauma centers in Kingsport and Bristol, the closing of the NICUs in Kingsport and Bristol, and the relocation of the Allandale cancer treatment center to Indian Path.

The resolutions also ask that the resolutions are forwarded to Ballad Health and the Tennessee Department of Health and Ballad’s changes are halted until the Tennessee Department of Health holds a public hearing where the details of Ballad's plans are made public and public concerns are heard and addressed.

 The public hearing on Ballad Health’s proposed changes begins at the 56:00 mark in this video.

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