That is when a 10-member board is scheduled to hear arguments for and against constructing a $41 million, 15-bed emergency department and accompanying diagnostic center that Wellmont announced in early November. The Health Services and Development Agency recently deemed Wellmont’s certificate of need (CON) application “complete,” setting the stage for the hearing.
Wellmont’s senior vice president of marketing communications, Pat Kane, said the system was grateful for what he called “the community’s outpouring of support” for the project.
“In the coming weeks, we’ll continue seeking input from the various constituencies in Washington County, including patients, community leaders and medical professionals,” Kane said. “We look forward to letting people know about the many benefits our planned center will bring to the region.”
The application was eligible for a Feb. 27 hearing, but another contested case is scheduled for appeal that day, and Wellmont officials opted to wait.
In a news conference the day of Wellmont’s Nov. 9 announcement, Mountain States Health Alliance expressed its opposition and said such a facility would worsen health care labor shortages and duplicate services.
The HSDA uses three criteria when reviewing applications — need, economic feasibility and “contribution to the orderly development of adequate and effective health care.”
MSHA spokesman Ed Herbert said Mountain States is parsing the nearly 100 pages of Wellmont’s CON application and “will have a formal response in early 2008.”
An attorney on staff at the HSDA said board members likely will have plenty to mull over prior to the actual hearing.
“Agency staff prepares a summary for each application, and there’s a bit of analysis contained in each one,” said Jim Christoffersen, the HSDA’s deputy general counsel.
Christoffersen said the Department of Health also reviews applications and submits reports with analysis pertaining to how an application fits with that department’s requirements and objectives. Those summaries are put in the hands of commissioners as early as possible, sometimes weeks before a hearing, but Christoffersen stressed that no specific recommendations are made.
“They do not try and tell the agency members how to vote on it. They try and provide useful analysis and perhaps additional statistical data so the members can decide for themselves.”
What members will be deciding in this case is whether Wellmont needs more emergency room capacity than it can practically provide at its Holston Valley Medical Center in Kingsport, and whether it makes sense to put that capacity in a satellite facility that would be much closer to MSHA’s Johnson City Medical Center than it is to HVMC.
HSDA board members, with their constituencies in parentheses, are Carl Koella III, Clark Jones and Dr. Gene Caldwell (consumers), Gregory Lammert (home care), Bryan Atchley (nursing homes), Peggy Troy (hospitals), Dr. Charles Handorf (physicians), John Morris (commerce and insurance), Keith Gaither (TennCare) and Faye Weaver (state comptroller’s office).
Should MSHA follow through on its pledge to appeal the CON, Christoffersen said it or Wellmont would have the opportunity to continue the process, depending on the HSDA board’s ruling in March. If the losing party wants to appeal, there are 15 days to do so, and state law calls for a case to be heard by an administrative judge and a trial completed within 180 days. That is a “de novo” process, and the only information the judge considers from the HSDA hearing is who the appealing party is to determine who has the burden of proof.
The process was a longer one when MSHA and Wellmont tangled at the beginning of this decade over Wellmont’s plan to build a hospital in Johnson City, with MSHA ultimately prevailing. In the wake of that case and other lengthy appeals, Christoffersen said the state abolished the Health Facilities Commission, altered its CON process and created the HSDA.
“The state added provisions to reduce the overall time of contested cases, but given the complexity of health care litigation ... it’s probably a bit optimistic to get it done within half a year,” Christoffersen said.
Even after an administrative judge rules on an appeal, Christoffersen said the losing party can still request the HSDA review the judge’s decision or can appeal the case to Davidson County Chancery Court.
Despite the appeal process, Wellmont could pursue its desired project timeline if the ruling in March goes its way, because Christoffersen said the certificate of need would be granted at that time.
But considering the likelihood of an appeal, Christoffersen said applicants who are successful in the first stage “proceed at their own risk. It’s a business decision that the company would have to make.”