University and Doctors hospitals say the state was wrong to deny them permission to put a free-standing emergency department in Evans. Getting to make that case at a hearing is likely many months away, a University official said.
Both hospitals have notified the Georgia Department of Community Health that they plan to appeal the denial of their applications.
University had planned a $9.6 million, 18-bed facility on its Evans campus on North Belair Road. Doctors had submitted plans for a $9.8 million, 12-room center on the same road on property across from Marshall Square. The state rejected the applications Jan. 25, saying there was no need for new facilities in Columbia County because of the abundance of ER facilities nearby.
The next step will be to get a hearing with an administrative law judge to make their case, said Ed Burr, University’s vice president for legal affairs.
“Essentially, the issue is the agency got it wrong when they said there was no need,” he said.
Both hospitals say their emergency rooms are full and they will find it difficult or more expensive to expand on their existing campuses.
“The strongest argument on our behalf is just how crowded our emergency room is,” Doctors CEO Doug Welch said. “We need to add more beds. And we think adding those beds makes sense in Columbia County … to be closer to that population base. And it is a little bit less expensive to do it there versus here. So it makes sense. Better access for patients and a lower cost.”
Burr doesn’t expect to have a hearing soon.
“We probably would be lucky to get an administrative law judge hearing done this year,” he said. “It’s possible but it would be late in the year, if it happens.”
Eastside Medical Center in Snellville, Ga., was blocked from opening a free-standing ER in neighboring Walton County in mid-December, and its appeal hearing was scheduled for the end of May, Burr said. The state has never granted permission for a free-standing ER, though South Carolina and many other states have.
The administrative law judge has 30 days after the hearing to issue an opinion. That opinion will be sent to the commissioner of the Department of Community Health or his designee, who can uphold or reverse the decision to deny the certificate of need.
If the denial is upheld, the hospitals can file suit in Superior Court, likely in Columbia County if past cases are an example.
“If it is an issue of agency policy, then the courts are going to give deference to the agency,” Burr said.
“The chance of success they’ve told us is small, but there’s a chance,” Welch said.
The appeal could give the hospital a chance to bolster its case, Burr said.
“We know that there was a lot of support for the idea” in Columbia County, he said. “We thought we had done a pretty fair job of making that case in the application. Maybe we can do a better job in the hearing.”
If nothing else, Welch said, perhaps the appeal will lead the state to set out more specific rules for where free-standing ERs can go and give health care facilities a better chance to plan for them.
“At this point in time, for us to maintain our efficiency, we’re going to have to do something,” he said. “And I don’t want to invest multimillion dollars here on campus if potentially in a year or two or three I might be able to do that in Columbia County.”