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Hospital committee to focus on needs in Columbia County

Wednesday, Jan. 22, 2014 9:26 PM
Last updated Thursday, March 20, 2014 9:36 PM
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The 11-member committee that will evaluate proposals to build a hospital in Columbia County appears to have little experience with the certificate of need process the proposal will have to go through for permission from the state.

That’s a good thing, a Columbia County official said.

The committee members, who include two physicians, are to focus more on who will best meet the needs of the county and not worry about the complicated process of meeting the licensing needs, Columbia County Administrator Scott Johnson said.

“This panel truly will be judging what’s best for Columbia County citizens and what is the best proposal as it relates to cost and what is being offered,” he said. “It will be up to our hospital partner, whoever that may be, to traverse the CON (certificate of need) issues.”

At its first meeting Wednesday night, the committee chose former Columbia County Commission Chairman and former state Sen. Jim Whitehead as its chairman and Barry Paschal as vice chairman.

The committee received copies of the three bids and set a schedule for meeting with representatives of the bidders in about three weeks. Officials hope the committee will make a recommendation to the county commission on who to work with to apply for a certificate for at least a 100-bed hospital with a trauma unit.

Three Augusta hospitals – Doctors Hospital, Georgia Regents Health System and University Hospital – have submitted proposals in response to Columbia County’s request for proposals to build a hospital in partnership with the county.

Doctors has proposed a $150 million, 108-bed hospital with a $14.5 million medical office building on the site. Georgia Regents has offered a $280 million to $310 million health campus with a 144-bed hospital that would include a satellite of the university to offer classes. University has proposed a $130 million to $140 million, 100-bed hospital on its existing Evans campus.

After University and Doctors were shot down last year in competing proposals to build a free-standing emergency department in Columbia County because the state ruled the county is adequately served by Augusta hospitals, officials at the Georgia Department of Community Health pointed county officials to three exceptions to that need standard: If the facility is part of an existing teaching hospital; if it is part of an existing trauma center; and if the county pays 20 percent of the cost.

None of the exceptions has ever been used to get a certificate of need.

Each proposal relies on one or more of those exceptions, and all feel they can get around the need for a certificate with the legal exception, Johnson said.

Getting a hospital has long been the desire of Columbia County officials but the certification standard has made that look daunting.

“With the number of beds in Augusta in close proximity, I think any hospital would have a difficult time obtaining a CON,” Johnson said.

In fact, Doctors Hospital wrote in its proposal that “if CON rules, including its need methodology for additional hospital beds, had allowed, Doctors Hospital would already have a hospital in Columbia County.”

County commission Chairman Ron Cross has acknowledged that getting the permission will be “a fight” and that whoever is not selected will likely put up a legal challenge to the effort.

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Riverman1
86854
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Riverman1 01/23/14 - 06:10 am
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Committee May Have More Experience Than Thought

Boy, are we reaching hard to get comments from anybody to say a CON will only be granted if one of the three exceptions is met. Keep in mind, as I've said many times, a CON for a hospital has never been applied for. When the three exceptions were noted, state officials were obviously referring to free standing emergency facilities as evidenced by them saying "existing trauma centers," but we've somehow stretched that to mean an exemption is the only way to have a hospital approved.

This committee has it right. Stay out of that CON process. Let the hospitals all apply to the state for a CON without the county contributing any funds whatsoever. If they want to use the exceptions for teaching hospitals or existing trauma centers, that's up to them.

I believe with the current population and growth rate of the county a CON will be granted without the county putting out tens of millions in funding. Keep in mind, the trend is for the CON committee to be more lenient if hospitals are willing to take the risk.

Riverman1
86854
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Riverman1 01/23/14 - 06:06 am
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Print the CON Methodology

"In fact, Doctors Hospital wrote in its proposal that “if CON rules, including its need methodology for additional hospital beds, had allowed, Doctors Hospital would already have a hospital in Columbia County.”

If we are going to discuss the CON methodology it would be helpful to list their guidelines instead of relying on what one of the hospitals claims. Why not print them? Or maybe no one actually knows what the guidelines are including whoever made the statement from Doctors?

rebellious
21295
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rebellious 01/23/14 - 08:13 am
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Just One More Step

towards Columbia County becoming a self sustaining, independent entity. To the East will be the scary, dilapidated remnants of a thriving city with nothing more than Manufacturing, a Military base, and a few additional necessities to support life in Columbia County. As needed, Columbia County residents will venture into this "garden" along wide, new thoroughfares, to harvest the essentials not already produced in their home county. Let them eat cake, they will say of the "Garden City" inhabitants.

seenitB4
90674
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seenitB4 01/23/14 - 08:35 am
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Smile Rebel

You can't stop progress & you know that....hospitals in Gwinnett didn't cause Atl to fall in...
I kinda feel the pain though because I cried for 3 days when I had to leave Augusta for biiig Atlanta Ga...Augusta needs a huge attraction, especially the south side, a big investment & some type entertainment center....the Regency Mall area would be a perfect spot. Horse racing would be ideal for that spot....so don't give up the ship just yet...we have a huge movie complex coming to our area near I-85 & Jimmy Carter, that could come your way too.

729
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Barry Paschal 01/23/14 - 11:11 am
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Response to Riverman

RM:
I serve on the committee and do not speak for the committee, but during our orientation I asked several specific questions about the ability of the hospitals to apply for a CON for a free-standing hospital without the involvement of the county or the need for the exceptions to the CON. The response from several people on the committee (some who do, in fact, have experience in the process) and from county officials is that because of existing bed counts in the surrounding area, no one would be able to get a CON for a hospital in Columbia County (they all said "never," but no one knows "never"). If you recall, several years ago MCG had to use Lincoln, McCormick and other nearby counties as examples of additional populations without hospital services in its application for a CON for just a free-standing medical center (which it later abandoned) - and even then, University and Doctors fought that scaled-down request as unjustified.

In short, the consensus is that if anyone could have received a CON for a hospital in Columbia County, they long ago would have pursued it. This process gives them the opportunity to bypass the restrictions that otherwise prevent it.

That's the limit of my comments. Again, I'm not speaking for the committee, and don't intend to provide further dialogue on the topic while the committee studies the proposals. But I thought it appropriate to address your specific question so you'd know it already had been considered. Thanks.

corgimom
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corgimom 01/23/14 - 12:40 pm
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I would've liked to see some

I would've liked to see some plain old ordinary citizens on the board, too.

corgimom
34004
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corgimom 01/23/14 - 12:42 pm
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2
Hey, what Rebellious said.

Hey, what Rebellious said. WORD.

whyme
1989
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whyme 01/23/14 - 01:21 pm
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what about us regular folks?

I too think that there should be some average residents on the committee-the ones who work regular paying jobs, who aren't totally clueless in case there is a question about their common sense in making such a big decision, but who will be looking out for the rest of the middle to low income residents in the county. You don't have to be a big executive or high-paid worker to know what is best for the county. Have a variety of incomes and education levels.

Sweet son
10729
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Sweet son 01/23/14 - 01:24 pm
3
0
If an exception or exclusion or whatever it is called is used to

justify a hospital then is it really needed? All three who have submitted bids are trying to get a 'cash cow' and nothing else.

Riverman1
86854
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Riverman1 01/23/14 - 03:25 pm
3
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Thanks Barry

Barry, I appreciate you being on the committee and reading what I had to say. I understand you not being able to go more into the matter. I'll try to answer your main points in a random order. I believe the nebulous criteria to receive a CON has been eased in the past few years. Expansions of existing facilities and other aspects now do not require a CON. Also, keep in mind a free standing ER has never been approved in the state. University said previously the reason they hadn't pursued a hospital was the economy without mention of a CON.

I have no preference for who is awarded the hospital, but I would hope the COUNTY gets the best deal without spending a fortune due to a misunderstanding. If, in fact, they all submit applications for a CON using the exceptions and one is awarded super...as long as it doesn't cost the county money. The county is certainly going to support all of them in their efforts to receive a CON, I would hope.

I think all three are fantastic institutions and we'll be happy with any of them.

Riverman1
86854
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Riverman1 01/23/14 - 03:22 pm
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Three Exceptions That Don't Cost County

Actually, all three hospitals can make applications and invoke the exceptions noted without the county contributing any funding. GRU of course is an existing trauma center and teaching hospital. Doctors says they will be a trauma center soon. University trains residents and can use that to justify a claim as a teaching hospital.

Riverman1
86854
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Riverman1 01/24/14 - 06:19 am
0
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Keep in Mind

"The response from several people on the committee (some who do, in fact, have experience in the process) and from county officials is that because of existing bed counts in the surrounding area, no one would be able to get a CON ..."

Barry, just keep in mind because someone has had some kind of involvement with a past CON (or claims such) that does not mean he (or they) is not under the same misconceptions that are floating around. There has not been an application for a hospital CON for Columbia County so I don't even know where these individuals would have been involved in the CON process for a hospital. Certainly not locally.

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