Back room dealing: Commissioners consider UHS deal in secret | Eastern North Carolina Now

     Publisher's Note: We do very much appreciate this fine article on the BRHS debacle from our friends at the Beaufort Observer. It is the opinion of this publisher that their continued, complete reporting and analysis of this controversial issue is unparalleled in scope.

    Do little or no negotiating with UHS reps in public, but meet in secret for over two hours

    The Beaufort County Board of Commissioners met Wednesday (1-26-11) at Beaufort Community College for the purpose of reviewing the recommendation from the Beaufort Health System Board of Commissioners to enter into an affiliation with University Health Systems (UHS) in Greenville. All members of the Commission were present. Also present was a bevy of lawyers, and representatives from UHS and about 50 citizens who sat and waited for over two hours.

    Immediately after convening, Commissioner Chair Jerry Langley called on County Manager Paul Spruill to explain the plans for the meetings. Spruill indicated that there would be two closed sessions. The first he indicated would be for the purpose of conferring with the Commissioner's attorneys and the second would be under a separate exclusion of the Open Meetings law to discuss "confidential health care contract information."

    The Beaufort Observer and the County Compass formally objected to the closed sessions and asked the Commissioners to preserve the record of what was discussed in closed session by recording the discussions, to allow the discussions to be released to the public after the purpose of the closed session had been satisfied. The Commissioners then voted unanimously to enter closed session without response or further discussion.

    Approximately 50 people sat in the auditorium while the board exited to an anteroom to meet in secret.

    They first met with their attorneys and then came back out into open session only to vote to return to closed session to meet with UHS representatives. After another hour they came back out and held a Q&A session in which the County Manager reviewed a list of questions that had been distributed to the participants and audience.

    Click here to download the questions.

    The videos below depict UHS's response to the questions. The acoustics are not ideal in the room but hopefully you will be able to get the tone of the meeting if not all of the details.



    The second video is simply a continuation of the first:



    Each question is responded to, mostly by Chief Growth and Development Officer Kathy Barger. Her responses were generally rather abstract and she went into relatively very little specific detail. There were, however, no give and take negotiations in the open session, indicating to us that either that was done in the closed session or not at all. Nonetheless, the commissioners appeared to be satisfied with the responses. There were few follow-up questions from any of the commissioners except on the issue of what Beaufort might expect in terms of UHS maintaining the facility during the term of the lease, indigent care and appointing the governing board. Other than that, the UHS responses were acceptable if judged by the silence of the commissioners.

    Not once did we hear UHS say "no," "that's not acceptable" or "we cannot agree to that" in response to any of the questions, written or verbal.

    The entire Q&A played out in just 30 minutes, while the backroom dealing went on for more than two hours.

    Thus, what may be more significant than what was said in the Q&A is what was not said and the questions that were not discussed so the public could hear them. Only one brief mention was made of the buyout provision at the end of the lease and there was no discussion about that. But it appeared that this issue had been discussed in the closed session and that there was no change in UHS's position that they will have unilateral rights to purchase the property for $10 million. There were no questions or discussion in the public session about precisely what properties would be included in a $10 million purchase or other details such as how much notice would be given to exercise the option to purchase.

    But in response to Question #1 UHS did say that if they exercise the option to purchase at the end of the lease that the purchase would be contingent on them continuing to operate the hospital as a hospital after the buyout. There had been some concern that they may build a new facility and turn the current facility back over to the county, but their response appeared to say that they would not do that.

    On the issue of insuring that the Certificate of Need would forever remain within the county UHS seemed to indicate that they would agree to that.

    Commissioner Ed Booth was concerned about indigent care. To the #3 question and to Mr. Booth's questions, UHS responded that they have a policy of and commitment to "community benefit" and they comply with the law not to turn any patients away because of inability to pay. Their website indicates that they contributed more than $125 million last year to unreimbursed Medicaid and other need-based programs, charity care, and other community benefits and programs.

    The Observer has been told by reliable sources that this issue (indigent care) is related to the Agape Health Clinic and that Agape has been seeking to be included in the deal so as to receive benefits either from the upfront cash settlement or from UHS. No commissioner would comment for the record on that however and UHS skirted the issue.

    On the issue of guaranteeing that the Aurora Clinic or something comparable to it would continue to be maintained near Potash Corp., the response was affirmative, but without specificity. We'll leave it to you to interpret that response from listening to the video.

    There was much less specificity on the issue of whether the UHS Foundation would assist with the construction of an Allied Health Building at Beaufort Community College. They indicated that in other communities the UHS Foundation had assisted those communities in developing their own foundations to support such projects in the community.

    They however were much more specific in agreeing to continue to provide "Medical Control" (#8) for the EMS system in the county.

    Another major issue that was addressed in more detail than most of the questions was on the issue of governance. UHS made it very clear that Beaufort would be included in an advisory committee but that this committee only makes recommendations to the governing board. It was made rather clear that Beaufort would not be assured of a seat on the UHS governing board and they seemed to be referring also to yet another governing board of East Carolina Heath Systems but this was not made clear. What was clear was that Beaufort will be assured of nothing more than making recommendations.

    These videos of the responses are the rough edits so we would suggest you check back after we have had an opportunity to edit the video to improve the sound quality.

    At the end of the meeting it was announced that no vote would be taken before a public hearing is held February 9 at 6:30 p.m. with the place to be announced. There was no indication about the process for developing, or when, a draft of the agreement might be made available for public review. Clearly, given the vagueness of many of the UHS answers the written agreement with the details will be significant in assessing the proposal.