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Erlanger council discusses Certificate of Need; majority votes to ask legislature to consider reform

By Patricia A. Scheyer
NKyTribune reporter

Erlanger’s council meeting room was full to overflowing for their council meeting this week, where council members voted to support a resolution about the Certificate of Need for medical facilities with a vote of 6-3.

That item on the agenda which caused the crowd of people was a resolution that urges state legislators to discuss legislation that would reform the requirements of the Certificate of Need for health institutions.

Garren Colvin, President and CEO of St. Elizabeth Healthcare (Photos by Patricia Scheyer/NKyTribune)

When a medical facility wants to locate in any area in Kentucky, they have to go through the Cabinet for Health and Family Services, and a Judge makes a decision on whether or not the facility will get the Certificate of Need that allows them to locate in the area they want to go.

Many of the people who attended were employees of St Elizabeth, or former employees, while others came from Erlanger, and surrounding cities to voice dissenting opinions.

Garren Colvin, President and CEO of St Elizabeth Healthcare, was the first speaker, and he praised the services offered by St Elizabeth hospital. He also told the audience and council that there have been a total of 28 Certificates of Need submitted in the last ten years, and 27 of those were approved by the state. The one that he said was denied was the ambulatory surgery center in Ft Mitchell requested by Christ Hospital. He denied that St Elizabeth has a monopoly. He said St Elizabeth is a safety net hospital, and they take any and all patients, regardless of their ability to pay.

“In the last three years health care costs have risen 8 percent per year,” he explained, comparing it to food costs, which have also risen, but he said store owners have been able to raise their prices to compensate for their price hike. “Because 70 percent of our businesses are (controlled by the government), we don’t have the ability to pass that on. We do not have the ability to recoup losses.”

Erlanger Mayor Fette reminded everyone that the resolution was to support reform, not to eliminate or repeal.

He stated that without a certificate of need, people could come into Northern Kentucky from across the river, or across the country, and since St Elizabeth has to take everyone, the newcomers could come in and build surgery centers, cherry-picking the services, and taking all of the paying customers, leaving the hospital with only the Medicaid patients, a move that would impact the profitability of the hospital. Currently 20 to 23 percent of St Elizabeth’s patients are Medicaid patients.

But some people aren’t happy with the hospital and would like a choice.

Carol Dwyer, a resident of Florence, told about her mom, who was sick, but her doctor wasn’t doing anything to make her better. She started accompanying her mom to the appointments, and demanding tests because her mother wasn’t getting better.

After a diagnosis of cancer, the doctor sent her to St Elizabeth for a paracentesis, which is draining excess fluid off the abdomen, Dwyer was told her mother’s white count had doubled, but they had done the procedure and were sending her mom home. Dwyer said her mom was almost unresponsive and looked seriously ill. Instead of taking her home, Dwyer took her mom to Christ Hospital, where she was immediately admitted with septic shock. Dwyer said she almost died, had it not been for her proactive actions.

“I had to drive her 30 minutes in rush hour traffic, to get there,” she said. “That’s why I need another hospital in Northern Kentucky that I can trust.”

Boone County Commissioner Chet Hand

Every statement inspired a round of applause, statements for St Elizabeth received applause from one faction of people and statements in favor of eliminating the Certificate of need encouraged applause and cheers from another faction of audience.

Bill Woodside told about how he had to go to the emergency room and was there for 5 1/2 hours. He does not believe the number he heard that only 6 percent of people need health care.

“Two weeks ago tomorrow I sat in the waiting room at the emergency room at St Elizabeth for hours, and hours and hours, and hours,” he said. “And once I got admitted to the emergency area, they wheeled me back and there were people on guerneys in the hallways. Now I know St.E. has just spent billions of dollars building a new heart center. Maybe they ought to expand the ER. The quality of care has been good, but the service. I heard the term “highest quality health care” a little while ago. I don’t know that I can agree with that. I didn’t receive the highest quality health care sitting in the emergency room for 5 1/2 hours.”

He turned to councilmember Tom Cahill, who works at St Elizabeth and said he should recuse himself from the vote.

“Competition is good!” he stated. “Obviously we need competition. Competition makes you sharp.”

There were definitely more people who had success stories from St Elizabeth than people who were advocating supporting the elimination of the Certificate of Need.

At one point, Erlanger Mayor Jessica Fette had to clarify that the resolution did not eliminate or repeal the Certificate of Need, it merely supported discussion to reform the legislation.

Someone intimated that the push to eliminate was initiated by a group in Boone County.

Chet Hand, a Boone County commissioner, was present, as was another commissioner, Cathy Flaig.

“Coincidentally I was informed by a constituent here tonight who works for St.E. that they were told to be here, (but since they (the constituent) support the CON repeal, they did not show up,” Hand explained. “This is about medical choice, healthy competition, and government’s role in health care. The government should stay out of medical care as much as possible. This is what monopolies are able to do, force behavior because there is no competition. This is not anti-St Elizabeth, but the fact that they see it this way makes it clear that they know they have a monopoly on services in Northern Kentucky. I urge you to take the side of repealing the Certificate of Need.”

Congressman Steve Doan got up to speak. He was one of the sponsors of the bill that was presented at the General Assembly and he thanked council for dealing with this statewide issue. He also thanked St Elizabeth for their committment to the community, and their willingness to work with the state legislature.

“The Certificate of Need came about from federal legislation in 1974. That legislation was later repealed in the 1980’s as a result of health care costs rising throughout the nation. and many states have repealed that. Garren Colvin has already agreed with House and Senate leadership to look at modernizing the Certificate of Need., For me, I’s like to take an incremental step if we can.”

Many more people spoke about St Elizabeth, relating how the hospital not only provides excellent services, but how they take supportive roles in the community, promoting healthy ways of living to discourage sickness from beginning.

Most of those speakers pointed out that people have choices, and that having a hospital like St Elizabeth in the community does not in any way discourage choice.

Then it was up to council.

Jennifer Jasper Lucas acknowledged that she received very many messages from people, but many of the messages asked her to vote no, and she thought the reasons were based in power and
control, and not because of quality and outcomes. She stated that she did not want the government to be in charge of her healthcare, and she believed that competition in health care is positive.

Tom Cahill repeated the praise of the hospita, and added that people with private insurance have always been able to choose what hospital they want to go to. He said he is employed at St Elizabeth, but he was going to vote as a member of the community and council.

Vicki Kyle announced that she is one of St Elizabeth’s success stories, since she had a heart valve transplant. But she thinks Colvin and other St Elizabeth administrators should help the legislature reform the CON certificate, and she is happy that they have agreed to do just that, to improve healthcare and promote choice.

Diana Niceley agreed with Kyle, saying everyone has choices in life and why wouldn’t people have choices in healthcare.

Tyson Hermes changed the title of the resolution to make sure everyone was not confused about what they were voting for.

A vote was held, and six members voted for reform of the Certificate of Need, Hermes, Nicely, Kyle, Jasper-Lucas, Renee Wilson, and Rebecca Reckers. Three members voted against the resolution to reform the CON: Cahill, Don Skidmore and Renee Skidmore.

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