Tag Archives: health care

Scott County’s only hospital files notice of closing

Pioneer Health Services has notified the State of Tennessee that it could potentially close its Scott County hospital although local administrators remain hopeful that the worst-case scenario will not pan out, reports the Oneida Independent Herald.

The Magee, Miss.-based corporation filed its 30-day notice with the state last week, as required by law. Tony Taylor, CEO of Pioneer Community Hospital of Scott, said his managers learned of the development Tuesday morning.

…Taylor, who has been chief administrator at the local hospital since Pioneer opened the facility in 2012, said the notice is not a guarantee that the the hospital will close.

“This is just a way of them fulfilling their obligation of notice,” Taylor said. “After June 26, they could close the hospital, if they chose to do so.”

PHS is currently restructuring, two months after filing for Chapter 11 bankruptcy protection. As part of that bankruptcy filing, PHS closed its MedSurge program at the Scott County facility, ending inpatient services while keeping all outpatient services — including surgery, physical therapy and diagnostics, among others — along with its emergency room.

Reportedly, PHS has been willing to entertain offers to sell the Scott County hospital. It is not known whether the corporation has been able to attract potential suitors.

Taylor said Pioneer has put no timeline on the hospital’s future.

…If the hospital closed, ownership of the real estate would revert to Scott County. The county is currently in the midst of a 10-year contract with Pioneer that requires the facility — ownership of which was transferred to Pioneer in 2012 at no cost — to be operated as a hospital or be returned to the county.

However, that, too, could be complicated. First National Bank currently has a lien on the property after Pioneer borrowed $400,000 for improvements in 2015. The Internal Revenue Service has also filed a separate $500,000 tax lien on the property due to back taxes owed by the corporation.

Some reporting from HarwellCare task force, meeting 6

Excerpts from some reporting on the sixth meeting of House Speaker Beth Harwell’s “3-Star Healthy Project” task force, held Tuesday in Nashville and to be followed by at least one more session with federal health care officials:

WPLN says the group “seems to favor giving more support to clinics over offering poor Tennesseans government insurance through Medicaid.”

That’s somewhat encouraging to Mary Bufwack, the president and chief executive of United Neighborhood Health Services, a network of nonprofit clinics around Nashville that provide primary and OB/GYN care. Bufwack agrees getting low-income people in to see doctors would be a good thing, but who pays for what happens after that, when those doctors discover medical problems that need more treatment?

“Expanding primary health care actually sometimes uncovers and identifies problems that need more specialists,” Bufwack says. “My concern is we make sure the people have the access needed to specialty, hospital and other kinds of services that are absolutely vital.”

Plus, Bufwack says, Tennessee’s clinics are nowhere close to being big enough to handle the number of people who need coverage.

From The Tennessean:

The five lawmakers who attended Tuesday’s meeting — Sexton, Reps. Matthew Hill, R-Jonesborough; Roger Kane, R-Knoxville; Steve McManus, R-Cordova; and Karen Camper, D-Memphis — reached no conclusions, but a variety of government officials offered ideas to consider as the group moves forward.

During his presentation, Douglas Varney, commissioner of the Department of Mental Health and Substance Abuse Services, made a variety of recommendations to the group, including suggesting that providing primary care providers with more education on substance abuse can help address the needs of those struggling with the problem.

Beyond Varney, the task force also heard testimony from Raquel Hatter, commissioner of the Department of Human Services, and Valerie Nagoshiner, chief of staff for the Department of Health. Hatter fielded several questions about the various programs that provide temporary financial assistance to Tennesseans, while Nagoshiner focused her comments on a variety of health care safety nets the state has.

With significant talks about mental health and substance abuse throughout the day, Sexton ultimately concluded the issue probably would be included in the task force’s final recommendations.

“If we’re looking at starting at some point, I’d say there’s a good chance that we would be starting at the behavioral health side,” he said after the meeting.

From Nashville Post Politics:

In comments after the almost three-hour meeting, committee member Rep. Roger Kane (said) that whatever the task force comes up with won’t be a whitewashed version of Gov. Bill Haslam’s plan to expand insurance coverage.

“We’re not going to be able to get Insure Tennessee 2.0 through the House,” Kane said bluntly. When asked if legislators, once safely re-elected in November, might change their minds, Kane shook his head. “I’m going to say the answer is still no. It wasn’t an election year last year, and we couldn’t get it passed then.”

It remains unclear whether the task force created by House Speaker Beth Harwell to come up with a conservative alternative to Insure Tennessee actually has the wherewithal or the political capital to get anything done.

… Beyond an expansion of low-cost community health clinics, which task force chair Rep. Cameron Sexton has endorsed, nothing in today’s presentations indicated what other ideas might make it into an official proposal — although a few moments were revealing of the panel’s general lack of knowledge surrounding some of the issues.

On TN prison problems with hepatitis C

As initially reported by the Tennessean in the first of a series of articles, Only eight of the 3,487 inmates known to have hepatitis C in Tennessee prisons are receiving medicine that can cure the disease, caused by a virus that can lead to fatal liver damage. Nearly one in two inmates the state did test in 2015 showed signs of having hepatitis C.

On Monday, Rep. John Mark Windle, D-Livingston, whose district includes one of the state’s biggest prisons in Morgan County, held a news conference to declare the situation poses a danger to the public at large. Excerpt from WPLN’s report:

“Ninety percent of all inmates are released back into the general population,” he says. “And if you’ve got 10,000 people that have got hepatitis C that are going to re-enter the population, the chance for the spread of that disease is phenomenal. And we need to take steps to try to address that immediately.”

But Windle says that 10,000 figure is conjecture, because prison officials don’t know for sure exactly how many inmates are carrying hepatitis C. It’s based on a screening of 900 inmates, roughly half of whom came up positive for hepatitis C.

Prison officials do know that more than 3,000 have the disease, which is spread through dirty needles, tattoos and bodily fluids.

Windle would like the state to give every inmate blood tests for hepatitis C — or at least develop a protocol for figuring out those most at risk for the disease. For the good of the public as much as the good of prisoners.

“If the correctional officers and the counselors are subject to being in the same personal space as those inmates … it’s not uncommon to be subjected to bodily fluids, urine, feces tossed on them,” he says. “At the very minimum, we should provide a safe workplace.”

Wider testing would be expensive, Windle admits. And treatment for hepatitis C could cost more than $80,000 per patient. Prison officials have cited that price — as well as the high likelihood that inmates will contract the disease again after they’re cured — as major barriers to eradicating the disease.

But, says Windle, the cost to the state if the disease spreads beyond the prison walls would be far greater.

“I just think it’s time to address (what) may be an epidemic,” he says.

A spokeswoman for the Department of Correction responds that Tennessee prisons already have safety protocols in place to protect employees from exposure to hepatitis C.

She adds that testing positive for hepatitis C does not necessarily mean an inmate is carrying the virus because antibodies remain in the bloodstream even after they’ve recovered. She says doctors weigh factors such as virus type, the patient’s liver condition and other health conditions before determining treatment.

Former GOP leader/lobbyist leads new Insure TN promotional campaign

The Tennessee Hospital Association earlier this year formed a spinoff group – named Tennesseans for a Responsible Future — to promote Gov. Bill Haslam’s Insure Tennessee proposal, a Medicaid expansion move that failed in the 2015 legislative session. Now, the group has chosen Adam Nickas, a former political operative for the state Republican party and more recently a lobbyist, as executive director.

Here’s the press release from Tennesseans for a Responsible Future:
NASHVILLE, Tenn. – Today, Tennesseans for a Responsible Future (TRF) announced Adam Nickas as Executive Director. A Nashville resident and Memphis-area native, Nickas served as Executive Director of the Tennessee Republican Party during the 2012 election cycle and Political Director during the 2010 cycle. TRF was launched in January 2016 with the goal of promoting healthcare policies that benefit Tennesseans.
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Harwellcare task force meets in Memphis; ‘It’s for real’

As the third meeting of House Speaker Beth Harwell’s the task force charged with finding alternatives to Insure Tennessee began breaking up Monday in Memphis, reports the Commercial Appeal, Rep. Steve McManus took hold of the microphone to rebut citizens’ criticism that the panel is a farce.

“We’re for real, and we’re going to work for you,” said McManus, a Cordova Republican who sits on the task force.

Rep. Cameron Sexton, chairman of the “3-Star Healthy Project” task force and a Crossville Republican, said after the meeting — agreeing with McManus — that the goal wasn’t to completely scrap Gov. Bill Haslam’s Insure Tennessee plan, which failed to win legislative approval. Instead, the task force will re-evaluate it to see what parts, if any, the General Assembly can support.

“Insure didn’t have the votes,” he said. “We’re going to look to see if there’s a different approach.”

Summing up his takeaways from the meeting, Sexton said the task force — which includes Rep. Karen Camper, D-Memphis — could try to ease restrictions on faith-based health care organizations like the Church Health Center, which connects patients with volunteer doctors for a flat $35 fee.

Dr. Scott Morris, CEO of Church Health Center, told the task force that state law should be changed to allow citizens to claim health care coverage to satisfy the requirements of the Affordable Care Act and avoid costly fines for being uninsured.

Harwellcare task force talks ‘circuit breakers’

Members of a health care task force assigned with proposing alternatives to Republican Gov. Bill Haslam’s Insure Tennessee plan on Tuesday stressed their desire to include “circuit breakers” to prevent out-of-control costs, reports the Times-Free Press.

The panel was appointed by Republican House Speaker Beth Harwell of Nashville earlier this month to design the plan expanding access to health coverage to present to the federal government this summer.

State Democratic Party Chairwoman Mary Mancini criticized the panel as a “political show” to give Republicans cover for voting last year to reject Haslam’s plan to extend coverage to 280,000 low-income people in the state.

…The panel was joined Tuesday by Republican Sen. Richard Briggs of Knoxville, who voted in favor of Insure Tennessee last year, and Democratic Rep. Karen Camper of Memphis.

Rep. Matthew Hill, R-Jonesborough, said he was concerned that the governor’s proposal wouldn’t have allowed for the program to pause and take stock of growing enrollment.

Hill said his preference would be to “roll it out in phases, keep in measurable and most important keep it measureable, with circuit-breakers and stuff, so that we can keep control.”

“Instead of, ‘Plop, here’s the 280,000 to 300,000 people, and good luck,'” he said.

Further, from The Tennessean:
Outgoing TennCare Director Darin Gordon and his successor, Dr. Wendy Long, provided lawmakers with a crash course on the state’s health care system. Continue reading

Harwell to study health care via task force; Democrats howl

By Erik Schelzig, Associated Press
NASHVILLE, Tenn. — Republican House Speaker Beth Harwell on Tuesday touted a new initiative to improve health care access in the state, but Democrats quickly derided it as an election-year “charade” to deflect criticism of lawmakers who rejected the governor’s Insure Tennessee proposal.

Harwell said she began talking with health policy experts at Vanderbilt University’s medical school to come up with alternatives last year after lawmakers rejected Republican Gov. Bill Haslam’s proposal to extend health coverage to 280,000 low-income Tennesseans.

Harwell, R-Nashville, has dubbed her initiative the “3-Star Healthy Project,” and said it will tap conservative ideas like encouraging greater responsibility for enrollees; create health savings accounts funded by co-payments; and provide more support for people trying to rejoin the workforce.

She is a creating task force to propose ways to improve access to health care in Tennessee. Harwell said the four Republican House members she has appointed to the task force will work to come up with a specific proposal to make to the federal government as early as June, though the plan could require lawmaker approval next year.

Democrats called the announcement an attempt to give Republicans political cover for rejecting Insure Tennessee.

“This is simply designed to give the false impression that the House Republican leadership is willing to do anything about health care,” said House Democratic Caucus Chairman Mike Stewart of Nashville. “It’s clearly not. This is a charade, it’s an effort to delay, and to not simply pass Gov. Haslam’s Insure Tennessee plan.

“It’s pathetic,” Stewart said.
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Legislature approves bill to let therapists shun patients

By Erik Schelzig and Sheila Burke, Associated Press
NASHVILLE, Tenn. — A Tennessee bill that would allow mental health therapists to turn away patients based on the counselors’ religious beliefs and personal principles passed Monday and is on its way to the governor.

The American Counseling Association said Tennessee would be the only state to allow counselors to refuse to treat patients if the bill is signed into law. The organization called the measure an “unprecedented attack” on its profession.

The measure is part of a wave of legislation across the country that opponents say legalizes discrimination against lesbian, gay, bisexual and transgender people. Supporters say it takes into account the rights of everyone.

In February, the Senate passed the bill that could allow counselors to turn away patients based on “sincerely held religious beliefs.” Last week the House passed a version that would allow therapists to turn away patients based on the “sincerely held principles of the counselor or therapist.”

The measure will not allow therapists to turn away people who are in imminent danger of harming themselves or others.

On Monday, the Senate agreed to the change that dropped religious beliefs and instead added the broader language of “principles.”
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State questions merger of Northeast TN hospital chains

The state Department of Health is questioning plans for the merger of Mountain States Health Alliance and Wellmont Health System in Northeast Tennessee, reports the Johnson City Press.

The department is asking the systems for more information about such issues as finances, public impact, competition and workforce consequences. In a letter dated March 28 and posted Thursday on the department’s website, Commissioner John J. Dreyzehner cited several deficiencies in the joint COPA (certificate of public advantage) application, including the lack of a separation plan in the event of failure.

“The department’s requirement for a plan of separation is to specifically ensure that if a COPA is issued and the New Health System (as defined in the application) fails to live up to the promised commitments and understanding reached by the department and the parties, the department may terminate the COPA and require a clear plan of action to return the parties to a pre-consolidation state,” Dreyzehner wrote. “The minimal framework presented in the application does not provide the level of detail necessary to meet the department’s requirement to outline a clear, actionable plan to separate a merged entity.”

On Feb. 16, the leaders of the nonprofit health organizations submitted thousands of pages of documents to state regulators asking for a COPA from Tennessee and a letter authorizing a cooperative agreement from Virginia. The applications kicked off a review process in both states — at least 120 days in Tennessee and 150 in Virginia — giving the health officials time to ponder the proposals before making final determinations, which the systems hope will be made in their favor this fall.

Asked for comment regarding the COPA letter, Mountain States and Wellmont issued a joint statement saying ongoing dialogue with both Virginia and Tennessee is an expected and welcome part of the application review process.

…Should regulatory approval be granted, the merged system would operate 19 hospitals, dominating the inpatient care system locally, and is expected to to reach $2 billion in annual revenues in two years, according to a budget included in the applications.

Deal cut on revising CON process, but not not repealing it

A negotiated deal has been reached on changing the Tennessee’s “certificate of need” (CON) program, which requires health care facilities to get a state agency’s approval before major expansions, reports the Commercial Appeal. This comes with a growing movement to completely repeal the CON program and abolish the oversight agency, the Health Services and Development Agency.

The deal is laid out in an amendment to Senate Bill 1842/House Bill 1730, a “caption bill” sponsored by Sen. Todd Gardenhire, R-Chattanooga, and Rep. Cameron Sexton, R-Crossville, with a goal, they say, of modernizing the process to give providers more flexibility and to make the system more “free-market oriented.”

The script calls for approval in health committees of both the House and Senate on Wednesday.

Its major provisions include:

Retaining the CON program and the HSDA but reducing the kinds of services, facilities and expansions that are subject to its provisions. CON approval would continue to be required, for example, for entirely new hospitals and for outpatient diagnostic centers statewide.

Allowing hospitals to add up to 10 percent of the beds they are currently licensed for, by specific categories, every three years without CONs.

Repealing the current requirement for a CON for any hospital modification or expansion project costing at least $5 million. Abolishing the $5 million threshold would let hospitals modify or expand non-health care areas regardless of the cost without HSDA approval.

Repealing the current requirement for a CON for the acquisition of major medical equipment exceeding $2 million, so most high-priced major equipment purchases would no longer require state approval.