Homer Alaska - Business

Story last updated at 5:43 PM on Wednesday, January 25, 2012

Central peninsula residents testify in favor of, against surgery center



By Brian Smith
Morris News Service - Alaska


 

Photo by M. Scott Moon, Morris News Service-Alaska

Henry Krull, one of the eight area doctors who formed Kahtnu Ventures, presents the group's case for a surgical center in Kenai before Alaska Department of Health and Social Services officials at the beginning of a Jan. 19 meeting. A standing room-only crowd at the Challenger Learning Center in Kenai presented testimony both supporting and opposing the proposed center during the meeting.

A standing room-only crowd weighed in last Thursday on Kahtnu Venture's proposal to build a surgical center in Kenai before Alaska Department of Health and Social Services officials.

Karen Lawfer, state certificate of need coordinator, said about 35 testimonies were gathered from the crowd that filled the Challenger Learning Center in Kenai.

Residents testified both in favor and against Kahtnu's proposal to build the 8,365-square-foot building at an estimated cost of $9 million.

Central Peninsula Hospital is fighting the surgery center idea on the grounds that it would take away one of the more profitable service lines it offers, thus damaging its less profitable areas and the hospital overall.

Kahtnu is heralding the proposal as a choice for health care consumers that would lower the cost of outpatient surgeries and prevent medical out-migration to Anchorage.

So many people attended the meeting that a number of others were turned away at the door because the building was at capacity.

Clam Gulch resident Joann Odd said she had to pay someone to drive her the 45 minutes from her home to Kenai, but was angered when she was turned away at the door.

"I was met at the door along with a number of other people and (someone) said, 'You can't come in,'" she said. "I said, 'What?'"

"They had such a turnout last night that they should have moved it next door to the auditorium because everybody was being turned away and this was like 15 minutes after 5 p.m."

Odd said she wanted the state to schedule another meeting so she and the many others turned away could speak to the issue.

Lawfer offered an apology to those who weren't able to testify.

"I had no idea there were going to be that many people there and that was going to happen," she said. "I can tell you that it has never happened in the past."

However, there won't be another public comment meeting scheduled, she said.

"No, I can't have another meeting because I literally am at the end of the comment period, we basically shut everything down and do a thorough review of the application," she said. "I can't get another public meeting set up, but people still have a chance to give me comments."

Among those residents that got in the building and spoke was Steve Doneth who supported Kahtnu's request.

"Free enterprise — these gentlemen want to spend their money, that's their right," Doneth said. "It is called America."

Doneth explained the state should be "continually" looking for economic growth.

"So just get out of their way," he said. "It is so simple. Let them build the building."

Jane Madison said she was against the proposal for a number of reasons.

"I have been totally impressed with Central Peninsula Hospital," she said. "I love the hospital ... and I want it to be successful and grow. It is by far one of the best hospitals in the nation. I do not want to see any entity establish any business that either unnecessarily duplicates hospital services or steals patients and personnel away. The Kahtnu center does both."

Many residents encouraged CPH officials and the eight local surgeons representing Kahtnu to collaborate.

"The hospital and Kahtnu somehow, some way need to work together because we are a small enough community that this shouldn't be a political race or an argument," said Leslie Marcon. "Everyone should work together for the patients. We are a small place and we all need everything."

John Parker agreed, citing economic and population concerns.

"That's what I see we are facing with our hospital — it is growing, they have always done a very good job, but I support the Kahtnu center not because we need an alternative but an addition," he said. "I would encourage CPH to work with the surgery center and make it a part of our whole community."

Linda Duce echoed a similar sentiment, but added that "despite the fear of change" she was leaning more toward Kahtnu's proposal.

"It should be noted as it relates to the potential bleeding off of revenue that Kahtnu did invite CPH to participate at the outset and were declined," she said. "As our population changes, and that should read also as we age, there are things that are needed ... these eight surgeons ... can do something to impact outpatient surgeries and costs and the needs of the community."

Charlotte Micheltree addressed issues of out-migration. She said she knows a number of peninsula residents that have recently had surgeries.

"Guess what? We all went out of the area for whatever reason," she said.

Micheltree held a sign at her feet reading, "Please, give me a local choice ..."

"The only thing that I am arguing is that when they are saying, 'Oh there is not that many people leaving the area to get medical help,'" she said. "I still go to Anchorage to get quite a few things. I think there is room for both here. They keep bringing in all these new doctors, but where are we going to put them?"

Both the Kenai and Soldotna city councils heard from Kahtnu and CPH officials during their respective meetings last week. One took action against the center and one remained neutral on the subject.

At last week's meeting, Kenai Mayor Pat Porter spoke to state officials about the city's consideration of Kahtnu's proposal.

"Originally when all of this began I was told it was not a political process so I chose not to bring a resolution to the city council of Kenai and to allow the certificate of need to be shown on the merits of whether it was needed or not, and not become a political issue," Porter said. "But obviously it has."

Porter then spoke in favor of the center, but clarified she was speaking as an individual and not as the mayor of Kenai.

The Soldotna City Council hosted a special meeting Jan. 18 and passed a resolution opposing the certificate of need for Kahtnu's proposal, Mayor Peter Micciche said.

"No one opposed the proposal, the council simply took the opportunity outlined in the certificate of need process to discuss the potential effects on the city and on Soldotna taxpayers and whether or not there was a need for an additional operating room," he said, adding there is no "ill will" to those involved with Kahtnu.

The vote was 4-2 in favor of the resolution, which states the surgery center would "duplicate already available health care facilities and would jeopardize community health planning that has been conducted by the Kenai Peninsula Borough and CPH for over 40 years."

"I think something that is really important is that this is a service area issue, it is not a Soldotna-Kenai issue," Micciche said.

Added Micciche, "In my view, and apparently the view of the council, this is protecting our taxpayers who work very hard to keep tax burden down in Soldotna and we fear this could increase taxes to continue providing those services in the future."

Kahtnu takes action against

CPH's 4th operating room

Details also emerged last week of a new development in the consideration of Kahtnu Venture's proposal.

Stephen Rose, an attorney with the Seattle-based law firm Garvey Schubert Barer, confirmed Kahtnu is seeking an injunction against the Department of Health and Social Services, with CPH listed as a party.

The group of eight surgeons is taking issue with the development and completion of CPH's fourth operating room, which has become a point of consideration surrounding whether Kahtnu's proposal is needed in the area.

"Kahtnu Ventures brought an action seeking an injunction against the Department of Health and Social Services asking to address the opinion that Karen Lawfer issued stating that the hospital did not need a certificate of need to build the fourth operating room," Rose said. "After we filed that action for an injunction, I spoke with the attorney representing the (state) department and it was her suggestion that since this was something that impacted the hospital that we bring (them) in as a party."

Rose said Kahtnu has questions about whether all of the costs to build CPH's operating room were included in the state's determination. They would like an independent voice to determine if the decision was indeed correct.

"We have filed an appeal of that decision and that we have sufficient time to have an independent judge hear our case and render a decision," Rose said. "If we lose on that administrative appeal then so be it. But, we would like to have someone non-biased review her decision."

CPH Chief Executive Officer Rick Davis explained the hospital originally obtained a CON for four surgery rooms when it started an expansion project several years ago, but never completed the fourth room, which was scheduled to become available in May. Davis said the cost of the OR was below the minimum to require a CON.

"It just begs the question of why they think it makes more sense to build a $9 million OR than the $900,000 OR when they are willing to sue us in order to make that happen," he said.

"This is just a delay thing for them to try and get their CON approved with only using (our three surgery rooms in the calculation)," Davis said. "Ultimately we will get our fourth OR built, but they're just trying to delay it."

cutline Photo by M. Scott Moon, Morris News Service Alaska Jane Madison, right, presents testimony Jan. 19 against a proposed ambulatory surgery center for Kenai during a meeting held by the Alaska Department of Health and Social Services at the Challenger Center of Alaska in Kenai.

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