Council denies grant for Chesapeake clinic
By Jon Hawley
Wednesday, January 30, 2019
City Council sent a message to Chesapeake Regional Healthcare Monday night: you can compete with Sentara Albemarle Medical Center in Elizabeth City, but we won't help you do it.
By a 5-4 vote, council opposed seeking a $70,000 state grant to help Chesapeake open a new convenient care clinic off Halstead Boulevard Extended. Councilors opposed the grant after hearing from doctors both for and against the clinic, which potentially could draw patients away from Sentara Albemarle Medical Center and its affiliated practices.
Councilors Gabriel Adkins, Darius Horton, Anita Hummer and Johnnie Walton opposed seeking the grant, voting for Adkins’ motion to not apply for it. Councilors Jeannie Young, Billy Caudle, Rickey King and Kem Spence voted no on Adkins’ motion, in effect saying the city should seek the grant.
Mayor Bettie Parker cast what she thought was a tie-breaking vote against seeking the grant, voting “no” on Adkins’ motion. It was only at the end of Monday’s meeting, when city staff raised the issue, that Parker clarified that she opposes seeking the grant, and that she had meant to vote “yes” on the motion.
Despite council’s decision on the grant, Chesapeake Regional Healthcare plans to move forward with its proposed convenient care clinic at 1805 W. City Drive, spokeswoman Tricia Hardy said Tuesday.
Chesapeake Regional unveiled plans for the clinic earlier this month, proposing to improve a facility where it already operates a sleep center and advanced wound care practice, to offer primary care, outpatient X-ray, and other services. The new facility would serve walk-in patients.
The Virginia-based health system is proposing to spend a minimum of $874,000 on the clinic, but also asked the city of Elizabeth City to sponsor its request for a Building Reuse grant for $70,000 from the N.C. Department of Commerce. The $70,000 grant would require Chesapeake Regional to create seven jobs; it also would require the city pay a local match of 5 percent, which would equate to $3,500.
Hardy said the grant would have helped the “small, independent organization” offset construction costs of its proposed clinic, and noted the grant reflected its goal to provide health care to under-served populations. She also said Chesapeake Regional Healthcare would serve indigent patients at the clinic, and that “self-care and indigent care” account for 8 percent of Chesapeake’s patients at Internal Medicine of Elizabeth City.
During a public hearing council held prior to its vote on the grant, local physicians — some favoring the grant, some opposed — weighed in on Chesapeake Regional’s proposal.
The first to speak, Dr. Rob Powell said he's retired and works for neither Chesapeake Regional nor Sentara. He urged council to support the new clinic.
“I think competition is good for the consumer in health care, just like in anything else,” Powell said. He also claimed, “Sentara does not want any providers working in this area unless they work for Sentara,” and claimed Sentara had driven away doctors, including some now practicing locally under Chesapeake.
Dr. Lynn Butler, of Chesapeake Regional’s Internal Medicine practice on North Road Street, supported the grant as well. The city has a shortage of doctors, and “Chesapeake is looking to help fill the gap,” she said.
Dr. Tony Ruiz, of Chesapeake Regional’s Carolina Surgical Care and Breast Center in Elizabeth City, also supported the grant. He said there are fewer primary care providers in the area than when he started, and argued both systems would help keep doctors in the area to serve patients.
Addressing concerns about Chesapeake Regional competing with Sentara Albemarle Medical Center, Ruiz countered that Chesapeake is a much smaller system than Sentara. He also noted Chesapeake Regional Medical Center is surrounded by major Sentara facilities, including Sentara Norfolk General, Sentara Leigh, and Sentara Princess Anne hospitals.
“I was going to say Sentara's the 500-pound gorilla in the room, but it's a million-pound gorilla in the room,” he said.
Speaking in opposition to Chesapeake’s clinic was Dr. Lindsay Stevenson, of Sentara Obstetrics and Gynecology Specialists.
“I think it's in the best interest of patients that you stay the course with Sentara,” he said.
To arguments about competition, Stevenson argued Sentara Healthcare showed it was best for the community when it won the lease for what's now Sentara Albemarle Medical Center in 2014.
Stevenson also said Sentara has heavily invested in improving local health care — to the tune of $50 million-plus. He claimed Chesapeake would harm access while driving patients away from the community. When patients need more than what Chesapeake can provide in Elizabeth City, they'll get sent to Chesapeake, he said.
He also claimed Chesapeake Regional would not “see the same patients I see,” meaning it would avoid low-income, uninsured patients.
Sentara Albemarle President Coleen Santa Ana attended Monday's meeting, but did not address council. She did address the clinic in a letter to Caudle, however.
In the letter, Santa Ana did not explicitly say she opposes the grant to Chesapeake Regional, but asked the city ensure Chesapeake’s clinic treats indigent patients. Her letter also drew attention to a 2017 vote of the Chesapeake City Council to deny Sentara's request to add a service for the Edinburgh community, and a zoning code limiting competition with Chesapeake Regional.
Following the doctors' comments, Adkins and Horton claimed council should not undermine Sentara Ablemarle by supporting a competing health system.
“As councilors, I personally feel it would be a smack in the face of Sentara, who has come to our community, to invest this money, and then to support an entity that, in my opinion, would be some sort of 'patch center,'” Horton said.
Horton also said that, because Chesapeake Regional Healthcare has said it intends to open the clinic regardless of the grant, he saw no need for the city to commit local dollars to the project.
Claiming Elizabeth City is a “Sentara-based city,” Adkins made his motion to deny the grant application.
Offering her support for Sentara, Hummer said the system is constantly investing in the community to offer services patients used to have to drive to Virginia for.
Walton said he saw both sides of the issue, and asked if the council could hear from both systems' CEOs about the issue. Horton said he would oppose the grant regardless of that, however.
In favor of the grant, Young and Caudle agreed that competition, and more providers, would benefit the community.
Caudle also said Elizabeth City only has one urgent care clinic — independent of either system — which is heavily used and sometimes has long wait times. Residents would benefit from another, similar clinic such as what Chesapeake Regional Healthcare is proposing, he said.
“I don't see why we would want to limit access of our citizens to health care,” he said.
King, who also serves on the city-county Economic Development Commission, supported the clinic for bringing money and jobs to the community.
Spence said the city should be willing to help Sentara seek a similar grant. Olson said Sentara has not sought a Building Reuse grant, which is for re-purposing vacant facilities, but the city would be happy to help if it does so.
Parker reiterated her concern about competition with Sentara Albemarle, which she praised for serving low-income city residents.
“I'm a Sentara person, I'll tell you that right now, because they do serve the indigent,” Parker said.
However, she also said she had spoken with Chesapeake Regional CEO Reese Jackson by phone, and he offered her assurances the health care system would seek to serve indigent patients and hire locally.
As councilors looked to her to cast a tie-breaking vote, she asked if someone would move to table the matter until Jackson provided those assurances in writing. No councilor did so; it would have been out of order to make that motion while the vote was pending on another motion, based on the city's rules of procedure and an opinion on Robert's Rules of Order from UNC-School of Government Professor Trey Allen.
With no councilor offering a motion to table, Parker voted “no” on the Adkins' motion, but later clarified she meant to oppose the grant.