BY ANDY TAYLOR
INDEPENDENCE — Healthcare coverage is now wide open for the Independence community after Independence city commissioners, in an agonizing 90 minute meeting on Friday, rejected a plan by a Tulsa-based health system to assume some of Mercy Hospital’s services in 2016.
The 2-1 decision to reject a three-year plan by St. John Health System was followed by the commission’s unanimous decision to open negotiations with interested medical providers — including Wilson County Medical Center in Neodesha, Neosho Regional Medical Center in Chanute, Coffeyville Regional Medical Center, Labette Health in Parsons and even St. John Health System — to open an urgent care or emergency department in Independence.
However, commissioners admitted that prospects would be slim that St. John Health System would be willing to entertain another proposal for Independence healthcare coverage.
Commissioners also emphasized they are fighting the clock because Mercy Hospital has previously indicated it would cease all clinics and services in Independence by Dec. 31. Mercy Hospital officials in early September indicated they would negotiate solely with St. John Health System, which owns Jane Phillips Medical Center in Bartlesville, for an assumption of Mercy’s clinics and related services in 2016. This would include the Cancer Center of Kansas, the Mercy Pharmacy, the Mercy Health For Life, and primary care clinics in Independence and Cherryvale. At the time Mercy made its announcement, the city commission voted to negotiate with Mercy and St. John Health System with the City’s offer of $3 million as an economic development incentive thrust into the mix.
It’s not yet known how Mercy will respond to the city commission’s decision or if the Missouri-based Catholic charity will stay firm with its timeline to close remaining services by the end of the year. A call to a Mercy spokesperson was not returned by the time of this posting on Friday afternoon.
Friday’s special city commission meeting was the first time the commission was able to publicly discuss any aspect of the negotiations between the commission, Mercy and St. John. Commissioners did reveal some details of those negotiations, including:
• Mercy Hospital dictated the conditions of the negotiations, including the provision that Mercy negotiate with only one party, which was St. John Health System.
• Mercy dictated that the negotiations be held confidentially. Discussions at city commission meetings were held in executive session, which are closed to the public and press.
The city commission picked a healthcare negotiation committee to handle those discussions not only with St. John but in previous discussions between Mercy and Coffeyville Regional Medical Center (the Mercy-CRMC talks broke off in early September, which caused Mercy to announce it would close its hospital and emergency department in October). Those committee members included city manager Micky Webb, city commissioner Fred Meier, city attorney Jeff Chubb and Mercy Hospital board chairman Jim Kelly.
• St. John, which operates primary care clinics in Coffeyville and Caney, offered to assume some of Mercy’s medical services in 2016, including operation of primary care clinics, Mercy Health for Life, the Mercy Pharmacy, and the Cancer Center of Kansas. St. John Health System also planned to operate an expanded urgent care but not an emergency department in the short term. A long-term vision, but not a contractual obligation, called for creation of an emergency department.
• St. John’s proposal was on a three-year term. The corporation asked the City of Independence to guarantee the company’s profit by assuming an annual loss of no more than $750,000 each year for three years. That would mean St. John would receive $2,250,000 in taxpayer funds over a three-year period. It was not known if St. John would accept the $3 million economic development offer and apply it to that yearly profit guarantee or if it would have been in addition to the $2,250,000 it was seeking.
While St. John was in discussions with Mercy and the City of Independence, Labette Health of Parsons also presented a preliminary proposal to the City of Independence to establish an emergency department in Independence. No action was taken on the Labette Health proposal.
Labette Health already operates an urgent care center in Independence and has offices for its visiting physicians from Parsons. Labette Health also operates a primary care clinic in Cherryvale.
However, Friday’s meeting was not held to decide the better of two different proposals. Because the city commission had previously announced it would negotiate a healthcare plan for the community, the meeting was held to decide solely whether to accept or reject the St. John plan.
For Commissioner Gary Hogsett, who voted against the St. John proposal, the question of whether to accept Oklahoma-based charity’s proposal was an issue of fairness. He said St. John made an unacceptable proposal by requiring city taxpayers to pay $750,000 per year for three years to guarantee its profits. He reminded audience members and fellow commissioners and city staff that St. John Health System is owned by Ascension, which is the world’s largest Catholic medical charity.
“I cannot vote to allow taxpayers to cover the losses for a billion dollar corporation,” said Hogsett.
Hogsett said he understands that most business ventures go through losses in their first years of operation. However, he said other local medical providers have not stretched out their hands to seek taxpayers’ money. He cited several medical providers, including a local dentist, chiropractor, a family practice physician, and an optometrist who dispense healthcare without asking for a single penny from city coffers.
Mayor Leonhard Caflisch, who joined Hogsett in rejecting the St. John plan, said he had concerns with the lack of local input in the St. John plan and in the negotiations in general. He said St. John, by virtue of being owned by a non-profit corporation that is based in St. Louis, Mo., would likely not include the concerns of local citizens in its operations in Independence. He said he felt the future needs of the Independence community would best be handled by an organization that allows for local decision making.
“The decisions of St. John will be made by Ascension,” said Caflisch. “I feel this is a matter where we as a community need to control our destiny. I don’t see that in the St. John proposal.”
Casting the lone vote in favor of the St. John plan was Commissioner Fred Meier, who was on the city’s negotiation team. Meier said the St. John proposal would have provided the community with basic medical services while also assuming some of the services that Mercy patients and customers have been accustomed to using, such as the Mercy Pharmacy and the Mercy Health for Life.
However, Meier said that he, too, had problems with St. John’s requirement that the City of Independence write off the company’s losses by contributing up to $750,000 each for three years.
The fact that a major medical provider like St. John sees a need to get public dollars into the mix only verifies that the future healthcare choices for the community will be dictated by the need for taxpayer money, Meier said.
“To be honest, healthcare in Independence will not be cheap,” he said. “For us to have quality healthcare, we are going to have to spend money.”
Following the commission’s rejection of the St. John plan, commissioners entered into a lengthy discussion about how to proceed. All three commissioners had separate visions. Meier proposed that the commission adopt the proposal put forward by Labette Health at a special meeting last week. However, Hogsett said he was not willing to address the Labette Health proposal without fully studying the proposal. He also said he believed the commission should avail themselves to other medical providers who have expressed an interest in the Independence market.
“I think we need to look at our neighbors and get them involved in the process,” said Hogsett.
Hogsett said Coffeyville Regional Medical Center had reached out to him in recent weeks about the possibility of healthcare coverage for Independence. Wilson Medical Center in Neodesha also has made a similar inquiry, and Labette Health has made a proposal to the commission at a previous meeting.
Meanwhile, Caflisch said he was looking for a medical provider that could bring an emergency department, which is one of the priorities set forth by the commission when Mercy Hospital announced its closure plans in early September. He also said he believed opening talks with other medical providers would free the City of the constraints that Mercy Hospital had placed on the negotiations with a sole provider (St. John Health System), which Mercy Hospital picked because of its Catholic affiliation.
In the end, Hogsett and Caflisch were adamant that future discussions involve area medical providers. Meier expressed reluctance in the process, saying it could take considerable time to make a decision when reviewing the proposals.
“Voting in favor of this is going against my better judgment . . . but I feel we are a team,” he said.
Commissioners directed city staff to notify St. John of the vote to reject their plan and also extend an opening to area medical providers to discuss healthcare plans for Independence.
Prior to the commission’s discussions and votes, they heard concerns from several Independence residents. Many of the residents spoke of the need to continue the Cancer Center of Kansas, which is located in a Mercy facility.
Other residents spoke of the need to have public input in the discussions.
Brian Williams, Labette Health chief executive officer, also spoke briefly about the Parsons-based hospital and its plans for Independence.
After the meeting, Williams said that as part of the Labette Health proposal, Labette Health would guarantee a placement of an Independence resident on its governance board to assure local input in its decisions.
No persons from St. John Health System or Jane Phillips Medical Center in Bartlesville spoke at Friday’s meeting.