Mayor Embarks on 273 mile walk to Washington DC

Eastern North Carolina Reporter Jonathan Rowe on Mayor Adam O'Neal's decision to walk 273 miles to Washington DC in the name of accessible emergency healthcare for his town and his region.

BELHAVEN — Belhaven Mayor Adam O’Neal announced he will walk to Washington, D.C., continuing his fight to save Pungo District Hospital.

O’Neal announced his plan to fight back against the closing of the hospital at Monday’s Beaufort County Commissioners meeting. Vidant Health closed the hospital on July 1 despite federal mediation between Vidant, the NC NAACP and the town. The mediation by the U.S. Department of Justice was in the effort to transfer the hospital from Vidant to the town.

At the meeting, O’Neal and Poole and Associates representative Dr. Norris Gunby, who is also an associate professor at the University of North Carolina-Chapel Hill, went before the commissioners and presented what they say is a feasible plan to reopen and operate the hospital. Poole and Associates is a consulting team aiding the NC NAACP and the Town of Belhaven in coming up with a plan to run the hospital. In response, the commissioners allocated $25,000 to aid in the fight, O’Neal said. [READ MORE]

From SaveOurHospital.org Official Press Release 

Republican Mayor to Begin 273-Mile Walk to DC to Ask Obama, Congress to Help Save Rural Hospital

NAACP’s Rev. Dr. William Barber to say prayer, join community in walking first leg,
GOP Mayor Emerges as National Voice for Medicaid Expansion 

(Washington, DC) On Monday the Republican Mayor of Belhaven, NC will begin a 14-day, 273-mile walk to the White House where he will ask for President Obama’s help with a healthcare crisis that has already caused loss of life, and threatened the well being of thousands in his rural community.

When Vidant Health, Inc. purchased, and announced the closure of Pungo District Hospital, Mayor Adam O’Neal emerged as a fiery advocate for the hospital, and the 23K people who depend on it. Thousands in his region must now travel as many as 84 miles to receive critical care. O’Neal and others believe the hospital was closed on July 1, 2014 in violation of the 1964 Civil Rights Act.

The mayor will carry with him the story Portia Gibbs, 48, the first person to die for lack of emergency care since the hospital’s closing. Her husband and her children will be there on Monday at 9 a.m. to see the mayor off.

Moral Monday leader Rev. Dr. William Barber will say a prayer to bless the mayor’s journey, and join him for the ceremonial first leg on Monday in Belhaven (also on Tuesday in Plymouth, NC, Barber’s home town).  [READ MORE]

 

 

Hyde County Death: Hurtful statements add to family's heartache



Just a few days after the death of Portia Gibbs, 48, her husband, Barry, and her children Justin and Ashely shared with us that they were wounded by two assertions that had reached them about Portia's death. They said that these assertions may have originated with Hyde County emergency management officials. 

Annabel-and-Barry-sm.jpgMr. Gibbs said he believes that the assertions were made to protect, or curry favor with Vidant Health, Inc — a corporation that donated $250,000 to Hyde County's emergency services after purchasing and then closing the only hospital within 90 miles for many of its residents. Belhaven, North Carolina's hospital had been closed at 12:01 am on July 2, 2014. Portia died on July 7.

When her heart began to fail, Portia was 75 miles from the nearest hospital, and, it seems clear that the decision to call for a helicopter rather that transport her by land was a direct result of the fact that Belhaven's hospital, which is 28 miles closer, had shut its doors.

Portia's husband, Barry, age 60, asked me if I knew if any of these statements were true. I said that I would find out. I spoke with Jared Holz, who literally "wrote the book" on policy and procedure for Hyde County Emergency Medical Service (he provided me the excerpt below). Holz is the former Emergency Services Director for Hyde County, and has 25 years of experience as a paramedic and as an emergency services supervisor, manager, and director in cities and towns up and down the eastern seaboard. Holz prefaced his remarks by relating that his statements are all based on second-hand understanding of the incident.

Is it true that if a person is brought to the EMT unconscious, they are not allowed to move them? 

Holz: No. It is every EMT’s responsibility to assess, treat, and if necessary transport any patient to the best of their ability based on their training. The only time you limit movement of a patient is in the case of trauma. But even then you take a life over limb approach to patient treatment. If this statement was made by an EMT or Paramedic in an EMS system, I would be greatly disappointed.

Is it true that an ambulance is equipped with all the same life-saving tools as an emergency room?

Holz: Any emergency room anywhere is better equipped than an ambulance to save a person's life. An ALS or Paramedic level ambulance has some of the same medications found in the ER for treating many medical or traumatic emergencies, but not all of them. And it goes without saying that an ambulance doesn’t have the diagnostic equipment available in an emergency room such as X-Ray, CT scan, or Ultrasound, to name a few. An ambulance is also limited by the number of personnel, their level of training, and their comfort with acting on any particular issue.

By far, the assertion that bothered the Gibbs family the most was the one they characterized as, "She would have died anyway," meaning the closing of Belhaven's hospital did not impact Portia's chance of survival. 

I have met the person to whom they attribute this statement. He struck me as an earnest young man who would never intentionally say something to hurt anyone, let alone neighbors and friends who have just suffered a tragic loss. If it is true that he said these words, I'm sure he meant them not for the Gibbs family, but for the public. It is likely he said this, not necessarily to defend Vidant Health's decision to close the hospital, but to prevent this tragedy from being framed in a political manner.

That said, when I shared with Mr. Holz what had been reportedly asserted, he was outraged. He said he would be extremely shocked to learn that such a statement came from anyone with experience in emergency services. He said the person who made this mistake has a lack of understanding of an EMS system. 

Holz said that, based on what he has heard of the incident, Portia's life could likely only have been saved by definitive treatment in a Catheterization Lab (a specialized room with diagnostic imaging equipment that can visualize the arteries and chambers of the heart and allow for some advanced procedures) or in an operating room with a cardiothoracic surgeon. The Belhaven hospital's emergency room did not have either of those available. Thus, its role in saving Portia's life would have been to stabilize her and/or to serve as a relay point from an ambulance to helicopter which would have taken her on to Vidant's hospital in Greenville, NC (another 60 miles away).

"If Pungo Hospital were open, I would have immediately started transporting the patient to the hospital and done everything that I could en route," Holz said. "If the helicopter was able to meet me before I reached the hospital, or meet me on the helicopter pad in Belhaven, I would have transferred her to the helicopter."  

READ MORE about why the hospital was closed

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Based on my account, Holz said of Portia Gibbs, "It sounds like she had a medical emergency that resulted in a cardiac arrest. There is no magic formula for fixing that. I've been on an ambulance talking to patients when they went into cardiac arrest, some lived and some didn't, and all of them were treated with the same procedures.” 

But during our conversation, Holz kept returning to the assertion that Portia would have died with or without Belhaven's hospital. He said:

To say a person would have died anyway is probably one of the most egregious statements you can make. What you need to be able to say, "We did everything we could and were unable to save her." It sounds like the EMT’s and Paramedics that were treating Mrs. Gibbs did everything right. It sounds like they did everything within their power and that they used all of the available treatment options. In our profession, we need to know that we did everything we could. In addition, for the friends and the family who either witnessed what happened or hear about it later; they need to know that we did whatever we could. That's part of the psychological healing process in death. Telling someone "they would have died anyway" is incredibly hurtful.

After our conversation, Holz emailed me a page from the Hyde County Emergency Medical Service Policy that he authored before leaving Hyde County. He pointed out that the very first scenario under which a patient SHOULD be transferred to an emergency room is loss of consciousness, the opposite of what Mr. Gibbs had been told:

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Vidant Health & Pantego Creek, LLC have closed Belhaven's Hospital, for now

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In late March, Vidant Health agreed to a settlement brokered by the U.S. Department of Justice in response to a Civil Rights Act (Title 6) complaint filed by the North Carolina NAACP. The settlement would have allowed the hospital in Belhaven, NC to remain open, but that settlement is now in doubt, and the hospital's doors are locked. Story of America was filming when employees of Vidant Health began covering the emergency room signs at 12:04 am, July 1, 2014.

The Title 6 complaint charged that the closing of the Vidant Pungo Hospital would disproportionately impact minorities and the poor. The Justice Department agreed, and this settlement was the result of 4 day-long meetings spread over a week and a half. During this time, Vidant Health drew up papers to transfer the hospital to Pantego Creek, LLC (PCLCC) — a "watch dog" organization Vidant had established when it purchased the hospital. This contract, which Story of America obtained during the second day of mediation, was an intense curiosity, defused when Vidant Health announced that the contract was never executed. But it looms large now, in light of Pantego Creek, LLC's June 16 announcement that it would block the mediated settlement that Vidant Health had agreed to, and, that the hospital would close on July 1.
Pantego Creek, LLC was created by Vidant Health in order to be the other side of a negotiation that purchased the hospital. PCLCC was designated the seller of the hospital after it absorbed another organization that had owned the hospital prior to this purchase. We are still unclear as to why Pantego Creek, LLC needed to be created before this deal was negotiated and signed. We do know that the contract stipulated that Vidant Health — then known as University Health Systems (UHS) would pay $50,000 to provide PCLCC with start-up and operating costs. 

When Vidant announced it would close the hospital 18 months later, there was speculation that PCLCC would object, given that the contract promised to keep the hospital open. But on February 25, 2014, PCLCC decided not to hold Vidant responsible, accepted that the hospital must be closed, and proclaimed that doing so would not be a breach of contract.

Facility-is-Closed-SoA-sm.jpgThe mediated settlement had chosen July 1 as the handover date. The team of lawyers and specialists assembled by the town of Belhaven had asked Vidant Health for 6 to 8 more weeks due to fundraising obstacles — for instance, Vidant Health had agreed to turn over the hospital's financial assets and $1 million to the new hospital management team, but had not done so. Rather than responding to this request, which the Department of Justice supported, Vidant Health allowed Pantego Creek, LLC to speak for them. The answer was no. Suddenly, public scrutiny on PCLCC intensified, whereas before Vidant Health was seen as the dominant power seeking the hospital's closure, one with a controlling influence over the LLC. 

Officially, Vidant Health's executives claimed to be surprised when PCLLC's attorney, Arey Grady III, announced in a letter sent to the town and to the NC NAACP that the mediated settlement would not go forward. However, one Vidant board member, Jay "Rocky" Jacobs, told Story of America that the February 25, 2014 vote by the LLC, which preceded the mediated settlement by a month, had ensured that the deal would not go through.

Jacobs, who is also a member of PCLCC, said that the only "surprise" to him was the timing of the announcement, which came just a few weeks before the hospital transfer had been scheduled to take place. By this time, nearly two hundred thousand dollars, and nearly three months of effort, had been spent racing to prepare for the July 1 transfer. Now, July 1 was shaping up to be a tragedy for the people of Belhaven, when it had been anticipated as a day of rejoicing.

The North Carolina NAACP responded by reopening the Title 6 Complaint under the Civil Rights Act of 1964. At a June 27 press conference, North Carolina NAACP attorney Alan McSurely explained his legal argument. "We feel that if the Department of Justice knew what we know about this situation, they would open up an investigation," he said afterward. 

The complaint asked for injunctive relief to prevent the closure of Pungo District Hospital, stating that a permanent closure would have a disproportionate impact on poor people and minorities. The complaint also asked for an investigation into the relationship between Vidant Health and Pantego Creek, LLC.  The Department of Justice said that there was not enough time to investigate whether an injunction was warranted, but that an investigation would take place.  In addition, the DoJ invited Vidant Health to return to mediation, and this time invited Pantego Creek, LLC.  The town of Belhaven, led by Mayor Adam O'Neal, continues to plan for, and raise funds for the reopening of the hospital.  On MSNBC's The Last Word with Lawrence O'Donnell, O'Neal asked for donations to a crowd-funding page created by Dr. Poole. 

https://www.youtube.com/watch?v=57EUVKEc0qQ&index=10&list=PL-3rkJCyh1bqL2T_W8db7aYRouoa6_vT1

Update:  We have just received a report that the Department of Justice is in possession of a documents that show Vidant Health President Robert Robertson offered back-office assistance to the four Pantego Creek, LLC managers, and requested amendments to the above-mentioned Transfer Agreement (we are unclear as to whether it was ever executed) in an April 4, 2014 letter that also copies PCLCC attorney Arey Grady, III. 

 

Tough Questions for Vidant

On June 18, 2014 in Hyde County, NC — which is one of the largest counties in the state and has no hospital at all — concerned citizens gathered to hear a presentation by Vidant Health CEO Dr. David Herman.  It had been only 2 days since the surprise announcement by Pantego Creek, LLC that the DoJ-mediated settlement would not go through, and that the hospital thus be closing on July 1. This would leave many residents in Hyde County 90 to 100 miles from emergency health services. In this video, Dr. Herman has just finished giving a presentation that outlines why it is so difficult to make a profit in the health care industry while still offering basic medical services in rural areas. 
Story of America decided to release this audio recording when Vidant Health released this statement, which we consider to be inaccurate:
The recording took place moments after Dr. Herman's presentation and contentious Q&A at the Swan Quarter, NC court house on June 18, 2014. We believe that Arthur H. Keeney, III — who, like Jay "Rocky" Jacobs is both a Vidant board member and a member of Pantego Creek, LLC — was being truthful when he told us that Vidant Health — then University Health Systems (UHC) — paid for the start-up costs of Pantego Creek, LLC. Keeney also says that there was no election to choose the Managers of the LLC, and that he believes that Jacobs appointed them. 
...Vidant Health was not involved in the establishment of the LLC, its membership, or its board. We are not involved its choice for independent legal counsel, nor do we pay for it.
We believe that Keeney's words, and the statement issued by Vidant Health on the day of the hospital's closing cannot both be true. We decided to correct the record because we feel it is in the public interest. 

Mayor Adam O'Neal's response

Here is Mayor O'Neal's response to the current situation, filmed earlier in the week at the Belhaven Town Council meeting:

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Lawrenceville, VA Rejects Immigrant Children as Diseased and Criminal

This was one of the most disturbing nights of filming I have experienced in America since Oct. 16, 2007 in Prince William County, VA (when, after 12 hours of heated public testimony, the Board of County Supervisors voted to fund a law requiring police to check immigration status based on a "probable cause" standard dangerously close to mandatory racial profiling).

On the day after the Lawrenceville incident, I was interviewed on MSNBC to report on what I had witnessed.

Prior to going on the air, I wrote this in an email to 9500 Liberty & Story of America co-director Annabel Park and Police Chief Charlie Deane (ret.) of Prince William County, VA:

I filmed the entire town hall event last night. I met the Sheriff and gave him two copies of the film. I also gave a copy of the film to the Mayor-elect and a county supervisor. The story in Lawrenceville is a lot more complex than "look how racist people can be" and also more complex than "country folk just hate the federal government" although I saw a lot of that too.

It seems that the administrator of the now-defunct college down there signed an agreement with the federal government to house these unaccompanied minors on the campus, without informing the local elected officials or the People. They have a right to be upset about the lack of transparency. I only counted 2 people who stood up to defend the idea of helping these young people in 3 and 1/2 hours (but I did step out for a while with 1 camera rolling).

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Republicans, NAACP join forces to prevent 'medical desert' in coastal NC

NOTE: Vidant Health declined to be interviewed for this web series, and declined our offer to submit a statement on this issue.

In September 2013, Vidant Health, a system of hospitals serving 29 counties in eastern North Carolina, that it would be closing the Vidant Pungo Hospital in Belhaven, NC, which they had purchased less than years earlier. Vidant has announced plans to close the hospital on April 1st and demolish the building. It plans to build a new 24-hour clinic that can turn away people without insurance, and does not offer emergency care.

save-our-hospital-sm.jpgThe closest hospital with emergency care would be Vidant Beaufort Hospital in Washington, NC which is located 30 miles (on two-lane rural roads) away from Vidant Pungo Hospital. In life-threatening emergencies such as car accidents or strokes, adding 30 miles can have fatal consequence. From the eastern side of Hyde County which is currently served by Vidant Pungo Hospital, it is a 90 mile drive to Vidant Beaufort Hospital.

When Vidant Health bought the community hospital which opened in 1948 from Pantego Creek, LLC, it signed a contract promising that the hospital would remain open, and that Vidant would improve services. Instead, Vidant stripped out equipment, beds, and services that had brought in revenue for the hospital, and added on the salary of a six-figure executive who visited the hospital only once a week.

At the time of the purchase, Pungo Hospital was losing 1 million dollars a year. Hospitals designated by the government as Critical Access Hospitals are not designed to make money, but rather to ensure that people in rural areas have access to emergency and preventative healthcare. Knowing that patients would be forced to travel to another hospital Vidant had recently purchased, it seemed like a common sense move to consolidate the two operations. If neighboring Hyde County — one of the largest in counties in North Carolina — had a hospital of its own, perhaps that argument could have been made. But forcing people who already travel 60 miles for emergency care to now travel 90 miles is not only bad for human life, it may also be bad business.

Vidant claims that it could not make the Pungo Hospital viable due to the building's deteriorated state and the lack of revenue. This assessment is fiercely disputed by Dr. Charles Boyette, the hospital's former chief of staff, former mayor and town physician and Mayor Adam O'Neal among others.

Oneal_Barber_still_sm.jpgMayor O'Neal believes that Vidant Health never intended to improve the management of Vidant Pungo Hospital to make it more efficient and had planned to close it down from the outset, shifting patients now served by Pungo Hospital to Vidant's larger hospitals in Washington and Greenville. Because Vidant owns all the hospitals in the area, O'Neal believes that Vidant knows that people will have to go to one of their hospitals anyway and closing one would reduce the cost of maintaining the facilities.

According to Vidant Health and heath care advocates, the NC General Assembly's decision to reject Medicaid expansion made it much more difficult for this hospital — and others in states that rejected federal dollars for Medicaid expansion — to operate without losing money. Under the Affordable Care Act, adjustments were made to the way in which Medicaid reimbursements are paid, with the expansion of Medicaid factored into that equation. Thus, states that refuse to accept this funding and allow its residents health insurance are doing more damage to struggling hospitals than they realize.

NAACP and U.S. Department of Justice step in

March 15, 2014: The U.S. Dept. of Justice has offered mediation to Vidant Health and the North Carolina NAACP to resolve a Title 6 complaint under the Civil Rights Act of 1964. Vidant Pungo Hospital in Belhaven, NC, which serves 23K people in Beaufort and Hyde counties, was purchased by Vidant Health two years ago under a contractual agreement stipulating that Vidant would keep the hospital open and expand services.

Six months ago, Vidant announced it would be closing the hospital instead, forcing patients to travel an additional 30 miles to another hospital recently purchased by Vidant, in Washington, NC.

Rev. Dr. William Barber, president of the North Carolina NAACP, has travelled to Belhaven, NC three times this year to join in local efforts to prevent the hospital's closing. In part 2 of our video series, and, in more detail in here, Rev. Barber explains the complaint. 

NAACP attorney Al McSurely said, "We have reason to believe that there will be talks between both sides to see whether an agreement can be made to slow up the decision to tear the hospital down until after the community can negotiate a better outcome, with the government's help."

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