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2020-09-28 Special Meeting NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 SPECIAL MEETING, SEPTEMBER 28, 2020 PAGE 475 ASSEMBLY The New Hanover County Board of Commissioners met for a Special Meeting on Monday, September 28, 2020, at 5:00 p.m. in the Assembly Room of the New Hanover County Courthouse, 24 North Third Street, Wilmington, North Carolina. Members present: Chair Julia Olson-Boseman; Vice-Chair Patricia Kusek; Commissioner Jonathan Barfield, Jr.; Commissioner Woody White; and Commissioner Rob Zapple. Staff present: County Manager Chris Coudriet; County Attorney Wanda M. Copley; and Clerk to the Board Kymberleigh G. Crowell. PUBLIC HEARING TO RECEIVE COMMUNITY INPUT Chair Olson-Boseman opened the public hearing stating the public hearing is being recorded and streamed live on the County’s Facebook page, NHCTV.com, and on NHCTV’s cable stations: Spectrum channel 13 and Charter channel 5. Each person will be able to speak for three minutes and will be able to see their time on the screens up front and the monitor at the podium. Speakers are asked to be courteous and end comments at three minutes. Several names will be called up at a time, and speakers will need to line up in order behind the podium. Please keep six feet of space between each speaker. Speakers were asked speak specifically about one or all of the following:  The Asset Purchase Agreement between New Hanover County, New Hanover Regional Medical Center (NHRMC), and Novant Health that was made public on September 18, 2020 and is available online at NHRMCfuture.org;  The use of net proceeds, to include the draft bylaws for a community foundation; and  The termination of the lease between the County and New Hanover Regional Medical Center, which would occur at closing if the agreement is approved, because properties and facilities being leased would be sold by the County – making the lease no longer relevant. Chair Olson-Boseman further stated that this is the third public hearing the Board has held throughout this exploration process; the first was in October, the second in June, and the third today. The Board continues to seek feedback and comments on this important topic for the community. There will be no vote by the Board during this meeting. The Board plans to consider and vote on this matter, after hearing comments from the public and receiving recommendations from the Partnership Advisory Group and NHRMC Board of Trustees this coming week, at the th October 5 meeting, which will begin at 4:00 p.m. in this same room. This public hearing is being held by the Board of Commissioners, but members of the NHRMC Board of Trustees and Partnership Advisory Group are here tonight and are also watching live to help inform and guide their continued in-depth conversations and ultimate recommendations to this Board. She thanked the Partnership Advisory Group for its continued work to review and research this opportunity, educate and engage the community, and provide the best recommendation for healthcare in this community, now and for the future. The members’ dedication to the process has been incredible and all are grateful for their work. For those who could not attend in person, there was also an opportunity offered to submit written comments by 6:00 p.m. yesterday through the public comments email. 16 written comments were received, and those have been shared with the Board of Commissioners and will be incorporated into the official meeting record by the Clerk to the Board. She asked that speakers state their name and address for the public record. Barb Biehner, Partnership Advisory Group (PAG) Co-Chair, resident of Buckeye Drive, stated she was excited to be present as a Co-Chair of the PAG and to be making progress with the overall process that the Board has asked the PAG to do. On behalf of the PAG, she thanked everyone who has been involved in sharing questions, offering opinions, and asking for consideration of different things throughout the process. The members have been listening and asking questions, looking over emails and reading every opinion and every opposition, to see what else they might need to think about. They also met with groups that wanted to talk about the options and learn more. In regard to Commissioner Barfield’s comments at a prior meeting on the members making sure to go out and meet with groups of people, that is what they have been doing and have met with a lot of groups in the past year. PAG members participated in more than 23 meetings and forums with various civic and interest groups. They have also had countless conversations with friends, family, coworkers, in grocery stores, and many other places they have had the opportunity to talk about this and are delighted to do it. Many people, like many in the PAG group, were skeptical that the sale of the well loved and respected local healthcare system could be the best thing for it and for all of us. Through the sessions and ongoing feedback, it all helped the PAG to consider all perspectives and to be sure it was addressing all of the concerns. It is hard to imagine any question that has not been asked and answered through the many months of discussion. It has been an enlightening process that led all 21 members of the PAG to recommend the partnership with Novant Health, UNC Health, and UNC School of Medicine that is now before us as a final agreement. This recommendation has been supported by the NHRMC Board of Trustees, Pender Memorial Hospital Board of Trustees, and the leadership of New Hanover Regional Medical Staff. The PAG was pleased last week to learn that 72% of the 1,000 area residents surveyed agreed that the sale will have a positive impact on the community. PAG members are here with the community tonight to listen once more. The PAG looks forward to hearing the views of the partnership and what it can mean for all. From the letter of intent (LOI) to the request for proposal (RFP) and from the definitive agreement to the asset purchase agreement (APA), the PAG’s journey is almost done and it is ready to deliver to the Board. Dr. Joseph Pino, PAG Vice Co-Chair, resident of Godfrey Way, stated he has had the privilege over the past year to serve as one of the Vice Co-Chairs for the PAG. He did not know exactly what he was signing up for but in the end, he has learned a tremendous amount. Over the last year, through the many meetings, hundreds of hours, and thousands of pages of documents, the PAG has learned so much through this process. It was able to identify from the six respondents, three that would have been terrific fits and in the end, Novant Health, UNC Health, and UNC School of Medicine made the most sense and is the best fit. The APA that has been put forward is a very detailed NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 SPECIAL MEETING, SEPTEMBER 28, 2020 PAGE 476 agreement with over 160 pages. It outlines the future possibilities for New Hanover County and our region. When he takes a step back and thinks about where the Board was a year ago, making a decision of whether to move forward or not, then courageously saying “let's evaluate further and get more information,” he knows it was not an easy decision. He thinks in the end what we have here today is an opportunity of a lifetime that brings forth the opportunity to transform our healthcare system much faster than could ever be done independently. Moreover, with the opportunity to develop a foundation that will eclipse many others across the state and nation, it will fast forward this community and region to provide services that certainly could not be provided without it. Over the last several weeks, Commissioner Barfield asked for many members to go out and beat the band, listen, and speak to people. The PAG members have done so. Over the last week, the PAG opened it up for community and regional physicians and gave them the opportunity to ask questions. In the end, he thinks all have come to the same conclusion. He thinks this is the best fit in moving forward. The Board has courageously stepped forward to say “let us look at what are the options,” and he does beseech the Board to courageously make that next step and vote to move forward with the APA, the partnership that stands before us. He expressed his appreciation to the Board, the public, and for the opportunity to serve on the PAG. Spence Broadhurst, PAG Co-Chair, stated as one of the Co-Chairs, he thanked the Board for the opportunity to be involved, to lead, and be a part of the process. It has been an honor and he would like to thank the other 20 members of the PAG for their dedication. The Board appointed, himself probably excluded, one of the most outstanding groups of citizens that could lead the process and he thanked and congratulated the Board for it. He would like to also thank the Board, as Dr. Pino stated, for having the vision and the wisdom and in a lot of cases, the backbone, to ask these serious questions at this time. They needed to be asked and he knows it was difficult, so he congratulates the Board for having that vision, and the interaction that the Board has had over the last year has proven that everybody is working towards the best thing for this community. He encourages and supports this and certainly encourages the Board to support this, but also encourages the community to come together to think about what we can do together moving forward, what we can do in healthcare, what we can do to solve health equity, what we can do to solve what we call health deserts, what we really can do as a community with Novant, UNC as a partner, and with the proposed community foundation that can really cure some ills that we all know need to be dealt with. In summary, he thanked the Board for this opportunity. David Long, resident of Poplar Branches Close (Belville, NC), stated he is an employee at NHRMC where he serves in spiritual care. When reading the book, It's Not Just Another Monday, by President and CEO Carl Armato, he was reminded of two key points. Communication is essential and is essential to a strong strategy and this day, Monday, September 28th, is not just another Monday. Not at all. It is such a very important day in that today each of the Commissioners will hear feedback and comments on the proposed partnership of NHRMC with Novant Health. He asked the Board to hear his feedback and hear him when he says how very much he supports the partnership and how much he supports the greatness and opportunity that will result from it. Novant Health is guided by a mission of improving the health of the community one person at a time. The UNC Health system is guided by a mission to improve the health of North Carolinians by providing leadership and excellence, and NHRMC's mission statement is “leading our community to outstanding health.” Growing up in the small town of Mount Airy, North Carolina, his family and he came to appreciate the presence that Novant Health brought in across the foothills of North Carolina. As a volunteer EMT with South Orange and Madison Rescue in Chapel Hill, he got to experience firsthand the greatness of the emergency department of UNC Hospital’s care for patients on a routine basis. In his tenure at NHRMC spanning over 19 years, it has given him a strong understanding of the outstanding work NHRMC does every day to lead the community to outstanding health. These three health systems are each so very strong. However, they and we would be so very, very strong together. In the words of the PAG, the combined commitment would enable our healthcare system to better meet the needs of our population and make a real difference in the quality of life here. We would be better together. Imagine the possibilities and consider the opportunities that this partnership would allow. More affordable healthcare options, more services that are convenient and accessible, and most importantly, more opportunities to live life to the fullest. He asked the Commissioners to please vote in favor of the partnership at its next meeting, another important Monday, on October 5th. Dr. Pam Oliver, Executive Vice President and President of the Novant Physician Health Network, resident of Plaza Boulevard (Winston-Salem, NC), stated it is her honor to be present at this meeting. She is excited about this partnership for many reasons. She was born and raised in eastern North Carolina, and she is passionate about the health and well-being of this part of the state. She knows firsthand the problems with access to quality, affordable healthcare that plagues our communities. As a practicing physician, she is an advocate for health equity and she knows what the partnership between Novant Health and NHRMC will mean for the residents of New Hanover County and other surrounding communities. Together, they will address barriers to care like access. By significantly expanding specialty care, they can meet people where they live and work. Novant Health will ensure that NHRMC has access to the resources needed to maintain and improve its facilities and serve the fast growing population in this region. The benefits of the partnership between Novant Health and NHRMC will further be increased by Novant Health's collaboration with UNC Health and UNC School of Medicine. As a graduate of UNC-Chapel Hill and UNC School of Medicine, she is very excited about Novant’s connection with UNC. The partnership means expanded access to pediatric specialty care right here in the community, so families do not have to travel out of town to get the quality care that they deserve. It means the community will have access to clinical trials and research programs, but it also means significantly expanding the medical education program currently offered at NHRMC. Novant Health already benefits from the UNC School of Medicine program that educates students in New Hanover County as it employs several physicians trained through that program at the Novant Health Brunswick Medical Center. Through Novant’s partnership with NHRMC and UNC School of Medicine, they will significantly invest in and expand this program in order to ensure that the region receives the best possible care. Finally, she is excited for NHRMC because as a leader of Novant Health, she can say that Novant stands by its promises. Its promise to improve the health of New Hanover County and the surrounding communities will not waiver. As a physician, it excites her to see the care NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 SPECIAL MEETING, SEPTEMBER 28, 2020 PAGE 477 all will bring to patients together. As a native eastern North Carolinian, it excites her to see care in rural communities improving. This is a transformative opportunity and she asks for the Board’s support of the partnership. Shelbourn Stevens, President and Chief Operating Officer of Novant Brunswick, resident of Weatherly Lane (Bolivia, NC), stated he has seen Novant Health relentlessly pursue its mission to improve the health of the community by expanding access to quality and affordable care for those in the rural community and supporting the growth of the economy through job expansion. When Brunswick Community Hospital joined Novant Health in 2006, the facility was older, outdated, and not well-maintained. Novant Health followed through on its promise to improve the quality of patient care by investing $107 million in a new facility. Brunswick Medical Center (BMC) offers the most cutting edge technology available in a community hospital of BMC’s size as well as new and expanded services. Novant Health has tripled the physician staff and services offered in Brunswick County which means more employment opportunities throughout the area. The team member count has grown from 384 to nearly 900, leading it to be one of the largest employers in Brunswick County. They invest in their team members. Novant Health recognizes that people are its greatest resource and the remarkable care starts with them. Novant Health’s prior partnership with Rowan Medical Center in Salisbury, North Carolina and Prince William Medical Center in Virginia demonstrated a track record of benefits of a merger, which includes achieving significant cost savings, improvement in clinical healthcare quality and safety, and significant improvements in patient and employee satisfaction. He is confident that a partnership between Novant Health and NHRMC will do remarkable things for New Hanover County and the surrounding communities by creating a top tier hospital network to serve this rapidly-growing area. It is an important moment in the already impressive legacies of these complementary organizations and the communities served, and BMC is excited to secure and transform the future of healthcare for our friends, neighbors, and beyond together. Neil Shulman, resident of Nash Drive, stated that the Board decided to have this mockery of a public hearing on one of the most sacred holidays in Jewish religion, Yom Kippur. Why not on Christmas? Have it on Easter. What about Juneteenth? So what does that make the Board? Anti-Semitic and racist? He thinks it does. This sham has nothing to do with healthcare. It is all about padding the Board’s pockets. The only one that has any integrity in the group is Commissioner Zapple because he realizes what it is. For example, both the Board and the partnership groups all said that Novant has substandard medical facilities with their definitions. But the Board wants to sell them the hospital, then take the proceeds and have Novant in control. That is a pretty good scam. This way they can finance their deal and in the process they can pay the Board all off. That would be a couple million for Commissioner White for legal services, a couple million for Vice-Chair Kusek. Commissioner White stated that he was not going to sit and listen to Mr. Shulman defame him and single him out without evidence. If he has some evidence, present it to the community as that is what the public hearing is meant to do. He asked Mr. Shulman if he had any evidence. Mr. Shulman responded that he did. Commissioner White asked him to please share it with anyone and everyone while he is on television in front of this community right now. Mr. Shulman responded that in the forums, he noticed questions were only answered unless they were sanitized. Commissioner White responded that Mr. Shulman said he was doing legal work and said they were padding their pockets. Mr. Shulman stated he did not, but said that Commissioner White will be doing legal work. Commissioner White responded that he does not represent hospitals and told Mr. Shulman to not come in here and defame him or anyone else. If he has evidence, he needs to share it. Mr. Shulman responded that he believes Commissioner White is not being straightforward, as well as Chair Olson- Boseman and Vice-Chair Kusek. He thinks he has the right to say that under the First Amendment. Commissioner White responded that Mr. Shulman certainly has the right to say that, just as he has the right to take action against people that tell lies against him and his hard-earned reputation. Mr. Shulman responded that maybe Commissioner White should do that. He further stated that Novant has an ICU with five beds, one nurse, one nurse’s aide, and they do not have a critical care physician. That is why they have to transfer so many people out to different facilities. Novant is financing this deal with the trust. Then the Board wants to take that trust and wants to then not have the public involved in it because it does not want them to know. The Board can do anything it wants. That is not right. That is a sham. That is wrong. The Commissioners are supposed to be representing the people of New Hanover County, not Novant, not the hospital employees. Not Bolivia. Not Columbus. Not Brunswick County. Natalie English, President and CEO of the Wilmington Chamber of Commerce (Chamber), resident of Wisteria Lane, stated she stood before the Board approximately a year ago on behalf of the Chamber board to encourage the exploration of a hospital partnership. The Chamber board believed this community should review the data and the pros and cons to ensure that the healthcare system will continue to be the economic development asset that it is. It was unknown then what the result might bring us, but it was known that there needed to be a thorough process. The Chamber commends the county manager and the hospital CEO for creating an open process for that review. The PAG members have spent countless hours learning about the system and the needs to accommodate the future growth and changes in our region's population. They thoroughly reviewed every proposal with a fine toothcomb. She feels she learned quite a bit and is well-informed on the issue and the need for a partnership with Novant Health. The PAG members stayed true to the priorities that they set at the beginning, that we would improve access to care, advance the value of care, achieve health equity through community partnerships, support NHRMC staff and culture that has become one that is envied around the country, partner with providers to make southern North Carolina an excellent place to practice medicine, drive quality care, grow the level and scope of care already in place available to everyone no matter how much it costs, and to invest in the long-term financial security of our system. The Chamber board earlier this year adopted a resolution in support of the letter of intent that would create a partnership with NHRMC, UNC Health, UNC Medical School, and Novant Health. The Chamber board believes the partnership will be in the best interest of southeastern North Carolina. In her 20 years in Charlotte prior to moving here, she had the opportunity to experience fantastic healthcare at Novant Health. She has many relationships with many of the executives that lead Novant Health and she knows them to be committed to the communities in which they do business. She has personal friends, a lot of them work for Novant Health, and they call Novant Health a great employer. All of those are the things that we say today about NHRMC. A vote yes next week is a vote to transform our community. A vote next week will allow for continued investments in exemplary NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 SPECIAL MEETING, SEPTEMBER 28, 2020 PAGE 478 healthcare across our region. A vote yes will mean a number of healthcare jobs available to citizens and will create an endowment that will invest in our community to create opportunities. The Chamber board urges the Commissioners to vote yes for this transformational opportunity. Ruth Glaser, President of Pender Memorial Hospital, resident of Vann Court (Burgaw, NC), stated she spoke at one of the Board’s public hearings early in the process about Pender Memorial Hospital’s experience with NHRMC. In June 2020, Pender Memorial has enjoyed its 21 years as part of the system. In July 1999, the Pender County Commissioners did what this Board is considering doing here tonight, and that is to take a leap of faith and be a part of a larger system. Pender Memorial is so blessed that it became a part of NHRMC in July 1999. She cannot imagine where they would be with their little hospital especially in light of COVID and everything else that has impacted them. As a reminder, and she knows that the Board knows this, NHRMC grew to be such a large facility as a result of this growing region of southeastern North Carolina. But NHRMC's hands are tied when it comes to growth and investment in the region because of their structure, they cannot do so; they cannot debt a project outside the County. The citizens in Pender County are deserving of more than what they have. Pender Memorial is excited about the opportunity to be a part of this. She has read the purchase agreement. She is excited to be a part of the overall partnership and supports this partnership on behalf of the employees with Novant and UNC. North Carolina Senator Harper Peterson, resident of Orange Street, stated that he is not here to comment on his opposition of the sale of NHRMC under the present terms other than to say this community-owned hospital was established 53 years ago by the vote of the citizens of New Hanover County and it is only right that they should vote on its future. It is the people's hospital and no one else's. Tonight he is speaking regarding the creation of the nonprofit foundation that will manage $1.25 billion in taxpayer dollars appropriated by New Hanover County as a result of this sale. The question is whether the foundation will be subject to North Carolina General Statute 159-30, Investment of Idle Funds, which applies to local governments and authorities. The sale document believes it is not. When the County solicited the opinion of the UNC School of Government and the North Carolina Office of the State Treasurer, their opinions were very specific and similar, and he quoted, “Based on the legal analysis we do not concur with your conclusion that the proposed foundation would not be required to follow the investment restrictions of the statute. Rather, it's our opinion that the foundation as proposed could in fact meet the legal definition of a local government and be subject to this statute." The council's concluding comment reads, "Therefore we suggest out of an abundance of caution that you proceed assuming the foundation must comply with this statute." As proposed, the foundation will not be required to comply with this statute or requirements regarding the County's authority or the potential uses of the funds for public purposes. It will invest as they see fit. It is onerous enough the new foundation will not have open meetings or open records laws, but will have unrestricted control over how the public's money is spent. He would add that it is not only the North Carolina Office of the State Treasurer that is concerned, the North Carolina Attorney General's counsel has clearly stated that the County and hospital, that the definitive documents for the hospital required notice and review before a sale is consummated. The Board’s legal counsel again disagrees. Is the Board prepared to contest the North Carolina Attorney General as well? Is it the intent of the County to continue with this sale regardless? Are we facing legal action at the taxpayer's expense? Why the rush? It is all about $1.9 billion of taxpayer dollars and quality healthcare for decades to come. Alex Hall, resident of Country Club Road, stated that he can count and understands this sale will go through. He could talk for 20 minutes on why it should not, but he can count the votes and knows which way it is going. He will limit his remarks to the foundation primarily. He called the County this morning and he could not help but notice the County's motto, "A model of good governance." The Board has the power with this foundation to set up how it is governed. The Board can say, “Let's do it in secret or let's do it in the open.” That is the Board’s choice. The Board can tell the people of this County that their money that they're getting, $1.25 billion, is from here on, “We're going to do it in secret because we're smarter than you are. We don't want any pesky people asking to attend the meeting to find out how we're going to spend $1.25 billion.” The other part of this foundation that he feels is appalling is that Novant gets to decide how the money is spent. This is a sale, this is not a partnership, he has read it and Novant will own the hospital. They will own the employees. Read it. He wonders how many of the Commissioners have read the 161-page contract. Some have and most have not. Novant will own it. For them to say how the money is spent is like him selling his house and then having the buyer say, “Oh, by the way, I'm going to tell you how to spend your money and I’m going to tell you how to invest it.” That is absolutely wrong. It flies in the face of the County’s motto, "A model of good governance." So he will ask the Board to please change that provision and let the people of New Hanover County or southeastern North Carolina that are served by this hospital, let them alone decide how this money is to be spent. Make that a change in the proposed contract. It makes no sense to allow the buyer to buy the hospital and then decide how we are going to spend the money. They get the majority votes. He understands how majority vote works. It is the same way it worked with the Board deciding to sell the hospital. It was 3-2. As much as two of them objected, the three won. Novant will have the majority vote in this arrangement. The other thing as he has read the contract, it also says there are no pending or threatened governmental actions. There are and the Board got notice of them. Senator Peterson outlined those. Nicole Sutton, resident of Bonfire Drive, stated she has had the pleasure of living in Wilmington for 25 years. She is also a proud NHRMC employee for 24 years, of which she has experienced a growth in services. However, she knows we have more to do to fill in our health disparities gap. She wants to share what the partnership means to her, not only as an employee of NHRMC, but as a community member. She grew up in a small rural town in North Carolina where a local community hospital was 20 minutes away from her home. It did not have the technology and advanced medical care that both of her parents would need. When she was 10 years old, her mom was diagnosed with multiple sclerosis. She had to travel over three hours to receive specialized neuro care, something their local hospital did not offer. Fast forward several years later at the age of 39, her father was diagnosed with colon cancer. She was only 13 years old. Their local hospital did not offer oncology services and her father had to travel six hours, round trip, every three weeks for chemo treatments of which she was his riding partner. Yes, that is six hours total. Most often than not, the drive home was longer as he had to stop on the side of the highway to excuse himself while NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 SPECIAL MEETING, SEPTEMBER 28, 2020 PAGE 479 he got sick. Unfortunately, because of the grueling travel to receive care, her father decided to discontinue his will to fight. He had to choose quality of life over quantity. Unfortunately, not both. He attended all of her sporting events and cheered her on. He was only 41 years old. That is way too young to give up the fight to live because he had no local treatments. He had to leave behind his children. She is a little older than the age he was when he died and she herself has two children. She cannot even imagine having to make that horrid decision to leave behind her children because the will to fight was no longer there because of the inaccessibility to potential life-saving care. Even driving 45 minutes to an hour for our rural communities to receive care is a long drive when you are that sick. It was completely inexcusable and her father's death is why she is passionate in ensuring that we have access to advanced medical care in our rural communities as she knows so many others share her story. In closing, we have such a wonderful opportunity at our front door with Novant and she would like for everyone to see the gift those at NHRMC as well as our community, have been offered. The difference with NHRMC and her small town hospital is that NHRMC is the hospital she wishes had been accessible to her parents. She thanked the Board for its time and for believing in them as an organization, as well as the PAG who also supported and believed in them. Tony McGhee, resident of Brickman Drive, stated he wants to thank the Board for the opportunity to share his thoughts on this matter. The Board has honored him with the privilege of serving on the NHRMC Board of Trustees, as well as being a member of the PAG. One of the things he wants to share is the idea of disruption. It is coming and there is a reason that is important. As he looks at times past, his older kids would go to Blockbuster. Blockbuster has been supplanted by Netflix. Disrupted. They had an opportunity to avoid that but they did not. It is similar with Sears. Sears sold the Sears building the same year that Amazon mailed their first package. Today Sears is gone. We have evidence of it right here in Wilmington. The Sears building has been razed and something else is being built in its place. Disruption with the medical center is so important. There are three main things. We are talking about medical innovation. It will be a disruptive process that is coming, and it is not maybe, it is on the way. Also policy. One of the more important policies that could contribute to disruption to the health center here is certificate of need. If that goes away, the hospital is completely vulnerable. He thinks we have to think about these kind of things and protect ourselves. Also, when we look at business disruptions, he thinks of JP Morgan, Amazon, and Berkshire Hathaway. In 2018, there was an article that said they would enter into the medical industry. He asked if everyone knows what they are going to do. He explained they are going to plop billions of dollars someplace and pick-off everything that allows the hospital to stand as it is. He is not saying the hospital has done a terrible job. It has been a greatly run organization. But, we have to think about the fact that disruption is coming. To him, being in support of the APA, we choose our disruption. We can sit back and think nothing will happen. But then destructive disruption comes and we will have our head in our hands begging for somebody to come bail us out, or we take advantage of what has been arguably called, and he thinks it is, the greatest opportunity of a generation in this community to embrace, a productive disruption. We have an impact. We have a way to make sure that this benefits not just NHRMC, but for this region in particular. Paul Sommers, resident of Inlet Point Drive, thanked the Board for the opportunity to speak for the citizens to address this issue about the hospital. He is not here to argue against the agreement, the sale of the hospital to the Novant - UNC Partnership. He is here to question the wisdom of doing it so quickly and in a rushed manner. He must say that he has not understood the headwinds that are said to be so strong as to threaten the existence of the healthcare system here. And he certainly has not been given access to the strategic plan or to understand what are the impediments to borrowing money to meet the goals of the strategic plan. He thinks the alternatives need to be th aired, and he still thinks even at this 11 hour that there is room for a high level debate between experts who are opposed to the sale and experts that are proposing it. So he would like to hear arguments. He is not professional enough to understand them. He does wonder about the conditions and if the best deal is being made for this county. There is a pot of $300 million that will come directly to the County for management by this Board. It could be more. There is $1.9 billion in total and $400 million or more is basically cash on hand from the hospital system. He thinks that we are selling short if we are talking about $300 million of discretionary money for the County. Putting it all in to a community foundation with a board of directors, which is not directly controlled, means that you walk a fine line. He does not think it is possible. Either you have no influence over it and the assets have been sold for the benefit of a private entity, 501(c)(3) nonprofit corporation, that will manage a trust fund perhaps doing what is in the interests of the County, but without any guarantee, or you do retain influence over what the foundation does and then you are limited in the types of investments you can make. William Smith, resident of Country Club Road, stated he is a physician, cardiologist, and medical director of Cape Fear Heart Associates. He is here to speak from the perspective of someone that walks the halls of the hospital most of his days. He and a lot of others are excited about the prospect of having the investment of the purchase agreement to come to this facility. He is very proud of what has been recognized as a fantastic and state of the art 21st century medical facility. It is there and functioning the way it does because they have stretched themselves and their resources thin. Not just the staff but also the facility. It is not just common but really the norm to have patients waiting in the emergency room for hours. Sometimes in hallways, patients in outlying facilities or in doctor's offices who cannot get in for sometimes days, sometimes with their condition deteriorating. Staff are staying late, sometimes hours at a time to finish procedures because there is not enough procedural space and there are no rooms to send the patients to afterwards. The opportunity to have the facilities increased to serve the community and that also need updating so that we have the latest technology and can match the expertise of the physician and provider staff, and the quality of the nursing and other professional care that we have at the hospital is very exciting and he appreciates this opportunity. Paul Carr, resident of Staffordshire Drive, stated he is the NHRMC Regional Disaster Operations Manager and has been at NHRMC for about two years. He has had the privilege to lead the system to outstanding preparedness, response, and recovery. There have been two years of multifaceted disasters since he has been here with winter storm Grayson, Hurricanes Florence, Dorian, and Isaias. There has been social injustice in this nation and now we are facing COVID-19. All of these disasters had a major economic impact on the region to include NHRMC. NEW HANOVER COUNTY BOARD OF COMMISSIONERS BOOK 34 SPECIAL MEETING, SEPTEMBER 28, 2020 PAGE 480 Throughout all of these disasters, NHRMC has continued to provide uninterrupted, exceptional care and has lived up to its mantra of “leading our community to outstanding health.” This constant barrage of disasters has cost NHRMC tens of millions in damage and revenue loss. Although it has managed to maintain the trust of its patients and the community, it has come at great cost to its ability to expand its high standard of care to the entire southeastern region of North Carolina. For NHRMC to continue to provide a high standard of care, it has to be able to adapt to the current and emerging threats. This is going to require a partnership with a large entity such as Novant to be a healthcare multiplier to provide the financial and medical service, front-line service, to be able to maintain and expand its healthcare vision as an industry leader in a new era of healthcare delivery. Our thriving community serves as a national model of achieving excellence for all. The Board can be rest assured in his limited time here this partnership comes with NHRMC’s commitment to exceptional quality and value and personal service. Health and vitality for all. A diverse and extraordinary work force and transformation through empowerment, innovation and inclusivity. Its leadership did not take this lightly and throughout this they have always been part of the community having included the community, the patients, and always put the community, the patients, and its staff first. With that, he supports the move forward with this partnership. th Scott Whisnant, resident of North 18 Street, stated he is the NHRMC Community Engagement Administrator and wanted to be here to talk about the foundation that this sale would produce. There are people hurting in this community. Food insecurity is running rampant, housing instability, transportation barriers. People cannot buy their medications from a drugstore for want of a ride to the pharmacy. Toxic stress in our children from adverse childhood experiences. Just enough has been done in the community to understand what a difference we can really make if we properly funded this and really focused on this. These problems are fixable. The Board cannot let this opportunity pass. It cannot. The very fact that this process has become political is the best argument he can think of why a County should not be running a hospital. In 1996, NHRMC attempted to move to a not for profit model. At the time, he was a reporter at the Wilmington Star News. The newspaper sent him to Winston-Salem to study another hospital that had done that 12 years before. That hospital was Novant. 12 years later, he found the people that opposed the conversion and found that not one of them, it is not that they did not turnaround, cared anymore. The day to day issue of the hospital ceased to be an issue. You have a community nonprofit with this pedigree, with this level of community involvement, they will run a quality hospital. This will cease to be an issue. The voters in this County in 1961 voted not to support the hospital operationally so they told New Hanover Regional, “You have to run like a business.” That is what it has done for 53 years. It has done it with little day-to-day input from the County or public. It has run as a business. Now the best business decision is to make this conversion. Today the hospital systems that did this 30 years ago are the ones that are able to bid on NHRMC today. As a citizen, he is tired of us being behind the curve. NHRMC was built 20 years too late and was the most outdated hospital in the state when it was built. NHRMC could continue as a box that treats sick and injured people, but it will slowly erode even with new tax levies on the public. Standing still and clinging to romantic sides past and present will lead to predictable results. We cannot walk away from $40 million to $60 million a year properly endowed and properly managed that can take care of the issues that he knows all of the Board, he knows most of the Board personally, cares about. This is the Board’s chance to do this and it cannot let it pass. There is a quote attributed to Henry Ford that said, "If I had asked people what they wanted, I would have given them faster horses." We need to give this community what they need. We are better than what we have been. We can do this. We can get this done. He asked the Board to please vote yes. ADJOURNMENT Chair Olson-Boseman thanked everyone who made comments during the public hearing and to those who submitted written comments. She appreciates the community’s continued engagement and its passion about our healthcare system and the wellbeing of our residents. She shares that same passion and she looks forward to the continued discussions and a vote of this Board in October, so that it can determine the best path forward for healthcare and our community for generations to come. She stated with that, the public hearing is closed and the meeting is adjourned. Chair Olson-Boseman adjourned the meeting at 5:52 p.m. Respectfully submitted, Kymberleigh G. Crowell Clerk to the Board Please note that the above minutes are not a verbatim record of the New Hanover County Board of Commissioners meeting. The entire proceedings are available for review online at www.nhcgov.com.