2020-07-02 PAG FinalPARTNERSHIP ADVISORY GROUP
JULY 2, 2020 MEETING
ASSEMBLY
PAGE 1
The Partnership Advisory Group met for a meeting on Thursday, July 2, 2020, at 5:30 p.m. in the Andre'
Mallette Training Rooms at the New Hanover County Government Center, 230 Government Center Drive,
Wilmington, North Carolina.
Members present via roll call: Co -Chair Barbara Biehner; Co -Chair Spence Broadhurst; Vice Co -Chair Bill
Cameron; Vice Co -Chair Dr. Joseph Pino; Members: Evelyn Bryant; Robert Campbell; Chris Coudriet; Hannah Gage;
John Gizdic; Tony McGhee; Dr. Michael Papagikos; Dr. Rob Shakar; and Jason Thompson.
Members participating via virtual format via roll call: Dr. Virginia Adams; Cedric Dickerson; Brian Eckel; Jack
Fuller; Dr. Sandra Hall; Dr. Mary Rudyk; Meade Van Pelt; and David Williams.
Staff present via roll call: County Attorney Wanda Copley; Clerk to the Board Kymberleigh G. Crowell;
Assistant County Manager Tufanna Bradley; Chief Communications Officer Jessica Loeper; Budget Officer Sheryl
Kelly; Intergovernmental Affairs Coordinator Tim Buckland; New Hanover Regional Medical Center (NHRMC)
Director of Marketing and Public Relations Carolyn Fisher; NHRMC Chief Legal Officer Lynn Gordon; NHRMC Chief
Strategy Officer Kristy Hubard; NHRMC Executive Vice -President and Chief Financial Officer Ed 011ie; Joseph Kahn,
Shareholder with Hall Render and outside counsel for NHRMC; Bobby Hamill, Attorney with Hall Render and outside
counsel for NHRMC; David Burik, Managing Director with Guidehouse; Bryan Burgett, Director with Guidehouse;
Greg Van Alstyne, Senior Strategy Consultant with Guidehouse; Eb LeMaster, Managing Director with Ponder &
Company; and Robert Jaeger, Vice President with Ponder & Company.
Co -Chair Broadhurst called the meeting to order and thanked everyone for attending. As with all other
meetings, the public can hear the open session portion of the meetings, but it is not participating in the meeting
discussion. There will be no questions from the public in this forum, but the public is encouraged to continue to
provide input through'
A coi'ni,n_ei'i't"s hcgov.coin.. There is no anticipation of a closed session this evening. If, for
some reason, a closed session becomes necessary, there will be adherence with state law in this regard and the
public will be excused. The public would then be welcomed back both in person and virtually when the PAG returns
to open session.
APPROVAL OF MINUTES
Co -Chair Biehner asked for a motion to approve the June 4, 9, 10, 11, and 18, 2020 regular and closed
session minutes as presented.
Member Gage MOVED, SECONDED by Member Thompson to approve the June 4, 9, 10, 11, and 18, 2020
regular and closed session minutes as presented. Upon vote, the MOTION CARRIED UNANIMOUSLY.
OUR JOURNEY (SLIDES 6-11)
Co -Chair Biehner reviewed slide 6 stating the process started well before the PAG began meeting and
provided a brief historical review of what lead to the PAG being formed in order to help bring citizen input into the
process. The information in slide 7 reflects a high level overview of the significant work done by the PAG since
October 2019. On behalf of the PAG, she expressed appreciation for the work of the support team and the
consultants.
Co -Chair Broadhurst reviewed slide 8 stating it is a summary of the pros and cons of the proposed
partnership models. A significant amount of research and discussion was held about the various options. While it
was initially thought a joint venture would be the right way to go, it was determined that full integration was the
best route. The work during the sessions in compiling the information to make this determination was done from
legal, financial, and practical standpoints.
Co -Chair Biehner reviewed slide 9 stating it shows the high-level overview of what a partnership with one
of the three proposals could offer versus status quo or restructuring. The key proposal elements (KPEs) were
developed by PAG workgroups who went through information line -by-line in their designated sections. The PAG
developed a very comprehensive letter of intent (LOI) for the request for proposal (RFP). The 18 goals were used to
do a detailed comparison of all the proposals, status quo, and restructuring. The information on the slide reflects
how the partnership column offers much more on each of the KPEs for staff, providers, and the community.
Co -Chair Broadhurst stated that slide 10 is not necessarily an analysis of the financials, it is a comparison.
He provided a brief overview of the financial information, noting the total financial consideration of each proposal
and the total cash proceeds to the County. Per an assessment by Ponder and Company of each offer, assurance has
been given that all three health systems are fully able to fund their proposal commitments.
Co -Chair Biehner reviewed slide 11 explaining the PAG's in-depth review of the top three proposals from
Atrium Health, Duke Health, and Novant Health. The slide information is a high level overview of the proposals and
what each could offer with respect to the key elements, and what is most important to meeting the strategic goals
and objectives for staff, providers, and the community. The scoring was based on numerous factors: proposals,
follow-up clarifications, virtual and actual site visits, and due diligence. All proposals were strong, but the PAG
identified material variances well beyond just the financial considerations.
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JULY 2, 2020 MEETING PAGE 2
Co -Chair Broadhurst reiterated Co -Chair Biehner's comments about the many hours put into the process
by the PAG members to develop the scoring system and the in-depth process used to score each proposal. He
provided an overview of the due diligence process of the three outstanding health organizations. After the due
diligence, the scoring of some key elements went up and some went down. This work was done over several weeks
of meetings. The summary on the slide reflects PAG's work and it is helpful in understanding how the PAG got to this
point.
Co -Chair Biehner stated the information presented today is a summarization of the PAG's significant work
to date. It entailed education, development of a thorough RFP, an analysis of status quo, SystemCo restructuring
and other independent models as compared to what six different proposals could bring to this community, staff and
providers, development of core considerations for any LOI, and extensive comparisons and vetting of all scenarios.
She believes that the PAG is prepared to vote on its next deliverable to the NHRMC Board of Trustees and the County
Commissioners, in accordance with the Partnership Advisory Group Charter. She recognized Vice Co -Chair Cameron
to make the motion.
Motion: Vice Co -Chair Cameron MOVED, SECONDED by Member McGhee for the PAG to vote on and recommend
to the NHRMC and County Boards the following: 1). That each Board approves moving forward with negotiating a
Letter of Intent for a proposed strategic partnership as we, the PAG, believe this step preferable to continuing status
quo or pursuing internal restructuring (SystemCo) or another independent or joint venture model at this time; and
2) That each Board approves focusing such Letter of Intent negotiations with Novant Health as the PAG's
recommended first choice of partner, with its solid proposal and intended partnership with the University of North
Carolina (UNC) Health and the UNC School of Medicine to enhance clinical services and medical education in this
region.
Co -Chair Biehner opened the floor for member discussion.
Vice Co -Chair Cameron stated 10 or 11 months ago when this first came up he made a statement that he
has made several times since then, as have others, that this is the biggest decision that would be made in New
Hanover County, and probably in his lifetime. It is important for everyone to hear how the PAG got to the point that
it thinks a transaction is important. It started with an overriding goal of working for the best long term healthcare of
this community. When he first started this process, he had a gut feeling a sale to a for-profit was a terrible idea and
was not sure what he thought about a potential transaction with a non-profit. He was committed to listening,
learning, and only after going through the process, making a decision about what he believes will be in the best
interest. He has learned more about the changing healthcare environment. There is a nationwide move to population
health and away from fee for service, which is led by the United States government and all the insurance payors.
There is more risk for outcomes being placed on hospitals and physicians, which is depriving them to have scale. For
people that do not understand these nationwide shifts of population health and the payment system, it is very hard
to have an informed opinion about what should be done locally. He encouraged everyone three weeks ago to
educate themselves. Through this process, he became familiar with the strategic plan the Board of Trustees put
together over the last few years. He learned a great deal through this process and is light-years ahead in
understanding the need for better health equity. He has gained an understanding of the financial limitations of
implementing the plan if NHRMC stayed as it is. Of the top three proposals, there is the recommendation of one that
will best allow NHRMC to implement its strategic plan, expand services, grant access to care closer to where people
live, greatly improve health equity, and use analytics to improve quality of care. He believes all of this can be done
and still maintain local control, the operation of the facilities in the area, and maintain relationships with health
providers and non-medical staff. Doing something does involve risk. Not doing something also involves risk. He
believes the risks of not doing something are far riskier than partnering with Novant, UNC Health, and UNC School
of Medicine. Even more importantly, he believes the opportunity of partnering with Novant and UNC will be
transcendent, and greatly increase the health of this community far beyond what NHRMC can achieve on its own.
As to why Novant and UNC Health, Vice Co -Chair Cameron further explained that the PAG received three
really good proposals from three quality organizations. All should be proud of our system for having those kinds of
organizations respond. For him, Novant stood out clearly in front of the others. In looking just at the Harvey ball
chart and all 18 KPEs, Novant was either at the top, far above others, or very close. Collectively, Novant's scorecard
was significantly the best on the Harvey ball chart. When factoring those together, to him, Novant is the best
opportunity for NHRMC to achieve and implement the strategic plan put forward by the NHRMC Board of Trustees.
How will they do it? The easy one is financial and clearly, Novant was the significant leader financially. It is not where
he hangs his hat even though it is important, he likes it, and it is good. Where he hangs his hat is on some of the
other things that he thinks they brought to the table, such as health equity. Novant is a national leader in health
equity and has won national awards in health equity. Novant has analytics and it was seen how it used analytics
through this COVID environment and it could be quickly implemented at NHRMC. NHRMC's existing 40 -year
relationship with UNC and UNC Medical School will be strengthened by Novant. They are bringing a growing program
that will be a significant improvement economically, medically, and provide more physicians in this area. Finally, and
maybe most important, culture. Throughout the entire process and every interview that was held, he thought, "Who
would I want to work with? Who would I want to have to make decisions with? Who would I want to have to walk
in the woods with to make a decision?" Each time the answer to him was Novant. This is why he made the motion.
Vice Co -Chair Pino stated while the PAG was being put together, the NHRMC medical staff put together a
Physician Advisory Council (PAC) made up of over 20 members of the medical staff representing roughly 600
physicians in this community. The PAC spent just as many hours poring over all of these documents that the PAG
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JULY 2, 2020 MEETING PAGE 3
had to try to come up with a good solution to move forward. The PAG was afforded the opportunity to evaluate six
proposals from strong institutions, and it had the unenviable task of reducing it to three and did so. The medical staff
group met throughout this process and had what he would call "spirited" conversations and with that, opinions
about the importance of the partner being a strong employer to physicians within the physician group and the
importance of the partner having a strong commitment to this community's health and well-being, not just to
healthcare, were a couple of things that really floated to the top. When the PAC was challenged to come up with a
proposal of a final recommendation for a partner, the leader of the NHRMC's primary care group made a motion not
to put forward any one name, but instead to say, "We have three outstanding choices. We look forward to working
with whoever the Partnership Advisory Group endorses." This motion was seconded by the leader of the
cardiothoracic surgery group. The motion received a unanimous vote by the PAC. NHRMC is fortunate to have a
strong medical staff driving great outcomes in this community and providing outstanding medical care. It is also
fortunate to have so many healthcare organizations come forward to say that they want to help improve care in this
region. He also believes we are fortunate to move forward with Novant Health, UNC Health, and UNC School of
Medicine.
Member Shakar stated that it has been an honor to serve on the PAG and to assess the RFP process for
NHRMC. He thanked the leaders, support team, and the members of the committee. He can attest that every
member of the group took this role seriously, understood the weight of this decision, and its effect on the community
and the surrounding counties, now and for the future. Personally, he came into the group hoping a way could be
found for NHRMC to remain independent and just be reorganized. But through the weeks of studying and evaluating
every option, he realized NHRMC does not have the debt capacity or the financial ability to remain an independent
entity. It needs that financial support to continue the great care currently provided at NHRMC to continue to improve
the healthcare in this region. Due to its status as a county owned hospital, NHRMC has limitations that it currently
cannot overcome. Through this year long process, he has not seen a viable alternative to a full implementation or a
sale, and therefore, he supports moving forward. He believes when all the information that the PAG evaluated is
made public, the community will draw the same conclusion. The volume of information shared will disprove the
belief that this is a rubber stamp or a conspiracy theory as stated by some. He hopes that when the public is educated
on the how and the why, and how the PAG came to this decision, it will be realized the PAG fully vetted all the
options. The decision was not taken lightly. As Vice Co -Chair Cameron said, it is really the most important decision
for NHRMC and the County at large that will probably ever occur. It is not just this committee making a decision and
it is affecting employees, their families, this community, and all the surrounding counties. The PAG has rated all of
the respondents based off of the Harvey balls as has been discussed. It is also well documented that successful
acquisitions occur when two entities share a similar vision. Through all of the meetings and due diligence, the
Novant-UNC proposal provides the most complete vision for improving NHRMC and meeting the strategic needs, as
well as the academic support to advance healthcare in this community. He hopes the County Commissioners will
recognize the time and effort expended by the PAG in coming to this decision and will support the PAG's efforts. He
thanked everyone again for the opportunity to serve and have input.
Member McGhee stated that it has been a privilege to be able to serve on the PAG, to evaluate the
information, and being able to say this is what we need to do. He is in sales and a lot of times he shares concepts
and ideas about disruption and disruptive types of business. When he looks at the health industry, there is the
disruption that is coming, technological innovation is coming, and it is going to disrupt the way we have always done
business. Additionally, we are now talking about particular policies and political winds that have the potential of
disrupting healthcare. Around January 2018, companies such as Amazon and JP Morgan said they would come
together to collaborate and enter into the healthcare industry. When these multibillion dollar organizations enter
in, they will do so with a huge footprint. They are going to pick all the low hanging fruit and when they do that,
hospitals like NHRMC will surely be threatened because there still has to be a margin to support other things that
need to occur in a hospital. He provided examples of what occurred to Blockbuster and Sears, and the effect market
disruption had on them. He is convinced that by making this decision, we are choosing our disruption. We are not
just allowing disruption to overtake us and are not standing here with our heads in our hands hoping that somebody
bails us out of trouble. NHRMC is in a strong position and is a strong leader in the healthcare industry. There were
six organizations that came forth, three finalists that are very reputable, whether talking about Atrium, Duke, or
Novant. All are saying they appreciate what NHRMC is doing and are willing to enter into a partnership with NHRMC
to help do some great things and continue to lead our community to excellence. For him, that says it all. Disruption
is coming. We either choose disruption or disruption chooses us.
Member Papagikos stated he thinks all three final respondents are phenomenal health systems and
partnering with any of them would, in his opinion, allow for the improvement of access, scope, and quality of care
at NHRMC for the residents of southeastern North Carolina. After being part of the discussions, deliberations, and
presentations, it seems to him that NHRMC is strategically much more important in the long term to Novant Health
than it is to Duke or Atrium. He believes that was manifested in their willingness to offer unprecedented degrees of
local control and governance through system level collaboration and the scale of their financial commitment. For
him the opportunity to not only maintain, but drastically expand NHRMC's academic affiliation with UNC via the new
Novant partnership excites him. He is keenly interested in advancing cancer care through clinical trial participation.
He is excited to see what that offers moving forward. Finally, he thinks patients are best cared for when their
physicians have an active and valued role in managing their local healthcare system. He was impressed by Novant's
commitment to the physician led, but professionally managed system. Those are some of the reasons why he
supports Novant.
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JULY 2, 2020 MEETING PAGE 4
Member Campbell stated that he is also happy to be a part of the PAG and does not think he has ever had
the pleasure of working with such a highly functioning working board. The robust discussions have been interesting,
but when the group got down to the idea of whether to go forward with a partner, all members were unanimous in
saying yes. There were robust conversations as to which partner would be chosen, but it was unanimous in saying
Novant. The PAG members are not rubber stamping members saying, "Let's do what you would like us to do." This
group is doing what it thinks is best for the community. When he first heard about the opportunity to find a partner
or sell the hospital, he remembers looking at Member Gizdic with a jaundiced eye and Member Coudriet not much
better. His thought was, "How are poor people going to get missed over in this process?" He asked Member Gizdic
to tell him what was in it for him as he was asking the questions that he knows the people he represents would want
to know. Members Gizdic and Coudriet both stated there was nothing in it for them. When asked why they were
doing this, both said it is the right thing to do. He agreed with them and it is the right thing to do. Timing is everything.
You can do the right thing at the wrong time and it will still be wrong. However, if you do the right thing at the right
time, it will always be right. This is the right time. As Member McGhee said, there has been a disruption. He was
impressed with Novant. They came in hungry. They came in with the biggest and the best offer not just financially,
but also when it came to integration, culture, and technology. He read an article today that said Novant is leaning
forward using technology and is the only administration that has gotten approval from the FAA to use drones to
deliver PPE for COVID-19. In 2018, Novant was the first to be recognized with the Centers for Medicare and Medicaid
Services award for health equity. He was very impressed with that. Health equity is important. He believes Novant
has proven their approach to inclusion, diversity, and proven systems, and did not just say what they can do. The
PAG was very careful to not look at just what Novant said it could do, but more importantly, what has it done. The
other thing that was very interesting to him was the PAG's discussion about local control. It was almost as a
misnomer to him, but now he knows what that looks like. The County appoints people to make up the Board of
Trustees. The Board of Trustees then go out and find the CEO. One of his members asked him, "If somebody comes
in, would we be able to control what kind of raise or increase the doctors get or the CEO receives?" He responded,
"No, but we do not control that now either. There's a board that hired a good CEO and evaluates how well that
person does the job. If the person continues to do the job, then the person continues to serve as CEO." He is very
pleased with the unanimous consent and decision to offer forth Novant as a partner.
Member Coudriet stated that July 2020 is actually the thirteenth month that this matter has been in the
public. It has been a long time. It has been a year since Member Gizdic and he brought forward that they were going
to ask the County to support them asking the question of, "What is the right model for hospital administration,
ownership, governance, and more importantly, healthcare in our community going forward?" When the PAG first
met on October 29th, everyone knew there was a lot of work to be done. He is thankful, not counting Mr. Gizdic and
himself as this is what they are charged with doing on a daily basis, for the 19 men and women from this community
and region, who have worked incredibly hard, have asked lots of very hard and uncomfortable questions, and have
challenged every assumption along the way. All did it in the spirit of helping answer the question of, "What is in the
best interest for healthcare and health in our community?" To share the opinion of Member Campbell that 13
months later, this group with unanimity in what it believes is in the best interest, and the PAC being in agreement,
that something needs to be different to ensure a better future for ourselves. He is thankful to each member letting
Member Gizdic and him ask the question, and just as importantly, for being a part of a very difficult process. He
knows that personally, each member put his/her personal brand at risk by agreeing to take on this work. He is
thankful for the commitment each and every member gave to this community and to the County, and he is glad to
count all as friends, he hopes, when this work is done.
Member Thompson stated on behalf of the NHRMC Board of Trustees, he appreciates the time and
dedication that this organization has put into the process, and he and the other members of this board will take this
to the full Board of Trustees for review next Tuesday. He will say the only difference for him is that he came into this
thinking that he knew that this is kind of where NHRMC needs to go. He did not know who it was going to be with,
but knew NHRMC could not keep doing what it was doing. It only took him seven years to get there and took this
group about 10 months. He appreciates everyone's efforts.
Member Bryant stated she is glad to be a part of the PAG. In the beginning, she was very skeptical and very
leery. As all know, her heart is with health equity and what it stands for. Through this process, she learned more
about what our local hospital does, how it not only works in this area, but also regionally in Pender and other
counties. It gave her better insight to know that we need more and better for our community. In order to do that,
we all have to be open minded to change. She grew up in this community and realizes that change is hard for a lot
of people here. As she sits on this team, she is glad to be a part of that change. It is needed. As the PAG looked at
the three organizations that would be willing to help make that change, her heart went with Novant. When COVID
first blossomed, she remembers hearing a radio commercial and was proud to know that Novant actually took the
lead in this community and put money into commercials that actually helped the African-American community know
and understand the importance of washing their hands, standing six feet apart, and wearing masks. She paid
attention to some of the things that Novant did in the community and it showed her they were willing to step out
there and help us become a better community. In looking at the health equity piece, she asked questions about
diversity and inclusion and where would we take part in that. This community has gone through so many changes in
the last four months that she would have never imagined. She has always been able to share with others how
minorities can make a big impact, the need to be open minded to change, and the need to create jobs for others. In
looking at Novant and what they have to offer, she would be happy if the vote went towards having Novant as a
partner within our community.
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JULY 2, 2020 MEETING PAGE 5
Member Gage stated that when the PAG started, she knew very little about Novant, but knew a lot about
Duke and Atrium. She has enormous respect for them, even more so today. She was completely unprepared for how
impressed she would be with Novant. From the beginning she was impressed with the culture, which felt right and
with the financial commitment and what they are willing to support in terms of NHRMC's strategic plan. What really
got her was Novant's vision. It is a very modern vision about how healthcare will be delivered, using technology and
other tools that she had never even imagined to improve health outcomes. As to health equity, Novant is already
doing the kinds of things that NHRMC dreams of doing. Novant is out there and ahead of most systems. That is the
kind of partner NHRMC needs. Novant, in a remarkably short amount of time, came back to the table after having
completed an amazing partnership with UNC that provides many of the things everyone was impressed with in the
beginning when UNC had put forth an academic partnership. For her, it became the dream package and she thinks
that with UNC as Novant's partner, NHRMC becomes a hub for medical education. She further believes it will
eventually develop into a health sector that will be transformative in this community. She expressed her appreciation
for being able to serve on the PAG and enthusiasm about the recommendation of Novant.
Member Adams expressed appreciation to everyone for her wonderful experience serving on the PAG. It
has been a tremendous opportunity to work with a phenomenal group of people and to be better educated about
the issues facing healthcare generally, as well as NHRMC. The region has a historic opportunity to thrive with the
right partner that could help with delivering the right healthcare services to the right populations in the timeliest
manner possible, using the most up to date technology that has been talked about, and rendering the greatest
impact on health in our community. She believes Novant Health is the best choice for partnering with NHRMC. In
the future, she sees a stronger community in our preferred future as NHRMC leads our communities to outstanding
health. What she has seen is that Novant Health has demonstrated success on many levels, but with intentional
focus on population health, achieving health equity, and avoiding staff shortages by investing in people and
developing and recruiting talent, real talent, and expertise. In terms of health equity, a major portion of addressing
health equity is just effectively integrating social care into the delivery of the healthcare system clinical care, but
that requires inter -professional teams. It includes experts like social workers, community health workers, nurses,
physicians, family caregivers, gerontologists, attorneys, and law enforcement. Novant has started this work and did
not just start this work yesterday. In collaboration with Winston-Salem State University, the School of Health
Sciences, Novant funded the launch of mobile units in 2011. It was first done for the School of Health Sciences faculty
and staff to provide preventative health services in the community for people who were uninsured or people who
were underinsured. There are now two mobile units there that provide quality, accessibility, and integrated wellness
services to reduce those health disparities. In addition, Winston-Salem State University and Novant Health partnered
to create the very first physical therapy residency program that is based at an HBCU in this country. She was also
impressed with Novant Health being a member of the CEO Action for Diversity and Inclusion, which is the largest
CEO business driven to commitment to diversity and inclusion in the workplace. It is one of three healthcare
organizations in this state to make that commitment. There are more than 1,000 CEOs in the world's leading
companies and business organizations that pledged to cultivate a trusting workplace that encourages those critical,
difficult conversations, to examine implicit biases, and share best practices for diversity and inclusion. She thinks
Novant has been preparing for such a time as this. In looking at the recruitment and retention of diverse nurses and
leadership positions, she thinks nurses are critical to the success of any healthcare organization. Novant has strong
support for career ladders in practice. They have strong relationships with nursing education. They have magnet
status, which provides a structure to help them to deal effectively with all of those factors as far as recruitment and
retention and the strategies are designed to increase professionalism. They have done that to increase autonomy.
They have reward structures in place and many options for continued education and professional growth. She was
really impressed with their student nurse program. They have a student nurse apprentice program. It is a 10 -week
long summer internship for nursing students between the junior and senior years and that program accommodates
80 to 100 students. They also have a nurse residency program for new graduates. For a whole year, the graduates
have an opportunity to go into four different disciplines during their tenure. Because of that, Novant has retained
their nurses at a rate of 99% and she thinks that is absolutely amazing. In these uncertain times, with the all of the
issues we are facing, she believes Novant is the right partner for this region at this time.
Member Dickerson stated he thinks it is very clear to the community how the PAG arrived at this and how
important it is to deliver quality health to the entire community. We have an outstanding hospital that does an
outstanding job. Many of the members did not know what they were getting into when this process started. He
thinks this process opened that up when the PAG started looking at what the impact health equity and some of these
other services were making on their communities. As to why Novant was his choice, a word that jumped out for
many was culture. Novant's culture seems to be aligned with NHRMC's better than anybody else's. When the PAG
looked at the packages, it was said many times, "Let's look at and evaluate these three respondents. Let's take the
money off the table. Let's look at each category and make our decision based on the person who is delivering the
best quality and each one of these categories." However, when you put the money back on the table, it's emphasizing
that NHRMC is a very desired partner for Novant. He thinks that the other partners wanted to also partner with
NHRMC and considered NHRMC the diamond that it is, but Novant considered it the crown jewel. They made it very
obvious. He remembers statements they made about how they have been spending down and controlling their debt,
waiting for an opportunity like this for over seven years. Novant has the financial commitments out there to hit the
ground running and to address health equity. When looking at all three respondents and all three are strong, the
culture and the commitment of Novant and they say up front that health equity is a core of the way they do business,
his recommendation would be to recommend Novant Health.
Member Fuller expressed appreciation to the PAG leadership team, the members and for the opportunity
to participate. Since the process started and through the help of the support staff and the specialists the PAG has
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JULY 2, 2020 MEETING PAGE 6
leveled the playing field of understanding what the issues are for the hospital and understanding the needs of the
community at the same time. He has always said change is the most difficult thing that human beings can go through,
but sometimes not making a change is an absolute disaster. He thinks going forward, we can look towards the
enlightenment of a new organization that addresses many of the issues that people have talked about here tonight
and that can bring to our community the kind of oversight, expertise, and community health equity that we have all
been striving for. He fully supports the PAG recommendation of Novant.
Member Hall stated she agrees with everything that has been said. From her perspective, all the time the
PAG has taken with all the respondents, which were all excellent, but based on Harvey ball scoring, culture and
reiterating what everybody said, that Novant really stood out for her from a community health physician culture.
She was really impressed with what they were able to do with independent physicians. She supports the
recommendation of Novant Health.
Member Rudyk expressed appreciation to the members and stated that she has learned a lot from
everyone. She thinks the PAG has come a very long way. She is extremely excited about the partnership going
forward with Novant, primarily for the health equity in the region, but also for the data analytics that it brings.
NHRMC's quality measures are really good, but they will become superb with the data analytics that it will be able
to get from Novant. She also stated how impressed she is with the medical staff. During the PAC meeting the main
feeling behind it was not about contracts or their salaries, it was they want to preserve the excellent care that they
have been able to give to the community. More importantly, they want to take this excellent care to the region. It
was a unanimous vote of the PAC to throw its trust and support to the PAG to make the right decision and selection
for the physicians on the medical staff. She can only state how impressed she was by the medical staff and the
community for coming forward with this. Everyone wants the best, health equity, and data analytics. She thinks
Novant is the best one to bring this forward to us.
Member Van Pelt expressed appreciation and her respect for everyone involved in this process. The PAG
has had a lot to learn as far as understanding the healthcare industry, the challenges that are in the healthcare
industry today, how those all roll to our hospital, and it had to find a way to keep the pace and move the community
forward. Novant Health immediately was striking to her in its vision, in its commitment to this specific area, its great
respect for the leadership that already exists here and that relationship, and ease of relationship that could be
further developed. They brought everything forth from the beginning in terms of capital, but again, that was not
really what it became about. It became about knowing NHRMC's culture, understanding it, understanding the need
for some local governance, bringing everything to be a better community overall, and she thinks the timing could
not be more appropriate. NHRMC is strong and at its peak. Therefore, it is appreciated and valued like it probably
has never been before. As everyone else has already stated, she endorses that the committee move forward with
the recommendation for Novant.
Member Williams stated Pender Hospital has enjoyed for over two decades a relationship with NHRMC and
it has been a good relationship for both sides. The thought of an organization taking NHRMC to the next level and
bringing Pender Hospital along with them as partners is very exciting. NHRMC cannot survive status quo. It is just
not an option. The five PAG members that also serve on the Board of Trustees have been going through this a little
longer than others. However, when the members got into the first meeting versus where they all are now, he thinks
everyone has learned from each other. He has learned from everyone on the medical staff and everyone in the
community. He expressed appreciation to Member Coudriet for his leadership, all the support staff, and all the
outside companies that worked with the PAG to guide it and make sure that it stayed on task because this is huge.
It is one of the most important things he has ever done as a County Commissioner and he has been serving as a
County Commissioner for a while. He feels good when he goes out in the community to speak with people about
how and why this group got to where it is. He hopes more people will get to learn more about who is on the PAG.
He thinks that will give them a good feeling about where the PAG is going because it has been a neat and genuine
group. He is thankful that the group is to this point and hopes the folks that take it from here will agree that Novant
is the way to go.
Co -Chair Broadhurst stated he agrees with what everyone has said and he has enjoyed serving as Co -Chair
with Co -Chair Biehner. He agrees with Member Cameron that this is probably the biggest decision that will be made
in their lifetimes. As he has grown and learned over the last nine months, he is convinced this is a unique situation
and a once in a lifetime opportunity that we cannot afford to lose. Rarely do you get an opportunity where, in his
opinion, everybody wins in this situation. This is an opportunity to expand healthcare to levels that NHRMC never
could without the extra investment from a partner for the entire area. It has been heard repeatedly about the
commitment to health equity. In these times that we are facing now, it is important to make sure there is the
opportunity for healthcare and health for all in our community. This gives NHRMC the opportunity to do that and it
is the right thing for the citizens of New Hanover County and the region. To be able to partner with an organization
like Novant Health who, as can been seen by the Harvey ball ratings, speak for themselves and it is a numerical score,
but that is the foundation of the PAG's decision. He thanked Duke Health and Atrium Health for their outstanding
proposals and their commitment to this community. They are outstanding medical centers and we should be
privileged to have them be as committed as they are. On behalf of the PAG, he thanked them for their time, effort,
and commitment. In going through the due diligence and having an opportunity to speak with Novant Health, he felt
like he was speaking to Member Gizdic and his staff, and Member Thompson and the Board of Trustees because the
missions and visions overlapped, are so identical, and it felt so comfortable. This is the team that is going to lead
NHRMC for generations to come and we should feel privileged, and he certainly feels privileged to be a part of it. He
fully supports Member Cameron's motion for Novant.
PARTNERSHIP ADVISORY GROUP
JULY 2, 2020 MEETING PAGE 7
Co -Chair Biehner stated she thinks everyone has said it all and she appreciates what everyone has brought
to the table and what the support team has done to get the PAG to this point. She appreciates people listening,
asking questions, people who pushed and pushed and asked even more questions. She would not have been able to
meet most of the members until this process. She has spent 40 years in healthcare and after spending these many
months with the group she thinks everyone gets honorary masters in health administration from all of this because
all were quick learners in spite of having very different backgrounds. She reiterated her appreciation for what
everyone has done and for what each member brought to the table.
Member Gizdic stated that NHRMC's mission is to lead our community to outstanding health. Its vision is
to be an industry leader in a new era of healthcare delivery and that its thriving community serves as a national
model of excellence for all. Easy to say, hard to do. The mission and vision are ambitious. They are bold. This
community deserves no less. To achieve the mission and vision requires bold action. Throughout this process, he
cannot state how extremely impressed he has been with all of the PAG members, including its tremendous
leadership of the Chairs and Vice -Chairs. He believes the members' commitment to making the right choice for the
NHRMC organization and the community is truly remarkable. The members have asked a lot of tough questions,
pushed, challenged, and considered every possible option. The NHRMC organization and the community owe the
members a tremendous amount of gratitude for having the courage to make a tough, bold, and passionate decision
to help NHRMC achieve an ambitious and bold vision for this community. Over the past year, too much of the
narrative around this situation has been about what might be lost or given up. Tonight, the narrative changed to
what is possible. NHRMC is committed to leading this community to outstanding health. It has great people, excellent
providers, and an unrivaled passion. With this recommendation, the PAG also gives NHRMC the resources it needs
to make what is possible a reality. He thanked the members for all their work on behalf of NHRMC and the
community.
Hearing no further discussion, Co -Chair Broadhurst reiterated the motion on the floor and called for a vote.
Upon vote, the MOTION CARRIED UNANIMOUSLY.
NEXT STEPS (SLIDE 13)
Co -Chair Biehner reviewed the next steps as shown on slide 13. The PAG meetings will be paused through
the rest of July and it is anticipated there will be meetings in August and September to carry out the final charges
under the PAG charter. Those meetings will deal with the actual documents and formalization of those items.
VISION FOR THE FUTURE (SLIDE 15)
Co -Chair Biehner reviewed slide 15 noting that our vision of the future is now a lot more exciting because
NHRMC has a lot more opportunity than it would have had on its own.
CLOSING REMARKS, AND ADJOURNMENT
There being no further business, Co -Chair Broadhurst adjourned the meeting at 6:58 p.m.
Respectfully submitted,
/Kymberleigh G. Crowell/
Kymberleigh G. Crowell
Clerk to the Board
Please note the above minutes are not a verbatim record of the Partnership Advisory Group meeting. Meeting
materials associated with this meeting are included as attachments to these minutes for reference.
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