Health care issues will take center stage Tuesday when the Kenai Peninsula Borough Assembly, borough mayor and local health care officials from Central Peninsula Hospital and private physicians will all meet for a work session.
The discussion begins at 1 p.m. and will be followed by the assembly's regular meeting at 7 p.m. at the George A. Navarre Borough Administration Building, 144 N. Binkley Street in Soldotna.
During its regular meeting later, the assembly will hear public comments on Ordinance 2011-10-72, which would appropriate $4.7 million to CPH to build a radiation oncology facility on the its campus, if approved.
Resolution 2012-012, which authorizes Borough Mayor Mike Navarre to amend CPH's lease and operating agreement to allow the Central Peninsula General Hospital Inc. Board to sublease a portion of the cancer center facility, will also be up for a decision.
Assembly president Gary Knopp organized the work session and "invited all the players," to keep them "fully informed of our conversations and to have them keep us accurate in our conversations," he said.
The main topic at the work session, Knopp said, will likely be the competing cancer center proposals, but the discussion will likely move into other subjects regarding the function and operations of the hospital.
CPH officials and Anchorage-based Dr. John Halligan both proposed building cancer centers for radiation oncology treatment in the area, but differ on the location -- on or off the hospital's campus -- and several other aspects of the specialized care.
In mid-February, discussions arose about removing Ordinance 2011-19-72 from the docket and thus conceding to Halligan's plan, but the mayor and CPH said they wanted to keep the options on the table.
However, Navarre gave little indication last week whether the ordinance would be pulled or not, but it was "definitely" still up for discussion on the agenda, he said.
"If (Halligan) still decides to go forward with his project then it would absolutely make no sense for us to consider pursuing ours," he said. "Passing ours would still leave the option for it to be on campus and that case needs to be made by the CPGH Inc. Board., the administration of the hospital and in communication with the assembly."
The mayor expects heavy dialogue on the subject, both in the assembly meeting and at the work session before hand. But that's prudent, he said, because it has the potential to shape local health care for years to come.
"That is how public decisions should get made," he said.
Knopp agreed, adding he was concerned about the center's future finances and having "fragmented" health care services, among other issues.
"The talk I really want to have with the assembly members is that this $5 million appropriation (for the cancer center) is really the tip of the iceberg," he said. "If we support this, we had better get on board with supporting the rest of the request that is going to be coming, including the additional $15 million down the road for the expanded campus, changes to the lease and operating agreement and so I want everyone to be aware of that. It doesn't end here by any means."
Knopp said he also wanted time to fully process the large amount of information and vet questions about changes to CPH's lease and operating agreement and why some people in the medical community aren't happy with how the hospital is doing business.
"You've got to ask the question, 'Why?'" he said.
"(The hospital) still doesn't like the system that we have and I don't know if it is the best system, but it is our system," he said. "They are going to want less and less borough involvement in the hospital and I personally think we should have more. I guess there are a lot of people not happy with the way it is functioning and we pretty much have washed our hands of its operations."
Knopp said he is also wondering why the medical community seems "divided," and said it was "not a healthy situation."
"I don't know if in fact physicians and hospitals are differing because they are jockeying for market position going forward," he said. "But obviously our physicians are not extremely happy or they wouldn't be going through all of this. They'd be finding a way to work together and I don't know the cause of that."
Navarre said the meeting fits into his goal of calming the tenor of the local health care discussion. He said such decisions, like the cancer center, require a "deliberate, civil and open dialogue" to take into account impacts to patients, doctors and taxpayers in an ever-changing industry.
"It is multifaceted ... and it has got to be a toned-down and reasoned discussion and debate," he said. "Sometimes it will undoubtedly get heated and you've got to be able to step back and make sure you retain relationships so you can make good decisions and try to build consensus rather than confrontation."
Brian Smith can be reached at firstname.lastname@example.org.