The Kenai Peninsula Borough Assembly took another step Tuesday in search of a solution to how area cancer care services — and health care in general — will look in the future.
At its regular meeting, the assembly unanimously approved Ordinance 2011-19-72, which appropriates $4.7 million from Central Peninsula Hospital coffers to pay for an on-campus radiation oncology facility. Assembly member Charlie Pierce was absent.
CPH officials and Anchorage-based radiation oncologist Dr. John Halligan both proposed building cancer centers 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 the ordinance from the docket and thus conceding to Halligan’s off campus plans, but Kenai Peninsula Borough Mayor Mike Navarre and CPH said they wanted to keep all options on the table.
Most notably, all sides aligned with the borough said the on-campus center would be best for cancer care, Navarre said.
“This is the way we think it should be done,” he said during a break in the meeting. “It is possible we still won’t get there, but now at least we can continue the dialogue.”
Navarre said the borough and CPH realized they “can’t win a race” against Halligan’s private development time frame which is moving “much quicker.”
However, if Halligan continues on with his plans, Navarre said CPH will likely step aside at some point. But, Navarre pegged the assembly’s Tuesday actions as part of keeping discussions ongoing.
Navarre said Halligan and the borough have had a dialogue and he wants to present the most attractive scenario possible to the doctor, asking, “now that we have got the pieces in place, are you interested in being on campus?”
“I think this shows that, yeah, we can get it done,” Navarre said. “... (Perhaps then) he can say, ‘I think this is what they think is best and I am going to take another look at it. He’ll look at it. He’s not done considering it.”
Halligan confirmed those feeling after the meeting.
“I think the reason for the discussion today and for the decision tonight was the way it was because I said I haven’t closed the door,” he said. “If I said, ‘We are definitely building starting next month, it would be a totally different discussion.’”
Added Halligan, “It’ll be a great thing for the community either way.”
Halligan’s proposal would be close to the hospital, but would ultimately require a small number of hospital inpatients receiving cancer care to be discharged from the hospital and take an ambulance to his facility.
CPH Chief Executive Officer Rick Davis spoke about the decision, citing its impact on the next three decades of cancer treatment in the area.
“So the question really is, do we work toward a comprehensive cancer treatment center with the patients’ best interests (and) a long term commitment to our community at heart?” he said. “Or do we allow our cancer services to become fragmented forcing patients to ride back and forth in an ambulance for the next 25 years and never realize the potential that we had a chance to achieve here tonight?”
Assembly member Bill Smith spoke in favor of the ordinance “because Dr. Halligan has expressed an interest in, or the ability to work with the hospital.”
Hal Smalley, an assembly member from Kenai, echoed a similar sentiment.
“I think this is an ideal partnership and I think it best serves our community,” he said of an on-campus location with Halligan operating it.
Assembly member Brent Johnson asked Halligan if the hospital builds, “can you work with them,” or does he feel “more comfortable that you wouldn’t be working with them and on your own?”
“I can work with the hospital,” Halligan said.
Navarre said the ordinance isn’t binding CPH to any construction plans.
“The assembly appropriates (funding), but that doesn’t mean the funds have to be expended,” he said.
That decision — or perhaps when to draw a line in the sand for a decision — is ultimately Navarre’s, but making it will be an “evolving process,” he said.
“I will do that obviously in very close discussions and cooperation with the assembly,” he said. “I wish I could give you an answer about whether it happens or not. I think those discussions really still have to take place.”
The assembly also unanimously approved Resolution 2012-016, which authorizes Navarre to amend CPH’s lease and operating agreement for Central Peninsula General Hospital, Inc. to sublease a portion of the proposed $4.7 million facility for oncology services.
The assembly discussed the length of the potential sublease, which was first written into the resolution as being limited to 10 years. An approved motion by Johnson doubled the potential term to 20 years.
Dan Moore, CEO of the Tennessee-based RBS Evolution helping handle Halligan’s proposal, said a longer lease would be more comforting, considering the initial costs of purchasing the multi-million dollar equipment.
Any lease agreed to by CPGH, Inc. would need to come back for assembly approval, Navarre said.
The assembly also unanimously approved Ordinance 2011-19-70, which appropriates $200,000 to hire one or more consultants to help investigate reduction of health care costs in the borough, identify directions the health care industry is taking and sufficiently prepare in a number of ways.
In June 2011, the borough administration began working with officials from the Kenai Peninsula Borough School District, CPH, South Peninsula Hospital and the cities of Homer, Kenai, Soldotna and Seward to consider options to reduce health care costs, which are otherwise expected to continue increasing.
“The first step is figuring out how to put an organization together to figure out how we can have some buying power,” Navarre said Tuesday.
Navarre said solutions and reductions found through the coalition for public employees could spill over into the private sector.
“I assure you I have a much broader goal in mind for the long term,” he said. “It’s not just public employees … but my goal is to try to make sure that all employers and their employees have the opportunity to see reduced health care costs.”