Getting a kidney dialysis center in Franklin grew more likely last week after a state committee agreed Macon County had demonstrated a tangible need for such a facility.

With a county population older than that of many surrounding communities, an increasing number of residents here have been forced to travel over Cowee Mountain to Sylva for treatment.

Driving to Sylva is an inconvenience during the warm-weather months, but during snowfall, it is a true danger for those seeking the lifesaving medical procedure, dialysis family members and patients have said. Last winter’s harsh weather set the stage for Macon County’s dialysis-center push, highlighting the difficulties patients faced making their way to the nearest facility in Sylva.

Macon County has a loose agreement from DaVita, a publicly traded national company that operates the dialysis center in Sylva, to come into Franklin if the state gives the OK. The state limits health care competition to ensure hospitals and medical facilities are financially viable, issuing a “certificate of need” only if patient demand warrants it. In this case, the state said there wasn’t enough demand for a dialysis center in Macon County.

Macon County leaders objected to the state’s assessment, however. DaVita prepared a letter of support for the county to show state officials, signaling its intentions to consider opening a center in Franklin.

The state requires that new dialysis facilities be able to project a need for at least 10 dialysis stations, or 32 patients — at last official count, in the state’s semiannual Dialysis Report, Macon County had just 23 residents receiving dialysis.

But county officials dispute that number, saying that more than 30 dialysis patients currently drive U.S. 441 from Macon County to Sylva for treatment. Additionally, officials suspect there are some dialysis patients in the southern end of the county driving to neighboring Clayton, Ga., who aren’t included in that number. The state’s threshold for justifying a kidney dialysis center also doesn’t take into account the particularly arduous health challenges associated with end-stage renal disease — yet Macon County’s end-stage population is increasing by an average of 10 percent a year, according to county records.

The state uses a 30-mile radius to determine locations of dialysis centers.

Friday, the long-term and behavioral care committee, meeting in Raleigh, agreed unanimously with Macon County’s arguments, according to County Manager Jack Horton. The committee recommended Macon County be allowed to build a five-bed dialysis center; that bed number could change to accommodate increased need.

The proposal now hangs on a State Health Coordinating Council meeting set for Sept. 28, said Macon County Commissioner Ronnie Beale, who has led the dialysis-center push.

Beale was optimistic the 29-member council would approve the proposal. If that happens, in March the county would apply for a certificate of need, which Beale believed would be forthcoming.

“We couldn’t be more pleased,” Beale said.

Macon County officials, concerned by the growing numbers of residents here forced to travel over Cowee Mountain to Sylva for treatment, are pushing for a kidney dialysis center in Franklin.

Macon County is a Mecca of sorts for retirees and aging seasonal visitors — the 2010 U.S. Census showed the average age of all residents living here is older than 50. County officials, citing Macon’s aging population and growing numbers of residents requiring dialysis, has asked that the state adjust methods it uses to award the required certificate of need.

The state requires that new dialysis facilities be able to project a need for at least 10 dialysis stations, or 32 patients — at last official count, in the state’s semiannual Dialysis Report, Macon County had just 23 residents receiving dialysis.

But county officials dispute that number, saying that more than 30 dialysis patients currently drive U.S. 441 from Macon County to Sylva for treatment. Additionally, officials suspect there are some dialysis patients in the southern end of the county driving to neighboring Clayton, Ga., who aren’t included in that number. Nor, said Commissioner Ronnie Beale, has the state considered all of the part-time residents that flood into Macon County each summer, a boost that almost doubles Macon County’s official 33,922-resident population — some that, no doubt, require dialysis.

A resolution adopted in June by Macon County pointed out that the state’s rules for allowing a private company to consider building in a community doesn’t allow for developing a kidney dialysis center to serve end-stage renal disease — yet Macon County’s end-stage population is increasing by an average of 10 percent a year, according to county records.

End-stage renal disease is the complete, or almost complete, ability of the kidneys to function. There are only two ways for patients to stay alive once their kidneys stop functioning: dialysis, in which the blood is artificially filtered; or kidney transplant.

Additionally, the state uses a 30-mile radius for determining locations of dialysis centers — but, Beale said at a recent Macon County Board of Commission meeting, there’s simply no comparing driving 30 miles on Interstate 40 downstate to driving 30 miles on mountain roads.

“Because of the terrain of the mountains, the distance is much more time consuming and difficult,” he said.

That’s certainly what Juanita and Leonard Max Wiggins have discovered, too. The couple has owned a residence in Macon County for two decades, but only started spending half of each year here after both retired a few years ago. Leonard Max Wiggins, who is 75, experienced kidney failure, and in January 2009 started dialysis.

Initially, he was able to drive himself much of the time. But his wife has been driving lately.

“When he gets so weak, he just can’t make that trip by himself,” she said Monday.

Her husband goes to Sylva three times each week, with each treatment lasting four hours. It requires 40 minutes to drive there, Wiggins said, and during the time he is in treatment she usually spends sitting outside in the car working on crossword puzzles.

The situation isn’t so hard in Florida, with a dialysis center just four or five miles from their home. Then, Wiggins can either slip back home for the wait, or her husband can make the trip by himself since it is a shorter distance.

By leaving the area in November, the couple misses the added difficulties of driving over Cowee Mountain in the snow and ice.

Commissioners last week passed an official petition asking the state to adjust its need determination. There would have to be an adjustment made to the need determination contained in the 2012 N.C. Medical Facilities Plan.

If granted, “hopefully private companies (would then) come in and determine if it is profitable for them to establish a center,” Chairman Brian McClellan said.

What is dialysis?

Dialysis is a medical process in which blood is cleansed of toxins the kidneys normally would flush out. It’s used when a person’s kidneys no longer function properly. This can be a result of congenital kidney disease, long-term diabetes, high blood pressure or other conditions.

Dialysis may be either temporary or permanent, depending on the person. If a dialysis patient is waiting on a kidney transplant, the procedure may be temporary. However, if the patient is not a good transplant candidate, or a transplant would not alleviate the condition, dialysis may be a life-long routine.