It was at 7:27 a.m. Monday when the red ball of fire broke the horizon line at Wrightsville Beach.

By Lorna Sterling • Guest Columnist

Like many in the Haywood County community, I am concerned about the transfer of the in-patient hospice unit into the hospital. Like many, I am convinced that this solution diminishes substantially the quality of services hospice can offer. 

The granting of a certificate of need by the state for The Homestead only eight years ago was based on a clear demonstration of need. As the county has continued to age, it is difficult to believe that the need for hospice services has decreased. 

A press release issued by Haywood Regional Medical Center on Oct. 26 touted renovations to an existing facility that will provide better building utilization and expansion of patient care services, but that’s not the part of the statement that’s got some local residents upset. 

The Hospice House Foundation of WNC is in the midst of a major fundraising campaign to construct and operate a six-bed hospice house in Franklin.

Hospice House of WNC passed a hurdle in its fundraising effort when the Macon County Board of Commissioners voted to submit a grant application on the organization’s behalf. In a 4-0 vote, the commissioners unanimously agreed to support the hospice house’s bid for the $100,000 Building Reuse Grant from the N.C. Department of Commerce. 

Hospice House of WNC suffered a setback last week when the Franklin Board of Aldermen made a split decision not to support the organization’s application for a $100,000 Department of Commerce grant. 

“It’s a worthy cause. That was not the question,” said Verlin Curtis, vice-mayor. “The problem was it looked like that their raising the money and being able to complete the project on time was not going to happen.”

Jake Flannick • SMN Correspondent

A nearly decade-long dream to build an inpatient hospice house for the terminally ill and their families in Franklin is closer to becoming a reality.

A group wanting to build a Hospice house in Macon County to serve the terminally ill in the westernmost counties says it will continue those efforts despite a recent thumb’s down from the state.

The N.C. Department of Health and Human Services said “no” to Hospice House Foundation of WNC’s request to build a six-bed hospice inpatient facility. New medical facilities — from hospitals to outpatient surgery centers — require state approval to move forward. The system supposedly prevents too much competition from undermining the financial viability of health care institutions.

But the closest comparable facility is two counties away in Haywood, where a six-bed Hospice house is under construction. The next closest is in Buncombe.

While there are no other hospice houses nearby, Angel Medical Center perceives such a facility as a competitor, claiming there is not enough demand to justify a stand-alone hospice and instead has plans to provide a hospice-like set-up within the hospital itself.

The hospice group has pledge to keep moving forward, however.

“Nothing has changed as far as our mission is concerned in providing this much needed facility for our hospice patients and their families in this part of Western North Carolina,” Michele Alderson, president of Hospice House Foundation, said via email to The Smoky Mountain News. “We are continuing in our fundraising.”

Chris Comeaux, president of Four Seasons Compassion for Life, a nonprofit Hospice group that has worked with the Macon County-based Hospice House Foundation on the project, said last week all options are being studied. Comeaux and Alderson have pointed out the state doesn’t always award a Certificate of Need on first application.

The state’s letter turning down the application noted an appeal could be filed with the N.C. Office of Administrative Hearings. Comeaux declined to outline specific strategy by the Hospice group, citing the legal proceedings.

Four Seasons, based in Henderson County, took over Highlands Hospice and Palliative Care from Highlands-Cashiers Hospital last year.

This triggered a less-than-happy reaction by Angel Medical Center in Franklin and ensuing controversy last year. The hospital administration cited conflict-of-interest concerns and severed ties with local Hospice volunteers who wanted to build the respite house. The hospital forced out five of its volunteers who also served on the hospice foundation, and demanded all of its 40 or so other volunteers sign confidentiality statements and conflict-of-interest disclosures.

Volunteers are the base of Hospice, which provides support for terminally ill patients and their families. Some caregivers sit with patients while family members run errands; others prepare meals or serve in various administrative roles for the organization.

Federal law requires that volunteers provide at least five percent of patient-care hours for institutions such as Angel Medical Center to receive Medicare and Medicaid reimbursement.

Angel Medical Center CEO Tim Hubbs has been direct about his beliefs that Four Seasons is a competitor in the local medical marketplace. Originally, plans called for Angel Medical Center and the Hospice House Foundation to build the house together, but the hospital pulled out of the project. To continue with its dream of a Hospice house, the foundation had to find another licensed operator to oversee the facility — and Four Seasons stepped up to fill that role.

Angel CEO Tim Hubbs said the hospital “believes the state made a good decision” in not giving the foundation a Certificate of Need.

He said the reasons provided by the state for disapproving the application were consistent with the concerns of Angel Medical Center. The state asserted Hospice House Foundation did not demonstrate adequate need, or the ability to raise the money needed to build the house.

“Plus we knew that many people that supported the Hospice House thought the house would provide residential and respite care for those patients without a caregiver, but the application filed did not include any residential beds and did not project any respite days of care,” Hubbs said.

He said Angel Medical Center has identified two additional patient rooms within the hospital and earmarked them “for enhancement” to meet the needs of hospice patients. The hospital, Hubbs said, will convert two adjacent rooms to help out caregivers and family members of the hospice patients.

The first inpatient hospice west of Asheville had its groundbreaking in Clyde last week — complete with Jimmy Jack the mule and its own theme song.

The hospital is targeting September 2011 as the opening date for the Homestead hospice, to be located on the campus of Haywood Regional Medical Center. The new facility will house six beds for hospice patients, offering families with a dying loved one a choice in between hospitalization and in-home care.

Anyone who’s seen a loved one face a terminal illness can appreciate the hospice that’s to come, said N.C. Rep. Phil Haire, D-Sylva, who was at the ceremony.

“I can’t think of anything more stressful,” Haire said.

The second phase of the project will be the end-of-life outreach center, which will offer:

• private rooms for counseling services and bereavement therapy.

• a reference library for resources related to terminal diseases and end-of-life issues.

• a community education center with multimedia capacity.

A courtyard will connect the two buildings. Memorial gardens will serve as a site for butterfly and dove releases.

The Homestead is expected to create 15 new permanent jobs, with an annual payroll of more than $500,000, along with dozens of short-term construction jobs.

An inpatient hospice center is also in the planning stages in Franklin. But as of now, families seeking that kind of setting must go to Asheville.

Mike Poore, CEO of MedWest — Haywood Regional Medical Center’s parent company — emphasized the significance of building a hospice like this closer to home.

“Having family close around is very important for patients,” said Poore. “We think this is really a sort of a new era for Haywood County.”

Poore added that the hospice is a testament to MedWest’s philosophy of keeping care in the community.

With more family members living far away from each other, Haire said hospice workers could also provide caring support to those who live far from their family.

“This is another way,” said Haire. “A lot of retired people don’t have support of families that live close.”

The $1 million difference

After several years of planning and fundraising, Haywood Regional Medical Center has raised $2.66 million of the $4.9 million needed for the Homestead hospice.

The effort got a major bump with a recent $1 million donation left in the will of Bernice “Bee” Medford, a long-time Haywood County benefactor who split her time between Maggie Valley and Sarasota, Fla.

“She loved this community,” said Bill Medford, her stepson. “She gave more to Haywood County than anybody in Florida.”

Medford said Bee would’ve been pleased to see her donation invested in the hospice.

Poore called Bee Medford a great friend to the hospital. “Her generosity will touch people’s lives well beyond her time,” said Poore.

Other contributions toward the hospice include $150,000 from The Duke Endowment and a $132,000 grant from the N.C. Rural Center.

State legislators Joe Sam Queen, Ray Rapp and Haire, who helped secure the grant money, all attended the groundbreaking on Friday.

“North Carolina is very proud of this project and what this community is doing,” said Queen.

The fundraising effort is still underway, and HRMC is still actively seeking grants and donations to finish the outreach center.

Call 828.452.8471 for more info.