Healthcare leaders Janice Brumit and Lakesha McDay recently gave a presentation about Dogwood Health Trust at Leadership Asheville Forum. It is the private, non-profit foundation set up following the sale of Mission Health Systems to the Hospital Corporation of America.
Its mission, according to its articles of incorporation, is “to dramatically improve the health and wellbeing of all people and communities of Western North Carolina.”
Brumit said as the First Chair of Dogwood Health Trust, she recognizes that the challenges in this region are many, including issues such as the opioid crisis, affordable housing, and so on.
“In North Carolina we are sicker, older, and poorer,” Brumit said. “Seventy-five percent of our payer mix was Medicaid, Medicare, or MedPay, so 25 percent of us were paying additional interest premiums to cover the cost for all of the healthcare cost of that larger constituency. It’s not a viable model for success.”
Brumit said that as the government was ratcheting down payments on Medicaid and Medicare, the Admission Board developed a forecast for the next five years.
“Things were going to change radically,” Brumit said. “Our margin at Mission Health was 3-5 percent annually, and that was going to be dramatically reduced over the next five years. Things were going to change in a draconian way in the way we survived healthcare in Western North Carolina. Most likely some of our regional hospital and the programs that we depended upon were going to have to close.”
Mission Health needed a partner with deep pockets. The Admission Board looked at three potential candidates and HCA was the one that came to the top.
“They promised to keep our rural hospitals open. They would build a 120 bed behavioral health building in Buncombe County, and also build a new hospital in Angel. That’s in Franklin. Also, they would pay us $1.5 Billion,” Brumit said.
If they waited five more years, they would probably have to turn it over to another partner and get nothing.
N.C. Attorney General Josh Stein approved the creation of Dogwood Health Trust to manage the $1.5 Billion.
“What we are determined to do with Dogwood Health Trust is to dramatically improve the health and wellbeing of the people in the community of Western North Carolina,” Brumit said.
This is to be accomplished by identifying the things that are harmful to health and prevent people from living at their best.
Nutritional insecurity is one problem.
“One in five children have food insecurity,” Brumit said. “Going to school hungry prevents them from performing at their best in school. They have all kinds of health problems throughout their lives. Some older people are also short on food. There’s an affordable housing problem. If you are living in your car, you may be occupying a mold infested environment. We also have an opioid crisis. These are the types of problems we’ll be working to solve at Dogwood Health Trust. We’ve started to embark on a strategic plan.”
McDay served for more than 22 years at Mission Health before joining the Dogwood Health Trust initiative. She is a member of the leadership team to foster community connections and collaborate community work in addressing the social determents of health for the WNC region.
McDay said Dogwood Health Trust has been very busy for the past eight months.
“We were able to conduct some listening sessions from winter of 2018 through the spring of this year. We’re talking to nonprofit leaders and asking some key questions. We’re trying to find out what is needed in the community instead to telling people what their problems are and how to solve them. We want the community to be part of that dialogue,” she said.
What does a healthy community look like? And, what are the barriers to a healthy community? These are the questions Dogwood Health Trust is asking.
“We know there are a lot of wonderful things that are happening across the 18 counties, great work across the 3,000 nonprofit organizations that we have. We also know that we have sometimes the systems don’t make it work, so how do we address those systems, and what is interconnected?”
McDay said the things that impact our health are not whether the X-Ray machine works, or if we get the right kind of cast on our broken limb.
“It’s really about, if I’ve been in the Emergency Department with an asthma attack three times in the last quarter, why was I there? Is it because I’m a noncompliant patient? Maybe it’s what’s happening in my home. That’s what we need to delve into. We’re wanting to pull together as much data as possible, and it’s all on our website,” said McDay.
McDay said Dogwood Health Trust had three public listening sessions in early October with Antony Chiang, panel experts Rebecca Onie of the Invest Health initiative, and Dr. Betsy Tilson from the N.C. Dept. of Health and Human Services.
“One of the things I loved most was Antony asking what their ‘dream number’ was. If you could change one number, whether it’s a disparity number, whether it’s a number that’s personal to you that you want to change, what would it be? We heard a wide range of things. We heard about closing the achievement gap, numbers about housing and homelessness, domestic violence, racial equity.”
McDay said “I thought it was an amazing opportunity for some folks to speak up. It’s also the opportunity to see how challenging it will be for the Board to decide where they will invest the money to have the greatest impact.”
Rick Lutovsky, former President & CEO of the Asheville Area Chamber of Commerce was presented with the LAF Circle of Excellence Award. As such, he joins other pillars of the community who are past recipients, John Ellis, Oralene Simmons, Deborah Miles, Dr. Gordon Grant, Susan Roderick, Dr. David G. Brown, and Laurey Masterton, among others.