Committee recommends denial of new emergency departments

Plans for two new emergency departments in Georgetown are moving forward, even though a committee has recommended denial of proposals submitted by Beebe Healthcare and Bayhealth.

Final approval of the plans has been delayed by the Delaware Health Resources Board. The board was scheduled to vote on the plans Thursday, July 25, but the meeting has been canceled because of lack of quorum. A date for the rescheduled meeting has not yet been set, said Jill Fredel, director of communications for the Department of Health and Social Services. The Delaware Health Resources Board is a 13-member governor-appointed board established by Delaware statute composed of county representatives and members of the healthcare industry.

On June 25, a committee reviewed Beebe's proposal for a 21-bed emergency department in an area that already houses La Red, a Veterans Administration clinic and Sun Behavioral Health. The three-member committee also reviewed Bayhealth's proposal for a 10-bed emergency department on Route 9 east of Harbeson.

Committee members Carolynn Morris, Leighann Hinkle and John Walsh concluded that both applications should be denied by the approving board – the Delaware Health Resources Board – largely because of the high cost of service. The committee references Gov. John Carney's 2018 Executive Order 25, in which he approved a series of healthcare benchmarks to cap rising medical costs. The use of pricey emergency room services instead of going to a primary care physician or walk-in clinic is targeted under the executive order, which sets goals to decrease the number of emergency room visits.

The committee stated that average costs for emergency department visits are $1,484 versus $126 for urgent care centers. Costs related to a freestanding emergency department, which both hospitals are proposing, generate two types of bills – one from the physician and the other from the facility, committee minutes state.

Fredel said healthcare facilities such as emergency departments must receive a certificate of need from the state before a facility can be built. The process began in 1978, and the Health Resources Board now grants the certificates, she said.

“The Delaware Health Resources Board Certificate of Need program was created to control healthcare costs through a formal review process that ensures public scrutiny of certain healthcare developments in the state. This public scrutiny is focused on balancing concerns for cost, access and quality,” Fredel said.

Speaking in favor of an emergency department during the May 16 committee hearing, Gust Bages, senior director of emergency and trauma services at Bayhealth, said an emergency department is needed to handle emergencies that a walk-in clinic cannot.

“A walk-in clinic, they handle certain things, such as ankle sprains, bug bites, bumps and bruises, earaches, fevers,” he said. “A freestanding emergency department can handle any emergency that comes down the road, from a motor vehicle accident to a loss of limb.”

An emergency department provides care for heart attack and stroke victims as well, he said.

John Van Gorp, senior vice president of planning and business development for Bayhealth, said an emergency department is also staffed with physicians, 24 hours, seven days a week compared to a walk-in clinic that often provides care by a nurse practitioner with limited hours.

Nanticoke Hospital, which offers healthcare 20 minutes from Georgetown, testified that the two new emergency departments would counter Nanticoke’s efforts to lower the cost of care. “The review committee stated both proposals will have a negative impact to the existing healthcare delivery system,” minutes read.

Van Gorp said Bayhealth intends to proceed with plans for emergency departments despite the committee's unfavorable recommendation. He said the emergency department is part of a greater plan to build an ambulatory center at the Route 9 and Hudson Road intersection that would offer primary care physicians, specialists, imaging and lab work. Sussex County recently approved new zoning for the site, and Bayhealth is moving forward to purchase the property and then proceed through further county approvals, Van Gorp said.

“Ideally, we would break ground in a year and construction will take another year,” he said.

At Beebe Healthcare, Alex Sydnor, vice president of external affairs and chief strategy officer, said at this stage, plans for an emergency department cannot be changed as Beebe awaits action by the Health Resources Board. He said the facility is needed because there is a lack of easy access to emergency care in Georgetown and Millsboro.

“Beebe Healthcare invested in growing services such as primary care physician offices and walk-in care in Georgetown and the surrounding area to keep residents and visitors from costly emergency department visits for non-emergencies,” Sydnor said. “Our analysis shows the Georgetown area has a gap in accessible, timely emergency care because of drive times.”

The hospitals also have support from members of the Georgetown community.

During the hearing, Georgetown Mayor Bill West said emergency services are needed as Georgetown continues to grow. He said a large senior citizen population and popular sports venues, such as Sports at the Beach and the Georgetown Speedway, are prime reasons for having a nearby emergency department.

“Seven hundred kids [on weekends] once that gets up and running. A chance for injuries that need to be transported. What better place to come than to come out of there and turn west and come right here,” West said about Bayhealth's proposal, to be located a short drive from the Route 9 ballpark. “It would be a lot quicker for the families. Because we have families from New York ... families from Canada with their child playing ball. Isn't it easier to tell them how to get here than it is to fight in that traffic?”

Editor’s note: The board has been updated to show Lynn Fahey’s name changed to Lynn Morrison.