By ROBERT JUMPER
ONE FEATHER EDITOR
Tribal Council approved funding of up to $31 million during the July 10 Budget Council session “for the remodel of the former Cherokee Indian Hospital including the construction of the Crisis Stabilization Unit.” Tribal Council Chairman Adam Wachacha convened a work session to address questions on the Crisis Stabilization Unit project on Monday, July 30.
He turned the floor over to Birdtown Rep. Albert Rose, who had requested the work session. He said that he had received several phone calls from his constituents with questions such as, “How was this costing almost $40 some million for 19 rooms?”
He also said people wanted to know if the facility could be built somewhere away from the existing hospital. Rep. Rose said there was an indication that the proposed building, the old hospital building, was not “up to code” and they needed an explanation of what codes that the building was not in compliance with.
Casey Cooper, Cherokee Indian Hospital chief executive officer, addressed Council and said the status of the project is that they were finishing up schematic design, led by McMillan, Padgett, Smith and have on-boarded the construction manager. Robbins and Morton is the construction management firm who also was selected for pre-construction. Cooper noted that the next step is to quickly move to design development and then demolition of the old in-patient unit.
He said that costs are in line with industry standards for construction of health care facilities across the country. Addressing a comparison made to a facility in Asheville that was recently renovated for a much lower cost than is projected for the Cherokee facility, Cooper explained that Caiyalynn Burrell Crisis Center was just a remodel of an existing building at the cost of $1.3 million. He said that the facility was already a fully-functioning adult treatment facility before they decided to “repurpose” it as a Crisis Center. The building was donated by Buncombe County. It only required light renovation.
As to the old hospital, Rep. Rose questioned as to whether the hospital was building new offices for existing employees.
Cooper responded that as part of the overall project, some offices and services currently housed in the old hospital would move into the current hospital and some offices that are in the existing hospital will move into the renovated old hospital with the Crisis Center. Cooper also pointed out that the project is the next phase of Cherokee Indian Hospital completion overall, which includes a Crisis Center component.
Wolfetown Rep. Jeremy Wilson clarified that there are federal regulations restricting the number of beds a facility may have.
Exceeding that number puts a facility in a designation of “mental institution” according to Cooper and would eliminate Medicaid and Medicare funding or payments. Rep. Wilson wanted to explain that due to the questions from the community as to why the limit on the number of beds for the Crisis Center. Cooper explained that the current number of beds proposed was a result of a calculation to balance standard, ER, and Crisis Center beds based on population and need. He indicated that a forecast above the average need was used to arrive at the number of beds to allow for growth.
Principal Chief Richard G. Sneed addressed the potential for sustaining the facility through Medicaid and Medicare reimbursements. He referenced his recent attendance and participation in meetings at the Center for Disease Control. “I can tell you that every panel discussion we, there were three issues on the table – substance abuse, behavioral health, and mental health. The discussion was the same in all in that you cannot uncouple these. They are all interconnected. You can’t treat one without the other.”
Tribal Treasurer Cory Blankenship spoke to the funding of the project and presented a recommendation to use a combination of monies from the debt service sinking fund (which was presented as a type of loan that would be repaid through gaming revenue allocation) at around $31 million and CIHA fund balance, which was currently estimated at $8-$12 million by both Blankenship and Cooper.
The entire official video record of this meeting is available at www.ebci.com.