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Ken Sunseri: We were able to take ownership of the hospital. An extremely trying time, but again, we put together people that were willing to work. It didn't matter if it was Thanksgiving or Christmas Day, we got everything done that we needed to do to maintain that hospital.
Host: That's the voice of Ken Sunseri, the mayor of Haleyville, Alabama. He's been in office for over 10 years and was a key player in preventing Lakeland Hospital from closing at the end of last year. In this episode, Ken explains the steps he and the city of Haleyville had to take in order to not only save the hospital, but the financial stability of their community.
Ken: The lesson I learned from it is you can't give up. You gotta keep going. You gotta keep pushing. You got to tap every resource there is. You have to talk to other people who've been through it. So these are the things. This is a risk we had to take and we understood that.
Host: This is Health IT on the Record, presented by MEDHOST, a show that explores how innovations in health information technology impact every aspect of a health system, from multi-hospital networks down to individual patients. In a moment, Ken will share how he was able to gain the support of legislators, investors, and other hospitals when it came to enacting a plan to save Lakeland. He also will discuss what it's like to navigate such a difficult situation for a rural city, the potential for a hospital closure. Enjoy the conversation.
Ken: Hello. My name is Ken Sunseri, and I am the mayor of Haleyville, and I'm in my third term. I've had 10 years in office.
Host: You've been here in this community 44 years?
Ken: Forty-four years. Right.
Host: For someone who's not been to Haleyville, how do you describe it? The people, the place, the atmosphere?
Ken: Well, Haleyville is a small city, population about 4,170, and we're kind of off of the beaten path. It is probably the prime example of a faith-based community, people that care for each other. Unfortunately, I think it's a situation where everyone knows everyone's business.
Host: For good or worse.
Ken: For good or bad, it doesn't matter. And again, we've got an excellent community, excellent community support. We're limited on transportation right now. In the entire county there's less than a half-mile of four-lane. But we do have an opportunity coming up with Freedom Fiber who's going to put in high-speed internet. So a resident will be able to get 100 megs for $49.95 or a gig for $79.95. And I really think this is the highway of the future.
Host: You have a lot of things you're juggling as mayor and the reason that we get to visit with you today is that we want to talk a little about this hospital that has a really special story. And so what I'd love to do is kind of rewind it back to November 2017. Can you paint us a picture of the news you received and just kind of walk us through the series of events?
Ken: On November 17th, I started receiving calls from citizens, and they were asking me, "What're we going to do about the hospital?" And I questioned, "What do you mean, 'What are we going to do'?" And they said, "The hospital employees have been called together and said the hospital is going to close on January the 1st." And that came as a shock to me. I immediately called the hospital administrator, and they said, "Yes, we're going to have a formal notice today." Well, that gave me a very, very short time frame because I had six weeks, and I had two major holidays in between there, had hundreds of phone calls to make.
I talked to several different mayors who've been through a situation like this. Asked them exactly, "How did you do this? What did you have to do?" And basically, the main thing was, "You've got to take ownership of the hospital." So what we did is we decided to go ahead and form a healthcare authority because the indebtedness of the healthcare authority would not count against the city. We went ahead and put that in place immediately, as soon as we could.
We had a meeting here with the owner of the hospital at that time, and I was able to bring in Congressman Robert Aderholt, State Senator Paul Bussman, State Representative Tim Wadsworth, who were all here to assist us in trying to find a way to keep the hospital open. Again, we were on a very, very short time frame.
Host: To put it in perspective, how short was this time frame and how did it measure up to maybe these other mayors as you were talking to them about similar situations? How did that compare?
Ken: We only had six weeks. Most of the others had a little bit more time, and they were notified early about the financial situations of the hospital, and they were able to go to major medical centers to have assistance. In talking with UAB, they said, "We need six to eight months." I only had six weeks. Talking with Huntsville Hospital, they were willing to come in and possibly do an urgent care center. I talked to Walker Hospital. They were interested in doing the same thing.
But we didn't need that. We needed the emergency room, okay? And that was the most critical thing. And the thing that probably drove me the hardest was the fact that our community had to have medical care. Not only affecting the citizens here because, once 911 was called and an ambulance was called, when that person was picked up, we were anywhere from 45 minutes to an hour from the emergency room. That's not a very good situation for somebody that has a stroke or a heart attack or other major accidents. There was things there that my key concern was the community.
Secondary was the economic development situation. You can not recruit an industry or a business if you can't provide healthcare for them. And again, that's one of the amenities that people are looking for because, if they're going to locate near a community, they want to ensure that their personnel will have adequate healthcare.
In addition to that, looking at the entire situation, we had to move as fast as we could. We had to put everything in place as fast as we could. We had to get a letter of intent. We had to get investors. And I was fortunate there that there were two investors that were here, and after that meeting we had a short meeting, and they went to see our hospital. They were very impressed with the hospital. It's a 50-year-old building, but it's in tremendous shape. It's oversized for our population medical needs right now. But again, this was critical to go ahead and get things moving. So we did everything rapidly.
The other thing I had to do was I had to come up with a way to not only to finance the loan for the hospital, but also to sustain the hospital. That was the key. So we instituted a one-cent sales tax, a half-cent going towards debt retirement, the other half-cent going to sustainment of the hospital, and that included supplementing payrolls, buying supplies, paying back debtors.
And one thing we found initially, and it really was disturbing, our vendors hadn't been paid in over a nine-month period, and that was critical. It was food vendors. It was people who assisted in home health. Just all different. There was nine pages of vendors anywhere from $28.50 to $55,000 that was owed. So we had to rectify that, and that was a major, major issue. And again, we had to have other resources. I mean, your organization was a tremendous help to us. I mean, we needed help, and we needed help immediately.
So we were able to negotiate a letter of intent that the hospital remain open till January the 31st. Again, that still didn't give us enough time. So the Java Medical Group moved in and was starting to manage the hospital. However, when you go back and look at this entire scenario, and this is one of the major problems we had, the organization that owned the hospital had purchased three hospitals. They purchased Russellville, Winfield, and Haleyville, okay?
When they purchased it, they did it on a USDA loan out of Tennessee. Well, I was trying to deal with the USDA people here in Alabama. Again, we had to go to the USDA people in Tennessee, and that's where Congressman Aderholt was a tremendous, tremendous influence to get us the information we needed and to provide us with the data that we had to provide. So that was critical. So once we saw that, yes, we can get this done, we can make the purchase, we went ahead and did an extension till March the 31st.
Again, the last week was kind of bad because there were other requirements put in that weren't in the letter of intent and that was something we couldn't do. So the city decided to borrow $1.5 million. Purchase price to USDA was $1,250,000. We kept the other $250,000 for legal fees and an emergency fund, whatever we needed.
So as of April the 1st, we were able to take ownership of the hospital. And it was an extremely trying time, but again, we put together people that were willing to work. It didn't matter if it was Thanksgiving or Christmas Day, if we had to talk to somebody we could call them. We got everything done that we needed to do to maintain that hospital, because the hospital's critical to us for the welfare of our citizens. That's the primary thing. And we knew that we were going to be in a battle for the next at least two, possibly three years, financially.
Host: Health IT on the Record is brought to you by MEDHOST. With over 30 years of experience partnering with providers nationwide, MEDHOST is helping evolve better solutions for healthcare management through innovative workflows and technologies. For more information, visit www.medhost.com. Let's jump back in.
Host: A moment ago you were talking about how so many people came together really quickly – government on all levels, top to bottom; different vendors; different groups – and that's pretty unusual. What was the secret ingredient, how did that actually happen? Six to eight weeks compared to maybe what some people were saying, eight to nine months?
Ken: The key was, and the major factor was, I had to keep the employees. That was critical because without the employees, we could not have gone through this. We could not have done this. They rallied together. We filled this courtroom with probably 120 people, hospital employees, state officials, federal officials, judges, everyone that we could contact that would come to our assistance and help us. And everybody worked together as a team.
And it wasn't one individual. But it was my council. They had to take a major step. That's tough when you have to raise sales tax one cent. And again, we're all elected officials, and you want to do things that if you want to run again you'd really like to be reelected. And raising sales tax is not one of the good things to do.
But again, the community came together, and they understood, "Look, if this happens, me or my loved one could be in an ambulance for almost an hour seeking medical care." And I think one thing that's happened, and I can't put a dollar figure on it, but in the last 11 months we've had six people, as a matter of fact, two children, four adults, whose life would've been lost if they didn't have immediate medical care. And they got it here. And that's critical. That's critical. And like I said, you can't put a dollar value on that.
And again, we've got a fantastic staff out there, and they've worked hard. And if you go out there and view the hospital, it's in excellent condition for a 50-year-old building. And that was the other thing we talked about. In the next five to ten years, we're going to have to be looking at rebuilding a hospital. So a lot of these funds we're taking in now could help us and give us time to go ahead and seek out different grants and different opportunities.
And we're working together as a team. I think the city and city council are all working together with the hospital and the hospital staff. We want to make it successful, however we understand it. Financially, we're not going to get at a break-even point anytime soon. And again, I think the federal government realizes this. And part of the problem you have is rural hospitals have a difficult time surviving and there's been numerous hospitals close in Alabama and Georgia.
And I think the lesson I learned from it is you can't give up. You gotta keep going. You gotta keep pushing. You got to tap every resource there is. You have to talk to other people who've been through it, gain from their knowledge and their experience. And I had one mayor tell me, he says, "We just invested six million dollars. I don't know if I lost it or not." So these are the things. This is a risk we had to take and we understood that.
Host: Just a moment ago, you were talking about just this image of someone having to be in an ambulance for an hour to get the medical care they need. And on that theme around emergency services, I think of 911, and here we are in Haleyville. There's a big connection in 911. I want to hear that from you.
Ken: Let's go back in history and talk about what was there before 911. If you recall, you had to have a phone number for the doctor, a phone number for the hospital, phone number for the police department, phone number for the fire department. Again, that was fine as long as you were home. What happened when you left home? You went into another area, you had no way of knowing how to contact or who to contact.
So again, 911 revolutionized everything. And the actual facts of what took place is, during that period of time, there was some industrial work going on here in Haleyville. There was equipment being brought in. The Alabama Telephone Company was irritated with AT&T because they were not part of the negotiations. They felt like, "We can do this." Well, they were working on Fayette, and they would come in here at night and work on the system here because they had the equipment here.
They chose Haleyville out of the 26 exchanges that they had, and they made the announcement we would have the first 911 call made. At that time it was Mayor James Whitt, who was my father-in-law. He called from his office. He had Rankin Fite call, and Congressman Tom Bevill answered the call in the police department with a simple, "Hello." One thing that's kind of unique about that, since it's our 50th anniversary, we had Congressman Aderholt and Speaker of the House Mac McCutcheon come in, and we actually did a reenactment of the initial phone call. And I'll provide you with a disk.
Host: Oh, my goodness. I would love that. We should totally have that.
Ken: And, again, nobody I don't think realized at that point in time how everything would be revolutionized on 911. And when you think now, there's been 240 million calls made a year to 911. We don't have exact figures. How many lives did it save? How many buildings did it save? How many people were injured and needed immediate assistance? How all that all worked.
And again, the bulk of that comes down to our dispatchers, and it was kind of unique. I've had the opportunity to go to the Next Generation 911. So that was a celebration we had here. Because now, sometime in the very near future, you'll be able to text 911. They will be able to pick up your location on a map. Right now when you call in, it shows up on the screen where you're at, and that's vital information. It saves time. We get immediate response from our fire department, police department, medical. It's just been revolutionary.
And this year we joined up with the National Emergency Numbers Association. We went to Washington, the celebration they had there. During that celebration, we were able to meet with an FCC commissioner, Jessica Rosenworcel, who said, "I'm coming to Haleyville to celebrate your 911 festival."
We have a 911 festival the first weekend in June every year. And she and a crew, Steve Saunders and Admiral Simpson and a group of people – we had people from Washington, DC, we had people from Texas, we had people from Florida, we had people from Massachusetts, just all over that came to celebrate with us for the 911 festival. And during that time when I went to Washington, we talked to the Smithsonian Institute about the possibility of taking the phone there. We also talked to the National Law Enforcement Museum.
So we made an agreement with the National Law Enforcement Museum, and the reason being is we could get the phone back when we needed it and when we wanted it. So right now, our phone is in Washington, DC, at the National Law Enforcement Museum, and I've got photographs of the Attorney General Jeff Sessions pictured with the phone.
Host: Well, there you go.
Ken: He had been a current visitor. I mean, he had visited Haleyville numerous times and was a true friend of Haleyville. And the other individual – and I'll have to look at his picture and get his name. During the Kennedy assassination, the Secret Service agent that jumped on the back of the vehicle to cover Mrs. Kennedy had his picture made with the phone. So these are kind of some of the unique things.
And it was hard to lose the phone, but we felt like we may have eight or ten visitors here a month. They're going to have 400,000 visitors, and the phone is highlighted in their display. As a matter of fact, they have an emergency operations center where you can go in, and you actually act as a dispatcher, and they give you a scenario.
Host: Oh, that's so cool. Well, I think it's really neat. As we're starting to wrap up here, you mentioned 50 years ago when that happened, it happened to be your father-in-law who was the mayor. And also, he was here when the hospital was built. So you fast-forward to today and what a really special story of how so many people came together in just the shortest amount of time to save the hospital. So really thankful I got to meet you today. We loved hearing your story. Is there any final things on your mind or on your heart that you want to leave us with?
Ken: Well, again, our appreciation goes to those hospital employees. During the holidays there was uncertainty whether they had an opportunity to work and some of the people had to turn down offers they had to stay with us. Again, without them, we couldn't have made it.
And the other thing is the citizens here. And I think by being transparent and explaining to them, "This is the situation. These are the facts. This is what we have to do. It's not going to be pleasant. It's going to hurt a little bit. But if we all pull together, we'll be able to save our hospital." Again, it's going to help us with economic development, and I think when we get our fiber in here and have telemedicine and some of the things we're planning on doing at the hospital, we're going to succeed. It's going to take time, and I think everybody understands that.
Host: Well, thank you, Mayor. Thanks for listening to Health IT on the Record, presented by MEDHOST. For more stories and content like this, be sure to visit medhost.com/resources. Thanks.