TERRE HAUTE, Ind. (WTWO/WAWV) — Could Vigo County healthcare be operated by one centralized system in the future?

Recent legislation authored by a local lawmaker and backed by Union Health leaders sets up the ability for a hospital merger to occur in Vigo County and other applicable rural Indiana counties.

Two Senate Enrolled Acts in Indiana, SEA 416 from the 2021 Regular Session and SEA 298 from the 2022 Regular Session, allow hospital merger agreements to take place in counties that fit the following criteria:

  • A population of less than 140,000
  • No bordering county with a population of more than 250,000
  • Two hospitals that are both under the statewide comprehensive trauma care system
  • One of the two hospitals is a teaching hospital with a medical residency program
  • Predominantly rural

In order for a hospital merger to be carried out through these laws, a certificate of public advantage, or COPA, application must be submitted to the Indiana Department of Health. COPAs traditionally displace antitrust laws and allow for states to approve and oversee hospital mergers and acquisitions.

The legislation in place in Indiana includes language that says that a hospital that has been issued a COPA may not be purchased by another hospital or system of hospitals unless the purchase has been approved by the Federal Trade Commission.

Union Health CEO Steve Holman testified on behalf of both bills at the statehouse. In February 2021, he shared the health metrics behind his reasoning for supporting the COPA legislation.

“All of you are aware there are 92 counties in the state of Indiana,” Holman said. “And we rank in the bottom 10 in most of the health metrics. We’re 84th in quality of life, which is physical and mental health, 85th in health factors, 87th in health behavior; smoking, obesity, drinking, so forth. 79th in socioeconomic factors; poverty, unemployment, educational attainment. That’s a call to action.”

That call to action was answered by Senator Jon Ford, who co-authored SEA 416 and SEA 298 alongside Senator Ed Charbonneau.

In a Senate Committee on Health and Provider Services meeting in 2021, Ford shared with fellow lawmakers the process he and others involved with the legislation had gone through to learn more about the COPA process.

“Through our research, we found many states are considering COPA,” Ford shared. “My community and I explored the opportunity and even met virtually with officials from Texas, the last state to pass similar legislation. As local legislators, we understand our communities much better than the federal government oversight agency, the Federal Trade Commission, so we should pass legislation that actually benefits our local communities.”

Representative Alan Morrison sponsored both pieces of legislation in the House, and he echoed the sentiments of Rep. Ford and Holman regarding health metrics in West Central Indiana and how a new healthcare system may help to improve those metrics.

“The ultimate goal is better health outcomes for the residents of West Central Indiana, and even those who come in from Illinois,” Morrison said. “We are kind of a county seat for five or six, seven different counties over there in Terre Haute.”

Morrison also addressed possible concerns over monopolization of healthcare.

“The federal government has a role in this too, to make sure that it does not turn into a monopoly,” Morrison said. “And so we put legislation in this previous session here in 2022 to address that. And it was something that was very important that we, that we did. And we wanna make sure that the legislation that we pass through does not allow for that a spike in cost. We want it to stay low and then also have great outcomes.”

According to SEA 298, the COPA holder will pay for the costs of any application and monitoring of the certificate, rather than using any taxpayer money.

As part of a COPA granted by the IDH, the state department may enter into an agreement with a nonprofit or a postsecondary educational institution to study the impacts of the COPA on the community’s health metrics and outcomes. The report must be completed within four years of the COPA being granted and a final report must be completed within 10 years of the granted COPA.

During his testimony at the statehouse in support of then Senate Bill 298, Holman shared an update on the COPA process and said that a lot of work had been done since the first bill, SEA 416, passed into law.

“We’ve collaborated quite a bit with the Department of Health,” Holman said. “We’ve had multiple meetings, and I’m happy to tell you that we have three areas of focus that we plan on, not pertinent to Senate Bill 298, but just to set in front of you, one is substance abuse treatment, the other is behavioral health services, and the third is early child interventions for at-risk children.”

As of August 8, there have been no COPA applications sent to the IDH and Holman declined an interview for this story. His words at the statehouse this past winter spoke to a sense of urgency when it comes to providing strong healthcare for locals.

“We believe now is the time for new opportunities for innovation to come to Vigo County to improve the health status of those that we’re serving,” Holman said. “These are real people with real conditions. We must do what it takes to better lives, better our communities, and offer people the opportunity to live healthier.”

Holman also wrote a letter to Union Health associates in December 2021 that announced “preliminary conversations with Terre Haute Regional Hospital about a unique and historic opportunity”. The letter went on to reference job security for employees:

There is a role for everyone on this journey and employees should feel confident with respect to job security. Together, we remain committed to serving our patients with compassionate health care of the highest quality. The future of health care in the Wabash Valley is bright with Union Health System as we look to collaborate with our many talented and respected peers.

Steven M. Holman, President & CEO of Union Health

Mywabashvalley.com has reached out to Senator Jon Ford and HCA Healthcare, the company that owns Regional Hospital for comment on this story and await a response from both.