Brittney Burns – Staff Writer

In the last week, the Macon County Health Department has seen nine new patients seeking prenatal care. Macon County Health Director Jim Bruckner told the Board of Health Tuesday night that the increase in new patients is likely just the beginning since Mission Health Systems will no longer be delivering babies at Angel Medical Center and have also significantly downsized their prenatal care options in Franklin.

“Right now we don’t have any idea of what to expect in terms of an increase in prenatal patients, it may be just a few or it may be a lot, but we do expect some sort of increase,” Bruckner told the board. “We will likely get the bulk of the Medicaid clients seeking prenatal care.”

Friday, July 14, was the last day babies were scheduled to be born at Angel Medical Center. Not only did Mission Health Systems close the Labor and Delivery Unit at AMC, but they also reduced their OB/GYN (obstetrics and gynecology) and pediatric practices and consolidated them to one office. The change gave the Macon County community just over two months to prepare for the transition. The health department began to research how the decrease in the availability of maternal and prenatal health care would impact their services and have attempted to brace for the changes, but according to Bruckner, it is still a series of “maybes” or “what-ifs.”

“Right now we are monitoring the number of new patients we see in the clinic and watching to see what impact it is going to have on the department,” said Bruckner. “We have not asked county commissioners for additional funds at this time. This does not mean that we won’t be asking for funds; however, until we see what the impact of the change in the outpatient OB services are, we cannot speculate what that amount may be.”

In addition to the anticipated increase in patients at the health department, Bruckner informed the board that after Aug. 15, the health department may not have an OB provider on contract to provide the services at all, although they are mandated by the state to have one. The health department’s current contracted provider’s last day is set to be Aug. 15, and according to Bruckner, Mission terminated that provider’s contract while downsizing, leaving the health department without an OB provider.

County health departments are required by law to provide services that are not otherwise readily available and easily accessible in an area. Bruckner told the board, that with Mission’s changes, maternal health and prenatal care by statute became a mandated service at that point. While the health department is legally obligated to provide the services, they are scrambling to find a provider to meet the mandate, while also seeing a decrease of funds on the state level to those programs.

“The health department was informed this past week of a reduction in Maternal Health funding due to realignment of federal Maternal and Child Health Block Grant Funds by the NC General Assembly as part of this year’s state budget,” said Bruckner. “For us, that is going to mean a reduction of $10,636 in those programs.”

Bruckner said that the state left it up to local departments to decide from three programs how to cut the $10,000. The health department could choose from prenatal services, maternal care, or family planning services. Combined, the health department gets less than $100,000 in state funds for those three programs, so a $10,000 cut is a significant blow. Bruckner said there is, however, a possibility that the health department could apply for grant funding to recoup that lost $10,000 based on grants available for rural counties facing hardships.

Since the Franklin hospital is no longer delivering babies, Bruckner said that when new clients visit the health department for services, one of the first questions they now ask is where the patient plans to deliver the baby. “We find out where they plan  to deliver whether that be Sylva, Haywood, Murphy, or wherever, so we can coordinate the transfer of the clinical records,” he said.

Bruckner noted that he is also working with Harris Regional Hospital to open up record sharing to make it easier to transfer client records there as needed. Bruckner said the health department is also waiting to see how Harris’ expansion of care in Franklin will impact prenatal clients as he believes those offices will likely receive many of the patients in the area.

Earlier this week, Harris Regional Hospital announced the expansion of women’s and children’s care in western North Carolina with the addition of three certified nurse midwives and a pediatrician. The hospital has also established a full-time presence for obstetrics, gynecology, and pediatrics at Harris Regional Hospital Medical Park of Franklin located at 55 Holly Springs Drive.

The three midwives have joined Harris Women’s Care, an obstetrics and gynecology practice with locations in Sylva, Franklin and Bryson City. Ryan Wade, MD will join the physicians of Harris Pediatric Care next month, seeing patients at the Sylva office and in the newly-expanded Franklin location.

·         Sally Schaefer, certified nurse midwife, will join Harris Women’s Care Aug. 1. Schaefer has cared for women and delivered babies in the region for decades. She completed her postgraduate training at the University of Miami in Coral Gables, Fla.

·         Rani Khan, certified nurse midwife, will join Harris Women’s Care Aug. 14. Khan completed her postgraduate training at Emory University School of Nursing and most recently practice in Asheville, Qatar, and Africa.

·         Judi Layton, certified nurse midwife, will join Harris Women’s Care Sept. 11. Layton has practiced in the region since 2012. She completed her postgraduate training at the University of Pennsylvania.

Khan, Schaefer, and Layton will provide obstetrical care and routine women’s healthcare alongside Sabine Kelischek, MD, Megan Metcalf, MD, and Kathy Walsh, NP serving the Sylva, Bryson City, and Franklin locations.

Ryan Wade, MD will join Harris Pediatric Care Aug. 14. Dr. Wade completed a residency in pediatrics at the University of Florida in Pensacola after receiving his medical degree from the Medical University of South Carolina in Charleston.

Dr. Wade will practice alongside Charles Toledo, MD, Nicholas Jernigan, MD, and Joshua Alweiss, MD at Harris Pediatric Care serving the Sylva and Franklin locations. Brooke Budde, DO provides pediatric care at Swain Family Care in Bryson City.

“We are excited to expand women’s and children’s services in western North Carolina,” said Steve Heatherly, CEO of Harris Regional Hospital and Swain Community Hospital. “Our hospitals have a decades-long tradition of serving families with world-class women’s and children’s care. Our full-time presence in Macon County will provide an opportunity for us to demonstrate our commitment and world-class care to families in the Franklin area by exceeding their expectations with these outstanding physicians and nurse midwives.”