Valley Medical Center’s Board of Commissioners passed a resolution March 15 authorizing the construction of a free standing emergency department in Covington, but the vote came after a contentious battle between the board members and staff.

The measure passed with commissioners Sue Bowman, Carolyn Parnell and Don Jacobson voting yes. Commissioner Anthony Hemstad voted no and Commissioner Aaron Heide abstained.

The commission asked the staff to present an options analysis of the best sites to place an emergency department, particularly comparing Kent and Covington or not building a facility at all.

Hemstad has been vocal about his concern with the choice of Covington and made the motion at the March 1 meeting for the options analysis, which passed unanimously.

Valley signed a contract with Ashton Development for a 10-acre site in the Town Center area of Covington in January. The price for the property came in at about $5 million, $11.50 per square foot.

Mike Glenn, senior vice president of business development for Valley, presented a series of slides and a discussion outlining why the staff decided Covington was the best choice.

A number of doctors attended the meeting and spoke in support of locating the emergency department in Covington.

It was noted the city would help the public hospital district protect its market share.

MultiCare plans on building both an emergency department and 54-bed hospital on its site in Covington. Swedish has plans to build a free standing emergency department in Maple Valley near Four Corners.

Dr. Maurice Montag said Covington is a “significant distance from Valley. If Swedish and MultiCare put ERs out there we will see patients moving away.”

Dr. Terence Block said one of the problems with “American health care is fragmentation.” He advocated for patients to have an emergency hospital “integrated with a full service hospital like Valley.”

Glenn described it as a placing the emergency department in the “outer reaches of the district.”

He stated people living in and around Kent have the ability to access other facilities and they are closer to Valley Medical than Covington.

“The market share of doing nothing is so great it is not a factor,” Glenn said.

Rich Roodman, Valley president and CEO, said the Covington market is an important part of the district.

“Inaction in Covington given the competitive environment is a poison pill to the financial viability of Valley,” Roodman said.

The contentious part of the meeting began after the presentation from Glenn and the physicians.

Hemstad raised questions about placing the emergency department in an area based on profits. He asked, “as a public hospital don’t we try to cater to those who have the needs…? Is it better to have (an emergency department) a few miles apart looking at health care rather than maximizing our profits?”

Commissioner Don Jacobson said the population movement in Kent is toward the east and Easthill.

“We should go where the population is going,” Jacobson said.

Hemstad continued to question whether the hospital should be looking to maximize profits.

Roodman said those operating MultiCare are “good business people. It (Covington) is our market to keep.”

Parnell said “from a business standpoint it is very important to maintain our market share. We have to make money to provide services.”

Concerning the staff analysis of Covington and Kent, Hemstad said, “it is hard to say this is a dispassionate analysis. It takes one side and stays with it. There are six mistakes in just the first sentence.”

Hemstad said this was the first time written material had been provided to the commission.

“We should not be doing this (voting on the resolution) today,” Hemstad said

Bowman countered by stating the commission had been discussing the issue.

Heide brought up there had been discussion about “Valley becoming a private entity, so we just compete. My question is should we be a hospital district or 501(c)(3).”

Roodman said Valley treats more Medicaid and uninsured patients than any other hospital other than Harborview and keeping the hospital district financially viable meant the district could provide that service.

Heide also asked for a disclosure of former Commissioner Mike Miller’s activities concerning the project.

Heide beat Miller for the board seat in the November 2009 general election.

Glenn said Miller introduced him to “people in Covington. He is just helping me with introductions. There has been no financial payments to Mr. Miller at all.”

A flash point was reached when Heide stated he was elected because people thought there was a problem with transparency on the board.

Parnell said Heide was elected because of lies.

Hemstad said there should have been a pubic hearing before the staff asked for approval of the project from the board.

The hospital’s attorney, George Beal, from the Seattle firm Perkins Coie, said it was not legally necessary for Valley to hold a public hearing for the facility.

Jacobson said, “this is an expansion of our business. This is not just going out into the woods. As a board member I got to believe we are in the right place at the right time.”

Heide abstained until the disclosure of Miller’s affiliation with the project.