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[00:00:01]

CLOSED CAPTIONING PROVIDED BY BUFORT COUNTY STATION, QUITE REVEALING.

UM, SO I'M NOT GONNA SPEND A LOT OF TIME JUST, UH, WANNA WELCOME THE CEO OF BUFORT MEMORIAL HOSPITAL.

MR. RUSSELL BAXLEY, THANK YOU FOR, FOR, UH, BEING SO GENEROUS WITH YOUR TIME, MR. BAXLEY.

AND THE HOUR IS YOURS.

I, I, I APPRECIATE IT, MAYOR WILLIAMS, AND I APPRECIATE, UH, UH, THIS COUNCIL HAVING ME AND ALLOWING ME TO PRESENT, UH, ABOUT BEAUTIFUL MEMORIAL.

I KNOW MOST OF YOU, UH, I'VE MET, UH, A NUMBER OF YOU.

I'VE BEEN HERE EIGHT YEARS NOW, UH, BELIEVE IT OR NOT.

AND, UH, AND SO I'VE HAD THE PLEASURE OF WORKING WITH A LOT OF YOU ON PREVIOUS PROJECTS OR CURRENT PROJECTS, OR EVEN DISCUSSIONS ON FUTURE PROJECTS.

AND SO A LOT OF WHAT I'M GONNA PRESENT TODAY IS, IS REALLY A, A LITTLE BIT OF HISTORY ON BMH, JUST TO REFRESHER WHERE WE'VE BEEN, UH, KIND OF WHERE WE'RE AT TODAY AND, AND CURRENT PROJECTS AND, AND REALLY WHERE WE'RE HEADED.

UH, AND TAKE A LITTLE BIT OF A FLAVOR ON SPECIFICALLY KIND OF HEALTHCARE ACCESS, UH, IN THE LOW COUNTRY.

AND, UM, I HEAR IT ALL THE TIME.

I'M, I'M SURE A NUMBER OF YOU HERE HEAR IT FROM, FROM THOSE THAT YOU SERVE IS, UM, I CAN'T FIND A DOCTOR.

I CAN'T GET AN APPOINTMENT.

UM, THERE'S NO ACCESS, UH, TO ANY SORT OF SPECIALTY CARE IN THE AREA.

AND ONE OF THE THINGS I'LL FOCUS ON IS REALLY HOW WE'RE TRYING TO ADDRESS THAT AND HOW WE CAN WORK TOGETHER COLLECTIVELY, UM, ON A COUPLE OF INITIATIVES THAT WILL HELP TO, UM, FURTHER AND ADVANCE HEALTHCARE ACCESS, UH, WITHIN ALL THE COMMUNITIES IN THE LOW COUNTRY.

UM, SO QUICKLY, YOU KNOW, JUST A BRIEF HISTORY ON WHO WE ARE.

WE ARE THE AREA'S LARGEST HOSPITAL PROVIDER, UH, THE LARGEST BETWEEN SAVANNAH IN CHARLESTON, 201 BEDS, 169 ACUTE CARE BEDS.

UH, 14 OF THOSE ARE REHAB BEDS.

AND THEN WE HAVE 18 ADULT MENTAL HEALTH BEDS.

WE ARE A THREE, THE THREE COUNTY AREA ONLY ADULT MENTAL HEALTH UNIT.

UH, SO ALL BASICALLY INPATIENT MENTAL HEALTH CARE COMES TO BEAUTIFUL MEMORIAL AT THIS TIME FROM THREE COUNTIES.

UH, WE ARE 1800 PLUS EMPLOYEES AND GROWING.

SO AS PRIVATE EMPLOYERS GO, WE ARE THE AREA'S LARGEST PRIVATE EMPLOYER.

UH, AND, UH, YOU SEE, WE HAVE TWO CANCER CENTERS.

THOSE TWO CANCER CENTERS HAVE THE SAME TECHNOLOGY THAT YOU WOULD FIND IN SAVANNAH, CHARLESTON, OR JACKSONVILLE, NEWEST STATE-OF-THE-ART LINEAR ACCELERATOR TECHNOLOGY FOR RADIATION THERAPY.

UH, WE HAVE, UH, MANY ROBOTS IN OUR ORS.

WE HAVE FOUR ROBOTS TO BE SPECIFIC IN TERMS OF MENTALLY INVASIVE SURGERY.

WE HAVE THREE EXPRESS CARES IN OCCUPATIONAL HEAD MEDICINE CLINICS FOR IMAGING CENTERS, FOR TELEMEDICINE KIOSK.

WE EMPLOY WELL OVER A HUNDRED PROVIDERS, AND WE DO HAVE A HOME HEALTHCARE COMPANY.

AND SO YOU CAN SEE THAT, YOU KNOW, WE ARE PROVIDING ACCESS TO CARE, YOU KNOW, ACROSS ALL LEVELS OF CARE, WHETHER IT'S IN THE HOME, IN THE GROCERY STORE, IN URGENT CARE, ER, SURGERY, IMAGING, YOU NAME IT.

WE'RE, WE'RE DOING IT RIGHT NOW.

THESE ARE SOME OF OUR LOCATIONS.

SO YOU CAN SEE WE SPAN ALL THE WAY, ALL THE, UH, UP TO YEE.

UH, WE HAVE THE RURAL HEALTH CLINIC, HARRISON PEEBLES, AND WE GO ALL THE WAY TO HILTON HEAD ISLAND WITH THE, UH, IMAGING CENTER DOWN THERE.

AND THEN OUR MAIN HUB OR OUR ANCHOR FACILITIES, OBVIOUSLY BEAUFORT MEMORIAL, UH, THAT SITS, UH, NORTH OF BROAD RIVER IN BUFORT.

YOU CAN'T TALK ABOUT HEALTHCARE WITHOUT TALKING ABOUT SAFETY FIRST.

SO I PRESENT AT EVERY ORIENTATION, AND THE FIRST THING I LEAD OFF WITH IS OUR PATIENTS WANT THREE THINGS.

DON'T HARM ME, HEAL ME, AND BE NICE TO ME IN THAT ORDER, RIGHT? SO THEY DON'T HARM ME IS, IS PROBABLY THE MOST IMPORTANT, RIGHT? BECAUSE HARM HAPPENS ON OUR WATCH.

AND SO WE PUT THESE AWARDS UP HERE BECAUSE WE INVITE THESE OUTSIDE AGENCIES TO TOUR, TO MONITOR, TO GRADE US AS A FACILITY, BECAUSE IT JUST REINFORCES THE GREAT CARE THAT WE PROVIDE.

AND SO YOU'LL SEE ZERO HARM AWARDS, THREE YEARS IN A ROW, TOP 5% HOSPITAL IN THE NATION, AWARD FOR PATIENT SAFETY AND, UH, HARM, ET CETERA.

I THINK THESE AWARDS SPEAK.

THIS JUST VALIDATES THE GREAT CARE THAT WE PROVIDE AT BEAUTIFUL MEMORIAL.

UM, WE ALWAYS SAY THAT, YOU KNOW, THIS IS WHAT, WHAT WE'RE MOST PROUD OF.

WE DO A LOT OF THINGS, BUT THE FACT THAT WE PREVENT HARM AND WE HEAL OUR PATIENTS IS WHAT WE'RE MOST PROUD ABOUT AT BEAUTIFUL MEMORIAL TERMS OF THE LARGEST PROVIDER.

WE DO WELL OVER 600,000 PATIENT ENCOUNTERS A YEAR, RIGHT? AND SO WE BREAK THOSE UP INTO DIFFERENT CATEGORIES, BUT, UH, I'LL START WITH ADMISSIONS.

WE ADMIT AND DISCHARGE ALMOST 9,000 PATIENTS A YEAR.

UH, WE SEE ABOUT 225 OUTPATIENT REGISTRATIONS, 225,000

[00:05:01]

OUTPATIENT REGISTRATIONS.

SO THINK OF AN MRIA CT, A CHEMO INFUSION, A PHYSICAL THERAPY VISIT, EMERGENCY DEPARTMENT.

WE SEE ABOUT 120 A DAY IN THE ER.

THAT IS, BY MEDICARE'S DEFINITION, A HIGH VOLUME ER.

THERE ARE MUCH LARGER HOSPITALS THAT SEE LESS, UM, THAN WE DO AT BEAUTIFUL MEMORIAL, UH, 12,000 SURGERIES AND GROWING A THOUSAND DELIVERIES.

AND THEN PHYSICIAN OFFICE VISITS, 276,000.

AND AS YOU GUYS PROBABLY CAN TELL, THAT DOESN'T EVEN COVER THE WATERFRONT.

IN TERMS OF THE NEED, IN TERMS OF PHYSICIAN PRACTICES, OUR FINANCIALS, WE LAST YEAR, SPENT ABOUT 300 MILLION.

WE MADE ABOUT 300 MILLION.

UM, YOU KNOW, THINGS HAVE CHANGED DRAMATICALLY POST COVID.

UH, WE DON'T TALK THAT MUCH ABOUT COVID ANYMORE, BUT AS YOU GUYS KNOW, THAT THE MARKET HAS SHIFTED IN A NUMBER OF WAYS.

AND BECAUSE OF THAT, YOU KNOW, OUR FINANCIALS HAVE SHIFTED A LITTLE BIT.

UM, WE'RE A LOT BETTER OFF THAN MOST HOSPITALS, ESPECIALLY INDEPENDENT COMMUNITY HOSPITALS, UM, WHERE WE'RE STILL MAKING A MARGIN AND THIS YEAR IS LOOKING MUCH BETTER THAN LAST.

UM, BUT IT IS MUCH DIFFERENT POST COVID FOR HOSPITALS AND HEALTHCARE SYSTEMS. SO, LAST YEAR, YOU KNOW, I'LL START WITH EXPANDING ACCESS TO CARE.

I KNOW WE HEAR A LOT ABOUT PEOPLE MOVING TO THE AREA SAYING THEY CAN'T GET A, A PROVIDER.

UM, THESE ARE ALL THE PROVIDERS THAT WE RECRUITED AND STARTED LAST YEAR.

AND THERE'S ACTUALLY MORE, UH, THE PICTURES JUST DON'T FIT ON THE SLIDE, RIGHT? AND SO YOU'LL SEE A FEW PEOPLE, AND I'LL START WITH PRIMARY CARE.

YOU'LL SEE ABOUT FOUR OR FIVE PRIMARY CARE PROVIDERS THAT WERE RECRUITED AND STARTED LAST YEAR WITH YOUTH MEMORIAL.

UH, JUST FOR FRAME OF REFERENCE, ONE PRIMARY CARE PROVIDER CAN HAVE ABOUT 1500 TO 2000 PATIENTS ON THEIR PANEL.

SO THINK ACTIVE CHARTS.

AND THAT'S A HEALTHY PANEL, 2000.

SO IF WE RECRUIT ONE PRIMARY CARE PROVIDER, THAT PROVIDER CAN ACTIVELY SEE 2000 PEOPLE AT ANY GIVEN TIME TO SEE, UH, MAINTENANCE MEDS, UH, CHRONIC CONDITIONS, SICK VISITS, ANNUAL MEDICARE WELLNESS VISITS, THOSE SORTS OF THINGS.

SO WHEN WE RECRUIT ONE, WE CAN ADD 2000 PEOPLE.

WHEN ONE RETIRES, 2000 PEOPLE NEED A PRIMARY CARE PHYSICIAN, FOR EXAMPLE, YOU CAN SEE GENERAL SURGERY.

YOU CAN SEE PSYCHIATRY, PULMONOLOGY, SPINE SURGERY, UH, FELLOWSHIP TRAINED BREAST SURGERY.

AGAIN, THERE ARE A LOT OF PROVIDERS THAT WE BROUGHT TO THE MARKET, AND WE STILL SEE, UH, ISSUES WITH SIX MONTHS WAIT FOR A PRIMARY CARE APPOINTMENT OR FOUR MONTH WAIT FOR NEUROLOGY, UH, OR A THREE MONTH WAIT FOR A PULMONARY APPOINTMENT.

WE CONTINUE TO TRY TO RECRUIT, BUT WE HAVE STARTED A NUMBER OF NEW PROVIDERS.

UH, WE DID ACQUIRE ISLAND IMAGING, SO THAT WAS OUR FIRST, UH, ASSET, IF YOU WILL, ON HILTON HEAD ISLAND.

WE DO INTEND TO GROW ON THE ISLAND MORE.

THERE'S A, UH, A NEED FOR GROWTH OF HEALTHCARE ON THE ISLAND, ESPECIALLY ON PRIMARY CARE.

AND I'M GONNA GET INTO A LITTLE BIT ON ONE OF MY SLIDES, THE ACTUAL PHYSICIAN SHORTAGE.

WE CAN TELL YOU THE NUMBER OF PHYSICIANS YOU NEED TODAY IN ORDER TO MEET THE DEMAND FOR HEALTHCARE.

AND I'D BREAK IT UP BY HEALTHCARE ECOSYSTEM, AS I CALL IT, UM, NORTH ABROAD.

THEN I HAVE, UH, BLUFF AND OKEE, AND THEN I HAVE HILTON HEAD.

BUT THIS IS KIND OF OUR FIRST STEP ON EXPANDING SERVICES ON THE ISLAND.

AND THEN JUST SOME OF WHAT WE INVESTED LAST YEAR IN THE HOSPITAL.

SO THIS ALL, UH, WERE PROJECTS THAT WE COMPLETED, UH, A NEW, UH, MINIMALLY INVASIVE ROBOT FOR DIFFERENT SURGERIES.

YOU SEE GYNECOLOGY, GENERAL SURGERY, UROLOGY, ONE NEW MRIA NEW CATH LAB.

AND THEN WE RENOVATED OUR HOSPITAL TOWER.

SO WE INVESTED, UH, ABOUT SEVEN AND A HALF MILLION DOLLARS LAST YEAR ALONE ON JUST HOSPITAL REPLACEMENT PROJECTS, RENOVATIONS AND UPDATING OUR FACILITIES.

ONE OF THE THINGS THAT, UH, WE'VE GOT A LOT OF PUBLICITY ABOUT, AND WE'RE MOST PROUD OF AS WELL, IN TERMS OF, UM, YOU KNOW, NO HARM TO PATIENTS, BUT IT'S HOW WE HELP OUR WORKFORCE.

UH, WORKFORCE CHALLENGES ARE NOT UNIQUE TO HEALTHCARE.

UM, BUT YOU KNOW, SPECIFICALLY TO HEALTHCARE, IF YOU LOOK AT, FOR EXAMPLE, THE NURSING SHORTAGE, DEPENDING ON WHAT STUDY YOU LOOK AT, SOUTH CAROLINA WILL EITHER BE SHORT BETWEEN SEVEN OR 10,000 NURSES BY THE YEAR 2030.

UH, A LOT OF THOSE NURSES ARE AT THE BEDSIDE.

SO THINK YOUR MED SURG UNITS, YOUR STEP DOWN UNITS, ET CETERA.

WE ARE STRUGGLING AS A STATE, REALLY, AND AS HEALTHCARE SYSTEMS GO, RECRUITING AND RETAINING NURSES IN HOSPITALS.

UM, ONE OF THE THINGS THAT WE'RE DOING IS THE PATH PROGRAM, WHICH IS KIND OF A TRIPLE AIM APPROACH.

WE LAUNCHED, UH, ABOUT THE MIDDLE OF COVID, ABOUT THE MIDDLE TO LATE PART OF COVID PANDEMIC.

UH, BY TRIPLE AIM, WE FIRST FOCUSED ON BURNOUT, MITIGATION, RIGHT? UH, THE PANDEMIC WAS HARD, ESPECIALLY, UH, FOR THOSE IN HOSPITAL SETTINGS.

AND SO WE LAUNCHED CERTAIN PROGRAMS LIKE, UH, MEQ AND SCHWARTZ ROUNDS, WHICH IS REALLY MENTAL STRESS, FIRST AID, UH, FOCUSED ON TALKING ABOUT WHAT IS HAPPENING IN BOTH THE HOSPITAL WORLD AND YOUR PERSONAL LIFE.

UH, WE HIRED A, UH, BASICALLY A SOCIAL WORKER JUST FOR OUR EMPLOYEES, UH, A RESOURCE FOR THEM TO MEET WITH, AS IF THEY'RE A GUIDANCE COUNSELOR, HELPING THEM MITIGATE AND WORK THROUGH SOME OF THESE ISSUES.

UM, HOUSING, I DON'T HAVE TO TELL ANYONE ON THIS, UH, ON THIS COUNCIL HOUSING IS AN ISSUE.

UH, THE COST OF LIVING IN THIS AREA IS A BIG ISSUE.

UM, YOU KNOW, WE FOLLOW THE SAME STUDIES LIKE UNITED WAY, SELF-SUSTAINING, SELF-SUSTAINABLE WAGE INDEX.

UM, WE'RE SECOND HIGHEST IN THE STATE ONLY TO CHARLESTON, RIGHT? FOR A SINGLE MOTHER AND A PRESCHOOLER, RIGHT? THAT'S A PROBLEM.

THAT'S A PROBLEM FOR RECRUITMENT, RETENTION TO THE AREA.

UH, SO ONE OF THE THINGS THAT WE'VE BEEN DOING, UH, IS HELPING EMPLOYEES BUY HOMES.

UH, WE HELP, UH, WITH COMMUNITY

[00:10:01]

WORKS.

SO THEY'RE PARTNERS OF OURS.

UH, WE HELPED 12 EMPLOYEES BUY HOMES WITH DOWN PAYMENT ASSISTANCE LAST YEAR.

UH, THERE'S THREE THAT WE'VE ALREADY HELPED THIS YEAR, UH, AND THREE MORE IN THE WORKS.

OUR GOAL IS TO HAVE ABOUT 20 A YEAR.

UM, WE DIDN'T HIT THAT LAST YEAR, BUT OUR GOAL IS TO HIT 20 AND THEN KEEP GROWING, HELPING EMPLOYEES BUY HOMES, UH, IN THE BEAUFORT COUNTY, JASPER COUNTY AREA.

AND THEN WE'VE LAUNCHED A FEW OTHER THINGS LIKE FACEBOOK FOR THE WORKPLACE, OUR HUB, FAMILY MEAL DEALS, UM, BUT AGAIN, JUST REALLY FOCUSED ON HOW DO WE SUPPORT OUR WORKFORCE.

THE OTHER THING THAT WE LAUNCHED WITH THE HELP OF, FOR EXAMPLE, BEAUFORT COUNTY, THE CITY OF BEAUFORT, IT'S BEEN VERY HELPFUL HERE, UM, IS REALLY THE THIRD AIM OF OUR PLATFORM, WHICH IS EDUCATION AND GROWTH WITHIN OUR WORKFORCE.

AND SO WE KNOW THAT, UM, CURRENTLY THERE'S JUST NOT ENOUGH SUPPLY.

NOT ONLY NURSES, BUT CERTIFIED MEDICAL ASSISTANTS IN THE PHYSICIAN CLINICS, PATIENT CARE TECHS, WHICH WORK WITH THE NURSES AT THE BEDSIDE TO PROVIDE CARE FOR THE PATIENTS, MEDICAL CODERS, ET CETERA.

SO OVER THE COURSE OF FIVE CLASSES, AND THESE ARE ABOUT 16 TO 20 WEEK COURSES, WE'VE BASICALLY CREATED OUR OWN SCHOOL AT BEAUTIFUL MEMORIAL.

WE TAKE OUR WORKFORCE, THOSE THAT MAYBE ARE IN DIETARY OR HOUSEKEEPING OR PATIENT ACCESS OR REGISTRATION, AND WE SAY, HOW DO YOU WANT TO GROW WITHIN THE ORGANIZATION? AND WE PUT THEM ON THE PATH.

UH, AND ESSENTIALLY WHAT WE DO IS WE LET THEM WORK PART-TIME.

WE GIVE THEM SCHOLARSHIPS TO MAKE UP THEIR FULL-TIME PAY.

UH, SO THEY'RE, SO THEY CAN CONTINUE TO SUPPORT THEIR FAMILY, UH, AND THEIR, AND THEIR LIFE, SO TO SPEAK.

AND WE EDUCATE THEM WITH OUR EDUCATORS.

AND SO WE'VE GRADUATED IN FIVE CLASSES, 51 PEOPLE, AND SUPPORTED THEM WITH, TO THE TUNE ABOUT $157,000 IN SCHOLARSHIPS.

UH, THESE PEOPLE ARE ALL CURRENTLY WORKING AT BE MEMORIAL AT THE BEDSIDE OR IN THE ADMINISTRATIVE BUILDING, HELPING TO GROW OUR WORKFORCE.

UM, WE'VE ALSO DONE JOB FAIRS, UH, IN THE HIGH SCHOOLS, UH, AND IN THE COMMUNITY SAYING, HEALTHCARE EXPERIENCE IS NOT REQUIRED.

WE CAN TEACH YOU HEALTHCARE.

WHAT WE WANT IS THE RIGHT ATTITUDE.

WE WANT WORK ETHIC, ATTITUDE, UM, AND THE RIGHT PERSON.

WE CAN TEACH YOU ALL THIS STUFF IN OUR PATH TO SCHOOL, SO TO SPEAK.

SO, A LITTLE BIT ABOUT, UH, SOME OF THE OTHER THINGS THAT WE DO IN THE COMMUNITY BEFORE I GET INTO KIND OF THE FUTURE OF HEALTHCARE.

SO WHAT DOESN'T GET, UH, I THINK DISTRIBUTED ENOUGH, COMMUNICATED ENOUGH IS REALLY WHO WE SEE AND HOW WE, HOW WE WORK WITH OUR COMMUNITY TO PREVENT, UM, ED, UH, VISITS UNNECESSARY, OR READMISSIONS OR TRYING TO KEEP PEOPLE OUTTA PSYCHIATRIC UNIT.

SO ONE OF THE THINGS WHEN WE SEE, SAY WE SEE ABOUT 44,000 PEOPLE IN THE EMERGENCY ROOM.

UH, 6,100 OF THOSE DON'T HAVE INSURANCE.

UM, THAT MAKES UP ABOUT $13.4 MILLION IN FREE CARE BETWEEN EMERGENCY VISITS, SURGERY, ADMISSIONS, AND DISCHARGES THAT WE OTHERWISE PROVIDE.

AND PART OF DOING THAT, WE PAY SPECIALISTS, ALL SPECIALISTS, TO BE ON CALL 24 7 AT THE ER.

YOU DON'T WANNA SHOW UP TO THE ER AND, UM, NEED YOUR APPENDIX REMOVED AND NOT HAVE A GENERAL SURGEON ON CALL, FOR EXAMPLE.

SO WE PAY ALL PROVIDERS TO BE ON CALL.

WE ALSO PROVIDE 24 7 ONSITE CRITICAL CARE INTENSIVIST COVERAGE, ALL THAT TO THE TUNE OF ABOUT ONE AND A HALF MILLION DOLLARS, UM, ON TOP OF EVERYTHING WE PROVIDE IN THE EMERGENCY ROOM, AND THEN THE INPATIENT PSYCHIATRIC SERVICES.

SO THE COUNTY IS, IS VERY GENEROUS IN HELPING TO SUPPORT THIS WITH, WITH SOME OF THE, UH, MILAGE THAT THEY GIVE TO THE HOSPITALS, ROUGHLY ABOUT A MILLION DOLLARS A YEAR.

UM, BUT WE LOSE ABOUT $1.7 MILLION A YEAR ON OUR INPATIENT PSYCHIATRIC UNIT.

UM, THERE'S A REASON A LOT OF PEOPLE AREN'T BUILDING PSYCHIATRIC HOSPITALS.

UM, THERE'S A REASON THAT YOU DON'T SEE A LOT OF FREESTANDING FACILITIES GOING UP ALL THE TIME.

UM, BECAUSE MOST OF THE TIME, INPATIENT ADULT MENTAL HEALTH IS NOT A PROFITABLE SERVICE.

UH, A GOOD NUMBER OF OUR PATIENTS, YOU CAN SEE 20%, UH, HAVE NO INSURANCE, AND THEY STAY 6, 7, 8, 9 DAYS, UH, UNTIL WE DISCHARGE THEM.

SO, NOT COMPLAINING, I'M JUST TRYING TO PAINT THE PICTURE OF, YOU KNOW, WHAT THE COMMUNITY HOSPITAL IN THIS AREA, WHAT WE PROVIDE BACK TO THE COMMUNITY.

SO WHAT ARE WE DOING TO TRY AND PREVENT SOME OF THIS? WELL, WE HAVE A, UH, MAT CLINIC OR ADDICTION MEDICINE CLINIC, UC, DR.

PHIL ANO, WHO SUBSEQUENTLY HAS RETIRED IN THE LAST COUPLE OF MONTHS.

WE'VE ALREADY REPLACED HIM, UH, WITH ANOTHER PROVIDER.

UM, BUT WE HAVE 109 PATIENTS WE'RE CURRENTLY TREATING FOR, UH, THE OPIOID PANDEMIC RIGHT NOW.

AND THAT CONTINUES TO GROW.

WE HAVE A PATIENT TRANSPORTATION SERVICE.

SO A LOT OF TIMES PATIENTS COME TO THE ER BECAUSE THEY HAVEN'T BEEN ABLE TO GET TO THEIR DOCTOR'S APPOINTMENT OR TO THEIR INFUSION CENTER APPOINTMENT, OR TO, UH, AN APPOINTMENT THAT THEY NEED FOR THE CHRONIC CARE MANAGEMENT THAT WE PROVIDE.

SO INSTEAD OF COMING TO THE ER VIA AMBULANCE, WE PUT TOGETHER OUR OWN TRANSPORTATION SERVICE.

AND WE'VE DRIVEN, LAST YEAR ALONE, 22,000 MILES TRA TRANSPORTING PATIENTS AT NO COST.

UM, THAT'S 1700 PATIENTS SERVING 26 ZIP CODES, UH, IN THE STATE OF SOUTH CAROLINA, GETTING THESE PATIENTS TO AND FROM THEIR APPOINTMENTS.

WE ALSO ARE TRYING TO ADDRESS FOOD INSECURITIES.

SO WHEN WE DISCHARGE PATIENTS FROM THE HOSPITAL, WE ASK THEM A LOT OF QUESTIONS, WHAT IS YOUR HOUSING LIKE? YOU GET DINNER ON A REGULAR BASIS.

UM, DO YOU HAVE TR YOU KNOW, WHAT IS YOUR TRANSPORTATION LIKE, ET CETERA.

WE DOCUMENT THIS AND THEN WE PUT OUR SOCIAL WORK TEAM, UH, ON TOP OF IT AND SAY, WHAT DO WE NEED TO DO FOR THESE PATIENTS? PART OF THIS IS WE DELIVER 50 MEALS A DAY, UH, FIVE DAYS A WEEK, TO THE FOOD INSECURE.

UM, WE TAKE THESE MEALS AS WE'RE PREPARING THESE MEALS EVERY

[00:15:01]

NIGHT AT DINNER, WE PREPARE, I DON'T KNOW WHAT, WE HAVE 120 PEOPLE IN THE HOSPITAL A DAY, THREE MEALS A DAY.

SO WE PREPARE 360 MEALS AT A MINIMUM, UH, A DAY FOR OUR PATIENTS.

SO WE JUST PREPARE AN EXTRA 50 PLUS MEALS, WE BOX 'EM UP AND WE TRANSPORT 'EM TO THE PATIENTS WE'VE IDENTIFIED THAT AREN'T GOING TO HAVE DINNER TODAY.

'CAUSE WE KNOW THAT FOOD IS HEALING, FOOD IS MEDICINE, SO TO SPEAK.

AND WE'RE TRYING TO ADDRESS THE FOOD INSECURITIES IN THE AREA.

AND THEN WE HAVE THE GOOD NEIGHBOR FREE MEDICAL CLINIC.

WE ALSO WORK WITH VIM, BUT YOU CAN SEE WE PROVIDE ABOUT, UM, $600,000 OF IN-KIND CARE TO GOOD NEIGHBOR AND THEIR PATIENTS.

UM, WE HAVE ACCESS HEALTH LOW COUNTRY, AND THEN WE HAVE THE SICKLE CELL ANEMIA CLINIC.

AGAIN, ONE OF THE CLINICS THAT WE PUT TOGETHER THAT WE'VE IDENTIFIED AS PATIENTS THAT CONTINUE TO COME TO THE ER, UM, THAT OTHERWISE WEREN'T GETTING THE CARE THAT THEY NEED.

SO WE SET UP A CLINIC SPECIFICALLY FOR THEM.

UH, AND THEY ARE ALSO HIGH UTILIZERS OF OUR TRANSPORTATION PROGRAM, BUT I CAN TELL YOU, WE'VE REDUCED THEIR RETURNS TO THE ERS BY ALMOST A HUNDRED PERCENT.

THEY RARELY SHOW UP TO THE ER ANYMORE, AND THEY'RE GETTING THE CARE THAT THEY NEED.

MOST OF YOU HAVE SEEN OUR ACCESS HEALTH, UH, OR OUR, UM, MOBILE WELLNESS UNIT.

SO YOU CAN JUST SEE SOME OF THE TESTING OF SOME OF THE EMPLOYERS WE WORK WITH THERE.

UM, AND, YOU KNOW, THAT GOES TO COMMUNITY CENTERS, CHURCHES FREE SCREENINGS, BLOOD DRAWS, UM, BLOOD PRESSURE.

UH, WE HAVE A NURSE PRACTITIONER THAT WORKS ON THAT, UH, DOING PHYSICALS, EXAMS, ET CETERA.

SO THESE ARE ALL THE THINGS THAT WE PROVIDE, AND A LOT OF THAT DOESN'T REALLY SHOW UP AND THAT $38 MILLION IN CHARITY CARE AND BAD DEBT.

UM, BUT THOSE ARE A LOT OF THE SERVICES THAT WE PROVIDE THAT WE JUST DON'T TALK ABOUT ENOUGH.

SO THIS IS OUR BUDGET THIS YEAR.

SO WE ARE MORE BULLISH THIS YEAR, UH, THAN WE WERE LAST YEAR AT BEFORD MEMORIAL.

SO WE, WE DO INTEND TO SEE OUR VOLUMES GROW.

FOR EXAMPLE, YOU SEE PHYSICIAN OFFICE VISITS.

UM, WE EXPECT THAT TO GROW BY A MINIMUM OF 11%, UH, TO 308,000, UH, SURGERIES.

WE EXPECT TO REALLY STAY THE SAME.

AND THERE'S SOME DETAILS THERE, BUT ULTIMATELY WE DO EXPECT THOSE TO START GROWING IN THE NEXT COUPLE OF YEARS TO 13,000 AND 15,000 SURGERIES RESPECTIVELY.

UH, EMERGENCY DEPARTMENT VISITS, OUTPATIENT REGISTRATIONS.

ALL IN ALL, WE EXPECT TO SEE WELL OVER 650,000 ENCOUNTERS AT BE MEMORIAL THIS, THIS COMING FISCAL YEAR.

UH, AND THEN YOU SEE OUR FINANCIALS.

WE DO EXPECT TO MAKE A LITTLE BIT MORE MONEY THIS YEAR THAN LAST.

UM, WE'RE A LITTLE BEHIND THAT RIGHT NOW, MOSTLY BECAUSE OF EXTREME BENEFITED COST AND EXPENSE, UM, THROUGH HEALTH INSURANCE CLAIMS PROVIDERS STARTING.

SO YOU CAN JUST SEE AGAIN, THESE PROVIDERS SIGNED THAT HAVE EITHER RECENTLY STARTED OR GETTING READY TO START WITH GENERAL SURGERY.

WE HAVE A NEW UROLOGIST STARTING.

YOU'LL SEE THAT, UH, THE PHYSICIAN NEEDS ANALYSIS THAT THE COUNTY NEEDS 7.2 UROLOGISTS TODAY.

UM, SO WE'RE TRYING TO MEET THAT NEED RIGHT NOW.

WE HAVE ONE STARTING AND TWO MORE INTERVIEWING ANOTHER MEDICAL ONCOLOGIST, A RECONSTRUCTIVE PLASTIC SURGEON.

UM, AND THEN PRIMARY CARE, WE CONTINUE TO RECRUIT FOR PRIMARY CARE.

WHAT I WOULD TELL YOU IS THAT WHEN WE LEAD, WHEN WE HAVE OPEN PHYSICIAN PHYSICIANS, WE NEVER CLOSE THE PRIMARY CARE PHYSICIAN.

WE ARE ALWAYS AND CONSTANTLY RECRUITING PRIMARY CARE PROVIDERS TO THE AREA.

AS THEY APPLY, WE HIRE 'EM.

UM, IT IS VERY COMPETITIVE FOR PRIMARY CARE, UH, EVERYWHERE.

SO ONE OF THE THINGS WE'RE ALSO WORKING ON TO SUPPORT THE NURSING WORKFORCE SHORTAGE IS THROUGH GOOD PARTNERSHIPS WITH THE COUNTY, THE CITY OF BEAUFORT, UM, AND UNIVERSITY OF SOUTH CAROLINA BEAUFORT.

WE ARE ALMOST FINISHED WITH OUR NEW NURSING SCHOOL.

UH, IT'S CURRENTLY UNDER CONSTRUCTION.

UH, IT WILL BE FINISHED IN JULY.

UH, USCB WILL NOW, UH, WORK TO CERTIFY THIS AS A SATELLITE LOCATION.

AND ULTIMATELY, WHAT THIS WILL ALLOW USCB TO DO IS INSTEAD OF ADMITTING ONE NURSING CLASS A YEAR, WE WILL NOW START ADMITTING TWO CLASSES A YEAR, BOTH A SPRING AND A FALL SEMESTER, DOUBLING THE ENROLLMENT CAPACITY OF USCB.

HOW ARE WE DOING THAT? WELL, IT'S NOT BY FACILITIES ALONE.

UH, WE'RE LEVERAGING OUR NURSING WORKFORCE TO BE ADJUNCT FACULTY, BECAUSE REALLY THE RATE LIMITING STEP IN NURSING SCHOOLS, UM, IS NOT PEOPLE WHO WANT TO BE NURSES.

IT'S PEOPLE WHO CAN TEACH NURSES.

UH, FOR EXAMPLE, AT CLEMSON, FOR EVERY FOUR PEOPLE THAT GO INTO A PRE-NURSING MAJOR AT CLEMSON UNIVERSITY, ONLY ONE ACTUALLY GET INTO THE NURSING SCHOOL.

WHAT DO THE OTHER THREE DO? BECOME MARKETING MAJORS.

THEY MAYBE GO INTO HO HOTEL AND TOURISM MANAGEMENT, MAYBE THEY GET INTO PUBLIC SERVICE, BUT THEY'RE NOT GONNA BE NURSES, RIGHT? THEY GO INTO SOMETHING ELSE.

IF WE COULD ADMIT ALL FOUR OF THOSE NURSES WHO, YOU KNOW, THOSE PEOPLE WHO WANTED TO BE NURSES, WE WOULD BE IN A MUCH BETTER PLACE.

AND SO, ONE OF THE THINGS THAT WE'RE TRYING TO DO IS IF WE CAN BRING THE NURSING SCHOOL ON CAMPUS, WE CAN TAKE OUR NURSES WHO ARE MOSTLY MASTER PREPARED OR FOUR YEAR PREPARED NURSES AND ALLOW THEM TO BE ADJUNCT FACULTY WORKING WITH USEB FACULTY TO INCREASE THEIR ENROLLMENT CAPACITY.

ONCE WE GET A GOOD CADENCE HERE, THE NEXT STEP IS TO CREATE AN ACCELERATED NURSING PROGRAM.

SO WHAT THAT DOES IS ESSENTIALLY GO BACK TO THAT NURSE OR THAT PRE-NURSING MAJOR, WHO THEN MAKE IT INTO NURSING SCHOOL.

PROBABLY HAD A REALLY GOOD GPA, PROBABLY 3.5 WITH CLEMSON, BUT THEY'RE IN MARKETING.

LET'S SAY THEY WANNA GET OUTTA MARKETING.

AN ACCELERATED NURSING PROGRAM ALLOWS THAT PERSON WHO GRADUATED WITH A FOUR YEAR DEGREE TO BECOME A NURSE IN ONE YEAR, BECAUSE THEY HAVE ALL THE PREREQS, AND WE JUST PUT THEM THROUGH NURSING SCHOOL, RIGHT? WE PUT 'EM THROUGH THE CLINICALS, THE PREREQS FOR ANATOMY, PHYSIOLOGY, CHEMISTRY, EVERYTHING THAT YOU NEED.

[00:20:01]

AND IT ACCELERATES THEM TO BECOME A NURSE IN ONE YEAR.

ESSENTIALLY, MUSC HAS A SIMILAR PROGRAM.

AND SO WE'RE TRYING TO MODEL THE MUSC VERSION OF THE ACCELERATED NURSING PROGRAM, BUT HERE IN BEAUFORT COUNTY AT THIS SCHOOL, AND AGAIN, THE PARTNERSHIP WITH OUR NURSES AND THEIR FACULTY IS WHAT'S GOING TO ALLOW US TO DO THIS, UM, AND HOPEFULLY PUT A DENT IN THE NURSING SHORTAGE IN THIS AREA.

CHILDCARE.

SO, UM, ANN IS SITTING BEHIND ME.

HE'S A CHAMPION FOR, FOR CHILDCARE.

I WAS, HE WAS GENEROUS ENOUGH OR GOOD ENOUGH TO PUT ME ON A COMMITTEE.

UH, ALTHOUGH I PROBABLY HAVE NO BUSINESS BEING ON A CHILDCARE COMMITTEE, UH, ON THERE ANYWAYS, MOSTLY BECAUSE WE ARE BUILDING CHILDCARE AT BEAUTIFUL MEMORIAL.

UM, AS WE KNOW, CHILDCARE, UM, IS, UM, VERY COST PROHIBITIVE FOR MOST OF OUR EMPLOYEES.

UH, WE HAVE ONE OF THE HIGHEST COST OF CHILDCARE IN SOUTH CAROLINA.

UH, IT IS PART OF THAT, YOU KNOW, WAGE INDEX THAT DRIVES THE COST UP.

IT SAYS THE PEOPLE CAN'T AFFORD TO WORK IN THIS COUNTY, UM, MOSTLY BECAUSE OF ACCESS.

UM, AND AS YOU HAVE LIMITED ACCESS COSTS GO UP.

AND SO WHEN THE PANDEMIC HIT, WE ACTUALLY OPENED OUR OWN CHILDCARE CENTER, UH, IN ABOUT 60 DAYS TIME.

UM, MOSTLY BECAUSE OUT OF NEED, RIGHT? BECAUSE WHILE EVERYONE ELSE WENT HOME AND, UH, WORKED REMOTELY HEALTHCARE, WE COULD NOT, WE WENT TO THE HOSPITAL.

AND SO REMOTE LEARNING WAS DIFFICULT FOR OUR NURSES AND OUR PHYSICIANS AND OUR RESPIRATORY THERAPISTS AND EVERYBODY ELSE.

SO WE, WITH THE HELP OF SHANNON ERICKSON AND, AND HOBBIT HILL OPENED UP A CENTER IN 60 DAYS, UH, STARTED E-LEARNING, WORKED WITH DSS TO BECOME A LICENSED CHILDCARE FACILITY.

AND WE'VE BEEN OPERATIONAL EVER SINCE.

UM, WHEN THE PANDEMIC, YOU KNOW, WHEN WE'VE MOVED ON FROM THAT, UH, OBVIOUSLY WHEN YOU START SOMETHING LIKE THIS, YOU CAN'T STOP IT.

UH, AND SO WE'VE ONLY, UH, WORKED TO ENHANCE IT.

AND SO WE ARE CURRENTLY BUILDING THIS ON OUR, UH, HOSPITAL LOCATION.

IT WILL HOUSE A HUNDRED KIDS INSTEAD OF 60.

UM, AND IT IS A SLIDING SCALE MODEL, RIGHT? SO IF YOU ARE A HOUSEKEEPER, YOU ARE PROBABLY GOING TO BE ABLE TO RECEIVE CHILDCARE FOR FREE.

UH, IF YOU'RE A PHYSICIAN, YOU'RE PROBABLY GONNA PAY THE MAX PRICE, BUT OUR MAX PRICE IS ABOUT 50% OF WHAT YOU'RE OTHERWISE GONNA FIND IN BEAUFORT COUNTY FOR CHILDCARE SERVICES.

SO WE OFFER SCHOLARSHIPS AND SLIDING SCALE.

AND BASED ON WHO YOU ARE AND YOUR INCOME LEVELS, YOU'RE GOING TO PAY MORE OR LESS, BUT YOU'RE NOT GONNA PAY MORE THAN WHAT YOU WOULD AT BEAUFORT COUNTY.

UM, WE ARE WORKING TO EXPAND THIS SOUTH OF ABROAD AS WELL, AND I'LL TALK A LITTLE BIT MORE ABOUT THAT IN JUST A FEW MINUTES.

AND IF YOU EVER COME TO THE CAMPUS, YOU CAN SEE IT ON THE BACK OF OUR CAMPUS.

THIS SHOULD BE COMPLETED, UH, IN THE JULY, AUGUST TIMEFRAME, UM, READY TO HAVE CHILDREN ON CAMPUS.

CURRENT RENOVATIONS.

UH, I'LL, I'LL, I'LL HIT ON ONE PROJECT IN PARTICULAR.

WE ARE ONE OF 13 HOSPITALS IN THE STATE TO PILOT A NEW CRISIS STABILIZATION UNIT.

UH, A CRISIS STABILIZATION UNIT IS A UNIT IN THE EMERGENCY ROOM, UM, THAT IS A LOCKED PSYCHIATRIC SUBSTANCE ABUSE UNIT THAT IS MEANT TO STABILIZE, TREAT, AND DISCHARGE WITHIN 24 TO 48 HOURS.

UM, THINK OF A PATIENT WHO'S MAYBE NOT SICK ENOUGH TO BE ADMITTED FOR A SIX OR SEVEN DAY INPATIENT STAY, BUT NOT WELL ENOUGH TO BE DISCHARGED TO THE COMMUNITY SAME DAY VISIT, RIGHT? AND SO WE ARE PUTTING THIS UNIT IN THE EMERGENCY ROOM 'CAUSE WE'VE SEEN OUR ARRIVALS FOR SUBSTANCE ABUSE GO UP.

WE'VE SEEN OUR ARRIVALS FOR MENTAL HEALTH CRISIS GO UP.

BUT A NUMBER OF THESE PATIENTS, AGAIN, AREN'T QUITE SICK ENOUGH TO BE ADMITTED.

AND SO THEY SIT IN THIS NO MAN'S LAND, SO TO SPEAK, UM, BECAUSE OUR COMMUNITY RESOURCES ARE NOT AS ROBUST AS THEY NEED TO BE TO INTAKE ALL THESE PATIENTS BEING DISCHARGED FROM THE HOSPITALS.

SO IT'S BASICALLY AN OBSERVATION UNIT.

YOU'LL STAY FOR 24 TO 48 HOURS.

UM, WE WILL WORK ON YOUR MEDICATIONS, WE'LL GET YOU BACK IN LINE, SO TO SPEAK, AND THEN WE'LL TRY TO DISCHARGE YOU TO AN APPROPRIATE SITE OF CARE AFTER THAT 24 TO 48 HOUR STAY IN OUR STABLE CRISIS STABILIZATION UNIT.

UH, WE START CONSTRUCTION ON THIS IN JUNE, AND IT'LL BE ABOUT AN EIGHT MONTH PROJECT BEFORE WE OPEN UP.

BUT AGAIN, ONE OF 13 HOSPITALS KIND OF PILOTING THIS ACROSS THE STATE OF SOUTH CAROLINA.

UM, UH, WE WERE SELECTED A COUPLE OF MONTHS AGO.

AND THEN LAST PROJECT, WE ARE CURRENTLY RENOVATING OUR SURGICAL, UH, PAVILION AT THE HOSPITAL.

WE CURRENTLY HAVE 10 ORS BETWEEN OUR INVENTORY SURGERY CENTER AND OUR HOSPITAL.

THIS WILL ADD AN ADDITIONAL TWO OPERATING SUITES, UM, AND, UH, AND WE'LL MODERNIZE OUR TECHNOLOGY AND OUR OTHER SUITES.

SO IT'LL BE A TOTAL OF 12 OPERATING SUITES IN THE BEAUFORT AREA, INCLUDING OUR A SC.

BUT THIS IS ABOUT A TWO AND A HALF YEAR PROJECT AND $24 MILLION REINVESTED BACK INTO BEAUFORT MEMORIAL.

SO I'M GONNA, I'M A FOCUS A LITTLE BIT ON THIS.

SO, AGAIN, I, I'VE BEEN HERE EIGHT YEARS AND I DON'T THINK, I FEEL LIKE WE HAVE RECRUITED A TON OF PROVIDERS, UH, TO THE AREA.

AND SOMETIMES IT FEELS LIKE WE STILL HAVE NOT MADE A DENT IN HEALTHCARE ACCESS.

UM, AND WE RECENTLY DID A PHYSICIAN NEEDS ANALYSIS WITH A THIRD PARTY.

AND I ASKED THIS THIRD PARTY CONSULTING FIRM TO BREAK IT UP BY AGAIN, I BREAK UP THIS COUNTY AND THIS AREA INTO HEALTHCARE ECOSYSTEMS. I KIND OF LOOK AT BUFORT ST.

HELENA, PORT ROYAL BLUFFTON, OKEE HARDY WOULD BE INCLUDED IN THAT.

AND HILTON HEAD.

AND I SAY, ALL RIGHT, WHAT, WHAT IS THE NEED? AND BREAK IT OUT BY KIND OF PRIMARY CARE, UH, MEDICAL SPECIALTY, AND THEN SURGICAL SPECIALTY.

AND SO,

[00:25:01]

IF YOU LOOK AT THE POPULATIONS AND YOU LOOK AT EACH OF THESE NEEDS, UH, IN TOTAL TODAY, IN THE NEXT COUPLE OF YEARS, WE NEED ABOUT 120 PROVIDERS, UH, OR MORE IN THE AREA.

UM, IF YOU LOOK AT, FOR EXAMPLE, BUFORT ST.

HELENA, PORT ROYAL, UH, WE NEED 14.9 PRIMARY CARE PHYSICIANS.

IF YOU LOOK AT BLUFF AND OTI, YOU NEED 16 PRIMARY CARE PHYSICIANS.

AND IF YOU LOOK AT HILTON HEAD, UM, WHICH OBVIOUSLY HAS THE SMALLEST POPULATION, YOU NEED NINE ADDITIONAL PRIMARY CARE PHYSICIANS.

UM, SPECIALTY NEED IS, IS, IS RIGHT UP THERE WITH IT.

RIGHT? IF YOU LOOK AT BLUFF AND OTI, UM, PROBABLY HAS THE HIGHEST NEED FOR SPECIALTY PROVIDERS.

UH, FOR EXAMPLE, THIS AREA NEEDS FOUR GASTROENTEROLOGISTS, UM, RECRUITED TO THE AREA TO MEET DEMAND.

THREE CARDIOLOGISTS, TWO PSYCHIATRISTS, AND ANOTHER PULMONOLOGIST, GENERAL SURGEONS 5.5.

YOU, YOU GET THE PICTURE RIGHT? THERE'S A LOT OF WORK TO BE DONE TO MEET THE DEMAND.

AND, AND THIS IS BASED ON GROWTH PROJECTIONS AS WELL.

SO IF THOSE PROJECTIONS ARE LIGHT OR CONSERVATIVE AND MORE PEOPLE MOVE TO THE AREA AND MORE HOMES ARE BUILT AND MORE MULTIFAMILY IS BUILT, THAT NEED JUST INCREASES.

IF MORE DOCTORS GO TO CONCIERGE MEDICINE, UM, THAT WE WEREN'T PREDICTING THAT NEED INCREASES, RIGHT? SO BACK TO THAT, A PRIMARY CARE PROVIDER CAN HANDLE ABOUT 2000 PATIENTS.

WHEN A PROVIDER GOES CONCIERGE, THEY MOVE THEIR PANEL DOWN TO ABOUT 500, WHICH MEANS 1500 PATIENTS ARE NOW LOOKING FOR A NEW PRIMARY CARE PROVIDER.

UNFORTUNATELY, THEY CALLED YOU FROM MEMORIAL AND YOU'RE LOOKING FOR A DOCTOR.

WE'RE GONNA TELL YOU IT'S A SIX MONTH WAIT.

UM, NOW WE TRY TO BRIDGE THAT GAP WITH OUR URGENT CARES, RIGHT? WE HAVE THREE URGENT CARES IN DIFFERENT AREAS.

AND SO WE SET THEM UP WITH AN URGENT CARE PHYSICIAN TO HELP WITH MAINTENANCE MEDICATIONS AND CHRONIC CARE MANAGEMENT UNTIL WE CAN GET THEM INTO A PRIMARY CARE MEDICAL HOME.

UM, THAT SIX MONTHS MIGHT HAVE EVEN BEEN GENEROUS, AND PEOPLE ARE SHOCKED, FRUSTRATED, CONFUSED, UM, AS TO WHY THIS IS HAPPENING AND WHY WE CAN'T GET THEM IN.

AND, UM, TALK TO ANYONE WHO MOVES HERE FROM AN AREA THAT HAS MORE HEALTHCARE RESOURCES.

IT'S VERY FRUSTRATING FOR THEM.

AND SOMETIMES IT'S FRUSTRATING FOR ME TO TRY TO EXPLAIN WHY BUFORT IS DIFFERENT, UM, THAN WHERE THEY MOVE FROM.

BUT THIS IS A REAL PROBLEM.

AND AGAIN, YOU GUYS PROBABLY HAVE HEARD THIS.

SO HOW DO WE ADDRESS THE PROBLEM? WELL, YOU KNOW, HERE ARE SOME OF THE PROJECTS WE'RE WORKING ON AND, AND, AND HERE'S, YOU KNOW, SOME OF THE SUPPORT WE'VE BEEN ASKING FOR, UM, FROM THE COMMUNITY IN TERMS OF HELPING US TO, TO GROW ACCESS.

SO I'LL START FIRST WITH PRIMARY CARE.

WE, WE ARE AGGRESSIVELY TRYING TO RENOVATE AND BUILD FOR PRIMARY CARE.

AND YOU'RE GONNA SEE THERE ARE PROJECTS, UM, IN OKEE.

THERE ARE PROJECTS, UH, WELL IN HARDY V AS WELL, OKEE, HARDY V, UH, THESE ARE, UH, BLUFFTON AND BEAUFORT, UH, AND PORT ROYAL SPECIFICALLY.

BUT WE'VE GOT THREE PROJECTS ON THE DOCKET TO HOPEFULLY HELP US RECRUIT EIGHT NEW PRIMARY CARE PROVIDERS TO THE MARKET.

UH, TWO TO LADIES, ONE TO LADIES ISLAND, TWO TO UH, OR TWO TO LADIES ISLAND, TWO TO PORT ROYAL, AND FOUR TO OKEE BLUFFTON AREA, UM, AT THAT NEW SITE, MAY RIVER, UM, GOING DURING ONE 70 AT THE MAY RIVER CROSSINGS LOCATION.

UM, NOT ENOUGH.

IF I ADD EIGHT PRIMARY CARE PROVIDERS, THAT'S 16,000 NEW PATIENT APPOINTMENTS, RIGHT? THERE'S A LOT MORE PEOPLE THAN 16,000 MOVING HERE OVER THE NEXT COUPLE OF YEARS.

UM, BUT THAT'S CURRENTLY WHAT WE HAVE PLANNED TODAY TO TRY TO MOVE FORWARD WITH OVER THE NEXT YEAR TO TWO YEARS.

AND THEN THERE'S THE HOSPITAL.

SO MOST OF YOU ARE AWARE THAT IN 2019, WE SUBMITTED TO THE STATE OF SOUTH CAROLINA TO BUILD A NEW HOSPITAL IN BLUFFTON.

UM, IT'S BEEN TIED UP IN LITIGATION, UH, ALL THE WAY UP UNTIL TODAY.

UM, BY LITIGATION, THROUGH THE CERTIFICATE OF NEED LAWS, UH, OTHERS CAN CHALLENGE THE STATE'S APPROVAL OF SAID HEALTHCARE FACILITIES.

UM, EVEN TODAY, WE ARE WAITING ON THE ADMINISTRATIVE LAW COURT TO COME BACK WITH A DECISION WHETHER WE CAN BUILD THIS OR NOT.

UM, IT IS A $90 MILLION PROJECT.

UH, IT WAS NOT $90 MILLION WHEN WE SUBMITTED IN 2019, UH, IS ALMOST DOUBLE BASED ON INFLATION AND EVERYTHING ELSE.

SO, UM, AS YOU CAN TELL, ONE OF THE TACTICS PROBABLY IS I WANT TO STALL AS LONG AS POSSIBLE TO MAKE THESE SORT OF THINGS MAYBE UNAFFORDABLE.

UH, IF YOU LIVE IN THE LOW COUNTRY, MAYBE THE LAND BECOMES TOO WET.

UM, I CAN TELL YOU AFTER EIGHT YEARS, THE WETLANDS TEND TO CREEP.

UM, WE EXPERIENCED THAT ON OUR OKEE PROJECT, UH, HERE IN HARDY.

WHEN WE BUILT THAT MOB, UM, WE HAD 20 ACRES OF HIGH AND DRY LAND, OR ACTUALLY WE BOUGHT 20 ACRES, UH, WHEN WE BOUGHT IT 10 YEARS PRIOR.

18 OF IT WAS HIGH AND DRY WHEN WE CAME BACK AROUND TO ACTUALLY BREAK GROUND.

13 OF IT WAS HIGH AND DRY.

UM, SO, YOU KNOW, BETWEEN INFLATION AND WETLANDS CREEP, YOU KNOW, LAND CAN BECOME, UM, MAYBE NOT VIABLE OVER THE COURSE OF TIME.

UM, THIS IS WHAT I WOULD CALL AN ANCHOR.

AND WHAT I MEAN BY ANCHOR IS IT IS DIFFICULT FOR HOSPITALS SUCH AS OURSELVES TO EXPAND OTHER OUTPATIENT RESOURCES LIKE PRIMARY CARE AND SPECIALTY CARE.

IF WE DON'T HAVE A HOSPITAL IN THE AREA IN WHICH WE'RE TRYING TO GROW, IT'S EASY FOR US TO GROW NORTH OF BROAD RIVER BECAUSE WE HAVE AN ANCHOR FACILITY, RIGHT? AND MOST HOSPITALS AND PATIENTS, UH, AND PRACTICES WANNA WORK WITH A HOSPITAL THAT'S RELATIVELY CLOSE.

BUT SAY WE RECRUIT A GENERAL SURGEON, UROLOGIST, AND WE SAY, WE WANNA PUT YOU ON HILTON HEAD

[00:30:01]

ISLAND OR SOUTH OF BLUFFTON, OR MAYBE HARDY.

BUT YOU HAVE TO WORK AT BEAUTIFUL MEMORIAL, WHICH MEANS YOU HAVE TO DRIVE BETWEEN 30 AND 45 MINUTES BOTH WAYS TO SEE YOUR PATIENTS OPERATE, BE ON CALL.

IT'S A LOT OF, A LITTLE BIT OF A NON-STARTER FOR A LOT OF PROVIDERS.

SO THE ONLY WAY FOR US TO GROW MORE HEALTHCARE SERVICES SOUTH, THE BROAD RIVER, IS IF WE BUILD THIS HOSPITAL, AND THE LONGER IT WAITS, THE LONGER WE'RE STALLED, THE LONGER WE DON'T ACT, THE MORE EXPENSIVE BECOME, THE MORE RISK THAT WE RUN OF WETLANDS ISSUES OR OTHER THINGS.

AND SO, I CANNOT STRESS HOW IMPORTANT IT IS THAT WE MOVE FORWARD WITH THIS HOSPITAL, UM, BECAUSE EVERY YEAR THAT THIS IS DELAYED IS ANOTHER YEAR THAT WE CAN'T RECRUIT PROVIDERS.

ANOTHER YEAR WE CAN'T BUILD ANOTHER PRIMARY CARE PRACTICE ANOTHER YEAR THAT WE CAN'T DO OTHER PROJECTS.

AND BY OTHER PROJECTS, I MEAN AFFORDABLE HOUSING.

SO WE HAVE 1800 EMPLOYEES, UM, AND GROWING.

IF WE BUILD THIS HOSPITAL, WE'LL HAVE ANOTHER 250 EMPLOYEES.

WE'LL CREATE $16.2 MILLION IN SALARY, WAGES, AND BENEFITS OVERNIGHT, RIGHT? WE DO THINK THIS HOSPITAL WILL BE BUSY IMMEDIATELY, UM, BASED ON DEMAND, BUT IT IS HARD TO RECRUIT 250 NEW PEOPLE TO THE AREA AND KEEP THEM IF PEOPLE A, CAN'T AFFORD CHILDCARE AND B, CAN'T AFFORD TO LIVE HERE.

AND SO CURRENTLY WE ARE IN A PROCESS OF, EXCUSE ME, BUILDING THREE DIFFERENT HOUSING PROJECTS, AND THEY'RE ALL IN DIFFERENT AND VARIOUS PHASES.

UM, I'LL START WITH THIS ONE.

SO THIS ONE IS, IS ONE THAT WE'VE BEEN WORKING ON WITH THE TOWN OF HARDY.

I APPRECIATE THEIR SUPPORT AND, UH, COLLABORATION ON THIS.

UH, WE ARE WAITING ON OUR PARTNER WODA COOPER.

SO ONE OF THE THINGS THAT WE ARE LOOKING TO DO IS WE FOUND A GOOD PARTNER IN WDA COOPER COMPANIES.

THEY ARE, UM, HEAVILY STEEPED IN WORKFORCE AND AFFORDABLE HOUSING PROJECTS.

THEY HAVE SEVERAL ASSETS IN SAVANNAH, BEAUFORT, HARDY AREA, UM, BAYSIDE OF OHIO.

BUT THIS IS THEIR MISSION.

AND THEIR MISSION ALIGNS VERY WELL WITH OUR MISSION AND OKEE.

WE HAVE OUR, UH, MEDICAL OFFICE BUILDING, BUT WE HAVE FOUR ACRES DOWN TO THE LEFT OF THAT THAT IS HIGH AND DRY.

AND SO OUR GOAL IS TO BASICALLY GIVE THE LAND TO WDA COOPER OR LEASE IT TO THEM AND HAVE THEM BUILD THIS FACILITY, WHICH WOULD INCLUDE 70 UNITS, UH, OF THREE, TWO, AND ONE BEDROOM UNITS ON THE SECOND, THIRD AND FOURTH FLOORS.

AND ON THE FIRST FLOOR, WE WOULD DEVELOP A PRIMARY CARE OFFICE THAT TO THE PRIMARY CARE NEED, WHICH WOULD ADD TO THE PRIMARY CARE PROVIDERS IN THE HARDY BILL AREA, AND WE WOULD BUILD OUR SECOND CHILDCARE LOCATION.

UM, RIGHT NOW, WDA COOPER IS WORKING WITH THE TOWN IN TERMS OF, UH, SITE PLANNING, STORMWATER MANAGEMENT, AND A FEW OTHER THINGS.

UH, TIA, UH, WE'RE WAITING ON THAT TO COME BACK, BUT ULTIMATELY WE WANT TO MOVE FORWARD WITH THIS WITH HOUSING TAX CREDIT APPLICATIONS.

THIS IS A PROJECT THAT IS CURRENTLY SITTING WITH THE STATE OF SOUTH CAROLINA AS A HA HOUSING TAX CREDIT OPPORTUNITY, UM, BEAUFORT COUNTY.

AND WE ARE WORKING TOGETHER ON THIS.

THIS IS AT BUCK WATER PLACE.

UH, CURRENTLY 30 APPLICATIONS HAVE BEEN SUBMITTED, UH, TO THIS YEAR'S ROUND OF SCORING.

UH, WE CURRENTLY SIT, I THINK AT 14TH.

UM, AS I UNDERSTAND IT, ABOUT FOUR TO FIVE ARE APPROVED THROUGH EACH FUNDING APPLICATION.

AND SO I'M NOT EXTREMELY HOPEFUL THAT WE'RE GOING TO CONTINUE TO CLIMB THE RANKS THROUGH THE DIFFERENT ROUNDS OF SCORING AND DISQUALIFICATIONS TO MAKE IT AT BUCK WATER PLACE.

UM, BUT WE'RE GONNA KEEP TRYING.

UM, I'M NOT AN EXPERT IN AFFORDABLE HOUSING.

I KNOW ENOUGH TO BE DANGEROUS.

UM, WHAT I WOULD TELL YOU IS, IS THAT, UM, ONE OF THE, THERE'S LOTS OF SCORING METHODOLOGY THAT GOES INTO THIS, AND I'M NOT TRYING TO TELL YOU GUYS SOMETHING YOU DON'T KNOW, BUT ONE OF THE, UM, HEAVIER WEIGHTED SCORES IS THE COST OF THE PROJECT.

UM, ULTIMATELY OUR COSTS ARE ALWAYS GOING TO BE HIGHER THAN COLUMBIA AND GREENVILLE.

YOU JUST CAN'T BUILD FOR ON THE SAME SCALE, AT THE SAME PRICE IN THE LOW COUNTRY DUE TO SOIL CONDITIONS, SCARCITY OF LABOR, AND OTHER ISSUES THAT YOU CAN IN COLUMBIA AND GREENVILLE.

SO WHEN YOU LOOK AT THAT SCORING, I'VE, I'VE LOOKED AT IT RECENTLY, THE HIGHEST SCORED PROJECTS THAT ALL SIT IN COLUMBIA AND GREENVILLE.

UM, ONE IS MAYBE POSSIBLE IN CHARLESTON.

EVERYTHING ELSE THAT THAT IS, IS JUST TOO EXPENSIVE.

SO ONE OF THE THINGS THAT WE NEED TO ADVOCATE FOR AS I GET, UM, MORE DANGEROUS, BUT NOT AN EXPERT IN THIS AREA IS, IS TRYING TO TALK TO OUR LEGISLATORS.

AND, AND TOM DAVIS, FOR EXAMPLE, I, I KNOW IS WORKING ON THINGS LIKE THIS, BUT THE SCORING METHODOLOGY NEEDS TO BE CHANGED A LITTLE BIT, OR ELSE IT'S GONNA BE VERY DIFFICULT FOR US TO WIN IN A, IN A, UM, 30 APPLICATION PROCESS.

UM, THAT'S VERY COMPETITIVE IF OUR PROJECT COSTS ARE ALWAYS GONNA BE MORE THAN OTHER AREAS.

SO THIS PROBABLY WON'T HAPPEN.

UM, BUT WE WILL FIND ANOTHER WAY TO APPLY AGAIN AT THE NEXT ROUNDING, UH, UH, NEXT ROUND OF FUNDING OPPORTUNITIES, UM, WITH THE STATE OF SOUTH CAROLINA THROUGH THESE HOUSING TAX CREDIT APPLICATIONS.

BUT THIS WAS GOING TO BE 120 UNIT, UH, WITH HEALTHCARE, UM, COMBINED IN THERE.

AND THEN LASTLY, UH, WE ARE WORKING WITH THE CITY OF BEAUFORT AND, AND HOPEFULLY BEAUFORT COUNTY TO BUILD TOWN HOMES AND SINGLE FAMILY HOMES NEXT TO THE HOSPITAL.

UM, BEAUFORT COUNTY, UH, ACQUIRED FIVE HOMES FROM TCL.

UM, THOSE FIVE HOMES REALLY AREN'T LIVABLE TODAY.

UH, SO THE PLAN WOULD BE IS TO DEMO THOSE HOMES.

AND BEAUFORT MEMORIAL WOULD TAKE THE LEAD IN BUILDING 29

[00:35:01]

TOWN HOMES, TWO BEDROOMS, AND FOUR SINGLE FAMILY HOMES THAT OUR EMPLOYEES COULD EITHER LEASE OR BUY.

UM, TRUST ME, I WOULD PREFER THAT THEY BUY 'EM FROM US.

UM, BECAUSE BEING A LANDLORD IS NOT SOMETHING THAT WAS IN OUR STRATEGIC PLAN.

UM, BUT IF YOU WOULD'VE TOLD ME, YOU KNOW, THIS IS WHAT IT TAKES.

IF YOU WOULD'VE TOLD ME 5, 6, 7, 8 YEARS AGO WHEN, YOU KNOW, I WAS COMING INTO BUFORT OR IN ANOTHER HOSPITAL AND SAID, RUSSELL, IN, IN, IN SEVEN, EIGHT YEARS, YOU'RE NOT GONNA BE JUST BUILDING HOSPITALS.

YOU'RE GONNA BE BUILDING CHILDCARE FACILITIES, YOU'RE GOING TO BE BUILDING AFFORDABLE HOUSING, YOU'RE GONNA BE DOING THESE OTHER THINGS.

I WOULD'VE SAY, THAT'S NOT WHAT WE DO.

THAT'S NOT WHO WE ARE.

AND I DON'T KNOW THE FIRST THING ABOUT ANY OF THAT.

THINGS CHANGE.

UM, SITUATIONS CHANGE AND, UM, UH, DESPERATE TIMES CALL FOR DESPERATE MEASURES.

AND, UH, I WOULD SAY WE ARE THERE.

UM, AND HEALTHCARE ACCESS AND AFFORDABILITY, UH, AND HOUSING AND AFFORDABILITY AND CHILDCARE, WHICH IS ONE OF THE REASONS THAT, YOU KNOW, WE ARE TRYING TO HELP BE A SMALL PART, UH, IN FIXING THOSE PROBLEMS WITH ALL OF THE VERY GOOD WORK YOU GUYS ARE DOING.

SO, I WILL PAUSE THERE AND OPEN IT UP FOR QUESTIONS.

THANK YOU, MR. BAXLEY.

THAT WAS REALLY A LOT OF INFORMATION, I THINK, UH, WHAT WE SHOULD ALL BE CONCERNED ABOUT.

I WILL REMIND THE BOARD IF YOU HAVE QUESTIONS, YOU GOTTA PRESS YOUR LITTLE BUTTON TO BE ON THE MICROPHONE.

UM, AND BEFORE I OPEN IT UP, I, I WAS REMISS I AT EVERY INTENTION OF DOING THIS, AT FIRST, I WOULD LIKE TO, UM, UH, WELCOME THE TOWN OF RIDGELAND WE HAVE, WHICH IS HAVE ALWAYS BEEN PART OF THE BOARD OF SO LOCO, UM, MAYOR PORT TEM, TOMMY RHODES, AND RECENTLY ELECTED A NEW MEMBER OF THE COUNCIL OF MR. BILL FISHBURN.

SO THANK YOU FOR JOINING US, AND, UH, REALLY HAPPY TO SEE, UH, LIND BE A PART OF THIS.

SO, UM, BE, UH, ONE MORE NOTE BEFORE I OPEN IT UP, UM, AS I'VE SEEN THIS PRESENTATION, AND I WANT TO JUST PUT IT IN THE MINDS OF THE BOARD, AND PERHAPS, UH, AFTER QUESTIONS, WE CAN HAVE A COUPLE MINUTES TO DISCUSS WHAT CAN WE DO AS A REGIONAL BOARD ELECTED OFFICIALS AND STAFF TO, UH, TAKE ON SOMETHING AND HELP THE MANY NEEDS OF HEALTHCARE IN OUR REGION.

SO THINK ABOUT THAT AND, AND PERHAPS WE CAN TALK ABOUT THAT BEFORE WE LEAVE.

OKAY.

NOW I'D LIKE TO OPEN IT UP FIRST TO BOARD MEMBERS AND REMIND EVERYBODY, MAYORS, COUNCIL, REPRESENTATIVES, ADMINISTRATORS ARE ALL PART OF THE BOARD, INCLUDING, UH, FROM RIDGELAND HARDY V, UH, BLUFFTON, UH, HILTON HEAD, BUFORD, AND PORT ROYAL.

SO THAT'S THE BOARD MEMBERS.

I'LL OPEN IT UP TO YOU FIRST AND OH, BOTH COUNTIES AND, OKAY.

UM, UH, UM, WE HAVE LADIES FIRST, UH, MS. VALERIE GUZMAN IS THE COUNCIL REPRESENTATIVE FROM HARDY.

PLEASE, UH, JOIN US.

VAL, YOU KNOW, THE, YOU KNOW, THE WE TEAM, I KNOW THE DRILL SON, YOU KNOW THE DRILL BECAUSE WE ARE RECORDING THIS AND IT'S SO IMPORTANT, UH, THAT WE HAVE A RECORD.

OKAY? UH, MY NAME IS VALERIE GUZMAN.

I AM ON THE BOARD OF SO LOCO AS WELL AS A COUNCIL MEMBER FOR THE CITY OF HARVILLE.

UM, VERY IMPRESSIVE.

I NEVER KNEW THE HISTORY OF BMH UNTIL I SAT THROUGH THIS PRESENTATION.

I'M JUST BLOWN AWAY.

UH, COMING FROM THE NORTH WHERE WE HAD TOP-NOTCH TEACHINGS, HOSPITALS AROUND THE AREA, ONE THING THAT I WAS, THAT I DID NOT SEE IN, IN THE WHOLE PRESENTATION WAS SOMEWHERE DOWN THE LINE, UH, EITHER A LEVEL TWO, TWO OR A LEVEL ONE TRAUMA CENTER COMING IN SOMEWHERE.

I KNOW WE DON'T HAVE FACILITIES TO TAKE CARE OF TRAUMAS THAT HAPPEN IN THE SURROUNDING AREA.

AND MOST OF THE TIMES THE AMBULANCES HAVE TO TRANSPORT THE PATIENTS TO MEMORIAL TO SAVANNAH OR, OR SOMEPLACE ELSE.

DOES BMH HAVE A PLAN TO SOON GET A LEVEL TWO, TWO OR A LEVEL ONE TRAUMA CENTER IN THE AREA? DO I SPEAK IN HERE? OR, OR YOU CAN SPEAK TO EITHER ONE.

UM, YOU KNOW, UH, SO, UM, AND THAT'S THE ONLY QUESTION.

YEAH.

SPEAKING, THAT'S THE ONLY QUESTION.

SO GET BACK, YOU CAN GO BACK TO THE PODIUM.

OKAY.

NO, THAT, THAT, THAT IS A VERY GOOD QUESTION.

SO I'LL FIRST START BY SAYING, EVEN THOUGH WE'RE NOT A LEVEL OR WE'RE NOT A TRAUMA CERTIFIED HOSPITAL, EVERYTHING THAT WE DO IS AT A MINIMUM LEVEL THREE AND PROBABLE LEVEL TWO.

UM,

[00:40:01]

THE MEDICAL STAFF HAS NOT REALLY EMBRACED SOME OF THE OTHER REQUIREMENTS THAT WOULD, UM, REQUIRE US TO BECOME LEVEL TWO CERTIFIED.

FOR EXAMPLE, UM, REQUIRED AT AN MDA ANESTHESIOLOGIST IN-HOUSE 24 7.

UM, EVEN THOUGH WE HAVE ANESTHESIA ON CALL, WE HAVE WHAT WE CALL, UH, CRNAS IN-HOUSE 24 7.

THERE ARE JUST CERTAIN ON-PREMISE REQUIREMENTS THAT OUR MEDICAL STAFF SAY, I LIVE FIVE MINUTES FROM THE HOSPITAL.

I DON'T WANT TO ACTUALLY BE IN THE HOSPITAL.

UM, THAT WOULD PROHIBIT US FROM BECOMING, SAY, A LEVEL TWO, UM, LEVEL ONE WOULD REQUIRE NEUROSURGERY, FOR EXAMPLE, WE DON'T HAVE NEUROSURGEONS ON STAFF.

UM, THERE'S REALLY, EVEN THOUGH, YES, WE HAVE NEUROSURGERY, FOR EXAMPLE, ABOUT THE NECK STUFF THAT WOULD GO OUT TO MEMORIAL OR CHARLESTON.

CURRENTLY AS WE LOOK AT THE DATA, THERE'S NOT ENOUGH NEUROSURGERY BUSINESS TO SUPPORT WHAT WOULD BE, WE'VE GOT TWO NEUROSURGEONS IN BEAUFORT COUNTY.

'CAUSE YOU CAN'T JUST HAVE ONE, 'CAUSE ONE CAN'T BE ON CALL 365 DAYS A YEAR.

YOU HAVE TO RECRUIT TWO.

AND THERE'S JUST NOT ENOUGH ACTUAL NEUROSURGERY BUSINESS TO SUPPORT TWO FULL-TIME NEUROSURGEONS IN THE AREA RIGHT NOW.

SO WE GET ALL THE TRAUMA, YOUR GUNS AND KNIFE CLUBS, EVERYTHING ELSE, YOUR FALLS, ET CETERA.

THEY ALL COME TO BE FROM MEMORIAL.

THAT, UM, ANYTHING BELOW THE NECK, UH, ANYTHING ABOVE THE NECK IS GONNA GET TRANSFERRED.

AND WE JUST DON'T HAVE THE CAPACITY YET AS A POPULATION, UM, TO SUPPORT THAT SORT OF LEVEL OF CARE, UH, AND MAKE IT SUSTAINABLE.

BUT WE ARE LOOKING AT IT, WE WILL PREPARE FOR IT.

IF I COULD EVER, YOU KNOW, THE, ONCE THE MEDICAL STAFF, UM, GETS TO A POINT WHERE THEY WANT TO BE SUPPORTIVE OF, OF BEING IN HOUSE MORE OFTEN, IE STAYING IN A CALL ROOM, UM, INSTEAD OF THEIR HOME, UH, THAT WOULD ALLOW US TO MOVE FORWARD WITH THE ACTUAL CERTIFICATIONS.

BUT, UM, I CAN PROMISE YOU, EVEN THOUGH WE'RE NOT CERTIFIED, WE HAVE ALL THE EXPERTISE AND CAPABILITY TO TAKE CARE OF MOST EVERYTHING.

SO, SO FOR EXAMPLE, IF A REALLY BAD MV ABLE TO, UH, SO I'M, I'M NOT SURE WHAT THE PROTOCOLS HERE, UH, FOR, UH, THE FIRST RESPONDERS, WHETHER THEY KNOW THAT THEY CAN COME TO YOU GUYS TO STABILIZE THE PATIENT AND THEN PROBABLY PUT THEM ON A BOARD AND TRANSFER THEM TO A TRAUMA CENTER THAT CAN HANDLE IT.

I MEAN, IS THAT A, IS THAT SOMETHING THAT YOU GUYS CAN DO OR MOST ARE TRIAGED IN THE FIELD.

OKAY.

AND WE HAVE TWO PHYSICIANS, FOR EXAMPLE, THAT ARE MEDICAL DIRECTORS OF EMS FIRE DEPARTMENTS.

RIGHT? RIGHT.

AND SO WE EVEN WORK, UH, ON A DAY-TODAY BASIS WITH EMS TO TALK ABOUT MEDICAL PROTOCOLS, ET CETERA.

WE, FOR EXAMPLE, IF YOU'RE HAVING CHEST PAIN MM-HMM, , THEY CAN SEND EKGS, UM, FROM TO YOUR DEPARTMENT YES.

FROM THE SITE.

RIGHT? IF I'M IN SOMEBODY'S HOME, EKG, THEY CAN SEND IT.

WE, AND AFTER OUR SEMI PROTOCOL, WE BRING EVERYBODY IN BEFORE THE PATIENT EVEN ARRIVES BASED ON, ON THAT.

SO TO ANSWER TO YOUR QUESTION, THEY TRIAGE IN THE FIELD, THEY REACH OUT TO US, AND BASED ON PROXIMITY TO EITHER A LEVEL ONE TRAUMA CENTERS, LET'S SAY IT HAPPENS IN BLUFFTON, IT MIGHT BE QUICKER, FASTER TO GO TO BLUFFTON MM-HMM.

AND, UH, FROM BLUFFTON TO MEMORIAL THAN WOULD BE TO BEAUFORT MEMORIAL STABILIZE THEM AND THEN AIRLIFT THEM FROM BUFORT TO MEMORIAL TO MEMORIAL.

OKAY.

BUT ALL THAT IS COMMUNICATED IN THE FIELD WITH OUR, WITH OUR PROVIDERS.

OKAY.

THANK, THANK YOU.

UM, UH, JOE, YOU HAD A QUESTION? UH, NOT A QUESTION.

UH, A COMMENT THAT, UH, AT OUR, UH, COUNCIL MEETING LAST NIGHT, WE PUT MORE MONEY IN FOR THE OPIOID SETTLEMENT THAT WE HAVE GOTTEN.

AND SO WE'LL ENCOURAGE YOU TO TAP INTO THOSE RESOURCES THERE.

UM, THE, THE COMMENT I HAVE IS, THIS IS A WONDERFUL PRESENTATION FOR WHAT WE NEED NOW AND WELL INTO THE FUTURE.

AND I APPLAUD WHAT, UH, VALERIE SAID.

WHEN WE LOOK WAY INTO THE FUTURE, WE'RE NOT JUST GOING TO GROW, UM, MINIMALLY, THE GROWTH IN BEAUFORT COUNTY IS GOING TO BE MIRRORED BY THE GROWTH IN JASPER COLLETON HAMPTON, OUR SURROUNDING COUNTIES.

WE MAY WELL HAVE TO HAVE A TRAUMA ONE CENTER AT SOME POINT IN TIME IN THE FUTURE.

AND IT WOULD BEHOOVE US TO UNDERSTAND THAT IT MAY WELL SERVE THE PURPOSES IN BEAUFORT COUNTY TO HAVE THAT TRAUMA CENTER HERE.

SURE.

OKAY.

UNDERSTOOD.

JOHN.

UH, VERY GOOD PRESENTATION.

THANK YOU.

I JUST, WHEN TALKING ABOUT THIS, THERE WAS NOTHING ABOUT UPPER PART OF JASPER.

I, I'M A COUNCILMAN OF JASPER COUNTY.

WE HAVE, UH, COASTAL CAROLINA DOWN IN HARDY V WE HAVE BEAUFORT MEMORIAL WHERE MA MAJORITY OF PEOPLE GO TO.

AND THEN WE HAVE ST.

JOSEPH CANDLER, AND THEY'RE UP IN RIDGELAND.

IS THERE ANY IDEA, OR HAVE YOU EVER THOUGHT ABOUT COMBINING ALL THREE GOING INTO THE UPPER PART OF JASPER COUNTY? OR HAVE YOU EVER THOUGHT ABOUT JASPER COUNTY UPPER PART? 'CAUSE THAT'S WHERE THE FUTURE IS, OR INTO LEADY DOWN LOWER, DOWN INTO, I GUESS WOULD THAT BE, WOULD BE HARDY V BUT THE NORTHERN PART OF JASPER COUNTY? HAVE YOU EVER THOUGHT ABOUT THAT? WE HAVE.

I MEAN, AND, AND AT ONE POINT WE HAD LAND

[00:45:01]

AS, AS A HOSPITAL IN UPPER PART OR JASPER COUNTY.

AND THEN WE DIDN'T, UM, AT ONE POINT I THINK WE EVEN, UH, HAD THE RIDGELAND HOSPITAL, UM, UH, WAY BEFORE MY TIME.

UH, AND THEN WE DIDN'T.

UM, I WOULD SAY WE HAVE STRATEGICALLY TALKED ABOUT THAT A LOT, BUT A LOT OF US GROWING IN A LOT OF AREAS RIGHT NOW IS HELD UP BECAUSE OF THE HOSPITAL IS, IS WHAT I WOULD SAY A LOT OF US MAKING A LOT OF OTHER FUTURE PLANS ABOUT ADDITIONAL FACILITIES, STRUCTURES, ET CETERA.

IT'S ALL HANGING IN THE BALANCE FOR US TO JUST BREAK GROUND ON THIS HOSPITAL BECAUSE WE CAN'T, WE FEEL WE CAN'T DO A WHOLE LOT MORE, UH, IN TERMS OF MAJOR FACILITIES AND MAJOR GROWTH UNTIL THAT PROJECT'S BEEN SITTING ON THE BOOKS FOR SEVEN YEARS RACE GROUND.

UM, AND SO I'M, I'M, WHAT I'M TRYING TO SAY IS THAT WE WOULD LOVE TO GROW IN VARIOUS AND DIFFERENT OTHER COUNTIES.

UM, IT'S HARD FOR US TO GROW UNTIL WE SECURE FINANCING, UH, SECURE THE CAPITAL, RAISE THE MONEY, AND MOVE FORWARD WITH THAT HOSPITAL.

'CAUSE THAT HOSPITAL IS THE KEY TO I THINK, THE NEXT 20 TO 30 YEARS TO BE FROM MORAL SUCCESS AND GROWTH CAPACITY.

WITHOUT THAT HOSPITAL.

WE, WE FEEL A LITTLE STUCK RIGHT NOW IN WHERE WE'RE AT TODAY.

UM, AND DON'T FEEL LIKE WE CAN MOVE FORWARD WITH A LOT OF OTHER LARGE PROJECTS, UM, WITH THAT HANGING KIND OF IN THE BALANCE, SO TO SPEAK.

UM, I HOPE THAT MAKES SENSE.

I UNDERSTAND THAT.

UH, BUT TELL THE PERSON UP IN JASPER COUNTY THAT NEEDS THE SERVICE.

ALL I'M SAYING IS WHEN I, IN MY EXPERIENCE, THE UPPER PART OF JASPER COUNTY DOESN'T EVEN HAVE BASIC, I MEAN, A NURSE GOING INTO A RECREATION CENTER JUST TO DO A TRIAGE, WHAT I WOULD CALL A TRIAGE, UH, JUST TO SAY BLOOD PRESSURE, UH, SICKLE CELL ANEMIA, YOU HAD THAT ON THERE.

MM-HMM.

.

I DON'T THINK ANYBODY IN JASPER COUNTY KNOWS ABOUT THAT.

AND WE HAVE A HEAVY BLACK POPULATION THAT COULD BENEFIT.

I HAVE NO IDEA WHAT THAT IS.

ALL I'M SAYING IS THAT, I GUESS I'M TELLING YOU JASPER COUNTY NEEDS HELP.

JUST LOOK AT IT.

YEP.

THANK YOU.

ABSOLUTELY.

ANYONE ELSE FROM THE BOARD BEFORE I OPEN UP TO THE PUBLIC? DANNY , YOU WERE TALKING EARLIER, YOU DON'T HAVE CALLED IT.

THERE YOU GO.

YOU WERE TALKING EARLIER ABOUT THE, SOMEONE WITH A BACCALAUREATE DEGREE CAN BECOME A NURSE IN ONE YEAR.

DOES THAT MEAN BY EXTENSION THAT SOMEONE WITH AN ASSOCIATE'S DEGREE CAN BECOME A REGISTERED NURSE IN LET'S SAY TWO YEARS? OR HOW DOES THAT WORK? UH, I, I MEAN, IN TWO YEARS, YES.

I MEAN, WE, YOU COULD BECOME A, UM, AN AN A DN WITHIN TWO YEARS WITH, UM, THROUGH US OR TCL, UM, THROUGH A SIMILAR TYPE OF PROGRAM.

YES.

I MEAN, I, I DON'T, I DON'T SEE THAT BEING A BARRIER.

AND PART OF THAT IS ALREADY HAPPENING.

IF YOU, IF I TRACK BACK, I DIDN'T HIGHLIGHT THIS, WE HAVE A NUMBER OF NURSES, UM, UH, OR OF CURRENTLY ASSOCIATE DEGREE TYPE PEOPLE THAT ARE CURRENTLY IN A SCHOLARSHIP NURSING PROGRAM WITH US AND TCL, UH, WE ALLOW THEM TO HAVE A FLEXIBLE SCHEDULE.

UM, WE PROVIDE THEM SCHOLARSHIPS AND WE ARE SENDING THEM TO TCL TO BECOME AN A DN TRAINED NURSE, UM, UH, AT AN ACCELERATED PACE WITH THE TECHNICAL COLLEGE TO PUT THEM BACK IN THE WORKFORCE.

SO WE HAVE ALREADY A TYPE OF PROGRAM, I THINK MODELING WHAT YOU'RE, WHAT YOU'RE DESCRIBING, UH, IN PARTNERSHIP WITH TCL AND RECRUITING FROM OUR WORKFORCE, SO TO SPEAK.

THANK YOU, SIR.

COME, I HAD ONE COMMENT.

UM, FEW FROM MEMORIAL HOSPITALS HAS MADE GREAT STRIDES WITH OUR DETENTION CENTER.

UH, AND I DON'T, I DON'T KNOW THAT PEOPLE APPRECIATE THE MENTAL HEALTH ASPECT OF PREVENTING PEOPLE FROM REPEATED VISITS TO THE DETENTION CENTER IN BEAUFORT COUNTY, BUT I JUST WANTED TO MENTION THAT AND, UM, APPRECIATE WHAT Y'ALL HAVE DONE IN COORDINATION WOULD BE FOR COUNTY ON THAT.

YEP, ABSOLUTELY.

SO WHAT, WHAT, UM, ALICE IS REFERRING TO IS WE DO ALL OF THE, UM, MEDICAL, MEDICAL DIRECTION AND TREATMENT OF ALL OF THE DETENTION CENTER, UM, UH, INMATES THERE, OR, UH, RESIDENTS THAT, UH, REALLY WE SHARE A LOT OF TIMES.

I MEAN, WE SEE THEM IN OUR ER, THEY GO BACK AND FORTH BETWEEN THE DETENTION CENTER, THE ER, MENTAL HEALTH UNIT.

AND SO IT REALLY IS INCUMBENT UPON BOTH US AND THE COUNTY TO, TO WORK TOGETHER TO KEEP THEM BOTH FROM CON CONTINUING TO COME TO OUR ER AND CONTINUING TO SHOW UP AT THE DETENTION CENTER BECAUSE THEY SIT IN THIS, AGAIN, THIS GAP OF, YOU KNOW, BUT PRIOR TO, NO ONE KNEW WHAT TO DO WITH THEM.

UM, AND NOW I THINK WE'RE FINDING A GOOD CADENCE AND PREVENTING A LOT OF THESE PEOPLE FROM EITHER BEING READMITTED TO DETENTION CENTER OR READMITTED TO OUR HOSPITAL IN SOME WAY, SHAPE OR FORM BY MANAGING THEIR MEDS WHEN THEY'RE, WHEN THEY'RE THERE, UM, AND, AND CONTINUING THEIR TREATMENT PROTOCOL, UM, UM, VERSUS WHEN THEY WERE AT THE, THE HOSPITAL AS WELL.

IT'S BEEN A GOOD PARTNERSHIP.

THANK YOU.

YES, RUSSELL, UH, THANK YOU FOR ALL THE INFORMATION AND THANK YOU FOR YOUR LEADERSHIP OF THE HOSPITAL AND WHAT YOU'VE BEEN ABLE TO DO OVER THE LAST EIGHT YEARS.

IT'S REALLY, REALLY IMPRESSIVE.

UM, FOLLOW UP QUESTION ON THE INFORMATION ABOUT EXPANDING THE GRADUATES FROM USCB IN THE NURSING PROGRAM.

MY UNDERSTANDING IS ONLY A SMALL PORTION OF THOSE GRADUATES CURRENTLY REMAIN IN THE AREA UPON GRADUATION

[00:50:01]

TODAY.

IN YOUR OPINION, IS HOUSING THE BIGGEST HURDLE TO INCREASING THAT PERCENTAGE FOR REMAINING HERE? 'CAUSE IF YOU DOUBLE THE GRADUATION RATE, THAT'S GREAT, BUT WE ALSO NEED TO DOUBLE THEN THE, THE AMOUNT OF NURSES THAT REMAIN IN THE AREA.

UH, IT IS A GOOD QUESTION.

IT'S, IT'S PROBABLY A COMBINATION OF HOUSING.

OKAY.

UH, AS WELL AS BACK TO THE, UM, THE REASON THAT SOME OF THEM DON'T STAY IS BECAUSE OF THE, UM, FACULTY SHORTAGE.

UM, MOST OF THE, UH, THOSE THAT DON'T STAY, MOST OF 'EM ARE ACTUALLY, AND TCL INCLUDED IN THIS ARE COMING FROM SAVANNAH OR CHARLESTON.

UM, AND SO THEY'RE COMMUTING AND THERE'S PLENTY OF NEED IN SAVANNAH AND CHARLESTON AS WELL FOR NURSES.

AND SO A LOT OF THEM, BECAUSE THEY, THEY CAN'T GET INTO A, A SCHOOL AT SAVANNAH OR CHARLESTON, UM, GET INTO USCB, THEY COMMUTE AND THEN THEY HAVE EVERY INTENT OF STAYING IN SAVANNAH OR CHARLESTON ONCE THEY GRADUATE.

SO SOME OF IT'S A COMBINATION, A COMBINATION OF HOUSING BECAUSE WE ARE ABLE TO ACTUALLY SAY TO THESE, HEY, WHY DON'T YOU CONSIDER WORKING HERE? MM-HMM.

, SOME OF 'EM ARE ACTUALLY VERY OPEN TO WORKING IN BEAUFORT AND THEN THEY REALIZE THAT THE RENT HERE IS $500 MORE THAN POOL OR SAVANNAH.

MM-HMM.

.

AND THEY SAY, WELL, I CAN'T AFFORD TO RENT IN BUFORT WHEN I ALREADY HAVE AN APARTMENT FOR $1,600 IN, OR $1,700 IN SAVANNAH AND BUFORT ISS NOW ASKING $2,100 FOR THAT SAME APARTMENT.

UM, SO IT IS, SO ONCE WE START TO TRY AND MOVE THE NEEDLE, RIGHT, THAT NEEDLE VERY QUICKLY, UM, SWINGS BACK INTO THE FAVOR OF SOME LOWER COST AREAS.

UM, AND NOT CHARLESTON, BUT YOU, YOU LIVE IN CHARLESTON FOR DIFFERENT REASONS, BUT YOU KNOW, SAVANNAH POOL OR THAT AREA, WE, WE CAN DRAW FROM THERE, BUT NOT IF, UM, NOT IF OUR HOUSING DOESN'T GET FIXED.

UM, YEP.

ANYONE ELSE FROM THE BOARD? OKAY, THEN ANYONE FROM THE PUBLIC? YES.

DAN, PLEASE.

YOU HAD MENTIONED, UM, OPIOID ADDICTION.

YES, SIR.

SO COULD YOU EXPAND ON THAT A LITTLE BIT ABOUT WHAT WE, WHAT YOU DO TO HELP ALLEVIATE THAT PROBLEM? YEP.

SO REALLY WHEN WE IDENTIFY THESE PATIENTS THAT, UM, UH, CONTINUE TO COME TO THE ER WITH, UH, ADDICTION OR, UM, OTHER ISSUES, WE REFER THEM IMMEDIATELY THROUGH SOCIAL WORK TO OUR MAT CLINIC, WHICH IS ESSENTIALLY A SUBOXONE CLINIC.

AND WHAT WE DO IS WE USE MEDICATIONS TO, UM, KEEP THEM IN TREATMENT AND WEAN THEM OFF OF OPIOIDS AND, AND OTHER MEDICATIONS.

AND, UM, IT'S NOT ALWAYS PERFECT.

UM, AND SOMETIMES WE HAVE RELAPSES.

UM, BUT ULTIMATELY WHAT THEY NEED IS SOMEONE JUST FOCUSED, UH, ON THEM AND A RESOURCE WHEN THEY HAVE, UM, ISSUES, CONCERNS, RELAPSES.

WE GET THEM INTO OTHER PROGRAMS SUCH AS AA OR OTHER SOCIAL SUPPORT, UH, PROGRAMS WITH THROUGH OUR SOCIAL WORK, UM, DEPARTMENT.

UM, BUT REALLY THE GOOD WORK IS DONE BY PHIL ANO AND, AND THOSE THAT WILL, WILL FOLLOW HIM, UM, BECAUSE THEY, THEY ARE ON CALL 24 7 FOR THESE PATIENTS.

UM, WHICH IS PART OF, I THINK, PART OF THE SERVICE THAT WE PROVIDE IS, IS PHIL, EVERY, ALL 117 OF THOSE PATIENTS HAD PHIL KUSAMA'S CELL PHONE NUMBER.

AND SO THERE WASN'T A DAY THAT DIDN'T GO BY THAT PHIL WASN'T RECEIVING A PHONE CALL FROM ONE OF HIS PATIENTS WORKING THROUGH, UM, YOU KNOW, NOT ONLY SUBSTANCE ABUSE ISSUES, BUT PSYCHIATRIC ISSUES AND OTHER THINGS THAT A LOT, A LOT OF TIMES ACCOMPANY THIS.

SO, SO REALLY IT'S A MATTER OF JUST FINDING THE OUTPATIENT RESOURCE, UH, FOR THESE, UH, PEOPLE, UH, MAKING SURE THAT FUNDING IS NOT A BARRIER, UM, UH, FOR A LOT OF THESE PEOPLE.

AND THEN MAKING SURE THAT, UH, WE'RE REACHING OUT AND THEY'RE CONSISTENTLY COMING TO THEIR VISITS AND, YOU KNOW, TRANSPORTATION IS AN ISSUE SOMETIMES AS WELL.

AND MAKING SURE THAT IF THEY HAVE AN ISSUE OF GETTING TO SEE PHIL ANO AND FOLLOW UP, UM, THAT WE GO GET THEM AND BRING THEM TO SEE PHIL ANO AND FOLLOW UP.

SO MOST OF IT IS THROUGH THAT SORT OF, THAT, THAT SUBOXONE, UM, CLINIC AND WEANING THEM OFF OF THAT MEDICATION, SO TO SPEAK.

ARE YOU THE ONLY HOSPITAL IN THE AREA? I MEAN, 'CAUSE I WAS UNDER THE IMPRESSION YOU HAD TO GO TO CHARLESTON OR COLUMBIA, SO I DID NOT KNOW YOU WERE OFFERING THIS LOCALLY.

ARE YOU THE ONLY HOSPITAL IN BEAUFORT COUNTY PROVIDING THIS? THE ONLY, I THINK SO.

I, I DO BELIEVE BEAUFORT, JASPER COMP HEALTH OFFERS, UM, SOME SUBOXONE, UM, ASSISTANCE.

UM, THEY HAVE AN MAT CLINIC AS WELL.

UM, WE'RE ACTUALLY GETTING READY TO SPEAK TO THEM ABOUT MAYBE COMBINING RESOURCES AND PUTTING TOGETHER A, A MORE COMPREHENSIVE PROGRAM COLLECTIVELY TOGETHER WITH BEAUFORT JASPER.

UM, BUT AS FAR AS I CAN TELL, IT'S EITHER US OR BEAUFORT JASPER.

I AM NOT AWARE OF ANY OTHER RESOURCES OR ANY OTHER HEALTHCARE PROVIDER RESOURCES IN THE AREA, UM, FOR, UM, SUBSTANCE ABUSE AND ADDICTION MEDICINE RIGHT NOW.

THANK YOU.

DO YOU HAVE ANY OTHER QUESTIONS FROM THE PUBLIC? PLEASE? UH, SPEAKING TO THE MICROPHONE, YOU, YOU KNOW THE DRILL TOO.

I KNOW THE DRILL.

UH, YOU DIDN'T MENTION MUCH ABOUT GERIATRICS AND GER GERONTOLOGY.

UH, AND WE KNOW THAT WE HAVE A LARGE SENIOR POPULATION IN THIS AREA, PARTICULARLY IN THE OAK D AREA.

CAN YOU GIVE US A LITTLE BIT OF AN IDEA OF WHAT YOU'RE, HOW YOU'RE TRYING TO ADDRESS THOSE, THAT ISSUE?

[00:55:04]

UH, SO GERONTOLOGY, UM, GERIATRICS, UM, WHAT I WOULD SAY IS, IS THAT, UM, MOST OF THOSE PROVIDERS, UH, ARE INTERNISTS FIRST AND THEN GO TO SPECIALIZE.

AND WHEN THEY SPECIALIZE IN GERIATRICS OR OTHER SPECIALTIES, SUCH AS NEUROLOGY OR, OR MOVEMENT DISORDERS OR CARDIOLOGY OR WHATEVER THAT MIGHT BE, UM, A LOT OF TIMES THOSE INTERNISTS DON'T GO INTO GERONTOLOGY.

THEY GO INTO HOSPITAL-BASED MEDICINE.

AND SO ONE OF THE ISSUES WE'RE FINDING BOTH WITH INTERNAL MEDICINE AND THOSE THAT EVEN GO ABOVE INTERNAL MEDICINE AND SPECIALIZE IN GERIATRICS, IS THEY'RE A LIMITED NUMBER BECAUSE MOST OF THOSE DO NOT WANNA PRACTICE OUTPATIENT PRIMARY CARE ANYMORE, ANYMORE.

WHICH IS WHY YOU SEE US RECRUITING MORE FAMILY MEDICINE THAN YOU DO SEE US ATTORNEY RECRUITING INTERNIST OR, YOU KNOW, INTERNISTS THAT SPECIALIZE.

UM, BECAUSE MOST INTERNISTS WANT TO GO ON TO SPECIALIZE INTO PROCEDURAL BASED SORT OF MEDICINE, UM, OR THEY WANT TO BE HOSPITAL BASED, MEANING A HOSPITALIST.

SO YOU'RE ADMITTED TO THE HOSPITAL, YOU SEE A DOCTOR YOU'VE NEVER SEEN BEFORE, THEY'RE ON SEVEN DAYS AND THEN THEY'RE OFF SEVEN DAYS.

UM, A LOT OF INTERNISTS LIKE THAT SCHEDULE AND REALLY GRAVITATE TOWARDS THAT.

SO THE STRATEGY IS TO RECRUIT THEM.

UM, WE'VE JUST HAD A VERY DIFFICULT TIME RECRUITING INTERNISTS AND EVEN MORE SPECIALIZED INTERNIST GERONTOLOGISTS, UM, WHO WANT TO PRACTICE OUTPATIENT MEDICINE.

UM, AND IT'S PROBABLY THE BEST ANSWER I CAN GIVE THERE.

IT'S JUST, THERE'S A DRASTIC SHORTAGE OF 'EM AND THEY'RE, IT IS A VERY COMPETITIVE MARKETPLACE FOR THOSE THAT WANT TO DO THAT, AND THEY TEND TO LEAN TOWARDS LARGER SYSTEMS AT TIMES.

THANK YOU.

YES, SIR.

ALL RIGHT.

THANK YOU.

IS THERE ANY OTHER QUESTIONS FROM THE PUBLIC OR THE BOARD? OKAY.

UM, I POSED A, A QUESTION TO THE BOARD AND I, I WANNA FOLLOW UP ON IT FOR A COUPLE OF MINUTES.

AND ONE OF THE THINGS THAT WE, AS SO LOCO HAVE DONE IN, IN OUR SEVEN YEARS IN EXISTENCE IS THAT, UH, LIKE-MINDED MUNICIPALITIES AND COUNTIES HAVE GOTTEN TOGETHER AND ADVOCATED FOR CERTAIN THINGS.

UH, WE ADVOCATED FOR AS A GROUP FOR, UH, BUSINESS LICENSING REFORM, AND THAT GOT THROUGH TO THE STATE.

UM, WE HAVE ALSO ADVOCATED, UH, INDIVIDUALLY AND, AND AS A GROUP FOR THINGS LIKE THE HATE CRIME BILL THAT, UH, CONTINUES TO GET STALLED UP IN COLUMBIA.

UM, BUT THERE, AND AS A GROUP, WE'VE GOTTEN A BUFORD JASPER HOUSING TRUST, WHICH IS, UH, A, A GREAT INITIATIVE.

DOES ANYBODY HAVE ANY THOUGHTS ON HOW WE AS A GROUP CAN GET INVOLVED IN THIS, IN THIS CRITICAL SHORTAGE OF, OF HEALTHCARE? FOR INSTANCE, ONE THING THAT WE COULD DO IN ADVOCACY IS TRY TO GET THIS SEVEN YEAR BACKLOG OF, OF A HOSPITAL AS A CRITICAL NEED.

UM, DO WE WANT AS A GROUP TO GET TOGETHER AND TRY TO PUSH THAT, THAT BOULDER UP THE HILL OR ANYTHING ELSE? DOES ANYBODY HAVE ANY THOUGHTS, COMMENTS ON HOW SO LOCO CAN BECOME INVOLVED IN WHAT SEEMS TO BE A HEALTHCARE CRISIS? MR. CHAIRMAN, I HAVE A QUESTION OF MR. BAXLEY FIRST, BEFORE I MAKE A COMMENT.

YOU MENTIONED THAT THE SEVEN YEAR BACKLOG AND HOW IT IS THAT, UH, YOU'RE UNABLE TO GET THE SITUATION OFF THE GROUND FOR BUILDING A NEW HOSPITAL.

UM, FROM A STATEWIDE PERSPECTIVE, IS IT A MATTER OF, UM, TERRITORIAL LIMITS OR HOW IS IT THAT IT IS DECIDED, OR HOW IS IT THAT YOU HAVE TO COMPETE TO BUILD A HOSPITAL? IS IT LIKE SPORTS WHERE YOU HAVE COMPETING INTERESTS FROM BALL CLUBS AND, YOU KNOW, YOU CAN'T JUST BRING A NEW TEAM INTO TEXAS, YOU HAVE TO GO THROUGH SOME THINGS OR LIKE UTILITIES WHERE YOU HAVE TERRITORIES, THE UTILITIES ARE DIVIDED UP INTO TERRITORIES.

HOW IS IT, WHAT'S THE MECHANICAL PROCESS FOR GETTING PAST WHATEVER HURDLES THERE ARE THAT EXIST? IT IS A GOOD QUESTION, AND I THINK REALLY, UM, ASTUTE COMPARISONS THERE.

UM, CERTIFICATE NEED PROCESS RIGHT NOW IN THE STATE OF SOUTH CAROLINA IS A LITTLE BIT IN FLUX.

AND, UM, I WILL SAY THAT BECAUSE IN THE LAST YEAR, UM, LEGISLATURE, UM, REPEALED THE CON CERTIFICATE A NEED, UM, FOR ALL THINGS THAT SET HOSPITALS, WHICH SUNSETS JANUARY 1ST, 2027.

UM, SO WHAT DOES THAT MEAN? SO PRIOR TO RIGHT WHEN A HOSPITAL WANTED TO BUILD A NEW HEALTHCARE FACILITY, AND IT COULD BE A HOSPITAL AND AN ACCELERATOR OR A SURGERY CENTER, IT WOULD APPLY TO THE STATE AND IT WOULD LOOK

[01:00:01]

AT THE STATE HEALTH PLAN AS THEY CALLED IT.

AND THAT STATE HEALTH PLAN CAME OUT EVERY TWO YEARS AND LOOKED AT EACH COUNTY AND KIND OF, UM, PREDICTED, UM, STATED THE NEED IN EACH COUNTY BY BED CAPACITY, PSYCH REHAB, ACUTE CARE BEDS, ET CETERA.

IF YOU HAD A COUNTY THAT SHOWED A NEED, YOU WOULD APPLY TO THE STATE TO BUILD AND MEET THAT NEED.

AND SO WE DID, THE COUNTY HAD A NEED IN 2019 FOR MORE ACUTE CARE BEDS.

SO THROUGH THE TWO CCON APPLICATION PROCESS WE SUBMITTED FOR THE HOSPITAL, THE STATE WOULD THEN APPROVE IT.

UM, AND AS THAT APPROVAL WAS HAPPENING THROUGH DEC, UM, OTHER HOSPITALS AND HEALTH SYSTEMS IN THE AREA COULD CHALLENGE THAT DECISION.

UH, FIRST THEY WOULD APPEAL TO THE BOARD OF DHC, UH, THE BOARD COULD CHOOSE TO HEAR THAT APPEAL OR NOT HEAR THAT APPEAL.

UH, IN THIS SITUATION, THE BOARD DID NOT HEAR THE APPEAL.

THEN YOUR NEXT RECOURSE WAS TO APPEAL TO THE ADMINISTRATIVE LAW COURTS.

AND, YOU KNOW, THAT PROCESS, UH, CAN TAKE SOME TIME.

NOW GRANTED, WE HAD A PANDEMIC, YOU KNOW, IN BETWEEN, AND WE WEREN'T FOCUSED ON THIS AND THE COURTS WEREN'T HAVING SESSION.

AND SO THIS GOT DELAYED BY THE PANDEMIC.

BUT BE THAT AS IT MAY, UM, THE A LC, UM, WOULD THEN HEAR THE CASE AND THEY'VE HEARD OURS, AND, YOU KNOW, WE HOPE TO HAVE A DECISION FROM THE A LC, UM, IN THE NEXT COUPLE OF MONTHS, UM, THAT DECISION COULD GO IN OUR FAVOR, COULD NOT GO IN OUR FAVOR IF IT DOES GO IN OUR FAVOR, THEN CURRENTLY UNDER CON LAW TODAY, STILL, BECAUSE HOSPITALS STILL REQUIRE CON, THEY COULD TAKE IT TO THE APPEALS COURT OF SOUTH CAROLINA, UM, IN THE RAREST OF OCCASIONS.

AND YOU CAN LOOK TO ROCK HILL, IT WENT ALL THE WAY TO SOUTH COUNTY SUPREME COURT AND A HOSPITAL TOOK 12 YEARS TO BUILD.

UM, BECAUSE HOSPITALS WERE FIGHTING AMONGST THEMSELVES.

ONE WANTED TO BUILD, OTHERS DIDN'T.

AND SO THEY CHALLENGED IT ALL THE WAY THROUGH.

UM, SO TODAY WE COULD BUILD AN EMERGENCY ROOM, UH, ANYONE COULD TODAY, UH, A SURGERY CENTER, UH, NO HOSPITAL BEDS, UM, WITHOUT CON, BUT YOU CAN'T BUILD A FULLY FUNCTIONAL HOSPITAL UNTIL 2027, WHICH IS REALLY WHAT WE WANT TO DO HERE.

UM, BECAUSE AGAIN, BACK TO THAT ANCHOR, THAT HEALTHCARE HOME, SO TO SPEAK, OF A NETWORK, IT IS HARD TO DO ANYTHING ANYWHERE WITHOUT A, AN ANCHOR OR A HOME TO BUILD A NETWORK AROUND, SO TO SPEAK.

SO TODAY, YOU KNOW, IF, IF WE'RE SUCCESSFUL IN A LC, UM, APPROVES THIS, THEN WE COULD THEORETICALLY BREAK GROUND IN A JANUARY TIMEFRAME.

UM, IF NOT, OR IT'S APPEALED OR CHALLENGED TO A HIGHER LEVEL, THEN WE WOULD BE POSSIBLY DELAYED YET AGAIN.

UM, EITHER TO THE POINT OF AN APPEALS COURT DATE AND DECISION OR 2027 ROLLS AROUND, UM, AT WHICH POINT, YOU KNOW, THAT'S THREE YEARS FROM NOW AND WE DON'T WANNA WAIT THREE YEARS.

NOW THOSE THAT ARE CHALLENGING, IT COULD BACK DOWN.

THEY COULD CHOOSE NOT TO CHALLENGE.

IT'S WELL WITHIN THEIR RIGHT TO SAY, HEY, WE'RE GONNA LIVE AND LET LIVE AND LET EVERYONE MOVE FORWARD.

UM, THAT HAS NOT BEEN, UM, UH, THE, THE STRATEGY OF, UM, THE PREVIOUS OWNERS AND NOW THE NEW CURRENT OWNERS OF THE HOSPITALS.

UM, THEY'RE STILL KIND OF IN THIS CHALLENGE MODE RIGHT NOW.

THANK YOU VERY MUCH.

AND, AND THANK YOU FOR YOUR TIME.

UH, I THINK IT'S GIVEN US A LOT TO THINK ABOUT AND, UH, THERE'S SOME QUESTIONS RAISED AND, AND, YOU KNOW, IF WE CAN, UH, THIS IS SOMETHING TO DIGEST AND PERHAPS THE BOARD WILL, UH, DO SOMETHING IN THE FUTURE.

UH, NEXT MONTH WE HAVE, UM, THERE'S BEEN A COUPLE OF THINGS THAT WE'VE TALKED ABOUT TO HAVE ON THE AGENDA, UH, THAT HAVE HAD TO SWITCH AROUND BECAUSE OF, OF SCHEDULES.

BUT NEXT MONTH WE HAVE, UH, TWO ITEMS ON, ON THE AGENDA.

THE MAIN ONE WILL BE, UH, WE TALKED ABOUT HAVING A CONVERSATION ABOUT CHILDCARE.

UM, AND DAN WOOD HAS BEEN ARRANGING THAT.

AND DAN, WE STILL OKAY FOR MAY? YES, SIR.

OKAY.

UH, ALSO, UH, I'VE INVITED, UH, FOR THOSE OF YOU WHO WATCHED WTOC, ONE OF THE ANCHORS, UH, YOUNG MAN BY THE NAME OF TYLER MANION, UH, IS INVOLVED IN, UM, ALZHEIMER'S.

AND HE'D LIKE TO GIVE A, A, A BRIEF PRESENTATION TO THE GROUP ABOUT ALZHEIMER, ALZHEIMER'S, UM, UH, WALK THAT TAKES PLACE IN BLUFFTON EVERY YEAR.

SO, UM, THOSE TWO ITEMS ARE SET FOR THE MAY AGENDA, WHICH IS THE 28TH IN BLUFFTON.

OKAY.

UH, SO THANK YOU ALL FOR JOINING US AND, UM, ENJOY THE REST OF THE SPRING.

MR. BAXLEY, THANK YOU SO MUCH.

THIS WAS A GREAT PRESENTATION.

AND CAN WE HAVE, UH, THIS FOR THE, UH, WE HAVE WEBSITES, THE LOCO WEBSITES ON HARDY V AND BLUFFTON.

CAN WE HAVE THAT, UH, TO PUT UP, GUYS? OKAY.

THANK YOU VERY MUCH.

UH, ROBIN, WILL YOU, YOU AND CARRIE MAKE

[01:05:01]

SURE THEY GET THIS GETS ON THE WEBSITES.

THANKS FOR WATCHING BC TV.

WHEN A DOG OR CAT IS ADOPTED FROM THE COUNTY ANIMAL SHELTER, A MICROCHIP CAN BE IMPLANTED IN THE ANIMAL IDENTIFYING ITS OWNER.

THE COST IS $20.

IN ADDITION TO AN ADOPTION FEE OF $80, WHICH INCLUDES SPAYING OR NEUTERING AND VACCINATIONS, A MICROCHIP PET MAY BE RECLAIMED BY THE OWNER FOR A FEE.

A MESSAGE FROM BEAUFORT COUNTY ANIMAL SHELTER AND CONTROL THE SHELTER IS ALWAYS HAPPY TO ACCEPT DONATIONS OF OLD BLANKETS, TOWELS, OR PET TOYS.

FORT FREMONT CLOSES OUT A 350 YEAR LEGACY OF COASTAL FORTIFICATIONS IN PORT ROYAL SOUND, BEGINNING IN THE MID 16TH CENTURY.

IT ALSO REPRESENTS THE CLOSING CHAPTER OF AMERICA'S COASTAL DEFENSE SYSTEM BEFORE THE DAWN OF AIR POWER.

PORT FREMONT IS AN EXAMPLE OF THE MOST ADVANCED MILITARY TECHNOLOGY OF ITS TIME.

IT WOULD PARALLEL THE B 17 AND AIRCRAFT CARRIER OF WORLD WAR II, THE F 35 OF TODAY.

FORT FREMONT WAS AN IMPORTANT PART OF THE BUFORD CULTURE, VERY SIMILAR TO PARIS ISLAND AND THE MARINE CORPS AIR BASE.

TODAY IN 1525, THE SPANIARDS NAMED THIS SOUND AND THIS HARBOR, SANTA ELENA, THEY CALLED THE NAVIGATIONAL POINT, LA PUNTA DE SANTA ELENA, THE POINT OF SANTA ELENA.

AND WHAT THE SPANISH EXPLORERS DISCOVERED IS THAT PORT ROYAL SOUND IS A UNIQUE PIECE OF GEOGRAPHY.

IT'S THE DEEPEST NATURAL HARBOR SOUTH OF THE CHESAPEAKE BAY, POSSIBLY SOUTH OF NEW YORK, THE CHANNEL INTO PORT ROYAL SOUND.

THIS, I FIND A REMARKABLE GEOLOGICAL FACT.

THE CHANNEL HA UH, HAS NOT CHANGED FOR 500 YEARS.

THERE'S NO INLET ON THE SOUTHERN COAST THAT HASN'T SHIFTED ENTIRELY IN 500 YEARS EXCEPT PORT ROYAL SOUND.

THERE'S SOMETHING GEOLOGICALLY DIFFERENT, OR ONE MIGHT SAY MAGICAL ABOUT PORT ROYAL SOUND.

SO SPANISH SAILORS BEING THE BEST IN THE WORLD IN THEIR TIME, FOUND THIS PLACE VERY EARLY, KNEW THAT FOR THE SPANISH EXPLORATIONS OF THE AMERICAN SOUTHEAST, THIS WOULD BE THE ENTRADA, THE ENTRANCE.

AND SO THEY BUILT A CITY ACROSS THE RIVER, UH, ACROSS THE SOUND FROM WHERE WE ARE ON PARIS ISLAND THAT BECAME THE FIRST CAPITAL OF FLORIDA.

AND THEY EXPLORED THE BACK COUNTRY FROM THIS LOCATION FOR, UH, MORE THAN A CENTURY, WITH THE OBJECT OF BUILDING A HIGHWAY FROM THIS MAGNIFICENT HARBOR TO MEXICO CITY.

SO THE SOUND WAS KNOWN TO THE SPANIARDS, IT WAS KNOWN TO THE FRENCH WHO ACTUALLY GOT HERE FIRST AND FOLLOW AND CREATED THE FIRST PROTESTANT COLONY IN THE NEW WORLD ON PARIS ISLAND OVER MY SHOULDER.

UM, AND THAT COLONY WAS A FAILURE.

THE SPANIARDS REPLACED THEM.

IT WAS PART OF SPANISH, FLORIDA WHEN THE ENGLISH ARRIVED 150 YEARS LATER.

AND THIS WAS BECAME, AS A CONSEQUENCE, A BATTLEGROUND IN THE 18TH CENTURY BETWEEN SPANISH INTERESTS IN FLORIDA AND ST.

AUGUSTINE AND THE ENGLISH COLONY IN CAROLINA AND IN CHARLESTON AND BACK AND FORTH.

THESE WARS WENT, MANY OF THEM NAVAL WARS, MANY OF THEM EMPLOYING AS ALL THE SAILORS KNEW BY THEN THE MAGIC OF PORT ROYAL SOUND.

BUT WHEN THE CIVIL WAR CAME, CONFEDERATES DEFENDED THE, UH, HARBOR, BUT IT WAS BASICALLY INDEFENSIBLE AGAINST, UH, LARGE NAVAL FORCES.

SO THE US NAVY MADE IT THEIR PRINCIPLE TARGET DURING THE BE BEGINNING OF THE CIVIL WAR AND SENT THE LARGEST FLOTILLA OF SHIPS, UM, ASSEMBLED BY THE UNITED STATES NAVY IN THE 19TH CENTURY INTO PORT ROYAL SOUND.

ON NOVEMBER, NOVEMBER 7TH, 1861, IN A FOUR HOUR CANNON AID, WHICH WOULD'VE BEEN DEAFENING FROM WHERE WE'RE SITTING, WAS HEARD FROM MILES FROM SAVANNAH, NEARLY TO CHARLESTON.

IT WAS CALLED THE DAY OF THE BIG GUN SHOOT.

DURING THE CIVIL WAR, THIS HARBOR THAT WE'RE LOOKING AT WAS FILLED WITH SHIPS.

THERE WOULD BE HUNDREDS OF SHIPS IN THIS HARBOR.

THERE WAS A THOUSAND FOOT, UH, DOCK WITH A RAILROAD ON TOP OFF OF HILTON HEAD.

[01:10:01]

UM, THE MILITARY INSTALLATION WAS MAMMOTH.

THERE WERE 13,000 US SOLDIERS ON HILTON HEAD, WHICH WE'RE LOOKING AT THE LARGEST POPULATION ON HILTON HEAD UNTIL 1974.

SO THIS WAS A MAJOR US GOVERNMENT INSTALLATION IN THE HEART OF THE SOUTH.

IT WAS THE HEADQUARTERS OF THE US ARMY DEPARTMENT OF THE SOUTH, BUT MORE IMPORTANTLY, IT WAS THE HEADQUARTERS OF THE UNITED STATES NAVY, SOUTH ATLANTIC BLOCKADING SQUADRON.

SO THE BIGGEST SHIPS IN THE NAVY WERE HERE.

AND, UM, SO IT, IT BECAME, AND, AND THAT'S REALLY WHERE THE STORY OF FREIGHT.

FORT FREMONT STARTS WITH THAT HUGE CIVIL WAR MILITARY, UH, OPERATIONS AND INSTALLATIONS, UM, ON HILTON HEAD, ON ST.

HELENA ISLAND, ON PARIS ISLAND.

AND IN BEFORD AFTER THE CIVIL WAR, WE'RE GONNA SEE A MASSIVE CHANGE IN TECHNOLOGY THAT'S GONNA REVOLUTIONIZE MILITARY.

DURING THE CIVIL WAR, WE HAD IRONCLAD SHIPS, WE HAD RIFLE CANNONS, BUT THEY WERE ALL MADE OUT OF IRON, AND THEY WERE NOT TERRIBLY EFFECTIVE.

BUT ITS TECHNOLOGY IS GONNA CHANGE.

AFTER THE CIVIL WAR, WE'RE GONNA SEE STEEL PRODUCED, AND STEEL IS MUCH HARDER.

SO NOW WE HAVE A NEW MATERIAL TO MAKE ARMOR OUT OF FOR SHIPS.

SO WE CAN HAVE THESE ARMORED SHIPS MADE WITH STEEL AND A MUCH MORE RESISTANCE TO THE SHOT.

AND BECAUSE I HAVE STEEL, I CAN MAKE, UH, STRONGER BARRELS FOR MY GUNS.

UH, I CAN RIFLE AND MACHINE THESE MUCH BETTER.

AND THE RIFLING IS THE SPIRALS THAT ARE CUT IN THE BARREL THAT ALLOWS IT TO SHOOT FURTHER WITH MORE ACCURACY.

AND WE CAN ALSO NOW HAVE BREACH LOADING GUNS THAT CAN LOCK FROM BEHIND.

SO I CAN LOAD MY GUN FROM BEHIND.

I DON'T HAVE TO GO HAVE THE OLD BLACK POWDER MUZZLE LOADING CANNON I HAD BEFORE.

NOW I CAN FIRE MUCH MORE RAPIDLY.

IF I COMPARE THE GUN OF, UH, 1890 TO THE GUNS OF 1860, UH, FOR THE SAME CALIBER, THE SAME DIAMETER GUN, UH, THE 1890 GUN WILL BE ABLE TO FIRE PROJECTILE AS FOUR TIMES HEAVIER, CAN SHOOT IT THREE TIMES FURTHER, CAN PUT IT IN WITH GREATER PRECISION, AND CAN PUT IT THROUGH MUCH MORE ARMOR THAN ANYTHING.

WE HAD IN 1860S WORLD DIFFERENCE.

A MILITARY HISTORIAN, ER LEWIS WOULD SAY THAT THE CHANGE BETWEEN THE CIVIL WAR IN 1890 AND ARTILLERY TECHNOLOGY WAS THE GREATEST THAT WOULD BE SEEN SINCE INVENTION OF ARTILLERY IN THE 14TH CENTURY TO THE INTRODUCTION OF THE NUCLEAR PROJECTILE IN THE 1950S.

SO THERE'S BEEN A HUGE CHANGE IN GUN TECHNOLOGY AT THE SAME TIME.

IT'S NOT JUST THE STEEL, BUT ALSO THE POWDER THAT FIRES THESE GUNS IS DIFFERENT.

WE'RE HAVING NEW CHEMICAL MAKEUP.

AND SO, LIKE CORDITE IS INVENTED NOW, AND IT'S STILL A WIDELY USED MILITARY EXPLOSIVE.

EVEN TODAY.

SMOKELESS POWDER IS INVENTED DURING THIS PERIOD OF TIME, AND IT'S NOT JUST CHEMICAL COMPOSITION, BUT IT'S THE DETAILS OF HOW YOU MAKE THE GRAIN, HOW FAST THEY BURN.

SO MUCH LIKE THE SKILL OF FIRING A SOLID ROCKET, UM, SOLID FUEL, UM, ROCKET.

IT'S THAT SAME KIND OF TECHNOLOGY THAT'S BEEN DEVELOPED IN THESE, UH, GUN POWDER, IN THIS NEW POWDER.

SO OUR WEAPONS OF THIS DAY ARE, ARE MUCH, MUCH GREATER.

UM, THEY WOULD BE THE GREAT KILLING MACHINES IN WORLD WAR I.

MOST OF THE CASUALTIES ON THE BATTLEFIELDS WORLD WAR I WOULD COME FROM ARTILLERY.

SO THE WORLD HAS SEEN A HUGE CHANGE IN ARTILLERY, AND THAT'S TIED INTO CHANGES IN SHIPS.

WE NOW HAVE STEEL ARMORED SHIPS.

THEY'RE ALL, UH, STEAM POWERED.

THEY ARE NOW EQUIPPED WITH THESE FINE LONG RANGE GUNS, AND THEY NOW BECOME THE DOMINANT THREAT OF THE LATE 19TH, EARLY 20TH CENTURY.

THIS IS THE THREAT.

THE FRENCH AND ENGLISH WOULD BOMBARD CITIES LIKE CAIRO AND REDUCE THEM TO RUBBLE BECAUSE THEY WERE UNABLE TO DEFEND THEM.

SO THIS IS HOW THE WORLD WAS SEEING THE THREAT FROM THIS NEW TECHNOLOGY.

BIG BATTLESHIPS ARE THE THREAT OF THE ERA, AND NEW GUNS AND FORTIFICATIONS ON, UH, THE GROUND ARE WHAT YOU HAVE TO HAVE TO DEFEND AGAINST THEM.

ONE OF THE MOST IMPORTANT AND FIRST THINGS THAT HAPPENED AFTER THE CIVIL WAR IS THEY BUILT A RAILROAD TO PORT ROYAL SOUND, WHICH DIDN'T EXIST.

IT WAS THE FIRST CONNECTION OF THE SEA ISLANDS TO THE MAINLAND.

AND THE ADVANTAGE OF THAT RAILROAD IS IT BROUGHT COLD PORT ROYAL SOUND.

SO WHEN THE COAL WAS DELIVERED, THE NAVY FOLLOWED IN 1872, ROBERT SMALLS WAS IN THE SOUTH CAROLINA LEGISLATURE, AND HE PUSHED THROUGH A RESOLUTION TO THE SECRETARY OF WAR CALLING FOR THEM TO PUT A NAVY STATION ON PARIS ISLAND.

AND EVENTUALLY HE WOULD GO ON TO CONGRESS WHERE HE WOULD CONTINUE HIS SUPPORT FOR A NAVY STATION HERE IN THE BEAUFORT FORT OIL AREA.

THEY EVENTUALLY OPENED A NAVY STATION HERE AND A COALING STATION THEY CREATED IN THE 1890S ON PARIS ISLAND, THE LARGEST DRY DOCK IN THE UNITED STATES.

THIS IS THE PERIOD WHEN THE US NAVY WAS SWITCHING FROM SAIL TO STEAM.

ALL THE NAVIES OF THE WORLD NEED COALING STATION.

THIS WAS THE PRINCIPLE COALING STATION BECAUSE OF THE RAILROAD FOR THE CARIBBEAN AND

[01:15:01]

SOUTH AMERICAN US FLEETS, THIS WOULD BE THE BIGGEST DRY DOCK SOUTH OF NORFOLK.

IN FACT, IT IS THE ONLY DRY DOCK SOUTH OF NORFOLK, VIRGINIA, THAT'S CAPABLE OF TAKING THESE NEW MODERN BATTLESHIPS AND THESE NEW MODERN ARMORED CRUISERS.

SO THIS BECOMES, AT THIS POINT, A STRATEGIC NAVY BASIN, THAT IT PROVIDES COAL AND IT PROVIDES, UH, TOP LINE SUPPORT TO THE SHIPS, AND THEY CAN REPAIR THE HULLS OF EVEN THE BIGGEST SHIPS IN THE US NAVY.

FOLLOWING THE CIVIL WAR, NATIONAL STRATEGY AND EMPHASIS IN THE UNITED STATES SHIFTED FROM TO RECOVERY FROM WAR, AND ALL OF OUR COASTAL FORTIFICATIONS WENT INTO NEGLECT.

THE MILITARY WAS BUSY TAMING THE WEST, AND COASTAL DEFENSES, UH, BECAME SOMETHING THAT WAS NO LONGER IMPORTANT.

AND THE REST OF THE WORLD, TECHNOLOGY IS MOVING FORWARD, AND THEY'RE DEVELOPING THESE BATTLESHIPS.

THEY'RE DEVELOPING NEW, UH, HIGH QUALITY ARTILLERY, AND THIS IS GOING ON WORLDWIDE.

AND IN 1885, PRESIDENT GROVER CLEVELAND APPOINTED ENDICOTT BOARD, THIS WAS SEC HEADED BY SECRETARY WAR ENDICOTT, WILLIAM ENDICOTT.

AND THE BOARD WOULD MEET AND ISSUE A REPORT IN 1886.

AND THEY SAID THE CONDITIONS OF OUR COASTAL DEFENSES WERE JUST UNBEARABLE.

IT CANNOT BE ALLOWED TO STAY LIKE THAT.

AND THEY MADE RECOMMENDATIONS FOR FORTIFICATION AND IMPROVEMENTS.

IDENTIFIED 29 PLACES THAT NEEDED FORTIFICATIONS, AND 11 OF WHICH WERE CRITICAL IN THAT LIST OF 29.

SAVANNAH AND CHARLESTON ARE ON THE LIST, BUT BEAUFORT IS NOT ON THE LIST.

IT'LL TAKE INTERNATIONAL EVENTS TO BRING BEAUFORT INTO THE PLAY OF, OF MODERN FORT TECHNOLOGY.

SO THE USS MAINE WAS HERE ON PATROL AND IN THE HARBOR, AND WHILE THEY WERE IN THE HARBOR, SEVERAL TIMES, THEY ENTERTAINED THE LOCAL POPULATION.

SO THE MERCHANTS AND THE SOCIAL LEADERS IN THE POLITICAL LEADERS OF BEAUFORT WERE INVITED TO COME HAVE LUNCH WITH THE CAPTAIN OF THE SHIP, CAPTAIN SBE.

AND THE OFFICERS GOT TO KNOW THE PEOPLE, THE PEOPLE GET, GOT TO KNOW THE OFFICERS.

THE CREW, WHICH WAS LARGE, WOULD GO ASHORE ON PAYDAY AND MAKE FRIENDS WITH EVERYBODY IN TOWN.

SO IT WAS A VERY SOCIAL, UM, ARRANGEMENT BETWEEN THE TOWNS, PORT ROYAL AND BEAUFORD AND THE SHIP.

SO THE MAIN LEFT HERE, IT WENT AND REPROVISION, IT REFUELED IN KEY WEST, AND THEN WENT TO 90 MILES ACROSS TO HAVANA INTO THE HARBOR AND BLEW UP THIS INFLAMED.

THE ALREADY, UH, HOT PASSIONS BOTH IN CUBA AND HERE IN THE UNITED STATES.

AT THAT POINT, SOMEBODY IN THE WAR DEPARTMENT REALIZED THAT WE HAD THIS BIG DRY DOCK, THE ONLY DRY DOCK IN THE SOUTH THAT COULD TAKE ON AND REPAIR THESE BIG CAPITAL SHIPS THAT WERE IN OUR NAVY.

WE WERE GOING TO START OPERATIONS AGAINST A POWER IN THE CARIBBEAN.

AND THIS FORT WAS TOTALLY UNDEFENDED, AND THAT'S WHAT PUT FORT FREMONT ON THE MAP.

WE HAD TO HAVE A FORT HERE TO DEFEND THE COALING STATION, AND ESPECIALLY THIS BIG DRY DOCK, AS WELL AS THIS FINE HARBOR THAT'S HERE.

AND OF COURSE, THAT EVENT, WHICH KILLED 300 OR MORE SAILORS ON THE SHIP, UM, WAS VERY MUCH FOLLOWED BY THE LOCAL NEWS MEDIA AND VERY MUCH LAMENTED BY THE MANY FRIENDS THAT THE CREW HAD MADE HERE.

THE DESTRUCTION OF THE USS MAINE WAS A PERSONAL MATTER TO BEAUFORT AND TO PORT ROYAL SOUND.

UM, AND OF COURSE, IT WAS THE SPANISH AMERICAN WAR AND THE ATTEMPT TO DEFEND THIS HARBOR AGAIN, WHICH LED TO THE, THE CREATION OF FORT FREMONT.

THE UNITED STATES DECLARED WAR ON SPAIN IN, IN APRIL, 1898.

AND BY EARLY MAY, WE HAD TEMPORARY BATTERIES IN PLACE HERE, SUBMARINE MINES WERE IN PLACE, AND IN THE SUMMER, THEY WOULD ACTUALLY PLACE THE MINES ACROSS THE BEAUFORT RIVER.

BEHIND ME.

THE TEMPORARY BATTERIES WERE A TEMPORARY EXPEDIENT.

THEY WERE LOCATED TO MY LEFT ABOUT A THOUSAND YARDS.

THEY IMMEDIATELY BEGAN CONSTRUCTION OF WHAT WOULD BECOME FORT FREMONT.

THE LARGE BATTERIES WOULD HOUSE THE LARGE GUNS BATTERY FOR N THE RAPID FIRE GUNS.

THE SMALLER BATTERY WAS COMPLETED BY JUNE OF 1898.

IN THE 1898, EVERYBODY IN TOWN WENT TO WAR.

UM, THEY HAD A NAVAL MILITIA UNIT, SOUTH CAROLINA NAVAL MILITIA UNIT, AND THEY WERE ABSORBED BY THE NAVY.

UH, MANY OF THEM RAN TUGBOATS FROM HERE TO NEW YORK TO KEY WEST, WHICH WAS THE PRINCIPAL SUPPORT BASE, TAMPA AND KEY WEST FOR THE US ARMY OPERATIONS IN CUBA.

PEACE WAS DECLARED BY THE END OF 1898, AND THE, UH, REMAINDER OF FORT FREMONT WOULD NOT BE FINISHED UNTIL EARLY 1899, AND THE FIRST SOLDIERS WOULD ARRIVE FROM THE REGULAR ARMY AT THAT POINT IN MARCH, 1899.

WELL, FORT FREMONT WAS NAMED FOR, UH, MAJOR GENERAL

[01:20:01]

JOHN FREMONT.

UH, HE WAS ACTUALLY A LOCAL BOY, SO TO SPEAK.

UH, HE WAS BORN AND GREW UP IN, UH, SAVANNAH, GEORGIA, JUST, UH, SOUTH OF US.

AND, UH, WENT TO, UH, COLLEGE IN THE COLLEGE OF CHARLESTON, UH, UP JUST NORTH OF US IN CHARLESTON.

HE SERVED IN THE ARMY AND, UH, PRIMARILY INITIALLY AS A, UM, EXPLORER, AS ARMY FORTS WERE GENERALLY NAMED FOR ARMY OFFICERS.

UH, AND HE WAS, UH, CONNECTED LOCALLY.

UH, THIS WAS MORE THAN LIKELY WHY THE FORT WAS NAMED FOR HIM.

THE FORT WAS CONSTRUCTED ON A SITE, UH, DIRECTLY ACROSS THE RIVER FROM, UH, THE PARIS ISLAND, UH, UH, NAVAL STATION.

AND THE SITE SELECTED WAS 170 ACRES, WHICH INCLUDED THE TWO, UH, ARTILLERY, UH, BATTERIES.

UH, FORT UH, F FREMONT, OF COURSE HAD BATTERY FOREIGNNESS AND BATTERY JESSUP.

UH, BUT THEN ADJACENT TO THE BATTERY SITE WAS AN ADMINISTRATIVE QUADRANGLE, A VERY TYPICAL MILITARY TYPE, UH, ADMINISTRATIVE SQUARE.

UH, WE ARE SITTING IN THE NUMBER THREE GUN POSITION OF A THREE GUN BATTERY BATTERY JESSUP, WHICH HAD THREE 10 INCH DISAPPEARING CARRIAGE, LARGE CALIBER GUNS BREACH LOADING GUNS.

THEIR PURPOSE WAS TO, UH, ENGAGE THE WARSHIPS THAT MIGHT, UH, BE ENTERING THE HARBOR, UH, AND PORT ROYAL SOUND.

WE'RE HERE NOW AT THE SECOND BATTERY, UH, THAT WAS PART OF FORT FREMONT.

THIS IS BATTERY FOR NANCE, UH, WAS NAMED FOR, UH, ARMY OFFICER, UH, THAT WAS ACTUALLY KILLED DURING THE SPANISH AMERICAN WAR.

UH, DURING THE BATTLE OF SAN JUAN HILL, UH, BATTERY ANCE MOUNTED TWO, UH, BRITISH MADE 4.72 INCH ARMSTRONG QUICKFIRE GUNS.

UH, THEY WERE CALLED QUICKFIRE BECAUSE THEY LOADED, UH, WERE LOADED WITH A COMPLETE CARTRIDGE, AND IT, UH, IN TIME OF ACTION, THEY COULD FIRE FOUR TO SIX ROUNDS PER MINUTE.

THE PURPOSE OF BATTERY FOR NANCE WAS TO DEFEND THE MINEFIELD, WHICH WAS THE OTHER COMPONENT OF THE ENDICOTT COAST ARTILLERY OR OR COAST DEFENSE SYSTEM.

UH, A MINEFIELD, UH, WITH CONTROLLED MINES.

CONTROLLED MEANING THAT THEY WERE CONNECTED ELECTRICALLY TO SHORE AND COULD BE FIRED ON COMMAND FROM SHORE.

THAT, UH, CONTROL STATION WOULD'VE BEEN, UH, PROBABLY SHARED WITH THE PLOTTING ROOM.

AND IN ORDER TO PROTECT THE MINEFIELD, OBVIOUSLY AN ENEMY WOULD WANT TO INTERFERE WITH THAT.

MIGHT SEND VESSELS, UH, SMALL SHIPS IN HERE AT NIGHT TO TRY TO INTERFERE.

AND THIS BATTERY WOULD TAKE THOSE VESSELS UNDER FIRE IF THERE WAS SOME, UH, THERE WAS SUSPECTED THAT, UH, UH, THEY WERE DOING SOMETHING TO INTERFERE WITH THE MINES, SUCH AS, UH, PULLING UP THE CABLES AND CUTTING THOSE.

THE IN OF GOD ERA.

FORT WAS A FORMIDABLE TECHNOLOGY.

IT REPRESENTED STATE-OF-THE-ART TECHNOLOGY, DEFENSE TECHNOLOGY OF ITS TIME AGAINST THE STATE-OF-THE-ART THREAT, WHICH WOULD BE THE BATTLESHIP.

THE LIFE FOR THE SOLDIERS AT FORT FREMONT WAS DISCIPLINED AND REGIMENTED.

THEY EVEN HAD MEALTIMES WERE SPECIFIED LENGTHS OF TIME, 15 MINUTES FOR LUNCH, 15 MINUTES AT BREAKFAST, 20 MINUTES OF SUPPER.

THEY HAD TO PRACTICE THEIR SKILLS.

THEY WERE TRAINING AND DOING MAINTENANCE CONSTANTLY, IF YOU CAN IMAGINE WITH THESE BIG GUNS.

THEY HAD TO HAVE SKILLS IN, IN PRACTICE SKILLS, IN ARTILLERY MIND, LAYING SIGNALING, WHICH INVOLVED IN OUR CASE AT FORT FREMONT, THE USE OF THE FIRE CONTROL TOWER, WHICH WAS A PRETTY SOPHISTICATED AND, UM, ADVANCED SIGNALING TECHNIQUE.

THEN THEY ALSO HAD TO, UM, PRACTICE THE TYPICAL MILITARY SKILLS, MARCHING AND DRILLING, SMALL ARMS, FIRE, FIRST AID, AND SO FORTH.

IN ADDITION TO THAT, THEY ALSO, UM, HAD PARTICIPATED IN ATHLETICS.

THEY HAD PHYSICAL TRAINING, PT, AND THEY ALSO HAD SPORTS TEAMS. SO THIS WAS TO KEEP THEM PHYSICALLY FIT SO THAT THEY COULD CONTINUE THEIR, THEIR DUTIES, BECAUSE THEY WERE, IT WAS PRETTY RIGOROUS AT FORT FREMONT.

WHEN EVENTUALLY THE DECISION WAS MADE TO MOVE A DRY

[01:25:01]

DOCK AND THE COALING STATION AND THE NAVY STATION UP TO CHARLESTON, THEN THIS FORT NO LONGER BECAME SIGNIFICANT.

THERE WAS NOTHING LEFT HERE THAT WAS TO BE PROTECTED.

AND AT THAT POINT, 1911, THE LAST TROOPS WERE TRANSFERRED OUT, AND FORT WAS CLOSED IN 1901, THE MAYOR OF CHARLESTON AND THE UNITED STATES SENATOR PITCHFORK, BEN TILLMAN FROM SOUTH CAROLINA, WANTED THIS TO MOVE FROM BEAUFORT COUNTY TO CHARLESTON COUNTY 'CAUSE THERE ARE MORE VOTES IN CHARLESTON COUNTY.

AND THE MAYOR WANTED THE US CORPS OF ENGINEERS THAN IN THE NAVY TO DREDGE THE HARBOR IN CHARLESTON.

'CAUSE BATTLESHIPS IN THOSE DAYS REQUIRED 26 FEET OF WATER.

CHARLESTON'S NATURAL HARBOR IS 15 FEET OF WATER.

PORT ROYAL IS 30 FEET OF WATER.

IN ORDER FOR CHARLESTON TO SUSTAIN ITS PORT, ITS COMMERCIAL PORT, IT HAD TO DREDGE THE HARBOR.

WELL, IF THEY COULD GET THE NAVY UP THERE, THEY GET THE CORPS OF ENGINEERS TO DRUDGE THE HARBOR.

THAT WAS THE PLAY.

AND THE, UH, THE PLAY FOR PITCHFORK, BEN TILLMAN, THE US SENATOR IN 1900 WAS THAT HE'D GET A WHOLE LOT MORE, MORE VOTES FROM VOTES FROM THE LARGEST CITY IN SOUTH CAROLINA.

SO IT WAS A POLITICAL COMMERCIAL OPERATION, AND THEY MOVED THE NATION AND IT WAS DONE, BOOM, LIKE THAT.

THE FORT DID ITS JOB, THE DETERRENT FOR ANYBODY THAT WISHED TO ATTACK THESE.

IT PROVIDED PROTECTION.

IN FACT, THE WHOLE INDICO SYSTEM, ALTHOUGH NEVER CHALLENGED IN, UH, THIS ERA HERE IN THE UNITED STATES, PROVIDED SOME 300 MAJOR GUNS, COASTAL GUNS, TO PRO, UH, PROTECT MAJOR AREAS, AND LEFT THE UNITED STATES AT THE BEGINNING OF THE 20TH CENTURY WITH AS WELL DEFENDED, UH, COASTLINE AS ANY PLACE IN, IN THE WORLD.

BUT I, I WOULD JUST LIKE TO SAY THAT IT'S A MAGNIFICENT ARTIFACT OF AN ERA, AND IT'S AN ERA THAT HAS BEEN NEGLECTED, UH, THE TURN OF THE 20TH CENTURY, UM, THE NAVAL STATION ACROSS THE RIVER HERE.

AND, UM, SO IT'S A, IT'S A PIECE OF HISTORY THAT'S DISAPPEARING AND THE FRIENDS OF FORT FREMONT AND BEAUFORT COUNTY HAVE PRESERVED IT BEFORE THE USE OF THE PUBLIC.

AND, UH, AS A MEMORIAL TO THAT MOMENT IN HISTORY, FORT FREMONT CLOSES A 350 YEAR STORY OF HOMELAND SECURITY ADDRESSING EUROPEAN IMPERIALISM IN THE 19TH CENTURY.

IT'S A TALE OF HOW GEOGRAPHY, TECHNOLOGY, AND NATIONAL SECURITY CREATES A TRANSITION FOR AMERICA TO BECOME A GLOBAL POWER.

IT'S ALSO A WONDERFUL SNAPSHOT OF AMERICA.

IN THE BEGINNING OF THE 20TH CENTURY, THE FRIENDS OF FORT FREMONT AND BEAUFORT COUNTY HAVE A VALUED PARTNERSHIP WORKING IN TANDEM TO PRESERVE THE FORT'S INTEGRITY AND PROMOTE THE HISTORICAL, NATURAL AND CULTURAL ASPECTS OF THE FORT.

MOST IMPORTANT, WE'RE ALWAYS LOOKING FOR CREATIVE WAYS TO ENHANCE THE VISITOR EXPERIENCE.