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082520 Public Hearing Randolph HealthAugust 25, 2020 — Public Hearing The Randolph County Board of Commissioners met in special session at 5:30 p.m. in the 1909 Randolph County Historic Courthouse Meeting Room, 145 Worth Street, Asheboro, NC. Chairman Darrell Frye, Vice -Chairman David Allen, Commissioner Kenny Kidd, Commissioner Maxton McDowell, and Commissioner Hope Haywood were present. Also present were County Manager Hal Johnson, Finance Officer Will Massie, County Attorney Ben Morgan, Deputy Clerk to the Board Sarah Pack, and Clerk to the Board Dana Crisco. Representatives from the City of Asheboro were Mayor David Smith and City Manager John Ogburn. Christy Myatt of Nexsen Pruet, Attorney for Randolph County and the City of Asheboro, was also in attendance. Those present representing Randolph Health were CEO Angie Orth, Attorney Bob Wilson, Attorney Cara Ludwig, Board Chairman Mac Pugh, and Ankura Senior Managing Partner Louis Robichaux. Required social distancing was maintained throughout the meeting due to the COVID-19 pandemic. Chairman Frye called the meeting to order at 5:30 p.m. He said this is a historic evening for Randolph County and the future of health care in the county. Chairman Frye explained the procedure for the Public Hearing, as protocols have changed due to the COVID-19 pandemic. He introduced Representatives Pat Hurley and Allen McNeill from the North Carolina House of Representatives and said that they were instrumental in creating the legislation behind the Rural Health Care Stabilization (RHCS) Program. Senator Jerry Tillman had originally spearheaded the legislation. Previously (in November 2019), the Commissioners had a public input session to decide whether or not to apply for the RCHS Program. Many things have changed since then, including Cone Health withdrawing their interest in partnering with Randolph Health. To secure the loan, a new application must be submitted that includes the operation plan of the potential management successor. Tonight's Public Hearing is to consider whether or not to borrow an amount not to exceed $20 million from the RHCS Program for the benefit of a hospital operating in Randolph County. Chairman Frye introduced Mayor David Smith. Mayor Smith made comments regarding the potential application for RHCS funding. Those comments follow these minutes as Attachment A following these minutes. Chairman Frye thanked Mayor Smith and the Asheboro City Council for their support. Chairman Frye introduced Senator Dave Craven, the new State Senator who replaced Jerry Tillman. Senator Craven thanked the hospital administration, their Board of Directors, and the Commissioners for the time they've dedicated to securing the future of local health care access. He urged the Board to support the action before them this evening and thanked them for their involvement. 8/25/20 Chairman Frye introduced Angie Orth. Not only has she been working to preserve local health care while the hospital worked through the bankruptcy process, but she also runs the hospital in a day to day capacity. Ms. Orth thanked the Board for the opportunity and for their efforts. She introduced Mac Pugh, Bob Wilson, Cara Ludwig, and Louis Robichaux. She stated there is now an option on the table for securing health care for the future in Randolph County. Randolph Health has been searching for an organization to run the hospital; Dava Foundation and Java Medical Group are now interested in purchasing the assets of the hospital. She asked that the Commissioners borrow the RHCS funds. She thanked the elected officials in the audience for their work with the RHCS Program. She introduced the representatives in attendance from Java Medical Group; Bappa Mukherji, Martha McCormick, and Quentin Whitwell. Ms. Orth gave an overview of Mr. Mukherji's professional accomplishments. Mr. Mukherji said his father was a surgeon in the small town where he grew up. He saw the impact of health care on a small town which influenced his career choices for the rest of his life. Java Medical Group was started in 2017 with the purpose of revitalizing rural hospitals; the sole purpose is to work with struggling rural hospitals. Rural hospitals are in a crisis. Especially when facing a pandemic, it is difficult for rural hospitals to survive this economic climate. He introduced his business partners Martha McCormick, COO of Java Medical Group, and Quentin Whitwell, Chairman of the Board and partner in the Panola Medical Center (a facility run by Java Medical Group). He mentioned that everyone in his organization works at or operates hospitals run by the Java Medical Group. When hospitals are managed by large management companies, the strategic plan may not fit a smaller facility. Randolph Health has been managed as a rural referral center. They did not take advantage of the programs available to small rural hospitals. There are approximately 43 in-patient individuals in the hospital on any given day which he stated was sufficient to sustain the hospital operations. Java does not plan to sacrifice any of the service lines at the hospital. Jobs will be offered to every person currently working at the hospital; no j obs or personnel will be lost. Federal programs will be utilized to change the revenue model. He believes in using today's reality rather than trying to build a new program. Hospitals must be able to reinvest in services, training, and equipment or they will not be viable. This hospital will be managed like a rural hospital instead of an urban hospital. Details have been shared with hospital staff for approval. Buying a hospital out of bankruptcy is not a new concept for Java Medical Group. Chairman Frye asked if his experience with rural hospitals predates 2017. Mr. Mukherji said yes, they bought their first rural hospital in 2002. Since then, twenty-five hospitals have been purchased and all are still in operation, including one that merged with another hospital. He spoke of saving a small town hospital in Haleyville, Alabama. It was estimated it would take three years to make the hospital profitable but it turned a profit one year ahead of schedule. There is a $7 8/25/20 million expansion plan now in effect for that hospital. Asheboro is a larger city than many places they've worked in the past but they are confident in the plan and the people. Commissioner Haywood asked if there are higher reimbursement rates for wellness visits and tests. Mr. Mukher i said if it is a provider based rural health clinic, then yes. The revenue model can be changed by filing paperwork with the federal government for a higher reimbursement rate which will take the clinic from losing money to generating income. Commissioner Haywood said to citizens listening, an active way to help the hospital is to use local providers and get wellness checks. Mr. Mukher i said yes, this is a big part of the plan. There are certain wellness services that providers don't offer because they won't get paid enough for them. If Medicare beneficiaries can come to the local clinics for preventative care, this will create a positive effect on health care in the community. Commissioner Haywood said this meshes well with the County's focus on creating a culture of wellness. Mr. Mukher i said if a person has a major health event and is transferred to a larger hospital system, the local hospital loses money. If the health of those people is managed, the patient population can be locally maintained. Commissioner Allen asked what the plans were for the $20 million. Mr. Mukher i stated that it would be exclusively earmarked for capital improvements particularly upgrades to the facility and equipment. Chairman Frye asked if Java will reopen the Intensive Care Unit (ICU). Mr.Mukher i responded yes, with correctly trained staff. Commissioner Haywood said, in previous discussions, the $20 million would have been used to keep the hospital running while another facility was being built. Instead, Java will use it to improve the current facilities. Mr. Mukher i said the previous analysis was done using an operational perspective. One of the things missing was to make sure the new facility was viable for this area. The same people live here regardless of the facility. Commissioner Haywood asked if the current hospital facilities were sound. Mr. Mukher i responded that they were and said Java would not operate a substandard facility. Commissioner McDowell asked if there were plans to add more services. Mr. Mukher i said all services will be kept. Long term viability will depend on raising the level of in-patient care services available. This usually requires additional staff and equipment. This doesn't happen overnight. Based on demographics, one service to add first will be outpatient opioid addiction treatment. Reestablishing the ICU is important as well. Commissioner McDowell inquired if the facility was workable. Mr. Mukherji said yes, some parts of the hospital are as new as 2008. There are parts that are outdated but that doesn't render 8/25/20 them useless or unable to be rehabilitated. It is a large space, possibly larger than needed, but it can be made to work. Commissioner McDowell commented that this was a complete variation from the hospital's original plan. Mr. Mukherji stated just because you build it doesn't mean it will change anything. Commissioner Haywood said one of her concerns with joining a larger system was that the County and its citizens would take on debt then down the road be without a hospital anyways. Java's track record shows this will not be the case. Mr. Mukher i said their approach is that a hospital should be independent and able to stand alone. There is no need to cut things if the hospital can stand on its own. Commissioner Kidd was impressed with Java's common sense management style and commitment to the communities they serve. Mr. Mukher i said it is based on incredible staff at the hospitals even under financial strain. Chairman Frye said this plan allows the hospital to remain open and to operate with management of a company with a track record for operating rural hospitals. The previous plan would have lumped everything into a larger system. We are here to start a new day for health care in Randolph County. Randolph Health as we know it will cease to exist. In its place will be the new hospital system presented tonight. It will provide vital health services and will be owned by Dava Foundation and managed by Java Medical Group. The money that the Board is considering at this meeting goes to the new entity; not the existing ownership. The money will be used to enhance the facility rather than cover operating losses. The current Randolph Health Board of Directors will cease to exist. There will be a new Board that will have local representation including members from the Randolph County Board of Commissioners and the City of Asheboro. Lastly, the method of repayment of the debt must be considered and that will be decided in the future. Public Hearing Chairman Frye went over the rules for the Public Hearing. Each speaker will be allotted four minutes. Names will be drawn randomly and called five at a time. All who wish to speak will be allowed to do so. Chairman Frye opened the Public Hearing at 6:18 p.m. Kelly Heath, 1030 Westmont Drive, Asheboro, thanked the Commissioners. She is the Chair for the Board of the Asheboro -Randolph Chamber of Commerce. The chamber supports the County securing the loan for $20 million to ensure access to local health care which is vital to the community. Businesses will think twice about moving or remaining here without local health care. Mark Hensley, 1326 Middleton Circle, Asheboro, Randolph Senior Adults Executive Director, supports the request for the loan. He thanked the Board for supporting local health care and complimented the Randolph Health team for continuing to deliver health care while dealing with the financial situation of the hospital. He expressed his gratitude for Java's dedication to rural 8/25/20 hospitals. We need local health care. Senior adults are the fastest growing demographic in the community. Ninety-nine percent of population growth in Randolph County is age 65 and older. Maintaining high quality local health care is vital to the quality of life for senior adults, their physical independence and healthy aging. Without local facilities, many seniors may go without health care. Mr. Hensley said, "Carpe Diem, seize the day." We need local health care for today and years to come. John Rogers, 1001 Kildare Road, Asheboro, said Randolph Health is important to the community. He is grateful for something positive to move forward. This is an answer to prayers. He thanked Randolph Health leadership for not giving up. He told an anecdote about a friend whose husband had been dealing with health issues. If the hospital had not been local, he would have passed away. This option will serve the county better than being swallowed by a big conglomerate. He challenged elected officials to continue looking for a way to make the loan forgivable. He assumes there could be a tax increase. He does not mind that because it's a service to the community. He suggested once the loan is paid off, the tax increase be discontinued. Trent Cockerham, 416 Vision Drive, Asheboro, CEO of Hospice of the Piedmont, said many patients have connections to Randolph Health. The availability of hospital services and ancillary services are crucial to ensuring the health and well-being of individuals in Randolph County. He supports applying for the loan which has the potential to act as a catalyst to align health care to the needs of the county. He thanked the Board and recommended swift and immediate action to secure health care. David Jones, 1699 Sylvan Way, Asheboro, complimented Ms. Orth on her work. Many people advocate for supporting the hospital. The pandemic has brought a different world where people wonder why they should live in cities and instead live rurally and work from home. Asheboro has potential as an independent rural town to attract people who want to work and live more comfortably. We need comprehensive medical services to provide for those people. As the former director of the NC Zoo, he commented that the zoo would have hit the one million visitors mark for the year if it hadn't been for the shutdown caused by the pandemic. With more people visiting Randolph County, there will be times when hospital service is required. Mark Trollinger, 2407 Old Lexington Road, Asheboro, spoke previously in support of the hospital. He is a lifetime resident and third generation business owner. If the hospital is lost, he sees negative effects on the community. He is also concerned about the economic crisis that would occur. The loss of Randolph Health would be a huge blow to the economy. We need to do all we can do to draw people to our community. Those that leave are often the leaders and those who have resources. We don't want to see that in Randolph County. This vote is in the best interest of all concerned. There has been controversy before; there is no controversy tonight. He urged the Board to vote to accept this $20 million debt. Jaylin Brower, 4297 Young Road, Asheboro, is an entrepreneur and is heavily invested in the community. Randolph County means the world to him. He spoke of a child in Randleman who 8/25/20 accidently shot himself in the face at point blank range in 2013. That child is his nephew. If he had been transported to any place other than Randolph Health, he would have died during transport. Instead, he survived and is thriving because of the hospital. Having hope was the only thing that got him through that situation. If we lost local health care, we would lose hope. He asked Commissioners to preserve the hope we have in Randolph Health. When you walk through the doors, you know you will be taken care of. He would not be successful as a personal trainer without local health care in the area. Commissioner Haywood thanked Mr. Brower for putting a face on the value of having local health care. Beth Knott, 1450 Westmont Circle, Asheboro, has many ties to Randolph Health and the community. She is an Asheboro City Schools Board Member. The children of the community need local health care. Nurses collaborate daily with pediatricians. If we were to lose pediatricians, unnecessary gaps will be created for children's well-being. Seventy-five percent of students in the City School district qualify for free or reduced lunches. If those parents had to drive their children out of the county for preventative care, it would be a burden to both parents and children. Healthy children make happy children. Happy children can learn and thrive. We owe that to the school system, teachers, parents, and especially the children. Faye Cox, 1211 Grantville Lane, Asheboro, said $15 million was spent on a Megasite and $2 million was used to purchase property for an Agricultural Events Center. That $17 million could have gone a long way in this situation. Two years ago she was sick. She had a variety of unsuccessful treatments; she found out she had two cancers. She was referred to health care providers in Winston-Salem. Her regular doctor refused to do bloodwork because they weren't in the "group." In the newspaper, it said that people on Medicare were part of the reason the hospital filed bankruptcy. It shouldn't have been in the paper that these people caused the problem; they didn't do it. Her medical insurance coverage costs $9,000 per year. Many elderly people can't afford insurance. It's not fair to blame the older people or the middle class. Someone needs to make certain this won't happen again. Tyler Wilhoit, 2550 Mountain Lake Road, Asheboro, is a Real Estate Broker in Randolph County. Local health care is crucial to the health and safety of local homeowners. Without it, the value of homes will decrease. Major corporations have been scared to locate here. He lost $4-5 million in sales of homes in Randolph County to neighboring counties due to the current hospital situation. He thanked the administration of Randolph Health and the Commissioners for not giving up the search for a new hospital operator. Commissioner Haywood said she was told by a Real Estate Agent that several employees from a company with change in management were looking at homes in Randolph County. Because there was potential not to have a hospital in Randolph County, none of those clients bought homes here. 8/25/20 Michael Smith, 1209 Idlewood Drive, Asheboro, thanked the Commissioners for the opportunity to speak. He is a third generation Randolph County native. For his entire life, Randolph Health has been providing health care. It is a model corporate citizen. Over the past few months, the word "essential" has been a part of our vocabulary. Locally accessible, quality health care is essential. He urged Commissioners to pursue and accept the loan on behalf of citizens. Chairman Frye closed the Public Hearing at 6:58 p.m. after everyone wishing to speak had done so. Commissioner Haywood said a lot of gratitude has been expressed to leaders of the hospital. The hospital would not have kept the doors open without all the health care workers including cafeteria and maintenance staff. This speaks volumes about the employees Randolph Health has. Chairman Frye said there is a cost to not having a hospital. The tentative figures they received from Randolph County Emergency Services to transport citizens out of the county exceed what the debt service would be on the loan that the Board is considering. Another factor to consider is that some people will pass away on the trip out of the county to get help. Commissioner McDowell said the real estate situation is real. People are moving away because they're afraid of not having local health care. Commissioner Allen said it was easy to vote to submit an application for the loan. The hard vote would have been whether to borrow the money, but after tonight the vote is simple. These funds will be used to purchase assets. Spending money to transport patients isn't tangible. Part of Java's plan is to utilize rural clinics. This is not just about Asheboro, it's about the entire county. What happened in the past is not a role of this Board. Commissioners will have some governance and input over this new entity. He doesn't think there could be a better solution. Commissioner Haywood responded to Ms. Cox's comment about seniors not being treated well because they have Medicare. It bothers her that Ms. Cox didn't feel like seniors were valued. In a large system, the services and reimbursements of this type aren't as valued. By remaining a rural hospital, this model is geared towards seniors, Medicaid patients, and more. When first meeting Mr. Mukher i, she was impressed by his comments regarding responsibility to taxpayers. This said to her that he understands and feels a high level of accountability for the use of taxpayer dollars. She is more inclined to trust taxpayer money with someone like that. Chairman Frye commented that the Board does value seniors. They increased the 2020-21 budget allocation for Randolph Senior Adults Association (RSAA). Since the start of the pandemic shutdown, RSAA has been able to serve 50,000 meals to seniors. 8/25/20 Commissioner Kidd thanked everyone who spoke tonight. The concerns from the community have emphasized local health care and accountability. Java has been very open and generous in explanations. This is public money. It is a loan and must be paid back. Chairman Frye stated there was a schedule put together for loan repayment. A one cent addition on the tax rate generates a little over a million dollars per year. The schedule reflects how long repayment will take. Currently, every repayment option available is being reviewed. The County has a contract with Waste Management to operate the landfill. That contract already generates a million dollars per year with a potential increase of another $500,000 a year. There is also sales tax which, in the past, has been used for expansion projects at Randolph Community College. A repayment source would not need to be decided until the next budget (FY2021-2022). Repayment likely wouldn't start until next fall. Commissioner Haywood said there will be an expense for health care in the budget and it would probably be higher if there is no hospital in Randolph County. Chairman Frye introduced the Resolution Making Required Findings. He explained the contents of the Resolution. The County has moved funding of capital projects to a later time when they could be handled in a fiscally responsible way. Debt has never put the County in a poor financial position. On motion of Kidd, seconded by Allen, the Board voted unanimously (5-0) to approve the adoption of the Resolution Making Required Findings. This Resolution will follow these minutes as Attachment B. Chairman Frye introduced the Resolution Requesting Approval of the Local Government Commission. On motion of Kidd, seconded by Haywood, the Board voted unanimously (5-0) to approve the adoption of the Resolution Requesting the Approval of the Local Government Commission. This Resolution will follow these minutes as Attachment C. Chairman Frye thanked attendees for coming and said this is part of a great future for the County. It is obvious Mr. Mukher i knows his business. This decision was easier to make than anticipated. He hoped the citizens feel good about the decision. He thanked those involved for their diligent efforts. Adjournment At 7:26 p.m., on motion of Allen, seconded by Kidd, the Board voted unanimously to adjourn. Darrell Frye, Chairman David Allen 8/25/20 Kenny Kidd Hope Haywood Maxton McDowell Dana Crisco, Clerk to the Board 8/25/20 CitV of R51jeboto 14G -north Eburrll Street sD flax l lOG gshcboro, C. 27204-1 10G Randolph County Commissioners Attachment A Trl: 330-026-1201 ffax: 33G-G2G-1218 Submission for August 25th public hearing re: County Application for Rural Healthcare Stabilization Funding Randolph Health was created in 1928 when a joint meeting of the Chamber of Commerce, Kiwanis Club, Rotary Club, the Town Council, and interested citizens approved a cooperative plan with the Duke Endowment to build a 40 bed hospital. In October of 1929, the Wall Street crash occurred and the nation entered the Great Depression. Undaunted, the founders and supporters moved forward and the hospital opened July 9, 1932 ... 88years ago. When a hospital fails, there are tragic consequences for the local community. Randolph Health has 1100 employees, a $50 million dollar payroll, a $5 million local spend. Over -900 babies were bom there last year. More than 38,000 emergency room visits were logged. The medical care issues are obvious. The economic impact is not quite as visible at first glance. Our hospital serves as a financial and profession anchor. In failure, Professionals will leave our area. Economic recruitment will become very difficult if not impossible. Local sales tax revenue falls. Quality of life declines. And most of all, mortalities increase due to the increased time required to access appropriate medical care for strokes, heart attacks, and trauma victims. This is a 'Rural Healthcare Crisis". It is not unique to Randolph County. Since 2010, 113 Rural Hospitals have closed. There are no less than 5 in North Carolina right now facing closure. Nearly 20% of all the nation's rural hospitals are on the verge of collapse. Not many facing this crisis will have the opportunity that you have tonight. A lot of work has been done over the last 2 years to 'keep healthcare local'. You, as Commissioners, the city council, the restructuring team and Management at Randolph Health, our State Representatives have been relentless, refusing to give up, as a viable solution was sought. I would take a moment of personal privilege to thank Senator Tillman, Representative Hurley, and Representative McNeill for the hard work they did in "toting the water for Randolph County". I cannot begin to recount the countless hours Chairman Frye put into the effort to keep healthcare local. We have a solution in Java Medical. I stand before you tonight as Mayor of Asheboro and strongly urge you to take the appropriate action to secure the Rural Healthcare Stabilization funding that is necessary to ensure another 88 years of local medical care. Thank you your time and consideration, David H. Smith, Mayor Fora,' of �(g Znologiral ir 11ttr[t Scanned with CamScanner y�. .ci se. :n o• a� ail Randolp un P tY Heart of North Carolina Attachment B RANDOLPH COUNTY BOARD OF COMMISSIONERS Randolph County Office Building ■ 725 McDowell Road Asheboro, North Carolina 27205 ■ Telephone 336-318-6300 RESOLUTION MAKING REQUIRED FINDINGS Darrell Frye, Chairman David Allen, Vice Chairman Kenny Kidd Maxton McDowell Hope Haywood Commissioner Kidd introduced the following resolution and moved that it be adopted, Commissioner Allen seconded the motion, and the resolution was read by the above title. RESOLVED that the Board of Commissioners of the County of Randolph (the "County") hereby makes the following factual findings: 1. Description of the project: Article 2 of Chapter 131A of the North Carolina General Statutes establishes the Rural Health Care Stabilization Program (the "Program") to provide for loans at below-market interest rates with structured repayment terms in order for financially distressed eligible rural hospitals to transition to sustainable, efficient, and more proportionately sized health care service models in their communities. The County proposes to borrow up to twenty million dollars ($20,000,000.00) from the Program for the benefit of Randolph Health's successor entity, said funds to be used to finance construction/renovation of health care facilities or to provide operational costs during this transition period, or both pursuant to the plan proposed by lava Medical Group (the "Plan"). The Plan shall be part of the loan application submitted to the Program. Pursuant to the requirements of the Program, the loan shall not be granted without the approval of both UNC Health Care and the North Carolina Local Government Commission. 2. Facts regarding the necessity of the proposed project: The proposed project is necessary and expedient because Randolph Health is the only community health system located in Randolph County, and it is the only access point for emergency, urgent, or outpatient care for the medically underserved and other vulnerable populations, with the exception of one outpatient Federally Qualified Health Center. Randolph Health is financially distressed, has filed bankruptcy, and faces imminent closure without funding from the Program. 3. Facts supporting the amount proposed: The loan amount proposed is adequate and not excessive for the Plan. 4. Facts supporting that the Plan demonstrates a financially sustainable health care service model for Randolph County. The Plan provides for the continuation of health care services in Randolph County at essentially the same level as services are currently provided by Randolph Health. 5. Past debt management policies: The County has in the past always appropriated funds in accordance with North Carolina law during each fiscal year in an amount sufficient to retire all principal and interest on indebtedness. 6. Past budgetary and fiscal management policies: The County has always adopted its budget in a timely manner in accordance with North Carolina statutory requirements and has obtained an unmodified opinion from a certified public accountant in connection with each annual audit. www. randolphcountync.gov 7. Retirement of debt: The proposed debt service on the full loan amount is expected to be the equivalent of the levy of approximately one cent on the County's property tax rate. Any increase in the County's property tax rate resulting from the issuance of the proposed loan would therefore not be excessive. Randolph County also has other financial resources that could be utilized without impacting the General Fund budget. The motion was adopted by the following vote: AYES: 5 NAYS: p This the 25th of August, 2020. ATTEST: Dana Crisco, Clerk Randolph County Board of Commissioners Darrell L. Frye, Chairman Randolph County Board of Commissioners www.randolphcountync.gov y. Rand�nJ 1 u� P tY Heart of North Carolina RANDOLPH COUNTY BOARD OF COMMISSIONERS Randolph County Office Building ■ 725 McDowell Road Asheboro, North Carolina 27205 ■ Telephone 336-318-6300 Attachment C Darrell Frye, Chairman David Allen, Vice Chairman Kenny Kidd Maxton McDowell Hope Haywood RESOLUTION REQUESTING APPROVAL OF THE LOCAL GOVERNMENT COMMISSION WHEREAS, Article 2 of Chapter 131A of the North Carolina General Statutes establishes the Rural Health Care Stabilization Program (the "Program") to provide for loans at below-market interest rates with structured repayment terms in order for financially distressed eligible rural hospitals to transition to sustainable, efficient, and more proportionately sized health care service models in their communities; and WHEREAS, on or about November 21, 2019, after holding a public hearing on the matter, the Randolph County Board of Commissioners voted unanimously to apply for a loan from the Program for the benefit of Randolph Hospital or its successor entity by submitting an application to UNC Health Care as provided for in North Carolina General Statute §131A-33; and WHEREAS, on or about August 25, 2020, the Randolph County Board of Commissioners held a duly -called and advertised public hearing on the matter of incurring a debt of up to twenty million dollars ($20,000,000.00) through a Program loan, if approved, for the benefit of Randolph Hospital or its successor entity; and WHEREAS, at the conclusion of the August 25, 2020 public hearing, the Randolph County Board of Commissioners passed a resolution making findings regarding: the necessity of the proposed project, the facts supporting the amount proposed, the facts supporting that the plan presented at the hearing demonstrates a financially sustainable health care service model for Randolph County, the County's past debt management, budget, and fiscal management policies, and the retirement of the proposed debt; and WHEREAS, pursuant to the requirements of the Program, no loan shall be granted without the approval of both UNC Health Care and the North Carolina Local Government Commission; NOW, THEREFORE, BE IT RESOLVED by the Randolph County Board of Commissioners as follows: The County Manager, the Finance Officer, the Associate County Attorney of the County are each hereby designated as a representative of the County to file an application for approval of the Program loan with the Local Government Commission of North Carolina and are authorized to take such other actions as may be advisable in connection with the proposed Program loan; and all actions heretofore taken by any of such officers or any other officer of Randolph County relating to such matters on behalf of the County are hereby approved, ratified and confirmed. 2. Following approval of the Program loan application and management plan by UNC Health Care, the Board hereby requests the Local Government Commission of North Carolina to www.randolphcountync.gov approve such proposed Program loan under Article 2, Chapter 131A of the General Statutes of North Carolina. 3. This Resolution shall become effective immediately upon its adoption. On motion of Commissioner Kidd , seconded by Commissioner Haywood , the motion was adopted by the following vote: AYES: 5 NAYS: 0 This the 25th day of August, 2020. Darrell L. Frye, Chairman Randolph County Board of Commissioners Attest: Dana Crisco, Clerk Randolph County Board of Commissioners www. randolphcountync. gov