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ASHEVILLE – Few cash crops carrythe allure – and risk – of industrialhemp.

The potential for big money is there:Americans import about $500 millionworth of hemp annually from places likeChina, while it grows well in local soils.

Only in 34 states, including NorthCarolina, is it legal to grow hemp, acousin of marijuana that by definitioncontains no more than 0.3 percent of thepsychoactive chemical THC.

One of the most profitable hempproducts is cannabidiol or CBD, a com-pound extracted from the plant’s flow-ers.

Touted as a miracle cure, CBD is saidto treat ills from arthritic pain to anxiety,and products from tinctures to energydrinks have exploded across the retaillandscape.

“You can’t walk 10 steps without trip-ping over a CBD latte or CBD ice cream atThe Hop,” said Brian Bullman, owner ofthe quickly growing Carolina Hemp Co.

“Asheville will undoubtedly becomeHemp City, USA.”

Classified federally as a drug

Hemp has a long history in Amer-ican agriculture, but it’s gone under-utilized since becoming the collateraldamage of marijuana prohibition.

Even now, hemp remains federallyclassified as a Schedule-1 narcotic.

But it’s one of the most promisingcash crops to replace tobacco in NorthCarolina yet, with the potential tostimulate the textile, farming and re-tail sectors.

That’s in part what helped push thepassage of a 2014 farm bill, whichpaved the way for states to mandatewhether farmers could plant hemp aspart of a Department of Agriculture-guided pilot program.

“This is a resilient plant, very dura-ble plant, and we’re learning that it’sdoing well in our soil, which we didn’treally learn until people started plant-ing it,” said Blake Butler, executive

CBD: Profitable, riskybusiness for farmers

Co-owners of Carolina Hemp Co. Patton Cardwell, left, Brian Bullman, center, and Randall Snyder pose for a photo in theirstorefront in Woodfin last month. The company sells a variety of CBD products from oils to edibles.

One of the most promising cash crops to replace tobacco in NC remains federally classified as a Schedule-1 narcotic

Bullman holds a handful of hempflower. According to the company’swebsite “all products available fromCarolina Hemp Company are lab testedto contain less than 0.3% THC byweight.”PHOTOS BY ANGELI WRIGHT/CITIZEN TIMES See HEMP, Page 5A

Mackensy LunsfordAsheville Citizen TimesUSA TODAY NETWORK

ASHEVILLE – Residents and gov-ernment officials in communitiesserved by smaller hospitals in the Mis-sion Health system are pushing formore assurances they won’t be short-changed if the system’s proposed saleto HCA Healthcare goes through.

They say the terms of the sale con-tain loopholes that would allow ruralhospitals to be closed. And they saythe board that will enforce the salecontract will not be independent ofMission or HCA and is not representa-tive of Western North Carolina. Theywant the state Justice Department toforce changes before Attorney GeneralJosh Stein approves it.

“We’re not against the deal, but wewant it to be done right,” said High-lands Mayor Patrick Taylor. His townboard is one of at least three govern-mental bodies that has formally askedfor alterations to the agreement.

Mission counters that the dealwould include reasonable safeguardsfor the five smaller hospitals in itshealth system in Brevard, Franklin,Highlands, Marion and Spruce Pine. Atop Mission official suggested thoseseeking changes are misguided.

“Critics are common in most everysituation, no matter whether reason-able or not,” said Rowena BuffettTimms, Mission Health’s senior vicepresident for government and commu-nity relations. “It is human nature to

Highlands Mayor Patrick Taylor, left,and Franklin Mayor Bob Scott, right,have expressed concerns about howrural hospitals would be protected ifMission Health is sold to HCAHealthcare. ANGELI WRIGHT/CITIZEN TIMES

Residentswant moreprotectionfor ruralhospitalsSome worry Missionsale will threaten sites

Mark Barrett Asheville Citizen TimesUSA TODAY NETWORK

See MISSION, Page 7A

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compare any change to ‘perfect’rather than present reality.”

NC Justice meets with critics

Some critics have brought theirconcerns to officials in the JusticeDepartment and apparently havegotten a more positive reception.

“I’m told those meetings havebeen productive and that our officeis in regular and close contact withcommunity leaders,” departmentspokeswoman Laura Brewer saidrecently. “We share many of theirconcerns.”

Brewer said the department isstill gathering information on theproposed $1.5 billion transaction.Mission submitted a proposed pur-chase agreement and a raft of otherdocuments for the department toconsider in early September.

Once it has all the information itis seeking in hand, the departmenthas up to 60 days to either allow thesale to go through or sue to block it.State law requires the review incases like the Mission-HCA deal, inwhich a nonprofit wants to sell itsassets to a for-profit company.

Some of those raising questionsabout the proposed sale also saythe state should not act until thepublic has more information tohelp people evaluate the deal. Mis-sion has posted the proposed salescontract and related documentsonline at missionhealthforwar-d.org, but parts are blacked out andsome documents, like a list ofplanned capital projects, are notincluded at all.

Rural hospitals are under eco-nomic pressure nationwide, espe-cially in states that have not ac-cepted federal funds to expand Me-dicaid, like North Carolina Theytend to have higher percentages ofpatients covered by federal pro-grams that have less generous re-imbursement policies than privateinsurance and the communitiesthey serve are generally less pros-perous.

What will HCA do?

The proposed sale contract be-tween Mission and HCA containslanguage to require services to re-main intact for five to 10 years afterthe sale, but also sets out severalexceptions HCA could use to shutdown facilities or programs beforethen.

Protections would apply to alengthy list of services at MissionHospital and Asheville-based Ca-rePartners, which provides homehealth, rehabilitation and otherservices, for at least 10 years.

The list of protected services forthe five smaller hospitals is shorter,typically covering only emergency,surgical and acute medical ser-vices. Long-term care at two hospi-tals and OB/GYN services at Mc-Dowell are also covered. The pro-tection period for services lasts forfive years, except for emergencyservices, which must be preservedfor 10 years.

There are also restrictions onHCA’s ability to close or sell a hos-pital. Dogwood Health Trust,which will get the proceeds fromthe Mission Health sale, would beallowed to bid unless HCA wereselling multiple hospitals.

But, critics say the contract of-fers plenty of ways HCA could jus-tify ending services or selling anentire hospital and local residentswould have little or no say. Localboards appointed by Mission andHCA would be involved.

In Franklin, “Angel MedicalCenter was at one time providingsome pretty significant medicalservices, and I am afraid that thoseare going to be cut back to whereour replacement hospital is goingto be essentially a big emergencyroom,” said Mayor Bob Scott.

“I have not seen anything tocalm my concern about that,” hesaid.

The Highlands Town Board andMitchell County Board of Commis-sioners passed similar resolutionsthis fall, stating the contract wouldallow services to end “even if thereis no event making the provision ofservices impossible or commer-cially unreasonable.”

“If you look in the fine details,there are so many caveats andconditions, those things can bechanged at will,” Taylor said.

Matthew “Vern” Grindstaff,chairman of Mitchell commission-ers, said he hears worries fromcounty residents about the possi-ble impact of the deal on MIssion’sBlue Ridge Medical Center inSpruce Pine. The hospital has al-ready stopped delivering babies,as did Angel in Franklin.

“Our constituents have seensome of the scalebacks ... over thelast year or two,” Grinstaff said.

But he said that after speakingwith HCA officials following thepassage of the commissioners’resolution, “I have become a littlemore optimistic” about how thedeal might affect Blue Ridge.

Group wants local purchaseoption for hospitals

A position paper adopted bySEARCH – a group of mostlyMitchell and Yancey county resi-dents, and some Buncombe Coun-ty residents and organizationstracking the sale process – saysthe list of protected services at thesmaller hospitals should be as de-tailed as the one for Mission Hos-pital in Asheville.

Along with Mitchell commis-sioners and the Highlands board,the groups also say there should bea mechanism in the sale contractto allow a community group to buya hospital if HCA proposes shut-ting it down.

As the contract stands now,

and “recognized that no outcomewould or could ever fully satisfy ev-eryone, particularly those withonly a limited understanding of thetransaction,” she said.

Will anyone stand up to HCA?

Beyond the language of theagreement, a major sticking pointfor critics of the deal in BuncombeCounty and some rural communi-ties is how likely the boardscharged with enforcing its termswould be to stick up for local inter-ests.

The contract says local advisoryboards could sign off on reductionsin services but also gives the Dog-wood Health Trust board overallpower to enforce the agreement.The trust will also award grants toorganizations in WNC to improveresidents’ health using investmentearnings from the money HCA is topay for Mission.

Two-thirds of Dogwood’s boardmembers live in Buncombe County,although the county makes up only28.6 percent of the population ofthe 18 counties Dogwood is toserve. Two board members arefemale and all but one has servedon a Mission board.

Buffett Timms said three morepeople are to be added to the nine-member board and that the searchfor new members is focused onwomen and people of color.

The board will eventually “befully reflective of the wonderful di-versity of our region,” she said.

But even if all three of the addi-tional appointees were from out-side Buncombe County, half theboard would still be Buncombe res-idents.

Risa Larsen, a member of theSEARCH group, said the namedmembers of the Dogwood boardappear to be “good people. ... I dowant to encourage them to opentheir aperture and look around a lit-tle more.”

Scott and Taylor said so manymembers of the Dogwood boardhave ties to Mission that they won-der whether it would later chal-lenge HCA over an agreement thatMission Health has worked so hardto sell to the public.

“It pretty much is Mission peo-ple in Buncombe County,” Scottsaid. “I really don’t think that as theDogwood Health Trust is constitu-ted right now it is representative ofWestern North Carolina, of thepeople that work and live and raisefamilies here.”

“Local input and control wouldbe essentially nonexistent” in theevent of a sale, Highlands’ townattorney, J.K. Coward Jr., wrotethe Justice Department.

Highlands-Cashiers Hospitalwas built with millions of dollarsin local donations that dwarf theamount of money that Missionhas put into the facility, Taylorsaid.

“We don’t want some develop-er to come here ... and turn it intosomething else,” he said.

A resolution passed by theBurnsville Town Council states ifHCA ever decided to close BlueRidge, the hospital “must be re-turned to the community at nocost.”

‘Very significant’ safeguards

Buffett Timms, of Mission,said the sales contract containsnumerous safeguards to keepservices going and that givenrapid changes in the health careindustry, the five- and 10-yearperiods in the contract represent“a comparatively long period oftime.”

The list of protected servicesat Mission Hospital is longer be-cause it offers more services thanthe smaller hospitals, she said.

Mission President and CEO Dr.Ron Paulus has said there wouldbe little to stop Mission if it cutservices at a rural hospital now.

If the deal goes through, Buf-fett Timms said, “every single en-tity within the Mission Healthsystem will have very significantprotections with this transactionthat they lack today.”

It appears that nothing in thecontract requires notice of a po-tential hospital closure to thecommunity at large, although alocal advisory board appointedby the hospital and HCA wouldbecome involved.

But, Buffett Timms said, if asale is ever considered, “there isnothing in the agreement thatprevents any entity from biddingon that hospital, including the lo-cal community.”

She pooh-poohed the ideathat the proposed sales contractcould be changed to addresscriticisms.

Terms of the deal are is “com-plex and interrelated. Changingany one part would result in theneed to change numerous oth-ers,” she said.

Mission’s governing board ap-proached its decision carefully

MissionContinued from Page 1A

A birthing suiteis shown inMcDowellHospital inMarion. Aproposed salescontract wouldrequire thatthe hospitalcontinue tooffer OB/GYNservices ifbought by HCAHealthcare.MATT BURKHARTT/

CITIZEN TIMES FILE

“AngelMedicalCenter was atone timeprovidingsome prettysignificantmedicalservices, andI am afraidthat thoseare going tobe cut backto where ourreplacementhospital isgoing to beessentially abigemergencyroom.”

Bob ScottFranklin mayor