Md. lawmakers weigh bills on hospital closure

Last summer’s decision to convert Laurel Regional Hospital from a full-service hospital to an outpatient facility prompted anger from lawmakers and community members who say they weren’t consulted about the change.

Now, lawmakers in Annapolis are considering a pair of bills related to hospital closure, each of which is being touted as a way to prevent such conflicts in the future.

The announcement about the Laurel hospital “shocked the community. It created fear in the community,” Sen. James C. Rosapepe, D-Prince George’s and Anne Arundel, told the Senate Finance Committee at a bill hearing Wednesday.  Leaving the community and local officials out of the loop “created a crisis that didn’t need to be a crisis,” he said.

Rosapepe and Sen. Steve Hershey, R-Middle Eastern Shore, have submitted a bill that would require county boards of health to give their approval if hospitals that receive state or county money want to close or partially close.

In addition, Sen. Thomas M. Middleton, D-Charles, has submitted a bill backed by the Maryland Hospital Association that would exempt hospitals that want to convert to freestanding medical facilities – which can provide outpatient and emergency care rather than inpatient services – from obtaining a certificate of need from the state.

Obtaining that certificate can be a lengthy process that doesn’t allow hospitals the flexibility they need to respond to changes in health care needs, according to the hospital association.

Such freestanding facilities have the potential to reduce hospital overcrowding while still providing acute care, said Ben Steffen, executive director of the Maryland Health Care Commission, the body that approves and issues certificates of need.

The commission supports Middleton’s bill, which requires that hospitals hold public hearings on their conversion plans in the counties where they are located.  The process of seeking an exemption from the certificate of need process would still require ample documentation that the conversion was in the best interest of the community and didn’t impede access to emergency services.

Middleton told the committee he was preparing an amendment to his bill that would create a work group to develop a comprehensive plan to address the health needs of Maryland’s rural communities. “We want to make sure we do it right,” he said.

Another amendment would ensure that the provisions of the bill wouldn’t apply to hospitals in Kent County until the work group completes its plan, Middleton said.

Kent County is home of the University of Maryland Shore Medical Center at Chestertown, and rumors that the hospital may become an ambulatory care center have prompted local residents to mount a campaign to save it.

If that hospital closes, the nearest hospital would be in Easton, which officials say is more than an hour away.

But Donna Jacobs, senior vice president for government and regulatory affairs at the University of Maryland Medical System, told the committee Wednesday that there’s been no decision on what may happen to the hospital.

Such a decision will be made by the board of the UM Shore Regional Health System, whose members are drawn from the five counties of the midshore region, Jacobs said.

But Rosapepe’s and Hershey’s bill doesn’t sit well with the Maryland Hospital Association.

“[It’s] bad public policy,” Carmela Coyle, the association’s president and CEO told the committee, explaining that it would take even relatively minor financial decisions out of the hands of hospital trustees and put them into the hand of a political body.

By removing that authority from the hospitals, the bill could make it more difficult for the institutions to obtain financing because banks might see them as a greater risk.

While the emergency bill may have been targeted at the Laurel and Chestertown hospitals, it would likely constrain every hospital in the state, since all facilities receive state Medicaid funds and some receive county funds, if only in small amounts, Coyle said.