Legislation that would allow health systems, such as the University of Maryland Upper Chesapeake Health, which operates two hospitals in Harford County, to open medical centers and close hospitals without going through the state's extensive certificate of need process, was approved on Monday's final day of the 2016 Maryland General Assembly session.
Passage of Senate Bill 707, sponsored by Sen. Thomas Middleton, D-Charles County, was a major victory for Harford County-based Upper Chesapeake Health and other hospital operators, who also beat back competing legislation that would have made it more difficult to close a hospital in the state. The bill still must be signed by Gov. Larry Hogan.
"University of Maryland Medical System appreciates legislative efforts to create a tool that recognizes and responds to the changing landscape of health care delivery in Maryland," Lyle Sheldon, president and CEO of Upper Chesapeake Health, said in an emailed statement Tuesday.
Upper Chesapeake Health announced in January it plans to build a $120 million medical center near the I-95/Route 155 interchange near the Bulle Rock community in Havre de Grace and then close Harford Memorial in the city's downtown. The new medical center will have a full-service emergency room, ambulatory care center and a behavioral health unit. Medical/surgical services at Harford Memorial will be transferred to Upper Chesapeake's Bel Air hospital, where a $60 million expansion is planned.
From the outset, Upper Chesapeake Officials said they needed a change in state regulations to meet their goal of having the new medical center built and the Bel Air hospital expanded by 2020. The proposed closing of Harford Memorial is one of three in the state announced in the past year, and SB-707 could facilitate those plans because it will lesson existing regulatory barriers, an issue raised by opponents of the legislation.
"The changing health care environment we live in is giving rise to a new form of health facility that offers easy access to the most in-demand health services and resources and also a broader range of services than a traditional hospital," Sheldon stated. "University of Maryland Upper Chesapeake Medical Center - Havre de Grace (UM UCMC - Havre de Grace) will do just that, by providing the right care, at the right place, at the right time."
A House version of Middleton's Senate bill, HB-1350, was passed by the Senate Monday, but contained amendments that would have put the brakes on the closing of Harford Memorial and a similar plan for University of Maryland Shore Medical Center in Chestertown, Kent County. Middleton, however, forced the House bill back to the Senate Finance committee on a floor motion, according to the General Assembly website, and that bill died there as the session ended.
The final version of SB-707 does, however, still contain an earlier amendment that could block any conversion of Shore Medical Center in Chestertown to a freestanding medical center prior to 2020 without a certificate of need approval by the state.
The plan for Harford's hospitals, as well as proposals to close community hospitals in Laurel and Chestertown, has attracted controversy from residents of the affected communities, local elected leaders, volunteer EMS providers and hospital employee unions concerned about the potential loss of jobs. Both Harford Memorial and the Chestertown hospital are part of the University of Maryland Health System.
Opposing legislation that would have required greater input and approval by local boards of health before hospitals can be closed included House Bill 1121, sponsored by Democratic Del. Joseline A. Pena-Melnyk, of Anne Arundel and Prince George's counties, and SB-12, sponsored by Democratic Sen. Jim Rosapepe, also of Anne Arundel and Prince George's. Both bills were opposed by hospital owners and both died in committees of their respective houses.
Harford Del. Mary Ann Lisanti, of Havre de Grace, testified last month during committee hearings in support of the opposing legislation. She also offered the amendment to the defeated HB-1350 to prevent a "licensed general hospital" in Harford from being closed before Oct. 1, 2017.
Lisanti, as well as a number of participants in recent community meetings in Havre de Grace and Perryville, have expressed concerns about the closure of Harford Memorial and their fears about the loss of medical services in their backyards and the impact on patients who would have to be transferred to the Bel Air hospital.
Opponents have also been concerned about the potential economic harm of closing the existing 279,400 square-foot hospital and having to redevelop the site at Union Avenue and Revolution Street.
Under SB-707, hospital operators do not have to obtain a certificate of need from the state to build a free-standing facility, if they notify the Maryland Health Care Commission at least 45 days before the scope of local services is changed, and commission members determine the changes are "not inconsistent with the State health plan," promote "the delivery of more efficient and effective health care services," and the changes are "in the public interest," according to the Senate bill.
The hospital owner also will be required to hold public information meetings on proposed changes, if they will happen in a county that has fewer than three hospitals – such as Harford – and the MHCC has been notified, according to an amended portion of the bill.
The hospital owner also will be required to provide details to state officials about the reasons for a proposed closure, or conversion of a community hospital, how the transition of "acute care services," such as treatment of major illnesses or injuries, outside the hospital's former service area will be handled, as well as the continued service of the health care needs of the surrounding community.
Details also must be furnished about how "displaced employees" will be retrained and reassigned and how the health system will take care of the former hospital's physical site, according to amendments to the legislation.
"As we move forward, we are committed to engaging the community in our plans," Sheldon said. "We look forward to working with our community members to make UM UCMC - Havre de Grace the best health care facility possible, to achieve our vision of creating the healthiest community in Maryland."
SB-707 also requires establishment of a work group on rural health care needs, composed of state and local representatives, that must hold meetings and produce a report on the state of health care in Kent County and the surrounding middle and upper Eastern Shore counties. The report must be delivered to the governor and General Assembly by Oct. 1, 2017.