Record-Journal
10-18-2007, 01:15 AM
HARTFORD — MidState Medical Center’s $45 million expansion proposal took a beating at a state public hearing Wednesday, mostly because of the hospital’s plan to shut down its small inpatient psychiatric unit.
The hospital had tried to scrap that part of the expansion plan, responding late last week to mounting opposition in the community.
But the state Office of Health Care Access was not willing to let MidState make a last-minute change to such a major proposal, said Cristine A. Vogel, agency commissioner.
Denying MidState’s plan modification was the only decision of the day, made early in the five-hour public hearing, and it put hospital officials on the defensive.
“It’s important to the agency that applicants come prepared with their plan and be prepared to defend it,” Vogel said after the hearing.
“Although we respect the fact that the community disapproved, that is not the basis for our decision,” she said.
The commission left MidState with some final homework, so the public hearing was not officially concluded.
Because of the size of MidState’s expansion plan in relation to the hospital’s revenues, there is no deadline for the state to decide on the application, said Vogel. A decision is likely by the end of the year, she said.
The state can accept, deny or modify the application, though modifications are extremely rare. In hundreds of similar decisions, Vogel could recall only three modifications.
MidState’s plan calls for an expanded emergency department, a new 30-bed inpatient wing, two empty or “shell” floors to accommodate future growth, and changes to the hospital’s entryway. But it was the psychiatric unit, by far, that dominated the hearing.
So much so that during a break, MidState’s president and chief executive, Lucille A. Janatka, was lamenting that it was taking so much attention away from the rest of the proposal.
“I want to refocus this on the project,” she said. “This is a great project.”
Everyone who testified as an intervenor spoke against MidState’s plan, with nearly all against it because of the proposal to drop the psychiatric unit.
The sole exception was Clarence Silvia, chief operating officer for the Hospital of Central Connecticut.
The combined hospital with campuses at New Britain General and Bradley Memorial, in Southington, supports MidState’s plan to expand its emergency department but objects to the new inpatient wing.
MidState is aggressively targeting the Southington market, said Silvia, and trying to lure physicians and medical staff, creating “a significant negative impact on the Bradley Memorial campus.”
Bradley’s market share in Southington dropped about 7 percent from 2001 to 2006, said Silvia, while the Meriden hospital’s market share in Southington has increased.
Karen T. Goyette, MidState’s director of business development, later countered that the loss of market share was due just as much to Bradley’s partner, New Britain General. “MidState is not the only factor in their decrease,” she said.
The new inpatient wing is an important element to the plan to expand the emergency department, she said.
To serve psychiatric and behavioral health patients, MidState proposes to expand emergency services but shut down its inpatient unit, transferring longer term patients to the Institute of Living, which specializes in mental health care.
The Institute of Living is a part of Hartford Hospital, MidState’s affiliate.
Several people working within MidState’s inpatient psychiatric unit spoke against the plan. Among them was Michele Jones, a registered nurse in the inpatient psychiatric unit who said she’d gone without sleep to attend the hearing, having worked a 7 p.m.-to-7 a.m. shift the night before.
Jones called the plan to shut down the unit “unjust to the most vulnerable members of our community.”
“It’s my opinion, after 30 years of psychiatric nursing, that MidState’s plan would be a great disservice to the community of Meriden and patients,” she said.
Also speaking in opposition were representatives from the Connecticut Legal Rights Project Inc., Advocacy Unlimited Inc. and the National Alliance on Mental Illness of Connecticut Inc. House Majority Leader Christopher G. Donovan, D-Meriden, asked the commission to reverse that part of the hospital’s application.
The most blistering criticism came from Dr. Paul Horton, a psychiatrist who has worked with Meriden’s hospital for 34 years and has concentrated on helping children and adolescents.
A decade ago, the hospital had 20 psychiatric beds, said Horton. Then, “chanting the mantra of profitability,” he said, the hospital continued “whittling away the number of beds until the lack of profitability became a self-fulfilling prophecy.”
“It is an absolute disgrace what goes on at MidState with regard to children and adolescents,” he said.
For the past couple of years, MidState has reported 10 inpatient psychiatric beds, but uses four as swing beds for medical/surgical. The hospital was told to amend its reporting to the state.
MidState had the opportunity to cross-examine those who testified against its plan, but chose instead to offer supporting statements.
J. Kevin Kinsella, vice president of Hartford Hospital, said he agreed with those defending the importance of keeping an inpatient unit, but also agreed with his MidState colleagues that the system of taking care of psychiatric patients needs re-examining.
“The other part of this application is really important to this community,” he said.
The hospital had tried to scrap that part of the expansion plan, responding late last week to mounting opposition in the community.
But the state Office of Health Care Access was not willing to let MidState make a last-minute change to such a major proposal, said Cristine A. Vogel, agency commissioner.
Denying MidState’s plan modification was the only decision of the day, made early in the five-hour public hearing, and it put hospital officials on the defensive.
“It’s important to the agency that applicants come prepared with their plan and be prepared to defend it,” Vogel said after the hearing.
“Although we respect the fact that the community disapproved, that is not the basis for our decision,” she said.
The commission left MidState with some final homework, so the public hearing was not officially concluded.
Because of the size of MidState’s expansion plan in relation to the hospital’s revenues, there is no deadline for the state to decide on the application, said Vogel. A decision is likely by the end of the year, she said.
The state can accept, deny or modify the application, though modifications are extremely rare. In hundreds of similar decisions, Vogel could recall only three modifications.
MidState’s plan calls for an expanded emergency department, a new 30-bed inpatient wing, two empty or “shell” floors to accommodate future growth, and changes to the hospital’s entryway. But it was the psychiatric unit, by far, that dominated the hearing.
So much so that during a break, MidState’s president and chief executive, Lucille A. Janatka, was lamenting that it was taking so much attention away from the rest of the proposal.
“I want to refocus this on the project,” she said. “This is a great project.”
Everyone who testified as an intervenor spoke against MidState’s plan, with nearly all against it because of the proposal to drop the psychiatric unit.
The sole exception was Clarence Silvia, chief operating officer for the Hospital of Central Connecticut.
The combined hospital with campuses at New Britain General and Bradley Memorial, in Southington, supports MidState’s plan to expand its emergency department but objects to the new inpatient wing.
MidState is aggressively targeting the Southington market, said Silvia, and trying to lure physicians and medical staff, creating “a significant negative impact on the Bradley Memorial campus.”
Bradley’s market share in Southington dropped about 7 percent from 2001 to 2006, said Silvia, while the Meriden hospital’s market share in Southington has increased.
Karen T. Goyette, MidState’s director of business development, later countered that the loss of market share was due just as much to Bradley’s partner, New Britain General. “MidState is not the only factor in their decrease,” she said.
The new inpatient wing is an important element to the plan to expand the emergency department, she said.
To serve psychiatric and behavioral health patients, MidState proposes to expand emergency services but shut down its inpatient unit, transferring longer term patients to the Institute of Living, which specializes in mental health care.
The Institute of Living is a part of Hartford Hospital, MidState’s affiliate.
Several people working within MidState’s inpatient psychiatric unit spoke against the plan. Among them was Michele Jones, a registered nurse in the inpatient psychiatric unit who said she’d gone without sleep to attend the hearing, having worked a 7 p.m.-to-7 a.m. shift the night before.
Jones called the plan to shut down the unit “unjust to the most vulnerable members of our community.”
“It’s my opinion, after 30 years of psychiatric nursing, that MidState’s plan would be a great disservice to the community of Meriden and patients,” she said.
Also speaking in opposition were representatives from the Connecticut Legal Rights Project Inc., Advocacy Unlimited Inc. and the National Alliance on Mental Illness of Connecticut Inc. House Majority Leader Christopher G. Donovan, D-Meriden, asked the commission to reverse that part of the hospital’s application.
The most blistering criticism came from Dr. Paul Horton, a psychiatrist who has worked with Meriden’s hospital for 34 years and has concentrated on helping children and adolescents.
A decade ago, the hospital had 20 psychiatric beds, said Horton. Then, “chanting the mantra of profitability,” he said, the hospital continued “whittling away the number of beds until the lack of profitability became a self-fulfilling prophecy.”
“It is an absolute disgrace what goes on at MidState with regard to children and adolescents,” he said.
For the past couple of years, MidState has reported 10 inpatient psychiatric beds, but uses four as swing beds for medical/surgical. The hospital was told to amend its reporting to the state.
MidState had the opportunity to cross-examine those who testified against its plan, but chose instead to offer supporting statements.
J. Kevin Kinsella, vice president of Hartford Hospital, said he agreed with those defending the importance of keeping an inpatient unit, but also agreed with his MidState colleagues that the system of taking care of psychiatric patients needs re-examining.
“The other part of this application is really important to this community,” he said.