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Misunderstandings over hospital issue must be cleared up

April 04, 2005|by JAMES HAMILL

Recently, there have been some serious misunderstandings about the Washington County Health System's proposed replacement hospital project. I would like the opportunity to set the record straight.

Misunderstanding: The City of Hagerstown, as an interested party, in the health system's certificate of need (CON) process, was responsible for reducing the requested rate increase from 13 percent to 4 percent.

Fact: It is important to note that in Maryland, hospital rates are set by the Health Services Cost Review Commission (HSCRC), a state agency. Washington County Hospital (WCH) had been and currently has the lowest charge per admission of any hospital in the state.

In its original CON submission, it was projected that the hospital needed an increase in rates of approximately 13 percent to make the project feasible. In July 2003 the hospital received a rate increase of 5 percent for inflation and an additional 6 percent in recognition of the increased severity of illness of the patients we were seeing.

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In the fall of 2003, the HSCRC adopted a formula for capital projects, which when applied to our project in January 2005 authorized a 4.7 percent increase to the hospital rates when the new hospital is occupied, hopefully in 2008.

At that time it is expected that the hospital's charges will still be among the lowest in the state. No outside factors, either in support of or opposition to the project, have had any impact on the rate setting system.

Misunderstanding: Building the new hospital at Robinwood Medical Center is the most expensive location.

Fact: It will cost an additional $30 million more to build in the city than at Robinwood. Additional costs would include a construction staging platform for downtown, a parking garage and a taller structure on a more constrained site.

Factoring in the time delay, which includes the laborious process of acquiring 59 individual properties to the cost of construction, the total cost to build in the city is $50 million more expensive than at the Robinwood site.

Misunderstanding: Currently, the City of Hagerstown states that it cannot transfer sewer and water capacity from the hospital's current site to the proposed Robinwood location.

Fact: The current sewer capacity plan will permit growth in an urban growth area at a manageable rate. Robinwood is in an urban growth area.

The hospital paid for a study to evaluate the sewer and water system, which had not been conducted by the city since 1989. The study was conducted under the guidance of the City of Hagerstown's staff. The recommendations offered several options that were acceptable to city staff and would allow the hospital to have sufficient capacity at the Robinwood site.

According to the Maryland Department of the Environment, the sewer and water capacity can be transferred from the current site to Robinwood. It is totally within the power of the mayor and city council to make this happen.

In the current filing of its certificate of need with the Maryland Health Care Commission and in an offer letter in November 2004, the hospital offered to pay the costs for the upgrade of the sewer and water system at Robinwood. In fact, the city turned down an offer of $26 million to assist with public facilities, roads and schools made by the hospital and Mount Aetna Farms.

Misunderstanding: Several Hagerstown City Council members have stated that they would support the hospital moving to Robinwood if the CON is approved. They have suggested that the hospital must get zoning approval before they would annex the site.

Fact: It is hard to imagine that the hospital could get zoning approval without documentation that it has a sewer and water plan that the city approves. If the hospital were to apply for a modification of the special exemption to the Robinwood zoning, it would likely be turned down by the zoning board of appeals without a sewer and water agreement. If it were turned down, the hospital could not apply for a modification of the special exception for another year. This delay would add to the expense of the final project. It should be noted that zoning approval is not a criterion for CON filing or approval.

Misunderstanding: The Robinwood site is six miles from the current location of the hospital.

Fact: The present hospital is only 2.3 miles by car from Robinwood. The hospital already operates a courtesy van for patient transport and will continue to do so.

Approximately 89 percent of the patients at the current hospital arrive by car and another 7 percent by ambulance. We do not expect those numbers to change, when the hospital moves to Robinwood. In addition, patients, visitors, physicians and staff will find it easier to park and access the new facility.

In addition, the hospital has continued to state that it will develop an urgent care center in downtown.

Misunderstanding:Hagerstown police responded to 400 calls to the hospital last year.

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