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Millard Gates may close in 3 years State gets hospital plan tied to growth of General

Millard Fillmore Hospital at Gates Circle could close in three years and most of its services be moved to Buffalo General Hospital, under a plan the hospital's parent company has filed with the state.

The plan depends on whether Kaleida Health receives $121 million from the state that officials say is needed to relocate Millard Fillmore's doctors, nurses and medical programs.

Among the elements of the plan:

*Renovate and expand Buffalo General, as well as build a new facility on the surrounding Buffalo Niagara Medical Campus, to accommodate such programs as the emergency department, stroke care, geriatrics and heart surgery.

*Move other Millard Fillmore services, including the Hand Center and hyperbaric chamber, to alternative sites chosen by physicians.

*Begin planning for the reuse of Millard Fillmore for commercial or residential projects.

*Strengthen ties with the University at Buffalo School of Medicine and Biomedical Sciences to make Kaleida a more academically oriented medical system with a new name.

"This is not just about relocating programs. It's about creating something better than what we have today," said James R. Kaskie, Kaleida's chief executive officer.

It will take at least three years to accomplish the transition, he said.

Kaleida Health formed in 1998 from the merger of five hospitals: Buffalo General, Millard Fillmore, Millard Fillmore Suburban, Women & Children's and DeGraff Memorial.

Back then, physicians threatened to leave after Kaleida sought to end acute care at Millard Fillmore. Now doctors are advocates of a move that Kaleida has promised will not cause job losses.

What changed? This time, Kaleida collaborated with physicians and designed the project around improving key services, not just moving personnel.

"We accept the fact that we have to change, that we have too many hospitals and hospital beds in this community, that care is fragmented," said Dr. M. Hashmat Ashraf, chief of cardiothoracic surgery at Kaleida. "The Kaleida administration is also different. Instead of telling us what to do, it is including physicians in almost every aspect of the decisions."

As part of an effort to restructure the state's inefficient health care system, the Commission on Health Care Facilities in the 21st Century, also known as the Berger Commission, last year recommended the closure of nine hospitals and seven nursing homes, as well as the restructuring of dozens of others. Sixty-two hospitals and nursing homes submitted applications to the Health Department seeking help to pay for the changes, which became law Jan. 1.

Kaleida Health also is seeking $1 million to study how to improve its long-term care services in the City of Buffalo, particularly with the old age of the Deaconess Center nursing home. The study also would address DeGraff Memorial in North Tonawanda, which the commission recommended converting into a nursing home. Kaleida estimates that this conversion would cost at least $36 million.

A third Kaleida Health application asks for $2.5 million for research and legal work if Kaleida and Erie County Medical Center agree to consolidate, as the commission recommended.

Kaleida and ECMC were supposed to seek funding in a unified plan. But the two have been deadlocked over significant issues, including the makeup of a new corporate structure and the location of services.

As a result, the Health Department in May took the unusual step of telling both sides that it would recommend a board of directors for a consolidated organization. Health Commissioner Dr. Richard F. Daines is likely to name the members within the next month, said Claudia Hutton, spokeswoman for the agency.

Statewide, facilities requested $2.5 billion, a far greater amount than the $550 million the Health Department has available in this latest round of grants to help facilities pay for commission recommendations. The state is expected to decide which projects to fund and to what extent by Sept. 30. Another round of grants is expected later this year.

The state is funding hospital restructuring with $1 billion of its own money and $1.5 billion from the federal government.

The applications for funding will likely clarify an ECMC-Kaleida consolidation.

The Berger Commission ordered the organizations to dissolve and combine into a new nonprofit corporation that includes the UB Medical School. It also called for closing Millard Fillmore and constructing a heart and vascular center.

If the would-be partners do not reach agreement by the end of 2007, the commission said, the Health Department could close ECMC or Buffalo General. However, the state is unlikely to move Millard Fillmore's doctors, nurses, other employees and patients into Buffalo General and then close Buffalo General.

Even if Kaleida remains a separate entity, its next plans are linked to how much money the state provides.

"The funds will determine the success of the plan to relocate Millard and whether, in the future, we are talking about a little or a big heart and vascular center," Ashraf said.

The Catholic Health System and ECMC also applied for funds, but officials would not disclose details.

Comments at this time could trigger expectations among residents, physicians and employees that may or may not come to pass, said Dennis McCarthy, spokesman for the Catholic Health System.

ECMC spokesman Thomas Quatroche said the medical center still favored consolidation if done properly. The hospital's application for funds addressed consolidation and plans for a new heart center, he said.


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