Hospital and union leaders criticized a state commission's recommendations for restructuring facilities at hearings Monday in the Buffalo area, saying the plan was flawed and underestimated costs.
The executive director of the Commission on Health Care Facilities in the 21st Century, in turn, defended the group's work. He termed the health care system as "badly broken," with far more facilities than needed and many of them financially weak.
"Everyone wants it to be someone else's hospital. But a not-in-my-back-yard mentality will not solve the problem," David Sandman said at a hearing the State Senate conducted at the University at Buffalo's North Campus.
The Assembly conducted a similar hearing at the Central Library on the commission's recommendations, which will take effect Dec. 31 unless rejected by the State Legislature.
Among the proposals:
* Close St. Joseph Hospital and Kaleida Health's Millard Fillmore.
* Convert North Tonawanda's DeGraff Memorial into a nursing home.
* Require Kaleida Health and Erie County Medical Center to merge into a newly created organization and to build a new facility for heart and vascular procedures.
* Give the state health commissioner authority to close ECMC or Kaleida's Buffalo General Hospital if a merger agreement isn't reached.
The Catholic Health System opposes the closing of St. Joseph in Cheektowaga, and contends it did its part for health reform by converting Our Lady of Victory Hospital in Lackawanna to other uses and merging St. Jerome Hospital in Batavia with another facility.
Joseph McDonald, chief executive officer of the Catholic Health System, also questioned if the $2.5 billion the state maintains may be available for restructurings matches the scope of the recommendations.
The Catholic Health System estimates it would cost $68 million to close St. Joseph, or about $500,000 per bed. With 467 hospital beds slated for closure in the area, that would bring the cost to $233 million. That doesn't include such additional expenses associated with the plan as paying off debts and building a new heart center.
"When you apply that thinking across more hospitals, it brings great concern that there is simply not enough money across the state to do the job," McDonald said.
Kaleida Health wanted and expected the commission to endorse a merger with ECMC that consolidated specialty services on the Buffalo Niagara Medical Campus while reorganizing ECMC's Grider Street facility to provide different services, such as mental health treatment.
Now, Kaleida Health argues the commission has placed the hospital network in an unacceptable position of having as many as three of its hospitals closed. By threatening to close Buffalo General, the commission has put an anchor of the downtown medical campus in jeopardy.
Kaleida Health also contends the commission appears to shift to Kaleida the unresolved challenges of operating ECMC, which receives a large taxpayer subsidy and whose work force receives richer benefits than employees in private hospitals.
"Our legal analysis finds the commission's report to be a direct overreach of government into the private sector," said James Kaski, Kaleida Health's chief executive officer.
Michael Young, chief executive of ECMC, praised the commission for establishing a framework for merger talks but stressed that success will rest on adequate funding and a clear process for obtaining it.
"The commission recognized that this is not a public versus private discussion, and this is not about the preservation of the ECMC or Kaleida organizational structure. This conversation is about delivering better health care for our community," Young said.
As for Niagara County, State Sen. George Maziarz, R-Newfane, faulted the commission for its proposal to convert the Mount View Health Facility in Lockport into an assisted living facility because it would undo the $2.4 million sale of the county-owned nursing home.
"You pulled the rug out from under the [county] Legislature," Maziarz said. "Now, you want us to spend millions more to convert the building. It's not going to happen."
Maziarz was also wary of a proposal to merge Mount St. Mary's Hospital in Lewiston with Niagara Falls Memorial Medical Center, noting that past merger efforts had failed.