ANNAPOLIS – Prince George’s County is calling in the cavalry in the fight for the new regional medical center, which recently added another front.
In addition to reduced operating and capital funding for the hospital in Gov. Larry Hogan’s 2018 budget, officials say the hospital is threatened by the possibility of a competing cardiac surgery program at Anne Arundel Medical Center (AAMC). County Executive Rushern Baker, III journeyed to Annapolis with county councilmembers and hospital officials on Jan. 25 to stand with the county’s General Assembly members in their public declaration of support for the hospital.
“What you see here is the Prince George’s County delegation, in the House (of Delegates) and Senate, the Prince George’s County Council and the county executive office, and what you’re hearing is a lot of frustration,” Baker said. “Number one, we need the governor to immediately follow the law. Put the money back in. The other is, we built a program, then you take it away? That’s a dumb investment for the state.”
The cardiac surgery program at Prince George’s Hospital Center has seen exponential growth after the hospital partnered with the University of Maryland Medical System (UMMS). Neil Moore, president and chief executive officer of Dimensions Healthcare System, which currently operates the hospital, said the program has approximately 240 active cases now, compared with fewer than 25 two-and-a-half years ago. It has also earned a three-star rating from the Society of Thoracic Surgery.
Officials say the program’s viability would be threatened if the Maryland Health Care Commission (MHCC) approves a cardiac surgery program at AAMC. On Jan. 23 the commission announced it would delay a vote on the program to allow Dimensions, UMMS and others to submit additional documentation supporting their opposition. The commission’s reviewer had initially recommended approval of the AAMC cardiac program.
Del. Joselyn Peña-Melnyk (D-21), who sits on the House Health and Government Operations committee, said the MHCC’s approval would violate Maryland law.
“It’s not something that we’re alleging. Look at the facts and you’ll see that the facts are there,” she said, “If you look at COMAR (Maryland law), it states the following: ‘An applicant shall demonstrate that the other providers of cardiac surgery in an adjacent health planning region will not negatively be affected.’ You hear that? ‘Will not negatively be affected.’”
The statue continues, quantifying negative impacts to include the case where a new cardiac surgery program would result in an existing program with two or more stars and 100 to 199 open heart surgery cases annually “dropping below an annual volume of 100 open heart surgery cases.”
State law also states a cardiac surgery program that “records a case volume of less than 100 open heart surgery cases for two consecutive years” must be closed. Officials are worried that approving a new program at a hospital just 20 miles from the regional medical center’s site would mean the Prince George’s program would fall below the required thresholds.
“What it means that if this second program were to be approved in Anne Arundel County, our ability, in Prince George’s County, to meet those numbers will be almost impossible,” Peña-Melnyk said. “Why does it make sense to approve a second program that will just get in the way of our success?”
Geraldine Valentino-Smith (D-23A), the delegation vice-chair, agreed.
“In this case, it’s clear that the applicant, Anne Arundel Medical Center, and its cardiac surgery program, relies almost entirely on siphoning volume from our existing cardiac surgery program,” she said. “By failing to acknowledge that the Prince George’s cardiac program needs to continue to grow – grow, not just maintain volume – we were subjected to what appears to be a discriminatory application of standards and guidelines.”
Officials also called on Hogan to provide full capital and operating funding for the new regional medical center. The proposed budget cuts $22.8 million in operating funds between fiscal year 2017 and 2018 and moves much of the capital funding into later fiscal years. Last year, the General Assembly passed a law mandating $15 million in operating funds and $67.5 million for fiscal year 2018 in capital funds. Baker said Hogan is violating the law and playing a “shell game.”
“The law says what the governor should do. We thought we already passed this Rubicon last year,” Baker said. “For him to take it out is playing politics with people’s lives, not with us (Democrats).”
Hogan’s office has said the cuts were made after discussions with UMMS officials over what their funding needs actually were. However John Ashworth, senior vice president at UMMS, said they had been making plans based on the funding levels set forth in the law.
“That capital is incredibly important to us. Our planning relative to everything we’ve been doing was based on the Senate bill that came out last year. And the consequence is that it has gotten us on the trajectory that we’re on,” he said.
He added the operating funds were necessary to build up or create the programs to be housed in the new hospital, like cardiac surgery, cancer care and a trauma center.
“This is where these dollars become important to us, because without those dollars, we’re just kind of at a sustaining level, as opposed to what we’re trying to do, and that is build,” Ashworth said.
The county and state-level officials both vowed to do what they could to ensure the funding was restored to the level required by law. Senate President Thomas V. “Mike” Miller (D-27) even threatened to not pass the state budget if it did not include appropriate funding levels.
“We’re going to have to find a way to get it. We’re not going to take this lying down,” Miller said. “By the time the session is adjourned, we’re going to get the $22.5 (million) back in the budget, and Prince George’s County is going to stand firm on this cardiac care, or guess what? The session is not going to come to an end on April the 10th.”