Buffalo Niagara Medical Campus | Clinical, Research, and Academic Excellence

Major heart center could be part of Kaleida-ECMC merger, but many hurdles remain

By Henry L. Davis
The Buffalo News
April 11, 2008

The board overseeing the consolidation of Kaleida Health and Erie County Medical Center endorsed a proposal Thursday to build a major center for heart, stroke and other vascular procedures downtown on the Buffalo Niagara Medical Campus.

The size and cost of the project remain unclear, but it could range from $100 million to $150 million, depending on state aid.

The state’s Berger Commission in 2006 called for construction of the center when it mandated the consolidation of ECMC and Kaleida Health. Since then, state officials have strongly suggested that funding will be available yet never confirmed it.

The board’s decision sets in motion a long-planned idea to create a specialized center in Buffalo that unites currently fragmented programs, improving their ability to broaden services, address a shortage of cardiac specialists, train new doctors and perform research.

Heart disease and stroke occur at very high rates in many parts of the region. The demand for care — everything from prevention programs to procedures — continues to increase, especially with the rise in obesity and diabetes.

What we envision is a center of excellence with a commitment to medical care, education and research, a linchpin for improving the area’s health system,” said Robert Gioia, a Buffalo businessman who heads the board.

The decision also underscores the divide between the board and ECMC, which has criticized the consolidation process and advocated that it be allowed to move forward with its own plan for a heart center on the medical center’s Grider Street campus.

The . . . vote today to locate this facility near Buffalo General Hospital through some arrangement with Kaleida Health is the decision of a paper board, which has no funding or employees,” Kevin Cichocki, chairman of the ECMC board of directors, said in a statement.

Gioia said details of what’s being called a global heart-vascular institute still must be worked out and a construction start date is not yet known.

The board must clear other hurdles first, such as meeting an April 17 deadline to apply for a state grant. It also must meet a June 30 deadline imposed by the commission to consolidate the hospitals, a process that requires state legislation giving the board the authority to make management decisions at the public ECMC.

As envisioned, the center will dovetail with separate plans by Kaleida Health to integrate its heart and stroke programs at Buffalo General Hospital as it closes Millard Fillmore Hospital, another commission mandate.

Kaleida Health, which already accounts for the majority of heart and stroke procedures in the region, was considering two locations – High and Ellicott streets or Goodrich and Ellicott streets — for a five-or six-story addition to Buffalo General that includes a ground-floor emergency department.

It anticipated funding the project with its own money and a large, anticipated philanthropic donation, funds that are expected to be folded into the board’s project. “The board’s decision was an endorsement of the physician-led process we’ve been involved with for the past 18 months,” said Kaleida Health spokesman Michael Hughes.

Conceptually, the board envisions a “hub-and-spokes” approach to care, with other spoke hospitals providing general cardiac care. Its decision comes after a study by consultant PricewaterhouseCoopers, which interviewed many specialists in the community about what they wanted to see built.

The doctors in this community realize that this should be done,” Gioia said.

Late last year, ECMC officials refused to sign a memorandum of understanding about how the hospitals should combine, and its representatives on the new board stopped participating at meetings until there is an agreement acceptable to the medical center.

ECMC officials describe the memorandum and an additional statement of principles as too vague. They want a more detailed contract, especially about how the board will decide where services are located in the future.

ECMC officials refused to allow their physicians to participate in the study because of the disagreement. But Gioia said the consultant did contact some medical center doctors.

In his statement, Cichocki described the health system’s plan as a “wishful approach” that reinforced ECMC’s decision to suspend participation until an agreement is signed by all parties on a governance structure for the combined organization.

However, one of ECMC’s four representatives on the 17-member board, Dr. James Evans, participated and voted for the project, Gioia said. Evans is president of ECMC’s medical-dental staff.

Cichocki also said ECMC has $100 million to build a heart hospital on its grounds. But the state, which must approve such projects, wants the hospitals and board to develop a unified proposal.

Gioia expressed exasperation with ECMC, saying he believes the project will benefit the medical center.

This institute is going to give us a stronger health system and, hopefully, improve the bottom line at all of our campuses, one of which is going to be ECMC,” he said.

In another matter, Gioia said the board endorsed a $4 million to $6 million plan to help find a new home in the city for the Community Health Center of Buffalo, which is planning to leave the ECMC campus. The federally qualified health center receives special financial help from the government, in exchange for providing basic care regardless of ability to pay.