Cardiac center for Buffalo Niagara Medical Campus gets big boost

By Robert J. McCarthy
The Buffalo News
April 17, 2008

The state health commissioner has given his crucial backing to the proposed cardiovascular institute on the Buffalo Niagara Medical Campus, generating visions of a world-class health care center downtown staffed by top physicians and offering both treatment and research.

The decision by Health Commissioner Richard F. Daines should end any remaining question about the facility’s location, according to Robert D. Gioia, chairman of a panel responsible for overseeing consolidation of Erie County Medical Center and Kaleida Health.

Gioia, whose panel voted to locate the facility at the downtown campus, also reassured backers of a competing proposal at ECMC that their hospital will not be harmed in the process.

“ECMC is convinced we will be taking all the good stuff,” Gioia said. “But it’s not going to happen. It doesn’t make good business sense or good medical sense.”

Still, major backlash already is aimed at the plan, with ECMC officials complaining that “politics” rather than business principles are guiding the process.

Daines’ action also prompted County Executive Chris Collins to defend ECMC, reiterating his fear that the lack of a signed agreement dealing with disparities caused by public-sector union costs could come back to haunt property taxpayers.

“I’m siding with the ECMC stance that the Department of Health has moved this forward in a relatively highhanded way,” Collins said late Wednesday. “In effect, it’s a hostile takeover. They could leave Erie County taxpayers out to dry and just say, ‘Have a nice day.’”

The announcement of Daines’ approval of the medical campus plan highlighted a Wednesday news conference at Hauptmann-Woodward Institute outlining the $115 million project to be built adjacent to Buffalo General Hospital. Gioia, chairman of the Western New York Healthcare System, introduced medical experts from the area to endorse the concept.

In a statement, Daines explained that he named the Health System board the “legitimate voice for the future of Erie County health care” and fired a warning shot at ECMC officials working to establish their own cardiac center at their Grider Street campus.

“Only the Health System board can designate the site of a new heart center in Western New York,” Daines said. “I strongly suggest that others who want a new heart center in Erie County should work with the Western New York Health System to make the new center a reality. The sooner, the better.”

The state’s Berger Commission in 2006 called for construction of the center when it mandated the consolidation of ECMC and Kaleida Health. But ECMC has unveiled its own plan for a cardiac center and said Wednesday that the downtown plan only hurts ECMC and ultimately may generate a major new cost for county taxpayers.

ECMC questioned whether the board even had the legal status to apply for state funds. In addition, ECMC said that it conducted a six-month study to back its own heart center project and that it is ready to build now in an economically disadvantaged section of the city.

“[The Daines decision] sounds like a political statement more than a business statement,” said Thomas J. Quatroche Jr., ECMC’s senior vice president of marketing and planning. “This is exactly the kind of decisionmaking we are concerned with, when it involves little or no planning.

Indeed, Collins said the arrangement is unsustainable as long as ECMC is run by a public-benefit corporation employing municipal union workers, which he said costs the hospital 15 percent to 20 percent more than those staffed by private-sector unions.

“There is no binding contract that deals with that cost disadvantage,” Collins said, “but it must be dealt with. So I’m saying to the health commissioner that I’m not standing idly by.

“They’re trying to have a shotgun marriage between Kaleida and ECMC without full consideration of the Erie County taxpayer.”

Gioia said he understands Collins’ concerns and has answers for him.

“I am more than willing to have that conversation with the county executive,” he said.

While Gioia’s group says a new “hub-and-spoke” system protects ECMC and other hospitals in the eight counties of Western New York, Quatroche said that it fails to recognize economic realities. He said the “miraculously” quick approval of the Healthcare System plan — while ECMC’s has languished in the state bureaucracy — demonstrates that key questions of funding and clinical delivery have not been adequately addressed.

But Gioia presented a plan he says has backing even from top officials of ECMC, such as Dr. James Evans, president of the hospital’s medical/dental staff. He said he expects the state to assume $40 million to $50 million of the cost, adding that a number of philanthropic entities also are expressing willingness to participate.

Other medical experts added their approval for a facility that will combine treatment with research in an area recording the state’s highest incidence of stroke and heart disease.

“Where have you seen a major medical center that did not have a research focus right nearby?” asked Dr. L. Nelson Hopkins, the University at Buffalo’s chief of neurology. “It will be the one missing piece of the puzzle in a major heart and vascular center.”

If the board overseeing the consolidation of Kaleida Health and ECMC gets its way, it would result in a 115,000-square-foot facility rising directly behind Buffalo General Hospital’s Tower A at Ellicott and Goodrich streets. Gioia anticipates that the new structure should be operating in about three years and that it will consolidate much of Western New York’s cardiovascular research into a “one-stop” facility that will help to retain and recruit major figures in the field.

In addition, Gioia said, the new center will partner with existing medical institutions on the campus such as Buffalo General, Hauptmann-Woodward, proposed UB facilities, the Center for Excellence in Bioinformatics and Roswell Park Cancer Institute. It will mirror the “Cleveland Clinic concept,” he added, and serve as both a treatment and research center.

“Fifteen percent of those needing heart and vascular procedures leave this community,” Gioia said. “We want to stem that migration and stimulate this as a ‘come to’ destination.”

Dr. Michael Cain, dean of the UB School of Medicine and one of approximately 10 leading physicians backing the recommendation, said the proposal allows the medical community to “fill gaps” in clinical service delivery.

Cain pointed out that “no single facility now has the critical mass of infrastructure, support and services.”

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