Spend hospital aid wisely
State merger and closing assistance must be carefully targeted and watched

EDITORIAL
The Buffalo News
08/10/2007

Kaleida Health now is looking for $121 million from the state — hospital system restructuring money that Kaleida officials say they need to relocate doctors, nurses and medical programs from Millard Fillmore Hospital at Gates Circle to Buffalo General Hospital. The planned move, filed with the state, may happen in three years.

As a community facing costly problems with its current hospital system, Buffalo must ensure this targeted state aid isn’t lost. But if it comes, it should come with sufficient strings to guarantee that the money goes toward reducing the amount of facility debt that currently burdens the health care delivery system, and is not simply used as a taxpayer subsidy of one competitor over the other.

The state money must go toward the common, public good, not just toward boosting the competitiveness of Kaleida in a marketplace that also includes the Catholic Health System and Erie County Medical Center, if that public hospital remains independent.

Kaleida Health officials want to renovate and expand Buffalo General Hospital, building a new facility on the growing Buffalo Niagara Medical Campus. The revamped hospital would pull together room and resources to accommodate programs such as emergency care, stroke care, geriatrics and heart surgery.

The proposal also calls for moving other Millard Fillmore services, including the Hand Center and hyperbaric chamber, to alternate facilities chosen by physicians, as Kaleida begins planning for reuse of Millard Fillmore for residential or commercial space. Kaleida also would seek to strengthen ties to the University at Buffalo School of Medicine and Biomedical Sciences.

State pressure for hospital mergers and closings, to be sure, stems from the dilemmas health care industry institutions such as Kaleida have, in some ways, inflicted upon themselves. The state’s Commission on Health Care Facilities in the 21st Century, better known as the Berger Commission, last year studied hospital capacity, finances and missions throughout New York and recommended closure of nine hospitals and seven nursing homes, in addition to the restructuring of dozens of others.

Buffalo’s system, with more beds than needed spread through more competing bricks-and-mortar facilities than prudent, wasn’t spared. The key will be to make the money New York can provide for the needed restructuring work primarily for the health of the community, and only secondarily for the health agencies planning change.

Kaleida, which has been the most proactive of the competing health systems so far, also wants $1 million to study how to improve its long-term care services in the City of Buffalo — citing concern, for example, over the age of the Deaconess Center nursing home. The study also would address DeGraff Memorial Hospital in North Tonawanda, and the commission’s recommendation that it be converted into a nursing home. The system’s third request involves $2.5 million for research and legal work if Kaleida and ECMC agree to consolidate.

The focus must remain on getting the best possible outcome — in terms of both health care and health care efficiency — out of the hospital system in this area. Without that focus, the public could be spending $121 million — or more — without changing the paradigm, improving excellence by concentrating services instead of splintering them among competitors or making health care more affordable.

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