By Stephanye R. Clarke
Stephanye Clarke is a long-time member of the New London community, as well as on staff at Universal Health Care Foundation of Connecticut.
Lawrence & Memorial Hospital (L+M), our community hospital, serves ten cities/towns in the lower tier of New London County.
Yale New Haven Health System (YNHHS), the largest, wealthiest, most powerful health care system in the state, is trying to take over our community hospital.
They also don’t like to be challenged—they want the keys to the castle and they want them quickly.
The Office of Health Care Access (OHCA) is toiling with the decision about whether or not to sign off on YNHHS’s proposed acquisition of L+M. The hearing for this proposal was unique, featuring two days of testimony and public comment. Part I included nearly four hours of public comment and Part II included additional public comment, cross-examination and questions from OHCA.
OHCA has pressed YNHHS for data as it relates to pricing, as part of what they need to consider the proposed acquisition. And for months, YNHHS has refused to comply. Now, they are insisting that if OHCA does not render its decision by the FTC deadline of September 8, 2016, that the deal will be dead in the water.
As a community member, three key issues remain at the heart of the matter: local control, access and Yale’s investment in community health.
YNHHS and L+M have spoken at length about the fact that there will be a local board making decisions for the hospital. Yale even brought board members of other hospitals they’ve taken over (like Bridgeport and Greenwich Hospitals) to provide public comment at the hearings. One in particular spoke of how YNHHS had not exercised its right to reject potential board members, and that services had not been shifted to the main campus in New Haven. YNHHS CEO Marna Borgstrom testified that it was their intent to run L+M similarly. In fact, the word “intent” was used several times during testimony and cross-examination.
Their intent, however, is not spelled out in the Certificate of Need application. What is spelled out is that YNHHS will be the Sole Corporate Member, meaning they’d be the only authority to say who can and who cannot serve on the board. They would also have the ONLY voice in all decisions impacting our community hospital. So while, on the onset, it might not be their intent to begin to move services to the New Haven campus (where, incidentally, they will likely receive a higher rate of payment from insurers), as written, YNHHS can do whatever they want, whenever they want.
Let that sink in for a moment—they can do whatever they want, whenever they want, with little to no concern about or interest in responding to the many needs of the community.
Simply stated, we need services supplied by the hospital to remain local. Data from the recent Community Health Needs Assessment reveals that 1 in 4 people who earn less than $15,000 “report using buses as their primary means of transportation. 2 in 5 residents earning less than $15,000 per year reported having to stay home when they needed to go somewhere in the past 12 months…”
It stands to reason that this same population also has limited access to reliable transportation (one in five report never or almost never having access to a vehicle, while one in four report using buses as their primary source of transportation). This means that community members likely already experience challenges accessing care locally.
The thought of services and programs being shifted to the New Haven campus of YNHHS is disheartening. As you may have imagined, YNHHS did testify that it was not their intent to move services to their main campus. While it might not be their intent now, in three or more years down the road, it may be their course of action. Remember—under the terms of the application as written, they can do whatever they want, whenever they want.
Investment in Community Health:
It has been touted, like some badge of honor, that YNHHS will be investing $300 million into L+M. That number is thrown around as though there is some special pot of money earmarked to be magically released into the local atmosphere once the deal is completed.
However, at the second hearing, it became clear that rumors of the $300 million investment have been greatly exaggerated, through a series of misleading statements. As a show of good faith, YNHHS and L+M should be more transparent with their intent concerning this lofty investment.
In 2015, L+M and Ledge Light Health District conducted a Community Health Needs Assessment and are now developing a Community Health Improvement Plan, based on the identified needs. One of the intervenors testified that resources should be leveraged in the way of a meaningful community benefits agreement, inclusive of the Community Health Improvement Plan.
Reading the editorial pages, the local paper would have you believe that concerns raised by community members are outrageous and unnecessary; that local elected leaders should mind their own business and see to the needs of their cities; that transparency and accountability are not in order; and that we should just surrender complete control of our community hospital over to YNHHS, trusting that they’ll do what is best for our community.
Not on my watch! As always, I hope someone listens. I’ll be watching.
The whole community will be watching.