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More changes to the Hospital Conversions Act

April 11, 2012

As I reported yesterday, the RI Senate Committee on Health and Human Services is voting today on a bill meant to change the way the state approves hospital sales and mergers.

The most controversial change allows for-profit entities to buy more than one hospital in a year instead of waiting three years. But there have been other little tweaks around the edges. Just last week the General Assembly received a new version of the bill. And late last night I received another revision.

Here is the most recent version of the bill (now titled S 2180 SUBSTITUTE A3.) It’s in various colors, which must reflect changes from each version, but I’m unclear about which layer is which. I’m waiting for notes from the Senate for a summary of what exactly is different this time around.

It is worth pointing out one portion of the bill that I didn’t notice before. The very last section tacks on a change, not to the Hospital Conversions Act, but to RI law concerning the Health care planning and accountability advisory council. This is the group responsible for figuring out how many hospitals we need, how many doctors and types of doctors do we need, and how can we make all these parts of the health care system work together efficiently. The Director of RI’s Department of Health talks a lot about the need for this kind of coordination.

The amendment looks similar to the existing law except for the last half of one paragraph-

The initial priority of the council shall be an assessment of the needs of the state with regard to hospital services and to present recommendations, if any, for modifications to the Hospital Conversion Act and the Certificate of Need Program to execute the strategic recommendations of the council. The council shall provide an initial report and recommendations to the governor and general assembly on or before March 1, 2013.

See that? It’s a deadline. Rhode Island has been talking about efforts to coordinate care for years, but it hasn’t taken much action. Will this little paragraph force the state to actually organize our health care system? No idea. But it seems like an acknowledgement that something needs to be done.

2 Comments leave one →
  1. Moe Howard permalink
    April 11, 2012 3:19 pm

    Hope does spring eternal. No, this enacting that piece of legislation won’t “force the state to actually organize our health care system”.

    In order for RI to fashion and implement a meaningful plan (even just for hospitals), there are several missing elements.

    The most obvious is the absence of any appropriation of money to fund the mandate.

    Also and more fundamentally problemmatic , despite the rhetoric, RI has historically demonstrated little interest in a top down approach to hospital planning. Back around 1980, with the benefit of years of substantial federal funding and considerable data and research, the RI Statewide Health Coording Council developed a comprehemsive draft health plan. Among many initiatives, the draft included proposals for minimum sized acute care hospitals, minimal occupancy standards and calculated the bed needs of the various planning areas- it did not propose closure of specific facilities. At that time it was clear that the state already was “over bedded”. The Council had rejected some more Draconian and direct approaches to hospital down sizing.

    When the draft plan was taken to seven public hearings around the state, there were widespread and hysterical responses. At the first hearing in Westerly [now in RECEIVERSHIP] the good citizens held a torchlight parade to the hearing site, complete with fire engines and marching citizens holding candles. Then gubernatorial candidate Vincent Buddy Cianci flew in by helicopter. The news media had a field day. It was worse in Newport where some opposed to the plan attempted to rush the stage and had to be restrained by police. Needless to say the draft plan was gutted to a point of being a mere shadow of the draft.

    Just saying . . .

    • April 11, 2012 5:10 pm

      I hear you Moe. One person once told me that people feel a sort of reverse “not in my backyard” reaction to hospitals. Everyone wants a hospital in their backyard. Whether it’s the smartest thing to do is another question.

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