Havre de Grace mayor, council members oppose hospital closure without a suitable replacement
By David Anderson and Allan Vought
Feb 20, 2018 | 12:45 PM
The mayor of Havre de Grace says he and a majority of the City Council members are opposed to having the city’s full service hospital replaced by a scaled-down emergency and ambulatory care center.
In a lengthy letter sent to a state regulatory commission earlier this month, Mayor William T. Martin said he is concerned with the plan by the University of Maryland Upper Chesapeake Health to close Harford Memorial Hospital and replace it with what Upper Chesapeake calls a freestanding medical facility to be built at another location in the city.
“We’re not against Upper Chesapeake,” Martin said in an interview Monday. “We just oppose the concept of the freestanding medical facility. We don’t feel it would adequately serve the needs of our citizens.”
Instead, Martin wrote in the letter, the city should maintain a full-service general hospital, perhaps one whose physical plant is scaled down from what exists at Harford Memorial.
“I am convinced that a FMF [freestanding medical facility] will not adequately serve the needs of the residents of our area as proposed, and I believe that a new small-scale, full-service acute care hospital is needed to replace the existing Harford Memorial Hospital facility,” Martin wrote in his Feb. 6 letter to the executive director of the Maryland Health Commission, which licenses hospital facilities in the state.
The letter took about a month to write, Martin said Monday. It was a collaborative effort of the mayor and his staff and the staff of the city’s Planning Department.
In an emailed request for comment Tuesday, Upper Chesapeake spokesperson Martha Mallonee wrote: “Despite our many efforts to personally educate and share information, the recent letter from Havre de Grace Mayor Bill Martin and five of the six City Council members contains numerous inaccuracies and misunderstandings.”
“We certainly recognize that those plans have some complexity to them, especially for those who are not familiar with the day-to-day use of our hospitals,” she continued. “The need for more centralized and accessible services in Havre de Grace is evident. As a 24/7 health care organization, our mission is to improve health care — not just put Band-aids on it.”
“I believe that the Maryland Health Care Commission needs to look objectively on health care delivery in our region separate from [University of Maryland Upper Chesapeake Health] with consideration for trends in hospital admissions and usage, the existing communities served by both hospital facilities, and regional population growth,” the letter continues. “I believe that this three-part reconfiguration of health care in Harford County warrants another look.”
Martin’s letter was also signed by City Council President David Glenn and council members Michael Hitchings, David Martin, Jason Robertson and Casi Tomarchio. Councilwoman Monica Worrell did not sign it.
Martin said he offered any council members who “share the same sentiments” the chance to attach their signature. He stressed signing it was “elective” and that he respects Worrell’s reasons for not doing so.
Worrell said she decided not to sign the letter “after careful thought and consideration” of constituents’ views, her research since she was elected to her first City Council term in 2015 and “several very good conversations” with colleagues.
“I, too, prefer a general hospital to a free-standing medical facility, but unfortunately, in today’s medical health care environment I don’t believe we can preserve two general hospitals in our community at this time,” she said Monday.
Worrell, a Republican, is a candidate for one of the two seats in the House of Delegates from the district representing Havre de Grace. If she makes it through the June primary election, she is likely to face incumbent Del. Mary Ann Lisanti, a Democrat, who has been a vocal foe of closing the hospital.
Worrell said she has had exposure to issues affecting the health care field through her work in marketing, patient relations, physician relations and operations with Advanced Eye Care & Aesthetics, of Bel Air.
She said the letter could slow the certificate of need process and push the health system “into a corner,” leaving Havre de Grace without either a general hospital or a freestanding medical center.
“I have the greatest respect for my colleagues, and it was a difficult decision for me to not stand united with them, specifically on such an important matter to our community,” she said.
The mayor’s letter comes two years after Upper Chesapeake Health announced its Vision 2020 plan that consists of closing Harford Memorial and replacing it with the freestanding medical center and an adjoining psychiatric hospital to be built on land Upper Chesapeake owns near the Interstate 95/Route 155 interchange, an area of the city called Bulle Rock.
It also isn’t the first time residents of Havre de Grace and city officials have banded together to thwart attempts by Upper Chesapeake Health to close Harford Memorial. In the late 1990s, a local group calling itself “Save Our Hospital,” stalled the state certificate of need process when Upper Chesapeake was building its new hospital in Bel Air. At the time, the leadership of Upper Chesapeake, which was an independent organization, gave assurances it would keep Harford Memorial running.
The proposed Havre de Grace medical center would have a full-service emergency medical department and ambulatory care services, as well as rooms to accommodate two-night patient stays. Acute medical and surgical services would be concentrated at the Upper Chesapeake Medical Center in Bel Air, where additional beds would be added. The Harford Memorial site in downtown Havre de Grace would be redeveloped for an as yet to be determined use.
The Havre de Grace City Council passed, unanimously, Ordinance 996 regarding hospital-related changes to the city zoning code Monday, following a public hearing with impassioned remarks on both sides about Upper Chesapeake Health's Vision 2020 plan.
Upper Chesapeake began the formal regulatory review process with the Maryland Health Care Commission only a few months ago. It has requested exemption of an often lengthy certificate of need review to build the new medical center and a similar exemption to merge and consolidate services currently available at Harford Memorial to the Bel Air hospital. It also seeks a license for the proposed 40-bed psychiatric hospital.
In 2016, Upper Chesapeake, backed by the Maryland Hospital Association, a trade and lobbying group supported by the state’s hospitals, successfully pushed for legislation from the Maryland General Assembly to make it easier to close an existing hospital and replace it with a scaled-down medical center.
Although Havre de Grace officials did not oppose the legislation, several of them did continue to express concern about what would happen to the Harford Memorial site and if the city’s health care needs would be adequately served by the Upper Chesapeake Health Vision 2020.
As the months have gone by, however, more opposition to the plan has surfaced from city residents and Harford Memorial employees.
Earlier this month, the City Council passed legislation addressing some of those concerns, such as requiring the operator of the new medical center to pay for ambulance transports to Bel Air, if necessary. Martin’s letter to the Health Care Commission is dated the day after the city legislation was passed.
Upper Chesapeake officials have maintained their plan is on track to be completed by late 2020 or early 2021. They haven’t said what will happen to the Harford Memorial site once that hospital closes, but pledged to work with city leaders to redevelop it.
Upper Chesapeake officials have also said that Harford Memorial’s physical plant is too old and would be too costly to renovate and upgrade to contemporary standards, and there is not enough demand for medical-surgical services in that area of Harford County to justify the cost of continuing to run two full-service hospitals.
Havre de Grace residents continue to express concerns about the medical center and psychiatric hospital that will be built near the Interstate 95/Route 155 interchange, as part of Upper Chesapeake Health's plan to close Harford Memorial Hospital.
Martin’s letter, however, takes issue with the latter claims.
“Our community is accustomed to a level of care that will soon disappear from this area,” he wrote. “[Harford Memorial] is a full-service hospital with 57 licensed [medical/surgical] beds and 29 licensed psychiatric beds (total of 86 beds). However, UM HMH has a maximum of 128 beds (as self-reported in 2016), which allows for acute inpatient care as admissions might warrant.”
“This is a fair amount of overflow capacity, if circumstances warrant its utilization, for instance with the current flu epidemic or in advance of population growth which is happening in this development corridor,” the letter continues. “This ‘physical capacity,’ however, does not transfer to University of Maryland Upper Chesapeake Medical Center Bel Air. This physical capacity is lost within the plans of UM UCH for the merger and consolidation of the two hospital facilities.”
In addition to asking the Health Commission to undertake an independent analysis of current and future health care service needs in the region, Martin’s letter requests an analysis of Harford Memorial’s admissions to determine if they are in fact declining.
He also asks the state regulators to stop any “downsizing” occurring at Harford Memorial until the admissions data has been analyzed.
In response, Upper Chesapeake’s Mallonee, wrote: “The health and well-being of our community is our priority at UM UCH. What we are proposing for the new medical campus in Bulle Rock will be a modern medical campus offering the highest quality health care services to meet the demand and changes for more efficient health care needs today and in the future.”
“University of Maryland Harford Memorial Hospital is nearing the end of its useful life and can no longer support the health care needs of the community,” her email continued. “That is a fact. Health care is not going to change in the future. It is changing today. Right now. We are already seeing some amazing results from our pilot programs to help our most vulnerable patients get the help and health care they need often in the comfort of their own home. UM UCH is committed to this plan. As community members ourselves, we would hope our community respects our long history of developing excellent health services and programs that serve people in every stage of health care from prevention and screening, monitoring and treatment to emergency intervention. All of these services will be available on the new medical campus in Bulle Rock.”