, Gloucester, MA

December 12, 2012

Lahey panelists need to fight for residents' needs

Gloucester Daily Times

---- — To the editor:

This is an open letter to the members of the new Cape Ann Community Panel of Addison Gilbert Hospital:

We understand that you have been selected by Lahey Health to represent the people of Cape Ann in planning the future of AGH and that your first meeting will take place Friday.

Lahey is holding these meetings because it was ordered by the state Public Health Council to complete a Cape Ann community health needs assessment as a condition of the council’s approval of the merger of Northeast and Lahey. This order resulted from the work of many of us who have fought for our hospital, most of whom are being excluded by Lahey from this panel.

Although you are charged with representing all of us, and our lives depend upon the decisions you make, Lahey has decided that the meetings will be secret and confidential.

Expect Lahey executives to give polished presentations to lead you to conclusions that you probably would not reach if you had all the information you need. Here are a few really important considerations to keep in mind.

The community’s need for AGH

Over the past 16 years, a firm consensus has been reached among many on Cape Ann, including elected officials of Rockport and Gloucester, that, because of our very tenuous connection to the mainland, Addison Gilbert Hospital must always have a fully licensed emergency department.

Take note of this extremely important ruling of the state Department of Public Health :

“The following services are the minimum services that must be available in a hospital building as a precondition for the authorized provision of emergency services at that site:

Inpatient medical and, or surgical beds.

Critical care beds.

24-hour availability of qualified physicians and other professional staff.

Lab service.

Radiology services.

Surgical services, including adequate operating room facilities, which are immediately available for life-threatening situations.

Post-anesthesia recovery services.

A blood bank.

Without inpatient beds and 24/7 capability for emergency surgery, the hospital will not be licensed for emergency services and may not receive and treat patients transported by ambulance through the emergency response system (e.g., 911 system).”

Please do nothing in these meetings to weaken Cape Ann’s repeated demand that these eight services be protected. We hope you’ll advocate for additional services so that acute care services at AGH match our needs.

The Cape Ann population of 36,000, particularly the higher than state proportion of people 65 or older (23 percent in Rockport and 18 percent in Gloucester) and the “baby boomers,” ages 55 to 64 (20 percent in Rockport and 17 percent in Gloucester), requires more inpatient hospital beds than the 23 now available at AGH, which remains licensed to operate 55 beds. Prudent planning dictates the expansion of AGH beds immediately and more in the immediate future to accommodate the impending baby boom demand.

The vast majority of hospitalizations of Cape Ann residents are for conditions appropriate for treatment at AGH: lung disease, heart disease, stroke, high blood pressure, diabetes, cancer, and injuries. For several of these diagnoses, both the hospitalization rates and deaths are higher than the state average. In Lahey’s health survey, 10 percent of Rockport respondents and 12 percent in Gloucester reported being in fair or poor health. That’s 3,600 people.

We acknowledge the problem of substance abuse on Cape Ann, but Lahey overstates it when it lumps “substance abuse and mental health” into one category. More than two-thirds of Cape Ann patients in that category were treated for mental health issues such as anxiety and depression.

The needs outlined above are only for those of us who live here year-round. When the Cape Ann population explodes by many thousands in summertime, so does the need for AGH services.

Finances of AGH/Northeast/Lahey

Lahey now holds all of Northeast’s financial resources that are more than sufficient to maintain and expand the acute care services we need at AGH. Non-profit, tax-exempt, charitable organizations have unique obligations and advantages, different from private corporations. More than half of its revenue comes from taxpayers in Medicare and Medicaid payments and other government grants. It has received donations to support their charitable mission. It has a corresponding duty to the community, including the community of Cape Ann.

An independent financial analyst for health care organizations has reviewed the audited financial reports of Northeast since 1996 and concluded that AGH has been a financial boon, not a drag on Northeast. The income generated by AGH investments alone has enriched Northeast by more than $9 million a year every year since the merger. Fifty-five percent of Northeast’s investment portfolio came from AGH. The portfolio’s current value exceeds $90 million.

You will be told that AGH had a $1.5 million operating deficit last year. The reason for the deficit is simple: the diversion of Cape Ann patients, and their revenue, away from AGH. We estimate that payments for hospital services for Cape Ann residents contribute up to one-third of Northeast’s $317 million annual operating revenue. Northeast ended 2011 with an operating surplus of $5.4 million, a total surplus of $7 million, and a total operating margin of 2.24 percent, higher than the median for Massachusetts hospitals.

So, when Lahey lays out the financials, make sure it gives you the whole picture.

Please do everything you can to protect all of us. I am always available to meet with you.

Peggy O’Malley, RN

Chairwoman, Partners for Addison Gilbert Hospital