BEVERLY — The planned partnership between Northeast Health System and Lahey Clinic is a model that aims to keep primary care in communities, state Sen. Bruce Tarr acknowledged during a state Department of Public Health hearing Thursday night.
But it's a model that can't exist without Addison Gilbert Hospital.
And without an assurance that Gloucester's local hospital will be part of that system, Tarr said, the state Department of Public Health should take another look at the two nonprofits' plans to affiliate.
"If we can't find those assurances," said Tarr, "I urge you to rethink the affiliation proposal."
In Northeast's transfer in ownership application, the company lays out a written, albeit, non-binding guarantee to maintain essential clinical services at no less than current levels at Beverly and Addison Gilbert hospitals for three years after the affiliation goes through.
But, according to the document, that maintenance is subject to exceptions — exceptions for "exigent financial circumstances and regulatory requirements" — determined by the affiliates' governing board. It's also listed in a "non-binding" terms section.
That hasn't been enough for a number of Cape Ann residents and officials, who drove home that point to the Department of Public Health during Thursday night's hearing at Memorial Hall in Beverly.
Local officials, including Congressman John Tierney, Tarr and Mayor Carolyn Kirk all urged the department to make the preservation of Addison Gilbert's essential services a condition of both companies' affiliation plans.
Tierney said the affiliation could improve health care services for much of the North Shore. But, he asked the department to find a way to ensure Addison Gilbert's future, especially regarding emergency services.
"The continuation of emergency services out there is a vital part of your decision," said Tierney.
The proposed new Lahey Health System, Northeast CEO Ken Hanover reiterated, has no plans to close Addison Gilbert, or drain essential services. Instead, he said, it will let the company invest in its community hospitals.
"On the contrary," he told the Department of Public Health, "the affiliation will allow us to promote greater access to services in the community for years to come."
Hanover and Dr. Howard Grant, president and CEO of Lahey Clinic, both spoke to an auditorium filled mostly by Cape Ann residents.
The two companies announced plans for a $1.5 billion affiliation in July, with an eye toward creating a new nonprofit corporation in Lahey Health Systems and effectively linking a network of hospitals from Lahey's headquarters in Burlington up Route 128 to Gloucester. Addison Gilbert was merged into Northeast, which also includes Beverly Hospital and other affiliates, in 1994.
The Department of Public Health held the hearing to hear from residents and the companies about the proposal before it decides whether or not to sign off on the affiliation. Northeast and Lahey's plans also need approvals from Attorney General Martha Coakley's office, and from the Federal Trade Commission.
All of those applications and approvals are still in progress; the Beverly hearing was the first of two public sessions to be held by the Department of Public Health. A second, expected to be held in Burlington, is still to be scheduled.
At Thursday's meeting, some Cape Ann residents said Addison Gilbert's future should rest on the area's need for it, not the affiliate's bottom line. Others said the affiliation would open the hospital for future investment.
Kirk said the city comes to the proposed merger with conditional support. She said the affiliation means better care in the new system. But that better care, she said, can't come at the expense of Addison Gilbert, or the city's investment in emergency medical services.
The loss of the emergency room would cause problems for the city's investment in the Gloucester Fire Department's ambulance service. The hospital receives about 13,000 emergency room visits each year, and Fire Department paramedics do about 4,000 ambulance runs annually as well.
"The loss of the hospital or the emergency room," Kirk said "would dilute the resources of the city with frequent transports to Beverly or beyond."
Gloucester's geography, said Peggy O'Malley, head of Partners for Addison Gilbert and a registered nurse, makes a local hospital necessary. O'Malley said that, with Gloucester and Rockport's aging populations and sometimes unreliable access to the mainland, the community needs its hospital.
"These circumstances are not rare, they're regularly occurring," she said.
As the health care world changes, said Ruth George, an registered nurse at Addison Gilbert, the hospital needs to be part of the solution. The affiliation, she said, will provide the resources it needs.
City Councilor Bruce Tobey told the department that the hospital provides an economic engine for the city — both as an employer and as part of what makes the community attractive for people and businesses. From personal experience, he said, the hospital needs a full service emergency room.
Residents who didn't get a chance to speak at the hearing, or didn't go, can submit written comment up to 5 p.m. on Jan. 23. Anyone wishing to provide that input can send comments to the Department of Public Health, Determination of Need Program, 99 Chauncy Street, Boston, MA 02111. Submitters should also include an email address.
Steven Fletcher may be contacted at 1-978-283-7000 x3455, or firstname.lastname@example.org. Follow him on Twitter at @stevengdt.