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Health Center Deal Urged

UConn, Hospitals Told To Collaborate

By HILARY WALDMAN, Courant Staff Writer

March 19, 2008

The University of Connecticut Health Center needs a big, modern teaching hospital to replace the outdated John Dempsey Hospital on its Farmington campus if it is to survive, according to a new report presented to members of the General Assembly Tuesday.

But that does not mean the state should proceed with its proposed $495-million expansion of the Dempsey building, says the study by the independent Connecticut Academy of Science and Engineering.

Instead, Dempsey — which the study group concluded is falling apart — should be closed, and UConn should collaborate with one or more of the hospitals that now compete for patients to create a new medical complex on the health center grounds.

The new complex could take many forms. But more important than the actual structure, the study said, is ending close to a half-century of Hatfield-McCoy-style fighting over paying patients among the Hartford-area hospitals and UConn.

"Continuing the status quo with no change in existing relationships and no change in the existing facility is not in the best interest of the state of Connecticut," said Dr. Myron Genel, a retired Yale University pediatrician and chairman of the study committee.

The study was commissioned by the legislature in August, after UConn officials proposed building a new 352-bed, state-run hospital in Farmington to replace the obsolete and undersized John Dempsey.

That sparked an uproar among competing hospitals, including Hartford Hospital, St. Francis Hospital and Medical Center in Hartford, and the Hospital of Central Connecticut at New Britain General. They complained that a brand new hospital in the heart of the region's wealthiest suburbs would skim off their insured suburban patients and leave them with the financial burden of caring for the area's poor.

The report suggested a collaborative approach, with area hospitals providing a training ground for UConn's medical students in the form of new inpatient and outpatient facilities. In return, those hospitals could reap the benefits of Dempsey's Farmington Valley clientele.

The study group said it was intentionally vague about how the collaboration might work — or how the new facility might look — to give the hospitals a chance to work it out for themselves.

UConn President Michael J. Hogan praised the report as reasoned and comprehensive.

For the past several months, Hogan has been meeting with leaders of the area hospitals in an informal effort to find a compromise. Recently, he proposed a more modest plan to renovate the 224-bed John Dempsey Hospital and enter a partnership with the surrounding hospitals to keep the health center afloat. The larger expansion plan is still on the table, though.

The health center is expected to close this fiscal year on June 30 with a $22 million deficit. Without some kind of deal, the future of the university's medical and dental schools are in jeopardy because John Dempsey is too small to generate enough money to keep itself and the schools afloat.

Although many past attempts to form a partnership have failed, Hogan said the state's commitment to brokering a regional solution gives him hope.

"Now I've got an army behind me," Hogan said holding up the 144-page study. "That's going to be good."

The study committee suggests giving UConn and the area hospitals two months to come up with a vision for establishing affiliation agreements. After that, the group should have six months to formalize the plan and set it in motion.

The committee asked the legislature to appoint an independent monitor to report on the progress and outcome of the negotiations.

"What this study has done is it's thrown out a challenge to all of us: 'It's time to work it out,'" said Kevin Kinsella, vice president of Hartford Hospital. "And if we can't, shame on all of us."

Christopher Dadlez, president and chief executive officer of St. Francis, agreed. "I think it makes a lot of sense for the university to get out of the business of hospital care."

Still, many obstacles to a partnership remain.

The study group recommended that John Dempsey Hospital, long a distinctive landmark for drivers traveling on I-84, be converted into classroom and research lab space for the medical and dental schools. Meanwhile, regional health care partners could build a new hospital and outpatient facility — perhaps even bigger than the 352-bed facility proposed by UConn — on land at the lower end of the health center campus off Farmington Avenue.

But because the region does not need any more hospital beds in the near future, the study group concluded, it is possible that the hospitals might have to give up some existing beds and transfer the licenses to the new Farmington facility — which could prove problematic.

Another sticking point, Hogan acknowledged, is that nurses, doctors and other personnel at Dempsey are state employees, often covered by union contracts that offer higher wages and benefits than the private, nonprofit hospitals. Hogan said Dempsey workers could not move to a new facility without their state benefits.

"We cannot work inside a partnership that does not protect our state employees," Hogan said.

He added that health center executives, including the medical school dean and the health center vice president, would have to retain authority over teaching and clinical programs at any partnership-run hospital.

During a legislative briefing on the report Tuesday, lawmakers struggled to understand how a hospital run by a state-private partnership might work.

State Rep. Walter M. Pawelkiewicz, D- Windham, said allowing one urban hospital to set up shop in Farmington might only increase tensions among area health care providers. "What's going to prevent you from creating Son of John Dempsey Hospital?" he asked.

That, Genel said, is why the report was vague about who the partners might be.

"The very difficult part will be coming up with relationships that provide for the health and welfare of all involved in the process," he said.

After sitting through a two-hour briefing by the study group, one state lawmaker said trying to find a solution that works for all of the area hospitals would be similar to attempting to make a rocky marriage work for the sake of the children.

"We're looking at couples counseling," said state Rep. Patricia A. Dillon, D- New Haven.