DHS chief praises catheterization pact St. Joseph plans service within 12 months

The community was the winner when Eastern Maine Medical Center dropped its opposition to a 3-year-old proposal by St. Joseph Hospital to build a cardiac catheterization laboratory, Department of Human Services Commissioner Kevin Concannon said Monday.

Because the service has rapidly become a standard medical procedure, Concannon said he quickly approved the $1.5 million project after the two sides announced last week the end of EMMC’s opposition. It was for that reason that he made the decision counter to the recommendation of an independent consulting firm the state had hired last year to determine how many laboratories were necessary across the state.

Concannon said cardiac catheterizations have become more routine since the consultant’s report issued in September 2000. The approval means St. Joseph patients won’t need to be transported to EMMC for diagnostic catheterizations, he said. The additional laboratory, on top of those at EMMC, will be a boon to the region, he added.

“It enhances the level of patient care in the Greater Bangor area,” Concannon said.

EMMC, which has offered the service since 1987, will see a few less patients, but the impact will be minimal, he said. Patients deemed to be at high risk will still need to be transported to EMMC, which provides more advanced cardiac care such as open heart surgery.

Concannon said both hospitals had spent heavily on legal help during the 3-year battle over the proposal. Monday, he proclaimed “peace at last, peace at last, God almighty, peace at last.”

The two hospitals announced last week that they had reached “an agreement,” which led to EMMC dropping its long opposition to St. Joseph’s application.

Concannon said he was not privy to the agreement.

Apparently, one feature of the agreement was that both hospitals would keep the details confidential. They issued identical press releases the evening before Thanksgiving and then officials refused to explain the agreement’s contents.

Little new about the agreement could be learned Monday.

An EMMC spokeswoman said the agreement is confidential and the administration would not go beyond last week’s press release. The release said both hospitals believe the agreement “will help meet the needs of patients coming to Bangor for cardiovascular procedures.”

St. Joseph spokeswoman Bethany McKnight said Monday that St. Joseph had made no concessions in regards to the service the hospital had asked the state to approve. She said the hospital was pleased the struggle had come to an end but could not elaborate on the agreement with EMMC since both sides agreed to maintain confidentiality.

The cardiac catheterization laboratory will be built in space where the hospital’s general laboratory is now located, she said. That laboratory is moving into space that had been occupied by Dahl-Chase Diagnostic Services, which itself is moving to space at EMMC. The plan is to have the new cardiac catheterization laboratory operating by Nov. 1, 2002.

“We are so excited,” McKnight said. “We said it was an early Christmas gift.”

Cardiac catheterization is used to look for cardiovascular blockages. A flexible tube is inserted into a vein or artery in a leg or arm and slithered toward the heart. Without considering discounts, the procedures cost about $3,000 each at Eastern Maine Medical Center.

Under state law, hospitals must get approval from the state for new services that are deemed expensive to start and to run. In late 1998, St. Joseph filed its application for cardiac catheterization services. In April 1999, DHS’ Certificate of Need Unit issued a preliminary recommendation against approval.

As the proposal went through the regulatory process, other hospitals added their own requests for cardiac catheterization services. By 2000, DHS officials said that with a handful of requests pending, they wanted to halt reviews to allow a statewide analysis of the need for the services.

The independent consulting group Public Health Resource Group of Portland conducted the statewide study and then recommended that some applications be approved. But it came down against St. Joseph’s proposal saying additional services in Bangor were unnecessary.

Shortly thereafter, the Certificate of Need Unit reversed its earlier 1999 recommendation. The new recommendation went to Concannon for his final decision.

Given this turn of events, EMMC asked for a public hearing on the application, which DHS approved.

The February meeting of DHS’ Certificate of Need Advisory Committee drew more than 100 people from around the state, but lasted just minutes. Three of six board members who turned out for the meeting disclosed significant conflicts of interest. Without a quorum, the hearing was canceled with another to be scheduled shortly.

In March, St. Joseph filed suit against DHS, saying no hearing should be held because it violated DHS rules. Just three weeks ago, a Superior Court judge upheld DHS’ actions and said the hearing could go on.

To that, Sister Mary Norberta said she was “disappointed that we are back to square one.”

With the surprise agreement, however, St. Joseph now expects that in less than a year the first cardiac catheterization will be performed at the 100-bed hospital.