Newark mayor questions planned cuts to hospital’s inpatient pediatric unit

Taken from Politico
By Sam Sutton

07/18/2018 05:01 AM EDT

Newark – Mayor Ras Baraka wants the state Department of Health to put the brakes on University Hospital’s plan to reduce the number of beds in its inpatient pediatric unit by more than 80 percent.

“There needs to be a discussion. People need to be involved. It needs to be as transparent as possible and we need to make sure it makes sense, not just for the hospital’s bottom line, but that it makes sense for the residents of this community,” Baraka said. “We should at least have the ability to weigh in. Things should be happening because of us, not to us.”

University Hospital filed a certificate of need with the state health department in April, requesting approval to eliminate 19 of the 23 beds from its inpatient pediatric unit, citing a lack of patients and the unnecessary diversion of resources. The hospital said it will continue to treat and stabilize children, but move those in need of longer term care three miles south to Newark Beth Israel Medical Center, an affiliate of RWJBarnabas Health.

The health department has yet to sign off on the certificate of need. The public hospital’s plan has drawn criticism from local activists who are concerned about the elimination of services and the diversion of patients — particularly those of low income — to a private nonprofit facility.

“Children are our most precious possessions,” said Dr. James Oleske, a professor of pediatrics at Rutgers New Jersey Medical School. “We made a promise to this community [to provide care] and this community should not let us go back on that promise.”

Around 50 doctors, nurses and community activists met recently with University Hospital officials to discuss the plan.

Baraka said he hadn’t been aware of the certificate of need’s ramifications and that he wants additional input from Newark Beth Israel, Gov. Phil Murphy’s office and the health department.

“They seem to be full steam ahead and it’s problematic for me,” Baraka said, adding that lack of clarity on University Hospital’s proposal was his main concern. “It’s not like the delivery of health care in our community is optimal.”

Hospital staff and local activists are also wary of any effort to transfer the responsibilities of University’s public employees to RWJBarnabas. University Hospital had more than 3,500 employees as of 2016, according to its website.

Baraka plans to meet with Murphy to discuss University Hospital’s plan, according to the mayor’s office. A senior Murphy administration official confirmed the governor’s office was in touch with Baraka and that they were “working with him and his office to find a path forward.”

Finding a path forward that satisfies all parties will be a challenge. While labor and community activists will bristle at efforts to move inpatient pediatric patients to Newark Beth Israel, the certificate of need indicates that fewer than seven of University’s inpatient pediatric beds are occupied on any given night, taking away resources from other, more-utilized areas of the hospital.

The hospital attributed declining patient volumes to improvements in treatment practices, which allow children to be treated and released, as well as competition among local hospitals for pediatric patients. Newark Beth Israel, home to the Children’s Hospital of New Jersey, has a 19-bed pediatric critical care unit in addition to offering outpatient and preventative services.

“It is [University Hospital’s] position that redirecting resources from the general inpatient pediatric services to our other services will provide what we have … identified as a greater community need as evident in the low volume and decline in the use of the service,” the hospital stated in its certificate of need.

Accordingly, University projects it will save roughly $3 million by reducing the size of its inpatient pediatric unit. Those savings could be vital, given the hospital’s financial situation.

University’s budget for the 2018 fiscal year assumed revenues would fall short of operating expenses by more than $25 million. Fitch Ratings downgraded the hospital’s New Jersey Health Care Facilities Financing Authority bonds from “BBB” to “BB-” in July, thanks largely to its $552 million net pension liability and “stable, but thin” operating margins.

“The pediatric program is a vital service that University Hospital provides, and we are not closing it — we are matching the level of service to the number of pediatric patients we treat on a daily basis,” a hospital spokesperson said in a statement.

The hospital is also working with the Department of Health and elected officials relating to its certificate of need and is “actively engaging the Newark community through public meetings to provide additional information and answer questions,” the spokesperson stated.

The Department of Health declined to comment specifically on the status of the certificate of need.

“We are committed to responsible health service development and ensuring that new construction, renovation, or relocation of certain health facilities meet the needs of local communities,” spokeswoman Donna Leusner said in a statement.

RWJBarnabas officials did not immediately respond to comment.

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