By James O’Brien
Globe Correspondent / May 24, 2009
Framingham’s Board of Health voted last week to urge the town and the state to take a second look at an outpatient surgical and screening center proposed by Newton-Wellesley Hospital.
But after realizing that hospital representatives were never formally notified of the Wednesday night hearing, the board decided to revisit the matter at its meeting this week, giving the hospital a chance to present its case. No representatives from Newton-Wellesley, or its parent company, Partners HealthCare System Inc., attended last week’s session.
Health Board chairman Michael Hugo said the three-member panel would likely rescind the first vote and hold a second vote at its Wednesday meeting, at 7 p.m. in the Memorial Building.
It is unclear whether the reopening of the hearing would change the outcome.
At last week’s hearing, board members concluded that the proposed Route 30 facility – approved by the Planning Board this month and so far not subject to state Department of Public Health review – would draw critical profits away from the MetroWest Medical Center’s campuses in Framingham and Natick, harming the area’s public-health system by compromising their viability.
The board voted to ask selectmen for permission to appeal the Planning Board decision, and members said they would do all they could to help the selectmen prompt a state review of whether Newton-Wellesley’s outpatient center is needed in the Framingham area.
Newton-Wellesley officials have said they need the new facility, which would include four operating rooms for outpatient procedures, to deal with an overflow of patients at the hospital’s main campus, on Route 16 in Newton. They also said that it is not meant to compete with MetroWest’s Framingham Union or Leonard Morse campuses.
The issue of the lack of notification to Newton-Wellesley was raised last week by hospital spokesman Brian O’Dea.
While acknowledging that the hearing date had been posted by the town, and cited in news media reports, O’Dea said, "In a situation like this, where there’s a chartered board, we expect our best info is going to come from that board. We were never notified or consulted."
The town’s Board of Health director, Ethan Mascoop, confirmed that Newton-Wellesley had not been directly notified of last week’s hearing.
Mascoop said the public hearing was posted at the town clerk’s office and on the town’s website, and by those notifications was a legal meeting.
Board member Nelson Goldin said he would approach the new hearing with an open mind, but set a threshold for any change in his vote.
"I need to see how Newton-Wellesley Hospital, coming nine miles away from their campus, is going to convince me that they’re not going to siphon off MetroWest patients and damage the community health programs we already have," said Goldin.
Framingham selectmen have stated their opposition to Newton-Wellesley’s plan, and on Monday asked the state for a determination-of-need review.
Tom Lyons, a spokesman for the state Department of Public Health, said his agency would fully consider the board’s request, but noted the threshold for conducting such reviews is for projects costing $25 million.
Newton-Wellesley has said its renovation of the Route 30 property, which previously housed a CompUSA store, is expected to cost about $17.5 million.
Framingham officials say two possible exceptions in state law could help them gain a review.
In the first, Hugo said, proponents could try to show that a determination by the state "is in the good of the public health."
Also, Selectman Dennis Giombetti said, the Newton-Wellesley facility should be classified as a type of outpatient ambulatory care center that would be subject to a review even below the $25 million threshold.
Lyons said he could not immediately comment on the exceptions cited by the officials.
Support for state review of the Newton-Wellesley plan also emerged in Natick last week.
Joshua Ostroff, vice chairman of Natick’s Board of Selectmen, said at last week’s Framingham hearing that he would ask his board to support the request to the Department of Public Health.
Newton-Wellesley Hospital officials say their expansion will help Framingham.
The hospital has committed to an annual payment of $92,000 over five years to the town, and a one-time payment of more than $120,000 in lieu of property taxes on the 3-acre site.
All told, Newton-Wellesley officials said, the facility’s economic contribution to Framingham would be approximately $3.3 million in jobs and other benefits.
Andrei Soran, chief executive officer of the MetroWest Medical Center, countered that the Newton-Wellesley outpatient surgical center would simply skim needed business from his institution.
The facility, said Soran, would compete against his hospitals for profitable surgeries, without taking on other high-cost services – like emergency rooms – that his full-service hospitals provide.
The effect, Soran said, would be akin to falling dominos.
If surgeons opt to do procedures at the Newton-Wellesley facility, which Soran predicted would offer preferred rates to doctors based on the influence of Partners HealthCare, its parent company, then Framingham Union would then be forced to cut staff and services to make up for lost revenue.
"This could lead to angioplasty closures," said Soran of the hospital’s blood-vessel repair unit.
"If that closes, we would have to close other units. If we close units, then there is a real question, why stay open?"
Following last week’s hearing, O’Dea said that the new facility would not offer any financial incentive to doctors to use its operating rooms. Only if a patient changed provider networks from MetroWest to Partners, for example, would the fees paid to surgeons change, O’Dea said.
"What patients value is their relationship with their primary-care physician," said O’Dea. Citing the outpatient services slated for the new facility, he said, "I don’t believe there’s anything that could induce your average patient to switch networks."
Meanwhile, for some at the hearing, the deliberation summoned memories of previous hospital closures in the region.
Natick resident Jenny Reynolds, a nurse at Leonard Morse Hospital, told the Board of Health that she saw parallels in the Newton-Wellesley expansion with her experience as an employee of now-closed Waltham Hospital, which ceased operations in 2003.
"I see a community hospital facing an invasion into its area of other facilities, coming in to provide like services," Reynolds said.
Others said Newton-Wellesley opponents failed to make a convincing case.
"I do think MetroWest Medical Center is vitally important to the community," said Theresa Jacobs of Framingham, a physical therapist employed at Newton-Wellesley Hospital. "But I’m not convinced that a surgical center would lead to the demise of a hospital."
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