Helen Gym has a plan to prevent another Hahnemann

A new bill introduced in Philadelphia City Council seeks to give local authorities additional oversight over future hospital closures.

Helen Gym speaks at a protest of the Hahnemann closure on June 27, 2019. (Nina Feldman/WHYY)

Helen Gym speaks at a protest of the Hahnemann closure on June 27, 2019. (Nina Feldman/WHYY)

When Hahnemann University Hospital’s owners announced they would shut it down this past June, city and state officials tried — and failed — to stop it.

Now a bill introduced by Councilmember Helen Gym seeks to give local authorities additional oversight over future hospital closures. The legislation is co-sponsored by a majority of City Council, and backed by Mayor Jim Kenney.

“The harsh realities and destructive practices of a ruthless private health-care market means cities have to step up in our protections and our demand for transparency,” said Gym.

Gym’s bill would require any closing hospital to give 180 days’ notice to the city’s health department, as opposed to the 90 days currently required under state law.

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The hospital would also be required to submit a detailed closure plan, which would need approval from Philadelphia’s health commissioner. The plan would outline the reason for the closure, how owners will ensure continuity of care while transferring patients and their medical records to other hospitals, and ways to assist staff in finding new work.

The bill comes at a time of turbulence among other hospitals in the city’s health systems. Just last week, Temple’s nurses rallied for successionary language in their contract to ensure that in the event of an ownership change, any new operator would honor their union contract, the product of years of negotiating.

Temple is in the process of selling the profitable Fox Chase Cancer Center, as well as its interest in Health Partners Plans to Jefferson Health. St. Christopher’s Children’s Hospital was just sold to Tower Health and Drexel University as a part of the Hahnemann bankruptcy proceedings.

Gym, who attended the rally held by Temple nurses, is pitching her bill as a requirement with more teeth than the current state rule. When Hahnemann announced its closure, the Pennsylvania Department of Health issued a cease-and-desist order to stop Hahnemann from closing down. They cited the state law requiring any hospital operator give state regulators 90 days’ notice before shuttering, and demanded the hospital’s owners submit a detailed closure plan to their office before moving forward.

A Philadelphia Court of Common Pleas judge approved an injunction against Hahnemann, requiring the state and bankruptcy court to approve the closure plan before operations began winding down.

But the hospital started closing anyway. By mid-July, it had stopped taking patients from the emergency room into the hospital. No patients remained at all by the end of the month. The state had appointed a monitor to ensure a smooth and safe closure process, but they weren’t able to actually halt the operations from winding down.

“It’s easier to flout regulations from Harrisburg”

Gym and her allies say the bill will bolster the power of local authorities, who are closest to the issues.

“Today, 10 of us introduced a bill to make sure Philadelphia will never again be left out of critical decisions that impact the lives of our neediest residents,” said Gym.

The type of bill the councilmember is proposing is not uncommon on a municipal level, but cities haven’t always been able to wield the laws as intended. In Washington, D.C., a similar bill was passed in efforts to prevent Providence Health System from closing. But the hospital did close, and has since transitioned to a scaled-back outpatient clinic.

But Gym says city workers are better suited to hold hospitals accountable than those on the state level, because municipalities understand how high the stakes are when urban safety net hospitals, which serve a majority of uninsured patients or those on public insurance, threaten to close.

“It’s easier to flout state regulations from Harrisburg rather than flouting them here,” said Gym.

While Hahnemann’s closure left thousands of employees out of work, and medical residents scrambling for new placements, it was not exactly a surprise to the city. Lobbyists working to keep Hahnemann open met with the Kenney administration and Council President Darryl Clarke’s office in the months leading up to the closure announcement. The two sides tried to work out a way to keep the hospital open. While the city ultimately did not agree to help in the way the hospital wanted, officials knew the institution’s financial trouble could close it down.

Health Commissioner Tom Farley said this bill would force hospital owners to make their intention to close more explicit.

“While this enforcement mechanism has its limits, the safeguard will definitely make it more difficult for irresponsible owners to just walk away from a hospital,” Farley said.

He echoed Gym’s assertion that local authorities are better suited to oversee the hospitals in their region than state regulators are, especially when it comes to a transfer of patients and their medical records to other local health care providers.

Temple Health System did not respond to a request for comment on the bill.

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