To Merge or not to Merge

The Organized Medical Staff of LICH (which is independent of management) maintains its own website. This group is opposed to a merger of LICH with the SUNY Downstate Medical Center. Readers of this blog know that there may indeed be good reasons for such a merger. In particular, Mr. Murray Adams has favored it (read and the postings following). I must confess that I am not adequately conversant with all the factors surrounding this issue. So, while strictly neutral on the matter of a merger, I do present the latest propositions from the group of doctors:

September 1, 2009
Dear Fellow Members of the Medical Staff of Long Island College Hospital:
Now that the summer is coming to an end and we are all focusing on the coming year, we are taking this opportunity to provide you with an update on the progress that we have made on our objective to separate LICH from Continuum and re-establish LICH’s independence.
Rumors that a Downstate Merger is Imminent are FALSE. We are well aware of the rumors that have been circulating that the LICH/Downstate merger is basically a “done deal”. This is ABSOLUTELY NOT TRUE.
The so-called Memorandum of Understanding that has been signed between the two hospitals has not been made available to us or the public, but we know that it is little more than a statement that the parties would like to come to terms on a deal.
Key Business Issues Have Not Been Resolved. We also know for a fact that there are many critical deal points that must be resolved before a merger can be completed including allocations of very significant expenses and professional liability exposure. There are issues relating to the Othmer Endowment. There will be issues since Downstate and LICH are served by different Unions. Sharing of systems and resources must be worked out. And the list goes on. It is quite possible that the parties will not be able to come to terms on these issues.
Numerous Approvals Required Any purported deal between Downstate and LICH require the approval of, among others:
• New York State Department of Health (DOH) • Public Health Council • Dormitory Authority of the State of New York (DASNY) • U.S. Department of Housing and Urban Development (HUD) • State University of New York (SUNY) • New York State Attorney General and Supreme Court • Medicare Program • Medicaid Program • Board of Regents of LICH
NONE OF THESE APPROVALS HAVE BEEN OBTAINED AND, IN FACT, SINCE NO FINAL DEAL HAS BEEN AGREED TO BETWEEN LICH AND DOWNSTATE, NO REQUEST FOR APPROVAL HAS EVEN BEEN SUBMITTED TO ANY OF THESE ENTITIES. Even if LICH and
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Downstate are able to come to terms on a deal, it is quite likely that some or all of these approvals will be denied. If approval is sought, we, the Medical Staff will have an opportunity to express our concerns and object to the plan. There are significant reasons why approvals may not be granted.
Very Positive Meeting with the DOH. IMPORTANTLY, we met with very senior level DOH officials on August 6, 2009 to discuss the Medical Staff’s position on the future of LICH and the Downstate proposal in particular. These officials have made it absolutely clear that the DOH understands that the continued existence of LICH under any plan will not be financially feasible without the full support of the Medical Staff and accordingly, THE APPROVAL OF THE MEDICAL STAFF IS CRITICAL to obtaining the approval of the DOH. In fact, the DOH has committed to use its influence to orchestrate a meeting between the Medical Staff Executive Committee and its advisors with Downstate to discuss what terms, if any, would be acceptable to the Medical Staff for an affiliation. As per the petition that we signed, we have and will continue to make it clear that we will not agree to any plan that does not result in re-establishing LICH as an independent institution.
Memorandum Summarizing the Improper Constitution of the Current LICH Board. The DOH has asked our attorneys to prepare a written summary of the reasons why the current LICH Board is improperly constituted and the Continuum takeover of LICH was improper. Our attorneys are in the process of preparing such Memorandum and have advised us that there are many grounds for making such determination that the Board is improper.
Appointment of a New Board for LICH In furtherance of our plan, we have selected and obtained the commitment of 10 highly qualified nominees to reconstitute the Board of LICH. We have submitted their names and CVs and other credentials to the DOH for their review. A copy of such submission is attached to this letter for your information.
Status of Our Plan. At this point, if the Downstate proposal is not approved, the only other plan that has been submitted to the DOH and others is the carefully prepared and analyzed plan presented by the team of professionals retained by the Medical Staff. While the DOH has not yet ruled on the plan since it has not been submitted by the LICH Board, we are confident that if the Downstate deal is not approved, the DOH will find our plan to be the only other feasible and acceptable plan for approval.
Application for HEAL Grant. We have prepared and submitted an application on behalf of LICH for a $15 million HEAL grant to be used in furtherance of the Hospital’s needs in accordance with our plan.
We look forward to meeting with you in early September, at which time we will be able to give you further updates and answer any questions that might occur. In the meantime, we implore you not to fall victim to believing rumors that are being circulated to induce you to passively fall in line and accept the Downstate proposal. A Downstate takeover would doom LICH. The only workable solution remains establishing an independent LICH with a possible affiliation with Downstate on terms acceptable to the independent LICH. STAY THE COURSE - WE WILL GET THERE IF WE REMAIN UNITED AND COMMITTED TO RETURNING LICH TO ITS FORMER INDEPENDENT STATUS.
Sincerely, The Medical Staff Legal Committee
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Secrecy at LICH

Reported negotiations to merge LICH with SUNY seem to proceed in utmost secrecy. There are reports that the medical staff, in particular, is upset because important medical decisions seem to be in negotiation without input from the professional staff.

Denis Hamill of the Daily News has a fulsome report. To read it, click here.

Springtime at LICH

Whatever the virtues and/or vices of LICH's past and LICH's future, for the moment there is springtime at LICH, at least in its landscaping.

LICH real estate up for sale

LICH property at 385 Hicks
photo by Werner Cohn

According to Barbara Benson (Crain's Health Pulse, Jan. 23), Continuum has put some of LICH's real estate up for sale.

Writes Benson:

Offered by Grubb & Ellis on an all-cash basis, the properties include 74, 76-78, 82 and 86 Amity St., and 113 Congress St. Of those, 74 Amity is a 12-unit walk-up apartment house; the others are townhouses. Also for sale is 43 Columbia Place, a four-story, 11-unit walkup. The last is 385-389 Hicks St., a one-building site that can be developed to about 23,000 square feet. Most of the buildings are vacant or will be by July.

Update from LICH Medical Staff

I have received the following communication from members of the LICH medical staff, and hasten to present it as received. WC

Update from the LICH Medical Staff
January 2009

Since there has been very little “official” activity on the LICH front in the past month, we have decided to provide an update of recent activity and events regarding LICH.

As you are all probably aware, in December 2008 the NY State Dept. of Health refused to allow the proposal by Continuum Health Partners (CHP) to close the Obstetrics and Pediatrics programs at LICH, and these departments, as well as all other services at LICH, are still fully functioning.

The LICH Medical Staff, at its quarterly meeting in December, unanimously passed a resolution demanding that CHP send out a letter to the Brooklyn community in this regard, in an effort to counteract the extreme negative publicity generated by the letter that CHP sent out in August 2008 announcing the proposed closures.

CHP has repeatedly refused to send out such a letter, and CHP CEO Stanley Brezinoff stated as recently as Jan. 5, 2008 at the LICH Medical Executive Meeting, that such a letter “Will not be sent”. Although the LICH Medical Staff offered to send such a letter out to the Brooklyn community at its own expense, if provided the database for the mailing, this request was denied as well.

In December 2008, the Chairmen of the Departments at LICH proposed to the CHP Board that all property sales and proposed program closures by CHP be halted until the NY State Dept. of Health makes its final determination regarding LICH. This proposal was voted against by every Manhattan-based CHP Board member, as well as by Board members Joseph Broadwin and Patrick Burns, who are a few of the remaining so-called LICH Board members. Mr. Broadwin is in fact part of a group calling themselves the “Ad-Hoc Committee for LICH”, but this group is clearly driven by its CHP ties and is not acting in the best interest of LICH.

John Wren, the titular “Chairman of the LICH/CHP Board”, has not been heard from in at least six months and clearly has abdicated any responsibility regarding LICH.

There is currently very little if any LICH voice on the CHP Board.
CHP CEO Stanley Brezinoff, who stated in August 2008 that if his plan to “close OB, Peds, and sell real estate” was not accepted, he would close LICH by year’s end, now says that “LICH will not be part of CHP, but if LICH is not merged with Downstate Medical Center, which I’m working on, it will close”.

CHP continues to attempt to sell off LICH properties – several LICH brownstones have recently been summarily emptied.

The LICH Medical Staff and its team is in active, ongoing discussions with the NY State Department of Health, DASNY (Dormitory Authority of the State of New York) and HUD (the holders of the LICH property mortgages), as well as the NY State Attorney General, and we have presented our plan for the preservation (and liberation) of LICH. These discussions have been constructive and well received by the authorities, and we are hoping to report a positive outcome in the very near future.

We still need support from all of you – the community, the elected officials, physicians and staff at LICH, and everybody else – we need letters, emails, meetings, articles, press contacts, etc……… the more you do, the better for LICH!

Thanking you all for your support of LICH, and hoping for a Happy New Year in the very near future for LICH.

The Medical Staff of LICH