Let's not rush St. Mary deal

The first reality check in the struggle to save St. Mary Hospital is at hand. It is the ordinance now before the City Council which, if approved, will put the full faith and credit of the City of Hoboken in a guarantee of a $52 million bond issue in support of the hospital. The language in the ordinance is astoundingly clear: "the City shall be unconditionally and irrevocably obligated to pay the principal of and interest on the (bond) and the City shall be unconditionally and irrevocably obligated to levy ad valorem taxes upon all the taxable property within the City for the payment thereof." (Ordinance for The Hoboken Municipal Hospital Authority Bonding, Section 1)

City Council President Richard DelBoccio quite rightly pulled the ordinance from the Dec. 6 council agenda in order to have time to obtain a review of and opinion on the bond issue from the state Local Finance Review Board. This would be, to our knowledge, the first independent look at the structure of the bond issue. We fear, however, that unless Mr. DelBoccio receives the support of a majority of the council members that pressure will be applied to move quickly and the bond issue will be back on the City Council agenda on Wednesday Dec.20. It should not happen.

Why the rush? Cannot Hoboken be given more time to examine the issue and to get responses to unanswered questions? Why couldn't the bond issue be supported by a lien on the hospital property itself rather than with the city's guarantee? Why must there be a guarantee at all? A bond advisor present at one of the Hospital Authority Board meetings noted under questioning that it is possible a bond issue could be financed without a guarantee. The effect would be about a 2.5 percent increase in the bond rate (from 5 to 7.5 percent) and a longer time to process the issue. But, it could be done.

The Hospital Authority's Business Plan notes that St. Mary is not sufficiently compensated for care given to the underinsured and the uninsured that use the ER and the Family Health Center. Reimbursement comes from federal funds called Disproportionate Share (DSH). St. Mary provides care for approximately 32,000 ER patients a year with one-third coming in under Medicaid and over one-third uninsured, leaving less than one-third paying full cost.

The hospital provides a "safety net" for patients from Union City, Weehawken, West New York, North Bergen as well as Hoboken. Isn't there some way that these other cities could be tapped to pay a portion of their residents' care? Even though the hospital will receive $15.8 million in improved DSH funds, those will be "reduced or eliminated" in about three years (Hospital Plan). Could the Hudson County Improvement Authority be a source for assistance in spreading out the unreimbursed care? If a bond guarantee is absolutely necessary, could the HCIA provide at least a portion of the guarantee, thereby sharing some of the costs with other municipalities?

We all want the hospital to survive. We all want to be supportive. The Hoboken Quality of Life Coalition urges that the council keep the bond ordinance off its agenda until the Local Finance Review Board has delivered its review and comments. The QLC puts forth questions as a way to possibly open the way to revisit plans that have been made in haste to meet a Jan. 1, 2007 deadline (imposed by Bon Secours?). In the rush to meet this deadline the City Council has not even seen the terms of the contract that will be offered to Harvey Holzberg to operate the hospital, nor has it seen the details of the agreement for the city to take ownership of the hospital. These are two critical pieces.

The council is faced with a momentous and far reaching decision. Please give Hoboken a break so that the council may make decisions based on knowledge, not pressure. We have to make certain that Hoboken's eyes are wide open.

BOARD MEMBERS HOBOKEN QUALITY OF LIFE COALITION, INC.

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Jersey Journal   11/10/2006

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Jersey Journal ,  9/1/2006

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Jersey Journal,  October 4, 2006

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Agenda of the Hoboken Municipal Hospital -  meeting 10/25/2006 ----   check out the budget.

See budget line item:  Hospital Organization Costs  $320,000.....

This hospital may become the "great sucking sound" as it pulls down the taxpayers of Hoboken...

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Much still unclear, but mayor and gov report 'commitment'

HOBOKEN - City Hall may soon be getting into the hospital business.

In the wake of news that a proposed deal with University of Medicine and Dentistry of New Jersey to take over
St. Mary Hospital had fallen through, Mayor David Roberts and Gov. Jon Corzine met with employees yesterday to float the possibility of a city takeover of the financially ailing 328-bed hospital.

"If I were a betting guy, I would say there is better than a 50/50 chance we'll get through this," said Corzine, a Hoboken
resident.

"I'm as certain as I could be that we're going to maintain our hospital," Roberts said after the meeting.

But Roberts and Corzine could offer no specifics about how the city, which struggled to balance its own budget this year,
could afford to operate the 1,000-employee hospital, which has lost an estimated $118 million since January 2000.

"This is not a subsidy . The city is not, in any way, going to suffer from economic difficulties from this proposal," Roberts said, adding he couldn't provide any information about the proposal due to pending negotiations.

City officials said Bon Secours Health System, the private Catholic health care system based in
Marriotsville, Md., that has operated the hospital for six years, would give the city an undisclosed amount of cash to help
pay for the cost of operations during the city takeover and reorganization.

However, it's unclear as to whether the city would ultimately have to pay Bon Secours to buy the hospital
and its property.

City officials said they're also still trying to determine how the city would operate the hospital - whether it should, for example,
be managed by an autonomous board or agency.

The potential city takeover would still have to clear a number of state bureaucratic hurdles, but a
"handshake" agreement could be in place as early as next week, officials said.

Corzine told the packed house he supports the city's proposal and promised to help find additional state
aid for the hospital.

"We do not have a plan in place today, what we have is a commitment from a group of public officials to
work on the situation to actually put a permanent and economically viable solution that serves the community," Corzine said.

In January, officials with Bon Secours submitted a certificate of need to the state, saying it can no longer afford to operate the hospital.

Newhouse News Service staff writer Angela Stewart contributed to this report.

Hospital 'miracle worker' tapped for duty

HOBOKEN - If the city does indeed take over the beleaguered St. Mary hospital, it will be up to Harvey Holzberg to turn it around.

Calling him a "miracle worker," city officials say Holzberg has a long track record of curing the financial
woes of ailing hospitals, including the Jersey City Medical Center.

"He's turned around three hospitals, and I am optimistic that he can do the same here," said Hoboken
Mayor David Roberts, following his announcement that the city is exploring taking over the hospital.

Holzberg retired last year as the president and chief executive officer of Robert Wood Johnson University Hospital in New Brunswick, where he served for 15 years.

Holzberg was also president and chief executive officer of Jersey City Medical Center for six years. Before that, he was senior vice president of administration at Lutheran Medical Center in Brooklyn.

Asked about his preliminary preview of St. Mary's situation, Holzberg said: "We need to find ways to get more money from the state and we need to offer a better alternative to people who are now going to Manhattan to get treatment."

Holzberg refused to say whether layoffs would be part of the strategy, but he did provide some observations.

"Up until now, I can proudly say that in my three decades of experience, I have never been involved in layoffs," he said.

St. Mary staffers hear 2, cheer, but want specifics

HOBOKEN - About 200 medical staff packed into a conference room at St. Mary Hospital yesterday initially heaved a collective sigh of relief, then burst into applause after hearing Mayor David Roberts and Gov. Jon S. Corzine announce they'll work together to save the financially ailing hospital.

But they also left wondering how much longer it would take before the details of the plan would be announced, and exactly what the outcome would be.

Dr. Tom Azzolini was the first in the audience to stand up and announce the staff members want to save their hospital.

"We are flexible and we are willing to do whatever it takes to keep it open," he said. "I think I speak for everyone here when I say we are not ashamed to say that we are desperate."

Dr. Barbara Pearlmutter followed, demanding specifics on the new plan for staff who felt sidelined.

"We need more than we're going to have plan A, B, C and D that we're working on," she said. "We need something tangible. Give us something we can sink our teeth into.

"We have people here who don't know what they should do. Should they look for another job at another hospital? We want to stay here - help us do that."

After the meeting, Nurse Janette Cucchiara said she was relieved to hear from Roberts and Corzine.

"I feel much better that we have a lot of powers-that-be on our side," she said. "I have been here 30 years and believe the hospital will go on another 30."