Delaware County Board Passes Emergency Hospital and Physician Services Ordinance in Light of Potential Crozer Changes



Kevin Madden, Delaware County Councilman.

MEDIA – In light of Crozer Health’s decision to recover $24 million in expenses from Delaware County and several municipalities – or to end various mental and behavioral health, addictions and allied health services – the county board of Delaware passed a unanimous emergency ordinance requiring time padding if some of the closings are to occur in the future.

“It’s no exaggeration to say that Delaware County faces an emergency here,” County Councilman Kevin Madden said, particularly for medical services in vulnerable areas of the county, whose need has only been exacerbated by the COVID pandemic. “It is our responsibility to ensure the health and well-being of our residents and the idea of ​​a for-profit provider using a short period of change that would have such a significant impact on our population as a means of obtaining an additional reward is something we cannot accept.

He said passing the emergency ordinance, effective immediately, was a matter of ensuring public safety.

“All of this gives the county and the hospital system time and planning,” Councilwoman Elaine Paul Schaefer said of the emergency order. “That’s all it is. It’s pretty reasonable. »

Then, she added, this drastic measure is necessary because she added: “This is a crisis that we are facing. This is a crisis happening right now and centered on our most vulnerable communities… Terminating services like this without notice will put thousands of our vulnerable residents at risk and we are simply asking for time and plan to make sure the transition of health care for these residents – thousands of them – goes smoothly.

Last week, Crozer chief Kevin Spiegel sent a letter to executives at Glenolden, Prospect Park, Tinicum, Norwood and Ridley Park, telling them that a $336,000 funding deal for the Advanced Response Vehicle Life Support, also known as chase car, providing paramedic services for these communities was to take place by April 22. Otherwise, 90 days notice of discontinuance of these services would occur on that date.

In addition, Crozer Health System‘s behavioral and mental health and addictions outpatient services that assist approximately 6,000 Delaware County residents are also at risk from what Spiegel says is a $20 million reimbursement need from the part of the county.

By a 4-0 vote, the board passed the emergency notice that requires 180 days notice to the county of any decision to close all or most units of a hospital or “impact units.” significant” such as emergency services, ambulance services, labor and delivery units or behavioral health services.

Additionally, a closure plan must be submitted to the Delaware County Health Department no later than 120 days from the planned closure date.

This plan should include continuity of patient care, diversion of patients from emergency departments to other services, processing of medical records, and a formal communication and engagement plan for the affected community. In the event of non-compliance, the county attorney could seek legal action.

The emergency order also requires hospitals and long-term care facilities to provide
Notice of Intention of Plans to Purchase, Sell or Transfer Interest in At Least One Hospital or Facility
less than 45 days before the scheduled transaction.

Supporters of the ordinance included Madden, Schaefer, and fellow council members Richard Womack and Christine Reuther. County Council President Dr. Monica Taylor was absent from the meeting.

Spiegel said the processes are already in place, as required by state law and the Pennsylvania attorney general’s office.

“It just adds an extra layer that could hurt the sale,” he said of the emergency order’s potential impact on the sale of Crozer Health to ChristianaCare Health System, which should be completed by the end of the year.

Schäfer disagreed.

Spiegel said discussions have been taking place with Delaware County Social Services for one to two months regarding outpatient behavioral, mental health and addictions services.

He said COVID had increased staff prices by 25% and supply costs by 15%.

“We went to the county and talked about additional support for the behavioral health program and we came to a roadblock,” Spiegel said, adding that the third-party administrator for Delaware County denied 30% of their complaints, mainly on technical problems. , not clinical denials. “Which really makes it almost impossible to really stay in business and be financially viable. We spend over $20 million providing behavioral health services. We went to the county in good faith to try to negotiate it. We We’ve always wanted to move this time forward with the notice of cancellation. We’re still open to negotiating with the county, but we submitted it legally and on time.

He said he had never been to a county where the county does not provide pre-hospital care.

“Most cities, from my past, provide police, fire and EMS,” he said. “Here, it’s up to a voluntary agency or a for-profit company to do it at their own expense. And, you know, we can’t do it for free… We can’t do it at a loss.

He said that the advice given to the municipalities was in accordance with the law.

After the vote, Spiegel said, “Crozer Health System is proud to provide both behavioral health and EMS services to this county and the communities we have served for many, many years. This is something we are very proud of. Funding – proper funding – from the county is essential for us to continue providing these services.

He said talks with the county had come to nothing and that “the lack of response really drove the notice.”

“Hopefully now that everyone is aware, maybe we can work these things out and that’s our intention,” Spiegel continued. “What we would really like to do is for the county and us to sit down and work.”

Prior to her vote, Madden noted that the board cannot compel a private organization to do what it decides is in its best interest.

However, he added, “what we need to ensure is that if there are any changes, they are made in an orderly manner that allows our audience to find alternative ways.”

Womack acknowledged that many have been impacted by COVID – including Crozer Health, those who have lost their jobs and others.

“Everyone has suffered a loss,” he said. “And almost coming out and saying, ‘Okay, we’re going to give you short notice that we’re leaving’ is really unacceptable to people in Delaware County.”

A resident of Darby Township, he says he knows what these residents face.

He said these municipalities need time and this ordinance will give them that time.

Reuther said the Pennsylvania legislature gave responsibility for ambulance services to municipalities, and over time local hospital systems purchased and took over those services as the skills needed for them increased.

“They could do it more efficiently and they also had a line to move patients to their hospitals,” she said.

She said the parts of the county that tend to rely disproportionately on hospital EMS services also tend to be the most under-reimbursed areas for insurance, due to need for medical assistance or underpayment. -assurance.

“It’s not the county’s responsibility that we got into this situation or the responsibility of the individuals,” Reuther said. “It’s the evolution of the health system… In the meantime, we have a problem. Ten days is not a lot, especially with municipalities that have already set their tax rate for the year.

Meanwhile, she said Crozer Health — for the past six months — had been the winning bidder for needed mental and behavioral health services in Delaware County.

“Now they’re telling us that during COVID…that they lost all that money,” Reuther said. “So why in the past six months would they have submitted this proposal?”

Backing the emergency order, Reuther said, “If they have to shut down anything else, I want the 180 days (notice).”

During the public comment section, John McBlain of Aldan, who previously served as chairman of the Delaware County Council, thanked the council for considering this emergency ordinance and urged them to pass it.

“Less than 10 days ago without any discussion or notice, at least seven municipalities received letters telling them within 10 days if they did not reward Crozer, that the services would be terminated and this constituted their notice,” he said. -he declares. “(He) emphasizes the need for the planning, the notice provisions that you have provided in this order and an orderly plan.”

McBlain agreed that a future discussion on the management of EMS services would be a great thing to do.

“As the world changes, we must continue to do so,” he said. “But generations of Delaware County residents have trusted Crozer with their health care – everywhere from maternity services to regular services. Crozer has been rewarded by the people of Delaware County for a very long time and they have been very successful for several years.

Owned by for-profit Prospect Medical Holdings, Inc., Crozer Health has gone through a list of changes in recent months.

Last month, Crozer announced the temporary closure of Delaware County Memorial Hospital’s 215-bed certified intensive care unit and surgery unit in Upper Darby by May 31 due to staffing issues due to of the pandemic.

Two months earlier, the DCMH inpatient obstetrics unit, where around 1,800 babies were born each year, was closed. These services were transferred to Crozer-Chester Medical Center in Upland, leaving only two hospitals in the county providing maternity care – CCMC and Riddle Hospital in Middletown.

In February, Crozer Health closed its inpatient palliative care unit at Taylor Hospital in Ridley Park due to the need for patient safety, declining palliative inpatient care admissions, and challenges posed by the national shortage of nurses.

Also in January, Crozer suspended emergency, pathology, laboratory, and medical imaging services at Springfield Hospital due to COVID overload and suspended the acute substance abuse and addiction inpatient program. in residence (first steps) at the Crozer-Chester Medical Center.


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