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The Lucknow Sentinel, 1979-12-26, Page 11The Wingham and District Hospital Board passed a motion on May 16 to main- tain 100 beds at the hospital at all •eeStS and,if necessary, take the province to court to obtain the money to operate the 14 beds declared surplus by the ministry guideline. If negotiation fails, the board decided they will have no recourse but to opt opt of medicare and bill Ontario direct ,-for services at the hospital. Deputy health minister Allan Dyer informed the board at a meeting in Wing - ham on May 8 they would not be perniitted to use the 14 surplus beds ad "floating beds” as they, had been • promised at a previous meet- ing with the health minister • Dennis Timbrell. The minist- ry has. sal they would convert seven beds to chronic care which would mean an additional $40,000 'being ad- ded to the hospital's budget. • The board has decided to stand by its previouS decision to keep open all 100 beds because the hospital cannot show they are needed for • • ospt a OHIP Wingham ' and District Hospital has decided to bypass the provincial health care .system and has billed 01 -HP. directly - for patient care at the hoipital for the months of May and June. The hospital billed01-BP •ata 'rate of $l 10 a day: for patients treated in the hos- pital making a bill of about $500,000. • • Wingham asked OHIP for pay within 1-5 days and the bilis were sent in a week ago. • - Executive director of the • hospital, Norman Hayes, an- nounced the bills had been sent to OHIP it the inaugural session of the 1979-80 board of goverriers of the hospital • on June '27. • Hayes did not know the amount billed for outpatient services because the type cif services varied. • • Thehospital submitted The bills. because there is "a need for clarification" as to where the hospital stands in its ,dispiite with the Ministry f Health. T ministry dared 18 beds surplus in January and cut $168,000 from the hospital's global • budget for this .y ..ear, The hospital decided to maintain its 82 active treatment beds because the hospital admini- stration and board of gover- nors believe all the beds are needed at the hospital. Hayes said if they don't get funding necessary to run a 100 bed hospital, " it is self-evident we are facing a deficit' '.' • •NOT I/4 01HP • Hayes disagreed the hos- pital was opting out of OHIP because ."you can't opt out of something you were never in". OHIP is a payment mechanism for the patients who are in it he said. WS a third party payment system and the hospital is not in it. "The hospital is simply asking to be paid for services rendered," flayertaid. ".11 ta! • chronic care. Boris Milosevic, assistant chairman of the board, told the meeting he contacted Liberal MPP Murray Gaunt who has arranged a meeting ' between the Wingham Hos- pital Board and the House Committee Friday, May 25. The board will negotiate with the ministry --for the addi- tional $142,000 required to operate all 100 beds at the •hospital. If the board fails to obtain the $142,.000 they will take. the necessary legal steps to test their billing for services in the courts. The board's solicitor, Bob Campbell, said it comes down to whether the province has •the right to close •hospital beds, Hayes said there is no provision in the Health legislation for the ministry to impose bed rati- os. 11e said he does think the health acts do force the - •ministry to pay for patients' hospital expenses. The whole' basis for the court case is being paid for work done which is common law said Campbell. The hospital will have to prepare a cost accounting system to • determine reasonable charg- es fot services available and the court will oversee fair charge for services rendered. The only way .to •obtain something definite from the ministery is to take' legal proceedings, said. Campbell: "You must hit them where HIP • • t Lneknow Sentbsel, We4nOilday, December 26, 1919-f,rlejige 11 it hurts," he commented. To aveid the publicity of a court battle with the Wingham Hospital, Campbell believes the government will probably eome up with a proposal acceptable to everyone. "We have .a good case,3 said Campbell. Hayes refused to rework the figures, of a hospital study to show Wingham needs 14 chronic beds to allow the surplus beds to remain open as chronie,beds, because they are needed for active treatment. The ministry •cannot un- derstand Wingham Hospital sees patients who_are chronic in nature in hospital for a few • days at a time as active patients said Hayes. He implied the ministry sees these patients as chronic even 'though they require active treatment while they are in hospital. The board decided not to persue a Health Service Or- , ganization because under the ministry's concept as outlin- ed by Dyer at the May 8 Wingham and District Hospital has announced the closing of 14 of its 82 active treatment beds and the lay off of 12 • full time staff effective September 21. • The hospital board unan- imously decided to close the beds .at a closed session September 19 to avoid an increasing deficit, situation. Executive director Norman Hayes said the hospital had an estimated budget deficit of more than $46,000 at the end of August and would face a deficit in the neigh- bourhood of $150,000 by the end of its fiscal year next March. By closing the beds •and reducing the 'staff, Mr. Hayes estimated the total deficit could be held to about $50.000: 6 meeting, it is an alternative method of closing beds. "Only we do it ourselves," remarked Dr. Doug Mow- bray. Dr. Dick Treleaven asked Mr. Campbell if the govern- ment would pass "legislation to close the beds if Wingham won their „Ease in court. Campbell answered the: gov- ernment talked of legislation when they were trying to close Doctors' Hospital in Toronto but they never took it to the legislature., Treleaven remarked the reason was political because Doctors' liciSpital •is in riding the government won by a very small margin in the • last election. Dr. Treleaven warned the board the -province will fight with all the assets and resources they've got. They let Clinton Hospital stay open because it did not mean that much but Wingham is a different case he said. It will mean every hospital in the province (will use Wingham :...ase as a precedent). ito.101-:(*.e$°, beds omic loss te the communities in an area where employ- ment is difficult to find. The board promised to continue to press for restora- tion of both beds and jobs through court action. Emergencies will continue to be dealt with immediately; but elective surgery will be -placed on waiting lists ac- cording to priority. To accommodate the bed • closures, the pediatrics ward, has been moved to the second floor and the number of chrenic care beds has been increased to 25 from 18. The 12 staffmembers hive - been placed on indefinite • layoff which means,. should a • part •time position become available, they will have the • first opportunity to apply for In a press release follow- • . refuses. ing the board's closed ses- • sion, .the board said it deplores the reduction in • to pay service to those cared for, the • • • those al o an t e econ- th'e position. The layoffs were not directed at one sector of hospital staff but rather across the various types of positions. Six months ago the hospit- al board voted to resist closure of a single bed by every means at its disposal. The cutbacks were announc- ed five months after Mr: Hays assured the board and members of the Citizens' Acticin Committee there would be no layoffs or reduc- tion of services at the hospit- al this year. At that time, Mr. Hayes reported .the. Ontario Health • Ministry had premised ade- quate funding to allow the, hospital to continue operat- • ing 100 beds for at least another year. The ministry subsequently denied this and • funding was not restored, Recently, the'ministry re- peated its offer, td let the hospital convert seven of the 14 active treatment beds scheduled for closure to chronic care -and added more than $54,000 to the budget. The board.accepted the offer, but the deficit was so huge, the board decided to close the I4 beds. The hospital is now in line with the ministry formula of 3.5 active treatment beds per thousand of referral popuia- flan, which it had been order- ed to meet -by next year. . Active treatment beds haye been reduced from SI to. 61 • and chronic beds have been 'increased from 18 toJ25. decides not pergue le al action Hospital boa -rd ' . • hardship to the families "f to The Ontario Hospital In- surance Plan has notified • Wingham and District Hos- • pital it refuses to pay bills submitted by the hospital for services rendered during May and June. Hospital ad, ministrator, Norman Hayes, • said OHIP has acknowledged receipt of the hills but has declined to pay them. • The board has retained Toronto lawyer, Warren Sey- fert, to handle its case to avoid bed closures against Ontario Ministry of Health. • Mr. Seyfert is a member of , thelaw ,firrn that handled the • case for Doctor's Hospital in Toronto when it was threat- ened with.closure three years ago. The Ministry subse- quently dropped plans to dose that hospital. Hospital board. chairman, Boris Milosevic, said Mon- day Mr. Seyfert is still In the • process of assessing • the • board ' s case and will inform the board how they stand by Thursday of this week. In the meantime the hos- pital continues to receive its regular budget from the health ministry, although ex- ecutive director Hayes earl- • ier warned the beard this will probably not be sufficient to see' it through the year. Nearly $170,000 was deduct- ed from the budget this year in an attempt to force closure of 14 active treatment beds. • According to Milosevic, the board .has not yetitAtade the deeision to proceed with legal action and -in the mean- time is looking for a show of • public support in its Opposi. tion to the bed closures.. • • • attk bed issue • The Wingham and District • Hospital is prepared to fight. Last week the hospital board announced it had decided to take the Ministty'. _ of Health to court to contest an order to reduce the nuM- ber of beds.. • H•spital board chairman, Bora \Milosevic issued the statement last week. The action follows the January order of the Ministry to the Wingham and District Hos- pital Board to close 14 beds. The board has retained the Toronto law firm "of Lang, Michener, Cranston and Far- quharson to act on its behalf in the action against the Ministry. The Ministry tried to force • the.board to comply with the closure • issue by deleting $168;000 from the operating budget. Last *month the board claimed the govern- ment refused to pay bills in • the amount of $205,000 for patient care during April and May. The board said it.would not send the government any further bills. There was no indication as to what course of legal action the board would initiate against the ministry. • Wingham and • District Hospital board of governors. decided Wednesday night • tJiey will not proceed with legal actichi against the Min- • istry of Health in their •• dispute to keep hospital bests open. •V. The board's management Committee Met before the Meeting and made a recom- mendation •to .the board that the legal action be dropped in view of the obvious lack of support from' the municip- alities using the hospital. Dr: Wilkins and Raye Elrnslie opposed the motion. • John Maim of the Citizens Action Committee, reported to the board their efforts to raise money for legal costs Wad failed. Only East :Wawa - nosh supported the appeal. ,Dr, -Douglas Mowbray sta- ted the managernent commit- tee and the board really had • no alternative due to the total lack of support from sur- • roundfq Municipalities. "They've cast the dye and will have to live with the results," he commented. On • a recommendation from the hospital's medial staff, the hospital will invite a joint committee of the Ontario Hospital Asktecjation and the College of PINcians to examine bed utilization at the hospital. The ministry has told the board there will be no negotiation of the hos- pital's funding until such a study ,is done. The board's Motion stipu- lated that the ministry be requested to provide *len terms of reference and their recommendations, stating the study is their wish. • The board fears the study will becompleted and then the ministry will change their terms of reference making the study an exercise in futility. The board made it clear ' the study is being done to • Continue negotiations with • the ministry over bed clesur- es and budget cuts. The hospital board is not conduct- ing the study to determine a lapse in medical standards at • the hospital. • osptia receives additional funding Wingham and • District • Hospital has received $45;000 from the Ministry of • Health to be applied towards its operating budget for this year. When the budget was • submitted to the ministry; the hospital was $56,000 over the ministry's net liability and would have operated at a deficit, if more funds were not obtained from the minis- try. " The Ministry of Health has had to review hospital bud; gets in the province because many were submitting bud- • gets with operating deficits. Ministry cost cutting pro- granis were reducing funds for operating budgets to the point where hospitals were submitting deficit budgets. The ministry will grint an additonal '1.5 per cent -of the original allotment to hospit- als with deficit budgets, if the hospitals adhere to there criteria. • • Winghan met the follow- ing criteria to qualify for the additional 1:5 per cent.. The hospital plosed. 14 beds to meet the ministry's'becl level guidelines and undertook a - cost containment study with . • the Ontario Hospital Assoc- iation (OHA). Despite the study, the hospital was un- able to brinriin a budget • under their original net lia- bility and.therefore, qualified for the additional funds. The hospital is still nego- tiating for the balance of their operating deficit which amounts to $10,500. The cost containment study by OHA to determine cost saving had identified $2,000 the hospital can save. Another study, retommend- ed by the hospital medical staff in October, to study utilization of services, v/111 get underway this Week.