The great hospital debate may start out muted when it reaches the city commission Nov. 12.
When Lawrence Memorial Hospital trustees appear before the city commission next month, there may be little said by anyone about the relative merits of Columbia/HCA Healthcare Corp.'s plan to build a competing hospital in the city.
Mayor John Nalbandian expects a narrow discussion about whether the issue should be sent back to the Lawrence-Douglas County Planning Commission, which approved Columbia's plans on a unanimous vote Sept. 25. LMH didn't send anyone to oppose Columbia's plans then.
Last week, however, the city hospital's board voted to oppose Columbia's plan to build a $20 million, 70-bed hospital at the northwest corner of West Sixth Street and Folks Road.
Hospital board chairman Ray Davis said the board needed time to weigh its options.
Now the hospital board hopes to convince city officials that Columbia's plan should be stopped. Financial advisers for the hospital believe the construction costs and other competitive expenses will result in higher hospital charges in Lawrence, and that the city hospital will lose value and struggle as it treats more of the city's poor and uninsured while Columbia takes care of wealthier patients who can pay for their services.
In other words, the hospital board will argue that a second hospital in Lawrence, when all is said and done, will be bad for the community.
Columbia executives have already argued just the opposite, that competition will lead to improved quality, if not lower costs, and that there's room for two hospitals to compete and survive in Lawrence.
The LMH board will take its case to the city commission on Nov. 12, when commissioners are scheduled to consider the planning commission's recommendation.
The hospital board will ask city commissioners to return the issue to the planning commission for further study.
Mayor John Nalbandian said this week that the meeting probably won't include any great debate on the Columbia proposal or the hospital's opposition to it. He doesn't expect to have any analysis prepared by a city attorney or staff in time for the meeting.
Given that the city commission has sent other proposals back to the planning commission, there may not be much discussion at all. Nalbandian said there also may not be any public comment taken on the issue at the Nov. 12 meeting.
But not to worry. If the site plan goes back to the planning commission, that will give public officials more time to study the issue. It also will give attorneys for the hospital and Columbia time to refine their legal arguments. Eventually, however, the city commission will address the issue and gather public comment.
"I hope we'll be deliberative, as we are in this city, and I hope that the planning commission will have some patience with us to come back with some additional information," Davis, the LMH board chairman, said this week.
Nalbandian said he hasn't yet formed an opinion on the hospital board's argument against Columbia, but he welcomed the response from the hospital board. Columbia revealed its construction plans in August.
"I'm glad the hospital board is doing something," Nalbandian said.
In August Nalbandian said there didn't appear to be many reasons why the city could deny Columbia a land use permit. But he also said there were "a lot" of reasons why the city would not want Columbia building a new hospital in Lawrence.
Before sending the matter back to the planning commission, city commissioner Bonnie Augustine wants assurance that the planning commission is going to hear new information that wasn't available the first time around.
"I do think it's unfortunate that they have to turn around and possibly hear it again," Augustine said. "I wish all this had been addressed at the first meeting."
Commissioner Allen Levine won't need to be convinced of anything on Nov. 12. If the hospital board wants to send the issue back to the planning commission, that's good enough for him.
"I'm happy to send it back to the planning commission," Levine said. "I think we've got a terrific hospital board. I think it's a pretty fair cross section of the community and I'm willing to give them a lot of leeway. I think the hospital board is extremely well-educated on how to approach these problems. They certainly are experts in the field far and above those of us on the commission."
Levine said the hospital board should take its case to the planning commission, even if it is late.
"If we're talking about the health care of the citizens of Lawrence, I want to look at this as carefully as possible and I want all sides to have their say," Levine said.
Meanwhile, Columbia, the nation's biggest for-profit hospital chain, has yet to decide whether it will actually build its proposed hospital in Lawrence even if it is approved. That decision is now in the hands of Columbia executives in Nashville and should be made by the end of the year.
Columbia already operates an outpatient clinic at Clinton Parkway and Kasold Drive, and it owns two medical practices. It's also in discussions to purchase a third, Lawrence Family Practice Center.