Leading up to the Massachusetts Public Health Council’s October 2016 approval of a Determination of Need (DoN) for Boston Children’s Hospital’s (BCH) massive $1 billion-plus expansion, much was said about the volume of out-of-state and international patients who would purportedly populate the new clinical tower. Indeed, even though the DoN process is specifically meant to ensure that proposed hospital projects are truly needed to serve in-state patients within given regions of the Commonwealth, the hospital itself acknowledged the new building would largely be supported by a surging volume of out-of-state and foreign children. The state, for its part, baked a condition into the DoN requiring BCH to file a report by April 1, 2017 containing “information concerning the degree to which the anticipated out-of-state demand is realized.”
The reasoning behind Condition 8 was obvious – if BCH’s projections for the number of out-of-state patients falls short, Massachusetts patients will be left paying the tab for a project that would be not only the costliest in state history but also superfluous. Following the November presidential election, members of the Ten Taxpayer Group legally challenging the project warned that changing attitudes and travel rules could curb the number of international patients coming to Boston for care.
The answer to whether non-Massachusetts patient volume is actually meeting projections and sufficient to support the new building is elusive, however. In response to a petition from the Ten Taxpayer Group, the state Department of Public Health (DPH) produced BCH’s April 1, 2017 report – which covers only Massachusetts patients. Excluding data on out-of-state and international patients, as required by the DoN, “obviously frustrates the whole purpose of Condition 8,” wrote the Plaintiffs, who on July 27 filed a proposed amendment to their pending lawsuit seeking to rescind state approval of the project.
The amended lawsuit names the state Health Facilities Appeals Board, DPH Commissioner Monica Bharel, Massachusetts Health and Human Services Secretary Marylou Sudders, and BCH as defendants. In addition to violating Condition 8 of the DoN, the lawsuit alleges that the hospital began construction activities associated with the new tower without written approval from DPH of preliminary and final architectural plans, as required by state law, and that BCH failed to implement a plan for communicating the status of the expansion project to community groups, as required by another DoN condition.
Keep your eye on this space for the date of a possible court hearing on this appeal, and other updates on this far from over story.