What’s up with the Berger Commission?

There are two stacks of documents in my office, totaling nearly 21 inches in depth. These are my notes, letters, worksheets, reports, legal memoranda, and state documents, all of which relate to the Berger Commission.

The Berger Commission is the informal name of the Commission on Health Care Facilities in the 21st Century that last year recommended

“Van Duyn Home and Hospital and Community General Hospital’s (CGH’s) Skilled Nursing Facility be joined…under the control of Community General Hospital, and downsize their combined number of RHCF (residential health care facility) beds by approximately 75” (p.103).

I’ve written about the Berger Commission before. See the previous posts: What the Berger Commission said, I wrote about ‘right-sizing’ before the Berger Commission, and Q&A on CGH & Van Duyn.

The Berger Report is more than a recommendation. According to a 2005 state law, the Commission’s recommendations became law on January 1, 2007 because they were not reversed by the State Legislature in the prior year. Therefore, CGH and Onondaga County, Van Duyn’s sponsor, are legally required to comply.

On July 11, 2007 CGH and the County applied for New York State grant funds so we can comply. The state made $550 million in grant funds available this year to help organizations meet the Berger mandates. The Commission itself understood the need for such funds. Writing about CGH and Van Duyn, it said “The reconfiguration and change of ownership…will require capital support” (p. 103).

CGH’s grant application includes planning money, as well as estimated implementation costs. The estimated costs could change as a result of planning yet to be done.

Figuring out how, exactly, to comply with the Berger Commission has not been easy – despite seven months of discussion with the County and despite a number of Albany trips to meet with the New York State Health Department. As a result of these talks, we have identified two possible models for compliance, dubbed scenarios A and B.

Scenario A assumes the intent of the Berger Commission can be achieved by a cooperative planning structure that involves both CGH and Van Duyn without any change in Van Duyn ownership. Scenario B would involve the transfer of Van Duyn to CGH’s corporate structure as the Commission envisioned. The state has not taken a position on either scenario but has stated an interest in seeing the costs associated with both.

The County prefers scenario A. In fact, the County has filed a lawsuit against the state that would block the Berger Commission as it affects Van Duyn. The Civil Service Employees Association (CSEA), one of the unions representing Van Duyn employees, has also filed suit against the state to stop the impact of Berger on Van Duyn. Both lawsuits are pending.

CGH sees advantages and disadvantages in each scenario and believes the preferred plan will emerge as a result of further negotiations involving the County, CGH and the State.

CGH and the County have a long history of cooperation. In fact, the 43 acres on which CGH sits came from the County in a series of land transfers and purchases that go back to the 1950’s. And CGH’s discussions with the County have been positive and cooperative throughout this process.

We both agree that making either scenario work will require state funds. And whichever scenario is decided upon – or perhaps another scenario entirely – will require adequate time to plan and to implement.

The Berger Commission had a vision for the future of CGH and Van Duyn. “An integrated organization,” it wrote, “will reduce the duplication of services across the two facilities, reduce operating costs at Van Duyn, enable Van Duyn to receive a hospital-based reimbursement rate, and create an integrated continuum of care on the campus" (p. 102).

What are the prospects of receiving grant funds necessary to achieve this vision? It’s hard to say. According to a July 18, 2007 state news release, more than 60 hospitals and nursing homes have applied for the $550 million in available funds.

Stay tuned.