Discussion On Hospital Issues Continues In Council

Council President and Ward IV Councilwoman Mary Louise Madigan called the February 17, 2015 Council meeting to order at 7:35 P.M. She then went on to deliver reports from a number of Committee of the Whole meetings.

The first meeting they had was with Cuyahoga County Health Commissioner, Terry Allen. Council asked Commissioner Allen to give them the current perspective on health and wellness and what it means to a city with the size and demograpics of Lakewood. They also wanted to know about population health and the social determinants of health. Lastly they wanted to review what services Lakewood currently contracts out with the County.

Councilwoman Madigan noted that his responses would be twofold, both helping them understand the landscape of the changes in healthcare nationwide, and also to help understand the context of the changes in healthcare in Lakewood, including the changes in Lakewood Hospital.

Before hearing from Commissioner Allen, Director of the City's Department of Human Services, Toni Gelsomino, gave Lakewood's perspective of what is needed including current and future investments in public health, and how to help keep families strong, children ready for school, seniors supported by their community, and community health and wellness.

Commissioner Allen began by explaining to Council that population health is the alignment of public health and medicine. These are broken down to several impacting factors including housing, education, air and water quality, transportation, safety, health behaviors, and clinical care. Commissioner Allen said national research shows health outcomes (quality and length of life) are impacted by many things other than medical care, including many of the factors above. Decisions on diet, exercise, and chemical use, as well as social determinants of health - which can sometimes be out of a person's control, such as air and water quality, education, income, safety, family and social support, and others - all have roles to play. The research shows that only 20% of a person's health outcome is determined by their access and quality of care. The other 80% is determined by policies, programs, and personal choices.

Council asked Commissioner Allen about relevant health risks, current health treatments, and appropriate ways to measure health in Lakewood. The report did not elaborate on the answers to those questions, but stated that, “It was a vibrant discussion.”

After the discussion Commissioner Allen said the County was available to help answer any further questions.

Councilwoman Madigan then began delivering her report for the next Committee of the Whole meeting. This meeting was with Lisa Fry of Subsidium Health Care, the consultant hired by the Lakewood Hospital Association to look at the future of the Hospital. Ms. Fry presented a slide show on the process she and Subsidium took to reach their conclusions. Members from Council asked her questions in relation to the properties involved, value, finance, service trends, and changes in service since the lease began. Some Council members shared concerns about being able to trust The Cleveland Clinic as a partner in the future, based on the current perception that services have been systematically removed over time.

Councilwoman Madigan reported that the slide show that was shared to them in their Committee of the Whole meeting with Ms. Fry is available on OneLakewood.com.

The last Committee of the Whole report was in regards to a proposed sale of the former McKinley Elementary site to a developer. The property is approximately 2.88 acres and the proposed purchaser, Liberty Development Company, would buy it for $500,000. Liberty would use the property to build approximately 40 residential units. The conversation over the sale of the property began in the fall and included many aspects that were mutually important to both the City and the schools. Some of those points included creating new residential options, bringing additional consumers in to that area, and adding to the taxpaying base to support the schools, the City government, and other public agencies. The discussions were largely public and included the Planning Commission and the Architectural Board of Review.

Councilwoman Madigan made a point to say that the $500,000 sale price will cover the City's cost of demolishing the building, clearing the land, and cleaning and maintaining the property for nearly two years. The Committee of the Whole unanimously recommended the passage of the ordinance by Council.

Also discussed at that Committee of the Whole was an appointment to the Planning Commission, which Councilwoman Madigan said they decided to defer. However, when the report was done and Council moved on to the next point of the agenda, which was the resolution for appointing someone to the Planning Commission, Councilwoman Madigan moved to defer, while Councilman Sam O'Leary (Ward II) moved to amend at the same time. A movement to amend is proposed so a name can be placed in the blank of the current ordinance and then subsequently passed.

As Council President, Councilwoman Madigan moved forward with the movement to defer by asking for those in favor, before deferring to Law Director Butler for procedural clarification. In the intermittent awkwardness Councilman O'Leary reasserted that he would like to move to amend. Director Butler then told Councilwoman Madigan that the vote to defer was inconclusive so they would have to take a role call. Upon taking a roll call Councilman O'Leary said no, as did Councilman Tom Bullock (At-Large), after a substantial pause. The rest said yes, though Councilwoman Cindy Marx asked for clarification, which she did not appear to get to her satisfaction, but said yes regardless. No further clarifications was given in regards to the disagreement.

Council then proceeded to pass the ordinance discussed in the Committee of the Whole report above, approving the sale of the McKinley School site.

Councilman O'Leary then asked Council to join him in drafting a request for Qualifications to identify a firm that could produce a study of the economic impact of the closure of Lakewood Hospital and the further impact of the proposal set forth in the letter of intent submitted to Council. In his letter, Councilman O'Leary discusses the integral part the Hospital plays in Lakewood and says he wants to be able to understand the full impact of the loss of it, not only on the City's finances, but also the impact on local businesses that are patronized by the patients, visiting family, and medical staff of the Hospital, the businesses that supply the hospital, the workers and residents that are employed by all of the above businesses, and Lakewood residents in general. Also of concern is the possible “exodus” of medical professionals and their associated practices, which will follow the relocation of the main services of the hospital. He said he thinks it is essential they both identify and measure the impact of this change to possibly help alleviate some of the consequences.

Councilman O'Leary recommended it be deferred to the Committee of the Whole for discussion.

Before voting there were some questions from members of Council. First Councilman Shawn Juris (Ward III) asked for some clarification. He said they could certainly discuss it in the Committee of the Whole but they already have a full plate and he thought maybe they could talk through some of it before then. He asked if they were weighing two specific conditions and if so what those condition were. He also asked what specific variables were to be considered and what time frame they would use for the study. He made the point that in 1996 Lakewood Hospital had substantially more employees and yet with fewer now there are many more, and quite successful, businesses in the area.

Councilman O'Leary responded that as a starting point they can look at the conditions of the letter as a guideline, looking for the impact on the city as it is today if the proposal moves forward. He also said that the point of his letter was to seek the kind of discussion they were having right then. He wrote it seeking input from other members of Council and the Administration to find out what exact conditions they all would want to see.

Councilman Juris responded that he still lacked clarity on what criteria they were comparing. He also said he wasn’t sure what the legislative intent for the study was. In addition, he raised concern on the lack of a time line, stating it could take weeks to put an RFQ together, and weeks to get responses and so on. He also thinks some of the information this study would be contracted for would be covered in processes already in progress.

In the end, he said he thought it was okay to put it in queue, but thinks it is premature and too undefined to bring to committee. He said, what is the cost, what is the time line, and what are they deciding on? Those are things that should be cleared up before they hold meetings on it.

Councilman O'Leary said he appreciated Councilman Juris's concerns and is with him in wanting to “see this information yesterday,” especially knowing that conversations had been going on for some time. He said the reason he wanted to start this process now is so they didn’t find themselves 12-16 weeks down the road wishing they had had the information, or at least had already started the process by then. He agreed that he thought plenty of time could be spent offline, out of meeting, working on a draft RFQ; however, he wanted to start with a group discussion. It was never his intention to bring a completed RFQ in and simply ask for an up or down vote, in fact he said that that was, “something I was trying to stay very clear of.”

Councilwoman Madigan then asked Councilman O'Leary how much he planned to set aside to pay for the study. She said that Council has about a $10,000 budget for consultants.

Councilman O'Leary said that he thinks it is reasonable to consider spending as much money on a study to get the facts as the administration is spending on a communications team that is conveying them. When pressed further he said he did not know an exact dollar figure at this time and more information would be needed before deciding that.

There was some further discussion and clarification requested before Council voted to move the issue to the Committee of the Whole.

Coming to the end of the meeting, Council President Madigan adjourned the meeting at 8:53 P.M.