Alliance retreat on children’s hospital turns focus to VCU – Richmond Times-Dispatch

Businessman and philanthropist William Goodwin on Tuesday said it was sad and a shame that the region’s hospital systems could not come together to develop a children’s hospital.

The Virginia Children’s Hospital Alliance’s Katherine Busser on Monday told Richmond City Council members not to hold aside land on the Boulevard being considered as a site for a children’s hospital and that the alliance was suspending for now its full-time effort to pursue the project.

“I don’t think the alliance is doing anything other than what they need to do,” Goodwin said. “The issue is VCU and Bon Secours said they are not going to cooperate. I don’t know how you can have a children’s hospital without their cooperation.

“It’s a shame that we can’t get together. It’s really sad. I think it’s sad and an inability to work together for the good of the whole community. That’s 100 percent of the problem.”

Goodwin and his wife, Alice Goodwin, had indicated that they would donate funds to cover about a third of the cost to build the facility, projected to have a price tag of $400 million to $500 million.

As for that donation, Goodwin on Tuesday said, “I don’t think it’s going to happen.”

The alliance’s retreat turns attention to VCU, where officials have indicated their recent strategic planning includes discussion of an inpatient pediatric facility.

“The vision of the future is really about care that’s extended out, and we — VCU — can’t deliver world-class pediatrics alone,” said Dr. Marsha D. Rappley, who took over as CEO of the VCU Health System in August.

“Really, it’s going to take all of the people that stepped up and declared their commitment and their passion to serving our children in the very best way possible. It’s going to take all of us together,” said Rappley, a pediatrician.

The alliance, a nonprofit created to broker the discussions between the hospital systems and community partners, had been working for more than a year to get agreement on developing a free-standing children’s hospital that would be controlled by an independent governing body with representatives from the health systems and the community. In October 2014, the Virginia Commonwealth University and Bon Secours health systems announced that they were willing to talk and signed a memorandum of understanding. But the two health systems unexpectedly withdrew from those talks in May.

They gave as reasons the cost of such a project, the changing health care marketplace, lack of Medicaid expansion in Virginia, and the proposed governance structure.

Though disappointed, Busser, the alliance’s CEO, and chairman Wallace B. Millner at the time said their efforts were continuing. The group’s decision to scale back for now came in recent weeks. They had been working against a deadline of early December to file a letter with state health facilities regulators to indicate their intentions.

Efforts to develop a free-standing children’s hospital for the Richmond region date back decades. Pediatricians Associated to Care for Kids, a grassroots organization of doctors, was the catalyst for the most recent push.

The doctors came together after another disappointment. VCU and the small, specialty Children’s Hospital of Richmond located on Brook Road announced in 2005 plans to build a children’s hospital at 10th and Broad Street, only to reverse course in 2007, saying the project had become too expensive.

VCU later, in 2010, acquired Children’s Hospital and rebranded VCU’s pediatrics services as Children’s Hospital of Richmond at VCU. The parcel at 10th and Broad Streets is the location of a new outpatient children’s pavilion slated to open next year.

The PACKids members and supporters want an inpatient facility that has its own campus and is open to all the doctors in the region and their patients. In order to develop top-tier pediatrics programs, they maintain that the pediatric patient volume has to be concentrated in one facility — not spread among three hospital systems as is currently the case.

“We were not willing to give up the fight because the need hasn’t changed,” said PACKids supporter Anne Maliff of Powhatan County, who has a child with special medical needs. “It’s motivated a lot of us now to pull together more than ever.”

When VCU and Bon Secours pulled out of the talks, the health systems announced they would collaborate on some child health projects, including care collaboration. Asked recently about what projects they are collaborating on, the health systems and HCA Virginia in October responded with a joint statement that said:

“Richmond’s three health systems — Bon Secours Richmond Health System, HCA Virginia Health System and VCU Health — are working together to achieve greater continuity and coordination of children’s health care needs in the Richmond area. While this team in the future will collaborate on asthma, obesity, and violence prevention, their initial focus is navigation and care coordination for children who have complex medical conditions. The work is quite extensive and discussions include such things as a comprehensive needs assessment, asset mapping of existing pediatric health community resources, and developing standard clinical protocols. One deliverable of the team that we talked about previously is to create a simple, sustainable Web application for navigating the pediatric health resources in our community that would be relevant and usable by all families with children.”

Maliff said she has not seen evidence of collaboration.

“The Children’s Hospital Foundation pledged $28 million to VCU for a new cardiology program and yet one of (VCU’s) top cardiologists left to go with (University of Virginia). It’s not giving the community a sense of confidence in what’s happening in our market,” Maliff said.

“Last week we went on a tour at Bon Secours and they showed us their new pediatric infusion wing. The (pediatric) oncology patients used to exclusively be treated at VCU. Now we are seeing them at Bon Secours, which just shows me these institutions are buildings these silos. It’s an arms race of pediatrics care and they are competing fiercely.”

Rappley said VCU’s planning is broader, including pediatrics, cardiology and cancer facilities.

“We are looking at different plans and different scenarios and thinking about logistics of parking, traffic access, pedestrian walkways as well as the kind of proximity if you need services close to one another, for example obstetrics and high-risk OB and neonatal, things like that,” she said. “That’s part of our planning, to look at how we assemble this full set of buildings.”

Goodwin said if VCU pursues a children’s hospital on its own, “They will spend a lot of money and not solve the problem.”

“The next thing you know you will have three hospital systems that will have spent a lot of money, more money than you would spend if you put it together, and they still won’t be giving the kind of care they should because it’s still fragmented,” Goodwin said.

In a statement Tuesday, Bon Secours said: “Bon Secours has long been a strong proponent of children and families in our community, providing excellent and accessible care across the greater Richmond area. Enhancements to our pediatric services have been a continued effort for many years, including 24/7 emergency care dedicated to children, and specialty care and programs across the continuum.

“We also continue to honor our commitment to collaboration with other local health organizations to close gaps in the coordination of care for the benefit all children and families.”