Mass. Department Of Public Health Recommends Boston Children's Expansion Move Forward

The Massachusetts Department of Public Health has recommended a planned $1 billion clinical building at Boston Children's Hospital be approved.

In a statement released Friday, DPH says its staff has determined the proposed building "meets the regulatory requirements and includes many positive aspects to improve care for the children and families the hospital serves."

The agency's Public Health Council will vote on the project on Oct. 20. That is the last regulatory hurdle the hospital needs to clear in order to begin construction on the 11-story building.

The proposed building includes a neonatal intensive care unit, pediatric cardiac center and 71 new patient beds. It would result in the hospital having all private patient rooms, as opposed to some double-bedded ones.

The project has been the subject of much public debate, largely because the building is set to be constructed on the site of the beloved Prouty Garden, a half-acre garden bestowed to the hospital 60 years ago that's been referred to as "the soul" of the facility. Patients, family members and hospital staff members use the garden as a place of respite, and its benefits as a healing garden have been documented. The garden is set to be demolished. More than 16,000 people have signed a petition calling for it to be preserved. Children's plans to replace the garden with a series of smaller "green spaces" inside the hospital, on the roof and on the grounds.

The DPH assessment focused on the project's impact on the health care marketplace in Massachusetts. The report cites an independent cost analysis conducted for the hospital at the request of the state, which found the new clinical building will not negatively impact health care costs in Massachusetts.

This week, however, the Massachusetts Health Policy Commission, the independent state agency charged with keeping costs in check in accordance with the health care cost containment law, concluded its own analysis that determined the project will result in an increase in health care costs of about $8 to $18 million per year. Commission Chairman Stuart Altman said that's partly because the new clinical space would likely draw patients to Children's Hospital from lower-cost pediatric hospitals, including Floating Hospital for Children at Tufts Medical Center and MassGeneral Hospital for Children.

Boston Children's has said the new clinical building is needed not only to provide more state-of-the-art care and to increase infection control, but to meet the needs of a growing patient population. The hospital has said most of its growth is coming from out of state and overseas, so it won't affect the local market.

Sandra Fenwick, president and CEO of Boston Children's Hospital, said in a statement she is pleased with DPH's recommendation.

"From the day we submitted our application, the health needs of the children we care for have been our focus. We will continue to advocate for improved health care facilities, updated technology, increased access and expanded green space offered as part of our proposed expansion plan at next month’s Public Health Council meeting and look forward to earning their support as well," she said in the statement.

An attorney who represents a group of opponents of the project, Greg McGregor, released a statement expressing disappointment with the DPH recommendation.

"If approved, this mammoth project would increase the price of hospital care, reduce competition, and expose Massachusetts consumers and taxpayers to untold millions of dollars in additional health care costs," the statement reads. "It would also destroy a beautiful, unique therapeutic healing garden that has given solace to generations of sick children and their families."

The group is suing the hospital to try to block the project. According to McGregor, hospital officials indicated in court that they would not proceed with construction while the lawsuit is pending. In a conference call with reporters today, he said the opponents can also appeal any approval from the Public Health Council and thereby put a hold on construction while that process plays out.

McGregor pointed to one section of the DPH report he says illustrates that the agency relied too heavily on the independent cost analysis the hospital itself commissioned, which was conducted by the firm Navigant. That section of the DPH report reads, in part:

The [Independent Cost Analysis] did not include rigorous testing of the assumptions made by [Boston Children's Hospital (BCH)] and the application did not include detailed information explaining the basis for the projections.

In the recommendation released Firday, DPH laid out conditions Boston Children's Hospital will have to meet in order to proceed with the building, including on-going reporting to verify that the project isn't going against state health care cost containment goals. The agency is recommending to its Public Health Council that the state retain the authority to limit the number of beds ultimately approved for the project if new data shows it will result in a substantial increase in health care spending.