1 1 certificate of need for the closure of ......2012/05/01 · 1 services in sussex county working...

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STATE SHORTHAND REPORTING SERVICE, INC.

1 CERTIFICATE OF NEED FOR THE CLOSURE OF INPATIENT 2 SERVICES AT SAINT CLARE'S HOSPITAL-SUSSEX 3 4 5 6 7 8 Tuesday, May 1, 2012 9 B E F O R E: JUDY DONLEN 10 ALISON GIBSON DR. POONAM ALAIGH 11 DEVON GRAF 12 13 14 15 16 17 18 19 20 21 22 23 STATE SHORTHAND REPORTING SERVICE, INC. 24 P.O. BOX 227 ALLENHURST, NEW JERSEY 07711 25 732-531-9500 FAX 732-531-7968 [email protected]

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1 MS GIBSON: Good evening. My name is 2 Alison Gibson and I'm the Acting Assistant Commissioner 3 for the Department of Health and Senior Services. And 4 I'm a member of this Board. Joining us on the Board 5 will also be Dr. Judy Donlen and Dr. Poonam Alaigh, 6 both of them have unfortunately been delayed by 7 traffic, but we're going to get started. I believe we 8 respect the fact that so many people have come tonight. 9 We will have the full two hours. So we're going to 10 start now at 10 after 6:00. We're going to go until 10 11 after 8:00. 12 This is a public hearing for the State 13 Health Planning Board in relation to the closure of 14 inpatient services at Saint Clare's Hospital. The 15 department deemed the application complete. And in 16 accordance with the requirements of law, the State 17 Health Planning Board is required to hold a public 18 hearing on this application within 30 days of this 19 action. Adequate notice of this hearing has been 20 published in accordance with the provisions of N.J.S.A. 21 26:2H-15.8. Notice was sent to the Secretary of State 22 who posted the notice in a public place. Copies of the 23 hospital CN application are available for review at the 24 Glen Ridge Public Library, the New Jersey State Library 25 in Trenton and the Department of Health and Senior

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1 Services. Information gathered at this hearing will be 2 reviewed by the State Health Planning Board in addition 3 to reviewing the application for St. Clare's Health 4 System and the Department's staff analysis and 5 recommendations in a public meeting. Although not all 6 of the members of the State Health Planning Board are 7 present tonight, this community public hearing is being 8 transcribed and the transcript, along with any written 9 comments submitted tonight, will be made available to 10 all Board members along with the transcript and written 11 submissions prior to the meeting to review this 12 application. There will also be limited time available 13 at the next public meeting of the State Health Planning 14 Board to hear from members of the public. At that 15 meeting, the applicant will present the application and 16 answer questions the Board members may have. 17 In the interest of making efficient use 18 of the time for tonight's hearing, each speaker will be 19 limited to three minutes. If you have longer -- sorry. 20 If you have longer written comments with you, please 21 provide a copy to the Board and they will be added to 22 the record. Anyone interested in speaking tonight 23 should sign in on the speaker sheet which we have here 24 at the table. Anyone who wants to submit written 25 comments after tonight's hearing and before the Board

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1 meeting is urged to do so. Such comments must be 2 submitted not later than Friday, May the 11th and 3 should be addressed to the State Health Planning Board 4 in care of the Department of Health and Senior 5 Services. 6 For those of you unfamiliar with the 7 Certificate of Need process, the State Health Planning 8 Board will vote on a recommendation as to the decision 9 on this application which will be submitted to the 10 Commissioner of Health and Senior Services. The State 11 Health Planning Board's hearing is part of the 12 Certificate of Need process, and your comments will be 13 considered as we review issues related to health 14 planning, hospital and related healthcare services and 15 access to healthcare services. Your comments are an 16 important part of this process and will be considered 17 along with the materials submitted by the applicant. 18 The Board can recommend approval of the 19 application, approval with conditions or denial of the 20 application before it. The Commissioner will make the 21 final decision on the application after the Board makes 22 its recommendation. The process that we will follow is 23 that we have the sign up list here. Each person will 24 have three minutes to speak. And I do have a timer 25 that we will be using. Learned how to use it. And one

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1 of the important things is when you come up to speak, 2 please state your name clearly at the microphone and 3 then spell your name for the recorder. So thank you. 4 The first person is Les Hirsch. 5 MR. HIRSCH: Good evening. I'm Les 6 Hirsch, president and CEO of Saint Clare's Health 7 System. Thank you for the opportunity to share some 8 thoughts about our plans for the future of Saint 9 Clare's Hospital-Sussex. While we are empathetic to 10 the community's concern, it is important to note that 11 the situation in Sussex has developed over a period of 12 many years. Prior to the arrival of the present 13 sponsor, Catholic Health Initiatives in 2008, the 14 hospital had a history of declining utilization, 15 declining numbers of physicians on the medical staff 16 and financial distress. In fact, our predecessors had 17 publicly announced their intent to completely close 18 the hospital. Even with the knowledge of this history, 19 we decided to make a go of it and renewed efforts to 20 increase utilization. Despite this, patient volumes 21 continued to decline causing unsustainable financial 22 loses. 23 Saint Clare's Hospital is the least 24 utilized hospital in the State of New Jersey. On 25 average there are three patients admitted daily and

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1 only eight, eight inpatient surgeries are performed 2 monthly. Very few hospitals, if any, could be 3 sustained with so little inpatient volume, especially 4 in New Jersey where many hospitals are struggling 5 financially. Even today, patients who require higher 6 levels of inpatient care that can be provided at Sussex 7 are routinely transferred or brought to other area 8 hospitals that are better equipped to provide these 9 services. 10 In today's healthcare environment it 11 isn't practical or prudent to continue operating the 12 hospital in its present form. Our analysis and that of 13 an independent consultant concluded that even with the 14 closure of inpatient services at Saint Clare's-Sussex 15 there would still be an appropriate number of hospital 16 beds available in Sussex County to serve the needs of 17 the population. 18 We are not closing this facility. I 19 repeat, we are not closing this facility. We will 20 continue to provide services that are important to the 21 Sussex community, especially emergency medical 22 services, both in the emergency room and in the 23 community via the advanced life support services 24 provided by Saint Clare's Mobile Intensive Care Unit 25 program. We are the state designated provider of MICU

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1 services in Sussex County working in close 2 collaboration with local ambulance squads. 3 Approximately 9,000 patients are treated annually in 4 the Sussex emergency room, and throughout Sussex 5 County, our Mobile Intensive Care Units respond to more 6 than 3,000 calls annually. We will also continue to 7 provide a variety of outpatient diagnostic and 8 treatment services including our new women's health 9 center. 10 Most importantly I want to recognize the 11 dedication of our employees who are the most affected. 12 Many have spent much of their lives working at the 13 hospital here in Sussex. We realize that there will be 14 some loss of jobs. We are doing everything possible to 15 minimize the impact and provide jobs in other Saint 16 Clare's facilities. 17 MS GIBSON: Thank you, Mr. Hirsch. 18 MR. HIRSCH: And I wanted to thank the 19 medical staff and the axillary and others and 20 appreciate sharing these thoughts tonight. 21 MS GIBSON: Lisa Vickery. 22 MS VICKERY: Good evening. I am Dr. 23 Linda Vickery, L-I-N-D-A Vickery, V as in Victor 24 I-C-K-E-R-Y. I had a thriving family practice in 25 Wantage for over 20 years until ill health forced me

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1 into an early retirement. So I have no financial 2 interest in the outcome of this. Saint Clare's Health 3 System has Mission and Vision Statements and a set of 4 core values which this Certificate of Need application 5 violates. The following are taken directly from the 6 Saint Clare's website. Quote, Mission Statement: The 7 mission of Saint Clare's Health System and Catholic 8 Health Initiatives is to nurture the healing ministry 9 of the church by bringing it new life, energy and 10 vitality in the 21-century. Fidelity to the gospel 11 urges us to emphasize human dignity and social justice 12 as we move toward the creation of healthier 13 communities. 14 Quote, Vision statement: Saint Clare's 15 Health System provides compassionate, family-centered 16 care and is consistently among the best performing 17 health systems in the country. We are the organization 18 of choice in the communities we serve. 19 Core values: One, reverence. Profound 20 respect and awe for all creation, the foundation that 21 shapes our spirituality, our relationships with others 22 and our journey with God. Two, integrity. Moral 23 wholeness, soundness, fidelity, trust, truthfulness in 24 all we do. Three, compassion. Solidarity with one 25 another. The capacity to enter into another's joy and

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1 sorrow. Four, excellence. Preeminent performance, 2 becoming the benchmark putting forth our personal and 3 professional best. Close quotes. 4 My comments: Mission: The 5 administration of Saint Clare's, both current and past, 6 has not nurtured social justice for the residents of 7 this service area, particularly of the poor and 8 elderly, in violation of its mission statement. 9 Vision: The Sussex hospital does 10 provide compassionate, family-centered care as it has 11 since the days of its founding by Dr. Alexander Linn in 12 1918. 13 Core values: The Saint Clare's 14 administration has not shown any respect much less 15 reverence for the people of Sussex County. The closure 16 of beds was not brought to the community advisory Board 17 prior to this filing. The whole purpose of the Board 18 Is to help a distant Morris County administration 19 understand local needs and conditions. The closure was 20 not discussed before its submission with local 21 governments, the first aid squads, the doctors, the 22 many dedicated employees at our hospital, and most 23 especially with the patients, all of whose lives will 24 be severely affected. I include my family and myself 25 among the patients who would suffer as a result of

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1 proposed closure. This application must be denied. 2 DR. ALAIGH: Dr. John Fisher. 3 DR. FISHER: I'm Dr. John Fisher, 4 F-I-S-H-E-R, Vice President of the Saint Clare's Sussex 5 Medical staff and a member of the Saint Clare's Health 6 System Board of Trustees. I am the immediate past 7 president of the Sussex County Medical Society. 8 In 1982, I was recruited by Wallkill 9 Valley General Hospital to fulfill a public health 10 service obligation to work in this federally designated 11 physician shortage area. When I came here 30 years ago 12 the Sussex hospital was a busy 106 bed facility with 45 13 members of the medical staff providing full services to 14 our isolated community. In the late 1980's Wallkill 15 Valley affiliated Saint Clare's Riverside and 16 petitioned the state to build a new hospital. That CON 17 was denied. 18 In spite of this setback, a full merger 19 created the Northwest Covenant Medical Center with a 20 promise of expanding health services in North Western 21 New Jersey. That never happened. Instead, a policy of 22 benign neglect and subsequent abandonment evolved. 23 First pediatrics was closed, then vascular lab was 24 disbanded and orthopedics was displaced. In 2006 Saint 25 Clare's threatened to sell the Sussex campus, but then

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1 the entire system was sold to CHI. The only saving 2 grace was that they did not shut us down. Now they are 3 planning to do exactly that. 4 Saint Clare's has submitted a 5 Certificate of Need to close the inpatient services at 6 the Sussex campus and to transform the hospital into an 7 outpatient facility and satellite emergency department. 8 In the last 30 years the population of Sussex County 9 has grown, but our hospital services have been 10 relentlessly reduced. Nevertheless, we remain a proud 11 medical staff with about a dozen active physicians 12 struggling to keep the least utilized hospital in the 13 State of New Jersey alive. 14 While no one can argue the reality of 15 our dire predicament, we can all argue for the 16 rationale to keep our essential inpatient services 17 open. Number one, we are geographically isolated and 18 the distance between our services area and the nearest 19 healthcare facility is just too far. Number two, the 20 closure of inpatient services will result in a 21 significant loss of jobs and it would also result in an 22 out-migration of New Jersey healthcare dollars to 23 nearby facilities in New York. Number three, the CON 24 as submitted by Saint Clare's is flawed. It is riddled 25 with misleading information. If this were not such a

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1 serious matter, the document itself would be laughable. 2 Number four, the alleged transformation of Sussex to an 3 ambulatory outpatient facility cannot occur given the 4 licensing requirements of the State of New Jersey. Our 5 facility is too old to meet current standards. Number 6 five, if the Department of Health makes a decision to 7 close inpatient services at the Sussex hospital based 8 on bad information in a poorly documented CON, then 9 that would be a bad decision for our patients, our 10 employees, our physicians and our state. 11 MS GIBSON: Thank you. 12 DR. ALAIGH: Mr. Nelson. Your full name, 13 please. 14 MR. NELSON: Kenneth Nelson, 15 N-E-L-S-O-N. I'm not a doctor, but I have been a 16 resident of Wantage for over 35 years. My family as 17 well as myself have used the services at Saint Clare's 18 on a number of occasions. I'm also a community 19 planner, city planner. And I've approached this issue 20 from the perspective of as a city planner. I should 21 also mention in the way of background that I served as 22 a planning director for Morristown for over 20 years. 23 And in that capacity had a great deal of experience 24 dealing with a major hospital and various issues that 25 relate to facilities of that type.

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1 I don't have to tell you that hospitals 2 are a unique public purpose use. They are a community 3 focal point just as schools and churches are in many 4 respects. And this proposal will dramatically change 5 the relationship of this facility to the community. In 6 reviewing the Certificate of Need, I put together a 7 report which you have in front of you. And I also 8 distributed tonight a one-page handout with some 9 population information. 10 My report, I cannot in three minutes go 11 into my report in any detail, so I'll just touch on a 12 couple of quick points regarding that. And I should 13 also point out that the exhibit that I prepared, the 14 map on the right, depicts a number of items and issues 15 that are relevant to this meeting tonight. Some of the 16 other speakers may use it later. But very quickly, the 17 primary service area is outlined in red. The six 18 municipalities are identified as a part of that service 19 area. The major state highways which are primarily two 20 lane roads are depicted on that map, as well as Saint 21 Clare's and the location of Saint Clare's and Newton 22 hospital. Finally, there are some pins that are shown 23 on that that are located on that map that depict the 24 route of the Sussex County bus system which a report 25 prepared for Saint Clare's relies heavily on as an

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1 adequate means of transportation for people needing to 2 get to Newton Hospital. 3 We can go into the details of that 4 system later. But very quickly, in reviewing the 5 Certificate of Need I reviewed a report prepared by the 6 Urban Health Institute. The report is inaccurate, 7 contains actual errors, it's not well researched and, 8 apparently, was done by someone not familiar with 9 Sussex County. It raises more questions than it 10 answers. In terms of the service area, there's 11 confusing data in there about zip codes and census 12 data. Wantage Township and Hardyston are completely 13 eliminated from that report in terms of population 14 information. Travel times are totally inaccurate. In 15 summary, the report lacks credibility and should not be 16 considered in the decision making process. Thank you. 17 DR. ALAIGH: Your name, please. 18 DR. AUTOTTE: Denise Autotte. It's 19 A-U-T-O-T-T-E. I have been a practicing family 20 physician in Sussex County since 1982, all of that time 21 as an active member of the medical staff of what is now 22 called Saint Clare's Hospital. In 1982 it was called 23 Wallkill Valley General Hospital. In that year I was 24 recruited along with Dr. John Fisher to work for the 25 hospital at the Health Center in Franklin. We both had

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1 obligations to the public health service to work in a 2 physician shortage area. At that time, there were 45 3 doctors associated with the hospital. In 1980 the 4 census shows that the combined populations of Franklin, 5 Hamburg, Sussex Borough, Vernon, Hardyston Township and 6 Wantage was 36,859. I mention these towns because they 7 are primary service areas for the hospital in Sussex. 8 They were not the only ones mentioned in the 9 Certificate of Need. However, as Mr. Nelson's report 10 points out, there are many more people served by our 11 hospital than just what was estimated in the 12 Certificate of Need. By 2010, the last year reported 13 by the United States census, the population had grown 14 to 53,966, an increase of 46.4 percent. This occurred 15 at a time when the number of doctors in this part of 16 the county was decreasing to less than a third of the 17 1982 number. In spite of this, Saint Clare's Hospital 18 continued to care for the sick and injured in the 19 northern part of the county. At present, there is a 20 ratio of one physician to a population of 1,967. The 21 statewide ratio area is 1 to 808. If there is no place 22 to admit patients in the future there will be no 23 incentive for any new physicians to set up practice in 24 this part of the county. Our patients will be left out 25 in the cold.

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1 The statement was made that we are the 2 smallest hospital in the state. That may be true, but 3 it is not a reason to close the hospital. Small does 4 not mean unimportant. Small does not mean expendable. 5 The report from the Governor's office from 6 November 2006 titled, quote, Rationalizing, Beds 7 Services and Payments For New Jersey Hospitals states 8 that, quote, The amount of charity care a hospital 9 provides is an important indication of the degree to 10 which a community needs the hospital. Close quote. 11 Because we have poor people in this area, in Sussex 12 Borough alone there are 15.1 percent of the population 13 living under the poverty level, it is clear that we 14 need to maintain the inpatient beds in Sussex. The 15 report goes on to state citing a situation that 16 happened with closing hospitals in Maryland that the 17 cost could increase if the closing hospital were less 18 costly than the surviving hospitals in the same service 19 area. 20 MS GIBSON: Thank you. 21 DR. ALAIGH: Your name, please. 22 MS PSAROUDIS: My name is Barbara 23 Psaroudis. And that's spelled P-S-A-R-O-U-D-I-S. Good 24 evening. I've been a resident of Vernon Township for 25 37 years. I feel I have a right to speak on behalf of

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1 my family, my friends and my neighbors. As a nurse 2 working in Saint Clare's for 20 years I not only have 3 that right, I feel I have a duty to advocate for my 4 patients, one which extends beyond my shift. While I 5 may have the good fortune to have a car, a job offer 6 and good health, that is not the case for many in 7 northern Sussex County. Those who frequent our 8 hospital are by and large the elderly and the 9 chronically ill. Many are poor and cannot afford the 10 added cost of travel. No one would be okay with a one 11 hour and 30-minute bus trip to Newton. That's assuming 12 they can get to Sussex first to catch that bus. 13 The Certificate of Need points to a 14 financial burden to the hospital and the 15 underutilization of services by area residents. We do 16 not dispute this. New Jersey's a tough market. 17 Overregulated, poorly reimbursed. But to suggest that 18 there will be a minimal impact on the local residents 19 is to ignore the evidence. 20 The issue before the Commission this 21 evening is simple. Access to care. And this will be 22 greatly diminished if our inpatient units close and our 23 emergency room becomes only a satellite ER, which, even 24 according to state regulations, should not be accepting 25 trauma, critical patients or anything that remotely

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1 looks like it might require surgery. 2 Make no mistake, patients and their 3 families must now endure what for some is a 55-minute 4 ride to Newton Hospital where there they will likely 5 encounter a very lengthy wait in the ER. Newton 6 Hospital is well known to us. We in Sussex have dealt 7 with their overflow and have readily accepted their 8 patients when those patients have left their ER in 9 frustration. Prior to merging with Atlantic Health, 10 Newton Hospital going on divert was a regular 11 occurrence. I believe that the only thing that has 12 changed is not their capacity or their throughput, but 13 their newer mandatory strategy of never going on 14 divert, no matter what the circumstances. 15 Commissioner, I urge you to require 16 Newton to produce their internal statistics that would 17 reflect the fact that both their med-surge beds and 18 their critical care beds are often at or over capacity, 19 a fact evidenced by the numerous patients who have 20 spent a day or a night waiting for a bed to become 21 available. 22 I have firsthand knowledge of recently a 23 co-worker's 80-year old father spent 28 hours in the 24 Newton ER. Is this what we want for our northern 25 residents of New Jersey? Baby boomers are now arriving

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1 at their golden years. This rapidly aging population 2 should not have to drive 45 minutes or more for 3 healthcare or to visit their loved ones in the 4 hospital. I urge you to deny this request because it 5 will disproportionately affect the poor, the elderly 6 and the chronically ill. Thank you. 7 DR. ALAIGH: Wayne Ross. 8 MR. ROSS: Good evening, ladies and 9 gentlemen. My name is Wayne Ross, W-A-Y-N-E R-O-S-S. 10 I represent three different organizations. I represent 11 the New Jersey State First Aid Council, 12th district, 12 which is all of the first aid squads in Sussex County 13 and about 8 or 10 from Morris County. I also represent 14 the Hardyston Township First Aid Squad of which I've 15 been a number for almost 35 years. And I also 16 represent Hardyston Township because I've been a 17 councilman for 20 years. Hardyston Township tonight 18 has passed a resolution in support to keeping the 19 hospital open. This will be forwarded to the 20 Department of Health as proper time. 21 I have to tell you I've been a squad 22 member for almost 35 years. And I have to tell you a 23 history lesson. I was told this years and years ago 24 that when Franklin Hospital closed its bed service that 25 the ER would remain open. I'm here to tell you that at

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1 one time an average ambulance run for Hardyston 2 Township would take a half an hour to 45 minutes. It 3 now takes between 45 minutes to an hour to go to Sussex 4 and back. It now takes between and hour and a half to 5 two hours to go to Newton and back. 6 I can't tell you the daytime problems 7 that we have. Most squads in the area if they have one 8 crew they're very fortunate. But if that crew is out 9 of town for two hours and, God forbid, I go to Saint 10 Clare's, where is it, Denville I was fortunate enough 11 couple weeks ago to go there I was out for almost three 12 hours. This is going to be a big problem. And the 13 biggest problem is people who have an illness or an 14 injury that is going to stay in the hospital will no 15 longer go to Sussex. Will have to transport to Newton. 16 I have to say as a member of the first aid council we 17 are proud to serve with members of the Saint Clare's 18 paramedics. Right, Deb? Good girl. 19 I feel on a personal note Sussex 20 hospital is my hospital of choice. I spent many times 21 there. Many more than my wife would like to admit. 22 And me, too, in 1982 I met Dr. Denise Autotte. And I 23 loved her. She was at Franklin Hospital. I met Dr. 24 Fisher. And she has been my physician ever since. And 25 I would hate to lose my physician. You're welcome.

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1 DR. ALAIGH: Joseph Martin. 2 MR. MARTIN: My name is Joseph Martin, 3 M-A-R-T-I-N. I am the First Lieutenant of the Wantage 4 First Aid Squad, a local volunteer EMS agency, and I 5 would like to take a moment to express my concerns 6 about the possibility of discontinuation of inpatient 7 services at Saint Clare's-Sussex campus. This will 8 have a detrimental effect on our community and our 9 residents. Saint Clare's-Sussex is one of only two 10 currently fully functioning hospitals in Sussex County 11 which stands about 519 square miles. The closure of 12 inpatient services and inpatient beds will put a major 13 strain on our surrounding hospitals as well as local 14 emergency medical services and local residents. This 15 may lead to life threatening delays in patient care. 16 The next closest facility to us is Newton Medical 17 Center can be a drive of up to an hour from sections of 18 our town. Local volunteer agencies struggle to run 19 emergency calls at the rate that they come in now and 20 this will only worsen. Along with this, in Wantage we 21 run mutual aid assisting other towns in their emergency 22 services. In 2011 alone we ran mutual aid calls into 23 five different towns, not including our own. Without 24 Saint Clare's-Sussex campus it may be near impossible 25 to continue to run all of our emergency calls and

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1 assist the towns around us. 2 Each transport to Newton Medical Center 3 will put our crews out of our town for an average of 60 4 to 90 minutes longer than transporting to Saint Clare's 5 Sussex. The trip is also an average 40 miles round 6 trip putting an extreme burden on our emergency 7 vehicles. Many of our calls are literally life or 8 death for our patients. It would be devastating to see 9 a patient left untreated in an emergency due to a 10 preventable situation like this one. Even though Saint 11 Clare's-Sussex will offer a satellite emergency 12 department, it is not enough. According to New Jersey 13 State guidelines, sub chapter 36 on satellite emergency 14 departments the following patients would be more 15 appropriately treated in an acute care hospital 16 emergency department. This includes all patients 17 attended by advanced life support or mobile intensive 18 care paramedics, individuals with an altered mental 19 status or under the influence of alcohol or other 20 substances. This criteria makes up a great majority of 21 our emergency calls. Again, this will pull our 22 emergency crews out of their response areas for 23 extended period of time leaving the residents of this 24 county in this area vulnerable in emergency situations. 25 As a volunteer, a healthcare provider

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1 and a member of the Sussex community I ask that you 2 take my thoughts into consideration with regards to 3 this issue. Our goal as healthcare providers is to 4 provide the best possible care that we can and we can 5 only do that by having Saint Clare's-Sussex fully 6 functioning. It would be a shame to see a patient's 7 condition worse severely or even death occur because we 8 were stripped of the necessary resources to provide 9 care in a timely manner. Thank you. 10 DR. ALAIGH: Dr. Dennis fielding. 11 DR. FIELDING: Good evening. I'm Dr. 12 Dennis Fielding, D-E-N-N-I-S F-I-E-L-D-I-N-G. I have 13 an internal medicine and geriatric practice in Hamburg 14 for the last 24 years. My practice is three and a 15 miles from the Sussex campus of Saint Clare's. 16 Medicare beneficiaries make up 40 percent of our 17 patients. Hospitalized patients account for 20 percent 18 of our work. I live in Vernon about 10 minutes away 19 from our hospital giving me the ability to respond to 20 medical emergencies quickly. Closure of the Sussex 21 Campus will remove that benefit from my patients. 22 Traveling to Newton Medical Center or Saint Clare's 23 Dover and Denville campus' would take between 40 to 24 60 minutes for me. However, I do not have admitting 25 privileges, nor do I seek them at these facilities due

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1 to the distances. 2 I'm also the medical advisor for the New 3 Jersey Region of the National Ski Patrol and Mountain 4 Creek Ski Patrol. Mountain Creek and Hidden Valley Ski 5 areas in Vernon are the two largest in New Jersey. 6 Visitors to these areas can easily surpass 10,000 7 skiers on a weekend day. The risk of significant 8 injury is 2.63 per 1,000 skier visits. Therefore, the 9 potential exists for 25 to 30 significant injuries 10 requiring a visit to a local emergency room. In the 11 past, those not requiring a Medevac helicopter were 12 taken to the Saint Clare's Emergency Department by a 13 Saint Clare's ambulance. Last Winter for some unknown 14 reason the contract was lost to Atlantic Health System. 15 The injured now are primarily transported the 35 to 16 40 minutes to Newton Medical Center. On a busy day 17 three ambulances are required to make these trips back 18 and forth to keep up with the injured. Only one 19 ambulance was required in the past when they used to go 20 just to Saint Clare's in Sussex. 21 Other recreational activities abound in 22 this county. Visitors utilize the many golf courses, 23 hiking and biking trails, lakes and rivers, parks and 24 forests for outdoor activities that results in injuries 25 or medical problems requiring hospitalization. Saint

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1 Clare's is positioned in close proximity to these 2 recreational areas in Northern Sussex County and can 3 provide access to medical care for those in need. 4 According to the rules of a satellite 5 emergency department, most of these serious medical 6 conditions or injuries would have to bypass Sussex 7 emergency department since there will be no inpatient 8 support. This satellite emergency room can be isolated 9 during adverse weather conditions due to our 10 mountainous terrain. Medevac helicopters do not fly in 11 these conditions. And the ambulance may take hours to 12 reach other hospitals in Winter conditions. 13 I strongly oppose the Certificate of 14 Need which requests a serious reduction of services at 15 Saint Clare's-Sussex campus. Approval will negatively 16 impact the access to medical care in our area for all 17 patients and visitors creating a risk of loss of life 18 and increased harm. Thank you. 19 DR. ALAIGH: Dr. Sami Yasin. 20 DR. YASIN: My name is Sami Yasin, 21 S-A-M-I Y-A-S-I-N. I'm a local physician. I have been 22 here for 20 years. Public transportation in Sussex 23 County is very limited. There was a study completed 24 last September of 2011 and the conclusions were there 25 were limited service locations, that there were limited

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1 hours of service, that there is lack of knowledge of 2 services available, that the services are not frequent 3 enough, and that there are limited connections. In the 4 Certificate of Need that Saint Clare's provided they 5 stated that the population of Sussex is used to travel 6 long distances to get their services needed. And they 7 also stated that it takes only an additional six 8 minutes to go from Vernon Township to Newton as opposed 9 to Sussex hospital. I took that route last Sunday 10 night, it took me an additional 30 minutes at 8 o'clock 11 Sunday night. When it's busy during the day it will 12 take maybe 40, 45 more minutes. I feel that the lack 13 of public transportation, the lack of private 14 transportation for a lot of my patients will severely 15 deny access to healthcare directly because they can't 16 get there and indirectly because it will be such a 17 threat to their family life to even go to the hospital 18 because they will know if they go there if they are 19 sick enough to be admitted they will be shipped down to 20 Denville 35 miles away, they will be shipped down to 21 Dover 30 something miles away, or they'll have to go to 22 Newton. Then they will not have a chance to see their 23 loved ones. And my patients right now won't even be 24 admitted two blocks from their house. So this will 25 severely affect access of care for mostly live the

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1 poor, the elderly which makes a large section of the 2 population in Sussex County. Thank you very much. 3 DR. ALAIGH: Charles Kuperus. 4 MR. KUPERUS: Thank you for making that 5 big trip here. Charles Kuperus, K-U-P-E-R-U-S. Now, 6 we've heard a lot of the stats already. Not one 7 speaker here spoke in favor except for the CO in favor 8 of closure. Sussex, Wantage and Saint Clare's is a 9 vital part of our community. You heard Ken Nelson say 10 that. And when we all sit here these are our 11 neighbors. This is part of our community. And when 12 you take that hospital away and its services away from 13 us you take a part of our community away. Now, some 14 people can say, a wholehearted accountant can say, oh, 15 yes, you shouldn't be so emotional. This is our 16 hospital. This is where my brother went when he was 17 kicked by a cow and had to stay overnight. This is 18 where my uncle stayed when he had an infection in his 19 finger. This is where the Sussex Fire Department 20 recuperated after a gas explosion. This is our 21 community. This is a vital part of our community to 22 say it's not -- (Inaudible). 23 So when I read the report I read the six 24 minutes to get to Newton. I thought that was 25 ridiculous. And then I read that this region's marked

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1 with heartlands and forest. And yes, it is. And we're 2 proud of it. But we're also businesses in our 3 community. There are excavators, restaurant owners, 4 schools, grocery stores. This is a dynamic community 5 that need a local hospital. Not one that can just 6 passively say we don't inpatient care because its 7 available somewhere else. 8 If the state is going to make a decision 9 about rural areas of this -- rural areas it needs to 10 make sure that inpatient care is a part of that just 11 like historically was since 1918 in our community. 12 Frankly, Sussex hospital was where I was 13 born. And I really think that as you struggle to make 14 this decision you see a community that's standing up 15 and saying, "Please, don't take those services away." 16 And yes, you know, hospitals business can diminish. If 17 you don't pay attention to business, and any other 18 business man in this audience will say the same thing, 19 it's going to decline. And most certainly this should 20 be a conversation about how we can change the 21 regulatory structure. We can expect change in this 22 community. We have adapted to much change in our 23 community in the past 50 years, in the past decades. 24 This should be a conversation of how to reduce the 25 regulatory woe, how to make the hospital code

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1 compliance and how to make this hospital service, this 2 rural community, our community, my community, my 3 family's community and my neighbor's community. 4 DR. ALAIGH: Dr. Donald Sugar. 5 DR. SUGAR: I'm Dr. Donald Sugar, Board 6 certified surgeon. S-U-G-A-R. A sweet name. I have 7 been working in this area at the Franklin Hospital, 8 Sussex Hospital for the past 45 years. I'm probably 9 the old -- one of the oldest physicians on the staff of 10 the hospital. My work is mainly fractures, general 11 surgery and dislocations which is part of the injuries 12 that occur in the ski area. Of course now those 13 injuries are much less coming to our hospital because 14 they're being shunted over to Newton at a very high 15 cost ambulance ride over there. And I think this is a 16 terrible thing for this hospital. If the people can 17 come to our hospital in 16 minutes they should ride 18 half hour, 45 minutes to get to Newton to get the same 19 care, it's ridiculous. We have a group of physicians, 20 nurses and personnel in the hospital second to none. 21 We've had accolades for nursing care, for doctor care, 22 cleanliness and other accolades for the hospital that 23 we have. I think it's tragedy to try to close this 24 hospital. This hospital is part of the emergency room. 25 Emergency rooms and hospitals work together. We can't

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1 be separated. 2 If a young person comes to our hospital 3 with an injury secondary to athletic endeavor and he 4 comes to us seemingly normal within a short time his 5 blood pressure can drop to a shock level and he may 6 need to have his spleen take out. And if you can't -- 7 if he's not stable you're not going to be able to 8 transfer him anywhere. And you need to get the surgeon 9 up here to help take the spleen out and save his life. 10 This has happened numerous cases for myself and other 11 surgeon that have been at the hospital. 12 As far as the closure goes, yeah, it's 13 $3,000,000 a year. Maybe. Maybe not. Maybe it's a 14 lot less for the hospital cost. Because, you know, 15 figures are per setting, but figures may be not. As 16 far as philosophy of Saint Clare's hospital, this 17 hospital wants high quality care, definitive care, 18 immediate care and passionate care for all our patients 19 regardless of the ability to pay. This is necessary. 20 Our country places a high value on individual lives and 21 it is very important that we keep these in 22 consideration. One life could be worth $10 million 23 rather than $3,000,000 a year. 24 MS GIBSON: Thank you. 25 DR. ALAIGH: Your name?

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1 DR. GEISEN: Hi. My name is Dr. Amy 2 Geisen, G-E-I-S-E-N. I'm one of the internists here at 3 Saint Clare's Hospital Sussex campus who takes care of 4 patients both in my office in Hamburg as well as in the 5 hospital. I also serve as one of the three 6 hospitalists. I wanted to point out that Saint Clare's 7 Sussex has received several top rankings in quality 8 measures. In 2010 Saint Clare's Sussex campus received 9 a 100 percent rating for treatment for myocardial 10 infarction ranking first place statewide tied only with 11 Saint Clare's Dover campus. Sussex Hospital was the 12 only hospital in the state to score 100 percent for 13 pneumonia quality measures. We scored 95 percent for 14 congestive heart failure measures, and a 94 percent 15 rating for surgical care improvement program. 16 Not only is it certain from the evidence 17 based quality measures data that the doctors and nurses 18 are practicing medicine to the highest standard of 19 care, it is clear that the patients notice the 20 excellent care they receive. In the April 2012 edition 21 of the Star Ledger's Inside Jersey, Saint Clare's 22 Sussex was ranked in four areas in the 350 beds or 23 fewer category. We were ranked number four for 24 patients being highly satisfied post discharge. We 25 were ranked number two for room cleanliness. Ranked

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1 number five for nursing communication and ranked number 2 one for physician communication. 3 The excellent nursing care is 4 highlighted by the yearly recognitions that both the 5 medical floor and same day surgery departments have 6 received. In 2006 and 2007 same day surgery was in the 7 greater than 90th percentile as rated by the Jackson 8 survey. In 2011 fourth quarter and 2012 first quarter 9 the medical floor has been rated in the greater than 10 90th percentile by Healthstream. 11 The Leapfrog Group is a survey company 12 that looks at patient safety measures. Saint Clare's 13 Sussex campus fully met all standards of care in the 14 categories of reducing pressure ulcers, reducing in 15 hospital injuries and managing serious errors. 16 Saint Clare's Hospital Sussex campus 17 provides excellent evidence based medical care. To 18 close the inpatient units and shut down the same day 19 surgery programs is a disservice to the community. 20 This kind of high quality patient focus care should be 21 rewarded and supported to enable the doctors and nurses 22 to continue to provide this community with the care 23 that they have relied on for over 90 years. 24 DR. ALAIGH: Thank you. Rachel Clawson. 25 MS CLAWSON: That's Rachel, R-A-C-H-E-L,

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1 Clawson, C-L-A-W-S-O-N. I'm the pharmacist in charge 2 at the Sussex campus. I began my career at Wallkill 3 Valley Hospital in 1986 once I settled into New Jersey 4 from a move from Ohio. I immediately acclimated to 5 Sussex County because it mirrored my hometown with 6 widespread farmland, it rural atmosphere and honesty of 7 the people. I pride myself that I have become a 8 dedicate and loyal healthcare professional to serve the 9 residents of Sussex County. And will do what I can to 10 see the community will not lose their hospital. 11 During the early years of my career the 12 hospital was flourishing with many services offered 13 such as chemotherapy, pediatrics and orthopedics. At 14 times the patient census exceeded the 106 beds 15 available. Today, the patient census is 12. The 16 pharmacy department was staffed with a director, two 17 full time pharmacists and two full-time techs. Today 18 that department is staffed by one, me. Over time the 19 workforce has been drastically reduced and we lost many 20 valuable physicians and surgeons. Now, approximately 21 55 employees will lose their jobs with the closing of 22 inpatient care. What happened? Why was the system 23 allowed to erode and lose market share to neighboring 24 health systems? 25 I also work part-time at Baker's

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1 Pharmacy in town. It's not usual to fill prescriptions 2 for patients that live here, could have been treated 3 here, but were not. Why? Recently one patient went to 4 our competitor's ER with her teenage daughter. She 5 stated they waited five hours to see the emergency room 6 physician. I said to her, "Why didn't use Saint 7 Clare's emergency room?" And she said, "I thought that 8 place was closed." This family lives in Sussex. And I 9 can't believe for the hospital being two blocks from 10 the drug store they thought it was closed. Public 11 awareness is vital to the success of any organization. 12 If the residents of Sussex County were aware of our 13 services, perhaps we would not be here tonight. 14 I'm finishing my MBA in healthcare 15 management and have written several papers about the 16 struggling healthcare environment and its future, but 17 there are strong ethical issues here, too. We're 18 talking about real people and their real needs. Would 19 you like to drive an hour or more to an alternative 20 facility and wait hours to see a physician? Think 21 about it, would you want your local hospital to close? 22 Probably not. 23 Saint Clare's provides essential 24 healthcare to the local community. Isn't that our 25 social responsibility? This is not just about the

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1 money. Social responsibility is a commitment to the 2 community to assure reasonable access to quality 3 healthcare for diagnosis, treatment, education and 4 simply doing the right thing. My hope is that when you 5 consider the Certificate of Need proposal you will take 6 to heart what has been said here tonight and that you 7 will do the right thing. Thank you. 8 DR. ALAIGH: Thank you. Dr. Farhad. 9 DR. IDJADI: Good evening. My name is 10 Dr. Farhad Idjadi. First name is Farhad, F-A-R-H-A-D. 11 Last name is Idjadi, I-D-J-A-D-I. I would like to 12 address two topics with some examples. Number one, the 13 apparent failure of physician recruitment by the Saint 14 Clare's Hospital System for our Sussex facility. After 15 residency and service in the United States Air Force I 16 served on the surgical staff of the Sussex Hospital for 17 32 years from 1974 through 2006. Before 1989, the year 18 affiliation with Saint Clare's Hospital System, there 19 were five full-time surgeons with unrestricted surgical 20 privileges here. Since 2008 to the best of my 21 knowledge there have been none. I'm going to summarize 22 the experiences that I know of as far as physicians 23 trying to admit -- get admitting privileges to this 24 hospital for the sake of time. 25 In 2006 and 2008 myself discussed with

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1 administration their interest in having me on the staff 2 here in an employed position due to my proximity to the 3 hospital. That's after my retirement. I never got a 4 response. Employment of physicians by hospital is a 5 national trend. A close example is Newton Hospital 6 that has three such general surgeons. About four years 7 ago a general surgeon who wanted to relocate here and 8 about a year ago an orthopedic surgeon who has already 9 relocated to Vernon expressed interest in getting 10 admitted privileges here. They never got a response. 11 This is personal communication. 12 Two, the closure of the inpatient 13 facility here will cause inevitable increases in 14 patient mortality. I'd like to give three quick 15 examples. These are my own examples, my own 16 experience. A 14-year old boy, a victim of hunting 17 accident with a gun shot wound in the heart. At a 18 later date, 65-year old patient with a shotgun wound to 19 the chest and the heart. Both of these patients had 20 developed what's called acute cardiac tamponade which 21 is uniformly fatal unless treated immediately. Within 22 minutes after admission upon arrival to the operating 23 room these two patients had no blood pressure. In each 24 case I was able to drain the blood from around the 25 heart and repair the heart. The third example, several

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1 years ago a 34-year old patient with severe laceration 2 of the spleen which is a very common injury in our 3 area. Despite massive blood transfusions his pressure 4 did not rise above 40. His shattered spleen was 5 removed within one hour of admission by myself. All 6 three patients mentioned above recovered fully and 7 walked out of the hospital healthy. This patient would 8 not have left the hospital alive if an inpatient 9 facility did not exist. Many other such examples 10 exist. 11 In conclusion, if the State of New 12 Jersey and the Saint Clare's Hospital System are 13 comfortable with the fact that more patients will die 14 avoidable deaths as the result of closure of the 15 inpatient facility and apparent lack of physician 16 recruitment on the part of Saint Clare's Hospital, thus 17 transforming our population into second class citizens, 18 then let us be heard here and recorded. Thank you. 19 DR. ALAIGH: Thank you. Jen Kovach. 20 MS KOVACH: Hi. Jennifer Kovach, 21 J-E-N-N-I-F-E-R K-O-V-A-C-H. And I'm not a doctor. 22 Something far worse. I'm an attorney. I'm also a 23 partner at a law in firm in Sparta, New Jersey as well 24 as the director of a new 94-unit senior housing 25 facility in Franklin, New Jersey, a neighboring town.

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1 As a long standing member of the Saint Clare's Sussex 2 Community Advisory Board I have witnessed several 3 changes within the went hospital. But despite the 4 changes one thing has always remained the same, and 5 that is Saint Clare's Sussex has continued to care for 6 the residents of Sussex County as a fully functional 7 hospital with inpatient capabilities. Having been born 8 and raised in the county, I can't tell you the number 9 of friends and family I have visited at the hospital. 10 As a mother of three I don't want to tell you the 11 number of times I visited the ER. 12 But more to the point, closing the 13 inpatient portion of the hospital will have a 14 significant detrimental impact on elderly residents of 15 the county. I see as the director of the senior 16 housing facility an incredible need for such services 17 on a regular basis in my capacity there. On the 18 unfortunate occasion when a resident must be 19 transported to a hospital when asked by the EMT's where 20 they would like to be transported the answer I hear 21 from most of the residents is take me to Saint Clare's 22 Sussex, please. The point is not just elderly but the 23 entire county needs Saint Clare's-Sussex to remain a 24 fully functional hospital. Make no mistake, there is a 25 very real need for this county for Saint Clare's

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1 inpatient facility. 2 There are only two choices in the county 3 as it stands. That's become apparent tonight. That 4 being said, the only logical conclusion is that the 5 proposed closure and the resulting lack of choice will 6 be harmful to the public interest of the residents of 7 the county. You may ask yourself, why should the 8 public interest of Sussex County matter to the powers 9 that be in Trenton? Well, the State Department of 10 Health is charged with guarding against the closing of 11 important institutions in a manner harmful to the 12 public interest. Also, we must not forget that this 13 country was founded on the premise of freedom of 14 choice. That the proposed closure takes away the 15 residents of Sussex County choice. They will have only 16 one choice. 17 So on behalf of all of the residents, 18 but namely the elderly who rely on this facility, I 19 submit that inpatient facilities at the Sussex campus 20 are an important facility by definition. That if close 21 is proposed will without a doubt be harmful, very 22 harmful to the public interest of the residents of 23 Sussex County. Thank you. 24 DR. ALAIGH: Thank you. James Opfer. 25 MR. OPFER: My name is James Opfer,

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1 O-P-F-E-R. I'm an attorney in Vernon and I've served 2 on the Community Board for nearly 30 years. I know I 3 don't look that old, but I have served for 30 years. I 4 had a wonderful presentation to give, but most of my 5 points have been covered by other people because they 6 speak with Sussex as part of their experience, as part 7 of their history and they spoke from their heart. I'm 8 quite jealous of the people sitting up there because 9 they have certain things I don't have. They have 10 water. They have their own microphones. They have 11 cookies. But one thing they do not have is a thorough, 12 accurate and complete report based upon which they must 13 make a very important decision. 14 Now, some of the deficiencies in the 15 report have been mentioned before. First of all, the 16 population. Just like a bad horror movie certain of 17 our geographical areas have disappeared from this 18 report. Wantage isn't there anymore. But very 19 importantly, I believe our population is about 54,000, 20 but we are a four season area. And during the Summer 21 we have 80 or more. 22 In the report they talk about minorities 23 as being equal to financial deprivation in some way. 24 But that doesn't only apply to minorities, especially 25 in our present financial situation. I found the travel

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1 time as did others absolutely amazing where it said the 2 time from Vernon to Newton Hospital is 23 minutes. As 3 an attorney I appreciate this because that would 4 increase my business by handling all the speeding 5 tickets that I'm sure will arise from getting there 6 that quickly. Unless, of course, they can say, "Beam 7 me up Scotty." I'd like to thank Wayne Ross for 8 reminding me that when Franklin was closed and 9 eventually terminated we were told there would be an 10 emergency room there. The emergency room might be 11 behind a tree or under a rock because that area is now 12 a vacant piece of property. We're told we'll have an 13 emergency room. But the only thing we appear to learn 14 from history is that we learn nothing from history. 15 And I would respectfully request that 16 any decision regarding closure of our hospital be based 17 on a full and accurate report and not what you have 18 been provided with because that is unfair to you. 19 There are no evil people here. Everybody cares. But 20 to quote Animal Farm, "Some people care more than 21 others." 22 MS GIBSON: Thank you. 23 DR. ALAIGH: Ginnie Littell. 24 MS LITTELL: My name is Ginnie Littell, 25 L-I-T-T-E-L-L. I'm the chairman of the Advisory Board

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1 of Saint Clare's Hospital Sussex. I have served as a 2 hospital trustee since 1976. I presently serve as a 3 member of the New Jersey Hospital Association Board and 4 its executive committee. The past 36 years of my 5 involvement have taught me many things that the prior 6 speakers have articulated so well. But the most 7 important lesson I learned was that as a nation, a 8 state and a community we must put the healthcare of how 9 our people first. As healthcare providers we must 10 treat everyone who comes to our facility. For over 11 100 years this rural, hard to access region of New 12 Jersey has always had a hospital staffed with teams of 13 medical professionals who treat everyone with 14 outstanding care and compassion. We truly are a 15 family. 16 A few of the issues that I would like to 17 reemphasize are as follows: Everyone talks today about 18 the tough economic times, but in our area this is the 19 norm. Our hospital provides many families with work 20 that allows them to provide for their families. There 21 are not a lot of places to work in our area. In fact, 22 65 percent of our population goes out of the county for 23 work. 24 Another issue that has been articulated 25 were the serious errors and omissions within the

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1 Certificate of Need that misrepresents the facts of the 2 real issues facing our growing aging population who, 3 now more than ever, need our hospital to remain as a 4 full service hospital. We all know that in New Jersey 5 there's a shortage of doctors. And if this Certificate 6 of Need is approved it will drive many of these 7 professionals out of New Jersey. But what it really 8 boils down to is one thing, and that is access to care. 9 And the New Jersey of Department of Health has always 10 been concerned that the citizens of our state be 11 readily able to receive healthcare. If this 12 Certificate of Need is approved there will be no access 13 to care for our people. We know that there is no one 14 size fits all in healthcare. We are a unique part of 15 New Jersey. And I know that hearing the facts 16 presented tonight will show you that we need to keep 17 our Sussex hospital as a full service hospital. And 18 dollars are important, and we all know that in the 19 business environment, but so is the health and the 20 safety of our patient population. And I know that you 21 will look at the access to care and the fact that it is 22 expensive to deliver it, but it's so important that we 23 do deliver it here. Thank you. 24 MS GIBSON: Thank you. 25 DR. ALAIGH: Thank you. Tom and Jean

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1 Lanzilotti. 2 DR. LANZILOTTI: Thomas -- Dr. Thomas 3 Lanzilotti, L-A-N-Z-I-L-O-T-T-I. 4 MS LANZILOTTI: Jean Marie Lanzilotti. 5 DR. LANZILOTTI: And I'm a cardiologist 6 at Saint Clare's-Sussex. Been there since 1985. My 7 wife, Jean Marie, is a nurse and she's an EMT for our 8 community. We're just going to read a poem. 9 The Night of the Closure. 'Twas the 10 night of the closure and all through the town not a 11 person was pleased with less healthcare around. 12 MS LANZILOTTI: The pink slips were 13 handed to the employees with care being told the 14 certificate of no need would be there. 15 DR. LANZILOTTI: And the doctors and 16 nurses and the whole healthcare crew were told that 17 their inpatient days were now through. 18 MS LANZILOTTI: Even though the care 19 given was second to none CHI was determined to have it 20 undone. 21 DR. LANZILOTTI: The hospital was 22 closing 'cause the census was low. So the sick and the 23 poor now have nowhere to go. 24 MS LANZILOTTI: And a place of 25 compassion with hospice supplying would no longer be

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1 near for the loved one who's dying. 2 DR. LANZILOTTI: Oh, yes, they could 3 travel but they'd have to go far and so many seniors 4 say they don't drive a car. 5 MS LANZILOTTI: And those who drive 6 local to the places they know can't drive the long 7 distance they're required to go. 8 DR. LANZILOTTI: Like the elderly farmer 9 with shortness of breath and the elderly woman with 10 pain in her chest. 11 MS LANZILOTTI: And those with pneumonia 12 who require 02 will leave all their family and friends 13 for from view. 14 DR. LANZILOTTI: And folks with a heart 15 that's too fast or too slow will be taken away to a 16 place they don't know. 17 MS LANZILOTTI: Though the ER is open 18 it's still not okay with all the new rules that now 19 come into play. 20 DR. LANZILOTTI: No more recommended for 21 a freestanding location our critical patients with some 22 complication. 23 MS LANZILOTTI: Like the mother who's 24 bleeding with abdominal pain will be sent somewhere 25 else with a tube in her vein.

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1 DR. LANZILOTTI: And gallbladder colic 2 or an appendix aflame can no longer be managed nearby. 3 It's a shame. 4 MS LANZILOTTI: Away they'll be a taken 5 afraid and alone where family and friends can just 6 reach them by phone. 7 DR. LANZILOTTI: And when someone needs 8 help and calls 9-1-1 the EMS volunteers and paramedics 9 still come. 10 MS LANZILOTTI: But most of all the 11 patients if they're in real distress will be taken much 12 further away nonetheless. 13 DR. LANZILOTTI: To Denville or Dover 14 Warwick or Newton, to Morristown, Chilton, Port Jervis 15 or Boonton. 16 MS LANZILOTTI: And all of the emergency 17 medical technicians will have to perform like 18 healthcare magicians. 19 DR. LANZILOTTI: For the time used for 20 travel and the time that they stall will keep them away 21 from the next 9-1-1 call. 22 MS LANZILOTTI: And in times when 23 there's snow and the roads are so bad, the trip could 24 be tragic for someone's sick dad. 25 DR. LANZILOTTI: For patients can't stay

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1 at the ER for care. They have up to 12 hours to get 2 out of there. 3 MS LANZILOTTI: And if there were a 4 disaster with a school bus and car how will they 5 transport so many so far? 6 DR. LANZILOTTI: Size doesn't matter 7 when lives are at stake. We need access to care to 8 keep Sussex first rate. 9 MS LANZILOTTI: And so we petition and 10 we hope you agree we need inpatient care close to home 11 where it's key. Thank you. 12 DR. ALAIGH: Thank you. Bob Kays. 13 MR. KAYS: Good evening. My name is Bob 14 Kays, K-A-Y-S. I've been asked to read two documents 15 tonight. The first is from Bill DeBoer, D-E-B-O-E-R. 16 He's a member of the Wantage Committee and he's unable 17 to be with us tonight. This is his personal letter. 18 "I've been a resident of Wantage for 27 19 years and served on the Wantage Township governing body 20 for the past 10, three as mayor. As such, the concerns 21 of the residents of Wantage are always foremost in my 22 mind. I have also been an EMT on the Wantage EMS squad 23 for the past 20 years. During this time I've brought 24 hundreds of our residents to Saint Clare's 25 Hospital-Sussex campus for emergency care. I have real

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1 concerns regarding the anticipated closing of the 2 hospital beds at Saint Clare's. One is that the 3 transport of any patient that needs admission for 4 further care would require more than 30 minutes. This 5 would not only affect patient care but also would 6 require our ambulance to travel out of our service 7 area. This would increase costs, wear and tear on our 8 equipment, but more importantly it could leave our 9 residents without EMS service should a second emergency 10 call arise. 11 How I hope that you will consider all 12 the factors when making your decision. Thank you for 13 your consideration." And it's signed Bill DeBoer. 14 Second document is a resolution from the 15 Mayor and Council of the Borough of Hamburg. Whereas, 16 the Saint Clare's Hospital Sussex campus has been a 17 local healthcare institution helping the residents of 18 Sussex County for many years dating back prior to 1974 19 when it was known as Alexander Linn Hospital. And 20 whereas, Saint Clare's Hospital is an enormous part of 21 the lives of many residents in Sussex County and having 22 the hospital close would diminish its services and 23 create the loss of healthcare jobs. And whereas, Saint 24 Clare's Health System is asking the State to close the 25 inpatient rooms, operating rooms and all the outpatient

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1 procedures and endoscopy facilities at the Sussex 2 campus. And whereas, should the State grant permission 3 only the emergency department, radiology and laboratory 4 facilities will remain open and the patients requiring 5 hospitalization will need to be transported elsewhere. 6 Cared for by physicians who are not their primary care 7 physicians and add up to 45 minutes to their travel 8 time to obtain healthcare services. Whereas, the 9 Sussex campus known as Little St. Clare's was recently 10 rated number one in the state for physician 11 communications to patients in less than 350 bed 12 hospitals, as well as being rated number two in 13 cleanliness. Whereas, Saint Clare's Hospital has 14 proven itself to be an outstanding facility and has 15 performed above 90 percent, as high a 100 percent in 16 the federally monitored programs for medical management 17 of heart attacks, heart failure and pneumonia. Now, 18 therefore, be it resolved, that the Mayor and Council 19 of the Borough of Hamburg, Sussex County, State of New 20 Jersey do hereby request by unanimous vote that the 21 facility known as Saint Clare's Health System Sussex 22 campus remain an active hospital as it stands today. 23 In the event that this is unattainable and the State of 24 New Jersey chooses to close the inpatient rooms, 25 operating rooms and all outpatient procedures, then it

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1 should at least remain active as an emergency facility. 2 Be it further resolved, by the Borough Council of 3 Hamburg. 4 And a quick note, personal note, one 5 quick personal note. If I had to have a 6 life-threatening condition and I had to take a 7 45-minute to an hour ride in an ambulance, I don't want 8 to die in that ambulance on my way to Dover or Denville 9 or Newton. I want to live in Sussex. Thank you. 10 DR. ALAIGH: Thank you. Austin. I'm not 11 going to even try the last name. 12 MR. CAREW: My name is Austin Carew, 13 C-A-R-E-W. And Austin is like in Texas. When I found 14 out that there was a proposal to close Saint Clare's 15 Hospital, to be honest with you, I was outraged and in 16 shock. I had served as the Mayor of Vernon Township 17 which is an adjacent town which happens to be the 18 largest town in the county. I think it's equivalent to 19 one fifth the size of the population. And we rely on 20 Sussex Saint Clare's Hospital quite a bit. I also 21 served as an EMT for many years. And I realize the 22 difficulty, if not the impossibility, of residents, 23 especially in my town, getting adequate medical care in 24 unexpected situations. When it's a nice sunny day and 25 there's not a life threatening situation, it's not a

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1 problem. But when a bus rolls over coming into our 2 town bringing in tourists or a gasoline truck explodes 3 and divides our town, in fact, it's a different story. 4 And yes, you can have an emergency room. And that's 5 great. But where do the people go? What does the bus 6 carry, 50 people? That's one incident. While I was on 7 the Board of Education we had a number of close calls. 8 Our town is very hilly. You get a couple buses or one 9 bus come down the hill the wrong way in a bad storm, 10 we're really in jeopardy. 11 I wanted to mention something else, if I 12 could. I don't know if the Board is aware of, but 13 Vernon Township has five redevelopment areas. And in 14 the redevelopment areas we actually designated 15 hospitals because we felt, as well as the developers 16 agree, that it's critical to have a hospital with 17 quality of life. You don't close hospitals when your 18 population has increased. I lived in this town in 19 Vernon Township for over 40 years. I've seen the 20 population triple. At this point our daytime 21 population is huge because of the tourist attractions. 22 We have over $800,000,000 potential 23 investment in Vernon Township. I don't know if your 24 Board is aware of some of those facts. $800,000,000 of 25 hotel rooms and facilities that are going to attract

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1 people, residents as well as tourists, daytime 2 tourists. In some seasons, the Winter season's a big 3 season with the ski areas. And you know what happens 4 in the Winter season in an area like Sussex County with 5 the hills and the roads. You definitely do not want to 6 close that hospital. I don't know about your business 7 practices, but why it's perhaps under utilized. I'm 8 unfamiliar with it. 9 But in closing I would like to if you 10 ask you to please reconsider. Quality of life, you 11 can't even put amount of money on quality of life. 12 Nobody knows what quality of life is, but they sure 13 know when they don't have it. And we have quality of 14 life. And I think your hospital has contributed to it. 15 So thank you for listening to my comments. 16 DR. ALAIGH: Pam Flynn. 17 MS FLYNN: Pamela Flynn, F-L-Y-N-N. I'm 18 here tonight as a resident of Sussex County, Sussex 19 Borough. I can call myself a neighbor of Saint Clare's 20 Hospital because I live a block from the hospital. I'm 21 also a member of the hospital's auxiliary for many 22 years, as well as a school nurse here in Sussex 23 Regional School District and also as a member of the 24 High Point High School Board of Education. So I'd like 25 to start off by reading a resolution that we recently

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1 passed at our May 23rd meeting. 2 "Dear Governor Christie, Senator Oroho, 3 Assemblyman Chiusano and Assemblywoman McHose, the High 4 Point Regional High School Board of Education strongly 5 objects to the proposed closure of the patient services 6 at Saint Clare's Hospital because of the impact it will 7 have on many High Point students and their families. 8 We ask that you postpone the decision to close the 9 hospital, set up a plan to increase utilization and 10 attach a reasonable a timeline to evaluate those 11 results. Sometimes we need to base our decision on 12 what is best for the community and not just what is 13 best for the bottom line. 14 Consideration should be given to the 15 fact that the condition of the economy has had adverse 16 effects on the people of Sussex County in the form of 17 unemployment, job loss, increased taxes, foreclosures 18 and reduced wages. This is an argument to preserve the 19 availability of the hospital services within our 20 community and not force already economically challenged 21 community members to travel out of state, in some 22 cases, to visit their loved one in the hospital. 23 The High Point Board members ask you to 24 consider the impact of this move on the Sussex 25 community and surrounding areas and reject the proposed

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1 termination of services. Thank you for your 2 consideration regarding this matter. Sincerely, John 3 Hannum, our superintendent as well as the members of 4 the Board of Education." 5 The resounding theme tonight that I'm 6 hearing over and over again is that there's no PR, no 7 public relations for our small community hospital. 8 People think it's closed because nobody's PR'ing for 9 it. Nobody's putting information out there to let them 10 know we exist. There's been no new physician 11 recruitment. We keep hearing that these doctors are 12 leaving and no one has brought new doctors in to 13 rejuvenate this hospital and keep it going. Saint 14 Clare's administration has allowed this to happen. You 15 need to lessen to our thoughts, our words, our fears 16 when considering our hospital Certificate of Need. 17 Please take it seriously to heart and do no harm to our 18 residents. Please do the right thing and reject the 19 Certificate of Need. Thank you. 20 DR. ALAIGH: Patricia Hefferan. 21 MS HEFFERAN: Hi. My name is Patricia 22 Hefferan, P-A-T-R-I-C-I-A H-E-F-F-E-R-A-N, as in 23 neighbor. I just wanted to very quickly extend my 24 compliments and gratitude to Eric Obernauer who was 25 writing for the New Jersey Herald who has presented a

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1 very balanced profile on the problem we're addressing 2 today. 3 I am a registered nurse. I hold a 4 Master's degree in education and counseling. Wasn't 5 going to mention that, but since it impacts my life, it 6 also impacts the commitment I feel for our local 7 hospital, what I'm sure is shared by many. I used to 8 work for Saint Clare's in Denville and Boonton for many 9 years. They were wonderful years. I have wonderful 10 memories and hold Saint Clare's in high regard. We are 11 here now to advocate for the hospital in Sussex 12 Borough. I'm sure that the new corporate overseers 13 will site red ink and underutilized services. So 14 rather than think outside the box, get to know the 15 impact of this hospital has on Sussex County come up 16 with answers that will turn red ink into black ink. 17 The quick and easy answer is to reduce services, off 18 with their heads hand move on. 19 My husband died in a lake on our 20 property as we were preparing to ice skate. Have any 21 of you ever lost someone to a stroke? Not a stroke 22 that lingers with slurred speech and paralysis but one 23 that is the equivalent of some putting a bullet to your 24 head and pulling the trigger. This is how Paul died. 25 He survived long enough to be put on a ventilator. His

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1 corneas were donated after his death. They gave sight 2 to a stranger. 3 Where would you want to be if this 4 happened? I want to be in a small local hospital with 5 close ties to the community. I want to be in a 6 hospital that employs nurses who are my neighbors that 7 I greet in the A&P. The care given me at that time was 8 above and beyond what any other hospital would do. I 9 was allowed to sleep in an empty bed to be near him. 10 And it took me less than 15 minutes to reach his 11 bedside when I was needed at home. We had only lived 12 in the community 18 months. 13 Because of Paul's death I met Dr. Dennis 14 Fielding who attended him. He became my primary care 15 physician. I was hospitalized for life threatening 16 asthma. Dr. Fielding attended me again. I mention 17 this doctor/patient relationship because doctors who 18 choose to practice in internal medicine are few and far 19 between. It is in ways similar to hospitals like Saint 20 Clare's in Sussex Borough. I only ask that services at 21 Saint Clare's in Sussex be allowed to remain as the 22 small hospital as part and parcel of our county. We 23 are a rare bucolic, rural area. We are a blend of 24 people who have chosen to live without many services to 25 enjoy the beauty of this area. Don't ask us to live

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1 without Saint Clare's in Sussex Borough. It is the 2 generator of warm and loving services that are 3 representative of and intrinsic to our county. To 4 reduce services at this hospital is to cast an axe blow 5 no only on medicine practiced in a deeply caring 6 community level, but it would yet be another hospital 7 with close ties to the community to be, and I put this 8 in quotes, excommunicated. Thank you and God bless. 9 DR. ALAIGH: Ed Izbicki. 10 MS DONLEN: I sincerely apologize. I 11 was stuck on Route 80 for over an hour. I'm Judy 12 Donlen. I do understand that that is an issue in this 13 kind of instance, but I did want to indicate to you 14 that I did appreciate all of your time for showing up 15 at 6:00. And I'm very sorry I couldn't be here, too. 16 MS PASTORE: I am not Dr. Izbicki. He 17 is the superintendent of the Sussex Wantage Regional 18 School District. My name is Tammy Pastore. I am a 19 school Board member. That's Tammy, T-A-M-M-Y Pastore, 20 P-A-S-T-O-R-E. Basically, I was given the -- I have 21 the same resolution that Pam Flynn had read from the 22 High Point Regional School District, so I'm not going 23 to repeat all of the words. It was the same letter 24 written to Littell McHose. 25 What I would like to do on another level

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1 is to, first of all, to say that for the Sussex Wantage 2 Regional School District I'm very proud that they took 3 the stand in the community to support this rejection. 4 As a community member I live in Wantage Township. That 5 was the township that was omitted. I have seven 6 children and we've used the hospital more than a number 7 of times. For a while they had an easy pass that I'd 8 be able to go in. So needless to say, I was always 9 given the utmost care. And I used it tremendously. As 10 a mother I'm also a member of the Sussex Ladies 11 Auxiliary in the hospital and we've had meetings 12 regarding this. And some of the points that have been 13 given as far as the PR for the hospital and the 14 promotion of it, one of the things that came up had to 15 do with health insurance. We all know how powerful 16 that industry is. And when -- I forget who it was that 17 stated that so many members of this community don't 18 realize that this hospital is even open or we have a 19 brand new women's facility that is not utilized. 20 The health industry -- the health 21 insurance needs to funnel people to that. When you 22 call and get a test or have one scheduled they don't 23 even suggest Saint Clare's hospital. It needs to be in 24 there as that. I know there's numerous people that 25 want to talk, so I am going to close. I'm just going

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1 to read the last sentence on this: "The Sussex-Wantage 2 Regional District Board members want ask you to 3 consider the impact of this move on the Sussex and 4 Wantage community and surrounding areas and reject the 5 proposed termination of services. Thank you for 6 consideration regarding this matter." 7 MS DONLEN: Jean Jaeger. 8 MS JAEGER: Jean Jaeger. That's J-E-A-N 9 J-A-E-G-E-R. I'm a retired teacher. And the first thing 10 I'd like to do is suggest that you revisit the report. 11 There are a lot of errors on it. It needs to be edited 12 and corrected before it's acceptable to any of us, I'm 13 sure. I didn't realize there were so many mistakes. 14 I'm afraid this is a deal that's probably been set and 15 settled and I feel kind of negative that this is just 16 to appease us country folk here tonight. I do have 17 some serious concerns. 18 If a patient is taken to Saint Clare's 19 emergency with a heart attack, stroke or perhaps 20 pneumonia and then transferred to Denville will that 21 patient need to spend time waiting in an ER there as 22 well? Or will that patient be seen promptly and 23 directed for treatment? Many of the residents of the 24 Sussex Wantage area, as we've heard before, are of the 25 elderly population. The ambulance ride alone,

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1 frightening experience even with our terrific volunteer 2 first aid squad. A second transfer and then a long 3 wait in the ER again could be deadly. Is there a 4 communication plan ready for prompt treatment upon 5 arrival in Denville or Dover or Morristown? If a 6 patient is brought into the ER in Sussex will he or she 7 receive medication necessary like a clot busting drug 8 for stroke victims or an antibiotic to treat pneumonia 9 at the Sussex campus or will that patient need to be 10 evaluated at Denville? Again, this could be deadly. 11 In such cases time is of the essence. I would like the 12 plan described. 13 In conclusion, I have a mom that's in 14 her mid 80's. She was hospitalized in the Spring and 15 Summer of 2011 in Sussex, in Newton, in Denville and 16 Morristown. Of all the hospitals Saint Clare's was the 17 place where she was treated the best. The staff was 18 always professional and caring. The facilities 19 absolutely the cleanest. And the fact that her own 20 personal physicians were there for her certainly helped 21 in her recovery. Her family was nearby. That alone 22 was a comfort to her. What a shame to let our little 23 community hospital go. 24 MS DONLEN: Bill Geddler. 25 MR. GEDDLER: Bill G-E double D L-E-R.

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1 First of all, I'd like to thank the woman up here for 2 proving the point about travel. President of the 3 Wantage Township Taxpayers Association but I'm here 4 tonight to speak for myself. I was never employed in 5 the medical field but I was employed for about 50 years 6 in the field of engineering. 1989 I was a resident in 7 the then Wallkill Valley Hospital twice. If it wasn't 8 for Dr. Chin, Dr. Idjadi and the dedicated staff of 9 Wallkill Valley I would not be here today. When I was 10 in the Wallkill there were three -- there were times 11 when, apparently, there are so many patients they had 12 extra beds in the halls. 13 As I already said, I was employed in 14 engineering for 50 years. During the 50 years I was 15 employed by several engineering consultant firms. I 16 was employed as an engineering manager of two New 17 Jersey corporations. I worked on studies for clients 18 and I contracted companies to do studies for me. Based 19 on my experience the study done by the Urban Health 20 Institute as submitted by Saint Clare's sits right up 21 there with some of the worse studies I've ever read. I 22 did get a copy. The study lists five communities, five 23 towns but the study doesn't even mention Wantage 24 Township. Wantage Township is only 68 plus square 25 miles. In fact, this public hearing is being held in

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1 Wantage Township. If the quote, experts, unquote, who 2 made the study don't even know the difference between a 3 zip code area and a municipality can we believe 4 anything else they come up with? 5 Obviously the mistake invalidates the 6 information contained in the study. On page two and 7 again on page five the study reads additional 6 to 8 22 minutes of travel time. A page 12 a chart shows 9 that the six minutes he had to travel 9.04 miles. To 10 accomplish this you had to drive at 90.4 miles per 11 hour. Based on recent (inaudible) depending on the 12 type of car that you drive you might qualify for State 13 Police escort. Page five reads that the patients will 14 then be transferred by local ambulance squads. The 15 members of these squads are dedicated volunteers not 16 paid taxi drivers. If they're transporting a patient 17 to Denville they obviously will not be available to 18 respond to a medical emergency in their municipality. 19 The study mentions Sussex County is starting to ride 20 bus lines. The study fails to mention the schedule 21 travel time is one hour and 20 minutes, not 26 minutes. 22 MS DONLEN: Thank you. I'm trying to 23 move it along to get as many people in. The more that 24 you applaud, if I have to wait to the end of your 25 applauding then you'll lose time. That's what I have

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1 to do. 2 MR. BASSO: Ronald Bassani, B as in boy 3 A-S-S-A-N-I. I'm the Deputy Mayor of Wantage Township. 4 And officially I'm here representing leadership 5 Wantage. I also have a proclamation which I will not 6 read tonight. I will turn it in so at least you have a 7 copy of it. But it basically is consistent with the 8 others that have been read before in support of denying 9 this application. But as I'm sitting here tonight I 10 found myself it taking some notes. 11 I'd like to just read a little bit for 12 myself as opposed to Deputy Mayor. Separating from by 13 official role, I would like to thank Dr. Fisher for 14 actually articulating the concerns that I also share. 15 You're watching a historically successful hospital 16 being systematically dismantled. All of us here 17 tonight are intimately aware of the state of the 18 economy and the pressures of all businesses to turn a 19 profit. We live right now in very difficult times, but 20 the business of healthcare is a unique business. It 21 impacts the life and death struggles of its customers, 22 the surround community. I must is say it's extremely 23 difficult to sit here tonight and listen to doctors 24 fight for the opportunity to treat family and friends. 25 I request the Board deny this application and force

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1 investment rather than except further dismantling. 2 Please be bold enough to send a strong message to the 3 business of healthcare that people come first. And the 4 responsibility to serve comes before profits. If not, 5 as you may have guessed, if you allow this facility to 6 be reduced to an emergency only facility there will be 7 a next smallest hospital in New Jersey. Stop the trend 8 now. Thank you. 9 MS DONLEN: Dough Ricker. 10 MR. RICKER: Douglas Ricker and Joy 11 Ricker, R-I-C-K-E-R. Former Mayor of the municipality 12 which you are now sitting in which is not in the 13 report. I'll start with the Wantage EMT. And we have 14 the greatest EMT's, Hardyston, Sussex, Wantage, you 15 name it. They're the greatest. And we want them to 16 work in the area not out on the roads. We are an 17 agriculture community. What that means? That's the 18 basics of everything. And we are a hazardous. So we 19 need this hospital. And I want to thank these doctors. 20 I think it's about six or seven of them have worked on 21 me. Had one guy poke me up the back end. Lanzilotti 22 here, he takes my blood pressure. I see him the other 23 day and I was 80 over 60. Hey, you lost 20-pound. 24 Maybe you should cut the medicine in half. And we have 25 Denise over here. One Sunday morning I called her

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1 husband who was the Chairman of our recreation 2 committee. I said, "I'm going to die." And I said, "I 3 got a pain in my shoulder." She said -- Denise came on 4 the phone. She said, "I'll meet you in Sussex hospital 5 in 15 minutes." She went down, put a shot in my 6 shoulder. You see it works. 7 So we have a situation here where we are 8 here to help you and we hear the word that we're from 9 Trenton and we are here to help you. So what we going 10 to do? I need this hospital here because I'm only one 11 slip from being in there. And 74 years. I wasn't born 12 in the hospital here. I was fortunate to have a 13 midwife that I was delivered by, but my first visit to 14 the hospital was out here in this where the school is, 15 that addition is. We had a herd of cows run out there 16 one night. And I come in and I was in the third grade. 17 And we went out for recess. We running around. And 18 wrestle with a few guys and this elbow went into a cow 19 hoof. So I made my first visit to the Sussex hospital. 20 I went to the hospital for my appendix. Doctor said 21 we'll pour a lot of Penicillin in there and we hope 22 you'll survive. I'm still here. And one doctor here 23 he said I needed something up my back end. And he said 24 everything's all right. My wife tried to save the 25 place to have maternity ward 38 years ago. So I think

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1 I've said enough. Listen to the boss of the family. 2 MS RICKER: I'm Joy Ricker. I've been a 3 resident of Wantage Township for 52 and a half years 4 which I say I've been married for 52 and a half years. 5 I came from (inaudible) county. I've had four kids 6 raised here. And I have one granddaughter right now. 7 But I'll tell you, the first 15 years my married life, 8 my children, myself, my husband a lot of us were in the 9 hospital. And then I had a short period where I did 10 not have hospitalization because I could not afford it. 11 And I fell in the barn. And the hospital treated me 12 with open arms. Dr. Idjadi was there. He told the 13 doctor that was going to do surgery on my knee, he 14 said, "Treat her nice. She's a good lady." I hope I 15 am a good lady. And all the doctors that are here we 16 have had as physicians, they have been great to us. 17 And I also will say the reason I got 18 involved in the maternity situation at Alexander Linn 19 Hospital is because I had all my children there but 20 one. And he had to be born in Port Jervis. So I've 21 used myself as the forefront for all the publicity and 22 stuff because I had no axe to grind with anybody. And 23 everybody was afraid if they put their foot forward 24 they were going to lose jobs and stuff like that. So I 25 said, "Well, you could use me." But right now I'm

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1 fighting for the hospital because it would be a dire 2 tragedy -- travesty for my husband and I at our late 3 stage in life, my husband doesn't get around too well 4 and I do fall once in a while which a couple doctors will 5 attest to because I've had a couple weird things happen 6 in the past year. So please keep the inpatient open 7 because we might need it. Thank you. 8 MS DONLEN: Carol Jaccodine. After that 9 it will be Carolyn Price and then Ron Price. 10 MS JACCODINE: It's Carol Jaccodine, 11 J-A-C-C-O-D-I-N-E. When we moved no Hardyston Township 12 several years we had a hospital in Franklin and Sussex. 13 Dr. Sugar saved my daughter's finger when it was almost 14 severed in an accident. Had we waited in the Newton ER 15 she could have lost it. My husband was bitten by a bee 16 and went into anaphylactic shock. Dr. Fisher and the 17 nurses in the ER saved his life. They were both taken 18 care of at Franklin hospital, but the hospital was 19 losing money so it was closed as an inpatient facility. 20 We were told that Sussex would take good care of 21 everyone. We would no longer have Franklin to go to. 22 Franklin was to remain open for support services and 23 counseling. We all saw what happened. It is gone. My 24 father and mother-in-law were both admitted to Saint 25 Clare's-Sussex for very critical condition. Dr. Fisher

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1 and Dr. Beckman and all the wonderful nurses took such 2 good care of both of them that my father lived to be 3 over 96 years old and Dr. Fisher took care of him right 4 up to his last day. My mother-in-law is over 97. And 5 thanks to Dr. Fisher's care is doing very well at 6 Bristol Glen. 7 Recently my husband was having side 8 pain. He visited Dr. Fisher who suggested a CAT scan. 9 When we left the hospital we called and he told my 10 husband to return and be admitted. Dr. Fisher referred 11 us to Dr. Gabre who had recently been added to the 12 staff at Saint Clare's. He assessed the symptoms and 13 he and Dr. Fisher treated my husband. And in one week 14 he was able to come home. His care while in the 15 hospital was incredible. And both Dr. Fisher and Dr. 16 Gabre visited and monitored him on a daily basis. 17 Surgery was later performed by Dr. Gabre, but all of 18 our pre and post-op visits were at the Sussex campus 19 which was more convenient for us. 20 All of our family has been treated Dr. 21 Fisher form many years. We trust him and we know he 22 will make certain that we receive the care we need. He 23 is always there for us to answer any questions or 24 address any concern we may have no matter what time, 25 day or night. A hospitalist cannot provide the comfort

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1 of your own doctor. They do not know you or your 2 history. They are reading about you from a lap top. 3 Traveling a great distance to get care will not allow 4 family members to visit when they want to stay. Being 5 in a massive hospital setting does not provide the kind 6 of personal attention a smaller setting provides. 7 We are being told that Saint Clare's 8 will stay open to provide ER and other services. We 9 were told that about Franklin, too. We need more than 10 a promise. We need a hospital that can continue to 11 provide the services that it has in the past by doctors 12 and staff who know and care about their patients. We 13 know everything is based on a business model and the 14 bottom to line is important, but Saint Clare's is a 15 life line to all who come here. We deserve to have the 16 care that we have depended upon all these years from 17 the doctors who have dedicated their lives to us and 18 their hospital. They deserve to have the opportunities 19 to care for their patients in a hospital as well as in 20 their office to make certain that what they prescribe 21 is carried through. When considering your decision, 22 please put yourselves into our shoes. Think about 23 whether or not you are willing to travel a great 24 distance to get care, take the risk of getting there 25 too late and then not have your own doctor to see or

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1 care for you. Would you want that for yourself or for 2 your family? Thank you. 3 MS PRICE: My name is Carolyn Price. I 4 live in Franklin. 5 MR. PRICE: And my name is Ronald Price. 6 I also live in Franklin. 7 MS PRICE: In 1994 my sister had 8 lymphoma. Her doctors, her hospital was Denville Saint 9 Clare's. She did not want to go in the rescue squad. 10 So I was her transportation each time she needed to go 11 to the emergency room toward the end. Okay. The 12 traffic was horrendous. The doctor told me I never 13 should have put her in my car, I should have given her 14 to emergency people because she went in on red alert 15 three times. When I there was a huge snowstorm, 16 blizzard coming. She was red alert into the hospital. 17 A neighbor brought my mother down in the blizzard so 18 that we could stay there. The whole waiting room was 19 full of people that were staying because they had 20 family members in that emergency room and they were not 21 expected to live. Had she been -- had doctors here in 22 Sussex County and utilized Saint Clare's here she would 23 have been far better off. In 2003 my mother fell and 24 broke her hip. She laid on the basement floor for six 25 hours because she had no way of communicating with

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1 anyone. I found out and I got a friend to go over and 2 she took care of my mother, got an ambulance and they 3 got her to Saint Clare's. Now, had she not had this 4 close proximity of Saint Clare's in Sussex she would 5 not have survived. They didn't expect her to survive 6 the operation for the hip replacement that she received 7 from Saint Clare's. Friends and our families said they 8 didn't even know that they did hip replacements in 9 Saint Clare's. They were really shocked because they 10 would have been there had they known it. In 2005 I had 11 a gallbladder attack. And I was very sick. Took me to 12 Saint Clare's. They took care of me. My mother came 13 in the ambulance with me. She was able to get a ride 14 home from a staff member which was not someone that we 15 knew, but someone that was gracious enough per hospital 16 administration to give my mom a ride home to Franklin. 17 She couldn't drive. She had no car. And they took my 18 son with us. And this was very nice. She had heart 19 problems. Dr. Lanzilotti helped us out significantly. 20 Had she had to go outside of the area she probably 21 would not have made it. 22 And the hospital staff and everyone in 23 the community has always been so gracious. And I have 24 not found that in other hospitals. And I know when we 25 were in Saint Clare's Denville there was not the

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1 community of professionals or residents there that you 2 find here in Saint Clare's. We need it. Please, 3 please, do not close it. Thank you. 4 MR. PRICE: To me Saint Clare's hospital 5 Is an extremely nice, very intelligent and I welcome to 6 have them. They're extremely, extremely -- they go 7 completely -- they go out of their way to do whatever 8 is needed. 9 MS DONLEN: Thank you. Visiting nurse 10 from Saint Clare's. I can't make out the name. Looks 11 like last name may be Franzin. 12 MS FUNGHINI: It's Jean Funghini, 13 F-U-N-G-H-I-N-I. I just want to say that nobody knows 14 better than me. These patients most of them I know. 15 And I know how difficult it is in the isolation. 16 Wantage is a big section. In some areas it takes an 17 hour to get to. Forget about 45 minutes. The other 18 thing is I guarantee you the mortality rates are going 19 to be affected. I can guarantee that. Old, rich, 20 everybody. Okay. Because by the time they get into a 21 hospital on time and if they're not treated by their 22 own doctors. Many times have multiple medical history. 23 The communication is also going to be another issue. 24 When they get to these other hospitals their own 25 doctors know them better than anybody else. Many of

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1 these people have never known other doctors but the 2 doctors here. So I can guarantee you the mortality 3 rates are going to go up. And it doesn't matter old, 4 rich and in between. And I just don't see why these 5 people have to lose their doctors or their lives. It's 6 just not right. Okay. So you need to take that into 7 consideration, too. Mortality rates are going to be 8 affected. 9 MS DONLEN: Cindy Kessler. And after 10 her will be Maureen Carr. Is Cindy Kessler here? All 11 right. Maureen Carr. And after Maureen Carr will be 12 Christine Capozzoli. 13 MS CARR: My name is Maureen Carr, 14 M-A-U-R-E-E-N C-A-R-R. I have come here tonight to 15 speak on behalf of a little known casualty of the 16 closures in Sussex. That casualty is the adult medical 17 clinic. I have been a registered nurse for 32 years 18 working mostly in emergency medicine, but more recently 19 have divided my time between the emergency room and the 20 adult medical clinic. I've been proud to work along 21 side Dr. Patel in caring for the patients who come to 22 the clinic for treatment. The clinic is only open 23 eight hours a week specifically on Monday and Thursday 24 morning. I am the only nurse and Dr. Patel is the only 25 physician. The patients who use the clinic are people

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1 who find themselves in difficult circumstances. Many 2 have lost their jobs and their health insurance. Some 3 do not even have their own vehicle to get around. They 4 rely on the kind necessary of others to get to the 5 clinic or they are walk to the hospital. Some cry in 6 the clinic office because they have had apply for 7 charity care, many for the first time in their lives. 8 The clinic provides these people with the needed 9 medical care including lab work and x-rays when 10 appropriate. New patients are added almost weekly. 11 Many of these knew patients are referred from the 12 emergency room. In the past few months alone we have 13 diagnosed two patients with different types of cancer. 14 In each case the patient was seen in the ER and then 15 referred to the clinic. It was not until they were 16 seen in the clinic that the diagnosis was made. We 17 were then able to arrange for the appropriate team and 18 timely treatment. The clinic also provides 19 prescriptions for medications for a myriad of diseases 20 such as hypertension, diabetes and asthma. We arrange 21 for some patients to receive their medications free of 22 charge through drug companies and many others receive 23 them through reduced rates at local pharmacies. If the 24 clinic closes many patients will not be able to get 25 their medications because they do not have the

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1 resources to obtain them from other places. A trip to 2 Newton or Dover will next to impossible for many of the 3 clinic patients. Additionally, the ER doctors cannot 4 write prescriptions for these patients because they 5 need to be monitored for changes in their health. It 6 is not the responsibility of the ER to do this. It is 7 the responsibility of the primary care physician, in 8 this case the clinic. The patients will to the ER in a 9 poor state of health because they will stop taking 10 their medications due to lack of access to care. Eight 11 hours a week for the clinic to be open is small 12 compared to an ER hospital bill that they may incur. 13 These people deserve our care and compassion. I 14 respectfully urge you to keep the clinic open for the 15 good of the community. Thank you. 16 MS DONLEN: After this speaker will be 17 Gregory Sheehan then Michael Brennan. Richard Brennan. 18 Sorry about that. 19 MS CAPOZZOLI: Good evening. My name is 20 Christine Capozzoli, C-A-P-O-Z-Z-O-L-I. I live in 21 Clove Hill Manor, a 55 plus community in Wantage. 22 Having a local hospital minutes away helped influence 23 our decision to live here. My husband passed away 24 December of 2011 after an almost three-year battle with 25 cancer. During those years there were many trips made

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1 to Saint Clare's had hospital in the middle of the 2 night. After so many chemo treatments Nick's blood 3 cell count would drop and he would need to be 4 hospitalized for blood transfusions. I would simply 5 drive to Saint Clare's emergency room where he would be 6 examined and admitted to the hospital for treatment and 7 see his local doctor the following day. After he was 8 settled, I would drive the 10 minutes home. He would 9 also need admittance if he ran fevers of only 100.1. 10 It was a very stressful time for both of us. What made 11 It bearable was knowing help was only minutes away and 12 people you knew would be caring for him. If I hadn't 13 had the convenience of Saint Clare's I would have had a 14 long, dark drive to either Newton Hospital over the 15 mountain which is incredibly dangerous in Winter, to 16 Port Jervis, to Bon Secours or to Saint Clare's in 17 Denville, a 45-minute drive at 2:00 or 3:00 a.m. Then 18 I would need to drive home after an exhausting, 19 frightening evening alone. If you don't live in a 20 rural area it's hard to imagine not having such 21 services readily available. If you don't drive or have 22 a car you are totally dependant on the kindness of 23 family and friends since mass transit is virtually 24 nonexistent. Yes, you can call an ambulance but how do 25 you get back home? Please, before you proceed with

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1 closing Saint Clare's do a more thorough investigation 2 of our area of needs. There are thousands of people 3 coming to the age where they'll need more healthcare 4 services, certainly not less. Thank you for coming 5 tonight and listening. I hope only hope you heard. 6 MS DONLEN: Gregory Sheehan. 7 DR. SHEEHAN: Good evening. My name is 8 Dr. Gregory Sheehan. G-R-E-G-O-R-Y S-H-E-E-H-A-N. I'm 9 a New Jersey state licensed chiropractor. I have 10 maintained a private practice in nearby Vernon Township 11 since 1978. As a chiropractor I'm not affiliated with 12 Saint Clare's hospital in Sussex, but in 33 years over 13 150,000 case history and patient encounters I'm very 14 aware of what this hospital means to the patients of 15 this area. Indeed, my family members have benefited 16 from care here. In my practice I've depended upon the 17 hospital for lab and imaging procedures and direct 18 referral. I respect the dedication and reliability of 19 the physicians, nurses, support staff, volunteers, EMS 20 and ambulance that work here. In any community one of 21 the first civic endeavors is to bring medical care 22 locally. It is regarded as progress toward the quality 23 of life. To take this patient services away is a 24 regression. To the parent company Saint Clare's must 25 ask that if your mission statement is to provide

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1 quality medical care whatever you must do keep the 2 hospital in tact. Good will come from that. In a day 3 and age when we read more about pharmaceutics and 4 health delivery systems in the business section of the 5 newspapers than in the science section, the mission can 6 become blurred. And in my opinion bad can come from 7 that. The fact that we are a relatively small 8 community in the corner of the state does not diminish 9 that opinion. Thank you. 10 MS DONLEN: After Mr. Brennan we have 11 time for two more speakers, Michael Puskas and Michael 12 Emmerich will be the two last speakers. 13 MR. BRENNAN: Richard Brennan, 14 B-R-E-N-N-A-N. And I'm from a town which you may never 15 have heard of called Hardyston. About 12,000 people in 16 Hardyston. And they're not mentioned in the 17 application as Wantage is not mentioned in the 18 application. But I want to thank you for coming here 19 tonight and spending a lot of time. You spent a lot of 20 time driving. And I hope that this really means that 21 you're going to listen to what's said and take it to 22 heart in an open frame of mind. This is not a closed 23 deal. This is an open session. And hopefully it will 24 be addressed that way. I would also like to thank all 25 my neighbors for coming out. These people came out and

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1 told their stories. And they're true. And they show a 2 real critical need for what's called inpatient hospital 3 some services tied to emergency room services, 4 outpatient service. But if go there and you need some 5 treatment to be admitted to the hospital, you need to 6 be admitted to the hospital as an inpatient. If that's 7 taken away, that takes away more than half of the 8 capability of what the hospital represents. There is 9 one other thing that I'd like to ask you to do, to take 10 a look at and possibly consider the misconception and 11 that is that Saint Clare's is licensed to have 106 12 beds. Does Saint Clare's have 106 beds available for 13 inpatient? I don't think so. I think they have about 14 30 something actual beds available for inpatient. And 15 they say that the average is about 12 patients as 16 Inpatient. That's nearly half the capacity of the 17 existing inpatient bed facility. That's hardly an 18 underused facility. That's a critical need facility. 19 We don't expect Saint Clare's to have 20 open heart surgery or brain surgery, but we do expect 21 them to be there for the critical continuing need. 22 When you're at the hospital, you need a few days of 23 hospitalization in order to get over whatever it is, 24 you need to have your primary care physician there. He 25 knows you. It's not an intern who's reading a chart

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1 and trying to figure out who you are and what you need. 2 It's your personal care physician who's there that 3 night right away. If it's not an inpatient facility 4 that's not available and will never be available again. 5 The other point is I wonder why a garden 6 is mowed down and distributed before the sale is 7 complete of a house. And what I'm referring to is you 8 have the ability to continue the people, the staff, 9 without firing them before the new people come in and 10 make an evaluation to see what is really needed, what 11 can be done and what should be done. You annihilate 12 the staff, they'll never come back. Please keep it 13 open. 14 MR. PUSKAS: Michael Puskas, 15 P-U-S-K-A-S. It's obvious by my shirt I'm also a 16 member of the Wantage First Aid Squad. And I've been a 17 member for the past 20 some odd years most of the time 18 that I've been a resident up here. Prior to this I was 19 a resident in Bergen County. And I'm also an EMT down 20 there. As part of my training many, many years ago 21 back in dinosaur days our first lesson was that you 22 treat all the patients with respect. And I think 23 that's the biggest, the biggest factor we have to take 24 away from this audience that is here today and the 25 people that are here today. The staff of that hospital

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1 that I've seen, the thousands of patients, literally 2 thousands of patients I've transported there over the 3 years have been treated with respect. And that is key 4 to any healthcare system. This hospital is important 5 to in community. This hospital means a lot to these 6 people who are here today. We're community. We have 7 doctors that are part of our community. Doctors that 8 we know. When I first moved up here Linda Vickery was 9 my neighbor. My son fell and almost bit through, 10 completely bit through his tongue, almost completely 11 off. She put my son in her car and drove him to the 12 hospital. And by that night he was eating a ham and 13 cheese sandwich because of the care that was taken by 14 Dr. Vickery. These doctors, we know them. They're 15 important to us. This hospital's important to us. 16 The second thing I have to say is I was 17 taught to do no harm. We are going to be doing harm to 18 patients by longer transport times. I have sat in that 19 ambulance holding people's hands. I have done CPR for 20 up to a half hour to an hour. The time on scene up 21 here is lengthy. It take us up to 20 minutes to get to 22 some of these house in the outlying areas of this 23 township. And that's not unique to our township. 24 There's other townships up here like Vernon same kind 25 of on scene times. By causing us to go to longer

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1 distances we are doing harm to patients. I am not a 2 mathematician. I'm a police officer. There's a reason 3 for that. But we were also taught a golden hour in 4 trauma. Our on scene time is 10 to 15 minutes. And 5 that's good time. Our time to the scene is another 10 6 to 15 minutes. And our time to the hospital if we have 7 to go to Newton is 30 to 40 minutes. Now, if I add 8 those times up that's 70 minutes. That's well beyond 9 that golden hour that that patient needs to be treated 10 immediately. This is our community as is seen by the 11 people that are here today. These are our doctors. 12 And this is our hospital. Please keep it open. 13 MS DONLEN: Michael Emmerich. 14 MR. EMMERICH: Hello, everybody. My 15 name is Michael Emmerich. Last name E-M-M-E-R-I-C-H. 16 Chief of the Vernon Ambulance Squad. This is actually 17 going to hurt us quite a bit. With all the rules and 18 regulations this going to a satellite ER, we're really 19 not going to be able to bring any patients over there 20 because every patient I expect to bring back to my 21 ambulance (inaudible) they're going to spend the night. 22 If you guys don't have that capability, I'm taking them 23 someplace else an hour down the road which is not fair 24 to the patient and it's not fair to anybody else. It's 25 also -- you know, a close like this, our on scene times

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1 and travel times it's almost going to double and 2 triple. For us to go to Newton and some parts of 3 Vernon it's going to be over an hour's ride. And a 4 winter storm, that's going to be almost two hours. 5 During Hurricane Irene when we couldn't get to Sussex 6 it took us almost three hours to get to Newton. So 7 this is actually going to hurt us more than it's going 8 to help us. Thank you. 9 MS DONLEN: Thank you very much for your 10 participation tonight. Two hours we had 39 speakers 11 which is very efficient group all of you and I applaud 12 you for all of that. And the State Health Planning 13 Board will be taking this up at the meeting in June. 14 We have our meetings the first Thursday of June. We 15 haven't actually schedule it, but I expect that this 16 will be on the agenda for the first week of June. And 17 that's when the State Health Planning Board will meet 18 to consider the application. Everything that's been 19 said tonight will be on the record. And all the 20 members will review it as well as all the other 21 materials that they've received. So thank you, again, 22 for your participation. 23 THE PUBLIC: Who else gets to go to that 24 hearing? 25 MS DONLEN: It's a public hearing. But,

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1 again -- 2 THE PUBLIC: How will we know about it? 3 MS DONLEN: It will be posted. And you 4 can contact the Department of Health. We have -- I can 5 give a number in a second, but more importantly, we 6 only have an hour of public comment at the public 7 hearing. And anybody who has spoken at this meeting 8 won't be able to speak at that meeting, but you're more 9 than welcome to attend the meeting. And we just have 10 to have a sign up list. You have to let the department 11 know that you plan to come so that they can plan that 12 in terms of the size of the rooms that they need to 13 get. 14 THE PUBLIC: Will the report be 15 corrected? 16 MS DONLEN: The report is what it is. 17 THE PUBLIC: No, the information with 18 missing townships, et cetera. 19 MS DONLEN: I'm hearing what you're 20 saying, but all the materials have been submitted. 21 There are no other materials that will be submitted, 22 but your concerns about what's incorrect and it will be 23 transmitted, obviously, to the Board. We really don't 24 participate at these meetings. The questions I've 25 answered --

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1 THE PUBLIC: Feel free to stop by our 2 hospital before you go home back to Trenton. 3 MS DONLEN: I saw it. I saw it when I 4 rode in. I absolutely will do that. 5 THE PUBLIC: Briefly for the record, I 6 have petitions. 7 MS DONLEN: The record's closed. 8 9 (Whereupon the matter is adjourned.) 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

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1 CERTIFICATE 2 3 4 I, CARMEN WOLFE, a Certified Court 5 Reporter, Registered Professional Reporter and Notary 6 Public of the State of New Jersey hereby certify the 7 foregoing to be a true and accurate transcript of the 8 proceedings as taken stenographically by me on the date 9 and place hereinbefore set forth. 10 11 12 13 14 15 C:\TINYTRAN\CARMEN.BMP 16 17 CARMEN WOLFE, C.C.R., R.P.R. 18 19 20 21 22 23 DATED: May 15, 2012 24 License No. 30XI00192200 25 Notary Commission Expiration Date: July 29, 2016

1 1 certificate of need for the closure of ......2012/05/01 · 1 services in sussex county working...

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