What is happening today to prepare for how UM UCH delivers care in the future?

Innovative Technology:

Healthcare is evolving every day.  Innovative telemedicine technology is now in place with many local skilled nursing facilities in the community that supports the real-time clinical care needs of nursing home residents. Nursing home care providers are able to remotely access UM UCH emergency medicine providers via the LifeBot telemedicine system.  This innovative technology has been in place for over a year and has prevented a significant number of unnecessary emergency room visits for seniors in distress allowing them to remain in familiar care environments. 

Care and support for our most vulnerable patients:


Two years ago, we started an initiative called the Comprehensive CARE Center that has already changed the way we care for individuals who frequently visit our hospitals and Emergency Rooms.  The Comprehensive CARE Center in Bel Air helps connect individuals with their primary care physician (or helps them find one) and, if needed, locates additional medical specialists as well as community resources for transportation, home health services, and insurance assistance.  The CARE team makes sure the individual understands his/her medications, how to take them and who to call with questions so they can manage their treatment on an ongoing basis.  When our resources are combined through enhanced community partnerships, we are able to help these people maintain or achieve better health, which ultimately results in better care for them and an overall improvement in the health of our community. 
 
In addition, through a Transformation Care Grant received last year, support was provided to allow us to start community-based care management teams, which we call our Wellness Action Teams in Cecil and Harford Counties (WATCH). The WATCH teams are comprised of nurses, social workers, community health workers and a pharmacist who are focused on working with individuals in their homes to address medical and social challenges. 
 
In effect, the WATCH teams:

  • Make house calls
  • Support medical needs
  • Evaluate if the individual has additional challenges with transportation or need further support in areas such as energy assistance or food support
  • Determine if the individual could benefit from additional community supportive care services such as supplemental security income, adult protective services, etc.  

These teams work with individuals for approximately 90 days to develop and monitor care plans that help them better understand their clinical conditions and coordinate care for follow-up appointments.   There are four WATCH teams:  two dedicated teams in Harford County, one team in Cecil County and another team that will work with individuals living in communities on either side of the Susquehanna River.  The WATCH program has been truly transformational for hundreds of our community’s most vulnerable people.

Why are we proposing to transition from the University of Maryland Harford Memorial Hospital (UM HMH) facility?
The UM HMH facility was constructed in phases from 1943 through 1972. University of Maryland Upper Chesapeake Health (UM UCH) leadership and its Board of Directors have remained committed to supporting both the facility infrastructure as well as the available technology at UM HMH. UM UCH has made capital investments of $13.4 million into UM HMH over the past five years (2012-2016), or $2.7 million per year. These capital investments continue and include the addition of major clinical equipment, facility improvements and renovation and information technology.

Even though we have appropriately maintained the building, the physical plant has outlived its useful life. Transitioning to a new facility with a current design, better visibility, and improved access is the most appropriate long-term strategy. We believe that the proposed University of Maryland Upper Chesapeake Medical Center Havre de Grace medical campus will better promote access to convenient and high- quality care.

What will happen to UM Harford Memorial Hospital?
UM UCH has been responsible for providing the highest level of care to the City of Havre de Grace for over a century. We remain responsible stewards to the Havre de Grace community. Working collaboratively with the City of Havre de Grace, UM UCH is committed to a thorough, transparent process for identifying productive new uses for the UM Harford Memorial Hospital (UM HMH) site.

Our Process to date:

  • Engaged Cushman & Wakefield, a nationally recognized real estate services firm
  • Analyzed demographic, employment and transportation trends
  • Engaged the community through stakeholder interview sessions
  • Reviewed wide range of future development strategies

Goals for the site:

  • Provides a transformative opportunity for the property and the City of Havre de Grace
  • Brings sustainable community benefit and makes good business sense
  • Responsive to the market demand indicators
  • Conforms to the general input gathered from stakeholder interviews
  • Synchronizes transition timing from UM HMH to the new Bulle Rock campus in late 2020

What is the timing of the future development of the current UCH HMH site?
The findings of the Cushman & Wakefield evaluation will be updated periodically as we move closer to construction of the new UCMC – Havre de Grace campus.  Once the state regulation approvals are received, Cushman and Wakefield will represent UM UCH in the “pre-marketing” of the UM HMH site.  The goal is to select a developer for the site by 2019 so that once the current UM HMH facility is vacated the development of the current site can begin in fulfillment of the vision for the property.

How is the new medical campus different from a traditional hospital like UM Harford Memorial Hospital?
The first phase of the medical portion of the campus will include a full service, 24/7 Emergency Department, observation beds for short term overnight stays (up to a 48 hour stay) for medical care, outpatient services, comprehensive Behavioral Health services and a modern medical office building for primary and specialty care physician practices and additional outpatient ambulatory services. Individuals requiring surgery or critical care services will be cared for either at the UM UCMC Bel Air campus, just 19 miles away, or at another area hospital.  Patients needing transfer to a hospital for a higher level of care will be transported via ambulance or helicopter to the appropriate facility.

Approximately 90 percent of our patients’ health care needs will be met with the ability to access the services they require locally on the new medical campus. In addition, we are planning the following outpatient services in our medical office building: a full complement of radiology services, select cardiology testing, laboratory testing, physical and occupational rehabilitation services, and select outpatient infusion services.

Additionally, the new facility will have 25 emergency bays (21 of which will serve traditional medical emergency care needs with an additional 4 behavioral health emergency care bays). The Emergency Department alone will more than double from its current size at the current UM HMH location. There will also be advanced diagnostic testing, including x-ray, CT scan, MRI, and ultrasound services, to support the needs of our Emergency Department and Observation stay patients.  

 

Will the services offered at the Havre de Grace Emergency Department differ from those currently offered in the UM HMH Emergency Department? Where will patients go for stroke care? How will patients experiencing a cardiac emergency be cared for?
The same level of emergency medical care provided today at UM HMH’s Emergency Department will be available in the new, modern, spacious setting at the Havre de Grace (Bulle Rock) Emergency Department, 24 hours a day, 7 days a week. This state-of-the-art Emergency Department will be supplemented by diagnostic services, including x-ray, CT scan, MRI, and ultrasound services. In addition, the new campus will also include a heliport for air ambulance transfers, a service that is not currently available at the existing UM HMH location.

Nearly all patients currently transported by EMS to UM HMH’s Emergency Department will be transported to the new ED—including individuals experiencing a stroke—due to our continued collaborative efforts with local EMS and MIEMSS leadership. In addition, we will continue to stabilize, treat and transfer our patients as we do today, and these services will continue to be provided by emergency medicine trained physicians employed by the Maryland Emergency Medical Network.

Current EMS protocols will be maintained after the facility is opened. For example, our local EMS providers are currently outfitted with EKG transmission devices which allow in the field assessment of potential cardiac events such as a heart attack or lethal arrhythmias. Today, MIEMSS protocols require that individuals experiencing a heart attack be transferred to a MIEMSS designated Cardiac Care Center. University of Maryland Upper Chesapeake Medical Center (UM UCMC) in Bel Air is already a designated Cardiac Care Center, and patients experiencing heart attacks today are already routed to UM UCMC pursuant to this protocol. These protocols will remain unchanged by our future plans. Similarly, pediatric emergencies are currently routed to UM UCMC in Bel Air due to the presence of an around-the-clock pediatric Emergency Department. 

Will patients be financially responsible for any ambulance transportation that may be needed from the Havre de Grace medical campus to another hospital?
If a patient is seen at the Havre de Grace Emergency Department and requires transfer to the UM UCMC Bel Air facility for an inpatient admission, the ambulance transportation from the Havre de Grace facility to our Bel Air facility will not be billable to the patient. Any cost related to another facility outside of UM UCH would be the responsibility of the patient and their insurance carrier as dictated by federal CMS regulations.

What impact will the proposed project have on EMS workload and transit times? Will there be Medivac/helipad capability?
For patients who need to be transported to another hospital for a higher level of care, such as UM UCMC in Bel Air or the University of Maryland Medical Center in Baltimore, we are developing seamless patient transfer arrangements utilizing a dedicated commercial ambulance service that would be stationed at the Havre de Grace facility. By doing so, we will ensure that the Havre de Grace medical campus does not impose an added burden on EMS in terms of an increase in volume of interfacility transfers or the duration of transit times returning from such transfers.

Hospital transfers which require air transport currently requires a transport to the National Guard Armory helipad because UM Harford Memorial does not contain a helipad on its property. The new facility will have its own helipad.  This will reduce the number of times that the EMS system is utilized to take patients to the Armory.  For non-emergency transfers or admissions, we will utilize University of Maryland Express Care or another ambulance company, depending on the given estimated time of arrival.

If an individual is taken to Bel Air for care, can follow-up care be received in Havre de Grace, or does the individual need to go back to Bel Air?It is our goal that patients will be able to receive their follow-up care on the Havre de Grace medical campus. However, the site of follow-up care will be dependent on each individual patients’ clinical needs, access to the appropriate physician specialist(s), and the patient’s choice.

What are the scope of Behavioral Health services on the new campus? Is it secure?
UM UCH’s plan includes continuing our commitment to providing behavioral health services to our regional, two county community in a 40 bed, state-of-the-art, self-contained, and secure inpatient unit. In addition, we have planned a broad scope of outpatient, ambulatory behavioral health services which allow an individual to transition through multiple stages of treatment without moving to multiple locations.

The Behavioral Health Pavilion will serve people from young adults (over age 18) to the senior population in need of mental health stabilization, treatment and ongoing counseling. The Emergency Department services provided on the same campus will offer a dedicated area for people suffering from a behavioral health emergency.

Services include hospital inpatient beds for acute needs, including a dedicated geriatric psychiatric unit, a Partial Hospitalization program, and an Intensive Outpatient program for transitional needs from the inpatient setting to the community setting. Our planned outpatient and inpatient behavioral health services allow the individual to transition back home without going far from their support network. UM UCH’s plan follows the national trend that integrates behavioral health services within a community setting to allow for accessible treatment, recovery and support.

The new behavioral health facility will not serve individuals currently involved in active criminal or sex offender proceedings; its focus will be on young adults to the senior population in need of mental health stabilization, treatment and ongoing counseling.  This is the same group of people that we already serve today—and have served for the last 26 years—at UM HMH.  The community can expect the same approach to security at the new location – locked units, strict guidelines on visitation, and security surveillance.  Our commitment to maintaining a safe environment for our patients, their families, and our community remain a top priority for UM UCH and this focus will remain unchanged in our new facility.

 

Why can’t Behavioral Health services be centralized in Bel Air?
Today, there are two well-established and effective Behavioral Health programs near Havre de Grace—one at UM Harford Memorial Hospital and the other at Union Hospital in Elkton.  Early in our plans for the Bulle Rock property, we knew that we needed to respond to the growing need to expand Behavioral Health services in the northeast region.  The current undeveloped state of the Bulle Rock property allows us to build a flexible, secure and modern Behavioral Health facility designed to care for the full continuum of care for this population. 

Is UM UCH planning an outpatient substance abuse program? Is UM UCH planning to provide a Methadone Clinic?
Many individuals we currently care for in our behavioral health services (inpatient and outpatient settings) have both mental health and substance use issues, often called co-occurring diagnoses. We often treat the urgent mental health issues while also stabilizing the substance use issues before referring that individual for more intensive addiction treatment following their discharge. The national standard of care is to treat both mental and physical disorders within the same site, at the same time. For longer-term substance use treatment, similar to long-term mental health treatment, we will be partnering (not just referring) with community providers as we have done with our relationship with Ashley Addiction Centers on the Bel Air campus or the new facility in Elkton. This partnering relationship creates improved transitions between services and permits us to better follow the individual’s progression in their treatment and ongoing care.  We are also focused on implementing earlier interventions while decreasing hospital readmissions, which is always better for the individual.

Many residents depend on public transportation that stops in front of UM HMH. What are you doing about public transportation to the new campus?
We are mindful that transportation access to health care is a challenge for some residents of our community, and will likely continue to be a challenge in the future. An important part of our ongoing planning process includes working in conjunction with the Harford County Transit department as they embark on their 5 year transportation strategic plan to appropriately plan for public transportation access to the new campus in Havre de Grace that is approximately 3 miles away from UM HMH.

Can UM UCMC – Bel Air handle the increase in volumes projected with the planning of the new Havre de Grace medical campus?
In the fall of 2017, construction to expand parking on the Bel Air campus will begin and will continue through the next year or so.  However, the construction of a new bed tower above the Kaufman Cancer Center at UM UCMC will take place at the same time as the construction of the new Havre de Grace medical campus.  Our goal is to complete the bed tower in Bel Air such that the medical/surgical patients and those requiring surgery will be transferred to the UM UCMC Bel Air campus once UM Harford Memorial Hospital closes.

What are the plans for the later phases of the Havre de Grace medical campus, including retail and commercial plans?
We are exploring the possibility of wellness and fitness services through potential partnerships with Healthy Harford and others as well as a walking/jogging/biking trail as part of an ongoing commitment to care for the overall health of our community members. It is too early in the planning process to know the exact timeframe for the retail and commercial development; however, it is estimated that the final phases of our development of the property will extend into the 2025-2035 timeframe.

Of the 97 acres owned by UM UCH, why don’t you have more details on the full scale use of the property?
Our first focus on developing our new property is to start with what we are calling Phase 1.  The planning involved in synchronizing the timing for Vision 2020 so that there is no negative impact on local patient care is quite complex.  It is critical that we proceed in a way that insures patient safety and quality healthcare.  Phase 1 will include an  Emergency Department, full diagnostic testing services and other outpatient services, 2-day stay observational beds for medical care and other outpatient services. In addition, Phase I of the project also includes a specialty psychiatric hospital which we refer to as a  Behavioral Health Pavilion offering both inpatient and outpatient services.

For now, further phases for the full-scale use of the property are possibilities based on what we expect might follow the successful opening of Phase 1 of the new campus. Market changes and other economic drivers will affect the types of businesses that lease space on this property in the future.  In addition, healthcare services will continue to shift and change affecting what we add to the campus as needs arise.  While questions remain, what we do know is that we will continue to be loyal stewards of our community and are focused on providing the safest and highest quality health care possible. 

Who will finance the building of the Havre de Grace medical campus project?
UM UCH and University of Maryland Medical System (UMMS) will finance the new Havre de Grace medical campus and the expansion at UM UCMC in Bel Air through the Maryland Health and Higher Education Facilities Authority with tax-exempt bonds.

How will this plan benefit the City of Havre de Grace and our local economy?
We have been working diligently on regional care planning for the past three years with a targeted completion date by late 2020. The Regional Economic Studies Institute (RESI) of Towson University conducted a study that estimated construction and renovations to UM UCH’s two facilities will generate over 975 construction jobs, $136.6 million in wages, and $435.4 million in economic impact. Between these two facilities, UM UCH will be supporting more than 3,000 jobs. As a result of the new facilities, RESI estimated that the net economic impact will generate an additional $13.1 million in wages and $39.5 million in economic activity for Harford County. In addition, development for the campus will require UM UCH to make significant investment in infrastructure, including water and sewer, and the project and resulting medical campus will result in an expanded tax base for the city of Havre de Grace.

Does UM UCH expect work force reductions with the transition from UM HMH to the new facility in Havre de Grace?
A large percentage of the current team members at UM HMH will be transitioning to the new campus. It is anticipated that the remaining positions will shift to our medical campus in Bel Air or other affiliate properties. Expanded employment opportunities will be available at the new campus in outpatient settings, where increased amounts of health care services delivered in the future. Team members will have the opportunity to seek new training, development and leadership opportunities because of this transformational shift in health care delivery.