By JIM BARON

PROVIDENCE — As the clock ticked down the final hours of the 2008 General Assembly session, local  lawmakers wondered and worried about what would become of legislation to facilitate the merger of Woonsocket’s Landmark Medical Center with Pawtucket’s Memorial Hospital.

“We’re still working on it,” Landmark spokesman Bill Fischer said at about 11 p.m. “We have been in discussions with the Department of Health (DOH) and the attorney general’s office all day. We are working on legislation and hope to have a bill in shortly. We are attempting to get this done tonight.
“To date,” he noted, “we have accepted every amendment that DOH and the attorney general have offered. We are trying to get all concerned parties to be comfortable with the legislation on the last day of the session. In two hours, it could be a completely different story.”
The remaining issues to be discussed, Fischer said, surround the conditions of the merger reviews and the length of the review.
“We remain hopeful,” he said. “There are a few twists and turns left in this story.”
But even if no bill materializes before the assembly adjourns, Fischer said, “we’re not closing our doors tomorrow.
“If we come up short on this legislative initiative, the one positive by-product to come out of this effort is both (DOH) Director (Dr. David) Gifford and the attorney general have expressed concern for our situation,” Fischer said. “We have had discussion over the last days related to expedited review and I feel confident we’ll be able to accomplish an expedited review within the current law.”
Upside-down with debt, Landmark fears it could not survive financially long enough for the proposed merger to undergo the scrutiny of the Hospital Conversion Act (HCA), a paperwork-heavy bureaucratic process that could take a year or more.
Woonsocket legislators Rep. Jon Brien and Sen. Marc Cote introduced a bill last week that would expedite the review process.
Instead of going through the HCA protocol, it would be subject to what is being called a “change of effective control” review, in which the Department of Health and attorney general would have to render a decision within 90 days of acceptance of an application.
Attorney General Patrick Lynch and Health Department Director Gifford objected to the measure, worrying about the consequences the legislation could have and and the precedents it might set. They cautioned against hastily amending the HCA.
If Landmark were forced to close, it would leave the northern part of the state without a major medical facility, including its emergency room, which is the state’s third busiest.
Landmark officials were meeting with the DOH and attorney general’s office into the evening Friday, trying to hammer out compromise language for legislation they hoped could win last-minute passage in the General Assembly.
“We continue to be concerned about unintended consequences of amending complex legislation in a hurry,” said Helen Drew, assistant director of the state Department of Health, as the assembly was still in session Friday.
“Our other concern is that the folks in northern Rhode Island continue to receive services,” she said.
“Regardless of what happens in the General Assembly (Friday night), whether a bill emerges or not, we believe that the scope of services at that hospital will have to change,” Drew said. “The number and types of services they are offering in the current configuration are part of the problem that they are facing and they are telling us it is not a viable situation up there.”
Exactly what services would have to be eliminated is not known, Drew said, “just that there would have to be some changes.
“Right now we are waiting to see what the legislature is going to do,” she said. “Once we know if they have acted or not acted and how that is moving forward, we will make another assessment. When we see what the latest version of the proposal is, we would respond to that.”
Pawtucket Rep. Peter Kilmartin, now a member of the House leadership, said he was involved in the creation of the HCA.
“Now, at the eleventh hour, to come and change that, I have serious reservations about that,” he said. “For any entity to come in, knowing full well that they had financial difficulties for a very long time and ask us as a legislature to exempt them out of it and short-circuit the process without proper oversight — I just think as public policy it is a bad thing to do.”
Kilmartin said he would vote against the bill if it came to the House floor Friday night.
“Even if we did the exemption and the merger came to fruition, nothing guarantees they will keep any of those facilities open in Woonsocket,” he said. “They could shut the beds down, they could shut the emergency room down, so short-circuiting the process could actually do them a disservice. These are some of the hard questions that the Department of Health and attorney general’s office can ask to see if it is a worthwhile consolidation.”
Kilmartin explained his reservations as follows: If Landmark is in such financial dire straits, in the long term Landmark may end up as an albatross around Memorial.
“It’s been hemorrhaging all these years, is this going to stop that hemorrhage?” he asked. “Memorial now has a strong endowment; Landmark has pretty much gone through all of theirs.”