The principal players in a pending hospital merger say they’ve been as open as they can be with the public about the potentially multi-billion dollar deal.

The consolidation of University of Louisville Hospital, Jewish/St. Mary’s Healthcare and Catholic Health Initiatives will result in a statewide care network and a $320 million cash infusion to the struggling University Medical Center (which includes U of L Hospital and the James Graham Brown Cancer Center) and Jewish/St. Mary’s. It will also lead to changes in certain reproductive care at U of L, the city’s hospital of last resort. The deal has many residents worried about the future of other procedures the Catholic Church frowns upon.

The exact details of which procedures will and will not be allowed and the exact structure of the final merged entity are still being discussed. Documents related to the merger have been kept private, and that’s led to two legal battles. One is a challenge to Attorney General Jack Conway’s ruling that the UMC is a public institution and subject to open records requests. The other is a records request filed by Jefferson County Attorney Mike O’Connell, who has been denied specific documents about the consolidation.

In a WFPL News special, U of L Hospital CEO Jim Taylor said UMC meets all the criteria of a private nonprofit entity. He declined to say which documents the organization is keeping private. Saint Joseph Health System—a division of Catholic Health Initiatives—Chief Medical Officer Dr. Dan Varga says the merging partners have to act as competitors during merger talks, and as such, cannot release certain operational information.

“If we had, we would have run the risk of not only putting the potential merger in jeopardy but also tripping some adverse events that none of us would have wanted to trip,” he says. “To a larger extent, much of our operational planning has only gotten started come July of this year.”

Some of the documents that have been released indicate that the partners were planning to have the necessary state and church approval for the merger by the end of the year. But the partners say there’s no specific target date for the merger.

“We are prepared to have that first day whenever the governor signs and we can close the deal,” says Taylor. “Whether that’s January 1st, February 1st or March 1st.”

Taylor adds that the documents will be made public once the university acts on them.

Managing care

The most controversial information that hasn’t been made public relates to which procedures will not be allowed at University Hospital after the merger. Rather than follow Catholic Ethical and Religious Directives—as St. Joseph’s and other religious hospitals do—UMC will adhere to a contract. The contract will block the merged entity from being in “a position of scandal” with the Catholic Church, but will not stop all procedures banned by the church.

At a public forum this fall, the partners outlined how UMC would handle procedures banned by the Catholic Church:

• Tubal ligations and any cesarean sections that precede a planned tubal ligation will be moved to Baptist Hospital East;
• Miscarriage management will not change;
• Elective abortions are not performed at University Hospital and will not be performed after the merger;
• Medically indicated abortions (when the life of mother is threatened or the fetus has a lethal anomaly) will be performed at University Hospital;
• Emergency contraception (the morning after pill) will still be offered. “At this point in time it will remain the same,” said Dr. Makhija.;
• Family Planning is usually done in outpatient centers and will not change;
• Vasectomies are out of office procedures and will not change;
• In vitro fertilization will remain an out of office procedure;
• Contraception counseling and prescriptions will be available, but the hospital will no longer fill prescriptions for contraceptives.

The contract has not been made public, but the partners say it respects the religious and academic heritages of each institution. It is not a religious document, but University Hospital CEO James Taylor says it is inspired by religious doctrine.

“So is it being inspired by the academic needs. So is it being inspired by the Jewish heritage of one of the partners. So I think it’s not fair to only pick out one. It’s, as Dr. Varga pointed out, respecting the heritages of each organization,” he says.

When asked if the contract means any practices will change at St. Joseph’s, Chief Medical Officer Dan Varga said no.

Hospital officials have said moving tubal ligations to Baptist Hospital East will not create an undue travel burden on patients, since many women who request the procedure live close to the hospital already. Critics, however, say the facility is too far away from lower-income parts of the city. Varga says about 300 women request tubal ligations each year, and the merger will benefit more than 300 patients when other services expand.

Effects on employees

In addition to changes in care, the merger will also bring about changes in insurance for employees. In 2013, the benefits package for UMC workers will change. Same-sex partners of hospital employees will no longer be offered benefits. Instead, each employee will have a “plus one” plan that allows them to add coverage to another person, be they partner, spouse or relative. But Taylor could not say whether the plus one benefits would be provided at the same cost same-sex partner benefits are provided now.

“That’s one of those things that isn’t totally priced out yet,” says Taylor. “Our motivation of course is to do that because we’re in a highly competitive market for the skilled people who work at hospitals.”

Hospital finances

The executives are most comfortable discussing the need for the merger, rather than the effects. Taylor says UMC could have difficulty meeting its requirements for indigent care if the merger didn’t go through. Further, the Affordable Care Act will create additional costs for administration and record keeping, which neither UMC nor Jewish/St. Mary’s could afford.

“Our operations are solvent just as the University Medical Center is,” says Jewish/St. Mary’s CEO David Laird. “However, when one looks at funding the IT requirements for the Affordable Care Act, it’s going to require a substantial amount of money. And we don’t have the cash reserves nor the ability to borrow the money required to sink into the information technology.”

UMC and Jewish discussed merging independently of CHI at first, but Taylor says CHI approached the two hospitals and proposed creating a statewide network. The millions of dollars CHI will pump into the merger will come out of the company’s cash reserves, according to Dr. Varga. The executives do not have specific plans for the money yet, but they say it will be spent “carefully.”

Oversight

After studying the merger, the Louisville Metro Board of Health released a report. It questioned “whether the impetus for merger is truly to preserve and expand continued access to care versus pursuing arrangements that are financially advantageous to the merging organizations.”

It appears the merger will do both, but Taylor insists that post-merger UMC will stand by its obligations to serve the entire community.

The board also recommended that a mechanism be put in place to make sure the merged entity fulfills its obligations and follows through on its promises to preserve care equity and access.

“We are already accountable as individual organizations for the care we provide to the underserved,” says Taylor, referring to the regular reports hospitals must file about care. “So I don’t see any reason why, going forward, the new organization wouldn’t be subject to the same.”

When asked whether the merging partners could agree to the specific type of oversight the board recommended, Taylor said he would need more details. The board has sent its recommendations to the governor and attorney general, who would have to create the necessary oversight mechanisms.

Listen to the entire news special here:

Today on our round-table news discussion show, the WFPL news team got started with an update that had just broken within the previous hour, Judy Green‘s decision to voluntarily resign from her Metro Council seat.  Political Editor Phillip M. Bailey and reporter Devin Katayama discussed the latest news and what it means.  Gabe Bullard discussed the news that the Louisville Orchestra was forced to cancel it’s November programs in light of the ongoing dispute between management and musicians.  Environmental reporter Erica Peterson discussed a proposed settlement of a lawsuit over mining company pollution reports, as well as her tour of the retooled Ford Assembly Plant in Louisville.  Devin Katayama outlined the events in Louisville this Sunday to commemorate the 10th anniversary of the Sept. 11 attacks of 2001.

Courier-Journal reporter Jim Carroll joined us by phone from Washington, D.C. to offer his insights on the reaction of Kentucky and Indiana lawmakers to President Obama’s jobs plan.  We also spoke with Chris Otts of the Courier-Journal for a snapshot of the employment situation in the region and the hopes and concerns of local companies with regards to Mr. Obama’s jobs plan.

Finally, we heard a feature and chatted briefly with reporter Abby Wendle on an Oklahoma community farmer who has worked with the soil for decades, and is now helping families, churches and schools build their own backyard gardens.

Last week, EPA officials toured eastern Kentucky, and WFPL’s Erica Peterson tagged along to report on the visit. They stopped in four communities, and spoke with residents concerned about the environmental impacts of mining.

On Here and Now today, we heard Erica’s interview with Gwen Keyes Fleming,  EPA Region 4 Administrator, as well as her feature report filed at the conclusion of the trip.

Rick Howlett hosted our weekly news round up today and we dug into the meaty stories of the week.  Devin Katayama discussed the start of class at JCPS and bus route performance.  Gabe Bullard explained the Insight Cable sale and the recent bankruptcy hearing with the Louisville Orchestra.  Phillip Bailey talked about the attempt to postpone Judy Green’s upcoming trial due to a hospitalization, as well as campaign news with Todd P’pool, Jack Conway, and David Williams.  Gabe and Devin dissected the unusual case of the Australian collar bomber, arrested this week in La Grange, Kentucky.  And Erica Peterson phoned home from Eastern Kentucky while on an EPA tour of communities affected by coal mining.

We checked in with David Weidner of MarketWatch to get caught up on the latest gyrations on Wall Street and the economy.  Plus, there was a conversation on social network privacy with tech writer, Neal Ungerleider.  And finally, a radio portrait of the first day of the Kentucky State Fair.

On Here and Now in the 1:00 hour, we had a quick update on the status of power being returned to households in the Louisville and Southern Indiana areas, as well as some of the considerations about whether JCPS will start tomorrow or not.  The good news is real progress has been made by the local utility companies.  JCPS is assessing street and traffic light functionality and has promised a decision by 6:00pm today.

State of the News today covered a broad range of topics, including the latest on Kentucky state senator Perry Clark; a new life preserver ordinance for children proposed in Louisville; the latest local environmental news headlines; drug tests for Louisville EMS employees; and the results of the Merger 2.0 task force survey, among other stories.  Courier-Journal writer Jim Carroll joined us from Washington to discuss the supercommittee of 12 tasked with taking on the national debt, and we heard a feature on the current reigning world champion auctioneer of cattle.

Full audio:

Today on Here and Now, we heard Gabe Bullard’s feature on the failure of the much-touted Museum Plaza project.  After airing the feature, Gabe spoke with Todd Mundt about local reaction to the cancellation, what the cancellation means to the MFA program at the University of Louisville, and how the failure reflects – or does not reflect – on perceptions of Louisville around the country, and world.

A handful of WFPL listeners making small contributions was responsible for the funding of Erica Peterson’s recent three-part series on coal ash though an experimental funding mechanism called Story Exchange.  It’s a new model that asks the question, “What if local public radio stations with loyal news audiences were able to pitch ambitious story and project ideas directly to listeners?” WFPL has been a pilot station for Story Exchange.

John Barth, managing director of Public Radio Exchange, visited with Todd Mundt today on Here and Now to explain how Story Exchange works, its advantages and also potential pitfalls, and how it will move forward.

The Halfway to Forecastle Festival took place a few weeks ago and by all reports was a success both artistically and commercially.  This was the first Halfway since founder JK McKnight partnered with AC Entertainment, and featured electronic/dance acts like Big Boi, RJD2, Twin Shadow, and Pretty Lights.  The next event will be the full-scale Forecastle Festival in the summer of 2012.

We spent a few minutes with JK McKnight today on Here and Now to review Halfway in terms of the expanded Waterfront locations, ticket sales, audience feedback, and to discuss the new partnership with AC Entertainment and what it means for the future.

As the NBA lockout nears the two week mark, players, managers and owners are no longer in talks about their franchises. For over thirty years, Louisville attorney J. Bruce Miller has been in talks to bring an NBA franchise to the city. But his latest attempt will most likely be his last.

Bruce Miller’s law office is a hybrid of two of his fascinations: Greek culture and professional basketball.  Behind his desk sits a model of the Parthenon. Strewn around his office he has basketball jerseys and other basketball paraphernalia.  Miller has white hair and speaks with a slight southern twang. When I spoke to him, he was wearing an NBA lapel pin on his suit.

Bruce Miller’s obsession with professional basketball started when there were two pro basketball leagues—the ABA and the NBA—and Kentucky still had a professional basketball team: the Kentucky Colonels.

A year after the Colonels overcame the Indiana Pacers in the 1975 ABA Championship, the NBA absorbed the league. Miller was in talks to preserve the Colonels with the NBA’s outside counsel, David Stern, who is now NBA commissioner.

At the end of the talks, the NBA took 4 ABA teams. The Colonels were left behind.

Since then, Miller has put an enormous amount of effort and capital into bringing a team back.

“I maxed out on credit cards and lost a 13 man law firm,” Miller said. “I was spending morning, noon, and night. We lost businesses as a result of it.  [I was] A million and a half dollars in debt, had spent my retirement. I was angry about it.”

Miller was closest to reaching his goal in 2001, when the Charlotte Hornets wanted to relocate. The team eventually chose New Orleans over Louisville. The team struggled and is now owned by the league. To survive, it will have to be purchased by local investors in New Orleans, or moved to another city.

Miller met with Stern in February to again discuss moving the Hornets, but says he hasn’t heard anything since because of the lockout.  Miller says Stern doesn’t want conversations about the vast sums of money an NBA franchise is worth while negotiations are being made about players’ salaries.

There are a lot of people who say Miller is wasting his time.  Kentucky is a state in which the red and blue of Republicans and Democrats pales in comparison to the red and blue of the Cards and Cats.  Many worry an NBA team would take away from college basketball.

Another argument is that the city and state aren’t wealthy enough.  That’s one University of Louisville Coach Rick Pitino has echoed at numerous press conferences.

“Louisville can’t afford it,” Pitino said at a press conference. “The NBA isn’t coming to Louisville, David Stern doesn’t want it. Before you have these wacky ideas, you have to talk to the commissioner.”

But Pitino has recently taken a step back from those views.

“The NBA would be lucky to be in Louisville. Lucky,” Pitino remarked at a press conference before a game against Rutgers.  ”But this is a poor state, there’s no question about it. Think about these prices, there are few people who could afford it.”

But it’s not clear that’s the case, at least according to a study that examined the issue.

“We’re not personally putting weights on how important income is versus population, the data is doing that using current NBA franchises,” said University of San Francisco professor Dr. Daniel Rascher.

Rascher co-authored a 2004 study that assessed the viability of NBA teams in various cities. It found Louisville to be the best out of the markets that don’t have teams and better than a few that currently do.

“It’s kind of a rough scale, but it ranked ahead of Memphis,” he said.

Miller holds up that study to validate his efforts. He paints those against his plan as people who view Louisville as a college town, holding it back from becoming a player in the global economy.  He sees the NBA as Louisville’s ticket to the big-time.

Miller’s detractors write him off as Louisville’s Captain Ahab, scouring the seas aimlessly for his white whale, an NBA team.

Miller says he has eager investors this time, but if the deal doesn’t happen this year or next, it probably never will — at least not with him behind it.

“I’m 70 years old, on top of it,” Miller said, looking uncharacteristically weary. “When you’re 50, there’s a lot of time to straighten out a mistake.  When you’re 70, there’s a lot less time.”