AG's ruling would allow for Spectrum heart transplants
By Elizabeth Slowik

Spectrum Health officials say they appreciate an opinion from Attorney General Mike Cox which states that Michigan has two heart transplant programs, opening the legal door for Spectrum’s proposal that is pending at the Michigan Department of Community Health.

“Spectrum Health appreciates the Michigan Attorney General’s opinion that there are only two approved heart transplantation services existing in Michigan and there is one available certificate of need for this service,” the statement reads. “We support the Michigan Department of Community Health’s CON process and anticipate a final decision in early March.”

In response to a request from state Sens. Bill Hardiman, R-Kentwood, and Roger Kahn, R-Saginaw Township, Cox issued an opinion Thursday that reads:

“Currently there are only two approved heart, heart/lung or lung transplantation services existing in Michigan, and thus there is one available certificate of need for these services under section 4(1) of the Certificate of Need Review Standards for Heart/Lung and Liver Transplantation Services.”

“We consider this to be a necessary step in the CON process however, the opinion does not imply state CON approval,” Spectrum’s statement indicated.

While it carries considerable weight, “that opinion is not binding on the department,” noted Lody Zwarensteyn, president of local health planning agency Alliance for Health.

The question was put to the attorney general as the MDCH considers Spectrum’s application for a Certificate of Need. The department is expected to make a decision by March 2.

The number of programs in the state came into question last summer after the Michigan Department of Community Health’s Certificate of Need Commission appointed a committee to study its standards for heart and lung transplants, responding to a request from Spectrum Health in Grand Rapids.

Currently heart transplants are performed at the University of Michigan Hospital, Henry Ford Hospital and the Children’s Hospital of Michigan. Despite a widespread assumption that those programs filled the three available for the entire state, the committee discovered that the adult program at Henry Ford Hospital and the pediatric program at the Children’s Hospital were considered to be a single program under the state standards.

Cox’s opinion indicates that in 1986, the MDCH approved four heart transplant programs, all in southeastern Michigan, with the understanding that one of them would step aside. Detroit Medical Center opted to do so.

In 1993, standards were changed to allow a joint program, and in 1996 the Children’s Hospital, which is associated with DMC, was approved to launch pediatric heart transplants as part of the Henry Ford Program.

In September 2008, the MDCH eliminated the Certificate of Need issued in 1986 for William Beaumont Hospital, which had stopped doing heart transplants, the opinion found.

Spectrum also thanked Hardiman and Kahn for requesting clarification from Cox.