“Disapproved.”

That was the word that appeared in bold, black print in the first paragraph of the Sept. 30 letter that the Michigan Department of Health and Human Services (MDHHS) sent to William Beaumont Hospital rejecting its certificate-of-need (CON) application to build a $140 million, 225,000-square-foot hospital in Oxford Township.

“This is to inform you that the proposed project to begin operation of a new 117-bed hospital in Limited Access Area (LAA)-6 with surgical service in new construction on vacant land has been reviewed and is disapproved,” wrote Chief Deputy for Administration Elizabeth Hertel in the five-page proposed decision.

A lack of population within the area that Beaumont was looking to serve and within 30 minutes’ drive time of the proposed hospital site was cited by the state as the reason.

According to the MDHHS letter, “A hearing may be requested on this proposed decision,” but the request “must be filed (by Beaumont) within 15 days of receipt of this letter.”

If a hearing is not requested, a final decision is issued by the MDHHS director. If a hearing is requested, it must begin within 90 days, unless waived by the applicant. The final decision is issued by the MDHHS director following the hearing.

After speaking with a Beaumont representative, Oxford Township Trustee and Planning Commissioner Jack Curtis, on Tuesday morning, said the hospital plans to fight this.

“I was told (Monday) night that there’s going to be a full-court press to appeal this decision,” he said. “Beaumont didn’t come here (on its own) looking to build a hospital. Beaumont came here because the need (for one) was identified (by the state). So, they’re going to (make) an all-out effort to determine what’s going on and why they were shot down.”

On Tuesday morning, Beaumont released the following statement: “Through the State’s Certificate of Need (CON) process, Beaumont responded to the State’s determination of a need for a limited access area hospital in Oxford. We remain committed to this project, and we are disappointed with the State’s recent reversal of its determination of a limited access area. We are evaluating our next steps to continue our efforts to provide health care in Oxford. We have land under agreement, and we’re committed to serve the community.”

In March, Beaumont announced that it wanted to construct a hospital on a 25-acre vacant parcel located on the east side of M-24, just south of E. Market St. and just north of the village limits. The proposed hospital was to span five stories, plus a mechanical penthouse.

On Feb. 1, Beaumont submitted a CON application to the state.

Enacted in 1972, the CON program is a state regulatory program that’s intended to ensure only needed services are developed in Michigan. Building a new health facility, such as a hospital, is one of those things for which a CON must be obtained.

Beaumont applied for all 117 acute care hospital beds identified by the state in September 2018 as the projected need for 2021 in what is labeled as LAA-6.

LAAs are underserved areas with a patient day demand that “meets or exceeds the statewide average of patient days used per 50,000 residents in the base year.” An underserved area is a geographic area that’s not within a 30-minute drive – utilizing “the most direct route” and “the lowest speed limits posted” – of an existing licensed acute care hospital with 24-7 emergency room services.

Three zip codes are included in LAA-6. They are 48371 (Oxford), 48462 (Ortonville) and 48348 (Clarkston).

In its Sept. 30 proposed decision, the MDHHS indicated that “the documentation submitted by” Beaumont for the proposed Oxford hospital “did not demonstrate that there is a population of 50,000 or more people inside the LAA-6 and within 30 minutes’ drive time of the proposed new hospital site,” therefore it “did not meet the necessary requirements for approval due to the lack of compliance with the applicable CON Review Standards for Hospital Beds, effective November 28, 2018.”

The letter goes on to state that the MDHHS “verified” the population “inside” LAA-6 is “less than 50,000.”

“The LAA-6 touches three (3) zip codes – 48462, 48371 and 48348, but the LAA-6 does not cover the entire geographic area contained in these three (3) zip codes,” Hertel wrote. “LAA-6 is a much smaller geographic area outlined by these zip codes . . . The Department’s analysis shows the following percentages of zip codes’ populations that will fall inside LAA-6: 7.58 (percent) of zip code 48462; 23.63 (percent) of zip code 48371; and 4.61 percent of zip code 48348, which totals approximately 7,687 people inside LAA-6.”

MDHHS Public Information Officer Lynn Sutfin explained, via an Oct. 1 email, “Only parts of the zip codes are included because only parts of those zip codes meet those definitions for both the underserved area and the Limited Access Area.”

“The rest of the area in those zip codes (does) not meet the definitions of both being more than 30 (minutes) from a hospital with an ER [underserved area] and (having) ‘a patient day demand that meets or exceeds the statewide average . . .’ [Limited Access Area],” Sutfin wrote. “Some parts of the zip codes may be considered an ‘underserved area’ as defined by the CON Hospital Bed Standard, but (they do) not meet the criteria to be a Limited Access Area.”

Curtis was “stunned” by the state’s proposed decision. “First off, the state identified our area as (having) a need (for hospital beds),” he said. “Beaumont didn’t come here and say, ‘Oh, we’d like to build a hospital.’ The state said we had a need here. We were excited because the state finally realized that a lot of people have a need for a hospital closer to the residents of Oxford.

“We get excited about this, the state pumps us up . . . (then Beaumont’s application gets) denied for the same reasons that (the state) wanted (a hospital). They said we had a need (for a hospital). Now, they say we don’t have the population for it. It’s typical state government . . . The state doesn’t know what they want, when they want it and how they want it.”

Curtis said he doesn’t care which hospital ultimately ends up planting its flag in Oxford. What “frustrates” him is “the state telling us we have a need and then all of a sudden, they shoot down the (hospital) that is committed to coming here.”

“Why, all of a sudden, did (the state) just turn them down after they stood up and raised their hand?” he said.

Curtis noted “intense efforts” have already been made at the township level “to ensure we have (adequate) power for the hospital, we have (natural) gas capacity for the hospital, sewer capacity for the hospital, water capacity.”

“The health, safety and welfare of our community is the top priority, so if the State of Michigan tells us (Oxford) should have a hospital here based on this need, we’re going to make sure our infrastructure is geared up for that,” he said. “We’ve had meetings with DTE (Energy), Consumers (Energy) and the (township) water (and) sewer committee to make sure everything’s done and now, the state pulls the rug out from under it.”

“It seems like (the state is) backpedaling. It’s typical of our state government. I can’t believe that they do this. They do it all the time,” Curtis added.