LANSING – The state could have two, rather than one, proton beam therapy facility under regulations being considered by the Certificate of Need Commission. But the new rules would make it easier to develop a collaborative to run the facility and would allow the rules to cover more technology.
The commission will be taking two versions of the rules to public hearing in the coming weeks. One would require any new collaborative running a proton beam therapy facility show its members care for at least 40 percent of the cancer patients in the state, while the alternative language would require a minimum number of treatments by member facilities.
The changes were proposed to meet concerns raised by Governor Jennifer Granholm last month in rejecting earlier standards.
Because Beaumont Hospitals has already been approved for a facility at its Royal Oak Campus, the rules would theoretically allow for as many as two more, but officials expected the cost, projected at $159 million per site, would limit the number of additional facilities.
There are four other applications for proton therapy facilities filed with the Department of Community Health under the current standards allowing any hospital to build one, but three of those applicants stated at Wednesday’s meeting they favored a collaborative to operate the facility and the fourth is reportedly in discussions with Beaumont to be a partner with that facility.
The commission sent the new language to public hearing with the express instruction that the version presented limit the number of facilities that could be developed. The staff language, requiring any collaborative to represent 40 percent of the patients in the state, would by definition limit the state to two facilities. But Henry Ford Health Systems, St. John’s Health Systems, University of Michigan Health Systems and Karmanos Cancer Institute joined in urging a standard based on the number of treatments.
The hospitals argued setting the standard based on numbers of treatments would eliminate the need for some of the reporting language the department proposed to overcome U.S. Department of Justice concerns that the original language vetoed by Granholm could violate federal anti-trust laws.
Lawyers for the commission said it technically was exempt from anti-trust laws.
The change in the threshold and some other language did, however, address Granholm’s concerns that it would be too difficult to form a collaborative to run a proton beam facility.
The latest proposals also expand the definition of “high megavoltage radiation therapy unit” to include not only the proton beam units but also carbon ion units that are being researched at some hospitals and potentially any new therapy that uses a particle larger than an electron.
The proton beam therapy attacks cancer cells using accelerated protons.
A final decision on the new language is expected at the commission’s September meeting.
But commission members still raised concerns that the facilities were even being considered given their cost and the limited number of cancers on which they have shown effectiveness.
“We’re dealing with Star Trek equipment while the quality of health in communities is going down,” said Commission Vice Chair Norma Hagenow (R-Grand Blanc).
“There is a huge misallocation of resources when dollars are being spent on this kind of equipment when it could be spent on other things,” said Commissioner Adam Miller (D-Detroit).
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