Pols & Politics: How exactly should Mass. lawmakers respond to Steward crisis?

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The Steward Healthcare crisis will be kept front and center on Beacon Hill this coming week when the Massachusetts House gavels into session to take up a nearly 100-page proposal that attempts to address some of its root causes.

Representatives will be asked to vote on legislation that top Democrats say directly responds to the issues that led Steward Healthcare to declare bankruptcy and put all of its hospitals — including the eight in Massachusetts — up for sale.

Steward owes more than $7 billion in leases and loans to Medical Properties Trust, the company that Steward sold its hospital properties to and then agreed to rent it back from. The company's CEO, Ralph de la Torre, argued in 2010 that the agreement "benefits our patients, employees and pensioners and tremendously benefits the communities."

But after the deal, the company found itself hard pressed to make payments to its landlord.

The House bill tapped for a floor vote would require acute care hospitals to own the land on which their facility is located as a condition for state licensure, though the policy would not apply to hospitals on or before April 1, according to House Speaker Ron Mariano's office.

Mariano said this week that it is the "Legislature's responsibility to ensure that what happened with Steward Health Care never happens again."

"The House will take up comprehensive legislation to address gaps in our regulatory process that Steward exploited, to stabilize the health care system, and to address the rising cost of health care," he said in a statement after the company declared bankruptcy.

The proposal also would ban contracts between vendors and hospitals that allow for the repossession of medical or surgical equipment without a 60-day prior notice to the state, another move directed at stories from Steward's hospitals.

After the bill moves through the House, pay close attention to the speed at which the Senate makes clear their intentions with the bill.

Senate President Karen Spilka has not given a clear signal about her stances on the particulars of the House bill but she has said her " immediate concern remains the quality and continuity of care for the thousands of patients."

"I'm confident that the Healey Administration is paying careful attention to this crisis, and look forward to working with them and our partners in the House to take the steps necessary to prevent the conditions within our health care system that would cause another acute situation like the one facing Steward today," she said in a statement.

Spending on migrants a debate likely to carry into 2025

If there was any hope that contentious debates at the State House over how much to spend on emergency shelters housing thousands of migrants and the constraints Massachusetts should put on the system would end this year, think twice.

Senate budget chief Michael Rodrigues was clear this past week that discussions on the topic could carry into "early next calendar year, next session again." He made that prediction as the Senate rolled out its fiscal year 2025 budget, which included only $500 million for the shelter system, well below the $915 million the Healey administration expects to spend.

So why not allocate enough money for the shelter system to make it through the entire fiscal year, one reporter asked Rodrigues.

"We want to keep the pressure on the (Healey) administration to make programmatic changes to make it more efficient and affordable. And if you just throw all the money they want at it, there's no incentive. We're saying make it work and if they can't make it work, then come back to us and justify why you could not make this investment work," Rodrigues responded.

But Rodrigues did not offer a direct answer on what "programmatic changes" he wants to see from Healey. The Legislature already approved nine-month time limits for families' stay in shelters and a requirement that those in overflow shelters reapply monthly for their spots.

The Westport Democrat did point out that shelter-related services are "very expensive." Contracts between multiple state agencies show nightly rates for hotels serving as shelters can approach at least $300 and renting larger areas like a space at a Quincy college can top $237,00 a month.

"I think there can be efficiencies made and we'll let them come to us with their proposals, them being the administration," Rodrigues said.

Rodrigues was also not shy about the potential to hand more money to the system through a potential supplemental spending bill next year.

"We do supplemental budgets all the time, right? We do two or three a year and if we have to readdress this, which we might next fiscal year, we'll address it then," he said.