As a state commission weighs the merits of two applications to bring cardiac surgery services to Anne Arundel, County Executive Steve Schuh is asking the body to speed up its decision-making process.

Anne Arundel Medical Center in Annapolis and Baltimore Washington Medical Center in Glen Burnie have each asked for a certificate of need to establish an open heart-surgery program. The requests must be approved by the Maryland Health Care Commission, a 15-member independent regulatory agency appointed by the governor.

In a recent letter to Commission Chairman Craig Tanio and Executive Director Ben Steffen, Schuh wrote that he is “deeply concerned about a very serious health matter as well as the process for resolving it.”

“While there are ten open-heart programs in Maryland [including five in Baltimore City], Anne Arundel County with 600,000 citizens is the third-largest county in Maryland that does not have such a program,” he wrote. “I would like to know why there has been such a delay in granting a [certificate of need] in this instance.”

Both hospitals submitted their applications for a certificate of need in February 2015. Documents posted to the commission's website show correspondence among the commission, applicants and other interested parties throughout the summer and as recently as this month.

Schuh cited statistics that show a 21 percent increase in the number of cardiac cases in Maryland and pointed to a burgeoning number of senior citizens in Anne Arundel as the county population ages.

Anne Arundel Medical Center transferred 300 patients out of the county for cardiac surgery last year, he said.

“Not only is there an urgent need today, but the need is growing,” Schuh wrote. “Let me state in the clearest terms: Anne Arundel County needs an open-heart program.”

The county executive also asked commissioners to visit the hospitals and take input from local officials.

Steffen declined to comment on Schuh's letter but wrote in an email that commission chairman Tanio “has indicated he plans to complete the reviews this fall.”

Tanio sent a letter this month to both hospitals asking for a commitment that they will not seek approval for budget increases as a result of adding a cardiac surgery program.

“My goal, in seeking responses to these... questions, is to obtain confirmation and a greater level of confidence that the system savings projected by the applicants through a shift in cardiac surgery case volume from higher charge to lower charge hospitals will be sustained if one or both of these (certificate of need) applications are approved,” he wrote.

Hospitals that want to have cardiac programs must show that they can get a minimum caseload of 200 cardiac surgeries by the second fill year. They must also demonstrate that the program would not cause any providers in the region to fall below 200 cases a year, according to the state's new standards.

If approved, Anne Arundel Medical Center plans to work with Johns Hopkins and bring its cardiac surgeons to the hospital to start the program. For Baltimore Washington Medical Center, the University of Maryland Medical System plans to hire two more cardiac surgeons and has been training the nursing staff.

House Speaker Michael Busch, an Annapolis Democrat who sits on the University of Maryland Medical System's board of directors, said he isn't surprised the commission is taking its time with the applications, which are opposed by Baltimore's Sinai Hospital, Union Memorial Hospital and Washington Hospital Center, one of the region's leading cardiac surgery providers.

“They do a pretty extensive review of what the needs are,” he said. “They can be taken to court over this decision.”

Busch said he sees a need for an open- heart surgery program in the county, but doubts both applications will be approved because of the hospitals' proximity. He wrote a letter to the commission supporting a program at Anne Arundel Medical Center.

“I personally believe that there's a justification for Anne Arundel County to have a facility to do open heart,” he said. “I believe that AAMC is best geographically located to serve the Eastern Shore, southern Maryland, as well as Anne Arundel County.”

Schuh's spokesman Owen McEvoy said the county executive is “hopeful both [hospitals] will be certified.”

Baltimore Sun Media Group reporter Meredith Newman contributed to this article.