Nine months after nine New York hospitals were ordered to close in an orderly fashion by a state commission charged with overhauling the states crumbling healthcare system, there has been some progress, albeit messy and gut-wrenching.
New York State Health Commissioner Richard Daines said he is confident that the long list of recommendations put forward last year by the Commission on Health Care Facilities in the 21st Century, known as the Berger Commission, will be put in motion, if not fully implemented by the June 30, 2008, deadline.
Were examining each of them (in terms) of whether they reach the overall goal of downsizing and streamlining the states healthcare system, Daines said. Thats the overall structure (of the Berger recommendations), so any proposal we look at has to fit in that.
Other states are no doubt watching the New York drama unfold with interest. The states groundbreaking process for restructuring the capital-starved hospital system potentially serves as a road map for other states struggling with the same politicized issues (Dec. 4, 2006, p. 6).
I think it was a wise process to try to break this off from direct political involvement, Daines said about the all or nothing format of the Berger commission recommendations, which became law on Jan. 1, 2007. That left the new administration of Democratic Gov. Eliot Spitzer with a whole package to implement rather than attempting to reform the system in a piecemeal fashion, he added.
Three of the hospitals marked for closure are battling the mandates with lawsuits, but all except oneParkway Hospital in Queenshave also come up with proposals that make some concessions to the recommendations.
Those concessions were helped in no small part by $550 million in state funding that was allocated for assisting hospitals and nursing homes in implementing the provisions. In July, the state Health Department announced that 62 hospitals and nursing homes had submitted applications for financial assistance, collectively requesting a total of $2.5 billion in grant requests. Health department officials said they anticipate announcing all the awards before the end of this month. The first award to be approved was $17 million to assist the Aug. 31 shutdown of St. Vincents Midtown Hospital in Manhattan. Cabrini Medical Center in New York and Millard Fillmore Gates Circle Hospital in Buffalo have also submitted closure plans with grant requests.
Cabrini, which originally filed a lawsuit that has since been withdrawn, is proposing a conversion to a multipurpose medical and ambulatory-care complex, said Gerald McKelvey, a Cabrini spokesman. Meanwhile, parent Kaleida Health said in a news release that it is seeking $121 million to relocate services at Millard Fillmore Gates to its Buffalo General Hospital and Buffalo Niagara campuses. Bellevue Womans Hospital in Schenectady has announced plans to transition to neighboring 351-bed Ellis Hospital.
Other proposed closings are not so tidy. Westchester Square Medical Center in the Bronx has submitted a grant proposal under a plan that would keep the hospitals emergency department and some overnight beds operational. Three other hospitals that are under orders to closeVictory Memorial Hospital in New York, Community Hospital at Dobbs Ferry, and St. Joseph Hospital in Cheektowagahave made similar requests, according to the health department. Covering its bases, St. Joseph has also filed a lawsuit fighting the mandate. In addition, Albert Lindley Lee Memorial Hospital in Fultonwhich short of being ordered to close was told to close all of its 67 beds and convert to an outpatient/urgent-care centerhas filed a lawsuit challenging the order and simultaneously submitted a grant proposal that would allow it to keep its emergency department and some overnight beds operational.
Those are kind of complex situations, Daines said. Were looking at how (the proposals) contribute to health services. We are much more focused now on the individual institutions and what needs to be done with them.
Westchester Squares plan actually proposes shutting down the hospital to allow New Yorks mammoth New-York Presbyterian Health System to locate a new acute-care facility on that site. The proposal presents compelling reasons why that should be permitted, said Nadine Woloshin, a Westchester Square spokeswoman. To complicate matters further, a lawsuit to stop the closing of the hospital is in the queue at the New York State Court of Appeals, the states highest court, said Andrew Blum, a spokesman for Chadbourne & Parke, one of the law firms representing the plaintiffsa patient and a neighborhood senior citizen center.