At town hall, concern with Brooklyn’s health care inequities and Medicaid waiver dollars

Interfaith, LICH, Downstate, Brookdale, Wyckoff and other hospitals in trouble

March 7, 2014 By Mary Frost Brooklyn Daily Eagle

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Supporters of a multitude of Brooklyn’s threatened hospitals, many in Central Brooklyn, filled the pews at the Pleasant Grove Baptist Tabernacle church in Brownsville on Thursday night to discuss the fight to keep hospitals open, end health care disparity, and make sure that Brooklyn gets its fair share of promised Medicaid waiver funds.

The town hall was called by Public Advocate Letitia James, who described the inequities affecting the borough’s hospitals, and some of the underlying causes of the crisis.

In Brooklyn, hospitals typically receive only about half of the insurance reimbursement that hospitals located in Manhattan get for providing the same treatment, she said. At the same time, Brooklyn has only a third of the number of hospital beds as Manhattan per resident — roughly two beds per thousand residents, versus Manhattan’s six beds per thousand residents.

The state had been trying to make the case that Brooklyn has too many hospital beds. “Brooklyn is not over-bedded. That’s a myth,” she said. “We need to end this tale of two boroughs.”

Ms. James said that while the opening of a new round of bidding for Long Island College Hospital (LICH) was a victory, “We still need a full service hospital” there, which is not guaranteed under the terms of the reissued Request for Proposals (RFP).

Sshe highlighted other endangered Brooklyn hospitals, including Interfaith Medical Center, SUNY Downstate, Brookdale Medical Center, and Wyckoff Heights Medical Center. (Victory Memorial, now closed, has been replaced by the SUNY Downstate Bay Ridge Urgent Care Center.) Ms. James said some of the reasons they are in trouble include underpayment by Medicaid, high debt, underinsured patients, a high number of patients with chronic diseases such as high blood pressure and diabetes, and a lack of primary care providers in underserved communities.

Supporters of many of these hospitals were in the audience.

Dr. Kevin Bond, the Pastor of Citadel of Worship and Praise, spoke of the critical importance of SUNY Downstate to Brooklyn, but warned that supporters of all of Brooklyn’s threatened hospitals needed to work together. “At the end of the day, we don’t want any hospital to close in Brooklyn. If they divide us, they’re able to win.” Dr. Bond said that a 48-hour fast to bring attention to the plight of Downstate would take place starting next Sunday at 3 p.m.

Interfaith Medical Center community advisory board chairwoman Sharonnie Perry rallied the crowd for the hospital, which serves Bedford-Stuyvesant and Crown Heights. She told the crowd, “I almost died last night” after having a bad reaction to something in some Chinese food. “They told me my body was going into shock. I’m so thankful Interfaith saved me.”

Interfaith’s bankruptcy case is pending before the U.S. Bankruptcy Court for the Eastern District of New York .

Last month, the U.S. Department of Health and Human Services approved a waiver for New York state that will provide up to $8 billion in extra Medicaid funding over the next five years.

Judy Wessler, former Director at the Commission on the Public’s Health System, explained the complexities of the waiver agreement and said that when it comes to Brooklyn hospitals seeing any of that money, much depends on the definition of “safety net” hospitals.

Governor Andrew Cuomo has promised that up to $1 billion in waiver money would flow to Brooklyn’s safety net hospitals. Traditionally, safety net hospitals are defined as those serving large numbers of low-income, uninsured, and Medicaid patients, conditions that have long existed in Central Brooklyn.

But there is an effort afoot to expand that definition to add hospitals that care for larger numbers of privately insured patients, she said.

Letting hospital associations decide this question is like “putting a fox in charge of the chicken coop,” she said. They would like to define safety net “to include almost everybody.”

Assemblyman Walter Mosley said that many upstate hospitals were trying to redefine themselves as safety net hospitals in order to get a larger share of the waiver funds. “We need to remain vigilant. We don’t want the rules of the game to change so others can take advantage of what we’ve been fighting for for the last two, three years. Places like Syracuse are trying to skirt the process to take money away from hospitals that really need these waiver dollars.”

Mosley added it was important to support all of Brooklyn’s hospitals. “Healthcare transcends neighborhoods. We can’t schedule to have a heart attack next to our neighborhood hospital.”

Brooklyn Borough President Eric Adams said that after looking at the numbers, “It’s amazing they are even thinking of closing hospitals in our community.”

Adams said he wanted to increase community participation in the process, and next week would be opening break out sessions at Borough Hall in order to get input. “It’s going to change. Let’s be part of that change.”

Assembly Member Annette Robinson (AD 56) said officials “must insure that resources are distributed fairly and equitably. We must all come together, review the proposals, and make sure that ours is one of the most outstanding to serve the Central Brooklyn community.”

Eliza Carboni, representing the New York State Nurses Association, said that the focus of hospitals should be health care, not finance. Of 15 Brooklyn hospitals, “Eight are at risk of closure,” she said. “Making money shouldn’t be their first goal. The goal should be providing the best care to communities.”

Carboni criticized a state report by the Berger Commission for skewing the figures concerning the number of hospital beds in Brooklyn. “Real capacity is based on how many beds are staffed and operating,” she said. “At LICH, SUNY (LICH’s operator) said only half the beds were filled. But 90 percent of LICH’s 250 operational beds were filled.”

The state is trying to make the case that the Medicaid waiver funds should be used to reduce the number of hospital beds in Brooklyn, she said. “But transforming hospitals doesn’t mean shutting them down.”

Bruce Richards, VP of 1199 SEIU said that inequality was built right into the system. “The more vulnerable people of color geet left out, while higher reimbursement rates go to rich hospitals in Manhattan.” He pushed for a co-op model as a possible option.

Richards added that the community needed to pay more attention to its health problems. “High blood pressure, diabetes, obesity are running rampant in this community.”

New York City Comptroller Scott Stringer told the crowd, “It make no sense to dismantle hospitals in Brooklyn. If you take away LICH, Interfaith, Downstate, all those services and infrastructure, five or ten years from now we are going to say, ‘Why did we let them take it away?

The real social justice issue of out time is health care for all of our children,” Stringer said. “I audit and I investigate. I have a lot of auditors, and they’re ready to roll. I’m going to put them in a room with Tish’s [Letitia Jame’s] lawyers. Let’s get this thing done right now.”

Maribel Agosto, medical surgical nurse at LICH was attending with members of Patients for LICH. “We need to make sure this money comes to Brooklyn to straighten out this mess,” she told the Brooklyn Eagle.

Other participants included the Reverend Dr. Herbert Daughtry of the House of the Lord Church; his daughter Dr Karen Daughtry, evangelist Denise Greene and Bishop Albert L. Jamison, Sr., Pastor of Pleasant Grove Baptist Tabernacle.

Update 3/10/14: Victory Memorial, now closed, has been replaced by the SUNY Downstate Bay Ridge Urgent Care Center.