Tag Archives: safetynet

New York Needs Safety Net Hospitals

Here is our op-ed on the Medicaid Redesign Team that ran in today’s Albany Times Union. Comments most welcome!

By Nisha Agarwal and Shena Elrington

Gov. Andrew Cuomo‘s Medicaid Redesign Team was handpicked by him and elected by no one. Though touted as a collection of health care “experts,” the majority of the team’s members have strong ties to special interests in the health care industry.

Not surprisingly, its proposals for cuts reflect the vested interests of its members.

Proposal 67 calls for the closing or downsizing of safety net hospitals that provide health care services in medically under-served areas. We need more health services in these communities, not less, particularly since these communities have been ravaged by hospital closures in recent years.

Central Brooklyn, with its extremely low-income and 90 percent black and Latino population, has lost two hospitals, OB-GYN and prenatal services at two other local hospitals, 13 outpatient clinics, a federally funded health center and at least two women, infants and children program centers that provide nutrition education and assistance in recent years, despite having some of the worst health outcomes in the city.

The infant mortality rate in the Brownsville section of central Brooklyn is nearly five times that of Manhattan’s Upper East Side.

Do we really need more hospitals in areas like central Brooklyn to close?

When safety net hospitals close, people are forced to travel farther to see care at the few institutions that remain open — usually elite private academic teaching centers. These are the very same institutions to which many of the Medicaid team’s members have strong connections, raising questions about the appropriateness of using the regulatory process to funnel business to special-interest groups.

What is more, proposals that would actually support safety net institutions and use public dollars in an accountable and transparent way never made it into the final Medicaid reform package.

Proposal 66, for example, would have recalibrated charity care and Medicaid dollars so that the distribution of that funding would be based on the actual Medicaid and uninsured losses. Hospitals in New York now receive “indigent care” funding regardless of the volume of care they actually provide to Medicaid and uninsured patients. So, hospitals that provide very little care to low-income New Yorkers often get more money from the indigent care pool than they deserve, while safety net institutions, which provide a lot of care to Medicaid and uninsured patients, do not get their fair share.

Recalibrating the way this funding is distributed would not only make sense and bolster the financial stability of critical safety net institutions. It also is required under federal health reform and was very favorably ranked through the Medicaid Redesign Team’s own scoring process. Yet, the proposal never made it into the team’s final recommendations.

New York is in the midst of an epic budget crisis. Medicaid is seen as the linchpin to solving that crisis. But its redesign should not be done in such a way as to threaten the very institutions that serve as a safety net for our state’s most vulnerable residents. The erosion of our health care safety net threatens the stability of the system for all of us.

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Filed under health disparities, legislation, news, people of color

Let’s Go Wisconsin On Them

We are back in New York City after a productive weekend at the black, Latino and Asian legislators caucus in Albany, where we presented on a panel about the Governor’s Medicaid Redesign Team with Judy Wessler from the Commission on the Public’s Health System and Laray Brown from the NYC Health and Hospitals Corporation, among others. Our collective message was clear. In not so many words: the MRT process sucks. The proposals it is considering also, by and large, suck. And the hurt will be felt most acutely by black and brown and immigrant communities across New York State. (Here’s a link to our PowerPoint presentation. Judy presented an overview of the MRT and all its problems, which you can download here, and Laray discussed the impact of the MRT on the city’s public hospitals in particular – click here for her presentation.)

Everyone we spoke to was hella angry about these Medicaid cuts and the means by which they are being made. As one panel attendee said, “we need to go Wisconsin on them!” And, indeed, we are plotting our next moves in advance of the MRT’s announcement of the cuts that it is recommending on March 1. We will keep you posted on this blog, or you can email the Save Our Safety Net Campaign to get up-to-the-minute updates (soscny@gmail.com). In the meantime, here are some important dates to keep in mind:

  • February 24 & 25: Next meeting of the Medicaid Redesign Team (open to the public): 10:30 a.m. in Meeting Rooms 2-4, Concourse, Empire State Plaza, in Albany.
  • February 28: Meeting of the Medicaid Redesign Team (open to the public): 10:30 a.m. in the Hart Theater of the Egg in Albany
  • March 1: Medicaid Redesign Team announces its recommendations

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Save Our Safety Net – Video from Medicaid Redesign Hearings

On February 4, 2011 – Governor Cuomo’s Mediciad Redesign Team (MRT) held a public hearing in NYC. The MRT has been charged with finding $2.85 billion of cuts to New York’s Medicaid budget by March 1st. The MRT – which has a disappointing lack of consumer voices  – gave New Yorkers 2 minutes during the hearings to give their suggestions for Medicaid redesign.

This video captures the repeatedly expressed sentiment that cuts to already struggling safety net providers will have catastrophic impacts on low-income, immigrant and disabled communities.

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Filed under health disparities, immigrant health, insurance, people of color