NEW YORK NURSE: November/December 2011
by Erin Silk
Six months ago, Commissioner Nirav Shah of the New York State Department of Health appointed the Brooklyn Health System Redesign Work Group (“the Work Group”) to assess the strengths and weaknesses of Brooklyn’s hospitals and healthcare system and evaluate the longer term viability of the hospitals as providers of care to the borough’s 2.5 million residents.
The Work Group was convened in the context of growing financial distress at three hospitals: Interfaith Medical Center, Wyckoff Heights Medical Center and Brookdale Hospital Medical Center, and concerns about the long-term stability of other providers given changes in Medicaid and Medicare funding and an evolving healthcare marketplace.
In an effort to preserve and improve healthcare access and quality for Brooklyn residents, NYSNA participated in the “Save Our Safety Net” campaign to urge the MRT to find alternatives to hospital closings in this underserved area. In testimony presented on July 28 and October 19, NYSNA encouraged the Work Group to look beyond immediate opportunities for cost-savings that might be achieved through facility closure and instead, to recognize the opportunities that now exist with the implementation of health homes and other new ideas emerging from the Medicaid Redesign Team, as well as the opportunities available with the implementation of the federal Affordable Care Act.
Over the past six months, the Work Group has convened three public meetings, visited all 15 hospitals in Brooklyn and a federally qualified health center, met with hospital executives, board members, medical staffs and healthcare experts, and reviewed data. They have considered reforms including new models of care and payment that emphasizes care coordination, prevention, and performance. The reforms demand integration and collaboration among providers along the continuum of care, in order to improve the quality of care for individuals, improve the health of communities, and reduce costs through improvement. According to the Work Group’s report, with or without federal reforms, clinical integration, clinical outcomes, expansion of primary care and contraction of inpatient beds must be priorities in order to improve health and healthcare, while reducing unnecessary costs. The Work Group has recommended the creation of a Brooklyn Healthcare Improvement Board to oversee the implementation of these reforms.
While NYSNA shares the Work Group’s recognition of the need to invest in an expansion of primary care and primary care facilities, it is deeply concerned that the Work Group’s report does not contain specifics on how these proposals are to be implemented. The report neglects to specify the Legislature’s role with regards to the proposals, or where the funding will come from and a timetable for implementation. NYSNA is also urging Health Commissioner Shah to involve stakeholders in the decision-making process and ensure that board meetings are open to the public and follow public meeting rules. Finally, NYSNA asks that Commissioner Shah consider the work of the Health Disparities Committee of the Medicaid Redesign Team, a group that largely represents people of or representing Medicaid consumers and their communities.
New York Nurse will keep you updated regarding the next steps of the redesign and of our efforts to protect access to quality health care for Brooklyn’s residents.