REPORT: December 2006
by Nancy Webber
In June 2005 a state law was passed to create a commission that would make recommendations on “rightsizing” healthcare facilities. Speculation began almost immediately over which facilities would be forced to close.
Still, when the report of the Commission on Healthcare Facilities in the 21st Century was released on Nov. 28, it sent shock waves through communities that suddenly realized they might lose well-established hospitals and nursing homes. The group’s chairman, investment banker Stephen Berger, announced that nine hospitals in the state would close and 48 would be required to merge with other facilities or close beds. (See page 3 for a list of facilities where NYSNA has local bargaining units.)
Total hospital inpatient capacity in the state would be reduced by 4,200 beds, or 7%, and nursing homes by 3,000 beds, or 2.6%.
The recommendations will take on the force of law on Jan. 1, 2007, unless they are rejected in their entirety by the Governor or the State Legislature. Within days of its release, both outgoing Gov. George Pataki and Governor-elect Eliot Spitzer endorsed the Commission’s report. As of Dec. 13, the legislature had taken no action.
Lolita Compas, former NYSNA president and chair of the bargaining unit at Cabrini Medical Center, said nurses were angry about the possible closure of their facility. Compas has worked at Cabrini since she came to the U.S. from the Philippines in 1969.
“Cabrini was the first hospital in New York City that provided care to poor immigrants for free,” she said. “We care for people from all walks of life, many of them minority patients. Where will they go when they can’t afford care at one of the large hospitals nearby?”
NYSNA members at Westchester Square Medical Center were surprised by the closure announcement. “We didn’t think the hospital was being considered,” said Jeanette Valdespino-Torres, chair of the local bargaining unit. “It did keep coming up in our contract negotiations, however.” The nurses ratified a new contract on Dec. 8.
Valdespino-Torres, who works in a busy ambulatory care unit, has been at “The Square” for her entire career. Her home is only 10 minutes away and she feels a special affinity for her patients, many of whom are Hispanic like herself. “I had offers to work at other hospitals for more pay, but I chose to stay where I could serve my own people,” she said.
For the nurses at The Square, “it’s been an emotional roller coaster,” Valdespino-Torres said. “The older nurses will probably retire. The rest are scared at the thought of starting over.”
NYSNA members at Van Duyn Home and Hospital near Syracuse have similar feelings of outrage and disappointment. “We took a very small increase in pay and were willing to make concessions in our contract, just to keep this facility viable,” said Stacy Gantt. “Van Duyn is a safety net for people who have nowhere else to go.”
Van Duyn is operated by Onondaga County, and is one of several public healthcare facilities across the state that would be privatized, according to the Berger Commission. SUNY Upstate Medical Center in Syracuse would merge with Crouse Hospital and become a privately-owned facility. Erie County Medical Center would merge with Buffalo General Hospital and cease operation as a public benefit corporation.
“The legislature would have to rescind the law creating the Erie County Public Benefit Corporation, which has been in effect for less than three years,” said Martha Hogarth, associate director in the NYSNA collective bargaining program. This merger would allow the private sector to steal public services.”
At a State Assembly Health Committee hearing in Buffalo on Dec. 11, Dennis Lindell, co-chair of the ECMC bargaining unit, speculated that by not opposing the merger, the medical center was trying to break its contracts with NYSNA and other public employee unions. The Berger Commission claimed in its report that “high fringe benefit costs” were a key factor in ECMC’s financial problems.
While some hospitals came out in support of the recommendations, others vowed to fight.
Managers at Westchester Square, Cabrini, and Van Duyn assured staff that the facilities would not close. St. Joseph’s Hospital in Elmira has filed a lawsuit against the Berger Commission.
State lawmakers suggested that the legislature might cancel at least some of the closings and mergers. Another unknown factor: a new Governor and Health Commissioner will be responsible for implementing the plan.
“The mergers raise significant problems that could drag this process on for years,” said Shaun Flynn, director of the NYSNA Governmental Affairs Program. “Unfortunately, this issue will dominate discussions at a time when more effective actions could be taken to improve health care in New York.”
Hospitals targeted for closure include Cabrini Medical Center in Manhattan and New York Westchester Square Medical Center in the Bronx. Together, these facilities employ approximately 380 RNs.
Facilities required to merge with other facilities:
NYSNA has received e-mails and calls from members who wonder why the association is opposing the recommendations of the Berger Commission.
“From the start, we were concerned about the criteria used by the Berger Commission in making these decisions,” said Carol Pittman, community affairs liaison for the NYSNA Economic & General Welfare Program. “The commission did not put a high priority on access to care, especially for minorities and the poor.”
NYSNA has played a leadership role in the Save Our Hospitals Coalition (SOS-C), which last year put forward legislation to redefine the commission’s mission and structure. The bill passed the State Assembly but was not voted on by the Senate. The coalition will continue to be active in demanding community input into the process.
The 18 commission members were appointed by Gov. George Pataki and legislative leaders. They primarily were former executives of healthcare corporations and heads of banking firms, investment firms, HMOs, and the energy industry. While claiming to be nonpartisan, the commission included a former Republican county executive, a former deputy secretary to the governor, and the governor-appointed chair of the state Consumer Protection Board.
The commission did not encourage public input. Regional advisory committees held hearings, and NYSNA members and staff spoke at many of them. But the hearings were not well publicized and individuals had to sign up a week in advance if they wanted to speak. All of the commission’s substantive deliberations were conducted in executive session.
“NYSNA believes that healthcare needs assessments should be done before decisions are made to close and downsize facilities,” said Pittman. “In addition, it is wrong to force hospitals and nursing homes to close, merge, and downsize based on the secret deliberations of commission that is not accountable to public.”
NYSNA members attended numerous protest events during the two weeks following the release of the Berger Commission report.