The bad news is that wage levels in the healthcare industry are likely to be under pressure. Though healthcare workers are scattered throughout various occupations, two of the largest super-categories are “healthcare practitioners and technical occupations,” whose median annual wages in 2010 were $58,490, and “healthcare support occupations,” with 2010 median annual wages of only $24,760. It’s not surprising that the data projects a more rapid growth of the latter than the former.
Kingston Hospital to close
On Monday HAHV presented its preliminary recommendation to the New York State Department of Health (DOH) and the Office of Mental Health (OMH) to repurpose the Benedictine Hospital facility on Mary’s Avenue into a single, full-service, nonsectarian community hospital in Kingston, without limitations on reproductive services. To execute the plan, HealthAlliance said it expected to continue its ongoing conversations with the state on several important issues, including patient service continuation and access to capital for facilities upgrades.
Lundquist described the Monday meeting in Albany in positive terms. “They [the state DOH] viewed it as very constructive,” he said. “They were very appreciative of the dialogue.”
Cynthia Lowe, chair of the HealthAlliance board of directors, was reported in the release as saying that state officials were supportive of the organization’s preliminary plan. “It is apparent from our meeting that all parties are aligned in our goal for a financially viable model that preserves quality healthcare services in Ulster County,” said Lowe.
The recommendation came after an accelerated planning period, which included analysis of current and future community needs, financial modeling, evaluation of facilities and calculation of capital upgrade requirements. Lundquist and chief strategy officer Josh Ratner said the state was satisfied that HealthAlliance had done a thorough analysis.
Lundquist said input was taken from meetings with all HealthAlliance board entities, physician representatives, community members and employees. “Our choice is responsive to the preferences of our physicians and the needs of the community,” said Lundquist in the press release. “We are working to strengthen our healthcare services and will provide more details as they are confirmed in the coming months.”
The certificate of need (CON) governs the establishment, construction, renovation and major medical equipment acquisitions of the state’s healthcare facilities, and ensures that services are aligned with community needs. All submissions are reviewed by the Department of Health’s Public Health and Health Planning Council. According to the state website, the CON process also reins in investments in excess facility capacity and unneeded medical equipment that drive up healthcare costs without contributing materially to community health.
Reactions to the decision
“I look at this as a particularly courageous decision by a healthcare administrator,”
said William Van Slyke, spokesman for the Healthcare Association of NYS (HANYS), to the news that Benedictine Hospital is slated to become Kingston’s only hospital campus. “There are emotional connections, both within the facilities and in the community that might keep a facility open when it’s not a sound strategy for the future. These kinds of decisions demonstrate forward-thinking administrators who are focusing on the sustainability of health care services for the community.”
HANYS is the policy and political muscle for New York’s hospitals and health systems. Van Slyke pointed out that what’s happening in Kingston is being echoed all over New York.
“In Albany, three major hospitals are now collaborating,” he said. “In Syracuse, they’re doing the same thing. It’s a reality of health care nowadays. In general, you have to think about sustainability and focus on protecting the status of health care services. In today’s hostile reimbursement environment, independent hospitals are likely to collapse, causing total chaos in local communities. And that same sustainability applies to jobs — the end goal is to preserve as many jobs as possible to continue hospitals roles as economic engines.”
The impact of the consolidation on existing mental health programs is one concern.
“What I care most about, obviously, is that we have inpatient services intact,” said Helen Edelstein, director of vocational and therapeutic services at Gateway Community Industries. “We need an ER for psychiatric emergencies. We need inpatient psychiatric services. And we need to maintain the partial hospitalization program at Benedictine. This is critical.”
Edelstein said the partial hospitalization program, an intensive day program on an outpatient basis, serves as a transition from inpatient care for many patients. “A lot of those patients are then referred to Gateway, where we continue to work with them to integrate them back into daily life,” said Edelstein. “These programs are critical.”
Jonathan Drapkin of Pattern for Progress, a regional think tank focused on economic development and sustainability in the region, called the closing “a hard decision, but you’ve got to do it if the community can’t support two hospitals.” It’s never good news when a hospital closes, Drapkin said. “But once you get past the initial reaction, you have to look for opportunities to make this a win for the city.”
