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Legislators Begin Learning Process on Establishing Public Health Center
County Executive asked for his backing on potential project
by Margaret Sternberg
Putnam County continued to take its first, tentative steps toward the establishing of a public health center, meant to provide health care to those under or uninsured, at the July 8, 2008 meeting of the Legislature's Health Committee.
Dr. Paul Kaye, Chief Medical Officer of Hudson River Healthcare appeared before the Committee primarily to educate its members on a public health center's establishment and financing, and while ensuring that County residents' health care needs were met remained the true issue for legislators, even in this nascent stage, financing of the center received the most intense scrutiny. Responding to one question, Dr. Kaye said that "like any not-for-profit, we live close to the [financial] margins, but it's now 32 years, and we're still here." Dr. Kaye went on to note that the Center has had a slight surplus the last two years, adding that they were in a "pretty good financial state."
The Center is financed by grants and the federal government, each supplying approximately 25 percent of funding, with patient revenues making up about 50 percent.
Dr. Kaye said that approximately 10 percent of the Center's patients are privately insured, roughly 40 percent pay out of pocket, and about 50 percent pay through Medicaid, Childhood Plus or another managed care program. All patients are charged for care, and no patients are turned away.
Among some of the requirements to be designated a "federally qualified health center," and so be eligible for federal benefits that include Medicaid and Medicare reimbursement, malpractice coverage, favorable drug pricing, and federal funding up to $650,000, the center must be non-profit, serve a medically underserved area or population, provide care regardless of ability to pay and assure that care is accessible.
Accessibility, which is the key to a center's success according to Dr. Kaye, involves addressing barriers of distance, finance, time, language and culture. These issues are addressed through transportation services, a sliding fee scale, extended hours and a "culturally and linguistically competent staff."
Hudson River Healthcare currently has sites in Westchester, Rockland, Orange, Ulster, Sullivan, Suffolk and Dutchess Counties and has seen continuous user growth, doubling since 2000. Services provided include family medicine, pediatrics, internal medicine, ob/gyn, optometry, dentistry, nutrition, prenatal, HIV services, laboratory, vaccinations and mental health.
Commissioner of Health Dr. Sherlita Amler noted that the establishment of a healthcare center to serve people not currently getting healthcare would ultimately be a savings for the County, enabling those people to get care for chronic medical conditions, such as diabetes or hypertension that if are diagnosed and treated early, can prevent higher financial and other costs that result from the conditions being left untreated.
Committee Chair Legislator Sam Oliverio asked Deputy County Executive John Tully to obtain feedback from County Executive Bob Bondi that "this is something he'd like to pursue" while Dr. Kaye indicated Hudson River Healthcare would be interested in pursuing the possibility of setting up a facility within the County.
The August meeting of the Health Committee will be posted on the PCN&R's website as soon as it becomes available.
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