July 2013: Interfaith Hospital goes from teetering to closing....
  • http://online.wsj.com/article/SB10001424127887323829104578622421122336606.html

    At this rate there may be soon very few hospitals that serve the poor, other than those operated by HHC....


  • Hospitals of the HHC are the only ones that can afford to serve the poor because taxpayer funding can always be increased. Frankly, we need less emergency rooms and more walk-in clinics that can get by with lower the lower reimbursements that Medicaid pays.


  • Anyone interested in some slightly less than prime real estate?

    Any nonprofits interested in taking over some government contracts that serve the poor and disabled?

    ...once this entity makes its way through bankruptcy proceedings, it could be your lucky day.

    MAIN HOSPITAL BUILDING

    Interfaith Medical Center

    1545 Atlantic Avenue

    Brooklyn, NY 11213

    Phone: (718) 613-4000

    Directions: By Car/Foot | By Subway/Bus

    AMBULATORY CARE CENTERS

    Medical Health Services

    Primary Care Designated

    AIDS Treatment Center

    880 Bergen Street

    Brooklyn, NY 11238

    (718) 613-7555

    Directions: By Car/Foot | By Subway/Bus

    Bishop Orris G. Walker, Jr. Health Care Center

    528 Prospect Place

    Brooklyn, NY 11238

    (718) 613-6800 Main Number

    (718) 613-6900 Medical Clinic

    Clinics Schedule

    Directions: By Car/Foot | By Subway/Bus

    Dental Services

    Dental Center

    1536 Bedford Avenue

    Brooklyn, NY 11216

    (718) 613- 7375

    Directions: By Car/Foot | By Subway/Bus

    Behavioral Health Services

    Alternative Housing /

    Apartment Program

    1366 East New York Avenue

    Brooklyn, NY 11233

    (718) 613-6701

    Directions: By Car/Foot | By Subway/Bus

    Behavioral Health Program-Adult Clinic

    (Satellite Location)

    1038 Broadway

    Brooklyn, NY 11221

    (718) 613-6210

    Directions: By Car/Foot | By Subway/Bus

    Behavioral Health Program - Child and Adolescent Clinic

    1545 Atlantic Avenue

    Brooklyn, NY 11213

    (718) 778-7251

    Directions: By Car/Foot | By Subway/Bus

    Center for Mental Health

    1545 Atlantic Avenue

    Brooklyn, NY 11213

    (718) 613-4494

    Directions: By Car/Foot | By Subway/Bus

    Center for Mental Health

    (Learning Center Satellite Location)

    960 Prospect Place

    Brooklyn, NY 11213

    (718) 363-2810

    Directions: By Car/Foot | By Subway/Bus

    Chemical Dependence Outpatient Services (CDOS)

    1545 Atlantic Avenue

    Brooklyn, NY 11213

    (718) 613-4450

    Directions: By Car/Foot | By Subway/Bus

    Continuing Day Treatment Program

    1275 Bedford Avenue

    Brooklyn, NY 11216

    (718) 613-7401

    Directions: By Car/Foot | By Subway/Bus

    Intensive Psychiatric Rehabilitation Therapy Program (IPRT)

    1545 Atlantic Avenue

    Brooklyn, NY 11213

    (718) 613-4354

    Directions: By Car/Foot | By Subway/Bus

    MMTP (Methadone Maintenance Treatment Program)

    882 Bergen Street

    Brooklyn, NY 11238

    (718) 613-7510

    Directions: By Car/Foot | By Subway/Bus

    MICA (Mentally- Ill Chemical Abuser)Continuing Day Treatment Program

    1545 Atlantic Avenue

    Brooklyn, NY 11213

    (718) 613-4355

    Directions: By Car/Foot | By Subway/Bus

    Mobile Crisis Team

    1545 Atlantic Avenue

    Brooklyn, NY 11213

    (718) 613-6618

    Directions: By Car/Foot | By Subway/Bus

    Partial Hospital Program

    1545 Atlantic Avenue

    Brooklyn, NY 11213

    (718) 613-4354

    Directions: By Car/Foot | By Subway/Bus

    http://www.interfaithmedical.com/locations.html


  • When you promise something to potential voters that you know that you have no ability to deliver, it is called "grandstanding".

    This rhetoric does nothing to address the systemic, long term structural problems that "safety net" hospitals are facing...

    http://www.dnainfo.com/new-york/20130729/cobble-hill/de-blasio-announced-healthcare-plan-save-brooklyn-hospitals


  • The timeline is set:

    Pending court and state approval, on Aug. 12 the hospital will end inpatient admissions and divert ambulances to other hospitals. Elective surgeries will end Aug. 19, the emergency department will shut Sept. 11, and all patients will be transferred from the hospital by Sept. 12. Outpatient programs will end Oct. 12 and detoxification and rehabilitation programs Nov. 11.

    http://www.crainsnewyork.com/article/20130731/HEALTH_CARE/130739962

    If LICH's experience is applicable, we can expect some rallies and court injunctions that delay the implementation schedule slightly.

    Related conversation about the closing of the Methadone program on Bergen St, in Crown Heights: http://www.brooklynian.com/forums/topic/in-the-spotlight-local-methadone-clinics


  • Wonder what's going to happen to the RE? The original chapel from St. John's Hospital is beautiful and as far as I know hasn't been landmarked. Its a huge facility which is some developer's wet dream.


  • Homeowner-

    I suspect the RE (Real Estate) will be disposed of after bankruptcy proceedings are finalized. It might take a year or so after it is closed.

    In light of how long the hospital has been teetering, I imagine most of the sites are leased, not owned, by Interfaith.

    I do hope some non-profits in the Mental health field are able to take over the sites that are leased, and that the OMH and DOHMH contracts are transferred with them.


  • Needless to say, those who advocate for persons with mental illness believe that many of these contracts and services will not simply be transferred to other providers, they will disappear:

    http://mobile.nytimes.com/2013/08/02/nyregion/brooklyn-hospital-closings-a-blow-to-psychiatric-care.html


  • Sept 11:

    The timeline is delayed again. It now looks like it may close as late as Dec 25.

    http://www.crainsnewyork.com/article/20130911/HEALTH_CARE/130919977


  • N.Y. Needs Medicaid waiver

    Kenneth E. Raske,

    Times Union

    By Kenneth E. Raske and George Gresham, Commentary

    If you Google "Brooklyn hospitals" these days, you'll see plenty about the looming closures of Long Island College Hospital and Interfaith Medical Center, the dire fiscal plight of several other Brooklyn hospitals, and the uncertainty gripping the borough's most vulnerable communities and thousands of health care workers.

    But the number of financially reeling hospitals — usually "safety net" facilities serving poor and uninsured patients — extends far beyond Brooklyn. From the Bronx to Buffalo, years of inadequate reimbursement, relentless government funding cuts, huge numbers of uninsured patients, and a still-sluggish economy have left dozens of hospitals in perilous financial condition, with many fighting for their survival.

    The numbers tell the story: 14 hospitals have closed across the state in just the last five years. We're fast approaching a tipping point where additional closures will severely harm New York's health care delivery system and threaten access to care — just as baby boomers reach their senior years and the Affordable Care Act is set to extend health coverage to a million currently uninsured New Yorkers.

    Despite that grim scenario, a healthier financial future for New York's hospitals is tantalizingly close. Last year, the state submitted a $10 billion Medicaid waiver request to Washington to transform health care delivery in New York from a fragmented system that prioritizes institutional care to an integrated system of highly coordinated care. The waiver funds would target primary care expansion, public health innovations, safety net hospital stabilization and workforce flexibility.

    A rapidly shifting health care landscape is forcing hospitals to restructure their business models and care for patients beyond their physical walls. These structural changes vary from hospital to hospital, but they all share the "triple aim" of improving population health, enhancing the patient care and reducing health care costs.

    New York's hospitals have embraced this challenge and have already made important strides. Under Gov. Andrew Cuomo's leadership, the state's Medicaid Redesign Team developed a five-year action plan that includes more than 200 recommendations, many of which have already lowered health care costs and improved quality.

    Our hospitals need additional resources to continue. They need Washington's help. They need the waiver.

    And the waiver is far from a handout — it's funding we've earned. The MRT's initiatives, including a "global cap" on Medicaid spending, have already saved huge sums and are projected to save the federal government $17 billion over the next five years, making the waiver a sensible reinvestment of a portion of those savings. The waiver will enable hospitals to implement new care delivery models and help ensure that New York has the necessary health care workforce for the future.

    The waiver has the strong support of Sen. Chuck Schumer, Sen. Kirsten Gillibrand, and the New York Congressional delegation. At a time when consensus rarely crosses party lines, the waiver enjoys near-universal support among New York's elected officials.

    Health care in New York is at a crossroads. Numerous Medicaid reforms have helped the state lower its health care costs without compromising quality and access, but as the Brooklyn crisis affirms, too many of our safety net hospitals lack the resources to build on that momentum, transform their delivery models and continue to meet the health care needs of their communities. The waiver would both acknowledge the progress New York has made and deliver the tools to stabilize vital institutions for years to come.

    On behalf of the patients our hospitals and health care workers serve, we urge Washington to approve New York's Medicaid waiver.

    Kenneth Raske is president of the Greater New York Hospital Association. George Gresham is president of 1199 SEIU.


  • Everyone is putting their hopes on the waiver.

    Without it, judges simply postpone closing money losing hospitals.

    http://ourtimepress.com/2013/09/21/hopeful-future-for-interfaith-medical-center/


  • Note, not all hospitals are teetering.

    Some are so confident in their ability to attract a population with the means to pay, that they are not enrolling in ACA.

    http://www.wnyc.org/story/wide-difference-interest-among-hospitals-participating-health-exchange-plans/


  • Meanwhile back at Interfaith, the timeline changes, but the end result appears the same:

    http://m.nydailynews.com/1.1480118


  • The back story:

    NYAPRS Note: Below are two articles from this week’s Crain’s Health Pulse that highlight the ongoing tension surrounding the closures of two hospitals in Brooklyn. As the state moves toward integrated practice settings and away from institutional care, private hospital systems often have two options: adapt to community-based service delivery models, or risk bankruptcy and failure.

    There is a continuous balance between policy reforms and budget agendas set by state lawmakers and agencies in Albany, with competing interests and the regional preferences and needs of hospitals, unions, and community members. This balance is particularly difficult to manage with healthcare systems in the five boroughs. Various viewpoints all seek to answer the question: what is our system going to look like in the coming generation?

    To raise your voice in answering this question, join DOHMH and NYAPRS at two upcoming forums: November 1 @ 125 Worth St. in Manhattan from 2-5pm, and November 7 @ Brooklyn Borough Hall from 11am-2pm.

    Brooklyn's health care crisis debated

    At a Crain's health care conference Thursday, Stephen Berger, who chaired the Medicaid Redesign Team's Brooklyn work group, said bluntly that some of the borough's hospitals must close. "Hospitals are part of the health care system, not the health care system," said Mr. Berger, who gave the keynote address at the conference on the future of Brooklyn's troubled hospitals. As part of the plan to turn the acute care system into one focused on primary care, he called for University Hospital to close and for SUNY Downstate to instead use Kings County as its teaching facility.

    He also called for the creation of an authority run jointly by the city and state to jump-start the restructuring.

    But Mr. Berger ran into opposition from NYSNA Executive Director Jill Furillo. The panelist said her union has a "zero tolerance" policy when it comes to hospital closures. She said a primary care network would have to be developed in advance of any changes in order to ensure access to health care.

    "When you close hospitals, you close primary care networks, and that's what's happening in Brooklyn," said Ms. Furillo. "The state has abdicated its role."

    Another panelist, Ngozi Moses, executive director of the Brooklyn Perinatal Network, agreed the state should take a greater role.

    "Leadership has not come out of the office of the governor," she said. "We don't want Albany to make decisions for us, but we need a commitment from the governor."

    The looming question was how to pay for primary care. Hospitals need higher reimbursement rates from payers to implement these changes, noted Alan Aviles, president of the Health and Hospitals Corp

    http://www.crainsnewyork.com/article/20131025/PULSE/131029927

    A plan for Brooklyn's share of the waiver



    A union-funded plan for Brooklyn's health care crisis has been circulating among Brooklyn politicians and state officials for the past few weeks. The project has the backing of doctors on the faculty of SUNY Downstate who have agreed to try to gain support for the project among their counterparts in emergency, urgent and ambulatory care from 14 other Brooklyn hospitals. The goal is to have a blueprint for using the funding set aside for Brooklyn from the proposed Medicaid waiver.

    Drafted by consultant Dr. Fred Hyde, the proposals (online at http://www.brooklynhospitalplan.org) lay out a plan to use the capital to create a business model where care is more accessible, and institutions can reconfigure as they employ fewer workers in an inpatient setting. Doctors can be trained in ambulatory care and FQHC settings.

    Dr. Hyde wants the waiver to fund grants—not hospital debt—so that institutions can develop ambulatory care networks. "I'm asking the state to look at the Medicaid waiver money as equity, not debt, so we don't set up another generation for failure," said Dr. Hyde.

    The effort to retrain workers in non-hospital settings and help hospitals transition to ambulatory care must be led by physicians at Brooklyn institutions—not by Albany—so the process isn't pulled by politics, he writes. Doctors see their emergency departments overwhelmed and "are concerned there are not enough settings for patients with less urgent problems," he said.

    "If you can help these hospitals decant inpatient staff and retrain them in an ambulatory care setting, not in an ER or a hospital, that is the key missing ingredient," said Dr. Hyde.

    Dr. Hyde's report is packed with financial, demographic and other data pertinent to the debate on how to fix Brooklyn's health care crisis. But his analysis is controversial. "Brooklyn is not 'overbedded' with an inappropriately large number of hospital inpatient beds," he writes.

    He places blame for the crisis on the underpayment of Brooklyn hospitals and doctors. There is "no evidence to support a charge that Brooklyn hospitals are managed any more or less competently than those in the other boroughs of New York City."

    http://www.crainsnewyork.com/article/20131024/PULSE/131029948


  • The structural issues remain. Not to be alarmist, but the ACA isn't going to save the "Safety Net" hospitals. In some cases, this is not a bad thing.

    Cuomo Spars with Obama Administration over Medicaid Exemption

    Washington Post; Reid Wilson, 12/12/13

    A plan to help struggling hospitals that cater to minority and low-income patients in New York City that has been under consideration for more than a year is causing friction between the state’s Congressional delegation and the Obama administration, and leading to heated words between Albany and Washington.

    In a tense phone call late last month, New York Gov. Andrew Cuomo (D) pushed Health and Human Services Secretary Kathleen Sebelius to act promptly on his state’s request to spend billions of dollars on Medicaid reforms, including hundreds of millions to shore up public hospitals on the brink of financial collapse.

    At issue is a 152-page request [pdf] for exemption from some of Medicaid’s rules that would let New York reinvest some of the $17 billion it says it can save the federal government through reforms to the Medicaid process. The money, $10 billion in all, would be reinvested into the state’s health programs. The request would allow implementation of a multi-year action plan that Cuomo’s Medicaid Redesign Team says will improve care for the more than 5 million New Yorkers who participate in Medicaid.

    On the call last month, Cuomo mused that he had expanded Medicaid in his state by executive order, which aides viewed as an implicit threat that he could unilaterally pull out of Medicaid expansion, dealing a major blow to the success of the Affordable Care Act at a critical juncture if the state’s request isn’t granted.

    But some close observers of the process say Cuomo’s administration is to blame. They say the Cuomo administration has tried to use political pressure to force HHS and CMS to grant the waiver, without answering questions the department has asked.

    A part of the request would address the ongoing financial crisis in New York City’s hospital system. The city’s health-care system, the largest municipal public health-care system in the country, is in a “dire fiscal situation,” according to a recent audit conducted by KPMG.

    The Health and Hospitals Corporation, which runs a $6.7 billion system that includes 11 hospitals, several nursing and treatment centers and more than 70 local clinics, is in such dismal shape that it has just enough on hand to operate for 30 days. The corporation’s debt has doubled in the past three years, and it projects losses of more than $3 billion over fiscal years 2014 to 2016.

    Much of the cash shortfall comes from uncompensated care costs incurred by uninsured patients that the hospitals must cover. Ballooning pension costs are also hurting the system’s bottom line.

    But one of the biggest culprits responsible for the budget shortfall is the Affordable Care Act itself. Obamacare cuts federal subsidies for treating low-income patients. For New York City hospitals, that means $3 billion less from the federal government over the next decade, according to Capital New York. Cuomo talked state hospitals into accepting the cuts several years ago, with the understanding that the shortfall would be made up by the $10 billion the state could spend after receiving the exemption.

    Put it all together, and the corporation faces a defining moment. In recent months, several hospitals have said they will need to close without a new infusion of funds.

    Enter Cuomo and his Medicaid Redesign Team. After a year of study, the team began implementing Medicaid reforms like spending caps and effective care management that will save an estimated $17 billion in costs. New York wants to use $10 billion of that money to invest both in the ailing city hospital system and in other areas of health care, like Health Homes, created by the Affordable Care Act.

    New York policymakers have been frustrated by what they see as HHS dragging its feet. The request was submitted more than a year ago, in August 2012. But HHS, through the Centers for Medicare & Medicaid Services, has yet to act on New York’s request. Most recently, CMS submitted a list of additional questions that New York must answer before the request is granted.

    HHS spokeswoman Joanne Peters said her department is working with New York to make its request compliant with Medicaid law.

    “We have been collaborating with New York on their waiver proposal to improve their Medicaid program. As part of that ongoing conversation, New York continues to provide additional details and technical clarifications to CMS,” Peters said in an e-mail. “We support their goal of providing quality, affordable coverage to New Yorkers, and are working closely with them to make sure that any proposal is consistent with Medicaid law and that we are good stewards of federal dollars.”

    Along with its request for exemption, New York submitted more than 650 pages of letters [pdf] from stakeholders supporting the request.

    “This reinvestment is critical to sustaining structural, technological and organizational improvements in New York’s health care system,” a bipartisan group of 26 members of Congress wrote in a letter to Sebelius in August 2012.

    The year-long delay led to Cuomo’s short remarks to Sebelius. Cuomo said he had been assuring members of Congress who represent New York City, like Reps. Charlie Rangel (D), Yvette Clarke (D) and Hakeem Jeffries (D), that the hospitals would be funded, but that he couldn’t prevent those members from publicly voicing their frustrations forever.

    Cuomo has his own political calculations to consider. He hopes to provide a tax cut in next year’s budget, and the extra $10 billion in funding would give him room in his budget to propose a cut.

    http://www.washingtonpost.com/blogs/govbeat/wp/2013/12/12/cuomo-spars-with-obama-administration-over-medicaid-exemption/


  • The revised schedule has Interfaith beginning its shutdown on January 7, 2014.

    http://www.crainsnewyork.com/article/20131220/HEALTH_CARE/131229984

    Meanwhile, DeBlasio is still claiming it can be saved:

    http://www.capitalnewyork.com/article/city-hall/2013/12/8537841/de-blasio-interfaith-closure-aint-over-til-its-over

    DeBlasio,

    The election is over; It is time to only promise things that can be achieved.


  • As a Christmas gift (?), Cuomo comes thru with money to make it last another month:
    image
    Gov. Andrew Cuomo pledges $2 million to sustain operations at Interfaith Medical Center
    Apparently euthanasia and palliative care are not acceptable.
  • DeBlasio seems to have genuine intent, but he lacks the means.
    image
    Mayor Bill de Blasio said at an MLK Day event in Brooklyn that he would not allow the two hospitals to close, even though the state has the final say.
  • This is interesting:NEW BROOKLYN THEATER TO PRESENTRARE REVIVAL OF EARLY EDWARD ALBEE PLAYIN BED-STUY HOSPITAL THREATENEDWITH IMMINENT CLOSURENew Brooklyn Theater’s site-specific production of Edward Albee’s The Death of Bessie Smith at Interfaith Medical Center has extended its run. Tickets are now available through February 9, 2014.Set in a 1937 Memphis whites-only hospital and its surrounding area, The Death of Bessie Smith uses the legend surrounding the death of the famous blues singer to mine the circumstances and attitudes that allow injustice to occur.image
  • Interfaith knows that if it gives up its clinics (listed above), its whole network will quickly go under. Its lawyers have refused to exchange them for cash. By doing so, the administration gets to say "we held out for as long as we could. The state and the creditors are going to have to pry us apart by force."
    image
    A U.S. bankruptcy court judge appeared to lose patience with the state\'s handling of Interfaith Medical Center on Tuesday, calling the process over the last few weeks "dysfunctional."
  • Depending upon your view, Interfaith has scored a lifeline, or is being refused permission to die with dignity.http://www.brooklyneagle.com/articles/saved-again-75-million-released-interfaith-medical-center-brooklyn-2014-01-27-233900If the Federal Waiver doesn't come through, we are merely kicking the can down the road.
  • Here's a nice exercise in press covering the same issue differently. This article by Crain's paints the management of Interfaith as getting in its own way, by refusing to transfer the clinics in exchange for cash.http://www.crainsnewyork.com/article/20140128/HEALTH_CARE/140129882?template=printThe management of Interfaith knows that they can't save the hospital long term by selling the clinics. The management knows that it CAN save the clinics by closing the hospital. ....DOH can run articles in Crain's is it likes, but those of us who know something about the industry see what is actually occurring.
  • There has been a lot of talk about whether the recently awarded Federal waiver money will help save Interfaith.

    To make a long story short, if Interfaith is still around in 2015, it will look very little like it does today.

    http://www.crainsnewyork.com/article/20140214/HEALTH_CARE/140219882/-8b-wont-save-hospitals-it-will-dismantle-them
  • Off line, people ask me how the HHC hospitals continue to survive in light of the economics that are killing Interfaith.

    A big part of the answer is that HHC's network is large enough that that they have economies of scale.    They also have their own HMO insurance plan, which helps them get low income people who live near their hospitals Medicaid BEFORE they come in for care.

    Here's a succinct article on the topic:   http://www.ibo.nyc.ny.us/iboreports/2014marchfopb5.pdf
  • Some of the best minds in the business have come up with a plan.
    The question is now whether the creditors and the DOH will approve it.

  • Federal funds arrive.    The city is told they may not be used to merely postpone the inevitable.  


    NYC and NYS, the ball is in your court.

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