Nurses Wary Of Hospital Cuts In Return for Aid

By HOWARD MEGDAL

The New York State Nurses' Association sounded a note of caution over last week's agreement between the U.S. Department of Health and Human Services and the state, providing Federal payments of $1.5 billion over five years in exchange for cost-cutting measures that would include hospital closures.

"The specifics of the agreement are new - but this confirms what we already knew," NYSNA Communications Director Nancy Webber said in an Oct. 4 phone interview. "It's going to be hard to avoid hospital closings. That is certainly a matter of concern to us - access to care is critically important."

Plans to Fill Voids

The state, which plans to cover the loss of some hospitals by making greater use of specific facilities and steering some patients who would go to the emergency room to outpatient facilities instead, negotiated for 16 months with HHS before reaching the agreement.

The final recommendations for the state to meet cost reductions will be provided by the Commission on Health Care Facilities in the 21st Century, a panel named by Governor Pataki and the State Legislature earlier this year, and headed by investment banker Stephen Berger.

The Healthcare Association of New York State, which represents more than 550 non-profit and public hospitals, nursing homes, home care agencies, and other health care organizations, had qualified praise for the agreement.

"This agreement is a significant achievement that, in addition to committing funds, lays out a very broad reform agenda that includes rightsizing activities, investments in information technology, covering the uninsured, expansion of primary care, and implementation of pay-for-performance activities, among others," the group said in an Oct. 3 statement.

'Preserve Patient Care'

HANYS warned, however, against cutting services too broadly.

"It is therefore critical that the next step be for the commission to realistically balance its recommendations with our capacity for implementation, given the resources that we have available. Most importantly, we must be careful to ensure our reform efforts do not hurt patient care."

Ms. Webber said that a safeguard against too drastic a reduction would be to involve her membership in the process, which she added hadn't occurred yet.

"There will be some restructuring, it seems," she said. "We hope to be involved in crafting it. Our members know the industry from the inside."