Health and the Medical Center

Richard Wishnie

The meeting commenced at 2:00 PM.

The first item for discussion was agenda item #12, a proposed act fixing and determining the charges for the care and maintenance of inpatients at the Westchester County Medical Center. After some discussion, Leg. Swanson moved to sign-out, seconded by Leg. La Motte. All in favor [3-0] (Leg. Bronz out for vote).

Next, the Committee discussed agenda item #13, a letter by a medical center resident regarding an extremely large increase in rent. (1/27/97) Leg. Stewart-Cousins questioned the large rent increase. Mr. Miller explained that all 2 bedrooms are at the same cost; however, there can be a difference in the rent rates according to how the Section 8 was calculated and were the Section 8 housing rate started. Mr. Miller stated he would get the Section 8 information for the Committee. Leg. Stewart-Cousins questioned whether the language is the lease was misleading tenants. Mr. Miller stated that he will look at the standard lease form and forward same to the Chair. In addition to the rent increase, Leg. Stewart-Cousins questioned the status of the fire escape at this particular residents home. Mr. Miller agreed that the fire escape is a specific structural item that should be looked into. Mr. Miller stated that Mr. Spiegel will sent to investigate. Leg. Stewart-Cousins requested the status of the fire escape by next week.

Next, Leg. Stewart-Cousins questioned parking rates. Mr. Miller stated that the rates are controlled by the parking agreement. These rates can be revisited if the lease is renegotiated. Leg. Stewart-Cousins stated that re-negotiating the contract would be a good idea. Mr. Miller did state that for families of long-term patients a monthly pass which gives a significant discount is available. Leg. La Motte explained how a constituent required parking for 28 days and was not allowed to buy a monthly pass. Leg. La Motte asked for flexibility in this area. Leg. La Motte will forward documents of her constituents dilemma to Mr. Miler.

Next, Leg. Wishnie questioned two transportation issues within the hospital: 1. renewal of the helicopter and 2. ambulance service. Leg. Wishnie asked what was included in the ambulance service. Mr. Miller stated that they are replacing the "Emperors" company. Leg. Swanson asked whether RFP’s were sent out. Mr. Miller believes they were. Leg. Stewart-Cousins would like to see the RFP’s. Leg. Wishnie also asked for information regarding the prior contract (how long, how much they were paid, what they were supplying ) and what the new company will be doing and whether any of this has changed. A letter will be forward according to the usual protocol.

Next, Mr. Cantor discussed Medicaid. Mr. Cantor discussed how the Governor submitted the budget on January 15 and had 30 days to revise this budget. In his revision the Governor restored approximately $100 million dollars into the overall deductions. However, he discussed that most of the cuts in this year’s budget are really coming from Medicaid. Leg. La Motte questioned the rational for this concentration of cuts in this particular area. Mr. Cantor answered that there is a belief that New York, compared to all other States, spends considerably more on Medicaid on a per beneficiary and on a per capita basis. Mr. Miller also stated that when the Governor proposes his Medicaid cuts that is only the State’s share of Medicaid, the providers (the hospitals) also get hit with 50 cents that the Federal Government matches and the 25 cents that the County matches. A conflict however is that the 25 cents savings for Social Services costs the hospital a total of $1.00 because of the way it is financed. Leg. La Motte asked about "price items" . Mr. Miller explained that Medicaid is continuing to pay on a DRG basis; however, they decided that even though this is a formula driven calculation and each hospital arrives at a different number, they override the DRG basis and just set their own flat rates.

Finally, the Committee discussed the minutes of January 18, 1997. Leg. La Motte moved to accept, seconded by Leg. Stewart-Cousins.

The meeting ended at 2:00 PM.