New York Hospitals Fail to Tell Patients About Free Care Availability, Study Finds

Though New York hospitals receive "millions in tax benefits and state reimbursements to provide charity care," a survey of seven hospitals on Long Island found that information given to callers about free care varied widely and that those who spoke Spanish or Haitian Creole were "almost never" able to have their questions about charity care answered, Newsday reports. Conducted by the Long Island Coalition for a National Health Plan as part of the Access Project, the survey found that uninsured individuals calling the hospitals had a "much harder time" having their questions answered than those calling from community or church groups. In addition, the callers reported that they were "treated rudely, transferred repeatedly [and] kept on hold for long periods." For example, one caller was told by a staffer at one of the hospitals surveyed that "free care does not exist here," adding "If they need free care, they should call and go to the county medical center." During a call to another hospital surveyed, the staffer told the caller, "There's no free care here. You have to go to Medicaid" (Eisenberg, Newsday, 4/25). Surveyors, including professional social welfare agency employees, church outreach workers and indigent community residents "trained by experts," made at least six telephone calls and one visit to each hospital. While all the hospitals surveyed have promised to consider changes in light of the findings, administrators at those facilities have said that the study was flawed because "it did not credit the hospitals for the charity care they have provided for years and the investments they have made in other community services." Dr. Lawrence Scherr, director of the office of community health and public policy for the North Shore-Long Island Jewish Health System, said, "The problem that the survey identified was in access to information, but not in access to health care" (Baker, New York Times, 4/26). But Dr. Rose Guercia, a former deputy commissioner at the Nassau County Health Department and one of the study project directors, said, "If someone is told there's no free care when they call up for information, that's essentially turning them away" (Eisenberg, Newsday, 4/25). Donna Kass, director of the study, said, "[P]eople are slipping through the safety nets. ... They don't know that free care is available, even if they can't pay, and therefore don't seek needed care and they are not getting it." Under New York state law, not-for-profit hospitals are considered charitable organizations and therefore must provide some free care. However, Kass noted, hospitals are allowed to design their own charity care programs and to determine spending levels (Baker, New York Times, 4/26). According to members of Long Island Coalition for a National Health Plan, the goal of the study is not to ask "cash-strapped CEOs to commit more money to uncompensated medical services," but rather that information about the care is "enunciate[d]" clearly to the public. "Where we can do a better job, we will," Richard Turan, president and CEO of Nassau University Medical Center, said, adding, "I would caution anyone from thinking that we could solve the health care needs of the entire community by putting the burden solely on the shoulders of the hospitals. If we advertised free care, we wouldn't be around very long" (Eisenberg, Newsday, 4/25).