New York City Public Hospital Agency Seeks to Close 27 Community Clinics, Citing Budget Deficit

The New York City Health and Hospitals Corporation, which administers the city's public health system, is seeking state permission to close 27 school-based and community clinics, citing "huge" budget deficits, the New York Times reports. The targeted clinics -- mainly located in New York's "most densely populated immigrant neighborhoods" -- include nine of the city's 42 neighborhood children's health clinics; three "so-called extension clinics," which serve both adults and children; and 15 of 109 city school-based clinics. Agency officials said they are facing a $300 million budget deficit this year, due in part to the impact of falling reimbursements from Medicaid and managed care organizations. As a result, the hospitals corporation "effectively subsidizes" the cost of patient care, by about $58 for an outpatient hospital visit and roughly $104 for a community clinic visit. At the same time, the agency has seen the number of uninsured patients seeking treatment rise 30% in the past four years. "We are deeply committed to our mission to provide health care services to all New Yorkers regardless of their insurance status. The challenge that we face is financing that mission," agency spokeswoman Jane Zimmerman said. The agency hopes to save $2 million to $3 million a year with the clinic closings. Child health advocates "criticized the plan sharply," saying that restricting access to preventive care would ultimately result in higher emergency room use. State health officials, who must approve the closings, said they needed to review "more detailed information about the impact of the proposal" before making a decision. The Times notes that the agency's request comes as Gov. George Pataki's (R) administration has stepped up efforts to recruit children into Medicaid and the state's CHIP program, known as Child Health Plus. The paper adds that the proposed closings are the "latest incident in the crisis facing primary health care for the poor" in New York, reporting that family health clinics that "sprouted in the city's poorest neighborhoods in the early 1990s" are now "struggling" and that the Health and Hospitals Corp. has recently begun charging a $10 copayment for prescription drugs at public pharmacies (Sengupta, New York Times, 5/15).