New York City Grants Public Hospital System $530K, Allowing 15 Clinics to Remain Open

The New York City Department of Health will "pay a lump sum" to allow 15 of 27 school health clinics scheduled for closing to remain open until next year, officials with the New York City Health and Hospitals Corp., which operates the clinics, said May 31. According to the New York Times, the corporation earlier this year had asked the state for permission to shut down 27 school-based and neighborhood clinics -- now "bleeding cash" -- that serve low-income children. However, the decision to close the clinics prompted "hostility" from advocates for the poor, public officials and neighborhood groups, who "argued" that the health centers served as the "only nearby place where poor and often sickly children could get care." Dr. Luis Marcos, president of the corporation, received a letter yesterday from Dr. Neal Cohen, the city's health commissioner, announcing that the city health department would divert $530,000 from the School Health Program fund to maintain the 15 clinics until January 2002 while the corporation sought more funding from the state. The corporation already receives $550,000 per year in State Health Department grants for the clinics. "These clinics have served an important public health function," Cohen wrote, adding, "Uninterrupted services will ensure that families continue to have access and linkages to preventative and primary health care."

Still Closing Some Doors
Still, the corporation plans to close 12 other community clinics and "consolidate services around the neighborhoods they serve." Despite the city's allocation, the corporation -- "besieged by swelling ranks" of uninsured patients and an "inability to manage various costs" -- will likely lose $2.7 million on the school-based clinics, part of a $210 million deficit that the group will likely face at the end of the fiscal year. "I see this as a gift," Marcos said, but he added, "I also believe that until we adequately cover the cost of health care, we will continue to struggle with the illusion that we can provide unlimited health care to everyone with limited resources" (Steinhauer, New York Times, 6/1). Meanwhile, opponents of the plan to close the clinics "promised to keep up the pressure." New York City Council member Victor Robles (D) said, "All 27 clinics are important. ... These clinics basically serve children -- many are immigrants without insurance" (Colangelo, New York Daily News, 6/1).

'Insufficient' Efforts
In an editorial, the New York Times maintains that the "survival" of the 27 clinics will ensure that many low-income children receive health care and urges state officials to "keep clinics open when there is no acceptable alternative." It suggests the state join forces with city officials to "commit themselves" to providing the corporation with "enough money to allow it to fulfill its mission of treating New Yorkers regardless of ability to pay." The editorial also points out that the corporation has "worked hard to cut costs" but the group cannot provide "adequate" care to low-income New York residents without a "change in attitude by the federal, state and city governments" -- including increased Medicaid reimbursements for outpatient care. According to the Times, the city's "short term fix" will likely prove "insufficient" to save the clinics. The editorial concludes, "The city needs outpatient clinics that serve the poorest New Yorkers, and these will not pay for themselves. New York must assure adequate financing of the clinics, or it will be abandoning its historic commitment to public health" (New York Times, 6/1).