- Associated Press - Monday, January 27, 2014

ALBANY, N.Y. (AP) - State health officials awarded $56 million to a dozen hospitals and nursing homes even as the governor repeated dire warnings Monday that some Brooklyn hospitals will close without more federal help.

The funding announced for community-based care for the poor and elderly include $10.5 million for Nassau University Medical Center on Long Island and $14.8 million for the Northeast Center for Special Care, a residential facility in the Hudson Valley. Other awards were $11.3 million for Richmond University Medical Center on Staten Island and $3.4 million for Woodhull Medical & Mental Health Center in Brooklyn.

Gov. Andrew Cuomo and New York City Mayor Bill de Blasio have said that New York needs federal approval of its proposed Medicaid waiver, which would provide about $2 billion annually for five years to help struggling hospitals cut capacity and admissions amid a broad shift toward more primary medical care. That includes $1 billion for Brooklyn hospitals, which have about 1,200 excess patient beds altogether. Some have been relying on extra state money to keep operating.

“The situation is critical. It’s especially critical in Brooklyn,” Cuomo said.

The state initially requested the federal waiver 18 months ago and in the fall amended its request after some provisions, including capital investment, were deemed ineligible. “We’re at the point if we don’t get help the system is going to crash,” Cuomo said. “There will be closures and it’s not necessary.”

De Blasio said 12 city hospitals have closed over the past 12 years, leaving gaps in health care. In Brooklyn, one-quarter of residents lack access to primary care.

“The waiver is meant specifically for this type of situation,” he said.

In a response to Cuomo and Health Commissioner Dr. Nirav Shah, who raised similar public warnings, U.S. Health and Human Services Secretary Kathleen Sebelius said in a letter Wednesday that officials have begun drafting a potential agreement, but there are outstanding issues. Sebelius said the waiver, meant to improve care and cut Medicaid costs, shouldn’t determine the future of particular New York hospitals.

“Those are decisions properly left to state and local officials and affected communities,” she wrote.

A spokeswoman for Sebelius declined further comment Monday.

The federal funds would provide temporary hospital subsidies and fund primary care programs for patients, all meant to reduce preventable hospital admissions by 25 percent. Financially troubled hospitals would likely have to make major changes, including closing wings and reducing excess capacity.

That would require rehabbing buildings. The Cuomo administration has proposed $1.2 billion for capital investment, which would come from state borrowing. The administration in budget documents also proposed allowing some private investment, though not actual privatization of nonprofit hospitals.

State Sen. Kevin Parker, a Brooklyn Democrat, said that there are about 15 hospitals in the borough and a few in serious trouble, including Long Island College Hospital, Interfaith Medical Center and Brookdale Medical Center.

“The larger context is that the way medical care is provided nationally, the national model, has changed, and we have failed as a state at a certain level to manage the process of that change,” Parker said. “The way technology and insurance works now, large campuses with 300, 400 beds, is no longer the model. And bringing people into emergency rooms is no longer the model. And even Obamacare is saying, we want people to get primary care. Hospitals are not primary care.”

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