New York City — The State University of New York Board of Trustees today voted to support a decision by SUNY Downstate Medical Center leadership to seek approval from the state Department of Health to cease operation of University Hospital of Brooklyn at Long Island College Hospital (LICH) as a full-service inpatient hospital facility.
The dire financial situation at Downstate is well-documented, most recently in a state Comptroller’s audit, and the decision to pursue closure was made following a public hearing and extensive discussions with elected officials, community leaders, and other stakeholders. SUNY and Downstate leadership will consult with the community, health care experts, the Department of Health, and others to explore fiscally responsible options to provide general and specialty health care services at or near the current LICH site.
"Our goal is to avoid insolvency for Downstate Medical Center and preserve the 8,000 jobs that depend on its continued operation," said Board Chairman H. Carl McCall. "This difficult decision is the first part of a series of steps that will need to be taken to ensure high quality medical education and healthcare services will continue to be provided for the people of Brooklyn. President Williams and his staff are developing a comprehensive plan that will allow Downstate to maintain its vital services and the Board supports their efforts."
"Downstate Medical Center is one of the country’s largest academic medical centers and is among New York's greatest assets," said SUNY Chancellor Nancy L. Zimpher. "A combination of financial challenges has led to today’s decision, and we are confident that ceasing LICH operations as a full-service inpatient hospital is the right course moving forward."
"Nobody wants to close a hospital but the economic realities at Downstate are too stark to overcome with good intentions alone," said Downstate President John F. Williams "Downstate’s ability to uphold its commitments to students, patients, faculty, staff, and the Brooklyn community is in jeopardy and closing LICH is most fiscally responsible solution at this time."
As the only academic medical center in Brooklyn, Downstate serves more than 2.3 million people who make up one of the most diverse populations in the world. As a public institution, Downstate serves many uninsured and under-insured members of the community, which places an enormous strain on teaching hospitals. Forty-five percent of its patient base is Medicaid-insured and almost two-thirds of inpatient discharges are Medicare or Medicaid patients.
Founded in 1860, Downstate was the first medical school in the country to bring teaching out of the lecture hall and to the patient’s bedside. A center of innovation and excellence in research and clinical service delivery, Downstate comprises a College of Medicine, Colleges of Nursing and Health Related Professions, a School of Graduate Studies, a School of Public Health, University Hospital of Brooklyn, and an Advanced Biotechnology Park and Biotechnology Incubator.
More physicians practicing in New York City have graduated from Downstate than from any other medical school. One in three physicians practicing in Brooklyn was trained at Downstate; and one in nine physicians in New York City were trained at Downstate.
LICH continues to struggle with a negative margin and low market share. It is projected to end the 2013/14 fiscal year with a significant negative cash balance. This deficit contributes to a larger cumulative deficit projected for Downstate at the end of April.
A recent State Comptroller's Report provides a thorough description of the current financial and operational issues facing Downstate, none of which are disputed by the SUNY Board or Downstate leadership. There are many reasons for the fiscal crisis facing Downstate, including:
- An extremely competitive Brooklyn healthcare market vying for insured patients and an increasing presence of Manhattan based medical centers providing ambulatory care and inpatient services for Brooklyn residents;
- Reductions in reimbursement rate and new payment methodologies by public and private insurers for hospital based care with concurrent growth of uninsured patients;
- The complexities of the State system that limits expeditious decision making and action by SUNY hospitals, including procurement, contracts, capital projects, and state employment rules;
- The high levels of health disparities in the communities which Downstate serves and the high rates of complex chronic disease, largely publicly insured;
- Lack of adequate support from the State to operate a SUNY hospital within the complex regulatory and financial environment of the State system.
About the State University of New York
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