Local Hospitals Receive $34 Million in State Grants

Aimed at Improving Technology and Funding Expansions

The borough’s health care system – which took a serious hit over the past year with the closing of three hospitals – has received about $34 million in state grants to improve technology and fund long-term care improvements.

Governor David Paterson revealed that $434 million has been approved under the state’s Health Care Efficiency and Affordability Law for health care facilities around the state. He made the announcement last Friday alongside state Department of Health Commissioner Richard F. Daines at New York Hospital of Queens in Flushing, which is receiving $4 million towards an $8.3 million expansion and renovation of its emergency department.

“New York health care centers are known for their expertise in patient care, and I am proud to announce these grants to institutions that are creating more effective and more efficient ways of caring for those in need,” said Gov. Paterson. “We want to bring the right care to the right venue at the right cost… This is our idea of health care reform in New York as Congress members, our two U.S. senators and our president fight for health care reform on the national level.”

Said Daines: “We congratulate all of the projects and look forward to working with them to achieve these very important clinical goals. We look forward to moving the state’s health information infrastructure from infancy to childhood, establishing an operational statewide health information exchange to put clinical information in the hands of practitioners when and where they need it.”

In all, the New York City region was awarded $140 million, with about $34 million of that going to facilities in Queens. The borough hospitals receiving aid are: Flushing Hospital and Medical Center ($4 million towards a new $10 million ambulatory care center), Forest Hills Hospital ($4 million towards a $33 million project to relocate its primary care clinic to a larger location and expand the emergency department), Jamaica Hospital Center Diagnostic and Treatment Center ($1 million for expansion of St. Albans and Hollis sites), Mount Sinai Hospital in Long Island City ($4 million towards $21 million emergency department expansion), Elmhurst Hospital Center ($4 million towards a $14.5 million women’s health center in northwest Queens), Queens Hospital Center ($4 million towards a $6.2 million project) and Wyckoff Heights Medical Center ($500,000 towards a $9.5 million effort to provide community-based health care services.

“Thanks to these grants, our health care facilities will get much needed technology upgrades that will save them money, more of our hospitals will be able to join forces to improve patient care and our long-term health care system will be able to provide better service to the growing population of aging New Yorkers and New Yorkers with disabilities,” said Gov. Paterson.

The funding was approved by the legislature during the recent budgetary process, despite the state’s fiscal problems.

City Announces New Swine Flu Strategy

Focuses on Keeping Public Schools Open

By Conor Greene

The city’s strategy to fight the expected breakout of swine flu this fall includes offering free vaccinations to all elementary school children and providing the public with information regarding the number of cases reported in a specific school.

The plan, announced on Tuesday by city officials at Gracie Mansion, includes an “open school policy” that seeks to slow spread of the H1N1 virus and avoid mass closures. Mayor Bloomberg sought to assure residents that the city is better prepared to deal with an outbreak this fall after hospitals were overwhelmed this past spring and parents complained about a lack of information.

A recent White House study predicted that as many as 90,000 Americans could die as a result of a new H1N1 outbreak, with 60 million to 120 million becoming sick and hospital emergency rooms overwhelmed. However, the mayor on Tuesday said signs suggest a more “moderate” outbreak than predicted in the panel’s report.

“There is no indication the virus will be more virulent than what we experienced in May and June, but we must have and do have contingency plans in place in case the virus becomes more widespread or more severe in its symptoms,” said Mayor Bloomberg. “In situations like this, it’s natural to imagine the worst-case scenario, but all signs at this point in time do point to an outbreak that will be much more moderate.”

The city’s strategy to fight the spread of swine flu, particularly in schools, centers on measures “designed to slow transmission while classes and activities continue,” according to a press release. Aspects of the plan include getting children vaccinated, keeping them home when sick and following basic procedures such as thoroughly and frequently washing hands.

Once a vaccine for H1N1 becomes available this fall, the city plans to distribute it to health care providers and offer it for free to school-aged students. For elementary-aged students, the vaccine will be available within each school building, while older students will have to travel to central sites within each borough. Parental consent will be required before students are vaccinated.

The city also plans to use a central database to allow school nurses to report the number of students seen for influenza-like illness during each day. A daily public report will be posted on nyc.gov/flu listing schools reporting five or more cases the previous day. The daily report will also show the previous day’s absentee rate for every public school – though the city stresses that it is “important to understand that absenteeism is not by itself a measure of influenza activity.”

The third aspect of the city’s plan is an influenza-prevention campaign in each of its 1,500 public schools. Signs and classroom instruction will stress the importance of covering coughs and washing hands, restrooms will be continually stocked with soap and paper towels and parents will get written reminders to keep their children home when they’re sick. That message will be reinforced if a nurse sees five or more cases of flu-like illness in one day.

If a school experiences “excessive influenza activity” – defined as four percent of the student body (at least 15 children) being seen by a school nurse on a single day – a doctor or supervising nurse will visit the school to assess the situation. The supervisor will determine whether the school has students whose health conditions place them at high risk of influenza complications and may “recommend additional safety measures.” However, school closure will only be considered “as a last resort,” the city announced.

“Today is the first of what will be many efforts to keep New Yorkers informed about what we are doing to prepare for the return of the H1N1 and seasonal flu,” said Mayor Bloomberg. “We can’t predict this year’s flu season, but we can make sure that city government is fully prepared for whatever happens.” It was noted that 15 separate groups worked over the summer to create a strategic citywide response to the expected outbreak.

Still, the mayor’s announcement was met with concern from some local elected officials, including Councilwoman Elizabeth Crowley (D-Middle Village), who is worried the vaccinations won’t be available in time. She also argued that outside nurses should be hired to administer the vaccine, instead of having school nurses shoulder that responsibility as currently planned. “Flu season officially starts today and we still do not know [by] who andwhere the H1N1 vaccinations will be administered,” she said.

Nick Comaianni, president of Community Education Council 24, said city officials should consider closing entire school buildings if an outbreak is detected. “Obviously they will have to use judgment, but if you’re trying to prevent something from spreading, the best option is to close the school for a few days and let the germs die,” he said. “If you have cases out there within a school population, then I agree the schools must be closed… Once you see it spreading, I think the best thing is to close the schools.”

On the national level, President Barack Obama was briefed by cabinet members including Secretary of Health and Human Services Kathleen Sebelius and Secretary of Homeland Security Janet Napolitano. “I don’t want anybody to be alarmed, but I do want everyone to be prepared,” he said.

The virus killed about 500 Americans after first emerging in April and sickened more than 1 million individuals across the nation. Worldwide, more than 2,000 people died during the initial outbreak. Development of the vaccine is still underway and officials expect it to be available to the public by October. While it is taken on a voluntary basis, the president said it is “strongly recommended.”

“We know that we usually get a second, larger wave of these flu viruses in the fall, and so response plans have been put in place across all levels of government,” added President Obama. “Our plans and decisions are based on the best scientific information available, and as the situation changes, we will continue to update the public.” The president also reminded Americans to take basic precautions, including staying home if sick and frequently washing hands. “I know it sounds simple, but it’s important and it works,” he said.

Locally, borough hospitals are making preparations to handle the expected influx of new patients this fall. Michael Hinck, director of public relations for MediSys Health Network, which runs Jamaica, Flushing and Peninsula hospitals in Queens, said preparation efforts have been ongoing after receiving as much as double the typical patient-load on certain days last spring.

“We’ve been expecting this since we were really at the center of the last outbreak. Our expectations are to see an increase,” said Hinck, who noted that two area hospitals closed earlier this year, just before the initial swine flu outbreak hit the area. “It put a strain on us, but luckily we have a long history of disaster preparedness so we quickly devised a plan. Like in the spring, we want the public to know we are prepared and will do everything we can to meet the needs.”

To prepare for the higher patient levels, Jamaica Hospital has added 40 additional in-patient beds and has plans to reallocate additional space for swine flu patients if necessary, added Hinck. Officials are also ready to be in constant communication with city and state health officials to monitor spread of the virus. “We’re going to manage all aspects of this situation and make sure we will be able to have continuity of care in other operations so other areas don’t suffer,” he said.

Parkway Hospital Claims Failure to Bribe Seminerio Led to Closure

By Conor Greene

New Parkway Hospital is claiming in a lawsuit that it was ordered to shut down by the state after its chief executive officer Robert Aquino refused to pay bribes demanded by former state Assemblyman Anthony Seminerio.

The lawsuit, filed last week in Queens Supreme Court, names the state as a defendant and seeks to have its operating license renewed after it was revoked last November based on the findings of the Berger Commission. Despite that group’s recommendation that the state wait two years before closing the Forest Hills facility, it was shut last year – something the lawsuit blames on Seminerio’s inappropriate lobbying activities.

The state Health Department has previously said that the closing of Parkway was because it received the lowest score on criteria used by the commission to rank struggling hospitals. Seminerio recently resigned after 30 years in office and pleaded guilty to fraud charges accusing him of taking illegal consulting fees from Jamaica Hospital. The lawsuit argues that Seminerio’s guilty plea dissolves his right against self incrimination and seeks to have him deposed regarding his alleged extortion attempt of Parkway.

In court documents, Aquino states that Seminerio told him that he would make Aquino’s life “miserable” if he didn’t agree to pay him consulting fees that reportedly would have been between $10,000 and $15,000 per month. “It is self-evident that Seminerio’s criminal conduct had a direct impact on the decision to close Parkway Hospital,” he argues. “As an operating hospital, Parkway’s license could not be revoked absent of due process. Having a license revoked for the refusal to pay a bribe to a public official surely constitutes the denial of due process.”

Aquino also argues that the 251-bed hospital should be considered for reopening since two other local hospitals closed after the Berger Commission made its recommendations. He also questions whether the city is ready to handle a possible new outbreak of Swine Flu this fall, which has hit the Southern Hemisphere hard during the first few weeks of its flu season.

The federal indictment against Seminerio also accused him of attempting to force another hospital, now know to be Parkway, to pay him monthly consulting fees. When Aquino refused his demands, Seminerio lobbied on behalf of Jamaica Hospital.

“There is little doubt that such ‘advocacy’ resulted in the closure of the ‘non-client hospital,’ which as everyone now knows is the New Parkway Hospital. Indeed, the Department of Health essentially overrode the initial recommendation of the so-called Berger Commissioner that a wait-and-see approach be taken with respect to Parkway and directed its closure,” wrote Aquino in a letter to Gov. David Paterson and state Attorney General Andrew Cuomo.

Thompson Warns of Queens Healthcare Crisis

The closing of two borough hospitals earlier this year and the recent swine flu outbreak have resulted in a healthcare crisis in Queens, warns city Comptroller William Thompson.

In a report issued on June 1, Thompson charged that hospitals in Queens, especially in the central and eastern portions, are in a “state of crisis” as their emergency rooms struggle to cope with a “torrent of patients amid H1N1 virus worries and the closures of St. John’s and Mary Immaculate hospitals” in February.

Thompson was joined by Queens Borough President Helen Marshall in front of Jamaica Hospital Center to bring attention to the growing crisis. Jamaica Hospital is among those facing a spike in patients as flu concerns have grown in recent weeks. A study by Thompson found that “emergency rooms are being flooded with patients, many who must now await admission, ambulance turnaround times are rising, and medical professionals are facing extraordinary challenges in their ability to provide care.”

Marshall, who first warned of the imminent closures of the hospitals at her State of the Borough address in January, noted that the state Department of Health has closed four borough hospitals in recent years, including Mary Immaculate and St. John’s, which combined accounted for about 50,000 emergency room visits each year.

“Short term funding from the state was targeted for equipment and infrastructure expansions, but did not address the need for additional healthcare professionals, especially nurses,” said Marshall. “Comptroller Thompson is right when he says that emergency rooms in Queens are in crisis. I warned the Governor’s office that the hospital system in Queens would not be able to handle a major emergency.”

The findings of Thompson’s latest study on the impact of hospital closings and the swine flu outbreak included:

•The number of emergency room patients at the surrounding hospitals soared right after St. John’s and Mary Immaculate hospitals closed earlier this year. For example, from mid-February to the end of March, there were 20 days when Jamaica Hospital’s emergency room exceeded 350 patients, versus only two such days during the same period in 2008.

•The number of patients brought to surrounding hospitals’ emergency rooms by ambulance soared. For example, comparing January to March 2009, the number of patients arriving by ambulance at Queens Hospital Center rose 51 percent, and at North Shore University Hospital-Forest Hills by 40 percent.

•Ambulance turnaround times – the amount of time from arrival at the emergency room until the ambulance is free to make the next call – increased significantly at Jamaica, Queens and North Shore University-Forest Hills hospitals.

•A Queens Hospital Center emergency room doctor with more than two decades of experience told the Comptroller’s office that he now sees 35 patients per shift compared with 20 before the two closures, that the conditions at the hospital have become a “living nightmare,” and that “the state of emergency medicine in Queens is the worst I’ve seen in my career.” His observations echoed other physicians, some of whom spoke of an overwhelming added patient load.

Thompson faulted the state DOH and city Department of Health and Mental Hygiene for “failing to acknowledge the deteriorating financial condition of Mary Immaculate and St. John’s hospitals in a timely fashion and failing to put in place a plan to address the impact of the closures.” After bailing out troubled healthcare provider Caritas, which owns the two closed hospitals, for the past several years, the state refused to provide any additional funding, leading to the closures in February.

“What we are seeing now is a crisis in the hospital and healthcare system in Queens, a version of which may very well spread to the other boroughs if H1N1 virus outbreaks appear in other neighborhoods,” said Thompson. “To be sure, while the timing of H1N1 virus itself was not foreseeable, the likelihood of some event of a similar nature causing a sudden surge in demand was both foreseeable and inevitable.”

Thompson offered a number of recommendations, including that individuals with flu symptoms should be triaged at ambulatory care facilities, the necessary resources to deal with emergencies should be activated, loans and working capital should be provided to cover expansion costs, data on emergency room utilization should be made public, hospitals should be staffed-up to meet increased demand, and gaps in service created by closures must be identified.

“The City and State need to pull key healthcare providers and other stakeholders together immediately to share information, identify patterns and develop solutions to address the current surge in demand stemming from the H1N1 virus,” said Thompson. “If the State Department of Health had begun planning in December 2006, as I suggested, it is likely that much of the current impacts in Queens could have been minimized or avoided entirely.”

Officials Discuss Impact of Federal Stimulus Plan

By Conor Greene

To make sense of the federal stimulus plan, two Queens lawmakers held a town hall meeting last week to explain how the American Recovery and Investment Act of 2009 will impact the average resident.

Rep. Anthony Weiner and Senator Joseph Addabbo met with several dozen residents last Wednesday afternoon in PS 254 in Woodhaven. They explained that the $787 billion will result in about $24 billion in aid to New York State, with about $5 billion coming to the city. Of the money coming to the state, about $6.2 billion will be used to help bridge the $17.7 billion budget deficit. The money must be spent over the next two years.

State officials are “still working to allocate the dollars effectively” and in a “transparent” manner, said Addabbo (D-Howard Beach). He called the aid “one shot for the most part” but both lawmakers said they hope this stimulus plan will have longer lasting impacts compared to the previous stimulus plan under the Bush Administration.

The money can be used for several purposes, including helping bridge state budget gaps, to prevent cuts to healthcare and education, for energy and infrastructure projects, for public safety and for housing and foreclosure prevention – something Addabbo called a “rising issue in our surrounding communities.” The money will primarily be distributed through 25 state agencies and the Governor’s Office, with the federal government overseeing some areas.

Weiner explained that there are several goals for the bill which “all need to be done in concert” to reverse the economy’s “downward direction.” The first is to provide money to states to avoid “giant slashing of their budgets.” However, he stressed that the “federal government didn’t do New York State any big favors – this is your money that’s been shortchanged.”

The bill is also intended to create jobs through construction projects including roads, bridges and schools, said Weiner, adding that the dual benefit is “having people at work” and having something to show in return for the cost. “They’re going to get a better state,” he said, in contrast to the tax cuts for the wealthy and the Iraq war, for which we have nothing to show.

Along those lines, the bill is also intended to provide tax cuts for the middle class. “We want to make sure people here have a few dollars in their pocket so they can go out to the neighborhood shopping strip,” said Weiner, adding that the top 2% will get no relief under the plan. “Every single middle class resident of Queens has something coming to them in that bill.”

Instead of receiving the entire relief within a single check, however, the relief is coming in the form of a reduction in federal withholdings in each paycheck over the next nine quarters, starting now. Those not working will receive the relief in their tax return at the end of the year. Last time, said Weiner, the stimulus plan helped China, not America. “It didn’t have the true stimulating month-by-month effect we hope this will have.”

Several residents asked if the money could help prevent some of the drastic service cuts the MTA is considering under its budget. Specifically, residents at the meeting were concerned about the impact of cuts to the B52 bus, which runs along Jamaica Avenue, and the Z Train.

Weiner explained that “the short answer is no” since the stimulus can only be used for capital projects, such as repainting the tracks the run above the avenue. He said the problem is a restriction against using federal dollars to help support MTA operations, which lawmakers “need to reverse.” Under the plan, the MTA is receiving about $1 billion for capital projects.

Addabbo said the looming MTA cuts will “have to be addressed in Albany… Certainly we’re not going to sit on the sidelines” as deep cuts are made. “I don’t believe the MTA is very good at accounting,” he added. “You’re handing them a lot of money… and then they’re back a year from now talking about [additional] fare increases and service cuts.”

The lawmakers also addressed the recent closings of St. John’s and Mary Immaculate hospitals and said the stimulus bill doesn’t provide money towards hospitals. “I think the government has done a terrible job,” said Weiner. “There is a shortage of healthcare in New York… we’re going to realize it’s a heck of a lot cheaper to keep it open. I think it was a huge mistake.”

Addabbo said the state Health Department made it clear that “they wanted out” after providing millions of dollars in funding the struggling hospitals over the past few years. “To me that was the easy way out, to stop funding and let it close. It’s something the state government is going to have to try to find a way.”

Two Area Hospitals Shut Doors

ST. JOHN’S AND MARY IMMACULATE CLOSE DUE TO BANKRUPTCY

By Conor Greene

With no last minute state bailout, the fear of many local residents and health care workers has come to fruition with the closings of two area hospitals this week.

St. John’s Hospital in Elmhurst and Mary Immaculate Hospital in Jamaica stopped admitting patients late on Saturday night and officially closed on Monday. The two hospitals, operated by bankrupt health care system Caritas, had stopped accepting patients at their emergency rooms earlier this month.

The ominous message, “Please don’t die on your way to another hospital,” was scrawled on a piece of plywood covering the entrance to the emergency room at St. John’s. A note on the main door told visitors who unwittingly arrived there to call 911 for medical help.

Myrna Bailey, who served as hospital administrator at St. John’s and Catherine Wilkinson, who rose to the ranks of administrative director during her 40 years at St. John’s, took one of their final walks through the empty corridors over the weekend.

“Silence is good in some situations, but not in this situation,” Wilkinson told NY1. “I’ve been listening to this silence for about a week now, so I’m kind of getting immune to it, if one can become immune to it, but initially it was very, very frightening.”

“Silence is golden, but not here,” added Bailey.

While the hospital’s parent company, Caritas, has struggled financially since purchasing the two facilities in late 2006, word of their imminent closure came earlier this year. Despite a number of rallies at the hospitals and pleas from residents, workers and elected officials, the state declined to provide additional funding to keep the facilities operating.

Instead, the state announced last month that it is providing $18 million to seven area hospitals to help them deal with the influx of new patients the closures are expected to generate. The money is to be used by the local facilities to expand their emergency rooms and add more beds. Combined, St. John’s and Mary Immaculate had about 450 beds and served nearly 200,000 patients annually.

City Comptroller William Thompson criticized the state for failing to bail out the two hospitals so they could continue operating until a plan is put into place to deal with fallout from the closings. “Despite numerous calls from the various stakeholders to prevent or delay the hospitals closures, the state has failed to keep [the] hospitals open,” he said in a statement. “Without putting a plan in place, the state has left many unanswered questions about how Queens residents will be able to get their health care needs met.”

According to Thompson, the fire department, which oversees Emergency Medical Services, “also has not addressed how the closures will impact the health and safety of area residents including transition plans for 911 emergency medical response and treatment services.”

Workers at other hospitals are now bracing for a rise in the number of patients showing up at their doors. For example, Jamaica Hospital’s emergency room had averaged about 350 patients per day. Now, with the emergency rooms at St. John’s and Mary Immaculate shut for the past few weeks, the number of daily patients at Jamaica is approaching 400, according to a report in the Daily News.

Now, about 2,500 healthcare workers are facing the grim prospects of entering the job market during at the worst possible time. “I want to chain myself to the chair,” a teary-eyed Laura Beidell told the New York Post. “Not only do we work here, but we’ve all brought our families here. We’ve had parents who died here. This place is very special to us.”

State Provides Funding to Area Hospitals; Refuses to Bail Out St. John's and Mary Immaculate

By Conor Greene

After refusing to bailout bankrupt St. John’s and Mary Immaculate hospitals, the state Department of Health announced on Wednesday that it is providing money to other area facilities to help deal with a spike in patients.

St. John’s in Elmhurst and Mary Immaculate in Jamaica stopped admitting patients on Saturday, including to their emergency rooms, as they prepare to close completely in the coming weeks. The move comes a week after parent company Caritas Health Care filed for Chapter 11 bankruptcy protection and submitted a closure plan to the state.

Last Friday, residents, community leaders and hospital staff gathered outside St. John’s in a last-ditch effort to convince Governor David Paterson to step in and save the hospitals.

However, their demands fell on deaf ears, and the hospitals began restricting admissions at midnight – leading to concerns that other area facilities will become overburdened by the increased demand for their services.

On Wednesday, state Health Commissioner Richard Daines announced $18 million in grants being provided to local hospitals “to ensure that residents of Queens continue to have access to essential health care services.” The money will also provide job placement services to the nearly 3,000 health care workers who lost their jobs when St. John’s and Mary Immaculate closed.

“These grants will help other health care facilities in the area expand their capacity to absorb the patients previously handled by these two Caritas hospitals and assist workers in finding new employment,” said Daines in a statement.

The grants include $14.5 million to expand capacity at eight facilities serving the Queens community and the extension of a state Department of Health contract with 1199 SIEU for the Displaced Workers Program. That will make up to $3 million available for job counseling, placement and retraining for displaced workers.

According to the press release, the state DOH has given “contingent approval for the closure plan” submitted by Caritas. “Despite over $55 million in state loans to Caritas, the hospital system was unable to develop a viable plan for continued operation,” the release notes.

In addition to the $3 million contract extension to 1199 SIEU for job counseling, placement and retraining, the following grants have been awarded:

•Health and Hospitals Corporation of New York City will receive
$3.6 million to expand patient capacity and emergency room services at its Elmhurst and Queens Hospital Centers;

•Medisys will receive $4.5 million for its Jamaica and Flushing sites;

•North Shore LIJ will receive $3.5 million for its Forest Hills and Franklin facilities;

•Wyckoff Medical Center near Ridgewood will receive $2.7 million;

•The Joseph P. Addabbo Family Health Center will receive $650,000 to maintain primary and preventative services at the St. Dominic’s Health Care Center.

The decision to provide the grant money comes as City Comptroller William Thompson, Councilman Tony Avella, Councilwoman Elizabeth Crowley and other elected officials have called upon the state to provide Caritas with the funding needed to keep the two hospitals open.

“The closing of Mary Immaculate and St. John’s Hospitals would not only have a detrimental affect on the 2,500 hospital employees by Caritas Health Care, but also on the entire Borough of Queens, which relies heavily on their medical services,” said Avella. “The best solution at this point would be for HHC [Health and Hospitals Corp] to take over the administration of these two hospitals. It would improve management operations and, I believe, make it easier for the State and City to allocate funding to keep the hospitals open.”

Combined, the hospitals have about 450 beds and serve nearly 200,000 patients each year. Mary Immaculate is a level-one trauma center and houses a cancer institute and 115-bed nursing home. St. John’s is a certified stroke and heart failure center and has the borough’s only hyperbaric oxygen therapy unit.

“People will die if the Health Department closes these hospitals,” said Therese Wittner, a registered nurse and representative for the state Nurses Association at Mary Immaculate. “It is also unthinkable that 115 elderly people will be put out of the Fitzpatrick nursing home where they have lived for up to 15 years and developed close family times… The surrounding hospitals are overflowing and will not be able to handle the volume of patients. We are already seeing the consequences.”

According to the DOH, the closure date for St. John’s and Mary Immaculate is February 28.

Two Hospitals Begin Limited Admissions

St. John's, Mary Immaculate Set to Close Within Weeks

By Conor Greene

Two local hospitals will no longer accept patients starting Saturday as they prepare to close in the coming weeks.

Caritas Health Care, the parent company of St. John’s Queens Hospital in Elmhurst and Mary Immaculate Hospital in Jamaica, filed last week for Chapter 11 bankruptcy and submitted a closure plan to the state Department of Health. That decision means, barring a last minute state bailout, the two hospitals will likely close by February 28.

The process of shutting down its operations began soon after the board voted to file for bankruptcy. Beginning this week, Mary Immaculate was no longer accepting psychiatric patients, while St. John’s was no longer accepting pediatric patients. Starting midnight Friday, both hospitals will no longer accept any patients, including at their emergency rooms.

According to a source who received the FDNY operational order sent to EMS units, two ambulances will be stationed at each hospital ER beginning Friday night. Patients who arrive for treatment unaware of the closings will instead be taken to nearby hospitals.

The board’s decision came after several weeks of emergency meetings between local officials and hospital executives, who worked to secure a last minute deal to keep the struggling facilities open. The two hospitals are losing a total of about $5 million each month and have received $50 million in state grants and loans in the past two years – including $6 million in January.

“Our round-the-clock efforts with elected officials and with the New York State Department of Health over the past week have proven futile,” said Caritas CEO John Kastanis in a memo sent to employees. “No adequate source of funding has been identified and no long-term plan for the continued operation of the hospitals has been forthcoming.

“Since there has been no official or unofficial news from Albany this week regarding a possible solution to our crisis, the Board was, much to its dismay, left with no recourse,” continued Kastanis. “Time has essentially run out.”

Closing the hospitals would cost 2,500 healthcare professionals their jobs and force Queens residents to go elsewhere for medical treatment. Combined, the hospitals have about 450 beds and serve 200,000 individuals annually, including 100,000 patients in the two emergency rooms.

Several rallies were held in front of both hospitals and at City Hall in the past few weeks, and employees headed to Albany on Wednesday in a last-ditch effort to convince the state to bail out St. John’s and Mary Immaculate. “Tomorrow is really to have the politicians see face to face the people who are going to be affected, to see the people who are providing for the registered voters and the community that we provide health care to” said registered nurse Carlos Quiles outside St. John’s on Tuesday.

Residents, employees and patients said that it is unacceptable for the state to refuse to take action to save the hospitals. “I can’t understand how they can close a hospital in such a heavily populated neighborhood such as this,” said Dave Herbert, whose father was rushed to St. John’s on Monday night. “I don’t know the politics behind this, but somebody needs to do something right away… If this place wasn’t open, where would we go? Elmhurst is already packed… It’s insane.”

Ken Akins, who brings his mother to St. John’s every week for wound care, thinks the impact on the patients is being ignored. “My mother is frightened. She doesn’t know if the hospital closes where she is going to go,” said Akins. “She has bonded very well with the people who give quality care here. It’s always the elderly, the disenfranchised that gets hit the hardest.”

Akins, who said he worked at Mary Immaculate for 30 years, blamed the hospital’s financial struggles on mismanagement. “It would be a shame before God if Governor Paterson allows them to close… It has nothing to do with the quality of care and support the staff gives their patients. If we lose, we’re losing something that can’t be replaced.”

Queens Borough President Helen Marshall called news of Caritas’ decision “distressing” in a statement. “We worked very hard to try and prevent the closures of both these hospitals. I have been in touch with Governor Paterson’s office on almost a daily basis to try and find a solution.”

Marshall, who first informed the public of the hospitals’ dire financial status at her State of the Borough address last month, said she is demanding to see the closure plan Caritas filed with the state. “I want to see how capacity will be built at other hospitals. I want to see that every resident of Queens continues to get the healthcare that they are entitled to receive,” she said.

In addition to the 400 beds that will be lost by the closures, Mary Immaculate features a 115-bed nursing home, a cancer center and is a level-one trauma center. St. John’s is a certified stroke and heart failure center and has the only hyperbaric oxygen therapy unit in Queens. These losses come just months after another local facility, Parkway Hospital in Forest Hills, closed, eliminating another 250 beds.

Over the past month, a group of local officials led by Senate Majority Leader Malcolm Smith (D-St. Albans) have held meetings in hopes of finding a way to keep the hospitals open. At one point, officials at North-Shore Long Island Jewish Health System were exploring a plan to acquire the two hospitals and replace them with a state-of-the-art facility in central Queens. However, that would have required funding from the state.

In the end, Caritas determined that the negotiations, which reportedly also involved another health system, proved “futile.” Caritas, which also runs Wyckoff Hospital in Brooklyn, purchased St. John’s and Mary Immaculate for $41.5 million in 2006 from St. Vincent’s Catholic Medical Centers, which had filed for bankruptcy protection the prior year.

Rally to Save Local Hospitals

Caritas Sends Notice of Pending Closings at St. John’s and Mary Immaculate

By Conor Greene

Shouting “Governor Paterson Shame on You” and waving signs to cars passing by on Queens Boulevard, hundreds of employees, residents and elected officials rallied outside St. John’s Hospital on Saturday in hopes of saving the bankrupt facility.

A similar rally was held on Tuesday on the steps of City Hall, and a third event is scheduled for Saturday in front of Mary Immaculate Hospital in Jamaica. Both hospitals are owned and operated by Caritas Health Care, which says it is forced to close the facilities because they are losing millions of dollars each year.

“We need to show Governor Paterson that St. John’s and Mary Immaculate are needed in the community,” said Myrna Bailey, administrative director of clinical services at St. John’s. “Losing 400 beds, a nursing home and trauma center is not acceptable.”

News of the hospital’s dire economic situation first came during Queens Borough President Helen Marshall’s state of the borough address several weeks ago. Caritas’ board of directors has since voted to give hospital executives permission to file for bankruptcy by the end of the month and close the facilities if “no other sources of funding can be identified,” according to a statement released by the health care system.

In addition, the board also authorized hospital executives to submit a draft closure plan to the state Department of Health, which is required before the hospital is allowed to close, and letters were mailed to all employees notifying them of the possible closures.

“Recognizing the serious, far-reaching consequences of these actions, the Board voted to take these measures reluctantly only after exhaustively examining all other options and determining that sufficient funds likely will not be available to present a viable alternative,” Caritas wrote. “Due to the unexpected financial difficulties resulting from the depth of the economic downturn, and its resulting unanticipated severe impact on the State and City’s ability to provide sufficient additional funding... a permanent shutdown of its operations may be necessary.”

The 2,500 employees at St. John’s and Mary Immaculate hospitals were informed in a January 23 letter from Caritas Chief Executive Officer John Kastanis that their employment with Caritas “will permanently terminate between February 14 and February 28” in the event of a shutdown.

Aside from the two hospitals, the closures would affect the 115-bed Monsignor Fitzpatrick Skilled Nursing Pavilion at Mary Immaculate and related medical practices and businesses in Elmhurst, Flushing and Jamaica, wrote Kastanis. In addition, Mary Immaculate is a level-one trauma center and also houses a cancer institute, while St. John’s is a certified stroke and heart failure center and has the only hyperbaric oxygen therapy unit in Queens.

In 2008, St. John’s had 48,000 emergency room visits, 7,000 surgeries, 1,227 deliveries, 14,000 discharges and 50,245 clinical visits. Mary Immaculate’s emergency room served another 50,000 patients last year.

According to Councilman Tony Avella’s office, which organized Tuesday’s rally at City Hall, the state and Governor Paterson’s office have yet to provide an update on the possibility that emergency funding could be released to prevent the closures. Marshall’s office has also been in touch with the state DOH on a nearly daily basis, but didn’t have any additional information on the funding request. However, a source at St. John’s said that the hospital is prepared to begin the closing process this Friday, meaning it might begin accepting people on an elective basis only.

The rally in front of St. John’s last Saturday was attended by hundreds of staff members and residents, along with elected officials including Avella and City Comptroller William Thompson (both men are mayoral candidates this year), State Senator Shirley Huntley, Assemblyman Michael DenDekker, Senator Toby Ann Stavisky, Assemblywoman Marge Markey and Councilwoman Elizabeth Crowley.

“We have to make sure the people of this city are protected,” said Avella. “This shouldn’t be about money... This is a battle that must be won no matter what.” He called working to keep the hospitals open a “top priority this year and beyond.”

Huntley stressed that the hospital is needed in the area, and suggested that other public officials aren’t doing enough to protect healthcare facilities. “I’m concerned about this hospital because we have people who need this hospital,” she said. “It makes you sad when we elect people who could care less about healthcare. We need to think about that.”

“Don’t let them tell you it’s about money,” said Thompson. “It’s not just about dollars and cents, it’s about people. We are here today to say no... The state has put dollars ahead of people, and we’re not going to allow this.”

Dr. Salman Aly, chief resident at St. John’s, said the impact of a closure would be “tremendous,” especially considering the facility is “packed” on a regular basis. “It’s going to be a substantial loss. We serve an under-served community. We put our hearts and souls into serving the community. The public needs to realize that we need their help... You can say that Elmhurst [Hospital] can take care of it or Jamaica [Hospital], but they’re already overcrowded.”

The two hospitals are losing a total of about $5 million each month and have received $44 million in state grants and loans in the past two years.

News of the potential closures comes just months after the closure of another Queens facility, Parkway Hospital in Forest Hills, which had 251 beds. Officials at North Shore-Long Island Jewish Health System are exploring a plan to acquire the two failing hospitals and replace them with a state-of-the-art hospital in central Queens.

Two Area Hospitals in Danger of Closing

St. John’s, Mary Immaculate on Verge of Bankruptcy

By Conor Greene

Residents and elected officials are anxiously awaiting word on the future of two Queens hospitals that might be forced to close if their parent company declares bankruptcy.

The executive board of Caritas Health Care, which owns both St. John’s Hospital in Elmhurst and Mary Immaculate Hospital in Jamaica, was set to meet on Wednesday afternoon to discuss the future of the struggling facilities, which each lose about $5 million annually. It is possible that Caritas will vote to declare bankruptcy at that meeting, according to people involved in the discussions.

While both hospitals have struggled financially for several years, news of their impending closure came during Queens Borough President Helen Marshall’s annual State of the Borough Address two weeks ago. “I am extremely concerned today about the stability of St. John’s Queens and Mary Immaculate hospitals,” she told a stunned audience. “I am working with the state to sustain health care in these communities.”

Both hospitals are operated by Caritas Health Care, a corporation created by Brooklyn Queens Health Centers of New York when it purchased both facilities from St. Vincent Catholic Medical Centers for $40 million in 2006. Brooklyn Queens Health Centers of New York also owns Wyckoff Hospital and created Caritas to continue running the two Catholic hospitals.

News of St. John’s and Mary Immaculate’s potential closure comes just months after another local facility, Parkway Hospital in Forest Hills, was shut based on a recommendation by the state’s Berger Commission. The closures would fly in the face of findings made in a 2006 PricewaterhouseCoopers study of the future of healthcare in Queens, according to Dan Andrews, spokesman for Marshall.

In response to the news about Caritas, Marshall held an emergency meeting last Friday with other elected officials and community board representatives. “Indications were that the outlook is rather bleak for the two hospitals to remain financially viable,” said Andrews. “At the meeting, both the state health commissioner and Caritas officially agreed that the future of both hospitals is bleak.”

A major concern for Marshall and other officials is “how in the world other local hospitals would absorb the patient load that would be generated, with both doing about 50,000 visits each to the emergency room on an annual basis,” said Andrews. In addition, the closings would result in the loss of about 3,000 jobs, “the majority of which are held by Queens residents,” he added.

The two hospitals have a total of about 400 beds and combined are losing about $5 million each month.

Marshall has reached out to Governor David Paterson for assistance and expects to meet with him soon to discuss health care issues. “She will be asking him to delay any closures and will see if the state has formulated a closure plan, which it is required to do,” he said. “The great concern obviously is for the health care needs of the two communities, and the fact that Mary Immaculate has a trauma center, which is one of only a few in the entire borough.”

However, given the state’s looming $15 billion budget gap, it is not clear now much financial assistance the state can provide to maintain the hospital’s operations. According to a source at St. John’s Hospital, staff there has already been instructed to put together a closure plan, which seemingly would pave the way for the hospital’s closure.

One possible outcome to the problem is a takeover of both facilities by North Shore-Long Island Jewish Hospital, which would close both buildings and construct a new state-of-the art facility in central Queens. In November, LIJ entered into an agreement allowing it to negotiate exclusively with Caritas, according to spokesman Terry Lynam.

“We’ve been in discussions with them as well as with the state, toured the facilities, done our due diligence with regards to their books, and what we have proposed is actually building a new facility for the people of central Queens,” he said Wednesday. “The current sites are antiquated and the feeling is you could deliver much better quality care in a much more efficient manner with a new facility.”

However, Lynam noted that the plans face the possibility of being derailed by the current economic crisis surrounding the state and city. “The obvious issue is money,” he said. “Like all hospitals, particularly in this environment, we don’t have that capital, the hundreds of millions needed to build a 400-bed facility.”

The hospital would need “significant state funding” to complete the project, but “given the state’s financial situation, that’s kind of where it’s hung up right now,” said Lynam.

If that plan ever came to fruition, LIJ would likely cease operations at Forest Hills Hospital, which it also operates. He couldn’t say whether the new facility would be built at one of the sites currently used by St. John’s and Mary Immaculate, or elsewhere in central Queens.

Marshall Focuses on Economy and Redevelopment During Annual Address

Seniors, Transit, Public Safety and Culture also Discussed

By Conor Greene

Borough President Helen Marshall covered a wide range of issues in her annual State of the Borough address on Tuesday, but not surprisingly given the current economic crisis, much of her focus was on several redevelopment projects underway across Queens.

Before a crowd of nearly 1,000 in Queens College’s Colden Center, Marshall touted projects she has funded at local libraries, parks and cultural centers, while asking residents to elect her to a third term in office.

“With your help we will build on the foundations that I have created during my tenure,” she said. “To continue the work, I will ask the good people of Queens to allow me four more years to get the job done.”

Residents Honored

While the borough’s economic woes surfaced throughout the speech, Marshall began on a positive note by honoring some of the Queens residents who made news this year for the right reasons.

Marshall congratulated Digna and Victor Carpio – a city Housing Authority employee – on the recent birth of sextuplets. She also thanked NYPD Officer Patrick Plunkett, who apprehended a bank robber in Maspeth in October while off duty.

“And talk about bravery, I think all of us have admiration for a Queens resident who represents courage and resiliency in the face of danger,” said Marshall. “Eighty-six-year-old Vivian Squires, despite having been stabbed by an intruder in her home just nine days ago, fought back, had surgery and was just released from the hospital… And, can you imagine – is here today.”

Marshall also thanked three FDNY fire marshals who arrested the man suspected of setting a Whitestone shopping center on fire several months ago. Also honored was the Francis Lewis High School girl’s volleyball team, which just won its second citywide championship. Marshall noted that Francis Lewis “is the city’s most sought-after school.”

Redevelopment Projects

With the city’s capital budget “battered and stretched by credit crunches and the losses by many of our financial institutions,” Marshall spent much of the 90-minute speech on several major redevelopment projects planned across Queens, including at Willets Point near Flushing and Hunters Point South on the East River in Long Island City.

Combined, those two projects are expected to create more than 10,000 housing units, a convention center, retail space, community facilities and two schools, according to Marshall. “It has been said that construction is the engine that drives the economy,” she said. “In this ailing economy, we can create jobs, we can build housing and we can boost businesses. Naysayers beware, we will move forward.”

New Schools and a Hometown Favorite

Marshall boasted that six new schools opened this past September, including PS 305 in Ridgewood, PS 307 in Corona, PS 244 in Flushing, PS 306 in Woodhaven, PS 303 in Forest Hills and the Elmhurst Educational Campus.

During her tenure in office, Marshall said she has “worked to create more than 27,000new seats in 48 new schools or additions.” Seven more schools with more than 2,700seats are expected to open in September, followed by the new Metropolitan Avenue campus in Forest Hills and the Gateway High School for Health Care Professionals.

In addition, Marshall said that it has “been a pleasure and thrill to work with legendary hometown hero Tony Bennett to open the new Frank Sinatra High School in Astoria, just blocks from where he grew up.” The school originally opened in 2001 and is moving into a new building this year.

With that, Marshall welcomed Bennett to the stage to introduce the Frank Sinatra High School Concert Chorus, which performed two songs for the audience. “Mr. Bennett may have left his heart in San Francisco, but I can tell you his soul is still right here in Astoria,” said Marshall.

After traveling around the world, “I still come back to Astoria and like it more than any other place in the world,” said Bennett. “It is the most exciting place to explain the greatness of the United States of America.”

Health Care and Seniors

While recognizing that “challenge and hope is felt no more acutely than in our health care delivery system,” Marshall delivered the bad news that one Queens health facility – Parkway Hospital in Forest Hills has been forced to shut its doors, while two others, St. John’s in Elmhurst and Mary Immaculate in Jamaica are currently threatened by bankruptcy.

However, there was some good news regarding local hospitals, as Elmhurst Hospital Center opened its new Hope Pavilion, a comprehensive cancer care treatment facility in July and the borough’s largest hospital, LIJ Medical Center, broke ground on a $300 million project that will feature a women’s hospital housed in a 10-story pavilion. In addition, New York Hospital Queens is planning to build a new seven-story wing that will add 80-acute care beds when completed next year.

Marshall also took time to speak against the city’s proposed changes to the Meals on Wheels program, slated to take effect in February. Under the new plan, frozen meals would be delivered to seniors instead of a fresh, hot meal. “It is obvious to me that the new system is designed to allow a caterer to deliver frozen – not hot – meals once or twice a week,” said Marshall. “And there is no menu of options for seniors in this, America’s most diverse county. Everyone gets the same meal.”

Public Safety and Fire Response

"Our city could not sleep restfully or get up every morning and function were it not for the commitment and dedication of our uniformed forces,” Marshall said, noting she is “deeply concerned that the average response time to structural fires in Queens is longer than in any other borough.”

She also said she is concerned about the “lack of Fire Department resources in western Queens, where almost 10,000 units of new housing are under construction, recently completed or planned.” As a result, she made reopening of Engine 261 a condition for her support of the Hunters Point South plan.

The borough’s crime rate dropped almost four percent in 2008, but the homicide rate in Queens South jumped a “staggering” sixty-five percent. “Despite reductions in the latest police class and pending budget cuts, we cannot accept the increase in murders from 43 to 71 lost lives,” said Marshall, adding that gunshot victims rose by twenty-six percent compared with 2007.

In addition, despite a more than seven percent increase in subway crime, the NYPD Transit Task Force was dismantled earlier this month, noted Marshall. “Because crime traditionally increases in times of economic pressures, it is clear to me that the police department cannot sustain any additional cuts,” she said.

Libraries and Culture

During her time in office, Marshall has provided more than $81 million in funding for local libraries and has worked on at least 18 library capital projects, but is “not finished yet.”

Recent efforts include an expanded children’s room in Ridgewood, and new branches in Corona, Long Island City and Cambria Heights. Moving forward, expansions are envisioned in Kew Gardens Hills, Elmhurst, East Elmhurst, Glen Oaks, Rego Park, Jackson Heights, Queens West and Far Rockaway. In addition, ground was recently broken for a project Marshall described as one of her favorites – a new children’s discovery center in Jamaica.

Culturally, Marshall bragged that Queens Botanical Garden’s new visitor and administration center was rated high by the U.S Green Building Council for its use of environmentally-friendly materials. She also called her allocation of more than $16 million to the New York Hall of Science for an expansion “a good investment,” especially considering the facility attracted a record half-million visitors last year. In what was one of her “largest capital investments” since taking office, Marshall looks forward to this summer’s groundbreaking for the Queens Museum of Art expansion, which will double its size and add new galleries, classrooms and event space.

Mass Transit

Marshall argued that “on the mass transit front, MTA must do more,” especially in eastern Queens, which needs “new bus routes, increased service and more express bus services.” She also called for the reopening of the Long Island Railroad stations in Queens neighborhoods such as Elmhurst to relieve subway overcrowding, something she has “been asking for since I became borough president.”

She opposes “any plan to toll East River bridges” since “too many of us here in Queens are victims of government’s failure to provide viable mass transit options.” She also called it “simply unfair to raise the fares while reducing services” and said she opposes the MTA’s doomsday budget.

Marshall also mentioned a recent fight to prevent the MTA from eliminating the residential rebate program on the Cross Bay Bridge linking Broad Channel and Rockaway. Pointing out that it is the only intra-borough toll in the city, Marshall noted that “shoppers on Fifth Avenue don’t pay a toll to drive to Madison Avenue.”

There was some good news in the past year on the transit front, as subway cars on the E line dating back to the 1960’s are being replaced with new cars. Working with several other local officials, also Marshall helped push for the installation of an elevator at the Union Turnpike/Kew Gardens station on the E and F lines, making it accessible to all riders.

Looking Ahead

While her speech touched on a wide range of topics, it constantly reverted back to themes of job creation and economic development. She pointed to examples such as Aqueduct racetrack in Ozone Park, where a developer plans construction of a gaming hall featuring 4,500 video lottery terminals, and the construction of a huge shopping center in Rego Park that will include the borough’s first Century 21 department stores.

“Almost everything I spoke about today is related jobs, jobs, jobs,” said Marshall. “I have talked about job loss, job creation, difficult economic times and transforming adversity into opportunity and hope… Though the stock market may resemble a roller coaster ride in an amusement park, and Wall Street has caused tremors on Main Street, every family and every level of government is finding new ways to maximize.”

Marshall ended her speech on a positive note, expressing hope that President Elect Barack Obama, who spent five years in New York and credits a local librarian with helping him to get a job as a community organizer in Chicago, “knows our problems.”

“In one week, we will inaugurate a new president who has also inspired us with amessage of change and a promise that help is on the way with millions of jobs, improved health care and an improved America,” said Marshall. “He has told us that the road ahead may be long and steep;

The Forum Newsgroup/photos by CONOR GREENE