Dear Mr. Stanzione,
I am writing on behalf of the Organized Medical Staff to
urgently request that a letter be immediately sent to the community database announcing that both the Obstetrical and Pediatric services shall remain open and active.
As the Administration did not hesitate in announcing the impending closure of these services so too should it not hesitate in announcing their current active status.
If you are unable or unwilling to do this please provide us with said database and we shall make the announcement.
This is the sense of the entire Medical Staff as expressed in it’s quarterly meeting last night.
Yours truly,
Arnold L. Licht, MD FAPA
President of the Organized Medical Staff
Of LICH
The message from BP Markowitz and the attached document clearly demonstrate that all of us have been successful thus far in our joint effort, and that the idea of an
"Independent, Brooklyn-based LICH"
is indeed an idea the NY State Department of Health wants to realize.
All of us, all of you - we have done a great job - the community, LICH physicians and employees, our friends and supporters - but it's now time to do even more, after this first victory - we need to KEEP UP THE PRESSURE - send emails and letters to Governor Paterson, the DOH, and Attorney General Cuomo, and let them all know that we want LICH back to what is was, bring it back to Brooklyn!
BP MARKOWITZ APPLAUDS HEALTH CARE VICTORY AS COMMUNITY EFFORTS LEAD TO STATE DEPARTMENT OF HEALTH’S DECISION TO PRESERVE OBSTETRICS, NEONATAL AND PEDIATRIC SERVICES AT LONG ISLAND COLLEGE HOSPITAL
“I applaud Governor Paterson and the New York State Department of Health for responding to the cry of the residents of the LICH catchment area to preserve the absolutely necessary services that have been offered by this hospital for generations and are vital to the health of our borough.
This could not have happened without the hard work of dedicated community residents and elected officials, as well as concerned LICH physicians and staff, who have all come together to form a very powerful and persuasive advocacy team.
As we have said from the start, closing Long Island College Hospital is not an option.
My office will continue to monitor the situation. We will continue to convene our stakeholder’s group and be vigilant in our advocacy efforts in the days ahead.
This is a solid first step as we move ahead with the real work of ensuring that LICH will remain a full-service hospital in this growing community for all the years to come.”
for The Brooklyn Paper
To the editor,
We read your exclusive interview with Long Island College Hospital’s Chief Restructuring Officer Dominick Stanzione with great disappointment and a touch of rage (“Exclusive! LICH speaks! Chief ‘restructurer’ explains layoffs and closures,” Nov. 1). The views expressed by Stanzione in this interview are replete with errors and misconceptions.
For example, he said that LICH is so financially unstable that only closing critical services can save it. He further stated that Brooklynites have abandoned LICH in favor of Manhattan hospitals. Both are demonstrably untrue and amount to an outright rationale for the scam to sell off LICH’s property to bolster Continuum Health Partners’ Manhattan hospitals.
Clearly, Mr. Stanzione is not a LICH official. He is a Continuum hire, hired in July, as his title indicates, for the express purpose of carrying out the company’s predetermined “restructuring” of LICH — i.e., closing the maternity, pediatrics, dentistry divisions and four children’s clinics in local public schools. He has a grand total of four months experience in Brooklyn.
Further, the LICH board to which Mr. Stanzione attributes all previous management errors is not a LICH board at all. It is a “mirror board,” so named because it mirrors the Continuum board. Its members are the exact same 100 or so individuals, fewer than 10 from Brooklyn, who sit on the Continuum board, the Beth Israel Medical Center board and the St. Luke’s/Roosevelt Hospital board. It does not represent the communities that are served by Long Island College Hospital. In fact, this Continuum/LICH board has only met in Brooklyn twice in 10 years.
It’s time that LICH have a board and an administration that actually represents our patients. This is the cornerstone of the plan that the LICH Medical Staff, supported by a whole range of community leaders, has submitted to the state Health Department. It is a realistic and practical plan that would return control of the LICH board to the Brooklynites it should represent, result in a far better LICH and restore the hospital to robust financial health — and it would do so without closing the services our patients rely on.
LICH has persevered for 150 years. Continuum seems ready to bury it after 10 years under its watch. It’s time to take LICH back.
Arnold Licht, MD
Toomas Sorra, MD
The writers are the current president and past present, respectively, of the Long Island College Hospital medical staff.
BP MARKOWITZ, CONGRESSWOMAN NYDIA VELÁZQUEZ, DOCTORS AND COMMUNITY GROUPS TO DEMAND IMMEDIATE ACTION TO RESUSCITATE LONG ISLAND COLLEGE HOSPITAL
1:00 P.M.
TUESDAY, OCTOBER 14
OUTSIDE LONG ISLAND COLLEGE HOSPITAL
HICKS STREET
BETWEEN ATLANTIC AVENUE AND PACIFIC STREET
COBBLE HILL, BROOKLYN
On Tuesday, October 14, Brooklyn Borough President Marty Markowitz, Congresswoman Nydia Velázquez and Special Assistant to the Borough President Yvonne Graham will join other elected officials, community leaders and members of the medical community at a press conference and rally outside Long Island College Hospital (LICH). The borough president will call for immediate action in saving essential services at the hospital.
CONTACT: Mark Zustovich 718-802-3830email: mzustovich@brooklynbp.nyc.gov
Statement on Long Island College Hospital announcing plans to close maternity, pediatric and dental units as well as school-based clinics:
"I echo the concerns of the community when I say that this is distressing. This is the second announcement in two months, and despite the assurances of leadership, the situation has seemingly continued to deteriorate. As Borough President, I am not only saddened by plans to pull the plug on several of the basic health care services that have been provided by Long Island College Hospital (LICH) for generations, I am also not pleased that these decisions have been presented by LICH and Continuum as a "done deal" rather than being brought before public officials and others who could potentially have helped prevent such sudden, drastic cutbacks.
It would be one thing if neighborhoods served by LICH were facing significant population decline or the market was not here for services like obstetrics, pediatrics, dentistry, and school clinics—but let's face it, all you have to do is walk down Court Street, Smith Street or Atlantic Avenue and count the strollers, or see the small children crowding area parks, or check out the number of students over-filling neighborhood schools to know that there is an exploding population of young families in great need of maternity, pediatric, and school-based medical services. Not only that, this community is expecting to grow by 15 to 20 thousand residents in the near future. And let's not forget the number of seniors in the LICH catchment area who will also need increased, not decreased, services in the days ahead. This should have been seen by hospital leadership as a chance to rise to the occasion and become known as the gold standard in all of these service areas—but instead, the opportunity is being squandered as LICH and Continuum turn their backs on the families of Downtown and "Brownstone" Brooklyn.
Certainly, in the recent past we have seen other Brooklyn hospitals struggling, and we know that Long Island College Hospital is not alone in dealing with the challenges of this financial climate, but I strongly believe that better, more proactive management at LICH could have stopped this hemorrhaging of red ink by doing things like having a financial risk management plan in place and working closely with a community advisory board. In fact, I am calling on LICH now to do both—form a community advisory board, on which the Borough President will have a seat, by the end of the year and draft both a comprehensive financial plan and risk management plan that will at least protect the hospital's remaining services.
The closing of LICH is unthinkable, and my office still holds out hope that there may be a way to save the services LICH has threatened to cut. I and my public health policy advisor Yvonne Graham will be reaching out to all groups who may be able to salvage these units—from LICH doctors to unions and interested outside medical groups who have expressed an interest in maintaining these important services in Downtown Brooklyn. We look forward to working with the LICH advisory board when it is formed. We are also convening an emergency task force of health care stakeholders in Brooklyn to assess the big picture of medical care options in this borough and begin to work together to stop the bleeding and restore health to our Brooklyn health care systems."
Brooklyn Borough President Marty Markowitz
Dental and pediatric services also cut to save cash-strapped hospital
By Jeffrey Harmatz
Confirming the worst fears of the community, representatives of Long Island College Hospital (LICH) announced that not only would the obstetrics facility at the hospital be closing, but that pediatric and dental services would be ending as well.
The announcement was made at a joint meeting of Community Board 6’s Executive and Housing and Human Services Committee Monday night, where concerned Brooklyn residents and hospital staff gathered to hear the unfortunate news.....
Letter to the Editor
Hi, Jeff – I’m the public affairs consultant for the LICH Medical Staff. I wanted to make one correction to your blog item from yesterday, if I may. Continuum does NOT have State DOH permission to close any of the units they want to close – obstetrics, pediatrics or dentistry. This is why Brezenoff made such a stink about demanding that the state move on them right away. Crain’s Health Pulse carried a very telling quote from DOH’s spokesperson on Wednesday – “[DOH] has to act to respond to the community and make sure there is enough capacity, and if that doesn’t meet his personal deadline, there’s not that much we can do about that.”
All hospitals lose money on OB and Peds. However, Continuum is sufficiently committed to them at their Manhattan hospitals that they recently opened a state-of-the-art birthing center at Beth Israel. By closing in Brooklyn, they would hurt LICH and downtown Brooklyn badly. These are critical services as evidenced by the 2,800 births a year there, according to Continuum’s own web site. In terms of the hospital’s all-important patient count, mothers are the health care gatekeepers in most family and they tend to return to where their children were born. Worse, they’d terminate, for all intents and purposes, hospital services to the masses of Brooklynites in the downtown area who are young enough to have a family and would therefore be abandoning the hospital’s 150 year old commitment to the communities it services.
Unfortunately, they don’t need permission to pull out of the four clinics they operated in nearby public schools, but have angered and scared a lot of parents by doing so as these great clinics provide primary care for many of the children who attend them who may have no other access to care.
Fred Winters
Vice President, George Arzt Communications
123 William Street, 22nd Floor
New York, NY 10038
Tel: 212-608-0333
Fax: 212-608-0458
Cell: 347-834-3719
The state Department of Health says it will not be rushed on its decision for service changes at Long Island College Hospital. Continuum Health Partners wants to discontinue maternity, pediatrics and dentistry there. “We cannot accept a negative response or a continued deferred decision from the state. The state should be responding right now,” Continuum President Stanley Brezenoff said at a community board meeting Sept. 22, according to the Brooklyn Paper. But a DOH spokeswoman responded sharply, saying that “[DOH] has to act to respond to the community and make sure there is enough capacity, and if that doesn’t meet his personal deadline, there’s not that much we can do about that.”
Yesterday evening’s meeting on the future of Long Island College Hospital, sponsored by Community Board Six, drew an audience that filled to capacity two adjoining large conference rooms at LICH. Those present included members of C.B. 6, many residents of the communities served by LICH, and several local political figures. Among the latter were City Councilman Bill de Blasio, Democratic State Senate candidate Daniel Squadron, Democratic District 52 Leader Jo Anne Simon, and representatives from the offices of U.S. Congresswoman Nydia Velazquez and State Assemblywoman Joan Millman. Facing the audience were: Stanley Brezenoff (center in photo above), Chairman and CEO of Continuum Health Partners, a not-for-profit consortium of hospitals that owns and manages LICH; Dominick Stanzione (right), newly appointed interim CEO of LICH; and the discussion leaders and moderators, C.B. 6 Chairman Richard Bashner (left) and Housing/Human Services Committee Chairman Brad Lander.
Mr. Bashner opened by noting that C.B. 6 had not yet taken a position on LICH’s proposed elimination of its obstetrics practice, and that the purpose of the meeting was to gather information, both from LICH’s management and from members of the community, not to be a “political rally”. Given that, he asked, “Is this ‘amputation’ necessary?”
Mr. Brezenoff replied that sometimes amputations are necessary, and that, in this case, it is required because LICH faces an immediate fiscal crisis. Unless action is taken quickly, he said, LICH will not have cash on hand to meet payrolls and other current expenses. He ascribed LICH’s problem to three factors. First, the hospital carries a heavy debt burden–approximately $150 million in long-term bonds financed through the New York State Dormitory Authority and $25 million in short-term commercial paper–which results in annual debt service (including interest and amortization) cost of approximately $22 million. Second, LICH has an operating deficit, presently about $40 million on an annual basis, the largest source of which is the obstetrics practice. Third, malpractice insurance premiums, largely imposed on the obstetrics practice, are a severe burden. The solution to these problems, he said, was to close obstetrics and thereby eliminate the expense associated with it, and to consolidate the hospital’s physical plant and use the proceeds of the sale of surplus buildings to pay down debt.
Mr. Stanzione then elaborated on LICH’s problems, saying that any alternative to shutting down obstetrics “would be worse”, and adding that the current overall economic crisis made the situation more difficult. He said LICH had applied in July to the New York State Department of Health for permission to close obstetrics. He added that LICH management had studied whether it was feasible to retain in-patient pediatrics after closing obstetrics, and had concluded that, because the bulk of pediatric intake came on referrals from obstetrics, it would not be possible to keep pediatrics. He said there were discussions between LICH and SUNY Downstate Medical Center concerning possible transition of the pediatrics practice. He also noted that, while LICH had considered closing its dental residency and clinic, there were discussions with other organizations that might continue dental services at LICH under their sponsorship. Later, when asked about rape crisis intervention services, he said that LICH had terminated a program under which such cases were referred from other facilities, but that treatment for rape victims was still available at LICH. He also said there was no plan to terminate gynecology at LICH, despite closing obstetrics.
Mr. Lander asked if closing obstetrics and pediatrics might not simply be the start of a “downward spiral” that would lead to closing more and more departments until there was nothing left. Mr. Brezenoff replied that there could be “no guarantees”, noting that LICH’s problems could be much worse if the New York State Medicaid budget is cut. Later, in response to a statement from Dan Wiley of Congresswoman Velazquez’s office, Mr. Brezenoff said there was a proposal to have the federal government take over more of the medicaid burden from the states, and praised Ms. Velazquez’s support of that legislation.
Mr. Stanzione then said that management’s intent was to have LICH “retrench around core services, and try to grow them.” He noted that the reason LICH, unlike some other hospitals also facing high malpractice premiums, could not continue to subsidize obstetrics was that LICH has also experienced declining revenues from practices like major surgery. When your correspondent asked what was the cause of this erosion, Mr. Stanzione replied that much of it was the result of trends in medical practice and technology that allowed more procedures to be done on a less invasive basis, often in an outpatient setting. Mr. Brezenoff added that, in LICH’s case, demographic trends were also an important factor. As more and more younger people moved into the brownstone neighborhoods in LICH’s area, the average age was declining. The ideal situation for a hospital, Mr. Brezenoff said, was to be surrounded by old people. In the case of LICH, he noted, it is not even surrounded, as “our back is to the River.” Ms. Simon later asked if these demographic trends might not be counteracted by development and by a trend toward more people “aging in place” instead of going to retirement havens like Florida.
Mr. Lander asked whether LICH’s problems were being addressed in the context of its being a community hospital, or if considerations affecting Continuum’s hospitals in Manhattan might be affecting plans for LICH. Mr. Brezenoff said that decisions affecting LICH were ultimately made by its Board of Trustees, which had made the initial decision to have LICH affiliate with Continuum eleven years ago. That Board is now comprised of the same members, described by Mr. Brezenoff as highly dedicated and qualified people, as the Board of Continuum and those of its other member hospitals. Mr. Brezenoff vehemently denied that LICH was in any way subsidizing its affiliate hospitals, all of which are located in Manhattan. Indeed, he said, there is a benefit to LICH from its affiliation with Continuum which he quantified as about $10 million per year.
Several members of the audience, including Councilman de Blasio and Mr. Squadron, asked how the community could become more involved and could help solve LICH’s crisis. Mr. Stanzione said LICH was collaborating with a number of community organizations, such as nursing homes and federally qualified health centers, concerning provision of emergency services. Mr. Brezenoff said he was very comfortable working with community boards and welcomed their input, but that the crisis was severe and quick action was imperative. Mr. Bashner asked if LICH was contemplating a bankruptcy filing; Mr. Brezenoff said it was not.
Paul Nelson, from Assemblywoman Millman’s office, asked how the State Legislature could help. Mr. Brezenoff said that if the Department of Health were to deny LICH’s application to close obstetrics, he would “be banging on your door” to seek a legislative solution. Dorothy Siegel, a community activist living in Cobble Hill, said that the solution for LICH should be the same as it was for the Cobble Hill Nursing Home some years ago: turn it over to the community to own and manage. “Give us your debt,” she said, noting that community management had succeed in turning around the Nursing Home when it was in financial straits, and in maintaining it as a first-class facility.
Notably absent from those making statements or asking questions at the meeting was any representative of the LICH physician staff.. However, there is strong and organized staff opposition to Continuum’s plan and, during the meeting, cards were circulated in the audience giving the web address of the medical staff’s site. The staff has retained the prestigious law firm Arnold & Porter to assist it in drafting an alternative plan that, it claims, can allow LICH to survive without terminating obstetrics or any other practice area. The plan is available in pdf format through a link on the medical staff site. It stresses rebuilding sources of patient intake, such as community clinics, while reducing losses by more aggressively pursuing overdue receivables, minimizing overhead costs, and renegotiating arrangements with insurance carriers.
Asked if he would meet with representatives of the staff concerning this plan, Mr. Brezenoff said “No.”
Contact: Fred Winters, George Arzt Communications,
212-608-0333 or 347-834-3719 – fred@arztcomm.com
PRESS ALERT
For immediate release: Wednesday, September 17, 2008
PRESS BRIEFING:
LONG ISLAND COLLEGE HOSPITAL MEDICAL STAFF PRESENTS HOSPITAL RESTRUCTURING PLAN
WILL SAVE HOSPITAL MATERNITY SERVICES, RESTORE FISCAL HEALTH AND RETURN HOSPITAL TO LOCAL CONTROL
The organized Medical Staff of Long Island College Hospital (LICH) has submitted their restructuring plan for the hospital, an alternative to the ruinous course down which Continuum Health Partners has led it, to the NY State Department of Health for their review. The plan is a practical, workable strategy to pull LICH back from the brink of insolvency, return it to fiscal health, restore closed clinical services and return this 150-year old Brooklyn institution to local control.
It will do so without closing maternity services, as Continuum has announced it plans to do, or any other medical service.
The restructuring plan will be released and explained.
WHEN: Tomorrow, Thursday, September 18, 2008 11 am
WHERE: The Brooklyn Historical Society
128 Pierrepont Street (at Clinton Street), Brooklyn Heights
1st Floor Auditorium
August 14, 2008
Stanley Brezenoff
President and CEO
Continuum Health Partners, Inc.
1111 Amsterdam Avenue
New York, NY 10025-1716
Dear Mr. Brezenoff:
I am writing to invite you, or your representative, to present at a Community Board 6 public information meeting your plans to close the maternity ward, sell off several Long Island College Hospital (LICH) properties, and any other potential measures that you may be considering to reduce operating costs, such as reducing the number of beds or eliminating other time-honored community services (such as inpatient pediatrics).
As you know, your announcement has sparked substantial concern in our community. High-quality, community-based health care is critical to a vibrant, healthy neighborhood. LICH is a critical asset to Cobble Hill and its many surrounding communities. Community members are eager to understand what your plans are, why you believe they are necessary, what the impact will be on the community, and what other alternatives might be considered. One essential role of the community board is to provide a forum for residents to learn and ask questions about items of import in the community.
I hope that you are amenable to participating in a broader discussion with the Community Board and community-at-large, which we would facilitate, to give us all a chance to learn more about your plans firsthand and engage in what we intend to be a constructive dialogue.
Please contact Craig Hammerman, our District Manager, at (718) 643-3027, extension 205, to arrange a date and logistics for the meeting.
Thank you very much for your attention to our request.
Sincerely,
Richard S. Bashner
Chairperson