February 08, 2013

Testimony: Support SUNY Downstate Medical Center

Source: NYSUT Legislative Department

Testimony of Andrew Pallotta, Executive Vice President, New York State United Teachers, to the Assembly Committee on Health, Richard Gottfried, Chair, on the Brooklyn Health Care Crisis. February 8, 2013.

Assemblyman Gottfried, honorable members of the Assembly Committee on Health, and distinguished staff, I am Andrew Pallotta, Executive Vice President of New York State United Teachers (NYSUT). NYSUT represents more than 600,000 teachers, school-related professionals, academic and professional faculty in higher education, professionals in education, in health care and retirees statewide. My testimony today represents the concerns of 3,000 faculty and professional staff who work at the State University of New York Downstate Medical Center.

These dedicated employees are members of United University Professions (UUP), a local union of NYSUT.

I am joined today by Dr. Phillip Smith, President of UUP, and by Dr. Karen Benker, Associate Professor of Health Policy and Management at the SUNY Downstate School of Public Health. You will hear from both Dr. Smith and Dr. Benker in a few minutes.

Thank you for convening these public hearings and for the opportunity to testify today.

SUNY Downstate is one of the nation's leading urban medical centers. SUNY Downstate comprises a College of Medicine, College of Health Related Professions, College of Nursing, School of Graduate Studies, School of Public Health, and University Hospital of Brooklyn.

I am here today to urge all of you to do whatever it takes to keep the University Hospital of Brooklyn (Downstate) from closing. I ask that you reject any notion that Downstate be privatized and urge you to provide state resources to keep Downstate a full-service state-operated public hospital.

During Superstorm Sandy, SUNY Downstate was there for New York City, opening its doors to patients from two private hospitals that were evacuated due to the storm. The health care professionals at Downstate selflessly answered the call by working around the clock to provide those evacuated patients with first-rate care.

Notwithstanding its tremendous contribution to the citizens of Brooklyn, New York City, and the state, Downstate is in serious financial jeopardy. An audit released on Jan. 17, 2013, by state Comptroller Thomas P. DiNapoli found that poor financial decisions by management greatly contributed to the hospital's dire financial situation. SUNY Downstate is facing insolvency and may run out of money by May unless drastic steps are taken. Increased state funding is needed now for this critical institution to survive.

The state should not walk away from its financial responsibility and commitment to Downstate and its public health care and academic mission. The fact is, however, that the state has not adequately funded this mission. This mission states that the state university shall provide the people of New York with, "educational and research programs of the highest quality," and this includes strengthening "its educational and research programs in the health sciences through the provision of high quality health care at its hospitals, clinics, and related programs." The closure or privatization recommendations of Downstate and the consistent under funding of this institution by the state are contradictory to this mission.

In recent years, the state has consistently reduced funding to SUNY's hospitals. In fact, since 2008, state support to these hospitals has been cut by nearly 50 percent (2008 funding = $128 million, 2013-14 Executive Budget proposed funding = $60 million). In 2010, the Executive Budget completely eliminated all state support to SUNY's hospitals. Thanks to the Legislature, $60 million was restored. Last year, you again added another $28 million but unfortunately, this year's Executive Budget cuts that funding. This proposed cut goes against the SUNY maintenance of effort provision contained in the recently enacted NY-SUNY 2020 legislation. The simple truth is that Downstate and our other two SUNY hospitals in Syracuse and on Long Island cannot carry out their critical public missions on this level of state funding. The state needs to make a financial commitment to these hospitals to ensure their survival.

Moreover, Downstate and the SUNY hospitals in general, are unfairly treated by the state when compared to other state entities. In fact, the SUNY hospitals are the only state entities that must pay their own increases in collective bargaining and fringe benefit costs as well as their own debt service on capital projects. All other state agencies or entities have these mandatory costs paid by the state through General State Charges. Why are the SUNY hospitals treated differently? This unfair treatment has contributed to Downstate's precarious financial situation. It's wrong and must be changed.

In addition, the Executive Budget proposes Article VII legislation (S.2606/A.3006 – Part E) which, if adopted, would set the stage for the closure, or at the very least, the privatization of SUNY Downstate. We ask that you reject this proposal.

I submit that closing Downstate is not in the best interest of the state and will have tremendous negative consequences on the citizens of central Brooklyn. If the hospital is closed or restructured and privatized, unique, life-saving critical health care services not readily available at other hospitals will be jeopardized, first-rate medical care to the citizens of central Brooklyn – regardless of their ability to pay – will be compromised, and graduate medical education and cutting-edge research will be negatively impacted.

Each day, thousands of people in Brooklyn depend on Downstate for medical care and specialized treatment. Many of these patients are indigent. As a state-operated public hospital, Downstate accepts all patients, regardless of their ability to pay for service. Families with no health insurance or those that are underinsured go to Downstate for care. If this hospital is closed or privatized, where will these families turn? It is not assured that these patients will be able to go to another private hospital in Brooklyn as these hospitals routinely send these same patients to Downstate.

Moreover, private hospitals typically do not offer the full range of specialty services, such as burn units, trauma care units and poison control that our SUNY hospitals provide because they are too expensive. You will hear specifics on the specialty services that Downstate offers the Brooklyn community from my colleagues in just a few minutes.

NYSUT is also very concerned about Downstate's academic mission. Without a closely connected hospital, you are not going to have a quality medical school. SUNY Downstate's medical school is a leader in medical education and research but is also heavily subsidized by the hospital. Without the financial support of the hospital, the medical school simply could not operate. We are talking about a medical school that serves the most diverse student population in the state. Where 55 percent of its students are minorities and 75 percent of its students receive financial aid. Where 41 percent of its students are Brooklyn residents and 70 percent are New York City residents. The Downstate medical school produces more New York City physicians than any other medical school and we all know about the growing shortage of physicians in this state and in this nation. More than 80 percent of Downstate medical school graduates stay to practice in this state. It was also the first institution to open a school of public health in New York City and it ranks higher than Johns Hopkins, NYU, Yale, Cornell, and UCSF in the number of graduates who hold faculty appointments at American Medical schools. We cannot afford to lose this fantastic medical school by closing SUNY Downstate. The two go hand-in-hand. (Medical School Statistics Source - SUNY Downstate Medical Center)

Finally, NYSUT is also troubled over the economic fallout that will occur if Downstate is closed or down-sized. More than half of Downstate's 8,000 workers live in Brooklyn and Downstate is the borough's fourth-largest employer. Downstate is an economic engine for Brooklyn and for the state. The medical center generates more than $1.3 billion yearly for the state's economy. Every dollar of state funding to Downstate returns $12 to the local economy.

These job losses would devastate Brooklyn's already weak economy. Reducing employment in this economically distressed area-an area that needs more jobs, not fewer jobs, is counterproductive and wrong. Brooklyn already suffers from one of the highest unemployment rates in the state as well as a high foreclosure rate. The unemployment rate is 9.5 percent which is the second highest rate in the city of New York and the fourth highest county rate in the state. (Source: NYS Department of Labor)

There are many revenue raising measures that we have presented to the joint fiscal committees such as closing certain corporate loopholes that would generate over a billion in new revenue without raising tax rates. There are viable short-term solutions to this problem that will allow us to address the longer-term challenge of providing adequate healthcare services to the citizens of Brooklyn.

Brooklyn deserves the best health care available. Please keep Downstate open to save vital health care services and jobs. Our patients and employees are depending on you.