Medical School in Recovery
The State University of New York has about two weeks to compile a report on how it intends to save its Downstate Medical Center after a series of investments left the campus hemorrhaging millions of dollars a month. The road to financial solvency, administrators say, could mean some faculty members will not have their contracts renewed.
SUNY Downstate, which educates about a third of Brooklyn's practicing doctors, attempted to grow itself out of its financial problems. It acquired Long Island College Hospital, or LICH, in May 2011, but the facility soon proved to be another drag on the institution’s already ailing finances. A state comptroller’s audit, released in January, found the institution lost $275.8 million in 2011, and that it could run out of funds as early as this month. Administrators said the campus is losing as much as $12 million every month -- $1 million from LICH alone.
After a series of legal challenges, SUNY’s Board of Trustees in March finally voted to close LICH. The decision triggered an outcry from employees, unions and Brooklyn residents, who launched lawsuits and protests in response. Late last month, SUNY called off the closing after a provision in the newly adopted state budget compelled it to submit a long-term sustainability plan by June 1.
If approved by the governor’s office and the state Department of Health, the plan would begin a restructuring process that aims to make the institution “elegantly efficient and lean,” said Lora Lefebvre, associate vice chancellor for health affairs for the SUNY system. That involves balancing cost-reducing measures with -- hopefully -- an increase in public funding, she said.
Cutting costs could mean finding a new operator for all or parts of the medical services offered by LICH and, as SUNY Downstate begins to reverse its financial downturn, reductions in staff. The campus has more than 8,000 employees and does not use a tenure model.
“We need to be able to right-size ourselves into a model that gets us a little more in line with where our revenues are,” Lefebvre said.
While some unions are cheering the last-minute effort to save LICH, others are preparing to mount another battle to limit the impending cuts.
“We have been chewing on [SUNY’s] ankles trying to get meetings and figure out what their plan is,” said Phil Smith, president of United University Professions, SUNY's main faculty union. According to the budget provision, SUNY is required to consult with all affected parties before submitting the plan, but Smith said he has yet to hear anything.
“The bottom line is that we represent about 3,100 people, and many of them feel that their jobs are in jeopardy,” Smith said. The UUP’s members at SUNY Downstate represent about one-tenth of the organization.
“I hate to make this analogy, but it’s kind of like finding a buyer for a building that’s on fire,” Smith said about finding a new operator, adding that he would rather see the state legislature invest more public funds in the medical system.
“Hospitals have been able to stretch a dollar only so far, and now it’s beyond the breaking point.... I wouldn’t call it a bailout, but it’s just basically the state putting its money where the resources are needed to provide services to the public. What’s the state to do otherwise? That’s why we have government.”
For the roughly 1,110 members of the Service Employees International Union Local 1199, “the overwhelming emotion is relief rather than concern,” said Kevin Finnegan, the political director. The union represents employees at nearly all of New York’s private hospitals, which means a private takeover is not seen as a threat to its members’ job security.
“We’ll cross that bridge when we come to it, because we don’t know what the proposals are going to look like,” Finnegan said.
Similarly, Jill Furillo, executive director of the New York State Nurses Association, in a statement called the decision to keep LICH open an “incredible victory for Brooklyn patients.”
“We hope that a sustainability plan from SUNY that includes input from patients, nurses, and caregivers, will help keep LICH and SUNY Downstate Medical Center open as full service hospitals for the long run,” she said.
Representatives of the Public Employees Federation, which also represents employees at SUNY Downstate, did not respond to a request to comment.
Lefebvre said SUNY is busily scheduling meetings with unions and other stakeholders to get public input before the June 1 deadline. “As we’re kind of looking at all of the options ... we really have to keep in our mind’s eye what it’s going to take to preserve this medical school,” she said.