Yes, Mr. B., there is so a Plan B

Not long ago, on September 22 of this year, Continuum boss Mr. Stanley Brezenoff pounded a table for emphasis and, he thought, laid down the law: I will cut out obstetrics at LICH, and, for good measure, I will cut pediatrics as well. That is my plan. There is no plan B.

Well, local officials, local activists, the medical staff of LICH, and many others organized to tell the State government that LICH should remain whole. And what do you know, the State listened, and decreed that yes, Mr. B., there is so a Plan B: the hospital will retain the services that Mr. B. had decided he would not.

For the text of the NYC Department of Health decision, click here.

Dr. Licht replies to Murray Adams

Mr. Cohn

Murray Adams has a personal view based on his feelings for what is best for LICH. However, he gives the wrong impression by characterizing the medical staff as being fractionated. All of the steps both leading to what is referred to as "the Doctor's Plan" as well as our public postures represent the nearly unanimous position of the Organized Medical Staff of LICH as voted on at our monthly Medical Executive Committee Meetings.

Murray makes it seem as if the LICH Medical Staff has no interest in a relationship with Downstate. That is not true. However we believe that any relationship with another institution including Downstate must include the Medical Staff as a full assenting partner. Murray's plan has LICH being handed over to Downstate as so much chattel without negotiation and without the involvement of the Organized Medical Staff. More bizarrely Murray's plan would have the current Continuum Board select the members of a new LICH Board. We have had 10 years of governance by a Continuum Board and cannot imagine having them appoint our new governing body.

There are indeed some physicians who, for whatever reason, are not in agreement with the majority opinion but they speak as individuals and not as representatives of the Organized Medical Staff and it's elected officers.

You may post this on your blog if you wish.

Arnold L. Licht, MD
President of the Organized Medical Staff
Long Island College Hospital

Some Doctors Have a Different View: Additional Comments from Murray Adams

Murray has sent me some additional comments regarding yesterday's posting (see below):

All of us owe a vote of thanks to Borough President Marty Markowitz for convening the hearing held at Borough Hall on Monday night. Inexplicably no one from the NYS Department of Health showed up. Fortunately, all of our local elected officials or their representatives were there to hear so many of our neighbors, our doctors, LICH’s employees and others who testified movingly and forcefully about the necessity for preserving Long Island College Hospital as an Brooklyn-managed major community hospital having all its present services, especially including Obstetrics and Pediatrics to serve our growing neighborhoods and the many young families with young children who crowd our sidewalks.
Unfortunately the top elected officials of the medical staff, Dr. Licht and Dr. Sorra, and other physicians such as Dr. Ricciardi, all of whose medical practices are office-based and who rarely if ever admit patients to LICH, do not agree with the plan I outlined to immediately affiliate LICH with SUNY Downstate. The Medical Staff Plan submitted to the Department of Health proposed that LICH re- establish itself as an independent hospital. Drs. Licht and Sorra however acknowledge the long-existing academic affiliation between the two institutions and agree that ultimately to enter into a management affiliation with Downstate or another large system might make sense.
On the other hand, I, several of the Brooklyn-based LICH trustees, including Rev. Dr. Paul Smith, Dr. Mike Avram, Joseph Broadwin and Lou Valentino, and most of the doctors whose practices, like Ciril Godec’s in urology, depends heavily on LICH’s surgical suites or, like Deborah Reade’s in radiology, depends heavily on LICH’s specialty equipment, do not believe that LICH can survive and rebuild as an independent hospital without affiliation with a major medical center such as SUNY Downstate.
I emphasize, however, that all of us are in full agreement that Continuum’s management of LICH must be terminated. Our major problem now is getting the Department of Health to turn down Continuum’s plan to close OB, inpatient Pediatrics, and Dentistry, bringing LICH’s management back to Brooklyn under a Brooklyn-based Board of Regents, and getting the DOH and our local elected officials to help us get Downstate to take over the management of LICH and its OB beds and getting help from them and HUD to make the takeover financially possible for Downstate. And it better come soon, or with Continuum continuing to shut down programs such as the school based clinics and the rape crisis intervention program and to fire large numbers of LICH employees, there will be nothing left of LICH to salvage.
C. Murray Adams

Cobble Hill Association: Have SUNY run LICH ! Submission by Murray Adams.

Murray Adams
photo by Werner Cohn

Murray Adams, a prominent personality in Cobble Hill and former president of the Cobble Hill Association, has presented a plan to save LICH at a public hearing last night. Here is his submission:

TESTIMONY OF C. MURRAY ADAMS, ON BEHALF OF
THE COBBLE HILL ASSOCIATION
November 10, 2008

My name is Murray Adams, and I speak on behalf of the Cobble Hill Association, a civic association which represents the interests of the residents of Cobble Hill, Brooklyn, where The Long Island College Hospital has been providing medical care for 150 years. The people of our community believe that the real reason behind Continuum Health Partners’ announced plans to close LICH’s Obstetrics and in-patient Pediatrics services, its Dentistry program and its school based clinics program is to close LICH entirely so they can sell off LICH’s valuable real estate to benefit Continuum’s Manhattan hospitals. This must not be allowed to happen!
Late in August, 2008, the Medical Staff of LICH filed a plan with the New York State Department of Health to revitalize LICH without closing any of these services and by returning LICH’s management to an independent group of Brooklyn-based trustees. That plan is a good plan, but it must be supplemented because it does not provide working capital which LICH must have in order to finance the transition and the rebuilding of the Hospital. Although the Medical Staff leadership has retained an investment banking firm to help obtain financing, given the present collapse of the credit markets, we do not think it likely that they will obtain loans for the necessary working capital in the very short time remaining to save LICH. To make the Medical Staff plan feasible, in our opinion, it needs to be supplemented in three respects:
First, the Medical School at SUNY Downstate and the Department of Health must agree that the management of LICH must be moved to Downstate and LICH’s Obstetric beds must be moved under Downstate’s operating certificate. This would mean New York State would bear the losses and the malpractice premiums which now burden LICH. Continuum wants to close Obstetrics, because, according to Continuum’s figures, this would save LICH more than $13 million per year. It would cost the State about half that much because the State does not have to pay malpractice premiums. Obviously, if Downstate continues to operate the Obstetrics beds at LICH where they are, there will be no need to close inpatient Pediatrics or the school based clinics program or the Dentistry program.
Second, the Medical School at Downstate and the Department of Health must agree to Downstate’s entering into leases of several LICH buildings so that Downstate can move much of its medical school as well as its clinical practices over to LICH. These buildings are LICH’s Polhemus building, where until 1953 Downstate had its medical school; LICH’s Clinic Building; and much of LICH’s 97 Amity Street building. This would answer Downstate’s need to expand its medical school facilities. An annual lease rental of $15 million will offset $15 million of LICH’s annual debt service, and so take care of the second part of what Continuum’s “plan” says needs to be done to put LICH on a stable financial basis.
Third, we need our elected officials’ help in getting the federal Department of Housing and Urban Development to defer for a reasonable period LICH’s debt service payments of about $2.5 million per month in order to provide LICH with working capital essential to LICH’s effort to restore itself. Also, LICH needs time to reconstitute and expand its primary care clinics, as the Medical Staff plan contemplates, and thereby rebuild LICH’s volume and its cash flow, which will probably take up to two years.
For the better health of all Brooklyn residents, Long Island College Hospital must be saved and restored as a premier Brooklyn health care institution. Brooklyn’s public health care standing is below New York City standards in almost every category, such as infant mortality per 1000 births, prevalence of asthma in children, incidence of heart disease, strokes, etc. The State would save money by setting up a Borough wide system of primary care clinics which would treat asthma, high blood pressure, breast cancer, high cholesterol conditions, nutrition problems, substance abuse and other common medical conditions that early intervention can treat much less expensively than if the patient arrives months or years later in a hospital emergency room and requires inpatient treatment because the untreated condition has become a major threat. We believe that what Brooklyn needs, as the Medical Staff Plan contemplates, is the establishment of a chain of Primary Care Clinics in the medically underserved areas of Brooklyn, such as Bedford-Stuyvesant, Brownsville, Mill Basin and East New York, and the linking up of existing clinics in those and other underserved areas, such as the BHS Clinic in East New York and the Red Hook Health Center in Red Hook, with the combined tertiary care capabilities of Downstate/University Hospital and LICH. We believe federal funds can be obtained to help establish this network of clinics.
We understand that Continuum and Downstate are in negotiations which we hope will result in LICH’s management being returned to Brooklyn under Downstate’s management and supervised by a new Brooklyn-based Board of Regents. We urge the Borough President and all our local elected officials to take every step in their power to make this come about and save our hospital for the entire Brooklyn community.
Thank you.