NORWICH – Faced with a projected annual loss of half a million dollars, Chenango Memorial Hospital made the decision late last week to close all four of its school-based health centers in Chenango County.
Effective at the end of the current school year, the decision affects the Norwich, Oxford, Bainbridge-Guilford and Unadilla Valley school districts, where Chenango Memorial has operated the primary care service centers for 15 years.
Speaking on behalf of the hospital’s board of directors, CMH President and CEO Dr. Drake Lamen said, “While they recognize how convenient these services have been over the past 15 years for students and their parents, board members also realize that the projected annual loss of $500,000 for this program is not sustainable for the hospital.”
Dr. Lamen added, “This difficult action by the board strengthens our ability to sustain essential healthcare services for all members of the community.”
School superintendents were notified last week, and parents of the more than 3,000 students enrolled across the county were told of the decision in a letter that went out Friday.
Historically, the School Based programs covered expenses roughly half and half from program revenues and state grants. In the past few years, Dr. Lamen said, expenses have grown such that in 2011 over one-third of program expenses are now unfunded, largely due to state staffing mandates, increasing salaries, and administrative reporting requirements.
“We were basically competing with ourselves,” Dr. Lamen said, noting that the primary and preventive care offered in the schools are also offered at the hospital and in its ancillary clinics. He emphasized that the cost savings realized by the hospital would be used toward augmenting those services – increasing clinic hours to make them more accessible for working parents. “That half million could easily be reinvested in our core facilities, programs and people,” he said. United Health Services, CMH’s parent organization, operates primary care offices in Norwich, Oxford, Sherburne and Sidney.
The decision to close the School Based centers – spread across 10 buildings over the four districts – will mean the loss of over 20 hospital jobs, Dr. Lamen said. A handful of those positions will be reabsorbed into other CMH operations.
“The hospital board and administration express their deepest appreciation for the dedicated School Based healthcare team, and for the wonderful working relationships we have enjoyed with each school,” said Dr. Lamen.
Already faced with deep state aid cuts and budgetary problems of their own, the decision to close the centers took school superintendents by surprise. “Closing the clinics will severely affect our students and families who rely upon or have ever used our School Based Health Clinics,” said Norwich City Schools Superintendent Gerard O’Sullivan. “Our students could be seen for physicals and vision and hearing examinations. Our clinics handled everything from sore throats, ear infections, sprains and injuries to dental cleanings. Without the clinics, we’ll see more students absent and more student health problems get worse because of the lack of early intervention.”
In a press release, CMH said most children enrolled in the program do have a primary care provider, and parents were encouraged to continue health care with their own doctors in the coming year. “It is important to remember that your child still needs to continue routine health maintenance and preventive care as well as treatment of chronic and acute illnesses,” the letter to parents stated. The letter gave parents contact information for United Health Services providers, and said students’ medical records would remain accessible.
O’Sullivan is being joined by Oxford Academy Superintendent Randy Squier in appealing to New York State representatives for help in dealing with the additional burden they see being placed on their systems.
“After speaking with representatives from CMH, it seems one major cause of the closure is the additional financial burden of new mandates placed on it by New York State,” Squier wrote in a letter to Senator Tom Libous, adding that CMH was recently mandated to staff the centers beyond the level that was actually needed. “Up until this year the clinic in our district has operated effectively with one licensed nurse practitioner. Now the state is requiring two to be present.”
Dr. Lamen reiterated that point, saying that previously CMH had been able to “buy some time,” but was recently forced to add six positions to bring the program up to mandated levels, driving the average cost per student visit from $102 a year ago to $144 now. “The mandates forced us to have 50 percent more providers than productivity called for. We put them off as long as we could,” he said.
“The mandates can be reversed now with your leadership. Introduce legislation to change the mandates to previous staffing requirements. Allow the clinics to collect co-pays from those who can afford it,” Squier wrote Libous.
In addition to lobbying efforts, O’Sullivan said he is looking at other ways to provide that level of service. “I’m meeting with the other school districts and BOCES to see where we can work together. We’ll look to see where we can find other providers of this program,” he said.