Vote New York

In Suffolk County, moves are afoot to sell the county’s nursing home. In Nassau, a years-long effort continues to improve and revitalize the public nursing home. The sharply different approaches are vivid examples of the counties’ divergent philosophies when it comes to public health. Suffolk wants increasingly to involve the private sector in areas once handled by government. Nassau, meanwhile, is deepening its commitment to publicly financed health care and figuring out ways to make it financially viable.

Suffolk County officials have discussed privatizing or closing some of the county’s 11 community health centers to offset patient revenue lost after the sale of the county’s health maintenance organization, Department of Health Services records show.

The documents also suggest that selling the Suffolk Health Plan, along with a proposal to sell or shutter county-owned John J. Foley Skilled Nursing Facility, are part of a broader strategy to reduce the county’s role in health care for the poor.

A health department PowerPoint presentation developed last year set out several options for making up lost patient revenue if the HMO is sold, including selling the health centers to a hospital such as Stony Brook University Medical Center, or consolidating them into three or four “regional supercenters.”

“Thought should be given as to private sector involvement in patient care especially for those who have insurance,” said the presentation.

County Executive Steve Levy said the PowerPoint was outdated and “an in-house thing for discussion. This is not a policy.”

Levy said the health centers will not be sold and argues privatizing the HMO will boost revenue to the centers. On Tuesday, he unveiled a $17.8-million deal to sell the Suffolk Health Plan – which manages health care for about 15,600 poor, elderly or disabled residents who use the health centers.

Split on privatization

While Levy dismissed plans for regional supercenters, he said two health centers in Brentwood and Central Islip soon will be consolidated into a new, larger facility in Bay Shore, which he said needs a facility. The merger, Levy said, is not related to the HMO sale.

To some lawmakers and health advocates, the privatization plans would dismantle a public health system designed for a far-flung poor population.

“I am gravely concerned that that network is being ripped apart strand by strand,” said Legis. John Kennedy (R-Nesconset).

Levy defended his health care record, citing reduced wait times at clinics, lower infant death rates and a 15 percent boost in health department funds since 2004.

He said closing the nursing home would save the county about $5 million to $15 million in annual subsidies. And the higher rates the health centers can charge a private HMO would bring in an extra $2.5 million a year.

“These are two instances where you can save a tremendous amount of money without cutting an ounce of service,” Levy said.

The extra revenue is contingent on Neighborhood Health Providers – a Manhattan firm with Islandia offices that was the highest bidder for the HMO – continually renewing a one-year agreement to use the health centers. The company’s chief executive said he plans to do so. But there is no written guarantee.

Losing nursing homes

The Suffolk Health Plan – the only county-run HMO in New York – was set up in 1995 to compete with private HMOs that were siphoning patients and Medicaid funds from the health centers.

Dr. Mary Hibberd, the former Suffolk health commissioner who oversaw the HMO’s creation, said selling Foley “would be a huge mistake” if it hurt the health centers.

“If the county gets out of providing services through the health centers, you will have thousands of people without health care,” she said.

Levy said Suffolk Health Plan was a “well-intentioned experiment” that hasn’t worked. The health department PowerPoint presentation noted the plan’s high administrative costs and said it is too small to compete with larger, private HMOs.

The state Department of Health, which wants small HMOs to merge with larger ones to reduce costs, has signed off on the sale.

State officials have also encouraged counties to close public nursing homes like Foley – a goal unsuccessfully pursued by previous county executives Patrick Halpin in 1991, and Robert Gaffney in 1997.

Incentive to sell

Levy has one advantage his predecessors did not – closing the 264-bed nursing home qualifies Suffolk for about $20 million in state incentives. Selling the Yaphank facility could net $10 million to $15 million.

The plan faces opposition. The Suffolk County Association of Municipal Employees and some lawmakers say Foley could generate revenue with better management.

Some upstate counties have closed nursing homes and cashed in. Others, like Nassau, are cutting beds in exchange for state money but maintaining a nursing home to serve the poor.

Suffolk officials say a publicly funded nursing home is not needed. The county’s 43 private facilities take Medicaid and can absorb Foley’s population, Levy said. Others aren’t sure. Foley has 12 beds for AIDS patients, the only unit like it in Suffolk. And it serves the uninsured.

Staff writer Rick Brand contributed to this story.

THE JOHN J. FOLEY SKILLED NURSING FACILITY, YAPHANK

Annual budget: $38 million

Beds: 264; 252 skilled nursing beds, 12 AIDS beds

Site: 4 acres

History: Opened in 1995, named after former Suffolk Legis. John J. Foley. Original facility built in 1871 as the Suffolk Alms-

house for the Poor, the Aged and the Destitute. Remodeled in 1919. Replaced in 1938, called the Suffolk County Infirmary.

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