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Apr 1, 2015 9:47 AMPublication: The Southampton Press

LaValle: Peconic Bay, North Shore-LIJ Partnership Not Consistent With State's Vision On Health Care Delivery

Apr 1, 2015 11:23 AM

Although Peconic Bay Medical Center in Riverhead has announced that it will join the North Shore-Long Island Jewish Health System, the two institutions still need approvals from the U.S. Justice Department and the State Department of Health to finalize the deal.

That last step could be a huge obstacle, however, as the partnership would put a dent in a long-term plan recommended by the state that all Eastern Long Island hospitals forge a relationship instead with Stony Brook University Hospital.

In 2006, the Long Island Regional Advisory Committee of the State Commission on Health Care Facilities—known less formally as the Berger Commission, for Chairman Stephen Berger—helped set goals for health care delivery throughout the state. It determined that community hospitals throughout central and eastern Suffolk County should be joined under the governance of Stony Brook University Hospital “to develop a strategic plan which restructures the hospitals to assure access to emergency services, rationalizes bed capacity, minimizes duplication of services and develops an integrated health care delivery system for the communities they collectively serve.”

The recommendations specifically targeted Peconic Bay Medical Center in Riverhead, Southampton Hospital and Eastern Long Island Hospital in Greenport, as well as John T. Mather Memorial Hospital in Port Jefferson, and Brookhaven Memorial Hospital and Medical Center in Patchogue.

Peconic Bay had also been in negotiations for the past few months with Stony Brook, which shared the state’s vision of creating a network of hospitals on the East End. The partnership would be modeled after Stony Brook’s planned partnership with Southampton, which was approved by the State University of New York Board of Trustees in January.

Eastern Long Island Hospital is currently in partnership discussions with both Stony Brook and North Shore-LIJ and is expected to make a decision by May 28, according to President and CEO Paul Connor.

However, now that Peconic Bay has opted to join North Shore-LIJ, following discussions that began last summer, it remains to be seen what Eastern Long Island’s decision will be. Mr. Connor—also a spokesperson for the East End Health Alliance, a three-pronged coalition established a decade ago consisting of Southampton, Peconic Bay and Eastern Long Island hospitals—said it is no surprise that all three hospitals are not on the same page.

“These hospitals are realizing that they need to be part of a larger system. They have to take care of their organizations. All three of us are pursuing our own solutions,” he said, noting that the Alliance will be disbanded once Peconic Bay officially joins North Shore’s system. “We support each other’s rights to do that. We all need to find the partners that we think will foster our needs best.”

State officials, on the other hand, have been vocal about what they believe is the right move.

While Senator Kenneth P. LaValle was in budget conferences in Albany all day Monday and Tuesday, he said in a statement through a spokesperson that Peconic Bay’s decision is not one he supports—especially because Stony Brook has already invested nearly $10 million in the Riverhead institution to help upgrade its facilities and strengthen the quality of its services.

“I do not believe that having our health care controlled by a system 85 miles to the west is in the best interest of my constituents,” Mr. LaValle stated, referring to North Shore-LIJ’s larger presence in Nassau County, Queens and Staten Island. “The argument that North Shore-LIJ has been in Suffolk for 20 years—meaning a presence in Huntington and Bay Shore—offers no consolation to those who live in Montauk and Orient Point and are in need of medical care.

“In my experience, local control seems lost when affiliations occur with distant systems,” the senator continued. “Peconic Bay’s plan seems to concentrate all services in one hospital and in one locale, to the detriment of other East End patients. I do not believe this is in the best interests of all East End communities or residents. An East End system remains a priority, but patient care must be at the forefront of any plan moving forward.”

Mr. LaValle hinted that other state officials may agree with his views on the matter. In his statement, the senator said that the State Department of Health aims to move toward a system where new health care programs are determined by regional planning and collaborative efforts, rather than one individual hospital. In other words: The deal with Peconic Bay and North Shore-LIJ might not fit the bill.

“The North Shore-LIJ/PBMC plan, as described to me by the board at Peconic Bay, sounds like an outdated hospital-centric approach that doesn’t fit into the health care delivery parameters outlined by the State Health Department,” Mr. LaValle said. “We just had great success with bringing together Stony Brook Medicine and Southampton Hospital. There is tremendous energy and enthusiasm in the community. I believe it is the right decision for the people I represent who want their medical needs addressed close to home—with local leadership.”

State Assemblyman Fred W. Thiele Jr. added that a partnership between Peconic Bay and Stony Brook makes more sense, not just because of the Berger Commission recommendation, or Stony Brook’s relative proximity to the East End, but also because he and Mr. LaValle would be able to step in and help out if problems arose, since Stony Brook is a public institution.

“First of all, I respect Peconic Bay Medical Center’s decision. It was their decision to make—they had a right to make it. Obviously, I don’t think it was the best decision,” Mr. Thiele said. “Stony Brook was already very much involved on the East End. From the beginning, Stony Brook was intended to be the regional hospital for Suffolk County.”

While Peconic Bay’s deal with North Shore-LIJ is somewhat different from what the partnership between Stony Brook and Southampton will entail—there will be no new hospital, as there is expected to be with Southampton—North Shore-LIJ has agreed to help Peconic Bay establish new programs in the forms of a cardiac catheterization lab, a trauma center, a cardiac intervention center and a cancer treatment center. Having these facilities would mean that fewer individuals who require such care would have to travel elsewhere—for instance to Stony Brook.

There could be many reasons why Peconic Bay opted for the expansive North Shore-LIJ network rather than the much smaller coalition envisioned by Stony Brook, which is often called the leader in tertiary care in Suffolk County.

Mike Anthony of Westhampton, a former associate executive director of the North Brooklyn Health Network, who spent more than 30 years with the New York City Health and Hospitals Corporation, said the Berger Commission recommendation should not be regarded as the only option, as all hospitals have specific needs that may have to be addressed differently. Mr. Anthony suggested that North Shore-LIJ might have been more aggressive in what it offered Peconic Bay, and that both its scale and experience in expanding its network, which consists of 19 hospitals, could have been appealing.

Additionally, Mr. Anthony said the changing face of health insurance, thanks to the Affordable Care Act, which encourages community hospitals to participate in larger health systems, most likely played a key role in Peconic Bay’s decision as well.

“The public and elected representatives have focused on aspects of the Affordable Care Act that expanded coverage through subsidized insurance, expanded Medicaid and the individual and employer mandate,” he explained. “Unexamined, until recently, is the important part of the Affordable Care Act that focuses on revamping modes of health care delivery. The North Shore-LIJ/Peconic consolidation reflects an attempt to follow the incentives and aspirations of this component of the Affordable Care Act.”

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Finally someone with a sense of reason-glad to see LaValle speak up
By EastEnd68 (888), Westhampton on Apr 1, 15 6:23 PM
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