Suffolk County Executive Steve Bellone is pursuing plans to remove the county from direct delivery of most health care services -- a move that could affect as many as 150 county jobs.
The administration is pressing ahead with ambitious efforts to shift direct care to third party providers to cut labor costs, gain higher aid reimbursements and jettison malpractice expenses. Bellone aides say the changes will enhance, not diminish, services.
Noting that state public health aid dropped from $30.4 million in 2008 to $16.3 million last year, Jon Schneider, deputy county executive, said, "The state is sending us a not so subtle message. . . . If we can find a way to save without impacting services it's a no-brainer."
Bellone signaled his intent to overhaul the health service in last month's state of the county message when he stated, "It's time for the county to get out of business of direct health care delivery." Bellone offered no details, and the administration has not estimated cost savings.
"I was amazed," said Legis. John Kennedy (R-Nesconset), the county legislature's minority leader. "It sounds like he embraces a wholesale off-loading of services." Kennedy said he doubted lawmakers would back the changes if they mean additional layoffs.
Bellone wants to have Hudson River HealthCare, a nonprofit network of 22 health centers, including Suffolk's Coram health center, take over Suffolk's 10 health clinics, which provide primary care services and had 233,000 patient visits last year. Hudson of Peekskill began operating Coram last year, and county officials estimate they will save $2.1 million this year.
Using a waiver to avoid the normal request for proposal process, the Bellone administration already has begun talks with Hudson River about taking over the county staffed health centers in Riverhead and Amityville as well as two satellite clinics on the South Fork -- with a total of 90 to 100 county employees. No changes are planned for the Dolan Family Health Center in Huntington, which operates independently but gets a county subsidy.
The three hospitals that run four health centers for the county also have filed proposals to partner with Hudson River.
In addition, the administration is seeking proposals for a takeover of Suffolk's four methadone clinics, which cost the county $2.7 million last year. Legislative analysts say those clinics have 55 county employees.
Officials say Suffolk's mental health clinics would remain under county control, in part because state law requires county intervention in certain cases.
Schneider said that in any overhaul, the health care centers will be dealt with case by case, but that he could not say what would happen to county employees in the shift. Hudson River officials did not respond to interview requests.
Michael Finland, Association of Municipal Employees executive vice president, expressed concern about Bellone's plans.
"I believe the county executive is surveying the landscape" of how to deliver services, he said. "But we stand 100 percent behind protecting county workers' jobs."
Kennedy said the county should assess Hudson River's performance in Coram before bringing them in elsewhere.