When Westchester County Executive Rob Astorino says he made tough choices in his proposed budget for next year, he often cites his plan to cut $3 million in funding for the three neighborhood health centers that give medical care to uninsured county residents.
Because the three centers have $57 million in combined assets, pay their chief executives a total of $1 million and are in line for more funding under federal health care reforms, Astorino argues they could sustain less funding in a budget where plenty of groups feel pain.
In his proposed $1.7 billion budget for 2013, Astorino has called for 126 layoffs, new debt and spending cuts to bridge a projected $85 million shortfall in revenues.
"We just think the time has come that the centers are on financially firmer ground than the county," said Ned McCormack, the county executive's communications director. "There is no longer a need for a local subsidy."
But the chief executives of the centers say Astorino, a Republican, is overlooking their role in the county's health system and demonizing them because the centers don't serve his political supporters.
"The poor people, they don't vote for him and they don't give to his campaign, either," said Carole Morris, CEO of the Mount Vernon Neighborhood Health Center.
Morris said she earns a $216,000 annual salary, not including benefits, overseeing Mount Vernon's nearly $30 million annual budget and three facilities. She founded the health center 40 years ago, she said. Last year, the centers treated about 104,000 people, half without health insurance.
The health center CEOs added that their assets are usually the buildings where they operate and grant money or other funding that's dedicated to specific uses, not liquid cash they can spend in any way they like.
Their salaries, they noted, were also in line with executives who oversee multimillion-dollar budgets and operations that treat thousands of people in numerous locations throughout the Hudson Valley.
"We're talking about quite a span of geography and patient care," said Anne Nolon, CEO of Hudson River Healthcare in Peekskill. "We're the only access for comprehensive care for the underserved."
Nolon, who has worked at the center for 30 years, said she earns $329,000, not including benefits. Her center has a $65 million budget and 22 sites that provided care to almost 70,000 patients last year and an expected 90,000 this year, she said.
The health centers provide preventive and primary care, charging fees on a sliding scale depending on services rendered and clients' ability to pay.
The county budgets $3 million a year to repay the centers when they screen for tuberculosis, sexually transmitted diseases and other threats to public health. At the same time, Westchester County also conducts screenings for communicable diseases in Health Department-run clinics in White Plains and Yonkers.
Under state law, the county is required to offer the screenings to residents -- a mandate fulfilled by the Health Department's two clinics. But the health center CEOs said they largely fulfill the county's state mandates because they see far more people than the clinics in the course of offering routine care to patients.
If the three centers lose county funding to screen patients, the Health Department's clinics won't be able to pick up the slack, especially since uninsured people can't necessarily travel to White Plains or Yonkers, said Lindsay Farrell, CEO of the Open Door Family Medical Center in Ossining.
"Imagine what it would be like if the county didn't fulfill its mandate," Farrell said. "We're talking about STDs. We're talking about tuberculosis. We're talking about exposing people, the whole county. Everybody is exposed if the county doesn't fulfill its responsibilities."
After 27 years at the center, Farrell earns an annual salary of $230,000, not including benefits, she said. Open Door's budget this year is $32 million. This year, about 200,000 people used the center's services, she said.
McCormack repeatedly said Astorino respected the centers' work. But he questioned whether they were vital to helping Westchester County meet its state mandates to provide screening for communicable diseases.
Last year, the clinics used only 60 percent of the $3 million allocated for state-mandated screening, McCormack said. This year, they are on track to apply for only 40 percent of the funding available to them.
The federal government provides roughly a third of the $3 million, McCormack said, so the county would save $2 million if the centers' subsidies were cut. Ultimately, McCormack said, the county executive would prefer to spend that money somewhere else.
"That $2 million basically translates into 20 jobs," he said.