Public Employee Press

HHC dialysis clinics
De Blasio axes Bloomberg contract-out plan
Unionists blast Road Ahead cutbacks as a dead end

By DIANE S. WILLIAMS

IN a move that union leaders hope speaks loudly of the future, the administration of Mayor Bill de Blasio quashed the Health and Hospitals Corp. plan to privatize outpatient dialysis at four more major hospitals.

The action by Deputy Mayor Lilliam Barrios-Paoli came only weeks after DC 37 and community groups pressed the contracting-out issue in testimony showing that HHC's "Road Ahead" cutbacks and outsourcing had hurt health care and failed to produce promised savings.

The mid-March decision dropped HHC's application to contract out dialysis clinics at Harlem, Kings County, Lincoln and Metropolitan hospitals to Big Apple Dialysis, a business under fire over its mortality and infection rates and staffing ratios. Dialysis at Bellevue Hospital and some other HHC facilities remains contracted out.

DC 37 had fought the privatization of dialysis clinics for years, invoking Section 11of the citywide contract and initiating legal action against HHC, as well as asking the state Health Dept. to reject the city's request for a certificate of need and identifying the dialysis contract as a priority concern during the transition to the new mayoralty.

In coalition with the Nurses Association and health-care advocates, the union worked to inform elected officials on the issue. New Public Advocate Letitia James publicly called for the application to be withdrawn, and City Council Speaker Melissa Mark-Viverito and Council Health Committee Chair Corey Johnson voiced concern over the contract.

Under Bloomberg, "HHC took a slash-and-burn approach. They put cost-cutting before patients," DC 37 Field Operations Director Barbara Edmonds testified Feb. 21 before the City Council Health Committee.

The Bloomberg administration paid a consultant $4 million for a cost-cutting plan called "The Road Ahead," which the union called a dead end. The 2010 cuts deepened the recession in neighborhoods throughout the city as HHC wiped out almost 4,000 jobs, including those of many DC 37 members among the 1,300 housekeeping and environmental workers, 900 clericals, 800 aides, 400 techs and more.

At the hearing, outgoing HHC President Alan Aviles claimed Road Ahead initiatives had saved the city $71 million, but Edmonds showed that the actual savings were far less and that $43 million of that came from earlier actions.

"Who pays the price?" she asked. "Patients, underserved communities, and the dedicated civil servants who provide care."

Higher mortality

Local 420 President Carmen Charles and Local 1549 2nd Vice President Ralph Palladino also testified, explaining that under Road Ahead HHC had shirked its mission of giving quality care regardless of ability to pay by contracting out vital health services and shrinking its own staff through hiring freezes, attrition and layoffs.

"We've been tasked to do more with fewer workers and fewer supplies," Charles said. "It's time for New York City to put residents' health first, restore health care and put the public back in public health!"

DC 37 and health care advocates at the hearing hit hard at HHC's outsourcing of outpatient chronic dialysis services to for-profit contractors with histories of poor patient care and mortality.

Patients who get renal dialysis care from Big Apple experience a 24 percent higher mortality rate than people treated in public clinics. Those treated at Apple's parent company, Atlantic Dialysis, which currently runs several HHC clinics, have a 1-in-4 chance of premature death. Both companies cherry-pick patients with good health insurance and routinely reject the uninsured, Edmonds said.

HHC's outsourcing of food services to the Sodexo firm led to patient complaints about the lack of hot food, smaller portions and poor quality. Achieving its savings goal, she testified, could only be done through drastic cuts in food and labor.

Edmonds said DC 37 believes HHC can realize true savings by:

• giving better primary and preventative care;
• hiring more doctors and support staff;
• establishing federally-qualified health centers to recoup $25 million in reimbursements; and
• contracting in information technology work.