Public Employee Press

Unions fight outsourcing HHC dialysis clinics
Rotten Apple

"Big Apple is a dialysis vampire that would be a rotten deal for New Yorkers." — Henry Garrido DC 37 Executive Director

By DIANE S. WILLIAMS

Unions are keeping the pressure on City Hall to cancel a contract outsoucing chronic dialysis clinics at four public hospitals.

Union officials contend that Big Apple Dialysis is a private contractor whose poor performance record should disqualify it from operating HHC's chronic care clinics.

"Big Apple is a dialysis vampire that would be a rotten deal for patients," said DC 37 Executive Director Henry Garrido. "Outsourcing HHC's dialysis clinics to them would endanger the lives of the most vulnerable patients."

DC 37, the New York State Nurses Association (NYSNA) and a coalition of health advocates and patients are fighting to keep the for-profit dialysis contractor out of Health and Hospitals Corp. facilities.

Big Apple Dialysis would take a $15 million a year bite out of HHC's chronic dialysis care business.

Last February, the state Public Health and Health Planning Council turned down Big Apple's application to run chronic dialysis clinics at Kings County, Harlem, Metropolitan and Lincoln hospitals.

On May 21, the committee will reconsider the application based on new competency and patient care data provided by Big Apple co-owners Jodumutt Bhat, MD and Nirmal Matloo, MD. The board will make a final decision June 11.

Records show that Bhat and Matloo own Atlantic Dialysis Management and 42 percent of its clinics perform at “worse than expected” levels. Of all dialysis clinics in New York State, just 10 percent perform at “worse than expected levels.”

Threat to patients' safety

"In my judgment, the proposed transfer of patients from HHC to Big Apple Dialysis poses a serious threat to patient safety," said internist David Himmelstein, MD,a Harvard Medical School lecturer who reviewed NYSNA's data on BAD

Patients treated at for-profit dialysis facilities have a 15 percent higher hospitalization rate, with almost 40 percent experiencing heart failure or worse, reports the website medscape.com.

Under the Bloomberg administration, consultant Deloitte devised a savings plan that slashed jobs and outsourced vital services, including dialysis at HHC. Under that plan, HHC lets Big Apple operate acute care dialysis clinics at Lincoln, North Central Bronx and Elmhurst under the hospitals' licenses. HHC hospitals provide acute care dialysis and chronic dialysis care.

HHC-run chronic dialysis clinics employ Registered Nurses, Biomed Techs, Social Workers and other staff who help patients get four-hour dialysis treatment three times a week. If Big Apple takes over, it would use less experienced technicians and cut patients' treatments to just twice a week.

"It shortens the longevity of patients; they cannot live a quality life. Their blood is not being cleaned properly," said Local 420 member Clive Davis, who has worked in dialysis
for 25 years. "Twice weekly dialysis leaves patients' urea-nitrogen levels so high you can smell urine on their breath."

"Private dialysis companies are about profits and chronic dialysis clinics are moneymakers," Davis said. "The uninsured cannot pay and are of no interest to them. No company should be allowed to cut lives short based on profits."

Big Apple would assign one tech to 112 patients, almost tripling HHC's current patient load. And because they get to pick and choose who gets treatment, DC 37's Barbara Edmonds said, "We're concerned whether the for-profit entity would treat homeless or uninsured patients."

Wall Street investors since the mid- 1990s have targeted lucrative chronic dialysis businesses and many have gotten rich off the backs of the sick and ailing

A 2010 ProPublica investigation revealed that Medicare covers dialysis and the costs of anemia and other related medications. Taxpayers are on the hook for $20 billion a year to treat 400,000 patients, or roughly $77,000 for every dialysis patient. Each year, 100,000 more people begin dialysis.

Publicly-traded dialysis companies Da- Vita and Fresenius, a German maker of dialysis machines, earned a combined $26 billion in recession-proof revenue in 2014. Through mergers, the dialysis duopoly acquires smaller for-profit companies in deals that make owners on both rich.

Dialysis can also be dangerous. Each year hundreds of dialysis clinics are cited for jeopardizing patients' health with breaches that expose them to deadly infectious diseases like Hepatitis B and C, staph, tuberculosis and HIV, a 2010 report in The Atlantic magazine revealed. Worse yet, too often patients at forprofit clinics hemorrhage, are hospitalized or die when dialysis needles and tubing dislodge or staff fails to follow safety guidelines.

HHC-run clinics have far better patient outcomes than Big Apple, where one in four patients dies.

"We are asking the state to reject HHC's misguided plan to use Big Apple Dialysis, whose high mortality rate is a red flag," Garrido said. "This plan is wrong for patients."

DC 37 and NYSNA are pushing Mayor Bill de Blasio, Public Advocate Letitia James and the City Council to put patients' health first and reject this contract.

Garrido added, "We are morally obligated to speak out and push for real solutions that use qualified, dedicated public servants to improve patient outcomes."