If you don’t like the medical care you’re receiving in Central New York, you have but one place to look for the problem: “About 75% of the doctors in this region are from Upstate Medical University . . .”
The minutes of the July meeting of the Health Committee of the Onondaga County Legislature are posted at http://www.ongov.net/legislature/minutes/meetmins/July2010.html. Dr. David Smith, president of Upstate, testified.
Upstate is the biggest employer in Onondaga County and has a budget about equal to that of the entire county government. Most of us either work for County Executive Joanie Mahoney or President David Smith.
For your convenience, here is Smith’s testimony. If you start with the premise, as many of us do, that our medical care sucks then this is really scary stuff. Read it and weep.
HEALTH COMMITTEE MINUTES, July 13, 2010
ROBERT D. WARNER, CHAIRMAN
MEMBERS PRESENT: Mr. Laguzza, Mr. Meyer, Mr. Holmquist, Mrs. Ervin
Dr. David Smith, President, Upstate Medical University
Dr. Smith congratulated the Legislators on passing the local law prohibiting smoking within 100 feet of the perimeter of property operating as a general hospital. It has made a difference, their own commissioned peace officers and others have found it easy to work with and they have found incredible compliance. Dr. Smith provided a map of the Upstate Medical University buildings (on file with Clerk) and noted the following:
- East Tower of Upstate Medical University: $150 million expansion to University Hospital, no state dollars in this facility, entirely bonded.
- Total budget for Upstate Medical University is $1.15 billion, 8,000 employees (added 442 employees this year). State funding is only about 10.1% of their entire budget.
- Hospital side: Trauma center for 17 counties from Canada into Pennsylvania; burn center for 32 counties, poison control center for 34 counties, telepsychiatry for 38 counties. Budget is a little over $600 million; only 6.2% of the budget comes from the State of New York.
- They are a private university with a public mission regulated like a state agency.
- Mission: teaching, research and service – it is a university with a hospital attached. They have a campus in Binghamton, opened a set of classrooms at Jefferson Community College in Watertown and have affiliations throughout the region.
- Vision: to be the finest regional academic health center in the country. They need a larger footprint to do that (now landlocked).
- Noted the addition of Kennedy Square where they are building a biotech center ($22 million), taking possession of Townsend and Harrison Towers this week. Towers will be renovated for student/resident housing ($16-17 million).
- Multi-dimensional growth – to be regionally responsive – growing enrollment (about 30%), growing research mission (19% this year), and being able to meet other degree needs such as their new nurse practitioners program and psychiatric health. Post traumatic stress and other things at Ft. Drum are creating tremendous demand on the region.
- Budget is driven predominantly by patient revenues, federal grants, research grants, private industry relationships, tuition which is less than 8% of their budget (a little over 1,500 students); also have about 500 medical residents. About 75% of the doctors in this region are from Upstate Medical University, about 90% of nurses stay in three county region (almost 100% in five county region). College of Health Professions: medical technologists, respiratory therapists, radiation therapists, perfusionists (heart/lung machine operators) – almost 89% stay within region.
- Had to offset substantial reductions of state support (almost 16% on the university side and about 18% on hospital side) – realized 16% growth in clinical revenue this year, research goal was 10% – realized 19% this year. They do about $40 million worth of research per year; National Science Foundation suggests for every million dollars of research, it produces 27 new jobs.
Dr. Smith noted that if they want to continue to grow and meet their mission and anticipating that there will be further state cuts next year; they will have to have capacity. Currently, the hospital is running 95-96% occupied. If they are going to continue to hit the mark of 5% annualized growth, they will have to have access to additional beds, also need to look at new ways to train (working with the private sector). They have submitted a proposal regarding a partnership with Community General Hospital because of their concern about regional services and the Berger Commission requirements for Community General, Van Duyn, Auburn and Fulton. According to their strategic plan, they need access to about 110 additional beds. With enrollment and faculty growth, they will need approximately 540 total bed access. Community General has about 306 licensed beds, staffs about 100 to 130 at one time. If Upstate were to build 100 new beds, it would cost in the range of $85-$90 million and then would have to get a certificate of need. Considering Community General’s debt, pension obligations and assets, Upstate is looking at a substantially less cost per bed and Community General has the certificate of need. It is an area where they could do more teaching and grow and expand their Family Medicine, also have interest in looking at Acute Mental Health needs. Upstate has a long-standing relationship with Community – has run the emergency room at Community General for several years under contract and also their rehabilitative medicine program. They are seeing more regional requirements for their graduates and on the revenue side it makes great sense. Concerning jobs in the area, there are 1, 0000 positions at Community General and there is 42 acres of land. They are beginning to have some dialog with Van Duyn concerning partnering with them because of their interest in long term care and other aspects of care of an aging population.
Mr. Warner noted that their budget is about equal to the entire County budget. Dr. Smith said their goal is not to go in a disrupt a lot of things, they are primarily here as a university, what drives their mission is education and research, would create more synergy than anxiety and should stabilize all the entities.