Press-Republican

Local News

June 9, 2009

No decision yet on E'town vets clinic

ELIZABETHTOWN — Elizabethtown Community Hospital is still awaiting word on the future of its Veterans Clinic.

Hospital CEO Rod Boula said ECH submitted its required documents by the May 15 deadline and, so far, they have not heard anything.

“What we sent, we feel, are fair proposals,” Boula said.

The hospital shipped four 28-pound boxes of materials to Buffalo, where the determination will be made about whether the clinic will stay where it is or be moved to the Tri-Lakes area.

Many veterans turned out for a May meeting to protest any change in location by the Veterans Administration.

“The prisoners in the state are treated better than veterans,” Boula said. “We have had a tremendous amount of support from the veterans.”



PROPOSALS

One ECH proposal had the hospital supplying the physician’s assistant, nurse and staff for the Elizabethtown clinic.

The other added a satellite clinic in Wilmington to help service the veterans in the Lake Placid and Saranac Lake areas.

Boula felt there is a trend by the VA to change clinic locations from hospital-based operations to so-called storefront locations. He cited the clinics in Malone and Plattsburgh as examples, with the primary reason being lower overhead.

The clinics have to submit a yearly cost report in which square footage dictates the overhead costs.



CHALLENGES

ECH Board President Rick Hoffmann said the board is very much committed to keeping the clinic in Elizabethtown.

Basically, ECH operates on expected income of costs, plus 1 percent.

“If they (the VA) would give us the same as Medicare, then we would be OK. If we were Mass. General (hospital), we could absorb any costs or losses,” Hoffmann said.

“We have a unique contract that is different than others,” Boula noted. “The VA contracts with Dr. (Herbert) Savel. He does not work for us. Perhaps they (VA) don’t like that, but they have never come to us. We can only theorize.”

Another factor that enters into the equation is that the VA calculates funding on a per-visit basis. Since the clinic is mandated to allow only one patient per half-hour, it reduces the revenue possibilities.

Boula indicated that a dollar amount per veteran per month of enrollment would be more appropriate.



SPECULATION

Boula felt the need to quell rumors that he was responsible for Alice Hyde Medical Center in Malone losing its contract with the VA clinic.

“I was not there. The VA elected to go with a private service. We have been listening to vets that come from Malone, and they say that they are not happy with their clinic, and in their views, we have better quality.”

There have also been rumors that if the VA closes the clinic in Elizabethtown, it will reduce hospital admissions.

“We have had 32 admissions for inpatient stays,” Boula said. “They were not driven by the VA. They had Medicare and other insurers as their primary methods of payment. For veterans who don’t have insurance, they can come to the ER, and then we would get authorization.”

If the contract is awarded elsewhere, Boula said, ECH has another option: to go to the contractor and operate the ECH VA clinic as a satellite a few days a week.

If all goes according to plan, ECH should know the VA’s decision in about two weeks, the hospital officials said.



E-mail Alvin Reiner at:

rondackrambler@yahoo.com

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