01/11/13 Westchester County Executive Rob Astorino And A Coalition Of Legislators Eliminated The Contracts For the Port Chester Neighborhood Health Center In The 2013 County Budget.

For more than 30 years, Westchester’s neighborhood health centers have had contracts with the county’s Department of Health to provide public health services and, most recently, screening and treatment of communicable diseases.

Because Westchester County Executive Rob Astorino's refunding this will be the first year that the Port Chester neighborhood health center will provide services without county support,Westchester County’s neighborhood health centers were operated by three nonprofit organizations with locations in Yonkers, Greenburgh, Mount Vernon, Port Chester, Sleepy Hollow, Ossining, Peekskill and MountKisco.

This healthcare refunding undermines the public-health safety net that has existed in Westchester for nearly four decades.

The Port Chester neighborhood center is the family doctor and dentist for thousands of village residents, the majority of whom have low incomes, are African American or Latino, and do not have employer-based health coverage or are covered by Medicaid.The Port Chester health-center patients are commonly described as the working poor — and in this means people who live and work in areas where there are low-wage jobs in the service economy.

Many Port Chester patients are employed in landscaping, housecleaning, house painting or by restaurants, dry-cleaners, and the like. Since the early 1980s, neighborhood health centers have worked closely with the county’s Department of Health in the delivery of services to residents who couldn’t go to a local doctor because of income and health-coverage issues.

While Westchester County operated a number of its own clinics across the region, employing its own doctors and dentists to provide care to low-income residents, it had to get out of doing so when managed care took hold in the mid-1990s.

Because county clinics weren’t comprehensive and didn’t meet rigorous standards expected by Medicaid managed care and other insurers, it made economic and clinical sense to outsource the work to neighborhood health centersThe model was a good one as reimbursement could be maximized in the health centers where it couldn’t in county clinics; health centers had a lower cost of doing business without a government salary and benefit structure; and health centers could meet managed-care standards for comprehensive service delivery.County Executives DelBello, O’Rourke and Spano recognized that paying health centers to deliver mandated public-health services to the uninsured made sense.Historically, the county has provided nearly $3 million annually to three organizations do this work, with $1 million of that coming from the state.In the 2013 budget, the county executive and a coalition of legislators eliminated these funds in total, walking away from the available state funds in order to save county taxpayers $2 million.While this may sound like a good deal for taxpayers on the surface, many would argue that a minimalist approach to public health is indeed foolish and that spending money on combatting communicable disease is necessary and important for the health and safety of every resident of the very dense Port Chester.No one can argue that the $2 million is a significant sum of money, but many Westchester County heath professionals have made the case that there are other ways to get these savings with refunding the Port Chester and other health centers.

For example, merging the Westchester County Health Department with its Mental Health Department (as the City of New York did years ago) would provide cost savings through the elimination of redundant positions.The effort would also lead to a more integrated approach to health. Further, savings could be achieved through a more prudent approach to employee and retiree health spending, either through utilization management or managed networks of providers.An annual budget is about priorities and just about everyone is disappointed that the Port Chester neighborhood health centers wasn't a priority for County Executive Rob Astorino.

Port Chester shouldn’t be famous for epidemics of disease that are entirely preventable;, just because County Executive Rob Astorino was penny wise and pound foolish.

Westchester County has never skimped when it came to the health and safety of its residents and County Executive Rob Astorino should not begin doing so today.

Port Chester needs its neighborhood health center.