'N.Y. Hospitals Face $400 Million in Cuts Even as Virus Battle Rages' diff viewer (0/1)

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N.Y. Hospitals Face $400 Million in Cuts Even as Virus Battle Rages	N.Y. Hospitals Face $400 Million in Cuts Even as Virus Battle Rages
2020-03-30 23:18:13 UTC	2020-06-12 17:28:30 UTC (2 months later)
For the last few weeks, Dr. David Perlstein has been scrambling to find more beds and ventilators, knowing that the coronavirus outbreak, which has filled his Bronx hospital with more than 100 patients, will undoubtedly get much worse.	For the last few weeks, Dr. David Perlstein has been scrambling to find more beds and ventilators, knowing that the coronavirus outbreak, which has filled his Bronx hospital with more than 100 patients, will undoubtedly get much worse.
Then a week ago, Dr. Perlstein, the chief executive officer of St. Barnabas Hospital, was given some disturbing news by a state senator: His hospital could soon lose millions of dollars in government funding.	Then a week ago, Dr. Perlstein, the chief executive officer of St. Barnabas Hospital, was given some disturbing news by a state senator: His hospital could soon lose millions of dollars in government funding.
The funding cut was proposed by a panel that Gov. Andrew M. Cuomo convened earlier this year, before the virus had reached the United States, to rein in the state’s growing Medicaid program by identifying $2.5 billion in savings.	The funding cut was proposed by a panel that Gov. Andrew M. Cuomo convened earlier this year, before the virus had reached the United States, to rein in the state’s growing Medicaid program by identifying $2.5 billion in savings.
But the timing of the proposals, which were released in mid-March and include about $400 million in cuts to hospitals, was a blow to the morale of many hospitals and medical workers on the front lines of the fight against a ruthless virus that has infected tens of thousands in New York.	But the timing of the proposals, which were released in mid-March and include about $400 million in cuts to hospitals, was a blow to the morale of many hospitals and medical workers on the front lines of the fight against a ruthless virus that has infected tens of thousands in New York.
“It’s a shot in the gut,” Dr. Perlstein said. “During a time I need to commit all the energy I have to really save lives and expand access and not skimp on resources, now I have to worry about how we’re going to continue to pay our bills.”	“It’s a shot in the gut,” Dr. Perlstein said. “During a time I need to commit all the energy I have to really save lives and expand access and not skimp on resources, now I have to worry about how we’re going to continue to pay our bills.”
Asked about the proposed cuts, the governor said on Saturday that hospitals would receive a windfall from the $2 trillion federal stimulus package, which provides over $150 billion in grants to hospitals fighting the virus across the country.	Asked about the proposed cuts, the governor said on Saturday that hospitals would receive a windfall from the $2 trillion federal stimulus package, which provides over $150 billion in grants to hospitals fighting the virus across the country.
“The places that are getting the most funding now because of what the federal government did are the hospitals,” Mr. Cuomo, a third-term Democrat, said. “They are doing better than anyone else.”	“The places that are getting the most funding now because of what the federal government did are the hospitals,” Mr. Cuomo, a third-term Democrat, said. “They are doing better than anyone else.”
He then said, as he has before, “The state has no money.”	He then said, as he has before, “The state has no money.”
Government spending cuts are inherently contentious, but the optics of reducing money to hospitals at the epicenter of the nation’s pandemic quickly sparked a backlash from elected officials across New York City.	Government spending cuts are inherently contentious, but the optics of reducing money to hospitals at the epicenter of the nation’s pandemic quickly sparked a backlash from elected officials across New York City.
Six lawmakers from Brooklyn wrote a letter to Mr. Cuomo calling the millions of dollars in cuts to four hospitals in their districts “cruel, inhumane and unacceptable” and “catastrophic during a pandemic.”	Six lawmakers from Brooklyn wrote a letter to Mr. Cuomo calling the millions of dollars in cuts to four hospitals in their districts “cruel, inhumane and unacceptable” and “catastrophic during a pandemic.”
Brad Hoylman, a state senator from Lower Manhattan, said the proposals seemed wildly out of step with the current images of doctors, nurses and others fighting the disease in hospitals across the city.	Brad Hoylman, a state senator from Lower Manhattan, said the proposals seemed wildly out of step with the current images of doctors, nurses and others fighting the disease in hospitals across the city.
“It seems tethered to a different time and place,” Mr. Hoylman said, of the proposal, noting that the formation of the panel, the Medicaid Redesign Team, was announced the same day — Jan. 21 — as the nation’s first confirmed case. “Now New York is the epicenter of the pandemic. And the members of the M.R.T. frankly didn’t have that information.”	“It seems tethered to a different time and place,” Mr. Hoylman said, of the proposal, noting that the formation of the panel, the Medicaid Redesign Team, was announced the same day — Jan. 21 — as the nation’s first confirmed case. “Now New York is the epicenter of the pandemic. And the members of the M.R.T. frankly didn’t have that information.”
The Democratic-controlled Legislature will be asked to approve the proposals this week, as it hustles to pass a state budget by the April 1 deadline, a usually arduous task made all the more difficult by the outbreak: Four members of the State Assembly have been diagnosed with the disease, and neither chamber has convened since mid-March.	The Democratic-controlled Legislature will be asked to approve the proposals this week, as it hustles to pass a state budget by the April 1 deadline, a usually arduous task made all the more difficult by the outbreak: Four members of the State Assembly have been diagnosed with the disease, and neither chamber has convened since mid-March.
Lawmakers are also considering the proposals against a bleak financial backdrop: The state was projected to have a $6 billion budget gap, mostly a result of increased Medicaid spending, but the coronavirus crisis could lead to an additional $10 billion to $15 billion shortfall.	Lawmakers are also considering the proposals against a bleak financial backdrop: The state was projected to have a $6 billion budget gap, mostly a result of increased Medicaid spending, but the coronavirus crisis could lead to an additional $10 billion to $15 billion shortfall.
State Senator Gustavo Rivera, the Bronx Democrat who serves as chairman of the Senate Health Committee, said Mr. Cuomo’s plans were a “debacle,” and particularly jarring considering the governor’s much-applauded handling of the coronavirus crisis.	State Senator Gustavo Rivera, the Bronx Democrat who serves as chairman of the Senate Health Committee, said Mr. Cuomo’s plans were a “debacle,” and particularly jarring considering the governor’s much-applauded handling of the coronavirus crisis.
“It still boggles my mind that this is the same guy who goes, and sits down in front of that TV, and in front of you all in Albany, lays it all out, smartly and ably,” Mr. Rivera said, praising the governor’s coronavirus performance. “And then he breathes in, and the next thing that comes out of his mouth, ‘And you got to let me cut the Medicaid system.’”	“It still boggles my mind that this is the same guy who goes, and sits down in front of that TV, and in front of you all in Albany, lays it all out, smartly and ably,” Mr. Rivera said, praising the governor’s coronavirus performance. “And then he breathes in, and the next thing that comes out of his mouth, ‘And you got to let me cut the Medicaid system.’”
As part of the budget negotiations, the executive branch provided the State Senate with data showing how hospitals could be affected by the proposed cuts; each senator then received an email detailing the impact on hospitals in their districts, Mr. Rivera said.	As part of the budget negotiations, the executive branch provided the State Senate with data showing how hospitals could be affected by the proposed cuts; each senator then received an email detailing the impact on hospitals in their districts, Mr. Rivera said.
Many of the hospitals that would be hurt by the cuts are so-called safety-net hospitals, which largely serve uninsured or undocumented residents, some of whom are considered susceptible to infection because of cramped living or work conditions.	Many of the hospitals that would be hurt by the cuts are so-called safety-net hospitals, which largely serve uninsured or undocumented residents, some of whom are considered susceptible to infection because of cramped living or work conditions.
Indeed, the brunt of the proposed cuts at St. Barnabas, where almost 90 percent of patients are partly covered by Medicaid, could come from reducing $7.7 million in Indigent Care Pool funds, grant money meant to reimburse hospitals for treating poor and uninsured patients for free.	Indeed, the brunt of the proposed cuts at St. Barnabas, where almost 90 percent of patients are partly covered by Medicaid, could come from reducing $7.7 million in Indigent Care Pool funds, grant money meant to reimburse hospitals for treating poor and uninsured patients for free.
Dr. Perlstein, who complimented Mr. Cuomo’s response to the coronavirus, said it was unconscionable to grapple with the prospect of a funding cut “when we’re 14 days from Armageddon.”	Dr. Perlstein, who complimented Mr. Cuomo’s response to the coronavirus, said it was unconscionable to grapple with the prospect of a funding cut “when we’re 14 days from Armageddon.”
	Updated June 12, 2020
	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
“Especially at a time I’m asking my staff to give it all,” said Dr. Perlstein, who has worked at the hospital for over 20 years. “If these cuts remain, I have no way to survive as a hospital. I’m already walking a very fine line when it comes to revenue.”	“Especially at a time I’m asking my staff to give it all,” said Dr. Perlstein, who has worked at the hospital for over 20 years. “If these cuts remain, I have no way to survive as a hospital. I’m already walking a very fine line when it comes to revenue.”
Robert Mujica, the state budget director, said that it was “disingenuous” to scrutinize any individual hospital cuts without taking into account “the full picture” of other savings and efficiencies from the proposals, which he stressed are still being negotiated with the Legislature.	Robert Mujica, the state budget director, said that it was “disingenuous” to scrutinize any individual hospital cuts without taking into account “the full picture” of other savings and efficiencies from the proposals, which he stressed are still being negotiated with the Legislature.
Asked about the proposals last week, Andrea Stewart-Cousins, the Senate majority leader, said the state should be looking for ways to “strengthen our system and not in any ways of undercutting it.”	Asked about the proposals last week, Andrea Stewart-Cousins, the Senate majority leader, said the state should be looking for ways to “strengthen our system and not in any ways of undercutting it.”
Mr. Hoylman said he was hoping that the Medical Redesign Team might reconsider its recommendations, or at least delay their implementation, saying he was concerned about the “public messaging” of Albany looking to save money in the middle of crisis.	Mr. Hoylman said he was hoping that the Medical Redesign Team might reconsider its recommendations, or at least delay their implementation, saying he was concerned about the “public messaging” of Albany looking to save money in the middle of crisis.