Gottfried: Community Health Centers No Replacement for ERs

As one hospital after another struggles to stay open in New York City, officials are looking to community health centers as one way to help fill the void in emergency and primary care that a closure brings.

But some experts, such as Assemblyman Richard Gottfried, argue that there is still a need for more primary care.

“Community health centers are not able to handle the things you should go to an ER for,” Gottfried said at a City & State healthcare panel on Thursday.  

Another panelist, Dr. Hany Abdelaal, chief medical officer of the visiting nurse service of New York, addd that going forward, the federal Affordable Care Act could alleviate pressure put on New York emergency rooms. 

Gottfried, the chair of the Assembly Health Committee, joined Abdelaal and David Pomeranz, the chief operating officer of the Hebrew Home at Riverdale, for a discussion entitled “Healthcare for New York City’s Most Vulnerable Populations.” The discussion, moderated by City Hall Bureau Chief Nick Powell and hosted by Baruch College, touched on access to healthcare, an emerging reliance on urgent care centers, mental health services for the homeless and medical marijuana. 

On the topic of long-term health for children and seniors, Pomeranz emphasized the need to reach out to vulnerable populations. Finding the right doctor or specialist is difficult for everyone, he said, particularly those least equipped to do so.

“Having care coordinators help the vulnerable population is key,” he said. 

Gottfried expressed his concern about who was going to be in charge of the coordinating and integrating. 

“So far it’s been rooted in an insurance company,” the assemblyman said.  “There are states where they do a terrific job without the insurance company–North Carolina, Oregon, Colorado. New York needs to learn from what these states are doing.” 

Powell brought up the issue of mental healthcare for the homeless, an at-risk population that has been a rhetorical focus of the de Blasio administration. The panel explained the idea of Health Homes under the Affordable Care Act as integrated networks of healthcare providers that combine the insurance and community models. “Health Homes are being designed right now to try and coordinate with these providers,” Abdelaal said.  “As the years go on, they will get better at it, but right now, they’re in a learning phase.”

When the conversation shifted to medical marijuana, Gottfried used the opportunity to describe the Compassionate Care Act, a bill that he is currently sponsoring in the legislature with state Sen. Diane Savino. 

“It is very similar to what the state of Colorado is doing in their medical marijuana program,” he said. “What we’re proposing is more tightly regulated than morphine, codeine, and valium.”

As for the fate of his bill, Gottfried said , “The issue is that the Senate Republican leadership has not wanted to move it to the floor … so if the governor would say, ‘Let’s do the Compassionate Care Act,’ it would happen.”  

All of the panelists agreed that if medical marijuana reduced pain or other symptoms for a patient without dangerous side affects, they would support it.

The panel ended with questions from the crowd, and included concerns about fast-tracking patients to urgent care, care giver burnout and increased radon levels in New York kitchens.  Gottfried said that because of potentially new and closer natural gas sources—through the controversial hydraulic fracturing natural gas drilling, which the state is reviewing but does not currently allow—stoves in New York would have higher levels of radon.

“We would be a whole lot better if we weren’t looking at doing hydrofracking in New York or Pennsylvania,” Gottfried said. “If more people knew about the radon reality in the gas … there would be a lot more opposition to allow that kind of drilling.”