Saturday, April 14, 2007

The senator and the budget

In December 2002 State Senator John DeFrancisco invited a couple of us to his Albany office to meet with officials of the State Department of Health. The subject was CGH’s application for the Physical Medicine and Rehabilitation Unit (PM and R), which had been stalled in the state’s approval process for a year or longer. The Senator thumped the desk. He looked each official in the eye. He said it was time to call the question, to get moving, to make a decision.

That meeting broke a logjam, and several months later the state officially approved the PM and R unit for CGH. In December 2003 Senator DeFrancisco helped us cut the ribbon at the PM and R opening on 4 East. I have a picture of that event in my office. He arrived here a few minutes before ribbon-cutting and asked me about CGH plans. I told him about the cardiac catheterization laboratory being developed in partnership with St. Joseph’s Hospital Health Center. In his typical way, the Senator asked several blunt questions, then said simply, “I’ll support it.”

Fast forward to the opening of the cardiac cath lab on February 14, 2006. The Senator had not only endorsed the project to the state, he had obtained $500,000 in state funds for it. A plaque outside the cath lab commemorates his assistance in securing that funding.

Two weeks ago the Legislature passed the 2007 state budget after a particularly difficult budget season.[1] As proposed by the Governor, the budget would have cost CGH some $940,000 a year. In the end, some of the proposed cuts were reversed by the Legislature. The new state budget will cost CGH about $440,000 a year. That is a significant reduction in revenue, but it is about a $500,000 improvement over the budget’s starting point.[2]

Two days after budget passage, Senator DeFrancisco called me. He said he had been able to secure in the final budget $200,000 in capital funds for CGH. “I know you can use it,” he said. Needless to say, I expressed appreciation for his assistance.

This was a difficult budget year and, despite the relative improvement for CGH – that is, fewer budget cuts than first proposed – the budget is a problem. All hospitals should have a bottom line of two or three percent a year so they can fund the necessary upgrades in equipment and physical plant.

CGH has been fortunate to have had a positive bottom line in each of the last four years, but in every case it is less than one percent. Enough to get by. But not what we should be earning as we make the longer term investments in patient care. The new state budget does nothing to help. It merely hurts us less than it could have.

In this difficult environment, CGH has had a constant friend in Senator DeFrancisco. He is interested in what we do, he has expressed support when needed, and he has secured additional state funds when it helps.

Thank you, Senator DeFrancisco.

[1] I wrote about the “The worrisome state and federal budgets” in my family letter of March 10, 2007. For a copy, go to

[2] In the weeks since budget passage, there has been a lot of talk in government and health care circles about who won and who lost the budget battle. Health care spending was particularly contentious this year with statewide advertising by SEIU 1199 and Greater New York Hospital Association, as well as advertising by the Governor himself. According to Crain’s Health Pulse, April 12, 2007, the Governor’s campaign manager said the budget includes $1 billion in health care cuts of the $1.3 billion initially proposed, or 77%. The Governor’s office considers the budget battle “a success.”

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