A mental health day-treatment program for 300 adults at Harlem Hospital Center is among the services that will be eliminated to save money.
New York City’s public hospital system announced Thursday that it was cutting 400 jobs and closing some children’s mental-health programs, pharmacies and community clinics that serve more than 11,000 patients.
Alan D. Aviles, president of the city’s Health and Hospitals Corporation, blamed reductions in state Medicaid reimbursement, a sharp increase in uninsured patients and the rising cost of labor, drugs and medical supplies for the cuts.
He warned that he would probably announce further job and service cuts in a month or two. The hospitals face a looming $316 million budget shortfall for the coming fiscal year, which begins in July, and the current plan would save $105 million.
“This is only the first round; we’re only dealing with one-third of the problem,” he said. “We do anticipate that there will be additional cost-containment measures.”
Speaking at a subdued news conference in the hospital system’s Manhattan headquarters near City Hall, Mr. Aviles said that the cuts would come at the expense of some of the city’s most vulnerable patients, the poor and uninsured, who he predicted would have a harder time finding the medical care they need. He said the system had been stressed by more uninsured patients, who numbered 450,000 at the end of last year, an 8 percent rise from the previous year. The rise in the number of people without insurance is accelerating in the city and nationally as unemployment rises, he said, adding that the corporation’s cost of treating the uninsured was $850 million last year.
Speaking for the governor on Thursday, Richard F. Daines, the state health commissioner, said that the use of federal stimulus money was still being negotiated, and that the governor was pursuing initiatives like higher reimbursement rates for the care of uninsured patients and increased payments for clinic care that could benefit public hospitals.
At the same time, in an e-mailed statement, Dr. Daines said that some cuts were necessary at a time of “unprecedented fiscal crisis,” but he said the corporation might be better off delaying major expansion projects and urged the public hospitals corporation to consider holding off on service cuts until the state budget had been adopted.
The move was, perhaps, not surprising in the current recessionary climate, which has produced widespread layoffs and has left the city hospital system struggling to cover its large pension rolls.
While the number of the jobs being eliminated is far smaller than the thousands of job cuts made at the hospitals in the 1990s, Mr. Aviles said there was less fat in the system now. He regretted having to retrench even as the public hospital system has been nationally recognized for the quality of its care, just over a decade after being so reviled that it was threatened with privatization.
Mr. Aviles called on Gov. David A. Paterson to direct to the public hospital system some of the nearly $10 billion that the state has received in federal stimulus money for Medicaid and health care. Public and private hospital officials have urged the governor to use the Medicaid money to offset state cuts to health care, but the governor has said he might use it in other ways.
“We want him to realize our backs are against the wall at this point,” Mr. Aviles said of Mr. Paterson. “Further cuts will lead to the beginning of dismantling our health care system in New York City.”
Mental health programs and community clinics will be hit especially hard, Mr. Aviles said, explaining that it does not make financial sense to cut hospital beds, which bring in revenue; clinics generally lose money. Mr. Aviles said patients would be directed to other clinics, though they might be less convenient.
Slated for closing are mental health programs at four Brooklyn schools — Public School 90, Public School 225, Public School 328 and Intermediate School 96 — that serve a total of 200 students. The community clinics being shuttered are Highbridge Health Center in the Bronx; Sunnyside Medical Center and Springfield Gardens Medical Center in Queens; and Sheepshead Bay Clinic in Brooklyn.
Along with the programs for children, a mental health day-treatment program for 300 adults at Harlem Hospital Center and another serving 80 adolescents at Lincoln Medical and Mental Health Center will be closed, officials said.
Of the 400 jobs being cut, 200 are layoffs, including about 13 doctors as well as managers, nurses, social workers and support staff. The other 200 will be absorbed through attrition by July. The system has 39,000 employees. Most of the job losses will come in the programs that are being cut.
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