Hugh Reynolds: The armored ambulance

The columnist Reynolds.

The columnist Reynolds.

Attendees were startled last year when HealthAlliance CEO Dave Scarpino revealed his $88.8 million “ask” for completing the $47 million consolidation of former Kingston and Benedictine hospitals at the Chamber of Commerce breakfast. To the surprise of many, approval was announced last week. They got the money.

As a dowry, it will certainly make HealthAlliance, currently courted by Westchester Medical Center as an operating partner, far more attractive. With almost $90 million in fresh cash, others might take an interest in what is now considered a very nice catch.

Given the endless paperwork and delays typical of grants, there’s the question of when the armored ambulance actually arrives, or at least the first significant installments. There was doubt in some quarters whether the Alliance would ever get another dime from the state, given state finances in general.


As one board member advised me over the weekend, “This is federal money!” Well, yes and no. The funding comes through Medicaid, but is administered by the state. For now, “in the pipeline” will have to suffice.

There remains a widespread perception that the original $47 million state grant secured by a previous administration 10 years ago could have been better spent. A third of that money went for a new emergency room at Kingston Hospital, only to have it now determined the future ER belongs at the former Benedictine. Paying down debt, funding golden parachutes for departing executives and trimming back already limited staff didn’t set well, either. As they like to say in politics, mistakes were made by previous administrators.

A new day has dawned, seemingly. Hospital services will move to the “Mary’s Avenue Campus” and could be expanded, while the “Broadway Campus” will be converted into a yet incompletely defined “medical village.”

All this, likely under the auspices of Westchester Medical, will take a couple of years. In some sectors, the notion of a community healthcare facility owned and operated by a foreign entity is worrisome. But then again, going it alone won’t work. Westchester is expected to be something of a hands-off parent, demanding only a majority of one on the Alliance’s board of directors. We’ll see. People with skin in the game tend to pay attention.

Scarpino and staff have done credible outreach in explaining their issues and plans to address the future healthcare needs of the community. The fact that new physicians are not flocking to Ulster County remains a chief concern. It appears interested doctors can read demographics, and that mountain greenery isn’t quite enough. Spanking new facilities with state-of-the-art equipment could sweeten the pot.

Going forward, the Alliance needs to better share its plans and progress with the public. There is after all no better disinfectant than transparency.

There remains a very large piece of this puzzle, the Medicaid discrepancy between Ulster and Dutchess counties. Former congressman Maurice Hinchey spent a good part of his two decades in federal office working to address the 20 percent reimbursement gap between the counties. He may have gotten close a few times, but those laudable efforts stalled in the U.S. Senate, where Chuck Schumer claims to be such a power.

By hospital standards, $88.8 million won’t last that long if HealthAlliance has to continue to operate at a competitive disadvantage with its neighbors.

Being a former sailor, I can appreciate the temptations of a sudden cash infusion. There will be much rejoicing at the Alliance’s annual ($210 a ticket) Tulip Ball on April 30 at the Lazy Swan in Saugerties. But given recent history, they might dance forward carefully. Dare we say tiptoe through the tulips?

Out to lunch

Given their propensity for ballyhooing the most mundane, local elected officials were conspicuously low-key after what may come to be known as “the blizzard of 88” (as in millions of dollars) was announced by the Alliance.

Assemblyman Kevin Cahill, the key player in securing the state grant a decade ago, issued only a brief press release. Congressman Chris Gibson didn’t crow, even with source funding coming from Uncle Sam. Maybe he was testing the waters for a race for governor in Hoosick Falls. County Executive Mike Hein, committed to making Ulster “the healthiest county in the state,” might have been preoccupied with sales taxes. Ditto for Mayor Steve Noble. And what about press-release-a-day Chuck Schumer? Zip.

For sure, we will need all these players united and vocal going forward. Given the entrenched rivalries, it might take a mass lobotomy, maybe at that spanking new operating suite at Benedictine.

Make no mistake, the success of the HealthAlliance is vital on several fronts. Healthcare is one of the community’s largest employers, with many well-paying jobs. And a vibrant “medical village” at the former Kingston Hospital can only advance the rejuvenation of Midtown Kingston.

Taxing times

No doubt to the chagrin of insiders, the sales tax dispute between the county and its subservient municipalities has been playing out in the media. Imagine that, taxpayers being informed on how their money might be spent!

Newly-minted Ulster County Legislature Chairman Ken Ronk is clearly enjoying the bully pulpit he was elected to by legislative peers in January. Ronk, as a county official, speaks to broader issues. He appears all-in on the trial balloon emanating from the legislature’s Ways & Means Committee to lower the current sales tax distribution to the city and towns.

The back-and-forth between Ronk and the media leaves the impression that this contract negotiation is in is in the hands of the legislature. By charter, however, the executive negotiates all contracts, not the legislature. Any contract in excess of $50,000 is subject to approval by the legislature. Same goes for city and town governments, where the mayor and supervisors negotiate and council members approve.

There is one comment

  1. endrun

    Great. This is like “feel-good Friday.” Let’s not dare speak about the abysmal situation overall in local doctor’s offices. Feel-good Friday would disappear mighty quickly into all the other days of the week.
    Oh but very nice vision of the “mass lobotomy.” Some characterize religion in this fashion already, and as we know those women who took vows of poverty–yet lived in Jersey where the cost-of-living is higher than a vow of poverty would accommodate–would have approved of the lobotomy to maintain the “particular level of poverty they enjoyed”(well at least in 1950–we’ve cough cough cough cough come cough cough cough cough such a cough long way in the cough field since cough cough cough).

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