With two hospitals, Margaretville and, Ellenville, at its edges, Dutchess County hospitals (Vassar, Northern Dutchess, MHWMC in Poughkeepsie) available across bridges, and several hospitals down south in Orange (Garnett, St. Anthony, St. Luke’s, Bon Secours), HealthAlliance Hospital in Kingston is hardly the sole provider for the medical needs of the 182,319 people of Ulster County.
It’s not uncommon for residents to head up to Albany (five hospitals) or down to New York City, where there are more than 60 hospitals, for their medical needs. Having a variety of options closer to home from which to choose — even if they’re a county over — is a great benefit.
But what if a general hospital like HealthAlliance Hospital in Kingston doesn’t offer an essential treatment, and what if the patient only finds that out after it’s too late? Can a hospital where a necessary procedure won’t be performed remain classified as a general hospital?
The Hospital Transparency Act, a bill currently before the governor sponsored in the State Senate by Michelle Hinchey and in the Assembly by Nily Rozic, may settle the questions and get a handle on healthcare deserts hiding proudly in plain sight.
Late last December, a statement released by WMCHealth, HealthAlliance’s corporate parent, reported active conversations with New York State officials on a new financial stabilization plan for Kingston-based HealthAlliance of the Hudson Valley (HAHV). The state has been reluctant to provide additional funding after the promised results from its current five-year commitment have proven insufficient.
“Given the prior partnership with the state and disclosure of the need for additional resources and time,” the hospital group said at that time, “we expected the need to be met. We are hopeful the active conversations with the state will result in a resolution that prioritizes the healthcare needs of Ulster and Delaware County residents and surrounding communities.”
WAMCHealth threatened service cutbacks at its subsidiary if state aid weren’t increased.
Unprovided services
At issue is the existence of policy-based exclusions, healthcare services that hospitals are licensed to deliver but choose not to provide.
“Policy-based exclusions typically are all kinds of reproductive care,” explained Hinchey. “Everything from miscarriage management, to abortion, to tubal ligations, to gender-affirming care, all those kinds of things, and also end-of-life care and hospice care.”
Finding out what those policies are beforehand is not easy for would-be patients. None of the three hospitals in Ulster County post this information on their websites. Ask a hospital worker manning the phones for a list of policy-based exclusions and either they haven’t heard of any such thing or say that’s a question for a patient to take up with their insurance company.
Queried on the topic, an unidentified spokesperson for WMCHealth, responded in a statement.
“At our facilities, including HealthAlliance Hospital and Margaretville Hospital,” the spokesperson said, “we prominently display the Patient Bill of Rights as outlined by New York State Department of Health guidelines… WMCHealth is dedicated to ensuring accessible healthcare services and protecting patient rights across all our facilities. We strictly comply with all state and federal regulations.”
The statement neither mentions policy-based exclusions nor addresses the question whether any exist at their hospitals. The spokesperson does note that patients receive a copy of their Bill of Rights upon admission to a WMCHealth hospital, They can request another copy at any time and find those bills of rights on the hospital websites.
The Patient Bill of Rights enumerates a baseline 22 rights, such as the right to receive an itemized bill and the right to refuse to participate in medical research.
Providing transparency
The right to be informed by the hospital of any policy-based exclusions which may affect treatment currently does not exist. If Hinchey’s bill becomes law, that right will be enshrined in a patient’s bill of rights.
“We need to know where and what hospitals are not providing that care,” said Hinchey. “When you have young families who move into our communities, who want to stay in our communities, if you’re choosing a doctor, you want to know. And let’s say you’re pregnant, you want to know what kind of care you will be able to have throughout that pregnancy, something that is, quite frankly, pretty dangerous, even today in 2024.”
The United States ranks 54th in the world for infant mortality. With the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, and the highest maternal mortality, the U.S. is the only country on a list of a dozen advanced nations that doesn’t provide universal health coverage.
While the bill will require hospitals to be transparent about what types of care they do not provide based on policy exclusions, Hinchey said “it would also require the Department of Health, the DOH, to publicly share that information as well. And then to have a study with that information on where healthcare deserts are across the state. The purpose of our bill is to provide that transparency and that insight.”
The WMC spokesperson affirmed that community transparency was a goal they shared with senator Hinchey. “As we await the governor’s decision on the bill, our commitment to patient well-being remains unwavering, and we stand ready to serve our community with compassion and excellence,” the statement said.
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