COMMUNITY SERVICES PLAN 2011

Comes out every September

 

1.  MISSION STATEMENT

Catskill Regional Medical Center’s (CRMC) Mission Statement is to “Improve the health of our community by providing exceptional health care.”  Catskill Regional Medical Center’s vision is to “be the best community hospital in New York State by providing outstanding service to all.”  CRMC’s values reflect our Mission and Vision by focusing specifically on care and compassion, safety and privacy, respect and integrity as well as quality and innovation.

 

2.  HOSPITAL SERVICE AREA

Catskill Regional Medical Center’s primary service area utilized for community health services planning has not changed since our Community Services Plan was submitted in September 2009.  CRMC’s service area for community/local health planning includes all 15 townships within rural Sullivan County, New York.  CRMC has been designated by both the New York State Health Department and federal CMS as both a sole community provider and a rural referral center. CRMC, with campuses in both Harris and Callicoon, is the sole acute care hospital serving Sullivan County.  The Medical Center has been and will continue to be an active partner with Sullivan County Public Health Services toward evaluating and enhancing the community health status.

The Hospital’s service area within Sullivan County is divided into primary and secondary service areas.  The primary service areas are those Sullivan County townships and zip codes which are either closer to CRMC than any other hospital facility, or where CRMC has a predominant market share.  Specifically, the Sullivan County townships in the primary service area are Bethel, Callicoon, Cochecton, Delaware, Fallsburg, Forestburgh, Fremont, Liberty, Neversink, Rockland, Thompson and Tusten. 

The three remaining townships of Highland, Lumberland and Mamakating within southeastern Sullivan County constitute CRMC’s secondary service areas.  These three townships represent approximately 19% of Sullivan County’s overall 76,500 population.   The following demographics characterize Sullivan County’s rural service area: 1.  Extensive and growing geriatric population; 2.  Higher proportions of black and Hispanic populations when compared with most upstate New York rural communities; 3.  Villages of Monticello and Liberty are surrounded by geographically dispersed rural populations; 4.  Economic base predominately comprised of agriculture as well as services focusing upon health care, tourism, government and education; 5.  Extensive medically indigent population with a high proportion of individuals either on Medicaid or totally lacking health insurance coverage.

 

3.  PARTICIPANTS’ AND CATSKILL REGIONAL MEDICAL CENTER’S ROLE

CRMC recognizes that broad-based public participation constitutes an integral component in the development and implementation of an updated Community Services Plan that is responsive to the health needs of the Sullivan County community.  The hospital has participated collaboratively in the Sullivan County Public Health Services (the local health department) 2010 – 2013 community needs assessment. with, Public participation was sought through a multitude of vehicles including four community health forums conducted in conjunction with Sullivan County Public Health Services.  These forums were held at different locales and times throughout Sullivan County to increase the likelihood of attendance by a broad cross-section of the community.  The forums were conducted in accordance with the timeline delineated below, and included an evening program to attract the working population, a meeting in Callicoon, N.Y., accessible to western Sullivan County consumers, as well as separate meetings in the more populous villages of Monticello and Liberty.  The four Sullivan County health forums were publicized by placing information flyers in local post offices, newspaper stories in three local newspapers, radio announcements on several Sullivan County radio stations, as well as news coverage on Cable Television Channel 6. 

The Sullivan County Health Department joined the six remaining Hudson Valley regional counties to conduct a consumer health survey funded through a HEAL 9 project grant. There were 280 respondents to the community surveys with a low percentage of both males and the elderly responding. Several preliminary findings identified additional community health needs including:  1.  High Sullivan County prevalence rates for obesity; 2.  Difficulty affording dental care treatment services; 3.  Significant need for diabetes and cardiovascular heart disease services; 4.  Falls prevention programs; 5.  Need for additional preventative health screening and educational program services.

The Sullivan County Public Health Department jointly contracted with New York Medical College to carry out a regional needs assessment survey of health care providers in the County.  The Hospital participated by requesting that CRMC department heads and members of senior management complete and return the provider survey questionnaire.  Furthermore, CRMC also forwarded the provider survey by e-mail to its current complement of more than 200 Sullivan County medical staff members.   

CRMC actively participated in the Hudson Valley Regional Health Planning Summit conducted in June 2010.  The Hudson Valley Health Planning Initiative, funded through a NYSDH HEAL 9 grant, provided updated community health status data on both a local and regional basis.  The Hudson Valley Health Planning Summit focus groups identified several regional health planning priority areas including: 1) Access to quality health care; 2) Chronic Disease prevention and control; and 3) Maternal and child health.  The first two regional health planning objectives are fully consistent with CRMC’s updated Sullivan County Community Services Planning priorities. 

In addition, CRMC received health care provider input and feedback from members of the Sullivan County Rural Health Network.  This Network is comprised of approximately one dozen local health and human service organizations, including administrative representatives from both the Harris and Callicoon campuses of CRMC.  The Sullivan County Rural Health Network adopted three local health care priorities including:  1. Access to health care services; 2. Maternal and Child health issues; 3. Behavioral and substance abuse issues.  CRMC remains an active partner in the Sullivan County Rural Health Network as reflected in the selection of Roland Bojo, Administrator of Patient Care Services, as Network Chairperson. 

CRMC established a multidisciplinary Community Advisory Board during the fall of 2007.  The CRMC Community Advisory Board is comprised of 33 consumer and provider representatives who continue meeting quarterly to provide feedback on hospital performance, as well as to provide input on Sullivan County community health needs, issues and priorities.  The Hospital Advisory Board identified the prevention, care and treatment of chronic diseases including diabetes and cardiovascular, as well as behavioral health issues including mental health and substance abuse, as the highest priority of unmet health care needs throughout Sullivan County.

Both the Sullivan County Rural Health Network and CRMC Community Advisory Board continue meeting on a regular basis.  The Sullivan County Rural Health Network meetings are generally bimonthly, while the CRMC Community Advisory Board meetings are quarterly.

 

4.  IDENTIFICATION OF PUBLIC HEALTH PRIORITIES

CRMC utilized the broad-based input received at four community health care forums, Sullivan County consumer survey findings, Sullivan County Rural Health Network feedback as well as recommendations from the Hospital Community Advisory Board to preliminarily select several health prevention priorities.  CRMC’s preliminary priorities were then reviewed by CRMC senior management executives with the Greater Hudson Valley Health System, the Sullivan County Health Department as well as other community partners.  CRMC has not altered its three paramount Sullivan County Public Health priorities since the 2009 Community Services Plan.

In order to measurably improve community health status by 2013, CRMC, working closely with key Sullivan County community health stakeholders, has adopted three prevention agenda items for Sullivan County.  Chronic disease is the first Sullivan County priority.  Selection of chronic diseases was predicated upon several factors including specifically:  1.  Its identification as a major community need within several community forums; 2.  Recommendation by the Hospital Community Advisory Board members that chronic diseases should be selected as a countrywide health priority initiative; 3.  Sullivan County’s extensive and growing geriatric population manifesting high prevalence rates for diabetes, coronary heart disease, congestive heart failure, cardiovascular disease and cancer; 4. High hospital inpatient admission rates at both the Harris and Callicoon campuses for chronic diseases; 5.  Sullivan County Health Indicator Profiles (2003-2007) substantiating high mortality rates for several chronic diseases.
The chronic disease community objectives posed by CRMC will focus upon achieving three objectives by the year 2013 in Sullivan County:  1.  Reducing the prevalence of adult diabetes and hospital complications of diabetes; 2.  Decreasing the age-adjusted coronary heart disease hospitalization rate; 3.  Reducing the congestive heart failure hospitalization rate among adults.

The Hospital has selected mental health and substance abuse as the second health prevention focus.  Mental Health and Substance Abuse were selected as a high public community health priority initiative in Sullivan County because of several factors including:  1.  Consistency with Sullivan County Rural Health Network priority; 2.  Excessive mortality rates during timeframe 2003-2007 from both suicide and cirrhosis of the liver; 3.  Identification of the unmet need for additional mental health services within western Sullivan County outlying communities as well as forums; 4.  Strong recommendation by the Hospital Advisory Committee that mental health and substance abuse should be selected as a County Community Public Health Initiative. 

CRMC’s Mental Health/Substance Abuse Sullivan County objectives will focus on:  1. Substantially reducing the excessive age adjusted suicide mortality rate; 2. Decreasing significantly the age adjusted alcohol and substance abuse hospital inpatient admission rates by 2013; 3.  Reducing the percentage of adult reporting greater than 14 days with poor mental health status to no more than 7.8%.

The Hospital selected access to quality health care as the third project for the multidisciplinary Sullivan County Prevention agenda.  Access to Quality Healthcare was selected based on several considerations including:  1.  Consumer feedback at each community forum; 2.  NYS DOH Prevention Quality Indicator’s data substantiating large number of Sullivan County hospital inpatient admissions for ambulatory care sensitive conditions; 3.  Priority selection by Sullivan County Rural Health Network Members; 4.  Preliminary results and findings from the Consumer community health needs assessment survey questionnaire, documenting needs for additional, accessible primary medical care and dental services;  5.  Documentation of nine rural western and northern Sullivan County communities as both primary care health professional shortage area, as well as medically underserved populations.

CRMC will work closely with Sullivan County Public Health Services and other community health organizations to enhance accessibility to quality health care services.  Together they will address this goal by focusing on these three objectives throughout Sullivan County:   1.  Expanding the percentage of adult residents who have a regular health care provider; 2.  Increasing the percentage of cancer cases diagnosed at early disease stage;  3.  Decreasing substantially from current baseline level of 19%, the proportion of adult residents lacking health insurance coverage.

 

5.  CATSKILL REGIONAL MEDICAL CENTER COMMUNITY SERVICE ACTION ANNUAL IMPLMENTATION PLAN UPDATE REPORT - 2011

CRMC has prepared a three-year Community Services Action Implementation Plan for 2010-2012.  The Action Implementation Plan will focus specifically on long-range solutions to improve the community health status of Sullivan County.  The Plan utilizes the limited available resources to collaboratively implement cost-effective proposals for these public health priority areas. Specifically, the Plan focuses on:  1.  Chronic disease; 2.  Mental health and substance abuse ; 3.  Access to quality health care.

CRMC continues to expand its current chronic disease initiatives.  In 2010, CRMC successfully completed several chronic care initiatives.  CRMC implemented an integrated chronic care disease management initiative focusing specifically on diabetes and cardiovascular disease.  We focused on rural western Sullivan County communities where the sizable geriatric population has higher prevalence rates for both diabetes and cardiovascular diseases according to updated NYSDH prevention quality health status indicators.  Using an approved federal small Health Care Provider Improvement grant, 144 high risk patients with chronic disease were enrolled.  The project substantially increased the proportion of patients with both cholesterol and blood pressure levels within clinically acceptable ranges.  The reduction in high cholesterol and blood pressure levels should enhance western Sullivan County’s community health status through reducing preventable chronic care disease complications.  CRMC’s successful chronic care disease management project was recognized in 2010 through its receipt of two national awards from the federal Office of Rural Health Policy.

In 2011, CRMC has focused on Diabetes education.  CRMC’s Diabetes education team has conducted numerous primary, secondary and tertiary prevention oriented educational programs at both Hospital Campuses as well as many community sites and events. The diabetes education team has attended over 40 events to date in 2011, and have initiated a weekly Diabetes Tip program on the widest reaching local radio station.  

The Medical Center’s Department of Rehabilitation Services continues to present quarterly well-attended community health promotional educational programs focusing on preventing complications from back injuries, arthritis and other frequent chronic disabilities.  The Grover Hermann Community Health Fair, conducted during July 2011, had several hundred attendees who were provided free cholesterol blood screening in addition to community health education on preventing as well as managing chronic disease complications. Furthermore, CRMC staff members have attended more than 10 local events in which they provided blood pressure screenings, reaching more than 500 individuals.

CRMC, as an integral member of the Sullivan County health care delivery system, partners with a large number of community health and human service organizations to provide chronic care prevention services.  The Hospital provides space without remuneration for a large number of community support groups such as the Osteoporosis Support Group, the Diabetes Support Group and the Cardiac Support Group. 
CRMC conducts community health promotion programs focusing on cancer. CRMC receives three grants in support of the Sullivan County Cancer Services Program (CSP).  The CSP provides no-cost breast, cervical and colon cancer screening to eligible low-income, uninsured men and women throughout Sullivan County.  Diagnostic services are also available to individuals who require follow-up testing. In 2010, 148 Sullivan County residents received at least one screening exam through the program, and the team is looking to surpass that number in 2011. In conjunction with the American Cancer Society-Relay for Life, Sullivan County cancer patients are provided cancer research awareness and updates on the scope of services.  During June 2011, CRMC held its annual Celebration of Life Picnic which represents a life-enhancing celebration for cancer survivors; this past year more than 150 participants attended.  

CRMC has selected Mental Health and Substance Abuse as the second component of the three year county community public health prevention agenda.  CRMC has requested NYSDOH start-up capital financial assistance through submittal of a HEAL NY Phase 18 application to enhance behavioral health care services throughout underserved rural Sullivan County.

CRMC’s HEAL 18 project proposal to expand behavioral health care services by establishing a 10-bed MICA inpatient program unit will be an integral component of Sullivan County’s behavioral health care delivery system. The application for the MICA unit is currently pending with the State of New York.  The MICA inpatient program will enhance access to behavioral health care services for Sullivan County’s extensive dual diagnosis patient population. Currently, there are no MICA program services within rural Sullivan County. The nearest MICA inpatient services are located between 32 and 85 miles distance thereby substantially diminishing accessibility.  CRMC’s proposed MICA inpatient program will utilize, as does our ‘939’ designated psychiatric inpatient program, Sullivan County’s community-based behavioral outpatient and ambulatory care services.

CRMC’s HEAL 18 behavioral health care project to establish a 10-bed MICA inpatient unit will address a substantial unmet need for additional inpatient capacity impacting both Sullivan County as well as Hudson Valley regional downstate basis.  As noted within the community needs assessment, CRMC and Sullivan County have been significantly negatively impacted by the closures of psychiatric inpatient capacity within adjacent Orange and Rockland counties.

The establishment of MICA inpatient program services within Sullivan County is completely consistent with Sullivan County behavioral health planning priorities.  CRMC’s MICA program will specifically target severe Sullivan County’s rural extensive and growing dual diagnosis population, the majority of whom are both medically underserved and are either Medicaid recipients or medically indigent without health insurance coverage.  The 10-bed inpatient MICA program will specifically target several underserved populations including:
1. CRMC psychiatric patients with extensive alcohol and substance abuse co-morbidities;
2. CRMC inpatients requiring acute care detoxification manifesting extensive clinical co-morbidities;
3. CRMC psychiatric Emergency Department patients whose dual diagnosis make them more clinically appropriate for MICA rather than psychiatric inpatient admissions;
4. Sullivan County community outpatients requiring a MICA inpatient therapeutic regimen;
5. Orange Regional Medical Center Emergency Department transferring clinically appropriate MICA inpatients rather than directly admitting for psychiatric hospitalization services only.

CRMC has selected access to quality health care as the final component for the three-year priority intervention plan.  CRMC has successfully completed or expanded several initiatives during 2011 to enhance accessibility to quality health care program services. 

Established in late 2010, a primary care practice in rural Livingston Manor situated within the Rockland/Neversink federally designated primary care health professional shortage area has been expanding since it has opened. Through word of mouth, event appearances and marketing efforts, this practice is now seeing 220 patients per month and increasing on an average of 10% per month. A primary care practice in Callicoon also has been growing. This practice gained a new nurse practitioner in January of 2011 and the practice has been growing at an average rate of 10% per month, and now sees an average of 130 patients per month. Both Callicoon and Livingston Manor were both underserved areas that now have primary health care services.

Another major initiative to increase access to quality health care is the renovation, reconfiguration and expansion of the Harris campus Emergency Department.  The Harris campus of CRMC has experienced a 50% increase in emergency room utilization during the last decade which creates, at times, substantial operational inefficiencies.  CRMC is utilizing funding from five major funding sources, including both government grants and private donations for the Emergency Department expansion project.  The Emergency Department expansion will increase access to both emergent and urgent care services to Sullivan County residents.  Funding came from: a Health and Human Services award through Congressmen Maurice Hinchey; a grant from the Dormitory Authority of New York; a HEAL 15 New York State Department of Health Grant; a NYS Member Item Grant from Senator John Bonacic; and a significant donation from a local philanthropist.  The expanded Emergency Department facilities should substantially improve patient throughput while the additional new medical equipment should ensure continued clinical excellence. Phase I of this project, more commonly known as the “new” construction, is slated to be complete in the fall of 2011, and Phase II, more commonly known as the reconstruction of the original Emergency Department, is slated to be completed by early 2012.

CRMC has undertaken a community initiative to improve access to quality health care by improving health care literacy.  CRMC has established its Health Science Library as a Community Health Information Resource Center for Sullivan County consumers.  The Community Health Information Resource Center is open three days/week and staffed with a professional librarian. The librarian assists consumers to identify and procure reference health information in a format readily usable by consumers.  This program has been actively promoted to the community through events, press releases, radio appearances and seminars.

CRMC is very active in the community in promoting access to quality healthcare. Due to a new tracking system, in 2012, CRMC will be able to quantitatively show increases or decreases in the amount of events/seminars staff takes part in. To-date it is estimated that CRMC staff members have attended or showcased the hospital at more than 100 local events. Additionally, CRMC offers many free support groups and no-cost or low-cost classes at the hospital, including: Childbirth Classes; Parenting Classes; Osteoporosis Support Group; Sexual Assault Trauma Recovery and Empowerment Group; Overeaters Anonymous; Bereavement Support Groups; Alzheimer's Group; Cancer Support Groups; Cardiac Support Group; Fibromyalgia; Chronic Fatigue Syndrome Myofasical Pain Support Group; Diabetes Discussion Group; Better Breathers and a Brain Injury Support Group. We are currently working with the Hearing Loss Association of America to bring a Hearing Loss Support Group to the Hospital.

The following are grants and funding that we have received in the past year, or from prior years that have helped us implement our access to quality health care priority:
CRMC receives funding from the New York State Department of Health, Office of Rural Health for both the Harris and Callicoon campuses.  The 2010 and 2011 funding priority for these grants is specifically to enhance access to services for New Yorkers living in rural areas.  In 2010, funding was utilized to purchase equipment, including the CT Scan that is being installed in 2011.  This year, CRMC will be utilizing funding to partially offset the cost of Krames-On-Demand patient education software as well as the building modifications necessary to install the CT equipment at the Callicoon campus and the upgraded MRI equipment in Harris.  The building modifications will allow for enhanced diagnostic imaging services at both hospital campuses.

In addition, CRMC received grant funding from three sources for its RISE (Rape Intervention Services and Education) Program.  The RISE program provides crisis intervention, group and individual counseling to victims of sexual assault and abuse.  RISE advocates also provide prevention education at several school districts within the county.  RISE is very active in the education at local High Schools. RISE funding comes to CRMC through two grants from the NYSDOH and a funding subcontract through the Sullivan County Rural Health Network.

The Callicoon campus received funding through two NYSDOH initiatives that support Critical Access Hospital activities.  First, the Callicoon campus received funding to partially offset the cost of JCAHO and NYSDOH survey readiness through the Small Hospital Improvement Program (SHIP).  In addition the Critical Access Hospital received funding through the Rural Hospital Flexibility Program (FLEX) to host an emergency services/first responder training program.  Both of these programs support Grover Hermann’s ability to provide quality inpatient and emergency services to the residents of rural western Sullivan County.

Finally, through a subcontract with the Sullivan County Rural Health Network (SCRHN), CRMC receives funding for three access-to-care initiatives.  As noted earlier, funding from the SCRHN is used to partially offset operating expenses for the RISE program.  In addition, the subcontract partially offsets operating expenses and equipment purchases at the new Callicoon Family Health Center.  Finally, a small portion of the SCRHN subcontract is used to partially offset the cost of medical language translation services which improves access and quality of care to CRMC’s non-English speaking patients within all CRMC’s departments.

One of the key barriers to implementing the plan is the fact that CRMC is a NYSDOH-designated financially-distressed hospital because of the Hospital’s high proportion of medically indigent patients.  This high proportion of medically indigent patients results in large amounts of bad debt and charity care, and limited discretionary financial working capital for community public health initiatives.  Therefore, the ability to collaboratively resolve these critical Sullivan County community public health initiatives will be conditional and largely predicated upon procuring additional financial resources.  Furthermore, the active participation and ongoing support by Sullivan County Public Health Services as well as other key community health and human service agency stakeholders will be essential for the successful resolution of these issues.

In addition to hospital sponsored programs, projects and activities, the culture attracts or fosters individual community leadership and service in community civic, political, educational and social welfare organizations promoting literacy, reducing child abuse and family violence, promoting participation in ambulance corps, economic development and beautification, and other efforts contributing to building a healthy community.  CRMC’s senior management and department heads participate on numerous community boards and organizations as an integral component of providing service to the greater Sullivan County community.  During 2011, CRMC leadership staff actively participated in the Sullivan County Partnership for Economic Development, Sullivan County Rural Health Network, Sullivan County Community Services Board of Directors, Sullivan County Chamber of Commerce, Sullivan County Lions, Catskill-Hudson Area Health Education Executive Committee, Sullivan County Rotary and New Hope Community Residential Center.  The ongoing extensive leadership involvement is a testimonial to CRMC’s commitment toward achieving Sullivan County’s community health status and furthering critically needed economic development infrastructure.

 

6.  DISSEMINATION OF REPORT TO THE PUBLIC

CRMC recognizes that broad-based dissemination of our updated Community Services Plan is critical for insuring feedback from both Sullivan County consumers and health care providers.  We have utilized several different vehicles for making our updated Sullivan County Community Services Plan readily available to consumers as well as key governmental and provider stakeholders.  A press release announcing the availability of CRMC’s Community Services Plan was prepared and sent out by the Director of Public Relations and Marketing.

Copies of CRMC’s 2011 updated Community Services Plan were disseminated to:
1.  Local newspapers for distribution; 2. CRMC’s Health Information Library which is widely utilized by both Sullivan County consumers and health care providers. 3. Notice will be put into the quarterly CRMC newsletter.

Furthermore, CRMC has posted an updated copy of the Community Services Plan on the Hospital Web site.  CRMC’s Community Services Plan has an easily identified listing on the Hospital’s home page. The Community Services Plan is widely viewed by the Sullivan County public as reflected on data indicating there was an average of 95 individuals viewing that page per month during 2011 ranking it CRMC’s 15th most popular web page.

 

7. CHANGES IMPACTING COMMUNITY HEALTH/PROVISION OF
CHARITY CARE/ACCESS TO SERVICES

CRMC has several additional strategic planning initiatives which supplement the Sullivan County public health priorities. 

Having received final approval last year, CRMC’s active participation within the Greater Hudson Valley Health System will generate several, substantial health care advantages for Sullivan County residents including specifically:
1. Enhanced accessibility to medical and surgical specialty services presently unavailable;
2. Clinical best-practice benchmarking opportunity to further improve hospital quality of services and generate operational economies of scale;
3. Facilitating enhanced coordination of hospitalization services;
4. Accessibility to a broad range of specialized administrative and financial expertise;
5. Capability of developing an integrated regional health care delivery system including implementation of an electronic medical record.

One major initiative currently underway is the renovation, reconfiguration and expansion of the Harris campus Emergency Department.  The Harris campus of CRMC has experienced a 50% increase in Emergency Room utilization during the last decade which creates, at times, substantial operational inefficiencies.  CRMC has been awarded several NYS and federal grants which will be supplemented by generous private donor philanthropy to construct an upgraded state-of-the-art Emergency Department facility.  The expanded Emergency Department facilities should substantially improve patient throughput while the additional new medical equipment should ensure continued clinical excellence. This initiative could also fall under the “access to quality health care” priority category as the square footage and number of rooms has more than doubled. Phase I of this project, more commonly known as the “new” construction, is slated to be complete in the fall of 2011, and Phase II, more commonly known as the reconstruction of the original Emergency Department, is slated to be completed by early 2012.

Additionally, the Grover Hermann Rural Critical Access Hospital has been expanding its Bridge to Home Rehabilitation Program Initiative during the last two years.  The program is specifically designed to provide short-term intensive rehabilitation services to discharged hospital inpatients.  The Bridge to Home Rehabilitation program was developed to provide a bridge between acute care hospitalization and home.  The Bridge to Home Rehabilitation program has specifically targeted western Sullivan County’s extensive and growing geriatric population.  There are presently no long-term care facilities within 25 miles of western Sullivan County, substantially diminishing accessibility to short-term rehabilitation services for frail elderly individuals.

However, state and federal cuts impacting CRMC could substantially diminish accessibility to high caliber medical services for medically underserved Sullivan County residents.  It is critical to recognize that these decreases to Medicaid and Medicare funding for NYS hospitals including CRMC will have detrimental impacts on all patients, not just elderly and low-income individuals. The financial cutbacks will seriously impact negatively on CRMC’s future capability to provide Sullivan County with current medical technology as needed.  Moreover, reimbursement cutbacks could preclude CRMC from having sufficient financial resources to fulfill many of the critical Sullivan County community health initiatives and priorities identified within our Community Services Plan.  CRMC will be working closely with community residents throughout Sullivan County to explain the serious implications from Medicaid and Medicare reimbursement cutbacks of such a large magnitude.  Furthermore, CRMC will continue to work collaboratively with the Sullivan County Health Department as well as local health and human service agencies to identify discretionary financial resources to resolve identified community public health priorities.

     
8. FINANCIAL AID PROGRAM

CRMC offers financial assistance to all patients that do not have medical coverage or non-covered benefits. Financial Counseling is available to the patients, focusing on applications for Medicaid or Medicaid HMO's in the high dollar services such as Inpatient, Ambulatory Surgery and Oncology. If denied or not eligible for any of the Medicaid programs, the patient is directed towards the Hospital Financial Assistance Program. Applications are available to all patients, including the Callicoon campus and the Emergency Room, that live within primary and secondary service areas defined by zip code.The Financial Assistance Program has grown considerably in the past year, due in part to the program’s advertising and the employment status of the community. Signage has been put up throughout the Hospital system promoting the service in English and Spanish.

This policy was adopted to ensure that charitable care services are provided first to those patients without available health insurance coverage.    All patients lacking health insurance coverage will receive a substantial discount (53.5%) from current Hospital changes. This policy, consistent with both AHA and HANYS recommendations, is designed to ensure that patients without health insurance pay fees approximating Federal Medicare reimbursement rates.  CRMC is anticipating during the next year modifying its financial assistance program to charge Medicare rates for medically indigent individuals lacking health insurance coverage.

 Furthermore, patients with limited financial assets and household income (lower than 300% of the current federal poverty level) are eligible for an additional discount based on income in accordance with our sliding fee schedule.

Primary and secondary service area zip codes for eligibility were based on Sullivan County demographics, coupled with updated CRMC demographics.  The primary and secondary service areas encompass all fifteen Sullivan County townships, as well as adjacent communities in Wayne County, Pennsylvania and Ellenville within southwestern Ulster County where CRMC receives a significant number of inpatients for medical and surgical specialty services.

An installment plan has been developed and implemented to enable hospital patients to minimize the short-term financial impact from hospital payments.

CRMC will periodically review and update the Financial Assistance Policy and Guidelines on an ongoing basis. The Hospital anticipates that the declining economy and rising number of uninsured Sullivan County residents will substantially increase CRMC’s bad debt, as well as its charitable care requirements. The Hospital’s commitment to meet the ongoing substantive charity care contributions and additional bad debts substantiates CRMC’s compliance with its Mission and its willingness to serve all clinically appropriate patients including Sullivan County’s medically indigent who are lacking health insurance coverage.

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Copyright © 2012 Catskill Regional Medical Center
A member of the Greater Hudson Valley Health System