Boerum HIll AssocIAtIon Brooklyn HeIgHts AssocIAtIon

cArroll gArdens neIgHBorHood AssocIAtIon

coBBle HIll AssocIAtIon rIversIde tenAnts AssocIAtIon
Wyckoff gArdens AssocIAtIon, Inc.
SUNY/LICH Community Health Forum Presentation March 3, 2014
We would like to thank suny and Board of trustees for hosting this community Health
care forum. We welcome the opportunity to discuss the needs of the roughly 300,000
residents in the catchment area of long Island college Hospital. this area includes some
of the most affluent communities in Brooklyn: cobble Hill, Brooklyn Heights, carroll
gardens and some of the fastest-growing neighborhoods in the city like the exciting
community springing up around the gowanus canal, the new residential towers in
downtown Brooklyn and Brooklyn Bridge Park, as well as the very large residential
populations in red Hook, gowanus, and Wyckoff public housing. All of our neighborhoods
share a strong desire to attract the best possible health care provider in this historic location
and all share a single objective: excellent medical services in a full-service hospital. so,
rather than speak in terms of needs, we would like to speak to the opportunities that we
see for potential operators.
Let's look at the population and communities served by LICH.
first, the physical facility is located in the center of Brooklyn's affluent Brownstone belt.
some of Brooklyn's wealthiest residents call Brooklyn Heights, cobble Hill, and Boerum
Hill home. these communities are consistently rated as having the best residential quality
in all of new york. Property values are among the highest in the city and retained their
value when almost all other communities across America lost value after the financial crisis
of 2008. Individual brownstone properties in the immediate vicinity of lIcH are now
selling in the $5 to $8 million range. It would be fair to say that this area's per capita
health care expenditures are some of the highest in the world and that this group represents
a major marketing opportunity for an operator that is prepared to address and serve the
needs of this group.
second, we are a growing community. from red Hook to gowanus and downtown
Brooklyn to Brooklyn Bridge Park, new residents are moving in at a pace that has not
been seen for many years. residents are moving to brownstone Brooklyn from all over
America and all over the world. this growth consists predominantly of younger families
attracted to our vibrant communities, excellent schools, cultural attractions, well-maintained
parks, and proximity to business and shopping opportunities in manhattan, located just
one subway stop away for many. this population growth is particularly evident in the
number of young children now populating our commercial streets. neighbors now speak
of "stroller jams". All of our businesses book stores, clothing stores, and restaurants
that cater to this youthful population explosion are experiencing major growth. the economic

desirability of our neighborhoods is evident in the rapidly increasing rents on all of our
major shopping streets. this rising trend is true throughout the entire lIcH catchment
area. red Hook and gowanus are now two of the fastest-growing communities, with
major new retailers like Ikea, Whole foods, and fairway providing a major boost to the
local economy, employment, and residential quality of life. the prediction of 40,000 new
residents in downtown Brooklyn by 2020 may, in fact, be a conservative estimate.
over the past decade, downtown Brooklyn and its surrounding residential communities
have become the fastest-growing, most dynamic residential hub in the entire new york
metropolitan region. every indication shows that this upward trend is going to continue
for the forseeable future. We believe that access to top-quality health care is critical to
sustaining this growth.
What do we think it will take for you to succeed in our community?
first, for excellence in medical services, the medical and nursing staff and the physical
facility are prerequisites to success. our residents have access to the finest medical facilities
in the world but have a strong desire to seek providers located near their homes, so it is
imperative that the highest standard of excellence and quality of care be offered. It is critical
to recognize the competitive environment and to calibrate the level of services based
upon the what the market demands. Previous operators have violated this first and most
important law of supply and demand to their peril.
next, focus on the youngest and oldest members of our community. this has proven to
be an effective strategy for success in cobble Hill. the lIcH catchment area contains
some of the largest concentrations of children of any census tract in America. It is critical
to recognize the importance of this market and how critical serving them will be to your
success in this market. centers for excellence in Pediatrics, oB/gyn and all services relating
to children and teens are essential, strongly desired and will be heavily used. the Pediatric
emergency room is an example of how catering to this segment of our population will
help attract and retain a loyal patient base. A children's hospital, a full-service Peds
clinic,and even private doctors' offices for pediatric specialties would all be embraced by
our residents.
for many of our residents in the red Hook and gowanus Houses critical health care access
issues that must be addressed include: diabetes, High Blood Pressure, respiratory
(Asthma from the mold in nycHA), dental care and reproductive services in addition
to community education and training to insure better health care education, access and
treatment. maintaining out patient services for community members who depend upon
them is essential.
lIcH also has 12 state-of-the-art operating suites, a linear accelerator, cAt scan and mrI
machines that are in demand for cardiac, orthopedic and stroke-related surgeries.
then, become a part of the community! lIcH is located in one of the most exciting,
dynamic multi-cultural communities in the world, one that is prepared to work for and
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support institutions that they see as part of their community. We are creative, we are
loyal and we are prepared to fight for what is important to our children, our families, our
seniors and our hospital! We have fought for lIcH again and again and we will fight for
you but only if you embrace our communities, treat us with care and respect, and accept
us as your partners. many years ago, we developed a simple but successful formula: what's
best for lIcH is best for the community, and what's best for the community is what's best
for lIcH. neglecting this simple rule has proven to be catastrophic, but following it is easy
(and we will help you every step of the way). It is a business plan that is guaranteed to
succeed.
How viable is LICH?
there's ample evidence that lIcH can be viable with the right operator working with the
community. lIcH was in the black as recently as the first quarter of 2011 according to its
last pre-suny ceo. According to new york state controller thomas dinapoli's January
2013 audit of suny downstate, lIcH's total operating losses for 2010 were only $4.7 million. more recently, Justice carolyn demarest of Brooklyn state court concluded in her
decision and order of August 20, 2013, "suny-downstate's actual losses attributable to
lIcH approximate $30 million dollars at this time."
the daily news reported on January 24, 2013 that lIcH's staffed beds were nearly full:
"the number of staffed beds is about 260 and on average 237 per day or more than 90%
of them were in use last year".
the laws of supply and demand favor lIcH. As suny's April 20, 2011 verified petition
to the court stated, "kings county, where lIcH is located, has a relatively low hospital
bed per 1,000 population ratio. there are 6,408 certified hospital beds in kings county,
which yields a ratio of 2.51 hospital beds per 1,000 population. [...] In comparison, new
york state has a ratio of 3.30 hospital beds per 1,000 population." there simply are not
enough hospital beds for Brooklyn's exploding population.
Why do we strongly favor a full-service hospital?
We know that you are all aware of our year-long battle to save our hospital, but you may
not be aware of why this is so important to us. first and foremost, we believe that a fullservice hospital large or small is essential for providing life-saving emergency and
acute care. We have thoroughly investigated existing "stand-alone emergency rooms"
and urgent care centers and we do not believe that this concept will provide the scope
of critical care services that are sufficient to serve a population that includes downtown
Brooklyn and a major swath of Brooklyn's brownstone belt. second, we are convinced
that stand-alone er's don't work for pediatric cases, and the same applies for the elderly.
Apart from a stand-alone er being only a stepping stone for seriously ill patients, the
choices of which hospital where a patient would be sent are inadequate or unacceptable.
At a very minimum the choice should be that of the patient. However, every additional
step in care transitions, creates more opportunities for error and miscommunication. We
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are absolutely convinced that neither a stand-alone er or an urgent care center will provide
sufficient protection for our residents nor will be insufficient to sustain the economic
growth of our region. governmental and business leaders have been rightfully proud of
the tremendous prices luxury condos bring in our community, but will this growth be
sustainable if there is a perception that there is insufficient medical service? We strongly
believe that the answer is no. no matter how wonderful the harbor views are, they
cannot make up for a lack of basic life saving services.
A few words about the Cobble Hill Health Center.
you know of our battle to save our hospital, but you may not be aware that it is just as
much a battle to preserve and protect the cobble Hill Health center. lIcH has been a
mainstay for the sole remaining major health care provider in cobble Hill the cobble
Hill Health center which provides services for rehabilitation, homecare and long term
nursing to our aging residents. this institution is one of the area's major successes and up
until a year ago, half of the residents at cobble Hill came from lIcH. lIcH provided
safe, nearby support for the elderly in need of emergency care, too. the cobble Hill
Health center's success should be the model for the new lIcH operator's success.
the elderly need access to primary care physicians and specialty services that would include:
cardiology; gastroenterology; Pulmonary; urology; orthopedics; cancer services; dialysis;
Psychiatry and Behavioral Health services; and diagnostic imaging. services to patients
with Alzheimers disease and related disorders and their family caregivers are seriously
inadequate. A diagnostic and treatment center would be an invaluable additional resource.
Where admission to acute care is unavoidable the following services are essential: coronary
care, intensive care, medical/surgical, physical medicine/rehabilitation, and palliative
care. Having geriatricians on staff can significantly enhance hospital in-patient services.
the above mentioned specialty care services also need to be available for in-patient care.
some of the previous proposals indicated that they would operate a free standing emergency
room and that patients requiring hospital services would be transferred to a neighboring
hospital. It is important to understand that for a geriatric patient to be admitted to an
emergency room is a traumatic experience. If the patient is taken to the er to be stabilized
and is then required to be transferred again to a hospital located elsewhere for in-patient
care, this doubles the trauma and increases the possibilities for poor transitions of care.
In conclusion...
We deeply appreciate that you are here today to listen to us. the opportunity to share our
concerns, our needs and our goals is a rare opportunity that few communities have ever
had. We thank suny, the suny trustees and all of the elected and governmental officials
who have made this meeting possible.

Key Facts:

lIcH, a teaching hospital founded in 1858, serves one of the fastest growing residen-

tial and commercial neighborhoods in new york city:

With approximately 110,000 residents (statistics are from government sources, unless
noted), the area (zip codes 11201 and parts of 11231 and 11217) is swelling with young
families: children under 9 years old have increased by 31% in Brooklyn Heights and
cobble Hill since 2000.

four public housing projects with over 13,400 residents are here.

the cobble Hill nursing Home, serving 1150 home and adult day care patients and
365 resident nursing and rehabilitation patients, is lIcH's next-door neighbor.

seven colleges and universities educate 40,000 students in the neighborhood -- more
even than cambridge, massachusetts.

the downtown office population is soaring, with 70,000 workers in metro tech.

dumBo, home to the city's burgeoning high-tech industries, has 9,600 employees in
500 companies and projected to rise to 17,900 by 2015.

the area draws thousands of employees, lawyers, litigants, and jurors to the nys and

federal courthouses; shoppers and tourists crowd the Atlantic center, fulton mall, smith
street restaurants and Brooklyn Bridge Park; and at night, 17,000 fans pour into the new
Barclay's center.

there is no precinct in the Brooklyn with more terrorist sites than the 84th, which
includes two bridges, the headquarters for the nyc fire department and the nyc transit
Authority, the 911 center, the nyc office of emergency management, courts, two
mosques, and several synagogues.

lIcH had the second best payer mix in Brooklyn with 32% of patients covered by private
insurers, 65% by medicare and medicaid, and only 2.5% uninsured in 2010. residents in
lIcH's 11201 zip code are among the city's most affluent with an average household
income of $114,165 in 2012, compared to $58,030 in kings county overall.

contrary to downstate's public statements that local residents don't use the hospital,
fully 50% of lIcH patients reside within 2 miles of the hospital.

downstate, listed lIcHs total operating losses for 2010 at $4.7 million, and Judge
demarests August 2013 decision and order stated that suny-downstates actual
losses attributable to lIcH approximate $30 million dollars at this time. this is far cry
from the hundreds of millions suny Board members have claimed in the press. think of
what a good hospital operator could achieve given the wealth of patients, workers and
visitors to the area each day!
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