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Serving the communities of Jefferson, St. Lawrence and Lewis counties, New York
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State Health Commissioner Dr. Nirav R. Shah has empaneled a commission charged to “create an effective, integrated health care delivery system for preventative, medical, behavioral and long-term care services to all communities throughout New York’s north country.”

Charged with providing its recommendations by March 30, the commission is off to a terrible start.

n A third of its members are elected officials with no apparent health care delivery experience. And the announcement didn’t even spell state Sen. Patricia A. Ritchie’s name correctly.

n The western half of the north country — Jefferson, St. Lawrence and Lewis counties — have only two nonpolitical members, both of whom are qualified for the job.

n The eastern half of the north country — the corridor from Plattsburgh to Saratoga Springs including the Adirondacks — has seven nonpolitical members.

n The expertise of some of the appointees is questionable. The elected officials will face voters in a year, and the last thing they will be interested in is long-range consolidation and efficiency. There are two eastern north country bank officers. This is not a banking issue. The North Country Chamber of Commerce executive director has no ties to the western half of the north country other than through the Regional Economic Development Council. His organization is Plattsburgh and Clinton County centric.

No hospital medical care delivery systems from Jefferson, Lewis or St. Lawrence County are represented. But from the east side, the Hudson Headwaters Health Network — the well-heeled area near high society Saratoga County — has a seat.

The western north country voices with health care delivery experience are limited to Denise Young from the Fort Drum Regional Health Planning Organization and Tedra Cobb, a health care consultant in Potsdam. And in the case of Ms. Young, the announcement did not even correctly identify the organization she leads.

The leadership of the commission is entrusted to Daniel Sisto, past president of the Hospital Association of New York State; Arthur Webb, a health care system consultant headquartered in Brooklyn; and Dr. John Rugge of the Hudson Headwaters Health Network.

It is distressing to think that the fate of the north country health care delivery system will be entrusted to a consulting group from Brooklyn where the health care system is essentially in disarray with bankrupt hospitals, political interference, missed debt payments and residents in need of medical care seeking help at facilities in Queens, on Long Island and in Manhattan.

It is concerning that the most experienced provider of health care appointed to the commission represents the well-to-do area encompassing portions of Saratoga, Washington and Warren counties, entities that face few or none of the issues burdening Jefferson, St. Lawrence and Lewis counties.

Given the makeup of the commission and Mr. Webb’s presence, one would guess that an outline of the final plan has been drafted by a consultant such as Mr. Webb. The commission will then be asked to ratify those recommendations.

The western half of the north country has some of the highest unemployment rates in the state. And it contains Fort Drum where nearly all health care is delivered by community facilities, not the Department of Defense heath care system. We have extraordinary demands from soldiers suffering from repeated long-term deployments to the war zones of Iraq and Afghanistan.

The region has fared reasonably well recently because of the Fort Drum Regional Health Planning Organization. The designation of this region as a health planning region was encouraging. Instead of being linked to neighboring disparate large regions, we are receiving direct attention from the state, which also has been funneling planning aid to the hospitals to prepare to deliver the services needed to satisfy our marketplace.

Despite that progress over the last couple of years, we still have several very challenged hospitals.

The Edward John Noble Hospitals of Gouverneur and Alexandria Bay have failed and are re-emerging as health care clinics. The Carthage Area Hospital has been struggling to survive, and it faces the fact that its key doctors are nearing retirement age with dim prospects for attracting new practitioners to treat patients. The North Country Children’s Clinic is being kept alive by Samaritan Medical Center while the state helps develop a long-term business model that can succeed.

We have a stressed medical system. We have hundreds of doctors, nurses and technicians who deliver services to sick Northern New Yorkers. Yet we have too many buildings, too many duplicated services and a lack of administrative cost sharing and coordination.

To combat this growing malaise, the health commissioner has appointed a commission that seems ill prepared to set a realistic course for tomorrow in our counties. The commission appears to need immediate resuscitation.

Dr. Shah can breathe some life into the commission with the appointment of additional members whose qualifications include health care delivery experience learned in Jefferson, St. Lawrence and Lewis counties. And we really don’t need any help from Brooklyn consultants.

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