Guthrie is pursuing plans to establish its own certified home health agency in Tompkins County, however its project has drawn debate in a regulatory committee and in the health care community.
The Guthrie Clinic of Sayre, Pennsylvania, applied for a Home Care License in Tompkins County with plans to establish a visiting nurse service similar to the Visiting Nurse Service of Ithaca and Tompkins County. Although the first attempt at acquiring the license was not approved at a meeting hosted by the New York State Department of Health, Public Health and Health Planning Council Project Review Committee on May 13, Guthrie officials made it clear they will continue to pursue the project.
Health care professionals in Tompkins County are concerned that Guthrie will not bring staff and will have to recruit from Tompkins County, which would destabilize providers, affect staffing, and would thus affect already present services. In addition, they say the costs for these services would increase.
“Providers in our area have a long history of collaboration,” said Sue Ellen Stuart, director of Visiting Nurse Services. “It’s very bothersome Guthrie didn’t come to talk with any of us for collaboration. We would be willing to collaborate.”
Cayuga Health collaborates with various organizations, like Visiting Nurse Services (VNS), throughout Tompkins County and beyond to manage the care of more than 50,000 attributed lives, or about 50% of the Tompkins County population, according to Dr. Martin Stallone, president and CEO of Cayuga Health.
“The application submission by Guthrie only covers approximately 600 attributed lives in home health care and the need in our community is far greater,” Stallone said in a press release. “Without VNS, those 50,000 lives are at risk of experiencing declining patient care access and management, patient health outcomes, cost-effectiveness in the use of health care services and community population health.”
Stallone continued: “I believe this project will negatively impact the residents of Tompkins County.”
In the committee meeting, Guthrie stated its position that it would improve the quality of care in Tompkins County.
“We do not anticipate drawing from other counties or Tompkins County per se employees, or we do not anticipate it being a burden to pull healthcare workers away from other organizations in those counties,” said Jeffrey Jenkins, a registered nurse and senior director of post acute care who was one of three people who spoke on behalf of Guthrie during the committee meeting. “We do have our own employees at this point, and we would transition once that closure plan was completed and accepted and we develop a plan to ramp up our (certified home health agency).
Some committee members were concerned about Guthrie’s plans.
“A large health system coming into a community and controlling the entire health care delivery system at the expense of nonprofits that have been serving that community for years, and successfully doing so, and the premise that you can’t work with a local nonprofit who’s successfully been supporting that community for years — I disagree with,” said Scott LaRue, a member of the Committee on Public Health. “You can, if you want to. People have reasons why they select local nonprofit providers and there has to be a space in the community for them.”
“I am very troubled by what I see is a lack of commitment to collaboration,” committee member Ann Monroe said.
However, another committee member, Dr. John Bennett, said competition should be encouraged.
“I think that one of the problems we have to remember is that while he rightly argues the dominance by a larger health system in a community, I don’t know that the alternative if we restrict competition to allow the local smaller community to dominate is any better a monopoly,” Bennett said during the meeting. “And I think we have to be mindful that competition is valuable.”
Bennett argued for carefully regulated competition.
“I think I have seen too many small communities where the local hospital or system has in essence total monopolistic power and it doesn’t lead to innovation, and it doesn’t lead to higher quality and it doesn’t lead to lower cost,” Bennett said. “Can the larger systems do better? I think we need to give them an opportunity to show. The winner should be the results … I think it’s our role to get the playing field level and let the best person win.”
Bennett supported the application.
“We can’t continue to use our regulatory authority to support organizations that aren’t successful,” Bennett said. “If the (certified home health agencies) are not successful it may be because their business model is not meeting the needs of the citizens, and what this represents is an opportunity to innovate around that.”
He continued: “And I think if we’re going to make progress in health care, we can’t keep supporting failing models. We have to allow for innovation and competition. It is absolutely essential.”
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