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Health Equity and Disparities in Outpatient Services and Referrals by Academic Medical Centers

To gather information on the subject

New York City

May 10, 2012
10:00 a.m.
Assembly Hearing Room
Room 1923, 19th Floor
250 Broadway

Concerns have been raised that academic medical centers refer low-income or uninsured patients to outpatient clinics staffed by residents, while higher-income patients and those with private insurance are referred to faculty practices which contributes to health care disparities and outcomes.

A June 2008 civil rights complaint by New York Lawyers for the Public Interest, on behalf of Bronx Health REACH, filed with the State Attorney General, alleged that three academic medical centers in New York City discriminated on the basis of payer status and race in their patterns of referral for outpatient services. There was no action on the complaint.

The Medicaid Redesign Team's Health Disparities Work Group final report issued on October 20, 2011 recommended that administrative actions be taken by the New York State Department of Health to assure that the health care delivered by academic medical teaching facilities to persons who are uninsured, to people covered by Medicaid, and to people who are privately insured is comparable and meets the same standards of care.

Legislation on this issue has been introduced which would make separate and unequal care a violation of the Public Health Law. The current legislation by Assembly Member Nelson Castro (A.7699-A) would require academic medical centers to provide outpatient specialty care in an integrated setting staffed by both attending physicians and residents. These integrated practices would be required to treat all patients regardless of insurance type or source of payment.

This hearing will review disparities in health care access and outcomes relating to hospital outpatient care. The Committee is interested in comments and recommendations relating to A.7699-A.

Persons wishing to testify at the hearing or planning to attend the hearing should complete and return the enclosed reply form by Monday, May 7. It is important that the reply form be fully completed and returned so that persons may be notified in the event of emergency postponement or cancellation of the hearing.

Oral testimony will be limited to 10 minutes' duration. In preparing the order of witnesses, the Committee will attempt to accommodate individual requests to speak at particular times in view of special circumstances. These requests should be made on the attached reply form or communicated to Committee staff as early as possible.

Ten copies of any prepared testimony should be submitted at the hearing registration desk. The Committee would appreciate advance receipt of prepared statements.

In order to meet the needs of those who may have a disability, the Assembly, in accordance with its policy of non-discrimination on the basis of disability, as well as the 1990 Americans with Disabilities Act (ADA), has made its facilities and services available to all individuals with disabilities. For individuals with disabilities, accommodations will be provided, upon reasonable request, to afford such individuals access and admission to Assembly facilities and activities.

Hon. Richard N. Gottfried
Member of Assembly
Committee on Health


Persons wishing to present testimony at the public hearing on Health Equity & Disparities in Primary Care Referrals by Academic Medical Centers are requested to complete this reply form as soon as possible, but no later than Monday, May 7, email or fax it to:

Estibaliz Alonso
Senior Legislative Analyst
Assembly Committee on Health
Room 520 - Capitol
Albany, New York 12248
Email: alonsoe@assembly.state.ny.us
Phone: (518) 455-4371
Fax: (518) 455-4693
I plan to attend the public hearing on Health Equity and Disparities in Outpatient Services and Referrals by Academic Medical Centers to be conducted by the Assembly Committee on Health on May 10, 2012.
I plan to make a public statement at the hearing. My statement will be limited to 10 minutes, and I will answer any questions which may arise. I will provide 10 copies of my prepared statement.
I will address my remarks to the following subjects:

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