Thomas Breen photo
54 Meadow St., the home of the city health department.
City Public Health Director Byron Kennedy pitches alders for extended hours and operations for public health clinic.
Does the city need to run its own public health and urgent care clinic for 12 hours a day, seven days a week, at a time when area providers are already working to consolidate their own primary care services independent of city involvement?
New Haven Public Health Director Byron Kennedy faced that question as he pitched skeptical and supportive alders alike on the necessity of extending the hours and operations for the city’s current public health clinic, which operates out of the department’s offices at 54 Meadow St.
His testimony came towards the end of a five-plus-hour Finance Committee workshop held Tuesday night in the Aldermanic Chambers on the second floor of City Hall about the mayor’s proposed $547.1 million budget for the fiscal year that starts July 1.
In a budget rife with service cuts and a proposed 11 percent tax hike, Public Health is one of the city departments looking to substantively increase its scope of operations. The department’s proposed general fund budget includes a $468,002 increase in its “Other Contractual Services” line item.
This money, Kennedy explained, would go towards extending the current public health clinic’s hours from 35 hours a week, or 7 hours a day on weekdays only, to 84 hours a week, or 12 hours a day on both weekdays and weekends.
Kennedy said that the extended hours will allow the clinic to cast a wider net with its current range of services, including well-child visits, sexually-transmitted disease (STD) testing, rapid HIV testing, and follow-up care for residents who have contracted tuberculosis.
The department’s proposed budget also includes $250,000 in capital fund requests to bolster the clinic’s current offerings with a new digital X‑Ray system, teleradiology capabilities, and electronic health records.
Kennedy said that he expects the clinic to pay for itself after its second year of expanded hours and operations. He said the clinic currently sees around 10 to 16 patients per day, and brings in around $100,000 in revenue each year.
He anticipates that the clinic will bring in upwards of 66 patients a day and over $2 million in annual revenue five years into its extended services.
East Rock Alder Anna Feta (at right in photo) questions the proposal.
East Rock Alder Anna Festa questioned the necessity of increasing the hours and services for the city’s clinic in what she saw as a crowded field of urgent care clinics.
“We have a lot of urgent care facilities popping up everywhere,” she said. “How does this differ from those?”
Kennedy said that New Haven, in fact, does not have any true urgent care facilities, according to industry standards set by groups like the Urgent Care Association of America. He said that “minute clinics” at Walgreens and even neighborhood clinics like Cornell Scott Hill Health Center may treat sore throats and flu symptoms, but do not offer EKGs for patients experiencing chest pain or X‑Rays to rule out pneumonia or a fracture.
Kennedy.
He noted that most ambulatory care centers are not located in inner cities, but rather in suburbs, where there tend to be wealthier populations with a greater proportion of commercial insurance coverage.
Kennedy also said that the city’s clinic will focus on public health concerns, such as child vaccinations and STD testing, as opposed to hyper-specialized care like neurosurgery.
“The demand is really there for this?” Festa asked. “For extending hours? If my kid is sick, I’m going to take them there during work hours. If I need an X‑ray, I’m not going to work; I’m going to the clinic. I’m trying to understand where the demand is for the extended hours” for weekday nights and weekends.
Kennedy said that he expects foot traffic to increase significantly with extended hours, particularly as the department plans to spent $5,000 a year advertising its services.
He said that 80 percent of primary care visits are scheduled, and that the city’s clinic serves a population that does not have the time or the ability to meet regularly with a primary care physician, needs urgent care, but whose condition is not severe enough to warrant going to a hospital’s Emergency Department (ED).
“You don’t schedule for your child to have a sore throat,” he said. “You don’t schedule for a child to roll their ankle while playing soccer.”
West River Alder Tyisha Walker-Myers.
West River Alder Tyisha Walker-Myers quizzed Kennedy on why the city is not partnering with Yale-New Haven Hospital (YNHH), the Fair Haven Community Health Center, and the Cornell Scott Hill Health Center in their proposed consolidation of primary care facilities on Long Wharf Drive.
“Why weren’t you a part of that conversation,” Walker-Myers asked, “if we’re talking about efficiency, about cutting down the rate that people use emergency rooms, about developing real comprehensive care around residents? I believe that some of the residents that you see at your health center also have doctors at these health centers as well.”
Kennedy said his department was rebuffed when it asked to participate in that consolidation project.
“I had heard from some of my colleagues that some of those discussions were going on,” he told the alders, “and we had asked inquiries about being involved in those discussions, and we were politely told: No.”
Westville Alder Adam Marchand said that he was initially skeptical of the proposal, but is more and more convinced for the need to have a public health clilnic and urgent care center that is not a “minute clinic” and that, unlike the Yale Health Center, is open to the New Haven public.
He asked Kennedy if his department had at least spoken with primary care providers at Yale, Fair Haven Health, and Cornell Scott Hill to gauge their opinion on the proposed city clinic expansion. Kennedy said that he has not engaged in any formal conversations on that topic with other providers.
Dixwell Alder Jeanette Morrison praises the proposed expansion of the city’s public health and urgent care clinic.
Dixwell Alder Jeanette Morrison, on the other hand, had nothing but praise for the proposal. She said that she is tired of recommending that friends go to an urgent care center and then not being able to point any out in the city proper.
“This kind of program I think will really be helpful to inner cities,” she said. “And you’re right, there are no urgent care facilities in New Haven. I just wanted to go on record and tell you that I think this is going to be very helpful for our community, and help us save money, because when you go to the hospitals, that’s big costs. I just wanted to say thank you for having this.”
The Board of Alders must approve a final version of the budget by the first week of June.
The next public budget hearing, during which the Finance Committee will hear testimony from the public about the budget, is on Wednesday, April 4, at 6 p.m. in the Troup School at 259 Edgewood Ave.