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Healthcare

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By Fr. Francis Pizzarelli

Father Frank Pizzarelli

It’s hard to believe that schools in our community  pare opening in a few weeks. Our school administrators, school boards, school support staff and teachers are working overtime to create safe, responsible learning opportunities for all of our students.

Every school community has a unique profile based on economics, size and cultural diversity. As community members, we need to urge caution, respect and responsible and doable planning based on each of these unique profiles.

For more than 40 years I’ve been privileged to be actively engaged in both public and private education as a school administrator, junior high and senior high school teacher, and undergraduate and graduate school professor in the area of social science and clinical social work. Our schools are the heart and soul of our communities. This pandemic has impacted them in more ways than many of us fully realize.

If we listen to our students on every grade level, lack of socialization and human interaction has been devastating for so many. Many traditional social experiences from senior proms to graduations were canceled for the class of 2020. For the class of 2021, many fall sports have been canceled and/or postponed.

Our students continue to get a mixed message regarding some of the very basic healthcare provisions that are critical and that we all must practice if we want to protect ourselves and others and reduce the spread of this virus.

As we scurry to get ready for a new school year, there is another vital resource for students that might not receive the support it needs, especially with so many schools facing economic issues and cutbacks due to the pandemic. So many of our students at all levels are reporting increased stress, anxiety and depression. They admit they do not have the coping skills to manage.

Unfortunately, during these tough economic times, we too often cut services that support our students psychological and emotional needs. I feel compelled to give voice to this issue. As a veteran educator and licensed clinical social worker who runs a mental health clinic in our community, I can attest firsthand that mental health services are desperately needed both in our schools and in our community. Our outpatient clinic has a waiting list that is growing every day.

Our two community hospitals have been heroic at the way in which they have responded to this pandemic with compassion and competence. What very few people realize is that John T. Mather Memorial Hospital in Port Jefferson is the only local hospital that provides comprehensive mental health services. St. Charles Hospital is the only hospital in our area that provides competent, comprehensive detox and residential rehabilitation services for drugs and alcohol.

The issue that no one wants to address, including the people who lead us, is that there is no money in mental health services and even less money for alcohol and drug rehabilitation services. I have heard too often the bureaucrats on the corporate side of healthcare say“there’s no money in these services. We lose money.” This kind of thinking coming from corporate healthcare systems is reprehensible and is a profound violation of their Hippocratic oath.

During these very difficult times, we need more than ever greater access to mental health beds and rehabilitation beds for substance abuse not less beds. Insurance companies should not sentence people to death; our young should not be denied treatment for being unable to make payment.

Let us stand up and support Mather and St. Charles and thank them for their courageous service and loudly advocate for their support. A growing number of young people are at risk if we remain silent. He or she could be your son or daughter!

Fr. Pizzarelli, SMM, LCSW-R, ACSW, DCSW, is the director of Hope House Ministries in Port Jefferson.

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Photo from Suffolk County District Attorney’s Office

An East Setauket man faces a multicount indictment for allegedly receiving more than $400,000 through insurance fraud.

On Feb. 28, Suffolk County District Attorney Tim Sini’s (D) office announced the unsealing of a 70-count indictment against former health care worker Joseph Basile, 50. It is alleged he fraudulently received more than $400,000 through a health insurance fraud scheme where he would file claims for unperformed procedures and list a former employer, a colorectal surgeon, on the forms.

“This was an act of pure greed,” Sini said. “He used his knowledge of the health care insurance system to illegally pocket hundreds of thousands of dollars, money that would have otherwise been used to care for people who were sick and in need.”

Basile was charged with insurance fraud in the first degree, three counts of health care fraud in the second degree, two counts of grand larceny in the second degree, health care fraud in the third degree, grand larceny in the third degree, scheme to defraud in the first degree and 60 counts of criminal possession of a forged instrument in the second degree.

Basile was employed as an office manager for a private health care practice by a colorectal surgeon in Port Jefferson before the practice closed in 2013, according to the DA’s office. From January 2014 through July 2016, Basile allegedly fraudulently filed insurance claims for medical procedures, including colorectal surgeries, to Empire BlueCross BlueShield in excess of $3.8 million on behalf of himself and others, listing his former employer as the provider. The medical procedures had not been performed.

Basile then allegedly forged the signature of his former employer and deposited the checks into his own account. The more than $400,000 received was paid by both the insurance company and John T. Mather Hospital.

The former health care worker also allegedly filed fraudulent insurance claims on behalf of another individual whose health care is provided through Teamsters Local 1205’s welfare fund, according to Sini’s office. Basile allegedly stole more than $3,000 from the fund by filing false health care insurance claims.

Basile was released on $5,000 bond and is due back in court March 12. If convicted of the top count, he faces a maximum sentence of eight and one-third to 25 years in prison.

He is being represented by Legal Aid of Suffolk County attorney Kathleen Evers who could not be reached for comment.

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U.S. Rep. Lee Zeldin tours Elsie Owens Health Center in Coram before a press conference in which he called on Congress to reauthorize CHIP. Photo from Zeldin's office

By Alex Petroski

Political gridlock is nothing new in Washington, but if an agreement on a federal funding bill isn’t reached by Jan. 19, this time children’s health will be at risk.

In September, the Children’s Health Insurance Program expired, and Congress passed a short-term funding bill just before Christmas to keep the federal government funded through this Friday. The program, also known as CHIP, is a service that provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. Originally enacted in 1997, CHIP provides matching funds to states for health insurance to families with children. It was slated to run for 10 years, but has since been reauthorized on several occasions since 2007. In 2016, almost 9 million children were enrolled in the program, according to Medicaid.gov. The program covers routine check-ups; immunizations; doctor visits; prescriptions; dental and vision care; and emergency services for enrollees. In November, the House passed a five-year reauthorization bill to keep the program running, but it never reached the Senate floor.

U.S. Rep. Lee Zeldin (R-Shirley) urged lawmakers to pass a bill reauthorizing funding for the program, which also provides funding for community health centers, during a press conference Jan. 12 at Elsie Owens Health Center in Coram. A long-term bill will need to be passed to keep services like CHIP running for the remainder of 2018.

“These essential programs provide millions of children, veterans and individuals with the healthcare services they need,” Zeldin said. “In New York alone, CHIP provides health insurance for 300,000 New York children, while nearly 2 million New Yorkers rely on Community Health Centers for their health care services. On behalf of the millions of New Yorkers who rely on CHIP and Community Health Centers, we must reach across the aisle and work together to preserve these vital programs.”

Although more political debates will likely ensue on other issues pursuant to funding the government through the end of the year, Zeldin said he doesn’t expect reauthorization of CHIP to be used for bargaining by either political party.

“I do not expect to see a partial shutdown after next Friday, so everyone anticipates the funding to continue, but this also presents an opportunity to add the reauthorization language into the next funding bill,” Zeldin said in an interview after the event. “It’s two parts that have been running on different tracks. However, I believe that there is an opportunity here to add the reauthorization language to get it through the House, through the Senate, signed by the President — and reauthorization done.”

New York’s U.S. Sens. Chuck Schumer (D) and Kirsten Gillibrand (D) have each stressed the importance of renewing CHIP as part of larger federal funding discussions.

“We have two weeks to negotiate a budget deal that must also address a host of other items, #ExtendCHIP, community health centers, disaster aid, and of course, the #Dreamers,” Schumer said in a Jan. 3 tweet.

HRH Care Community Health President and Chief Executive Officer Anne Kauffman Nolon, Elsie Owens Health Center Medical Director Nadia Arif and Brookhaven Memorial Hospital Medical Center President and CEO Richard Margulis were among the healthcare professionals in attendance who applauded Zeldin’s calls for funding.

“Not extending the funding for these vital programs could have a devastating effect on both our population, and BMHMC, which also faces potential cuts as a Disproportionate Share Hospital,” Margulis said.

According to the Congressional Budget Office, five-year reauthorization of CHIP would cost $800 million over a 10-year period.

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Legislator William Spencer during the phone bank last weekend. Photo from Eve Meltzer Krief

Several Huntington doctors used an unusual tool this past weekend to abide by their sworn oath to do no harm — their phones — in an effort to deter passage of the Better Care Reconciliation Act, the U.S. Senate’s answer to the Affordable Care Act, known as Obamacare.

Physicians working throughout the town gathered to participate in a phone bank, calling residents in other states to try and encourage them to call their senators and protest the bill.

“The most important thing we can do right now is focus on a few key senators who will make or break this bill,” physician Eve Meltzer Krief said in a phone interview. “Senators want to hear from constituents so we’re talking to the constituents themselves. The people we spoke with this past weekend were overwhelmingly against the bill but weren’t calling their senators.”

The doctors called out of a pediatric office in Huntington and focused on West Virginia residents where U.S. Sen. Shelley Moore Capito (R) presides and had not yet declared if she would support the bill.

“When we call as physicians people listen,” Krief said. “We explain that we’re concerned, and we didn’t have one person hang up on us. Everyone listened to what we had to say. Doctors generally don’t get involved politically — I never have in my life — but this [bill] is definitely the wrong direction for American health care.”

For Suffolk County Legislator William “Doc” Spencer (D-Centerport), this event hit closer to home, as he was born and raised in West Virginia. His father was a schoolteacher in Welch, West Virginia.

Spencer said for West Virginia citizens, health care coverage is extremely vital, especially for residents who rely on Medicaid. So if the Senate’s bill is passed and Medicaid funding is cut, people there will suffer.

“The life expectancy here in Long Island is 82 years old and in West Virginia it’s 62 years old,” he said in a phone interview. “That’s the life span of a third-world country — for a place about 500 miles away from us.”

Spencer said most people he spoke to said they would call their senator after he spoke with them.

“This was very personal for me,” he said. “Most people there are going about their daily lives trying to make ends meet, and they aren’t thinking about what their officials are voting on.”

The legislator and Huntington-based doctor said he felt inspired after participating in the phone bank.

“I felt that I was making a difference not only for the people in West Virginia but also for my constituents in Suffolk County,” he said.

Although the Senate announced late Monday night they no longer had the votes to bring the health care bill to the floor, as two more Republican senators announced they would not support it, that does not mean the effort to change the current system was defeated.

“I was pleased and relieved to hear that two more senators pulled out of the bill and it was dead,” Dr. Kristin Bruning, a Huntington-based child psychiatrist who also participated in the phone bank said in a phone interview. “But when I woke up the next morning and heard about the repeal … I am very concerned.”

U.S. Sen. and Senate Majority Leader Mitch McConnell (R-Kentucky) said he now plans for the Senate to vote for a repeal alone and worry about a replacement later on.

“It feels like it’s just a desperate effort to do anything to annihilate the Affordable Care Act without careful planning,” Bruning said. “I worry that will throw the insurance industry into more disarray.”

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