Written by Elizabeth Izzo in the Adirondack Daily Enterprise on May 7, 2020

SARANAC LAKE — Local hospitals collectively received more than $14 million on Wednesday in the latest round of federal aid through the Coronavirus Aid, Relief and Economic Security Act.

Adirondack Health, which operates the Adirondack Medical Center in Saranac Lake and other facilities, received a little more than $5.3 million. Alice Hyde Medical Center in Malone received $4.9 million. Elizabethtown Community Hospital and its Ticonderoga campus at the former Moses Ludington Hospital got $3.8 million. All three totals were confirmed by representatives of the hospitals.

“It’s safe to say that it’s a big help, and not a moment too soon for us,” Adirondack Health spokesman Matt Scollin said.

The $2.2 trillion CARES Act, passed by Congress in March, set aside $100 billion in federal aid for a provider relief fund to benefit hospitals and community health centers. Congress approved an additional $75 billion in federal aid for hospitals last month. Around 60% of the first $100 billion has been disbursed so far.

Federal aid

The latest $4.9 million in federal aid for Alice Hyde is in addition to $1,641,000 received by the hospital in the first round of CARES Act disbursements, according to spokesman Phillip Rau. In the first round, ECH and its Ticonderoga campus received $657,000, and Adirondack Health received $2,073,000.

Health care facilities around the country are facing financial shortfalls and furloughing staff as the novel coronavirus spread. For North Country hospitals, the impact has come not from a flood of patients but from a lack of them. To prepare for an anticipated rush of COVID-19 patients, a surge that has yet to occur, New York state directed hospitals in March to cancel elective surgeries and increase their bed capacity by 50%.

Adirondack Health was expected to lose upward of $4.6 million in April on top of $1.4 million lost in March. Alice Hyde could be facing a deficit between $7 million and $8 million, according to Rau. ECH has not specified how much it would likely lose, but President John Remillard has said it needs at least $1.5 million in federal support each month. Spokeswoman Elizabeth Rogers said the cancellation of elective procedures cut the ECH’s incoming revenue in half.

The University of Vermont Health Network — which includes Alice Hyde, ECH and its Ticonderoga campus, and Champlain Valley Physicians Hospital in Plattsburgh — anticipates $152 million in coronavirus-related revenue losses network-wide this fiscal year. The network announced in a news release Friday that it would be “reducing the base salary of leaders, eliminating employer retirement benefit contributions to leaders, and instituting a hiring freeze at all network affiliates” in an effort to slash expenses.

As the number of hospitalizations across New York declines, the state has started to reverse some of those directives this month. On April 28, the state issued new guidance allowing some elective procedures at hospitals where a surge of patients isn’t expected to restart — as long as patients test negative for COVID-19 beforehand, they don’t stay overnight, and the number of new hospitalizations and number of patients taking up hospital beds remains below a certain threshold. Most local hospitals have already started scheduling appointments and testing incoming patients for COVID-19.

ECH reopened its clinics in Wilmington and Crown Point on Monday and hosted its first outpatient appointments with clinicians on Tuesday.

“All who visit our facilities are screened and required to wear a mask, provided upon entry,” ECH spokesperson Elizabeth Rogers said. “We are doing everything we can to accommodate patients. Though it is not required, those who prefer to do so may check in by phone and wait in their car.”

People are still being asked to call their local hospital ahead of time before going there in person. Those with symptoms of COVID-19 can call the state COVID-19 hotline at 1-888-364-3065 or call their local hospital’s COVID-19 hotline. Adirondack Health’s COVD-19 hotline is 518-897-2462.

CARES Act

The U.S. Department of Health and Human Services has been tasked with disbursing funding from the initial $100 billion CARES Act provider relief fund Congress passed in March, as well as an additional $75 billion for hospitals Congress approved last month.

HHS faced criticism from across party lines because of how it allocated the first round of CARES Act funding. The department divided the first 30% based on Medicare fee-for-service claims in 2019, a decision that was expected to let it disburse funds more rapidly. But lawmakers in both major parties, particularly those representing New York state, said that way benefits hospitals with larger populations rather than those most burdened by COVID-19 caseloads, or those facing the largest revenue losses.

U.S. Rep. Elise Stefanik, a Republican from Schuylerville who represents the North Country, reached out to HHS Deputy Secretary Eric Hargan last month and asked that the department update its formula. The way the first round of funding was disbursed was “not reflective” of where hospitals and community health centers are today, Stefanik said last month, “and the significant budget hole they have because of the elimination of elective surgeries at this time.” Stefanik has said she believes more funding should have been directed to New York hospitals and other hot spots that are experiencing a disproportionate number of cases compared to other states.

The next 20% of the $100 billion, disbursed last month, was based on 2018 net patient revenue.

The new funding local hospitals received Wednesday appears to be part of $10 billion in aid specifically for rural health care providers. That is being disbursed based on operating expenses, according to HHS.

“This method recognizes the precarious financial position of many rural hospitals, a significant number of which are unprofitable,” the department’s website reads. “Rural hospitals are more financially exposed to significant declines in revenue or increases in expenses related to COVID-19 than their urban counterparts.”

In the aid package passed last month, Congress left it to HHS to determine how to allocate the new $75 billion in aid.

Scollin thanked the state’s congressional delegation, specifically Stefanik, for their advocacy for rural hospitals.

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