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Village and town meet to discuss ER plans

June 1, 2013

LAKE PLACID - The town of North Elba and village of Lake Placid boards joined together in signing a letter Tuesday night asking the Adirondack Health Board of Trustees to take more time deciding in whether to convert the 24/7 emergency room in Lake Placid into a 12-hour urgent care clinic.

Adirondack Health's board plans to decide on the issue at a meeting scheduled for 6:30 p.m. Thursday, Adirondack Health spokesman Joe Riccio said after the meeting. Riccio said the decision will be announced at a press conference Friday morning.

He called the process Adirondack Health has gone through "exhaustive outreach."

The town and village boards held a joint meeting Tuesday night to discuss the issue, and each member of each board spoke out against Adirondack Health's proposal.

Several said to approve the proposal now would be hasty - made over the course of a few months without any in-depth studies done to look at the potential impact of the closure and other options for the company to save money - and premature, since no one knows yet the full impact of the Affordable Care Act (Obamacare) will have on the health care industry. Board members also said they don't fully understand Adirondack Health's financial situation, and the public information sessions the nonprofit company held in recent weeks brought up more questions than were answered.

Others noted that the Lake Placid area, with its strong Olympic history, has a number of sports-related events and people who come to the area to ski, skate and otherwise recreate. Having an emergency room locally helps Lake Placid compete with other winter sport venues, said town Councilman and former Whiteface Mountain Ski Area manager Jay Rand. He said he knows Lake Placid often sees "extremely serious" injuries with both competitors and the public that need immediate attention.

"There's no question the facility is extremely important," Rand said.

Several board members said there would be extra stress on local volunteer rescue squads, increasing turnaround and possibly creating a necessity for more ambulances.

Village Mayor Craig Randall read a letter to Adirondack Health from state Olympic Regional Development Authority Chairman Pat Barrett, and town Supervisor Roby Politi read one from Essex County Emergency Services Director Don Jaquish, both in opposition to converting the emergency room.

After each board member spoke, Randall and Politi presented a letter they wrote to the boards. The Enterprise will run the letter in full Thursday.

Randall read the first section, which he wrote and which highlights Lake Placid's history with Adirondack Health. The Lake Placid and Saranac Lake hospitals decided to consolidate 23 years ago after boards of both institutions realized they couldn't succeed on their own. Along with Placid Memorial Hospital, Saranac Lake General Hospital gained access to Placid's $5 million endowment, the Redfield Trust. Placid Memorial gave up inpatient service but was not willing to let go of its emergency room. The board considered making the Redfield funds contingent on the hospital maintaining the ER but decided not to restrict the money since "it was evident they would be key to the future success of Adirondack Medical Center," Randall wrote in the letter.

He wrote that AMC's investment in nursing homes that were already in financial decline may be the root cause of the company's problems.

"Without the Redfield funds and the monies its investment has generated, Adirondack Health might never have achieved the success it has enjoyed in recent years, nor of course might it have become involved with the nursing homes that have dragged it down so much," Randall wrote.

Politi read the section of the letter he wrote, which looks toward the future and calls for Adirondack Health to complete an independent study on its options.

"The decision to transform our community hospital is significant and requires extensive thought and careful planning," Politi read from the letter. "Sound decisions do not happen quickly and certainly not over the course of several weeks and two public forums. It is evident to us that there has been a 'rush to judgement' by the leadership of Adirondack Health to counteract its poor business choices of the past."

Politi said a number of questions still need to be answered, including whether more ambulances will be needed, what the greater demand will be on local rescue personnel, whether there would be extended waiting times at the Saranac Lake ER and what problems there would be with employees losing jobs or having to travel a different amount.

Politi said he expects cost burdens to be shifted to the community of Lake Placid.

"This is especially tough to swallow in light of Lake Placid's past transfer of millions of dollars of hospital endowment monies to AMC for its use elsewhere," he said.

He said the closure of the ER would be more palatable if the plan was to replace it with a 24-hour urgent care center, but the one Adirondack Health has proposed would be open the same hours as the already-existing urgent care center in town, Mountain Medical. He called the move a likely attempt to eliminate a competitor.

"As leaders of the Lake Placid community, we respectfully ask that you give more time and consideration to your decision-making process," Politi said. "An independent professional study of all possible alternatives and the unanswered questions set forth above is clearly needed. Sometimes the longer road is the wiser route to one's destination."

After Politi finished, some of the crowd of about 20 people at the meeting broke out into applause as members of both boards started to sign it. Several board members and members of the public commented on how well the letter expressed the community's feelings and concerns.

Politi said he has an email list of all the Adirondack Health board members, and he plans to send the letter to each of them as well as to Adirondack Health President and CEO Chandler Ralph.

Ralph attended the meeting but declined to comment afterward, saying she had to run to a meeting in Saranac Lake.

Riccio said any comment at his point would be premature until the Adirondack Health board makes a decision. But he noted Adirondack Health has done several public meetings and gotten much feedback.

"Everyone is entitled to their input," Riccio said.

Contact Jessica Collier at 891-2600 ext. 26 or jcollier@



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