Your guide to NYC's public proceedings.
Q&A
Discussion of CDPAP program and adult day health center challenges
1:00:05
ยท
5 min
Chair Mercedes Narcisse introduces the topic of CDPAP and its relation to adult day health centers, leading to a discussion about the challenges and limitations of these programs.
- Narcisse highlights the potential benefits of facilities like Neponset in light of CityPAP qualification changes
- Dr. Katz explains the budgetary constraints and trade-offs involved in healthcare service provision
- The discussion covers the specific requirements and limitations of adult day health center models
- Dr. Katz emphasizes the niche nature of adult day health centers and why they have become less common
Mercedes Narcisse
1:00:05
Thank you.
1:00:06
And one of the thing I may add is a follow-up understanding of what's going on.
1:00:15
CityPAP was the one, the program where family members can take care of their family at home and now we have a threat with that city pap, people not being qualified.
1:00:27
So facility like the one that my colleagues mentioned will be beneficial to our community while we closing city pap, A lot of folks not being qualified and they need the skilled care.
1:00:38
They need the nurses.
1:00:39
They need people to access them.
1:00:40
They need someone to give them insulin and they don't have no family members and then at least they can get out and then go back home.
1:00:47
So what your understanding of what I'm saying?
Dr. Mitch Katz
1:00:49
I I think, you know, again, there's no right or wrong answer to this question.
Mercedes Narcisse
1:00:54
Mhmm.
Dr. Mitch Katz
1:00:54
There are always more services that we could provide to people as and the only thing I could say, and this is a budget hearing, is all the money is spent.
1:01:07
So any it becomes at a any point in time, all things are a zero sum game.
1:01:14
We can do more of this and less of that.
1:01:18
That's that's how our budget works.
1:01:21
So PAP, for example, yes, some of the people in PAP may have a skilled nursing need.
1:01:29
They could be eligible for this so long as they're willing to go on a van.
1:01:34
If they have no one to do their insulin, then they can't really go to this because who's gonna do their insulin when it's not Monday through Friday?
1:01:42
This program actually only works.
1:01:44
And again it has to do with the niche of it.
1:01:47
You can't be in this program unless you have an incredibly loving family because it's an incredible intensive program that runs Monday through Friday nine to five.
1:01:57
So if you have if you have that level of intensity need that you qualify for the skilled nursing need, then who's doing it when it's not nine to five?
Mercedes Narcisse
1:02:07
No.
1:02:07
Because
Dr. Mitch Katz
1:02:07
And there are people for whom, and and I think the majority whip has a good example.
1:02:13
If you were family that was incredibly supportive and loving and you had a job and the job was nine to five Mhmm.
1:02:23
And your person could go on the van Mhmm.
1:02:26
That would be someone for whom this program is a very good choice.
1:02:30
But again, there's a reason I mean, think about we have 11 acute care hospitals.
1:02:38
We have four skilled nursing facilities.
1:02:41
We have 40 outpatient clinics.
1:02:44
How many of these do we have?
1:02:47
Do any of you have one in your district?
1:02:50
No.
1:02:51
This particular model, again, and I don't in any way denigrate the people for whom it works.
1:02:59
It's wonderful for the people for whom it works.
1:03:02
It's just not a very broad model.
1:03:05
And it comes because of the the the state's requirements about what must be provided even fully enrolled, there's a loss.
1:03:17
Mhmm.
1:03:17
Now many of our services have a loss.
1:03:19
In fact, all our services have a loss.
1:03:22
So as long as if we as a group of people decide this is the service, but then it begs the question of why do we have only one of them?
1:03:31
Mhmm.
1:03:31
We're if what we're deciding is this is the thing that matters, why do we have one?
1:03:37
And I recognize that closing something is very different than not opening something.
1:03:43
I understand how that works.
1:03:46
But it's true that we have not tried to promote enrollment because we made a decision that given that we did not own the building, we had increases in rent.
1:03:57
We were it's a large subsidy for a very small number of people in a service we don't provide to everyone.
1:04:05
And generally, we try because we're a government thing.
1:04:09
Generally, I feel if if I'm providing something it should be available to everybody.
1:04:14
And and I do think a majority of that's part of why I am so passionate about the trauma center.
1:04:20
Because I say, well, but, you know, it's not fair that people on Far Rockaway don't have access to it.
1:04:25
But in some way, this is the opposite side of the coin.
1:04:29
This is something that exists in Far Rockaway that doesn't exist anywhere else.
1:04:32
So it doesn't have for me the same equity argument.
1:04:36
Again, I don't want to in any way diminish that if you fit this criteria, this is the right program.
1:04:45
But in general, the world has closed these programs because the number of people for whom it's the right program has become too small.
1:04:55
And I, you know, I feel for the people who like it.
1:04:58
And again, you know, I'm all about, you know, consensus decision making.
1:05:03
If we as a city are deciding this is the thing, then you you can always count on me to be there.
1:05:09
But but in general, it hasn't because of the small number of ones we run, it hasn't felt that way that this was the thing that we were making our mark to.
1:05:21
Uh-huh.
Selvena Brooks-Powers
1:05:21
I'm sorry, chair.