SARANAC LAKE - Adirondack Health's Board of Trustees has voted to convert the around-the-clock emergency room at its Lake Placid hospital to part-time.
The news came in a statement emailed to the Enterprise late Friday morning by Adirondack Health Communications Director Joe Riccio.
"Having used the past 60 days to conduct additional research, explore alternative options and following a thoughtful and thorough discussion around the issue, the board has voted to transition to a part-time ER in Lake Placid," Riccio wrote. "This option is being pursued in conjunction with the state Department of Health to ensure all quality, patient safety and regulatory requirements are held to the high standard set by Adirondack Health and its staff."
Adirondack Medical Center at Lake Placid
(Photo for the Enterprise — Richard Rosentreter)
For now, the Lake Placid ER will continue to operate 24 hours a day, seven days a week. State Health Department approval is required to convert it to part-time hours. If Adirondack Health's plan gets the green light, Riccio said the part-time Lake Placid ER would operate a minimum of 12 hours per day.
"An ad hoc transition team of community members is being formed to provide advice and assistance during the transition process," Riccio also wrote.
The direction the board chose Thursday night is the same one it tried unsuccessfully to pursue legislatively last month, after its plan to convert the Lake Placid ER to an urgent care clinic drew strong opposition.
In the waning days of the state Legislature session in June, bills were introduced in the Senate and Assembly that would have let Adirondack Health run a part-time, off-site emergency room in Lake Placid as part of a five-year pilot program under the state Health Department. The legislation was approved by the Senate but failed to make it to the Assembly floor for a vote before the chamber adjourned June 21.
"The effort was unsuccessful, but it did open the door for productive dialogue with the Department of Health to pursue the part-time ER option," Riccio told the Enterprise.
After the bill failed, state Sen. Betty Little said she learned that the Health Department can create such a pilot program on its own.
"We don't need the legislation any longer," she said Friday. "We've talked to the Department of Health, and they've agreed they can do this program administratively."
A state Department of Health spokesman wasn't immediately able to comment Friday on the proposed part-time ER.
Adirondack Health officials first announced the plan to convert the Lake Placid ER to an urgent care clinic in March. They said the Lake Placid ER doesn't have modern medical technology and that most seriously ill patients already bypass it and are taken to the ER at in Saranac Lake. They also said the low volume of patients at the Lake Placid ER, especially at night, doesn't justify keeping it open around the clock. Adirondack Health officials have also said the change would cut costs at a time when the hospital has seen big operating losses due to federal budget cuts.
Many people in Lake Placid said the loss of around-the-clock emergency room care would leave the community's residents and visitors vulnerable. Local ambulance squads worried about losing revenue and the extra time it would take to get patients to Saranac Lake. The New York State Nurses Association, the state Olympic Regional Development Authority, and the Lake Placid village and North Elba town boards also lined up against the urgent care concept.
A part-time ER is seen as a better option because state law requires emergency rooms to have more staff on duty than urgent care clinics and because an ER is required to accept all patients, regardless of their ability to pay. Ambulance squads can also bill patients' insurance companies if they take them to emergency rooms, but not if they go to an urgent care center.
Local and state officials said they support the Adirondack Health board's decision to pursue a part-time ER, calling it a good compromise. Little said it would be a demonstration project for rural areas around the state.
"I think this is a good resolution," Little said. "This will help Lake Placid. During the day is when they have all the busy calls from Whiteface Mountain and the other Olympic venues. They'll be able to take care of them and have an emergency room. In the evening hours when it's not utilized as much and there's a lot less traffic, they'll use the ambulance to take people to Saranac Lake.
"It's a change, and change is always difficult," Little added, "but for many communities, getting to an emergency room is even farther than Lake Placid to Saranac Lake."
Lake Placid Mayor Craig Randall called the decision "a good development.
"The job's not done, but it does leave the door open for further community discussions to see what we can come out with," he said. "That does not mean to say for one minute that we're not looking to have some kind of 24-7 access for people that need to be seen beyond the hours they would operate an emergency room, but I think those discussions are ahead of us."
"I think this is a step in the right direction," said North Elba Supervisor Roby Politi. "It's certainly a better option than a part-time urgent care. It maintains jobs. It satisfies a lot of the sports governing bodies. I'm sure it will help Wilmington, Keene and others. We'll probably have to figure out another way to make sure there's adequate coverage 24 hours a day."
Both Randall and Politi said they were pleased that an ad hoc committee is being formed, saying "that piece has been missing."
The New York State Nurses Association had opposed the idea of a part-time ER when it was pursued legislatively. The union, which represents Adirondack Health nurses, said such a move would limit life-saving, emergency care to the residents and visitors of Lake Placid and surrounding towns and put increased pressure on EMS services in the area. A NYSNA spokesman didn't immediately comment on the board's decision when informed of it by the Enterprise Friday.
Contact Chris Knight at 518-891-2600 ext. 24 or firstname.lastname@example.org.