Research

Scope and Content Note

These records consist of typescripts of expert testimony presented before Department of Health hearing officers to refine proposed State Hospital Code policies and formulas. As part of the Department's function to regulate health care, the State Hospital Code empowers the department to develop and administer comprehensive policies for medical care delivery by hospitals and related services. Its intent is to improve quality of care while containing costs.

Witnesses at the 1969 advisory hearing on proposed principles of hospital reimbursement were representatives of hospitals, Blue Cross plans, physicians' groups, labor organizations, and consumer affairs agencies. They testified on issues such as appropriate economic indexes on which to compute reimbursement rates, and exclusion of medical education and research from the rate-setting formula. Differing views of the scope and purpose of medical institutions emerge through the testimony and follow-up questions.

Witnesses at this hearing often referred to the Governor's Committee on Hospital Costs, chaired by Dr. Marion B. Folsom. Its 1965 recommendations resulted in passage of the State Hospital Code and were the basis for the proposed indirect system of hospital cost control. The Hospital Cost Control amendment (Laws of 1969, Chapter 957) to which the hearing contributed required uniform accounting and cost-finding systems, and state-level control of rates for Medicaid and Blue Cross reimbursement for hospital patient services.

The 1971 fact-finding hearing on determining regional needs for nursing home beds and health-related facility beds drew witnesses from New York City and state health agencies, regional Health and Hospital Planning Councils, and representatives of nursing home administrators and proprietors. Shortages of nursing home and health-related facilities, which provide minimal nursing supervision for the amulatory, mentally alert elderly, had resulted in costly system-wide placements at unnecessarily high levels of care. Following presentations by State Department of Health officials George Warner, M.D., and William Leavy, the witnesses discuss definitions of "public need" and methods of measuring existing institutional capacities, evaluating appropriateness of utilization, and projecting needs for different levels of institutional care for the chronically ill elderly. Several witnesses presented extensive data on facilities and needs in New York City and Westchester, Rockland, and Putnam counties.