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Future of north country health care under review this week in Watertown

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By GORDON BLOCK

WATERTOWN - In the face of tough economics and changing guidelines, the word of the day Tuesday for the North Country Health Systems Redesign Commission was collaboration.

However, the differing range of available resources and sprawling geographic area of the nine-county north country region present major challenges for the commission as it looks to make large-scale improvements.

Denise K. Young, executive director of the Fort Drum Regional Health Planning Organization, outlined the high stakes for the region: a combination of reduced patient volumes and revenues, a shortfall in providers and increased costs for providers.

“In rural health, the bottom line is for all of us, this isn’t about some other population we’re talking about. This is health care for our friends and our family and our neighbors,” she said. “We can’t afford not to work together; we can’t afford to miss this train. We must stand up and lead.”

The commission held the first of two days of meetings Tuesday at the Best Western Carriage House Inn on Washington Street. The state group heard from a wide range of experts representing medical providers covering Jefferson, Lewis, St. Lawrence, Franklin, Essex, Clinton, Hamilton, Warren and Washington counties.

The commission held in first meeting in the fall in Lake Placid, and Massena Memorial Hospital Chief Executive Officer Charles F. Fahd II said that session focused on senior state Health Department officials sharing information about all aspects of health care in the north country. “We’ll see where these two meetings go,” Mr. Fahd told his hospital’s board of managers Monday night.

He said the commission will be meeting again on the second Tuesday and Wednesday in February in Canton as they continue to review the health needs assessment for the region.

Jefferson County Public Health Director Ginger B. Hall, representing the departments of the nine counties, said that for the combined counties, top health care issues are chronic illness, mental health care and access to care. She painted a bleak picture of the region’s health, reporting all of the counties are above the state average in categories such as childhood obesity, diabetes mortality rate, suicide rate and smoking rates.

Mrs. Hall said in the short term the area should focus on collaboration and in the long term strengthen public and private partnership.

A group of five local physicians and Fort Drum Medical Activity Commander Col. Matthew E. Mattner also spoke about the challenges they face and the progress they have seen with the collaboration already done.

“We have those building blocks. We’ve developed an incredibly increased sense of mutual trust,” said Dr. Collins F. Kellogg, a Watertown internist.

Dr. Steven L. Lyndaker, Lowville Medical Associates, said that for any change to work, it would require engaging area physicians to get them to collaborate. Asked about what level of collaboration would be too big, Dr. Troy R. Johnson, of River Hospital, Alexandria Bay, expressed concern about having to cover too large of a geographic area, or as he called it, “windshield time.”

“Any time you have to look at a windshield instead of patients, it’s a waste of time,” he told the commission.

Any change to the area’s mental health care by the commission would have a large impact, said Linda Nelson, director of the state Office of Mental Health’s Central New York Field office. She cited 2011 department statistics that the public mental health system touches the lives of more than 5,300 people in the region weekly.

“The public system is the underpinnings of the most vulnerable,” she said.

The commission’s agenda for today includes discussions on the area’s health care needs and ability to meet them, along with Medicaid reimbursements.

Among the dozens of people in attendance for the meeting was U.S. Rep. William L. Owens, D-Plattsburgh, making his first public appearance since announcing last week that he would not seek re-election.

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