[Congressional Record Volume 143, Number 160 (Thursday, November 13, 1997)]
[Senate]
[Pages S12642-S12643]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                       MONTEFIORE MEDICAL CENTER

 Mr. D'AMATO. Mr. President, I rise to discuss one important 
health care initiative in New York State. This worthy project is the 
Montefiore Medical Center and it is located in the Bronx section of New 
York City.
  The Montefiore Medical Center system, established over 100 years ago, 
is an integrated health delivery system with two acute care hospitals 
providing access to over 1,000 beds, 30 community-based primary care 
centers, and a range of other outreach services operating in the Bronx 
and the surrounding communities. Through its extensive network, 
including comprehensive-care sites in some of the Nation's most 
economically deprived areas, Montefiore provides care to medically 
underserved residents. The Montefiore system provides nearly 20 percent 
of all inpatient acute care, and nearly 40 percent of all tertiary care 
required by Bronx residents, including over $50 million in 
uncompensated charity care annually. In addition, in partnership with 
the Children's Health Fund, Montefiore administers the Nation's largest 
medical program for homeless children.
  The Bronx is home to 400,000 children under age 21. In 1995, 
Montefiore conducted an extensive review of the health status of Bronx 
children and concluded that the overwhelming majority are at serious 
health risk, for reasons such as abuse, pediatric AIDS, lead poisoning, 
and asthma. In particular, asthma is the most serious health risk to 
Bronx children. Nearly one-third of births in the borough are to 
teenage mothers who receive no pre-natal care. As a result, the child 
hospitalization rate is 50 percent above the national average.
  Montefiore's study also demonstrated that a fundamental restructuring 
of its pediatric health care delivery system should be necessary to 
meet the growing challenge of providing services to these extremely at-
risk children. Managed care is rapidly transforming how health care 
services are delivered in underserved communities. To remain viable in 
the evolving health care marketplace, Montefiore's child health 
treatment, prevention, and education services must be organized and 
efficiently coordinated.

[[Page S12643]]

  Montefiore has long been recognized as one of the Nation's premier 
pediatric research and training institutions, having trained a 
significant percentage of the country's pediatricians. In recent years, 
Montefiore has lost substantial numbers of pediatric specialists to 
more traditional children's hospitals which could have a dramatic 
impact on the numbers of physicians who practice in inner-city 
communities. To ease the competitive disadvantage and ensure its 
capacity to retain critically needed pediatric resources for the Bronx, 
Montefiore must consolidate pediatric specialists and specialty care in 
one location, a children's hospital.
  To meet the enormous challenge of providing high-quality, 
comprehensive services for Bronx children, Montefiore will develop the 
Montefiore Medical Center Child Health Network [CHN], an integrated 
system of family-centered care for families of all socio-economic 
levels. The CHN, organized around the core principal of providing 
enhanced access to high quality primary care, will offer a full 
complement of child health services.
  As the central institution of the CHN, the Montefiore Children's 
Hospital will feature 106 beds in age-appropriate units, state-of-the-
art pediatric emergency and intensive care units, a full spectrum of 
tertiary subspecialties, including environmental sciences and 
behavioral pediatrics, a short-stay day hospital, support facilities 
and services for children and their families, including playrooms, 
school facilities, and a family resource center, and lastly, innovative 
communications technologies including a telemedicine consultation 
service and on-line teaching and tele-conferencing capabilities.
  Montefiore Medical Center has provided community services and 
community-based health care programs for over a century. It is uniquely 
qualified to implement an initiative as innovative and far reaching as 
the child health network. This initiative will strengthen and extend 
Montefiore's commitment to the Bronx community as a whole, and the 
children of the Bronx in particular. Through the centralization of its 
diverse services in this borough of New York City, the new Children's 
Hospital and its satellites will elevate the quality, scope, and 
accessibility of primary and specialty health care services available 
to children and their families.
  Mr. President, the Senate Labor, Health and Human Services 
Subcommittee on Appropriations includes a reference to this initiative 
in its report. The language is as follows:

       The health status of children living in the Bronx section 
     of New York City is particularly worrisome with 
     sociodemographic and health status indicators which 
     underscore a need for improved health care services. The 
     Committee is aware of plans to establish a state-of-the-art 
     children's hospital in the Bronx to address the critical 
     needs of its pediatric population. To enhance current Federal 
     child health care programs in the area, the Committee 
     encourages the Department to assist in the planning of this 
     new facility and its potential programs.

  Mr. President, I look forward to working with the administration, the 
Congress, and the medical center on developing a Federal partnership 
for this initiative. This initiative could serve as a national model of 
how complete health systems can adapt and respond to the very unique 
and challenging health needs of children in medically underserved urban 
communities.

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