With the support of state Sen. Toni Harp ARC ’78, a group of Yale medical and public health students have proposed the creation of a community review board to ensure free care is available to qualified indigent patients at Yale-New Haven Hospital.
Though hospital representatives have agreed to meet with the students, the hospital already has community-based nominators overseeing the allocation of free bed funds for qualified patients, hospital spokesman Vin Petrini said. He said additional money for free care is spent in hospital operating funds.
In the wake of recent lawsuits concerning unfair billing practices, the hospital has changed a number of its policies and removed property liens against former patients. It currently offers free care for patients at or below 250 percent of the poverty level, and reduced-cost care for those at or below 400 percent.
But members of the Student Initiative for Health Care Access and Compassionate Care say the current system includes obstacles that impede qualified patients from receiving free or low-cost care.
David Chandrasekaran MED ’07 said not all free bed funds available to indigent patients are subject to community oversight, a function the medical students hope their proposed review board would perform.
The board would consist of both community and hospital representatives, with members or advisors from the New Haven Legal Assistance Association and the Connecticut Health Policy Project, he said.
“We would like to oversee all of free care to make sure people don’t fall through the cracks, because the system currently in place hasn’t been working,” Chandrasekaran said. “The people on our proposed board would be ideal patient advocates, because that’s what many of them do professionally. They would really know the community.”
He said since the review board would consist of more than just hospital-selected representatives, it could be a true mediator between the hospital and patient community. The board would enable patients to learn important information about available bed funds and have enough time to complete appropriate applications.
Harp, who has lobbied Yale-New Haven on behalf of the students, said the plan would benefit all parties by preventing conflicts between patients and the hospital.
“Putting in a citizen’s review board would work not only in the interest of community, but in the hospital’s interest as well, as it has a stake in ensuring these resources are available to all people who need them,” Harp said.
Harp said the board would hold Yale-New Haven accountable for providing charitable care in accordance with its legal obligations.
But Petrini said the current system, in which community nominators meet regularly with hospital officials, is adequate. He said case-by-case considerations are made for each patient qualified for free bed funds.
“We feel we already have strong community input concerning these funds,” Petrini said. “We’ve got a strong structure in place.”
Sheldon Toubman of the New Haven Legal Assistance Association said establishing a citizen’s review board to check the hospital’s practices would not be unprecedented.
“There have been precedents involving similar review boards set up in communities that have wanted to have impartial oversight over certain practices of institutions,” Toubman said. “This situation is serious, as the hospital has violated a number of requirements in the past. Patients lacking medical insurance have had to worry about losing their homes.”
The student group and Yale-New Haven have yet to determine a meeting date.