Health and Safety

Challenges and Opportunities in Public Health Care

Challenges and Opportunities in Public Health Care

December 5, 2012
By Lillian Roberts, Executive Director District Council 37 AFSCME

The public health care delivery system in New York City is one of the best in the nation. This is largely due to the dedicated civil servants who provide the quality services to the public each and every day. District Council 37, AFSCME represents 4,000 members who are on the frontlines at the Department of Health and Mental Hygiene (DOHMH) and 18,000 in the NYC Health and Hospitals Corporation (HHC).

These two agencies are the primary public health providers for New York City. The Health Department monitors public health and disease outbreaks, ensures that our restaurants and childcare centers are safe for children and the public and provides education about improving health outcomes. HHC cares for millions of children, seniors, disabled, regardless of insurance status. Our union members include public health nurses and sanitarian, nurses aides, service aides, social workers, respiratory therapists, clerical associates, and psychologists.


In anticipation of the Affordable Care Act, our public health care delivery system is ahead of the curve in providing innovative quality public health care to 1.1 million patients. Yet we still face many challenges.

In the Health Department we continue to see deep cuts in critical services and privatization that directly impact the public health. Half of the City Pest Control Aides were laid off, even though they provide critical rodent prevention and extermination services. Early Child Consultants inspect and permit child care centers but there are not enough staff for the workload.

In HHC this administration is pursuing a dangerous path to privatize dialysis in-patient and out-patient services with a for-profit vender, Atlantic Dialysis Services in all of HHC’s nine hospitals. We feel strongly that this initiative will negatively impact patient care through reduced patient services and in the end will not save the HHC the projected savings of $150 million over nine years.


Our union has had a strong tradition of developing programs that help our members’ transition into new jobs and through training and education programs in this transforming health care delivery system. With a focus at HHC on primary care and coordination of care we are taking advantage of opportunities to use our DC 37 Education Training and Fund and collaborations with the City and our higher educational partners to create opportunities for our members to grow and thrive in the new health care delivery system in NYC.

Our union and our parent union AFSCME have a rich history of surviving even in these tough economic times. Our members live and work in the community. We will continue to advocate for quality public health care services and to protect those most vulnerable populations that our members and this union are committed to serving. It is the morally right thing to do for the millions of New Yorkers who depend upon public health care in our great city!


December 5, 2012

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