Safety-net hospitals save New Yorkers in their time of need, now the hospitals need help from Albany with fair funding

On May 11, the Biden administration will declare an end to the COVID-19 public health emergency. While the acute trauma has ended, the lingering after-effects and uncertainty will remain with us all for quite some time. Safety-net hospitals like Maimonides here in Brooklyn served communities that suffered from some of the highest rates of COVID hospitalizations, and the overall toll that it took on both the hospital and staff cannot be overstated.

As a physician who focuses on child abuse and child welfare, I want to reflect on what I have learned from the pandemic, and what it means for the future of health care in Brooklyn.

When I was three years-old, my teenage mother immigrated to the United States from Jamaica to find work. I was raised by my father until the age of 10, when we left Jamaica to join my mother in Brooklyn where I struggled to both be a caregiver to my younger sibling and keep up with my schoolwork.

My path to success was not preordained, but I was fortunate to have programs and interventions available to me. Through a non-profit that assists talented young people of color, I received an ABC scholarship to attend a boarding school in New England, a life-changing experience that ultimately provided the path to my medical degree and a career that allows me to give back to my community. What separates me from the vulnerable children I serve are merely circumstances and luck.

Ever since I wanted to give back.

Since I knew that I wanted to work with at-risk children, Maimonides, home to Brooklyn’s only comprehensive children’s hospital, was the perfect place for me. There I currently function in four roles: as a general and child abuse pediatrician; the vice chair of education in the Department of Pediatrics; the program director for the Pediatrics Residency Training program; and the director of the Child Abuse Fellowship Program. Through my multiple clinical roles, I am proud to have pioneered and established standards on monitoring child abuse as a crucial component of comprehensive pediatric health care with a focus on the social justice component to address policies that unfairly impact children and families of the Black and Brown communities that we serve.

Unfortunately, the racial inequities in health outcomes were only exacerbated by the pandemic. Black Americans endured higher rates of serious illness and death from COVID-19 than other groups. Many NYC children of color struggled (and are still struggling) with school absenteeism, mental health challenges and chronic illnesses like diabetes.

These deep, persistent inequities stem from multiple systemic factors that affect the determinants of a child’s health — factors that are complex and defy easy answers. However, one solution is staring us in the face: fix the gaping disparity between what health care providers are paid to treat underserved populations and what they are paid to treat more affluent populations.

There is no way for our society to address the disparity in health care access and outcomes if we do not address the disparity in allocation of health care resources. Today, New York’s safety-net hospitals, which serve the vast majority of Medicaid and uninsured patients in the city, are often the only places to go for emergency care in medically underserved areas, including much of Brooklyn, and they are struggling due to years of underfunding.

If nothing else, COVID-19 showed us the essentiality of hospitals like Maimonides, which redeployed its clinical staff across numerous subspecialties to meet overwhelming community needs at the height of the pandemic. As we emerge from the pandemic, the dedication and professionalism of our healthcare workers remains on display every day. Maimonides utilizes an entire team, including general pediatricians, pediatric subspecialists, nurse navigators, social workers, psychiatrists and nurses to work in sync with one another to recommend the best treatment plan for each child’s unique diagnosis and personal needs. We address not just the physical ailments, but the underlying emotional, mental and behavioral challenges that so many young people are facing.

During COVID-19, we stepped up to help New York; now it is time for New York to help us. As Albany is in the final stretch of negotiating New York State’s budget, I urge policymakers to prioritize funding for safety-net hospitals like Maimonides that serve New Yorkers with the greatest needs, but fewest resources. Chronic underfunding is a structural problem that needs to be fixed to correct decades of disinvestment and inequity. Failure to do so could leave Maimonides and other safety-net hospitals without the resources they necessary to ensure that underserved communities retain access to critical services-exacerbating the health crises that these communities have been facing.

During COVID-19, we stepped up to help New York; now it is time for New York to help us. The time to act is now.

Walker-Descartes is vice chair of education in the department of pediatrics at Maimonides Medical Center and the program director for the pediatrics residency training program as well as the child abuse fellowship.