A series of events that began with the pandemic and continued with the closure of Kingsbrook Jewish Medical Center has led the city’s public hospital system to decertify dozens of drug treatment beds and replace them with medical beds to meet an onslaught of cases in the heart of Brooklyn.
New York City Health and Hospitals filed plans with the state to remove 25 defunct substance use beds from the operating certificate of Kings County Hospital Center, a 624-bed hospital in East Flatbush serving a large Medicaid and uninsured population. In their place, health system leaders want to add 20 medical or surgical beds to meet an increasing demand for services in one of Brooklyn’s growing health care deserts.
The move is the result of two separate but coinciding trends. One is the shift from long-term care in hospitals towards outpatient services, where residents can get treatment without being admitted. The other is the immense overburdening of the public hospital system in Central Brooklyn, compounded by nearby hospital closures and poor housing and residential treatment options that choke hospital discharge rates and keep beds full longer than medically necessary.
Visits to Kings County’s emergency department have exploded in recent years, rising from 84,000 in 2021 to 109,000 in 2023, according to the filing. Its current medical and surgical beds, which number 246, are at 100% capacity, driving up emergency department wait times. The hospital also has a large number of patients who no longer need acute care but cannot be safety discharge, the filing states.
Part of the influx of patients is due to the void in care left by the recent closure of services at Kingsbrook Jewish Medical Center, according to the report. Last year, Health and Hospitals President and CEO Mitchell Katz told members of the City Council that closure helped make Kings County one of the most overcrowded hospitals in the system.
The neighborhood Kings County serves is predominantly Black with hundreds of thousands of people, roughly a third of whom are on Medicaid, and a dwindling number of hospitals. Outside of neighboring SUNY Downstate Medical Center, which was on the verge of closing last year before lawmakers infused it with cash, there are no hospitals in a roughly two-mile perimeter.
A “paradigm shift” in the way addiction is treated is what freed up the space for the new beds, the filing states. That shift is a move towards medication-assisted treatment, like ones offered at methadone clinics to people with opioid addiction, which is available at Kings County, South Brooklyn and Woodhull hospitals, according to H+H spokeswoman Stephanie Buhle. As a result, there is no construction proposed along with the bed certification and the price of the total conversion is pegged at just $400,000, which accounts for minor modifications like the addition of a nurse call station, Buhle said.
Ultimately, the hospital will reduce its bed count slightly on paper. But the drug treatment beds that will be replaced have lay empty since the height of the pandemic in March 2020 when the hospital closed its detox unit, at first on a temporary basis, as part of its Covid-19 emergency plan, the filing states. Later that year, the health system submitted a plan to permanently close the program to the state Office of Addiction Services and Supports, saying the unit was underused, according to the filing.
