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Cardiac Rehab: Bringing It All Back Home

8/17/2017

 
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Imagine this scenario: your chest is cracked open by expert surgeons, veins are taken from other parts of your body to bypass a blockage, and you wake up in a recovery room believing that the hard part is finally over.  But then you learn it’s not - your recovery is just beginning.  You are sent home with instructions to begin cardiac rehabilitation, only to find out that to get to the nearest facility you’re forced to cross a bridge. 
 
This scary scenario is all too real – and it is unacceptable.  And it is going to change.
 
What is cardiac rehabilitation? According to the American Heart Association, it is a “medically supervised program designed to improve your cardiovascular health if you have experienced heart attack, heart failure, angioplasty, or heart surgery.”
 
It includes three important components:
 
  1. Supervised exercise counseling and training, to help get your body moving in ways that promote heart health.
  2. Education to promote a heart-healthy lifestyle.
  3. Counseling to reduce stress – so important because of the damage stress can inflict upon the heart.
 
Cardiac rehab is a team effort, a medically supervised program where physicians and other medical professionals help individuals who have been given a second lease on life.  The studies prove it works, and that it’s a necessary and effective path forward for patients who wish to have a healthy and fulfilling future.
 
How do patients benefit? They lower their risk of future cardiac events; they learn how to eat better; they lose weight; and they are able to return to work and engage in daily activities more quickly.  Clinical research has reveals that cardiac rehabilitation reduces mortality by up to 40% compared to those patients who do not participate.  Participation in cardiac rehab can also reduce the likelihood of hospital readmissions (for all causes) by 25% as well as the use of medical resources
 
So try to imagine my shock at the inaugural meeting of my Heart Health Advisory Committee about a year and a half ago, when I learned that our borough had no cardiac rehab facilities at all.  This situation forces Staten Islanders to go to other areas of the city - or to New Jersey - to access this potentially life-saving treatment.  In speaking with cardiologists, I found that of the hundreds that qualify for cardiac rehab every year, less than 5% of Staten Islanders are actually getting it.  Isn’t it ironic that if you have simple knee surgery there are plenty of local options available for physical therapy, but if you have complex quadruple bypass surgery you lack any local options at all.
 
This sad situation, which to some could be considered catastrophic, was the result of two things: low financial reimbursements to cardiac rehab providers, and high co-payments required of patients each time they attended a session. When combined, these factors caused the operation of such facilities to be simply not feasible. 
 
My team and I, in consultation with the eminent experts present in the room that day, decided we would do something about it, and so began our quest to bring cardiac rehab back to Staten Island.  Happily, we were able to convince both borough hospital systems – Richmond University Medical Center (RUMC) and Staten Island University Hospital (SIUH) – to agree to work towards the goal of providing this necessary service.
 
So strong was my belief in the value this would provide Staten Islanders that I allocated taxpayer funds – $250,000 for each hospital – to be used for equipment and other costs to get the new facilities up and running.  As with any similar project there were fits and starts, but I’m happy to say that we went recently to RUMC for the announcement of a brand new cardiac rehab facility that will be opening next year on their campus, a facility that will have the capacity to serve about 600 Staten Islanders.  And we will soon be announcing the progress made at SIUH as well. 
 
So from currently having no facility at all, in a short span of time we will have two. 
 
We are also in the preliminary stages of working on the burdensome co-payment issue. Most of us have to make a small co-payment on the day of a doctor visit, but since our doctor visits are generally not frequent, such co-payments are ordinarily not too painful to our wallets.  When it comes to a cardiac rehab program, however, patients are advised to attend regularly.  The cost of these co-payments add up rather quickly, making it less likely those patients will complete this necessary treatment.  I am happy to report that Dr. Ginny Mantello, our Director of Health and Wellness, is working with a variety of healthcare insurers on a plan that might give cardiac rehab patients some co-payment relief.  It’s a bit too early to talk about the details, but two such insurers have expressed an interest in exploring possible avenues of relief.
 
I firmly believe Staten Islanders should have access to the same kind of health care enjoyed by residents of other areas, and the moment I became aware of the importance of having cardiac rehab available locally was the moment I decided that we’d do all it takes to get it done.  Thankfully, this is one of those rare matters we can take into our own hands, one that doesn’t require the approval of City Hall.  Instead, in a public-private partnership with our local hospitals, we as Staten Islanders are able to handle it all on our own. 
 
It is not often that one gets to work on a project that will literally save lives.  This is one of those times, and I’m thankful not only for the opportunity, but for being in a position where I could help make it happen.
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    You’re following us on Facebook and probably see our tweets, but this blog is an opportunity for us to get a little more in depth on the issues on the minds of the folks at Borough Hall, specifically BP Oddo. The blog is published regularly and with you – our readers and constituents – in mind.
    ​Enjoy.

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