A Manhattan hospital executive has been tapped to become the Spitzer administration's health commissioner.
The appointment puts Dr. Richard Daines front and center in the upcoming wars over which hospitals and nursing homes in the state will survive.
Daines, a Mormon who once spent two years as a church missionary in Bolivia, gave no indication Thursday that he envisions any drastic changes to a recent state plan that calls for shutting down or restructuring dozens of hospitals across the state, including several in Western New York.
"The goal is to have the most high-quality health care and to provide it in an efficient way so it's not a drain on the economy and is good for the communities in every way -- and we'll get there," Daines said.
Largely unknown to hospital executives outside New York City, Daines in the coming year will become the face of the Spitzer administration's health policies to reduce the number of underused hospital beds and slow the growth of the Medicaid program while reducing the ranks of the uninsured by several hundred thousand people.
Daines, 56, who acknowledged a lack of knowledge about upstate health issues, said that if he is confirmed by the Senate, he will travel the state to learn about rural and urban health care matters outside the boroughs of New York.
The health commissioner will be charged with implementing a set of restructuring recommendations from a state panel that became law Dec. 31. The plan calls for closing Millard Fillmore Hospital in Buffalo and St. Joseph Hospital in Cheektowaga, turning DeGraff Memorial Hospital in North Tonawanda into a long-term care facility, and merging Erie County Medical Center and Kaleida Health.
Asked if the panel's recommendations can be changed, Daines said it is his understanding that the plans are to be "implemented as presented unless the whole thing is -- changed." He declined to comment on whether the Legislature can remove individual hospitals from the closure list.
Gov. Eliot L. Spitzer's choice is a bit of an anomaly among recent health commissioner selections. Daines comes directly from a hospital administration post instead of a public health or a government post.
That gave some health care groups reason for hope Thursday that one of their own will be taking the helm of an agency, but it left some in the industry and Legislature wondering about his experience in public health issues -- from infectious diseases to food safety, which are major components of the agency's tasks.
Daines, born in Idaho and raised in a small town just across the border in Utah, today lives in a co-op building on Park Avenue in Manhattan's tony upper West Side neighborhood of Carnegie Hill. A graduate of Cornell University Medical College in 1978, Daines used the Spanish he learned as a missionary when he joined St. Barnabas Hospital in the Bronx in 1981 when the AIDS epidemic was emerging. Trained in internal medicine, he eventually took over the hospital's intensive care unit.
Since 2002, he has been president of St. Luke's-Roosevelt Hospital Center, which is part of Continuum Health Partners, a five-facility system that was left unscathed in the recent downsizing plan by the state.
Daines would be paid $136,000; he did not disclose his current salary, but it is likely a sizable cut in pay.
Representatives of hospitals that would be regulated by Daines all praised Spitzer's choice. Daniel Sisto, president of the Healthcare Association of New York State, said Daines "should be warmly received around the state."