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Michael Young is the recently appointed chief executive officer of the Erie County Medical Center. The hospital continues to endure cutbacks in county aid as a result of the budget crisis that has impacted a wide array of county services. Young discussed the hospital's future under trying fiscal times.

Q: How have Erie County budget cuts and the ensuing layoffs by the medical center affected operations?

A: The cuts to the Erie County Medical Center have forced the hospital to look at offering a more focused array of services to the community. This will result in ECMC focusing its attention on providing the medical services that we specialize in, such as trauma, burn treatment, cardiac programs, orthopedics, renal/kidney services, physical and occupational rehabilitation, neurosurgery and substance abuse rehabilitation.

The county layoffs have had a significant financial impact on ECMC. Since the county employees in the AFSCME union (sometimes referred to as the blue-collar union) are not "separate" from the AFSCME employees of ECMC, the county employees "bumped" into ECMC positions and caused our employees to be laid off. This resulted in ECMC accepting the more senior, higher salary county employees to replace our full-time and part-time employees. In addition, we have to pay for the unemployment benefits of the employees we laid off. These costs, along with employee retraining costs, resulted in an approximate cost of $1.5 million to the center.

Q: What is the status of the lawsuit calling for the release of all the capital money the county administration had owed the hospital since last year?

A: ECMC's subsidy has been cut from $29 million to $19 million, and the hospital has not received capital dollars of approximately $18 million for 2004 and 2005. We are continuing discussions with the county and are hopeful that these dollars will be appropriated. In the meantime, the lack of capital dollars is delaying projects that will generate additional revenue for ECMC. The lack of this funding is costing us money every day.

Q: Why is a county hospital necessary? Wouldn't the same services automatically be picked up by other area hospitals?

A: Good question. ECMC is the only Level 1 Trauma Center in the eight counties of Western New York. Other hospital systems have not accepted this responsibility because it requires a tremendous amount of infrastructure and expensive expertise to provide these services well. If ECMC were to close, it would be very costly to move these services. Also, ECMC provides a very high level of care, which may be the best in Buffalo. Not only am I confident that ECMC will actually make money in the future, I believe we will eventually create a world-class environment for health care in Western New York.

Q: What types of collaboration with other hospitals has the hospital pursued since you arrived?

A: It is too early to get into detail. However, I have met with both CEOs from Kaleida and the Catholic Health System and we are looking at collaborating in areas in which we specialize and provide the best care. All of our focus has to be on patient care, and thus far, I have been encouraged by some of our initial conversations.

Q: Has the hospital gained any tangible benefits since converting into a public benefit corporation last year?

A: The most notable is the independence of most of our operations from the county bureaucracy. ECMC never had a chance of being profitable as a county department, now it has a fighting chance.