City STD Clinics to Close Mondays to Cut Costs Amid Meningitis Outbreak
HARLEM — Four city clinics that treat sexually transmitted diseases are cutting hours on one of their busiest days — even as New York struggles to cope with a deadly meningitis outbreak that has killed seven people since 2010.
Under a proposal the New York City Department of Health and Mental Hygiene unveiled to employees earlier this month, high-volume STD clinics in Chelsea, Harlem, Fort Greene and Jamaica will be closed on Mondays, which is often one of the busiest days at those clinics.
Instead, these clinics will increase their service on Saturday from five hours to eight hours. A fifth clinic in Morrisania will eliminate Saturday hours altogether, and some other clinics will remain open on Monday. City health officials say the move will help eliminate overtime costs and save $600,000.
"The Health Department will be staggering its hours of clinic operations to make sure that STD services are available to New Yorkers six days a week, while reducing expenses to align with the city's finances," a city Health Department spokeswoman said in a statement.
"With the new schedule, clinics open on Saturday will now be open for a full business day, as opposed to a half-day in the past," she added.
Clinic employees and union officials say the move will hamstring clinics at the forefront of administering vaccinations for invasive meningococcal disease, a severe bacterial infection of the blood stream that has sickened 22 men who have sex with men, including 13 in 2012 and four this year. Three of the last five men to become infected have died.
"We've had an outpouring of requests for the meningitis vaccine," said a staff member at one of the city's STD clinics who requested anonymity for fear of reprisal.
The STD clinics are also waging battles on other important sexual health fronts, such as monitoring incidences of multi-drug resistant gonorrhea and HIV testing. Central Harlem and Chelsea, where two of the clinics are located, have some of the highest HIV infection rates in the city, according to a Department of Health study released in December.
On a recent Monday morning, the majority of patients at one of the clinics were there to get the vaccination, the staffer said. Demand for the vaccine at the city STD clinics is also high because many doctors don't have the vaccine on hand and it may not be covered by insurance. The vaccine is issued for free at the city clinics.
"A lot of private physicians and places that treat people with HIV are sending patients to us for the vaccine," the staffer said.
The potentially deadly strain of meningitis infection causes high fever, rashes and a stiff neck. The disease is spread by close contact with someone who is infected, which could involve intimate activities such as kissing or sex.
In October, the city's Department of Health issued a warning for men to get vaccinated if they are "HIV positive" and had "had intimate contact with another man that he met through a website, digital application (“App”), or at a bar or party since Sept. 1, 2012."
On March 25, the state Department of Health expanded that recommendation to include anyone in the state who had traveled to New York City and engaged in any of the risk behaviors listed in the first advisory.
A 23rd person who does not live in New York City but had spent a significant amount of time here also became infected with meningitis but recovered.
"It's a weird time to be cutting hours," said Judith Arroyo, president of Local 436, which represents the public health nurses in the STD clinic. "The numbers show Monday is the busiest time. You want to give the community more choice about when they want to come for a visit."
John Mazzarella, a grievance officer with the Organization of Staff Analysts, the union that represents the clinics' support staff, said his organization planned to file a grievance against the city because they believe changing hours to save overtime costs violates the terms of their contract.
"I can understand not wanting to spend money on overtime. But to give up one of your busiest days means the people that came on Monday are going to be seriously inconvenienced," he said.
Clinic staffers said Mondays tend to be busier because patients often come in wanting to be checked out after engaging in unprotected sexual activities over the weekend.
"They come Monday either because they've developed symptoms or they're worried about their weekend exposure," said the clinic staffer.
A health department official acknowledged that Monday is indeed a "very busy day," but said that from January 2012 until last month, Tuesdays were the day of the week with the highest average number of visits.
Arroyo said the amount of money saved by the proposed measure could easily be made up if the city did things like examine how many nurses it hires from outside agencies.
"If one of your busiest days is on a Monday, why close on one of the busiest days?" Arroyo asked.
Staff at the clinics in question will be required to work Tuesday through Saturday schedules. Union officials say they are also concerned about employees with conflicts because of religious observances and employees with child care problems.
"We have people who are Sabbath observers. There seems to be a lack of connection on the human level with this issue," Arroyo said.