A panel set up to determine the future of the troubled Kings County Hospital reconstruction project yesterday recommended building a smaller hospital, with significantly fewer beds, and establishing a system of community clinics.
But the new plan pared its nearly $1 billion budget by only $16 million.
The recommendations, virtually certain to be accepted by the city's Health and Hospitals Corporation, called on the agency to scrap plans to build a new, separate building for labs and outpatient services, and use the savings to open at least four community clinics.
The plan also calls for closer cooperation with the State University of New York's Health Science Center at Brooklyn, which faces Kings County on Clarkson Avenue.
It would reduce the number of beds from 1,254 to 983, mostly by eliminating 208 beds used to treat jail inmates, with the remaining cuts in acute care beds that the panel said would not be needed as hospital stays continue to become shorter.
Fears Eased
But in many ways the new proposal is not as drastic an overhaul as officials had suggested several months ago, easing fears by Brooklyn political and community leaders that hospital officials would substantially reduce the size and services of Kings County.
Since early February, all work on Kings County has been stalled by a moratorium that Mayor Rudolph W. Giuliani imposed amid concerns that more than $120 million had been spent with very little to show for it. As a result of the moratorium, officials of the Health and Hospitals Corporation set up a task force to recommend a smaller, more efficient institution.
The panel said that reconstruction should go forward as soon as possible -- within a matter of months, according to John Billings, an associate professor of health policy management at New York University, who chaired the 10-member panel.
Also yesterday, Dr. Bruce Siegel, president of the hospitals agency, said for the first time that the agency would not undertake the reconstruction project itself. While he said no group had been chosen to take on the project, the Dormitory Authority, a state agency, is the most likely candidate.
Approval Needed
The corporation's board must formally approve his recommendation that the agency cede direct responsibility for the reconstruction, but Dr. Siegel said the board would not vote on the recommendations of the task force. He said such a vote simply would not be necessary, and Mr. Billings said no one on the board opposed the panel's conclusions.
The report also drew tentative praise from Mayor Giuliani, who called it was "a very realistic plan." He said he would review it further over the weekend but said that "in so far as I can tell from the brief review that I've made of it, it articulates to a very large extent the direction I think the project should go."
Yesterday, he said, "we're anxious to get started again," but the moratorium still has not been lifted.
Brooklyn public officials who had bitterly opposed the delay were even more enthusiastic about the group's recommendations. But agency officials and community leaders differed on whether the task force had radically overhauled the project or merely tinkered at its margins.
'A Vindication'
Enoch H. Williams, a Democrat who represents Brooklyn in the City Council, said, "I thought the recommendation was a vindication of all the slander about Kings' County. The final result is that they found this is about the amount of money it takes to build a project this size. All they did was say we should continue to build minus the prison beds we never wanted to begin with."
Dr. Siegel acknowledged that the plan had not slashed the budget significantly, but said, "this wasn't an exercise in making it smaller for the sake of making it smaller."
And he defended the process, which he said would result in vastly improved primary care and much more efficient delivery of care.
Mr. Williams said the Mayor owed the people of Brooklyn an apology for halting a project that could have been revised while work continued.
But Dr. Siegel said the halt in construction was valuable because it allowed officials to step back and change direction. "The moratorium ended up saving us time," he said.
Study Called Essential
Karen Crowe, deputy press secretary for the Mayor, said the study was essential, and called for major change.
"Eliminating the prison unit is a big thing," she said. "And how could we continue moving forward with something that wasn't resulting in a building?"
She said the moratorium would not be lifted until after a city investigation into all the project's contracts and expenditures, and an internal agency task force report due within a few weeks.
In the reconfigured project, some of the $58 million that would be saved if the new lab and outpatient building is not constructed would be spent on the community clinics, which would be housed in existing buildings throughout the neighborhood.
The laboratories that would have been built in the new building will now be installed in the main hospital, while the prisoners will be moved to another public hospital or treated under an arrangement with a private hospital.
Dr. Siegel said several of the public hospitals have space for a wing for inmates, but he declined to be more specific about where they might be treated.
Modular Units Favored
In terms of the design of the hospital complex, the plan favors the use of adaptable modular units that would allow construction to go forward with a window of six to nine months during which decisions about "what goes where" could still be changed, said Mr. Billings.
"The pods are different," said State Assemblyman Clarence Norman, who represents the area. "But our main concern is not the aesthetic design. The main concern is that they move forward."
Mr. Billings said the panel had estimated that it will take almost six years "from the time they shovel the dirt until they open the door."
And Dr. Siegel said $60 million is available to start excavation immediately, with $720 million still to be raised.
When asked if he would still describe the project as a $120 million hole in the ground, he said the money "was spent on a project many people were dissatisfied with." But some of the money, he said, in a departure from remarks in the past, was "spent on good things."
"You want to learn from the past, but you don't want to be bogged down in it," he said.
