The past few weeks have been difficult for me and my colleagues at Homedical Associates and Alliance for Homebound People.I have attached three files to provide background information and encourage you to view them. During this period, I have made a concerted effort to inform the Capital District and its political representatives of the severe financial problems confronting Homedical Associates. My hope is that a solution can be found to enable us to continue the medical care that we provide to homebound people in the four county Capital District. While I realize that other public service entities in the Capital District face similar hardships, I also realize that I have a responsibility to prioritize Homedical's issues and to attempt to develop a solution for our predicament. To that end, I have worked tirelessly to develop support for Homedical Associates to enable us to survive through 2005. I believe that I have now substantially discharged this responsibility and that I must leave the future of Homedical Associates and Alliance for the Homebound in the hands of "The Community" and our political representatives who have the perspective and the influence to preserve the crucial services that Homedical provides to the citizens of the Capital District. We currently have funds to survive to the end of January 2005. At that time, if no support is available to continue our medical practice, we will have no choice but to close our doors. We currently provide medical care to about 500 homebound people in the 4 county Capital District (We estimate that there are at least 4000 more). We will inform our patients of our financial distress and the need for them to find medical care elsewhere prior to the end of January 2005. We believe that the cost of providing alternative care to these people will far exceed the cost of supporting Homedical through our difficulties. Furthermore, we had hoped that our example will provide a prototype for other counties in New York State for dealing with the long-term care crisis that has begun and will intensify over the next 30 years. We believe that in-home medical care and special approaches to housing are needed to avert disaster. Supporting Homedical Associates and Alliance for the Homebound provides a cost-effective means to deal with the looming crisis. The funding we are requesting is equivalent to the cost of providing nursing home care for one person in each of the four Capital District Counties for a period of one year. If Homedical is no longer able to provide medical care to our existing patients, many more than 4 of them will require institutional long term care at far greater to expense to New York State and the 4 Capital District Counties. We realize that the personal toll on our patients and their families will be enormous and that there will be political repercussions. Yet, as I have explained recently, we are left with little choice. We are not able to survive financially without immediate financial assistance. Whether this financial assistance will be in the form of support from local foundations, private philanthropists or State funds or a combination of these sources is not known at present. Financial assistance is required now to enable us to develop other resources over the next 12 months. We have begun to develop mechanisms to augment the fees we receive from insurers. At present, Medicaid pays only $8.00 for a home medical visit that routinely require an hour or more of the provider's time. Medicare, while providing about $120 per visit, still fails to cover our operating costs. I am available to discuss these issues at your convenience. Feel free to contact me via email or phone. Please help. David Hornick
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