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Health Care Reform

We work to protect and secure health care coverage and services for those groups that lack the economic or political resources to obtain them on their own.

New Jersey is in the midst of a health care crisis, with high numbers of uninsured and underinsured of all ages, and an alarming increase in the number of hospital closures, especially in urban areas. We work to protect and secure health care coverage and services for those groups that lack the economic or political resources to obtain them on their own.

Our primary activities are:

Monitor sales, closings, and status changes of non-profit hospitals
The law requires non-profit hospitals to continue dedicating funds for their original purposes, regardless of transitions in ownership or structure. For communities whose hospitals are closing or changing to for-profit status, we have helped to implement sizable charitable trust funds and other protections to ensure that those communities continue to have access to health care services and benefit from their hospital’s assets. We also oversee non-profit to non-profit mergers to ensure that communities retain reasonable access to acute care and medical services. To expand and strengthen our work in this area, we received a grant from the Healthcare Foundation of New Jersey in 2008.

Expand health insurance coverage for low-income residents
To achieve this goal, NJ Appleseed was awarded a sub-contract grant from the Robert Wood Johnson Foundation’s Consumer Voices for Coverage initiative. As part of the initiative, RWJF awarded grants in 12 states to boost efforts to expand health coverage. NJ Appleseed is a member of the leadership team and is also the legal arm of the coalition. We are also working to both protect and expand New Jersey’s State Children’s Health Insurance Program (S-CHIP), currently one of the best of its kind in the nation.

Explore innovative ways to improve low-income kids’ health
We have worked to establish that New Jersey kids have a legal right to adequate and educationally appropriate school playgrounds, which can help improve the overall health of low-income kids.


Legislation and ongoing oversight to protect community health care assets and access to medical care
NJA partnered with New Jersey Citizen Action to get one of the best community health assets protection acts in the country. New Jersey’s Act ensures the involvement of the Department of Health, the Attorney General’s Office and the public when a nonprofit hospital enters into a sale, merger or other corporate transaction with another hospital that involves the transfer of assets. The Act covers non-profit to non-profit mergers as well as conversion of non-profit community hospitals to for-profit status. Since this legislation was passed in 2001, NJ Appleseed has been able to oversee numerous hospital transactions and protect community access to healthcare services and assets. We are now seeking to ensure that the law applies to hospital closings.

Protections for reproductive rights
NJA, with the assistance of the NJ ACLU, secured the first court order in the country acknowledging that the merger of a secular hospital into a Catholic hospital was a change in mission requiring a charitable trust settlement (Elizabeth General Hospital/St. Elizabeth’s Merger). NJA caused a trust to be created that was dedicated to providing low-income women residing in Elizabeth, New Jersey, the monetary resources to secure reproductive services, including abortions, tubal ligation surgery and other services, in neighboring counties. As a result of NJA’s litigation efforts, NJA has been able to negotiate several charitable trust payments in similar cases.

Urban kids and health: Establishing a right to adequate school playgrounds
Initially on behalf of the Trust for Public Land in New Jersey, NJ Appleseed created a legal argument to enable urban school districts to acquire land for schoolyards. As a result of our efforts, the School Construction Corporation changed its regulations to make the rehabilitation or creation of playgrounds a reimbursable expense. In its work, NJA made innovative use of the State’s Abbott Law, which is part of the State’s constitutional mandate to provide a “thorough and efficient education,” and which addresses the gap between suburban and urban school districts. Our publication, “Where Do Our Children Play? The Importance and Design of Schoolyards” is available for purchase in the Store on this website.

Past initiatives:

Protecting Health Insurance Coverage for NJ Kids (2008)
New Jersey’s State Children’s Health Insurance Program (S-CHIP) is one of the nation’s broadest and most successful. New mandatory federal requirements are threatening to limit the program and end coverage for many children and their parents who are currently enrolled. The State of New Jersey has taken the US Dept. of Health and Human Services to court over the matter. NJ Appleseed, represented pro bono by Arent Fox in Washington, DC, submitted a brief to the court as an ‘amicus’ (a ‘friend’ of the court) to support the State’s case. This ‘amicus brief’ was filed on April 4, 2008 on behalf of 16 state and local health care advocacy groups seeking to stop the implementation of the new requirements and preserve New Jersey’s S-CHIP.

Protecting Community Assets in Hospital Closings & Sales (2007-8)
NJ Appleseed has written letters to the Attorney General and Department of Health to express our concern about several hospital transactions, including the sale of Cathedral Health Systems (St. Michael’s, Columbus, and St. James) to Catholic Health East, the closing of Union Hospital, the bankruptcy of Bayonne Medical Center, Pascack Valley Hospital (Westwood) and Barnert Hospital (Paterson), and most recently, the closing of Muhlenberg Hospital. In each transaction we are acting to ensure that the financial assets of these institutions, as well as the essential health services, remain in the community

Victory in Mountainside Hospital Sale to Merit Health Systems (2007)
NJ Appleseed secured several provisions to ensure that this non-profit hospital continued to serve the community, despite its sale to a for-profit entity. One provision guarantees that the facility will operate as a hospital for at least 10 years, which is also binding on any future purchaser. Another provision establishes a Citizens Advisory Group to provide ongoing community input and oversight. We also helped to ensure the independence of the Mountainside Foundation, which held funds dedicated to the hospital’s non-profit mission, and we will participate in the Court’s process to determine the application of those assets. NJ Appleseed represented NJ Citizen Action and AARP-NJ in the case.

Victory in Passaic Beth Israel Hospital Sale to St. Mary’s (2007)
NJ Appleseed represented a coalition of groups seeking to protect access to women’s health services, and contraceptive and family planning services, after PBI was sold to a Catholic hospital. The coalition was comprised of MergerWatch Project, National Organization of Women (NOW)-NJ and NOW-Passaic County, and the New Jersey Religious Coalition for Reproductive Choice. The Commissioner of Health imposed conditions that addressed the groups’ concerns. Furthermore, all parties are required to be notified of any move by St. Mary’s to modify those conditions in the future.

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