Protecting North Central Bronx Hospital was a prevalent concern among local elected officials and advocates testifying at a Bronx hearing on possible reductions in state medical facilities last week. The Norwood institution does not appear to be under an immediate threat, but some worry that prior downsizing makes it vulnerable to closure.

“The possibility of closing NCB would amount to an attack on the people of the northwest Bronx,” said Assemblyman Jeffrey Dinowitz, in testimony read by a staffer.

The three-hour session was the Bronx’ chance to respond to a state commission charged with examining New York’s hospitals and nursing homes. State lawmakers are hoping to reduce costs by whittling down the system’s capacity. The governor is also intent on curbing the growing cost of Medicaid — the public insurance system that is the lifeline for many hospitals — by keeping reimbursement rates flat.

As it is, city public hospitals are struggling financially. The Health and Hospitals Corporation (HHC), which oversees the city’s public facilities, is estimated to be running a $510 million budget deficit, according to an analysis the city’s Independent Budget Office released last month.

“If current trends continue and the additional state and federal resources are not available, HHC will soon be unable to cover its expenses,” stated the report.

The governor and state legislature established the task force (officially called the Commission on Health Care Facilities in the 21st Century) last year to study how the hospital system can be downsized. Possibilities include “consolidation, closure, conversion, and restructuring of institutions,” as their Web site states.

North Central Bronx (NCB) faced some of those options in 1999, when the city reportedly sought to close the hospital. NCB never shuttered its doors, but it did go through an extensive downsizing. Its inpatient pediatrics and rehabilitation units were closed, beds were shed, and staffing levels were cut roughly in half.

Today, NCB is the Bronx’ third smallest hospital. It employs 1,200 staff, contains 190 beds and made 7,237 discharges in 2004, according to state figures. In comparison, Montefiore Medical Center saw almost 36,000 patients and maintained 706 beds in just the division that neighbors NCB.

But NCB is still a valuable local resource. The facility’s sexual assault response team provides services throughout the Bronx, and other city hospitals have replicated its award-winning work. NCB offers comprehensive psychiatry and addiction programs, special adolescent pregnancy services and a trauma unit. And as a public hospital, it cannot turn away the poor or uninsured.

“We need a public hospital for our community,” said Elizabeth Thompson, an NCB employee for the past 23 years and a Kingsbridge Heights resident. “[Officials] kept saying they weren’t going to close it, but now we’re faced with it again.”

Arthur Wagner, NCB’s executive director, said he felt “absolutely” secure about the hospital’s fate. “I am very comfortable with the state we are in,” he said. Wagner thinks the state should see the hospital’s prior downsizing as a model of resource restructuring.

But advocates believe prior efforts to shut NCB make it more vulnerable. “The same politics that have been there for years is the same politics that will be there now,” said Judy Wessler of the Commission on the Public’s Health System, a city advocacy group.

Beyond NCB, speakers repeatedly cited the borough’s rapidly growing population and extensive healthcare needs as reasons not to close facilities. The Bronx has one of the city’s highest rates of diabetes, HIV infection and obesity. “The Bronx’ high incidences of disease makes its service needs higher per capita than any other in the city,” said state Senator Jeffrey Klein, in testimony read by a staffer.

Speakers also repeatedly criticized downsizing for its ramifications on Bronx employment. A third of Bronx residents currently work in the health care sector.

Congressman José Serrano, state Senator Efrain Gonzalez and Bronx Borough President Adolfo Carrión also submitted testimony, but Council Member Oliver Koppell was the only elected official who spoke in person. Plenty of union representatives, but few residents, were in attendance.

Wessler thought the low numbers were due to a hearing on the Yankee Stadium development that day, and poor publicity. “The commission hasn’t made a serious effort to get people there,” she said.

The City Council has also formed a task force to study the possible closures. They held their first public meeting at Fordham University on April 3, and will solicit opinion throughout the boroughs. They will issue a report in September.

All five boroughs have now given testimony to the state commission, which will make final recommendations in December. Wessler thinks the hearings sent a strong message against closures, but she’s worried that it won’t reach the final decision makers. “How much of it will make it up there is unclear,” she said.