BY LINCOLN ANDERSON | Dr. Jeremy Boal, the new president of the Mount Sinai Downtown health network, and Susan Somerville, Beth Israel Hospital’s president for the last three years, recently teamed up to lead a community informational meeting on the Beth Israel rebuilding plans.
A concerned crowd of more than 100 locals, including area politicians, filled Baruch College’s Mason Hall, on E. 23rd St., on Oct. 27 to hear the presentation of the hospital plans, followed by a Q & A.
Despite Boal and Somerville’s reassurances, the politicians pushed for more information, particularly from the state Department of Health. Local residents, meanwhile, expressed skepticism that the new hospital would adequately meet the community’s needs.
The day before, Dr. Ken Davis, the Mount Sinai Health System C.E.O., had announced Boal’s appointment as the head of Mount Sinai Downtown, the new name the health system recently gave to its facilities below 23rd St.
Boal’s job will be to oversee the creation of that new network’s centerpiece, a scaled-down Mount Sinai Beth Israel Hospital on Second Ave. between E. 14th and 13th Sts., which is slated to be completed in four years from now. Boal will also oversee the “enhancement” of the New York Eye and Ear Infirmary on the same block, plus the upgrading of two other major medical hubs the health system runs in the Downtown area — on Union Square East and on W. 15th St. — plus other scattered physician sites.
Boal, who trained in geriatric medicine, started out as an intern at Mount Sinai 25 years ago. He has two decades of experience in patient care and hospital management.
He is currently still executive vice president and chief medical officer of the larger Mount Sinai Health System. In January, he will fully take over the new Downtown network and Somerville will step down.
Previously, Boal was chief medical officer for North Shore-LIJ Health System, now known as Northwell Health, which operates the Lenox Health Greenwich Village 24/7 stand-alone emergency department at W. 12th St. and Seventh Ave. on part of the former St. Vincent’s Hospital site.
Under the Beth Israel rebuilding plan, the eyeglasses store at the southeast corner of E. 14th St. and Second Ave. will be replaced with an open plaza that Boal described as “a giveback” to the community. However, he later noted, Mount Sinai is also proactively opening up this corner because it potentially could be the site of a Second Ave. subway entrance/exit at some point in the future — so, they might as well do it up now.
Over all, Boal said, Mount Sinai hopes the new compact full-service hospital — designed by architects Perkins Eastman, and sporting a scrim-like overhead structure to define the corner plaza — will be “sort of a gateway to the East Village.”
The walk-in entrance for its emergency room will be on E. 14th St. Whether the ambulance bay, however, will be on 14th or 13th St. still hasn’t been decided.
The new hospital will only have 70 acute-care beds. But it will be built so that, if it turns out more hospital beds are needed, two or three floors could be added atop its E. 13th St. side. But Boal said Mount Sinai feels 70 is the correct number, at least right now.
Nevertheless, Boal said, it’s good to have the possibility of adding beds.
“It is critical to be able to expand,” he stressed.
Currently, the existing Beth Israel Hospital, at E. 16th St. and First Ave., sees about 300 of its acute-care beds filled on a daily basis. (The hospital’s Bernstein Pavilion, at E. 16th St. and Perlman Place, has 150 beds for behavioral-health patients that are filled to capacity, and that number won’t change under the plan.)
Mount Sinai arrived at the number or 70 acute-care beds by factoring in expected and planned reductions. For example, 60 of the current beds at Beth Israel will no longer be needed due to advances in ambulatory treatment, according to Mount Sinai. In addition, patients needing complex care, such as kidney transplants or neurosurgery, as well as women giving birth, all who would normally fill another 100 of the hospital’s beds, will be shifted to Mount Sinai’s uptown hospitals — including Mount Sinai West (the formerly Roosevelt Hospital) and Mount Sinai St. Luke’s. Another 40 beds will no longer be needed thanks to a new “Hospital at Home” program, for which the federal government recently gave Mount Sinai a $20 million grant, which will treat more people where they live. Finally, a 30-bed Mount Sinai Brooklyn Obstetrics Center will be created to serve Beth Israel’s current Brooklyn patients; about half of the births at Beth Israel are by Brooklyn residents.
In fact, Boal pointed out, it’s best for people just to stay out of hospitals, if they safely can, since hospitals are full of infections, among other things. Plus, “patient satisfaction” is higher when people can be treated at home, he noted.
About one-third of the city’s acute-care hospital beds are currently empty, and this percentage increases every year, Somerville pointed out.
“The number of patients that spend time in hospitals will go down, and they’ll spend less time in hospital beds,” Boal stated.
However, not all at the meeting were convinced. During the Q & A, Sue Ellen Kennedy, an East Village resident, accused the Beth Israel plan of being based on “magic beds” that don’t exist.
As for Mount Sinai’s plan to sell its Beth Israel Hospital campus in Gramercy, Boal and Somerville explained that the square block between E. 16th and 17th Sts. and First Ave. and Perlman Place — a.k.a. “the superblock” — will be sold, along with Gilman Hall, on the northwest corner of E. 17th St. and First Ave., plus a row of small buildings along First Ave. In short, all of the current Beth Israel property except for the Bernstein Pavilion will be sold, and all proceeds from the sale will be funneled into the $500 million Downtown plan, mostly for the construction of the mini-hospital, though more funds will likely be needed, they said.
The current hospital will keep operating until the new one opens.
As for what kind of housing will be built on the Gramercy site, they said Mount Sinai strongly supports affordable housing, but that it will be up to the developer to determine this.
However, speaking on behalf of Gale Brewer, the Manhattan borough president, Matthew Washington, the deputy borough president, told the hospital officials, “The Borough President’s Office would love to see a 100-percent affordable housing project there.”
The audience applauded its support.
“We’re certainly going to advocate for it,” Boal said of affordable housing.
Dan Sheppard, a deputy commissioner of the New York State Department of Health, explained that “certificates of need” are required for each step of closing down the current Beth Israel Hospital and opening the new smaller version. The “C.O.N.’s” will be viewable on the department’s Web site, he said.
But local politicians at the presentation said they want a lot more notification and input than that. Assemblymember Brian Kavanagh, during his remarks, brandished a letter to the state D.O.H. commissioner that 16 of the area’s elected officials jointly signed back in July soon after news of the Beth Israel rebuilding plan broke.
Their letter stated, in part, “Given our and the public’s concern over past losses of hospital services in Manhattan, it is important that D.O.H. attend a public meeting to explain the criteria and process that might be used by the department in evaluating and responding to the applications that Mount Sinai is considering for Beth Israel Hospital and Mount Sinai’s downtown services. We are hopeful that D.O.H. will provide the community with information and answer questions about the regulatory decision-making standards and process, and that any decisions your agency ultimately makes will be fully informed by the community’s input.”
“There’s a lot of moving parts,” Kavanagh stated. “The hospital has been very forthcoming — but we would like to see comprehensive review [of each stage of the process]. The community has seen hospitals come and go. We’d like much more clarity. We’re looking for the Health Department to act as the ultimate arbiter of this plan and make sure it’s meeting people’s needs,” Kavanagh said, to the audience’s applause.
Added Wendi Paster, Assemblymember Richard Gottfried’s chief of staff, “Perhaps there was a communication problem because we would have liked to hear a little more. Also, we’d like to hear a little more about affordable housing.”
State Senator Liz Krueger expressed concern that no one seems to be overseeing Manhattan’s shifting healthcare landscape — much less the whole city’s — in terms of public and private hospitals, and whether this seemingly increasingly random patchwork actually all works together.
“I’m very concerned that somebody’s not looking at the big picture,” Krueger said. “This is like reorganizing the deck chairs of healthcare,” she added, riffing on the “rearranging the deck chairs on the Titanic” line.
However, Somerville added that Mount Sinai is, in fact, taking the time to do things correctly.
“We’ve all seen where hospitals close and it’s terrible for patients — just a hard stop,” she said. “With the Beth Israel plan, the four-year timeline affords us the opportunity to get it right.”
Boal added there would be many more meetings to keep the community informed about the plan’s progress.
Umair Khan, deputy counsel to Public Advocate Letitia James, was skeptical that Mount Sinai would have space at its uptown hospitals for
Downtown women to deliver babies, since this service won’t be done at Beth Israel anymore.
“We know N.Y.U. [Langone] is filled to capacity, as is Bellevue,” he said.
But Somerville answered, “We have pockets of beds in many facilities that aren’t being used.” Plus, there will be the new Brooklyn obstetrics facility, she added.
Regarding the downsized East Village hospital’s emergency department, Boal explained, “This will be a very busy, very large emergency department.”
The E.R. won’t treat trauma patients, though, who will continue to be sent to Bellevue Hospital, as is done now, he said.
Somerville added that the new M.S.B.I. hospital will have “a surge plan,” such as would be needed during a flu epidemic, for example. Superstorm Sandy was a situation that saw a surge of patients, she noted.
The new hospital will be built mostly on E. 13th St. on the site of a former New York Eye and Ear residential building and a small parking lot. There will be parking underneath the new hospital, Boal noted.
Responding to concerns about the future of Beth Israel’s employees, the hospital leaders said they are proud of Mount Sinai’s agreement to ensure that all unionized employees get equivalent union jobs.
“It has been an absolute priority to preserve jobs for employees,” Somerville said. “It’s not perfect, but we’re not doing layoffs.”
A West Village woman, recalling the terror blast in Chelsea two months ago, said it could have been much worse, and that the area needs a Level I trauma center, like the one St. Vincent’s Hospital had before that hospital shuttered in 2010.
“Everything is on the East Side, but we need something on the West Side,” she said of how hospitals south of 23rd St. are distributed.
“St. Vincent’s closing was a tragedy that wasn’t supposed to happen,” Boal said, sympathetically.
Lower East Side activist K Webster of Neighbors to Save Rivington House asked what Mount Sinai is doing “to prepare for the crisis you don’t know about.”
“There’s Ebola, climate change, a lot of unknowns are out there,” she said. “We lost Rivington House, an AIDS hospice — the Department of Health dropped the ball in a major way.”
Boal answered that Mount Sinai has “studied projections on aging and young families” for the new hospital’s service area. The health system, in fact, creates a “likely threat list” each year, he added. noting they had just worked up a scenario for dealing with the possibility of “another Superstorm Sandy downtown.”
The audience expressed its approval as Boal added that a key to ensuring the new hospital meets the community’s needs will be for it to have “multicultural physicians and services.”
