Mount Sinai criticized on lack of public notice, closure of maternity services at forum

Mount Sinai Chief of Ambulatory Care Kelly Cassano, VP and Chief of Strategy for Behavioral Health Sabina Lim and Executive Vice President and Chief Medical Officer of the Mount Sinai Health System Jeremy Boal addressed questions at the public hearing held at Baruch last Wednesday. (Photo by Maria Rocha-Buschel)

By Maria Rocha-Buschel

Residents and local elected officials at a sparsely attended public hearing on Mount Sinai Beth Israel’s downsizing plan last Wednesday slammed the hospital system for the lack of notice about public meetings on the project and the elimination of the maternity ward at the facility.

The $1 billion project from Mount Sinai includes a new hospital facility at East 14th Street and Second Avenue to replace the Beth Israel Hospital on First Avenue, which is expected to open in 2022.

While Mount Sinai Corporate Director of Community Affairs Brad Korn attributed the low attendance at the event to the soggy weather because a nor’easter was moving through the city in the midst of Wednesday’s evening commute, Epstein argued that it had more to do with lack of notice to residents in the neighborhood, or that even if attendance was affected by weather, the outreach was insufficient regardless.

Korn said that Mount Sinai publicized the most recent hearing, which was held at Baruch College, by sending the flyer out through the local community boards and the working group with the Borough President’s office, and Epstein argued that wasn’t enough.

“I’m just concerned that that’s really not outreach on your part and you’re putting the burden on the community boards and the elected official offices to do the outreach in a community where there are hundreds of thousands of people,” he said. “You have to do real outreach instead of relying on all our offices to do the outreach for you. It would be really good to have people on the streets flyering and putting it up in stores.”

Korn noted that this isn’t the last public meeting that Mount Sinai will be hosting so there will be additional opportunities for residents to learn more about the project, and he said that they would also take Epstein’s note into account for the future meetings. The hospital system has previously held almost 70 meetings on the downsizing plan and has committed to remaining open throughout the process.

Town & Village previously reported in 2017 that the current Beth Israel facility would stop delivering babies and there have been no plans for a maternity program at the new hospital. Resident Penny Mintz said at the meeting last week that she was concerned about the fact that the hospital had eliminated its maternity ward and questioned whether Mount Sinai would be reintroducing any of those services at the new facility.

“There were hundreds of births at Beth Israel every year,” she said. “I had all my children there. You haven’t brought anything back to make up for that.”

Another resident said that she felt that downtown residents would appreciate a new facility given the condition of the current building.

“Did you consider in the beautiful new hospital that you’re building that women would want to come and deliver babies there and whether or not you could rebuild that capability?” she said. “I think everybody knows that the old hospital is not the loveliest place to be. But now you’re going to build this beautiful, shiny thing I think a lot of women downtown would really look forward to delivering there in a state-of-the-art facility.”

Jeremy Boal, Executive Vice President and Chief Medical Officer of the Mount Sinai Health System, said that the elimination of maternity services at Beth Israel was a matter of safety because the number of births at Beth Israel has actually been decreasing.

“The service was a fraction of what it was in its heyday,” he said. “They were delivering less than six babies a day when healthy programs are delivering easily twice, three times, four times that volume. So for us, it was less of an issue about the normal deliveries but when things went wrong, the volumes were so low that we couldn’t guarantee that we could maintain the competency of the staff to manage every type of emergency and complication. Our neonatal ICU was down to a handful of babies at a time, where a healthy neonatal ICU has 20 infants in it.”

Mount Sinai West on the Upper West Side and Mount Sinai Hospital on the Upper East Side will continue to provide labor and delivery services and both hospitals are equipped with full-service, Level III neonatal intensive care unit (NICU) for infants born prematurely or with complications. Although there will not be a dedicated maternity ward in the new Mount Sinai Beth Israel, the hospital’s current emergency room has the capability to deliver babies if necessary and the ER in the new hospital will also have that capability.

As in previous meetings, attendees also questioned the drastic reduction in beds at the new facility. The current hospital is a 799-bed facility, with 649 medical-surgical beds and 150 psychiatric beds, and the new hospital will have 70 medical-surgical beds with 135 psychiatric beds, although now those beds will be relocated to the new facility downtown on Rivington Street.

Boal said on Wednesday, as the hospital has stated in previous meetings, that the reason for the reduction is that only a quarter of the medical-surgical beds are filled at a time and since more patients are also receiving care outside traditional hospital settings, hospitals need fewer beds. The hospital will also be able to increase capacity if community needs require it.

Sabina Lim, Vice President and Chief of Strategy for Behavioral Health, also went into more detail during this meeting about the decision to close the Bernstein Pavilion and move behavioral health services to a new facility on Rivington Street.

Lim said that one of the main reasons for the relocation, in addition to poor infrastructure at the current facility, is to address gaps in service.

“It’s either locked 24-seven supervision and the other option is primarily seeing a doctor or therapist once a week or once a month,” she said. “There are very few options in between and the fact of the matter is many of the conditions that people have don’t necessarily require hospitalization, but they need more than seeing a doctor or therapist once a week or once a month.”

The new facility will also create a more comprehensive outpatient model so that patients will be able to get both mental and physical health services all in one place.

Another goal for the new facility is to work with partners in community-based organizations and create different types of pilot programs to increase access to various services, in addition to psychosocial support services, vocational training and education.

Aside from the infrastructure issues with the building, which Town & Village previously reported would ultimately be prohibitively expensive to renovate, other physical problems with the building include the layout, which the new facility will be able to correct.

“The shape of the building would basically require us to continue to have what we call triples or quads so people will be sharing with two or three other people and that’s not the climate model that we wanted to have,” she said. “And if we wanted to create integrated services and space where everyone can get together, whether you need a mental health professional or substance use disorder professional or primary care professional, we wouldn’t be able to do that with everything on two different floors.”

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