By Penny Mintz
On Thursday, February 6th, 2020, the full Public Health and Health Planning Council (PHHPC) met to vote on the recommendation of its Establishment and Project Review Committee. On January 23th, 2020 the Establishment Committee had voted to conditionally approve Mount Sinai’s application for a Certificate of Need that would enable Mount Sinai to build a 70-bed facility to replace the 650-bed Beth Israel Hospital building on First Avenue and East 16th Street. However, three conditions were imposed on that conditional approval.
The first condition requires Mount Sinai to submit a plan that would help patients navigate the evolving Mount Sinai health system. This plan must be acceptable to the Department of Health and must be provided to the department within 90 days of PHHPC’s approval letter. Second, no later than 90 days before the new 70-bed facility opens, Mount Sinai must provide the Department of Health with a comprehensive transition plan, including a communications plan, that is acceptable to the DOH. Third, within 18 months of PHHPC’s approval letter, Mount Sinai must submit documentation of its exploration of the possibility of opening a birthing center. The documentation must include a business feasibility study, potential site locations, review of quality and safety concerns, and consideration of birthing center governance models.
Two members of PHHPC opposed the application. One, Dr. Howard Berliner, who is a professor at SUNY Downstate Medical Center and chair of that hospital’s Health Policy and Management Council, voiced three serious concerns about Mount Sinai’s application. First, Dr. Berliner pointed out that a large number of acute-care beds have already been removed from Lower Manhattan, which has a growing population and experiences the largest daily surge in population of any place in the United States. He did not think that removing another 500 beds and replacing them with a 70-bed facility “is adequate in a part of New York City which is growing in population.” PHHPC Chair Jeffrey Kraut, who is the executive vice president of Strategy and Analytics at Northwell Health, asked if he would “rather have the St. Vincent’s outcome?” Dr. Berliner replied that luxury housing was not the only option. Mount Sinai could, for example, be required to build a 150-bed acute-care replacement facility.
Dr. Berliner also took issue with Mount Sinai’s emergency room plan. “The ER is overcrowded today,” he said, “and the increase in size is not enough to make up for the lack of acute-care beds in that area.” He added that it is great to have primary care clinics and other practice plans, but “those don’t operate 24 hours a day, seven days a week.” Dr. Berliner finds that Mount Sinai’s ER plans for Lower Manhattan are “just scary.”
Finally, Dr. Berliner does not believe that the addition of a birthing center is a sufficient resolution of the problem of access to maternity care that was created in Lower Manhattan when Mount Sinai closed the highly successful maternity unit at Beth Israel.
Chairperson Kraut instructed the PHHPC members that their determination must be based on three criteria: whether a project is needed, whether it is financially feasible, and whether the applicant has the character and competence to carry it out. Guaranteeing the healthcare of New Yorkers is, apparently, not among the concerns that PHHPC is charged with considering.
Tracy Raleigh, a DOH official who does research and background work for PHHPC and prepares DOH recommendations to the Council, promised that, in view of public concern about the application, the department will report back to the full PHHPC regarding Mount Sinai’s compliance with the conditions imposed on the council’s approval.
After the application passed with two PHHPC members voting to oppose, nearly half of the people in the audience got up and left—an indication of the continuing level of public concern.