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2009-27080 ResoRESOLUTION NO. 2009-27080 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, AUTHORIZING THE CITY OF MIAMI BEACH TO SUBMIT AN APPLICATION FOR FUNDING TO THE U.S. DEPARTMENT OF HOMELAND SECURITY ON BEHALF OF MOUNT SINAI MEDICAL CENTER FOR THE STORM SURGE EMERGENCY POWER PROTECTION PROJECT; DIRECTING THE CITY MANAGER TO SIGN ALL CORRESPONDING DOCUMENTS FOR THE SUBMISSION OF THE APPLICATION; AND ACKNOWLEDGING THE RETAINED ACCOUNTABILITY BY THE CITY OF MIAMI BEACH FOR THOSE FUNDS THAT ARE AWARDED TO THE PROJECT. WHEREAS, Mount Sinai Medical Center (the "Hospital"), in conjunction with its emergency room operations, is the City of Miami Beach's primary health care provider, which is located upon a barrier island and is placed at great risk during each hurricane season; and WHEREAS, the Hospital has been designated as a regional Emergency Command Center, which mandates that its facilities, power supply and services are and remain available for use by patients, local law enforcement, and first responders during disaster events; and WHEREAS, the Hospital is seeking to acquire funding for the construction of a disaster resistant, centralized, redundant 5-bay power facility (the "Project"), which will help ensure that all Hospital services and facilities are secure and stable during disaster events consistent with its designation as a regional Emergency Command Center; and WHEREAS, the Hospital will seek federal funding in the total amount of $12 million, and the Hospital is prepared to contribute $12 million in order to satisfy the total cost for the Project which exceeds $24 million; and WHEREAS, Congresswoman Debbie Wasserman Schultz has identified the Project as one of her fiscal year 2010 appropriation requests in the amount of $5 million through the Labor/Health and Human Services Appropriations Bill; and WHEREAS, the U.S. Department of Homeland Security, by and through the Federal Emergency Management Agency, authorizes local governments to apply for funding from the Pre-Disaster Mitigation program on behalf of a private non-profit organization in order to mitigate the impact of disaster events; and WHEREAS, the submission of this application by the City of Miami Beach neither conflicts nor competes with any federal appropriation requests submitted by the City of Miami Beach for the fiscal year 2010 appropriations cycle,- and will allow the City of Miami Beach to retain accountability for the funds awarded to the Project. 2009-27080 NOW, THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH FLORIDA, that the Mayor and City Commission hereby authorize the City of Miami Beach to submit an application for funding to the U.S. Department of Homeland Security on behalf of Mount Sinai Medical Center for the Storm Surge Emergency Power Protection Project; directing the City Manager to sign all corresponding documents for the submission of the application; and acknowledging the retained accountability by the City of Miami Beach for those funds that are awarded to the Project. PASSED and ADOPTED this 3rd day of June, 2009. ATTESTED BY: HERR A OWER MA OR ~~ ROBERT PARCHER CITY CLERK ~~~~~ ~ .ro fCJgMi ~ 1~1~.1sAC3E ~ CUTl~A~1 f~~" .~ z~ ~y, ~ ~~ T:\AGENDA\2009\June 3\Consent\Sinai Reso.doc COMMISSION ITEM SUMMARY Condensed Title: A Resolution authorizing the submission of a federal funding application on behalf of Mount Sinai Medical Center. Key Intended Outcome Supported: Ensure well-maintained infrastructure Supporting Data (Surveys, Environmental Scan, etc.): In 2007, 58% of residents, and 63% rated storm drainage (to avoid flooding) as fair or poor. Issue: Shall the City submit a federal funding request to the Department of Homeland Security on behalf of Mount Sinai Medical Center, for their Storm Surge Emergency Power Protection Project? item Summary~ircecommenaation: Mount Sinai has requested that the City serve as the sub-applicant on behalf of Mount Sinai for its funding application to the U.S. Department of Homeland Security. Mount Sinai has submitted a request for federal funding to support the construction of a disaster resistant, centralized, redundant 5-bay power facility, which will help ensure that all services and facilities provided by the Hospital are secure and stable during disaster events. More information on the project is provided in the attached project summary. The total cost of the project is $24 million, of which Mount Sinai will seek federal funding in the total amount of $12 million, $5 million of which has been submitted by Congresswoman Debbie Wasserman Schultz as one of her FY 2010 appropriation requests. Congressional staff have informed the Administration that the U.S. Department of Homeland Security requires that the City submit the application for funding on behalf of the Hospital. The Administration has spoken with the Congresswoman's staff, who confirmed that this request for funding does not conflict or compete with any federal appropriation requests submitted by the City for the FY 2010 appropriations cycle. Board Recommendation: Financial Information: Source of Amount Account Funds: ~ N/A 2 3 OBPI Total Financial Impact Summary: NIA Ci Clerk's Office Le islative Trackin Kevin Crowder, City Manager's Office Sign-Offs: Department Director Ass' t t City Manager City Manager KC HF" JMG T:\AGENDA\2009Uune 3\Consent\Sinai Summary.doc m MIAMIBEACH J~ , AGENDA ITEM C7C DATE ~0`.3"'U9 m MIAMIBEACH City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov COMMISSION MEMORANDUM To: Mayor Matti Herrera Bower and Members of the City Commission FROM: Jorge M. Gonzalez, City Manager DATE: June 3, 2009 SUBJECT: A RESOLUTION OF THE MAYOR D CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, AUTHORIZING THE SUBMISSION OF AN APPLICATION FOR FUNDING TO THE U.S. DEPARTMENT OF HOMELAND SECURITY ON BEHALF OF MOUNT SINAI MEDICAL CENTER, FOR THE STORM SURGE EMERGENCY POWER PROTECTION PROJECT. ADMINISTRATION RECOMMENDATION Adopt the Resolution. ANALYSIS Attached, please find a letter from Mount Sinai Medical Center, requesting that the City serve as the sub-applicant on behalf of Mount Sinai for its funding application to the U.S. Department of Homeland Security. Mount Sinai has submitted a request for federal funding to support the construction of a disaster resistant, centralized, redundant 5-bay power facility, which will help ensure that all services and facilities provided by the Hospital are secure and stable during disaster events. More information on the project is provided in the attached project summary. The total cost of the project is $24 million, of which Mount Sinai will seek federal funding in the total amount of $12 million, $5 million of which has been submitted by Congresswoman Debbie Wasserman Schultz as one of her FY 2010 appropriation requests. Congressional staff has informed the Administration that the U.S. Department of Homeland Security requires that the City submit the application for funding on behalf of the Hospital. No City funding commitment or match is required. Additionally, the Administration has spoken with the Congresswoman's staff, who confirmed that this request for funding does not conflict or compete with any federal appropriation requests submitted by the City for City projects for the FY 2010 appropriations cycle. CONCLUSION The Administration recommends that the Mayor and City Commission adopt the attached Resolution approving the submission of the funding application on behalf of Mount Sinai Medical Center. J Mg/H F/kc Attachments (2) T:WGENDA\2009\June 3\Consent\Sinai Memo.doc Mount Sinai May 22, 2009 MEDICAL C E N T E R Mr. Jorge M. Gonzalez City Manager City of Miami Beach 1700 Convention Center Drive Miami Beach, FL 33139 RE: Emergency Power Protection Project Dear Jorge: Mount Sinai Medical Center kindly requests the City of Miami Beach to serve as the sub- applicant on behalf of Mount Sinai for its funding application to the Department of Homeland Security. As part of the request, Mount Sinai is proposing Homeland Security funding designed to protect emergency power in future hurricanes and windstorms. Specifically, the request will. include funding for the centralization of all emergency power systems in a new above- flood stage, 5-bay facility ensuring emergency generators and other vulnerable equipment are safely located. This project also will improve the efficiency and redundancy of back- up power system infrastructure increasing the Medical Center's self-sufficiency during extended power outages. Attached please find the details of our funding request. Congresswoman Debbie Wasserman Schultz has submitted this project as one of her 2010 appropriation requests. The Department of Homeland Security requires that the City of Miami Beach submit the application for funding on behalf of Mount Sinai. We are requesting an initial allocation of $5 million. It is our understanding that this request does not directly conflict with any of the City's requests. As you know, Mount Sinai Medical Center is a critical component of the City of Miami Beach life safety system. We appreciate the City of Miami Beach's support in this manner. If you have any questions, please do not hesitate to contact me at (305) 674-2520. Sincerely, Amy Perry Senior Vie resid Chief Op ing O cc: Steven D. Sonenreich, President & C.E.O. Mount tiinai Campus Miami Heart Campus Mount Sinai Aventura Mount Sinai Key Biscayne 4300 Alton Road 4701 N. Meridian Avenue 2545 Aventura Boulevard 200 Crandon Blvd., Suite 300 Miami Beach, FL 33140 Miami Beach, FI_ 33140 Aventura, FL 33150 Key Biscayne, Ft. 33149 Phone:305-674-2121 Phone: 305-672-1111 Phone: 30.5-692-1010 Phone:305-674-2599 W W W.m5IT1C.COfT1 Mount Sinai Medical Center Storm Surge Emergency Power Protection Project Providing and Protecting Emergency Power February 2009 STORM SURGE EMERGENCY POWER PROTECTION PROJECT PROTECTING EMERGENCY POWER AT MOUNT SINAI MEDICAL CENTER, MIAMI BEACH, FLORIDA Fc,~a~n~~Re4u~sr~or>~2o~a...~ ., ,{~~.~.,.. ..: ;$5,o~a,ool ~.:1~ t.~gf.$1a~9.~.*~,.....,.FY1.Q l.~bQr, HHS and EduGatian ~P~QPf'l~~ls~'i~sj~ ~ ~ ~ ~ ~. ~ ~ U ~,S .Dapartme~~o>i' HHS ;•>. ~'. auto:~...~ ...................................,....:...:..:.:.: .. ... ..,..H1RSA. Project Summary Mount Sinai Medical Center, located in Miami Beach, Florida, is seeking funding to support the construction of a disaster resistant, centralized, redundant, 5-bay power facility. Mount Sinai's role as the primary community health care provider mandates that immediate steps be taken to ensure that all services and facilities are secure and stable during disaster events. This initiative will mitigate the effects of future hurricanes and flooding through the following realignment of facilities and infrastructure. Legislative Report Language "The Committee has provided $5,000,000 for emergency power equipment at Mount Sinai Medical Center in Florida." Uses of Federal FY 2010 Funding • Construction • Equipment • Technology Funding History Total Project Cost: $24,000,000 Federal Appropriations to date: FY 2006 - $1,000,000 (E&W; Science) Total Federal Funding Sought: $12,000,000 FY10 Request: $5,000,000 2 STORM SURGE EMERGENCY POWER PROTECTION Mount Sinai Medical Center Proiect Purpose Mount Sinai Medical Center (MSMC), located in Miami Beach, Florida is located on a barrier island, placing this vital community health resource at great risk each hurricane season. Mount Sinai is a 955 bed, not-for-profit, tertiary healthcare facility and Miami Beach's primary community health care provider. It has also been designated as a regional Emergency Command Center (ECC). As such it is mandatory that its facilities, power supply and services are and remain available for use by patients, local law enforcement and first responders during these events. The 2005 Hurricane season underscored the need for Mount Sinai to harden its facilities against the very real possibility of a severe storm occurring at least once each year. Hurricane Katrina caused unprecedented devastation in Louisiana and Mississippi. But the combined impact of Hurricanes Katrina and Wilma were a very serious one-two punch on South Florida, and caused widespread damage at Mount Sinai Medical Center. As part of its hardening initiative, the Medical Center's current emergency power generators must be replaced and a new Centralized Storm Surge Emergency Power Protection facility constructed. This Project will ensure the institution's patient care services and facilities are operable during disaster events, such as recent hurricanes Wilma, Rita, Katrina, Jeanne, Ivan, Frances, and Charley. The Storm Surge Emergencv Power Protection Project will save the lives of our patients who depend on equipment and technology that require electricity. The Project includes: 1) Relocate and centralize all emergency power systems in a new above-flood stage, 5-bay facility ensuring emergency generators and other vulnerable equipment are located off flood stage level and available in emergency situations; 2) Expand capacity of emergency power generators that supply power to all patient care areas and critical care units; 3) Create on-site, centralized diesel fuel storage for replenishment and maintenance; and, 4) Improve efficiency and redundancy of back-up power system infrastructure increasing the Medical Center's self-sufficiency during extended power outages. This Project is a substantial financial undertaking for Mount Sinai. The total cost for the new Storm Surge Emergency Power Protection facility is over $24 million. Mount Sinai is prepared to contribute $12 million over the course of the nett several years towards this project. Given the multifaceted nature of this project, Mount Sinai is seeking federal funding through the Department of Health & Human Services (HRSA) to support individual elements of the initiative: Labor-HHS-Education (HHS; HRSA) - To assist with the acquisition of critical emergency equipment, technology and energy needs, Mount Sinai is requesting a total of $12 million through the LHHS appropriations bill. An initial $5 million is sought in FY10 for generator equipment and construction. This initiative will dramatically enhance patient care and safety. As the result of strong and insightful leadership, MSMC has remained fmancially viable even as the rest of the nation's health care mazket struggles. Despite that tremendous achievement and an active effort to address the many service and facility needs on its campus, resources aze scarce and the Medical Center needs assistance to fund the estimated $200 million in other essential upgrades needed through 2012. The creation of a federal funding partnership in 2008 and beyond to support this initiative is critical and justified given Mount Sinai's role in regional emergency response activities, its sole responsibility for acute and emergency healthcaze on the Miami Beach Community, and its role as one of only six statutorily designated teaching hospitals in the state of Florida. Even if completed by 2012, as planned, Mount Sinai will face four more hurricane seasons before its facilities aze adequately hardened. MOUNT SINAI MEDICAL CENTER Miami Beach, FL Mount Sinai Medical Center, located in Miami Beach, Florida is seeking $12 million over several funding cycles to support the construction and equipping of a new Storm Surge Emergency Power Protection facility. Mount Sinai's role as a regional Emergency Command Center (ECC) and primary community health care provider mandates that immediate steps be taken to ensure that all emergency power functions seamlessly during disaster events. This initiative will save the lives of patients that aze dependent on equipment and technology that require electricity: 1) Relocate and centralize all emergency power systems in a new above-flood stage, 5-bay facility ensuring back-up generators and other vulnerable equipment are located off flood stage level and available in emergency situations; 2) Expand capacity of emergency power generators that supply power to all patient care areas and critical caze units; 3) Create on-site, centralized diesel fuel storage for replenishment and maintenance; and, 4) Improve efficiency and redundancy of back-up power system infrastructure increasing the Medical Center's self-sufficiency during extended power outages. T'he new facility will feature "the latest technology" in redundant and efficient back-up power infrastructure for the highest capacity and reliability. A new 3-story structure including on-site fuel storage will protect emergency power systems to ensure quality patient care can continue during crises and disasters. The latest hurricane season exposed some vulnerability in the facilities during periods of weather-related crisis. Significantly, Mount Sinai's emergency generators are located on the ground level of various patient caze facilities and aze insufficient for future growth needs. The threat that this poses is obvious. To mitigate future hurricane, flood or other storm damage, the Medical Center has engaged in a sweeping project to ensure that it can withstand flooding and maintain the appropriate backup generators and medical gas delivery systems to improve the safety of its patients, surgeons and staff. Conditions of Existing Emergency Generators The emergency power infrastructure serving the patient caze facilities on the Mount Sinai Medical Center campus is comprised of stand-alone emergency generators serving the main patient towers, ER/Radiology, and Ambulatory Surgery buildings. Emergency generators in the main patient towers and ER/Radiology buildings aze at the end of their useful life and in need of immediate replacement. Additionally, replacement parts for these generators and their associated main electrical distribution switchgeaz are no longer readily available in the market place. Field surveys of the ER/Radiology and Ambulatory Surgery buildings revealed emergency generators that would be nearing the end of their useful life within the next 3 to 5 yeazs. As a result of these findings, it was noted that potential equipment 4 failure associated with these systems was likely in the short term and the Medical Center must consider immediate short-term temporary improvements, as well as a more long-term permanent solution. Patient Care Building Emergency Power Each patient care building currently has one generator in case of a power failure. The main patient towers each have two (2) generators. These six (6) emergency generators and the transfer switches serving the main patient towers, intensive caze building, radiology, emergency, and ambulatory surgery buildings aze approaching the end of their useful life. This condition compromises the reliability of the generators and transfer switches greatly increasing the likelihood of an emergency power failure. The generators for the main patient tower alone aze approximately 23 years old. In addition, the building's current eleven transfer switches, required by code for a hospital system, are similarly aged. These power transfer switches are critical to the back-up power infrastructure because once equipment becomes this old they aze very difficult to maintain and test; the risk of failure is also greatly increased and grows over time. The synchronizing switch gear electrical distribution equipment used to connect multiple generators, as in the main patient tower, so that they work in tandem to provide additional power and redundancy, aze in poor working condition and replacement parts aze not readily available from local suppliers. While one of the patient towers has a backup generator, it has no synchronizing switchgeaz to connect them and therefore the transfer of power in case of one generator's failure must be accomplished manually. Additional issues that compromise the system include that electrical distribution downstream of existing generators does not meet current code and non-essential loads aze co-mingled with critical loads, which inhibits the hospital's ability to properly shed power loads when necessary. Cooling towers and air handling equipment aze also not currently supported by emergency generators. Finally, the physical location of these emergency generators and transfer switches creates an additional danger. The two emergency generators and transfer switches serving one patient tower and the intensive care building are at ground level and therefore endangered by potential storm surge. The goal of replacing generators and transfer switches will be to improve overall system capacity, reliability and redundancy, compliance with hospital code, mitigate vulnerability to storm surge and provide cooling capability for patient care areas. The project will also create consolidated generator facility which can be expanded to include capacity for all patient buildings and Energy Center. It is essential to elevate the back-up power generators to above flood level to mitigate potential future hurricane, flood or other storm damage. Storm Surge Emergency Power Protection Plant The best disaster mitigation solution for Mount Sinai Medical Center is the creation of a centralized emergency power plant to be located adjacent to the existing central energy plant. By consolidating all new emergency generation equipment in one location, the hospital would benefit from a more redundant and efficient infrastructure serving the campus. The centralized concept would permit on-site diesel fuel storage to be located in one location for replenishment and maintenance. Serviceability, maintenance, and testing of the equipment would be simplified as a result of the major equipment being centrally located. Additionally, exhaust emissions and system noise levels could be better treated without the close proximity of outside air intakes and patient caze azeas. The Storm Surge Emergency Power Protection Project is a capital improvement project that upgrades the existing emergency power infrastructure serving these buildings to improve the overall system reliability 5 and capacity. The new system increases the Medical Center's capability to be self-sufficient during extended power outages. The physical design of the new centralized power plant reflects the best thinking available regarding the proper physical environment in which to ensure optimal automatic emergency power transfer for the entire campus. The new facility will include dedicated transfer switches to each of the following hospital- wide power system branches: 1) Life Safety Systems: emergency egress, alarm systems, medical gasses. 2) Critical Care Systems: OR, procedure rooms, ED imaging equipment, medical gas booms and columns and selected lighting and receptacles deemed critical to Hospital operations to perform procedures. 3) Equipment: motor loads, mechanical equipment to maintain pressurization, elevators, motors/pumps serving areas that must continue to function such as ventilation, exhaust fans for isolation rooms or for immuno-suppressed patients. 4) Non-Essential Systems: not code required, but desirable to institution to provide or maintain normal operation. This branch is designed to be easily disconnected if needed. The project consists of selective site demolition and new construction of a second story building mounted on a reinforced concrete frame open to the sides for expansion of the existing Central Energy Plant. It will be constructed over the yard at the back of the existing the Energy Center Building and in between the Incinerator Building at the Western side and the access road on the Eastern side. Also selective demolition and construction of a new Fuel Farm including (4) four aboveground fuel oil tanks of 12,000 gallons capacity each mounted on a concrete pad and protected by a concrete wall. The building's second story will comprise two large rooms separated by a chase space within two demising CMU walls without openings. Each separate room will be accessed by separate stairs. The area occupied by the generators will have ventilation and an exhaust system of proper capacity to expel the toxic gases far away from the building. The area occupied by the parallel switchgear will be air-conditioned for optimal maintenance and operability. The total additional two story area will be approximately 125'x64' equal to 8,000 s.f., plus two stairs at 300 s.f. each for a total of 8,600 s.f. The Electrical Substations will be housed in specially renovated rooms located inside the existing facilities. The total square footage of renovated room areas for the Double Loaded Substation is 11,000 s.f.. Implementation of the centralized emergency power project plan concept is a multiyear capital expenditure project with a construction budget of approximately $24,303,000. The preliminary project schedule commences with design and permitting/approvals in the first year, followed by three years of construction including site preparation and development, building shell and foundation, and fmal build out. At the conclusion of this capital project, the existing emergency generators serving the patient care facilities would be decommissioned and removed. The new emergency power generation plant will have sufficient capacity to serve future patient care expansions, as well as the capability to provide emergency back up power to building ventilation and cooling systems. Importantly, the new facility will be designed to accommodate future expansion, including the requirements of Mount Sinai's Surgical Tower. Goals / Cure problems associated with emergency power generators that have inadequate capacity and that are currently located below flood-level. / Providing uninterrupted service before, during and after a disaster. 6 / Maintaining the community's access to resources in a disaster, both surgical and medical. Benefits / Protect the lives and health of patients and hospital staff during weather emergencies. / Allow Mount Sinai to function smoothly as the regional Emergency Command Center in times of natural or other disasters / Provide adequate power for lights, surgical equipment, respirators and other vital needs in times of weather emergencies. / Save millions of dollars in repairs from damage incurred in future severe weather events 7 STORM SURGE EMERGENCY POWER PROTECTION PROJECT AT MOUNT SINAI MEDICAL CENTER PROPOSED PROJECT BUDGET AND FUNDING STRATEGIES TOTAL PROJECT COST $24,303,000 Construction $ 6,846,000 Generators, Fuel Tanks & Switchgear Equipment 8,102,000 Mechanical & Electrical Capacity 4,325,000 Design & Professional Fees 1,040,000 Contingency Fees 1,158,000 Renovations to existing buildings to receive new addition 2,832,000 TOTAL FEDERAL FUNDING REQUEST Construction Equipment, Technology and Energy Needs TOTAL MOUNT SINAI CONTRIBUTION TOTAL MOUNT SINAI CONTRIBUTION TO DATE $12 million over several funding cycles $6.8 million $8.1 million $12,303,000 $2,000,000* *Mount Sinai has invested more than $2 million in the last twelve months as part of its short-term temporary generator upgrade project. Further, Mount Sinai has retained the engineering necessary to develop the power infrastructure and specifications. Uses of FY10 Federal Funding • Construction • Equipment • Technology FY10 Funding Request: $5,000,000 Potential Funding Source: FY10 LHHS appropriations bill; HRSA 8 FEDERAL FUNDING JUSTIFICATION AND STRATEGIES Mount Sinai Medical Center is Miami Beach's primary community health care provider and designated Emergency Command Center and is seeking $12 million over several funding cycles to support the construction and equipping of its new centralized emergency power plant. The creation of a public/private funding partnership with Congress will ensure that Mount Sinai has the capability to continue to operate during the most challenging of natural or other disasters and to save lives through its ability to provide emergency care for all patients in the region. This program strengthens Mount Sinai's health care delivery infrastructure to ensure that patient safety and care are not interrupted or compromised by power outages which are regular threats due to tropical storms and hurricanes in south Florida. MOUNT SINAI MEDICAL CENTER Founded in 1949, Mount Sinai Medical Center a 955 bed, not-for-profit tertiary healthcare provider in Miami Beach, Florida, has been providing a wide variety inpatient and outpatient services to the Miami Beach community. Since its beginnings, the Medical Center is a critical and respected partner in the regional economic and health care infrastructure. Its mission is to provide high quality health care to its diverse community enhanced through teaching, research, charity care and financial responsibility. The institution is also the City's primary community provider and the designated command center for Miami Beach in the event of any mass casualty, terror or natural disaster. EMERGENCY SERVICES More than 41,600 patients received emergency medical care at Mount Sinai Medical Center in 2006, a more than 21% increase over 2005. The Medical Center's emergency department is the only available emergency department located in the City of Miami Beach and is open twenty-four hours a day, seven days per week. Mount Sinai is also the Emergency Command Center for Miami Beach. In the event of a disaster, city officials, police, fire and emergency personnel may work from the command center where essential communications can be maintained through a sophisticated telecommunication and computer network. As the primary community health-care provider for Miami Beach, Mount Sinai Medical Center serves as a "safety-net" for the community. Mount Sinai provides specialty and subspecialty coverage in more than 60 areas. The depth and breadth of Mount Sinai services provide the community with significant medical coverage and comprehensive care options. While many hospitals in the state of Florida have dropped their obstetrics services, neurosurgical services, and/or other high cost services, Mount Sinai is committed to providing care for its community SERVICE AREA The Medical Center primary service area includes Miami Beach, Bal Harbour and Surfside in Miami- Dade County. Its secondary service area includes portions of Miami, North Miami Beach, Sunny Isles and Aventura. The Medical Center's tertiary service includes the remaining portions of Miami-Dade County and south Broward County. Also, as a tourist community and gateway to the Americas, Mount Sinai provides services for a worldwide clientele. Miami Beach is a diverse community home to a large Hispanic, Russian and Caribbean population. ECONOMIC IMPACT Mount Sinai Medical Center is the largest private, not-for-profit teaching hospital in Florida. As such it has a significant impact on economic stability of its community. As the largest employer in Miami Beach, Mount Sinai is home to more than '700 physicians, 3,000 employees and 400 volunteers. In 2006, the Medical Center paid more than $199 million in salaries, wages and capital investments and 9 approximately $5 million in taxes. In total, through taxes paid, salaries, wages, benefits, capital investments and charitable and uncompensated care, Mount Sinai returned more than $267 million to the community. Despite being located in a diverse bedroom community with a solid economic status, Mount Sinai Medical Center routinely provides ample amounts of care to uninsured and underinsured patients. In fact, in 2006 Mount Sinai provided nearly $50 million in charitable and uncompensated care. In addition, as the sole provider of labor and delivery services on Miami Beach, its obstetrical program lost an estimated $2.8 million in 2007 providing services to those who need them but who cannot afford to pay. In 2007, Mount Sinai's payor base was 7.6 percent Medicaid, 42.4 percent Medicare, 41.7 percent Managed Care and 8.4 percent other. COMMUNITY BENEFIT Mount Sinai gives back to the community through a wide array of programs and services. The Medical Center sponsors free health screenings for conditions such as cholesterol and blood pressure at local churches and community events and participates in health fairs. Additionally, Mount Sinai is continuously building and improving its relationships with a multitude of local institutions including senior centers, churches and schools. It also makes use of local media to improve the community's knowledge of access to comprehensive health care available at Mount Sinai. In 2007, Mount Sinai sponsored support groups served over 4,600 participants. Community benefit programs include: • Geriatric House Call Program • Emergency Command Center • Patient Assistance Program • Support Groups (Alzheimer's Disease, Bereavement, Cancer, Rehabilitation) Mount Sinai, as the result of strong and insightful leadership has remained financially viable even as the rest of the nation's health care market struggles. Despite that tremendous achievement and an active effort to address the many service and facility needs on its campus, resources are scarce and the Medical Center cannot possibly fund the estimated $200 million in essential upgrades needed through 2010. Therefore, the Medical Center is seeking to establish apublic/private partnership to support the construction and equipping of a new Surgical Tower that will upgrade aged operating rooms, integrate a comprehensive Clinical Information System and upgrade its emergency power. 10 Damage to Mount Sinai Medical Center as a direct result of Hurricanes Katrina and Wilma, during 2005: ~1 ~-~ ~. _° ~. A r ..; ~~ ~{ ~~~ }~ r ~~ ~ r ~_ ~- 3 ~ kc aw. ,... ~' .. 11