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LTC 055-2006 Mt. Sinai Medical CenterMIAMIBEACH OFFICE OF THE CITY ~VL~,NAGER NO. LTC # 0.55-2006 LETTER TO COMMISSION TO: Mayor David Dermer and Members of the City Commission FROM: Jorge M. Gonzalez, City Manager ~ ,._~/ DATE: February 22, 2006 SUBJECT: Mount Sinai Medical Center The purpose of this LTC is to transmit the attached correspondence received from Steve Sonenreich, President and CEO of Mt. Sinai Medical Center. Mr. Sonenreich and I routinely meet to ensure appropriate communication and coordination. At our most recent meetings we have generally discussed issues related to our community's hurricane preparedness and the challenges our organizations face given our geographic limitations as a barrier island. The increases in storm activity of the past two years and the predicted weather patterns for the near future, make the issue of hurricane preparedness something that we should all be concerned with. In his correspondence, Steve identifies the Medical Center's short term and long term issue regarding hurricane preparedness and the hospital's needs. In addition, he identifies a series of services provided by the medical center which he deems are of a charitable or public benefit. His requests are: · An "Emergency Allocation" of $1.9 million to begin to make the facility hurricane ready. · An allocation of $35 million to address further hurricane preparedness needs to the facility. Needless to say, the Medical Center and the services it provides are an incredibly important contributor to the overall quality of life in our community. However, these requests are significant and represent a significant departure from what the City has traditionally obligated itself to fund and support. Traditionally, a municipality's core mission is to provide for public safety, public works and quality of life services such as recreation and culture. Obviously this request and the policy choices and implications it represents will require yOur careful attention and consideration. Pursuant to requests from Commissioners Cruz, Steinberg and Garcia, this subject will be ~aCe~°on the March 8~h Commission Meeting Agenda for discussion and referral to the Finance an~City~i~e Projects committee for further consideration. Should you have any questions or wish to give me additional guidance at this time, please fe~ free~ contact me. JMG:ptw Attachment F:lcmgrlSalllltcO61Mount Sinai Letter-LTC Mount Sinai MEDICAL CENTER Febm~' g, 2006 Mr. Jorge Gonzalez City Manager City of Miami Beach 1700 Convention Center Drive Miami Beach, FL 33139 Dear Jorge: Thank you for taking the time to meet with me. It is critical that I communicate to you and our community about the urgency of protecting Mount Sinai in the event of a hurricane. I would like to accentuate several points in the presentation that I made to you: Mount Sinai is a not-for-profit, mission-driven organization that reinvests all of its net income back into the hospital and into the community; - Mount Sinai is a valuable economic engine for the City of Miami Beach as the largest employer and investing more than $225 million annually in taxes, wages, capital investments, charitable and uncompensated care. - Mount Sinai provides the only full-service Emergency Department for the community and is committed to staffing it with a comprehensive array of subspecialists, including neurosurgeons; Mount Sinai's comprehensive obstetrics and neonatal intensive care program delivered more than 2,000 babies last year; - Mount Sinai coordinates with the local, state and federal governments to provide emergency response to bioterrorism activity or a mass casualty incident and provides hazardous materials decontamination and other disaster response services; - Mount Sinai provides emergency and disaster response and plays a critical role for the public safety of Miami Beach; - Mount Sinai is unable to evacuate in the event of a hurricane due to its size and acuity of its patients. Even after police and fire personnel are evacuated from Miami Beach in a category 4 or 5 hurricane, Mount Sinai must shelter its patients and caregivers in place; Mount Sinai Campus Miami Heart Campus Mount Sinai Aventura 4300 Alton Road 4701 N. Meridian Avenue 2845 Aventura Boulevard Miami Beach, FL 33140 Miami Beach, FL 33140 Aventura, FL 33180 Phone: 305-674-2121 Phone: 305-672-1111 Phone: 305-932-2099 www. msmc.com - Mount Sinai protects approximately 1,000 people in a hurricane - this includes critically ill patients, their caregivers, medically fragile residents who are electrically and/or oxygen dependent; expectant mothers; and emergency command personnel; - Mount Sinai sustained more than $3 million in damage from Hurricane Wilma; Mount Sinai must further harden its facility to achieve maximum protection for its occupants. This includes new windows, shutters, roofs, generators, communication systems, and elevation projects; - Mount Sinai currently has $35 million in hurricane preparedness projects pending and has requested support from the City of Miami Beach in the amount of $5 million per year for seven years to protect Mount Sinai. We appreciate your direction to find one or several commissioners to sponsor our request and advocate on our behalf at the Commissioners Retreat held in May, where the City's priorities are established for the 2006/2007 budget. I am following up on your recommendation and setting up meetings with the Mayor and Commissioners. If there is anything else I can do to ensure Mount Sinai's success in this endeavor, please let me know. We also appreciate your support and understanding of Mount Sinai's important role in public safety in this community. Sincerely, Stev~D. Sonem-eich President & Chief Executive Officer cc: Mayor David Dermer Commissioner Matti Herrerra Bower Commissioner Simon Cruz Commissioner Luis R. Garcia Commissioner Saul Gross Commissioner Jerry Libbin Vice Mayor/Commissioner Richard Steinberg Mount Sinai MEDICAL CENTER February 15, 2006 Mr. Jorge Gonzalez City Manager City of Miami Beach 1700 Convention Center Drive Miami Beach, FL 33139 RE: Urgent Request Dear Jorge: We are just months from the start of another daunting hurricane season. Just last week, federal weather officials announced that the arrival of the La Nina phenomenon could mean stronger and more numerous storms. During this critical preparation time, I ask you for your urgent support in en.quring that Mount Sinai Medical Center is properly retrofitted and funding is appropriately secured to ensure the safety and ongoin~ availability of medical services to the residents and tourists of Miami Beach and the Miami-Dade community. Although the hospital has extensive hurricane and disaster plans and our team of proven physicians, nurses, and other essential employees have consistently demonstrated effectiveness in responding to crises (e.g. Hurricanes Jeanne, Francis, Katrina, Rita and Wilma), a long-term solution is needed to harden and protect our facility, which serves as the health care infrastructure of Miami Beach. Crucial parts of the medical center's exterior are in serious need of repair or replacement. This increases the probability of damage due to wind-borne debris, even in a low category hurricane. Necessary window and roof retrofit projects not only put the building at greater risk for storm damage, but more urgently, this situation puts critically ill patients, their families and the hospital staff at increased vulnerability. Mount Sinai needs to immediately commit to more than $3 million of improvements in windows and roofs. We are ordering $1.9 million in storm-rated windows now to upgrade our deHirsch Meyer patient tower. We need the City of Miami Beach to urgently assist us with an emergency allocation of $1.9 million to help us protect Mount Sinai. The situation is further complicated by limitations of South Florida's health care system, as a whole. Currently, Mount Sinai Medical Center has an exemption to shelter in place during a category 1, 2 or 3 hurricane. The facility is expected to evacuate all patients in the face of stronger storms. However, history has shown it is simply not possible to find other facilities willing or able to adequately care for hundreds of displaced patients. Even if space were available, the time and resources needed to execute such a massive evacuation would be prohibitive. Furthermore, just moving such critically ill individuals is a hazard to their health. In the face of these great challenges, we weathered the 2005 storm season, but not without incurring costly structural damage. Hurricane Katrina caused more than $500,000 in direct storm damage to the hospital, excluding costs like debris removal and overtime pay. Preliminary damage estimates from Hurricane Wilma have exceeded $3 million. Over the past several years, Mount Sinai Medical Center has applied for support under several FEMA mitigation grant programs, specifically the Pre-disaster Mitigation (PDM) and FEMA 404 Hazard Mitigation Grant Programs (HMGP). To date, we have not yet been able to secure funding. Mount Sinai Medical Center is currently doing everything within its power to ensure that all facilities can withstand wind and flooding and maintain the appropriate structural integrity, power, medical gas and other clinical resources to ensure the safety of its patients, physicians and members of the community who seek shelter and care within the facility. Our plan is focused on installing storm protection measures, including hurricane resistant windows, hurricane resistant roofs, and shutters. Our initial focus is on mitigating damage to the infrastructure which supports our high acuity patient care areas, including the inpatient towers (comprised of ICUs, Telemetry and medical beds), surgical areas, emergency room and other key medical departments essential to serving the community. However, grant funds are essential for us to complete the massive task of hurricane mitigation. On behalf of Mount Sinai Medical Center, our patients, physicians and employees, I thank you for your time and immediate attention to this critical matter. Sincerely, Steven D. Sonenreich President & Chief Executive Officer cc: Mayor David Dermer Commissioner Matti Herrerra Bower Commissioner Simon Cruz Commissioner Luis R. Garcia Commissioner Saul Gross Commissioner Jerry Libbin Vice Mayor/Commissioner Richard Steinberg