by Yori Yanover

The new facility’s lobby (artist’s rendering) Gouverneur Healthcare Services Executive Director Mendel Hagler The September 22 groundbreaking ceremony for Gouverneur’s modernization project. Speakers included HHC President Alan Aviles, SMHN Senior VP Lynda Curtis, Executive Director Mendel Hagler, State Assembly Speaker Sheldon Silver, and City Council Members Alan Gerson, Rosie Mendez and Daniel Garodnick. The waiting area at the modernized Gouverneur (artist’s rendering) The new nursing facility (artist’s rendering)

ouverneur Healthcare Services Executive Director Mendel Hagler speaks passionately, almost urgently. Tall, slender and intense, he leans into his listener’s space, eager to transmit information, letting it out at high speed, as if there’s so much of it, he fears time constraints would leave this listener less than fully informed.

“This is a significant investment in the community,” he says, “and it tells the community we care about you, we want you to believe in us. The continued trust between us and the community is very important to us. We’ve been here for 123 years, we hope to be here for at least another 123 years.”

Gillian Hertzberg Fein, Gouverneur’s Director of Marketing and Development, complements her boss’s info gush with precise, punctuated notes, as if the two have divided their roles into text for him, headlines for her.

Both are beaming with a kind of Christmas morning glow, still a bit stunned by the sheer size and magnitude of the gift box sitting on the floor between them. “I’ve been at Gouverneur since 2004 and I heard about this project when I was interviewing for the job,” confides Gillian with a big smile. “These have been exciting days for us.”

This fall, with the exuberant support of local public officials—most notably Assembly Speaker Sheldon Silver—Gouverneur, comprising a long term care nursing facility and the largest city-run community health center, began construction on its $180 million, four-year modernization project that will expand primary and preventive care services, transform the clinical and residential environments, and create a larger, modern, 295-bed nursing facility to serve the Lower East Side and Chinatown community. The project is part of a city-wide, five year $1.2 billion capital investment program to modernize and rebuild New York City Health and Hospital (HHC) facilities.

The new facility, expected to be completed by 2012, will remain in its current address at 227 Madison Street. It will house a new ambulatory care pavilion, dubbed The Center for Community Health and Wellness and designed to serve more than 345,000 outpatient visits a year – a 15 percent increase from its current capacity. It will also include The Residence at Gouverneur Court, a modern nursing facility that will represent the next generation of long-term care, with home-like spaces, private rooms and suites.

“We’ll be a renovating 300,000 square feet of our existing space,” says Gillian Hertzberg Fein, “and we’re adding an additional 110,000 square feet. It’s huge. And we project hiring between 50 and 100 new staff members. That’s a five to ten percent increase.”

The project was designed by the RMJM Hillier Architects and will be built by Hunter-Roberts Construction Company. The Dormitory Authority of the State of New York (DASNY) will be the construction manager.

It’s obvious why this local magazine would be delighted at any time to report on a project of such magnitude in our neighborhood. But starting as it has done, in the midst of what could be the scariest economic time in the lives of most of our readers, the new project seems like an outright miracle. Which brings us to the obvious question: “You’ve gotten $180 million for the project, but we may be walking into a deep dark night in terms of the economy at large. Haven’t you just doubled your aggravation and anxiety over future budgeting for a much larger facility?”

Mendel Hagler barely pauses before answering: “This is a long-term project, we’re talking about four years until it’ll be finished. A lot of what’s been going on in the economy is short-term—which, admittedly, could potentially have long-term effects. But we don’t know what these long term effects are going to be. I don’t think anybody knows what’s going to happen in two years, much less in four years.”

But isn’t the future of Medicaid and Medicare in doubt – and don’t those two programs provide much of your budget?

“We do get a considerable amount of our budget from Medicaid,” Hagler agrees, “but none of us believe that, even with the perilous nature of the crisis the city faces, there will be mass reductions in Medicaid payments. We will have to be even more efficient in managing our operation, because we’re going to get less reimbursement. We recognize that. We’ve already taken steps to make ourselves more efficient.”

The Medicare program is a different story, according to Hagler. “It is more of a long-term issue, which the federal government is going to have to take on, and it’ll take more than four years to fix.”

Then he rediscovers his intense optimism and says, honestly, “I don’t have any idea what’s going to happen with those programs, but the good thing is that four years from now things will not be like they are today. Hopefully, we’ll be able to support our continuing mission of good public health policy.”

The new ambulatory care pavilion space will house Gouverneur’s full spectrum of medical, dental, obstetrical, pediatric, rehabilitation and behavioral health services. The health center will feature a state-ofthe-art 30,000 square foot Women and Children’s Center, a dialysis center, a new CT scan area and space for a full spectrum ambulatory surgery center. In addition, sweeping advances in the facility’s design and equipment will increase patient safety, enable greater efficiency, and provide state-of-the-art technology and comfortable amenities in patient care and public areas.

“Our on-site dialysis center will support both our nursing facility residents and our ambulatory care patients,” Hagler says with unconcealed pride. “Also coming—if everything goes okay and the state approves it—a full, comprehensive ambulatory surgery center, for same day surgery. Things like colonoscopy, cystoscopy, optimological procedures, GYN procedures – five days a week.”

Where do Lower East Side kidney patients go for dialysis today?

“Right now in this area there really is no dialysis center,” says Hagler. “You have to go to lower Manhattan, to New York Downtown Hospital. Or uptown.” This is an inconvenient, sometimes painful, and costly procedure. “That will be eliminated with our new dialysis center.”

“It’s critical to note here that, as part of the planning process, we examined the supply and demand factors for services,” Gillian Hertzberg Fein interjects. “We really had our ears to the ground as far as what people were looking to have. Our planning department has a good understanding of the demographics of this neighborhood, and certain age specific services, like the dialysis, that made sense based on who our patients are.”

“I personally met with a number of local acute care facilities, and talked to them about what their needs are,” says Hagler.

When it opened, in 1885, Gouverneur offered the full scope of hospital services. When it began to be phased down, in the 1970s, it lost elements of its hospital setting. It is rewarding for us, local old-timers, to see the facility returning to its former glory.

“We already knew there was a need for a lot of additional services,” Hagler continues, “because today we end up sending cases to our sister facilities, mostly not within this catchment area. We’ve also interviewed quite a number of patients and asked them what their desires were.”

Most patients, according to Hagler, said they preferred one-stop shopping for their healthcare. So this became the plan: Make Gouverneur a one stop shopping healthcare Center. “We began to really focus on how to make this an environment where people feel comfortable, regardless of their age and ethnicity, and certainly regardless of their ability to pay – so one-stop shopping became the core of these new initiatives.”

Meanwhile, how will the modernization affect Gouverneur’s satellite clinics in local housing projects?

“We’ve redesigned our community health center model and it’s now a family practice model,” says Hagler.

Gillian explains: “Our family practitioners are trained and qualified to see both pediatric and adult patients. And they can deal with internal and GYN.”

“In our community health centers, like Baruch, Smith, Robert Clemente and Judson Health Center, we focus on the family practice model because we think that’s the best,” says Hagler. “The people who work there are really tied into the community, they live there, it’s a much better setup to have one doctor take care of the entire family. They blend with the community.”

“Gouverneur is like the Little Engine that Could,” says Gillian, “and getting a state-of-the-art environment is not only going to provide our patients with more space, more amenities, and more technological advances: A lot of time has been spent planning the interior design and function of the new facility, to enable our practitioners to work in a more effective and efficient way. We’re even modifying the way the rooms are located, the position of the doors, it’s all being taken into account.”

Mendel Hagler looks lovingly at the artist’s rendering of his new facility. Admittedly, the artist has taken some liberties with the depiction of the corner of Clinton and Madison Streets, making them look a lot less gritty than they are in real life. But regardless of the hard, Lower East Side surroundings, the new facility is sure to emerge as one of the more beautiful edifices this side of Delancey Street.

“This is something that I started dreaming about when I came to work here 24 years ago,” Hagler says quietly.

“The glass front says everything, it’s going to be open, inviting. It’ll be a masterpiece.”