Staten Island’s COVID-19 positive-test rate is the city’s highest, with 15% of the borough’s hospital beds filled with coronavirus patients and fears of more cases spurring Gov. Andrew Cuomo to reopen an emergency field hospital.

For local leaders, the growing crisis underscored Staten Island’s status as the only borough without a city-run public hospital — and sparked renewed calls for more health care funding. 

“The city has a responsibility to bring health care resources to this population,” said City Councilmember Debi Rose (D-Staten Island).

“The need remains and Staten Islanders deserve their fair share of the city’s health care resources,” she added.

As of Tuesday morning, Richmond University Medical Center and Staten Island University Hospital, the two private hospitals that serve the borough, were treating a total 175 COVID patients. Staten Island hospitalizations peaked at 554 on April 8 during the first wave. 

Staten Island has a total of 1,139 hospital beds, which is the highest per capita of any borough, but the infections are surging. On Monday, 361 Staten Islanders tested positive for COVID, Richmond County’s highest one-day increase since April. 

Staten Island’s positive test rate now sits at 6.18%, with much of the borough in restricted state-imposed yellow or orange zones. Not a single Staten Island ZIP code is below 4%, and rates in 10 of 12 of those ZIP codes have been on the rise over the past two weeks.

The state was set to reactivate a field hospital at the South Beach Psychiatric Hospital on Staten Island, Nov. 30, 2020. Credit: Clifford Michel/THE CITY

Cuomo, who ordered hospitals across New York on Monday to come up with plans to boost beds by 50%, reopened the field hospital at the South Beach Psychiatric Center last week as a 100-bed-plus convalescent center. He said he acted after local medical officials told him Staten Island needed emergency beds.

RUMC, which has 26 intensive care unit beds, expanded that capacity to 71 during the first wave. SIUH has 82 ICU beds for COVID patients, but a spokesperson noted the hospital could “rapidly expand its ICU capacity by converting other units to COVID-19 units, as needed.”

‘We are Shortchanged’

In early April, the city made changes through its public hospitals to address the pandemic’s first wave. 

But when the city first announced that it would staff up its health care workers, add intensive care unit beds and provide more testing, the Staten Island hospitals were left out. 

When the city first sent military medical personnel to city hospitals, the borough was initially forgotten. And Staten Island hospitals’ health care workers were excluded from an $8.2 million fundraising effort by city hospitals.

Staten Island Borough President James Oddo’s office even formed an “Incident Command System” where the chief medical officers of both hospitals were able to speak to local officials a few times a day so the borough’s political delegation could streamline communication to state and city efforts. 

Staten Island residents wait at a coronavirus testing site at the South Beach Behavioral Center, Mar. 19, 2020. Credit: U.S. Air National Guard/Maj. Patrick Cordova

The fight to remedy the hospital disparity dates back years, according to State Sen. Diane Savino (D-Staten Island/Brooklyn). And while advocates still call for a new public hospital, elected officials are most immediately focused on pushing for a substantial and sustained increase in public funding. 

Savino and State Sen. Andrew Lanza (R-Staten Island) have long carried a bill that would allocate 10% of NYC Health + Hospitals’ nearly $8 billion annual budget to be spent on Staten Island’s existing health care infrastructure. 

“But just the fact that we don’t have a facility that is managed or run by [H+H] means that we are shortchanged,” said Savino. “And I don’t like to play the victim card the way some people do, but there is absolutely no doubt that when it comes to health care, we’re getting the short end of the stick.”

But the bill has never passed both state chambers in the same year, said Savino, who blamed opposition from the Mayor’s Office.

A Mix of Public Funds

The borough’s two private hospitals do get some government support.

RUMC received a $30 million FEMA grant this year to make its buildings more resistant to flooding. Last year, the City Council’s Staten Island members secured $8.4 million so the hospital could create new surgical suites. 

Staten Island University Hospital, which is part of Northwell Health, New York’s largest health system, received $28 million from City Hall in 2014 for storm resilience and $1.3 million from the City Council in 2008 for a new emergency room.

“We do feel that we continue to get solid city and state support. Gov. Cuomo and Mayor de Blasio have been invaluable resources and have been side by side with the hospitals throughout the pandemic,” said Daniel Messina, RUMC’s CEO.

An SIUH spokesperson said that supplies and equipment sent by city and state officials made it possible for its parent company to deal with COVID-19 surges.

Richmond University Medical Center on Staten Island, Nov. 30, 2020. Credit: Clifford Michel/THE CITY

Local politicians advocate almost every year for funding for the two hospitals, especially for RUMC, which is most accessible to residents of Staten Island’s North Shore, a diverse area with the borough’s highest share of residents living in poverty.

“In the absence of an H+H hospital on Staten Island, I want RUMC to receive the same resources that H+H hospitals are because, in reality, it serves the same population that a public hospital would,” Rose told THE CITY in a statement. 

The city has expanded its insurance vehicle, MetroPlus, to Staten Island in recent years, and brought NYC Care, a health care access program, to the borough in January.

“NYC Health + Hospitals has worked with city agencies and private institutions throughout the COVID-19 health crisis to ensure that all New Yorkers had the high-quality, comprehensive healthcare they needed to fight off this virus,” said Stephanie Guzman, a city Health + Hospitals spokesperson. “Our priority was to help save as many lives as possible by responding as one city.”

But Rose pointed to large-scale investments  –– such as the opening of Staten Island’s Health + Hospitals/Gotham Health Vanderbilt public health care clinic in 2018 and $36 million in City Council funding for a RUMC emergency unit –– as an appropriate starting point. 

‘Our Hospitals Need More’

RUMC’s current emergency room was built in 1978 to serve around 25,000 people a year. Today, that ER sees 60,000 to 65,000 patients annually. The new unit, set to open in spring 2022, will be designed to meet that demand.

“The technicalities of how RUMC receives city resources would be between the city and RUMC. I just know that the need is there and the city has a responsibility to bring health care resources to this population,” said Rose.

Councilmember Debi Rose attends an event in May 2018. Credit: Emil Cohen/New York City Council

Other local leaders argue that Staten Island hospitals should receive more money than the average Health + Hospitals facility since borough residents can’t directly reap the  benefits of the public system. 

“Our hospitals actually need more than what city hospitals are getting, not the same level,” said Assemblymember Charles Fall (D-Staten Island).