St. Mary's Healthcare starts expansion that will put coordinate care under one roof

JOHN CROPLEY/BUSINESS EDITORDignitaries attend the ground-breaking ceremony Thursday for the expansion of the Rao Outpatient Pavilion at St. Mary's Healthcare in Amsterdam. — JOHN CROPLEY/BUSINESS EDITOR
Dignitaries attend the ground-breaking ceremony Thursday for the expansion of the Rao Outpatient Pavilion at St. Mary's Healthcare in Amsterdam.

AMSTERDAM — St. Mary’s Healthcare has begun a project to expand not just the footprint of its still-nearly-new outpatient building but its ability to provide a more complete array of services under a single roof.

The single site will offer a suite of physical and behavioral health care. St. Mary’s received a $5.1 million state grant for the $6 million project, which will add a drive-thru pharmacy, mental health services and primary care to the Rao Outpatient Pavilion on the Route 30 campus.

When the work is complete in the summer of 2021, the Rao Pavilion will have expanded from 40,000 to 57,000 square feet.

The hospital held a ceremonial groundbreaking Thursday, small and brief due to the continuing COVID-19 precautions.

Afterward, CEO Scott Bruce recalled submitting the grant application to the state.

“What we said we wanted to do was bring together in almost a medical village approach all these essential services, ideally in one location,” he said.

“The anchor for it of course is primary care … having all these support services not even collocated with but actually embedded into the practice.”

State regulators support this type of coordinated care, Bruce said, and St. Mary’s has embraced it as well.

The project was conceived and the grant secured not long before COVID scrambled the operating model and finances of the healthcare industry. Some pandemic-related changes will endure, particularly telehealth, but so will the need for coordinated one-source care, Bruce said.

“We’ve had some challenges with the pandemic, however it doesn’t change the mission of the organization,” he said.

He doesn’t know yet whether St. Mary’s will end the year with a deficit because it lost surgical revenue or with a surplus thanks to federal relief dollars. “It’s hard to tell right now, things are on the upswing.”

Duane Miller, vice president of behavioral health, said a centerpiece of the project is integrating mental health care with physical health care, by embedding counselors in the primary care setting.

“It certainly helps in terms of access, it helps in terms of stigmas,” he said. “Anxiety, depression are common ailments and they shouldn’t be stigmatized or need to be referred to another setting.”

With this kind of team approach, there can be a seamless transition from identification of problems to treatment, including for substance abuse, which makes up a significant portion of the behavioral care St. Mary’s provides, on both an inpatient and outpatient basis.

Dr. Megan Sumigray’s primary care practice is one of three that will be relocating into the new portion of the Rao Pavilion, along with internal medicine and pediatrics.

“Our office, me as a family doctor, we see birth until death, we see all ages,” she said. There’s also a range of demographics among her patients — well-off and impoverished, gold-level health insurance and no insurance.

Across all these groups to a greater or lesser degree, there are a range of reasons why patients do not get the preventative care that family medicine provides, so she’s excited to see a greater number of intake points coming under the same roof with her.

“Having everything in one building is really going to help those underserved people,” Sumigray said.

Driving from the doctor’s office to the X-ray lab to the pharmacy can be a huge obstacle for someone who doesn’t have a car in a city with limited public transportation, she explained.

The St. Mary’s Emergency Department refers many patients to Sumigray, who has been working at the hospital system where she was born for only a year and is still building her practice. Being next door to the urgent care clinic will help with that.

Having behavioral health specialists on-site will also be a big help, she said, because mental problems are often a prime cause of physical health problems and also a reason why those physical problems aren’t addressed.

“Being able to talk about things for a lot of patients is the hardest step,” Sumigray said.

She says the full continuum of care model, the medical village Bruce cited, is uncommon in smaller communities such as Amsterdam; having behavioral health as part of the mix will help overcome the fears some patients have about getting medical care.

The Rao Outpatient Pavilion was completed in 2015 and is named for Dr. Govind Rao, a longtime pediatrician in Amsterdam’s East End who contributed $1 million to its construction. Along with the drive-thru retail pharmacy and the three medical practices, the expansion now underway will include 30 exam rooms and a healing garden for relaxation.

It is likely also one of the first medical facilities to be designed and built with full COVID precautionary protocols in mind.