New York City Health and Hospitals officials told City Council members during the FY 2026 executive budget hearing that the system's capital commitment plan for 2025–2029 totals roughly $2.83 billion and includes major flood mitigation, hospital modernization and emergency department expansion needs.

Council Member Mercedes Narcisse, chair of the Committee on Hospitals, and Council Member Justin Brannan, chair of the Committee on Finance, asked H+H leaders to explain why some projects — notably a requested $65 million expansion of Metropolitan Hospital's emergency department and an expansion of Elmhurst's emergency department — were not included in the executive capital plan and what timelines and funding pathways exist.

Dr. Mitchell Katz testified that flood mitigation funding for Bellevue and South Brooklyn is included in the executive capital plan (Bellevue flood wall: $90 million; South Brooklyn: $24.4 million; Kohler Hospital mitigation: $114.5 million in FEMA-allocated funds moved forward). Katz said H+H is working with the Office of Management and Budget (OMB) and FEMA on timing and matching requirements and acknowledged that most capital funding is devoted to deferred infrastructure needs (roofs, air handlers, boilers, elevators) that keep hospitals operating.

On emergency departments, Katz and H+H staff described Metropolitan and Elmhurst as top priorities. Council members recounted field visits and long waits; Katz said Elmhurst operates at roughly three times the volume the ED was built for and is "landlocked," making expansion complex and expensive. He cited potential multi-phase approaches and an estimated $600 million tag for the larger Lincoln outpatient campus referenced elsewhere in the hearing; H+H said it does not yet have a firm cost estimate for an Elmhurst ER rebuild but is pursuing options including off-site construction and phased building that would allow the hospital to remain operational.

On Far Rockaway, Council Member Brooks Powers and others reported progress on a trauma facility effort and asked about a requested $300,000 to complete a land transfer for a trauma center site at Hammels/Arverne (NYCHA land). Katz said the administration and state have been constructive and the plan remains in development; H+H also said the proposed Far Rockaway primary care center (an executive-plan line item of $28 million) remains on schedule for a 2027 opening.

Katz emphasized that flood mitigation projects often rely on FEMA funds allocated after Superstorm Sandy and require city matching dollars; H+H has moved several FEMA-funded projects forward in the capital plan and will pursue extensions and matches as FEMA rules allow. Council members asked H+H to provide cost breakdowns, timelines and prioritization lists for committee review.

Ending: The committees asked H+H and OMB to provide more detailed timelines and specific capital cost estimates for the Metropolitan ER expansion, Elmhurst options and other high-priority projects, and to return with feasibility and funding scenarios before adoption.