A view of Upstate's emergency room from the intersection of Elizabeth Blackwell Street and East Adams Street. Credit: Debadrita Sur

Editor’s Note: This story was updated after publication with additional information sent by a Upstate University Hospital spokesperson.

Upstate University Hospital’s vision for its ambitious $450 million emergency room expansion includes closing a block of a key street connecting downtown Syracuse to the Syracuse University area. 

In order to pull off the expansion, Upstate said it would require the closure of East Adams Street, between Elizabeth Blackwell Street and Irving Avenue so that it could connect its current emergency department to a new building. That building will include a new emergency department, a burn unit and an operating room. 

Upstate officials believe connecting the buildings will decrease the time it takes to transfer patients to the emergency room and reduce mortality rates, according to a 27-page pitch document presented to lawmakers and obtained by Central Current. 

Upstate’s desire to close the block laid bare a disagreement between the state hospital and Crouse Hospital. Just four years ago, the hospitals’ officials were exploring a merger. In a statement sent late Wednesday to Central Current, a Crouse spokesperson wrote that Crouse opposed any closures to East Adams Street. 

“Permanently closing Adams Street would also run counter to one of the central promises of the I-81 Community Grid: reconnecting Syracuse and improving access to essential destinations, including its hospitals,” said Laurie Clark, the director of communications at Crouse Health. 

If the purpose of the Community Grid is to remove barriers and create a more connected downtown, stakeholders “should not replace one barrier with another by eliminating an established route to care,” Clark wrote. 

In a statement to Central Current Wednesday afternoon, an Upstate spokesperson said hospital officials are working with the stakeholders, including the city and the state Department of Transportation to move forward with the expansion program. 

“Any and all steps taken as part of the design and construction process will follow expert guidance and are focused on saving lives and serving the patients who rely on Upstate Medical,” said Matthew Chadderdon, an associate vice president at Upstate and President Mantosh Dewan’s chief of staff.

Chadderdon, in response to Crouse’s statement, said Upstate has been working for months with stakeholders, including police, fire, emergency medical technicians and the Department of Transportation to ensure emergency routing options are based on input and needs of patients who seek care from the hospitals in the area. The conversations with stakeholders are “a necessary part of the process and project,” Chadderdon said. 

Upstate and Crouse officials have met, he said. Chadderdon said that he “wasn’t going to discuss a private meeting with the media.”

Upstate officials in the last few weeks have started pitching the plan to the Common Council, two lawmakers said. The council has the authority to close the block for Upstate. 

City officials have received “preliminary information” about the project and the “proposal to close East Adams Street,” said Sol Muñoz, a spokesperson for Mayor Sharon Owens. The city has urged Upstate leadership to consult with elected officials and community stakeholders to assess how the closure could affect the University Hill area and nearby neighborhoods, Muñoz wrote. 

The closure would be part of the $450 million emergency department expansion approved in the state’s 2026 budget.  

State officials in November picked CannonDesign, a Buffalo-based architecture, engineering and consulting firm, to design the new emergency room annex. The contract is worth nearly $35 million and will run through November 2030, according to the contract published by state Comptroller Thomas DiNapoli’s office. The firm has previously worked with New York State, including designing the $180 million innovation center at the University of Albany. 

Upstate has the only level one trauma center serving 14 counties across Central New York as well as the sole burn center serving 37 counties across upstate New York and northern Pennsylvania.  The hospital has seen 1.4 million inpatient, outpatient and emergency room visits in 2025 and has faced challenges with long wait times at its ER. The new expansion plan is a “clinical necessity” to improve patient health outcomes, the design proposal said.

Clark wrote in a statement that Crouse provides “some of the region’s most time-sensitive care” for stroke patients, emergency cardiac care and high-risk maternal and newborn care. Having the proposed detour will compel emergency responders to take “a more constrained corridor,” especially in unforeseen circumstances like accidents, road closures or traffic congestion. 

“A detour is not simply a traffic inconvenience when the destination is a hospital,” Clark added. “Any change that adds delay or uncertainty to reaching care creates an unnecessary patient-safety risk.”

Upstate’s proposal compared different health outcomes involving patients being transferred via the proposed ground-level corridor versus through a sixth floor bridge among the new and existing buildings. The Upstate pitch document labeled other options to establish the connection between the two buildings “cost-prohibitive.” 

The pitch document emphasized having shorter travel times in emergency situations, especially for health events involving strokes, myocardial infarctions, trauma with hemorrhagic shocks and other medical emergencies that require urgent intervention. Every minute of delay for medical intervention to resuscitate trauma patients increases mortality by 2%, the pitch document cited. 

The block closure will reduce the time taken to transfer a patient to the emergency department from the helipad by 33%, according to the pitch document. The transfer between emergency rooms will be safer and eight times faster by the ground-level connection compared to emergency responders having to use the bridge, according to the pitch document. 

A reporter in July reached out to Upstate for confirmation of the plan. A spokesperson for Upstate requested a reporter to reach out in 30 to 60 days to follow up about Upstate’s design plan. Central Current recently obtained the pitch document Upstate sent to lawmakers from multiple sources. 

A traffic study conducted by Upstate proposes new traffic patterns, which include two different main entries to University Hill: starting at the new Interstate 690 exit on Irving Avenue; or via the Van Buren Street roundabout which is part of the construction on the Interstate 81 Community Grid project. 

According to the state traffic study presented in the pitch document, potential traffic mitigation will require updates to future I-81 viaduct teardown project contracts. The state Department of Transportation did not respond to Central Current’s request to explain what the modifications to Harrison Street might look like. 

The document appears to indicate a DOT study suggested adding a second eastbound turning lane along Harrison Street, allowing drivers to turn onto Irving Avenue. The study also suggested installing an eastbound left turn only lane at Harrison Street and Irving Avenue.

The westbound lane on Harrison Street that allows drivers to turn left or continue on Harrison Street would be converted to a left turn only lane. The DOT advised monitoring traffic at the intersection of Salina and Onondaga Streets and consider a one-lane roundabout or restructure the left turns on Salina Street. 

Several councilors declined to talk on the record about the proposal. 

Councilor Donna Moore said that it is too early to declare her position on Upstate’s proposal but said she has concerns about it. Moore would like to discuss Upstate’s proposal with other major stakeholders, namely Crouse and the Syracuse VA Medical Center, both located on Irving Avenue, she said.

Councilor Jimmy Monto also said it is too early weigh in.

“The [Upstate] level one trauma center is important. Crouse is important. The VA is important,” Monto said. “We want to make sure that we are getting people that have medical emergencies to the place they need to go to as fast as possible. So we need to take all of that into consideration.”

Read more of Central Current’s coverage

Debadrita Sur is a multimedia journalist and Report for America corps member who reports on the I-81 project and public housing for Central Current. In 2023, Sur graduated with a master’s degree in journalism...