REPORT TO THE BOARD OF DIRECTORS – April 2023

Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS
PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
April 27, 2023

COVID-19 UPDATE

Following updates by the Centers for Disease Control and Prevention (CDC) late last month, NYC Health + Hospitals began to offer the Pfizer-BioNTech bivalent vaccine as a single-dose booster to children 6 months to 4 years of age who completed their primary series of the Pfizer-BioNTech monovalent vaccine at least two months ago. Children in this age group were previously not eligible for a booster shot because the primary monovalent series still offered protection against the most serious outcomes from the newest variants.

The CDC also added COVID-19 vaccines to the child immunization schedule, which means parents will no longer have to make a separate vaccine appointment with their family’s pediatrician. Beginning at 6 months, the Pfizer-BioNTech primary series with the bivalent vaccine as the third dose will be part of the immunization schedule, meaning it will be administered along with other vaccinations usually given at this age.

As the Covid-19 public health emergency enters its final weeks, our health System will continue to be a gateway for New Yorkers seeking COVID-19 testing, treatment, and vaccination, regardless of their insurance or immigration status.

PROTECTING ACCESS TO MEDICATION ABORTION

This past Friday night the United States Supreme Court allowed the abortion drug Mifepristone to remain on the market while an appeal of the Texas judge’s ruling moves forward. We let our abortion care providers know that they may continue to prescribe mifepristone (including the generic) as they had been prior to any rulings. Our Abortion Care Task Force, led by Dr. Allen, Dr. Wilcox, and Dr. Marisa Nadas, with the guidance of our Office of Legal Affairs, has been monitoring the situation extremely closely. We will continue to offer the full scope of abortion options to our patients, including medication abortion using mifepristone, and will adapt our protocol as needed to comply with the law.

HELPING THOUSANDS OF PATIENTS KEEP MEDICAID COVERAGE

A federal requirement automatically keeping people on Medicaid during the COVID-19 pandemic, is now coming to an end. Our health System has a very assertive strategy to help patients avoid disruptions in coverage, providing peace of mind and uninterrupted access to health care services. More than 600,000 of the 1.1 million patients we serve annually have public health insurance coverage through Medicaid. Thousands more have health insurance coverage through an Essential Plan or Child Health Plus, which have similar recertification requirements. Our plan includes outreach by our financial counselors and other staff, as well as an education campaign. NYC Health + Hospitals is also working with our Managed Care Organization partners such as MetroPlusHealth and HealthFirst to engage with Medicaid recipients in their communities through town halls in our facilities and community based events.

EXPANDING HOUSING NAVIGATION SERVICES TO DOUBLE NUMBER OF UNHOUSED PATIENTS WHO GET HELP APPLYING FOR HOUSING

As part of our Housing for Health initiative, NYC Health + Hospitals will double the number of patients experiencing homelessness who receive one-to-one expert support to find and apply for housing. We are investing $10m over the next 3 years to match approximately 600 patients a year with housing navigation experts from the nonprofit consortium, Coordinated Behavioral Care, to help patients find housing they qualify for, complete applications, accompany them to view apartments and help them settle into a new home with their rent paid by City and Federal rental subsidies Coordinated Behavioral Care and their partners were selected due to their long history offering housing and social services to people experiencing homelessness. Their housing consortium includes Catholic Charities, Services for the Underserved The Bridge and Welllife.

We know that patients experiencing homelessness are also more likely to experience poor health. Adults experiencing homelessness have three times more hospital and emergency department visits than the general population. In addition to improving our patients’ health outcomes by finding them housing, our program also saves health care costs by reducing hospitalizations and emergency room visits. Our housing navigation team will employ a ‘whatever it takes’ approach to meet patients where they are and support them through the process of finding a stable, safe and affordable home.

BUILDING MORE AFFORDABLE AND SUPPORTIVE HOUSING ON HOSPITAL CAMPUS

In another project that is part of our Housing for Health initiative, today we broke ground on a new, $41.5 million, 93-unit apartment building on the campus of NYC Health + Hospitals/Woodhull in Brooklyn. This project is a partnership with the NYC Department of Housing Preservation and Development (HPD) and Comunilife. Patients who are experiencing homelessness will be selected for 56 units of supportive housing, and they will receive services from Comunilife and health care from Woodhull Hospital. The remaining apartments are for low-income New Yorkers. The building is expected to open in 2025 and is the second phase of affordable and supportive housing development on the hospital campus. The first phase, also financed by HPD, and developed by Comunilife, opened in 2019 and has 89 units of affordable and supportive housing. This project is one of several that will contribute to our commitment to create nearly 650 new affordable homes in the next five years.

NYC HEALTH + HOSPITALS RECEIVES HIGHEST RATING FOR MEETING FEDERAL HOSPITAL PRICE TRANSPARENCY REQUIREMENTS

In a new national study NYC Health + Hospitals earned the highest rating for sharing hospital pricing data and meeting federal requirements to help consumer understand the cost of health care. We received the highest score of 5 in an April 18 study by Turquoise Health, which analyzed pricing data posted online by more than 5,300 hospitals across the country. Our health System was among the top 1% of hospitals nationwide, and one of only three health care organizations in New York State to earn the top rating. Since 2021, federal law has required hospitals to publicly post information about their standard prices and negotiated discount rates for common health services to encourage consumers to compare prices and to promote competition. In addition to posting price data online, NYC Health + Hospitals has extensive financial counseling support services for patients to make health care affordable and accessible.

We are committed to providing patients with the best information possible so they can make informed decisions about their care. This includes sharing our hospital charges and providing an online tool to estimate out of pocket costs for the most common services we provide. But our commitment to help consumers understand the cost of health care services goes deeper than posting the required price information. Because of our long-standing mission to serve poor and uninsured New Yorkers, we have built a robust financial counseling support system to help patients understand costs, avoid debt, sign up for insurance coverage they may not know they qualify for, and most importantly, access the medical care they need regardless of ability to pay or insurance status.

RESPONDING TO THE HUMANITARIAN CRISIS

NYC Health + Hospitals has responded to the asylum seeker crisis, operating nine Humanitarian Emergency Response and Relief Centers (HERRCs) for nearly 14,500 asylum seekers since the crisis began. The family and adult humanitarian centers provide a one-stop concentration of services, including three fresh meals and healthy snacks, round-the-clock medical care, access to vaccinations, mental health support, language interpretation, school enrollment, insurance enrollment, and resettlement services. To date, HERRC staff have provided asylum seekers more than 16,000 vaccinations—including about 10,000 vaccinations to children who are then eligible to enroll in New York City public schools—and enrolled over 10,000 people in health insurance. Since our humanitarian centers welcomed their first guests, nearly 5,000 asylum seekers have been reconnected with their families or reached their desired destination.

CELEBRATING OUR DIVERSE ROOTS ON IMMIGRANT HERITAGE WEEK

I was fascinated to learn from a recent survey of our staff that our essential workforce speaks 66 different languages. Yet regardless of where we all come from and what languages we speak, we are united by our shared mission to serve all New Yorkers. Everything about our varied ancestry and heritage supports the core values of NYC Health + Hospitals to provide equitable access to quality health care, with respect and compassion for the diverse communities we serve. After all, we are a country built by immigrants, a City built by immigrants and a health care System built by immigrants. We are a mirror reflection of our patients, which drives us all to take care of them as we would take care of our own families. In fact, over the years I have met so many NYC Health + Hospitals staff who told me stories about bringing their immigrant parents to our facilities, translating for them, and being so impressed by the quality of care they received that they made a commitment to come work for us; to give back what they got for their families. So, as we celebrate Immigrant Heritage Week, we also honor our roots and the diversity of backgrounds they represent– because all those differences are exactly what make NYC Health + Hospitals whole in every way.

PROMOTING HEALTH CARE AND SOCIAL SERVICES AVAILABLE TO IMMIGRANT COMMUNITIES ON STATEN ISLAND

NYC Health + Hospitals and our NYC Care team partnered with our health plan MetroPlusHealth to host a resource fair on April 21 to connect more Staten Islanders – particularly new immigrants in the borough — to a wide range of health care and social services support. We worked with a number of Staten Island community partners and City agencies, including Project Hospitality/El Centro, NY Foundling, La Colmena, the Mayor’s Office to End Domestic and Gender-Based Violence, the Mayor’s Office of Immigrant Affairs, African Refuge, and the United Network for Early Childhood Education Provider Network. The partners provided a range of services for Staten Islanders, including connecting them to health care coverage, sharing information on how to access free immigration legal help, and providing services for expecting mothers.

KEEPING CHILDBIRTH SAFE FOR ALL

On April 10 we recognized national Black Maternal Mortality week. That such a week even exists is a sobering reminder that Black and Brown mothers are still dying during child birth at alarming rates across the country. I am proud that since 2018 our health System has been committed to the Maternal Mortality Reduction Project, a series of initiatives designed to make childbirth a joyful and life affirming experience for our patients of all backgrounds and circumstances. One component of the project is regular, systemwide training of more than 2,000 Labor and Delivery nurses at all 11 facilities. Our skilled nursing team routinely practices delivering babies during special simulations of high-risk deliveries. Simulation Nurse Educators travel from facility to facility working with staff on our life-like high tech mannequins, teaching how to handle any situation that comes up. The most common scenarios they work through are cardiac arrest, hemorrhage, dangerously high blood pressure also known as pre-eclampsia, and shoulder dystocia, when the baby’s shoulder gets lodged behind the mother’s pubic bones. Our training is designed to get our nurses so familiar with these situations they know exactly what to do every time and do not waste a second getting mom the care she needs for a safe delivery and healthy baby.

INAUGURAL FACULTY DEVELOPMENT DAY

NYC Health + Hospitals hosted an Inaugural Faculty Development Day on April 18 with the Equity and Access Council of the Equity Diversity and Inclusion Committee of the Board of Directors to showcase academic advancement opportunities for our staff. Special speakers included Dr. José Pagán, Chairperson of our Board of Directors and Chairman of the NYU Department of Global Public Health, and Dr. Joan Reede, Harvard Medical School’s first dean for diversity and community partnership. Dr. Reede is the first African American woman to hold a position of that rank at HMS and one of the few African American women to hold a deanship at a medical school in the United States. Other speakers included Dr. Kathie Ann Joseph, Professor of Surgery NYU Grossman School of Medicine; Dr. Fritz Francoise, Professor Department of Medicine at the NYU Grossman School of Medicine and Vice Dean and Chief of Hospital Operations at NYU Langone; and Alice Stafford, NYC Health + Hospitals Program Manager for Training and Development. The daylong conference had over 140 registrants.

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