REPORT TO THE BOARD OF DIRECTORS – February 2023

Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS
PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
February 23, 2023

COVID-19 UPDATE

Across New York City, and specifically at NYC Health + Hospitals, we continue to see a decline in COVID-19 hospital admissions. In fact, we are seeing the lowest levels since May of last year, and are hopeful the downward trend will continue.

Earlier this month, the New York State Department of Health officially ended its requirement that facemasks be worn in health care settings, and left it up to each hospital and health system to determine their own policy. We have decided to maintain universal masking, as New York City is still experiencing high levels of transmission of COVID-19. All staff, visitors and vendors in all NYC Health + Hospitals facilities, both clinical and non-clinical, must continue to wear facemasks until further notice. Levels of community transmission will dictate our next steps. If community transmission decreases, we will allow optional mask wearing in certain areas where patient encounters do not take place. Masks will continue to be required in patient care areas, regardless of levels of transmission. We will be monitoring the data closely to determine when New York City shifts away from high levels of community transmission, and we will update our masking policy accordingly.

CARING FOR ASYLUM SEEKERS

Since opening the first Humanitarian Emergency Response and Relief Center in October 2022, NYC Heath + Hospitals has cared for more than 10,000 asylum seekers. We are currently caring for more than 7,000, offering them food, shelter, 24/7medical care, vaccinations, laundry, DOE school enrollment, and reconnections to help them be reunited with friends and family across the country. These numbers are, of course, in addition to all that is being done for asylum seekers through the DHS system. At the humanitarian relief centers, over 90% of our staff are bilingual, speaking English and Spanish, and many speak other languages. We have opened six of these large-scale relief centers already, with each focused on specific populations: families with children, single adult men, and single adult women/adult families.

CITY OF NEW YORK AND DC37 REACH COLLECTIVE BARGAINING AGREEMENT

Mayor Adams and the City last week reached a five-year collective bargaining agreement with District Council 37 (DC37), the City’s largest municipal labor union that represents more than 18,000 NYC Health + Hospitals employees. If ratified by DC 37 members, the City-funded deal will provide 3 – 3.5 percent wage increases annually to our staff, with retroactive payments going back to May 2021. The agreement also includes a bonus for members, as well as the creation of an “Equity Fund” to make salary adjustments to help fill hard-to-recruit positions, and several other provisions. This is the first major labor deal for the administration.

IN RECOGNITION OF BLACK HISTORY MONTH – STANDING UP FOR EQUITY, ACCESS AND INCLUSION

Black History Month is an important time to educate ourselves about the progress and the lack of progress that has been made confronting racism. You do not have to look further than recent events in Memphis to understand how deep and complicated the issues of racism are in this country, and how far we are from Dr. Martin Luther King’s dream. Deep systemic and institutional inequities exist in almost all walks of American life that continue to put Black communities at a disadvantage; inequities in law enforcement, education, political representation, our prison system, and of course, in health care. The theme of this year’s Black History Month is Black Resistance, highlighting the myriad ways Black Americans have fought against racial inequality for decades. This includes the fight against inequality in health care, but I am proud of the way NYC Health + Hospitals joins the resistance every day.

Our health System’s strategic priorities have been restructured to include social and racial equity as the foundation of our mission and values. Working with the NYC Department of Health, we continue our leadership on the Coalition to End Racism in Clinical Algorithms to stop bias in medicine and advance racial justice in health care for all New Yorkers. We have made major inroads in our hiring practices and in our partnerships with minority vendors to get the broadest representation we can. A full forty-five percent of our staff identifies as Black and African American, and that number edges up every year as we make diverse hiring a focus of recruiting efforts. We are working with schools and universities to create pathways for young Black people dreaming of careers in medicine. And we open our doors, our clinics and our hearts to Black New Yorkers — more than one-third of our NYC Health + Hospitals patients identify as Black or African American.

I am proud of NYC Health + Hospitals’ commitment to equal access to high quality health care and compassion for all. Not just during February, but always.

NYC HEALTH + HOSPITALS LAUNCHES NEW INITIATIVE TO INCREASE PHYSICIAN DIVERSITY

NYC Heath + Hospitals launched an exciting new initiative to encourage students, trainees and physicians from groups under-represented in medicine to join the NYC Health + Hospitals clinician workforce. Our new physician diversity initiative we call MOSAIC, for Medical Opportunities for Students and Aspiring Inclusive Clinicians, will support students ranging from middle school through graduate medical education, as well as attending physicians, to increase diversity in medicine. This work has been financed with $500,000 from our health System’s unrestricted philanthropic funds. Through MOSAIC, we started the Visiting Scholars Program to place medical students from backgrounds under-represented in medicine in clinical rotations across our facilities where they will gain experience in specialties ranging from emergency medicine to plastic surgery. We will collaborate with Mentoring in Medicine to provide underserved middle and high school students with training, mentorship, and Medical College Admission Test (MCAT) preparation to help expand the pool of students interested in going into careers in medicine. We will also partner with East Side House to help at-risk 16- to 24-year-old students train for careers in health care, including as a pharmacy technician, phlebotomist, home health aide, or nursing assistant. I am very proud to support and expand diversity among the next generation of clinicians, and grateful for our generous donors whose philanthropic investment in this program will have a profound impact on how we provide our patients with the highest quality care.

HELPING HEALERS HEAL CONTINUES TO BE A VITAL RESOURCE FOR NYC HEALTH + HOSPITALS STAFF

We continue to expand our vital Helping Healers Heal program, first launch in 2018, to support workforce wellness – because as healers or those supporting the healing of others, sometimes we need healing too. This became painfully clear during the pandemic and remains a NYC Health + Hospitals priority. Today the wellness program is going full steam ahead and has adopted the eight dimensions of wellbeing approach to support emotional, environmental, financial, intellectual, occupational, physical, social, and spiritual well-being of our staff. We have won several international awards including “Outstanding Wellness Program: Large Organization” and “Best Mental Health Initiative” for the Ragan’s Workplace Wellness Awards in 2021. We also marked some important program milestones:

$1,000,000+ – In funds raised to renovate and create 20 Wellness Rooms at facilities throughout the health System.
60,000 – Staff have benefited from the services since the program launched in 2018.
56,000 – Wellness Rounds were completed since the beginning of the COVID-19 pandemic in 2020.
13,703 – Emotional and psychological support encounters completed—which included one-on-one and group debriefs as well as events focused on the Dimensions of Well-being
51 – Just-in-Time Training sessions delivered—covering topics such as Emotional Intelligence in Times of Stress, Compassion Fatigue Training and Live Yoga.

Staff wellness is a fundamental value at NYC Health + Hospitals and we are committed to evolving our support services from crisis and trauma response to overall preventative approaches that help our staff live their healthiest life both at work, and at home.

NYC HEATH + HOSPITALS/KINGS COUNTY OPENS NEW NEUROSCIENCE CENTER

NYC Health + Hospitals/Kings County opened the new Brooklyn Neuroscience Center to offer comprehensive services to treat disorders of the brain, spine, and peripheral nervous system under one roof. Our expert clinical team will be able to treat patients of all ages for conditions that range from headaches and carpal tunnel syndrome, to epilepsy and stroke. They will also offer neurosurgery and rehabilitation medicine services. This is a wonderful way to improve access to these specialized services for the people of Brooklyn, who now do not have to leave the borough to get the best treatment for these challenging conditions. The team at Kings County Hospital also contribute to the advancement of knowledge in the neurosciences through its clinical and translational research program. They are a part of the National Institutes of Health STROKENET, SIREN, and Neuro NEXT research consortia in collaboration with SUNY Downstate Health Sciences University. They also have numerous investigator-initiated projects in clinical and translational research in epilepsy and traumatic brain injury.

EXTERNAL AFFAIRS UPDATE

State – Earlier this month, the Governor released her $227 billion executive budget plan, which includes total Federal, State and local Medicaid spending of $94.4 billion.

NYC Health + Hospitals is working with the Governor on amendments and working with the Legislature to repeal the pharmacy carve out from Medicaid managed care, to increase Medicaid rates for hospitals and nursing homes, including specific funding for essential safety net providers, and allow our work force to work at the top of their license.

We are pleased to be collaborating with our colleagues Safety Net providers in particular as we seek equitable safety net funding. We are also pleased that the Governor released capital funding to support NYC Health + Hospitals/Bellevue and Woodhull Hospitals, and Gotham Health/East New York health center. There is an additional $1 billion health care capital funding proposed for the upcoming State fiscal year and we will advocate for a set aside of these funds be allocated for safety net providers.

EO4, the statewide executive order authorizing regulatory flexibilities for the COVID-19 response, was extended in part on February 21, 2023. It was narrowed to continue many of the workforce flexibilities but allowing some lesser-used flexibilities to expire. We are working through implementation and do not have any major concerns.

Federal – NYC Health + Hospitals received $10.5M in Congressionally-Directed Spending in the FY-23 Consolidated Appropriations Act. Planning is underway with facilities to finalize FY-24 proposals. The Biden Administration intends to terminate the COVID-19 Public Health Emergency (PHE) on May 11, 2023, after which all regulatory flexibilities attached to the PHE will expire. HHS issued a roadmap to the end of the PHE, and we are working across the System to ensure awareness of the end to many of these regulatory flexibilities. We continue to advocate to Congressional leaders, in collaboration with our hospital association partners. Priorities include preventing DSH cuts, maintaining certain COVID-19 regulatory flexibilities, and funding for Graduate Medical Education, safety net hospitals and health care infrastructure.

We are fortunate to have been visited in person by Representatives Goldman and Nadler in the past few weeks at NYC Health + Hospitals/Governor and NYC Health + Hospitals/Bellevue. We were also able to host the combined staffs of Senators Schumer and Gillibrand to tour NYC Health + Hospitals/South Brooklyn Health and Bellevue Hospital on February 22, 2023 and appreciate their ongoing support.

NEWS AROUND THE HEALTH SYSTEM