REPORT TO THE BOARD OF DIRECTORS – June 2023

Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS
PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
June 29, 2023

RESPONDING TO THE HUMANITARIAN CRISIS – SERVICES FOR ASYLUM SEEKERS

NYC Health + Hospitals’ Humanitarian Emergency Response and Relief Centers (HERRCs) continue to play a vital role in the city’s response to the historic asylum seeker crisis. This month we opened three humanitarian centers on the Upper West and Upper East Side, repurposing American Musical and Dramatic Academy and Columbia University dorms not housing students this summer to provide new facilities for single adults and families with children.

Our 11 humanitarian centers are a cornerstone of the city’s network of over 175 shelters and respite sites supporting this massive humanitarian effort. HERRC facilities have provided a place to stay and compassionate care for more than 20,000 asylum seekers, including 12,000 people currently in our care.

Humanitarian centers provide asylum seekers and their children a one-stop concentration of services, including medical care, nutrition, language access, mental health support, school enrollment, social programs, technology, and reunification resources. We have administered over 15,000 vaccinations to children and enrolled over 12,000 people in health insurance.

The city’s Arrival Center at the Roosevelt Hotel — which NYC Health + Hospitals launched in early May to provide a centralized location to efficiently process new arrivals — now welcomes about 400 people through its doors each day. The streamlined services available at the center readily connect asylum seekers to intake, medical, legal, and reconnection services, as well as placement, if needed, in a shelter or humanitarian center.

LABOR RELATIONS UPDATE

The City and NYC Health + Hospitals have reached agreement on two major collective bargaining agreements in recent months covering health system employees – District Council 37 and Teamsters Local 237, the latter of which is still pending ratification by members. These roughly five-year agreements provide for cost of living increases, ratification bonuses, and other benefits to our employees. The City and the health system are also in active negotiations with the New York State Nurses Association. We have repeatedly noted the importance of nurses to our system and our interest in reaching fair compensation that allows us to recruit and retain nurses and to reduce our reliance on temp nursing agencies.

NYC CARE: NEW PATIENT DATA SHOWS STRONG ENGAGEMENT WITH DOCTORS AND PRIMARY CARE

NYC Health + Hospitals’ NYC Care health care access program released key findings from a study demonstrating the program’s success in connecting new members to primary and specialty care. The data shows even higher engagement among members who had two or more chronic diseases and spoke English as a second language. The results demonstrate our success in engaging undocumented and low-income New Yorkers who don’t have access to health insurance, and regardless of language barriers or burden of chronic disease. Overall, 76.9% of new NYC Care members returned to primary care for an additional visit in their first year, 80.7% received a referral outside of primary care, and 75.4% visited specialty care. For new members with two or more chronic diseases, 86.1% returned to primary care, 87.1% received a referral, and 86% visited specialty care. There was also strong engagement for new members whose primary language is not English, where 86.1% returned to primary care, 80.2% received a referral, and 74.7% visited specialty care. This data suggests that NYC Care has spurred patient engagement at rates comparable to Medicaid, and that the data reflects member satisfaction and confidence in the high-quality care they are receiving. The investigation, “Engaging New Primary Care Patients: Access for Uninsured Patients at an Urban Safety Net System,” was published for the AcademyHealth Annual Research Meeting by Caroline Cooke, MPH, CHES, Christine Zhang, MPA, NYC Care Executive Director Jonathan Jiménez, MD, MPH, and Remle Newton-Dame, MPH and focused on new NYC Care members initiating primary care at NYC Health + Hospitals from November 1, 2020 – October 31, 2021.

GOTHAM HEALTH CENTERS EARN PATIENT-CENTERED MEDICAL HOME RECOGNITION

Three NYC Health + Hospitals/Gotham Health neighborhood health centers this month received the highest-level Patient-Centered Medical Home (PCMH) designation for our work to improve patient health outcomes and patient satisfaction. The teams at Gotham Health Bushwick and Greenpoint in Brooklyn, and Gotham Health Gunhill in the Bronx, earned the National Committee for Quality Assurance’s PCMH 2023 recognition for meeting rigorous national standards to make high-quality primary care more accessible to the community. Primary care clinics receive this special status for their heightened focus on identifying patients with high needs for care management, integrating behavioral health screenings and treatment into primary care practice, and engaging patients in their own care. This requires a special delivery model of care that ensures access, communication, and shared responsibility across the care team of doctors, nurses, and social workers. NYC Health + Hospitals/Gotham Health has eleven PCMH certified health centers.

IN SUPPORT OF MEDICAID AND CHIP POSTPARTUM COVERAGE EXPANSION

NYC Health + Hospitals Chief Women’s Health Officer Wendy Wilcox, MD, issued the following statement on behalf of our health system to express our support of the recent Medicaid and Children’s Health Insurance Program (CHIP) coverage expansion for postpartum individuals for a full 12 months:

“We are grateful to the Biden Administration for recognizing that new parents need more than two months to recover after birthing a baby. Maternal health risks linked to childbirth persist throughout the first year postpartum. Ob-gyns are seeing higher rates of cardiovascular disease, behavioral health and substance use disorders among patients late in the postpartum period, especially among people of color. With this one-year extension in Medicaid postpartum coverage, NYC Health + Hospitals and providers across New York State will be able to continue to provide integrated, patient-centered, high-quality, comprehensive care to address the full spectrum of health needs which patients deserve and have come to expect.”

A MONTH OF PRIDE

As June comes to an end, so do our diverse, colorful and joyful Pride celebrations both throughout our city, and our health system. Hundreds of our staff participated in Pride community events across the city, marched at the Pride parade on 5th Avenue, and demonstrated our values of openness, acceptance and tolerance of every individual at facility-based events across our health system. Embracing Pride is at the heart of the NYC Health + Hospitals mission of equity and equality for all. Needless to say, we are proud of our Pride. We are also proud of the five NYC Health + Hospitals doctors chosen as Castle Connolly Top LGBTQ+ Doctors 2023. Castle Connolly is a research-led organization that identifies the nation’s top doctors:

Dr. Gregory L. Almond, Chair of the emergency department at NYC Health + Hospitals/Metropolitan
Dr. Richard E. Greene, Director of LGBTQ+ Services at NYC Health + Hospitals/Bellevue
Dr. M. Margaret Kemeny, Surgery at NYC Health + Hospitals/Queens
Dr. Robert A. Pitts, Infectious Disease Specialist at NYC Health + Hospitals/Bellevue
Dr. Warren M. Seigel, Chair of Pediatrics and the Director of Adolescent Medicine at NYC Health + Hospitals/South Brooklyn Health

IN RECOGNITION OF JUNETEENTH

Our health system came together in various events and ceremonies to recognize the Juneteenth holiday – the date we officially commemorate the end of slavery in the United States. As we reflected on the important of this history day, we also shared our hope, and our mission, that we will soon see Black communities celebrate another kind of independence: freedom from health care disparities. Much has been documented about health challenges plaguing historically Black communities, where chronic diseases such as hypertension, diabetes, obesity and heart disease persist. These preventable diseases are the legacy of generations of unequal access to health care and the racist values which divide us. This is the devastating result of the long arm of slavery. While NYC Health + Hospitals is addressing these racial disparities in health outcomes – by removing race based clinical algorithms in clinical care, by implementing the maternal home to reduce maternal morbidity and mortality, by screening patients for those social determinants which impact health outcomes, and by implementing unconscious bias training simulations – there’s still much work to do. Let’s keep fighting for independence, by bringing respectful, equitable care to all those populations which have been marginalized by the structural racism in health care. Let’s keep advocating for and providing equal access to the best doctors, clinics, experts and specialists. Let’s keep tackling the parallel social determinants of health: like stable housing, education and nutrition that go hand in hand with chronic health problems. In doing all of these things, let’s continue to heal the harm done by decades of injustice. I am proud to lead an organization that is continually moving forward on the long march toward freedom and independence.

BEHAVIORAL HEALTH STAFF RECEIVE $1 MILLION IN DEBT RELIEF IN EXCHANGE FOR THREE-YEAR COMMITMENT TO NYC HEALTH + HOSPITALS

As part of our Behavioral Health Loan Repayment Program, we are distributing $1 million in student loan repayments to members of our workforce who practice in behavioral health. Twenty-seven clinicians will receive between $30,000 and $50,000 of student debt relief in exchange for a three-year commitment to serve in our public health system. The program is designed to help attract and retain clinicians who care for New Yorkers with mental health or substance use needs, as the U.S. faces a national mental health professional shortage.

Offering student loan debt relief is one way that NYC Health + Hospitals can close the gap between the number of providers and the number of New Yorkers in need. And it’s our way to underscore how essential these health care professionals are to our mission. The recipients are a mix of new and existing employees and include behavioral health licensed clinical social workers, psychiatric nurse practitioners, psychologists and psychiatrists. Together, these individuals serve 25,000 patients annually. The loan repayment program was made possible by a $1 million donation from an anonymous donor and was first announced last summer by Mayor Adams.

On average, early career psychiatrists have $190,000 of student debt, psychologists have $80,000 of student debt, social workers have $68,000 of student debt, and psychiatric nurse practitioners have $56,000 of student debt. NYC Health + Hospitals recognizes the burden that student debt places on its workforce and is committed to programs that reduce it.

PAINT PARTIES KICK-OFF NEXT ROUND OF COMMUNITY MURALS ACROSS NYC HEALTH + HOSPITALS FACILITIES

The NYC Health + Hospitals Arts in Medicine program kicked off a new season of paint parties, where anyone can be an artist using a “paint by numbers” format, for new murals that will be permanently installed at many of our health system facilities. The murals were designed by 10 artists selected earlier this year and developed through focus groups with patients, staff, and neighborhood residents. Our Community Mural Project was featured in the latest episode of “That’s So New York” on NYC Life (WNYE-TV/Channel 25. Watch the video here. These works of public art bring lots of joy to both our patients and staff, and we are incredibly grateful to our sponsor, the Laurie M. Tisch Illumination Fund.

NYC HEALTH + HOSPITALS FACILITIES HOST FARMER’S MARKETS

It’s Farmer’s Market season at NYC Health + Hospitals. Many of our hospitals and community health centers across the city sponsor farmers markets operated by local nonprofit partners. We do this to make it easy for our staff, patients and members of the community to access fresh, local fruits and vegetables at an affordable price, and expand access to these products in communities that often have limited options. The markets accept various payment options and vouchers from government benefits programs to help New Yorkers take advantage of the healthy, fresh produce. Summer is a great time of year to try new fruits and vegetables, and we encourage everyone to shop locally at these markets and adopt a healthier diet with more plant-based meals.

NYC HEALTH + HOSPITALS RECEIVES GAGE AWARD FOR CARE IMPROVENT INITIATIVE

America’s Essential Hospitals (AEH), which represents more than 300 hospitals that care for low-income and other marginalized people, this month awarded NYC Health + Hospitals a 2023 Gage Quality Award Honorable Mention for our Care Improvement Contest initiative. Our team was recognized at the AEH’s annual VITAL Conference for activities that improve the quality of care or that mitigate threats to patient safety. NYC Health + Hospitals launched the contest to educate health care workers on patient experience and build their capacity to lead successful quality improvement projects. Eleven teams documented the current state of the inpatient experience; discussed gaps, challenges, and barriers to success; and devised and tested solutions. Projects focused on nurse leader rounding, interdisciplinary provider rounding, empathy skill building and teach-back training, complex discharge planning and post-discharge follow-up, and daily management system boards and whiteboards. In addition to improving patient experience scores in winning units, the contest facilitated a system wide increase in patient experience scores, including communication with physicians and nurses and overall hospital ratings.

CAPACITY BUILDING FOR QUALITY & SAFETY

Our health system graduated the second cohort of Quality Academy participants for the 6-month multidisciplinary quality and safety capacity building program. There were 142 graduates, 105 capstone QI projects submitted, and 79 of those projects had an equity lens. Our Healthcare Administration Scholars Program across Elmhurst, Queens, Jacobi, NCB, Metropolitan and Kings County hospitals graduated 35 senior residents through the 2-year quality and safety capacity building program geared towards building the next generation of clinical leaders. We completed the inaugural 7- week Risk Management Training Program for over 104 NYC Health + Hospitals staff. And we will graduate our fourth cohort of Clinical Leadership Fellowship this month. That includes six fellows who served across four central office divisions and in NYC Health + Hospitals/Jacobi who are all staying in our health system for their post fellowship.

EXTERNAL & COMMUNITY AFFAIRS UPDATE

City – Adopted budget is expected to be passed this week. We thank the Speaker, the Hospital and Health Chairs, and all of our Council champions for their support.

State – The New York State Legislature concluded its 2023 legislative session with a total of 14,973 bills that were introduced. Nearly 1,800 bills passed either the State Assembly or the State Senate; 896 bills passed both houses and now await the Governor’s action between now and the end of the year. We were pleased that the Governor sign into law a bill to strengthen access to reproductive health care and protect patients and doctors who require abortion care through telehealth services. In addition, there was legislation that passed that will be helpful for our workforce and patients. These include changes to support clinical laboratory workers, expansion of non-patient specific standing orders, protections for the delivery of gender-affirming care, and making community violence prevention services available, if permitted by federal law, to Medicaid patients. We are hopeful that the Governor will sign each of these.

On June 22, the Governor did not renew Executive Order 4 Declaring a Statewide Disaster Emergency Due to Healthcare Staffing Shortages that has been in effect since 2021. As a result, the regulatory flexibilities extended by State Department of Health and the State Education Department per EO 4 have expired. We thank our system Regulatory leads who supported our facilities over the last few years with advocacy and analysis of this information.

Federal – Earlier today, I joinedU.S. Department of Health and Human Services Secretary Xavier Becerra in a tour of NYC Health + Hospitals/Metropolitan and at NY Academy of Medicine roundtable with hospital CEOs on the Inflation Reduction Act. The secretary also toured NYC Health + Hospitals/Lincoln and hosted another roundtable on mental health. Secretary Becerra is in town to highlight the Biden-Harris Administration’s efforts to lower prescription drug costs, bolster the health workforce pipeline, improve mental health, and expand language access programs. We continue to advocate to our Congressional delegation about the importance of maintaining existing funding levels and we are grateful for their continued support.

Community – We hosted an educational conference for our Community Advisory Board (CAB) members on June 23^rd, focusing on how to run meetings most efficiently and effectively. Thank you to the 50+ CAB members who attended. We will be hosting the 19^thMajorie Mathews Awards on July 20^th at NYC Health + Hospitals/Coler. This is a great event to thank our system CAB and Auxiliary members. Board members are welcome to join us.

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