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  • REPORT TO THE BOARD OF DIRECTORS – March 2024

REPORT TO THE BOARD OF DIRECTORS – March 2024

Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS
PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
March 28, 2024

NYC HEALTH + HOSPITALS FACILITIES RECOGNIZE WOMEN’S HISTORY, NUTRITION, AND SOCIAL WORK MONTH

As stalwarts of their neighborhoods, our facilities take every opportunity to recognize employees, patients, and the communities they serve through various recognition events. This month, many facilities held Women’s History events and panels, nutrition workshops, and cooking demonstrations, and recognized social workers who play such an important role in our continuum of care.

As a part of Women’s History, two CEOs were recognized this month: Helen Arteaga Landaverde, CEO of NYC Health + Hospitals/Elmhurst and Cristina Contreras, CEO of NYC Health + Hospitals/Metropolitan. As part of Women’s History Month, Contreras was recognized as a trailblazer in the Dominican community by ABC7 news and Landaverde was recognized by NBC News as the first woman and first Hispanic woman to lead Elmhurst Hospital.

MAYOR ADAMS COMPLETES LIFESTYLE MEDICINE PROGRAM EXPANSION WITH SEVENTH PROGRAM AT NYC HEALTH + HOSPITALS/LINCOLN

Late this month, Mayor Adams and NYC Health + Hospitals announced the launch of its nationally recognized Lifestyle Medicine Program at a new location at NYC Health + Hospitals/Lincoln, marking the first time the program is available in the South Bronx. The program is now active at seven sites across the five boroughs, with six new locations previously launched: NYC Health + Hospitals/Jacobi in the Bronx; NYC Health + Hospitals/Woodhull and NYC Health + Hospitals/Kings County in Brooklyn; NYC Health + Hospitals/Elmhurst in Queens; and NYC Health + Hospitals/Gotham Health, Vanderbilt on Staten Island. The pilot program — launched at NYC Health + Hospitals/Bellevue in 2019 with the support of then-Brooklyn Borough President Eric Adams — has already served hundreds of patients. Together, the program’s seven sites will serve approximately 4,000 patients each year, providing them with the tools and support to prevent and manage common chronic conditions, such as Type 2 diabetes and high blood pressure.

Prior to the Lincoln Hospital expansion, the program opened at NYC Health + Hospitals/Gotham Health, Vanderbilt in Staten Island, the first time the program is available in Staten Island. The Lifestyle Medicine Program’s team supports patients in making evidence-based lifestyle changes, including adopting a healthful plant-based diet, increased physical activity, improved sleep habits, stress reduction, avoidance of substance use, and stronger social connections. Adults living with prediabetes, type 2 diabetes, high blood pressure, heart disease, or health concerns related to excess weight are eligible to enroll. The NYC Health + Hospitals/Gotham Health, Vanderbilt program can accommodate 32 new patients each month, and the care team includes physicians, a nurse practitioner, a dietitian, a health coach, a program coordinator, and an exercise trainer. Current patients of NYC Health + Hospitals can be referred to the program from their provider, and people who are not yet patients of NYC Health + Hospitals can see if they qualify to enroll.

RECORD 1.2 MILLION PLANT-BASED MEALS SERVED AT NYC HEALTH + HOSPITALS

NYC Health + Hospitals in partnership with Sodexo celebrated over 1.2 million plant-based meals served since the program began in March 2022. In 2023, the first full calendar year of the program, NYC Health + Hospitals served over 783,000 plant-based meals to its patients. Scientific research has shown that plant-based eating patterns are linked to significantly lower risk of cardiovascular disease, type 2 diabetes, obesity, and certain cancers. Plant-based meals can also be effective for weight management and treatment of hypertension and hyperlipidemia. In addition to these considerable health benefits, the plant-based meals served in 2023 led to a 36% reduction in carbon emissions and a cost savings of 59 cents per meal. Patients who ate plant-based meals at NYC Health + Hospitals reported a satisfaction rate over 90%.

All meals are made from scratch at the health System’s Culinary Center in Brooklyn. The culinary team includes Food Service Associates at each hospital who take patients’ food orders, educate them about the flavor and nutrition of the day’s plant-based options, and gather patient feedback about the meal. New recipes are piloted as a “Chef’s Recommendation” and only enter the menu rotation if they achieve an 80% patient satisfaction rate or above. Patients who are discharged from the hospital receive a booklet of plant-based recipes to make at home. Non-plant-based options continue to be available at patients’ requests and in accordance with their prescribed diet. ​

MAYOR ADAMS ANNOUNCES PLANS TO OPEN SUBSTANCE USE DISORDER CLINIC FOR EXPECTING AND PARENTING FAMILIES

Mayor Adams and the health System announced plans to open an $8 million health and substance use disorder clinic at NYC Health + Hospitals/Lincoln for pregnant and postpartum women and their families. The clinic will offer pregnant and parenting individuals living with substance use disorder — dependence on alcohol, tobacco, and other drugs — a safe and supportive place to access prenatal and postnatal care, addiction medicine, and behavioral health care. As the City aims to reduce Black maternal mortality by 10 percent and reduce opioid deaths by 25 percent by 2030, this clinic will support healthy birth outcomes, reduce the likelihood and impact of postpartum relapse, and address the needs of older children living in these families. Funded with an investment through “Women Forward NYC: An Action Plan for Gender Equity” — the Adams administration’s $43 million plan with the ambitious goal of making New York City the most woman-forward City in the country — the clinic will build on the City’s cross-sector work to improve the health and well-being of all women.          

The 6,500 square foot space, expected to open in 2026, will serve approximately 200 families per year and will be located in the Bronx — the borough with the highest rate of opioid overdose death in New York City. In addition to substance use support, patients will be able to access connections to community-based organizations for other critical services supporting recovery, such as housing, food, and employment. Care teams will be comprised of medical and behavioral health providers, including social workers, community health workers, and certified peer counselors with lived experience of substance use disorder.

‘NURSES4NYC’ RECRUITMENT CAMPAIGN LAUNCHES

In mid-March, NYC Health + Hospitals embarked on a major recruitment campaign to help fill nurse positions and expand access to community-based primary care at NYC Health + Hospitals/Harlem, Woodhull, and Lincoln. The recruitment campaign, Nurses4NYC, is intended to encourage more New Yorkers to apply for jobs as nurses with the health System. In addition to traditional advertising, the campaign is supplemented by targeted social media ads on LinkedIn and Facebook.

Currently, there are over 9,600 full and part-time nurses in the NYC Health + Hospital System. The public health System has an array of benefits, including a pension. New nurses can take advantage of the Nurse Residency Program, nursing fellowships, tuition reimbursement, loan forgiveness, and scholarship programs through NYC Health + Hospitals.

UPDATE ON CHANGE HEALTHCARE

On February 21, one of our vendors, Change Healthcare, experienced a cyber incident that affected many businesses across the nation and NYC, including NYC Health + Hospitals. Thanks to the vigilance of the company and to our EITS team led by Kim Mendez, to our knowledge, no NYC Health + Hospitals patient health information was stolen or released as a result of this incident.

Change Healthcare is the clearinghouse with which our health System contracts for electronic claim submission, remittance posting, patient statements, and insurance eligibility transactions. The company has been out of commission since the incident, in effect suspending our ability to submit claims to insurance carriers. In response, we have been working with State and Federal partners to expedite funding to NYC Health + Hospitals and to prioritize review and approval of pending initiatives and current-year reimbursements.

We have also contacted all of our managed care plans seeking administrative waivers in recognition of our inability to submit claims.  The health System has taken the following operational steps:  stepped up a planned July 1, 2024 go-live with Experian for the same services, implemented some manual work-arounds, and expedited a planned transition to paperless patient statements. We anticipate being live with Experian on Monday, April 1, 2024.

PATIENT TRANSFER CENTER OPENS AT 50 WATER ST.

At the end of February, NYC Health + Hospitals opened its own patient transfer center at our 50 Water Street Central Office headquarters. Known as the Transfer, Access and Capacity Center (TACC), NYC Health + Hospitals staff will oversee patient transfers all day, 365 days a year. For the first time, the health System will manage moving patients between all of its facilities, streamlining control and standardizing all transfer procedures and protocols. Facilities will be linked together through a team of nurses and support staff who will help provide our patients the best care possible during any transfer process.

NYC Health + Hospitals moves approximately 30 patients between facilities every day. Clinical teams at the facilities will be able to order transfers directly through Epic for non-emergent cases.  Emergency transfers will be handled by phone. The Transfer Center will use Epic to document all transfers, improving transparency and allowing greater insight into capacity, availability, and services. 

MAYOR ADAMS ADVANCES OUTPOSTED THERAPEUTIC UNITS AT NYC HEALTH + HOSPITALS/WOODHULL AND NORTH CENTRAL BRONX

In early March, Mayor Adams announced progress on several jails-focused initiatives to provide greater care and enhanced programming for people in custody. As part of this announcement, the Mayor directed NYC Health + Hospitals to move forward with construction of more than 350 outposted therapeutic housing beds that will increase access to specialty health care services for people in custody while moving those who are most clinically vulnerable off of Rikers.

The outposted therapeutic housing units at NYC Health + Hospitals/Woodhull and North Central Bronx are part of the administration’s commitment to increasing access to specialty care services for people in custody while moving the most clinically vulnerable people off of Rikers. The units will house patients who have serious medical, mental health, and substance-use needs and would benefit from a more structured, clinical environment. The NYC Department of Correction (DOC) will provide security and custody management in the units, and NYC Health + Hospitals/Correctional Health Services (CHS) will continue to be the primary provider of care, in closer coordination with hospital specialists.

Construction is already underway at NYC Health + Hospitals/Bellevue, the first of the three units, with anticipated completion by spring 2025. Construction of the units at NYC Health + Hospitals/Woodhull and North Central Bronx will be completed in summer 2027, assuming timely completion of design and barring significant unforeseen field conditions. Construction of all units is fully funded, with a total capital investment of $718 million, and will comprise of approximately 360 beds, depending on final designs. All three hospitals will benefit from an infusion of funds to renovate and repurpose hospital space to create the outposted therapeutic housing units. NYC Health + Hospitals/Woodhull recently relocated and renovated its inpatient pediatrics unit and upgraded other clinical and administrative spaces to prepare for the construction of the outposted unit.

THE REMEDY, THE NYC HEALTH + HOSPITALS PODCAST, RELEASED TWO NEW EPISODES

On March 5, the health System released the fifth episode of its new podcast, The Remedy. Episode 5: Caring for the Newest New Yorkers covers how the staff at NYC Health + Hospitals are rising to the challenge of caring for the over 180,000 asylum seekers who have come to our City since spring 2022. Host Dr. Michael Shen was joined by Dr. Ted Long, Senior Vice President of Ambulatory Care and Population Health at NYC Health + Hospitals, and Dr. Natalie Davis, Associate Medical Director of Ambulatory Women’s Health Services at NYC Health + Hospitals/Bellevue, to discuss NYC Health + Hospitals’ humanitarian centers, providing access to healthcare for asylum seekers, and helping migrants deal with the trauma they have experienced on their journeys.

The sixth episode, Caring for Homeless Patients, covers how NYC Health + Hospitals serves its over 70,000 patients who are experiencing homelessness. Dr. Shen was joined by Dr. Amanda Johnson, Assistant Vice President of Ambulatory Care and Population Health at NYC Health + Hospitals, and Leora Jontef, Assistant Vice President of Housing and Real Estate at NYC Health + Hospitals, to delve into New York City’s housing crisis, explain how safety net clinics and mobile vans are providing care to patients experiencing homelessness, and why New York City’s public health system now has a path connecting hundreds of patients to their own homes.

The Remedy is available on Apple Podcasts, Spotify, iHeartRadio, and other podcast platforms.

THE HEALTH SYSTEM SCREENED MORE THAN 50,000 PATIENTS FOR COLORECTAL CANCER IN 2023 USING FIT TEST, A 20 PERCENT INCREASE OVER 2022

For National Colorectal Cancer Awareness Month, NYC Health + Hospitals announced that it has screened over 50,000 patients for colorectal cancer in 2023 using the at-home fecal immunochemical test (FIT), a 20% increase over 2022. FIT is an easier, less invasive screening test for colon cancer. The health System increased patient engagement by launching a Colorectal Cancer Screening Registry, which captures all patients who are eligible for a colorectal cancer screening and encourages their primary care provider to offer a test during their annual appointment. The System also increased the availability of prepaid envelopes and instructions available in 14 languages to reduce barriers to patients collecting their sample and mailing back their test for processing.

NYC HEALTH + HOSPITALS/BELLEVUE OPENS NEW PALLIATIVE CARE SERENITY UNIT

Earlier this month, NYC Health + Hospitals/Bellevue opened a new Palliative Care Serenity Unit for patients and families. The new unit provides support and services for patients with serious illness who can benefit from extra support and expert symptom management, including patients who are waiting to transfer to hospice or who are nearing the end of life. The Palliative Care Program, which is accredited with Advanced Certification for Palliative Care from The Joint Commission, began in 2006. The program serves a diverse and often vulnerable patient population. The team works with experts in child life, therapeutic arts, legal health, psychiatry, critical care, and community hospices to serve patients and families. The demand for services has increased steadily year by year, and last year the Palliative Care team provided almost 1,000 patient consultations.

The Palliative Care program at Bellevue Hospital consists of physicians, nurse practitioners, nurses, social workers, and a dedicated chaplain, who, along with primary care teams and specialists, take care of patients who have cancer, advanced heart failure, kidney failure, serious lung disease, as well as patients who are very sick in the ICU, with dementia or serious brain injury. The program provides a full array of clinical services for patients and families experiencing the impact of serious illness or injury who are facing end-of-life care. Services include an inpatient consultation service, an outpatient palliative care clinic, pediatric palliative care consultation, a bereavement program, a volunteer/doula program, and an inpatient end-of-life care unit.

RESPONDING TO THE HUMANITARIAN CRISIS – SERVICES FOR ASYLUM SEEKERS

The public health System continues to help lead the City’s response to the historic influx of asylum seekers. Our network of 15 humanitarian centers provides vital aid to the approximately 25,000 asylum seekers in our care, with families with children comprising around three-quarters of this demographic. At our humanitarian centers, our newest neighbors receive dignified care and the resources they need to find a path towards a more promising future.

At NYC Health + Hospitals, we believe healthcare is a human right. That is why, from the outset of this humanitarian crisis, we created a coordinated system of medical care that begins at the front door of our shelter system and extends to our public hospital system and other federally-qualified health centers. Our staff at the Arrival Center have now cared for over 125,000 new arrivals, providing immediate, centralized access to essential medical services, including screenings for communicable disease, urgent care, screening for depression, vaccinations, and connections to the case management and social services people need to take their next steps forward.

Through every twist and turn of this emergency response, our staff have been driven by our mission to protect asylum seekers’ human rights and provide urgent, comprehensive care. As we navigate the months to come, we will continue to prioritize our enhanced case management services to ensure asylum seekers are receiving meaningful assistance towards their goals and the journey ahead.

NYC HEALTH + HOSPITALS NOW USES THE AMERICAN FOUNDATION FOR SUICIDE PREVENTION’S INTERACTIVE SCREENING PROGRAM TO SUPPORT EMPLOYEE WELLNESS

NYC Health + Hospitals has partnered with the American Foundation for Suicide Prevention (AFSP) to implement the Interactive Screening Program, an online self-screening tool for staff to connect to peer and clinical support before a potential crisis emerges. This partnership builds upon Helping Healers Heal (H3), NYC Health + Hospitals’ staff wellness program. The anonymous screening tool is customized for the health System. Employees take a brief stress and depression questionnaire, receive feedback about the mental health programs that are available, and, if desired, schedule a debrief with a H3 Peer Support Champion. The AFSP created ISP in 2001 to lessen mental health stigma in providing mental health help to all who are in need.

As of today, ISP has assisted over 280,000 employees working in over 200 organizations ranging across healthcare, academic institutions, law enforcement agencies and other workplaces. In 2022, the Center for Disease Control and Prevention reported that nearly half of health workers said they felt burned out and recently stated that there is a bourgeoning mental health crisis for healthcare workers. The Physicians Foundation found that over 76% of physicians, residents, and medical students agree that physician mental health stigma still exists. According to a recent study by the Journal of the American Medical Association, healthcare workers in the US are at increased risk of suicide as compared to non-healthcare workers.

NYC HEALTH + HOSPITALS/ELMHURST PARTNERS WITH EHL HOSPITALITY BUSINESS SCHOOL

NYC Health + Hospitals/Elmhurst has partnered with EHL Hospitality Business School —a leading academic hospitality management institution founded in 1893 and based in Switzerland and Singapore — to share best practices and resources related to the hospitality sector and its intersection with health care. EHL students will gain first-hand experience assisting hospital leadership on hospitality-related projects, training the next generation of care experience leaders. NYC Health + Hospitals/Elmhurst will additionally be the first healthcare institution worldwide to join the school’s EHL Alliance, a global professional network that brings industry and academic leaders together. It specializes in providing education, resources, and services to enhance working environments that are people-centered and welcome all. This inclusive approach is essential to Elmhurst Hospital’s mission, with nearly one million patient visits each year in the City’s most diverse borough. The partnership with the school and collaboration with the Alliance is an investment in the hospital’s strategic plan, called Elmhurst 2.0, which looks to transform the hospital to meet the ever-growing needs of the area’s expanding and thriving community.

MOTHER CABRINI HEALTH FOUNDATION GRANTS SUPPORT CAREER DEVELOPMENT FOR PSYCHIATRIC PHYSICIAN ASSISTANTS AND CARE FOR ASYLYM SEEKERS

NYC Health + Hospitals received $550,000 in funding from the Mother Cabrini Health Foundation for two programs. A $300,000 grant will fund the launch of the Psychiatric Physician Assistant Career Pathways Program, which will include courses at local colleges, guest lectures by behavioral health professionals, clinical placements, fellowships, and tuition repayment. The program is designed to help attract and retain clinicians who care for New Yorkers with mental health or substance use needs. The program will launch later this year.

The second grant of $250,000 will fund care at NYC Health + Hospitals/Elmhurst for asylum seekers who are survivors of torture. The funding will allow the Libertas Center for Human Rights at Elmhurst Hospital to continue its focus on delivering trauma-informed, culturally responsive mental health care; integrated medical, legal and social case management; and care coordination for survivors of torture and allow it to serve more individuals in response to the recent surge of asylum seekers in New York City.

NYC HEALTH + HOSPITALS/BELLEVUE ATTAINS NATIONAL ACCREDITATION FROM AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER

NYC Health + Hospitals/Bellevue received accreditation as an Academic Comprehensive Cancer Program under the American College of Surgeons (ACS) Commission on Cancer (CoC) Accreditation Program. The accreditation tells cancer patients that they will have access to the highest-quality of cancer diagnosis, care coordination, treatment, and support at the hospital. The accreditation standards supply the structure for providing all patients with a full range of services either on-site or by referral, including community-based resources. Bellevue Hospital is one of only 14 hospitals in New York State to receive accreditation at this level.

The ACS CoC is a consortium of professional organizations dedicated to improving survival and quality of life for patients with cancer. The American College of Surgeons accreditation is granted to institutions committed to providing high-quality cancer care by demonstrating compliance with CoC standards. Each cancer program must undergo a rigorous evaluation and review of its performance and compliance with CoC standards. To maintain accreditation, cancer programs must undergo a site visit every three years.

NEW MURAL UNVIELED AT NYC HEALTH + HOSPITALS/LINCOLN

“Legacy” at NYC Health + Hospitals/Lincoln, was unveiled in late March. The mural, developed by artist Dister Rondon, was drawn up during a series of focus groups with community members, staff, and patients and brought to life at a paint party where the community painted the mural together. It depicts the Young Lords’ takeover of Lincoln Hospital in 1970 at a pivotal moment in the fight for improved healthcare and patient advocacy. Through their activism, they not only challenged the deplorable health conditions for patients and staff, but also confronted racial and class inequalities embedded within the healthcare System.

“Legacy” is one of nine new murals that have been created in the past year, building on the 26 murals created in the first wave of the Community Mural Project.  Many of those murals are featured in a new book, “Healing Walls: New York City Health + Hospitals Community Mural Project 2019-2021”.  The Community Mural Project is made possible through the generous support of the Laurie M. Tisch Illumination Fund.

EXTERNAL AFFAIRS UPDATE

In late February, the City Council Committee on Hospitals held a hearing on “Addressing the Healthcare Staffing Crisis – Examining Residency Conditions and Worker Concerns,” during which Dr. Eric Wei provided testimony. In early March, Dr. Katz also testified at the City Council Preliminary Budget Hearing.

All facilities submitted their FY ‘25 capital funding requests to Borough Presidents and City Council.

State: The State fiscal year ‘24-25 budget process is in full swing. Earlier this month, the NYS Assembly and Senate passed their one house budget in response to the Governor’s budget. Fortunately, both houses address the majority of NYC Health + Hospitals’ priorities including, but not limited to, rejecting proposed Medicaid cuts, such as the capital reimbursement cut and undisclosed Medicaid cuts. We were pleased to see both the Senate and Assembly increase Medicaid rates by providing an across-the-board Medicaid rate increase of three percent, and additional increases for inpatient and outpatient hospitals services and nursing home providers. Although both houses rejected the proposed Safety Net Transformation Fund, there is new capital funding, and we are requesting a set-aside for safety net providers.

It is unlikely at this time that the budget will be passed by the April 1st deadline, and we continue to advocate for the needs of the public health System.

Federal: This month, Congress passed two major Appropriations packages relevant to NYC Health + Hospitals. The first will eliminate the rest of the FY ‘24 Medicaid DSH cut and delay the start of the FY ‘25 DSH cut to January 1, 2025 (instead of October 1, 2024).

The second funded the Department of Health and Human Services and federally funded health programs and included Congressionally Directed Spending (aka earmarks) awards. NYC Health + Hospitals received $2M with the support of New York Senators Schumer and Gillibrand for the Cardiac Cath Lab project at NYC Health + Hospitals/Elmhurst.

Community Affairs: Twelve CABs met with their local State representatives to discuss the impact of the NYS budget on their facilities. Additionally, ten CABs hosted legislative breakfasts/lunches.

The March 5th Council of CABs included a presentation by the Social Determinants of Health team regarding the new Findhelp platform.

We have also been working with Auxiliaries to complete IRS filing and audit processes and to strengthen the relationship between NYC Health + Hospitals and the Auxiliaries.

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