REPORT TO THE BOARD OF DIRECTORS – November 2022

Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS
PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
November 17, 2022

CORONAVIRUS UPDATE

COVID-19 hospitalizations remain low but steady. We are keeping a vigilant eye on the trends as we enter flu season. We continue to provide all New Yorkers access to COVID-19 vaccinations and booster shots, testing and treatment. In fact, we recently launched an ad campaign to encourage use of the NYC Health + Hospitals virtual ExpressCare for New Yorkers who test positive, and directing people to our mobile units. The ads are appearing in multiple languages on digital platforms, print, radio, and outdoor spaces in targeted communities. They will run from now until the end of the year. Our 75 mobile Test to Treat units out in the community have distributed more than 67 million free home tests. The mobile units also have performed more than 100,000 COVID-19 tests and provided more than 2,500 prescriptions for paxlovid.

RESPIRATORY SYNCYTIAL VIRUS INFECTION

Respiratory Syncytial Virus (RSV) infection is a common respiratory illness that typically spreads during the fall and winter months, and is now on the rise in NYC, across the State and nationally. Many of the protections we put in place during the COVID-19 pandemic helped to prevent many of these seasonal viruses from spreading, but as we relaxed policies, especially the use of masks, we now see an increasing rate of infection.

Anyone can be infected, but RSV can be especially harmful to very young children, older adults, or those born preterm or with underlying lung conditions. Typical symptoms resemble the common cold. However, RSV infection can also result in pneumonia, especially in the very young, the elderly or those with weakened immune systems.

As has been widely reported, RSV is having a significant impact among the young. We are seeing more cases in our pediatric emergency rooms and in the rate of pediatric hospitalizations. It is important that parents with children who have symptoms consistent with RSV, or any respiratory illness, contact a health care provider right away who can help with diagnosis and care. While sick, adults and children should stay home from school or work to prevent spreading the illness.

Unfortunately, there is no vaccine yet to prevent RSV infection, but scientists are working to develop one. The best protection against RSV and all seasonal illness continues to be COVID-19 vaccination for everyone ages six months or older, updated bivalent COVID-19 boosters for people ages five and older, and the annual flu shot for everyone 6 months and older. We continue to encourage New Yorkers to wear a mask in crowded, indoor settings as well.

NYC HEALTH + HOSPITALS ANNOUNCES “HOUSING FOR HEALTH” TO CONNECT PATIENTS EXPERIENCING HOMELESSNESS TO PERMANENT HOUSING

I have always been a believer that stable health requires stable housing. Patients with chronic conditions like diabetes or hypertension cannot manage their condition without a safe and stable place to live. Too often, our patients stay in the hospital for far longer than they should because they have nowhere else to go. That is one reason why NYC Health + Hospitals proudly launched “Housing for Health” – a comprehensive initiative to connect our patients experiencing homelessness with permanent housing. With the support of Mayor Adams and our city partners in government, NYC Health + Hospitals will create an inventory of housing units and services that will help patients experiencing homelessness restore their health and get back on their feet. Housing for Health is our investment in these patients’ health outside of the hospital walls: to a safe, stable place to live so they can focus on their health. Our program has four strategic area of focus:

navigation services to help patients experiencing homelessness through the City’s complex housing landscape.
medical respite beds for medically frail patients
affordable housing on hospital land
social service support for formerly homeless patients in permanent housing

We have already placed more than 1,000 patients in medical respite beds or permanent housing since January 2020 and we will leverage NYC Health + Hospitals land to create nearly 650 new affordable homes in the next 5 years.

NYC HEALTH + HOSPITALS UPGRADES LABS TO PROVIDE FASTER TEST RESULTS,

REDUCE COSTS

NYC Health + Hospitals marked the completion of a major, five-year project to upgrade chemical laboratories across all our 11 public hospitals with new chemical analyzer technology and equipment. With this modern technology, our patients will receive highly reliable test results sooner and we will be able to analyze and test a greater number of specimen types. For example, turnaround time for Basic Metabolic profile test will now take 45 minutes instead of 60 minutes. In addition, by standardizing practices and purchasing equipment for 11 labs, the health system achieved economies of scale that will help reduce its annual chemistry spend from $12 million to $7.7 million – resulting in an annual savings of $4.3 million. The opening of the new state-of-the-art lab at NYC Health + Hospitals/Bellevue marked the final stage of the system wide project. Our labs process more than 4.3 million routine chemistry tests annually for cardiac conditions, diabetes, pregnancy and more.

JOINT COMMISSION, KAISER PERMANENTE RECOGNIZE NYC HEALTH + HOSPITALS’ NYC CARE PROGRAM FOR EXCELLENCE IN THE PERSUIT OF HEALTH CARE EQUITY

The Joint Commission and Kaiser Permanente awarded the 2022 Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity to NYC Health + Hospitals for the NYC Care program, our health care access program for uninsurable New Yorkers, including undocumented individuals, and a first-of-its-kind health care access program because of its comprehensiveness and scale. The award is named for the late Kaiser Permanente Chairman and CEO Bernard J. Tyson, a trailblazer who worked tirelessly to improve health care disparities. It recognizes our work for meaningful, measurable efforts to address inequities based on race, ethnicity, immigration status and other social factors.

We have so far enrolled more than 100,000 members to NYC Care. By February of this year, they had made 264,976 primary care visits and 227,481 specialty visits. After six months of enrollment, 51% of NYC Care members with diabetes had improved hemoglobin A1C, and 68% of members with hypertension had improved blood pressure. I am proud of the entire team at NYC Care as we also honor the late Bernard J. Tyson. His legacy serves as a guide for how we must continue to eliminate barriers to care and champion the health needs of the most vulnerable through both the NYC Care program and the overarching mission of our health system.

NYC HEALTH + HOSPTIALS/SEA VIEW MARKS 50 YEARS AND 5 STARS

NYC Health + Hospitals/Sea View has a lot to celebrate these days. The facility is ranked by Newsweek as one of the best nursing homes in New York State, and has a coveted Five-Star rating from the Centers for Medicaid and Medicare. Just last week the facility celebrated the 50th Anniversary of the main building on the campus, which is named after Dr. Edward Robitzek who was instrumental in developing the drug that eventually cured tuberculosis in the 1950’s. I was pleased to join the staff there earlier this month to celebrate the 50 years of service as a long-term care facility. However, Sea View’s history of service goes further back.

In the early 1900s, Sea View served as a hospital to treat people suffering from the deadliest disease of the era – tuberculosis. The hospital quickly earned a world-famous reputation for treating TB and by 1930, it was successfully treating more than 2,000 TB patients a year, and discharging patients back to their communities who might otherwise not have survived. The work of Dr. Robitzek eventually helped to eliminate the need for a TB hospital, and Sea View Hospital began caring for the elderly in the 1970’s.

Today, Sea View is a 304-bed nursing facility with nearly 500 dedicated and highly trained health care professionals who provide 24- hour medical and nursing care for the elderly and chronically ill who come from all over New York City. The facility also has a world class Traumatic Brain Injury Center and an Alzheimer’s care Unit, well known for its serene and therapeutic setting and dedicated caregivers. Sea View’s architectural and historic significance have earned it a place on the National Register of Historic Places. But it is simply their excellent staff and their care of the elderly that has earned it a place in the hearts of patients, families and the community.

NYC HEALTH + HOSPITALS COMMUNITY MURALS COMMEMORATED IN NEW BOOK

From 2019 to 2021, NYC Health + Hospitals sponsored a burst of mural making: twenty-six new murals developed by artists working with hospital staff and the community, one in each of the system’s hospitals and long-term care facilities, as well as many Gotham Health ambulatory care centers and our headquarters in lower Manhattan. The Community Mural Project was the country’s largest public hospital mural program since the Works Progress Administration (WPA) mural program of the 1930s. This historic project will now be commemorated in a colorful new book published by the Laurie M. Tisch Illumination Fund as a gift to our health care system, in gratitude for the bravery and dedication of our workforce. The Illumination Fund also underwrote the creation of the murals themselves. The book, called “Healing Walls” will be distributed to NYC Health + Hospitals staff and more than 1,500 employees and community members who participated in the project. It will be available for purchase on Amazon later this year, with all proceeds going to the NYC Health + Hospitals Arts in Medicine program.

EXTERNAL AFFAIRS UPDATE

Federal -Democrats secured their hold on control of the Senate after the midterm elections last week, and a runoff election in Georgia on December 6 will decide if they have 50 or 51 seats. Republicans won back control of the House and secured the 218th seat needed to flip the House from Democratic control. The majority of the NYC Congressional delegation remains the same, with a few notable changes.

Newly elected Member of Congress Dan Goldman will now represent NYC Health + Hospitals/Gouverneur and Gotham Health Judson in redrawn NY-10. Long-time Member of Congress Rep. Jerry Nadler will now serve in a redrawn NY-12, representing NYC Health + Hospitals/Bellevue, Coler, and Gotham Health Roberto Clemente. Rep. Nadler defeated Rep. Carolyn Maloney in the Democratic primary earlier this year, and her tenure in Congress will end at the end of this year. We have begun engagement with Reps. Goldman and Nadler.

Congress extended federal government funding through December 16. Before then, Congress will have to agree on a long-term FY23 spending plan before then, or pass another continuing resolution continuing existing funding levels until they can hammer out an agreement. It is likely there will be a large omnibus spending bill before the end of the year. No decisions on earmark funding applications will be made until Congress agrees on a FY23 spending plan. HHS will extend the COVID-19 Public Health Emergency beyond January 2023.

State- Incumbent Democrat Kathy Hochul defeated her GOP opponent, Lee Zeldin, in the governor’s race. Democrats maintained their supermajority in the State Assembly and secured a strong majority in the State Senate, but the GOP did pick up seats in both houses. Due to redistricting and some unexpected election results, 14 of our facilities will have changed State Assembly Members or Senators representing them directly or in their catchment areas. This includes some of our current representing shifting. We have begun outreach to those new State elected officials. We have begun our advocacy on State budget priorities; this work will continue over the next several months.

City- There will be a City Council Hospital Committee Oversight Hearing on November 30 regarding “State of Nursing in NYC – Staffing and Retention”.

CONTRACTS

There is an unprecedented wave of asylum seekers coming to our city, which necessitated Mayor Adams to issue an Emergency Executive Order on October 7, 2022, allowing the City to expedite its procurement processes to timely meet the needs of the asylum seekers. Our system has been an integral part of the City’s response in providing support for the arriving immigrants, and I have similarly authorized limited emergency contracting to support such efforts. Funding for these contracts is being provided by the City under a memorandum of understanding between NYC Health + Hospitals and the Mayor’s Office. I have authorized the following contracts with:

Rapid Reliable Testing, LLC – for medical triage, urgent medical care, intake and registration, distribution of personal hygiene items and food; not to exceed $11,400,000 for a period of 5 months (October 26, 2022 through March 25, 2023) and can be terminated without cause on 30 days’ notice.
Huron Consulting Services, LLC – for project management services, which includes overseeing the opening and daily operation of the sites, management of third-party vendors, reporting of project activities, and escalation of operational issues; not to exceed $18,500,000 for a period of 6 months (September 30, 2022 through March 29, 2023) and can be terminated without cause on 30 days’ notice.
The Wolcott, The Watson and Row NYC hotels, for the following periods and not to exceed amounts:
- The Wolcott – November 4, 2022 through April 30, 2023; not to exceed $5,827,500; can be terminated without cause on 30 days’ notice
- Row NYC – November 12, 2022 through April 11, 2023; not to exceed $40,000,000; can be terminated without cause on 60 days’ notice
- The Watson – November 14, 2022 through May 13, 2023; not to exceed $19,980,000; can be terminated without cause on 30 days’ notice

We anticipate there will be further contracting needs and I will continue to update the Board on the status of these contracts.

IN MEMORIUM: JOSEPH MASCI, MD

The NYC Health + Hospitals family is deeply saddened by the passing of one of our own this week – Dr. Joseph Masci. Known to most of us simply as “Joe”, Dr. Masci was an internationally recognized infectious disease and environmental medicine expert, a physician, a teacher, an author and a beloved leader in our health system. Joe was deeply committed to our patients, to our mission and helped our City respond to many major health crises. He served NYC Health + Hospitals for 40 years until his passing and he will be profoundly missed.

Dr. Joe Masci began his career with us as an attending physician. He went on to serve as the Director of Medicine at NYC Health + Hospitals/Elmhurst for 15 years before taking on the role as Chairman of the hospital’s Global Health Institute in 2017. Over the years, he was a continuous source of support to our health system as we faced emerging pathogens. His early work and research focused on AIDS. He was a major contributor to the development of therapeutics that suppressed HIV and was invited to consult with the Vatican in Rome to help shape their response to HIV/AIDS. After 9/11, his work focused on Emergency Preparedness, Bioterrorism, TB and Ebola. Most recently, Dr. Masci played a vital role in our response to the COVID-19 pandemic.

Dr. Masci graduated from the NYU School of Medicine, completed a Medicine internship and residency at the Boston City Hospital and a fellowship in Infectious Diseases at Mount Sinai Medical Center. He was a long-time faculty member at the Icahn School of Medicine at Mount Sinai where he was Professor of Medicine, Infectious Diseases, Public Health and Global Health.

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