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  • REPORT TO THE BOARD OF DIRECTORS – September 2023

REPORT TO THE BOARD OF DIRECTORS – September 2023

Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS
PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
September 28, 2023

RESPONDING TO THE HUMANITARIAN CRISIS – SERVICES FOR ASYLUM SEEKERS

NYC Health + Hospitals continues to offer life-changing assistance to asylum seekers pursuing a better life. Our Humanitarian Emergency Response and Relief Centers (HERRCs) and Arrival Center are the backbone of the city’s response to this unprecedented crisis, which has seen 118,000 people arrive here last spring. In August, to meet the demands of housing the burgeoning asylum seeker population, the public health system opened a humanitarian center on Randall’s Island, a tent facility providing housing for 3,000 adults. 

Our 15 humanitarian centers provide humane, dignified care for over 20,000 asylum seekers, nearly one third of the 61,000 people currently in the city’s care across its network of 210 shelters and respite sites. The facilities ensure asylum seekers and their children have on-site access to comprehensive services, including medical care, nutrition, language access, mental health support, school enrollment, social programs, technology, and reunification resources. Together, our staff at the humanitarian centers and Arrival Center have helped register over 50,000 asylum seekers, administered nearly 40,000 vaccinations and enrolled over 14,000 people in health insurance.

In early September, NYC Health + Hospitals helped launch a citywide assessment of adult asylum seekers to determine their needs and how best to support them with case management to help achieve their goals. The intensified case management services we are offering on-site at our humanitarian centers will help each asylum seeker develop a plan for these next steps. Whether completing asylum or work authorization applications, enrolling in educational or job training services, or connecting with family and friends to find a place to resettle, case management will help asylum seekers get the specific help and services they need to move forward with their journeys as quickly as possible. 

BEST HOSPITALS, BEST NURSING HOMES, BEST DOCTORS, RECOGNITIONS & AWARDS

U.S. News and World Report’s annual “Best Hospitals” list recognizes 10 NYC Health + Hospitals acute care facilities for quality care –  For the first time, NYC Health + Hospitals/Elmhurstwas ranked as one of the best hospitals in New York: 26th in the New York Metro Area and 28th in New York State. Our hospitals received high marks in heart failure, diabetes, kidney failure, chronic obstructive pulmonary disease (COPD), stroke, hip fracture and pneumonia. This is an amazing achievement and reflection of the hard work and focus on providing high quality, accessible and compassionate care for all New Yorkers. Here’s the list:

  • NYC Health + Hospitals/Jacobi, High Performing in Heart Failure and Diabetes
  • NYC Health + Hospitals/Lincoln, High Performing in Heart Failure, Diabetes, Kidney Failure, and Chronic Obstructive Pulmonary Disease (COPD)
  • NYC Health + Hospitals/Kings County, High Performing in Heart Failure, Diabetes, Stroke, and Chronic Obstructive Pulmonary Disease (COPD)
  • NYC Health + Hospitals/South Brooklyn Health, High Performing in Heart Failure, Diabetes, Stroke, and Hip Fracture
  • NYC Health + Hospitals/Woodhull, High Performing in Diabetes, Chronic Obstructive Pulmonary Disease (COPD), and Pneumonia
  • NYC Health + Hospitals/Bellevue, High Performing in Neurology & Neurosurgery, Heart Attack, Heart Failure, Stroke, and Pneumonia
  • NYC Health + Hospitals/Harlem, High Performing in Heart Failure and Diabetes
  • NYC Health + Hospitals/Metropolitan, High Performing in Heart Failure and Chronic Obstructive Pulmonary Disease (COPD)
  • NYC Health + Hospitals/Elmhurst, Ranked as #26 in the New York Metro Area and #28 in New York State. High Performing in Orthopedics, Heart Attack, Heart Failure, Diabetes, Kidney Failure, Stroke, Hip Fracture, Chronic Obstructive Pulmonary Disease (COPD), and Pneumonia
  • NYC Health + Hospitals/Queens, High Performing in Heart Failure and Diabetes

All NYC Health + Hospitals long term care facilities ranked “Best Nursing Homes of 2023” – Newsweek’s fourth annual “Best Nursing Homes 2023” rankings recognized the health care system’s skilled nursing facility NYC Health + Hospitals/Sea View as the number one nursing home in the State. Three of our post-acute care sites – Carter, Coler and Gouverneur — ranked in the top ten; and McKinney ranked among the top 40. The rankings are based on four criteria including a performance data score, a reputation score, and a COVID-19 score. The rankings are designed to assist patients and their families in making informed decisions about where to receive their long-term and post-acute care. For the rankings, Newsweek identified 475 top facilities across 25 states, with 42 in New York State. Being once again recognized by Newsweek as having some of the best post-acute and long-term care facilities in the State is an incredible honor. We are extremely proud of our dedicated staff who work so hard every day to provide our patients with the quality of life they deserve.

Six NYC Health + Hospitals facilities certified by Planetree International for excellence in person-centered care. The organization recognized NYC Health + Hospitals/Bellevue, Elmhurst, Jacobi, Kings County hospitals, and our Gotham Health centers in East New York and Morrisania. Planetree International works with organizations across the globe to enhance the staff, patient and family experience in health care settings. Over three years, these six sites met several criteria to provide high-quality care, improve clinical outcomes, enhance patient experience, and develop workforce recruitment and retention. Planetree’s model of patient, family, staff, and community engagement has shown to improve patient outcomes, lower rates of staff burnout, and lower costs. At NYC Health + Hospitals we pride ourselves on our high quality care and empathy, and this certification recognizes the hard work our staff do every day to ensure our patients and their families receive the best care. We are committed to providing a kinder care experience where patients and their families feel valued and included in healthcare decision-making, and we are proud to do this work as the largest municipal health care system in the nation. Additionally, our System now has 24 employees that passed examination and are carrying the Fellow of Person-Centered Care credential. We have four more facilities now completing their three-day onsite audits and we should soon learn of their certification status.

Gold+ for helping New Yorkers reduce risk of heart attack and stroke – The American Heart Association and the American Medical Association gave NYC Health + Hospitals acute-care and Gotham Health facilities a Gold+ rating for our work in managing hypertension, or high blood pressure, a leading cause of heart attack and stroke. Our health System is one of two in New York State to achieve this highest ranking for blood pressure control.

NYC Health + Hospitals/Elmhurst earns gold standard certification for Health Equity through The Joint Commission. This is a remarkable milestone as NYC Health + Hospitals/Elmhurst is the first hospital in New York State to achieve this certification. This certification signifies that our Elmhurst Hospital team has met rigorous standards set by The Joint Commission demonstrating their dedication to reducing disparities in health care access, outcomes, and experiences. The Joint Commission highlighted the hospital’s diverse staff and its language access program, which offers services in over 125 languages. The Joint Commission also recognized the application of an equity lens in the hospital’s Quality Improvement and RCAs. Through quality improvement efforts stratified by race and ethnicity, our team at Elmhurst Hospital demonstrated improvement in diabetes and hypertension management, admission/readmission rates, and access to Doula services. By obtaining this certification, NYC Health + Hospitals/Elmhurst has proven its commitment to addressing health disparities and making healthcare equity a strategic priority.

Promoting Safe Sleep Practices for Newborns – Four of our hospitals were recognized for educating parents and caregivers about safe sleep practices for newborns, which helps reduce the chance of Sudden Infant Death Syndrome. Cribs for Kids, a national organization dedicated to promoting safe sleep education, awarded NYC Health + Hospitals/Metropolitan, North Central Bronx, South Brooklyn Health and Bellevue hospitals with the special recognition for their excellence and commitment to infant safety.

Top Latino Doctors – Ten NYC Health + Hospitals physicians were among a distinguished list of doctors across 32 States and 60 specialties named to Castle Connolly’s inaugural list of ‘Top Hispanic & Latino Doctors’ for their outstanding expertise, patient care, and contributions to the field of health care. Presented as a part of National Latino Physician’s Day, all to doctors who made the list were nominated by their peers, and evaluated by a research team. Castle Connolly is a health care directory that helps patients find providers. The ten honorees from NYC Health + Hospitals are:

MITIGATING THE BLACK MATERNAL HEALTH CRISIS

NYC Health + Hospital’s Maternal Home and our health System’s Chief Women’s Health Officer Dr. Wendy Wilcox are featured in the article “Mitigating the Black Maternal Health Crisis through a Five-Step Framework “ published by America’s Essential Hospitals (AEH). The blog is intended as a guide to demonstrate how essential hospitals can build strong social support programs to help improve Black obstetric outcomes. While there are many strategic frameworks to address social integration of care, this particular blog highlights examples hospitals can use to achieve significant changes. In the article, Dr. Wilcox explains how the Maternal Home is just one of many ways NYC Health + Hospitals provides integrated care to patients and their families. Providers identify patient needs with screenings for social health, behavioral health, and complex clinical needs. The program links patients with a multitude of community resources, including doula support and home visits for newborns. Since 2019, the program has had more than 5,000 unique patients and more than 14,000 referrals.

PEER ACADEMY EXPANDS BEHAVIORAL HEALTH WORKFORCE

NYC Health + Hospitals graduated over 50 people with lived experience with mental health or substance use conditions to become peer counselors. Twenty-five of the 38 graduates in the first two classes have been hired as peer counselors, and 17 of them work within our health System. Peer counselors are able to connect with traditionally hard-to-reach patients by sharing their lived experience. Peers are living proof that recovery is possible, and they are highly adept at inspiring hope for those that they serve. We have 86 peers on staff across the System, the largest hospital-based peer workforce in the City. The program includes six weeks of classroom training and a six-week, full-time, hospital-based internship with rotations in the inpatient mental health unit, emergency department, and mobile crisis teams. Peer Academy staff work with the students to help them find and maintain employment for up to six months after graduation. Peer counselors are an important and growing occupation in the behavioral health field, but the jobs are hard to fill. An increasing number of the students are former NYC Heath + Hospitals patients who were referred by clinicians throughout the System, and are in recovery yet have very limited work histories. There is huge interest in participating in the program, as it is a job that provides meaning and purpose. The work is also attractive because it is a unionized, City job, with built-in career ladders and ample opportunity to grow at a large organization.

 NYC HEALTH + HOSPITALS ACO ACHIVES MEDICARE SHARED SAVINGS FOR TENTH YEAR IN A ROW

NYC Health + Hospitals’ Medicare Shared Savings Program Accountable Care Organization (ACO) earned $8M from the Federal government for reducing avoidable costs and meeting high standards of quality care for patients. This is $4M more than last year’s shared savings. NYC Health + Hospitals is the only health System in New York State to achieve savings for ten years in a row. Our ACO saved Medicare $10.9 million for 2022, all while achieving impressive scores across a number of quality-of-care measures. The program achieves savings by supporting primary care providers and care coordination, which prevents unnecessary emergency department visits, avoidable hospitalizations, and other high-cost care for the more than 8,000 Medicare fee-for-service patients who are served through the program. Since our health System ACO’s inception in 2013, it has saved Medicare over $83.6M, resulting in earned shared savings and subsequent investment of approximately $47.1M for NYC Health + Hospitals and our community partners.

EXPANDING, ENHANCING SERVICES THANKS TO SUPPORT FROM GOVERNOR, CITY COUNCIL

During the past two months we announced a number of service expansions thanks to the support of our elected representatives at the local and state level.

  • NYC Health + Hospitals/South Brooklyn Health received $6 million in FY-24 capital funding from NYC Council Speaker Adrienne Adams, Chair of the Committee on Hospitals Mercedes Narcisse, Council Members Inna Vernikov and Ari Kagan, and members of the Brooklyn Delegation to create a Collaborative Learning Center for the Practice of Medicine. This funding will help us develop a comprehensive, interdisciplinary learning center in the Health & Wellness Institute, to provide an enhanced learning experience for our medical staff, nursing, and ancillary health care staff. 
  • Patients at NYC Health + Hospitals/Metropolitan will soon benefit from access to a state-of-the-art suite for minimally invasive interventional radiology procedures, made possible through a $4M award in Fiscal Year 2024 capital funding from New York City Council Deputy Speaker Diana Ayala.
  • NYC Health + Hospitals/Jacobi’s Comprehensive Addiction Treatment Center (CATC) was awarded $660,000 by Governor Kathy Hochul, the Office of Addiction Services and Supports (OASAS), and the New York State’s Opioid Settlement Fund to enhance CATC services which includes the Intensive Outpatient Treatment Program, Ancillary Withdrawal Service, and will now integrate an Opioid Treatment Program.

NEW BUPRENORPHINE TREATMENT SERVICES TO ADDRESS OPIOID ADDITION IN STATEN ISLAND

NYC Health + Hospitals/Gotham Health, Vanderbilt opened a Buprenorphine Clinic to provide comprehensive treatment for individuals with addiction to opioids, which includes substances such as heroin, fentanyl and oxycodone. Buprenorphine is incredibly safe and highly effective medication that can reduce the cravings and withdrawal symptoms of opioids as well as substantially reduce the risk of an opioid overdose and death. The Buprenorphine Clinic will prescribe buprenorphine as part of a holistic approach to healing and long-term recovery. The evidence-based program is designed to address the underlying causes of addiction and help patients recover, and it is available to all qualified New Yorkers regardless of ability to pay or immigration status. Currently, Staten Island has the 2nd highest rate of overdoses in the five boroughs. The Buprenorphine Clinic is funded by the NYC Health Department.

NYC HEALTH + HOSPITALS REGIONAL PERINATAL CENTER HOSTS CONFERENCE TO ADD ADDRESS MATERNAL/CHILD HEALTH

The Regional Perinatal Center for NYC Health + Hospitals, located at NYC Health + Hospitals/Bellevue sponsored a conference on September 14th  featuring a full spectrum of topics including a discussion about the challenges the recent abortion restrictions are placing on health care providers. Dr. Michael Meguerdichian, NYC Health + Hospitals Senior Assistant Vice President of the Simulation Center and Emergency Medicine Physician, spoke about our health Systems’ innovative teaching and clinical simulation technology for maternal child health simulation trainings. Other speakers included Dr. Frank Chervenak, internationally renowned for his expertise in obstetrics and gynecology, who discussed these reproductive health dilemmas;  Dr. Garfield Clunie, Immediate Past National President of the National Medical Association, who made the case to increase diversity of clinicians at the decision-making table; and Dr. Matthew Lin, a specialist in Neonatal Medicine and Palliative Care at NYU, who gave a compelling talk about expanding the spectrum of palliative care, especially for premature neonates, to keep families at the center of the care. 

STAFF WELLNESS UPDATE

Helping Healers Heal – Our award winning workforce wellness program has spread internationally. The HERO-NY training that was based on our System’s approach to psychological and emotional support during the height of COVID-19, and our internal model has now reached 100,296 healthcare workers across 43 different countries.  During the last Quarter of 2023, our Helping Healers Heal program activity included 1,804 Debriefs and Wellness Events, and 1,442 Wellness Rounds.

National Physician Suicide Awareness Day – More than 500 participants joined a number of events we hosted to recognize this day and increase awareness about the many wellness programs we offer to make time for open, honest dialogue about physician mental health. Being a physician is hard. Physicians have one of the highest suicide rates of any profession. The responsibility to make the right diagnosis and offer the right treatment can feel overwhelming. And it takes a toll. I am so proud of the work NYC Health + Hospitals is doing to foster a culture of well-being and psychological safety that breaks down the walls of silence surrounding physician mental health and suicide. We prioritize wellness for all our health care professionals and help address the stigma that often surrounds mental health by fostering open dialogue about secondary victimization, anxiety, feelings of sadness and depression, compassion fatigue, and burnout. As doctors, the more we normalize our human experiences, the better able we are to prioritize mental health and freely seek wellness resources that enable us to care for our patients. We can all help prevent physician suicide. When we take better care of ourselves, we can continue to take care of others.

QUALITY UPDATE

Visit from SingHealth – NYC Health + Hospitals hosted and facilitated the “International Care Experience Summit” bringing together internal subject matter experts to share lessons learned surrounding patient experience and employee engagement with nine delegates from SingHealth, the largest public health system in Singapore with acute general hospitals, national specialist centers, community and primary care medical practices.  

Quality Academy Cohort 3 Launched – NYC Health + Hospitals launched the start of Class 3 for the Quality Academy program, a capacity building program to build the next generation of improvement leaders throughout the System, with the application deadline at the beginning of September. This third cohort represents an expansion from previous classes, with almost 300 participants anticipated to start the 6-month program on October 12. There were 254 participants in the first two classes of Quality Academy, undertaking 179 performance improvement projects, of which 123 (69%) projects reviewed data with a health equity lens, focused on reducing disparities across the System.

Healthcare Administration Scholars – Six health care sites have begun their new classes for Healthcare Administration Scholars Program (HASP), a quality and leadership program for PGY2 residents and above. Classes have been conducted at NYC Health + Hospitals/Elmhurst, Jacobi/NCB, Kings, Metropolitan and Lincoln hospitals. We are excited that more than 40 residents from across these sites are engaging in this 2-year effort. Our goal is to retain this talent once their residencies are completed.

FINANCE UPDATE

On September 9th, NYC Budget Director Jacques Jiha issued a directive requiring all City agencies to reduce City Tax Levy spending by 5 percent in order to address the growing NYC fiscal crisis related to funding the cost associated with providing services and shelter to the growing population of asylum seekers. This reduction plan, referred to as a Program to Eliminate the Gap (PEG), is due by October 6th. The directive also mentions that upwards of $7 billion in unanticipated spending could occur over the next 3 fiscal years and that additional 5 percent PEGs may also be necessary for both the January and April plans. The Finance Committee meeting is on October 16th and we will provide additional updates at that time.

EXTERNAL & COMMUNITY AFFAIRS UPDATE

Federal – Congress is also debating various health-related policies, including delaying the Medicaid DSH cuts slated to go into effect on October 1st, and Site Neutral policies that would reduce payments received for services provided in hospital outpatient departments to the amounts paid for similar procedures in physician offices. Our health System continues to advocate directly to the NYC Congressional Delegation about our priorities, supported by the related work of our association partners.

State – The Governor appointed Blake Washington as the new Director of the NYS Division of Budget. Mr. Washington comes from the NYS Assembly where he was Secretary to Ways and Means Committee for 11 years. As a result of this change, Assembly Speaker Carl Heastie announced Philip Fields as the new head of the Assembly Ways and Means Committee. Our health System has a strong relationship with both individuals and look forward to working with them in their new positions.

A special election was held on September 12th, for Assembly District 27 in Queens to replace Dan Rosenthal who resigned this past summer. Sam Berger won the special election and has been sworn in as the new Assembly member. Although there is not a Health + Hospitals facility in the district, Health + Hospitals does serve some of the Assembly Member’s constituents and look forward to meeting with him. 

City – On September 20th, the City Council committees on Health and Hospitals held an oversight hearing evaluating access to sickle cell care in NYC. A bill was also heard (Int. 978-A), requiring the Department of Health and Mental Hygiene to develop a sickle cell disease professional education program that would be made available to all medical professionals employed in the City at least twice per year. Dr. Kenneth Rivlin, Director of the Division of Pediatric Hematology and Oncology at NYC Health + Hospitals/Jacobi, provided testimony.

CONTRACTS

Since my last update to you regarding our asylum seeker contracting response, we have had the following additional contract actions:

To house the families of migrant asylum seekers the rental of a hotel at 29 Ryerson Street, Brooklyn, NY from Sela Ryerson, LLC, for 24 months from September 15, 2023 through September 16, 2026 for an amount not to exceed $65,514,18, with a 21-month minimum term.

To provide security services at the HERRC sites we have contracted with a security services provider, Mulligan Security, LLC for a period of 5 months in an amount not to exceed $23,000,000.  An RFP for HERRC security services was issued and we expect to request approval of award from the Board for such contracts in October. Such contracts will replace this emergency contract.

NEWS AROUND THE HEALTH SYSTEM

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