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New York City Council Hearing Oversight: Access to Primary Care via New York City Health + Hospitals

Andrew Wallach, M.D., Ambulatory Care Chief Medical Officer
NYC HEALTH + HOSPITALS
Friday, February 25, 2022

Good afternoon Chairwoman Narcisse, and members of the Hospitals Committee. I am Dr. Andrew Wallach, the Ambulatory Care Chief Medical Officer at New York City Health + Hospitals (“Health + Hospitals”). I am joined today by my colleagues, Dr. Justin List, Assistant Vice President of Ambulatory Care at Health + Hospitals, and Dr. Jonathan Jimenez, Interim Executive Director of NYC Care. Thank you for the opportunity to testify before you regarding the most essential part of health care – access to primary care.

Primary care is the first point of contact for all health care needs. Having a primary care doctor is the key to a person’s overall sense of health. Regular visits help people get to know their doctor; making them more comfortable in talking about their health concerns as well as making it easier to recognize any changes in their body in a timelier manner. Likewise, their doctor also gets to know them well and is able to ask the right questions and catch issues before they become more serious. With regular primary care, people do not have to rely on the emergency room for routine health care services.

Health + Hospitals offers high quality and affordable primary care services at all 11 acute care sites by way of its hospital-based primary care practices, and through our Federally Qualified Health Center (FQHC) known as Gotham Health. NYC Health + Hospitals/Gotham Health was formed in 2015 to address the primary care needs of families and individuals in their own neighborhoods. It has 50 Community Health Centers in all five boroughs.

At both our hospital-based primary care practices and Gotham Health centers, we provide:

  • Routine check-ups, preventive health screenings and immunizations for children and adults
  • Chronic disease management, including for asthma, heart care and diabetes
  • Adolescent health services
  • Behavioral health services
  • Diagnostic imaging services
  • Women’s health and maternity care services
  • Well baby care and pediatric services
  • Senior care and geriatric specialties
  • Help with implementing lifestyle changes including stopping smoking, losing weight and any other wellness goals

To become a patient at Health + Hospitals, New Yorkers can call us at our Centralized Contact Center at 1-844-NYC-4NYC (1-844-692-4692) to schedule an appointment. Our contact center agents can access interpreters in 200+ languages and dialects, as needed, and many of them are multilingual themselves. Patients can typically be seen by a primary care provider in our system within one to two weeks of their request.

In 2019, Health + Hospitals teamed with New York City to set forth an ambitious plan to create a unique program that would guarantee primary care for New Yorkers without insurance – NYC Care. NYC Care was established to ensure that the 400,000 New Yorkers without insurance, including those not eligible for insurance as they are undocumented, have direct access to Health + Hospitals’ physicians, pharmacies and mental health and substance abuse services. NYC Care is now the biggest and most comprehensive health coverage program in the country with over 100,000 active members enrolled.

Unfortunately, during the surge of COVID-19 in the Spring of 2020, we clearly saw the negative effects that the pandemic had on the most vulnerable communities of this City, especially when it came to primary care. In particular, patients were fearful of seeking care at medical facilities over concerns of contracting the virus. In addition, many of our staff- clerks, nurses, advanced practice providers and doctor were reassigned to care for patients with COVID-19 due to staffing shortages in the Acute facilities. Together, this was a perfect storm which negatively impacted preventive care such as cancer screenings and immunizations as well as chronic disease care. And, indeed, we saw decreases in each of these metrics. The silver lining, of course, was that our strong ties to the communities that we serve helped to quickly restore that trust and allay fears and, ultimately, allowed our patients to start to return to their medical homes for care and, then, for COVID-19 vaccines and outpatient treatments such as monoclonal antibodies and oral anti-viral medications, such as Paxlovid. And, as our patients returned, we saw a sharp improvement in our quality care metrics.

Lastly, in direct response to the changing landscape of the COVID-19 pandemic, Health + Hospitals opened three new outpatient primary care Gotham sites. These sites are called the COVID-19 Centers of Excellence (COE). The COEs provide comprehensive short- and long-term care to support patients recovering from COVID-19. The centers have been opened in communities of color that have been hardest-hit by the COVID-19 pandemic – Bushwick, Brooklyn; Jackson Heights, Queens; and Tremont, Bronx.

It is the mission of Health + Hospitals to deliver high quality health services with compassion, dignity, and respect to all, regardless of income, gender identity, or immigration status. Every day, we work towards that mission and strive to continuously improve our services and access to primary care. Thank you again for the opportunity to testify before you. I look forward to your questions.