REPORT TO THE BOARD OF DIRECTORS – February 2022

Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
February 24, 2022

CORONAVIRUS UPDATE

We are finally seeing a significant decline in COVID-19 cases and hospitalizations after the Omicron variant that hit us so hard in the last few months – and I’m beginning to have hope that the end of the pandemic may be near. COVID-19 is not going away, but I am cautiously optimistic that we will not have another overwhelming flood of hospitalized patients. In the meantime, we continue to push vaccination and testing to keep NYC safe. Here are some recent highlights:

Thanks to our NYC Health + Hospitals and Test & Trace teams, we have administered more than 10.5 million tests
We continued focused on arming New Yorkers with home tests, distributing hundreds of thousands at libraries and cultural institutions
This month, we released a tool to help those exposed to COVID-19 know exactly what to do, based on their vaccination status. Going to be building further tools to help New Yorkers get tailored guidance for what to do if they have a positive test or have an exposure
We continue to support New Yorkers, and have delivered more than 2 million meals to help people isolate/quarantine

New COVID-19 Center of Excellence Opens in Brooklyn – I was pleased to be joined by Mayor Adams and NYC Health + Hospitals/Gotham Health staff to announce the opening of our third COVID-19 Centers of Excellence in a community that has suffered so much during this pandemic. The new community health center is in Bushwick, Brooklyn and will support recovering COVID-19 patients and provide comprehensive ambulatory services to the community. As we continue to learn more about the long-lasting health impacts of this pandemic, we’re being proactive to create medical homes for New Yorkers. This site will not only provide critical health support to those still recovering from COVID-19, but will also provide new opportunities for this community to access high-quality, ongoing primary care.

Support from U.S. Department of Defense (DoD) Medical Teams – The DoD teams have been providing much welcome support to the front-line providers at both NYC Health + Hospitals/Coney Island and North Central Bronx Hospitals. The team of DoD physicians, RNs, LPNs, Army medics, and respiratory technicians have been working side-by-side in our EDs, ICUs, and the medical-surgery units. They will continue to support our hospital teams for another week and we are tremendously grateful to them, Governor Hochul and the Biden Administration for their support.

New Wellness Rooms for Health Care Heroes – Thanks to an anonymous $100,000 donation, we will fund new wellness spaces at NYC Health + Hospitals/Gotham Health Belvis and Cumberland to provide respite and support for health care workers who have served in some of the hardest-hit neighborhoods of New York City during the COVID-19 pandemic. The new rooms, expected to open later this year, will provide a quiet place for frontline workers to recharge, de-stress, heal, and emphasize the importance of taking a break and taking care of themselves during the workday. Wellness rooms are an essential part of our Helping Healers Heal program, and as we enter the third year of the pandemic, these rooms have become ever more important to the health and well-being of health care heroes.

NYC State Suspends Booster Mandate for Health Care Workers – The New York State Department of Health (NYSDOH) last week announced that it will not enforce the COVID-19 booster mandate for health care personnel that was set to go into effect on Monday, February 21. The State intends to reassess its position on the booster shots at some point in the future. NYSDOH is taking this action to avoid potential staffing issues and give healthcare workers more time to get boosted. However, we continue to encourage everyone to get a booster vaccine as the best protection against the COVID-19 virus.

NYC HEALTH + HOSPTIALS EXPANDS ACCESS TO LIFESTYLE MEDICINE PROGRAM

I joined Mayor Adams and Dr. Machelle McMacken, our health system’s new Executive Director of Nutrition and Lifestyle Medicine, at NYC Health + Hospitals/Kings County Hospital earlier this month to announce the expansion of our groundbreaking lifestyle medicine services at six public health care sites across NYC— the most comprehensive expansion of lifestyle medicine programming in the U.S. Modeled off the popular and successful Plant-Based Lifestyle Medicine Program run by Dr. McMacken at NYC Health + Hospitals/Bellevue, the new expansion will provide patients living with chronic disease the tools to make healthy lifestyle changes, included providing them access to plant-based diet resources. The program will expand to serve qualifying NYC Health + Hospitals adult patients at Jacobi, Lincoln, Woodhull, Kings County, and Elmhurst hospitals, as well as Gotham Health, Vanderbilt. The program expansion will be implemented over the coming year. As a physician, I know that medicine doesn’t always come in the form of a pill. Eating a diet of fruits and vegetables can help prevent and treat chronic illnesses like heart disease – the leading cause of death among New Yorkers – cancer, and type 2 diabetes. Low-income New Yorkers are much more vulnerable to these diseases and we want to continue offering them an alternative way of eating that works on a limited budget and is accompanied by a network of medical and nutritional professionals. We are grateful to Mayor Adams for his continued support and innovation as we tackle the problem of chronic illnesses.

NYC CARE REACHES MILESTONE OF 100K MEMBERS

This month we celebrated an important milestone to mark the success of NYC Care, our health system’s health care access program that guarantees free and low-cost services to New Yorkers who do not qualify for or cannot afford health insurance: Fifty-four-year-old Jorge Lara became our 100,000th NYC Care member. Lara had developed severe arthritis after settling in New York City from his native Ecuador and was forced to quit his job and depended on others for help when his arthritis became debilitating. He was not eligible for health insurance and with no income, could not afford to pay for medical costs out of pocket. He learned about our NYC Care from a friend and now receives primary and specialty care, which he credits with a dramatic improvement in his day-to-day life. This milestone represents 100,000 people who got connected to primary, preventive and specialty care who may never have found their way to good health. This program has become a national model and I am so proud of everyone who helped make this program a success.

IN RECOGNITION OF BLACK HISTORY MONTH

This Black History Month we honor those courageous pioneers who fought against discrimination and sacrificed their lives for racial justice. As we reflect back, we must also acknowledge those who live and work among us today, supporting our commitment to address the health inequities that remain in the Black community and our work to eliminate health disparities and strengthen access to care. All of us at NYC Health + Hospitals are contributing to that legacy by providing more equitable health care to Black New Yorkers, and shining a light on Black excellence as represented by our health system leaders, physicians, nurses and frontline health care workers. A special congratulations to all the NYC Health + Hospitals and MetroPlus staff who were included in Crain’s New York’s notable Black leaders list. Together, we are making a real difference in advancing Black Health and Wellness by delivering on our commitments to:

reduce maternal mortality rates among Black mothers and improve patient safety during labor and delivery
eliminate medical racism and practices based on biased assumptions that negatively impact quality of care for patients of color
ensure broad access to COVID-19 testing, vaccination and treatment to communities hit hardest by the pandemic
build a diversified workforce reflective of our patient population.

LEADERSHIP APPOINTMENTS

Dr. Khoi Luong appointed NYC Health + Hospitals Senior Vice President of Post-Acute Care — Dr. Luong has been serving in an interim capacity in this role since October, and now will permanently lead all aspects of operations and patient care provided in our top-ranked skilled nursing facilities, Long-Term Acute Care Hospital (LTACH), short-term rehabilitation, and adult day health care programs. Dr. Luong has dedicated much of his career to making a meaningful difference in the lives of geriatric patients and those who require long-term care. He has served our health system in various leadership roles since 2016, most recently as Chief Medical Officer (CMO) of our post-acute service line where he helped our facilities achieve top national rankings by the Centers for Medicaid and Medicare, Newsweek, and U.S. News & World Report. Dr. Luong’s significant experience in post-acute care and deep commitment to quality long-term care services for all New Yorkers will be incredibly valuable to our patients and community. I am delighted to see him officially step into this new role.

Linda Dehart appointed NYC Health + Hospitals Vice President, Finance – Ms. Dehart is an experienced finance professional with a nearly twenty-five-year track record in government and health care organizations, including sixteen years with NYC Health + Hospitals. She has particular expertise in funding for safety net health care systems. As Senior Assistant Vice President-Finance she currently manages intergovernmental funding, reimbursement services, capital budget, debt finance, and cash planning for the System. Prior to joining the Central Office Finance team, she was Associate Executive Director for Finance at Kings County Hospital and Assistant Director for Health in the NYC Mayor’s Office of Management & Budget. Ms. DeHart is a graduate of Wesleyan University and the Robert F. Wagner Graduate School of Public Service at New York University.

TWO NYC HEALTH + HOSPITALS EMPLOYEES RECEIVE PRESTIGIOUS SLOAN PUBLIC SERVICE AWARD, THE ‘NOBEL’ OF CIVIL SERVICE

I am so proud to announce that Director of Utilization/Care Management at NYC Health + Hospitals/Metropolitan Paula Evans, BSN, RN and Chief Operating Officer at NYC Health + Hospitals/Elmhurst David Guzman, MPA, FAB were selected as two of this year’s six recipients for the Sloan Public Service Award. Evans is recognized for her contributions for nearly 30 years of service at the hospital, where she has dedicated her career to providing compassion and care to New Yorkers. Guzman is being honored for his work increasing efficiency and revenue for one of the city’s busiest hospitals to allow its patients to receive high-quality, comprehensive health care. This award is regarded as the Nobel Prize of city government and presented annually by the Fund for the City of New York to civil servants from all levels and ranks of city government. The winners were nominated by their colleagues, peers, and friends and selected from more than 250,000 eligible City workers. Each will receive $10,000. On behalf of NYC Health + Hospitals, I congratulate Paula and David on their achievement and share our deep gratitude for their extraordinary work and commitment to the public and our patients.

EXTERNAL AND COMMUNITY AFFAIRS UPDATE

City – I want to thank Mayor Adams for making an important investment in the health of NYC mothers and young families. He added $3 million to the fiscal 2023 budget for obstetrics simulation training through the NYC Health + Hospitals Simulation Center as part of the City’s Maternal Medical Home program to provide care coordination to high-risk prenatal patients and ensure new moms get a healthy start. Our Simulation Training program embeds specialized training mannequins and simulation mini-labs in our hospitals to help our clinical teams master skills and prepare for obstetric emergencies and improve outcomes.

I joined Mayor Adams to announce his Subway Safety Plan, which lays out how his administration will begin addressing public safety concerns and supporting people experiencing homelessness and serious mental illness on New York City’s subways. The plan includes comprehensive investments in short- and medium-term solutions, including expanded outreach teams with NYPD officers and clinicians, additional housing and mental health resources, and outlines long-term systems improvements through changes to state and federal laws to connect more New Yorkers to the care they need. At every public hospital system where I’ve worked — in San Francisco, Los Angeles, and now New York City — a priority of mine has been a focus on the homeless population. Mayor Adams’ plan outlines clear steps to address homelessness on the subway, and it offers an array of services to those in need, including supportive housing. At our hospitals, providers, nurses, and peer counselors work closely together to ensure that our patients who experience housing instability receive the care they deserve.

We are pleased to get to know our new City Council Chairs and members. In particular, we appreciate Hospital Chair Mercedes Narcisse recently spending time with our team to familiarize herself with our work and priorities. City Council Hospitals Committee is holding a hearing on Friday, February 25th regarding access to primary care. Dr. Andrew Wallach, the Chief Medical Officer for Ambulatory Care, will testify on behalf of our health system. City Council preliminary budget hearings are being scheduled for March, and our hearing will be on March 21 at 10am. We look forward to that process. Capital Funding Requests for FY23 are due to the Borough Presidents and City Council this week. Our facilities have been working with our team in Central Office to prepare their proposals and submit requests for funding. We are grateful to our local elected officials for their ongoing support of our facilities and system as we try to address ongoing needs.

State – Last month, Governor Hochul proposed a $216.3 billion all funds budget for State Fiscal Year (SFY) 2023, which begins on April 1, 2022. The proposed budget is balanced through SFY 2027, and allows for investments in health care based in part of increased tax receipts and increased federal funding. We are thankful that the Governor has prioritized investments in health such as restoring a 1.5% Medicaid reimbursement cut, increasing Medicaid rates by 1%, and making investments in the workforce and investments to help improve mental health care access, we are still seeking additional support. In particular, we are advocating for equitable access to the distressed hospital funding pool, reinstatement of prior capital cuts, and parity in telehealth reimbursement. we are joined in this work by our Community Advisory Boards, our partners in advocacy and labor, and so many of our legislative champions in Albany.

We also note that the Governor’s budget includes an important proposal for procurement of managed care plans to participate in the Medicaid program. We appreciate the Governor’s acknowledgment of health plans like MetroPlus that are committed to serving our patients and community. We appreciate the opportunity to work with the State to continue improving how managed care works for all New Yorkers. Throughout the budget season, we will continue to meet with our elected officials and the State. We appreciate their time and concern for our system and our patients.

Federal – A Continuing Resolution extending federal government funding through March 11 was passed by Congress and signed into law on February 18. Unfortunately, the Build Back Better Act has stalled in the Senate, and progress looks unlikely in the near term. Nonetheless, NYC Health + Hospitals continues to communicate with our Congressional representatives on our priorities. In particular, we continue to seek funding for health care infrastructure and staving off of harmful cuts. The Biden Administration has extended the COVID-19 Public Health Emergency (PHE) beyond March 1. There is not an identified ending date, but they have previously committed to a 60-day warning on the end of the PHE, so safe to assume the emergency will go through at least April 30.

CONTRACTS

This past December, I declared a procurement emergency in response to the Omicron wave of CoViD-19. This was to allow NYC Health + Hospitals to effectively respond to the City’s needs and help manage the Omicron wave. That emergency declaration was effective through January 31, 2022. While we have several contracts in place to respond to the City’s needs, the scale of the Omicron wave created increased demand for services as well as required additional services to support our response. There were five actions taken that I want to bring to the Board’s attention. Three of them were for supplemental staffing to include nurses, doctors, and support staff for our hospitals, nursing homes, testing centers, and the hotels we manage on behalf of the City. Those agreements were for $90 million dollars, and we expect the expenses to be reimbursed through FEMA and City funds. The other two actions were to support enhanced community testing, and community outreach and education. The additional community testing contract is $11 million dollars and the outreach and education support increase to existing agreements is $6 million dollars. We expect these expenses will also be reimbursed to us through FEMA and our OMB MOU. Below are the vendors and the services we procured.

Vendor	Services	Amount/th>
Comprehensive Health Services, LLC	Emergency Staffing	$15 million
Comprehensive Health Services, LLC	Community testing	$35 million
Krucial Staffing, LLC	Emergency Staffing	$40 million
Doral Medical and Multispecialty Facility LLC	Community testing	$11 million
T2 Canvassing Contracts	Outreach/education	Increase of $6 million

NEWS FROM AROUND THE HEALTH SYSTEM