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REPORT TO THE BOARD OF DIRECTORS – July 2022

Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS
PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
July 28, 2022

CORONAVIRUS UPDATE

NYC Test & Trace Corps – We launched the country’s first-ever mobile-based “Test to Treat” program at a press event with Mayor Adams on June 30. The new mobile testing units managed by our NYC Test & Trace Corps will now include a clinician on their team to provide instant access to prescriptions for no-cost, antiviral medications for eligible New Yorkers who test positive at these sites. The initial Test to Treat units are partnering with local pharmacies to provide immediate distribution of medication from the prescription. We now have 30 units and plan to shift to be able to distribute antiviral medications in the units this summer, ensuring New Yorkers have even more immediate access to life-saving treatments.  We continue our work to make testing available citywide and have 385 testing sites in NYC, that including some PCR test sites, like all our hospitals, some mobile sites that have PCR and rapid tests, and some sites like libraries where you can pick up free home tests. We have distributed more than 37M home tests in NYC, including through more than 930 community based organizations and houses of worship.       

Our Telehealth Expertise Tapped for Statewide Treatment Services – Our innovative telehealth program, Virtual ExpressCare, will be the lifeline behind a new statewide plan to provide COVID-19 treatment across the Empire State. All New Yorkers from Buffalo to Montauk and everywhere in between, can now connect with our expert Virtual ExpressCare team and get immediate access to anti-viral medications if they test positive for COVID-19. Governor Kathy Hochul and the State Department of Health announced a dedicated hotline, 888-TREAT-NY, and online evaluation at the NYS COVID-19 ExpressCare Therapeutics Access website, to connect New Yorkers with NYC Health + Hospitals providers.  The agreement with the State is an expansion of the successful ‘test to treat’ services already provided locally for New York City by our Virtual ExpressCare team through the 212-COVID-19 number. State officials turned directly to us when they needed an innovative way to provide COVID-19 therapeutics to all New Yorkers. That is a true testament to our nimbleness and success in responding to every new stage of this epidemic.

MONKEYPOX UPDATE

MONKEYPOX UPDATE

The World Health Organization declared monkeypox a global health emergency on July 23. The virus now joins the likes of H1N1, Zika, Poliomyelitis and COVID-19 as diseases declared public health emergencies of international concern. As of July 27, NYC reported 1,148 cases.  Thankfully, cases have been generally mild and most people can isolate and recover at home. Monkeypox is caused by the monkeypox virus which is related to smallpox but it is less contagious and causes less severe illness.  It is transmitted through close contact with an infected person or with material contaminated with the virus.  Symptoms include a flu-like illness followed by a characteristic rash and typically last 2-4 weeks.  In the current outbreak, most cases are being spread in social networks of men who have sex with men and/or transgender, gender non-conforming, or gender non-binary who have multiple or anonymous sex partners.  There is an FDA-approved vaccine, JYNNEOS, and an anti-viral agent developed for smallpox, Tecovirimat (TPOXX).

The NYC Health Department has established pre-exposure prophylaxis (PEP++) vaccine clinics to prevent further spread of the outbreak.  NYC Health + Hospitals was asked to support this vaccination effort and we have opened two vaccine clinics at Gotham Health/Vanderbilt in Staten Island, and Lincoln Hospital in the Bronx.  As additional vaccine supply becomes available, NYC Health + Hospitals will continue to expand vaccination to additional sites.  All appointments for the pre-exposure vaccines are through the city’s health department online vaccine scheduler or hotline.

NYC Health + Hospitals is also working with the NYC Health Department to provide post-exposure prophylaxis (PEP) for those individuals who are determined by the health department contact tracing team to have had a high-risk exposure.  We currently offer PEP for monkeypox at NYC Health +Hospitals/Bellevue and Metropolitan Hospitals. NYC Health + Hospitals is also supporting the city’s outbreak effort by providing assessment and testing of suspected monkeypox cases as well as providing treatment with the antiviral agent, Tecovirimat (TPOXX).

US NEWS & WORLD REPORT RANKS NYC’S 11 PUBLIC HOSPITALS AS ‘HIGH PERFORMING’ ACROSS A RANGE OF SPECIALTY SERVICES

The 11 public hospitals in NYC Heath + Hospitals received “high-performing” ranking in at least one category by U.S. News & World Report in their 2022-23 Best Hospitals list. The annual report helps guide patients, in consultation with their doctors, to the right hospital when they need care. U.S. News Best Hospitals ranked hospitals in the U.S. in 15 adult specialties, as well as recognized hospitals by state, metro, and regional areas for their work in 20 more widely performed procedures and conditions. We are honored to be recognized by U.S. News and World Report for our patient-centered care. This would not be possible without the expertise and dedication of our health care workers. Congratulations to our amazing hospital teams and thank you for providing New Yorkers with the highest quality care.

Facilities and their category recognized as high-performing are: 

NEW NYC HEALTH + HOSPITALS LOAN FORGIVENESS PROGRAM FOR BEHAVIORAL HEALTH PROFESSIONALS

Mayor Adams joined us last week at NYC Health + Hospitals/Harlem to announce the launch of a new student loan forgiveness program for behavioral health providers, funded by a $1 million contribution to our health system from an anonymous donor. The new program will help us attract and retain doctors, nurse practitioners, clinical social workers and other clinicians who care for New Yorkers with mental health or substance use disorder as the U.S. faces a national mental health professional shortage. We will be able to offer new and current staff who are eligible between $30,000 and $50,000 of debt relief in exchange for a three-year commitment to serve our health system.

As the mayor noted, too often, these health care workers graduate with crippling debt and have no choice but to work in the private sector to pay off their bills. With less debt to worry about, our mental health teams can focus on doing what they do best: providing high-quality mental health support to New Yorkers. We are tremendously grateful for our donor’s exemplary investment in this work. With this generous contribution, we hope to inspire more philanthropic interest and create a steady pipeline of support for high-achieving behavioral health staff in the years to come.

NYC HEALTH + HOSPITALS RECEIVES $45M FROM BROOKLYN BOROUGH PRESIDENT TO SUPPORT MATERNAL HEALTH SERVICES AT THREE BROOKLYN HOSPITALS

We are very pleased and grateful to Borough President Antonio Reynoso for his vision to make Brooklyn one of the safest places to give birth.  The Borough President is allocating his entire FY23 capital funds – a total of $45M – to our three public hospitals in Brooklyn – Woodhull, Coney Island and Kings County Hospitals — to help improve maternal health care services that will in turn reduce disparities in maternal mortality rates found between Black pregnant people and their white counterparts.

While racial disparities in birth outcomes are evident nationwide, our health care system is committed to reducing and eliminating these inequalities by creating safer birth experiences for New Yorkers. The borough president’s investment in our patients and their families will help us further improve maternal health outcomes. We thank Mr. Reynoso for his tremendous partnership and generosity.

NYC HEALTH + HOSPITALS/METROPOLITAN RECEIVES $4.9M IN FUNDING FROM MANHATTAN COUNCIL MEMBER AND NY CITY COUNCIL SPEAKER

Patients at NYC Health + Hospitals/Metropolitan will soon benefit from access to the latest computed tomography (CT) diagnostic technology, made possible through a $4.9M award in Fiscal Year 2023 capital funding from Council Member Diana Ayala and New York City Council Speaker Adrienne Adams. In addition to the CT Scanner, the funds will also be used to purchase a new portable C-ARM and ultrasound machines. Our patients deserve to walk into our health care facilities and know that their providers are using only the latest, most state-of-the-art medical equipment. The new CT Scanner, C-ARM, and ultrasound machines will improve image quality, ensure faster results, and assist practitioners with devising a course of treatment that gets patients on track for healthier outcomes. We are grateful to Council Member Diana Ayala for her continued support, generosity, and commitment to the East Harlem/El Barrio community.

NYC HEALTH + HOSPITALS/ELMHURST OPENS NEW MOM-BABY SIMULATION CENTER

NYC Health + Hospitals/Elmhurst opened a new Mother-Baby Simulation Center to help reduce maternal deaths and life-threatening conditions in patients during childbirth. Using a specially-designed, high-tech, full-body mannequin of color, along with a mannequin infant, obstetric (OB) physicians, anesthesiologists, nurse practitioners, nurses, midwives, physician assistants, and respiratory therapists will participate in simulations that further help in identifying and treating potentially life-threatening conditions during labor and childbirth. Elmhurst Hospital is one of six hospitals in our health system to be outfitted with its own OB simulation lab to help make trainings more accessible for OB teams, building on the City’s program to reduce maternal deaths and life-threatening complications from childbirth among women of color. Having an on-site OB sim lab where our team can practice and master their skills to handle complex cases will have a direct benefit for our patients, who often come from underserved communities and have high-risk pregnancies.  

WEEK OF ACTION TO PROMOTE NYC CARE ACROSS THE FIVE BOROUGHS

This past Tuesday, NYC Care, in collaboration with the Mayor’s Public Engagement Unit (PEU) and the Mayor’s Office of Immigrant Affairs, launched a “Healthcare Week of Action” to connect New Yorkers to health care and encourage them to make primary care appointments. The Week of Action will include outreach in all five boroughs, capped by a closeout event at NYC Health + Hospitals/Elmhurst offering health care resources, including health screenings and COVID-19 testing. The event will include a speaking program featuring Mayor Eric Adams, PEU Executive Director Adrienne Lever, NYC Care Executive Director Dr. Jonathan Jiménez, a GetCoveredNYC and NYC Care patient, and local elected officials. The Week of Action is supported by more than one hundred PEU Summer Youth Employment Program (SYEP) interns from the City University of New York (CUNY) Career Launch Program, as well as PEU Outreach Specialists and NYC Care community-based organization partners.

SIX HEALTH SYSTEM VOLUNTEERS HONORED AT MARJORIE MATTHEWS EVENT CELEBRATING CAB AND AUXILIARY MEMBERS

Since 2004, NYC Health + Hospitals has hosted the annual Marjorie Matthews Celebration to honor our exceptional volunteers who serve on our Community Advisory Boards (CAB) and Auxiliaries. This year’s special event was held in person again for the first time in 2 years, on July 21, at NYC Health + Hospitals/Kings County. Marjorie Matthews was a towering figure in Brooklyn, known for her dedication to her community and to improving access to excellent health care. She served on the NYC Health + Hospital/Kings County CAB for 20 years, and her service continues to inspire long past her death. As a public health system with deep ties to all of our diverse communities, we rely on our CABs and Auxiliary members and hundreds of other volunteers to help make NYC Health + Hospitals the best health care provider we can be. This year’s Marjorie Matthews honorees are listed below. Congratulations to all. We are so grateful for their service.

  • Warren Berke – NYC Health + Hospitals/Kings County
  • William Hamer – NYC Health + Hospitals/Harlem
  • Esme Sattaur-Low – NYC Health + Hospitals/ North Central Bronx
  • Gail Di Pasquale- NYC Health + Hospitals/Elmhurst
  • Georgia Flowers – NYC Health + Hospitals/Gotham Health, Cumberland
  • Carlos Cortes –  NYC Health + Hospitals/ Elmhurst

NYC HEALTH + HOSPITALS/LINCOLN CELEBRATES FIVE YEARS OF “GUNS DOWN LIFE UP” PROGRAM TO ADDRESS GUN VIOLENCE IN COMMUNITY

On July 22, NYC Health + Hospitals staff, elected officials, community partners and the “Guns Down Life Up” (GDLU) team celebrated the fifth anniversary of the program at NYC Health + Hospitals/Lincoln. The hospital-based program was established in 2017 to offer alternatives and resources to stop violence by tracking gun shots, assaults and stabbing cases that present to the emergency department, and provide alternatives and resources to interrupt the cycle of violence that affect too many of our patients and the communities we serve. GDLU violence interrupters and credible messengers respond immediately and can often be seen at the bedside meeting with victims and their families. Since the program began at Lincoln Hospital, GDLU has intervened with over one thousand patients and their families to eliminate retaliation and emergency room return visits.

EXTERNAL AFFAIRS UPDATE

City – We are pleased to host Council Member Mercedes Narcisse, Chair of the City Council Hospitals Committee and a nurse, as she continues to tour our facilities this summer. Chair Narcisse is a strong supporter of NYC Health + Hospitals and we are grateful to partner with her.

State – Four of our hospitals – Harlem, Jacobi, Kings County and Lincoln – were named as recipients of the first phase of the State’s new abortion provider support funds. Clinicians from these facilities joined Governor Hochul at a small roundtable to discuss the needs and experiences of our system and how New York is confronting challenges and protecting access post-Roe. We are grateful to the Governor and her team for the funding and supporting the needs of our patients and clinicians.

August 23rd will be the primaries for State Senate and Congressional candidates. We will be watching the outcome of these races for potential changes to our facility representation.

Federal – Congress is working on a significantly reduced budget reconciliation package, which could be passed by a simple majority vote of 50 Democratic Senators. Yesterday, a revised expanded package was announced that has the support of Senator Manchin, a key moderate. The reported package includes extending ACA Marketplace subsidies slated to expire at the end of the year and efforts to reduce prescription drug prices.

FINANCE UPDATE

NYC Health + Hospitals closed May with approximately $375 million (16 days cash-on-hand)and we are projecting to close June with approximately $700 million (30 days cash-on-hand). Through April, the health system has achieved a positive Net Budget Variance of $270 million. Direct Patient Care Receipts (Inpatient and Outpatient) were $550 million higher than the same period in FY21due to patient volume, our continued success in maintaining recent revenue initiatives, and UPL conversion funds coming through patient care.

Patient care volume in FY22 is returning to pre-COVID levels, but still 4% below FY20 in discharges.  Revenue base remains strong and resilient primarily driven by returning volume and higher average collectability rate. Overall, our strategic Financial Initiatives remain on track with our post-COVID strategies, generating over $691 million through April of FY22. Areas of strongest net performance as of April include revenue cycle improvement ($339 million), growth & service line improvements ($164 million), and value-based payment/managed care initiatives ($167 million).

NEWS AROUND THE HEALTH SYSTEM