Staten Island Public Meeting

Remarks by Dr. Mitchell Katz
NYC Health + Hospitals President & CEO
Annual Public Meeting – Borough of Staten Island
NYC Health + Hospitals/Sea View
Wednesday, May 2, 2018

Welcome and thank you for coming.

I am Mitch Katz, President and CEO of NYC Health + Hospitals, and I’m delighted to be here at NYC Health + Hospitals/Sea View, one of our top ranked post -acute care facilities in the City. On behalf of myself, our Board of Directors, our executive staff and workforce, thank you for attending this annual public meeting. We are deeply appreciative of the commitment to public health care that you are demonstrating by being here tonight, and we look forward to hearing your comments and concerns about the current and future state of New York City’s essential public health care delivery system.

This is my first annual public hearing in Staten Island and I want to take this opportunity to report on some of the progress made last year, and highlight my vision for the future success that we will achieve together.

I am a Brooklyn boy, a product of the New York City public school system. Growing up my family received their care at Coney Island Hospital and Kings County Hospital, so I know how critical public hospitals are to the well-being of families and their communities.

At heart, I am a primary care doctor. I will begin my New York City medical practice as an outpatient doctor at our community health center on the Lower East Side as soon as the privileging process is complete. I will also work as an inpatient doctor at all our hospitals on a rotating basis, including our two hospitals here in Queens. I love public hospitals and clinics and the people who work in them and the patients who come to them.

Last year a lot of important work was done across NYC Health + Hospitals in order for us to continue delivering on our mission of providing quality, affordable, culturally responsive health care to New Yorkers. As the safety net provider for all New Yorkers, our commitment to the patients and communities we serve has never been stronger. Last year we provided care for more than 1 million New Yorkers, of which more than 400,000 were uninsured. In FY 2017, we provided approximately 5.3 million outpatient visits and 1.2 million emergency room visits. There were more than 19,000 patient discharges, including 17,323 newborn deliveries.

In the first few months I’ve been on the job, I can confidently say that NYC Health + Hospitals is filled with mission driven doctors, nurses, social workers, pharmacist and other professionals. The quality of medical and nursing care provided at NYC Health + Hospitals is excellent, and above the community standard. Every day our hospitals save the lives of critically ill patients in our emergency rooms, intensive care units, and hospital units. However, our system suffers from several serious problems related to access if you are not critically ill. And these access problems compound our financial problems because they discourage paying patients from seeking our care. I was charged by the Mayor to take the work on transformation to another level – to turbocharge it – in order to ensure long term stability and quality. I want to work with all of you here to make the “system” as good as the people working in it.

I see we have many of these good people in the room tonight. Similarly, at our meeting at Bellevue in Manhattan last month and more recently in Queens, many nurses and representatives from NYSNA – the nurse’s union — spoke compellingly about their commitment to their patients and the challenges they are facing. I want to let you know that I hear you, my team hears you and that we are working to address these issues. We have streamlined our hiring process for nurses so that we can identify candidates, hire, and train and have them serving patients as quickly as possible.

To date, NYC Health + Hospitals has been successful in reducing expenses and increasing revenue in order to lessen the risks to meeting our financial targets. For example, through our work to standardize purchases and get the best price we can for products, we have saved more than $106 million over the past two fiscal years. By improving our billing and revenue collection processes, we have garnered more than $107 million in the last fiscal year. Most prominently, we have managed personnel expenses closely over the past three fiscal years for savings estimated at more than $400 million. This is progress but more needs to be done.

Moving forward my three top priorities are: invigorate and expand primary care, improve access to needed specialty care, and bring fiscal solvency to NYC Health + Hospitals. By focusing on all three, we will better address community health needs, improve the patient experience and maximize opportunities for new revenue. I am certain that with the help of our Board, those of you here today, the Mayor, our organized labor partners, and the incredibly dedicated staff of NYC Health + Hospitals, we can achieve these three goals.

While there’s been a lot of focus on improving our fiscal health, the last year has been filled with important achievements that illustrate our continued commitment to quality care and meeting the health needs of the communities we serve. Here’s a few of the highlights:

• NYC Health + Hospitals has emerged as a key partner in the City’s fight against the Opioid epidemic. Seventeen of our patient care sites are now State certified Opioid Overdose Prevention Programs that routinely dispense naloxone based on best practices, including overdose prevention training of patients and community members. With the support of the Mayor and First Lady, our system is expanding peer intervention programs, increasing naloxone distribution and training on how to use this lifesaving drug, and connecting more New Yorkers struggling with substance misuse to treatment.
• Last April, and again last month, 22 of our patient care locations – including our Gotham Health community centers and our long term care facilities — received the national designation of “Leader in LGBTQ Healthcare Equality”. We are proud of this recognition, which underscores our health system’s tradition of pioneering diversity and inclusion in the workplace and developing specialized programs to effectively serve the healthcare needs of our city’s diverse LGBTQ community.
• Our Accountable Care Organization (ACO) achieved shared savings for the fourth consecutive year—the only program in the state to achieve such shared savings success based on outstanding quality performance. The ACO saved the Medicare program $3.59 million for 2016 and returned $1.58 million in shared savings to the public health system. Through enhanced care coordination, the health system was able to prevent unnecessary emergency department visits, avoidable hospitalizations, and other high-cost care for the more than 10,000 Medicare fee-for-service patients who are followed through the program.
• We completed renovations at several community based outpatient care sites over the past year to increase access to primary and specialty care in seven underserved communities. Through the Mayor’s Caring Neighborhoods initiative, we are expanding services at these sites, and now include comprehensive primary care and specialties based on community needs, which include behavioral health, cardiology, endocrinology, and after-hours urgent care. The seven sites will be able to serve 42,000 more patients than before the expansion.
• Seven of our hospitals were recognized as U.S. News & World Report Best Hospital for 2017-18 in Heart Failure. Of those, three hospitals also earned Best Hospital for 2017-18 in Chronic Obstructive Pulmonary Disease (COPD) care.
• Ten of our hospitals received national recognition awards from the American Heart Association and the American Stroke Association for excellence in heart and stroke care.
• With the support of First Lady Chirlane McCray, and under the City’s ThriveNYC program, we expanded maternal depression screenings for pregnant women and new mothers, and are making depression screening a routine part of care at pre-natal clinics.
• We also established the integration of in-clinic technology to provide faster point-of-care hemoglobin A1c testing to patients with diabetes. This enables physicians to assess a patient’s average blood sugar level at the time of their appointment and adjust treatment as needed.
• Thirty-two of our hospital and community-based primary care clinics received Level 3 — highest-level Patient-Centered Medical Home (PCMH) recognition for meeting rigorous national standards and establishing a model to deliver patient-centered, coordinated, and convenient health care services to New Yorkers. Level 3 designation is expected to yield NYC Health + Hospitals approximately $60 million in state reimbursements over fiscal years 2018 and 2019.
• Our Correctional Health Services recently established the 24/7 enhanced pre-arraignment screening unit (EPASU) to better identify and respond to acute medical and mental health issues, expanded Hepatitis C treatment, opened seven satellite clinics to bring our services closer to patients, opened two new specialized housing units for patients with serious mental illness, nearly tripled the number of daily patients on methadone maintenance and buprenorphine, distributed thousands of naloxone kits to members of the public at the Rikers Island visitor’s center, and enhanced mental health services for women in jail.
• Last May, the New York State Department of Health awarded our MetroPlus Health Plan the highest quality measures score among Medicaid managed care plans statewide. The quality scores reflect the investments the plan is making to keep members healthy. MetroPlus scored particularly high in timeliness of prenatal care, administration of flu shots, smoking cessation, asthma medication management, and two key indicators of diabetes management. MetroPlus also received high scores for postpartum care and well child visits.

NYC Health + Hospitals/Sea View, one of five top-ranked post-acute care facilities in our health system, has consistently received high marks for excellence in the provision of short term rehab, skilled nursing and post-acute care. Sea View earned top ratings in the U.S. News & World Report’s “Best Nursing Homes” report for 2016-2017 for their quality of care, safety, staffing, and rehabilitation services. Since 2008 it has maintained the highest five star rating from the US Department of Health and Human Services Center for Medicare and Medicaid Services—a result of favorable scores for onsite inspections, hours of care provided to residents, and quality measures for meeting patients’ physical and clinical needs.

The team here at Sea View recently received two prestigious national awards for its palliative care program. The awards—one from AMDA: The Foundation for Post-Acute and Long Term Care Medicine, the other from Intalere Healthcare—reflect a continuing tradition of excellence at the 304-bed skilled nursing facility. Sea View is the only post-acute facility in the nation to receive the AMDA award, which recognized the Enhanced Interdisciplinary Palliative Care Services program that enables the alignment of palliative care with family and residents’ wishes. They were also the only recipient in our region – and one of three nationwide — to receive the Intalere award for innovation and best practices in palliative care.

Strengthening primary care here on Staten Island, and throughout the city is one of my main priorities and reflects our health system’s focus on building healthier communities. Later this month, we will open the doors of the brand new NYC Health + Hospitals/Gotham Health Center on Staten Island. This $28 million state-of-the-art ambulatory care facility on Vanderbilt Avenue will offer primary, out-patient, and urgent care services, and expanded evening and Saturday hours. We anticipate that this new ambulatory care center will provide as many as 8,000 patient visits annually.

The new health center will supplement our two very active neighborhood based centers – Gotham Health center in Mariner’s Harbor and the Gotham Health center in Stapleton, which provide a full array of primary care, chronic disease management and behavioral health services for both adults and children.

Our health plan, MetroPlus, the plan of choice for more than 500,000 New Yorkers, recently opened its first community location on Staten Island. The new site in Port Richmond serves as resource center for New Yorkers to get answers to health insurance program questions and receive assistance to enroll in plans such as Child Health Plus, Medicaid, Qualified Health Plans and the Essential Plan. We know how important it is to be able to able to talk to a health care representative in your own neighborhood, and we’re pleased to be able to provide this convenient option to the people on Staten Island. MetroPlus is committed to serving more of our members where they live and work and to helping enroll new members into the affordable quality health insurance they deserve.

Thanks for allowing me to share this overview of the challenges and positive developments. Now let’s proceed to the main purpose of tonight’s meeting – to hear from you, members of our community. Your input is so important to the future success of this system. We are ready to listen.