Monthly Report July 2013

In an announcement earlier this week at Lincoln Medical Center, Deputy Mayor Linda I. Gibbs, Health Commissioner Dr. Thomas A. Farley and HHC Chief Medical Officer Dr. Ross Wilson launched a new initiative to give New Yorkers greater access to farmers markets’ produce and increase healthy eating. The Fruit and Vegetable Prescription Program (FVRx) is being piloted at Lincoln and at Harlem Hospital Center. Under the program, a doctor and nutritionist assess the health and nutritional habits of patients and families at risk for obesity and provide “prescriptions” to consume more fruits and vegetables. FVRx patients at the two hospitals will then receive Health Bucks, which are coupons from the Human Resources Administration and the Health Department that can be redeemed for fruit and vegetables at all New York City farmers markets.

The announcement came as HHC welcomed back farmers markets at eight hospital campuses this summer, making fresh fruits and vegetables available and promoting healthy foods for all New Yorkers. Farmers markets are open now through November, with one market, at Queens Hospital Center open year-round. A variety of regionally-grown vegetables, fruits and fresh juices will be offered on a weekly basis in communities where residents don’t always have access to fresh fruits and vegetables at reasonable prices.

At HHC we promote healthy eating, along with regular checkups and exercise, to help people stay physically fit and to control the chronic conditions that affect many of our patients, such as obesity, high blood pressure and diabetes. Farmers markets support HHC’s efforts to keep communities healthy by providing healthy and affordable dietary options for patients, employees and the local community.

The farmers markets are hosted in partnership with Harvest Home and Greenmarket. Shoppers can pay for their fresh fruits and leafy greens using EBT cards (food stamps), Health Bucks, Green Checks, Senior Farmers Market Nutrition Program (FMNP) coupons and Women, Infants and Children (WIC) coupons.

On August 21, HHC will hold a ribbon-cutting ceremony for the Henry J. Carter Specialty Hospital and Nursing Facility, an important new healthcare facility on Park Avenue at 122nd Street in Harlem. HHC leaders, elected officials, residents, staff, and community members will mark the completion of the 365-bed skilled nursing facility and long-term care hospital named after HHC’s most generous benefactor, Henry J. Carter.

Through his organization Wheelchair Charities, Inc., Hank Carter has donated more than $25 million to HHC for a variety of equipment and programs for residents of Coler-Goldwater Specialty Hospital and Nursing Facility. Because Hank has been such an extraordinary and loyal friend to HHC and to those we serve, we have, for the first time, named a public healthcare facility for a living individual. It is a richly deserved honor.

As the Board knows, the move to the new 400,000 square-foot Carter facility will also enable HHC to return the Goldwater site to the city, and to offer state-of-the-art, technologically advanced acute care and skilled nursing services to current Goldwater residents and to the community of Harlem. Residents will move into the new hospital in October.

As part of HHC’s continuing cost containment and restructuring plan, most HHC contracting and procurement functions will be integrated into a single central office location beginning mid-August. This will permit HHC to better leverage its size and volume to negotiate corporate-wide contracts that lower our cost and achieve significant savings through increasing standardization. As we centralize this important function, we also will establish clinical advisory workgroups and value analysis committees that will assist and better inform the Supply Chain Council’s efforts to achieve greater standardization, operational efficiency and financial improvement in procurement.

The new system will require a shift in the skill set needed by our contracting and procurement staff, and some positions will require new minimum entry competencies. Continuous staff education and training will be provided. While not all of the current employees working on contracting and procurement functions will be needed in the new model, there will be no layoffs. Staff who are not moved into the centralized office will be re-deployed to fill other organizational vacancies.

HHC’s Operating Procedure 100-5 — our rules that define all procurement procedures — must be revised before these changes can take place and that revision will be completed imminently. As part of implementation, we are also developing a communication strategy to inform staff within our facilities about these new protocols. The new procedures and the transition plan for the new centralized procurement unit have been reviewed and approved by the Network Senior Vice Presidents, Human Resources and the Office of Labor Relations.

The rates that our MetroPlus Health Plan submitted as part of its application to become a Qualified Health Plan for the New York State Benefit Exchange have been approved by the State. The announcement was made by Governor Cuomo earlier this week, making MetroPlus Health Plan one of the seventeen plans statewide that have completed another step in the process of becoming certified to participate in the NYS Benefit Exchange beginning October 1st.

MetroPlus is also one of eight plans on the rate approval list that will be offering commercial health insurance for the first time. The exchange will give consumers and businesses the opportunity to choose among affordable, high quality health insurance options. Full certification for Qualified Health Plans is expected to be received by the end of July. MetroPlus’ application includes 32 different plans with a variety of benefits and cost-sharing options in all tiers.

On June 24, 2013, the Corporate Office of Patient Safety convened an Employee Safety Forum at Harlem Hospital on Workplace Violence Prevention. This forum was designed to support HHC’s strategic priority to assure a safe environment for our employees. The keynote presentation, “When Push Comes to Shove: Workplace Violence Prevention in the Healthcare Setting” was provided by Zachary Goldfarb, President of Incident Management Solutions, Inc. The forum objectives were to help our employees better understand the prevalence of workplace violence in healthcare, describe prevention and control measures, discuss the special considerations in healthcare settings, and identify specific ways employees can assist with their own safety.

In addition to the keynote speaker, the program included interactive case scenarios and “actors” from Coney Island Hospital to demonstrate de-escalating the potential for workplace violence. Following the case scenarios, Anthony S. Notaroberta, Senior Associate Director of Hospital Police at Metropolitan Hospital, delivered a talk on “Workplace Violence Prevention Utilizing TeamSTEPPS.” Donna Leno-Gordon, RN, Director of Behavioral Health at Coney Island Hospital also spoke on “Calming Agitated Patients: Verbal and Physical De-Escalation” and Katie Walker, RN, Director of HHC’s Institute for Medical Simulation and Advanced Learning gave a talk on “Using Simulation to Learn Debriefing Skills.”

Approximately 170 HHC clinical and non-clinical staff participated in the Forum.

As part of our focus on improving communication with our workforce, the homepage of HHC’s corporate intranet will get a new look and name later this month. Now called the HHC Insider, the revamped homepage will be the first step in a series of intranet improvements that will take place during the coming months. The homepage will offer regularly updated news and announcements about HHC and our staff and other new features, such as the HHC Photo of the Day.

A project team comprising staff from Information Technology (IT), the Office of Special Projects (OSP), and the Internal Communications Group (ICG) reviewed the existing content and created a new visual design for the homepage.

In addition to a cleaner design, the new homepage will be easier to navigate. Links to other pages will be in alphabetical order and organized into categories for information, functional applications, and external resources. Later this year, IT will migrate the homepage to SharePoint, a platform that will become the standard intranet tool for all of HHC.

I encourage you to visit the new homepage at http://intranet.nychhc.org in the coming weeks.

On Wednesday, July 17th, the 9th Annual Marjorie Matthews Community Advocate Recognition Award Ceremony was held at the Susan Smith McKinney Nursing and Rehabilitation Center’s beautiful gardens.

Thirty-five individuals from our facilities’ Community Advisory Boards and Auxiliaries were recognized for their exemplary leadership, community advocacy and the support provided to their respective HHC facility and its patients. In addition, the Jacobi Auxiliary nominated its honorary member, Elvis, a comfort dog, to be recognized for his volunteerism and the joy he brings to many Jacobi and North Central Bronx patients. Despite the record-breaking hot weather, more than two hundred people attended the awards ceremony and barbecue — including honorees’ family members and friends, HHC facility leadership and Central Office staff and Brooklyn City Council Member Matthieu Eugene.

As you know, we engage in an approach for setting, cascading and managing HHC’s multi-year strategic goals called hoshin kanri — a strategic planning process which is linked to our Breakthrough work. By focusing each year on a few very high priority initiatives that are key building blocks toward our longer-term vision, we better align resources throughout the organization to ensure achievement of related targets.

Our goals for Fiscal Year 2014 have been set and we will measure progress against a balanced scorecard that includes the dimensions of Quality and Safety, Human Development, Finance, Throughput, and Capacity. We will continue to improve the quality of our care and the safety of our patients by continuing to reduce the incidence of targeted hospital-acquired infections and by continuing to improve the health status of our patients with hypertension. We have ambitious goals around the further reduction of costs and the enhancement of revenue to address our projected budget gaps. Our operational improvement work on increasing access, especially to primary care services, and on care coordination also constitute critical strategic goals for this fiscal year. We also will carry forward from last year our continued investment in the development of current and future leaders as well as the further engagement and training of our workforce in Breakthrough process improvement activities.

On May 13th, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule to implement the Medicaid Disproportionate Share (DSH) cuts mandated by the Accountable Care Act (ACA). The formula in the proposed rule is designed to incentivize states to target DSH payments to those hospitals serving the most low-income patients. This proposed rule would be effective for the first two years of Medicaid DSH reductions, for federal fiscal year 2014 ($500 million nationwide) and for federal fiscal year 2015 ($600 million nationwide). A new rule will be issued after two years of ACA implementation data becomes available. It should be noted that CMS has not yet determined how to factor in states’ decisions not to expand their Medicaid programs to include individuals and families with incomes up to 133% of the federal poverty level. In our July 12th comment letter to CMS, we advocated that states that do not expand their Medicaid programs should not be rewarded with a lesser reduction to their Medicaid DSH allocations. HHC’s Financial Plan projects a $56 million reduction in DSH funding in our fiscal year 2014.

On June 27th, the Senate passed an immigration reform bill, The Border Security, Economic Opportunity and Immigration Modernization Act. This legislation would allow undocumented immigrants who are currently in the United States to enter a path to citizenship. On this path, however, immigrants would be required to wait a total of 15 years for public benefit eligibility including Medicaid and Medicare. Notably, the bill does not change the current eligibility criteria for Emergency Medicaid.

The bill also raises the cap on temporary H1B visas from 65,000 to 110,000, which can increase to 180,000 under certain conditions. HHC, like many large healthcare systems, has employees who are in the country on H1 visas, many of whom are doctors. The Senate’s immigration bill would also create a merit-based program to award visas for legal permanent resident status based on a point system.

No comprehensive immigration bill has been passed by the House and it is unclear how passage will be attained. Speaker Boehner so far has taken the position that he will only allow floor consideration of immigration legislation if it is supported by the majority of the Republican members. The House Judiciary Committee has reported several immigration bills on various topics; none include a path to citizenship. One of them provides for a visa system similar to the H1 visa provisions contained in the Senate-passed bill.

As we prepare our system for the fast-changing healthcare reform environment, one of our most experienced and accomplished network senior vice presidents, Lynda Curtis, will be allocating more of her time to leading some of our corporate-wide operational restructuring. Ms. Curtis will be retaining her role as the Senior Vice President of our vast South Manhattan Healthcare Network (SMHN), but will step out of her role as Executive Director of Bellevue to enable her to take on her new responsibilities.

As many of you know, Lynda is a veteran leader with the skills and insight that come from nearly four decades of service to HHC. She has led the SMHN, which includes Bellevue, Metropolitan, Coler-Goldwater and Gouverneur, since 2005, and has excelled in a variety of leadership positions at several of our facilities over the course of her long HHC career. By devoting more of her time to some of our most important strategic initiatives, Lynda will help ensure that the operational perspective of our network and facility leaders more fully informs our strategic agenda and work.

Lynda will be assuming her expanded duties on September 1st, and I am pleased to announce that the role of Executive Director at Bellevue will be filled by Steven Alexander. Steve, who started at HHC as a Pharmacist, has demonstrated his ability in numerous roles of progressively expanding responsibility in clinical and operational administration at both Elmhurst and Bellevue. Steve has 27 years of proven leadership with HHC, and has served as Bellevue’s Deputy Executive Director since 2005. As Deputy Executive Director, he has proven his leadership skill in motivating staff at all levels and in aligning hospital operations with the strategic values and goals that are central to our mission. I am confident that Steve will continue Bellevue’s tradition of excellent performance.

Please join me in wishing Lynda and Steve our best wishes and support as they assume their new responsibilities.

At Gouverneur Health, Executive Director Mendel Hagler has resigned, effective September 15th. We will begin actively recruiting to fill his position and will shortly convene a search committee to assist us in this process, including participation by the Gouverneur Community Advisory Board. Mr. Hagler has been a member of the HHC staff since 1983. Please join me in thanking him for his many years of service and in wishing him well in his future endeavors.

Last week Governor Cuomo appointed Dr. Ann Sullivan as Acting Commissioner of the state Office of Mental Health, effective November. Governor Cuomo intends to nominate her to serve as Commissioner of OMH during the next legislative session, when her nomination will be subject to Senate confirmation.

Dr. Sullivan has been an outstanding Senior Vice President of the Queens Health Network, the home of Elmhurst and Queens Hospital Centers, two public hospitals which serve a community of over 2 million New York City residents. In addition, Dr. Sullivan is a Clinical Professor of Psychiatry at the Icahn School of Medicine at Mt. Sinai.

Dr. Sullivan has been an appointee in several important public health advisory positions, including the New York State Public Health and Health Planning Council and its Mental Health Services Committee, the New York State Medicaid Redesign Team and the National Quality Forum Hospital Measures Group. She is also on the Board of Directors of the New York City Mental Health Association.

Dr. Sullivan has been an active advocate for her patients and her profession and will be sorely missed. I know the board joins me in wishing her the very best as she assumes a new and critical public sector role.

Broadcast

Disaster Planning: Preparing for the Unexpected, President Alan Aviles, HHC, Hospitals & Health Networks, 07/19/13

New Hospital Program “Prescribes” Fresh Produce For Bronx Families, Dr. Ross Wilson, HHC, Dr. Katherine Szema, Lincoln Medical Center, Lincoln Medical Center and Harlem Hospital Center, NY1, 07/23/13 (Covered in numerous other media outlets)

From Britain to the Bronx: Labor pains at Lincoln Hospital, Dr. Khaldun Ferreira, Chief Resident of Obstetrics and Gynecology, Lincoln, WPIX 11, 07/22/13

Effects of a Summer Heat Wave on Your Health, Dr. Fernando Jara, Lincoln, Dr. Susi Vassallo, Bellevue, WPIX, 07/19/13

US News & World Report List of Best Hospitals, Jacobi Hospital, News 12 Bronx, 07/17/13

Grow NYC farmers market on East 149th St. offers fresh local produce outside Lincoln Hospital, Lincoln Hospital, News 12 Bronx, 07/05/13

Hospital Food Begins To Resemble What The Doctor Ordered, Queens Hospital, NY1, 07/16/13

Disaster Preparedness Exercise, Dr. Bonnie Arquilla, SUNY Downstate/Kings County, News 12 Brooklyn, 07/10/13

National HIV Testing Day, NYC public hospitals, News 12 Bronx, 06/27/13

Missing Man Reunion, Coney Island Hospital, News 12 Brooklyn/YouTube, 06/22/13

Print

‘Prescription’ for fruits, vegetables city’s next remedy in battle against obesity, Dr. Ross Wilson, HHC, Dr. Katherine Szema, Lincoln Medical Center, Lincoln Medical Center and Harlem Hospital Center New York Daily News, 07/23/13

‘SHARE’ brings breast cancer support groups to Jacobi Medical Center, Jacobi Hospital, New York Daily News, 07/17/13

Staten Island’s Sea View Hospital receives highest state ranking, Sea View Hospital, HHC, Staten Island Advance, 07/01/13

MLB, Mets donate mobile fun system to hospital, Coney Island Hospital, MLB.com, 07/11/13 (Also covered in Sheepsheadbites.com)

Elmhurst Hospital Center Hosts First Annual Pediatric Health And Safety Fair, Queens Gazette, 07/10/13

Nelson Allocates Nearly $2 Million To Coney Island Hospital, Sheepsheadbites.com, 07/01/13

Homicide ‘directly affecting’ racial gap in U.S. life expectancy, study shows, Dr. Robert Gore, Kings County Hospital, NBCNews.com, 07/18/13

Cuomo shuffles top staff for health issues, Dr. Ann Sullivan, HHC, The Wall Street Journal, 07/22/13 (Also covered in Crain’s Health Pulse and Albany Times Union)

Nearly Killed at 15 by a Bullet That Tore Through Her Brain, Lincoln Hospital, Vada Turns Experience Into Art, CUNY Newswire, July 2013

Fear of humiliation leads to mistakes, doctor says, Dr. Danielle Ofri, Bellevue Hospital, MPRnews, 07/09/13 (Also covered in UPI.com)

Best Hospitals 2013-14: Overview and Honor Roll, Jacobi, Harlem, U.S News & World Report, 07/16/13
(Also covered in NY Daily News)

Your local health agenda, Tu agenda local de salud, HHC Farmers Markets, El Diario, 07/15/13

Cancer patients tell their stories in theater play, Pacientes de cáncer retratan historia en teatro, Lincoln Hospital, AP, 07/09/13

HHC Contracts, Crain’s Health Pulse, 07/17/13

Fitch affirms New York City’s AA-minus appropriation debt, HHC, Reuters, 07/09/13