REPORT TO THE BOARD OF DIRECTORS – April 2019

On April 10, Dr. Machelle Allen, Senior Vice President and Chief Medical Officer joined David Hansell, Commissioner of the New York City Administration for Children’s Services at a City Council hearing on the impact of marijuana policies on child welfare. Dr. Allen shared with the Council that Health + Hospitals’ goal is to always protect the mother and infant, and provide appropriate substance abuse treatment and support.

New York State is facing one of the most severe measles outbreaks in years. And as of earlier this week, there were 329 cases in New York City, including 25 hospitalizations and 6 ICU admissions to date. The City declared a public health emergency in select zip codes in Williamsburg, and is requiring unvaccinated individuals living in those ZIP codes who may have been exposed to measles to receive the measles-mumps-rubella (MMR) vaccine in order to protect others in the community and help curtail the ongoing outbreak. While Health + Hospitals has not seen increases in volume of cases – in fact, we’ve only had one confirmed case this year — we are taking every precaution to ensure our hospitals and community based clinics are on extra alert to quickly identify, isolate and treat anyone who needs our care. We have an agreement with the FDNY and they will give us early notification if they are transporting anyone suspected of having the measles to any of our hospitals, so we can move them straight to isolation. And we are preparing additional education materials to increase awareness among patients and staff.

Another serious public health risk is challenging healthcare professionals across the country. A fungal and often drug-resistant infection, Candida Auris – which affects individuals with weakened immune systems and frail elderly in nursing homes and hospital settings – is also on the rise. We’ve been aware, alert and monitoring this particular infection since the CDC issued a notification back in 2016. Since then, we’ve shared guidance to our clinicians and conducted staff training to ensure our readiness to respond, identify and treat patients quickly and effectively, and to prevent the spread with proper hygiene and cleaning. We follow state protocols for reporting. And most importantly, we have adopted a number of system wide policies and best practices to address overuse of antibiotics – one of the main reasons for the growing number of germs that have evolved defenses against common medicines. Our expert Infection Control teams, Clinical Service lines leaders and Office of Quality and Risk have collaborated to implement antibiotic stewardship strategies and the “Choosing Wisely” quality improvement process to insure appropriate medication utilization. The good news is that the risk of C. auris is very low for healthy people going about their lives. Nevertheless, we will remain vigilant.

I’m pleased to report that we have successfully reached beyond the half-way point in what’s considered one of the largest electronic medical records (EMR) implementation projects in the country. This month, 19 NYC Health + Hospitals patient care locations successfully went live with the new EMR, which we named H2O (Health + Hospitals Online), bringing the total number of public hospitals and health centers using this advanced technology to 50 patient care locations with more than 19,000 users system-wide. We went live at NYC Health + Hospitals/Harlem, NYC Health + Hospitals/Bellevue and 17 Gotham Health ambulatory care sites.

H2O is the technology foundation that supports our key transformation initiatives to advance quality of care, provide a better patient experience, and achieve financial health for our essential system. By 2020, we will have more than 45,000 users unified under a single, shared platform to make it easier for our clinicians to deliver great care and support the city’s commitment to guarantee health coverage to all New Yorkers. This is a significant milestone in this massive enterprise-wide project and a tremendous testament to the dedicated clinical teams and IT professionals who have worked together seamlessly to support their shared vision for excellent patient care for the more than one million New Yorkers who rely on our services every year.

This week, New York City celebrates Immigrant Heritage Week to build cross-cultural understanding and reaffirm our City’s commitment to equity and social justice. At NYC Health + Hospitals, this week is an opportunity to showcase our diversity and remind New Yorkers of our commitment to serve all regardless of immigration status. To mark this annual recognition, we launched an awareness campaign to promote patient rights to language services and help eliminate barriers to care, improve patient safety and increase patient satisfaction. The “I Speak” campaign features education materials in many languages to promote the services we have available in 200 languages, palm cards to help patients request an interpreter and communicate in their preferred language, a special video of our staff delivering a welcoming message in different languages, and buttons for staff to showcase our language diversity. You have sample materials in your package.

Language access services help close racial disparities and communication barriers that can lead to fewer doctor visits, avoidance of preventive health services, misdiagnoses and poor patient satisfaction. As a primary care doctor, I know well how important it is to understand and be understood by my patients. I speak Spanish and use it all the time with my patients at Gouverneur. It makes a huge difference. And I am grateful to have access to the amazing interpretation services we have available to help the many other limited English speakers I care for.

And in what has become tradition to recognize Immigrant Heritage Week, NYC Health + Hospitals and the Mayor’s Office of Immigrant Affairs are also re-issuing our open letter to immigrant New Yorkers in 14 languages to reaffirm our commitment to be a safe space where anyone can receive exceptional care and no one inquires about immigration status. While we highlight these efforts this week, ours is a year-round commitment to offer a safe and welcoming environment so that everyone can seek care without fear and live their healthiest life.

MetroPlus Health announced partnerships with the NYC Department of Probation and the NYC Department of Small Business Services (SBS) to provide New Yorkers who interact with the two agencies information about its affordable health insurance plan and encourage them to enroll. MetroPlus will conduct on-site outreach, education and enrollment at six Probation offices and 18 new SBS Workforce 1 and Business Solution Career Centers. These government agency offices serve nearly 55,000 New Yorkers every year. This new collaboration supports the Executive Order signed by Mayor Bill de Blasio in January requiring city agencies to enroll people in insurance anywhere New Yorkers are directly served. The new strategic partnerships with city agencies is one more way in which MetroPlus is redeploying resources to support New York City’s commitment to guarantee health care to all New Yorkers.

I was pleased to join our staff from NYC Health + Hospitals/Woodhull and MetroPlus, and our partners from Comunilife to mark the opening of a wonderful new 89-unit supportive and affordable housing residence for New Yorkers with special needs – many of them our patients and members of our health plan. The new studio apartments have been built in what used to be the hospital’s parking lot and will be home to formerly homeless adults living with special needs and low-income community residents. This is a very special collaboration in our efforts to do more to address social determinants of health. And we are committed to doing more. As I’ve said at various forums: we have a cure for homelessness, it’s called a home. It’s 100 percent effective and has no side effects.

I’m very pleased to report that thanks to the help of OneCity Health, our health system was able to secure more than $2 million in special loan forgiveness grants for physicians in exchange for their commitment to continue serving needy New Yorkers in the Health + Hospitals system. OneCity Health supported the application process as part of the goals of the State’s Delivery System Reform Incentive Payment (DSRIP) Program to increase access to care. The 17 physicians – with specialties ranging from psychiatry, pediatrics and emergency medicine – currently practice in our hospitals and community based health centers. They will receive $40,000 per year for up to three years to pay down their medical school debt. The grants were provided by the State’s Doctors Across New York Physician Loan Repayment program and will result in more than 50 years of combined service to our health system. I had the opportunity to meet with many of the grant winners earlier this month. They are an impressive and diverse group of doctors. With this added incentive and financial relief, they can continue giving back to communities that desperately need their expertise and dedication.

NYC Health + Hospitals/Elmhurst earned the prestigious “Baby-Friendly” designation for promoting the highest level of care for infants through breast-feeding and promoting bonding between mother and baby. The recognition is awarded to hospitals all over the world by Baby-Friendly USA, an initiative of the World Health Organization and the United Nations Children’s Fund (UNICEF). NYC Health + Hospitals/Elmhurst joins nine hospitals in the public health system that have achieved Baby-Friendly designation. Improving maternal health has been a central focus of the de Blasio administration, and this effort builds on the efforts undertaken by NYC Health + Hospitals to ensure safe maternity care at all our hospitals.

In recognition of National Youth HIV/AIDS Awareness Day, NYC Health + Hospitals/Gotham Health center in East New York received a grant from the New York City Department of Health and Mental Hygiene to provide young people ages 13 to 24 years HIV prevention services, including pre-exposure prophylaxis (PrEP). To more effectively serve this population, the clinic offers co-located services, flexible appointment scheduling and extended walk-in capacity, and personalized communication, including by text message. We are pleased to be able to empower young people of East New York, particularly adolescents who identify as LGBTQ, thanks to the new grant that will help us expand access to HIV screening, treatment, prevention, and care coordination through the support of a dedicated social worker and other expert staff who understand the special needs of adolescents. The grant is part of Mayor Bill de Blasio’s Ending the Epidemic plan, which aims to end the HIV epidemic in New York City by 2020, and First Lady Chirlane McCray’s NYC Unity Project, the first-ever citywide commitment to supporting and empowering LGBTQ young people.

In collaboration with NYC Health + Hospitals, OneCity Health helped the system secure $72M in funding as part of the New York State Care Restructuring Enhancement Pilot. The pilot aims to train our workforce to better serve the needs of our populations with managed long-term care or significant behavioral health needs in home-and community-based settings. To date, 275 staff in post-acute care facilities have been trained on a curriculum that aims to improve the ability of the workforce to meet the needs of the managed long-term care population both inside and outside of the hospital setting, as well as during the transition from the hospital to either the home, community or other care settings. These efforts have been accomplished in collaboration with CUNY and the Montefiore Care Management Organization.