REPORT TO THE BOARD OF DIRECTORS – December 2015

Good afternoon. I will highlight just a few items from the full version of my report to the board. The full version is available to all here and will be posted on our website.

As is customary at every board meeting we feature the work of one or more individuals who demonstrate the true spirit of what the public hospital system means to New York City.

During the month of December we recognize an individual who has championed the things that we in the public hospital system care most about.

Tonight I am delighted to recognize Chirlane McCray, the First Lady of New York City as New York City Health and Hospitals’ Person of the Year.

For so long, issues of mental health have been a source of indifference, or shame, or fear. These issues were not talked about. Instead they were like mere whispers;

Mere whispers suggesting that people were suffering, but leaving them —and their families— to fend for themselves.

All too often this country has postponed addressing mental health issues until social tragedy spurs us to action. But the public consciousness of such tragedies usually fades away, as do the cries for mental health solutions.

For so long, mental health needs have been left to be addressed by the criminal justice system, which has often been unprepared and inadequate to the task.

For so long patients with mental health needs have been left untreated. They’ve aroused misunderstanding and hostility, rather than intelligence and compassion.

Finally however, things are beginning to change in New York City.
Today, there is growing recognition that a community’s well-being is tremendously impacted by how it addresses mental health issues.

This shift is in no small part, due to the First Lady’s tireless efforts to push mental health issues to the forefront. Issues of stigma, of access, and of treatment have become a part of the conversation across the city, and the nation. It’s about time.

This topic couldn’t be more important to us. As the largest provider of mental health services in New York, our commitment to a strengthened mental health infrastructure is strong and longstanding.

When other health systems built profitable service lines, we built socially responsible service lines.

However, we can’t shoulder the burden alone. It is too big… Too complicated for one system to address. We need strong partners to help us constantly develop better, more effective ways of addressing the mental health needs of New Yorkers.

That is why we have such respect for Chirlane McCray’s work as a knowledgeable advocate.

That is why we are so appreciative of her candor in sharing her personal life story.

That is why we are so supportive of her commitment to change the culture when it comes to more openly discussing mental health.

We congratulate the First Lady for spearheading Thrive NYC! It’s a dynamic plan of action…one that issues a clarion call for sorely needed new initiatives. It strengthens existing programs that are designed to promote the mental well-being of New Yorkers.

We applaud the First Lady’s commitment to building a community of solutions, like improving connections between medical and mental health — that will enable us to deliver care in a more integrated, more coordinated, more effective manner.

We are so pleased tonight to have this opportunity to tell Chirlane McCray how greatly we appreciate her leadership on mental health issues. On behalf of the 1.4 million patients we serve annually…on behalf of our 42,000 employees… I am delighted to tell you that you can depend on our partnership. We stand with you in this great effort to guide the city toward a more effective and holistic mental health system. And we offer you our heartfelt congratulations for the brave and necessary work that you are doing.

In keeping with the theme of the First Lady’s phenomenal work, we are highlighting the continuum of mental health services offered by New York City Health and Hospitals, as our Program of the Month. We are truly the backbone of mental health care in New York City. Approximately 40% of all psychiatric, psychological, chemical dependency and substance abuse services delivered in the five boroughs are provided by our expert and compassionate care givers.

This evening, to better appreciate our work in this critical area, I’ve requested that the Office of Medical and Professional Affairs offer the Board an Informational Item on mental health programming, which will be presented by Senior Vice President and Chief Medical Officer, Dr. Ross Wilson.

Returning to the regular agenda order, as customary I will now highlight one item from the full version of my report to the board.

I’d like to take a moment to note the impending retirements of several esteemed leaders of our system: This evening marks the occasion of the final Board meeting at which six longtime, loyal and committed public servants of our health system will be present.

Senior Network Vice Presidents Christopher Constantino, George Proctor, Denise Soares, and Arthur Wagner will be departing at the end of this year, after many years of exemplary service.

Caroline Jacobs, Senior Vice President for Safety and Human Development and LaRay Brown, Senior Vice President for Corporate Planning, Community Health and Intergovernmental Relations will be leaving also, after many years of exemplary service.

Each of these members of our NYC Health + Hospitals family have given decades and decades of their lives to improving the public hospital system, and to safeguarding the health of our patients. They will be missed.

On November 17, 2015 First Lady of NYC Chirlane McCray, Deputy Mayor for Strategic Policy Initiatives Richard Buery and New York City Health + Hospitals President and CEO Dr. Ram Raju announced that New York City is setting a goal to screen and treat all pregnant women and new mothers for maternal depression. As the first step toward this goal, NYC Health + Hospitals and Maimonides Medical Center – who together perform approximately one-quarter of all deliveries in New York City – have committed to achieve universal screening and connection to treatment for maternal depression within two years.

Recognizing that maternal and postpartum depression often go undiagnosed, this initiative emphasizes the importance of being attentive to mental, as well as physical health. And by performing well visits for babies, and for mothers. NYC Health + Hospitals’ practice has long been to screen for depression before and after birth, because depression can affect not just the mother but also how parents care for their children. We are glad to partner with private health systems and the Greater New York Hospital Association to make this practice universal in New York City.

NYC Health + Hospitals|Harlem is the only hospital in New York State to be named by The Leapfrog Group to its list of the nation’s “Top Hospitals” for 2015. Just 62 urban hospitals received the recognition which gauges hospital performance on measures of patient safety and quality, from prevention of medical errors to physician staffing levels to performance on high-risk surgeries and procedures.

The award is based on the results of The Leapfrog Group’s annual hospital survey, which measures hospitals’ performance on patient safety and quality, focusing on three critical areas of hospital care: how patients fare; resource use; and prevention of medical errors. The performance of each eligible hospital care is reviewed by Leapfrog’s Top Hospital Selection Committee to ensure it embodies the highest standards of excellence.

Inclusion on this list validates the idea that public hospitals, with limited resources and complex patient populations, can also perform at the top level nationally. Credit goes to the hospital’s leadership and its culturally diverse workforce. This is an endorsement of their hard work for the Harlem community.

NYC Health and Hospitals has announced the appointment of Plachikkat (P.V.) Anantharam as Chief Financial Officer following his unanimous approval by the Board of Directors on November 17, 2015. Prior to coming to NYC Health + Hospitals, Mr. Anantharam served as Deputy Director for Health and Social Services at the New York City Office of Management and Budget (OMB) since 1998. Mr. Anantharam replaces former Chief Financial Officer Marlene Zurack, who retired after 15 years of service at NYC Health + Hospitals.

On December 7, 2015 NYC Health + Hospitals President and CEO Dr. Ram Raju and Mark G. Peters, Commissioner of the New York City Department of Investigation (“DOI”), jointly announced the signing of a Memorandum of Understanding (“MOU”) giving DOI control over a new Office of the Inspector General for NYC Health + Hospitals (“NYC Health + Hospitals OIG”). Under the agreement signed last week, NYC Health + Hospitals’ existing internal inspector general’s office, which previously reported to NYC Health + Hospitals’ President and Board of Directors, will now be under the full authority and supervision of DOI.

A new inspector general will report to DOI Commissioner Peters. The move was prompted by NYC Health + Hospitals Board of Directors and Dr. Raju, who requested that DOI provide independent and transparent oversight. The Inspector General’s oversight will allow the highest levels of integrity and transparency by giving full control to Commissioner Peters and the Department of Investigation.

The Department of Justice has filed a Writ of Certiorari‎ requesting the U.S. Supreme Court Review a federal appeals court decision (Texas et al v. United States et al) that temporarily blocks President Obama’s executive orders on immigration.

The President executive initiatives would provide work permits and protection from deportation to nearly 5 million ‎undocumented immigrants. If the Supreme Court decides to hear the case, it will be early in 2016 and a decision might be expected by June 2016.

The James L. Zadroga 9/11 Health and Compensation Act is included in omnibus legislation anticipated to be approved by Congress this week.

The bill extends the Zadroga medical program, which includes Health and Hospitals’ World Trade Center Environmental Health Center program, for 75 years. The bill extends the companion Victims Compensation Fund for 5 years.

I want to thank and congratulate all those who are working so hard for passage, which includes our City Hall partners, the New York Congressional delegation especially Senators Gillibrand and Schumer along with Representatives Nadler, Maloney and King, the many responders and survivors who advocated for themselves and their compatriots, and certainly the patients and staff of the World Trade Center Environmental Health Center here at the New York City Health + Hospitals. The World Trade Center Health Program is an absolute priority at the New York City Health + Hospitals and we are proud to continue this noble program to render 9/11-related care and services for decades to come.

The OneCity Health Centralized Services Organization (CSO) is on track to submit its December 31 DSRIP quarterly report to NYS DOH. The report details our PPS’ progress in reaching its DSRIP commitments as defined by NYS DOH mandated milestones.

Site-level planning and implementation for three clinical projects across the entire OneCity Health network have been initiated.

For Project 11, as part of the initial pilot, OneCity Health has trained representatives from over 15 community-based organizations and seven NYC Health + Hospitals sites in the use of a survey tool to measure patient activation (PAM ®).
Survey administration is one of the earliest steps in the project, and the overall goal is to engage uninsured and Medicaid low- and non-utilizing New Yorkers and link them effectively to primary care.

For asthma home-based self-management, OneCity Health has engaged three NYC Health + Hospitals sites, including the ED and pediatrics clinics of each, as well as DOHMH and community based organizations to provide the clinical care, home-based services, and education needed to prevent asthma attacks.

For integration of palliative care into the Patient Centered Medical Home (PCMH), we have engaged 3 of our Gotham sites for pilot and are currently evaluating five OneCity Health partner organizations who self-identified as wishing to provide palliative care training and education.

Over the next three months, OneCity Health will pilot the remainder of projects across the network, with sites selected according to community need, site readiness, and our commitments to NYS DOH.

For two population- or public health focused projects, our OneCity Health PPS has spent the last year in close collaboration with other NYC PPSs in planning, and will seek to begin implementation over next 3 months:

For collaborative HIV work, NYC Health + Hospitals and its OneCity Health partners will work on a collection of six discrete projects intended to improve HIV care and prevention. During project implementation, this collaborative group will be convened by DOHMH.

For the collaborative Mental Health and Substance Abuse (MHSA) project, a consortium of four PPSs will work to improve adolescent mental health by identifying behavioral health needs, implementing preventive interventions, and creating effective linkages to community support resources. Project implementation will occur within 100+ middle schools throughout the city under governance of the consortium, and DOHMH and OMH will continue to serve in an advisory capacity throughout implementation.

The MHSA project, which will be carried out collaboratively with other NYC PPSs, DOHMH and OMH serve in advisory capacity. The Department of Education is also an advisor as this work will be carried out in middle schools.

OneCity Health is in the process of executing the Master Services Agreements for all partners and the payment schedules for each project in which a partner will participate. We expect to flow funds first to our community partners and are working relentlessly to distribute funds beginning in January, 2016.

BROADCAST

• NYC sets goal of screening all new mothers for depression, NY1 News
• IDNYC service offered at NYC Health + Hospitals/North Central Bronx, News 12 Bronx
• NYC First Lady urges postpartum depression screening, WNBC
• Bronx residents rally against gun violence, News 12 Bronx
• Mayor Bill de Blasio unveils mental health initiative. WABC
• NYC Health + Hospitals/Kings County receives new cancer treatment machine, News 12 Brooklyn
• PRINT
• Op-Ed: Yes, doctors and lawyers can work together, Crain’s New York Business
• Danny Meyer explains how to put the hospitality in hospitals, Crain’s Health Pulse
• A New York initiative to promote mental health, The Wall Street Journal
• The important thing Hospitals have pledged to do for new moms, HuffPost Life Handbook
• NYC Health + Hospitals to overhaul its patient-experience strategy, Crain’s Health Pulse
• NYC Health + Hospitals avoids consultants for patient experience overhaul, Becker’s Hospital Review
• NYC’s public health care system rebrands to unify 70+ patient care locations, Queens Latino
• NYC Health + Hospitals names new CFO, Modern Healthcare
• NYC Health + Hospitals names CFO: 4 things to know, Becker’s Hospital Review
• IDNYC Service offered at NYC Health + Hospitals/North Central Bronx, Norwood News
• NYC Health + Hospitals/Harlem to earn the Leapfrog Group’s “Top Hospital”, Harlem World
• NYC Health + Hospitals reminds New Yorkers to get tested, Amsterdam News
• NYC Health + Hospitals/Jacobi celebrates 60th Anniversary, Bronx Times
• MetroPlus COO Seth Diamond, City & State