REPORT TO THE BOARD OF DIRECTORS – December 2021

COVID-19 Cases and Response – NYC has been experiencing a fourth wave of COVID-19 since roughly mid-November. The percent of patients testing positive for COVID-19 in the community has been increasing sharply and is now over 3.5 percent. The number of patients with COVID-19 who have been admitted to our hospitals has also been on the rise, though at a more moderate level. Our current census of COVID-19 positive inpatients is comparable to the peak of the Aug/Sept ’21 surge, and significantly lower than at the peak of the pre-vaccine second surge last winter. We remain hopeful that we will not see anywhere near that volume, but our hospitals are getting their plans in place to respond as needed to flex bed capacity, take advantage of our ability to level-load patients across facilities, and have staffing plans in place to address potential need. The overwhelming majority of patients admitted are not vaccinated, and almost all cases to date are Delta variant. As we head into the holidays, we continue to keep close watch on evolving needs for both our patients and staff. Indoor masking, continued social distancing, vaccination and specially booster shots are our best protection.

Omicron variant – We have been closely following the developments around the Omicron variant that has been spreading across the country. It appears that the Omicron strain may cause less severe illness than the Delta variant. Omicron variant has more mutations, including many new mutations not seen before in other variants. Although Omicron has been found in NYC, Delta continues to be the main variant circulating here, and is responsible for almost all cases currently identified.

COVID-19 vaccines – This week we marked the one-year anniversary of providing COVID-19 vaccines to New Yorkers. The first doses in 2020 were administered at NYC Health + Hospitals/Elmhurst to employees William Kelly and Veronica Delgado. Since then, our health system has administered more than 1.4 million doses of the life-saving vaccine to New Yorkers who are at least five years of age. We also began offering booster shots to 16 -17-year olds, following last week’s CDC approval of the Pfizer vaccine for this younger group. And everyone over the age of 18 can get a booster shot from any of the approved manufacturers. I am so proud of the tremendous life-saving work our public health system has done to protect New Yorkers during this horrible pandemic, and celebrating one-year of providing vaccines against this virus is truly remarkable. We could not have achieved 1.4 million doses without the support of our incredible workforce at every level of the process – including registrars, nurses, pharmacists, and so many other dedicated healthcare professionals across our health system.

To support our efforts to get many more New Yorkers vaccinated, specially coming back to get their booster shots, we will be launching a public awareness campaign to direct people to get their vaccines at any NYC Health + Hospitals facility. The city-wide, multi-language campaign will appear on digital, print and outdoor venues such as LinkNYC and subways, particularly targeting neighborhoods with low vaccination rates. The ads feature real patients and employees of the public health system.

NYC Test & Trace Corps – The work of our Test & Trace Corps continues to be an essential part of NYC’s response strategy. As community spread of COVID-19 increases, testing and contact tracing remain bedrocks of our ability to fight the spread of this disease. Our Test & Trace team has provided more than 7 million tests, reached nearly 90% of all who have tested positive, identified 1.3 million close contacts, and offered a wide range of support services to New Yorkers who had to isolate/quarantine at home or in one of our hotels. We have served more than 26,500 individuals in our hotels and our Navigators have completed more than 322,000 health and social service referrals to New Yorkers with Long COVID. Our Test & Trace team are also providing vaccines for all and are reaching underserved neighborhoods with our mobile testing and vaccination units. Our NYC Test & Trace Corps mobile vaccination clinics have administered over 58,000 pediatric vaccinations to New York City students ages 5 to 11—over a quarter of all vaccinated New Yorkers in this age group. Clinics were established at every public elementary school in the City and many charter schools who opted into the program. Over the course of five weeks, Test & Trace mobile units and clinicians offered both first and second doses to nearly 1,100 City public and charter schools, holding over 2,600 pop-up vaccine clinics while mobilizing the largest school vaccination campaign in the country.

We are very proud to have received the Health Association of New York State 2021 Pinnacle Award for Quality and Patient Safety. As the hospital at the epicenter of the first COVID-19 surge, NYC Health + Hospitals/Elmhurst was the first to dramatically expand the peer support program under our Helping Healers Heal initiative, which has now become a system wide model for providing emotional and psychological support for all our health care workers. You can watch the video featuring one of the staff members who benefitted from the program and clinical leaders who have been instrumental in building this vital service to all staff across the health system: HANYS awards 2021 Pinnacle Award to NYC Health + Hospitals/Elmhurst.

Last week, the Supreme Court declined to block a Texas state law severely limiting abortions. We believe this ruling will have horrible consequences for pregnant people, continuing to disrupt access to health care and worsen health inequities. NYC Health + Hospitals has strongly defended the right to choose, and we believe it is crucial that New Yorkers have multiple ways to access vital reproductive health and pregnancy termination services wherever they feel most comfortable. As a public health system, we will continue to provide comprehensive and safe reproductive health services to all New Yorkers, including abortion services.

This month we announced two important staff appointments. David Silvestri, MD, MBA, MHS will serve as the new NYC Health + Hospitals Assistant Vice President of Emergency Management. Dr. Silvestri will be responsible for planning, coordinating, and executing emergency and disaster response systemwide, including the ongoing COVID-19 efforts. Dr. Silvestri, an emergency medicine physician at NYC Health + Hospitals/Lincoln, has served in various leadership roles within the Office of Quality & Safety and Office of Ambulatory Care since his arrival to the public health system in 2019. As a key player in our pandemic response, his expertise and passion will surely carry us as we continue to strengthen and prepare our system for other threats – from weather-related disasters to other dangerous pathogens – while continuing to provide direct patient care at NYC Health + Hospitals/Lincoln.

Dr. Silvestri will replace Dr. Laura Lavicoli, who has transitioned back to NYC Health + Hospitals/Elmhurst after leading our systemwide emergency management response for the last year. She will serve as the new Deputy Chief Medical Officer for the hospital where she will work closely with the hospital’s Chief Medical Officer Dr. Jasmin Moshirpur to oversee quality improvement, risk management, patient safety, and medical department service line operations. She will also be assisting with facility growth initiatives and system service line operations. Dr. Lavicoli, an experienced and seasoned board-certified emergency medicine physician with an expertise in disaster preparedness and pandemic response, has worked at Elmhurst Hospital for more than 20 years and played a pivotal role in guiding the hospital through the first COVID-19 surge, using her background in disaster management to develop new and innovative procedures and treatment protocols in the hospital.

Unsung Heroes in Emergency Medicine – Congratulations to four of our outstanding emergency physicians who have been named 2021 New York American College of Emergency Physicians (ACEP) Unsung Heroes of Emergency Medicine. This award recognized outstanding emergency physicians who go above and beyond for their patients, colleagues, and community. Their leadership sets an example for every medical professional and I am very grateful and proud of their contributions to our health system and our patients. The four physicians are:

• Cara Taubman, MD, MPH, Assistant Director, Emergency Department, NYC Health + Hospitals/Harlem, 11 Years of Service
• Frosso J. Adamakos, MD FACEP, Vice Chair of Education, Metropolitan Harlem Emergency Medicine Residency, NYC Health + Hospitals/Metropolitan, NYC Health + Hospitals/Harlem, 4 Years of Service
• James M. Willis, MD, Emergency Medicine, NYC Health + Hospitals/Kings County, 11 Years of Service
• Mary T. Ryan, MD, Emergency Medicine, NYC Health + Hospitals/Lincoln, 20 Years of Service

Outstanding Nursing Professionals – Earlier this month, NYC Health + Hospitals honored more than 30 nurse professionals from across the public health care system as part of our annual Nursing Excellence Awards. These nurse trailblazers represent the more than 9,600 dedicated nurses who care for patients in our hospitals, neighborhood health centers, in home care and every corner of our health care system. I truly believe that our nurses are at the heart of our mission to care for every New Yorker without exception. Every day, our nurses reach beyond their routine duties to ensure patients are tested, vaccinated and taking better charge of their own health and the health of their families. Our Nursing Excellence honorees exemplify what it means to be a healthcare hero and this is a great opportunity for us to shine a light on their extraordinary work. Congratulations to all our nursing awards winners. You can visit our website for a complete list of names, bios and photos: https://www.nychealthandhospitals.org/nursing-excellence-awards-2021/.

Federal – The President has signed the Protecting Medicare and American Farmers from Sequester Cuts Act, which contains several measures that temporarily delay scheduled cuts to Medicare reimbursement. The House passed the Build Back Better Act last month, and the Senate has now taken up the legislation. The Senate draft text is being modified for both political and procedural objectives. This is a bill that would have to be passed through the reconciliation process. Senate Majority Leader Chuck Schumer is pushing for this to be complete before the Senate goes on break for Christmas. Congress has passed and the President is expected to sign legislation to increase the debt ceiling. NYC Health + Hospitals continues to communicate our priorities to our champions in government, and we are grateful for their ongoing support.

State – With the uptick of COVID-19 cases around the State, the Governor is taking steps to maintain necessary hospital capacity. Under Executive Order, she has granted authority to the State Department of Health to take necessary surge and flex actions, including potentially postponing non-essential elective procedures. So far, this authority has not had any impact on NYC or NYC Health + Hospitals. The State’s review is a two-part process, beginning with a study of the volume in a particular region of the State and then with an examination of individual hospitals for decreased capacity. NYC has not been determined to be an at-risk region and thus NYC Health + Hospitals has not been required to take actions relating to elective procedures. Regardless, we are continuing our work as a System, ensuring that we can level load and share resources as necessary to best protect our patients and staff.

On December 13, 2021, the Governor’s mandated that masks are required to be worn in all indoor public places unless businesses implement a vaccine requirement went into effect statewide. This mandate is in effect until January 15, 2022.

On January 5th, the NYS Legislature will return to Albany to start a new legislative session. The Governor will give her first State of the State address, and a few weeks later will issue her Executive Budget for State Fiscal Year 22-23. NYC Health + Hospitals is already meeting with key legislators and staff, as well as working with the Department of Health and Governor’s Office to advance our financial and programmatic priorities.

Sadly, Assembly Health Committee Chair Dick Gottfried has announced that he will not seek reelection. Assembly Member Gottfried is the longest serving legislator in New York history, and he has been a staunch supporter of NYC Health + Hospitals and equitable health care for decades. We will miss his leadership, intelligence, commitment, and wry humor.

City – January 1st is when new administration begins and all other local officers get sworn in. Mayor-elect Adams has announced that his inauguration will be in Brooklyn on the evening of Saturday, January 1 so that people who observe the Jewish Sabbath can participate. Incoming Comptroller Brad Lander and re-elected Public Advocate Jumaane Williams will also hold their inaugurations at this event. NYC Health + Hospitals is thrilled to partner with our new Mayor and elected officials. We appreciate their commitment to our shared values and mission.

I have approved one contract extension, given its time-sensitivity, and I want to take this opportunity to summarize it for the Board. I approved an exception to further extend our contract with LaGuardia Associates LP for the rental of the LaGuardia Plaza Hotel as part of the COVID-19 isolation program. I had originally approved this contract under the NYC Health + Hospitals COVID-19 emergency declaration in April 2020. It was subsequently extended through December 31, 2021. Given the increase in COVID cases and the need to continue helping New Yorkers who test positive for the virus to find a safe place to isolate to protect their loved ones, I have approved an extension through June 30, 2022. The extension includes a provision to terminate after January 31, 2022 if the hotel is no longer needed. The cost for the six-month extension will not exceed $7,050,067. Funding for the hotel continues to be provided through the City of New York.