REPORT TO THE BOARD OF DIRECTORS – February 2017

NYC Health + Hospitals partnered with the Mayor’s office to provide communications and collateral support for the February 22 National Day of Action against repeal of the Affordable Care Act (ACA). Mayor de Blasio led efforts to rally more than 70 cities in opposition to ACA repeal. Mayors from across the nation spent the day highlighting the devastating impact repeal of the health care law would have at the local level. New York State estimates that repeal threatens 2.6 million New Yorkers with the loss of health insurance, including up to 1.6 million residents of New York City. Health insurance for 200,000 NYC Health + Hospitals patients is at risk, as is coverage for 120,000 Medicaid recipients, and 169,000 MetroPlus members.

In response to efforts to eviscerate the ACA, the Mayor’s office and NYC Health + Hospitals have aggressively promoted the GetCoveredNYC campaign, which seeks to enroll as many eligible but as yet uninsured New Yorkers as possible in 2017. We were able to sign up roughly 14,000 New York City residents before the end of Open Enrollment on January 31, 2017.

We also supported a community rally on February 18 at NYC Health + Hospitals/ Gouverneur hosted by the New York Congressional delegation, including Rep. Nydia M. Velázquez, Rep. Hakeem Jeffries, House Democratic Caucus Chairman Rep. Joseph Crowley, and Rep. Jerrold Nadler. The rally was attended by many seniors and others who have benefited from the Affordable Care Act, as well as representatives from Doctors Council, SEIU 1199 and Make the Road New York.

New York City has joined Chicago, San Francisco, Minneapolis, Nashville, Albany, and other municipalities across the nation in filing an amicus brief supporting injunctive relief for plaintiffs harmed by President Donald Trump’s executive order titled “Protecting the Nation from Foreign Terrorist Entry into the United States” (the travel ban). The brief argues that the travel ban promotes xenophobia and religious discrimination that is particularly toxic for New York City and other jurisdictions whose social fabric depends on tolerance and inclusiveness. The brief emphasizes irreparable harm caused by the travel ban’s disruption of the operations of New York City safety net hospitals relying on dozens of medical residents affected by the travel ban.

NYC Health + Hospital’s Law Department and my office have collaborated on other activities relevant to the travel ban, including the signing on to another amicus brief being prepared by Arnold and Porter Kaye Scholer LLP on behalf of a number of health care organizations. We will continue to monitor all policy actions taken by the federal administration, as well as rhetoric from administration officials – and assess the impact on our system, our patients, and our staff.

More than 100 Community Advisory Board members organized by NYC Health + Hospitals staff converged on Albany on February 14 to advocate for safety net funding legislation and to express concerns regarding ACA repeal and DSH payment cuts. More than 60 meetings were scheduled with members of the Senate and Assembly. As a result of our Lobby Day, the entire Bronx legislative delegation signed a letter to request safety net funding for NYC Health + Hospitals. In addition, Assembly Member Pamela Harris submitted a letter on our behalf for safety net funding. Both letters were submitted to the Speaker of the Assembly requesting the Assembly’s budget include funding for NYC Health + Hospitals.

NYC Health + Hospitals/Coney Island is scheduled to launch Epic, our new, state-of-the-art electronic medical record (EMR) on February 25. The new EMR will put complete, up-to-date patient information at our clinicians’ fingertips, resulting in a better and safer care experience for our patients. It will also empower them with access to their health information online with MyChart, Epic’s patient portal tool.

To prepare for the implementation, we have drawn on the expertise and hard work of the IT teams responsible for successfully bringing more than 8,000 clinicians at NYC Health + Hospitals/Queens, NYC Health + Hospitals/Elmhurst and NYC Health + Hospitals/At Home (our system’s home care agency) care agency — onto the new EMR . Coney Island has trained more than 2,000 employees on the new EMR, and has planned for the necessary processes and people to ensure that the next important phase of our transition to Epic is as smooth as possible.

Today NYC Health + Hospitals and Northwell Health announced the start of work on a $47.7 million shared, state-of-the-art laboratory in Queens, designed to enhance quality and patient service while reducing costs for both health systems and their hospitals. The new lab will primarily perform microbiology tests, including molecular diagnostics from local hospitals, clinics and physicians’ offices. It will incorporate the latest technology and advanced robotic testing systems.

Our health system currently operates four core labs and seven rapid response labs, which together perform about 15 million lab tests each year. Under the partnership, our health system will consolidate our four core lab operations into the new cooperative lab in Queens, which will eventually process about half of our lab tests. Northwell Health will make the upfront investment to build the facility, with the goal of consolidating and streamlining the operations of the two health systems. Joint savings are expected to be more than $30 million annually. Once completed the centralized Queens lab will be the largest, nonprofit, hospital-operated lab network in the nation, processing over 50 million tests annually.

The New York State Department of Health’s Health Workforce Retraining Initiative awarded a $2.3 million grant to our system to expand staff training designed to enhance clinical skills, cultural competency, leadership innovation, computer skills, and behavioral health care at many of our facilities. The state initiative is designed to promote training and retraining of health industry workers with the skills necessary in today’s health care market.

This grant will also allow our office of Diversity and Inclusion to offer staff trainings focused on the following areas: Interreligious Awareness for Patients and Staff, Strategies for Fostering Diversity and Inclusion in the Workplace –including proactively addressing unconscious biases and the intersection of LGBTQ issues and religious identities in the workplace, and more training relevant to practices for communication with patients who are deaf or hard of hearing or who have other disabilities.

MetroPlus Health Plan recently announced the introduction of a Healthy Rewards program that encourages members to earn reward points for completing healthy activities, like managing their diabetes, attending pre-and postpartum visits for a healthy pregnancy, taking an annual Health Risk Assessment, and more.

As individuals complete their healthy activities, they can visit the Healthy Rewards Portal via smartphone, tablet, or desktop to track their progress, access personalized wellness tools and resources, redeem reward points and order healthy items from the MetroPlus Healthy Rewards Catalog. The program also provides support to members over the phone. Rewards cover a wide spectrum of popular items that promote physical activity, and focus on nutrition and health.

NYC Health + Hospitals is partnering with First Lady Chirlane McCray’s ThriveNYC initiative, the Mayor’s Office to Combat Domestic Violence, the Chapman Perelman Foundation, and Columbia University Medical Center to expand a pilot program that has achieved success placing mental health care providers within the Bronx NYC Family Justice Center (FJC). FJCs are one-stop centers providing comprehensive services to domestic violence survivors and their children, regardless of income, language, immigration status, gender identity or sexual orientation.

On-site clinical psychiatric services provided by skilled NYC Health + Hospitals clinicians to survivors began recently at the FJCs in Queens and Brooklyn, and are expanding to FJCs in Manhattan and Staten Island. NYC Health + Hospitals facilities in close proximity to FJCs will oversee, supervise and hire the staff to provide services to the program: NYC Health + Hospitals/Lincoln for the Bronx FJC, NYC Health + Hospitals/Kings County for the Brooklyn FJC and NYC Health + Hospitals/Queens for the Queens FJC. Each FJC has an on-site, full-time psychotherapist, part-time psychiatrist, and full-time administrator.

NYC Health + Hospitals has been named a 2017 “Training Top 125” winner by Training magazine. Our system was chosen as one of only 125 organizations worldwide—and the only health system in New York State—to be recognized for demonstrating excellence in employer-sponsored training and development programs, and for implementing training programs tied to corporate strategic goals, with measurable results. This is the first “Training Top 125” award for the system, which provided training to more than 38,000 employees during FY16 and offers more than 5,500 courses annually, including in-person, virtual, and self-paced sessions focusing on leadership development, new employee orientation, behavior-based interviewing, dietary education and computer skills as well as training on serious public health threats, such as infectious pathogens like Ebola, and mass casualty incidents.

Erika Mendelsohn, LMSW, Director of NYC Health + Hospitals/Jacobi’s “Stand Up to Violence” (SUV) program, has been named an “Emerging Leader” by the National Association of Social Workers, New York City Chapter (NASW-NYC).

Ms. Mendelsohn is a graduate of the Columbia School of Social Work and has spent her career advocating for social justice. She has led Jacobi’s SUV program since June 2014, during which time is has successfully expanded its target area from two to three precincts, and played a critical role in reducing gun violence by 40 percent in those precincts. The program is based on the nationwide Cure Violence initiative, to target areas prone to gun violence using credible messengers, men or women once involved in gangs or violent incidents. Congratulations to Erika Mendelsohn for this recognition.

A $12 million grant from the Centers for Disease Control and Prevention (CDC) and the Office of the U.S. Department of Health and Human Services Assistant Secretary for Preparedness and Response (ASPR) established the National Ebola Training and Education Center (NETEC) in 2015. NYC Health + Hospitals/Bellevue, the University of Nebraska Medical Center in Omaha, and Emory University in Atlanta are the co-leads of NETEC and recipients of the 2015 grant and a recently announced additional $12 million to allow for a variety of expanded services, including creation of a special pathogens research network.

The supplemental funding will allow Bellevue and its partners to perform additional site visits, conduct more education and training courses, and build a special pathogens research network. Since December 2014, the three institutions have trained more than 840 health care workers on all aspects of infection control and patient care for individuals with Ebola.

This month The Joint Commission completed its triennial survey of NYC Health + Hospitals/Queens, and has accredited the hospital for the next three years. Over the course of 4 days, a team of 7 surveyors conducted countless tracers, reviewing inpatient and outpatient processes and procedures at the main campus and at the off-site clinics. Tremendous focus was placed on TJCs top challenging issues identified nationwide, including infection control and environment of care. All citations were written up, as per the new process this year. There were minimal citations in Infection Control and the Environment. The survey team reported that all staff were engaged, many processes were well done and that Queens has set the bar for other NYC Health + Hospitals facilities up for survey this year.

Congratulations to Christopher Roker, CEO, Jasmin Moshirpur, MD, Chief Medical Officer, Dean Mihaltses, COO, Joan Gabriele, RN, Chief Nurse Executive, Kenneth Hart, Sr. Associate Director, Regulatory Services, and the staff of NYC Health + Hospitals/Queens, on a successful survey. Thank you also to Board Member Helen Arteaga-Landaverde, for participating and representing the H+H Board at the Leadership Session of the survey.

Support for patients at high risk of readmission

One City Health Transition Management Teams (TMTs) are continuing to provide 30 days of supportive care management for patients at high risk of readmission at NYC Health + Hospitals/Bellevue and NYC Health + Hospitals/Kings County. To date, 750 patients have been referred to the program, and 375 have completed all 30 days. Four of our community-based partners – VillageCare, ArchCare, BrightPoint Health and New York City Department for the Aging – will soon provide an additional ten TMTs across medicine and behavioral health inpatient units in NYC Health + Hospital facilities.

Medicaid Accelerated exchange targeting super utilizers

Action teams from NYC Health + Hospitals/Bellevue and NYC Health + Hospitals/Lincoln kicked off participation in the State Department of Health Medicaid Accelerated eXchange (MAX) in January. MAX is a 6-month program that puts front-line clinicians from both hospitals in a position to lead rapid change and innovation designed to help achieve DSRIP goals. Our action teams will quickly implement changes to improve care for the relatively small proportion of inpatients who account for a disproportionate amount of utilization and cost (often referred to as ‘super utilizers’). Additionally, through the MAX “Train the Trainer” Program, Xincon Home Health Care Services, one of our community partners, will work with both action teams to help sustain and proliferate these changes throughout our system.

Community Health Workers Assisting Asthma Patients

Over 100 patients have been assigned to community health workers (CHWs) from our partner organizations as part of our clinical asthma program. CHWs – from VillageCare, Urban Health Plan, St. Mary’s Healthcare System for Children, Asian Community Care Management and NYC Health + Hospitals complete asthma assessments, reinforce recommendations from the clinical team, and conduct home visits to evaluate the environment.

100 Schools Project

OneCity Health and three other New York City-based DSRIP Performing Provider Systems (PPS)—Community Care of Brooklyn, Bronx Health Access, and Bronx Partners for Healthy Communities— have expanded the 100 Schools Project, which trains schools to connect students who have emotional, behavioral, or substance-abuse challenges with top-tier local mental health providers while enabling them to remain in school. 100 Schools launched at 10 schools in September. 20 more schools have been engaged in the work in 2017, with a dozen more set to start soon. The four PPS are funding and overseeing the project, while one of our community partners, the Jewish Board of Family and Children’s Services, is coordinating the initiative.

Identifying gaps in service delivery system-wide

50 community partner sites, including five NYC Health + Hospital sites, will undergo site assessments to understand the current state, strengths and opportunities for cultural competence and health literacy improvement. This initiative will provide the OneCity Health network with additional insights on disparities and gaps in service delivery, and promote best clinical and administrative processes to improve them.