REPORT TO THE BOARD OF DIRECTORS – February 2020

City

On February 24, Dr. Eric Wei, Chief Quality Officer and Dr. Natalia Cineas, Chief Nursing Executive for NYC Health + Hospitals jointly testified at the City Council”s Hospitals Committee oversight hearing on the safety of New York City emergency departments. Their testimony focused on one of Health + Hospitals” top priority, developing and maintaining a culture of safety for our patients and staff. They also shared our health system”s strategies to address wait-times and overcrowding in EDs: hiring 600+ new nurses in the last two years; opening six ExpressCare clinics; and implementing a provider-in-triage model, which places a physician or advanced practice provider at the front end of the ED to evaluate patients.

State

State Budget negotiations are ongoing. The Governor has convened the Medicaid Redesign Team (MRT), which is expected to identify $2.5 billion in State Medicaid savings through a public process fueled by stakeholders” submitted policy proposals, which were due by February 24. The MRT”s recommendations will then go to the Legislature for approval. If the Legislature fails to enact the $2.5 billion in savings, the Division of Budget would have authority to impose across-the-board Medicaid reduction to achieve the savings. The 21-member MRT met on February 11 and will meet again on March 2, with one more meeting expected but without a specified date. We submitted a set of recommendations for MRT consideration and we are working with State staff, legislators, and partners to advance our key priorities, which include protection for safety net hospitals, greater commitment for value-based care, and regulatory relief. We are grateful for our allies, including our Community Advisory Board members and other advocates who join us in working to protect the public safety net system and the communities we are proud to serve.

Federal

On February 24, the Federal government denied New York State’s application to continue the Delivery System Reform Incentive Payment (DSRIP) program to reduce avoidable hospitalizations and promote value-based care. New York had sought approval to extend DSRIP first through March 2021 and subsequently through March 2024 with an additional $8 billion in Federal funding. With this denial, the current waiver will continue only through March of this year, and the Federal government will NOT allow the State to use a remaining $625m of previously approved but unspent DSRIP funding. We are disappointed that the Federal government has denied the state’s request. Under this program, we were able to reduce unnecessary hospital utilization, improve outcomes for patients and lower the cost of care for this population. Despite this decision, we will continue our commitment to providing value-based care through targeted patient-centered services and partnerships with critical community organizations. This remains vital to the health and well-being of the vulnerable New Yorkers who rely on our care.

Earlier this week, the NYC Care staff was joined by 15 faith leaders at NYC Health + Hospitals/Gotham Health, Vanderbilt in Staten Island to discuss the human right to health care and to hear how we can better engage with Staten Islanders through houses of worship. Representatives from the Mayor”s Community Affairs Unit and the Center for Faith and Community Partnerships were in attendance and participants shared stories of how access to health care through NYC Care will be life saving for their parishioners and clients. Since the launch of NYC Care in Brooklyn and Staten Island in late January, enrollment continues to climb and all new patients have been offered an appointment with their assigned primary care provider within two weeks of enrollment in the program. The nine CBOs conducting outreach in Brooklyn and Staten Island are off to a strong start, reaching close to 14,000 residents of the two boroughs in less than a month.

NYC Health + Hospitals has been following the coronavirus outbreak very closely and we have taken all necessary steps to prepare and respond. In collaboration with the City and State Departments of Health and the Centers for Disease Control, we are closely monitoring the outbreak and our renowned special pathogens team is coordinating efforts system-wide. We have taken concrete steps to update the travel history screen in our electronic medical record, are educating and preparing frontline teams with the most up to date clinical guidelines and infection prevention precautions, and are using secret shoppers to ensure our front-line teams are ready to respond with the best practice standards to protect our patients and staff. We activated our Emergency Operations Center under the leadership of Dr. Machelle Allen, Senior Vice President and Chief Medical Officer, and have been conducting weekly briefings to review the status of system resources to support our clinical, operational and finance efforts. Just yesterday, Dr. Allen joined the Mayor in a citywide briefing to share an update about how New York City is responding to the outbreak and is well prepared to handle any cases.

NYC Health + Hospitals this month marked the opening of four new ExpressCare Clinics at NYC Health + Hospitals/Queens, Harlem, Metropolitan and Woodhull. The new urgent care clinics provide faster access to medical care for patients with non-life-threatening conditions. The clinics offer walk-in services for conditions such as colds, flu, sprains, skin rashes, minor cuts and lacerations, and certain types of infections. Patients who typically use the emergency department for these conditions will find shorter wait times and faster service at our ExpressCare clinics. This is a unique urgent care model that differs from stand-alone urgent care centers by offering a closer connection to primary care providers. The emergency-trained physicians in our ExpressCare clinics help ensure patients receive the appropriate follow-up care by connecting them with primary care doctors in our health system. In addition, their close proximity to the hospital Emergency Rooms ensure that patients who cannot be treated in the urgent care setting, or who may require hospital admission, will be fast-tracked to the Emergency Department for further treatment. NYC Health + Hospitals worked with OneCity Health, the State”s largest Performing Provider System, part of the Medicaid Delivery System Reform Incentive Payment (DSRIP) program, to create the clinical model for the ExpressCare clinics, which are designed to support the DSRIP goal to reduce avoidable hospital use by 25 percent by 2020.

The federal “public charge” rule formally took effect earlier this week. We know this policy technically impacts just a narrow subset of the immigrant population – but it has a much broader effect on the community we serve. Like recent announcements about more aggressive forms of immigration enforcement – this rule is intended to instill fear in immigrant communities. We need to help our community members understand that NYC Health + Hospitals is a safe space, no matter where they come from, how they got here, or how long they”ve been here. We continue to direct patients with concerns regarding public charge rule or overall immigration matters to the free, on-site, confidential legal services available in our facilities through NYLAG LegalHealth and to the useful information we have made available in 13 languages on our website. NYC Health + Hospitals has been working in lockstep with the Mayor”s Office and City agencies to stay aligned on overall messaging, and to combat the chilling effect that would have the broadest impact. We continue to engage with media, community partners, elected officials, and healthcare partners to underscore our message that access to healthcare is not impacted by the rule and people should continue to seek care without fear no matter how long they have been in New York or how they got here.

NYC Health + Hospitals received the 2019 Brandon Hall Group”s “Excellence in Learning” gold award — considered the “Oscar” for human resources managers and learning and development teams. Our health system received this recognition for aligning staff training to larger organizational goals and employee engagement. The award recognizes our extensive staff training program, which includes computer skills training completed by more than 2,000 employees in 2019, and the system-wide new employee orientation program completed by more than 11,000 new employees since 2015. In 2019, employees completed more than 200,000 learning engagements, which include online courses and in-person trainings. Our health system was in good company receiving this award – others recognized for their employee learning and development initiatives included Johnson & Johnson, Cardinal Health, Accenture, Colgate-Palmolive, Google, Microsoft, and PepsiCo.

This month we celebrated the NYC Hospital Police Academy graduation for 26 of our newest special officers who have a vital role in keeping our patient care facilities safe and secure. The ceremony was hosted at NYC Health + Hospitals/Jacobi and marked the culmination of 10 weeks of intensive training that includes basic NYS Criminal procedural law, powers of a peace officer, how to prevent and manage crisis situations, and First Aid/CPR. We recruit special officers with different levels of experience and cultural competencies, we train them to use the very best policing practices, and to provide the best service possible for our patients, visitors and staff. We are very pleased to welcome this cadre of safety professionals into the NYC Health + Hospitals family.

NYC Health + Hospitals and the Mayor”s Office of ThriveNYC announced the launch of the redesigned Mental Health Service Corps (MHSC), an innovative program that provides three years of high-quality training to early-career behavioral health clinicians. Sixty Corps members will deliver services at NYC Health + Hospitals facilities across the five boroughs, reaching thousands of high-need New Yorkers who might otherwise go without behavioral healthcare. We”re looking forward to integrating Mental Health Service Corps members throughout the public health system and further support the behavioral needs of our patients. A healthy pipeline of any medical professional, especially those working in the mental health space, is incredible important to ensure we continue to take care of New Yorkers.”

OneCity Health, the NYC Health + Hospitals Performing Provider System under New York State”s Delivery System Reform Incentive Payment (DSRIP) program, announced the launch of two new programs to address food and housing insecurities for the patients we serve. The Food and Nutrition Service Networks and Housing Navigation Network will connect patients to available services that are traditionally fragmented and difficult to navigate. Three lead community-based organizations (CBOs) — BronxWorks, Public Health Solutions and RiseBoro – will receive a total of $4.3 million to organize a network of 26 smaller CBOs to assist with outreach and referrals to available services, such as Safe Haven beds and eviction prevention services for those facing housing insecurities, and food pantries and SNAP enrollment for those facing nutrition challenges. The contracts will run through December 2020. By helping patients access and more easily navigate resources like affordable foods or housing, we can create a seamless experience for patients to address both their clinical and social needs.

NYC Health + Hospitals/Queens opened a new employee wellness room designed to provide a quiet place for hospital employees to recharge, de-stress, heal, and to emphasize the importance of taking a break and taking care of themselves during the workday. The 350-square-foot room will be a space for health coaching, aromatherapy, yoga, and meditation. Healthcare workers perform at their best when they are taking good care of themselves. The introduction of a wellness room enables our staff to take a much-needed break when necessary, engage in therapeutic activities, and step away from pressing issues so they can reassess, regroup, and gain a sense of perspective. Having this outlet available to them builds morale, reinforces the idea of an employee family, and improves overall patient care.

NYC Health + Hospitals/Lincoln received $884,000 in FY20 funding from Speaker Corey Johnson and NYC Councilmember Rafael Salamanca to transform two X-ray rooms in the Emergency Department (ED). The space will be renovated into a state-off-the-art digital radiology suite, including two GE-656 digital X-ray units, a central control station, and dressing rooms. The new equipment has is fully digital to improve image quality. The upgrades to the ED”s radiology space is expected to increase patient satisfaction, reduce waiting times, speed up diagnoses, and enhance patient experience. The ED at NYC Health + Hospitals/Lincoln remains the region”s busiest, single site Level 1 Trauma Center. Renovations are expected to begin this spring. We are grateful to the Council Members Johnson and Salamanca for their commitment to the City”s public hospital system and our patients in the Bronx.

NYC Health + Hospitals/Queens unveiled an updated, more patient friendly family waiting area in the hospital”s pediatric clinic designed to ease stress and support the overall health and well-being of pediatric patients and their families. The newly-renovated space was funded by a $1.5 million grant from the Dunkin” Joy in Childhood Foundation and the Starlight Children”s Foundation. The updated space features a private lactation room, custom-painted child-friendly murals, a reading nook for young childrenen, and a tween-teen waiting area with a new Virtual Reality Learning Center. We are dedicated to ensuring the comfort and a positive experience for our patients at all times, and these new enhancements to the pediatric wing will be a welcome addition for children, parents and caregivers.