REPORT TO THE BOARD OF DIRECTORS – January 2020

City

On January 21, Dr. Machelle Allen, Senior Vice President and Chief Medical Officer for NYC Health + Hospitals, and Dr. Wendy Wilcox, Chair of OB/GYN at Health + Hospitals/Kings County and Clinical System Lead for Maternal Mortality Reduction and Women’s Health, jointly testified at the City Council’s Hospitals Committee oversight hearing on prenatal care in NYC hospitals. Their testimony focused on our system’s progress in implementing several initiatives to improve pregnancy and birth outcomes, including our partnership with the Mayor’s Office and the NYC Department of Health and Mental Hygiene to address pregnancy-related morbidity and mortality for women of color. Through this partnership, we have implemented a maternal medical home, simulation-based programs that train providers on the highest risk emergencies in labor and birthing suites, interval pregnancy optimization and mother-baby coordinated visit programs. They also discussed the implementation of implicit bias training for our staff, our programs to reduce preterm birth and maternal depression, our midwifery services, and how we work with community-based organizations to connect patients to doula services.

State

On January 8, the NYS Legislature commenced the 2020 Legislative session. It is an election year for all state assembly and senate seats, with primaries slated for April for the first time. On January 21, the Governor outlined the 2021 State fiscal year $178 billion dollar budget, which includes a plan to address the projected $6.1 billion Budget deficit by reconvening the Medicaid Redesign Team to identify cost-containment measures that will provide approximately $2.5 billion in gap closing actions. The Governor has already implemented a 1% across the board cut to Medicaid reimbursement rates, which represents a $30m annual reduction in NYC Health + Hospitals revenue. With further cuts and potential cost shifts to local governments under consideration by the State, NYC Health + Hospitals, in consultation with the Mayor’s Office, agreed to temporarily pause administrative hiring until the full impact of the budget becomes more clear. The health system will continue to invest in clinical positions and revenue generating positions during the pause. NYC Health + Hospitals continues to work with the State and City to develop long-term, structural solutions to protect our patients and to continue to improve the system’s financial sustainability.

On January 22, Dr. Wendy Wilcox joined ACOG to provide an update on maternal health to the NYS Bi-Partisan Pro-Choice Legislative Caucus. Her testimony reiterated our health system’s commitment to this work.

Federal

In December, there was an additional delay of the pending Medicaid DSH cuts until May 22 of this year. NYC Health + Hospitals continues to work with our Federal representatives and advocacy partners to stave off these cuts, ideally on a more permanent basis. There continues to be widespread bipartisan opposition to the Medicaid DSH cuts.

• NYC Care now available in Brooklyn and Staten Island — Starting today, New Yorkers in both Brooklyn and Staten Island will have much-needed access to high quality, affordable, preventive care. I was joined by Deputy Mayor Perea-Henze, staff and community partners at two events this morning to launch NYC Care — our new health care access program that fundamentally changes the way our healthcare system connects with New Yorkers without insurance, regardless of immigration status or ability to pay, to the high-quality healthcare we deliver every day. New Yorkers who enroll in Brooklyn and Staten Island will gain access to a dedicated primary care provider, receive preventive care and routine screenings, enhanced access to pharmacy services and specialty care services, and the ability to make appointments and navigate their health care needs through a new 24/7 customer service center. All services and care are provided by the dedicated team of health care professionals at NYC Health + Hospitals, and all information about patient care and treatment is kept private and confidential. Eligible New Yorkers in Brooklyn and Staten Island are able to begin the enrollment process today by calling 646-NYC-CARE, and they will receive a personalized NYC Care welcome packet in the mail, including their new membership card. Our goal is to enroll 15,000 NYC Care members in Brooklyn and Staten Island in the first six months of the program.
• NYC Care a success in the Bronx – More than 13,000 New Yorkers have already enrolled in the program since its launch in August in the Bronx and they’ve had more than 27,000 visits with their primary care and specialty care providers. All new members have been offered a primary care appointment within the first two weeks of enrollment. Through the program’s extended pharmacy hours, members have filled close to 20,000 prescriptions in the program’s extended pharmacy hours in just the first five months, most commonly for prescriptions to treat diabetes and hypertension, conditions that require timely medication management and adherence.
• CBO Partners — In an effort to reach more New Yorkers eligible for NYC Care, nine community-based organizations will receive seven-month contracts through a partnership between NYC Health + Hospitals, the Mayor’s Office of Immigrant Affairs (MOIA) and the Mayor’s Fund to Advance New York City to conduct culturally appropriate outreach to prospective NYC Care members in Brooklyn and Staten Island. The nine community-based organizations: African Refuge, Brighton Neighborhood Association, Arab-American Family Support Center, Council of Peoples Organization, Jewish Community Council of Greater Coney Island, Make the Road New York, Mixteca Organization, Project Hospitality, and Single Stop. They were selected through a request for proposal process and will have full-time outreach workers who will conduct grassroots outreach in multiple languages in order to identify, engage, and refer uninsured New Yorkers for screening and enrollment in NYC Care.

The U.S. Supreme Court this week determined that the Trump administration can move forward with the “public charge” rule that would deny permanent legal status to certain immigrants who do not meet income thresholds or if they use public benefits like Medicaid, food stamps and housing vouchers for a period of time. The rule can become effective immediately while it continues to be subject of litigation across the United States and here in New York.

The rule does not impact all immigrants – it will impact a narrow subset of people when they apply for a green card or certain types of visas if they have used or are likely to use certain government benefits. It does not directly impact citizen children of immigrants. It does not penalize people for enrolling in Emergency Medicaid, Medicaid for Pregnant Women, the Essential Plan, or NYC Care, our health system’s new health care access program for uninsured New Yorkers.

But we know the public charge policy intends to instill fear even in those who are not directly impacted. We need to fight that fear with facts by helping our patients, their families and the communities we serve to get the information and support they need.

For those patients concerned about the rule, we will continue to direct them to the free, on-site, confidential legal services available in our facilities through NYLAG LegalHealth at 212-659-6188. NYC Health + Hospitals will continue to reinforce our commitment to help patients know they are welcome to seek care without fear no matter where they came from, no matter their insurance status, and no matter their income.

NYC Health + Hospitals, in collaboration with the City and State Departments of Health and the Centers for Disease Control, is closely monitoring the novel coronavirus outbreak and our renown special pathogens team is coordinating our 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.On a related note, Syra Madad, NYC Health + Hospitals System-Wide Special Pathogens Program Senior Director, is one of the national experts featured in a new Netflix six-episode docuseries that just aired last week: “Pandemic: How to Prevent an Outbreak.”

We have successfully completed an obstetrics life support clinical simulation training program to help our Labor and Delivery providers master skills, reduce the rate of maternal mortality, and address avoidable and potentially fatal complications during childbirth. More than 1,000 anesthesiologists, nurses, midwives, and physician assistants from all 11 public hospitals participated in the training, which featured real life scenarios with specially-designed, high tech mannequins that simulated patients having heart attacks during labor. The next round of simulation trainings will begin next month to practice scenarios of patients in labor experiencing massive hemorrhages. We are committed to reducing maternal mortality and are making these significant investments in training our providers on some of the rare and deadly complications of childbirth. These simulations allow our provider teams the opportunity to hone and perfect those life-saving skills which thankfully we rarely have to employ. But when that rare event occurs, our teams will be well prepared.

NYC Health + Hospitals announced the expansion of our text message appointment reminder platform, which has been live at NYC Health + Hospitals/Coney Island since July 2019. The new platform used for patients in adult and pediatric primary care practices is now also live at NYC Health + Hospitals/Elmhurst, Queens, Woodhull and NYC Health + Hospitals/Gotham Health, Gouverneur. We send these text messages in the 14 most common languages spoken by the patient population, including Spanish, Urdu, and Mandarin. This has helped to reduce missed appointments by 6.1 percent. The new platform offers scheduling flexibility by allowing patients to directly connect to the call center to reschedule and it is improving communication between patients and providers. Text message appointment reminders will be system-wide by the end of 2020 and will include other specialty areas. We understand that New Yorkers live hectic, unpredictable lives and providing patients the ease of canceling and rescheduling appointments is helping our health system take care of more people when it’s most convenient for them.

We’re happy to extend our long-lasting partnership with SUNY College of Optometry to ensure New Yorkers receive important eye and vision care to help prevent vision loss and help reveal other undetected chronic diseases. This partnership allows us to advance eye and vision care throughout the five boroughs while also creating new opportunities for doctors, researchers, optometry students and residents. Our renewed agreement will help expedite hiring of additional optometrists through SUNY College of Optometry to practice at NYC Health + Hospitals/Woodhull and NYC Health + Hospitals/Gotham Health, East New York, Gouverneur, and Vanderbilt. The timeline for hiring new optometrists, previously between six and eight months, will be cut by more than half. We know that early detection of eye and vision problems can lead to better learning outcomes for school-age children, increased work productivity for adults, and help reveal presence of undetected chronic diseases, such as diabetes and hypertension. This groundbreaking partnership enhances accessibility for patients across New York City and addresses several barriers to improving population health.

NYC Health + Hospitals/Metropolitan CEO Alina Moran, New York City Council Speaker Corey Johnson and Council Member Diana Ayala announced plans to improve access to care, experience and comfort for patients with new, upgraded radiology equipment. Council Member Ayala helped secure $3,750,000 capital funding for the upgrades. The Council allocation will fund a new magnetic resonance imaging system and modular building for inpatient and outpatient use. This level of capital investment from the City Council will allow us to provide an even better care experience, with shorter wait-times, and faster examinations for more patients.

The first Joint Commission survey of 2020 began this month at NYC Health + Hospital/Queens and our team was ready to secure full accreditation. The surveyors were meticulous. During a 4-day visit, they reviewed more than 290 standards related to patient care, patient safety, infection control, medication management, performance improvement, information management, life safety and environment of care, national patient safety goals and governance. The surveyors were very impressed and praised what they continuously observed during their visit as great communication and collaboration between leadership, medical and nursing staff around patient safety and quality care. The team identified several best practices, including mother/baby abduction drills, labeling of ultrasound probes using green stickers for clean and red for dirty, and white board team rounding, where the entire patient care team meets to discuss the patient’s care then goes to the patient’s bedside.

Congratulations to hospital CEO Christopher Roker and the entire staff of NYC Health + Hospitals/Queens for their hard work and commendable performance on this external validation of the safe and quality care provided to our patients. Thanks to Board Member Helen Arteaga Landaverde and hospital Community Advisory Board President Anthony Andrews for participating in The Joint Commission’s Leadership session.

Our health system’s first baby of 2020 was born at NYC Health + Hospitals/Coney Island at exactly 12:00AM on New Year’s Day. Aidan Zobnin was born to parents Jennet and Artyom Zobnin of Brighton Beach, Brooklyn. As is tradition every new year, we celebrated all the first borns at each hospital. Our health system delivers approximately 16,000 new New Yorkers every year and we offer a wide range of services to help pregnant patients and their families – including prenatal care, labor and delivery services, family planning, comprehensive gynecology, women’s health and primary care outpatient medical support for patients at every stage of life.

This month we also marked the arrival of Momo, our first in-residence therapy dog, who will supplement and support treatment and recovery services for residents at NYC Health + Hospitals/Coler. The yellow labrador retriever was welcomed by residents and staff at a “collar ceremony” and his services have been made available to our patients thanks to the charitable group, Healing Pause, and the Angelica Patient Assistance Program. Momo will provide therapy support spending time with residentsmaking regular bedside visits and attending the facility’s special events. Studies have clearly documented the healing power of animals on patients, and I know that Momo will have the same effect on ours. Momo will help to reduce stress and anxiety, while promoting the health and wellbeing of our residents.

Svetlana Lipyanskaya was appointed CEO of NYC Health + Hospitals/Coney Island effective January 2. Svetlana will lead the hospital in delivering high quality care to patients in South Brooklyn, continue to grow innovative programs and re-engineer processes to increase access to affordable and comprehensive health care for all patients. She will help guide the next phase of NYC Health + Hospitals/Coney Island transformation and renovations as part of its Hurricane Sandy recovery project, and will oversee the completion of its new hospital campus. Svetlana has deep personal connections to the South Brooklyn community she will serve. She moved to Bensonhurst from Odessa, Ukraine in 1989 when she was nine years old. She speaks fluent Russian, a prominent language of patients serviced by the hospital.

We are extremely fortunate to be able to tap our own, highly talented senior executives to take on new leadership roles in our health system effective February 24. Christopher Roker, CEO of NYC Health + Hospitals/Queens, will become CEO of NYC Health + Hospitals/Metropolitan and serve as the health system’s Chief Growth Officer. Chris will replace Alina Moran who is relocating to the West Coast after more than 20 years of service to our public health system. We are grateful to Alina for her numerous contributions, effective leadership and commitment to our mission. She will be greatly missed by the people of East Harlem and the Health + Hospitals family. Israel Rocha, CEO of NYC Health + Hospitals/Elmhurst and CEO of OneCity Health, will leave his OneCity post and take on the additional role as CEO of NYC Health + Hospitals/Queens, facilitating increased coordination across the two facilities to better serve the people of Queens. Matthew Siegler, Health System Senior Vice President of Managed Care and Patient Growth, will take on the added role as CEO of OneCity Health. Matt’s appointment will be subject to OneCity Health board approval. Each of these leaders have made vital contributions to the transformation of NYC Health + Hospitals and I am grateful for their willingness to take on added responsibilities to keep our progress on track. They are all effective advocates for our patients and staff, have deep understanding of what it takes to deliver quality care and have demonstrated an ability to respond to the unique needs of local communities. I am confident they will be able to seamlessly transition in their new roles and continue to move forward the strategic plans and commitments we have made to the patients, staff and communities we serve.

I’d like to congratulate Talya Schwartz, President and CEO of MetroPlus Health Plan, and Patsy Yang, SVP for NYC Health + Hospitals/Correctional Health Services, for being named in City & State’s “2020 Health Power 100” list. Talya was recognized for her leadership in helping our MetroPlus health plan succeed and Patsy for her work to transform the delivery of health care services in the City’s jails. City & State’s “2020 Health Power 100” program honors individuals in healthcare who are deemed by their peers and the outlet’s senior editors to be the most influential individuals in the industry as a result of their leadership and impact they have in the community we serve.