REPORT TO THE BOARD OF DIRECTORS – July 2019

The key Committee in the US House of Representatives has advanced legislation to avert the DSH cuts scheduled to take effect this October. Rather than simply delay the cuts, this legislation eliminates them for two years and then reduces their size by $4b in FY2022. The provision was included in a package with funding for community health centers and passed the committee unanimously with little debate. It does not appear the funding will be included in the recently announced budget package to raise the debt ceiling before Congress leaves for the August recess. However, the DSH package is poised to pass the House with overwhelming bipartisan support setting up action in the Senate in the fall.

We are excited and starting to count down toward the NYC Care program launch in the Bronx next week on August 1. Operational details, such as the enrollment process and call center workflows have been finalized and are being tested. The new 24/7 pharmacy access through extended pharmacy hours at all our pharmacies in the Bronx will be in place, as well as a new arrangement with a 24-hour retail pharmacy for emergency prescriptions overnight. The new call center and website will go live August 1, and our multilanguage advertising campaign will be visible in subway stations, bus shelters and strategic places across the borough where people live and work. We have selected five community-based organizations to lead the important outreach work and help us reach eligible New Yorkers who will benefit from the new program. Our staff recruitment is on track and with new extended hours of operation at our ambulatory care clinics, we’ll be ready to enroll our target of 10,000 NYC Care members in the first 6 months.

Today we announced the launch of a comprehensive, primary care-centered diabetes management program that includes investments in new clinical pharmacy staff, equipment, and telehealth strategies to help improve the health of more than 60,000 New Yorkers with diabetes who receive care in our public hospitals and community-based health centers. We are investing in these new programs to make primary care more robust and effective for patients with uncontrolled diabetes, and help them adhere to their medications, take care of their vision, get counseling from someone who has experienced the same challenges, and ultimately feel empowered to take charge of their health. The new NYC Health + Hospitals initiatives to help improve health outcomes for New Yorkers with diabetes include:

• Integrating Clinical Pharmacists in Primary Care – Twenty new clinical pharmacists will join the public health system by the end of 2020 to work as integrated members of primary care teams with a focus on medication management.
• Teleretinal Screening in Primary Care – Hospitals, Gotham Health centers and Correctional Health Services will offer advanced teleretinal screenings as part of routine primary care visits for patients with diabetes. Patients will be able to get their preventive care in a more convenient way instead of having to schedule a separate ophthalmology appointment.
• Peer Mentors a Phone Call Away – A telehealth pilot program that connects patients with diabetes with peer mentors on the phone to help enhance their diabetes self-management. This remote workforce of peer mentors helps address each patient’s barriers related to the social determinants of health while inspiring healthy lifestyle behavioral changes.
• A Coach in Your Pocket Smartphone App – Another telehealth pilot — an app that provides real-time, individualized coaching, reminders and support, as well as diabetes educational tools that are actionable and personalized for each patient to monitor and manage their type-2 diabetes. The app helps to bridge the gap between patients and their providers outside of the clinic visit.

I joined Mayor de Blasio and Deputy Mayor Palacio earlier this month to announce that our public health care system will cease participating in the federal Title X program for as long as the “gag rule” is in effect. The rule prevents medical providers from sharing information and counseling about abortion to their patients. I sent a directive to all NYC Health + Hospitals personnel instructing doctors and nurses to support patients on whatever pathway they choose, including providing referrals to abortion and reproductive health services. The mayor was very clear in expressing his belief that the doctors and nurses at NYC Health + Hospitals took an oath to protect and serve patients. And we will do whatever’s necessary to ensure they are able to provide the best medical treatment. The decision to reject Title X funds sends a clear message that we will not stand by while the Trump Administration tries to censor our providers and prevent them from giving patients information about abortions.

NYC Health + Hospitals Arts in Medicine has selected nine artists to lead community-based mural projects at hospitals and post-acute care facilities in our health system. The artists, chosen from more than 100 applications, will engage patients, staff, and local community residents to create an integrated internal or external mural as a tool to encourage creativity, build trust and engagement between the patient care facilities and their communities. They will begin their work August 1. The project is a flagship component of our arts-based initiatives, made possible through the Laurie M. Tisch Illumination Fund and the Mayor’s Fund to Advance New York City. Arts help celebrate shared history and culture, and it also promotes healing and reduces stress. We are proud to work with these talented artists who will be helping us create emotionally nourishing spaces for the communities we serve.

NYC Health + Hospitals has again partnered with Harvest Home Farmers Market and GrowNYC, two local non-profit organizations, to host farmer’s markets and fresh food box programs at patient care locations throughout the city and make fresh fruits and vegetables more accessible for patients, staff, and the community. Farmers markets offer a variety of affordable, regionally grown vegetables, fruits, and fresh juices in communities where residents sometimes lack access to quality produce at reasonable prices. Shopping at farmers markets supports regional agriculture and helps educate communities about the importance of healthy eating through on-site cooking and nutrition demonstrations, health tips, and healthy recipes, and as well as information about how eating fruits and vegetables can prevent or control the symptoms of obesity and chronic disease. Part of our work at Health + Hospitals is to understand the needs of the communities we serve to guarantee they have all the tools necessary to live healthy lives. Proper nutrition is foundational to good health and we want to make sure we’re providing New Yorkers with affordable and convenient food options to help control or avoid chronic health conditions.

NYC Health + Hospitals and St. George’s University School of Medicine selected 12 students from the New York metropolitan area to receive a total of $1.8 million in CityDoctors scholarships in return for their commitment to practice primary care medicine for at least two years at one of the 11 public hospitals following their medical training. Since its inception in 2012, the CityDoctors scholarship program has awarded 113 aspiring and current doctors with scholarships worth a total of $12.3 million through the NYC Health + Hospitals partnership. This is an important and reliable pipeline of well-trained doctors who have expressed an early commitment to primary care along with a heart-felt connection to the people we serve.

MetroPlus Health Plan, the City’s Public Option component of Mayor de Blasio’s Guaranteed Health Care for All initiative, announced its Member Rewards Program exceeded expectations in serving as an incentive for members to take a more active role in their own health care. The program uses health intelligence and gamification, and allows members to accumulate points for primary care visits, dental check-ups, preventive screenings and other healthy activities. More than 300,000 New Yorkers who have MetroPlus earned 150 million rewards points last year – valued at more than $15 million worth of products from the MetroPlus rewards catalog. More than 60 percent of eligible MetroPlus members participated in the program with 94 percent of members surveyed reporting that the program has helped them improve their health. We want New Yorkers to see their primary care physician as often as necessary to ensure they stay healthy. This rewards program is a great incentive to get them to do the right thing for their health.

Earlier this month we were joined by New York State Senator Gustavo Rivera and Independence Care System of New York (ICSNY) Senior Vice President Marilyn Saviola to celebrate the newly renovated radiology suite at NYC Health + Hospitals/Gotham Health, Morrisania that’s designed to enhance access for people with disabilities. The space features modified mammography machine to enhance accessibility for women who use wheelchairs, a moveable examination table, and a patient lift. The facility also widened exam rooms to accommodate wheelchairs. The renovated space will now enable women with disabilities to receive accurate mammogram and/or preventative OB/GYN care for the first time. While women with disabilities get breast cancer at the same rate as other women, they die from breast cancer at a much higher rate because they do not get timely screenings and treatment. The renovated suite will also enable the facility to increase capacity and facilitate additional procedures, such as sonograms and dual energy x-ray absorptiometry, which were not possible before. The $853,294 renovation was funded by the NYC City Council with support from ICSNY.

As part of this event, we also had the opportunity to present a special award to Marilyn Saviola for her advocacy for people with disabilities and her life-long efforts to protect their right to quality health care. Marilyn is the founder of ICSNY Women’s Health Program and has been a fierce advocate for spaces and technology that enable women with disabilities to receive accurate mammogram and preventative OB/GYN care. Thanks to her efforts, preventative, gender-specific health services, such as breast and cervical cancer screenings, are more widely available in New York. She continues her work to expand these services, as well as to add accessible primary care, which will benefit both women and men. Many women will live longer and healthier lives because of Marilyn’s tireless efforts, and we are grateful for her support and partnership.

NYC Health + Hospitals/Bellevue won the 2019 Pinnacle Award for Quality and Patient Safety from the Healthcare Association of New York State (HANYS) for reducing the rate of ventilator-associated pneumonia (VAP) in adult trauma patients and achieving 100 percent compliance with best practice care protocols. The hospital team succeeded in reducing VAP in trauma patients from 3.5 percent to 0.5 percent through interventions including data analysis to determine the most at-risk patients, ventilator care protocols, an oral care tracking system, sedation guidelines and real-time monitoring. The hospital team also credits its success to improved teamwork among physicians, nurses, and respiratory therapists. By preventing hospital acquired infections in critically ill patients, the team helped patients recover faster, decreased duration of mechanical ventilation, avoided antibiotic use, and helped reduce healthcare costs.

NYC Health + Hospitals/Bellevue celebrated the installation of a new state-of-the-art Computerized Tomography (CT) Scanner in the Emergency Department, part of a series of modern, high-technology additions to the Radiology Service planned over the summer at the hospital that will reduce wait times, produce faster and better image quality, and lead to quicker diagnoses and treatment for patients, particularly critical patients in the Emergency Department. The $6.5 million dollar project will add a total of four new state-of-the-art medical machines at the hospital: two new CT Scanners and two new MRI machines. The Radiology and nursing staff now have new, state-of-the-art and dependable medical equipment to support patient care and provide more efficient and effective diagnosis and treatment.

NYC Health + Hospitals/Elmhurst, in partnership with Centering Healthcare Institute, launched a new program for pregnant women aimed at reducing preterm births and encouraging greater patient engagement during the prenatal experience. The program will feature group pregnancy visits with obstetricians, networking with other pregnant women, group discussions, and prenatal wellness and education classes on nutrition, stress management, and breastfeeding. Improving maternal health has been a central focus of the de Blasio administration, and this effort builds on the efforts undertaken by NYC Health + Hospitals to ensure safe maternity care at all our hospitals. We are excited to offer expectant mothers an opportunity to share their experience with other new mothers and learn together about many topics they often must navigate alone. These prenatal group care sessions have been proven to help patients improve their self-confidence, decrease rates of preterm and low-weight babies, and contributes to the reduction of racial disparities in preterm birth.

On June 19, 2019, NYC Health + Hospitals received the Adam Solomon Award for Excellence from the Tanenbaum Center for Interreligious Understanding for our leadership in educating health care providers on how to respectfully deliver care to the religiously diverse patients we serve across New York City. We work with the Tanenbaum Center to offer our staff the training they need to help build practical skills to assess and meet a patient’s religious or spiritual and cultural needs, as well as understand key demographics and trigger topics in health care related to religious beliefs and accommodations. The trainings discusses real-life case scenarios and strategies for culturally responsive engagement to improve patient safety, satisfaction, and quality of care. We are proud of this recognition and thank our Office of Diversity and Inclusion for leading these important efforts that ensure our excellence in providing culturally responsive services. Thanks to board members Jose Pagan and Helen Ortega for participating in the awards celebration.