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Mitchell H. Katz, MD
July 30, 2020


Our thoughts go out to the southern and western parts of the country who are struggling with COVID-19 surge. It’s a sober reminder that while NYC is doing relatively well, we must prepare for potential future surges in NYC. Our readiness includes surveillance for early warning signs of increasing cases, hardwiring our alternative care and ICU surge spaces, incorporating lessons learned into our emergency operations plans, and working closely with local and state partners on improved coordination.

Visitation – Last month we began to safely ease restrictions on visitations in all our 11 acute hospitals for the first time since the COVID-19 peak. Limiting visitors during the surge was a difficult but necessary decision to ensure the safety of our staff, patients, and their loved ones. Following State guidance, visits are limited to just one visitor at a time per patient for four hours a day. Patients in all departments of the hospitals are now allowed visitors. And we are enforcing meticulous hand hygiene, requiring face coverings, and doing symptom and temperature checks to keep everyone safe. We’ve been excited to welcome people back to provide patients the love and support they need to heal – and we’ve seen more than 13,000 visitors in the first month of limited visitation.

Surgical Services – As a system we are currently at 92% of pre-covid surgical productivity. In fact, several facilities have exceeded pre-covid productivity with surgical volumes at 101% (Bellevue) , 113% (Harlem) and 126% (Jacobi) of pre-covid volumes. While we are re-opening our operating rooms, we are also improving our operational efficiencies by tracking the first case on time starts, surgical case cancellations rates, and the amount of time between cases. Kings County, Coney Island, Jacobi, Lincoln, Metropolitan, Queens and Woodhull all have on time starts better than target. (> 80%). And Kings County leads the system with the lowest case cancellation rate (2%). There is great enthusiasm among all of our facilities to get back to work, increase the volume of cases and transform the entire surgical experience to a high-quality experience for both surgeons and patients alike.

Ambulatory Care Re-opening – Since early March, we have completed greater than 465,000 televisits Enterprise wide. Currently, we are completing 24,000 televisits / week enterprise-wide. At the present time, 62% of all ambulatory care visits are in-person visits. Throughout the pandemic, Primary Care and General Behavioral Health maintained their pre-covid productivity.


It’s been approximately two months since standing up the nation’s largest contact tracing initiative and I’m pleased to report that the NYC Test & Trace Corps is now reaching more than 95% of new coronavirus cases across the City, and we are right at our evidence-based benchmark of having 75% all new cases completing intake, meaning they are isolating at home or at a hotel with our help. We know the importance of our efforts to keep New Yorkers both safe and healthy and currently the rate of new COVID-19 cases and hospitalizations are the lowest since the COVID-19 epidemic began. It’s exciting to see that our efforts are working, giving us the reassurance we need to reopen our City safely.

This week we distributed $7.8 million in grant funding to community-based organizations who will be helping us promote COVID-19 testing and tracing in neighborhood hardest hit by the virus. These 38 community-based organizations selected serve low-income and vulnerable communities across the five boroughs at increased risk of contracting COVID-19 and will help educate the public on how to protect themselves from COVID-19 and the role of the Test & Trace Corps in the City’s public health response. As we emerge from the crisis, we are doing everything we can and working with our community partners to deliver care to New Yorkers in the heart of these hart hit communities and ensuring they have the tools they need to protect themselves and their loved ones.


  • NYC Health + Hospitals closed FY20 with approximately $680M cash-on-hand, beating our initial target of $600M.
  • We are losing approximately $15M per week in July due to volume declines. However, there has been an uptick with volume increases of 27% for outpatient and 9% for inpatient since the end of May (outpatient remains 17% off baseline, inpatient remains 13% off baseline).
  • Medicaid Managed Care enrollment in MetroPlus and Healthfirst has increased by 8.5% since January, which should yield a financial benefit to the system as these members will be enrolled in Value Based Payments arrangements. We expect that there may be some declines in these enrollment figures in the fall as disenrollments are expected to begin again at that time.
  • We will finalize our three-phased budget strategy for FY21 by the first week of August. The final budget will include systemwide initiatives and facility specific business plans tailored to meet the needs of the community. The major themes of systemwide initiatives include continued move to Value Based Payments, implementation of initiatives endorsed by the MRT II, and increasing access to telehealth services in a post-COVID-19 environment.
  • Consistent with our Memorandum of Understanding, the City will be transferring nearly $100M to support T2 spending commitments to-date.

Federal Relief

  • NYC Health + Hospitals has been informed by OMB and the State that we will receive $199M within the next two weeks as an advance related to our initial submission of $650M.
  • Our revised FEMA cost estimate could reach an estimated $1.6B and will be submitting these revised estimates to FEMA. The change encompasses the increased scope that the system undertook including setting up the field hospitals and higher-than-anticipated contracted staffing commitments for nursing and respiratory therapists due to greater levels of staff absences and higher patient volume.
  • Thanks to our ongoing advocacy efforts, H+H received an additional $120M from the CARES Act Provider Relief Fund from the general distribution, high-impact (hot-zone), and safety-net hospital allocations, bringing the total Provider Relief Fund allocation received by the system to $1.2B. We are continuing to assess the distribution methodology to ensure that we have received the appropriate allocations and is being treated fairly. Furthermore, we continue to review and seek guidance on the interrelation of Provider Relief and FEMA funds, and are strongly advocating for the flexible use of these Provider Relief Funds to allow us to serve our patients full range of needs throughout this pandemic.



NYC Health + Hospitals’ President issued a Declaration of Emergency dated March 1, 2020, which was reissued April 1, 2020. A summary report was provided at the April 30, 2020 Board meeting, at which time it was reported that NYC Health + Hospitals (the System) had entered into a total of 68 new contracts to support the COVID-19 response effort. It was noted these included a wide range of agreements made, including agency staffing, hotels, pharmaceutical, telemedicine, and transportation. In addition, emergency purchase orders had been issued against existing contracts to obtain additional medical equipment and supplies needed in our hospitals as well as with new vendors, given the need to source scare supplies more broadly.

The April 30, 2020 summary included that the Office of Facilities Development was managing emergency construction in every one of our hospitals to increase bed capacity through task orders issued against existing contracts and through the award of several key new contracts.

The report also noted that the Office of Facilities Development was managing substantial construction projects at Coler to create Roosevelt Island Medical Center (RIMC) with 320 beds out of available space at NYC Health + Hospitals/Coler and to create 120 ICU beds out of unused or administrative space at NYC Health + Hospitals/North Central Bronx.

Update through June 30, 2020

Since the April 30, 2020 report, the NYC Health + Hospitals’ President issued a subsequent Declaration of Emergency for the month of May 2020, and a more limited Declaration of Emergency for the month of June, 2020. Another limited Declaration of Emergency has been issued for the month of July 2020 and any contracts entered into during July will be reported on at the next Board of Directors Meeting.

Since the last report up through June 30, 2020, the System has entered into 14 additional contracts; these include contracts with 6 staffing agencies, 7 contracts for testing and tracing support, and one consultant agreement to assist with FEMA reimbursement. Most of the now 82 contracts executed under the COVID-19 emergency authority are no longer being used, with the exception of Testing and Tracing support, laboratory testing services, the consultants for FEMA reimbursement, and some supplemental staffing support. Through June 30, 2020, the System has paid $623,550,000 for services under these emergency contracts.

The Office of Facilities Development continues to provide support to the System facilities, concentrating on infrastructure upgrades for patient, staff, and visitor safety, as well as supporting the Testing and Tracing program throughout New York City. There are a total of 49 additional work orders through June 30, 2020, with a total maximum authority to spend $54,265,116. This brings the total Office of Facilities Development maximum authority, since March 1, 2020, to $223,586,174.