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REPORT TO THE BOARD OF DIRECTORS – June 2020

REPORT TO THE BOARD OF DIRECTORS – June 2020

Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS
PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
June 25, 2020

CORONAVIRUS UPDATE

NYC Health + Hospitals is Open and Safe for Care

As the City prepares for Phases 2 and 3 of the reopening, we are urging all New Yorkers to seek the care they need and deserve, and we stand ready to care for all patients safely and effectively whether they are existing patients or new to the system who need ongoing, preventative or emergency care. Patients in need of in-person appointments or who are seeking emergency care, will experience a new, safer patient environment. Our reopening plans includes: 1) increasing capacity to perform a higher number of scheduled medically necessary surgeries for existing patients; 2) increasing the capacity of limited in-person ambulatory care visits across the health system, while maintaining our hugely successful telehealth apparatus; 3) changing the physical layout of our emergency departments to maximize distance between patients in waiting rooms and care areas, while creating new spaces for isolation and negative pressure rooms to prevent the spread of diseases such as COVID-19; and 4) continuing to test and trace positive cases for COVID-19.

Yesterday morning, Senior VP and Chief Quality Officer Dr. Eric Wei, testified before the NYC Council Committee on Hospitals and shared our health system’s reopening plans, highlighting all of the work we have done to ensure our patient care sites are safe and ready to offer care to New Yorkers. Dr. Wei also shared that effective this week, NYC Health + Hospitals will ease restrictions on visitations in all of its 11 acute-care hospitals for the first time since the COVID-19 peak. Visits at each of the hospitals will be limited to just one visitor at a time per patient for four hours a day. Visitors will be advised to perform meticulous hand hygiene, be required to wear appropriate personal protective equipment (PPE), and undergo symptom and temperature checks upon entering the hospital.

New COVID-19 Centers of Excellence

The global public health community anticipates uncovering the long-term impacts of COVID-19 for generations to come. However, NYC Health + Hospitals is proactively establishing COVID-19 Centers of Excellence to begin caring for those who have already been impacted by this vicious virus. Three new NYC Health + Hospitals/Gotham Health sites will open this fall in communities of color that have been hardest-hit by the COVID-19 pandemic and provide the foundation for long-term health recovery. These new health centers in Bushwick, Jackson Heights, and Tremont, will specifically provide pulmonary care, radiologic and diagnostic services, as well as mental health services to help address anxiety, depression, post-traumatic stress disorder, and psychological distress. When it comes to the novel Coronavirus, the global medical community is at an unprecedented disadvantage of not knowing all of the facts and what to expect, but New York City won’t wait around to start assessing the long-term health impacts of this pandemic.

Success of Telehealth Expansion in Response to COVID-19

Earlier this month we marked an important milestone in our efforts to keep patients connected to care through our telehealth services. Within a week of documented community spread of the virus in NYC, we were able to convert all routine face-to-face visits to televisits, or scheduled telephonic visits. We quickly scale up, going from just 500 billable virtual visits in the month prior to the COVID-19 pandemic, up to nearly 57,000 in the first three weeks of the pandemic, and more than 235,000 televisits to-date. We also handled approximately 13,000 patient messages over six weeks during the pandemic through our MyChart patient portal, which allows patients to directly communicate with their care teams. Our transformation work over the past two years and our smart investments — to expand telehealth services and adopt a unified electronic medical record system — really served to lay the groundwork for this success.

NYC TEST & TRACE CORPS UPDATE

This month, the NYC Test & Trace Corps launched more testing sites and mobile testing vans serving the hardest-hit communities. Widespread testing remains our best defense against the virus and we are building capacity to reach 50,000 tests per day by July.

We also began our Trace work and have attracted and quickly onboarded a cadre of talented, passionate and trained professionals committed to improving public health — many from NYC neighborhoods hardest hit by COVID-19 — who have joined NYC Health + Hospitals to serve as Contact Tracers under the NYC Test & Trace Corps. They play a critical role in supporting New Yorkers who test positive for COVID-19 and identifying their close contacts to help prevent the spread of the virus. The work of our Trace team has already yielded great results:

  • The Test & Trace Corps is actively monitoring 6,395 cases.
  • They have reached 97% of cases with a phone number, and 84% of those were reached within 24 hours.
  • Of those who completed an interview, 74% offered at least one contact.
  • Through these efforts the Test & Trace Corps identified 652 symptomatic contacts. We estimate that assisting these New Yorkers to separate safely has potentially prevented more than 2,000 additional new Covid-19 infections.
  • New Yorkers are taking advantage of the Resource Navigators. These navigators assist with food and pharmacy delivery among other services. More than 2,000 have taken advantage of this program.

UNITED IN SILENT REFLECTION AGAINST HATE

2020 has been an extremely challenging and devastating year for our country with the disparaging effects of COVID-19 especially on Black and Brown communities, the biased attacks against Asians and other ethnic groups, 40+ million Americans unemployed, and the recent horrific police abuse that caused the death of George Floyd.

Health care professionals across the country and in NYC this month joined the ‘White Coats for Black Lives’ movement in solidary with thousands of Americans who have taken to the street to protest the repeated injustices.

I want to thank Dr. Allen and Natalia Cineas for sharing their solidarity, personal perspective and support for members of our workforce who have experienced the pain of injustice. I was particularly proud to support our staff in standing firm against racism and violence at a June 9 demonstration and moment of silence outside our facilities to honor the life and memory of George Floyd. The demonstration observed 8 minutes and 46 seconds of silence.

Staff all across our health system donned their masks, kept 6ft apart and shared the moment of silent reflection together as a powerful symbol of our unity, our values and our respect for our staff, patients and community.

We are taking additional action to support NYC Health + Hospitals’ ongoing efforts to promote racial and social equity. Our Human Resources Office of Diversity and Inclusion will be offering unconscious bias training to all employees – to recognize and address the effects of bias, and learn strategies to mitigate against implicit bias in the workplace. And next month we will launch a series of anti-racism dialogue sessions to hold real time, anonymous conversations with employees on the topic of implicit bias and racism.

FINANCE UPDATE

NYC Health + Hospitals is targeting to close the fiscal year with approximately $600M cash-on-hand, which includes major transactions that are in process including, State UPL and DSH payments, CARES Act funding, and a FEMA reimbursement advance.

  • The system is still losing approximately $23M per week due to volume declines, however, we have begun to see an uptick in recent weeks (OP visits are up 4%, IP admissions up 2%) and will continue to improve as NYC enters Phase 2.
  • Medicaid enrollment has increased nearly 5% which is expected to provide some financial benefit since these members will be enrolled in VBP arrangements.
  • H+H is continuing to develop its three-phased budget strategy for FY21 which will include major themes such as continued move to VBP, implementation of initiatives endorsed by the MRT II, and increasing access to telehealth services in a post-COVID environment.
  • We signed an MOU with the City of New York related to the Test & Trace program and held its first interagency working group aimed at coordinating policy and financial resources among the involved City agencies.

NYC Health + Hospitals has updated its claim submission to FEMA from the initial value of $650M up to over $1B. The change encompasses the increased scope that the system undertook including setting up the field hospitals (Billie Jean King Tennis Center and Brooklyn Cruise Terminal) 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, the health system received an additional $277.6M from the $10B CARES Act safety-net hospital allocation, bringing the total CARES Act relief received by the system to $1.1B. We are continuing to assess the distribution methodology for this payment to ensure that we received the appropriate allocation.

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