REPORT TO THE BOARD OF DIRECTORS – June 2021

We continue to see steady declines in COVID-19 hospitalizations and ICU admissions – and have the lowest rates we have seen since last August/September – with hospitalizations in the 30s and less than 10 ICU cases system-wide. We have come a long way and are feeling very hopeful for New York City’s recovery. Of course, the pandemic is not over and we remain focused on testing and vaccination.

With cases declining, our NYC Test & Trace Corps team has continued to provide a strong layer of protection for NYC. We are currently reaching 95% of all new cases. We have also served more than 21,000 total guests in our Take Care hotel program. To date, NYC Health + Hospitals has completed more than 3.5 million COVID-19 diagnostic tests at all of our sites, including our hospitals, Gotham Health centers and Test & Trace locations.

This week we marked a major milestone in our vaccination efforts – we administered our one-millionth vaccine. Twelve-year-old Ciara McAvoy and 71-year-old Francisca Lind helped mark the occasion by receiving their first and second doses, respectively, at NYC Health + Hospitals/Coney Island. This historic moment was captured live yesterday by Mayor de Blasio during his daily press conference, where the Mayor expressed his deep appreciation to everyone at NYC Health + Hospitals who have served such an important role in fighting this pandemic. McAvoy is the daughter of Jeffrey McAvoy, an Executive Assistant who joined the hospital this past year in the beginning of the COVID-19 pandemic. Lind is a patient of NYC Health + Hospitals/Coney Island and resident of South Brooklyn.nn

All of our hospitals and clinics have been working tirelessly to get anyone who wants to be vaccinated, vaccinated. The numbers today show that work. Because our public health system has built the trust of immigrant communities, Black and Brown communities, and low-income communities, we have been able to proudly narrow vaccine disparities in NYC.

I am very pleased about this ruling. The Affordable Care Act has guaranteed health care to thousands of New Yorkers. It has allowed them to identify ahealth care plan that suits their needs and budget. As a primary care physician, I know that having health care gives people peace of mind, and today New Yorkers can once again rest easy that their insurance through the ACA will not be taken away. In New York City we know that health care is a human right, which is why NYC Health + Hospitals’ mission is to serve everyone regardless of their ability to pay or immigration status. This should be the last time the ACA is ever challenged in the Supreme Court as it is now part of the health care fabric of this nation.

NYC Health + Hospitals/Jacobi and NYC Health + Hospitals/North Central Bronx (NCB) formally merged as of Feb 27, 2021 to become one CMS hospital entity with two distinct campuses that continue to provide quality, responsive care to their local communities. We were successful in protecting the acute care hospital designation for NCB while continuing its role as a provider of psychiatric services to the community. We have also achieved operational efficiencies to support staff and improve patient experience, and we have increased the medicine/surgical census. Initially due to COVID-19, and now due to increased volume and census at Jacobi, NCB has become an extension of Jacobi, with more than 700 patients who transferred from Jacobi to NCB since December. All the transfers were voluntary. All patients requiring admission to Jacobi were offered a choice between NCB and Jacobi, and half chose NCB. All were transferred without complications nor complaints. This has been a seamless merger, and has made a positive impact on several levels: it helped keep Emergency Department length of stay at acceptable levels, improved case mix index at both campuses, and has allowed us to focus on the higher acuity patients and surgeries.

The NYS Legislature concluded its legislative session earlier this month. This was a challenging year, as the Capitol remained closed due to COVID-19 protocols and session mostly operated remotely. A total of 892 bills passed both houses, an increase of 116% over last session. These bills will be considered by the Governor through the end of the year. We continue to review the impact of these bills on the health system.

As expected, there were many bills related to the pandemic response, including a package of bills related to Nursing Homes protocols. As previously noted, the Legislature passed two bills that set staffing-related requirements in hospitals and nursing homes, respectively. The hospital clinical staffing committee bill was a product of negotiations between health care labor unions and hospital associations. The nursing home bill mandates specific hours of care per resident and was not a product of negotiations. Both bills were signed into Law on June 18.

Although important telehealth reforms were enacted in the budget, unfortunately the bill related to telehealth payment parity provisions did not pass. Likewise, two equity related bills we advocated for did not advance, namely the NY Health Act and Indigent Care Pool reform. We will continue to work with the sponsors to see these bills enacted. Despite the record number of bills, we do expect the Legislature to return this summer to address a variety of issues that were left unfinished.

NYC Health + Hospitals had a closing Cash Balance of $550M (25 days cash-on-hand) through May. The health system achieved a net budget variance of $160M, exceeding the budget by 1% through April FY-21. The variance excludes T-2 revenue and includes about $401.7M in COVID costs that we have not yet received Federal relief for. Our direct Patient Care Receipts came in $446M higher than YTD April FY-20 continuing the pace of positive performance that we experienced during FY-20, where direct patient care revenue came in $500M over the prior year. Our patient care volume is returning to pre-COVID levels in Q3 of FY-21 but is still below Q3 FY-20. Revenue base is strong and resilient primarily driven by Medicare rate increases and the stability of VBP/sub-cap contracts. Overall, our Strategic Financial Initiatives remain on track with our post-COVID strategies, generating $523M with a line of sight of $650M. Strong areas of performance include:

• Value Based Payment Initiatives
• Managed Care Contract Negotiations
• Revenue Cycle Improvement
• We have made staffing investments consistent with our overall system needs with additional RN and targeted nursing support positions (specifically Patient Care Associates and Behavioral Health Associates) to help support COVID surge needs and stabilize ongoing services.

• Dr. Eric Wei Named Among 50 Most Influential Clinical Leaders
• Dr. Katz Named Among 2021 Pride Power 100
• NYC Health + Hospitals Opens Gender Affirming Services Practice for LGBTQ Patients in the Bronx
• Chercares Donates COVID-19 Testing and Vaccination Bus to NYC Health + Hospitals Test & Trace Corps
• NYC Health + Hospitals Test & Trace Corps and New York Public Library Announce Partnership To Bring Mobile COVID-19 Vaccination Clinics to Communities in Need
• NYC Health + Hospitals Receives Grant to Evaluate High-Risk Medication in Older Adults
• NYC Health + Hospitals Test & Trace Corps Announces Mobile Language Teams for Vaccination
• Music for the Soul Returns, Providing Live Music for Healthcare Workers