REPORT TO THE BOARD OF DIRECTORS – July 2014

We recently learned from the State Department of Health that HHC will receive an initial award of $35.5 million from the state’s Interim Access Assurance Fund (IAAF), a Waiver fund intended to temporarily support participating providers under significant financial threat. This early infusion of funds will help with our cash flow shortages. But, more importantly, it will ensure HHC can take the first steps to be much more than an active participant in this process and become an indispensable leader in the transformation of healthcare delivery in our city and our state. We are grateful to the State for releasing these funds so promptly. We initially submitted a request to the state for $213 million, and have received indications that HHC will receive more funding at a later time.

Today, HHC submitted its initial planning applications for the Delivery System Reform Incentive Program (DSRIP), the $6.42B Medicaid Waiver program intended to both transform care delivery in NYS and significantly reduce costs, with overall program goal of 25% statewide reduction in preventable admissions over a five-year timeframe.

In our planning applications, we specify that seven HHC hospitals will lead seven Performing Provider Systems (PPS), each of which will undertake 7-10 clinical projects intended to improve the health of Medicaid and uninsured patients in its local geographic area. My thanks to the members of our Corporate Steering Committee, who continue to guide the difficult work of strategic alignment, partnership formation, community needs assessment, and project selection, with advice from our consultant vendor KPMG.

We will continue to monitor forthcoming guidance from NYS DOH on the remainder of Waiver funding dedicated to development of Long-Term Care workforce and Health Homes.

Mayor Bill de Blasio announced yesterday that the City of New York reached tentative contract agreements with 1199 SEIU United Healthcare Workers East (1199SEIU) and the New York State Nurses Association (NYSNA). As part of the tentative contracts, the City and the unions have agreed to set up a first-of-its-kind childcare and eldercare fund for member’s dependents and to fund and restructure a new, innovative employee-training fund. The City and NYSA have also agreed to create Nursing Practice Councils at each HHC facility, focused on evidence-based initiatives to improve the patient experience, ensure excellent outcomes and encourage recruitment and retention of the best nurses.

I am deeply appreciative of the sustained efforts of Mayor de Blasio’s office and our organized labor partners in reaching these tentative contract agreements. They reflect the reform-minded, innovative thinking that benefits our employees and our health system, as we pursue the transformations required to better serve our patients in a rapidly changing healthcare delivery environment. I am particularly pleased by the collaboration envisioned by the Nursing Practice Councils to enhance the patient experience and the quality of care at our facilities. My congratulations to all those who have worked tirelessly in reaching these milestone agreements.

Queens Hospital Center was recently the third hospital in New York City and the first one in Queens to be designated “Baby-Friendly” by Baby-Friendly, USA. The international designation is sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to recognize hospitals with maternity facilities that offer optimum levels of breastfeeding support and a strong environment for maternal-infant bonding. The other two NYC hospitals to achieve the designation were HHC’s Harlem Hospital, in 2008 and NYU Medical Center is 2011.

The certification process for Baby-Friendly status has validated QHC’s efforts to advance the care of pregnant women, mothers and newborns at health facilities that provide maternity services for protecting, promoting and supporting breastfeeding, which is known to lower risks for certain diseases and improve health outcomes for mothers and babies.

Researchers at HHC’s Jacobi Medical Center in the Bronx have helped to develop a method to genetically modify T-cells within the body to make them more resistant to HIV, the human immunodeficiency virus that causes AIDS. The researchers believe that similar technology could be used in the future to target problematic genes and cells to reduce disease for a variety of other illnesses and infections as well.

The results of the study were recently published in the prestigious New England Journal of Medicine.

Under the clinical leadership of David K. Stein, MD, Director of Adult HIV Research at Jacobi and Associate Professor of Clinical Medicine at Albert Einstein College of Medicine, five patients who have the HIV virus participated in the study at Jacobi. Another seven patients with HIV participated at the University of Pennsylvania.

Jacobi Medical Center has an extensive history of pioneering HIV/AIDS research and treatments. These efforts are part of a citywide initiative have produced measurable results. Just this year, the New York City Department of Health announced that AIDS is no longer among the top ten causes of death in New York City. This is the first time the disease has fallen off this list since the epidemic began in 1983.

Three HHC hospitals were recognized in June by Healthgrades for top performance and high patient safety ratings in women’s health services. Coney Island Hospital and Queens Hospital Center both received the Healthgrades 2014 Maternity Care Excellence Award, a distinction that Coney Island also earned in 2012 and 2013. Woodhull Medical Center received the Healthgrades 2014 Gynecologic Surgery Excellence Award, which it also won in 2013. The awards are given to hospitals that perform in the top ten percent of all hospitals analyzed by Healthgrades across 17 states, and patients who have procedures at these top-performing hospitals have a significantly lower chance of experiencing complications than they do at hospitals rated poorly by Healthgrades. I commend Coney Island, Queens and Woodhull for their quality work in this area.

Eight HHC hospitals will host farmers markets this year, helping to make fresh fruits and vegetables available and promote healthy eating habits for all New Yorkers. Farmers markets directly support HHC’s efforts to make communities healthy and bring affordable food options to more and more neighborhoods.

HHC’s farmers markets offer a variety of regionally-grown vegetables, fruits, fresh juices and flowers in communities where residents sometimes lack access to fresh fruits and vegetables at reasonable prices. Numerous programs are in place to help residents take advantage of farmers markets, and shoppers can take advantage of a variety of payment options, including EBT/SNAP, Health Bucks, Green Checks, Senior Farmers Market Nutrition Program (FMNP) coupons and Women, Infants and Children (WIC) coupons.

To help meet the growing need for mental health professionals, Touro College and University System and HHC are joining to educate physician assistants (PAs) with a focus in psychiatry. The new initiative is designed to help address the growing shortage of psychiatrists in the United States and the tri-state area, which is expected to worsen exponentially over the next few years. The shortage requires innovative training that will produce an adequate number of clinicians to keep up with the demand for mental health services and address the limited access to care for thousands of patients suffering from mental illness.

Beginning with a pilot initiative in summer 2014, Touro’s School of Health Sciences will offer a new “Behavioral Health Option” that includes a four-month rotation in psychiatry at HHC public hospitals. This goes beyond the core curriculum and rotations currently offered to master’s level students enrolled in Touro’s Manhattan PA program. HHC is the major provider of behavioral and mental health services in New York City, and will link Touro students to an extensive health network within the tri-state area.

PAs are healthcare professionals certified to practice medicine as part of a health care team with physician supervision. They can prescribe medication, perform physical exams, diagnose and treat illnesses, and order and interpret lab tests in collaboration with physicians. Students enrolled in Touro’s behavioral health option who complete the PA curriculum and clinical experiences will perform day-to-day psychiatric evaluations and management tasks in in-patient, emergency and out-patient settings for psychiatric disorders; identify and triage medical/medication complications, changes in conditions, psychiatric and overlapping medical emergencies; and provide psychotherapeutic methods to improve outcomes for common mood, anxiety and psychotic illnesses.

The Joint Commission arrived on Tuesday this week for its first survey of the recently opened Henry J. Carter Specialty Hospital and Nursing Facility. The surveyors completed the survey earlier today. Both the Nursing Facility and Hospital did very well. The facility received a full three-year accreditation. The Life Safety surveyor complimented Leadership, staff and systems in place, saying “hats off to the organization for what they’ve done to protect their patients during Hurricanes Irene and Sandy. They lived it and proved it”. The Long Term Care Nurse Surveyor commented that “she observed that staff were really engaged in quality and safety, and that families she spoke to were extremely complimentary of the care received by their family member.” The Physician Surveyor also noted during the leadership session that the organization is very committed to becoming a high reliability organization, as demonstrated by their patient safety and performance improvement outcomes.

Congratulations to Executive Vice President/Acting Senior Vice President Antonio D. Martin; Executive Director, Robert Hughes; Medical Director Yolanda Bruno, MD; Chief Nurse Leah Matias, RN; Associate Executive Director of Quality Management/Regulatory Affairs Steven Catullo; and the staff.

This concludes the last survey in the 2014 cycle. In 2015, Coney, Kings County, Lincoln and Metropolitan are scheduled to be surveyed.

The New York State Legislature adjourned on June 20th. HHC was successful in advocating against legislation that would have largely prevented the Corporation from using Job Order Contracts, which are an important procurement option employed to complete critical projects in a timely manner. We were pleased that both houses passed legislation to eliminate duplicative surveys of outpatient mental health and substance abuse services. Other legislation that would have impacted HHC failed to pass both houses, including bills that alter the rules governing medical malpractice and legislation imposing inflexible nurse-to-patient staffing ratios in hospitals and nursing homes. Staff will provide a comprehensive overview of the outcome of the 2014 Legislative Session at the July Strategic Planning Committee Meeting.

The City Council formally passed the FY15 Budget late last night following the announcement at the end of last week that an agreement had been reached. The $75 billion spending plan maintained the level of financial support for HHC that was proposed in the Executive Budget. Funding for City Council initiatives that was baselined last year was also maintained and includes support for HHC’s Child Health Clinics, Expanded HIV Testing, Behavioral Health programs and HHC’s unrestricted subsidy. The spending plan includes $12 million in Capital funding for several of HHC’s facilities to purchase new equipment or make needed renovations so that we can better serve our patients. We are very appreciative of the support that the Council and Mayor provided to HHC in this year’s budget.

On June 11th, about 100 HHC staff members gathered at Harlem Hospital Center for the first Guns Down, Life Up (GDLU) Internal Planning Retreat organized by The Fund for HHC.

The event brought together staff from HHC facilities with existing hospital-based violence interruption programs and those who are interested in learning more about GDLU efforts to reduce violence in our neighborhoods and communities. They were joined by leaders of other gun violence reduction movements (Harlem Mothers S.A.V.E. and I Love My Life/LifeCamp) and representatives of HHC’s non-governmental partner organizations (Operation SNUG, Man Up!, and S.O.S. Crown Heights) for a day of networking, sharing of best practices, and strategic planning for The Fund’s citywide Guns Down, Life Up Summit to be held in the fall.

Guns Down, Life Up is the broad title under which HHC’s response to violence in our communities is organized and supported by The Fund for HHC. The planning retreat showcased GDLU programs already established successfully within HHC and advanced the discussion for facilities that are interested in building programs that can address, reduce, and intervene in the cycle of violence.

Network Senior Vice President Denise Soares, RN, provided opening remarks and I delivered the keynote address at the event. Every HHC hospital was represented at the planning retreat, and actively participated in the first stages of The Fund’s planning of the citywide summit that will bring together all stakeholders committed to reducing gun violence in New York City.

HHC will release Better, its first report to the community in eight years, in early July. An early copy is included in your packet today. This comprehensive document highlights the many accomplishments of HHC’s leadership and staff since 2006 that enabled us to make significant progress toward our strategic and organizational goals.

Better captures our improvements in patient safety and quality, the adoption of new care delivery models, and describes how advancements in IT and robust work in Breakthrough are supporting our transformation into a more integrated, efficient, and effective healthcare system.

Although the document speaks to the challenges and uncertainties that we face, it also tells the story of the many ways in which HHC is a better healthcare organization — providing better patient care and better population health at a better value. The report to the community, which will be available in print and electronically, will provide a compelling portrait of HHC’s work on many fronts to a wide range of audiences and stakeholders.

I want to give the warmest possible thanks to my predecessor, Alan D. Aviles, whose inspired leadership as President of HHC drove most of the changes that are spoken of in this report. His unwavering dedication to the best healthcare for all New Yorkers has produced a quality organization, committed to constant improvement — a pleasure for me to lead.

Today I want to bring your attention to one of the many areas where HHC’s commitment to providing high quality healthcare to all New Yorkers shines — our work with our Lesbian, Gay, Bisexual and Transgender (LGBT) patients.

HHC practitioners have long been aware that LGBT adults face barriers to seeking healthcare. Many will delay medical care and limit information they share with healthcare providers out of fear of discrimination and uncomfortable environments.

We also saw early that our employees will benefit from special training to ensure that they provide respectful, patient-centered and culturally competent healthcare services to LGBT New Yorkers who are served by the public hospitals, community health centers and nursing homes each year.

In 2011, HHC became the first public healthcare system in the United States to mandate a Cultural Competence Training program for staff. Part of the training included a video “To Treat Me, You Have to Know Who I Am,” to help staff better understand LGBT patients to improve access to healthcare and help reduce health disparities related to sexual orientation and gender identification. HHC continues to offer staff training sessions to secure the Human Rights Campaign’s (HRC) designation “Leader in LGBT Healthcare Equality” for hospitals and health centers in the system.

To demonstrate the excellent care we provide, HHC recently announced the opening of a new health center in East Harlem — the Comprehensive LGBT Health Center at HHC’s Metropolitan Hospital — to provide primary, preventive and specialty care by a team of professionals who are specially trained to manage the health care needs of the LGBT community. The hospital is designated as a “Leader in LGBT Healthcare Equality” by HRC and has earned top marks for its commitment to equitable, inclusive care for LGBT patients and their families. I recently joined Metropolitan Hospital Executive Director Meryl Weinberg, patients and community advocates to mark the opening of the health center.

The Metropolitan Hospital Comprehensive LGBT Center will be staffed by primary care physicians, nurses, health educators, patient advocates, and other healthcare professionals who have been working across disciplines, and in conjunction with community based organizations and patients, to ensure that the center meets the needs of LGBT patients. Services include men’s health, OB/GYN and women’s health, trans/affirmative care, senior health, HIV screening and treatment, infectious disease risk reduction and prevention, family planning, specialty immunizations, addiction counseling and rehabilitation services, behavioral health services, community-specific support groups, art therapy groups, referrals and other specialty service linkages.

Through awareness, training and top quality healthcare, we hope to make it clear to our LGBT patients — and indeed all New Yorkers — that no one will be left behind in our mission to provide comprehensive health services of the highest quality to ALL New Yorkers, regardless of their ability to pay.

Now I want to tell you a brief story.

Earlier this month, a 14-year-old boy was struck by a car as he crossed a Brooklyn street near an intersection that neighbors say is notorious for accidents. The teenager was taken to the hospital in critical condition and, sadly, he died a short time later.

The boy was not treated an HHC hospital. Yet some special HHC employees were called on to provide an important service to the community after this tragic accident.

The boy who died attended school just a few blocks from Metropolitan Hospital and his classmates were in need of grief counseling. Without hesitation, the members of the Behavioral Health Social Work Team at Met were immediately available to serve the children in that school who were left behind in sadness and confusion.

I’m talking about a team of social workers at Metropolitan Hospital who together have decades of experience working with adults and children with chronic and persistent mental illness. On any given day, they provide counseling and support to the patients in our care and are a vital part of the clinical team. But on this day, the day the boy was killed by a car, they were called on to serve our community and share their expertise beyond the walls of our facility.

Over the course of three days, these five HHC employees, trained and licensed social workers, most of them bilingual, individually counseled more than 50 children. The students were extremely sad at losing a friend and some of them recounted other losses they had experienced. The social workers used supportive techniques, allowing the students to express their fears and anger and helping them come to grips with the fact that sometimes bad things do happen. The social workers were able to help ease the students’ pain and process their grief.

These employees, and so many like them, are our organization’s best kept secret. They represent the best HHC has to offer — in social work, behavioral work, community service and human kindness.

I’d like to recognize these five social workers:

John Cancel, Nancy Singer, Kedelyn Urbaniak, Roberto Guerrero and Carlos Ramos.

Thank you for your service.

Broadcast

New President Brings New Vision to City’s Health & Hospitals Corporation, Dr. Ram Raju, President, NY1, 6/24/14

Lawyers, Doctors Join Forces to Help Children with Mental Illness, Dr. Jennifer Havens, Director and Chief of Service for Child & Adolescent Psychiatry, Bellevue, WNBC, 6/24/14

HHC received initial $35.5M from Medicaid waiver, Dr. Ram Raju, President, Marlene Zurack, Chief Financial Officer, HHC, Capital New York, 6/24/14

The Revolutionaries Who Rescued a Hospital, Lincoln, WNYC Radio, 6/2/14

Feds Cut Cash for Local Hospitals with High Infection Rates, HHC, WNYC Radio, 6/22/14

Harlem Hospital Hosts Commemorative Performance of Play Highlighting HIV/AIDS, NY1, 6/22/14

At A Glance: Bellevue Hospital to Receive Federal Funding for Sandy Damage, NY1, 5/22/14

Print

Cool and Calm at Center of an E.R. Maelstrom in the Bronx, Dr. Ram Raju, President, Milton Nunez, Executive Director, Lincoln, Dr. Fernando Jara, Chair of Emergency Medicine, Lincoln, The New York Times, 5/28/14

Metropolitan Hospital offers LGBT health center , Dr. Ram Raju, President, Meryl Weinberg, RN, Executive Director, Metropolitan , Dr. Nadia Duvilaire, Chief of Family Medicine, Metropolitan, New York Daily News, 6/5/14 ( Also covered in HarlemWorldMag.comGlobalnewsupdates.net)

HHC Launches First LGBT Health Clinic, in Harlem, Dr. Ram Raju, President, Dr. Nadia Duvilaire, Chief of Family Medicine, Metropolitan, EDGE NY, 6/24/14

Harlem nonprofit fights youth drug use, Dr. Maurice Wright, Medical Director, Harlem, New York Daily News, 6/23/14

New York Today: Public Servants of the Year, Janice A. Halloran, Network Senior Associate Director, Department of Emergency Medicine, North Bronx Healthcare Network, HHC, The New York Times, 6/4/14

2014 Sloan Public Service Awards, Janice A. Halloran, Network Senior Associate Director, Department of Emergency Medicine, North Bronx Healthcare Network, HHC, The New York Times, 6/4/14 (Also covered in Bronx Times, New York Daily News, Huffington Post, The Bronx Chronicle)

New York Grows More Physician Assistants, HHC, Crain’s Health Pulse, 6/3/14

Touro College And NYC Health and Hospitals Corporation Announce Partnership to Educate Physician Assistants in Psychiatry, Dr. Ram Raju, President, Ein Newsdesk, 6/4/14 (Also covered in Yahoo! Finance)

Collaborating for Medicaid Reform, Dr. Ram Raju, President Crain’s Health Pulse, 5/27/14

HHC receives initial $35.5M from Medicaid waiver, Capital New York, 6/24/14

New York’s Medicaid Waiver Windfall Comes With a Catch, Dr. Ram Raju, President, Capital New York, 6/3/14

H.H.C. president postpones controversial dialysis outsourcing, Dr. Ram Raju, President, Capital New York, 5/27/14

H.H.C. explains plan to close $200 budget gap, Dr. Ram Raju, President, Marlene Zurack, Chief Financial Officer, Capital New York, 5/27/14

Lincoln, Jacobi and North Central Bronx Farmers Markets Bring Fresh Frutis and Vegetables To The Bronx, The Bronx Chronicle, 6/18/14

HHS invests close to $1 billion in healthcare innovation, HHC, EHRintelligence.com, 5/22/14

CMS Grants $1 Billion For Care Improvement, HHC, Politico, 5/27/14

On HIV, HHC, Capital New York, 5/29/14

Safety Program , Dr. Toni Stern, Coney Island, Melencio Friginal, RN, Metropolitan Crain’s Health Pulse, 6/11/14

NCBH Maternity Goal, Crain’s Health Pulse, 6/20/14

Panel to Create Plan to Reduce Number of Mentally Ill People in New York City Jails, Dr. Ram Raju, President, The New York Times, 6/1/14

Mayor De Blasio Appoints Physician to New Task Force Dr. Ram Raju, President, NewsIndiaTimes.com, 6/3/14

Boardroom Beats Broadway – Service, not stardom is ticket to success for Antonio Martin, Antonio Martin, Executive Vice President and Chief Operating Officer, Positive Community Magazine, 5/16/14

Depression During Pregnancy: What Moms Need to Know, Dr. Judy Greene, Bellevue, Cafemom.com, 6/19/14

Ambulatory care nurse give power to their patients, Emina Useinovic, RN, Bellevue, Nurse.com, 6/9/14

When Asthma Appears After Childhood, Dr. Riyad Basir, Lincoln, Bronx Free Press, 6/11/14

Celebrity Chefs Hosting Healthy Food Fundraiser at Elmhurst Hospital, DNAinfo, 6/9/14

Prescription for Treatment: Hospital Examines Violence As A Disease, Kings County, Canarsie Courier, 5/22/14

Building a Healthier B’klyn, Ernest Baptiste, Executive Director, Dr. Mauvareen Beverly, Deputy, Executive Director, Case Management, Ronald Pedalino, Director of Service, Cardiology, Suzette, Williams, Family Nurse Practitioner, Kings County, Caribbean Life, 6/10/14