REPORT TO THE BOARD OF DIRECTORS – March 2018

Last week, Congress passed a $1.3 trillion spending plan that adds both domestic and military spending in accordance with a broad agreement reached by Congressional leaders at the end of February. After initially threatening to veto the bill, the President signed the omnibus measure which funds the government through the end of this federal fiscal year. NYC Health + Hospitals is very thankful for the support we received from New York’s Congressional delegation during the budget process this year. To recap the issues of critical importance to NYC Health + Hospitals, the Bipartisan Budget Act of 2018 that Congress passed last month included a 2 year delay of disproportionate share funding cuts, reauthorized funding for community health centers and further extended the Children’s Health Insurance Program. Additional funding to fight the Opioid epidemic was also included in the budget last week. In particular, I’d like to thank Senator Charles Schumer and Congressman Eliot Engel for their leadership on our issues.

In Albany, legislative leaders are working towards an agreement for the State Budget and details are not finalized at the time of this writing. Of the issues of importance to NYC Health + Hospitals, we were working to make sure that we had access to the Healthcare Shortfall fund if one is going to be created. The State wants to set funds aside to be used in the event of federal funding reductions. We were also working to secure new funding for an enhanced safety net reimbursement rate increase. Heath + Hospitals has been advocating for this increase over the past year. In addition, even though federal Disproportionate Share Funding cuts were delayed by Congress, we’ve been advocating for a workgroup to further study DSH and other reimbursement issues in the event of future cuts two years from now. I’d like to thank our community advisory board members, our labor partners and healthcare advocates for their advocacy on funding for Health+ Hospitals.

Two weeks ago, I testified before the City Council Hospital Systems Committee on our FY Preliminary Budget. In my testimony, I explained my priorities for the system including invigorating end expanding primary care, improving access to specialty care and bringing fiscal solvency to Health + Hospitals. As you can imagine, the Council had dozens of questions for me and was eager to hear the details on how I will achieve these priorities. I highlighted the broad categories for how we will achieve these goals by: reducing administrative expenses, billing insurance for insured patients, more effective coding and documentation, retaining paying patients, making investments into revenue generating positions, providing additional specialty services and converting eligible but uninsured patients into insured patients. I committed to providing more detail on these items when we testify before the Council again later in May on the FY2019 Executive Budget.

OneCity Health’s call for applicants for its $5M Innovation Fund generated more than 41 applications from 55 organizations. This special fund provides NYC Health + Hospitals and DSRIP community partners to apply for funding beyond targeted DSRIP programs to design and implement an innovative program to reduce avoidable hospitalizations, improve community health outcomes, and address social determinants of health. OneCity Health expects to fund up to ten awards that will be announced in April. The selection committee is comprised of OneCity Health, New York Immigration Coalition, United Hospital Fund, Northern Manhattan Perinatal Partnership and the Greater New York Hospital Association.

OneCity Health continues to implement strategies linking individuals with appropriate social services including screening them for unmet social needs.

• Following the launch of NowPow trainings for all NYC Health + Hospitals staff and OneCity Health partners, 115 partner organizations are now using the software that allows users to identify social services resources, refer patients to services, and track engagement.
• To date, OneCity Health has held two trainings for NYC Health + Hospitals staff and community partners on addressing the housing needs of patients, attended by 66 people.
• To date, 194 staff from NYC Health + Hospitals and community partner organizations have been trained on how to screen and refer for legal needs of clients and patients.

To support partners in the transition from volume-based payments to value-based payments, OneCity Health provided an educational webinar, “Getting Ready for Value-Based Payment: Strategy and Information Management”, in collaboration with the McSilver Institute for Poverty Policy and Research.

I am pleased to inform the Board of a successful negotiation we completed on our pharmaceutical distribution contract with Cardinal Health. After a competitive RFP process, we negotiated a 3-year agreement with two one-year renewal options with Cardinal that will result in more than $31 million in savings to our health system. Every year, we spend approximately $200 million on medications for our patients, including patients served by Correctional Health Services. Given the large number of uninsured and underinsured patients we serve, we are able to purchase a large percentage of our medications at the lowest pricing level, often referred to as 340B pricing. The new arrangement with Cardinal Health offered the best value and will provide additional discounts beyond the 340B program. As you know, contracts for goods and commodities are not required to come before the Board, but I wanted to share the good news. This represents a large and important part of our business and our new approach to maximize our purchasing power to achieve savings and efficiencies.

NYC Health + Hospitals/Jacobi and NYC Health + Hospitals/North Central Bronx have expanded access to pediatric dental services thanks to a $2.5 million grant from the federal Health Resources and Services Administration that allowed the hospitals to serve an additional 2,500 children over the past two years. The grant funds were used to employ additional pediatric dental staff experts, purchase equipment, facilitate expanded hours of operation and build community collaborations. Tooth decay is the most prevalent childhood disease, affecting more youngsters than asthma or hay fever. This grant and the great work done by our dental team represent the commitment of our health system to provide world-class outpatient care to all New Yorkers and help more children establish a dental home by their first birthday.

Mayor Bill de Blasio and First Lady Chirlane McCray this month announced a $22 million annual investment to expand HealingNYC, the citywide plan to combat the opioid epidemic. This new investment will create peer intervention programs at more hospitals across the City, increase naloxone distribution and training on how to use this lifesaving drug, and connect more New Yorkers struggling with substance misuse to treatment. With this new investment, the City will spend a total of $60 million annually to reduce opioid overdose deaths. This new funding will start in Fiscal Year 2019 and be at full ramp up in Fiscal 2020. The additional funds will help New York City Health + Hospitals expand our peer advocate program from three to all 11 emergency departments by the end of 2018, and expand the Consult for Addiction Treatment and Care in Hospitals (CATCH) program from four to six hospitals in our health system. The six included: NYC Health + Hospitals/Bellevue, /Lincoln, /Metropolitan, /Coney Island, /Elmhurst, and /Woodhull. These sites were chosen because their neighborhoods are some of the hardest hit by the opioid epidemic.

NYC Health + Hospitals this month announced that 17 of our patient care sites are now certified Opioid Overdose Prevention Programs. The certification by the New York State Department of Health enables the 11 public hospitals and six large Gotham Health centers to routinely dispense naloxone based on best practices, including overdose prevention training of patients and community members. Simply stated, increasing naloxone availability saves lives. Making naloxone easily accessible to our patients and members of the community who may have friends or family struggling with opioid use is an important part of New York City’s response to the opioid epidemic. And our pursuit of State certification at all these sites underscores how important a priority this is for us.

Mayor de Blasio this month announced that the city’s GetCoveredNYC campaign helped enroll 80,000 New Yorkers in new health insurance plans last year, surpassing the goal to enroll 50,000 New Yorkers in quality, affordable health insurance in 2017. The initiative is a partnership between the Mayor’s Public Engagement Unit, NYC Health + Hospitals, Department of Health and Mental Hygiene, Human Resources Administration and our MetroPlus Health Plan. GetCoveredNYC outreach specialists proactively engage uninsured New Yorkers, providing free support in over 12 languages to help people understand their eligibility and assist them throughout the enrollment process.

As of the close of Open Enrollment on January 31, 2018, over 2,267,000 New York City residents were insured through the New York State of Health, the health insurance marketplace created under the Affordable Care Act (ACA). This is an increase of more than 263,200 new enrollments, or 13%, over the previous year. Expanding insurance coverage is a critical priority to connect people to primary care and to reduce the incidence of expensive episodic care. Significantly surpassing last year’s enrollment target means more than just the numbers; it means improving the quality of more people’s lives.

NYC Health + Hospitals/North Central Bronx is the first hospital in the Bronx to be designated a Gold Safe Sleep Champion by Cribs for Kids®, a national safe sleep hospital certification program. To earn the designation, the hospital was required to demonstrate its commitment to best practices in promoting safe sleep guidelines recommended by the American Academy of Pediatrics and educating patients and families about how to reduce the risk of injury and death to infants while sleeping. Our health system now has seven hospitals that have received this national designation: NYC Health + Hospitals/Coney Island, NYC Health + Hospitals/Woodhull, NYC Health + Hospitals/Harlem, NYC Health + Hospitals/Metropolitan, NYC Health + Hospitals/Elmhurst and NYC Health + Hospitals/Queens.

NYC Health+ Hospitals/Elmhurst launched a webinar series for the United Nations Medical Services Division as part of the agency’s Continuous Medical Education program. Hosted by Dr. Joseph Masci, director of the hospital’s Global Health Institute and a well-known infectious disease expert, the series will serve more than 300 UN physicians, nurses, paramedics, and other health care workers in countries around the world. The webinars allow UN health care providers in the most remote and resource-poor locations to enhance their clinical skills, promote patient safety, and improve patient outcome. Under Dr. Masci’s leadership and expertise, the Global Health Institute at NYC Health + Hospitals/Elmhurst is greatly advancing global understanding of public health issues. The hospital plans additional webinars on malaria, dengue fever and HIV/AIDS.

I had the pleasure to join the team at NYC Health + Hospitals/Kings County to celebrate the successful partnership with the Ronald McDonald House. NYC Health + Hospitals/Kings County is the only health care facility in New York that is home to a Ronald McDonald Family Room and has been able to extend the services of Ronald McDonald House to over 1,000 family members in its first year. NYC Health + Hospitals/Kings County is the only public hospital in the country that has a Ronald McDonald Family Room. This sanctuary for families of Neonatal Intensive Care Unit patients provides an extension of the services that have become synonymous with the Ronald McDonald House® brand. Caregivers now have access to a comfortable space with snacks and refreshments, entertainment and laundry, steps away from their admitted child.

The post-acute care team at NYC Health + Hospitals/McKinney in Central Brooklyn this month honored six female centenarian residents as part of their Women’s History Month activities. Each of these residents have reached their 100th birthday — together they celebrated 600 years of life and were joined by their families, staff and local elected officials. The Central Brooklyn post-acute care facility provides high quality short-term rehabilitation, long-term skilled nursing services and specialized care by a dedicated medical team who deliver 24-hour care to facilitate each resident’s healing and recovery. This special event was a wonderful demonstration of their true patient-centered approach and the sincere love and compassion they share for the residents under their care.