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REPORT TO THE BOARD OF DIRECTORS – March 2022

REPORT TO THE BOARD OF DIRECTORS – March 2022

Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS
PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
March 31, 2022

CORONAVIRUS UPDATE

COVID-19 community positivity remains low in New York City but slowly rising as expected with the increase in Omicron BA.2 prevalence, following trends seen in Europe. Given the higher rates of boosters and natural immunity in New York City now compared to winter, we do not expect positivity to rise to the same levels as late December/early January. Our COVID-19 hospitalizations remain at their lowest levels since summer 2021. We continue to focus on promoting vaccinations and boosters as the best defense. And I remain hopeful that the worse is behind us.

I also want to acknowledge that this month marks two years since NYC Health + Hospitals admitted our first patient with COVID-19. We reflect on this moment and remember the lives lost and the sacrifices made by our amazing health care heroes. Throughout the entire pandemic, NYC Health + Hospitals, in collaboration with our NYC Test & Trace Corps (T2), provided care, treatment, testing, tracing, vaccination, shelter, food and so much more to New Yorkers who needed it most. The Trace part of T2 is winding down at the end of April, but much of the work to support New Yorkers continues. Some of our achievements of the last two years include:

  • more than 10.5 million COVID-19 tests
  • administered more than 1.7 million vaccine doses across the five boroughs
  • opened COVID-19 Center of Excellence in Bushwick, Brooklyn; Tremont, Bronx; and Elmhurst, Queens
  • through contact tracing, regularly reached 90% of all cases and identified 1.7M contacts
  • helped 33,000 people isolate at a quarantine hotel and delivered more than 2.2M free meals to those in isolation or quarantine
  • launched the Street Health Outreach & Wellness (SHOW) mobile units that have offered services to over 119,000 New Yorkers, with a focus on people experiencing homelessness
  • launched COVID-19 Treatment Outreach or CATCH to ensure life-saving oral antiviral treatments, monoclonal antibody treatment, and other healthcare resources are promptly delivered to those in need
  • launched AfterCare to support New Yorkers living with the long-term effects of COVID-19 and connect them to a full range of resources
  • launched the COVID-19 Quarantine and Isolation Guidance Tool to offer personalized guidance to New Yorkers who were exposed to or test positive for COVID-19.

And because the work of the healers is not over, we continue to offer our heroic workforce all the resources and support they need to recharge, de-stress and heal through our Helping Healers Heal program. The COVID-19 pandemic has shown how necessary New York City’s public health system and its employees truly are.

PROMOTING COLON CANCER SCREENING

In recognition of Colorectal Cancer Awareness Month, we are urging all New Yorkers to begin life-saving colorectal cancer screening starting at age 45. Colorectal cancer is the second-leading cause of cancer death in New York City, but can be preventable and treatable with early screening. Yet too many New Yorkers have postponed colon cancer screenings because of the COVID pandemic. There is no reason to put it off any longer. We are making the easy, convenient, non-invasive fecal immunochemical (FIT) test widely available as an option in addition to traditional colonoscopy. While colonoscopy continues to be the preferred screening test for patients at higher risk for the disease, FIT is ideal for those at lower risk and significantly more convenient than a colonoscopy, which requires a special diet, sedation, and recovery. FIT requires only a stool sample that can be collected at home. Patients can request a fecal immunochemical test from their NYC Health + Hospitals primary care provider or by calling 1-844-NYC-4NYC to set up an appointment.

NYC HEALTH + HOSPITALS/METROPOLITAN RECOGNIZED FOR INNOVATION AND COMMITMENT TO PREVENT HEART ATTACKS AND STROKES

Million Hearts, a national initiative to prevent 1 million heart attacks and strokes in 5 years, this month recognized NYC Health + Hospitals/Metropolitan for excellence in preventing heart attacks and strokes. The hospital team was celebrated for the use of innovative care strategies and their prevention and treatment achievements – which includes their focus on cholesterol management, aspirin use, nutrition and addressing food insecurity for patients. They were also recognized for supporting the mental health needs of its employees through various programs to reduce stress and support staff, especially during the COVID-19 pandemic. I am thrilled that NYC Health + Hospitals/Metropolitan received this national recognition for providing the highest level of cardiovascular care to our patients. Heart disease is the leading cause of death for adults in New York City and our team at Metropolitan is a great example of our System wide efforts to improving New Yorkers’ heart health by lowering readmissions and mortality rates.

LEADERSHIP APPOINTMENT

Sewit Teckie, MD is the new System Chief of Radiation Oncology. In this newly created role, Dr. Teckie will share best practices and expertise with her oncology peers across the health System to expand cancer care. Her goal is to build cancer programs that are equitable, giving patients access to high quality, comprehensive cancer care right in their neighborhood. She will also be focusing on head-and-neck cancers as Director of Head-and-Neck Radiation Oncology at NYC Health + Hospitals/Kings County. She is widely published in the fields of head-and-neck cancer and digital health technology. Dr. Teckie attended Harvard College and Harvard Medical School. She completed residency at Memorial Sloan-Kettering Cancer Center, and practiced at Northwell Health. She will receive her MBA from Columbia University this spring. We are thrilled to welcome Dr. Teckie to the NYC Health + Hospitals community. Her clinical and research expertise in head-and-neck radiation oncology will help us advance our mission to give patients the best chance at a long, healthy life no matter their degree of malignancy. She is dedicated to innovation in care, has an outstanding record of accomplishment as a mentor, and I am confident radiation oncology will thrive under her leadership.

EXTERNAL AND COMMUNITY AFFAIRS UPDATE

State – Negotiations continue on the New York State budget for state fiscal year 22-23, which starts on April 1. We were pleased to see that the Executive’s proposed budget includes investments in health care after several years of austerity budgets. Both the Senate and Assembly one-house budgets accepted the Governor’s proposal to restore a 1.5% Medicaid reimbursement cut and increase Medicaid by 1%. These investments in Medicaid are certainly helpful to our health System, though we continue to support even greater and well-needed increases. In addition, both the Assembly and Senate explicitly proposed additional operating and capital funding for public, private and safety net hospitals. We are in support of this new proposed funding by the Legislature, and we continue our advocate for NYC Health + Hospitals to have equitable access to any additional State funding for capital and operating needs.

City – On Monday, March 21, I presented testimony before the City Council for our Preliminary Budget Hearing. We are pleased to work with our new colleagues in the Council. To that end, we will be participating in a hearing on April 18 regarding “The Impact of the COVID-19 Pandemic on the Health of Immigrant New Yorkers.”

Federal – I am pleased that four NYC Health + Hospitals facilities earmark funding — more formally known as Congressionally-Directed Spending in the Senate, or Community Project Funding in the House — in the FY-2022 Consolidated Appropriations Act signed into law last week: Queens, Jacobi, Elmhurst, and Coney Island hospitals. We are grateful to the Congressional Representatives in these districts, as well as to our Senators, for their support in this process. The FY-23 earmark process has begun, and facilities are in the process of drafting earmark requests for consideration.

FINANCE UPDATE

NYC Health + Hospitals is in good financial health going into the next fiscal year — we have come a long way since the days when we were looking at a nearly $2 billion budget deficit. As I testified before the City Council, we have 42 days of cash on hand – historically, that is the most we have had, thanks to the receipt of FEMA and DSH funds. Our February closing cash balance was $650M. We closed the second quarter with a negative Net Budget Variance of $142M due to COVID disbursements ($389M) not yet fully covered with Federal relief dollars. When adjusting for the unreimbursed COVID spend, our underlying budget performance is positive.

Through the second quarter, our direct patient care receipts were $243M higher than the same period in FY-21, continuing the pace of positive performance that we experienced during FY-21. Our patient care volume continued to return towards our pre-COVID levels, but discharges remain 4% below the second quarter in FY-20. Our revenue base remains strong and resilient primarily driven by higher average collectability rate and returning volume.

Overall, our strategic Financial Initiatives remain on track with our post-COVID strategies, generating $396M through the second quarter with an annual FY-22 line of sight of $679M. Our areas of strongest net performance include Revenue Cycle Improvement, Growth & Service Line Improvements, and Value-Based Payment Initiatives & Managed Care Initiatives.

NEWS FROM AROUND THE HEALTH SYSTEM

WE ALWAYS PUT PATIENTS FIRST