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REPORT TO THE BOARD OF DIRECTORS – October 2021

REPORT TO THE BOARD OF DIRECTORS – October 2021

Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS
PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
October 28, 2021

CORONAVIRUS UPDATE

COVID-19 cases – Positive COVID-19 cases, hospitalizations and deaths continue to decline across the City. In fact, the number of citywide cases have been recategorized by the CDC — from a “high” level of transmission to a “substantial” level of transmission — a sign things are going in the right direction. At NYC Health + Hospitals, our COVID-19 hospitalizations and ICU admissions have also declined and have remained steadily low in the last few weeks.

Vaccine – Our health system has administered nearly 1.3 million total doses and over 650,000 first doses across all our 21 vaccine hubs. We expanded Covid-19 booster program on October 26th to offer Moderna and Johnson & Johnson booster doses in addition to Pfizer, and created education and marketing materials in multiple languages to support communication to staff, patients, and community members. We also updated our online appointment scheduler to allow our patients and the public to make appointments online. We expect approval next week of the Pfizer vaccine for 5 to 11-year-olds and will be ready to begin vaccinating our youngest patients once the vaccine for children goes through the full approval process.

Staff vaccine mandate – Following the State mandate requiring vaccines for health care workers, we have experienced and great response from our staff and have reached 95 percent vaccination rates among our workforce.

NYC Test & Trace – Our Test & Trace team continues to reach an incredibly high proportion of all new cases, currently reaching 88% of all new cases citywide. We’ve identified nearly 1.2 million close contacts to date as well. We also just surpassed completing over 300,000 referrals for resources for cases and close contacts in NYC, which is something unique that we do – connect cases and contacts to the resources that they need in order to quarantine or isolate. These services include food delivery, hotel stay, home vaccine, home testing, monoclonal antibody treatment, navigation of cash assistance and paid sick leave. This is all is done through the big front door of contact tracing.

PREPARING FOR THE FLU SEASON

It’s that time of year again — the 2021 – 2022 flu season is upon us. With COVID-19 and flu season occurring together. It is more important than ever to protect ourselves and loved ones from getting sick. We really need to avoid what some are referring to as the possibility for a ‘twindemic.’ Flu vaccines are available at all NYC Health + Hospitals acute care hospital sites and Gotham Health centers. I got my flu shot and I know many of you got yours this morning. We all need to be at our healthiest so that we can together take care of each other and our most vulnerable.
The flu vaccine is safe and efficient in preventing the influenza (flu) virus and can be safely taken together with the COVID-19 vaccine, COVID-19 3rd dose or booster shots to reduce risk of illness, hospitalization and even death. It is safe to get the flu vaccine at the same time that you get a second COVID-19 vaccine, or COVID-19 3rd dose, or a booster shot. So please, get vaccinated for influenza to protect your health and for those around you.

JOINT COMMISSION SURVEYS

The Joint Commission (JC) Triennial surveys that were postponed for an extended period due to the COVID-19 pandemic, finally occurred at two of our hospitals. NYC Health + Hospitals/Kings County was surveyed October 4 -8, and NYC Health + Hospitals/Coney Island was surveyed October 12-15. The JC’s lead surveyor, Tom Barton, a former emergency department nurse, was truly inspired by how committed our staff are to each other and to the communities we serve. Both surveys were successful. Various clinical services were praised, including but not limited to dialysis, ambulatory care sites, intensive care units, emergency departments, and behavioral health. Additionally, each survey’s specific administrative function sessions were highly regarded, including human resources, infection prevention and control, data and quality improvement, and emergency management, all critically important aspects within the overall hospital infrastructure.

Thank you to NYC Health + Hospitals Board Chair José Pagán for participating in-person in the two hospital Leadership Sessions. These sessions focused predominantly on ways in which each hospital weaves health equity into the overall organizational framework, as well as how they institute a culture of safety from leadership to front line staff members. The participation of our board members in these sessions is always instrumental and further generates positivity and inspiration, contributing to successful surveys.

NYC HEALTH + HOSPITALS, CUNY EXPAND NURSING PARTNERSHIP

NYC Health + Hospitals and the City University of New York (CUNY) finalized an agreement to expand our partnership to strengthen our nursing relationship by employing CUNY graduates, while also working with their expert faculty to offer ongoing professional development opportunities to our existing nurse workforce. CUNY Nursing Grads and highly trained nurses will be recruited to our health system from the more than 2,000 CUNY nursing students who graduate each year. Our nurses will have access to over 50 nursing advanced credit-bearing certificate and degree programs across CUNY institutions, including nursing programs at senior and community colleges. Congratulations to our System’s Chief Nurse Executive Natalia Cineas for helping us to build on this important partnership.

HISPANIC HERITAGE MONTH RECOGNITION

The Latino community forms a significant portion of our incredible health system staff, as well as the patient population that we serve. Nearly 8,000 NYC Health + Hospitals employees identify as Hispanic or Latinx, and nearly 27 percent of our patients are Latino. Last year, we provided nearly 1 million Spanish language interpretation requests and Spanish ranks as the top requested language across our health system. To celebrate Hispanic Heritage Month, we hosted a virtual forum entitled, “A Discussion about Health Equity in the Latinx Community” featuring leading experts in Latino studies, health care, and immigrant affairs who discussed community and health equity issues impacting Latinx communities in New York City. Our facilities also hosted a number of staff recognition activities and community forums celebrating Latino culture.

RECOGNIZING OUR PHARMACISTS DURING NATIONAL PHARMACY MONTH

Each day, approximately 1,000 NYC Health + Hospitals pharmacy professionals make a difference in the lives of countless patients at our acute care facilities, Gotham Health centers, post-acute facilities, and Correctional Health Services sites. Pharmacy staff across the health system have been especially invaluable to our health system during the COVID-19 pandemic. They took on new responsibilities and challenges with confidence, including compounding vital medications from scratch during shortages and managing the delivery, acceptance, storage, preparation, disbursement and, in some cases, administration of the vaccines. They did an exceptional job and I’m so thankful to our health system’s pharmacists, who worked tirelessly to mobilize with nurses and physicians and save lives. During National Pharmacy Week, October 17- 23, our health system recognized pharmacy teams and departments for their invaluable contributions to patient care in all our health care settings.

2021 HEALTHCARE QUALITY WEEK HIGHLIGHTS CHAMPIONS

In recognition of National Health Care Quality Week, our health system hosted a Webinar Series entitled Inclusive & Accessible Performance Improvement: Nurturing New Voices. The series spotlighted various leaders in quality and performance improvement across the health system, recognized the 2021 Performance Improvement Champions, and feature a keynote speaker from the NYC Department of Health and Mental Hygiene. Six outstanding health system leaders, and our Community Care COVID-19 Isolation Hotel Program team who were recognized as 2021 Performance Improvement Champions. They were among more than 50 health care staff and teams nominated for a quality improvement project that they worked on or led. This year’s winners succeeded in making significant improvements in reducing hospital infections, engaging post-acute residents, improving engagement of PrEP patients and promoting safety for guests at COVID-19 Hotel program. We congratulate this year’s Performance Improvement Champions, as well as all who were nominated.

  • Mary Deady-Rooney, DNP, RN, CCRN, NEA-BC, Associate Director of Nursing, Department of Medicine, Intensive Care and Medical/ Surgical Units, NYC Health + Hospitals/Metropolitan
  • Shoshana Marmon, MD, PhD Attending Physician, Department of Dermatology, NYC Health + Hospitals/Coney Island and NYC Health + Hospitals/Gotham Health, Cumberland
  • Howard Finger, DO Attending Physician, Department of Internal Medicine, NYC Health + Hospitals/Coler and NYC Health + Hospitals/Carter
  • Community Care COVID-19 Isolation Hotel Program Core Team: Dayo Alalade, Saubirah Hack, KeenFan (Rebecca) Sze, and Tawana Wilson
  • Angelina Gomes, MD Attending Physician, Department of Primary Care, NYC Health + Hospitals/Gotham Health, Gouverneur
  • Maria R. Creta, RPH, CCHP Director of Pharmacy for Clinical Services, NYC Health + Hospitals/Correctional Health Services
  • Albert Belaro, DNP, RN Senior Director, Professional Practice/Education, NYC Health + Hospitals Office of Patient Centered Care

PUBLIC AFFAIRS UPDATE

Federal – Most of you know that activity on Capitol Hill is still very much in flux. Federal funding expires on December 3, and the debt ceiling (federal borrowing limit) must be increased by then as well. This is mixed into the ongoing negotiations on the potential infrastructure plan and significant social spending bill, as well as some well-documented political dynamics. These have really been the priorities for our champions on Capitol Hill, but we continue to stay in good contact with our Senators and Representatives, particularly in regards to the need for stable funding and infrastructure support. We are grateful for their attention and partnership. In particular, I want to continue to thank Majority Leader Schumer and Representative Torres for their strong support for our critical COVID-related FEMA reimbursements.

State – On Election Day, there are 2 state special elections for state offices that have NYC Health + Hospitals facilities in their district. One is for Lt. Governor Brian Benjamin’s former senate seat, Senate District 30 which has NYC Health + Hospitals/Harlem, Carter, and Sydenham in its district. The other seat is for former Assembly member Victor Pichardo, this seat has the NYC Health + Hospitals/Gotham Health, Tremont Center of Excellence in its district.

City – Election Day is November 2. New Yorkers can vote early or on the 2nd for the offices of Mayor, City Council, Borough Presents, and the State special races. We participated in a hearing on 10/27 regarding “NYC Hospitals Preparedness for Weather Emergencies” and were represented by Dr. Laura Iavicoli and Christine Flaherty. City Hall in Your Borough – Manhattan was celebrated this week and a number of our facility teams are joining the Mayor’s Resource Fair today.

Community – Our health system hosted a Digital Health Forum/ Insurance 101 Workshop with the Centers for Medicare and Medicaid Services (CMS) and the NY State of Health. More than 70 CBOs joined the session.

FINANCE UPDATE

NYC Health + Hospitals closed September with approximately $700 million, 33 days cash-on-hand. The Net Budget Variance for FY21 was close to plan, reflecting the timing impact on cash of the delayed COVID-19 Federal reimbursement received in FY22. Patient Care Receipts came in $636M higher than planned, due to the higher acuity of the COVID patients as well as Revenue Cycle and other targeted efforts plus improved timing of risk pool payment. Strategic Initiatives continued to stay on track despite COVID-19. We met or exceeded our target in: Revenue Cycle & Enrolling the Uninsured ($432M); 340B pharmacy revenue ($69M); and Value-Based Payment initiatives ($53M).

We have continued to make key staffing investments since FY19 including:

  • RNs (+486) and other Nursing positions (+257) to ensure quality patient care;
  • Targeted clinical growth initiatives to meet patient care needs while ensuring financial sustainability;
  • Stabilizing and sustaining Revenue Cycle Operations (+361) to enhance and ensure billing integrity.
  • NYSNA/Doctors’ Council contract agreements, including COLA increases

CONTRACTS

I have approved 2 contracts, given their time-sensitivity, that would otherwise have been brought to the Board, and I want to take this opportunity to summarize them.

One exception was an extension of our contract with Procor, an agency which specializes in reviewing the invoices of contractors, to assure the documentation of their charges is complete and the invoices are in a form acceptable for Federal reimbursement. Procor was initially contracted July 1, 2020. We have extended the term of the agreement through June 30, 2022 with the not-to-exceed amount of $6,395,400.

The second exception was a contract amendment with Optum Insight, Inc., who has provided call center support for COVID contract tracing, and a vaccination scheduling campaign, along with Optum’s subcontractor, McKinsey, who has provided operational support and leadership for the Trace Contract Center and more recently the Delta variant management strategy. This contract amendment is to extend their support through December 2021, at an additional cost of $6.6M as part of our community testing program. Funding for these services is provided through OMB.

HEALTH SYSTEM NEWS

WE ALWAYS PUT PATIENTS FIRST