REPORT TO THE BOARD OF DIRECTORS – September 2014

Good afternoon. As customary, I will highlight just a few items from the full version of my report to the board. The full version is available to all here and will be posted on our website.

We continue planning HHC’s participation and leadership role in the Delivery System Reform Incentive Payment (DSRIP) program — the $6.42B Medicaid Waiver program that will help transform healthcare delivery in NY State. HHC will create one single Performing Provider System (PPS) with four borough-based hubs to achieve simplicity in management and governance. As one large PPS we can take advantage of our scale and be flexible as we plan projects to meet the healthcare needs of our local communities.

The corporation is committed to collaborating with other PPS applicants and healthcare systems across the city, and where possible, we want to jointly select, design, and plan DSRIP projects at the borough level as informed by the community needs assessments. We strongly believe that having uniformity in project design and implementation across approved PPS’s is key to enabling success for community and other providers who will carry out the work of improving the health of New Yorkers. We are doing extensive outreach to community providers and stakeholders and look forward to building close working relationships as we continue the planning process.

To help support much of this planning, New York State approved our request for additional DSRIP planning dollars. We will receive an additional $3 million by this coming November, bringing the total planning grant to $5 million.

Following the extensive damage we sustained during hurricane Sandy, the State of New York, the City of New York and HHC continue to negotiate with the Federal Emergency Management Agency (FEMA) to finalize funding support for mitigation and restoration at Coney Island Hospital, Bellevue Hospital Center, Coler, and Metropolitan Hospital. We are close to having a final agreement and expect to secure a FEMA grant award in the coming weeks that will combine costs for repair and restoration, as well as mitigation projects to harden our facilities against future storms. I have been meeting weekly with executive FEMA staff to assure a comprehensive, fair and timely agreement.

There are many who are supporting our efforts to secure this much needed funding for our public healthcare facilities. I want to express my particular gratitude to Dr. Howard Zucker, Acting Commissioner of the New York State Department of Health… Brad Kieserman and Chris Smith and their staff at FEMA for their commitment and support.

Once we have a final and official memorandum of understanding with FEMA, I will advise the Board of Directors and provide a full and detailed briefing.

In recognition of the 13th anniversary of the September 11 attacks on the World Trade Center, I want to again recognize our HHC colleagues who experienced deep personal loss 13 years ago and yet, in the proud HHC tradition of compassion, stood ready to serve New Yorkers who needed us. I also want to salute and thank the HHC team members of the World Trade Center Environmental Health Center at Bellevue Hospital, Gouverneur Health and Elmhurst Hospital, who continue to help survivors overcome not just physical ailments associated with the events of 9/11, but also the mental health issues that can be similarly debilitating.

Our HHC World Trade Center Environmental Health Center team runs the only Center of Excellence dedicated to treating community victims of the attacks — the children and adults who lived there, worked there and went to school there — and continue to need our care. Though 13 years have passed, more and more community members continue to come forward for treatment. In fact, nearly 1,200 additional patients enrolled in HHC’s program just in the last year.

The continued need for our services makes it evidently clear that Congress must reauthorize the James Zadroga 9/11 Health and Compensation Act to help survivors get the care they need now and well into the future.

The New York Congressional delegation — Senator Gillibrand, Representatives Maloney, Nadler and King — hosted a press conference at Ground Zero on Monday, September 8th, along with Mayor de Blasio, 9/11 first responders, community survivors and labor leaders, to officially kick-off their push in Congress to reauthorize the Zadroga program until at least 2041. One notable change in the new draft bill is that it would repeal of the requirement that all applicants be checked against the Terrorist Watch List, a change that HHC supports. Given the political climate, including the possibility that the Senate may change hands from Democrat to Republican control, reauthorization of the bill is not guaranteed.

The flu season will start again this fall and HHC is again preparing for immunization of all patients and staff, so they can avoid getting the flu and to reduce the chance that they will pass it on to other members of their community. Last year more than 82% of all HHC staff were immunized against the flu — the highest level ever.

Again this year HHC will be following the direction of the NY state Department of Health that any staff member who is not immunized must wear a mask for the duration of the flu season, as defined by the Health Commissioner.

Flu vaccination is starting this week and vaccine will be broadly available at the beginning of October, as more supplies from manufacturers become available. The vaccine is safe and the flu is a common disease. It remains vital that all of our patients and especially our staff are immunized against this disease that can become fatal for those whose health is already fragile. About 36,000 people die in the U.S. each year from flu and its complications. With proper precautions, few of our patients will have to be among them.

Last month, HHC convened a training program on TeamSTEPPS and Limited English Proficiency (LEP), together with the federal Agency for Healthcare Research and Quality (AHRQ). The training taught specific techniques, tools and strategies to be used when working with patients who have difficulty communicating in English. This day-long invitational training program was open to both HHC and non-HHC healthcare professionals and had over 150 participants.

I had the privilege of beginning the program by sharing my personal experience with disparity. I emphasized the importance of understanding the cultures and backgrounds of patients in order to provide effective care and how cultural factors may serve as barriers to access.

To date, approximately 27,000 HHC employees and medical staff have been trained in TeamSTEPPS as a core strategy for improving staff teamwork and communication across the enterprise. The HHC health centers will soon begin to roll-out the TeamSTEPPS and Limited English Proficiency training module as a key patient safety priority.

HHC wants New Yorkers to make the most of their health coverage options. That’s why we will partner with the Centers for Medicaid and Medicare (CMS) to host free public workshops at our hospitals over the next two months to help New Yorkers understand and get the most out of benefits during the Medicare open enrollment period that begins October 15 and ends December 7. The sessions will offer information about healthcare reform, the Affordable Care Act (ACA) and how to select and purchase health insurance online through the New York State health exchange, which offers many people subsidies to make health coverage affordable. Health insurance specialists from CMS will conduct seven learning sessions at HHC hospitals and health centers in Manhattan, the Bronx, Brooklyn and Queens between October 1st and November 21. We are particularly encouraging senior citizens, caregivers and people who work with seniors to take advantage of these learning sessions.

In our October tradition, we will once again promote our Take Care New York campaign message and remind and offer patients, staff and the community an opportunity to get preventive immunizations, and health screenings to stay healthy. This year, we will also continue our effort to curb obesity and increase fitness with our “Move to Improve” message to challenge New Yorkers to eat healthier and add more physical activity into their routine. Our facilities will offer flu shots and screenings for HIV, blood pressure, cancer, asthma, diabetes and other health conditions at over fifty events. We will incorporate a robust fitness component by partnering with Shape Up NYC to provide free exercise classes and raffle guest-passes to Crunch fitness centers, as well as memberships for the Citi Bike Share Program. We will also aim to engage New Yorkers through social media and ask our friends and followers to tell us how they “move to improve” to stay healthy by posting photos and stories online. I encourage all board members to follow HHC’s Facebook page and Like and Share our social media posts during the campaign.

Our health plan MetroPlus will be a key partner of the Take Care New York Campaign and have representatives available at the education and screening events. October is a prime enrollment period for MetroPlus and the TCNY campaign can be a helpful platform for them to maximize enrollments.

Ida G. Israel Community Health Center, affiliated with Coney Island Hospital — the health center which was completely destroyed by super storm Sandy, will soon reopen at a new location. We have secured FEMA funding and will start construction of the new 13,000 square-foot, $7.5 million health center at Surf Avenue and West 19th St, right across the street from the Brooklyn Cyclones stadium.

Prior to Sandy, the Ida Israel center served 60,000 adult patients from Southern Brooklyn. We have redirected our patients to services elsewhere, to Coney Island Hospital, to our mobile medical vans, and to other community providers. The Center provided services in dentistry, pediatrics, social services, family planning, behavioral health, and chemical dependence and rehabilitation. It also housed an active W.I.C. program. We expect to have all the same services and look forward to having our patients return to their local medical home. Construction is expected to be completed in February 2015.

I am participating, along with members of my senior staff, in several initiatives of Mayor de Blasio and his administration to further his vision for New York City. Some members of this Board — Deputy Mayor Barrios-Paoli and her representative Ms. Yang, Commissioners Bassett and Banks, Dr. Belkin — are familiar with these interagency efforts to address specific policy priorities of City Hall. These mayoral initiatives include:

• The Task Force on Behavioral Health and The Criminal Justice System,
• The “Children’s Cabinet” to bolster interagency communication related to children’s well-being,
• The Immigrant Taskforce, and
• The Interagency Taskforce on Homelessness

In addition, just last week we participated in an interagency meeting, led by Commissioner Agarwal of the Mayor’s Office of Immigrant Affairs, on a variety of issues including healthcare access, relating to newly arrived unaccompanied child immigrants from Central America.

All these efforts stress active interagency collaboration, idea and data sharing, and creation of an actionable policy agenda to advance social justice in New York City. They each present an opportunity for us to actively contribute to a forward looking agenda to further goals shared by us, the Mayor, and our sister agencies.

We learned this week, as reported by the Staten Island Advance, that Staten Island Borough President James Oddo has proposed an ambitious plan to address the needs of growing senior population and special needs children. His plan calls for developing a “Health and Wellness Campus” in the underutilized property on our Sea View campus with a mix of residential communities for special needs children and adults, an independent village for seniors with a special unit for seniors with Alzheimer’s, a cancer institute, a children’s hospital and much more.

We met with the Borough President to discuss his proposal and are fully supportive of his vision. After all, HHC’s mission is to make New York City healthy so we are very supportive of a Staten Island wellness campus that can supplement the care and services we deliver at our Sea View Nursing Home. This proposal aligns with our hope to create a new, state-of-the-art nursing facility there that embraces a resident-centered approach for its long-term care patients, fostering a greater sense of community.

HHC has agreed to contribute half the cost of a $250,000 feasibility study for the wellness campus. The Borough President hopes a Request for Proposals could be issued by the end of this year or early in 2015. We look forward to working with the Borough President to build a healthy Staten Island.

The Centers for Medicare & Medicaid Services (CMS) this week issued quality and financial performance results showing that our Accountable Care Organization (ACO) has achieved significant savings in the first year participating in the Medicare Shared Savings program. Our ACO reduced costs by nearly 7 percent while improving the quality of care among more than 12,000 Medicare beneficiaries in our program.

As you may know, in addition to providing more Americans with access to quality, affordable healthcare, the Affordable Care Act encourages doctors, hospitals and other healthcare providers to work together to better coordinate care and keep people healthy rather than treat them when they are sick which also helps to reduce healthcare costs. ACOs are one example of the innovative ways to improve care and reduce costs

Our ACO is proud to be one of the nation’s top-performing accountable care organizations, demonstrating that our longstanding commitment to population health and caring for all New Yorkers regardless of ability to pay is fertile ground for innovative care delivery and payment models that focus on keeping patients healthy and in their homes and communities, rather than in the hospital.

As customary this month I want to bring your attention to a program has grown stronger over the years due to an unwavering commitment of our employees. I’m talking about the American Cancer Society’s Making Strides Against Breast Cancer walk. Sunday, October 19, will mark the twelfth year that our corporation will serve as a flagship sponsor of the event to help end breast cancer. The flagship status is due to the outstanding commitment of our employees.

We are committed to fighting cancer in the communities we serve through early detection, education, and high-quality care. Every year, we perform more than 100,000 mammograms; every year we spearhead a breast cancer awareness campaign. In 2014 alone, our facilities hosted more than 65 public education and screening events across the City.

All of our hospitals provide access to high-quality cancer treatment services to help women affected by breast cancer. Three of our facilities — Bellevue, Jacobi and Lincoln — hold the nation’s highest form of clinical and quality care recognition for breast centers, the Center of Excellence Accreditation from the American College of Surgeons.

Yet our staff doesn’t stop there. Compassion drives them to actively raise funds each and every year through the Making Strides walk, to help advance breast cancer research, patient support, and prevention efforts. Last year, about 500 of our employees participated in the walk. Over the years, our deep commitment to the Making Strides walks has resulted in more than $1 million in donations to ACS.

As they have in the past, Joe Schick, Executive Director of The Fund for HHC, and Ann Frisch, Executive Director of our Health and Home Care, are spearheading our efforts. This year they are joined in leadership by Dr. Martha Sullivan, Executive Director of Gouverneur Health.

I urge all HHC employees to support the fight to end breast cancer by joining Making Strides team, by supporting the cause, and by walking with colleagues, friends, and family on October 19.

Before I end my report I want to talk about a very special person at HHC — someone who is known for her consistent, patient-centered and culturally-competent approach.

Before I introduce this outstanding HHC team member, I want all of us — for a moment — to put ourselves in one of our patient’s shoes.

Imagine that one’s health is failing.
Imagine one is addicted to chemical substances or alcohol, destroying health and life.
Imagine you need healthcare and advice.
Imagine you are new to our country
And imagine you don’t speak English

But Nina Mirkin does not have to imagine.

She deals with it each and every day at Coney Island

Nina is a bilingual certified social worker who is specially licensed to treat addiction.

She leads individual and group counseling sessions in Russian – her patients’ primary language. Nearly a third of the patients who seek care at her department speak only Russian.

Nina’s patients depend on her skills …. her skill with language … her skill with culture …. her skill in psychotherapy. After all, effective treatment and recovery require improving the health of the whole person — body, mind and spirit. And Nina’s patients know that she is a true advocate for them — they know that she will go to any length to safeguard their health and wellbeing.

Nina is no stranger to life’s challenges herself. She came to the U.S. 15 years ago from Azerbaijan as a refugee. She was able to stay in the U.S. with family, and after further education started working at Coney Island Hospital.

Nina is one of hundreds of our dedicated and talented social workers who forge a special bond with our patients — particularly those new to this country — and help them not just to recover, but also to feel a little more at home.

I am proud to say that, like Nina, so many members of our team reflect the ethnic, religious and cultural diversity of our patients. This is one of our greatest strengths.

And Nina is one of our great examples. So much so, that the state Office of Alcoholism & Substance Abuse Services has named Nina Mirkin the 2014 Addiction Licensed Certified Social Worker of the Year.

Please join me in thanking Nina Mirkin for the outstanding work that she does every day for our patients and their families.

Thank you, Nina.

Broadcast

Renee Report Interview with Dr. Ram Raju, Dr. Ram Raju, President, International Broadcasting Network/ITV, 8/25/14

Art Therapy Program Provides Outlet for NYers With Painful September 11 Memories, Dr. Nomi Levy-Carrick, Mental Health Director, HHC WTC Environmental Health Center, Irene Rosner David, Director of Therapeutic Arts, Bellevue, NY1, 9/11/14 (Also covered by the Associated Press)

9/11 Memorial at Jacobi Medical Center, Jacobi, News 12 Bronx, 9/11/14

Doctors at North Central Bronx Hospital offer parents advice to prepare for school year, Dr. Heather Lawsky, Pediatrician, NCB, News 12 Bronx, 8/9/14

Doctors: Back-to-school vaccinations needed, Dr. Warren Seigel, Coney Island, News 12 Brooklyn, 8/6/14

Asthma Peak Season, Dr. Katherine Szema, Lincoln, News 12 Bronx, 9/11/14

City Officials Urge Calm on Ebola, Dr. Ross Wilson, Corporate Chief Medical Officer, HHC, NY1, 8/5/14

Ebola Unlikely to Reach NYC, Officials Say, Dr. Ross Wilson, Chief Medical Officer, HHC, WNBC, 8/1/14

Harlem Barbershop Serves Up Preventative Medical Care, Dr. Joseph Ravenell, Attending Physician, Department of Medicine, Co-Director, Bellevue Hospital Resistant Hypertension Clinic, Dr. Stephen Wall, Attending Physician, Emergency Medicine, Bellevue, WNBC, 8/25/14

NYC has one of the lowest stroke death rates, Dr. Eduardo Lopez, Metropolitan, NY1 Noticias, 8/28/14

Lincoln and Yankees Immunization Campaign at Yankee Stadium, Lincoln, News 12 Bronx, 8/27/14

Print

100 Most Influential People in Healthcare-2014, Dr. Ram Raju, President, Modern Healthcare Magazine, 8/25/14 (Also covered in Crain’s Health Pulse)

Two Indian American Doctors Are Healthcare’s ‘Most Influential’, Dr. Ram Raju, President, India West, 9/10/14

De Blasio’s Surgeon, Dr. Ram Raju, President, Capital New York, 7/31/14

Seeking help for 9/11’s psychological trauma, after years of resolve and survivor guilt
Associated Press, 9/11/14, HHC WTC Environmental Health Center, Dr. Nomi Levy-Carrick, Mental Health Director (Also covered in US News & World Report Online and ABCNews.com)

NYC hospital holds 9/11 art exhibition, Bellevue, AP/Newsday, 9/11/14

Ebola Virus: Mount Sinai Hospital in New York City Tests Patient, Dr. Ross Wilson, Corporate Chief Medical Officer, HHC, Bellevue, The Wall Street Journal, 8/5/14

New York State Gives Health Insurers Average Rate Rise of 5.7%, MetroPlus, The New York Times, 9/4/14 (Also covered in Crain’s Health Pulse)

Tracking premium changes on New York’s health exchange, MetroPlus, Capital New York, 9/8/14

A familiar recommendation for reducing city’s legal costs, HHC, Capital New York, 8/14/14

HHC’s Model Settlements, Crain’s Health Pulse, 8/7/14

NYS Medicaid providers awarded design grants, Dr. Ram Raju, President, Crain’s Health Pulse, 8/7/14

9/11 Health Law, Dr. Ram Raju, President, Bellevue, Gouverneur, Elmhurst, Crain’s Health Pulse, 8/18/14

Kids need to heed the rules of road as they head back to school: health experts, Dr. Concepcion Songco, Associate Director for Pediatrics, Elmhurst, New York Daily News, 9/4/14

HHC Pediatricians Share “Back to School” Health Tips, Dr. Warren Seigel, Chairman of Pediatrics, Coney Island, Harlemworldmag.com, 9/3/14

Back to School 101: What college students need to know, Dr. Warren Seigel, Chairman of Pediatrics, Coney Island Hospital, Metro Newspaper, 9/8/14

Elmhurst Hospital pediatric patients to get Fruit & Vegetable Prescription Program, Dr. Randi Wasserman, Director of Pediatrics, Elmhurst, Queens Courier, 8/8/14

Jacobi doc wins Bronx Peer award, Maria Castaldi, Chief of Breast Surgery, Jacobi, Bronx Times, 8/17/14

Capital Health Care: Raju on the health system; MVP hits at state, Dr. Ram Raju, President, Capital New York, 9/8/14

Raju named to AHA Board of Trustees, Dr. Ram Raju, President, Capital New York, 8/14/14

Interview with Martha Sullivan, Executive Director of Gouverneur Health, Martha Sullivan, Executive Director, Gouverneur Health, Social Work (video), 8/11/14

Leaving Stigma Behind, NY Cuts Red Tape on the IUD, Dr. Amita Murthy, Director of Reproductive Choice, Bellevue, WNYC Radio, 7/24/14

Bellevue Hospital gets FEMA aid for Sandy, HHC, Bellevue, Associated Press/The Wall Street Journal, 8/14/14 (Also covered in Capital New York and Crain’s Health Pulse)

NYSNA: FEMA’s snubbing HHC, Crain’s Health Pulse, 9/2/14

Results Drive Demand for Ventilator Care And Weaning at Harlem’s Henry J. Carter Specialty Hospital, Leading Age Magazine, Summer 2014

HHC’s New Housing Project, Crain’s Health Pulse, 8/13/14

Friends of Harlem Hospital Honors Rangel And Others with the Memorial Award, HHC, Harlem Hospital, Harlemworldmag.com, 8/13/14

Doctors Council Embraces Politics, HHC, Crain’s Health Pulse, 9/15/14