REPORT TO THE BOARD OF DIRECTORS – September 2021

COVID Cases – Positive COVID-19 cases, hospitalizations and deaths have been on a general decline across the City. At NYC Health + Hospitals, our COVID-19 hospitalizations and ICU admissions during this third wave have also begun to decline. The hospitalizations we are seeing continue to be overwhelmingly among the unvaccinated. We continue to promote vaccinations and testing as our best tools to fight the epidemic. And all our health care facilities continue to require face masks for all staff, patients and visitors.

COVID-19 Vaccination – As of September 26th, we have administered more than 1.2 million total doses across 21 NYC Health + Hospitals vaccine hubs. We are now offering the 3rd dose of the mRNA vaccine to eligible immunocompromised individuals and this week also started offering the Pfizer booster for eligible individuals who have received the second Pfizer dose at least six months ago. Our vaccination hubs are also participating in the City’s incentive program that offers New Yorkers $100 when they get their first dose with us.

Vaccine Mandate for Health Care Workers – The State mandate requiring all health care workers to have at least one COVID-19 vaccine dose went into effect this week. We had an overwhelming response and achieved more than 92% staff vaccination rates. We had contingency plans in place to fill any expected staff gaps and many of those strategies were not necessary, as so many members of our workforce came forward to take this important step to keep our patients and each other safe. Our hospitals and health centers were open for care without interruption.

NYC Test & Trace Corps – Our NYC Test & Trace Corps team has continued to provide vital services to protect all New Yorkers. We are currently reaching more than 90% of all new cases, have identified more than one million close contacts, and have engaged 72% of them. We have succeeded because of the incredible work and sacrifice of our teams on the ground who have directed so many New Yorkers to critical help and lifesaving treatments ranging from our free hotels program, direct cash assistance, monoclonal antibodies, at home testing, and at home vaccinations. Our Test & Trace team is also helping NYC public schools, leading the Situation Room with DOE and DOHMH to keep our students and teachers safe, and giving our students the most important thing – an in-person education.

Public Health Corps – NYC Health + Hospitals is playing a lead role in launching the NYC Public Health Corps, a signature program announced by the Mayor earlier this year that will be a transition for many NYC Test & Trace Corps staff. This program will allow us to build a sizeable workforce of over 200 Community Health Workers (CHWs) who will focus on assisting patients meet their health goals and can be activated in future public health emergencies. CHWs will initially be recruited from the existing teams of contact tracers who already have deep experience engaging with patients in very challenging circumstances. CHWs are trained public health workers who have a close understanding of the communities they serve. This enables CHWs to serve as a liaison between health and social services, bridge cultural and linguistic barriers, address barriers to health and well-being, improve primary care engagement, and reduce avoidable hospitalizations.

Most of the Public Health Corps workers will be based in NYC Health + Hospitals outpatient clinical sites, and some will work in the community doing home visits. This program will serve different segments of NYC’s population, including children and families, adults, New Yorkers experiencing homelessness and those involved in the criminal-legal system. Building a strong, well-trained workforce of CHWs is key to investing in the health and well-being of New Yorkers, particularly in low-income neighborhoods and communities of color that were disproportionately affected by the COVID-19 pandemic. This large new workforce reflects our commitment to providing quality health care for our patients – care that is not limited to the walls of our doctors’ offices, but extend into NYC communities to address patients’ social needs, like food, income, housing, that are so essential to achieving health and well-being.

Federal – Last week, FEMA notified NYC Health + Hospitals that they are planning to provide reimbursement for the full amount of temporary staffing costs from March-August 2020 that had been pending with them since fall 2020. This would increase the FEMA reimbursement amount awarded thus far to over $600 million. The timeline for full payment has yet to be determined, but with strong support from Senator Schumer and Representative Torres, we are confident that we will not face substantial delays. We are extremely grateful to our leaders for their relentless support of our needs and our mission.

NYC Health + Hospitals recently submitted three sets of comments to federal regulatory agencies and Congress:

• Physician Fee Schedule comments: Our feedback concerned maintaining telehealth flexibilities that have assisted NYC Health + Hospital during the COVID Public Health Emergency and can be of use going forward, and strategies to advance health equity.
• Outpatient Prospective Payment System comments: Our feedback concerned maintaining all regulatory flexibilities that have assisted our health system during the COVID Public Health Emergency and can be of use going forward, and strategies to advance health equity.
• Social Determinants of Health comments to the Congressional Social Determinants of Health Caucus, regarding funding and programmatic strategies that could be implemented at the Federal level to make an impact in this subject area.

State – On August 24, Kathy Hochul was sworn in as the 57th Governor finish former Governor Andrew Cuomo’s term following his resignation. The Governor is in the process of establishing her own cabinet, some staff announcements have been made and more changes could be expected as the Governor set a 45-day evaluation period of current staff and Commissioners. Governor Hochul has appointed former State Senator Brian Benjamin as the new Lieutenant Governor. Lieutenant Governor Benjamin represented 3 Health + Hospitals facilities in his State Senate district (Harlem Hospital, Carter, and Sydenham). He has been a steadfast supporter of our system, and we are thrilled to have him move into a State leadership role. There will be a special election in November to replace him in the State Senate. In addition, there will be a special election for Assembly District 86 as the former Assembly member stepped down. Gotham Health’s COVID Center of Excellence in Tremont is in his district.

City – The City Council is moving through its fall calendar, holding 3 relevant hearings in the month of September.

• September 17 – Coordinating City Agencies to Address Serious Mental Illness, Committee: Mental Health, Disabilities and Addiction. NYC Health + Hospitals participated in Q&A only – Dr. Barron and Rebecca Linn-Walton. Susan Herman led testimony from CH.
• September 24 – NYC Interns and Residents’ Wellness and Health, Committee: Hospitals. NYC Health + Hospitals provided testimony by Dr. Donnie Bell with Q&A with Dr. Omar Fattal and Jeremy Segall.
• September 30 – Mandated COVID-19 Vaccinations and Testing for All Municipal Workers, Committee: Joint Health Committee and Hospitals Committee. NYC Health + Hospitals will be participating in this hearing for Q&A only.

Community – The NYC Health + Hospitals Council of CABS conducted the first meeting of its 2021-2022 cycle on Tuesday, September 14. We are delighted to have new leadership at the Council of CABS. Warren Berke from Kings County Hospital is serving as Chair, building on the work of his predecessor, Dr. Anthony D. Andrews, Jr. of Queens. We look forward to working with Mr. Berke and the rest of our CAB leadership.

NYC Health + Hospitals had an FY-21 closing cash balance of $737M (33 days cash-on-hand). This is right in line with the system’s target from the Executive 2022 Financial Plan. The health system had a net budget variance of -$10.9M, through May FY-21. The variance excludes T2 revenue and includes about $630M in COVID costs that we have not received federal relief for yet. Our direct Patient Care Receipts came in $459M higher than YTD May FY-20 continuing the pace of positive performance that we experienced during FY-20, where direct patient care revenue came in $500M over the prior year. Our patient care volume is returning to pre-COVID-19 levels in Q3 of FY-21, but is still below Q3 FY-20. Revenue base is strong and resilient primarily driven by Medicare rate increases and the stability of VBP/sub-cap contracts.

FEMA Reimbursement – Following up on the meetings with Senator Schumer and Congressman Torres, FEMA has re-engaged with NYC Health +Hospitals/OMB and appears committed to resolving our outstanding COVID-19 claim issues as soon as possible.

DSH Glitch– NYC Health + Hospitals has received the Federal fiscal year 2020 payment and expects to receive the 2021 payment balance, securing over $800 million, that would have otherwise been lost if Congress did not act.

Temp Staffing – We have hired sufficient temporary staff to cover those employees who have thus far opted not to be vaccinated. NYC Health + Hospitals will also be implementing an enhanced overtime program for RNs in an effort to reduce expensive contract nurses.

NYC Health + Hospitals is very proud of all the Correctional Health Services (CHS) professionals who provide health care to persons detained in the City’s jail system. Our services include medical, nursing, and mental health care; substance use treatment; social work; dental and vision care; and discharge planning and reentry support. The care CHS provides meets or exceeds national standards for quality and state-of-the-art interventions that help keep our patients healthy, including the first and largest jail methadone program; our cutting-edge mental health therapeutic PACE units; and the only jail-based geriatric program in the country.

Due to the courageous efforts of our Correctional Health Services staff, the jails on Rikers Island and in the borough facilities did not experience catastrophic COVID-19 outcomes last year and our staff were able to consistently keep the overall prevalence of COVID-19 below the community average after the initial wave until late summer 2021.

Unfortunately, our ability to provide the best health care on Rikers has been compromised by the lack of sufficient number of correctional officers to enable our staff to deliver all the health care that patients need in a safe environment. The Mayor has instituted a multi-pronged plan that has already improved conditions. The biggest changes have been to move the intake area to a much larger space that allows better patient flow and sufficient physical distancing to decrease transmission of COVID-19; increase in the number of officers in key positions including in the clinical areas so that it is safe for providing care; increased cleaning of the facilities to ensure a more sanitary environment; decrease of the number of persons in custody through transfers to the other jurisdictions and safe releases; and extensive efforts to bring more correction officers back to work.

We believe that the standard of medical care should be the same whether you are in the community or in a jail, and CHS continues to deliver to this standard.

This past month, the remnants of tropical storm Ida inundated a number of NYC Health + Hospitals facilities, which were impacted by such a high volume of intense rainfall overnight, which backed up the City’s and our local storm water systems. Elmhurst, Lincoln, Harlem, Woodhull and Jacobi hospitals were some of our most heavily impacted sites, although all sites required additional cleaning and at times pumping of minor water damage. NYC Health + Hospitals facilities staff worked through the night and vendors were deployed to address flooded elevator pits and some damaged elevator equipment due to the flooding. Clinical operations were able to continue with minimal impact.

The Governor yesterday announced that Dr. Mary Bassett has been appointed Commissioner of the New York State Department of Health. With more than 30 years of experience devoted to promoting health equity and social justice, Dr. Bassett’s career has spanned academia, government, and not-for-profit work. Many of us in this room have had the pleasure of working closely with Dr. Bassett in her former role as NYC’s Health Commissioner and as member of the NYC Health + Hospitals Board of Directors. She has been a strong supporter of our health system since the beginning of her career when she did her residency at NYC Health + Hospitals/Harlem and we look forward to working with Dr. Bassett in her new role.

NYC Health + Hospitals Senior Vice President of Facilities Management Christine Flaherty will be honored by the National Association of Minority Contractors (NAMC) and the NAMC New York Tri-State Chapter as a Silent Hero for outstanding work during the COVID-19 recovery process in New York. As you know, Christine and her team have been instrumental in supporting all our space and infrastructure needs through this pandemic, including our ability to expand ICU beds during the surge. NAMC, the oldest minority construction trade association in the United States, has been a major voice for minority-, women-, and veteran-owned construction contractor small businesses. They will present this well-deserved award next month at their annual gala.

Congratulations to NYC Health + Hospitals/Metropolitan CEO Cristina Contreras on being honored as one of the Distinguished Dominicans Abroad by the President of the Dominican Republic Luis Abinader. Cristina was recognized for her great contributions to the Dominican community and her professional achievements, including her many years of service and leadership roles at NYC Health + Hospitals. The award was presented at a special ceremony hosted by the Dominican Republic’s Ministry of Foreign Relations through the Instituto de Dominicanos y Dominicanas en el Exterior (Institute of Dominicans Abroad) and Cristina was joined by US Congressman Adriano Espaillat, members of the Dominican government, and other community leaders.

NYC Health + Hospitals Chief Nurse Executive Natalia Cineas, DNP, RN, NEA-BC has been selected to be a Fellow of the American Academy of Nursing. Induction into the Academy is a significant milestone in a nurse leader’s career in which their accomplishments are honored by their colleagues within and outside the profession. Fellows are selected based on their contributions and impact to advance the public’s health. Natalia is one of 225 individuals selected to be inducted into the 2021 Class of Fellows. Congratulations to Natalia, “Dr. Cineas has led our system’s nurses through challenging times during her tenure, but with steadfastness she led her workforce through those moments triumphally.

Earlier this month we announced the appointment of Eric Wei, MD, MBA as interim CEO of NYC Health + Hospitals/Harlem. Eric will temporarily replace outgoing CEO Eboné Carrington while we conduct a national search to fill the executive position for the hospital permanently. We are fortunate to have Eric take on this additional responsibility. Not only has he worked shifts in every Emergency Department across our system, including at Harlem Hospital, he most recently served as interim CEO of NYC Health + Hospitals/Elmhurst. His clinical expertise and extensive knowledge of our operations have ensured a seamless transition.

NYC Health + Hospitals Chief Value Officer Hyung (Harry) Cho, MD, FACP, SFHM, has been named to Modern Healthcare’s Top 25 Innovators list for 2021. This year’s Top 25 Innovators championed solutions to reshape the industry in big and small ways, pushing boundaries to help solve healthcare’s greatest challenges. Harry was recognized for his innovation and leadership in a number of value and safety initiatives at NYC Health + Hospitals, including preventing unnecessary testing and treatment that leads to patient harm. Such programs have helped secure over $11 million per year in estimated cost savings and improving safety for patients. Harry is our inaugural Chief Value Officer and has been an incredible asset to our health system.

• Mayor de Blasio Launches the NYC Public Health Corps
• Test & Trace Engages Over 1 Million Close Contacts through Trace Program
• NYC Health + Hospitals/Gotham Health, Vanderbilt Celebrates Diabetes Center Grand Opening
• NYC Health + Hospitals/Metropolitan, the Government of the Dominican Republic Announce New Partnership Regarding Health Care of Dominican Government Employees in NYC
• Vaccine Referral Bonus Program’s Organizations Refer Over 20k Vaccinations
• Flu Testing Now Available at All Test & Trace Mobile Testing Units
• World Trade Center Environmental Health Center Commemorates 20th Anniversary of 9/11
• Newsweek Names Bellevue Hospital Among Nation’s Best Physical Rehab Centers
• System’s ACO earns Medicare Shared Savings for 8th Consecutive Year
• Families Reminded to Schedule Kids’ Well-Visits, Vaccinations Ahead of School Year
• Vaccine For All: Over 200,000 Vaccinations Administered at Citi Field
• American Heart Association Recognizes NYC Health + Hospitals for Efforts in Cardiovascular Treatment
• Coney Island Hospital Receives $17M to Rebuild, Expand Primary Care Services
• NYC Health + Hospitals/Gotham Health, Vanderbilt to Open Diabetes Center in the Fall
• Virtual ExpressCare Proves to Reduce Unnecessary ED Visits
• NYC Launches Comprehensive Mental Health Resources Website
• Jacobi Doctors Appointed Honorary NYPD Police Surgeons
• NYC Test & Trace Announces At-home Testing for Immunocompromised and Those Ages 65+
• Bellevue Hospital Opens News Same-Day Surgery Suite
• 500th Person Donates Blood at NYC Health + Hospitals/Bellevue To Replenish New York’s Blood Supply Amidst Shortage
• City & State Names Bronx Hospital CEOs on 2021 Bronx Power 100 List
• US News Rates All Public Hospitals as High Performing in At Least One Specialty Area
• Coney Island Hospital Campus To Be Renamed As South Brooklyn Health
• NYC Care Celebrates Two-Year Anniversary with Membership Drive
• Family Health Program Provides Enhanced Health Services to Children in Foster Care
• Statement from Mitchell Katz, M.D., President and CEO Of NYC Health + Hospitals, On New City Health and Safety Requirement For COVID-19 Vaccine On Weekly Testing for Health Care Workers
• Annual Farmers Markets Helps Expand Access to Affordable Healthy Food Options
• MetroPlusHealth Ranks #1 in 2020 Medicaid Quality Incentive Program