RAMANATHAN RAJU, MD
HHC PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
DECEMBER 18, 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.
Next week, HHC will submit the final application to participate in the Delivery System Reform Incentive Payment (DSRIP) program, a $6.42B Medicaid Waiver program intended to achieve sustainable health care system transformation and significantly decrease avoidable hospitalizations. HHC is leading a Performing Provider System (PPS) which is organized into local, borough-based hubs to best meet community needs. Each PPS hub is comprised of Medicaid providers, community-based organizations and other stakeholders who will undertake the eleven selected DSRIP projects over the next five years.
As I reported last month, we secured agreements with four other emergent PPS's to work together to implement health care projects in the Bronx, Brooklyn and Queens. This month, SUNY Downstate Medical Center officially joined the HHC-led PPS and will be a key partner to help transform the health care delivery system in the borough of Brooklyn. We continue to engage in discussions with many other community-based and city-wide organizations, labor and affiliate partners, our Community Advisory Board members and others about the community needs assessment (CNA) process and results and the creation of guiding principles for successful partnership over the five-year program period and beyond.
We believe that by working together, all our institutions have greater opportunity to lead in improving the health of the communities we serve in every borough. We look forward to the approval of our application, which will officially set in motion a major change in the way the entire industry delivers care to New Yorkers and will accelerate HHC’s goals to create a sustainable health care system focused on providing high quality, person-centered care in a population health management model.
CURE VIOLENCE AGREEMENTS WITH HHC PARTNERS
In August 2014, the de Blasio Administration and the New York City Council announced a $12.7 million investment to support and expand Cure Violence (CV) programs and other comprehensive, community-based strategies to prevent gun violence. The CV programs operate in conjunction with HHC’s Guns Down, Life Up programs.
Of the allocated grant monies, HHC and The Fund for HHC serve as the fiscal conduit for approximately $5 million for Fiscal Year 2015, which will support Cure Violence organizations and other hospital-based work aligned with Guns Down, Life Up. As of today, HHC has entered into 24 contracts with provider organizations selected by the City Council and the de Blasio Administration for their respective locations within high-violence areas and for their capability to undertake and execute violence reduction work. The Fund for HHC will oversee these fully grant-funded contracts.
FLU SEASON BEGINS
Last week we received notice that Acting NYS Health Commissioner Dr. Howard Zucker had declared that influenza is now prevalent in New York. At HHC, this means that all personnel must either be vaccinated against flu or wear a mask whenever they are in HHC facilities, including a home health care setting for home health personnel.
This is the policy of the NYS Department of Health and it will be the HHC policy for the duration of flu season, but it is so much more. It represents our ongoing commitment to our patients and our families, to do whatever we can to keep them healthy. It is particularly urgent for health care providers to get a flu shot to protect their own health and the health of our patients, whose health is already fragile.
Our employee vaccination rate is presently 63%, well short of the 92% target that we've set to achieve what is called "herd immunity" -- the state of the community in which there is unlikely to be any new infections.
HHC offers vaccination that is readily available and free of charge, at vaccination tables in lobbies, at many facility events, and at Employee Health Service. Nurses also make rounds in all divisions, so employees can be vaccinated right where they work. Until employees are vaccinated, they must mask. Masks will be provided by all supervisors, and are free of charge. They must be used without exception until Dr. Zucker declares that flu season is officially ended.
HHC LEADERS SHARE EXPERTISE AT BREAKTHROUGH CONFERENCE
Last month more than 200 HHC leaders and staff had the unique opportunity to attend the 6th Annual Breakthrough Conference. The audience learned about Lean Leadership and Management Systems from two guest lecturers and panels composed of HHC leaders. Many HHC facilities and individuals were recognized for their contributions to advance Breakthrough's implementation and improvements. One example is Elmhurst Hospital, which reduced the Average Length of Stay for Behavioral Health inpatients from 26 to 16 days.
On December 13th, the Senate passed what the House of Representatives had already approved on December 11th -- a $1.1 trillion spending plan to fund most government agency operations through September 2015. The spending bill includes $5.4 billion in emergency funding to support domestic and international efforts to combat Ebola.
Hospitals across the country will have access to funding to support Ebola preparedness, and treatment efforts through several different funding streams. The bill provides $1.77 billion for the Centers for Disease Control and Prevention (CDC). The CDC will have funding to support public health emergency preparedness, state and local response, worker training and migration and quarantine efforts. In addition, the bill includes $733 million for HHS to prevent, prepare for, and respond to Ebola. HHS will also have funds to implement a regional strategy for designating treatment Centers. Bellevue is on track to becoming recognized by HHS.
Within 30 days, HHS Secretary Burwell has a mandate from Congress to release details about the various Ebola funding streams and the process to apply for such funds. HHC will be prepared to apply to all CDC and HHS programs for which we might possibly be able to draw down support for funding as soon as details from HHS are available.
The Corporation held meetings last week in Washington with staffers from the NYC Congressional delegation to brief them on our two-year effort to achieve Federally Qualified Health Center (FQHC) status for HHC's six diagnostic and treatment centers from HRSA. We will keep you up to date on further developments.
Near the end of last month, President Obama announced Immigration Accountability Executive Actions which challenge illegal immigration at the border, prioritize deporting felons rather than families, and require certain undocumented immigrants to pass a criminal background check and pay their fair share of taxes as they register to temporarily stay in the U.S. without fear of deportation. Most Immigrants who have children who were either born in the United States or came when minors will benefit from the Executive Action, which will allow them some leeway to stay in the United States.
The President's Executive Action will also lead to tens of thousands of New York residents becoming eligible for Medicaid coverage in New York, since New York State is required to grant Medicaid to any immigrant residing legally in the state. However, the federal government will not contribute its normative 50% match as the eligibility is only through state law. It is unclear how many uninsured HHC patients will gain insurance coverage as a result, but some should.
START OF STATE LEGISLATIVE SESSION
The 2015 state legislative session will kick-off on January 7th when the Governor delivers his annual State of the State Message to a joint session of the Senate and Assembly. Work on the 2015-16 State Budget is already underway, with much attention focused on how to spend the projected $5.1 billion surplus that has resulted from payments for legal settlements negotiated by State regulators. Because these are one-time payments, State Comptroller Tom DiNapoli and others have urged that it be spent on non-reoccurring expenses. Health care associations are advocating for $1 billion of the surplus to be added to the health care Capital Restructuring Financing Program. The Governor must release his Executive Budget proposal by February 1st.
CITY COUNCIL APPROVES LEASING OF DRAPER HALL FOR
DEVELOPMENT OF LOW-INCOME HOUSING
This month, the City Council voted to approve HHC's proposal to enter into a long term lease for the development of 203 units of housing for low-income elderly and/or disabled individuals in Draper Hall, which is part of the campus of Metropolitan Hospital Center. HHC has worked closely with several City agencies, local elected officials, community representatives and the developer, SKA Marin, on this project. Through the efforts of Speaker Melissa Mark-Viverito, the U.S. Department of Housing and Urban Development (HUD) agreed to a 25% community preference requirement for the units that will be developed. This will ensure that at least 50 apartments will be set aside for eligible residents of the community. HUD also agreed to perform a demographic analysis to determine if an increase in the community preference requirement would be feasible for this project.
I want to thank the Speaker and the City Council for approving this project and providing $2 million in capital funding as part of the budget agreement adopted in June for Fiscal Year 2015.
HHC FEATURED PROGRAM:
THE FUND FOR HHC/GUNS DOWN, LIFE UP VIOLENCE INTERRUPTION
As I do at every Board meeting, I'd like to highlight an important HHC program that is making a real difference in our communities far beyond the work inside the walls of our health care facilities.
As you all know, in addition to its many quality contributions internal to the Corporation, The Fund for HHC connects our corporation with highly significant and productive external undertakings across our city’s communities. A remarkable anti-violence program -- Guns Down/Life Up -- is one of these. I ask your forbearance as I invite Senior Advisor to the President and Executive Director of the Fund for HHC, Mr. Joe Schick, to briefly sketch the latest news of the Fund, and to highlight this very special program….
[Mr. Schick - - - 10 min presentation]
Thank you, Joe. I salute and congratulate the staff of all our Guns Down, Life Up programs for their courage and their message of positive change.
HHC FEATURED PERSON OF THE YEAR:
LILLIAN ROBERTS, LABOR LEADER
In my monthly report to the Board of Directors, I’ve begun a new tradition to highlight an HHC employee who has made an outstanding contribution to the communities we serve. I hope you have enjoyed meeting these wonderful and deserving members of our staff. For the month of December, I want to expand that tradition to feature a Person of the Year -- someone who has made a substantial contribution to our organization, to our patients and to our employees.
For the inaugural Person of the Year, I have chosen Ms. Lillian Roberts, the outstanding labor leader whose career in union activism, and advocacy in the pursuit of fairness and justice, spans half a century.
Ms. Roberts plans to retire at the end of this year and I could not end 2014 without a special thank you on behalf of the HHC employees she has so ably represented and on behalf of our patients who have benefitted from her compassionate leadership.
During the last 13 years, she has been the Executive Director of District Council 37, New York City's largest public employee union of 120,000 members. In our hospitals, more than 15,000 workers are members of DC 37, including social workers, psychologists, housekeepers, engineers, hospital technicians, and even chaplains.
But the long, proud history of Ms. Roberts as a unionist fighting for worker’s rights goes back many more decades. She grew up in the tenements of Chicago’s South Side and became a nurse’s aide. In 1959, she joined the hospital local of District Council 34, and was eventually hired as a union rep by District Council 19 in Chicago. She spearheaded the creation of five locals, and led an organizing drive in four Chicago mental health hospitals. She moved to New York to build up DC 37’s Hospitals Division, leading the union’s campaign to organize thousands of city hospital workers. She has led DC 37 since 2002 when she was elected as its first female executive director.
Time and again Lillian Roberts led negotiations for fare wages and expanded services for union members that range from improved access to affordable housing, to legal advice and educational programs. She’s dedicated her career to giving a voice to her members, helping to provide better opportunities and improve the quality of life of working men and women.
At the same time, she has always worked to develop strong, positive relationships with the representatives of management with whom she negotiated, recognizing the solid partnership between labor and management that insures our patients receive the very best health care.
Essence Magazine called her one of the most powerful persons in American labor and the New York Post included her in the list of 30 Most Influential Black New Yorkers in 2007. She has won much praise and respect from municipal leaders and hospital workers across our city. Today, I’m happy to join that throng of admirers as I name her: the Health and Hospitals Corporation 2014 Person of the Year.
Thank you, Lillian, for everything you've done for our employees and for our patients.
HHC IN THE NEWS HIGHLIGHTS
Hospital sexual assault program gets global attention, NCBH: Brigitte Alexander, MD, Medical Director of the Bronx Sexual Assault Treatment Program, News12 Bronx, 12/8/14
Expert offers tips on flu season protection, Dr. Elizabeth Jenny-Avital, Infectious Disease Specialist, Jacobi, News12 Bronx, 12/16/14
Brooklyn man who traveled to Mali tests negative for Ebola at Bellevue, WABC, 11/20/14
Patient at Bellevue Hospital tests negative for Ebola, WPIX, 11/20/14
U.S. designates 35 hospitals as Ebola centers, USA Today, 12/3/14
Monitoring for Those Exposed to New York Ebola Patient Ends, The New York Times, 12/3/14
U.S. hospitals wary of caring for Ebola patients because of cost and stigma, Bellevue, The Washington Post, 12/1/14
Costs of responding to Ebola adding up, HHC, Bellevue, USA Today, 11/26/14
GNYHA presses Obama for more Ebola aid, Bellevue, Crain’s New York, 12/3/4
Ebola: Who Bears The Cost of Keeping Us Safe? Bellevue, Roll Call, 12/10/14
Feds to reimburse Bellevue for Ebola treatment, Bellevue, AM New York, 12/12/14
Bronx health-care workers will fight spread of Ebola in Liberia, Dr. Julie Hoffman, Infectious Disease Specialist, Jacobi, Sara Back, Family Nurse Practitioner and HIV/AIDS Specialist, NCBH, New York Daily News, 12/15/14
Treating Ebola May Be Cheaper in Texas Than in New York, Dr. Raju, HHC President; Bellevue, Bloomberg News, 12/5/14
H.H.C. receives boost from de Blasio's budget, Marlene Zurack, HHC Chief Financial Officer, Bellevue, Capital NY, 12/12/14
Controller Thomas DiNapoli: NYC's financial outlook getting rosier, HHC, New York Daily News, 12/17/14
FEMA Grants $1.6 Billion in Assistance for Hospitals Hit by Superstorm Sandy, Terry Mancher, RN, CNO, Coney Island Hospital, HHC, Bellevue, Metropolitan, Coler, Nurse.com, 12/12/14
Insurers prepare for Obamacare, round two, MetroPlus, Crain’s 12/3/14
City hospital ranked as top performers by country's leading accreditor of health care organizations, Lincoln, NCBH, Bellevue, The Daily News, 12/2/14
HHC Lincoln Medical Center named "Top Performer", Denise Soares, Sr. Vice President of the Gen+/Northern Manhattan Health Network, Amsterdam News, 12/16/14
Bellevue Hospital recognized as "top performer", Steven R. Alexander, Executive Director, Bellevue, Town & Village, 12/15/14
Prescribing Vegetables, Not Pills, HHC, Harlem, Lincoln, Elmhurst, Bellevue, Dr. Sundari Periasamy, Harlem, The New York Times, 12/2/14
A Prescription for Produce?, Lincoln, Harlem, Yahoo.com, 11/26/14
Surgeon as Comfortable With a Paintbrush as She Is With a Scalpel, Dr. Kathryn Ko, Neurosurgeon, Kings County, The New York Times, 12/12/14
City to Lease Site to Affordable Developer for $100K per Year, HHC, Metropolitan, NY Observer, 11/26/14
City seeks to lease former nurses' dorm to affordable housing firm, build units for seniors, HHC, New York Daily News, 12/1/14
Health care is a civil right, says Dr Ramanathan Raju, HHC President Dr. Raju, Coney Island, MetroPlus, Asian Tribune, 12/16/14
East Harlem Nurses Welcome Patients to New LGBT Clinic, Metropolitan: Clifettia Grissett, RN, clinic staff nurse; Lillian Diaz, RN, CNO and Deputy Executive Directorn Nurse.com, 11/24/14
New York City’s HHC honors nurses, film director, Nurse.com, 11/19/14
Cash Money Records founders return to Harlem for annual turkey giveaway, Harlem, New York Daily News, 11/24/14
Changed Life for Brooklyn Boy Hit by Crossfire, Kings County, The New York Times, 11/28/14
Teen boy who survived East Harlem explosion has world of thanks to give, Harlem, New York Daily News, 11/28/14
Cheery Playroom Unveiled at Elmhurst Hospital's Pediatric Department, Chris Constantino, Senior Vice President of the Queens Health Network, Executive Director, Elmhurst, DNAinfo, 12/15/14
New foreign visit to hospital unit, NCHB, NY Daily News, 12/4/14
Plans resume to turn historic T Building into affordable housing, Queens, Queens Courier, 12/17/14
Audit finds city misspent $183 million in Sandy hospital funds, HHC, Bellevue, Coney Island, Capital New York, 11/28/14