RAMANATHAN RAJU, MD
HHC PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
May 28, 2015
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.
OneCity Health Update
Dr. Christina Jenkins was appointed by unanimous vote as President and CEO of OneCity Health, the HHC subsidiary that serves the partners of our DSRIP Performing Provider System (PPS). I am most pleased to announce this appointment because the transformation of our healthcare delivery system needs leaders like Dr. Jenkins. She knows how to put patients first, and is the perfect choice to guide our team and help us meet the Medicaid reform program goals and objectives for better-coordinated care and improved health outcomes for all New Yorkers.
This month, we held kick-off meetings within each of our four OneCity Health PPS hubs. At them, Dr. Jenkins provided updates on implementation planning, hub level planning, and the contracting process. Various patient scenarios were presented to partners and opportunities to collaborate on improving the provision of care were explored and discussed.
We expect to receive our first DSRIP payment in early to mid June.
Harmful 340B Drug Discount Program Language Dropped from 21st Century Cures Bill
Legislation was introduced recently in Washington in an attempt to speed up the drug approval process and combat various rare diseases, disease treatment, management, and cures. The 21st Century Cures bill recognizes that health research and technology that develops breakthrough medicines moves quickly, but the federal drug and device approval has not kept pace.
HHC, and other providers who participate in the federal 340B drug pricing program, were very concerned with amendments to the bill that were proposed by the pharmaceutical industry, which seek to weaken or eliminate the program. After considerable push back by 340B program advocates, the House Committee on Energy and Commerce did not include proposals to reform the 340B Program. The bill was reported out of committee and will now head to the House floor for a vote in the coming weeks.
Testimony at City Council Budget Hearing
Last week, I testified before the City Council Finance, Health and Mental Health Committees on HHC's budget.
In my testimony I highlighted HHC's Vision 2020 agenda. I told the Council that improving the patient experience is my number one priority for the Corporation.
The Council raised concerns regarding our finances over the long term. However, they expressed support for our efforts to secure financial viability.
Many Council Members expressed strong support for HHC in our efforts to attract new patients and increase revenue. They will continue to advocate with us to reform the State's charity care funding distribution formula
Patient-Centered Medical Home Recognition for All Primary Care Practices at
HHC Health Centers on Staten Island
I am very glad to announce that we now have NCQA recognized Patient-Centered Medical Home primary care practices in all five boroughs. The recent recognition of Mariner's Harbor and Stapleton health centers on Staten Island as Patient-Centered Medical Homes at level 3, the top level, is further evidence of HHC's commitment to high quality primary care as the foundation for improving the health of New Yorkers. These two centers join the primary care sites at our hospitals and diagnostic and treatment centers in the other four boroughs that have been designated by NCQA at level 3.
HHC Fellowship Program
I was very pleased last week to address a gathering of HHC leaders - 24 Fellows who have been nominated and endorsed by their Senior Vice Presidents and Executive Directors and individually selected out of a pool of 54 applicants. They are the inaugural class of HHC Fellows who will attend six intensive sessions of three days each, learning more about how they can leverage their skills, passion and vision for healthcare leadership. These are some of our best and brightest, and they are fully committed to having a strong impact on achieving our strategic priorities. We continue to nurture and train our leaders, preparing them to lead us into an even stronger future.
Lastly, thank you to HHC Board Member Dr. Jo Ivey Boufford for lending her expertise to the program by leading a session with the Fellows on population health.
HHC FABWay Awards
We have a winner! Ms. Elizabeth Pierre Assistant Director from HHC’s Office of Patient-Centered Care received the first FABWay (Finding a Better Way) award for going above and beyond to support her team and further HHC's goals. This program honors the work of outstanding Central Office employees who exemplify our Guiding Principles. Details about next quarter's FABWay nominations will be announced in July.
Health Equity Symposium
This morning I delivered the opening address at our full-day Health Equity Symposium. At Baruch College we convened nearly 100 key stakeholders to identify innovative initiatives to improve the timely delivery of quality, equitable and culturally competent care. Our staff reflects the same diversity that our patients do -- one of the great strengths of our system. We have a long history of providing equitable healthcare and we're convinced that even more can be done. We plan to set clear and tangible outcomes that will improve our ability to provide equitable healthcare and preserve our role as a leader in healthcare reform.
HHC Harlem Hospital Opens Expanded and Modernized Dental Center
Early this month I joined HHC Harlem Hospital leaders as they celebrated the opening of the hospital’s newly renovated and expanded dental clinic. The $6.3 million project brings increased patient capacity along with new dentistry and imaging equipment to a clinic that last year handled over 21,000 patient visits. I was joined by many luminaries, including Congressman Charles B. Rangel, Councilmember Inez E. Dickens and Mrs. Gwen Elliott-McIntosh, widow of the Center’s namesake Dr. James E. McIntosh.
As I’ve said repeatedly, there is no health without oral health. Dental hygiene is often overlooked as part of effective primary care, but poor oral health has been shown to contribute to other conditions such as stroke and heart disease. We are happy to make this investment in the long-term health of the Harlem community.
New Mental Health Service for Children and Teens at HHC Bellevue Hospital
A few days later I was very pleased to join First Lady Chirlane McCray this month as we announced a new mental health program at HHC Bellevue Hospital Center. The new Children’s Partial Hospitalization Program (CPHP) at Bellevue will provide day treatment and a “soft landing” for patients, aged 6 to 17, between hospitalization and outpatient care.
The program provides treatment in a medically supervised, safe and structured environment for patients who are at risk for psychiatric hospitalization or are experiencing significant functional impairment at home, in school, or in the community. Children in the program attend a K-12 NYC Department of Education special education school co-located with the acute and intermediate care services at Bellevue. The new program will expand access to psychiatric treatment and support to as many as 550 children and adolescents every year.
Proposed City Funding for Partnership with
Family Justice Centers to Provide Mental Health Services
The Mayor’s proposed Executive budget provides $1 million in FY16 and $1.7 million in FY17 and beyond to full-time mental health services at all family justice centers, in partnership with our providers. The centers serve more than 36,000 survivors of domestic violence each year.
The program is part of a major new investment in mental health the de Blasio Administration recommends as part of its Executive Budget, with $54.4 million FY16 and $78.3 million in FY17 and beyond to build a more effective and inclusive mental health system in New York City.
Lincoln Hospital Earns High Praise in Joint Commission Survey
Lincoln hospital performed extremely well on their survey by the Joint Commission early this month. They are accredited for another three years.
The survey team on a whole were extremely impressed by what they saw. Two of the surveyors were very emotional in their summation -- a tribute to what they saw during the survey. Congratulations to SVP Denise Soares, Executive Director Milton Nunez, Internal Medical Director Dr. Anita Soni and all the staff of Lincoln Hospital, for a job well done. Many thanks to our own Robert Nolan for representing the Board and attending the Leadership Session of the survey.
The remaining facilities being surveyed this year are Kings County Hospital Center and Sea View Hospital Rehabilitation Center and Home.
Last week we honored our doctors by celebrating 24 physicians in all five boroughs, during a ceremony marking Doctors’ Day 2015. Physicians from our hospitals, community health centers, home health services, and MetroPlus Health Plan were recognized for their leadership and commitment to advancing the mission of the public hospital system.
The practice of medicine is a unique profession. There is no greater responsibility than protecting and maintaining the health and vigor of one’s neighbors. Our doctors pursue one of the greatest and most meaningful callings and make the sacrifices that come with the territory. Thank you to all our doctors for choosing to work at HHC, where we strive to heal all New Yorkers regardless of their ability to pay or their immigration status.
Better Healthcare Needs Secure Housing
Today, as the Health and Hospitals Corporation Program of the Month, we shine a spotlight on our initiative to increase housing opportunities for our patients.
We understand that as healthcare leaders, we cannot just focus on healthcare anymore---not if we are serious about creating wellness throughout New York City.
We cannot just say:
“I have opened these clinics. I have provided excellent medical care. My job is over.”
Instead, we must act to improve the socio-economic determinants which affect the health of our patients. Among the most important of these is housing.
At our Corporation we understand that safe, affordable and accessible housing provides our patients with the best opportunity to connect to care.
I’d like to commend Senior Vice President Laray Brown’s longstanding leadership on this issue. Laray has spearheaded our partnership with NYC Housing Preservation and Development, NYCHA, HUD and the NY State Departments of Health and Housing and Community Renewal to develop a gorgeous apartment complex at Metro East 99th Street, adjacent to Metropolitan Hospital.
This new 10-story structure includes 176 one-bedroom and studio apartments. These units were designed to address the special needs of many of our skilled nursing home residents with mobility impairments that limited their opportunity for independent community living.
Health and Hospitals Corporation recognized a long time ago that only a holistic approach will result in our delivering the best care possible.
We believe that healthcare leaders can’t just complain about negative social determinants.
Wherever and whenever we can, we must do something about them.
That is why we have worked with other agencies and housing developers to create housing at Metro East 99th Street---
and at Camba Gardens on the Kings County Hospital Campus---
and at other projects across the city.
The Health and Hospitals Corporation is at the forefront of healthcare leadership in New York City because we strongly believe in serving as a social change agent. This is another way that we will empower our patients to lead the healthiest lives possible.
Josie Amilcar, Hospital Care Investigator and Christine Lascase, Social Worker
Queens Hospital Center
We hear so often about people who disappear from the lives of their family and friends. Sometimes over a period of time, sometimes abruptly and without explanation. These are tragedies of modern life--- always painful to learn about.
In 2012 a 74 year old Haitian-American woman here in New York City went missing. Her family has been looking for her ever since.
Fast forward to last month--- April 2015.
An elderly woman was found wandering and disoriented in a terminal at JFK.
She was taken to Queens Hospital Center for treatment.
She entered our system with…
no verifiable name…
While being cared for at the hospital, Josie Amilcar, a Patient Accounts Hospital Care Investigator and Christine Lascase, an In-patient Psychiatry Social Worker…each took an interest in this older lady.
Over a period of days, Josie and Christine visited repeatedly with the patient.
She was often disorganized and irritable.
She told stories of traveling the world, and of hotel suites.
It was difficult to determine what was accurate and what wasn’t.
Despite these obstacles, and the fact that neither Josie nor Christine were members of the provider team, these committed caregivers checked on the patient again and again ---in a dogged effort to understand, and help her.
They developed a relationship with her.
And at some point, in one of those conversations, our patient divulged her social security number to Ms. Amilcar.
And then, after a lot of internet searching, cross referencing, and monitoring social media, Josie and Christine came across a Facebook posting from the patient’s son indicating that his mother was missing.
They were able to identify her, and eventually, over a period of time, reunite her with her family.
What makes this story unique, is this:
Normally, hospital systems would have treated the patient, improved her condition, and placed her in a nursing home, without worrying about her fate after that.
She would have entered the hospital as a “Jane Doe”, and she would have left the hospital as “Jane Doe”.
But here at Queens Hospital Center, our patient left HHC with her identify recovered, and her family intact once again.
That empathy…That commitment to our patients… is what differentiates the great care that HHC provides, from that of our competitors.
We understand that what happens to our patients outside the medical arena impacts the care we provide inside.
And we act on that philosophy!
Please join me in thanking Ms. Josie Amilcar and Ms. Christine Lascase for demonstrating this so well.
HHC in the News Highlights
Bronx DA’s Office Offers Helping Hand to Sexual Assault Victims Years after Crime, NY1 News, NCBH: Dr. Brigitte Alexander, Medical Director, Sexual Assault Response Team
First Lady Chirlane McCray Announces Children’s Mental Health Program at HHC Bellevue, WNBC; WABC; WNYW: Bellevue, Dr. Jennifer havens, Director, Child and Adoescent Psychiatry; Elmhurst
Breast Cancer Awareness, News 12 Brooklyn, Woodhull: Dr. Stefan Balan, Chief, Cancer Care Center
Hospital Safety Ratings, News 12 Bronx, Lincoln; Jacobi
Breast Cancer Awareness, NY1 News, Elmhurst: Dr. Marlon Brewer, Associate Director for Ambulatory Care
Hepatitis Awareness Month Program, News 12 Bronx, NCBH: Dr. Yvette Calderon, Director of Emergency Medicine Department
Exclusive Interview with Chirlane McCray on 'Up Close', WABC, Bellevue
Man Reunites with Hospital Workers Who Saved His Life, WABC, Bellevue: Dr. William Goldberg, Dr. Robert Roswell, Dr. Nate Link
NYS Veteran Hall of Fame, News 12 Bronx, Jacobi: Analiza Benjamin, Senior Nursing Director
CEO Power Panel poll finds broad support for value-based pay, Modern Healthcare, Dr. Ram Raju, President
New kids’ “partial hospitalization” psych program in NYC, timesunion.com, Bellevue: Dr. Jennifer Havens, Director, Child and Adolescent Psychiatry
Chirlane McCray launches Bellevue Hospital program for kids with mental health problems, Bellevue: Dr. Jennifer havens, Director, Child and Adolescent Psychiatry; Elmhurst
Bellevue Psych Program, Bellevue: Dr. Ram Raju, President
Program targets mental health services for children, Bellevue
Harlem Hospital Opens New Dental Center, Harlem World, Dr. Raju, HHC President; Denise C. Soares, Senior Vice President of Generations+/Northern Manhattan Health Network and Executive Director of HHC Harlem Hospital Center; Ebonè Carrington, Chief Operating Officer of HHC Harlem Hospital Center
Harlem Hospital Center Renovates Dental Clinic, Healthcare Construction & Operations, Harlem: Dr. Raju, HHC President
Bellevue to host Breast Cancer info events, Town & Village Blog, Bellevue; Metropolitan: Dr. Ram Raju, President
How to have a healthy baby, Bronx Free Press, Lincoln: B.K. Rajegowda, MD, Director of Neonatology Services
Jacobi, NCB get new Chief Medical Office, Bronx Times, Dr. Jon Marley
Those saved by FDNY rescuers thank workers at National EMS Week ceremony, New York Daily News, Bellevue: Dr. William Goldberg
New York public health system's deficit to balloon without federal aid, Modern Heathcare, Dr. Ram Raju, President
Federal Cuts would be major blow to New York City’s Public Hospitals, Comptroller Says, The New York times, Dr. Ram Raju, HHC President; Lincoln
H.H.C. Pulls Plug on Dialysis Deal, Crain's Health Pulse, Dr. Ram Raju, President