ALAN D. AVILES
HHC PRESIDENT AND CHIEF EXECUTIVE
REPORT TO THE BOARD OF DIRECTORS
October 26, 2006

In recent months I have reported on our corporate-wide quality improvement collaboratives focusing on chronic disease management and critical care that have produced very promising results. I want to alert you that we have established a separate learning collaborative specifically to address chronic disease management for HHC’s pediatric patients, and we held our third learning collaborative session for ten pediatric clinical teams from various facilities earlier this month.

The National Institutes of Health reports that more than 20 percent of all children in the United States suffer from chronic health conditions, with asthma being the most prevalent chronic health problem. Many of our facilities already have made significant headway in the consistent prescribing of the most appropriate asthma medications and in the use of asthma action plans for our pediatric asthmatics. As a result, we had 2000 fewer pediatric emergency room encounters and more than 600 fewer pediatric hospital admissions related to asthma this past year. The teams involved in our pediatric chronic care collaborative will be deepening our work around family engagement in asthma management and will addressing the management of diabetes in children. Ours is the first quality improvement collaborative in the nation to focus on pediatric diabetes and we're working with a faculty of national experts to jointly develop best practices in this area.

I will keep the Board apprized of our teams’ progress in this important area.

While I have reported before on our HIV testing program expansion, earlier this month we publicly released our results for the first full year of the initiative and they are worth repeating. As you know, HHC is working to make HIV testing part of routine medical care to lessen the stigma still associated with HIV and to help reach more New Yorkers who may have the disease and not know it.

As a result of the hard work of staff across our system, HHC tested more than 92,000 patients during FY06, a 63 percent increase over the 58,000 tested in FY05. In the process, we were able to more than double the number of HIV positive patients identified from 720 patients in FY05 to 1,514 individuals in FY06. The vast majority of these newly identified HIV positive patients have been linked to care. Our success thus far results from the wide use of rapid testing methodologies and the expansion of our testing beyond the HIV and prenatal clinics, where it is commonly done, to emergency departments, outpatient clinics and inpatient units. We are committed to continuing to expand our efforts and will seek to test 150,000 patients in the next year.

Our Take Care New York health screening campaign continues through next week for the last of five Take Care New York Tuesday events. Last month I shared with you our radio public service announcement with the variety of staff voices saying “Take Care New York” in multiple languages. That radio PSA, along with the print public service ad, has resulted in more than $335,000 of free advertising placements in daily and ethnic press across the city – including significant placements in the NY Times, NY Daily News, NY Post, Hoy and numerous popular radio stations like WABC, WCBS, CD101.9, KISS FM, and WADO radio. This represents an estimated 35 million reader and listener impressions across the city that we have been able to reach with no advertising expenses. We also reached an estimated 4.5 million readers and viewers through the news media which provided significant coverage of the campaign.

A battle over babies took place Tuesday, October 17 when Elmhurst Hospital claimed the 300 millionth American with the birth of Emanuel Plata, a 6 lbs., 15 oz. baby boy born at 7:46 a.m. – the precise time the U.S. Census Bureau expected the historic population milestone to be reached. While other area hospitals identified other baby contenders for the title, ours led in recognition with his distinct hat and blanket – including a prominently placed HHC logo – which proclaimed him the official 300 millionth American baby. While it is impossible to identify the 300 millionth American with certainty, the birth at Elmhurst was a symbolic representation of this population landmark that allowed HHC to be part of an important moment in history.

Emanuel’s parents are Gricelda Plata and Armando Jimenez, residents of Brooklyn and natives of Mexico. It’s no surprise that the 300 millionth American was born in an HHC facility to an immigrant family – after all, we deliver more than 21,000 babies a year. For all the extraordinary changes across our public hospital system, one part of our history has remained the same: we continue to be the preferred medical home for our city’s immigrant families. And we demonstrated it proudly with Emanuel’s birth. Other HHC babies came close to being the 300 millionth: Kings County delivered a baby at 7:43 a.m.; Metropolitan Hospital delivered a baby at 7:55 a.m.; Woodhull Hospital delivered a baby at 7:57 a.m.; and Jacobi Medical Center delivered a baby at 8:01 a.m.

As you know, HHC has been working continuously with various stakeholders on Staten Island to establish additional primary care services for medically underserved Staten Island residents. Earlier today I joined Mayor Bloomberg at an eagerly anticipated ribbon cutting ceremony for the Community Health Center of Richmond - the new health center which has been developed to meet many of the health needs on Staten Island's north shore. The center has now added adult primary care to its existing OB/Gyn and pediatric services. Work continues on a planned expansion of the center’s current space. The center began providing services on July 5th, as previously reported to the board.

A further milestone was achieved for Staten Island residents this month when the Staten Island Health Access (SIHA) program passed the 2,000 mark at the end of September, having registered 2,006 individuals in SIHA and obtained public health insurance for more than 200 individuals. The SIHA program was initiated to offer primary and preventive health services to low-income Staten Island residents who do not qualify for other programs and it will continue to operate through June 2007.

Coney Island Hospital recently launched its Healthy Heart Program targeted to the South Asian community which suffers from a high incidence of premature Coronary Artery Disease. South Asians are four times as likely as Caucasian or other Asian populations to be diagnosed with early onset Coronary Artery Disease. The program has aggressively reached out to the Pakistani, Bangladeshi and Indian communities in southern Brooklyn to encourage screening at the hospital.

HHC facilities continue to be recognized nationally by top professional organizations and health advocacy groups for providing outstanding patient care, leading edge medical technology and improved access for underserved communities.