Remarks by Alan D. Aviles
President, NYC Health and Hospitals Corporation

Good Evening, I am Alan Aviles, President of the New York City Health and Hospitals Corporation (HHC). Thank you for coming to speak tonight. I would also like to acknowledge our hosts Angelo Mascia, Executive Director of Sea View Rehabilitation Center and Home and Peter Wolf, Senior Vice President of our Southern Brooklyn and Staten Island Health Network.

Before Mr. Levy calls upon the speakers, I would like to provide an overview of HHC’s accomplishments this past year on Staten Island and to highlight some of our commitments for the next three years.

Across our entire system, we are working to provide safer care that prevents unnecessary harm to our patients, to provide more effective care that better manages chronic disease, and to provide more preventive care that averts disease or that diagnoses disease at an early stage. Our success on these fronts – which has increasingly received both local and national recognition -- speaks to the commitment of our staff at all levels, to our mission and to our patients.

In September, HHC became the first healthcare system in the state of New York to voluntarily disclose certain detailed quality and patient safety data to the public. The information we are sharing includes our mortality and hospital-acquired infection rates; how often we follow best clinical practices in treating heart attacks, pneumonia, and other medical conditions; and how well our nursing homes are doing in providing quality care. This data is available on our public website which is nyc.gov/hhc.

On the site, you can see that our hospitals and nursing homes compare well to state, regional, and national standards on a number of important quality measures. Sea View has done quite well on two of the three standards related to nursing home care and continues to improve on the third. Specifically:

• Pressure ulcers among Sea View’s high risk patients decreased from 9% for the period from January through June 2006 to 6% for July through December 2006. Sea View’s rate of pressure ulcers is better than the national average of 13%, the NYS average of 14% and the HHC average of 10%.

• 3% of Sea View’s short-stay nursing home residents reported moderate or extreme pain within 7 days of admission for the time period from July through December 2006, decreasing from 7% for the previous time period of January through June 2006. Sea View’s rate was considerably better than the national, NYS and HHC averages of 22%, 17% and 10%, respectively.

• 7.9% of Sea View’s residents had a fall during the period of January through June 2006, higher than the 6.95% reported in the previous six month period. Sea View’s prevalence of falls among its residents was significantly lower than the NYS average of 15.4%, but slightly higher than the HHC average of 7.63%.

Apart from showcasing some of our very positive results in rendering high quality care, I am convinced that our commitment to transparency related to quality and patient safety data will help to drive further improvements throughout HHC. The information on our website effectively provides a baseline from which the public and we, ourselves, can measure our performance over time. Sharing this information may leave us open to criticism in some areas, however we believe that it helps to build trust and confidence in our commitment to ensure that the care we render is as safe, effective, efficient and patient-centered as possible.

Before the end of this year, we will release data on our efforts around prevention and early detection of disease, as well as data on how well we are doing in helping our patients manage their chronic diseases such as diabetes and asthma.

We believe that capital investments in our facilities and programs play an important role in our efforts toward continual improvements in quality, safety, patient-centered care and efficiency. Therefore we have continued to invest in our Staten Island facilities. During fiscal year 2007:

• Phase 1 of an upgrade to Sea View’s Robitzek Building was completed;

• Seventy-five (75) new beds for the nursing facility’s residents were installed;

• Seven (7) new buses, which support Sea View’s Adult Day Health Care Service and a variety of the therapeutic activities provided to residents, were purchased. Of these, three (3) were funded by the City Council;

• A new digital x-ray unit was installed at Sea View. This state-of-the art equipment was funded by Council Member Oddo;

• The Colony Hall ramp was replaced; and

• The new site for the Mariner’s Harbor Child Health Clinic at 2040 Forest Avenue was fully renovated. These renovations were supported with funds provided by Council Member McMahon.

We have another $3.5 million worth of capital projects that were completed this fiscal year or will be completed by June 2008. They include routine improvements on the Sea View campus such as sprinkler system upgrades, boiler plant tank replacement, campus roadway resurfacing, and signage updates. Importantly, they also include the purchase of 155 Vanderbilt Avenue for the development of an HHC–operated ambulatory care center, as well as the completion of renovations at the Community Health Center of Richmond. These renovations will enable the Community Health Center to increase service capacity.

We also began the design phase for two new projects on Sea View’s campus this year: the upgrade to Robitzek Building’s elevators and the renovation of the Shakespearean Theatre.

The cost of design for the renovations to the Shakespearean Theatre was funded by the Borough President’s Office; and in addition to the completed projects that I have mentioned, the Council is providing funding to support the Sea View campus roadways improvements.

We appreciate the capital funding support that HHC’s facilities have received from Staten Island’s elected officials and respect their strong commitment to ensuring that Staten Island residents have access to quality health care. While our elected officials will continue to challenge us to do more, over the past two years, we have made important investments to improve access to primary care and health promotion services on Staten Island for uninsured, low-income and vulnerable Staten Island residents. These include:

• Continuing to significantly subsidize the operations of the Community Health Center of Richmond by more than $3 million. The Community Health Center celebrated its first year anniversary in July; and has served more than 6,500 adult and pediatric patients, who made nearly 9,500 visits to the Center this past year. HHC is proud of the dedication and work of the Community Health Center’s Board – led by President Maribel Sansone and Vice President Dr. Tony Baker – and its Executive Director, Jack Essex.

• Extending the Staten Island Health Access (SIHA) program. Through SIHA, HHC has engaged 19 Staten Island-based physicians to serve as primary care doctors for 3,770 individuals. As part of this program, we have also funded the Staten Island Jewish Community Center to assist uninsured individuals in obtaining the public health insurance for which they are eligible. One thousand and sixty-six (1,066) individuals have obtained health insurance through the SIHA program. HHC will have provided $3.8 million in funding for this program by July 2008.

• Providing funding to the Institute for Behavioral Research (IBR), a Staten Island-based provider of services for persons with disabilities. HHC is committed to providing $200,000 to support diagnostic consultation and training services conducted by IBR this year.

• Expanding access to mammography services through a $300,000 contract with the Women’s Outreach Network (WON). WON has screened 113 women through this contract so far this year; we anticipate that a total of 1,700 women will be served by June 2008 through this contract.

• Funding Staten Island University Hospital and Richmond University Medical Center to provide uninsured Staten Island residents access to colonoscopies when we conduct extensive city-wide colon cancer screening and outreach campaigns.

• Purchasing 155 Vanderbilt Avenue, a community health facility that was sold by the Catholic Medical System. This purchase represents another $1.3 million investment towards strengthening the primary care infrastructure for adults and children in the borough.

We will continue to invest in expanding primary care and specialty care services capacity on Staten Island. Over the next three (3) years, we will implement a $15.15 million plan that includes:

• Provision of mobile medical services that will serve residents throughout the borough;

• Establishment of two additional health centers to be operated by the Community Health Center of Richmond; and

• Establishment of an HHC primary care and specialty services ambulatory care center at 155 Vanderbilt Avenue.

We are committed to working with all of our elected officials and other stakeholders to obtain input on these program strategies and to carry-out this action plan.

Lastly, over the past several years, there have been numerous speakers who have raised concerns about the need for affordable senior housing on Staten Island. We are pleased to have signed a lease with the Arker and Domain companies to convert the Nurse’s Residence on Sea View’s campus into 104 apartments for seniors. HHC is also pleased to have been able to contribute toward this long-awaited residential resource becoming a reality.

That concludes my remarks. I look forward to listening to all of the speakers. Thank you.