Reports to the Board
RAMANATHAN RAJU, MD
HHC PRESIDENT AND CHIEF EXECUTIVE
REPORT TO THE BOARD OF DIRECTORS
NOVEMBER 20, 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.
A MESSAGE ABOUT DOCTORS COUNCIL AND OUR PHYSICIANS
I want to inform you that labor negotiations, led by the New York City Office of Labor Relations, currently are ongoing between the Doctors Council, HHC, and our three affiliate physician groups. We are actively engaged in these talks and optimistic that a fair and timely resolution soon will be forthcoming. I know the Board joins in my view that HHC physicians every day earn our respect and admiration for the compassionate, high quality, mission-driven care that they render to patients across our Corporation.
Also, you should know that we are working with Doctors Council, along with City Hall and community groups, to create a team to implement (within the boundaries of governance and regulatory constraints) the recommendations of the Doctors Council "whitepaper" that seeks increased collaboration with physician staff on issues of patient quality and related matters.
LEASING OF HHC SPACE
In recent months, the Board and its Capital Committee inquired as to HHC policy concerning the leasing of space to City agencies, and to non-profit organizations.
My staff has reported in detail on these matters to the Capital Committee and has consulted individually with the Committee Chair, Committee members, and the Board's Acting Chair. As a result of these discussions, I wish to report that going forward management is implementing a policy whereby HHC generally will not charge any city agency to occupy leased space unless, in specific cases, economic considerations such as reimbursement of lease fees through a grant are cause to override the general policy. Lease of space to non-profit organizations that further the mission of HHC will be viewed similarly.
Of course, the Board retains its discretion on all such transactions.
EBOLA PATIENT TREATED AND DISCHARGED
On November 11th, I proudly joined Dr. Craig Spencer, Mayor de Blasio, DOH Commissioner Bassett, HHC's Dr. Laura Evans, and Sophie Delaunay of Doctors Without Borders on the occasion of Dr. Spencer's discharge from Bellevue Hospital.
Dr. Spencer, New York City's first and only patient treated for Ebola Virus Disease, was going home healthy and disease free after the dedicated, compassionate, and skillful care provided him by the Bellevue team and its collaborators.
I believe Dr. Spencer is a true hero who put himself in harm's way to care for others at the source of this epidemic in West Africa. We are especially proud to have cared for him and brought him back to good health.
As Dr. Spencer and we approached the grand Bellevue atrium for the press conference, dozens and dozens of staff lined the hallway cheering. Many of his nurses stood proudly behind him at the podium as Dr Spencer spoke movingly of the need for all of us to focus – not upon him – but upon the continuing disease burden in West Africa. As I witnessed Dr. Spencer's remarks, those of Dr Evans, and the nurses standing behind, it was clear that a quite special bond had developed between our patient and his dedicated care team.
The world watched as New York City Health and Hospitals Corporation and Bellevue joined the very limited ranks of hospitals in the US that have successfully treated an Ebola patient. And we once again demonstrated the value of public hospital systems in this country, why we need to support them, and why the compassionate and selfless professionals who staff them deserve our gratitude and respect.
I want to extend my heartfelt thanks to the Bellevue team and to every one of our hospitals and their teams who stand ready to serve -- I could not be more proud.
EBOLA COSTS
When New York City had the urgent need to prepare for Ebola it was HHC that stepped forward first and did the job right, without concern over costs. Our focus from the beginning of the Ebola crisis has rightly been on providing only the best care to our patients and ensuring our staff has the resources they need to work safely. But, clearly, this has been an expensive undertaking at a time that our public health care system faces tough fiscal challenges.
We estimate that New York City's preparation and continued response to the Ebola epidemic, which has been a multiagency effort, has cost the City more than $20 million to date. Thankfully, we have the support of Senator Schumer, who last Sunday made a very public stand by calling for the federal government to cover the city's Ebola expenses. The Senator said federal reimbursement for most of the costs is justified because the efforts are helping to prevent the deadly disease from getting a foothold in the United States. As a major port of entry to this country, New York City receives the largest amount of travelers from the affected West African countries. And with the ongoing Ebola outbreak in West Africa, the city's costs are expected to rise.
FEMA COMMITMENT TO HHC
After many months of negotiations, I was once again joined by Mayor de Blasio, along with Senator Schumer, at Coney Island Hospital, to announce and celebrate a milestone. The Federal Emergency Management Agency (FEMA) approved a commitment of at least $1.6 billion that will permit the restoration and fortification of four Health and Hospitals Corporation facilities that suffered damage during Hurricane Sandy two years ago now.
When Coney Island Hospital was temporarily closed after Hurricane Sandy, it reminded us all that hospitals are not just about healthcare delivery but are part of the social fabric of the community and of the local economy. When public hospitals close as did Coney Island and Bellevue after Sandy, the community loss and suffering is even greater because of the especially vulnerable persons who rely on them.
The federal funding will assure over the long term that never again will we face the circumstances of a storm like Sandy without structures designed to withstand extraordinary climate forces like those of Superstorm Sandy.
We would not have reached this agreement without the persistent, professional, caring efforts of many. From the bottom of my heart I wish to express my personal gratitude and the gratitude of all of the HHC family to all those who worked to bring us this agreement. I specifically want to thank: Tony Martin, Marlene Zurack, Fred Covino, Arthur Wagner, Steve Alexander, Jeremy Berman and John Levy of Base Tactical who has advised us throughout.
DSRIP UPDATE
HHC is moving forward in developing a Performance Provider System (PPS) to participate in the State Medicaid Waiver program, the Delivery System Reform Incentive Payment (DSRIP) program that will provide funding for public and safety net providers who meet outcome milestones and achieve statewide metrics. The goal of this $6.42 billion allocation to the Medicaid program is to reduce healthcare costs and avoidable hospital use by 25 percent over five years.
Late last month we secured agreements with four other emergent PPS's to work together to implement health care projects that will improve quality, expand access, lower costs and transform the healthcare delivery system in New York City. By working under a common set of projects and metrics, HHC and the PPS's lead by SBH Health System in the Bronx, Maimonides in Brooklyn, Lutheran in Brooklyn and Medisys Health Network in Queens, will be able to avoid duplication, create a more complete continuum of care for patients and make it easier for community-based partners in each PPS to participate in the program.
DSRIP requires that each PPS select a number of projects from a list of 44 based on the results of Community Needs Assessments. Although the DSRIP program does not require emerging provider systems to work on the same projects, we felt strongly that the needs of our communities and patients will be best met with a consistent and coordinated approach to improving the models of care throughout the city. Our collaboration with the other healthcare systems and their PPS's is a common sense strategy to bring more value to the healthcare improvement projects we need to develop for the community we collectively serve.
HHC remains on target to meet the State's December 16th deadline to apply as a PPS.
The HHC-led Performing Provider System (PPS) held its first formal Advisory Committee meeting on November 18th at Bellevue Hospital. We are honored to have engaged over 130 community and city-wide partners, community-based organizations, labor and affiliate partners, and HHC Community Advisory Board members in discussion of the community needs assessment (CNA) process and results, review of our selected projects, and creation of guiding principles for successful partnership over the five-year program period and beyond. HHC looks forward to holding two educational e-townhalls in the next two weeks, so that our community partners from across the city can log in and learn more about the requirements of each project and more specific opportunities for involvement.
FLU IMMUNIZATION CAMPAIGN
The last few months of public concern about Ebola have given us an opportunity to talk about the flu virus – which results in similar symptoms, but is a much more serious risk to the health of our communities. Both Mayor de Blasio and Health Commissioner Bassett were very forceful in their advocacy in urging New Yorkers to get a flu shot.
Influenza kills more than 1,800 New Yorkers and HHC is committed to doing all we can to make the vaccine available for our patients and our staff.
It is particularly urgent for health care providers to get a flu shot to protect their own health and the health of our patients. All our health care facilities are actively offering free flu shots to our employees before the state Health Commissioner designates the beginning of the flu season. We will be subject to the same regulation that was adopted last year by the NYS Department of Health, which requires that all healthcare workers are either vaccinated or use a mask for the duration of the flu season. HHC strongly supports that regulation and we are committed to exceeding our employee vaccination rate from last year.
A GREENER, STORM RESILIENT CONEY ISLAND HOSPITAL
HHC has just completed a $21 million project to make Coney Island Hospital more energy efficient and more resilient for future storms like Sandy. Thanks to a grant from the New York Power Authority and National Grid, we have a brand new boiler plant, more than 2,000 new windows and 500 air conditioning units that will save HHC over $1.2 million per year in energy costs and will reduce greenhouse gas emissions from the hospital by over 7,000 tons per year. The hospital will run on clean natural gas for the first time in 100 years. The new heating system, which was completely destroyed by Sandy, includes new emergency generators and was built on new concrete floor slabs. Other critical equipment was elevated above the FEMA 100-year flood line to ensure this does not happen again.
I'd like to thank Governor Cuomo and the Power Authority for their support and we look forward to completing other energy efficiency projects at other HHC facilities, including Elmhurst, Metropolitan, Woodhull, Harlem, Kings and Lincoln.
SUPPORTIVE HOUSING COLLABORATION BETWEEN
KINGS COUNTY HOSPITAL AND CAMBA
HHC has a unique role in New York City's healthcare system. Sometimes we make headlines with cutting edge medicine, such as leading the City's response to the Ebola crisis. But more often we are known as the healthcare provider for the City's neediest and most vulnerable residents. That is really our core mission, and it's one that we excel at. We serve all New Yorkers, without exception, and our aim is always to keep the City's most vulnerable populations at their healthiest.
That's the driving force behind our great partnership with CAMBA Housing Ventures, Inc. On Monday, we celebrated the CAMBA Gardens Phase I ribbon cutting and CAMBA Gardens Phase II groundbreaking, which together provide 502 units of sustainable, supportive and affordable rental housing in Wingate, Brooklyn, representing over $165 million in public and private investment. The CAMBA Gardens model re-uses underutilized public hospital property to create much-needed affordable housing for local residents, connects formerly homeless families and individuals to stable housing and critical social services, and provides tenants with access to healthcare. Both Phase I and II, in partnership with HPD and HHC provide preferences within the HPD housing lottery for local community board residents and Kings County Hospital Center employees, among other preferences.
As HHC leads the transformation of healthcare in Brooklyn, which is being incentivized by the State's Medicaid waiver, projects such as these help us manage population health. By harnessing the resources of a great institution such as Kings County Hospital Center, and partnering with innovative and compassionate groups such as CAMBA, we not only create over 500 units of sustainable, supportive and affordable rental housing, but we do so in a way that maximizes the well-being of the residents, helps them stay healthy and avoid unnecessary hospitalizations, and best of all, enhances their dignity and their quality of life.
I'm very proud of what has been achieved here. I'm very glad HHC has helped produce this remarkable and supportive new environment for Brooklyn. And I hope that in the future we can be involved with more projects such as these, and work with other groups similar to CAMBA, to bring more people closer to better healthcare, and to help them live better lives.
BELLEVUE, LINCOLN AND NCB PRAISED BY THE JOINT COMMISSION
Three of our hospitals were acknowledged this month by The Joint Commission, the national organization that accredits our hospitals and nursing homes, as Top Performers in their Key Quality Measures program. Bellevue, Lincoln and North Central Bronx hospitals were in good company, including Johns Hopkins, Cleveland Clinic and the Mayo Clinic, in showing that evidence-based interventions are delivered in the right way and at the right time. Bellevue and Lincoln are recognized for improvement in heart attack, heart failure, pneumonia and surgical care, NCB for heart failure, pneumonia and surgical care. The Joint Commission published the acknowledgment in its annual report America's Hospitals: Improving Quality and Safety. Congratulations to Steve Alexander, Milton Nuñez and Bill Walsh, and their staffs for this outstanding honor. Let me direct your attention to the framed certificate of this recognition from The Joint Commission that is now on display in the light box located near the entrance of HHC's Board Room.
NURSING CHAMPION AWARD
As I mentioned in my report to the Board last month, we held our annual Nursing Excellence Awards to acknowledge the impressive talents, skill and dedication of our nurses, and to celebrate the accomplishments of six of our nurses. I'd like to bring your attention to the plaque for the Nursing Champion Award that will be hung in this room as a permanent reminder of their excellence and commitment to our patients. That award yearly will recognize one individual whose work supports and elevates the voices of nurses. This year the recognition went to Carolyn Jones, Director of The American Nurse, an award winning documentary that follows the work of five nurses, inspiring a newfound appreciation for nurses and the challenges they face.
Last year, the first time we presented the nurse champion category, the award went to our own, HHC Board Member Josephine Bolus, for her tireless work in the field leading up to and following her retirement in 1997. Josephine served as a Staff Nurse in the Pediatric Emergency Room at Kings County Hospital. She pioneered the establishment of the certification guidelines for the nurse practitioner in New York State, and served as Preceptor for Pediatric Nurse Practitioner students at Columbia University and for Registered Nurse students at Kingsboro Community College. As a Board member, Josephine is a true advocate and voice for patients and nurses, and we are very fortunate to have her serving in this role.
We'll keep the award in this room to be reminded of the efforts put forth by our Nursing Champions, and the indispensable role of nurses on the front lines of today's healthcare delivery.
GUNS DOWN, LIFE UP ASSEMBLY
Just as an announcement, I wish to let you know that The Fund for HHC tomorrow will host the inaugural Guns Down, Life Up Assembly at Pier 60 / Chelsea Piers to bring together violence-reduction activists, experts, and leaders. Guns Down, Life Up (GDLU) is the banner under which HHC's gun violence prevention work is organized. My gratitude and best wishes for the success of this event and these programs go to the organizers at the Fund for HHC.
FEDERAL UPDATE
In Washington, the Republicans gained a majority in the US Senate with several seats still undecided.
The current session must resolve several issues: funding Federal agencies and programs into next year and the Administration's $6 billion request for supplemental funding to address the international and domestic Ebola crisis.
For domestic preparedness through State and Local Governments and Hospitals the Administration proposes the following:
- Using the Public Health Emergency Preparedness Program, the Centers for Disease Control (CDC) would get $1.8 billion, of which $7.13 million would come to New York to support accelerated planning and operational readiness for Ebola Virus Disease (EVD) preparedness and response within state and local public health systems including post arrival monitoring.
- The U.S. Department of Health and Human Services (HHS), excluding the CDC, would also receive $318 million of which $2.5 million would be distributed to New York, for direct support to no less than one Ebola treatment center in the State and an additional $4.89 million would come to Hospital Preparedness Program (HPP) awardees in New York State.
- The Hospital Preparedness Program (HPP) awardees would support overall health system preparedness and response for Ebola. Funding will be allocated to awardees by formula. All U.S. health care facilities must be prepared to screen patients for Ebola.
- A contingency fund of $1.5 billion would be created "to ensure that there are resources available to meet the evolving nature of the epidemic." This fund would be split equally between HHS, which includes CDC, and USAID.
In addition to the funding listed above, the Administration is requesting funds to conduct further research to advance drug development.
Nearly $2 billion of the request would be directed toward the U.S. Agency for International Development, $127 million for State Department multilateral assistance and $112 million for the Pentagon and its Defense Advanced Research Projects Agency efforts to address the virus.
Of the $6.2 billion, more than $4.5 billion would be designated as emergency spending, not needing to be offset with corresponding cuts elsewhere in the budget.
Current thinking is that the current session will adjourn December 12, one day after the current Continuing Resolution to fund the federal government expires.
If the President issues an Executive Order regarding Immigration policy, it is expected to be during the window between Congressional adjournment and the new year.
When the new Congress begins in January, they will face the March 31 deadline for fixing the Medicare physician reimbursement cut under the Sustainable Growth Rate formula as well as potential breach of the debt ceiling around the same time. There is the ever-present concern of GME, IME and other hospital programs being cut to pay for other spending. A Republican Congress might also undertake "entitlement reform" also known as block granting Medicaid or funding Medicaid on a per capita basis. There is also a concern that Medicare might be privatized through a voucher to participants to buy their health insurance on the market.
STATE UPDATE
In a turn of events few expected, voters elected a clear majority of Republicans in the New York State Senate. Republicans held onto all of the 29 seats they had previously occupied and picked up an additional three seats Upstate. This gives them a 32-vote majority in the 62 member Senate.
The governor must submit the proposed Executive Budget for Fiscal Year 2015-16 no later than February 1st. Although the State expects to end the year with a projected $4.8 billion surplus, the state Dept. of Budget (DOB) asked agencies to submit requests reflecting flat funding. Governor Cuomo is seeking to continue to limit overall growth in State spending to two percent annually, except for education funding and Medicaid.
As you may recall, since 2010 the State Budget has included a Global Cap on Medicaid Spending and corresponding authority for the State Health Commissioner to make cuts to keep spending beneath the Cap.
On October 23rd, Governor Cuomo released "Moving the New New York Forward," a 259-page document that highlights the accomplishments of his first term and lays out an agenda for his second term.
Cuomo devoted four pages to outline his successes in the area of healthcare: the approval of the Medicaid Redesign Team (MRT) Waiver; the implementation of the new Health Insurance Exchange; increasing recoveries for services inappropriately billed to Medicaid; legalizing Medical Marijuana; implementing initiatives to combat Opioid abuse; increasing investments in Supportive Housing and the Statewide Health Information Network (SHIN-NY); and developing a plan to end the AIDS epidemic.
The document included one new initiative: the State Health Innovation Plan (SHIP). The Plan, which he describes as a "five-year strategic blueprint," is designed to "align the entire health care system, including private insurance, to further improve quality, keep costs low, and improve the health of all New Yorkers." Specifically, the Plan focuses on the following:
- Improving coordination and integration of care;
- Improving transparency to allow patients and providers access to information they need to make informed healthcare decisions;
- Transforming healthcare payment systems from models that are based on volume to models that pay based on efficiently provided care with the best possible outcomes; and
- Developing a healthcare continuum that links physicians and community-based resources.
The State recently applied for a $100 million federal State Innovation Model (SIM) grant to implement the Plan. In the grant application, the State indicates that the Plan is expected to generate $4.4 billion in savings, of which $2.2 billion will be reinvested in the healthcare system.
FEATURED PROGRAM:
WOODHULL HOSPITAL'S CHRONIC PUBLIC INEBRIATE (CPI) PROGRAM
Most of you in this room know that alcoholism can be both a cause and a result of homelessness. Individually, each of those conditions impacts health outcomes of many in our city. Experienced together, the complications are enormous for the men and women who are living through both. It also creates a unique set of challenges for the health, social service and public safety agencies that, historically, have tried to solve each of these problems in isolation.
I believe both issues need to be addressed simultaneously, and through true collaborations between health care providers and community based organizations. An innovative new program at HHC Woodhull Hospital is aiming to do just that.
The partnership between the Woodhull Hospital Emergency Department, the NYC Department of Homeless Services and a nonprofit housing agency, Common Ground, is helping persons who have chronic alcohol intoxication and have also been homeless for a good part of the last two years. The goal of the program is to place individuals into long-term housing as an initial step to reduce the high utilization of ED services in this population.
Like many urban emergency rooms, Woodhull sees a significant number of homeless individuals who suffer from substance abuse. This population represents many of the high utilizers of ED services. In fact, when Woodhull conducted a snapshot look at ED visits during a three week span in January, they identified more than 30 individuals who came to the ED once daily -- on average -- due to alcohol intoxication, and a majority of them were homeless.
Now, with the help of the Department of Homeless Services and Common Ground, the staff at Woodhull can begin to direct some of these patients to safe, secure housing, with essential on-site support services to help them address the psychosocial, mental, and physical health problems that are obstacles to independent living.
Though the program is still under development, they already have been able to place a few high utilizers of ED services at Woodhull in steady housing. Because this is a voluntary program, not everyone accepts the offer and some remain on the street. And two of the patients on the original list recently died, underscoring the vulnerability of this population and the great need for effective collaborations and interventions like this one.
This partnership is a model for how we need to be doing population health management, particularly among the most vulnerable in our community. It is the way of the future of health care, and an example of how HHC will lead in the transformation of health care delivery in our city.
I want to thank the staff and partners in this effort: Dr. Robert Chin, Chief of Emergency Medicine at Woodhull; Chris Tabellario, Brooklyn Community Director of Common Ground; Danielle Minelli Pagnotta, Assistant Commissioner and Cindy Voorspuy, Program Analyst, Department of Homeless Services.
Patients who have chronic alcoholism and are also considered chronically homeless represent a revolving door in our EDs. It is a cycle that needs to be broken.
HHC FEATURED INDIVIDUAL:
DONA GREEN, SENIOR ASSISTANT VICE PRESIDENT, CORPORATE PLANNING
I want to recognize an HHC employee who is extraordinary by many measures and highly respected by her colleagues at HHC. Time and again, she's stepped forward to take on some of the biggest, most complex and most challenging projects, always finding ways to keep patients first, support the needs of the communities we serve, value team work, and help HHC become more efficient.
I'm speaking of Dona Green, HHC's Senior Assistant Vice President for Corporate Planning Services. Dona has been with HHC 27 years. And the number and variety of tasks that she and her team have taken on over the years is truly impressive.
Dona's personal beginnings were as diverse as the HHC projects she has led. She is the seventh daughter of a seventh daughter – and has always relished her family placement. Her father is from Baltimore, her mother from the Caribbean. Her extended family also has East Indian and Puerto Rican roots. She received a Bachelor's degree from Antioch College, known for its communitarian commitment to social action, and followed it up with an MBA in Finance from NYU and an MA in Aging Services from the University of Maryland.
That training proved incredibly relevant from her first planning project here at HHC -- at the Brooklyn Long Term Care Facility, to the planning around Gotham Health, our future Federally Qualified Health Center look-alike, to the planning of the relocation of Goldwater patients who no longer required skilled nursing care but needed support to live on their own.
The Goldwater project was certainly complex and vital to the well-being of many of our residents and to the financial health of HHC. Dona worked with city and state agencies and community-based organizations to find proper housing for over 200 people, and found solutions for another 150 people who could live in the community with some assistance. That was an amazing achievement.
Her latest contribution to HHC also promises to be a high impact operation that's creating a critical base for HHC's work to transform health care delivery in New York City. Dona has been leading the team responsible for the CNA's – the Community Needs Assessments -- that will determine and define HHC projects under the $6.42 billion Medicaid program – the DSRIP program.
I don't know if many people know this, but Dona has yet another talent: she does more than practice yoga – she is a certified yoga instructor and is seeking certification from the Arthritis Foundation in Yoga for Arthritis. It's part of her passion to find alternatives for people whose lives are challenged by disabilities.
Dona Green has shown time and again that she has the passion and energy to lead HHC in the months and years ahead. We're lucky to have her as part of our leadership at HHC.
Please join me in thanking Dona Green for her many contributions to our patients and our Corporation.
HHC IN THE NEWS HIGHLIGHTS
Broadcast
City Officials Confirm Patient at Bellevue Hospital Tests Positive for Ebola, NY1, 10/24/14
HHC President Dr. Ram Raju, CNN "New Day," 10/28/14
Coalition for Asian American Children and Families Awards Gala, Myfoxny.com, 10/30/14
Four City Hospitals Damaged by Sandy Get $1.6 Billion for Upgrades, NY1, 11/7/14
Dr. Craig Spencer Leaves New York Hospital Ebola-Free, ABC News, 11/12/14
Should cities be reimbursed for Ebola costs? One U.S. senator says yes, CNN, 11/17/14
Completed Project Makes Coney Island Hospital More Energy Efficient, NY1, 11/14/14
Ebola Puts Spotlight on Bellevue, Key NYC Trauma Center, Dr. Ram Raju, HHC, The Wall Street Journal, 10/23/14
ICU Team Takes on Ebola, Dr. Ram Raju, Dr. Laura Evans, Bellevue, The Wall Street Journal, 10/26/14
NYC's famed Bellevue Hospital put to the test with Ebola patient, Dr. Lewis Goldfrank, New York Daily News, 11/2/14
Bellevue Hospital ICU patients head to NYU Langone to free up staff for Ebola cases: sources, HHC, Bellevue, New York Daily News, 10/27/14
Bellevue Employees Face Ebola at Work, and Stigma of It Everywhere, Mayra Martinez, Dr. Nate Link, Ana Marengo, The New York Times, 10/30/14
Plenty of Hugs as Craig Spencer, Recovered New York Ebola Patient, Goes Home, Dr. Laura Evans, Dr. Ram Raju, Bellevue, The New York Times, 11/11/14
Dr. Craig Spencer, NY Ebola Patient, is Released, The Wall Street Journal, 11/12/14
Four New York City Hospitals to Receive $1.6 Billion for Storm Improvements, Bellevue, Metropolitan, Coler, New York Times, 11/6/14
Coney Island Hospital gets $21 million for storm enhancements, Coney Island, NY Daily News, 11/13/14
Report: HHC's financial picture is "troubled", Dr. Ram Raju, Crain's New York Business, 11/6/14
Fiscal Challenges for NYC's Health and Hospitals Corporation, HHC, Huff Post New York, 11/11/14
New York's Heroes: Dr. Spencer and Bellevue RNs, Bellevue, NYSNA.org, 11/13/14
HHC chief: system needs help caring for uninsured, Dr. Ram Raju, HHC, 11/18/14
Wealthy hospitals warned they need to care better for city's uninsured patients, Dr. Ram Raju, HHC, New York Daily News, 11/18/14
New Labor & Delivery Unit a NCBH delivers first baby, NCBH, Bronx Times, 11/3/14
Baby step! First infant born at North Central Bronx Hospital's new maternity ward, NCBH,
New York Daily News, 10/28/14
Bronx Networks Collaborate, HHC, Crain's Health Pulse, 11/10/14
East Harlem Seniors May Soon Call former Dormitory Home, HHC, NY1, 10/23/14
500 Affordable apartments Underway at Kings County Hospital Complex, DNAInfo New York, 11/17/14
Ebola case puts spotlight on Staten Islander, Dr. Ramanathan Raju of HHC, Dr. Ram Raju, HHC, 11/5/14
Indian American Doctor Ramanathan Raju Leads Ebola Response Team, Dr. Ram Raju, 10/27/14
"Walk with a Doc" steps off on a crisp fall morning: "Let's make Staten Island the healthiest borough," Dr. Ram Raju, Staten Island Advance, 11/9/14
Six nurses at New York City Health and Hospital Corporation facilities are honored for going above and beyond the call of duty, Dr. Ram Raju; Lauren Johnston, Senior Assistant Vice President, HHC CNO, Marian McNamara, RN, Sea View; Grace Ann Rodicol, BSN, Elmhurst; Lovely Simon, RNC, Coney Island; Michael Impollonia, RN, Woodhull; Terry Hunte, RN, Kings County; Jeanmarie Fitch, BSN, Health & Home Care, New York Daily News, 10/29/14
Harlem Hospital Leads Way in Effort to Increase Cord Blood Donations, Dr. Edgar Mandeville, NY1 News, 11/3/14
Elmhurst Hospital to Prescribe Fruit & Veggies, Dr. Ram Raju, HHC, Elmhurst, Bellevue, Tribune Online, 10/23/14
East Harlem nurses welcome patients to new LGBT clinic, Metropolitan, Lillian Diaz, Nurse.com, 11/12/14
New report examines suicide rates of Asian immigrants treated at Elmhurst and Bellevue Hospitals, New York Daily, News, 11/3/14
Lincoln Hospital Auxiliary celebrates hospital's 175 years, Lincoln, Harlem, Carl Kirton, Evelyn Montecer, Elaine Stewart-Hylton, Denise Soares, Milton Nunex, Amsterdam News, 10/30/14
ACS Partners with Bellevue for Juvenile Justice MH Services, Dr. Ram Raju, Dr. Jennifer Havens, New York Nonprofit Press, 11/2/14