RAMANATHAN RAJU, MD
HHC PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
June 18, 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
The New York State Health Department recently announced five-year valuations for Performing Provider Systems (PPSs) who will participate in the DSRIP program. OneCity Health, the HHC-led PPS, received a valuation of $1.2 billion to carry out eleven projects. The payments are not guaranteed; the valuation represents a maximum potential payment if OneCity Health successfully achieves all performance targets over program life.
DSRIP implementation planning has commenced at the hub-level and will continue through the summer months. We expect to use our increasingly detailed understanding of each partner's contribution to program efforts to enter partner contracting in 3Q, 2015.
On June 1, we submitted the DSRIP State Implementation Plan to NYS DOH. This plan provides the framework for quarterly reporting of the OneCity Health PPS against predefined milestones. We expect to receive comments from the state's Independent Assessor in July.
Congressional Hearing on Zadroga 9/11 Reauthorization Act
Congressional lawmakers at a House Energy and Commerce Health Subcommittee hearing last week pushed for the James R. Zadroga 9/11 Health and Compensation Reauthorization Act that would make the program permanent. Reauthorization would ensure the uninterrupted care for the more than 8,100 enrollees in HHC's World Trade Center Environmental Health Program that cares for area workers, residents, students and passersby suffering from 9/11-related illnesses.
Medicaid DSH Funding Provisions Included in the Sustainable Growth Rate Repeal
s I reported at the April Board meeting, the Medicare Access and Child Health Insurance Program Reauthorization Act of 2015 became law, repealing the Sustainable Growth Rate (SGR), which attempted to limit physician payments under Medicare. One of the ways Congress paid for the repeal was through cuts to Medicaid Disproportionate Share Hospital (DSH) funding.
The new law offers a short term reprieve to HHC by postponing the start of Medicaid DSH funding cuts for one year until the beginning of Federal Fiscal Year 2018. However, the law both extends DSH cuts another year to 2025 and significantly increases the amount of cuts each year. Under the new law, we now face a potential loss of up to $289 million in federal funds in 2018. By 2025, this grows to $462 million. These estimates would double if local matching funds were also eliminated. Left unchanged, HHC faces a potential loss of $3.25 billion in federal funds between 2018 and 2025.
We continue to advocate to further delay and, ultimately, eliminate Medicaid DSH funding cuts.
Setback for Obama Administration on Immigration Executive Orders
In November of 2014, President Obama issued new Executive Orders that would have granted deferred action protections from deportation to some undocumented immigrants. If these orders are ultimately upheld, HHC would benefit since it would allow thousands of undocumented immigrants in New York City -- who qualify under program requirements -- to apply for work authorization, protection from deportation and health insurance coverage. Implementation of these orders has been challenged by the state of Texas. The Justice Department is currently reviewing its legal options. Oral arguments in the case are tentatively scheduled for the week of July 6.
The New York State Legislature is pushing to conclude the 2015 Session. I'd like to focus on a few bills that are key to the Corporation:
- Informal Caregivers: Both houses passed legislation to that would put in place new requirements for contacting and coordinating discharge of inpatients with any informal caregivers the patient designates. We anticipate that the Governor will approve this legislation.
- Sepsis Reporting: The Senate passed and the Assembly is expected to pass legislation that would provide up to a two-year delay on the public release of data related to incidents of sepsis in hospitals, which the State Health Department began collecting last year. The delay gives the Department time to validate and analyze the data so they can provide accurate and meaningful information to the public.
- Staffing Ratios: The Assembly moved, but is not expected to pass, legislation imposing mandatory nurse staffing ratios for hospitals and nursing homes. It would require HHC to hire 3,200 new nurses costing more than $388 million annually just for our 11 hospitals and possibly more for our nursing homes. The Senate did not act on this bill.
- HHC-specific legislation: Last week the Senate passed a bill that would require HHC to spend at least 10 percent of its operating budget in every borough. The Assembly did not move this legislation.
We will provide an update on legislation affecting HHC at the July Strategic Planning Committee meeting.
Kings County and Sea View Hospitals Earn Praise from the Joint Commission
During Recent Surveys
I am extremely pleased to report that as of last week, The Joint Commission completed its surveys of Sea View Hospital Rehabilitation Center and Home and Kings County Hospital Center. Both facilities did extremely well with Sea View receiving a deficiency-free survey result. At Kings County, the surveyors were "wowed" by the leadership and the engagement of physicians and staff, and noted that the organization, including its Behavioral Health services, is "right up there" when compared to some of the more well-known organizations across the country.
Generally, the survey team has been extremely impressed with HHC, which they acknowledge has changed their perception of a public health system. Throughout this year's surveys, they have consistently praised the quality of care provided and the commitment of staff, to an underserved and sometimes vulnerable population.
Congratulations to Arthur Wagner, Angelo Mascia, George Proctor, Ernest Baptiste and the staff of both facilities, for a job well done.
Bellevue Hospital Named as Regional Pathogen Treatment Center
Bellevue Hospital, in partnership with the NYC Department of Health & Mental Hygiene, has been named by the U.S. Dept. of Health and Human Services as one of nine regional centers for the treatment of Ebola and Other Special Pathogens. The move expands the US ability to respond to outbreaks of severe, highly infectious diseases. The regional facilities are part of a national network of 55 treatment centers, any of which may also be called upon to handle one or more simultaneous clusters of patients. Each of the nine regional centers will receive $3.25 million in federal funding over five years.
HHC Assumes Responsibility for City's Correctional Health Service
The City of New York has announced that the Health and Hospital Corporation will assume management of New York City correctional health services. We will manage the quality of care provided to the approximately 70,000 people moving through the City's correctional system each year and seek to assure the coordination and continuity of services to people during and after incarceration.
We are conducting an in-depth review of the current operations, developing a plan that strengthens the integration of physical and behavioral health care provided to individuals while they are incarcerated, and ensuring continuity of services upon their return to the community. This represents a challenging, but important opportunity to improve New York City's correctional health services. We look forward to taking on this critical work on behalf of the City.
HHC Enhances Healthcare by Providing Nutritional Assistance
We continue to provide our patients with nutritional resources that they require as part of living a healthy life. This year, 11 of our facilities have farmers markets and other food programs, giving our patients and our communities access to affordable, regionally-grown fruits and vegetables. Another project, the Food to Overcome Outcomes Disparities (FOOD) program also provide consistent access to nutritional resources for our patients who are completing prescribed cancer treatment. The FOOD program, on which we collaborate with the Immigrant Health and Cancer Disparities Service, is established in five of our hospitals and will be expanded during the next year to three more. These are more examples of how our public hospital system goes beyond providing healthcare to address some of the key social and economic challenges faced by our patients.
HHC Hospitals Honored for Top Achievements
Six HHC hospitals have earned top awards from the American Heart Association / American Stroke Association for their achievements on the “Get with the Guidelines” quality measures. Congratulations to the staffs at Bellevue, Elmhurst, Harlem, Kings County, Lincoln and Woodhull hospitals for achieving this important national recognition. The local periodical It’s Queens The Magazine also listed six doctors at Elmhurst and Queens hospitals among their “Top 15 Docs” in Queens.
“Patients First” Electronic Newsletter Promotes Positive Patient Experience
HHC has relaunched its electronic newsletter to promote the positive experiences that so many of our patients have. This issue features a video that tells the story of a patient with diabetes who is successfully managing her disease, with the help of her healthcare providers at Gouverneur Health and health insurance through MetroPlus. Also featured is a story about the mother of two young patients who are keeping their asthma under control through Lincoln Medical Center and the Bronx Respirar Asthma Coalition it leads. We look forward to hearing from our patients as we continue to spread the healthy living message.
Employee Wellness Promoted Through Newsletter
In your packet today, you will receive the current issue of the Employee Wellness Focus newsletter that has been distributed to staff. It includes advice on how employees can live better lives by maintaining a healthy weight. We also list the many fitness classes available to staff at our facilities each week, and the farmers markets at our hospitals that provide fresh food and healthy cooking tips. We remain committed to our employees' well-being, and urge them -- the same way we urge our patients -- to develop healthy goals that lead to long, satisfying lives.
Artists Exchange Expertise for Excellent Healthcare Services
At HHC, our enduring goal is to provide healthcare for ALL New Yorkers.
There are so many fundamental ways that New York City is unique. One of these is that it remains a city of artists. People come here from all four corners of the earth, to perform, to create, to become noticed and renowned.
But the way to the top is not paved with gold. These artists, writers, musicians, dancers, actors, singers, and poets labor mightily here in New York. They work hard. They struggle. They encounter tough times, during which they need healthcare.
We’ve crafted a program for them. We offer them an opportunity to do what they love to do --- performing, or playing, or creating at hospital and community functions in order to provide solace and comfort to our patients. In exchange, these artists receive credits to use to pay for health care via our HHC Options plan. This is a wonderful and unique program---one that enhances the healing process of our patients while at the same time bolstering the dignity and self-esteem of artists who are part of the HHC community.
The Artist Exchange program demonstrates the importance of tailoring our approach to meet the specific healthcare needs of creative communities. I believe it’s another example of HHC’s care and compassion that differentiates us from our competitors.
Join me in thanking Volunteer coordinator Timothy McDonough who manages our program at Woodhull, and Fund for HHC Executive Director Joe Schick who oversees this unique effort corporation-wide.
Dr. Edwin Fishkin and the Kids Ride Program
At the Health and Hospitals Corporation our commitment and our primary goal is to empower each and every New Yorker to live the healthiest life possible.
We pursue this goal, relentlessly, in wide variety of ways. We are constantly working to expand access to our services. And we have tremendous, ongoing, outreach efforts designed to increase awareness and education about critical health issues, like the need for mammographies or colonoscopies.
But we don’t stop there. Our caregivers devote their professional lives---and sometimes their non-working hours as well---to developing new programs to promote health and wellness.
The Kids Ride Club, developed by Dr. Edward Fishkin, Medical Director at Woodhull Hospital Center, is just such a unique and innovative program, and Ed is our HHC Individual of the Month.
Every spring and summer for the past 20 years scores of young people mount bicycles and join Doctor Fishkin, and the program’s adult volunteers on bicycling adventures around New York City.
The youngsters who participate are thrilled with the sense of self-reliance and freedom inherent in bike riding.
But beyond conveying the joy of cycling, Ed has always had a bit of an ulterior motive:
As we well know, many New Yorkers are afflicted with elevated rates of Asthma, Obesity, Hypertension and other chronic illnesses.
By getting young people enthusiastic about cycling, Dr. Fishkin is instilling the great habit of regular exercise---exercise that can be a vitally important component of maintaining good health and preventing chronic illness.
These kids are estimated to collectively pedal more than 10,000 miles and burn more than a million and a half calories during the club's outings.
For many, this gift of interest and enthusiasm for exercise will last a lifetime.
They---and we---have Dr. Fishkin to thank for that.
He lives up to the credo that we at the Health and Hospitals Corporation will never stop working to ensure that New Yorkers live the healthiest lives possible.
HHC In the News Highlights
Future of Healthcare in New York, City & State, Dr. Ram Raju, HHC President
NYC Hospitals Join Effort to Offer Donated Breast Milk, NY1 News, Bellevue: Dr. Elena Wachtel
New Farmers Markets Open at Two Queens Hospital, NY1 News, Elmhurst Hospital: Dr. Tina Cheng
Jacobi Hospital Burn Center Has Worldwide Recognition, NY1 News, Dr. Bruce Greenstein, Dr. Michael Tonger
NYC to end correctional health contract, will transfer service to HHC, NY1 News
Treatment of H.I.V.: New York Health Agency's View, The New York Times, Dr. Ross Wilson, Corporate Chief Medical Officer, Dr. Joseph Masci, Director of Medicine, Elmhurst
HHC farmers markets bring fresh fruits, veg to New Yorkers, Amsterdam News
Coney Island Hospital’s Farmers Market Kicks Off Season – Fresh, Local Foods Available Every Wednesday and Friday!, Sheepshead Bites
The Doctor Who Got Ebola, New York Magazine, Bellevue: Dr. Laura Evans Director of Critical Care; Dr. Amit Uppal, Critical Care, Attending
Top 15 Doctors in Queens, It’s Queens The Magazine, Elmhurst Hospital: Dr. Marlon Brewer, Dr. Joseph Masci, Dr. Concepcion Songco: Queens Hospital: Dr. Margaret Kemeny, Dr. Martin Maurer, Dr. Farshid Radparvar
H.H.C. named a regional Ebola treatment center, Capital New York, Dr. Ross Wilson, Corporate Chief Medical Officer
HHC gets $1.2 billion for Medicaid reform, Crain's Health Pulse
HHC 'leans' in on patient experiences, Crain's Health Pulse, Dr. Ram Raju, HHC President; Bill Hicks, Bellevue COO
Weaving a Tightly Knit Safety Net, Press Ganey Partners, Harlem: Ebone Carrington, Chief Operating Officer
Jacobi, NCBH's ACT Program Provide Community Services, Bronx Times, Jacobi, NCBH: Karen Inghilterra, Director, Behavioral Health Outpatient Services; Kara Simpson, NCBH ACT Team Leader; Nathania Kurtz, Licensed Social Worker
City Health CEO Dr. Ramananthan Raju: Take Advantage of “tremendous Opportunities” in STEM Fields, Touro College News
Townsend Harris High School Adds First Woman to Hall of Fame, DNAinfo, NCBH: Dr. Heather Nash
Mayor Announces City Will Take over Jail Health Care from Corizon, DNAinfo