50 Water Street ▪ New York, NY ▪ 10004
BOARD OF DIRECTORS MEETING
THURSDAY, JUNE 27, 2024
A•G•E•N•D•A•
CALL TO ORDER - 2:00 PM
1. Executive Session | Facility Governing Body Report
NYC Health + Hospitals l Sea View Nursing and Rehabilitation Center
2023 Performance Improvement Plan and Evaluation (Written Submission Only)
NYC Health + Hospitals| Morrisania - Gotham Center
Semi-Annual Governing Body Report (Written Submission Only)
NYC Health + Hospitals | McKinney Nursing and Rehabilitation Center
2. OPEN PUBLIC SESSION - 3:00 PM
3. Adoption of the Board of Directors Meeting Minutes – May 30, 2024
4. Chair’s Report
5. President’s Report
6. Authorizing New York City Health and Hospitals Corporation (the “System”) to sign a lease with 175 Varick
Street LLC (“Landlord”) for approximately 10,000 square feet on the 7th floor at 145 East 32nd Street, New
York, NY (the “Premises”) to house the World Trade Center Environmental Health Center (the “Center”) that
is currently located in NYC Health + Hospitals/Bellevue (“Bellevue”) for an initial term of approximately 16
months with the System holding two 5-year options to extend the lease at an initial rent of $54/sf to increase
annually at 2.75% for an initial annual rent of $540,000 and a total rent over the potential term of 12 years
and 4 months of $7,805,015
(Presented Directly to the Board: 06/27/2024)
Vendex: Approved
EEO: Pending
7. AMENDED - Authorizing the New York City Health and Hospitals Corporation (the “System”) to sign a five-year
license agreement with Sodexo (“Sodexo”) for its use and occupancy of approximately 4,936 square feet at
NYC Health + Hospitals/Bellevue (“Bellevue”) for a retail food operation for which it will pay a minimum
annual amount of $100,000, plus 8% of annual gross sales over $3M and 12% of annual gross sales over $3.5M
with such agreement to be terminable by each party on thirty days’ notice without cause.
(Presented to the Capital Committee: 06/10/2024)
Vendex: NA
EEO: NA
8. Authorizing New York City Health and Hospitals Corporation (the “System”) to amend the existing agreement
with Tasty Picks, Inc. #5 (“Tasty Picks”) for its occupancy of space at NYC Health + Hospitals/Jacobi (“Jacobi”)
for a retail food operation to increase the area licensed from 1,000 square feet to 1,890 square feet and to
increase the occupancy fee, calculated at $25/square foot, from $25,000 per year to $47,250 per year.
(Presented to the Capital Committee: 06/10/2024)
Vendex: NA / EEO: NA
9. Authorizing New York City Health and Hospitals Corporation (“NYC Health + Hospitals”) to execute a contract
with Vanguard Construction and Development Co., Inc. (the “Contractor”), to undertake a project to
renovate the D5 Labor & Delivery suite at NYC Health + Hospitals/Elmhurst Hospital for a contract amount of
$11,783,528, with a 10% project contingency of $1,178,353, to bring the total cost not to exceed $12,962,881.
(Presented to the Capital Committee: 06/10/2024)
Vendex: Approved / EEO: Pending
Ms. Wang
Ms. Wang
Ms. Wang
Dr. Katz
Ms. Wang
Ms. Wang
Ms. Wang
Ms. Wang
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10. Authorizing the Executive Director of MetroPlus Health Plan, Inc. (“MetroPlus or “the Plan”) to negotiate and
execute a best-interest extension of the current contract with Clarity Software Solutions, Inc. for fulfillment
and distribution services for a period of two years and 1 one-year renewal option, for an amount not to
exceed $31,500,000, which includes a 6% contingency, over the lifetime of the contract, effective August 8,
2024.
(Presented to the MetroPlus Board: 06/06/2024)
Vendex: Approved / EEO: Approved
COMMITTEE AND SUBSIDIARY REPORTS
Medical and Professional Affairs / Information Technology Committee
Strategic Planning Committee
Capital Committee
Metroplus Health - Subsidiary
>>Old Business<<
>>New Business<<
>>Adjournment<<
Ms. Hernandez- Piñero
Ms. Wang
Dr. Calamia
Ms. Wang
Ms. Wang
Ms. Hernandez- Piñero
Ms. Wang
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NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
A meeting of the Board of Directors of New York City Health and Hospitals
Corporation was held in room 1701 at 50 Water Street, New York, New York 10004
on the 30th day of May, 2024 at 2:00 P.M., pursuant to a notice, which was sent
to all of the Directors of New York City Health and Hospitals Corporation and
which was provided to the public by the Secretary. The following Directors
participated in person:
Mr. José Pagán
Dr. Mitchell Katz
Ms. Erin Kelly
Dr. Vincent Calamia
Ms. Freda Wang – Arrived at 2:13p.m.
Ms. Molly Wasow Park – Left at 3:00 p.m.
Ms. Karen St. Hilaire – Joined at 3:00 p.m.
Dr. William Fisher
Ms. Anita Kawatra
Ms. Sally Hernandez-Piñero
Dr. Patricia Marthone
José Pagán, Chair of the Board, called the meeting to order at 2:06 p.m.
Mr. Pagán chaired the meeting and Colicia Hercules, Corporate Secretary, kept
the minutes thereof.
Mr. Pagán noted that Erin Kelly is representing Deputy Mayor Anne
Williams-Isom, and Dr. William Fisher is representing Dr. H Jean Wright II –
all in a voting capacity.
EXECUTIVE SESSION
Upon motion made and duly seconded, the members voted to convene in
executive session because the matters to be discussed involved confidential
and privileged information regarding patient medical information.
OPEN SESSION
The Board reconvened in public session at 3:10 p.m.
Mr. Pagán noted that Erin Kelly is representing Deputy Mayor Anne
Williams-Isom, Dr. William Fisher is representing Dr. H Jean Wright II; and
Karen St. Hilaire is representing Molly Wasow Park – all in a voting capacity.
ACTION ITEM 3 - ADOPTION OF MINUTES
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The minutes of the Board of Directors meeting held on April 25, 2024
were presented to the Board. Then, on motion duly made and seconded, the
Board unanimously adopted the minutes.
RESOLVED, that the minutes of the Board of Directors Meeting held on
April 25, 2024, copies of which have been presented to the Board be, and
hereby are, adopted.
ITEM 4 - CHAIR’S REPORT
Mr. Pagán advised that during the Executive Session, the Board received
and approved the governing body oral and written report from NYC Health +
Hospitals| Jacobi/North Central Bronx
The Board received and approved the written submission of the NYC Health
+ Hospitals| Gouverneur Gotham Center 2023 Performance Improvement Plan and
Evaluation.
The Board also received and approved the written submission of the NYC
Health and Hospitals| Lincoln and NYC Health and Hospitals| South Brooklyn
Health semi-annual governing body report.
FY 2024 ANNUAL PUBLIC MEETINGS
Mr. Pagán reminded the Board of the Fiscal Year 2024 Annual public
meeting series schedule for each borough and provided information for those
who wish register to speak at the meetings.
Bronx - June 4th at Lincoln Hospital
Staten Island - June 18th at Sea View Nursing and Rehabilitation Center
VENDEX APPROVALS
Mr. Pagán noted there are three items on the agenda requiring Vendex
approval, two of which have that approval. There is one item from previous
Board meetings pending Vendex approval.
The Board will be notified as outstanding Vendex approvals are received.
ACTION ITEM 6:
Ms. Hernandez-Piñero read the resolution
Authorizing the New York City Health and Hospitals Corporation (the
“System”) to execute an agreement with KPMG LLC for the provision of
audit services on behalf of the System, including its subsidiaries, for
an initial period beginning June 2024 through the end of the CY 2027
Audit period for an amount not to exceed $5,566,000 over the full term.
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The System will have the right to terminate the agreement without cause
with 30 days’ notice.
(Presented to the Audit Committee: 05/06/2024)
David Guzman, Corporate Comptroller, was joined by James L. Linhart,
Deputy Corporate Comptroller. Mr. Guzman provided background information
regarding the regulatory requirements for audits and the current state of the
existing contract. The entities and services within the scope of the new
contract were also discussed. James Linhart, Deputy Corporate Comptroller,
provided an overview of the RFP criteria, procurement process and auditor
independence analysis. The firm has agreed to an MWBE goal of 25%.
Hearing no questions, upon motion duly made and seconded, the Board
unanimously approved the resolution.
ACTION ITEM 7:
Ms. Hernandez-Piñero read the resolution
Approving the designation of Sofia Khalid, Executive Compliance and
Privacy Officer, as the New York City Health and Hospitals Corporation
(the “System”) Record Management Officer (the “RMO”), as that term is
defined under New York State Education Department regulations found at
8 NYCRR § 185.1(a), to coordinate the development of and oversee the
System’s records management program in accordance with the requirements
set forth under Article 57-A of the New York State Arts and Cultural
Affairs Law and the implementing regulations thereof.
(Presented to the Audit Committee: 05/06/2024)
Catherine Patsos, Chief Corporate Compliance Officer, provided a
description of the responsibilities of an Executive Compliance and Privacy
Officer and shared highlights of Ms. Khalid’s background and experience.
The Board welcomed and congratulated Ms. Khalid on her new role as
Executive Compliance Officer.
After discussion, upon motion duly made and seconded, the Board
unanimously approved the resolution.
ACTION ITEM 8:
Mr. Pagán read the resolution
Authorizing New York City Health and Hospitals Corporation (the “System”)
to sign a 5-year renewal lease with David Welner d/b/a Welner Associates
(“Landlord”) for the use of the entire building at 279-281 Graham Avenue,
Brooklyn, NY consisting of approximately 10,900 square feet (the
“Building”) together with the 1,185 square feet of vacant land adjacent
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to the Building for use by NYC Health + Hospitals/Gotham Health
(“Gotham”) for a primary care clinic at an initial rent of $57.83 per
square foot which will increase by 3.5% annually to reach $66.36 per
square foot by the 5th year; provided that the System will hold three
options each for 5 years at a rent based upon a continuation of the
pattern of 3.5% annual increases for a total rent payable over the
potential 20-year term of $17.83M.
(Presented to the Capital Committee: 05/06/2024)
Dr. Theodore Long, Senior Vice President, Ambulatory Care and Population
Health, provided an overview of the existing Gotham Health locations across
the City and more specifically, the current services and history of the Gotham
Health Williamsburg site. Dr. Long also discussed the ethnic and racial data
and community health profile of the patients being served at the Williamsburg
location. Leora Jontef, Assistant Vice President, Real Estate & Housing,
provided an overview of the lease terms and lease structure.
The Board remarked on the strategic approach to the structure of the
lease. In response, Dr. Long added that there will continued evaluation of
the community’s needs and the System’s options.
After discussion, upon motion duly made and seconded, the Board
unanimously approved the resolution.
ACTION ITEM 9:
Mr. Pagán read the resolution
Authorizing New York City Health and Hospitals Corporation (the “System”)
to sign a five-year renewal revocable license agreement with Sleep
Disorders Institute (“SDI”) for its use of approximately 1,038 square
feet to operate a sleep disorder clinic on the 7th floor of the “H
Building” at NYC Health + Hospitals/Bellevue (the “Facility”) at an
annual occupancy fee of $68,954 or $66.43/ft. to escalate at 2.75% each
year for a five-year total of $429,347.
(Presented to the Capital Committee: 05/06/2024)
Deborah Morris, AICP, Senior Director, Real Estate & Housing, was joined
by Marcia Peters, NYC Health + Hospitals/Bellevue COO, and Ms. Jontef. Ms.
Morris and Ms. Peters provided background information on the Sleep Disorders
Institute and its work with NYC Health + Hospitals/Bellevue.
The Board asked for clarification about the billing process. Ms. Peters
explained that the Sleep Disorders Institute does independent billing. The
Facility is responsible for paying for services rendered to its uninsured
patients.
Follow -Up: Ms. Peters will share the billing rates for uninsured NYC
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Health + Hospitals/Bellevue patients receiving care/services at the Sleep
Disorders Institute at a later date.
After further questions, Ms. Peters added that the increased volume of
sleep studies is attributed to different factors including the trauma
following the COVID-19 pandemic and an easier referral process to the on-site
Sleep Study Institute. Dr. Katz added, while there is still controversy among
clinicians about the benefits of sleep studies and treatments for sleep apnea,
there is an overall increase interest in the area and interventions to improve
patient’s quality of life. There are also challenges among the different
insurers as they have different requirements to approve the sleep studies and
the use of CPAP/
BiPAP machines at home.
After discussion, upon motion duly made and seconded, the Board
unanimously approved the resolution.
ACTION ITEM 10:
Mr. Pagán read the resolution
Authorizing New York City Health and Hospitals Corporation (the “NYC
Health + Hospitals”) to execute a design-build contract with Axis
Construction Corporation, (the “Contractor”) to undertake a development
an integrated women’s health suite at New York City Health +
Hospitals/South Brooklyn Health for a contract amount of $22,995,627,
with a 10% project contingency of $2,299,563, to bring the total cost
not to exceed $25,295,190.
(Presented to the Capital Committee: 05/06/2024)
Kelly Burns, Director, Office of Facility Development, provided an
overview of the background and current state of the Women’s Health services
at Health + Hospitals South Brooklyn Health and a summary of the proposed
future state. Oscar Gonzalez, Senior Assistant Vice President, Office of
Facility Development, continued with an overview of the selection process
explaining the rationale for the RFQ and RFP criteria and the procurement
process. The contract details including an MWBE goal of 32%, vendor performance
evaluation rating and the project budget breakdown were also discussed.
After questions from the Board, Ms. Burns clarified that the Women’s
Health Services include the provision of care before, during and after labor
and birth. There will be no disruption on the delivery of Women’s health
services
After discussion, upon motion duly made and seconded, the Board
unanimously approved the resolution.
ACTION ITEM 11:
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Mr. Pagán read the resolution
Authorizing the New York City Health and Hospitals Corporation (“NYC
Health + Hospitals”) to execute a contract with Jensen Hughes
Engineering, P.C. (the “Contractor”), to provide life safety services
at all acute hospitals for a contract amount of $7,348,135, with a 10%
project contingency of $734,813.50, to bring the total cost not to exceed
$8,082,949.
(Presented to the Capital Committee: 05/06/2024)
Manuel Saez, Vice President, Office of Facilities Development, provided
background information regarding the existing contract and scope of service
with the vendor. Mr. Saez explained the RFP criteria, procurement process and
vendor performance. An overview of the contract budget, including the 10%
contingency, and the vendor diversity goal of 30% was also discussed.
Hearing no questions, upon motion duly made and seconded, the Board
unanimously approved the resolution.
COMMITTEE AND SUBSIDIARY REPORTS
Mr. Pagán noted that the Committee and subsidiary reports are included
in the materials for review and were submitted into the record. Mr. Pagán
welcomed questions or comments regarding the reports.
ITEM 5 - PRESIDENT REPORT – FULL WRITTEN SUBMISSION INCLUDED IN THE MATERIALS
WITH FEW VERBAL HIGHLIGHTS:
NYC HEALTH + HOSPITAL FACILITIES RECOGNIZE
NURSES AND HOSPITAL POLICE DURING SPECIAL MAY OBSERVANCES
The System held ceremonies and recognition events that highlighted the
critical roles the nurses and hospital police play at the facilities.
MAYOR ADAMS AND NYC HEALTH + HOSPITALS HAS HIRED OVER 1,000 NEW NURESES
New York City Mayor Eric Adams and Dr. Katz announced that more than 1,000
new union nurses have been hired over the past eight months at the City’s
public hospital System, replacing many temporary nurses. This investment in
the System’s workforce ensures patients are served by permanent employees who
are committed to the mission, come from the community, and have developed
institutional knowledge.
CHIEF QUALITY OFFICER DR. ERIC WEI AND NYC HEALTH + HOSPITALS/ELMHURST CEO
HELEN ARTEAGA LANDAVERDE JOINED SENATOR GILLIBRAND IN CALLING FOR MORE
INTERAGENCY COORDINATION TO RESPOND TO THE AVIAN FLU OUTBREAK IN CATTLE
Senator Gillibrand held a press conference to advocate for additional
interagency coordination to respond to the avian flu outbreak in cattle. She
was joined by NYC Health + Hospitals/Elmhurst CEO Helen Arteaga Landaverde,
Chief Quality Officer and Senior Vice President Dr. Eric Wei, and the CEO of
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Mt. Sinai. NYC Health + Hospitals officials spoke to the System’s critical
role at the front line in responding to the public health crisis in New York
City.
OMER CABUK, ME APPOINTED TO LEAD HEALTH SYSTEM DECARBONIZATION EFFORTS
NYC Health + Hospitals appointed Omer Cabuk, ME as its first ever Chief
Decarbonization Officer. In this role, Mr. Cabuk will spearhead the
organization’s robust decarbonization initiatives, adhering to the targets
set by Local Law 97 of 2019, which mandates a 40% reduction in operational
emissions by 2025 and a 50% reduction by 2030.
LEGAL SERVICES FOR PATIENTS EXPAND AT THE HEALTH SYSTEM
The health System announced the expansion of free health-related legal
services for its patients in partnership with LegalHealth, a division of the
New York Legal Assistance Group (“NYLAG”). Nearly 5,000 patients accessed
legal services at NYC Health + Hospitals in 2023. The expansion includes
increased staffing, capacity building for increased patient access, and data-
driven analysis on how legal services can impact patient health. The medical-
legal partnership is funded in part by the New York City Council.
NEW PSYCHIATRY RESIDENCY ESTABLISHED AT NYC HEALTH + HOSPITALS/QUEENS
NYC Health + Hospitals/Queens received initial accreditation for a new
psychiatry residency at the hospital. This new program will allow the health
System to be more equipped to face the challenges of hiring in the behavioral
health workforce. Residents will have a rich clinical and educational exposure
during their training at Queens Hospital.
NYC HEALTH + HOSPITALS HAS SERVED NEARLY 14,000 PATIENTS
THROUGH ITS TELEHEALTH BEHAVIORAL HEALTH SERVICE
Nearly 14,000 patients have received behavioral health care through the health
System’s telehealth service, Virtual ExpressCare, since the program launched
in 2022. Through this service, patients can speak to a provider on demand via
video or phone for help with anxiety, depression, stress, burnout, substance
use disorders, withdrawal, and emotional distress. Services have expanded
capacity to provider specialty services to children and adolescents. The
System is the largest provider of behavioral health in New York City.
INAUGURAL BLACK MATERNAL HEALTH FORUM HELD
AT NYC HEALTH + HOSPITALS/GOTHAM HEALTH, GOUVERNEUR
The System held its inaugural Black Maternal Health Forum on Tuesday, May 21
at NYC Health + Hospital/Gotham Health, Gouverneur. The forum focused on the
current state of Black perinatal health, the legacy of Black midwives, and a
panel discussed “A Solution Approach to Supporting Black Birthing People.”
BLOOMBERG CONNECTS APP FEATURES NEARLY 850 PIECES
OF NYC HEALTH + HOSPITAL ART
NYC Health + Hospitals is the first health care organization on Bloomberg
Connects, which features more than 350 cultural organizations, including many
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of the world’s major museums. The Arts in Medicine department has been working
closely with Bloomberg Connects to add content to its app. Nearly 850 works
of art from the health System’s collection are available to view worldwide on
the free app.
NEW MURALS INSTALLED ON THE FENCING OUTSIDE OF NYC HEALTH +
HOSPITALS/METROPOLITAN
In partnership with ArtBridge, two new murals were installed on the scaffolding
of NYC Health + Hospitals/Metropolitan. The works were developed by artists
Dario Mohr and JR in collaboration with residents from the nearby East River
Houses over a series of workshops and community engagement events. The project
received support from the System’s Arts in Medicine program.
DIAGNOSTIC RADIOLOGIC INTERPRETATION SERVICES GOES ONLINE
NYC Health + Hospitals has embarked on the implementation of teleradiology to
provide diagnostic radiologic interpretation services to several acute care
hospitals for some inpatient and Emergency Department exams performed
evenings, nights, and weekends. It will also include all NYC Health +
Hospitals/Gotham Health outpatient radiology exams with the exception of
mammography.
With teleradiology, the System is able to improve both the quality of clinical
care and operational efficiencies. The System will continue to employ on-site
radiologists to effectively coordinate care for patients. The second phase of
the effort, expected to begin this fall, will bring 24/7 coverage utilizing a
hybrid of onsite and Teleradiology models.
DISCUSSION: Dr. Fisher and other Board members asked about the communication
process between the referring clinician, and the reading radiologist. Dr. Katz
explained that the process would not differ from the current system where the
full reports are available online via Epic along with the radiologist’s contact
information should one need to contact them directly via phone or via the Epic
messaging platform.
Dr. Katz added that the utilization of artificial intelligence is a great
enhancement in prioritizing the most critical scans in the queue for the
radiologists to read.
Dr. Katz also added that leveraging virtual consults and management provides
enhanced and much needed care in areas such as child psychiatry, where there
are limited providers available in the System and in the City.
Following questions from the Board, Dr. Katz confirmed that the team conducted
an assessment to identify the needs of each site based on their volume and
the corresponding number of radiologists needed to manage that volume.
Additionally, hiring radiologists versus utilizing vendors has its benefits.
It is overall less expensive and there is more familiarity with the System’s
needs, platforms and patients.
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Regarding STAT scans, there is a dedicated person who reads the most urgent
scans. Their work is also enhanced by artificial intelligence which is able
to identify and prioritize scan readings for the radiologists within the STAT
cases.
The Board returned to the discussion regarding the availability of behavioral
health professionals. Dr. Katz explained that there is an overall shortage of
mental health professionals, more specifically psychiatrists and child
psychiatry. The in-patient psychiatry and the use of virtual care remains a
challenging area from a regulatory perspective. However, in an out-patient
setting, such as the emergency room, the regulations do not require that a
child in need of psychiatry services is seen by a child psychiatrist.
The Board inquired about the nearly 14,000 patients who have received
behavioral health care through the System’s telehealth service, in-person
visit and about managing the patient as a whole. Dr. Katz confirmed that the
14,000 figure refers to out-patient visits. The System does a great job of
referring patients to receive care beyond their behavioral health needs and
manage other social determinants of health. While there was some reluctance
at first, there is an increased interest in virtual care. Care will be
delivered in the best way possible to meet the patient’s needs whether that
is in-person or via virtual care.
NYC HEALTH + HOSPITALS/SOUTH BROOKLYN HEALTH MARKS ONE YEAR WITHOUT A
CATHETER-ASSOCIATED URINARY TRACT INFECTION (“CAUTI”)
NYC Health + Hospitals/South Brooklyn Health reached a significant milestone,
one year without a single catheter-associated urinary tract infection
(“CAUTI”).
METROPLUSHEALTH OFFERS MEDICALLY TAILORED MEALS (MTM) AS A PERMANENT
MEDICAID BENEFIT
In 2022, New York State Medicaid approved MetroPlusHealth to implement the
cost-effective medically-tailored meals (“MTM”) program, designed to be
delivered to members’ homes either in lieu of Personal Care Aide service hours
used for meal preparation and food shopping, or in lieu of hospital inpatient
stays and/or emergency department visits. To date, MetroPlus Health and its
partners have enrolled almost 1,200 members.
ROBOTIC SURGERY PROGRAM EXCELS AT NYC HEALTH + HOSPITALS/HARLEM
Harlem Hospital celebrated the one-year anniversary of its Robotic Surgery
program. In 2023, Harlem Hospital introduced the state-of-the-art da Vinci
surgical system as a means to perform surgical procedures with the advanced
capabilities of robotic technology.
NEW HOME HEALTH SIMULATION SATELLITE OPENS
NYC Health + Hospitals/Community Care opened a new Home Health Simulation
Satellite site for all home health nurses to use. The site gives home health
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COMMITTEE REPORTS
Capital Committee Meeting – May 6, 2024
As reported by: José Pagán
Committee Members Present: Mitchell Katz, MD, Sally Hernandez-Piñero, Freda
Wang
Mr. José Pagán called the meeting to order at 10:06 a.m.
Mr. Pagán called for a motion to approve the April 8, 2024 minutes of the
Capital Committee meeting.
Upon motion made and duly seconded the minutes of the Capital
Committee meeting held on April 8, 2024, were unanimously approved.
VICE PRESIDENT REPORT
Manuel Saez provided the Vice President’s for the Office of Facilities
Development report.
• As the end of the fiscal year nears, we are working diligently to
ensure that our Fiscal Year 2024 contracts are registered with the
comptroller to ensure that we meet our commitment goals and have
timely starts to the projects.
• We received approval to proceed with the next phase of OTxHU and are
actively working with our CHS, DOC, and SCOC partners to move forward
with procurement for work at NYC H+H/Woodhull and NYC H+H/NCB.
• At NYC H+H/Elmhurst we are currently in procurement for the first
phase of their larger Emergency Department renovation. We have opened
the staff Wellness room, as well as the Radiation Oncology suite,
which includes new LINAC and CT scanner.
• At NYC H+H/Metropolitan, the new Wellness room is complete and has
been furnished. We have commenced design for the Condensate Riser, and
the Ronald McDonald House sprinkler work has started.
• At NYC H+H/Jacobi, we completed renovations for the IT department
which included two training rooms for staff.
• We have four items this month, the NYC H+H/South Brooklyn Health
Maternal Health Renovation, System-Wide Life Safety Services, NYC H+H
Gotham/Williamsburg Clinic Lease, and NYC H+H/Bellevue Sleep Disorder
Clinic Lease.
That concluded Mr. Saez’s report.
• Sally Hernandez-Piñero asked for status of the OTxHU project at NYC
Health + Hospitals/Bellevue. Mr. Saez explained that the project was
moving along with parking lot expansion on-going, flood protections in
process, and canopy and tie-ins are under way. Mr. Gonzalez added that
completion was expected by end of year.
• Dr. Katz said he remembered there being some discussion as to which
size generator was selected. Mr. Gonzalez said the larger generator
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was selected and has been ordered and there is a back up plan in place
if the equipment does not arrive in time.
Leora Jontef read the resolution into the record:
Authorizing New York City Health and Hospitals Corporation (the “System”)
to sign a 5-year renewal lease with David Welner d/b/a Welner Associates
(“Landlord”) for the use of the entire building at 279-281 Graham Avenue,
Brooklyn, NY consisting of approximately 10,900 square feet (the
“Building”) together with the 1,185 square feet of vacant land adjacent
to the Building for use by NYC Health + Hospitals/Gotham Health
(“Gotham”) for a primary care clinic at an initial rent of $57.83 per
square foot which will increase by 3.5% annually to reach $66.36 per
square foot by the 5th year; provided that the System will hold three
options each for 5 years at a rent based upon a continuation of the
pattern of 3.5% annual increases for a total rent payable over the
potential 20-year term of $17.83M.
Ms. Jontef was joined by Ted Long, MD, MHS Senior Vice President, Ambulatory
Care and Population Health, who presented the background information on the
clinic, services provided, and the surrounding community. Ms. Jontef
described the lease terms.
• Ms. Hernandez-Piñero asked about demographic profile for the clinic
and asked if there was any insight into the 62% who did not disclose
race. Dr. Long said that was not unlike most of the data collection
that happens throughout the system. Roman Ryniewski, Deputy Executive
Director, NYC Health + Hospitals/Gotham Health, said there had been an
uptick in utilization from the Latin community.
• Ms. Hernandez-Piñero asked if there was a difference in patient
population between the Greenpoint and Williamsburg clinics. Jeremy
Berman, Deputy Counsel, said that historically there was a large
polish population in the Greenpoint area.
• Ms. Hernandez-Piñero noted the 3.5% annual increases and asked if our
existing relationship with the landlord helped facilitate
negotiations. Ms. Jontef said yes, but the market in the neighborhood
is very hot and the location of the clinic is desirable so we wanted
to remain in the space for continuation of services to the community.
The H+H team negotiated terms, which included some work that needed to
be addressed and this is the outcome of that work.
• Ms. Hernandez-Piñero asked what capital improvements would be made.
Deborah Morris, Director, Housing and Real Estate, said that roof work
and duct work was underway, estimated to be several hundred thousand
dollars, the basement stairs would be replaced, HVAC, roof work and
coping on the exterior would be done.
• Freda Wang asked if the landlord would be paying for that. Ms. Morris
said yes. Mr. Berman added that landlords were often responsible for
replacements and H+H responsible for maintenance.
• Ms. Wang asked what the prior terms of the lease were. Mr. Berman said
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the prior lease was for 20 years and this one is for 5 years. Ms. Wang
asked what would happen in 5 years if the lease increases. Mr. Berman
said negotiations would be step one because moving is a big lift and
purchasing is not really on option.
• Mr.
Pagán said he feels the 5-year term provides us with time to assess
other options as needed.
After discussion - upon motion duly made and seconded the resolution was
approved for consideration by the Board of Directors.
Ms. Morris read the resolution into the record:
Authorizing New York City Health and Hospitals Corporation (the “System”)
to sign a five-year renewal revocable license agreement with Sleep
Disorders Institute (“SDI”) for its use of approximately 1,038 square
feet to operate a sleep disorder clinic on the 7th floor of the “H
Building” at NYC Health + Hospitals/Bellevue (the “Facility”) at an
annual occupancy fee of $68,954 or $66.43/ft. to escalate at 2.75% each
year for a five-year total of $429,347.
Ms. Morris narrated a presentation providing background information,
services to be provided, and terms of lease.
• Ms. Hernandez-Piñero said she had experience there and while there was
a difference between locations she visited it was a fine facility.
• Ms. Wang asked if there was a priority in the program for Bellevue
patients. Ms. Morris said the majority of patients came from Bellevue
but outside patients were welcome.
• Mr.
Pagán asked if there was any quality consistency check completed
during negotiations to ensure that all sites were equal in comfort and
service. Ms. Morris said she would discuss with appropriate parties.
After discussion - upon motion duly made and seconded the resolution was
approved for consideration by the Board of Directors.
Mr. Saez read the resolution into the record:
Authorizing New York City Health and Hospitals Corporation (the “NYC
Health + Hospitals”) to execute a design-build contract with Axis
Construction Corporation, (the “Contractor”) to undertake a development
an integrated women’s health suite at New York City Health +
Hospitals/South Brooklyn Health for a contract amount of $22,995,627,
with a 10% project contingency of $2,299,563, to bring the total cost not
to exceed $25,295,190.
Oscar Gonzalez, Senior Assistant Vice President was joined by Kelly Burns,
Director of Design and Construction, Office of Facilities Development, to
narrate a presentation providing background information, overview of project
scope, solicitation process, contract terms, MWBE status, and project
budget.
14
• Ms. Hernandez-Piñero asked what the purpose of the various rooms would
be. Ms. Burns said they range from pre to post-partum uses.
• Ms. Hernandez-Piñero asked what was meant by community rooms. Ms.
Burns said there would be community education spaces to educate future
parents and additional waiting areas with a children’s section and
stroller areas.
• Mr.
Pagán noted that the increase in births was impressive and asked if
we were sure this project would accommodate future needs. Dr. Katz
noted that there had been increases in birth rates throughout the
borough and System.
• Ms. Wang asked if the design-build model was working successfully for
H+H. Mr. Gonzalez said it was still early but the design-build project
at Harlem was going well.
• Ms. Wang asked how it was determined which projects would use the
design-build model. Mr. Gonzalez said one mandated criterion was a $10
million minimum project budget, but additionally it had to be a
project that leant itself to collaboration and flexibility.
• Ms. Wang asked if this model was a Gross Maximum Price (GMP) contract.
Mr. Gonzalez said no, this is more of a not-to-exceed, there is a
contingency included within the $23 million for field conditions but
the owner’s contingency is more for scope changes or additions. There
is extra budget built in and available.
• Ms. Wang asked about contract term. Mr. Gonzalez said the 3-year
contract with two one-year options to renew but completion was
anticipated for end of year two. The additional time provides for
close-out, and other end of project deliverables.
• Ms. Hernandez-Piñero asked if services would be interrupted during
construction. Ms. Burns said no.
After discussion - upon motion duly made and seconded the resolution was
approved for consideration by the Board of Directors.
Mr. Saez read the resolution for consideration:
Authorizing the New York City Health and Hospitals Corporation (“NYC
Health + Hospitals”) to execute a contract with Jensen Hughes
Engineering, P.C. (the “Contractor”), to provide life safety services at
all acute hospitals for a contract amount of $7,348,135, with a 10%
project contingency of $734,813.50, to bring the total cost not to exceed
$8,082,949.
Mahendranath Indar, Assistant Vice President, narrated a presentation
providing background information, scope of services, solicitation process,
contract terms, MWBE utilization, and contract budget.
• Ms. Hernandez-Piñero asked for clarification on budget. Mr. Indar
explained that there was additional square footage in the new
15
agreement and market rates had also increased.
• Ms. Wang asked why we were seeing the new agreement so far in advance
of expiration. Mr. Saez said, we wanted to be prepared.
After discussion - upon motion duly made and seconded the resolution was
approved for consideration by the Board of Directors.
There being no further business, the Committee Meeting was adjourned at
10:58 a.m.
Finance Committee Meeting – May 6, 2024
As Reported By: Freda Wang
Committee Members Present: Mitchell Katz, MD, Freda Wang, José Pagán, Sally
Hernandez-Piñero, Barbara Lowe
NYC Health + Hospitals Employees in Attendance:
Michline Farag, Tasha Philogene, Marji Karlin, John Ulberg, Linda Dehart,
James Cassidy, David Guzman, Megan Meagher, Mariel McLeod, Ted Long, MD,
Rafelina Hernandez, Colicia Hercules
CALL TO ORDER
Ms. Wang called the meeting of the New York City Health + Hospitals Board of
Directors Finance Committee Meeting to order at 11:02 a.m.
Ms. Wang called for a motion to approve the March 11, 2024 minutes of the
Finance Committee meeting.
Upon motion made and duly seconded the minutes of the Finance
Committee meeting held on March 11, 2024 were adopted.
FINANCIAL UPDATE
Mr. Ulberg opened the presentation with the FY-24 Quarter 3 Highlights. He
conveyed that March closed with $708M (26 days cash-on-hand). The budget
overperformed by 1% and closed YTD February with a positive Net Budget
Variance of $155.7M.
Mr. Ulberg continued that direct patient care receipts came in $325M higher
than the same period in FY-23 due to continued increases in IP and OP
services in FY-24, UPL Conversion, and overall improved cash performance. IP
Patient care volume in FY-24 has surpassed pre-COVID levels (1.5%) and OP
visits are 9.3% ahead of FY-20 pre-COVID levels. Revenue base remains strong
and resilient primarily driven by returning volume and higher average
collectability rate over the base. Overall, our strategic financial
initiatives are ongoing. YTD Q3 performance generated $824.7M against an
annual target of $1.08B. Financial updates through this period are still in
progress as some initiatives have been impacted by the interruption of
Change Healthcare. Several areas of strong Q3 performance were noted.
Mr. Ulberg presented the cash projections for FY-24. The System is estimated
to close April with approximately $600 million (21 days cash-on-hand) and
expects to close May with approximately $600 million (21 days cash-on-hand).
16
We continue to work closely with the City on our remaining liabilities due
to them as we continue to closely monitor our cash position.
Mr. Ulberg continued presenting the external risks. Several areas of focus
include the Staffing Glidepath, temp services, and sessional costs, which
continue to present a financial challenge. Full-time RN hiring is well ahead
of target by 575 RNs, beating the glidepath, and temps are meeting the
glidepath reduction targets as orientation is complete which ranges from 3
to 6 months, and potentially beating the 18-months glidepath target. A
sessional and locum expense reducing glide path has been implemented and is
assumed to start in FY-24 Q3, reaching target by the end of FY-25.
H+H is diligently working to address inflationary pressures which continue
to present a strain on and risk to our cost reduction plans. Facilities
submitted gap closing plans to reduce spend and generate revenue. Timing to
achieve the spend reductions is at risk due to increased pharmacy and
Medsurg Supply Costs driven by inflationary challenges, increased patients,
and higher acuity patients that require more expensive drugs and services.
Medsurg spending is projected to increase 46% since FY-19, driven by
inflation and increased volume.
City and State budgets currently presents a low risk to H+H. OMB released
its Executive Plan on April 24
th
, with no PEGs in this plan. Moreover, H+H
continues to review the impacts of the SFY-24-25 Enacted State budget which
passed on April 20
th
. A summary of the major SFY-24-25 Enacted State budget
provisions detailed were noted.
Medicaid Recertification is currently meeting our budgeted recertification
targets and continues to optimize our overall strategies to ensure that we
stay on track.
Lastly, the Change Healthcare (CHC) Cyberattack presents a lower financial
challenge to H+H as we continue to make progress. The incident has national
impacts, primarily on health care provider organizations, retail pharmacies,
and payors, which use CHC technologies/services. H+H has reconnected with
CHC for pharmacy and has connected to Experian for claims processing and
eligibility transactions. H+H continues to wait for responses from some
health plans regarding waivers as outlined by Department of Financial
Services Circular Letter.
Mr. Ulberg provided an overview of the State Budget. There were positive and
negative highlights from the SFY-24-25 Enacted Budget. Several positive
highlights included the Hospital and Nursing Homes Medicaid Rate increases,
Expands of Access to Primary Care, Essential Plan and Medicaid Coverage
Provisions, Safety Net Transformation Program, Behavioral Health
Investments, Workforce Proposals, and Health Care Stability Fund/HMO Tax.
Some of the negative highlights included the Partial Reduction in Managed
Care Quality Pools, 10% Capital Reimbursement Cuts on top of existing 10%
Cut for Hospitals and 5% Nursing Homes, and 1% across the board cuts to
health plans.
Dr. Katz inquired on the 1% across the board cuts to health plans. Is that
the State looking at their balance sheets?
Mr. Ulberg agreed and added that looking at all those cuts, the State was
17
just trying to get to a target.
Dr. Katz continued, the State is adding and subtracting noting that they
need to also add initiatives. There is some data that suggest that plans
really have been taking unfair profit and just wondering if the 1% across
the board is based on them reviewing the balance sheet of plans and feeling
like this is doable, or is it just we have got to close the gap somewhere
and people hate plans, go ahead and do it there.
Mr. Ulberg responded that this is probably a combination of trying to hit
the budget target. In his old job, you would always pay attention to that
point, how much profit is being made and are you setting the right rate? At
the end of the day, the State still has to set a rate that is reasonable and
fits within the bounds that would be accepted by CMS. At one point they were
trying to reach closer to the 25% of the range and is a combination of
things. For H+H it becomes a direct cut due to our relationship with
Healthfirst and MetroPlus. It is not a cut to us from most other plans where
we do not engage in capitation arrangements, but that is a direct cut.
Dr. Katz asked if it affects every single line of plan business or just
certain lines of the plan.
Mr. Ulberg responded that they set the premium and they cut it once. The
total premium would just be reduced from where they would set it by 1%. It
will still be a year-to-year increase as they need to factor in inflation,
utilization increases, those are all part of the rate setting process but
they will take a reduction of 1% that is part of the process. We do not like
it but it is a real improvement from the Executive Budget to where they
landed in the final budget. The Executive Budget had many deep cuts that
were in essence, quote bought back, but next year will be interesting with
the HMO tax, we will watch that carefully.
Ms. Hernandez-Piñero inquired on the focus on the Essential Plan, doing all
pools more for Essential Plan in reducing for Medicaid. There seems to be a
real focus on the Essential Plan, increasing the income level eligibility.
There was an article talking about QHP and people falling out of QHP into
essential plan.
Mr. Ulberg responded that we have added a slide on this and will be talking
about this. We asked the question of why would you cut, and it goes back to
Dr. Katz point about the budget, and trying to hit certain targets. The
Essential Plan is 100% Federal funded, so they will go there first to try to
maximize those Federal dollars and that is more than likely why they
increased the quality pool there, but cut it on the Medicaid side. It is
always important to maintain parity where you can, as the incentive
structure will have an effect, and everybody knows the essential plan is a
pretty rich plan at this point. The rates are very desirable level compared
to Medicaid, but you need to always be mindful of keeping that balance as it
will drive incentives that perhaps you do not want to create.
Ms. Lowe inquired on prison health and the potential movement occurring to
move the work efforts further north.
Dr. Katz clarified that she meant upstate, Ms. Lowe agreed. This is due to
workforce being less expensive upstate.
Ms. Farag presented the financial performance highlights for FY-24 thru
18
February Net Budget Variance. She noted that February ended with a net
budget variance of $155.7M (1%). Receipts exceeded budget by $464M primarily
driven by Patient Care and Risk Revenue. Risk is higher due to improved PMPM
and other PY reconciliations. Disbursement exceeded budget by $308M, which
includes expenses associated with Temp coverage, Affiliation, Discretionary
OTPS, and Overtime costs.
Ms. Philogene provided the FY-24 thru February performance drivers updates.
Cash receipts are 9% ahead of budget. Much of the overage can be attributed
to Risk revenue exceeding target due to higher than anticipated PMPM and PY
reconciliations. FY-24 thru February, cash disbursements are over budget by
5% primarily resulting from Temp spending and Agency costs exceeding target.
Ms. Wang asked if there is breakdown of what is due to inflation and due to
higher volume.
Ms. Philogene responded that for volume we are seeing about 40% and then the
balance is inflation. We do have some analysis for each separately on
pharmaceuticals and medical supplies, and hopefully some of the savings that
we realize in temps perhaps can cover some of the spending on that side.
Ms. Wang asked regarding the temps, the $130M expense, even though on the
glidepath we are ahead of schedule but the dollars have not been realized.
Ms. Farag responded that there is a lag between off boarding the temps and
then starting to see the annualized fiscal dollars, so it is not immediate.
Most of the reductions have been after the settlement of the NYSNA contract
in August so it takes a lag of hiring first our full-time staff, or putting
them through orientation properly for safe transition, to transition the
temps off so there is a lag by the point of the temps transition off. Most
of the progress we have seen has actually been in the last couple of months,
or the last quarter. That is on actual off boarding of the actual staff, the
temp staff, and then you start to see the financial savings come after that,
now you are reducing post them leaving.
Ms. Wang added that when we are kind of projecting out for the next budget,
we want to think about that time because this is a pretty big swing, $175
million, so even though our timing is on track or ahead of schedule, the
dollars are not.
Ms. Farag agreed and added that we do not see the larger dollars immediately
but you will see larger financial gains in FY-25.
Mr. Ulberg added that we are very confident that the savings will
materialize as Natalia and her team actualize the contract on a nurse by
contract nurse basis, knows when they are going to depart, knows who has
been hired and where they are in their training path; knows who needs to
exit and the processes underway. Ms. Farag added, that she knows on the
individual level by facility issues, meeting with facility weekly, and is
really a great effort.
Ms. Lowe commented that there are some common factors that we can expect
this time of the year, new grads. They run to us for orientation, and then
they have a plan to move out of New York or do whatever, go somewhere else,
and it is always that way. But we have done phenomenally much better than we
have done in years.
Ms. Farag added, absolutely, the progress is evident in our hiring so it has
been really great.
19
Ms. Lowe added that when personally going to the facility, she loves seeing
their faces as everyone is happy.
Ms. Wang commented, that is great.
Mr. Ulberg added that it is a great point, as it gives us the chance to
change the culture. With many new nurses, Natalia has done a great job with
that training program, and on the way out the door we are recruiting the
contract nurses as they go. We will tell them, we have enjoyed having you
and we have a job for you so they can still choose. Things are moving well
there.
Ms. Wang commented that we are 1% ahead of budget which is great although
this does not reflect some of the Change Healthcare impact, but we will hear
that it is coming along as from the cash forecast, it looks like we are
going to recover from that. The one thing to note is that some of the
variances, we are fortunate we have high variances on the revenue side as it
is offsetting the high variances on the expense side, so in terms of risk
pool performance, the 79% better than expected PMPM performance that we
cannot anticipate necessarily, is that correct?
Ms. Farag responded that the ones that we have the reconciliation is for the
prior year for one-time, and the PMPM improvement will be doing more. We
will be able to see that continuity, but there is definitely a lot of that.
Ms. Wang added, the 26%. Ms. Farag agreed.
Ms. Wang continued, when we review the risk pool we may see that might start
to change, is that correct? Mr. Ulberg agreed. Ms. Wang added that it is
factored into our budget moving forward.
The revenue performance for FY-24 thru February was presented by Ms.
Philogene. FY-24 direct patient care revenue (IP and OP) is $325.2M higher
than FY-23 actuals. Patient revenue increases year-over-year can be
attributed to approved State Medicaid increases, Federal approved Billing
UPL, overall increased volume and cash performance on revenue improvement
initiatives.
Ms. Karlin provided an update on Medicaid Recertification results that
remain in line with NYC Health + Hospitals Financial Plan 2/3rds of the way
through. NYC H+H is currently averaging 79% for June 2023 through February
2024 cohorts recertified from the biggest health plan partners.
Recertification percentages for MetroPlusHealth and Healthfirst members
dipped over winter holidays but are showing signs of recovery in February
and March 2024, which is not complete. Further, atypically high
recertification percentage for Healthfirst for December 2023 cohort is
primarily driven by automatic extension of coverage for large cohort of
aged, blind and disabled members with coverage through LDSS-HRA who were due
for recert in that month.
An overview of NYC Health + Hospitals continuing to make progress in
recovering from Change HealthCare Cyberattack was presented by Ms. Karlin.
Change HealthCare, NYC Heath + Hospitals vendor for claims clearinghouse,
experienced a cyberattack on 02/21/24. In terms of Cash Flow management, H+H
20
is closely working with our City, State, and Federal partners to expedite
approved funding to H+H and prioritize review and approval of pending
initiatives and current-year reimbursements. H+H has notified National
Government Services (NGS) about the interruption in order to avoid PIP
timeliness reviews; Medicare payments have been steady. Insurance payments
are starting to come in based on recent claims submissions, and H+H
continues to have ongoing conversations with managed care partners to afford
leniency related to timely filing and appeals deadlines. Revenue Cycle is
accelerating planned implementation of paperless billing - live since 02/28,
and expedited planned 7/1/24 implementation of Experian clearinghouse for
eligibility, authorization, claims and remits. H+H is live with eligibility
and claims with the exception of real time eligibility and dental claims.
H+H is not live with remittances and expect to go live on Experian by June
1
st
. The live dates for eligibility, claims and remits were noted. Revenue
Cycle continues to optimize Experian implementation in the weeks and months
ahead, and currently working with facilities to address backlogs in
eligibility and claims/denials follow-up.
Ms. Wang asked how do we think this will show up in our financials.
Mr. Ulberg responded that the complete recovery plan we had discussed have a
three-phase recovery plan each one being 6 weeks. We were fortunate that we
had cash balances available that carried us through the first 6 weeks. The
second six weeks, we were working closely with our City partners to move
funds back and forth, and the final phase is tracking how are we doing with
denials which we are asking our insurance partners to be flexible with us in
terms of the processing of the denials, and we are making progress there. We
do a lot of business Medicaid Fee for Service business with the State and
having them be good partners with us in terms of how they treat the denials,
and allow appeal denials, will be important. We have asked them to just
follow the guidelines set out by the Department of Financial services, so we
do not anticipate it being an issue. The other important part of phase 3 is
dealing with our Federal and State partners, we have two significant
transactions that were built into the plan for the year.
The first is inpatient UPL, which is a transaction initially approved by CMS
last year, they renewed that approval almost 3 months ago. It is our
understanding that the status of that package has moved from the Health
Department over to the budget division and that is the last step. But again,
time is of the essence there, as to effectuate the transaction it takes at
least 6 to 7 weeks since there are other things that we have to do in terms
of moving the money between us and the State, and then the plans back to us.
It is just part of our plan. The last transaction is outpatient UPL which is
new to CMS and they have not done that before. Dr. Katz added that we mainly
focus on timing, making sure we can pay our bills, but if we put that aside
for a second at the end of the day, would we lose money due to this?
Mr. Ulberg responded that we are not sure but there is a possibility that we
could lose money on the denial remittance part of the glitch here, but Bob
has been looking at our cash and it is about 94-96% of where we should be
with cash, some of that is the denials and it will come back. We make our
living we say on the last 1%, and 1% makes the difference, that’s the margin
that we work with here.
Ms. Karlin agreed and added that from a pure operational standpoint, if the
payors do not all cooperate with the extensions, that is the possibility of
21
where we lose money. If they cooperate, it is going to take us some time to
dig out from under these, but from the payers that we are getting the remit
files we are seeing as expected higher than typical denial rate for
eligibility, because our eligibility was not live and we send it to the
payer that we had on file not necessarily the right payer. And so, we were
scoring and trying to address all of those in a priority manner, and then we
have the denials sort of laid out in a priority order. For instance, if a
payor comes back and said you were too late to bill us because we did pass
their timely filing and we could not post the remit file from 4 months ago,
that is the danger. But we are labeling and categorizing everything to fight
it down to the last dollar.
Ms. Wang asked if there have been any regulations from the Federal
government to extend this.
Ms. Karlin responded that there has been guidance. CMS gave their guidance
as to what they were planning to do, but it is not regulation.
Ms. Wang added that payors have the option to not do it.
Mr. Ulberg added that DFS, Department of Financial Services regulates the
non-Medicaid insurers, issued very direct guidance and what we do is keep
track of who is in fact recognizing that we have issues and who is not. The
best that we can do is to inform them really on a claim by claim basis of
what is kind of fallen within being classified as an impact related to
Change. We are fairly successful with even the State, we have a file for
claims that fit within the denial period that we want you to recognize. And
again, we even had to attest to DFS that we in fact had these various issues
that we were requesting that the insurers address. We do not believe it is
over, and it is not as big of an issue as we move quickly and other
providers have moved quickly to try to switch to another clearing house and
put in other systems.
Dr. Katz commented that Sally is the only lawyer at the table, that if we
were to lose money because of insurers unwillingness to go beyond the date,
would we not have a legal case claim against Change Healthcare? This is a
company that had a $300 billion dollar profit last year, they are not going
bankrupt. No matter how many claims, they are not going bankrupt.
Ms. Karlin responded that OLA is looking at that as well, and we are as well
ticking and tying, and making sure we put everything into an appropriate
bucket, all of our claims, all of our denials, and working through it as
well as any expenses that we have incurred because of this. OLA is looking
at our options.
Ms. Hernandez-Piñero answered that she thinks we will have to get in line
and asked if we had an interim vendor before Experian.
Ms. Karlin responded that we did not. Change HealthCare was our vendor, and
the board approved a transition from Change Healthcare to Experian. We were
just able to leverage that Experian contract to implement it earlier.
Dr. Katz added that we just started sooner and depending what you think, it
was either brilliant judgement but we got very lucky, as we were able to
start it earlier. We are lucky we were prepared.
Mr. Ulberg added that it raises the issue of this redundancy. Do we need to
22
have redundancy? Once we put this behind us, we will come back and answer
that question of do we need to have redundancy to be prepared.
Ms. Hernandez-Piñero added that MetroPlus tried to have the redundancy built
in, and then companies kept getting swallowed up, so everyone that you were
using for redundancy was taken over.
Ms. Karlin added that we have already started engaging in that conversation
with IT and we will see what their recommendation is.
Ms. Wang commented that from a timing standpoint, it sounds like the team
has back up plans and back up plans, and the bigger question is, are we
actually out a loss.
Mr. Ulberg added that we will report back on it.
Ms. Wang continued that the team is doing everything possible to prevent
that but obviously that is the question.
Mr. Ulberg added that we are keeping track of it, we are tagging each claim
as well.
Ms. Meagher provided an update on the Risk Surplus for Year-End 2023.
Significant surplus payments achieved in 2023, but expecting much less
surplus in 2024 due to NYS Medicaid and Healthfirst Medicare premium rate
cuts against consistent medical spend. Membership remaining mostly flat due
to strong Essential Plan performance and high Medicaid recertification
rates.
Ms. Lowe asked if there is any one population that we can look at a little
further, maybe adolescents and pediatrics.
Ms. Meagher responded that we can. We can definitely try to see what is
changing with our pediatrics population, what proportion. They should mostly
be in the blue bar, kids do not qualify for Essential Plan, we can try to
quantify what proportion of that bar are kids and CHP.
Mr. Ulberg added that anyone who has been involved in measuring risk
surpluses has never seen the performance that we saw this year. It was just
quite remarkable for many reasons. We take that information when they set
their budget, we try to triangulate between what we are seeing in the data,
what Healthfirst sees, and what MetroPlus is also seeing. When we are
setting our rates, we have the advantage of having the information from two
other plans. So, when we do the FY-25 budget we will take that all into
account that there will be some sort of drop and as Megan pointed out, we
can already start to see it. Healthfirst is on a January calendar year
basis, they predicted a drop but they are performing better than they had
predicted due to the Medicaid rates that the State set in April was a little
bit better than they had forecasted. Everybody is expecting a drop but how
far the drop, we will have to see. But Healthfirst, first quarter, they are
doing better than budget.
An overview of the recent changes in NYC Insurance market was presented by
Ms. Meagher. Some recent changes highlights include starting in July 2023,
Medicaid recerts contributing to growth in Essential Plan membership which
is now tied to a much richer reimbursement rate. From a claims and surplus
23
perspective there is more revenue. Starting in January 2024, Medicaid
Managed Care coverage was newly eligible for undocumented seniors over the
age of 65. Starting in April 2024, the Essential Plan further expanded to
Essential Plan 200-250 providing new, better coverage for individuals
struggling to afford QHP coverage from HIE.
Dr. Katz added that the President made it possible for people who are
dreamers to qualify previously DACA would not qualify for anything. How big
of a population could that be, of people who are using our service
presumable under NYC Care currently.
Ms. Meagher added that we believe this was part of the 1332 waiver.
Mr. Ulberg added that we will double check and get back to you on this.
Dr. Katz mentioned that it is good news, and it is something to watch and
have some sense of what it would be. It shares in some ways the process of
the seniors, they are in our System and we need to get them into a different
program, presumably the same would be true for the DACA youth. Just need to
figure out how to transition them.
Ms. Hernandez-Piñero added that they are eligible to enroll in a QHP through
the marketplace.
Ms. Dehart commented that this is also a subject to CMS approval, same for
the 1332 waiver that Megan referenced.
Mr. Ulberg added that a newly important regulation that the Biden
administration released last week or the week before, aimed at health equity
access to services, rate transparency and is very comprehensive. We are now
going through the different elements of the rule. It was great to see them
take such an active rule.
Ms. Wang added that it would be great to get a briefing on it.
Dr. Ted Long commenced the presentation with an overview of the HERRC
program and a financial update. H+H currently oversees 14 H+H HERRC sites
serving approximately 24,000 daily guests, a reduction of one HERRC site
since Q2 close. At the 24/7 Arrival Center, over 131,000 asylum seekers have
been served. H+H committed $1.2B of HERRC expenses on behalf of the City
through Q3 of FY-24. In the City’s Executive plan, H+H budget for the HERRC
program is $1.6B in FY-24 and $1.7B in FY-25. OMB has provided H+H with
revenue to cover committed expenses to date through the HERRC MOU with the
Mayor’s Office.
Ms. Wang polled the Committee for questions. There being no further
questions, Ms. Wang thanked and commended the team for the great work.
ADJOURNMENT
There being no further business before this committee, the meeting adjourned
at 11:58 A.M.
AUDIT COMMITTEE TALKING POINTS – May 06, 2024
As Reported by: Ms. Sally Hernandez-Piñero
Committee Members Present:
Mr. José Pagán, Dr. Katz, and Freda Wang
24
The meeting was called to order by Ms. Sally Hernandez-Piñero at 12:04 P.M.
Ms. Sally Hernandez-Piñero asked for a motion to adopt the minutes of
the Audit Committee meeting held on February 5, 2024. A motion was made
and duly seconded with all in favor to adopt the minutes.
Ms. Sally Hernandez-Piñero called on Mr. Guzmán to read and presented the
resolution of Independent Audit Services for the record.
Authorizing the New York City Health and Hospitals Corporation (the
“System”) to execute an agreement with KPMG LLC for the provision
of audit services on behalf of the System, including its
subsidiaries, for an initial period beginning June 2024 through the
end of the CY 2027 Audit period for an amount not to exceed
$5,566,000 over the full term. The System will have the right to
terminate the agreement without cause with 30 days’ notice.
Mr. Guzmán provided background on the resolution and reported that
financial statements for the Health and Hospitals Corporation and its
subsidiaries must be audited by an independent CPA firm as well as
stated as such in the New York City Health and Hospital Corporate
bylaws. Federal and State agencies also require independent audit
certification. He mentioned that Grant Thornton is the incumbent
vendor, their recent contract expired in 2021 and had contract value of
$3,871,500. In 2021 an extension was signed and expires when all audits
covering fiscal year end and calendar year end 2023 have been
completed. Which is around the issuance of the financial statements for
1 of our subsidiaries on or around March/April 2024. The extension
contract value was $2,019,500.
The entities that fall within scope of the audit are The New York City
Health and Hospitals Corporation, Metro Plus, HHC INSURANCE, HHC ACO,
NY Community IPA(FY25-27) and Metro Plus OneX (CY26-27). The audit
services cover tax return prep and state charities reporting for the
Gotham health FQHC.
Mr. Guzmán turned it over to Mr. James Linhart Deputy Comptroller to
discuss RFP process.
Mr. James Linhart discussed RFP Minimum Criteria that was establish first
was that the audit firm needs to be on The New York City Comptroller’s
Pre-Qualified CPA listing, be registered with the New York State
Department of States to do business, licensed and active in public
accounting for at least 9 years and of those 9 years at least 5 of those
years of successful experience auditing the revenue, expenditures and
programs of State or local governments and health systems with revenues
and expenditures over $1.0 billion and the bidder needs to have a MWBE
Status Utilization Plan or Waiver request in order to participate in the
RFP.
The scoring of the substantive criteria was 40% based on experience, 20%
of cost, 10% expertise in federal and New York state reimbursement
methodologies and regulations, 10% experience with public bond offerings
and related requirements of underwriters and attorneys, 10% of depth of
tax consulting division and 10% MWBE utilization.
25
The evaluation committee was made up of 7 individuals they were members
of the audits, finance department and the reimbursements teams. One-
member from Office of Legal Affairs, one-member internal audits team and
2 individuals from facilities finance and other subsidiaries. He
discussed the Overview of Procurement process on November, 14th of 2023
the application to issue request for proposal approved by CRC, On
February 20
th
, 2023 the RFP was posted on City Record and sent directly to
41 Vendors. On February 26,2024 they held a Pre-proposal conference 8
vendors had participated in the proposal conference, On March 13th, 2024
we had received 6 proposals. The evaluation committee submitted their 1st
set of scores on April 1st,2024, and since the score for the top two
bidders were within 5% of each other, it was deemed that a second vote
was required. In the 2nd scoring, the evaluation committee selected KPMG.
Mr. David Guzman stated that KPMG was the top bidder, KPMG has done and
continues to do some consulting /advisory work within the system, in
accordance with the various professional auditing standards, including
AICPA and GAO, KPMG must perform an analysis and determine that none of
its advisory work would compromised its independence as our auditor.
In addition, KPMG has completed an initial independence analysis at our
request, which we have reviewed carefully, and which determined that they
do not have any advisory work with H+H that would impair KPMG’S
independence as our auditor. KPMG will complete a full independence and
risk clearance process if they are approved for the auditor work. David
stated we will work closely with our counsel and KPMG to ensure that
independence issues are fully analyzed and that appropriate safeguards,
if any, are implemented before finalizing a contract with KPMG.
Mr. James Linhart stated that MWBE goal setting methodology for KPMG that
they said can achieve a 25% goal and they are using vendor Katigbak CPA,
otherwise known as TEAM Avaloria.
Ms. Sally Hernandez-Piñero asked David if Grant Thornton original
contract was for 4 years before the extensions?
Mr. David Guzman responded yes.
Ms. Sally Hernandez-Piñero second question was we have a new accounting firm
coming on how do we see that affecting the time line to complete the
audit?
Mr. David Guzman responded that KPMG was actually our audit firm before
Grant Thornton, so they have familiarity with our System, there will be a
transition period and some incremental effort pursuant associated with
that transition as there will be a discovery process. He does not
believe there will any delay in terms of that transition process, this
year will be atypical relative to prior years. We have been with the same
firm for 6 years and a lot of that work, unfortunately will fall on the
Comptroller’s division; he stated he is ready to take it on. I am sure
Grant Thornton will also work with KPMG in accordance with auditing
standards to really facilitate a professional transition.
Dr. Katz stated that Grant Thornton is not going away, it is in their
26
interest to be cooperative just like KPMG had the contract before they
are going to want it in the future. Periodically you should change
auditors. They have looked at our System for 6 years it will be helpful
to see what another auditor sees, Katz believes the transition would be
pretty smooth.
Mr. James Linhart pointed out that the audit team that KPMG is proposing
is familiar with us they were a part of our audit team back in 2017
predated Epic. With the discovery stage every Auditor and Accounting firm
always give the courtesy of the new accounting firm the rights to open up
the books and take a look and clip whatever is needed, they would share
their work papers with them it is a normal practice.
Ms. Freda Wang ask does your audit delivery date change?
Mr. James Linhart answered no the audit delivery does not change it is
due on October 18, we have to deliver it to the Comptroller’s office for
the City.
Ms. Freda Wang asked does the contract actually start like June 1st or
June 30
th
? Can they get started before the end of the fiscal year?
Mr. James Linhart answered we are timing to start in June, we are not and
can not provide them with any information or anything like that until the
next round because we would have to take this to the Board.
Sally Hernandez-Piñero asked if there are any other questions this item
is an item for voting. I will take a motion for adoption of the
resolution, naming KPMG our auditors for the next auditing period she
asks for a second Ms. Freda Wang said yes, Dr. Katz said yes and Mr. José
Pagán said yes motion adopted.
Ms. Sally Hernandez-Piñero called on Ms. Catherine Patsos to read and
present the resolution of Appointment of Record Management Officer for
the record.
Approving the designation of Sofia Khalid, Executive Compliance and
Privacy Officer, as the New York City Health and Hospitals
Corporation (the “System”) Record Management Officer (the “RMO”),
as that term is defined under New York State Education Department
regulations found at 8 NYCRR § 185.1(a), to coordinate the
development of and oversee the System’s records management program
in accordance with the requirements set forth under Article 57-A of
the New York State Arts and Cultural Affairs Law and the
implementing regulations thereof.
Ms. Catherine Patsos stated that pursuant to the arts and cultural
affairs law, all government, and public benefit corporations, which
include the System are required to designate a records management officer
which we currently have a vacancy in that position, Catherine and the
Chief Corporate compliance officer nominates Sofia to serve as the
Systems RO and Dr. Kats agrees with Catherine selection. She stated that
Sofia is currently an Executive Compliance and Privacy Officer, she
handles the matters related to Bellevue and Elmhurst and also assist
Catherine with various system-wide compliance matters and legal issues.
27
Sofia also manages HIPPA Compliance and Privacy including participating
in the Annual Risk Assessments in reviewing and responding to potential
compliance issues and complaints. Sofia has been part of the office of
Compliance since April 2023 and prior to that Sofia was an Associate
Compliance officer from 2016 to 2021 in between that she served as Deputy
Data Privacy Compliance Council at Bloomberg where she served as a
project manager for Data Protection Impact Assessments. Catherine confirm
that Sofia has a Doctorate Degree she is licensed to practice in the
State of New York, she also holds a certificate healthcare compliance,
Sofia received her Health Care Compliance certificate from Seton hall in
June 2016. I believe she was well qualified to carry out the functions
set forth in the applicable law. With the approval of the audit committee
I asked for the recommendation of the systems Audit Committee of Board of
Directors to appoint Sofia Khalid Systems RMO.
Ms. Sally Hernandez-Piñero accepted a motion for adoption of the
resolution all in favor please say yes everyone agreed.
Ms. Sally Hernandez-Piñero called on Joseph O’Keefe from Internal Audits
Department.
Joseph O’Keefe started with the Internal Audit updates. The first audit
he mentioned was the Correctional Health which the City Comptroller are
auditing, he mentioned that’s been going on for about a year it has been
stuck in various legal issues over the last year and they are now
starting to make some headway and progress in this audit.
The second item, the State Comptroller is auditing the Language Services
provided by Health and Hospitals. The audit started back in December
2023, he mentioned the audit was reviewing whether or not we have
adequate supervision of Language Services. He went on to discuss the
third item which is of The BeHeard Program behavioral health audit. He
mentioned that audit has also been going on for little under a year which
the city comptroller office is auditing. He asked if anyone had a
question?
Freda Wang asked him 2 are from the City and 1 is the state?
Joseph O’Keefe responded yes and clarified that Language Access is the
New York State Comptroller and the other 2 are with the city.
The next item he presented was the 14 Internal Audits Planned for FY24.
He mentioned 6 of the audits are completed 6 are in progress and 2 have
not yet started.
Freda Wang asked would you anticipate to do all 14 still?
Joseph O’Keefe responded that they will be started but whether they will
be completed by the end of the fiscal year he was not sure.
Freda Wang asked do we usually get a report on the audit?
Joseph O’Keefe responded yes, you will be getting the audits in reports
under separate cover.
28
The last item he discussed was Auxiliary Audit, he mentioned they will be
performed by Bonadio Group on our various Auxiliary. You can see there
are various states of progress and completion. The CY-23 is the last year
that the Internal Audit Department will pay for those Auxiliary Audits it
is going to be the responsibility of the Auxiliary to complete its audit
and pay for them.
Freda Wang asked what is the legal relationship of the auxiliary?
Joseph responded we have no legal relationship to the Auxiliary they are
independent 501C3s, we have been paying for it because we have history
with them and it one way to reassures us that its actually getting done.
Freda Wang asked so in the revenues slide in 2022 are those negatives are
for the year?
Joseph Okeefe responded most of them are due to losses on investments and
the facilities that were impacted were Bellevue, Gouverneur and Coler.
Ms. Sally Hernandez-Piñero called on Catherine Patsos to give an update
on Compliance.
Catherine Patsos mentioned some of the activities of the office of
Corporate Compliance in the last meeting and she reported the 2025 risk
assessment. She also met with Internal Audit and prepared the draft risk
assessment which was presented to the Enterprise Risk and Compliance
Committee in February meeting and again in the April meeting when the
risk assessment was approved by ERCC.
She went on to discuss Coalfire 2024 Risk Analysis as required by the
HIPAA regulations and the document collection interviews in site visits
for the skilled nursing facilities and the acute care facilities have
been completed the same for the diagnostic treatment centers and the
neighborhood health clinics also has started and the interviews for those
sites began in April and the site visit will occur in May.
She went on to discuss Updates and New Operating procedures for code of
ethics new operating procedure. Changes are as follow: Existing Code of
Ethics, which applies to non-employees of the System, is very outdated
and does not align with operations of the System, the revised Code of
Ethics incorporates the conflicts of Interest Law requirements for System
employees and Board Member, The revised code of Ethics also aligns with
the current System operations, including the operation of Faculty
Practice Plan and Affiliation Agreements, The revised Code of Ethics was
approved by Dr.Katz on April 9, 2024 and the OCC will be sending a
system-wide email alert workforce members of the OP. The Social Media Use
was also revised : Updating this Operation Procedure to align with
current social media outlets, and System values and philosophies and The
OCC will be sending a system-wide email alert informing workforce members
of the revised OP. The next update is Procedure for Identification of
Unidentified Patients
Ms. Sally Hernandez-Piñero asked does the Compliance Plan come to the
Audit Committee or The Board?
29
Ms. Catherine Patsos responded yes it goes to the Audit Committee in
Executive Session in July.
Catherine went on to her next slide and mentioned she is working with the
Data Analytics Team to develop a Policy Management Tool, that will allow
us to automate the ease of Drafting and revising all kinds of resource
documents, including offering procedures, policies, guidance documents,
and tips sheets. Anything that is considered a resource for workforce
numbers. She presented it to the Stakeholders on March 15, 2024 to get
feedback on the tools. Catherine is currently working with EITS to have
this tool into production and revising Operating Procedures to be
completed by July 2024, notifications will be sent out to the owners of
those operating procedures that it is time for them for review and
revision.
Ms. Sally Hernandez-Piñero asked can you fresh our memories on the
Genesis?
Catherine stated this is actually a work plan item to update the life of
operating procedure library and then it’s kind of evolved into creating a
system that can instead of just getting everybody to update their
operating procedure let's put in place a tool that will assist in that
process and get all the tools that would help facilitate the process and
make it easier for operating procedures owners to get them up to date.
Freda Wang asked, can everybody access the library to look for operating
procedures?
Catherine responded yes even on the Internet, keyword, Searchable and
Tags.
Freda Wang asked is there a policy of how often OB needs to updated.
Catherine responded it really depends on the individual operating
procedure but what is stated in the operating procedure on how frequently
it needs to be updated. She also conducted workforce compliance survey in
December 2023, unfortunately the response rate was much lower than the
previous year, but she is planning to coordinate survey on compliance
weeks so that the Compliance Officers encourage the people to take the
survey at the high level. She reported that there was an increase in
respondents that know how to contact the Office of Corporate Compliance
or their Compliance Officers similar to last year. The supervisors and
managers were the point of contact for people who had a compliance issue,
which is fine as long as the supervisor managers knows to bring them to
the Office of Compliance. The training provided good guidance and key
lessons from it. She mentioned more than half of them want to see more
electronic communications which will be implemented, as we roll out our
communications plan in the coming months.
Her next slide was Compliance Report Metrics it displayed 1st quarter
comparison from 2022,2023 and 2024 and we did have increase in 2024 1st
quarter.
Ms. Sally Hernandez-Piñero asked what kind of cases that comes first in
30
compliance report metrics?
Catherine responded it can be misconduct, inappropriate behavior, Human
Resources issues, patient care, patient rights, falsification of record,
Billing compliance and etc.
Ms. Sally Hernandez-Piñero asked if there was one category that jumped
out, right in terms of a traumatic increase?
Catherine responded for compliance issues we do get a lot of human
resources and labor relations types of issues.
Freda asked just on the compliance slide was there a big drop in 2023
just that quarter dropped or was the whole year a lot lower than?
Catherine responded the whole year was not a lot lower it was just the
timing.
Ms. Sally Hernandez-Piñero stated asked is there any old business or
new business to bring before the Committee.
Hearing none the Committee adjourn at 12:40.
Equity, Diversity and Inclusion Committee Meeting – May 7, 2024
As Reported by: Patricia Marthone
Committee Members Present: Patricia Marthone, Mitchell Katz, José Pagán,
Jackie Rowe-Adams
CALL TO ORDER
The meeting of the Equity, Diversity and Inclusion Committee of the NYC
Health + Hospitals’ Board was called to order at 4:20 p.m.
Sally Hernandez-Piñero participated virtually in a listening capacity.
Dr. Marthone moved for a motion to adopt the minutes of the March 5, 2024
meeting.
Upon motion made and duly second the minutes of the March 5, 2024 meeting
was unanimously approved.
DIVERSITY AND INCLUSION UPDATE
Ivelesse Mendez-Justiniano, Vice President, Chief Diversity, Equity, &
Inclusion Officer, provided an overview of the System’s latest diversity and
inclusion achievements and activities.
Ms. Mendez-Justiniano reported out on the top five training completions from
January – May 2024, which included: Identifying and Managing Unconscious
Bias, Religion as a Social Determinant of Health, Women’s History Month:
Women Mentors in the Workplace, Black History Month: Keeping it Alive, and
Building Psychological Safety.
The next update she presented was in the Language Access category, regarding
the RFP for interpretation services. The new interpretation services were
approved by the Contracts Review Committee (CRC) on April 16
th
and will be
31
presented to the M&PA Board in June. The new contracts will cover the
following: Over-the-Phone and Video-Remote Interpretation (OPI & VRI), On-
Site Interpretation (OSI) for Spoken Languages, On-Site Interpretation (OSI)
for Sign Languages, and Language Proficiency and Interpreter Skills
Assessment.
Ms. Mendez-Justiniano continued on to highlight a new focus on Veterans
Services. She shared that a Veterans Pop Up site, in partnership with the
Mayor’s Office of Veterans Affairs, was launched as a pilot at Metropolitan
Hospital. Woodhull held a Veterans Pop Up session on May 3
rd
. The sessions
are open to employees, patients, and the community at large. Onsite staff at
the sessions can assist with:
• Starting VA Claim
• Updating military records
• Copying of military records
• Appealing VA decision
• Sharing information about services available & more
Ms. Mendez-Justiniano was pleased to announce that 18 NYC Health + Hospitals
facilities (including all 11 acute care facilities and 7 Gotham sites)
earned the “LGBTQ+ Healthcare Equality Leader” Designation in Human Rights
Campaign Foundation’s Healthcare Equality Index.
Ms. Mendez-Justiniano went on to share that in the Gender Equity category,
there was a training developed in collaboration with the Institute for Human
Identity. The three-month long (18 hours) training is an advanced clinical
training program for the System’s mental health professionals aimed at
building their clinical knowledge and skills to provide affirming therapy to
LGBTQ+ patients.
Ms. Mendez-Justiniano concluded her report by highlighting a few notable
events and presentations including: a Women’s History Month webinar about
“Women Mentors in the Workplace”, a Holi celebration, H+H staff speaking on
panels at Becker’s Healthcare 14
th
Annual Conference, and a feast celebrating
Eid.
Follow-up: The Committee would like to know in the future the numbers of
veterans served by the veteran services initiatives.
EQUITY AND ACCESS COUNCIL UPDATE
Nichola Davis, Chief Population Health Officer, and Co-Chair of the Equity
and Access Council (“Council”) initiated the presentation and introduced Dr.
Komal Bajaj, who is the Monitoring and Evaluation Workgroup co-chair.
Dr. Bajaj first discussed the Institute for Health Improvement (IHI)
framework for health care organizations to improve health equity. Strategies
for building health equity infrastructure include:
• Create the data infrastructure to improve health equity
• Build organizational capacity to support efforts to improve health
equity
32
In terms of creating the data infrastructure, the steps include:
1. Provide staff training and support in obtaining accurate race,
ethnicity, and language (REaL) data
2. Articulate the reason for stratifying REaL data
3. Characterize missing REaL data
4. Assess the accuracy of your REaL data
Dr. Bajaj then summarized the dimensions of REaL data which include:
Accuracy, Completeness, Timeliness, and Consistency.
She then provided a brief outline of how the System has been working on
improving race, ethnicity, and language (REaL) data over time. In 2021, data
collection fields were updated, ethnic groups were standardized, and ethnic
background categories expanded from 20 to 200. An enterprise definition for
race and ethnicity was also approved. From 2021-2022, departments began
utilizing the same standardized ethnic groupings. From 2022-2024, data
collection methods improved (MyChart, kiosks). The goal continues to be to
stratify quality measures by complete and accurate REaL data across the
System.
Dr. Bajaj noted after improving REaL data collection, key health care metrics
can be viewed and tracked from an equity lens. She then provided the example of
blood pressure control rates by race/ethnicity among adults with hypertension.
Looking at the variation of the results allows for the ability to deliver more
targeted solutions to address gaps in care.
She then outlined next steps as it relates to assessing completeness,
consistency, and accuracy. For assessing completeness, the rate of missing race
and ethnicity among H+H patients from 2020-2024 should be evaluated, in terms
of how the completion rates have changed since the new REaL fields were
implemented. Comparing Race/Ethnicity standardized groupings in June 2022 vs.
in April 2024, the “Unknown” category dropped from 18% to 8% and the “Something
else” category dropped from 18% to 10%, thereby showing an improvement.
In terms of assessing consistency, Dr. Bajaj indicated that next steps would be
to: 1. Map ethnicities/countries listed in the ethnic background field to H+H
racial/ethnic categories and; 2. Assess agreement between patient’s
race/ethnicity and ethnic background. For assessing accuracy, the next step is
to survey patients to collect self-reported race/ ethnicity data.
Following Dr. Bajaj’s report, there was discussion around how to encourage
patients to provide or validate their data, while also giving them the choice
of not disclosing their information. The group also discussed how it will be
important to assess the flow of data collection at the point of care at each
site (both inpatient and outpatient), whether a registration staff member
inputs data, or there is a proxy, or it is self-reported by the patient.
The Committee recommended to staff that communities sometimes respond better to
surveys when there is an understanding of how the information being collected
is for their improvement and betterment. The staff further explained the
process of using a proxy and why it is used.
Dr. Marthone asked if there was any old business or new business, and
hearing none, the meeting concluded and was adjourned at 4:48 p.m.
33
Community Relations Committee IN-PERSON MEETING – May 7 2024
As Reported by Ms. Jackie Rowe Adams
Committee Members Present: Dr. Mitchell Katz, Jackie Rowe-Adams, Dr. Jose
Pagan, Dr. Patricia Marthone
Sally B. Hernandez-Piñero (virtually so in a listening capacity only)
Ms. Jackie Rowe-Adams called the meeting of the Community Relations
Committee meeting to order at 5:00 p.m.
Quorum was established – the minutes of the Community Relations Committee
meeting held on March 5, 2024 were reviewed and upon motion made, and duly
seconded the minutes were unanimously approved.
Ms. Rowe-Adams reminded the Committee that the Board of Director’s Annual
Public Meetings for Fiscal Year 2024 has been scheduled as follows:
• For Brooklyn: Tuesday, May 14, 2024 at Kings County Hospital
• For the Bronx: Tuesday, June 4, 2024 at Lincoln Hospital
• For Staten Island: Tuesday, June 18, 2024 at Sea View Hospital
Speakers are asked to register in advance by calling:
Ms. Colicia Hercules Secretary to the Corporation at 212-788-3359
Ms. Rowe-Adams noted the Community Advisory Boards annual verbal reports
scheduled to present at this meeting:
1. NYC Health + Hospitals/Cumberland
2. NYC Health + Hospital/Elmhurst
3. NYC Health + Hospitals/Gouverneur
4. NYC Health + Hospitals/Lincoln
Dr. Katz shared the President’s report:
• The Bloomberg Connects App has 850 pieces of art that can be viewed by
anyone from NYC Health + Hospitals.
• Michelle Lewis was recognized as a power woman of Manhattan for 2024
• Several staff members were honored by the media for healthcare heroes
recognition
• 14,000 people have been served through telehealth behavioral health
services
• NYC Health + Hospitals/ South Brooklyn Health has had a year without
catheter associated urinary tract infections
• NYC Health + Hospitals/ Elmhurst celebrated earth month with a series
of green events
• Local author Carmen Noboa Espinal had an event at NYC Health +
Hospitals/Queens inspiring children and families
34
• NYC Health + Hospitals/Gotham Health, East New York has a new
mammogram machine which is more effective and comfortable for patients
• Correctional Health Services unveiled a new mural at the Reentry
Center at Riker’s Island
• NYC Health + Hospitals is opening 16 mental health clinics in public
schools
• NYC health + Hospitals/ Bellevue is now able to do a micrographic
surgery for the treatment of skin cancer
PRESENTERS:
Ms. Rowe-Adams moved the agenda to the (5) facilities presenting their
verbal annual reports. Each presentation is allotted 5 minutes.
NYC Health + Hospitals/Cumberland
Mr. Corey Evans, Chair of the NYC Health + Hospitals/Cumberland CAB,
presented the report to the CRC. Mr. Evans stated the accomplishments and
recognitions which includes AHA and AMA Gold + Award for BP Control for
September 2023, over 13 successful employees engagement events, and 2023
Patient Centered Medical Home Re-Accreditation. Projects completed include
replacement of cooling towers, parking lot LED lighting, wellness center
project, and radiology department improvements. Mr. Evans presented on the
frequent complaints and responses, which included communication/updates on
wait time; response- ADIET training provided to all staff members and
clinicians, and access improvement; response- overbooking strategy and
recruitment improvements. Issues impacting the community includes challenges
in mental health services, unaffordable housing market/distribution of low-
income lotteries apartments, and access to healthier food options.
Ms. Rowe-Adams polled Committee members for their comments or questions.
NYC Health + Hospitals/Elmhurst
Ms. Luisang Tamang, Chair of the NYC Health + Hospitals/Elmhurst CAB,
presented the report to the CRC. Mr. Tamang stated that last year the
hospital had close to 700,000 ambulatory care visits and over 130,000
emergency room visits and are an economic engine in the community.
The hospital has had one of the highest levels of translation
services in the system. Awards received includes recognition from US
News and World Report as a ‘Best Regional Hospital” and recognition
from the American Heart Association for several years in a row.
Accomplishments include Phil Jackson, Care Experience Ambassador
being recognized as 2023 Amazing Employee of the Year for the entire
system, and a partnership with EHL Hospitality Business School. In
addition, multiple improvements to the facility have been recently
completed, including new operation rooms.
Elmhurst Hospital is in an underserved community. Expanded access to
resources such as youth centers and services for seniors are needed.
35
Ms. Rowe-Adams polled Committee members for their comments or
questions.
NYC Health + Hospitals/Gouverneur
Dr. Morris from NYC Health + Hospitals/Gouverneur presented the
report to the CRC. Dr. Morris was accompanied by Ms. Susan Sales, CEO
of Gouverneur Skilled Nursing Facility. Dr. Morris stated that the
main site has no significant infrastructure concerns. One of the
satellite sites requires significant renovations to the second floor
to make that usable clinical space. The upgrade of outdoor community
garden has been completed and gym equipment upgrade and refurbishment
of dining areas is underway. Dr. Morris stated that march data for
patient satisfaction at the ambulatory care site has surpassed to
city and state statistics. The patient satisfaction rates for the
skilled nursing site are at about 70 percent as well. The structured
process has been put in the patient relations department to address
complaints.
Historically the neighborhood surrounding the facility has dealt with
poverty but the life expectancy is higher and chronic illness
outcomes are better overall.
Ms. Rowe-Adams poll Committee members for their comments or
questions.
Dr. Katz asked what is the long-term plan for the vacant street level
space, Dr. Morris stated that there is a plan to potentially expand
the dental department and use that space, or enhancing the space and
making it a community art center.
Ms. Rowe-Adams asked if patients have been receptive to the plant-
based food. Ms. Sales stated that some meal items are embraced more
than others, and the food service staff has been hosting tasting to
see what could be changed to make the meals more palatable.
NYC Health + Hospitals/Lincoln
Mr. Richard Izquierdo, CAB Liaison of the Lincoln CAB presented the report
to the CRC. The facility has received support from elected officials
including from Bronx borough President, councilmembers and US senators.
Guest experience hours have extended to 9PM, to improve patient experience.
The facility has also been awarded the Silver Level Beacon Award for
Excellence and the Brown Certificate for Excellence in People Centered Care,
Planetree Certification. Frequent complaints include communication,
attitude-behavior, coordination of care, and waiting time, in addition to
mishandling of property.
Issues impacting the community includes gun violence. The facility has
implemented initiatives targeting gun violence through its Guns Down Life Up
program. The lifestyle medicine program has also been implemented at the
facility and helps to improve sleep patterns, stress reduction, and
36
avoidance of substance use.
Dr. Katz recognized the challenges at NYC Health + Hospitals/Lincoln
and health disparities among the community.
Dr. Marthone and Ms. Rowe-Adams commended the team for their efforts
in the fight against gun violence.
Hearing no old or new business to come before the Committee.
ADJOURNMENT:
Meeting adjourned at 5:52 P.M
37
Mitchell H. Katz, MD
NYC HEALTH + HOSPITALS - PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
May 30, 2024
NYC HEALTH + HOSPITAL FACILITIES RECOGNIZE
NURSES AND HOSPITAL POLICE DURING SPECIAL MAY OBSERVANCES
At various ceremonies and recognition events, NYC Health + Hospitals
highlighted the critical roles our nurses and hospital police play at our
facilities.
The System’s 9,600 nurses are a vital part of the high-quality care that we
deliver every day to our patients. NYC Health + Hospitals/Lincoln hosted
multiple events throughout the month and had a closing ceremony last week.
It has been a great year for our nurses. Our Chief Nurse Executive and
Senior Vice President Natalia Cineas, SVP, has hired over 1,000 new nurses
in the past 8 months, and we expect several hundred more to join our health
system before the end of the year.
Our highly-trained hospital police are also on the frontlines of our
facilities – they are often the first people that our patients meet when
they enter a facility. The officers provide patient and family assistance,
on-site security, and enforce state and city laws at all NYC Health +
Hospitals facilities. In recognition of National Peace Officers Day, on May
16, NYC Health + Hospitals/Woodhull unveiled a newly renovated hospital
police command center.
MAYOR ADAMS AND NYC HEALTH + HOSPITALS HAS HIRED OVER 1000 NEW NURESES
New York City Mayor Eric Adams and NYC Health + Hospitals President and CEO
Dr. Mitchell Katz today announced that more than 1,000 new union nurses have
been hired over the past eight months at the City’s public hospital System,
replacing many temporary nurses. This investment in the health System’s
workforce ensures patients are served by permanent employees who are
committed to the mission, come from the community, and have developed
institutional knowledge. New Nurses Can Take Advantage of Nurse Residency
Program, Nursing Fellowships, Tuition Reimbursement, Loan Forgiveness, and
Scholarship Programs
CHIEF QUALITY OFFICER DR. ERIC WEI AND NYC HEALTH + HOSPITALS/ELMHURST CEO
HELEN ARTEAGA LANDAVERDE JOINED SENATOR GILLIBRAND IN CALLING FOR MORE
INTERAGENCY COORDINATION TO RESPOND TO THE AVIAN FLU OUTBREAK IN CATTLE
On Tuesday, May 21, Senator Gillibrand held a press conference to advocate
for additional interagency coordination to respond to the avian flu outbreak
in cattle. She was joined by NYC Health + Hospitals/Elmhurst CEO Helen
Arteaga Landaverde, Chief Quality Officer and Senior Vice President Dr. Eric
Wei, and the CEO of Mt. Sinai. In a letter the Senator wrote to the White
House Office of Pandemic Preparedness and Response Policy, she urged the
agency to give information regarding its role in coordinating amongst
Federal agencies and continue to provide the public and State agencies with
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up-to-date, accurate information on the spread of Highly Pathogenic Avian
Influenza (HPAI), also known as H5N1.
NYC Health + Hospitals officials spoke to the health System’s critical role
at the front line in responding to the public health crisis in New York
City, including its response to Ebola and the recent COVID-19 pandemic.
OMER CABUK, ME APPOINTED TO LEAD HEALTH SYSTEM DECARBONIZATION EFFORTS
NYC Health + Hospitals appointed Omer Cabuk, ME as its first ever Chief
Decarbonization Officer. In this role, Cabuk will spearhead the
organization’s robust decarbonization initiatives, adhering to the targets
set by Local Law 97 of 2019, which mandates a 40% reduction in operational
emissions by 2025 and a 50% reduction by 2030. He will serve as an
executive-level strategist, partnering with leadership team, capital project
leads, facilities management staff, and other key stakeholders to fully
embed energy efficiency, electrification, and renewable energy initiatives
for the built environment into corporation’s policy, operations, and capital
planning. He will also advise executive leadership on strategic
opportunities, critical issues, and risks impacting decarbonization efforts
within the organization’s operations. His appointment was effective April 8.
Cabuk will also support the health System’s Climate Resiliency Goals by
implementing decarbonization projects and initiatives that reduce
environmental impacts, enhance energy reliability, improve public health,
and ensure sustainable and resilient infrastructure. Today’s announcement
builds on the health System’s Climate Resiliency Plan announced last week.
Cabuk brings experience and a proven track record to his new role. As the
former Senior Director of Decarbonization and Sustainability at NYC Health +
Hospitals, he led significant decarbonization projects that substantially
reduced both direct and purchased energy emissions. These initiatives were
crucial in enabling the organization to sign the U.S. Department of Health
and Human Services Health Sector Climate Pledge in May 2022, which included
commitments to reduce direct and purchased energy emissions, complete a
climate resilience study, and conduct an inventory of all indirect
greenhouse gas emissions that occur in an organization's value chain.
Additionally, during his tenure, Cabuk managed an annual utilities budget of
$100 million, optimizing and reducing costs associated with gas,
electricity, and district steam utilities.
NYC HEALTH + HOSPITALS CELEBRATED NATIONAL SKILLED NURSING CARE WEEK AND
RECOGNIZED THE HIGH-QUALITY SERVICES ACROSS ITS FIVE NURSING HOMES
In celebration of National Skilled Nursing Care Week, formerly Nursing Home
Week, NYC Health + Hospitals/Post-Acute Care proudly celebrated its five
skilled nursing facilities and Long-Term Acute Care Hospital, recognizing
their new services and high-performance ratings. In the past year, NYC
Health + Hospitals/McKinney and NYC Health + Hospitals/Sea View began
offering Parkinson’s care, NYC Health + Hospitals/Carter launched telemetry
services and hospice care, NYC Health + Hospitals/Gouverneur launched
enhanced dining for its residents, and NYC Health + Hospitals/Coler opened
The Coler Café.
The facilities are widely recognized for providing high quality care. In
2024, Newsweek ranked Carter, Coler, Gouverneur, and Sea View in the Top 10
of Best Nursing Homes 2024 in New York State, and McKinney ranked in the Top
30. U.S. News & World Report recognized NYC Health + Hospitals/Carter,
Gouverneur, McKinney, and Sea View for high performance in short-term
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rehabilitation, and for the latter three sites, high performance in long-
term care. NYC Health + Hospitals/Sea View, Coler, Carter, Gouverneur and
McKinney consistently earn four- and five-star ratings from the U.S. Centers
for Medicare & Medicaid Services (CMS), which designates five-star rated
skilled nursing facilities among the top 10 percent of nursing homes in the
country. Additionally, NYC Health + Hospitals/Post-Acute Care facilities are
ranked in the top 1st quintile in the New York State Department of Health
Nursing Home Quality Pool.
LEGAL SERVICES FOR PATIENTS EXPAND AT THE HEALTH SYSTEM
In late April, the health System announced the expansion of free health-
related legal services for its patients in partnership with LegalHealth, a
division of the New York Legal Assistance Group (NYLAG). Nearly 5,000
patients accessed legal services at NYC Health + Hospitals in 2023. The
expansion includes increased staffing, capacity building for increased
patient access, and data-driven analysis on how legal services can impact
patient health. Patients can access free health-related legal services over
the phone or in person at one of twelve brick-and-mortar sites in the health
system through a referral by a doctor, social worker, or community health
worker. This is one of the longest-running and largest medical-legal
partnerships in the country, which dates back to 2002 and has provided free
legal assistance to thousands of New Yorkers seeking help with public
benefits, immigration, health insurance, advance planning, and housing,
among other legal issues. The medical-legal partnership is funded in part by
the New York City Council.
26 NYC HEALTH + HOSPITALS DOCTORS RECOGNIZED
AT ANNUAL DOCTOR’S DAY CELEBRATION
At the beginning of May, NYC Health + Hospitals celebrated its Doctors’ Day
and the 26 doctors recognized for their outstanding patient care. This year,
for the first time, NYC Health + Hospitals honored three physicians at the
new Gotham Health Centers of Excellence, which provide Long COVID services
as well as primary care services. The doctors were nominated by their
facility’s Chief Medical Officer to qualify for the achievement. This year’s
honorees include pediatricians, primary care doctors, emergency department
physicians, an oncologist, a pathologist, a neurologist, an HIV specialist,
an optometrist, and others. They come from a diverse array of nations such
as Ukraine, Nigeria, China, Burma, Nepal, Bangladesh, Cyprus, Haiti, India,
and Pakistan.
NEW PSYCHIATRY RESIDENCY ESTABLISHED AT NYC HEALTH + HOSPITALS/QUEENS
Earlier this month, NYC Health + Hospitals/Queens received initial
accreditation for a new psychiatry residency at the hospital. This new
program will allow the health System to be more equipped to face the
challenges of hiring in the behavioral health workforce. Recruitment of
adult psychiatrists in our region has become increasingly competitive in
recent years. Residents will have a rich clinical and educational exposure
during their training at Queens Hospital. The addition of residents will
also enhance the psychiatric service provided to our patients, particularly
in busy rotations, including, but not limited to our Comprehensive
Psychiatric Emergency Program for adult, Extended Emergency Length of Stay
(EELOS) for child and adolescent patients, inpatient psychiatry service,
outpatient mental health clinic, Consultation-Liaison Service, Addiction
Psychiatry Service, Partial Hospitalization Program, Assertive Community
Treatment Teams, Medicine, and Neurology.
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We anticipate that a prolific and rewarding experience will continue to
encourage retention within the NYC Health + Hospitals system upon
graduation.
NYC HEALTH + HOSPITALS HAS SERVED NEARLY 14,000 PATIENTS
THROUGH ITS TELEHEALTH BEHAVIORAL HEALTH SERVICE
Nearly 14,000 patients have received behavioral health care through the
health System’s telehealth service, Virtual ExpressCare, since the program
launched in 2022. Through this service, patients can speak to a provider on
demand via video or phone for help with anxiety, depression, stress,
burnout, substance use disorders, withdrawal, and emotional distress. The
service provides patients with immediate access to a wide range of
behavioral health professionals, including psychiatrists, social workers,
addiction counselors, and mental health nurse practitioners. A significant
enhancement to this service is its expanded capacity to provider specialty
services to children and adolescents, addressing a crucial need within this
population. This responsive on-demand service model is tailored to meet the
urgent behavioral health needs of the City.
NYC Health + Hospitals is the largest provider of behavioral health in New
York City. The system provides almost 60% of behavioral health services
citywide serving over 75,000 patients annually across emergency, inpatient
and outpatient care.
NYC CARE HOSTS ITS 22 NEW AND RETURNING COMMUNITY BASED ORGANIZATIONS TO
ASSIST WITH CONNECTING NEW YORKERS TO HEALTH CARE
The NYC Health + Hospitals’ NYC Care program hosted its 22 community-based
organizations (CBOs) from across the city to provide outreach, education,
and NYC Care enrollment services. The CBOs have a presence across all five
boroughs, and have a proven track record of serving NYC Care priority zip
codes, which represent areas with the highest rates of uninsured New Yorkers
and the lowest rates of NYC Care enrollment. Additionally, the organizations
have staff that speak over 30 different languages and many come from the
communities they serve, highlighting their roles as trusted messengers. The
majority of the selected CBOs are multi-service organizations representing
additional programmatic areas, including civic engagement, housing and
homelessness, and food security, among others. Many of the CBOs have worked
with the program previously since it launched in the Bronx in 2019. The
current CBO partners’ success in outreach and enrollment is such that the
zip codes they currently serve were not included as priority targets in the
new round of funding.
INAUGURAL BLACK MATERNAL HEALTH FORUM HELD
AT NYC HEALTH + HOSPITALS/GOTHAM HEALTH, GOUVERNEUR
The health System held its inaugural Black Maternal Health Forum on Tuesday,
May 21 at NYC Health + Hospital/Gotham Health, Gouverneur. Gotham Health’s
Regional Medical Director Morris Gagliardi, MD, MBA and system Chief Medical
Officer and Senior Vice President Machelle Allen, MD gave open remarks
alongside Gotham Health’s Regional Director of Nursing Marie Wilson, DNP,
APRN, WHNP. The forum focused on the current state of Black perinatal
health, the legacy of Black midwives, and a panel discussed “A Solution
Approach to Supporting Black Birthing People.” The event was open to all NYC
Health + Hospitals staff in person and virtually via Webex.
NYC HEALTH + HOSPITALS AND METROPLUS LEADERS RECOGNIZED
AS “AAPI POWER PLAYERS” BY POLITICSNY AND amNY
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Four leaders from across the health system and MetroPlusHealth were named to
PoliticsNY and amNY Metro’s 2024 “AAPI Power Players” list. Launched in
honor of Asian American and Pacific Islander Heritage Month, the recognition
list honors leaders from a range of industries and fields making a bold
impact across New York. This year, the list recognizes Lila Benayoun, Chief
Operating Officer for MetroPlusHealth; Dr. Zeshan Chaudhry, Director of
Neuroradiology for NYC Health + Hospitals/Kings County; Dr. Khoi Luong,
Senior Vice President of Post-Acute Care for NYC Health + Hospitals; and Dr.
Eric Wei, Senior Vice President and Chief Quality Officer for NYC Health +
Hospitals. The 2024 AAPI Power Players recognition list is part of a monthly
series by PoliticsNY and amNY Metro on New York’s Power Players, including
business executives, educators, government affairs experts, and nonprofit
directors.
BLOOMBERG CONNECTS APP FEATURES NEARLY 850 PIECES
OF NYC HEALTH + HOSPITAL ART
NYC Health + Hospitals is the first health care organization on Bloomberg
Connects, which features more than 350 cultural organizations, including
many of the world’s major museums. The Arts in Medicine department has been
working closely with Bloomberg Connects to add content to its app. Nearly
850 works of art from the health System’s collection are available to view
worldwide on the free app. The NYC Health + Hospitals guide includes artwork
by nearly 400 artists and can be accessed by searching the artist’s last
name, the location of the art, or in a featured story. In addition, nearly
850 artworks across the health System’s facilities now have informational
wall text and a QR code leading to additional material on Bloomberg
Connects. The Arts in Medicine department at NYC Health + Hospitals is made
possible in part with the generous support of the Laurie M. Tisch
Illumination Fund.
NEW MURALS INSTALLED ON THE FENCING OUTSIDE OF NYC HEALTH +
HOSPITALS/METROPOLITAN
In partnership with ArtBridge, two new murals were installed on the
scaffolding of NYC Health + Hospitals/Metropolitan. The works were developed
by artists Dario Mohr and JR in collaboration with residents from the nearby
East River Houses over a series of workshops and community engagement
events. Dario Mohr’s work, Adinkrahene, is tied together through Adinkra
symbols originating from the Asante Kingdom. East River Houses residents
contributed their own Adrinkra symbols to this mural, which also features
elements of works by Knii Shippie Afotey of Ghana and Faith Omole of
Nigeria. The second mural, The Peoples’ Art Project, is an exhibition based
on input from the East River Houses community, created by renowned
artist/activist JR as part of his well-known Inside Out Project, drawing on
global participation from 152 countries with nearly 600,000 photos
contributed to date, intended to spark conversations and collaborations that
lead to social change. The two murals are located on 2nd Avenue between 97th
Street and 99th Street. Once the scaffolding is taken down, Metropolitan
Hospital will host a permanent display of the works. ArtBridge transforms
construction fencing and scaffolding in New York City with new art developed
by artists. The project received support from the health system’s Arts in
Medicine program.
NYC HEALTH + HOSPITALS/HARLEM’S BURN INTENSIVE CARE UNIT RECOGNIZED WITH
SILVER-LEVEL BEACON AWARD FOR EXCELLENCE
Harlem Hospital’s Burn Intensive Care Unit recently received a silver-level
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Beacon Award for Excellence from the American Association of Critical-Care
Nurses (AACN). The unit at NYC Health + Hospitals/Harlem is the only Burn
Intensive Care Unit in New York City, only the second in New York State, and
only one of four in the United States to earn this silver-level designation.
The Beacon Award for Excellence — a significant milestone on the path to
exceptional patient care and healthy work environments — recognizes unit
caregivers who successfully improve patient outcomes and align practices
with AACN’s six Healthy Work Environment Standards.
The silver-level Beacon Award for Excellence signifies an effective approach
to policies, procedures and processes that includes engagement of staff and
key stakeholders. The unit has evaluation and improvement strategies in
place and good performance measures when compared to relevant benchmarks.
HEALTH SYSTEM LAUNCHES NEW COMPREHENSIVE PATIENT BLOOD MANAGEMENT INITIATIVE
TO IMPROVE PATIENT OUTCOMES
As patient blood management has become standard across health care systems,
the NYC Health + Hospitals’ Office of Medical and Professional Affairs and
Office of Quality and Safety launched the Comprehensive Patient Blood
Management initiative. The initiative is focused on improving patient
outcomes by managing and preserving a patient’s own blood, while promoting
patient safety and empowerment.
DIAGNOSTIC RADIOLOGIC INTERPRETATION SERVICES GOES ONLINE
NYC Health + Hospitals has embarked on the implementation of teleradiology
to provide diagnostic radiologic interpretation services to several acute
care hospitals for some inpatient and Emergency Department exams performed
evenings, nights, and weekends. It will also include all NYC Health +
Hospitals/Gotham Health outpatient radiology exams with the exception of
mammography.
With teleradiology the health System is able to improve both the quality of
clinical care and operational efficiencies. The system will continue to
employ on-site radiologists to effectively coordinate care for patients. The
second phase of the effort is expected to begin this fall, will bring to
24/7 coverage utilizing a hybrid of onsite and Teleradiology models.
NYC HEALTH + HOSPITALS/SOUTH BROOKLYN HEALTH MARKS ONE YEAR WITHOUT A
CATHETER-ASSOCIATED URINARY TRACT INFECTION (CAUTI)
NYC Health + Hospitals/South Brooklyn Health reached a significant milestone
in ensuring the highest quality of care for its patients: one year without a
single catheter-associated urinary tract infection (CAUTI). A CAUTI is a
common infection that occurs when bacteria enter and infect the urinary
tract through a urinary catheter, a tube placed in the body to drain and
collect urine from the bladder. Up to three-quarters of urinary tract
infections are caused by a placed urinary catheter. The hospital achieved
this milestone by implementing a daily review system for its patients,
accountability protocols and care team collaboration. There were two
reported CAUTI infections in the previous year.
NYC HEALTH + HOSPITALS/WOODHULL UNVEILS NEWLY
RENOVATED HOSPITAL POLICE COMMAND CENTER
On May 16, Woodhull Hospital unveiled its newly renovated Hospital Police
Command Center, which is situated in the main floor lobby. The revamped
space is characterized by its modern design, spacious layout, and abundant
natural lighting, providing an optimal environment for effective command
operations. Equipped with state-of-the-art technology, including multiple
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screens displaying real-time footage from hospital cameras, the command
center empowers hospital police officers to monitor events throughout the
facility. With the ability to monitor all areas of the hospital, the
dedicated team of Hospital Police can efficiently coordinate responses to
ensure a safe and secure environment for employees, patients, and visitors.
HEALTH SYSTEM DETAILS CLIMATE RESILIENCE PLAN,
BUILDING ON EXISTING EFFORTS AND COMMITMENT
Last week, NYC Health + Hospitals announced the completion of its Climate
Resilience Plan, a significant milestone in its commitment to ensuring the
resilience of the health System’s infrastructure in the face of climate
change. The plan fulfills a key commitment under the U.S. Department of
Health and Human Services Health Sector Climate Pledge, which NYC Health +
Hospitals signed in May 2022. It is the result of a thorough survey of the
health System’s hospitals and post-acute care facilities. A team studied the
impact of climate hazards, such as stormwater flooding, coastal flooding,
extreme heat, and wind, on each facility under different levels of projected
greenhouse gas emissions and the resulting extreme weather due to climate
change. It considered the impacts on key facility operations, including
electrical power, natural gas, steam, telecommunication, potable water,
wastewater, transportation, and logistics. The Plan recommends a series of
infrastructure projects, such as installation of additional emergency
generators linked to critical HVAC equipment, improving the drainage
capacity of roofs and windows, building additional flood barriers, and
installing green infrastructure to reduce ponding and heat island effect.
This effort builds on the health System’s commitment to addressing climate
change while reducing its carbon footprint. NYC Health + Hospitals has
already achieved a 30% reduction in carbon dioxide emissions since 2006 and
is continuing its efforts to achieve a 50% reduction by 2030. The Climate
Resilience Plan aligns with the Mayor’s PlaNYC: Getting Sustainability Done
long-term strategic climate plan.
PRIDE CENTER AT NYC HEALTH + HOSPITALS/BELLEVUE HONORED FOR ADVANCING
EFFORTS TO TRAIN AND EDUCATE LGBTQ+ PROVIDERS
Building the Next Generation of Academic Physicians (BNGAP) selected
Bellevue Hospital’s Pride Health Center as the recipient of its
Organizational/Institutional Leadership Award. The award recognizes
Bellevue’s commitment to advancing efforts to train and educate health care
professionals on LGBTQ+ health and healthcare. The award was presented
during the LGBTQ+ Health Workforce 12th Anniversary Conference, held in
early May in New York City.
Building the Next Generation of Academic Physicians (BNGAP) works to help
diverse medical students and residents become aware of academic medicine as
a career option and to provide them with the resources to further explore
and potentially embark on an academic medicine career. The theme of this
year’s conference was Creating a Roadmap to Empower the LGBTQ+ Health
Community.
The Pride Health Center at Bellevue was established in 2018 to address the
needs of LGBTQ patients and communities across New York City.
NEW STUDY WILL EVALUATE THE IMPACT OF MURALS IN HOSPITALS
NYC Health + Hospitals is participating in a first-of-its-kind global
evaluation of the impact of murals in hospitals, being led by the Jameel
Arts & Health Lab (JAHL) and NYU Steinhardt in collaboration with the World
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Health Organization.
In the first study of its kind, HoME seeks to advance understanding of the
impact that murals in hospitals and other clinical settings can have on
people who view these large visual artworks including patients, staff, and
visitors. The project will involve a mixed-methods study at sites in
Slovenia, Nigeria, the UK and US, assessing possible correlations between
viewing murals and workplace belonging, perceived quality of care, and
wellbeing.
The HoME research team, overseen by NYU Steinhardt Associate Professor and
JAHL Co-Director, Dr. Nisha Sajnani, and co-led with JAHL Research &
Evaluation Associate, Marcel Foster, MPH. The team consists of members from
the Jameel Arts & Health Lab, the Center for Arts in Medicine at the
University of Florida, Harvard University, a research team from the Lagos
University Teaching Hospital, The Art of Healing, Norwich University of the
Arts, Hospital Rooms, the Arts in Medicine department at NYC Health +
Hospitals, the University Children’s Hospital in Ljubljana, and the Nordic
Art Initiative.
RESPONDING TO THE HUMANITARIAN CRISIS – SERVICES FOR ASYLUM SEEKERS
The public health System continues to help lead the City’s response to the
historic influx of asylum seekers. Last week, New York City's Arrival
Center, the city’s one-stop, centralized intake facility for all newly
arriving asylum seekers, celebrated its one-year anniversary of dedicated
service. Since the Arrival Center first opened its doors in May 2023, our
staff have registered and provided care to nearly 150,000 people from over
160 countries, creating a modern-day Ellis Island that expedites asylum
seekers’ access to streamlined, responsive services moments after they
arrive in New York City.
The Arrival Center successfully addresses three significant challenges of
the asylum seeker crisis — providing immediate medical screenings and
healthcare for all new arrivals, coordinated reconnections for people whose
intended destination is not New York City, and case management services to
help people complete their journeys quickly, including same day referrals
for legal assistance.
Since the crisis began, we have seen asylum seekers’ with acute and urgent
need for medical care. At the Arrival Center, our staff address this need by
offering immediate medical screenings, urgent care, behavioral health
screenings and care, and vaccinations. Clinicians provide urgent care for
common medical conditions and dispense medications and prescriptions as
needed and can refer asylum seekers to NYC Health + Hospitals’ facilities to
receive more intensive care. To date, staff at the Arrival Center and NYC
Health + Hospitals’ 13 Humanitarian Emergency Response and Relief Centers
(HERRCs) have performed over 130,000 depression screenings and administered
over 70,000 vaccinations.
From managing the Arrival Center, to establishing emergency humanitarian
centers that currently house 25,000 people, and coordinating case management
services across the City shelter sites, NYC Health + Hospitals remains a
cornerstone of the City’s efforts to provide life-changing care to the
nearly 200,000 asylum seekers who turned to our City for help.
METROPLUSHEALTH OFFERS MEDICALLY TAILORED MEALS (MTM) AS A PERMANENT
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MEDICAID BENEFIT
Increasingly, food is recognized as medicine, whether as part of a plant-
based lifestyle or medically-tailored meals. Evidence is mounting that
securing access to nutritional food is critical to health and well-being.
Notably, NYC Health + Hospitals is leading the way nationally in creating
unique opportunities for New Yorkers to be able to benefit from this
progress. In 2022, New York State Medicaid approved MetroPlusHealth to
implement the cost-effective medically-tailored meals (MTM) program,
designed to be delivered to members’ homes either in lieu of Personal Care
Aide (PCA) service hours used for meal preparation and food shopping, or in
lieu of hospital inpatient stays and/or emergency department visits.
Initially launched as a pilot program, it is now approved as part of the
permanent Medicaid benefit package.
The largest plan of its size to implement this State-funded program,
MetroPlusHealth delivers MTM through unique partnerships: with God’s Love We
Deliver, the direct provider of the meals, and with NYC Health + Hospitals,
which helps identify and refer members to the program in addition to the
members the Plan identifies. Once enrolled, participants living with certain
chronic conditions such as diabetes and heart disease, meet with a
registered dietician who designs their menu, taking their chronic conditions
into consideration, and provides them with unlimited nutrition education and
counseling. Through the program, members receive up to two meals a day
delivered to their homes, seven days a week.
To date, MetroPlusHealth and its partners have enrolled almost 1,200
members. Among those enrolled, 82% are aged 40+, 66% are Black or Hispanic,
59% live in the Bronx or Brooklyn. The top chronic conditions of enrolled
members were diabetes, hypertension, hyperlipidemia, and chronic kidney
disease.
According to a formal evaluation conducted among enrolled members, member
feedback has been overwhelmingly positive, with 95% expressing satisfaction
with the MTM program, and 94% feeling that the meals assist them in managing
their disease. Through this program and the unique partnerships that support
it, MetroPlusHealth is doing more to ensure that an increasing number of New
Yorkers have access to a healthy lifestyle and diet to improve their health.
ROBOTIC SURGERY PROGRAM EXCELS AT NYC HEALTH + HOSPITALS/HARLEM
Harlem Hospital celebrated the one-year anniversary of its Robotic Surgery
program. In 2023, Harlem Hospital introduced the state-of-the-art da Vinci
surgical system as a means to perform surgical procedures with the advanced
capabilities of robotic technology. The Robotics team has since grown to
include a total of seven highly skilled surgeons specializing in Bariatrics,
General Surgery, Gynecology and Urology. Together, they have leveraged the
da Vinci system to perform complex procedures with precision, leading to
enhanced patient outcomes including improved patient recovery times and
overall satisfaction. Within just one year, the Robotic Surgery team has
successfully completed over 400 surgeries using the da Vinci system. This
remarkable achievement reflects not only the advanced capabilities of
robotic technology, but also the dedication, skill, and teamwork of the
staff.
NYC HEALTH + HOSPITALS/COLER OPERNS WELLNESS ROOM TO OFFER EMOTIONAL AND
MENTAL HEALTH SUPPORT FOR STAFF
NYC Health + Hospitals/Coler opened its new, dedicated wellness room to
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support the physical and mental well-being of more than 700 employees
serving its five-star rated nursing home and rehabilitation center. This
new, permanent space includes amenities designed to help busy staff relax
and destress, such as coffee machines, aromatherapy, calm music, fruit-
infused water, healthy snacks, and designated areas for creative activities
or just healthy conversation between colleagues. The dedicated space has
modern lounge-style furniture, soothing color patterns, and windows adorned
with natural green landscapes. The designers focused on comfort and
functionality to create an inviting space that will encourage staff to
invest time in their self-care. The wellness room also includes art from the
health system’s art collection installed by the Arts in Medicine department.
ELEVEN NYC HEALTH + HOSPITAL AND METROPLUSHEALTH
EMPLOYEES HONORED AS “HEALTHCARE HEROES”
Eleven staff members were recognized as honorees in Schneps Media’s annual
“Healthcare Heroes” recognition list. Health care professionals from New
York City to Long Island were celebrated for their dedication to serving
their patients and advancing their fields. Schneps Media is a local media
company that reaches over 2 million readers per week across two daily
newspapers and a large group of community newspapers, magazines, and
websites.
ONE OF THE OLDEST MEDICAL HONOR SOCIETIES, ALPHA OMEGA ALPHA, INDUCTS NYC
HEALTH + HOSPITAL’S PARTNER CUNY SCHOOL OF MEDICINE
Located in Harlem, a Federally designated Health Professional Shortage Area
(HSPA), CUNY School of Medicine is the only public medical school in
Manhattan and is distinguished by its mission to recruit and train diverse
students, many of whom come from, and go on to practice in, communities that
are underserved and underrepresented in medicine. As a partner, many CUNY
Medicine students join the health System after graduating to further their
career in medicine. NYC Health + Hospitals has six providers who have been
previously inducted into the prestigious society.
HEALTH SYSTEM PARTNERS WITH THE NYC ADMINISTRATION FOR CHILDREN’S SERVICES
TO ENHANCE FAMILY SUPPORT FROM COMMUNITY-BASED ORGANIZATIONS
NYC Administration for Children’s Services (ACS) and NYC Health + Hospitals
launched Pathways to Prevention, a new pilot initiative aimed at connecting
more families in need with family support services, while also reducing
unnecessary reports made to the State’s child abuse hotline. The initiative
is just one of the ways in which New York City is working to make sure
families have direct access to the resources and services they need.
As part of the pilot, social workers, physicians and other staff at NYC
Health + Hospitals/Elmhurst and Lincoln, and NYC Health + Hospitals/Gotham
Health, Morrisania will be trained on how to best identify and connect
patients to beneficial family support services. Staff will be able to
facilitate such connections through the findhelp.org social services
directory or by contacting one of the participating ACS prevention providers
directly. The pilot will be rolled out with the following ACS community-
based prevention partners: JCCA, Children’s Aid, Cardinal McCloskey, Good
Shepherd Services, SCO Family of Services and The New York Foundling.
NEW HOME HEALTH SIMULATION SATELLITE OPENS
NYC Health + Hospitals/Community Care opened a new Home Health Simulation
Satellite site for all home health nurses to use. The site gives home health
nurses a way to practice various scenarios, from routine procedures to
47
emergencies, in a simulated home or other community-based setting. Nursing
simulation is a training technique that provides an opportunity for students
and qualified nurses to practice responding to various clinical situations
and then to reflect on how they performed, what went well and what needs to
be changed. This is key to their development of clinical skills and
judgement, including critical thinking, decision-making, and problem-solving
skills.
LOCAL AUTHOR CARMEN NOBOA-ESPINAL READS TO CHILDREN AND FAMILIES AT NYC
HEALTH + HOSPITALS/QUEENS EVENT
Local author Carmen Noboa-Espinal recently promoted children’s literacy
through family reading at NYC Health + Hospitals/Queens. Noboa-Espinal, a
talented author known for her captivating storytelling in adult fiction and
children’s literature, shared her children’s book “Abuelita and the Magic
Stove” with children and families in the Pediatric Clinic waiting area. Her
visit to the hospital served as an important reminder of the power of
storytelling and the impact it can have on young minds.
Through readings in both English and Spanish, the author captivated the
audience with her narrative that celebrates the cherished values of love and
family. Inspired by her personal experiences with influential women in her
family, Noboa-Espinal’s storytelling resonated with all those present,
spreading joy and fostering a love for reading.
The event highlighted NYC Health + Hospitals/Queens’ commitment to promoting
children’s literacy through various initiatives. The hospital has an 18-year
partnership with the Reach Out and Read program and participates in New York
City’s Pediatric Bundle Initiative. Reach Out and Read encourages parents to
read to their children regularly, while the Pediatric Bundle Initiative
focuses on comprehensive care for pediatric patients, such as HealthySteps,
developmental screening, maternal depression screening, and Triple P –
Positive Parenting Program.
HEALTH SYSTEM EXPANDS LIVE CONCERTS FOR STAFF, PATIENTS, AND VISITORS
THROUGH NEW PARTNERSHIP WITH SING FOR HOPE
NYC Health + Hospitals is expanding its live concert series, Music for the
Soul, with a new partnership with Sing for Hope. For the first time, the
program will offer concerts during the night shift and in locations
throughout the hospital beyond the main lobby. The live concert series began
as virtual performances in 2020 in partnership with the Mayor’s Office as a
way to honor the work of NYC Health + Hospitals frontline staff during the
height of the pandemic and support local musicians while music venues were
closed. The program has since transitioned to in-person concerts and
includes New York City-based musicians who perform a variety of genres,
including Jazz, Classical, Folk, Hip Hop, and Latin music. The first concert
of the season took place last month at NYC Health + Hospitals/North Central
Bronx, where the musicians Larry Siegel, Hasan Bakr, and Victoria Paterson
played during the night shift, followed by a concert at NYC Health +
Hospitals/Queens by The FAB 4 String Quartet and one at NYC Health +
Hospitals/Jacobi by The JuanMa Trio. Music for the Soul is run by the health
system’s Arts in Medicine department and funded by the Laurie M. Tisch
Illumination Fund.
AS PART OF INTERNATIONAL EARTH MONTH,
NYC HEALTH + HOSPITAL/ELMHURST GOES GREEN
48
Elmhurst Hospital hosted a series of activities in April to highlight the
hospital’s commitment to energy conservation and environmental stewardship.
These included community outreach activities, a virtual and in-person
conference called “Decarb the OR” on greening operating rooms and reducing
medical waste, and an Earth Day celebration featuring a plant-based cooking
demo and a presentation by ConEdison on the impact of climate change and how
consumers can reduce energy consumption.
EXTERNAL AFFAIRS UPDATE
City: The City released its FY-25 Executive Budget on April 24. The budget is
balanced at $111.6B, and does not reflect any further PEGs. NYC Health +
Hospitals’ Executive Budget hearing was held on May 13. Dr. Katz testified
along with John Ulberg and Patsy Yang. We are grateful to the Chairs of the
Hospital, Health, and Finance Committees and to all of our Council Member
partners for their ongoing support of our system.
State: The NYS Legislature is in the final stages of the 2024 session, with
less than two weeks remaining. We are advocating for workforce provisions
that were not accomplished during the budget negotiations.
We will also be watching the NYS primary, which takes place on June 25, and
is expected to impact some facility representations due to retirements. We
will be encouraging staff to vote, no matter their political affiliations, as
we do before every election.
Federal: Congress continues to debate appropriations priorities for FY-25,
which begins on October 1. NYC Health + Hospitals submitted several
Congressionally-Directed Spending ("earmarks") requests to Senators Schumer
and Gillibrand, and we remain thanking for their consistent support.
Community Affairs: Community Affairs hosted our annual CAB Education
Conference on May 17, titled “Utilizing Effective Communication Techniques to
Develop Influential, Culturally Competent Leaders.” The conference was well
attended, with over 80 CAB members and staff liaisons actively participating
in the discussions and activities.
Community Affairs also hosted two internal Billing and Revenue Educational
Webinars on May 22 with the Health + Hospitals Revenue Cycle Institute and
NGS (National Government Services). Topics covered included Medicare Part A
and B, national coverage determination versus local coverage determination,
top billing errors, and coding edit procedures. The two webinars were well
attended by NYC Health + Hospitals staff, with over 200 attendees.
The next Central Council of Auxiliaries meeting will be on June 5, and the
next Council of CABs meeting will be on June 11 before the summer break. The
current Chair of the Council of CABs will be terming out, so they will be
voting in a new Chairperson for the Council of CABs, along with all the seats
on the Executive Committee.
The 20th Annual Marjorie Matthews Celebration will be on July 18 at NYC
Health + Hospitals/Coler, where we will be celebrating all our CAB and
Auxiliary volunteers.
49
NEWS FROM AROUND THE SYSTEM
• NY1: Arrival Center Announces One-Year Anniversary of Opening
• Becker’s: Mayor Adams Announces 1,000+ New Nurses Hired By NYC Health
+ Hospitals
• Time Out: These murals in front of NYC Health + Hospitals/Metropolitan
are turning ugly scaffolding into beautiful art
• Harlem World: NYC Care Program Teams Up With Community Orgs To Enhance
Health Access
• mHealth Intelligence: How telehealth is boosting care access among
NYC’s homeless population
• NPR: A Girl Scouts troop offers hope and 'sisters for life' for
migrant children
• Politics NY: Dr. Wei, Dr. Luong, Dr. Chaudhry, Lila Benayoun Named
AAPI Power Players
• STAT News: From sewage to safety: Hospital wastewater surveillance as
a beacon for defense against H5N1 bird flu
• Brooklyn Paper: South Brooklyn Health honors the ‘profound impact’ of
its nurses during National Nurses Month
• WNYC: Morning Edition with Guests CM Brooks-Powers and Dr. Katz
• Becker’s: New York City hospital goes 1 year CAUTI-free
June 2024
RESOLUTION - 06
Authorizing New York City Health and Hospitals Corporation (the “System”) to sign
a lease with 175 Varick Street LLC (“Landlord”) for approximately 10,000 square
feet on the 7
th
floor at 145 East 32
nd
Street, New York, NY (the “Premises”) to
house the World Trade Center Environmental Health Center (the “Center”) that
is currently located in NYC Health + Hospitals/Bellevue (“Bellevue”) for an initial
term of approximately 16 months with the System holding two 5-year options to extend
the lease at an initial rent of $54/sf to increase annually at 2.75% for an initial annual
rent of $540,000 and a total rent over the potential term of 12 years and 4 months of
$7,805,015.
WHEREAS, Bellevue first saw patients from the World Trade Center on the day of the attack; and
WHEREAS, since the World Trade Center attack, Bellevue has housed a center to treat survivors
of the attack and the first responders to the site using funding from various sources and programs; and
WHEREAS, due to the growth of the Center and a sharp increase in Bellevue’s patient census it is
urgent for the Center to relocate from Bellevue to free space for a significant number of medical surgical
beds; and
WHEREAS, in 2010 the federal James Zadroga Act was passed into law and has provided funding
for the Center to this date due to extensions of the statute that will not expire until 2090; and
WHEREAS, the current grant for the Center ends September 30, 2025 but the start of the lease
depends on how quickly the lease is finalized and thus the initial term is “approximately” 20 months; and;
WHEREAS, grants of funding for the Center are awarded on five-year cycles; and
WHEREAS, the length of the initial and the renewal terms of the proposed lease allow the System
to exercise its renewal options only once it has secured funding for the Center so the System is never
exposed to an unfunded lease obligation; and
WHEREAS, other centers treating patients injured in the WTC attack are housed at NYC Health +
Hospitals Gouverneur and at NYC Health + Hospitals/Elmhurst will remain at their current locations; and
WHEREAS, responsibility for administering the proposed lease will be with the System’s Sr. Vice
President for Ambulatory Care.
NOW, THEREFORE, be it
RESOLVED, that New York City Health and Hospitals Corporation (the “System”) be and hereby
is authorized to sing a lease with 175 Varick Street LLC (“Landlord”) for approximately 10,000 square
feet on the 7
th
floor at 145 East 32
nd
Street, New York, NY (the “Premises”) to house the World Trade
Center Environmental Health Center (the “Center”) that is currently located in NYC Health +
Hospitals/Bellevue (“Bellevue”) for an initial term of approximately 20 months with the System holding
two options to extend the lease at an initial rent of $54/sf to increase annually at 2.75% for an initial annual
rent of $540,000 and a total rent over the potential term of 12 years and 4 months of $7,805,015.
June 2024
EXECUTIVE SUMMARY
LEASE FOR 10,000 SF AT 145 E. 32
nd
STREET
WORLD TRADE CENTER PROGRAM
OVERVIEW: Bellevue received WTC-related patients starting on 9/11. A pilot healthcare program
for WTC survivors at Bellevue was first funded in 2003. Other funding was received
until 2008’s Non-Responder Grant from CDC, followed in 2010 with the James
Zadroga Act. The Center serves the majority of the System’s 14,000+ WTC patients
(69%) versus Elmhurst/Gouv (31%). The World Trade Center Health Program,
legislated under the Zadroga Act and funded by CDC/NIOSH through 2090, covers
care for 9/11 FDNY members, General Responders, and enrolled community
members (“Survivors”). The Zadroga Act consolidated many different community-
based/locally funded programs that began as early as 2003 at Bellevue. The program
provides healthcare to Responders and Survivors, through CCEs and enrolled
external providers. There are multiple CCEs across the metropolitan area for FDNY,
General Responders, and Survivors. The System is funded as one of two NYC-based
CCEs for Survivors.
PROGRAM: The Center provides initial assessments, monitoring/surveillance, ongoing treatment,
and diagnostic services to 9,500+ enrolled/active members, with ~30 new members
every week. In calendar year the Center had 13,000+ visits for treatment, diagnostic
evaluations, initial assessments and monitoring. The Center provides medical
care/treatment, behavioral health treatment, medical management, pharmacy
assistance for WTC medications, Care Management services, and ongoing
surveillance for approved WTC-related conditions, such as pulmonary, some
cancers, aerodigestive disorders, mental health).
TERMS: To accommodate Bellevue’s urgent need to recover the use of the space the Center
now occupies; the Landlord will initially make available to the Center 5,500 square
feet on the 11
th
floor of 145 E. 32
nd
Street which is empty and is in move-in condition.
The Center will be on the 11
th
floor for the 4-6 months needed to prepare the 7
th
floor
for the Center’s use. Rent will be charged at $54/sf. The initial rent on the 7
th
floor
will be $540,000 for the first year. Rent will increase at 2.75% per year. The System
will get 4 months of free rent at the start of each of the two option terms. The System
will pay for its own electrical consumption by direct payments to the utility. The
System will pay for its share (computed based on the size of the Premises relative to
the size of the entire building) of increases in real estate taxes assessed against the
building over the taxes in effect during the first year of the lease.
FINANCING: It is expected that substantially all of the rent and operational costs of the program
will be covered by the NIOSH grant and third-party billing.
Request to Lease with
175 Varick Street LLC
for New York City Health + Hospitals
World Trade Center Program
Environmental Health Center
145 East 32nd Street
NY, NY, 10016
Board of Directors Meeting
June 27, 2024
Matt Siegler, Senior Vice President of Managed Care and Patient Growth
J o hn Ulb e rg , Chie f Financial Office r
Scott VanOrden, Assistant Vice President, World Trade Center
Marle e Icko w icz, Assistant Vice Pre sid e nt, Quality & Safe ty
1
2
Authorizing New York City Health and Hospitals
Corporation (the “System”) to sign a lease with 175
Varick Street LLC (“Landlord”) for approximately
10,000 square feet on the 7
th
floor at 145 East 32
nd
Street, New York, NY (the “Premises”) to house the
World Trade Center Environmental Health Center (the
“Center”) that is currently located in NYC Health +
Hospitals/Bellevue (“Bellevue”) for an initial term of
approximately 16 months with the System holding two 5-
year options to extend the lease at an initial rent of $54/sf
to increase annually at 2.75% for an initial annual rent of
$540,000 and a total rent over the potential term of 12
years and 4 months of $7,805,015.
For Board Consideration
World Trade Center Program
at NYC Health + Hospitals
The World Trade Center Health Program is legislated under the James
Za d ro g a Act (2010)
Funded by Centers for Disease Control and Prevention (CDC)
/National Institute for Occupational Safety and Health (NIOSH)
through 2090
Covers care for 9/11 FDNY members, General Responders, and
enrolled community members (“Survivors”)
Za d ro g a Act consolidated many different community-b a se d / lo cally
funded programs that began as early as 2003 at Bellevue center
H+H contracted as one of two NYC-b a se d Clinical Ce nte rs o f Exce lle nce
(CCEs) for Survivors
Th re e NYC H+ H WTC lo ca tio n s: Bellevue, Gouverneur, Elmhurst
Contract details req uirements for CCE operations/p erformance, and
provides reimbursement structure(s)
Federal reimbursement covers the cost of the program and it is net
revenue generating for NYC H+H
3
The center provides initial assessments,
m o n ito rin g / su rve illa nce , o n g o ing
treatment, and diagnostic services
13,000+ virtual and in person
visits fo r e lig ib le p a tie n ts in 2 02 3
Se rvice s in clud e m e d ica l
care/treatment, behavioral health
treatment and medical
management, pharmacy
assistance for WTC medications,
Care Management services, and
o n g o in g su rve illa n ce fo r a p p ro ve d
WTC-re la te d co n d itio n s (e .g .
pulmonary, some cancers,
aerodigestive disorders, mental
health)
Services
WTC at Be lle vue
Bellevue received WTC-
related pts starting on 9/11
Pilot healthcare program for
survivors at BE first fund e d
in 2003. Other funding
received until 2008’s Non-
Responder Grant from CDC,
followed by 2010’s Za d ro g a
Act
The p ro g ra m is lo cate d in a n
inpatient unit and was used
as surge unit during COVID-
19.
4
Ba ckg ro un d
Need for Relocation
Growing Enrollment and Insufficient Space
Su rvivo r e n ro llm e nt co n tinue s to g ro w p ast o rig ina l Za d ro g a e stim a te s. Po p u la tio n is
aging and seeing increased 9/11 related health conditions, cancers, etc.
H+H receives about 30 new enrollments every week from CDC/NIOSH, space at Bellevue
no longer sufficient – ne ithe r clinically n o r a d m in istra tive ly
Bellevue Census Growth and Urgent Capacity Expansion Needs
The sp a ce will b e re p urp o se d fo r a sig nifica n t num b e r o f critically ne e d e d inp a tie nt b e d s
Be lle vue ce nsu s is ve ry hig h a n d clim b ing
Stakeholders invested in staying close to Bellevue
Survivor Steering Committee, CDC/NIOSH, and staff expressed this as a priority
Current contract funding continues for 16 months; CDC/NIOSH has indicated they will
cove r costs of lease for remainder of current contract and are favorab ly disposed to
continued H+H participation in the program over the long term
5
6
Evaluating New Space Options
Lo o ke d e xte nsive ly a t NYC H+ H facilitie s, n o sp ace
adequate to satisfy program needs
Turned to built-out healthcare commercial space for
other options, which is standard for other WTC
programs around the city and nation.
Visited 7 properties, 145 E 32nd met largest number
of requirements
Condition and layout
# of exam and consulting rooms
Pt. flow through space
Build ing lo ca tio n
Build ing se curity
7
32
nd
Street 7
th
Floor Space
Distance to Bellevue and Security:
Quiet street, easy patient drop off and pick up
Short walk to elevator and into clinical space.
Doorman and video security.
Little disruption to member / staff travel, short walk
to Be lle vue
Sp ace and Flo orp lan:
10,000 sq. ft, high quality and excellent condition
11 Exam Rooms, 4 MH Consulting Rooms (currently
have 8 exam, 2 consulting/PCA rooms)
Stakeholders:
NIOSH and Survivor Steering Committee reps
viewed space, very positive feedback and support
for move to this
property
8
▪ Tw o -Part Move:
▪ 7th Floor space currently occupied by tenant
▪ Pro g ra m will initially mo ve to im m e d ia te ly a vailab le 11th flo o r sp a ce (5500 sq . ft)
to accommodate Bellevue’s need for current inpatient space
▪ Move to 7th floor within 4-6 months
▪ Allows us to vacate Bellevue while current tenant vacates permanent space on
the 7th floor
▪ Term and Renewals:
▪ Term is 16 months followed by two 5 year renewal options; aligned with
Program contract and funding periods
▪ Option terms align with NIOSH funding cycles so H+H is never at risk of an
unfunded lease obligation
▪ Re n t:
▪ $54/sf. $540,000 per year.
▪ Increases at 2.75% annually
▪ 4 months of free rent given at beginning of each of the two 5-year renewal terms
▪ H+H to pay its share of increased taxes over 2024-2025 base year; expect to be
covered by Federal reimbursement
Lease Terms
9
Authorizing New York City Health and Hospitals
Corporation (the “System”) to sign a lease with 175
Varick Street LLC (“Landlord”) for approximately
10,000 square feet on the 7
th
floor at 145 East 32
nd
Street, New York, NY (the “Premises”) to house the
World Trade Center Environmental Health Center
(the “Center”) that is currently located in NYC Health
+ Hospitals/Bellevue (“Bellevue”) for an initial term of
approximately 16 months with the System holding two 5-
year options to extend the lease at an initial rent of $54/
sf to increase annually at 2.75% for an initial annual rent
of $540,000 and a total rent over the potential term of 12
years and 4 months of $7,805,015.
Board of Directors Approval Request
June 2024
RESOLUTION - 07
AMENDED - Authorizing the New York City Health and Hospitals Corporation
(the “System”) to sign a five-year license agreement with Sodexo (“Sodexo”) for
its use and occupancy of approximately 4,936 square feet at NYC Health +
Hospitals/Bellevue (“Bellevue”) for a retail food operation for which it will pay
a minimum annual amount of $100,000, plus 8% of annual gross sales over $3M
and 12% of annual gross sales over $3.5M with such agreement to be terminable by
each party on thirty days’ notice without cause.
WHEREAS, for many years Bellevue had both a “grab and go” type retail food operation and a
sit-down diner-type restaurant, however since Fall 2022, Bellevue has not had the restaurant operation
leaving Bellevue staff and visitors without this option; and
WHEREAS, the System’s primary goal in establishing retail food service operations is to ensure
affordable and healthy food for staff and visitors and not to maximize the revenue; and
WHEREAS, Sodexo is an international food service and facilities management company that
has prepared patient meals for all of the system’s patients since 2005; and
WHEREAS, Sodexo also operates retail food establishments in institutional settings such as
hospitals, schools and private companies; and
WHEREAS, Bellevue and Central Office staff toured a comparable Sodexo retail food operation
in the area and found an impressive variety of healthy food options at low prices and in attractive settings;
and
WHEREAS, Sodexo will offer a culturally diverse and healthy menu at affordable prices for the
Bellevue community, and Bellevue will approve the rotating menus & prices other than cost of living
adjustments; and
WHEREAS, responsibility for the operation of the proposed food service operation and
administering the proposed agreement will be with the Executive Director of Bellevue.
NOW, THEREFORE, be it
RESOLVED, that the New York City Health and Hospitals Corporation (the “System”) be and
hereby is authorized to sign a five-year license agreement with Sodexo (“Sodexo”) for its use and
occupancy of approximately 4,936 square feet at NYC Health + Hospitals/Bellevue (“Bellevue”)
for a retail food operation for which it will pay a minimum annual amount of $100,000, plus 8% of
annual gross sales over $3M and 12% of annual gross sales over $3.5M with such agreement to be
terminable by each party on thirty days’ notice without cause.
June 2024
EXECUTIVE SUMMARY
SODEXO
LICENSE AGREEMENT FOR FOOD SERVICE OPERATIONS AT
NYC HEALTH + HOSPITALS/BELEVUE
OVERVIEW: Bellevue, the largest hospital in the System has long had multiple food vendors
operating within the hospital with one or more “grab and go” operations and a sit-
down restaurant. The former operator of the restaurant, Moonstruck, closed in
Fall 2022 and Bellevue has been searching for a replacement vendor since then.
VENDOR: Sodexo is an international company that offers food services and various
BACKGROUND: facility management services. Sodexo has worked for the System for close to 20
years having responsibility for the preparation of meals for patients and also
handling the System’s laundry needs. Additionally, Sodexo operates retail food
establishments. A team of Central Office and Bellevue representatives visited a
Sodexo restaurant at Stamford Hospital in Stamford, CT. Sodexo will model the
Bellevue restaurant after the Stamford restaurant. The food to be offered is
indicated in the attached menu. The team of System staff that visited the Stamford
restaurant found the food to be quite varied, tasty, health and inexpensive.
TERMS: The proposed agreement will be for five years and will be terminable by each
party without cause on thirty days’ notice. Sodexo will be bound to the menu and
prices attached except for increases necessary to keep pace with cost of living
expenses.
Sodexo will pay a minimum occupancy fee of $100,000/year. In addition, Sodexo
will pay the System 8% on gross sales over $3M and 12% on gross sales over
$3.5M. Sodexo will invest approximately $1M to outfit the space licensed
including bringing in all new kitchen equipment. The System will not pay any
portion of such renovation and outfitting cost.
Sodexo will manage its own employees rather than managing H+H’s unionized
staff as it does with its other contracts with H+H for patient food preparation or
environment services.
Because of the percentage rent approach to this transaction, it is not possible to
determine an equivalent fair market value. In comparing this transaction to others,
one also has to factor in the substantial investment Sodexo will make in the
physical restaurant.
Request to Authorize
License Agreement with
Sodexo for Retail Food Location at
NYC Health + Hospitals/ Bellevue
Board of Directors Meeting
June 27, 2024
Marcia Peters, Chief Operating Officer, NYC Health + Hospitals/Bellevue
Mercedes Redwood, Assistant Vice President, Managed Services
Leora Jontef, Assistant Vice President, Housing and Real Estate
Jeremy Berman, Deputy General Counsel
1
For Board Consideration
AMENDED: Authorizing the New York City Health and
Hospitals Corporation (the “System”) to sign a five-year
license agreement with Sodexo (“Sodexo”) for its use
and occupancy of approximately 4,936 square feet at
NYC Health + Hospitals/Bellevue (“Bellevue”) for a
retail food operation for which it will pay a minimum
annual amount of $100,000, plus 8% of annual gross
sales over $3M and 12% of annual gross sales over
$3.5M with such agreement to be terminable by each
party on thirty days’ notice without cause.
2
Current State at Bellevue
Convenient onsite food options is important to staff and patient satisfaction.
Many facilities are not near retail corridors
Work schedules require easy access to food 24/7
Healthy food options are core to H+H values
Cost conscious pricing allows access to all hospital visitors
Covid caused several food service vendors to close, leaving many hospitals without food
services or with old operations in need of updating.
Moonstruck diner closed in July 2022.
The old Moonstruck license agreement had required Moonstruck to pay a minimum of $150,000/yr
or 12% of Gross Sales, whichever was higher.
Currently the only option on campus is “grab and go” style at Panera Bakery, which does
not have seating for dining.
NYC Health + Hospitals/Bellevue selected Sodexo based on:
Sodexo’s organizational experience with NYC Health + Hospitals for almost two decades
Sodexo’s qualifications and reputation for appetizing food options next door at NYU Langone
Health.
Sodexo’s proposal to offer affordable menu prices at Bellevue.
3
Background: Sodexo
Sodexo was established in 1966 and has grown to be a global leader in on-site food
services in the healthcare industry across 45 countries
Sodexo partnerships for retail food venues include:
Tisch Café at NYU Langone Health, New York, NY
The Café at Stamford Hospital, Stamford, CT
Casey’s Café at RWJ Barnabas Health, Livingston, NJ
NYC Health + Hospitals and Sodexo have partnered together for over 19 years:
Patient Food & Nutrition Systemwide ($1.12 Billion, 2005-2029)
Laundry & Linen services ($339.5 million, 2011-2029)
Sodexo has embraced the NYC Health + Hospitals plant-based patient dining
program since March of 2022
Served over 1.2 million plant-based patient meals
Reduced carbon emissions by 36%
Reduced cost by 22%
4
Proposed Menu
Sodexo will offer a culturally diverse and healthy menu at affordable prices for the Bellevue
community
Bellevue will approve the rotating menus & prices other than cost of living adjustments.
Hot Breakfast
Made to Order Eggs, Breakfast Meats, French Toast, Pancakes $2.99 - $5.69
Breakfast Combos: Eggs, Sausage & Potatoes or Eggs, Pancakes, Sausage $9.99 - $12.99
From the Grill
Entrees: Tacos, Quesadillas, Grilled Sandwiches $6.49 - $8.59
Sides: Baked French Fries, Baked Sweet Potato Fries $2.29 - $4.29
Pizza Slices & Pizzettas
Whole Grain, Vegetable, Chicken Slices $2.99 - $7.29
Entrees
Rotating Menu: Grilled Spiced Shrimp Salad, Noodle Bowls, Irish Beef Stew, Shakshuka,
BBQ Pork Loin $5.59 - $8.99
Kosher & Halal options from a third party vendor
Other
Hot Meals: Breakfast Bowls, Chicken Francese, Orecchiette & Meatballs $10.00 - $15.00
Snacks: Snack Boxes, Parfaits $6.50 - $9.50
5
Proposed Renovation
6
Sodexo will be responsible
for the cost of construction.
Sodexo estimates capital
investment of over $1 million
for the renovation.
License Terms
7
Term: Five years, terminable by either party upon thirty days notice without cause.
If we terminate early without cause, then we will be obligated to refund Sodexo’s documented and
unamortized costs of renovating the premises.
If we terminate with cause, then we do not need to refund the renovation costs.
Location: Ground floor in the F-Link of NYC Health + Hospitals/Bellevue
Hours of Operation: Approximately 6:30 am to 7:00 pm on weekdays and 6:30 am to 3:00 pm on
weekends
Will be open by the end of the year.
FMV is not relevant when part of the rent is a percentage of sales.
Staffing: Sodexo will manage its own employees rather than managing H+H’s unionized staff as it
does with its other contracts with H+H for patient food preparation or environmental services.
Occupancy Fee: $100,000 annually, guaranteeing at least $8,333.33 per month. In addition, there
will be revenue sharing of:
8% of annual gross sales over $3M
12% of annual gross sales over $3.5M
Board of Directors Approval Request
AMENDED: Authorizing the New York City Health and
Hospitals Corporation (the “System”) to sign a five-year
license agreement with Sodexo (“Sodexo”) for its use
and occupancy of approximately 4,936 square feet at
NYC Health + Hospitals/Bellevue (“Bellevue”) for a
retail food operation for which it will pay a minimum
annual amount of $100,000, plus 8% of annual gross
sales over $3M and 12% of annual gross sales over
$3.5M with such agreement to be terminable by each
party on thirty days’ notice without cause.
8
June 2024
RESOLUTION - 08
Authorizing New York City Health and Hospitals Corporation (the
“System”) to amend the existing agreement with Tasty Picks, Inc.
#5 (“Tasty Picks”) for its occupancy of space at NYC Health +
Hospitals/Jacobi (“Jacobi”) for a retail food operation to increase the
area licensed from 1,000 square feet to 1,890 square feet and to increase
the occupancy fee, calculated at $25/square foot, from $25,000 per year
to $47,250 per year.
WHEREAS, the System Board of Directors voted in May 2023 to approve a 5-year
terminable license of 1,000 square feet at Jacobi to EveryTable for the operation of a food service
business at $25/square foot; and
WHEREAS, EveryTable abruptly closed all of its east coast operations in January 2024
once again depriving Jacobi staff and visitors of this needed service after many previous months
without a food purveyor extending back to the onset of Covid; and
WHEREAS, in recognition of the negative impact on staff morale of again being without
food service, the System President, Mitchell Katz, authorized an exception to policy to allow Tasty
Picks to take over the EveryTable operation at Jacobi on the same terms as had been approved for
EveryTable; and
WHEREAS, Tasty Picks was able to quickly step into the space that had been used by
EveryTable and commenced operations in mid-February; and
WHEREAS, staff at Jacobi has been so enthusiastic about Tasty Picks that Jacobi
leadership wants Tasty Picks to expand its operations into an additional 890 square feet at a
corresponding increase in the occupancy fee; and
WHEREAS, responsibility for the operation of the proposed food service operation and
administering the proposed agreement will be with the Jacobi Executive Director.
NOW, THEREFORE, be it
RESOLVED, that the New York City Health and Hospitals Corporation (the “System”)
be and hereby is authorized to amend the existing agreement with Tasty Picks, Inc. #5 (“Tasty
Picks”) for its occupancy of space at NYC Health + Hospitals/Jacobi (“Jacobi”) for a retail food
operation to increase the area licensed from 1,000 square feet to 1,890 square feet and to increase
the occupancy fee, calculated at $25/square foot, from $25,000 per year to $47,250 per year.
June 2024
EXECUTIVE SUMMARY
TASTY PICKS, INC. #5
AMENDMENT OF LICENSE AGREEMENT FOR
FOOD SERVICE OPERATIONS AT
NYC HEALTH + HOSPITALS/JACOBI
OVERVIEW: After not having any food service for well over a year, in May 2023, Jacobi
obtained Board approval for an agreement with EveryTable to operate a
restaurant at Jacobi. Unfortunately, EveryTable ceased all business
operations on the east coast leaving Jacobi again without a food purveyor.
In recognition of the negative impact on staff morale of again being without
food service, the System President authorized an Exception to Policy to
permit Tasty Picks to take over from EveryTable on the same terms as had
been approved for EveryTable. Tasty Picks commenced operations in mid-
February 2024 and has been so enthusiastically received by Jacobi staff that
Jacobi leadership wants to expand the area licensed to Tasty Picks so it can
enlarge its operations. The approval of the System’s Board of Directors to
the expansion of the existing space license is requested.
VENDOR: Tasty Picks is a local business that started operation at Jacobi’s NCB
BACKGROUND: campus in Fall 2021. Tasty Picks brought affordable, healthy and tasty
food to NCB that was particularly well oriented to the ethnic preferences
of staff and patients. NYC Health + Hospitals/Jacobi, being aware of Tasty
Pick’s good work at NCB and Metropolitan, sought them out.
TERMS: The previously approved terms were for 1,000 square feet of space at
$25/foot on a five-year terminable license. The proposed amendment to the
license agreement will not change its duration or any of its terms other than
to increase the area licensed to 1,890 at $25/ft for a total annual fee of
$47,250. As before, the rate will increase by 2% per year.
Lease Comps Summary
Lease Comps Report
6 - - 11
Deals NNN Asking Rent Per SF NNN Starting Rent Per SF Avg. Months On Market
LEASE COMPARABLES
SUMMARY STATISTICS
Rent Deals Low Average Median High
NNN Asking Rent Per SF
NNN Starting Rent Per SF
NNN Effective Rent Per SF
Asking Rent Discount
TI Allowance
Months Free Rent
-
-
-
-
-
1
-
-
-
-
-
2
-
-
-
-
-
2
-
-
-
-
-
2
-
-
2
-
-
-
Lease Attributes Deals Low Average Median High
Months on Market
Deal Size
Lease Deal in Months
Floor Number
5
6
6
6
5
520
60.0
1
11
795
64.0
1
8
850
60.0
1 2
22
1,000
84.0
5/4/2023
© 2023 CoStar Group - Licensed to Newmark - 77912
Page 1
Lease Comps Summary
Lease Comps Report
Property Name - Address Rating
SF Leased
Floor Sign Date Rent Rent Type
Lease
Type
Rents
-
1
2040-2046 Eastchester Rd
1,000 1st 7/23/2022 $33.60/mg EffectiveNew
-
2
1801-1807 Williamsbridg…
520 1st 3/21/2019 $41.54/mg EffectiveNew
-
2
1801-1807 Williamsbridg…
550 1st 8/2/2016 $46.62/mg EffectiveNew
-
3
1888-1892 Eastchester Rd
1,000 1st 6/1/2016 $54.00/mg EffectiveNew
-
3
1888-1892 Eastchester Rd
950 1st 2/1/2016 $50.53/mg EffectiveNew
-
4
1965 Williamsbridge Rd
750 2nd 10/1/2015 $31.69/fs EffectiveNew
5/4/2023
© 2023 CoStar Group - Licensed to Newmark - 77912
Page 2
Mg = modified gross (can run the gamut of included and excluded costs, likely excludes taxes and includes some
maintenance or utilities),
fs= full service gross (a type of commercial lease often found in multi-tenant office buildings, and occasionally retail and
industrial space and may include utilities, janitorial, and sometimes trash.)
Tasty Picks
License Agreements
NYC Health + Hospitals/
Jacobi Hospital
Board of Directors Meeting
June 27, 2024
Christopher Mastromano, CEO, Jacobi | North Central Bronx Hospitals
Leora Jontef, Assistant Vice President Housing and Real Estate
Jeremy Berman, Deputy Counsel
1
For Board Consideration
Authorizing New York City Health and Hospitals
Corporation (the “System”) to amend the
existing agreement with Tasty Picks, Inc. #5
(“Tasty Picks”) for its occupancy of space at
NYC Health + Hospitals/Jacobi (“Jacobi”) for
a retail food operation to increase the area
licensed from 1,000 square feet to 1,890 square
feet and to increase the occupancy fee,
calculated at $25/square foot, from $25,000 per
year to $47,250 per year.
2
Convenient onsite food options is important to staff and patient satisfaction.
Many facilities are not near retail corridors
Work schedules require easy access to food 24/7
Healthy food options are core to H+H values
Cost conscious pricing allows access to all hospital visitors
The System Board of Directors voted in May 2023 to approve a 5-year
terminable license of 1,000 square feet at Jacobi to EveryTable for the
operation of a food service business at $25/square foot.
EveryTable abruptly closed all of its east coast operations in January 2024
once again depriving Jacobi staff and visitors of this needed service after
many previous months without a food purveyor extending back to the onset of
COVID19.
Background: Food Vendors at Jacobi
3
Each facility independently selects the vendors that suit their patient and staff needs
taking into consideration:
evaluating menus for healthy options
ability to provide culturally sensitive foods
pricing and tastings
cultural sensitivities
24/7 operations
Tasty Picks has shown its affordable, appealing, and healthy food by its successful
launch and continued operations at NYC Health + Hospitals/North Central Bronx.
In recognition of the negative impact on staff morale of again being without food
service, the System President, Mitchell Katz, authorized an exception to policy to
allow Tasty Picks to take over the EveryTable operation at Jacobi on the same terms
as had been approved for EveryTable.
As their operations have been successful, Jacobi is requesting that Tasty Picks be
able to expand the footprint of their operation by an additional 890 SF, making a total
space of 1,890 SF.
Under the System’s rules, real estate space license agreements, such as the
proposed agreement, do not require an RFP.
Selection Process
4
Tasty Picks is a North Central Bronx-based food store that boasts a diverse
range of culinary offerings. It has operated for over 10 years and has been a
food vendor at NYC Health + Hospitals/North Central Bronx for two years.
Hours of operation will be 24 hours per day, 7 days per week
Tasty Picks will offer a diverse menu of fresh food within a price range
$1.99 - $11.99
Smoothies, Acai Bowls, and Juices: $7.99-$10.99
Hot breakfast and bakery items $1.99-$11.99
Fresh Salads $7.99-$10.99
Mexican, Halal, and Meatless Options $6.50 - $11.99
Fresh Sandwiches and Paninis $8.50 - $11.99
Full complement of drinks, hot and iced coffee and tea. $1.89 - $3.75
Catering available for all hospital staff needs
Culturally sensitive foods will be offered
Food Vendor: Tasty Picks
5
Space
Current Space Expanded Layout
6
Location: Increase the previously approved terms for 1,000 sf to 1,890 ft on first floor
of Building 1 at NYC Health + Hospitals/Jacobi.
License Fee: $25/SF, with a 2% increase per year.
Year 1 fee: $47,250
Term: 5 years with annual 2% increase
Total rent over 5 years: $245,891
Agreement may be terminated for convenience.
Price increases other than those to keep pace with cost of living increases must be
approved by facility
7
License Terms
Year Price PSF
Current 1,000 SF
Space Annual
Occupancy Fee
Proposed 1,890 SF
Space Annual
Occupancy Fee2
1 $ 25.00 $ 25,000 $ 47,250
2 $ 25.50 $ 25,500 $ 48,195
3 $ 26.01 $ 26,010 $ 49,159
4 $ 26.53 $ 26,530 $ 50,142
5 $ 27.06 $ 27,061 $ 51,145
Total $ 130,101 $ 245,891
Board of Directors Approval Request
Authorizing New York City Health and Hospitals
Corporation (the “System”) to amend the
existing agreement with Tasty Picks, Inc. #5
(“Tasty Picks”) for its occupancy of space at NYC
Health + Hospitals/Jacobi (“Jacobi”) for a retail
food operation to increase the area licensed from
1,000 square feet to 1,890 square feet and to
increase the occupancy fee, calculated at
$25/square foot, from $25,000 per year to
$47,250 per year.
8
June 2024
RESOLUTION – 09
Authorizing New York City Health and Hospitals
Corporation (“NYC Health + Hospitals”) to execute a
contract with Vanguard Construction and
Development Co., Inc. (the “Contractor”), to
undertake a project to renovate the D5 Labor & Delivery
suite at NYC Health + Hospitals/Elmhurst Hospital for a
contract amount of $11,783,528, with a 10% project
contingency of $1,178,353, to bring the total cost not to
exceed $12,961,881.
WHEREAS, Elmhurst Hospital, one of the primary maternity care facilities in Queens,
has seen a 47% increase in births from FY 21’ to FY 23’; and
WHEREAS, Elmhurst Hospital’s labor and delivery unit was last renovated in 1996 and,
due to the current state of the facility and the increase in births, it has been determined that a project
should be undertaken to address such issues and to provide expanded care for maternal fetal
medicine; and
WHEREAS, in accordance with Operating Procedure 100-5 a solicitation was issued,
pursuant to which bids were received and publicly opened on March 28, 2024, and NYC Health +
Hospitals determined that the Contractor submitted the lowest responsible bid; and
WHEREAS, the Contractor has met all, legal, business and technical requirements and is
qualified to perform the services as required in the contract documents; and
WHEREAS, the overall responsibility for the administration of the proposed contract shall
be with the Vice President, Facilities Development.
NOW, THEREFORE, be it
RESOLVED that the New York City Health and Hospitals Corporation be and hereby is
authorized to execute a contract with Vanguard Construction & Co. in the amount of $11,783,528,
with a 10% project contingency of $1,178,353, to bring the total cost not to exceed $12,961,881
for a renovation project of the labor and delivery unit at NYC Health + Hospitals/Elmhurst
Hospital.
June 2024
EXECUTIVE SUMMARY
ELMHURST HOSPITAL
LABOR AND DELIVERY RENOVATION PROJECT
VANGUARD CONSTRUCTION AND DEVELOPMENT CO., INC.
CONTRACT SCOPE: Labor and delivery renovation project.
NEED: NYC Health + Hospitals facilities needs general construction
services to undertake the labor and delivery renovation project at
Elmhurst Hospital.
CONTRACT DURATION: 24 months, slated to commence Fall of 2024 with anticipated
completion in Fall of 2026.
PROCUREMENT: A competitive sealed bid was issued on 1/172024; twenty-eight
contractors attended one of two pre-bid on site visits on 1/24/2024
and 1/25/2024; ten contractors submitted bids with the lowest
responsible and responsive bidder being Vanguard Construction and
Development Co., Inc., for a contract value of $11,783,528.
PRIOR EXPERIENCE: Vanguard Construction and Development Co., Inc has previously
worked on projects at Elmhurst, Jacobi and Harlem Hospitals and
has received one excellent and two good ratings.
CONTRACT AMOUNT: Not to Exceed $12,961,881.
PASSPORT APPROVAL: Approved
EEO APPROVAL: Pending
MWBE STATUS: Contractor has committed to a 38% MWBE contract goal.
.
To: Colicia Hercules
Chief of Staff, Office of the Chair
From: Franco Esposito
Senior Counsel
Office of Legal Affairs
Re: Vendor Responsibility, EEO and MWBE status for Board review of contract
Vendor: Vanguard Construction and Development Co., Inc.
Date: May 23, 2024
The below information indicates the vendor’s status as to responsibility, EEO and MWBE as
provided by the Office of Facilities Development and Supply Chain:
Vendor Responsibility
EEO
MWBE
Approved
Pending
38%
Request to Award Contract for to Vanguard
Construction and Development Co., Inc. for
D5 Labor & Delivery Renovation Project
at NYC Health + Hospitals/ Elmhurst
Board of Directors Meeting
June 27, 2024
Helen Arteaga-Landaverde, PhD, Chief Executive Officer, NYC H+H/Elmhurst
Mike Milinic, Chief Operations Officer, NYC H+H/Elmhurst
Manuel Saez, PhD, Vice President, OFD
Oscar Gonzalez, Senior Assistant Vice President, OFD
Erin Egan, Senior Regional Director, OFD
George Asadoorian, Director, NYC H+H/Elmhurst + OFD
1
For Board Consideration
2
Authorizing New York City Health and Hospitals
Corporation (“NYC Health + Hospitals”) to
execute a contract with Vanguard Construction
and Development Co., Inc. (the “Contractor”), to
undertake a project to renovate the D5 Labor &
Delivery suite at NYC Health +
Hospitals/Elmhurst Hospital for a contract
amount of $11,783,528, with a 10% project
contingency of $1,178,353, to bring the total
cost not to exceed $12,961,881
NYC H+H/Elmhurst is one of the primary maternity care providers in Queens. Built in 1957,
the facility has seen deliveries increase 47% from 1,799 births (FY 21) to 2,651 births (FY
23).
To meet this increased need, we are expanding our Labor and Delivery to continue
providing quality care and excellent service
Newly renovated unit will serve as the Maternal Fetal Medicine (MFM) Unit for expanded care
of High-Risk Mothers
The Labor and Delivery unit is located on the 5th Floor, D wing, (Unit D5). The current space
was last renovated in 1996
Renovation of the unit will include new equipment, a new layout, and upgrades to six (6)
Delivery rooms, two (2) Nurses' Stations, one (1) Operating Room, eight (8) bed recovery
rooms, and the Triage/ Antepartum/ Holding/ Waiting Areas
Labor and Delivery services will not be disrupted by construction
Six part phasing plan that will allow us to maintain services as we cycle through various
sections of the department
In order to achieve this, we will be decanting outpatient sonogram services off of the unit
to create swing space
Program Background/ History
3
Construction Scope & Schedule
4
Elmhurst, D-Wing, Fifth Floor, Labor & Delivery (L&D):
Complete interior demolition and renovation of existing L&D and
Sonogram Suites
Project consists of a combined 15,400 SF demolition and construction
build out of the D5 Labor and Delivery Suite (14,000 SF) + Sonogram
Suite (1,400 SF)
Provide one (1) new operating room with enhanced ceiling strut-mounted
medical gas and vacuum ports, and LED surgical lighting fixtures
Outfit with new equipment (i.e., Electric Fetal Monitors, Cardiac Monitors,
Ultrasound Equipment, Baby Scales) to improve the standard of care
Provide new reception and waiting areas to enhance the environment of
care
Installation of new Medical Gas lines
Work to be performed in six (6) coordinated phases over 24 months
Mechanical, Electrical and Plumbing upgrades throughout the space
Construction is expected to begin Fall 2024 with completion planned by
Fall 2026
Phasing Plan
5
Phase 6 is HVAC system and not on this floorplan
Current State Future state
6
Overview of Procurement
January 2024: Publicly advertised, Site tours held for
perspective bidders; Total of 28 contractors attended
March 2024: Bid due date 3/15/24, 10 bids received
April 2024: Determination of low bid finalized, and Vanguard
Construction was selected as the lowest responsive and
responsible bidder
7
Construction Contract
Contract amount is $ 11,783,528
Expected to begin September 2024 with completion by October 2026
The vendor has completed three previous projects for the system – at Elmhurst, Jacobi, and Harlem,
and has received one excellent and two good reviews.
Elmhurst, Renovation of the H bldg. 3rd floor DSRIP behavioral health integration into primary care setting. $2,086,727
(Excellent)
Jacobi, 10th floor DSRIP integration of behavioral health into primary care setting. $5,646,362 (Good)
Harlem, 4th Floor Post-Partum Unit Renovation, MLK Building. $3,997,837 (Good)
Sourced via public bid
Vanguard Construction was the lowest of ten (10) bidders
Vanguard has committed to a 38% MWBE subcontractor utilization plan presented below:
8
Subcontractor MWBE Status Supplies/Services Utilization Plan % Utilization $s
Redd Electrical Services Black MBE Electrical 13% $1,531,858
Mason Technologies Non-minority WBE Low Voltage 2% $235,670
Cardoza Plumbing Hispanic MBE Plumbing 14% $1,649,693
Greenebuild, LLC Black MBE Drywall/Carpentry 9% $1,060,517
Total 38% $4,595,573
Performance Evaluation
9
Vendor Performance Evaluation
Vanguard
DESCRIPTION ANSWER
Did the vendor meet its budgetary goals, exercising reasonable efforts to contain costs, including change order
pricing?
Yes
Has the vendor met any/all of the minority, women and emerging business enterprise participation goals and/or
Local Business enterprise requirements, to the extend applicable?
Yes
Did the vendor and any/all subcontractors comply with applicable Prevailing Wage requirements? Yes
Did the vendor maintain adequate records and logs, and did it submit accurate, complete and timely payment
requisitions, fiscal reports and invoices, change order proposals, timesheets and other required daily and periodic
record submissions (as applicable)?
Yes
Did the vendor submit its proposed subcontractors for approval in advance of all work by such subcontractors? Yes
Did the vendor pay its suppliers and subcontractors, if any, promptly? Yes
Did the vendor and its subcontractors perform the contract with the requisite technical skill and expertise? Yes
Did the vendor adequately supervise the contract and its personnel, and did its supervisors demonstrate the
requisite technical skill and expertise to advance the work
Yes
Did the vendor adequately staff the contract? Yes
Did the vendor fully comply with all applicable safety standards and maintain the site in an appropriate and safe
condition?
Yes
Did the vendor fully cooperate with the agency, e.g., by participating in necessary meetings, responding to agency
orders and assisting the agency in addressing complaints from the community during the construction as applicable?
Yes
Did the vendor adequately identify and promptly notify the agency of any issues or conditions that could affect the
quality of work or result in delays, and did it adequately and promptly assist the agency in resolving problems?
Yes
Performance and Overall Quality Rating Good
71% ‐ 80% ‐‐‐‐‐‐‐‐ Satisfactory
81% ‐ 90% –‐‐‐‐‐‐ Good
91% ‐ 100% ‐‐‐‐‐‐‐ Excellent
Project Budget
10
NYC H+H/ Elmhurst Labor & Delivery Renovation Project
Construction $11,783,528
Project Contingency (10%) $1,178,353
Total $12,961,881
$3M of the budget was generously provided by Congresswomen Meng & Ocasio-Cortez
$7.5m Mayoral Funding
Board of Directors Approval Request
11
Authorizing New York City Health and Hospitals
Corporation (“NYC Health + Hospitals”) to
execute a contract with Vanguard Construction
and Development Co., Inc. (the “Contractor”), to
undertake a project to renovate the D5 Labor &
Delivery suite at NYC Health +
Hospitals/Elmhurst Hospital for a contract
amount of $11,783,528, with a 10% project
contingency of $1,178,353, to bring the total
cost not to exceed $12,961,881
June 2024
RESOLUTION - 10
Authorizing the Executive Director of MetroPlus Health Plan, Inc. (“MetroPlus or
“the Plan”) to negotiate and execute a best-interest extension of the current
contract with Clarity Software Solutions, Inc. for fulfillment and distribution
services for a period of two years and 1 one-year renewal option, for an amount not
to exceed $31,500,000, which includes a 6% contingency, over the lifetime of the
contract, effective August 8, 2024.
WHEREAS, MetroPlus, a subsidiary corporation of NYC Health + Hospitals, is a Managed Care
Organization and Prepaid Health Services Plan, certified under Article 44 of the Public Health Law of the State of
New York; and
WHEREAS, MetroPlus is required to provide essential fulfillment and distribution services in accordance
with established regulatory guidelines and to timely distribute materials to members consistent with regulatory
guidelines for all lines of business; and
WHEREAS, an RFP for fulfillment and distribution services was issued in 2017 in compliance with the
contracting policies and procedures of MetroPlus; and
WHEREAS, Clarity Software Solutions, Inc. was selected as the successful respondent and has since
demonstrated its ability to provide said services effectively; and
WHEREAS, in June 2022, the MetroPlus and NYC Health + Hospitals Board of Directors approved the Plan
to enter into a best-interest extension of the current contract with Clarity for an additional two years; and
WHEREAS, MetroPlus seeks a second best-interest extension to allow for continuity of fulfillment services
while the Plan undergoes its CPS CORE system transition from SS&C to HealthEdge; and
WHEREAS, extending MetroPlus’ contract with Clarity and keeping the current fulfillment services intact,
is in the best interest of the Plan as we undergo the significant system transition to replace the Plan’s Core platform
because continuing with the existing fulfillment vendor at this time, will avoid risks of any disruption in the Plan’s
operations and provide a seamless member experience.
WHEREAS, due to the complexity of the CPS Core system implementation currently underway, a separate
implementation to a new fulfillment vendor during the implementation period poses risks to timeline, configuration
and service delivery.
WHEREAS, on Thursday, June 6, 2024, the MetroPlusHealth Board of Directors considered and approved
the submission of the resolution to execute a best-interest extension of the contract with Clarity Software Solutions,
Inc. for fulfillment and distribution services.
NOW THEREFORE, be it
RESOLVED, that the Executive Director of MetroPlus Health Plan, Inc. (“MetroPlus or “the Plan”)
to negotiate and execute a best-interest extension of the current contract with Clarity Software Solutions, Inc.
for fulfillment and distribution services for a period of two years and 1 one-year renewal option, for an amount
not to exceed $31,500,000, which includes a 6% contingency, over the lifetime of the contract, effective August 8,
2024.
June 2024
EXECUTIVE SUMMARY
METROPLUS HEALTH - BEST INTEREST EXTENSION
CLARITY SOFTWARE SOLUTIONS, INC
FULFILMENT AND DISTRIBUTION SERVICES
BACKGROUND: MetroPlus, a subsidiary corporation of NYC Health + Hospitals, is a Managed Care
Organization and Prepaid Health Services Plan, certified under Article 44 of the Public
Health Law of the State of New York. The Certificate of Incorporation of MetroPlus
reserves to NYC Health + Hospitals the power to approve MetroPlus contracts, other than
with NYC Health + Hospitals or a health care service provider, with an annual value in
excess of $3,000,000.
In 2017, Clarity Software Solutions, Inc. (“Clarity”) was selected through an RFP process,
to provide fulfilment and distribution services to MetroPlus and on July 12, 2017, the
MetroPlus Board of Directors authorized MetroPlus to enter into a three-year contract with
two one-year options for renewal, with Clarity at an annual cost not to exceed $2,900,000.
In 2022, MetroPlus re-engaged Clarity for an additional two-year term. The MetroPlus
Board and NYC Health + Hospitals Board of Directors both approved the Clarity resolution
for a total amount not to exceed of $8,000,000 in June 2022.
NEED: In the best interest of the Plan, MetroPlus seeks to extend its current contract with Clarity
for an additional 2-year term and 1 one-year option to renew.
Due to the complexity of the CPS Core System implementation currently underway; a
separate implementation to a new fulfillment vendor during this period, poses risks to
timeline, configuration, and service delivery.
Continuing with Clarity during the implementation period will mitigate any disruption of
services during the transition from the legacy platform to HealthEdge’s platform. SS&C,
the Plan’s current core system vendor, provides pass-through fulfillment services from
their own direct contract with Clarity for EOPs, EOBs and letters. With the CPS core
implementation, MetroPlus will be directly responsible for the fulfillment of these items.
Continuing with Clarity will simplify the integration of these fulfillment services.
The best-interest extension will yield cost savings associated with implementation.
Pricing for services will be maintained at the same rates as the current contract. The
$31,500,000 not to exceed amount request, accounts for approximately 2 million
additional letters, EOPs and EOBs the Plan will need to directly fulfill once moving off of
the SS&C platform and over to HealthEdge. The Plan is also requesting a 6% contingency
to account for any regulatory requirements that may arise and require fulfillment and
distribution of plan materials.
In 2023 the Plan sent out approximately 9.3 million pieces of mail across all lines of
business. Approximately 5.5 million was fulfilled by MetroPlus’ direct contract with
Clarity and includes the fulfillment of ID cards, member welcome kits, and letters.
Approximately 3.8 million was fulfilled by SS&C, through their direct contract with
Clarity, as a pass-through service to MetroPlus. The Plan anticipates future volume to be
close to 13 million annually.
PROPOSAL: The term of the proposed agreement is two years, and 1 one-year option to renew.
MWBE: Clarity submitted a 30% MWBE utilization plan. Clarity will continue to utilize
Highroad Press, LLC, a supplier of paper, a NYS MWBE certified vendor.
To: Colicia Hercules
Chief of Staff, Office of the Chair
From: Steven Stein Cushman
Chief Counsel, Legal
Re: Vendor responsibility, EEO and MWBE status or Board review of contract
Vendor: Clarity Software Solutions, Inc.
Date: June 11, 2024
The below chart indicates the vendor's status as to vendor responsibility, EEO and MWBE:
Vendor Responsibility
EEO
MWBE
Approved
Approved
30% Utilization Plan
The above status is consistent and appropriate with the applicable laws, regulations, and operating
procedures to allow the Board of Directors to approve this contract.
DocuSign Envelope ID: 6F988575-119B-48D9-8A1C-0C853C142925
MetroPlusHealth | Clarity Software Solutions
Fulfillment and Distribution Services
NYC Health + Hospitals Board of Directors Meeting
Thursday, June 27
th
, 2024
Dr. Mitchell Katz, NYC H+H CEO
Dr. Talya Schwartz, MetroPlusHealth CEO
1
FOR BOARD OF DIRECTORS
CONSIDERATION
Authorizing the Executive Director of MetroPlus Health
Plan, Inc. (“MetroPlus or “the Plan”) to negotiate and
execute a best-interest extension of the current
contract with Clarity Software Solutions, Inc. for
fulfillment and distribution services for a period of two
years and 1 one-year renewal option, for an amount not to
exceed $31,500,000, which includes a 6% contingency,
over the lifetime of the contract, effective August 8, 2024.
2
BACKGROUND
Clarity Software Solutions ("Clarity”) provides fulfillment and distribution services: fulfilling ID cards, plan
enrollment materials, correspondence, and other member mailings on behalf of MetroPlusHealth.
Clarity is integrated with MetroPlusHealth’s customer relationship management system,
member/provider portals and data warehouse.
In 2023 the Plan sent out approximately 9.3 million pieces of mail
Approximately 5.5 million ID cards, member welcome kits, and letters were printed and mailed by
Clarity through MetroPlusHealth’s direct contract.
Approximately 3.8 million Explanation of Benefits, Explanation of Payments, and letters were
printed and mailed by Clarity as a pass-through service to MetroPlusHealth from its SS&C contract.
Future fulfillment volume will be close to 13 million annually.
MetroPlusHealth is currently undergoing a major core system transition, entailing the migration from
SS&C legacy system to the new HealthEdge system platform.
As an outcome of this migration, MetroPlusHealth will also inherit responsibility of the fulfillment services
SS&C is currently fulfilling beginning in April 2025.
3
BACKGROUND CON’T.
The Plan originally entered in a contract with Clarity Software Solutions (“Clarity”) in August 2017 for
three years with 2 one-year options for renewal.
The MetroPlusHealth Board approved the Clarity Resolution in June 2017 for an amount not to
exceed $14,500,000 for total of five (5) years.
At the time, the contract did not require approval of the NYC Health + Hospitals Board.
In 2022, to conform and keep preparation intact for the upcoming electronic fulfillment mandate, ensure
continuity of essential fulfillment and distribution, the Plan contracted with Clarity for an additional 2-year
term.
Clarity demonstrated its ability to provide services effectively for the Plan.
The MetroPlusHealth Board and the NYC Health + Hospitals Board approved the Clarity Resolution
in June 2022, for an amount not to exceed $8,000,000, for two years.
MetroPlusHealth plans to issue an RFP in 2025, to award a new contract and align with the completion of
the system migration from the legacy platform to HealthEdge’s core admin and clinical platforms.
4
BEST-INTEREST RATIONALE
Extending Clarity's contract is in the best interest of MetroPlus for the
following reasons:
Due to the complexity of the Core system migration underway; a separate
implementation to a new fulfillment vendor will require intense coordination
and pose risks to the migration timeline, configuration and service delivery.
Continuing our existing partnership with Clarity will mitigate any disruption of
fulfillment services and ensure a seamless transition during the complex
system migration from the legacy platform to HealthEdge's platform.
The extension will yield cost savings associated with implementation. Clarity
has agreed to waive ~$400,000 in implementation fees.
Clarity will maintain pricing at the same rates as the current contract. The
additional funding required is due to the increased volume of notices being
fulfilled.
5
SPENDING AUTHORITY REQUEST BREAKDOWN
The spending authority request
combines MetroPlusHealth and
current third-party agreements to one
contract for the full suite of fulfillment
services.
Pricing represents fair market pricing for
on demand printing services and
includes previous discounts received by
MetroPlusHealth.
Contingency is requested as part of the
not to exceed amount to account for any
regulatory requirements that may arise
and require fulfillment and distribution of
materials.
Contingency (%)
6%
Total Annual Request
$10,500,000
Not to Exceed Amount Request
31,500,000
MPH
Volumes
SS&C
Volumes Total ($s)
Fulfillment Services
(includes ID Cards, Member
Kits, Letters, EOP, EOBs,
and others) 5,467,000 7,510,000 $9,872,600
6
CLARITY SLA PERFORMANCE
Clarity continues to meet or
exceed established 95%
service level agreements
for both turnaround time
and production quality.
7
CURRENT MWBE UTLIZATION PLAN
Vendor Name MWBE Vendor Subcontractor
SOW
Certification UP Goal %
Clarity Software
Solutions
Highroad Press, LLC Paper
Supplier
NYS
WBE
30%
Clarity will continue to utilize Highroad Press, LLC to meet the full
MWBE utilization goal.
8
BOARD OF DIRECTORS APROVAL REQUEST
Authorizing the Executive Director of MetroPlus Health
Plan, Inc. (“MetroPlus or “the Plan”) to negotiate and
execute a best-interest extension of the current
contract with Clarity Software Solutions, Inc. for
fulfillment and distribution services for a period of two
years and 1 one-year renewal option, for an amount not to
exceed $31,500,000, which includes a 6% contingency,
over the lifetime of the contract, effective August 8, 2024.
.
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