Friday Memo- November 8, 2019


Dear Team:

This autumn I visited our health centers to listen to the leadership teams describe the wins and challenges they face. I left each center inspired by the determination and commitment of the Community Healthcare Networks leaders across the City.

In part, we focused on issues facing particular health centers such as security in Harlem or administrative clarity for Kelly Street. We frequently discussed ways to approach system-wide issues that affect each of our centers. Here are highlights, along with a glimpse of how we will approach these concerns.

There is a near universal desire for greater administrative autonomy at our 14 health centers. 2020 will bring a greater shift at CHN to “localization.” This is not a black or white issue. There is a need for standardization of certain activities and processes. We are one organization with common regulatory, quality, and financial requirements. How we get there, I agree, must involve localized answers.

Each of our health centers is unique. The physical plants, the specialized cultural and service needs of our patients, vary from community to community. One size cannot fit all. Medical Affairs, for instance, is customizing provider scheduling with local Medical and Center Director guidance. Now is the time to develop the financial metrics to match greater local authority with local accountability.

Related is the concern that closer connections between the Centers and our centralized Contact Center and Referral Department could improve services for CHN patients.There is strong respect for the work of both departments throughout our Network, and appreciation of the difficulty the departments face.

Our Contact Center has grown considerably with the introduction of an overflow service. We are answering, timely, nearly 95 percent of our calls today. That is as good as it gets in the call center business. Additional training and oversight of our Contact Center staff is underway, and are negotiations with the overflow service – where a disproportionate number of errors occur. I have asked the leadership of the Contact Center to identify new ways other CHN departments can adjust protocols to simplify some of the many, many tasks we impose on Contact Center staff.

Other Network-wide issues: It is fair to say that the 2019 roll out of iPad registration in our waiting has been rocky. While working smoothly at some CHN centers,troubles ranging from hardware to software to electrical connections to patients just not being able to figure it out have been common.

Mavis Pacheco, Director of Informatics, is in the midst of an in-person Network-wide audit to capture each of the troubles, and get them fixed. We are committed to the Kiosk registration process, but need to fine tune. This will include stronger training for our own staff, and clear guidelines on how best to intervene and assist patients who struggle through the process.

Last pervasive challenge: There was a time when I was widely quoted as saying the three-word solution to homelessness is “housing, housing, housing”. Too simple,but true. Same goes for the three-word solution to CHN’s challenges: staffing, staffing staffing. We are on a full court press to fill vacant slots, in the area of Family Providers – and across the board. Let’s all be recruiters (and retainers).


From the category A Day in the Life at CHN, here is a note received yesterday from Paul Regoord, our Center Director for Mobile Health Vans. As most of you know, our Integration Mobile provides health care to homeless men living at the City’s 30th Street Shelter (on First Avenue):

“At the shelter, a client came with an emergent issue needing to see dental and optometry.

“We were able to get him in to the dentist today at LES and he came back to let us know they helped him and that he was switching his PCP to CHN. Thank you to Maddie Olmeda and Sasha Jorge for helping get him in. Please let Dr. Lee know the patient was very happy and stopped back to let us know.

“He will be seeing the eye mobile on Tuesday at LES.”

We matter.

Have a good weekend.