GUIDANCE Test, Trace and Take Care Initiative Timesheet Reimbursement Code

Version 1 Issued by Corporate Finance Issue Date: 29 May 2020 Page 1 of 4

Purpose To provide guidance on proper timesheet reimbursement codes to be used for COVID-19 Test, Trace and Take Care Initiative related activities for the purpose of reimbursement of NYC Health + Hospital expenses from FEMA and/or other Federal, State and City sources. The “Reimbursement Code” is used in addition to the regular timesheet payroll “Code” used for OT, Leave, Telecommuting and other payroll codes. Scope This guidance applies to all employees.

Test, Trace and Reimbursement Code (4 Characters) Take Care First Digit Second Digit Third Digit Fourth Digit Reimbursement (Required) (Required) (Required) (Only if applicable) Code Structure COVID Test, Trace and Take Facility Identifier Code Location Code Identifier Care Identifier (see facility code list) (see location code list) (constant) (constant)

Facility Identifier Please use the facility identifier code of the facility where work was performed. Codes If work was performed at a community testing site, please use the facility identifier of the (First digit): facility which the testing site rolls up to as indicated in the chart on page 2.

Facility Facility Identifier Where COVID Work Was Performed Identifier Where COVID Work Was Performed Codes Codes A Central Office R Kings County Hospital B Bellevue Hospital S Woodhull D North Central Bronx V Metropolitan E Bird S. Coler Hospital W Accountable Care Organization F Coney Island X Queens G Cumberland Y One City Health Central Services H Epic EMR Z Seaview I Elmhurst 2 Correctional Health Services J Lincoln 3 Enterprise IT Services L MetroPlus - HMO 4 East NY DTC M Henry J. Carter 5 Renaissance DTC N Gouverneur Healthcare Services 6 Morrisania NFCC O McKinney Nursing/Rehab Cent 7 Segundo Belvis NFCC P Harlem 8 Certified Home Health Agency Q Jacobi Medical Center 9 Other (go to location code)

COVID Identifier Test, Trace (Second digit); COVID and Take Care Description Identifier Identifier Test, Trace and All activities related to the NYC Test, Trace and Take Care Initiative, C 4 Take Care including staff reassigned to hotels and community testing sites.

Identifier (Third digit):

GUIDANCE Test, Trace and Take Care Initiative Timesheet Reimbursement Code

Version 1 Issued by Corporate Finance Issue Date: 29 May 2020 Page 2 of 4

Location Code Location (Fourth digit): Location Codes (if different from Facility) blank leave blank if work is performed at facilities A-Z and 2-8 and not in a tent Community Testing Site (Tent/Pop-up Location not within existing H+H T1 facility) Y YMCA/Hotels R Roosevelt Island Medical Center N New NCB COVID Beds

Facility Rollup Linked H+H Borough Name Address Facility

Bronx 4006 3rd Ave 4006 3rd Avenue, Bronx, NY 19457 NCB

Bronx Bronxwood Preparatory Academy 921 East 228th Street, Bronx, NY 10466 Jacobi

Bronx Edward Grant 1302 Edward L Grant Hwy, Bronx, NY 10452 Jacobi

Bronx PS X017 778 Forest Avenue, Bronx, NY 10456 Lincoln

Bronx St James Rec Center 2530 Jerome Avenue, Bronx, NY 10468 Lincoln

Brooklyn 4002 Fort Hamilton 4002 Fort Hamilton Parkway, Brooklyn, NY 11218 Woodhull

Brooklyn Bay Ridge 5th Ave 8511 & 8515 5th Avenue, Brooklyn, NY 11209 Kings

Brooklyn Bensonhurst 14th Ave 6315 14th Avenue, Brooklyn, NY 11219 Coney

Brooklyn Brooklyn Army Terminal 140 58th street, Brooklyn, NY 11220 Kings

Brooklyn Lenox Hill Radiology 6740 3rd Avenue, Brooklyn, NY 11220 Kings McCarren Park Recreation Center and Pool, 776 Brooklyn McCarren Park Recreation Center Woodhull Lorimer Street, Brooklyn, NY 11222 Brooklyn Midwood 1223 Coney Island Avenue, Brooklyn, NY 11230 East New York

Brooklyn Red Hook Recreation Center 144 Bay Street, Brooklyn, NY 11231 Woodhull

Brooklyn South Shore HS 6565 Flatlands Avenue, Brooklyn NY Kings

Manhattan East 111th 141 East 111th Street, New York, NY 10029 Met

Manhattan Highbridge Pool 2301 Amsterdam Avenue, New York, NY 10033 Sydenham

Manhattan Manhattanville Health Center 21 Old Broadway, New York, NY 10027 Bellevue

Queens 1716 Bleecker 1716 Bleecker Street, Queens, NY 11385 Queens

Queens 51-30 Northern Boulevard 51-30 Northern Boulevard, Woodside, NY 11377 Elmhurst

Queens Beach 39th Beach 39th Street, Queens, NY 11691 Elmhurst

Queens Jacob Riis Settlement House 10-25 41st Avenue, Queens, NY 11101 Elmhurst

Queens Leavitt Field Parking Lot 34-41 137th Street, Flushing, NY 11354 Queens

Queens Sorrentino Rec Center 18-48 Cornaga Avenue, Queens, NY 11691 Coney

Staten Island Former St John Villa HS 57 Cleveland Place, Staten Island, NY 10305 Woodhull

Staten Island Greenbelt Recreation Center 501 Brielle Avenue, Staten Island, NY 10314 Coney

Staten Island P.S. 21 Margaret Emery-Elm Park 168 Hooker Place, Staten Island Woodhull

Staten Island Tottenville High School 100 Luten Avenue, Staten Island, NY 10312 Woodhull

1 Location code T is used when COVID activities are performed either at a tent located on a hospital campus or at community testing site. It can be used with Facility identifier code 9 if the location is offsite or the appropriate Facility code if on campus or If the facility is linked as per the chart on page 2. Other location codes (e.g. hotels) should only be used in conjunction with Facility identifier code 9.

GUIDANCE Test, Trace and Take Care Initiative Timesheet Reimbursement Code

Version 1 Issued by Corporate Finance Issue Date: 29 May 2020 Page 3 of 4

Code Structure 1. A Harlem Hospital employee performing Test, Trace and Take Care functions at Highbridge Pool, and Timesheet a new community site, Timesheet reimbursement code – 9C4T

Examples COVID Test, Trace and Take Facility Identifier Location Code (see facility code list) Identifier Care Identifier (see location code list) (constant) (constant) 5 C 4 T 5 – Renaissance DTC C – COVID19, COVID Identifier (constant) 4 – Test, Trace and Take Care Identifier (constant) T – Community Testing Site

2. A Central Office employee spends the afternoon working at a hotel as part of the Test, Trace and Take Care Initiative: Timesheet reimbursement code – 9C4Y

COVID Test, Trace and Take Facility Identifier Location Code (see facility code list) Identifier Care Identifier (see location code list) (constant) (constant) 9 C 4 Y 9 – Other C – COVID19, COVID Identifier (constant) 4 – Test, Trace and Take Care Identifier (constant) Y – Hotels

3. An EITS employee supporting Bellevue for the day as part of the Test, Trace and Take Care initiative while telecommuting: Timesheet reimbursement code – BC4

COVID Test, Trace and Take Facility Identifier Location Code (see facility code list) Identifier Care Identifier (see location code list) (constant) (constant) B C 4 blank B – Bellevue C – COVID19, COVID Identifier (constant) 4 – Test, Trace and Take Care Identifier (constant)

GUIDANCE Test, Trace and Take Care Initiative Timesheet Reimbursement Code

Version 1 Issued by Corporate Finance Issue Date: 29 May 2020 Page 4 of 4

4. An Epic employee spends the morning performing a system upgrade to support the Test, Trace and Take Care initiative from EPIC’s corporate office: Timesheet reimbursement code – HC4

COVID Test, Trace and Take Facility Identifier Location Code (see facility code list) Identifier Care Identifier (see location code list) (constant) (constant) H C 4 blank H – Epic EMR C – COVID19, COVID Identifier (constant) 4 – Test, Trace and Take Care Identifier (constant)

5. A Cumberland employee spends the day performing Test, Trace and Take Care functions in an onsite clinic: Timesheet reimbursement code – GC4

COVID Test, Trace and Take Facility Identifier Location Code (see facility code list) Identifier Care Identifier (see location code list) (constant) (constant) G C 4 blank G – Cumberland C – COVID19, COVID Identifier (constant) 4 – Test, Trace and Take Care Identifier (constant)

6. A Community Care employee spends the day working at a hotel as part of the Test, Trace and Take Care Initiative: Timesheet reimbursement code – 9C4T