BCHN 2017 ANNUAL REPORT LEADERSHIP

BOARD OF DIRECTORS ADVISORY COUNCIL EXECUTIVE TEAM Eduardo Alayon, LMSW Katherine S. Lobach, MD Eleanor Larrier, MPA President Chairperson Chief Executive Officer

Richard Thomas Torrance Akinsanya, MPA Sharon Edwards-Bandyopadhyay, MBA Vice President Chief Financial Officer Lucy Aponte Sandra Piggee, LCSW Jay Izes, MD Treasurer Marta I. Baez, MS Chief Medical Officer Quality Improvement Director David Fletcher, Ph.D. James Carey, BS Compliance Director Corporate Secretary Hyrjana Dibra Tashi Chodon, BSN, MPH Charles Barnett, BBA Director of Programs Recording Secretary Stella Onuoha-Obilor, MD

Robin Bethea Calvin Ramsey

Marjorie A. Cadogan, JD Linda Ricci

Arthur G. Edwards, MPA Maria Rodriguez, MSA

Zahra Elmekkawy, MIA Miriam D. Tabb

Tanya Johnson, MS

Millie Pacheco, BA

Victor Quarshie, BSc

John Ruiz, BLA

John Sibiski, BSc, BA

Members of BCHN’s Board of Directors at the 2017 Annual Meeting & Symposium.

BCHN 2017 Annual Report | 2 DEAR FRIEND S,

Concerns about spiraling government and BCHN experienced dramatic changes in 2017, personal healthcare costs without the expanding the depth and reach of our expected value outcomes and return on services across as we work to keep investment have led to focused investments pace with health care reform. According to in technology and healthcare delivery Compass Point’s Theory of Change, “Change systems redesign. Federal and state doesn’t take root without attending to skills, healthcare reform initiatives are designed to systems and culture in concert”. By the end achieve the Triple Aim: improving the health of 2017 the number of employees doubled to of populations; reducing costs; and forty. Our network added one community, In 2017, with the help of consultants and improving healthcare quality, health and three school-based health centers, and input from key stakeholders, a joint Board outcomes and patient satisfaction. our Community Health and Wellness and management team worked to update Program added care coordination to patient our Strategic Plan. The result are goals that The Triple Aim is very much a part of the and community engagement strategies for employ our organizational strengths to meet shared missions of the community health managing chronic illness and maintain new regulatory requirements, expand our center movement and BCHN. In fact, healthy lifestyles. quality improvement focus and solidify our community health centers are featured Social Supports Enterprise. Key to our prominently in the design of many reform Eighteen community health workers were success will be our ability to partner and initiatives. They are credited with delivering hired and rigorously trained. The majority collaborate in the emerging healthcare cost effective and innovative care for have been integrated into multi-disciplinary Value-based Payment world. populations with complex healthcare and Patient Centered Medical Home teams at 10 social needs and disproportionate rates of BCHN/Montefiore health centers. They Our Board of Directors has been a guiding chronic and preventable illness. screen patients for social determinants of light through the past years. We thank the health (SDH), make referrals for assistance members and our president, Mr. Eduardo New York State’s Delivery System Reform with housing, food, jobs and other needs, Alayon, for their leadership and support. Incentive Program (DSRIP) forged and assist clients with navigating the collaboration and partnerships between complex health and social services systems Sincere thanks to all our partners, supporters various provider systems, including so they can focus on healthy living. Other and donors. We invite you to stay with us for community health centers and community- CHWs are focused on health promotion, the upcoming ride! based organizations. As a federally funded literacy and SDH referrals in neighborhood health center and CBO, BCHN is a member of sites. Like our patient navigators and Sincerely, DSRIP’s Bronx Partners for Healthy emergency room liaisons, they bring a

Communities Preferred Provider System. tremendous understanding of the cultures Eduardo Alayon, LMSW Eleanor Larrier, MPA and customs in our multi-ethnic Bronx Board President Chief Executive Officer communities. At the centers, they help providers and professionals work to “the top of their licenses”.

BCHN 2017 Annual Report | 3 CARING FOR THE COMMUNITY BCHN ORGANIZATIONAL 2017 AT A GLANCE REACH $11,137,909 118,653 grant funds assured individuals were Bronx Community Health Network access to affordable, cared for at 18 (BCHN) assures access to quality, quality healthcare in community and affordable medical, oral and health centers and school-based health behavioral health care and related Bronx communities centers diagnostic and social support services at 18 network health centers, for children and adults, regardless of their ability to pay, 434,258 visits were made for 38,127 immigration or other status. children and youth medical, pediatric and oral health care We continue the tradition of 66,118 and related services adults 18-64 years old community and migrant health centers that began during the civil rights movement of the 1960s. 69,560 Community health centers are 42% patients used community-governed, not-for-profit Hispanics/Latinos Medicaid, CHIP or organizations that go above and 27% other public insurance beyond the traditional model of for primary care Blacks/African health care to provide access to Americans (7,188 uninsured) essential primary and preventive health care services for everyone. 43% of all patients had 21,597 incomes below patients patients were 200% of the Federal diagnosed with Poverty Level hypertension (13,484 diabetes, ($12,060 for an 13,297 asthma) individual)

BCHN 2017 Annual Report | 4 RECOGNIZING A N D EXPANDING

PIONEERS CHCC & CFCC CELEBRATE 50th ANNIVERSARY , 20 YEARS IN BCHN NETWORK In 1997 two Bronx health centers joined the fledgling community health center movement, affirming their commitment to the movement’s goal and vision: access to quality, affordable, coordinated, patient-centered and community-driven health care and related services in economically challenged communities. Those centers, Montefiore’s Comprehensive Health Care Center and Comprehensive Family Care Center, celebrated 50 years of service in May 2017. Celebratory events at the centers honored patients with longstanding affiliations and those who have had great success with staff and patients. The 50th anniversary of two health center pioneers and BCHN network members, was celebrated at both sites in May. Pictured left: BCHN chief executive officer Eleanor Larrier, Montefiore Health System chief operating officer Dr. Philip O. Ozuah, and BCHN Board President Eduardo Alayon. Pictured right: CFCC site administrator Carol Lau, CFCC founder and BCHN Advisory Council chairperson Dr. Katherine S. Lobach, BCHN chief financial officer Sharon Edwards; original patient Ms. Dunn, and Montefiore Health System chief medical officer Dr. Andrew Racine.

OUR EXPANDING STAFF MARBLE HILL FAMILY PRACTICE JOINS BCHN NETWORK The Bronx Community Health Network staff, which has doubled in Montefiore’s Marble Hill Family Practice became our 18th member the past three years, posed for “Wear Blue Day” to raise health center. Site administrator Odelisa Joaquin proudly displays awareness during Men’s Health Month. the sliding fee scale that assures affordable healthcare for all. BCHN 2017 Annual Report | 5 MAKING A DIFFERENCE

BCHN BCHN’S CENTER OF EXCELLENCE IN 2017 PROGRAMS

REACH BCHN’s outreach team 701 counseled pregnant women and BCHN is an innovative, caring families gained access to organization that is changing lives 38,310 Bronx residents on maternal and child health every day. We do this through our gaining access to services through the nationally recognized community social support services Healthy Start program health and wellness program, our center of excellence. BCHN's outreach team (patient navigators, 3,707 18 people enrolled in community health community health workers, New York State of workers facilitated emergency department liaisons and Health insurance at access to social health educators) reflect the BCHN health determinants of health wonderful diversity of the Bronx. centers and in the (SDH) resources and community improved quality of patient care 8,223 patients screened for 2,309 social determinants emergency of health at BCHN department patients health centers assigned to a primary (1,850 linked by a care physician community health worker) 1,004 600 HIV+ patients received life-saving naloxone care through the CICERO kits distributed to prevent program opioid overdose deaths (84% virally suppressed)

BCHN 2017 Annual Report | 6 TELLING OUR STORIES

MIRIAM TAKES CHARGE OF HER SHIRA CREATES A HEALTHY START BRIDGET GETS HEALTH INSURANCE HEALTH FOR HER NEW FAMILY AND A NEW LEASE ON LIFE

“I joined the Diabetes Prevention Program Shira enrolled in BCHN’s Healthy Start “For two years I was going to the doctor, to help me lose weight and reduce my risk program during her first pregnancy. At the and I would have to pay out of pocket. of Type-2 diabetes.” time she did not fully understand the That was extremely hard for me because importance of breastfeeding, the best sometimes I had to choose…either I go to Miriam did not miss a session during the positions for her baby to sleep or rest, and the doctor or buy food.“ program at Williamsbridge Family Practice, the value of ongoing medical care to and was also an enthusiastic supporter of ensure a healthy parenting journey. “I met Rhea, a community health worker other programs at the health center. at BCHN, and she helped change my life. Shira attended workshops on safe sleep I was so happy when she told me I was “I realized I had the control to take my and breastfeeding, childbirth education, qualified and could get insurance. I am health into my own hands. I lost 22 postpartum depression, car seat safety, and now able to see a doctor on a regular pounds and I’m proud to say my clothes no baby-proofing her home. During the basis, and get the care that I need.” longer fit, so I need a new wardrobe! I’ve classes, Shira received a crib, car seat, also seen improvement in my blood sugar stroller and diapers to help support her Bridget’s health insurance worries are level and cholesterol.” and her baby, and was able to bond with now out of her way. She is still working other new mothers and families. with Rhea, and now focusing on the The Williamsbridge staff raves about future. She is looking forward to pursuing Miriam’s positive influence on family, “I was so overjoyed to receive these items certification as a massage therapist. friends and co-workers. that helped ensure a healthy start for my baby.” “Thank you to the team of Williamsbridge Family Practice for your support. I have Shira was inspired by the Healthy Start made a lot of progress and I plan to program, and is considering a career in continue.” healthcare to give back to her community

BCHN 2017 Annual Report | 7

LEADING THE WAY

BCHN COLLABORATION MODEL LEADS TO REFERRAL AWARD BCHN IS AT THE FOREFRONT OF THE OPIOID EPIDEMIC

Recognizing that gaps in health care often occur because patients In the first six months of 2017, 166 Bronx residents died of a drug have multiple social barriers, BCHN continues to build partnerships, overdose. Naloxone, a medication designed to rapidly reverse an expand the outreach team, and increase the number of services opioid overdose, can drastically reduce that number. Over the past offered. It has become a center of excellence, connecting Bronx two years, more than 600 naloxone kits have been distributed to date residents to social support services such as food pantries, SNAP, at workshops led by BCHN. After a recent BCHN training session, housing, health insurance, jobs and education. Captain Alba N. Diaz from the Fordham Plaza Department of Public Safety used the kit she received to save a life. In July, Food Bank of presented BCHN with an award for making the most referrals in the Bronx through their Tiered Captain Diaz was alerted to an overdose occurring in the paid Engagement Network (TEN). bathroom at the Fordham Plaza Transit Hub, and took action. Captain Diaz administered the first dose of naloxone but the community To further improve the efficiency and effectiveness of the processes, member did not start breathing. As instructed in the training, she BCHN is implementing NowPow, a comprehensive social services then administered a second dose which immediately revived the directory and referral system. person, who was taken to a nearby hospital for additional care.

21,825 249 PATIENTS BEING TREATED INDIVIDUALS ENGAGED AND WITH BUPRENORPHINE AFTER EMPOWERED BY THE BCHN 55 PROVIDERS TRAINED TO OUTREACH TEAM PRESCRIBE

BCHN 2017 Annual Report | 8 SHARING OUR SUCCESSES

NACHC CONFERENCES to let lawmakers and the Cuomo REACH SYMPOSIUM BCHN joined health center leaders, decision- administration know that New York's health In September, BCHN partnered with three makers and public health leaders in the heart care safety net is at risk. It was the largest other New York City grantees of the Center of Washington, D.C. to focus on the future at turnout in the event's history. for Disease Control and Prevention's Racial the NACHC Annual Policy and Issues Forum in and Ethnic Approaches to Community Health March. BCHN brought a team of Board members, (REACH) and Partnerships to Improve staff and patients to meet with elected Community Health (PICH) for the "Community Five months later, a team from BCHN officials that represent the Bronx. Transformation through Partnership" traveled to San Diego for the NACHC Com- symposium. munity Health Institute (CHI) and Expo, the AFRICAN CONFERENCE largest annual gathering of health center clin- Key members of BCHN’s outreach team The event featured stakeholders from icians, executives, consumer board members traveled to Washington, D.C. in October for community-based organizations, health, along with Health Center Controlled Net- the 5th United States Conference on African policy makers and advocates, nonprofit works and State/Regional Primary Care Asso- Immigrant Health. This year’s conference groups, academic institutions and ciations. BCHN presented posters on theme was "Advancing the Health of African governmental agencies across the country. “Improving Access to Naloxone: Community Immigrants through Research, Advocacy and Health Worker-Led Opioid Overdose Community Engagement." The team IN THE MEDIA Prevention Program in the Bronx, New York” presented our substance abuse and BCHN’s naloxone work received national and “Emergency Department Diversion emergency department work. recognition during an episode of The Model: Successes and Lessons Learned”. GroundTruth podcast. NYC RING CONVOCATION BCHN ADOVCATES IN ALBANY BCHN also presented its naloxone and Quest Diagnostics produced an ad aired on BCHN joined the Community Health Care emergency department successes at the New iHeartRadio featuring CICERO patient Sylvia Association of NYS (CHCANYS) and 900 York City Research and Improvement Young, who heads the program’s community community health care supporters in Albany Networking Group in October. advisory board.

BCHN 2017 Annual Report | 9 REACHING FOR BETTER HEALTH

BCHN’S INCREASING ACCESS IN THE BRONX BRONX REACH CHAMPS 845,855 Bronx residents have been reached as a BCHN received funding from the result of new programs added through BCHN’s Bronx REACH Champs initiatives Centers for Disease Control & since 2014 Prevention in 2014 to implement a REACH (Racial and Ethnic Approaches to Community Health) program in the northeast Bronx. 2 business networks 7 BCHN, in collaboration with its (Fordham BID & parks and open spaces now have partners, formed the Bronx REACH Bronx Chamber of Commerce) adopted enhanced Champs coalition with the goal of healthy food physical activity reducing obesity and improving the standards for programs and overall health and wellness of the meetings and events park guides Bronx's culturally and ethnically diverse population. 9 19 Six initiatives were created that bodegas, corner in-home childcare stores and providers are now focused on nutrition, physical activity supermarkets have using BCHN’s or clinical and community linkages. added healthy multicultural food and beverage curriculum to ensure options kids are more active

126,013 patients now have 25 access to a community schools adopted new health worker to physical activity connect them to social programs, such as biking support services and tennis

BCHN 2017 Annual Report | 10 FIGHTING OBESITY IN THE BRONX SETON FALLS PARK FINDS WORKSITE WELLNESS PROGRAM MULTICULTURAL TOOLKIT BRINGS SUCCESS WITH NEW PROGRAMS CONTINUES TO EXPAND ACTIVITIES TO IN-HOME PROVIDERS

Renee Patterson, who represents Seton Two key business networks were added to Minerva Heredia of Heredia Day Care Falls Park on BCHN’s Bronx REACH Champs BCHN’S Bronx REACH Champs Worksite completed BCHN’s Bronx REACH Champs Parks and Open Spaces Coalition, joined Wellness program in 2017: Bronx training series on Multicultural Age the network of over 30 organizations in Chamber of Commerce and the Fordham Appropriate Physical Activity. The series, 2015 with a goal to bring more people and Road Business Improvement District. geared toward in-home childcare activities to the park’s 30 acres of With the Chamber and BID committed to providers, focused on cultural diversity, the preserved nature land. providing healthier food and beverage importance of physical activity in early options for their employees, the program childhood. BCHN’s “Go Healthy with Little She participated in a Bronx REACH Champs now potentially impacts 250 total Ones” toolkit was created to enhance training course that taught members how businesses in the Bronx. physical activities in a multicultural to lead Qigong meditation classes, and childcare setting. distributed BCHN park guides. She also BCHN also released "Go Healthy at Work: learned how formerly observing park usage A Worksite Wellness Toolkit,” and worked Minerva incorporates activities from the can positively impact funding for activities with the leadership of local organizations curriculum in her work with children aged in the park. to make a commitment to promote from 0 to 12 years old in her home. She healthy nutrition habits in their work enhances her own activities through With new knowledge and a network environments. By making healthy American, Latin and Afro Caribbean music behind her, Renee began to find success. beverage, meal and snack options and movement suggested in the In 2017, the park conducted nature walks, available for employees, volunteers, curriculum, and encourages her children to and offered fitness classes and movie clients and guests, organizations take an express themselves through dance and nights to the community. Through a important step towards improving the movement games. summer jobs program, Renee empowers overall health of Bronx residents. local youth to conduct urban research that “I am very happy with the curriculum. I measures community use of the park so began using it the day after we finished the that they can advocate for enhanced park workshops. The children enjoy playing programming. Musical Statues, and they love the music.”

BCHN 2017 Annual Report | 11 STATEMENT OF FINANCIAL POSITION

ASSETS 2016 2015 REVENUE 2016 2015

Current assets DHHS Grants $10,120,442 $8,186,136 Cash $510,982 $345,308 Donated Space $252,247 $21,935 DHHS Grants Receivable $2,262,542 $1,634,092 Fundraising $106,828 $106,828 Other Grants Receivable $79,170 $21,935 Other $6,987 $3,446 Prepaid Expenses/Other Assets $16,063 $16,079 Total Revenue $10,486,504 $8,318,345 Total Assets $2,868,757 $2,017,414

LIABILITIES AND NET ASSETS 2016 2015 EXPENSES 2016 2015

Current liabilities Program Services $9,044,135 $6,855,342 Liabilities-Accounts Payable General and Administrative $1,421,677 $1,498,732 and Accrued Expenses $2,691,107 $1,860,456 Unrestricted Net Assets $177,650 $156,958 Total Expenses $10,465,812 $8,354,074

Total Liabilities $2,868,757 $2,017,414 Increase in Unrestricted Net Assets $20,692 ($35,729)

Unrestricted Net Assets, Beginning $156,958 $192,687

Unrestricted Net Assets, Ending $177,650 $156,958

BCHN 2017 Annual Report | 12 O U R D O N O R S Fiscal Year 2017

Acacia Network Francis Derival Margaret Kessler Mavis Quarshie Israel Addo Sharon Distant Angela Larrier Victor Quarshie Abbas Akesse Arthur G. Edwards Coleen Larrier Quest Diagnostics Eduardo Alayon Jacqueline Edwards Eleanor Larrier Natalix R Amazon Smile Zahra El-Mekkawy Ian Larrier Ranie Rampersaud Argus Community Judy Farnum John Larrier Linda Ricci John Armato Gladys O. Feliciano Keith Larrier Jose A. Rivera Arnesi Amron Maria Ferraioli Wayne Leacock Jose A. Rivers Gibril Baba Gladys Feliciano Ira Levenberg-Engel Maria A. Rodriguez Charles Barnett Sebastian Fiaku Sonia Livingstone David Rosado Susan Beane David Fletcher Alberto Lopez John Ruiz Robin Bethea Simone Foster Andriy Lutsak Ruiz Family Foundation Brenda Bernie Gallagher Tony Madera Raul Russi Evelyn Briones Steve Gallagher Joyce Martindale Irene Ruz Gwen Brimmage Tonya Gayle Gumersindo Martinez Yarilda Santos Samisha Brimmage Joe Gordon Mildred Martinez Khady Seck Samuel Brimmage Ronnie Green Jeanine Mendez Jennifer Simmons Bronx Museum of the Arts Andre Higgins Harry Mictene Amarilis Soler George W. Cadogan Healthfirst Julissa Miranda Angel Sotomayor Marjorie A. Cadogan HMB Pharmacy Montefiore Lillian Sweeney James Carey Joyce Hogi Sharon Myrie Miriam D. Tabb Miriam Carmona Madeline Holder Roger Newcomb Terry Zondra Carter Craig Holmes Ladi Oko Richard Thomas George Caswell Jay & Lois Izes Lil Orozco Layofutte Thompson Ruth Clay Lisa Izes Wendy Ortega Marcos Torres Arlyne H. Coker Rachel Izes Joseph M. Ortiz Evelyn Trinidad Tyrone Carroll Ayisha Jackson Millie Pacheco John Tutt Michael P. Deignan Harriet Jacobs Ray Patel Omar Vargas Henry DeJesus Joan Sandra Piggee Gene Whatley Cynthia Dela Rosa Malik Johnston R. Poindexter William Doreen Proverbs Adrienne Williams

We regret any errors or omissions. To report an error, please contact us at 718.405.7720

BCHN 2017 Annual Report | 13

1 Fordham Plaza, Suite 1108, Bronx NY 10458 Phone: 718.405.7720 bchnhealth.org

OUR HEALTH CENTERS Adlai E. Stevenson Educational Campus Health Center | 1980 Lafayette Avenue, Bronx, NY 10473 Castle Hill Family Practice (CHFP) | 2175 Westchester Avenue, Bronx, NY 10462 Claremont Family Care Center | 264 East 174th Street, Bronx, NY 10457 Clay Avenue Family Health Center | 1776 Clay Avenue, Bronx, NY 10457 Comprehensive Family Care Center (CFCC) | 1621 Eastchester Road, Bronx, NY 10461 Comprehensive Health Care Center (CHCC) | 305 East 161st Street, Bronx, NY 10451 DeWitt Clinton High School Health Center | 100 West South, Bronx, NY 10468 Family Health Center (FHC) | 1 Fordham Plaza, 5th Floor, Bronx, NY 10458 I.S. 217 Entrada Academy | 977 Fox Street, Bronx, NY 10459* Marble Hill Family Practice (MHFP) | 5525 Broadway, Bronx, New York 10463* Morris High School Campus | 1110 Boston Road, Bronx, NY 10456* Mott Haven Campus Health Center | 730 Concourse Village West, Bronx, New York 10451 Park Ave Health Center | 4196 Park Avenue, Bronx, NY 10457-6009 P.S. 55 Benjamin Franklin | 450 St Pauls Pl, Bronx, NY 10456* South Bronx High School Health Center | 710 Saint Anns Avenue, Bronx, NY 10455 University Avenue Family Practice | 105 West 188th Street, Bronx, NY 10468 Via Verde Family Practice | 730 Brook Avenue, Ground Floor, Bronx, NY 10455 Walton Campus Health Center | 2780 Reservoir Avenue, Bronx, NY 10468 West Farms Family Practice | 1055 East Tremont Avenue, Bronx, NY 10460 William Howard Taft Campus Health Center | 240 E. 172nd Street, Bronx, NY 10457 Williamsbridge Family Practice (WBFP) | 3011 Boston Road, Bronx, NY 10469

* Added in 2017