Advocacy in an Epicenter: A Conversation with NYC Health + Hospitals’ Deborah Brown
Each quarter, we feature a Federal Action Network (FAN) member leading the charge on Capitol Hill to protect essential hospitals. This quarter, we spoke with Deborah Brown, JD, MSW, senior vice president for external and regulatory affairs at NYC Health + Hospitals (NYC H+H), in New York. Advocating for a health system in a COVID-19 epicenter, Brown has relied on education, teamwork, and shared humanity to advance NYC H+H’s mission.
Advocacy as Brown knew it ended with a New York State Medicaid Redesign Team meeting in mid-March, in Manhattan.
“That was one of the last times that I remember being able to go over and joke around with someone, and talk to them and just kind of do the things you do when you’re building relationships with people,” she recalls. “And then, three days later, four days later, we went into lockdown.”
As the city went into quarantine and NYC H+H began caring for a surge of COVID-19 patients, press coverage led to an outpouring of support from elected officials and their staff.
“We have 11 acute-care facilities, and different lawmakers have different priorities, but it was really heartening to see how many of them came to us to say, ‘What can we do?’” Brown says.
She spent hours on the phone educating lawmakers and staff about the rapidly evolving nature of the virus and developed a fact sheet highlighting its financial toll on the system.
“I didn’t understand droplet precautions, the need for a face shield; these were things I’d been blessed to never have to deal with before, so it certainly made sense to me that people didn’t know either,” Brown says.
Initial conversations focused on staff, patient, and community safety. Many lawmakers expressed concerns about perceived personal protective equipment (PPE) shortages, which led to bigger conversations about the hospital supply chain. Later conversations explored the health system’s partnership with the New York City Department of Health and mayor’s office for testing and contact tracing efforts.
Above all, Brown continues to focus on front-line workers in her advocacy.
“We never, ever wanted to have any conversation that might suggest anything other than [front-line worker] prioritization,” she says. “They, our patients, [and] our communities were always first.”
To give clinicians an advocacy voice, Brown sets up meetings for the hospital’s CEO, Mitch Katz, MD, head of ambulatory care, chief quality officer, and other clinical leaders to speak with elected officials. She’s quick to stress that advocacy is a true team effort.
“Part of being an effective advocate is knowing when you are not the right voice,” Brown says. “To say [Katz] was generous with his time is like saying the sky was blue. He would and did answer anyone’s questions, speak to anyone; he passionately understood how important that education was.”
Brown says it has been a challenge to strike a balance between the health system’s role as a hotspot caregiver and its special needs as a safety-net provider. And, while issues like Medicaid funding and state support have taken a backseat to the COVID-19 pandemic, these funding streams remain an advocacy priority for the health system, especially during New York’s budget-planning season.
“I think that, quite frankly, part of our state strategy … was you cannot cut safety-net hospitals in the middle of the worst public health crisis in the century,” Brown says. “In that way, I guess there’s linkages, like it creates a larger and bleaker context for everything, but that balance has been hard.”
She appreciates that the New York City Council delayed oversight hearings during the apex of the pandemic, and she commends lawmakers for their responsiveness to digital communication. While Brown can’t make jokes or build relationships in person, she finds common ground with elected and appointed officials in other ways.
“They’re New Yorkers too, so everything that we were experiencing on a personal level in terms of health concerns, in terms of fear, in terms of risk, they were very much there with us,” she reflects. “Sometimes, those were moments where, just being on the phone, I think you really established a person-to-person connection, and that wasn’t necessarily strategic, but it was really critical.”
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