CM Narcisse on H&H cash on hand and financial cushion

20 days cash on hand in line with historical performance.

You know that.

But 2022 days appears thin for a system about to absorb a federal shock.

A healthy system targets a far larger cushion.

What's the floor before it, you know, threatens our operations?

Well, I think the reason we don't operate the same as people do in the private sector is that we have the advantage of the city and the state.

So how much cash we have on hand has some relationship to how much the state owes us at any one moment.

And sometimes how much the feds owe us through the state, how much the city owes us for different things, the ability to move payments.

So we're always around, and that's why it's always around that number, 28 days.

Ultimately, if there were markedly less insured people and we were providing the same level of services, that will open a hole.

And then that hole can only be filled either by the city, by the state, or us figuring out more.

efficient models.

And we will never back off on providing services, but we could, in a bad scenario, have to look at, for example, maybe we can't provide every service at every hospital.

That could happen, right?

Would the service still be available?

Yes.

Would it be available at every hospital?

Potentially no.

I mean, that's, I'm very firm in all of the government systems that I've run.

You get to spend what your leaders give you.

You don't get to spend more than that.

Yeah.

That's how it works.

It's like our checking accounts.

You might want to buy something more, but if you don't have the money, you don't.

We will always prioritize services over administration.

We don't have the high salaries that exist in the private sector.

But I think what we would have to do is we'd have to look at

the places we provide services and probably decrease it.

If you look at the other systems, they don't do the large systems, whether we're talking NYU, Northwell, Mount Sinai, for example, they don't do OBGYN at every hospital.

Well, they do GYN at every hospital.

They don't do OB at every hospital.

They have a hospital for birthing.

And that's where you have to go.

Health and hospitals has a different tradition because our hospitals really grew up around taking care of the neighborhoods.

So Harlem takes care of the world of Harlem, and that's more our tradition.

And so all our hospitals do OB, and that's a good thing.

Pretty much all our hospitals do a pretty full spectrum of services.

I think in a scenario where there was less dollars and you were prioritizing services, you'd probably have to provide the services at fewer sites, and people would have to travel for those services.

But at least the service would be available.

It wouldn't be cut.

Yeah.

You're talking about enrollment.

I still, I know we're going to have some complex moment to get people re-enrolled because the fact that we're dealing with population,

elderlies, people that don't have no support, that live alone.

So as we're talking about enrollment, I know we have strategy to recruit volunteers and stuff.

And I pray God since New York City is a great place, despite everything going over our head.

So I'm hoping that a lot of people will be recruiting to help address that enrollment.

And you said you're going to have kind of hub-like to do that.

So thank you in advance for doing that.

Thank you.

Great news that we have hired 200 nurses.

You know that brings me joy, right?

I'm very happy.