Nassau Queens PPS Community Profile

Nassau Queens PPS Community Profile Counties served: Nassau and Queens DEMOGRAPHICS 1 The total population of the two counties served by the Nassau Queens (Nassau University Medical Center) PPS is 3,631,203. Nassau County has population 1,350,601 and Queens County has population 2,280,602. Age: Across both counties, 19.9% of the population is age 60 or older. Race/Ethnicity: Overall, the two counties have a population that is 40.3% White. The non-white majority is driven by Queens, where 27.8% of residents are Hispanic ethnicity (of any race) and 25.9% of residents identify as Other Race (non-hispanic ethnicity), which includes Asian, Hawaiian / Pacific Islander, and Native American. Foreign-born residents: 38% of total residents are foreign-born; in Queens alone, 47.8% are foreign-born. Approximately 180 cultures are represented in the borough. Language: Only 54.1% of residents of these counties speak only English at home. 12.6% of Nassau residents and 23.9% of Queens residents speak Spanish at home. Poverty: In Nassau, only 6.3% of residents live below Federal Poverty Guidelines (FPG), while Queens has 15.3% living in poverty. The overall poverty rate is 12.0%. Nassau Queens PPS Executive Summary page 1

HIV/AIDS 2 3 New HIV Diagnoses: Between 2011 and 2013, there were a total of 1,764 new HIV diagnoses in the PPS s two counties. Queens County had the largest number of new HIV cases 1,392 during these three years. The HIV incidence for these counties is comparable to New York State s overall 19.1 case rate per 100,000 residents, and higher than New York State s case rate with New York City excluded 8.2 new cases per 100,000 residents. PLWHA: As of December 31, 2013, there were 20,600 people living with HIV/AIDS in the PPS region; 2,987 lived in Nassau and 17,613 lived in Queens. The HIV prevalence rate for these combined counties are lower than New York State s overall 666.9 per 100,000 residents, but lower than New York State s prevalence rate with New York City excluded 243.9 per 100,000. Deaths: From 2011 to 2013, a total 597 deaths occurred among PLWHA in the PPS region. HIV/AIDS Hospitalization Costs: In 2014, HIV-related hospitalization costs in both counties (514 patients and 6,354 days) totaled $45 million; 68% of costs occurred in Queens County. Nassau Queens PPS Executive Summary page 2

HIV DISPARITIES 1 2 HIV and AIDS disproportionately impact non-white residents and especially residents identifying as Hispanic (of any race) and Black (non-hispanic) across both of the PPS s counties. Despite Black individuals comprising only 15.0% of the counties total population, this racial group represented 40.2% of all PLWHA in the region, as well as 32.0% of the region s new HIV diagnoses between 2011 and 2013. Similarly, Hispanics accounted for 40.9% of new diagnoses and 35.8% of PLWHA in these combined counties, while comprising only 23.2% of the total population. Of all PLWHA in the PPS, 14.7% (3,043 individuals) indicated transmission by injection drug use (IDU) or MSM/IDU, and 37% (7,638) indicated transmission by MSM. Nassau Queens PPS Executive Summary page 3

HIV RISK FACTORS 4 5 6 7 8 9 Homelessness The Alliance for Better Health Care PPS spans four HUD Continuum of Care (CoC) regions, which are comprised of Albany, Rensselaer, Schenectady, Saratoga, Washington, Warren, and Hamilton Counties. o In this region in January 2015, a total of 1,417 individuals were homeless in this region. Of these, 1,328 were sheltered and 89 were unsheltered. o Thirty percent 430 individuals were members of homeless families. o The number of homeless unaccompanied youth (under age 25) was 121. Parolees in the Region As of December 2015, 5,530 parolees reside in the Queens / Long Island region. Counties included in the Queens / Long Island region: Nassau, Queens, and Suffolk. Substance Use Only 13% of adults in both Nassau and Queens smoke cigarettes, a rate lower than the statewide rate of 15.9%. 14.3% of adults reported binge drinking in the last month, ranging from 13.2% of adults in Nassau County to 15% in Queens. This is lower than the statewide rate of 17.7%. The two counties in the Nassau Queens PPS incurred total drug/alcohol-related hospitalization costs of over $181.7 million in 2014, serving 7,421 patients. PPS-wide, the majority of costs were incurred by 3,493 patients admitted for Alcohol Abuse and Dependence, costing over $97.8 million. o Opioid abuse and dependence accounted for 1,446 patients and over $29.6 o million in hospitalization costs. A total of 292 patients (97% of which resided in Nassau County) were admitted for Drug or Alcohol Dependence with Rehab or Detox Therapy, with average length of stay of 24 days and total cost of $23.1 million. Nassau Queens PPS Executive Summary page 4

Mental Health Average Age-adjusted Percentage of Adults with Poor Mental Health for 14 days or more Days in the Past Month: 8.6%, lower than the state-wide rate of 11.1%. Nassau and Queens rates ranged from only 8.0% to 8.9%, respectively. Mental health-related hospitalization costs for both counties totaled $942.1 million, for 16,949 patients. o Queens accounted for two-thirds of the total mental health-related hospitalization costs for the PPS region, with 12,007 patients and $625.5 million. Across the PPS region, Schizophrenia and other psychotic disorders accounted for the largest proportion of mental health-related hospitalization costs: a total of 7,252 patients were admitted at a cost of $491.4 million. Mood disorders accounted for 8,020 patients and $380.5 million in hospitalization costs, between Nassau and Queens. Nassau Queens PPS Executive Summary page 5

SOURCES 1 U.S. Census Bureau, 2010-2014 American Community Survey 5-Year Estimates. 2 New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program. Accessed July 2016 at http://www.nyc.gov/html/doh/html/data/hivtables.shtml. 3 New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). 4 U.S. Housing and Urban Development, Continuum of Care Homeless Assistance Program Homeless Population and Subpopulation Report, Point in Time (PIT) counts from January 2015. Published November 2015. Retrieved July 2016 from https://www.hudexchange.info/resources/documents/2007-2015-pit-counts-by-coc.xls 5 New York State Department of Corrections, 2015 FOIA request on Community Supervision Offenders. 6 2013-2014 NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of 2015. Retrieved July 2016 from https://www.health.ny.gov/statistics/chac/general/g110.htm; https://www.health.ny.gov/statistics/chac/general/g108.htm. 7 New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR MDC = Alcohol / Drug Use & Alcohol/Drug Induced Organic Mental Disorders. APR DRG = Alcohol & Drug Dependence w Rehab or Rehab/Detox Therapy (772); Alcohol Abuse & Dependence (775); Cocaine Abuse & Dependence (774); Drug & Alcohol Abuse or Dependence, Left Against Medical Advice (770); Opioid Abuse & Dependence (773); and Other Drug Abuse & Dependence (776). 8 New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. APR MDC = Mental Diseases and Disorders. CCS Diagnosis Categories = Mood Disorders (657); Schizophrenia and other psychotic disorders (659); and, sum of all other CCS Diagnoses under Mental Diseases and Disorders: Adjustment Disorders (650), Anxiety Disorders (651), Attention-Deficit (652), Delirium (653), Developmental Disorders (654), Miscellaneous Disorders (670), Other congenital abnormalities (217), Personality disorders (658), and Suicide and other intentional self-inflicted injury (662). 9 2013-2014 NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of 2015. Retrieved July 2016 from https://www.health.ny.gov/statistics/chac/general/g106.htm Nassau Queens PPS Executive Summary page 6

Nassau Queens PPS Executive Summary page 7

Community-Based Organizations funded by NYS Department of Health, AIDS Institute in the Nassau Queens PPS Region Long Island Minority AIDS Coalition, Inc. 100 Broadhollow Road, Suite 100 Farmingdale, NY 11735 Contact person: Lakeshia Dandy, CEO Phone: (516) 398-1758 Email: lk@lkdandy.com Long Island Council on Alcoholism and Drug Dependence 114 Old Country Road, Suite 114 Mineola, NY 11501 Contact person: Steve Chassman, LCSW Phone: (516) 747-2606 Email: schassman@licadd.org Planned Parenthood of Nassau County, Inc. 540 Fulton Ave Hempstead, NY 11550 Contact person: JoAnn Smith, President / CEO Phone: (516) 750-2601 Email: joannd.smith@ppnc.org AIDS Center of Queens County, Inc. 161-21 Jamaica Avenue, 7 th Floor Jamaica, NY 11432 Contact person: Philip Glotzer, Chief Executive Director Phone: (718) 896-2500 Email: pglotzer@acqc.org Economic Opportunity Commission of Nassau, Inc. 134 Jackson St Hempstead, NY 11550 Contact person: Iris Johnson, Executive Director Phone: (516) 292-9710 Email: johnsoni@eoc-nassau.org The Fortune Society, Inc. 29-76 Northern Blvd Queens, NY 11101 Contact: JoAnne Page, President / CEO Phone: (347) 510-3601 Email: jpage@fortunesociety.org Five Towns Community Center, Inc. 270 Lawrence Avenue Lawrence, NY 11559 Contact person: Lorenzo Sistrunk, Executive Director Phone: (516) 239-6244 Email: lsistrunk@fivetownsmail.org Circulo de la Hispanidad, Inc. 26 West Park Ave Long Beach, NY 11561 Contact: Gil Bernardino, Executive Director Phone: (516) 889-3869 Email: gbernardino@cdlh.org Nassau Queens PPS Executive Summary page 8

Additional Resources AIDS Institute HIV Education & Training Program The site offers a range of trainings that are intended for non-physician health and human services providers who offer HIV, STI and viral hepatitis prevention, testing, care, and support services. All trainings are free of charge and funded by the New York State Department of Health AIDS Institute. https://www.hivtrainingny.org/ Ending the Epidemic (ETE) Dashboard This purpose of this site is to measure, track and disseminate actionable information on progress towards achieving New York State s Ending the Epidemic (EtE) Initiative s goals to all interested stakeholders. http://etedashboardny.org/ NYS Department of Health HIV/AIDS Home Page The New York State Department of Health, AIDS Institute has lead responsibility for coordinating state programs, services and activities relating to HIV/AIDS, sexually transmitted diseases (STDs) and hepatitis C. The site provides resources related to the AIDS Institute s priorities and work as well as links to resources for consumers and providers and surveillance statistics. https://www.health.ny.gov/diseases/aids/ NY Links NY Links focuses on improving linkage to care and retention in care and supports the delivery of routine, timely, and effective care for Persons living with HIV/AIDS (PLWHA) in New York State. NY Links uses a regional approach, utilizing the learning collaborative model, to fortify the links holding together communities of practice, and the links grounding them in the communities of consumers they serve. http://www.newyorklinks.org/ Nassau Queens PPS Executive Summary page 9

DEMOGRAPHICS i Nassau County Community Profile Nassau County s Total Population is 1,350,601. Residents of Nassau County have a median age of 41.3, and 22.0% are 60 years or older. 63.7% of the population is White; 10.8% is Black, 15.4% Hispanic, 1.3% Multi-Race and 8.8% Other Races. 21.5% of residents are foreign-born; 50.2% (146,002) of foreign-born residents were born in Latin America, 30.2% (87,919) in Asia, and 16.5% (48,102) in Europe. 72% of residents speak only English at home; 12.6% speak Spanish at home, 10.0% speak other Indo-European languages, and 4.3% speak an Asian or Pacific Islander language. ECONOMIC INDICATORS ii Indicator Nassau County NY Statewide Rate Median Household Income $98,401 $58,687 % living at less than 100% of Federal Poverty Level 6.3% 16.0% Unemployment Rate 7.1% 8.9% % receiving Medicaid / means-tested Public Coverage 10.1% 22.5% % Uninsured 8.4% 10.6% HIV/AIDS IN NASSAU COUNTY New HIV Infections: Between 2011 and 2013, the average annual number of new HIV diagnoses in Nassau County was 124.0 per year. Annual HIV incidence is 9.2 per 100,000 residents. PLWHA: As of December 31, 2013, there were 2,987 people living with HIV/AIDS in Nassau County. HIV prevalence rate is 220.9 per 100,000 residents. (New York State s overall prevalence rate is 666.9 per 100,000 residents.) Deaths: Between 2011 and 2013, the average annual number of deaths among PLWHA was 42.0. HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses % # of PLWHA Nassau County page 1 % # Deaths among PLWHA Total 124.0 100.0% 2987 100.0% 42.0 100.0% Sex at Birth Male 92.7 74.8% 2008 67.2% 26.0 61.9% Female 31.3 25.2% 979 32.8% 16.0 38.1% Age 12 and under 0.3 0.2% 4 0.1% 0.0 0.0% 13-19 4.3 3.5% 31 1.0% 0.0 0.0% 20-24 17.3 14.0% 82 2.7% 0.3 0.7% 25-29 15.3 12.3% 170 5.7% 0.7 1.7% 30-39 28.3 22.8% 398 13.3% 3.3 7.9% 40-49 26.3 21.2% 788 26.4% 10.7 25.5% 50-59 22.3 18.0% 983 32.9% 11.3 26.9% 60+ 9.7 7.8% 530 17.7% 15.7 37.4% %

HIV/AIDS Hospitalization Costs iv In 2014, a total of $14,596,066 in costs were incurred by 144 patients admitted for HIV with Major and Multiple Major Related Conditions. 63 patients were treated for HIV with Major Related Conditions, accounting for $3,585,707 in hospitalization costs. 81 patients were treated for HIV with Multiple Major Related Conditions, at a total cost of $11,010,359. HIV/AIDS Disparities In Nassau County, HIV and AIDS disproportionately impacts non-white individuals, especially those identifying as Black (not Hispanic), Multi-Race (not Hispanic), and Hispanic (of any race). Over 70% of PLWHA in the county are non-white, despite non-white residents representing only 36.3% of the total County population. From 2011 through 2013, 61.8% of males newly diagnosed with HIV indicated a transmission risk of men who have sex with men (MSM); almost 30% indicated unknown transmission risk. Of females newly diagnosed during these three years, 96% as well as 83% of all female PLWHA - had a transmission risk of heterosexual or presumed heterosexual contact. HIV/AIDS Incidence and Prevalence by Transmission Risk v HIV Diagnoses (2011-13 Annual Average) Living HIV and AIDS Cases (December 2013) Transmission Risk Group Males Total 92.7 100.0% 2008 100.0% MSM 57.3 61.8% 973 48.5% IDU 2.7 2.9% 247 12.3% MSM/IDU 2.7 2.9% 86 4.3% Heterosexual 4.7 5.1% 161 8.0% Blood Products 0.0 0.0% 9 0.4% Pediatric Risk 0.0 0.0% 37 1.8% Unknown 27.3 29.4% 495 24.7% Nassau County page 2

HIV Diagnoses (2011-13 Annual Average) Living HIV and AIDS Cases (December 2013) Transmission Risk Group Females Total 31.3 100.0% 979 100.0% IDU 1.0 3.2% 124 12.7% Heterosexual Contact 10.7 34.2% 426 43.5% Female Presumed Heterosexual Contact 19.3 61.7% 385 39.3% Blood Products 0.0 0.0% 8 0.8% Pediatric Risk 0.3 1.0% 36 3.7% Unknown 0.0 0.0% 0 0.0% HIV/AIDS RISK FACTORS Substance Use Among adults, 13.1% of adults smoke cigarettes, lower than the New York State-wide rate of 15.9% of adults. The percentage of adults in Nassau County who report binge drinking in the past month is 13.2%, lower than the statewide rate of 17.7%. vi In 2014, Drug/Alcohol-Related hospitalizations in Nassau County had a total cost of over $96.5 million for 3,294 patients admitted for 20,498 total days. The largest proportion of hospitalization costs was $37.2 million for 1,158 patients admitted for Alcohol Abuse and Dependency, followed by $23 million for 287 patients admitted for Drug / Alcohol Dependence with Rehab Stay with average length of stay of 25 days. vii Mental Health In 2014, the age-adjusted percentage of adults who reported poor mental health for 14 or more days in the past month is 8.0% - lower than the statewide rate of 11.1%. viii Hospitalizations due to mood disorders and schizophrenia or other psychotic disorders accounted for 4,220 patients, 73,363 hospital days, and over $281.3 million in costs in 2014. In addition, 722 patients were admitted for an other mental health disorder, for a total 7,014 days and cost of $35.3 million. ix Nassau County page 3

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REFERENCES i U.S. Census Bureau, 2010-2014 American Community Survey 5-Year Estimates. ii U.S. Census Bureau, 2010-2014 American Community Survey 5-Year Estimates. iii New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December 2013. Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August 2015. iv New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December 2013. Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August 2015. vi 2013-2014 NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of 2015. https://www.health.ny.gov/statistics/chac/general/g110.htm; https://www.health.ny.gov/statistics/chac/general/g108.htm. vii New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. viii 2013-2014 NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of 2015. https://www.health.ny.gov/statistics/chac/general/g106.htm ix New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. Nassau County page 5

DEMOGRAPHICS i Queens County Community Profile Queens County s Total Population is 2,280,602. Residents of Queens County have a median age of 37.5, and 18.6% are 60 or older. 26.5% of the population is White, 17.5% is Black, 27.8% Hispanic, 2.2% Multi-Race, and 25.9% Other Races. 47.8% of residents are foreign-born. (521,527) born in Latin America (including 176,642 in Caribbean, 99,052 in Central America, 245,833 in South America - 77,824 from Guyana alone). (410,519) in Asia (including 33,387 in Philippines, 48,481 in India, 44,483 in Bangladesh); (24,632) born in Africa. 44% of residents speak only English at home; 23.9% speak Spanish at home. ECONOMIC INDICATORS ii Indicator Queens County NY Statewide Rate Median Household Income $57,210 $58,687 % living at less than 100% of Federal Poverty Level 15.3% 16.0% Unemployment Rate 9.5% 8.9% % receiving Medicaid / means-tested Public Coverage 26.4% 22.5% % Uninsured 17.1% 10.6% HIV/AIDS IN QUEENS COUNTY New HIV Infections: In 2014, the total number of new HIV diagnoses in Queens County was 464. Annual HIV incidence is 19.9 per 100,000 residents. (New York State s overall incidence rate is 19.1 per 100,000 residents.) PLWHA: As of December 31, 2014, there were 17,613 people living with HIV/AIDS (PLWHA) in Queens County. HIV prevalence rate is 772 per 100,000 residents. (New York State s overall prevalence rate is 666.9 per 100,000 residents.) Deaths: In 2014, the total number of deaths among PLWHA was 157. HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses (2014) % # of PLWHA (Dec 2014) % # Deaths among PLWHA (2014) Total 464 100.0% 17613 100.0% 157 100.0% Sex at Birth Male 395 85.1% 12934 73.4% 112 71.3% Female 69 14.9% 4679 26.6% 45 28.7% Age 12 and under 0 0.0% 22 0.1% 0 0.0% 13-19 16 3.4% 105 0.6% 0 0.0% 20-29 148 31.9% 1405 8.0% 6 3.8% 30-39 148 31.9% 2690 15.3% 10 6.4% 40-49 88 19.0% 4837 27.5% 30 19.1% % Queens County page 1

50-59 47 10.1% 5714 32.4% 49 31.2% 60+ 17 3.7% 2840 16.1% 62 39.5% HIV/AIDS Hospitalization Costs iv In 2014, a total of $30,475,894 in costs were incurred by 370 patients admitted for HIV with Major and Multiple Major Related Conditions. 186 patients were treated for HIV with Major Related Conditions, accounting for $7.2 million in hospitalization costs. 184 patients were treated for HIV with Multiple Major Related Conditions, at a cost of $23.3 million. HIV/AIDS Disparities In Queens County, HIV and AIDS disproportionately impacts Black (not Hispanic) individuals, who comprise the largest proportion of PLWHA in the county (40.5%) but only 17.5% of the county s total population. Also disproportionately impacted are people of Hispanic ethnicity (of any race), who represent nearly 38% of PLWHA and 28% of the county population. The least impacted demographic is Other Races (not Hispanic), which only comprise 5.2% of PLWHA but represent 26% of residents. Of the 395 males newly diagnosed with HIV in 2014, 80.3% identified their transmission risk as men who have sex with men (MSM); 5.3% identified transmission as heterosexual; and, 1.8% indicated transmission by injection drug use (IDU) or MSM / IDU. Of the 69 females newly diagnosed in 2014, 75.4% indicated a transmission risk of heterosexual contact; 2.9% indicated transmission by IDU; and, 21.7% indicated unknown transmission risk. Of all PLWHA in the county, 14.6% (2,586 individuals) indicated transmission by IDU or MSM/IDU. HIV/AIDS Incidence and Prevalence by Transmission Risk v HIV Diagnoses (2014) Living HIV and AIDS Cases (December 2014) Transmission Risk Group Males Total 395 100.0% 12934 100.0% MSM 317 80.3% 6665 51.5% IDU 3 0.8% 1565 12.1% MSM/IDU 4 1.0% 354 2.7% Queens County page 2

HIV Diagnoses (2014) Living HIV and AIDS Cases (December 2014) Heterosexual 21 5.3% 1151 8.9% Other 0 0.0% 22 0.2% Perinatal Risk 0 0.0% 180 1.4% Unknown 50 12.7% 2997 23.2% Transmission Risk Group Females Total 69 100.0% 4679 100.0% IDU 2 2.9% 667 14.3% Heterosexual Contact 52 75.4% 2719 58.1% Other Risk 0 0.0% 19 0.4% Perinatal 0 0.0% 170 3.6% Unknown 15 21.7% 1104 23.6% HIV/AIDS RISK FACTORS Substance Use County-wide, 13.0% of adults smoke cigarettes, less than the New York State-wide rate of 15.9% of adults. The percentage of adults in Queens County who report binge drinking in the past month is 15.0%, less than the statewide rate of 17.7%. vi In 2014, Drug/Alcohol-Related hospitalizations in Queens County had a total cost of over $85.1 million for 4,127 patients admitted for 19,524 total days. o The largest proportion of hospitalization costs was for 2,335 patients admitted for Alcohol Abuse and Dependency, which accounted for 12,877 hospital days and over $60.5 million in costs. o o o o o Opioid Abuse and Dependence incurred $8.2 million for 498 patients and 2,439 days. Cocaine Abuse and Dependence accounted for $4.2 million in costs for 271 patients and 1,193 hospital days. Other Drug Abuse and Dependence totaled $2.49 million for 115 patients and 606 days. Drug/Alcohol Dependence with Rehab Stay incurred $142,226 in costs for only five patients with an average length of stay of 5 days (23 total hospital days). An additional $9.5 million was attributed to Drug/Alcohol Abuse and Dependence, Patient Left Against Medical Advice for 903 patients and 2,386 days. vii Queens County page 3

Mental Health In 2014, the age-adjusted percentage of adults in Queens County who reported poor mental health for 14 or more days in the past month was 8.9% lower than the statewide rate of 11.1%. viii Mental Health-Related Hospitalizations in Queens County had a total cost of over $625.4 million for 12,007 patients admitted for 187,443 hospital days in 2014. o Mood disorders (5,477 patients) accounted for 66,053 days and $248.6 million in costs. o Schizophrenia or other psychotic disorders (5,575 patients) accounted for 111,334 o days and $342.0 million in costs. In addition, 955 patients were admitted for an other mental health disorder, for a total 10,056 days and cost of $34.8 million. ix REFERENCES i U.S. Census Bureau, 2010-2014 American Community Survey 5-Year Estimates. ii U.S. Census Bureau, 2010-2014 American Community Survey 5-Year Estimates. iii New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program. Accessed July 2016 at http://www.nyc.gov/html/doh/html/data/hivtables.shtml. iv New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York City HIV/AIDS Annual Surveillance Statistics for 2014 (documents cases diagnosed through December 2014). New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program. Accessed July 2016 at http://www.nyc.gov/html/doh/html/data/hivtables.shtml. Queens County page 4

vi 2013-2014 NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of 2015. https://www.health.ny.gov/statistics/chac/general/g110.htm; https://www.health.ny.gov/statistics/chac/general/g108.htm. vii New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. viii 2013-2014 NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of 2015. https://www.health.ny.gov/statistics/chac/general/g106.htm ix New York State Department of Health, Statewide Planning and Research Cooperative System (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. Queens County page 5