Sean T. Granahan, President & General Counsel of The Floating Hospital, on 160 Years of Care and Community

[MUSIC] We're back with another episode of Schnitz-Kenecks. And again, I want to remind everybody, please become a part of Schnitz-Kenecks, not just by listening to the podcast, but by attending monthly business networking events that we're hosting out on Long Island. And each event has a really a keynote conversation with an amazing industry leader. So check out Schnitz-Kenecks.com, sign up to attend one of our events, and hopefully learn more about everything that we do. And certainly, if you're listening to this podcast, you know that we're on all podcasts, platforms, and our own website, podcast.napsmedia.com. We're going to delve into healthcare today, and I'm really happy to be joined by Sean T. Grana-Han, who's the President and General Counsel of the Floating Hospital. The Floating Hospital was founded in 1866. They provide a tremendous number of services, including medical, dental, behavioral healthcare, critical support services, all different types of programs and resources for families and individuals indeed. Sean leads one of New York City's largest providers of charity healthcare. So those families could be homeless shelters, living in homeless shelters, or domestic violence, abuse victims, living in safe houses. Since joining the organization in 2003, he's helped transform it from near bankruptcy. Into a thriving operation, growing its budget more than fourfold, and significantly expanding its reach and impact across the city. With a background healthcare policy, law and operations, Sean oversees a team approximately 200 clinical financial and ministry of staff, managing everything from day to day operations to legal affairs and strategic growth. Prior to his current role, he worked at Epstein Becker in Green, where he handled major litigation and advised healthcare clients on complex regulatory matters. So Sean, I'm happy to have you here, and I'm really happy that you're going to share everything that the floating hospital does. Great, thank you, and I appreciate being here. And we have to make clear the floating hospital is no longer floating. We are solid ground. Is that right? That is correct. We are no longer floating. We're fully land-based. We became focused on our land-based services after 9/11. 9/11 was the last day that we maintained ship operations. We were down at the South Street Seaport, and when the towers fell, the debris went across the island. The South Street Seaport was used as a means of taking debris out and bringing new building materials in. So we lost our dock space. We went over to the Brooklyn Navy yards. We were there for a while. And then ultimately, my predecessor sold the Lila, which was the name of our barge. Today, she sits up in Kingston on the river, up in Kingston. And she's in pretty rough shape. But we've been up there a couple of times. We've spoken to the people that own it. And to see if there's any ideas about maybe bringing your back to life and bringing your on the water. So we're starting to have that conversation. So talk a little bit about what got you involved in this role. I mean, obviously, it sounds like your corporate attorney definitely good to be an attorney with an organization. As attorneys are expensive. So anytime you could probably handle the matters yourself, the better. And imagine it's a real ship, though, right? Going from being a lawyer to running a nonprofit. Before I went to Epstein, Becker, and Green, I was in the trucking and warehousing business as an attorney for about four years, closer to five years. And in those roles, I was running departments. So I already had some management experience from doing that. And then when I was at the firm, we worked on the World Trade Center litigation, the two towers issue. We were representing the broker. And so I was working on covering for the broker, so to speak. And at that time, I had the floating hospital, myself and others actually, a few of us were advising the floating hospital as a lawyer. I knew the people over there. I had worked on like three or four different matters for them at this particular point. And then in speaking to them afterwards, I had a couple of conversations. I was ready to go back in house again. I had been at the firm about close to seven years at that point. I was ready to go back in house. And I frankly didn't know what I wanted to do. So I went to the floating hospital really just to kill the summer. And that was 23 years ago. So it was a very long summer. I love it. We talked about how the floating hospital literally went from that barge to being brick and mortar. But what was the original founding of the floating hospital? And going back all those years, what was it primarily serving or what was the foundation that got started? I think what's really genuinely unique about the floating hospital is the fact that it is actually doing the exact same thing it did in 1866. And it hasn't stopped in that entire time. It hasn't been purchased by anybody else. It's remained a small private charity hospital. And it's done consistently the same work, which is three legs of a stool. First is health care in whatever form it happens to be. In whatever decade you're talking about. The second is health education. So we were providing health education back in the 1860s, except then the health education was figuring out whether the milk you were purchasing was actually milk or was it chalk water or other types of fake milk or adulterated milk at the time. And then the third component has always been relief, which we continue to do. So we provide food, clothes, diapers, whatever families need when they walk in the door. We provide on top of the health education and on top of the medical services. So we've consistently done the same thing. We've actually even consistently kept the same general business model in the sense that back in 1866, we traveled from the docks over to the Tenement Houses, brought the families from the Tenement Houses over to the ship at services. And then today we send out a bunch of mini buses to all the family home shelters, all the domestic violence safe houses, and some of the families that are doubled up with families and friends. And we pick them up and we bring them to the clinic. I would put a caveat on there. We obviously don't go directly to the safe houses. In the case of safe houses, we don't want our drivers knowing where the safe houses are. So we have designated pickup spots with all the different safe houses. So they send the family someplace we go pick them up at that spot. I love to hear that you're able to go back to the original mission 160 years ago and say, still doing the work that we were doing before, maybe differently. But I love to hear that because how many organizations, whether nonprofit or for-profit, last that long, and can stay true to their mission, which is really important. So talk more about your services, because I really think the audience should understand the diversity of services that you provide. And where people go to get those services, as well as the kinds of people that you're servicing. I mean, you mentioned some of those home shelters and safe houses, but I think it's much broader than that. For us, the actual population is families. Are we focused and we specialize in families? We always look from a mission perspective for the families who are the poorest or have the greatest needs. And so for us in New York City today, that is homeless families. And so there's a difference between treating what they generally refer to as street homeless. So if you think of the single male or the single female, usually someone with some significant mental health issues. And there's generally some type of drug use or alcohol use involved, as well. When you think of that population, that is not us. We don't do that because you need an emergency room, frankly, to treat that group. And you need either a psych ward, like in a traditional hospital. We don't really do any of that work. Instead, we focus on homeless families. They're the largest component of the homeless population in New York City. There's over 100,000 homeless kids in the New York City school system. Wow. What do you think about it? Yeah, that's a huge issue. You said reality, yeah. Like I said, they live either in shelters. They live in hotels and motels. There's an even literally tens of thousands that live in the hotels and motels scattered around the city on the edge of the boroughs. So they live in food deserts, pharmacy deserts, store deserts. So our buses go. We pick them up. We bring them back to the main clinic. They can get food. They can get clothes. We have a pharmacy. So in terms of services, we provide primary medical care, behavioral health services, dental services. We cover infectious disease as well in podiatry. We actually spend a good portion of the time we have with the families, like health education classes for the kids. And we focus a lot on literacy because literacy is a big issue for a lot of homeless mothers. sure I could imagine when you see children what's kind of an age run. that you serve. Primarily zero to ten or just population of the kids. It's usually a young mother, two or three kids, and the mothers come from primarily three situations. One is eviction in a multiple family apartment. So usually I think of a grandmother that has a large public housing apartment and she have two of her daughters living with her, their children, occasional boyfriends coming in and out of that situation. And then one of the granddaughters gets pregnant and it's just one too many and so they'll find themselves evicted. So that's one big issue. The second is domestic violence. It's a huge driver in in the poor populations and it's a huge driver across the board in terms of women leaving homes and relationships. The third area which is maybe surprising is foster care. So foster care produces an enormous amount of homeless mothers. You know as young girls cycle out of foster care a lot of times they're you know they're basically left to their own devices and the best way to get cared for or to find shelter is to have a child. So the system sadly encourages pregnancy you know for the wrong reasons basically but it does. Interesting. Listen you're seeing it all first and I'm sure through the clinic. So talk about the clinic a little bit. You know in Long Island City you have really a lot of thought that went through the layout and design of the space but share a little bit more for people to understand what that Long Island City clinic offers and is all about. Sure so after 9/11 we moved our main site to East Broadway in Manhattan and we stayed there for a while ultimately though we needed to find ourselves a new home. The Long Island City where we are it's this 1-1-1-1 zip code. It was a medically underserved area we were able to get the designation from the federal government and they agreed to kick in and treat it as a new site and so does that give you extra funding? It does it gives us a better Medicaid rate gives us some base funding to help offset some salaries with we got some money from the federal government and more importantly it gives us free-mount practice insurance kind of. So that designation really helped us the medically underserved area designation was very helpful and so we opened up in 2004 right on Queens Plaza North where the subway for the QNRW attaches to the building. A Greek family owned it and we were there from 2004 until 2020. Probably about in 2018 or 19 we started looking for a new space and we pulled together the funding and we renovated three floors directly across the street from Queens Bridge on 41st and 21st on the corner there right above the F train. Yes and so we renovated three full floors it gave us double the square footage we had before and it was one of those things that was really an adventure in terms of trying to build during COVID because the the governor had placed a moratorium on most construction projects except hospitals. The problem is the Department of Buildings really didn't know this and so you know we had to keep going back to the Department of Buildings and they would close us on Monday we would go back on Tuesday and we would have to sign Friday they'd close us the following Monday because we you know it was always different inspectors you know that was a bit of an adventure and dragged on a little bit of the construction but it all we made it happen. Exactly and it's three floors of large open spaces lots of windows it's bright it's designed it's kid friendly and the health education component straddles the waiting rooms so that the families can go in and out of the health education world and they can do everything from learning how to cook to you know getting clothes to teaching kids the best foods to eat and how to be concerned about predators and other things so it's a lot mistaken I think you're right across from the Lord as nature development in the country. We are North America believe it or not. Yeah the combined Queensborough and Woodhouses is the largest in North America. So I mean you must be a blessing to the people living there because it's a tremendous community there and they build a health care in their backyard is certainly something that they needed. Sure and we're one of the few federally qualified health center NYCHA tenants so we have a small satellite office directly in the NYCHA housing as well. I didn't realize that. Yeah so we can send patients back and forth for either dental services or other services that we can't see in the satellite. So you mentioned you qualified for that federal funding but I have to imagine all nonprofits are fighting for every penny they can. So where else are you getting funding from and are there ways that people can make donations as well? Sure so the most difficult thing for us is covering the broad extent of services that we provide that aren't reimbursable. So health education the transportation service none of that is billable to Medicaid none of it is government funded and so we have to fundraise for it we have to do it the whole fashion way and pass the hat. The other issue for us is that moms with kids routinely fall out of Medicaid and so in those periods when they have to recertify and they don't have what they need to recertify and they fall out we still have to see the kids because it's part of our charity mission so for every family that walks in the door I should say for every four families that walk in the door one of those families will not have any insurance at all. So you serve a quarter of people don't have insurance. Yeah so I end to put that in perspective the average nonprofit hospital provides about one to one and a half percent charity rate the flow has a 25 percent charity rate. So how are you making that up? How are you able to afford that? Has to have. Yeah so it's really so you're very much we're very focused on donations and focused on fundraising. It's a third of what we do. Wow. Yeah. So what are some of those major fundraising initiatives? I have to imagine also you have to be doing something big around your 160th anniversary. Sure. So on June 2nd we're having our 160th birthday party. It's our annual gala. We have it at the hotel Edison Duke Ellington's grandson has been a friend of ours for the last 10-15 years. So he comes and he plays with a big 10-piece jazz orchestra for the night and we don't really do the unarie thing. We usually make it a short sweet program and we show video of our work and then you know we ask for money which is what you do at these events. Don't ask you don't get. You don't ask you don't get exactly exactly. And then we have an annual appeal you know we have the basics that all nonprofits have to do but we also have a very strong volunteer core. And you know volunteers are generally donors and there's a lot for volunteers to do in our organization and so that helps us generate you know people who want to help out. That's great. I'm glad you have listened. Sometimes it's a blessing and it's a curse when you need to raise private funds but at least you know creates an opportunity for you to develop relationships with people that want to give and that you're not solely relying on you know federal money or even you know state and then city funds because sometimes those can disappear too. Absolutely. Has there been any impact on federal funds for you since? It hasn't happened yet and it's one of those kind of storm clouds that are threatening. There have been several of the executive orders have the potential to impact us. Some aspects of the big beautiful bill may impact us. There are a lot of lawsuits going on and at the moment that does just hasn't settled yet. Listen as long as you're continuing to get your money. That's good news. So as long as it keeps you know keeping us moving right that's the important thing. Well listen you deserve every penny you're getting you're serving a community that desperately needs those services and you know so glad you could share your mission and the work that you're doing and hopefully somebody listening here will be able to give. That would be great. We would appreciate it. It was a pleasure talking to you. I'm looking forward to my tour. Wonderful. You know. Good to get to see the space myself because it's really you know it's really important and it's always it makes people happy. I have to say it's it always makes people happy to come see us. Well thank you again for your time. It was a pleasure to hear more about the hospital and thanks for having me. I appreciate it. My pleasure. Thanks. Bye-bye.