Partnerships for Healthy Communities

Transcription

1 CONFERENCE OF BOSTON TEACHING HOSPITALS Partnerships for Healthy Communities Community Benefits Report

2 Conference of Boston Teaching Hospitals Members Beth Israel Deaconess Medical Center Boston Children s Hospital Boston Medical Center Brigham and Women s Faulkner Hospital Brigham and Women s Hospital Cambridge Health Alliance Dana-Farber Cancer Institute Lahey Hospital & Medical Center Massachusetts Eye and Ear Massachusetts General Hospital Steward Carney Hospital Steward St. Elizabeth s Medical Center Tufts Medical Center

3 PARTNERSHIPS FOR HEALTHY COMMUNITIES From Boston s very beginning, healthcare was viewed as a right to be provided to all citizens. Paul Revere, the city s first health commissioner, developed a program whereby Boston residents with financial means could purchase healthcare tokens for the underprivileged at the same time that they purchased tokens for their own families. While greater Boston s teaching hospitals have worldrenowned reputations and attract patients from around the world, their roots are grounded in public service to communities in and around Boston. In 2015, COBTH member hospitals partnered with more than 400 agencies and provided more than $140M to develop and support innovative programs aimed at serving those in need. The programs described in this report and dozens of others like them are designed to meet well identified and specific community needs that, without hospital support, would likely require public funding or simply go unmet. These programs illustrate the ongoing commitment of COBTH hospitals as they fulfill their mission of community service every day, going beyond the delivery of quality core health care services to ensure healthier children and families, a safer environment, earlier detection of disease and enhanced access to basic health care services. These programs are more than just statistics and numbers; they represent neighborhoods, parents, children, recent immigrants, the homeless, and those with nowhere else to turn. COBTH hospitals work with local public and private agencies to assess the needs of communities and partner to develop, implement, support and manage dozens of community benefit programs that have a real impact on people s lives. Highlighting support groups, free clinics, programs for the elderly and immigrants, and outreach to reduce disparities in healthcare, this report highlights how some of the COBTH hospital community benefit programs have touched the lives of the less fortunate while helping to build healthier communities. 1

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5 RESOURCES This report quantifies the community benefit contributions of COBTH member hospitals based on the Massachusetts Attorney General s Community Benefits Guidelines for Non- Profit Acute Care Hospitals, as well as community service and net charity reported to the Attorney General s office for hospitals FY2015. A COMMUNITY INVESTMENT COBTH hospitals provided more than $141M in direct community benefit funding, partnering with more than 400 agencies to develop and deliver programs. Community benefit programs are those developed with community representatives or a community health needs assessment that serves that target population identified in a hospitals Community Benefits Plan. More than $3M was provided by COBTH hospitals to community service programs, which are programs or initiatives that advance the health care or social needs of Massachusetts communities, but is not related to the priorities identified in the hospital s formal Community Benefits Plan. COBTH hospitals provided more than $123M in net charity care to Massachusetts citizens in FY15. In addition to community benefit activities, COBTH hospitals support research, medical education and community building activities and are among the largest employers in the area employing more than 66,000 full time employees and attracting more than $1.2B in federal research funds. Our Commitment to the Community COMMUNITY BENEFITS Direct Expenditures Determination of Need Employee Volunteerism Other Leveraged Resources Total Community Benefit Community Service Expenditures Net Charity Care Provided Total Resources $ 141,230,539 $ 2,214,201 $ 107,303 $ 35,943,601 $ 179,495,643 $ 3,372,070 $123,327,946 $306,195,659 *As reported by hospitals on FY15 reports to Attorney General. Does not include Boston Medical Center and Cambridge Health Alliance. 3

6 Beth Israel Deaconess Medical Center In Teaching Wellness, Train4Change Teaches to Give Back In the heart of Dorchester s Bowdoin-Geneva neighborhood, the 4,100 square foot Wellness Center at Bowdoin Street Health Center has a fully stocked test kitchen, beautiful exercise space and exciting opportunities for residents. After opening its new facility in June of last year, the Wellness Center expanded resources to strengthen community cohesion while at the same time helping individuals improve in many ways: from exercise and cooking classes, to programs focused on skills training and employment opportunities. Train4Change is an innovative workforce development program, which has proven to be a wonderful example of how wellness activities can be successfully integrated with primary care services, says Jen French, Program Administrator for the Wellness Center at Bowdoin. Even in the early stages of the program s onset, it was evident that participants were not only passionate about improving their own health and wellbeing, but also cared deeply about passing on their knowledge to fellow patients and community members. First piloted by Tufts School of Medicine, Bowdoin Street partnered with BIDMC s Community Benefits Program to fund Train4Change. Blending wellness and workforce development, the Train4Change program helps people become certified exercise instructors, increasing job and economic opportunities, while simultaneously educating them about the importance of exercise and nutrition. Once certified, instructors can go on to teach group fitness classes at the Wellness Center and other community locations. The new certification positions participants not only for sustainable jobs, but to become leaders in their community, build wellness and teach friends and neighbors the tools and benefits of healthier lifestyles. Dunia Goncalvez, lifelong Boston resident and mother of one, is among the first of four graduates of Train4Change at Bowdoin Street. She has already started teaching group exercise classes for kids and adults. It is all about health, fitness and helping the community, Dunia says. The Wellness Center programs let people know how to exercise and what they should and shouldn t be eating. That s so important. French says seeing Dunia leading a class has inspired others to follow. It has been exciting to see the program come fullcircle, with patients in these classes expressing interest in enrolling to become fitness instructors themselves! 4

7 Boston Children s Hospital Reaching Children Where They Live and Learn Research shows that adverse childhood experiences can have a long-term negative impact on a child s academic achievement, school attendance and lifelong physical health. To help promote the healthy development of children, Boston Children s Hospital s Department of Psychiatry has placed social workers, psychologists and psychiatrists in schools and community health centers in Boston neighborhoods for the past 13 years. Through the Children s Hospital Neighborhood Partnerships Program (CHNP), this team provides an array of behavioral health services to children and adolescents where they live and learn. School-based efforts are in partnership with 12 schools in the Boston neighborhoods of Jamaica Plain, West Roxbury, Dorchester, Mattapan, and Roslindale. Clinicians provide clinical, early intervention, prevention and promotion services directly to students and support staff and teachers with behavioral health training and consultation. Psychiatrists provide care and treatment to children and families at four community health center sites. CHNP has launched the Training and Access Project, which aims to build the capacity of schools by providing indepth training and consultation in social, emotional, and behavioral health to school professionals in 20 additional schools over the next four years. This comprehensive program is reaching more than 1,350 children and youth and over 250 teachers and parents annually. CHNP not only improves access to care for children and youth, it s also promoting change in behavioral health service delivery. The team has a close partnership with the Boston Public Schools and has helped to develop a model to identify and address the behavioral health concerns of students across the district. Additionally, 5

8 Boston Medical Center Preventive Food Pantry and Demonstration Kitchen at BMC The Preventive Food Pantry and Demonstration Kitchen address hunger-related illness and malnutrition among a low-income, largely underserved and vulnerable patient population. Individuals at risk for malnutrition are referred to the program by Boston Medical Center or Boston HealthNet community health center physicians or nutritionists who provide prescriptions for supplemental food that best promotes physical health, prevents future illness, and facilitates recovery. completed in Spring of For the Pantry, this will nearly double the storage space available, improve client access, and improve the waiting room facility. In addition, the relocation and expansion of the Demonstration Kitchen space will enable it to serve a magnet to patients and providers, making them more aware of these services and creating a welcoming and active atmosphere for patients. The Food Pantry now provides nutritional food prescriptions to approximately 7,000 people each month, and continues to see a great number of new clients and families. The Pantry served over 80,000 people in Fiscal Year 2015; of these numbers, over 900 were new families and over 2,800 new individual clients were served. The Pantry continues to distribute approximately 12,000 pounds of food per week. The Demonstration Kitchen complements the work of the Food Pantry by educating patients about nutrition through cooking methods that are compatible with their medical and dietary needs, as prescribed by their physicians. During Fiscal Year 2015, the Demonstration Kitchen s community-wide impact grew exponentially, conducting 167 classes for 1,432 participants. In response to the tremendous need for these services, the Pantry and Kitchen are currently undergoing expansion, to be 6

9 Brigham and Women s Faulkner Hospital Feeding Families in Jamaica Plain and Beyond In many of Boston s neighborhoods, fresh, healthy foods are not available in local markets or the residents in the area lack the financial resources to afford them. This is what is known as food insecurity. At Brigham and Women s Faulkner Hospital (BWFH), the Community Health and Wellness Department is reaching out to residents of Jamaica Plain and beyond to tackle food insecurity through two unique programs. BWFH s Community Health and Wellness Department has long partnered with the Joseph P. Manning Elementary School to bring health education to students in the community. In 2015, 25 students were identified as food insecure. Now, in collaboration with the Fresh Truck, these students receive a bag of fresh food each Friday so that the students and their families can eat healthy over the weekend. The program has been such a success that BWFH is partnering with Boston Public Schools to expand the program to other schools within the system. There are also plans to offer the program to the students at Joseph P. Manning Elementary School over the summer and during school vacations. Another program sponsored by BWFH s Community Health and Wellness Department aims to make resources for finding fresh food available to residents in neighborhoods throughout Boston. Currently, food resource boxes have been placed in the Emergency Department and other areas within the hospital. The boxes contain information on food pantries and other free food options by zip code. Information is available in English and Spanish. In the near future, boxes will be placed in primary care offices within the hospital and surrounding communities. Each Friday, the Fresh Truck delivers enough produce for the weekend to food insecure students at the Joseph P. Manning Elementary School. Food resource boxes are labeled with two questions to determine food insecurity. 7

10 Brigham and Women s Hospital A Pathway of Opportunity Justyn Owens is one extraordinary example of how Brigham and Women s Hospital s (BWH) programs have fostered success in Boston s youth. Owens, now a high school senior, has been involved with BWH s Center for Community Health and Health Equity (CCHHE) youth programs since second grade, beginning in the Pen Pal program, which improves elementary school students literacy skills by a letter exchange with BWH employees. CCHHE offers 8 programs for youth from preschool to high school and college providing a pathway of opportunity for young people in Boston. Annually, over 520 students participate, with more than 300 BWH staff volunteers. The programs are designed to build upon one another to inspire and excite students about their education and future career options. Today, Owens is approaching his high school graduation and attributes much of his success to the mentoring and wide range of experiences these programs have granted him. Reflecting on his experiences, Owens is unequivocal and shares If I could, I would definitely go back and do it again. I ve loved my experience at the Brigham. I wouldn t change it for the world. It was definitely one of the best experiences and choices of my life. The CCHHE youth programs have had a major impact on Owens transition through adolescence and, as he notes they helped him come out of his shell. He continued on his journey with his involvement through Project TEACH and the Student Success Jobs Program where he worked in various positions throughout the hospital, including the Central Transport Department and the Center for Women and Newborns. Justyn confidently shares he knows the innards and outtards of the hospital. This is an incredible statement for a high school student, but Justyn has spent eleven years partnered with BWH. 8

11 Cambridge Health Alliance Engaging Muslim Immigrants When I see the CHA banner written in Arabic with women wearing hijabs, It makes me feel so good like people really care about us - Houria C., Sawa member CHA s Department of Community Health Improvement has taken the well-being of Muslim immigrants to the forefront via a robust collaboration among CHA employees, faith leaders, community members and a large team of CHA volunteers known as Sawa (Sawa is the Arabic word for together). Sawa s diverse cadre of well-trained volunteers is made up of nearly two dozen Muslim and non-muslim community members dedicated to reducing barriers to health by facilitating access to health insurance, primary care, and needed services. These CHA volunteers provide free health screenings (glucose, cholesterol, blood pressure, bone density) and present educational messages at area mosques and in neighborhoods with large numbers of Muslims. Availability of specially designed patient gowns at CHA which offer women greater modesty during medical visits and hospital stays Our Cambridge Health Department partnered with faith-leaders at the Islamic Society of Boston to offer flu shots at the Cambridge mosque. Collaboration with the CHA Pharmacy to develop informational materials for community members about the availability of pork-free insulin and alcohol-free asthma inhalers. Host and presenters at the Greater Boston Muslim Symposium held in April Sawa was established in January 2014 and took on an advisory role at CHA to address healthcare challenges. The resulting initiatives spearheaded by Sawa include: Development and delivery of Caring For our Muslim Patients seminars attended by over 200 CHA medical providers and staff. 9

12 Dana-Farber Cancer Institute Saving Lives Through Education and Vaccines While HPV-related cancer rates are on the rise, HPV vaccination rates are well below the Healthy People 2020 goal of 80 percent, at roughly 50 percent for girls and 25 percent for boys in Massachusetts in Along with 69 other NCI-designated cancer institutes, Dana-Farber is calling for increased vaccination to prevent cervical, head and neck, and genital cancers that are caused by the virus. In January 2016, DFCI launched a groundbreaking mobile HPV vaccination program in partnership with the Boston Public Health Commission s School-Based Health Centers at two high schools in Hyde Park by providing education and vaccines for free. DFCI community outreach staff lead workshops for students and parents about the safety and effectiveness of the HPV vaccine in preventing cancer. Dana-Farber nurses and staff then administered the vaccine to students aboard the Blum Family Resource Center Van. The program mitigated the most common barriers to HPV vaccination; inconvenience, cost, and lack of information. Students were able to complete the 3 dose series and an even number of boys and girls received the vaccine. In the fall of 2016 the mobile HPV vaccine program will expand to other BPS high schools. 10

13 Lahey Hospital & Medical Center Promoting Wellness and Empowering Families One Meal at a Time Four in ten families in the city of Lowell do not have access to fresh produce in their neighborhood. In an effort to increase access to healthy foods and nutritional education, Lahey Health has partnered with Mill City Grows a nonprofit working to improve health, economic independence and environmental sustainability on an initiative to promote wellness in Lowell. The partnership began in 2014 with a free eight-week farmers market for families at the Robinson and McAuliffe schools, and has grown to include a mobile market and the farm-to-table family cooking class. The cooking classes are offered in partnership with the Lowell Public Schools system s Out of School Time program. Families commit to attending the full series of five classes, which include cooking instruction, a shared meal and fresh ingredients to take home for cooking and eating. The classes empower families beyond the classroom with new information and skills. In total, 10 families come together to learn how to make healthy, easy-to-prepare meals and how to make it a group activity. It s not just a class for adults on how to cook for your family, said Francey Slater, Co-Director of Mill City Grows. It s how to cook with your family. The partnership demonstrates the organizations shared values, and a focus on delivering local, healthy, culturally appropriate food for all residents regardless of neighborhood, race/ethnicity, or socioeconomic status. Participant Dave Steward told the Boston Herald that his family learned to incorporate new vegetables into their meals during the cooking course. They (the kids) were willing to try out the new vegetables because they were a part of the process, he told the Herald. 11

14 Massachusetts Eye and Ear Making a Difference at Neighborhood House Charter School When Mass. Eye and Ear was founded in 1824 by eye surgeons John Jeffries and Edward Reynolds, the mission of the Boston Eye Infirmary as the hospital was first known was to alleviate the suffering of less fortunate brethren. Despite the hospital s growth in size and reputation in the past 192 years, Mass. Eye and Ear continues to take great pride in serving all Boston residents. One of Mass. Eye and Ear s enduring community partnerships is with the Neighborhood House Charter School, which is perched atop Pope s Hill in Dorchester, a residential neighborhood dotted with triple-decker homes. At a typical vision screening, for example, the whole team pitches in to conduct the initial visual acuity tests (i.e. reading charts), but then the team s physicians administer the stereo, depth-perception, binocularity and eyealignment tests. Students who need more attention are referred to their own physicians or to Mass. Eye and Ear for follow-up care. Working with the Neighborhood House students was very inspiring for me, said Erin McAvoy, Mass. Eye and Ear, Longwood s Ophthalmology Practice Manager. Helping people is what motivates me to go to work every day, so offering vision care to students who might not have access makes me feel as if I might be making a small difference in their lives. Working closely with school nurse Mary McNulty-Anglin, Mass. Eye and Ear pediatric physicians, nurses, technicians and other staff members have gathered twice a year for the past 20 years to administer free vision and hearing screenings for the students, who range in age from about four to 12 years old. Mass. Eye and Ear has screened approximately 4,000 Neighborhood House Charter School students during the past two decades. Under the watchful eyes of McNulty-Anglin, a number of teachers and volunteer parents are charged with maintaining order among the restless children waiting in line, allowing the screenings to proceed smoothly. 12

15 Massachusetts General Hospital Substance Use Disorders: A Coordinated Comprehensive Ongoing Approach to Care At Massachusetts General Hospital we are undertaking a comprehensive new approach to caring for patients with substance use disorders, building on more than 20 years of community prevention and early intervention work of the MGH Center for Community Health Improvement. Substance use is the number one priority identified by communities in our most recent community health needs assessments. The hospital made improvements to care for MGH patients with substance use disorders a key priority in its overall strategic plan. The plan addresses this chronic disease through an evidence-based system of care that starts with community-based prevention and then builds strong connection and linkages among inpatient, outpatient and community-based services throughout Greater Boston, improving access to treatment, smoothing transition among care levels and reducing relapse and readmissions. This will improve the quality of patient care and reduce health care costs. barriers to treatment and serve as navigators; enhanced substance use disorder treatment within MGH health centers; a discharge clinic to deliver post-hospitalization addiction treatment and stabilization; and strengthened partnerships with community treatment providers already delivering effective care. The new model shifts from treating only the acute medical complications of substance use to addressing the underlying cause addiction. This chronic disease management approach is similar to managing other chronic diseases such as diabetes and hypertension. Key components include a dedicated multidisciplinary and multispecialty inpatient addiction medicine consult team; community-based recovery coaches who serve as addiction-focused community health workers to remove 13

16 Steward Carney Hospital Healthy Cooking Club with the Dorchester YMCA As a community hospital, partnerships with local, allied agencies and civic organizations remain at the core of Carney Hospital s community benefits programs. Over the course of the year, the hospital teamed with local schools, churches, neighborhood associations and community development groups to provide health education, preventative screenings and other public health services. The Dorchester YMCA has been a key community partner of Carney Hospital s for the past several years. Home to more than 5,000 members and hundreds of children participating in after school and summer camp programs, the Dorchester Y is located in the heart of the hospital s service area. the Ashmont/Peabody Square Farmers Market on Friday s to shop for fresh fruits, vegetables and other healthy foods for their recipes, introducing the children to new foods and encouraging them to explore different recipes. Campers then prepared recipes and tasted samples, which they discussed and rated. The campers displayed their new culinary skills during the final week of camp, preparing foods and sharing samples with delighted parents. In 2015, the hospital again teamed with the Y to provide farmers market vouchers to families, allowing neighborhood residents to purchase fresh produce at a discount from the many local farmers markets located in and around Dorchester. This summer, the program expanded to include the Y s summer camp Healthy Cooking Club. Twice a week, Y campers participated in an hour long class that provided them with the opportunity to research recipes, discuss healthy eating and learn about making good food choices. Using the farmers market vouchers, the campers visited 14

17 Steward St. Elizabeth s Medical Center A Support System is the Key to Reaching a Healthy Weight St. Elizabeth s continues to grow community partnership to broaden the reach in the community resulting in increased participation in health screenings, educational lectures and support groups. This past year, one of St. Elizabeth s focuses was to tackle the obesity crisis though support groups and lectures leading to healthy lifestyles that reduce their risk of diseases. Weight loss can significantly reduce obesity-related co-morbidities, such as type 2 diabetes, hypertension and sleep apnea, and thus prolong life spans. Nicole Pecquex, MD, director of the Bariatric Program at St. Elizabeth s, performed Ricardo s Roun-ex-y gastric bypass surgery and worked with him pre- and post-op. For many morbidly obese patients, reaching optimal weight is a hard-fought victory, possible only with the help of a team of specialists who provide support and coaching throughout a lifelong process, says Dr. Pecquex. St. Elizabeth s offers free monthly support groups for the pre- and post-operative weight loss patients. Support groups hold participants accountable for their actions as well as teach ways to live a healthier lifestyle. Ricardo, pictured here, is one of the many patients that have seen tremendous success from participating in the support group and bariatric surgery. Ricardo said, I was an unhealthy 350-pound man with lots of emotional and psychological issues, and the surgery gave me a new start, a fresh start on life. Today, 135 pounds lighter, I feel invincible. Once idle and relegated to the sidelines, Ricardo now rides bikes with his daughter, ran his first 5K and is feeling grateful for his new-found healthy and active lifestyle. 15

18 Tufts Medical Center Using Media for Health Education and Prevention Boston and Metropolitan Boston is home to many newcomers whose first language is not English and whose methods of information gathering and approach to preventative care may differ from mainstream standards. To help newcomers increase their health knowledge, encourage preventative care, and promote health screenings, early diagnosis and treatment, Tufts Medical Center s Asian Health Initiative collaborates with community-based organizations to reach out to their constituents through print and electronic media. Sampan is a bi-weekly, bilingual newspaper reaching the Chinatown and Greater Boston Chinese community and beyond through its on-line presence. Sampan produces a health page addressing a broad range of topics which has included information on western and traditional treatments for a number of diseases such as diabetes and obesity. The on-line version of the newspaper provides an avenue for feedback on articles and suggestions for other health topics. Asian Spectrum, a cable access program, has developed a series of in-depth broadcasts to help community members in Boston, Malden and Quincy, to understand mental health and diabetes. The series broadcasts are available on DVD, and will be accessible via YouTube and their website to expand the audience base. The next series in production will focus on breast cancer. 16

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20 COBTH Domestic Violence Council Sexual Assault: Historical Context & Current Trends Survivors, Advocates and Providers came to watch two films and hear from local experts in the field of sexual violence. The films were: Boys and Men Healing and UnSlut. Boys and Men Healing is a short film that highlights survivors who talk about the impact of being sexually assaulted and abused. Unslut focuses on bullying and labeling and the denigration, particularly of girls and young women which can lead to deadly consequences as teens get harassed 24/7 through social media without reprieve. Our speakers and panelists included: Veronica Ryback, LICSW, Private Practice & Consultation (Keynote Speaker); Hales Burton, LICSW, Fenway Health; Alison Safran, Surviving in Numbers; Steven Procopio, ACSW, LICSW, Trainer & Consultant and Sharon Imperato, LMHC, Boston Area Rape Crisis Center. The comments from the panelist were on point with active audience engagement which included dialogue and questions. The format provided relevant contemporary issues to be fleshed out while holding the historical context through the keynote speaker s comments at the head of the program. Sponsored by COBTH and the D.V. Council of COBTH, Beth Israel Deaconess Medical Center donated space and the speakers/panelists donated their time and talents. Many thanks to the survivors in the audience who participated in this event. 18

21 ABOUT COBTH The Conference of Boston Teaching Hospitals (COBTH) is an organization of thirteen Boston-area teaching hospitals that works to advance policies critical to the core mission of academic medicinal centers: medical education, biomedical research, patient care and serving vulnerable populations. Through COBTH, member hospitals work with city, state and federal officials, members of the business community, consumer groups and others to effect needed change and to make the communities they serve healthier places to live. CHAIR John Fernandez President and Chief Executive Officer Massachusetts Eye and Ear EXECUTIVE DIRECTOR John Erwin

22 Conference of Boston Teaching Hospitals 11 Beacon Street, #710 Boston, MA