Community Benefit 2017 Report and 2018 Plan

Transcription

1 Merced, California Community Benefit 2017 Report and 2018 Plan

2 A message from Charles Kassis, President and CEO of, and Barry McAuley, Chair of the Dignity Health Community Board. Dignity Health's comprehensive approach to community health improvement aims to address significant health needs identified in the Community Health Needs Assessments that we conduct with community input, including from the local public health department. Our multi-pronged initiatives to improve community health include financial assistance for those unable to afford medically necessary care a range of prevention and health improvement programs conducted by the hospital and with community partners, and investing in efforts that address social determinants of health. shares a commitment to improve the health of our community, and delivers programs and services to achieve that goal. The Community Benefit 2017 Report and 2018 Plan describes much of this work. This report meets requirements in California state law (Senate Bill 697) that not-for-profit hospitals produce an annual community benefit report and plan. Dignity Health produces these reports and plans for all of its hospitals, including those in Arizona and Nevada. We are proud of the outstanding programs, services and other community benefits our hospital delivers, and are pleased to report to our community. In fiscal year 2017 (FYl7), provided $7,107,548in patient financial assistance, unreimbursed costs of Medicaid, community health improvement services, and other community benefits. The hospital also incurred $27,465,066 in unreimbursed costs of caring for patients covered by Medic are. Dignity Health's Community Board reviewed, approved and adopted the Community Benefit 2017 Report and 2018 Plan at its November 2, 2017 meeting. Thank you for taking the time to review our report and plan. If you have any questions, please contact us at Charles Kassis President/CEO Barry McAuley Chair, Community Board 1

3 TABLE OF CONTENTS Executive Summary Page 3 Mission, Vision, and Values Page 5 Our Hospital and Our Commitment Page 6 Description of the Community Served Page 8 Community Benefit Planning Process Community Health Needs Assessment Process Page 10 CHNA Significant Health Needs Page 11 Creating the Community Benefit Plan Page Report and 2018 Plan Strategy and Program Plan Summary Page 13 Anticipated Impact Page 17 Planned Collaboration Page 17 Financial Assistance for Medically Necessary Care Page 18 Program Digests Page 19 Economic Value of Community Benefit Page 33 Appendices Appendix A: Community Board and Committee Rosters Page 34 Appendix B: Other Programs and Non-Quantifiable Benefits Page 35 Appendix C: Financial Assistance Policy Summary Page 36 2

4 EXECUTIVE SUMMARY (MMC), a Dignity Health member, is a 186 acute care, religioussponsored, not-for-profit hospital located in the city of Merced, California. The city of Merced is the County seat and is the largest of the six incorporated cities in the county. MMC opened on May 2, 2010 and employs over 1,300 people, making it one of the largest employees in Merced County. MMC has a professional relationship with more than 250 local physicians. Major programs and services include: one licensed acute care facility with a family birthing center, intensive care unit, emergency care and four floors housing, telemetry and medical/surgical nursing units. There are three outpatient facilities, Mercy UC Davis Cancer Center, Mercy Outpatient Center and the Mercy Medical Pavilion. Services at these outpatient centers include home care, physical and cardiac rehabilitation, ambulatory surgery, cancer care, laboratory, imaging and endoscopy. MMC primary service area includes Merced, Atwater, Winton and Planada for a total of 160,215 residents in Merced County. Secondary service areas include Los Banos, Livingston, Dos Palos, Chowchilla, Le Grand and Mariposa totaling 104,122 lives. The significant community health needs that form the basis of this report and plan were identified in the hospital s most recent Community Health Needs Assessment (CHNA), which is publicly available at mercymercedcares.org. Additional detail about identified needs, data collected, community input obtained, and prioritization methods used can be found in the CHNA report. The significant community health needs identified are: o Access to Healthcare Services o Cancer o Diabetes o Infant Health & Family Planning o Nutrition, Physical Activity and Weight o Heart Disease & Stroke o Respiratory Diseases In FY17, took numerous actions to help address identified needs. These included: o Chronic Disease Self-Management (English and Spanish) o Labor of Love & Lactation o Live Well With Diabetes (English and Spanish) o Mercy Cancer Center Support o Mercy Yoga and Zumba Classes o Mercy Cancer Center Community Programs o Bi-National Week Activities o Diabetes Self-Management Program o Dignity Health Community Grant Program o Human Trafficking Task Force o Stroke Support and Education Program 3

5 For FY18, the hospital plans to expand the Diabetes Self-Management Program to include Spanish workshops and through the Stroke Support Group offer quarterly educational seminars. A Human Trafficking Task Force has been formed to educate staff on what to do, should a victim of Human Trafficking be identified in the hospital. MMC is a member of the Whole Health Partnership, a group of Merced health professionals working for the advancement of integrated behavioral health in Merced County. MMC has completed a contract with the local ambulance company to provide transportation for non-emergency low income patients, funding for this service will cost the hospital $70,000. The economic value of community benefit provided by in FY17 was $7,107,548, excluding unpaid costs of Medicare in the amount of $27,465,066. This report and plan is publicly available at mercymercedcares.org and on the Dignity Health website. The two local newspapers, The County Times and the Merced Sun Star were issued a public service announcement from the hospital Marketing Department, announcing to the community that the report is available on line. Hospital staff announced to the public at various service clubs that the report was available and gave a brief summary of the report. The Mercy Medical Center Foundation uses the report as a tool in their philanthropic community information packets Written comments on this report can be submitted to the Mercy s Community Health Office, 333 Mercy Avenue, Merced California or by to Janice.wilkerson@dignityhealth.org 4

6 MISSION, VISION AND VALUES is part of Dignity Health, a non-profit health care system made up of more than 60,000 caregivers and staff who deliver excellent care to diverse communities in 21 states. Headquartered in San Francisco, Dignity Health is the fifth largest health system in the nations. At Dignity Health, we unleash the healing power of humanity through the work we do every day, in hospitals, in other care sites and in the community. Our Mission We are committed to furthering the healing ministry of Jesus. We dedicate our resources to: Delivering compassionate, high-quality, affordable health services; Serving and advocating for our sisters and brothers who are poor and disenfranchised; and Partnering with others in the community to improve the quality of life. Our Vision A vibrant, national health care system known for service, chosen for clinical excellence, standing in partnership with patients, employees, and physicians to improve the health of all communities served. Our Values Dignity Health is committed to providing high-quality, affordable healthcare to the communities we serve. Above all else we value: Dignity - Respecting the inherent value and worth of each person. Collaboration - Working together with people who support common values and vision to achieve shared goals. Justice - Advocating for social change and acting in ways that promote respect for all persons. Stewardship - Cultivating the resources entrusted to us to promote healing and wholeness. Excellence - Exceeding expectations through teamwork and innovation. 5

7 OUR HOSPITAL AND OUR COMMITMENT (MMC) is a 186-bed acute care, religious-sponsored, not-for-profit hospital located in the city of Merced, California. MMC is a member of Dignity Health, a family of over 60,000 caregivers and staff. On May 2, 2010 MMC moved into a brand new 262,000 square foot facility on Mercy Avenue. MMC has a staff of more than 1,300 and professional relationships with more than 250 local physicians. Major programs and services include: one licensed acute care facility with a family birthing center, intensive care unit, emergency care and four floors covering telemetry and medical/surgical nursing units. Two outpatient facilities that combined services include outpatient home care, physical and cardiac rehabilitation, ambulatory surgery, wound care, laboratory, imaging and a Medical Assistance Program pharmacy. There are three rural health clinics; Family Practice (70.36% of patients are on Medicaid/Medical), General Medicine Clinic (specialist clinic) and Kids Care combined see over 4,000 patients a month. The clinics are highlighted in the Program Digest section of this report. In response to identified unmet health-related needs in the community health needs assessment, during FY 2017 MMC focused on increasing access to health care for the broader and underserved disadvantaged members of the surrounding community. Major Community Benefit activities focused on increasing programming, Coalition Building and Health Education for those with disproportionate unmet health-related needs (DUHN). Rooted in Dignity Health s mission, vision and values, is dedicated to delivering community benefit with the engagement of its management team, Community Board and Community Advisory Committee. The board and committee are composed of community members who provide stewardship and direction for the hospital as a community resource. The Community Board reviews health initiatives and the health needs of the medically under-served and the multicultural populations of Merced County. They provide assistance to administration in developing the strategic direction of the hospital. The Board participates in the process of establishing priorities, plans and programs for the Healthy Communities Initiatives based on an assessment of community needs and assets and monitors progress toward identified goals. They provide advice and consultation concerning the annual operating and capital budgets for the hospital as part of the budget development process and receive periodic reports from management comparing actual operations to budget. The Community Advisory Committee (CAC) members assist and advise the community benefit planning process for MMC. The Chair of the committee is a member of MMC s Community Board. The CAC meets quarterly and represents diverse sectors of the community. They interact to raise issues and identify areas for community outreach opportunities. Special meetings may be arranged as needed. This committee oversees the Dignity Health Community Grant program selection process. The CAC is accountable to the Board and reports their activities after each meeting and on an annual basis. 6

8 CAC Committee Responsibility Support and implement Dignity Health s mission and core values related to health services Serve as a resource for MMC by bringing forward information relative to unmet needs of the medically under-served communities in Merced County Offer recommendations regarding health services needs of Merced County s medically underserved populations Serve as a link between MMC s Board of Directors and the Community Health Benefit planning process, coordinating and overseeing the development of the annual Health Benefit Plan Provide leadership for the Dignity Health Community Grant Program For a roster of Community Board and the Community Advisory Committee members see Appendix A. s community benefit program includes financial assistance provided to those who are unable to pay the cost of their care, unreimbursed costs of Medicaid, subsidized health services that meet a community need, and community health improvement services. Our community benefit also includes monetary grants we provide to not-for-profit organizations that are working together to improve health on significant needs identified in our Community Health Needs Assessment. Many of these programs and initiatives are described in this report. 7

9 DESCRIPTION OF THE COMMUNITY SERVED s primary service area is comprised of the communities of Merced, Atwater, Winton and Livingston. There is only one other hospital in the county, Memorial Los Banos, a Sutter Health affiliate that is a 44-bed facility with basic emergency services. A summary description of the community is below, and additional details can be found in the CHNA report online. Merced County is located in the heart of the San Joaquin Valley and spans from the coastal ranges to the foothills of Yosemite National Park. The county encompasses 1, square miles with a population density of per square mile. The county is predominantly urban, with 85.7% of the population living in areas designated as urban. The City of Merced is the County seat and is the largest of the six incorporated cities. County and City municipalities are a major source of employment along with agricultural related industries, retailing, manufacturing, food processing and tourism. Merced County is ranked 53 rd among 58 California counties on social and economic health factors (including income, poverty unemployment, education and other factors) by County Health Rankings. Data gathering and reporting has shown poverty to be a chronic and pervasive reality affecting all aspects of healthy living. Merced County s poverty rate is significantly higher for persons under the age of 18. It is important to understand the age distribution of the population as different age groups have unique health needs which should be considered separately from other along the age spectrum. In Merced County, 28.85% of the population is infants, children, or adolescents, age 0-17; another 39.76% are age 18 44, 21.05% are while 10.35% are age 65 and older. The median age is younger than the state and the nation. Demographic indicators source: 2017 Claritas Company and 2017 Truven Health Analytics LLC Total Population: 124,276 White Non Hispanic: 33.1% Black/African American: 4.2% Hispanic or Latino: 49.9% Asian/Pacific Islander: 9.3% All Others: 3.5% Median Income: $49,941 Unemployment: 9.6% No High School Diploma: 23.8% Medicaid* 42.8% Uninsured: 8.4% *Does not include individuals dually-eligible for Medicaid and Medicare. 8

10 One tool used to assess helath need is the Community Need Index (CNI) created and made publicly avilable by Dignity Health and Truven Health Analytics. The CNI analyzes data at the zip code level on five factors known to contribute or be barriers to health care access: income, culture/language, education, housing status, and insurance coverage. Scores from 1.0 (lowest barriers) to 5.0 (highest barriers) for each factor are averaged to calculate a CNI score for each zip code in the community. Research has shown that communities with the highest CNI scores experience twice the rate of hospital admissions for ambulatory care sensitive conditions as those with the lowest scores. 9

11 COMMUNITY BENEFIT PLANNING PROCESS The hospital engages in multiple activities to conduct its community benefit and community health improvement planning process. These include, but are not limited to: conducting a Community Health Needs Assessment with community input at least every three years; using five core principles to guide planning and program decisions; measuring and tracking program indicators; and engaging the Mercy Medical Center Community Advisory Committee and other stakeholders in the development and annual updating of the community benefit plan. Community Health Needs Assessment Process This assessment was conducted on behalf of by Professional Research Consultants, Inc. completed report was published in the month of August It is a follow-up to a similar study conducted in 2012; it is systematic, data-driven approach to determining the health status, behaviors and needs of the residents in Merced County. A precise and carefully executed methodology is critical in asserting the validity of the results gathered. To ensure the best representation of the population surveyed, a telephone interview methodology one that incorporates both landline and cell phone interviews was employed. The primary advantages of telephone interviewing are timeliness, efficiency and random-selection capabilities. There were 400 random surveys completed with individuals 18 and older in Merced County. PRC s preferred practice is to weight the raw data to improve the representativeness even further. This is accomplished by adjusting the results to match the geographic distribution and demographic characteristics of the population surveyed. To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey was also implemented as part of the process. Online surveys were sent to 12 community/business leaders, 119 physicians, 98 public health representatives, 15 social services providers and 5 other health providers; reminder s were sent as needed to increase participation. In all, 73 community stakeholders took part in the Online Key Informant Survey. On pages of the CHNA report is a list of the final representatives, their organizations and further description of the process. A variety of existing data sources was consulted to complement the research quality of this assessment. A complete list of sources is included in the CHNA. The final CHNA report can be found on the hospital website, mercymercedcares.org and the Dignity Health website. Community members were informed by two local newspapers that if they would like a copy sent to them, either electronically or hard copy, they are to make their request to the hospital s Community Benefit office by calling While the assessment is quite comprehensive, it cannot measure all possible aspects of health in the community, nor can it adequately represent all possible populations of interest. In terms of content, the assessment is designed to provide a comprehensive and broad picture of the health of the overall community. 10

12 CHNA Significant Health Needs Prior survey results and historical data for secondary data indicators are also included for the purposes of trending. Statewide risk factor data was provided where available as an additional benchmark which to compare local survey findings; this data was reported in the most recent (Behavioral Risk Factor Surveillance System) Prevalence and Trend Data published by Centers for Disease Control and Prevention and the US Department of Health & Human Services. National risk factor data also provided in comparison charts was taken from 2013 PRC National Health Survey. Healthy People 2020 provided science-based, 10 year objectives for improving the health of all Americans. The following areas of opportunity represent the significant health needs of the community, based on the information gathered through the CHNA and the guidelines set forth in Healthy People Areas of Opportunity Identified: Access to Healthcare Services; Insurance instability, barriers to access, primary care physician ratio. Cancer; Cancer deaths, Cancer incidence including lung and cervical, female breast cancer and colorectal cancer screening Dementia, Including Alzheimer s deaths Diabetes; diabetes ranked #2 as a major problem in the Online Key Informant Survey Heart Disease & Stroke; ranked #5 as a major problem in the Online key Informant Survey Immunization & Infectious Diseases; Hepatitis B vaccination Infant Health & Family Planning; prenatal care, teen births Injury & Violence; motor vehicle crash deaths, firearm-related deaths, homicide deaths and violent crime rate Mental Health; symptoms of chronic depression, suicide deaths, seeking help for mental health, ranked #1 as a major problem in the Online Key Informant Survey Nutrition, Physical Activity and Weight; low healthy food access, overweight & obesity adult and children, moderate physical activity, access to recreation/fitness facilities, ranked #3 as a major problem in the Online Key Informant Survey Potentially Disabling Conditions; sciatica/back pain, blindness/vision trouble Respiratory Diseases; CLRD, COPD Substance Abuse; cirrhosis/liver disease deaths, drug-induced deaths, seeking help for alcohol/drug issues, ranked #4 as a major problem in the Online Key Informant Survey Health education was selected as a priority to address prevention of disease, to empower community members to assume responsibility for their health and to educate people about various medical conditions and the ability they have to make wise choices. MMC is addressing, as indicated in the Digest Progress section of this report, the following identified areas of opportunity : access to health services; cancer; diabetes; heart disease & stroke; immunization & infectious diseases; infant health; mental health; respiratory diseases; nutrition, physical activity and weight. Areas of opportunity that are identified but not being addressed by MMC are: family planning, dementia including Alzheimer s death; injury and violence; potentially disabling conditions and substance abuse. 11

13 Services for these health priorities are being provided in the community by other entities and MMC does not have expertise in these areas. Creating the Community Benefit Plan As a matter of Dignity Health policy, the hospital s community benefit programs are guided by five core principles. All of our initiatives relate to one or more of these principles. All of our initiatives relate to one or more of these principles: Focus on Disproportionate Unmet Health-Related Needs: Seek to address the needs of communities with disproportionate unmet health-related needs. Emphasize Prevention: Address the underlying causes of persistent health problems through health promotion, disease prevention, and health protection. Contribute to a Seamless Continuum of Care: Emphasize evidence-based approaches by establishing operational linkages between clinical services and community health improvement activities. Build Community Capacity: Target charitable resources to mobilize and build the capacity of existing community assets. Demonstrate Collaboration: Work together with community stakeholders on community health needs assessments, health improvement program planning and delivery to address significant health needs. s community health programs reflect our commitment to improve the quality of life in the community we serve. The Community Advisory Committee (CAC), Community Board, Mercy Administration along with key management staff provides oversight and policy guidance for all charitable services and activities supported by the hospital. The people on these committees and boards represent a health professionals as well as community residents. This group reviews the CHNA to determine that MMC s community health programs are addressing identified needs. The CAC members meets on a quarterly basis and the Community Board meets monthly. Identified needs are also reviewed by the Mercy Foundation to determine their philanthropic strategies. A rooster of members in the CAC and Community Board is attached in Appendix A. MMC is committed to the Dignity Health s annual community grant program which supports the continuum of care in the community offered by other not-for-profit organizations. In FY17 MMC awarded $127,390 in community grants. These not-for-profit organizations addressed one or more of the areas of opportunity identified in the 2015 CHNA. Health priorities being addressed are: access to health services; infant health; mental health; nutrition, physical activity and weight; and substance abuse. A new CHNA is in the planning for the FY 2018, the new survey data will be provided in the FY18-19 Community Benefit report. 12

14 2017 REPORT AND 2018 PLAN This section presents strategies and program activities the hospital is delivering, funding or on which it is collaborating with others to address significant community health needs. It summarizes actions taken in FY17 and planned activities for FY18, with statements on anticipated impacts, planned collaboration, and patient financial assistance to address access. Program Digests provide detail on select programs goals, measurable objectives, expenses and other information. The strategy and plan specifies planned activities consistent with the hospital s mission and capabilities. The hospital may amend the plan as circumstances warrant. For instance, changes in significant community health needs or in community assets and resources directed to those needs may merit refocusing the hospital s limited resources to best serve the community. Strategy and Program Plan Summary Health Need: Access to Healthcare Services Strategy or Activity Summary Description Active FY17 Planned FY18 Family Practice Clinic Clinic is in affiliation with UC Davis Residency program. Serves primarily Medi-cal patients and the underinsured. Kids Care Pediatric Pediatric and obstetric clinic with OB services provided by Clinic contracted physicians from Merced Faculty Associates. Primarily serves managed Medi-cal patients. General Medicine Clinic to provide rotating specialty physicians who see poor, Clinic underinsured and working poor individuals. Patient Financial Financial assistance available to uninsured or underinsured Assistance Program patients. Community Medical A program in middle schools and high schools to stimulate Academy interest in the medical field to the students in Merced County. Anticipated Impact: Provide well medicine to patients to prevent future illness and to treat medical needs of the uninsured and underinsured population of Merced County. By being more involved with schools, students will be interested in pursuing a career in medicine and practice in Merced County. 13

15 Health Need: Cancer Strategy or Activity Summary Description Mercy UC Davis Cancer Center American Cancer Society Cancer Support Group Massage Therapy Provides quality oncology care to the community. Partners with the American Cancer Society for various outreach programs and support services. The Collaborative Action Plan is a partnership with ACS and the cancer center to provide these three programs: Look Good, Feel Better; Wig Bank; I Can Cope. Meets monthly at the cancer center, is facilitated through Mercy Spiritual Services and is open to any person affected by cancer, patient or family member, regardless of where they receive treatment. Occurs after the support group meets, providing 15 minute massage by certified massage therapist to cancer patients to Active FY17 Planned FY18 help decrease stress, anxiety, pain and fatigue. Anticipated Impact: Cancer patients given high quality care without having to leave Merced County. Cancer patients and their families will feel less stressed, will feel supported with the needed resources to help them cope while going to their oncology treatments. Health Need: Diabetes Strategy or Activity Summary Description Chronic Disease Self -Management Program Diabetes Classes Diabetes Self- Management Program National Diabetes A six week comprehensive, outcomes-based program developed by Stanford University which includes education and action planning for participants living with a chronic disease. Weekly diabetes education classes in English and Spanish. Classes provide the opportunity for participants to bond and offer each other support. A six week comprehensive, outcomes-based program developed by Stanford University which includes education and action planning for participants living with diabetes. Partnership with the Center for Disease Control offering Active FY17 Prevention Program participants to join a year-long lifestyle coach program. Anticipated Impact: Help diabetes patients manage their diabetes and to help pre-diabetic individuals prevent the onset of the disease. Planned FY18 14

16 Health Need: Heart Disease & Stroke Strategy or Activity Summary Description Certified Stroke Hospital Stroke Telemedicine As a certified primary stroke center there is a dedicated stroke program focused on bringing high quality care to our community. The Stroke Center is certified by the Joint Commission and is staffed by qualified medical professionals trained in the care of the patient suffering from a stroke. The program focuses on high quality individualized care to meet the needs of our patients and improve the patient outcomes. The telemedicine for the treatment of stroke helps to bring highly specialized care to our community. It brings immediate access to Board Certified Neurologists who offer lifesaving medical care when time and treatment is of the highest importance. Active FY17 Planned FY18 Cardiac Rehab Physical therapy for individuals with heart disease Stroke Support & Meets quarterly to offer individuals information on Resource Class preventing another stroke, coping with disabilities after a stroke and help for caregivers. Anticipated Impact: To provide the community education about the signs and symptoms of a stroke so that potential stroke patients are brought to the ED as quickly as possible. For stroke patients and patients with heart disease programs will help them to manage their challenges as they cope with their lifestyle changes. Families of stroke and heart disease patients will feel less stressed and will learn about the resources available to them and the patients. Health Need: Nutrition, Physical Activity and Weight Strategy or Activity Summary Description STEPS Zumba Yoga School Outreach Program Family Health Festival & 5K Stroke Awareness run A joint replacement education program; how to prepare for joint replacement, stay in hospital, recovery exercise, nutrition & home environment. Offers a walking club and is open to any individual who has had a joint replacement. Program is offered in English and Spanish. Community Zumba classes offered twice a week to any adult individuals in the community. Dance exercise. Exercise classes one time a week for adults to increase balance, strengthen muscles, relieve stress, and to help maintain flexibility. Community Health Educators visits to local schools providing speakers to address with students, weight management, good nutrition and importance of physical activity. An annual event with over 40 vendors providing health information, screenings and physical activities. 15 Active FY17 Planned FY18

17 Anticipated Impact: Community members will become more active, learn to manage their weight, better understand nutritional needs and encourage others to do the same. Health Need: Respiratory Diseases Strategy or Activity Summary Description Asthma Coalition Smoking Cessation Program Tobacco Coalition Mercy is a partner on the coalition and the steering committee. Participates in World Asthma Day and community health fairs. Future classes to help persons who smoke to stop by providing education, support and resources. Mercy is a partner in the education to the community component of the coalition. Participates in community health fairs. Active FY17 Planned FY18 Anticipated Impact: Community members will better understand how to manage their asthma. By providing education people will be less likely to start smoking and those that are smoking will hopefully stop. Health Need: Community Classes Strategy or Activity Summary Description Active FY17 Planned FY18 Childbirth Classes To help pregnant women and their support person to prepare and educate them on what to expect with childbirth. Lactation Classes Class covers the basics of breastfeeding: reasons to breastfeed, how to hold and latch your baby and how your support people can help. Breast Feeding Child birth educator facilitates the support group which Support Group offers mothers who are breast feeding meet to help each other with the challenges they are having while breast feeding. Caesarian Class OB RN presents information to mothers to prepare them for their caesarian birth. Hmong Shaman Six week long educational program designed for Shaman to Spiritual Healer learn about Western medicine and visit with hospital staff all in the efforts to bridge the understanding of the two cultures. Spiritual Services 101 Twenty one hours of class for faith leaders to deepen their skill in ministry to the sick. Spiritual Services 102 Faith leaders who have completed SS 101 will take SS102 for additional training in order to become SS Volunteers. Anticipated Impact: Partnerships within the community are strengthened through our community classes. 16

18 Anticipated Impact The anticipated impacts of the hospital s activities on significant health needs are summarized above, and for select program initiatives are stated in the Program Digests on the following pages. Overall, the hospital anticipates that actions taken to address significant health needs will: improve health knowledge, behaviors, and status; increase access to needed and beneficial care; and help create conditions that support good health. The hospital is committed to measuring and evaluating key initiatives. The hospital creates and makes public an annual Community Benefit Report and Plan, and evaluates impact and sets priorities for its community health program in triennial Community Health Needs Assessments. Planned Collaboration MMC has engaged community-based partners representing the spectrum of agencies providing services vital to Merced County residents include: Merced Rescue Mission, Merced County Department of Public Health, Merced County Department of Mental Health, Central California Alliance for Health, Golden Valley Health Clinics and the Livingston Community Health Center. The following pages include Program Digests describing key programs and initiatives that address one or more significant health needs in the most recent CHNA report. 17

19 Financial Assistance for Medically Necessary Care delivers compassionate, high quality, affordable health care and advocates for members of our community who are poor and disenfranchised. In furtherance of this mission, the hospital provides financial assistance to eligible patients who do not have the capacity to pay for medically necessary health care services, and who otherwise may not be able to receive these services. A plain language summary of the hospital s Financial Assistance Policy is in Appendix C of this report. The hospital notifies and informs patients and members of the community about the Financial Assistance Policy in ways reasonably calculated to reach people who are most likely to require patient financial assistance. These include: providing a paper copy of the plain language summary of the Policy to patients as part of the intake or discharge process; providing patients a conspicuous written notice about the Policy at the time of billing; posting notices and providing brochures about the financial assistance program in hospital locations visible to the public, including the emergency department and urgent care areas, admissions office and patient financial services office; making the Financial Assistance Policy, Financial Assistance Application, and plain language summary of the Policy widely available on the hospital s web site; making paper copies of these documents available upon request and without charge, both by mail and in public locations of the hospital; and providing these written and online materials in appropriate languages. The hospital notifies and informs patients about the Financial Assistance Policy by offering a paper copy of the plain language summary of the Policy to patients as part of the intake or discharge process. At the time of billing, each patient is offered a conspicuous written notice containing information about the availability of the Policy. Notice of the financial assistance program is posted in locations visible to the public, including the emergency department, billing office, admissions office, and other areas reasonably calculated to reach people who are most likely to require financial assistance from the hospital. The hospital provides brochures explaining the financial assistance program in registration, admitting, emergency and urgent care areas, and in patient financial services offices. The Financial Assistance Policy, the Financial Assistance Application, and plain language summary of the Policy are widely available on the hospital s web site, and paper copies are available upon request and without charge, both by mail and in public locations of the hospital. Written notices, posted signs and brochures are printed and available online in appropriate languages. 18

20 PROGRAM DIGESTS Significant Health Needs Addressed Mercy UC Davis Cancer Center Community Program Maternal/Infant Health Diabetes Mental Health Nutrition, Physical Activity and Weight X Cancer Program Emphasis X Disproportionate Unmet Health Related Needs Primary Prevention X Seamless Continuum of Care Build Community Capacity Collaborative Governance Program Description The community programs offered at the Mercy UC Davis Cancer Center are funded through the Mercy Foundation as well as through the cancer center itself. The hospital provides a team of staff from all disciplines to help coordinate, facilitate and raise awareness of the program for patients as well as the community at large. The program provides to the community information, education, location and staffing. Planned Collaboration Collaboration with this program occurs within our internal resources to include the physicians, nursing staff, radiation therapists, case management, social workers, marketing, community education and outreach. In addition there is collaboration with the other cancer centers in our community for cancer awareness events, seminars and programs Community Benefit Category Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Baseline / Needs Summary Intervention Actions for Achieving Goal Program Performance / Outcome Hospital s Contribution / Program Expense Program Goal / Anticipated Impact A1 d Community Health Education FY 2017 Report Address the need in the community for supportive programs, education and resources with regards to cancer patients. Create a support group that is lacking and much needed in our service area. Increase access to support, education, and resources for both cancer patients and their family/caregivers. Track the number of community outreach/education events that the Cancer Center participates in as well as the # of attendees at such events (health fairs, symposiums etc.). Continue to collaborate with the American Cancer Society per our Collaborative Action Plan, to enhance supportive care programs such as monthly Cancer Support Group, Look Good Feel Better and the Wig Bank. Continue to track the # of contacts made by Cancer Centre social worker to assist cancer patients for psychosocial concerns related to having cancer. Cancer, as identified in the most recent CHNA is a leading health concern and need in our service area. In addition, there are no other cancer centers in our community that offers educational and supportive services to all in need. Cancer Center participated in 3 health fairs and 2 symposiums across Merced, Atwater and Sacramento. # of people attended our supportive care programs (monthly Cancer Support Group, Wig Bank, Look Good Feel Better) Cancer Center Social Worker made an average of 40 contacts per month to assist patients with psychosocial concerns. Allowed for patients and community members to increase access to resources and services they need in the midst of their care and foster more positive outcomes. The hospital contributed funding as well as Mercy Foundation in the amount $16, FY 2018 Plan Continue to provide the community with supportive services that address emotional, spiritual, and care related needs to help address the patients, caregivers and family and friends. Enhance 19

21 Measurable Objective(s) with Indicator(s) Baseline / Needs Summary Intervention Actions for Achieving Goal existing partnerships and seek new partners to combine resources and create a more impactful program and positive outcomes. Track and collect data and information of the number of encounters/sessions and attendance. Collect data on the newly implemented programs and those that will be implemented later this fiscal year. This program will continue to be offered and grow to address the needs identified in our latest CHNA that found cancer as the second leading cause of death in Merced County. The ageadjusted death rate for cancer in Merced County is per 100,000 which is above the state rate of Continue and increase participation in supportive care programs that are offered through collaboration with the American Cancer Society. Continue the grant funded social worker program enabling screening for cancer patients for distress due to psychosocial, transportation, anxiety, physical changes and related issues associated with having cancer. Initiate Smoking Cessation Counseling Classes in order to focus on cancer prevention as tobacco consumption has a high correlation with lung cancer. Significant Health Needs Addressed X Childbirth Preparation Course Maternal/Infant Health Diabetes Mental Health Nutrition, Physical Activity and Weight Cancer Program Emphasis X Disproportionate Unmet Health Related Needs X Primary Prevention X Seamless Continuum of Care Build Community Capacity Collaborative Governance Program Description This program prepares expectant mothers for the childbirth experience, including the stages of labor, what to expect during pregnancy and delivery, cesarean birth, the importance of prenatal care, breastfeeding and infant health care. Planned Collaboration The Childbirth preparation Course addressed a community need and as a result there is collaboration within the community with local groups as well as local Federally Qualified Health Centers and the Merced County Department of Public Health. Community Benefit Category Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Baseline / Needs Summary A1 Community Health Education FY 2017 Report There was and increase the number of women enrolled in program, especially targeting the Spanish classes and young/teenage mothers. In addition, the breastfeeding program grew in number of participants as well as the addition of the breastfeeding support group. Lastly, work towards establishing and addition we added component of the program with the Merced County Human Services Agency Mommy Boot Camp Program to enhance the existent Daddy Boot Camp Program. Growth of our Spanish Childbirth Preparation Program. Tracking of registrations and attendance for each program. Offering the New Dad Boot Camp and New Mom Boot Camp programs onsite. Number of sites we offer Childbirth courses in the communities that are part of our service areas Merced County continues to lack any other resource or program that addresses the needs of 20

22 Intervention Actions for Achieving Goal mothers to be in the community regardless of socio economic status. Our program is the only one available due to lack of funding of our community partners. Between 2011 and % of all Merced County live births did not receive prenatal care in the first trimester of pregnancy and 10.7% births were to women age Increase enrollment by more community outreach especially to pregnant teenager by contacting a local high school that enrolls the pregnant teens. Add a Saturday class. Encourage enrollment in the breastfeeding class. FY 14 saw an increase by 30% looking for a 50% increase in FY15. In partnership with Sierra Vista Children s Services a new postpartum depression support group will be offered to the community, due to a very low census in FY14 the program is on hold. Program Performance / Outcome Hospital s Contribution / Program Expense Program Goal / Anticipated Impact We added 4 cesarean birth preparation classes and 6 classes offered offsite at various locations in the community. In addition, some of those classes were in Spanish. Hospital provided space, refreshments, educational materials and instructors. Cost $39, FY 2018 Plan Continue with the cesarean course offered quarterly to the community to address the need for education to emergency cesareans on previous pregnancy or scheduled first time cesareans. Grow our weekly Breastfeeding Support Group to provide a resource in the community for new moms that may have some challenges with breastfeeding to increase breastfeeding rates in our community by increasing attendance by 20%. Also creating a breastfeeding nook to allow for one on one education and troubleshooting for new moms in our community. Create a drop in breastfeeding program in our rural health clinics to increase access for new mothers in south side Merced. Targeting those mothers that have transportation issues. Measurable Objective(s) with Indicator(s) Baseline / Needs Summary Intervention Actions for Achieving Goal Number of added sessions as well as the addition of the new programs. Tracking and monitoring the number of participants and the languages they are offered in. Utilization of the one on one sessions as well of number of drop in sessions to assess the needs in different areas within our community. Merced County continues to lack any other resource or program that addresses the needs of mothers to be regardless of socio economic status or patient status. Our program is the only one available due to lack of funding of our community partners. Partner with Merced County Human Services Agency to strategically increase the attendance in our New Mom and New Dad Boot Camp programs. Collaborate with neighboring FQHC s and Merced County Department of Public Health Latch Clinic Team to increase the number of sessions, locations and access to childbirth and breastfeeding programs. Enhance communication with participants prior to start date of program and follow up to increase satisfaction and confidence in new moms and moms to be. 21

23 Significant Health Needs Addressed X Live Well With Diabetes Maternal/Infant Health Diabetes Mental Health Nutrition, Physical Activity and Weight Cancer Program Emphasis X Disproportionate Unmet Health Related Needs X Primary Prevention X Seamless Continuum of Care Build Community Capacity Collaborative Governance Program Description This is a weekly program that teaches strategies for understanding, managing and living with diabetes. It s a multi purpose support program that features medical professional guest speakers, interactive educational experiences and develops personal actions plans. Program is offered in English and Spanish. Planned Collaboration The Living Well With Diabetes program collaborates with community partners in recruiting participants such as local physicians and clinics. There is also a process in place for referral from our inpatient to this community program. In addition, collaboration with faith based organizations and local schools on providing diabetes education off site, directly in the community. Community Benefit Category Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Baseline / Needs Summary Intervention Actions for Achieving Goal A1 Community Health Services FY 2017 Report The Community Health Diabetes Education program offered educational programs throughout the year in addition to the diabetes support group. We completed the accreditation process through the AADE and addition of DSME as a new service line to our service area. Collaborated with local physicians, FQHC s and RHC s as well as the Merced County Health Department and the Central California Alliance for Health managed care. We also partnered with the Hmong Shaman Group and offered educational classes in Hmong to participant about diabetes and prevention. We increased the reach to patients that access our services in enrolling them into the diabetes classes, support group and education. Lastly, we started the process of getting staff trained in the National Diabetes Prevention Program. Maintain the increase in attendance to both the English and Spanish Diabetes programs. Increase the number of classes offered to the community and the number of community members accessing the educational intervention. Continue to track the number of diabetes referrals from inpatient and number of readmissions within 90 days. Increase in the number of diabetes screenings, health fairs for the community. There are no other ongoing community (free of charge) educational diabetes classes in Merced County that offer English, Hmong and Spanish instructions. Between 2011 and 2013 there was an annual average age adjusted diabetes mortality rate of 29.0 deaths per 100,000 populations in Merced County. This is less favorable than that of the statewide rate of 20.7 deaths and national rate of 21.3 deaths. The statewide and national rates both declined from 25.8 in previous reports, while the rates in Merced County. These numbers also fail to satisfy the Healthy People 2020 target of 20.5 or lower. Current weekly diabetes class was modeled to be more of a diabetes support group. Community Health Diabetes Education will begin to encompass the Center for Diabetes in our General Medicine Clinic. Collaborate with the Mercy rural health clinics to reach more diabetic patients. Continued to work on developing a more efficient referral process from inpatient to diabetes 22

24 education programs. Program Performance / Outcome There was an increase in new participants enrolled in educational classes and support group from FY2015 by 10% and attendance per session averaged 12 participants. In addition, we were able to provide screening and education on diabetes in the community in FY 2017 to 1,294 people. Lastly, we also increased the number of Spanish language programs to 5. Hospital s Contribution / Program Expense Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Baseline / Needs Summary Intervention Actions for Achieving Goal Hospitals contribution was $26,292 for educational materials, supplies and instructors. FY 2018 Plan Collaborate with Shaman group and other leaders in the Hmong community to develop a Diabetes Program to be offered in Hmong in the community. Offer a Diabetes Support group monthly and an additional program each month of the year in both English and Spanish. Develop a program that would provide more access to routine care for diabetics such as foot care, eye care, blood sugar monitoring and A1c tracking. In addition continue to develop a walking group as an added component to the support group. Maintain the increase in attendance to both the English and Spanish Diabetes programs. Increase the number of classes offered to the community and the number of community members accessing the educational intervention. Continue to track the number of diabetes referrals from inpatient and number of readmissions within 90 days. There are no other ongoing community (free of charge) educational diabetes classes in Merced County that offer English, Hmong and Spanish instructions. Between 2011 and 2013 there was an annual average age adjusted diabetes mortality rate of 29.0 deaths per 100,000 populations in Merced County. This is less favorable than that of the statewide rate of 20.7 deaths and national rate of 21.3 deaths. The statewide and national rates both declined from 25.8 in previous reports, while the rates in Merced County. These numbers also fail to satisfy the Healthy People 2020 target of 20.5 or lower. Establish stronger partnerships with leaders in the Hmong community. Connect with other service lines and local healthcare providers to develop programs that will allow for greater access to care that will enhance self management skills. Connect with resources system wide and internally to continue to develop an efficient referral process to link patients to diabetes education. In addition, we will be in full swing of Diabetes Self Management Education Program and offering a robust curriculum that includes workshops and one on ones. Lastly, work on recognition with the CDC on our DPP program and begin to offer in the community. 23