Mercy Medical Center Redding. Community Benefit 2017 Report and 2018 Plan

Transcription

1 Community Benefit 2017 Report and 2018 Plan

2 A message from Todd Smith, President and CEO of, and Jim Cross, Chair of the Dignity Health North State Service Area 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 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 (FY17), provided $26,843,485 in patient financial assistance, unreimbursed costs of Medicaid, community health improvement services, and other community benefits. The hospital also incurred $36,290,605 in unreimbursed costs of caring for patients covered by Medicare. Dignity Health s North State Service Area Board of Directors reviewed, approved and adopted the Community Benefit 2017 Report and 2018 Plan at its October 12, 2017 meeting. Thank you for taking the time to review our report and plan. If you have any questions, please contact us at

3 TABLE OF CONTENTS Executive Summary 3 Mission, Vision, and Values 4 Our Hospital and Our Commitment 5 Description of the Community Served 6 Community Benefit Planning Process Community Health Needs Assessment Process 8 CHNA Significant Health Needs 9 Creating the Community Benefit Plan Report and 2018 Plan Strategy and Program Plan Summary 11 Anticipated Impact 12 Planned Collaboration 12 Financial Assistance for Medically Necessary Care 12 Program Digests 13 Economic Value of Community Benefit 20 Appendices Appendix A: Community Board and Committee Rosters 21 Appendix B: Other Programs and Non-Quantifiable Benefits 23 Appendix C: Financial Assistance Policy Summary 24 2

4 EXECUTIVE SUMMARY is a member hospital of Dignity Health. As part of Dignity Health, plays a lead role in caring for the community and partnering with others to help make Redding and the surrounding areas a healthier place. In living out the mission, Mercy Redding is particularly attentive to the needs of the poor, disadvantaged and vulnerable. The significant community health needs that form the basis of this document were identified in the hospital s most recent Community Health Needs Assessment (CHNA), which is publicly available at Additional detail regarding identified needs, data collected, community input obtained, and prioritization methods used can be found in the CHNA report. In FY17, MMCR took numerous actions to help address identified needs. These included: Lung cancer screening Tobacco cessation classes Diabetes Empowerment Education Program Chronic Disease Self-Management Program Low-Cost prostate cancer screening Provided $196,760 in community grants to local non-profit organizations. For FY18, the hospital plans to continue all of the above programs and explore the viability of providing the following additional programs: Diabetes Self-Management Program Cancer: Thriving and Surviving Program Chronic Pain Self-Management Program The economic value of community benefit programs/services provided by Mercy Medical Center Redding FY17 was $26,843,485 excluding unpaid costs of Medicare. This amount includes patient financial assistance, community health improvement services, and the hospital s reinvestment through community grants and other gifts/sponsorships to help improve community health. Including the unreimbursed costs of caring for patients covered by Medicare, the hospital s total community benefit expense was $63,134,090. The FY17 Community Benefit Report and FY18 Plan is also publicly available at Written comments on this report can be submitted to Mercy Medical Center Redding via the Community Health Office at 2175 Rosaline Ave, Redding, CA or by to Alexis Ross at Alexis.Ross@dignityhealth.org. 3

5 MISSION, VISION AND VALUES 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. 4

6 OUR HOSPITAL AND OUR COMMITMENT The Hospital is located at the tip of the Sacramento River Valley in Redding, California and serves as a regional referral center for far Northern California. The Hospital offers major medical services including a Level II Trauma Center with a dedicated Orthopedic Traumatologist, Level III Neonatal Intensive Care Unit, Cardiovascular Services, and Oncology Services. is also the sole provider of obstetrical services in its primary service area. Mercy Medical Center Redding is licensed for 267-beds and has approximately 1,800 employees. In addition to the key services listed above, also offers a wide array of specialty and surgical services including but not limited to: Pediatric Care Surgical Inpatient and Outpatient Care Center for Joint and Spine Health Joint Venture with 21 st Century Oncology Mercy Regional Cancer Center in Redding o Ida C. Emerson Oncology Unit o Outpatient Chemotherapy Services o Floyd Morgan Family Cancer Resource Center & Medical Library Mercy Home Health & Hospice Services Mercy Family Medicine Residency Program Mercy Family Health Center A clinic associated with the Mercy Family Practice Residency Program. The clinic serves Medi-Cal and Medicare patients as well as un-/under-insured individuals, under the direction of the Mercy Family Practice Residency faculty. Mercy Maternity Clinic This Clinic helps mothers and babies achieve a healthy start, by offering comprehensive prenatal care for low-income mothers and high-risk pregnancies. Wound Healing and Hyperbaric Medicine Center This freestanding service cares for individuals with hard-to-heal wounds. An 11-room hospitality house for families of patients who reside outside of the greater Redding area and must travel to for trauma, cardiac or cancer care. These families are often unable to sustain this unforeseen financial burden and these rooms are provided at a low nightly rate or at no cost for those who cannot afford to pay. A dedicated campus for senior services. Named Mercy Oaks, this campus currently features a senior housing complex operated by Mercy Housing, a comprehensive senior nutrition and transportation program and a myriad of social services dedicated to seniors and people who have disabilities. Rooted in Dignity Health s mission, vision and values, is dedicated to improving community health and delivering community benefit with the engagement of the North State Community Board, the Mercy Redding Advisory Council, and the Hospital s leadership team. Membership on the North State Board and the Mercy Redding Advisory Council are comprised of community members and stakeholders, Sisters of Mercy, senior hospital leadership, and physicians. Rosters for the North State Community Board and Mercy Redding s Advisory Council can be found in Appendix A. The members of each committee provide stewardship and direction for the Hospital as a community resource. Specific responsibilities of the Board and the Advisory Council include: 5

7 Review and approval of the annual community benefit report and plan to ensure it is aligned with s mission and strategy, is focused on the priority needs identified through the community health assessment and/or by hospital leadership, and fulfills responsibilities as a charitable organization. Provide oversight for the Dignity Health Grants Program, including the identification of grant funding priorities and selection of grant review committee members. Serve as advocates in the community that further s mission and help foster strategic partnerships to improve community health. Community benefit is also integrated into the strategic planning process at Mercy Medical Center Redding and is demonstrated at multiple levels throughout the organization. In addition to the involvement and oversight of the Dignity Health North State Board, developed an ad-hoc sub-committee of the Advisory Council to provide a community perspective to help prioritize the health opportunities for the organization. The 24-member Council represents a broad range of community organizations and needs. 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. DESCRIPTION OF THE COMMUNITY SERVED Dignity Health hospitals define service areas as the zip codes that represent the geographic area served by the hospital based on approximately 80% of hospital discharges. (MMCR) serves a primary service area comprised of ten zip codes in Redding and surrounding communities in Shasta, Tehama and Trinity County. Portions of Shasta County and all of Trinity County are federally designated as Medically Underserved Areas and Populations. A summary description of the community is below, and additional community facts and details can be found in the CHNA report online. Total Population: 205,776 Hispanic or Latino: 11.4% Race: 78.7% White, 1.0% Black/African American, 3.0% Asian/Pacific Islander, 5.8% All Others Median Income: $47,604 Uninsured: 8.2% Unemployment: 6.0% No HS Diploma: 10.9% Median CNI Score: 3.6 Medicaid Population: 32.5% - Does not include individuals dually-eligible for Medicaid and Medicare. Other Area Hospitals: 1 Medically Underserved Areas or Populations: Yes 6

8 One tool used to assess health need is the Community Need Index (CNI) created and made publicly available 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. Most of the communities in our primary service area are considered to have disproportionate unmet health care needs. In fact, the median CNI score for our primary service area is 3.6 indicating a high level of need. The most current CNI map can be found below. This is a major challenge for us as we plan and implement our community benefit programs and services. It is imperative that we provide a leadership role in building local capacity with our community partners in our efforts to create healthy communities. Community Need Index Map 7

9 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 key stakeholders in the development and annual updating of the community benefit plan. Community Health Needs Assessment Process MMCR is committed to involving and informing the residents of Shasta County in a Community Needs Assessment Survey process. A community health needs assessment (CHNA) is a systematic process involving the community, to identify and analyze community health needs in order to prioritize, plan and act upon unmet community health needs. An assessment is conducted every three years, most recently in 2014, and identifies the health needs of residents by acknowledging ongoing health concerns within the community. Through surveys and the evaluation of existing health related data, community benefit staff compiled a report inventorying community health priorities and provided recommendations for areas of intervention. MMCR conducted the 2014 CHNA at the facility level using community benefit staff to oversee the process. By conducting the CHNA at the facility level, the Hospital was able to gain a better insight into the needs of the community. MMCR took into consideration available internal and external resources and partnered with outside individuals and organizations as appropriate throughout the CHNA process. Based on this assessment, issues of greatest concern were identified and the Hospital determined the areas to commit resources to, thereby focusing outreach efforts to continually improve the health status of the community we serve. The CHNA process incorporated data from primary sources (survey) and secondary data research (vital statistics and other existing health-related data) relating to a wide array of community health indicators. Primary data was collected by using paper surveys and an identical web-based survey via Survey Monkey.com. We looked to our community partners to represent their respective communities in the survey process. The final survey instrument was developed by and Public Health and is similar to the previous surveys used in the region. The surveys were used to collect information from community members, stakeholders and providers for the purpose of understanding community perception of needs. The surveys were ed to approximately 1,000 s through a distribution list that the Hospital compiled and uses to disseminate health education materials. The Hospital distributed surveys to zip codes within the primary service area, including zip codes with disproportionate unmet health needs. There were 168 surveys completed for a return rate of approximately 16.8%. The following partners assisted the hospital in conducting the needs assessment: Advisory Council - This group of active community members represent all of the communities in our primary service area. They completed the survey in addition to participating in the priority setting process once the data was compiled. Shasta County Public Health In addition to providing assistance with the survey design, Public Health representatives distributed the surveys to their employees and clients. Secondary data was used to validate the information obtained from the surveys and was provided through the free web-based platform CHNA.org. This web-based tool was designed to assist hospitals 8

10 in completing the CHNA at the local level in order to help reduce the costs incurred by Hospitals. The data provided through CHNA.org has aggregated data available from 7,000 public data sources, including the Centers for Disease Control and Prevention and the National Center for Chronic Disease Prevention and Health promotion. Once the primary and secondary data were collected and compiled, MMCR community benefit staff analyzed the data and compared it to prior assessments to determine which information from the previous assessments would be useful in building upon for the health of the community. The results revealed a list of top perceived health risks and behaviors from the community s perspective, many of which overlap. CHNA Significant Health Needs The top areas of opportunity for the current assessment are listed below: Health Concerns: mental health problems, obesity, cancers, domestic violence, child abuse/neglect, aging problems, diabetes, heart disease and/or stroke. Health Risk Behaviors: drug abuse, being overweight, alcohol abuse, poor eating habits, tobacco use, and lack of exercise. A formal community asset assessment has not been conducted at this time, and may be addressed in the future in partnership with the Shasta County Public Health Services Agency. Creating the Community Benefit Plan As a matter of Dignity Health policy, the hospital s community health and community benefit programs are guided by five core principles. All of our initiatives relate to one or more of these principles: Focus on Disproportionate Unmet Health-Related Needs Emphasize Prevention Contribute to a Seamless Continuum of Care Build Community Capacity Demonstrate Collaboration An essential component of the CHNA is to prioritize the health opportunities that are identified through the assessment process. MMCR carefully considered how to prioritize various community benefit initiatives. After the health opportunities were identified, they were ranked by a small committee comprised of a representative from a local community health collaborative and a representative of Shasta County Public Health. The ranking tool contained seven criteria with which to rank each health opportunity. Each criterion was assigned a specific weighted value. Definitions of the criteria used are listed below: High Incidence or Prevalence - Is the local rate/percent higher than the state or national rate/percent? Consider absolute numbers directly affected by the problem, as well as disproportionate rates among special populations (subgroups of age, sex, race/ethnicity, geographic region). Trending - What are the trends? Is the rate/percent increasing or decreasing over time? Severity of Problem/Consequences - Consider the degree to which the problem leads to death, disability or impairs one s quality of life. Also consider the risk of exacerbating the problem by not addressing at the earliest opportunity. 9

11 Amenable to Intervention - Consider how likely it is that interventions will be successful in preventing or reducing the consequences of a problem. Keep in mind all types of intentions (e.g., community education, policy and/or organizational changes, etc.), the potential to reach populations at greatest risk, and the ability of the community at large to mobilize to support the intervention. In other words can we make a difference? Resources Available - Consider what programs are currently in place to address the problem, and consider the ability of organizations to reasonably impact the issue, given available resources. Costliness of Treatment of Problem/Consequences - Consider the financial costs of treating the problem; what costs might be saved by preventing or reducing the severity of the problem? Acceptability - Considering what the community feels is important, as it can mean greater community support later on. After the participants ranked each of the areas of opportunity, the results were then calculated and further discussion ensued to select the areas that should be the focus for the next community benefit planning cycle (FY2015 FY2018). As a result of the ranking and prioritization process by the ranking committee, and taking into account that the hospital has limited financial resources, the Mercy Medical Center Redding will be addressing the following health areas: Mental health Obesity Cancers Aging problems Diabetes Heart disease and/or stroke Poor eating habits Lack of exercise Substance Abuse Tobacco Use Some, if not all, of the health needs listed above will be addressed in part through the Chronic Disease Self-Management Program (CDSMP). CDSMP is designed to educate participants and promote selfmanagement of any chronic disease. After completion of a workshop series, participants are able to improve their understanding of their condition and be able to better self-manage symptoms of their disease. As a result of this evidence-based chronic disease self-management program, participants are empowered to better self-care; and as a result of partnerships established in support of a healthcare continuum, community residents have access to vital support services. In addition to the CDSMP program, the Hospital will also continue to provide other community health education programs including the tobacco cessation program and diabetes management classes. While the health needs and risks of domestic violence and child abuse/neglect were also identified in the Community Health Needs Assessment, the hospital has limited resources and ability to effect sustainable change. MMCR will support local non-profit organizations that address those needs through donations, sponsorships, and the community grants program as appropriate. 10

12 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 The initiatives listed below are regularly monitored by the Service Area Manager of Community Health & Strategy and senior management team. Additionally, regular updates are provided to the Dignity Health North State Service Area Community Board, Advisory Council, as well as, shared with hospital managers during the monthly management team meetings. Health Need: Chronic Pain, Substance Abuse, and Mental Health Programs Strategy or Activity Summary Description Health Education Community Building Explore viability of offering additional Stanford Self- Management Resource Center programs for pain management and mental health Support the Empire Recovery Center for their detox program that provides detox services for homeless and Active FY17 Planned FY18 indigent addicts. Anticipated Impact: Evidence-based chronic disease self-management programs offered in our community, empower participants to have better self-care and as a result the Hospital has seen a reduction in either hospitalizations or emergency room visits 90-days post intervention. In addition to the health education, Empire Recovery Center s Detox program assists with the continuum of care for homeless and indigent addicts. Health Need: Cancer Deaths/Skin Cancers/Prostate Exams Strategy or Activity Summary Description Active FY17 Health Education Tobacco cessation classes Quit for Good Health Education Provider of Every Women Counts State Program Health Screening Lung Cancer Screenings Health Education Explore viability of offering the Stanford Self- Management Resource Center s Cancer Thriving and Surviving program. Planned FY18 Anticipated Impact: Offering screenings and establishing partnerships in support of a healthcare continuum ensures that community residents have access to vital support services. 11

13 Health Need: Chronic Disease Strategy or Activity Summary Description Community Health Education Offer Chronic Disease Self-Management Program (CDSMP) titled Healthier Living, as well as trained community members to become workshop leaders Active FY17 Planned FY18 Community Health Education Offer Diabetes Empowerment Education Program. This six-week long workshop is intended to educate participants about day-to-day living with diabetes Community Health Education Offer Diabetes Self-Management Program (DSMP) titled Healthier Living, as well as trained community members to become workshop leaders Anticipated Impact: As a result of evidence-based chronic disease self-management programs offered in our community, participants in the programs have been empowered to better self-care and as a result the Hospital has seen a reduction in either hospitalizations or emergency room visits 90- days post intervention. 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 maintains collaborative partnerships with Shasta County Public Health agencies. MMCR is a founding member of the Healthy Shasta collaborative in partnership with Shasta County Public Health. The collaborative is still going strong 10-years later and its goal is to reduce childhood obesity and reduce the prevalence of chronic disease. In addition to that collaborative, MMCR participated in Shasta County Public Health s community-wide assessment process as part of their accreditation requirements in FY17. In addition to the relationships with the County, MMCR is actively involved with other community organizations and Boards. Hospital Executives have a seat on the Board Shasta Community Health Center, a Federally-Qualified Health Center, as well as, the YMCA, and SHARC Collaborative. 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 12

14 services. A plain language summary of the hospital s Financial Assistance Policy is in Appendix C. The amount of financial assistance provided in FY17 is listed in the Economic Value of Community Benefit section 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 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. Program Digests 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. The digests include program descriptions and intervention actions, statements of which health needs are being addressed, any planned collaboration, and program goals and measurable objectives. 13

15 PROGRAM DIGESTS Chronic Disease Self-Management Significant Health Needs Addressed Mental Health Obesity Cancers Aging problems Diabetes Heart disease and/or stroke Poor eating habits, Lack of exercise Program Emphasis Disproportionate Unmet Health-Related Needs Primary Prevention Seamless Continuum of Care Build Community Capacity Collaborative Governance Program Description Chronic disease workshops are designed for adults who have a chronic disease and those that care for them. The workshop participants learn how to manage stress, fight fatigue and pain, learn how to communicate with their doctor and family members and set goals and learn problem solving techniques. This program is funded and staffed through the Community Health Department as is offered at low or no cost to community members. Community Benefit A Community Health Improvement Services Category FY 2017 Report Program Goal / Anticipated Impact Provide education and skills to assist community members living with chronic disease by increasing/enhancing their self-efficacy, thereby, increasing their quality of life which may lead to preventing or reducing unnecessary admissions Measurable Objective(s) with Indicator(s) Intervention Actions for Achieving Goal Planned Collaboration Program Performance / Outcome to the Hospital. Develop community leaders to expand sustainability of the CDSMP program. Increase the number of participants in the CSDMP program. Implement new Diabetes Empowerment Education Program establish baseline for participation. Outreach to local non-profits and community clinics for participants Conduct at least one Healthier Living workshop during the next fiscal year Host one leader trainer during FY17 to train additional leaders to increase CDSMP sustainability within the community Community Health Manager to become a trained facilitator for the Diabetes Empowerment Education Program Offer two Diabetes Empowerment Education Program workshops None Collateral materials were provided to local non-profits and community clinics encouraging participation in the workshops. One Healthier Living workshop was offered and attended by 8 individuals. A leader training was also conducted in early FY17 and a total of 10 leaders were trained. Leader trainings enhance partnerships and create sustainability for the Healthier Living program within the community. Community Health Manager became a trained facilitator for the Diabetes Empowerment Education Program 14

16 Hospital s Contribution / Program Expense Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Intervention Actions for Achieving Goal Planned Collaboration Due to resource constraints and challenges the DEEP program was not offered in the community. However, it will remain as an FY18 goal. $5,000 FY 2018 Plan Provide education and skills to assist community members living with chronic disease by increasing/enhancing their self-efficacy, thereby, increasing their quality of life which may lead to preventing or reducing unnecessary admissions to the Hospital. Develop community leaders to expand sustainability of the CDSMP program. Increase the number of participants in the CSDMP program. Implement new Diabetes Empowerment Education Program establish baseline for participation. Conduct at least one Healthier Living workshop during the next fiscal year Host one leader trainer during FY18 to train additional leaders to increase CDSMP sustainability within the community Offer at least one Diabetes Empowerment Education Program workshops Community Health Manager to become a trained facilitator for the Diabetes Self-Management Program (DSMP) Offer at least one DSMP workshop Explore viability of offering two complementary diabetes programs Explore viability of Community Health Manager becoming a trained facilitator for other Stanford Self-Management modules such as pain management, cancer, and mental health None Cancer Programs Significant Health Needs Mental Health Addressed Obesity Cancers Aging problems Diabetes Heart disease and/or stroke Poor eating habits, Lack of exercise Program Emphasis Disproportionate Unmet Health-Related Needs Primary Prevention Seamless Continuum of Care Build Community Capacity Collaborative Governance Program Description Provide services/programs that respond to the cancer needs of the community as identified in the community health needs assessment to help improve community health. Community Benefit A Community Health Improvement Services Category FY 2017 Report Program Goal / Anticipated Impact Provide health education, cancer screenings, and other educational opportunities to increase awareness about risk factors and early identification of cancer in an effort to reduce preventable cancer-related deaths. 15

17 Measurable Objective(s) with Indicator(s) Intervention Actions for Achieving Goal Planned Collaboration Program Performance / Outcome Hospital s Contribution / Program Expense Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Intervention Actions for Achieving Goal Offer the Quit for Good tobacco cessation classes. Cross-market the CDSMP to assist with the referral of participants to the Healthier Living Workshops to identify improvement in symptom management. Continue to offer and promote the Quit for Good tobacco cessation classes throughout FY2018. Refer community members to the Healthier Living Workshops as appropriate to help community members learn strategies for symptom management and increase self-efficacy. Offer low-cost prostate screening for early intervention of prostate cancer. None Tobacco cessation classes were continued and offered throughout FY17. The correlation between tobacco use, lung cancer and COPD is covered in the curriculum. Community members were referred to the Healthier Living workshop as appropriate. A low-cost prostate screening was offering and over 100 men screened for early detection of prostate cancer $4,000 FY 2018 Plan Provide health education, cancer screenings, and other educational opportunities to increase awareness about risk factors and early identification of cancer in an effort to reduce preventable cancer-related deaths. Offer the Quit for Good tobacco cessation classes. Cross-market the CDSMP to assist with the referral of participants to the Healthier Living Workshops to identify improvement in symptom management. Offer low to no-cost cancer screenings e.g. breast, skin, prostate Continue to offer and promote the Quit for Good tobacco cessation classes throughout FY2018. Refer community members to the Healthier Living Workshops as appropriate to help community members learn strategies for symptom management and increase self-efficacy. Offer low-cost prostate screening for early intervention of prostate cancer. Chronic Pain, Substance Abuse, and Mental Health Programs Significant Health Needs Addressed Mental Health Obesity Cancers Aging problems Diabetes Heart disease and/or stroke Poor eating habits, Lack of exercise Program Emphasis Disproportionate Unmet Health-Related Needs Primary Prevention Seamless Continuum of Care Build Community Capacity Collaborative Governance 16

18 Program Description Planned Collaboration Community Benefit Category Develop and implement an educational campaign and support investments to increase awareness and identification of risk factors that can contribute to unhealthy behaviors. None A Community Health Improvement Services Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Intervention Actions for Achieving Goal Program Performance / Outcome Hospital s Contribution / Program Expense Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Intervention Actions for Achieving Goal FY 2017 Report Increase awareness by offering educational opportunities regarding identification of risk factors that can contribute to unhealthy behaviors and leverage community resources. Offer chronic disease workshops to community members as appropriate. Increase the number of participants in the CSDMP program to identify improvement in symptom management. Build community partnerships and develop a partnership strategy for addressing the needs of the community. Explore the ability to offer a more specialized area of this program e.g. mental health and pain management. Refer community members to the Healthier Living Workshops as appropriate to help community members self-manage their condition Due to limited resources and facilitator challenges only the general chronic disease self-management program (CDSMP) was offered in FY17. An independent contractor agreement was established to assist with the delivery of this program and future topic-specific modules may be offered in FY18. Community members were referred to the CDSMP for chronic pain, depression, and other conditions that would be appropriate for selfmanagement coping strategies. In addition to referring community members to the CDSMP program, the Hospital provided a community grant to Empire Recovery Center for their detox program that provides detox services for homeless and indigent addicts. $100,000 FY 2018 Plan Increase awareness by offering educational opportunities regarding identification of risk factors that can contribute to unhealthy behaviors and leverage community resources. Offer chronic disease workshops to community members as appropriate. Increase the number of participants in the CSDMP program to identify improvement in symptom management. Build community partnerships and develop a partnership strategy for addressing the needs of the community. Explore the ability to offer a more specialized area of this program such as mental health and pain management. Refer community members to the Healthier Living Workshops as appropriate to help community members self-manage their condition 17

19 Significant Health Needs Addressed Program Emphasis Program Description Community Benefit Category Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Intervention Actions for Achieving Goal Planned Collaboration Program Performance / Outcome Dignity Health Community Grants Program Access to Healthcare Cancer Disability & Chronic Pain Heart Disease & Stroke Injury & Violence Mental Health & Mental Disorders Nutrition, Physical Activity & Overweight Respiratory Disease Substance Abuse Tobacco Use Disproportionate Unmet Health-Related Needs Primary Prevention Seamless Continuum of Care Build Community Capacity Collaborative Governance Providing funding to support community based organizations who will provide services to underserved populations to improve the quality of life. The objective of the Community Grants Program is to award grants to organizations whose proposals respond to the priorities identified in the most recent Community Health Needs Assessment (CHNA). E Cash and In-Kind Contributions FY 2017 Report To build community capacity by identifying community organizations and funding programs that are in alignment with the needs identified in the most recent CHNA. Funding will be awarded to organizations whose programs respond to a need identified in the most recent CHNA and align with at least one of the five core principles (listed in the Program Emphasis above). Prioritize grant applications that address the target areas and award funding as appropriate None Community Grants were provided to three lead non-profit organizations that will serve as the fiscal agent for 10 other local agencies. Organizations receiving grants were: Empire Recovery Center received funds for their Detox Program. The funds will be used to provide food, shelter, clothing and counseling to assist an underserved population of alcoholics and addicts (homeless/indigent and low to moderate income) with their recovery efforts and help them work toward improving their health status and quality of life. Friends of Whiskeytown received funds for their Learn SUP N (stand up paddle boarding) at Whiskeytown. This program will provide educational and physical activity opportunities to children and families through participation in stand-up paddle board tours. The funds will also be used to provide scholarships for low income children to attend the Whiskeytown Environmental School for an overnight 4 night program. 18

20 Hospital s Contribution / Program Expense Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Intervention Actions for Achieving Goal Northern California Center for Family Awareness received funds for their Kids Turn Workshop series. The workshops aim to improve interpersonal, family communication and conflict resolution skills for families that are separated or divorced. The workshops focus on teaching children how to understand the changes in their family, processing their grief and sense of loss, and finding positive methods to cope with parental conflict $196,760 FY 2018 Plan To build community capacity by identifying community organizations and funding programs that are in alignment with the needs identified in the most recent CHNA. Funding will be awarded to organizations whose programs respond to a need identified in the most recent CHNA and align with at least one of the five core principles (listed in the Program Emphasis above). Prioritize grant applications that address the target areas and award funding as appropriate. 19

21 ECONOMIC VALUE OF COMMUNITY BENEFIT uses a cost accounting methodology for calculating costs for community benefit. 9/26/ Complete Summary - Classified Including Non Community Benefit (Medicare) For period from 7/1/2016 through 6/30/2017 Total Offsetting Net % of Organization Persons Expense Revenue Benefit Expenses Benefits for Living in Poverty Financial Assistance 1,604 2,255, ,255, Medicaid 45, ,246, ,507,182 20,739, Means-Tested Programs 3 6,034 3,803 2, Community Services A - Community Health Improvement Services , , E - Cash and In-Kind Contributions 2, ,318 29, , G - Community Benefit Operations 0 73, , Totals for Community Services 3, ,147 29, , Totals for Living in Poverty 50, ,151, ,540,667 23,610, Benefits for Broader Community Community Services A - Community Health Improvement Services , , B - Health Professions Education 71 4,197,761 1,019,873 3,177, C - Subsidized Health Services 14 5, , E - Cash and In-Kind Contributions 297 8, , Totals for Community Services 660 4,252,761 1,019,873 3,232, Totals for Broader Community 660 4,252,761 1,019,873 3,232, Totals - Community Benefit 50, ,404, ,560,540 26,843, Medicare 47, ,053, ,763,031 36,290, Totals with Medicare 98, ,457, ,323,571 63,134,

22 APPENDIX A: COMMUNITY BOARD AND COMMITTEE ROSTERS FY 2018 DIGNITY HEALTH NORTH STATE SERVICE AREA COMMUNITY BOARD MEMBERS Jim Cross, Chairperson Ryan Denham, Secretary Mark Korth, North State Service Area President Fernando Alvarez, M.D. Diane Brickell Sister Nora Mary Curtin Sister Clare Marie Dalton Sandra Dole Alan Foley Douglas Hatter, M.D. Eva Jimenez Patrick Quintal, M.D. Any communications to Board Members should be made in writing and directed to: Lynn Strack, Executive Assistant Dignity Health North State P.O. Box Redding, CA (530) (530) fax 7/1/17 21

23 MERCY MEDICAL CENTER REDDING ADVISORY COUNCIL MEMBERS 2017 MEMBER TERM REAPPTD Jonathan Anderson, Vice Chair (Good News Rescue Mission) 1/2015 to 12/2020 to 12/2018 Les Baugh (Shasta County Board of Supervisors) 1/2015 to 12/2020 to 12/2018 Stacey Carman (Redding Rancheria) 1/2013 to 12/2018 to 12/2018 Jim Cloney (Shasta Unified School District) 1/2013 to 12/2018 to 12/2018 Steve Craft (Coldwell Banker C&C Properties) 1/2016 to 12/2021 to 12/2017 Donnell Ewert (Shasta County Public Health) 1/2013 to 12/2018 to 12/2018 Gordon Flinn, Secretary (GoForth Consulting) 1/2015 to 12/2020 to 12/2018 Jean King (One SAFE Place) 1/2014 to 12/2019 to 12/2017 April LaFrance (Woodstone Construction) 1/2015 to 12/2020 to 12/2018 Jake Mangas (Redding Chamber of Commerce) 1/2016 to 12/2021 to 12/2017 Julie McClelland, MD (Anesthesiologist/Critical Care Medicine 1/2017 to 12/2022 to 12/2018 Tracey Moore (Sierra Pacific Industries) 1/2012 to 12/2017 to 12/2017 Matt Moseley (Cornerstone Community Bank) 1/2016 to 12/2021 to 12/2017 Scott Putnam, Chairperson (Apex Technology Management Inc.) 1/2014 to 12/2019 to 12/2017 Laura Redwine (City of Shasta Lake) 1/2014 to 12/2019 to 12/2017 Mark Rincon (FIT Physical Therapy) 1/2015 to 12/2020 to 12/2018 Lea Tate, Psy.D. (Patients Hospital of Redding) 1/2017 to 12/2022 to 12/2018 Joe Wyse (Shasta College) 1/2014 to 12/2019 to 12/

24 APPENDIX B: OTHER PROGRAMS AND NON-QUANTIFIABLE BENEFITS The hospital delivers a number of community programs and non-quantifiable benefits in addition to those described elsewhere in this report. Like those programs and initiatives, the ones below are a reflection of the hospital s mission and its commitment to improving community health and well-being. Non-Quantifiable Benefits Mercy Redding gives to the community in many ways that are difficult to measure. Through leadership and advocacy efforts, the Hospital works collaboratively with many local organizations to enhance community-building activities and programs to help address the root causes of health problems. During FY2017, MMCR provided expertise and/or hospital resources to help strengthen the following community partnerships: Economic Development Council Good News Rescue Mission Leadership Redding Northern Valley Catholic Social Services North State Symphony One Safe Place Redding Chamber of Commerce Redding Rancheria Shasta County Public Health Simpson University St. Joseph Parish School Turtle Bay Exploration Park YMCA 23

25 APPENDIX C: FINANCIAL ASSISTANCE POLICY SUMMARY Dignity Health s Financial Assistance Policy describes the financial assistance programs available to uninsured or under-insured patients who meet certain income requirements to help pay for medically necessary hospital services provided by Dignity Health. An uninsured patient is someone who does not have health coverage, whether through private insurance or a government program, and who does not have the right to be reimbursed by anyone else for their hospital bills. An underinsured patient is someone who has health coverage, but who has large hospital bills that are not fully covered by their insurance. Free Care If you are uninsured or underinsured with a family income of up to 200% of the Federal Poverty Level you may be eligible to receive hospital services at no cost to you. Discounted Care If you are uninsured or underinsured with an annual family income between % of the Federal Poverty level, you may be eligible to have your bills for hospital services reduced to the highest amount reasonably expected to be paid by a government payer, which is usually the amount that Medicare would pay for the same services. If you are uninsured or underinsured with an annual family income between % of the Federal Poverty level you may be eligible to have your bills for hospital services reduced to the Amount Generally Billed, which is an amount set under federal law that reflects the amount that would have been paid to the hospital by private health insurers and Medicare (including co-pays and deductibles) for the medically necessary services. If you are eligible for financial assistance under our Financial Assistance Policy you will not be required to pay more than the Amount Generally Billed described above. If you qualify, you may also request an interest-free extended payment plan. You will never be required to make advance payment or other payment arrangements in order to receive emergency services. Free copies of the hospital s Financial Assistance Policy and financial assistance application forms are available online at your hospital s website listed below or at the hospital Admitting areas located near the main entrance. (Follow the signs to Admitting or Registration ). Copies of these documents can also be mailed to you upon request if you call Patient Financial Services at the telephone number listed below for your hospital. Traducción disponible: You may also obtain Spanish and other language translations of these documents at your hospital s website, in your hospital s Admitting area, or by calling your hospital s telephone number. Dignity Health Financial Counselors are available to answer questions, provide information about our Financial Assistance Policy and help guide you through the financial assistance application process. Our staff is located in the hospital s Admitting area and can be reached at the address and telephone number listed here, 2175 Rosaline Ave., Redding, CA 96001; Financial Counseling ; Patient Financial Services or by visiting 24