Bakersfield Memorial Hospital. Community Benefit 2015 Report and 2016 Plan

Transcription

1 Bakersfield Cmmunity Benefit 2015 Reprt and 2016 Plan

2 A message frm Jn Van Bening, president and CEO f, and Rbert Nriega, Chair f the Dignity Health Cmmunity Bard. The Hell humankindness campaign launched by Dignity Health is a mvement ignited by and based n the prven idea that human cnnectin, be it physical, verbal, r therwise, leads t better health. Dignity Health s cmprehensive apprach t cmmunity health imprvement includes multi-prnged initiatives directed at significant health needs, partnering with thers in the cmmunity wrking t imprve health, and investing in effrts that address scial determinants f health. shares a cmmitment t imprve the health f ur cmmunity, and delivers prgrams and services t achieve that gal. The Cmmunity Benefit 2015 Reprt and 2016 Plan describe much f this wrk. This reprt meets requirements f nt-fr-prfit hspitals in the Patient Prtectin and Affrdable Care Act t adpt a cmmunity health Implementatin Strategy at least every three years, and in Califrnia state law (Senate Bill 697) t prduce an annual cmmunity benefit reprt and plan. Dignity Health cmplies with bth mandates in all f its hspitals, including thse in Arizna and Nevada. We are prud f the utstanding prgrams, services and ther cmmunity benefits ur hspitals deliver, and are pleased t reprt t ur cmmunity. In fiscal year 2015 (FY15), prvided $9,046,452 in patient financial assistance, unreimbursed csts f Medicaid, cmmunity health imprvement services, and ther cmmunity benefits. Including the unreimbursed csts f caring fr patients cvered by Medicare, the hspital s ttal cmmunity benefit expense was $18,715,477. Dignity Health s Bard f Directrs reviewed, apprved and adpted the Cmmunity Benefit 2015 Reprt and 2016 Plan at its Octber 28, 2015 meeting. Thank yu fr taking the time t review ur reprt and plan. If yu have any questins, please cntact us at (661)

3 TABLE OF CONTENTS Executive Summary Page 3 Missin, Visin, and Values Page 4 Our Hspital and Our Cmmitment Page 5 Descriptin f the Cmmunity Served Page 7 Cmmunity Benefit Planning Prcess Cmmunity Health Needs Assessment Prcess Page 9 CHNA Significant Health Needs Page 10 Cmmunity Benefit Plan Develpment Prcess Page 10 Planning fr the Uninsured/Underinsured Patient Ppulatin Page Reprt and 2016 Plan Summary, Anticipated Impact and Planned Cllabratin Page 12 Prgram Digests Page 15 Ecnmic Value f Cmmunity Benefit Page 29 Appendices Appendix A: Cmmunity Bard and Cmmittee Rsters Page 30 Appendix B: Other Prgrams and Nn-Quantifiable Benefits Page 32 2

4 EXECUTIVE SUMMARY serves all f Kern Cunty, including Bakersfield (the cunty seat) and utlying rural cmmunities such as Lst Hills, Taft, and Wasc. The cunty cvers mre than 8,100 square miles, making it the gegraphically third largest cunty in the state. The landscape is diverse, ranging frm high desert t muntains t vast expanses f rich agricultural flatlands. Accrding t the 2010 United States Census, Kern Cunty's ppulatin was 839,631. Additinal cmmunity facts and details can be fund in the Descriptin f Cmmunity Served sectin n page 8. The significant cmmunity health needs that frm the basis f this reprt and plan were identified in the hspital s mst recent Cmmunity Health Needs Assessment (CHNA), which is publicly available at Additinal detail abut identified needs, data cllected, cmmunity input btained, and priritizatin methds used can be fund in the CHNA reprt. The 10 significant cmmunity health needs identified are: Heart Disease and Strke* Cancer Diabetes* Preventive Screenings* Cancer Screenings Access t Health Care* Lw Birth Weight/Infant Mrtality Asthma* Wmen's Health Screenings Sexually Transmitted Diseases (STDs) further priritized these 10 needs t five fcus areas that are indicated by the * symbl. In FY15, we tk numerus actins t help address identified needs. These included: Breast Health Prgram Preventive Health Screenings and Flu Clinics In-Hme Health Educatin Health Educatin Classes/Seminars Cmmunity Health Initiative Prgram Chrnic Disease Self-Management and Diabetes Self-Management Seminars Prescriptin Prgram Hmemaker Care Prgram Outpatient Navigatr Prgram Fr FY16, will cntinue respnding t the abve mentined cmmunity needs. We will als develp an Asthma Management Prgram and healthy cking classes t be scheduled thrugh the new kitchen classrm lcated at ur Cmmunity Wellness Center. The ecnmic value f cmmunity benefit prvided by in FY15 was $9,046,452, excluding unpaid csts f Medicare in the amunt f $9,669,025. maintains its strng, missin-based cmmitment t caring fr Medi-Cal enrllees and all members f the cmmunity. The hspital served 65,257 Medi-Cal patients in FY15, cmpared t 53,439 in FY14, an 18% percent increase. This reprt and plan is publicly available at 3

5 MISSION, VISION AND VALUES Our Missin We are cmmitted t furthering the healing ministry f Jesus. We dedicate ur resurces t: Delivering cmpassinate, high-quality, affrdable health services; Serving and advcating fr ur sisters and brthers wh are pr and disenfranchised; and Partnering with thers in the cmmunity t imprve the quality f life. Our Visin A vibrant, natinal health care system knwn fr service, chsen fr clinical excellence, standing in partnership with patients, emplyees, and physicians t imprve the health f all cmmunities served. Our Values Dignity Health is cmmitted t prviding high-quality, affrdable healthcare t the cmmunities we serve. Abve all else we value: Dignity - Respecting the inherent value and wrth f each persn. Cllabratin - Wrking tgether with peple wh supprt cmmn values and visin t achieve shared gals. Justice - Advcating fr scial change and acting in ways that prmte respect fr all persns. Stewardship - Cultivating the resurces entrusted t us t prmte healing and whleness. Excellence - Exceeding expectatins thrugh teamwrk and innvatin. Hell humankindness After mre than a century f experience, we ve learned that mdern medicine is mre effective when it s delivered with cmpassin. Stress levels g dwn. Peple heal faster. They have mre cnfidence in their health care prfessinals. We are successful because we knw that the wrd care is what makes health care wrk. At Dignity Health, we unleash the healing pwer f humanity thrugh the wrk we d every day, in the hspital and in the cmmunity. Hell humankindness tells peple what we stand fr: health care with humanity at its cre. Thrugh ur cmmn humanity as a healing tl, we can make a true difference, ne persn at a time. 4

6 OUR HOSPITAL AND OUR COMMITMENT Hspital Descriptin As Bakersfield's largest acute care facility, pened its drs t the public in 1956 t serve the grwing needs f the cmmunity. Lcated in the heart f a re-energized dwntwn, the campus has received numerus awards and recgnitin fr its quality care. When the grund was turned n this cmmunity treasure 65 years ag, n ne culd knw then hw wuld grw. But thrugh the leadership and heart f Larry Carr, the 112 bed cmmunity hspital grew int mre than 400 and thusands f lives were changed. Tday, Memrial is hme t the Sarvanand Heart and Strke Center, the Lauren Small Children s Medical Center, and sn, the new Rbert A. Grimm Children s Pavilin fr Emergency Care. has many features designed t make patients and visitrs feel cmfrtable and welcmed. The Einstein Pavilin, built in hnr f Dr. Hans E. Einstein, is an architectural mnument t the warmth and grace that defined its namesake. A landscaped plaza and cvered entryway frm an asis frm the utside wrld. Inside, waterfalls and lush plant life define a space f natural beauty and harmny. ffers a large variety f health services including an Accredited Chest Pain Center, da Vinci Surgical System, Diabetes Clinic, Certified Strke Center, the area s nly Pediatric Intensive Care Unit, and the Wund Healing, Hyperbarics, and Amputatin Preventin Center. is hme t the Rnald McDnald Huse and is a member f Children s Miracle Netwrk Hspitals. Our Cmmitment Rted in Dignity Health s missin, visin and values, is dedicated t delivering cmmunity benefit with the engagement f its management team, Cmmunity Bard and Cmmunity Benefit Cmmittee. The bard and cmmittee are cmpsed f cmmunity members wh prvide stewardship and directin fr the hspital as a cmmunity resurce. s president is cmmitted t the Cmmunity Benefit prcess and accuntable t Dignity Health system leadership. A Cmmunity Benefit Cmmittee f the Bard assists the Department f Special Needs and Cmmunity Outreach in priritizing prgrams that are in line with the hspital s strategic plan. Cmmittee members include representatives f the hspital Executive Management Team, the business cmmunity, scial service agencies, cmmunity vlunteers, bard members, and emplyees. This grup meets fur times annually t help ensure that ur utreach services respnd t identified cmmunity needs and are effectively wrking t imprve the verall health status f the cmmunity. The Cmmittee prvides input, advice, and apprval fr the Cmmunity Benefit Plan. The apprved plan is then submitted t the bard f fr final apprval. During FY 2015, the Cmmunity Benefit Cmmittee lst three members and gained five new members. A rster f current Cmmittee members is attached as Appendix A. Caring fr the cmmunity beynd the hspital walls led t the funding f the Department f Special Needs and Cmmunity Outreach in In respnse t identified unmet health-related needs in the cmmunity, tday the department perates mre than 45 prgrams in Bakersfield, Arvin, Shafter, McFarland, Delan, Lst Hills, Ridgecrest, Taft, Wasc, and ther utlying cmmunities in Kern Cunty where there is limited access t health care and related services. 5

7 With 38 emplyees and an annual budget f $2,960,154 (including bth Mercy and s), the department s prgrams target lw-incme, uninsured, r underinsured individuals, as well as Kern Cunty citizens with unmet health needs, including migrant farm wrkers and ther disenfranchised ppulatins. The department s leaders include Debbie Hull, Reginal Directr; Felicia Crna, Cmmunity Benefit CBISA Crdinatr; Rita Flry, Prgrams and Prjects Crdinatr; Edgar Aguilar, Manager, Cmmunity Health Initiative; Judith Harniman, Manager, Cmmunity Wellness Prgram; Freddy Hernandez, Supervisr, Learning and Outreach Centers; David Mazne, Supervisr, Hmemaker Care Prgram; and Dnna Tirp, Manager, Art and Spirituality Center. The department frequently cllabrates with mre than 100 public, private, and nnprfit rganizatins. The three Dignity Health hspitals in Bakersfield (Mercy Hspital Dwntwn, Mercy Hspital Suthwest, and ) are the largest prviders f health services in the Suthern San Jaquin Valley, serving a diverse ppulatin f urban and rural residents. Cmbining resurces, Mercy and Memrial Hspitals respnd t identified unmet health-related needs thrughut Kern Cunty in a unified way thrugh fur Outreach Centers: Learning Center 631 E. Califrnia Avenue, Bakersfield, CA 93307, (661) Outreach Center 1627 Virginia Avenue C, Bakersfield, CA 93307, (661) Cmmunity Wellness Center 2634 G Street, Bakersfield, CA 93301, (661) Art and Spirituality Center 2215 Truxtun Avenue, Bakersfield, CA (661) s cmmunity benefit prgram includes financial assistance prvided t thse wh are unable t pay the cst f their care, unreimbursed csts f Medicaid, subsidized health services that meet a cmmunity need, and cmmunity health imprvement services. Our cmmunity benefit als includes mnetary grants we prvide t nt-fr-prfit rganizatins that are wrking tgether t imprve health n significant needs identified in ur Cmmunity Health Needs Assessment. Many f these prgrams and initiatives are described in this reprt. 6

8 DESCRIPTION OF THE COMMUNITY SERVED serves all f Kern Cunty, including Bakersfield (the cunty seat) and utlying rural cmmunities such as Lst Hills, Taft, and Wasc. We further define the cmmunity served by the hspitals primary service area. This is based n the percent f discharges. Nearly tw-thirds f Kern Cunty s residents and mst f its majr health care prviders are clustered in and arund Bakersfield. In additin t, ther health prviders in Bakersfield include: Mercy Hspital Dwntwn, Mercy Hspital Suthwest, Kern Medical Center, Kaiser Permanente, San Jaquin Cmmunity Hspital, The Heart Hspital, Gd Samaritan Hspital, Clinica Sierra Vista and Omni Family Health. The service area fr these prviders is als Kern Cunty. Whenever pssible, an effrt is made fr cmmunity-based cllabratin t slve prblems and ensure sustainable health prgrams ver the lng term t ppulatins that need it the mst. Many f Bakersfield's prest residents are cncentrated in the city's sutheast quadrant, the site f tw f ur cmmunity utreach centers. The ppulatin is largely African American and Hispanic/Latin, with a high cncentratin f limited-english speaking individuals (many undcumented), elevated yuth gang activity, and a high unemplyment rate. These neighbrhds include rundwn mtels that huse a transient hmeless ppulatin, including many families with children. Mst f these residents have nt received health services r assistance because f pverty, chrnic substance abuse, language barriers, lack f transprtatin, a strng mistrust f established institutins, r lack f knwledge abut accessing and using available services. Fr many lw-incme individuals and families living in the utlying rural cmmunities f Kern Cunty, gegraphic islatin heightens these barriers t health care and ther services. Demgraphic indicatrs using 2015 Truven Health Analytics and Nielsn Cmpany estimates: Ttal Ppulatin: 583,150 Hispanic r Latin: 53.6% Race: 33.7% White, 5.4% Black/African American, 4.4% Asian/Pacific Islander, 0.7% American Indian/Alaska Native, 0.2 % Other, 2.0% Tw r Mre Races Median Incme: $51,126 Uninsured: 11.4% Unemplyment: 8.8% N HS Diplma: 27.9% CNI Scre: 4.6 Medicaid Ppulatin*: 35.4% Other Area Hspitals: 8 Medically Underserved Areas r Ppulatins: Yes *Des nt include individuals dually-eligible fr Medicaid and Medicare. 7

9 Cmmunity Needs Index (CNI) Map 8

10 COMMUNITY BENEFIT PLANNING PROCESS The hspital engages in multiple activities t cnduct its cmmunity benefit and cmmunity health imprvement planning prcess. These include, but are nt limited t: cnducting a Cmmunity Health Needs Assessment with cmmunity input at least every three years; using five cre principles t guide planning and prgram decisins; measuring and tracking prgram indicatrs; and engaging the Cmmunity Benefit Cmmittee and ther stakehlders in the develpment and annual updating f the cmmunity benefit plan. Cmmunity Health Needs Assessment Prcess The Kern Cunty cmmunity health needs assessment prcess was initiated by the Kern Cunty Cmmunity Benefit Cllabrative in July The Cllabrative is cmprised f Delan Reginal Medical Center, Dignity Health (Mercy and s), Kaiser Permanente, and San Jaquin Cmmunity Hspital. The Kern Cunty Cmmunity Benefit Cllabrative alng with its Steering Cmmittee guided the study. The Steering Cmmittee met numerus times ver the curse f the prcess t prvide guidance n the cmpnents f the Kern Cunty cmmunity health needs assessment. The cllabrative met with cmmunity and hspital/health leaders in Nvember 2012 t review and priritize the cmmunity needs. In an effrt t examine the health related needs f the residents f Kern Cunty, the Steering Cmmittee and cnsulting team emplyed bth qualitative and quantitative data cllectin and analysis methds. The reprt develpment was cmpleted in March The Steering Cmmittee members and cnsulting team made significant effrts t ensure that all areas f the cunty, all sci-demgraphic grups and all underrepresented ppulatins were included in the study. This bjective was addressed by cnducting tw surveys and identifying key stakehlders that represented varius subgrups within the cmmunity. In depth interviews were cnducted with these stakehlders t identify needs and pririties. In additin, the prcess included public health participatin and input, bth thrugh extensive use f Califrnia Department f Public Health data, as well as thrugh the participatin f the lcal department f health representatives in the priritizatin prcess. The quantitative secndary data cllectin prcess included a cmprehensive cllectin and review f health and quality f life data, cllected and analyzed thrugh the use f the Health Cmmunities Netwrk system, a web-based cmmunity health data platfrm develped by the Healthy Cmmunities Institute. The system is hsted n the Healthy Kern website at HealthyKern.rg. The qualitative primary data cllectin prcess included a Needs Assessment Survey with a ttal f 970 participants. The survey was cnducted by cnsulting team Strategy Slutins. A ttal f 27 individual interviews were cnducted with key stakehlders in the cmmunity t gather a persnal perspective frm thse wh have insight int the health f a cmmunity r the regin. The interviews were designed t gain insights frm diverse cmmunity grups and underrepresented ppulatins. The Cmmunity Assets sectin in the CHNA lists existing health care facilities and resurces within the cmmunity that are available t respnd t the health needs f the cmmunity. The cmplete CHNA reprt can be fund at and n the website at 9

11 CHNA Significant Health Needs With supprt frm the Healthy Cmmunities Institute and Strategy Slutins, members f the Cmmunity Benefit Cllabrative undertk a structured apprach t review public health data and cnduct interviews f city and cunty residents and public health fficials. This assessment resulted in a list f 40 health needs which were discussed at a cmmunity priritizatin meeting. Cmmunity Benefit Cllabrative members came t agreement n a set f criteria t evaluate the 40 health needs identified thrugh the assessment prcess. In rder t determine cmmunity needs, each f the 140+ indicatrs n HealthyKern.rg were analyzed n the fllwing criteria: (1) Hw des Kern Cunty perfrm cmpared t ther cunties in the state r natin? (2) Des Kern Cunty meet natinal Healthy Peple 2020 gals? (3) Was there an apparent health disparity? and (4) Des histric data shw that Kern Cunty is trending in a negative directin? The priritizatin prcess identified 10 pririty issues fr the cmmunity: 1. Heart Disease and Strke 2. Cancer 3. Diabetes 4. Preventative Screenings 5. Cancer Screenings 6. Access t Health Care 7. Lw Birth Weight/Infant Mrtality 8. Asthma 9. Wmen's Health Screenings 10. Sexually Transmitted Diseases (STDs) is addressing all f these needs with ne r mre cmmunity benefit prgrams, with the exceptin f lw birth weight and infant mrtality. This issue is addressed in the cmmunity by entities and rganizatins ther than ur three hspitals. Cmmunity Benefit Plan Develpment Prcess As a matter f Dignity Health plicy, the hspital s cmmunity benefit prgrams are guided by five cre principles. All f ur initiatives relate t ne r mre f these principles: Disprprtinate Unmet Health-Related Needs: Seek t address the needs f cmmunities with disprprtinate unmet health-related needs. Primary Preventin: Address the underlying causes f persistent health prblems thrugh health prmtin, disease preventin, and health prtectin. Seamless Cntinuum f Care: Emphasize evidence-based appraches by establishing peratinal linkages between clinical services and cmmunity health imprvement activities. Cmmunity Capacity: Target charitable resurces t mbilize and build the capacity f existing cmmunity assets. Cllabrative Gvernance: Engage diverse cmmunity stakehlders in the selectin, design, implementatin, and evaluatin f prgram activities. s Cmmunity Benefit Plan and Implementatin Strategy was develped based n the findings and pririties established by the Kern Cunty Cmmunity Health Needs Assessment and review f the hspital s existing cmmunity benefit activities. Each year Department emplyees present prgress reprts t the Cmmunity Benefit Cmmittee. The Cmmittee cncentrated n prgram expansins and service quality. The Cmmittee, as well as management and executive emplyees f each hspital, prvide input and, as a result, make adjustments t prgrams, services, and the Cmmunity Benefit Plan. The Plan is then submitted t the bard fr final 10

12 apprval. Each initiative in the Cmmunity Benefit Plan fr relates directly t ne r mre needs identified in the Cmmunity Assessment. Other stakehlders invlved in the selectin f pririty areas f fcus are thse rganizatins with which ur hspitals c-spnsr cmmunity benefit prgrams and utreach activities. Sme include the Kern Cunty Public Health Services Department, Greater Bakersfield Legal Assistance, Clinica Sierra Vista, United Way f Kern Cunty, Cmmunity Actin Partnership f Kern, Kern Family Health Care, Kern Cunty Department f Human Services, Omni Health Services, Kern Cunty Netwrk fr Children, First 5 Kern, and St. Vincent de Paul. Planning fr the Uninsured/Underinsured Patient Ppulatin In keeping with its missin, the hspital ffers patient financial assistance (als called charity care) t thse wh have health care needs and are uninsured, underinsured, ineligible fr a gvernment prgram r therwise unable t pay. The hspital strives t ensure that the financial capacity f peple wh need health care services des nt prevent them frm seeking r receiving care. The amunt f financial assistance prvided in FY15 is listed in the Ecnmic Value f Cmmunity Benefit sectin f this reprt n page 29. Brchures annuncing financial assistance are lcated in each Emergency Department, patient registratin area and varius lcatins thrughut each facility fr patient and family review. Every patient is given a financial assistance brchure upn admissin. If admitted in an emergent manner, the patient infrmatin binder cntains the financial assistance infrmatin. Each facility als has financial cunselrs n site t assist patients and their families upn discharge with bill reslutin and applicatins fr gvernment spnsred insurance services. Individuals with financial capacity t purchase health insurance are encuraged t d s as a means f assuring access t health care services. Additinally, thrugh grants frm First 5 Kern, Kern Cunty Public Health Services Department and The Califrnia Endwment, Mercy and s crdinate the Cunty s Cmmunity Health Initiative. It uses mnthly meetings, utreach, a strng netwrk f partner agencies, and ther methds t enrll and renew adults and children in health insurance thrugh the Affrdable Care Act. They minimize r eliminate barriers t enrllment. The Cmmunity Health Initiative f Kern Cunty cnducts utreach t infrm and enrll hard t reach individuals int health insurance, and t build awareness and supprt in the cmmunity at large. The Cmmunity Health Initiative als wrks t develp new ways that residents might access health care utside f an insurance prgram s that all Kern Cunty residents might have a medical hme. 11

13 2015 REPORT AND 2016 PLAN This sectin presents prgrams and initiatives the hspital is delivering, funding r n which it is cllabrating with thers t address significant cmmunity health needs. It includes bth a reprt n activities fr FY15 and planned prgrams with measurable bjectives fr FY16. SUMMARY Belw are the majr initiatives and key cmmunity-based prgrams f. These prgrams were develped in respnse t the Kern Cunty Cmmunity Health Needs Assessment and are guided by the fllwing five cre principles: Fcus n Ppulatins with Disprprtinate Unmet Health-Related Needs Seeking t accmmdate the needs f cmmunities with disprprtinate unmet health-related needs. Emphasize Primary Preventin Addressing the underlying causes f persistent health prblems. Build a Seamless Cntinuum f Care Emphasizing evidence-based appraches by establishing a link between clinical services and cmmunity health imprvement services. Increase Cmmunity Capacity Targeting charitable resurces t mbilize and build the capacity f existing cmmunity assets. Strengthen Cllabrative Gvernance Engaging diverse cmmunity stakehlders in the selectin, design, implementatin, and evaluatin f prgram activities Majr Initiatives Asthma Management prvides Kern Cunty families with a new level f asthma educatin and management using state f the art technlgy. Chrnic Disease Self-Management Prgram/Diabetes Self-Management Prgram prvides patients wh have chrnic diseases with the knwledge, tls and mtivatin needed t becme practive in their health. Cmmunity Health Initiative f Kern Cunty (CHI) increases access t health insurance and health care fr hard t reach individuals in Kern Cunty. Cmmunity Wellness Prgram - prvides persnalized in-hme health educatin and mnitring, cmmunity health screening clinics, health educatin classes, and referrals t ther lcal health care and scial service resurces. Hmemaker Care Prgram - prvides hmemaker services t frail elderly and disabled adults by helping them live independently fr as lng as pssible. This prgram als prvides jb training t unemplyed/hard t emply individuals by helping them learn marketable skills and transitin int the wrk frce. 12

14 is a key player when it cmes t building a healthier Kern Cunty. This is demnstrated by several n-ging prgrams including: Breast Health Prgram - prvides qualifying individuals wh are pr and uninsured with a mammgram free f charge fr preventive health care and when necessary, a breast ultrasund r a breast needle bipsy. Prescriptin Prgram - purchases necessary medicatins in emergency situatins fr peple wh must have the medicines fr their health but have n mney t buy them. The hspital evaluated all current Cmmunity Benefit prgrams and their relatin t the selected primary health needs. In many instances the structure was in place fr existing prgrams t address the selected primary health needs. Where there was a deficiency, new prgrams r practices were develped. This prcess resulted in the develpment f the implementatin plan described belw. New prgrams that the hspital plans t deliver in 2016 are dented by *. Other prgrams and nn-quantifiable benefits can be fund in Appendix B. Access t Health Care Breast Health Prgram Charity Care fr uninsured/underinsured and lw incme residents Cmmunity Health Initiative Enrllment Assistance/Gvernment Prgrams Flu Clinics Guidance and Referrals t Cmmunity Services Health Fairs Hmemaker Care Prgram - In-Hme Care Prescriptin Purchases fr Indigents Preventive Screenings Health Screenings Heart Disease and Strke Health Educatin Seminars and Classes Chrnic Disease Self-Management Prgram Diabetes Healthy Kids in Healthy Hmes In-Hme Health Educatin Diabetes Self-Management Prgram Asthma* Asthma Prgram Anticipated Impact The anticipated impact f specific prgram initiatives, including gals and bjectives, are stated in the Prgram Digests n pages 16 t 29. Overall, the hspital anticipates that actins taken t address significant health needs will: imprve health knwledge, behavirs, and status; increase access t care; and help create 13

15 cnditins that supprt gd health. The hspital is cmmitted t mnitring key initiatives t assess and imprve impact. The Cmmunity Benefit Cmmittee, hspital executive leadership, Cmmunity Bard, Dignity Health System Office and department emplyees receive and review prgram updates. In additin, the hspital evaluates impact and sets pririties fr its cmmunity benefit prgram by cnducting Cmmunity Health Needs Assessments every three years. Planned Cllabratin The hspital wrks with ver 100 lcal cmmunity rganizatins t achieve its gals, including cmmunity health centers, public health services, scial services, schl districts, and ther private and public stakehlders. This cmmunity benefit plan specifies significant cmmunity health needs that the hspital plans t address in whle r in part, in ways cnsistent with its missin and capabilities. The hspital may amend the plan as circumstances warrant. Fr instance, changes in significant cmmunity health needs r in ther cmmunity assets and resurces directed t thse needs may merit refcusing the hspital s limited resurces t best serve the cmmunity. The fllwing pages include Prgram Digests describing key prgrams and initiatives that address ne r mre significant health needs in the mst recent CHNA reprt. 14

16 PROGRAM DIGESTS Cmmunity Wellness Prgram Significant Health Needs Addressed Preventive Screenings Diabetes Asthma Heart Disease and Strke Access t Health Care Prgram Emphasis Disprprtinate Unmet Health-Related Needs Primary Preventin Seamless Cntinuum f Care Build Cmmunity Capacity Cllabrative Gvernance Prgram Descriptin The Cmmunity Wellness Prgram is fcused n preventive health care by prviding nsite screenings and health and wellness educatin classes n relevant tpics fr residents thrughut Kern Cunty. Planned Cllabratin Our prgrams wrk with dzens f lcal cmmunity rganizatins t achieve its gals, including cmmunity health centers, public health, scial services, schl districts, and ther private and public stakehlders. Cmmunity Benefit Categry A1-a Cmmunity Health Educatin - Lectures/Wrkshps A1-c Cmmunity Health Educatin - Individual health ed. fr uninsured/under insured A2-d Cmmunity Based Clinical Services - Immunizatins/Screenings FY 2015 Reprt Prgram Gal / Anticipated Impact The Cmmunity Wellness Prgram will increase access t preventive health screenings and educatin fr residents f Kern Cunty. Measurable Objective(s) The bjectives fr FY 2015 were: with Indicatr(s) Prvide 33,000 bld pressure, chlesterl, glucse and BMI screenings thrughut Kern Cunty. Prvide 12,000 clients with health educatin thrugh in-hme visits and classes/seminars including Empwerment-Chrnic Disease and Diabetes. Achieve an average evaluatin scre f 4 r higher frm attendees at Cmmunity Health Educatin Classes. Add ne mnthly Cmmunity Screening Clinic in a new rural cunty lcatin. Baseline / Needs Summary Interventin Actins fr Achieving Gal Enhancement strategies were: Prvide mini-educatin sessins t encurage participatin f screening clients in Cmmunity Health Educatin Classes and Empwerment Seminars. Accrding t HealthyKern.rg: 30.8% f adults in the Cunty are bese and the percentage has cntinued t increase ver the past five years (CHIS ). The age-adjusted diabetes death rate in Kern Cunty fr the 2010 t 2012 measurement perid is 33 per 100,000 cmpared t the State value f 20.6per 100,000. The age-adjusted diabetes hspitalizatin rate in Kern Cunty fr the 2011 t 2013 measurement perid is 25.1 per 100,000 ppulatin. Interventin actins were: Enhance ur wrk with Mercy & s Case Management Department and ther health care entities t implement a mdel cntinuum f care. Imprve tracking mechanisms that will enhance mnitring, fllw-up, and retentin f Cmmunity Clinic participants. Demnstrate the impact n hspital utilizatin patterns by expanding the envirnment f seamless cntinuum f care between the hspital, the prvider and the Cmmunity Wellness Prgram. 15

17 Prgram Perfrmance / Outcme Hspital s Cntributin / Prgram Expense Prgram Gal / Anticipated Impact Measurable Objective(s) with Indicatr(s) Baseline / Needs Summary Interventin Actins fr Achieving Gal During FY 15, the Cmmunity Wellness Prgram accmplished the fllwing: Prvided 31,130 health screenings. (Gal: prvide 33,000 screenings) Prvided 13,385 clients with health educatin. (Gal: Educate 12,000 clients) Achieved an average evaluatin scre f 4.75 frm attendees at Cmmunity Health Educatin Classes. (Gal: Scre 4 r higher) Added ne mnthly Cmmunity Screening Clinic in Tehachapi. (Gal: Add ne new clinic in a rural cunty lcatin) Enhancement strategies cmpleted: Prvided multiple team appraches in prviding mini-educatin sessins with screening clients, fllwed by scheduled Health Educatin Classes and Empwerment Seminars in nearby lcatins. The ttal FY 2015 expense fr the Cmmunity Wellness Prgram was $783,092. Of this amunt, $159,348 was grant dllars, and $623,744 was cntributed by Mercy and s. Capital funding used fr the Cmmunity Wellness Center renvatins was $115,942. All f the capital amunts were paid thrugh grants and dnatins. Other hspital cntributins include prgram supervisin, strategic planning, evaluatin, fundraising supprt, educatinal materials, liability insurance fr the prgram and prgram s clinic van, bkkeeping, and human resurce supprt fr the prgram. FY 2016 Plan The Cmmunity Wellness Prgram will increase access t preventive health screenings and educatin fr residents f Kern Cunty. The bjectives fr FY 2016 are: Prvide 32,000 bld pressure, chlesterl, glucse and BMI screenings thrughut Kern Cunty. Prvide 11,000 clients with health educatin thrugh in-hme visits and classes/seminars including Empwerment-Chrnic Disease and Diabetes. Prvide 150 Cmmunity Health Educatin classes acrss the cunty. Add ne mnthly Cmmunity Screening Clinic in a new rural cunty lcatin. Add 5 new lcatins fr Cmmunity Health Educatin classes. Prvide 10 cking classes thrugh the Kitchen Classrm. Enhancement strategies are: Prmte kitchen classrm thrugh cllabrative meetings, Cmmunity Wellness Prgrams, and ther events. Meet with head f Bakersfield Cllege Culinary Arts prgram t establish instructr recruitment. Accrding t HealthyKern.rg: 30.8% f adults in the Cunty are bese and the percentage has cntinued t increase ver the past five years (CHIS ). The age-adjusted diabetes death rate in Kern Cunty fr the 2010 t 2012 measurement perid is 33 per 100,000 cmpared t the State value f 20.6per 100,000. The age-adjusted diabetes hspitalizatin rate in Kern Cunty fr the 2011 t 2013 measurement perid is 25.1 per 100,000 ppulatin. Interventin actins are: Imprve cllectin f health screening data by utilizing technlgy that will be available n-site at health screening clinics. Develp methds t track utilizatin by clients acrss all Cmmunity Wellness prgrams that will track utcmes. 16

18 Significant Health Needs Addressed Prgram Emphasis Prgram Descriptin Planned Cllabratin Cmmunity Benefit Categry Prgram Gal / Anticipated Impact Measurable Objective(s) with Indicatr(s) Baseline / Needs Summary Chrnic Disease Self-Management Prgrams Preventive Screenings Diabetes Asthma Heart Disease and Strke Access t Health Care Disprprtinate Unmet Health-Related Needs Primary Preventin Seamless Cntinuum f Care Build Cmmunity Capacity Cllabrative Gvernance Our cmprehensive Chrnic Disease Self-Management Prgrams (Empwerment- Chrnic Disease and Empwerment-Diabetes) are designed t prvide patients wh have diabetes and ther chrnic illnesses with the knwledge, tls and mtivatin needed t becme practive in their health. Each prgram seminar cnsists f six (6) weekly classes cvering a variety f tpics including nutritin, exercise, use f medicatins, cmmunicatin with dctrs, stress management, and evaluating new treatments. Our prgram wrks with ver a dzen lcal cmmunity rganizatins t achieve its gals, including cmmunity health centers and ther private and public stakehlders. A1-a Cmmunity Health Educatin - Lectures/Wrkshps FY 2015 Reprt By ffering evidence-based chrnic disease self-management (CDSM) prgrams, Mercy and s will be effective in aviding hspital admissins fr tw f the mst prevalent ambulatry care sensitive cnditins in ur cmmunity (Diabetes and Cngestive Heart Failure). The bjectives fr FY 2015 were: Prvide 20 Empwerment-Chrnic Disease and Empwerment-Diabetes seminars in Kern Cunty areas with a Cmmunity Need Index (CNI) scre f 3 r abve t ensure that underserved persns thrughut the cunty will have access t the Seminars. 85% f all participants with chrnic diseases wh cmplete Empwerment-Chrnic Disease and Empwerment-Diabetes seminars will remain healthier after their seminars, as measured by thse wh avid admissins t the hspital r emergency department fr the six mnths fllwing their participatin in the prgram. Establish a regular system referring hspital-discharged patients t Empwerment seminars. Enhancement strategies were: Expand access t Empwerment-Chrnic Disease and Empwerment-Diabetes selfmanagement educatin t residents f tw new Kern Cunty cmmunities with a Cmmunity Need Index (CNI) scre f 3 r abve r t new high-risk cmmunities. Test the use f a Sessin Zer befre Empwerment Seminars t determine impact n retentin f participants. Accrding t HealthyKern.rg: The age-adjusted diabetes death rate in Kern Cunty fr the 2010 t 2012 measurement perid is 33 per 100,000 cmpared t the State value f 20.6 per 100,000. Kern has the secnd highest diabetes death rate in the State. The age-adjusted diabetes hspitalizatin rate in Kern Cunty fr the 2011 t 2013 measurement perid is 25.1 per 100,000 ppulatin. 33.2% f adults in the Cunty are bese and the percentage has cntinued t increase ver the past five years (CHIS ). Kern Cunty has the highest death rate in the State due t Crnary Heart Disease. 17

19 Interventin Actins fr Achieving Gal Prgram Perfrmance / Outcme Hspital s Cntributin / Prgram Expense Prgram Gal / Anticipated Impact Interventin actins were: Engage clinical health prfessinals t guide prgram imprvement. Fcus n the uninsured and ppulatins cvered by Medicaid, Medicare/Medicaid. Expand awareness and access f Empwerment-Chrnic Disease and Empwerment-Diabetes Self-Management Prgrams by increasing partnership with cmmunity rganizatins serving residents with chrnic cnditins, i.e., Arthritis Fundatin, MS Sciety, etc. Encurage and supprt cntinuing educatin fr staff develpment t ensure quality service is ffered by the Empwerment Self-Management Prgrams. During FY 2015, Empwerment accmplished the fllwing: Cmpleted 27 Empwerment-Chrnic Disease and Empwerment-Diabetes Seminars in Kern Cunty (Gal 20 seminars). A ttal f 11 seminars were fr Diabetes Self-Management, and 16 seminars were fr Chrnic Disease Self- Management. 98.9% f participants with chrnic diseases wh cmpleted the Empwerment- Chrnic Disease and Empwerment-Diabetes seminars avided admissins t the hspital r emergency department fr the three mnths fllwing their participatin in the prgram. (Gal 85%) 197 participants cmpleted Empwerment-Chrnic Disease and Empwerment- Diabetes seminars. Referrals are received frm hspital Care Managers fr hspitalized patients wh can benefit frm Empwerment Seminars. Enhancement strategies cmpleted: Expanded access with Empwerment-Chrnic Disease and Empwerment-Diabetes self-management seminars prvided in Wasc, and fur new lcatins in Bakersfield with a Cmmunity Needs Index (CNI) scre f 3 r abve, including Central Church and Bessie Owens Elementary Schl. Sessin Zer was tested n three Diabetes Self-Management Seminars and tw Chrnic Disease Self-Management Seminars. There was n difference seen in retentin by using Sessin Zer in any f the seminars. Hwever, it did save time during Sessin One. It als signals the leaders when a seminar needs t be split because f a large turnut. Expenses in FY 2015 have been $71,931. Mercy and s cntributed 100% f the funding t the Chrnic Disease Self-Management Prgrams annual budget. Other hspital cntributins include prgram supervisin, strategic planning, evaluatin, fundraising supprt, educatinal materials, liability insurance, bkkeeping, and human resurce supprt fr the prgram. FY 2016 Plan By ffering evidence-based chrnic disease self-management (CDSM) prgrams, Mercy and s will be effective in aviding hspital admissins fr tw f the mst prevalent ambulatry care sensitive cnditins in ur cmmunity (Diabetes and Cngestive Heart Failure). 18

20 Measurable Objective(s) with Indicatr(s) Baseline / Needs Summary Interventin Actins fr Achieving Gal The bjectives fr FY 2016 are: Prvide 20 Empwerment-Chrnic Disease and Empwerment-Diabetes seminars in Kern Cunty areas with a Cmmunity Need Index (CNI) scre f 3 r abve t ensure that underserved persns thrughut the cunty will have access t the Seminars. 85% f all participants with chrnic diseases wh cmplete Empwerment-Chrnic Disease and Empwerment-Diabetes seminars will remain healthier after their seminars, as measured by thse wh avid admissins t the hspital r emergency department fr the three mnths fllwing their participatin in the prgram. Prvide 2 new lcatins in Kern Cunty fr Empwerment-Chrnic Disease and Empwerment- Diabetes Seminars in rder t expand ur services. Enhancement strategies are: Create a methd t mnitr each certified Empwerment leader at least annually t ensure that Stanfrd Leader Standards are being faithfully fllwed by all leaders. We expect this prgram fidelity practice t prvide supprt in adhering t the strict Stanfrd methd f leading amng ur lay leaders. Train 10 new leaders fr Empwerment-Chrnic Disease in English t ensure that an adequate number f seminars will be available fr the cmmunity. Accrding t HealthyKern.rg: 30.8% f adults in the Cunty are bese and the percentage has cntinued t increase ver the past five years (CHIS ). The age-adjusted diabetes death rate in Kern Cunty fr the 2010 t 2012 measurement perid is 33 per 100,000 cmpared t the State value f 20.6per 100,000. The age-adjusted diabetes hspitalizatin rate in Kern Cunty fr the 2011 t 2013 measurement perid is 25.1 per 100,000 ppulatin. Interventin actins are: Engage clinical health prfessinals t guide prgram imprvement. Fcus n the uninsured and ppulatins cvered by Medicaid, Medicare/Medicaid. Encurage and supprt cntinuing educatin fr leader develpment t ensure quality service is prvided by the Empwerment Self-Management Prgrams. 19

21 Significant Health Needs Addressed Prgram Emphasis Prgram Descriptin Planned Cllabratin Cmmunity Benefit Categry Prgram Gal / Anticipated Impact Measurable Objective(s) with Indicatr(s) Baseline / Needs Summary Interventin Actins fr Achieving Gal Asthma Management Preventive Screenings Diabetes Asthma Heart Disease and Strke Access t Health Care Disprprtinate Unmet Health-Related Needs Primary Preventin Seamless Cntinuum f Care Build Cmmunity Capacity Cllabrative Gvernance The Asthma Management prject s gal is t bring a new level f asthma educatin and management t Kern Cunty families, and t reduce repeated hspitalizatins due t uncntrlled asthma. Certified Asthma Educatrs prvide educatin t individuals and small grups thrughut ur cunty. Educatin is supprted by state f the art technlgy that mnitrs a client s usage f bth rescue and cntrller medicatins. This technlgy als ntifies ur educatrs when direct interventin is needed t help a client avid an asthma crisis. Our prgram partners with Kern Health Systems, the American Lung Assciatin and several lcal cmmunity rganizatins t achieve its gals. A1 Cmmunity Health Educatin FY 2015 Reprt An Asthma Management pilt prject will be established as a part f the Cmmunity Wellness Prgram, and 20 clients will be mnitred and supprted fr the ne-year prject perid. The bjectives fr FY 2015 were: Three emplyees f the Cmmunity Wellness Prgram (CWP) will becme Certified Asthma Educatrs. 20 clients will be enrlled int the pilt prject. Prtcls fr mnitring and interventin will be established. Enhancement strategies were: Partner with cmmunity rganizatins t identify ptential clients fr pilt prject. Outcmes will be carefully mnitred and cmpared with ther Prpeller Health client cmpanies and Dignity Health hspitals that have used the technlgy. Accrding t the Califrnia Department f Public Health, 111,000 children and adults in Kern Cunty (13.9% f the ppulatin) have been diagnsed with asthma in their lifetime, and 9.2% currently have active asthma. Asthma diagnses, deaths, Emergency Department visits and hspitalizatins ccur at a higher rate in Kern than in Califrnia as a whle. Asthma is cnsidered t be a manageable cnditin with apprpriate medical interventin and cnsistent use f medicatin. Unfrtunately, ne-third f diagnsed Kern residents (32.3%) have nt received a written self-management plan frm a health care prvider. (Surce: 2009 Califrnia Health Interview Survey) Accrding t HealthyKern.rg the adult asthma age-adjusted hspitalizatin rate in Kern Cunty fr the 2011 t 2013 measurement perid is 49.1 per 10,000 ppulatin. Interventin actins were: An agreement will be made with Prpeller Health t utilize their prprietary technlgy mnitring system. Cmmunicatin will be established between CWP emplyees and apprpriate hspital persnnel t identify patients wh are candidates fr the pilt prject. 20

22 Prgram Perfrmance / Outcme Hspital s Cntributin / Prgram Expense Prgram Gal / Anticipated Impact Measurable Objective(s) with Indicatr(s) Baseline / Needs Summary Interventin Actins fr Achieving Gal Our emplyees are unable t becme Certified Asthma Educatrs at this pint. This certificatin requires a minimum f 1,000 hurs f prviding r receiving asthma educatin. Prgram staff is cmpiling infrmatin abut their qualifying hurs. An agreement with Prpeller Health was signed in March Clients will be enrlled thrugh a partnership with Kern Health Systems. Discussins are underway t implement the pilt prject. Prtcls have nt yet been started. N expense was incurred during FY FY 2016 Plan An Asthma Management pilt prject will be established as a part f the Cmmunity Wellness Prgram, and 20 clients will be mnitred and supprted fr the ne-year prject perid. The bjectives fr FY 2016 are: A structured plan will be in place fr three Cmmunity Wellness Prgram emplyees t achieve the 1,000 hurs needed t becme Certified Asthma Educatrs. 20 clients will be enrlled int the pilt prject. Prtcls fr mnitring and interventin will be established. Enhancement strategies are: Wrk with Kern Health Systems t identify ptential clients fr pilt prject. Outcmes will be carefully mnitred and cmpared with ther Prpeller Health client cmpanies and Dignity Health hspitals that have used the technlgy. Accrding t the Califrnia Department f Public Health, 111,000 children and adults in Kern Cunty (13.9% f the ppulatin) have been diagnsed with asthma in their lifetime, and 9.2% currently have active asthma. Asthma diagnses, deaths, Emergency Department visits and hspitalizatins ccur at a higher rate in Kern than in Califrnia as a whle. Asthma is cnsidered t be a manageable cnditin with apprpriate medical interventin and cnsistent use f medicatin. Unfrtunately, ne-third f diagnsed Kern residents (32.3%) have nt received a written self-management plan frm a health care prvider. (Surce: 2009 Califrnia Health Interview Survey) Accrding t HealthyKern.rg the adult asthma age-adjusted hspitalizatin rate in Kern Cunty fr the 2011 t 2013 measurement perid is 49.1 per 10,000 ppulatin. Interventin actins are: Cmmunity Wellness persnnel will wrk tgether with Kern Health Systems emplyees n technlgy training and mnitring prtcls. Cmmunicatin will be established between CWP emplyees and apprpriate KHS prviders and persnnel t identify patients wh are candidates fr the pilt prject. 21

23 Significant Health Needs Addressed Prgram Emphasis Prgram Descriptin Planned Cllabratin Cmmunity Benefit Categry Prgram Gal / Anticipated Impact Measurable Objective(s) with Indicatr(s) Baseline / Needs Summary Cmmunity Health Initiative Preventive Screenings Diabetes Asthma Heart Disease and Strke Access t Health Care Disprprtinate Unmet Health-Related Needs Primary Preventin Seamless Cntinuum f Care Build Cmmunity Capacity Cllabrative Gvernance The Cmmunity Health Initiative (CHI) f Kern Cunty is a grant-funded prject which wrks with mre than 50 public, private and nn-prfit rganizatins t enrll children and adults int health insurance prgrams and educate them n hw t utilize insurance. The CHI endeavrs t prvide access t health care fr Kern Cunty residents fr whm n insurance prgram is available. The cunty-wide effrt is further enhanced by prviding training t Certified Enrllment Cunselrs (CECs) and by wrking with lcal and state stakehlders t streamline the smetimes-burdensme prcess f navigating the public health system. Our prgram wrks with dzens f lcal rganizatins t reach the different ppulatins residing in Kern Cunty. Partners include: cmmunity health centers, public health, scial services, schl districts, cmmunity-based rganizatins and ther private and public stakehlders. A3-d Health Care Supprt Services - Enrllment Assistance FY 2015 Reprt With a calitin f Kern Cunty rganizatins, educate and enrll uninsured adults and children int a health insurance plan thrugh an innvative new plan. The bjectives fr FY 2015 were: Enrll 5,000 individuals in health insurance thrugh Medi-Cal and Cvered Califrnia. 2,000 enrllments will be made by Dignity Health emplyees, and 3,000 will be verified as enrlled r renewed by partner agencies. Prvide enrllment assistance in five new lcatins thrughut the cunty, and eight lcatins previusly supprted. Prvide Outreach and Enrllment supprt at six events spnsred by Dignity Health Marketing. Develp utilizatin strategies and educatin methds that result in 20% f assisted clients scheduling their first dctr appintment within six mnths f enrllment. 100% f clients wh receive enrllment assistance by CHI emplyees will be ffered annual renewal assistance. Enhancement strategies were: Expand the cunty s netwrk f partner agencies prviding enrllment services. Prvide nging training and supprt fr the new enrllment practices f Cvered Califrnia. The Califrnia Health Interview Survey (CHIS) describes Kern Cunty with a high percentage f children enrlled in health insurance. The indicatrs fr Kern Cunty, based n 2014 data, shw that 93% f children have health insurance. Hwever, 25% f adults ages are uninsured, accrding t the same survey (based n 2012 data). The Affrdable Care Act (ACA) is prviding new pprtunities fr lw-incme adults t have access t health insurance. The partner agencies f the Cmmunity Health Initiative are already putting the cllective expertise develped ver the past 10 years t gd use in develping new, innvative methds t reach these adult ppulatins. 22

24 Interventin Actins fr Achieving Gal Prgram Perfrmance / Outcme Hspital s Cntributin / Prgram Expense Prgram Gal / Anticipated Impact Measurable Objective(s) with Indicatr(s) Interventin actins were: Cntinue develpment f cntinuus flw f funding fr prgram sustainability. Prvide utreach and enrllment services t ppulatins that have been hard-treach thrugh ur traditinal channels. Cntinue t wrk at lcal, state and federal levels t eliminate barriers and streamline applicatin prcesses. During FY 15, the Cmmunity Health Initiative accmplished the fllwing: Verified enrllment f 1,164 children and adults int health insurance prgrams by CHI staff. Prvided enrllment assistance in 25 new lcatins thrughut the cunty and 42 lcatins previusly supprted. Prvided Outreach and Enrllment supprt at 48 events in cllabratin with Dignity Health Marketing. The My Path t Gd Health Bklet was created as an educatin tl fr Certified Enrllment Cunselrs and a resurce fr clients wh were prvided applicatin assistance. Cnfirming the scheduling f clients first dctr appintment within six mnths f enrllment did nt begin this year. 100% f clients wh received enrllment assistance by CHI emplyees were ffered renewal assistance. Enhancement strategies cmpleted: One additinal agency became a Certified Enrllment Entity assciated with the Cmmunity Health Initiative. Cnducted 11 partner trainings, with 398 partner agency persnnel trained, n the new enrllment practices f Cvered Califrnia. The ttal FY 2015 expense fr the Cmmunity Health Initiative was $683,700. The full $683,700 was secured thugh grant dllars. Hspital cntributins include prgram supervisin, strategic planning, evaluatin, fundraising supprt, educatinal materials, liability insurance fr the prgram, bkkeeping, and human resurce supprt fr the prgram. FY 2016 Plan With a calitin f Kern Cunty rganizatins, educate and enrll uninsured adults and children int a health insurance plan thrugh innvative appraches. The bjectives fr FY 2016 are: Enrll r renew 2,500 individuals in health insurance thrugh Medi-Cal and Cvered Califrnia. 1,000 enrllments/renewals will be made by CHI emplyees, and 1,500 will be verified as enrlled r renewed by partner agencies. Prvide enrllment assistance in five new lcatins thrughut the cunty, and 15 lcatins previusly supprted. Prvide Outreach and Enrllment supprt at 10 events in cllabratin with Dignity Health Marketing. Develp utilizatin strategies and educatin methds that result in 50% f assisted clients selecting a primary care prvider and 20% scheduling their first dctr appintment within six mnths f enrllment. 100% f clients wh receive enrllment assistance by CHI emplyees will be ffered annual renewal assistance. Enhancement strategies are: Incrprate Prmtras in utreach, enrllment and utilizatin effrts t reach the Latin cmmunity. Expand the cunty s netwrk f partner agencies prviding enrllment services. Prvide nging training and supprt n utreach, retentin, enrllment and utilizatin practices. 23