Improvement. Report UNIVERSITY OF MARYLAND BALTIMORE WASHINGTON MEDICAL CENTER 1

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C O M M U N I T Y H E A LT H Improvement Report 20 18 S U P P O R T I N G O U R C O M M U N I T I E S UNIVERSITY OF MARYLAND BALTIMORE WASHINGTON MEDICAL CENTER 1

University of Maryland Baltimore Washington Medical Center (UM BWMC) University of Maryland Baltimore Washington Medical Center (UM BWMC), a regional health care facility located in Anne Arundel County, is one of 14 hospitals that make up the University of Maryland Medical System. Our expert physicians and experienced, compassionate staff provide high-quality care to the community, backed by nationally recognized specialty services at the University of Maryland Medical Center and the University of Maryland School of Medicine. For patients, this means access to the highest quality of care and research discoveries aimed at improving Maryland s health. As we extend our services beyond the hospital walls by engaging with community leaders and organizations, we combine our efforts to fulfill our mission to provide the highest quality health care services to the community that we serve. Comprehensive, collaborative and integrative services are the key ingredients for our communities health. This report highlights a few of UM BWMC s fiscal year 2018 health improvement activities. This summary reflects our dedication to our community and to helping improve the health of the people we serve. We are always engaging in new collaborations and enhancing existing ones to meet the needs of the community. We place particular emphasis on reaching vulnerable populations and addressing the health improvement priorities identified through our Community Needs Assessment. Our community benefit programs include health promotion and outreach services to provide people with the education and tools they need to lead healthier lives. UM BWMC does this through community awareness events, screenings for early disease diagnosis, and other community building activities. Fiscal year 2018 highlights include our cancer support services, our inaugural Spring into Wellness Block Party to increase health care awareness and access to care in our community, the Opioid Response Program to combat the growing opioid epidemic, and our Transitional Care Center to help keep patients well in the community by bridging the gap between hospital discharge and home. a message to OUR COMMUNITY: We are pleased to present the University of Maryland Baltimore Washington Medical Center s (UM BWMC) Community Health Improvement Report for fiscal year 2018. This summary reflects our unwavering commitment to improving the health and wellbeing of the communities we serve. We know that providing high quality health care to patients within the walls of our facilities is not enough. We strive to bring support to community members where they live and work every day, in Anne Arundel County and the surrounding area. Our goal is to empower families and individuals with the resources and education they need to prevent disease and stay healthy. Together, we re helping families build healthy habits, manage chronic conditions, and make informed health care decisions. Community benefits are activities or programs that focus on meeting community health needs and promoting health and wellbeing. Throughout FY18 and every Our goal is to empower year, we provide community programs that focus on preventive health, such as blood pressure families and individuals with screenings, flu shot clinics, and pregnancy and the resources and education parenting education to those at high risk. We also they need to prevent disease help individuals make healthy lifestyle changes, and stay healthy. with offerings such as support groups, smoking cessation classes, exercise classes and more. Our community benefit activities are made possible by the dedication of so many individuals. We partner with health providers, non-profit organizations, local government agencies, schools, religious groups, volunteers and many other local and regional affiliates who share our passion for community health. Together through grassroots efforts, educational workshops and annual health fairs, we collaborate to address the ever-changing, urgent health needs of our neighbors. Inside this report are just a few of the many programs that we offer to the communities we serve. Thank you for taking time to learn about our mission and how we re making a long-lasting impact on the families in Anne Arundel County. We look forward to supporting our community for many more years to come. Sincerely, For more information about UM BWMC s community benefit activities or this report, please visit umbwmc. org/community-benefit, send an email to bwmcpr@umm.edu or call Community Outreach at 410-553-8103. Karen E. Olscamp President and CEO UM Baltimore Washington Medical Center Michael Caruthers Chair, Community Benefit Committee UM Baltimore Washington Medical Center 2 2018 COMMUNITY HEALTH IMPROVEMENT REPORT

COMMUNITY HEALTH IMPROVEMENT REPORT Spring into Wellness Block Party In April 2018, UM BWMC hosted its first Spring into Wellness Block Party where over 400 community members were welcomed to the hospital campus. This fun-filled yet educational event had something for the entire family to enjoy! This free event was designed to bring access to care and education to county residents and to encourage them to adopt healthy lifestyle choices, and consider making positive changes regarding their health. Spring into Wellness was located in the front parking lot of the UM BWMC hospital campus and included a number of different hospital departments and community organizations. All providing health education, screenings, demonstrations and more to our local community. Different topics that were included in this year s event were CPR demonstrations, blood pressure, skin cancer and dental screenings, Emergency Department and mobile care resources, mental health and opioid response education, infant safe sleep education, nutrition and Medicare and Medicaid resources. Attendees who met age and/or health requirements were also provided a voucher to receive a free vascular screening that included abdominal aortic aneurysm, peripheral artery disease, and carotid artery disease screening. Food trucks, dance and exercise demonstrations, the Red Cross Blood Mobile, and a giant inflatable walk-through brain were also on hand to educate on how the brain works, and brain conditions such as stroke, headaches, brain tumors, concussions, and more. Opiod Response Program In response to the growing opioid epidemic, UM BWMC is now offering free Overdose Response Program classes. These classes, which were implemented in July 2017 and are ongoing monthly, are open to anyone in the community. Classes are two hours in length and are taught by trained clinical staff from UM BWMC. Each class covers how to spot the signs and symptoms of someone who is experiencing an opioid-related overdose and how to administer Naloxone (also known as Narcan). The Opioid Response Program was created in response to the General Assembly passing the Heroin and Opioid Prevention Effort (HOPE) Act of 2017 that in part allows for the public to help save the life of someone who is suspected of suffering from an opioid overdose. The law allows someone with no medical background to provide the life-saving medication. This program is also part of the Maryland Department of Health and Mental Hygiene s strategy to reduce overdose deaths. Since the conception of the Opioid Response Program community members continue to be trained in these classroom sessions. By offering the Opioid Response Program class, UM BWMC remains firm on their position to be proactive in the battle against the Classes are two hours in length and are taught by trained clinical staff from UM BWMC. Since the conception of the Opioid Response Program, community members continue to be trained in these classroom sessions. opioid epidemic. The Opioid Task Force, led by the Clinical Director of Addiction Services at UM BWMC, is comprised of physicians who serve as medical department chairmen, pharmacists and nurses. Through the Opioid Task Force, educational flyers have been created to provide patients who are prescribed opioids. These flyers include how to safely take and handle your prescriptions, how to store and dispose of your medications, warning signs of addiction, and a list of Anne Arundel County support services. UNIVERSITY OF MARYLAND BALTIMORE WASHINGTON MEDICAL CENTER 1

Transitional Care Center UM BWMC is committed to supporting patients and their families, especially those with chronic conditions or those who may lack resources to maintain their best health. Through the Transitional Care Center patients are empowered to better manage their chronic conditions and understand their medications to help them to not only stay healthy, but to avoid hospital readmissions and repeat visits to the Emergency Department. The Transitional Care Center is a transitional healthcare clinic for high-risk patients who frequently utilize the Emergency Department, have repeat observation or inpatient hospital readmissions, and those without a primary care physician or have not had a primary care visit in the last 12 months. The clinic provides up to two visits as a transition out of hospital discharge care. The visits will include time to meet with a provider for an overall evaluation and time spent with a pharmacist for medication reconciliation and review. Patients will also be provided with health education from a nurse, and spend time talking with a social worker for social support resources. All services are free of charge to the patient. Center staff will also maintain contact with the patient and provide follow-up on outstanding medical tests, and additional appointments when necessary. The Center notably looks at the whole health of a patient and connects them with additional community resources that they may need to help them improve their overall quality of life. Resources include: helping to set up medical assistance, getting gas and electric delivered to their home, and connecting them with local housing shelters. As a bridge from hospital to home, all patients who utilize the Transitional Care Center for a complex visit after their hospital discharge will be referred back to a community physician. If a patient does not have a primary care physician they will be helped to set up an appointment with one for continued follow-up care. Cancer Support Services UM BWMC provides cancer support services to the community on an ongoing basis, whether patients are at the onset of diagnosis or in the middle of treatment, and after, UM BWMC is here to support patients and their families. UM BWMC and the Tate Cancer Center are proud to offer the cancer support group which is a self-care class and group discussion offering information and support for cancer patients and survivors. In addition to networking and peer support, the group discusses timely topics related to treatment and care. The Tate Cancer Center, a designated site for the American Cancer Society s Look Good, Feel Better workshop, rebranded their program and re-launched with their first class in February 2018. This program is free for adults of all genders and ages who are dealing with appearance changes (hair loss and/or skin changes) from cancer treatment. Classes are taught by licenses beauty professionals (cosmetologists, estheticians, nail technicians). During this workshop, participants learn specific techniques to enhance their appearance and are provided a kit with beauty samples to take home. UM BWMC is also pleased to partner with Tafiya Yoga and Wellness to provide a free therapeutic yoga class for all cancer survivors and their caregivers on a weekly basis. No prior yoga experience is necessary, with sessions being conscious of individual s needs, participants can participate in a gentle yoga experience on the floor or in a chair. In honor of those who have survived cancer UM BWMC hosted its annual Cancer Survivors Day event on June 6th. Cancer Survivors Day is a national celebration observed every June to honor those who have survived cancer, to support families and patients recently diagnosed, and to reach out and provide resources to the community. The event was attended by over 150 current and former patients and their families, community members, physicians, nurses, staff members and others, including therapy dogs. Attendees had the opportunity to browse education displays, participate in art activities, and enjoy a catered lunch. In addition to our cancer support services, UM BWMC provides a variety of cancer prevention and screening awareness programs, including smoking cessation classes, educational sessions and clinical research through our tumor registry. + 2 2018 COMMUNITY HEALTH IMPROVEMENT REPORT

and health system transformation initiatives. This results-driven plan also explains the structure for assuring that the UM BW- MC s community benefit program has the appropriate resources to support the successful implementation of this plan and improve the outcomes in the areas identified. COMMUNITY HEALTH NEEDS ASSESSMENT UM BWMC collaborated with the Healthy Anne Arundel Coalition to perform a comprehensive countywide Community Health Needs Assessment (CHNA) that integrated quantitative and qualitative date. The CHNA is conducted every three years, and is encompasses several research components, including an analysis of secondary data sources (census data, hospital discharge data and others) and primary data collection through key stakeholder interviews and focus groups. The CHNA examined a variety of indicators, including social determinants of health (e.g. income, housing and education), mortality rates, risky behaviors (e.g. alcohol, drug and tobacco use) and chronic health conditions such as diabetes and heart disease. Additional analyses were conducted by race, age, ethnicity and zip code. The CHNA also focused on understanding current challenges and possible solutions to health care access, utilization and care coordination. Key stakeholder interviews and focus group participation provided valuable insight on what they believe is the most pressing health needs and strategies for population health improvement. Focus group participants include county residents, consumers of health care services and their caregivers, behavioral health providers and emergency department clinicians. The qualitative data collected in the interviews and focus groups illustrated the needs of vulnerable patients, including Medicare and Medicaid dual-eligible patients, high-utilizers of emergency department and inpatient hospital services and patients with complex or chronic physical and behavioral health conditions. UM BWMC believes the CHNA is an important tool to help achieve its mission of providing the highest quality health care services to the communities that it serves. UM BWMC has used and will continue to use the CHNA findings to help implement strategies and create opportunities to design community outreach programs to encourage individuals in the county to make positive changes regarding their health, and to help guide clinical program development. The CHNA findings are also used by the Healthy Anne Arundel Coalition and other county organizations to develop and implement strategies to improve health. The Community Benefit Plan for fiscal year 2016 to 2018 addresses these community health improvement priorities: Chronic health conditions (cancer, cardiovascular disease, diabetes, and obesity/overweight) Behavior health Maternal and child health Health care access and utilization Community support UM BWMC engages in a number of strategies to prevent county residents from being overweight/obese and suffering from the related chronic health conditions. UM BWMC offers healthy eating and physical activity classes, community events and other activities to help people achieve a healthy weight and prevent chronic diseases such as diabetes, heart disease and cancer. UM BWMC hosts education opportunities, Preventing Diabetes classes and support groups. UM BWMC provides free screenings for vascular disease, heart disease and other conditions. UM BWMC offers support for individuals and families impacted by mental health conditions and substance abuse. Through its many partnerships, UM BWMC will continue to improve access to and enhance the quality of behavioral health care resources. UM BWMC is the only hospital in Anne Arundel County to offer inpatient psychiatric care and will continue to provide physician subsides to help meet the community s behavioral health needs. As part of our commitment to provide the highest quality health care services to the communities that we serve, UM BWMC is working to ensure patients receive the right care, at the right place at the right time. UM BWMC is a co-lead for the Bay Area Transformation Partnership to improve access to care, care coordination and health outcomes, particularly among patients with complex, chronic illness and behavioral health conditions. UM BWMC s CHNA can be found at: www.umms.org/bwmc/community/community-benefit. CHNA IMPLEMENTATION PLAN The UM BWMC Community Benefit Implementation Plan describes the process used to prioritize the community s health needs and the goals, strategies and partnerships for advancing the communities health. In addition, this plan describes the alignment with local, state and national health improvement priorities UNIVERSITY OF MARYLAND BALTIMORE WASHINGTON MEDICAL CENTER 3

COMMUNITY BENEFITS FINANCIAL CONTRIBUTIONS for Fiscal Year 2018 Mission Driven Health Care Services Charity Care $12,776,163 $6,845,000 Medicaid Assessments Community Health Services Health Professional Education Research Community Benefit Operations $1,426,809 $1,146,187 $554,991 $466,240 $381,227 $23,691,460 TOTAL COMMUNITY BENEFIT 4 2018 COMMUNITY HEALTH IMPROVEMENT REPORT Community Financial Building Contributions Activities $84.951 $7,832 Foundation Funded Community Benefit $2,060

FINANCIAL ASSISTANCE POLICY University of Maryland Baltimore Washington Medical Center (UM BWMC) is committed to providing financial assistance to patients who have health care needs and are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay for emergent and medically necessary care based on their individual financial situation. It is the policy of UM BWMC to provide Financial Assistance based on indigence or high medical expenses for patients who meet specified financial criteria and request such assistance. UM BWMC publishes the availability of Financial Assistance on a yearly basis in local newspapers and posts notices of availability at appropriate intake locations as well as the Billing Office. Notice of availability is also sent to patients with patient bills. Signage in key patient access areas is available. A Patient Billing and Financial Assistance Information Sheet is provided before discharge and is available to all patients upon request. Financial Assistance may be extended when a review of a patient s individual financial circumstances has been conducted and documented. This should include a review of the patient s existing medical expenses and obligations (including any accounts having gone to bad debt, except those accounts that have gone to lawsuit and a judgment has been obtained) and any projected medical expenses. Financial Assistance Applications may be offered to patients whose accounts are with a collection agency and may apply only to those accounts on which a judgment has not been granted. UM BWMC retains the right in its sole discretion to determine a patient s ability to pay. All patients presenting for emergency services will be treated regardless of their ability to pay. For emergent/urgent services, applications to the Financial Clearance Program will be completed, received and evaluated retrospectively and will not delay patients from receiving care. For more information about UM BWMC s Financial Assistance Policy, visit mybwmc.org/financial-assistance or call: 410-821-4140. If you cannot pay for all or part of your care from our hospital, you may be able to get free or lower cost services. PLEASE NOTE: 1. We treat all patients needing emergency care, no matter what they are able to pay. 2. Services provided by physicians or other providers may not be covered by the hospital Financial Assistance Policy. You can call 410-821-4140 if you have questions. How We Review Your Application The hospital will look at your ability to pay for care. We look at your income and family size. You may receive free or lower costs of care if: 1. Your income or your family s total income is low for the area where you live, or 2. Your income falls below the federal poverty level if you had to pay for the full cost of your hospital care, minus any health insurance payments. PLEASE NOTE: If you are able to get financial help, we will tell you how much you can get. If you are not able to get financial help, we will tell you why not. How To Apply For Financial Help 1. Fill out a Financial Assistance Application form. 2. Give us all of your information to help us understand your financial situation. 3. Turn the application form into us. PLEASE NOTE: The hospital must screen patients for Medicaid before giving financial help. Other Helpful Information 1. You can get a free copy of our Financial Assistance Policy and Application form: Online at www.mybwmc.org/financial-assistance In person at the Patient Accounts Department UM Baltimore Washington Medical Center, 301 Hospital Drive, Glen Burnie, Maryland 21061 By mail: call 410-821-4140 to request a copy 2. You can call the Financial Assistance Department if you have questions or need help applying. You can also call if you need help in another language. Call: 410-821-4140. UNIVERSITY OF MARYLAND BALTIMORE WASHINGTON MEDICAL CENTER 5

301 Hospital Drive Glen Burnie, MD 21061 410-787-4000 umbwmc.org 6 2018 COMMUNITY HEALTH IMPROVEMENT REPORT