St. Francis Hospital, The Heart Center Community Service Plan

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St. Francis Hospital, The Heart Center Community Service Plan 2014 2016 Approved by the Board of St. Francis Hospital on September 17, 2013, and Catholic Health Services on July 29, 2013 Updated June 23, 2014 100 Port Washington Blvd. Roslyn, NY 11576 (516) 562-6000 www.stfrancisheartcenter.com 1

Mission Statement Catholic Health Services of Long Island (CHS), as a ministry of the Catholic Church, continues Christ s healing mission, promotes excellence in care and commits itself to those in need. CHS affirms the sanctity of life, advocates for the poor and underserved, and serves the common good. It conducts its health care practice, business, education and innovation with justice, integrity and respect for the dignity of each person. St. Francis Hospital Service Area St. Francis Hospital, The Heart Center is a not-for-profit hospital located in Roslyn, New York, on the North Shore of Nassau County in the Town of North Hempstead. It is a member of Catholic Health Services (CHS). The Hospital s primary service area is Nassau County, but it also serves patients from eastern Queens and western Suffolk. St. Francis hospital discharge data indicates that we are serving an ever increasingly older population. St. Francis Hospital s primary and secondary service areas include 85 percent of hospital discharges. In 2012, the Hospital obtained 56.3 percent of its discharges from its primary service area, Nassau County (up from 55.3 percent in 2011). The secondary service area provides another 29.2 percent of discharges (down from 29.8 percent) and comprises two areas, west and east. The Western area consists of 31 zip codes (30 in Queens and one in Brooklyn) and provided 15.6 percent of discharges (the same as 2011). The Eastern area consists of 26 zip codes in Suffolk County and provided 13.6 percent of discharges (down from 14.2 percent). The population in the St. Francis Hospital service area is projected to become more racially and ethnically diverse in the coming years with the Asian and Hispanic communities growing rapidly. In addition, the increasing portion of the population over age 45 is projected to place significant demand on cardiovascular, orthopedic, oncologic, and neurologic services. 2012 St. Francis Hospital discharge data by ethnicity White 14,069 90.4% African American (Black) 735 4.7% Other Race 510 3.3% Asian 230 1.5% Native American 23 0.1% Total 15,567 100.0% 2012 St. Francis Hospital discharge data by age 0 5 1 0.0% 6 13 2 0.0% 14 17 3 0.0% 18 24 71 0.5% 25 34 200 1.3% 35 45 462 3.0% 45 54 1370 8.8% 55 64 2413 15.5% 2

65 74 3637 23.4% 75-84 4557 29.3% 85+ 2851 18.3% Founded in 1922, St. Francis offers high quality cardiac and noncardiac care to the community regardless of race, creed, ethnic origin, or ability to pay. As a Catholic health care facility, St. Francis embraces the tradition, values, and chrism of its founders, the Sisters of Franciscan Missionaries of Mary, emphasizing respect for the dignity of individuals and compassionate treatment for all. St. Francis is New York State s only specialty designated cardiac center and a nationally recognized leader in cardiac care. The Hospital also provides an outstanding program in noncardiac surgery that employs the most advanced technology and minimally invasive techniques available for vascular, prostate, ear-nose-throat (ENT), abdominal, oncologic, gastrointestinal, and orthopedic surgery. In July 2013, U.S. News & World Report ranked St. Francis Hospital among the top 10 hospitals in the nation for cardiology and heart surgery. It was the seventh consecutive year that U.S. News named St. Francis one of the Best Hospitals in America. The magazine also rated St. Francis among the best in the country in seven other adult specialties: ear, nose and throat; gastroenterology and GI surgery; geriatrics; neurology and neurosurgery; orthopedics; pulmonology; and urology more than any other hospital on Long Island. In the U.S. News regional rankings, St. Francis was the top ranked hospital on Long Island by U.S. News and rated fifth in the New York metro area. The magazine also recognized the Hospital as high performing in three specialties: cancer; diabetes and endocrinology; and nephrology. St. Francis Hospital reported $3.7 million in charity care at cost net of offsetting revenues in 2012. Community service, uncompensated care and other charitable activities provided for the community totaled $11.9 million at cost, and $808 thousand was reported in bad debt at cost net of offsetting revenues in 2012. New IRS Requirements The Affordable Care Act (ACA), enacted March 23, 2010, added new requirements that all not-forprofit hospitals, recognized as 501(c)(3) organizations, are required to complete a Community Health Needs Assessment (CHNA). A CHNA is designed to identify, prioritize, and address health issues in a hospital s primary service area. According to IRS regulations, a CHNA must be completed at least once every three years. A successful CHNA: Defines the hospital service area Identifies key health partners Includes results of a community-wide survey Identifies health priorities Explains how each partner plans to address health priorities through an Implementation Plan Reports health outcomes in the community 3

Disseminates the findings to stakeholders Public Participation Community health needs are assessed on a continual basis by St. Francis Hospital s Board of Trustees and Executive Leadership Council, and its Department of Community Health & Outreach Education at collaborative sessions with member hospitals in Nassau and Suffolk counties. St. Francis Hospital also works closely with the Long Island Hospital Network (LIHN), including fellow member hospitals of Catholic Health Services of Long Island (CHS), as well as with partners in community agencies and organizations such as schools, nursing homes, and rehabilitation centers. Assessments are also conducted via participant surveys collected at multiple outreach sites in the community. St. Francis Hospital distributed community needs surveys throughout Nassau County at over 900 community outreach events in 2012 alone. Surveys are distributed in English and in Spanish, and are available in written form and online. Free health screening and education events are promoted via calendar listings in parish bulletins and flyers, which are posted in places of business and worship in the community, and are available on St. Francis Hospital s internet and intranet websites. Key Health Partners Partnering with community-based organizations is the most effective way to determine how the health priorities will be addressed. Some of these organizations include: Nassau County Department of Health and other hospitals in Nassau County, Island Harvest, and United Way of Long Island and local affiliates of American Heart Association, American Diabetes Association and American Cancer Society. This community collaboration team then develops its implementation plan in which all community-based organizations pool their resources and determine which agencies can address specific health priorities. In 2012 and 2013 member hospitals gathered with the Nassau County Department of Health to assess community health needs by standardizing a survey that was distributed to businesses and patrons. This goal was to capture effectively pertinent data about the communities the Hospital serves, as well as to completely understand the public health needs and priorities in Nassau County. Community Health Assessment NASSAU COUNTY DEMOGRAPHICS 2012 Nassau County New York State Population, 2012 estimate 1,349,233 19,570,261 Population, 2010 (April 1) estimates base 1,339,529 19,378,104 Population, percent change, April 1, 2010 to July 1, 0.7% 1.0% 2012 Population, 2010 1,339,532 19,378,102 Persons under 5 years, percent, 2012 5.4% 6.0% Persons under 18 years, percent, 2012 22.5% 21.8% 4

Persons 65 years and over, percent, 2012 15.8% 14.1% Female persons, percent, 2012 51.5% 51.5% White alone, percent, 2012 (a) 77.3% 71.2% Black or African American alone, percent, 2012 (a) 12.2% 17.5% American Indian and Alaska Native alone, percent, 0.5% 1.0% 2012 (a) Asian alone, percent, 2012 (a) 8.4% 8.0% Native Hawaiian and Other Pacific Islander alone, 0.1% 0.1% percent, 2012 (a) Two or More Races, percent, 2012 1.6% 2.2% Hispanic or Latino, percent, 2012 (b) 15.3% 18.2% White alone, not Hispanic or Latino, percent, 2012 64.1% 57.6% Living in same house 1 year & over, percent, 2007-93.1% 88.5% 2011 Foreign born persons, percent, 2007-2011 20.9% 21.8% Language other than English spoken at home, 27.5% 29.5% percent age 5+, 2007-2011 High school graduate or higher, percent of persons 89.9% 84.6% age 25+, 2007-2011 Bachelor's degree or higher, percent of persons 41.2% 32.5% age 25+, 2007-2011 Veterans, 2007-2011 67,872 986,313 Mean travel time to work (minutes), workers age 16+, 2007-2011 33.5 31.4 Housing units, 2011 468,593 8,119,364 Homeownership rate, 2007-2011 81.8% 54.8% Housing units in multi-unit structures, percent, 21.1% 50.5% 2007-2011 Median value of owner-occupied housing units, $478,600 $301,000 2007-2011 Households, 2007-2011 443,315 7,215,687 Persons per household, 2007-2011 2.96 2.59 Per capita money income in the past 12 months $42,307 $31,796 (2011 dollars), 2007-2011 Median household income, 2007-2011 $95,823 $56,951 (a) Includes persons reporting only one race. (b) Hispanics may be of any race, so also are included in applicable race categories. D: Suppressed to avoid disclosure of confidential information F: Fewer than 25 firms FN: Footnote on this item for this area in place of data NA: Not available S: Suppressed; does not meet publication standards 5

X: Not applicable Z: Value greater than zero but less than half unit of measure shown (Source U.S. Census Bureau: State and County QuickFacts. Data derived from Population Estimates, American Community Survey, Census of Population and Housing, State and County Housing Unit Estimates, County Business Patterns, Non-employer Statistics, Economic Census, Survey of Business Owners, Building Permits. Last Revised: Thursday, 27-Jun-2013) Community Partners In order to better serve these diverse communities and decrease health disparities, St. Francis Hospital has an ongoing relationship with the following community partners who are involved in the planning and implementation of programs: AHRC Freeport Magnolia Gardens, Westbury Rev. Mitchell Mallette Housing Complex, Freeport Paternana Terrace, Freeport YMCA Glen Cove Glen Cove Senior Center Westbury Memorial Library St. Brigid s Church, Westbury St. Brigid s Senior Center Elmont Public Library Glen Cove Public Library Memorial Presbyterian Church, Roosevelt St. Vincent de Paul Church, Elmont Mary s Manor & Enriched Housing, Inwood Jasa Long Beach The North Hempstead YES Community Center, Westbury Freeport Recreation Center 6

Christ First Presbyterian Church, Hempstead Behtel AME Church, Freeport Uniondale Public Library Freeport Memorial Library Hempstead Senior Community Center Our Lady of Good Concil, Inwood Elmont Memorial High School Town of North Hempstead Project Independence Island Harvest St. Mary of the Isle, Long Beach St. Aloysius, Great Neck Our Lady of Loretto, Hempstead St. Boniface, Elmont St. Killian, Farmingdale St. Patrick, Glen Cove Blessed Sacrament, Valley Stream We also participate annually in: American Heart Association Walk, Breast Cancer Walk, and Marcum Challenge to promote physical activity and healthy lifestyle living. Community partners are involved in the needs identification, planning, implementation, and evaluation of community health programs that are conducted by St. Francis Hospital. Community Health Needs Assessment forms are given out at sites (in English and Spanish as may be indicated), and results are analyzed for ongoing collaborative, future planning efforts. Community relationship building provides a direct access point to increase knowledge about chronic disease prevention. Relationships are developed at each of our community partner sites where we know the contact people by name. We discuss the needs of their specific target population and implement health screenings and educational programs that are appropriate for them. Programs include: Healthy nutrition, smoking cessation, physical activity, and how to call 911 Falls prevention for seniors Breast cancer awareness and prostate screening for cancer prevention 7

Assessment of body mass index and waist circumference for obesity and nutrition initiatives Screening of blood glucose, cholesterol and blood pressure for cardiovascular disease prevention Community talks on chronic disease prevention and management by health care professionals on a variety of health-related topics We will also partner with the Long Island Health Collaborative (LIHC) which is a working group of hospital members, local health department personnel, representatives from social service organizations, public health specialists from colleges, and others who form the core of health and human service for all Long Islanders. LIHC s goal is to help Long Islanders understand why prevention and primary care are important, why each patient must play a more active role in their own health, what resources and services are available here on Long Island, and how these resources and services can be reached. Member organizations include: Brookhaven Memorial Hospital Eastern Long Island Hospital Franklin Hospital Medical Center Glen Cove Hospital Good Samaritan Hospital Medical Center Huntington Hospital Long Beach Medical Center John T. Mather Memorial Hospital Mercy Medical Center Nassau University Medical Center North Shore University Hospital Peconic Bay Medical Center Plainview Hospital St. Catherine of Siena Medical Center St. Charles Hospital St. Francis Hospital St. Joseph Hospital South Nassau Communities Hospital Southhampton Hospital Southside Hospital Stony Brook University Hospital Syosset Hospital Veterans Affairs Medical Center Winthrop University Hospital Nassau County department of health Suffolk County department of health Nassau-Suffolk Hospital Council New York State Department of Health United Way of Long Island American Lung Association of Northeast 8

Adelphi University Western Suffolk BOCES Cornell University Cooperative Extension YMCA Catholic Charities Hospital Association of New York State Kaiser Family Foundation Robert Wood Johnson Foundation County Health Rankings and Roadmaps Centers for Disease Control and Prevention (CDC) Institute of Medicine U.S. Department of Health and Human Services National Institutes of Health Healthypeople.gov LIHC formed as a result of health care s change in direction and to provide the public with an online portal to the health and social service resources available. It is a collaborative effort to provide a forum for health care providers, local health departments and community-based service organizations to work together to assure and improve the health in the communities that they serve. Results of Community-Wide Survey* During various meeting in 2012 and 2013, members of the Nassau County Department of Health, in addition to community service plan coordinators from participating hospitals (including St. Francis), reviewed the New York State Prevention Agenda Objectives and discussed the areas of greatest need in Nassau County. The results of the 2012 and 2013 CHNA Surveys identified the following areas of health concern in our community: Cancer Diabetes Heart disease High blood pressure Obesity Nutrition Consequently, the health priorities chosen were: Chronic disease prevention Obesity reduction Vaccine-preventable disease prevention The survey revealed that the priority geographical areas in Nassau County included: Freeport Hempstead Inwood Long Beach Westbury 9

Roosevelt Uniondale Elmont Glen Cove In analyzing the results (1083 surveys in 2012 and 166 surveys as of June 2013), it was noted: 66.7 percent of the respondents were female, and 33.3 percent were male Age range of respondents: o 51 percent were in the 60 79 age group o 27 percent of the respondents were in the 40-59 age group o 14 percent were 80+ With regard to the top health challenges being faced: o 69 percent of participants felt that learning more about nutrition as it relates to healthy weight management was an overriding health concern o 53 percent responded Heart Disease o 43 percent responded Cancer o 32 percent responded Diabetes When asked to identify barriers to care: o 47 percent cited lack of health insurance o 27 percent noted inability to pay co-pays o 21 percent responded transportation problems When asked what health education/screenings were needed in the community, responses were: o Cancer: 51 percent o Heart Disease: 47 percent o Cholesterol: 45 percent o High Blood Pressure: 45 percent o Healthy Nutrition/Weight management: 38 percent o Diabetes: 36 percent Key themes were also noted by the Nassau County community-based organization surveys that included needs related to: o Access to care o Education and resources o Transportation o Hypertension o Obesity o Chronic disease management that includes heart disease, cancer and diabetes 10

By condensing these results, St. Francis Hospital identified the following areas of health concern: Cancer Diabetes Heart Disease High Blood Pressure Obesity/Overweight Nutrition/Healthy Eating St. Francis Hospital s Plan to Address Community Health Priorities a) Chronic Disease Prevention (Priority #1): Provide preventive health and fitness classes at low or no cost, including free student athlete cardiac screenings and free preventive health screenings for cholesterol, blood pressure and glucose via the St. Francis Hospital mobile outreach bus as well as other local venues easily accessed by public transportation throughout our communities. Expand prevention programs and increase access to high-quality chronic disease preventive care and management for cardiovascular disease, diabetes, and cancer in both clinical and community settings. Explore new opportunities to expand cancer screenings in conjunction with the opening of The Cancer Institute at St. Francis Hospital. Work with the Long Island Health Collaborative (LIHC) by attending regional meetings, accessing the inventory of services, and utilizing the universal screening tool as appropriate. b) Obesity Reduction (Priority #2): Integrate a focus on obesity and nutrition in the hospital s community screening and education programs, by adding Body Mass Index (BMI) and waist circumference measurement to outreach program screening events. Increase community-based awareness initiatives related to obesity. Enhance services within the diabetes education department and services, and support the new bariatric surgical services at St. Francis with community education programs. Work with the Long Island Health Collaborative (LIHC) by attending regional meetings, accessing the inventory of services, and utilizing the universal screening tool as appropriate. c) Vaccine-Preventable Disease (Priority #3): Expand the free vaccination program by offering it to all outreach patients. Priority #3 was selected because it clinically supports Priority #1, the prevention of chronic disease. Preventing the will avert complications that may occur in high risk populations, and in patients who may already have cancer, heart disease, and/or diabetes. Work with the Long Island Health Collaborative (LIHC) by attending regional meetings, accessing the inventory of services, and utilizing the universal screening tool as appropriate. 11

Note: The areas of mental health, substance abuse, and prenatal care were not selected because St. Francis Hospital does not have a behavioral health department, or OB/GYN services to support initiatives in these areas. St. Francis Hospital s Three-Year Plan of Action Priority #1: Prevent Chronic Disease increase access to high-quality chronic disease preventive care and management for cardiovascular disease, diabetes, and cancer in both clinical and community settings. Goal: Increase access to care via community-based approach. Action Plan Strategy: o Expand free community-based screenings for cholesterol, blood pressure, BMI, waist measurement and glucose via St. Francis Hospital s mobile outreach bus in communities across Long Island. o Offer free cardiac screenings to high school athletes. o Expand free blood pressure and glucose screenings via the Healthy Sunday programs, as well as at local libraries and community centers. o Expand cancer screenings and educational programs in conjunction with the opening of the Cancer Institute at St. Francis Hospital. o Select community centers and parishes in medically underserved areas with a high proportion of uninsured or under-insured individuals. o Those individuals screened through the outreach program who are in need of further medical care or follow-up will be referred to either the patient s primary care physician (PMD), or if there is no PMD and/or no health insurance, the patient will be referred to the Catholic Health Services/St. Francis Hospital s Bishop McHugh Health Center for free medical care, management and treatment. Evaluation: Programs will be evaluated on a monthly basis of participation and successful management of those patients identified as at-risk based on the free health screenings provided. The universal screening tool will be used as appropriate. Priority #2: Reduce obesity in adults through community-based awareness initiatives and the addition of bariatric services at St. Francis Hospital. Goal: Increase awareness of achieving and maintaining a healthy weight. 12

Action Plan/Strategy: o Add Body Mass Index (BMI) and waist circumference measurement to free community based screenings. o Continue to develop and distribute free educational tools (in English and Spanish) to promote the benefits of healthy nutrition and increased physical activity. o Refer those patients with identified elevated blood glucose/bmi/waist circumference measurements to the Bishop McHugh Health Center, and/or newly expanded Diabetes Education Center for medical management and education. o Expand the Diabetes Education Center, a comprehensive educational program for non-insulin and insulin dependent people with diabetes and their families. Emphasize the treatment, selfmanagement, and awareness of possible complications and prevention of diabetes. o Continue to promote and offer nutrition classes, such as the Heart of Good Eating, to assist participants in making nutritious food choices. o Establish a bariatric surgical specialty at St. Francis Hospital. Evaluation: Programs will be evaluated on a monthly basis by the numbers of participants who attend. Educational material, health counseling and referral to medical evaluation will be offered to those who screen out of range. The universal screening tool will be used as appropriate. Priority #3: Prevent vaccine-preventable disease through community wide efforts to decrease the burden of inenza. Goal: Provide free inenza vaccine to high risk/medically underserved populations at outreach sites across Long Island. Action Plan/Strategy: Flu immunization is an existing priority at St. Francis Hospital and represents an area of potential growth. The Hospital seeks to increase its reach in delivering free immunizations to seniors and the community through the addition of outreach sites and number of vaccinations offered. We plan to expand the free vaccination program through the Healthy Sundays program, and focus upon serving medically underserved communities identified in the CHNA. We will utilize the outreach bus to bring registered nurses with vaccines to community sites (i.e. senior centers, libraries, Project Independence locations, etc.) o 1,600 vaccines are already on order for community use for the 2013-2014 season 13

Evaluation: St. Francis Hospital s goal is to reach more seniors and people with limited access to care with free immunizations during critical season. Evaluation of the program will be based on a monthly evaluation of the number of immunizations provided compared to previous years. The universal screening tool will be used as appropriate Dissemination of the Plan to the Public The St. Francis Hospital Community Service Plan will be posted on the hospital s website at www.stfrancisheartcenter.com. Copies will be available at local free health screenings and can be mailed upon request. A summary of the three-year Community Service Plan will be incorporated into a new publication titled St. Francis Hospital Serves the Community. This report will reflect the amount of charity care, uncompensated care, community service, and other charitable activities provided by St. Francis Hospital on an annual basis. It will be posted on the St. Francis Hospital website and be distributed at the Hospital s community events. By encouraging our friends and neighbors to complete our CHNA Survey online or at local screenings, our Community Health Needs Assessment will help St. Francis continue to develop ways to best serve our community. The SFH Community Health Survey What is it? And Why? (attached) is a single-page explanation of the health survey, which is available at www.stfrancisheartcenter.com. In addition, a condensed How Are We Doing? survey describing patient and program satisfaction (attached) will be disseminated to the public at local screenings and collected for analyses. In addition, the plan was shared with the public at Adelphi University s fall symposium, Public Health in the Suburbs, Part 2: Medical Centers Meeting Community Health Needs, on November 8, 2013, with extended coverage across the Long Island region through the diocesan website (www.drvc.org) and TV station, Telecare TV (www.telecaretv.org). Tracking Progress St. Francis Hospital maintains a database of all patients screened on the outreach bus and in the community. Those who screen out of range will receive follow-up telephone calls to assure that they have access to care and have made medical appointments as needed. If individuals do not have health insurance, a referral is made to the St. Francis Hospital/CHS Bishop McHugh Health Center. We also expect that our new Community Health Needs Assessment will help us to develop ways to best serve our community. The results of these surveys are being collected and incorporated into a statistical database for review and analysis. Responses to the How Are We Doing? survey focused on patient and program satisfaction will be collected for analysis. LYONS/CBISA statistical analyses are run on a monthly basis to determine program needs and trajectory. 14

Data: Collected from St. Francis Hospital community outreach in a variety of ways: Community Health Needs Assessment (CHNA): St. Francis Hospital continues to gather data from the Community Needs Assessment survey tool (which is available in both English and Spanish). Survey data is obtained from individuals who attend programs at the DeMatteis Center and offsite community programs and screenings, and from visitors/family members at the St. Francis Hospital main hospital. The following questions are asked: 1. What are the biggest health issues or concerns in your community? 2. What keeps people in your community from seeking treatment? 3. What is needed to improve the health of your family and neighbors? 4. What health screenings or education/ information services are needed in your community? 5. If you or someone in your family were ill and required medical care, where would you go? 6. Where do you and your family get most of your health information? 7. When seeking care, which hospital would you visit first? 8. Have you had a routine physical exam in the past two years? 9. What is your gender? 10. What is your age category? 11. What is your racial/ ethnic identification? 12. What is your highest level of education? 13. Do you have health insurance? Program planning is organized around needs as identified by the community. Data is collected in an ongoing fashion. Results are to be run quarterly to analyze progress in regard to meeting identified community needs in the number and types of programs offered, as well as in the total participants seen. Community sites, as listed in our community partners listing, specific program given and number served are recorded. The communities identified by St. Francis Hospital s Community Outreach Department as being in most need are given priority in terms of site scheduling. Our goal is to continually strive to see more clients. We track the numbers of clients seen and communities visited with a focus on serving the select communities, as identified by the Nassau County Department of Health county-wide community needs assessment completed in 2013. These communities are: 15

Freeport Hempstead Inwood Long Beach Westbury Roosevelt Uniondale Elmont Glen Cove Zip codes from these areas are tracked in our database. The following is a list of the community outreach sites visited by the RNs in 2013: 1/3 AHRC-Freeport 1/4 Angelo Petromelis Senior Center 1/7 Rego Park Senior Center 1/8 Port Washington Senior Center 1/9 Magnolia Gardens 1/10 Manhasset Calley Residence 1/14 Great Neck Senior Center 1/15 AHRC- Helen Kaplan Location 1/16 Alpha Phi Alpha 1/17 YMCA-Cross Island 1/22 Sid Jacobson JCC 1/23 SFH (DeMatteis Center) 1/24 Shoprite 1/25 Hillside Public Library (NHP) 1/28 Allyn P. Robinson Village 1/29 Oceanside Senior Center 1/30 Rev. Mitchell Mallette Housing Complex 1/31 Life Enrichment Center @ Oyster Bay January Total: 430 16

2/2 Healthy Saturday St. Mary of the Isle, Long Beach 2/5 Fuschillo Park (Carle Place Seniors) 2/6 Floral Park Public Library 2/7 AHRC-Brookville 2/12 CW Post campus (students only) 2/13 St. Hugh of Lincoln Roman Catholic Church 2/14 Peternana Terrace 2/15 Green Acres Mall 2/19 AHRC-Plainview 2/20 Maple Pointe Assisted Living 2/21 Sachem Public Library 2/22 YMCA Glen Cove 2/25 Cohalan Court Complex 2/26 Glen Cove Senior Center 2/27 Brentwood Public Library 2/28 First Baptist Church Bayshore February Total: 327 3/2 Healthy Sundays - St. Jude s, Mastic Beach (held after Saturday mass) 3/5 Blessed Sacrament 3/6 SFH Main lobby 3/11 Westbury Memorial Library 3/13 Henry Schein 3/14 Cablevision Health Fair Woodbury 3/15 Commack Public Library 3/18 Deer Park Public Library 3/19 East Meadow Public Library 3/20 Cablevision Woodbury 3/21 South Huntington School District 3/22 Copiague Memorial Library 3/25 Bethpage Senior Center 3/26 St. Bernard's Church 3/27 Henry Schein 3/28 Gold Coast Library March Total: 693 17

4/2 AHRC Helen Kaplan 4/3 Central Islip Public Library 4/4 William P. Bennet Hicksville Comm. Center 4/5 Central Islip Early Head Start - 4/9 Paumanack Village I & II 4/10 St. Brigid Church 4/11 Woodhaven Senior Center 4/12 Harborfields Publc Library 4/16 Herrick's Senior Center 4/17 Adelphi University Annual Health Fair 4/18 Babylon School District Public Library 4/19 Seaford Public Library 4/22 Peninsula Public 4/23 Lindenhurst Library 4/24 Broadway Mall 4/25 Touro College 4/26 Elmont Public Library 4/30 Holy Spirit Church April Total: 320 5/1 Merrick Library 5/2 Atria Plainview Assisted Living 5/3 The New Homestead Home For Adults 5/6 Self Help Austin Street Senior Center 5/7 Stroke Awareness 5/8 Stroke Awareness 5/9 Christ First Presbyterian Church 5/10 Franklin Square Public Library 5/13 Glen Cove Public Library 5/15 North Massapequa Community Center 5/16 YMCA Huntington 5/18 Harborfields High School Health and Wellness 5/20 Memorial Presbyterian Church 5/22 Dominican Village Assisted Living 5/23 Central Islip Early Childhood Center 5/24 Syosset Woodbury Park 5/28 Bayside Senior Center 5/29 Atria Cutter Mill 18

5/30 Islip Public Library 5/31 West Islip Public Library May Total: 510 6/3 James A. Dever Elementary School 6/4 Lake Success Shopping Center 6/5 St. Vincent de Paul Church 6/10 Angelo Petromelis Senior Center 6/11 Deepdale CARES NORC 6/12 Catholic Charities Bohemia 6/13 Health and Wellness Fair (Lido Beach) 6/15 Cancer Survivors Day Health Fair DeMatteis Center 6/18 Our Lady of Lourdes Church 6/19 Atria Great Neck 6/21 Mary's Manor & Enriched Housing 6/24 JASA Long Beach 6/25 West Babylon Public Library 6/26 Hauppauge Community Center 6/27 West Hempstead Public Library June Total: 429 7/2 Jewel Quinn Senior Center 7/3 Magnolia Gardens 7/5 Wyandanch Senior Nutrition Center 7/8 Kimmel Housing Development Foundation 7/9 Elwood Public Library 7/10 Great Neck Social (Senior) Center 7/11 Bethel AME Church 7/15 Rego Park Senior Center 7/16 Long Beach Public Library 7/18 St. Francis Hospital 7/19 Alpha Phi Alpha 7/22 Allyn P. Robinson Village 7/23 Bethpage Community Park 7/24 Glen Head Community Center 7/25 Manhasset Valley Residence 7/29 Bar Beach - Healthfair 7/30 Sid Jacobson YJCC 19

7/30 DeMatteis Center 7/31 Reverend John J. Madden Housing July Total: 252 8/1 Deliverance Baptist Church 8/5 Peternana Terrace 8/6 Oceanside Senior Center 8/7 The North Hempstead YES Community Center 8/9 Middle Country Public Library 8/12 Paumanack Village III & IV 8/13 Port Washington Senior Center 8/14 Hillside Public Library 8/15 St. Hugh of Lincoln Roman Catholic Church 8/21 Brentwood Public Library 8/22 St. Francis Hospital 8/26 St. Francis Hospital 8/28 DeMatteis Center 8/29 Sachem Public Library 8/30 St. Francis Hospital 8/30 Lakeview Public Library August Total: 270 9/3 St. Francis Hospital 9/4 St. Francis Hospital 9/4 Magnolia Gardens 9/5 St. Francis Hospital 9/5 Hicksville Mid Island Seniors 9/6 St. Francis Hospital 9/7 St. Francis Hospital 9/8 St. Francis Hospital 9/9 St. Francis Hospital 9/9 Wyandanch Senior Nutrition Center 9/10 Hauppauge Public Library 9/11 St. Francis Hospital 9/13 East Northport Public Library 9/16 St. Francis Hospital 9/16 Baldwin Public Library 9/18 Hempstead Senior Community Center 20

9/18 St. Francis Hospital 9/18 DeMatteis Center 9/19 East Williston Public Library 9/20 Jericho Public Library 9/23 Wantagh Park 9/24 AHRC - Plainview 9/25 Life Enrichment Center at Oyster Bay 9/26 DeMatteis Center 9/27 Locust Valley Library September Total: 187 10/1 Sid Jacobson YJCC 10/2 Great Neck Social (Senior) Center 10/3 Senator Kemp Hannon Senior Event 12 th Annual 10/4 Sandel Senior Center 10/7 Oceanside Senior Center 10/8 AHRC - Freeport 10/9 Freeport Recreation Center 10/15 AHRC - Brookville 10/17 DeMatteis Center SFH 10/18 Elmont Public Library 10/21 James Vernon School 10/22 Christ First Presbyterian Church 10/24 Theodore Roosevelt School 10/25 St. Martha's Church, Uniondale 10/28 Amsterdam At Harborside 10/29 SFH World Stroke Day 10/30 Oyster Bay High School October Total: 385 11/1 St. Aloysius Church 11/4 Bethel AME Church 11/5 Eisenhower Aquatic Center 11/6 DMV- Hauppauge 11/7 Uniondale Public Library 11/8 St. Francis Hospital 11/12 Franklin Square Senior Center (Catholic Charities) 11/12 Newsday Melville 21

11/13 Henry Waldinger Memorial Library Valley Stream 11/14 Banfi Health Fair 11/14 Freeport Memorial Library 11/15 St. Francis Hospital 11/18 Rego Park Senior Center 11/19 AHRC - Helen Kaplan Location 11/20 Bethpage Senior Center 11/21 Alpha Phi Alpha 11/22 Westbury Memorial Library 11/25 Hauppauge Community Center 11/27 North Massapequa Community Center November Total: 447 12/2 Cablevision Melville Health Fair 12/3 Clinton G. Martin Park 12/4 New Hyde Park Memorial H.S. 12/5 St. Martin of Tours 12/9 North Babylon Public Library 12/10 The North Hempstead YES Community Center 12/11 Hempstead Senior Community Center 12/12 Blessed Sacrament Church 12/16 Kimmel Housing Development Foundation 12/18 West Islip Public Library 12/18 St. Francis Hospital 12/19 Five Towns Community Center 12/23 Selfhelp Clearview Senior Center 12/30 DeMatteis Center December Total: 220 2013 FINAL TOTAL: 4,470 The goal is to increase the total number of clients seen each year with a notable increase in the numbers reached in the identified communities. A database of information is kept to maintain information from the screening programs. Participants who screen outside of normal parameters are referred to appropriate sources of care. Follow-up reminders are given and information is tracked. If individuals do not have health insurance, a referral is made to the St. Francis Hospital Bishop McHugh Health Center or other venue that is acceptable to the patient. 22

Outreach referrals for 2013 are as follows: BAYSHORE-BISHOP MCHUGH 1 LOCAL CLINIC 28 FRESH MEADOWS PRACTICE 1 HICKSVILLE-BISHOP MCHUGH 153 OTHER LOCAL HOSPITAL 4 PMD 1,981 ST. FRANCIS REFERRAL LINE 13 SOUTH BAY PRACTICE 4 TOTAL: 2,185 Healthy Sundays 2013 Report Date Site Town Screened Date 2/2 Site ST. MARY OF THE ISLE, Long Beach Total Screened LONG BEACH 49 Follow- Up Follow- Up 2/23 ST. ALOYSIUS GREAT NECK 13 3 3/2 ST. ANDREWS EPISCOPAL, Mastic Beach MASTIC BEACH 3/3 ST. BRIGID'S WESTBURY 87 3/9 SACRED HEART (Island Park) ISLAND PARK 20 OUR LADY OF 6/2 LORETTO - HEMPSTEAD 83 7 SHARED EVENT 37 Flu Glucose T-dap BP's 12 87 5 17 glucose 10 glucose 8 tdap Type of Screening / Program Type of Screening / Program BP, glucose, shots & tetanus shots Flu, Choleterol, Glucose, BMI, Ht & Wt, glucose, tdap Flu Shots 5,BP,Glucose 23

6/23 10/5 10/13 11/2 11/17 11/24 12/12 ST. BONIFACE - SHARED EVENT ST. ALYOSIUS, GREAT NECK KOREAN BIBLE CHURCH ST. KILLEEN FARMINGDALE ST BRIGIDS, WESTBURY 10-2 ST. PATRICK, GLEN COVE Blessed Sacrament Church ELMONT 21 7 21 21 GREAT NECK 210 DIX HILLS 206 FARMINGDAL E 82 WESTBURY 178 GLEN COVE 46 VALLEY STREAM 20 Total: 1052 Total: 17 210 206 82 178 46 20 BP, Glucose, BMI The goal is to increase the number of patients identified in need of care that are seen in follow up. The Long Island Health Collaborative has used a universal screening wellness tool of health behaviors to be at St. Francis Hospital Community Health and Wellness programs that meet for at least two sessions. Data will be de-identified and entered into a Nassau-Suffolk database that will be coordinated by Stonybrook University to track aggregate health behavior changes as a result of attending our programs. CBISA Lyons software community benefit reporting data is input monthly listing programs completed, the location, and the number of persons screened or educated. This information is tracked against goals. Changes are made to increase the frequency or expand programs as may be needed. Sustainability of changes will be our goal with continuing input and involvement from our community partners, and review of program outcomes. Current goals include increasing the number of oncology screenings/educational community programs that are done with numbers of clients seen to foster cancer prevention, in addition to our cardiovascular wellness programs that are already well established. Financial Statement The Institutional Cost Report has been provided to the New York State Department of Health under separate cover. Conclusion The Community Service Plan is intended to be a dynamic document. Using the Hospital s strengths and resources, St. Francis, along with community partners, will work to continue to best address health disparities and needs. We will strive to improve the overall health and well-being of individuals and families by expanding free health promotion and disease prevention/education screenings and programs in communities where they are most needed. St. Francis Hospital is committed to continue to develop ways to best serve the community. 24

*Note: Year 2013 data is based on 166 collected and analyzed surveys. Year 2012 data is based on 1083 collected and analyzed surveys. Resources NYS Department of Health: http://www.health.ny.gov/statistics/quickfacts.census.gov/qfd/states/36/36059.html 25