| 2009 RESTATEMENT OF REVENUES, EXPENSES AND NET ASSETS: |
FORM 990 PART I LINES 8-19 |
PRIOR TO 2010, FSLHC RECORDED EMPLOYEE EXTENDED SICK LEAVE TIME ON THE CASH BASIS WHEN BENEFITS WERE PAID OUT TO RETIRING EMPLOYEES WHO HAD MET ALL THE REQUIRED ELIGIBILITY CRITERIA. THESE CONSOLIDATED FINANCIAL STATEMENTS HAVE BEEN RESTATED TO REFLECT AN ESTIMATE FOR THESE FROM THEIR EFFECTIVE DATE AS THE BENEFITS ACCUMULATE. THE EFFECT OF THE ADJUSTMENT WAS TO DECREASE UNRESTRICTED NET ASSETS AT DECEMBER 31, 2001 BY $8,007,000 AND TO DECREASE THE EXCESS OF REVENUES OVER EXPENSES BY $1,495,000 IN 2009. |
| AUDITED FINANCIAL STATEMENTS |
FORM 990 PART IV LINE 20B |
THE AUDITED FINANCIAL STATEMENTS OF FAXTON - ST. LUKE'S HEALTHCARE ARE ATTACHED. |
| NEW PROGRAM SERVICES |
FORM 990, PART III, LINE 2 |
A. THE HOSPITALISTS PROGRAM PROVIDES IN-PATIENT CARE FROM ADMISSION TO DISCHARGE FOR PATIENTS WHO DO NOT HAVE A PRIMARY CARE PHYSICIAN AND REQUIRE HOSPITAL ADMISSION FOR NON-SURGICAL REASONS. THE HOSPITALISTS ALSO ACCEPT REFERRALS FROM PRIMARY CARE PHYSICIANS WHO WANT TO FOCUS ON THEIR OUTPATIENT PRACTICES. B. THE STROKE CENTER AT FAXTON-ST. LUKE'S HEALTHCARE IS NOW THE ONLY DESIGNATED PRIMARY STROKE CENTER IN THE MOHAWK VALLEY. WE ARE ONE OF ONLY 115 DESIGNATED STROKE CENTERS IN NEW YORK STATE. TO IMPROVE THE STANDARD OF QUALITY AND ACCESS TO CARE FOR PATIENTS WITH SIGNS AND SYMPTOMS OF STROKE, THE NEW YORK STATE DEPARTMENT OF HEALTH DESIGNATES STROKE CENTERS STATEWIDE. C. SIMULATION LAB WAS BUILT FOR SIMULATION TRAINING; THE LIFESAVING POTENTIAL OF SIMULATION TRAINING HAS LED TO THE PATIENT SIMULATOR BECOMING A CRUCIAL COMPONENT OF HEALTHCARE EDUCATION. AT THE STATE-OF-THE-ART LAB, WE OFFER FIVE MANIKINS THAT OUR EMPLOYEES WILL TRAIN WITH, INCLUDING THREE MEN, A PREGNANT WOMAN AND AN INFANT. MORE AND MORE, SIMULATORS ARE FOUND IN EDUCATIONAL INSTITUTIONS, HOSPITALS, THE MILITARY AND OTHER AREAS OF HEALTHCARE EDUCATION AT EVERY LEVEL. THERE IS A GROWING NEED TO TRAIN STAFF WITHOUT RISK TO PATIENTS, TO PREVENT MEDICAL ERRORS AND, WHEN ERRORS DO OCCUR, TO FIND OUT WHY. D. FSLHC BEGAN OFFERING ELECTIVE CORONARY ANGIOPLASTY FOR SERIOUS BLOCKAGES OF THE CORONARY ARTERIES AT THE CARDIAC CATHETERIZATION LAB ON THE ST LUKE'S CAMPUS. E. FSLHC IS THE FIRST HOSPITAL IN THE AREA TO INSTALL A NEXT-GENERATION SCANNER WHICH HELPS DOCTORS TO DETECT DISEASE IN EARLY STAGES, AS WELL AS MONITOR THE PROGRESS OF A PATIENT'S TREATMENT. THE SCANNER COMBINES 2 KINDS OF IMAGING TO GIVE DOCTORS COMPLETE INFORMATION ABOUT THE PATIENT'S CONDITION IN A SINGLE EXAM, DECREASING EXAM TIME BY HALF. PREVIOUSLY, 2 SEPARATE SCANS WERE DONE TO OBTAIN SIMILAR INFORMATION. F. FSLHC NOW HAS AN OBSERVATION UNIT (SEE EXPLANATION BELOW IN PART III, 3.) |
| CHANGES IN PROGRAM SERVICES |
FORM 990, PART III, LINE 3 |
THE RAPID ADMISSIONS UNIT WAS ELIMINATED AND REPLACED WITH THE OBSERVATION UNIT. THIS REFLECTS AN OUTPATIENT STATUS AND ALLOWS FOR PATIENTS TO COME FROM ER AND SURGERY INTO A LOCATION ON THE ACUTE CARE FLOORS FOR OBSERVATION/DETERMINATION OF WHETHER THEY NEED TO BE ADMITTED OR RELEASED. |
| FORM 990, PART VI, SECTION A, LINE 6 |
|
LINE 6: MOHAWK VALLEY NETWORK, INC. IS THE SOLE MEMBER OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A |
|
LINE 7 A: MOHAWK VALLEY NETWORK, INC. APPOINTS THE DIRECTORS AND GOVERNING BODY OF THE ORGANIZATION. A CURRENT LISTING OF THE BOARD OF DIRECTORS FOLLOWS: BOARD OF DIRECTORS 2010 GREGORY B. MCLEAN, CHAIR RICHARD TANTILLO, VICE CHAIR TODD HUTTON, PHD, SECRETARY STEPHEN SWEET, TREASURER SCOTT H. PERRA, FACHE * PRESIDENT/CEO * COTERMINOUS WITH POSITION DOMENIC P. AIELLO, M.D. GARY E. GILDERSLEEVE ESTHER BANKERT, PHD. KAREN LEACH SIDNEY J. BLATT, M.D. CHRISTOPHER MAX, M.D., PRESIDENT, MEDICAL STAFF * MARTIN D. BULL ROGER MCREYNOLDS JOAN COMPSON MICHAEL PAPARONE LEROY COOLEY, M.D. WILLIAM PARKER, M.D. JOHN L. CROSSLEY JAMES B. STEWART JAMES E. FREDERICK, M.D. BONNIE WOODS MAILING ADDRESS FOR THE BOARD: FAXTON ST. LUKE'S HEALTHCARE P. O. BOX 479 UTICA, NEW YORK 13503-0479 |
| FORM 990, PART VI, SECTION B, LINE 11 |
|
LINE 11B: THE FORM 990 AND FORM 990T WERE REVIEWED AT A MEETING ON 07/13/2011 WITH THE EXECUTIVE COMMITTEE AND ON 08/25/2011 WITH THE BOARD OF DIRECTORS. |
|
|
FORM 990, PART VI, SECTION B, LINE 12C |
LINE 12C: IN ADDITION TO THE CONFLICT OF INTEREST POLICY, ALSO INCLUDED IS THE MVN, INC. CONFLICTS OF INTEREST ACKNOWLEDGEMENT AND DISCLOSURE FORM. POLICY: ANY DIRECTOR, PRINCIPAL OFFICER, MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, AS DEFINED BELOW, IS AN INTERESTED PERSON. IF A PERSON IS AN INTERESTED PERSON WITH RESPECT TO ANY ENTITY IN THE HEALTH CARE SYSTEM OF WHICH THE CORPORATION IS A PART, HE OR SHE IS AN INTERESTED PERSON WITH RESPECT TO ALL ENTITIES IN THE HEALTH CARE SYSTEM. A PERSON HAS A FINANCIAL INTEREST IF HE OR SHE PERSONALLY HAS, DIRECTLY OR INDIRECTLY, THROUGH BUSINESS, INVESTMENT OR FAMILY: (1)AN OWNERSHIP OR INVESTMENT INTEREST IN ANY ENTITY WITH WHICH THE CORPORATION HAS A TRANSACTION OR ARRANGEMENT, OR (2)A COMPENSATION ARRANGEMENT WITH THE CORPORATION OR WITH ANY ENTITY OR INDIVIDUAL WITH WHICH THE CORPORATION HAS A TRANSACTION OR ARRANGEMENT, OR (3)A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, ANY ENTITY OR INDIVIDUAL WITH WHICH THE CORPORATION IS NEGOTIATING A TRANSACTION OR ARRANGEMENT. COMPENSATION INCLUDES DIRECT AND INDIRECT REMUNERATION AS WELL AS GIFTS OR FAVORS THAT ARE SUBSTANTIAL IN NATURE. DUTY TO DISCLOSE: IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OR HIS OR HER FINANCIAL INTEREST, OR ANY CIRCUMSTANCES WHICH MAY IMPAIR HIS OR HER ABILITY TO EXERCISE INDEPENDENT FIDUCIARY JUDGMENT, TO THE OTHER DIRECTORS, OR TO THE OTHER MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, CONSIDERING A PROPOSED TRANSACTION OR ARRANGEMENT. DETERMINING CONFLICT: AN INTERESTED PERSON MAY AFTER DISCLOSING A KNOWN CONFLICT, DISQUALIFY HIM OR HERSELF FROM FURTHER PARTICIPATION IN DISCUSSIONS OR DETERMINATIONS REGARDING THE TRANSACTION OR ARRANGEMENT OR MAY SEEK THE GUIDANCE OF THE BOARD OR COMMITTEE. IN SUCH CASES, THE INTERESTED PERSON MAY BE ASKED TO LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE ACTUAL OR APPARENT CONFLICT IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. ADDRESSING THE CONFLICT OF INTEREST: (1) THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. (2)AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. (3) IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATIONS BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. VIOLATIONS OF CONFLICT (1)IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. (2)IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS, IN FACT, FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE CORRECTIVE ACTION AS DETERMINED BY THE BOARD, WITH RESPECT TO THE DIRECTOR AND THE TRANSACTION OR ARRANGEMENT. RECORDS OF PROCEEDINGS: THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: (A) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARDS OR COMMITTEES DECISION AS TO WHETHER A CONFLICT OF INTEREST, IN FACT EXISTED; AND (B)THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH. COMPENSATION COMMITTEE: (A)A VOTING MEMBER OF ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE CORPORATION FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBERS COMPENSATION. (B)PHYSICIANS WHO RECEIVE COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE CORPORATION OR ANY AFFILIATE, WHETHER AS EMPLOYEES OR INDEPENDENT CONTRACTORS, ARE PRECLUDED FROM MEMBERSHIP ON ANY COMMITTEE WHOSE JURISDICTION INCLUDES PHYSICIAN COMPENSATION MATTERS. ANNUAL STATEMENTS: EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: (A)HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY AND THE CORPORATIONS BY-LAWS; (B)HAS READ AND UNDERSTANDS THOSE PROVISIONS; (C)HAS AGREED TO COMPLY WITH THOSE PROVISIONS; AND (D)UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. PERIODIC REVIEW: TO ENSURE THAT THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED. THE PERIODIC REVIEW SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: (A)WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARMS LENGTH BARGAINING; (B)WHETHER ACQUISITIONS OF PHYSICIAN PRACTICES AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. (C)WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATIONS CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. (D)WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYERS FURTHER THE CORPORATIONS CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. USE OF OUTSIDE EXPERTS: IN CONDUCTING THE PERIODIC REVIEWS PROVIDED FOR IN SECTION 7 OF THIS POLICY, THE CORPORATION MAY, BUT NEED NOT, USE OUTSIDE ADVISORS. IF OUTSIDE EXPERTS ARE USED, THEIR USE SHALL NOT RELIEVE THE BOARD OF ITS RESPONSIBILITY FOR ENSURING THAT PERIODIC REVIEWS ARE CONDUCTED. LOANS: NO LOANS, OTHER THAN THROUGH THE PURCHASE OF BONDS, DEBENTURES, OR SIMILAR OBLIGATIONS OF THE TYPE CUSTOMARILY SOLD IN PUBLIC OFFERINGS, OR THROUGH THE ORDINARY DEPOSIT OF FUNDS IN A BANK, SHALL BE MADE BY THE CORPORATION TO ITS DIRECTORS OR OFFICERS, OR TO ANY OTHER CORPORATION, FIRM, ASSOCIATION OR OTHER ENTITY IN WHICH ONE OR MORE OF ITS DIRECTORS OR OFFICERS ARE DIRECTORS OR OFFICERS OR HOLD A SUBSTANTIAL FINANCIAL INTEREST, EXCEPT A LOAN TO ANOTHER TYPE B NOT-FOR-PROFIT CORPORATION. THE CORPORATION MAY, NEVERTHELESS, ENGAGE IN TRANSACTIONS WITH ITS CORPORATE AFFILIATES PROVIDED THAT SUCH TRANSACTIONS ARE CONSISTENT WITH THE CORPORATIONS TAX EXEMPT STATUS AND ANY EXEMPTION RULINGS OR GUIDANCE ISSUED BY THE INTERNAL REVENUE SERVICE. |
|
|
FORM 990, PART VI, SECTION B, LINE 15 |
LINE 15B: THE BOARD'S EXECUTIVE COMPENSATION COMMITTEE, HAS ADOPTED AND FOLLOWS A PROCESS FOR REVIEWING AND DETERMINING THE COMPENSATION OF THE CEO AND THE EXECUTIVE MANAGEMENT TEAM. THE EXECUTIVE MANAGEMENT TEAM CONSISTS OF THE FOLLOWING POSITIONS: SENIOR VICE PRESIDENT/CHIEF OPERATING OFFICER; SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER; SENIOR VICE PRESIDENT/CHIEF MEDICAL OFFICER; AND SENIOR VICE PRESIDENT/CHIEF NURSING OFFICER. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE INFORMATION AND ADVICE TO COMMITTEE, INCLUDING BUT NOT LIMITED, PROVIDING INDEPENDENT COMPENSATION COMPARABILITY DATA FOR FUNCTIONALLY COMPARABLE POSITIONS IN SIMILARLY SITUATED HOSPITALS. THE DATA IS PROVIDED ON AN ANNUAL BASIS AND IS REVIEWED BY THE COMMITTEE, ALONG WITH OTHER INFORMATION, PRIOR TO APPROVING ANY CHANGES TO COMPENSATION. THE INDEPENDENCE OF THE COMMITTEES MEMBERS IS REVIEWED AND VERIFIED PRIOR TO THE START OF THE ANNUAL COMPENSATION REVIEW PROCESS. SHOULD A CONFLICT PRESENT, THOSE INDIVIDUALS WITH ACTUAL OR PERCEIVED CONFLICTS ABSTAIN FROM VOTING UNTIL SUCH TIME AS THE CONFLICT CAN BE RESOLVED OR A REPLACEMENT MEMBER IS APPOINTED TO THE COMMITTEE. THE COMMITTEES DELIBERATIONS AND DECISIONS ARE GUIDED BY A WRITTEN COMPENSATION PHILOSOPHY AND DOCUMENTED THROUGH WRITTEN MINUTES TAKEN DURING EACH MEETING. THE MINUTES INCLUDE, AMONG OTHER THINGS, THE WRITTEN MATERIALS DISTRIBUTED OR PRESENTED DURING THE MEETING AND THE SPECIFIC DECISIONS TAKEN AT THE MEETING. |
|
|
FORM 990, PART VI, SECTION C, LINE 19 |
LINE 19: POLICY: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. IT IS THE POLICY OF THIS HOSPITAL TO MAKE AVAILABLE TO ANYONE WHO ASKS A COPY OF ITS ANNUAL REPORT TO THE INTERNAL REVENUE SERVICE (IRS) ON FORM 990, AND ITS EXEMPT STATUS FORM. IN ACCORDANCE WITH THE LAW, FORM 990 FOR A GIVEN YEAR WILL BE MADE AVAILABLE FOR PUBLIC INSPECTION FOR A THREE-YEAR PERIOD. PURPOSE: THE PURPOSE OF THIS POLICY IS TO COMPLY WITH IRS LAW, WHICH APPLIES FOR TAX YEARS BEGINNING AFTER JUNE 8, 1999. REPLACES ADMINISTRATIVE DIRECTIVE FN-9-OP, SAME TITLE, DATED 12/2/2003 SPECIAL INSTRUCTIONS: A. A COPY OF THE ABOVE NAMED DOCUMENT(S), WILL BE MADE AVAILABLE FOR INSPECTION BY A REQUESTER, IN A DESIGNATED ROOM, IN THE FINANCE DEPARTMENT OF THE HOSPITAL. B. THE DOCUMENTS WILL BE MADE AVAILABLE, IMMEDIATELY, TO ANYONE WHO APPEARS IN PERSON DURING USUAL BUSINESS HOURS. FOR WRITTEN REQUESTS FOR COPIES OF DOCUMENTS, RESPONSE WILL BE PROVIDED WITHIN THIRTY (30) DAYS OF RECEIPT OF PAYMENT OF REASONABLE COPYING FEES*. C. EITHER THE HOSPITAL SENIOR VICE PRESIDENT/CFO, THE CONTROLLER, OR THEIR DESIGNATED REPRESENTATIVE WILL BE PRESENT DURING AN INSPECTION BY A REQUESTER. D. ONLY THE HOSPITAL SENIOR VICE PRESIDENT/CFO, THE CONTROLLER, OR THEIR DESIGNATED REPRESENTATIVE WILL BE PERMITTED TO ANSWER QUESTIONS THAT A REQUESTER MAY HAVE. *SHOULD A REQUESTER ASK THE HOSPITAL FOR A PHOTOCOPY OF ANY OR ALL PARTS OF DOCUMENTS, THE HOSPITAL WILL CHARGE $1.00 FOR THE FIRST PAGE, PLUS $.15 FOR EACH ADDITIONAL PAGE. |
| CONFLICTS OF INTEREST POLICY ACKNOWLEDGEMENT & DISCLOSURE FORM |
FORM 990 PART VI SECTION B LINEC 12C |
MOHAWK VALLEY NETWORK, INC. CONFLICTS OF INTEREST POLICY ANNUAL ACKNOWLEDGEMENT AND DISCLOSURE FORM PURSUANT TO THE PURPOSES AND INTENT OF THE CONFLICTS OF INTEREST POLICY AND THE ORGANIZATIONS BYLAWS THAT REQUIRE DISCLOSURE OF CERTAIN INTERESTS (COPIES OF WHICH ARE ATTACHED TO THIS ACKNOWLEDGMENT AND DISCLOSURE FORM) I HEREBY STATE THAT I, OR THE MEMBERS OF MY IMMEDIATE FAMILY HAVE THE FOLLOWING PRIVATE INTERESTS AND HAVE TAKEN PART IN THE FOLLOWING TRANSACTIONS THAT, WHEN CONSIDERED IN CONJUNCTION WITH MY POSITION WITH OR RELATIONSHIP TO MOHAWK VALLEY NETWORK, INC., AND/OR ITS AFFILIATES (MVN), MIGHT POSSIBLY CONSTITUTE A CONFLICT OF INTEREST. 1) PLEASE IDENTIFY ALL FINANCIAL INTERESTS (AS DEFINED IN SECTION 2(B) OF THE CONFLICTS OF INTEREST POLICY) YOU PERSONALLY HAVE, WHETHER HELD DIRECTLY OR INDIRECTLY, THROUGH BUSINESS, INVESTMENT OR FAMILY. A. ALL OWNERSHIP OR INVESTMENT INTEREST(S) IN ANY ENTITY WITH WHICH MVN HAS A TRANSACTION OR ARRANGEMENT. ( ) NONE _______________________________________________________________________ B. ALL COMPENSATION ARRANGEMENTS WITH MVN OR WITH ANY ENTITY OR INDIVIDUAL WITH WHICH MVN HAS A TRANSACTION OR ARRANGEMENT. ( ) NONE _______________________________________________________________________ C. ALL POTENTIAL OWNERSHIP OR INVESTMENT INTERESTS IN, OR COMPENSATION ARRANGEMENTS WITH, ANY ENTITY OR INDIVIDUAL WITH WHICH MVN IS NEGOTIATING A TRANSACTION OR ARRANGEMENT. ( ) NONE _______________________________________________________________________ 2) GIFTS, GRATUITIES, FAVORS AND/OR ENTERTAINMENT THAT ARE SUBSTANTIAL IN NATURE ARE CONSIDERED COMPENSATION (AS DEFINED IN SECTION 2(B) OF THE CONFLICTS OF INTEREST POLICY). NEITHER I NOR ANY MEMBER OF MY FAMILY HAS ACCEPTED GIFTS, GRATUITIES, FAVORS AND/OR ENTERTAINMENT EXCEPT AS LISTED BELOW. ( ) NONE _______________________________________________________________________ 3) PLEASE IDENTIFY ANY ACTIVITIES UNRELATED TO MVN (SUCH AS OTHER NOT-FOR-PROFIT ORGANIZATIONS OR BOARDS) THAT YOU OR YOUR IMMEDIATE FAMILY PARTICIPATE IN, RENDER DIRECTIVE, MANAGERIAL OR CONSULTATIVE SERVICES TO THAT DO BUSINESS WITH OR ARE IN COMPETITION WITH MVN. ( ) NONE _______________________________________________________________________ 4) PLEASE IDENTIFY ANY FAMILY OR BUSINESS RELATIONSHIP YOU HAVE WITH ANY OTHER OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE OF MVN. ( ) NONE _______________________________________________________________________ BY MY SIGNATURE BELOW, I HEREBY ATTEST THE INFORMATION PROVIDED ABOVE IS ACCURATE AND COMPLETE. I FURTHER ACKNOWLEDGE THAT I HAVE READ, UNDERSTAND AND AGREE TO BE BOUND BY THE MVN CONFLICTS OF INTEREST POLICY AND THE BY-LAWS OF MVN AND ITS AFFILIATES. I UNDERSTAND IT IS MY ONGOING OBLIGATION AND RESPONSIBILITY TO IMMEDIATELY REPORT ANY NEW FINANCIAL INTERESTS THAT ARISE WHICH MAY IMPAIR MY ABILITY TO EXERCISE INDEPENDENT FIDUCIARY JUDGMENT TO THE OTHER DIRECTORS, OR TO THE OTHER MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS. ________________________________________________ MEMBERS SIGNATURE __________________________________________________________ MEMBERS NAME PRINTED _______________________________________ DATE |
| PROGRAM EXPENSES INFORMATION |
FORM 990 PART IX LINE 24C |
THE SERVICE CONTRACTS EXPENSE DOES NOT INCLUDE $2,658,096 BECAUSE IT IS BEING REPORTED ON LINE 14 FOR IT EXPENSES. |
| BALANCE SHEET ADJUSTMENT OF PRIOR YEAR |
FORM 990 PART X |
PRIOR TO 2010, FSLHC RECORDED EMPLOYEE EXTENDED SICK LEAVE TIME ON THE CASH BASIS WHEN BENEFITS WERE PAID OUT TO RETIRING EMPLOYEES WHO HAD MET ALL THE REQUIRED ELIGIBILITY CRITERIA. THESE CONSOLIDATED FINANCIAL STATEMENTS HAVE BEEN RESTATED TO REFLECT AN ESTIMATE FOR THESE FROM THEIR EFFECTIVE DATE AS THE BENEFITS ACCUMULATE. THE EFFECT OF THE ADJUSTMENT WAS TO DECREASE UNRESTRICTED NET ASSETS AT DECEMBER 31, 2001 BY $8,007,000 AND TO DECREASE THE EXCESS OF REVENUES OVER EXPENSES BY $1,495,000 IN 2009. |
| CHANGES IN NET ASSETS OR FUND BALANCES: |
FORM 990, PART XI, LINE 5: |
SEE SCHEDULE O |
|
|
FORM 990 PART XI LINE 2C |
NO CHANGE FROM PRIOR YEAR. |
| RECONCILIATION OF NET ASSETS |
FORM 990 PART XI LINE 5 |
FORM 990 PART XI RECONCILIATION OF NET ASSETS LINE 5 OTHER CHANGES IN NET ASSETS/FUND BALANCES: CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS ($809,818) CHANGE IN INTEREST IN UNRESTRICTED NET ASSETS OF FOUNDATION 286,153 CONTRIBUTIONS USED FOR CAPITAL ACQUISITIONS 530,254 CHANGE IN NET UNREALIZED GAINS AND LOSSES ON INVESTMENTS 3,409,058 OTHER CHANGES IN UNRESTRICTED NET ASSETS (488,338) CHANGE IN INCOME ON INVESTMENTS TEMPORARILY RESTRICTED 745 CHANGE IN INTEREST IN TEMPORARILY RESTRICTED NET ASSETS OF FOUNDATION 2,077,766 |
| FINANCIAL STATEMENTS AND REPORTING |
FORM 990 PART XII LINE 2C |
THE ORGANIZATION HAS A FINANCE COMMITTEE WHICH OVERSEES THE AUDIT, REVIEW AND COMPILATION OF FINANCIAL STATEMENTS AND IS RESPONSIBLE FOR THE SELECTION OF AN INDEPENDENT AUDITOR. THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED. |
| COMMUNITY SERVICE PLAN |
SCHEDULE H PART I LINE 6A |
2009 COMMUNITY SERVICE PLAN SUBMITTED SEPTEMBER 15, 2010 BY FAXTON ST. LUKES HEALTHCARE 1656 CHAMPLIN AVENUE, UTICA, NY 13502 315.624.6000 WWW.FAXTONSTLUKES.COM COMMUNITY SERVICE PLAN FAXTON ST. LUKE'S HEALTHCARE - UTICA, NEW YORK SUBMITTED: WEDNESDAY, SEPTEMBER 15, 2010 FAXTON ST. LUKE'S HEALTHCARE (FSLH) PRESENTS THE 2009 COMMUNITY SERVICE PLAN. THE PLAN INCORPORATES OUR WORK WITH COMMUNITY PARTNERS INCLUDING THE HEALTH DEPARTMENTS OF ONEIDA AND HERKIMER COUNTIES, ONEIDA COUNTY HEALTH COALITION, HERKIMER COUNTY HEALTHNET, LOCAL HOSPITALS (ST. ELIZABETH MEDICAL CENTER AND ROME MEMORIAL HOSPITAL), ALONG WITH INPUT FROM MANY OTHER HEALTH AND SOCIAL SERVICE AGENCIES, BUSINESS LEADERS,CLERGY, EDUCATORS, AND LAW ENFORCEMENT OFFICERS. THIS PLAN IDENTIFIES SPECIFIC COMMUNITY HEALTH IMPROVEMENT ACTIONS IN RELATIONSHIP TO THE STATE OF NEW YORK DEPARTMENT OF HEALTH PREVENTION AGENDA. IT IS NOT THE INTENT OF THIS COMMUNITY SERVICE PLAN TO DUPLICATE THE DATA, COMMUNITY INPUT,AND DETAILED DESCRIPTION OF THE PROCESSES THAT ARE CONTAINED IN BOTH THE ONEIDA COUNTY AND HERKIMER COUNTY COMMUNITY HEALTH ASSESSMENTS. THAT INFORMATION IS AVAILABLE ON THE COUNTY WEB SITES OR BY CONTACTING THE COUNTY HEALTH DEPARTMENTS. SECTION 1: MISSION STATEMENT OUR MISSION CONTINUES TO BE TO PROVIDE THE HIGHEST QUALITY HEALTH CARE IN OUR REGION. SECTION 2: FSLH GEOGRAPHIC SERVICE AREA FSLHS PRIMARY AND SECONDARY SERVICE AREAS, AS BASED ON A ZIP CODE ANALYSIS OF PATIENT ORIGIN, INCLUDES ALL COMMUNITIES, EXCEPT THE MOST DISTANT WESTERN TOWNS, IN ONEIDA COUNTY AND ALL BUT THE MOST SOUTH EASTERN TOWNS, IN HERKIMER COUNTY. THE POPULATION OF THIS SERVICE AREA IS APPROXIMATELY 284,552 PEOPLE. FOR SELECTED SPECIALTIES, SUCH AS DIALYSIS AND CANCER CARE, FSLH IS RECOGNIZED AS A TERTIARY CENTER SERVING PARTS OF MADISON, LEWIS, FULTON, HAMILTON, AND MONTGOMERY COUNTIES. THE POPULATION OF THE TERTIARY MARKET IS APPROXIMATELY 361,000 PEOPLE. SECTION 3: PUBLIC PARTICIPATION FSLH IS AN ACTIVE PARTICIPANT IN THE ONEIDA COUNTY AND HERKIMER COUNTY COMMUNITY HEALTH ASSESSMENTS. THIS PLAN INCORPORATES THE PRIORITIES FROM THE REGIONAL HEALTH SUMMIT WHICH WAS HELD IN APRIL 2009. REGIONAL HEALTH PRIORITIES: APRIL 2009 - RECAP ONEIDA AND HERKIMER COUNTIES HAVE SIMILAR HEALTH ISSUES WHICH ARE ADDRESSED BY ORGANIZATIONS SERVING BOTH COUNTIES. THE AREAS UNITED WAY IS ALSO ENGAGED IN AN INITIATIVE TO IDENTIFY HEALTH INVESTMENT AREAS FOR THE ONEIDA-HERKIMER REGION. IN APRIL 2009 BOTH COUNTIES COORDINATED THEIR PRIORITY-SETTING EFFORTS TO IDENTIFY THE HEALTH PRIORITIES FOR THE REGION FROM THE NYSDOH PREVENTION AGENDA. THIS COLLABORATIVE REGIONAL HEALTH SUMMIT WAS SPONSORED AND COORDINATED BY REPRESENTATIVES FROM THE REGIONS HOSPITALS, LHDS, CHA PLANNING TEAMS, AND THE UNITED WAY AND INCLUDED THE FOLLOWING AGENCIES: .. FAXTON ST. LUKES HEALTHCARE .. HERKIMER COUNTY HEALTH DEPARTMENT .. HERKIMER COUNTY HEALTHNET .. ONEIDA COUNTY HEALTH COALITION & MAPP ADVISORY TEAM .. ONEIDA COUNTY HEALTH DEPARTMENT .. ST. ELIZABETH MEDICAL CENTER .. ROME MEMORIAL HOSPITAL .. UNITED WAY OF THE VALLEY AND GREATER UTICA AREA .. MOHAWK VALLEY PERINATAL NETWORK ACTIONS PLANS WERE DEVELOPED AND VOLUNTEERS INTERESTED IN EACH PRIORITY AREA WERE IDENTIFIED, COLLECTED AND ORGANIZED BY THE SPONSORS (REGIONAL PLANNING TEAM).SECTION 4: COMMUNITY HEALTH PRIORTIES THE COMMUNITY ASSESSMENT FOR HERKIMER AND ONEIDA COUNTIES IDENTIFIED THE SAME ITEMS FROM THE PREVENTION AGENDA AS THE HEALTH PRIORITIES FOR THEIR RESPECTIVE COUNTIES. MENTAL HEALTH AND SUBSTANCE ABUSE HEALTHY MOTHERS, HEALTHY BABIES, HEALTHY CHILDREN CHRONIC DISEASE ACCESS TO QUALITY HEALTHCARE PHYSICAL FITNESS AND NUTRITION FOCUS AREAS FOR FAXTON ST. LUKES HEALTHCARE, ST. ELIZABETH MEDICAL CENTER (SEMC), ROME MEMORIAL HOSPITAL, ONEIDA COUNTY HEALTH DEPARTMENT AND THE HERKIMER COUNTY HEALTH DEPARTMENT ARE: MENTAL HEALTH AND SUBSTANCE ABUSE SPECIFIC ACTION AREA THE LACK OF ACUTE EMERGENCY SUPPORT, ESPECIALLY COMMUNITY MENTAL HEALTH SERVICES FOR ADOLESCENTS. HEALTHY MOTHERS, HEALTHY BABIES, HEALTHY CHILDREN SPECIFIC ACTION AREA COMPLETE THE CONSOLIDATION OF THE PCAP CLINICS OPERATED BY FSLH AND SEMC AND ENHANCE THOSE SERVICES WITH THE POTENTIAL OFFERING OF COMMUNITY SERVICES, SUCH AS MEDICAID ENROLLMENT AND WIC ENROLLMENT AT THE NEW SITE. THIS TACTIC WOULD ALSO INCLUDE ACTIONS FOR INCREASING THE HEALTH DEPARTMENTS ROLE IN PRENATAL AND POST NATAL EDUCATION. CHRONIC DISEASE SPECIFIC ACTION AREA TOBACCO USE IS A SIGNIFICANT FACTOR/CONTRIBUTOR TO MANY CHRONIC DISEASES. THE HOSPITALS AND HEALTH DEPARTMENTS COLLABORATE WITH THE SMOKING CESSATION EFFORTS OF TRI-COUNTY SMOKING CESSATION CENTER. THESE 3 IDENTIFIED ACTION AREAS FOR THE HOSPITAL COMMUNITY SERVICE PLANS ARE THE FOCUS OF THE THREE YEAR ACTION PLANS REQUIRED BY THE NYSDOH FOR COLLABORATIVE HEALTH IMPROVEMENT INITIATIVES BY THE HEALTH DEPARTMENTS AND THE HOSPITALS. |
| COMMUNITY SERVICE PLAN |
SCHEDULE H PART I LINE 6A |
SECTION 5: UPDATE ON THE PLAN OF ACTION THE ONEIDA COUNTY HEALTH COALITION STEERING COMMITTEE MEETS MONTHLY, AND HAS BECOME THE BODY THAT OVERSEES PROGRESS OF THE PUBLIC HEALTH PRIORITIES WORK GROUPS. THE STEERING COMMITTEES PURPOSE IS TO IMPROVE COMMUNICATION; COORDINATE HEALTH SUMMIT WORKGROUPS; PROBLEM-SOLVE, COMMUNICATE AND REPORT ON SUCCESSES AND CHALLENGES. REPRESENTATIVES INCLUDES THE HOSPITALS (FSLH, SEMC AND ROME MEMORIAL), CATHOLIC CHARITIES, ONEIDA COUNTY HEALTH COALITION, KIDS ONEIDA, MEDICAL SOCIETIES OF HERKIMER AND ONEIDA COUNTIES, MOHAWK VALLEY RESOURCE CENTER FOR REFUGEES, AND HERKIMER COUNTY INTEGRATED PLANNING, MEMBERS OF THE ONEIDA COUNTY HEALTH COALITION STEERING COMMITTEE/MAPP TEAM AND HERKIMER COMMUNITY HEALTH ASSESSMENT STEERING COMMITTEE. THE TOP THREE SELECTED PRIORITIES ARE PROFILED IN DETAIL, ALONG WITH THE ADDITIONAL TWO PRIORITIES WHICH HAVE BEGUN TO DEVELOPMENT ACTION PLANS. THE 5 PRIORITIES AND THEIR ACTION PLANS ARE NUMBERED 1 TO 5. PRIORITY 1 MENTAL HEALTH AND SUBSTANCE ABUSE THE THREE-YEAR PLAN OUTLINED IN 2009:2009-2010 WORK GROUPS IN EACH OF THE IDENTIFIED PRIORITY AREAS WILL IDENTIFY STRONG LEADERS, EXAMINE DATA AND DETERMINE SPECIFIC COMMUNITY NEEDS AND MEASUREMENT TOOLS.2010-2011 MEMBERS OF THE REGIONAL HEALTH COORDINATING COUNCIL (RHCC) WILL ALLOCATE RESOURCES, BOTH STAFF AND FINANCIAL, TO ADDRESS THE PRIORITY ISSUES AND TAKE ACTION. 2011-2012 MEMBERS OF THE RHCC WILL MEASURE THE ACTIONS FOR POSITIVE OUTCOMES AND DETERMINE NEXT STEPS. THE WORK GROUPS MEETINGS WITH THE ONEIDA COUNTY DEPARTMENT OF MENTAL HEALTH TO COORDINATE PRIORITIES WITHIN THEIR PLANNING PROCESS RESULTED IN A CHANGE IN THE ACTION AREAS. ACCESS TO MENTAL HEALTH CARE, CROSS-SYSTEMS COLLABORATION AND SUICIDE RATES ARE AREAS THAT THE COUNTY HEALTH DEPARTMENTS MENTAL HEALTH SUBCOMMITTEE HAVE IDENTIFIED AND INTEGRATED WITH THE FINDINGS OF THE COUNTYS COMMUNITY HEALTH ASSESSMENT. THE MENTAL HEALTH PRIORITY IS PREEXISTING AND ACTION IS URGENTLY NEEDED FOR ACUTE AND COMMUNITY MENTAL HEALTH SERVICES FOR ADULTS, ADOLESCENTS AND CHILDREN. THE ONEIDA COUNTY DEPARTMENT OF MENTAL HEALTH (OCDMH) CREATED AN EMERGENCY PSYCHIATRIC SERVICES SYSTEM (EPSS) COMMITTEE, WHICH MET QUARTERLY IN 2009 AND INCLUDES REPRESENTATIVES FROM ALL THREE ONEIDA COUNTY HOSPITALS (FAXTON ST. LUKES HEALTHCARE, ST. ELIZABETH AND ROME MEMORIAL), AND THE MOBILE CRISIS ASSESSMENT TEAM (MCAT) OF THE NEIGHBORHOOD CENTER. ALSO INCLUDED WERE REPRESENTATIVES OF LOCAL LAW ENFORCEMENT AND COMMUNITY MENTAL HEALTH PROVIDERS. AS THE ONEIDA COUNTY MOBILE CRISIS ASSESSMENT TEAM (MCAT) CEASED ASSESSING ADULTS IN EMERGENCY DEPARTMENTS AS OF AUGUST 1, 2009 AND CEASED ASSESSING CHILDREN IN THE EDS AS OF OCTOBER 1, 2009, THREE EPSS SUBCOMMITTEES WORKED ON PLANS TO IMPROVE MENTAL HEALTH/SUBSTANCE ABUSE SERVICES TO PATIENTS. EACH COLLABORATIVE COMMITTEE IS COMPRISED OF REPRESENTATIVES OF THE ABOVE ORGANIZATIONS. THE COMMITTEES ARE TRANSITION SUBCOMMITTEE, 9.41/UTILIZATION REVIEW SUBCOMMITTEE AND COMMUNITY DEVELOPMENT SUBCOMMITTEE. THE LAST FULL GROUP MEETING OF THE EMERGENCY PSYCHIATRIC SERVICES SYSTEM (EPSS) COMMITTEE WAS HELD JANUARY 25, 2010, AT WHICH TIME IT WAS DECIDED THAT QUARTERLY MEETINGS WERE NO LONGER NEEDED IN LIEU OF ONGOING SUBCOMMITTEE WORK. THE THREE SUBCOMMITTEES, TRANSITION, 9.41/UTILIZATION REVIEW AND COMMUNITY DEVELOPMENT, CONTINUED TO MEET PERIODICALLY SINCE THEN ON THEIR APPOINTED CHARGES. DATA IS ALSO BEING COLLECTED REGARDING MCATS SHIFT FROM A PRIMARY ED RESPONDER TO GREATER MOBILITY TO THE COMMUNITY-AT-LARGE FOR SITUATIONS INVOLVING BOTH CHILDREN AND ADULTS. SUBCOMMITTEE RESULTS IN 2010 ARE: TRANSITION (ADULT) THIS IS NO LONGER OPERATIONAL, AS FORMAL PROTOCOLS HAVE BEEN DEVELOPED AND IMPLEMENTED AND ALL RELATED TRAININGS HAVE BEEN COMPLETED; LOCAL HOSPITALS HAVE HIRED OR REALIGNED STAFF TO REPLACE MCAT FUNCTIONS IN THE ED. TRANSITION (CHILDREN AND YOUTH) THE TRANSITION SUBCOMMITTEES GOAL WAS TO CONVERT MCATS ED COVERAGE TO HOSPITAL STAFF BY TRAINING IN SCREENING AND ASSESSMENT FOR ADULTS AND CHILDREN. THIS ENABLES HOSPITALS TO DEVELOP RESOURCES AND INTERNAL PROFICIENCIES TO HELP MEET THESE NEEDS. THE GOAL ADDRESSS SYSTEMS OBSTACLES, PARTICULARLY THE PROCURING OF APPROPRIATE REFERRALS TO INPATIENT AND OUTPATIENT RESOURCES. THE SUBCOMMITTEE DEVELOPED A SURVEY AND DISTRIBUTED IT TO VARIOUS STAKEHOLDERS (INCLUDING NYS OFFICE OF MENTAL HEALTH, HOSPITAL EDS, AND THE MVPC PINEFIELD UNIT) TO EXAMINE PERCEPTIONS AND POSSIBLE REASONS FOR THE ONGOING FACT OF CHILDREN WITH LENGTHY ED STAYS. THE TRANSITION SUBCOMMITTEE OUTCOME MEASURE WAS DEFINED: TO REDUCE THE LENGTH OF STAY FOR CHILDREN WHO REMAIN IN THE ED, ONCE MEDICALLY CLEARED VIA: A. DATA COLLECTION AND PERFORMANCE MEASUREMENT B. CONTINUED REVIEW AND REFINEMENT OF EXISTING PROTOCOLS C. TRAINING FOR ALL PROVIDERS RELATED TO THE 3 PROTOCOLS D. FINALIZATION OF THE MCAT FOLLOW-UP PROTOCOL, SO EDS CAN UTILIZE MCAT AS PART OF A VIABLE DISCHARGE PLAN. FAXTON ST. LUKES HEALTHCARE IS NOW PROVIDING TWO NURSE PRACTITIONERS NPS)WITH PSYCHIATRIC BACKGROUNDS TO ASSESS CHILDREN UNDER THE AGE OF 18 WHO ARE IN THE EMERGENCY DEPARTMENT. THE ASSESSMENT IS IN COLLABORATION WITH A NEWLY-HIRED HOSPITAL PSYCHIATRIST. FUNDING FOR THE NPS WAS SECURED THROUGH THE CHILDRENS MIRACLE NETWORK, A FUNDRAISING ARM OF THE HOSPITAL, TO SUPPORT THIS SERVICE. THE SERVICE BEGAN IN MAY 2010 AND FUNDING IS AVAILABLE THROUGH APRIL 30, 2011. THROUGHOUT THIS INITIATIVE FSLH WILL ACCESS THE PATIENT CARE OUTCOMES AND MAKE FURTHER RECOMMENDATIONS FOR 2011. ONEIDA COUNTY DEPARTMENT OF MENTAL HEALTH HAS ALSO TRAINED THE FOLLOWING PROVIDERS IN THE USE OF INFORMATION-SHARING PROTOCOL AND/OR THE CHILDREN & YOUTH ED PROTOCOL: NEIGHBORHOOD CENTER IN UTICA AND ROME; UCP/CHBS, INSIGHT HOUSE, HOUSE OF THE GOOD SHEPHERD, MILESTONES AND THE UTICA RESCUE MISSIONS ADDICTION CRISIS CENTER. TRANSITION SUBCOMMITTEE MEMBERS ALSO MET WITH REPRESENTATIVES OF ONEIDA COUNTY DEPARTMENT OF SOCIAL SERVICES (OCDSS), TO DISCUSS REGISTRATION REQUIREMENTS TO ADMIT CHILDREN AND YOUTH TO DSS CUSTODY AT MVPC PINEFIELD. THE NEED FOR A CASE REVIEW PROCESS FOR HIGH USERS OF EDS AND INPATIENT PSYCHIATRIC SERVICES HAS ALSO BEEN DISCUSSED. A MEETING WAS HELD ON JULY 16, 2010. THE SUBCOMMITTEE CONTINUES TO MEET MONTHLY IN AN EFFORT TO ADDRESS ONGOING COMMUNICATION ISSUES BETWEEN PROVIDERS, EDS AND MVPCS PINEFIELD. 9.41/UTILIZATION REVIEW THE UTILIZATION REVIEW SUBCOMMITTEES GOALS IDENTIFY AND REVIEW ALL INDIVIDUALS WHO PRESENTED WITH A PSYCHIATRIC DISABILITY AT LOCAL EDS AND DETERMINE, CASE-BY-CASE, IF THE PATIENT WAS APPROPRIATE FOR THE ED, FOR MCAT INVOLVEMENT OR FOR ANOTHER RESPONSE. IT ALSO ADDRESSS INDIVIDUAL AND COLLECTIVE SYSTEM OBSTACLES AND ARRANGES FOR CASE CONFERENCES. THE TEAM MET ON JULY 20, 2010 WITH ONGOING MONTHLY MEETINGS SCHEDULED. A MEMORANDUM OF UNDERSTANDING BETWEEN ONEIDA COUNTY DEPARTMENT OF MENTAL HEALTH, ONEIDA COUNTY LAW ENFORCEMENT, ONEIDA COUNTY HOSPITALS, EMERGENCY MEDICAL SERVICES AND LOCAL COMMUNITY SUPPORTS (KNOWN COLLECTIVELY AS THE EMERGENCY PSYCHIATRIC SERVICES SYSTEM) IS NEARLY FINALIZED, AWAITING SIGNATURES; CASES ARE REVIEWED FOR APPROPRIATENESS AND ARE TRACKED BY TRANSPORT METHOD AND PRESENTING PROBLEM(S). IN ADDITION, PROGRESS INCLUDES FINALIZATION OF A REQUEST FOR EXAMINATION FORM FOR LAW ENFORCEMENT OFFICIALS, A CASE REVIEW FORM, AND A STATISTICAL REPORTING PROCESS THAT MONITORS OUTCOMES. PERFORMANCE OUTCOME MEASURES ARE: 1. MCAT FACE-TO-FACE COMMUNITY SCREENINGS WILL ACHIEVE THE SAME NUMBERS AS PRIOR TO MCAT LEAVING THE EDS. 2. MCAT WILL DEMONSTRATE INCREASED LAW ENFORCEMENT INTERACTIONS ON THE 4-12 PM SHIFT. 3. TOTAL 9.41S (EMERGENCY ADMISSIONS FOR IMMEDIATE OBSERVATION, CARE AND TREATMENT) WILL DECREASE IN NUMBER. COMMUNITY DEVELOPMENT THIS SUBCOMMITTEE NO LONGER MEETS. ITS GOAL WAS TO EXPAND MCATS EXPERTISE BY ADDING PEER ADVOCATES, AGREEING UPON NEW TASKS AND APPROACHES, AND ENHANCING PARTNERSHIPS WITH OTHER COMMUNITY PROVIDERS SUCH AS LAW ENFORCEMENT AND DSS PROTECTIVE SERVICES IN ORDER TO ACHIEVE THE MOST EFFECTIVE EPSS RESPONSE FOR ONEIDA COUNTY RESIDENTS. |
| COMMUNITY SERVICE PLAN |
SCHEDULE H PART I LINE 6A |
MCAT HAS PROVIDED NUMEROUS TRAININGS THROUGHOUT THE COMMUNITY REGARDING ITS CHANGED ROLE AND HOW TO EFFECTIVELY NEGOTIATE THE RESTRUCTURED EMERGENCY PSYCHIATRIC SERVICE SYSTEM. DATA COLLECTED OVER TIME REFLECTS A GRADUAL DECREASE IN LAW ENFORCEMENT PICK-UP ORDERS, WITH A CORRESPONDING INCREASE IN MCAT COMMUNITY SCREENINGS. PERFORMANCE MEASUREMENT INDICATORS HAVE BEEN IMPLEMENTED FOR MCAT. NO PEER STAFF MEMBERS HAVE BEEN HIRED TO DATE. THE ONEIDA COUNTY DEPARTMENT OF MENTAL HEALTH CONTINUES TO GATHER RELEVANT DATA ELECTRONICALLY FROM THE EDS AT FAXTON ST. LUKES HEALTHCARE, ST. ELIZABETH MEDICAL CENTER AND ROME MEMORIAL HOSPITAL, AND ADULT INPATIENT PSYCHIATRIC UNITS (INCLUDING MOHAWK VALLEY PSYCHIATRIC CENTER) TO HELP IDENTIFY A GROUP OF HIGH- RISK, HIGH-USE INDIVIDUALS OF SERVICES AND MEDICAID, IN HOPES THAT A MORE STRATEGIC, COST-EFFECTIVE FOCUS CAN THEN BE APPLIED TO THESE CASES. IT IS ANTICIPATED THAT THE NEXT FULL GROUP EMERGENCY PSYCHIATRIC SERVICES SYSTEM (EPSS) MEETING WILL BE HELD IN JANUARY 2011. ONE OF THE OVERALL GOALS OF THE STRATEGIES WAS TO RECRUIT A PEDIATRIC PSYCHIATRIST TO THE AREA OR DEVELOP A CONTRACT WITH A PEDIATRIC PSYCHIATRIST VIA TELEMEDICINE, SO CHILDREN AND ADOLESCENTS WILL RECEIVE TIMELY, EFFECTIVE TREATMENT. THIS GOAL HAS NOT BEEN MET. ANOTHER GOAL IS TO INSTALL COMPUTER PROGRAMS AND GAIN ACCESS FOR COMMUNITY PARTNERS TO SHARE INFORMATION AND INPUT DATA ON PATIENTS. OCDMH IS RESEARCHING GRANT FUNDING FOR AN ELECTRONIC MEDICAL RECORD FOR THIS PURPOSE. ANOTHER GOAL IS TO RESEARCH NYS GUIDELINES TO LEARN IF MEDICATIONS MAY BE ADJUSTED FOR PATIENTS WITH DEVELOPMENTAL DISABILITIES OR MENTAL HEALTH PROBLEMS. GOALS WILL CONTINUE TO BE MEASURED FOR EFFECTIVENESS BY: . INCREASED NUMBERS OF COMMUNITY SCREENINGS, SO PATIENTS DO NOT GO TO THE ED FOR INAPPROPRIATE MENTAL-HEALTH CONCERNS . DECREASED NUMBERS OF ED VISITS AND INVOLUNTARY TRANSFERS OF SUCH PATIENTS . DEVELOPMENT OF A MEDICALLY MANAGED DETOXIFICATION PROGRAM IN THE AREA. THERE ARE NOT MANY SERVICES IN THE REGION THAT PROVIDE SERVICES FOR HEAVY SUBSTANCE ABUSERS. PRIORITY 2 - HEALTHY MOTHERS, HEALTHY BABIES, HEALTHY CHILDREN 2009-2010 - OB CARE PROGRAM RENOVATION/ IS IN PROGRESS WITH EXPANDED WORK GROUPS, IN ADDITION TO THE HOSPITALS, PARTICIPATING IN THE OCTOBER 2009 HEALTH SUMMIT. 2010-2011 - COMPLETION OF THE OB CARE CENTER AT THE ST. LUKES CAMPUS OF FAXTON-ST. LUKES HEALTHCARE AND FULL CONSOLIDATION OF SERVICES. MEMBERS OF THE HEALTHY MOTHERS, BABIES AND CHILDREN WORK GROUP TO DEVELOP PRIORITIES, ASSESS RESOURCES AND TAKE ACTION TO DEVELOP A COMPREHENSIVE APPROACH TO SERVING THE IDENTIFIED POPULATION. 2011- 2012 - MEMBERS OF THE TEAM WILL CONTINUE TO MEASURE ACTIONS FOR POSITIVE OUTCOMES AND DETERMINE NEXT STEPS. THE INITIATIVES IDENTIFIED BY THE TEAMS IN ONEIDA AND HERKIMER COUNTIES INCLUDE BETTER ACCESS TO CARE AND COORDINATION OF CARE. THE UNDER-SERVED ARE IDENTIFIED AS A HIGH PRIORITY. 1. BETTER ACCESS TO CARE INCLUDES CONSOLIDATION OF OB CARE SERVICES AT ONE PROVIDER LOCATION. BACKGROUND: FAXTON ST. LUKES HEALTHCARE AND ST. ELIZABETH MEDICAL CENTER PROVIDE GYN AND/OR OB CARE SERVICES THROUGH THEIR INDIVIDUAL HOSPITALS. THE COVERAGE AREA FACES SEVERAL CHALLENGES INCLUDING HIGH RATES FOR TEEN PREGNANCY, INFANT MORTALITY, INFANT LOW BIRTH WEIGHT AND LOW PERCENTAGE OF BIRTHS WITH PRENATAL CARE (AS COMPARED TO THE NEW YORK STATE AVERAGE). THERE ARE MORE THAN 57,000 WOMEN OF CHILDBEARING AGE WITHIN ONEIDA AND HERKIMER COUNTIES. IN APRIL 2008 THE HOSPITALS BEGAN COLLABORATION TO CENTRALIZE THE SERVICES AT ONE SITE AND PROVIDE A COMPREHENSIVE, COMMUNITY-BASED PROGRAM. THE PROJECT INVOLVED RENOVATIONS TO THE EXISTING 1,810 SQUARE FOOT OB CARE CENTER LOCATED AT THE ST. LUKES CAMPUS OF FAXTON ST. LUKES HEALTHCARE AND ADDED A NEW ADDITION OF 3,860 SQUARE FEET. THE NEW CENTER, WOULD ACCOMMODATE THE SERVICES OF THE ST. ELIZABETH FAMILY PRACTICE RESIDENCY PROGRAM, TO SUPPORT THE STAFFING NEEDS OF THE CENTER. ESTIMATED PROJECT COST (2008) IS $1.6 MILLION. THE ORGANIZATIONS APPLIED FOR AND RECEIVED A $1.6 MILLION GRANT FROM THE HEAL NY PHASE 7 AWARDS IN SEPTEMBER 2008. THE INITIAL PLAN CALLED FOR RENOVATION AND CONSTRUCTION WITH THE FIRST PHASE BEGINNING IN LATE 2009 AND COMPLETION ANTICIPATED BY SUMMER 2010. ANNUALLY THE TWO OB SERVICES SEE APPROXIMATELY 13,000 OB VISITS THAT ARE MEDICAID INSURED PATIENTS. DELIVERIES FOR THE COMMUNITY ARE AT THE BIRTHPLACE OF FAXTON ST. LUKES HEALTHCARE WHICH SEES ABOUT 2,200 DELIVERIES ON AN ANNUAL BASIS, 825 OF WHICH ARE PATIENTS FROM THE OB CARE CENTERS. STATUS UPDATE OF OVERALL GOALS FOR THE INITIATIVE- COORDINATE AND CENTRALIZE OB CARE SERVICES FOR UNINSURED/UNDERSERVED HIGH-RISK WOMEN AND STREAMLINE OB/GYN SERVICES IN ONE COMMUNITY-BASED CARE CENTER. THE ORGANIZATIONS (FAXTON ST. LUKES HEALTHCARE AND ST. ELIZABETH MEDICAL CENTER) ARE CURRENTLY WORKING WITH THE NEW YORK STATE DEPARTMENT OF HEALTH TO ADDRESS AND SECURE A SUCCESSFUL REIMBURSEMENT MODEL FOR THE NEW COMBINED PROGRAM. THE DEVELOPMENT AND IMPLEMENTATION OF THE MODEL HAS DELAYED THE PROGRESS OF THE PROGRAM. AN EXTENSION OF THE $1.6 MILLION HEAL NY PHASE 7 AWARD IS BEING APPLIED FOR IN ANTICIPATION OF A SUCCESSFUL RESOLUTION OF THE REIMBURSEMENT BARRIER. - ALLEVIATE CURRENT OBSTETRICIAN SHORTAGE AT FAXTON ST. LUKES HEALTHCARE BY SHARING PHYSICIAN SERVICES AND INCREASE EFFICACY OF TREATMENT BY USING FAMILY PRACTICE RESIDENTS TO ASSIST IN PROVIDING TREATMENT. THE ORGANIZATIONS HAVE EXPLORED A LABORIST MODEL FOR PROVIDER COVERAGE. THERE ARE CURRENTLY 12 LABORIST MODELS ACROSS THE COUNTRY MANAGED BY AN ORGANIZATION KNOWN AS DELPHI HEALTHCARE PARTNERS, INC. THIS POSSIBLE MODEL WOULD BE COMPATIBLE WITH THE FAMILY RESIDENCY PROGRAM OF ST. ELIZABETH MEDICAL CENTER. 2. REMOVE PERCEIVED BARRIERS TO ACCESSING PRENATAL CARE SERVICES. MUCH OF 2010 WAS SPENT IDENTIFYING WHAT RESOURCES ARE CURRENTLY AVAILABLE, AREAS OF OVERLAP AS WELL AS UNMET NEEDS. WORK GROUPS ARE ADDRESSING ACCESS TO PRENATAL CARE,ACCESS TO CARE AND TEEN PREGNANCY PREVENTION. TEAM MEMBERS INCLUDE FAXTON ST. LUKES HEALTHCARE, CATHOLIC CHARITIES, PLANNED PARENTHOOD, YWCA MOHAWK VALLEY, MOHAWK VALLEY PERINATAL NETWORK, ST. ELIZABETH MEDICAL CENTER, ONEIDA COUNTY HEALTH DEPARTMENT, CORNELL COOPERATIVE EXTENSION, CARE NET PREGNANCY CENTER OF CNY, UTICA SAFE SCHOOLS AND HERKIMER COUNTY HEALTH NET. MATERNAL-CHILD HEALTH WORKGROUP IS ADDRESSING PRIORITY AREAS OF LOW BIRTH WEIGHT, PRETERM BIRTH, AND EARLY ENTRY TO PRENATAL CARE. LED BY THE MOHAWK VALLEY PERINATAL NETWORK, THE TEAM IS EXPLORING A CONCEPT KNOWN AS CENTERING PREGNANCY, A MODEL OF GROUP HEALTH CARE DELIVERY COORDINATED THROUGH LOCAL PRENATAL CARE CENTERS AND PRIVATE OBSTETRICAL OFFICES. A COMMUNITY-WIDE PRESENTATION WILL BE HELD IN SEPTEMBER 2010. FOLLOWING THE PROGRAM THE TEAM WILL DEVELOP SPECIFIC ACTION PLANS AND TIMELINES FOR IMPLEMENTATION SHOULD THE MODEL BE ADOPTED. NOTES ABOUT THE MODEL: CENTERING PREGNANCY HAS THREE COMPONENTS HEALTH ASSESSMENT, EDUCATION, AND SUPPORT THAT ARE PROVIDED IN A GROUP FACILITATED BY A CREDENTIALED HEALTH PROVIDER AND A CO-FACILITATOR WHO IS A NURSE OR OTHER APPROPRIATE STAFF MEMBER. THIS EVIDENCE-BASED REDESIGN OF HEALTH CARE DELIVERY HELPS PROMOTE SAFETY, EFFICIENCY, EFFECTIVENESS, TIMELINESS, CULTURALLY APPROPRIATE PATIENT-CENTERED CARE, AND MORE EQUITABLE CARE. GROUP PARTICIPANTS MEET REGULARLY WITH THEIR CARE PROVIDER AND OTHER GROUP PARTICIPANTS FOR MUCH LONGER (UP TO TWO HOURS) THAN A USUAL CHECK-UP VISIT. EVIDENCE SUGGESTS THAT OUTCOMES FOR PEOPLE RECEIVING CARE IN GROUPS ARE UNIFORMLY BETTER THAN FOR THOSE IN TRADITIONAL CARE. THE MODEL HAS SHOWN TO HELP REDUCE PRETERM BIRTH FOR WOMEN IN CENTERING GROUPS, INCREASE PATIENT SATISFACTION, INCREASE BREAST-FEEDING RATES, AND IMPROVED KNOWLEDGE AND READINESS FOR BIRTH AND PARENTING. IT HAS BEEN PROVEN THAT CENTERING PREGNANCY CAN BE COST NEUTRAL WITH THE REDUCTION IN PRETERM BIRTHS SAVING SIGNIFICANT DOLLARS WITHIN THE HEALTH SYSTEM. OTHER CONSIDERATION OF COST EFFECTIVENESS ALSO INCLUDES LONG-TERM MEASURES SUCH AS: INCIDENCE AND EFFECTIVE TREATMENT OF DEPRESSION, MATERNAL AND CHILDHOOD OBESITY, SCHOOL READINESS, AND EFFECTIVE CONTRACEPTION. |
| COMMUNITY SERVICE PLAN |
SCHEDULE H PART I LINE 6A |
3. COMMUNICATION AND OUTREACH, ACCESS TO CARE - IN 2010 INFORMATIONAL POSTERS/BROCHURES HAVE BEEN DEVELOPED AND DISTRIBUTED BY FAXTON ST. LUKES HEALTHCARE AND MOHAWK VALLEY PERINATAL NETWORK TO PROMOTE AWARENESS OF RESOURCES AVAILABLE FOR NEWLY PREGNANT MOTHERS, ENCOURAGING THE IMPORTANCE OF GOOD PRENATAL CARE. - TEEN PREGNANCY PREVENTION NETWORK IS LED THE MOHAWK VALLEY PERINATAL NETWORK. THE OBJECTIVE OF THE TEAM IS TO DECREASE THE PERCENTAGE OF ADOLESCENT TEEN PREGNANCIES OF 15-19 YEAR-OLDS IN ONEIDA, HERKIMER, AND MADISON COUNTIES BY 5-10% OVER THE COURSE OF 5 YEARS (2011 TO 2016) AS MEASURED BY NYS DEPT. OF HEALTH VITAL RECORDS DATA. STRATEGIES INCLUDE: - HALF DAY TRAINING AND AWARENESS PROGRAM FOR HEALTH AND PHYSICAL EDUCATION TEACHERS, SCHOOL NURSES, FAMILY EDUCATORS, AND ANY OTHER INTERESTED SCHOOL PERSONNEL ON VARIOUS SEX-ED TOPICS. TARGET DATES FOR PROGRAM WILL TIE TO AVAILABLE DAYS WITH SCHOOL PERSONNEL, SUCH AS A SCHEDULED DAY OFF (SUPERINTENDENTS DAY) IN THE SPRING 2011 AND SUMMER 2011. PARTNERS INCLUDE: .. BOCES ONEIDA-HERKIMER-MADISON .. BOCES MADISON-ONEIDA .. LOCAL SCHOOLS .. AGENCIES WITHIN OUR NETWORK - UTICA SAFE SCHOOLS, YWCA, FAXTON ST. LUKES, PLANNED PARENTHOOD, MVPN, AIDS COMMUNITY RESOURCES, CATHOLIC CHARITIES, ETC. - COLLABORATE WITH COMPEER AND LOCAL COLLEGES TO RECRUIT VOLUNTEERS TO BE MENTORS FOR LOCAL MENTORING PROGRAMS (COMPEER, HAMILTON COLLEGE, FOR THE GOOD, ETC.) TARGET DATE TO BE DETERMINED. PARTNERS INCLUDE: .. COMPEER .. HAMILTON COLLEGE - FOR THE GOOD .. OTHER LOCAL COLLEGES A FREE COMMUNITY PROGRAM OFFERED IN SEPTEMBER 2010 UNDERSTANDING AND ENGAGING TEENS BY THE MOHAWK VALLEY PERINATAL NETWORK IS PART OF EDUCATIONAL SERVICES TO HELP AGENCIES AND CARE PROVIDERS BETTER UNDERSTAND WHAT MOTIVATES YOUTH AND PROVIDE INFORMATION ON HOW TO ENGAGE THEM IN THEIR OWN HEALTH DECISIONS. BARRIERS TO CARE CONTINUE TO BE SCHEDULING AND ACCESS FOR CONVENIENT APPOINTMENT TIMES, PROVIDING SHORTER WAIT TIMES FOR CARE, TRANSPORTATION ISSUES, AND A ONE-STOP SHOPPING CONCEPT FOR LABORATORY AND RADIOLOGY SERVICES, FINANCIAL COUNSELING, NUTRITIONAL SERVICES, SOCIAL WORK, SMOKING CESSATION AND THE OPPORTUNITY FOR SUPPORTING COUNTY AGENCIES TO BE AVAILABLE DURING THE PRENATAL VISITS. PRIORITY 3 - CHRONIC DISEASE MANAGEMENT IN 2009, THE 3-YEAR PLAN FOCUSED UPON TOBACCO CESSATION, WHICH WAS AN EXISTING PRIORITY FOR THE REGION. THE REGIONAL PROGRAM CURRENTLY IN PLACE IS THE TRI-COUNTY TOBACCO CESSATION CENTER AT THE REGIONAL CANCER CENTER OF FAXTON-ST. LUKES HEALTHCARE. THIS PROGRAM IS FUNDED BY THE NEW YORK STATE DEPARTMENT OF HEALTH TOBACCO CONTROL PROGRAM (TCP). IT IS A COMPONENT OF A COMPREHENSIVE STATE-WIDE APPROACH TO REDUCE MORBIDITY AND MORTALITY AND ALLEVIATE THE SOCIAL AND ECONOMIC BURDEN CAUSED BY TOBACCO USE IN NEW YORK STATE (TCP STRATEGIC PLAN). THE PROGRAM IS ACTIVE IN ONEIDA, HERKIMER AND MADISON COUNTIES. THERE ARE CURRENTLY 123 PARTICIPATING PARTNER HEALTHCARE PROVIDER ORGANIZATIONS, INCLUDING FAXTON ST. LUKES HEALTHCARE, ST. ELIZABETH MEDICAL CENTER, MOHAWK VALLEY HEART INSTITUTE, ONEIDA HEALTHCARE, ROME MEMORIAL HOSPITAL, LITTLE FALLS HOSPITAL, COMMUNITY MEMORIAL HOSPITAL, SLOCUM-DICKSON MEDICAL GROUP, PLLC AND BRIDGES. THE TRI-COUNTY TOBACCO CESSATION CENTER RECEIVED AN ADDITIONAL 3-YEAR GRANT FROM THE NYSDOH IN 2009. THE GRANT IS FUNDED AND REVIEWED ANNUALLY. MEMBERS FROM THE TRI-COUNTY TEAM PARTICIPATE IN THE CHRONIC DISEASE WORK GROUP. USING EVIDENCE-BASED METHODOLOGIES, THE CESSATION CENTER INCORPORATES THE FOLLOWING GOALS AND STRATEGIES (BASED ON THE TCP STRATEGIC PLAN): . INCREASE THE NUMBER OF HEALTHCARE ORGANIZATIONS AND PROVIDERS THAT EFFECTIVELY IMPLEMENT THE PUBLIC HEALTH SERVICE CLINICAL PRACTICE GUIDELINE FOR TREATING TOBACCO USE AND DEPENDENCE.. ADVANCE TOBACCO-FREE POLICIES AND PROVISIONS OF TOBACCO DEPENDENCE TREATMENT IN ALL HEALTHCARE SETTINGS, INCLUDING HOSPITALS AND PHYSICIAN PRACTICES, SUBSTANCE ABUSE TREATMENT FACILITIES, MENTAL HEALTH TREATMENT AND SUPPORT SETTINGS, ADULT CARE FACILITIES AND HIV CARE SETTINGS. SUPPORT EMPLOYER PROVISION AND PROMOTION OF TOBACCO DEPENDENCE TREATMENT FOR EMPLOYEES AND ADOPTION OF TOBACCO-FREE CAMPUSES. . INCREASE THE NUMBER OF PUBLIC AND PRIVATE HEALTH INSURANCE PLANS THAT PROVIDE COMPREHENSIVE, LIFETIME COVERAGE OF TOBACCO DEPENDENCE TREATMENT. . EXPAND AND SUSTAIN EFFORTS TO PROMOTE THE NEW YORK STATE SMOKERS QUITLINE WEBSITE. THE TOBACCO CESSATION CENTER AT THE REGIONAL CANCER CENTER OF FAXTON ST. LUKES HEALTHCARE ENCOMPASSES A CATCHMENT AREA OF ONEIDA, HERKIMER AND MADISON COUNTIES. THESE COUNTIES REPRESENT SEVERAL DEMOGRAPHIC CHALLENGES IN TREATING TOBACCO USE AND DEPENDENCE. THE AREAS CLASSIFIED AS CITIES RANGE IN POPULATION SIZE FROM 3,000 TO 60,000. THE GENERAL POPULATION IS SCATTERED AMONG MANY SMALL TOWNS AND VILLAGES, SOME LOCATED AS FAR AWAY AS 60 MILES FROM THE NEAREST CITY OR HOSPITAL. ACCESS TO SERVICES, INCLUDING PRIMARY CARE PROVIDERS (PCP) IN SOME AREAS IS LIMITED. GAPS IN CARE CAN BE DIRECTLY RELATED TO ACCESS ISSUES: FOR EXAMPLE, A PATIENT WHO LIVES IN NORTHERN HERKIMER COUNTY, MAY HAVE ACCESS TO A PCP, BUT MIGHT BE REQUIRED TO TRAVEL 50 OR MORE MILES TO RECEIVE TREATMENT FOR LUNG CANCER. OTHER DEMOGRAPHICS, SUCH AS ATTAINED EDUCATIONAL LEVELS, LANGUAGE AND CULTURAL DIVERSITY, AND ECONOMIC LEVELS, PROVIDE ADDITIONAL CHALLENGES WITHIN THE CATCHMEN AREA. FOR EXAMPLE: THE CITY OF UTICA IS HOME TO THE FOURTH-LARGEST REFUGEE CENTER IN THE UNITED STATES; MANY OF THESE RECENT REFUGEES AND THEIR FAMILIES ENCOUNTER LANGUAGE, LITERACY, CULTURAL, AND ECONOMIC BARRIERS IN ACCESSING CARE. |
| COMMUNITY SERVICE PLAN |
SCHEDULE H PART I LINE 6A |
LOCAL CESSATION SERVICES/EFFECTIVENESS OF PROGRAM SUCCESS OF THE PROGRAM IS MEASURED THROUGH THE SUCCESS OF INDIVIDUAL FACILITIES AND COMMUNITY EDUCATION AND COMPLIANCE. DEPARTMENT OF HEALTH TOBACCO CONTROL PROGRAM DELIVERABLES, GROWTH REQUIRED/MEASURED ANNUALLY INCLUDE: -NUMBER OF HEALTHCARE PROVIDER ORGANIZATIONS THAT PARTICIPATE IN PROVIDER EDUCATION AND SUSTAINABLE DOCUMENTATION SYSTEMS CHANGE -NUMBER OF HEALTHCARE PROVIDER ORGANIZATIONS THAT MOVE TO A MAINTENANCE PHASE; DEMONSTRATING SUSTAINED CHANGES IN STANDARD OF CARE FOR THE TREATMENT OF TOBACCO DEPENDENCE (CRITERIA EXISTS) -NUMBER OF TRAININGS AND TECHNICAL ASSISTANCE VISITS PROVIDED BY CESSATION CENTER STAFF TO LOCAL HEALTHCARE PROVIDER ORGANIZATIONS -NUMBER OF MEDICAID CLAIMS FOR PHARMACOTHERAPY FOR SMOKING CESSATION -NUMBER OF MEDICAID CLAIMS FOR SMOKING CESSATION COUNSELING (PREGNANT WOMEN) -NUMBER OF HEALTHCARE PROVIDER REFERRALS TO THE NEW YORK STATE SMOKERS QUITLINE THE CESSATION CENTER HAS FACILITATED A WELL-ESTABLISHED COLLABORATION AMONG LOCAL HCPOS TO OFFER INTENSIVE INTERVENTION COMMUNITY SMOKING CESSATION CLASSES AT SEVEN DIFFERENT LOCATIONS WITHIN THE TRI-COUNTY REGION. IT IS THE ROLE OF THE CESSATION CENTER TO ESTABLISH PARTICIPATION AGREEMENTS, PROVIDE BASELINE TRAINING TO CLASS FACILITATORS, FACILITATE THE CREATION OF THE TRI-ANNUAL CESSATION CLASS CALENDAR, MAIL CALENDARS TO LOCAL HEALTH CARE PROVIDER ORGANIZATIONS (HCPOS) AND PRIMARY CARE PROVIDERS (PCP), COLLECT AND ANALYZE OUTCOMES DATA, AND ADMINISTER STIPENDS TO ORGANIZATIONS THAT HOST THE CLASSES. THESE CLASSES HAVE DEMONSTRATED 6-MONTH QUIT RATES OF 20-35% AND 12-MONTH QUIT RATES OF 20-30% OVER TIME. LOCAL HEALTHCARE PROVIDERS APPRECIATE HAVING A LOCAL RESOURCE FOR CESSATION FOR THEIR PATIENTS TO ENHANCE THE SERVICES AVAILABLE THROUGH THE QUITLINE. IN ADDITION, MUCH OF THE HOSPITAL STAFF RESPONSIBLE FOR PROVIDING BRIEF CESSATION INTERVENTIONS, AS WELL AS PCP OFFICE STAFF, HAVE PARTICIPATED IN TRAININGS ON TREATING TOBACCO USE AND DEPENDENCE, MAKING THEM AVAILABLE AS INDIVIDUAL, LOCAL CESSATION RESOURCES. THE TOBACCO CESSATION CENTER ALSO SUPPORTS CESSATION AMONG LOCAL EMPLOYERS AND COLLEGE CAMPUSES. STARTED IN 2004, THE CESSATION CENTER HAD ESTABLISHED A COMPREHENSIVE EMPLOYEE AND STUDENT CESSATION PROTOCOL THAT INCLUDES THE DISTRIBUTION ON NICOTINE REPLACEMENT THERAPY (NRT) TO INDIVIDUALS WHOSE INSURANCE DOES NOT COVER NRT. THE PROGRAM COMBINED COUNSELING, PHARMACOTHERAPY AND SUPPORT FOR EMPLOYEES AND STUDENTS AT PARTICIPATING ORGANIZATIONS. AS THE DOH FUNDING FOR THE PROVISION OF NICOTINE REPLACEMENT THERAPY HAS SIGNIFICANTLY DIMINISHED, THE CESSATION CENTER HAS WORKED WITH LOCAL EMPLOYERS TO ENHANCE THEIR CESSATION BENEFITS AVAILABLE THROUGH THEIR OWN HEALTH INSURANCE, MAKING THE PROGRAM SUSTAINABLE. IN ADDITION TO WORKING THROUGH THE TRI-COUNTY TOBACCO CESSATION CENTER, THE ONEIDA AND HERKIMER COUNTIES CHRONIC DISEASE WORK GROUP IS DEDICATED TO AN EXPANDED REGIONAL EFFORT TO DEVELOP AND IMPLEMENT STRATEGIES THAT WILL ENHANCE THE HEALTH AND WELLNESS OF THE COMMUNITY MEMBERS IN ONEIDA AND HERKIMER COUNTIES. THE GROUP IS COMPRISED OF REPRESENTATIVES FROM DIFFERENT HEALTHCARE AND COMMUNITY ORGANIZATIONS AND HAS AGREED TO A COLLABORATIVE APPROACH TO MEET THE FOLLOWING TWO, DATA-DRIVEN OBJECTIVES: 1. REDUCE THE MORBIDITY AND MORTALITY ASSOCIATED WITH CANCER, HEART DISEASE, STROKE AND DIABETES. 2. INCREASE HEALTHCARE PROVIDER INTERVENTIONS RELATED TO PREVENTION AND EARLY DETECTION OF CHRONIC DISEASES (CANCER, HEART DISEASE, STROKE AND DIABETES.) AS OF JULY 17, 2010, THE WORK GROUP HAS MET FOUR TIMES (APRIL 22, MAY 27, JUNE 24 AND JULY 17) AND HAS A STANDING MEETING SET FOR THE FOURTH THURSDAY OF EACH MONTH AT 8 A.M. AT THE INITIAL MEETING, INFORMAL SUB-GROUPS WERE FORMED AND COMPLETED A ROOT-CAUSE ANALYSIS OF THE DATA-DRIVEN OBJECTIVES RELATED TO CANCER, HEART DISEASE, STROKE AND DIABETES. COMMON AREAS BETWEEN THE DISEASES WERE IDENTIFIED: . NEED FOR INCREASED HEALTHCARE PROVIDER UNDERSTANDING OF BEST PRACTICES FOR PREVENTION . LACK OF APPROPRIATE COMMUNITY HEALTH SCREENINGS . LACK OF AN INFORMATION CLEARINGHOUSE IN EACH COUNTY TO DISSEMINATE INFORMATION ON ALREADY EXISTING SERVICES RELATED TO PREVENTION AND TREATMENT. STRATEGIES TO ADDRESS THE COMMON AREAS WERE CONCEIVED. AT SUBSEQUENT MEETINGS, SUBJECT-MATTER EXPERTS WERE INVITED TO JOIN THE GROUP; THE STRATEGIES WERE REFINED AND A PERMANENT SUB-GROUP WAS FORMED TO RESEARCH AND MAKE RECOMMENDATIONS RELATED TO BEST PRACTICES. MUCH DISCUSSION HAS ENSUED OVER THE USE OF SCREENINGS AS A METHOD TO MEET OUR OBJECTIVES. THE GROUP HAS COME TO CONSENSUS IN AGREEING THAT SCREENINGS SHOULD BE VIEWED IN TWO WAYS: ENGAGING PATIENTS WHO HAVE HEALTH INSURANCE TO PARTICIPATE IN COVERED HEALTH SCREENINGS AND THE PROVISION OF COMMUNITY SCREENINGS TO TARGET POPULATIONS (UNINSURED, THOSE WHO LIVE IN RURAL AREAS, AND TARGET POPULATIONS IDENTIFIED IN THE DATA). RECOMMENDED STRATEGIES AND OPERATIONAL METHODOLOGIES: 1. DEVELOP AND DISTRIBUTE EVIDENCE-BASED PRACTICES GUIDES TO LOCAL HEALTHCARE PROVIDERS FOR REVIEW WITH THEIR PATIENTS, AS WELL AS ENCOURAGING PATIENT SELF-ADVOCACY. A. USE EXISTING SCREENING RECOMMENDATION MATERIALS FROM THE AMERICAN CANCER SOCIETY (ACS), AMERICAN HEART ASSOCIATION (AHA), AND AMERICAN DIABETES ASSOCIATION (ADA). SCREENING GUIDES ARE A PRODUCT OF THE PREVENTATIVE HEALTH PARTNERSHIP, A NATIONAL COLLABORATIVE OF THE ACS, AHA AND ADA. THEY INCLUDE THE MOST UP-TO-DATE SCREENING RECOMMENDATIONS AND HAVE BEEN FIELD TESTED BY THE PREVENTATIVE HEALTH PARTNERSHIP. B. USE CURRENT WORK GROUP MEMBER ACTIVITIES, I.E. COUNTY FAIRS, CANAL DAYS, ETC. TO DISTRIBUTE THE SCREENING GUIDELINES. C. DEVELOP A PROTOCOL FOR UTILIZING THE MATERIALS AT SELECT CONFIRMED PILOT HEALTHCARE PROVIDERS: ROME MEDICAL GROUP ROME MEDICAL GROUP: CAMDEN CAMPUS FSLH ADIRONDACK COMMUNITY PHYSICIANS NORTH UTICA OFFICE FSLH ADIRONDACK COMMUNITY PHYSICIANS WATERVILLE OFFICE SEMC CLINTON MEDICAL PRACTICE GROUP SEMC SAUQUOIT MEDICAL PRACTICE GROUP LITTLE FALLS HOSPITAL NEWPORT PRIMARY CARE SITE D. BEGIN PILOT (PROVIDER DISTRIBUTION OF MATERIALS AND PLACEMENT OF PATIENT EDUCATION MATERIALS IN EXAM AND WAITING ROOMS) SEPTEMBER 15, 2010, ENDING DECEMBER 15, 2010, WITH 30- AND 90-DAY FOLLOW-UP VISITS. THE WORK GROUP HAS PROPOSED USING THE MATERIALS IN TWO DIFFERENT WAYS: . WORKING WITH A PILOT STUDY GROUP OF PHYSICIAN OFFICES, PATIENTS WILL BE EXPOSED TO A HEALTH CARD WITH INFORMATION (PASSIVELY) IN THE WAITING ROOM. UPON BEING ESCORTED TO AN EXAM ROOM, THE NURSE WILL POINT OUT A POSTER ON THE WALL AND GIVE THE PATIENT A "TEAR-OFF" SHEET TO DISCUSS WITH THE PROVIDER. THE PROVIDER WILL QUERY THE PATIENT FOR QUESTIONS AND RECOMMEND (AND HOPEFULLY, ORDER) APPROPRIATE SCREENS. THIS THREE-MONTH PILOT WILL INCLUDE MONTHLY SITE VISITS AND A FORMAL PROVIDER EVALUATION AT THE END OF THE TRIAL. . UTILIZING COMMUNITY EDUCATION OPPORTUNITIES, MEMBERS OF THE CHRONIC DISEASE WORK GROUP WILL DISTRIBUTE THE "TEAR OFF" SHEETS AT HEALTH FAIRS, EMPLOYEE FAIRS, ETC. A FORMAL EVALUATION TOOL HAS BEEN DEVELOPED TO DETERMINE THE EFFECTIVENESS OF THIS APPROACH, AS WELL. E. DEVELOP EVALUATION MEASURES: EVALUATE PILOT PROGRAM, COMPLETE RECOMMENDED PROCESS/PERFORMANCE IMPROVEMENTS, WITH COMMUNITY-WIDE ROLLOUT (GROUP MEMBER REPRESENTATION) APRIL 2011. F. INCREASE THE REACH OF THE INFORMATION BY REQUESTING THAT LOCAL EMPLOYERS AND HEALTH INSURERS DISTRIBUTE AND DISSEMINATE INFORMATION ON HEALTH SCREENINGS. G. MAKE A COLLECTIVE REQUEST (FSLH, ROME MEMORIAL HOSPITAL, SEMC, AND BASSETT) TO LOCAL MEDIA OUTLETS TO DEVELOP AND AIR COMMERCIALS PROMOTING THE SCREENING CAMPAIGN. 2. DEVELOP A MULTI-ORGANIZATIONAL COLLABORATIVE TO PROVIDE SELECTED COMMUNITY SCREENINGS TO TARGET POPULATIONS (UNINSURED, RURAL COMMUNITY MEMBERS, SELECT TARGET POPULATIONS IDENTIFIED IN THE DATA).A. COMPLETE AN ASSESSMENT OF WHAT SCREENING/EDUCATION/TREATMENT OFFERINGS ARE CURRENTLY BEING OFFERED BY WORK GROUP MEMBERS (COMPLETE). B. WORK WITH CANCER PROGRAM SERVICES (COVERS BOTH ONEIDA AND HERKIMER COUNTIES) TO ENHANCE THE FOUR EXISTING RURAL HEALTH FAIRS. C. SUPPLEMENT THE CURRENT SCHEDULE WITH ONE TO TWO ADDITIONAL OPPORTUNITIES TO REACH THE TARGET POPULATIONS. IT IS THE RECOMMENDATION OF THE BEST PRACTICES SUBGROUP TO PARTICIPATE IN THE VOICES FOR CHRIST CRUSADE IN ROME ON AUGUST 21. (THIS EVENT DREW OVER 2,000 PARTICIPANTS LAST YEAR, PRIMARILY AFRICAN AMERICANS AND HISPANICS FROM BOTH ROME AND UTICA.) THERE WAS A REQUEST FROM ORGANIZERS FOR HEALTHCARE PARTICIPANTS, AND A SMALL CONTINGENT OF THE SUBGROUP TOOK PART IN THE CRUSADE (MAMI INTERPRETERS, FSLH, ROME MEMORIAL HOSPITAL AND CPS). THE GENERAL CONSENSUS WAS IT WAS VALUABLE AND IF THE GROUP GETS INVOLVED EARLIER ON, IT WOULD BE BENEFICIAL TO PARTICIPATE IN FUTURE YEARS. |
| COMMUNITY SERVICE PLAN |
SCHEDULE H PART I LINE 6A |
3. DISSEMINATE INFORMATION THROUGH AN INFORMATION CLEARINGHOUSE IN EACH COUNTY. A. GARNER AN ADMINISTRATIVE COMMITMENT FROM THE HEALTH DEPARTMENT IN ONEIDA AND HERKIMER COUNTIES TO SERVE AS INFORMATION CLEARINGHOUSES (PROVIDING RESOURCES TO COMMUNITY/BUSINESS MEMBERS WHO ARE LOOKING FOR LOCAL SCREENING, PREVENTION AND TREATMENT SERVICES WITHIN THE COUNTY). THIS WOULD INCLUDE POSTING COMMUNITY EVENTS SUCH AS HEALTH FAIRS, ETC. TO THE COUNTY DOH WEBSITES, AS WELL AS RESPONDING TO REQUESTS FROM COMMUNITY MEMBERS/BUSINESSES FOR RESOURCES TO PROVIDE REQUESTED SERVICES. (EXAMPLE: A LOCAL BUSINESS COULD CALL THE HEALTH DEPARTMENT AND RECEIVE INFORMATION ON WHAT ORGANIZATIONS WOULD PROVIDE A BLOOD PRESSURE SCREENING FOR THEM.) THIS WEBSITE MAY BE ORGANIZED INTO DIRECT CATEGORIES: COMMUNITY CALENDAR, PREVENTION/EDUCATION, TREATMENT OPTIONS, AND FINANCIAL RESOURCES. A SUBCOMMITTEE HAS BEEN FORMED TO FINALIZE THE ELEMENTS OF THIS INITIATIVE. B. UTILIZING THE WORK GROUP, PROVIDE THE TWO COUNTIES WITH AS MUCH INFORMATION AS POSSIBLE TO UTILIZE, DEVELOP AND MAINTAIN THE INFORMATION CLEARINGHOUSE. C. COLLECTIVELY REQUEST (FSLH, ROME MEMORIAL HOSPITAL, SEMC, AND BASSETT) THAT LOCAL MEDIA OUTLETS DEVELOP AND RUN PUBLIC SERVICE ANNOUNCEMENTS RELATED TO THE ROLE OF THE HEALTH DEPARTMENTS, TO PROVIDE GOOD PUBLIC RELATIONS BETWEEN ALL OF THESE HEALTHCARE ENTITIES AND THE COMMUNITY, AND TO PROMOTE COLLABORATION AMONG THE HOSPITALS, NOT COMPETITION. PRIORITY 4 ACCESS TO QUALITY HEALTHCARE THIS IDENTIFIED INITIATIVE, WHILE NOT A CORE COMPONENT OF THE 2009 ACTION PLANS, HAS A COLLABORATIVE TEAM OF AREA AGENCIES AND PROVIDERS WORKING TO DEVELOP AN ACTION PLAN FOR 2011 AND BEYOND. THE GOAL IS BETTER USE OF COMMUNITY HEALTH RESOURCES THROUGH HEALTH EDUCATION AND AWARENESS WITH A STRATEGY TO REDUCE EMERGENCY ROOM USAGE FOR PRIMARY NON-EMERGENT PURPOSES VIA A PUBLIC EDUCATION CAMPAIGN. FOUR OBJECTIVES HAVE BEEN IDENTIFIED: 1. ASSESS CURRENT EMERGENCY ROOM USAGE PATTERNS. 2. ASSESS URGENT AND PRIMARY CARE PROVIDERS ABILITY TO ACCOMMODATE NON-EMERGENT NEEDS. 3. ASSESS CURRENT INFORMATION AND EDUCATION CAMPAIGNS DESIGNED TO REDUCE INAPPROPRIATE USE OF EMERGENCY ROOMS. 4. DEVELOP RECOMMENDATIONS FOR NEW STRATEGIES THAT WILL POSITIVELY IMPACT EFFECTIVE UTILIZATION OF EMERGENCY ROOMS. IMPLEMENTATION STEPS ARE IN THE DEVELOPMENT PHASE AND THE TEAMS, AND THEIR SUBCOMMITTEES ARE GATHERING DATA THROUGH THE END OF 2010 WITH RECOMMENDATIONS TO BE DEVELOPED IN 2011. PRIORITY 5 PHYSICAL FITNESS AND NUTRITION ALSO NOT A CORE PRIORITY - THE GET MOVING! INITIATIVE IS BEING DEVELOPED BY THE REGIONAL HEALTH COUNCIL OF HERKIMER AND ONEIDA COUNTIES WITH THE HELP OF THE COMMUNITYS VOICE THROUGH THE 2010 REGIONAL HEALTH SUMMIT. THE PROJECT IS SPEARHEADED BY A NUMBER OF INFLUENTIAL POLICY MAKERS AND PUBLIC HEALTH ADVOCATES FROM BOTH HERKIMER AND ONEIDA COUNTY IN ADDITION TO MANY LOCAL NOT-FOR-PROFIT ORGANIZATIONS. GET MOVING! IS FUNDED BY THE HEALTHY COMMUNITIES GRANT FROM THE NYS DEPARTMENT OF HEALTH THROUGH THE ONEIDA COUNTY DEPARTMENT OF HEALTH WITH SUBSTANTIAL SUPPORT BY HERKIMER COUNTY HEALTHNET AND THE PARTICIPATION OF THE HERKIMER COUNTY PUBLIC HEALTH AND THE UNITED WAY OF THE VALLEY AND GREATER UTICA AREA. GET MOVING! SUPPORTS THE GOAL OF IMPROVING THE HEALTH/WELLNESS OF HERKIMER AND ONEIDA COUNTY RESIDENTS. MORE SPECIFICALLY, GET MOVING! AIMS TO ADDRESS THE ISSUES OF PHYSICAL ACTIVITY AND NUTRITION AT THREE LEVELS OF IMPLEMENTATION ACROSS BOTH COUNTIES. THREE AREAS HAVE BEEN DEFINED: SCHOOLS, WORKPLACE, AND THE COMMUNITY. RESEARCH SUGGESTS THAT SUCCESSFUL INTERVENTIONS AT ALL THREE LEVELS WILL HELP TO REDUCE THE NUMBER OF SEDENTARY AND OVERWEIGHT INDIVIDUALS RESIDING IN OUR REGION OF NYS AND SUBSEQUENTLY REDUCE THE POOR HEALTH OUTCOMES AND LARGE HEALTH CARE COSTS ASSOCIATED WITH OBESITY.STRATEGIC PLANNING AND ACTION PLANS ARE CURRENTLY UNDER DEVELOPMENT, BASED UPON THE RESEARCH CONDUCTED BY MASTER OF PUBLIC HEALTH CANDIDATE KYLE MILLER, UNDER THE GUIDANCE OF THOMAS H. DENNISON, PH.D., ASSOCIATE DIRECTOR, CENTRAL NEW YORK MASTER OF PUBLIC HEALTH, THE MAXWELL SCHOOL, SYRACUSE UNIVERSITY. SECTION 6: DISSEMINATION OF THE REPORT TO THE PUBLIC THE COMMUNITY SERVICE PLAN IS SHARED WITH THE PUBLIC THROUGH OUR WEB SITE WWW.FAXTONSTLUKES.COM AS WELL AS WITH OUR COMMUNITY PARTNERS INCLUDING THE DEPARTMENT OF HEALTH FOR BOTH ONEIDA AND HERKIMER COUNTIES, ST. ELIZABETH MEDICAL CENTER AND ROME MEMORIAL HOSPITAL. SECTION 7: CHANGES IMPACTING COMMUNITY HEALTH/PROVISION OF CHARITY CARE/ACCESS TO SERVICES THE ORGANIZATION MONITORS THE TRENDS IN BAD DEBT AND CHARITY CARE OF THE UNINSURED AND UNDER-INSURED PATIENTS. 2007 CHARITY CARE $1,758,000 BAD DEBT $7,132,309 2008 CHARITY CARE $1,724,000 BAD DEBT $9,026,867 2009 CHARITY CARE $1,399,044 BAD DEBT $9,259,592 2010 (YTD THROUGH AUGUST 2010) PROJECTED CHARITY CARE $ 1,006,490 ANNUALIZED: $1,509,736 BAD DEBT $5,465,326 $ 8,197,989 CONSOLIDATION PLAYS A KEY ROLE IN THE MANAGEMENT OF LIMITED RESOURCES. FAXTON ST. LUKES HEALTHCARE COMBINED THE MANAGEMENT TEAMS OF VISITING NURSE ASSOCIATION, MOHAWK VALLEY HOME CARE AND SENIOR NETWORK HEALTH TO BETTER CONTROL OVERSIGHT COSTS AND PROVIDES THE SAME LEVEL OF CARE FOR OUR COMMUNITIES. WE CONTINUE TO COLLABORATE WITH ST. ELIZABETH MEDICAL CENTER THROUGH THE MOHAWK VALLEY HEART INSTITUTE. THE HEART SURGERY AND REHABILITATION PROGRAM PROVIDES THE ONLY HEART SURGERY PROGRAM IN THE AREA ENSURING ACCESS FOR A TWO COUNTY AREA AND SUPPORTS KEEPING OUR PATIENTS CLOSE TO HOME AND FAMILY. FSLH OPERATES AND FINANCIALLY SUPPORTS THE DIABETES OUTREACH PROGRAM, CENTRAL NEW YORK DIABETES EDUCATION PROGRAM. THE PROGRAM WORKS COLLABORATIVELY WITH ST. ELIZABETHS TO IDENTIFY PATIENTS IN THE COMMUNITY WHO ARE AT RISK AND NEED ADDITIONAL SUPPORT WITH CARE. PHYSICIAN RECRUITMENT CONTINUES TO BE CHALLENGING FOR OUR AREA AND THROUGHOUT NEW YORK STATE. OUR ORGANIZATION CONTINUES TO SEEK NEW PROVIDERS FOR A NUMBER OF PHYSICIAN SPECIALTIES AND THAT LIST IS EXPECTED TO GROW IN THE NEXT FIVE YEARS AS A LARGE NUMBER OFPHYSICIANS RETIRE AND LEAVE THE STATE. NEW YORK STATE IS LESS ATTRACTIVE THAN OTHER STATES DUE TO HIGH REGULATION, TAXES AND LACK OF GROWTH IN THE UPSTATE REGION. PHYSICIANS ARE ALSO LOOKING FOR SETTINGS WITH GROUP PRACTICES OR HOSPITAL EMPLOYMENT WHICH PROVIDES THEM WITH A BETTER QUALITY OF LIFE. THEY WANT LIMITED OR NO CALL RESPONSIBILITIES, AND GREATER ACCESS TO CLINICAL AND INFORMATION TECHNOLOGY. NEW YORK STATE GOVERNMENT PLAYS A SIGNIFICANT ROLE IN CREATING A BETTER, MORE ECONOMICAL ENVIRONMENT FOR PHYSICIAN RECRUITMENT. CONTINUED WORK WITH OUR LEGISLATORS IS IMPERATIVE FOR ALL OF NEW YORK STATE HEALTHCARE. SECTION 8: FINANCIAL AID PROGRAM THE TREND CONTINUES WITH AN INCREASING NUMBER OF OUR AGING POPULATION ON MEDICARE WITHOUT A SUPPLEMENTAL PLAN, WHO CANNOT AFFORD TO PAY THE DEDUCTIBLE/CO-INSURANCE BALANCES. IN MOST CASES, THEY DO NOT QUALIFY FOR CHARITY CARE OR MEDICAID. WE OFFER A TWELVE-MONTH INTEREST FREE PAYMENT PLAN ON BALANCES GREATER THAN $500 AND A SIX-MONTH PLAN FOR BALANCES UNDER $500. WE PROVIDE A MEDICAID ADVOCATE, WHO MEETS WITH THE SELF PAY INPATIENTS, WHILE THEY ARE IN THE HOSPITAL OR MAKES AN APPOINTMENT TO MEET WITH THEM AT THEIR HOME TO ASSIST THEM IN THE APPLICATION AS WELL AS MEETING WITH THE COUNTY TO SEEK ASSISTANCE. FOR OUR INCREASING SELF PAY POPULATION, WE HAVE MORE EMPLOYED MORE FINANCIAL COUNSELORS. THIS HELPS THE PATIENTS IN MAKING AN APPROPRIATE CHOICE FOR THEIR FINANCIAL NEEDS WHETHER IT IS AFFORDABLE INSURANCE, BANK LOAN, INTEREST FREE LOAN, OR CHARITY CARE WRITE-OFF. OUR STATEMENTS ARE ALSO MORE PATIENT-FRIENDLY WITH A BROCHURE FOR OUR PATIENTS DESCRIBING ALL OF OUR PAYMENT OPTIONS INCLUDING CONTACT NUMBERS. THE BROCHURE IS LOCATED IN ALL OF OUR WAITING ROOMS, PHYSICIAN'S OFFICES AND IS AVAILABLE ON THE HOSPITAL WEBSITE. _______ THE 2009 COMMUNITY SERVICE PLAN IS A PUBLICATION OF FAXTON ST. LUKES HEALTHCARE, UTICA, NEW YORK AND SUBMITTED TO THE NEW YORK STATE DEPARTMENT OF HEALTH, WEDNESDAY, SEPTEMBER 15, 2010. SCOTT H. PERRA, FACHE PRESIDENT/CEO FAXTON ST. LUKES HEALTHCARE MAIN CAMPUS 1656 CHAMPLIN AVENUE UTICA, NEW YORK 13502 (315) 624-6000 WWW.FAXTONSTLUKES.COM FOR ADDITIONAL COPIES OF THE REPORT CONTACT: DEBRA ALTDOERFFER, VP COMMUNICATIONS AND MARKETING DALTDOER@MVNHEALTH.COM |
| UNCOMPENSATED CARE PROGRAM |
SCHEDULE H PART III LINE 9B |
FAXTON- ST. LUKE'S HEALTHCARE UTICA, NEW YORK ADMINISTRATIVE MANUAL NEW: LAST REVIEW: 9/1/2009 EFFECTIVE DATE: 6/24/2002 DIRECTIVE: FN-14-OP SUBJECT: UNCOMPENSATED CARE PROGRAM ADMINISTRATIVE APPROVAL: SCOTT H. PERRA PRESIDENT/CEO STEVEN J. BROWN SENIOR VICE PRESIDENT/COO MICHAEL J. HAILE SENIOR VICE PRESIDENT/CFO POLICY: FAXTON-ST. LUKE'S HEALTHCARE COMPLIES WITH REGULATION 312-D OF THE HCFA MANUAL AND PROVIDES AN UNCOMPENSATED CARE PROGRAM FOR THOSE INDIVIDUALS WHO CANNOT PAY FOR NEEDED HEALTHCARE SERVICES. PURPOSE: TO PROVIDE SERVICES TO PATIENTS WHO ARE UNINSURED OR UNABLE TO COMMIT TO A FINANCIAL AGREEMENT. THIS POLICY DOES NOT APPLY TO THOSE PATIENTS WHO SEEK ELECTIVE SERVICES OR PROCEDURES SUCH AS ELECTIVE COSMETIC SURGERY, ELECTIVE DENTAL SURGERY, MEALS ON WHEELS, LIFELINE SERVICES, HEARING AIDS, OR THERAPIES OUTSIDE THE SCOPE OF PHYSICIANS ORDERS. SCOPE:ORGANIZATION-WIDE REPLACES:ADMINISTRATIVE DIRECTIVE FN-14-OP, SAME TITLE, DATED 4/6/2006 SPECIAL INSTRUCTIONS: ACCORDING TO REGULATION 312-D OF THE HCFA MANUAL, THE HOSPITALS/CLINICS MUST INVESTIGATE THE FINANCIAL SITUATION OF PATIENTS WHO REQUEST THE UNCOMPENSATED CARE PROGRAM. PROCEDURE:1.A PATIENT OR GUARANTOR REQUESTING UNCOMPENSATED CARE MAY BE ASKED TO APPLY FOR MEDICAID. PATIENT/GUARANTOR WILL HAVE UP TO NINETY DAYS FROM SERVICE DATE TO APPLY FOR FINANCIAL ASSISTANCE. THE FOLLOWING INFORMATION MUST BE PROVIDED WITH THE APPLICATION TO AID IN THE DECISION BY THE HOSPITAL TO PROVIDE FREE CARE. A COPY OF THE LATEST YEAR OF TAX FILING. A COMPLETED UNCOMPENSATED CARE APPLICATION, WHICH IS PROVIDED BY THE HOSPITAL MUST BE COMPLETED IN ITS ENTIRETY WITHIN THIRTY DAYS OF RECEIPT OF THE APPLICATION. PROOF OF INCOME INFORMATION, WE MUST CONSIDER BANK ACCOUNTS, PENSION CHECKS AND INSURANCE POLICIES. AS THE LAW STATES ONLY THOSE ASSETS CONVERTIBLE TO CASH AND UNNECESSARY FOR THE PATIENTS DAILY LIVING. 2.THE CALCULATION OF ELIGIBILITY MAY INCLUDE SOME OR ALL OF THE FOLLOWING SOURCES:ALL ASSETS, EXCESS AMOUNT,SPEND DOWN AMOUNT,BANK ACCOUNTS,PENSION ACCOUNTS,INSURANCE POLICIES,PLUS INCOME=EQUALS GUIDELINE AMOUNT THE GUIDELINE AMOUNT IS COMPARED TO (3X) THE FEDERAL POVERTY GUIDELINE. THE FEDERAL POVERTY GUIDELINE CAN BE OBTAINED AT: HTTP:/ASPE.HHS.GOV/POVERTY>SHTML. 3.THE PATIENT IS NOTIFIED WITH A DECISION WHETHER APPROVED OR DENIED BY THE CREDIT MANAGER WITHIN FOURTEEN BUSINESS DAYS OF RECEIPT OF AN APPLICATION. 4.IF THE PATIENT IS APPROVED THE ACCOUNT IS WRITTEN OFF TO CHARITY/BAD DEBT. IF THE PATIENT HAS MEDICARE FOR INSURANCE, THE HOSPITAL WILL PROCESS AS A MEDICARE CHARITY/BAD DEBT WRITE OFF. 5.FURTHER INTERNAL REQUIREMENTS FOR MEDICARE WRITE OFF MUST INCLUDE A CODR (CREATE ON DEMAND BILL) AND MEDICARE EOB (EXPLANATION OF BENEFITS), WHICH ACCOMPANIES EACH MEDICARE ACCOUNT THAT IS BEING CONSIDERED FOR A WRITE OFF. 6.AN AGENCY ACTIVITY REPORT IS UTILIZED TO REPORT ANY MEDICARE RECOVERIES. SIZE OF FAMILY GUIDELINES 1 $ 32,490.00 2 43,710.00 3 54,930.00 4 66,150.00 5 77,370.00 6 88,590.00 7 99,810.00 8 111,030.00 FOR FAMILY UNITS WITH MORE THAN EIGHT MEMBERS ADD $ 3,740 FOR EACH ADDITIONAL MEMBER. GENERAL GUIDELINES FOR EMERGENCY DENTAL TREATMENT ON UNINSURED PATIENTS THE DENTAL SERVICE WILL SCREEN ALL UNINSURED PATIENTS AND EVALUATE THE PATIENTS NEED FOR EMERGENCY DENTAL TREATMENT. WALK-IN DENTAL EMERGENCY PATIENTS WHO INDICATE THEY ARE UNABLE TO PAY FOR SERVICES ARE EXPECTED TO COMPLY WITH HOSPITAL POLICY REQUIRING THEM TO FILL OUT A MEDICAID APPLICATION. IN THE MEANTIME, DENTAL PAIN IS MANAGED ON AN INDIVIDUAL BASIS AND MAY BE EITHER TREATED OR SCRIPTED AT THE DISCRETION OF THE EXAMINING DOCTOR. PALLIATIVE TREATMENT MAY BE ALL THAT IS OFFERED UNTIL PAYMENT FOR DEFINITIVE TREATMENT IS SECURED OR UNTIL IT IS DETERMINED THAT THE PATIENT IS ELIGIBLE FOR CHARITY CARE. DEFINITIVE TREATMENT IS LIMITED TO THE APPROPRIATE PROCEDURE(S) TO ELIMINATE THE SOURCE OF THE PAIN AND DOES NOT NECESSARILY INVOLVE ADDITIONAL PROCEDURES TO RESTORE MISSING TOOTH STRUCTURE OR REPLACE ANY SUBSEQUENT MISSING TEETH. ASSOCIATED FORMS FOR FN-14-OP: APPLICATION/ELIGIBILITY DETERMINATION FOR UNCOMPENSATED CARE ASSISTANCE |
| EMERGENCY CARE POLICY |
SCHEDULE H PART III LINE 9B |
FAXTON-ST. LUKE'S HEALTHCARE UTICA, NEW YORK ADMINISTRATIVE MANUAL NEW: X LAST REVIEW: 5/1/07 DIRECTIVE: FN-13-OP EFFECTIVE DATE: 8/1/2002 SUBJECT: EMERGENCY DEPARTMENT CO-PAYMENT/CO-INSURANCE COLLECTION ADMINISTRATIVE APPROVAL: KEITH FENSTEMACHER PRESIDENT/CHIEF EXECUTIVE OFFICER SCOTT PERRA EXECUTIVE VICE PRESIDENT/COO MICHAEL HAILE SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER PATRICIA ROACH SENIOR VP/CHIEF NURSING OFFICER POLICY: IN ORDER TO ENHANCE CUSTOMER SERVICE AND CONVENIENCE FOR OUR PATIENTS, FAXTON-ST. LUKE'S HEALTHCARE WILL IDENTIFY AND ACCEPT CO-PAYMENTS, CO-INSURANCE PAYMENTS, OR ACCOUNT DEPOSITS FROM PATIENTS IN THE EMERGENCY DEPARTMENT. TO ENSURE THAT ALL PATIENTS IN THE EMERGENCY DEPARTMENT WILL BE TREATED WITHOUT REGARD TO THEIR ABILITY TO PAY, DISCUSSION AND COLLECTION OF CO-PAYMENTS, CO-INSURANCE, OR ACCOUNT DEPOSITS WILL BE MADE IN ACCORDANCE WITH THE PROCEDURE BELOW. SCOPE: EMERGENCY DEPARTMENT STAFF, REGISTRATION STAFF, FINANCE STAFF. REPLACES: ADMINISTRATIVE DIRECTIVE FN-13-OP, SAME TITLE, DATED 8/1/2002. PROCEDURE: 1. DISCUSSION OF CO-PAYMENT, CO-INSURANCE OR ACCOUNT DEPOSIT OBLIGATIONS AND COLLECTION OF SUCH PAYMENTS, WILL BE PART OF THE INSURANCE REGISTRATION PROCESS. THIS PROCESS SHALL NOT BEGIN UNTIL AFTER THE PATIENT HAS BEEN INITIALLY TRIAGED IN ACCORDANCE WITH DEPARTMENT POLICY. 2. ALTHOUGH THE INSURANCE REGISTRATION PROCESS, AND THE DISCUSSION AND COLLECTION OF CO-PAYMENTS, CO-INSURANCE, OR ACCOUNT DEPOSITS MAY BEGIN AFTER INITIAL TRIAGE, MEDICAL SCREENING/MEDICAL TREATMENT BY DEPARTMENT CLINICAL STAFF MAY NOT BE DELAYED OR CONDITIONED ON THE COMPLETION OF THE INSURANCE REGISTRATION PROCESS OR THE COLLECTION OF A CO-PAYMENT, CO-INSURANCE, OR ACCOUNT DEPOSIT. IF THE PROCESS HAS ALREADY BEGUN, IT WILL BE SUSPENDED WHILE THE PATIENT RECEIVES THE MEDICAL SCREENING OR TREATMENT. 3. SPECIFIC CO-PAYMENT OR CO-INSURANCE INFORMATION WILL BE DETERMINED BY THE PATIENTS INSURANCE CARD, THE PATIENTS PERSONAL KNOWLEDGE OF THEIR REQUIRED PAYMENT, HIS ELIGIBILITY SOFTWARE OR PATIENT ACCOUNTING DATA. WHERE SPECIFIC CO-PAYMENT INFORMATION IS NOT AVAILABLE, OR WHERE THE PATIENT HAS A CO-INSURANCE OBLIGATION OR IS A SELF-PAY PATIENT, REGISTRATION STAFF WILL REQUEST A FIFTY DOLLAR ($50.00) ACCOUNT DEPOSIT. IN SUCH CASES, THE PATIENT WILL BE ADVISED THAT AFTER DETERMINATION OF THE PATIENTS INSURANCE AND PAYMENT OBLIGATIONS, THE HOSPITAL WILL EITHER REFUND ANY OVERPAYMENT OR BILL THE PATIENT FOR UNDERPAYMENTS AS APPROPRIATE. 4. IF A PATIENT IS NOT ABLE TO MAKE THE REQUIRED PAYMENT ON THE DAY OF TREATMENT, THE PATIENT MUST BE REASSURED THAT THIS WILL IN NO WAY AFFECT HIS/HER TREATMENT AND THAT THE HOSPITAL WILL BE GLAD TO BILL THEM LATER. REGISTRATION AND OTHER DEPARTMENT STAFF MUST NOT SAY OR IMPLY THAT TREATMENT WILL IN ANY WAY BE DELAYED OR CONDITIONED ON THE PATIENTS ABILITY TO PAY FOR SERVICES, INCLUDING CO-PAYMENT, CO-INSURANCE OR ACCOUNT DEPOSITS. 5. WHERE THE PATIENT BYPASSES THE EMERGENCY DEPARTMENT REGISTRATION OFFICE ON ARRIVAL, THE REGISTRATION STAFF WILL ATTACH A ROUTING SLIP TO THE PATIENTS RECORD. ON DISCHARGE, THE EMERGENCY DEPARTMENT NURSING STAFF WILL HAND THE ROUTING SLIP TO THE PATIENT AND ESCORT THE PATIENT TO THE REGISTRATION OFFICE FOR CO-PAYMENT/CO-INSURANCE COLLECTION AND INFORMATION VERIFICATION. 6. WHERE THE PATIENT IS ACCOMPANIED BY AN ADULT (SPOUSE, FAMILY MEMBER, FRIEND) WHO IS KNOWLEDGEABLE ABOUT THE PATIENTS INSURANCE STATUS REGISTRATION STAFF MAY OFFER TO GATHER INSURANCE REGISTRATION INFORMATION AND DISCUSS AND COLLECT CO-PAYMENTS, CO-INSURANCE OR ACCOUNT DEPOSITS WITH THAT PERSON WHILE THE PATIENT IS OBTAINING MEDICAL SCREENING OR TREATMENT. HOWEVER, WHERE THIS PERSON PREFERS TO REMAIN WITH THE PATIENT DURING MEDICAL SCREENING OR TREATMENT, THEY SHOULD BE ENCOURAGED TO DO SO. 7. NO SIGNAGE WILL BE POSTED IN THE EMERGENCY DEPARTMENT WAITING AREAS REGARDING CO-PAYMENTS, CO-INSURANCE, OR ACCOUNT DEPOSITS, EXCEPT FOR A NOTICE IN THE FORM ATTACHED TO THIS POLICY, WHICH WILL BE PLACED IN THE REGISTRATION AREA. 8. ALL REGISTRATION STAFF WILL BE TRAINED TO COLLECT CASH BY THE CREDIT MANAGER OR DEPARTMENTAL DESIGNEE BEFORE BEING ASSIGNED TO COLLECT PAYMENTS. STAFF WILL BE TRAINED TO USE A PRE-DETERMINED SCRIPT WHEN DISCUSSING THESE PAYMENTS (SEE ATTACHED SCRIPT). COMPLETION OF TRAINING WILL BE DOCUMENTED AND STORED IN EACH EMPLOYEES PERSONNEL FILE. THIS TRAINING WILL INCLUDE SPECIFIC REFERENCE TO THE TIMING OF COLLECTION AS STATED IN THIS PROCEDURE. 9. CASHIER DUTY WILL BE ROTATED THROUGH ALL REGISTRATION STAFF AND WILL BE NOTED ON THE REGISTRATION STAFF SCHEDULE. ONE REGISTRATION EMPLOYEE ON EACH SHIFT WILL BE ASSIGNED CASHIER DUTIES FOR CASH COLLECTIONS, THE GENERATION OF PATIENT RECEIPTS, THE MAINTENANCE AND SECURITY OF THE CASH DRAWER, AND THE DAILY DEPOSIT OF ANY COLLECTIONS INTO THE HOSPITAL SAFE. 10. PAYMENTS WILL BE ACCEPTED IN THE FORM OF CASH, CREDIT CARDS AND PERSONAL CHECKS. PAYMENTS FOR PREVIOUS VISITS OF ANY TYPE WILL BE ACCEPTED, EVEN IF FOR NON-EMERGENCY SERVICES. 11. PAYMENTS WILL BE STORED IN A LOCKED CASH DRAWER AND STAFF WILL MAKE A DEPOSIT DAILY TO THE PATIENT REGISTRATION/ADMITTING SAFE OR DIRECTLY TO THE FINANCE DEPARTMENT AT THE ST. LUKES CAMPUS, AS OUTLINED IN THE CASH COLLECTION AND DEPOSIT PROTOCOL. 12. ALL REGISTRATION AREAS WILL BE SUPPLIED WITH FINANCIAL COUNSELOR BUSINESS CARDS BY THE CREDIT MANAGER. ANY PATIENT WITH PAYMENT CONCERNS OR BILLING QUESTIONS WILL BE GIVEN A CARD FOR THE APPROPRIATE CAMPUS. ALL SELF-PAY PATIENTS WILL BE REFERRED TO THE FINANCIAL COUNSELOR, AS WELL. ATTACHMENT TO CO-PAY POLICY/SCRIPT: CO-PAYMENTS: 1. IF THE AMOUNT OF THE CO-PAYMENT IS KNOWN: YOUR CO-PAYMENT FOR TODAYS VISIT IS $_______. WOULD YOU PREFER TO PAY BY CASH, CHECK OR CREDIT CARD? 2. IF THE AMOUNT OF THE CO-PAYMENT IS UNKNOWN: DO YOU KNOW THE AMOUNT OF YOUR INSURANCE CO-PAYMENT? IF KNOWN BY THE PATIENT: WOULD YOU PREFER TO PAY BY CASH, CHECK OR CREDIT CARD? 3. IF THE PATIENT DOES NOT KNOW THE AMOUNT OF THE CO-PAYMENT: THE HOSPITALS POLICY IS TO COLLECT A $50.00 DEPOSIT TO APPLY TO YOUR CO-PAYMENT OBLIGATION. AFTER WE RECEIVE THE INFORMATION FROM YOUR INSURANCE COMPANY THE HOSPITAL WILL REFUND ANY OVERPAYMENT OR SEND YOU A BILL FOR ANY UNDERPAYMENT. 4. IF THE PATIENT OR ACCOMPANYING ADULT SAYS THAT HE OR SHE CANNOT PAY AT THIS TIME: ALL RIGHT, THE HOSPITAL WILL SEND YOU A BILL. CO-INSURANCE: 1. IF REGISTRATION DETERMINES THAT THE PATIENT HAS A CO-INSURANCE OBLIGATION UNDER HIS OR HER INSURANCE PLAN: YOUR INSURANCE PLAN HAS A CO-INSURANCE REQUIREMENT OF _____%: (GENERALLY 20%). THE HOSPITALS POLICY IS TO COLLECT A $50.00 DEPOSIT. AFTER WE RECEIVE THE INFORMATION FROM YOUR INSURANCE COMPANY THE HOSPITAL WILL REFUND ANY OVERPAYMENT OR SEND YOU A BILL FOR ANY UNDERPAYMENT. WOULD YOU PREFER TO MAKE THE DEPOSIT BY CASH, CHECK, OR CREDIT CARD? 2. IF THE PATIENT OR ACCOMPANYING ADULT SAYS THAT HE OR SHE CANNOT PAY AT THIS TIME: ALL RIGHT, THE HOSPITAL WILL SEND YOU A BILL. SELF-PAY: 1. IF THE PATIENT IS A SELF-PAY PATIENT: THE HOSPITALS POLICY IS TO COLLECT A $50.00 DEPOSIT FOR SERVICES. AFTER THE FINAL BILL IS DETERMINED WE WILL REFUND ANY OVERPAYMENT, OR BILL YOU FOR ANY ADDITIONAL CHARGES. 2. IF THE PATIENT OR ACCOMPANYING ADULT SAYS THAT HE OR SHE CANNOT PAY AT THIS TIME: ALL RIGHT, THE HOSPITAL WILL SEND YOU A BILL. *AFTER REGISTRATION, THE PATIENT SHOULD ALSO BE INSTRUCTED TO RETURN TO THE WAITING AREA FOR TREATMENT WHEN CALLED BY THE CLINICAL STAFF. *REGISTRATION OR OTHER STAFF MUST NOT SAY OR IMPLY THAT TREATMENT WILL IN ANY WAY BE DELAYED OR CONDITIONED ON THE PATIENTS ABILITY TO PAY FOR SERVICES, INCLUDING CO-PAYMENT, CO-INSURANCE OR ACCOUNT DEPOSITS. |
| PRIOR YEAR |
FORM 990 SCHEDULE R PART I |
NDS WAS REPORTED HERE IN 2009, INCORRECTLY. IT HAS BEEN REMOVED FROM THE 2010 REPORTING. |
| TRANSACTION TYPES 2009 |
FORM 990 SCHEDULE R PART VII |
IN 2009, THE FOUNDATION TRANSACTION TYPE N WAS REPORTED AS TOTAL SALARIES INCORRECTLY AT $344,834; THIS SHOULD HAVE BEEN ONLY THE SHARED SERVICES AMOUNT OF $4,892. IT HAS BEEN PROPERLY REPORTED IN 2010. |
Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.