| BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES |
FORM 990, PART I AND PART III, LINE 1 |
FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $2.5 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS OVER HALF A MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF 2,563 AFFILIATED PHYSICIANS AND 13,323 EMPLOYEES AMONG ITS FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH CARE, AND AN AMBULATORY CARE NETWORK OF CLINICS, PHYSICIANS' OFFICES AND OUTPATIENT CENTERS THROUGHOUT THE SAN DIEGO REGION. SCRIPPS HEALTH'S MISSION STATEMENT IS AS FOLLOWS: SCRIPPS STRIVES TO PROVIDE SUPERIOR HEALTH SERVICES IN A CARING ENVIRONMENT AND TO MAKE A POSITIVE MEASURABLE DIFFERENCE IN THE HEALTH OF INDIVIDUALS IN THE COMMUNITIES WE SERVE. WE DEVOTE OUR RESOURCES TO DELIVERING QUALITY, SAFE, COST-EFFECTIVE, AND SOCIALLY RESPONSIBLE HEALTH CARE SERVICES. WE ADVANCE CLINICAL RESEARCH, HEALTH EDUCATION, EDUCATION OF PHYSICIANS AND HEALTH CARE PROFESSIONALS, AND SPONSOR GRADUATE MEDICAL EDUCATION. WE COLLABORATE WITH OTHERS TO DELIVER THE CONTINUUM OF CARE THAT IMPROVES THE HEALTH OF OUR COMMUNITY. |
| SIGNIFICANT PROGRAM SERVICES |
FORM 990, PART III, LINE 2 |
EFFECTIVE NOVEMBER 21, 2011, THE WHITTIER INSTITUTE FOR DIABETES AND ENDOCRINOLOGY MERGED WITH ITS TAX-EXEMPT PARENT, SCRIPPS HEALTH. SCRIPPS HEALTH IS NOW CONDUCTING THE ACTIVITIES PREVIOUSLY CARRIED OUT BY THE WHITTIER INSTITUTE, INCLUDING INNOVATIVE EDUCATION PROGRAMS, CLINICAL CARE, RESEARCH AND COLLABORATIONS THAT PURSUE PREVENTION AND A CURE FOR DIABETES. |
| FY12 PROGRAM SERVICES ACCOMPLISHMENTS |
FORM 990, PART III, LINE 4A |
FULFILLING THE SCRIPPS MISSION DURING THIS FISCAL YEAR, SCRIPPS DEVOTED $302,843,744 TO COMMUNITY BENEFIT PROGRAMS AND SERVICES IN THE AREAS OF UNCOMPENSATED CARE, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND HEALTH RESEARCH. OUR PROGRAMS EMPHASIZE COMMUNITY-BASED PREVENTION EFFORTS AND USE INNOVATIVE APPROACHES TO REACH RESIDENTS AT GREATEST RISK FOR HEALTH PROBLEMS WE MAKE COMMITMENTS TO IMPROVE THE HEALTH OF OUR PATIENTS AND OUR SAN DIEGO COMMUNITIES. AS A LONG-STANDING MEMBER OF THESE COMMUNITIES, AND AS A NOT-FOR-PROFIT COMMUNITY RESOURCE, OUR GOAL AND RESPONSIBILITY ARE TO PROVIDE HELP AND ASSISTANCE FOR ALL WHO COME TO US FOR CARE, AND TO REACH OUT ESPECIALLY TO THOSE WHO FIND THEMSELVES VULNERABLE AND WITHOUT SUPPORT. THIS RESPONSIBILITY IS AN INTRINSIC PART OF OUR MISSION. THROUGH OUR CONTINUED ACTIONS AND COMMUNITY PARTNERSHIPS, WE STRIVE TO RAISE THE QUALITY OF LIFE IN THE COMMUNITY AS A WHOLE. ASSESSING COMMUNITY NEED CALIFORNIA SENATE BILL 697 REQUIRES THE UPDATING OF A COMMUNITY HEALTH NEEDS ASSESSMENT AT LEAST EVERY THREE YEARS. IDENTIFYING SAN DIEGO COUNTY'S HEALTH PRIORITIES IS A COMPLEX PROCESS OUTLINED IN THE FOLLOWING PAGES. SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS, GOVERNMENT AGENCIES, BUSINESSES AND GRASSROOTS MOVEMENTS, WE ARE BETTER ABLE TO BUILD UPON EXISTING ASSETS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS. THE REPORT IS THE SIXTH EDITION OF THE TRIENNIAL NEEDS ASSESSMENT. THE PROJECT WAS INITIALLY UNDERTAKEN BY THE HOSPITAL COUNCIL OF SAN DIEGO AND IMPERIAL COUNTIES IN 1995 TO ASSIST PRIVATE NOT-FOR-PROFIT HOSPITALS TO COMPLY WITH STATE COMMUNITY BENEFIT LEGISLATION SENATE BILL 697 (SB697), WHICH REQUIRED THEM TO CONDUCT A PERIODIC ASSESSMENT OF THE HEALTH NEEDS OF THOSE LIVING IN THEIR SERVICE AREA IN ORDER TO BETTER RESPOND TO THE COMMUNITY'S HEALTH NEEDS. THE GROUP WAS INITIALLY KNOWN AS THE SAN DIEGO COUNTY SB697 COALITION AND ATTENDED BY REPRESENTATIVES FROM OVER 25 HEALTH CARE-RELATED ORGANIZATIONS. THE GOAL OF THE COALITION WAS TO COLLABORATE AND PRODUCE ONE NEEDS ASSESSMENT IN ORDER TO MAXIMIZE RESOURCES AND DEVELOP A MORE COMPREHENSIVE REPORT FOR THE COUNTY OF SAN DIEGO. DURING THE FIVE SUBSEQUENT NEEDS ASSESSMENTS, THE COALITION, RENAMED COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP), SHORTLY AFTER THE COMPLETION OF THE FIRST ASSESSMENT, FORMALIZED ITS ROLE TO PROVIDE OVERSIGHT AND DIRECTION TO THE PERIODIC NEEDS ASSESSMENT PROCESS. COMMUNITY HEALTH IMPROVEMENT PARTNERS SCRIPPS IS AN OFFICIAL PARTNER AND AN ACTIVE PARTICIPANT IN COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP). THROUGH CHIP, MORE THAN 25 COMMUNITY HEALTH-RELATED ORGANIZATIONS COME TOGETHER TO JOINTLY ADDRESS THE COUNTY'S HEALTH NEEDS. SCRIPPS WORKS WITH CHIP AND OTHER HEALTH CARE SYSTEMS AND PARTNERS TO DEVELOP A COMPREHENSIVE COUNTY HEALTH NEEDS ASSESSMENT WHICH IS UPDATED EVERY THREE YEARS, INCLUDING COUNTY, STATE AND NATIONAL HEALTH STATISTIC COMPARISONS. THE COLLABORATIVE ASSESSMENT PROCESS IS ONE OF THE MOST RESPECTED IN CALIFORNIA. CHARTING THE COURSE VI: HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY CHARTING THE COURSE VI IS INTENDED TO HELP FULFILL LEGISLATIVE REQUIREMENTS OF SB 697 AND TO PROVIDE A RESOURCE FOR INDIVIDUALS, AGENCIES AND INSTITUTIONS TO IDENTIFY COMMUNITY HEALTH NEEDS AND CONCERNS. READERS ARE ENCOURAGED TO EXPLORE CHARTING THE COURSE VI TO LEARN MORE ABOUT THE CRITICAL HEALTH ISSUES IMPACTING SAN DIEGO COUNTY RESIDENTS. THIS DOCUMENT PRESENTS A WEALTH OF INFORMATION RELATING THE HEALTH ISSUES TO RACE/ETHNICITY, GENDER, AGE CATEGORY AND GEOGRAPHIC REGION. THE REPORT ALSO MONITORS CHANGES AND TRENDS IN HEALTH STATUS AMONG SAN DIEGO COUNTY RESIDENTS. THIS INFORMATION PROVIDES THE BASIS UPON WHICH COMMUNITY HEALTH PROGRAMS AND INTERVENTIONS CAN BE TARGETED, DEVELOPED AND EVALUATED, WITH THE ULTIMATE GOAL OF IMPROVING THE HEALTH OF THE COMMUNITY AND ITS MEMBERS. TO GAIN A FULL UNDERSTANDING OF SCRIPPS' HEALTH ASSESSMENT AND ANALYSIS OF COMMUNITY NEED IN SAN DIEGO, WE RECOMMEND REVIEWING THE CHIP 2010 "CHARTING THE COURSE VI" SAN DIEGO COUNTY HEALTH NEEDS ASSESSMENT AT HTTP://WWW.SDCHIP.ORG. 2010 PRIORITY SETTING PROCESS ONE OF THE MAJOR FEATURES OF EACH NEEDS ASSESSMENT IS THE REVIEW OF HEALTH ISSUES FELT TO BE IMPACTING THE SAN DIEGO REGION. THESE HEALTH ISSUES ARE EXAMINED FROM A LOCAL (SAN DIEGO COUNTY), STATE AND NATIONAL PERSPECTIVE. THE STARTING POINT FOR THIS PROCESS WAS A REVIEW OF THE 38 HEALTHY PEOPLE 2020 FOCUS AREAS. BECAUSE OF THE LARGE NUMBER AND THE DIVERSITY OF HEALTH ISSUES, THE NEEDS ASSESSMENT COMMITTEE SELECTED 17 OF THESE HEALTH ISSUES FOR ADDITIONAL STUDY AND POSSIBLE INCLUSION IN THIS YEAR'S NEEDS ASSESSMENT. THESE ISSUES WERE SELECTED BASED ON AN EXTENSIVE REVIEW OF THE ISSUES AND A RANKING OF THEIR PERCEIVED IMPORTANCE BY THE NEEDS ASSESSMENT COMMITTEE. THE GOAL OF THE PRIORITY-SETTING PROCESS FOR CHARTING THE COURSE VI WAS TO PROVIDE AN ORGANIZED, OBJECTIVE METHOD OF REVIEWING AND PRIORITIZING THE HEALTH ISSUES FACING SAN DIEGO COUNTY. BECAUSE OF THE LARGE NUMBER AND THE DIVERSITY OF HEALTH ISSUES, THE NEEDS ASSESSMENT COMMITTEE SELECTED 17 OF THESE HEALTH ISSUES FOR ADDITIONAL STUDY AND POSSIBLE INCLUSION IN THIS YEAR'S NEEDS ASSESSMENT. THESE ISSUES WERE DIVIDED INTO THREE CATEGORIES: - OVERARCHING ISSUES (4 ISSUES) - CONSIDERED OVERARCHING BECAUSE THEY POTENTIALLY IMPACT ALL OF THE OTHER ISSUES IN THIS REPORT. THESE INCLUDED: O ACCESS TO HEALTH SERVICES O HEALTH COMMUNICATIONS AND HEALTH INFORMATION TECHNOLOGY O PUBLIC HEALTH INFRASTRUCTURE O SOCIAL DETERMINANTS OF HEALTH - HEALTH-RELATED BEHAVIORS (6 ISSUES) - BEHAVIORS THAT ARE IMPORTANT COMPONENTS IN LONG-TERM HEALTH, SUCH AS: O IMMUNIZATION O SMOKING CESSATION O IMPROVING NUTRITION O INCREASING PHYSICAL ACTIVITY O ACHIEVING A HEALTHY WEIGHT STATUS O ORAL HEALTH O VIOLENCE AND INJURY PREVENTION - HEALTH OUTCOMES (7 ISSUES) - LOOKS AT THE CHANGE IN THE HEALTH STATUS OF THE POPULATION AND VARIOUS DEMOGRAPHIC GROUPS OVER TIME RELATED TO: O CANCER O DIABETES O HEART DISEASE AND STROKE O INFECTIOUS DISEASES O MATERNAL, INFANT AND CHILD HEALTH O MENTAL HEALTH O RESPIRATORY DISEASES TO HELP NARROW THE NUMBER OF HEALTH ISSUES, 379 COMMUNITY LEADERS FROM THROUGHOUT SAN DIEGO COUNTY WERE INVITED TO PRIORITIZE EACH ISSUE BASED ON THE FOLLOWING FOUR CRITERIA: 1. WHAT IS THE SIZE OF THE HEALTH ISSUE IN SAN DIEGO COUNTY? 2. WHAT IS THE SERIOUSNESS OF THE HEALTH ISSUE IN SAN DIEGO COUNTY? 3. WHAT COMMUNITY RESOURCES ARE CURRENTLY AVAILABLE TO ADDRESS THE HEALTH ISSUE? 4. HOW MUCH DATA OR INFORMATION DO WE HAVE TO EVALUATE THE HEALTH ISSUE'S OUTCOME? PARTICIPANTS IN THIS PRIORITY-SETTING PROCESS WERE ASKED TO REVIEW THE INFORMATION FOR EACH HEALTH ISSUE COVERED IN A BRIEFING DOCUMENT, PROVIDE THEIR RATINGS FROM THEIR PERSPECTIVE AND WEIGH EACH ISSUE USING THE INFORMATION PROVIDED ALONG WITH THEIR KNOWLEDGE OF THE HEALTH ISSUE. OVERALL, 72 COMMUNITY LEADERS PARTICIPATED IN THE PRIORITY SETTING PROCESS. BASED ON INPUT FROM THIS PRIORITY-SETTING PROCESS, THE NEEDS ASSESSMENT COMMITTEE SELECTED FIVE HEALTH ISSUES FOR THE FOCUS OF CHARTING THE COURSE IV. - ACCESS TO HEALTH SERVICES - SOCIAL DETERMINANTS OF HEALTH - WEIGHT STATUS AND PHYSICAL ACTIVITY - INJURY AND VIOLENCE - MENTAL HEALTH CHARTING THE COURSE IV CONTAINS AN IN-DEPTH REVIEW OF THESE FIVE HEALTH ISSUES ABOVE ALONG WITH THE PRIORITY-SETTING PROCESS USED TO SELECT THESE ISSUES AND THE BACKGROUND INFORMATION RELATED TO 17 ADDITIONAL ISSUES REVIEWED AS PART OF THE PRIORITY-SETTING PROCESS. IN ADDITION, INFORMATION IS PRESENTED RELATED TO THE COMMUNITY FORUMS HELD IN EACH OF THE SIX REGIONS OF SAN DIEGO COUNTY TO GAIN INSIGHTS INTO THE HEALTH ISSUES OF WEIGHT STATUS, MENTAL HEALTH, AND INJURY AND VIOLENCE, AND TO BEGIN THE PROCESS OF IDENTIFYING SOME OF THE ROOT CAUSES RELATED TO THESE ISSUES. |
| PROGRAM SERVICE ACCOMPLISHMENTS CONTINUED |
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2013 COMMUNITY HEALTH NEEDS ASSESSMENT IN ADDITION TO THE EXISTING STATEWIDE LEGISLATION, THE INTERNAL REVENUE SERVICE (IRS) RECENTLY RELEASED NEW REQUIREMENTS FOR TAX-EXEMPT HOSPITALS UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010. THE NEW INTERNAL REVENUE CODE (IRC) SECTION 501 (R) REQUIRES THAT CERTAIN TAX-EXEMPT FACILITIES CONDUCT A NEEDS ASSESSMENT IN THE COMMUNITY AND ADOPT AN IMPLEMENTATION STRATEGY FOR EACH STATE-LICENSED HOSPITAL FACILITY IT OPERATES TO MEET COMMUNITY NEEDS IDENTIFIED. THE 2013 NEEDS ASSESSMENT WILL BE COORDINATED BY THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC). HASD&IC IS A NONPROFIT ORGANIZATION PROVIDING LEADERSHIP, REPRESENTATION AND ADVOCACY ON BEHALF OF MORE THAN 35 HOSPITALS AND INTEGRATED HEALTH SYSTEMS IN THE TWO-COUNTY REGION. SCRIPPS HEALTH AND OTHER MEMBER HOSPITALS WILL COLLABORATE TOGETHER AND DEVELOP A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). HASD&IC WILL PROVIDE PROJECT ADMINISTRATION AND FACILITATION OF THE CHNA PROCESS THROUGH THE CHNA ADVISORY WORKGROUP (WORKGROUP). THE WORKGROUP WILL OVERSEE ACTIVITIES AND OUTCOMES RELATED TO THE CHNA AND WILL BE INSTRUMENTAL IN PROVIDING LEADERSHIP AND GUIDANCE THROUGHOUT THE PROCESS. AS A RESULT OF THE CHNA PROCESS, HEALTH INDICATORS WILL BE IDENTIFIED AND PRIORITIZED THROUGH A THREE-TIERED PROCESS INVOLVING BOTH QUANTITATIVE AND QUALITATIVE DATA ANALYSIS. A CONTRACTOR WILL FIRST ANALYZE DATA FROM MULTIPLE SOURCES AND IDENTIFY BROAD HEALTH INDICATORS FOR INITIAL REVIEW. NEXT, WORKING WITH THE CHNA ADVISORY WORKGROUP, FOCUS AREAS WILL BE PRIORITIZED FOR ANALYSIS AND CORRELATION WITH HEALTH DISPARITIES DATA. FINALLY, FOCUSED INDICATORS WILL BE CONSIDERED BY HEALTH EXPERTS AND LOCAL LEADERS FOR FEEDBACK REGARDING ALIGNMENT AND RELEVANCE WITH THE HEALTH NEEDS OF THE COMMUNITY. THE 2013 COMMUNITY NEEDS ASSESSMENT WILL BE COMPLETED IN SPRING 2013, AND THE SCRIPPS IMPLEMENTATION STRATEGIES TO MEET THE IDENTIFIED NEEDS WILL BE COMPLETED IN THE FALL OF 2013. MEETING THE CHALLENGES OF A DIVERSE BORDER COMMUNITY SAN DIEGO COUNTY IS AN INTERNATIONAL BORDER COMMUNITY COMPRISED OF 3.2 MILLION PEOPLE. GEOGRAPHICALLY DISPERSED OVER 4,300 SQUARE MILES, THE POPULATION REPRESENTS MULTIPLE ETHNIC GROUPS. THE SAN DIEGO ASSOCIATION OF GOVERNMENT'S (SANDAG) POPULATION GROWTH PROJECTIONS ARE JUST OVER 1 PERCENT PER YEAR, EXTENDING OUT 25 YEARS TO THE YEAR 2030. THE SANDAG 2050 SUB-REGIONAL GROWTH FORECAST PROJECTS POPULATION GROWTH TO 4.4 MILLION BY 2050. THIS IS A 40.0% INCREASE IN POPULATION GROWTH. DEMOGRAPHIC ESTIMATES AND PROJECTIONS ARE BASED ON SANDAG 2010 ESTIMATES AND ARE AVAILABLE AT THE ZIP CODE LEVEL AT HTTP://DATAWAREHOUSE.SANDAG.ORG. A BREAKDOWN OF THE REGIONAL DEMOGRAPHICS CAN BE FOUND IN THE REGIONAL FORUM SECTIONS OF THE CHARTING THE COURSE VI: HEALTH NEEDS ASSESSMENT FOR SAN DIEGO COUNTY (APPENDIX SECTION) HTTP://WWW.SDCHIP.ORG. SCRIPPS SERVES A QUARTER OF THE TOTAL COUNTY POPULATION, CONCENTRATING SERVICES IN THE NORTH COASTAL, NORTH CENTRAL, CENTRAL AND SOUTH REGIONS OF SAN DIEGO COUNTY WHERE SCRIPPS FACILITIES ARE LOCATED. UNCOMPENSATED HEALTH CARE SCRIPPS CONTRIBUTES SIGNIFICANT RESOURCES TO PROVIDE LOW AND NO-COST HEALTH CARE FOR OUR PATIENTS IN NEED. DURING FISCAL YEAR 2012, SCRIPPS CONTRIBUTED $249,200,233 IN UNCOMPENSATED HEALTH CARE, INCLUDING $45,451,898 IN CHARITY CARE, $186,625,215 IN MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS AND MEDICARE SHORTFALL, AND $71,682,666 IN BAD DEBT. SCRIPPS PROVIDES HOSPITAL SERVICES FOR ONE-QUARTER OF THE COUNTY'S UNINSURED PATIENTS. SCRIPPS MERCY HOSPITAL, SAN DIEGO AND SCRIPPS MERCY HOSPITAL, CHULA VISTA PROVIDE 66 PERCENT OF SCRIPPS' CHARITY CARE. THE HEALTH CARE SAFETY NET IN SAN DIEGO COUNTY IS HIGHLY DEPENDENT UPON HOSPITALS AND COMMUNITY HEALTH CLINICS TO CARE FOR UNINSURED AND MEDICALLY UNDERSERVED COMMUNITIES. FINDING MORE EFFECTIVE WAYS TO COORDINATE AND ENHANCE THE SAFETY NET IS A CRITICAL POLICY CHALLENGE. WHILE PUBLIC SUBSIDIES (E.G., COUNTY MEDICAL SERVICES) HELP FINANCE SERVICES FOR SAN DIEGO COUNTY'S UNINSURED POPULATIONS, THESE SUBSIDIES DO NOT COVER THE FULL COST OF CARE. COMBINED WITH MEDI-CAL AND MEDICARE FUNDING SHORTFALLS, SCRIPPS AND OTHER LOCAL HOSPITALS ABSORB THE COST OF CARING FOR UNINSURED PATIENTS IN THEIR OPERATING BUDGETS. THIS PLACES A SIGNIFICANT FINANCIAL BURDEN ON HOSPITALS AND PHYSICIANS. THE PERCENTAGE OF CALIFORNIANS WITH EMPLOYER-BASED COVERAGE CONTINUED TO FALL, DROPPING FROM 65 PERCENT IN 1987 TO 52 PERCENT IN 2011. WHILE PUBLIC INSURANCE HAS PARTIALLY FILLED THIS GAP, ALMOST 22 PERCENT OF CALIFORNIANS REMAIN UNINSURED. THIS STATISTIC SHOULD CHANGE DRAMATICALLY IN THE COMING YEARS AS THE PATIENT PROTECTION AND AFFORDABLE CARE ACT IS IMPLEMENTED. DURING THE SAME PERIOD, THE PERCENTAGE OF STATE RESIDENTS COVERED BY MEDI-CAL INCREASED FROM 13.3 PERCENT IN 2000 TO 19.8 PERCENT IN 2011. INCOME WAS ALSO A FACTOR, WITH 35.5 PERCENT OF STATE RESIDENTS WITH ANNUAL INCOMES UNDER $25,000 LACKING INSURANCE. CALIFORNIANS WITH ANNUAL FAMILY INCOMES BELOW $25,000 ARE MOST LIKELY TO BE UNINSURED. THE LIKELIHOOD OF BEING UNINSURED IS GREATER IN CALIFORNIA THAN THE UNITED STATES AS A WHOLE FOR ALL INCOME LEVELS. THE RATES OF UNINSURED RESIDENTS IN THE STATE COULD DECLINE AS MORE ADULTS WITHOUT INSURANCE FIND COVERAGE THROUGH THE STATE'S BRIDGE TO REFORM PROGRAM. SINCE THE START OF 2011, A DOZEN COUNTIES HAVE LAUNCHED LOW-INCOME HEALTH PLANS TO COVER UNINSURED ADULTS WHO DON'T QUALIFY FOR MEDI-CAL, PROVIDING COVERAGE FOR MORE THAN 200,000 RESIDENTS. MEDICARE AND MEDICAID PAYMENTS ARE VITAL TO PRESERVE ACCESS TO CARE CALIFORNIA HOSPITALS CONTINUE TO FACE CHALLENGES DUE TO PAYMENT SHORTFALLS; KEY WORKFORCE SHORTAGES; UNFUNDED STATE MANDATES; AN INCREASING REGULATORY BURDEN; AND THE CONTINUED ESCALATION OF TECHNOLOGY COSTS, INCLUDING HEALTH INFORMATION TECHNOLOGY. WITH MEDICARE AND MEDICAID PAYMENTS NOT FULLY COVERING THE COSTS OF CARE, HOSPITALS ARE CONCERNED ABOUT THE SUSTAINABILITY OF SERVICES REQUIRED BY AN AGING AMERICAN PUBLIC THAT IS EXPERIENCING A HIGHER RATE OF CHRONIC DISEASE. INCREASING DEMANDS FOR SERVICES ARE ALSO EXPECTED, AS MORE INDIVIDUALS OBTAIN HEALTH INSURANCE AND SEEK ACCESS TO CARE DUE TO HEALTH CARE REFORM. FINANCIAL ASSISTANCE ASSISTING LOW-INCOME, UNINSURED PATIENTS ASSISTING LOW-INCOME, UNINSURED PATIENTS. THE SCRIPPS FINANCIAL ASSISTANCE POLICY IS CONSISTENT WITH AB774 CALIFORNIA HOSPITAL FAIR PRICING POLICY LEGISLATION. THESE PRACTICES REFLECT OUR COMMITMENT TO ASSISTING LOW-INCOME AND UNINSURED PATIENTS WITH DISCOUNTED HOSPITAL CHARGES, CHARITY CARE AND FLEXIBLE BILLING AND DEBT COLLECTION PRACTICES. THESE PROGRAMS ARE AVAILABLE TO EVERYONE IN NEED, REGARDLESS OF THEIR RACE, ETHNICITY, GENDER, RELIGION OR NATIONAL ORIGIN. SCRIPPS PROVIDES FULL FINANCIAL ASSISTANCE FOR LOW-INCOME AND UNINSURED PATIENTS EARNING LESS THAN 200 PERCENT OF THE FEDERAL POVERTY LEVEL GUIDELINES. FOR INDIVIDUALS WHO QUALIFY, BETWEEN 201-400 PERCENT OF THE POVERTY LEVEL, FINANCIAL ASSISTANCE IS BASED ON A DISCOUNT SCHEDULE. FOR 2012, THE DEPARTMENT OF HEALTH AND HUMAN SERVICES DEFINED A FAMILY OF FOUR'S 200 PERCENT FEDERAL POVERTY LEVEL AS $46,100. COMMUNITY HEALTH SERVICES COMMUNITY HEALTH SERVICES INCLUDE PREVENTION AND WELLNESS PROGRAMS SUCH AS SCREENINGS, HEALTH EDUCATION, SUPPORT GROUPS AND HEALTH FAIRS, WHICH ARE SUPPORTED BY OPERATIONAL FUNDS, GRANTS, IN-KIND DONATIONS, AND PHILANTHROPY. THESE PROGRAMS ARE DESIGNED TO RAISE PUBLIC AWARENESS, UNDERSTANDING OF AND ACCESS TO IDENTIFIED COMMUNITY HEALTH NEEDS. SCRIPPS CATEGORIZES COMMUNITY HEALTH SERVICES ACCORDING TO THE SCHEDULE H 990 CATEGORIES MANDATED BY THE IRS. IT IS CATEGORIZED INTO FIVE MAIN AREAS: o COMMUNITY HEALTH IMPROVEMENT SERVICES o COMMUNITY BENEFIT OPERATIONS o CASH AND IN-KIND CONTRIBUTIONS o SUBSIDIZED HEALTH SERVICES o COMMUNITY BUILDING ACTIVITIES DURING THIS FISCAL YEAR, SCRIPPS INVESTED $18,651,796 IN COMMUNITY HEALTH SERVICES (INCLUDES SUBSIDIZED HEALTH). THIS FIGURE REFLECTS THE COST ASSOCIATED WITH PROVIDING SUCH ACTIVITIES, INCLUDING SALARIES, MATERIALS AND SUPPLIES, MINUS REVENUE. |
| PROGRAM SERVICE ACCOMPLISHMENTS CONTINUED |
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FOLLOWING ARE HIGHLIGHTS OF JUST SOME OF THE ACTIVITIES CONDUCTED BY SCRIPPS DURING THIS FISCAL YEAR. ACCESS TO CARE TWO PRIMARY BARRIERS TO OBTAINING HEALTH CARE, ON BOTH THE LOCAL AND NATIONAL LEVEL, ARE LACK OF HEALTH INSURANCE AND ACCESS TO SPECIALTY AND PRIMARY CARE PROVIDERS. REDUCED ACCESS TO BASIC HEALTH CARE SERVICES INCREASES ILLNESS, INJURY AND MORTALITY AND IS A MAJOR BURDEN ON HOSPITALS AND HEALTH PROVIDERS, WHO MUST PROVIDE UNCOMPENSATED CARE FOR THE UNINSURED. MORE PEOPLE WITHOUT INSURANCE TRANSLATES INTO HIGHER USE OF EMERGENCY DEPARTMENTS, WHICH BY LAW MUST PROVIDE STABILIZING CARE TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. REVIEW OF THE SAN DIEGO COUNTY EMERGENCY DEPARTMENT (ED) DISCHARGES BY SOURCE OF PAYMENT, BETWEEN 2006 AND 2008, FOUND THE DEMAND ON ED SERVICES INCREASED BY 11.9 PERCENT, TO 582,129 AND 651,595 RESPECTIVELY. IN ADDITION, SHIFTS IN PAYOR SOURCES WERE NOTED, INCLUDING A DECLINE IN PRIVATE HMO AND WORKER COMPENSATION ED DISCHARGES AND INCREASES IN BOTH SELF-PAY AND MEDI-CAL ED DISCHARGES. THE DECLINE IN PRIVATE HMP COVERAGE WAS OFFSET BY A SLIGHT INCREASE IN OTHER PRIVATE INSURANCE. THE INCREASE IN SELF-PAY AND MEDI- CAL DISCHARGES SUGGESTS MORE PATIENTS ARE RELYING ON ED CARE DUE TO LACK OF INSURANCE COVERAGE. IN AN EFFORT TO PROVIDE FOR PEOPLE IN NEED, SCRIPPS SPONSORED A NUMBER OF PROGRAMS IN FISCAL YEAR 2012. MERCY OUTREACH SURGICAL TEAM WORKING IN MEXICO, THE MERCY OUTREACH SURGICAL TEAM (MOST) PROVIDES RECONSTRUCTIVE SURGERIES FOR CHILDREN AT NO COST. MOST VOLUNTEERS PERFORMED RECONSTRUCTIVE SURGERIES ON CHILDREN SUFFERING FROM BIRTH DEFECTS OR ACCIDENTS. IN SPECIAL CIRCUMSTANCES, SURGERIES ARE ALSO PROVIDED FOR ADULTS. DURING FISCAL YEAR 2012, THE MOST TEAM PROVIDED RECONSTRUCTIVE SURGERIES FOR MORE THAN 486 CHILDREN. (SPONSORED BY SCRIPPS MERCY HOSPITAL, SAN DIEGO AND AFFILIATED PHYSICIANS) GRADUATE MEDICAL EDUCATION STAFF SUPPORT ST. VINCENT DE PAUL VILLAGE MEDICAL CENTER AND ST. LEO'S CLINIC WEEKLY COMMUNITY CLINICS WERE HELD AT THE ST. VINCENT DE PAUL AND ST. LEO'S CLINICS. STAFFED BY SCRIPPS GREEN HOSPITAL AND SCRIPPS CLINIC INTERNAL MEDICINE RESIDENTS, THESE CLINICS CARED FOR APPROXIMATELY 800 OF OUR COUNTY'S MOST VULNERABLE RESIDENTS DURING FISCAL YEAR 2012. (SPONSORED BY SCRIPPS CLINIC/GREEN HOSPITAL) FIJI ALLIANCE PROJECT IN PARTNERSHIP WITH THE INTERNATIONAL RELIEF TEAMS OF SAN DIEGO AND THE LOLOMA FOUNDATION, SCRIPPS EMPLOYEES, SCRIPPS CLINIC PHYSICIANS AND OTHER SCRIPPS-AFFILIATED PHYSICIANS PROVIDED MEDICAL AND SURGICAL SERVICES IN FIJI. AS ONE OF THEIR ROTATIONS, RESIDENTS FROM SCRIPPS CLINIC AND SCRIPPS GREEN HOSPITAL HAVE THE OPPORTUNITY TO PARTICIPATE IN THESE MEDICAL MISSIONS. THE TEAM PERFORMS PROCEDURES TO REMEDY CLEFT LIPS AND PALATES, EYELID, FACE AND FEET DEFORMITIES, BURN SCARS, BREAST MASSES AND HERNIAS, AS WELL AS PROVIDING DIABETES MANAGEMENT. ALL SURGICAL SUPPLIES WERE DONATED BY PROFESSIONAL HOSPITAL SUPPLY CORPORATION (PHS), THE SUPPLIER FOR SCRIPPS HEALTH. THE SUPPLIES INCLUDED SURGICAL GOWNS, GLOVES, DRAPES, DRESSINGS, BANDAGES, SUTURES, ETC. CARDINAL HEALTH SYSTEMS, WHICH PROVIDES PHARMACEUTICALS AND OTHER SUPPLIES FOR SCRIPPS HEALTH, DONATED ALL MEDICATIONS. (SPONSORED BY SCRIPPS CLINIC/GREEN HOSPITAL) SCRIPPS HEALTH COMMUNITY BENEFIT (CB) FUND IN 2012, SCRIPPS AWARDED $215,000 IN COMMUNITY GRANTS TO PROGRAMS IN SAN DIEGO (SIX GRANTS RANGING FROM $10,000 TO $120,000). THE FUNDED PROJECTS ADDRESS SOME OF SAN DIEGO COUNTY'S HIGH-PRIORITY HEALTH NEEDS, SEEKING TO IMPROVE ACCESS TO VITAL HEALTH CARE SERVICES FOR AT-RISK POPULATIONS, INCLUDING THE HOMELESS, ECONOMICALLY DISADVANTAGED, MENTALLY ILL AND OTHERS. SINCE THE COMMUNITY BENEFIT FUND BEGAN, SCRIPPS HAS AWARDED $2.4 MILLION. PROGRAMS FUNDED DURING FISCAL YEAR 2012 INCLUDE: CONSUMER CENTER FOR HEALTH EDUCATION AND ADVOCACY (CCHEA) FUNDING PROVIDES LOW-INCOME, UNINSURED MERCY CLINIC AND BEHAVIORAL HEALTH PATIENTS HELP OBTAINING HEALTH CARE BENEFITS, SSI AND RELATED SERVICES, WHILE REDUCING UNCOMPENSATED CARE EXPENSES AT MERCY. THE PROJECT PROVIDES ADVOCACY SERVICES FOR TIME-INTENSIVE GOVERNMENT BENEFIT CASES. (SPONSORED BY SCRIPPS MERCY HOSPITAL ADMINISTRATION) CATHOLIC CHARITIES FUNDING PROVIDES SHORT-TERM EMERGENCY SHELTER FOR MEDICALLY FRAGILE HOMELESS PATIENTS BEING DISCHARGED FROM SCRIPPS MERCY HOSPITAL, SAN DIEGO. THE PROGRAM IS BEING EXPANDED TO SCRIPPS MERCY HOSPITAL, CHULA VISTA. CASE MANAGEMENT AND SHELTER ARE PROVIDED FOR HOMELESS PATIENTS DISCHARGED FROM SCRIPPS MERCY HOSPITAL. WHILE THESE PATIENTS NO LONGER REQUIRE HOSPITAL CARE, THEY DO NEED A SHORT-TERM RECUPERATIVE ENVIRONMENT. PATIENTS WHO DEMONSTRATE A WILLINGNESS TO CHANGE RECEIVE ONE WEEK IN A HOTEL, ALONG WITH FOOD AND BUS FARE TO PURSUE A CASE PLAN. THE FOCUS OF THE CASE MANAGEMENT IS TO STABILIZE THE CLIENT BY HELPING THEM CONNECT TO MORE PERMANENT SOURCES OF INCOME, HOUSING AND OTHER SELF-RELIANCE MEASURES. THE PARTNERSHIP SEEKS TO REDUCE EMERGENCY ROOM RECIDIVISM IN THIS POPULATION AND IMPROVE THEIR QUALITY OF LIFE. 2-1-1 HEALTH CARE NAVIGATION PROGRAM THERE IS AN OVERWHELMING NEED FOR A DEPENDABLE SERVICE TO HELP PEOPLE NAVIGATE TODAY'S COMPLEX HEALTH CARE SYSTEM. SINCE THE INCEPTION OF THE HEALTH CARE NAVIGATION PROGRAM, 2-1-1 HAS RESPONDED TO MORE THAN 6,000 CALLS FROM CLIENTS SEEKING HEALTH-RELATED RESOURCES. IN ADDITION, 5,726 SELF-SELECTED "HEALTH" AS THEIR NEED. 2-1-1 SAN DIEGO IS THE DIALING CODE FOR INFORMATION ABOUT COMMUNITY, HEALTH AND DISASTER SERVICES. IT CONNECTS PEOPLE WITH RESOURCES OVER THE PHONE, ONLINE AND IN PRINT. LOCALLY, 2-1-1 SAN DIEGO WAS LAUNCHED IN JUNE 2005 AS A MULTILINGUAL AND CONFIDENTIAL SERVICE COMMITTED TO PROVIDING ACCESS 24/7. AMERICAN HEART ASSOCIATION SCRIPPS PROVIDED FUNDING FOR THE 2012 HEART WALK CORPORATE SPONSORSHIP. HEART DISEASE AND STROKE ARE THE NUMBER ONE AND THREE CAUSES OF DEATH IN THE NATION. HEART DISEASE CLAIMS MORE THAN 950,000 AMERICANS EACH YEAR. SCRIPPS PARTNERS WITH THE AMERICAN HEART ASSOCIATION ON ITS ANNUAL HEART WALK TO RAISE FUNDS FOR RESEARCH, PROFESSIONAL AND PUBLIC EDUCATION AND ADVOCACY. CANCER/ONCOLOGY CANCER IS THE SECOND LEADING CAUSE OF DEATH IN THE U.S., EXCEEDED ONLY BY HEART DISEASE, AND ACCOUNTS FOR ALMOST ONE-QUARTER OF ALL DEATHS IN SAN DIEGO COUNTY. ACCORDING TO NATIONAL CANCER INSTITUTE (NCI) ESTIMATES, IN 2009 THERE WERE 1,479,350 NEW CANCER CASES AND AN ESTIMATED 562,540 CANCER DEATHS. CURRENTLY, LUNG, BREAST, COLORECTAL AND PROSTATE CANCERS ACCOUNT FOR 53 PERCENT OF ALL NEW CANCER CASES AND 50 PERCENT OF ALL CANCER DEATHS. TRENDS BETWEEN 2000 AND 2007, SAN DIEGO COUNTY'S AGE-ADJUSTED MORTALITY RATE FOR CANCER HAS DECLINED FROM 189.1 TO 162.6 PER 100,000 POPULATION. IN RESPONSE TO THIS SERIOUS HEALTH CONCERN, SCRIPPS HAS DEVELOPED A SERIES OF PREVENTION AND WELLNESS PROGRAMS TO EDUCATE PEOPLE ABOUT THE IMPORTANCE OF EARLY DETECTION AND TREATMENT FOR SOME OF THE MOST COMMON FORMS OF CANCER. HERE ARE A FEW EXAMPLES OF SCRIPPS CANCER PROGRAMS DURING FISCAL YEAR 2012. SCRIPPS GREEN HOSPITAL CANCER SUPPORT GROUPS SCRIPPS GREEN SUPPORT GROUPS OFFER CANCER PATIENTS THE OPPORTUNITY TO EXPRESS THE EMOTIONS THAT COME WITH A CANCER DIAGNOSIS AND HELP THEM COPE MORE EFFECTIVELY WITH THEIR TREATMENT REGIMENS BY THE SUPPORT GROUPS NURTURE THEIR PHYSICAL, EMOTIONAL AND SPIRITUAL WELL-BEING. CLASSES AT SCRIPPS GREEN HOSPITAL, SUCH AS THE FREE CANCER WRITING WORKSHOP, WHEN WORDS HEAL, USE EXPRESSIVE WRITING TO HELP PATIENTS NAVIGATE THEIR JOURNEY WITH CANCER. IN 2012, 30 CANCER PATIENTS ATTENDED A SUPPORT GROUP AT SCRIPPS GREEN. THESE FREE SERVICES COST $2,475. (SPONSORED BY SCRIPPS GREEN HOSPITAL) SCRIPPS MERCY HOSPITAL, CHULA VISTA: COMMUNITY BENEFIT SERVICES, BREAST HEALTH CLINICAL SERVICES A TOTAL OF 5,148 WOMEN WERE REFERRED TO CLINICAL BREAST HEALTH SERVICES AT COMMUNITY AND SCRIPPS MERCY HOSPITAL, CHULA VISTA RADIOLOGY SERVICES. A TOTAL OF 3,722 SERVICES WAS PROVIDED, INCLUDING TELEPHONE REMINDERS, OUTREACH AND EDUCATION, CASE MANAGEMENT, AND A VARIETY OF PRESENTATIONS. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS). PATIENT CONTINUITY OF CARE WITH SCRIPPS MERCY HOSPITAL, CHULA VISTA RADIOLOGY A TOTAL OF 10 SERVICES WAS PROVIDED, INCLUDING ENCOURAGEMENT FOR PATIENTS TO REPEAT EXAMS, ASSISTANCE TO GET PATIENTS HEALTH INSURANCE APPROVAL TO REPEAT EXAMS, SOCIAL/EMOTIONAL SUPPORT AND EDUCATION ABOUT PREVENTING BREAST CANCER. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS) |
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SCRIPPS MERCY HOSPITAL, CHULA VISTA RADIOLOGY, POSITIVE BREAST CANCER PATIENT SUPPORT A TOTAL OF 31 SERVICES WAS PROVIDED, INCLUDING PHONE CALLS, SOCIAL/EMOTIONAL SUPPORT AND HOME VISITS, AS WELL AS RESOURCE PACKAGES WITH EDUCATIONAL MATERIALS ON NUTRITION, TREATMENT OPTIONS, COMMONLY ASKED QUESTIONS AND LOCAL RESOURCES. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS) SCRIPPS POLSTER BREAST CARE CENTER, MUSIC AS MEDICINE PROGRAM PATIENTS AND THEIR SUPPORTERS PARTICIPATE IN THE MUSIC AS MEDICINE THERAPY CLASS. THE MUSIC THERAPIST ASKS QUESTIONS AND TAILORS THE THERAPY TO THE PARTICIPANTS' EMOTIONAL AND PHYSICAL NEEDS. SESSIONS INVOLVE LISTENING TO MUSIC, WRITING SONGS, DISCUSSING WHAT LYRICS MEAN TO THE PARTICIPANTS, USE OF SINGING BOWLS, VOCALIZATION AND DRUMMING. RESEARCH HAS SHOWN THAT MUSIC CAN BOOST IMMUNE FUNCTION, BLOCK INCOMING PAIN STIMULI, LOWER BLOOD PRESSURE AND INFLUENCE EMOTIONAL WELL-BEING. (SPONSORED BY SCRIPPS POLSTER BREAST CARE CENTER) SCRIPPS POLSTER BREAST CARE CENTER, SUPPORT GROUPS SCRIPPS POLSTER BREAST CARE CENTER SUPPORT GROUPS PROVIDE A VENUE FOR WOMEN TO COME TOGETHER, DISCUSS ISSUES RELATING TO DIAGNOSES AND RECEIVE SUPPORT. (SPONSORED BY SCRIPPS POLSTER BREAST CARE CENTER) CANCER AWARENESS AND EDUCATIONAL EVENTS A SERIES OF EDUCATIONAL EVENTS ARE COORDINATED WITH AMERICAN CANCER SOCIETY AWARENESS MONTHS. THE EVENTS FOCUS ON VARIOUS TYPES OF CANCER, INCLUDING BREAST, LUNG, CERVICAL, COLORECTAL, SKIN, OVARIAN/GYNECOLOGICAL AND PROSTATE. A REGISTERED NURSE CLINICIAN ANSWERS QUESTIONS AND PROVIDES EDUCATIONAL MATERIALS. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA CANCER CENTER) HEALTH EDUCATION AND SUPPORT GROUPS EDUCATION AND SUPPORT GROUPS ARE PROVIDED TO SAN DIEGO COUNTY RESIDENTS FOR A WIDE VARIETY OF HEALTH CONCERNS. TOPICS INCLUDE FAMILIES WHO HAVE EXPERIENCED THE LOSS OF A CHILD, CHILDREN WHO HAVE LOST A PARENT TO CANCER, INFERTILITY, PARENTING TWINS, IMPROVING CHILDREN'S READING ABILITIES, HUNTINGTON'S DISEASE, PARKINSON'S DISEASE, MENTAL ILLNESS, OSTOMY, POSTPARTUM ISSUES, GYNECOLOGICAL CANCER, CHRONIC PAIN AND MULTIPLE SCLEROSIS. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA, COMMUNITY BENEFITS) CARDIOVASCULAR DISEASE CORONARY HEART DISEASE AND STROKE ARE THE NUMBER ONE AND THREE CAUSES OF DEATH IN THE NATION. HEART DISEASE CLAIMS MORE THAN 950,000 AMERICANS EVERY YEAR. STROKE KILLED 137,119 PEOPLE IN 2006 AND IS A LEADING CAUSE OF SERIOUS, LONG-TERM DISABILITY. ACCORDING TO THE AMERICAN HEART ASSOCIATION, AN ESTIMATED 80 MILLION AMERICAN ADULTS HAVE ONE OR MORE TYPES OF CARDIOVASCULAR DISEASE (CVD). FEWER THAN HALF OF THESE, 38,100,000, ARE 60 OR OLDER. HIGH BLOOD PRESSURE, CORONARY HEART DISEASE (CHD) AND STROKE ARE THE MOST COMMON FORMS OF CVD. CHD WAS THE LARGEST SINGLE KILLER OF AMERICANS IN 2006, RESULTING IN 445,687 DEATHS. THE PREVALENCE OF CHD AMONG U.S. ADULTS AGE 20 AND OLDER WAS 16,800,000, AND AN ESTIMATED 785,000 PERSONS IN THE U.S. HAD A NEW CORONARY ATTACK, AND ANOTHER 470,000 HAD A RECURRENT ATTACK DURING 2006. AN ESTIMATED ADDITIONAL 195,000 PERSONS HAD A SILENT ATTACK DURING THIS SAME PERIOD. THERE ARE NINE POTENTIALLY MODIFIABLE RISK FACTORS FOR CVD, INCLUDING CIGARETTE SMOKING, ABNORMAL BLOOD LIPID LEVELS, HYPERTENSION, DIABETES, ABDOMINAL OBESITY, A LACK OF PHYSICAL ACTIVITY, LOW DAILY FRUIT AND VEGETABLE CONSUMPTION, ALCOHOL OVERCONSUMPTION, AND PSYCHOSOCIAL ISSUES. DURING 2007, HEART DISEASE WAS THE SECOND LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY, ACCOUNTING FOR 4,743 DEATHS DURING THIS PERIOD. BETWEEN 2003 AND 2007, THE NUMBER OF HEART DISEASE DEATHS DROPPED 12 PERCENT FROM 5,404. THE AGE-ADJUSTED HEART DISEASE DEATH RATE DURING 2007 WAS 151 PER 100,000 POPULATION. DURING 2007, THE SAN DIEGO COUNTY CHD DEATH RATE PER 100,000 WAS 112.5. MALES WERE MOST IMPACTED AT 148.3, WHITES AT 118.8, AFRICAN-AMERICANS AT 179.0. PEOPLE 65 AND OLDER, ACCOUNTED FOR 82 PERCENT OF CHD DEATHS. THE SAN DIEGO DEATH RATE FOR STROKE WAS 36.1 PER 100,000 POPULATION. HISPANICS AND AFRICAN-AMERICANS HAD THE HIGHEST STROKE RATE, 43.1 AND 41.0, RESPECTIVELY. WOMEN, AT 36.1, ACCOUNTED FOR 59.1 PERCENT OF SAN DIEGO COUNTY STROKE DEATHS. DURING FISCAL YEAR 2012, SCRIPPS ENGAGED IN THE FOLLOWING HEART HEALTH, CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT ACTIVITIES. AMERICAN HEART WALK SCRIPPS ALLOCATED $10,000 IN OPERATIONAL FUNDS AND $30,512 IN IN-KIND DONATIONS TO SUPPORT THE AMERICAN HEART ASSOCIATION'S EFFORTS TO FIGHT HEART DISEASE AND STROKE. IN ADDITION, SCRIPPS EMPLOYEE VOLUNTEER PROGRAM COORDINATED WALKER PARTICIPATION AND FUNDRAISING EFFORTS. THE SAN DIEGO HEART WALK EXCEEDED ITS GOAL BY RAISING MORE THAN $1 MILLION. IN 2012, MORE THAN 1,700 SCRIPPS HEART WALK PARTICIPANTS - EMPLOYEES, FAMILIES AND FRIENDS - WALKED TO RAISE MORE THAN $137,600. ADDITIONALLY, SCRIPPS REACHED OUT TO THE COMMUNITY AT THE EVENT BY PROVIDING BLOOD PRESSURE SCREENINGS, HEALTH EDUCATION MATERIALS AND MORE. (SPONSORED BY SCRIPPS COMMUNITY BENEFIT SERVICES) COMMUNITY HEALTH EDUCATION PROGRAMS THE COMMUNITY HEALTH EDUCATION PROGRAMS COVER A WIDE VARIETY OF TOPICS ON DISEASE MANAGEMENT, HEALTH CARE UPDATES AND PREVENTION. THE PROGRAMS COVER HYSTERECTOMY, STROKE, STRESS, VARICOSE VEINS, INFERTILITY, CARDIAC, DEPRESSION, MACULAR DEGENERATION, MEMORY, BRAIN, ORTHOPEDIC CARE, ROBOTIC SURGERY, SKIN CARE, BACK CARE, MIGRAINES, KNEE PAIN, PELVIC FLOOR INCONTINENCE, SAFETY AND FALL PREVENTION, BLADDER HEALTH, HEALTHY DINING, EXERCISE, VOICE, FLU PREVENTION, SLEEP DISORDERS, NUTRITION, HYPERTENSION, FOOT CARE, SPINE SURGERY, JOINT REPLACEMENT, BREATHING, PAIN MANAGEMENT AND MEDICATION. (SPONSORED BY SCRIPPS LA JOLLA COMMUNITY BENEFIT SERVICES) CPR CLASSES FOR PATIENTS AND FAMILIES OF THE CARDIAC TREATMENT CENTER CPR CLASSES ARE OFFERED FOUR TIMES A YEAR TO CARDIAC TREATMENT CENTER PATIENTS AND THEIR FAMILIES. THE PROGRAM IMPROVES COMMUNITY HEALTH BY INCREASING KNOWLEDGE OF CARDIOPULMONARY RESUSCITATION PRACTICES. (SPONSORED BY CARDIAC TREATMENT CENTER AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA) CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS INCLUDE TAI CHI, OFFERED TWICE WEEKLY; CLASSES TO DECREASE STRESS AND IMPROVE BALANCE, STRENGTH AND FLEXIBILITY; RESTORATIVE YOGA, OFFERED THREE TIMES A WEEK; FIT BALL, OFFERED TWICE A WEEK; CLASSES TO IMPROVE STRENGTH, POSTURE AND CORE STABILITY; YOGA FOR CANCER RECOVERY, OFFERED WEEKLY; CLASSES TO DECREASE STRESS, IMPROVE CIRCULATORY FLOW, AND EASE TENSION DURING HEALING; CLASSES CENTERING ON BALANCE, OFFERED WEEKLY; CLASSES TO BUILD BALANCE, POSTURE AND COORDINATION; POWER YOGA, OFFERED TWICE WEEKLY; CLASSES TO IMPROVE STRENGTH AND FLEXIBILITY; WEEKLY PILATES CLASSES, YOGA FOR MULTIPLE SCLEROSIS, OFFERED WEEKLY; CLASSES TO PROMOTE HEALING AND IMPROVE STRENGTH AND FLEXIBILITY; AND WEEKLY MEDITATION CLASSES. (SPONSORED BY THE CARDIAC TREATMENT CENTER, SCRIPPS MEMORIAL HOSPITAL LA JOLLA) STROKE CARE PROGRAMS SCRIPPS SPONSORED A WIDE VARIETY OF STROKE-RELATED EDUCATION AND AWARENESS PROGRAMS. (SPONSORED BY SCRIPPS MERCY HOSPITAL STROKE PROGRAM) HEART HEALTH, SCRIPPS HOME HEALTH SERVICES SCRIPPS HOME HEALTH PROVIDED COMMUNITY EDUCATION TO PROMOTE INDEPENDENT CONGESTIVE HEART FAILURE (CHF) MANAGEMENT TO PREVENT EXACERBATIONS AND HOSPITALIZATIONS. PATIENTS RECEIVED INFORMATION ON WHAT CHF IS, MEDICATIONS, DIET, WEIGHT AND EXERCISE. IN FISCAL YEAR 2012, 20 SAN DIEGO COUNTY RESIDENTS WERE SERVED. (SPONSORED BY SCRIPPS HOME HEALTH SERVICES) CARDIOVASCULAR DISEASE PREVENTION, SCRIPPS HOME HEALTH SERVICES COMMUNITY EDUCATION PROGRAMS PROMOTED A HEART-HEALTHY DIET AND HEALTHY EATING. IN FISCAL YEAR 2012, 45 SAN DIEGO COUNTY RESIDENTS WERE SERVED. (SPONSORED BY SCRIPPS HOME HEALTH SERVICES) THE ERIC PAREDES SAVE A LIFE FOUNDATION THE ERIC PAREDES SAVE A LIFE FOUNDATION IS COMMITTED TO PREVENTING SUDDEN CARDIAC ARREST AND DEATH IN MIDDLE AND HIGH SCHOOL-AGED CHILDREN THROUGH AWARENESS, EDUCATION AND ACTION. SCRIPPS MADE A $15,000 DONATION TO PURCHASE EKG MACHINES. THE DONATION HELPED THE FOUNDATION PROVIDE ELECTROCARDIOGRAM AND ECHOCARDIOGRAM SCREENINGS FOR 2,426 CHILDREN BEFORE THEY COULD PARTICIPATE IN ORGANIZED SPORTS AND OTHER ACTIVITIES. THE GIFT ALSO PURCHASED AUTOMATED EXTERNAL DEFIBRILLATORS FOR SCHOOLS. |
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DIABETES THE 2007 NATIONAL DIABETES FACT SHEET (THE MOST RECENT YEAR DATA IS AVAILABLE) ESTIMATES 23.6 MILLION CHILDREN AND ADULTS IN THE U.S., 7.8 PERCENT OF THE POPULATION, HAVE DIABETES. THESE STATISTICS INCLUDE 17.9 MILLION PEOPLE WITH DIAGNOSED DIABETES AND ANOTHER 5.7 MILLION PEOPLE WITH UNDIAGNOSED DIABETES. ADDITIONALLY, THERE WERE 57 MILLION PEOPLE WITH PREDIABETES. EACH YEAR 1.6 MILLION NEW CASES OF DIABETES ARE DIAGNOSED IN PEOPLE 20 AND OLDER. THERE ARE THREE MAJOR TYPES OF DIABETES: TYPE 1, TYPE 2 AND GESTATIONAL. ALL THREE TYPES SHARE SIMILAR CHARACTERISTICS - THE BODY LOSES THE ABILITY TO EITHER MAKE OR TO USE INSULIN. WITHOUT ENOUGH INSULIN, GLUCOSE STAYS IN THE BLOOD, CREATING DANGEROUS BLOOD SUGAR LEVELS. OVER TIME, THIS BUILDUP DAMAGES KIDNEYS, HEART, NERVES, EYES AND OTHER ORGANS. TYPE 1 DIABETES MOST OFTEN OCCURS DURING CHILDHOOD OR ADOLESCENCE, ACCOUNTING FOR 5 TO 10 PERCENT OF ALL DIAGNOSED DIABETES CASES. TYPE 2 DIABETES TYPICALLY OCCURS LATER IN LIFE, FREQUENTLY AS THE RESULT OF OBESITY, PHYSICAL INACTIVITY AND OTHER RISK FACTORS. TYPE 2 DIABETES ACCOUNTS FOR 90 TO 95 PERCENT OF DIABETES CASES. HOWEVER, DUE TO THE CURRENT OBESITY EPIDEMIC, IT IS ESTIMATED THAT 39 PERCENT OF THE GIRLS AND 33 PERCENT OF THE BOYS WHO ARE NOW HEALTHY 2 TO 3 YEAR OLDS ARE LIKELY TO DEVELOP DIABETES. MORE THAN 90 MILLION AMERICANS (33 PERCENT) LIVE WITH A CHRONIC DISEASE. WHILE THERE ARE MANY DISABLING CHRONIC DISEASES, DIABETES HAS BEEN IDENTIFIED AS ONE OF THE PRIMARY CHRONIC CONDITIONS IN SAN DIEGO COUNTY. AS THE SEVENTH LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY DURING 2007, DIABETES WAS RESPONSIBLE FOR 2.7 PERCENT (520) DEATHS. IN SAN DIEGO COUNTY, THE AGE-ADJUSTED ESTIMATE OF ADULTS DIAGNOSED WITH DIABETES IN 2007 WAS 6.7 PERCENT. NATIONALLY, DIABETES WAS THE SIXTH LEADING CAUSE OF DEATH DURING 2006, ACCOUNTING FOR 72,449 DEATHS. HEALTH CONSEQUENCES THE COMPLICATIONS ASSOCIATED WITH DIABETES ARE SIGNIFICANT AND WELL-ESTABLISHED. ACCORDING TO THE CDC, COMPLICATIONS INCLUDE HEART DISEASE, STROKE, HYPERTENSION, BLINDNESS, KIDNEY DISEASE, PREGNANCY ISSUES, LOWER-LIMB AMPUTATIONS, PERIODONTAL DISEASE AND NERVOUS SYSTEM DISEASE. o THE AGE-ADJUSTED HOSPITALIZATION RATE FOR PEOPLE WITH DIABETES AMONG SAN DIEGO COUNTY RESIDENTS IN 2008 WAS 128.5 PER 100,000, AN 18.9 PERCENT INCREASE SINCE 2001. o IN 2008, HISPANICS AND AFRICAN-AMERICANS LIVING IN SAN DIEGO COUNTY EXPERIENCED DIABETES-RELATED HOSPITALIZATION RATES 1.8 AND 2.6 TIMES HIGHER THAN THE OVERALL POPULATION. o IN SAN DIEGO COUNTY, THE AGE-ADJUSTED DIABETES-RELATED MORTALITY RATES DECREASED FROM 21.4 PER 100,000 IN 2005 TO 17.5 IN 2007, AN 18.2 PERCENT DECREASE. o IN 2007, DIABETES WAS THE SEVENTH LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY, ACCOUNTING FOR 520 DEATHS. o IN 2007, DIABETES WAS THE SEVENTH LEADING CAUSE OF DEATH IN THE U.S. WITH AN AGE-ADJUSTED DEATH RATE OF 23.5 PER 100,000. AMONG THOSE 65 AND OVER, DIABETES WAS THE SIXTH LEADING CAUSE OF DEATH WITH A DEATH RATE OF 135.6 PER 100,000. MORE THAN SIX MILLION AMERICANS ARE UNAWARE THEY HAVE DIABETES. THE COMPLICATIONS RELATED TO DIABETES ARE SERIOUS AND CAN BE REDUCED WITH PREVENTIVE PRACTICES. DIABETES IS A SERIOUS COMMUNITY HEALTH PROBLEM, LEADING TO SCHOOL AND WORK ABSENTEEISM, ELEVATED HOSPITALIZATION RATES, FREQUENT EMERGENCY ROOM VISITS, PERMANENT PHYSICAL DISABILITIES AND SOMETIMES DEATH. DURING FISCAL YEAR 2012, SCRIPPS SPONSORED THE FOLLOWING DIABETES MANAGEMENT INITIATIVES. PROJECT DULCE A COLLABORATION BETWEEN THE WHITTIER DIABETES INSTITUTE, THE COUNCIL OF COMMUNITY CLINICS AND COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP), PROJECT DULCE IS A COMPREHENSIVE, CULTURALLY SENSITIVE DIABETES MANAGEMENT PROGRAM FOR UNDERSERVED AND UNINSURED PEOPLE IN SAN DIEGO COUNTY. THE PROGRAM IS TEAM-BASED AND INCORPORATES THE CHRONIC CARE MODEL. PROJECT DULCE HAS BEEN ACTIVE IN COMMUNITIES ACROSS SAN DIEGO FOR THE PAST 10 YEARS, PROVIDING DIABETES CARE AND SELF-MANAGEMENT EDUCATION. NURSE-LED TEAMS STRIVE FOR MEASURABLE IMPROVEMENTS IN THEIR PATIENTS' HEALTH; NURSE EDUCATORS LEAD MULTIDISCIPLINARY TEAMS THAT PROVIDE CLINICAL MANAGEMENT; AND PEER EDUCATORS FROM EACH CULTURAL GROUP, KNOWN AS PROMOTORAS, PROVIDE PUBLIC AND PATIENT EDUCATION FOR THEIR COMMUNITIES. THIS INNOVATIVE PROGRAM COMBINES STATE-OF-THE-ART CLINICAL DIABETES MANAGEMENT WITH PROVEN EDUCATIONAL AND BEHAVIORAL INTERVENTIONS. IN FISCAL YEAR 2012, PROJECT DULCE PROVIDED 7,594 DIABETES CARE AND EDUCATION VISITS FOR LOW-INCOME AND UNDERSERVED INDIVIDUALS THROUGHOUT SAN DIEGO AND ENROLLED MORE THAN 932 NEW PATIENTS. THE PROGRAM ALSO INITIATED FOUR NEW PROJECTS: PREVENTION FOR WOMEN WITH A HISTORY OF GESTATIONAL DIABETES, REPLICATING PROJECT DULCE IN TIJUANA, DIABETES PEER CARE COORDINATION AT SCRIPPS MERCY HOSPITAL, CHULA VISTA AND THE DIABETES GENE BANK PROGRAM. THE WHITTIER DIABETES INSTITUTE PROFESSIONAL EDUCATION AND TRAINING THE WHITTIER DIABETES INSTITUTE PROFESSIONAL EDUCATION TEAMS PROVIDE STATE-OF-THE-ART EDUCATION AND TRAINING FOR PEOPLE WHO WISH TO INCREASE THEIR DIABETES MANAGEMENT KNOWLEDGE AND SKILLS. WITH THE RISE IN DIABETES, MEDICATION UPGRADES, NUTRITIONAL ADJUSTMENTS AND CHANGES IN DIABETES-RELATED DEVICES, THERE IS A GREAT NEED TO EQUIP CLINICIANS WITH THE LATEST INFORMATION AND CLINICAL SKILLS. THE WHITTIER INSTITUTE'S PROFESSIONAL EDUCATION PROGRAM IS LED BY A TEAM OF EXPERTS, INCLUDING: ENDOCRINOLOGISTS, NURSES, DIETICIANS, PSYCHOLOGISTS AND OTHER DIABETES SPECIALISTS. THESE INDIVIDUALS TRAIN PRACTICING PROFESSIONALS TO DELIVER THE BEST POSSIBLE CARE FOR THEIR DIABETES PATIENTS. COURSES RESPOND TO THE NEEDS OF ALLIED HEALTH PROFESSIONALS SEEKING TO UNDERSTAND NEW AND COMPLEX CLINICAL TREATMENT OPTIONS FOR TYPE 1, TYPE 2 AND GESTATIONAL DIABETES. PROFESSIONAL EDUCATION WAS PROVIDED FOR 679 PEOPLE ON INSULIN MANAGEMENT, INCRETIN THERAPY, THE DIABETES DIET AND DIABETES BASICS. PARTICIPANTS CAME FROM LOCAL HEALTH INSTITUTIONS AND THROUGHOUT THE UNITED STATES TO LEARN FROM THE WHITTIER INSTITUTE'S MOST EXPERIENCED DIABETES EXPERTS. OVER THE LAST FISCAL YEAR, THE WHITTIER INSTITUTE'S PROFESSIONAL EDUCATION DEPARTMENT PROVIDED 19 SEPARATE PROGRAMS FOR PHYSICIANS, NURSES, PHARMACISTS, DIETITIANS, MIDLEVEL PROVIDERS AND SOCIAL WORKERS. HEALTH-RELATED BEHAVIORS HEALTH-RELATED BEHAVIOR IS ONE OF THE MOST IMPORTANT ELEMENTS IN PEOPLE'S HEALTH AND WELL-BEING. ITS IMPORTANCE HAS GROWN AS SANITATION HAS IMPROVED AND MEDICINE HAS ADVANCED. DISEASES THAT WERE ONCE INCURABLE CAN NOW BE PREVENTED OR SUCCESSFULLY TREATED. HEALTH-RELATED BEHAVIORS, SUCH AS IMMUNIZATION, SMOKING CESSATION, IMPROVED NUTRITION, INCREASED PHYSICAL ACTIVITY; ORAL HEALTH AND INJURY PREVENTION, HAVE BECOME IMPORTANT COMPONENTS OF LONG-TERM HEALTH. UNDERSTANDING THAT PERSONAL BEHAVIORS PLAY A SIGNIFICANT ROLE IN AN INDIVIDUAL'S OVERALL HEALTH STATUS, SCRIPPS HAS DEVELOPED A SERIES OF PREVENTION AND WELLNESS PROGRAMS THAT HELP PEOPLE TAKE CHARGE OF THEIR OWN, AND THEIR FAMILIES', HEALTH. DURING FISCAL YEAR 2012, SCRIPPS SPONSORED A NUMBER OF HEALTH BEHAVIOR MODIFICATION EFFORTS. FLU VACCINATION CAMPAIGN ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), AN AVERAGE 50,000 ADULTS DIE ANNUALLY IN THE UNITED STATES FROM DISEASES THAT ARE PREVENTABLE THROUGH VACCINATION. APPROXIMATELY 36,000 ADULTS DIE FROM INFLUENZA, MORE THAN 6,000 FROM INVASIVE PNEUMOCOCCAL DISEASE AND 5,000 FROM HEPATITIS B. IN SAN DIEGO COUNTY, INFLUENZA AND PNEUMONIA WERE THE 10TH LEADING CAUSE OF DEATH IN 2007, WITH 1,111 DEATHS RECORDED BETWEEN 2005 AND 2007. BASED ON 2007 CHIS DATA, ONLY 34.6 PERCENT OF SAN DIEGO COUNTY RESIDENTS REPORTED RECEIVING AN INFLUENZA VACCINATION DURING THE PREVIOUS 12 MONTHS. BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA FOR 2008 REPORTED ONLY 26.5 PERCENT OF ADULTS 65 AND OVER HAD BEEN VACCINATED FOR INFLUENZA DURING THE PREVIOUS 12 MONTHS. VACCINATIONS MAY NOT BE RECEIVED DUE TO COST AND LOCAL AVAILABILITY ISSUES OR A LACK OF EDUCATION ABOUT TIMING AND EFFECTIVENESS. MISUNDERSTANDING, MISINFORMATION OR SKEPTICISM RELATED TO THE BENEFITS AND POSSIBLE RISKS ASSOCIATED WITH VACCINES MAY ALSO REDUCE VACCINATION RATES. |
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MATERNAL CHILD HEALTH MOTHERS, INFANTS AND CHILDREN MAKEUP A LARGE SEGMENT OF THE U.S. POPULATION AND THEIR WELL-BEING IS A HEALTH PREDICTOR FOR THE NEXT GENERATION. THERE IS TREMENDOUS FOCUS ON MATERNAL ILLNESS AND DEATH, AND INFANT HEALTH AND SURVIVAL, INCLUDING INFANT MORTALITY RATES, ACCESS TO PREVENTIVE CARE, AND FETAL, PERINATAL AND OTHER INFANT DEATHS. MATERNAL AND INFANT HEALTH ISSUES INCLUDE: o ALCOHOL, TOBACCO AND ILLEGAL SUBSTANCES DURING PREGNANCY, WHICH ARE MAJOR RISK FACTORS FOR LOW BIRTH WEIGHT AND OTHER POOR OUTCOMES. o VERY LOW BIRTH WEIGHT ASSOCIATED WITH PRETERM BIRTH, SPONTANEOUS ABORTION, LOW PRE-PREGNANCY WEIGHT AND SMOKING. o INFANT DEATH RATES ARE HIGHEST AMONG INFANTS BORN TO YOUNG TEENAGERS AND MOTHERS 44 AND OLDER. BEING PREGNANT, OR TRYING TO BECOME PREGNANT, IS ONLY A SMALL PORTION OF A WOMAN'S LIFE. UNINTENDED PREGNANCY, EITHER MISTIMED OR UNWANTED AT THE TIME OF CONCEPTION, ACCOUNTS FOR AN ESTIMATED 49 PERCENT OF PREGNANCIES IN THE U.S. THESE PREGNANCIES ARE ASSOCIATED WITH INCREASED MORBIDITY, AS WELL AS BEHAVIORS LINKED TO ADVERSE HEALTH. WOMEN WHO CAN PLAN THE NUMBER AND TIMING OF THEIR CHILDREN EXPERIENCE IMPROVED HEALTH, FEWER UNPLANNED PREGNANCIES AND BIRTHS, AND LOWER ABORTION RATES. WHO IS MOST IMPACTED DURING 2008, SAN DIEGO COUNTY'S CRUDE BIRTH RATE PER 1,000 WAS 14.9, ACCOUNTING FOR 46,742 LIVE BIRTHS.6 CRUDE BIRTH RATES RANGED FROM 9.2 AMONG WHITE WOMEN TO 22.3 AMONG HISPANIC WOMEN. DURING 2008, HISPANICS ACCOUNTED FOR 44.7 PERCENT OF ALL LIVE BIRTHS, FOLLOWED BY 30.9 PERCENT FOR WHITES. WOMEN BETWEEN THE AGES OF 20 AND 34 ACCOUNTED FOR 74.2 PERCENT OF BIRTHS. SCRIPPS HEALTH CONTINUED TO ENHANCE PRENATAL EDUCATION FOR LOW-INCOME WOMEN IN SAN DIEGO COUNTY IN FISCAL YEAR 2012. THE FOLLOWING ARE SOME EXAMPLES. SCRIPPS MEMORIAL HOSPITAL LA JOLLA COMMUNITY BENEFIT SERVICES o OFFERED MORE THAN 1,000 MATERNAL CHILD HEALTH CLASSES THROUGHOUT SAN DIEGO COUNTY TO ENHANCE PARENTING SKILLS. LOW-INCOME WOMEN IN SAN DIEGO WHO WERE ELIGIBLE ATTEND CLASSES AT NO CHARGE OR ON A SLIDING-FEE SCHEDULE. o MAINTAINED EXISTING PRENATAL EDUCATION SERVICES IN ALL REGIONS OF THE COUNTY, ENSURING THAT PROGRAMS CONTINUED TO DEMONSTRATE A SATISFACTION RATING ABOVE 90 PERCENT. o PROVIDED AND SUPPORTED WEEKLY BREASTFEEDING SUPPORT GROUPS AT FIVE LOCATIONS THROUGHOUT SAN DIEGO COUNTY, INCLUDING TWO WITH BILINGUAL SERVICES. o OFFERED A MATERNAL CHILD HEALTH EDUCATION SERIES IN NORTH COUNTY COVERING DOGS AND BABIES, SAFETY, GRANDPARENTING AND BABYSITTER SAFETY. o OFFERED MATERNAL CHILD HEALTH CLASSES AT THE MENDE WELL BEING CENTER, SUCH AS BASIC TRAINING FOR DADS, GETTING READY FOR THE BABY, INFANT CPR AND SAFETY, PARENT CONNECTION PROGRAMS AND REDIRECTING CHILDREN'S BEHAVIOR. o OFFERED THE DOGS AND BABIES PROGRAMS QUARTERLY, WITH MORE THAN 40 ATTENDEES. o OFFERED WEEKLY MOMMY AND ME YOGA PROGRAMS FOR NEW PARENTS. o OFFERED A PRENATAL YOGA PROGRAM FOR EXPECTANT WOMEN IN SAN DIEGO COUNTY. o OFFERED A PREGNANCY NUTRITION PROGRAM QUARTERLY AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA. o OFFERED CLASSES IN PELVIC FLOOR AND PREGNANCY CHANGES FOR EXPECTANT FAMILIES AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA, COMMUNITY BENEFITS) FIRST 5 AND PROMISE NEIGHBORHOODS FIRST-TIME MOTHERS RECEIVED MORE THAN 647 SERVICES, INCLUDING HOME VISITS, REFERRALS, DATA ENTRY, FOLLOW-UP CALLS, PARENTING CLASSES AND OTHERS. A TOTAL OF 290 PEOPLE PARTICIPATED IN PARENTING CLASSES. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS) SCRIPPS MERCY'S SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) SCRIPPS MERCY HOSPITAL IS ONE OF FIVE REGIONAL ORGANIZATIONS THAT ADMINISTERS THE STATE-FUNDED WIC PROGRAM. THE PROGRAM SERVES SIX LOCATIONS CONVENIENTLY SITUATED NEAR COMMUNITY CLINICS AND/OR HOSPITALS IN CENTRAL SAN DIEGO AREA. WIC TARGETS LOW-INCOME PREGNANT AND POSTPARTUM WOMEN, INFANTS AND CHILDREN (AGES 0 TO 5). SCRIPPS MERCY WIC SERVES APPROXIMATELY 9,000 WOMEN AND CHILDREN ANNUALLY, 44 PERCENT IN THE CITY HEIGHTS COMMUNITY. IN CITY HEIGHTS, CLIENTS ARE 91 PERCENT HISPANIC AND INCLUDE PREGNANT AND POSTPARTUM WOMEN (24 PERCENT), INFANTS (20 PERCENT) AND CHILDREN (56 PERCENT). IN FISCAL YEAR 2012, THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS FOR 107,980 WOMEN AND CHILDREN IN SOUTH AND CENTRAL SAN DIEGO. THE SCRIPPS MERCY WIC PROGRAM PLAYS A KEY ROLE IN MATERNITY CARE BY REACHING LOW-INCOME WOMEN TO PROMOTE PRENATAL CARE, GOOD NUTRITION AND BREASTFEEDING. NUTRITION STAFF EDUCATE WOMEN ABOUT THE IMPORTANCE OF BREASTFEEDING DURING PREGNANCY AND OFFER LACTATION SUPPORT (ONE-ON-ONE AND GROUP), AS WELL AS SUPPLIES - PUMPS AND BREAST PADS - DURING THE POSTPARTUM PERIOD. (SPONSORED BY SCRIPPS MERCY HOSPITAL, SAN DIEGO). SUBSTANCE AND TOBACCO ABUSE SUBSTANCE ABUSE HAS A MAJOR IMPACT ON INDIVIDUALS, THEIR FAMILIES AND THEIR COMMUNITIES. THE EFFECTS OF SUBSTANCE ABUSE ARE CUMULATIVE, CONTRIBUTING TO COSTLY SOCIAL, PHYSICAL, MENTAL AND PUBLIC HEALTH PROBLEMS. THESE PROBLEMS INCLUDE TEENAGE PREGNANCY, HIV/AIDS, OTHER SEXUALLY TRANSMITTED DISEASES (STDS), DOMESTIC VIOLENCE, CHILD ABUSE, MOTOR VEHICLE CRASHES, FIGHTS, CRIME, HOMICIDE AND SUICIDE. ACCORDING TO THE NATIONAL INSTITUTE ON DRUG ABUSE, SUBSTANCE ABUSE COSTS HALF A TRILLION DOLLARS, INCLUDING APPROXIMATELY $181 BILLION FOR ILLICIT DRUGS, $168 BILLION FOR TOBACCO AND $185 BILLION FOR ALCOHOL. DURING 2009, CALIFORNIA'S ESTIMATED SMOKING-RELATED HEALTH CARE COSTS WERE $9.14 BILLION. TOBACCO USE o BASED ON THE YOUTH RISK BEHAVIOR SURVEILLANCE SURVEY (YRBSS), DURING 2007, 43.6 PERCENT OF STUDENTS IN THE SAN DIEGO UNIFIED SCHOOL DISTRICT (GRADES 9-12) REPORTED THEY HAD NEVER TRIED CIGARETTES. o DURING THAT SAME TIME PERIOD, 11 PERCENT OF STUDENTS IN GRADES 9-12 REPORTED CURRENT CIGARETTE USE, AND SEVEN PERCENT REPORTED THEY SMOKED MORE THAN 10 CIGARETTES PER DAY. o OF THE STUDENTS WHO CURRENTLY SMOKE, 41.4 PERCENT REPORTED THEY HAVE TRIED TO QUIT SMOKING AT LEAST ONCE DURING THE PREVIOUS 12 MONTHS. o DURING 2008, BASED ON THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM DATA FOR SAN DIEGO COUNTY, 14.5 PERCENT OF ADULTS, 18 OR OLDER, CURRENTLY SMOKE. MOREOVER, 23 PERCENT ARE FORMER SMOKERS AND 62.5 PERCENT HAVE NEVER SMOKED. ALCOHOL USE o BASED ON THE YRBSS, DURING 2007, 72 PERCENT OF STUDENTS IN THE SAN DIEGO UNIFIED SCHOOL DISTRICT (GRADES 9-12) REPORTED THEY HAD AT LEAST ONE ALCOHOLIC DRINK AT LEAST ONE TIME IN THEIR LIFE. o DURING THIS SAME TIME PERIOD, 36.7 PERCENT OF STUDENTS IN GRADES 9-12 REPORTED THEY HAD AT LEAST ONE ALCOHOLIC DRINK ON AT LEAST ONE DAY DURING THE PREVIOUS 30 DAYS PRIOR. o EPISODIC HEAVY DRINKING (FIVE OR MORE ALCOHOLIC DRINKS IN A ROW WITHIN A COUPLE OF HOURS) AT LEAST ONCE DURING THE PREVIOUS 30 DAYS WAS REPORTED BY 21.8 PERCENT OF STUDENTS. o DURING 2008, BASED ON BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM DATA FOR SAN DIEGO COUNTY, 55.1 PERCENT OF ADULTS, 18 OR OLDER, HAD AT LEAST ONE DRINK DURING THE PREVIOUS 30 DAYS. |
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IN AN EFFORT TO ENCOURAGE MORE PEOPLE TO TAKE STEPS TO PREVENT SUBSTANCE ABUSE, SCRIPPS ENGAGED IN THE FOLLOWING ACTIVITIES: INTERVENTION WORKSHOPS AIM TO IMPROVE COMMUNITY HEALTH THE INTERVENTION PROGRAM AT THE SCRIPPS DRUG AND ALCOHOL TREATMENT PROGRAM OFFERS FREE WORKSHOPS FOR PARENTS TO HELP THEM BETTER UNDERSTAND ADOLESCENT ALCOHOL AND SUBSTANCE ABUSE AND THE WIDESPREAD PROBLEM OF TEEN ADDICTION. OTHER INTERVENTION WORKSHOPS ADDRESS THE WARNING SIGNS OF ADULT ADDICTION FOR FAMILIES AND EMPLOYERS, PROVIDING AGE-SPECIFIC INFORMATION ON HOW TO HELP LOVED ONES RECOGNIZE THE SIGNS OF ADDICTION AND HOW TO GET AN ADDICTED INDIVIDUAL TO SEEK TREATMENT. MORE THAN 10,000 PEOPLE ATTENDED THE WORKSHOPS ON THE SCRIPPS MEMORIAL HOSPITAL LA JOLLA CAMPUS IN FISCAL YEAR 2012. EVERY 15 MINUTES THE EVERY 15 MINUTES PROGRAM IS A TWO-DAY EVENT THAT EXPOSES HIGH SCHOOL STUDENTS TO THE CONSEQUENCES OF DRINKING AND DRIVING THROUGH A DRAMATIC REENACTMENT OF AN ALCOHOL-RELATED TRAFFIC ACCIDENT. THE "INJURED" STUDENTS ARE TAKEN TO SCRIPPS MERCY TRAUMA CENTER. THIS PROGRAM IS SPONSORED JOINTLY BY LOCAL HIGH SCHOOLS, COUNTY POLICE, SHERIFFS, CHP, EMERGENCY DEPARTMENTS AND AMBULANCE SERVICES. DURING FISCAL YEAR 2012, SCRIPPS MERCY HOSPITAL PARTICIPATED IN EIGHT EVERY 15 MINUTES PROGRAMS, REACHING MORE THAN 3,000 HIGH SCHOOL STUDENTS THROUGHOUT SAN DIEGO COUNTY. SCRIPPS MEMORIAL HOSPITAL LA JOLLA PARTICIPATED IN ONE EVERY 15 MINUTES PROGRAM, REACHING 4,056 HIGH SCHOOL STUDENTS IN LA JOLLA. (SPONSORED BY SCRIPPS MERCY HOSPITAL TRAUMA AND ED AND SCRIPPS MEMORIAL HOSPITAL LA JOLLA TRAUMA DEPARTMENT) STAY QUIT STUDY-HOSPITALIZED PATIENTS SMOKING CESSATION STUDY A TOTAL OF 292 PARTICIPANTS WERE INCLUDED IN THE STAY QUIT STUDY, A PARTNERSHIP WITH THE CALIFORNIA SMOKERS HELPLINE. A TOTAL OF 3,407 PEOPLE HAVE BEEN SCREENED FOR THE STUDY. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA) YOUTHFUL DRINKING AND DRIVING PROGRAM AS AT LEAST 74.3 PERCENT OF HIGH SCHOOL STUDENTS IN THE U.S. REPORT DRINKING ALCOHOL, IT IS IMPERATIVE THAT STUDENTS UNDERSTAND THE RISKS ASSOCIATED WITH ALCOHOL ABUSE. IN AN EFFORT TO EDUCATE AT-RISK STUDENTS ABOUT THE DANGERS ASSOCIATED WITH DRINKING AND DRIVING, SCRIPPS MERCY HOSPITAL EMERGENCY DEPARTMENT AND TRAUMA CENTER PARTICIPATED IN THE CORRECTIVE BEHAVIOR INSTITUTE'S YOUTHFUL DRINKING AND DRIVING PROGRAM, PROVIDING TEENS WITH A TRAUMA CENTER EXPERIENCE. THIS FOUR-HOUR SUPERVISED TRAUMA VISITATION PROGRAM FOR DRIVERS 14 AND OVER SHOWS THE REAL CONSEQUENCES OF DRIVING UNDER THE INFLUENCE. MORE THAN 22 HIGH SCHOOL STUDENTS WERE SERVED THROUGH THE PROGRAM. PARTICIPANTS VISIT THE TRAUMA ROOM, ER, ICU, CAT SCAN AND OTHER HOSPITAL AREAS. (SPONSORED BY SCRIPPS MERCY HOSPITAL EMERGENCY DEPARTMENT AND TRAUMA CENTER). SAN DIEGO COUNTY POLICY PANEL ON YOUTH ACCESS TO ALCOHOL SCRIPPS PARTICIPATES ON A PANEL THAT WORKS TO SHAPE LOCAL, STATE AND NATIONAL POLICIES ON UNDERAGE DRINKING. IT IS THE LEAD ORGANIZATION FOR THE REGION'S COMBATING UNDERAGE DRINKING INITIATIVE AND SUPPORTS THE PROJECT'S STRATEGIES THROUGH MEDIA ADVOCACY, DATA COLLECTION, RESPONSIBLE BEVERAGE SERVICE TRAINING AND YOUTH PARTICIPATION. (SPONSORED BY SCRIPPS MERCY HOSPITAL TRAUMA SERVICES) SAN DIEGO COUNTY METHAMPHETAMINE STRIKE FORCE (MSF) CONVENED IN 1996 BY THE COUNTY BOARD OF SUPERVISORS, THIS MULTIAGENCY GROUP IS DEVELOPING A REGIONAL PREVENTION AND TREATMENT STRATEGY TO ADDRESS METHAMPHETAMINE ABUSE. SCRIPPS MERCY HOSPITAL TRAUMA SERVICES IS ON THE COORDINATING COMMITTEE. THE STRIKE FORCE TRACKS ITS PROGRESS WITH AN ANNUAL REPORT CARD OF 10 INDICATORS. THE STRIKE FORCE PROGRAMS HAVE BEEN DUPLICATED IN OTHER PARTS OF THE UNITED STATES. (SPONSORED BY SCRIPPS MERCY HOSPITAL TRAUMA SERVICES). UNINTENTIONAL INJURY AND VIOLENCE IN CALIFORNIA, INJURIES ARE THE NUMBER ONE KILLER AND DISABLER OF PEOPLE AGED 1 TO 44 (CDPH, 2010). UNINTENTIONAL INJURIES OCCUR AT HOME, AT WORK, WHILE PARTICIPATING IN SPORTS AND RECREATION, ON THE STREETS AND AT SCHOOL AND ARE ASSOCIATED WITH MOTOR VEHICLE ACCIDENTS, FALLS, FIREARMS, FIRE/BURNS, DROWNING, POISONING (INCLUDING DRUGS AND CAUSTIC SUBSTANCES), ALCOHOL, GAS, CLEANERS AND MANY OTHER CAUSES. THE DEATHS ASSOCIATED WITH UNINTENTIONAL INJURIES ARE SIGNIFICANT, YET REPRESENT ONLY A SMALL PART OF A MUCH LARGER PUBLIC HEALTH PROBLEM. HOSPITALIZATION DATA IS A BETTER MEASURE OF THE INJURY PROBLEM THAN DEATH DATA ALONE. IN SAN DIEGO COUNTY DURING 2008, THERE WERE MORE THAN 930 DEATHS, MORE THAN 20,800 HOSPITALIZATIONS, AND NEARLY 150,000 EMERGENCY DEPARTMENT VISITS FOR UNINTENTIONAL INJURIES. THE NUMBER OF UNINTENTIONAL INJURIES TREATED IN PHYSICIANS' OFFICES AND CLINICS, WHILE UNKNOWN, IS LIKELY MUCH HIGHER THAN THE NUMBER OF EMERGENCY DEPARTMENT VISITS. UNINTENTIONAL INJURIES ARE ONE OF THE LEADING CAUSES OF DEATH FOR SAN DIEGO COUNTY FOR RESIDENTS OF ALL AGES, REGARDLESS OF GENDER, RACE OR REGION. DURING 2008, UNINTENTIONAL INJURIES WERE THE LEADING CAUSE OF DEATH FOR PEOPLE 1 TO 4 YEARS, AND 15 TO 34 YEARS AND THE SIXTH LEADING CAUSE OF DEATH OVERALL. DURING 2008, THERE WERE 149,900 SAN DIEGO COUNTY ED DISCHARGES FOLLOWING TREATMENT FOR UNINTENTIONAL INJURIES, ACCOUNTING FOR ALMOST ONE IN FOUR (24.2 PERCENT) OF ALL ED DISCHARGES. THE RATE OF ED DISCHARGES RELATED TO UNINTENTIONAL INJURY WAS 4,735 PER 100,000 AND REPRESENTED THE LOWEST RATE DURING THE PREVIOUS THREE YEARS. THE FOLLOWING ARE A NUMBER OF SCRIPPS HEALTH PROGRAMS THAT ADDRESSED UNINTENTIONAL INJURIES AND VIOLENCE FOR FISCAL YEAR 2012. HEALTH AND WELLNESS, SCRIPPS HOME HEALTH SERVICES THIS PROGRAM EDUCATES SENIORS ABOUT FALL PREVENTION (THE PRIMARY CAUSE OF FRACTURES) AND FIRE SAFETY. HOME HEALTH NURSES ALSO TEACH SENIORS AND THEIR FAMILIES ABOUT CONTINUUM-OF-CARE OPTIONS. IN FISCAL YEAR 2012, 30 SAN DIEGO RESIDENTS WERE SERVED. (SPONSORED BY SCRIPPS HOME HEALTH SERVICES) SPORTS CONCUSSION PROGRAM, REHABILITATION CENTER AT SCRIPPS MEMORIAL HOSPITAL ENCINITAS THERE ARE NEARLY 300,000 SPORTS-RELATED CONCUSSIONS IN THE U.S EACH YEAR - 1,000 IN FOOTBALL ALONE - AND APPROXIMATELY 130,000 HIGH SCHOOL ATHLETES SUFFER A CONCUSSION. A RECENT REPORT SHOWED THAT CLOSE TO 40 PERCENT OF HIGH SCHOOL ATHLETES WHO SUSTAIN A CONCUSSION RETURN TO PLAY TOO SOON. THE REHABILITATION CENTER AT SCRIPPS ENCINITAS HAS DEVELOPED A PUBLIC EDUCATION AND COMMUNITY OUTREACH PROGRAM TO RAISE AWARENESS ABOUT CONCUSSION SIGNS AND SYMPTOMS, AS WELL AS HOW TO AVOID, TREAT AND UNDERSTAND THEIR CONSEQUENCES. APPROXIMATELY 70 STUDENTS HAVE BEEN SERVED BY THIS PROGRAM. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL ENCINITAS) SAN DIEGO FALL PREVENTION TASK FORCE THIS COUNTY HHSA-AGING AND INDEPENDENCE SERVICE-SUPPORTED TASK FORCE SEEKS TO REDUCE FALLS AND THEIR DEVASTATING CONSEQUENCES. THE TASK FORCE INCREASES CONNECTIONS BETWEEN PHYSICIANS AND OTHER COMMUNITY FALL PREVENTION SERVICES, AS WELL AS INCREASING AWARENESS AMONG OLDER ADULTS. SCRIPPS MERCY HOSPITAL TRAUMA CENTER PARTICIPATES IN THIS TASK FORCE. WEIGHT STATUS, NUTRITION, ACTIVITY AND FITNESS THE NUMBERS SPEAK FOR THEMSELVES - 63 PERCENT OF AMERICAN ADULTS ARE EITHER OVERWEIGHT OR OBESE. NATIONALLY, THE PREVALENCE OF OBESE ADULTS (THOSE WITH A BODY MASS INDEX (BMI) OF 30 OR MORE) HAS INCREASED BY 68 PERCENT SINCE 1995, FROM 16 PERCENT TO ALMOST 27 PERCENT. DURING THIS SAME PERIOD, THE PREVALENCE OF OVERWEIGHT ADULTS (BMI BETWEEN 25.0 AND 29.99) HAS INCREASED BY ONLY TWO PERCENT, FROM 35.5 PERCENT TO 36.2 PERCENT. SAN DIEGO COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA FOR 2009 INDICATES THAT ALMOST 59 PERCENT OF ADULTS ARE CONSIDERED EITHER OVERWEIGHT OR OBESE. SINCE 2005, THE FIRST YEAR BRFSS DATA WAS REPORTED FOR SAN DIEGO COUNTY, THE PREVALENCE OF OBESE ADULTS HAS RANGED FROM 20 PERCENT IN 2005 TO 26.7 PERCENT IN 2006, WITH THE MOST CURRENT MEASURE AT 21.6 PERCENT. SINCE 2006, THE PREVALENCE OF OVERWEIGHT ADULTS IN SAN DIEGO COUNTY HAS INCREASED SLIGHTLY FROM 36.5 PERCENT TO 37.7 PERCENT. |
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AT THE NATIONAL, STATE AND COUNTY LEVELS, OBESITY PREVALENCE RATES AMONG LATINOS AND AFRICAN-AMERICANS ARE SIGNIFICANTLY HIGHER THAN THOSE FOR WHITES. OBESITY RATES BY GENDER ALSO VARIED SIGNIFICANTLY IN THE 2007 CHIS, THE MOST RECENT COUNTY DATA BY GENDER, WITH 25.4 PERCENT OF MALES AND 18.1 PERCENT OF FEMALES HAVING A BMI 30 OR HIGHER. MALES WERE SIGNIFICANTLY MORE LIKELY TO BE OVERWEIGHT THAN FEMALES, 40.5 PERCENT AND 25.8 PERCENT, RESPECTIVELY. CAUSES MANY FACTORS PLAY A ROLE IN OBESITY, MAKING IT A COMPLEX HEALTH ISSUE TO ADDRESS. FACTORS INCLUDE (DH&HS, 2010): o GENETIC PREDISPOSITION o BEHAVIOR (DIETARY PATTERNS AND PHYSICAL ACTIVITY) o ENVIRONMENTAL INFLUENCES o CULTURAL INFLUENCES o SOCIOECONOMIC STATUS9 TO IMPLEMENT PREVENTION STRATEGIES, IT IS IMPORTANT TO UNDERSTAND THE EFFECT EACH OF THESE FACTORS HAS ON OBESITY AND WHICH CAN BE CHANGED. THE FOLLOWING ARE SOME EXAMPLES OF SCRIPPS PROGRAMS THAT ADDRESS THESE HEALTH ISSUES. NUTRITION SERVICES AND PHYSICAL ACTIVITY ACCORDING TO THE 2009 BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA FOR SAN DIEGO COUNTY, MORE THAN 59 PERCENT OF ADULTS ARE OVERWEIGHT OR OBESE. OBESITY INCREASES THE RISK FOR HEART DISEASE, TYPE 2 DIABETES, HIGH BLOOD PRESSURE, STROKE AND SOME FORMS OF CANCER. THE NATION'S LOW-INCOME, MINORITY POPULATIONS ARE AT EVEN GREATER RISK. IN AN EFFORT TO ADDRESS THIS CRITICAL HEALTH CONCERN, STAFF MEMBERS AT THE CITY HEIGHTS WELLNESS CENTER HAVE ESTABLISHED A VARIETY OF NUTRITION EDUCATION PROGRAMS TO MEET THE NEEDS OF LOW-INCOME, MINORITY POPULATIONS. THE CENTER USES A COMBINATION OF APPROACHES TO ADDRESS A BROAD ARRAY OF COMMUNITY HEALTH PRIORITIES, INCLUDING NUTRITION, ACCESS TO SERVICES AND COMMUNITY ENGAGEMENT. THE "HUB" OF THE WELLNESS CENTER IS THEIR TEACHING KITCHEN - A HANDS-ON INTERACTIVE SETTING FOR COOKING DEMONSTRATIONS, WEIGHT MANAGEMENT, MEAL PREPARATION, NUTRITION EDUCATION AND COUNSELING. DURING FISCAL YEAR 2012, NUTRITION EDUCATION AND COUNSELING SERVICES AT THE CITY HEIGHTS WELLNESS CENTER RECEIVED MORE THAN 6,000 VISITS. (SPONSORED BY SCRIPPS MERCY HOSPITAL, SAN DIEGO COMMUNITY BENEFIT SERVICES) SCRIPPS MERCY'S SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) SCRIPPS MERCY HOSPITAL IS ONE OF FIVE REGIONAL ORGANIZATIONS THAT ADMINISTER THE STATE-FUNDED WIC PROGRAM, SERVING SIX LOCATIONS CONVENIENTLY SITUATED NEAR COMMUNITY CLINICS AND/OR HOSPITALS IN CENTRAL SAN DIEGO. WIC TARGETS LOW-INCOME PREGNANT AND POSTPARTUM WOMEN, INFANTS AND CHILDREN (AGES 0 TO FIVE). EACH YEAR, SCRIPPS MERCY WIC SERVES APPROXIMATELY 9,000 WOMEN AND CHILDREN, 44 PERCENT IN CITY HEIGHTS. THE CLIENT BASE IN CITY HEIGHTS IS 91 PERCENT HISPANIC AND MADE UP OF PREGNANT OR POSTPARTUM WOMEN (24 PERCENT), INFANTS (20 PERCENT) AND CHILDREN (56 PERCENT). IN FISCAL YEAR 2012, THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS FOR 107,980 WOMEN AND CHILDREN IN SOUTH AND CENTRAL SAN DIEGO. (SPONSORED BY SCRIPPS MERCY HOSPITAL, SAN DIEGO) LIVE HEALTHY FAMILY NUTRITION PROGRAM USING THE COOPERATIVE EXTENSION'S RESEARCH-BASED CURRICULUMS AND BILINGUAL STAFF, A REGISTERED DIETITIAN IMPLEMENTED WEEKLY NUTRITION EDUCATION CLASSES IN SPANISH. THE PROGRAM TARGETS LOW-INCOME PEOPLE WHO USE FOOD STAMPS AND OFFERS A SERIES OF EIGHT WEEKLY CLASSES. THE PROGRAM INCREASES RESIDENTS' KNOWLEDGE, SKILLS AND MOTIVATION TO HELP THEM PRACTICE HEALTHY EATING AND RELATED BEHAVIORS. CLASSES FOCUS ON NUTRITION, PHYSICAL FITNESS, FOOD SAFETY, MEAL PLANNING AND FOOD SHOPPING. (SPONSORED BY SCRIPPS MERCY HOSPITAL, COMMUNITY BENEFIT SERVICES) COLLABORATE FOR HEALTHY WEIGHT COLLABORATE FOR HEALTHY WEIGHT IS A HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) AND NATIONAL INITIATIVE FOR CHILDREN'S HEALTH CARE QUALITY (NICHQ) PROGRAM. THIS ADVISORY GROUP MEETS MONTHLY TO CREATE PARTNERSHIPS AMONG PRIMARY CARE, PUBLIC HEALTH AND COMMUNITY ORGANIZATIONS TO FIND SUSTAINABLE WAYS TO PROMOTE HEALTHY WEIGHT AND ELIMINATE HEALTH DISPARITIES ACROSS THE UNITED STATES. ALL THREE SECTORS COLLABORATE, USING EVIDENCE-BASED APPROACHES, TO REVERSE THE OBESITY EPIDEMIC AND IMPROVE THE HEALTH OF OUR COMMUNITIES. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFIT SERVICES). MENTAL HEALTH AND MENTAL DISORDERS ACCORDING TO THE NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH), AN ESTIMATED 13 MILLION AMERICAN ADULTS (APPROXIMATELY ONE IN 17) HAVE A SERIOUSLY DEBILITATING MENTAL ILLNESS ANNUALLY (NIMH, 2008). MENTAL HEALTH DISORDERS ARE THE LEADING CAUSE OF DISABILITY IN THE U.S., ACCOUNTING FOR 25 PERCENT OF ALL YEARS OF LIFE LOST TO DISABILITY AND PREMATURE MORTALITY (WHO, 2004). IN 2007, SUICIDE WAS THE 11TH LEADING CAUSE OF DEATH IN THE U.S., ACCOUNTING FOR MORE THAN 34,500 DEATHS (NVSS, 2010). SAN DIEGO COUNTY, PREVALENCE OF SERIOUS MENTAL ILLNESS THERE ARE 141,420 PEOPLE IN SAN DIEGO COUNTY WITH SERIOUS MENTAL ILLNESS, REPRESENTING 4.9 PERCENT OF THE COUNTY'S HOUSEHOLD POPULATION (DMH, 2007). PEOPLE UNDER 18 AND THOSE LIVING IN HOUSEHOLDS UNDER 200 PERCENT OF THE FEDERAL POVERTY LEVEL ARE MOST IMPACTED BY SERIOUS MENTAL ILLNESS IN SAN DIEGO, 7.4 PERCENT AND 8.8 PERCENT RESPECTIVELY. EMERGENCY DEPARTMENT DISCHARGES DURING 2008, THERE WERE 25,468 DISCHARGES FROM SAN DIEGO COUNTY HOSPITAL EMERGENCY DEPARTMENTS WITH A PRIMARY DIAGNOSIS OF MENTAL DISORDER, ACCOUNTING FOR 4.1 PERCENT OF ALL ED DISCHARGES. THE PRIMARY DIAGNOSIS OF MENTAL DISORDER INCLUDES A WIDE RANGE OF DIAGNOSES, INCLUDING ALCOHOLISM AND DRUG PSYCHOSES, DEPENDENCE AND ABUSE. THE OVERALL RATE OF ED DISCHARGES WITH A MENTAL DISORDER DIAGNOSIS WAS 809.5 PER 100,000. HOSPITALIZATIONS DURING 2008, THERE WERE 22,971 HOSPITALIZATIONS IN SAN DIEGO COUNTY HOSPITALS WITH A PRINCIPAL DIAGNOSIS OF MENTAL DISORDERS (ICD-9-CD CODE 290-319), ACCOUNTING FOR 7.4 PERCENT OF ALL HOSPITALIZATIONS. THESE INCLUDED 17,556 WITH A PRINCIPAL DIAGNOSIS OF PSYCHOSES, ACCOUNTING FOR 59 PERCENT OF ALL MENTAL HEALTH HOSPITALIZATIONS. THERE WERE 6,210 WITH A PRINCIPAL DIAGNOSIS OF SCHIZOPHRENIC DISORDERS AND 4,583 WITH A PRINCIPAL DIAGNOSIS OF MAJOR DEPRESSIVE DISORDER, ACCOUNTING FOR 27 PERCENT AND 20 PERCENT OF ALL MENTAL HEALTH HOSPITALIZATIONS, RESPECTIVELY (COSDEPI, 20010). SUICIDE AND SUICIDE ATTEMPTS SUICIDE IS A MAJOR COMPLICATION OF DEPRESSION AND A LEADING CAUSE OF NON-NATURAL DEATH FOR ALL AGES IN SAN DIEGO COUNTY, SECOND ONLY TO MOTOR VEHICLE ACCIDENTS. IN 2010, 372 SAN DIEGANS DIED BY SUICIDE, A RATE OF 11.5 PER 100,000. THIS WAS HIGHER THAN CALIFORNIA OVERALL (9.9 PER 100,000) AND SLIGHTLY LOWER THAN THE NATIONAL RATE (11.9 PER 100,000). SUICIDE DEATHS ARE ONLY PART OF THE PROBLEM; MORE PEOPLE SURVIVE SUICIDE ATTEMPTS THAN DIE. THOSE WHO ATTEMPT SUICIDE ARE OFTEN SERIOUSLY INJURED AND REQUIRE MEDICAL AND PSYCHIATRIC CARE. BETWEEN 2000 AND 2008, 2,896 SAN DIEGANS DIED FROM SUICIDE. ON AVERAGE, ONE SUICIDE AFFECTS THE LIVES OF AT LEAST SIX PEOPLE, CAUSING CONSIDERABLE GRIEF, SOCIAL STIGMA AND, IN SOME CASES, ELEVATED RISK OF ADDITIONAL SUICIDES. IN 2010, THE COUNTY OF SAN DIEGO HEALTH AND HUMAN SERVICES AGENCY (HHSA) LAUNCHED A SUICIDE PREVENTION PLANNING PROCESS, WHICH WAS INFORMED BY THE NATIONAL STRATEGY FOR SUICIDE PREVENTION AND THE CALIFORNIA STRATEGIC PLAN ON SUICIDE PREVENTION. SCRIPPS IS A MEMBER OF THE COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP), WHICH COLLABORATES WITH THE COUNTY ON THIS INITIATIVE. SCRIPPS OFFERS BOTH INPATIENT AND OUTPATIENT ADULT BEHAVIORAL HEALTH SERVICES AT SCRIPPS MERCY HOSPITAL, SAN DIEGO. THE BEHAVIORAL HEALTH PROGRAM AT SCRIPPS MERCY ALSO SUPPORTS COMMUNITY PROGRAMS TO REDUCE THE STIGMA OF MENTAL ILLNESS AND HELP AFFECTED INDIVIDUALS LIVE AND WORK IN THE COMMUNITY. |
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SCRIPPS HEALTH BEHAVIORAL HEALTH INPATIENT PROGRAMS INDIVIDUALS SUFFERING FROM ACUTE PSYCHIATRIC DISORDERS ARE SOMETIMES UNABLE TO LIVE INDEPENDENTLY OR MAY EVEN POSE A DANGER TO THEMSELVES OR OTHERS. IN SUCH CASES, HOSPITALIZATION MAY BE THE MOST APPROPRIATE ALTERNATIVE. THE BEHAVIORAL HEALTH INPATIENT PROGRAM AT SCRIPPS MERCY HOSPITAL HELPS PATIENTS AND THEIR LOVED ONES WORK THROUGH SHORT-TERM CRISES, MANAGE MENTAL ILLNESS AND RESUME THEIR DAILY LIVES. CHALLENGES o LIKE MANY BEHAVIORAL HEALTH PROGRAMS ACROSS THE COUNTRY, FUNDING IS DIFFICULT, AS PAYMENT RATES HAVE NOT KEPT PACE WITH THE COST TO PROVIDE CARE. o IN 2012, THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM LOST $5.3 MILLION. o IN 2012, 17 PERCENT OF PATIENTS IN THE INPATIENT UNIT WERE UNINSURED. SCRIPPS HEALTH BEHAVIORAL HEALTH OUTPATIENT PROGRAMS SCRIPPS MERCY PROVIDES COMMUNITY-BASED ADULT PSYCHIATRIC TREATMENT AT SCRIPPS MERCY HOSPITAL, SAN DIEGO. THE INTENSIVE DAY PROGRAM HELPS PARTICIPANTS REDUCE THEIR SYMPTOMS WHILE THEY CONTINUE TO LIVE IN THE COMMUNITY. THE PROGRAM PROVIDES TWO LEVELS OF CARE: o THE OUTPATIENT PROGRAM OFFERS PATIENTS ONE TO FOUR TREATMENT DAYS PER WEEK. o THE PARTIAL HOSPITALIZATION PROGRAM PROVIDES MORE INTENSIVE TREATMENT FIVE TO SIX DAYS PER WEEK. MENTAL HEALTH OUTREACH SERVICES, A-VISION SERVICE PROGRAM BEHAVIORAL HEALTH SERVICES AT SCRIPPS MERCY HOSPITAL, IN PARTNERSHIPS WITH THE SAN DIEGO MENTAL HEALTH ASSOCIATION, ESTABLISHED THE A-VISION VOCATIONAL TRAINING PROGRAM (SOCIAL REHABILITATION AND PREVOCATIONAL SERVICES FOR PEOPLE LIVING WITH MENTAL ILLNESS) TO HELP DECREASE THE STIGMA OF MENTAL ILLNESS. THE PROGRAM PROVIDES VOCATIONAL TRAINING FOR PEOPLE RECEIVING MENTAL HEALTH TREATMENT, POTENTIALLY LEADING TO GREATER INDEPENDENCE. THIS YEAR, BEHAVIORAL HEALTH SERVICES CONTINUED PARTICIPATING IN THE A-VISION PROGRAM. IN FISCAL YEAR 2012, 44 CLIENTS WERE SERVED. CURRENTLY, EIGHT PEOPLE ARE VOLUNTEERING AND 23 PEOPLE ARE PARTICIPATING IN SUPPORTIVE EMPLOYMENT. THE TOTAL EXPENSE FOR THE A-VISION PROGRAM FOR FISCAL YEAR 2012 WAS $154,307. INCREASING AWARENESS OF MENTAL HEALTH AND GERIATRIC PSYCHIATRIC ISSUES IN FISCAL YEAR 2012, SCRIPPS BEHAVIORAL HEALTH SERVICES IMPROVES AWARENESS OF MENTAL HEALTH AND GERIATRIC ISSUES BY PROVIDING INFORMATION AND SUPPORTIVE SERVICES FOR MORE THAN 1,000 PEOPLE AT COMMUNITY EVENTS. EMERGING MENTAL HEALTH ISSUES HEALTHY PEOPLE 2020 HAS IDENTIFIED SEVERAL MENTAL HEALTH ISSUES THAT HAVE EMERGED AMONG SPECIAL POPULATIONS, INCLUDING POST-TRAUMATIC STRESS DISORDER (PTSD) AMONG VETERANS AND OTHERS WHO HAVE EXPERIENCED A TRAUMATIC EVENT. THESE EVENTS MAY INCLUDE WAR, RAPE, NATURAL DISASTERS, A CAR OR PLANE CRASH, KIDNAPPING, VIOLENT ASSAULT, SEXUAL OR PHYSICAL ABUSE AND MEDICAL PROCEDURES (ESPECIALLY IN KIDS). SCRIPPS MEMORIAL HOSPITAL ENCINITAS OFFERS A TWO-DAY COURSE CALLED BRAIN INJURY REHABILITATION CONFERENCE: BEYOND THE HOSPITAL, INTO THE COMMUNITY. THIS TWO-DAY COURSE ON PTSD AND STRESS DISORDER PROVIDES STRATEGIES AND A FRAMEWORK TO MANAGE BRAIN-INJURED PATIENTS BOTH WITHIN AND OUTSIDE THE CLINICAL SETTING. TREATMENTS ARE FOCUSED ON THE TOTAL CARE CONTINUUM - PHYSICAL, COGNITIVE, PERCEPTUAL, EMOTIONAL AND SOCIAL - IN A MULTIDISCIPLINARY FORMAT. THIS CONFERENCE ALSO PROVIDES PARTICIPANTS WITH THEORETICAL, PRACTICAL AND ADVANCED APPLICATIONS IN BRAIN INJURY REHABILITATION. THE COURSE IS TAUGHT BY AN INTERDISCIPLINARY TEAM OF SPECIALISTS IN BRAIN INJURY REHABILITATION AT SCRIPPS MEMORIAL HOSPITAL ENCINITAS. APPROXIMATELY 281 PEOPLE PARTICIPATED IN THIS CONFERENCE. INFECTIOUS DISEASES SEXUALLY TRANSMITTED DISEASES AND HIV/AIDS ACCORDING TO THE INSTITUTE OF MEDICINE, SEXUALLY TRANSMITTED DISEASES (STDS) AND HIV/AIDS ARE A "HIDDEN EPIDEMIC OF ENORMOUS HEALTH AND ECONOMIC CONSEQUENCE IN THE U.S. THEY ARE HIDDEN BECAUSE MANY AMERICANS ARE RELUCTANT TO ADDRESS SEXUAL HEALTH ISSUES IN AN OPEN WAY AND BECAUSE OF THE BIOLOGICAL AND SOCIAL CHARACTERISTICS OF THESE DISEASES." STDS ENCOMPASS MORE THAN 25 INFECTIOUS ORGANISMS TRANSMITTED PRIMARILY THROUGH SEXUAL ACTIVITY. LOCAL, STATE AND NATIONAL HEALTH AGENCIES ARE RESPONSIBLE FOR SURVEILLANCE AND MONITORING OF STDS. TUBERCULOSIS TUBERCULOSIS (TB) IS AN AIRBORNE INFECTIOUS DISEASE CAUSED BY MYCOBACTERIUM TUBERCULOSIS AND USUALLY AFFECTS THE LUNGS, ALTHOUGH OTHER ORGANS AND TISSUES SUCH AS KIDNEYS, SPINE AND BRAIN CAN BE AFFECTED AS WELL. TB CAN BE SPREAD BY COUGHING, SNEEZING, LAUGHING OR SINGING. DURING 2009, THERE WERE 264 TUBERCULOSIS CASES. PEOPLE DIAGNOSED WITH TB ARE MOST COMMONLY HISPANIC (52.3 PERCENT) OR ASIAN/PACIFIC ISLANDER (31.1 PERCENT), MALE (62.5 PERCENT) AND BETWEEN THE AGES OF 25 AND 64 YEARS (61 PERCENT). HIV/AIDS AS OF DECEMBER 31, 2008, 13,820 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) CASES HAD BEEN REPORTED IN SAN DIEGO COUNTY SINCE 1981. PEOPLE DIAGNOSED WITH AIDS IN SAN DIEGO COUNTY ARE MOSTLY WHITE, MALE, 30 TO 39 AND HAVE MALE SEX PARTNERS. DURING THIS PERIOD, 3,847 HUMAN IMMUNODEFICIENCY VIRUS (HIV) CASES WERE REPORTED. BECAUSE OF A CHANGE IN THE HIV REPORTING SYSTEM, ALL HIV REPORTING DATA COVERS THE PERIOD APRIL 17, 2006, THROUGH DECEMBER 2008. INDIVIDUALS MOST COMMONLY DIAGNOSED WITH HIV ARE WHITE, MALE AND AGED 30 TO 39. SCRIPPS HEALTH ADDRESSES INFECTIOUS DISEASE WITH THE FOLLOWING PROGRAMS. SCRIPPS MERCY HOSPITAL, CHULA VISTA WELL-BEING CENTER, SENIOR PREVENTION AND WELLNESS SENIOR HEALTH CHATS WERE IMPLEMENTED TO PROVIDE HEALTH EDUCATION FOR OLDER ADULTS IN SOUTH SAN DIEGO. APPROXIMATELY 860 SENIORS ATTENDED THESE MONTHLY THROUGHOUT THE YEAR. PRESENTATIONS INCLUDED HEALTH AND AGE-RELATED PREVENTION AND WELLNESS INFORMATION, SUCH AS TUBERCULOSIS, HOW TO RECOGNIZE SIGNS AND SYMPTOMS, AND HOW TO PREVENT AND TREAT IT. PRESENTATIONS ARE FACILITATED BY SCRIPPS MERCY HEALTH CARE PROFESSIONALS, PHYSICIANS AND FAMILY MEDICINE RESIDENTS. TOPICS ARE CHOSEN BY THE SENIORS THEMSELVES. THE HEALTH CHATS PROVIDE AN INTERCHANGE AMONG COMMUNITY MEMBERS, MEDICAL RESIDENTS AND OTHER HEALTH CARE PROFESSIONALS TO FOSTER HEALTHY LIFESTYLES AND PREVENTION. SCRIPPS MERCY HOSPITAL, CHULA VISTA WELL-BEING CENTER STAFF CONDUCT THESE SESSIONS TO FOSTER PREVENTION, AWARENESS AND DIALOGUE. MANY QUESTIONS ARE ASKED ABOUT CHRONIC HEALTH ISSUES AND OTHER HEALTH CONCERNS. SCRIPPS MERCY HOSPITAL, CHULA VISTA WELL-BEING CENTER, YOUTH PREVENTION AND WELLNESS SCRIPPS MERCY HOSPITAL HEALTH CARE PROFESSIONALS, FAMILY MEDICAL RESIDENTS, DIETICIANS, NURSES AND DOCTORS REACH OUT TO STUDENTS AT TEN LOCAL HIGH SCHOOLS ON HEALTH-RELATED TOPICS, INCLUDING SEXUALLY TRANSMITTED DISEASES AND TUBERCULOSIS. STUDENTS RECEIVED INFORMATION ON PREVENTION AND DETECTION, AS WELL AS TREATMENT, SIGNS AND SYMPTOMS. AROUND 1,230 STUDENTS PARTICIPATED IN THESE PROGRAMS. SCRIPPS MERCY HOSPITAL FAMILY MEDICINE RESIDENCY THIS PROGRAM RUNS TWO HEALTH CLINICS AT PALOMAR AND SOUTHWEST HIGH SCHOOL. FAMILY MEDICINE RESIDENTS GAIN ADDITIONAL SKILLS IN ADOLESCENT MEDICINE, AND STUDENTS LEARN SKILLS NECESSARY TO PURSUE HEALTH CAREERS. FAMILY MEDICINE RESIDENTS AND FACULTY MEET TWICE A WEEK AT THE CLINIC TO TREAT STUDENTS. THE PROGRAM INCLUDES ONE-ON-ONE MEETINGS WITH STUDENTS TO DISCUSS SEXUALLY TRANSMITTED DISEASES, PREVENTION, SIGNS, SYMPTOMS AND TREATMENT, AS WELL AS TUBERCULOSIS PREVENTION, SIGNS, SYMPTOMS AND TREATMENT. RESPIRATORY DISEASES RESPIRATORY DISEASES, SUCH AS ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), ARE A SIGNIFICANT PUBLIC HEALTH BURDEN IN THE UNITED STATES. ASTHMA AND COPD ARE AMONG THE 10 LEADING CHRONIC CONDITIONS THAT RESTRICT ACTIVITY. AFTER CHRONIC SINUSITIS, ASTHMA IS THE MOST COMMON CHRONIC ILLNESS IN CHILDREN. COPD, WHICH INCLUDES EMPHYSEMA AND CHRONIC BRONCHITIS, IS THE FOURTH LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY AND THE U.S. IN 2007, COPD ACCOUNTED FOR 1,023 DEATHS IN SAN DIEGO COUNTY AND 123,311 DEATHS NATIONALLY FOR AN AGE-ADJUSTED MORTALITY RATE PER 100,000 OF 34.1 AND 40.5, RESPECTIVELY. |
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HOSPITALIZED PATIENTS SMOKING CESSATION STUDY A TOTAL OF 292 PARTICIPANTS INCLUDED IN THE STAY QUIT STUDY, A PARTNERSHIP WITH THE CALIFORNIA SMOKERS HELPLINE. A TOTAL OF 3,407 PEOPLE HAVE BEEN SCREENED FOR THE STUDY. THE SMOKING CESSATION PILOT AND EXPANDED STUDY ARE RESPIRATORY DISEASE PREVENTION PROGRAMS AND RESPIRATORY THERAPISTS ARE CENTRAL TO THE PILOT, AS WELL AS TO THE LARGER NIH STUDY. MANY OF THE HOSPITALIZED SMOKERS ARE ADMITTED FOR PULMONARY AND RESPIRATORY DISEASES LINKED TO SMOKING. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA) CITY HEIGHTS WELLNESS CENTER, HEALTHY HOMES AND ASTHMA TRIGGER NIGHT FORUM FAMILIES WITH ASTHMATIC CHILDREN OFTEN FACE A NUMBER OF CHALLENGES THAT CAN LEAD TO ANXIETY, FEAR AND CONFLICT. THE CITY HEIGHTS WELLNESS CENTER PARTNERED WITH THE COMMUNITY ASTHMA TASK FORCE (CAT FORCE) TO PRESENT WAYS PARENTS CAN OVERCOME THE MANY CHALLENGES PRESENTED BY THEIR CHILD'S CONDITION. TOPICS INCLUDED GETTING AN ASTHMA ACTION PLAN FROM A DOCTOR; RECRUITING SCHOOL NURSES AND CLASSROOM TEACHERS TO FOLLOW THE ASTHMA ACTION PLAN; RIDDING HOMES OF MOLD, ALLERGENS AND OTHER ASTHMA TRIGGERS; PREVENTING ASTHMA ATTACKS AND HAVING HOMES OR APARTMENTS RENOVATED AT NO COST. (SPONSORED BY SCRIPPS MERCY HOSPITAL, COMMUNITY BENEFIT SERVICES) ORAL HEALTH ORAL HEALTH IN AMERICA: A REPORT OF THE SURGEON GENERAL DECLARES THAT "ORAL HEALTH IS ESSENTIAL TO THE GENERAL HEALTH AND WELL-BEING OF ALL AMERICANS." THE REPORT IDENTIFIES HUGE ORAL HEALTH DISPARITIES AMONG LOW-INCOME FAMILIES, RURAL COMMUNITIES, RACIAL OR ETHNIC MINORITIES, CHILDREN, THE ELDERLY AND THE DEVELOPMENTALLY DISABLED. THE 2005 CALIFORNIA ORAL HEALTH NEEDS ASSESSMENT REPORTED 54 PERCENT OF KINDERGARTENERS AND 71 PERCENT OF THIRD GRADERS HAVE A HISTORY OF TOOTH DECAY, AND MORE THAN 25 PERCENT OF ELEMENTARY SCHOOL CHILDREN HAVE UNTREATED DECAY. A REPORT CARD ISSUED IN 2010 BY CHILDREN NOW GAVE CALIFORNIA A D+ FOR HEALTH COVERAGE AND A D+ FOR ORAL HEALTH. THOSE WHO SUFFER THE WORST ORAL HEALTH ARE FOUND AMONG THE POOR OF ALL AGES, WITH CHILDREN AND OLDER AMERICANS PARTICULARLY VULNERABLE. BARRIERS TO CARE INCLUDE: NO PERCEIVED NEED FOR ORAL CARE, POLICYMAKERS PLACING A LOW PRIORITY ON ORAL HEALTH AND PREVENTION STRATEGIES, LACK OF ACCESS TO DENTISTS, LOW SOCIO-ECONOMIC STATUS, LACK OF RESOURCES TO PAY FOR CARE, INADEQUATE REIMBURSEMENT BY GOVERNMENT INSURANCE PROGRAMS, EXCESSIVE PAPERWORK REQUIRED FOR REIMBURSEMENT, LACK OF TRAINED PROVIDERS TO CARE FOR DIVERSE POPULATIONS, VERY YOUNG CHILDREN AND PEOPLE WITH SPECIAL NEEDS, AND MEDI-CAL BENEFICIARIES BEING UNAWARE THAT DENTAL BENEFITS ARE INCLUDED. PROJECT DULCE :PROJECT DULCE ADDRESSES ORAL HEALTH ISSUES WITH PATIENTS DURING COUNSELING VISITS. FOSTERING VOLUNTEERISM SCRIPPS BELIEVES THAT HEALTH IMPROVEMENT BEGINS WHEN PEOPLE TAKE AN ACTIVE ROLE IN MAKING A POSITIVE IMPACT ON THEIR COMMUNITY. FOR THIS REASON, SCRIPPS SUPPORTS VOLUNTEER PROGRAMS FOR SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS WHO WANT TO MAKE AN EVEN LARGER IMPACT ON THEIR COMMUNITY. THE SCRIPPSASSISTS EMPLOYEE VOLUNTEER CLUB IS ONE WAY SCRIPPS MATCHES THE TALENTS AND INTERESTS OF EMPLOYEES AND PHYSICIANS WITH COMMUNITY NEEDS, SUCH AS MENTORING PARTNERSHIPS WITH LOCAL SCHOOLS AND PROVIDING FREE MEDICAL AND SURGICAL CARE FOR PATIENTS IN NEED. IN ADDITION TO THE FINANCIAL COMMUNITY BENEFIT CONTRIBUTIONS MADE DURING FISCAL YEAR 2012, SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS DONATED A SIGNIFICANT PORTION OF THEIR PERSONAL TIME VOLUNTEERING TO SUPPORT SCRIPPS-SPONSORED COMMUNITY BENEFIT PROGRAMS. WITH CLOSE TO 8,027 HOURS, THE ESTIMATED DOLLAR VALUE OF THIS VOLUNTEER LABOR IS $352,933.87, WHICH IS NOT INCLUDED IN THE SCRIPPS FISCAL YEAR 2012 COMMUNITY BENEFIT PROGRAMS AND SERVICES TOTALS. PROFESSIONAL EDUCATION & HEALTH RESEARCH QUALITY HEALTH CARE IS HIGHLY DEPENDENT UPON HEALTH EDUCATION SYSTEMS AND MEDICAL RESEARCH PROGRAMS. WITHOUT THE ABILITY TO TRAIN AND INSPIRE A NEW GENERATION OF HEALTH CARE PROVIDERS, OR TO OFFER CONTINUING EDUCATION TO EXISTING HEALTH CARE PROFESSIONALS, THE QUALITY OF HEALTH CARE WILL BE GREATLY DIMINISHED. MEDICAL RESEARCH ALSO PLAYS AN IMPORTANT ROLE IN IMPROVING THE COMMUNITY'S OVERALL HEALTH BY DEVELOPING NEW AND INNOVATIVE TREATMENTS. EACH YEAR, SCRIPPS ALLOCATES RESOURCES TO ADVANCE HEALTH CARE SERVICES THROUGH CLINICAL RESEARCH, MEDICAL EDUCATION AND HEALTH PROFESSIONAL EDUCATION. DURING FISCAL YEAR 2012 (OCTOBER 2011 TO SEPTEMBER 2012), SCRIPPS INVESTED $34,095,6951 IN PROFESSIONAL TRAINING PROGRAMS AND CLINICAL RESEARCH TO ENHANCE SERVICE DELIVERY AND TREATMENT PRACTICES IN SAN DIEGO COUNTY. THIS SECTION HIGHLIGHTS SOME OF OUR PROFESSIONAL EDUCATION AND HEALTH RESEARCH ACTIVITIES. HEALTH PROFESSIONS TRAINING: INTERNSHIPS SCRIPPS' COMMITMENT TO ONGOING LEARNING AND HEALTH CARE EXCELLENCE EXTENDS BEYOND OUR ORGANIZATION. OUR INTERNSHIP PROGRAMS HELP PROMOTE HEALTH CARE CAREERS TO A NEW GENERATION, SHAPE THE FUTURE WORKFORCE AND DEVELOP FUTURE LEADERS IN OUR COMMUNITY. INTERACTING WITH HEALTH CARE PROFESSIONALS IN THE FIELD EXPANDS EDUCATION OUTSIDE THE CLASSROOM. SCRIPPS STAFF PLAY AN IMPORTANT ROLE AS PRECEPTORS BY INVESTING THEIR TIME TO CREATE A VALUABLE EXPERIENCE FOR THE COMMUNITY. IN FISCAL YEAR 2012, SCRIPPS HOSTED 2,188 INTERNS WITHIN OUR SYSTEM AND PROVIDED 291,797 DEVELOPMENT HOURS SPANNING NURSING AND ANCILLARY SETTINGS. TABLE 5:1 PROVIDES A BREAKDOWN OF INTERNS BY SCRIPPS FACILITY. COLLEGE AND UNIVERSITY AFFILIATIONS SCRIPPS COLLABORATES WITH LOCAL HIGH SCHOOLS, COLLEGES AND UNIVERSITIES TO HELP STUDENTS EXPLORE HEALTH CARE ROLES AND GAIN FIRSTHAND EXPERIENCE AS THEY WORK WITH SCRIPPS PROFESSIONALS. SCRIPPS IS AFFILIATED WITH MORE THAN 90 SCHOOLS AND PROGRAMS, INCLUDING CLINICAL AND NONCLINICAL PARTNERSHIPS. LOCAL SCHOOLS INCLUDE, BUT ARE NOT LIMITED TO, POINT LOMA NAZARENE UNIVERSITY (PLNU), UNIVERSITY OF CALIFORNIA SAN DIEGO (UCSD), CALIFORNIA STATE UNIVERSITY SAN MARCOS (CSU.S.M), SAN DIEGO STATE UNIVERSITY (SDSU), UNIVERSITY OF SAN DIEGO (U.S.D), MESA COLLEGE, SAN DIEGO CITY COLLEGE, GROSSMONT COLLEGE AND MIRA COSTA COLLEGE. SCRIPPS IS REGULARLY ACCEPTING NEW PARTNERSHIPS, BASED ON COMMUNITY AND WORKFORCE NEEDS, AND ESTABLISHED AN AFFILIATION AGREEMENT COMMITTEE TO REVIEW ALL REQUESTS AND PROVIDE A SYSTEM WIDE APPROACH TO SECURING NEW STUDENT PLACEMENTS. THIS INTERDISCIPLINARY COMMITTEE REPRESENTS EDUCATION AND DEPARTMENT LEADERSHIP ACROSS THE SCRIPPS SYSTEM, ENSURING A PROACTIVE APPROACH TO BUILDING A CAREER PIPELINE FOR TOP TALENT. RESEARCH STUDENTS SCRIPPS SUPPORTS GRADUATE RESEARCH FOR MASTERS AND DOCTORAL STUDENTS AT UNIVERSITIES WITH AFFILIATION AGREEMENTS. SCRIPPS CENTER FOR LEARNING & INNOVATION OVERSEES THE STUDENT PLACEMENT PROCESS. NON-PHYSICIAN STUDENTS WHO CONDUCT RESEARCH AT SCRIPPS REPRESENT A VARIETY OF HEALTH CARE DISCIPLINES, INCLUDING PUBLIC HEALTH, PHYSICAL THERAPY, PHARMACY AND NURSING. IN FISCAL YEAR 2012, SCRIPPS RESEARCH INCLUDED STUDENTS FROM U.S.D, WESTERN GOVERNORS, SDSU, PLNU AND POSTDOCTORAL PHARMACY RESIDENCY PROGRAMS, INCLUDING THE PGY1 PHARMACY RESIDENCY PROGRAM. |
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COLLEGE COLLABORATIONS SCRIPPS PARTNERED WITH PLNU TO CREATE HEALTH CARE FOCUS COURSES, INCLUDING HEALTH CARE FINANCE AND HEALTH CARE OPERATIONS. PLNU STUDENTS (NON-SCRIPPS EMPLOYEES) MAY ELECT TO TAKE THESE COURSES TOWARDS THEIR MBA. HIGH SCHOOL PROGRAMS SCRIPPS IS DEDICATED TO PROMOTING HEALTH CARE AS A REWARDING CAREER, COLLABORATING WITH A NUMBER OF HIGH SCHOOLS TO OFFER STUDENTS OPPORTUNITIES TO EXPLORE A ROLE IN HEALTH CARE AND GAIN FIRSTHAND EXPERIENCE WORKING WITH SCRIPPS HEALTH CARE PROFESSIONALS. HERE IS A SUMMARY OF THE HIGH SCHOOL PROGRAMS SCRIPPS MADE AVAILABLE TO THE COMMUNITY. SCRIPPS HIGH SCHOOL EXPLORATION PROGRAM AND REGIONAL ALLIED HEALTH AND SCIENCE INITIATIVE (RAHSI) THIS PROGRAM REACHES OUT TO SAN DIEGO HIGH SCHOOL STUDENTS INTERESTED IN EXPLORING A CAREER IN HEALTH CARE. IN FISCAL YEAR 2012, SCRIPPS HIRED 35 STUDENTS TO PARTICIPATE IN THE PROGRAM. DURING THEIR PAID FIVE-WEEK ROTATION, THE STUDENTS WORK IN DIFFERENT DEPARTMENTS, EXPLORING CAREER OPTIONS AND LEARNING VALUABLE LIFE LESSONS ABOUT HEALTH AND HEALING. UC HIGH SCHOOL COLLABORATION UC HIGH SCHOOL AND SCRIPPS PARTNERED TO PROVIDE A REAL-LIFE CONTEXT TO THE SCHOOL'S HEALTH CARE ESSENTIALS COURSE. FOR FISCAL YEAR 2012, SEVEN STUDENTS WERE SELECTED TO ROTATE THROUGH THREE DIFFERENT SCRIPPS CLINIC LOCATIONS, DURING THE FALL AND SPRING SEMESTER, TO INCREASE THEIR AWARENESS OF HEALTH CARE CAREERS. UC HIGH STUDENTS VISITED SCRIPPS CLINIC, MISSION VALLEY, RANCHO BERNARDO AND CARMEL VALLEY, SHADOWING HEALTH CARE PROFESSIONALS IN INTERNAL MEDICINE, RADIOLOGY, ASC, PHYSICAL THERAPY, DERMATOLOGY, CARDIOLOGY AND PEDIATRICS. YOUNG LEADERS IN HEALTH CARE AN OUTREACH PROGRAM AT SCRIPPS HOSPITAL ENCINITAS, YOUNG LEADERS IN HEALTH CARE TARGETS LOCAL HIGH SCHOOL STUDENTS INTERESTED IN EXPLORING HEALTH CARE CAREERS. STUDENT'S GRADES 9-12 PARTICIPATE IN THE PROGRAM, WHICH PROVIDES A FORUM FOR HIGH SCHOOL STUDENTS TO LEARN ABOUT THE HEALTH CARE SYSTEM AND ITS CAREER OPPORTUNITIES. THIS COMBINED EXPERIENCE INCLUDES WEEKLY MEETINGS AT LOCAL SCHOOLS FACILITATED BY TEACHERS AND ADVISORS, AS WELL AS MONTHLY MEETINGS AT SCRIPPS HOSPITAL ENCINITAS. THE PROGRAM MENTORS STUDENTS ON LEADERSHIP AND PROVIDES TOOLS FOR DAILY LIFE CHALLENGES. YOUNG LEADERS IN HEALTH CARE ALSO INCLUDES A SERVICE PROJECT TO MEET HIGH SCHOOL REQUIREMENTS AND MAKE A POSITIVE IMPACT ON THE COMMUNITY. THE PROGRAM CLOSES THE YEAR WITH A PRESENTATION ALIGNED WITH THE YEARLY FOCUS. MORE THAN 100 STUDENTS, COMMUNITY MEMBERS AND HEALTH CARE SPECIALISTS ATTENDED THE YOUNG LEADER IN HEALTH CARE FINAL MEETING, CULMINATING WITH STUDENT PRESENTATIONS ON SPORTS INJURIES AND PREVENTION. WORKABILITY SCRIPPS PARTNERS WITH THE SAN DIEGUITO ACADEMY WORKABILITY PROGRAM, WHICH EDUCATES STUDENTS AND THE COMMUNITY ON HEALTH CARE CAREER OPPORTUNITIES. SCRIPPS PROVIDES FIRSTHAND TOURS OF HOSPITAL FACILITIES AND EDUCATES PARTICIPANTS ABOUT THE COMPLEXITIES OF HOSPITAL OPERATIONS. THE PROGRAM IS DESIGNED TO PROVIDE PRE-EMPLOYMENT SKILLS DEVELOPMENT, WORKSITE TRAINING AND FOLLOW-UP SERVICES FOR YOUTH (AGES 12-22) WITH SPECIAL NEEDS WHO ARE MAKING THE TRANSITION FROM SCHOOL TO WORK. WHILE STUDENTS GET CLASSROOM TRAINING, SCRIPPS PARTNERS WITH THE PROGRAM TO PROVIDE ONSITE CAREER TRAINING. IN FISCAL YEAR 2012, FOUR STUDENTS PARTICIPATED IN THE PROGRAM AT SCRIPPS GREEN HOSPITAL AND SCRIPPS MEMORIAL HOSPITAL ENCINITAS. NEW GRADUATE RESIDENCY PROGRAM DESIGNED FOR THE NEWLY GRADUATED REGISTERED NURSE (RN), THIS INNOVATIVE PROGRAM IMPROVES PATIENT CARE QUALITY AND SAFETY DURING THE FIRST YEAR ON THE JOB. BY TRAINING NEW NURSES AND BUILDING CONFIDENCE AT THE BEDSIDE, THE PROGRAM HELPS MAKE THE INITIAL YEAR OF A NURSE'S CAREER A LAUNCH PAD TO SUCCESS. |
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THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM WITH THE SUPPORT OF THE CORPORATE FINANCE TEAM WITH INPUT FROM HUMAN RESOURCES, FOUNDATION, AND LEGAL OFFICE. THE FORM 990 WAS REVIEWED BY THE PRESIDENT, LEGAL COUNSEL, CHIEF FINANCIAL OFFICER, AUDIT COMMITTEE, HUMAN RESOURCES AND COMPENSATION COMMITTEE PRIOR TO FILING. IN ADDITION, A FULL COPY OF THE 990 WAS PROVIDED TO THE BOARD OF TRUSTEES VIA EMAIL IN ADVANCE OF FILING FORM 990 WITH THE IRS. |
| COMPLIANCE POLICY MONITORING |
FORM 990, PART VI, LINE 12C |
WITHIN 60 DAYS OF HIRE AND ANNUALLY THEREAFTER ALL SUPERVISORS AND ABOVE; ALL EMPLOYEES IN THE SUPPLY CHAIN MANAGEMENT DEPARTMENT, AUDIT & COMPLIANCE SERVICES DEPARTMENT, AND CASE MANAGEMENT DEPARTMENT OR FUNCTION; AND ANY OTHER EMPLOYEE WHO IS IN A POSITION TO REFER PATIENTS THAT ARE FEDERALLY FUNDED HEALTHCARE BENEFICIARIES TO OTHER PROVIDERS AND SERVICES; AND OTHERS AS DETERMINED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE WILL BE REQUIRED TO COMPLETE AND SIGN THE CONFLICT OF INTEREST COMMITMENT DISCLOSURE FORM. IT IS THE RESPONSIBILITY OF ANY EMPLOYEE WHO HAS A CHANGE IN OUTSIDE PROFESSIONAL ACTIVITIES, SIGNIFICANT FINANCIAL INTERESTS, OR POTENTIAL OR ACTUAL CONFLICT OF INTEREST, OR COMMITMENT SITUATIONS THAT ARISE DURING THE YEAR TO DISCLOSE THE INFORMATION TO THEIR SUPERVISORS AS SOON AS THE EMPLOYEE BECOMES AWARE OF THE POTENTIAL OR ACTUAL SITUATION CREATING A POSSIBLE CONFLICT OF INTEREST OR CONFLICT COMMITMENT. SUPERVISORS WILL ASSESS THE SITUATION AND REFER TO THEIR BUSINESS UNIT MANAGEMENT AND/OR THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE, AS APPROPRIATE. IN ADDITION, EACH PERSON ENTRUSTED WITH A POSITION OF RESPONSIBILITY IN THE GOVERNANCE AND MANAGEMENT IS REQUIRED TO COMPLETE AND SUBMIT DISCLOSURE STATEMENTS AS FOLLOWS: 1. INITIAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT (INITIAL DISCLOSURES) 2. ANNUAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT 3. SUBSEQUENT OCCURRENCES REPORTING UPON THE OCCURRENCE OF ANY NEW POTENTIAL CONFLICT OF INTEREST ACTUAL OR POTENTIAL CONFLICT DISCLOSURES REGARDING EMPLOYEES ARE REVIEWED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE. DISCLOSURES REQUIRING MITIGATION ARE DISCUSSED WITH THE BUSINESS UNIT CHIEF EXECUTIVE AND EMPLOYEE'S SUPERVISOR. LEGAL COUNSEL REVIEWS EACH BOARD OF TRUSTEES MEETING AGENDA PRIOR TO THE MEETING AND POTENTIAL CONFLICTS OF INTERESTS ARE IDENTIFIED, CONSIDERED AND AN APPROPRIATE COURSE OF ACTION IS DETERMINED BY THE MEMBER AND LEGAL COUNSEL WITH THE INVOLVEMENT OF THE PRESIDENT AND BOARD CHAIR, WHERE APPROPRIATE. COURSE OF ACTION MAY INCLUDE THE CONFLICTED BOARD MEMBER RECUSING THEMSELVES, ABSTAINING FROM VOTING AND/OR READING A STATEMENT INTO THE BOARD MINUTES REGARDING SUCH CONFLICT. AS IT RELATES TO BOARD OF TRUSTEES, WHEN A DETERMINATION IS THAT AN ACTUAL CONFLICT OF INTEREST EXISTS AND A COVERED INDIVIDUAL IS AN "INTERESTED PERSON" UNDER CALIFORNIA LAW, THE TRANSACTION BEING CONSIDERED WILL COMPLY WITH APPLICABLE STATUTORY REQUIREMENTS TO AVOID PARTICIPATION IN THE DECISION MAKING PROCESS BY THE COVERED INDIVIDUAL. THE MINUTES OF BOARD MEETINGS SHALL DOCUMENT ALL RECUSALS FROM DISCUSSION AND VOTING. |
| OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN |
FORM 990, PART VI, LINE 15A & 15B |
PURSUANT TO PROCEDURES REQUIRED BY TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1983 (TEFRA), SCRIPPS HEALTH'S PROCEDURES ARE AS FOLLOWS: THE BOARD OF TRUSTEES REVIEWS EXECUTIVE COMPENSATION FOR OFFICERS AND ALL KEY EMPLOYEES ON AN ANNUAL BASIS UTILIZING COMPARABILITY DATA OBTAINED BY AN EXTERNAL CONSULTANT. IT IS THE PHILOSOPHY OF THE SCRIPPS BOARD OF TRUSTEES TO COMPENSATE THE CORPORATION'S EXECUTIVES FAIRLY RELATIVE TO THE MEDIAN COMPENSATION OF PEER ORGANIZATIONS, CONSIDERING AND MAKING APPROPRIATE ADJUSTMENTS FOR THE COST OF LIVING IN SAN DIEGO, CALIFORNIA AND OTHER RELEVANT FACTORS. TO ACCOMPLISH THIS, THE BOARD HAS ADOPTED A PHILOSOPHY OF TARGETING EXECUTIVE SALARIES AT APPROXIMATELY THE 65TH PERCENTILE OF A NATIONAL PEER GROUP OF ORGANIZATIONS AS DETERMINED THROUGH AN INDEPENDENT OUTSIDE CONSULTANT ENGAGED BY THE BOARD AND WILL RELY ON THEIR RECOMMENDATIONS USING A DATABASE OF INDEPENDENTLY COLLECTED DATA. THE PHILOSOPHY STATES: -FOR PURPOSES OF EXECUTIVE COMPENSATION COMPARISONS, SCRIPPS WILL USE A NATIONAL PEER GROUP OF MEDICAL DELIVERY SYSTEMS OF SIMILAR REVENUE SIZE AND COMPLEXITY. THE PEER GROUP WILL BE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. -SALARIES ARE TARGETED AT APPROXIMATELY THE 65TH PERCENTILE OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. -TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE OF THE PEER GROUP WHEN MAXIMUM LEVEL INCENTIVES ARE PAID FOR ACHIEVEMENT OF MAXIMUM LEVEL OF PREDETERMINED OBJECTIVES AGREED UPON BY THE BOARD. -BENEFITS ARE POSITIONED AT THE 65TH PERCENTILE OF THE PEER GROUP. -ANNUALLY, TOTAL CASH COMPENSATION FOR EACH POSITION WILL NOT EXCEED THE BASE SALARY ESTABLISHED FOR THE PERIOD PLUS THE MAXIMUM INCENTIVE PERCENTAGE PAYOUT ALLOWABLE AS DETERMINED BY THE SCRIPPS MANAGEMENT INCENTIVE PLAN APPROVED BY THE BOARD OF TRUSTEES FOR THE RESPECTIVE POSITION. THE REPORT FROM THE EXTERNAL CONSULTANT ENGAGED TO REVIEW EXECUTIVE COMPENSATION IS PRESENTED TO THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ON AN ANNUAL BASIS AND THE MOST RECENT REPORT WAS REVIEWED ON DECEMBER 14, 2011. REVIEW AND DISCUSSION OF SUCH REPORT IS DOCUMENTED IN THE MINUTES. |
| JOINT VENTURES |
FORM 990, PART VI, LINE 16 |
SCRIPPS HEALTH HAS MAINTAINED A LONG STANDING PRACTICE OF REVIEWING ALL POTENTIAL JOINT VENTURE OR SIMILAR ARRANGEMENTS TO ENSURE THAT CONTRACT TERMS ARE CONSISTENT WITH THE PROTECTION OF ITS TAX-EXEMPT STATUS. |
| AVAILABILITY OF DOCUMENTS TO THE GENERAL PUBLIC |
FORM 990, PART VI, LINE 19 |
FINANCIAL STATEMENTS ARE POSTED QUARTERLY ON THE DAC (DIGITAL ASSURANCE CERTIFICATION) WEBSITE AND THE MUNICIPAL SECURITIES RULEMAKING BOARD'S (MSRB) ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE IN SATISFACTION OF CONTINUING DISCLOSURE REQUIREMENTS RELATING TO THE ORGANIZATION'S TAX-EXEMPT DEBT ISSUANCES. THE AUDITED FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990, IN ACCORDANCE WITH THE IRS INSTRUCTIONS. SCRIPPS HEALTH'S CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. |
| STATEMENT OF FUNCTIONAL EXPENSES |
PART IX, LINE 24E |
INCOME TAX EXPENSE - $53,529 |
| OTHER CHANGES TO NET ASSETS/FUND BALANCES |
FORM 990, PART XI, LINE 5 |
UNREALIZED GAIN / LOSS ON INVESTMENTS $161,802,555 CONSOLIDATE TWI EQUITY 11,615,480 CHANGE IN VALUE IN DEFERRED GIFTS (1,346,688) JOINT VENTURES-NONCONTROLLING INTERESTS 2,858,742 OTHER CHANGES IN NET ASSETS 76,536 ---------------- TOTAL $175,006,625 |
| TAX EXEMPT BONDS |
SCHEDULE K, PART I, ISSUE PRICE |
BOND ISSUE A (2007A): THE STATED PAR OF $49,995,000 DIFFERS FROM THE $149,875,000 REPORTED ON THE 8038 TAX FORM AS THE $49,995,000 AMOUNT REPRESENTS ONLY SCRIPPS HEALTH'S PORTION IN A POOL BOND LOAN PROGRAM. BOND ISSUE B (2008A): 2008A - THE STATED PAR OF $99,020,000 DIFFERS FROM THE $99,830,304 LISTED IN FORM 8038 PART III LINE 21 (B) BECAUSE OF AN $810,304 ORIGINAL ISSUE PREMIUM. |
| SCHEDULE K, PART I, CUSIP NUMBER |
BOND ISSUE D (2005A/2008G): |
THE SERIES 2005A BONDS, CUSIP 13033FWK2, WERE EXCHANGED FOR THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2008G, CUSIP 13033F5M8 (SCRIPPS HEALTH), ON AUGUST 14, 2008. |
| SCHEDULE K, PART I, DESCRIPTION OF PURPOSE |
BOND ISSUE A (2007A): |
POOL BOND. PROCEEDS WERE USED TO REFUND COMMERCIAL PAPER REVENUE NOTES, SERIES 2005A, WHICH WERE USED TO PURCHASE EQUIPMENT. BOND ISSUE B (2008A): REFUNDING OF PRIOR ISSUES 07/07/2005 BOND ISSUE C (2008B-F): THE $221,230,000 (2008B - F) REFUNDED THE 2005B - F BONDS. THE ISSUE DATE FOR THE 2005 B - F WAS 6/17/2005. BOND ISSUE D (2005A/2008G): THE $40,975,000 (2008G) EXCHANGED THE 2005A BOND. THE ISSUE DATE FOR THE 2005A WAS 6/2/2005. THE PROCEEDS OF THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2005A (SCRIPPS HEALTH), WERE ISSUED FOR THE PURPOSE, TOGETHER WITH OTHER AVAILABLE FUNDS, OF ADVANCE REFUNDING THE ORGANIZATION'S SERIES 1998C BONDS. THE SERIES 2005A BONDS, WERE EXCHANGED FOR THE CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2008G (SCRIPPS HEALTH), ON AUGUST 14, 2008. BASED ON THE ADVICE OF BOND COUNSEL, THE ORGANIZATION IS TREATING THE SERIES 2008G BONDS AS THE SAME ISSUE AS THE SERIES 2005A BONDS FOR FEDERAL INCOME TAX PURPOSES. FURTHER INFORMATION REGARDING THE SERIES 2008G BONDS: ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY; ISSUER EIN: 52-1643828; CUSIP #: 13033F5M8; DATE EXCHANGED: 8/14/2008; ISSUE PRICE: N/A; DESCRIPTION OF PURPOSE: EXCHANGE FOR SERIES 2005A BONDS (SAME ISSUE). BOND ISSUE A-2 (2010A): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE B-2 (2010B & C): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE C-2 (2012A-C): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. |
| SCHEDULE K, PART II, QUESTION 3 |
TOTAL PROCEEDS OF ISSUE |
BOND ISSUE C-2 (2012A-C): THE AMOUNT SHOWN IN PART II, LINE 3 CONSISTS OF THE ISSUE PRICE OF THE BONDS ($288,143,095) PLUS INVESTMENT EARNINGS OF $17,234. |
| SCHEDULE K, PART II, QUESTION 8 |
BOND ISSUE B (2008B-F): |
SUBSTANTIALLY COMPLETE PRIOR TO ISSUANCE BOND ISSUE D (2005A/2008G): SUBSTANTIALLY COMPLETE PRIOR TO ISSUANCE |
| SCHEDULE K, PART III |
|
BOND ISSUE B (2008A): THE SERIES 2008A BONDS REFUNDED PRIOR BONDS ORIGINALLY ISSUED BEFORE 2003. ACCORDINGLY, PART III REPORTING IS NOT REQUIRED. BOND ISSUE D (2005A) THE SERIES 2005A BONDS REFUNDED PRIOR BONDS ORIGINALLY ISSUED BEFORE 2003. ACCORDINGLY, PART III REPORTING IS NOT REQUIRED. |
| SCHEDULE K, PART III, QUESTION 3B |
OPEN |
THE OBLIGOR'S LEGAL DEPARTMENT REVIEWS CONTRACTS AND AGREEMENTS TO ENSURE COMPLIANCE WITH PRIVATE BUSINESS USE REGULATIONS, ENGAGING OUTSIDE LEGAL COUNSEL, AS NECESSARY. |
| SCHEDULE K, PART IV, ARBITRAGE, QUESTION 2 |
SWAP COUNTERPARTY |
BOND ISSUE C-2 (2012A-C): THE 2012A TOTALING $188,143,094.65 IS A FIXED RATE ISSUE WHEREAS THE 2010B&C TOTALING $100,000,000 IS A VARIABLE RATE ISSUE. |
| SCHEDULE K, PART IV, ARBITRAGE, QUESTION 3B |
NAME OF PROVIDER |
BOND ISSUE C (2008B-F): ON SEPTEMBER 18, 2012 THE ORGANIZATION ENTERED INTO INTEREST RATE SWAP NOVATIONS WITH WELLS FARGO BANK, N.A. AND UNION BANK, N.A., AS COUNTERPARTY, REPLACING THEN-EXISTING INTEREST RATE SWAPS WITH CITIBANK, N.A. BOND ISSUE D (2005A/2008G): ON SEPTEMBER 18, 2012 THE ORGANIZATION ENTERED INTO INTEREST RATE SWAP NOVATIONS WITH WELLS FARGO BANK, N.A., AS COUNTERPARTY, REPLACING THEN-EXISTING INTEREST RATE SWAPS WITH CITIBANK, N.A. |
| SCHEDULE K, PART IV, ARBITRAGE, QUESTION 5 |
BOND ISSUE A (2007A): |
AN AMOUNT IN THE COSTS OF ISSUANCE FUND NOT EXCEEDING $100,000 WAS NOT DISBURSED UNTIL MAY 2008. BOND ISSUE D (2005A/2008G): THE COST OF ISSUANCE WAS NOT EXPENDED UNTIL 1/4/2006. PER THE TAX CERTIFICATE IT WAS EXPECTED TO BE EXPENDED WITHIN 180 DAYS. |
| SCHEDULE K, PART V |
PROCEDURES TO UNDERTAKE CORRECTIVE ACTION |
THE ORGANIZATION HAS ADOPTED TAX-EXEMPT BOND COMPLIANCE PROCEDURES, INCLUDING PROCEDURES TO MONITOR PRIVATE BUSINESS USE OF FINANCED PROPERTY AND TAKING REMEDIAL ACTIONS, IF NECESSARY. THE ORGANIZATION IS AWARE OF THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS, AND HAS DISCUSSED THAT PROGRAM WITH COUNSEL. THE ORGANIZATION IS SUPPLEMENTING ITS WRITTEN PROCEDURES TO SPECIFICALLY MAKE REFERENCE TO THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS. |
Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.