| 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 $2.6 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS OVER HALF A MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF 2,600 AFFILIATED PHYSICIANS AND 13,000 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. RECOGNIZED AS A LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE, SCRIPPS IS ALSO AT THE FOREFRONT OF CLINICAL RESEARCH, GENOMIC MEDICINE, WIRELESS HEALTH AND GRADUATE MEDICAL EDUCATION. WITH THREE HIGHLY RESPECTED GRADUATE MEDICAL EDUCATION PROGRAMS, SCRIPPS IS A LONGSTANDING MEMBER OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES. MORE INFORMATION CAN BE FOUND AT WWW.SCRIPPS.ORG. TODAY, THE HEALTH SYSTEM EXTENDS FROM CHULA VISTA TO OCEANSIDE, WITH 26 PRIMARY AND SPECIALTY CARE OUTPATIENT CENTERS. A LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE, SCRIPPS WAS NAMED BY TRUVEN IN 2013 AS ONE OF THE TOP 15 LARGE HEALTH SYSTEMS IN THE NATION FOR PROVIDING HIGH-QUALITY, SAFE AND EFFICIENT PATIENT CARE. ON THE FOREFRONT OF GENOMIC MEDICINE AND WIRELESS HEALTH TECHNOLOGY, THE ORGANIZATION IS DEDICATED TO IMPROVING COMMUNITY HEALTH WHILE ADVANCING MEDICINE THROUGH CLINICAL RESEARCH AND GRADUATE MEDICAL EDUCATION. SCRIPPS HAS ALSO EARNED A NATIONAL REPUTATION AS A PREMIER EMPLOYER, NAMED BY FORTUNE MAGAZINE AS ONE OF AMERICA'S "100 BEST COMPANIES TO WORK FOR" EVERY YEAR SINCE 2008. 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. |
| FY13 PROGRAM SERVICES ACCOMPLISHMENTS |
FORM 990, PART III, LINE 4A |
FULFILLING THE SCRIPPS MISSION DURING THIS FISCAL YEAR, SCRIPPS DEVOTED $355,306,156 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. COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ORIGINATED FROM CALIFORNIA STATEWIDE LEGISLATION IN THE EARLY 1990S. SB 697 TOOK EFFECT IN 1995, WHICH REQUIRED PRIVATE NON-PROFIT HOSPITALS TO SUBMIT DETAILED INFORMATION TO THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) ON THEIR COMMUNITY BENEFIT CONTRIBUTIONS. ANNUAL HOSPITAL COMMUNITY BENEFIT REPORTS ARE SUMMARIZED BY OSHPD IN A REPORT TO THE LEGISLATURE, WHICH PROVIDES VALUABLE INFORMATION FOR GOVERNMENT OFFICIALS TO ASSESS THE CARE AND SERVICES PROVIDED TO THEIR CONSTITUENTS. AS PART OF THE COMMUNITY BENEFIT REPORTS FILED, NON-PROFIT HOSPITALS ARE REQUIRED TO CONDUCT A CHNA EVERY THREE YEARS. THIS COMPREHENSIVE ACCOUNT OF HEALTH NEEDS IN THE COMMUNITY IS DESIGNED FOR HOSPITALS TO PLAN THEIR COMMUNITY BENEFIT PROGRAMS TOGETHER WITH OTHER LOCAL HEALTH CARE INSTITUTIONS, COMMUNITY BASED ORGANIZATIONS, AND CONSUMER GROUPS. IN SAN DIEGO COUNTY, THE LONG HISTORY OF COLLABORATION AMONG HOSPITALS, HEALTHCARE SYSTEMS AND COMMUNITY PARTNERS HAS RESULTED IN SUCCESSFUL PARTNERSHIP ON PAST CHNAS. WHILE PUBLIC INSTITUTIONS AND DISTRICT HOSPITALS DO NOT HAVE TO REPORT UNDER SB 697, THESE INSTITUTIONS HAVE BECOME AN INTEGRAL PART OF THE CHNA IN SAN DIEGO COUNTY. INFORMATION IS GATHERED THROUGH THE CHNA FOR THE PURPOSES OF REPORTING COMMUNITY BENEFIT, DEVELOPING STRATEGIC PLANS, CREATING ANNUAL REPORTS, PROVIDING INPUT ON LEGISLATIVE DECISIONS, AND INFORMING THE GENERAL COMMUNITY OF HEALTH ISSUES AND TRENDS. SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS, GOVERNMENT AGENCIES, BUSINESSES AND GRASSROOTS MOVEMENTS, SCRIPPS IS BETTER ABLE TO BUILD UPON EXISTING ASSETS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS. BACKGROUND/REQUIRED COMPONENTS OF THE ASSESSMENT SCRIPPS HEALTH HAS A LONG HISTORY OF RESPONDING TO THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES, EXTENDING BEYOND TRADITIONAL HOSPITAL CARE TO ADDRESS THE HEALTH CARE NEEDS OF THE REGION'S MOST VULNERABLE POPULATIONS. SINCE 1994, THESE PROGRAMS HAVE BEEN CREATED BASED ON AN ASSESSMENT OF NEEDS IDENTIFIED THROUGH HOSPITAL DATA, COMMUNITY INPUT, AND MAJOR TRENDS. PREVIOUS COLLABORATIONS AMONG NON-PROFIT HOSPITALS, HEALTHCARE SYSTEMS, AND OTHER COMMUNITY PARTNERS HAVE RESULTED IN NUMEROUS WELL-REGARDED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) REPORTS. THE PATIENT PROTECTION AND AFFORDABLE CARE ACT ("AFFORDABLE CARE ACT" OR "ACA") OF 2010 IS BRINGING ABOUT SIGNIFICANT REGULATORY CHANGES IN THE HEALTHCARE INDUSTRY. SCRIPPS HEALTH WAS GIVEN THE TASK OF CONDUCTING AN EXPANDED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT MET THE NEW FEDERAL REQUIREMENTS. ADDITIONAL INFORMATION ON THE ACA REQUIREMENTS FOR NONPROFIT HOSPITALS CAN BE FOUND AT WWW.IRS.GOV, KEYWORD: "CHARITABLE ORGANIZATIONS". AS A NONPROFIT HOSPITAL, SCRIPPS HEALTH FULFILLED THIS REQUIREMENT THROUGH THE DEVELOPMENT AND DISTRIBUTION OF THIS ASSESSMENT. WHILE THIS IS A FEDERALLY MANDATED EXERCISE, SCRIPPS HEALTH HOPES TO LEVERAGE THE INFORMATION COLLECTED FOR THIS REPORT TO BENEFIT THE COMMUNITY AT-LARGE IN OTHER FUTURE PLANNING INITIATIVES. THE IRS ALSO REQUIRED HOSPITAL ORGANIZATIONS THAT CONDUCT A CHNA TO MAKE THE REPORT WIDELY AVAILABLE BY POSTING IT ON A PUBLICLY ACCESSIBLE WEBSITE. REQUIRED COMPONENTS OF THE ASSESSMENT PER IRS REQUIREMENTS, THERE ARE FIVE COMPONENTS THE CHNA MUST INCLUDE: - A DESCRIPTION OF THE COMMUNITY SERVED BY THE HEALTH SYSTEM AND HOW IT WAS DETERMINED. - A DESCRIPTION OF THE PROCESSES AND METHODS USED TO CONDUCT THE ASSESSMENT. - A DESCRIPTION OF HOW THE HOSPITAL ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY. - A PRIORITIZED DESCRIPTION OF ALL OF THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA, AS WELL AS A DESCRIPTION OF THE PROCESS AND CRITERIA USED IN PRIORITIZING SUCH HEALTH NEEDS. - A DESCRIPTION OF THE EXISTING HEALTH CARE FACILITIES AND OTHER RESOURCES WITHIN THE COMMUNITY AVAILABLE TO MEET THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA. EXECUTIVE SUMMARY GROUNDED IN A LONGSTANDING COMMITMENT TO ADDRESS COMMUNITY HEALTH NEEDS IN SAN DIEGO, SEVEN HOSPITALS AND HEALTHCARE SYSTEMS CAME TOGETHER UNDER THE AUSPICES OF THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC) TO CONDUCT A TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT IDENTIFIES AND PRIORITIZES THE MOST CRITICAL HEALTH-RELATED NEEDS OF SAN DIEGO COUNTY RESIDENTS. PARTICIPATING HOSPITALS WILL USE THE FINDINGS TO GUIDE THEIR COMMUNITY PROGRAMS AND TO MEET IRS REGULATORY REQUIREMENTS THAT NOT FOR PROFIT (TAX EXEMPT) HOSPITALS CONDUCT A HEALTH NEEDS ASSESSMENT IN THE COMMUNITY ONCE EVERY THREE YEARS. PER GUIDANCE FROM AN ADVISORY GROUP OF HOSPITAL REPRESENTATIVES, HASD&IC CONTRACTED WITH THE INSTITUTE OF PUBLIC HEALTH (IPH) AT SAN DIEGO STATE UNIVERSITY TO DESIGN AND IMPLEMENT THE CHNA. THE IPH EMPLOYED A RIGOROUS METHODOLOGY USING BOTH COMMUNITY INPUT (PRIMARY DATA SOURCES) AND QUANTITATIVE ANALYSIS (SECONDARY DATA SOURCES) TO IDENTIFY AND PRIORITIZE THE TOP HEALTH CONDITIONS IN SAN DIEGO COUNTY. SAN DIEGO COUNTY IS A SOCIALLY AND ETHNICALLY DIVERSE COMMUNITY WITH A POPULATION OF 3.2 MILLION PEOPLE. ALTHOUGH THE STUDY AREA FOR THIS CHNA IS THE ENTIRE COUNTY, EACH HOSPITAL HAS THE ABILITY TO USE THE COUNTY-WIDE FINDINGS OR ADAPT THE FINDINGS TO REFLECT THE COMMUNITIES THEY SERVE, AS MUCH OF THE DATA IS AVAILABLE AT ZIP CODE LEVEL. IN ORDER TO PRIORITIZE THE COMMUNITY HEALTH NEEDS, THE IPH DEVELOPED A METHODOLOGY THAT INCLUDED BOTH QUALITATIVE AND QUANTITATIVE DATA SOURCES. QUANTITATIVE DATA INCLUDED HOSPITAL DISCHARGE DATA, STATISTICS FROM THE SAN DIEGO COUNTY HEALTH AND HUMAN SERVICES AGENCY, THE US CENSUS BUREAU, THE CENTERS FOR DISEASE CONTROL, AND OTHERS. THE IPH ALSO SOUGHT DIRECT INPUT FROM THE COMMUNITY THROUGH AN ELECTRONIC SURVEY TO HEALTH EXPERTS AND COMMUNITY LEADERS, KEY INFORMANT INTERVIEWS, AND COMMUNITY FORUMS. HEALTH EXPERT, COMMUNITY LEADER AND RESIDENT FEEDBACK THE IPH AND CHNA ADVISORY WORKGROUP SOUGHT FEEDBACK FROM COMMUNITY LEADERS, HEALTH EXPERTS AND RESIDENTS OF VULNERABLE COMMUNITIES. THIS WAS DONE THROUGH THREE METHODS: AN ELECTRONIC SURVEY FOR COMMUNITY LEADERS AND HEALTH EXPERTS; KEY INFORMANT INTERVIEWS; AND COMMUNITY FORUMS FOR RESIDENTS IN VULNERABLE COMMUNITIES THROUGHOUT SAN DIEGO COUNTY. - ONLINE SURVEY OF HEALTH EXPERTS AND LEADERS INITIAL EMAIL SAMPLE (N=120). TOTAL SURVEYS COMPLETED (N=89). - COMMUNITY FORUMS (106 COMMUNITY RESIDENTS)EL CAJON, OCEANSIDE, ESCONDIDO, LOGAN HEIGHTS, AND SAN YSIDRO CONDUCTED IN NEIGHBORHOODS WITH HIGH COMMUNITY NEED INDEX SCORES - FIVE KEY INFORMANT INTERVIEWS LEADERS CHOSEN BASED ON DISCIPLINE EXPERTISE AND KNOWLEDGE OF HEALTH ISSUES AFFECTING COMMUNITIES |
| PRIORITIZED HEALTH CONDITIONS |
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PRIORITIZED SAN DIEGO COUNTY COMMUNITY HEALTH NEEDS: THE HEALTH NEEDS WERE PRIORITIZED BASED ON THE FOLLOWING CRITERIA: - HAVE A SIGNIFICANT PREVALENCE IN THE COMMUNITY, - CONTRIBUTE SIGNIFICANTLY TO THE MORBIDITY AND MORTALITY IN SAN DIEGO COUNTY, - DISPROPORTIONATELY IMPACT VULNERABLE COMMUNITIES, - REFLECT A NEED THAT EXISTS THROUGHOUT SAN DIEGO COUNTY, AND - CAN BE ADDRESSED THROUGH EVIDENCE-BASED PRACTICES BY HOSPITALS AND HEALTH CARE SYSTEMS. REPORT FINDINGS SAN DIEGO COUNTY COMMUNITY HEALTH NEEDS WHEN THE IPH COMBINED THE RESULTS OF ALL THE DATA AND INFORMATION GATHERED, FOUR CONDITIONS EMERGED CLEARLY AS THE TOP COMMUNITY HEALTH NEEDS IN SAN DIEGO COUNTY (IN ALPHABETICAL ORDER): - CARDIOVASCULAR DISEASE - MENTAL/BEHAVIORAL HEALTH - DIABETES (TYPE 2) - OBESITY HEALTH THEMES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT ONCE ALL THE COMMUNITY INPUT WAS INTEGRATED (SURVEY RESPONDENTS, KEY INTERVIEWEES, AND COMMUNITY FORUM PARTICIPANTS) THE FOLLOWING FIVE BROAD CATEGORIES EMERGED AS RECOMMENDATIONS FOR HOSPITALS TO ORGANIZE COMMUNITY HEALTH PROGRAMS: - ACCESS TO CARE OR INSURANCE - CARE MANAGEMENT - EDUCATION - SCREENING SERVICES - COLLABORATION SCRIPPS HEALTH IMPLEMENTATION PLAN SCRIPPS HEALTH HAS A LONG HISTORY (SINCE OCTOBER 1994) OF RESPONDING TO THE HEALTH NEEDS OF THE COMMUNITIES THEY SERVE, EXTENDING BEYOND TRADITIONAL HOSPITAL CARE TO PROVIDE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THE HEALTH CARE NEEDS OF THE REGION'S MOST VULNERABLE POPULATIONS. WITH THE CHNA COMPLETE AND HEALTH PRIORITY AREAS IDENTIFIED, SCRIPPS HEALTH DEVELOPED A SYSTEM-WIDE CORRESPONDING IMPLEMENTATION PLAN. THE IMPLEMENTATION PLAN TRANSLATES THE RESEARCH AND ANALYSIS PRESENTED IN THE ASSESSMENT INTO ACTUAL, MEASURABLE STRATEGIES AND OBJECTIVES THAT CAN BE CARRIED OUT TO IMPROVE COMMUNITY HEALTH OUTCOMES. SCRIPPS HEALTH CONVENED AN INTERNAL WORKGROUP COMPRISED OF SCRIPPS EXECUTIVES, COMMUNITY BENEFIT REPRESENTATIVES AND CLINICAL CARE LINE LEADERS TO LEAD THE DEVELOPMENT OF THE SCRIPPS HEALTH IMPLEMENTATION PLAN. WHILE SCRIPPS HEALTH CANNOT REALISTICALLY ADDRESS EVERY ISSUE, SCRIPPS HEALTH WILL ENDEAVOR TO RESOLVE THOSE THAT MOST HEAVILY AFFECT OUR PATIENT POPULATIONS, SERVICE AREA AND ARE CONSISTENT WITH OUR STRATEGY AND RESOURCE AVAILABILITY. IN ADDITION TO THE CHNA AND IMPLEMENTATION PLAN, SCRIPPS HEALTH WILL CONTINUE TO MEET COMMUNITY NEEDS BY PROVIDING CHARITY CARE AND UNCOMPENSATED CARE, PROFESSIONAL EDUCATION AND COMMUNITY BENEFIT PROGRAMS. SCRIPPS OFFERS COMMUNITY BENEFIT SERVICES THROUGH OUR FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH SERVICES, WELLNESS CENTERS AND CLINICS. IN SUPPORT OF THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT, AND ONGOING COMMUNITY BENEFIT INITIATIVES, A DETAILED DESCRIPTION OF SCRIPPS STRATEGIES AND CORRESPONDING MEASURES/METRICS FOR THE FOUR HEALTH ISSUES CAN BE FOUND AT SCRIPPS.ORG/COMMUNITYBENEFIT. LISTED BELOW ARE THE PROGRAMS SCRIPPS HEALTH WILL ADDRESS FOR THE HEALTH PRIORITY AREAS IDENTIFIED IN THE CHNA: CARDIOVASCULAR DISEASE - ERIC PAREDES SAVE A LIFE FOUNDATION (SCREENINGS). PREVENT SUDDEN CARDIAC ARREST AND DEATH IN MIDDLE AND HIGH SCHOOL AGED CHILDREN, INCLUDING UNDERSERVED AREAS IN SAN DIEGO COUNTY, THROUGH AWARENESS, EDUCATION AND ACTION. DIABETES - DIABETES COMMUNITY HEALTH EDUCATION AND OUTREACH. PROVIDE OUTREACH AND EDUCATIONAL RESOURCES THAT IMPROVE HEALTH STATUS AND ACCESS FOR THE COMMUNITY AND THE UNDERSERVED POPULATION. - PROJECT DULCE. IMPROVE SELF-MANAGEMENT EDUCATION FOR UNDERSERVED POPULATION LIVING WITH DIABETES. MENTAL AND BEHAVIORAL HEALTH - DEPRESSION SCREENINGS. IMPLEMENT MENTAL HEALTH SCREENINGS AND PROVIDE RESOURCES TO RAISE AWARENESS OF MENTAL HEALTH DISEASE AND ITS SYMPTOMS, AS WELL AS PROVIDE REFERRALS FOR THOSE AT RISK FOR HAVING MENTAL HEALTH PROBLEMS. OBESITY - DULCE MOTHERS. DECREASE THE INCIDENCE OF TYPE 2 DIABETES BY MANAGING A MAJOR DIABETES RISK FACTOR, OBESITY IN UNDERSERVED, ETHNICALLY DIVERSE POPULATIONS BY TESTING THE EFFECTIVENESS OF A WEIGHT MANAGEMENT CURRICULUM DESIGNED FOR LATINO WOMEN DIAGNOSED WITH GESTATIONAL DIABETES (GDM). 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 2013, SCRIPPS CONTRIBUTED $301,570,492 IN UNCOMPENSATED HEALTH CARE, INCLUDING $48,697,171 IN CHARITY CARE, $239,315,221 IN MEDI- CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS AND MEDICARE SHORTFALL, AND $13,558,100 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 67 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. CALIFORNIA'S UNINSURED CALIFORNIA HAD THE GREATEST NUMBER OF UNINSURED RESIDENTS OF ANY STATE, SEVEN MILLION, AND THE SEVENTH LARGEST PERCENTAGE OF UNINSURED UNDER 65 IN THE COUNTRY. MANY OF THE STATE'S UNINSURED ARE EMPLOYED, HOWEVER THE PERCENTAGE OF RESIDENTS WHO RECEIVE COVERAGE THROUGH THEIR JOBS HAS DECLINED DRAMATICALLY, DROPPING FROM 63% IN 1988 TO 54% IN 2012. WHILE PUBLIC INSURANCE HAS MOSTLY OFFSET THIS GAP, 20% OF CALIFORNIANS REMAINS UNINSURED. WITH THE IMPLEMENTATION OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010 (ACA), THE NUMBERS OF UNINSURED RESIDENTS IN CALIFORNIA WILL BE REDUCED, ALTHOUGH A SIGNIFICANT NUMBER WILL BE LEFT BEHIND. THE PERCENTAGE OF CALIFORNIANS WITH EMPLOYER-BASED COVERAGE CONTINUED TO FALL, DROPPING FROM 63 PERCENT IN 1988 TO 53.5 PERCENT IN 2012. 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. 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. CALIFORNIA'S NOT-FOR-PROFIT HOSPITALS ARE NAVIGATING THROUGH A CHANGING AND EXTREMELY UNCERTAIN LANDSCAPE, AS IMPLEMENTATION OF THE ACA MOVES FORWARD WITH MANY UNANSWERED QUESTIONS. AT LEAST 4 MILLION CALIFORNIANS MAY BE ABLE TO OBTAIN HEALTH CARE COVERAGE WHO WERE UNCOVERED BEFORE, MEANING NEW DEMAND ON HOSPITALS AND THE SERVICES THEY PROVIDE. AT THE SAME TIME, DEEP CUTS IN MEDI-CAL AND MEDICARE FUNDING ARE COMING FROM THE STATE AND FEDERAL GOVERNMENTS. CALIFORNIA'S HOSPITALS ALREADY PROVIDE MORE THAN $13 BILLION IN UNREIMBURSED, OR FREE, HEALTH CARE, ACCORDING TO DATA FROM THE CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. REQUIRING HOSPITALS TO ABSORB POTENTIALLY BILLIONS OF DOLLARS MORE IN UNCOMPENSATED CARE, AT A TIME WHEN POLITICIANS ARE CUTTING PAYMENT LEVELS, PUTS THESE HOSPITALS AND THE COMMUNITIES THEY SERVE IN JEOPARDY. 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 |
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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 $47,700. 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: - COMMUNITY HEALTH IMPROVEMENT SERVICES - COMMUNITY BENEFIT OPERATIONS - CASH AND IN-KIND CONTRIBUTIONS - SUBSIDIZED HEALTH SERVICES - COMMUNITY BUILDING ACTIVITIES DURING THIS FISCAL YEAR, SCRIPPS INVESTED $5,866,944 IN COMMUNITY HEALTH SERVICES (INCLUDES SUBSIDIZED HEALTH). THIS FIGURE REFLECTS THE COST ASSOCIATED WITH PROVIDING SUCH ACTIVITIES, INCLUDING SALARIES, MATERIALS AND SUPPLIES, MINUS REVENUE. 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. IN AN EFFORT TO PROVIDE FOR PEOPLE IN NEED, SCRIPPS SPONSORED A NUMBER OF PROGRAMS IN FISCAL YEAR 2013. 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 2013, THE MOST TEAM PROVIDED RECONSTRUCTIVE SURGERIES FOR MORE THAN 486 CHILDREN. (SPONSORED BY SCRIPPS MERCY HOSPITAL, SAN DIEGO AND AFFILIATED PHYSICIANS) SCRIPPS RECUPERATIVE CARE PROGRAM (RCU) THE SCRIPPS RESCUE MISSION PROJECT PROVIDES A SAFE DISCHARGE FOR CHRONICALLY HOMELESS PATIENTS WITH ONGOING MEDICAL NEEDS. ALL THESE PATIENTS ARE UNFUNDED AND MANY HAVE SUBSTANCE ABUSE AND/OR MENTAL HEALTH ISSUES - ADDITIONAL PROBLEMS THAT MAKE THESE PATIENTS DIFFICULT TO PLACE POST-ACUTE. RN CASE MANAGEMENT OVERSIGHT IS PROVIDED BY SCRIPPS HEALTH WITH PHYSICIAN BACKUP TO ENSURE COMPLETION OF THEIR MEDICAL RECOVERY GOALS. THE RESCUE MISSION PROVIDES A SAFE, SECURE ENVIRONMENT WITH 24HR SUPERVISION, MEDICATION OVERSIGHT, MEALS, CLOTHING, COUNSELING, ASSISTANCE WITH MEDI-CAL AND DISABILITY APPLICATION, PLUS HELP FINDING HOUSING. SCRIPPS HEALTH PAYS A DAILY FEE TO THE RCU TO SUPPORT THE PATIENT'S COST IN THE PROGRAM. FOR FY13, TOTAL COST SAVINGS FOR SCRIPPS HAS BEEN OVER $176,000. 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 2013. (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 2013, 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 2013 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 2013 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. |
| BACK PAIN |
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MOST PEOPLE IN THE UNITED STATES WILL EXPERIENCE LOWER BACK PAIN AT LEAST ONCE DURING THEIR LIVES. BACK PAIN IS ONE OF THE MOST COMMON REASONS PEOPLE GO TO THE DOCTOR OR MISS WORK. SOME CAUSES OF BACK PAIN INCLUDE MUSCLE OR LIGAMENT STRAIN, BULGING OR RUPTURED DISKS, ARTHRITIS, SKELETAL IRREGULARITIES AND OSTEOPOROSIS. RISK FACTORS FOR BACK PAIN INCLUDE: - EXCESS WEIGHT OR OBESITY - LACK OF EXERCISE - IMPROPER LIFTING - THOSE WITH PSYCHOLOGICAL ISSUES, SUCH AS DEPRESSION AND ANXIETY (REASONS UNKNOWN) DISPARITIES IN THE UNITED STATES (NHIS, 2010): - ADULTS WITHOUT A HIGH SCHOOL DIPLOMA WERE MORE LIKELY TO HAVE LOWER BACK PAIN. - ADULTS IN POOR FAMILIES WERE MORE LIKELY TO EXPERIENCE LOWER BACK PAIN. - WOMEN ARE MORE LIKELY THAN MALES TO HAVE EXPERIENCED PAIN IN THE LOWER BACK (30.0% VERSUS 26.0%). HEALTHY PEOPLE 2020: - GOAL: REDUCED ACTIVITY LIMITATION DUE TO CHRONIC BACK CONDITIONS. - TARGET: 27.6 PER 1,000. - BASELINE: 30.7 IN 2008 DATA SOURCE: NATIONAL HEALTH INTERVIEW SURVEY, CDC, NCHS BURDEN: - LOWER BACK PAIN HAS BEEN REPORTED AS THE 6TH MOST COSTLY CONDITION IN THE UNITED STATES. - 29% OF ADULTS OVER THE AGE OF 18 HAVE PAIN IN THE LOWER BACK. - BACK PAIN AFFECTS 60% TO 80% OF PEOPLE IN THEIR LIFETIME. DURING FISCAL YEAR 2013, SCRIPPS ENGAGED IN THE FOLLOWING HEALTHY BACK PAIN PREVENTION AND TREATMENT ACTIVITIES. SCRIPPS MENDE WELL BEING THE SCRIPPS MENDE WELL BEING OFFERED VARIOUS LECTURES ON CHRONIC PAIN MANAGEMENT AND NEW ALTERNATIVES TO HEALING. THESE LECTURES FOCUSED ON ADVANCED PROGRAMS, TREATMENTS AND RELIEF FROM PAIN AND SUFFERING. THIS ORIENTATION INCLUDED RELATED IRRITABLE BOWEL, INSOMNIA, STRESS, BACK PAIN, DEPRESSION AND CHRONIC FATIGUE INFORMATION. THESE LECTURES WERE FREE AND OPENED TO THE COMMUNITY. (SPONSORED BY SCRIPPS MEMORIAL HOSPITAL LA JOLLA, COMMUNITY BENEFITS). 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. BREAST CANCER BREAST CANCER IS DEFINED AS ANY CANCEROUS GROWTH THAT INHABITS THE TISSUES IN THE BREAST. IN THIS TYPE OF CANCER, THE CELLS IN THE BREAST REGION GROW ABNORMALLY AND IN AN UNCONTROLLED WAY. THOUGH BREAST CANCER IS MOSTLY FOUND IN WOMEN, IN RARE CASES IT IS ALSO FOUND IN MEN. IN THE U.S. ALONE, ONE OUT OF EVERY EIGHT WOMEN HAS THIS DISEASE. COMMON TYPES INCLUDE: DUCTUAL CARCINOMA BREAST CANCER AND LOBULAR CARCINOMA BREAST CANCER, NAMED FOR THE LOCATION OF THE BREAST IN WHICH THEY BEGAN. NOT COUNTING SOME KINDS OF SKIN CANCER, BREAST CANCER IN THE UNITED STATES IS: - THE MOST COMMON CANCER IN WOMEN, NO MATTER YOUR RACE OR ETHNICITY. - THE MOST COMMON CAUSE OF DEATH FROM CANCER AMONG HISPANIC WOMEN. - THE SECOND MOST COMMON CAUSE OF DEATH FROM CANCER AMONG WHITE, BLACK, ASIAN/PACIFIC ISLANDER, AND AMERICAN INDIAN/ALASKA NATIVE WOMEN. BREAST CANCER DISPARITIES IN THE UNITED STATES: ALTHOUGH THE INCIDENCE OF BREAST CANCER IN WHITE, NON-HISPANIC FEMALES IS GREATER THAN THAT OF BLACK FEMALES, THE MORTALITY RATES AMONG BLACK FEMALES IS MUCH GREATER THAN THAT OF WHITE, NON-HISPANIC FEMALES. COLORECTAL CANCER NCI DEFINES COLORECTAL CANCER AS ANY CANCER "THAT FORMS IN THE TISSUES OF THE COLON OR RECTUM." MOST COLON CANCERS ARE ADENOCARCINOMAS (CANCERS THAT BEGIN IN CELLS THAT MAKE AND RELEASE MUCUS AND OTHER FLUIDS). OF CANCERS THAT AFFECT BOTH MEN AND WOMEN, COLORECTAL CANCER IS THE SECOND LEADING CAUSE OF CANCER-RELATED DEATHS IN THE UNITED STATES. COLORECTAL CANCER ALSO IS ONE OF THE MOST COMMONLY DIAGNOSED CANCERS IN THE UNITED STATES; AMONG ALL MEN AND WOMEN IT IS THE THIRD MOST COMMON CANCER IN THE US TODAY. CLINICAL SYMPTOMS INCLUDE BLOOD IN/ON THE STOOL, PERSISTENT CRAMPING, PAINS, AND ACHING IN THE STOMACH, AND UNEXPLAINED WEIGHT-LOSS. RISK FACTORS FOR COLORECTAL CANCER INCLUDE: - AGE: 90% OF ALL CASES DIAGNOSED ARE IN PEOPLE ABOVE THE AGE OF 50 YEARS. - INFLAMMATORY BOWEL DISEASE. - A PERSONAL OR FAMILY HISTORY OF COLORECTAL CANCER OR COLORECTAL POLYPS. - A GENETIC SYNDROME OR HEREDITARY NON-POLYPOSIS COLORECTAL CANCER (LYNCH SYNDROME). - LIFESTYLE FACTORS SUCH AS, LACK OF REGULAR PHYSICAL ACTIVITY, LOW FRUIT AND VEGETABLE INTAKE, LOW-FIBER AND HIGH-FAT DIETS, ALCOHOL CONSUMPTION, TOBACCO USE, AND BEING OVERWEIGHT OR OBESE. COLORECTAL CANCER PREVALENCE IN THE UNITED STATES: SEER ESTIMATES THAT 1,140,161 MEN AND WOMEN CURRENTLY HAVE BEEN DIAGNOSED WITH COLORECTAL CANCERS. LUNG CANCER LUNG CANCER IS THE LEADING CAUSE OF CANCER DEATH AND THE SECOND MOST DIAGNOSED CANCER IN BOTH MEN AND WOMEN IN THE UNITED STATES. IN 2008, 14% OF ALL CANCER DIAGNOSES AND 28% OF ALL CANCER DEATHS WERE DUE TO LUNG CANCER. LUNG CANCERS USUALLY ARE GROUPED INTO TWO MAIN TYPES CALLED SMALL CELL AND NON-SMALL CELL. THESE TYPES OF LUNG CANCER PROGRESS IN DIFFERENT MANNERS, AND THEREFORE REQUIRE DIFFERENT COURSES OF TREATMENT. NON-SMALL CELL LUNG CANCER IS MORE COMMON THAN SMALL CELL LUNG CANCER. CLINICAL SYMPTOMS CAN INCLUDE, CHEST PAIN, SHORTNESS OF BREATH, WHEEZING, COUGHING UP BLOOD, CONSTANT FATIGUE, UNEXPLAINED WEIGHT LOSS, AND COUGHING THAT PROGRESSIVELY WORSENS AND DOES NOT SUBSIDE. SOME FACTS ABOUT LUNG CANCER IN 2008: - 208,493 PEOPLE IN THE UNITED STATES WERE DIAGNOSED WITH LUNG CANCER, INCLUDING 111,886 MEN AND 96,607 WOMEN. - 158,592 PEOPLE IN THE UNITED STATES DIED FROM LUNG CANCER, INCLUDING 88,541 MEN AND 70,051 WOMEN. LUNG CANCER PREVALENCE IN THE UNITED STATES:ON JANUARY 1, 2009, IN THE UNITED STATES THERE WERE APPROXIMATELY 387,762 MEN AND WOMEN ALIVE WHO HAD A HISTORY OF CANCER OF THE LUNG AND BRONCHUS - 178,490 MEN AND 209,272 WOMEN. |
| PROSTATE CANCER |
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NCI DEFINES PROSTATE CANCER AS A CANCER THAT FORMS IN TISSUES OF THE PROSTATE, A GLAND IN THE MALE REPRODUCTIVE SYSTEM FOUND BELOW THE BLADDER AND IN FRONT OF THE RECTUM. WHILE CANCEROUS CELLS WITHIN THE PROSTATE ITSELF ARE GENERALLY NOT DEADLY ON THEIR OWN, AS A CANCEROUS TUMOR GROWS SOME OF THE CELLS CAN BREAK OFF AND SPREAD TO OTHER PARTS OF THE BODY THROUGH THE LYMPH OR THE BLOOD, THROUGH THE PROCESS OF METASTASIS. PROSTATE CANCER USUALLY OCCURS IN OLDER MEN. CLINICAL SYMPTOMS INCLUDE: DIFFICULTY STARTING URINATION, WEAK/INTERRUPTED FLOW OF URINE, PAIN/BURNING DURING URINATION, FREQUENT URINATION, BLOOD IN URINE OR SEMEN, AND UNSPECIFIED PAIN IN THE BACK, HIPS OR PELVIS. NOT COUNTING SOME FORMS OF SKIN CANCER, PROSTATE CANCER IN THE UNITED STATES IS: - THE MOST COMMON CANCER IN MEN, NO MATTER YOUR RACE OR ETHNICITY. - THE SECOND MOST COMMON CAUSE OF DEATH FROM CANCER AMONG WHITE, AFRICAN AMERICAN, AMERICAN INDIAN/ALASKA NATIVE, AND HISPANIC MEN. - THE FOURTH MOST COMMON CAUSE OF DEATH FROM CANCER AMONG ASIAN/PACIFIC ISLANDER MEN. RISK FACTORS FOR PROSTATE CANCER INCLUDE: - AGE: THE OLDER A MAN IS, THE GREATER HIS RISK FOR GETTING PROSTATE CANCER. - FAMILY HISTORY: A MAN WITH A FATHER, BROTHER, OR SON WHO HAS HAD PROSTATE CANCER IS TWO TO THREE TIMES MORE LIKELY TO DEVELOP THE DISEASE HIMSELF. - RACE: PROSTATE CANCER IS MORE COMMON IN SOME RACIAL AND ETHNIC GROUPS THAN IN OTHERS. PROSTATE CANCER PREVALENCE IN THE UNITED STATES: SEER ESTIMATES THAT 2,496,784 MALES CURRENTLY HAVE BEEN DIAGNOSED WITH CANCER OF THE PROSTATE. SKIN CANCER SKIN CANCER IS A CANCER THAT FORMS IN THE VARIOUS TISSUES OF THE SKIN, AND IS THE MOST COMMON FORM OF CANCER IN THE UNITED STATES. THE TWO MOST PREVALENT TYPES OF SKIN CANCER-BASAL CELL (FORMS IN THE LOWER PART OF THE EPIDERMIS) AND SQUAMOUS CELL (FORMS IN THE FLAT CELLS THAT FORM THE SURFACE OF THE SKIN) CARCINOMAS-ARE HIGHLY CURABLE. HOWEVER, THE THIRD MOST COMMON SKIN CANCER, MELANOMA, FORMS IN THE CELLS THAT MAKE THE PIGMENT MELANIN AND ARE CONSIDERED MORE DANGEROUS. ABOUT 65%-90% OF MELANOMAS ARE CAUSED BY EXPOSURE TO ULTRAVIOLET (UV) LIGHT. CLINICAL SYMPTOMS INCLUDE MOLES THAT ARE ASYMMETRICAL, HAVE IRREGULAR BORDERS, UNEVEN COLORATION, EXPERIENCE INCREASES IN DIAMETER, OR HAVE EVOLVED OR CHANGED IN RECENT WEEKS OR MONTHS. RISK FACTORS FOR THE THREE MOST COMMON TYPES OF SKIN CANCER: - SUNLIGHT - SEVERE, BLISTERING SUNBURNS - LIFETIME SUN EXPOSURE - TANNING MELANOMA OF THE SKIN PREVALENCE IN THE UNITED STATES: SEER ESTIMATES THAT 876,344 PERSONS CURRENTLY HAVE BEEN DIAGNOSED WITH MELANOMA OF THE SKIN. 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 2013. 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. (SPONSORED BY SCRIPPS GREEN HOSPITAL) |
| SCRIPPS MERCY HOSPITAL, CHULA VISTA: COMMUNITY BENEFIT SERVICES, BREAST |
HEALTH CLINICAL SERVICES |
A TOTAL OF 3,873 WOMEN WERE REFERRED TO CLINICAL BREAST HEALTH SERVICES AT COMMUNITY AND SCRIPPS MERCY HOSPITAL, CHULA VISTA RADIOLOGY SERVICES. A TOTAL OF 4,431 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 25 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) SCRIPPS MERCY HOSPITAL, CHULA VISTA RADIOLOGY, POSITIVE BREAST CANCER PATIENT SUPPORT A TOTAL OF 40 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. THE WORLD HEALTH ORGANIZATION DEFINES CARDIOVASCULAR DISEASE (CVD) AS A GROUP OF DISORDERS OF THE HEART AND BLOOD VESSELS THAT INCLUDE CORONARY HEART DISEASE, CEREBROVASCULAR DISEASE, PERIPHERAL ARTERIAL DISEASE, RHEUMATIC HEART DISEASE, CONGENITAL HEART DISEASE, DEEP VEIN THROMBOSIS AND PULMONARY EMBOLISM. CORONARY HEART DISEASE IS THE MOST COMMON FORM OF HEART DISEASE. HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, AND SMOKING ARE ALL RISK FACTORS THAT COULD LEAD TO CVD AND STROKE. ABOUT HALF OF AMERICANS (49%) HAVE AT LEAST ONE OF THESE THREE RISK FACTORS. HEART DISEASE IS THE LEADING CAUSE OF DEATH IN THE UNITED STATES. - HEART DISEASE IS THE LEADING CAUSE OF DEATH FOR PEOPLE OF MOST RACIAL/ETHNIC GROUPS IN THE UNITED STATES, INCLUDING AFRICAN AMERICANS, HISPANICS AND WHITES. - BETWEEN 70% AND 89% OF SUDDEN CARDIAC EVENTS OCCUR IN MEN. - ABOUT TWO-THIRDS (64%) OF WOMEN WHO DIE SUDDENLY OF CORONARY HEART DISEASE HAVE NO PREVIOUS SYMPTOMS. PREVALENCE DATA: IN 2010 4.1% OF ADULTS LIVING IN SAN DIEGO HAD EVER HAD CORONARY HEART DISEASE. IN 2010 3.6% OF ADULTS LIVING IN CALIFORNIA HAD EVER HAD CORONARY HEART DISEASE. DURING FISCAL YEAR 2013, SCRIPPS ENGAGED IN THE FOLLOWING HEART HEALTH, CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT ACTIVITIES. AMERICAN HEART WALK IN ADDITION, SCRIPPS EMPLOYEES VOLUNTEERED THEIR TIME TO COORDINATE WALKER PARTICIPATION AND FUNDRAISING EFFORTS. THE SAN DIEGO HEART WALK RAISED MORE THAN $1.19 MILLION. IN 2013, MORE THAN 1,700 SCRIPPS HEART WALK PARTICIPANTS - EMPLOYEES, FAMILIES, AND FRIENDS - WALKED TO HELP RAISE MORE THAN $142,000. ADDITIONALLY, SCRIPPS REACHED OUT TO THE COMMUNITY AT THE EVENT AND PROVIDED HEALTH EDUCATION MATERIALS AND GIVEAWAYS.(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, 30 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 2,991 CHILDREN BEFORE THEY COULD PARTICIPATE IN ORGANIZED SPORTS AND OTHER ACTIVITIES. THE GIFT ALSO PURCHASED AUTOMATED EXTERNAL DEFIBRILLATORS FOR SCHOOLS. |
| DIABETES |
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THE 2011 NATIONAL DIABETES FACT SHEET (THE MOST RECENT YEAR DATA IS AVAILABLE) ESTIMATES 25.8 MILLION CHILDREN AND ADULTS IN THE U.S., 8.3 PERCENT OF THE POPULATION, HAVE DIABETES. THESE STATISTICS INCLUDE 18.8 MILLION PEOPLE WITH DIAGNOSED DIABETES AND ANOTHER 7.0 MILLION PEOPLE WITH UNDIAGNOSED DIABETES. EACH YEAR 1.9 MILLION NEW CASES OF DIABETES ARE DIAGNOSED IN PEOPLE 20 AND OLDER. 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. THE DIABETES DEATH RATE WAS 17.4 PER 100,000 IN 2009. 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 II DIABETES, ONCE KNOWN AS ADULT-ONSET OR NONINSULIN-DEPENDENT DIABETES, IS A CHRONIC CONDITION THAT AFFECTS THE WAY YOUR BODY METABOLIZES SUGAR (GLUCOSE), WHICH IS YOUR BODY'S MAIN SOURCE OF FUEL. WITH TYPE 2 DIABETES, YOUR BODY EITHER RESISTS THE EFFECTS OF INSULIN - A HORMONE THAT REGULATES THE MOVEMENT OF SUGAR INTO YOUR CELLS - OR DOESN'T PRODUCE ENOUGH INSULIN TO MAINTAIN A NORMAL GLUCOSE LEVEL. IF LEFT UNTREATED, TYPE 2 DIABETES CAN BE LIFE-THREATENING. CLINICAL SYMPTOMS CAN INCLUDE: FREQUENT URINATION, EXCESSIVE THIRST, EXTREME HUNGER, SUDDEN VISION CHANGES, UNEXPLAINED WEIGHT LOSS, EXTREME FATIGUE, SORES THAT ARE SLOW TO HEAL, AND INCREASED NUMBER OF INFECTIONS. SOME ALARMING FACTS ABOUT TYPE 2 DIABETES: - ABOUT 1.9 MILLION PEOPLE AGED 20 YEARS OR OLDER WERE NEWLY DIAGNOSED WITH DIABETES IN 2010 IN THE U.S.39 - DIABETES IS THE LEADING CAUSE OF KIDNEY FAILURE, NON-TRAUMATIC LOWER-LIMB AMPUTATIONS, AND NEW CASES OF BLINDNESS AMONG ADULTS IN THE UNITED STATES. - DIABETES IS A MAJOR CAUSE OF HEART DISEASE AND STROKE, AND IS THE 7TH LEADING CAUSE OF DEATH IN THE UNITED STATES. SOME RISK FACTORS FOR DEVELOPING DIABETES INCLUDE: - BEING OVERWEIGHT OR OBESE. - HAVING A PARENT, BROTHER, OR SISTER WITH DIABETES. - HAVING HIGH BLOOD PRESSURE MEASURING 140/90 OR HIGHER. - BEING PHYSICALLY INACTIVE-EXERCISING FEWER THAN THREE TIMES A WEEK. DIABETES PREVALENCE: U.S. AGE-ADJUSTED PREVALENCE RATES FOR ADULT DIAGNOSED DIABETES FOR THE YEAR OF 2010 WERE 8.7%, AS COMPARED TO A RATE OF 3.7% RATE IN 1980. THE STATE OF CALIFORNIA REPORTED A RATE OF 8.9% FOR THE SAME YEAR. MORE THAN SEVEN 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 2013, SCRIPPS SPONSORED THE FOLLOWING DIABETES MANAGEMENT INITIATIVES. PROJECT DULCE A COLLABORATION BETWEEN THE SCRIPPS 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 2013, PROJECT DULCE PROVIDED 7,128 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 253 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. DEMENTIA AND ALZHEIMER'S DISEASE DEMENTIA IS A CLINICAL SYNDROME OF DECLINE IN MEMORY AND OTHER THINKING ABILITIES. IT IS CAUSED BY VARIOUS DISEASES AND CONDITIONS THAT RESULT IN DAMAGE TO BRAIN CELLS AND LEAD TO DISTINCT SYMPTOM PATTERNS AND DISTINGUISHING BRAIN ABNORMALITIES. ALZHEIMER 'S DISEASE (AD) IS A PROGRESSIVE BRAIN DISORDER THAT GRADUALLY DESTROYS A PERSON'S MEMORY AND ABILITY TO LEARN, REASON, MAKE JUDGMENTS, COMMUNICATE AND CARRY OUT DAILY ACTIVITIES SUCH AS BATHING AND EATING. ALZHEIMER'S IS THE SIXTH LEADING CAUSE OF DEATH IN THE UNITED STATES. - AD IS THE MOST COMMON FORM OF DEMENTIA ACCOUNTING FOR 70% OF ALL CAUSES OF DEMENTIA. - MOST PEOPLE WITH AD ARE DIAGNOSED AT AGE 65 OR OLDER. - WOMEN ARE MORE LIKELY THAN MEN TO HAVE AD. - PEOPLE LIVING WITH DEMENTIA ARE AT GREATER RISK FOR GENERAL DISABILITY AND EXPERIENCE FREQUENT INJURY FROM FALLS. - OLDER ADULTS WITH DEMENTIA ARE 3 TIMES MORE LIKELY TO HAVE PREVENTABLE HOSPITALIZATIONS. FINANCIAL BURDEN: - PAYMENTS FOR AD CARE ARE ESTIMATED AT $200 BILLION IN 2012 WITHIN THE UNITED STATES. PREVALENCE: - THERE ARE MORE THAN 5.2 MILLION PEOPLE IN THE UNITED STATES LIVING WITH AD. AS THE POPULATION AGES THE NUMBER IS EXPECTED TO TRIPLE BY 2050. - IN CALIFORNIA THERE ARE 588,208 PEOPLE 55 YEARS AND OLDER LIVING WITH AD. ONE TENTH OF AD PATIENTS LIVE IN CALIFORNIA. DURING FISCAL YEAR 2013, SCRIPPS ENGAGED IN THE FOLLOWING PREVENTION AND TREATMENT ACTIVITIES. PURCHASE EKG MACHINES. THE DONATION HELPED THE FOUNDATION PROVIDE ELECTROCARDIOGRAM AND ECHOCARDIOGRAM SCREENINGS FOR 2,991 CHILDREN BEFORE THEY COULD PARTICIPATE IN ORGANIZED SPORTS AND OTHER ACTIVITIES. THE GIFT ALSO PURCHASED AUTOMATED EXTERNAL DEFIBRILLATORS FOR SCHOOLS. |
| SENIOR HEALTH AND WELL-BEING PROGRAMS |
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THE GOAL IS TO INCREASE HEALTH CARE, INFORMATION AND PREVENTATIVE SERVICES FOR SENIORS/OLDER ADULTS IN THE SOUTH BAY. EACH MONTH A VARIETY OF SENIOR PROGRAMS ARE HELD AT LOCAL SENIOR CENTERS, CHURCHES AND SENIOR HOUSING. SOME OF THESE ACTIVITIES INCLUDED DEMENTIA, ALZHEIMER'S AND PAIN MANAGEMENT. (SPONSORED BY SCRIPPS MERCY HOSPITAL, CHULA VISTA, COMMUNITY BENEFITS) MATERNAL CHILD HEALTH & HIGH RISK PREGNANCY 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: - ALCOHOL, TOBACCO AND ILLEGAL SUBSTANCES DURING PREGNANCY, WHICH ARE MAJOR RISK FACTORS FOR LOW BIRTH WEIGHT AND OTHER POOR OUTCOMES. - VERY LOW BIRTH WEIGHT ASSOCIATED WITH PRETERM BIRTH, SPONTANEOUS ABORTION, LOW PRE-PREGNANCY WEIGHT AND SMOKING. - 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. HIGH RISK PREGNANCY HIGH RISK PREGNANCY CAN BE THE RESULT OF A MEDICAL CONDITION PRESENT BEFORE PREGNANCY OR A MEDICAL CONDITION THAT DEVELOPS DURING PREGNANCY FOR EITHER MOM OR BABY AND CAUSES THE PREGNANCY TO BECOME HIGH RISK. A HIGH RISK PREGNANCY CAN POSE PROBLEMS BEFORE, DURING OR AFTER DELIVERY AND MIGHT REQUIRE SPECIAL MONITORING THROUGHOUT THE PREGNANCY. RISK FACTORS: - ADVANCED MATERNAL AGE: INCREASED RISK FOR MOTHERS 35 YEARS AND OLDER. - LIFESTYLE CHOICES: SMOKING, ALCOHOL CONSUMPTION, USE OF ILLEGAL DRUGS. - MEDICAL HISTORY: PRIOR HIGH RISK PREGNANCIES OR DELIVERIES, FETAL GENETIC CONDITIONS, FAMILY HISTORY OF GENETIC CONDITIONS. - UNDERLYING CONDITIONS: DIABETES, HIGH BLOOD PRESSURE AND EPILEPSY. - MULTIPLE PREGNANCY. - OBESITY DURING PREGNANCY. UNITED STATES GENERAL STATISTICS: - THE NUMBER OF BIRTHS DECLINED BY 3% FROM 2009 TO 2010. - GENERAL FERTILITY RATE ALSO DECLINED BY 3%. - TEENAGE BIRTH RATE FELL 10% FROM 2009 TO 2010. - THE BIRTH RATE OF WOMEN AGED 40-44 YEARS CONTINUED TO RISE. - CESAREAN DELIVERY RATE WAS DOWN FOR THE FIRST YEAR SINCE 1996, TO 32.8% - IN SAN DIEGO COUNTY, THE INFANT MORTALITY RATE WAS 4.4 DEATHS PER 1,000 LIVE BIRTHS IN 2009. SCRIPPS HEALTH CONTINUED TO ENHANCE PRENATAL EDUCATION FOR LOW-INCOME WOMEN IN SAN DIEGO COUNTY IN FISCAL YEAR 2013. THE FOLLOWING ARE SOME EXAMPLES. SCRIPPS MEMORIAL HOSPITAL LA JOLLA COMMUNITY BENEFIT SERVICES - 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. - MAINTAINED EXISTING PRENATAL EDUCATION SERVICES IN ALL REGIONS OF THE COUNTY, ENSURING THAT PROGRAMS CONTINUED TO DEMONSTRATE A SATISFACTION RATING ABOVE 90 PERCENT. - PROVIDED AND SUPPORTED WEEKLY BREASTFEEDING SUPPORT GROUPS AT FIVE LOCATIONS THROUGHOUT SAN DIEGO COUNTY, INCLUDING TWO WITH BILINGUAL SERVICES. - OFFERED A MATERNAL CHILD HEALTH EDUCATION SERIES IN NORTH COUNTY COVERING DOGS AND BABIES, SAFETY, GRAND PARENTING AND BABY SITTER SAFETY. - 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. - OFFERED THE DOGS AND BABIES PROGRAMS QUARTERLY, WITH MORE THAN 40 ATTENDEES. - OFFERED WEEKLY MOMMY AND ME YOGA PROGRAMS FOR NEW PARENTS. - OFFERED A PRENATAL YOGA PROGRAM FOR EXPECTANT WOMEN IN SAN DIEGO COUNTY. - OFFERED A PREGNANCY NUTRITION PROGRAM QUARTERLY AT SCRIPPS MEMORIAL HOSPITAL LA JOLLA. - 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 350 SERVICES, INCLUDING HOME VISITS, REFERRALS, DATA ENTRY, FOLLOW-UP CALLS, PARENTING CLASSES AND OTHERS. A TOTAL OF 260 PARENTS PARTICIPATED IN PARENTING CLASSES; 225 SESSIONS PROVIDED. (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 2013, THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS FOR 100,380 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). 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 2009, THERE WERE MORE THAN 949 DEATHS, MORE THAN 21,149 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. FALLS WERE THE MOST COMMON CAUSE OF UNINTENTIONAL INJURY IN 2009, FOLLOWED BY MOTOR-VEHICLE INJURIES. THE FOLLOWING ARE A NUMBER OF SCRIPPS HEALTH PROGRAMS THAT ADDRESSED UNINTENTIONAL INJURIES AND VIOLENCE FOR FISCAL YEAR 2013. |
| AARP DRIVER SAFETY PROGRAM |
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A FOUR-HOUR SUPERVISED TRAUMA VISITATION PROGRAM FOR YOUNG DRIVERS AGES 14 AND UP TO SHOW THEM THE REALISTIC CONSEQUENCES OF DRIVING UNDER THE INFLUENCE. PARTICIPANTS VISIT THE TRAUMA ROOM, ER, ICU, CAT SCAN AND OTHER HOSPITAL AREAS. (SPONSORED BY SCRIPPS MERCY HOSPITAL) EVERY 15 MINUTES ALCOHOL CAN BE ATTRIBUTED TO MORE THAN 100,000 DEATHS IN THE U.S. ANNUALLY, INCLUDING 41% OF ALL TRAFFIC FATALITIES. THE EVERY 15 MINUTES PROGRAM IS A TWO-DAY IMMERSION EXPERIENCE FOR TEENS ON THE REALISTIC CONSEQUENCES OF DRINKING AND DRIVING, WHICH INVOLVES THE SCHOOLS, LAW ENFORCEMENT, COURTS, EMERGENCY SERVICE PROVIDERS, AND THE MORTUARY. THE "INJURED" STUDENTS ARE TAKEN TO SCRIPPS MERCY TRAUMA CENTER. THIS PROGRAM IS SPONSORED JOINTLY BY LOCAL HIGH SCHOOLS, COUNTY POLICE AND SHERIFFS DEPARTMENTS, AMBULANCE SERVICES, AND EMERGENCY DEPARTMENTS (SPONSORED BY SCRIPPS MERCY HOSPITAL) 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. SPORTS CONCUSSION PROGRAM, REHABILITATION CENTER AT SCRIPPS MEMORIAL HOSPITAL IN 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. OBESITY OBESITY IS A MEDICAL CONDITION IN WHICH EXCESS BODY FAT HAS ACCUMULATED TO THE EXTENT THAT IT MAY HAVE AN ADVERSE EFFECT ON HEALTH. OVERWEIGHT AND OBESITY RANGES ARE DETERMINED USING WEIGHT AND HEIGHT TO CALCULATE A NUMBER KNOWN AS "BODY MASS INDEX" (BMI). AN ADULT WITH A BMI BETWEEN 25 AND 29.9 IS CONSIDERED OVERWEIGHT, WHILE AN ADULT WHO HAS A BMI OF 30 OR HIGHER IS CONSIDERED OBESE. FOR CHILDREN AND ADOLESCENTS AGED 2-19, OVERWEIGHT IS DEFINED AS A BMI AT OR ABOVE THE 85TH PERCENTILE AND LOWER THAN THE 95TH PERCENTILE FOR CHILDREN OF THE SAME AGE AND SEX, WHILE OBESE IS DEFINED AS A BMI AT OR ABOVE THE 95TH PERCENTILE FOR CHILDREN OF THE SAME AGE AND SEX. IN SAN DIEGO COUNTY, ACCORDING TO THE 2009 CALIFORNIA HEALTH INTERVIEW SURVEY, 22.1% OF ADULTS AGED 20 YEARS AND OLDER WERE OBESE (BMI 30.0 OR HIGHER) BASED ON THEIR HEIGHT AND WEIGHT. SOME FACTS ABOUT OBESITY IN THE UNITED STATES: - IN 2009, MORE THAN ONE-THIRD OF U.S. ADULTS (35.7%) WERE OBESE AND 16.9% OF CHILDREN AND ADOLESCENTS WERE CONSIDERED OBESE. - OBESITY-RELATED CONDITIONS INCLUDE HEART DISEASE, STROKE, TYPE 2 DIABETES AND CERTAIN TYPES OF CANCER, WHICH ARE SOME OF THE LEADING CAUSES OF PREVENTABLE DEATH. HEALTH CONSEQUENCES DUE TO OVERWEIGHT AND OBESITY: RESEARCH HAS SHOWN THAT AS WEIGHT INCREASES TO REACH THE LEVELS OF "OVERWEIGHT" AND "OBESITY," THE RISKS FOR THE FOLLOWING CONDITIONS ALSO INCREASES: - CORONARY HEART DISEASE - TYPE 2 DIABETES - CANCERS (ENDOMETRIAL, BREAST, AND COLON) - HYPERTENSION (HIGH BLOOD PRESSURE) - STROKE - LIVER AND GALLBLADDER DISEASE - SLEEP APNEA AND RESPIRATORY PROBLEMS - OSTEOARTHRITIS OVERWEIGHT AND OBESITY ASSOCIATED COSTS: IN 2008, MEDICAL COSTS ASSOCIATED WITH OBESITY WERE ESTIMATED AT $147 BILLION; THE MEDICAL COSTS FOR PEOPLE WHO ARE OBESE WERE $1,429 HIGHER THAN THOSE OF NORMAL WEIGHT. 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. 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): - GENETIC PREDISPOSITION - BEHAVIOR (DIETARY PATTERNS AND PHYSICAL ACTIVITY) - ENVIRONMENTAL INFLUENCES - CULTURAL INFLUENCES - SOCIOECONOMIC STATUS 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 2013, 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 2013, THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS FOR 100,380 WOMEN AND CHILDREN IN SOUTH AND CENTRAL SAN DIEGO. (SPONSORED BY SCRIPPS MERCY HOSPITAL, SAN DIEGO) |
| LIVE HEALTHY FAMILY NUTRITION PROGRAM |
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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 ILLNESS MENTAL HEALTH IS DEFINED AS "A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, AND NOT MERELY THE ABSENCE OF DISEASE". MENTAL ILLNESS IS DEFINED AS "COLLECTIVELY ALL DIAGNOSABLE MENTAL DISORDERS" OR "HEALTH CONDITIONS THAT ARE CHARACTERIZED BY ALTERATIONS IN THINKING, MOOD, OR BEHAVIOR (OR SOME COMBINATION THEREOF) ASSOCIATED WITH DISTRESS AND/OR IMPAIRED FUNCTIONING". DEPRESSION: - DEPRESSION IS THE MOST COMMON TYPE OF MENTAL ILLNESS, AFFECTING MORE THAN 26% OF THE U.S. ADULT POPULATION. - IT HAS BEEN ESTIMATED THAT BY THE YEAR 2020, DEPRESSION WILL BE THE SECOND LEADING CAUSE OF DISABILITY THROUGHOUT THE WORLD, TRAILING ONLY ISCHEMIC HEART DISEASE. DISPARITIES: - MALES COMMIT SUICIDE FOUR TIMES MORE THAN FEMALES. - YOUNGER AMERICAN ADULTS, AGED 18-24 YEARS, SUFFERED THE MOST MENTAL HEALTH DISTRESS. - ADULTS WITH THE LOWEST INCOME OR EDUCATION REPORT MORE UNHEALTHY DAYS THAN THOSE WITH HIGHER INCOME OR EDUCATION. - MENTAL ILLNESS IS ASSOCIATED WITH CHRONIC DISEASES SUCH AS CARDIOVASCULAR DISEASE, DIABETES, AND OBESITY. PREVALENCE: - ABOUT 25% OF U.S. ADULTS HAVE A MENTAL ILLNESS (BRFSS, 2004). - NEARLY 50% OF U.S. ADULTS WILL DEVELOP AT LEAST ONE MENTAL ILLNESS DURING THEIR LIFETIME. 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. 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 - LIKE MANY BEHAVIORAL HEALTH PROGRAMS ACROSS THE COUNTRY, FUNDING IS DIFFICULT, AS PAYMENT RATES HAVE NOT KEPT PACE WITH THE COST TO PROVIDE CARE. - IN 2013, THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM LOST $4.5 MILLION. - IN 2013, 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: - THE OUTPATIENT PROGRAM OFFERS PATIENTS ONE TO FOUR TREATMENT DAYS PER WEEK. - 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 2013, 50 CLIENTS WERE SERVED. CURRENTLY, TWO PEOPLE ARE VOLUNTEERING AND 23 PEOPLE ARE PARTICIPATING IN SUPPORTIVE EMPLOYMENT. THE TOTAL EXPENSE FOR THE A-VISION PROGRAM FOR FISCAL YEAR 2013 WAS $207,820. INCREASING AWARENESS OF MENTAL HEALTH AND GERIATRIC PSYCHIATRIC ISSUES IN FISCAL YEAR 2013, 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. DEPRESSION SCREENINGS SCRIPPS HEALTH IMPLEMENTS MENTAL HEALTH SCREENINGS AND PROVIDE RESOURCES TO RAISE AWARENESS OF MENTAL HEALTH DISEASE AND ITS SYMPTOMS, AS WELL AS PROVIDE REFERRALS FOR THOSE AT RISK FOR HAVING MENTAL HEALTH PROBLEMS. 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. ACUTE RESPIRATORY INFECTIONS/PNEUMONIA 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. DEATH RATES FROM COPD HAVE DECLINED FROM 2000 TO 2009 AT THE NATIONAL, STATE, AND LOCAL LEVELS. INFLUENZA, ALSO KNOWN AS THE "FLU", IS A CONTAGIOUS RESPIRATORY ILLNESS CAUSED BY INFLUENZA VIRUSES THAT INFECT THE NOSE, THROAT, AND LUNGS. IT CAN CAUSE MILD TO SEVERE ILLNESS, AND AT TIMES CAN LEAD TO DEATH. COMPLICATIONS OF FLU CAN INCLUDE BACTERIAL PNEUMONIA (PARTICULARLY FOR OLDER AND IMMUNOCOMPROMISED INDIVIDUALS), EAR INFECTIONS, SINUS INFECTIONS, DEHYDRATION, AND WORSENING OF CHRONIC MEDICAL CONDITIONS, SUCH AS CONGESTIVE HEART FAILURE, ASTHMA, OR DIABETES. CLINICAL SYMPTOMS INCLUDE FEVER, COUGH, SORE THROAT, CHILLS, MUSCLE AND BODY ACHES, RUNNY OR STUFFY NOSE, AND CONGESTION. |
| SOME FACTS ABOUT ACUTE RESPIRATORY INFECTIONS AND PNEUMONIA: |
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- ACUTE RESPIRATORY INFECTIONS, INCLUDING PNEUMONIA AND INFLUENZA, ARE THE 8TH LEADING CAUSE OF DEATH IN THE UNITED STATES, ACCOUNTING FOR 56,000 DEATHS ANNUALLY. - ON AVERAGE, INFLUENZA LEADS TO MORE THAN 200,000 HOSPITALIZATIONS AND 36,000 DEATHS EACH YEAR. - THE 2009 H1N1 INFLUENZA PANDEMIC CAUSED AN ESTIMATED 270,000 HOSPITALIZATIONS AND 12,270 DEATHS (1,270 OF WHICH WERE OF PEOPLE YOUNGER THAN AGE 18) BETWEEN APRIL 2009 AND MARCH 2010. THE POPULATIONS AT HIGHER RISK FOR COMPLICATIONS DUE TO ACUTE RESPIRATORY INFECTIONS AND PNEUMONIA: - CHILDREN YOUNGER THAN 5, BUT ESPECIALLY CHILDREN YOUNGER THAN 2 YEARS OLD. - ADULTS 65 YEARS OF AGE AND OLDER. - PREGNANT WOMEN. - ALSO, AMERICAN INDIANS AND ALASKAN NATIVES SEEM TO BE AT HIGHER RISK OF FLU COMPLICATIONS. FLU/PNEUMONIA-ASSOCIATED COSTS: PNEUMONIA AND THE FLU COST $6 BILLION IN DIRECT MEDICAL CARE AND ANOTHER $34.2 BILLION IN PROJECTED LOST EARNINGS IN 2007, ACCORDING TO THE AMERICAN LUNG ASSOCIATION. THIS REPRESENTED AN INCREASE OF NEARLY 50 PERCENT FROM 2003, THE PREVIOUSLY REPORTED YEAR. HEALTH DISPARITIES IN INFLUENZA: HISPANIC CHILDREN YOUNGER THAN 18 YEARS OF AGE ACCOUNT FOR 27% OF 210 REPORTED 2009 H1N1 INFLUENZA- ASSOCIATED DEATHS IN THE UNITED STATES. THEIR REPRESENTATION IN THE US POPULATION IS 21%. ASTHMA ASTHMA IS A CHRONIC BREATHING CONDITION DUE TO INFLAMMATION OF THE AIR PASSAGES IN THE LUNGS. ASTHMA AFFECTS THE SENSITIVITY OF THE NERVE ENDINGS IN THE AIRWAYS CAUSING THEM TO BECOME EASILY IRRITATED. DURING AN ASTHMA ATTACK, THE LINING OF THESE PASSAGES SWELL CAUSING THE AIRWAYS TO NARROW THEREBY REDUCING THE FLOW OF AIR IN AND OUT OF THE LUNGS. ASTHMA ATTACKS CAN RANGE IN SEVERITY FROM MILD TO LIFE-THREATENING. CLINICAL SYMPTOMS INCLUDE COUGHING, SHORTNESS OF BREATH, WHEEZING, AND TIGHTNESS OR PAIN IN THE CHEST. IN 2009, 12.3% OF SAN DIEGO COUNTY RESIDENTS REPORTED EVER BEING DIAGNOSED WITH ASTHMA. THE COUNTY AGE-ADJUSTED ASTHMA RATES DECREASED SLIGHTLY BETWEEN 2001 AND 2004, BEFORE INCREASING AGAIN IN 2005. IT THEN DECREASED AGAIN IN 2006 AND HIT A NEW LOW IN 2009. TRIGGERS OF ASTHMA ATTACKS INCLUDE: - ALLERGENS (LIKE POLLEN, MOLD, ANIMAL DANDER, AND DUST MITES) - EXERCISE - OCCUPATIONAL HAZARDS - TOBACCO SMOKE - AIR POLLUTION - AIRWAY INFECTIONS SOME RISK FACTORS FOR DEVELOPING ASTHMA INCLUDE: - DEMOGRAPHIC VARIABLES SUCH AS GENDER, AGE, RACE/ETHNICITY - EDUCATIONAL LEVEL - INCOME LEVEL - SMOKING - OBESITY ASTHMA-ASSOCIATED COSTS: IN 2009, IT WAS ESTIMATED THAT ASTHMA RELATED COSTS EXCEEDED $56 BILLION DOLLARS PER YEAR. THE AVERAGE YEARLY COST OF CARE FOR A CHILD WITH ASTHMA WAS $1,039 IN 2009. ASTHMA PREVALENCE: U.S. AGE-ADJUSTED PREVALENCE RATES FOR CURRENT DIAGNOSED ASTHMA FOR THE YEAR OF 2010 WERE 8.6%, AS COMPARED TO A RATE OF 7.3% IN 2001. THE STATE OF CALIFORNIA REPORTED A RATE OF 7.7% FOR ADULTS AND 5.9% FOR CHILDREN FOR THE YEAR OF 2010. DURING FISCAL YEAR 2013, SCRIPPS ENGAGED IN THE FOLLOWING RESPIRATORY DISEASE PREVENTION AND TREATMENT ACTIVITIES. HOSPITALIZED PATIENTS SMOKING CESSATION STUDY A TOTAL OF 408 PARTICIPANTS INCLUDED IN THE STAY QUIT STUDY, A PARTNERSHIP WITH THE CALIFORNIA SMOKERS HELPLINE. A TOTAL OF 5,508 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) 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 2013, SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS DONATED A SIGNIFICANT PORTION OF THEIR PERSONAL TIME VOLUNTEERING TO SUPPORT SCRIPPS-SPONSORED COMMUNITY BENEFIT PROGRAMS. WITH CLOSE TO 10,803 HOURS, THE ESTIMATED DOLLAR VALUE OF THIS VOLUNTEER LABOR IS $474,989.98 WHICH IS NOT INCLUDED IN THE SCRIPPS FISCAL YEAR 2013 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 2013 (OCTOBER 2012 TO SEPTEMBER 2013), SCRIPPS INVESTED $37,652,958 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. GRADUATE MEDICAL EDUCATION OUR GRADUATE MEDICAL EDUCATION PROGRAMS AT SCRIPPS GREEN HOSPITAL AND SCRIPPS MERCY HOSPITAL, CHULA VISTA MAKE A POSITIVE IMPACT ON OUR COMMUNITY. IN 2013 WE HAD A TOTAL OF 125 RESIDENTS AND 33 FELLOWS ENROLLED THROUGHOUT THE SCRIPPS SYSTEM. SCRIPPS CONTRIBUTED $15,393,152 IN GRADUATE MEDICAL EDUCATION FOR FISCAL YEAR 2013. 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 2013, SCRIPPS HOSTED 1,884 INTERNS WITHIN OUR SYSTEM AND PROVIDED 256,773 DEVELOPMENT HOURS SPANNING NURSING AND ANCILLARY SETTINGS. 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 2013, SCRIPPS RESEARCH INCLUDED STUDENTS FROM U.S.D, WESTERN GOVERNORS, SDSU, PLNU AND POSTDOCTORAL PHARMACY RESIDENCY PROGRAMS, INCLUDING THE PGY1 PHARMACY RESIDENCY PROGRAM. 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 2013, SCRIPPS HIRED 32 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 2013, TEN STUDENTS WERE SELECTED TO ROTATE THROUGH THREE DIFFERENT SCRIPPS LOCATIONS, DURING THE SPRING SEMESTER, TO INCREASE THEIR AWARENESS OF HEALTH CARE CAREERS. UC HIGH STUDENTS VISITED SCRIPPS MERCY SAN DIEGO, SCRIPPS MEMORIAL HOSPITAL LA JOLLA AND GREEN. THE STUDENTS WERE ABLE TO VIEW SURGERIES AND SHADOWING HEALTHCARE PROFESSIONALS IN THE EMERGENCY DEPARTMENT, CARDIOLOGY, FOOD SERVICES, PHYSICAL THERAPY AND TRAUMA. 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 2013, TWO 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. MILITARY MENTORSHIP SCRIPPS HAS PARTNERED WITH MARINE CORPS BASE CAMP PENDLETON AND THE CARLSBAD CHAMBER OF COMMERCE TO PROVIDE JOB-SHADOWING EXPERIENCES TO ACTIVE MILITARY MEMBERS AND THEIR SPOUSES AS THEY PREPARE FOR DISCHARGE FROM THE MILITARY. THE PROGRAM IS CALLED MILITARY MENTORING INITIATIVE AND ITS MISSION IS TO HELP ACTIVE VETERANS LEARN ABOUT THE BUSINESS WORLD SO THEY CAN NAVIGATE THEIR WAY TOWARD SUCCESSFUL CAREERS. THE GOAL IS TO HAVE MILITARY MEMBERS GAIN FIRST-HAND EXPOSURE IN THE CIVILIAN WORKFORCE THROUGH JOB-SHADOWING PRIOR TO THEIR DISCHARGE FROM SERVICE. MILITARY MEMBERS ARE ALLOWED UP TO 30 DAYS OF PAID TEMPORARY ASSIGNMENT TO BE MENTORED TO HELP THEM DETERMINE WHICH OCCUPATIONS ARE A GOOD FIT, WHICH COMPANIES AND POSITIONS TO APPLY FOR IN THEIR FUTURE, AND WHAT FURTHER EDUCATION OR TRAINING IS NEEDED TO ACHIEVE THEIR CAREER GOALS. SCRIPPS HOSTED SEVEN MARINES THROUGHOUT OUR HOSPITALS. THE MARINES SHADOW VARIOUS HEALTHCARE PROFESSIONS INCLUDING PHYSICAL THERAPIST, NURSES, PHYSICIANS, AND BIOMEDICAL ENGINEERS. AT THE END OF THEIR SHADOWING ROTATION, THE MARINES MEET WITH TALENT DEVELOPMENT TO DISCUSS THEIR ACADEMIC PLAN ONCE THEY TRANSITION OUT OF THE MILITARY TO START THEIR SECOND CAREER IN HEALTHCARE. |
| 990 REVIEW PROCESS WITH GOVERNING BODY |
FORM 990, PART VI, LINE 11 |
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. -THE BOARD SELECTS THE 65TH PERCENTILE FOR BASE COMPENSATION OF PEER GROUP ADJUSTED FOR COST OF LIVING OF URBAN WEST COAST MARKET AT THE 50TH PERCENTILE (I.E. THE 50TH PERCENTILE OF CALIFORNIA MARKET IS THE 65TH PERCENTILE OF NATIONAL PEER MARKET AS OUR EXECUTIVE RECRUITMENT MARKET IS NATIONAL). -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, 2012. 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. |
| OTHER CHANGES TO NET ASSETS/FUND BALANCES |
FORM 990, PART XI, LINE 9 |
JOINT VENTURES-NONCONTROLLING INTERESTS $ 2,342,232 OTHER CHANGES IN NET ASSETS 39,558 USE OF FACILITIES & EQUIPMENT 55,870 ----------- TOTAL $ 2,437,660 |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES |
FORM 990 PART IX LINE 11G |
DESCRIPTION:PHYS FEES-PROVIDER SVS AGRMNT TOTAL FEES:XXX-XX-XXXX |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES |
FORM 990 PART IX LINE 11G |
DESCRIPTION:OTHER PURCHASE SVS - NON MED TOTAL FEES:54145034 |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES |
FORM 990 PART IX LINE 11G |
DESCRIPTION:PHYSICIAN FEES TOTAL FEES:50282213 |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES |
FORM 990 PART IX LINE 11G |
DESCRIPTION:PURCHASED MEDICAL SERVICES TOTAL FEES:26134559 |
| OTHER FEES FOR SERVICES FOR NON-EMPLOYEES |
FORM 990 PART IX LINE 11G |
DESCRIPTION:ALL OTHER FEES FOR SERVICES TOTAL FEES:21462270 |
Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.