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Schedule H, Part V, Section B, Line 5 Facility A, 1
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Facility A, 1 - Facility 1 -- Seton Medical Center Austin. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive.
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Schedule H, Part V, Section B, Line 5 Facility A, 2
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Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive.
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Schedule H, Part V, Section B, Line 5 Facility A, 3
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Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive.
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Schedule H, Part V, Section B, Line 5 Facility A, 4
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Facility A, 4 - Facility 6 -- Seton Northwest Hospital. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive.
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Schedule H, Part V, Section B, Line 5 Facility A, 5
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Facility A, 5 - Facility 7 -- Seton Southwest Hospital. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive.
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Schedule H, Part V, Section B, Line 5 Facility A, 6
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Facility A, 6 - Facility 9 -- Seton Medical Center Williamson. The WilCo Wellness Alliance was formed as a result of Williamson County being designated as an ACHIEVE (Action Communities for Health, Innovation, and Environmental Change) community in 2009. The mission of the alliance is to empower the people of Williamson County to lead healthy lifestyles by promoting a safe environment through public and private initiatives. The Alliance, grassroots and volunteer organizations, civic groups, philanthropy and foundation, and other groups provide forums for community members and leaders to come together to discuss and plan action in communities. Alliance leadership identified the history of coalitions and other alliances as well as citizen and leadership support for health and quality of life measures as a major strength of Williamson County. Leadership also recognizes the county's interactive values for being helpful and resourceful, supportive, sharing and caring about each other, having intergenerational and close-knit communities, connectedness, being proactive and involved in issues, and having a common unity.
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Schedule H, Part V, Section B, Line 5 Facility A, 7
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Facility A, 7 - Facility 10 -- Seton Medical Center Hays. The Seton Healthcare Family, in collaboration with the CommuniCare Health Centers of Central Texas, hosted a Community Health Needs Summit for Hays County. The Summit was designed as a way to update the community on progress that has been made since the last CHNA and to provide them with current data to engage in needs identification. The two goals for the summit were for the community to discuss current needs effecting Hays and then prioritize those needs in order of importance. The invitation to the Summit was sent out through local collaborations, partnership, and council list serves with targeted outreach to schools and other key community stakeholders. In attendance was representation from the public health department, hospitals, clinics, school districts, and other service providers that serve the community. A complete list of Summit participants can be found in Appendix 1 of the Community Health Needs Assessment. In order to identify the community's needs, Seton Healthcare Family presented current health and demographic data to the Summit participants. Participants then engaged in table discussions regarding what the data revealed to them as well as what other needs they see in the community that did not show up in the data. This collaborative process created a list of needs that were shared with the larger group and categorized by theme. These themes served as the overarching needs that were identified with sub groups identified within each category. Participants then used a dot voting method to express their opinion as to which category was the highest priority need and which sub group was most important within that need. After tallying the results, the participants reviewed the results and further added any remaining thoughts. The following information is a summation of the data analysis coupled with the feedback from the community.
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Schedule H, Part V, Section B, Line 5 Facility A, 8
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Facility A, 8 - Facility 11 -- Cedar Park Regional Medical Center. The WilCo Wellness Alliance was formed as a result of Williamson County being designated as an ACHIEVE (Action Communities for Health, Innovation, and Environmental Change) community in 2009. The mission of the alliance is to empower the people of Williamson County to lead healthy lifestyles by promoting a safe environment through public and private initiatives. The Alliance, grassroots and volunteer organizations, civic groups, philanthropy and foundation, and other groups provide forums for community members and leaders to come together to discuss and plan action in communities. Alliance leadership identified the history of coalitions and other alliances as well as citizen and leadership support for health and quality of life measures as a major strength of Williamson County. Leadership also recognizes the county's interactive values for being helpful and resourceful, supportive, sharing and caring about each other, having intergenerational and close-knit communities, connectedness, being proactive and involved in issues, and having a common unity.
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Schedule H, Part V, Section B, Line 5 Facility A, 9
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Facility A, 9 - Facility 12 -- Central Texas Rehabilitation Hospital. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive.
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Schedule H, Part V, Section B, Line 6a Facility A, 1
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Facility A, 1 - Facility 1 -- Seton Medical Center Austin. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health
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Schedule H, Part V, Section B, Line 6a Facility A, 2
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Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health
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Schedule H, Part V, Section B, Line 6a Facility A, 3
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Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health
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Schedule H, Part V, Section B, Line 6a Facility A, 4
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Facility A, 4 - Facility 6 -- Seton Northwest Hospital. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health
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Schedule H, Part V, Section B, Line 6a Facility A, 5
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Facility A, 5 - Facility 7 -- Seton Southwest Hospital. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health
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Schedule H, Part V, Section B, Line 6a Facility A, 6
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Facility A, 6 - Facility 12 -- Central Texas Rehabilitation Hospital. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health
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Schedule H, Part V, Section B, Line 6b Facility A, 1
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Facility A, 1 - Facility 1 -- Seton Medical Center Austin. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation
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Schedule H, Part V, Section B, Line 6b Facility A, 2
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Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation
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Schedule H, Part V, Section B, Line 6b Facility A, 3
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Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation
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Schedule H, Part V, Section B, Line 6b Facility A, 4
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Facility A, 4 - Facility 6 -- Seton Northwest Hospital. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation
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Schedule H, Part V, Section B, Line 6b Facility A, 5
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Facility A, 5 - Facility 7 -- Seton Southwest Hospital. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation
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Schedule H, Part V, Section B, Line 6b Facility A, 6
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Facility A, 6 - Facility 9 -- Seton Medical Center Williamson. The other organizations with which the reporting hospital facility conducted its CHNA, include: - Baylor Scott and White Healthcare - St. David's Healthcare
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Schedule H, Part V, Section B, Line 6b Facility A, 7
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Facility A, 7 - Facility 10 -- Seton Medical Center Hays. The CHNA was conducted with Communicare Health Centers of Central Texas.
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Schedule H, Part V, Section B, Line 6b Facility A, 8
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Facility A, 8 - Facility 11 -- Cedar Park Regional Medical Center. The other organizations with which the reporting hospital facility conducted its CHNA, include: - Baylor Scott and White Healthcare - St. David's Healthcare
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Schedule H, Part V, Section B, Line 6b Facility A, 9
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Facility A, 9 - Facility 12 -- Central Texas Rehabilitation Hospital. The other organizations with which the reporting hospital facility conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation
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Schedule H, Part V, Section B, Line 7 Facility A, 1
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Facility A, 1 - Facility 1 -- Seton Medical Center Austin. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf
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Schedule H, Part V, Section B, Line 7 Facility A, 2
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Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf
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Schedule H, Part V, Section B, Line 7 Facility A, 3
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Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf
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Schedule H, Part V, Section B, Line 7 Facility A, 4
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Facility A, 4 - Facility 6 -- Seton Northwest Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf
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Schedule H, Part V, Section B, Line 7 Facility A, 5
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Facility A, 5 - Facility 7 -- Seton Southwest Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf
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Schedule H, Part V, Section B, Line 7 Facility A, 6
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Facility A, 6 - Facility 9 -- Seton Medical Center Williamson. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Williamson-CHA_Final_Approved.pdf
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Schedule H, Part V, Section B, Line 7 Facility A, 7
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Facility A, 7 - Facility 10 -- Seton Medical Center Hays. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Hays_Community_Needs_assessment.pdf
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Schedule H, Part V, Section B, Line 7 Facility A, 8
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Facility A, 8 - Facility 11 -- Cedar Park Regional Medical Center. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: http://www.cedarparkregional.com/Uploads/Public/Documents/Division%202/Cedar%20Park%20Regional%20Medical%20Center/2013Williamson-CHA.pdf
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Schedule H, Part V, Section B, Line 7 Facility A, 9
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Facility A, 9 - Facility 12 -- Central Texas Rehabilitation Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: http://austintexas.gov/sites/default/files/files/Health/CHA-CHIP/cha_report_Dec2012.pdf
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Schedule H, Part V, Section B, Line 11 Facility A, 1
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Facility A, 1 - SETON MEDICAL CENTER AUSTIN - PART 1. The SMCA Implementation Plan addresses the four health needs; access to care, behavioral health, chronic disease, and obesity in the order of priority identified through the Travis County CHNA. Also addressed in the SMCA plan is an overview of the hospital's policy of providing financial assistance to low income patients and a strategy for addressing community collaboration. Obesity The 2012 Travis County Community Health Needs Assessment identified obesity as one of the most pressing health issues. While obesity in Travis County is below the national average, childhood obesity was listed as a particular area of need as this condition is disproportionately evident among minority populations. With a 24% obesity rate in adults, Travis County falls below the state average of 29.6%. However, when that rate is broken down by ethnicity, the need to address obesity among minority populations becomes more obvious. 41.7% of the Black/African American adults in Travis County and 36.5% of Latino/Hispanic adults are considered obese compared to 19.4% for White residents. According to CHNA data and focus group respondents, this disparity may be attributed to the unequal distribution and affordability of fresh fruit and vegetable outlets throughout the County as well as an unequal distribution of obesity-related programs. The City of Austin Health Department, the local school districts, and many local non-profits are working to reduce the obesity rate in our community. One way that Seton is exploring to reduce obesity is through the Seton Healthcare Family Pre-Diabetes Program. This program is a pilot program associated with the Seton Health Centers located in Travis County. The program helps to transform the lives of vulnerable working poor patients - patients who have been identified as being at increased risk for developing diabetes - by providing an array of empowering and essential interventions including psychosocial assessment, health literacy assessment, spiritual counseling, weight loss counseling, diabetes prevention education, nutrition counseling, grocery store tours, social services referrals, and community resource referrals. The program provides poor, at-risk adults with the information, tools and support they need to achieve obesity risk-reduction to help prevent diabetes, and to move patients from having from pre-diabetes glucose levels to having normal glucose. Seton currently serves in a leadership role with the Mayor's Health and Fitness Council (MHFC). MHFC is a local non-profit organization in Travis County whose vision is to support and inspire people to improve their health by encouraging physical activity, improved nutrition and tobacco-free living. A Seton hospital Chief Operating Officer currently serves on the board as the Vice Chair for the Council and Seton will continue to participate in this collaborative effort to make Austin the healthiest city in America. The CHNA identified access to healthy foods as a high priority. With the number of visitors and community members who visit the SMCA cafeteria on a daily basis, SMCA is dedicated to improving the nutritional value of the food offered at the facility. SMCA will work with TouchPoint, its food service vendor, to improve the nutritional content in the food served through a Healthy Dining Program to ensure that our daily offerings are geared toward providing healthy choices and options for our guests. This will not only benefit patients but also visitors, physicians, and community members who frequent the hospital. Chronic Disease and Disease Management The 2012 Travis County Community Health Needs Assessment identified chronic disease and disease management as the second highest health issue facing residents of Travis County. For the past six years the top three causes of death in Travis County have been related to chronic disease. Many focus group participants and interviewees cited chronic disease - specifically diabetes, heart disease, and cancer - among the greatest areas of concern. Seton Network Oncology Services currently works with several Seton hospitals, including SMCA, providing access to the Seton Cancer Prevention and Early Detection program, the Oncology Nurse Registry, the Survivorship Program, the Multidisciplinary Cancer Conference and clinics, and Navigation service. Seton's comprehensive oncology programs provide residents of Central Texas access to cancer services that promote early detection and a coordinated approach to care throughout the continuum which includes screening, diagnosis, treatment and survivorship. SMCA refers patients to the Seton Shivers Cancer Center, located within University Medical Center Brackenridge. The Shivers Cancer Center provides a variety of outpatient services for adult cancer patients in Central Texas regardless of ability to pay. In addition to clinical services, the Shivers health care professionals work closely with the Seton Cancer Care Team to provide vital case management services plus a variety of physical, emotional, and spiritual support programs to adult cancer patients and their families. SMCA will work with the new Women's Oncology Care Screening program. This program expands timely access to breast and cervical cancer screening via a mobile unit for uninsured and underinsured women in Central Texas who, without this expansion, likely would not receive these life-saving services. This expansion in screening is part of Seton's digital mammography mobile unit known as the Big Pink Bus. Access to cervical cancer screenings are now expanded to mobile mammography program participants by using advanced practice nurses on the mobile unit or at our community clinics that provide indigent care. In addition to the screening, SMCA will incorporate Women's Oncology Navigation as a method of expanding existing patient navigation services that connect women with cancer diagnosis to treatment and/or survivorship support services. Seton also has established the Seton Total Health Transitions team as a prototype of disease management as patients leave the hospital setting. Based on a successful pilot, SMCA will enhance and expand the model to better coordinate care through a Care Transition Intervention. This approach includes a multi-disciplinary team that monitors and coordinates the care of patients with chronic diseases immediately following discharge from hospital to home, and from home to primary care. This project is expected to optimize the patient's recovery and avoid readmission. Services include home visits to provide short-term direct care, social services, behavioral health support, transportation, telehealth and patient training regarding self-care management of the chronic disease(s). SMCA is developing a Chronic Care Management program that provides direct health care and care coordination for adults who have been seriously injured and to those who have experienced a serious illness due to multiple chronic conditions. This will be an extension of the Seton Total Health Partners pilot established in January 2012. This program assists enrollees in finding and receiving the medical care they need to achieve optimal health and prevent avoidable hospitalization and inappropriate use of emergency departments. The program provides a number of patient care interventions, a structured and monitored hand-off process, training for optimal self-care, counseling, and facilitated integration with primary and specialty physicians responsible for each patient's care. SMCA proposes to develop and implement a process improvement methodology to improve outcomes for adult inpatients diagnosed with Diabetics Mellitus. Diabetes Chronic Care Management will implement small, straightforward evidence-based practices to implement a Diabetes Care Bundle that, when performed collectively and reliably, has been proven to improve patient outcomes. In addition, this project will establish an interdisciplinary diabetes team, led by an endocrinologists and a diabetes clinical nurse specialist, to address the clinical, safety, and psychosocial needs of inpatients with diabetes while preparing for a successful discharge. The project will also implement evidence-based practice (EBP) protocols to ensure improved clinical outcomes during and post-hospitalization.
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Schedule H, Part V, Section B, Line 11 Facility A, 2
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Facility A, 2 - SETON MEDICAL CENTER AUSTIN - PART 2. SMCA will continue to offer Seton's Asthma Education program to Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages. Seton Healthcare Family facilities are a tobacco free environment, prohibiting tobacco use at all of its hospitals and places of work. Seton is an active participant in community efforts to combat tobacco use, providing tobacco cessation services to Travis County residents. SMCA will continue to support the Tobacco Cessation Program that provides community-wide training for physicians and local clinics based on best practices for treating nicotine addiction. In addition, The Seton Tobacco Education Resource Center offers a comprehensive tobacco education program which provides cessation classes that are based on the Mayo Clinic Model for treating Tobacco Dependence. Sessions follow a support group setting and are facilitated by Certified Tobacco Treatment Specialist. Through motivational interviewing techniques CTTS are able to conduct sessions that aim at maximizing & promoting participant dialogue. SMCA will continue its support of various clinics that help provide care for patients suffering from heart related chronic diseases. Heart disease was identified in the CHNA as a top cause of death for the community and SMCA will continue to provide support through the Heart Specialty Care and Transplant Center and Cardiac Rehab Clinic as a means of addressing the increasing need for cardiology services. Behavioral Health The CHNA identified mental health as one of the foremost health concerns raised by Travis County residents. Focus group participants and interviewees alike mentioned the rising rates of mental health conditions among Travis County residents. This included areas such as substance abuse and inadequate mental health services. The CHNA identified that 20% of Travis County adults experienced five or more days of poor mental health in the past month, which is well above the national median. SMCA has expanded access to Psychiatric Telemedicine to the Emergency Department and Intensive Care Units and will continue to expand these behavioral health services to the Med Surg/Inpatient floors by the end of 2013. By providing 24/7 psychiatric consultations patients in psychiatric crisis will be able to be evaluated and treated in a timely manner. Typically patients would have to wait until the next day for appropriate psychiatric assessment. This new approach to psychiatric telemedicine can lead to timely assessment, earlier disposition and less costly level of care. Other programs targeted to improve the health and well-being of SMCA patients and the community includes: No One Dies Alone (NODA) and the Seton Cove Spirituality Center. NODA provides trained volunteer bedside companionship for patients who might otherwise be alone at the time of death while Seton Cove Spirituality Center provides spiritually healing discussion groups, classes and events led by a multidisciplinary faculty both on the SMCA campus and at the Spirituality Center. Programs are open to the community. To augment the public school health education curriculum, Seton Healthcare Family has purchased HealthTeacher, a comprehensive K-12 online health education curriculum for teachers in school districts within Travis, Williamson, and Hays County. The curriculum provides over 300 age-appropriate lessons across 10 content areas aligned with the National Health Education Standards (NHES). Lessons are designed for integration into core curriculum areas such as language arts, science and social studies, and have been aligned with the Texas TEKS. They provide skills-based instruction linked to assessments. Health educators in school districts in Travis County were trained by national HealthTeacher staff on how to integrate and implement the HealthTeacher curriculum in the classroom. Access to Care Access to health care was a predominant theme among residents, specifically the availability and accessibility of health care facilities and resources. Also mentioned were the difficulty of navigating the health care system, the high cost of care, and the inability to gain and retain health insurance. Community forum participants recognized a presence of facilities and programming but the majority noted that health care resources are greatly lacking, especially for low-income and aging populations. The Seton Health Centers were established to provide accessible, comprehensive health services to medically underserved families in Austin. Primary care physicians, nurse practitioners and physician assistants provide quality primary care to community residents on a sliding scale based on family size and income. Medicare, Medicaid and CHIP are also accepted. Each of the three clinics offers primary care, laboratory, case management, and health education services. Comprehensive social services are part of the Centers' medical mission as well. SMCA has and will continue to refer unfunded patients without a medical home to the Seton Community Health Centers for primary care. The Travis County Medical Society, the Seton Healthcare Family and other members of the Integrated Care Collaboration have initiated a coordinated system of volunteer doctors called Project Access. They work with other local providers to provide medical, hospital, diagnostic and pharmacy assistance for the uninsured in Travis County. The mission of Project Access is to provide ready access to appropriate health care services for uninsured people in Travis County whose incomes are at or below 200% of the Federal poverty level and to improve the overall health of our community. Seton helped secure a grant to create the program. More than 1,000 volunteer physicians participate in Project Access and Seton will continue to support the work of this collaboration to improve access to care. To help underserved residents navigate the complicated and fragmented health care system, SMCA will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified health disparities and inequities in the ability of different ethnic groups to access care. The reasons are complex. Research shows providing professional medical interpretation at initial assessment and discharge reduces readmissions within 30 days, reduces patient bed days, improves medication adherence and leads to better health outcomes. In addition, research also shows providing cultural competence training to our clinical care teams improves communication between patients and their clinical care team including their doctors and nurses as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems ("HCAHPS") Survey, the first national, standardized, publicly reported survey of patients' perspectives of hospital care. Currently Seton provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, Seton provides in person sign language contracted services at all of our facilities. As part of an integrated approach to administer care in a person centered, culturally competent manner, Seton Healthcare Family through SMCA, will develop a Language Services Resource Center and a Culturally Competent Care Curriculum. The Language Services Resource Center is a new project which will provide professional medical interpretation at initial assessment and discharge by centralizing interpretation & translation services, and increasing the number of professional medical interpreters for patients with Limited English Proficiency including but not limited to Spanish and sign language. The Culturally Competent Care Curriculum is expected to increase the quality of communication between the clinical care team and the patient in order to achieve greater patient involvement in shared decision making. The Diversity Department through the Culturally Competent Care Curriculum will provide training and education to the clinical care team to increase the likelihood of safe and effective person centered care in a culturally competent manner and leads to better health outcomes.
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Schedule H, Part V, Section B, Line 11 Facility A, 3
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Facility A, 3 - SETON MEDICAL CENTER AUSTIN - PART 3. Access to prenatal care in the first trimester was identified as a need especially among the Latino/Hispanic population. To address this, SMCA will expand it Obstetrics Navigation (OB Navigation) project to improve access to pre- and post-natal care for uninsured Hispanic women with limited English proficiency through comprehensive, effective patient navigation services. Currently the SMCA Navigators work with women after they have established prenatal care. The new navigation initiative will place navigators out in the community to help assist newly pregnant women with accessing care in their first trimester and following them throughout their pregnancy ensuring they receive a post-partum check-up and are connected to medical home for on-going primary care. The OB Navigation Program will use culturally and linguistically competent community health workers to serve as patient navigators. SMCA will continue to increase access to services by supporting the Seton League House, a 38-room bed-and-bath facility designed to provide families and caregivers with a place to stay while their loved ones are hospitalized in an Austin-area hospital. The subsidized rooms reduce the barrier of travel costs associated with treatment. Community Collaboration Despite many non-profit and social service organizations within Travis County, many focus group participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of cohesiveness and focused vision leads residents to feel that there is more dialogue than there is action. More coordinated approaches would help maximize limited resources. In 1997, Seton led the formation of the Integrated Care Collaboration (ICC), an alliance of community providers for the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure. In 2012, Seton and the Travis County Healthcare District began development of a non-profit Community Care Collaborative (CCC) with the purpose of advancing the health of identified vulnerable populations in Travis County through high-quality, cost effective, person centered care. The essential elements of the CCC are: patient centered medical homes, developing a health information exchange for its patients, case management of a selected high risk population, pharmacy management, integrated outpatient/inpatient protocols, and transitional care. The CCC will be outcome driven and rely heavily on analytics to drive process improvement and innovation. Seton Healthcare Family is a partner of the Community Action Network (CAN) and will continue to support this local collaboration. CAN is a partnership of government, non-profit, private, and faith-based organizations who work together to enhance the social, health, educational, and economic well-being of Central Texas. As a partner of CAN, Seton has representatives on the Board of Directors and is committed to working with other CAN Partners to attain the mission of CAN. Financial Assistance Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. SMCA screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers SMCA patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level.
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Schedule H, Part V, Section B, Line 11 Facility A, 4
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Facility A, 4 - UNIVERSITY MEDICAL CENTER BRACKENRIDGE - PART 1. The UMCB Implementation Plan addresses the four health needs; access to care, behavioral health, chronic disease, and obesity in the order of priority identified through the Travis County CHNA. Also addressed in the UMCB plan is an overview of the hospital's policy of providing financial assistance to low income patients and a strategy for addressing community collaboration. Obesity The 2012 Travis County Community Health Needs Assessment identified obesity as one of the most pressing health issues. While obesity in Travis County is below the national average, childhood obesity was listed as a particular area of need as this condition is disproportionately evident among minority populations. With a 24% obesity rate in adults, Travis County falls below the state average of 29.6%. However, when that rate is broken down by ethnicity, the need to address obesity among minority populations becomes more obvious. 41.7% of the Black/African American adults in Travis County and 36.5% of Latino/Hispanic adults are considered obese compared to 19.4% for White residents. According to CHNA data and focus group respondents, this disparity may be attributed to the unequal distribution and affordability of fresh fruit and vegetable outlets throughout the County as well as an unequal distribution of obesity-related programs. The City of Austin Health Department, the local school districts, and many local non-profits are working to reduce the obesity rate in our community. One way that Seton is exploring to reduce obesity is through the Seton Healthcare Family Pre-Diabetes Program. This program is a pilot program associated with the Seton Health Centers located in Travis County. The program helps to transform the lives of vulnerable working poor patients - patients who have been identified as being at increased risk for developing diabetes - by providing an array of empowering and essential interventions including psychosocial assessment, health literacy assessment, spiritual counseling, weight loss counseling, diabetes prevention education, nutrition counseling, grocery store tours, social services referrals, and community resource referrals. The program provides poor, at-risk adults with the information, tools and support they need to achieve obesity risk-reduction to help prevent diabetes, and to move patients from having from pre-diabetes glucose levels to having normal glucose. Seton currently serves in a leadership role with the Mayor's Health and Fitness Council (MHFC). MHFC is a local non-profit organization in Travis County whose vision is to support and inspire people to improve their health by encouraging physical activity, improved nutrition and tobacco-free living. A Seton hospital Chief Operating Officer currently serves on the board as the Vice Chair for the Council and Seton will continue to participate in this collaborative effort to make Austin the healthiest city in America. The CHNA identified access to healthy foods as a high priority. With the number of visitors and community members who visit the UMCB cafeteria on a daily basis, UMCB is dedicated to improving the nutritional value of the food offered at the facility. UMCB will work with TouchPoint, its food service vendor, to improve the nutritional content in the food served through a Healthy Dining Program to ensure that our daily offerings are geared toward providing healthy choices and options for our guests. This will not only benefit patients but also visitors, physicians, and community members who frequent the hospital. Chronic Disease and Disease Management The 2012 Travis County Community Health Needs Assessment identified chronic disease and disease management as the second highest health issue facing residents of Travis County. For the past six years the top three causes of death in Travis County have been related to chronic disease. Many focus group participants and interviewees cited chronic disease - specifically diabetes, heart disease, and cancer - among the greatest areas of concern. Seton Network Oncology Services currently works with several Seton hospitals, including UMCB, providing access to the Seton Cancer Prevention and Early Detection program, the Oncology Nurse Registry, the Survivorship Program, the Multidisciplinary Cancer Conference and clinics, and Navigation service. Seton's comprehensive oncology programs provide residents of Central Texas access to cancer services that promote early detection and a coordinated approach to care throughout the continuum which includes screening, diagnosis, treatment and survivorship. UMCB refers patients to the Seton Shivers Cancer Center, located within UMCB. The Shivers Cancer Center provides a variety of outpatient services for adult cancer patients in Central Texas regardless of ability to pay. In addition to clinical services, the Shivers health care professionals work closely with the Seton Cancer Care Team to provide vital case management services plus a variety of physical, emotional, and spiritual support programs to adult cancer patients and their families. UMCB will work with the new Women's Oncology Care Screening program. This program expands timely access to breast and cervical cancer screening via a mobile unit for uninsured and underinsured women in Central Texas who, without this expansion, likely would not receive these life-saving services. This expansion in screening is part of Seton's digital mammography mobile unit known as the Big Pink Bus. Access to cervical cancer screenings are now expanded to mobile mammography program participants by using advanced practice nurses on the mobile unit or at our community clinics that provide indigent care. In addition to the screening, UMCB will incorporate Women's Oncology Navigation as a method of expanding existing patient navigation services that connect women with cancer diagnosis to treatment and/or survivorship support services. Looking to improve the health of patients with chronic disease, Seton has established the Seton Total Health Transitions team as a prototype of disease management as patients leave the hospital setting. Based on a successful pilot, UMCB will enhance and expand the model to better coordinate care through a Care Transition Intervention. This approach includes a multi-disciplinary team that monitors and coordinates the care of patients with chronic diseases immediately following discharge from hospital to home, and from home to primary care. This project is expected to optimize the patient's recovery and avoid readmission. Services include home visits to provide short-term direct care, social services, behavioral health support, transportation, telehealth and patient training regarding self-care management of the chronic disease(s). UMCB is developing a Chronic Care Management program that provides direct health care and care coordination for adults who have been seriously injured and to those who have experienced a serious illness due to multiple chronic conditions. This will be an extension of the Seton Total Health Partners pilot established in January 2012. This program assists enrollees in finding and receiving the medical care they need to achieve optimal health and prevent avoidable hospitalization and inappropriate use of emergency departments. The program provides a number of patient care interventions, a structured and monitored hand-off process, training for optimal self-care, counseling, and facilitated integration with primary and specialty physicians responsible for each patient's care. UMCB proposes to develop and implement a process improvement methodology to improve outcomes for adult inpatients diagnosed with Diabetics Mellitus. Diabetes Chronic Care Management will implement small, straightforward evidence-based practices to implement a Diabetes Care Bundle that, when performed collectively and reliably, has been proven to improve patient outcomes. In addition, this project will establish an interdisciplinary diabetes team, led by an endocrinologists and a diabetes clinical nurse specialist, to address the clinical, safety, and psychosocial needs of inpatients with diabetes while preparing for a successful discharge. The project will also implement evidence-based practice (EBP) protocols to ensure improved clinical outcomes during and post-hospitalization.
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Schedule H, Part V, Section B, Line 11 Facility A, 5
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Facility A, 5 - UNIVERSITY MEDICAL CENTER BRACKENRIDGE - PART 2. UMCB will continue to offer Seton's Asthma Education program to Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages. Seton Healthcare Family facilities are a tobacco free environment, prohibiting tobacco use at all of its hospitals and places of work. Seton is an active participant in community efforts to combat tobacco use, providing tobacco cessation services to Travis County residents. UMCB will continue to support the Tobacco Cessation Program that provides community-wide training for physicians and local clinics based on best practices for treating nicotine addiction. In addition, The Seton Tobacco Education Resource Center offers a comprehensive tobacco education program which provides cessation classes that are based on the Mayo Clinic Model for treating Tobacco Dependence. Sessions follow a support group setting and are facilitated by Certified Tobacco Treatment Specialist. Through motivational interviewing techniques CTTS are able to conduct sessions that aim at maximizing & promoting participant dialogue. Behavioral Health The Travis County CHNA identified a shortage of behavioral health providers. By expanding the behavioral health workforce, greater care can be provided to individuals with behavioral health needs in Travis County, especially those who are under- or uninsured. UMCB plans to expand Post Graduate Training for Psychiatric Specialties/Psychiatric Residency Programs. This project will expand the residency training programs in psychiatric specialties to increase the workforce of providers in our community treating psychiatric patients and increase access to behavior health services for the indigent and uninsured. Focus group participants and interviewees alike mentioned the rising number of mental health conditions among Travis County residents. This included areas such as substance abuse and inadequate mental health services. The CHNA identified that 20% of Travis County adults experienced five or more days of poor mental health in the past month, which is well above the national median. UMCB has expanded access to Psychiatric Telemedicine to the entire UMCB facility and will continue to support this behavioral health service. By providing 24/7 psychiatric consultations, including after hours, patients in psychiatric crisis will be able to be evaluated and treated in a timely manner. Typically patients would have to wait until the next day for appropriate psychiatric assessment. This new approach to psychiatric telemedicine can lead to timely assessment, earlier disposition and less costly level of care. With a need for timely mental health assessments, UMCB will explore the development of a Behavioral Health Assessment and Resource Navigation project. This will be a free comprehensive assessment of behavioral health needs that can then be used to connect patients to community resources. Substance abuse and Substance Use Disorder (SUD) were concerns for community members. UMCB will develop a Substance Abuse Navigation transition service for patients who are at risk for SUD. The program will direct individuals to early intervention and provide access to treatment opportunities and education for the indigent and uninsured. Other programs targeted to improve the health and well-being of UMCB patients and the community includes: No One Dies Alone (NODA) and the Seton Cove Spirituality Center. NODA provides trained volunteer bedside companionship for patients who might otherwise be alone at the time of death while Seton Cove Spirituality Center provides spiritually healing discussion groups, classes and events led by a multidisciplinary faculty both on the UMCB campus and at the Spirituality Center. Programs are open to the community. To augment the public school health education curriculum, Seton Healthcare Family has purchased HealthTeacher, a comprehensive K-12 online health education curriculum for teachers in school districts within Travis, Williamson, and Hays County. The curriculum provides over 300 age-appropriate lessons across 10 content areas aligned with the National Health Education Standards (NHES). Lessons are designed for integration into core curriculum areas such as language arts, science and social studies, and have been aligned with the Texas TEKS. They provide skills-based instruction linked to assessments. Health educators in school districts in Travis County were trained by national HealthTeacher staff on how to integrate and implement the HealthTeacher curriculum in the classroom. Access to Care Access to health care was a predominant theme among residents, specifically the availability and accessibility of health care facilities and resources. Also mentioned were the difficulty of navigating the health care system, the high cost of care, and the inability to gain and retain health insurance. Community forum participants recognized a presence of facilities and programming but the majority noted that health care resources are greatly lacking, especially for low-income and aging populations. The Seton Health Centers were established to provide accessible, comprehensive health services to medically underserved families in Austin. Primary care physicians, nurse practitioners and physician assistants provide quality primary care to community residents on a sliding scale based on family size and income. Medicare, Medicaid and CHIP are also accepted. Each of the three clinics offers primary care, laboratory, case management, and health education services. Comprehensive social services are part of the Centers' medical mission as well. UMCB has and will continue to refer unfunded patients without a medical home to the Seton Community Health Centers for primary care. UMCB will also continue to maintain its close relationship to the Paul Bass Clinic located at the hospital. Paul Bass Clinic serves as the medical home for more than 1,500 individuals. It provides additional capacity for residents with multiple diagnoses and no established medical home. In addition to the primary care services, the clinic will offer quality specialty care in such specialties as cardiology, pulmonology, gastroenterology, orthopedics, otolaryngology, endocrinology, and rheumatology. The Travis County Medical Society, the Seton Healthcare Family and other members of the Integrated Care Collaboration have initiated a coordinated system of volunteer doctors called Project Access. They work with other local providers to provide medical, hospital, diagnostic and pharmacy assistance for the uninsured in Travis County. The mission of Project Access is to provide ready access to appropriate health care services for uninsured people in Travis County whose incomes are at or below 200% of the Federal poverty level and to improve the overall health of our community. Seton helped secure a grant to create the program. More than 1,000 volunteer physicians participate in Project Access and Seton will continue to support the work of this collaboration to improve access to care. UMCB will continue to support the Clinic at Brackenridge, an outpatient department of UMCB that provides specialty evaluation, treatment, and follow-up care to adults on an outpatient basis. Referrals come from the Austin/Travis county community health clinics and some other community agencies, labor and delivery, and the emergency department according to referral guidelines. The clinics are transitional in nature and after consultation the patient is sent back to the referring entity for primary care. This clinic provides specialty care to un/underinsured patients and sees over 25,000 individuals a year.
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Schedule H, Part V, Section B, Line 11 Facility A, 6
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Facility A, 6 - UNIVERSITY MEDICAL CENTER BRACKENRIDGE - PART 3. To help underserved residents navigate the complicated and fragmented health care system, UMCB will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified health disparities and inequities in the ability of different ethnic groups to access care. The reasons are complex. Research shows providing professional medical interpretation at initial assessment and discharge reduces readmissions within 30 days, reduces patient bed days, improves medication adherence and leads to better health outcomes. In addition, research also shows providing cultural competence training to our clinical care teams improves communication between patients and their clinical care team including their doctors and nurses as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems ("HCAHPS") Survey, the first national, standardized, publicly reported survey of patients' perspectives of hospital care. Currently Seton provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, we provide in person sign language contracted services at all of our facilities as well as Spanish in person interpreters at UMCB. As part of an integrated approach to administer care in a person centered, culturally competent manner, Seton Healthcare Family through UMCB, will develop a Language Services Resource Center and a Culturally Competent Care Curriculum. The Language Services Resource Center is a new project which will provide professional medical interpretation at initial assessment and discharge by centralizing interpretation & translation services, and increasing the number of professional medical interpreters for patients with Limited English Proficiency including but not limited to Spanish and sign language. The Culturally Competent Care Curriculum is expected to increase the quality of communication between the clinical care team and the patient in order to achieve greater patient involvement in shared decision making. The Diversity Department through the Culturally Competent Care Curriculum will provide training and education to the clinical care team to increase the likelihood of safe and effective person centered care in a culturally competent manner and leads to better health outcomes. Access to prenatal care in the first trimester was identified as a need especially among the Latino/Hispanic population. To address this, UMCB will expand it Obstetrics Navigation (OB Navigation) project to improve access to pre- and post-natal care for uninsured Hispanic women with limited English proficiency through comprehensive, effective patient navigation services. Currently the UMCB Navigators work with women after they have established prenatal care. The new navigation initiative will place navigators out in the community to help assist newly pregnant women with accessing care in their first trimester and following them throughout their pregnancy ensuring they receive a post-partum check-up and are connected to medical home for on-going primary care. The OB Navigation Program will use culturally and linguistically competent community health workers to serve as patient navigators. UMCB will continue to increase access to services by supporting the Seton League House, a 38-room bed-and-bath facility designed to provide families and caregivers with a place to stay while their loved ones are hospitalized in an Austin-area hospital. The subsidized rooms reduce the barrier of travel costs associated with treatment. Community Collaboration Despite many non-profit and social service organizations within Travis County, many focus group participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of cohesiveness and focused vision leads residents to feel that there is more dialogue than there is action. More coordinated approaches would help maximize limited resources. In 1997, Seton led the formation of the Integrated Care Collaboration (ICC), an alliance of community providers for the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure. In 2012, Seton and the Travis County Healthcare District began development of a non-profit Community Care Collaborative (CCC) with the purpose of advancing the health of identified vulnerable populations in Travis County through high-quality, cost effective, person centered care. The essential elements of the CCC are: patient centered medical homes, developing a health information exchange for its patients, case management of a selected high risk population, pharmacy management, integrated outpatient/inpatient protocols, and transitional care. The CCC will be outcome driven and rely heavily on analytics to drive process improvement and innovation. Seton Healthcare Family is a partner of the Community Action Network (CAN) and will continue to support this local collaboration. CAN is a partnership of government, non-profit, private, and faith-based organizations who work together to enhance the social, health, educational, and economic well-being of Central Texas. As a partner of CAN, Seton has representatives on the Board of Directors and is committed to working with other CAN Partners to attain the mission of CAN. Financial Assistance Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. UMCB screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers UMCB patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level.
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Schedule H, Part V, Section B, Line 11 Facility A, 7
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Facility A, 7 - DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS - PART 1. Due to its large service area, the identified health needs from all seven CHNA's were taken into account when creating the Implementation Plan for DCMC. The three health needs; behavioral health, chronic disease, and obesity were identified in every CHNA. Another gap identified consistently across all counties was access to care. This large need bucket includes a multitude of factors including lack of providers for the un/underinsured; the high cost of care; education on service navigation; limited specialty care or services; lack of insurance coverage, and transportation-related issues. Additional needs identified in the communities that DCMC serves were increased community collaboration and addressing accident-related injuries/deaths. Obesity A majority of key informants, including Central Health Connection interviewees, considered obesity to be a pressing health issue, particularly among children and in relation to other chronic diseases such as diabetes and heart disease. Interview participants identified disparities among racial/ethnic groups impacted by obesity, especially Blacks/African Americans and Latinos/Hispanics. While obesity was only mentioned as a community concern in a few focus groups, the importance of and challenges around nutrition and exercise were frequently discussed. Quantitative results show that in 2008-2010, the percentage of obese youth at the county level was below that of Texas overall (15.6%) and the national HP2020 target (14.6%), yet higher among Blacks/African Americans (12.0%) and Latinos/Hispanics (13.0%). Additionally male youth (13.8%) were more than twice as likely to be obese than female youth (6.0%). DCMC has implemented various community outreach programs and educational opportunities to help educate children and their families about living a healthy lifestyle. In response to the growing trend of obese children, DCMC established the Texas Center for the Prevention and Treatment of Childhood Obesity (TCPTCO) in 2010. The aim of TCPTCO was to provide children and their families an opportunity to learn from a multidisciplinary team through classes, nutrition education, and counseling to achieve a healthy lifestyle. In addition, DCMC collaborates with dozens of community organizations and advocacy groups whose goal is to turn the curve on the obesity trend in Central Texas. During 2013 - 2015, DCMC will incorporate a Multi-level Family and Child Obesity Initiative into the currently established programs available at the TCPTCO. This program will be a comprehensive childhood obesity intervention with a tiered approach, increasing the intensity of the intervention depending upon the unique needs of the child. This initiative will address the lack of: 1) Accessible information on local programming and resources that help support healthy active living; 2) Primary care provider's ability to effectively address childhood obesity in their offices; and 3) Access to services for the dramatic number of morbidly obese children in Travis County. The CHNA identified access to healthy foods as a high priority. With the number of visitors and community members who visit the DCMC cafeteria on a daily basis, DCMC is dedicated to improving the nutritional value of the food offered at the facility. DCMC will work with TouchPoint, its food service vendor, to improve the nutritional content in the food served through a Healthy Dining Program to ensure that our daily offerings are geared toward providing healthy choices and options for our guests. This will not only benefit patients but also visitors, physicians, and community members who frequent the hospital. Chronic Disease and Disease Management The 2012 Travis County Community Health Needs Assessment identified chronic disease and disease management as the second highest health issue facing residents of Travis County. For the past six years the top three causes of death in Travis County have been related to chronic disease. During the CHNA process many focus group participants and interviewees cited chronic disease - specifically diabetes, heart disease, and cancer - among the greatest areas of concern. DCMC will expand a pilot to manage the comprehensive care of children with complex, chronic disease in the outpatient setting with its Care Management for Chronically Ill Children and Adolescents project. The purpose of this project is to identify and manage a population of children with a very high disease complexity and multiple co-morbid conditions to deliver comprehensive integrated care that can improve outcomes. The proposed model creates an outpatient clinic to deliver comprehensive integrated primary and specialty care to these children. Multidisciplinary services such as palliative care, behavioral medicine and psychiatric care are embedded in the care structure in a manner that affirms the family as a unit of concern and designs processes that maximize well days for the entire family unit. While communicable disease was not discussed during focus groups or interviews, effective population health management through immunizations for diseases has been proven to drastically decrease and eradicate these life-threatening illnesses. In the CHNA parents mentioned the importance of immunizations for their children. DCMC has helped AISD meet the state milestone of having 100% of the schools with 95% of students fully vaccinated. DCMC will continue to support AISD in meeting this standard of immunization but in recognizing that immunization challenges still exist, DCMC will conduct Immunization Clinics at schools with the greatest need. These immunizations will be given free of charge and will provide students access to the necessary immunizations earlier in the school year cycle. DCMC will continue to offer Seton's Asthma Education program to Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages. Behavioral Health The CHNA identified mental health as one of the foremost health concerns raised by Travis County residents. Focus group participants and interviewees alike mentioned the rising rates of mental health conditions among Travis County residents. Through the Children's/AISD Student Health Services collaboration, DCMC has been able to build a collaborative approach for responding to student behavioral and mental health needs. The school nurses, which are employees of DCMC, provide identified students with individualized care plans for significant ongoing behavioral and mental health needs. DCMC will increase professional development for these school based nurses to aid in identifying and addressing behavioral health issues in addition to improving its electronic system for capturing and reporting care plans, with the hope of improved identification and documentation of student behavioral health needs. As a result of the SHS data analysis and the CHNA, DCMC and SHS will work to improve information sharing on campus safety and student behavioral health issues between SHS, Child Study Teams, and community partners. Additionally, through this collaborative DCMC will support the implementation of the Social Emotional Learning (SEL) by AISD. SEL is a curriculum-based, evidence -based approach to teaching skills that support student behavioral health.
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Schedule H, Part V, Section B, Line 11 Facility A, 8
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Facility A, 8 - DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS - PART 2. To augment the public school health education curriculum, Dell Children's has purchased HealthTeacher, a comprehensive K-12 online health education curriculum for teachers in school districts within Travis, Williamson, and Hays County. The curriculum provides over 300 age-appropriate lessons across 10 content areas aligned with the National Health Education Standards (NHES). Lessons are designed for integration into core curriculum areas such as language arts, science and social studies, and have been aligned with the Texas TEKS. They provide skills-based instruction linked to assessments. AISD Health educators were trained by national HealthTeacher staff on how to integrate and implement the HealthTeacher curriculum in the classroom. DCMC is home to the Texas Child Study Center, a collaboration between Dell Children's Medical Center of Central Texas and the College of Educational Psychology of The University of Texas. The Texas Child Study Center provides evidence based treatment for children and adolescents with emotional, behavioral, and developmental disabilities. In addition, Texas Child Study Center provides assessment and treatment for those children with acute or chronic medical illnesses, epilepsy, cystic fibrosis, diabetes, obesity, and traumatic injuries to address co-occurring mental health issues that these youth often face. DCMC proposes to increase access to behavioral health services through the delivery of psychotherapy, psychiatric assessments and medication management on school campuses to children and adolescents through a Campus Based Counseling Referral Center. This project will provide psychotherapy and medication management on campuses of select AISD schools, especially targeting students who have difficulty accessing services due to funding, transportation, or access to providers. Each school year, this project will establish and operate one or more school-based behavioral health clinics; thereafter the established clinic(s) will be operated by Lone Star Circle of Care in collaboration with AISD under the direction of DCMC. Early identification of mental health needs and access to services is crucial to preventing the unnecessary use of crisis services, utilization of the DCMC Emergency Department and use of inpatient resources. By providing services on the school campus, less classroom time is lost and transportation burdens are alleviated as students will not need to leave the school campus. Access to Care Access to health care was a predominant theme among residents, specifically the availability and accessibility of health care facilities and resources. Also mentioned were the difficulty of navigating the health care system, the high cost of care, and the inability to gain and retain health insurance. Community forum participants recognized a presence of facilities and programming but the majority noted that health care resources are greatly lacking, especially for low-income and aging populations. Dell Children's and Lone Star Circle of Care, a Federally Qualified Health Center, have partnered to increase access to care for children by opening five Dell Circle of Care pediatric clinics. The clinics will provide greater access to high-quality health care for underserved children in Williamson County, providing a combined capacity to serve 40,000 children each year. Over the next three years Dell Children's will continue to work with Lone Star to expand access to other counties. As the population of central Texas grows and to increase the availability of pediatric specialty services, DCMC has committed to hire additional physicians in the following specialties: pediatric gastroenterology, pediatric endocrinology, pediatric neurology, adolescent medicine, pediatric pain management and medical pediatrics/transitional medicine. With the addition of these specialists, DCMC will not only be able to better serve children in central Texas, we will be able to serve those in rural communities in Williamson County, Waco and Bryan/College/Station. In continuing with the charge that all children deserve quality health care, DCMC will continue to provide primary care services for uninsured children and their teen parents through its mobile health unit, Children's Health Express. The mission of Children's Health Express is to address the health needs of children who do not have a medical home. This mobile health team delivers primary care and preventative pediatric health care at several school sites and community based organizations around the County. The Children's Health express will work with community partners to identify additional potential stops for the mobile clinic as the access needs change over time. To help underserved residents navigate the complicated and fragmented health care system, DCMC will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. In addition to providing access to primary care, DCMC is committed to providing access to specialty care through its Specialty Care Center. The specialty care center is made up of a neurosurgery center, a craniofacial plastic surgery center, pediatric orthopedics, and a cystic fibrosis center in an effort to increase the availability and access of specialty services in Central Texas. DCMC will support exploring opportunities to expand and increase specialty services to medically underserved areas of their community. Financial Assistance Being uninsured can be a barrier to access. In order to help connect residents with publically available assistance programs, insure-a-kid, a Seton Healthcare Family department, is available to help community members apply for publically subsidized health care coverage. Insure-a-kid staff is located in the community and within DCMC to help families with uninsured children apply for and enroll in Medicaid and CHIP. Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. DCMC screens all uninsured patients and if a patient is not eligible for a government funded program, Seton's financial assistance policy covers DCMC patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level. Accidents Accidents and injury prevention were needs that came up in some of the rural CHNA's. Dell Children's has created an Injury Prevention Program whose mission is to lessen the burden of pediatric injury by identifying and addressing injury risks that affect the lives of patients and families at DCMC and throughout our Central Texas communities. The DCMC injury prevention program will accomplish this by strengthening individual knowledge and skills, providing community education and access to resources, educating providers, fostering coalitions and networks, influencing organizational practices, and advocating at all levels of policy and legislation that protect children from injury.
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Schedule H, Part V, Section B, Line 11 Facility A, 9
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Facility A, 9 - DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS - PART 3. The Austin Area Safe Kids Coalition will also continue to be supported by DCMC. Safe Kids Austin, led by Dell Children's Medical Center of Central Texas, is a member of Safe Kids Worldwide, the nation's first non-profit organization dedicated solely to the prevention of accidental childhood injury. Safe Kids Worldwide is made up of more than 600 state and local Safe Kids coalitions in all 50 states, the District of Columbia and Puerto Rico. Safe Kids Austin consists of more than 30 community, civic, and state organizations. The Coalitions' initiatives include classroom-based programs and educational events for families. The Coalition focuses on promoting safety in vehicles, around water and while walking and biking. Safe Kids Austin promotes changes in attitudes, behaviors, laws and the environment to prevent accidental injury to children. In the United States, Safe Kids partnerships have contributed to a 45 percent reduction in the child fatality rate from accidental injury - saving an estimated 38,000 children's lives. Locally, this is done thru community partnerships, advocacy, public awareness and distribution of, and education on the proper uses of, safety equipment. The Childhood Transportation Safety Committee is a group of stakeholders committed to reducing the incidence of unintentional injuries in the City of Austin by raising awareness of injury risks and encouraging behavioral, environmental and policy changes that prevent injury related to child motor vehicle occupants, child pedestrians, and child cyclist in targeted geographic areas. There are multiple workgroups under the committee attempting to develop a Childhood Transportation Safety Strategy (i.e. plan) for specific geographic areas in the Austin City limits. Community Collaboration Despite the formation of individual county collaborations and children's collaborations focused on improving the health and well-being of the community, several of the CHNA's identified a need to improve on strengthening community partnerships. DCMC will continue to support Children's Optimal Health as a community collaboration that aims to pull community based organizations together in an effort to identify and address the community needs of childhood obesity, access to prenatal care, motor vehicle collisions, and access to primary care. Through this collaboration DCMC will assist in the review of geo mapping data regarding where there are volumes of families with uninsured children and no nearby public health clinics. Through this collaborative, DCMC's Injury Prevention Program has identified "hot spots" or areas of Travis County where child passenger seats are underutilized. The Program has moved child passenger seat fitting stations to the "hot spot" areas to improve access and education to those communities. In 1997, Seton led the formation of the Integrated Care Collaboration (ICC), an alliance of community providers that serve the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on providing quality healthcare to children and adults in specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure. In 2012, Seton and the Travis County Healthcare District began development of a non-profit Community Care Collaborative (CCC) with the purpose of advancing the health of identified vulnerable populations in Travis County through high-quality, cost effective, person centered care. The essential elements of the CCC are: patient centered medical homes, developing a health information exchange for its patients, case management of a selected high risk population, pharmacy management, integrated outpatient/inpatient protocols, and transitional care. The CCC will be outcome driven and rely heavily on analytics to drive process improvement and innovation.
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Schedule H, Part V, Section B, Line 11 Facility A, 10
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Facility A, 10 - SETON NORTHWEST HOSPITAL - PART 1. THE SNW IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE TRAVIS COUNTY CHNA. ALSO ADDRESSED IN THE SNW PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. OBESITY THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE MOST PRESSING HEALTH ISSUES. WHILE OBESITY IN TRAVIS COUNTY IS BELOW THE NATIONAL AVERAGE, CHILDHOOD OBESITY WAS LISTED AS A PARTICULAR AREA OF NEED AS THIS CONDITION IS DISPROPORTIONATELY EVIDENT AMONG MINORITY POPULATIONS. WITH A 24% OBESITY RATE IN ADULTS, TRAVIS COUNTY FALLS BELOW THE STATE AVERAGE OF 29.6%. HOWEVER, WHEN THAT RATE IS BROKEN DOWN BY ETHNICITY, THE NEED TO ADDRESS OBESITY AMONG MINORITY POPULATIONS BECOMES MORE OBVIOUS. 41.7% OF THE BLACK/AFRICAN AMERICAN ADULTS IN TRAVIS COUNTY AND 36.5% OF LATINO/HISPANIC ADULTS ARE CONSIDERED OBESE COMPARED TO 19.4% FOR WHITE RESIDENTS. ACCORDING TO CHNA DATA AND FOCUS GROUP RESPONDENTS, THIS DISPARITY MAY BE ATTRIBUTED TO THE UNEQUAL DISTRIBUTION AND AFFORDABILITY OF FRESH FRUIT AND VEGETABLE OUTLETS THROUGHOUT THE COUNTY AS WELL AS AN UNEQUAL DISTRIBUTION OF OBESITY-RELATED PROGRAMS. THE CITY OF AUSTIN HEALTH DEPARTMENT, THE LOCAL SCHOOL DISTRICTS, AND MANY LOCAL NON-PROFITS ARE WORKING TO REDUCE THE OBESITY RATE IN OUR COMMUNITY. ONE WAY THAT SETON IS EXPLORING TO REDUCE OBESITY IS THROUGH THE SETON HEALTHCARE FAMILY PRE-DIABETES PROGRAM. THIS PROGRAM IS A PILOT PROGRAM ASSOCIATED WITH THE SETON HEALTH CENTERS LOCATED IN TRAVIS COUNTY. THE PROGRAM HELPS TO TRANSFORM THE LIVES OF VULNERABLE WORKING POOR PATIENTS - PATIENTS WHO HAVE BEEN IDENTIFIED AS BEING AT INCREASED RISK FOR DEVELOPING DIABETES - BY PROVIDING AN ARRAY OF EMPOWERING AND ESSENTIAL INTERVENTIONS INCLUDING PSYCHOSOCIAL ASSESSMENT, HEALTH LITERACY ASSESSMENT, SPIRITUAL COUNSELING, WEIGHT LOSS COUNSELING, DIABETES PREVENTION EDUCATION, NUTRITION COUNSELING, GROCERY STORE TOURS, SOCIAL SERVICES REFERRALS, AND COMMUNITY RESOURCE REFERRALS. THE PROGRAM PROVIDES POOR, AT-RISK ADULTS WITH THE INFORMATION, TOOLS AND SUPPORT THEY NEED TO ACHIEVE OBESITY RISK-REDUCTION TO HELP PREVENT DIABETES, AND TO MOVE PATIENTS FROM HAVING FROM PRE- DIABETES GLUCOSE LEVELS TO HAVING NORMAL GLUCOSE. SETON CURRENTLY SERVES IN A LEADERSHIP ROLE WITH THE MAYOR'S HEALTH AND FITNESS COUNCIL (MHFC). MHFC IS A LOCAL NON-PROFIT ORGANIZATION IN TRAVIS COUNTY WHOSE VISION IS TO SUPPORT AND INSPIRE PEOPLE TO IMPROVE THEIR HEALTH BY ENCOURAGING PHYSICAL ACTIVITY, IMPROVED NUTRITION AND TOBACCO-FREE LIVING. A SETON HOSPITAL CHIEF OPERATING OFFICER CURRENTLY SERVES ON THE BOARD AS THE VICE CHAIRFOR THE COUNCIL AND SETON WILL CONTINUE TO PARTICIPATE IN THIS COLLABORATIVE EFFORT TO MAKE AUSTIN THE HEALTHIEST CITY IN AMERICA. THE CHNA IDENTIFIED ACCESS TO HEALTHY FOODS AS A HIGH PRIORITY. WITH THE NUMBER OF VISITORS AND COMMUNITY MEMBERS WHO VISIT THE SNW CAFETERIA ON A DAILY BASIS, SNW IS DEDICATED TO IMPROVING THE NUTRITIONAL VALUE OF THE FOOD OFFERED AT THE FACILITY. SNW WILL WORK WITH TOUCHPOINT, ITS FOOD SERVICE VENDOR, TO IMPROVE THE NUTRITIONAL CONTENT IN THE FOOD SERVED THROUGH A HEALTHY DINING PROGRAM TO ENSURE THAT OUR DAILY OFFERINGS ARE GEARED TOWARD PROVIDING HEALTHY CHOICES AND OPTIONS FOR OUR GUESTS. THIS WILL NOT ONLY BENEFIT PATIENTS BUT ALSO VISITORS, PHYSICIANS, AND COMMUNITY MEMBERS WHO FREQUENT THE HOSPITAL. SNW IS COMMITTED TO ITS SUPPORT OF THE IGNITE WOMEN'S HEALTH PROGRAM WHICH IS DEDICATED TO PROVIDING WOMEN WITH A CONTINUUM OF SUPPORT REGARDING THEIR HEALTH AND WELLNESS, AND OPPORTUNITIES TO LIGHT UP THEIR LIVES. IGNITE OFFERS AN ARRAY OF PROGRAMS FROM PREVENTATIVE WELLNESS TO RESTORATIVE HEALTH CARE, TO EDUCATE AND ENCOURAGE WOMEN IN A HEALTHY LIFESTYLE AND IN TURN - A HEALTHY COMMUNITY. PROGRAMS INCLUDE FREE FITNESS, ZUMBA, YOGA, AND SELF- DEFENSE CLASSES, IN ADDITION TO FREE CARDIAC SCREENINGS, BMI, BLOOD PRESSURE, AND MANY MORE TESTS THAT HELP WOMEN MEASURE THEIR OVERALL HEALTH. IGNITE ALSO OFFERS NUTRITION AND COOKING CLASSES TO HELP PROMOTE HEALTHY EATING HABITS. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH ISSUE FACING RESIDENTS OF TRAVIS COUNTY. FOR THE PAST SIX YEARS THE TOP THREE CAUSES OF DEATH IN TRAVIS COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY FOCUS GROUP PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE - SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER - AMONG THE GREATEST AREAS OF CONCERN. SETON NETWORK ONCOLOGY SERVICES CURRENTLY WORKS WITH SEVERAL SETON HOSPITALS, INCLUDING SNW, PROVIDING ACCESS TO THE SETON CANCER PREVENTION AND EARLY DETECTION PROGRAM, THE ONCOLOGY NURSE REGISTRY, THE SURVIVORSHIP PROGRAM, THE MULTIDISCIPLINARY CANCER CONFERENCE AND CLINICS AND NAVIGATION SERVICE. SETON'S COMPREHENSIVE ONCOLOGY PROGRAMS PROVIDE RESIDENTS OF CENTRAL TEXAS ACCESS TO CANCER SERVICES THAT PROMOTE EARLY DETECTION AND A COORDINATED APPROACH TO CARE THROUGHOUT THE CONTINUUM WHICH INCLUDES SCREENING, DIAGNOSIS, TREATMENT AND SURVIVORSHIP. SNW REFERS PATIENTS TO THE SETON SHIVERS CANCER CENTER. THE SHIVERS CANCER CENTER PROVIDES A VARIETY OF OUTPATIENT SERVICES FOR ADULT CANCER PATIENTS IN CENTRAL TEXAS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO CLINICAL SERVICES, THE SHIVERS HEALTH CARE PROFESSIONALS WORK CLOSELY WITH THE SETON CANCER CARE TEAM TO PROVIDE VITAL CASE MANAGEMENT SERVICES PLUS A VARIETY OF PHYSICAL, EMOTIONAL, AND SPIRITUAL SUPPORT PROGRAMS TO ADULT CANCER PATIENTS AND THEIR FAMILIES. SNW WILL WORK WITH THE NEW WOMEN'S ONCOLOGY CARE SCREENING PROGRAM. THIS PROGRAM EXPANDS TIMELY ACCESS TO BREAST AND CERVICAL CANCER SCREENING VIA A MOBILE UNIT FOR UNINSURED AND UNDERINSURED WOMEN IN CENTRAL TEXAS WHO, WITHOUT THIS EXPANSION, LIKELY WOULD NOT RECEIVE THESE LIFE-SAVING SERVICES. THIS EXPANSION IN SCREENING IS PART OF SETON'S DIGITAL MAMMOGRAPHY MOBILE UNIT KNOWN AS THE BIG PINK BUS. ACCESS TO CERVICAL CANCER SCREENINGS ARE NOW EXPANDED TO MOBILE MAMMOGRAPHY PROGRAM PARTICIPANTS BY USING ADVANCED PRACTICE NURSES ON THE MOBILE UNIT OR AT OUR COMMUNITY CLINICS THAT PROVIDE INDIGENT CARE. IN ADDITION TO THE SCREENING, SNW WILL INCORPORATE WOMEN'S ONCOLOGY NAVIGATION AS A METHOD OF EXPANDING EXISTING PATIENT NAVIGATION SERVICES THAT CONNECT WOMEN WITH CANCER DIAGNOSIS TO TREATMENT AND/OR SURVIVORSHIP SUPPORT SERVICES. LOOKING TO IMPROVE THE HEALTH OF PATIENTS WITH CHRONIC DISEASE, SETON HAS ESTABLISHED THE SETON TOTAL HEALTH TRANSITIONS TEAM AS A PROTOTYPE OF DISEASE MANAGEMENT AS PATIENTS LEAVE THE HOSPITAL SETTING. BASED ON A SUCCESSFUL PILOT, SNW WILL ENHANCE AND EXPAND THE MODEL TO BETTER COORDINATE CARE THROUGH A CARE TRANSITION INTERVENTION. THIS APPROACH INCLUDES A MULTI-DISCIPLINARY TEAM THAT MONITORS AND COORDINATES THE CARE OF PATIENTS WITH CHRONIC DISEASES IMMEDIATELY FOLLOWING DISCHARGE FROM HOSPITAL TO HOME, AND FROM HOME TO PRIMARY CARE. THIS PROJECT IS EXPECTED TO OPTIMIZE THE PATIENT'S RECOVERY AND AVOID READMISSION. SERVICES INCLUDE HOME VISITS TO PROVIDE SHORT-TERM DIRECT CARE, SOCIAL SERVICES, BEHAVIORAL HEALTH SUPPORT, TRANSPORTATION, TELEHEALTH AND PATIENT TRAINING REGARDING SELF-CARE MANAGEMENT OF THE CHRONIC DISEASE(S). SNW IS DEVELOPING A CHRONIC CARE MANAGEMENT PROGRAM THAT PROVIDES DIRECT HEALTH CARE AND CARE COORDINATION FOR ADULTS WHO HAVE BEEN SERIOUSLY INJURED AND TO THOSE WHO HAVE EXPERIENCED A SERIOUS ILLNESS DUE TO MULTIPLE CHRONIC CONDITIONS. THIS WILL BE AN EXTENSION OF THE SETON TOTAL HEALTH PARTNERS PILOT ESTABLISHED IN JANUARY 2012. THIS PROGRAM ASSISTS ENROLLEES IN FINDING AND RECEIVING THE MEDICAL CARE THEY NEED TO ACHIEVE OPTIMAL HEALTH AND PREVENT AVOIDABLE HOSPITALIZATION AND INAPPROPRIATE USE OF EMERGENCY DEPARTMENTS. THE PROGRAM PROVIDES A NUMBER OF PATIENT CARE INTERVENTIONS, A STRUCTURED AND MONITORED HAND-OFF PROCESS, TRAINING FOR OPTIMAL SELF-CARE, COUNSELING, AND FACILITATED INTEGRATION WITH PRIMARY AND SPECIALTY PHYSICIANS RESPONSIBLE FOR EACH PATIENT'S CARE.
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Schedule H, Part V, Section B, Line 11 Facility A, 11
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Facility A, 11 - SETON NORTHWEST HOSPITAL - PART 2. SNW PROPOSES TO DEVELOP AND IMPLEMENT A PROCESS IMPROVEMENT METHODOLOGY TO IMPROVE OUTCOMES FOR ADULT INPATIENTS DIAGNOSED WITH DIABETICS MELLITUS. DIABETES CHRONIC CARE MANAGEMENT WILL IMPLEMENT SMALL, STRAIGHTFORWARD EVIDENCE-BASED PRACTICES TO IMPLEMENT A DIABETES CARE BUNDLE THAT, WHEN PERFORMED COLLECTIVELY AND RELIABLY, HAS BEEN PROVEN TO IMPROVE PATIENT OUTCOMES. IN ADDITION, THIS PROJECT WILL ESTABLISH AN INTERDISCIPLINARY DIABETES TEAM, LED BY AN ENDOCRINOLOGISTS AND A DIABETES CLINICAL NURSE SPECIALIST, TO ADDRESS THE CLINICAL, SAFETY, AND PSYCHOSOCIAL NEEDS OF INPATIENTS WITH DIABETES WHILE PREPARING FOR A SUCCESSFUL DISCHARGE. THE PROJECT WILL ALSO IMPLEMENT EVIDENCE-BASED PRACTICE (EBP) PROTOCOLS TO ENSURE IMPROVED CLINICAL OUTCOMES DURING AND POST-HOSPITALIZATION. SNW WILL CONTINUE TO OFFER SETON'S ASTHMA EDUCATION PROGRAM TO CENTRAL TEXAS RESIDENTS. THIS PROGRAM PROVIDES HOME VISITS FOR ASTHMA EDUCATION TO NEARLY 1,000 UNINSURED AND UNDERINSURED FAMILIES PER YEAR. BY PROVIDING EDUCATION ABOUT SERVICES IN THE HOME, RESIDENTS OVERCOME TRANSPORTATION BARRIERS THAT OFTEN ACCOMPANY THIS TARGET POPULATION. THE SETON ASTHMA & COPD CENTER PROVIDES A COMPREHENSIVE DISEASE MANAGEMENT PROGRAM DESIGNED TO PROVIDE CARE COORDINATION, SOCIAL SERVICES, AND ASTHMA/COPD EDUCATION FOR ALL AGES. SETON HEALTHCARE FAMILY FACILITIES ARE A TOBACCO FREE ENVIRONMENT, PROHIBITING TOBACCO USE AT ALL OF ITS HOSPITALS AND PLACES OF WORK. SETON IS AN ACTIVE PARTICIPANT IN COMMUNITY EFFORTS TO COMBAT TOBACCO USE, PROVIDING TOBACCO CESSATION SERVICES TO TRAVIS COUNTY RESIDENTS. SNW WILL CONTINUE TO SUPPORT THE TOBACCO CESSATION PROGRAM THAT PROVIDES COMMUNITY-WIDE TRAINING FOR PHYSICIANS AND LOCAL CLINICS BASED ON BEST PRACTICES FOR TREATING NICOTINE ADDICTION. IN ADDITION, THE SETON TOBACCO EDUCATION RESOURCE CENTER OFFERS A COMPREHENSIVE TOBACCO EDUCATION PROGRAM WHICH PROVIDES CESSATION CLASSES THAT ARE BASED ON THE MAYO CLINIC MODEL FOR TREATING TOBACCO DEPENDENCE. SESSIONS FOLLOW A SUPPORT GROUP SETTING AND ARE FACILITATED BY CERTIFIED TOBACCO TREATMENT SPECIALIST. THROUGH MOTIVATIONAL INTERVIEWING TECHNIQUES CTTS ARE ABLE TO CONDUCT SESSIONS THAT AIM AT MAXIMIZING & PROMOTING PARTICIPANT DIALOGUE. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE FOREMOST HEALTH CONCERNS RAISED BY TRAVIS COUNTY RESIDENTS. FOCUS GROUP PARTICIPANTS AND INTERVIEWEES ALIKE MENTIONED THE RISING RATES OF MENTAL HEALTH CONDITIONS AMONG TRAVIS COUNTY RESIDENTS. THIS INCLUDED AREAS SUCH AS SUBSTANCE ABUSE AND INADEQUATE MENTAL HEALTH SERVICES. THE CHNA IDENTIFIED THAT 20% OF TRAVIS COUNTY ADULTS EXPERIENCED FIVE OR MORE DAYS OF POOR MENTAL HEALTH IN THE PAST MONTH, WHICH IS WELL ABOVE THE NATIONAL MEDIAN. SNW WILL EXPANDED ACCESS TO PSYCHIATRIC TELEMEDICINE TO THE EMERGENCY DEPARTMENT IN AUGUST 2013 AND WILL CONTINUE TO EXPAND THESE BEHAVIORAL HEALTH SERVICES TO REMAINDER OF THE HOSPITAL FLOORS BY THE END OF 2014. BY PROVIDING 24/7 PSYCHIATRIC CONSULTATIONS PATIENTS IN PSYCHIATRIC CRISIS WILL BE ABLE TO BE EVALUATED AND TREATED IN A TIMELY MANNER. TYPICALLY PATIENTS WOULD HAVE TO WAIT UNTIL THE NEXT DAY FOR APPROPRIATE PSYCHIATRIC ASSESSMENT. THIS NEW APPROACH TO PSYCHIATRIC TELEMEDICINE CAN LEAD TO TIMELY ASSESSMENT, EARLIER DISPOSITION AND LESS COSTLY LEVEL OF CARE. OTHER PROGRAMS TARGETED TO IMPROVE THE MENTAL HEALTH AND WELL- BEING OF SNW PATIENTS AND COMMUNITY MEMBERS INCLUDE THE SETON COVE SPIRITUALITY CENTER. THE SETON COVE SPIRITUALITY CENTER PROVIDES SPIRITUALLY HEALING DISCUSSION GROUPS, CLASSES AND EVENTS LED BY A MULTIDISCIPLINARY FACULTY BOTH ON THE SNW CAMPUS AND AT THE SPIRITUALITY CENTER. PROGRAMS ARE OPEN TO THE COMMUNITY. TO AUGMENT THE PUBLIC SCHOOL HEALTH EDUCATION CURRICULUM, SETON HEALTHCARE FAMILY HAS PURCHASED HEALTHTEACHER, A COMPREHENSIVE K-12 ONLINE HEALTH EDUCATION CURRICULUM FOR TEACHERS IN SCHOOL DISTRICTS WITHIN TRAVIS, WILLIAMSON, AND HAYS COUNTY. THE CURRICULUM PROVIDES OVER 300 AGE-APPROPRIATE LESSONS ACROSS 10 CONTENT AREAS ALIGNED WITH THE NATIONAL HEALTH EDUCATION STANDARDS (NHES). LESSONS ARE DESIGNED FOR INTEGRATION INTO CORE CURRICULUM AREAS SUCH AS LANGUAGE ARTS, SCIENCE AND SOCIAL STUDIES, AND HAVE BEEN ALIGNED WITH THE TEXAS TEKS. THEY PROVIDE SKILLS-BASED INSTRUCTION LINKED TO ASSESSMENTS. HEALTH EDUCATORS IN SCHOOL DISTRICTS IN TRAVIS COUNTY WERE TRAINED BY NATIONAL HEALTHTEACHER STAFF ON HOW TO INTEGRATE AND IMPLEMENT THE HEALTHTEACHER CURRICULUM IN THE CLASSROOM. ACCESS TO CARE ACCESS TO HEALTH CARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE AVAILABILITY AND ACCESSIBILITY OF HEALTH CARE FACILITIES AND RESOURCES. ALSO MENTIONED WERE THE DIFFICULTY OF NAVIGATING THE HEALTH CARE SYSTEM, THE HIGH COST OF CARE, AND THE INABILITY TO GAIN AND RETAIN HEALTH INSURANCE. COMMUNITY FORUM PARTICIPANTS RECOGNIZED A PRESENCE OF FACILITIES AND PROGRAMMING BUT THE MAJORITY NOTED THAT HEALTH CARE RESOURCES ARE GREATLY LACKING, ESPECIALLY FOR LOW-INCOME AND AGING POPULATIONS. THE SETON HEALTH CENTERS WERE ESTABLISHED TO PROVIDE ACCESSIBLE, COMPREHENSIVE HEALTH SERVICES TO MEDICALLY UNDERSERVED FAMILIES IN AUSTIN. PRIMARY CARE PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS PROVIDE QUALITY PRIMARY CARE TO COMMUNITY RESIDENTS ON A SLIDING SCALE BASED ON FAMILY SIZE AND INCOME. MEDICARE, MEDICAID AND CHIP ARE ALSO ACCEPTED. EACH OF THE THREE CLINICS OFFERS PRIMARY CARE, LABORATORY, CASE MANAGEMENT, AND HEALTH EDUCATION SERVICES. COMPREHENSIVE SOCIAL SERVICES ARE PART OF THE CENTERS' MEDICAL MISSION AS WELL. SNW HAS AND WILL CONTINUE TO REFER UNFUNDED PATIENTS WITHOUT A MEDICAL HOME TO THE SETON COMMUNITY HEALTH CENTERS FOR PRIMARY CARE.
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Schedule H, Part V, Section B, Line 11 Facility A, 12
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Facility A, 12 - SETON NORTHWEST HOSPITAL - PART 3. THE TRAVIS COUNTY MEDICAL SOCIETY, THE SETON HEALTHCARE FAMILY AND OTHER MEMBERS OF THE INTEGRATED CARE COLLABORATION HAVE INITIATED A COORDINATED SYSTEM OF VOLUNTEER DOCTORS CALLED PROJECT ACCESS. THEY WORK WITH OTHER LOCAL PROVIDERS TO PROVIDE MEDICAL, HOSPITAL, DIAGNOSTIC AND PHARMACY ASSISTANCE FOR THE UNINSURED IN TRAVIS COUNTY. THE MISSION OF PROJECT ACCESS IS TO PROVIDE READY ACCESS TO APPROPRIATE HEALTH CARE SERVICES FOR UNINSURED PEOPLE IN TRAVIS COUNTY WHOSE INCOMES ARE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL AND TO IMPROVE THE OVERALL HEALTH OF OUR COMMUNITY. SETON HELPED SECURE A GRANT TO CREATE THE PROGRAM. MORE THAN 1,000 VOLUNTEER PHYSICIANS PARTICIPATE IN PROJECT ACCESS AND SETON WILL CONTINUE TO SUPPORT THE WORK OF THIS COLLABORATION TO IMPROVE ACCESS TO CARE. SNW IS CURRENTLY ENGAGED IN A PARTNERSHIP WITH LONE STAR CIRCLE OF CARE TO BRING OBSTETRIC AND GYNECOLOGICAL SERVICES TO LOW INCOME WOMEN AND PEDIATRIC SERVICES TO CHILDREN IN NORTHWEST TRAVIS COUNTY TO HELP UNDERSERVED RESIDENTS NAVIGATE THE COMPLICATED AND FRAGMENTED HEALTH CARE SYSTEM, SNW WILL CONTINUE TO PROVIDE ACCESS TO THE NURSE TRIAGE CALL CENTER. FUNDED BY THE SETON HEALTHCARE NETWORK, THE SETON'S NURSE TRIAGE CALL CENTER MAKES REGISTERED NURSES AVAILABLE 24/7 FREE OF CHARGE TO FOLKS CALLING ONE OF SETON'S EMERGENCY DEPARTMENTS. NURSES ASSIST CALLERS WITH URGENT CARE NEEDS AND SCHEDULE DOCTORS' APPOINTMENTS TO AVOID UNNECESSARY EMERGENCY ROOM VISITS. CALL CENTER NURSES ARE ABLE TO SCHEDULE SAME-DAY AND NEXT-DAY APPOINTMENTS FOR CALLERS AT PARTICIPATING CLINICS. THE CHNA IDENTIFIED HEALTH DISPARITIES AND INEQUITIES IN THE ABILITY OF DIFFERENT ETHNIC GROUPS TO ACCESS CARE. THE REASONS ARE COMPLEX. RESEARCH SHOWS PROVIDING PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE REDUCES READMISSIONS WITHIN 30 DAYS, REDUCES PATIENT BED DAYS, IMPROVES MEDICATION ADHERENCE AND LEADS TO BETTER HEALTH OUTCOMES. IN ADDITION, RESEARCH ALSO SHOWS PROVIDING CULTURAL COMPETENCE TRAINING TO OUR CLINICAL CARE TEAMS IMPROVES COMMUNICATION BETWEEN PATIENTS AND THEIR CLINICAL CARE TEAM INCLUDING THEIR DOCTORS AND NURSES AS MEASURED BY THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS ("HCAHPS") SURVEY, THE FIRST NATIONAL, STANDARDIZED, PUBLICLY REPORTED SURVEY OF PATIENTS' PERSPECTIVES OF HOSPITAL CARE. CURRENTLY SETON PROVIDES TELEPHONE INTERPRETATION SERVICES IN OVER 140 LANGUAGES, 24 HOURS, 7 DAYS A WEEK, 365 DAYS A YEAR. IN ADDITION, SETON PROVIDES IN PERSON SIGN LANGUAGE CONTRACTED SERVICES AT ALL OF OUR FACILITIES. AS PART OF AN INTEGRATED APPROACH TO ADMINISTER CARE IN A PERSON CENTERED, CULTURALLY COMPETENT MANNER, SETON HEALTHCARE FAMILY THROUGH SNW, WILL DEVELOP A LANGUAGE SERVICES RESOURCE CENTER AND A CULTURALLY COMPETENT CARE CURRICULUM. THE LANGUAGE SERVICES RESOURCE CENTER IS A NEW PROJECT WHICH WILL PROVIDE PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE BY CENTRALIZING INTERPRETATION & TRANSLATION SERVICES, AND INCREASING THE NUMBER OF PROFESSIONAL MEDICAL INTERPRETERS FOR PATIENTS WITH LIMITED ENGLISH PROFICIENCY INCLUDING BUT NOT LIMITED TO SPANISH AND SIGN LANGUAGE. THE CULTURALLY COMPETENT CARE CURRICULUM IS EXPECTED TO INCREASE THE QUALITY OF COMMUNICATION BETWEEN THE CLINICAL CARE TEAM AND THE PATIENT IN ORDER TO ACHIEVE GREATER PATIENT INVOLVEMENT IN SHARED DECISION MAKING. THE DIVERSITY DEPARTMENT THROUGH THE CULTURALLY COMPETENT CARE CURRICULUM WILL PROVIDE TRAINING AND EDUCATION TO THE CLINICAL CARE TEAM TO INCREASE THE LIKELIHOOD OF SAFE AND EFFECTIVE PERSON CENTERED CARE IN A CULTURALLY COMPETENT MANNER AND LEADS TO BETTER HEALTH OUTCOMES. THE NUMBER OF SPANISH SPEAKING ONLY PATIENTS DELIVERING AT SNW IS GROWING. MANY OF THESE WOMEN ARE LOW INCOME AND ARE ENROLLED IN PUBLICALLY FUNDED HEALTHCARE COVERAGE; CHIP PERINATE OR MEDICAID. IN ORDER TO ENSURE THESE PATIENTS HAVE AN EASY TRANSITION FROM THE CLINIC TO THE HOSPITAL, SNW HAS EMPLOYED A CULTURALLY AND LINGUISTICALLY COMPETENT OB NAVIGATOR TO CONNECT WITH THESE PREGNANT PATIENTS PRIOR TO DELIVERY. THE OB NAVIGATOR ENSURES THE PATIENT IS PRE-REGISTERED WITH THE HOSPITAL AND RECEIVES A TOUR OF THE FACILITY. THE NAVIGATOR ASSISTS THE PATIENT WITH THEIR INSURANCE NEEDS AND EXPLAINS THE PROCESS OF ENROLLING THEIR NEWBORNS INTO MEDICAID. THE NAVIGATOR IS A PATIENT RESOURCE, ANSWERING ALL NON- CLINICAL QUESTIONS THE PATIENT MAY HAVE. SNW WILL CONTINUE TO INCREASE ACCESS TO SERVICES BY SUPPORTING THE SETON LEAGUE HOUSE, A 38-ROOM BED-AND-BATH FACILITY DESIGNED TO PROVIDE FAMILIES AND CAREGIVERS WITH A PLACE TO STAY WHILE THEIR LOVED ONES ARE HOSPITALIZED IN AN AUSTIN-AREA HOSPITAL. THE SUBSIDIZED ROOMS REDUCE THE BARRIER OF TRAVEL COSTS ASSOCIATED WITH TREATMENT. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN TRAVIS COUNTY, MANY FOCUS GROUP PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESIVENESS AND FOCUSED VISION LEADS RESIDENTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. MORE COORDINATED APPROACHES WOULD HELP MAXIMIZE LIMITED RESOURCES. IN 1997, SETON LED THE FORMATION OF THE INTEGRATED CARE COLLABORATION (ICC), AN ALLIANCE OF COMMUNITY PROVIDERS FOR THE MEDICALLY INDIGENT, INCLUDING HEALTH CARE ORGANIZATIONS, GOVERNMENT ENTITIES AND VOLUNTEER CLINICS. KNOWN AS THE ICC, THE GROUP'S GOAL WAS TO WORK TOGETHER TO INCREASE ACCESS, IMPROVE QUALITY AND FIND CREATIVE FINANCING SOLUTIONS FOR THE PROVISION OF HEALTH CARE FOR THE REGION'S UNINSURED. THE ICC HAS DEVELOPED AN AREA WIDE HEALTH INFORMATION EXCHANGE (HIE) FOR THE UN- AND UNDERINSURED THAT IS USED TO INFORM PROVIDERS ON THE CARE A SPECIFIC INDIVIDUAL HAS RECEIVED WHILE ALSO PROVIDING COMMUNITY WIDE ANALYTICS ON HEALTHCARE USAGE AND DIAGNOSTIC TRENDS. SINCE ITS INCEPTION THE ICC HAS BROKEN INTO MULTIPLE COLLABORATIONS, FOCUSING ON SPECIFIC GEOGRAPHIC AREAS. THE SETON HEALTHCARE FAMILY CONTINUES TO FUND THE ICC INFRASTRUCTURE. IN 2012, SETON AND THE TRAVIS COUNTY HEALTHCARE DISTRICT BEGAN DEVELOPMENT OF A NON-PROFIT COMMUNITY CARE COLLABORATIVE (CCC) WITH THE PURPOSE OF ADVANCING THE HEALTH OF IDENTIFIED VULNERABLE POPULATIONS IN TRAVIS COUNTY THROUGH HIGH-QUALITY, COST EFFECTIVE, PERSON CENTERED CARE. THE ESSENTIAL ELEMENTS OF THE CCC ARE: PATIENT CENTERED MEDICAL HOMES, DEVELOPING A HEALTH INFORMATION EXCHANGE FOR ITS PATIENTS, CASE MANAGEMENT OF A SELECTED HIGH RISK POPULATION, PHARMACY MANAGEMENT, INTEGRATED OUTPATIENT/INPATIENT PROTOCOLS, AND TRANSITIONAL CARE. THE CCC WILL BE OUTCOME DRIVEN AND RELY HEAVILY ON ANALYTICS TO DRIVE PROCESS IMPROVEMENT AND INNOVATION. SETON HEALTHCARE FAMILY IS A PARTNER OF THE COMMUNITY ACTION NETWORK (CAN) AND WILL CONTINUE TO SUPPORT THIS LOCAL COLLABORATION. CAN IS A PARTNERSHIP OF GOVERNMENT, NON-PROFIT, PRIVATE, AND FAITH-BASED ORGANIZATIONS WHO WORK TOGETHER TO ENHANCE THE SOCIAL, HEALTH, EDUCATIONAL, AND ECONOMIC WELL-BEING OF CENTRAL TEXAS. AS A PARTNER OF CAN, SETON HAS REPRESENTATIVES ON THE BOARD OF DIRECTORS AND IS COMMITTED TO WORKING WITH OTHER CAN PARTNERS TO ATTAIN THE MISSION OF CAN. FINANCIAL ASSISTANCE SETON IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HEALTH SYSTEM, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. SNW SCREENS ALL UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE PROVIDES APPLICATION ASSISTANCE TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SETON'S FINANCIAL ASSISTANCE POLICY COVERS SNW PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; SETON PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375% OF THE FEDERAL POVERTY LEVEL.
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Schedule H, Part V, Section B, Line 11 Facility A, 13
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Facility A, 13 - SETON SOUTHWEST HOSPITAL - PART 1. THE SSW IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE TRAVIS COUNTY CHNA. ALSO ADDRESSED IN THE SSW PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. OBESITY THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE MOST PRESSING HEALTH ISSUES. WHILE OBESITY IN TRAVIS COUNTY IS BELOW THE NATIONAL AVERAGE, CHILDHOOD OBESITY WAS LISTED AS A PARTICULAR AREA OF NEED AS THIS CONDITION IS DISPROPORTIONATELY EVIDENT AMONG MINORITY POPULATIONS. WITH A 24% OBESITY RATE IN ADULTS, TRAVIS COUNTY FALLS BELOW THE STATE AVERAGE OF 29.6%. HOWEVER, WHEN THAT RATE IS BROKEN DOWN BY ETHNICITY, THE NEED TO ADDRESS OBESITY AMONG MINORITY POPULATIONS BECOMES MORE OBVIOUS. 41.7% OF THE BLACK/AFRICAN AMERICAN ADULTS IN TRAVIS COUNTY AND 36.5% OF LATINO/HISPANIC ADULTS ARE CONSIDERED OBESE COMPARED TO 19.4% FOR WHITE RESIDENTS. ACCORDING TO CHNA DATA AND FOCUS GROUP RESPONDENTS, THIS DISPARITY MAY BE ATTRIBUTED TO THE UNEQUAL DISTRIBUTION AND AFFORDABILITY OF FRESH FRUIT AND VEGETABLE OUTLETS THROUGHOUT THE COUNTY AS WELL AS AN UNEQUAL DISTRIBUTION OF OBESITY-RELATED PROGRAMS. THE CITY OF AUSTIN HEALTH DEPARTMENT, THE LOCAL SCHOOL DISTRICTS, AND MANY LOCAL NON-PROFITS ARE WORKING TO REDUCE THE OBESITY RATE IN OUR COMMUNITY. ONE WAY THAT SETON IS EXPLORING TO REDUCE OBESITY IS THROUGH THE SETON HEALTHCARE FAMILY PRE-DIABETES PROGRAM. THIS PROGRAM IS A PILOT PROGRAM ASSOCIATED WITH THE SETON HEALTH CENTERS LOCATED IN TRAVIS COUNTY. THE PROGRAM HELPS TO TRANSFORM THE LIVES OF VULNERABLE, WORKING POOR PATIENTS - PATIENTS WHO HAVE BEEN IDENTIFIED AS BEING AT INCREASED RISK FOR DEVELOPING DIABETES - BY PROVIDING AN ARRAY OF EMPOWERING AND ESSENTIAL INTERVENTIONS INCLUDING PSYCHOSOCIAL ASSESSMENT, HEALTH LITERACY ASSESSMENT, SPIRITUAL COUNSELING, WEIGHT LOSS COUNSELING, DIABETES PREVENTION EDUCATION, NUTRITION COUNSELING, GROCERY STORE TOURS, SOCIAL SERVICES REFERRALS, AND COMMUNITY RESOURCE REFERRALS. THE PROGRAM PROVIDES POOR, AT-RISK ADULTS WITH THE INFORMATION, TOOLS AND SUPPORT THEY NEED TO ACHIEVE OBESITY RISK-REDUCTION TO HELP PREVENT DIABETES, AND TO MOVE PATIENTS FROM HAVING FROM PRE- DIABETES GLUCOSE LEVELS TO HAVING NORMAL GLUCOSE. IN ORDER TO INCREASE THE PHYSICAL FITNESS ACTIVITIES IN THE COMMUNITY, SSW SERVES AS THE SPONSOR FOR VARIOUS COMMUNITY EVENTS AIMED AT PROVIDING ACTIVE LIFESTYLE OPPORTUNITIES FOR COMMUNITY MEMBERS. SSW WILL CONTINUE THE RUN/WALK PROGRAM AIMED AT HELPING RESIDENTS TRAIN TO RUN A LOCAL 5K OR 10K. IN ADDITION, SSW WILL CONTINUE TO BE ONE OF THE LEADING SPONSORS IN THE MANY LOCAL RACES SUCH AS THE DOGGIE DASH, DONKEY DASH, AND RUN FOR THE WATER (10 MILE RACE WITH KIDS 1K). SSW CURRENTLY SERVES IN A LEADERSHIP ROLE WITH THE MAYOR'S HEALTH AND FITNESS COUNCIL (MHFC). MHFC IS A LOCAL NON-PROFIT ORGANIZATION WHOSE VISION IS TO SUPPORT AND INSPIRE PEOPLE TO IMPROVE THEIR HEALTH BY ENCOURAGING PHYSICAL ACTIVITY, IMPROVED NUTRITION AND TOBACCO-FREE LIVING. THE SSW CHIEF OPERATING OFFICER CURRENTLY SERVES ON THE BOARD AS THE VICE CHAIR FOR THE COUNCIL AND SSW WILL CONTINUE TO PARTICIPATE IN THIS COLLABORATIVE EFFORT TO MAKE AUSTIN THE HEALTHIEST CITY IN AMERICA. SETON HEALTHCARE FAMILY IS RECOGNIZED BY THE MHFC AS A CERTIFIED HEALTHY EMPLOYER. SSW WILL CONTINUE ITS PARTNERSHIP WITH THE AUSTIN INDEPENDENT SCHOOL DISTRICT (AISD) AFTER SCHOOL PROGRAMS AND THEIR MICRO- SOCIETY PROGRAM. SSW CURRENTLY PROVIDES EDUCATION RELATED TO THE SUPPORT OF COMMUNITY HEALTH AND NUTRITION TO STUDENTS WHO HAVE CREATED A MICRO-COMMUNITY THAT THEY ARE RESPONSIBLE FOR MAINTAINING. SSW WILL CONTINUE TO WORK WITH THE SOUTHWEST AUSTIN AISD PROGRAMS AND OTHER ADDITIONAL OPPORTUNITIES RELATED TO IMPROVING THE HEALTH OF CHILDREN IN THE SOUTHWEST AUSTIN COMMUNITY. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH ISSUE FACING RESIDENTS OF TRAVIS COUNTY. FOR THE PAST SIX YEARS THE TOP THREE CAUSES OF DEATH IN TRAVIS COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY FOCUS GROUP PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE - SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER - AMONG THE GREATEST AREAS OF CONCERN. SETON NETWORK ONCOLOGY SERVICES CURRENTLY WORKS WITH SEVERAL SETON HOSPITALS, INCLUDING SSW, PROVIDING ACCESS TO THE SETON CANCER PREVENTION AND EARLY DETECTION PROGRAM, THE ONCOLOGY NURSE REGISTRY, THE SURVIVORSHIP PROGRAM, THE MULTIDISCIPLINARY CANCER CONFERENCE AND CLINICS, AND NAVIGATION SERVICE. SETON'S COMPREHENSIVE ONCOLOGY PROGRAMS PROVIDE RESIDENTS OF CENTRAL TEXAS ACCESS TO CANCER SERVICES THAT PROMOTE EARLY DETECTION AND A COORDINATED APPROACH TO CARE THROUGHOUT THE CONTINUUM WHICH INCLUDES SCREENING, DIAGNOSIS, TREATMENT AND SURVIVORSHIP. SSW REFERS PATIENTS TO THE SETON SHIVERS CANCER CENTER. THE SHIVERS CANCER CENTER PROVIDES A VARIETY OF OUTPATIENT SERVICES FOR ADULT CANCER PATIENTS IN CENTRAL TEXAS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO CLINICAL SERVICES, SHIVERS HEALTH CARE PROFESSIONALS WORK CLOSELY WITH THE SETON CANCER CARE TEAM TO PROVIDE VITAL CASE MANAGEMENT SERVICES PLUS A VARIETY OF PHYSICAL, EMOTIONAL, AND SPIRITUAL SUPPORT PROGRAMS TO ADULT CANCER PATIENTS AND THEIR FAMILIES. SSW WILL WORK WITH THE NEW WOMEN'S ONCOLOGY CARE SCREENING PROGRAM. THIS PROGRAM EXPANDS TIMELY ACCESS TO BREAST AND CERVICAL CANCER SCREENING VIA A MOBILE UNIT FOR UNINSURED AND UNDERINSURED WOMEN IN CENTRAL TEXAS WHO, WITHOUT THIS EXPANSION, LIKELY WOULD NOT RECEIVE THESE LIFE-SAVING SERVICES. THIS EXPANSION IN SCREENING IS PART OF SETON'S DIGITAL MAMMOGRAPHY MOBILE UNIT KNOWN AS THE BIG PINK BUS. ACCESS TO CERVICAL CANCER SCREENINGS ARE NOW EXPANDED TO MOBILE MAMMOGRAPHY PROGRAM PARTICIPANTS BY USING ADVANCED PRACTICE NURSES ON THE MOBILE UNIT OR AT OUR COMMUNITY CLINICS THAT PROVIDE INDIGENT CARE. IN ADDITION TO THE SCREENING, SSW WILL INCORPORATE WOMEN'S ONCOLOGY NAVIGATION AS A METHOD OF EXPANDING EXISTING PATIENT NAVIGATION SERVICES THAT CONNECT WOMEN WITH CANCER DIAGNOSIS TO TREATMENT AND/OR SURVIVORSHIP SUPPORT SERVICES. LOOKING TO IMPROVE THE HEALTH OF PATIENTS WITH CHRONIC DISEASE, SSW WILL CONTINUE TO OFFER SETON'S ASTHMA EDUCATION PROGRAM TO CENTRAL TEXAS RESIDENTS. THIS PROGRAM PROVIDES HOME VISITS FOR ASTHMA EDUCATION TO NEARLY 1,000 UNINSURED AND UNDERINSURED FAMILIES PER YEAR. BY PROVIDING EDUCATION ABOUT SERVICES IN THE HOME, RESIDENTS OVERCOME TRANSPORTATION BARRIERS THAT OFTEN ACCOMPANY THIS TARGET POPULATION. THE SETON ASTHMA & COPD CENTER PROVIDES A COMPREHENSIVE DISEASE MANAGEMENT PROGRAM DESIGNED TO PROVIDE CARE COORDINATION, SOCIAL SERVICES, AND ASTHMA/COPD EDUCATION FOR ALL AGES. SETON HEALTHCARE FAMILY FACILITIES ARE A TOBACCO FREE ENVIRONMENT, PROHIBITING TOBACCO USE AT ALL OF ITS HOSPITALS AND PLACES OF WORK. SETON IS AN ACTIVE PARTICIPANT IN COMMUNITY EFFORTS TO COMBAT TOBACCO USE, PROVIDING TOBACCO CESSATION SERVICES TO TRAVIS COUNTY RESIDENTS. SSW WILL CONTINUE TO SUPPORT THE TOBACCO CESSATION PROGRAM THAT PROVIDES COMMUNITY-WIDE TRAINING FOR PHYSICIANS AND LOCAL CLINICS BASED ON BEST PRACTICES FOR TREATING NICOTINE ADDICTION. IN ADDITION, THE SETON TOBACCO EDUCATION RESOURCE CENTER OFFERS A COMPREHENSIVE TOBACCO EDUCATION PROGRAM WHICH PROVIDES CESSATION CLASSES THAT ARE BASED ON THE MAYO CLINIC MODEL FOR TREATING TOBACCO DEPENDENCE. SESSIONS FOLLOW A SUPPORT GROUP SETTING AND ARE FACILITATED BY CERTIFIED TOBACCO TREATMENT SPECIALIST. THROUGH MOTIVATIONAL INTERVIEWING TECHNIQUES CTTS ARE ABLE TO CONDUCT SESSIONS THAT AIM AT MAXIMIZING & PROMOTING PARTICIPANT DIALOGUE. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE FOREMOST HEALTH CONCERNS RAISED BY TRAVIS COUNTY RESIDENTS. FOCUS GROUP PARTICIPANTS AND INTERVIEWEES ALIKE MENTIONED THE RISING RATES OF MENTAL HEALTH CONDITIONS AMONG TRAVIS COUNTY RESIDENTS. THIS INCLUDED AREAS SUCH AS SUBSTANCE ABUSE AND INADEQUATE MENTAL HEALTH SERVICES. THE CHNA IDENTIFIED THAT 20% OF TRAVIS COUNTY ADULTS EXPERIENCED FIVE OR MORE DAYS OF POOR MENTAL HEALTH IN THE PAST MONTH, WHICH IS WELL ABOVE THE NATIONAL MEDIAN.
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Schedule H, Part V, Section B, Line 11 Facility A, 14
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Facility A, 14 - SETON SOUTHWEST HOSPITAL - PART 2. SSW HAS EXPANDED ACCESS TO PSYCHIATRIC TELEMEDICINE TO THE ENTIRE SSW FACILITY AND WILL CONTINUE TO SUPPORT THIS BEHAVIORAL HEALTH SERVICE. BY PROVIDING 24/7 PSYCHIATRIC CONSULTATIONS, INCLUDING AFTER HOURS, PATIENTS IN PSYCHIATRIC CRISIS WILL BE ABLE TO BE EVALUATED AND TREATED IN A TIMELY MANNER. TYPICALLY PATIENTS WOULD HAVE TO WAIT UNTIL THE NEXT DAY FOR APPROPRIATE PSYCHIATRIC ASSESSMENT. THIS NEW APPROACH TO PSYCHIATRIC TELEMEDICINE CAN LEAD TO TIMELY ASSESSMENT, EARLIER DISPOSITION AND LESS COSTLY LEVEL OF CARE. OTHER PROGRAMS TARGETED TO IMPROVE THE MENTAL HEALTH AND WELL- BEING OF SSW PATIENTS AND COMMUNITY MEMBERS INCLUDE THE SETON COVE SPIRITUALITY CENTER. THE SETON COVE SPIRITUALITY CENTER PROVIDES SPIRITUALLY HEALING DISCUSSION GROUPS, CLASSES AND EVENTS LED BY A MULTIDISCIPLINARY FACULTY BOTH ON THE SSW CAMPUS AND AT THE SPIRITUALITY CENTER. PROGRAMS ARE OPEN TO THE COMMUNITY. TO AUGMENT THE PUBLIC SCHOOL HEALTH EDUCATION CURRICULUM, SETON HEALTHCARE FAMILY HAS PURCHASED HEALTHTEACHER, A COMPREHENSIVE K-12 ONLINE HEALTH EDUCATION CURRICULUM FOR TEACHERS IN SCHOOL DISTRICTS WITHIN TRAVIS, WILLIAMSON, AND HAYS COUNTY. THE CURRICULUM PROVIDES OVER 300 AGE-APPROPRIATE LESSONS ACROSS 10 CONTENT AREAS ALIGNED WITH THE NATIONAL HEALTH EDUCATION STANDARDS (NHES). LESSONS ARE DESIGNED FOR INTEGRATION INTO CORE CURRICULUM AREAS SUCH AS LANGUAGE ARTS, SCIENCE AND SOCIAL STUDIES, AND HAVE BEEN ALIGNED WITH THE TEXAS TEKS. THEY PROVIDE SKILLS-BASED INSTRUCTION LINKED TO ASSESSMENTS. HEALTH EDUCATORS IN SCHOOL DISTRICTS IN TRAVIS COUNTY WERE TRAINED BY NATIONAL HEALTHTEACHER STAFF ON HOW TO INTEGRATE AND IMPLEMENT THE HEALTHTEACHER CURRICULUM IN THE CLASSROOM. ACCESS TO CARE ACCESS TO HEALTH CARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE AVAILABILITY AND ACCESSIBILITY OF HEALTH CARE FACILITIES AND RESOURCES. ALSO MENTIONED WAS THE DIFFICULTY OF NAVIGATING THE HEALTH CARE SYSTEM, THE HIGH COST OF CARE, AND THE INABILITY TO GAIN AND RETAIN HEALTH INSURANCE. COMMUNITY FORUM PARTICIPANTS RECOGNIZED A PRESENCE OF FACILITIES AND PROGRAMMING BUT THE MAJORITY NOTED THAT HEALTH CARE RESOURCES ARE GREATLY LACKING, ESPECIALLY FOR LOW-INCOME AND AGING POPULATIONS. THE SETON HEALTH CENTERS WERE ESTABLISHED TO PROVIDE ACCESSIBLE, COMPREHENSIVE HEALTH SERVICES TO MEDICALLY UNDERSERVED FAMILIES IN AUSTIN. PRIMARY CARE PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS PROVIDE QUALITY PRIMARY CARE TO COMMUNITY RESIDENTS ON A SLIDING SCALE BASED ON FAMILY SIZE AND INCOME. MEDICARE, MEDICAID AND CHIP ARE ALSO ACCEPTED. EACH OF THE THREE CLINICS OFFERS PRIMARY CARE, LABORATORY, CASE MANAGEMENT, AND HEALTH EDUCATION SERVICES. COMPREHENSIVE SOCIAL SERVICES ARE PART OF THE CENTERS' MEDICAL MISSION AS WELL. SSW HAS AND WILL CONTINUE TO REFER UNFUNDED PATIENTS WITHOUT A MEDICAL HOME TO THE SETON COMMUNITY HEALTH CENTERS FOR PRIMARY CARE. THE TRAVIS COUNTY MEDICAL SOCIETY, THE SETON HEALTHCARE FAMILY AND OTHER MEMBERS OF THE INTEGRATED CARE COLLABORATION HAVE INITIATED A COORDINATED SYSTEM OF VOLUNTEER DOCTORS CALLED PROJECT ACCESS. THEY WORK WITH LOCAL PROVIDERS TO PROVIDE MEDICAL, HOSPITAL, DIAGNOSTIC AND PHARMACY ASSISTANCE FOR THE UNINSURED IN TRAVIS COUNTY. THE MISSION OF PROJECT ACCESS IS TO PROVIDE READY ACCESS TO APPROPRIATE HEALTH CARE SERVICES FOR UNINSURED PEOPLE IN TRAVIS COUNTY WHOSE INCOMES ARE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL AND TO IMPROVE THE OVERALL HEALTH OF OUR COMMUNITY. SETON HELPED SECURE A GRANT TO CREATE THE PROGRAM. MORE THAN 1,000 VOLUNTEER PHYSICIANS PARTICIPATE IN PROJECT ACCESS AND SETON WILL CONTINUE TO SUPPORT THE WORK OF THIS COLLABORATION TO IMPROVE ACCESS TO CARE. TO HELP UNDERSERVED RESIDENTS NAVIGATE THE COMPLICATED AND FRAGMENTED HEALTH CARE SYSTEM, SSW WILL CONTINUE TO PROVIDE ACCESS TO THE NURSE TRIAGE CALL CENTER. FUNDED BY THE SETON HEALTHCARE NETWORK, THE SETON'S NURSE TRIAGE CALL CENTER MAKES REGISTERED NURSES AVAILABLE 24/7 FREE OF CHARGE TO FOLKS CALLING ONE OF SETON'S EMERGENCY DEPARTMENTS. NURSES ASSIST CALLERS WITH URGENT CARE NEEDS AND SCHEDULE DOCTORS' APPOINTMENTS TO AVOID UNNECESSARY EMERGENCY ROOM VISITS. CALL CENTER NURSES ARE ABLE TO SCHEDULE SAME-DAY AND NEXT-DAY APPOINTMENTS FOR CALLERS AT PARTICIPATING CLINICS. THE CHNA IDENTIFIED HEALTH DISPARITIES AND INEQUITIES IN THE ABILITY OF DIFFERENT ETHNIC GROUPS TO ACCESS CARE. THE REASONS ARE COMPLEX. RESEARCH SHOWS PROVIDING PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE REDUCES READMISSIONS WITHIN 30 DAYS, REDUCES PATIENT BED DAYS, IMPROVES MEDICATION ADHERENCE AND LEADS TO BETTER HEALTH OUTCOMES. IN ADDITION, RESEARCH ALSO SHOWS PROVIDING CULTURAL COMPETENCE TRAINING TO OUR CLINICAL CARE TEAMS IMPROVES COMMUNICATION BETWEEN PATIENTS AND THEIR CLINICAL CARE TEAM INCLUDING THEIR DOCTORS AND NURSES AS MEASURED BY THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS ("HCAHPS") SURVEY, THE FIRST NATIONAL, STANDARDIZED, PUBLICLY REPORTED SURVEY OF PATIENTS' PERSPECTIVES OF HOSPITAL CARE. CURRENTLY SETON PROVIDES TELEPHONE INTERPRETATION SERVICES IN OVER 140 LANGUAGES, 24 HOURS, 7 DAYS A WEEK, 365 DAYS A YEAR. IN ADDITION, SETON PROVIDES IN PERSON SIGN LANGUAGE CONTRACTED SERVICES AT ALL OF OUR FACILITIES. AS PART OF AN INTEGRATED APPROACH TO ADMINISTER CARE IN A PERSON CENTERED, CULTURALLY COMPETENT MANNER, SETON HEALTHCARE FAMILY THROUGH SSW, WILL DEVELOP A LANGUAGE SERVICES RESOURCE CENTER AND A CULTURALLY COMPETENT CARE CURRICULUM. THE LANGUAGE SERVICES RESOURCE CENTER IS A NEW PROJECT WHICH WILL PROVIDE PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE BY CENTRALIZING INTERPRETATION & TRANSLATION SERVICES, AND INCREASING THE NUMBER OF PROFESSIONAL MEDICAL INTERPRETERS FOR PATIENTS WITH LIMITED ENGLISH PROFICIENCY INCLUDING BUT NOT LIMITED TO SPANISH AND SIGN LANGUAGE. THE CULTURALLY COMPETENT CARE CURRICULUM IS EXPECTED TO INCREASE THE QUALITY OF COMMUNICATION BETWEEN THE CLINICAL CARE TEAM AND THE PATIENT IN ORDER TO ACHIEVE GREATER PATIENT INVOLVEMENT IN SHARED DECISION MAKING. THE DIVERSITY DEPARTMENT THROUGH THE CULTURALLY COMPETENT CARE CURRICULUM WILL PROVIDE TRAINING AND EDUCATION TO THE CLINICAL CARE TEAM TO INCREASE THE LIKELIHOOD OF SAFE AND EFFECTIVE PERSON CENTERED CARE IN A CULTURALLY COMPETENT MANNER AND LEADS TO BETTER HEALTH OUTCOMES.
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Schedule H, Part V, Section B, Line 11 Facility A, 15
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Facility A, 15 - SETON SOUTHWEST HOSPITAL - PART 3. SSW WILL CONTINUE TO INCREASE ACCESS TO SERVICES BY SUPPORTING THE SETON LEAGUE HOUSE, A 38-ROOM BED-AND-BATH FACILITY DESIGNED TO PROVIDE FAMILIES AND CAREGIVERS WITH A PLACE TO STAY WHILE THEIR LOVED ONES ARE HOSPITALIZED IN AN AUSTIN-AREA HOSPITAL. THE SUBSIDIZED ROOMS REDUCE THE BARRIER OF TRAVEL COSTS ASSOCIATED WITH TREATMENT. SSW HAS DEVELOPED A RELATIONSHIP WITH BETHANY LUTHERAN CHURCH (BLC) IN SOUTHWEST AUSTIN TO HELP SPONSOR A COMMUNITY HEALTH FAIR. SSW HAS PROVIDED A HOST OF SERVICES SUCH AS HEART AND STROKE EDUCATION, SKIN CANCER SCREENINGS, DIET AND EXERCISE AWARENESS, AND VACCINATIONS. THESE HEALTH FAIRS HELP REACH MEMBERS OF THE COMMUNITY WHO MAY NOT TRADITIONALLY ACCESS CARE DUE TO TRANSPORTATION, SCHEDULE, OR OTHER PERCEIVED CONFLICTS. SSW WILL CONTINUE TO FOSTER THIS RELATIONSHIP WITH BLC AND PROVIDE RESOURCES FOR THIS ANNUAL HEALTH FAIR. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN TRAVIS COUNTY, MANY FOCUS GROUP PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESIVENESS AND FOCUSED VISION LEADS RESIDENTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. MORE COORDINATED APPROACHES WOULD HELP MAXIMIZE LIMITED RESOURCES. IN 1997, SETON LED THE FORMATION OF THE INTEGRATED CARE COLLABORATION (ICC), AN ALLIANCE OF COMMUNITY PROVIDERS FOR THE MEDICALLY INDIGENT, INCLUDING HEALTH CARE ORGANIZATIONS, GOVERNMENT ENTITIES AND VOLUNTEER CLINICS. KNOWN AS THE ICC, THE GROUP'S GOAL WAS TO WORK TOGETHER TO INCREASE ACCESS, IMPROVE QUALITY AND FIND CREATIVE FINANCING SOLUTIONS FOR THE PROVISION OF HEALTH CARE FOR THE REGION'S UNINSURED. THE ICC HAS DEVELOPED AN AREA WIDE HEALTH INFORMATION EXCHANGE (HIE) FOR THE UN- AND UNDERINSURED THAT IS USED TO INFORM PROVIDERS ON THE CARE A SPECIFIC INDIVIDUAL HAS RECEIVED WHILE ALSO PROVIDING COMMUNITY WIDE ANALYTICS ON HEALTHCARE USAGE AND DIAGNOSTIC TRENDS. SINCE ITS INCEPTION THE ICC HAS BROKEN INTO MULTIPLE COLLABORATIONS, FOCUSING ON SPECIFIC GEOGRAPHIC AREAS. THE SETON HEALTHCARE FAMILY CONTINUES TO FUND THE ICC INFRASTRUCTURE. IN 2012, SETON AND THE TRAVIS COUNTY HEALTHCARE DISTRICT BEGAN DEVELOPMENT OF A NON-PROFIT COMMUNITY CARE COLLABORATIVE (CCC) WITH THE PURPOSE OF ADVANCING THE HEALTH OF IDENTIFIED VULNERABLE POPULATIONS IN TRAVIS COUNTY THROUGH HIGH-QUALITY, COST EFFECTIVE, PERSON CENTERED CARE. THE ESSENTIAL ELEMENTS OF THE CCC ARE: PATIENT CENTERED MEDICAL HOMES, DEVELOPING A HEALTH INFORMATION EXCHANGE FOR ITS PATIENTS, CASE MANAGEMENT OF A SELECTED HIGH RISK POPULATION, PHARMACY MANAGEMENT, INTEGRATED OUTPATIENT/INPATIENT PROTOCOLS, AND TRANSITIONAL CARE. THE CCC WILL BE OUTCOME DRIVEN AND RELY HEAVILY ON ANALYTICS TO DRIVE PROCESS IMPROVEMENT AND INNOVATION. SETON HEALTHCARE FAMILY IS A PARTNER OF THE COMMUNITY ACTION NETWORK (CAN) AND WILL CONTINUE TO SUPPORT THIS LOCAL COLLABORATION. CAN IS A PARTNERSHIP OF GOVERNMENT, NON-PROFIT, PRIVATE, AND FAITH-BASED ORGANIZATIONS WHO WORK TOGETHER TO ENHANCE THE SOCIAL, HEALTH, EDUCATIONAL, AND ECONOMIC WELL-BEING OF CENTRAL TEXAS. AS A PARTNER OF CAN, SETON HAS REPRESENTATIVES ON THE BOARD OF DIRECTORS AND IS COMMITTED TO WORKING WITH OTHER CAN PARTNERS TO ATTAIN THE MISSION OF CAN. FINANCIAL ASSISTANCE SETON IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HEALTH SYSTEM, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. SSW SCREENS ALL UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE PROVIDES APPLICATION ASSISTANCE TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SETON'S FINANCIAL ASSISTANCE POLICY COVERS SSW PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; SETON PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375% OF THE FEDERAL POVERTY LEVEL.
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Schedule H, Part V, Section B, Line 11 Facility A, 16
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Facility A, 16 - SETON MEDICAL CENTER WILLIAMSON - PART 1. THE SMCW IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE WILLIAMSON COUNTY CHNA. ALSO ADDRESSED IN THE SMCW PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. ACCESS TO CARE ACCESS TO HEALTHCARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE HIGH COST OF PREVENTATIVE CARE AND THE NEED FOR EDUCATION ON SERVICES AND APPROPRIATE UTILIZATION. ALSO MENTION WAS THE DIFFICULTY NAVIGATING THE HEALTH CARE SYSTEM FOR THE UN- AND UNDERINSURED. WITH 81% OF ADULTS WITH HEALTH INSURANCE AND 89% OF CHILDREN WITH HEALTH INSURANCE, BOTH FALL BELOW THE DESIRED CENTRAL TENDENCY. THE CHNA IDENTIFIED A PRESENCE OF FACILITIES AND PROVIDERS BUT WITH A HIGH UNINSURED RATE AND TRANSPORTATION ISSUES, THESE FACILITIES MAY NOT BE ACCESSIBLE FOR ALL RESIDENTS. SMCW SPONSORED THE PRIMARY CARE CLINIC MANAGED BY LONE STAR CIRCLE OF CARE AT THE TEXAS A&M UNIVERSITY HEALTH SCIENCE CENTER IN ROUND ROCK AS WELL AS AN ADDITIONAL PRIMARY CARE CLINIC ON GATTIS SCHOOL ROAD. THESE CLINICS PROVIDE PRIMARY CARE FOR RESIDENTS OF WILLIAMSON COUNTY. LONE STAR'S DESIGNATION AS A FEDERALLY QUALIFIED HEALTH CENTER PROVIDES CARE FOR THE UN- AND UNDERINSURED. SMCW WILL CONTINUE TO WORK CLOSELY WITH LONE STAR CIRCLE OF CARE (LSCC) AND IS COMMITTED TO EXPLORING OPPORTUNITIES TO INCREASE PRIMARY AND SPECIALTY CARE ACCESS ACROSS WILLIAMSON COUNTY. SMCW IS COMMITTED TO THE CONTINUED SUPPORT OF THE SACRED HEART CLINIC IN ROUND ROCK. THIS CLINIC PROVIDES PRIMARY CARE SERVICES FOR THE UNINSURED RESIDENTS OF WILLIAMSON COUNTY AND SMCW PROVIDES THE LAB AND RADIOLOGY FUNCTIONS FOR SACRED HEART. SMCW WILL CONTINUE TO SUPPORT THE SACRED HEART CLINIC IN THIS MANNER IN ORDER TO FURTHER THE WORK OF THE CLINIC. SMCW WILL WORK WITH COMMUNITY PARTNERS IN ITS REGION TO EXPLORE POTENTIAL COLLABORATIONS AND DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PROJECTS THAT MAY BE AVAILABLE IN THE FUTURE TO ADDRESS THE DIFFICULTIES RESIDENTS HAVE ACCESSING CARE. TO HELP UNDERSERVED RESIDENTS NAVIGATE THE COMPLICATED AND FRAGMENTED HEALTH CARE SYSTEM, SMCW WILL CONTINUE TO PROVIDE ACCESS TO THE NURSE TRIAGE CALL CENTER. FUNDED BY THE SETON HEALTHCARE NETWORK, THE SETON'S NURSE TRIAGE CALL CENTER MAKES REGISTERED NURSES AVAILABLE 24/7 FREE OF CHARGE TO FOLKS CALLING ONE OF SETON'S EMERGENCY DEPARTMENTS. NURSES ASSIST CALLERS WITH URGENT CARE NEEDS AND SCHEDULE DOCTORS' APPOINTMENTS TO AVOID UNNECESSARY EMERGENCY ROOM VISITS. CALL CENTER NURSES ARE ABLE TO SCHEDULE SAME-DAY AND NEXT-DAY APPOINTMENTS FOR CALLERS AT PARTICIPATING CLINICS. THE CHNA IDENTIFIED HEALTH DISPARITIES AND INEQUITIES IN THE ABILITY OF DIFFERENT ETHNIC GROUPS TO ACCESS CARE. THE REASONS ARE COMPLEX. RESEARCH SHOWS PROVIDING PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE REDUCES READMISSIONS WITHIN 30 DAYS, REDUCES PATIENT BED DAYS, IMPROVES MEDICATION ADHERENCE AND LEADS TO BETTER HEALTH OUTCOMES. IN ADDITION, RESEARCH ALSO SHOWS PROVIDING CULTURAL COMPETENCE TRAINING TO OUR CLINICAL CARE TEAMS IMPROVES COMMUNICATION BETWEEN PATIENTS AND THEIR CLINICAL CARE TEAM INCLUDING THEIR DOCTORS AND NURSES AS MEASURED BY THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS ("HCAHPS") SURVEY, THE FIRST NATIONAL, STANDARDIZED, PUBLICLY REPORTED SURVEY OF PATIENTS' PERSPECTIVES OF HOSPITAL CARE. CURRENTLY SETON PROVIDES TELEPHONE INTERPRETATION SERVICES IN OVER 140 LANGUAGES, 24 HOURS, 7 DAYS A WEEK, 365 DAYS A YEAR. IN ADDITION, SETON PROVIDES IN PERSON SIGN LANGUAGE CONTRACTED SERVICES AT ALL OF OUR FACILITIES. AS PART OF AN INTEGRATED APPROACH TO ADMINISTER CARE IN A PERSON CENTERED, CULTURALLY COMPETENT MANNER, THE SETON HEALTHCARE FAMILY WILL DEVELOP A LANGUAGE SERVICES RESOURCE CENTER AND A CULTURALLY COMPETENT CARE CURRICULUM AT FOUR SETON HOSPITALS AND WILL IMPLEMENT THE LEARNINGS AND BEST PRACTICES AT SMCW. THE LANGUAGE SERVICES RESOURCE CENTER IS A NEW PROJECT WHICH WILL PROVIDE PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE BY CENTRALIZING INTERPRETATION & TRANSLATION SERVICES, AND INCREASING THE NUMBER OF PROFESSIONAL MEDICAL INTERPRETERS FOR PATIENTS WITH LIMITED ENGLISH PROFICIENCY INCLUDING BUT NOT LIMITED TO SPANISH AND SIGN LANGUAGE. THE CULTURALLY COMPETENT CARE CURRICULUM IS EXPECTED TO INCREASE THE QUALITY OF COMMUNICATION BETWEEN THE CLINICAL CARE TEAM AND THE PATIENT IN ORDER TO ACHIEVE GREATER PATIENT INVOLVEMENT IN SHARED DECISION MAKING. THE DIVERSITY DEPARTMENT THROUGH THE CULTURALLY COMPETENT CARE CURRICULUM WILL PROVIDE TRAINING AND EDUCATION TO THE CLINICAL CARE TEAM TO INCREASE THE LIKELIHOOD OF SAFE AND EFFECTIVE PERSON CENTERED CARE IN A CULTURALLY COMPETENT MANNER AND LEADS TO BETTER HEALTH OUTCOMES. ACCESS TO PRENATAL CARE IN THE FIRST TRIMESTER WAS IDENTIFIED AS A NEED ESPECIALLY AMONG THE LATINO/HISPANIC POPULATION. TO ADDRESS THIS, SMCW WILL EXPAND ITS OBSTETRICS NAVIGATION (OB NAVIGATION) PROJECT TO IMPROVE ACCESS TO PRE AND POSTNATAL CARE FOR UNINSURED HISPANIC WOMEN WITH LIMITED ENGLISH PROFICIENCY THROUGH COMPREHENSIVE, EFFECTIVE PATIENT NAVIGATION SERVICES. CURRENTLY THE SMCW NAVIGATORS WORK WITH WOMEN AFTER THEY HAVE ESTABLISHED PRENATAL CARE. THE NEW NAVIGATION INITIATIVE WILL PLACE NAVIGATORS OUT IN THE COMMUNITY TO HELP ASSIST NEWLY PREGNANT WOMEN WITH ACCESSING CARE IN THEIR FIRST TRIMESTER AND FOLLOWING THEM THROUGHOUT THEIR PREGNANCY ENSURING THEY RECEIVE A POST-PARTUM CHECK-UP AND ARE CONNECTED TO MEDICAL HOME FOR ON-GOING PRIMARY CARE. THE OB NAVIGATION PROGRAM WILL USE CULTURALLY AND LINGUISTICALLY COMPETENT COMMUNITY HEALTH WORKERS TO SERVE AS PATIENT NAVIGATORS. THE NUMBER OF SPANISH SPEAKING ONLY PATIENTS, MANY OF THEM FIRST GENERATION IMMIGRANTS, DELIVERING AT SMCW ARE GROWING. IN ORDER TO ENSURE THEY UNDERSTAND THE HOSPITAL PROCESS. SMCW HAS EMPLOYED A CULTURALLY AND LINGUISTICALLY COMPETENT OB NAVIGATOR TO CONNECT WITH MEDICAID AND CHIP PERINATE PREGNANT PATIENTS DUE TO THEIR DELIVERY AT SMCW. THE NAVIGATOR ENSURES THE PATIENT IS PRE- REGISTERED WITH THE HOSPITAL AND RECEIVES A TOUR OF THE FACILITY. THE NAVIGATOR ASSISTS THE PATIENT WITH THEIR INSURANCE NEEDS AND EXPLAINS THE PROCESS OF ENROLLING THEIR NEWBORNS INTO MEDICAID. THE NAVIGATOR WILL FOLLOW THE BABY UNTIL THEY ARE ENROLLED IN MEDICAID TROUBLESHOOTING OF BEHALF OF THE PATIENT ANY ISSUES THAT MAY ARISE. OBESITY THE 2012 WILLIAMSON COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE PRESSING HEALTH ISSUES. THIS INCLUDED THE HIGH RATE OF OVERWEIGHT AND OBESE ADULTS LIVING IN THE COMMUNITY AS WELL AS THE CONCERN FOR CHILDHOOD OBESITY. IN ADDITION TO THE STAKE HOLDER COMMENTS DIRECTLY RELATED TO OBESITY, THE FOCUS GROUPS FREQUENTLY DISCUSSED THE CHALLENGES OF NUTRITION AND EXERCISE IN WILLIAMSON COUNTY. WHILE WE CERTAINLY NEED TO ADDRESS THE IMPACT OF OBESITY IN OUR COMMUNITY, IT IS ALSO CRUCIAL THAT WE TAKE STEPS TO ADDRESS THE ISSUE PRIOR TO INDIVIDUALS BECOMING OBESE. WITH 67% OF WILLIAMSON COUNTY ADULTS CLASSIFIED AS OVERWEIGHT AND OBESE, WILLIAMSON COUNTY FALLS IS ABOVE STATE AND NATIONAL BENCHMARK. ACCORDING TO CHNA DATA AND FOCUS GROUP RESPONDENTS, THIS DISPARITY MAY BE ATTRIBUTED TO THE UNEQUAL DISTRIBUTION AND AFFORDABILITY OF FRESH FRUIT AND VEGETABLE OUTLETS THROUGHOUT THE COUNTY AS WELL AS AN UNEQUAL DISTRIBUTION OF OBESITY RELATED PROGRAMS. THE CHNA IDENTIFIED ACCESS TO HEALTHY FOODS AS A HIGH PRIORITY. WITH THE NUMBER OF VISITORS AND COMMUNITY MEMBERS WHO VISIT THE SMCW CAFETERIA ON A DAILY BASIS, SMCW IS DEDICATED TO IMPROVING THE NUTRITIONAL VALUE OF THE FOOD OFFERED AT THE FACILITY. SMCW WILL WORK WITH TOUCHPOINT, ITS FOOD SERVICE VENDOR, TO IMPROVE THE NUTRITIONAL CONTENT IN THE FOOD SERVED THROUGH A HEALTHY DINING PROGRAM TO ENSURE THAT OUR DAILY OFFERINGS ARE GEARED TOWARD PROVIDING HEALTHY CHOICES AND OPTIONS FOR OUR GUESTS. THIS WILL NOT ONLY BENEFIT PATIENTS BUT ALSO VISITORS, PHYSICIANS, AND COMMUNITY MEMBERS WHO FREQUENT THE HOSPITAL. SMCW IS COMMITTED TO ITS SUPPORT OF THE IGNITE WOMEN'S HEALTH PROGRAM WHICH IS DEDICATED TO PROVIDING WOMEN WITH A CONTINUUM OF SUPPORT REGARDING THEIR HEALTH AND WELLNESS, AND OPPORTUNITIES TO LIGHT UP THEIR LIVES. IGNITE OFFERS AN ARRAY OF PROGRAMS FROM PREVENTATIVE WELLNESS TO RESTORATIVE HEALTH CARE, TO EDUCATE AND ENCOURAGE WOMEN IN A HEALTHY LIFESTYLE AND IN TURN - A HEALTHY COMMUNITY. PROGRAMS INCLUDE FREE FITNESS, ZUMBA, YOGA, AND SELF- DEFENSE CLASSES, IN ADDITION TO FREE CARDIAC SCREENINGS, BMI, BLOOD PRESSURE, AND MANY MORE TESTS THAT HELP WOMEN MEASURE THEIR OVERALL HEALTH. IGNITE ALSO OFFERS NUTRITION AND COOKING CLASSES TO HELP PROMOTE HEALTHY EATING HABITS.
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Schedule H, Part V, Section B, Line 11 Facility A, 17
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Facility A, 17 - SETON MEDICAL CENTER WILLIAMSON - PART 2. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 WILLIAMSON COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH ISSUE FACING RESIDENTS OF WILLIAMSON COUNTY. FOR THE PAST SIX YEARS THE TOP THREE CAUSES OF DEATH IN WILLIAMSON COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY FOCUS GROUP PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE - SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER - AMONG THE GREATEST AREAS OF CONCERN. WITH THE LONG-TERM DEVELOPMENTS OF CHRONIC DISEASE AND THE LIFESTYLE ATTRIBUTES THAT CONTRIBUTE TO THESE DISEASES, IT IS IMPERATIVE THAT A CONCERTED EFFORT BE MADE BY THE COMMUNITY TO PROMOTE HEALTHY CHOICES WHERE RESIDENTS LIVE, WORK, PLAY, AND WORSHIP. SETON NETWORK ONCOLOGY SERVICES CURRENTLY WORKS WITH SEVERAL SETON HOSPITALS, INCLUDING SMCW, PROVIDING ACCESS TO THE SETON CANCER PREVENTION AND EARLY DETECTION PROGRAM, THE ONCOLOGY NURSE REGISTRY, THE SURVIVORSHIP PROGRAM, THE MULTIDISCIPLINARY CANCER CONFERENCE AND CLINICS, AND NAVIGATION SERVICE. SETON'S COMPREHENSIVE ONCOLOGY PROGRAMS PROVIDE RESIDENTS OF CENTRAL TEXAS ACCESS TO CANCER SERVICES THAT PROMOTE EARLY DETECTION AND A COORDINATED APPROACH TO CARE THROUGHOUT THE CONTINUUM WHICH INCLUDES SCREENING, DIAGNOSIS, TREATMENT AND SURVIVORSHIP. SMCW REFERS PATIENTS TO THE SETON SHIVERS CANCER CENTER. THE SHIVERS CANCER CENTER PROVIDES A VARIETY OF OUTPATIENT SERVICES FOR ADULT CANCER PATIENTS IN CENTRAL TEXAS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO CLINICAL SERVICES, THE SHIVERS HEALTH CARE PROFESSIONALS WORK CLOSELY WITH THE SETON CANCER CARE TEAM TO PROVIDE VITAL CASE MANAGEMENT SERVICES PLUS A VARIETY OF PHYSICAL, EMOTIONAL, AND SPIRITUAL SUPPORT PROGRAMS TO ADULT CANCER PATIENTS AND THEIR FAMILIES. SMCW WILL WORK WITH THE NEW WOMEN'S ONCOLOGY CARE SCREENING PROGRAM. THIS PROGRAM EXPANDS TIMELY ACCESS TO BREAST AND CERVICAL CANCER SCREENING VIA A MOBILE UNIT FOR UNINSURED AND UNDERINSURED WOMEN IN CENTRAL TEXAS WHO, WITHOUT THIS EXPANSION, LIKELY WOULD NOT RECEIVE THESE LIFE-SAVING SERVICES. THIS EXPANSION IN SCREENING IS PART OF SETON'S DIGITAL MAMMOGRAPHY MOBILE UNIT KNOWN AS THE BIG PINK BUS. ACCESS TO CERVICAL CANCER SCREENINGS ARE NOW EXPANDED TO MOBILE MAMMOGRAPHY PROGRAM PARTICIPANTS BY USING ADVANCED PRACTICE NURSES ON THE MOBILE UNIT OR AT OUR COMMUNITY CLINICS THAT PROVIDE INDIGENT CARE. IN ADDITION TO THE SCREENING, SMCW WILL INCORPORATE WOMEN'S ONCOLOGY NAVIGATION AS A METHOD OF EXPANDING EXISTING PATIENT NAVIGATION SERVICES THAT CONNECT WOMEN WITH CANCER DIAGNOSIS TO TREATMENT AND/OR SURVIVORSHIP SUPPORT SERVICES. LOOKING TO IMPROVE THE HEALTH OF PATIENTS WITH CHRONIC DISEASE, SETON ALSO HAS ESTABLISHED THE SETON TOTAL HEALTH TRANSITIONS TEAM AS A PROTOTYPE OF DISEASE MANAGEMENT AS PATIENTS LEAVE THE HOSPITAL SETTING. BASED ON A SUCCESSFUL PILOT, THE SETON TOTAL HEALTH TRANSITIONS TEAM WILL EXPAND TO SMCW IN THE COMING YEARS TO ENHANCE AND EXPAND THE MODEL TO BETTER COORDINATE CARE THROUGH A CARE TRANSITION INTERVENTION. THIS APPROACH INCLUDES A MULTI- DISCIPLINARY TEAM THAT MONITORS AND COORDINATES THE CARE OF PATIENTS WITH CHRONIC DISEASES IMMEDIATELY FOLLOWING DISCHARGE FROM HOSPITAL TO HOME, AND FROM HOME TO PRIMARY CARE. THIS PROJECT IS EXPECTED TO OPTIMIZE THE PATIENT'S RECOVERY AND AVOID READMISSION. SERVICES INCLUDE HOME VISITS TO PROVIDE SHORT-TERM DIRECT CARE, SOCIAL SERVICES, BEHAVIORAL HEALTH SUPPORT, TRANSPORTATION, TELEHEALTH AND PATIENT TRAINING REGARDING SELF- CARE MANAGEMENT OF THE CHRONIC DISEASE(S). SMCW WILL SERVE AS A LOCATION OF POTENTIAL EXPANSION FOR THE CHRONIC CARE MANAGEMENT PROGRAM THAT PROVIDES DIRECT HEALTH CARE AND CARE COORDINATION FOR ADULTS WHO HAVE BEEN SERIOUSLY INJURED AND TO THOSE WHO HAVE EXPERIENCED A SERIOUS ILLNESS DUE TO MULTIPLE CHRONIC CONDITIONS. THIS WILL BE AN EXTENSION OF THE SETON TOTAL HEALTH PARTNERS PILOT ESTABLISHED IN JANUARY 2012. THIS PROGRAM ASSISTS ENROLLEES IN FINDING AND RECEIVING THE MEDICAL CARE THEY NEED TO ACHIEVE OPTIMAL HEALTH AND PREVENT AVOIDABLE HOSPITALIZATION AND INAPPROPRIATE USE OF EMERGENCY DEPARTMENTS. THE PROGRAM PROVIDES A NUMBER OF PATIENT CARE INTERVENTIONS, A STRUCTURED AND MONITORED HAND-OFF PROCESS, TRAINING FOR OPTIMAL SELF-CARE, COUNSELING, AND FACILITATED INTEGRATION WITH PRIMARY AND SPECIALTY PHYSICIANS RESPONSIBLE FOR EACH PATIENT'S CARE. THIS PROJECT WILL START IN TRAVIS COUNTY HOSPITALS AND THEN EXPAND TO SMCW IN THE COMING YEARS. SMCW WILL POSITION ITSELF AS AN EXPANSION SITE FOR THE NEWLY DEVELOPED AND IMPLEMENTED PROCESS IMPROVEMENT METHODOLOGY TO IMPROVE OUTCOMES FOR ADULT INPATIENTS DIAGNOSED WITH DIABETICS MELLITUS. THE DIABETES CHRONIC CARE MANAGEMENT WILL IMPLEMENT SMALL, STRAIGHTFORWARD EVIDENCE-BASED PRACTICES TO IMPLEMENT A DIABETES CARE BUNDLE THAT, WHEN PERFORMED COLLECTIVELY AND RELIABLY, HAS BEEN PROVEN TO IMPROVE PATIENT OUTCOMES. IN ADDITION, THIS PROJECT WILL ESTABLISH AN INTERDISCIPLINARY DIABETES TEAM, LED BY AN ENDOCRINOLOGISTS AND A DIABETES CLINICAL NURSE SPECIALIST, TO ADDRESS THE CLINICAL, SAFETY, AND PSYCHOSOCIAL NEEDS OF INPATIENTS WITH DIABETES WHILE PREPARING FOR A SUCCESSFUL DISCHARGE. THE PROJECT WILL ALSO IMPLEMENT EVIDENCE-BASED PRACTICE (EBP) PROTOCOLS TO ENSURE IMPROVED CLINICAL OUTCOMES DURING AND POST-HOSPITALIZATION. THIS PROJECT IS GEARED TO START IN TRAVIS COUNTY AND THEN EXPAND TO SMCW. SMCW WILL CONTINUE TO OFFER SETON'S ASTHMA EDUCATION PROGRAM TO CENTRAL TEXAS RESIDENTS. THIS PROGRAM PROVIDES HOME VISITS FOR ASTHMA EDUCATION TO NEARLY 1,000 UNINSURED AND UNDERINSURED FAMILIES PER YEAR. BY PROVIDING EDUCATION ABOUT SERVICES IN THE HOME, RESIDENTS OVERCOME TRANSPORTATION BARRIERS THAT OFTEN ACCOMPANY THIS TARGET POPULATION. THE SETON ASTHMA & COPD CENTER PROVIDES A COMPREHENSIVE DISEASE MANAGEMENT PROGRAM DESIGNED TO PROVIDE CARE COORDINATION, SOCIAL SERVICES, AND ASTHMA/COPD EDUCATION FOR ALL AGES.
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Schedule H, Part V, Section B, Line 11 Facility A, 18
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Facility A, 18 - SETON MEDICAL CENTER WILLIAMSON - PART 3. SETON HEALTHCARE FAMILY FACILITIES ARE A TOBACCO FREE ENVIRONMENT, PROHIBITING TOBACCO USE AT ALL OF ITS HOSPITALS AND PLACES OF WORK. SETON IS AN ACTIVE PARTICIPANT IN COMMUNITY EFFORTS TO COMBAT TOBACCO USE, PROVIDING TOBACCO CESSATION SERVICES TO WILLIAMSON COUNTY RESIDENTS. SMCW WILL CONTINUE TO SUPPORT THE TOBACCO CESSATION PROGRAM THAT PROVIDES COMMUNITY-WIDE TRAINING FOR PHYSICIANS AND LOCAL CLINICS BASED ON BEST PRACTICES FOR TREATING NICOTINE ADDICTION. IN ADDITION, THE SETON TOBACCO EDUCATION RESOURCE CENTER OFFERS A COMPREHENSIVE TOBACCO EDUCATION PROGRAM WHICH PROVIDES CESSATION CLASSES THAT ARE BASED ON THE MAYO CLINIC MODEL FOR TREATING TOBACCO DEPENDENCE. SESSIONS FOLLOW A SUPPORT GROUP SETTING AND ARE FACILITATED BY CERTIFIED TOBACCO TREATMENT SPECIALIST. THROUGH MOTIVATIONAL INTERVIEWING TECHNIQUES CTTS ARE ABLE TO CONDUCT SESSIONS THAT AIM AT MAXIMIZING & PROMOTING PARTICIPANT DIALOGUE. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE FOREMOST HEALTH CONCERNS IDENTIFIED IN WILLIAMSON COUNTY. THE ASSESSMENT EXPOSED HIGH RATES OF POOR MENTAL HEALTH AND SUBSTANCE ABUSE. 12% OF ADULTS REPORTED TO HAVING 5 OR MORE POOR MENTAL HEALTH DAYS PER MONTH WHICH PLACE WILLIAMSON BELOW THE NATIONAL AVERAGE. THESE STATISTICS COUPLED WITH THE ABOVE AVERAGE RATE OF ADULTS WHO DRINK EXCESSIVELY, REVEALS WHY BEHAVIORAL HEALTH WAS IDENTIFIED AS THE SECOND HIGHEST PRIORITY FOR WILLIAMSON COUNTY. SMCW HAS DEVELOPED A CLINICAL PSYCHIATRY PROGRAM THROUGH PARTNERSHIP WITH LONE STAR CIRCLE OF CARE (LSCC). THIS IS AIMED AT INCREASING BEHAVIORAL HEALTH SERVICES IN WILLIAMSON COUNTY AND SETON IS COMMITTED TO ITS CONTINUED SUPPORT. SMCW HAS EXPANDED ACCESS TO PSYCHIATRIC TELEMEDICINE TO THE ENTIRE SMCW FACILITY DURING DAYTIME HOURS THROUGH A PARTNERSHIP WITH THE SETON MIND INSTITUTE. SMCW WILL CONTINUE TO SUPPORT THIS BEHAVIORAL HEALTH SERVICE AND WILL EXPAND TO WEEKEND AND EVENING PSYCHIATRIC TELEMEDICINE DURING THE FALL OF 2013. BY PROVIDING 24/7 PSYCHIATRIC CONSULTATIONS, INCLUDING AFTER HOURS, PATIENTS IN PSYCHIATRIC CRISIS WILL BE ABLE TO BE EVALUATED AND TREATED IN A TIMELY MANNER. TYPICALLY PATIENTS WOULD HAVE TO WAIT UNTIL THE NEXT DAY FOR APPROPRIATE PSYCHIATRIC ASSESSMENT. THIS NEW APPROACH TO PSYCHIATRIC TELEMEDICINE CAN LEAD TO TIMELY ASSESSMENT, EARLIER DISPOSITION AND LESS COSTLY LEVEL OF CARE. OTHER PROGRAMS TARGETED TO IMPROVE THE MENTAL HEALTH AND WELL- BEING OF SMCW PATIENTS AND COMMUNITY MEMBERS INCLUDE THE SETON COVE SPIRITUALITY CENTER AND THE PROPOSED EXPANSION TO SMCW OF THE NO ONE DIES ALONE (NODA) PROGRAM. NODA PROVIDES TRAINED VOLUNTEER BEDSIDE COMPANIONSHIP FOR PATIENTS WHO MIGHT OTHERWISE BE ALONE AT THE TIME OF DEATH WHILE THE SETON COVE SPIRITUALITY CENTER PROVIDES SPIRITUALLY HEALING DISCUSSION GROUPS, CLASSES AND EVENTS LED BY A MULTIDISCIPLINARY FACULTY BOTH ON THE SMCW CAMPUS AND AT THE SPIRITUALITY CENTER. PROGRAMS ARE OPEN TO THE COMMUNITY. TO AUGMENT THE PUBLIC SCHOOL HEALTH EDUCATION CURRICULUM, SETON HEALTHCARE FAMILY HAS PURCHASED HEALTHTEACHER, A COMPREHENSIVE K-12 ONLINE HEALTH EDUCATION CURRICULUM FOR TEACHERS IN SCHOOL DISTRICTS WITHIN TRAVIS, WILLIAMSON, AND HAYS COUNTY. THE CURRICULUM PROVIDES OVER 300 AGE-APPROPRIATE LESSONS ACROSS 10 CONTENT AREAS ALIGNED WITH THE NATIONAL HEALTH EDUCATION STANDARDS (NHES). LESSONS ARE DESIGNED FOR INTEGRATION INTO CORE CURRICULUM AREAS SUCH AS LANGUAGE ARTS, SCIENCE AND SOCIAL STUDIES, AND HAVE BEEN ALIGNED WITH THE TEXAS TEKS. THEY PROVIDE SKILLS-BASED INSTRUCTION LINKED TO ASSESSMENTS. HEALTH EDUCATORS IN SCHOOL DISTRICTS IN WILLIAMSON COUNTY WERE TRAINED BY NATIONAL HEALTHTEACHER STAFF ON HOW TO INTEGRATE AND IMPLEMENT THE HEALTHTEACHER CURRICULUM IN THE CLASSROOM. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN WILLIAMSON COUNTY, MANY FOCUS GROUP PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESIVENESS AND FOCUSED VISION LEADS RESIDENTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. MORE COORDINATED APPROACHES WOULD HELP MAXIMIZE LIMITED RESOURCES. IN 1997, SETON LED THE FORMATION OF THE INTEGRATED CARE COLLABORATION (ICC), AN ALLIANCE OF COMMUNITY PROVIDERS FOR THE MEDICALLY INDIGENT, INCLUDING HEALTH CARE ORGANIZATIONS, GOVERNMENT ENTITIES AND VOLUNTEER CLINICS. KNOWN AS THE ICC, THE GROUP'S GOAL WAS TO WORK TOGETHER TO INCREASE ACCESS, IMPROVE QUALITY AND FIND CREATIVE FINANCING SOLUTIONS FOR THE PROVISION OF HEALTH CARE FOR THE REGION'S UNINSURED. THE ICC HAS DEVELOPED AN AREA WIDE HEALTH INFORMATION EXCHANGE (HIE) FOR THE UN- AND UNDERINSURED THAT IS USED TO INFORM PROVIDERS ON THE CARE A SPECIFIC INDIVIDUAL HAS RECEIVED WHILE ALSO PROVIDING COMMUNITY WIDE ANALYTICS ON HEALTHCARE USAGE AND DIAGNOSTIC TRENDS. SINCE ITS INCEPTION THE ICC HAS BROKEN INTO MULTIPLE COLLABORATIONS, FOCUSING ON SPECIFIC GEOGRAPHIC AREAS. THE SETON HEALTHCARE FAMILY CONTINUES TO FUND THE ICC INFRASTRUCTURE. FINANCIAL ASSISTANCE SETON IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HEALTH SYSTEM, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. SMCW SCREENS ALL UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE PROVIDES APPLICATION ASSISTANCE TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SETON'S FINANCIAL ASSISTANCE POLICY COVERS SMCW PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; SETON PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375% OF THE FEDERAL POVERTY LEVEL.
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Schedule H, Part V, Section B, Line 11 Facility A, 19
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Facility A, 19 - SETON MEDICAL CENTER HAYS - part 1. THE SMCH IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE HAYS COUNTY CHNA. ALSO ADDRESSED IN THE SMCH PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. OBESITY THE 2013 HAYS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE PRESSING HEALTH ISSUES. WHILE OVERALL, OBESITY IN HAYS COUNTY IS BELOW THE NATIONAL AVERAGE, NEIGHBORHOOD WELLNESS PROGRAMS AND ACCESS TO HEALTHY FOODS WERE AREAS OF PARTICULAR FOCUS. IN ADDITION TO THESE COMMENTS ON OBESITY, THE DATA REVEALED THAT COMMUNITY MEMBERS EXPERIENCE CHALLENGES MAINTAINING AN ACTIVE LIFESTYLE. WHILE WE CERTAINLY NEED TO ADDRESS THE IMPACT OF OBESITY IN OUR COMMUNITY, IT IS CRUCIAL THAT WE TAKE STEPS TO ADDRESS THE ISSUE PRIOR TO INDIVIDUALS BECOMING OBESE. WITH A 30% OBESITY RATE IN ADULTS, HAYS COUNTY IS SLIGHTLY ABOVE THE STATE AVERAGE OF 29.6%. SMCH IS DEDICATED TO IMPROVING THE NUTRITIONAL VALUE OF THE FOOD OFFERED AT THE FACILITY. SMCH WILL WORK WITH TOUCHPOINT, ITS FOOD SERVICE VENDOR, TO IMPROVE THE NUTRITIONAL CONTENT IN THE FOOD SERVED THROUGH A HEALTHY DINING PROGRAM TO ENSURE THAT OUR DAILY OFFERINGS ARE GEARED TOWARD PROVIDING HEALTHY CHOICES AND OPTIONS FOR OUR GUESTS. THIS WILL NOT ONLY BENEFIT PATIENTS BUT ALSO VISITORS, PHYSICIANS, AND COMMUNITY MEMBERS WHO FREQUENT THE HOSPITAL. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 HAYS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH RELATED PRIORITY FACING RESIDENTS OF HAYS COUNTY. FOR THE PAST 6 YEARS THE TOP THREE CAUSES OF DEATH IN HAYS COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY SUMMIT PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE - SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER - AMONG THE GREATEST AREAS OF CONCERN. SETON NETWORK ONCOLOGY SERVICES CURRENTLY WORKS WITH SEVERAL SETON HOSPITALS, INCLUDING SMCH, PROVIDING ACCESS TO THE SETON CANCER PREVENTION AND EARLY DETECTION PROGRAM, THE ONCOLOGY NURSE REGISTRY, THE SURVIVORSHIP PROGRAM, THE MULTIDISCIPLINARY CANCER CONFERENCE AND CLINICS, AND NAVIGATION SERVICE. SETON'S COMPREHENSIVE ONCOLOGY PROGRAMS PROVIDE RESIDENTS OF CENTRAL TEXAS ACCESS TO CANCER SERVICES THAT PROMOTE EARLY DETECTION AND A COORDINATED APPROACH TO CARE THROUGHOUT THE CONTINUUM WHICH INCLUDES SCREENING, DIAGNOSIS, TREATMENT AND SURVIVORSHIP. SMCH REFERS PATIENTS TO THE SETON SHIVERS CANCER CENTER. THE SHIVERS CANCER CENTER PROVIDES A VARIETY OF OUTPATIENT SERVICES FOR ADULT CANCER PATIENTS IN CENTRAL TEXAS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO CLINICAL SERVICES, THE SHIVERS HEALTH CARE PROFESSIONALS WORK CLOSELY WITH THE SETON CANCER CARE TEAM TO PROVIDE VITAL CASE MANAGEMENT SERVICES PLUS A VARIETY OF PHYSICAL, EMOTIONAL, AND SPIRITUAL SUPPORT PROGRAMS TO ADULT CANCER PATIENTS AND THEIR FAMILIES. SMCH WILL WORK WITH THE NEW WOMEN'S ONCOLOGY CARE SCREENING PROGRAM. THIS PROGRAM EXPANDS TIMELY ACCESS TO BREAST AND CERVICAL CANCER SCREENING VIA A MOBILE UNIT FOR UNINSURED AND UNDERINSURED WOMEN IN CENTRAL TEXAS WHO, WITHOUT THIS EXPANSION, LIKELY WOULD NOT RECEIVE THESE LIFE-SAVING SERVICES. THIS EXPANSION IN SCREENING IS PART OF SETON'S DIGITAL MAMMOGRAPHY MOBILE UNIT KNOWN AS THE BIG PINK BUS. ACCESS TO CERVICAL CANCER SCREENINGS ARE NOW EXPANDED TO MOBILE MAMMOGRAPHY PROGRAM PARTICIPANTS BY USING ADVANCED PRACTICE NURSES ON THE MOBILE UNIT OR AT OUR COMMUNITY CLINICS THAT PROVIDE INDIGENT CARE. IN ADDITION TO THE SCREENING, SMCH WILL INCORPORATE WOMEN'S ONCOLOGY NAVIGATION AS A METHOD OF EXPANDING EXISTING PATIENT NAVIGATION SERVICES THAT CONNECT WOMEN WITH CANCER DIAGNOSIS TO TREATMENT AND/OR SURVIVORSHIP SUPPORT SERVICES. LOOKING TO IMPROVE THE HEALTH OF PATIENTS WITH CHRONIC DISEASE, SETON ALSO HAS ESTABLISHED THE SETON TOTAL HEALTH TRANSITIONS TEAM AS A PROTOTYPE OF DISEASE MANAGEMENT AS PATIENTS LEAVE THE HOSPITAL SETTING. BASED ON A SUCCESSFUL PILOT, THE SETON TOTAL HEALTH TRANSITIONS TEAM WILL EXPAND TO SMCH IN THE COMING YEARS TO ENHANCE AND EXPAND THE MODEL TO BETTER COORDINATE CARE THROUGH A CARE TRANSITION INTERVENTION. THIS APPROACH INCLUDES A MULTI- DISCIPLINARY TEAM THAT MONITORS AND COORDINATES THE CARE OF PATIENTS WITH CHRONIC DISEASES IMMEDIATELY FOLLOWING DISCHARGE FROM HOSPITAL TO HOME, AND FROM HOME TO PRIMARY CARE. THIS PROJECT IS EXPECTED TO OPTIMIZE THE PATIENT'S RECOVERY AND AVOID READMISSION. SERVICES INCLUDE HOME VISITS TO PROVIDE SHORT-TERM DIRECT CARE, SOCIAL SERVICES, BEHAVIORAL HEALTH SUPPORT, TRANSPORTATION, TELEHEALTH AND PATIENT TRAINING REGARDING SELF- CARE MANAGEMENT OF THE CHRONIC DISEASE(S). SMCH WILL SERVE AS A LOCATION OF POTENTIAL EXPANSION FOR THE CHRONIC CARE MANAGEMENT PROGRAM THAT PROVIDES DIRECT HEALTH CARE AND CARE COORDINATION FOR ADULTS WHO HAVE BEEN SERIOUSLY INJURED AND TO THOSE WHO HAVE EXPERIENCED A SERIOUS ILLNESS DUE TO MULTIPLE CHRONIC CONDITIONS. THIS WILL BE AN EXTENSION OF THE SETON TOTAL HEALTH PARTNERS PILOT ESTABLISHED IN JANUARY 2012. THIS PROGRAM ASSISTS ENROLLEES IN FINDING AND RECEIVING THE MEDICAL CARE THEY NEED TO ACHIEVE OPTIMAL HEALTH AND PREVENT AVOIDABLE HOSPITALIZATION AND INAPPROPRIATE USE OF EMERGENCY DEPARTMENTS. THE PROGRAM PROVIDES A NUMBER OF PATIENT CARE INTERVENTIONS, A STRUCTURED AND MONITORED HAND-OFF PROCESS, TRAINING FOR OPTIMAL SELF-CARE, COUNSELING, AND FACILITATED INTEGRATION WITH PRIMARY AND SPECIALTY PHYSICIANS RESPONSIBLE FOR EACH PATIENT'S CARE. THIS PROJECT WILL LAUNCH IN TRAVIS COUNTY HOSPITALS AND THEN EXPAND TO SMCH IN THE COMING YEARS. SMCH WILL POSITION ITSELF AS AN EXPANSION SITE FOR THE NEWLY DEVELOPED AND IMPLEMENTED PROCESS IMPROVEMENT METHODOLOGY TO IMPROVE OUTCOMES FOR ADULT INPATIENTS DIAGNOSED WITH DIABETICS MELLITUS. THE DIABETES CHRONIC CARE MANAGEMENT WILL IMPLEMENT SMALL, STRAIGHTFORWARD EVIDENCE-BASED PRACTICES TO IMPLEMENT A DIABETES CARE BUNDLE THAT, WHEN PERFORMED COLLECTIVELY AND RELIABLY, HAS BEEN PROVEN TO IMPROVE PATIENT OUTCOMES. IN ADDITION, THIS PROJECT WILL ESTABLISH AN INTERDISCIPLINARY DIABETES TEAM, LED BY AN ENDOCRINOLOGISTS AND A DIABETES CLINICAL NURSE SPECIALIST, TO ADDRESS THE CLINICAL, SAFETY, AND PSYCHOSOCIAL NEEDS OF INPATIENTS WITH DIABETES WHILE PREPARING FOR A SUCCESSFUL DISCHARGE. THE PROJECT WILL ALSO IMPLEMENT EVIDENCE-BASED PRACTICE (EBP) PROTOCOLS TO ENSURE IMPROVED CLINICAL OUTCOMES DURING AND POST- HOSPITALIZATION. THIS PROJECT IS GEARED TO START SETON TRAVIS COUNTY HOSPITALS AND THEN WILL EXPAND TO SMCH. SMCH WILL CONTINUE TO OFFER SETON'S ASTHMA EDUCATION PROGRAM TO CENTRAL TEXAS RESIDENTS. THIS PROGRAM PROVIDES HOME VISITS FOR ASTHMA EDUCATION TO NEARLY 1,000 UNINSURED AND UNDERINSURED FAMILIES PER YEAR. BY PROVIDING EDUCATION ABOUT SERVICES IN THE HOME, RESIDENTS OVERCOME TRANSPORTATION BARRIERS THAT OFTEN ACCOMPANY THIS TARGET POPULATION. THE SETON ASTHMA & COPD CENTER PROVIDES A COMPREHENSIVE DISEASE MANAGEMENT PROGRAM DESIGNED TO PROVIDE CARE COORDINATION, SOCIAL SERVICES, AND ASTHMA/COPD EDUCATION FOR ALL AGES.
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Schedule H, Part V, Section B, Line 11 Facility A, 20
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Facility A, 20 - SETON MEDICAL CENTER HAYS - part 2. SETON HEALTHCARE FAMILY FACILITIES ARE A TOBACCO FREE ENVIRONMENT, PROHIBITING TOBACCO USE AT ALL OF ITS HOSPITALS AND PLACES OF WORK. SETON IS AN ACTIVE PARTICIPANT IN COMMUNITY EFFORTS TO COMBAT TOBACCO USE, PROVIDING TOBACCO CESSATION SERVICES TO WILLIAMSON COUNTY RESIDENTS. SMCH WILL CONTINUE TO SUPPORT THE TOBACCO CESSATION PROGRAM THAT PROVIDES COMMUNITY-WIDE TRAINING FOR PHYSICIANS AND LOCAL CLINICS BASED ON BEST PRACTICES FOR TREATING NICOTINE ADDICTION. IN ADDITION, THE SETON TOBACCO EDUCATION RESOURCE CENTER OFFERS A COMPREHENSIVE TOBACCO EDUCATION PROGRAM WHICH PROVIDES CESSATION CLASSES THAT ARE BASED ON THE MAYO CLINIC MODEL FOR TREATING TOBACCO DEPENDENCE. SESSIONS FOLLOW A SUPPORT GROUP SETTING AND ARE FACILITATED BY CERTIFIED TOBACCO TREATMENT SPECIALIST. THROUGH MOTIVATIONAL INTERVIEWING TECHNIQUES CTTS ARE ABLE TO CONDUCT SESSIONS THAT AIM AT MAXIMIZING & PROMOTING PARTICIPANT DIALOGUE. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE THIRD GREATEST HEALTH CONCERNS RAISED BY HAYS COUNTY RESIDENTS. SUMMIT PARTICIPANTS AND STAKEHOLDERS ALIKE BOTH MENTIONED THE RISING RATES OF MENTAL HEALTH CONDITIONS AMONG RESIDENTS IN THE COUNTY. THIS INCLUDED AREAS SUCH AS SUBSTANCE ABUSE AND AN INADEQUATE NUMBER OF MENTAL HEALTH PROVIDERS WHO COULD PRESCRIBE MEDICATION. THE CHNA IDENTIFIED THAT HAYS COUNTY ADULTS EXPERIENCED ON AVERAGE 4 POOR MENTAL HEALTH DAYS IN THE PAST MONTH WHICH WAS MUCH HIGHER THAN THE NATIONAL BENCHMARK OF 2.6. SMCH WILL EXPLORE HOW THEY CAN WORK WITH HILL COUNTY MHMR AND COMMUNICARE HEALTH CENTERS TO EXPAND SERVICES TO MEET THE BEHAVIORAL HEALTH NEEDS IN HAYS COUNTY. IT IS UNCLEAR HOW THIS COLLABORATIVE EFFORT MAY UNFOLD, BUT SMCH IS WILLING TO WORK WITH LOCAL PARTNERS TO IDENTIFY WAYS TO ADDRESS THE BEHAVIORAL HEALTH NEEDS. SMCH HAS EXPANDED ACCESS TO PSYCHIATRIC TELEMEDICINE TO THE ENTIRE SMCH FACILITY DURING DAYTIME HOURS THROUGH A PARTNERSHIP WITH THE SETON MIND INSTITUTE. SMCH WILL CONTINUE TO SUPPORT THIS BEHAVIORAL HEALTH SERVICE AND WILL EXPAND TO WEEKEND AND EVENING PSYCHIATRIC TELEMEDICINE DURING THE FALL OF 2013. BY PROVIDING 24/7 PSYCHIATRIC CONSULTATIONS, INCLUDING AFTER HOURS, PATIENTS IN PSYCHIATRIC CRISIS WILL BE ABLE TO BE EVALUATED AND TREATED IN A TIMELY MANNER. TYPICALLY PATIENTS WOULD HAVE TO WAIT UNTIL THE NEXT DAY FOR APPROPRIATE PSYCHIATRIC ASSESSMENT. THIS NEW APPROACH TO PSYCHIATRIC TELEMEDICINE CAN LEAD TO TIMELY ASSESSMENT, EARLIER DISPOSITION AND LESS COSTLY LEVEL OF CARE. TO AUGMENT THE PUBLIC SCHOOL HEALTH EDUCATION CURRICULUM, SETON HEALTHCARE FAMILY HAS PURCHASED HEALTHTEACHER, A COMPREHENSIVE K-12 ONLINE HEALTH EDUCATION CURRICULUM FOR TEACHERS IN SCHOOL DISTRICTS WITHIN TRAVIS, WILLIAMSON, AND HAYS COUNTY. THE CURRICULUM PROVIDES OVER 300 AGE-APPROPRIATE LESSONS ACROSS 10 CONTENT AREAS ALIGNED WITH THE NATIONAL HEALTH EDUCATION STANDARDS (NHES). LESSONS ARE DESIGNED FOR INTEGRATION INTO CORE CURRICULUM AREAS SUCH AS LANGUAGE ARTS, SCIENCE AND SOCIAL STUDIES, AND HAVE BEEN ALIGNED WITH THE TEXAS TEKS. THEY PROVIDE SKILLS-BASED INSTRUCTION LINKED TO ASSESSMENTS. HEALTH EDUCATORS WERE TRAINED BY NATIONAL HEALTHTEACHER STAFF ON HOW TO INTEGRATE AND IMPLEMENT THE HEALTHTEACHER CURRICULUM IN THE CLASSROOM. ACCESS TO CARE ACCESS TO HEALTHCARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE EDUCATION AND OUTREACH OF SERVICES IN THE COMMUNITY. IN ADDITION, THE DECREASE IN FUNDING FOR WOMEN'S HEALTH AND FAMILY PLANNING SERVICES HAS LEFT A LARGE UNMET NEED IN THE COMMUNITY. SUMMIT PARTICIPANTS RECOGNIZED A PRESENCE OF FACILITIES AND PROGRAMMING BUT THE MAJORITY OF PARTICIPANTS NOTED THAT ACCESS TO THESE PROGRAMS IS DIFFICULT, ESPECIALLY FOR THOSE LOW- INCOME AND AGING POPULATIONS. SMCH HAS, AND WILL CONTINUE TO ENGAGE IN ITS PARTNERSHIP WITH COMMUNICARE HEALTH CENTERS OF CENTRAL TEXAS AS A WAY OF INCREASING PRIMARY CARE ACCESS FOR THE UN- AND UNDERINSURED RESIDENTS OF HAYS COUNTY. CURRENTLY, SMCH PROVIDES FUNDING FOR COMMUNICARE STAFF TO COME TO VARIOUS PARTS OF THE COUNTY MULTIPLE TIMES PER WEEK AND SMCH WILL LOOK TO EXPAND THE SCOPE OF THIS PARTNERSHIP IN THE FUTURE. SMCH IS WITHIN CLOSE PROXIMITY TO SOUTH AUSTIN AND PATIENTS COME TO SMCH FROM NOT ONLY FROM HAYS COUNTY BUT ALSO SOUTHERN TRAVIS COUNTY. THE SETON HEALTH CENTERS WERE ESTABLISHED TO PROVIDE ACCESSIBLE, COMPREHENSIVE HEALTH SERVICES TO MEDICALLY UNDERSERVED FAMILIES IN AUSTIN. PRIMARY CARE PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS PROVIDE QUALITY PRIMARY CARE TO COMMUNITY RESIDENTS ON A SLIDING SCALE BASED ON FAMILY SIZE AND INCOME. MEDICARE, MEDICAID AND CHIP ARE ALSO ACCEPTED.
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Schedule H, Part V, Section B, Line 11 Facility A, 21
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Facility A, 21 - SETON MEDICAL CENTER HAYS - part 3. EACH OF THE THREE CLINICS OFFERS PRIMARY CARE, LABORATORY, CASE MANAGEMENT, AND HEALTH EDUCATION SERVICES. COMPREHENSIVE SOCIAL SERVICES ARE PART OF THE CENTERS' MEDICAL MISSION AS WELL. SMCH HAS AND WILL CONTINUE TO REFER UNFUNDED PATIENTS WITHOUT A MEDICAL HOME TO THE SETON COMMUNITY HEALTH CENTERS FOR PRIMARY CARE. TO HELP UNDERSERVED RESIDENTS NAVIGATE THE COMPLICATED AND FRAGMENTED HEALTH CARE SYSTEM, SMCH WILL CONTINUE TO PROVIDE ACCESS TO THE NURSE TRIAGE CALL CENTER. FUNDED BY THE SETON HEALTHCARE NETWORK, THE SETON'S NURSE TRIAGE CALL CENTER MAKES REGISTERED NURSES AVAILABLE 24/7 FREE OF CHARGE TO FOLKS CALLING ONE OF SETON'S EMERGENCY DEPARTMENTS. NURSES ASSIST CALLERS WITH URGENT CARE NEEDS AND SCHEDULE DOCTORS' APPOINTMENTS TO AVOID UNNECESSARY EMERGENCY ROOM VISITS. CALL CENTER NURSES ARE ABLE TO SCHEDULE SAME-DAY AND NEXT-DAY APPOINTMENTS FOR CALLERS AT PARTICIPATING CLINICS. THE CHNA IDENTIFIED HEALTH DISPARITIES AND INEQUITIES IN THE ABILITY OF DIFFERENT ETHNIC GROUPS TO ACCESS CARE. THE REASONS ARE COMPLEX. RESEARCH SHOWS PROVIDING PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE REDUCES READMISSIONS WITHIN 30 DAYS, REDUCES PATIENT BED DAYS, IMPROVES MEDICATION ADHERENCE AND LEADS TO BETTER HEALTH OUTCOMES. IN ADDITION, RESEARCH ALSO SHOWS PROVIDING CULTURAL COMPETENCE TRAINING TO OUR CLINICAL CARE TEAMS IMPROVES COMMUNICATION BETWEEN PATIENTS AND THEIR CLINICAL CARE TEAM INCLUDING THEIR DOCTORS AND NURSES AS MEASURED BY THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS ("HCAHPS") SURVEY, THE FIRST NATIONAL, STANDARDIZED, PUBLICLY REPORTED SURVEY OF PATIENTS' PERSPECTIVES OF HOSPITAL CARE. CURRENTLY SETON PROVIDES TELEPHONE INTERPRETATION SERVICES IN OVER 140 LANGUAGES, 24 HOURS, 7 DAYS A WEEK, 365 DAYS A YEAR. IN ADDITION, SETON PROVIDES IN PERSON SIGN LANGUAGE CONTRACTED SERVICES AT ALL OF OUR FACILITIES AND IN PERSON SPANISH TRANSLATION AT SMCH. AS PART OF AN INTEGRATED APPROACH TO ADMINISTER CARE IN A PERSON CENTERED, CULTURALLY COMPETENT MANNER, THE SETON HEALTHCARE FAMILY WILL DEVELOP A LANGUAGE SERVICES RESOURCE CENTER AND A CULTURALLY COMPETENT CARE CURRICULUM AT FOUR SETON HOSPITALS AND WILL IMPLEMENT THE LEARNINGS AND BEST PRACTICES AT SMCH. THE LANGUAGE SERVICES RESOURCE CENTER IS A NEW PROJECT WHICH WILL PROVIDE PROFESSIONAL MEDICAL INTERPRETATION AT INITIAL ASSESSMENT AND DISCHARGE BY CENTRALIZING INTERPRETATION & TRANSLATION SERVICES, AND INCREASING THE NUMBER OF PROFESSIONAL MEDICAL INTERPRETERS FOR PATIENTS WITH LIMITED ENGLISH PROFICIENCY INCLUDING BUT NOT LIMITED TO SPANISH AND SIGN LANGUAGE. THE CULTURALLY COMPETENT CARE CURRICULUM IS EXPECTED TO INCREASE THE QUALITY OF COMMUNICATION BETWEEN THE CLINICAL CARE TEAM AND THE PATIENT IN ORDER TO ACHIEVE GREATER PATIENT INVOLVEMENT IN SHARED DECISION MAKING. THE DIVERSITY DEPARTMENT THROUGH THE CULTURALLY COMPETENT CARE CURRICULUM WILL PROVIDE TRAINING AND EDUCATION TO THE CLINICAL CARE TEAM TO INCREASE THE LIKELIHOOD OF SAFE AND EFFECTIVE PERSON CENTERED CARE IN A CULTURALLY COMPETENT MANNER AND LEADS TO BETTER HEALTH OUTCOMES. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN HAYS COUNTY, SUMMIT PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESION AND FOCUSED VISION LEAD PARTICIPANTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. THE DESIRE FOR A MORE COORDINATED APPROACH WAS IDENTIFIED AS AN AREA OF NEED IN ORDER TO MAXIMIZE THE LIMITED RESOURCES OF THE AREA. SMCH AND THE SETON HEALTHCARE FAMILY PROVIDED STRONG SUPPORT IN THE CREATION OF THE HEALTHY COMMUNITY COLLABORATIVE. THIS COLLABORATION COMPRISED OF VARIOUS COMMUNITY STAKEHOLDERS IS A LOCAL COLLABORATION THAT REMAINS AS A SUBGROUP OF THE INTEGRATED CARE COLLABORATION (ICC). IN 1997, SETON LED THE FORMATION OF THE INTEGRATED CARE COLLABORATION (ICC), AN ALLIANCE OF COMMUNITY PROVIDERS FOR THE MEDICALLY INDIGENT, INCLUDING HEALTH CARE ORGANIZATIONS, GOVERNMENT ENTITIES AND VOLUNTEER CLINICS. KNOWN AS THE ICC, THE GROUP'S GOAL WAS TO WORK TOGETHER TO INCREASE ACCESS, IMPROVE QUALITY AND FIND CREATIVE FINANCING SOLUTIONS FOR THE PROVISION OF HEALTH CARE FOR THE REGION'S UNINSURED. THE ICC HAS DEVELOPED AN AREA WIDE HEALTH INFORMATION EXCHANGE (HIE) FOR THE UN- AND UNDERINSURED THAT IS USED TO INFORM PROVIDERS ON THE CARE A SPECIFIC INDIVIDUAL HAS RECEIVED WHILE ALSO PROVIDING COMMUNITY WIDE ANALYTICS ON HEALTHCARE USAGE AND DIAGNOSTIC TRENDS. SINCE ITS INCEPTION THE ICC HAS BROKEN INTO MULTIPLE COLLABORATIONS, FOCUSING ON SPECIFIC GEOGRAPHIC AREAS. THE SETON HEALTHCARE FAMILY CONTINUES TO FUND THE ICC INFRASTRUCTURE. FINANCIAL ASSISTANCE SETON IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HEALTH SYSTEM, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. SMCH SCREENS ALL UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE PROVIDES APPLICATION ASSISTANCE TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SETON'S FINANCIAL ASSISTANCE POLICY COVERS SMCH PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; SETON PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375% OF THE FEDERAL POVERTY LEVEL.
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Schedule H, Part V, Section B, Line 11 Facility A, 22
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Facility A, 22 - CEDAR PARK REGIONAL MEDICAL CENTER - part 1. THE CPRMC IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE WILLIAMSON COUNTY CHNA. ALSO ADDRESSED IN THE CPRMC PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. ACCESS TO CARE ACCESS TO HEALTHCARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE HIGH COST OF PREVENTATIVE CARE AND THE NEED FOR EDUCATION ON SERVICES AND APPROPRIATE UTILIZATION. IN ADDITION TO THE HIGH COST OF CARE, THE DIFFICULTY OF NAVIGATING THE HEALTH CARE SYSTEM FOR THE UNINSURED AND UNDERINSURED ALSO PROVED TO BE BARRIERS TO ACCESS. WITH 81% OF ADULTS HAVING HEALTH INSURANCE AND 89% OF CHILDREN WITH HEALTH INSURANCE, BOTH CATEGORIES CURRENTLY FALL BELOW THE DESIRED CENTRAL TENDENCY. THE CHNA IDENTIFIED A PRESENCE OF FACILITIES AND PROVIDERS BUT WITH A HIGH UNINSURED RATE AND TRANSPORTATION ISSUES, THESE FACILITIES MAY NOT BE ACCESSIBLE FOR ALL RESIDENTS. CPRMC WORKS CLOSELY WITH THE LEANDER INDEPENDENT SCHOOL DISTRICT TO INCREASE ACCESS TO HEALTH SCREENINGS AND HEALTH EDUCATION WHILE AT THE SAME TIME PROMOTE THE HEALTH OBJECTIVES OF STUDENTS, ASSOCIATES AND PARENTS OF THE DISTRICT. AN ANNUAL LISD HEALTH EXPO IS PROVIDED FOR APPROXIMATELY 4,500 DISTRICT EMPLOYEES. HEALTH SCREENINGS, ONE-ON-ONE INFORMATION AND WELLNESS SEMINARS ARE PROVIDED AT THE EVENT. TOPICS INCLUDE THE PREVENTION AND TREATMENT OF CHRONIC DISEASES, HEALTHY NUTRITION AND THE PREVENTION OF OBESITY. CPRMC ALSO PROVIDES SPEAKERS ON HEALTH-RELATED TOPICS FOR AN ANNUAL CONFERENCE FOR THE PARENTS OF LISD, CALLED CONNECTING U. CPRMC HAS WORKED ON MULTIPLE INITIATIVES TO IMPROVE PATIENTS' ACCESS TO CARE. CPRMC WILL WORK WITH PRIMARY CARE CLINIC PARTNERS WHO HAVE OPENED AND ARE PLANNED TO OPEN FACILITIES IN THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS. THOUGH MANY AREA PROVIDERS NO LONGER ACCEPT MEDICAID AND MEDICARE, PATIENTS ON THESE PLANS CAN RECEIVE CARE AT THESE CLINICS. IN AN EFFORT TO INCREASE ACCESS TO SPECIALTY CARE, CPRMC PLANS FOR EXPANSION INCLUDE A HEART AND VASCULAR CENTER, PEDIATRIC UNIT AND A FREESTANDING EMERGENCY CENTER. OBESITY THE 2012 WILLIAMSON COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE PRESSING HEALTH ISSUES. THIS INCLUDED THE HIGH RATE OF OVERWEIGHT AND OBESE ADULTS LIVING IN THE COMMUNITY AS WELL AS THE CONCERN FOR CHILDHOOD OBESITY. IN ADDITION TO THE STAKE HOLDER COMMENTS DIRECTLY RELATED TO OBESITY, THE FOCUS GROUPS FREQUENTLY DISCUSSED THE CHALLENGES OF NUTRITION AND EXERCISE IN WILLIAMSON COUNTY. WHILE WE CERTAINLY NEED TO ADDRESS THE IMPACT OF OBESITY IN OUR COMMUNITY, IT IS ALSO CRUCIAL THAT WE TAKE STEPS TO ADDRESS THE ISSUE PRIOR TO INDIVIDUALS BECOMING OBESE. WITH 67% OF WILLIAMSON COUNTY ADULTS CLASSIFIED AS OVERWEIGHT AND OBESE, WILLIAMSON COUNTY FALLS ABOVE STATE AND NATIONAL BENCHMARKS. ACCORDING TO CHNA DATA AND FOCUS GROUP RESPONDENTS, THIS DISPARITY MAY BE ATTRIBUTED TO THE UNEQUAL DISTRIBUTION AND AFFORDABILITY OF FRESH FRUIT AND VEGETABLE OUTLETS THROUGHOUT THE COUNTY AS WELL AS AN UNEQUAL DISTRIBUTION OF OBESITY RELATED PROGRAMS. CPRMC WILL CONTINUE TO SUPPORT THE EFFORTS OF LOCAL YMCA PROGRAMS THAT ARE AIMED AT PROVIDING HEALTHY AND ACTIVE LIFESTYLE OPTIONS FOR CHILDREN AND THEIR FAMILIES. CPRMC HAS AND WILL CONTINUE TO SUPPORT THE YMCA TO ACHIEVE THESE OBJECTIVES. CPRMC HAS IDENTIFIED SUPPORT GROUPS AS A VITAL PART IN THE SUCCESS OF THEIR PATIENTS. CPRMC'S BARIATRIC SUPPORT GROUP PROVIDES SEMINARS ON GOAL SETTING, NUTRITION EDUCATION, BODY IMAGE, PHYSICAL FITNESS, GROCERY SHOPPING TOURS AND MANY OTHER OBESITY RELATED TOPICS FREE OF CHARGE FOR THOSE WHO ARE INTERESTED. IN ADDITION, THE BARIATRIC SUPPORT GROUP HOSTS GUEST SPEAKERS SUCH AS DIETICIANS, SURGEONS, AND PSYCHOLOGISTS TO HELP EDUCATE PARTICIPANTS ON HEALTHY LIFESTYLES AND OPTIONS FOR LOSING WEIGHT. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 WILLIAMSON COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH ISSUE FACING RESIDENTS OF WILLIAMSON COUNTY. FOR THE PAST 6 YEARS THE TOP THREE CAUSES OF DEATH IN WILLIAMSON COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY FOCUS GROUP PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE, SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER AS SOME OF THE GREATEST AREAS OF CONCERN. WITH THE LONG TERM DEVELOPMENTS OF CHRONIC DISEASE AND THE LIFESTYLE ATTRIBUTES THAT CONTRIBUTE TO THESE DISEASES, IT IS IMPERATIVE THAT A CONCERTED EFFORT BE MADE BY THE COMMUNITY TO PROMOTE HEALTHY CHOICES WHERE RESIDENTS LIVE, WORK, PLAY, AND WORSHIP.
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Schedule H, Part V, Section B, Line 11 Facility A, 23
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Facility A, 23 - CEDAR PARK REGIONAL MEDICAL CENTER - part 2. CPRMC PROVIDES NUMEROUS EDUCATIONAL PROGRAMS AND OUTREACH ACTIVITIES TO BENEFIT THE COMMUNITY. THE HEALTHY WOMAN AND SENIOR CIRCLE PROGRAMS, WITH MORE THAN 6,000 MEMBERS, ARE IMPORTANT FOR THEIR SUPPORT, HEALTH, AND WELLNESS ACTIVITIES. THROUGH REGULAR E- NEWSLETTERS AND WELLNESS SEMINARS, MEMBERS LEARN STRATEGIES TO IMPROVE THEIR HEALTH STATUS AND PREVENT CHRONIC DISEASES. CPRMC ALSO HAS A FREE MEMBERSHIP PROGRAM FOR EXPECTANT MOTHERS CALLED TINY TOES WITH MORE THAN 2,000 MEMBERS, WHERE WOMEN RECEIVE INFORMATION ON PREGNANCY AND CHILDBEARING. EACH MEMBER RECEIVES THE CHILDBIRTH PREPARATION BOOK, WHAT TO EXPECT WHEN YOU'RE EXPECTING IN EITHER ENGLISH OR SPANISH. ALL PATIENTS AFTER DELIVERY ARE PROVIDED A FREE CAR SEAT AND INSTRUCTION TO PROMOTE INFANT SAFETY. SUPPORT GROUPS ON VARIOUS HEALTH TOPICS ARE PROVIDED FREE OF CHARGE TO SUPPORT THE NEEDS OF THE COMMUNITY. A MONTHLY BREAST CANCER SUPPORT GROUP IS OFFERED AT CPRMC IN COLLABORATION WITH THE BREAST CANCER RESOURCE CENTER OF TEXAS. A MONTHLY BREASTFEEDING SUPPORT GROUP IS ALSO OFFERED TO PROMOTE BREASTFEEDING FOR MOTHERS IN THE COMMUNITY. BLOOD PRESSURE AND GLUCOSE SCREENINGS ARE OFFERED REGULARLY AT COMMUNITY LOCATIONS SUCH AS ST. MARGARET MARY'S CATHOLIC CHURCH AND HILL COUNTRY BIBLE CHURCH TO IMPROVE HEALTH OUTCOMES. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE FOREMOST HEALTH CONCERNS IDENTIFIED IN WILLIAMSON COUNTY. THE ASSESSMENT EXPOSED HIGH RATES OFF POOR MENTAL HEALTH AND SUBSTANCE ABUSE. 12% OF ADULTS REPORTED TO HAVING 5 OR MORE POOR MENTAL HEALTH DAYS PER MONTH WHICH PLACE WILLIAMSON BELOW THE NATIONAL AVERAGE, HOWEVER THE SUICIDE RATE WAS HIGHER THAN THE STATE AVERAGE. THESE TWO STATISTICS COUPLED WITH THE ABOVE AVERAGE RATE OF ADULTS WHO DRINK EXCESSIVELY, REVEALS WHY BEHAVIORAL HEALTH WAS IDENTIFIED AS THE SECOND HIGHEST PRIORITY FOR WILLIAMSON COUNTY. AS A HEALTHCARE PROVIDER THAT OFFERS ADVANCED MEDICAL CARE AND COMPREHENSIVE SERVICES, CPRMC PROVIDES MULTIDISCIPLINARY TEAMS TO HELP DEVELOP A COMPREHENSIVE TREATMENT PLAN FOR PATIENTS. FOR THOSE PATIENTS IDENTIFIED TO HAVE BEHAVIORAL HEALTH RELATED NEEDS, CPRMC WORKS WITH BLUEBONNET TRAILS SERVICES TO HELP TREAT THOSE PATIENTS AND TO IDENTIFY TRANSFER TO A MORE APPROPRIATE TREATMENT FACILITY I.E. AN INPATIENT FACILITY IF NEEDED. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN WILLIAMSON COUNTY, MANY FOCUS GROUP PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESIVENESS AND FOCUSED VISION LEADS RESIDENTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. THE DESIRE FOR A MORE COORDINATED APPROACH WAS IDENTIFIED AS AN AREA OF NEED IN ORDER TO MAXIMIZE THE LIMITED RESOURCES OF THE AREA. IN AN EFFORT TO CONTINUALLY FOSTER COMMUNITY COLLABORATION, CPRMC ALSO SUPPORTS THE PROGRAMS AND OBJECTIVES OF AREA HEALTHCARE NONPROFIT AGENCIES INCLUDING THE AMERICAN HEART ASSOCIATION, AMERICAN DIABETES ASSOCIATION, MARCH OF DIMES, YMCA AND AMERICAN CANCER SOCIETY. TEAMS FROM CPRMC PARTICIPATE IN THE ANNUAL WALKS OF THESE ORGANIZATIONS TO RAISE AWARENESS AND FUNDS. PROCEEDS FROM CEDAR PARK REGIONAL MEDICAL CENTER'S RACE AGAINST COLON CANCER ALSO BENEFIT THE AMERICAN CANCER SOCIETY'S PATIENT SERVICES. CPRMC IS A PROUD SUPPORTER OF THE LEANDER ISD EDUCATIONAL EXCELLENCE FOUNDATION (LEEF), HELPING TO PROVIDE INNOVATIVE TEACHING MINI-GRANTS TO IMPROVE ACADEMIC OUTCOMES FOR ALL STUDENTS IN LISD. CPRMC'S EXTENSIVE COMMUNITY PARTNERSHIPS INCLUDE GENEROUS DONATIONS FROM CPRMC ASSOCIATES TO HILL COUNTRY MINISTRIES' FOOD BANK. AN ANNUAL UNITED WAY CAMPAIGN IS ALSO PROVIDED AT CPRMC TO MEET THE CRITICAL COMMUNITY NEEDS IN WILLIAMSON COUNTY. THE ANNUAL LEADERSHIP CEDAR PARK AND LEADERSHIP LEANDER PROGRAMS ARE SUPPORTED BY CPRMC WITH DAY-LONG SEMINARS ON OUR CAMPUS TO SUPPORT EDUCATION TO COMMUNITY LEADERS ON HEALTHCARE ISSUES AND COMMUNITY PRIORITIES. ACCIDENTS A COMPREHENSIVE PLAN FOR TRAUMA DESIGNATION IS CURRENTLY UNDERWAY AND NUMEROUS PUBLIC SAFETY AND TRAUMA PREVENTION ACTIVITIES ARE OFFERED TO THE COMMUNITY. CPRMC PROVIDES A BIKE RODEO AND PARTICIPATES IN NUMEROUS HEALTH FAIRS HELP TO PROMOTE CHILDREN'S SAFETY SKILLS. CPRMC PARTNERS WITH THE CAPITAL AREA TRAUMA REGIONAL ADVISORY COUNCIL (CATRAC) TO PROVIDE BICYCLE HELMETS TO CHILDREN IN NEED. CPRMC ALSO PARTNERS WITH TWO CEDAR PARK HIGH SCHOOLS IN THE CREATION OF SHATTERED DREAMS, A FILM CREATED BY STUDENTS TO DRAMATICALLY DEMONSTRATE THE DANGERS OF DRUNK DRIVING AND PROMOTE HEALTHY DECISION MAKING. EDUCATIONAL PROGRAMS FOR EMS PROFESSIONALS ARE OFFERED ON A QUARTERLY BASIS TO PROMOTE THE QUALITY AND COORDINATION OF EMERGENCY CARE. FINANCIAL ASSISTANCE CPRMC IS COMMITTED TO DELIVERING SAFE, PERSON-CENTERED, QUALITY HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A JOINT VENTURE WITH A NONPROFIT HOSPITAL PARTNER, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. TO HELP ADDRESS THE FINANCIAL MEANS TO ACCESSING CARE, CPRMC'S FINANCIAL ASSISTANCE POLICY IS THE SAME POLICY THAT SETON INSTITUTED TO COVER PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILL. WITH SOME PUBLICLY SUBSIDIZED PROGRAMS AVAILABLE IN THE COUNTY, STAFF WILL WORK WITH PATIENTS AND THEIR FAMILIES TO HELP CONNECT THEM TO THESE RESOURCES THAT MAY HELP PAY FOR THE SERVICES THEY RECEIVED DURING THEIR VISIT. IF COVERAGE IS NOT AVAILABLE, THE PATIENT CAN REQUEST FINANCIAL ASSISTANCE. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE CURRENT YEAR'S FEDERAL POVERTY GUIDELINES AND CPRMC AND SETON PROVIDE FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375 PERCENT OF THE FEDERAL POVERTY LEVEL.
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Schedule H, Part V, Section B, Line 11 Facility A, 24
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Facility A, 24 - CENTRAL TEXAS REHABILITATION HOSPITAL - part 1. CTRH IS AN INPATIENT REHABILITATION HOSPITAL THAT OFFERS INTENSE INPATIENT PROGRAMS THAT PROVIDE ONGOING CARE. OUR GOAL IS TO PREPARE OUR PATIENTS FOR A RETURN HOME INDEPENDENTLY OR WITH ASSISTANCE FROM FAMILY MEMBERS OR OTHER CARE PROVIDERS. INPATIENT REHABILITATION HOSPITALS ARE FOR INDIVIDUALS WHO HAVE BEEN IMPAIRED BY AN INJURY OR ILLNESS AND ARE CONSIDERED BY THEIR PHYSICIANS TO BE MEDICALLY STABLE AND PHYSICALLY ABLE TO BEGIN A COMPREHENSIVE REHABILITATION PROGRAM CONSISTING OF AT LEAST THREE HOURS OF THERAPY A DAY, FIVE DAYS A WEEK. PATIENTS ADMITTED TO CTRH BENEFIT FROM SPECIALIZED INTENSE REHABILITATION FOR MEDICAL NEEDS THAT PRECLUDE THEM FROM BEING ACCEPTED INTO A LOWER LEVEL OF CARE SUCH AS A SKILLED NURSING FACILITY. ALL THERAPY PROGRAMS ARE CUSTOMIZED BASED ON THE INDIVIDUAL'S EXISTING ABILITIES, TOLERANCE FOR THERAPY AND DESIRED OUTCOMES. PROSPECTIVE PATIENTS REQUIRE DAILY PHYSICIAN OVERSIGHT, A MINIMUM OF TWO TYPES OF THERAPY AND 24-HOUR NURSING CARE. EVERY PATIENT IN OUR HOSPITAL IS TREATED WITH DIGNITY, RESPECT AND COMPASSION. ALL OF OUR PROGRAMS CONSIST OF AN INTERDISCIPLINARY REHABILITATION TEAM COMMITTED TO HELPING EACH PATIENT AND FAMILY PROGRESS TO RECOVERY. THIS SPECIALIZED TEAM EVALUATES AND DEVELOPS A PERSONALIZED TREATMENT PLAN DESIGNED TO HELP EACH INDIVIDUAL RECOVER AND DEVELOP THE SKILLS NEEDED TO RETURN HOME OR TO LIVE AS INDEPENDENTLY AS POSSIBLE. GIVEN THE SPECIFIC FOCUS AND MISSION OF CTRH AS AN INPATIENT REHABILITATION HOSPITAL, CTRH RECOGNIZES THAT SOME COMMUNITY HEALTH NEEDS MAY FALL OUTSIDE OF OUR DIRECT LINE OF SERVICE. ADDITIONALLY, THESE NEEDS MAY BE BETTER SERVED BY OTHER COMMUNITY PARTNERS WHOSE MISSION IS TO ADDRESS CHRONIC DISEASE, OBESITY, AND BEHAVIORAL HEALTH DIRECTLY. HOWEVER, GIVEN THAT ALL OF THESE HEALTH NEEDS ARE INTERRELATED, CTRH WILL INCORPORATE IMPLEMENTATION STRATEGIES FOR ALL AREAS OF NEED. THE CTRH IMPLEMENTATION PLAN ADDRESSES THE FOUR HEALTH NEEDS TO VARYING DEGREES; ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE, AND OBESITY IN THE ORDER OF PRIORITY IDENTIFIED THROUGH THE TRAVIS COUNTY CHNA. ALSO ADDRESSED IN THE CTRH PLAN IS AN OVERVIEW OF THE HOSPITAL'S POLICY OF PROVIDING FINANCIAL ASSISTANCE TO LOW INCOME PATIENTS AND A STRATEGY FOR ADDRESSING COMMUNITY COLLABORATION. OBESITY THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED OBESITY AS ONE OF THE MOST PRESSING HEALTH ISSUES. WHILE OBESITY IN TRAVIS COUNTY IS BELOW THE NATIONAL AVERAGE, CHILDHOOD OBESITY WAS LISTED AS A PARTICULAR AREA OF NEED AS THIS CONDITION IS DISPROPORTIONATELY EVIDENT AMONG MINORITY POPULATIONS. WITH A 24% OBESITY RATE IN ADULTS, TRAVIS COUNTY FALLS BELOW THE STATE AVERAGE OF 29.6%. HOWEVER, WHEN THAT RATE IS BROKEN DOWN BY ETHNICITY, THE NEED TO ADDRESS OBESITY AMONG MINORITY POPULATIONS BECOMES MORE OBVIOUS. 41.7% OF THE BLACK/AFRICAN AMERICAN ADULTS IN TRAVIS COUNTY AND 36.5% OF LATINO/HISPANIC ADULTS ARE CONSIDERED OBESE COMPARED TO 19.4% FOR WHITE RESIDENTS. ACCORDING TO CHNA DATA AND FOCUS GROUP RESPONDENTS, THIS DISPARITY MAY BE ATTRIBUTED TO THE UNEQUAL DISTRIBUTION AND AFFORDABILITY OF FRESH FRUIT AND VEGETABLE OUTLETS THROUGHOUT THE COUNTY AS WELL AS AN UNEQUAL DISTRIBUTION OF OBESITY-RELATED PROGRAMS. WITH AN UNEQUAL DISTRIBUTION AND EDUCATION REGARDING HEALTHY EATING THROUGHOUT THE COUNTY, CTRH RECOGNIZES THAT HEALTHY EATING EDUCATION IS OFTEN REQUIRED IN ORDER FOR PATIENTS TO SUCCEED WHEN THEY GO BACK INTO THEIR COMMUNITIES. FOR THIS REASON, CTRH PROVIDES A DIETICIAN ON-SITE TO CONDUCT HEALTHY EATING EDUCATION TO OBESE PATIENTS. THESE CONSULTATIONS ALLOW FOR PHYSICIANS TO WRITE SPECIFIC DIETARY ORDERS FOR PATIENTS AND FOR PATIENTS TO HAVE SPECIALIZED ONE ON ONE EDUCATION ON HOW TO ACHIEVE THE HEALTHY EATING GOALS SET BY THE PHYSICIAN.
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Schedule H, Part V, Section B, Line 11 Facility A, 25
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Facility A, 25 - CENTRAL TEXAS REHABILITATION HOSPITAL - part 2. CHRONIC DISEASE AND DISEASE MANAGEMENT THE 2012 TRAVIS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED CHRONIC DISEASE AND DISEASE MANAGEMENT AS THE SECOND HIGHEST HEALTH ISSUE FACING RESIDENTS OF TRAVIS COUNTY. FOR THE PAST SIX YEARS THE TOP THREE CAUSES OF DEATH IN TRAVIS COUNTY HAVE BEEN RELATED TO CHRONIC DISEASE. MANY FOCUS GROUP PARTICIPANTS AND INTERVIEWEES CITED CHRONIC DISEASE - SPECIFICALLY DIABETES, HEART DISEASE, AND CANCER - AMONG THE GREATEST AREAS OF CONCERN. CTRH WILL DEVELOP A STROKE PREVENTION AND EDUCATION CLASS DESIGNED TO PROVIDE EDUCATION AND RESOURCES TO THE ELDERLY MEMBERS OF THE COMMUNITY. THESE CLASSES WILL BE CONDUCTED AT LOCAL CHURCHES AND TEACH PARTICIPANTS THE SIGNS OF A STROKE AND THE STEPS TO TAKE TO PREVENT STROKES. BEHAVIORAL HEALTH THE CHNA IDENTIFIED MENTAL HEALTH AS ONE OF THE FOREMOST HEALTH CONCERNS RAISED BY TRAVIS COUNTY RESIDENTS. FOCUS GROUP PARTICIPANTS AND INTERVIEWEES ALIKE MENTIONED THE RISING RATES OF MENTAL HEALTH CONDITIONS AMONG TRAVIS COUNTY RESIDENTS. THIS INCLUDED AREAS SUCH AS SUBSTANCE ABUSE AND INADEQUATE MENTAL HEALTH SERVICES. THE CHNA IDENTIFIED THAT 20% OF TRAVIS COUNTY ADULTS EXPERIENCED FIVE OR MORE DAYS OF POOR MENTAL HEALTH IN THE PAST MONTH, WHICH IS WELL ABOVE THE NATIONAL MEDIAN. MANY PATIENTS THAT COME TO CTRH HAVE A PSYCHIATRIC CO-MORBIDITY (I.E. DEPRESSION, BIPOLAR, SCHIZOPHRENIA, ETC.). IN ORDER TO MEET THIS NEED WITHOUT HAVING TO SEND PATIENTS TO A SEPARATE FACILITY, CTRH HAS PARTNERED WITH BEHAVIORAL HEALTH CONSULTANTS, A BEHAVIORAL HEALTH CARE GROUP, TO PROVIDE CONSULTATIONS TO PATIENTS WITH BEHAVIORAL HEALTH RELATED ILLNESSES. IN ORDER TO ASSIST IN THE REHABILITATION PROCESS AND ADDRESS ANY CO-MORBIDITIES, CTRH HAS A PSYCHOLOGIST TO HELP WORK WITH THEIR PATIENTS. ACCESS TO CARE ACCESS TO HEALTH CARE WAS A PREDOMINANT THEME AMONG RESIDENTS, SPECIFICALLY THE AVAILABILITY AND ACCESSIBILITY OF HEALTH CARE FACILITIES AND RESOURCES. ALSO MENTIONED WERE THE DIFFICULTY OF NAVIGATING THE HEALTH CARE SYSTEM, THE HIGH COST OF CARE, AND THE INABILITY TO GAIN AND RETAIN HEALTH INSURANCE. COMMUNITY FORUM PARTICIPANTS RECOGNIZED A PRESENCE OF FACILITIES AND PROGRAMMING BUT THE MAJORITY NOTED THAT HEALTH CARE RESOURCES ARE GREATLY LACKING, ESPECIALLY FOR LOW-INCOME AND AGING POPULATIONS. MANY PATIENTS IN NEED DO NOT HAVE A FUNDING SOURCE AND TYPICALLY WILL NOT RECEIVE THE REHABILITATION NEEDED TO ALLOW THEM TO RECOVER TO THEIR FULLEST POTENTIAL. MOST OF THESE PATIENTS WILL BE DISCHARGED HOME OR TO A NURSING HOME WHERE THEIR RECOVERY PROCESS WILL BE HALTED. CTRH SUPPORTS THE SETON MISSION BY PROVIDING REHABILITATION TO PATIENTS WITHOUT FUNDING. ON ANY GIVEN DAY, CTRH WILL HAVE AT LEAST 1 UNFUNDED PATIENT IN-HOUSE. WITH INCREASINGLY STRETCHED HEALTH CARE RESOURCES, HELPING FAMILIES CONNECT TO A FUNDING SOURCE IS THE FIRST STEP IN MEETING THE ACCESS TO CARE NEEDS. CTRH ASSISTS FAMILIES IN OBTAINING DRS-CRS FUNDING WHICH FUNDS ACUTE REHABILITATION, OUTPATIENT REHABILITATION, AND POST-ACUTE REHABILITATION FOR PATIENTS WITH TRAUMATIC BRAIN INJURIES AND TRAUMATIC SPINAL CORD INJURIES. THIS FUNDING COMES FROM THE STATE OF TEXAS AND HELPS ALLEVIATE THE BURDEN OF FAMILIES WHO FACE BARRIERS DUE TO THE HIGH COST OF INTENSIVE CARE. CTRH WILL CONTINUE TO SUPPORT THE SETON COMMUNITY HEALTH CENTERS. THE SETON HEALTH CENTERS WERE ESTABLISHED TO PROVIDE ACCESSIBLE, COMPREHENSIVE HEALTH SERVICES TO MEDICALLY UNDERSERVED FAMILIES IN AUSTIN. PRIMARY CARE PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS PROVIDE QUALITY PRIMARY CARE TO COMMUNITY RESIDENTS ON A SLIDING SCALE BASED ON FAMILY SIZE AND INCOME. MEDICARE, MEDICAID AND CHIP ARE ALSO ACCEPTED. EACH OF THE THREE CLINICS OFFERS PRIMARY CARE, LABORATORY, CASE MANAGEMENT, AND HEALTH EDUCATION SERVICES. COMPREHENSIVE SOCIAL SERVICES ARE PART OF THE CENTERS' MEDICAL MISSION AS WELL. CTRH HAS AND WILL CONTINUE TO SUPPORT THE WORK AND VISION OF THESE MINISTRIES THROUGH FUNDRAISING, EDUCATION, AND COMMUNITY ADVOCACY FOR THESE COMMUNITY HEALTH CENTERS. COMMUNITY COLLABORATION DESPITE MANY NON-PROFIT AND SOCIAL SERVICE ORGANIZATIONS WITHIN TRAVIS COUNTY, MANY FOCUS GROUP PARTICIPANTS FELT THAT EFFORTS COULD BE MORE INTEGRATED AND COORDINATED TO REDUCE THE DUPLICATION OF SERVICES AND THE FRAGMENTATION THAT HAS RESULTED. WHILE ORGANIZATIONS APPEAR TO BE ENGAGED IN COLLABORATIVE EFFORTS, THE LACK OF COHESIVENESS AND FOCUSED VISION LEADS RESIDENTS TO FEEL THAT THERE IS MORE DIALOGUE THAN THERE IS ACTION. MORE COORDINATED APPROACHES WOULD HELP MAXIMIZE LIMITED RESOURCES. CTRH ENGAGES REPRESENTATIVES OF THE COMMUNITY IN THE IDENTIFICATION OF COMMUNITY REHABILITATION NEEDS THROUGH ITS COMMUNITY ADVISORY COUNCIL. THE PURPOSE OF THIS COUNCIL IS TO CONTINUE TO IDENTIFY THE NEEDS OF THE COMMUNITY AND ENSURE CENTRAL TEXAS REHABILITATION HOSPITAL IS ENHANCING THE QUALITY AND SCOPE OF SERVICES PROVIDED. CTRH WILL CONTINUE ITS SUPPORT OF THE LONESTAR PARALYSIS FOUNDATION. THE MISSION OF THE LONE STAR PARALYSIS FOUNDATION IS TO CURE SPINAL CORD PARALYSIS THROUGH FUNDING RESEARCH, ADVANCED RECOVERY, AND COMMUNITY OUTREACH. CTRH FULLY SUPPORTS THE FOUNDATION BY SPONSORING AND PARTICIPATING IN MANY EVENTS THROUGHOUT THE YEAR. CTRH PARTICIPATES IN THE ANNUAL COLLABORATING FOR CURES EVENT. THIS EVENT PROVIDES THE COMMUNITY WITH EDUCATION ABOUT CURRENT RESEARCH, REHABILITATION AND TREATMENT ADVANCES AS WELL AS EMERGING APPROACHES FOR ALZHEIMER'S, STROKE AND TRAUMATIC BRAIN INJURY CARE. CTRH HAS BEEN A PARTICIPATING MEMBER IN YEARS PAST AND WILL CONTINUE TO BE A PART OF THIS IMPORTANT COMMUNITY EVENT IN THE YEARS TO COME. FINANCIAL ASSISTANCE CTRH IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A MEMBER OF THE HEALTH SYSTEM, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. THE CHNA REVEALED THAT THE COUNTY HAD A HIGH UNINSURED RATE, AND A LACK OF INSURANCE CAN BE ONE OF MANY FACTORS THAT PREVENT INDIVIDUALS FROM ACCESSING CARE. CTRH SCREENS ALL UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE PROVIDES APPLICATION ASSISTANCE TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SETON'S FINANCIAL ASSISTANCE POLICY COVERS CTRH'S PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; CTRH PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 375% OF THE FEDERAL POVERTY LEVEL.
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Schedule H, Part V, Section B, Line 16 Facility A, 1
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Facility A, 1 - Facility 1 -- Seton Medical Center Austin. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 16 Facility A, 2
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Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 16 Facility A, 3
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Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 16 Facility A, 4
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Facility A, 4 - Facility 6 -- Seton Northwest Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 16 Facility A, 5
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Facility A, 5 - Facility 7 -- Seton Southwest Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 16 Facility A, 6
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Facility A, 6 - Facility 9 -- Seton Medical Center Williamson. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 16 Facility A, 7
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Facility A, 7 - Facility 10 -- Seton Medical Center Hays. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 16 Facility A, 8
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Facility A, 8 - Facility 11 -- Cedar Park Regional Medical Center. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 16 Facility A, 9
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Facility A, 9 - Facility 12 -- Central Texas Rehabilitation Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 22 Facility A, 1
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Facility A, 1 - Facility 1 -- Seton Medical Center Austin. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 22 Facility A, 2
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Facility A, 2 - Facility 2 -- University Medical Center Brackenridge. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 22 Facility A, 3
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Facility A, 3 - Facility 3 -- Dell Children's Medical Center of Central Texas. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 22 Facility A, 4
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Facility A, 4 - Facility 6 -- Seton Northwest Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 22 Facility A, 5
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Facility A, 5 - Facility 7 -- Seton Southwest Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 22 Facility A, 6
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Facility A, 6 - Facility 9 -- Seton Medical Center Williamson. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 22 Facility A, 7
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Facility A, 7 - Facility 10 -- Seton Medical Center Hays. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 22 Facility A, 8
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Facility A, 8 - Facility 11 -- Cedar Park Regional Medical Center. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 22 Facility A, 9
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Facility A, 9 - Facility 12 -- Central Texas Rehabilitation Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 5 Facility B, 1
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Facility B, 1 - Facility 4 -- Seton Edgar B. Davis Hospital. Seton Healthcare Family, in collaboration with the Community Health Coalition of Caldwell County, hosted a Community Health Needs Summit for Caldwell and Gonzales counties. The Summit was designed as a way to update the community on progress that has been made since the last CHNA and to provide them with current data to engage in needs identification. The two goals for the summit were for the community to discuss current needs affecting Caldwell and Gonzales and then prioritize those needs in order of importance. The invitation to the Summit was sent out through local collaborations, partnership, and council list serves with targeted outreach to schools and other key community stakeholders. In attendance was representation from the public health department, hospitals, clinics, school districts, and other service providers that serve the community. A complete list of Summit participants can be found in Appendix 1 of the Community Health Needs Assessment. In order to identify the community's needs, Seton Healthcare Family presented current health and demographic data to the Summit participants. Participants then engaged in table discussions regarding what the data revealed to them as well as what other needs they see in the community that did not show up in the data. This collaborative process created a list of needs that were shared with the larger group and categorized by theme. These themes served as the overarching needs that were identified with sub groups identified within each category. Participants then used a dot voting method to express their opinion as to which category was the highest priority need and which sub group was most important within that need. After tallying the results, the participants reviewed the results and further added any remaining thoughts. The following information is a summation of the data analysis coupled with the feedback from the community.
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Schedule H, Part V, Section B, Line 5 Facility B, 2
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Facility B, 2 - Facility 5 -- Seton Highland Lakes Hospital. Seton Healthcare Family, in collaboration with the Highland Lakes Health Partnership, conducted a virtual Community Health Needs Survey for Burnet County. The survey was designed as a way to gain insight into the progress that has been made since the last CHNA and to provide participants an avenue to identify current needs. The two goals for the survey were for the community to discuss current needs affecting Burnet County and then prioritize those needs in order of importance. The survey invitation was sent out through local collaborations, partnership, and council list serves with targeted outreach to schools and other key community stakeholders. In response, there was representation from the public health department, hospitals, clinics, school districts, and other service providers that serve the community. A complete list of survey participants' occupations can be found in Appendix 1 of the Community Health Needs Assessment. This collaborative process created a list of needs that were prioritized by survey respondents and categorized by theme. These themes served as the overarching needs that were identified with sub groups identified within each category. Participants used a Likert scale to express their opinion as to which category was the highest priority need and which sub group was most important within that need. The following information is a summation of the data analysis coupled with the feedback from the community.
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Schedule H, Part V, Section B, Line 5 Facility B, 3
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Facility B, 3 - Facility 13 -- Seton Medical Center Harker Heights. Seton Healthcare Family, in collaboration with Seton Medical Center Harker Heights, conducted a virtual Community Health Needs Survey for Bell County. The survey was designed as a way to gain insight into the progress that has been made since the last CHNA and to provide participants an avenue to identify current needs. The two goals for the survey were for the community to discuss current needs affecting Bell County and then prioritize those needs in order of importance. The survey invitation was sent out through local collaborations, partnership, and council list serves with targeted outreach to community members, public health officials, and other key community stakeholders. In response, there was representation from the public health department, hospitals, clinics, school districts, and other service providers that serve the community. A complete list of survey participants' occupations can be found in Appendix 1 of the Community Health Needs Assessment in addition to the organizations those participants represent (only listed if participants choose to provide their organization). This collaborative process created a list of needs that were prioritized by survey respondents and categorized by theme. These themes served as the overarching needs that were identified with sub groups identified within each category. Participants used a Likert scale to express their opinion as to which category was the highest priority need and which sub group was most important within that need. The following information is a summation of the data analysis coupled with the feedback from the community.
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Schedule H, Part V, Section B, Line 5 Facility B, 4
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Facility B, 4 - Facility 14 -- Seton Smithville Regional Hospital. Seton Healthcare Family, in collaboration with the Community Health Coalition of Caldwell County, hosted a Community Health Needs Summit for Bastrop County. The Summit was designed as a way to update the community on progress that has been made since the last CHNA and to provide them with current data to engage in needs identification. The two goals for the summit were for the community to discuss current needs affecting Bastrop County and then prioritize those needs in order of importance. The invitation to the Summit was sent out through local collaborations, partnership, and council list serves with targeted outreach to schools and other key community stakeholders. In attendance was representation from the public health department, hospitals, clinics, school districts, community residents and other service providers that serve the community. A complete list of Summit participants can be found in Appendix 1 of the Community Health Needs Assessment. In order to identify the community's needs, Seton Healthcare Family presented current health and demographic data to the Summit participants. Participants then engaged in table discussions regarding what the data revealed to them as well as what other needs they see in the community that did not show up in the data. This collaborative process created a list of needs that were shared with the larger group and categorized by theme. These themes served as the overarching needs that were identified with sub groups identified within each category. Participants then used a dot voting method to express their opinion as to which category was the highest priority need and which sub group was most important within that need. After tallying the results, the participants reviewed the results and further added any remaining thoughts. The following information is a summation of the data analysis coupled with the feedback from the community.
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Schedule H, Part V, Section B, Line 7 Facility B, 1
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Facility B, 1 - Facility 4 -- Seton Edgar B. Davis Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Caldwell_Community_Needs_assessment.pdf
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Schedule H, Part V, Section B, Line 7 Facility B, 2
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Facility B, 2 - Facility 5 -- Seton Highland Lakes Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Burnet_Community_Needs_assessment.pdf
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Schedule H, Part V, Section B, Line 7 Facility B, 3
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Facility B, 3 - Facility 13 -- Seton Medical Center Harker Heights. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: http://setonharkerheights.net/wp-content/uploads/2013/12/Final-Bell-County-CHNA-Written-Report-06_24_13.pdf
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Schedule H, Part V, Section B, Line 7 Facility B, 4
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Facility B, 4 - Facility 14 -- Seton Smithville Regional Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Bastrop_Community_Needs_assessment.pdf
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Schedule H, Part V, Section B, Line 11 Facility B, 1
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Facility B, 1 - SETON EDGAR B. DAVIS HOSPITAL - PART 1. BEHAVIORAL HEALTH The CHNA identified mental health as the greatest health concern raised by Caldwell County residents. With few behavioral health providers in the both Caldwell and Gonzales, it was no surprised that behavioral health was noted as the top priority by Summit participants. According to a 2011 report created by the Department of State Health Services, no psychiatrists had their primary county of practice in Caldwell or Gonzales. While this does not take into account the number of psychologists and/or counselors in Caldwell and Gonzales or the number of psychiatrists who visit these counties on a part time bases, it further supports the community perspective on the lack of mental health providers in these counties. In addition to the lack of providers, Summit participants expressed the need for long term behavioral health services as well as the need to integrate primary care with behavioral health in order to meet the comprehensive needs of county residents. It was suggested that this could be conducted through the co-location of services such as school health clinics in order to facilitate better access and earlier detection. One program currently in place through SEBD is the Heritage Program. The Heritage Program provides an intensive outpatient psychiatric program for seniors in Caldwell and surrounding counties. The seniors served have a mental health need, primarily anxiety or depression, and a comorbidity including congestive heart failure, diabetes, or COPD. The program provides group, individual, and family therapy, as well as family and community education. The Heritage staff includes a nurse, master level therapist, and a program psychiatrist that comes in weekly. Transportation is provided to participants and home assessments are done to ensure the best referral is made. The Heritage program also offers specialty groups to the community such as geriatric attention deficit disorder and trauma groups. SEBD will expanded access to Psychiatric Telemedicine in the Emergency Department beginning in September 2013 and will continue to expand these behavioral health services to remainder of the hospital floors by the end of 2014. By providing 24/7 psychiatric consultations patients in psychiatric crisis will be able to be evaluated and treated in a timely manner. Typically patients would have to wait until the next day for appropriate psychiatric assessment. This new approach to psychiatric telemedicine can lead to timely assessment, earlier disposition and less costly level of care. SEBD will collaborate with Bluebonnet Trails Community Services and the Community Health Centers of Central Texas in an attempt identify ways to expand behavioral health services in Caldwell County. Access to Care Access to care was identified as the second highest priority need by summit participants. This included many aspects that fall under the umbrella of access to care but the greatest concern for residents was afterhours care and primary care for the un- and underinsured. In addition, community members expressed concern about the growing number of uninsured residents, and transportation issues that inevitably arise when examining the needs of rural counties. SEBD supports the Lockhart Rural Health Clinic and will open the Luling Rural Health Clinic to provide additional options for low income residents to access to primary care. The CHNA identified a decreasing number of providers that accept new Medicare and Medicaid patients and it was speculated that these rural health clinics, along with the Community Health Centers of Central Texas FQHC's, are the only clinics accepting these patients. As a response to the growing need for extended hours care, the Lockhart RHC has extended hours Monday - Saturday, until 7pm, which gives patients appointment flexibility and access to walk in care without having to take time off work. In addition, the Lockhart RHC provides a Specialty Clinic with outpatient lab services, an Internal Medicine Clinic, Family Practice, as well as Cardiology and Pulmonology for those patients with specialty needs. SEBD has, and will continue to engage in its partnership with Community Health Centers of Central Texas (CHCCT) as a means of increasing primary care access for the un- and underinsured residents of Gonzales and Caldwell County. CHCCT has a Federally Qualified Health Center in southern Caldwell County and Seton will continue to look for ways to support these services for low income residents. Given the need to increase primary care access, especially for the un- and underinsured, SEBD is committed to the continuation of the Seton Children's Care-A-Van. Offering primary care services, the mobile clinic is often available for same day acute visits, eliminating some of the barriers residents face trying to access care. The Care-A-Van currently visits schools and churches that have been identified as areas of need and can serve as a primary care home for children ages birth- 18, who cannot access care anywhere else. With the CHNA identifying a gap in services for the uninsured and underinsured, SEBD has committed to taking on the management of the Caldwell County Indigent Program (CCI). This program provides services for those residents at or below 21% of the federal poverty limit and SEBD will act as an Accountable Care Organization to manage the entirety of a CCI members care. By doing this, SEBD will be able to provide case management services to the individual and provide them with a medical home to ensure proper and timely care is being delivered. To help underserved residents navigate the complicated and fragmented health care system, SEBD will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified large disparities in the ability of different ethnic groups to access care. The reasons are complex but, in an effort to administer care in a patient centered, culturally competent manner, SEBD provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, SEBD provides in-person sign language services to those that need it. Obesity The 2013 Caldwell County Community Health Needs Assessment identified obesity as another one of the community's health needs. While overall, obesity in Central Texas is close to the national average, Caldwell County has continually seen its rates stay above the national median. Residents identified a lack of access to healthy food and resources in addition to the need for age appropriate education for children as the two obesity related gaps. While we certainly need to address the impact of obesity in our community, it is crucial that we also take steps to address the issue prior to individuals becoming obese. As identified in the CHNA, healthy food access and nutrition education are two elements of a healthy lifestyle that were identified gaps in Caldwell County. In order to fill this need, SEBD will partner with the Community Health Coalition of Caldwell County and work to develop an environment that increases access to healthy foods. This will involve the creation of Farmer's Market's, community gardens, and working to connect local foods to local businesses. This program will attempt to develop environmental changes that can help support a healthy lifestyle and combat obesity in Caldwell County. Chronic Disease and Disease Management The 2012 Caldwell County Community Health Needs Assessment identified chronic disease and disease management as a health related priority facing residents of Caldwell County. Chronic disease has remained the top cause of death for the past 6 years and, with cancer and heart disease topping the list again, chronic disease is expected to remain as the top cause of death for the foreseeable future. Many community members cited chronic disease education, specifically self-disease management as one of the greatest needs for their community.
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Schedule H, Part V, Section B, Line 11 Facility B, 2
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Facility B, 2 - SETON EDGAR B. DAVIS HOSPITAL - PART 2. Seton Network Oncology Services currently works with several Seton hospitals, including SEBD, providing access to the Seton Cancer Prevention and Early Detection program, the Oncology Nurse Registry, the Survivorship Program, the Multidisciplinary Cancer Conference and clinics, and Navigation service. Seton's comprehensive oncology programs provide residents of Central Texas access to cancer services that promote early detection and a coordinated approach to care throughout the continuum which includes screening, diagnosis, treatment and survivorship. According to the National Cancer Institute, Caldwell County has an age adjusted annual incident rate of 1,302 per 100,000 for all races 50 and over. Compounding the problem is a 14.5% poverty rate. The need for the SEBD Outpatient Chemotherapy Service is apparent and until now it has not been accessible for a large demographic population primarily due to funding and transportation. Prior to the implementation of chemotherapy services at SEBD, patients had to drive as far as Kyle, New Braunfels, or Austin to seek treatment. Many patients did not have the resources to make this commitment and some chose to forgo treatment. The Leadership Team of SEBD and Seton Physicians recognized this need in our community and immediately took action. SEBD is now offering chemotherapy services to all of the surrounding communities. The impact these services will have for the community is immeasurable in time and convenience. As an Accountable Care Organization, SEBD is committed to expanding our scope service to provide chemotherapy to this demographic population. SEBD will work with the new Women's Oncology Care Screening program. This program expands timely access to breast and cervical cancer screening via a mobile unit for uninsured and underinsured women in Central Texas who, without this expansion, likely would not receive these life-saving services. This expansion in screening is part of Seton's digital mammography mobile unit known as the Big Pink Bus. Access to cervical cancer screenings are now expanded to mobile mammography program participants by using advanced practice nurses on the mobile unit or at our community clinics that provide indigent care. In addition to the screening, SEBD will incorporate Women's Oncology Navigation as a method of expanding existing patient navigation services that connect women with cancer diagnosis to treatment and/or survivorship support services. Looking to improve the health of patients with chronic disease, SEBD will continue to support Seton's Asthma Education program for Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages. Seton Healthcare Family facilities are a tobacco free environment, prohibiting tobacco use at all of its hospitals and places of work. Seton is an active participant in community efforts to combat tobacco use, providing tobacco cessation services to Central Texas residents. SEBD will continue to support the Tobacco Cessation Program that provides community-wide training for physicians and local clinics based on best practices for treating nicotine addiction. In addition, The Seton Tobacco Education Resource Center offers a comprehensive tobacco education program which provides cessation classes that are based on the Mayo Clinic Model for treating Tobacco Dependence. Sessions follow a support group setting and are facilitated by Certified Tobacco Treatment Specialist. Through motivational interviewing techniques CTTS are able to conduct sessions that aim at maximizing & promoting participant dialogue. With the CHNA emphasizing self-disease management, SEBD proposes to work with the Community Health Coalition of Caldwell County to establish and implement a Diabetes Education Program. This proposed program will identify Caldwell County residents diagnosed with diabetes and will provide disease education and nutrition guidance to help patients manage their own care. As chronic disease continues to be the top causes of death for Caldwell County, SEBD is committed to help find additional ways to decrease chronic disease. As a first step, SEBD will work with the Community Health Coalition in Caldwell County as they work to identify and encourage healthy lifestyle policies for Caldwell County. This will include such policies as smoke and tobacco free workplaces and restaurant serving local and healthy foods. Community Collaboration Despite non-profit and social service organizations within Caldwell County, and many in the surrounding counties, many summit participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of education on how to connect to these programs has been a challenge. The desire for a more connected approach to service delivery will help maximize the limited resources of the area. SEBD and the Seton Healthcare Family provided strong support for the creation of the Community Health Coalition of Caldwell County. This local collaboration is comprised of various community stakeholders that work as a subgroup of the Integrated Care Collaboration (ICC). In 1997, Seton led the formation of the ICC, an alliance of community providers for the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure. Accidents With motor vehicle accidents representing a need identified in the CHNA, summit participants felt the biggest area for improvement was with resident driving under the influence. This sentiment was echoed by community residents and given this need, SEBD believes that this particular need falls outside of the hospitals direct mission to provide high quality healthcare with special concern for the poor and vulnerable. However, as a stakeholder concerned with community safety, SEBD will join in community discussions around highway safety and the prevention of resident driving under the influence. Financial Assistance Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. SEBD screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers SEBD patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level. As the cost of care rises, summit participants suggested that there was a need to identify ways to connect patients to resources that may be able to help lower the cost of care. SEBD has established a partnership, and provides support to, the Community Health Coalition of Caldwell County (CHCCC) to provide a Prescription Assistance Program to residents of Caldwell County. SEBD will continue to support this partnership and work to identify ways to increase the ability to connect residents to this valuable resource.
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Schedule H, Part V, Section B, Line 11 Facility B, 3
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Facility B, 3 - SETON HIGHLAND LAKES HOSPITAL - PART 1. The SHL Implementation Plan addresses the four health needs; access to care, behavioral health, chronic disease, and obesity in the order of priority identified through the Burnet County CHNA. Also addressed in the SHL plan is an overview of the hospital's policy of providing financial assistance to low income patients and a strategy for addressing community collaboration. Behavioral Health The CHNA identified mental health as the greatest health concern raised by Burnet County residents. With few behavioral health providers in the Burnet County, it was no surprise that behavioral health was noted as the top priority by survey respondents. According to a 2011 report created by the Department of State Health Services, 3 psychiatrists had their primary county of practice in Burnet County. While this does not take into account the number of psychologists and/or counselors in Burnet County or the number of psychiatrists who visit this area on a part time bases, it further supports the community perspective on the lack of mental health providers in these counties. In addition to the lack of providers, survey respondents expressed the need for substance abuse treatment and prevention measures in Burnet County. SHL proposes to collaborate with Lone Star Circle of Care to examine opportunities to bring psychiatric services to Burnet County. SHL will collaborate with Bluebonnet Trails Community Services and the Burnet County Sheriff's Department to develop a Crisis Assessment for Persons in Behavioral Health Crisis program. This program will provide crisis assessment, referral and short term stabilization in Burnet County. To establish this service, a space near the Emergency Department (ED) of SHL in Burnet, Texas will be renovated so that it is suitable for walk-in patients and for law enforcement. Frequently, law enforcement will use it for persons who are being held under Emergency Detention and require evaluation to determine the best options for treatment and stabilization. SHL will expanded access to Psychiatric Telemedicine in the Emergency Department beginning in August 2013 and will continue to expand these behavioral health services to remainder of the hospital floors by the end of 2014. By providing 24/7 psychiatric consultations patients in psychiatric crisis will be able to be evaluated and treated in a timely manner. Typically patients would have to wait until the next day for appropriate psychiatric assessment. This new approach to psychiatric telemedicine can lead to timely assessment, earlier disposition and less costly level of care. Access to Care Access to care was identified as the second highest priority need by survey respondents. While this included a broad spectrum of needs that fall under the access to care umbrella, the greatest concern for residents was care for the older members of the county and services for the un- and underinsured. With the 65+ population in Burnet County expected to double over the next 18 years, services for the aging will continue to be in need. Given the need to increase primary care access, especially for the un- and underinsured, SHL is committed to the continuation of the SHL Care-A-Van to help eliminate some of the barriers residents face while trying to access care. This mobile clinic will target care toward low income residents and eliminate the transportation barriers associated with accessing care in rural communities. The Care-A-Van currently visits schools and churches that have been identified as areas of need and can serve as a primary care home for those residents who cannot access care elsewhere. SHL is committed to providing support for the Highland Lakes Rural Health Clinics which provides additional options for low income residents to access to primary care. SHL has clinics located in Burnet, Bertram, Lampasas, and Marble Falls in an attempt to provide services in the communities with the greatest need. The CHNA identified a decreasing number of providers that accept new Medicare and Medicaid patients, both of which are accepted by these clinics. To help underserved residents navigate the complicated and fragmented health care system, SHL will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified health disparities and inequities in the ability of different ethnic groups to access care. The reasons are complex. Research shows providing professional medical interpretation at initial assessment and discharge reduces readmissions within 30 days, reduces patient bed days, improves medication adherence and leads to better health outcomes. In addition, research also shows providing cultural competence training to our clinical care teams improves communication between patients and their clinical care team including their doctors and nurses as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems ("HCAHPS") Survey, the first national, standardized, publicly reported survey of patients' perspectives of hospital care. Currently Seton provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, Seton provides in person sign language contracted services at all of its facilities. As part of an integrated approach to administer care in a person centered, culturally competent manner, the Seton Healthcare Family will develop a Language Services Resource Center and a Culturally Competent Care Curriculum at four Seton hospitals and will implement the learnings and best practices at SHL.The Language Services Resource Center is a new project which will provide professional medical interpretation at initial assessment and discharge by centralizing interpretation & translation services, and increasing the number of professional medical interpreters for patients with Limited English Proficiency including but not limited to Spanish and sign language. The Culturally Competent Care Curriculum is expected to increase the quality of communication between the clinical care team and the patient in order to achieve greater patient involvement in shared decision making. The Diversity Department through the Culturally Competent Care Curriculum will provide training and education to the clinical care team to increase the likelihood of safe and effective person centered care in a culturally competent manner and leads to better health outcomes. It is projected that the population over the age of 65 will more than double over the next 18 years and because of this projected need for aging services, SHL will continue to support the Highland Lakes Hospice and Home Health that provide a portion of the aging services for Burnet County. By supporting these programs, SHL will help ensure that appropriate services are available for residents as they age. SHL proposes to develop a Patient Care Navigation program to effectively navigate services for indigent and uninsured patients in Burnet County. This project will implement a patient navigation system to connect indigent and uninsured patients with primary care or medical homes in order to reduce inappropriate utilization and provide cost-effective, timely, and site-appropriate health care services. Patients will be routed to a medical home by care navigators responsible for managing long-term relationships with the patients to reduce the patient's need for advanced medical care, including the (ED). Chronic Disease and Disease Management The 2012 Burnet County Community Health Needs Assessment identified chronic disease and disease management as a health related priority facing residents of Burnet County. Chronic disease has remained the top cause of death for the past 6 years and, with cancer and heart disease topping the list again, chronic disease is expected to remain as the top cause of death for the foreseeable future. Many survey respondents cited chronic disease - specifically diabetes, heart disease, and cancer - among the greatest areas of concern. With the long-term developments of chronic disease and the lifestyle attributes that contribute to these diseases, it is imperative that a concerted effort be made by the community to promote healthy choices where residents live, work, play, and worship.
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Schedule H, Part V, Section B, Line 11 Facility B, 4
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Facility B, 4 - SETON HIGHLAND LAKES HOSPITAL - PART 2. Seton Network Oncology Services currently works with several Seton hospitals, including SHL, to provide access to the Seton Cancer Prevention and Early Detection program, the Oncology Nurse Registry, the Survivorship Program, the Multidisciplinary Cancer Conference and clinics, and Navigation service. Seton's comprehensive oncology programs provide residents of Central Texas access to cancer services that promote early detection and a coordinated approach to care throughout the continuum which includes screening, diagnosis, treatment and survivorship. SHL refers patients to the Seton Shivers Cancer Center. The Shivers Cancer Center provides a variety of outpatient services for adult cancer patients in Central Texas regardless of ability to pay. In addition to clinical services, the Shivers health care professionals work closely with the Seton Cancer Care Team to provide vital case management services plus a variety of physical, emotional, and spiritual support programs to adult cancer patients and their families. SHL will work with the new Women's Oncology Care Screening program. This program expands timely access to breast and cervical cancer screening via a mobile unit for uninsured and underinsured women in Central Texas who, without this expansion, likely would not receive these life-saving services. This expansion in screening is part of Seton's digital mammography mobile unit known as the Big Pink Bus. Access to cervical cancer screenings are now expanded to mobile mammography program participants by using advanced practice nurses on the mobile unit or at our community clinics that provide indigent care. In addition to the screening, SHL will incorporate Women's Oncology Navigation as a method of expanding existing patient navigation services that connect women with cancer diagnosis to treatment and/or survivorship support services. Looking to improve the health of patients with chronic disease, SHL will continue to support Seton's Asthma Education program for Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages. Seton Healthcare Family facilities are a tobacco free environment, prohibiting tobacco use at all of its hospitals and places of work. Seton is an active participant in community efforts to combat tobacco use, providing tobacco cessation services to Central Texas residents. SHL will continue to support the Tobacco Cessation Program that provides community-wide training for physicians and local clinics based on best practices for treating nicotine addiction. In addition, The Seton Tobacco Education Resource Center offers a comprehensive tobacco education program which provides cessation classes that are based on the Mayo Clinic Model for treating Tobacco Dependence. Sessions follow a support group setting and are facilitated by Certified Tobacco Treatment Specialist. Through motivational interviewing techniques CTTS are able to conduct sessions that aim at maximizing & promoting participant dialogue. As chronic disease continues to be the top causes of death for Burnet County, SHL is committed to help find additional ways to decrease chronic disease. As a next step, SHL will work with the Highland Lakes Partnership as they work to identify and encourage healthy lifestyle policies for Burnet County. This will include such policies as smoke and tobacco free workplaces and restaurants serving local and healthy foods. Obesity The 2013 Burnet County Community Health Needs Assessment identified obesity as one of the most pressing health issues. While overall, obesity in Central Texas is close to the national average, Burnet County has continually seen its rates stay above the national median. Residents identified a lack of access to healthy food and resources in addition to the need for improve recreation areas as the two obesity related gaps. While we certainly need to address the impact of obesity in our community, it is crucial that we also take steps to address the issue prior to individuals becoming obese. As identified in the CHNA, healthy food access and nutrition education are two elements of a healthy lifestyle that were identified gaps in Burnet County. In order to fill this need, SHL will work with the Williamson County Collaborative and the Highland Lakes Partnership to develop policies and programs that increase access to healthy foods. This may involve the creation of Farmer's Market's, community gardens, and working to connect local foods to local businesses. This program will attempt to develop environmental changes that can help support a healthy lifestyle and combat obesity in Burnet County. SHL is dedicated to improving the nutritional value of the food offered at the facility. SHL will work with TouchPoint, its food service vendor, to improve the nutritional content in the food served through a Healthy Dining Program to ensure that our daily offerings are geared toward providing healthy choices and options for our guests. This will not only benefit patients but also visitors, physicians, and community members who frequent the hospital. Community Collaboration Despite many non-profit and social service organizations within Burnet County, survey participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of cohesion and focused vision lead participants to feel that there is more dialogue than there is action. The desire for a more coordinated approach was identified as an area of need in order to maximize the limited resources of the area. SHL and the Seton Healthcare Family provided strong support for the creation of the Highland Lakes Partnership. This local collaboration is comprised of various community stakeholders that work as a subgroup of the Integrated Care Collaboration (ICC). In 1997, Seton led the formation of the Integrated Care Collaboration (ICC), an alliance of community providers for the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure. Accidents With motor vehicle accidents representing a need identified in the CHNA, survey respondents felt the biggest area for improvement was around road safety. This sentiment was echoed by community residents. Given the nature of this need, SHL believes that it currently falls outside of the hospitals direct mission to provide high quality healthcare with special concern for the poor and vulnerable. However, as a stakeholder concerned with community health and safety, SHL will join in community discussions around road safety. Financial Assistance eton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. SHL screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers SHL patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level.
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Schedule H, Part V, Section B, Line 11 Facility B, 5
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Facility B, 5 - SETON MEDICAL CENTER HARKER HEIGHTS - PART 1. Access to Care Bell County participants listed access to care as the highest ranking health priority. Care for the un- and underinsured and improved access to primary care were the two areas identified as needing improvement by the survey participants. With twice the amount of population per primary care provider than the national average, it was no surprise that these two subgroups emerged. The fewer the primary care providers, the longer individuals have to wait to receive care and the fewer options available for un- and underinsured patients. As the population continues to grow in Bell County, opportunities exist to streamline avoidable hospital use and cost, especially among more vulnerable populations. In June 2012 SMCHH opened its doors and by doing so gave the community in Bell County increased options to access care. While this was a major step forward in increasing access to care, SMCHH is committed to continue to look for ways to increase access. Currently SMCHH is actively recruiting physicians to the area to help bring specialty services to Bell County rather than forcing residents travel to neighboring counties to receive care. Since SMCHH has opened it has brought 21 new physicians/specialists to Bell County and is projected to bring an additional 15 over the next three years. Currently there are over 250 physicians on the medical staff. SMCHH has an on campus Physician Group that offers same day appointments for those residents needing non-emergent care. This physician group offers services such as primary care, obstetrics, gastroenterology, pulmonary, ENT, orthopedics and general surgery. The physician group currently accepts both Medicare and Medicaid and will continue to look for ways to expand access to their services in the coming years. SMCHH has worked with multiple community partners to improve patients' access to care. SMCHH will work with primary care clinic partners who have opened and/or are planning to open facilities in the hospital's primary and secondary service areas. Currently, SMCHH is engaged in collaboration with the Killeen Free Clinic to help provide access to care for the most vulnerable residents of Bell County. Behavioral Health With limited behavioral health providers in Bell County, the need for behavioral health services was noted as a high priority by community residents. According to a 2011 report created by the Department of State Health Services, 20 psychiatrists had their primary county of practice in Bell County. This equates to one psychiatrist per 14,833 residents. While this does not take into account the number of psychologists and/or counselors in Bell County, or the number of psychiatrists who visit the county on a part-time basis, it supports the community's perceived lack of mental health services. SMCHH works closely with the Central Counties MHMR to help coordinate services for those individuals that enter through the Emergency Department. When a patient enters SMCHH and is experiencing a mental health crisis that can better be treated by mental health professionals, SMCHH coordinates with Central Counties MHMR to help provide a more appropriate treatment option than can be provided at the hospital. This partnership increases the timeliness of the patient receiving the most appropriate care. SMCHH is currently evaluating options to connect with local behavioral health providers to provide a better continuum of care for community residents needing to access behavioral health services. The SMCHH Emergency Department is currently exploring a Psychiatric Telemedicine model that would allow for patients to be seen by mental health professional in a timelier manner. Typically, patients in psychiatric crisis presenting after-hours to the SMCHH ED wait until the next day for appropriate psychiatric assessment. Through implementation of telemedicine, patients will receive a timely assessment, leading to earlier disposition at a less intense (and costly) level of care. SMCHH currently works with Army Marathon and will continue to pursue this partnership to benefit the behavioral health needs of the community. With Fort Hood being located in Bell County and the increasing awareness of the impact combat has on the mental health of our veterans, the Army Marathon helps raise support for behavioral health services and research in the military. Chronic Disease and Disease Management As has been the case for many years, cancer and heart disease are the leading causes of death across the Central Texas region. While not prioritized as the highest need category, the need for more chronic disease education and treatment of long-term health problems was clear given survey responses. In addition, survey participants also prioritized the prevention of chronic disease in older adults as an area of improvement related to chronic disease. Participants understood that chronic disease and other health needs are often intertwined. Because of this, many community members expressed the need for a multidisciplinary approach to care because; success would require addressing chronic disease with attendant behavioral health, lifestyle and cultural barriers. SMCHH currently funds a Diabetes Academy that helps educate persons with diabetes and those that care for them. Three family medicine physicians spearhead the education series with support from a diabetes educator and hospital clinical dietitian. The group is fed healthy snacks and the physicians offer ideas and support for those in attendance. After the session, a one-on-one visit with a physician and educator occurs. As a method of treating and providing resources for those community members suffering from chronic conditions, SMCHH has added two new internal medicine physicians to its staff. While this is a giant step in helping manage and treat those residents with chronic diseases, SMCHH will explore opportunities to bring more physicians to the community who focus on the treatment of chronic disease. By bringing more physicians to the area community members will not have to wait as long to be seen and the un- and underinsured will have more options. SMCHH will explore adding additional classes as necessary to meet the health needs of the community. Currently, SMCHH offers CPR and first aid classes in addition to the Diabetes Academy and will look for opportunities to expand the scope of classes offered. Some classes currently being discussed are those revolving around healthy lifestyle, nutrition, and healthy heart. Obesity Within the region as a whole, obesity continues to increase and is consistently above the national average. The data points out that there is limited access to healthy foods and participants agreed that healthy eating education and access to healthy food were the areas of greatest need. It was noted by some stakeholders that while recreation outlets may be available in the community, the rural nature of the county may not allow residents to access them because they have to travel long distances to get to them. SMCHH is currently engaged in collaboration with the Armed Services YMCA to build a Community Fitness and Rehabilitation Facility that will help promote a healthy and active environment for the community. This new recreation facility will go beyond the simple workout equipment found in most YMCAs and will offer soldier rehabilitation programs, military family counseling, family meet-ups, holistic wellness programs and nutrition classes. Groundbreaking for this center is expected within the next year and being completed within 2015.
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Schedule H, Part V, Section B, Line 11 Facility B, 6
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Facility B, 6 - SETON MEDICAL CENTER HARKER HEIGHTS - PART 2. With limited access to healthy food being a need identified by the CHNA, SMCHH will explore ways to offer community education on healthy eating. With a Clinical Dietician/Nutritionist on staff, SMCHH will identify opportunities to host classes that teach residents about what makes a healthy meal, how to shop for healthy foods, and provide healthy recipe ideas to participants. These classes are in the early stages of implementation at SMCHH and will look to expand these classes in the next three years. Community Collaboration In an effort to increase and foster community collaboration, SMCHH has collaborative partnerships with many local agencies and other non-profit organization including but not limited to: the Armed Service YMCA, the Killeen Free Clinic, the Heart Association, the Regional Health Policy Group, Hope Pregnancy Center, Harker Heights Food Bank, and the United Way. Through these partnerships, SMCHH is able to better connect residents to service organizations and support community health needs that fall outside the scope of the hospital. SMCHH expects to continue these collaborative partnerships and will explore opportunities to engage other community based organizations. Financial Assistance SMCHH is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a member of the health system in Bell County, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. SMCHH screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers SMCHH's patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level.
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Schedule H, Part V, Section B, Line 11 Facility B, 7
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Facility B, 7 - SETON SMITHVILLE REGIONAL HOSPITAL - PART 1. Access to Care Access to care was identified as the highest priority need by summit participants. This included many aspects that fall under the umbrella of access to care but the greatest need was to identify ways to connect residents to available resources, especially for the un- and underinsured. In addition, community members felt that the lack of certain types of providers was the cause for long wait times and difficulties accessing care. Dental care and specialty care were identified as the top two needed services. The ability to recruit and retain specialist has been a challenge for Bastrop County and according to community stakeholders still remains a top need when addressing access related issues. Seton Smithville has, and will continue to engage in its partnership with Lone Star Circle of Care as a means of increasing primary care access for the un- and underinsured residents of Bastrop County. LSCC and Seton are committed to bringing a Federally Qualified Health Center to Bastrop County and Seton will provide financial support for this project. Given the need to increase primary care access, especially for the un- and underinsured, Seton Smithville will implement a mobile Care-A-Van in Bastrop County to help eliminate some of the barriers residents face trying to access care. This mobile clinic will target care for low income residents and eliminate the transportation barriers associated with accessing care in rural communities. To help underserved residents navigate the complicated and fragmented health care system, Smithville will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified health disparities and inequities in the ability of different ethnic groups to access care. The reasons are complex. Research shows providing professional medical interpretation at initial assessment and discharge reduces readmissions within 30 days, reduces patient bed days, improves medication adherence and leads to better health outcomes. In addition, research also shows providing cultural competence training to our clinical care teams improves communication between patients and their clinical care team including their doctors and nurses as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems ("HCAHPS") Survey, the first national, standardized, publicly reported survey of patients' perspectives of hospital care. Currently Seton provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, Seton provides in person sign language contracted services at all of its facilities. As part of an integrated approach to administer care in a person centered, culturally competent manner, the Seton Healthcare Family will develop a Language Services Resource Center and a Culturally Competent Care Curriculum at four Seton hospitals and will implement the learnings and best practices at Smithville. The Language Services Resource Center is a new project which will provide professional medical interpretation at initial assessment and discharge by centralizing interpretation & translation services, and increasing the number of professional medical interpreters for patients with Limited English Proficiency including but not limited to Spanish and sign language. The Culturally Competent Care Curriculum is expected to increase the quality of communication between the clinical care team and the patient in order to achieve greater patient involvement in shared decision making. The Diversity Department through the Culturally Competent Care Curriculum will provide training and education to the clinical care team to increase the likelihood of safe and effective person centered care in a culturally competent manner and leads to better health outcomes. Obesity The 2013 Bastrop County Community Health Needs Assessment identified obesity as a pressing health issue. While overall, obesity in Central Texas is close to the national average, Bastrop County has continually seen its rates remain consistently above the national median. Residents identified nutrition education and the lack of recreation outlets as two prominent gaps related to obesity. While we certainly need to address the impact of obesity in our community, it is crucial that we also take steps to address the issue prior to individuals becoming obese. As identified in the CHNA, healthy food access and nutrition education are two elements of a healthy lifestyle that were identified gaps in Bastrop County. In order to fill this need, Smithville will partner with the Community Health Coalition of Caldwell County and work to develop an environment that increases access to healthy foods. This will involve the creation of Farmer's Market's, community gardens, and working to connect local foods to local businesses. This program will attempt to develop environmental changes that can help support a healthy lifestyle and combat obesity in Bastrop County. Smithville is dedicated to improving the nutritional value of the food offered at the facility. Smithville will work with TouchPoint, its food service vendor, to improve the nutritional content in the food served through a Healthy Dining Program to ensure that our daily offerings are geared toward providing healthy choices and options for our guests. This will not only benefit patients but also visitors, physicians, and community members who frequent the hospital. Community Collaboration Despite non-profit and social service organizations within Bastrop County, and many in the surrounding counties, many summit participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of joint use agreements for use of facilities has provided challenges to leveraging resources. The desire for a more connected approach and the ability to access resources in nearby counties was identified as an area of need in order to maximize the limited resources of the area. Smithville and the Seton Healthcare Family provided strong support for the creation of the Opportunity Bastrop Collaborative. This local collaboration is comprised of various community stakeholders that work as a subgroup of the Integrated Care Collaboration (ICC). In 1997, Seton led the formation of the ICC, an alliance of community providers for the medically indigent, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal was to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure.
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Schedule H, Part V, Section B, Line 11 Facility B, 8
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Facility B, 8 - SETON SMITHVILLE REGIONAL HOSPITAL - PART 2. Behavioral Health The CHNA identified mental health as one of the three greatest health concerns raised by Bastrop County residents. Summit participants mentioned the rising rates of mental health conditions among residents in the County. These included areas such as substance abuse, suicide interventions, and an inadequate number of mental health providers who could prescribe medication. The CHNA identified that Bastrop County adults experienced on average 2.8 poor mental health days in the past month and slightly higher than average suicide rates. Currently psychiatric care is provided by Bluebonnet Community Services on-site, but as the need grows Smithville will explore the option of incorporating access to Psychiatric Telemedicine throughout the facility if it is determined that this is needed. Through Psychiatric Telemedicine, Smithville could provide 24/7 psychiatric consultations patients in psychiatric crisis who will be able to be evaluated and treated in a timely manner. Typically patients would have to wait until the next day for appropriate psychiatric assessment. This new approach to psychiatric telemedicine can lead to timely assessment, earlier disposition and less costly level of care. Smithville will collaborate with Bluebonnet Community Services and Lone Star Circle of Care in an attempt identify ways to expand behavioral health services in Bastrop County. Chronic Disease and Disease Management The 2012 Bastrop County Community Health Needs Assessment identified chronic disease and disease management as a health related priority facing residents of Bastrop County. Chronic disease has remained the top cause of death for the past 6 years and, with cancer and heart disease topping the list again, chronic disease is expected to remain as the top cause of death for the foreseeable future. Many community members cited chronic disease education, specifically self-disease management as one of the greatest needs for their community. Seton Network Oncology Services currently works with several Seton hospitals, including Smithville, providing access to the Seton Cancer Prevention and Early Detection program, the Oncology Nurse Registry, the Survivorship Program, the Multidisciplinary Cancer Conference and clinics, and Navigation service. Seton's comprehensive oncology programs provide residents of Central Texas access to cancer services that promote early detection and a coordinated approach to care throughout the continuum which includes screening, diagnosis, treatment and survivorship. Smithville refers patients to the Seton Shivers Cancer Center. The Shivers Cancer Center provides a variety of outpatient services for adult cancer patients in Central Texas regardless of ability to pay. In addition to clinical services, the Shivers health care professionals work closely with the Seton Cancer Care Team to provide vital case management services plus a variety of physical, emotional, and spiritual support programs to adult cancer patients and their families. Smithville will work with the new Women's Oncology Care Screening program. This program expands timely access to breast and cervical cancer screening via a mobile unit for uninsured and underinsured women in Central Texas who, without this expansion, likely would not receive these life-saving services. This expansion in screening is part of Seton's digital mammography mobile unit known as the Big Pink Bus. Access to cervical cancer screenings are now expanded to mobile mammography program participants by using advanced practice nurses on the mobile unit or at our community clinics that provide indigent care. In addition to the screening, Smithville will incorporate Women's Oncology Navigation as a method of expanding existing patient navigation services that connect women with cancer diagnosis to treatment and/or survivorship support services. Looking to improve the health of patients with chronic disease, Smithville will continue to support Seton's Asthma Education program for Central Texas residents. This program provides home visits for asthma education to nearly 1,000 uninsured and underinsured families per year. By providing education about services in the home, residents overcome transportation barriers that often accompany this target population. The Seton Asthma & COPD Center provides a comprehensive disease management program designed to provide care coordination, social services, and Asthma/COPD education for all ages.
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Schedule H, Part V, Section B, Line 11 Facility B, 9
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Facility B, 9 - SETON SMITHVILLE REGIONAL HOSPITAL - PART 3. Seton Healthcare Family facilities are a tobacco free environment, prohibiting tobacco use at all of its hospitals and places of work. Seton is an active participant in community efforts to combat tobacco use, providing tobacco cessation services to Central Texas residents. Smithville will continue to support the Tobacco Cessation Program that provides community-wide training for physicians and local clinics based on best practices for treating nicotine addiction. In addition, The Seton Tobacco Education Resource Center offers a comprehensive tobacco education program which provides cessation classes that are based on the Mayo Clinic Model for treating Tobacco Dependence. Sessions follow a support group setting and are facilitated by Certified Tobacco Treatment Specialist. Through motivational interviewing techniques CTTS are able to conduct sessions that aim at maximizing & promoting participant dialogue. With the CHNA emphasizing self-disease management, Smithville proposes to work with the Community Health Coalition of Caldwell County, and Lone Star Circle of care to establish and implement a Diabetes Education Program. This proposed program will identify Bastrop County residents diagnosed with diabetes and will provide disease education and nutrition guidance to help patients manage their own care. In addition, Smithville will support the development of a Care Coordination Partnership between these same organizations to help navigate patients with chronic illnesses and connect them to available resources. Seton Smithville will work in partnership with The Seton Brain and Spine Institute to bring community education events regarding stroke symptoms and prevention to Bastrop County. Seton Smithville is committed to continuing this partnership and will look for additional opportunities for community education. As chronic disease continues to be the top causes of death for Bastrop County, Seton Smithville is committed to help find additional ways to decrease chronic disease. As a first step, Seton Smithville will work with the Community Health Coalition in Caldwell County to identify and encourage healthy lifestyle policies for Bastrop County. This will include such policies as smoke and tobacco free workplaces and restaurant serving local and healthy foods. Accidents With motor vehicle accidents representing a significant amount of the years of potential life lost in Bastrop County, the CHNA identified it was one of Bastrop County's needs. This sentiment was echoed by community residents but with the focus being on improved highway safety, Seton Smithville believes that this falls outside of its direct mission to provide high quality healthcare with special concern for the poor and vulnerable. However, as a stakeholder concerned with community safety, Smithville will join in community discussions around highway safety and the prevention of resident driving under the influence. Financial Assistance Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. Smithville screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers Smithville patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level. As the cost of care rises, summit participants suggested that there was a need to identify ways to connect patients to resources that may be able to help lower the cost of care. Smithville has established a partnership, and provides support to, the Community Health Coalition of Caldwell County (CHCCC) to provide a Prescription Assistance Program to residents of Bastrop County. Smithville will continue to support this partnership and work to identify ways to increase the ability to connect residents to this valuable resource.
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Schedule H, Part V, Section B, Line 16 Facility B, 1
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Facility B, 1 - Facility 4 -- Seton Edgar B. Davis Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 16 Facility B, 2
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Facility B, 2 - Facility 5 -- Seton Highland Lakes Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 16 Facility B, 3
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Facility B, 3 - Facility 13 -- Seton Medical Center Harker Heights. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 16 Facility B, 4
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Facility B, 4 - Facility 14 -- Seton Smithville Regional Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 22 Facility B, 1
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Facility B, 1 - Facility 4 -- Seton Edgar B. Davis Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 22 Facility B, 2
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Facility B, 2 - Facility 5 -- Seton Highland Lakes Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 22 Facility B, 3
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Facility B, 3 - Facility 13 -- Seton Medical Center Harker Heights. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 22 Facility B, 4
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Facility B, 4 - Facility 14 -- Seton Smithville Regional Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Schedule H, Part V, Section B, Line 5 Facility , 1
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Facility , 1 - Seton Shoal Creek Hospital. From February - May 2012, forums, focus groups, and interviews were conducted with leaders from a wide range of organizations in different sectors, community stakeholders, and residents to gauge their perceptions of the community, their health concerns, and what programming, services, or initiatives are most needed to address these concerns. Priority sectors and representative participants were identified based on: 1) a brainstorming session with members from the Core Coordinating and Steering Committees, 2) a survey completed by the Steering Committee nominating key informants, and 3) a survey completed by the Outreach and Engagement Subcommittee identifying focus group sectors and relevant community-based organizations. To this end, a total of 4 community forums, 14 focus groups, and 28 interviews with community stakeholders were conducted. Additionally, findings from 25 key informant interviews with senior leaders in multiple sectors including the business, education, and health fields previously conducted for the Central Health Connection's Leader Dialogue Series were included in the analysis. Ultimately, the qualitative research engaged over 300 individuals in discussion about the health issues they deemed critical in their community. Specifically, the qualitative data collection addressed the last two goals of the assessment: 1) to explore the current health priorities among Austin/Travis County residents within the social context of their communities and 2) to identify community strengths, resources, forces of change, and gaps in services to inform funding and programming priorities of Austin/Travis County. For this first goal which encompassed the community themes and strengths assessment, focus groups, interviews, and community precinct forums were completed. For the second goal of the forces of change assessment, focus groups and interviews discussed important external factors that have had and will have an impact on the community's health. More about these qualitative data collection methods can be found below: Community Forums Four community forums were held in different areas of Austin/Travis County and engaged a total of 152 participants. During each forum an overview of ATCHHS and its partners' programs and services was given, local health indicators were presented, and attendees participated in a dialogue around health and their community. Facilitators guided discussions using a set of questions (see Community Health Needs Assessment Appendix A) and notetakers captured responses. In addition, each forum had bilingual staff available to simultaneously interpret presentations, facilitate, and take notes in Spanish. On average, each community forum lasted two hours, of which the community dialogue comprised one hour. Forums were advertised to a wide variety of community entities such as schools, churches, neighborhood associations, social services agencies, and local business. Free health screenings (e.g.: blood pressure, HIV, etc.) were offered before and after the forum. In addition, the first 50 participants received a $20 gift card to a local grocery store if they attended the duration of the event. Focus Groups and Interviews In total, 14 focus groups and 28 interviews were conducted with individuals from across Austin/Travis County. Focus groups were with the general public and with selected priority populations. For example, three focus groups were conducted with senior citizens, two groups with public housing residents, and two groups with refugees. A total of 101 individuals participated in the focus groups. Interviews were conducted with 31 individuals representing a range of sectors. These included government officials, educational leaders, social service providers, and health care providers. A full list of the different sectors engaged during the focus group and interview process can be found in Community Health Needs Assessment Appendix B. Focus group and interview discussions explored participants' perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. A semi-structured moderator's guide was used across all discussions to ensure consistency in the topics covered (Community Health Needs Assessment Appendix C and D). Each focus group and interview was facilitated by a trained moderator, and detailed notes were taken during conversations. On average, focus groups lasted 90 minutes and included 6-12 participants, while interviews lasted approximately 30-60 minutes. Participants for the focus groups were recruited by community and social service organizations located throughout Travis County. As an incentive, focus group participants received a $30 gift card to a local grocery store. Analyses The collected qualitative information was coded using NVivo qualitative data analysis software and then analyzed thematically by data analysts for main categories and sub-themes. Analysts identified key themes that emerged across all groups and interviews as well as the unique issues that were noted for specific populations. Throughout the qualitative findings included in this report the term "participants" is used to refer to community forum, focus group, and key informant interview participants. Unique issues that emerged among a group of participants are specified as such (e.g.: community forum participants, Spanish-speaking focus group participants, etc.). Frequency and intensity of discussions on a specific topic were key indicators used for extracting main themes. While regional differences are noted where appropriate, analyses emphasized findings common across Austin/Travis County. Selected paraphrased quotes - without personal identifying information - are presented in the narrative of this report to further illustrate points within topic areas. Limitations As with all research efforts, there are several limitations related to the assessment's research methods that should be acknowledged. It should be noted that for the secondary data analyses, in several instances, city-level data were not available or could not be analyzed due to small sample sizes. In some cases, data was aggregated across multiple years to increase sample size (e.g. 2005-2009). Additionally, several sources did not provide current data stratified by race/ethnicity, gender, or age thus, these data could only be analyzed by total population. Due to the variety of sources used to conduct this assessment, it is also important to note that the term "Hispanic" could not be consistently defined throughout the report. For example, in demographic data presented, Hispanic refers to an ethnicity of any race; however, the qualitative data represents the perspectives of participants who may define the term Hispanic differently. Likewise, data based on self-reports should be interpreted with particular caution. In some instances, respondents may over- or underreport behaviors and illnesses based on fear of social stigma or misunderstanding the question being asked. In addition, respondents may be prone to recall bias that is, they may attempt to answer accurately but remember incorrectly. In some surveys, reporting and recall bias may differ according to a risk factor or health outcome of interest. Despite these limitations, most of the self-report surveys here benefit from large sample sizes and repeated administrations, enabling comparison over time. Additionally, public health surveillance data has its limitations regarding how data are collected and reported, who is included in public health datasets, and whether sample sizes for specific population groups is large enough for sub-group analyses While the focus groups and interviews conducted for this study provide valuable insights, results are not statistically representative of a larger population due to non-random recruiting techniques and a small sample size. Recruitment for focus groups was conducted by community organizations, and participants were those individuals already involved in community programming. Because of this, it is possible that the responses received only provide one perspective on the issues discussed. In addition, organizations did not exclude participants if they did not live in the particular neighborhood, so participants in a specific community's focus group might not necessarily live in that area, although they did spend time there through the organization. Lastly, it is important to note that data were collected at one point in time, so findings, while directional and descriptive, should not be interpreted as definitive.
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Schedule H, Part V, Section B, Line 6a Facility , 1
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Facility , 1 - Seton Shoal Creek Hospital. The other hospital facilities with which the reporting hospital facility conducted its CHNA, include: - Central Health - UT Health
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Schedule H, Part V, Section B, Line 6b Facility , 1
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Facility , 1 - Seton Shoal Creek Hospital. The other organizations with which the reporting hospital conducted its CHNA, include: - City of Austin - County of Travis - St. David's Foundation
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Schedule H, Part V, Section B, Line 7 Facility , 1
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Facility , 1 - Seton Shoal Creek Hospital. The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address: https://www.seton.net/wp-content/uploads/2016/06/Final-AustinTravis-County-CHA-CHIP_Report10-24-13.pdf
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Schedule H, Part V, Section B, Line 11 Facility , 1
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Facility , 1 - SETON SHOAL CREEK HOSPITAL - PART 1. Seton Shoal Creek Hospital (SSC) has been serving Austin-area patients for more than 30 years and offers a wide spectrum of mental health and substance abuse services. SSC treats, on an inpatient or outpatient basis, children, adolescents, adults and senior adults who may be experiencing emotional and/or substance abuse difficulties. Inpatient services include intensive psychiatric stabilization for patients dealing with emotional crises, depression and drug/alcohol dependence. For those individuals requiring less intensive, longer term treatment, outpatient services are offered. SSC has a complete continuum for patient care which includes in-patient hospitalization, ECT services, Partial Hospitalization, Intensive Outpatient Programs including geri-psych and telepsychiatric consults. The Seton Mind Institute is the faculty practice of board certified psychiatrists that supervise the UT Southwestern psychiatric residency program. Given the behavioral health and substance abuse scope and mission of SSC, obesity and chronic disease treatment fall outside the realm of the hospitals direct service capabilities. While SSC does not have programs directly focused on these areas of need, SSC does participate in many collaborative efforts to provide behavioral health services as part of a multidisciplinary approach to obesity and chronic disease treatment including oncology. Behavioral Health The CHNA identified mental health as one of the foremost health concerns raised by Travis County residents. Focus group participants and interviewees alike both mentioned the rising rates of mental health conditions among residents in the County. This included areas such as substance abuse and inadequate mental health services. It was reported that 20% of Travis County adults experienced five or more days of poor mental health in the past month which is well above the national median. In an attempt to expand access to provide 24/7 psychiatric consultations and through SCC's close relationship with the Seton Mind Institute, SCC will provide the expansion of Psychiatric Telemedicine services to all Seton Hospitals. Typically, patients in psychiatric crisis presenting after-hours to hospital ED's wait until the next day for appropriate psychiatric assessment. Through implementation of telemedicine, patients across the Seton network will be able to connect to SSC physicians via telemedicine and receive a timely assessment, leading to earlier disposition at a less intense (and costly) level of care. SSC is committed to the support of the Seton Cove Spirituality Center. This center offers people of all faiths the opportunity to nourish and foster this journey towards wholeness. Through a variety of seminars, classes and events led by a multidisciplinary faculty, Seton Cove is a place of hospitality and solace for people seeking to integrate spirituality more fully into their daily lives. These programs are open to the community and hope to increase awareness within society of the healing role of spirituality for individuals and communities. SSC has been a founding financial member of the Ending Community Homelessness Collaboration (ECHO) and is committed to remaining involved to help meet the needs of some of Austin's most vulnerable residents. In collaboration with other community stakeholders, SSC provided initial funding for the ECHO to apply for 501(c)3 status and hirer full time staff. SSC lead the creation of the Crisis Implementation Committee (CIC) which is a collaboration of all behavioral health providers, EMS, Austin Policy Department and other governmental entities involved in care of patients with behavioral health. For the past seven years the CIC has collaborated in building programs and brining in public and private dollars to fund expanded safety net that improve access to care in less expensive settings and improving the system of care for crisis services. Over the years CIC has created more bed capacity for hospitalization, funded access for partial hospitalization and IOP services. In addition, the CIC has built a dashboard to monitor services with metrics guiding the committee on process improvement initiatives. Outcomes include expanded 24/7 Psychiatric Emergency Services, Communitywide Peer Review program, Expanded Mobile Crisis Services and Telepsychiatric consults. The CIC reports to a behavioral health stakeholder group under the hospital District which advocates for improved services for behavioral health patients. Shoal Creek Hospital and The Seton Mind Institute are active members in both the CIC and the Stakeholder group and have led many initiatives for improvement of care in behavioral health services. To augment the public school health education curriculum, Seton Healthcare Family has purchased HealthTeacher, a comprehensive K-12 online health education curriculum for teachers in school districts within Travis, Williamson, and Hays County. The curriculum provides over 300 age-appropriate lessons across 10 content areas aligned with the National Health Education Standards (NHES). Lessons are designed for integration into core curriculum areas such as language arts, science and social studies, and have been aligned with the Texas TEKS. They provide skills-based instruction linked to assessments. Health educators in school districts in Travis County were trained by national HealthTeacher staff on how to integrate and implement the HealthTeacher curriculum in the classroom. SSC will continue to support the Generations Program. The Generations Program provides an intensive outpatient psychiatric program for seniors in Travis and surrounding counties. The seniors served have a mental health need, primarily anxiety or depression, and a comorbidity including congestive heart failure, diabetes, or COPD. The program provides group, individual, and family therapy, as well as family and community education. The Generations staff includes a nurse, master level therapist, and a program psychiatrist that comes in weekly. Transportation is provided to participants and home assessments are done to ensure the best referral is made. The Generations program also offers specialty groups to the community such as geriatric attention deficit disorder and trauma groups. Obesity The 2012 Travis County Community Health Needs Assessment identified obesity as one of the most pressing health issues. While obesity in Travis County is below the national average, childhood obesity was listed as a particular area of need as this condition is disproportionately evident among minority populations. With a 24% obesity rate in adults, Travis County falls below the state average of 29.6%. However, when that rate is broken down by ethnicity, the need to address obesity among minority populations becomes more obvious. 41.7% of the Black/African American adults in Travis County and 36.5% of Latino/Hispanic adults are considered obese compared to 19.4% for White residents. According to CHNA data and focus group respondents, this disparity may be attributed to the unequal distribution and affordability of fresh fruit and vegetable outlets throughout the County as well as an unequal distribution of obesity-related programs. SSC partners with the Texas Center for the Prevention and Treatment of Childhood Obesity (TCPTCO) to provide behavioral health resources to children suffering from obesity. With many social and individual pressures associated with childhood obesity, behavioral health services help children maintain a healthy perspective and deal with many of the mental challenges obesity brings. SSC will continue to support these services for TCPTCO and look for addition ways to engage in obesity treatment.
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Schedule H, Part V, Section B, Line 11 Facility , 2
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Facility , 2 - SETON SHOAL CREEK HOSPITAL - PART 2. Seton currently serves in a leadership role with the Mayor's Health and Fitness Council (MHFC). MHFC is a local non-profit organization in Travis County whose vision is to support and inspire people to improve their health by encouraging physical activity, improved nutrition and tobacco-free living. A Seton hospital Chief Operating Officer currently serves on the board as the Vice Chair for the Council and Seton will continue to participate in this collaborative effort to make Austin the healthiest city in America. Access to Care Access to health care was a predominant theme among residents, specifically the availability and accessibility of health care facilities and resources. Also mentioned were the difficulty of navigating the health care system, the high cost of care, and the inability to gain and retain health insurance. Community forum participants recognized a presence of facilities and programming but the majority noted that health care resources are greatly lacking, especially for low-income and aging populations. The Seton Health Centers were established to provide accessible, comprehensive health services to medically underserved families in Austin. Primary care physicians, nurse practitioners and physician assistants provide quality primary care to community residents on a sliding scale based on family size and income. Medicare, Medicaid and CHIP are also accepted. Each of the three clinics offers primary care, laboratory, case management, and health education services. Comprehensive social services are part of the Centers' medical mission as well. SSC has and will continue to refer unfunded patients without a medical home to the Seton Community Health Centers for primary care. The Travis County Medical Society, the Seton Healthcare Family and other members of the Integrated Care Collaboration have initiated a coordinated system of volunteer doctors called Project Access. They work with other local providers to provide medical, hospital, diagnostic and pharmacy assistance for the uninsured in Travis County. The mission of Project Access is to provide ready access to appropriate health care services for uninsured people in Travis County whose incomes are at or below 200% of the Federal poverty level and to improve the overall health of our community. Seton helped secure a grant to create the program. More than 1,000 volunteer physicians participate in Project Access and Seton will continue to support the work of this collaboration to improve access to care. To help underserved residents navigate the complicated and fragmented health care system, SSC will continue to provide access to the Nurse Triage Call Center. Funded by the Seton Healthcare Network, the Seton's Nurse Triage Call Center makes registered nurses available 24/7 free of charge to folks calling one of Seton's Emergency Departments. Nurses assist callers with urgent care needs and schedule doctors' appointments to avoid unnecessary emergency room visits. Call Center nurses are able to schedule same-day and next-day appointments for callers at participating clinics. The CHNA identified health disparities and inequities in the ability of different ethnic groups to access care. The reasons are complex. Research shows providing professional medical interpretation at initial assessment and discharge reduces readmissions within 30 days, reduces patient bed days, improves medication adherence and leads to better health outcomes. In addition, research also shows providing cultural competence training to our clinical care teams improves communication between patients and their clinical care team including their doctors and nurses as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems ("HCAHPS") Survey, the first national, standardized, publicly reported survey of patients' perspectives of hospital care. Currently Seton provides telephone interpretation services in over 140 languages, 24 hours, 7 days a week, 365 days a year. In addition, Seton provides in person sign language contracted services at all of our facilities. As part of an integrated approach to administer care in a person centered, culturally competent manner, the Seton Healthcare Family will develop a Language Services Resource Center and a Culturally Competent Care Curriculum at four Seton hospitals and will implement the learnings and best practices at SSC. The Language Services Resource Center is a new project which will provide professional medical interpretation at initial assessment and discharge by centralizing interpretation & translation services, and increasing the number of professional medical interpreters for patients with Limited English Proficiency including but not limited to Spanish and sign language. The Culturally Competent Care Curriculum is expected to increase the quality of communication between the clinical care team and the patient in order to achieve greater patient involvement in shared decision making. The Diversity Department through the Culturally Competent Care Curriculum will provide training and education to the clinical care team to increase the likelihood of safe and effective person centered care in a culturally competent manner and leads to better health outcomes. SSC will continue to increase access to services by supporting the Seton League House, a 38-room bed-and-bath facility designed to provide families and caregivers with a place to stay while their loved ones are hospitalized in an Austin-area hospital. The subsidized rooms reduce the barrier of travel costs associated with treatment. SSC will continue to expand IOP and partial hospitalization services to other counties and to unique segments of the population with specific behavioral health disorders. IOP is already located in Travis, Williamson and Hays counties. Chronic Disease The 2012 Travis County Community Health Needs Assessment identified chronic disease and disease management as the second highest health issue facing residents of Travis County. For the past six years the top three causes of death in Travis County have been related to chronic disease. Many focus group participants and interviewees cited chronic disease - specifically diabetes, heart disease, and cancer - among the greatest areas of concern. Seton Healthcare Family has many different programs aimed at addressing chronic disease management, education, and navigation. SSC has, and will continue, to connect with these programs in an effort to help provide behavioral health services to those suffering from chronic diseases. These programs include Seton Total Health Partners, Seton Total Health Transitions, Cancer Care Team and Navigation, and Diabetes Management. Through this collaborative approach, SSC plans to have staff embedded in these programs allowing these programs to fully meet the needs of the community's most vulnerable residents and will continue to explore the ways to connect to other programs around the community by integrated behavioral health with medical care. Community Collaboration Despite many non-profit and social service organizations within Travis County, many focus group participants felt that efforts could be more integrated and coordinated to reduce the duplication of services and the fragmentation that has resulted. While organizations appear to be engaged in collaborative efforts, the lack of cohesiveness and focused vision leads residents to feel that there is more dialogue than there is action. More coordinated approaches would help maximize limited resources. In 1997, Seton led the formation of the Integrated Care Collaboration (ICC), an alliance of community providers for the un/underinsured, including health care organizations, government entities and volunteer clinics. Known as the ICC, the group's goal is to work together to increase access, improve quality and find creative financing solutions for the provision of health care for the region's uninsured. The ICC has developed an area wide health information exchange (HIE) for the un- and underinsured that is used to inform providers on the care a specific individual has received while also providing community wide analytics on healthcare usage and diagnostic trends. Since its inception the ICC has broken into multiple collaborations, focusing on specific geographic areas. The Seton Healthcare Family continues to fund the ICC infrastructure and plays a leadership role in the collaborations organized and supported by ICC in six counties (Bastrop, Caldwell, Williamson, Hays, Burnet and Travis.
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Schedule H, Part V, Section B, Line 11 Facility , 3
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Facility , 3 - SETON SHOAL CREEK HOSPITAL - PART 3. In 2012, Seton and the Travis County Healthcare District began development of a non-profit Community Care Collaborative (CCC) with the purpose of advancing the care coordination and access to the most vulnerable populations in Travis County through high-quality, cost effective, person centered care. The essential elements of the CCC are: patient centered medical homes, developing a health information exchange for its patients, case management of a selected high risk population, pharmacy management, integrated outpatient/inpatient protocols, and transitional care. The CCC will be outcome driven and rely heavily on analytics to drive process improvement and best practice clinical care through system innovation and care coordination. Seton Healthcare Family is a partner of the Community Action Network (CAN) and will continue to support this local collaboration. CAN is a partnership of government, non-profit, private, and faith-based organizations who work together to enhance the social, health, educational, and economic well-being of Central Texas. As a partner of CAN, Seton has representatives on the Board of Directors and is committed to working with other CAN Partners to attain the mission of CAN. Financial Assistance Seton is committed to delivering effective, safe, person-centric, health care to all patients regardless of their ability to pay. As a nonprofit health system, it is our mission and privilege to play this important role in our community. The CHNA revealed that the County had a high uninsured rate, and a lack of insurance can be one of many factors that prevent individuals from accessing care. SSC screens all uninsured patients and if found potentially eligible for a government funding source provides application assistance to the patient and their family. If a patient is not eligible for a payment source, Seton's financial assistance policy covers SSC patients who lack the financial resources to pay for all or part of their bills. Eligibility for financial assistance is based upon the annual federal poverty guidelines; Seton provides financial assistance for those who earn up to 375% of the federal poverty level.
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Schedule H, Part V, Section B, Line 16 Facility , 1
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Facility , 1 - Seton Shoal Creek Hospital. A summary of the charity care policy (in both English and Spanish) and financial assistance contact information are posted in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. - Brochures (English and Spanish) explaining the availability, criteria and process for applying for financial assistance are available in patient registration areas and in the patient financial services reception area. - Seton associates inform patients of the availability of financial assistance and other potential federal, state, and/or local governmental funding programs (i.e.: Medicaid, CHIP, SSI, Crime Victims, COBRA, County Indigent, Veterans' Benefits, Third Party Liability, etc.) as part of the intake process prior to, during, and/or after service as clinically appropriate for the care setting. - Uninsured and underinsured patients are assisted and supported as needed through the entire eligibility and application process (completion of the application, collection and copying of supporting documentation, transportation to appointments, etc.) through the collaborative efforts of patient access (admitting/registration), Seton's insure-a-kid employees, case management, on-site HHSC caseworkers, and Seton's contracted eligibility vendor.
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Schedule H, Part V, Section B, Line 22 Facility , 1
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Facility , 1 - Seton Shoal Creek Hospital. Patients with income levels up to 250% of the FPIL will be asked to pay a co-payment for services received. Patients with income levels above 250% and below 375% of the FPIL will be asked to pay a sliding fee scale deductible.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.