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FORM 990 SCHEDULE H PART V, SECTION C:
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SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY BENEFITS MISSION STATEMENT NEW ENGLAND BAPTIST HOSPITAL IS COMMITTED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS ACROSS BOSTON TO IDENTIFY AREAS OF SPECIAL NEED IN MUSCULOSKELETAL DISEASE AND COLLABORATE ON PROGRAMS TO ADDRESS THESE NEEDS, WITH SPECIAL FOCUS ON UNDERSERVED POPULATIONS THROUGH OUTREACH, EDUCATION AND PROVISION OF SERVICES TO ADDRESS MUSCULOSKELETAL HEALTH.AS NOTED THROUGHOUT THIS NARRATIVE, NEW ENGLAND BAPTIST HOSPITAL'S (NEBH OR HOSPITAL) PRIMARY PURPOSE IS THE OPERATION AND MAINTENANCE OF AN ACUTE CARE, ORTHOPEDIC SPECIALTY HOSPITAL AND PROVISION OF ALL SERVICES RELATED THERETO FOR THE BENEFIT OF PATIENTS. THE HOSPITAL OPERATES AS AN ADULT MEDICAL / SURGICAL HOSPITAL WITH A NATIONAL REPUTATION IN ORTHOPEDIC CARE. PATIENTS ARE OFFERED A FULL RANGE OF SERVICES IN ORTHOPEDICS AND RHEUMATOLOGY, JOINT REPLACEMENT, SPINE CARE, FOOT AND ANKLE CARE, HAND SURGERY, OCCUPATIONAL MEDICINE AND SPORTS MEDICINE. COMMUNITY BENEFITS PHILOSOPHY NEBH IS COMMITTED TO ITS COMMUNITY. THE HOSPITAL'S PHILOSOPHY IS TO PARTNER DIRECTLY WITH LOCAL ORGANIZATIONS TO PROVIDE DIRECT SERVICES IN OUR PRIORITY AREAS, TO STREAMLINE AND REDUCE DUPLICATION AND TO BUILD POSITIVE RELATIONSHIPS IN THE SURROUNDING NEIGHBORHOODS. DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $639,164 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I, COLUMN C.COMMUNITY BENEFITS LEADERSHIP AND PROCESSCOMMUNITY BENEFITS LEADERSHIP THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT ARE RESPONSIBLE FOR OVERSEEING THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY BENEFITS PLAN BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH IMPLEMENTATION STRATEGY/PLAN (CHIP). COMMUNITY PLANNING IS DONE IN CONJUNCTION WITH MEMBERS OF THE DESIGNATED HOSPITAL COMMUNITY, WHO MAY PROVIDE INSIGHT AND RECOMMENDATIONS ON COMMUNITY HEALTH ISSUES. THE BOARD IS RESPONSIBLE FOR DEVELOPING POLICY TO IMPLEMENT AND EVALUATING THE HOSPITAL'S CURRENT AND FUTURE COMMUNITY PROGRAMS. THE DIRECTOR OF PUBLIC AFFAIRS AND COMMUNITY RELATIONS REPORTS TO SENIOR MANAGEMENT AND TO THE PRESIDENT OF THE HOSPITAL ON COMMUNITY BENEFIT ACTIVITIES AND PLANS. DIRECTOR OF PUBLIC AFFAIRS AND COMMUNITY RELATIONS, RESPONSIBILITIES INCLUDE:-PLANNING, ORGANIZING AND EVALUATING THE COMMUNITY BENEFITS PROGRAMMING IN COLLABORATION WITH HOSPITAL ADMINISTRATION, NEBH STAFF AND THE KEY STAKEHOLDERS WITHIN THE COMMUNITY.COORDINATING THE HOSPITAL'S CURRENT COMMUNITY BENEFIT PROGRAM WITH NUMEROUS DEPARTMENTS THROUGHOUT THE HOSPITAL. NEBH STAFF ADVISORSCOMMUNITY RELATIONS STAFF WORKS COLLABORATIVELY WITH MULTIPLE DEPARTMENTS TO DEVELOP AND IMPLEMENT COMMUNITY BENEFIT ACTIVITIES. THESE ADVISORS PROVIDE INPUT ON THE DIRECTION OF THE HOSPITAL'S COMMUNITY BENEFIT EFFORTS. THESE ADVISORS ADD SIGNIFICANT VALUE IN THESE AREAS:-AS HEALTH CARE PROVIDERS WHO CAN OFFER THEIR EXPERTISE AS THE HOSPITAL COLLABORATES WITH THE COMMUNITY TO DEVELOP NEW HEALTH EDUCATION PROGRAMS ADDRESSING THE KEY ASPECTS OF THE HOSPITAL MISSION.-AS RESIDENTS WITHIN THE HOSPITAL'S IMMEDIATE NEIGHBORHOODS THEY HELP THE COMMITTEE ASSESS THE NEEDS OF THIS COMMUNITY.-THEY ARE INVOLVED AS PROVIDERS IN THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM, AND CAN HELP DETERMINE THEIR EFFECTIVENESS-THEY HAVE SPECIAL EXPERTISE ESSENTIAL TO THE COMMUNITY BENEFIT PLANNING PROCESS; E.G., STAFF FROM ORGANIZATIONAL/QUALITY IMPROVEMENT DEPARTMENT HAS COMMUNITY EDUCATION EXPERTISE.-THEY ARE DIRECTLY RESPONSIBLE OR INVOLVED IN MANAGING THE CLINICAL AREAS IDENTIFIED IN THE COMMUNITY BENEFIT MISSION STATEMENT, SPECIFICALLY TO ADDRESS MUSCULOSKELETAL DISEASE AND CAN GUIDE THE HOSPITAL AS IT WORKS WITH THE COMMUNITY TO DEVELOP PROGRAMS.-THE PATIENT AND FAMILY ADVISORY COUNCIL PROVIDES INPUT INTO THE COMMUNITY BENEFITS PROGRAM, THROUGH COMMITTEE COLLABORATION, ASSISTANCE WITH IMPLEMENTATION, ANALYSIS AND FEASIBILITY ASSESSMENT.THE HOSPITAL'S COMMUNITY BENEFITS COMMITTEE CONSISTS OF EMPLOYEES, COMMUNITY RESIDENTS, REPRESENTATIVES FROM COMMUNITY AGENCIES AND MEMBERS OF THE HOSPITAL'S PRESIDENT'S COUNCIL. THE COMMITTEE REVIEWS THE COMMUNITY SERVICE AND COMMUNITY BENEFITS PROGRAM PROVIDED BY THE HOSPITAL. THE HOSPITAL FOCUSES ON THE FOLLOWING AREAS: MUSCULOSKELETAL HEALTH, OBESITY PREVENTION, FOOD INSECURITY/HUNGER, MOBILITY AND TRANSPORTATION FOR THE ELDERLY, ACCESS TO HEALTHY AFFORDABLE FOOD, ELDER ISOLATION, VIOLENCE PREVENTION AND WORKFORCE DEVELOPMENT. COMMUNITY BENEFITS COMMITTEE MEMBERS AND ADVISORS-DAVID PASSAFARO, SENIOR VICE PRESIDENT, EXTERNAL AFFAIRS -CHRISTINE DWYER, DIRECTOR, PUBLIC AFFAIRS AND COMMUNITY RELATIONS -BETH DONATO, MSPT, DIRECTOR OF INPATIENT REHABILITATIVE SERVICES-CARMEN POLA, FOUNDING MEMBER OF THE MISSION HILL SENIOR LEGACY PROJECT-JARLIN RIZIK, MANAGER, CENTRAL TRANSPORTATION-LYNN STEWART, MANAGER, AMENITIES AND STUDENT SERVICES-ELAINE ADAMS, RN, REGISTERED NURSE AND COMMUNITY MEMBER-JANET MCCARTHY, RN, REGISTERED NURSE AND COMMUNITY MEMBER-ASHLEY DUBOIS, HRIS MANAGER & COMPENSATION, HUMAN RESOURCES -EILEEN O'DONNELL, RN, CLINICAL LEADER, EMPLOYEE HEALTH -LAURA ADAMS, SENIOR PROGRAM COORDINATOR, ROXBURY TENANTS OF HARVARD, AND COMMUNITY MEMBER-JOHN JACKSON, ADMINISTRATIVE COORDINATOR, TOBIN COMMUNITY CENTER, BOSTON CENTERS FOR YOUTH & FAMILIES (BCYF)-MICHAEL HOWE, EXECUTIVE ASSISTANT-KATHLEEN HAYES, RN, REGISTERED NURSE-LEON BRASFIELD, CAST TECHNICIAN, REHAB SERVICES-PAIGE LEGASSIE, BUSINESS PARTNER, HUMAN RESOURCES
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COMMUNITY HEALTH NEEDS ASSESSMENT
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COMMUNITY HEALTH NEEDS ASSESSMENT - INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA), REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. NEBH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016. THAT CHNA WAS APPROVED BY THE BOARD OF TRUSTEES IN SEPTEMBER 2016. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD OF TRUSTEES IN SEPTEMBER 2016 WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER IRC SECTION 501(R). THIS MOST RECENT CHNA AND IMPLEMENTATION STRATEGY (CHIP) INFORMED NEBH'S COMMUNITY BENEFITS PROCESS FOR THE PERIOD COVERED BY THIS FILING. THE PREVIOUS NEEDS ASSESSMENT AND ACCOMPANYING IMPLEMENTATION PLAN WERE APPROVED BY THE NEBH BOARD OF TRUSTEES IN SEPTEMBER 2013 AND INFORMED NEBH'S COMMUNITY BENEFIT PROCESS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2014, SEPTEMBER 30, 2015 AND SEPTEMBER 30, 2016. DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015), NEBH CONDUCTED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT FOCUSING ON THE MISSION HILL AND ROXBURY NEIGHBORHOODS IN BOSTON WHICH, AS PREVIOUSLY NOTED, ARE THE HOSPITAL'S PRIMARY COMMUNITY BENEFITS SERVICE AREAS. THE OVERALL GOAL OF THE ASSESSMENT WAS TO COMPILE INFORMATION FROM A RANGE OF QUANTITATIVE AND QUALITATIVE SOURCES TO CLARIFY THE HEALTH CARE NEEDS AND PRIORITIES OF COMMUNITY RESIDENTS AND ASSESS THE OVERALL STRENGTHS AND WEAKNESSES OF THE HEALTH AND SOCIAL SERVICE SYSTEMS. THE PROJECT WAS ALSO DESIGNED TO FULFILL BOTH THE COMMONWEALTH OF MASSACHUSETTS ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT THE HOSPITAL ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW THE HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WOULD ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT. THE CHNA CONDUCTED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016, FOCUSED ON THE BOSTON NEIGHBORHOODS OF MISSION HILL AND ROXBURY, WHICH AS NOTED ABOVE, ARE NEBH'S PRIMARY SERVICE AREA WITH RESPECT TO ITS COMMUNITY BENEFIT INITIATIVES. AS REQUIRED UNDER THE LAW, THE OVERALL GOAL OF THE ASSESSMENT WAS TO COMPILE INFORMATION FROM A RANGE OF QUANTITATIVE AND QUALITATIVE SOURCES TO CLARIFY THE HEALTH CARE NEEDS AND PRIORITIES OF COMMUNITY RESIDENTS AND ASSESS THE OVERALL STRENGTHS AND WEAKNESSES OF THE AREA'S HEALTH AND SOCIAL SERVICE SYSTEMS WITH THE GOAL TO FACILITATE THE DEVELOPMENT OF A STRATEGIC PLAN/IMPLEMENTATION STRATEGY DESIGNED TO GUIDE HOW NEBH WOULD WORK WITH STAKEHOLDERS IN MISSION HILL AND ROXBURY TO STRENGTHEN THE COMMUNITY AND IMPROVE HEALTH STATUS DURING THE FISCAL YEAR COVERED BY THIS FILING. THE IDENTIFIED NEEDS IN THE CHNA WHICH WILL INFORM NEBH'S COMMUNITY BENEFIT OPERATIONS FOR THE NEXT THREE FISCAL YEARS AS NOTED ABOVE ARE: MUSCULOSKELETAL HEALTH, OBESITY PREVENTION, VIOLENCE PREVENTION, WORKFORCE DEVELOPMENT, ELDER ISOLATION, ACCESS TO HEALTHY AFFORDABLE FOOD, FOOD INSECURITY/HUNGER AND MOBILITY AND TRANSPORTATION FOR THE ELDERLY AS WELL AS IMPROVING THE HEALTH, FUNCTION, AND QUALITY OF LIFE OF OLDER ADULTS. PLANS FOR NEXT REPORTING YEARDURING THE FISCAL YEAR OCTOBER 1, 2018 - SEPTEMBER 30, 2019 (FY19) AS REQUIRED UNDER IRC SECTION 501(R)(3), NEBH WILL CONDUCT ITS NEXT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)., NEBH WILL BE COLLABORATING WITH BOSTON HOSPITALS ON A JOINT CITY-WIDE CHNA AND WILL ALSO CONDUCT ITS OWN CHNA. IN ACCORDANCE WITH THE TREASURY REGULATIONS NEBH WILL ENGAGE IN A PROCESS TO DETERMINE THE CURRENT COMMUNITY HEALTH NEEDS IN THE COMMUNITIES SERVED BY NEBH AND ALL COMMUNITIES WHERE THE HOSPITAL HAS FACILITIES AND WILL THEN PRIORITIZE THE IDENTIFIED NEEDS. THE CHNA CONDUCTED IN FY19 WILL THEN INFORM NEBH'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIODS ENDING SEPTEMBER 30, 2020, SEPTEMBER 30, 2021 AND SEPTEMBER 30, 2022. NEW ENGLAND BAPTIST HOSPITAL IS COMMITTED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS ACROSS BOSTON TO IDENTIFY AREAS OF SPECIAL NEED IN MUSCULOSKELETAL DISEASE AND COLLABORATE ON PROGRAMS TO ADDRESS THESE NEEDS, WITH SPECIAL FOCUS ON UNDERSERVED POPULATIONS THROUGH OUTREACH, EDUCATION AND PROVISION OF SERVICES TO ADDRESS MUSCULOSKELETAL HEALTH.COMMUNITY HEALTH NEEDS ASSESSMENT - COMMUNITY INFORMATIONAS NOTED ABOVE, THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTS CONDUCTED BY NEBH FOCUSED ON THE MISSION HILL AND ROXBURY NEIGHBORHOODS IN BOSTON WHICH, AS PREVIOUSLY NOTED, ARE THE HOSPITAL'S PRIMARY COMMUNITY BENEFITS SERVICE AREAS.(SCHEDULE H PART VI QUESTION 4).
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COMMUNITY HEALTH NEEDS ASSESSMENT -- APPROACH AND METHODS
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NEBH IS COMMITTED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS FROM ACROSS BOSTON TO IDENTIFY AREAS OF SPECIAL NEED AND IMPROVE THE OVERALL HEALTH OF THE REGION. NEBH WORKS WITH ALL SEGMENTS OF THE POPULATION BUT IN RECOGNITION OF ITS STRONG TIES TO ITS SURROUNDING COMMUNITY AND ITS SPECIFIC CLINICAL EXPERTISE, NEBH FOCUSES ITS COMMUNITY BENEFIT EFFORTS ON IMPROVING THE HEALTH AND WELL-BEING OF THE LOW INCOME, UNDERSERVED POPULATIONS LIVING IN MISSION HILL AND ROXBURY AND ON MUSCULOSKELETAL HEALTH. NEBH CURRENTLY OPERATES NUMEROUS EDUCATIONAL, OUTREACH, AND COMMUNITY-STRENGTHENING INITIATIVES, COLLABORATES WITH MANY OF THE COMMUNITY'S LEADING SERVICE ORGANIZATIONS. DURING THE PERIOD COVERED BY THIS FILING, THE HOSPITAL COST TO SUPPORT ITS COMMUNITY BENEFIT COMMITMENTS AND THE MASSACHUSETTS UNCOMPENSATED CARE POOL EXCEEDED $4.5 MILLION. NEBH IS ALWAYS EAGER TO EXPLORE WAYS THAT IT CAN FURTHER ENGAGE AND ENRICH ITS CONNECTIONS TO THE COMMUNITY.THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED COMMUNITY HEALTH IMPROVEMENT PLAN WERE THE CULMINATION OF SEVERAL MONTHS OF WORK. THIS PROJECT WAS BORNE LARGELY OUT OF NEBH'S DESIRE TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS SURROUNDING COMMUNITY. THE PROCESS IS ALSO DESIGNED TO MEET THE REQUIREMENTS OF THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REQUIREMENTS UNDER INTERNAL REVENUE CODE SECTION 501(R), WHICH MANDATE THAT ALL NONPROFIT HOSPITALS CONDUCT A PERIODIC COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND STRATEGIC PLANNING PROCESS. THE COMMONWEALTH REQUIRES NONPROFIT HOSPITALS AND MANAGED CARE ORGANIZATIONS TO UPDATE THEIR CHNAS EVERY YEAR AND THE IRS REQUIRES THAT A CHNA BE CONDUCTED EVERY THREE YEARS. MORE SPECIFICALLY, THE COMMONWEALTH AND IRS REGULATIONS REQUIRE THAT NEBH ASSESS COMMUNITY HEALTH NEED, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW THE HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT.IN LIGHT OF THESE REQUIREMENTS, NEBH HIRED JOHN SNOW, INC. (JSI), A NATIONALLY RECOGNIZED PUBLIC HEALTH CONSULTING FIRM, TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT FOCUSING ON MISSION HILL AND ROXBURY, ITS PRIMARY SERVICE AREA WITH RESPECT TO ITS COMMUNITY BENEFIT INITIATIVES. THE OVERALL GOAL OF THE ASSESSMENT WAS TO COMPILE INFORMATION FROM A RANGE OF QUANTITATIVE AND QUALITATIVE SOURCES TO CLARIFY THE HEALTH CARE NEEDS AND PRIORITIES OF COMMUNITY RESIDENTS AND ASSESS THE OVERALL STRENGTHS AND WEAKNESSES OF THE AREA'S HEALTH AND SOCIAL SERVICE SYSTEMS. THE CHNA PROCESS WAS CONDUCTED IN THREE PHASES:-PHASE I: THE JSI PROJECT TEAM CONDUCTED A PRELIMINARY NEEDS ASSESSMENT THAT RELIED HEAVILY ON QUANTITATIVE HEALTH-RELATED DATA DRAWN FROM THE MASSACHUSETTS COMMUNITY HEALTH INFORMATION PROFILE MASSCHIP) SYSTEM AS WELL AS OTHER NATIONAL, STATE, AND LOCAL SOURCES. THESE DATA ALLOWED THE JSI PROJECT TEAM TO UNDERSTAND THE UNDERLYING CHARACTERISTICS OF AREA RESIDENTS AND IDENTIFY THE SPECIFIC SEGMENTS OF THE COMMUNITY MOST AT-RISK.-PHASE II: JSI CONDUCTED A SERIES OF INTERVIEWS WITH KEY STAKEHOLDERS AND TWO FOCUS GROUPS WITH COMMUNITY MEMBERS. THE FOCUS GROUPS HELPED THE JSI PROJECT TEAM TO ENGAGE THE COMMUNITY AND BETTER UNDERSTAND THEIR HEALTH STATUS, HEALTH-SEEKING BEHAVIORS, SERVICE GAPS, HEALTH-RELATED CHALLENGES, AND PRIORITIES. -PHASE III: CHRISTINE DWYER, DIRECTOR OF PUBLIC AFFAIRS AND COMMUNITY RELATIONS, WORKED WITH JSI TO INTEGRATE THE CHNA'S FINDINGS, INCLUDING FEEDBACK FROM NEBH STAFF AND THE COMMUNITY, AND DEVELOPED NEBH'S COMMUNITY HEALTH IMPROVEMENT PLAN. IN PHASE III, JSI ALSO DEVELOPED A FINAL CHNA REPORT, OBTAINED APPROVAL FOR ITS COMMUNITY HEALTH IMPROVEMENT PLAN FROM NEBH'S BOARD OF TRUSTEES, AND DISSEMINATED THE RESULTS OF THE PROJECT TO INTERNAL AND EXTERNAL STAKEHOLDERS.THE CHNA UTILIZED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. AS NOTED ABOVE, THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS IN THE REGION AS WELL AS INFORMATION FROM COMMUNITY DIALOGUES CONDUCTED WITH COMMUNITY RESIDENTS, AND INTERVIEWS WITH COMMUNITY STAKEHOLDERS. (SCHEDULE H, PART V, SECTION B, QUESTION 5). NEBH CONDUCTED THIS CHNA PROCESS INDEPENDENTLY AS REPORTED IN (SCHEDULE H, PART V, SECTION B, QUESTIONS 6A AND 6B).
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LEADING HEALTH-RELATED FINDINGS
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-SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A TREMENDOUS IMPACT ON MANY SEGMENTS OF THE POPULATION. THE DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE CONTINUED IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THE CBSA'S LOW INCOME, UNDERSERVED, DIVERSE POPULATION COHORTS. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT, AND COMMUNITY COHESION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. -LOW INCOME. 35% OF ROXBURY RESIDENTS AND 41% OF MISSIONHILL RESIDENTS LIVED BELOW THE FEDERAL POVERTY LINE COMPARED TO 22% FOR BOSTON AND 12% FOR THE COMMONWEALTH OVERALL. 58% OF ROXBURY'S POPULATION AND 62% OF MISSION HILL'S POPULATION LIVE IN HOUSEHOLDS EARNING LESS THAN 200% OF THE FEDERAL POVERTY LEVEL COMPARED TO 38% FOR BOSTON AND 25% FOR THE COMMONWEALTH OVERALL. -ECONOMIC CHALLENGES. 79% OF ROXBURY'S HOUSING UNITS AND 91% OF MISSION HILL'S HOUSING UNITS WERE RENTER-OCCUPIED COMPARED TO 66% FOR BOSTON AND 38% FOR THE COMMONWEALTH. 46% OF ROXBURY RESIDENTS AND 50% OF MISSION HILL RESIDENTS LIVING IN RENTAL UNITS WERE CONSIDERED TO BE "HOUSE POOR" AS 35% OR MORE OF THEIR INCOME WAS SPENT ON HOUSING COMPARED TO 41% FOR BOSTON AND THE COMMONWEALTH.-EDUCATIONAL ATTAINMENT. 77% OF ROXBURY'S POPULATION AND 85% OF MISSION HILL'S POPULATION HAD A HIGH SCHOOL DEGREE OR HIGHER COMPARED TO 85% FOR BOSTON AND 90% FOR THE COMMONWEALTH. ONLY 23% OF ROXBURY'S POPULATION AND 36% OF MISSION HILL'S POPULATION HAD A BACHELOR'S DEGREE OR HIGHER COMPARED TO 45% FOR BOSTON AND 40% FOR THE COMMONWEALTH.-VIOLENCE. KEY INFORMANTS AND COMMUNITY FORUM ATTENDEES NAMED VIOLENCE AS A LEADING HEALTH AND SAFETY CONCERN. NEIGHBORHOOD VIOLENCE CAN SEVERELY LIMIT AN INDIVIDUAL'S ABILITY AND MOTIVATION TO EXERCISE AND PARTICIPATE IN OUTDOOR EVENTS AND ACTIVITIES. FURTHERMORE, STUDIES HAVE SHOWN THAT NEIGHBORHOODS IN WHICH RESIDENTS SHARE FEELINGS OF MUTUAL TRUST AND CONNECTEDNESS ARE MORE LIKELY TO WORK TOGETHER TO ACHIEVE COMMON GOALS, LIKE CLEANER AND SAFER PUBLIC SPACES, AND MAINTAIN SOCIAL CONTROLS THAT DISCOURAGE UNDESIRABLE BEHAVIORS, LIKE UNDERAGE SUBSTANCE USE AND GANG ACTIVITY. AMONG RESIDENTS OF ROXBURY, THE HOMICIDE RATE PER 100,000 POPULATION WAS 16.1 COMPARED TO 6.6 FOR BOSTON OVERALL.4 THE RATE OF NONFATAL GUNSHOT/STABBING EMERGENCY DEPARTMENT VISITS WAS 153.6 PER 100,000 POPULATION IN ROXBURY, COMPARED TO 76.9 FOR BOSTON OVERALL.-TRANSPORTATION. COMMUNITY FORUM ATTENDEES IDENTIFIED A NEED FOR A BROAD INTERVENTION TO ADDRESS TRANSPORTATION EQUITY ISSUES ON MISSION HILL. ACCESS TO AFFORDABLE AND RELIABLE FORMS OF TRANSPORTATION WAS A KEY AREA OF CONCERN FOR OLDER ADULTS, WHO RELY ON VARIOUS FORMS OF PUBLIC TRANSPORT TO ATTEND DOCTOR'S APPOINTMENTS, VISIT THE PHARMACY, AND ACCESS OTHER HEALTH AND SOCIAL SERVICES.-OLDER ADULTS. 12% OF ROXBURY'S POPULATION AND 7% OF MISSION HILL'S POPULATION IS OVER 65 YEARS OF AGE COMPARED TO 10% FOR BOSTON AND 14% FOR THE COMMONWEALTH.6 MANY FORUM ATTENDEES IDENTIFIED OLDER ADULTS AS A POPULATION THAT HAS UNIQUE NEEDS AND DISPARATE HEALTH OUTCOMES, YET ARE RELUCTANT TO VOICE CONCERNS OVER FEAR OF DISPLACEMENT FROM THEIR HOMES AND COMMUNITIES.-DISPARITIES IN HEALTH OUTCOMES EXIST IN NEBH CBSA BY RACE/ETHNICITY, FOREIGN BORN STATUS, AND LANGUAGE: AS WAS ESTABLISHED IN THE 2013 NEBH COMMUNITY BENEFITS CHNA REPORT, THERE ARE MAJOR HEALTH DISPARITIES FOR RESIDENTS LIVING IN NEBH'S CBSA. THIS IS PARTICULARLY TRUE FOR RACIALLY/ETHNICALLY DIVERSE, FOREIGN BORN, AND NON-ENGLISH SPEAKING RESIDENTS LIVING IN ROXBURY, AT THE HEART OF NEBH'S CBSA, WHICH FACE MANY OF THE MOST SIGNIFICANT DISPARITIES IN THE CITY OF BOSTON AND MASSACHUSETTS OVERALL. THE IMPACT OF RACISM, BARRIERS TO CARE, AND DISPARITIES IN HEALTH OUTCOMES THAT THOSE LIVING IN NEBH'S CBSA FACE ARE WIDELY DOCUMENTED IN THE LITERATURE AND ARE CONFIRMED BY NUMEROUS NATIONAL, COMMONWEALTH, AND LOCAL DATA SOURCES, INCLUDING QUANTITATIVE DATA FROM THE BOSTON PUBLIC HEALTH COMMISSION 2014-15 HEALTH OF BOSTON REPORT.7 IT SHOULD ALSO BE NOTED THAT ONE OF THE DOMINANT THEMES FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS LISTED ABOVE HAVE ON THE SERVICE AREA, PARTICULARLY ON LOW INCOME, RACIALLY/ETHNICALLY DIVERSE, AND OLDER ADULT COHORTS.-RACE/ETHNICITY. 9% OF ROXBURY'S POPULATION AND 45% OF MISSION HILL'S POPULATION IS NON- HISPANIC WHITE COMPARED TO 75% FOR BOSTON AND THE COMMONWEALTH. NON-HISPANIC BLACKS, NON-HISPANIC ASIANS, AND HISPANICS REPRESENT A SIGNIFICANTLY LARGER PERCENTAGE OF ROXBURY'S POPULATION (55%, 2%, 29%) AND MISSION HILL'S POPULATION (21%, 12%, 20%)COMPARED TO BOSTON (13%, 6%, 5%) AND THE COMMONWEALTH (6%, 6%, 10%).-FOREIGN BORN. 27% OF ROXBURY'S POPULATION AND 23% OF MISSION HILL'S POPULATION IS FOREIGN BORN COMPARED TO 15% FOR THE COMMONWEALTH.-LINGUISTICALLY ISOLATED. 43% OF ROXBURY'S POPULATION AND 39% OF MISSION HILL'S POPULATION IS LINGUISTICALLY ISOLATED COMPARED TO 37% FOR BOSTON AND 22% FOR THE COMMONWEALTH. 27% OF ROXBURY'S POPULATION AND 18% OF MISSION HILL'S POPULATION SPEAK SPANISH AT HOME COMPARED TO 16% FOR BOSTON AND 8% FOR THE COMMONWEALTH.IT IS CRUCIAL THAT THESE DISPARITIES BE ADDRESSED AND, TO THIS END, NEBH'S COMMUNITY HEALTH IMPROVEMENT PLAN CONTINUES TO INCLUDE A RANGE OF PROGRAMS THAT ARE TARGETED TO ADDRESS THESE DISPARITIES. HOWEVER, IT IS CRITICAL TO NOTE THAT THERE IS A MULTITUDE OF INDIVIDUAL, COMMUNITY AND SOCIETAL FACTORS THAT WORK TOGETHER TO CREATE THESE INEQUITIES. THE UNDERLYING ISSUE IS NOT ONLY RACE/ETHNICITY, FOREIGN BORN STATUS, OR LANGUAGE BUT RATHER A BROAD ARRAY OF INTER-RELATED ISSUES INCLUDING ECONOMIC OPPORTUNITY, EDUCATION, CRIME, AND COMMUNITY COHESION. ARGUABLY, THESE ARE THE LEADING DETERMINANTS OF HEALTH FOR ALL URBAN COMMUNITIES IN THE UNITED STATES, AND THEY ARE DAUNTING CHALLENGES. NEBH IS COMMITTED TO DOING WHAT IT CAN TO ADDRESS THESE FACTORS AND MANY OF THE COMPONENTS OF NEBH'S CHIP IS STRUCTURED TO ADDRESS THE EXISTING HEALTH DISPARITIES AND INEQUITIES IN SOME WAY.-LIMITED ACCESS TO PRIMARY CARE MEDICAL AND SPECIALTY CARE, ORAL HEALTH, AND BEHAVIORAL HEALTH SERVICES FOR LOW INCOME, MEDICAID INSURED, UNINSURED, AND OTHER POPULATION SEGMENTS FACING BARRIERS TO CARE. MASSACHUSETTS HAS ONE OF THE HIGHEST RATES OF HEALTH INSURANCE AND ONE OF THE STRONGEST, MOST ROBUST HEALTH SERVICE SYSTEMS IN THE NATION, YET THERE ARE STILL SUBSTANTIAL POCKETS OF LOW INCOME, MEDICAID INSURED, UNINSURED, AND UNDERINSURED RESIDENTS WHO HAVE LIMITED ACCESS TO NEEDED SERVICES AND/OR ARE NOT PROPERLY ENGAGED IN ESSENTIAL MEDICAL, ORAL, AND BEHAVIORAL HEALTH SERVICES. AS WILL BE DISCUSSED BELOW, THESE POPULATIONS ARE, IN TURN, MORE LIKELY TO USE THE EMERGENCY ROOM AND MORE LIKELY TO HAVE HEALTH RISK FACTORS SUCH AS OBESITY, POOR FITNESS, AND RISKY ALCOHOL USE AS WELL AS MORE LIKELY TO HAVE DIABETES, HYPERTENSION, AND ASTHMA.-LOW INCOME SEGMENTS MOST AT-RISK. KEY INFORMANTS AND COMMUNITY FORUM PARTICIPANTS STRESSED THE FACT THAT DESPITE THE RELATIVE AFFLUENCE OF THE AREA, THERE WERE POCKETS OF SERVICE AREA RESIDENTS WHO STRUGGLED WITH POOR HEALTH OUTCOMES AND FACED SIGNIFICANT BARRIERS TO ACCESS.12 THESE POPULATIONS WERE MORE LIKELY TO BE LOW INCOME, OLDER ADULT, AND FOREIGN BORN.-HIGH UNINSURANCE RATES IN LOW INCOME. AMONG LOW-INCOME RESIDENTS OF THE COMMONWEALTH, THE UNINSURANCE RATE WAS 8% - DOUBLE THE UNINSURANCE RATE OF THE COMMONWEALTH'S TOTAL POPULATION (4%).13 ACCORDING TO THE BLUE CROSS FOUNDATION, UNINSURED ADULTS IN THE COMMONWEALTH WERE MORE LIKELY TO BE YOUNG, MALE, AND SINGLE, WITH LOWER REPORTED EDUCATIONAL ATTAINMENT. HOWEVER, THE MAJORITY OF UNINSURED ADULTS WERE EMPLOYED.-LACK OF ACCESS TO PRIMARY MEDICAL AND ORAL HEALTH CARE SERVICES. UNINSURED ADULTS ARE LESS LIKELY TO USE HEALTH CARE SERVICES THAN THOSE THAT ARE INSURED. APPROXIMATELY 87% OF INSURED ADULTS IN THE COMMONWEALTH REPORTED VISITING A GENERAL PHYSICIAN WITHIN THE PAST 12 MONTHS, COMPARED TO 63% OF UNINSURED ADULTS. UNINSURED ADULTS ARE MORE LIKELY TO REPORT PROBLEMS OBTAINING CARE COMPARED TO THOSE THAT WERE INSURED (37% VERSUS 21%, RESPECTIVELY. MOST CONCERNING IS THAT AMONG ALL ADULTS WHO REPORTED A HEALTH CARE VISIT, UNINSURED ADULTS WERE NEARLY 30 PERCENTAGE POINTS LESS LIKELY TO RATE THE QUALITY OF CARE AS VERY GOOD OR EXCELLENT.15 FINALLY, 3 IN 10 (30.1%) OF THOSE LIVING AT 138% OF THE FEDERAL POVERTY LEVEL OR BELOW REPORTED NOT GETTING NEEDED DENTAL CARE DUE TO COST AND 1 IN 5 (19.3%) WERE NOT ABLE TO FILL A NEEDED DRUG PRESCRIPTION DUE TO COST.
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-LACK OF ACCESS TO BEHAVIORAL HEALTH SERVICES
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ONE OF THE MOST COMMON FINDINGS FROM THOSE WHO WERE INTERVIEWED OR PARTICIPATED IN THE COMMUNITY FORUMS WAS THE BURDEN OF MENTAL HEALTH AND SUBSTANCE ABUSE ON RESIDENTS THROUGHOUT NEBH'S SERVICE AREA. RESIDENTS SUFFERED FROM A BROAD RANGE OF ISSUES INCLUDING DEPRESSION, ANXIETY, DEMENTIA, ALCOHOL ABUSE, AND OPIOID ABUSE. IN ADDITION TO DISCUSSING THE BURDEN OF THESE ISSUES ON INDIVIDUALS, FAMILIES, AND THE COMMUNITY, PARTICIPANTS REFLECTED ON THE LACK OF EDUCATIONAL, ASSESSMENT, AND TREATMENT SERVICES AVAILABLE IN THE COMMUNITY TO SUPPORT THOSE WITH BEHAVIORAL HEALTH ISSUES.-HIGHER EMERGENCY DEPARTMENT UTILIZATION. APPROXIMATELY 38% OF UNINSURED ADULTS IN THE COMMONWEALTH REPORTED VISITING THE EMERGENCY DEPARTMENT IN THE PAST YEAR; 18% REPORTED THAT THEIR MOST RECENT ED VISIT WAS FOR A NON-EMERGENCY CONDITION THAT COULD HAVE BEEN TREATED BY A GENERAL PHYSICIAN IF ONE WAS AVAILABLE. THIS COMPARED TO 32% AND 13%, RESPECTIVELY, FOR INSURED ADULTS.-HIGH RATES OF THE LEADING HEALTH RISK FACTORS. ONE OF THE LEADING FINDINGS FROM THE ASSESSMENT IS THAT MANY COMMUNITIES AND/OR POPULATION SEGMENTS IN NEBH'S CBSA HAVE HIGH RATES OF CHRONIC PHYSICAL AND BEHAVIORAL HEALTH CONDITIONS. IN SOME INDIVIDUALS, THESE CONDITIONS HAVE UNDERLYING GENETIC ROOTS THAT ARE DIFFICULT TO COUNTER. HOWEVER, FOR MOST PEOPLE THESE CONDITIONS ARE WIDELY CONSIDERED TO BE PREVENTABLE OR MANAGEABLE. ADDRESSING THE LEADING HEALTH RISK FACTORS (E.G., LACK OF NUTRITIONAL FOOD AND PHYSICAL ACTIVITY, ALCOHOL/ILLICIT DRUG ABUSE, AND TOBACCO USE) IS CRITICAL TO CHRONIC DISEASE PREVENTION AND MANAGEMENT EFFORTS. IT SHOULD BE NOTED THAT MOST AREAS WITHIN NEBH'S SERVICE AREA FARE WELL AGAINST COMMONWEALTH AVERAGES ON THESE RISK FACTORS. HOWEVER, THERE ARE CITIES/TOWNS WHOSE RATES ARE NOT AS FAVORABLE. AS STATED ABOVE, LOW-INCOME, FOREIGN BORN, AND OLDER SEGMENTS OF THE POPULATION ARE MORE LIKELY TO BE AT-RISK.-OVERWEIGHT/OBESE. 30% OF ROXBURY ADULTS REPORTED IN OBESE CATEGORIES COMPARED TO 22% FOR BOSTON. 30% OF ROXBURY ADULTS CONSUMED VEGETABLES LESS THAN ONCE PER DAY COMPARED TO 25% FOR BOSTON.-CIGARETTE SMOKING. 18% OF ROXBURY ADULTS REPORTED AS CURRENT SMOKERS COMPARED TO 16% FOR BOSTON OVERALL.-ALCOHOL USE. ROXBURY'S ALCOHOL-RELATED HOSPITAL PATIENT ENCOUNTER RATE PER 1,000 POPULATION WAS 22.6 COMPARED TO 17.7 FOR BOSTON.-HIGH RATES OF SUBSTANCE USE AND MENTAL HEALTH ISSUES. DURING INTERVIEWS AND COMMUNITY FORUMS, RESIDENTS AND AREA SERVICE PROVIDERS SPOKE PASSIONATELY ABOUT THE TREMENDOUS IMPACT THAT MENTAL HEALTH AND SUBSTANCE USE ISSUES HAVE ON MANY INDIVIDUALS AND FAMILIES IN THE SERVICE AREA. DEPRESSION AND ANXIETY, ISOLATION, ALCOHOL ABUSE, OPIOID AND PRESCRIPTION DRUG ABUSE, AND POST-TRAUMATIC STRESS DISORDER WERE IDENTIFIED AS MAJOR HEALTH CONCERNS. OPIOID ABUSE WAS A PARTICULAR CONCERN FOR RESIDENTS AND SERVICE PROVIDERS IN NEBH'S SERVICE AREA AND THERE WERE CALLS FOR GREATER OUTREACH, EDUCATION, SCREENING, AND TREATMENT SERVICES FOR ALL SEGMENTS OF THE POPULATION. DESPITE THE BURDEN OF MENTAL HEALTH AND SUBSTANCE ABUSE ON ALL PEOPLE, THERE IS AN EXTREMELY LIMITED SERVICE SYSTEM AVAILABLE TO MEET SPECIALIZED NEEDS, ESPECIALLY FOR OLDER ADULTS, THOSE WITH MILD TO MODERATE EPISODIC ISSUES, AND THOSE WITH SEVERE, COMPLEX, CHRONIC CONDITIONS. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE (INCLUDING STIGMA), AND IMPROVE THE QUALITY OF PRIMARY CARE AND SPECIALIZED BEHAVIORAL HEALTH SERVICES.-SUBSTANCE USE. ROXBURY'S RATE OF ADMISSIONS TO TREATMENT PROGRAMS FOR SUBSTANCE USE PER 1,000 POPULATION WAS 55.8 COMPARED TO 30.2 FOR BOSTON.-SUBSTANCE USE. ROXBURY'S ALCOHOL-RELATED HOSPITAL PATIENT ENCOUNTER RATE PER 1,000 POPULATION WAS 22.6 COMPARED TO 17.7 FOR BOSTON. SIMILARLY, THE DRUG-RELATED HOSPITAL PATIENT ENCOUNTER RATE PER 1,000 POPULATION WAS 12.2 COMPARED TO 6.8 FOR BOSTON.-SUBSTANCE USE. ROXBURY'S UNINTENTIONAL DRUG OVERDOSE DEATH RATE PER 100,000 POPULATION WAS 15.9 COMPARED TO 15.5 FOR BOSTON. THE UNINTENTIONAL OPIOID OVERDOSE/POISONING HOSPITAL PATIENT ENCOUNTER RATE WAS 1.9 FOR ROXBURY COMPARED TO 1.1 FOR BOSTON.-SUBSTANCE USE. ROXBURY'S SUBSTANCE ABUSE MORTALITY RATE PER 100,000 RESIDENTS WAS 36.3 COMPARED TO 33.9 FOR BOSTON (HOB 2012-2013 - AVERAGE ANNUAL RATES FOR 2005- 2011).-MENTAL HEALTH. THE RATE OF MENTAL HEALTH HOSPITALIZATIONS FOR ROXBURY WAS 9.0 COMPARED TO 8.0 FOR BOSTON.-MENTAL HEALTH. 13% OF ROXBURY ADULTS REPORTED AS BEING IN POOR MENTAL OR EMOTIONAL HEALTH MORE THAN 15 DAYS IN THE PAST MONTH COMPARED TO 12% FOR BOSTON RESIDENTS.-MENTAL HEALTH. KEY INFORMANTS AND COMMUNITY FORUM PARTICIPANTS IDENTIFIED ISOLATION AND DEPRESSION AS A LEADING ISSUE FACED BY THE AREA'S OLDER ADULT POPULATION. INTERVIEWEES AND FORUM PARTICIPANTS DISCUSSED ADDITIONAL CHALLENGES FACED BY OLDER ADULTS WHO ARE MORE LIKELY TO STRUGGLE WITH CHRONIC PHYSICAL HEALTH CONDITIONS. THEY FACE BARRIERS THAT MAKE IT HARDER FOR THEM TO LEAVE THEIR HOMES, ESPECIALLY IF THEY ARE SICK, FRAIL, OR DEPRESSED.-HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS, PARTICULARLY FOR LOW INCOME POPULATIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). THE ASSESSMENT'S QUANTITATIVE DATA SHOWS THAT, OVERALL, NEBH'S SERVICE AREA FARES BETTER THAN THE COMMONWEALTH WITH RESPECT TO CHRONIC DISEASE RATES. IT SHOULD BE NOTED THAT EVEN FOR THOSE COMMUNITIES THAT DO NOT HAVE RATES THAT ARE STATISTICALLY HIGHER THAN THE COMMONWEALTH, THESE CONDITIONS ARE STILL THE LEADING CAUSES OF PREMATURE DEATH.-CARDIOVASCULAR DISEASE. THE HOSPITALIZATION RATE PER 1,000 POPULATION DUE TO HEART DISEASE WAS 13.2 FOR ROXBURY COMPARED TO 9.1 FOR BOSTON. THE MORTALITY RATE PER 100,000 DUE TO HEART DISEASE WAS 148.3 FOR ROXBURY COMPARED TO 133.6 FOR BOSTON.-HYPERTENSION. THE HOSPITALIZATION RATE PER 100,000 DUE TO HYPERTENSION WAS 110 FOR BOSTON COMPARED TO 45 FOR THE COMMONWEALTH. 28.3% OF ROXBURY ADULTS REPORTED HAVING HYPERTENSION COMPARED TO 24% FOR BOSTON OVERALL.-DIABETES. THE DIABETES PREVALENCE IN ROXBURY WAS SIGNIFICANTLY HIGHER COMPARED TO BOSTON OVERALL. 15.1% OF ROXBURY ADULTS REPORTED HAVING DIABETES COMPARED TO 8.6% OF BOSTON ADULTS. THE HOSPITALIZATION RATE DUE TO DIABETES PER 1,000 POPULATION WAS 3.5 FOR ROXBURY, COMPARED TO 1.9 FOR BOSTON.-ASTHMA. 13.8% OF ROXBURY ADULTS REPORTED HAVING ASTHMA COMPARED TO 11.1% FOR BOSTON. THE HOSPITALIZATION RATE DUE TO ASTHMA PER 1,000 POPULATION WAS 5.9 FOR ROXBURY, COMPARED TO 2.6 FOR BOSTON. SIMILARLY, THE HOSPITAL EMERGENCY DISCHARGE PER 1,000 POPULATION DUE TO ASTHMA WAS 17.5 FOR ROXBURY, COMPARED TO 9.0 FOR BOSTON OVERALL.-HIGH RATES OF HIV/AIDS. GREAT STRIDES HAVE BEEN MADE IN CONTROLLING AND MANAGING HIV/AIDS, AND FOR MANY IT IS MANAGED AS A CHRONIC CONDITION WITH MEDICATIONS. ALTHOUGH RATES OF ILLNESS, DEATH, AND HIV TRANSMISSION DECLINED OVERALL IN THE PAST DECADE, HIV/AIDS CONTINUES TO IMPACT CERTAIN SEGMENTS OF THE POPULATION, INCLUDING MEN WHO HAVE SEX WITH MEN AND INJECTION DRUG USERS. IN NEBH'S CBSA, RATES OF HIV/AIDS ARE PARTICULARLY HIGH IN ROXBURY. THE HOSPITALIZATION RATE PER 100,000 WHERE HIV/AIDS WAS THE PRIMARY REASON FOR THE VISIT WAS 40 FOR BOSTON COMPARED TO 12 FOR THE COMMONWEALTH.-HIGH RATES OF CANCER, PARTICULARLY FOR LOW INCOME, RACIALLY/ETHNICALLY DIVERSE, AND OTHERWISE AT- RISK POPULATION SEGMENTS. MANY OF THE COMMUNITIES THAT ARE PART OF NEBH'S SERVICE AREA HAVE HIGH CANCER INCIDENCE, HOSPITALIZATION OR MORTALITY RATES. THIS IS PARTICULARLY TRUE FOR CERTAIN CANCERS IN SPECIFIC COMMUNITIES. ROXBURY IS MORE BURDENED BY COLORECTAL CANCER, BREAST CANCER, LUNG CANCER, PANCREATIC CANCER, AND PROSTATE CANCER. THERE ARE A MYRIAD OF FACTORS ASSOCIATED WITH CANCER AND MANY OF THEM ARE DIFFICULT TO ASSESS OR ADDRESS. HOWEVER, AT THE ROOT OF ADDRESSING CANCER AND HIGH MORTALITY IS SCREENING, EARLY DETECTION, PEER SUPPORT, AND ACCESS TO TIMELY, SUPPORTIVE, QUALITY TREATMENT.-CANCER. ROXBURY'S MORTALITY RATE DUE TO COLORECTAL CANCER PER 100,000 POPULATION WAS25.5 COMPARED TO 16.4 FOR BOSTON. THE MORTALITY RATE DUE TO LUNG CANCER WAS 64.3 COMPARED TO 45.4 FOR BOSTON.-CANCER. ROXBURY'S MORTALITY RATE DUE TO BREAST CANCER IN FEMALES PER 100,000 POPULATION WAS 23.6 COMPARED TO 17.9 FOR BOSTON. THE MORTALITY RATE DUE TO PROSTATE CANCER WAS49.5 COMPARED TO 25.7 FOR BOSTON.-CANCER. ROXBURY'S MORTALITY RATE DUE TO PANCREATIC CANCER PER 100,000 WAS 16.1 COMPARED TO 12.1 FOR BOSTON.
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COMMUNITY HEALTH PRIORITIES
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NEBH'S CHNA'S APPROACH AND PROCESS PROVIDED AMPLE OPPORTUNITY TO VET THE QUANTITATIVE AND QUALITATIVE DATA COMPILED DURING THE ASSESSMENT. NEBH HAS FRAMED THE COMMUNITY HEALTH NEEDS IN THREE PRIORITY AREAS, WHICH TOGETHER ENCOMPASS THE BROAD RANGE OF HEALTH ISSUES AND SOCIAL DETERMINANTS OF HEALTH FACING RESIDENTS LIVING IN NEBH'S CBSA. THESE THREE AREAS ARE: 1) SOCIAL DETERMINANTS HEALTH (INCLUDING POVERTY, FOOD INSECURITY, SAFETY AND VIOLENCE), 2) CHRONIC DISEASE MANAGEMENT AND PREVENTION (INCLUDING PHYSICAL, BEHAVIORAL, AND EMOTIONAL RISK FACTORS AS WELL AS CHRONIC DISEASE MANAGEMENT) AND 3) ELDER HEALTH (INCLUDING ACCESS TO CARE, FALLS PREVENTION, DEPRESSION/ANXIETY, AND ISOLATION).IT SHOULD BE NOTED THAT ONE OF THE PRIMARY DIFFERENCES WITH RESPECT TO NEBH'S COMMUNITY HEALTH ASSESSMENT IN 2016 COMPARED TO ITS ASSESSMENT IN 2013 WAS THE IMPACT AND BURDEN OF BEHAVIORAL HEALTH ISSUES. WHILE, NEBH DOES NOT HAVE THE EXPERTISE AND CAPACITY TO DEDICATE A GREAT DEAL OF COMMUNITY BENEFITS RESOURCES TO BEHAVIORAL HEALTH ISSUES, THE ORGANIZATION IS COMMITTED TO DOING WHAT IT CAN TO PROMOTE AWARENESS, EDUCATE, AND REDUCE THE IMPACTS OF BEHAVIORAL HEALTH ISSUES, PARTICULARLY FOR YOUTH/ADOLESCENT AND OLDER ADULT SEGMENTS OF ITS SERVICE AREA. FOR EXAMPLE, NEBH WORKS WITH COMMUNITY PARTNERS TO REDUCE VIOLENCE AND ITS IMPACTS AMONG YOUTH. NEBH ALSO PROMOTES PHYSICAL ACTIVITY AND SOCIALIZATION AMONG ITS OLDER ADULT POPULATION WITCH HAS CLEAR BENEFITS WITH RESPECT TO PHYSICAL AND EMOTIONAL WELL-BEING. FINALLY, WITH RESPECT TO CHRONIC DISEASE MANAGEMENT, NEBH SPONSORS EDUCATIONAL SESSIONS AND WORKSHOPS THAT EDUCATE PARTICIPANTS ON THE RISK FACTORS ASSOCIATED WITH CHRONIC DISEASE, INCLUDING THE PHYSICAL, BEHAVIORAL, AND EMOTIONAL FACTORS SUCH AS DEPRESSION, ALCOHOL AND DRUG ABUSE.
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COMMUNITY HEALTH NEEDS ASSESSMENT - ADDRESSING COMMUNITY HEALTH NEEDS
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LARGE PROPORTIONS OF INDIVIDUALS RESIDING WITHIN BOSTON AND NEBH'S COMMUNITY BENEFITS SERVICE AREA LIVE IN POVERTY, HAVE LIMITED FORMAL EDUCATION, ARE UNEMPLOYED, AND STRUGGLE TO AFFORD FOOD AND OTHER ESSENTIAL HOUSEHOLD ITEMS. THESE POPULATIONS ARE DISPROPORTIONATELY FROM RACIAL/ETHNIC MINORITY GROUPS AND, PARTLY AS A RESULT OF THEIR POVERTY, FACE DISPARITIES IN HEALTH AND ACCESS TO CARE OUTCOMES. IT IS CRITICAL TO NOTE THAT THERE IS A MULTITUDE OF INDIVIDUAL, COMMUNITY AND SOCIETAL FACTORS THAT WORK TOGETHER TO CREATE THESE INEQUITIES. IT IS INSUFFICIENT TO TALK SOLELY ABOUT RACE/ETHNICITY, FOREIGN BORN STATUS, OR LANGUAGE AS THE UNDERLYING AND CORRELATIVE ISSUES RELATED TO HEALTH AND WELL-BEING INVOLVE ECONOMIC OPPORTUNITY, EDUCATION, CRIME, AND COMMUNITY COHESION. NEBH STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY WHICH ARE AVAILABLE ON THE HOSPITAL'S WEBSITE. AS NOTED THROUGHOUT THIS FORM 990 SCHEDULE H, NEBH'S MOST RECENTLY COMPLETED CHNA WAS COMPLETED DURING THE FISCAL YEAR ENDED 2016. THAT CHNA AND IMPLEMENTATION STRATEGY (CHIP) ARE AVAILABLE ON THE NEBH WEBSITE AT:HTTPS://WWW.NEBH.ORG/WHO-WE-ARE/GIVING-BACK/IN ADDITION, THE CHNA AND CHIP WHICH WERE COMPLETED PREVIOUSLY COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2013 AND UNDER WHICH COMMUNITY BENEFITS ACTIVITIES WERE GUIDED FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2014, SEPTEMBER 30, 2015 AND SEPTEMBER 30, 2016 S ARE AVAILABLE ON THE NEBH WEBSITE AT: HTTPS://WWW.NEBH.ORG/WHO-WE-ARE/GIVING-BACK/ IN ADDITION, ALL OF THESE DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST. (SCHEDULE H, PART V, SECTION B, LINE 7A)A SUMMARY OF NEBH'S COMMUNITY BENEFIT ACTIVITIES WHICH ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016 AND PRIORITIZED IN THE RELATED CHIP ARE PROVIDED HERE ALONG WITH THE ENTITIES WITH WHICH THE HOSPITAL PARTNERS RELATED TO THESE EFFORTS.COMMUNITY HEALTH PRIORITIES AND TARGET POPULATIONSONCE ALL OF THE ASSESSMENT'S FINDINGS WERE COMPILED, HOSPITAL AND COMMUNITY STAKEHOLDERS PARTICIPATED IN A PLANNING PROCESS THAT INTEGRATED DATA FINDINGS FROM PHASES I AND II OF THE PROJECT, INCLUDING INFORMATION GATHERED FROM INTERVIEWS AND COMMUNITY FORUMS. PARTICIPANTS REVIEWED THE ASSESSMENT FINDINGS AND THE CURRENT COMMUNITY BENEFITS PROGRAM ACTIVITIES. FROM THESE DISCUSSIONS, A LISTING OF COMMUNITY BENEFITS TARGET POPULATIONS AND COMMUNITY HEALTH PRIORITIES WERE IDENTIFIED. FINALLY, NEBH STAFF, WITH INPUT FROM JSI AND THE COMMUNITY BENEFITS COMMITTEE, DEVELOPED NEBH'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP), WHICH BUILDS ON PRIOR WORK. CARE WAS TAKEN TO IDENTIFY THOSE ACTIVITIES THAT CONTINUE TO BE ALIGNED WITH COMMUNITY NEED AND ARE HAVING A A POSITIVE IMPACT ON THE COMMUNITY. NEW COMMUNITY HEALTH ACTIVITIES WERE IDENTIFIED IN RESPONSE TO KNOWLEDGE OF BEST PRACTICES AND NEW NEEDS IDENTIFIED BY THE ASSESSMENT. FOLLOWING IS A BRIEF SUMMARY OF THE TARGET POPULATIONS AND COMMUNITY HEALTH PRIORITIES THAT WERE IDENTIFIED. ALSO INCLUDED BELOW IS A REVIEW OF THE GOALS, OBJECTIVES, AND CORE ELEMENTS OF NEBH'S COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP).NEBH'S COMMUNITY HEALTH IMPLEMENTATION PLANGIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, NEBH HAS BEEN STRATEGIC IN IDENTIFYING ITS PRIORITY AREAS IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. BASED ON THE DATA, NEBH HAS IDENTIFIED THE FOLLOWING AS THE HIGHEST PRIORITY NEEDS OF THE CBSA:1.SOCIAL DETERMINANTS AND HEALTH2.CHRONIC DISEASE MANAGEMENT AND PREVENTION3.ELDER HEALTHTHESE HEALTH PRIORITIES HAVE DIRECTED NEBH'S COMMUNITY HEALTH IMPLEMENTATION PLANNING PROCESS. THE PRIORITIES OUTLINED BELOW ARE DESIGNED TO PROMOTE COMMUNITY-BASED WELLNESS AND DISEASE PREVENTION, AND ENSURE ONGOING SELF-MANAGEMENT OF CHRONIC DISEASES AND BEHAVIORAL HEALTH DISORDERS. THE GOALS AND ACTIVITIES DRAWN FROM THESE PRIORITIES WILL MAKE EXTENSIVE USE OF EXISTING PARTNERSHIPS, RESOURCES AND PROGRAMS IN ORDER TO FACILITATE THE LARGEST POSSIBLE HEALTH IMPACT.THE FOLLOWING GOALS ADDRESS THE EXISTING ACCESS, CARE COORDINATION ISSUES, BARRIERS, AND TARGETED SERVICE GAPS IDENTIFIED THROUGH THE CHNA PROCESS.IMPROVEMENTS IN HEALTH STATUS BEGIN WITH KNOWLEDGE OF THE POPULATION'S CHARACTERISTICS AS WELL AS THE UNDERLYING SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS THAT IMPACT HEALTH AND HEALTH EQUITY. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT, AND COMMUNITY COHESION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. THE FOLLOWING GOALS AND OBJECTIVES ADDRESS THE EXISTING CHALLENGES, ACCESS ISSUES, BARRIERS TO CARE, AND TARGETED SERVICE GAPS IDENTIFIED THROUGH THE NEEDS ASSESSMENT PROCESS.PRIORITY AREA # 1 : SOCIAL & ECONOMIC DETERMINANTS OF HEALTHA.INCREASE ACCESS TO HEALTHY FOODS AND OTHER BASIC HOUSEHOLD NEEDS-TARGET POPULATION: LOW-INCOME INDIVIDUALS AND FAMILIES-PROGRAMMATIC OBJECTIVES: I.EDUCATE INDIVIDUALS AND FAMILIES ABOUT HEALTHY EATING, MEAL PLANNING, HOUSEHOLD BUDGETING, ETC. II.DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO SUFFER FROM FOOD INSECURITY AND/OR LACK BASIC HOUSEHOLD ITEMS-COMMUNITY ACTIVITIES:I.EMERGENCY FOOD PANTRY SERVICES FOR LOW-INCOME FAMILIES. NEBH PROVIDES FINANCIAL SUPPORT FOR THE FOOD PANTRY AT THE ABCD, PARKER HILL/FENWAY SITE. THE PANTRY PROVIDES EMERGENCY FOOD FOR LOW INCOME FAMILIES IN THE COMMUNITY. II.EMERGENCY FOOD FOR UNDERSERVED, LOW-INCOME RESIDENTS THAT LIVE IN MISSION HILL/ROXBURY. PROVIDED EMERGENCY FOOD TO FAMILIES IN NEED INCLUDING BABY FORMULA AND DIAPERS. NEBH WILL CONTINUE TO HELP FAMILIES IN OUR COMMUNITY THAT NEED FOOD. III.TURKEY GIVE-A-WAY DURING THANKSGIVING; NEBH PROVIDES FINANCIAL SUPPORT FOR THE SENIORS IN MISSION HILL DURING THE HOLIDAYS. THE MISSION HILL LEGACY PROJECT AND THE TOBIN COMMUNITY CENTER PROVIDED TURKEYS TO OVER 200 LOW INCOME SENIORS IN MISSION HILL/ROXBURY. IV.NEBH IS COMMITTED TO COMBATING HUNGER IN OUR LOCAL NEIGHBORHOOD BY PARTNERING WITH THE MISSION HILL ELEMENTARY SCHOOL AND MISSION HILL RESIDENTS. LAST YEAR, NEBH HELPED 46 FAMILIES WITH FOOD ASSISTANCE THROUGH STOP AND SHOP GIFT CARDS AND FOOD. DOE HOUSE IS ONE OF THE PINE STREET INN'S SUPPORTIVE HOUSING SITES FOR FORMER HOMELESS MEN AND WOMEN. ON THE THIRD WEDNESDAY OF THE MONTH, STAFFS PREPARE AND SERVE A HEALTHY MEAL FOR THEM AND SPEND TIME SOCIALIZING WITH THE RESIDENTS. EVERY MONTH, EACH RESIDENT RECEIVES A GIFT CARD TO STOP & SHOP SO THAT THEY MAY PURCHASE FOOD AND, MUCH NEEDED CLOTHING, WINTER COATS, TOILETRIES, ETC.V.NEBH IS COMMITTED TO PROVIDING ACCESS TO HEALTHY AND AFFORDABLE FOOD TO THE MISSION HILL COMMUNITY. NEBH COLLABORATED WITH ROXBURY TENANTS OF HARVARD (RTH) AND FAIR FOODS ON THE $2 A BAG PROGRAM TO OFFSET THE COST OF FRESH FRUITS AND VEGETABLES.VI.DURING DECEMBER, NEBH PARTICIPATES IN THE MISSION HILL ELEMENTARY SCHOOL'S "ADOPT A FAMILY" PROGRAM. OVER 74 CHILDREN AND 12 PARENTS/GRANDPARENTS RECEIVED HOLIDAY GIFTS AND MUCH NEEDED WINTER COATS AND BOOTS THAT WOULD OTHERWISE HAVE NOT BEEN AVAILABLE TO THEM. YEAR AFTER YEAR, NEBH EMPLOYEES AND THE HOSPITAL DONATE THE GIFTS. NEBH ALSO PROVIDES GIFTS FOR THE RESIDENTS OF THE DOE HOUSE.-COMMUNITY PARTNERS:-ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD)-SOCIEDAD LATINA-MISSION HILL ELEMENTARY SCHOOL-ROXBURY TENANTS OF HARVARD (RTH)-TOBIN COMMUNITY CENTER-FAIR FOODS-PINE STREET INN-DOE HOUSEB.PROMOTE VIOLENCE PREVENTION AND ADDRESS TRAUMA (SAFE NEIGHBORHOODS/COMMUNITY COHESION)-CREATING A STRONG FEELING OF COMMUNITY AND FOCUSING ON YOUTH EDUCATION ARE TWO IMPORTANT ASPECTS OF VIOLENCE PREVENTION. -NEBH WORKS WITH COMMUNITY GROUPS SUCH AS THE MISSION HILL YOUTH COLLABORATIVE (MHYC), THE MISSION HILL CRIME COMMITTEE AND THE BOSTON POLICE TO HELP EDUCATE OUR COMMUNITY AND TO KEEP OUR YOUTH ENGAGED IN PRODUCTIVE ACTIVITIES TO PREVENT VIOLENCE IN OUR COMMUNITY. THE MHYC SERVES OVER 1,500 YOUTH AND FAMILIES LIVING IN THE MISSION HILL AREA BY HOSTING EDUCATIONAL AND FUN EVENTS, SUCH AS HALLOWEEN ON THE HILL. SECURITY CAMERA'S AND ROUNDS -NEBH PERFORMS SECURITY ROUNDS THROUGHOUT THE MISSION HILL AREA 7 DAYS A WEEK 24 HOURS A DAY AT SCHEDULED AND UNSCHEDULED INTERVALS. THIS SERVICE PROVIDES VIOLENCE DETERRENCE IN THE NEIGHBORHOOD. NEBH IN CONJUNCTION WITH COMMUNITY LEADERS REVIEWED AND UPGRADED ITS VIDEO SYSTEM TO ENHANCE NEIGHBORHOOD SECURITY. NEBH ALSO WORKS WITH THE MISSION HILL PROBLEM PROPERTIES TASK FORCES TO IMPROVE SAFETY AND SECURITY OF THE COMMUNITY. C.INCREASE JOB OPPORTUNITIES FOR YOUTH AND ADULTS -TARGET POPULATION: YOUTH AND ADULTS
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-PROGRAMMATIC OBJECTIVES:
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I.PROJECT SEARCH HIGH SCHOOL TRANSITION PROGRAM : A ONE-YEAR, SCHOOL-TO-WORK PROGRAM THAT TAKES PLACE ENTIRELY AT THE WORKPLACE. TOTAL WORKPLACE IMMERSION FACILITATES A SEAMLESS COMBINATION OF CLASSROOM INSTRUCTION, CAREER EXPLORATION, AND RELEVANT JOB-SKILLS TRAINING THROUGH STRATEGICALLY DESIGNED INTERNSHIPS. THE PROGRAM PROVIDES REAL-LIFE WORK EXPERIENCE COMBINED WITH TRAINING IN EMPLOYABILITY AND INDEPENDENT LIVING SKILLS TO HELP YOUTHS WITH SIGNIFICANT DISABILITIES MAKE SUCCESSFUL TRANSITIONS FROM SCHOOL TO PRODUCTIVE ADULT LIFE.II.IMPROVEMENTS IN HEALTH STATUS BEGIN WITH KNOWLEDGE OF THE POPULATION'S CHARACTERISTICS AS WELL AS THE UNDERLYING SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS THAT IMPACT HEALTH AND HEALTH EQUITY. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT, AND COMMUNITY COHESION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH.III.THE HOSPITAL'S FOCUS FOR WORKFORCE DEVELOPMENT IS PROVIDING EMPLOYMENT, JOB TRAINING AND SUPPORTING THE EDUCATIONAL NEEDS OF OUR COMMUNITY RESIDENTS. IN ADDITION TO PROMOTING NEIGHBORHOOD DEVELOPMENT BY PROVIDING JOBS, THE HOSPITAL WORKS WITH SCHOOLS ON INTERNSHIPS TO HELP ENCOURAGE YOUNG PEOPLE TO ENTER HEALTHCARE AS A CAREER AND TO SUCCEED.COMMUNITY ACTIVITIES:I.NEBH PARTNERED WITH MORGAN MEMORIAL, GOODWILL AND MADISON PARK HIGH SCHOOL TO OFFER A ONE-YEAR, SCHOOL-TO-WORK INTERNSHIP THROUGH THE PROJECT SEARCH HIGH SCHOOL TRANSITION PROGRAM. IN 2018, EIGHT STUDENTS PARTICIPATED IN THE PROGRAM. THE STUDENTS LEARNED SKILLS THAT WILL ENABLE THEM TO APPLY FOR A RELATED POSITION WHEN THEY GRADUATE FROM HIGH SCHOOL. AFTER COMPLETION OF THE PROGRAM, NEBH HIRED THREE STUDENTS INTO PERMANENT POSITIONS AT THE HOSPITAL.II.ABCD SUMMERWORKS PROGRAM OFFERS YOUTH LIVING IN MISSION HILL A MEANINGFUL WORK EXPERIENCE AT LOCAL NON-PROFIT, ACADEMIC, AND MEDICAL INSTITUTIONS DURING THE SUMMER. NEBH HAS SUPPORTED THIS PROGRAM FOR MANY YEARS, PROVIDING YOUTH LIVING IN MISSION HILL THE OPPORTUNITY FOR SUMMER EMPLOYMENT THROUGH ABCD.III.THE MEREDITH CAMERON YOUTH OPPORTUNITY INTERNSHIP OFFERS HIGH SCHOOL AND COLLEGE STUDENTS FROM BOSTON, (WITH A FOCUS ON MISSION HILL) PAID SUMMER INTERNSHIPS. ELEVEN STUDENTS WERE GAINFULLY EMPLOYED DURING THE SUMMER OF 2018. THE STUDENTS PARTICIPATED IN WEEKLY LUNCH AND LEARN LECTURES. INTRODUCING THEM TO CLINICAL AND ADMINISTRATIVE CAREERS.-COMMUNITY PARTNERS:-ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD)-SOCIEDAD LATINA-ROXBURY TENANTS OF HARVARD (RTH) -MISSION MAIN-TOBIN COMMUNITY CENTER-PRIVATE INDUSTRY COUNCIL (PIC)D.IMPROVE ACCESS AND SAFETY TO ESSENTIAL COMMUNITY VENUES FOR MISSION HILL RESIDENTS TARGET POPULATION: MISSION HILL COMMUNITYPROGRAMMATIC OBJECTIVES: I.INCREASE THE NUMBER OF MISSION HILL RESIDENTS WHO HAVE ACCESS TO AFFORDABLE TRANSPORTATION TO ENSURE ACCESS TO BASIC NEEDS AND REDUCE ISOLATIONII.IMPROVE ACCESSIBILITY AND BEAUTIFY COMMUNITY PARKS AND OTHER AREASIII.REMOVE TRASH AND PROVIDE CLEANING SERVICES IN COMMUNITY IV.BECAUSE THE NEIGHBORHOOD OF MISSION HILL IS LOCATED ON A "HILL", THE NEED FOR TRANSPORTATION UP AND DOWN THE HILL IS NEEDED ESPECIALLY FOR THE ELDERLY. AS PEOPLE GROW OLDER, THE LEVEL OF MOBILITY THAT THE ELDERLY POPULATION HAS CAN BECOME LIMITED. THE NEED FOR A BUS IN THE MISSION HILL COMMUNITY IS MUCH NEEDED. WITHOUT THE MONETARY ASSISTANCE FROM NEBH AND THE MBTA, THE COMMUNITY WOULD NOT HAVE TRANSPORTATION UP AND DOWN THE HILL.COMMUNITY ACTIVITIES:I.THE MISSION LINK BUS PROVIDES MUCH NEEDED TRANSPORTATION FOR THE ELDERLY, GETTING THEM TO AND FROM THEIR DOCTOR'S APPOINTMENTS, FOOD SHOPPING, PHARMACY, ETC. AS WELL AS PROVIDING THE OPPORTUNITY FOR THEM TO BE SOCIAL AND ACTIVE. NEBH IS COMMITTED TO ENABLING A HEALTHY LIFESTYLE FOR SENIORS THAT LIVE IN OUR COMMUNITY. MANY SENIORS WOULD NOT BE ABLE TO GET TO THEIR DOCTORS APPOINTMENTS, SHOP FOR FOOD, ATTEND EVENTS, ETC. IN MISSION HILL WITHOUT THE MISSION LINK BUS. II.MAINTENANCE OF THE CITY OF BOSTON'S MCLAUGHLIN PARK AND TWO BALL FIELDS ATOP MISSION HILL. THE CITY OF BOSTON'S MCLAUGHLIN PARK/FIELDS IS MAINTAINED ON A WEEKLY BASIS BY NEBH ALLOWING THE RESIDENTS OF MISSION HILL TO PLAY BASEBALL, SOFTBALL, SOCCER, ETC. THIS ALLOWS THE RESIDENTS TO MAINTAIN AN ACTIVE LIFESTYLE WITH PHYSICAL ACTIVITY. III.CLEANER NEIGHBORHOODS LEAD TO LOWER CRIME AND MORE ACTIVITY IN PARKS AND PLAY. MORE ACTIVITY LEADS TO BETTER HEALTH, IMPROVED PERFORMANCE IN SCHOOL AND LONG TERM ECONOMIC GAINS. SEVERAL LONG-TERM STUDIES HAVE BEEN DONE THAT SHOW THIS. CLEANER NEIGHBORHOOD. THEY DERIVE ECONOMIC VALUE FROM THIS AS WELL AS MENTAL AND PHYSICAL HEALTH BENEFITS. NEBH CONTINUES TO BEAUTIFY THE NEIGHBORHOOD HIRING A TRASH TRUCK EACH YEAR DURING STUDENT MOVE IN WEEK, HELPING WITH SNOW REMOVAL FOR THE CITY OF BOSTON, SWEEPING AND CLEANING THE STREETS THAT SURROUND THE HOSPITAL AND COMMUNITY AND WORKING WITH COMMUNITY MEMBERS AND MISSION MAIN STREETS ON KEEPING MISSION HILL CLEAN.IV.NEBH FINANCIALLY SUPPORTS MUCH NEEDED OFFICE SPACE FOR MISSION HILL MAIN STREETS IN A NEW ENGLAND BAPTIST HOSPITAL BUILDING IN MISSION HILL.-COMMUNITY PARTNERS:-MISSION LINK-FRIENDS OF MCLAUGHLIN PARK-CITY OF BOSTON-PROBLEM PROPERTIES TASK FORCE -MISSION HILL COMMUNITYPRIORITY AREA # 2 : CHRONIC DISEASE MANAGEMENT AND PREVENTIONLACK OF PHYSICAL ACTIVITY, POOR NUTRITION, ALCOHOL ABUSE, DEPRESSION/ISOLATION, AND TOBACCO USE ARE SOME OF THE LEADING RISK FACTORS FOR CHRONIC DISEASE AND POOR EMOTIONAL HEALTH. ADDRESSING THESE ISSUES AND DEVELOPING HEALTHY HABITS IN THESE AREAS ARE AMONG THE MOST IMPORTANT THINGS PEOPLE OF ALL AGES CAN DO TO IMPROVE THEIR HEALTH AND MANAGE THEIR CHRONIC HEALTH CONDITIONS. PHYSICAL ACTIVITY HELPS PREVENT MANY DISEASES (E.G. HEART DISEASE, DIABETES AND SOME CANCERS), STRENGTHENS BONES AND MUSCLES, REDUCES STRESS AND DEPRESSION AND MAKES IT EASIER FOR PEOPLE TO MAINTAIN A HEALTHY BODY WEIGHT. EATING A HEALTHY DIET CAN HELP LOWER PEOPLE'S RISK FOR HEART DISEASE, HIGH BLOOD PRESSURE, DIABETES,OSTEOPOROSIS AND CERTAIN CANCERS, AND ALSO HELPS PEOPLE MAINTAIN A HEALTHY BODY WEIGHT AND PROMOTE A SENSE OF OVERALL HEALTH AND EMOTIONAL WELL-BEING. LIMITING ALCOHOL CONSUMPTION AND NOT USING TOBACCO CAN DRAMATICALLY REDUCE ONE CHANCES OF CONTRACTING HEART DISEASE, DIABETES, AND RESPIRATORY DISEASE AS WELL AS DEPRESSION AND ANXIETY.THERE ARE A BROAD RANGE OF CHRONIC AND INFECTIOUS DISEASES PREVALENT IN NEBH'S CBSA, INCLUDING HEART DISEASE, DIABETES, ASTHMA, HYPERTENSION, CANCER, HIV/AIDS, AND DEPRESSION. ALTHOUGH TREATING THESE ILLNESSES REQUIRES A RANGE OF CLINICAL INTERVENTIONS, THERE IS A GREAT DEAL OF OVERLAP WITH RESPECT TO THE POTENTIAL COMMUNITY INTERVENTIONS. POPULATION-LEVEL RESPONSES TO CHRONIC AND INFECTIOUS ILLNESSES ALL REQUIRE COMMUNITY BASED EDUCATION, SCREENING, TIMELY ACCESS TO TREATMENT AND SEAMLESS COORDINATION OF FOLLOW-UP SERVICES, INCLUDING ACCESS TO WELLNESS ACTIVITIES THAT ADDRESS HEALTH RISK FACTORS.NEBH, IN COLLABORATION WITH PUBLIC HEALTH OFFICIALS, COMMUNITY BASED ORGANIZATIONS AND OTHER CLINICAL PROVIDERS IS ALREADY FULLY ENGAGED ON THESE ISSUES AND NEBH HAS A BROAD RANGE OF EXISTING PROGRAMS THAT WORK TO ADDRESS PREVENTION, SERVICE COORDINATION, IMPROVE FOLLOW-UP CARE, AND ENSURE THAT THOSE WITH CHRONIC AND INFECTIOUS CONDITIONS ARE ENGAGED IN THE SERVICES THEY NEED. HOWEVER, THESE EFFORTS NEED TO BE ENHANCED AND REFINED BASED ON DATA FROM THIS ASSESSMENT. MOVING FORWARD, IT IS CRITICAL THAT THESE ISSUES BE ADDRESSED AND PERFECTED SO THAT NEBH, OTHER CLINICAL PROVIDERS, AND THE BROAD RANGE OF KEY COMMUNITY BASED ORGANIZATIONS CAN WORK COLLABORATIVELY TO ADDRESS COMMUNITY NEED WITH RESPECT TO PHYSICAL, BEHAVIORAL, AND EMOTIONAL HEALTH ISSUES. THE FOLLOWING GOALS AND OBJECTIVES ADDRESS THE EXISTING EDUCATIONAL, ASSESSMENT, CARE COORDINATION, AND ACCESS TO CARE AND SERVICES ISSUES IDENTIFIED THROUGH THE ASSESSMENT PROCESS.A.PROMOTE GENERAL HEALTH AND WELLNESS-TARGET POPULATION: CHILDREN, YOUTH, AND ADULTS-PROGRAMMATIC OBJECTIVES: I.EDUCATE THE PUBLIC ABOUT HEALTH RISK FACTORS, HEALTH PROMOTION, AND BASIC WELLNESS -COMMUNITY ACTIVITIES:I.DECREASE THE NUMBER AND PERCENTAGE OF BOTH ADULTS AND CHILDREN WHO ARE OVERWEIGHT AND OBESE BY EDUCATING AND PROMOTING WELLNESS AND EXERCISE. NEBH CONTINUES TO MAINTAIN MCLAUGHLIN PARK IN MISSION HILL. THIS ALLOWS THE RESIDENTS OF BOSTON ACCESS TO TWO BALL FIELDS AND A PLAYGROUND, RESULTING IN ACTIVITY AND EXERCISE. NEBH COLLABORATES WITH ROXBURY TENANTS OF HARVARD (RTH) ON THREE PROGRAMS, EASY STEPS PROGRAM, AN EXERCISE CLASS FOR SENIORS THAT CONCENTRATES ON STRENGTH, BALANCE, FLEXIBILITY, FALL SAFETY AND ENDURANCE; WALK AND TALK, A WALKING GROUP THAT WALKS TWICE A WEEK; AND HEALTHY MOVES, A PROGRAM FOR SENIORS THAT HAVE COMPETED THE EASY STEPS PROGRAM.
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COMMUNITY ACTIVITIES CONTINUED
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THIS PROGRAM FOCUSED ON BUILDING UPON THE STRENGTH, BALANCE, FLEXIBILITY, AND ENDURANCE LEARNED IN EASY STEPS AS WELL AS AN EDUCATIONAL SERIES THAT INCLUDED CLASSES ON COGNITIVE THINKING, FALL PREVENTION AND NUTRITION.OBESITY PREVENTION OBESITY HAS REACHED EPIDEMIC PROPORTIONS IN THE UNITED STATES. OBESITY IS BECOMING A MAJOR ISSUE IN MASSACHUSETTS AND HAS A SIGNIFICANT NEGATIVE IMPACT ON THE MUSCULOSKELETAL SYSTEM. NEBH HAS A LONG-STANDING COMMITMENT TO IMPROVING THE HEALTH STATUS OF BOSTON RESIDENTS, WITH A FOCUS ON MOVEMENT AND PREVENTION OF OBESITY. THE HOSPITAL SUPPORTS THE MISSION HILL LITTLE LEAGUE, MISSION HILL SOFTBALL LEAGUE, MAURICE J. TOBIN COMMUNITY CENTER, ROXBURY TENANTS OF HARVARD AND SOCIEDAD LATINA FOR THE PROGRAMS IN PHYSICAL ACTIVITY. THE HOSPITAL SUPPORTS THE GYM, LEAGUES, AND SUMMER CAMP AT THE MAURICE J. TOBIN COMMUNITY CENTER AS WELL AS THE HEALTH EDUCATORS IN ACTION PROGRAM AT SOCIEDAD LATINA. FOR MANY YEARS, NEBH HAS MAINTAINED AND IS A MAJOR CONTRIBUTOR TO THE LIGHTING AT MCLAUGHLIN FIELD AT NIGHT TO FOSTER ITS USE FOR PHYSICAL ACTIVITY. OVER THE LAST YEAR, TEEN HEALTH EDUCATORS IMPLEMENTED A RANGE OF HEALTH AND WELLNESS ACTIVITIES RELATED TO FITNESS AND NUTRITION THAT REACHED MORE THAN 1,643 MISSION HILL YOUTH AND FAMILIES. HEALTH EDUCATORS HELD ENGAGING ACTIVITIES SURROUNDING FITNESS AND NUTRITION, INCLUDING SPINNING THE "WHEEL OF HEALTH" TO RECEIVE FUN PRIZES AND A JEOPARDY-STYLE TRIVIA GAME, AS WELL AS HOLDING PEER-TO-PEER CONVERSATIONS WITH COMMUNITY YOUTH ON THE IMPORTANCE OF MAKING HEALTHY FOOD AND BEVERAGE CHOICES. HEATH EDUCATORS ENCOURAGE AND ENABLE MISSION HILL YOUTH AND FAMILIES TO MAKE POSITIVE BEHAVIOR CHANGES THAT IMPROVE THEIR OVERALL HEALTH AND QUALITY OF LIFE.B.INCREASE PHYSICAL ACTIVITY -TARGET POPULATION: CHILDREN, YOUTH, AND ADULTS-PROGRAMMATIC OBJECTIVES: I.EDUCATE ON HEALTHY EATING AND ACTIVE LIVINGII.INCREASE THE NUMBER OF CHILDREN AND ADULTS WHO ARE PHYSICALLY ACTIVEIII.IMPROVE ACCESSIBILITY AND BEAUTIFY OF WALKWAYS, COMMUNITY PARKS, AND RECREATION AREAS-COMMUNITY ACTIVITIES:I.THE SUMMER CAMP AT THE BOSTON CENTER FOR YOUTH AND FAMILIES-TOBIN COMMUNITY CENTER, ENCOURAGES YOUNG CHILDREN TO EXERCISE AND KEEP ACTIVE TO PREVENT OBESITY. DURING THE SUMMER OF 2018, NEBH SPONSORED TEN ADOLESCENTS FROM MISSION HILL. THEY WERE ABLE TO ATTEND SUMMER CAMP, KEEPING THEM HEALTHY AND ACTIVE. II.NEBH HAS A LONG-STANDING COMMITMENT TO IMPROVING THE HEALTH STATUS OF BOSTON RESIDENTS, WITH A FOCUS ON MOVEMENT AND PREVENTION OF OBESITY. THE HOSPITAL SUPPORTS THE MISSION HILL LITTLE LEAGUE, BOSTON CENTER FOR YOUTH AND FAMILIES-TOBIN COMMUNITY CENTER, ROXBURY TENANTS OF HARVARD, MISSION HILL LEGACY PROJECT AND SOCIEDAD LATINA FOR THEIR PROGRAMS IN PHYSICAL ACTIVITY. EACH COMMUNITY GROUP HAS MANY EVENTS AND PROGRAMS THAT THE HOSPITAL SUPPORTS. THE HOSPITAL WILL CONTINUE TO SUPPORT THEIR PROGRAMS THAT KEEP PEOPLE ACTIVE AND MOVING.III.THIS PROGRAM ENCOURAGES ELDERLY MEMBERS OF THE BOSTON COMMUNITY TO MAINTAIN AN ACTIVE LIFESTYLE THROUGH PARTICIPATION IN FITNESS AND HEALTH EDUCATION CLASSES. TWO FITNESS CLASSES WERE HELD IN 2018, WITH OVER 150 SENIORS ATTENDING EACH SESSION. SENIORS PARTICIPATED IN PHYSICAL ACTIVITY AND LECTURES ABOUT NUTRITION AND HEALTHY EATING. NEBH NUTRITIONISTS, PHYSICAL THERAPISTS AND NURSES ARE PART OF THE PROGRAM. IV. THE JR. CELTICS PROGRAM CHALLENGES 3RD-5TH GRADERS TO DEVELOP THEIR BASKETBALL GAME THROUGH SKILLS, DRILLS AND LEADERSHIP TRAINING. ALSO, PROVIDING PHYSICAL ACTIVITY. THE JR. CELTICS HELD 2 PROGRAMS IN THE MISSION HILL AREA THAT BENEFITTED YOUTH IN MISSION HILL. OVER 600 3RD-5TH GRADERS PARTICIPATED IN THIS ONGOING PROGRAM.C.INCREASE HEALTHY EATINGTARGET POPULATION: CHILDREN, YOUTH & ADULTSPROGRAMMATIC OBJECTIVES: I.EDUCATE ON HEALTHY EATING AND ACTIVE LIVINGII.DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO SUFFER FROM FOOD INSECURITYIII.INCREASING ACCESS TO HEALTHY FOODS, FRUITS, AND VEGETABLES-COMMUNITY ACTIVITIES:I.SUPPORT COMMUNITY FOOD PANTRIESII.SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS, COOKING CLASSES, AND EDUCATION SESSIONSIII.PROMOTE PARTICIPATION IN MOBILE FARMERS' MARKETSIV.SUPPORT AND COLLABORATE WITH BOSTON FOOD & FITNESS COLLABORATIVEV.THERE IS A HUGE NEED IN MISSION HILL FOR ACCESS TO AFFORDABLE, HEALTHY FOOD. NEBH IS COMMITTED TO HELPING TO PROVIDE ACCESS TO AFFORDABLE, HEALTHY FOOD. NEBH OFFERS $1 COUPONS TO THE RESIDENTS OF ROXBURY TENANTS OF HARVARD (RTH) TO OFFSET THE COST OF FRESH FRUITS AND VEGETABLES AT THE $2 A BAG PROGRAM EACH MONTH AT RTH. OVER 100 PEOPLE PURCHASE FRESH FRUIT AND VEGETABLES EACH MONTH.MISSION HILL ELEMENTARY SCHOOL, MISSION HILL LEGACY PROJECT AND BOSTONCANSHARE HUNGER IS ON THE RISE IN MASSACHUSETTS. FOOD IS NEEDED TO SUSTAIN FAMILIES DURING THE HOLIDAYS, SCHOOL VACATIONS AND WHEN THE CHILDREN ARE NOT ATTENDING SCHOOL. NEBH PARTNERED THE MISSION HILL ELEMENTARY SCHOOL AND THE MISSION HILL LEGACY PROJECT TO COMBAT HUNGER. NEBH IS COMMITTED TO COMBATING HUNGER IN OUR LOCAL NEIGHBORHOODS. EACH YEAR, MUCH NEEDED FOOD IS GIVEN DURING THE THANKSGIVING AND CHRISTMAS HOLIDAYS AND DURING SCHOOL VACATIONS. FOOD IS PROVIDED TO SUPPLEMENT STUDENT AND FAMILY FOOD NEEDS, AS MEALS ARE NOT SERVED BY THE SCHOOL SYSTEM DURING VACATIONS. LUNCH IS ALSO PROVIDED DURING THE WINTER MONTHS FOR CHILDREN PARTICIPATING IN THE YMCA AND THE CHILL FOUNDATION'S SKI PROGRAM. DURING THE HOLIDAYS, FOOD IS GIVEN TO SENIORS IN NEED THROUGH THE MISSION HILL SENIOR LEGACY PROGRAM. NEBH PROVIDES FINANCIAL SUPPORT FOR THE FOOD PANTRY AT THE ABCD PARKER HILL/FENWAY SITE. THE PANTRY PROVIDES EMERGENCY FOOD FOR LOW INCOME FAMILIES IN THE COMMUNITY. THE PANTRY HELPS OVER 100 FAMILIES A MONTH WITH FOOD ASSISTANCE. NEBH PROVIDES FOOD AND STOP & SHOP GIFT CARDS TO FAMILIES FROM THE MISSION HILL SCHOOL DURING HOLIDAYS AND SCHOOL VACATIONS AND TO FAMILIES THAT LIVE IN MISSION HILL THROUGHOUT THE YEAR. LAST YEAR NEBH HELPED 46 FAMILIES WITH FOOD ASSISTANCE THROUGH STOP AND SHOP GIFT CARDS AND FOOD.NEBH DONATED TO THE BOSTON CAN SHARE PROGRAM WHICH IS THE ANNUAL FOOD DRIVE SPONSORED BY THE MAYOR'S OFFICE OF FOOD INITIATIVES. INCREASE ACCESS TO HEALTHY FOODS -- ACCESS TO HEALTHY FRUITS AND VEGETABLESAS IDENTIFIED IN THE CHNA, THERE IS A NEED IN MISSION HILL FOR ACCESS TO AFFORDABLE HEALTHY FOOD. NEBH IS COMMITTED TO PROVIDING ACCESS TO AFFORDABLE HEALTHY FOOD BY PARTNERING WITH THE MISSION HILL HEALTH MOVEMENT AND THE MISSION HILL FARMERS MARKET. NEBH OFFERED $2 COUPONS TO THE FARMERS MARKET EACH WEEK DURING THE SUMMER AND FALL TO MISSION HILL/ROXBURY RESIDENTS SO THAT THEY MAY PURCHASE FRESH FRUIT AND VEGETABLES AT A DISCOUNTED RATE. OVER 3,950 COUPONS WERE GIVEN OUT TO COMMUNITY RESIDENTS.D.INCREASING SCREENING, IDENTIFICATION AND REFERRAL FOR PEOPLE WITH CHRONIC DISEASE AND / OR ASSOCIATED RISK FACTORSTARGET POPULATION: CHILDREN, YOUTH & ADULTS-PROGRAMMATIC OBJECTIVES:I.PROMOTE OBESITY SCREENING FOR CHILDREN AND YOUTH IN COMMUNITY BASED SETTINGII.LINK CHILDREN AND YOUTH WHO ARE OVERWEIGHT OR OBESE TO EVIDENCE BASED PROGRAMS THAT PROMOTE HEALTHY EATING AND ACTIVE LIVINGIII.INCREASE THE NUMBER OF ADULTS SCREENED FOR HYPERTENSION, DIABETES, DEPRESSION, HIGH CHOLESTEROL, AND OTHER LEADING CHRONIC DISEASESIV.LINK THOSE WHO HAVE CHRONIC DISEASE OR ITS ASSOCIATED RISK FACTORS TO PRIMARY CARE AND/OR EVIDENCE-BASED CHRONIC DISEASE MANAGEMENT PROGRAMS-COMMUNITY ACTIVITIES:I.NEBH PROVIDES MUCH NEEDED MEDICAL SUPPLIES TO THE MISSION HILL ELEMENTARY SCHOOL. EACH YEAR, A REQUEST COMES FROM THE SCHOOL NURSE FOR ITEMS SUCH AS COUGH MEDICINE, BAND AIDS, ACETAMINOPHEN, IBUPROFEN, COUGH DROPS, BANDAGES, ETC.II.THROUGH ROXBURY TENANTS OF HARVARD AND MISSION HILL MOVEMENT HEALTH, NEBH SUPPORTSAND PROMOTE COMMUNITY HEALTH FAIRS AND SCREENING/REFERRAL EVENTSIII.SUPPORT THE MISSION HILL HEALTH MOVEMENT'S ANNUAL HEALTH FAIR.OBESITY, FITNESS, NUTRITION, AND CHRONIC DISEASE - COMMUNITY PARTNERS: -BOSTON PUBLIC HEALTH COMMISSION-SOCIEDAD LATINA-ROXBURY TENANTS OF HARVARD (RTH)-MISSION MAIN-TOBIN COMMUNITY CENTER-MISSION HILL HEALTH MOVEMENT-ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD)-PUBLIC HOUSING FACILITIES-LITTLE LEAGUE-MISSION HILL LEGACY PROJECT-MARIA SANCHEZ HOUSE-BOSTON CELETICSPRIORITY AREA # 3 : ELDER HEALTHIN THE UNITED STATES, IN THE COMMONWEALTH, AND IN NEBH'S CBSA, PARTICULARLY ON MISSION HILL, OLDER ADULTS ARE ONE OF THE FASTEST GROWING POPULATIONS AND ARE WIDELY CONSIDERED TO BE AMONG THOSE MOST AT-RISK. THE FIRST "BABY BOOMERS" (ADULTS BORN BETWEEN 1946 AND 1964) TURNED 65 IN 2011 AND OVER THE NEXT 20 YEARS THESE "BABY BOOMERS" WILL GRADUALLY ENTER THE OLDER ADULT COHORT. OLDER ADULTS ARE MUCH MORE LIKELY TO DEVELOP CHRONIC ILLNESSES AND RELATED DISABILITIES SUCH AS HEART DISEASE, HYPERTENSION, AND DIABETES AS WELL AS CONGESTIVE HEART FAILURE, DEPRESSION,
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PRIORITY AREA # 3 : ELDER HEALTH CONTINUED
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ANXIETY, ALZHEIMER'S, PARKINSON'S DISEASE, AND DEMENTIA. BY 2030, THE CDC AND THE HEALTHY PEOPLE 2020 INITIATIVE ESTIMATES THAT 37 MILLION PEOPLE NATIONWIDE (60% OF THE OLDER ADULT POPULATION 65+) WILL MANAGE MORE THAN ONE CHRONIC MEDICAL CONDITION. MANY EXPERIENCE HOSPITALIZATIONS, NURSING HOME ADMISSIONS, AND LOW-QUALITY CARE. THEY ARE ALSO PRONE TO FALLS AND MAY LOSE THEIR ABILITY TO LIVE INDEPENDENTLY AT HOME. CHRONIC CONDITIONS AND UNINTENTIONAL INJURY ARE AMONG THE LEADING CAUSE OF ILLNESS AND DEATH AMONG OLDER ADULTS.30 ACCORDING TO QUALITATIVE INFORMATION GATHERED THROUGH INTERVIEWS AND COMMUNITY FORUMS, ELDER HEALTH IS ONE OF THE HIGHEST PRIORITIES. CHRONIC DISEASE, DEPRESSION, ISOLATION AND FRAGMENTATION OF SERVICES WERE IDENTIFIED AS SOME OF THE LARGEST ISSUES FACING THE AREA'S SENIOR POPULATION.A.PROMOTE GENERAL HEALTH AND WELLNESS FOR ELDERS-TARGET POPULATION: ELDERS-PROGRAMMATIC OBJECTIVES: I.INCREASE GENERAL KNOWLEDGE ABOUT CHRONIC DISEASE, PHYSICAL ACTIVITY, NUTRITION, BEHAVIORAL HEALTH, AND FALLS PREVENTION -COMMUNITY ACTIVITIES:I.SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS AND EDUCATIONAL SESSIONS II.CREATE AN ELDER HEALTH EDUCATION AND PREVENTION CENTERIII.WEEKLY YOGA CLASS FOR SENIORS AT THE BOSTON PUBLIC LIBRARY, PARKER HILL BRANCH. THE BENEFITS FROM YOGA INCLUDE FLEXIBILITY, INCREASED MUSCLE STRENGTH AND TONE, IMPROVED RESPIRATION, ENERGY AND VITALITY, MAINTAINING A BALANCED METABOLISM, WEIGHT REDUCTION, CARDIO AND CIRCULATORY HEALTH, AND PROTECTION FROM INJURY. KEEPING YOUR JOINTS MORE FLEXIBLE CAN HELP REDUCE PAIN THROUGH GENTLE STRETCHING. EACH WEEK, BETWEEN 20-25 OLDER ADULTS PARTICIPATE IN YOGA.IV.NEBH COLLABORATED WITH THE BOSTON CELTICS ON SR. CELTICS. THE SR. CELTICS PROGRAM ENCOURAGES ELDERLY MEMBERS OF THE MISSION HILL/ROXBURY COMMUNITY TO MAINTAIN AN ACTIVE LIFESTYLE THROUGH PARTICIPATION IN FITNESS AND HEALTH EDUCATION CLASSES. CELTICS PLAYERS, LEGENDS AND NEW ENGLAND BAPTIST HOSPITAL STAFF LED SENIORS IN GROUP WORKOUTS AND DISCUSSED THE BENEFITS OF PHYSICAL EXERCISE.V.EASY STEPS PROGRAM AND HEALTHY MOVES ARE PROGRAMS FOR SENIORS THAT FOCUS ON STRENGTH, BALANCE, FLEXIBILITY, ENDURANCE, NUTRITION AND FALL PREVENTION. EVERY WEEK, BETWEEN 15-20 ELDER RESIDENTS PARTICIPATE IN THE EASY STEPS AND HEALTHY MOVES PROGRAMS. RESIDENTS HAVE REPORTED THAT THEY FEEL HEALTHIER, STRONGER AND HAVE MORE ENERGY. B. REDUCE FALLS FOR ELDERS-TARGET POPULATION: ELDERS-PROGRAMMATIC OBJECTIVES: I.INCREASE BALANCE TRAINING AND PHYSICAL ACTIVITY; MEDICAL MANAGEMENT OF EXISTING ILLNESS; AND ENVIRONMENTAL/HOME MODIFICATIONS TRANSPORTATION - THE MISSION LINKBECAUSE THE NEIGHBORHOOD OF MISSION HILL IS LOCATED ON A STEEP HILL, AT THE HIGHEST ELEVATION IN BOSTON, IT PRESENTS A SIGNIFICANT ISSUE TO MOBILITY FOR THE ELDERLY POPULATION. THE NEED FOR REGULAR TRANSPORTATION TO AVOID SOCIAL ISOLATION OF THOSE SENIORS IN THE MISSION HILL COMMUNITY WAS IDENTIFIED AS A CRITICAL ISSUE DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT. NEBH HAS BEEN A MAJOR SPONSOR OF THE MISSION LINK BUS FOR MANY YEARS TO INCREASE ACCESS TO HEALTHY FOOD OPTIONS, MEDICAL CARE, AND PUBLIC TRANSPORTATION. C.DECREASE DEPRESSION AND SOCIAL ISOLATION IN ELDERS-TARGET POPULATION: ELDERS-PROGRAMMATIC OBJECTIVES: I.INCREASE THE NUMBER OF MISSION HILL RESIDENTS WHO HAVE ACCESS TO AFFORDABLE TRANSPORTATIONII.REDUCE ISOLATIONIII.INCREASE SCREENING, IDENTIFICATION, AND REFERRAL FOR ELDERS WITH DEPRESSION -COMMUNITY ACTIVITIES:I.THERE ARE MANY ISSUES RELATED TO OLDER ADULT HEALTH WITH ISOLATION BEING ONE OF THEM. NEBH IS COMMITTED TO THE SENIORS LIVING IN AND AROUND MISSION HILL/ROXBURY/JAMAICA PLAIN TO HELP WITH ELDER ISOLATION. IN 2018, NEBH HELD A BIRTHDAY CELEBRATION EACH QUARTER FOR SENIORS LIVING IN MISSION HILL/ROXBURY/JAMAICA PLAIN. BETWEEN 100-125 SENIORS FROM THE AREA COME TO THE CELEBRATION. THE PARTY IS HELD AT A DIFFERENT HOUSING DEVELOPMENT OR COMMUNITY AGENCY 4 TIMES A YEAR. SENIORS RECEIVE A HEALTHY LUNCH, GIFT AND ENJOY ENTERTAINMENT. II.MONTHLY BINGO AT THE MARIA SANCHEZ HOUSE - EACH MONTH, STAFF FROM NEBH PLAY BINGO WITH THE RESIDENTS OF THE MARIA SANCHEZ HOUSE. THIS HELPS WITH SOCIALIZING AND GETTING SENIORS OUT OF THEIR APARTMENT WHILE HAVING FUN. NEBH PROVIDES HEALTHY SNACKS AND PRIZES. III.THIS EXERCISE CLASS CONCENTRATES ON STRENGTH, BALANCE, FLEXIBILITY, AND ENDURANCE AND ENCOURAGES RELAXATION AND BREATHING TO FOCUS THE MIND AND DEAL WITH STRESS. EIGHT CLASSES WERE HELD OVER TWO MONTHS WITH 15 PEOPLE ATTENDING. WORKING WITH RTH ON INCREASING PARTICIPATION. D.INCREASE SCREENING, IDENTIFICATION AND REFERRAL FOR HEALTH ISSUES SUCH AS OSTEOPOROSIS, ARTHRITIS / LUPUS, AND DEPRESSIONTARGET POPULATION: ELDERSPROGRAMMATIC OBJECTIVES: I.INCREASE THE NUMBER OF ELDERS SCREENED FOR OSTEOPOROSIS, ARTHRITIS/LUPUS, DEPRESSION, JOINT ISSUES, AND OTHER LEADING ELDER HEALTH ISSUES/CONDITIONSII.LINK THOSE WHO HAVE CHRONIC DISEASE OR OTHER HEALTH ISSUES TO APPROPRIATE PRIMARY AND SPECIALTY CARE COMMUNITY ACTIVITIES:I.EVERY MONTH, 12-15 PEOPLE WITH ARTHRITIS AND OR LUPUS ATTEND THE SUPPORT GROUP. THE GROUP LEADER IS ALWAYS AVAILABLE FOR QUESTIONS AND CALLS FROM POTENTIAL GROUP MEMBERS. THE GROUP LEADER IS ALWAYS LOOKING FOR NEW MEMBERS AND SENDS OUT A MONTHLY MAILING TO THE GROUP AND POTENTIAL MEMBERS.II.RAISE FUNDS FOR THE GREATER BOSTON ARTHRITIS FOUNDATION'S JINGLE BELL RUN AND INCREASE AWARENESS TO HELP CURE AMERICA'S #1 CAUSE OF DISABILITY.OSTEOPOROSIS OSTEOPOROSIS IS A MAJOR PUBLIC HEALTH THREAT FOR AN ESTIMATED 54 MILLION AMERICANS AGE 50 AND OLDER. TWENTY PERCENT OF NON-HISPANIC CAUCASIAN AND ASIAN WOMEN AGED 50 AND OLDER ARE ESTIMATED TO HAVE OSTEOPOROSIS, AND 52 PERCENT ARE ESTIMATED TO HAVE LOW BONE MASS. THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH (DPH) HAS IDENTIFIED OSTEOPOROSIS AS A PUBLIC HEALTH ISSUE AND ESTABLISHED THE OSTEOPOROSIS AWARENESS PROGRAM. PHYSICAL ACTIVITY CAN IMPROVE THE OVERALL HEALTH AND WELL-BEING OF OLDER ADULTS. EVEN MODEST LEVELS OF ACTIVITY, DONE EACH DAY FOR A TOTAL OF 30 MINUTES, CAN PREVENT OR CONTROL OSTEOPOROSIS AND WEIGHT GAIN. NEBH SUPPORTS TWO WALKING GROUPS AT ROXBURY TENANTS OF HARVARD (RTH): A WALKING/EXERCISE PROGRAM HELD IN MISSION HILL, SERVING BETWEEN 20-40 WOMEN AND MEN BETWEEN THE AGES OF 40 AND 90 FROM ALL ETHNIC BACKGROUNDS AT EACH SESSION. THE HOSPITAL ALSO OFFERS EDUCATIONAL PROGRAMS SUCH AS STRETCHING, EATING HEALTHY, ETC. TO THIS GROUP. IN ADDITION TO RTH, NEBH SUPPORTS SR. CELTICS AND WEEKLY YOGA FOR SENIORS AT THE BOSTON PUBLIC LIBRARY, PARKER HILL BRANCH, MENTIONED ABOVE, TO PROMOTE HEALTHY AND ACTIVE LIFESTYLE.-ELDER CARE - COMMUNITY PARTNERS-BOSTON PUBLIC HEALTH COMMISSION-MISSION HILL HEALTH MOVEMENT-ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD)-ROXBURY TENANTS OF HARVARD (RTH)-LEGACY PROJECT-PUBLIC HOUSING FACILITIES-MA DEPARTMENT OF PUBLIC HEALTH-NEBH AND CAREGROUP MEMBER ORGANIZATIONS2016 COMMUNITY HEALTH IMPLEMENTATION STRATEGY/PLAN - ISSUES NOT ADDRESSEDAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, NEBH IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, AS NOTED IN SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT INCLUDED IN THE IMPLEMENTATION STRATEGY/CHIP. IN THE 2016 CHIP THAT GUIDED THE NEBH COMMUNITY BENEFIT ACTIVITIES FOR THE FISCAL PERIOD COVERED BY THIS FILING, EXAMPLES OF IDENTIFIED NEEDS THAT WERE NOT MET ARE CHRONIC DISEASE, BEHAVIORAL HEALTH AND MATERNAL AND CHILD HEALTH. NEBH IS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES. IN ADDITION, THE HOSPITAL IS AN ORTHOPEDIC SPECIALTY-REFERRAL HOSPITAL FOR THE NEW ENGLAND REGION. IT IS NOT A FULL-SERVICE COMMUNITY HOSPITAL. BECAUSE OF THIS, AND TO AVOID DUPLICATION OF SERVICES, THE HOSPITAL IDENTIFIED RESOURCES AND STRENGTHS IN ITS SPECIALTY AREAS WHEN DETERMINING ITS PRIORITIES IN ITS IMPLEMENTATION STRATEGY/PLAN. (SCHEDULE H PART V SECTION B QUESTION 11)AS NOTED IN DETAIL ABOVE, NEBH'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND CHIP (SCHEDULE H PART VI QUESTION 2). ISSUES NOT ADDRESSED: CHRONIC DISEASE NEW ENGLAND BAPTIST HOSPITAL IS FULLY ENGAGED THROUGH ITS AFFILIATIONS WITH OTHER HOSPITALS, CLINICS AND PHYSICIAN GROUPS WHO HAVE SIGNIFICANT EXPERTISE IN CHRONIC DISEASE MANAGEMENT TO ENSURE THAT THE NEEDS OF OUR COMMUNITY ASSOCIATED WITH DIABETES, CONGESTIVE HEART FAILURE, ETC., ARE MET. BEHAVIORAL HEALTH SUPPORT PROGRAMS IN NEARBY CLINICS AND HOSPITALS HAVE BEEN ESTABLISHED TO PROVIDE BEHAVIORAL HEALTH MANAGEMENT TO BETTER ASSESS, MONITOR AND TREAT PATIENTS WITH MOOD DISORDER, SUBSTANCE ABUSE, ETC., IN OUR COMMUNITY. MATERNAL AND CHILD HEALTH NEW ENGLAND BAPTIST DOES NOT PROVIDE MATERNAL AND CHILD HEALTH.
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MATERNAL AND CHILD HEALTH CONTINUED
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THE COMMUNITY IS SURROUNDED BY MEDICAL INSTITUTIONS THAT OFFER THESE SERVICES.PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTHPRIORITY AREA 2: CHRONIC DISEASE MANAGEMENT AND PREVENTIONON-GOING PLANNING, COMMUNITY ENGAGEMENT, AND IMPLEMENTATIONHISTORICALLY, NEBH HAS RELIED HEAVILY ON MISSION HILL'S AND ROXBURY'S LEADING HEALTH AND SOCIAL SERVICE ORGANIZATIONS TO IMPLEMENT ITS COMMUNITY BENEFIT INITIATIVES. TO THIS END, THE HOSPITAL HAS PROVIDED FINANCIAL SUPPORT DIRECTLY TO COMMUNITY ORGANIZATIONS SUCH AS SOCIEDAD LATINA, THE TOBIN COMMUNITY CENTER, MISSION HILL SENIOR LEGACY PROJECT, ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD), MISSION HILL LITTLE LEAGUE, AND THE ROXBURY TENANTS OF HARVARD (RTH) AS WELL AS MANY OTHER ORGANIZATIONS. NEBH WILL CONTINUE TO OPERATE IN THIS MANNER BUT WILL ALSO EXPAND EXISTING AND DEVELOP NEW COMMUNITY EDUCATION, OUTREACH, HEALTH PROMOTION, AND COMMUNITY ENRICHMENT ACTIVITIES. THIS ASSESSMENT WAS MEANT TO ENSURE THAT THE COMMUNITY BENEFIT PROGRAM WAS ALIGNED WITH AND RESPONSIVE TO THE NEEDS OF ITS TARGET POPULATION. ALL THE ACTIVITIES DISCUSSED IN NEBH'S COMMUNITY HEALTH IMPROVEMENT PLAN ARE ALIGNED WITH KEY FINDING IDENTIFIED DURING THE ASSESSMENT.THE EFFORTS THAT ARE PART OF NEBH'S COMMUNITY HEALTH IMPROVEMENT PLAN WILL BE IMPLEMENTED AND COORDINATED BY CHRISTINE DWYER, DIRECTOR OF PUBLIC AFFAIRS AND COMMUNITY RELATIONS AT NEBH, WHO WILL WORK IN CLOSE CONCERT WITH NEBH'S COMMUNITY BENEFIT COMMITTEE AND PATIENT AND FAMILY ADVISORY COUNCIL AS WELL AS KEY STAKEHOLDERS THROUGHOUT THE COMMUNITY. ULTIMATELY, THE COMMUNITY HEALTH IMPROVEMENT PLAN WILL BE OVERSEEN BY DAVID PASSAFARO, SR. VICE PRESIDENT, EXTERNAL AFFAIRS AND NEBH'S PRESIDENT'S COUNCIL, WHICH IS COMPRISED OF THE HOSPITAL'S SENIOR LEADERSHIP TEAM.NEW ENGLAND BAPTIST HOSPITAL IS COMMITTED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS TO STRENGTHEN THE COMMUNITY AND IMPROVE OVERALL HEALTH AND WELL-BEING. NEBH IS ALSO COMMITTED TO LEVERAGING EXISTING RESOURCES AND BUILDING LOCAL CAPACITY. NEBH LOOKS FORWARD TO STRENGTHENING ITS CONNECTIONS AND TO CONTINUED COLLABORATION WITH THE AREA'S SOCIAL SERVICE ORGANIZATIONS, COMMUNITY GROUPS, AND RESIDENTS.FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW NEBH CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AS WELL AS COMMUNITY BUILDING ACTIVITIES. AS DEMONSTRATED IN THIS SCHEDULE H, DURING THE PERIOD COVERED BY THIS FILING, 4.1% OF THE NEBH'S TOTAL EXPENSES WERE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. IN ADDITION AS NOTED IN THE NARRATIVE BELOW, THERE ARE ADDITIONAL ACTIVITIES AND EXPENDITURES WHICH NEBH CONSIDERS FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. UNDER THE INSTRUCTIONS TO THIS SCHEDULE H QUESTION 7 THESE ITEMS ARE NOT QUANTIFIED IN SCHEDULE H QUESTION 7, BUT IT IS WORTH NOTING THAT IF NEBH HAD INCLUDED THESE IN SCHEDULE H QUESTION 7, THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WOULD BE 11.71% FOR THE PERIOD COVERED BY THIS FILING. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AT COST AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - FINANCIAL ASSISTANCE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEAS REPORTED IN THE NEBH CONSOLIDATED FINANCIAL STATEMENT AND IN THIS FORM 990, SCHEDULE H, NEBH'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND PAYMENTS TO AND RECEIPTS FROM THE HEALTH SAFETY NET TRUST, WAS $3,223,843 IN FISCAL YEAR ENDED SEPTEMBER 30, 2018 AND HAS BEEN REPORTED AS PART OF THE FINANCIAL ASSISTANCE AND CHARITY CARE REPORTED IN THIS SCHEDULE H, PART I, LINE 7A. OTHER UNCOMPENSATED CHARITY CARE - MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, NEW ENGLAND BAPTIST HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW INCOME FAMILIES, INCLUDING THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS WHICH INSURE LOW INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, NEBH COLLECTED $1,125,647 IN MEDICAID REVENUE WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY NEBH FOR SUCH SERVICES BY $772,851 AS REPORTED ON THIS SCHEDULE H, PART I, LINE 7B. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND THE HOSPITAL PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 35.36% OR 44,617 OF NEBH'S PATIENT ENCOUNTERS WERE WITH MEDICARE PATIENTS. THIS TRANSLATED TO MEDICARE REVENUE OF $71,485,789. HOWEVER, BECAUSE PAYMENTS TO HOSPITALS THROUGH THIS GOVERNMENT SPONSORED PROGRAM HAVE NOT KEPT PACE WITH INFLATION, REVENUE COLLECTED WAS LESS THAN THE COST OF SERVICES BY $17,990,558. OF THIS AMOUNT, $326,475 IS INCLUDED IN FORM 990 SCHEDULE H PART I, LINE 7G AND RELATED TO THE PROVISION OF SUBSIDIZED HEALTH SERVICES FOR PROVIDING CASTS AND MRSA TEST TO PATIENTS. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH NEBH CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE ADDITIONAL MEDICARE SHORTFALL OF $17,988,618 IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, NEBH HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. IF NEBH HAD INCLUDED THE FULL MEDICARE SHORTFALL IN SCHEDULE H QUESTION 7, THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WOULD BE 11.71% FOR THE PERIOD COVERED BY THIS FILING. BAD DEBTSAS REPORTED IN THE NEBH AUDITED FINANCIAL STATEMENT FOR THE PERIOD COVERED BY THIS FILING, IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, NEBH ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS, AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES WERE $41,751 DURING THE FISCAL PERIOD COVERED BY THIS FILING AS REPORTED IN THE FINANCIAL STATEMENTS AND IN THIS FORM 990 SCHEDULE H, PART III AS REQUIRED.AS REQUIRED BY THIS FORM 990, SCHEDULE H, PART III, LINE 4, BELOW ARE THE BAD DEBT AND ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTES FROM THE NEBH AUDITED FINANCIAL STATEMENTS. AS PREVIOUSLY NOTED IN THIS FORM 990, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF NEBH AND AFFILIATES FOR FISCAL YEAR ENDED SEPTEMBER 30, 2018 INCLUDE THE ACCOUNTS OF THE NEW ENGLAND BAPTIST MEDICAL ASSOCIATES AN ENTITY INTEGRALLY RELATED TO HELPING NEBH ACCOMPLISH ITS CHARITABLE PURPOSES. THE NEBH FORM 990 IS PREPARED FOR NEBH ONLY AND AS SUCH, THE METRICS INCLUDED IN THESE FOOTNOTES WILL NOT TIE TO THE FACE OF THE NEBH FORM 990, SCHEDULE H.FINANCIAL STATEMENT FOOTNOTES:BAD DEBTSTHE AUDITED FINANCIAL STATEMENTS OF NEW ENGLAND BAPTIST HOSPITAL (HOSPITAL) INCLUDE THE HOSPITAL AND NEW ENGLAND BAPTIST MEDICAL ASSOCIATES, OF WHICH NEBH IS ITS SOLE MEMBER. FOOTNOTE 3 (INCLUDED IN ITS ENTIRETY BELOW) OF THOSE STATEMENTS DESCRIBE AND DETAIL FY 2018 BAD DEBT EXPENSE. IN ADDITION, AS NOTED IN SCHEDULE H PART III SECTION A QUESTION 1, THE HOSPITAL RECORDS BAD DEBTS IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. AS SUCH, THE EXPENSE REPRESENTS THE EXPECTED LOST REVENUE RATHER THAN THE FULL CHARGES OR AT COST.(3) COMMUNITY SERVICE AND UNCOMPENSATED CARETHE COST OF THE CORPORATION'S UNREIMBURSED CHARITY AND OTHER UNCOMPENSATED CARE CONSISTED OF THE FOLLOWING (IN THOUSANDS): YEAR ENDED SEPTEMBER 30 2018 2017UNREIMBURSED CHARITY CARE-AT COST $89 $37UNCOMPENSATED CARE EXPENSE $4,112 $5,068 TOTAL $4,201 $5,105(A) UNREIMBURSED CHARITY CARETHE CORPORATION PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY.
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FINANCIAL STATEMENT FOOTNOTES CONTINUED
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BECAUSE THE CORPORATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE EXCEPT TO THE EXTENT REIMBURSED BY THE STATEWIDE HEALTH SAFETY NET (HSN).THE AMOUNT OF CHARITY CARE AT ESTABLISHED CHARGES, AND THE COST OF UNREIMBURSED CHARITY CARE AS ESTIMATED USING AN OVERALL RATIO OF COST TO CHARGE PROVIDED BY THE CORPORATION, IS COMPRISED OF THE COMPONENTS LISTED BELOW (IN THOUSANDS): YEAR ENDED SEPTEMBER 30 2018 2017CHARITY CARE-AT ESTABLISHED CHARGES $154 $65ESTIMATED COST OF CHARITY CARE $89 $37 B) UNCOMPENSATED CARETHE CORPORATION ALSO PROVIDES FOR THE DELIVERY OF CHARITY CARE TO THE INDIGENT STATEWIDE THROUGH PAYMENTS TO THE HSN THAT IS OPERATED BY THE COMMONWEALTH OF MASSACHUSETTS. IN ADDITION, THE CORPORATION PROVIDES SERVICES THAT WERE NOT PAID BY PATIENTS AND, THEREFORE, ARE RECORDED AS BAD DEBTS. THE CORPORATION HAS REPORTED ITS GROSS OBLIGATION TO THE HSN FOR THE DELIVERY OF CHARITY CARE TO THE INDIGENT STATEWIDE AND BAD DEBTS AMOUNTING TO $3,134 AND $4,149 AT SEPTEMBER 30, 2018 AND 2017, RESPECTIVELY, WHICH IS REFLECTED AS UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS.PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSPATIENTS ACCOUNTS RECEIVABLE ARE REFLECTED NET OF AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST COLLECTION HISTORY, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN GOVERNMENTAL AND EMPLOYEE HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS FOR EACH OF ITS MAJOR CATEGORIES OF REVENUE BY PAYER TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR CATEGORIES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THROUGHOUT THE YEAR, THE CORPORATION, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, WILL WRITE OFF THE DIFFERENCE BETWEEN THE STANDARD RATES (OR DISCOUNTED RATES IF APPLICABLE) AND THE AMOUNT ACTUALLY COLLECTED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN ADDITION TO THE REVIEW OF THE CATEGORIES OF REVENUE, MANAGEMENT MONITORS THE WRITE OFFS AGAINST ESTABLISHED ALLOWANCES TO DETERMINE THE APPROPRIATENESS OF THE UNDERLYING ASSUMPTIONS USED IN ESTIMATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTSFINANCIAL ASSISTANCE POLICY - INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE NEBHS MISSION IS TO TRANSFORM PATIENTS' LIVES BY PROMOTING WELLNESS, RESTORING FUNCTION, LESSENING DISABILITY, ALLEVIATING PAIN, AND ADVANCING KNOWLEDGE IN MUSCULOSKELETAL DISEASES AND RELATED DISORDERS.NEBH ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. NEBH MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY WHICH IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE RECEIVED FROM QUALIFYING NEBH PROVIDERS.NEBH DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) WHICH APPLIES TO ALL MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY. ALTHOUGH NEBH IS NOT LICENSED TO OPERATE AN EMERGENCY DEPARTMENT, NEBH STILL PROVIDES CARE TO ALL WHO NEED URGENT CARE, REGARDLESS OF THEIR ABILITY TO PAY. ALL PATIENTS WHO PRESENT AT NEBH ARE TRIAGED TO THE APPROPRIATE VENUE FOR THEIR CARE DEPENDING UPON THEIR CLINICAL PRESENTATION. A CLINICAL RESOURCE NURSE AND HOSPITALIST COLLABORATE TO IDENTIFY VENUE PRIOR TO THE ARRIVAL OF PATIENT WHEN POSSIBLE. THE HOSPITALIST WILL MAKE A DETERMINATION AS TO THE BEST PATIENT DISPOSITION. CLINICAL SITUATIONS RECEIVED BY PHONE OR WALK-IN REQUIRING EMERGENCY MANAGEMENT ARE DIRECTED TO THE NEAREST EMERGENCY DEPARTMENT, SUCH AS BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A RELATED AFFILIATE AND TERTIARY CARE ACADEMIC MEDICAL CENTER WHICH OPERATES A LEVEL 1 TRAUMA EMERGENCY DEPARTMENT 24 HOURS A DAY, 7 DAYS A WEEK AND WHICH IS LOCATED APPROXIMATELY 1 MILE FROM NEBH.(SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY THE HOSPITAL'S BOARD PRIOR TO SEPTEMBER 30, 2018 AND THESE DOCUMENTS WERE ALL EFFECTIVE AS OF OCTOBER 1, 2017, THE FIRST DAY OF THE HOSPITAL'S FISCAL YEAR IN WHICH THE HOSPITAL WAS REQUIRED TO BE IN COMPLIANCE WITH THE REGULATIONS PROMULGATED BY THE TREASURY AND RELATED TO IRC SECTION 501(R). FINANCIAL ASSISTANCE POLICY - APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY - ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE - PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.
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FINANCIAL STATEMENT FOOTNOTES CONTINUED
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THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY - TRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, USING THE HEALTH AND HUMAN SECRETARY GUIDANCE SAFE HARBOR OF 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS. BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: GREEK, PORTUGUESE, RUSSIAN AND SPANISH. (SCHEDULE H PART V SECTION B QUESTION 16I).FINANCIAL ASSISTANCE POLICY - WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL OR BY MAIL FREE OF CHARGE AND ON THE HOSPITAL'S WEBSITE AT (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H):WWW.NEBH.ORG/POLICIESIN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY - PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION (INCLUDING THE BUILDING AND ROOM NUMBER) AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LIMITATION ON CHARGES - INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY URGENT OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED - LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00.
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BILLING AND COLLECTIONS -- 501(R)(6)
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EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLANDETAIL RELATED TO THE NEBH COMMUNITY HEALTH NEEDS ASSESSMENT, IMPLEMENTATION STRATEGY AND COMMUNITY BENEFITS ACTIVITIES HAS BEEN PROVIDED IN FORM 990, SCHEDULE H, PART V, SECTION C ABOVE.COMMUNITY BENEFITS - ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, THE HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016 AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, NEBH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND AT THE HOSPITAL UPON REQUEST AND ON NEBH'S WEBSITE AT: HTTPS://WWW.NEBH.ORG/WHO-WE-ARE/GIVING-BACK/ THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT THE HOSPITAL FILED WITH THE ATTORNEY GENERAL'S OFFICE.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.