| FORM 990, PART I AND PART III, LINE 1 |
MISSION STATEMENT FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $3.4 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS OVER HALF A MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF 2,600 AFFILIATED PHYSICIANS AND 18,000 EMPLOYEES AMONG ITS FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH CARE, AND AN AMBULATORY CARE NETWORK OF CLINICS, PHYSICIANS' OFFICES AND OUTPATIENT CENTERS THROUGHOUT THE SAN DIEGO REGION. RECOGNIZED AS A LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE, SCRIPPS IS ALSO AT THE FOREFRONT OF CLINICAL RESEARCH, GENOMIC MEDICINE, WIRELESS HEALTH AND GRADUATE MEDICAL EDUCATION. WITH THREE HIGHLY RESPECTED GRADUATE MEDICAL EDUCATION PROGRAMS, SCRIPPS IS A LONG STANDING MEMBER OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES. MORE INFORMATION CAN BE FOUND AT WWW.SCRIPPS.ORG. TODAY, THE HEALTH SYSTEM EXTENDS FROM CHULA VISTA TO OCEANSIDE, WITH 26 PRIMARY AND SPECIALTY CARE OUTPATIENT CENTERS. A LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE, SCRIPPS WAS NAMED BY TRUVEN IN 2013 AS ONE OF THE TOP 15 LARGE HEALTH SYSTEMS IN THE NATION FOR PROVIDING HIGH-QUALITY, SAFE AND EFFICIENT PATIENT CARE. ON THE FOREFRONT OF GENOMIC MEDICINE AND WIRELESS HEALTH TECHNOLOGY, THE ORGANIZATION IS DEDICATED TO IMPROVING COMMUNITY HEALTH WHILE ADVANCING MEDICINE THROUGH CLINICAL RESEARCH AND GRADUATE MEDICAL EDUCATION. SCRIPPS HAS ALSO EARNED A NATIONAL REPUTATION AS A PREMIER EMPLOYER, NAMED BY FORTUNE MAGAZINE AS ONE OF AMERICA'S "100 BEST COMPANIES TO WORK FOR" EVERY YEAR SINCE 2008. SCRIPPS HEALTH'S MISSION STATEMENT IS AS FOLLOWS: SCRIPPS STRIVES TO PROVIDE SUPERIOR HEALTH SERVICES IN A CARING ENVIRONMENT AND TO MAKE A POSITIVE MEASURABLE DIFFERENCE IN THE HEALTH OF INDIVIDUALS IN THE COMMUNITIES WE SERVE. WE DEVOTE OUR RESOURCES TO DELIVERING QUALITY, SAFE, COST-EFFECTIVE, AND SOCIALLY RESPONSIBLE HEALTH CARE SERVICES. WE ADVANCE CLINICAL RESEARCH, HEALTH EDUCATION, EDUCATION OF PHYSICIANS AND HEALTH CARE PROFESSIONALS, AND SPONSOR GRADUATE MEDICAL EDUCATION. WE COLLABORATE WITH OTHERS TO DELIVER THE CONTINUUM OF CARE THAT IMPROVES THE HEALTH OF OUR COMMUNITY. |
| FORM 990, PART III, LINE 4A |
FULFILLING THE SCRIPPS MISSION DURING THIS FISCAL YEAR, SCRIPPS DEVOTED $442,735,122 TO COMMUNITY BENEFIT PROGRAMS AND SERVICES IN THE AREAS OF UNCOMPENSATED CARE, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND HEALTH RESEARCH. OUR PROGRAMS EMPHASIZE COMMUNITY-BASED PREVENTION EFFORTS AND USE INNOVATIVE APPROACHES TO REACH RESIDENTS AT GREATEST RISK FOR HEALTH PROBLEMS. WE MAKE COMMITMENTS TO IMPROVE THE HEALTH OF OUR PATIENTS AND OUR SAN DIEGO COMMUNITIES. AS A LONG-STANDING MEMBER OF THESE COMMUNITIES, AND AS A NOT-FOR-PROFIT COMMUNITY RESOURCE, OUR GOAL AND RESPONSIBILITY ARE TO PROVIDE HELP AND ASSISTANCE FOR ALL WHO COME TO US FOR CARE, AND TO REACH OUT ESPECIALLY TO THOSE WHO FIND THEMSELVES VULNERABLE AND WITHOUT SUPPORT. THIS RESPONSIBILITY IS AN INTRINSIC PART OF OUR MISSION. THROUGH OUR CONTINUED ACTIONS AND COMMUNITY PARTNERSHIPS, WE STRIVE TO RAISE THE QUALITY OF LIFE IN THE COMMUNITY AS A WHOLE. ASSESSING COMMUNITY NEED SCRIPPS HEALTH HAS A LONG HISTORY OF RESPONDING TO THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES, EXTENDING BEYOND TRADITIONAL HOSPITAL CARE TO ADDRESS THE HEALTH CARE NEEDS OF THE REGION'S MOST VULNERABLE POPULATIONS. COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ORIGINATED FROM CALIFORNIA STATEWIDE LEGISLATION IN THE EARLY 1990S. SB 697 TOOK EFFECT IN 1995, WHICH REQUIRED PRIVATE NOT-FOR-PROFIT HOSPITALS TO SUBMIT DETAILED INFORMATION TO THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) ON THEIR COMMUNITY BENEFIT CONTRIBUTIONS. ANNUAL HOSPITAL COMMUNITY BENEFIT REPORTS ARE SUMMARIZED BY OSHPD IN A REPORT TO THE LEGISLATURE, WHICH PROVIDES VALUABLE INFORMATION FOR GOVERNMENT OFFICIALS TO ASSESS THE CARE AND SERVICES PROVIDED TO THEIR CONSTITUENTS. THE SB 697 REQUIREMENT WAS SUPPLEMENTED IN 2010 BY REQUIREMENTS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OR ACA THAT NOT-FOR-PROFIT HOSPITALS CONDUCT COMMUNITY HEALTH NEEDS ASSESSMENTS WITH COMMUNITY STAKE HOLDERS TO DETERMINE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY THEY SERVE AND IMPLEMENTATION STRATEGIES TO HELP MEET THOSE NEEDS. ADDITIONAL INFORMATION ON THE ACA REQUIREMENTS FOR NOT-FOR-PROFIT HOSPITALS CAN BE FOUND AT HTTP://WWW.IRS.GOV, KEYWORD: "CHARITABLE ORGANIZATIONS." AS PART OF THE FEDERAL REPORTING REQUIREMENT FOR PRIVATE, NOT-FOR-PROFIT (TAX EXEMPT) HOSPITALS, SCRIPPS CONDUCTS A CONSOLIDATED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND CORRESPONDING JOINT IMPLEMENTATIONS STRATEGY FOR ITS LICENSED HOSPITAL FACILITIES EVERY THREE YEARS. THIS COMPREHENSIVE ACCOUNT OF HEALTH NEEDS IN THE COMMUNITY IS DESIGNED FOR HOSPITALS TO PLAN THEIR COMMUNITY BENEFIT PROGRAMS TOGETHER WITH OTHER LOCAL HEALTH CARE INSTITUTIONS, COMMUNITY-BASED ORGANIZATIONS AND CONSUMER GROUPS. THE 2019 SCRIPPS HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS DESIGNED TO PROVIDE A DEEPER UNDERSTANDING OF BARRIERS TO HEALTH IMPROVEMENT IN SAN DIEGO COUNTY. THE REPORT WILL HELP US UNDERSTAND OUR COMMUNITY'S HEALTH NEEDS AND INFORM COMMUNITY BENEFIT PLANNING AND THE IMPLEMENTATION STRATEGY FOR SCRIPPS HEALTH. IN ADDITION, THE ASSESSMENT ALLOWS INTERESTED PARTIES AND MEMBERS OF THE COMMUNITY A MECHANISM TO ACCESS THE FULL SPECTRUM OF INFORMATION RELATIVE TO THE DEVELOPMENT OF THE SCRIPPS HEALTH 2019 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS, GOVERNMENT AGENCIES, BUSINESSES AND GRASSROOTS MOVEMENTS, SCRIPPS IS BETTER ABLE TO BUILD UPON EXISTING ASSETS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS. THE COMPLETE REPORT IS AVAILABLE ONLINE AT SCRIPPS HEALTH 2019 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. CHNA EXECUTIVE SUMMARY THE EXECUTIVE SUMMARY PROVIDES A HIGH-LEVEL SUMMARY OF THE 2019 CHNA METHODOLOGY AND FINDINGS. THE FULL CHNA REPORT CONTAINS IN-DEPTH INFORMATION AND EXPLANATIONS OF THE DATA THAT PARTICIPATING HOSPITALS AND HEALTHCARE SYSTEMS WILL USE TO EVALUATE THE HEALTH NEEDS OF THEIR PATIENTS AND DETERMINE, ADAPT, OR CREATE PROGRAMS AT THEIR FACILITIES. GROUNDED IN A LONGSTANDING COMMITMENT TO ADDRESS COMMUNITY HEALTH NEEDS IN SAN DIEGO, SEVEN HOSPITALS AND HEALTH CARE SYSTEMS, INCLUDING SCRIPPS HEALTH CAME TOGETHER UNDER THE AUSPICES OF THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC) TO CONDUCT A TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT IDENTIFIES AND PRIORITIZES THE MOST CRITICAL HEALTH-RELATED NEEDS OF SAN DIEGO COUNTY RESIDENTS. PARTICIPATING HOSPITALS WILL USE THE FINDINGS TO GUIDE THEIR COMMUNITY PROGRAMS AND MEET IRS REGULATORY REQUIREMENTS. PER LEGISLATION, HOSPITALS CONDUCT A HEALTH NEEDS ASSESSMENT IN THE COMMUNITY ONCE EVERY THREE YEARS. THE 2019 SCRIPPS HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS DESIGNED TO PROVIDE A DEEPER UNDERSTANDING OF BARRIERS TO HEALTH IMPROVEMENT IN SAN DIEGO COUNTY AND BUILD ON THE RESULTS OF THE 2016 CHNA. IT INCLUDES THREE TYPES OF COMMUNITY ENGAGEMENT EFFORTS: FOCUS GROUPS WITH RESIDENTS, COMMUNITY-BASED ORGANIZATIONS, SERVICE PROVIDERS, AND HEALTH CARE LEADERS; KEY INFORMANT INTERVIEWS WITH HEALTH CARE EXPERTS; AND AN ONLINE SURVEY FOR RESIDENTS AND STAKEHOLDERS. IN ADDITION, THE CHNA INCLUDES EXTENSIVE QUANTITATIVE ANALYSIS OF NATIONAL AND STATE-WIDE DATA SETS, SAN DIEGO COUNTY EMERGENCY DEPARTMENT AND INPATIENT HOSPITAL DISCHARGE DATA, COUNTY MORTALITY AND MORBIDITY DATA, AND DATA RELATED TO SOCIAL DETERMINANTS OF HEALTH. THESE TWO DIFFERENT APPROACHES ALLOWED THE CHNA COMMITTEE TO VIEW COMMUNITY HEALTH NEEDS FROM MULTIPLE PERSPECTIVES. PARTICIPATING HOSPITALS WILL USE THIS INFORMATION TO INFORM AND GUIDE HOSPITAL PROGRAMS AND STRATEGIES. THIS REPORT INCLUDES AN ANALYSIS OF HEALTH OUTCOMES AND ASSOCIATED SOCIAL DETERMINANTS OF HEALTH WHICH CREATE HEALTH INEQUITIES-THE UNFAIR AND AVOIDABLE DIFFERENCES IN HEALTH STATUS SEEN WITHIN AND BETWEEN COUNTRIES AND COMMUNITIES WITH THE UNDERSTANDING THAT THE BURDEN OF ILLNESS, PREMATURE DEATH, AND DISABILITY DISPROPORTIONALLY AFFECTS RACIAL AND MINORITY POPULATION GROUPS AND OTHER UNDERSERVED POPULATIONS. UNDERSTANDING REGIONAL AND POPULATION-SPECIFIC DIFFERENCES IS AN IMPORTANT STEP TO UNDERSTANDING AND ULTIMATELY STRATEGIZING WAYS TO MAKE COLLECTIVE IMPACT. THESE NEW INSIGHTS WILL ALLOW PARTICIPATING HOSPITALS TO IDENTIFY EFFECTIVE STRATEGIES TO ADDRESS THE MOST PREVALENT AND CHALLENGING HEALTH NEEDS IN THE COMMUNITY. OVERVIEW AND BACKGROUND HASD&IC CONTRACTED WITH THE INSTITUTE FOR PUBLIC HEALTH (IPH) AT SAN DIEGO STATE UNIVERSITY (SDSU) TO PROVIDE ASSISTANCE WITH THE COLLABORATIVE HEALTH NEEDS ASSESSMENT THAT WAS OFFICIALLY CALLED THE HASD&IC 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (2019 CHNA). THE OBJECTIVE OF THE 2019 CHNA IS TO IDENTIFY AND PRIORITIZE THE MOST CRITICAL HEALTH-RELATED NEEDS IN SAN DIEGO COUNTY BASED ON FEEDBACK FROM COMMUNITY RESIDENTS IN HIGH NEED NEIGHBORHOODS AND QUANTITATIVE DATA ANALYSIS. THE 2019 CHNA INVOLVED A MIXED METHODS APPROACH USING THE MOST CURRENT QUANTITATIVE DATA AVAILABLE AND MORE EXTENSIVE QUALITATIVE OUTREACH. THROUGHOUT THE PROCESS, THE IPH MET BI-WEEKLY WITH THE HASD&IC CHNA COMMITTEE TO ANALYZE, REFINE, AND INTERPRET RESULTS AS THEY WERE BEING COLLECTED. THE RESULTS OF THE 2019 CHNA WILL BE USED TO INFORM AND ADAPT HOSPITAL PROGRAMS AND STRATEGIES TO BETTER MEETING THE HEALTH NEEDS OF SAN DIEGO COUNTY RESIDENTS. COMMUNITY DEFINED FOR THE PURPOSES OF THIS 2019 CHNA, THE SERVICE AREA IS DEFINED AS THE ENTIRE COUNTY OF SAN DIEGO DUE TO A BROAD REPRESENTATION OF HOSPITALS IN THE AREA. OVER THREE MILLION PEOPLE LIVE IN THE SOCIALLY AND ETHNICALLY DIVERSE COUNTY OF SAN DIEGO. CURRENT POPULATION DEMOGRAPHICS AND CHANGES IN DEMOGRAPHIC COMPOSITION OVER TIME PLAY A DEFINING ROLE IN THE TYPES OF HEALTH AND SOCIAL SERVICES NEEDED BY COMMUNITIES. POPULATION SIZE, CHANGE IN POPULATION, RACE AND ETHNICITY, AND AGE DISTRIBUTION OF A POPULATION ARE ALL IMPORTANT FACTORS IN UNDERSTANDING COMMUNITIES AND THEIR RESIDENTS. POPULATION: OVER THREE MILLION PEOPLE (3,283,665) LIVE IN THE 4,207 SQUARE MILE AREA OF SAN DIEGO COUNTY ACCORDING TO THE U.S. CENSUS BUREAU ACS 2013 TO 2017, 5-YEAR ESTIMATES. THE POPULATION DENSITY FOR THIS AREA, ESTIMATED AT 781 PERSONS PER SQUARE MILE, IS GREATER THAN THE NATIONAL AVERAGE POPULATION DENSITY OF APPROXIMATELY 91 PERSONS PER SQUARE MILE. AGE: THE MEDIAN AGE FOR SAN DIEGO COUNTY IS 35.4 YEARS. THE DISTRIBUTION OF THE POPULATION BY AGE SHOWS THAT 22.2% OF THE POPULATION IS UNDER THE AGE OF 18, 64.9% IS BETWEEN THE AGES OF 18 AND 64, AND 12.9% IS 65 YEARS OLD OR GREATER. ADDITIONAL INFORMATION ON SOCIOECONOMIC FACTORS, ACCESS TO CARE, HEALTH BEHAVIORS, AND THE PHYSICAL ENVIRONMENT CAN BE FOUND IN THE FULL SCRIPPS 2019 CHNA REPORT AT SCRIPPS HEALTH 2019 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
BECAUSE OF ITS LARGE GEOGRAPHIC SIZE AND POPULATION, THE SAN DIEGO COUNTY HEALTH AND HUMAN SERVICES AGENCY (HHSA) ORGANIZED THEIR SERVICE AREAS INTO SIX GEOGRAPHIC REGIONS. CENTRAL, EAST, NORTH CENTRAL, NORTH COASTAL, NORTH INLAND AND SOUTH. WHEN POSSIBLE, DATA IS PRESENTED AT A REGIONAL LEVEL TO PROVIDE MORE DETAILED UNDERSTANDING OF THE POPULATION. SCRIPPS HEALTH COMMUNITY SERVED HOSPITALS AND HEALTH CARE SYSTEMS DEFINE THE COMMUNITY SERVED AS THOSE INDIVIDUALS RESIDING WITHIN ITS SERVICE AREA. A HOSPITAL OR HEALTH CARE SYSTEM SERVICE AREA INCLUDES ALL RESIDENTS IN A DEFINED GEOGRAPHIC AREA SURROUNDING THE HOSPITAL. SCRIPPS SERVES THE ENTIRE SAN DIEGO COUNTY REGION WITH SERVICES CONCENTRATED IN NORTH COASTAL, NORTH CENTRAL, CENTRAL AND SOUTHERN REGION OF SAN DIEGO. COMMUNITY OUTREACH EFFORTS ARE FOCUSED IN THOSE AREAS WITH PROXIMITY TO A SCRIPPS FACILITY. SCRIPPS HOSTS, SPONSORS AND PARTICIPATES IN MANY COMMUNITY-BUILDING EVENTS THROUGHOUT THE YEAR. PER CALENDAR YEAR 2017, OSHPD ANNUAL FINANCIAL DATA THERE WERE 19 OTHER HOSPITAL FACILITIES SERVING THE SAN DIEGO COMMUNITY. SCRIPPS MERCY HOSPITAL (SAN DIEGO AND CHULA VISTA CAMPUSES) PROVIDES 64 PERCENT OF THE CHARITY CARE WITHIN THE SCRIPPS SYSTEM. SCRIPPS MERCY'S SERVICE AREA HAS A MORE ECONOMICALLY DISADVANTAGED POPULATION COMPARED TO THE COUNTY AS A WHOLE, WITH THE LOWEST NUMBERS OF INSURED ADULTS IN THE COUNTY AND A MUCH HIGHER PERCENTAGE OF ETHNIC MINORITIES, PRIMARILY HISPANIC AND ASIAN. AS A DISPROPORTIONATE-SHARE HOSPITAL, SCRIPPS MERCY SAN DIEGO AND CHULA VISTA CAMPUSES PLAY IMPORTANT HEALTH CARE SERVICE ROLES IN THE CENTRAL/SOUTHERN SAN DIEGO COUNTY SERVICE AREA (RANGING FROM INTERSTATE 8 TO THE UNITED STATES-MEXICO BORDER). MORE THAN HALF OF SCRIPPS MERCY SAN DIEGO AND CHULA VISTA PATIENTS ARE GOVERNMENT INSURED MEDICARE AND MEDI-CAL. SCRIPPS HOSPITALS HOUSED 24.5% PERCENT OF THE COUNTY'S GENERAL ACUTE-CARE LICENSED BEDS. SCRIPPS PROVIDES SIGNIFICANT AND GROWING VOLUMES OF EMERGENCY, OUTPATIENT AND PRIMARY CARE. IN FY17, SCRIPPS PROVIDED 2,513,440 OUTPATIENT VISITS. NEARLY HALF (38.8%) OF SAN DIEGO COUNTY'S 60,325 SAFETY NET DISCHARGES ARE FROM CENTRAL AND SOUTH SUBURBAN REGIONS. SAFETY NET DISCHARGES INCLUDE COUNTY INDIGENT PROGRAMS, MEDI-CAL AND SELF-PAY. SOURCE: OSHPD 2017 CY HOSPITAL ANNUAL SELECTED FILE. COMMUNITY PRIORITY PROCESS (CHNA METHODOLOGY) FOR THE 2019 CHNA QUANTITATIVE ANALYSES OF PUBLICLY AVAILABLE DATA PROVIDED AN OVERVIEW OF CRITICAL HEALTH ISSUES ACROSS SAN DIEGO COUNTY, WHILE QUALITATIVE ANALYSES OF FEEDBACK FROM THE COMMUNITY PROVIDED AN APPRECIATION FOR THE EXPERIENCES AND NEEDS OF SAN DIEGANS. THE CHNA COMMITTEE REVIEWED THESE ANALYSES AND APPLIED A PRE-DETERMINED SET OF CRITERIA TO THEM TO PRIORITIZE THE TOP HEALTH NEEDS IN SAN DIEGO COUNTY. FOR A COMPLETE DESCRIPTION OF THE HASD&IC 2019 PROCESS AND FINDINGS, SEE FULL REPORT AVAILABLE AT HTTPS://WWW.HASDIC.ORG/2019-CHNA. QUANTITATIVE QUANTITATIVE DATA WERE DRAWN FROM SEVERAL PUBLIC SOURCES. DATA FROM DIGNITY HEALTH/TRUVEN HEALTH COMMUNITY NEEDS INDEX (CNI) AND THE PUBLIC HEALTH ALLIANCE OF SOUTHERN CALIFORNIA'S HEALTHY PLACES INDEX (HPI) WERE USED TO IDENTIFY GEOGRAPHIC COMMUNITIES IN SAN DIEGO COUNTY THAT WERE MORE LIKELY TO BE EXPERIENCING HEALTH INEQUITIES, WHICH GUIDED THE SELECTION OF COMMUNITIES FOR THE ENGAGEMENT AND THE DEVELOPMENT OF ENGAGEMENT QUESTIONS. HOSPITAL DISCHARGE DATA EXPORTED FROM SPEEDTRACK'S CALIFORNIA UNIVERSAL PATIENT INFORMATION DISCOVERY, OR CUPID APPLICATION WERE USED TO IDENTIFY CURRENT AND THREE-YEAR TRENDS IN PRIMARY DIAGNOSIS DISCHARGE CATEGORIES AND WERE STRATIFIED BY AGE AND RACE. THIS ALLOWED FOR THE IDENTIFICATION OF HEALTH DISPARITIES AND THE CONDITIONS HAVING THE GREATEST IMPACT ON HOSPITALS AND HEALTH SYSTEMS IN SAN DIEGO COUNTY. DATA FROM NATIONAL AND STATE-WIDE DATA SETS WERE ANALYZED INCLUDING SAN DIEGO COUNTY MORTALITY AND MORBIDITY DATA, AND DATA RELATED TO SOCIAL DETERMINANTS OF HEALTH. IN ADDITION, KAISER PERMANENTE CONSOLIDATED DATA FROM SEVERAL NATIONAL AND STATE-WIDE DATA SETS RELATED TO A VARIETY OF HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH IN SAN DIEGO COUNTY AND CONDUCTED A COMPREHENSIVE STATISTICAL ANALYSIS TO IDENTIFY WHICH SOCIAL DETERMINANTS OF HEALTH WERE MOST PREDICTIVE OF NEGATIVE HEALTH OUTCOMES. KAISER PERMANENTE THEN CREATED A WEB-BASED DATA PLATFORM (CHNA.ORG/KP) TO POST THESE ANALYSES FOR USE IN THE CHNA. THESE ANALYSES GUIDED THE DESIGN OF THE ONLINE SURVEY, INTERVIEW, AND FOCUS GROUP QUESTIONS. COMMUNITY ENGAGEMENT COMMUNITY ENGAGEMENT ACTIVITIES INCLUDED FOCUS GROUPS, KEY INFORMANT INTERVIEWS, AND AN ONLINE SURVEY WHICH TARGETED STAKEHOLDERS FROM EVERY REGION OF SAN DIEGO COUNTY, ALL AGE GROUPS, AND NUMEROUS RACIAL AND ETHNIC GROUPS. COLLABORATION WITH THE COUNTY OF SAN DIEGO HEALTH & HUMAN SERVICES AGENCY, PUBLIC HEALTH SERVICES WAS VITAL TO THIS PROCESS. A TOTAL OF 579 INDIVIDUALS PARTICIPATED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 138 COMMUNITY RESIDENTS AND 441 LEADERS AND EXPERTS. 2019 CHNA PRIORITIZATION OF THE TOP HEALTH NEEDS THE CHNA COMMITTEE COLLECTIVELY REVIEWED THE QUANTITATIVE AND QUALITATIVE DATA AND FINDINGS. SEVERAL CRITERIA WERE APPLIED TO THE DATA TO DETERMINE WHICH HEALTH CONDITIONS WERE OF THE HIGHEST PRIORITY IN SAN DIEGO COUNTY. THESE CRITERIA INCLUDED: THE SEVERITY OF THE NEED, THE MAGNITUDE/SCALE OF THE NEED; DISPARITIES OR INEQUITIES AND CHANGE OVER TIME. THOSE HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH (SDOH) THAT MET THE LARGEST NUMBER OF CRITERIA WERE THEN SELECTED AS TOP PRIORITY COMMUNITY HEALTH NEEDS. 2019 FINDINGS: TOP 10 COMMUNITY HEALTH NEEDS THE CHNA COMMITTEE IDENTIFIED THE FOLLOWING AS THE HIGHEST PRIORITY COMMUNITY HEALTH NEEDS IN SAN DIEGO COUNTY (IN ALPHABETICAL ORDER BY SDOH OR HEALTH CONDITION). ACCESS TO HEALTH CARE OVERCOMING BARRIERS TO HEALTH CARE, SUCH AS LACK OF HEALTH INSURANCE AND INSURANCE ISSUES, ECONOMIC INSECURITY, TRANSPORTATION, THE SHORTAGE OF CULTURALLY COMPETENT CARE, FEARS ABOUT IMMIGRATION STATUS, AND THE SHORTAGE OF HEALTH CARE PROVIDERS EMERGED AS A HIGH PRIORITY COMMUNITY NEED. IN ADDITION, SPECIFIC SERVICES WERE IDENTIFIED AS CHALLENGING TO OBTAIN, INCLUDING BEHAVIORAL HEALTH CARE, DENTAL CARE, PRIMARY CARE, AND SPECIALTY CARE. AGING CONCERNS CONDITIONS THAT PREDOMINANTLY AFFECT PEOPLE WHO ARE 65 AND OLDER SUCH AS ALZHEIMER'S DISEASE, PARKINSON'S, DEMENTIA, FALLS, AND LIMITED MOBILITY WERE IDENTIFIED AS A HIGH PRIORITY HEALTH NEED. COMMUNITY ENGAGEMENT PARTICIPANTS MOST OFTEN DESCRIBED AGING CONCERNS IN RELATION TO THE SOCIAL DETERMINANTS OF HEALTH, INCLUDING: TRANSPORTATION, ACCESS TO FRESH FOOD, SOCIAL ISOLATION AND INADEQUATE FAMILY SUPPORT, AND ECONOMIC INSECURITY. BEHAVIORAL HEALTH GREATER ACCESS TO BEHAVIORAL HEALTH CARE WAS CITED AS A PRIORITY HEALTH NEED. THREE TYPES OF BEHAVIORAL HEALTH CARE WERE IDENTIFIED AS CHALLENGING TO ACCESS: URGENT CARE SERVICES FOR CRISIS SITUATIONS; INPATIENT PSYCHIATRIC BEDS AND SUBSTANCE ABUSE FACILITIES; AND TRANSITIONAL PROGRAMS AND SERVICES FOR POST-ACUTE CARE. IN ADDITION, SEVERAL BARRIERS TO BEHAVIORAL HEALTH CARE WERE NAMED AS PRIORITIES TO ADDRESS, INCLUDING A LACK OF AVAILABILITY OF NEEDED SERVICES AND APPOINTMENTS, INSURANCE ISSUES, LOGISTICAL ISSUES, SUCH AS TRANSPORTATION AND TIME OFF WORK, AND THE INABILITY TO PAY CO-PAYS AND DEDUCTIBLES. CANCER HEALTH NEEDS RELATED TO CANCER WERE DESCRIBED IN RELATION TO THE EFFECTS ON WELL-BEING BEYOND PHYSICAL HEALTH. THESE INCLUDE FINANCIAL, PRACTICAL, AND EMOTIONAL IMPACTS ON INDIVIDUALS AND FAMILIES; THESE EFFECTS ARE EXACERBATED BY BARRIERS TO CANCER CARE. CHRONIC CONDITIONS THREE CHRONIC CONDITIONS WERE IDENTIFIED AS PRIORITIES: CARDIOVASCULAR DISEASE, DIABETES, AND OBESITY. KEY FACTORS THAT INDIVIDUALS STRUGGLE WITH TO PREVENT CHRONIC DISEASES INCLUDE ACCESS TO FRESH, HEALTH FOODS AND SAFE PLACES TO EXERCISE AND PLAY. IN ADDITION, ECONOMIC ISSUES, TRANSPORTATION TO MEDICAL CARE, FEARS ABOUT IMMIGRATION STATUS, AND A LACK OF KNOWLEDGE ABOUT CHRONIC CONDITIONS WERE NAMED AS PARTICULAR CHALLENGES RELATED TO THE MANAGEMENT OF CHRONIC CONDITIONS. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
COMMUNITY AND SOCIAL SUPPORT A HIGH PRIORITY FOR THE WELL-BEING OF SAN DIEGO RESIDENTS IS ENSURING THAT INDIVIDUALS HAVE ADEQUATE RESOURCES AND SUBSTANTIAL SUPPORT WITHIN THEIR NEIGHBORHOOD. VALUABLE NEIGHBORHOOD RESOURCES INCLUDE FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) AND THOSE THAT ARE CULTURALLY AND LINGUISTICALLY COMPETENT. WITHOUT ADEQUATE SUPPORT FROM OTHERS, COMMUNITY ENGAGEMENT AND COMMUNITY SPIRIT ARE AFFECTED. ECONOMIC SECURITY ECONOMIC SECURITY WAS NAMED AS VITALLY IMPORTANT TO THE WELL-BEING OF SAN DIEGO RESIDENTS AND WAS DESCRIBED AS IMPACTING EVERY ASPECT OF RESIDENTS' DAILY LIFE. THE HEALTH OF THOSE WHO ARE ECONOMICALLY INSECURE IS NEGATIVELY AFFECTED BY FOOD INSECURITY, CHRONIC STRESS AND ANXIETY, AND THE LACK OF TIME AND MONEY TO TAKE CARE OF HEALTH NEEDS. IN SAN DIEGO COUNTY, 13.3% OF RESIDENTS HAVE INCOMES BELOW THE FEDERAL POVERTY LEVEL AND 15% EXPERIENCE FOOD INSECURITY. THOSE WHO ARE ECONOMICALLY INSECURE ARE AT GREATER RISK OF POOR MENTAL HEALTH DAYS, AS WELL AS, ASTHMA, OBESITY, DIABETES, STROKE, CANCER, SMOKING, PEDESTRIAN INJURY AND VISITS TO THE EMERGENCY DEPARTMENT FOR HEART ATTACKS. FACTORS IDENTIFIED AS CONTRIBUTING TO ECONOMIC INSECURITY INCLUDE HOUSING AND CHILD CARE COSTS AS WELL AS LOW WAGES. EDUCATION RECEIVING A HIGH SCHOOL DIPLOMA, HAVING THE OPPORTUNITY TO PURSUE HIGHER OR VOCATIONAL EDUCATION, BEING HEALTH LITERATE, AND HAVING OPPORTUNITIES FOR NON-ACADEMIC CONTINUING EDUCATION WERE IDENTIFIED AS IMPORTANT PRIORITIES FOR THE HEALTH AND WELL-BEING OF SAN DIEGO RESIDENTS. FAMILY STRESS AND A LACK OF SCHOOL AND COMMUNITY RESOURCES WERE IDENTIFIED AS FACTORS UNDERLYING LOW LEVELS OF EDUCATIONAL ATTAINMENT. HOMELESSNESS AND HOUSING INSTABILITY HOMELESSNESS AND HOUSING INSTABILITY WERE NAMED AS IMPORTANT FACTORS AFFECTING THE HEALTH OF SAN DIEGO COUNTY RESIDENTS. THEY WERE DESCRIBED AS HAVING SERIOUS HEALTH IMPACTS, SUCH AS INCREASING EXPOSURE TO INFECTIOUS DISEASE, CREATING SUBSTANTIAL CHALLENGES IN THE MANAGEMENT OF CHRONIC DISEASES AND WOUND CARE, AND INCREASING STRESS AND ANXIETY. POOR HOUSING CONDITIONS WERE ALSO CITED AS IMPACTFUL OF PHYSICAL AND MENTAL HEALTH; CROWDED HOUSING LEADS TO THE SPREAD OF ILLNESS, AND ENVIRONMENTAL HAZARDS CAN EXACERBATE CONDITIONS LIKE ASTHMA. UNINTENTIONAL INJURY AND VIOLENCE EXPOSURE TO VIOLENCE AND NEIGHBORHOOD SAFETY WERE CITED AS PRIORITY HEALTH NEEDS FOR SAN DIEGANS. NEIGHBORHOOD SAFETY WAS DISCUSSED AS INFLUENCING RESIDENTS' ABILITY TO MAINTAIN GOOD HEALTH, WHILE EXPOSURE TO VIOLENCE WAS DESCRIBED AS TRAUMATIC AND IMPACTFUL ON MENTAL HEALTH. COMMUNITY RESOURCES THE 2019 CHNA IDENTIFIED MANY HEALTH RESOURCES IN SAN DIEGO COUNTY, INCLUDING THOSE PROVIDED BY COMMUNITY-BASED ORGANIZATIONS, GOVERNMENT DEPARTMENTS AND AGENCIES, HOSPITAL AND CLINIC PARTNERS, AND OTHER COMMUNITY MEMBERS AND ORGANIZATIONS ENGAGED IN ADDRESSING MANY OF THE HEALTH NEEDS IDENTIFIED BY THIS ASSESSMENT. IN ADDITION, 2-1-1 SAN DIEGO IS AN IMPORTANT COMMUNITY RESOURCE AND INFORMATION HUB THAT FACILITATES ACCESS TO SERVICES. THROUGH ITS 24/7 PHONE SERVICE AND ONLINE DATABASE, 2-1-1 SAN DIEGO HELPS CONNECT INDIVIDUALS WITH COMMUNITY, HEALTH, AND DISASTER SERVICES. IN ADDITION TO COMMUNITY INPUT ON HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH, A WEALTH OF IDEAS EMERGED FROM COMMUNITY ENGAGEMENT PARTICIPANTS ABOUT HOW HOSPITALS AND HEALTH SYSTEMS COULD SUPPORT, EXPAND, OR CREATE ADDITIONAL RESOURCES AND PARTNER WITH ORGANIZATIONS TO BETTER MEET SAN DIEGO'S COMMUNITY HEALTH NEEDS. CONCLUSIONS AND NEXT STEPS THE 2019 CHNA WILL BE UTILIZED BY SCRIPPS HEALTH AND PARTICIPATING HOSPITALS AND HEALTH SYSTEMS TO EVALUATE OPPORTUNITIES FOR NEXT STEPS TO ADDRESS THE TOP IDENTIFIED HEALTH AND SOCIAL NEEDS IN THEIR RESPECTIVE PATIENT COMMUNITIES. IN ADDITION, THE CHNA REPORT WILL BE MADE AVAILABLE TO THE BROADER COMMUNITY AND IS INTENDED TO BE A USEFUL RESOURCE TO BOTH RESIDENTS AND HEALTH CARE PROVIDERS TO FURTHER COMMUNITYWIDE HEALTH ACCESS AND HEALTH IMPROVEMENT EFFORTS. THE CHNA COMMITTEE IS IN THE PROCESS OF PLANNING PHASE 2 OF THE 2019 CHNA, WHICH WILL INCLUDE GATHERING COMMUNITY FEEDBACK ON THE 2019 CHNA PROCESS AND STRENGTHENING PARTNERSHIPS AROUND THE IDENTIFIED PRIORITY HEALTH NEEDS AND SOCIAL DETERMINANTS OF HEALTH. SCRIPPS HEALTH IMPLEMENTATION PLAN WITH THE 2019 CHNA COMPLETE AND HEALTH PRIORITY AREAS IDENTIFIED, SCRIPPS HEALTH HAS DEVELOPED A CORRESPONDING IMPLEMENTATION STRATEGY-A MULTIFACETED, MULTI-STAKEHOLDER, PLAN THAT ADDRESSES THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE CHNA. THE IMPLEMENTATION PLAN TRANSLATES THE RESEARCH AND ANALYSIS PRESENTED IN THE ASSESSMENT INTO ACTUAL MEASURABLE STRATEGIES AND OBJECTIVES THAT CAN BE CARRIED OUT TO IMPROVE COMMUNITY HEALTH OUTCOMES. SCRIPPS HEALTH ANTICIPATES THE IMPLEMENTATION STRATEGIES MAY EVOLVE DUE TO THE FAST PACE AT WHICH COMMUNITY AND HEALTH CARE INDUSTRY CHANGE. THEREFORE, A FLEXIBLE APPROACH IS BEST SUITED FOR THE DEVELOPMENT OF ITS RESPONSE TO THE SCRIPPS HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). ON AN ANNUAL BASIS SCRIPPS HEALTH EVALUATES THE IMPLEMENTATION STRATEGY AND ITS RESOURCES AND INTERVENTIONS; AND MAKES ADJUSTMENTS AS NEEDED TO ACHIEVE ITS STATED GOALS AND OUTCOME MEASURES AS WELL AS TO ADAPT TO CHANGES AND RESOURCES AVAILABLE. SCRIPPS DESCRIBES ANY CHALLENGES ENCOUNTERED TO ACHIEVE THE OUTCOMES AND MAKES MODIFICATIONS AS NEEDED. IN ADDITION, SCRIPPS HEALTH IMPLEMENTATION PLAN IS FILED WITH THE INTERNAL REVENUE SERVICE USING FORM 990 SCHEDULE H ON AN ANNUAL BASIS. IN RESPONSE TO IDENTIFIED UNMET HEALTH NEEDS IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT DURING THE TIME PERIOD OF FY20-FY22, SCRIPPS HEALTH IS FOCUSING ON THE STRATEGIES AND INITIATIVES, THEIR MEASURES OF IMPLEMENTATION AND THE METRICS USED TO EVALUATE THEIR EFFECTIVENESS. SCRIPPS WILL MONITOR AND EVALUATE THE STRATEGIES LISTED IN THE IMPLEMENTATION PLAN FOR THE PURPOSE OF TRACKING THE IMPLEMENTATION OF THOSE STRATEGIES AS WELL AS THE DOCUMENT THE ANTICIPATED IMPACT. PLANS TO MONITOR WILL BE TAILORED TO EACH STRATEGY AND WILL INCLUDE THE COLLECTION AND DOCUMENTATION OF TRACKING MEASURES. THE COMPLETE FY 2020 - 2022 SCRIPPS IMPLEMENTATION PLAN IS AVAILABLE ONLINE AT SCRIPPS.ORG. IN AN EFFORT TO PROVIDE FOR PEOPLE IN NEED, SCRIPPS SPONSORED/ENGAGED IN THE FOLLOWING PROGRAMS IN FISCAL YEAR 2019. ACCESS TO CARE ACCESS TO HIGH QUALITY, COMPREHENSIVE CARE IS VITAL FOR PRESERVING GOOD HEALTH, PREVENTING AND MANAGING DISEASE, DECREASING DISABILITY, AVERTING PREMATURE DEATH, AND ACHIEVING HEALTH EQUITY FOR ALL. TO ACCESS CARE, PEOPLE NEED HEALTH INSURANCE COVERAGE AND A CONSISTENT SOURCE OF CARE THAT PROVIDES EVIDENCE-BASED, CULTURALLY COMPETENT PREVENTIVE AND EMERGENCY MEDICAL SERVICES IN A TIMELY MANNER. A LACK OF HEALTH INSURANCE COVERAGE REPRESENTS A MAJOR BARRIER TO HEALTH CARE SERVICES. IN SAN DIEGO COUNTY, 12% OF PEOPLE ARE UNINSURED. CERTAIN GROUPS, INCLUDING THOSE WHO IDENTIFY AS "OTHER," NATIVE AMERICAN/ALASKA NATIVES, HISPANICS, PACIFIC ISLANDERS, AND BLACKS, HAVE HIGHER RATES OF BEING UNINSURED THAN OTHERS. ACCESS TO CARE INCLUDES TWO COMPONENTS-THE SPECIFIC SERVICES THAT INDIVIDUALS ARE UNABLE TO OBTAIN AND THE BARRIERS AND SDOH THAT PREVENT INDIVIDUALS FROM OBTAINING THESE SERVICES. 1. TYPES OF CARE THAT ARE DIFFICULT TO ACCESS - BEHAVIORAL HEALTH CARE - DENTAL CARE - PRIMARY CARE - SPECIALTY CARE 2. BARRIERS TO ACCESSING CARE & ASSOCIATED SDOH - CULTURALLY COMPETENT CARE - ECONOMIC SECURITY - FEAR RELATED TO IMMIGRATION STATUS - LACK OF HEALTH INSURANCE & INSURANCE ISSUES - SHORTAGE OF HEALTH CARE PROVIDERS - TRANSPORTATION A LACK OF HEALTH INSURANCE IS A PREDICTOR OF MANY HEALTH CONDITIONS, INCLUDING MORE POOR MENTAL HEALTH DAYS, MORE VISITS TO THE ED FOR HEART ATTACKS, A HIGHER PREVALENCE OF ASTHMA, AND OBESITY, MORE LOW BIRTH WEIGHT BABIES, AND HIGHER PREVALENCE OF SMOKING. REDUCED ACCESS TO BASIC HEALTH CARE SERVICES INCREASES ILLNESS, INJURY AND MORTALITY AND IS A MAJOR BURDEN ON HOSPITALS AND HEALTH PROVIDERS, WHO MUST PROVIDE UNCOMPENSATED CARE FOR THE UNINSURED. ACCESS TO HEALTH CARE EMERGED AS A HIGH PRIORITY HEALTH NEED IN BOTH THE SECONDARY DATA ANALYSES AND COMMUNITY ENGAGEMENT EVENTS IN THE 2019 SCRIPPS COMMUNITY HEALTH NEEDS ASSESSMENT. THROUGH THE COMMUNITY ENGAGEMENT CONDUCTED WE HEARD FROM THE COMMUNITY THAT EVEN WHEN INSURANCE IS SECURED, INCLUDED LACK OF TRANSPORTATION - ESPECIALLY FOR SENIORS - AND LACK OF CULTURALLY AND LINGUISTICALLY COMPETENT CARE ARE MAIN BARRIERS. IN AN EFFORT TO PROVIDE FOR PEOPLE IN NEED, SCRIPPS SPONSORED A NUMBER OF PROGRAMS AND ACTIVITIES IN FY19. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
MERCY OUTREACH SURGICAL TEAM PROVIDES LIFE-CHANGING CARE TO CHILDREN IN MEXICO FOR THREE DECADES, THE MERCY OUTREACH SURGICAL TEAM (M.O.S.T) HAS BEEN CROSSING BORDERS AND CHANGING LIVES. WORKING IN MEXICO, THE MERCY OUTREACH SURGICAL TEAM PROVIDES RECONSTRUCTIVE SURGERIES FOR CHILDREN SUFFERING FROM BIRTH DEFECTS OR ACCIDENTS. IN SPECIAL CIRCUMSTANCES, SURGERIES ARE ALSO PROVIDED FOR ADULTS. DURING FY19, THE M.O.S.T TEAM SERVED IN TWO OUTREACH MISSION TRIPS. THE M.O.S.T TEAM VOLUNTEERED OVER 2,800 HOURS TO PROVIDE RECONSTRUCTIVE SURGERIES FOR MORE THAN 200 PEOPLE. THE M.O.S.T PROGRAM CELEBRATED ITS 32ND ANNIVERSARY THIS YEAR. - OCTOBER 2018 IN OCTOBER 2018, A TEAM OF 48 M.O.S.T. VOLUNTEERS INCLUDING THREE PLASTIC SURGEONS, ONE UROLOGIST, AND A GENERAL SURGEON TRAVELED OVER 1,500 MILES FROM SAN DIEGO TO MORELIA, MEXICO. THE TEAM HELPED 168 PATIENTS ON THIS MISSION. - MAY 2019 WITH SO MANY PATIENTS IN NEED, M.O.S.T. TRAVELED TO HERMOSILLO IN THE STATE OF SONORA TO OFFER EYE SURGERIES IN EARLY MAY OF 2019. DURING THIS 4-DAY MISSION TRIP, THE TEAM PROVIDED 105 EYE SURGERIES AND PROVIDED EYEGLASSES TO 41 CHILDREN. SCRIPPS RECUPERATIVE CARE PROGRAMS (RCU) THE SCRIPPS/SD RESCUE MISSION RECUPERATIVE CARE UNIT (RCU) PROJECT PROVIDES A SAFE DISCHARGE FOR CHRONICALLY HOMELESS PATIENTS WITH ONGOING MEDICAL NEEDS. ALL PATIENTS ARE UNFUNDED OR UNDERFUNDED. MOST HAVE SUBSTANCE ABUSE AND/OR MENTAL HEALTH ISSUES. LACK OF FUNDING, MENTAL ILLNESS, AS WELL AS ALCOHOL AND/OR SUBSTANCE ABUSE, MAKES POST-ACUTE PLACEMENT OF THESE HOMELESS PATIENTS DIFFICULT. RN CASE MANAGEMENT ASSISTS WITH APPOINTMENTS, MEDICATIONS, DURABLE MEDICAL EQUIPMENT (DME), AND PLANS OF CARE, WHILE WORKING CLOSELY WITH RCU STAFF. OVERSIGHT IS PROVIDED BY SCRIPPS WITH PHYSICIAN BACKUP TO ENSURE COMPLETION OF THEIR MEDICAL RECOVERY GOALS. SCRIPPS PAYS THE RESCUE MISSION A DAILY RATE FOR HOUSING AND SERVICES PROVIDED TO THE PATIENTS. THE RESCUE MISSION PROVIDES A SAFE, SECURE ENVIRONMENT, WITH 24-HOUR SUPERVISION, MEDICATION OVERSIGHT, MEALS, CLOTHING, AND COUNSELING, ASSISTANCE WITH MCAL, AND DISABILITY APPLICATIONS, REFERRALS TO REHAB AND OTHER PROGRAMS, AND HELP FINDING PERMANENT OR TRANSITIONAL HOUSING USING COUNTY RESOURCES. PATIENT TRANSPORTATION NEEDS ARE COORDINATED AND PROVIDED BY BOTH THE RESCUE MISSION AND SCRIPPS. TO MAINTAIN THE PATIENT'S MEDICAL STABILITY, MEDICATIONS, DME AND OTHER NEEDED SERVICES ARE PROVIDED BY SCRIPPS WHEN FUNDING IS NOT AVAILABLE. PATIENTS WITH PSYCHIATRIC DISORDERS ARE ESTABLISHED WITH A PSYCHIATRIST IN THE COMMUNITY IF THEY ARE WILLING. ALL PATIENTS ARE REFERRED TO A MEDICAL HOME IN THE COMMUNITY. THE RCU LOCATED AT THE SAN DIEGO RESCUE MISSION CLOSED ITS DOORS ON JANUARY 14, 2019. THIS YEAR, 15 PATIENTS ACCOUNTED FOR RCU ADMISSIONS. AS A GROUP, THE RCU PATIENTS HAD A CUMULATIVE 223 HOSPITAL DAYS OF STAY, AN AVERAGE OF 14 HOSPITAL DAYS OF STAY, BEFORE GOING TO RCU. THE RCU HAS TAKEN MEDICALLY COMPLEX PATIENTS, INCLUDING THOSE WITH: IV ANTIBIOTICS, WOUND VACS, SKIN GRAFTS, FRACTURES, ABSCESSES, OSTEOMYELITIS, AMPUTATION, PARAPLEGIA, DOG BITES, DKA, GI BLEEDS, PANCREATITIS, ESRD ON DIALYSIS, END STAGE LIVER DISEASE, DIABETES, TRAUMATIC BRAIN INJURY OR ENCEPHALOPATHY, OSTOMIES, COMPLEX TRAUMA, MVA, PEDESTRIAN VERSUS AUTO, PLEURAL EFFUSION, CVA, CANCER (LYMPHOMA, PANCREATIC CANCER, BRAIN MASS), HIV/AIDS, SEPSIS, RESPIRATORY FAILURE, PNEUMONIA, CHF. PATIENTS WERE ASSAULT VICTIMS WITH GUNSHOT AND STAB WOUNDS, FACIAL TRAUMA, AND SURGICAL POST OP PATIENTS. MANY ARE DIABETIC AND HAVE PSYCHIATRIC CONDITIONS. OVER 70% OF THIS GROUP WERE EITHER POSITIVE FOR ALCOHOL, DRUGS ON DRUG SCREEN OR HAD A DRUG HISTORY ADDRESSED BY THE PHYSICIAN IN THE H & P. MORE SPECIFICALLY, 43% OF RCU CLIENTS HAD USED HEROIN OR METH. THE FOLLOWING ARE OUTCOME METRICS TRACKED BY SCRIPPS FOR THE SD RESCUE MISSION PROGRAM. - FOR YEAR 2018-2019, TOTAL COST SAVINGS FOR SCRIPPS WAS $703,385. - OF RCU PATIENTS, 27% HAD STANDARD MEDI-CAL INSURANCE, 26% MEDI-CAL HPE (HEALTH PRESUMPTIVE ELIGIBILITY), 20% MEDI-CAL HMO'S (MOLINA MEDI-CAL AND COMMUNITY HEALTH GROUP. FURTHER, 13% HAD OUT OF STATE OR OUT OF COUNTY AND 6% HAD RESTRICTED MCAL AND 6% CMS. - APPROXIMATELY 38% WERE INVOLVED WITH RCU SOCIAL WORKER TO SECURE INCOME FROM GOVERNMENT PROGRAMS, SOCIAL SECURITY AND CA SHORT TERM DISABILITY. - 94% PATIENTS WERE CONNECTED TO A PRIMARY CARE PROVIDER OR HAD ESTABLISHED CARE AT ONE OF THE COMMUNITY CLINICS AND 6% STAYED LESS THAN 1 DAY AND DID NOT COMPLETE THE PCP APPOINTMENT. - THIS YEAR, 80% DID NOT RETURN TO THE STREETS: 26% DISCHARGED TO FAMILY OR FRIEND, 27% TO A COMMUNITY PROGRAM, 27% OF THE RESIDENTS TRANSITIONED TO A SHELTER, AND MANY PARTICIPANTS WENT TO SRO, ILF OR ESTABLISHED RESIDENCE WHICH WAS 13%. HOUSING PROGRAMS AND RESOURCES CONTINUE AS CHALLENGES FOR OUR COMMUNITY. CITY OF REFUGE PARTNERSHIP AFTER THE CLOSURE OF THE SAN DIEGO RESCUE MISSIONS RCU IN JANUARY 2019, SCRIPPS FACILITATED AN OUTREACH PARTNERSHIP WITH THE CITY OF REFUGE THAT BEGAN TAKING PATIENTS ROUTINELY IN MARCH OF 2019. THIS YEAR 20 PATIENTS SO FAR HAVE MET THE NEED FOR RCS ADMISSION. AS A GROUP, THE RCS PATIENTS HAD A CUMULATIVE OF 224 HOSPITAL DAYS OF STAY, AN AVERAGE OF 10 HOSPITAL DAYS OF STAY, BEFORE GOING TO RCS BEGINNING MARCH 2019 TO DATE. THE RCS HAS TAKEN MEDICALLY COMPLEX PATIENTS, INCLUDING THOSE WITH: IV ANTIBIOTICS, WOUND VACS, SKIN GRAFTS, FRACTURES, ABSCESSES, OSTEOMYELITIS, AMPUTATION, PARAPLEGIA, DOG BITES, DKA, GI BLEEDS, PANCREATITIS, ESRD ON DIALYSIS, END STAGE LIVER DISEASE, DIABETES, MILD ENCEPHALOPATHY, OSTOMIES, MVA, PEDESTRIAN VERSUS AUTO, PLEURAL EFFUSION, CVA, CANCER (LYMPHOMA, PANCREATIC CANCER), HIV/AIDS, SEPSIS, RESPIRATORY FAILURE, PNEUMONIA, CHF. PATIENTS WERE ASSAULT VICTIMS WITH GUNSHOT AND STAB WOUNDS, FACIAL TRAUMA, AND SURGICAL POST OP PATIENTS. MANY ARE DIABETIC. PSYCH PROBLEMS ARE COMMON, OCCASIONALLY THE MAIN PROBLEM FOR RCS CLIENTS. OVER 70% THIS GROUP WERE EITHER POSITIVE FOR ALCOHOL, DRUGS ON DRUG SCREEN OR HAD A DRUG HISTORY ADDRESSED BY THE PHYSICIAN IN THE H & P. MORE SPECIFICALLY, 30 % OF RCS CLIENTS HAD USED OPIATES, HEROIN OR METH. THE FOLLOWING ARE OUTCOME METRICS TRACKED BY SCRIPPS FOR THE CITY OF REFUGE PROGRAM. - FOR FY19, TOTAL COST SAVINGS FOR SCRIPPS WAS $623,410.00 FOR MARCH 2019-SEPTEMBER 2019. - OF RCS PATIENTS, 25% HAD STANDARD MEDI-CAL INSURANCE, 25% HPE (HEALTH PRESUMPTIVE ELIGIBILITY) MEDI-CAL, 40% MEDI-CAL HMO'S, SUCH AS MOLINA, COMMUNITY HEALTH GROUP MEDI-CAL, HEALTH NET MEDI-CAL, AND ALAMEDA MEDI-CAL. OF THESE MANAGED PLANS, MOLINA MEDI-CAL WAS THE HIGHEST UTILIZER. FURTHER, 10% HAD OUT OF STATE OR OUT OF COUNTY MEDICAID/MEDI-CAL AND THERE WERE NO CLIENTS WITH RESTRICTED MEDI-CAL. - APPROXIMATELY 25% SOUGHT TO SECURE INCOME FROM GOVERNMENT PROGRAMS, SOCIAL SECURITY AND CA SHORT TERM DISABILITY: FOUR TOTAL CLIENTS APPLIED OR RECEIVED INCOME BENEFITS. FOUR HAVE APPLIED AND RECEIVED MCAL HMO'S WHILE AT THE RCS. - SEVENTY FIVE PERCENT OF PATIENTS WERE CONNECTED TO A PRIMARY CARE PROVIDER OR HAD ESTABLISHED CARE AT ONE OF THE COMMUNITY CLINICS. TEN PERCENT OF THE PATIENTS ADMITTED TO RCS WERE ESTABLISHED WITH ONGOING ONCOLOGY CARE AND TREATMENT. THIRTY FIVE PERCENT DID NOT COMPLETE THE PCP APPOINTMENT AND SEVERAL PATIENTS WERE INTRODUCED TO FHC MENTAL HEALTH SERVICES. - FOLLOWING THE STAY AT CITY OF REFUGE, 50% DID NOT RETURN TO THE STREETS; 5% WENT BACK TO THE HOSPITAL, (MOST RETURNED TO THE RCS AFTER A SHORT STAY); 15% TO FAMILY OR FRIEND, 30% TO A COMMUNITY PROGRAM, 50% OF THE RCS PARTICIPANTS DISCHARGED TO THE STREETS. TWO CONTINUE THEIR STAY AT THE RCS AND WILL GO HOME TO FAMILY WITH ASSISTANCE TO TRANSPORT VIA GREYHOUND BUS. HOUSING PROGRAMS AND RESOURCES CONTINUE AS CHALLENGES FOR OUR COMMUNITY. GRADUATE MEDICAL EDUCATION STAFF SUPPORT, ST. LEO'S CLINIC THE GRADUATE MEDICAL EDUCATION (GME) PROGRAM AT SCRIPPS GREEN HOSPITAL AND SCRIPPS CLINIC FOCUSES ON PHYSICIAN TRAINING AND CLINICAL RESEARCH, WITH 45+ RESIDENTS AND 43 FELLOWS. GME RESIDENTS AND MANY ATTENDING PHYSICIANS MAINTAIN AN EVENING CLINIC AT ST. LEO'S MISSION COMMUNITY CLINIC IN NORTH COUNTY. TWO RESIDENTS VOLUNTEER EVERY WEDNESDAY TO PROVIDE MEDICAL CARE TO UNINSURED PATIENTS WITH A VARIETY OF CONDITIONS, INCLUDING DIABETES, HIGH BLOOD PRESSURE AND HIGH CHOLESTEROL. THEY ALSO IDENTIFY MANY ACUTE CONDITIONS, INCLUDING VIRAL INFECTIONS, SKIN INFECTIONS, EYE PROBLEMS AND MUSCULOSKELETAL ISSUES, AND EDUCATE PATIENTS ABOUT THEIR HEALTH. PATIENTS MAY GET FLU VACCINATIONS AND SOME BASIC LAB TESTS. IF NEEDED, ST. LEO'S PATIENTS ARE REFERRED TO PROVIDERS WHO PROVIDE CARE AT A REDUCED COST. DURING FY19, ST. LEO'S CARED FOR APPROXIMATELY 800 OF OUR COUNTY'S MOST VULNERABLE RESIDENTS. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
MIGRANT SHELTER CLINIC IN RESPONSE TO THE URGENT NEED FOR PHYSICIAN VOLUNTEERS TO HELP SCREEN MIGRANTS SEEKING ASYLUM IN THE US, MULTIPLE GME RESIDENTS VOLUNTEERED FOR A REFUGEE HEALTH ASSESSMENT PROGRAM AT A SOUTH BAY SHELTER. MEDICAL INTERPRETERS ON SITE HELPED RESIDENTS COMMUNICATE WITH MIGRANTS AND FACILITATE THE SCREENINGS. SCRIPPS RESIDENTS SCREENED BETWEEN 30 AND 150 PATIENTS DAILY OVER APPROXIMATELY EIGHT MONTHS. FIJI SOLOMON ISLANDS MEDICAL MISSION THE MEDICAL MISSION CONSISTS OF SCRIPPS HEALTH GENERAL MEDICAL SPECIALISTS AND RESIDENTS SETTING UP CLINICS ON RURAL ISLANDS FOR THE PURPOSE OF PROVIDING MUCH NEEDED MEDICAL CARE, MEDICAL SUPPLIES AND SURGICAL SCREENING FOR AN UNDERSERVED POPULATION THAT HAVE NO ACCESS TO BASIC MEDICAL CARE. THE INTERNATIONAL MEDICAL MISSIONS PROVIDE AN EXCEPTIONAL CLINICAL EDUCATION EXPERIENCE TO OUR SENIOR INTERNAL MEDICINE RESIDENTS AT SCRIPPS CLINIC AND SCRIPPS GREEN HOSPITAL. THE 2019 MISSION BROUGHT RESIDENTS TO THE SOLOMON ISLANDS IN THE SOUTH PACIFIC, WHERE THE RATIO OF DOCTORS TO POPULATION IS 1:20,000. THE LOLOMA FOUNDATION PROVIDES MEDICAL CARE TO THESE ISLANDERS IN ASSOCIATION WITH SCRIPPS HEALTH. RESIDENTS EXPERIENCED THE CHALLENGES OF PROVIDING CARE IN THIRD WORLD CONDITIONS, WITHOUT TECHNOLOGY, AND USING ONLY THEIR EXCELLENT ACADEMIC AND PRACTICAL TRAINING TO DIAGNOSE AND TREAT PATIENTS. ISLANDERS WITH SERIOUS MEDICAL CONDITIONS ARE REFERRED TO THE NEAREST HOSPITAL, WHICH IS SEVERAL HOURS AWAY BY BOAT AND CAR. ALONG WITH EVALUATING AND TREATING UP TO 150 PATIENTS A DAY, RESIDENTS PROVIDED TRAINING TO MEDICAL PROFESSIONALS ON THE ISLAND. SCRIPPS - SPONSORED AMERICAN RED CROSS BLOOD DRIVES SCRIPPS HEALTH PARTNERED WITH THE AMERICAN RED CROSS IN FY19 TO HOST 15 BLOOD DRIVES; 478 SCRIPPS EMPLOYEES DONATED BLOOD THROUGHOUT THE YEAR. SCRIPPS HEALTH COLLECTED 478 PINTS OF BLOOD (FOR EVERY PINT DONATED 3 LIVES ARE SAVED), WHICH SAVED APPROXIMATELY 1,434 LIVES. SCRIPPS PROMOTED THE BLOOD DRIVES THROUGH OUR SYSTEM WIDE COMMUNICATION CHANNELS AND OUR WELLNESS ALL AROUND YOU CAMPAIGN. CELEBRATION OF HEROES BLOOD DRIVE SCRIPPS SPONSORED THE CELEBRATION OF HEROES BLOOD DRIVE EVENT WITH CBS 8 TELEVISION STATIONS KYLE KRASKA, SPORTSCASTER AND THE AMERICAN RED CROSS. KRASKA WAS THE VICTIM OF MULTIPLE GUNSHOT WOUNDS ON FEBRUARY 10, 2015, KRASKA WAS TRANSPORTED TO SCRIPPS MEMORIAL HOSPITAL LA JOLLA TRAUMA DEPARTMENT. DUE TO HIS INJURIES, KRASKA WAS THE RECIPIENT OF MULTIPLE BLOOD TRANSFUSIONS AND WITH THE QUICK RESPONSE OF SAN DIEGO FIRE RESCUE AND CARE OF THE SCRIPPS TRAUMA TEAM THEY SAVED HIS LIFE. KRASKA CHOSE VALENTINE'S DAY 2019 TO SHOW HIS APPRECIATION TO ALL THAT HAD SAVED HIS LIFE AND TO HONOR THE COMMUNITY BY HOSTING A BLOOD DRIVE TO SAVE THE LIVES OF OTHERS. THE CENTRAL ENGAGEMENT OF THE EVENT WAS TO SIGN UP PEOPLE ON-LINE AND FOR PEOPLE TO COME TO THE EVENT TO DONATE BLOOD. SCRIPPS HAD STAFF AT THE EVENT FOR OUTREACH ENGAGEMENT, STOP THE BLEED, AND HELMET SAFETY EDUCATION WAS PRESENTED TO ABOUT 50-75 PEOPLE. SCRIPPS PUBLIC RELATIONS PROVIDED SUPPORT FOR MULTIPLE SOCIAL MEDIA POST, LIVE TELEVISION AND RADIO INTERVIEWS WITH DR. FADY NASRALLAH, THE TRAUMA SURGEON THAT TREATED KRASKA. DR. NASRALLAH WAS ABLE TO DEMONSTRATE ON TV, AND LIVE SOCIAL MEDIA, HOW PEOPLE IN THE COMMUNITY CAN USE A TOURNIQUET AND "STOP THE BLEEDSAVE A LIFE. THE EVENT BROUGHT IN 178 ATTENDEES AND 412 UNITS OF BLOOD WERE DONATED WITH ON-LINE PLEDGES AND WALK-INS. SCRIPPS HEALTH COMMUNITY BENEFIT (CB) FUND IN FY19, SCRIPPS HEALTH CONTINUED TO DEEPEN ITS COMMITMENT TO PHILANTHROPY WITH ITS COMMUNITY BENEFIT FUND. OVER THE COURSE OF THE YEAR, IT AWARDED $221,000 IN COMMUNITY GRANTS TO PROGRAMS IN SAN DIEGO (FOUR GRANTS RANGING FROM $10,000 TO $120,000). THE FUNDED PROJECTS ADDRESS SOME OF SAN DIEGO COUNTY'S HIGH PRIORITY HEALTH NEEDS, SEEKING TO IMPROVE ACCESS TO VITAL HEALTH CARE SERVICES FOR AT RISK POPULATIONS, INCLUDING THE HOMELESS, ECONOMICALLY DISADVANTAGED, MENTALLY ILL AND OTHERS. SINCE THE COMMUNITY BENEFIT FUND BEGAN, SCRIPPS HAS AWARDED $3.9 MILLION. PROGRAMS FUNDED DURING FY19 INCLUDED: CONSUMER CENTER FOR HEALTH EDUCATION AND ADVOCACY (CCHEA) FUNDING PROVIDES LOW INCOME, UNINSURED MERCY CLINIC AND BEHAVIORAL HEALTH PATIENTS HELP OBTAINING HEALTH CARE BENEFITS, SSI AND RELATED SERVICES, WHILE REDUCING UNCOMPENSATED CARE EXPENSES AT MERCY. THE PROJECT PROVIDES ADVOCACY SERVICES FOR TIME INTENSIVE GOVERNMENT BENEFIT CASES. THE CONSUMER CENTER STRESSES THE IMPORTANCE OF ACCESSING COMMUNITY-BASED SERVICES FOR ROUTINE HEALTH CARE INSTEAD OF USING THE ED'S AND HOSPITAL DEPARTMENTS. THEY ALSO EMPHASIZE THE IMPORTANCE OF ESTABLISHING MEDICAL HOMES. CATHOLIC CHARITIES FUNDING PROVIDES SHORT TERM EMERGENCY SHELTER FOR MEDICALLY FRAGILE HOMELESS PATIENTS UPON DISCHARGE FROM SCRIPPS MERCY HOSPITAL, SAN DIEGO AND CHULA VISTA. CASE MANAGEMENT AND SHELTER ARE PROVIDED FOR HOMELESS PATIENTS DISCHARGED FROM SCRIPPS MERCY HOSPITAL. WHILE THESE PATIENTS NO LONGER REQUIRE HOSPITAL CARE, THEY DO NEED A SHORT-TERM RECUPERATIVE ENVIRONMENT. PATIENTS WHO DEMONSTRATE A WILLINGNESS TO CHANGE RECEIVE ONE WEEK IN A HOTEL, ALONG WITH FOOD AND BUS FARE TO PURSUE A CASE PLAN. THE FOCUS OF THE CASE MANAGEMENT IS TO STABILIZE THE CLIENT BY HELPING THEM CONNECT TO MORE PERMANENT SOURCES OF INCOME, HOUSING AND OTHER SELF-RELIANCE MEASURES. THE PARTNERSHIP SEEKS TO REDUCE EMERGENCY ROOM RECIDIVISM IN THIS POPULATION AND IMPROVE THEIR QUALITY OF LIFE. 2-1-1 HEALTH CARE NAVIGATION PROGRAM LOCALLY, 2-1-1 SAN DIEGO WAS LAUNCHED IN JUNE 2005 AS A MULTILINGUAL AND CONFIDENTIAL SERVICE COMMITTED TO PROVIDING 24/7 ACCESS. THERE WAS AN OVERWHELMING NEED FOR A DEPENDABLE SERVICE TO HELP PEOPLE NAVIGATE TODAY'S COMPLEX HEALTH CARE SYSTEM. SCRIPPS HEALTH HAS BEEN A LONGTIME SUPPORTER OF 2-1-1 SAN DIEGO'S HEALTH NAVIGATION PROGRAM WHICH CREATES A RECORD FOR EVERY PERSON WHO CALLS, IN ORDER TO PROVIDE A SERVICE THAT NAVIGATES CLIENTS THROUGH DIFFERENT REFERRALS AND TRACKS THEIR SUCCESS TOWARD ACHIEVING IMPROVED SOCIAL DETERMINANTS OF HEALTH. ALL 2-1-1 STAFF ARE TRAINED TO IDENTIFY INDIVIDUALS WHO ARE IN NEED OF CARE COORDINATION SERVICES, PARTICULARLY INDIVIDUALS WHO ARE HAVING DIFFICULTIES MANAGING THEIR CHRONIC HEALTH CONDITIONS. HEALTH NAVIGATORS ARE TRAINED TO DETERMINE CLIENT RISK USING THE RISK RATING SCALE (RRS). THE RRS DETERMINES A CLIENT'S STATUS RANGING FROM "IN CRISIS" TO "THRIVING" USING SOCIAL DETERMINANTS OF HEALTH SUCH AS HOUSING, NUTRITION, PRIMARY CARE AND HEALTH MANAGEMENT. HEALTH NAVIGATORS ASSESS ON THE FOLLOWING TO DETERMINE WHETHER A CLIENT HAS DECREASED IN VULNERABILITY FOR HEALTH MANAGEMENT: - UNDERSTANDING OF PRESCRIPTION MEDICATION: DOES THE CLIENT UNDERSTAND HOW AND WHEN TO TAKE THEIR MEDICINE AND DO THEY UNDERSTAND THE USE/IMPORTANCE OF EACH MEDICATION? - HEALTH CONDITION MANAGEMENT: DOES THE CLIENT UNDERSTAND THE ILLNESS/DISEASE THAT THEY HAVE BEEN DIAGNOSED WITH, WHAT THEIR PROGNOSIS IS, AND WHAT THEY NEED TO DO IN ORDER TO REMAIN HEALTHY? - HEALTH INSURANCE/ MEDICAL HOME: DOES THE CLIENT HAVE HEALTH INSURANCE, AND DO THEY KNOW HOW TO UTILIZE IT? DOES THE CLIENT HAVE A PRIMARY CARE DOCTOR AND/OR SPECIALIST THAT THEY SEE, AND DO THEY KNOW HOW TO MAKE APPOINTMENTS WITH EACH? DOES THE CLIENT KNOW IN WHAT SITUATION THEY SHOULD MAKE AN APPOINTMENT WITH THE PCP VERSUS GOING TO AN EMERGENCY ROOM FOR AN IMMEDIATE MEDICAL NEED? TRANSPORTATION: DOES THE CLIENT HAVE THE MEANS TO GET TO THEIR DOCTOR'S APPOINTMENTS? DURING THIS GRANT PERIOD 2-1-1 PROVIDED CARE COORDINATION SERVICES TO 576 CLIENTS WITH COMPLEX CHRONIC CONDITIONS. CLIENTS DECREASED VULNERABILITY IN THE FOLLOWING SOCIAL DETERMINANTS OF HEALTH: HOUSING, NUTRITION, PRIMARY CARE, AND HEALTH MANAGEMENT BY 67%. CLIENTS ALSO REPORTED FEELING BETTER TO MANAGE THEIR HEALTH CONDITION BY 71% INCREASE. 2-1-1 HEALTH NAVIGATORS PROVIDED INDIVIDUALIZED NEEDS ASSESSMENTS, CASE PLANNING, INFORMATION, EDUCATION AND REFERRALS AND PROVIDED ONGOING CLIENT CONTACT AND PROGRESS CHECKS VIA PHONE OVER A PERIOD OF TIME RELEVANT TO THE CLIENT'S NEEDS TO CHECK ON AND DOCUMENT CLIENT PROGRESS. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
CANCER/ONCOLOGY CANCER IS A TERM USED TO DESCRIBE A GROUP OF DISEASES THAT CAUSE THE UNCONTROLLED GROWTH, INVASION, AND SPREAD (METASTASIS) OF ABNORMAL CELLS. CANCER IS CAUSED BY EXTERNAL FACTORS SUCH AS ENVIRONMENTAL CONDITIONS, RADIATION, INFECTIOUS ORGANISMS, POOR DIET AND LACK OF EXERCISE, AND TOBACCO USE, AS WELL AS INTERNAL FACTORS SUCH AS GENETIC MUTATIONS, AND HORMONES. CANCER IS THE SECOND LEADING CAUSE OF DEATH IN THE UNITED STATES. CANCER CAUSES ONE OUT OF EVERY FOUR DEATHS IN THE UNITED STATES. ACCORDING TO THE AMERICAN CANCER SOCIETY, CANCER SURVIVAL IS MORE LIKELY TO BE SUCCESSFUL IF THE CANCER IS DIAGNOSED AT AN EARLY STAGE. SUCH DIAGNOSIS IS AN INDICATION OF SCREENING AND EARLY DETECTION. REGULAR SCREENING THAT ALLOW FOR THE EARLY DETECTION AND REMOVAL OF PRECANCEROUS GROWTHS ARE KNOWN TO REDUCE MORTALITY FOR CANCERS OF THE CERVIX, COLON AND RECTUM. FIVE-YEAR RELATIVE SURVIVAL RATES FOR COMMON CANCERS, SUCH AS BREAST, PROSTATE, COLON AND RECTUM, CERVIX, AND MELANOMA OF THE SKIN, ARE 93 PERCENT TO 100 PERCENT IF THEY ARE DISCOVERED BEFORE HAVING SPREAD BEYOND THE ORGAN WHERE THE CANCER BEGAN. A SUMMARY OF THE MAGNITUDE AND PREVALENCE OF CANCER IS DESCRIBED BELOW: - THE HASD&IC 2019 CHNA CONTINUED TO IDENTIFY CANCER DISEASE AS ONE OF THE TOP PRIORITY HEALTH CONDITIONS AMONG SAN DIEGO COUNTY HOSPITALS. - IN 2016, CANCER WAS THE LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY, RESPONSIBLE FOR 24.1 PERCENT OF ALL UNDERLYING CAUSES OF DEATH. - IN 2016, THERE WERE 5,096 DEATHS DUE TO CANCER (ALL SITES), AND AN AGE ADJUSTED DEATH RATE OF 146.6 DEATHS PER 100,000 POPULATION. - IN 2016, 19.3 PERCENT OF ALL CANCER DEATHS IN SAN DIEGO COUNTY WERE DUE TO LUNG CANCER, 9.3 PERCENT TO COLORECTAL CANCER, 7.4 PERCENT TO FEMALE BREAST CANCER, 7.2 PERCENT TO PANCREATIC CANCER, 6.7 PERCENT TO PROSTATE CANCER, 5.7 PERCENT TO LIVER AND FEMALE REPRODUCTIVE CANCERS, AND 3.6 PERCENT TO LEUKEMIA. - ACCORDING TO THE AMERICAN CANCER SOCIETY (ACS) 2017 CALIFORNIA CANCER FACTS & FIGURES REPORT, IN 2014 THERE WERE 13,625 OBSERVED NEW CANCER CASES AND 4,868 CANCER DEATHS IN SAN DIEGO COUNTY. - ACCORDING TO THE ACS CANCER STATISTICS CENTER, IN 2018 THERE WILL BE AN ESTIMATED 29,360 NEW CASES OF BREAST CANCER AND 4,500 BREAST CANCER DEATHS FOR FEMALES IN CALIFORNIA. - IN 2016, THE AGE-ADJUSTED MORTALITY RATE FOR BREAST CANCER IN SAN DIEGO COUNTY WAS 20.0 PER 100,000 WOMEN. THIS FALLS SLIGHTLY BELOW THE HP2020 TARGET OF 20.7 BREAST CANCER DEATHS PER 100,000 WOMEN. - ACCORDING TO THE 2015 SUSAN G. KOMEN FOR THE CURE SAN DIEGO AFFILIATE COMMUNITY PROFILE REPORT, IN SDC THERE WERE 46.1 LATE-STAGE CASES OF BREAST CANCER PER 100,000 WOMEN, EXCEEDING THE HP2020 TARGET OF 42.4 CASES PER 100,000 WOMEN. THE REPORT PROJECTS THAT SDC WILL MEET THE HP2020 TARGET WITHIN FIVE YEARS. - THE 2015 SUSAN G. KOMEN FOR THE CURE SAN DIEGO AFFILIATE COMMUNITY PROFILE ALSO REPORTED THAT, IN 2013, BREAST CANCER MORTALITY RATES IN SDC WERE HIGHEST AMONG AFRICAN AMERICAN WOMEN, AT 27.7 DEATHS PER 100,000. THIS EXCEEDED THE MORTALITY RATE FOR CAUCASIAN (23.9), LATINA (17.3) AND ASIAN/PACIFIC ISLANDER (13.2). - ACCORDING TO THE ACS 2017 CALIFORNIA CANCER FACTS & FIGURES REPORT, 72.4 PERCENT OF BREAST CANCER CASES AMONG NON-HISPANIC WHITE WOMEN IN SAN DIEGO COUNTY WERE DIAGNOSED AT AN EARLY STAGE, COMPARED TO 69.3 PERCENT OF AFRICAN AMERICAN CASES, 68.1 PERCENT OF HISPANIC CASES AND 70.4 PERCENT OF ASIAN/PACIFIC ISLANDER CASES. DATA SUGGESTS THAT EARLY BREAST CANCER DETECTION RESOURCES ARE NEEDED IN MINORITY COMMUNITIES. - ACCORDING TO 2015-2016 CHIS DATA, 85.6 PERCENT OF WOMEN IN SAN DIEGO COUNTY BETWEEN THE AGES OF 50 TO 74 REPORTED HAVING A MAMMOGRAM IN THE PAST TWO YEARS. THIS EXCEEDS THE HP2020 TARGET OF 81.1 PERCENT FOR BREAST CANCER SCREENINGS. APPROXIMATELY 2.9 PERCENT OF WOMEN IN THIS AGE RANGE IN SDC REPORTED THAT THEY HAD NEVER HAD A MAMMOGRAM. - ACCORDING TO FINDINGS FROM THE ACS 2018 CANCER FACTS & FIGURES REPORT, SCREENING OFFERS THE ABILITY FOR SECONDARY PREVENTION BY DETECTING CANCER EARLY. FOR EXAMPLE, THE 39 PERCENT DECREASE IN THE FEMALE BREAST CANCER DEATH RATE BETWEEN 1989 AND 2015 IS ATTRIBUTED TO IMPROVEMENTS IN EARLY DETECTION, NAMELY SCREENING AND INCREASED AWARENESS. IN ADDITION, OVER THE PAST THREE DECADES, FIVE-YEAR RELATIVE SURVIVAL RATES FOR ALL CANCERS COMBINED INCREASED BY 20 PERCENT AMONG WHITES AND 24 PERCENT AMONG BLACKS, REFLECTING EARLIER DIAGNOSIS FOR SOME CANCERS AS WELL AS IMPROVEMENTS IN TREATMENT (ACS, 2018). - STUDY FINDINGS FROM THE 2015 SUSAN G. KOMEN FOR THE CURE SAN DIEGO AFFILIATE COMMUNITY PROFILE INDICATE A CRITICAL NEED FOR CULTURALLY COMPETENT OUTREACH, ESPECIALLY FOR HISPANIC, MIDDLE EASTERN AND AFRICAN AMERICAN WOMEN (SUSAN G. KOMEN, 2015). - A RECENT STUDY BY THE ACS FOUND THAT 42 PERCENT OF NEWLY DIAGNOSED CANCER CASES IN THE U.S. ARE POTENTIALLY AVOIDABLE. MANY OF THE KNOWN CAUSES OF THE CANCER-AND OTHER NON-COMMUNICABLE DISEASES-ARE ATTRIBUTABLE TO BEHAVIORAL FACTORS INCLUDING TOBACCO USE AND EXCESS BODY WEIGHT DUE TO POOR DIETARY HABITS AND LACK OF PHYSICAL ACTIVITY (ACS, 2018). - THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY (ASCO) EMPHASIZES THE IMPORTANCE OF PATIENT NAVIGATORS AS PART OF A MULTIDISCIPLINARY ONCOLOGY TEAM WITH THE GOAL OF REDUCING MORTALITY AMONG UNDERSERVED PATIENTS. A PATIENT NAVIGATOR MAY ASSIST WITH VARIOUS TASKS, INCLUDING PSYCHOSOCIAL SUPPORT; ASSISTANCE WITH TREATMENT DECISIONS; ASSISTANCE WITH INSURANCE ISSUES; ARRANGEMENT OF TRANSPORTATION; COORDINATION OF ADDITIONAL SERVICES (I.E., FERTILITY PRESERVATION); AND TRACKING OF INTERVENTIONS AND OUTCOMES. THE NAVIGATOR WORKS WITH THE PATIENT ACROSS THE CARE CONTINUUM, ENSURING COORDINATION AND EFFICIENCY OF CARE, AND REMOVAL OF BARRIERS TO CARE (ASCO, 2016). - ACCORDING TO THE NIH, CLINICAL TRIALS, A PART OF CLINICAL RESEARCH, ARE AT THE HEART OF ALL MEDICAL ADVANCES. CLINICAL TRIALS LOOK AT NEW WAYS TO PREVENT, DETECT OR TREAT DISEASE BY DETERMINING THE SAFETY AND EFFICACY OF A NEW TEST OR TREATMENT. GREATER CLINICAL TRIAL ENROLLMENT BENEFITS MEDICAL RESEARCH AND INCREASES THE HEALTH OF FUTURE GENERATIONS AS WELL AS IMPROVES DISEASE OUTCOMES, QUALITY OF LIFE AND HEALTH OF TRIAL PARTICIPANTS. SCRIPPS HAS DEVELOPED A SERIES OF PREVENTION AND WELLNESS PROGRAMS TO EDUCATE PEOPLE ABOUT THE IMPORTANCE OF EARLY DETECTION AND TREATMENT FOR SOME OF THE MOST COMMON FORMS OF CANCER. AT SCRIPPS, CANCER CARE IS MORE THAN JUST MEDICAL TREATMENT, AND A WIDE ARRAY OF RESOURCES ARE PROVIDED SUCH AS COUNSELING, SUPPORT GROUPS, COMPLEMENTARY THERAPIES AND EDUCATIONAL WORKSHOPS. HERE ARE A FEW EXAMPLES OF SCRIPPS CANCER PROGRAMS DURING FY19: SCRIPPS MD ANDERSON CANCER CENTER DIRECTORY OF COMMUNITY RESOURCES SCRIPPS COLLABORATES WITH THE COMMUNITY AND DEVELOPS A CANCER DIRECTORY OF A COMPREHENSIVE LIST OF RESOURCES AVAILABLE FOR CANCER SURVIVORS, THEIR FAMILIES, AND THE COMMUNITY. SCRIPPS MD ANDERSON GREEN CANCER CENTER SUPPORT GROUPS SCRIPPS GREEN HOSPITAL SUPPORT GROUPS OFFER CANCER PATIENTS THE OPPORTUNITY TO EXPRESS THE EMOTIONS THAT COME WITH A CANCER DIAGNOSIS AND HELP THEM COPE MORE EFFECTIVELY WITH THEIR TREATMENT REGIMENS BY SUPPORT GROUPS THAT NURTURE THEIR PHYSICAL, EMOTIONAL AND SPIRITUAL WELL-BEING. SCRIPPS MD ANDERSON CANCER CENTER - REGISTERED NURSE NAVIGATOR PROGRAM SCRIPPS PROVIDED A REGISTERED NURSE, DEDICATED TO ASSISTING CANCER PATIENTS AND THEIR FAMILIES WITH NAVIGATING THROUGH THE JOURNEY FROM DIAGNOSIS, TREATMENT AND SURVIVORSHIP FROM CANCER. THE FOCUS IS ON EDUCATION AND OUTREACH, AS WELL AS, SUPPORT SERVICES IN THIS POPULATION. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
SCRIPPS MD ANDERSON CANCER CENTER - OUTPATIENT HEREDITY AND CANCER GENETIC COUNSELING PROGRAM THIS PROGRAM PROVIDES GENETIC TESTING AND COUNSELING TO CANCER PATIENTS, ALONG WITH PROVIDING EDUCATION TO HEALTH PROFESSIONALS AND CAREGIVERS. SCRIPPS MD ANDERSON CANCER CENTER - OUTPATIENT SOCIAL WORKER & LIAISON PROGRAM SCRIPPS PROVIDES A SOCIAL WORKER, DEDICATED TO ASSISTING CANCER PATIENTS, ALONG WITH PROVIDING EDUCATION TO HEALTH PROFESSIONALS AND CAREGIVERS. SCRIPPS MD ANDERSON CANCER CENTER HEAD AND NECK SUPPORT GROUP SCRIPPS PROVIDES SUPPORT GROUPS DESIGNED FOR INDIVIDUALS DIAGNOSED WITH HEAD AND NECK CANCER. THIS GROUP PROVIDES EDUCATION AND RESOURCES TO HELP MANAGE EMOTIONAL AND PHYSICAL CHALLENGES NORMALLY ENCOUNTERED DURING AND AFTER CANCER TREATMENT. SCRIPPS MD ANDERSON CANCER CENTER LYMPHEDEMA SUPPORT GROUP SCRIPPS PROVIDES EDUCATION AND SUPPORT FOR THOSE DIAGNOSED WITH LYMPHEDEMA AND UNDERGOING TREATMENT FOR THE DISEASE. SCRIPPS MD ANDERSON CANCER SURVIVORS DAY SURVIVORS DAY IS A TIME TO RECOGNIZE THE NATION'S 15.5 MILLION CANCER SURVIVORS, TO FOCUS ATTENTION ON ISSUES OF SURVIVORSHIP, AND TO ACKNOWLEDGE MEDICAL PROFESSIONALS DEDICATED TO CANCER TREATMENT, RESEARCH AND SUPPORT SERVICES. NATIONAL CANCER SURVIVORS DAY EVENTS ARE HELD IN HUNDREDS OF COMMUNITIES NATIONWIDE THROUGHOUT THE MONTH OF JUNE. SCRIPPS HOLDS A CELEBRATORY EVENT AT VARIOUS SCRIPPS HOSPITALS EACH YEAR TO PROVIDE AN OPPORTUNITY FOR THOSE THAT HAVE BATTLED CANCER TO COME TOGETHER AND ENJOY THE COMPANY OF FRIENDS, FAMILY AND THE CAMARADERIE OF FELLOW CANCER SURVIVORS. CANCER SURVIVORS AND OTHER GUESTS SHARE INSPIRATIONAL STORIES LEARN ABOUT ADVANCES IN CANCER TREATMENT AND RESEARCH AND ENJOY THE OPPORTUNITY TO CONNECT WITH CAREGIVERS AND FELLOW SURVIVORS. EACH YEAR THE CANCER SURVIVOR EVENT HELPS CELEBRATE LIFE, INSPIRE THOSE RECENTLY DIAGNOSED, OFFER SUPPORT TO FAMILY AND LOVED ONES AND RECOGNIZE ALL WHO PROVIDED SUPPORT ALONG THE WAY. THEY ALSO PROVIDE A FORUM FOR DISCUSSING THE PHYSICAL, FINANCIAL AND SOCIAL ISSUES THAT MANY CANCER SURVIVORS FACE FOLLOWING COMPLETION OF TREATMENT. SCRIPPS MD ANDERSON CANCER CENTER - GYNECOLOGICAL SUPPORT GROUP SCRIPPS HEALTH PROVIDES MEETING SPACE FOR WOMEN FACING GYNECOLOGICAL CANCERS. SAN DIEGO CITY FIREFIGHTERS, LIFEGUARDS AND POLICE OFFICERS SKIN CANCER SCREENINGS A TOTAL OF 112 FIREFIGHTERS, LIFEGUARDS AND POLICE OFFICERS WERE SCREENED FOR SKIN CANCER. LOCAL STATE BEACHES LIFEGUARD SKIN CANCER SCREENINGS A TOTAL OF 94 LOCAL STATE BEACHES LIFEGUARDS WERE SCREENED FOR SKIN CANCER. SCRIPPS MERCY HOSPITAL CHULA VISTA WELL BEING CENTER CANCER SUPPORT SERVICES: HEALTHY WOMEN, HEALTHY LIFESTYLES: SCRIPPS MERCY BREAST HEALTH OUTREACH AND EDUCATION PROGRAM A PROMOTORA LED HEALTH AND WELLNESS PROGRAM THAT AIMS TO IMPROVE THE LIVES OF WOMEN IN SAN DIEGO'S SOUTH BAY WITH BREAST CANCER EDUCATION, PREVENTION AND TREATMENT SUPPORT. PROMOTORAS TEACH BREAST HEALTH TO WOMEN WHO HAVE LIMITED OR NO ACCESS TO HEALTH CARE. PROMOTORAS TEACH WOMEN IN THEIR NATIVE LANGUAGE WITH SENSITIVITY TO A WOMAN'S ETHNIC AND CULTURAL NORMS. THE PROGRAM MODEL INCLUDES A PROMOTORA, CANCER SURVIVOR AND A NURSE NAVIGATOR. THE PROMOTORA HAS KNOWLEDGE OF BREAST CANCER, OFFERS EDUCATION AND EMOTIONAL SUPPORT. SHE ALSO PROVIDES REFERRALS IN CULTURALLY APPROPRIATE AND LANGUAGE SENSITIVE WAY. A BREAST CANCER SURVIVOR AND VOLUNTEER STRENGTHEN THE BENEFITS OF BREAST CANCER EDUCATION AND PREVENTION BY TALKING TO SOMEONE WHO HAS BEEN THERE AND CAN PROVIDE INSIGHT AND SUGGESTIONS AND IS LIVING PROOF THAT THE DISEASE IS NOT FATAL. WORKING HAND-IN-HAND, THE PROMOTORA AND VOLUNTEER PRESENT A VERY STRONG FRONT FOR BREAST CANCER AWARENESS AND FULL SUPPORT SYSTEM FOR THOSE ALREADY DIAGNOSED. MOREOVER, THE FACT THEY ARE BI-LINGUAL LATINAS, LEND AN AIR OF AUTOMATIC TRUST AMONG THE HISPANIC COMMUNITY AS THEY CAN CONNECT WITH THE RESIDENTS ON A CULTURAL LEVEL. SCRIPPS MERCY HOSPITAL CHULA VISTA: BREAST HEALTH CLINICAL SERVICES A TOTAL OF 150 WOMEN WERE REFERRED TO CLINICAL BREAST HEALTH SERVICES IN THE COMMUNITY AND TO SCRIPPS MERCY HOSPITAL, CHULA VISTA RADIOLOGY SERVICES. A TOTAL OF 2,073 SERVICES WERE PROVIDED, INCLUDING TELEPHONE REMINDERS, OUTREACH AND EDUCATION AND CASE MANAGEMENT/CARE COORDINATION. SCRIPPS MERCY HOSPITAL CHULA VISTA RADIOLOGY SERVICES MORE THAN 500 SERVICES WERE PROVIDED SERVICES. SERVICES INCLUDED PATIENTS THAT NEED REPEAT EXAMS AND THOSE DUE FOR ROUTINE SCREENING MAMMOGRAM, ALONG WITH ASSISTING PATIENTS TO GET HEALTH INSURANCE APPROVAL, TELEPHONE REMINDERS AND EDUCATION BY PHONE ABOUT PREVENTING BREAST CANCER. SCRIPPS MERCY HOSPITAL CHULA VISTA RADIOLOGY, POSITIVE BREAST CANCER PATIENT SUPPORT MORE THAN 300 SERVICES WERE PROVIDED FOR PATIENTS WITH A DIAGNOSIS OF BREAST CANCER. THESE INCLUDED PHONE CALLS, HOME VISITS, AND EDUCATIONAL MATERIAL PACKETS, SUPPLIES (WIGS, BRAS, PROSTHESIS AND MEDICAL RECORD ORGANIZER BINDER), BREAST CANCER SUPPORT GROUP AND SOCIAL/EMOTIONAL SUPPORT. SCRIPPS MERCY HOSPITAL CHULA VISTA BREAST CANCER SUPPORT GROUP TOGETHER PROMOTORAS AND CANCER SURVIVORS HOLD A BI-MONTHLY SUPPORT GROUP THAT HELPS INDIVIDUALS COPE WITH LIVING WITH CANCER. ON AVERAGE 15 WOMEN PARTICIPATE AS PART OF THIS GROUP TWICE MONTHLY. GROUP SUPPORT INCLUDING NAVIGATING THE CANCER SYSTEM AND EDUCATIONAL PRESENTATIONS BY LOCAL PROVIDERS ARE OFFERED. SCRIPPS POLSTER BREAST CARE CENTER (SPBCC) SCRIPPS POLSTER BREAST CARE CENTER (SPBCC) SPONSORS THE YOUNG WOMEN'S SUPPORT GROUP WHICH PROVIDE A VENUE FOR WOMEN UNDER THE AGE OF 40 TO COME TOGETHER, DISCUSS ISSUES RELATING TO DIAGNOSES AND RECEIVE SUPPORT. THE GROUPS ARE OFFERED TO WOMEN IN THE SAN DIEGO COMMUNITY. TOPICS RELATED TO BREAST HEALTH ARE ALSO OFFERED TO THE COMMUNITY. AMERICAN CANCER SOCIETY (ACS) MAKING STRIDES AGAINST BREAST CANCER SCRIPPS HEALTH PARTICIPATED AND SPONSORED THE MAKING STRIDES AGAINST BREAST CANCER WALK IN THE AMOUNT OF $10,000 TO RAISE MONEY FOR BREAST CANCER RESEARCH. THE WALK RAISES CRITICAL FUNDS TO SAVE LIVES FROM BREAST CANCER AND ENSURE NO ONE FACES BREAST CANCER ALONE. A SERIES OF EDUCATIONAL EVENTS ARE COORDINATED WITH THE AMERICAN CANCER SOCIETY AWARENESS MONTHS. THE EVENTS FOCUS ON VARIOUS TYPES OF CANCER, INCLUDING BREAST, LUNG, CERVICAL, COLORECTAL, SKIN, OVARIAN/GYNECOLOGICAL AND PROSTATE. A REGISTERED NURSE CLINICIAN ANSWERS QUESTIONS AND PROVIDES EDUCATIONAL MATERIALS. CARDIOVASCULAR DISEASE 'DISEASES OF THE HEART' WERE THE SECOND LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY IN 2016. IN ADDITION, 'CEREBROVASCULAR DISEASES' WERE THE FOURTH LEADING CAUSE OF DEATH, AND ESSENTIAL (HYPERTENSION AND HYPERTENSIVE RENAL DISEASE' WAS THE TENTH. CORONARY HEART DISEASE IS THE MOST COMMON FORM OF HEART DISEASE. HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, AND SMOKING ARE ALL RISK FACTORS THAT COULD LEAD TO CVD AND STROKE. ABOUT HALF OF AMERICANS (49%) HAVE AT LEAST ONE OF THESE THREE RISK FACTORS. RISK FACTORS FOR CARDIOVASCULAR DISEASE: BEHAVIORS: TOBACCO USE, OBESITY, POOR DIET THAT IS HIGH IN SATURATED FATS, AND EXCESSIVE ALCOHOL USE. CONDITIONS: HIGH CHOLESTEROL LEVELS, HIGH BLOOD PRESSURE AND DIABETES. HEREDITY: GENETIC FACTORS LIKELY PLAY A ROLE IN HEART DISEASE AND CAN INCREASE RISK. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
A SUMMARY OF THE MAGNITUDE AND PREVALENCE OF CARDIOVASCULAR DISEASE IS DESCRIBED BELOW: - THE SCRIPPS 2019 CHNA CONTINUED TO IDENTIFY CARDIOVASCULAR DISEASE (INCLUDING CEREBROVASCULAR DISEASE/STROKE) AS A PRIORITY HEALTH ISSUE AFFECTING MEMBERS OF THE COMMUNITIES SERVED BY SCRIPPS. - ACCORDING TO DATA PRESENTED IN THE SCRIPPS 2019 CHNA, HIGH BLOOD PRESSURE, HIGH CHOLESTEROL AND SMOKING ARE ALL RISK FACTORS THAT COULD LEAD TO CARDIOVASCULAR DISEASE AND STROKE. ABOUT HALF OF ALL AMERICANS (47 PERCENT) HAVE AT LEAST ONE OF THESE THREE RISK FACTORS. ADDITIONAL RISK FACTORS INCLUDE ALCOHOL USE, OBESITY, PHYSICAL INACTIVITY, POOR DIET, DIABETES AND GENETIC FACTORS (CDC, 2015). - HEART DISEASE IS THE LEADING CAUSE OF DEATH FOR PEOPLE OF MOST RACIAL/ETHNIC GROUPS IN THE UNITED STATES, INCLUDING AFRICAN AMERICANS, HISPANICS AND WHITES. - IN 2016, CEREBROVASCULAR DISEASES INCLUDING STROKE WERE THE FOURTH LEADING CAUSE OF DEATH FOR SAN DIEGO COUNTY OVERALL. - IN 2016, THERE WERE 1,362 DEATHS DUE TO STROKE IN SAN DIEGO COUNTY, A 17.2 PERCENT INCREASE FROM 2015. THE AGE-ADJUSTED DEATH RATE DUE TO STROKE WAS 38.3 PER 100,000 POPULATION, WHICH WAS HIGHER THAN THE HP2020 TARGET OF 34.8 DEATHS PER 100,000. - IN 2016, THERE WERE 6,346 HOSPITALIZATIONS FOR STROKE IN SAN DIEGO COUNTY, WITH AN AGE-ADJUSTED RATE OF 183 PER 100,000 POPULATION. THE RATE OF HOSPITALIZATION FOR STROKE INCREASED 2.8 PERCENT FROM 2015 TO 2016-THE FIRST INCREASE SINCE 2011, WHEN SAN DIEGO COUNTY RECORDED A STROKE RATE OF 218.4 PER 100,000 POPULATION. - IN 2016, THERE WERE 2,371 STROKE-RELATED ED VISITS IN SAN DIEGO COUNTY. THE AGE-ADJUSTED RATE OF ED VISITS WAS 68.9 PER 100,000 POPULATION. - ACCORDING TO 2016-2017 CHIS DATA, AN ESTIMATED 23.9 PERCENT OF ADULTS IN SAN DIEGO COUNTY WERE OBESE, 9.7 PERCENT SMOKED CIGARETTES AND 62.0 PERCENT DID NOT REGULARLY WALK FOR TRANSPORTATION, FUN, OR EXERCISE. IN 2016, 16.3 PERCENT OF ADULTS IN SDC REPORTED EATING FAST FOOD FOUR OR MORE TIMES IN THE PAST WEEK. - THE NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE (NINDS) REPORTS THAT 25 PERCENT OF PEOPLE WHO RECOVER FROM THEIR FIRST STROKE WILL HAVE ANOTHER STROKE WITHIN FIVE YEARS (NINDS, 2016). - THE CDC ESTIMATES THAT UP TO 80 PERCENT OF STROKES ARE PREVENTABLE THROUGH THE RECOGNITION OF EARLY SIGNS/SYMPTOMS AND THE ELIMINATION OF STROKE RISK FACTORS. - ACCORDING TO THE CDC, HEALTHY LIFESTYLE CHOICES CAN HELP PREVENT STROKE. BEHAVIORS THAT CAN MITIGATE THE RISK OF STROKE INCLUDE CHOOSING A HEALTHY DIET FULL OF FRUITS AND VEGETABLES, MAINTAINING A HEALTHY WEIGHT, ENGAGING IN AT LEAST 2.5 HOURS OF MODERATE-INTENSITY AEROBIC PHYSICAL ACTIVITY EACH WEEK, REFRAINING FROM OR QUITTING SMOKING, AND LIMITING ALCOHOL INTAKE (CDC, 2018). NOT ONLY IS SCRIPPS A NATIONALLY RECOGNIZED HEART CARE LEADER, CONSISTENTLY RANKED BY U.S. NEWS & WORLD REPORT AS ONE OF AMERICA'S BEST HOSPITALS FOR CARDIOLOGY AND HEART SURGERY, BUT WE TREAT MORE HEART PATIENTS THAN ANY OTHER HEALTH CARE PROVIDER IN SAN DIEGO. WE HAVE STATE-OF-THE-ART TECHNOLOGY AND HIGHLY TRAINED HEART CARE SPECIALISTS, PROVIDING AN INNOVATIVE AND EXPANSIVE SCOPE OF SERVICES AND HIGH-QUALITY OUTCOMES. ALONG WITH THE TREMENDOUS CARE SCRIPPS PROVIDES WITHIN OUR HOSPITALS AND OUTPATIENT CLINICS, SCRIPPS ALSO SUPPORTS OUR SURROUNDING COMMUNITIES WITH RESOURCES, OUTREACH PROGRAMS AND PARTNERSHIPS TO ENSURE THE HEARTBEAT OF OUR COMMUNITY CONTINUES. DURING FY19, SCRIPPS ENGAGED IN THE FOLLOWING HEART HEALTH, STROKE, AND CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT ACTIVITIES. AMERICAN HEART ASSOCIATION - HEART WALK SCRIPPS PARTNERS WITH THE AMERICAN HEART ASSOCIATION ON ITS ANNUAL SAN DIEGO HEART AND STROKE WALK TO RAISE FUNDS FOR RESEARCH, PROFESSIONAL AND PUBLIC EDUCATION AND ADVOCACY. HEART DISEASE AND STROKE ARE THE NUMBER ONE AND THREE CAUSES OF DEATH IN THE NATION. HEART DISEASE CLAIMS MORE THAN 950,000 AMERICANS EACH YEAR. SCRIPPS HAS PROUDLY SUPPORTED THE AHA'S ANNUAL SAN DIEGO HEART & STROKE WALK, WHICH PROMOTES PHYSICAL ACTIVITY TO BUILD HEALTHIER LIVES, FREE OF CARDIOVASCULAR DISEASES AND STROKE. IN SEPTEMBER 2019, SCRIPPS EMPLOYEES VOLUNTEERED THEIR TIME TO COORDINATE WALKER PARTICIPATION AND FUNDRAISING EFFORTS. THE SAN DIEGO HEART WALK RAISED MORE THAN $959,884. IN FY19, MORE THAN 1,060 SCRIPPS HEART WALK PARTICIPANTS, (EMPLOYEES, FAMILIES, AND FRIENDS) AND MORE THAN 114 TEAMS REPRESENTING ENTITIES ACROSS SCRIPPS HEALTH WALKED TO HELP RAISE MORE THAN $102,600. TO DATE, SCRIPPS HAS RAISED MORE THAN $3 MILLION THROUGH ITS SAN DIEGO HEART & STROKE WALK FUNDRAISING EFFORTS. AMERICAN HEART ASSOCIATION - GO RED FOR WOMEN'S LUNCHEON SCRIPPS SPONSORS THIS ANNUAL EVENT THAT BRINGS PHILANTHROPISTS, CARDIOLOGISTS, AND SURVIVORS TOGETHER TO CREATE AWARENESS AROUND HEART DISEASE AND STROKE. FUNDS RAISED HELP SUPPORT LOCAL RESEARCH PROJECTS IN SAN DIEGO. CPR CLASSES FOR PATIENTS AND FAMILIES OF THE CARDIAC TREATMENT CENTER CPR CLASSES ARE OFFERED FOUR TIMES A YEAR TO CARDIAC TREATMENT CENTER PATIENTS AND THEIR FAMILIES. THE PROGRAM IMPROVES COMMUNITY HEALTH BY INCREASING KNOWLEDGE OF CARDIOPULMONARY RESUSCITATION PRACTICES. CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS ARE DESIGNED FOR CARDIOVASCULAR HEALTH IMPROVEMENT. CLASSES INCLUDE TRAINING IN BALANCE, HATHA YOGA, TAI CHI, FIT BALL, CHAIR YOGA AND MEDITATION, AND LEBED METHOD OF EXERCISE. THE CARDIAC TREATMENT CENTER ALSO PROVIDES EXERCISE PROGRAMS THAT INCLUDE NUTRITIONAL EDUCATION THROUGH THE PULMONARY CLASS, DIETARY ONE-ON-ONE COUNSELING, AND THE CARDIAC LIFE PROJECT. THE BETTER BREATHERS AND SELF-DEFENSE FITNESS CLASSES PROVIDE ADDITIONAL EDUCATION IN CARDIOVASCULAR HEALTH. CARDIAC LIFE PROJECT THE CARDIAC TREATMENT CENTER'S LIFE PROJECT IS A SUPPORT GROUP FOR PEOPLE WITH HEART DISEASE AND THEIR FAMILY MEMBERS. THE GOAL IS TO PROVIDE EDUCATION AND RESOURCES ON COPING WITH HEART DISEASE IN A FRIENDLY AND SUPPORTIVE ENVIRONMENT. PULMONARY CARDIAC CLASS THIS EDUCATIONAL CLASS PROVIDED BY THE SCRIPPS CARDIAC TREATMENT CENTER IS A COMPREHENSIVE SIX-WEEK EDUCATION PROGRAM FOR PULMONARY PATIENTS TO HELP THEM TO MANAGE THEIR DISEASE. THEY WILL LEARN LIFESTYLE MANAGEMENT FOR A HEALTHY LIFE, NUTRITION AND EXERCISE ARE PART OF THE SERIES. STROKE CARE PROGRAMS ON AVERAGE, A STROKE OCCURS EVERY 40 SECONDS IN THE UNITED STATES. MORE THAN 1,000 STOKE DEATHS OCCURRED IN SAN DIEGO COUNTY IN 2018, AND ABOUT 15 PEOPLE ARE HOSPITALIZED DUE TO STROKE EVERY DAY. SCRIPPS SPONSORS A WIDE VARIETY OF STROKE RELATED EDUCATION AND AWARENESS PROGRAMS. THESE INCLUDE SUPPORT GROUPS AND EDUCATION FOR STROKE AND BRAIN INJURY SURVIVORS AND THEIR LOVED ONE. INFORMATION AND RESOURCES ARE PROVIDED, ALONG WITH SKILLS TO HELP REINFORCE INNER STRENGTHS AND LEARN SELF-CARE STRATEGIES. SUPPORT GROUPS OFFER THE ABILITY TO DEVELOP ENCOURAGING PEER RELATIONSHIPS ALONG WITH THE GOAL OF RETURNING TO AND CONTINUING A LIFE OF MEANING AND PURPOSE. STUDENT PRECEPTORSHIPS AT CARDIAC TREATMENT CENTER SCRIPPS PROVIDES PRECEPTORSHIPS FOR STUDENT RNS, EXERCISE PHYSIOLOGISTS AND CARDIAC SONOGRAPHERS. THE SCRIPPS CARDIAC TREATMENT CENTER NURSES' MENTOR THE STUDENTS THROUGH EDUCATION AND MODELING. THE STUDENTS LEARN THE ROLES AND RESPONSIBILITIES REQUIRED OF THE POSITIONS. LEFT VENTRICULAR ASSIST DEVICE (LVAD) SUPPORT GROUP SCRIPPS OFFERS A SUPPORT GROUP FOR PATIENTS WITH A LEFT VENTRICULAR ASSIST DEVICE. THIS GROUP PROVIDES EDUCATION AND SUPPORT TO THOSE PATIENTS AND THEIR CAREGIVERS/PARTNERS. TOPICS INCLUDE SAFETY AND PROPER MECHANICS REQUIRED FOR THE DEVICE. |
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JOE NIEKRO FOUNDATION SCRIPPS HEALTH PROVIDES MEETING SPACE FOR THE JOE NIEKRO FOUNDATION SUPPORT GROUPS OF PATIENTS, FAMILIES AND FRIENDS WHO HAVE BEEN AFFECTED WITH BRAIN ANEURYSMS OR HEMORRHAGIC STROKE. THE PROGRAM IS OPENED TO THE PUBLIC. SAN DIEGO ECHO SOCIETY SCRIPPS HEALTH PROVIDES MEETING SPACE TO THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY. THIS IS AN ORGANIZATION OF PROFESSIONALS COMMITTED TO EXCELLENCE IN CARDIOVASCULAR ULTRASOUND AND ITS APPLICATION TO PATIENT CARE THROUGH EDUCATION, ADVOCACY, RESEARCH, INNOVATION AND SERVICE TO OUR MEMBERS AND THE PUBLIC. WOMEN HEART - THE NATIONAL COALITION FOR WOMEN WITH HEART DISEASE - SUPPORT GROUP SCRIPPS HEALTH PROVIDES MEETING SPACE FOR WOMEN'S HEART SUPPORT GROUP. WOMEN HEART'S MISSION IS TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF WOMEN LIVING WITH OR AT RISK OF HEART DISEASE, AND TO ADVOCATE FOR THEIR BENEFIT. WOMEN WITH HEART DISEASE CAN HAVE THE OPPORTUNITY TO SHARE THEIR STORIES, SUPPORT EACH OTHER AND HEAL TOGETHER. EXPERTS ARE INVITED TO TALK TO THE GROUP ABOUT DIFFERENT KINDS OF HEART CONDITIONS, HEART ATTACK PREVENTION, BLOOD PRESSURE, EXERCISE AND NUTRITION. EDUCATING WOMEN ABOUT HEART HEALTH TOGETHER WITH WOMEN HEART NATIONAL HOSPITAL ALLIANCE, SCRIPPS CARDIOVASCULAR DEVELOPED A WOMEN AND HEART DISEASE EDUCATION PROGRAM. THE EFFORTS EDUCATE WOMEN ON THE IMPORTANCE OF HEART HEALTH, PROVIDE SUPPORT GROUPS AND ADVOCATE FOR RESEARCH FUNDING AND POLICIES. SENIOR HEALTH CHATS A WIDE VARIETY OF SENIOR CHATS ARE OFFERED AT LOCAL SENIOR CENTERS IN SOUTH BAY TO ADDRESS EDUCATION AND PREVENTION OF HEART DISEASE. SOME TOPICS INCLUDE HEART HEALTH 101, STROKE, AND A VARIETY OF PREVENTION EDUCATION. A TOTAL OF 10 PRESENTATIONS ARE GIVEN YEARLY TO MORE THAN 264 INDIVIDUALS. THE ERIC PAREDES SAVE A LIFE FOUNDATION EACH YEAR, 7,000 TEENS LOSE THEIR LIVES DUE TO SUDDEN CARDIAC ARREST (SCA). SCA IS NOT A HEART ATTACK, IT IS CAUSED BY AN ABNORMALITY IN THE HEART'S ELECTRICAL SYSTEM THAT CAN EASILY BE DETECTED WITH A SIMPLE ELECTROCARDIOGRAM (EKG). UNFORTUNATELY, HEART SCREENINGS ARE NOT PART OF A REGULAR, WELL-CHILD EXAM OR PRE-PARTICIPATION SPORTS PHYSICAL. THE FIRST SYMPTOM OF SCA COULD BE DEATH. SAN DIEGO ALONE LOSES THREE TO FIVE TEENS FROM SCA ANNUALLY. SCRIPPS EFFORTS BEGAN WHEN A REGISTERED NURSE AT SCRIPPS CREATED THE FOUNDATION AFTER HER 15-YEAR-OLD SON, ERIC PASSED AWAY FROM SUDDEN CARDIAC ARREST IN 2009. TURNING TRAGEDY INTO AN OPPORTUNITY, THE PAREDES' ESTABLISHED THE ORGANIZATION TO PREVENT SUDDEN CARDIAC ARREST IN SCHOOL-AGE CHILDREN AND ADOLESCENTS. AS A SPONSOR FOR THE ERIC PAREDES SAVE A LIFE FOUNDATION, SCRIPPS HAS HELD MORE THAN 20,000 FREE CARDIAC SCREENINGS TO LOCAL TEENS, INCLUDING THE HOMELESS, UNINSURED AND UNDERINSURED. IN FY19, SCRIPPS MADE AN $8,500 CONTRIBUTION TO HELP PAY FOR SCREENINGS. IN FY19, SCRIPPS SUPPORTED SCREENING EVENTS AT AREA HIGH SCHOOLS AND SCREENED 4,269 TEENS, IDENTIFYING 46 WITH ABNORMALITIES AND 20 WHO WERE AT RISK. THE FOLLOWING ARE ADDITIONAL METRICS TRACKED: - TEENS UNINURED: 6% - TEENS WITHOUT A PEDIATRICIAN/FAMILY DOC: 525 - TEENS WHO USE A FAMILY CLINIC: 714 - AVERAGE PERCENT OF MODERATE TO EXTREMELY LOW HOUSEHOLD INCOME: 62% - ETHNICITY: 58% REPRESENT DIVERSE ETHNICITIES - PARENTS UNAWARE OF SCA IN YOUTH: 55% - PARENTS UNAWARE OF WARNING SIGNS/RISK FACTORS: 68% - NUMBER OF YOUTHS SCREENED WHO PARTICIPATE IN SPORTS: 78% - SCRIPPS VOLUNTEERS: 100 - SCRIPPS VOLUNTEER HOURS: 500 SWEETWATER UNION HIGH SCHOOL DISTRICT - SPORTS SCREENINGS EVERY YEAR, THREE TO FIVE STUDENT ATHLETES IN SAN DIEGO COUNTY DIE SUDDENLY AND UNEXPECTEDLY FROM SUDDEN CARDIAC ARREST/DEATH (SCA/D). SCA IS AN ABNORMALITY IN THE HEART'S ELECTRICAL SYSTEM THAT CAN HAPPEN WITHOUT SYMPTOMS OR WARNING SIGNS. HOWEVER, THIS LIFE-THREATENING CONDITION CAN BE DETECTED WITH A CARDIAC SCREENING EXAM. SCRIPPS MERCY HOSPITAL CHULA VISTA FAMILY MEDICINE RESIDENCY, SOUTHWEST SPORTS WELLNESS FOUNDATION AND THE SWEETWATER UNION HIGH SCHOOL DISTRICT PARTNER TO PREVENT SUDDEN CARDIAC ARREST AND DEATH AMONG HIGH SCHOOL STUDENTS BY INCREASING AWARENESS OF THE IMPORTANCE OF HEALTHY LIFESTYLES AND CARDIOVASCULAR SCREENINGS AMONG ACTIVE STUDENTS. FAMILY MEDICINE RESIDENTS OFFER YEARLY CARDIAC SCREENING AND SPORTS PHYSICALS BEFORE STUDENTS PARTICIPATE IN ORGANIZED SPORTS AND IMPLEMENT AN INJURY CLINIC DURING FOOTBALL SEASON TO EVALUATE AND TREAT POSSIBLE CONCUSSIONS AND OTHER INJURIES. SU VIDA, SU CORAZON / YOUR LIFE, YOUR HEART COMMUNITY INTERVENTION TO IMPROVE EDUCATION AND AWARENESS OF HEART DISEASE HEART DISEASE IS ONE OF THE MOST WIDESPREAD AND COSTLY HEALTH PROBLEMS FACING OUR NATION, EVEN THOUGH IT'S ALSO ONE OF THE MOST PREVENTABLE. HEART FAILURE AND STROKE ACCOUNT FOR MORE THAN $500 BILLION IN HEALTH CARE COSTS PER YEAR. HEART FAILURE IS A PROGRESSIVE DISEASE, PRIMARILY CAUSED BY HIGH BLOOD PRESSURE, HIGH CHOLESTEROL/LIPIDS AND DAMAGE TO THE HEART MUSCLE FROM CORONARY ARTERY DISEASE. SCRIPPS HEALTH OFFERS A THREE-WEEK EDUCATIONAL BASED COMMUNITY INTERVENTION PROGRAM TO SUPPORT IMPROVED QUALITY OF LIFE FOR PATIENTS DIAGNOSED WITH HEART DISEASE. TOBACCO USE, ALCOHOL ABUSE, LACK OF PHYSICAL ACTIVITY, POOR NUTRITION, STRESS AND DEPRESSION ARE SOME OF THE MAJOR CONTRIBUTING FACTORS LEADING TO HEART DISEASE, HEART FAILURE AND READMISSION. RECENT LITERATURE SUGGESTS THAT POST DISCHARGE, SOCIAL SUPPORT AND EDUCATION ARE IMPORTANT TO PREVENT READMISSION. GROUP SESSIONS PROVIDE EDUCATION AND SOCIAL SUPPORT. DISCHARGE PLANNING THAT USES TRANSITIONAL COACHES HAS BEEN PROVEN TO REDUCE READMISSION RATES. THE OVERALL GOAL OF YOUR LIFE, YOUR HEART IS TO DECREASE THE READMISSION RATES FOR HEART FAILURE PATIENTS, WHICH REDUCES MEDICAL COSTS FOR THE PATIENT AND IMPROVES THEIR QUALITY OF LIFE. A TOTAL OF 125 COMMUNITY MEMBERS HAVE PARTICIPATED IN THIS EDUCATIONAL SERIES FOR THOSE AFFECTED BY HYPERTENSION, ANGINA, CARDIAC HEART FAILURE OR ANY OTHER HEART HEALTH CONCERNS. TOPICS COVERED INCLUDE THE RISK OF HEART DISEASE, SIGNS OF HEART ATTACK, DIABETES, CHOLESTEROL, PHYSICAL ACTIVITY, HEALTHY EATING AND MUCH MORE. HEALTH ASSESSMENTS ARE REVIEWED INCLUDING WAIST CIRCUMFERENCE, WEIGHT, HEIGHT, BMI AND BLOOD PRESSURE. OVERALL, PARTICIPANTS HAVE MADE A POSITIVE IMPACT FROM THE COURSE. 2019 BE THERE SAN DIEGO PREVENTING HEART ATTACKS AND STROKES SUMMIT BE THERE SAN DIEGO IS AN UNPRECEDENTED, NATIONALLY RECOGNIZED COLLABORATION AND COMMUNITY-WIDE ACTIVATION FOCUSED ON PREVENTING HEART ATTACKS AND STROKES IN THE SAN DIEGO REGION. SCRIPPS SPONSORED THE 2019 SUMMIT AS IT IS A UNIQUE OPPORTUNITY TO BRING TOGETHER PHYSICIANS, COMMUNITY LEADERS, HEALTHCARE SYSTEMS, AND COMMUNITY PARTNERS TO IMPACT THE REGION'S HEALTH BY SHARING BEST PRACTICES AND DISCUSSING STRATEGIES FOR FUTURE PROGRESS. DIABETES DIABETES IS AN IMPORTANT HEALTH NEED BECAUSE OF ITS PREVALENCE, ITS IMPACT ON MORBIDITY AND MORTALITY, AND ITS PREVENTABILITY. AN ANALYSIS OF MORTALITY DATA FOR SAN DIEGO COUNTY FOUND THAT IN 2016 'DIABETES MELLITUS' WAS THE SEVENTH LEADING CAUSE OF DEATH. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
A SUMMARY OF THE MAGNITUDE AND PREVALENCE OF DIABETES IS DESCRIBED BELOW: - THE SCRIPPS 2019 CHNA CONTINUED TO IDENTIFY DIABETES AS A PRIORITY HEALTH ISSUE AFFECTING MEMBERS OF THE COMMUNITIES SERVED BY SCRIPPS. - THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) IDENTIFY DIABETES AS THE SEVENTH LEADING CAUSE OF DEATH IN THE U.S., AS WELL AS THE LEADING CAUSE OF KIDNEY FAILURE, NON-TRAUMATIC LOWER-LIMB AMPUTATIONS AND NEW CASES OF BLINDNESS AMONG ADULTS. - THE NUMBER OF ADULTS DIAGNOSED WITH DIABETES IN THE U.S. HAS MORE THAN TRIPLED IN THE LAST 20 YEARS (CDC, 2017). - IN 2016, THERE WERE 734 DEATHS DUE TO DIABETES IN SAN DIEGO COUNTY OVERALL, A 3.7 PERCENT INCREASE WHEN COMPARED TO 2015 (708 DEATHS). THE AGE-ADJUSTED DEATH RATE DUE TO DIABETES WAS 20.7 PER 100,000 POPULATION. - IN 2016, THERE WERE 4,132 HOSPITALIZATIONS DUE TO DIABETES IN SAN DIEGO COUNTY. THE AGE-ADJUSTED RATE OF HOSPITALIZATION WAS 120.9 PER 100,000 POPULATION IN 2016, WHICH WAS SLIGHTLY LOWER THAN THE AGE-ADJUSTED RATE IN 2015 (123.1 PER 100,000 POPULATION). - IN 2016, THERE WERE 5,168 DIABETES-RELATED ED DISCHARGES IN SDC, AN 8 PERCENT INCREASE FROM 2015 (4,783 ED DISCHARGES). THE AGE-ADJUSTED RATE OF DIABETES RELATED ED DISCHARGES WERE 151.9 PER 100,000 POPULATION IN 2016, WHICH WAS HIGHER THAN THE AGE-ADJUSTED RATE IN 2015 (143.5 PER 100,000 POPULATION). - ACCORDING TO 2016-2017 CHIS DATA, 8.6 PERCENT OF ADULTS LIVING IN SAN DIEGO COUNTY INDICATED THAT THEY HAD EVER BEEN DIAGNOSED WITH DIABETES, WHICH WAS LOWER THAN THE STATE OF CALIFORNIA (9.9 PERCENT). DIABETES RATES AMONG SENIORS WERE PARTICULARLY HIGH, WITH 18.8 PERCENT OF SAN DIEGO COUNTY ADULTS OVER 65 REPORTING THAT THEY HAD EVER BEEN DIAGNOSED WITH DIABETES. - ACCORDING TO 2016-2017 CHIS DATA, 12.3 PERCENT OF SAN DIEGO COUNTY RESIDENTS HAD BEEN TOLD BY THEIR DOCTOR THAT THEY HAVE PRE OR BORDERLINE DIABETES. - ACCORDING TO THE CDC'S 2017 NATIONAL DIABETES STATISTICS REPORT, 87.5 PERCENT OF ADULTS DIAGNOSED WITH DIABETES WERE OVERWEIGHT OR OBESE. TO PREVENT OR DELAY THE ONSET OF DIABETES, THE CDC RECOMMENDS LIFESTYLE CHANGES SUCH AS LOSING WEIGHT, EATING HEALTHIER, AND GETTING REGULAR PHYSICAL ACTIVITY. THE CDC ESTIMATES THAT 30.3 MILLION PEOPLE IN THE U.S. HAVE DIABETES. OF THOSE INDIVIDUALS, 1 IN 4 IS NOT AWARE THEY HAVE THE DISEASE (CDC NATIONAL DIABETES STATISTICS REPORT, 2017). THE PERCENTAGE OF ADULTS AGED 20 AND OLDER WHO HAVE EVER BEEN DIAGNOSED WITH DIABETES WAS 9.4% IN 2017 IN SAN DIEGO COUNTY AND HAS BEEN STEADILY RISING SINCE 2005 ACCORDING TO THE NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION. TYPE 2 DIABETES IS AN IMPORTANT TARGET FOR INTERVENTION BECAUSE HOSPITALIZATIONS DUE TO DIABETES RELATED COMPLICATIONS ARE POTENTIALLY PREVENTABLE WITH PROPER MANAGEMENT AND A HEALTHY LIFESTYLE. THERE ARE THREE MAJOR TYPES OF DIABETES: TYPE 1, TYPE 2 AND GESTATIONAL. ALL THREE TYPES SHARE SIMILAR CHARACTERISTICS, THE BODY LOSES THE ABILITY TO EITHER MAKE OR USE INSULIN. WITHOUT ENOUGH INSULIN, GLUCOSE STAYS IN THE BLOOD, CREATING DANGEROUS BLOOD SUGAR LEVELS. OVER TIME, THIS ACCUMULATION DAMAGES KIDNEYS, HEART, NERVES, EYES AND OTHER ORGANS. TYPE 2 DIABETES, ONCE KNOWN AS ADULT ONSET OR NONINSULIN DEPENDENT DIABETES, IS A CHRONIC CONDITION THAT AFFECTS THE WAY YOUR BODY METABOLIZES SUGAR (GLUCOSE), WHICH IS YOUR BODY'S MAIN SOURCE OF FUEL. WITH TYPE 2 DIABETES, YOUR BODY EITHER RESISTS THE EFFECTS OF INSULIN, A HORMONE THAT REGULATES THE MOVEMENT OF SUGAR INTO YOUR CELLS OR DOESN'T PRODUCE ENOUGH INSULIN TO MAINTAIN A NORMAL GLUCOSE LEVEL. IF LEFT UNTREATED, TYPE 2 DIABETES CAN BE LIFE THREATENING. CLINICAL SYMPTOMS CAN INCLUDE FREQUENT URINATION, EXCESSIVE THIRST, EXTREME HUNGER, SUDDEN VISION CHANGES, UNEXPLAINED WEIGHT LOSS, EXTREME FATIGUE, SORES THAT ARE SLOW TO HEAL, AND INCREASED NUMBER OF INFECTIONS. TYPE 2 DIABETES HAS REACHED EPIDEMIC PROPORTIONS, AND PEOPLE OF HISPANIC ORIGIN HAVE DRAMATICALLY HIGHER RATES OF THE DISEASE AND THE COMPLICATIONS THAT GO ALONG WITH ITS POOR MANAGEMENT, INCLUDING CARDIOVASCULAR DISEASE, EYE DISEASE AND LIMB AMPUTATION. IN FACT, IT IS ESTIMATED THAT ONE OUT OF EVERY TWO HISPANIC CHILDREN BORN IN 2000 WILL DEVELOP DIABETES IN ADULTHOOD. THIS IS ESPECIALLY TRUE IN THE SOUTH BAY COMMUNITIES IN SAN DIEGO. SPECIFICALLY, THE CITY OF CHULA VISTA IS HOME TO 26,000 LATINOS WITH DIAGNOSED DIABETES AND TENS OF THOUSANDS MORE WHO ARE UNDIAGNOSED, HAVE PRE- DIABETES AND ARE AT HIGH RISK OF DEVELOPING DIABETES. SOME FACTS ABOUT TYPE 2 DIABETES: - DIABETES IS A MAJOR CAUSE OF HEART DISEASE AND STROKE AND IS THE 7TH LEADING CAUSE OF DEATH IN THE UNITED STATES AND CALIFORNIA. - MORE THAN 1 OUT OF 3 ADULTS HAVE PREDIABETES AND 15 TO 30% OF THOSE WITH PREDIABETES WILL DEVELOP TYPE 2 DIABETES WITHIN 5 YEARS. - NINE OUT OF 10 PEOPLE WITH PREDIABETES DON'T KNOW THEY HAVE IT. SOME RISK FACTORS FOR DEVELOPING DIABETES INCLUDE: - BEING OVERWEIGHT OR OBESE - HAVING A PARENT, BROTHER OR SISTER WITH DIABETES. - SMOKING - HAVING BLOOD PRESSURE MEASURING 140/90 OR HIGHER. - BEING PHYSICALLY INACTIVE, EXERCISING FEWER THAN THREE TIMES A WEEK. - A HISTORY OF GESTATIONAL DIABETES - IF YOU ARE 65 YEARS OF AGE OR OLDER A STUDY BY THE UNIVERSITY OF CALIFORNIA, LOS ANGELES (UCLA) CENTER FOR HEALTH POLICY RESEARCH FOUND THAT 13 MILLION ADULTS IN CALIFORNIA (46 PERCENT) ARE ESTIMATED TO HAVE PREDIABETES OR UNDIAGNOSED DIABETES, WHILE ANOTHER 2.5 MILLION (9 PERCENT) HAVE ALREADY BEEN DIAGNOSED WITH DIABETES (UCLA CENTER FOR HEALTH POLICY RESEARCH, 2016). THE COMPLICATIONS RELATED TO DIABETES ARE SERIOUS AND CAN BE REDUCED WITH PREVENTIVE PRACTICES. DIABETES IS A SERIOUS COMMUNITY HEALTH PROBLEM, LEADING TO SCHOOL AND WORK ABSENTEEISM, ELEVATED HOSPITALIZATION RATES, FREQUENT EMERGENCY ROOM VISITS, PERMANENT PHYSICAL DISABILITIES AND SOMETIMES DEATH. DURING FISCAL YEAR 2019, SCRIPPS SPONSORED THE FOLLOWING DIABETES MANAGEMENT INITIATIVES: WOLTMAN FAMILY DIABETES CARE AND PREVENTION CENTER IN CHULA VISTA THE WOLTMAN FAMILY DIABETES CARE AND PREVENTION CENTER IN CHULA VISTA SERVES ONE OF SAN DIEGO'S COMMUNITIES HIT HARDEST BY THE DIABETES EPIDEMIC. NEARLY 40 PERCENT OF PATIENTS ADMITTED TO SCRIPPS MEMORIAL HOSPITAL CHULA VISTA, AND NEARLY 32 PERCENT OF PATIENTS IN THE HEART CATHETERIZATION LAB, HAVE DIABETES. COUNTY STATISTICS TELL US THAT THE RATES OF DEATH, HOSPITALIZATIONS AND EMERGENCY ROOM VISITS ARE TWICE AS HIGH IN CHULA VISTA COMPARED TO ALL OF SAN DIEGO COUNTY. WITH THE GENEROUS SUPPORT OF PHILANTHROPIST RICHARD WOLTMAN, THE CENTER ADDED CRITICAL CLASSROOM SPACE IN 2017 TO MEET THE HIGH DEMAND FOR SERVICES. THE CENTER OFFERS A FULL RANGE OF WELLNESS, PREVENTION, DIABETES EDUCATION AND NUTRITION SERVICES IN ENGLISH AND SPANISH. PROJECT DULCE PROJECT DULCE IS A COMPREHENSIVE, CULTURALLY SENSITIVE DIABETES MANAGEMENT PROGRAM FOR UNDERSERVED AND UNINSURED PEOPLE IN SAN DIEGO COUNTY. THE PROGRAM IS TEAM BASED AND INCORPORATES THE CHRONIC CARE MODEL. PROJECT DULCE HAS BEEN ACTIVE IN COMMUNITIES ACROSS SAN DIEGO FOR THE PAST 24 YEARS, PROVIDING DIABETES CARE AND SELF-MANAGEMENT EDUCATION. NURSE LED TEAMS STRIVE FOR MEASURABLE IMPROVEMENTS IN THEIR PATIENTS' HEALTH, NURSE EDUCATORS LEAD MULTIDISCIPLINARY TEAMS THAT PROVIDE CLINICAL MANAGEMENT; AND PEER EDUCATORS FROM EACH CULTURAL GROUP, KNOWN AS PROMOTORAS, PROVIDE PUBLIC AND PATIENT EDUCATION FOR THEIR COMMUNITIES. THIS INNOVATIVE PROGRAM COMBINES STATE OF THE ART CLINICAL DIABETES MANAGEMENT WITH PROVEN EDUCATIONAL AND BEHAVIORAL INTERVENTIONS. ONE OF THE PRIMARY COMPONENTS OF THE PROGRAM IS RECRUITING PEER EDUCATORS FROM THE COMMUNITY TO WORK DIRECTLY WITH PATIENTS. THESE EDUCATORS REFLECT THE DIVERSE POPULATION AFFECTED BY DIABETES AND HELP TEACH OTHERS ABOUT CHANGING EATING HABITS, ADOPTING EXERCISE ROUTINES AND NURTURING THEIR WELLBEING TO MANAGE THIS CHRONIC DISEASE. IN FY19, PROJECT DULCE PROVIDED 650 DIABETES CARE, RETINAL SCREENINGS AND EDUCATION VISITS FOR LOW INCOME AND UNDERSERVED INDIVIDUALS THROUGHOUT SAN DIEGO AND ENROLLED 3,075 NEW PROJECT DULCE PATIENTS. MEDICAL ASSISTANT HEALTH COACHING (MAC) FOR DIABETES IN DIVERSE PRIMARY CARE SETTINGS DIABETES AFFECTS NEARLY 30 MILLION INDIVIDUALS IN THE U.S., AND IF CURRENT TRENDS CONTINUE, 1 OF 3 ADULTS WILL HAVE DIABETES BY 2050. DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT (DSME) IS A CORNERSTONE OF EFFECTIVE CARE THAT IMPROVES CLINICAL CONTROL AND HEALTH OUTCOMES; HOWEVER, DSME PARTICIPATION IS LOW, PARTICULARLY AMONG UNDERSERVED POPULATIONS, AND ONGOING SUPPORT IS OFTEN NEEDED TO MAINTAIN DSME GAINS. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
IN 2015, THE NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES (NIH/NIDDK) GRANTED SCRIPPS WHITTIER DIABETES INSTITUTE $2.1 MILLION TO FUND THE MAC TRIAL, WHICH IS STUDYING AN INNOVATIVE TEAM CARE APPROACH THAT TRAINS MEDICAL ASSISTANTS (MAS) TO PROVIDE HEALTH COACHING IN THE PRIMARY CARE SETTING TO PATIENTS WITH POORLY CONTROLLED TYPE 2 DIABETES, HELP THEM PROBLEM SOLVE, AND IMPROVE THEIR DIABETES-RELATED HEALTH OUTCOMES. THE GOALS INCLUDE IMPROVING DIABETES SELF-MANAGEMENT AND CLINICAL OUTCOMES, SUCH AS BLOOD GLUCOSE LEVELS, CHOLESTEROL AND BLOOD PRESSURE. THE STUDY IS BEING CONDUCTED IN TWO DIVERSE SETTINGS: A SCRIPPS HEALTH PRIMARY CARE PRACTICE, AND A COMMUNITY HEALTH CENTER, NEIGHBORHOOD HEALTHCARE. DIABETES PREVENTION THE UCLA CENTER FOR HEALTH POLICY AND RESEARCH RECENTLY PUBLISHED DATA THAT REVEALED NEARLY HALF OF CALIFORNIA ADULTS HAVE PREDIABETES OR DIABETES. WHILE THE SCRIPPS WHITTIER DIABETES INSTITUTE HAS BEEN PROVIDING THE BEST CARE FOR PEOPLE WITH DIABETES FOR DECADES, THE INSTITUTE CONTINUED WITH THE SCRIPPS DIABETES PREVENTION PROGRAM (DPP), WHICH IS A YEARLONG INTERVENTION WHERE PEOPLE WITH PREDIABETES MEET WEEKLY FOR 16 WEEKS, THEN MONTHLY THEREAFTER. THE DPP IS AN INTENSIVE LIFESTYLE BEHAVIOR CHANGE INTERVENTION PROGRAM THAT HAS BEEN PROVEN TO PREVENT DIABETES IN LARGE-SCALE NATIONAL STUDIES. THE PRIMARY OBJECTIVE IS TO LOSE 5 TO 7% OF BODY WEIGHT THROUGH HEALTHY EATING AND PHYSICAL ACTIVITY. THE DIABETES PREVENTION PROGRAM (DPP) HAS BEEN THOROUGHLY EVALUATED IN NIH SPONSORED RANDOMIZED CONTROLLED TRIALS AND HAS BEEN FOUND TO DECREASE THE NUMBER OF NEW CASES OF DIABETES AMONG THOSE WITH PREDIABETES BY 58%. AMONG PEOPLE OVER AGE 60, THERE WAS A 71% REDUCTION IN NEW CASES. IN FY19, 1,759 PATIENTS ATTENDED 31 SCRIPPS DPP ORIENTATION SESSIONS. MUCH OF THE EFFORT IS FOCUSED IN THE SOUTH BAY FOR THE LATINO POPULATION, WHICH IS AT HIGHER RISK OF GETTING DIABETES THAN THEIR WHITE COUNTERPARTS. DIGITAL DIABETES-ME: AN ADAPTIVE MHEALTH INTERVENTION FOR UNDERSERVED HISPANICS WITH DIABETES DIABETES IS A FAST-GROWING EPIDEMIC. IN THE US, NEARLY 11% OF ADULTS WERE LIVING WITH DIAGNOSED DIABETES IN 2017, WHICH REPRESENTED AN ANNUAL ECONOMIC BURDEN OF $327.2 BILLION, WITH AN AVERAGE ANNUAL COST OF $13,240 PER CASE. HISPANICS FACE A HIGHER RISK OF DEVELOPING THE DISEASE-13.9 PERCENT COMPARED WITH 7.6 PERCENT FOR NON-HISPANIC WHITES. THE NIH'S NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES AWARDED $2.9 MILLION, THE LARGEST NIH AWARD TO SCRIPPS WHITTIER DIABETES INSTITUTE TO DATE, TO STUDY AN INNOVATIVE APPROACH TO HELPING HISPANICS WITH DIABETES BETTER MANAGE THEIR DISEASE. DULCE DIGITAL-ME PROVIDED PATIENTS WITH TOOLS TO HELP THEM MANAGE THEIR DIABETES DAY TO DAY AND IMPROVE THEIR HEALTH, INCLUDING TEXT MESSAGING, WIRELESS BLOOD GLUCOSE AND MEDICATION MONITORING, DIET AND EXERCISE ASSESSMENTS, AND PERSONALIZED FEEDBACK AND GOAL SETTING. THIS STUDY WAS CONDUCTED IN COLLABORATION WITH NEIGHBORHOOD HEALTHCARE, SAN DIEGO STATE UNIVERSITY AND THE UNIVERSITY OF CALIFORNIA SAN DIEGO. THE PARTICIPANTS RECEIVED HEALTH-RELATED TEXT MESSAGES EVERY DAY FOR SIX MONTHS AND THEY SAW IMPROVEMENTS IN THEIR BLOOD SUGAR LEVELS THAT EQUALED THOSE RESULTING FROM SOME GLUCOSE-LOWERING MEDICATIONS. THE DULCE DIGITAL-ME CLINICAL TRIAL REPRESENTS THE FIRST RANDOMIZED CONTROLLED STUDY TO LOOK AT THE USE OF TEXT MESSAGES TO HELP UNDERSERVED HISPANICS BETTER SELF-MANAGE THEIR DIABETES THROUGH GLYCEMIC CONTROL. THE RESULTS WERE PUBLISHED BY DIABETES CARE IN AN ONLINE PRE-PRINT VERSION OF THE STUDY, WHICH IS SCHEDULED TO BE PUBLISHED IN A FUTURE ISSUE OF THE JOURNAL. HEALTHY LIVING IN 2015, SCRIPPS BEGAN HEALTHY LIVING CLASSES WHICH ARE OPEN TO ANYONE INTERESTED IN LEARNING ABOUT THE BENEFITS OF GOOD NUTRITION, PHYSICAL ACTIVITY, AND AVOIDING TOBACCO. THESE BEHAVIORS CAN HELP TO PREVENT THE FOUR CHRONIC DISEASES (LUNG DISEASE, CANCER, TYPE 2 DIABETES AND, CARDIOVASCULAR DISEASE) THAT CONTRIBUTE TO 50 PERCENT OF ALL THE DEATHS IN THE US. THE THREE-CLASS SERIES IS HELD AT LOCATIONS THROUGHOUT THE COMMUNITY. ONE HUNDRED SIXTY-EIGHT PEOPLE ATTENDED HEALTHY LIVING CLASSES THAT WERE PROVIDED THROUGHOUT THE COUNTY, AGAIN WITH SPECIAL ATTENTION TO THE LATINO COMMUNITY OF THE SOUTH BAY. SCRIPPS WHITTIER DIABETES INSTITUTE PROFESSIONAL EDUCATION AND TRAINING SCRIPPS WHITTIER DIABETES INSTITUTE PROFESSIONAL EDUCATION TEAMS PROVIDE STATE OF THE ART EDUCATION AND TRAINING FOR PEOPLE WHO WISH TO INCREASE THEIR DIABETES MANAGEMENT KNOWLEDGE AND SKILLS. WITH THE RISE IN DIABETES RELATED DEVICES, THERE IS A GREAT NEED TO EQUIP CLINICIANS WITH THE LATEST INFORMATION AND CLINICAL SKILLS. THE WHITTIER'S PROFESSIONAL EDUCATION PROGRAM IS LED BY A TEAM OF EXPERTS, INCLUDING ENDOCRINOLOGISTS, NURSES, DIETICIANS, PSYCHOLOGISTS AND OTHER DIABETES SPECIALIST. THESE INDIVIDUALS TRAIN PRACTICING PROFESSIONALS TO DELIVER THE BEST POSSIBLE CARE FOR THEIR DIABETES PATIENTS. COURSES ARE TAILORED TO THE NEEDS OF ALLIED HEALTH PROFESSIONALS SEEKING TO UNDERSTAND NEW AND COMPLEX CLINICAL TREATMENT OPTIONS FOR TYPE 1, TYPE 2 AND GESTATIONAL DIABETES. PROFESSIONAL EDUCATION WAS PROVIDED FOR 249 PEOPLE ON INSULIN MANAGEMENT, INCRETIN THERAPY, AND DIABETES DIET AND DIABETES BASICS. PARTICIPANTS CAME FROM LOCAL HEALTH INSTITUTIONS AND THROUGHOUT THE UNITED STATES TO LEARN FROM THE WHITTIER INSTITUTE'S MOST EXPERIENCED DIABETES EXPERTS. OVER THE LAST FISCAL YEAR, THE WHITTIER INSTITUTE'S PROFESSIONAL EDUCATION DEPARTMENT PROVIDED FOUR CME PROGRAMS FOR PHYSICIANS, NURSES, PHARMACISTS, DIETITIANS, MIDLEVEL PROVIDERS AND SOCIAL WORKERS AND MADE NUMEROUS ACADEMIC AND RESEARCH PRESENTATIONS AT PROFESSIONAL ASSOCIATION MEETINGS. RETINAL SCREENING PROGRAM IT IS ESTIMATED THAT EVERY 24 HOURS, 55 PEOPLE WILL LOSE THEIR VISION AS A RESULT OF DIABETIC-RELATED EYE DISEASE (DIABETIC RETINOPATHY) EVEN THOUGH 95 PERCENT OF DIABETIC BLINDNESS COULD BE PREVENTED WITH EARLY DIAGNOSIS AND TREATMENT. FOR MORE THAN A DECADE, SCRIPPS HAS BEEN SCREENING PEOPLE IN UNDERSERVED COMMUNITIES FOR DIABETIC RETINOPATHY USING A MOBILE CAMERA. OUR FREE OR LOW-COST EYE EXAMS DIAGNOSE INDIVIDUALS AT HIGH RISK FOR RETINAL DAMAGE AND HELP PATIENTS GET TREATMENT AND REFERRALS TO SPECIALISTS. IN FY19, 1,617 PEOPLE WERE SCREENED, AND 6.4 PERCENT HAD SOME DEGREE OF DIABETES-RELATED EYE DISEASE. THIS PROGRAM REFERRED 38 PEOPLE WHO HAD ADVANCED DISEASE, 2.4 PERCENT OF ALL SCREENED OR NEARLY 36.9 PERCENT OF POSITIVES, TO SPECIALISTS FOR FURTHER CARE. HEALTH RELATED BEHAVIORS HEALTH RELATED BEHAVIOR IS ONE OF THE MOST IMPORTANT ELEMENTS IN PEOPLE'S HEALTH AND WELL-BEING. ITS IMPORTANCE HAS GROWN AS SANITATION HAS IMPROVED AND MEDICINE HAS ADVANCED. DISEASES THAT WERE ONCE INCURABLE CAN NOW BE PREVENTED OR SUCCESSFULLY TREATED. HEALTH RELATED BEHAVIORS, SUCH AS IMMUNIZATION, SMOKING CESSATION, IMPROVED NUTRITION, INCREASED PHYSICAL ACTIVITY, ORAL HEALTH AND INJURY PREVENTION, HAVE BECOME IMPORTANT COMPONENTS OF LONG-TERM LIFE. |
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OPIOID STEWARDSHIP PROGRAM (OSP) THE OPIOID STEWARDSHIP PROGRAM HAS SPEARHEADED MULTIPLE PROJECTS AT SCRIPPS TO EDUCATE PATIENTS AND PROVIDERS ABOUT THE RISKS OF OPIOIDS AND THE BENEFITS OF ALTERNATIVE MULTI-MODAL PAIN MANAGEMENT OPTIONS TO REDUCE OPIOID USE. THE PROGRAM HAS ESTABLISHED PRESCRIBING STANDARDS FOR OPIOIDS, RESULTING IN A 25 PERCENT REDUCTION IN THE NUMBER OF OPIOID PILLS PER PRESCRIPTION AT SCRIPPS HOSPITALS AND OUTPATIENT CENTERS IN 2019. SCRIPPS ALSO HAS OPENED THREE DRUG TAKE-BACK KIOSKS AT ITS ON-SITE PHARMACIES, OFFERING PATIENTS YEAR-ROUND ACCESS TO DISPOSE OF UNUSED, UNNEEDED OR OUTDATED MEDICATIONS. SOCIAL DETERMINANTS OF HEALTH PER SECTION 2, COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), IN ADDITION TO THE HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA, SOCIAL DETERMINANTS OF HEALTH (SDOH) WERE ALSO IDENTIFIED IN ALL THE COMMUNITY ENGAGEMENT ACTIVITIES. APPROXIMATELY 80 PERCENT OF MODIFIABLE RISKS FOR DISEASES ARE ATTRIBUTABLE TO NON-MEDICAL (UPSTREAM) DETERMINANTS OF HEALTH, SUCH AS HEALTH BEHAVIORS, SOCIOECONOMIC STATUS, AND ENVIRONMENTAL CONDITIONS. TO PREVENT CHRONIC CONDITIONS AND PROMOTE HEALTH, GREATER EMPHASIS SHOULD BE PLACED ON POPULATION HEALTH, WHICH HAS BEEN DEFINED TO FOCUS ON OUTCOMES AS WELL AS ON THE BROADER FACTORS THAT INFLUENCE HEALTH AT A POPULATION LEVEL, INCLUDING MEDICAL CARE SYSTEMS, THE SOCIAL ENVIRONMENT, AND THE PHYSICAL ENVIRONMENT. THE CHNA IDENTIFIED ECONOMIC SECURITY AS A PRIORITY SDOH NEED IN THE SECONDARY DATA ANALYSES AND IN THE COMMUNITY ENGAGEMENT PROCESS. ECONOMIC SECURITY REFERS TO THE ABILITY TO MEET ESSENTIAL FINANCIAL NEEDS SUSTAINABLY, INCLUDING THOSE FOR FOOD, SHELTER, CLOTHING, HYGIENE, HEALTH CARE, AND EDUCATION. ECONOMIC INSECURITY IS ASSOCIATED WITH: . POOR MENTAL HEALTH DAYS . VISITS TO THE ED FOR HEART ATTACKS . ASTHMA . OBESITY . DIABETES . STROKE . CANCER . SMOKING . PEDESTRIAN INJURY ECONOMIC INSECURITY MAY ALSO LEAD TO FOOD INSECURITY, WHICH IS LINKED TO: - FAIR OR POOR HEALTH, ANEMIA, AND ASTHMA IN CHILDREN - MENTAL HEALTH PROBLEMS, DIABETES, HYPERTENSION, HYPERLIPIDEMIA, AND ORAL HEALTH PROBLEMS IN ADULTS - FAIR OR POOR HEALTH, DEPRESSION, AND LIMITATIONS IN ACTIVITIES OF DAILY LIVING IN SENIORS ECONOMIC SECURITY IS ALSO LINKED TO WAGES. - EDUCATIONAL ATTAINMENT IS DIRECTLY RELATED TO ECONOMIC INSECURITY BY WAY OF LOW WAGES AND/OR LIMITED ACCESS TO EMPLOYMENT - IN SAN DIEGO, ADULTS WHO HAD LESS THAN A HIGH SCHOOL DIPLOMA WAS HIGHEST IN SOUTH (21.9%) AND CENTRAL (19.9%) REGIONS. FOOD INSECURITY FOOD INSECURITY IS THE INABILITY TO AFFORD ENOUGH FOOD FOR AN ACTIVE, HEALTHY LIFE. THE HASD&IC 2019 CHNA IDENTIFIED FOOD INSECURITY AND ACCESS TO HEALTHY FOOD AS A SOCIAL DETERMINANT IMPACTING SAN DIEGO'S PRIORITY HEALTH NEEDS. ACCORDING TO THE LATEST RESEARCH FROM THE SAN DIEGO HUNGER COALITION, ALMOST HALF A MILLION SAN DIEGANS,1 IN 7 RESIDENTS, OR 15 PERCENT OF THE SAN DIEGO COUNTY POPULATION ARE CONSIDERED FOOD INSECURE, AN ECONOMIC AND SOCIAL CONDITION CHARACTERIZED BY LIMITED OR UNCERTAIN ACCESS TO ADEQUATE FOOD. TO PUT THE TOTAL NUMBER OF FOOD INSECURE SAN DIEGANS INTO PERSPECTIVE, IT IS ROUGHLY EQUIVALENT TO THE ENTIRE POPULATIONS OF CHULA VISTA, OCEANSIDE, IMPERIAL BEACH, CORONADO, AND SOLANA BEACH COMBINED. RATES IN IMPERIAL COUNTY ARE EVEN HIGHER, WITH 17% OF THE GENERAL POPULATION SUFFERING FOOD INSECURITY. EVEN MORE ALARMING IS THAT THE RATE OF FOOD INSECURITY AMONG CHILDREN IN IMPERIAL COUNTY IS THE HIGHEST IN CALIFORNIA AT OVER 33%. IN SAN DIEGO COUNTY: - 14% OF PEOPLE EXPERIENCE FOOD INSECURITY, 1 IN 7 PEOPLE - 22% OF CHILDREN ARE IN FOOD INSECURE HOUSEHOLDS, MORE THAN 1 IN 5 CHILDREN - 9% OF SENIORS EXPERIENCE FOOD INSECURITY, 1 IN 11 SENIORS. IN ADDITION, STUDIES DEMONSTRATE THAT HUNGER SIGNIFICANTLY IMPACTS HEALTH. LACK OF ACCESS TO HEALTHY FOOD, OFTEN DUE TO AVAILABILITY AND COST, ARE STRESSORS THAT CONTRIBUTE TO DIABETES, HEART DISEASE, OBESITY, AND OTHER BEHAVIORAL HEALTH ISSUES IN A MYRIAD OF WAYS: - FOOD INSECURE ADULTS WITH DIABETES HAVE HIGHER AVERAGE BLOOD SUGARS. - FOOD INSECURE ADULTS ARE MORE LIKELY TO BE OBESE. - FOOD INSECURITY IS SIGNIFICANTLY MORE PREVALENT IN ADULTS WITH MOOD DISORDERS. - FOOD INSECURITY IS ASSOCIATED WITH INCREASED RISK OF SUICIDAL THOUGHTS AND SUBSTANCE USE IN ADOLESCENTS. - FOOD INSECURE SENIORS HAVE A SIGNIFICANTLY HIGHER LIKELIHOOD OF HEART DISEASE, DEPRESSION AND LIMITED ACTIVITIES OF DAILY LIVING. - FOOD INSECURE ADULTS DELAY BUYING FOOD IN ORDER TO PURCHASE MEDICATIONS. CALFRESH PROGRAM THE CALFRESH PROGRAM, FEDERALLY KNOWN AS THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP), ISSUES MONTHLY ELECTRONIC BENEFITS THAT CAN BE USED TO BUY FOOD AT PARTICIPATING MARKETS AND STORES. IN SAN DIEGO COUNTY, AN ESTIMATED ADDITIONAL 185,000 PEOPLE ARE "FOOD SECURE" BUT RELY ON CALFRESH AND/OR WIC TO SUPPLEMENT THEIR FOOD BUDGET. THIS REPRESENTS 96,000 ADULTS AND 89,000 CHILDREN WHO ARE AT RISK OF FOOD INSECURITY SHOULD THEY LOSE CALFRESH OR WIC BENEFITS. THE TOTAL POPULATION IN SAN DIEGO COUNTY THAT IS EITHER FOOD INSECURE OR FOOD SECURE WITH CALFRESH OR WIC ASSISTANCE IS 671,000 OR 1 IN 5 PEOPLE. FEDERAL REDUCED-PRICE MEALS PROGRAM (FRPM) ACCORDING TO A NEW REPORT RELEASED IN 2019 BY THE SAN DIEGO COUNTY CHILDHOOD OBESITY INITIATIVE, WWW.SDCOI.ORG, THE EFFECT OF POVERTY AND FOOD INSECURITY ON STUDENTS' OVERWEIGHT AND OBESITY RATES CAN PERHAPS MOST PROFOUNDLY BE OBSERVED WHEN LOOKING AT DISTRICTS WITH HIGH CONCENTRATIONS OF STUDENTS ENROLLED IN THE FEDERAL REDUCED-PRICE MEALS PROGRAM (FRPM). ALL STUDENTS CAN PARTICIPATE IN SCHOOL NUTRITION PROGRAMS; HOWEVER, STUDENTS WITH FAMILY INCOMES UNDER 130% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR FREE MEALS, AND THOSE WITH INCOMES BETWEEN 130% AND 185% OF THE POVERTY LEVEL ARE ELIGIBLE FOR LOW-COST (OR "REDUCED PRICE") MEALS. STUDENTS ENROLLED IN THIS PROGRAM NOT ONLY COME FROM LOWER INCOME HOUSEHOLDS BUT ARE ALSO LIKELY TO BE FOOD INSECURE. FIFTY PERCENT, OR HALF OF ALL STUDENTS IN SAN DIEGO COUNTY ARE ENROLLED IN THE FEDERAL REDUCED-PRICE MEALS PROGRAM. SOURCE: CALIFORNIA DEPARTMENT OF EDUCATION. 2018-2019 STUDENT POVERTY FRPM DATA. THE PROGRAMS HIGHLIGHTED BELOW ARE WAYS THAT SCRIPPS HEALTH IS ADDRESSING FOOD INSECURITY; SCREENINGS AND ELIGIBILITY BENEFITS. SCRIPPS HEALTH CALFRESH SCREENINGS AS HEALTH CARE DELIVERY SYSTEMS MOVES TOWARDS A POPULATION HEALTH PARADIGM THAT INCENTIVIZES KEEPING PATIENT'S HEALTHY, HOSPITALS AND CLINICS ARE RECOGNIZING THE SIGNIFICANCE OF ADDRESSING SOCIAL DETERMINANTS OF HEALTH, SUCH AS FOOD INSECURITY (FI). HOSPITALS HAVE BEEN MORE PROACTIVE IN INTERVENING AT SOME LEVEL OF CARE TO AID THE INDIVIDUALS SUFFERING FROM FI AND THEIR ABILITY TO GAIN CONTROL OVER THEIR HEALTH. ACCORDINGLY, FOOD ASSISTANCE PROVIDED BY THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)-KNOWN AS CALFRESH IN CALIFORNIA, SIGNIFICANTLY REDUCES THE RATE AND SEVERITY OF POVERTY THROUGHOUT THE STATE (CALIFORNIA BUDGET & POLICY CENTER, 2018). WHILE SNAP AND WOMEN'S, INFANTS, CHILDREN (WIC) HAVE BEEN SUCCESSFUL IN ASSISTING LOW-INCOME CHILDREN AND THEIR FAMILIES WITH ADDITIONAL FUNDING FOR PURCHASING HEALTHY FOODS, THERE IS EVIDENCE THAT SUGGESTS SCREENING FOR FI IN HEALTHCARE SETTINGS IS THE BEST INDICATOR FOR PATIENTS TO ACCESS FOOD-RELATED ASSISTANCE.IN A 25 PERCENT REDUCTION IN THE NUMBER OF OPIOID PILLS PER PRESCRIPTION AT SCRIPPS HOSPITALS AND OUTPATIENT CENTERS IN 2018. SCRIPPS ALSO HAS OPENED THREE DRUG TAKE-BACK KIOSKS AT ITS ON-SITE PHARMACIES, OFFERING PATIENTS YEAR-ROUND ACCESS TO DISPOSE OF UNUSED, UNNEEDED OR OUTDATED MEDICATIONS. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
CALIFORNIA BRIDGE PROGRAM SCRIPPS RECEIVED MORE THAN $435,000 OF STATE GRANTS AT EACH SCRIPPS MERCY CAMPUS FROM THE CALIFORNIA BRIDGE PROGRAM AND THE CENTER AT SIERRA HEALTH FOUNDATION TO REMOVE BARRIERS TO IDENTIFYING AND TREATING PATIENTS WITH OPIOID USE DISORDER AND PROVIDE MEDICATION-ASSISTED TREATMENT (MAT). SCRIPPS ACTIVELY PROMOTES MAT ACCESS FOR PATIENTS IN THE FORM OF BUPRENORPHINE. THE BRIDGE PROGRAM AIMS TO HELP HOSPITALS AND HEALTH CENTERS EXPAND PATIENT ACCESS TO TREATMENT FOR OPIOID USE DISORDER, INCLUDING ON-THE-SPOT MEDICAL TREATMENT AND COORDINATED OUTPATIENT CARE. AS PART OF THE GRANT, SCRIPPS NOW HAS BRIDGE COUNSELORS AT BOTH MERCY CAMPUSES TO HELP PATIENTS WITH OPIOID ADDICTION. BRIDGE COUNSELORS ARE CERTIFIED THROUGH THE CALIFORNIA CONSORTIUM OF ADDICTION PROGRAMS AND PROFESSIONALS OR THE CALIFORNIA ASSOCIATION FOR DRUG/ALCOHOL EDUCATORS. THEY MEET PATIENTS IN THE EMERGENCY DEPARTMENT AND OTHER INPATIENT AREAS OF BOTH SCRIPPS MERCY CAMPUSES TO PROVIDE RAPID EVIDENCE-BASED MEDICATION-ASSISTED TREATMENT. THEY ALSO CONNECT PATIENTS DIRECTLY TO CONTINUED TREATMENT IN THE COMMUNITY. IN THE FIRST TEN MONTHS, SCRIPPS IDENTIFIED MORE THAN 300 MAT-ELIGIBLE PATIENTS AND TREATED MORE THAN 160 PATIENTS. OUT OF THE 160 PATIENTS TREATED 210 ACCEPTED LINKAGE TO OUTPATIENT MAT SERVICES. THE CALIFORNIA BRIDGE GRANT ALSO ENABLED SCRIPPS TO HIRE SUBSTANCE USE DISORDER NURSES (SUDS) TO FACILITATE TREATMENT AND ENTRY INTO A COMMUNITY-BASED MAT PROGRAM. SCRIPPS DEPLOYS SPECIALIZED NURSES CERTIFIED IN ADDICTION TO SEE PATIENTS AT THEIR BEDSIDE AND WORK CLOSELY WITH THE PATIENT'S ENTIRE HEALTH CARE TEAM IN FACILITATING A SAFE DETOX TREATMENT WHILE HOSPITALIZED. THEY IDENTIFY PATIENTS WHO ARE AT RISK OR ARE CURRENTLY EXPERIENCING WITHDRAWAL FROM ALCOHOL AND OTHER ADDICTIVE SUBSTANCES. SUBSTANCE USE DISORDER SERVICE (SUDS) NURSES EVALUATE PATIENTS WHO MEET CERTAIN CRITERIA AND WORK DIRECTLY WITH THE NURSE AND PHYSICIAN TO ENSURE THE PATIENT IS ADEQUATELY MEDICATED IN ORDER TO CONTROL SYMPTOMS OF WITHDRAWAL. SUDS NURSES AT SCRIPPS FUNCTION IN A PROACTIVE AND REACTIVE ROLE AT ALL SCRIPPS HOSPITALS AND COLLABORATE WITH COMMUNITY RESOURCES, INCLUDING FAMILY HEALTH CENTERS OF SAN DIEGO TO PROVIDE MAT, MCALLISTER INSTITUTE FOR DETOX BEDS AND THE BETTY FORD CENTER FOR OUTPATIENT CARE. ENCINITAS STREET FAIR SCRIPPS PARTICIPATED IN THE ENCINITAS STREET FAIR AND PROVIDED CONVERSATIONS AND DEMONSTRATIONS ON FALL RISKS, STOP THE BLEED, HEAD INJURY, SEAT BELT, CHILD SEAT SAFETY, AND EDUCATED THE COMMUNITY ON THE EFFECTS AND IMPAIRMENT OF ALCOHOL AND DRUGS THROUGH DEMONSTRATIONS/SIMULATIONS. SPONDYLITIS ASSOCIATION SCRIPPS HEALTH PROVIDES MEETING SPACE TO THE SPONDYLITIS ASSOCIATION OF AMERICA (SAA). THIS IS A NON-PROFIT ORGANIZATION FOUNDED IN 1983 TO ADDRESS THE NEEDS OF PEOPLE AFFECTED BY SPONDYLARTHRITIS. SINCE THAT TIME, SAA HAS BEEN AT THE FOREFRONT OF THE FIGHT TO PROMOTE MEDICAL RESEARCH, EDUCATE BOTH THE MEDICAL COMMUNITY AND GENERAL PUBLIC AND ADVOCATE ON BEHALF OF THE PEOPLE THEY SERVE. AGING CONCERNS IN SAN DIEGO COUNTY, THE POPULATION OF OLDER ADULTS AGED 55 AND OLDER WAS MORE THAN 820,000 IN 2015. BY 2030, THAT NUMBER IS PROJECTED TO BE MORE THAN 1.1 MILLION. IN ADDITION, THE FASTEST GROWING AGE GROUP IS THOSE OVER THE AGE OF 85. AGING CONCERNS ARE DEFINED AS THOSE CONDITIONS THAT PREDOMINANTLY AFFECT SENIOR - PEOPLE WHO ARE 65 AND OLDER-SUCH AS ALZHEIMER'S DISEASE, PARKINSON'S, DEMENTIA, FALLS AND LIMITED MOBILITY. PER THE 2019 CHNA, CONDITIONS THAT DISPROPORTIONALLY AFFECT OLDER ADULTS WERE IDENTIFIED AS A HIGH PRIORITY HEALTH NEED THROUGH BOTH COMMUNITY ENGAGEMENT EVENTS AND THE SECONDARY ANALYSES. COMMUNITY ENGAGEMENT PARTICIPANTS MOST OFTEN DESCRIBED AGING CONCERNS IN RELATION TO THE SDOH THAT AFFECT SENIORS SUCH AS: - ACCESS TO FRESH FOOD - ECONOMIC INSECURITY (ESPECIALLY FOOD INSECURITY AND HOUSING UNAFFORDABILITY) - SOCIAL ISOLATION AND INADEQUATE FAMILY SUPPORT (LACK OF COMPANIONSHIP, ANXIETY, DEPRESSION, HOPELESSNESS. INADEQUATE FAMILY SUPPORT OR SUPPORT AT HOME TO RECOVER, MAINTAIN ONE'S HEALTH, OR MANAGE THEIR MEDICATIONS INCLUDING ORDERING REFILLS, PICKING UP PRESCRIPTIONS, AND TAKING THE RIGHT DOSE OF MEDICATIONS AT THE RIGHT TIME, CAN BE CHALLENGING FOR OLDER ADULTS WHO DO NOT HAVE ADEQUATE SUPPORT). - TRANSPORTATION (LACK OF ACCESSIBLE OR RELIABLE TRANSPORTATION OPTIONS TO AND FROM APPOINTMENTS, TO GO GROCERY SHOPPING, OR JUST SOCIALIZE WITH OTHERS) IN ADDITION, ALZHEIMER'S DISEASE WAS THE THIRD LEADING CAUSE OF DEATH AND PARKINSON'S DISEASE WAS THE 12TH LEADING CAUSE OF DEATH AMONG SAN DIEGO COUNTY RESIDENTS IN 2016. DEMENTIA IS A CLINICAL SYNDROME OF DECLINE IN MEMORY AND OTHER THINKING ABILITIES. IT IS CAUSED BY VARIOUS DISEASES AND CONDITIONS THAT RESULT IN DAMAGE TO BRAIN CELLS AND LEAD TO DISTINCT SYMPTOM PATTERNS AND DISTINGUISHING BRAIN ABNORMALITIES. ALZHEIMER'S DISEASE (AD) IS A PROGRESSIVE BRAIN DISORDER THAT GRADUALLY DESTROYS A PERSON'S MEMORY AND ABILITY TO LEARN, REASON, MAKE JUDGEMENTS, COMMUNICATE AND CARRY OUT DAILY ACTIVITIES SUCH AS BATHING AND EATING AN ESTIMATED 84,405 ADULTS AGE 55 AND OLDER ARE LIVING WITH SOME FORM OF DEMENTIA AND THIS NUMBER IS PROJECTED TO INCREASE TO MORE THAN 115,000 BY 2030. ALZHEIMER'S DISEASE IS THE MOST EXPENSIVE DISEASE IN THE NATION, WITH ASSOCIATED COSTS HIGHER THAN THOSE OF BOTH CANCER AND HEART DISEASE. RESEARCHERS ESTIMATE THAT BETWEEN INFORMAL CAREGIVING, OUT-OF-POCKET COSTS, AND MEDICAID AND MEDICARE EXPENDITURES, THE LIFETIME COST FOR A PERSON LIVING WITH DEMENTIA IS OVER $320,000. IN SAN DIEGO, THOUSANDS OF RESIDENTS 65+ YEARS AND OLDER VISIT AN EMERGENCY DEPARTMENT (ED) FOR FALL-RELATED INJURIES. THE FOLLOWING ARE THE HOSPITAL DISCHARGE AND DEATH RATES FOR FALLS, AGE 65+, 2016 (RATES PER 100,000 POPULATION). - DEATH - 60 - ED DISCHARGE - 4,695 - INPATIENT DISCHARGE - 1,859 |
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A SUMMARY OF THE MAGNITUDE AND PREVALENCE OF AGING CONDITIONS ARE DESCRIBED BELOW: - THE 2019 HASD&IC AND SCRIPPS CHNA IDENTIFIED AGING CONCERN AS ONE OF THE TOP HEALTH CONDITIONS AMONG SAN DIEGO COUNTY HOSPITALS. - THE 2019 HASD&IC AND SCRIPPS CHNA IDENTIFIED PHYSICAL AND NON-PHYSICAL BARRIERS TO CARE. SENIORS ACCESSING HEALTH CARE CAN BE PARTICULARLY DIFFICULT. WHEN SENIORS CAN NO LONGER DRIVE, FINDING RELIABLE, AFFORDABLE TRANSPORTATION CAN BE CHALLENGING. SENIORS MOST OFTEN HAVE LIMITED INCOME AND AREA CONSTANTLY SHIFTING THEIR FINANCIAL PRIORITIES BETWEEN PAYING FOR HOUSING, FOOD, OR COSTS ASSOCIATED WITH SEEKING HEALTH CARE. HIGH COST OF MEDICATIONS, CO-PAYS AND DEDUCTIBLES WERE CITED AS CREATING FINANCIAL BARRIERS TO ACCESSING HEALTH CARE. PHYSICAL BARRIERS TO CARE, SUCH AS LIMITED MOBILITY, HEARING OR VISION ISSUES MAY ALSO CREATE CHALLENGES FOR SENIORS NEEDING ADDITIONAL ASSISTANCE. FOR THOSE WHO DO NOT SPEAK ENGLISH AS A FIRST LANGUAGE, LANGUAGE CAN ALSO BE A BARRIER TO ACCESSING CARE. AFTER DISCHARGE FROM A HOSPITAL STAY, SENIORS MAY HAVE INADEQUATE SUPPORT AT HOME TO RECOVER WELL AND FOLLOW-UP CARE IS HARD FOR SENIORS TO LOCATE AND SECURE. THESE NEEDS IDENTIFIED BY THE COMMUNITY OVERALL SPOKE TO THE OVERWHELMING NEED TO INCREASE AWARENESS OF COMMUNITY AND SOCIAL SUPPORT PROGRAMS AND SERVICES FOR THIS PARTICULARLY VULNERABLE GROUP. - IN 2016, ALZHEIMER'S DISEASE WAS THE 6TH LEADING CAUSE OF DEATH IN THE UNITED STATES AND 3RD LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY. - IN 2016, THE TOP 10 LEADING CAUSES OF DEATH AMONG ADULTS AGES 65 AND OLDER IN SAN DIEGO COUNTY WERE (IN RANK ORDER): OVERALL CANCER, ALZHEIMER'S DISEASE AND OTHER DEMENTIAS (ADOD), CORONARY HEART DISEASE (CHD), STROKE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), CHRONIC LOWER RESPIRATORY DISEASES, OVERALL HYPERTENSIVE DISEASES, DIABETES, UNINTENTIONAL INJURIES, PARKINSON'S DISEASE AND FALLS. - IN 2016, HOSPITALIZATION RATES AMONG SENIORS WERE HIGHER THAN THE GENERAL POPULATION DUE TO CHD, STROKE, COPD, NONFATAL UNINTENTIONAL INJURIES (INCLUDING FALLS), OVERALL CANCER AND ARTHRITIS. - THE TOP THREE CAUSES OF ED UTILIZATION AMONG SAN DIEGO COUNTY RESIDENTS AGES 65 AND OLDER IN 2016 WERE UNINTENTIONAL INJURIES, FALLS AND ARTHRITIS/OTHER RHEUMATIC CONDITIONS. - SENIORS IN SAN DIEGO COUNTY USE THE 911 SYSTEM AT HIGHER RATES THAN ANY OTHER AGE GROUP. THE MOST COMMON COMPLAINTS INCLUDE GENERAL MEDICAL, ALTERED NEUROLOGICAL STATE, RESPIRATORY DISTRESS, CARDIAC CHEST PAIN AND TRAUMA TO THE EXTREMITIES (HHSA, 2015). - ACCORDING TO THE CDC, 2.8 MILLION OLDER ADULTS, OR MORE THAN ONE IN FOUR, ARE TREATED IN THE ED FOR FALLS EVERY YEAR. ONE IN FIVE FALLS CAUSES A SERIOUS INJURY, SUCH AS BROKEN BONES OR A HEAD INJURY, AND WITH EACH FALL, THE CHANCE OF FALLING AGAIN DOUBLES. THESE INJURIES MAY RESULT IN SERIOUS MOBILITY ISSUES AND DIFFICULTY WITH EVERYDAY TASKS OR LIVING INDEPENDENTLY. THE DIRECT MEDICAL COSTS FOR FALL INJURIES ARE ESTIMATED AT $31 BILLION ANNUALLY (CDC, 2018). - IN 2013, AN ESTIMATED 62,000 SAN DIEGANS AGES 55 AND OLDER WERE LIVING WITH ALZHEIMER'S DISEASE AND OTHER DEMENTIAS (ADOD), WHICH ACCOUNTED FOR 8.3 PERCENT OF THIS AGE GROUP. ASSUMING CURRENT TRENDS CONTINUE, BY 2030, NEARLY 94,000 RESIDENTS 55 YEARS AND OLDER WILL BE LIVING WITH ADOD, WHICH IS A 51 PERCENT INCREASE FROM 2013 (ALZHEIMER'S DISEASE AND OTHER DEMENTIAS IN SAN DIEGO COUNTY, HHSA, 2016). - IN 2016, AN ESTIMATED 71.4 PERCENT OF SAN DIEGO COUNTY RESIDENTS AGES 65 AND OLDER REPORTED THAT THEY WERE VACCINATED FOR INFLUENZA IN THE PAST 12 MONTHS (CHIS, 2016). IN 2016, 26 OF THE 46 RECORDED INFLUENZA DEATHS IN SAN DIEGO COUNTY OCCURRED AMONG RESIDENTS AGES 65 AND OLDER. THE AGE-ADJUSTED RATE OF INFLUENZA DEATH AMONG THIS GROUP WAS 6.0 PER 100,000 (HHSA, 2016). - RESEARCH SHOWS THAT CAREGIVING CAN HAVE SERIOUS PHYSICAL AND MENTAL HEALTH CONSEQUENCES. ACCORDING TO FINDINGS FROM THE STRESS IN AMERICA SURVEY DESCRIBED IN A REPORT TITLED "VALUING THE INVALUABLE", CAREGIVERS TO OLDER RELATIVES REPORT POORER HEALTH AND HIGHER STRESS LEVELS THAN THE GENERAL POPULATION. FIFTY-FIVE PERCENT OF SURVEYED CAREGIVERS REPORTED FEELING OVERWHELMED BY THE AMOUNT OF CARE THEIR FAMILY MEMBER NEEDS (AARP PUBLIC POLICY INSTITUTE, UPDATED JULY 2015). - ACCORDING TO AARP, MORE THAN 40 MILLION PEOPLE IN THE U.S. ACT AS UNPAID CAREGIVERS TO PEOPLE AGES 65 AND OLDER. MORE THAN 10 MILLION OF THESE CAREGIVERS ARE MILLENNIALS WITH SEPARATE FULL OR PART-TIME JOBS, AND ONE IN THREE EMPLOYED MILLENNIAL CAREGIVERS EARNS LESS THAN $30,000 PER YEAR (AARP, 2018). - ACCORDING TO A REPORT FROM THE NATIONAL ALLIANCE FOR CAREGIVING (NAC) AND AARP TITLED CAREGIVING IN THE U.S. 2015, 60 PERCENT OF UNPAID CAREGIVERS ARE FEMALE, AND NEARLY 1 IN 10 CAREGIVERS ARE AGES 75 OR OLDER (AARP AND NAC, 2015). - THE UCLA CENTER FOR HEALTH POLICY RESEARCH CONDUCTED A STUDY HIGHLIGHTING THE PLIGHT OF CALIFORNIA'S "HIDDEN POOR," FINDING 772,000 SENIORS WHO LIVE IN THE GAP BETWEEN THE FPL AND THE ELDER ECONOMIC SECURITY STANDARD. THE HIGHEST PROPORTION OF SENIORS LIVING IN THIS GAP INCLUDES RENTERS, LATINOS, WOMEN AND GRANDPARENTS RAISING GRANDCHILDREN (PADILLA-FRAUSTO & WALLACE, 2015). DURING FISCAL YEAR 2019, SCRIPPS ENGAGED IN THE FOLLOWING PROGRAMS AND SERVICES TO MEET THE NEEDS OF THE AGING POPULATION. DEMENTIA AND ALZHEIMER'S DISEASE DEMENTIA IS A CLINICAL SYNDROME OF DECLINE IN MEMORY AND OTHER THINKING ABILITIES. IT IS CAUSED BY VARIOUS DISEASES AND CONDITIONS THAT RESULT IN DAMAGE TO BRAIN CELLS AND LEAD TO DISTINCT SYMPTOM PATTERNS AND DISTINGUISHING BRAIN ABNORMALITIES. ALZHEIMER'S DISEASE (AD) IS A PROGRESSIVE BRAIN DISORDER THAT GRADUALLY DESTROYS A PERSON'S MEMORY AND ABILITY TO LEARN, REASON, MAKE JUDGEMENTS, COMMUNICATE AND CARRY OUT DAILY ACTIVITIES SUCH AS BATHING AND EATING. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
A SUMMARY OF THE MAGNITUDE AND PREVALENCE OF DEMENTIA AND ALZHEIMER'S DISEASE IS DESCRIBED BELOW: - THE HASD&IC 2016 CHNA CONTINUED TO IDENTIFY ALZHEIMER'S DISEASE AS ONE OF THE TOP 15 PRIORITY HEALTH CONDITIONS AMONG SAN DIEGO COUNTY HOSPITALS. - IN 2016, ALZHEIMER'S DISEASE WAS THE 6TH LEADING CAUSE OF DEATH IN THE UNITED STATES AND 3RD LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY. - IN 2016, THE TOP 10 LEADING CAUSES OF DEATH AMONG ADULTS AGES 65 AND OLDER IN SAN DIEGO COUNTY WERE (IN RANK ORDER): OVERALL CANCER, ALZHEIMER'S DISEASE AND OTHER DEMENTIAS (ADOD), CORONARY HEART DISEASE (CHD), STROKE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)/CHRONIC LOWER RESPIRATORY DISEASES, OVERALL HYPERTENSIVE DISEASES, DIABETES, UNINTENTIONAL INJURIES, PARKINSON'S DISEASE AND FALLS. - IN 2016, HOSPITALIZATION RATES AMONG SENIORS WERE HIGHER THAN THE GENERAL POPULATION DUE TO CHD, STROKE, COPD, NONFATAL UNINTENTIONAL INJURIES (INCLUDING FALLS), OVERALL CANCER AND ARTHRITIS. - THE TOP THREE CAUSES OF ED UTILIZATION AMONG SAN DIEGO COUNTY RESIDENTS AGES 65 AND OLDER IN 2016 WERE UNINTENTIONAL INJURIES, FALLS AND ARTHRITIS/OTHER RHEUMATIC CONDITIONS. - SENIORS IN SAN DIEGO COUNTY USE THE 911 SYSTEM AT HIGHER RATES THAN ANY OTHER AGE GROUP. THE MOST COMMON COMPLAINTS INCLUDE GENERAL MEDICAL, ALTERED NEUROLOGICAL STATE, RESPIRATORY DISTRESS, CARDIAC CHEST PAIN AND TRAUMA TO THE EXTREMITIES (HHSA, 2015). - ACCORDING TO THE CDC, 2.8 MILLION OLDER ADULTS, OR MORE THAN ONE IN FOUR, ARE TREATED IN THE ED FOR FALLS EVERY YEAR. ONE IN FIVE FALLS CAUSES A SERIOUS INJURY, SUCH AS BROKEN BONES OR A HEAD INJURY, AND WITH EACH FALL, THE CHANCE OF FALLING AGAIN DOUBLES. THESE INJURIES MAY RESULT IN SERIOUS MOBILITY ISSUES AND DIFFICULTY WITH EVERYDAY TASKS OR LIVING INDEPENDENTLY. THE DIRECT MEDICAL COSTS FOR FALL INJURIES ARE ESTIMATED AT $31 BILLION ANNUALLY (CDC, 2018). - IN 2013, AN ESTIMATED 62,000 SAN DIEGANS AGES 55 AND OLDER WERE LIVING WITH ALZHEIMER'S DISEASE AND OTHER DEMENTIAS (ADOD), WHICH ACCOUNTED FOR 8.3 PERCENT OF THIS AGE GROUP. ASSUMING CURRENT TRENDS CONTINUE, BY 2030, NEARLY 94,000 RESIDENTS 55 YEARS AND OLDER WILL BE LIVING WITH ADOD, WHICH IS A 51 PERCENT INCREASE FROM 2013 (ALZHEIMER'S DISEASE AND OTHER DEMENTIAS IN SAN DIEGO COUNTY, HHSA, 2016). - IN 2016, AN ESTIMATED 71.4 PERCENT OF SAN DIEGO COUNTY RESIDENTS AGES 65 AND OLDER REPORTED THAT THEY WERE VACCINATED FOR INFLUENZA IN THE PAST 12 MONTHS (CHIS, 2016). IN 2016, 26 OF THE 46 RECORDED INFLUENZA DEATHS IN SAN DIEGO COUNTY OCCURRED AMONG RESIDENTS AGES 65 AND OLDER. THE AGE-ADJUSTED RATE OF INFLUENZA DEATH AMONG THIS GROUP WAS 6.0 PER 100,000 (HHSA, 2016). - RESEARCH SHOWS THAT CAREGIVING CAN HAVE SERIOUS PHYSICAL AND MENTAL HEALTH CONSEQUENCES. ACCORDING TO FINDINGS FROM THE STRESS IN AMERICA SURVEY DESCRIBED IN A REPORT TITLED "VALUING THE INVALUABLE", CAREGIVERS TO OLDER RELATIVES REPORT POORER HEALTH AND HIGHER STRESS LEVELS THAN THE GENERAL POPULATION. FIFTY-FIVE PERCENT OF SURVEYED CAREGIVERS REPORTED FEELING OVERWHELMED BY THE AMOUNT OF CARE THEIR FAMILY MEMBER NEEDS (AARP PUBLIC POLICY INSTITUTE, UPDATED JULY 2015). - ACCORDING TO AARP, MORE THAN 40 MILLION PEOPLE IN THE U.S. ACT AS UNPAID CAREGIVERS TO PEOPLE AGES 65 AND OLDER. MORE THAN 10 MILLION OF THESE CAREGIVERS ARE MILLENNIALS WITH SEPARATE FULL- OR PART-TIME JOBS, AND ONE IN THREE EMPLOYED MILLENNIAL CAREGIVERS EARNS LESS THAN $30,000 PER YEAR (AARP, 2018). - ACCORDING TO A REPORT FROM THE NATIONAL ALLIANCE FOR CAREGIVING (NAC) AND AARP TITLED CAREGIVING IN THE U.S. 2015, 60 PERCENT OF UNPAID CAREGIVERS ARE FEMALE, AND NEARLY 1 IN 10 CAREGIVERS ARE AGES 75 OR OLDER (AARP AND NAC, 2015). - THE UCLA CENTER FOR HEALTH POLICY RESEARCH CONDUCTED A STUDY HIGHLIGHTING THE PLIGHT OF CALIFORNIA'S "HIDDEN POOR," FINDING 772,000 SENIORS WHO LIVE IN THE GAP BETWEEN THE FPL AND THE ELDER ECONOMIC SECURITY STANDARD. THE HIGHEST PROPORTION OF SENIORS LIVING IN THIS GAP INCLUDES RENTERS, LATINOS, WOMEN AND GRANDPARENTS RAISING GRANDCHILDREN (PADILLA-FRAUSTO & WALLACE, 2015). DURING FISCAL YEAR 2019, SCRIPPS ENGAGED IN THE FOLLOWING PROGRAMS AND SERVICES TO MEET THE NEEDS OF THE AGING POPULATION. THE ALZHEIMER'S PROJECT - SAN DIEGO UNITES FOR A CURE AND CARE THE ALZHEIMER'S PROJECT IS A COUNTYWIDE INITIATIVE AIMED AT ACCELERATING THE SEARCH FOR A CURE AND HELPING THE ESTIMATED 60,000 SAN DIEGANS WITH THE DISEASE, ALONG WITH THEIR CAREGIVERS. PARTICIPANTS BEGAN MEETING IN EARLY 2016 TO CRAFT A REGIONAL ROADMAP TO ADDRESS THE DISEASE, FOCUSING ON CURE, CARE, CLINICAL, AND PUBLIC AWARENESS AND EDUCATION INITIATIVES. THE BOARD OF SUPERVISORS APPROVED THE ROADMAP IN DECEMBER 2014 AND LATER VOTED IN SUPPORT OF AN IMPLEMENTATION TIMETABLE. DR. MICHAEL LOBATZ FROM SCRIPPS HEALTH IS A LEADING PARTICIPANT OF THIS INITIATIVE AS A CO-CHAIRPERSON OF THE CLINICAL ROUND TABLE AND IS A MEMBER OF THE STEERING COMMITTEE. STANDING STRONG FOR FALL ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), MORE THAN ONE THIRD OF ADULTS 65 AND OLDER FALL EACH YEAR IN THE UNITED STATES AND 20 TO 30% OF PEOPLE WHO FALL SUFFER MODERATE TO SEVERE INJURIES. SCRIPPS HELD A FREE INTERACTIVE EVENT ON FALL PREVENTION. PARTICIPANTS LEARNED ABOUT IMPROVING BALANCE AND FLEXIBILITY AND STRENGTH. IT ALSO INCLUDED BALANCE AND FALL RISK SCREENING ASSESSMENT BY SCRIPPS PHYSICAL THERAPY DEPARTMENT OCCUPATIONAL THERAPY SPECIALIST. SENIOR HEALTH AND WELLBEING PROGRAMS EACH MONTH A VARIETY OF SENIOR PROGRAMS ARE HELD IN PARTNERSHIP WITH LOCAL SENIOR CENTERS, CHURCHES, AND SENIOR HOUSING. THE FOLLOWING PROGRAMS ARE CONDUCTED AS PART OF SCRIPPS MERCY HOSPITAL CHULA VISTA SAN DIEGO BORDER AREA HEALTH EDUCATION CENTER AND SCRIPPS FAMILY MEDICINE RESIDENCY PROGRAM. THESE SENIOR HEALTH CHATS ARE DESIGNED TO PROVIDE HEALTH EDUCATION TO THE OLDER ADULT COMMUNITY. APPROXIMATELY 20-25 SENIORS ATTEND THESE MONTHLY THROUGHOUT THE YEAR. THESE PRESENTATIONS INCLUDE A VARIETY OF HEALTH AND AGE-RELATED TOPICS THAT INCLUDE NUTRITION, HEARING LOSS, DEMENTIA, ALZHEIMER'S, PAIN MANAGEMENT AND MAINTAINING A HEALTHY LIFESTYLE. THESE PRESENTATIONS ARE FACILITATED BY VARIOUS HEALTH CARE PROFESSIONS AND RESIDENTS. TOPICS ARE ALL CHOSEN BY THE SENIORS THEMSELVES SO AS TO MEET THEIR LOCAL NEEDS. ALSO, THE HEALTH CHATS PROVIDE AN INTERCHANGE BETWEEN THE COMMUNITY MEMBERS AND OUR MEDICAL RESIDENTS AND OTHER HEALTH CARE PROFESSIONALS TO FOSTER HEALTHY LIFESTYLES AND HEALTH PREVENTION. THE PROGRAM IS CONDUCTED IN COLLABORATION WITH NORMAN PARK CENTER, CONGREGATIONAL TOWERS SENIOR LIVING AND ST CHARLES NUTRITION CENTER. FAMILY MEDICINE RESIDENTS ROTATE THROUGH THESE PROGRAMS TO LEARN MORE ABOUT GERIATRIC MEDICINE, HEALTH AND WELLNESS AND OVERALL PUBLIC HEALTH AND COMMUNITY TRAINING. OVER 264 SENIORS PARTICIPATED IN THESE PROGRAMS. PARKINSON'S LSVT (LEE SILVERMAN TRAINING) BIG EXERCISE: SCRIPPS PROVIDES A MAINTENANCE CLASS FOR THOSE WHO HAVE COMPLETED THE LSVT BIG EXERCISE PROTOCOL. THIS CLASS IS TAUGHT BY A PHYSICAL THERAPIST AND IS DESIGNED FOR PARKINSON'S PATIENTS TO IMPROVE STRENGTH AND MOBILITY FOR A HEALTHIER LIFE. FALL PREVENTION AND HOME SAFETY WORKSHOPS MANY OLDER ADULTS EXPERIENCE CONCERNS ABOUT FALLING AND RESTRICT THEIR ACTIVITIES. SCRIPPS SOCIAL WORKERS AND NURSES LECTURE ON WAYS TO REDUCE FALL RISK, IMPROVE SAFETY AWARENESS AND UTILIZE AVAILABLE RESOURCES TO PROMOTE INDEPENDENCE AND OVERALL SAFETY. BALANCE CLASSES ARE DESIGNED TO HELP BUILDING BALANCE, POSTURE AND COORDINATION THROUGH STRENGTHENING AND BALANCE EXERCISES. THIS IMPORTANCE ASPECT TO HEALTHY LIVING FOR SENIORS PROVIDES EDUCATION ON PREVENTING FALLS THROUGH EXERCISE AND BEING PROACTIVE THROUGH SAFETY MEASURES IN THE HOME. SCRIPPS PT DEPARTMENT AND PT SCHOOL VOLUNTEERS PROVIDE FALL RISK ASSESSMENTS. SENIORS MAY ATTEND FROM ALL OVER THE SD COUNTY REGION. A MATTER OF BALANCE: MANAGING CONCERNS ABOUT FALLS SCRIPPS EDUCATES OLDER ADULTS ON PREVENTING FALLS THROUGH EXERCISE AND BEING PROACTIVE THROUGH SAFETY MEASURES IN THE HOME. AN 8-WEEK PROGRAM AND LECTURE SERIES PROVIDE PRACTICAL STRATEGIES TO MANAGE FALLS, IMPROVE SAFETY AWARENESS AND UTILIZE AVAILABLE RESOURCES TO PROMOTE INDEPENDENCE AND OVERALL SAFETY. OBESITY, WEIGHT STATUS, NUTRITION, ACTIVITY AND FITNESS OBESITY IS AN IMPORTANT HEALTH NEED DUE TO ITS HIGH PREVALENCE IN THE U.S. AND SAN DIEGO. ALTHOUGH IT IS NOT A LEADING CAUSE OF DEATH, IT IS A SIGNIFICANT CONTRIBUTOR TO THE DEVELOPMENT OF OTHER CHRONIC CONDITIONS. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
A SUMMARY OF THE MAGNITUDE AND PREVALENCE OF OBESITY, WEIGHT STATUS, NUTRITION AND ACTIVITY & FITNESS IS DESCRIBED BELOW: - THE SCRIPPS 2019 CHNA CONTINUED TO IDENTIFY OBESITY AS A PRIORITY HEALTH ISSUE AFFECTING MEMBERS OF THE COMMUNITIES SERVED BY SCRIPPS. - ACCORDING TO 2017 CHIS DATA, THE SELF-REPORTED OBESITY RATE FOR ADULTS AGES 18 AND OLDER IN SAN DIEGO COUNTY WAS 22.5 PERCENT. - ACCORDING TO A NEW REPORT RELEASED IN 2019 BY THE SAN DIEGO CHILDHOOD OBESITY INITIATIVE, 34%, OR NEARLY 1 OUT OF EVERY 3 CHILDREN IN SAN DIEGO COUNTY'S SCHOOLS WERE OVERWEIGHT OR OBESE. THESE RATES THESE RATES VARY BY GRADE, WITH 5TH GRADERS HAVING THE HIGHEST RATES OF OVERWEIGHT AND OBESE CHILDREN - 36% - COMPARED TO 7TH GRADERS (34%) AND 9TH GRADERS (33%). IN EXAMINING TRENDS ACROSS LONGER PERIODS OF TIME, OVERWEIGHT AND OBESITY PREVALENCE AMONG CHILDREN IN SAN DIEGO COUNTY APPEARS TO BE LEVELING OFF AND EVEN DECLINING SLIGHTLY. FOR EXAMPLE, A 2005 UCLA STUDY ESTIMATED 36% OF CHILDREN IN SAN DIEGO COUNTY WERE OVERWEIGHT OR OBESE, WITH THAT NUMBER DECREASING TO 35% IN 2010. BASED ON THESE DATA, CHILDHOOD OVERWEIGHT AND OBESITY PREVALENCE IN 2018 HAS DECREASED BY TWO PERCENTAGE POINTS SINCE 2005. THIS SMALL DECREASE FROM 36% TO 34%, HOWEVER, WOULD REPRESENT APPROXIMATELY 8,600 FEWER STUDENTS ACROSS PUBLIC SCHOOL DISTRICTS WHO WERE OVERWEIGHT AND OBESE IN 2017-2018. MORE INFORMATION CAN BE FOUND AT, WWW.SDCOI.ORG. - IN 2017, BETWEEN 25 AND 30 PERCENT OF ADULTS IN CALIFORNIA SELF-REPORTED BEING OBESE. OBESITY LEVELS DECREASED AS EDUCATION LEVELS INCREASED, INDICATING A NEED FOR HEALTH EDUCATION AS A TOOL FOR REDUCING OBESITY RATES (CDC, 2017). - OBESITY HAS BEEN LINKED TO ENVIRONMENTAL FACTORS, SUCH AS ACCESSIBILITY AND AFFORDABILITY OF FRESH FOODS, PARK AVAILABILITY, SOCIAL COHESION AND NEIGHBORHOOD SAFETY (UCLA CENTER FOR HEALTH POLICY RESEARCH, 2015). - ACCORDING TO DATA FROM THE 2016 NATIONAL STUDY OF CHILDREN'S HEALTH, NEARLY ONE-THIRD OF CHILDREN IN CALIFORNIA ARE OBESE. CALIFORNIA HAS ONE OF THE HIGHEST CHILDHOOD OBESITY RATES IN WESTERN STATES (THE STATE OF OBESITY, 2018). - ACCORDING TO THE CDC, SOME OF THE LEADING CAUSES OF PREVENTABLE DEATH INCLUDE OBESITY-RELATED CONDITIONS, SUCH AS HEART DISEASE, STROKE, TYPE 2 DIABETES AND CERTAIN TYPES OF CANCER. IN 2016, 39.8 PERCENT OF AMERICANS WERE OBESE (CDC, 2017). - OBESITY IS LARGELY CATEGORIZED AS A SECONDARY DIAGNOSIS IN HOSPITAL DISCHARGE DATA. WHEN EXAMINING INPATIENT HOSPITAL DISCHARGE DATA WITH OBESITY AS A SECONDARY DIAGNOSIS, IT WAS FOUND THAT THE MOST COMMON PRIMARY DIAGNOSIS OF THOSE PATIENTS WAS NONSPECIFIC CHEST PAIN IN AGES 25-64, ABNORMAL PAIN FOR THOSE AGES 15-24, AND THOSE OVER 65 YEARS THEIR PRIMARY DIAGNOSIS WAS OSTEOARTHRITIS, SEPTICEMIA FOLLOWED BY CONGESTIVE HEART FAILURE. - RESEARCH HAS SHOWN THAT AS WEIGHT INCREASES TO REACH THE LEVELS OF "OVERWEIGHT"OBESITY" THE RISKS FOR THE FOLLOWING CONDITIONS ALSO INCREASES: - CORONARY HEART DISEASE - TYPE 2 DIABETES - CANCERS (ENDOMETRIAL, BREAST AND COLON) - HYPERTENSION (HIGH BLOOD PRESSURE) - STROKE - LIVER AND GALLBLADDER DISEASE - SLEEP APNEA AND RESPIRATORY PROBLEMS - OSTEOARTHRITIS OBESITY IS ADDRESSED THROUGH GENERAL NUTRITION AND EXERCISE EDUCATION AND RESOURCES PROVIDED AT SCRIPPS AS WELL AS PROGRAMS THAT ADDRESS A HEALTHY LIFESTYLE AS PART OF CARE FOR HEART DISEASE, CANCER, DIABETES AND OTHER HEALTH ISSUES INFLUENCED BY HEALTHY WEIGHT AND EXERCISE. DURING FY19, SCRIPPS ENGAGED IN THE FOLLOWING OBESITY PREVENTION AND TREATMENT ACTIVITIES: SAN DIEGO CHILDHOOD OBESITY INITIATIVE THE SAN DIEGO COUNTY CHILDHOOD OBESITY INITIATIVE (COI) WAS ESTABLISHED IN 2006 AND IS A PRIVATE PUBLIC PARTNERSHIP WITH THE MISSION OF REDUCING AND PREVENTING CHILDHOOD OBESITY THROUGH POLICY, SYSTEMS, AND ENVIRONMENT CHANGE. CORE FUNDING FOR THE INITIATIVE IS PROVIDED BY THE COUNTY OF SAN DIEGO, FIRST 5 COMMISSION OF SAN DIEGO COUNTY, THE CALIFORNIA ENDOWMENT, AND KAISER-PERMANENTE. SCRIPPS IS A STRONG PARTNER WITH CHIP AND THE OUTCOMES OF THE INITIATIVE HAVE SHOWN AN OVERALL REDUCTION IN CHILDHOOD OVERWEIGHT AND OBESITY, FROM 36% IN 2005 TO 34% IN 2015 (MANY AREAS HAVE SEEN INCREASES). A NEW STATE OF CHILDHOOD OBESITY SUPPLEMENTAL REPORT RELEASED BY THE SAN DIEGO COUNTY CHILDHOOD OBESITY INITIATIVE RELEASED IN 2019, WWW.SDCOI.ORG, FINDS THAT DESPITE THE POTENTIAL IMPROVEMENTS IN SAN DIEGO COUNTY, DISPARITIES AMONG CHILDREN WHO ARE OVERWEIGHT OR OBESE PERSIST, PARTICULARLY AMONG DIVERSE RACIAL, ETHNIC, AND ECONOMIC GROUPS. FOR EXAMPLE, IN 2018, 43% OF HISPANIC STUDENTS WERE OVERWEIGHT OR OBESE. COMPARED TO WHITE STUDENTS WITH AN OVERWEIGHT AND OBESITY PREVALENCE OF 24%, HISPANIC STUDENTS WERE NEARLY TWICE AS LIKELY TO BE OVERWEIGHT OR OBESE. THESE FINDINGS ARE RELEVANT AS NEARLY HALF - OR 48% - OF ALL STUDENTS TESTED IN SAN DIEGO COUNTY IDENTIFIED AS HISPANIC OR LATINO, COMPARED TO 29% OF STUDENTS IDENTIFYING AS WHITE FOR THE 2017-2018 SCHOOL YEAR.3 STUDENTS WHO IDENTIFIED AS AMERICAN INDIAN OR ALASKAN NATIVE, OR NATIVE HAWAIIAN OR PACIFIC ISLANDER, HAD OVERWEIGHT AND OBESITY RATES OF 44% AND 49%, RESPECTIVELY. FOR STUDENTS IDENTIFYING AS BLACK OR AFRICAN AMERICAN, THE STORY WAS SIMILAR WITH 37% BEING OVERWEIGHT OR OBESE. ONLY STUDENTS IDENTIFYING AS ASIAN HAVE RATES LOWER THAN WHITE CHILDREN-22% COMPARED TO 24%. DURING THE 2017-2018 SCHOOL YEAR, MORE THAN HALF, OR 53% OF SAN DIEGO COUNTY STUDENTS IN BOTH PUBLIC AND CHARTER SCHOOLS, WERE IDENTIFIED AS SOCIOECONOMICALLY DISADVANTAGED. SOCIOECONOMICALLY DISADVANTAGED IS DEFINED AS STUDENTS WHO ARE: MIGRANTS, IN FOSTER CARE OR HOMELESS AT ANY TIME DURING THE ACADEMIC YEAR, ELIGIBLE OR HAD DIRECT CERTIFICATION FOR THE FREE OR REDUCED-PRICED MEAL (FRPM) PROGRAM OR ARE IN A FAMILY WHERE BOTH PARENTS DID NOT RECEIVE A HIGH SCHOOL DIPLOMA. AMONG THESE STUDENTS, 42% WERE OVERWEIGHT OR OBESE. COMPARED TO THEIR NON-ECONOMICALLY DISADVANTAGED PEERS, SOCIOECONOMICALLY DISADVANTAGED STUDENTS WERE ALMOST TWICE AS LIKELY TO BE OVERWEIGHT OR OBESE (42% VS 24%). OVERWEIGHT AND OBESITY PREVALENCE AMONG THESE STUDENTS HAS HELD STEADY AT 42% SINCE 2014; HOWEVER, ALARMING DISPARITIES CONTINUE TO GROW ACROSS RACIAL AND ETHNIC GROUPS. AMERICAN INDIAN OR ALASKAN NATIVE STUDENTS, FOR EXAMPLE, HAD A 10% INCREASE IN OVERWEIGHT AND OBESITY PREVALENCE BETWEEN 2014 AND 2018, AND NATIVE HAWAIIAN OR PACIFIC ISLANDER STUDENTS HAD AN EVEN GREATER INCREASE- 12%-DURING THIS TIME PERIOD. DIABETES PREVENTION PROGRAM (DPP) A LARGE CLINICAL TRIAL CONCLUDED THAT PEOPLE WITH PREDIABETES COULD REDUCE THEIR LIKELIHOOD OF DEVELOPING DIABETES BY 58-70 PERCENT IF THEY LOST JUST 5-7 PERCENT OF THEIR BODY WEIGHT. THE DIABETES PREVENTION PROGRAM IS A SCIENTIFICALLY VALIDATED LIFESTYLE INTERVENTION-BASED MODEL. THE CENTERS FOR DISEASE CONTROL (CDC) AND THE NATIONAL INSTITUTES OF HEALTH (NIH) PROMOTE WIDESPREAD ADOPTION OF THE DPP DUE TO ITS DEMONSTRATED EFFECTIVENESS. SCRIPPS IS RECOGNIZED BY THE CENTERS FOR DISEASE CONTROL AS A NATIONAL DPP PROVIDER AND ROLLED OUT THE PROGRAM TO PATIENTS AND COMMUNITY MEMBERS IN 2016. SCRIPPS AIMS TO DECREASE THE INCIDENCE OF TYPE 2 DIABETES BY MANAGING A MAJOR DIABETES RISK FACTOR, OBESITY IN THE UNDERSERVED, ETHNICALLY DIVERSE POPULATIONS BY TESTING THE EFFECTIVENESS OF LIFESTYLE CURRICULUM. THE PROGRAM USES TRAINED LIFESTYLE COACHES AND A STANDARDIZED CURRICULUM; PARTICIPANTS MEET IN GROUPS WITH A COACH FOR 16 WEEKLY SESSIONS AND SIX TO EIGHT BIMONTHLY FOLLOW-UP SESSIONS. PARTICIPANTS MUST HAVE PREDIABETES AND BE OVERWEIGHT TO ENROLL. NO PHYSICIAN REFERRAL IS REQUIRED, ALTHOUGH MANY PHYSICIANS DO REFER THEIR PATIENTS TO THIS VALUABLE RESOURCE. ORIENTATION SESSIONS ARE HELD IN SPANISH AND ENGLISH THROUGHOUT THE COUNTY. HEALTHY LIVING PROGRAM DIABETES, HEART DISEASE, CANCER AND RESPIRATORY DISEASE ARE THE FOUR MOST PREVALENT SERIOUS CHRONIC DISEASES IN CALIFORNIA. THESE DISEASES CAUSE 50 PERCENT OF ALL DEATHS IN SAN DIEGO AND THROUGHOUT THE U.S., AND MANY PEOPLE HAVE MORE THAN ONE OF THESE CONDITIONS. BECAUSE LIFESTYLE CAN PLAY A MAJOR ROLE IN PREVENTING THESE CHRONIC ILLNESSES, SCRIPPS INTRODUCED HEALTHY LIVING, A FREE, INTERACTIVE EDUCATION PROGRAM TO HELP THE SAN DIEGO COMMUNITY LEARN ABOUT AND ADOPT PRACTICAL WAYS TO IMPROVE THREE BEHAVIORS: SMOKING, POOR DIET AND PHYSICAL INACTIVITY THAT CONTRIBUTE TO THESE FOUR DISEASES. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
PARTICIPANTS LEARN HOW TO MAKE HEALTHY FOOD CHOICES USING LOW COSTS OPTIONS, MAKE PHYSICAL ACTIVITY PART OF THEIR DAILY LIFE AND LEARN HOW TO STAY MOTIVATED AND MAINTAIN HEALTHY HABITS. SCRIPPS IMPLEMENTS A SERIES OF THREE FREE SESSIONS THAT ENCOURAGE PARTICIPANTS TO IDENTIFY AND ADOPT PRACTICAL WAYS TO IMPROVE THEIR HEALTH HABITS. SESSIONS ARE OFFERED THROUGHOUT SAN DIEGO COUNTY IN ENGLISH AND SPANISH, WITH SPECIAL EMPHASIS ON THE LATINO AND UNDERSERVED COMMUNITIES. SESSIONS INCLUDE HEALTH SCREENINGS, HEALTHY COOKING TIPS, AND MINDFUL EATING PRACTICE SESSIONS. PARTICIPANTS ALSO RECEIVE A PREDIABETES SCREENING; THOSE WHO SCORE HIGH ARE THEN REFERRED TO THE SCRIPPS DIABETES PREVENTION PROGRAM. PROMISE NEIGHBORHOOD INITIATIVE SCRIPPS ALSO ADDRESSES CHILDHOOD OBESITY AT THE HIGH SCHOOL LEVEL IN SAN DIEGO'S SOUTH BAY COMMUNITIES THROUGH ITS PARTNERSHIP WITH THE PROMISE NEIGHBORHOOD INITIATIVE, WHICH IMPLEMENTS ACTIVITIES RELATED TO THE NATIONAL 5210 CAMPAIGN. THE MESSAGE IS TO PROMOTE A HEALTHY LIFESTYLE (5 SERVINGS OF FRUITS AND VEGETABLES, 2 HOUR SCREEN TIME LIMIT, 1 HOUR OF PHYSICAL ACTIVITY AND 0 SUGARY DRINKS) PER DAY. THIS FIVE-SESSION SERIES IS DESIGNED TO INCREASE KNOWLEDGE AND BEHAVIORS REGARDING A HEALTHY LIFESTYLE. THE SERIES INCLUDES HANDS-ON ACTIVITIES AND DEMONSTRATIONS. SCRIPPS PARTNERS WITH THE PROMISE NEIGHBORHOOD INITIATIVE AND CASTLE PARK ELEMENTARY SCHOOL TO INCREASE EDUCATION AND AWARENESS ABOUT HEALTHY LIFESTYLES FOR STUDENTS, THEIR PARENTS AND SCHOOL STAFF. PROMISE NEIGHBORHOOD DEVELOPED A WELLNESS COMMITTEE COMPOSED OF THE SCHOOL PRINCIPAL, TEACHERS, PARENTS AND SCRIPPS STAFF AIMED TO IMPLEMENT ACTIVITIES THAT SUPPORT 5-2-1-0. SCHOOL ADMINISTRATORS AND STAFF ARE CLOSELY INVOLVED IN THE PROGRAM, WHICH INCLUDES FIVE EDUCATIONAL SESSIONS, A HEALTH ASSESSMENT SURVEY AND HEALTH PLAN, AND SUPPORT TO HELP THE STUDENTS PASS THEIR YEARLY PHYSICAL EDUCATION REQUIREMENTS. SINCE 2013, MORE THAN 400 CHILDREN AND 200 PARENTS HAVE PARTICIPATED IN WELLNESS ACTIVITIES ON CAMPUS. AS A RESULT OF ACTIVITIES, LESSON PLANS AND ADVOCACY FOR HEALTHY LIVING, THE AMOUNT OF PHYSICAL ACTIVITY AND CONSUMPTION OF FRUITS AND VEGETABLES BY CHILDREN, PARENTS AND STAFF HAS INCREASED. STUDENT RESPONSES VIA A POST HEALTH ASSESSMENT SURVEY SHOWED THAT THERE WAS AN 80% IMPROVEMENT RATE FOR KNOWLEDGE AFTER PARTICIPATING IN THE 5210 SESSIONS. AND A 38% IMPROVEMENT RATE FOR BEHAVIOR AFTER PARTICIPATING IN THE 5210 SESSIONS. CITY HEIGHTS WELLNESS CENTER LA MAESTRA FAMILY CLINIC, INC. JOINED THE CITY HEIGHTS WELLNESS CENTER (CHWC) COLLABORATIVE PARTNERSHIP WITH SCRIPPS MERCY HOSPITAL AND RADY CHILDREN'S HOSPITAL AS THE LEASE HOLDER OF THE WELLNESS CENTER STARTING SEPTEMBER 1, 2016. SINCE ITS INCEPTION IN 2002, THE CITY HEIGHTS WELLNESS CENTER HAS BEEN A DYNAMIC, COMMUNITY-BASED PROGRAM DEVELOPED BY SCRIPPS MERCY HOSPITAL AND RADY CHILDREN'S HOSPITAL, WORKING WITH RESIDENTS TO IMPROVE THEIR LIFESTYLE BEHAVIORS AND SELF-SUFFICIENCY SKILLS. MULTIPLE NOT-FOR-PROFIT AND GOVERNMENTAL ORGANIZATIONS, PHILANTHROPIC FOUNDATIONS AND GRASSROOTS GROUPS HAVE JOINED THE EFFORT CONDUCTING HEALTH PROMOTION AND EDUCATIONAL ACTIVITIES FOR COMMUNITY RESIDENTS. A UNIQUE ASPECT OF THE CITY HEIGHTS WELLNESS CENTER IS THE TEACHING KITCHEN THAT IS KNOWN THROUGHOUT THE COMMUNITY AS A PLACE WHERE RESIDENTS AND PROVIDERS COME TOGETHER TO COOK, DISCOVER AND COMMUNICATE IN A SAFE AND TRUSTED ENVIRONMENT. LA MAESTRA FAMILY CLINIC BRINGS A NEW PERSPECTIVE TO THE PARTNERSHIP AS A COMMUNITY HEALTH CENTER AND PRIMARY CARE PROVIDER SERVING THE CULTURALLY DIVERSE POPULATIONS WITHIN THE CITY HEIGHTS COMMUNITY. LA MAESTRA IS COMMITTED TO MAINTAINING THE COLLABORATIVE NATURE OF THE PARTNERSHIP AND CONTINUES TO WORK WITH CURRENT CHWC AGENCIES AS WELL AS LOOK FOR OPPORTUNITIES TO EXPAND HEALTH PROMOTION SERVICES. THE SCRIPPS MERCY SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC), COLLOCATED IN THE WELLNESS CENTER, CONTINUES TO PROVIDE WIC SERVICES AS ONE OF THE PROGRAMS WITHIN THE CITY HEIGHTS WELLNESS CENTER. COLLABORATIVE FOR HEALTHY WEIGHT COLLABORATE FOR HEALTHY WEIGHT IS A PROGRAM OF THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) AND THE NATIONAL INITIATIVE FOR CHILDREN'S HEALTHCARE QUALITY (NICHQ). THE SHARED VISION IS TO CREATE PARTNERSHIPS BETWEEN PRIMARY CARE, PUBLIC HEALTH, AND COMMUNITY ORGANIZATIONS TO DISCOVER SUSTAINABLE WAYS TO PROMOTE HEALTHY WEIGHT AND ELIMINATE HEALTH DISPARITIES IN COMMUNITIES ACROSS THE UNITED STATES. COLLABORATE FOR HEALTHY WEIGHT MEETS MONTHLY AND ALL THREE SECTORS COLLABORATE, USING EVIDENCE-BASED APPROACHES, TO REVERSE THE OBESITY EPIDEMIC AND IMPROVE THE HEALTH OF OUR COMMUNITIES. THIS PROGRAM WILL CONTINUE IN 2019 AND SEVERAL MANUSCRIPTS ARE UNDER DEVELOPMENT. FOOD ADDICTS ANONYMOUS SCRIPPS HEALTH PROVIDES FOOD ADDICTS ANONYMOUS MEETING SPACE TO MEET. FOOD ADDICTS ANONYMOUS IS AN INTERNATIONAL FELLOWSHIP OF MEN AND WOMEN WHO HAVE EXPERIENCED DIFFICULTIES IN LIFE AS A RESULT OF THE WAY THEY EAT. TAKE OFF POUNDS SENSIBLY (TOPS) MEETING SCRIPPS HEALTH PROVIDES MEETING SPACE TO TAKE OFF POUNDS SENSIBLY (TOPS). TOPS (TAKE OFF POUNDS SENSIBLY) IS THE SHORT NAME FOR TOPS CLUB, INC., THE ORIGINAL NON-PROFIT, NON-COMMERCIAL NETWORK OF WEIGHT-LOSS SUPPORT GROUPS AND WELLNESS EDUCATION ORGANIZATION. OVEREATERS ANONYMOUS - SPANISH SCRIPPS HEALTH PROVIDES MEETING SPACE FOR OVEREATERS ANONYMOUS. THIS IS A SUPPORT GROUP THAT PROVIDES DIETARY EDUCATION FOR INDIVIDUALS WHO DESIRE TO LOSE WEIGHT. THE GROUPS ARE HELD IN SPANISH. GREATER LA JOLLA MEALS ON WHEELS GREATER LA JOLLA MEALS ON WHEELS IS A NON-PROFIT SENIOR SERVICE ORGANIZATION. IT PROVIDES NUTRITIOUS MEALS TO SENIORS, THE HOMEBOUND AND THE DISABLED RESIDING IN THE COMMUNITIES OF LA JOLLA AND UNIVERSITY CITY. SCRIPPS LA JOLLA PROVIDES OFFICE SPACE TO THE LA JOLLA CHAPTER OF MEALS ON WHEELS. THIS ALLOWS MEALS ON WHEELS TO CONDUCT BUSINESS AND INTERACT WITH VOLUNTEERS FROM A CENTRAL, ESTABLISHED LOCATION. FOOD HANDLERS TRAINING COURSE SCRIPPS HEALTH PROVIDES THE USE OF A CLASSROOM TO FULL SPECTRUM NUTRITION SERVICES TO PROVIDE A THREE-HOUR COURSE WHICH PROVIDES CERTIFICATION FOR FOOD HANDLERS AND MEETS REQUIREMENTS OF THE SAN DIEGO COUNTY FOOD HANDLERS ORDINANCE. MATERNAL CHILD HEALTH & HIGH-RISK PREGNANCY MOTHERS, INFANTS AND CHILDREN MAKEUP A LARGE SEGMENT OF THE U.S. POPULATION AND THEIR WELL-BEING IS A HEALTH PREDICTOR FOR THE NEXT GENERATION. THERE IS TREMENDOUS FOCUS ON MATERNAL ILLNESS AND DEATH, AND INFANT HEALTH AND SURVIVAL, INCLUDING INFANT MORTALITY RATES, PERINATAL AND OTHER INFANT DEATHS. ACCORDING TO A NEW YORK TIMES ARTICLE, "HUGE RACIAL DISPARITIES FOUND IN DEATHS LINKED TO PREGNANCY, MAY 2019, AFRICAN AMERICAN, NATIVE AMERICAN AND ALASKA NATIVE WOMEN ARE ABOUT THREE TIMES MORE LIKELY TO DIE FROM CAUSES RELATED TO PREGNANCY, COMPARED TO WHITE WOMEN IN THE UNITED STATES. MATERNAL AND INFANT HEALTH ISSUES INCLUDE: - ALCOHOL, TOBACCO AND ILLEGAL SUBSTANCES DURING PREGNANCY, WHICH ARE MAJOR RISK FACTORS FOR LOW BIRTH WEIGHT AND OTHER POOR OUTCOMES. - VERY LOW BIRTH WEIGHT ASSOCIATED WITH PRETERM BIRTH, SPONTANEOUS ABORTION, LOW PRE-PREGNANCY WEIGHT AND SMOKING. - INFANT DEATH RATES ARE HIGHEST AMONG INFANTS BORN TO YOUNG TEENAGERS AND MOTHERS 44 YEARS AND OLDER. BEING PREGNANT, OR TRYING TO BECOME PREGNANT, IS ONLY A SMALL PORTION OF A WOMAN'S LIFE. UNINTENDED PREGNANCY, EITHER MISTIMED OR UNWANTED AT THE TIME OF CONCEPTION, ACCOUNTS FOR AN ESTIMATED 49 PERCENT OF PREGNANCIES IN THE U.S. THESE PREGNANCIES ARE ASSOCIATED WITH INCREASED MORBIDITY, AS WELL AS BEHAVIORS LINKED TO ADVERSE HEALTH. WOMEN WHO CAN PLAN THE NUMBER AND TIMING OF THEIR CHILDREN EXPERIENCE IMPROVED HEALTH, FEWER UNPLANNED PREGNANCIES AND BIRTHS, AND LOWER ABORTION RATES. HIGH RISK PREGNANCY HIGH RISK PREGNANCY CAN BE THE RESULT OF A MEDICAL CONDITION PRESENT BEFORE PREGNANCY OR A MEDICAL CONDITION THAT DEVELOPS DURING PREGNANCY FOR EITHER MOM OR BABY AND CAUSES THE PREGNANCY TO BECOME HIGH RISK. A HIGH-RISK PREGNANCY CAN POSE PROBLEMS BEFORE, DURING OR AFTER DELIVERY AND MIGHT REQUIRE SPECIAL MONITORING THROUGHOUT THE PREGNANCY. RISK FACTORS: - ADVANCED MATERNAL AGE: INCREASED RISK FOR MOTHER'S 35 YEARS AND OLDER. - LIFESTYLE CHOICES: SMOKING, ALCOHOL CONSUMPTION, USE OF ILLEGAL DRUGS. - MEDICAL HISTORY: PRIOR HIGH-RISK PREGNANCIES OR DELIVERIES, FETAL GENETIC CONDITIONS, FAMILY HISTORY OF GENETIC CONDITIONS. - UNDERLYING CONDITIONS: DIABETES, HIGH BLOOD PRESSURE AND EPILEPSY. - MULTIPLE PREGNANCY. - OBESITY DURING PREGNANCY. |
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A SUMMARY OF THE MAGNITUDE AND PREVALENCE OF MATERNAL AND CHILD HEALTH & HIGH-RISK PREGNANCIES ARE DESCRIBED BELOW: - IN 2016, THERE WERE 42,654 LIVE BIRTHS IN SDC OVERALL. THE 2016 FETAL MORTALITY RATE WAS 3.2 INFANT DEATHS PER 1,000 LIVE BIRTHS IN THE NORTH INLAND REGION, 3.4 IN THE NORTH COASTAL REGION, 3.7 IN THE EAST REGION AND SDC OVERALL, 3.8 IN THE CENTRAL REGION, 3.9 IN THE NORTH CENTRAL REGION, AND 4.3 IN THE SOUTH REGION. - IN 2016, 159 INFANTS DIED BEFORE THEIR FIRST BIRTHDAY IN SDC. INFANT MORTALITY WAS HIGHER AMONG MALE INFANTS (93 DEATHS) THAN FEMALE INFANTS (66 DEATHS). AFRICAN AMERICAN/BLACK INFANTS HAD THE HIGHEST MORTALITY RATE (10.7 INFANT DEATHS PER 1,000 LIVE BIRTHS) WHEN COMPARED TO INFANTS OF ALL OTHER RACES AND ETHNICITIES. HISPANIC INFANTS HAD THE SECOND HIGHEST MORTALITY RATE OF 4.5 DEATHS PER 1,000 LIVE BIRTHS. IN ADDITION, THERE WERE 3,628 PRETERM BIRTHS (LESS THAN 37 WEEKS GESTATION) IN SDC DURING 2016. COMPARED TO ALL OTHER RACES AND ETHNICITIES, HISPANIC MOTHERS HAD THE HIGHEST TOTAL NUMBER OF BIRTHS (16,978), 8.2 PERCENT OF WHICH WERE PRETERM. DESPITE HAVING FEWER TOTAL BIRTHS THAN HISPANIC MOTHERS (1,781), 11.6 PERCENT OF BIRTHS BY AFRICAN AMERICAN/BLACK MOTHERS WERE PRETERM. SIMILARLY, ALTHOUGH WOMEN AGES 25 TO 39 HAD THE HIGHEST TOTAL NUMBER OF BIRTHS COMPARED TO OTHER AGE GROUPS, MOTHERS AGE 40 AND ABOVE WERE MORE LIKELY TO GIVE BIRTH PRETERM COMPARED TO YOUNGER AGE GROUPS (45.8 PERCENT PRETERM BIRTHS AMONG MOTHERS AGE 40 AND ABOVE COMPARED TO 15.4 PERCENT PRETERM BIRTHS AMONG MOTHERS AGES 25 TO 39). - IN 2016, ALL SDC REGIONS MET THE HP2020 NATIONAL TARGETS FOR PRENATAL CARE, PRETERM BIRTHS, LOW BIRTH WEIGHT (LBW) INFANTS, VERY LOW BIRTH WEIGHT (VLBW) INFANTS AND INFANT MORTALITY. SEE TABLE 2 FOR A SUMMARY OF MATERNAL AND INFANT HEALTH INDICATORS IN SAN DIEGO COUNTY IN 2016 AND TABLE 3 FOR A SUMMARY OF MATERNAL AND INFANT HEALTH INDICATORS BY REGION. SCRIPPS HEALTH CONTINUED TO ENHANCE PRENATAL EDUCATION FOR LOW INCOME WOMEN IN SAN DIEGO COUNTY IN FISCAL YEAR 2019. THE FOLLOWING ARE SOME EXAMPLES: COMMUNITY BENEFIT SERVICES - OFFERED MORE THAN 1,200 MATERNAL CHILD HEALTH CLASSES THROUGHOUT SAN DIEGO COUNTY TO ENHANCE PARENTING SKILLS. LOW INCOME WOMEN IN SAN DIEGO WHO WERE ELIGIBLE ATTENDED CLASSES AT NO CHARGE OR ON A SLIDING FEE SCHEDULE. - MAINTAINED EXISTING PRENATAL EDUCATION SERVICES IN ALL REGIONS OF THE COUNTY, ENSURING THAT PROGRAMS CONTINUED TO DEMONSTRATE A SATISFACTION RATING ABOVE 90 PERCENT. - PROVIDED AND SUPPORTED WEEKLY BREASTFEEDING SUPPORT GROUPS AT SIX LOCATIONS THROUGHOUT SAN DIEGO COUNTY, INCLUDING THREE WITH BILINGUAL SERVICES. - OFFERED MATERNAL CHILD HEALTH CLASSES THROUGHOUT THE COMMUNITY, SUCH AS GETTING READY FOR THE BABY AND GRAND PARENTING TODAY. - OFFERED THE DOGS AND BABIES PROGRAMS QUARTERLY, WITH MORE THAN 40 ATTENDEES. - OFFERED CLASSES IN PELVIC FLOOR AND POSTPARTUM CHANGES FOR NEW MOTHERS THROUGHOUT THE COMMUNITY. FIRST 5 PARENTING EDUCATION PARENTING CLASSES ARE OFFERED AT SCRIPPS MERCY HOSPITAL CHULA VISTA WELL-BEING CENTER FOR PARENTS WITH INFANTS, TODDLERS AND PRESCHOOLERS. A WIDE VARIETY OF TOPICS ARE COVERED INCLUDING ISSUES RELATED TO HEALTH, LEARNING/DEVELOPMENT, FAMILY/SAFETY, ADVOCACY AS WELL AS PARENTING TIPS. DEVELOPMENTAL ASSESSMENTS ARE CONDUCTED BY RADY CHILDREN'S HOSPITAL. MORE THAN 400 SERVICES WERE RECEIVED FOR FIRST TIME MOTHERS INCLUDING: HOME VISITS, REFERRALS RECEIVED, DATA ENTRY, FOLLOW UP PHONE CALLS, PARENTING CLASSES AND OTHER SUPPORT SERVICES. A TOTAL OF 240 UNDUPLICATED PARENTS PARTICIPATED IN PARENTING EDUCATION WORKSHOP SERIES AND 150 SESSIONS WERE PROVIDED. MATERNAL CHILD HEALTH NURSING STUDENTS SCRIPPS PERINATAL EDUCATION PROGRAM SUPPORTS LOCAL NURSING STUDENTS WITH THE OPPORTUNITY TO OBSERVE PRENATAL EDUCATIONAL CLASSES. THIS CRITICAL ASPECT OF THE NURSING EDUCATION ALLOWS THE HOURS AND INFORMATION TO MEET THEIR CLINICAL ROTATION REQUIREMENTS IN MATERNAL CHILD HEALTH. SCRIPPS MERCY'S SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) THE SPECIAL SUPPLEMENT NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) WAS ESTABLISHED AS A PERMANENT PROGRAM IN 1974 TO SAFEGUARD THE HEALTH OF LOW-INCOME WOMEN, INFANTS AND CHILDREN UP TO AGE 5 WHO ARE AT NUTRITIONAL RISK. SCRIPPS MERCY HOSPITAL IS ONE OF FIVE REGIONAL ORGANIZATIONS THAT ADMINISTER THE STATE FUNDED WIC PROGRAM. THE PROGRAM SERVES SIX LOCATIONS CONVENIENTLY SITUATED NEAR COMMUNITY CLINICS AND/OR HOSPITALS IN THE CENTRAL SAN DIEGO AREA. WIC TARGETS LOW INCOME PREGNANT AND POSTPARTUM WOMEN, INFANTS AND CHILDREN (AGES 0 TO 5 YEARS). SCRIPPS MERCY WIC SERVES APPROXIMATELY 6,500 WOMEN AND CHILDREN ANNUALLY, 44 PERCENT IN THE CITY HEIGHTS COMMUNITY. IN CITY HEIGHTS CLIENTS ARE 91 PERCENT HISPANIC AND INCLUDE PREGNANT AND POSTPARTUM WOMEN (24%), INFANTS (20%) AND CHILDREN (56%). IN FY19, THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS FOR 67,625 WOMEN AND CHILDREN IN SOUTH AND CENTRAL SAN DIEGO. THE SCRIPPS MERCY WIC PROGRAM PLAYS A KEY ROLE IN MATERNITY CARE BY REACHING LOW INCOME WOMEN TO PROMOTE PRENATAL CARE, GOOD NUTRITION AND BREASTFEEDING DURING PREGNANCY AND OFFER LACTATION SUPPORT (ONE ON ONE AND GROUP), AS WELL AS BREAST PUMPS, PADS, AND OTHER SUPPLIES DURING THE POSTPARTUM PERIOD. CENTERING PREGNANCY, SCRIPPS FAMILY MEDICINE RESIDENCY RAISING HEALTHY FAMILIES AND CARING FOR THE NEXT GENERATION OF SAN DIEGANS BEFORE THEY'RE BORN HELP CREATE A HEALTHIER COMMUNITY FOR YEARS TO COME. THE SCRIPPS FAMILY MEDICINE PROGRAM AT SCRIPPS MERCY HOSPITAL CHULA VISTA IS PROVIDING ACCESS, EDUCATION AND CLINICAL SERVICES TO NEARLY 200 PREGNANT WOMEN IN SOUTH SAN DIEGO COUNTY. THE GOAL OF THE PROGRAM, "IMPROVING PERINATAL CARE FOR UNDERSERVED LATINA WOMEN - HEALTHY WOMEN, HEALTHY BABIES", IS TO PROVIDE ACCESS TO PERINATAL CARE FOR UNDERSERVED LATINA WOMEN IN ORDER TO IMPROVE BIRTH OUTCOMES. THE PROGRAM APPLIES THE PRINCIPLES OF THE CENTER HEALTH CARE INSTITUTE AND FOCUSES ON CHANGING THE WAY PATIENTS EXPERIENCE THEIR CARE THROUGH ASSESSMENT, EDUCATION AND GROUP SUPPORT. CENTERING PREGNANCY IS THE INSTITUTE'S MODEL DEVOTED SPECIFICALLY TO IMPROVING MATERNAL AND CHILD HEALTH AND HAS BEEN SHOWN TO RESULT IN INCREASED PRENATAL VISITS, GREATER LEVELS OF BREASTFEEDING AND STRONGER RELATIONSHIPS BETWEEN MOTHERS AND THEIR HEALTHCARE PROVIDERS BEFORE, DURING AND AFTER PREGNANCY. WOMEN WHO GAVE BIRTH REPORTED AN ENHANCED PRENATAL EXPERIENCE, GAINED LESS WEIGHT THROUGHOUT THEIR PREGNANCY AND SHOWED IMPROVED HEALTHCARE KNOWLEDGE. SERVICES INCLUDE HOME VISITS, REFERRALS, DATA ENTRY, FOLLOW UP PHONE CALLS, AND OTHER SUPPORT SERVICES. HOME VISITING IS OFFERED TOGETHER WITH FAMILY MEDICINE RESIDENCY AND PARENTING EDUCATION. MIRACLE BABIES SCRIPPS HEALTH PARTNERED WITH MIRACLES BABIES ON THEIR 5K WALK/RUN ON MAY 5, 2019. THE MISSION IS TO UNITE FAMILIES WITH THEIR SICK NEWBORNS THROUGH FINANCIAL ASSISTANCE AND SUPPORTIVE SERVICES TO REDUCE PREGNANCY COMPLICATIONS THROUGH PREVENTION, EDUCATION AND RESEARCH. SCRIPPS PROVIDED INFORMATION ON BREASTFEEDING AND A DIAPER CHANGING STATION FOR PARENTS TO USE. UNINTENTIONAL INJURY AND VIOLENCE PER THE HEALTHY PEOPLE 2020, "UNINTENTIONAL INJURIES AND VIOLENCE-RELATED INJURIES CAN BE CAUSED BY A NUMBER OF EVENTS, SUCH AS MOTOR VEHICLE CRASHES AND PHYSICAL ASSAULT CAN OCCUR VIRTUALLY ANYWHERE." UNINTENTIONAL INJURY AND VIOLENCE WERE IDENTIFIED AS A PRIORITY HEALTH NEED IN THE COMMUNITY ENGAGEMENT PROCESS OF THE 2019 CHNA. EXPOSURE TO VIOLENCE AND NEIGHBORHOOD SAFETY WERE CITED AS PRIORITY HEALTH NEEDS FOR SAN DIEGANS. NEIGHBORHOOD SAFETY WAS DISCUSSED AS INFLUENCING RESIDENTS' ABILITY TO MAINTAIN GOOD HEALTH, WHILE EXPOSURE TO VIOLENCE WAS DESCRIBED AS TRAUMATIC AND IMPACTFUL ON MENTAL HEALTH. IN 2016, ACCIDENTS (UNINTENTIONAL INJURIES) WERE THE FIFTH LEADING CAUSE OF DEATH FOR SAN DIEGO COUNTY OVERALL. THE DEATHS ASSOCIATED WITH UNINTENTIONAL INJURIES ARE SIGNIFICANT; YET REPRESENT ONLY A SMALL PART OF A MUCH LARGER PUBLIC HEALTH PROBLEM. HOSPITALIZATION DATA IS A BETTER MEASURE OF THE INJURY PROBLEM THAN THE DEATH DATA ALONE. UNINTENTIONAL INJURIES, MOTOR VEHICLE ACCIDENTS, FALLS, PEDESTRIAN RELATED, FIREARMS, FIRE/BURNS, DROWNING, EXPLOSION, POISONING (INCLUDING DRUGS AND ALCOHOL, GAS, CLEANERS AND CAUSTIC SUBSTANCES) CHOKING/SUFFOCATION, CUT/PIERCE, EXPOSURE TO ELECTRIC CURRENT/RADIATION/FIRE/SMOKE, NATURAL DISASTERS AND INJURIES AT WORK, ARE ONE OF THE LEADING CAUSES OF DEATH FOR SAN DIEGO COUNTY RESIDENTS OF ALL AGES, REGARDLESS OF GENDER, RACE OR REGION. |
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MOST EVENTS RESULTING IN INJURY, DISABILITY OR DEATH ARE PREDICTABLE AND PREVENTABLE. THERE ARE MANY RISK FACTORS FOR UNINTENTIONAL INJURY AND VIOLENCE, INCLUDING INDIVIDUAL BEHAVIORS AND CHOICES, SUCH AS ALCOHOL USE OR RISK TAKING; THE PHYSICAL ENVIRONMENT BOTH AT HOME AND IN THE COMMUNITY; ACCESS TO HEALTH SERVICES AND SYSTEMS CREATED FOR INJURY RELATED CARE; THE SOCIAL ENVIRONMENT, INCLUDING INDIVIDUAL SOCIAL EXPERIENCES. A SUMMARY OF THE MAGNITUDE AND PREVALENCE OF UNINTENTIONAL INJURY AND VIOLENCE IS DESCRIBED BELOW: DRUGS, ALCOHOL, VEHICLES, FALLS, GUNS AND SUICIDE CONTINUE TO BE LEADING CAUSES OF DEATHS INVESTIGATED BY THE SAN DIEGO COUNTY MEDICAL EXAMINER'S OFFICE. UNDER LAW, THE COUNTY MEDICAL EXAMINER'S OFFICE INVESTIGATES ALL "UNNATURAL" DEATHS, SUCH AS SUSPECTED HOMICIDES, SUICIDES, ACCIDENTS, AND NATURAL DEATHS THAT ARE SUDDEN AND UNEXPECTED. ACCORDING TO A 2018 ANNUAL REPORT, SUICIDES INCREASED FROM 458 IN 2017 TO 465, CONTINUING A TREND THAT HAS SEEN SUICIDE NUMBERS INCREASE 13% OVER THE PAST 10 YEARS, TAKING POPULATION GROWTH INTO ACCOUNT. HOMICIDES DECREASED FROM 106 TO 104. AND ACCIDENTAL DEATHS, WHICH INCLUDE FATALITIES FROM DRUGS, ALCOHOL, FALLS, TRAFFIC, DROWNING, CHOKING, ASPHYXIATION AND OTHER CAUSES, INCREASED FROM 1,522 IN 2017 TO 1,583. SOME OF THE 2018 ANNUAL REPORT'S FINDINGS INCLUDED: - THE THREE LEADING CAUSES OF ACCIDENTAL AND SUDDEN, UNEXPECTED DEATHS -ACCOUNTING FOR 88% OF ALL ACCIDENTAL DEATHS-WERE DRUGS, FALLS, AND BEING KILLED IN OR BY VEHICLES. - 577 DEATHS WERE CAUSED BY OVERDOSES: FROM ILLEGAL DRUGS, FROM MISUSED OR ILLEGALLY OBTAINED PRESCRIPTION DRUGS, AND ALCOHOL. OF THOSE, FENTANYL DEATHS CONTINUED TO RISE, FROM 33 IN 2016, TO 84 IN 2017 AND 92 IN 2018. METHAMPHETAMINE DEATHS ALSO INCREASED BY 21% IN 2018. - 488 PEOPLE WERE KILLED BY FALLS, MAINLY IN THE HOME, BUT ALSO AT JOBS, OUTDOORS IN RURAL AND URBAN AREAS, FROM BRIDGES, MOUNTAINS AND BEACH CLIFFS. - 316 PEOPLE-24 MORE THAN 2017-WERE KILLED BY BEING HIT BY VEHICLES, OR IN VEHICLE ACCIDENTS. THAT INCLUDED 107 PEDESTRIANS, AN INCREASE OF SIX OVER 2017, WHICH WAS ALREADY THE HIGHEST NUMBER OF PEDESTRIAN DEATHS IN SAN DIEGO COUNTY IN 24 YEARS. - MOTORCYCLE WRECKS KILLED 48 PEOPLE, A 51% DECREASE. - ACCIDENTAL DROWNINGS IN BATHTUBS AND SPAS INCREASED SIGNIFICANTLY, FROM EIGHT TO 18 IN BATHTUBS AND FROM THREE TO 10 IN SPAS. - FIREARMS KILLED 235 PEOPLE: 61 IN HOMICIDES AND 174 IN SUICIDES. - MEN MADE UP 68% OF ALL THE DEATHS THE MEDICAL EXAMINER'S OFFICE FULLY INVESTIGATED: 2,196 MEN TO 1,034 WOMEN. - THE HASD&IC 2019 CHNA CONTINUED TO IDENTIFY UNINTENTIONAL INJURY AND VIOLENCE AS ONE OF THE TOP PRIORITY HEALTH CONDITIONS AMONG SAN DIEGO COUNTY HOSPITALS. - IN 2016, THERE WERE 1,071 DEATHS DUE TO UNINTENTIONAL INJURY IN SAN DIEGO COUNTY. THE COUNTY'S AGE-ADJUSTED DEATH RATE DUE TO UNINTENTIONAL INJURY WAS 31.1 DEATHS PER 100,000 POPULATION. IN 2016, UNINTENTIONAL INJURY ACCOUNTED FOR 5.1 PERCENT OF TOTAL DEATHS IN SAN DIEGO COUNTY. - IN 2016, THERE WERE 20,247 HOSPITALIZATIONS RELATED TO UNINTENTIONAL INJURY IN SAN DIEGO COUNTY. THE AGE-ADJUSTED RATE OF HOSPITALIZATIONS DUE TO UNINTENTIONAL INJURY WAS 589.4 PER 100,000 POPULATION. - IN 2016, THERE WERE 169,017 ED DISCHARGES RELATED TO UNINTENTIONAL INJURY IN SDC. THE AGE-ADJUSTED RATE OF DISCHARGES DUE TO UNINTENTIONAL INJURY WAS 5,160.3 PER 100,000 POPULATION. - CDPH INJURY DATA REPORTS THAT IN 2016, UNINTENTIONAL INJURIES CAUSED OVER 13,000 DEATHS, 200,000 NON-FATAL HOSPITALIZATIONS, AND 2.3 MILLION NON-FATAL ED VISITS (CDPH, SAFE AND ACTIVE COMMUNITIES BRANCH, 2016). - IN 2016, UNINTENTIONAL INJURY WAS THE THIRD LEADING CAUSE OF DEATH ACROSS ALL AGE GROUPS IN THE U.S., ACCOUNTING FOR OVER 160,000 DEATHS. UNINTENTIONAL INJURY WAS THE LEADING CAUSE OF DEATH IN THE U.S. FOR PEOPLE AGES 1 TO 44, AND THE SEVENTH LEADING CAUSE OF DEATH FOR THOSE OVER AGE 65 (CDC, 2018). - ACCORDING TO DATA FROM NCHS, IN 2016, OVER 130,000 DEATHS IN THE U.S. WERE ATTRIBUTED TO THREE CAUSES: POISONING (26 PERCENT), MOTOR VEHICLE TRAFFIC ACCIDENTS (16.9 PERCENT), AND FALLS (16.5 PERCENT). - UNINTENTIONAL INJURIES ARE THE LEADING CAUSE OF DEATH AMONG CHILDREN IN THE U.S., WHILE NONFATAL UNINTENTIONAL INJURIES CAN RESULT IN CHILDREN HAVING LONG-TERM DISABILITIES (LWSD REPORT CARD ON CHILDREN, FAMILIES, AND COMMUNITY, 2017). - TRAUMATIC INJURY IS THE LEADING CAUSE OF DEATH AMONG CHILDREN, WITH MANY SURVIVORS ENDURING THE CONSEQUENCES OF BRAIN AND SPINAL CORD INJURIES. THE PHYSICAL, EMOTIONAL, PSYCHOLOGICAL AND LEARNING PROBLEMS THAT AFFECT INJURED CHILDREN, ALONG WITH THE ASSOCIATED COSTS, MAKE REDUCING TRAUMATIC INJURIES A HIGH PRIORITY FOR HEALTH AND SAFETY ADVOCATES THROUGHOUT THE NATION. EDUCATIONAL PROGRAMS FROM THE THINKFIRST NATIONAL INJURY PREVENTION FOUNDATION INCREASE KNOWLEDGE AND AWARENESS OF THE CAUSES AND RISK FACTORS OF BRAIN AND SCI, INJURY PREVENTION MEASURES, AND THE USE OF SAFETY HABITS AT AN EARLY AGE, WWW.THINKFIRST.ORG/KIDS. - SAN DIEGO COUNTY HAS MADE STRIDES TO DECREASE DEATHS FROM UNINTENTIONAL INJURIES AS WELL AS NON-FATAL UNINTENTIONAL INJURY RATES, THOUGH NON-FATAL UNINTENTIONAL INJURY RATES CONTINUE TO EXCEED STATE AND FEDERAL RATES. SDC HAS FOCUSED INJURY PREVENTION EFFORTS ON THE MOST VULNERABLE POPULATIONS, INCLUDING CHILDREN OF ALL AGES (ESPECIALLY OLDER CHILDREN), NATIVE AMERICAN AND RURAL CHILDREN. SUCCESSFUL INTERVENTIONS INCLUDE SAFETY CAMPAIGNS, EDUCATIONAL STRATEGIES AND CHANGES IN PARENTING PRACTICES (LWSD REPORT CARD ON CHILDREN, FAMILIES, AND COMMUNITY, 2017). - ACCORDING TO HP2020, MOST EVENTS RESULTING IN INJURY, DISABILITY OR DEATH ARE PREDICTABLE AND PREVENTABLE. THERE ARE MANY RISK FACTORS FOR UNINTENTIONAL INJURY AND VIOLENCE, INCLUDING INDIVIDUAL BEHAVIORS AND CHOICES, SUCH AS ALCOHOL USE OR RISK-TAKING; PHYSICAL ENVIRONMENT BOTH AT HOME AND IN THE COMMUNITY; ACCESS TO HEALTH SERVICES AND SYSTEMS FOR INJURY-RELATED CARE; AND SOCIAL ENVIRONMENT, INCLUDING INDIVIDUAL SOCIAL EXPERIENCES (E.G., SOCIAL NORMS, EDUCATION AND VICTIMIZATION HISTORY), SOCIAL RELATIONSHIPS (E.G., PARENTAL MONITORING AND SUPERVISION OF YOUTH, PEER GROUP ASSOCIATIONS AND FAMILY INTERACTIONS), COMMUNITY ENVIRONMENT (E.G., COHESION IN SCHOOLS, NEIGHBORHOODS AND COMMUNITIES) AND SOCIETAL FACTORS (E.G., CULTURAL BELIEFS, ATTITUDES, INCENTIVES AND DISINCENTIVES, LAWS AND REGULATIONS). SCRIPPS HEALTH CONTINUES TO ADDRESS UNINTENTIONAL INJURY AND VIOLENCE IN FY19. THE FOLLOWING ARE SOME EXAMPLES: CAR SEAT PROGRAM SCRIPPS MEMORIAL HOSPITAL LA JOLLA EMERGENCY DEPARTMENT PROVIDES CAR SEATS TO PATIENTS WHO HAVE BEEN IN AN AUTOMOBILE ACCIDENT AND THEIR CHILD'S CAR SEAT HAS BEEN RENDERED UNSAFE TO USE. THE SERVICE PROVIDES THE EASE OF MIND FOR THE PATIENT IN THEIR ABILITY TO TRANSPORT THEIR CHILD HOME SAFELY. SAN DIEGO BRAIN INJURY FOUNDATION SCRIPPS HEALTH PROVIDES MEETING SPACE TO THE SAN DIEGO BRAIN INJURY FOUNDATION. THE ORGANIZATION PROVIDES QUALITY OF LIFE IMPROVEMENTS FOR BRAIN INJURY SURVIVORS AND SUPPORT TO FAMILY MEMBERS. BRAINMASTERS BRAINMASTERS IS A SUPPORTIVE COMMUNICATION GROUP FOR ADULTS COPING WITH ACQUIRED BRAIN INJURY. IT IS OFFERED AS A COMMUNITY BENEFIT THROUGH THE REHABILITATION CENTER AT SCRIPPS MEMORIAL HOSPITAL ENCINITAS. THE MAIN GOAL OF BRAINMASTERS IS TO HELP BRAIN INJURY SURVIVORS TO BUILD CONFIDENCE BY PRACTICING THINKING ON THEIR FEET. THIS HELPS TO ALLEVIATE CHALLENGES WITH COMMUNICATION AND SOCIAL ISOLATION THAT SO MANY BRAIN INJURY SURVIVORS EXPERIENCE. EVERY 15 MINUTES ALCOHOL CAN BE ATTRIBUTED TO MORE THAN 100,000 DEATHS IN THE U.S. ANNUALLY, INCLUDING 41% OF ALL TRAFFIC FATALITIES. EVERY 15 MINUTES PROGRAM IS A TWO-DAY IMMERSION EXPERIENCE FOR TEENS ON THE REALISTIC CONSEQUENCES OF DRINKING AND DRIVING, WHICH INVOLVES THE SCHOOLS, LAW ENFORCEMENT, COURTS, EMERGENCY SERVICE PROVIDERS, AND THE MORTUARY. THE "INJURED" STUDENTS ARE TAKEN TO SCRIPPS MERCY TRAUMA CENTER. THIS PROGRAM IS SPONSORED JOINTLY BY LOCAL HIGH SCHOOLS, COUNTY POLICE AND SHERIFF'S DEPARTMENTS, AMBULANCE SERVICES, AND EMERGENCY DEPARTMENTS. BEACH AREA COMMUNITY COURT PROGRAM THE PROGRAM IS AN EDUCATIONAL PROGRAM FOR FIRST TIME OFFENDERS FOR QUALITY OF LIFE CRIMES. THIS IS A COLLABORATION WITH THE SAN DIEGO POLICE DEPARTMENT, PARKS AND RECREATION, DISTRICT ATTORNEY'S OFFICE AND DISCOVER PACIFIC BEACH. EDUCATION IS PROVIDED TO THE PARTICIPANTS REGARDING THESE QUALITY OF LIFE CRIMES AND THEIR EFFECTS ON THE COMMUNITY, THE EFFECTS OF SMOKING AND ALCOHOL CONSUMPTION AND THE RULES AND REGULATIONS FOR THE BEACH COMMUNITY. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
SAN DIEGO COUNTY LIFEGUARD EDUCATION CONFERENCE IN FY19, THE SCRIPPS MEMORIAL HOSPITAL LA JOLLA TRAUMA DEPARTMENT AT SCRIPPS LA JOLLA HOSTED THE SECOND SAN DIEGO COUNTY LIFEGUARD EDUCATION CONFERENCE. MORE THAN 157 LIFEGUARDS REPRESENTING ALL 11 SAN DIEGO COUNTY LIFEGUARD AGENCIES ATTENDED THE EVENT. INFORMATION WAS SHARED ON SEVERAL TOPICS CRITICAL FOR LIFEGUARDS, INCLUDING DOWNING RESUSCITATION, SNORKELER DROWNING AND SHALLOW WATER BLACKOUT, HUMAN FACTORS IN LIFEGUARDING: REDUCING DISTRACTIONS AND IMPROVING SURVEILLANCE, MARINE MAMMAL UPDATE: SHARKS AND STING RAYS AND SKIN CANCER PREVENTION. THE TRAUMA DEPARTMENT PLANS TO CONTINUE THIS PARTNERSHIP WITH THE COUNTY LIFEGUARDS TO PROVIDE EDUCATION AND HELP THEM FURTHER IDENTIFY OPPORTUNITIES FOR COMMUNITY OUTREACH AND INJURY PREVENTION. SAN DIEGO HUMAN TRAFFICKING TASK FORCE AND PROJECT LIFE SCRIPPS HAS PARTNERED WITH THE SAN DIEGO HUMAN TRAFFICKING TASK FORCE AND PROJECT LIFE TO OFFER "SOFT ROOMS" AT ALL SCRIPPS HOSPITAL FACILITIES EXCEPT SCRIPPS GREEN HOSPITAL. THESE SOFT ROOMS WILL BE AVAILABLE TO PROJECT LIFE ON A MOMENT'S NOTICE TO SERVE AS A SAFE, CONFIDENTIAL ENVIRONMENT FOR LAW ENFORCEMENT TO INTERVIEW VICTIMS OF HUMAN TRAFFICKING AND FOR SERVICE PROVIDERS TO CONNECT WITH THE VICTIMS WITH EMERGENCY SHELTER AND COMMUNITY RESOURCES. THE SAN DIEGO HUMAN TRAFFICKING TASK FORCE RECEIVES 3,000 TO 8,000 HUMAN TRAFFICKING VICTIMS EVERY YEAR IN SAN DIEGO COUNTY. APPROXIMATELY 80 PERCENT ARE BORN IN THE UNITED STATES. SAVING LIVES THROUGH STOP THE BLEED CAMPAIGN WHETHER FROM A BULLET WOUND OR OTHER TRAUMATIC INJURY, SEVERE BLOOD LOSS CAN KILL IN JUST FIVE MINUTES. HOWEVER, ONE-FIFTH OF TRAUMA DEATHS, THE LEADING CAUSE OF DEATH FOR AMERICANS UNDER AGE 46, COULD BE PREVENTED BY STAUNCHING THE BLEEDING. SCRIPPS DOCTORS ARE GETTING BEHIND THE NATIONAL STOP THE BLEED CAMPAIGN. SUPPORTED BY THE AMERICAN COLLEGE OF SURGEONS, THE DEPARTMENT OF HOMELAND SECURITY AND NUMEROUS POLICE DEPARTMENTS, IT AIMS TO TEACH BYSTANDERS HOW TO PROPERLY PLACE PRESSURE ON A WOUND OR APPLY A TOURNIQUET IN AN EMERGENCY. SCRIPPS PROVIDERS PARTICIPATE IN THIS PROGRAM BY TEACHING NONMEDICAL AUDIENCES TO CONTROL LIFE-THREATENING BLEEDING UNTIL PROFESSIONAL MEDICAL HELP ARRIVES. THE 90-MINUTE COURSE INCLUDES A PRESENTATION AND PRACTICE ON APPLYING DIRECT PRESSURE, WOUND PACKING AND USING A TOURNIQUET. TRAUMA AWARENESS CONFERENCE SCRIPPS PARTICIPATES WITH LOCAL AGENCIES GIVING ATTENDEES THE OPPORTUNITY TO LEARN MORE ABOUT TRAUMA SERVICES. EDUCATION WAS PROVIDED ON INJURY PREVENTION AND THE LATEST TRAUMA RESEARCH. PARTICIPANTS HAD THE OPPORTUNITY TO MEET SAN DIEGO'S FIRST RESPONDERS, EXPLORE EQUIPMENT, AND LEARN ABOUT CAREERS FROM SAN DIEGO FIRE, SAWT, SDPD CANINE UNIT, CAL FIRE, AMBULANCE, AND RESCUE HELICOPTERS. INTERACTIVE BOOTHS EDUCATED FAMILIES ON IMPORTANT ISSUES LIKE THE DANGERS OF DISTRACTED/IMPAIRED DRIVING, DROWNING PREVENTION, FALL PREVENTION, AND HELMET SAFETY. DISASTER PREPAREDNESS EXPO SCRIPPS MERCY HOSPITAL HELD A DISASTER PREPAREDNESS EXPO ON MARCH 23, 2019. THE EVENT INCLUDED A SIDEWALK CPR, STOP THE BLEED WHICH INCLUDE LEARNING BASIC TECHNIQUES OF BLEEDING CONTROL, LEARNING THE SIGNS AND SYMPTOMS OF STROKE AND MEETING THE MEMBERS OF THE TRAUMA TEAM AT SCRIPPS MERCY HOSPITAL. CRIME STOPPERS SAN DIEGO COUNTY CRIME STOPPERS IS A CITIZEN-RUN, CHARITABLE ORGANIZATION THAT PARTNERS WITH THE COMMUNITY, THE MEDIA AND LAW ENFORCEMENT AGENCIES TO SOLVE CRIME. OVER THE PAST 35 YEARS, CRIME STOPPERS HAS HELPED LOCAL LAW ENFORCEMENT SOLVE MORE THAN 6,100 CRIMES INCLUDING 146 HOMICIDES. CRIME STOPPERS EXISTS THROUGH THE SUPPORT OF RESPONSIBLE COMPANIES AND COMMUNITY MEMBERS WHO ENVISION A SAFE SAN DIEGO. FUNDS RECEIVED FROM MEMBERSHIPS AND EVENTS GO DIRECTLY INTO OUR FELONY REWARD FUND AND STUDENTS SPEAKING OUT PROGRAMS. SCRIPPS WAS A SPONSOR OF THE ENOUGH IS ENOUGH FUNDRAISING LUNCHEON HELD ON APRIL 23, 2019. CHULA VISTA POLICE FOUNDATION - EVENING WITH HEROES SCRIPPS HEALTH SPONSORED THE CHULA VISTA POLICE FOUNDATION EVENING WITH HEROES' EVENT. THE CHULA VISTA POLICE FOUNDATION IS A 501(C)(3) ORGANIZATION WHOSE MISSION IS TO SUPPORT A VARIETY OF PROGRAMS WHICH INCLUDE COMMUNITY RELATIONS EVENTS, TECHNOLOGY INITIATIVES AND THOSE WHICH SUPPORT ADVANCING STATE-OF-THE-ART SAFETY EQUIPMENT TO FURTHER THE PUBLIC SAFETY GOALS OF THE CHULA VISTA POLICE DEPARTMENT. THE CHULA VISTA POLICE FOUNDATION WAS ESTABLISHED IN 2003 AND HAS RAISED $1.6 MILLION DOLLARS OVER THE LAST 15 YEARS, WHICH WAS USED TO DIRECTLY SUPPORT LINE-LEVEL OFFICERS AND THE POLICE SERVICE NEEDS TO RESIDENTS AND BUSINESSES OF CHULA VISTA. SAN DIEGO POLICE FOUNDATION SCRIPPS HEALTH SPONSORED THE TRUE-BLUE LUNCHEON WHICH RAISED OVER $150,000 TO SUPPORT THOSE WHO PROTECT AND SERVE. THE SAN DIEGO POLICE FOUNDATION RAISES MUCH-NEEDED FUNDS FOR THE SAN DIEGO POLICE DEPARTMENT. THE FOUNDATION FUNDRAISES FOR EQUIPMENT, TRAINING AND OUTREACH PROGRAMS FOR THE POLICE DEPARTMENT IN ORDER TO FIGHT CRIME. 645 SQUAD CLUB - LAW ENFORCEMENT MEMORIAL FOUNDATION SCRIPPS HEALTH SPONSORED THE SAN DIEGO COUNTY LAW ENFORCEMENT MEMORIAL FOUNDATION. THE SAN DIEGO COUNTY LAW ENFORCEMENT MEMORIAL FOUNDATION HONORS THOSE LAW ENFORCEMENT MEMBERS WHO HAVE GIVEN THE ULTIMATE SACRIFICE TO ENSURE PUBLIC SAFETY. BEHAVIORAL HEALTH BEHAVIORAL HEALTH ENCOMPASSES MANY DIFFERENT AREAS INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSE. BECAUSE OF THE BROADNESS OF THIS HEALTH ISSUE, IT IS OFTEN DIFFICULT TO CAPTURE THE NEED FOR BEHAVIORAL HEALTH SERVICES WITH A SINGLE MEASURE. MENTAL HEALTH CAN BE DEFINED AS "A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, AND NOT MERELY THE ABSENCE OF DISEASE". MENTAL ILLNESS IS DEFINED AS "COLLECTIVELY ALL DIAGNOSABLE MENTAL DISORDERS"HEALTH CONDITIONS THAT ARE CHARACTERIZED BY ALTERATIONS IN THINKING, MOOD, OR BEHAVIOR (OR SOME COMBINATION THEREOF) ASSOCIATED WITH DISTRESS AND/OR IMPAIRED FUNCTIONING". BEHAVIORAL HEALTH IS AN IMPORTANT HEALTH NEED BECAUSE IT IMPACTS AN INDIVIDUAL'S OVERALL HEALTH STATUS AND IS A COMORBIDITY OFTEN ASSOCIATED WITH MULTIPLE CHRONIC CONDITIONS, SUCH AS DIABETES, OBESITY AND ASTHMA. AN ANALYSIS OF MORTALITY DATA IN SAN DIEGO COUNTY FOUND THAT IN 2016, INTENTIONAL SELF-HARM (SUICIDE) WAS THE NINTH LEADING CAUSE OF DEATH. IN 2016, THE AGE-ADJUSTED SUICIDE RATE IN SAN DIEGO WAS 11.9 PER 100,000. RATES WERE HIGHEST AMONG WHITES (18.7), FOLLOWED BY BLACKS (11.5), ASIAN PACIFIC ISLANDERS (8.2) AND HISPANICS (5.3). WHILE THE RATE OF SUICIDE DECREASED SLIGHTLY (1.3%) FROM 2014-2016, THE RATES OF SUICIDE FOR PEOPLE WHO IDENTIFY AS ASIAN/PACIFIC ISLANDER, BLACK, AND "OTHER," INCREASED IN THOSE SAME YEARS BY 13.3%, 47.2%, AND 93.0% RESPECTIVELY. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
A SUMMARY OF THE MAGNITUDE AND PREVALENCE OF BEHAVIORAL HEALTH IS DESCRIBED BELOW: - THE SCRIPPS 2019 CHNA CONTINUED TO IDENTIFY BEHAVIORAL HEALTH AS A PRIORITY HEALTH ISSUE AFFECTING MEMBERS OF THE COMMUNITIES SERVED BY SCRIPPS. - THE HASD&IC 2019 CHNA IDENTIFIED BEHAVIORAL HEALTH A TOP PRIORITY HEALTH ISSUE BOTH IN THE SECONDARY DATA ANALYSES AND IN THE COMMUNITY ENGAGEMENT EVENTS. - HASD&IC 2019 CHNA CONDUCTED A COMMUNITY ENGAGEMENT ANALYSIS AND ACROSS ALL TYPES OF COMMUNITY ENGAGEMENT-FOCUS GROUPS, KEY INFORMANT INTERVIEWS, AND THE ONLINE SURVEY. BEHAVIORAL HEALTH ISSUES WERE IDENTIFIED AS BOTH PREVALENT AND DEBILITATING IN THE COMMUNITY. IN THE ONLINE SURVEY, BEHAVIORAL HEALTH WAS RANKED AS THE HEALTH CONDITION HAVING THE GREATEST IMPACT ON THE HEALTH AND WELL-BEING OF SAN DIEGO COUNTY RESIDENTS AND AS THE SECOND MOST IMPACTFUL CONDITION WHEN HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH WERE COMBINED (ONLY ACCESS TO CARE RANKED HIGHER). IN ADDITION, 63% OF SURVEY RESPONDENTS INDICATED THAT THEY BELIEVE BEHAVIORAL HEALTH IS WORSENING IN SAN DIEGO COUNTY. RESPONDENTS WERE ALSO ASKED TO RANK SPECIFIC BEHAVIORAL HEALTH CONDITIONS HAVING THE GREATEST IMPACT IN SAN DIEGO. THE TOP SEVEN CONDITIONS IDENTIFIED WERE AS FOLLOWS: 1. ALCOHOL USE DISORDER 2. MOOD DISORDERS 3. SUBSTANCE USE DISORDER 4. ANXIETY 5. OPIOID USE 6. SUICIDE AND SUICIDE THOUGHTS/IDEATION 7. SELF-HARM OR SELF-INJURY - THE COMMUNITY ENGAGEMENT EVENTS CONDUCTED IN THE 2019 CHNA, IDENTIFIED THAT WHILE SAN DIEGO HAS INNOVATIVE PROGRAMS TO ADDRESS MENTAL HEALTH, RESIDENTS FACE CHALLENGES IN ACCESSING TIMELY, CONSISTENT MENTAL HEALTH CARE. CARE WAS DESCRIBED AS ESPECIALLY DIFFICULT TO OBTAIN WHEN THE MENTAL HEALTH ISSUE WAS NOT CONSIDERED AN EMERGENCY. - MENTAL HEALTH ISSUES AFFECT NEARLY 1 IN 5 PEOPLE, AND WHEN LEFT UNTREATED, ARE A LEADING CAUSE OF DISABILITY, ARE ASSOCIATED WITH CHRONIC DISEASE, AND MAY LEAD TO PREMATURE MORTALITY. IN SAN DIEGO COUNTY, 12.4 PEOPLE PER EVERY 100,000 DIE FROM SUICIDE ANNUALLY, AND APPROXIMATELY 10% OF ALL ADULTS SERIOUSLY CONSIDER COMMITTING SUICIDE. WHILE THE RATE OF SUICIDE DECREASED SLIGHTLY (1.3%) FROM 2014-2016, THE RATES OF SUICIDE FOR PEOPLE WHO IDENTIFY AS ASIAN/PACIFIC ISLANDER, BLACK, AND "OTHER," INCREASED IN THOSE SAME YEARS (13.3%, 47.2%, 93.0%). IN ADDITION, MORE PEOPLE ARE BEING DISCHARGED EMERGENCY DEPARTMENTS FOR ANXIETY THAN IN THE PAST, RATES INCREASED BY 4.3% BETWEEN 2014-2016, WHILE RATES OF INPATIENT DISCHARGES FOR ANXIETY DECREASED BY 7.9% DURING THE SAME TIME PERIOD. PEOPLE WHO IDENTIFY AS "OTHER RACEBLACK/AFRICAN AMERICAN HAD THE HIGHEST RATES OF ED AND HOSPITAL DISCHARGE FOR ANXIETY. - AN ANALYSIS OF 2016 MORTALITY DATA FOR SAN DIEGO COUNTY REVEALED ALZHEIMER'S DISEASE AND SUICIDE AS THE THIRD AND NINTH LEADING CAUSES OF DEATH FOR SAN DIEGO COUNTY, RESPECTIVELY. - RATES OF DISCHARGE FROM EMERGENCY DEPARTMENTS DUE TO ANXIETY INCREASED BY 4.3% BETWEEN 2014-2016, WHILE RATES OF INPATIENT DISCHARGES FOR ANXIETY DECREASED BY 7.9% DURING THE SAME TIME PERIOD. PEOPLE WHO IDENTIFY AS "OTHER RACEBLACK/AFRICAN AMERICAN HAD THE HIGHEST RATES OF ED AND INPATIENT DISCHARGE FOR ANXIETY. - ED DISCHARGES FOR MOOD DISORDERS ALSO INCREASED (5.9%) FROM 2014-2016, WHILE INPATIENT DISCHARGES FOR MOOD DISORDERS DECREASED BY 2.9%. DISCHARGE RATES FOR MOOD DISORDERS WERE HIGHER FOR PEOPLE WHO IDENTIFY THEIR RACE AS BLACK/AFRICAN AMERICAN THAN FOR ANY OTHER RACE. - ACCORDING TO 2017 DATA FROM THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD), ANXIETY DISORDERS WERE THE TOP PRIMARY DIAGNOSIS FOR BEHAVIORAL HEALTH-RELATED ED DISCHARGES AMONG THOSE AGES FIVE TO 44 AND AGES 65 AND OLDER. FOR THOSE AGES 45 TO 64, THE TOP ED DISCHARGE FOR BEHAVIORAL HEALTH WAS ALCOHOL-RELATED DISORDERS, FOLLOWED BY ANXIETY AND MOOD DISORDERS. - ACCORDING TO 2017 CHIS DATA, 11.8 PERCENT OF ADULTS IN SDC HAVE EVER SERIOUSLY THOUGHT ABOUT COMMITTING SUICIDE, A 40.5 PERCENT INCREASE SINCE 2013 (8.4 PERCENT). - IN 2016, THERE WERE 1,080 HOSPITALIZATIONS DUE TO OVERDOSE/POISONING IN SDC. THE AGE-ADJUSTED RATE OF HOSPITALIZATIONS DUE TO OVERDOSE/POISONING WAS 31.2 PER 100,000 POPULATION. - IN 2016, THE AGE-ADJUSTED RATE OF OVERDOSE/POISONING-RELATED ED DISCHARGES IN SDC WAS 162.3 PER 100,000 POPULATION. AGE-ADJUSTED RATES FOR OVERDOSE/POISONING-RELATED ED DISCHARGES WERE HIGHER AMONG MALES, BLACKS AND INDIVIDUALS AGES 15 TO 24 YEARS IN COMPARISON AMONG GROUPS. - WHILE ED DISCHARGES FOR ACUTE SUBSTANCE USE ROSE BY 51.0% FROM 2014-2016, INPATIENT DISCHARGES DROPPED BY 18.5%. THE HIGHEST DISCHARGE RATES OF BOTH TYPES WERE AMONG BLACK/AFRICAN AMERICANS. STEEP INCREASES IN BOTH TYPES OF DISCHARGE OCCURRED FOR CHRONIC SUBSTANCE USE; ED DISCHARGE RATES INCREASED BY 559.3%, AND INPATIENT DISCHARGE RATES INCREASED BY 195.1%. ED DISCHARGE RATES WERE HIGHEST AMONG WHITES (36.7, PER 100,000), WHILE INPATIENT DISCHARGES WERE HIGHEST AMONG THOSE WHO IDENTIFY AS "OTHER" RACE. ACROSS AGE GROUPS, RATES OF ED DISCHARGE FOR CHRONIC SUBSTANCE ABUSE INCREASED THE MOST FOR THOSE OVER 65 YEARS BY 714%. IN ADDITION, NEARLY 20% OF ADULTS AGES 18 AND OLDER SELF-REPORT EXCESSIVE ALCOHOL USE. - HEAVY ALCOHOL CONSUMPTION IS ALSO PROBLEM IN SAN DIEGO COUNTY. NEARLY 20% OF ADULTS AGES 18 AND OLDER SELF-REPORT EXCESSIVE ALCOHOL USE. PARTICIPANTS IN THE COMMUNITY ENGAGEMENT PROCESS DISCUSSED THE LINK BETWEEN MENTAL HEALTH AND SUBSTANCE MISUSE, ARGUING THAT THE FAILURE TO PROVIDE PREVENTIVE AND ACUTE MENTAL HEALTH SERVICES OFTEN LEADS TO SELF-MEDICATING WITH DRUGS AND ALCOHOL. THEY ALSO AN INSUFFICIENT SUPPLY OF SUBSTANCE USE DISORDER OUTPATIENT AND IN-PATIENT DRUG TREATMENT PROGRAMS AS A CRITICAL NEED IN SAN DIEGO COUNTY. - ED DISCHARGES FOR OPIOID MISUSE INCREASED BY 267.2% FROM 2014-2016, WHILE INPATIENT DISCHARGES INCREASED BY 239.3%. THE STEEPEST INCREASES IN BOTH DISCHARGE RATES WERE AMONG PEOPLE 65+, WHO EXPERIENCED A 1,734.4% INCREASE IN ED DISCHARGES AND AN 863.1% INCREASE IN HOSPITAL DISCHARGES. - 11.8% OF ADULTS IN SAN DIEGO SERIOUSLY CONSIDERED COMMITTING SUICIDE IN 2017. IN 2016, THE AGE-ADJUSTED SUICIDE RATE IN SAN DIEGO WAS 11.9 PER 100,000. RATES WERE HIGHEST AMONG WHITES (18.7), FOLLOWED BY BLACKS (11.5), ASIAN PACIFIC ISLANDERS (8.2) AND HISPANICS (5.3). WHILE THE RATE OF SUICIDE DECREASED SLIGHTLY (1.3%) FROM 2014-2016, THE RATES OF SUICIDE FOR PEOPLE WHO IDENTIFY AS ASIAN/PACIFIC ISLANDER, BLACK, AND "OTHER," INCREASED IN THOSE SAME YEARS BY 13.3%, 47.2%, AND 93.0% RESPECTIVELY. SUICIDE AND SUICIDE ATTEMPTS SUICIDE IS A MAJOR COMPLICATION OF DEPRESSION AND A LEADING CAUSE OF NON-NATURAL DEATH FOR ALL AGES IN SAN DIEGO COUNTY, SECOND ONLY TO MOTOR VEHICLE ACCIDENTS. ACCORDING TO A SAN DIEGO COUNTY SUICIDE PREVENTION COUNCIL'S 2019 REPORT THE NUMBER AND RATE OF PEOPLE WHO DIED BY SUICIDE IN SAN DIEGO COUNTY ROSE SLIGHTLY. THERE WERE 465 DEATHS BY SUICIDE IN 2018, UP FROM 458 REPORTED IN 2017. THE ANNUAL REPORT PROVIDES A COMPREHENSIVE LOOK AT SUICIDE IN THE REGION AND BRINGS TOGETHER DATA FROM MULTIPLE SOURCES FOR THE YEARS 2014 THROUGH 2017. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
AMONG THE REPORT'S FINDINGS: - TOTAL NUMBER OF SUICIDES: 465 COMPARED TO 458 IN 2017. - SUICIDE RATE (PER 100,000 POPULATION): 13.9 COMPARED TO 13.8 IN 2017. - EMERGENCY DEPARTMENT DISCHARGES DUE TO SELF-INFLICTED INJURY: DOWN SLIGHTLY TO 3,091 IN 2017 (MOST RECENT YEAR AVAILABLE) COMPARED TO 3,098 IN 2016. - THE PERCENTAGE OF SUICIDE CRISIS CALLS, AS OPPOSED TO CALLS ABOUT OTHER MENTAL HEALTH ISSUES, TO THE COUNTY'S ACCESS AND CRISIS LINE SAW A SHARP 52 PERCENT INCREASE TO 47.6 PERCENT OF CALLS COMPARED TO 31.4 PERCENT IN 2017. - FIREARMS HAVE BEEN THE PRIMARY MEANS USED IN SUICIDE DEATHS IN SAN DIEGO COUNTY AND HAVE BEEN INCREASING OVER THE LAST THREE YEARS. FIREARMS ACCOUNT FOR 37 PERCENT OF THE DEATHS BY SUICIDE, FOLLOWED BY HANGING AND SUFFOCATION AT 33 PERCENT. IN 2010, THE COUNTY OF SAN DIEGO HEALTH AND HUMAN SERVICES AGENCY (HHSA) LAUNCHED A SUICIDE PREVENTION PLANNING PROCESS, WHICH WAS FORMED BY THE NATIONAL STRATEGY FOR SUICIDE PREVENTION AND THE CALIFORNIA STRATEGIC PLAN ON SUICIDE PREVENTION. SCRIPPS IS A MEMBER OF THE COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP), WHICH COLLABORATES WITH THE COUNTY ON THIS INITIATIVE. FOR MORE INFORMATION ON THE STATUS OF SUICIDE AND SUICIDE PREVENTION IN SAN DIEGO COUNTY: 2019 REPORT CARD. http://www.sdchip.org/wp-content/uploads/2019/09/2018-San-Diego-County-Sui cide.pdf THE REPORT CARD BRINGS TOGETHER THE MOST RECENT DATA AVAILABLE FROM MULTIPLE SOURCES (FOR THE YEARS 2014 THROUGH 2018) TO PRESENT A PROFILE OF SUICIDES FOR ALL AGES IN SAN DIEGO COUNTY. INFORMATION FROM THE COUNTY MEDICAL EXAMINER, THE ACCESS & CRISIS LINE, HOSPITAL EMERGENCY DEPARTMENTS, STUDENT SELF-REPORTS, SUICIDE PREVENTION AWARENESS CAMPAIGNS AND SUICIDE PREVENTION TRAINING PROGRAMS ARE PRESENTED TO PROVIDE A MORE COMPLETE UNDERSTANDING OF THE STATUS OF SUICIDE AND EFFORTS TO PREVENT THEM IN SAN DIEGO COUNTY. THE BEHAVIORAL HEALTH PROGRAM AT SCRIPPS MERCY ALSO SUPPORTS COMMUNITY PROGRAMS TO REDUCE THE STIGMA OF MENTAL ILLNESS AND HELP AFFECTED INDIVIDUALS LIVE AND WORK IN THE COMMUNITY. SCRIPPS HEALTH BEHAVIORAL HEALTH INPATIENT PROGRAMS INDIVIDUALS SUFFERING FROM ACUTE PSYCHIATRIC DISORDERS ARE SOMETIMES UNABLE TO LIVE INDEPENDENTLY OR MAY EVEN POSE A DANGER TO THEMSELVES OR OTHERS. IN SUCH CASES, HOSPITALIZATION MAY BE THE MOST APPROPRIATE ALTERNATIVE. THE BEHAVIORAL HEALTH INPATIENT PROGRAM AT SCRIPPS MERCY HOSPITAL HELPS PATIENTS AND THEIR LOVED ONES WORK THROUGH SHORT-TERM CRISES, MANAGE MENTAL ILLNESS AND RESUME THEIR DAILY LIVES. CHALLENGES - LIKE MANY BEHAVIORAL HEALTH PROGRAMS ACROSS THE COUNTRY, FUNDING IS DIFFICULT, AS PAYMENT RATES HAVE NOT KEPT PACE WITH THE COST TO PROVIDE CARE. - IN FY19, THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM EXPERIENCED A $4.1 MILLION LOSS IN TOTAL OPERATIONS, HOWEVER 3.4 MILLION OF THIS IS CAPTURED IN MEDI-CAL/CMS AND CHARITY CARE. - IN FY19, 1.8 PERCENT OF PATIENTS IN THE INPATIENT UNIT WERE UNINSURED. BEHAVIORAL HEALTH OUTPATIENT PROGRAMS SCRIPPS BEHAVIORAL HEALTH ENTERED INTO AN AGREEMENT IN MAY 2016 TO TRANSITION THE INTENSIVE BEHAVIORAL HEALTH OUTPATIENT PROGRAM TO THE FAMILY HEALTH CENTERS OF SAN DIEGO AND EXPAND OUTPATIENT BEHAVIORAL HEALTH OFFERINGS TO THE POPULATION SERVED. SCRIPPS MERCY AND FAMILY HEALTH CENTERS BEHAVIORAL HEALTH PARTNERSHIP SCRIPPS MERCY HAS ESTABLISHED AN INITIATIVE WITH FAMILY HEALTH CENTERS OF SAN DIEGO (FHCSD) TO CREATE A MORE ROBUST BEHAVIORAL HEALTH CARE SYSTEM FOR MEDI-CAL PATIENTS THAT RECEIVE CARE AT SMH. THE GOAL IS TO STRENGTHEN THE CONTINUUM OF INTEGRATED PRIMARY AND MENTAL HEALTH SERVICES FOR PATIENTS DISCHARGED FROM VARIOUS HOSPITAL SETTINGS (MEDICAL AND BEHAVIORAL HEALTH INPATIENT AND EMERGENCY CARE) THROUGH A VARIETY OF TIMELY PATIENT ENGAGEMENT STRATEGIES INCLUDING THE EXPANSION OF COMMUNITY-BASED BEHAVIORAL HEALTH SERVICES ADJACENT TO THE HOSPITAL. THE ULTIMATE GOAL IS TO INVOLVE PATIENTS IN APPROPRIATE OUTPATIENT CARE BEFORE THEIR BEHAVIORAL HEALTH ISSUES BECOME ACUTE, PREVENTING RETURNS TO THE EMERGENCY DEPARTMENT. MENTAL HEALTH OUTREACH SERVICES, A-VISONS VOCATIONAL TRAINING PROGRAM BEHAVIORAL HEALTH SERVICES AT SCRIPPS MERCY HOSPITAL, IN PARTNERSHIP WITH THE SAN DIEGO CHAPTER OF MENTAL HEALTH OF AMERICA ESTABLISHED THE A-VISONS VOCATIONAL TRAINING PROGRAM (SOCIAL REHABILITATION AND PREVOCATIONAL SERVICES FOR PEOPLE LIVING WITH MENTAL ILLNESS) TO HELP DECREASE THE STIGMA OF MENTAL ILLNESS AND OFFER VOLUNTEER AND EMPLOYMENT OPPORTUNITIES TO PERSONS WITH MENTAL ILLNESS. THIS SUPPORTIVE EMPLOYMENT PROGRAM PROVIDES VOCATIONAL TRAINING FOR PEOPLE RECEIVING MENTAL HEALTH TREATMENT, POTENTIALLY LEADING TO GREATER INDEPENDENCE. THIS YEAR, BEHAVIORAL HEALTH SERVICES CONTINUED PARTICIPATING IN THE A-VISIONS PROGRAM. SINCE ITS INCEPTION, 611 INQUIRIES HAVE COME IN, 165 OF THESE RESULTED IN QUALIFIED CANDIDATES WITH 100 VOLUNTEERS AND 54 EMPLOYEES THUS FAR. CURRENTLY, THERE ARE A TOTAL OF 23 ACTIVE CANDIDATES: 22 EMPLOYEES AND ONE VOLUNTEER WHO PARTICIPATE IN THIS SUPPORTIVE EMPLOYMENT PROGRAM. THE AVERAGE LENGTH OF EMPLOYMENT FOR THE 54 EMPLOYEES IS 5.6 YEARS, WITH A RANGE OF 2 MONTHS TO 14.7 YEARS. THE CURRENT PAID EMPLOYEES HAVE BEEN EMPLOYED BETWEEN 1.9 YEARS TO 12.6 YEARS, WITH THE AVERAGE LENGTH OF EMPLOYMENT BEING 7 YEARS. A-VISIONS PARTICIPANTS HAVE BEEN EMPLOYED ON A CASUAL/PER DIEM BASIS BY SCRIPPS ENVIRONMENTAL SERVICES, FOOD SERVICES AND CLERICAL SUPPORT FOR HEALTH AND INFORMATION SERVICES, EMERGENCY SERVICES, NURSING RESEARCH, HUMAN RESOURCES, ACCESS, BEHAVIORAL HEALTH, CREDENTIALING, LABOR AND DELIVERY, LABORATORY, MEDICAL STAFFING, PERFORMANCE IMPROVEMENT, SPIRITUAL CARE AND PALLIATIVE CARE SERVICES. PAID A-VISIONS CANDIDATES TYPICALLY LIMIT THEIR WORK TO EIGHT HOURS PER WEEK, WHICH ALLOWS THEM TO MAINTAIN ELIGIBILITY FOR THE DISABILITY BENEFITS, MEDICATIONS AND ONGOING BEHAVIORAL HEALTHCARE THAT SUPPORTS THEIR WORK. INCREASING AWARENESS OF MENTAL HEALTH ISSUES IN FY19, SCRIPPS BEHAVIORAL HEALTH SERVICES IMPROVED AWARENESS OF MENTAL HEALTH ISSUES BY PROVIDING INFORMATION AND SUPPORTIVE SERVICES FOR MORE THAN 900 PEOPLE AT COMMUNITY EVENTS. COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP) AND THE SUICIDE PREVENTION COUNCIL THE SAN DIEGO COUNTY SUICIDE PREVENTION COUNCIL (SPC) IS A COLLABORATIVE COMMUNITY-WIDE EFFORT FOCUSED ON REALIZING A VISION OF ZERO SUICIDES IN SAN DIEGO COUNTY. ITS GOAL IS TO PREVENT SUICIDE AND ITS DEVASTATING CONSEQUENCES IN SAN DIEGO COUNTY. SINCE 2010, WITH SUPPORT FROM THE COUNTY OF SAN DIEGO BEHAVIORAL HEALTH SERVICES, CHIP PROVIDES DIRECT OVERSIGHT AND GUIDANCE TOWARD THE IMPLEMENTATION OF THE SUICIDE PREVENTION ACTION PLAN. THE CORE STRATEGIES OF THE SUICIDE PREVENTION COUNCIL ARE: - ENHANCING COLLABORATIONS TO PROMOTE A SUICIDE-FREE COMMUNITY - CONDUCTING NEEDS ASSESSMENTS TO IDENTIFY GAPS IN SUICIDE PREVENTION SERVICES AND SUPPORTS - DISSEMINATING VITAL INFORMATION ON THE SIGNS OF SUICIDE AND EFFECTIVE HELP-SEEKING - PROVIDING RESOURCES TO THOSE AFFECTED BY SUICIDE AND SUICIDAL BEHAVIOR - ADVANCING POLICIES AND PRACTICES THAT CONTRIBUTE TO THE PREVENTION OF SUICIDE PSYCHIATRIC LIAISON TEAM (PLT) THE PSYCHIATRIC LIAISON TEAM IS A MOBILE PSYCHIATRIC ASSESSMENT TEAM. CLINICIANS PROVIDE MENTAL HEALTH EVALUATION AND TRIAGE SERVICES TO ACCURATELY ASSESS PATIENTS AND PROVIDE THEM WITH THE BEST AND SAFEST COMMUNITY RESOURCES TO PROMOTE ONGOING CARE. THE TEAM AIMS TO HELP PEOPLE ADHERE TO TREATMENT PLANS, REDUCE HOSPITAL READMISSION RATES, RELIEVE SYMPTOMS AND ULTIMATELY ENSURE THE LONG-TERM STABILIZATION OF THE PATIENT'S MENTAL HEALTH. SCRIPPS WILL CONTINUE TO PROVIDE A DEDICATED PSYCHIATRIC LIAISON TEAM AT ALL SCRIPPS HOSPITALS EMERGENCY DEPARTMENTS AND URGENT CARE SETTINGS (RANCHO BERNARDO AND TORREY PINES). MI PUENTE: "MY BRIDGE" TO BETTER CARDIOMETABOLIC HEALTH AND WELL BEING SCRIPPS WHITTIER DIABETES INSTITUTE RECEIVED A $2.4 MILLION STUDY GRANT FROM THE NIH'S NATIONAL INSTITUTE OF NURSING RESEARCH IN 2015 TO EVALUATE MI PUENTE, A PROGRAM AT SCRIPPS MERCY CHULA VISTA HOSPITAL THAT USES A "NURSE + VOLUNTEER" TEAM APPROACH TO HELP HOSPITALIZED HISPANIC PATIENTS WITH MULTIPLE CHRONIC DISEASES REDUCE THEIR HOSPITALIZATIONS AND IMPROVE THEIR DAY-TO-DAY HEALTH AND QUALITY OF LIFE. INDIVIDUALS OF LOW SOCIOECONOMIC (SES) AND ETHNIC MINORITY STATUS, INCLUDING HISPANICS, THE LARGEST U.S. ETHNIC MINORITY GROUP ARE DISPROPORTIONATELY BURDENED BY CHRONIC CARDIOVASCULAR AND METABOLIC CONDITIONS ("CARDIOMETABOLIC" E.G. OBESITY, DIABETES, HYPERTENSION, HEART DISEASE). HIGH LEVELS OF UNMET BEHAVIORAL HEALTH IN THIS POPULATION CONTRIBUTE TO STRIKING DISPARITIES IN DISEASE PREVALENCE AND OUTCOMES. |
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A BEHAVIORAL HEALTH NURSE PROVIDES IN-HOSPITAL COACHING TO PATIENTS, WHO ARE THEN FOLLOWED POST DISCHARGE BY A VOLUNTEER COMMUNITY PEER MENTOR TO ASSIST THEM IN OVERCOMING BARRIERS THAT MAY INTERFERE WITH ACHIEVING AND MAINTAINING GOOD HEALTH. MI PUENTE AIMS TO IMPROVE CONTINUITY OF CARE AND ADDRESS THE (PHYSICAL AND BEHAVIORAL) HEALTH NEEDS OF THE AT-RISK HISPANIC POPULATION. THIS PROGRAM HOLDS PROMISE FOR IMPACTFUL EXPANSION TO OTHER CONDITIONS AND UNDERSERVED POPULATIONS. BEHAVIORAL HEALTH INTEGRATION PROGRAM (BHIP) IN DIABETES MANY PEOPLE FIND THAT THE DAY-TO-DAY TASKS ASSOCIATED WITH HAVING DIABETES TESTING ONE'S BLOOD SUGAR, PLANNING MEALS, GETTING ENOUGH PHYSICAL ACTIVITY AND REMEMBERING TO TAKE MEDICATIONS CAN BE STRESSFUL. A COMMON CONDITION KNOWN AS "DIABETES DISTRESS" CAN BE THE RESULT OF FEELING LIKE IT'S ALL TOO MUCH. SCRIPPS DIABETES CARE AND PREVENTION HAS A DIABETES BEHAVIORAL SPECIALIST ON STAFF TO HELP PEOPLE MANAGE THEIR DIABETES WITHOUT BEING OVERWHELMED OR UNDULY DISTRESSED. THE BEHAVIORAL HEALTH INTEGRATION PROGRAM (BHIP) IN DIABETES IS AN INTEGRATED, INTERDISCIPLINARY APPROACH TO MANAGING THE EMOTIONAL AND BEHAVIORAL NEEDS THAT OFTEN LEADS TO BURNOUT OF INDIVIDUALS WITH TYPE 1 AND TYPE 2 DIABETES. THE COLLOCATION OF MEDICAL AND BEHAVIORAL HEALTH SERVICES IN THE SAME FACILITY ALLOW FOR A CONVENIENT, WARM HAND-OFF FROM PHYSICIAN TO BEHAVIORAL HEALTH SPECIALIST. IT ALSO AFFORDS OPPORTUNITIES FOR PHYSICIANS, DIABETES EDUCATORS AND OTHERS TO RECEIVE CONSULTATION ON BEHAVIORAL HEALTH CONCERNS, AND IN TURN, MORE COMPREHENSIVELY ADDRESS THE MULTI-FACETED NEEDS OF THEIR PATIENTS WITH DIABETES. GUIDING VETERAN'S TO MENTAL HEALTH SERVICES SAN DIEGO IS HOME TO MORE THAN 250,000 VETERANS. A SUBSTANTIAL NUMBER OF OUR SERVICE MEMBERS HAVE SUFFERED OR ARE STRUGGLING WITH POST-TRAUMATIC STRESS DISORDER (PTSD), DEPRESSION, ANXIETY AND OTHER PSYCHOLOGICAL CONDITIONS RELATED TO MILITARY SERVICE AND REPEATED DEPLOYMENTS. PARTNERING WITH COMMUNITY-BASED ORGANIZATIONS, SCRIPPS IS ACTIVELY WORKING TO ASSIST THESE VETERANS THROUGH INFORMATIONAL SESSIONS DESIGNED TO IMPROVE KNOWLEDGE OF VETERAN'S MENTAL HEALTH ISSUES AND ACCESS TO COMMUNITY-BASED SERVICES. SCRIPPS IS WORKING WITH SAN DIEGO STATE UNIVERSITY TO IMPLEMENT A VETERAN'S MENTAL HEALTH COURSE IN THE SOCIAL WORK DEPARTMENT. MENTAL HEALTH SUPPORT SERVICES AT LOCAL SCHOOL-BASED CLINICS SCRIPPS FAMILY MEDICINE RESIDENCY AND SCRIPPS MERCY HOSPITAL CHULA VISTA WELL-BEING CENTER HAVE PARTNERED TO OFFER CLINICAL TRAINING OPPORTUNITIES FOR MASTER SOCIAL WORK STUDENTS IN TRAINING FROM SAN DIEGO STATE UNIVERSITY AT SOUTHWEST AND PALOMAR HIGH SCHOOLS. THESE STUDENTS WORK WITH LOCAL PROVIDERS THAT ADDRESS THE MENTAL HEALTH NEEDS OF VULNERABLE ADOLESCENTS. A VARIETY OF MENTAL HEALTH ISSUES ARE PRESENT FOR LOCAL HIGH SCHOOL STUDENTS. MANY OF THESE ISSUES INCLUDE DEPRESSION, ANXIETY AND SUICIDE RELATED CONCERNS. THE PROGRAM WORKS TO IMPROVE OVERALL MENTAL HEALTH CARE FOR LOCAL STUDENTS THROUGH A SCHOOL-BASED CLINIC. APPROXIMATELY 240 HOURS WERE SPENT IN THE SCHOOL-BASED CLINICS OFFERING SERVICES FOR ADOLESCENTS TO AN AVERAGE OF 12 STUDENTS PER WEEK. PATIENT COMMUNITY SERVICES PATIENTS ARE REFERRED FROM SCRIPPS MERCY HOSPITAL CHULA VISTA, FOR ASSISTANCE WITH A WIDE VARIETY OF BEHAVIORAL HEALTH NEEDS INCLUDING ADDICTION, LOSS, ANXIETY AND OTHER MENTAL HEALTH ISSUES. THE WELL-BEING CENTER OFFERS WEEKLY COUNSELING AND/OR REFER PATIENTS TO LOCAL MENTAL HEALTH COUNSELING SERVICES. ALCOHOLIC ANONYMOUS SCRIPPS HEALTH PROVIDES MEETING SPACE FOR MEMBERS OF ALCOHOLIC ANONYMOUS. A FELLOWSHIP OF MEN AND WOMEN WHO SHARE THEIR EXPERIENCE, STRENGTH AND SUPPORT OF EACH OTHER. GRIEF RECOVERY AFTER A SUBSTANCE PASSING (GRASP) SCRIPPS HEALTH PROVIDES MEETING SPACE FOR MEMBERS OF GRASP. GRASP WAS FOUNDED TO HELP PROVIDE SOURCES OF HELP, COMPASSION AND MOST OF ALL, UNDERSTANDING, FOR FAMILIES OR INDIVIDUALS WHO HAVE HAD A LOVED ONE DIE AS A RESULT OF SUBSTANCE USE OR ADDICTION. NATIONAL ALLIANCE OF MENTAL ILLNESS (NAMI) SIBLINGS SUPPORT SCRIPPS HEALTH PROVIDES MEETING SPACE FOR MEMBERS OF NAMI SIBLING SUPPORT. THIS IS A CONFIDENTIAL SUPPORT GROUP FOR SIBLINGS OF PERSON WITH MENTAL ILLNESS AND ADULT CHILDREN OF PARENTS WITH MENTAL ILLNESS. SURVIVORS OF SUICIDE LOSS - SAN DIEGO CHAPTER SCRIPPS HEALTH PROVIDES MEETING SPACE FOR MEMBERS OF THE SURVIVORS OF SUICIDE LOSS - SAN DIEGO CHAPTER. THE ORGANIZATION REACHES OUT TO AND SUPPORTS PEOPLE WHO HAVE LOST A LOVED ONE TO SUICIDE. THE GOAL IS TO GIVE SURVIVORS A PLACE WHERE THEY CAN BE COMFORTABLE EXPRESSING THEMSELVES, A PLACE TO FIND SUPPORT, COMFORT, RESOURCES AND HOPE IN A JUDGMENT-FREE ENVIRONMENT. TRANSITIONS OF CARE INITIATIVE (TOC) FAMILY HEALTH CENTER OF SAN DIEGO (FHCSD) RECEIVED FUNDING FROM BLUE SHIELD PROMISE TO HIRE TWO SOCIAL WORK STAFF POSITIONS THAT ARE EMBEDDED INTO OPERATIONS AT SCRIPPS MERCY HOSPITAL FOR THE GOAL OF CONNECTING PATIENTS TO FHCSD FOR NEEDED SERVICES. THE TOC INITIATIVE IS DESIGNED TO HELP PATIENTS AT ALL LEVELS OF CARE WITHIN THE HOSPITAL, WITH ESPECIALLY THOSE WITH MENTAL HEALTH AND DRUG AND ALCOHOL PROBLEMS TO CONNECT WITH APPROPRIATE FHCSD RESOURCES. THE GOAL IS TO CONNECT PATIENTS WITH AN ARRAY OF OUTPATIENT HEALTH AND SOCIAL SERVICE RESOURCES TO PREVENT READMISSIONS. SCRIPPS DRUG AND ALCOHOL RESOURCES THERE ARE IN EXCESS OF 25 MILLION ILLICIT DRUG USERS IN THE US. THERE ARE AN ESTIMATED 136.9 MILLION CURRENT DRINKERS OF ALCOHOLIC BEVERAGES AND OF THOSE, APPROXIMATELY 23 PERCENT BINGE DRANK IN THE LAST 30 DAYS AND 6.3 PERCENT ARE CONSIDERED HEAVY DRINKERS. IT IS ESTIMATED THERE ARE 8.7 MILLION UNDER-AGE DRINKERS. SUBSTANCE USE, PARTICULARLY OPIOID MISUSE, IS A HEALTH CRISIS THAT HAS REACHED EPIDEMIC PROPORTIONS BOTH NATIONALLY AND LOCALLY. IN SAN DIEGO, THE RATE OF DISCHARGE FROM EMERGENCY DEPARTMENTS FOR CHRONIC SUBSTANCE USE INCREASED BY 559% FROM 2014-2016; RATES FOR THOSE 65 YEARS AND OLDER INCREASED THE MOST-BY 714%. THE RATE OF DISCHARGE FOR OPIOID MISUSE FOR THIS AGE GROUP WAS EVEN MORE STARTLING-IT ROSE BY 1.734% OVER THIS TWO-YEAR PERIOD. RATES OF DISCHARGE FROM EMERGENCY DEPARTMENTS FOR ACUTE SUBSTANCE USE ALSO ROSE. RATES INCREASED FOR PEOPLE OF ALL RACIAL AND ETHNIC BACKGROUNDS; HOWEVER, THE MOST SUBSTANTIAL INCREASES (177%) WAS FOR BLACKS. HEAVY ALCOHOL CONSUMPTION IS ALSO A PROBLEM IN SAN DIEGO. NEARLY 20% OF ALL ADULTS AGES 18 AND OLDER SELF-REPORT EXCESSIVE ALCOHOL USE. SCRIPPS SUBSTANCE USE DISORDER SERVICE (SUDS) NURSES AWARE OF THE IMPACT DRUGS AND ALCOHOL CAN HAVE ON OUR COMMUNITY, SCRIPPS HAS DEVELOPED INNOVATIVE WAYS TO TREATING THIS DESTRUCTIVE DISEASE. SCRIPPS HAS DEPLOYED SPECIALIZED NURSES CERTIFIED IN ADDICTION; THEY SEE PATIENTS AT THEIR BEDSIDE AND WORK CLOSELY WITH THE PATIENT'S ENTIRE HEALTH CARE TEAM TO HELP FACILITATE A SAFE DETOX WHILE HOSPITALIZED. THE SUBSTANCE USE DISORDER SERVICE (SUDS) NURSES ACT IN A PROACTIVE AND REACTIVE ROLE IN ALL SCRIPPS HOSPITALS, HELPING TO IDENTIFY PATIENTS WHO ARE AT RISK, OR ARE CURRENTLY EXPERIENCING WITHDRAWAL FROM ADDICTIVE SUBSTANCES. THIS MOBILE GROUP OF SPECIALLY TRAINED DRUG AND ALCOHOL RESOURCE NURSES PROVIDE EDUCATION, INTERVENTIONS AND DISCHARGE PLACEMENT ASSISTANCE TO PATIENTS IN THE SCRIPPS HOSPITALS. THE RESOURCE NURSES WORK DIRECTLY WITH THE NURSING STAFF AT EACH OF THE HOSPITALS IN SEARCH OF PATIENTS WHO MAY BE AT RISK FOR ALCOHOL/DRUG WITHDRAWAL AND ASSIST WITH IMPLEMENTING A STANDARDIZED PROTOCOL WITHDRAWAL PROCESS. SCRIPPS HAS CHANGED THE WAY WE DELIVER DRUG AND ALCOHOL TREATMENT BY COLLABORATING WITH OTHERS TO DELIVER A CONTINUUM OF CARE THAT IMPROVES THE HEALTH OF OUR COMMUNITY. WHEN PATIENTS NEED ADDITIONAL CARE, SCRIPPS HAS LINKED ITSELF TO TWO SEPARATE TREATMENT PROGRAMS DESIGNED TO MEET THE COMMUNITY NEEDS. BETTY FORD CENTER IN 2016, SCRIPPS PARTNERED WITH THE BETTY FORD CENTER, WHICH EXPANDED ITS DRUG AND ALCOHOL TREATMENT PROGRAMMING INTO SAN DIEGO. THIS TREATMENT CENTER BRINGS WORLD-RENOWNED ALCOHOL AND DRUG REHAB TO MORE PEOPLE THROUGH WEEKDAY AND WEEKNIGHT OUTPATIENT SERVICES. FAMILY HEALTH CENTERS OF SAN DIEGO FAMILY HEALTH CENTERS OF SAN DIEGO PROVIDES AN ARRAY OF SERVICES, INCLUDING OUTPATIENT DRUG AND ALCOHOL TREATMENT ALONG WITH MEDICATION-ASSISTED TREATMENT AND HARM REDUCTION PROGRAMS. THEIR SERVICES ALSO INCLUDE INDIVIDUAL COUNSELING AND ONE-ON-ONE SUPPORT, EDUCATIONAL SESSIONS, HIV RESTING, HEPATITIS B & C TESTING AND TREATMENT. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
OPIOID STEWARDSHIP PROGRAM (OSP) THE OPIOID STEWARDSHIP PROGRAM HAS SPEARHEADED MULTIPLE PROJECTS AT SCRIPPS TO EDUCATE PATIENTS AND PROVIDERS ABOUT THE RISKS OF OPIOIDS AND THE BENEFITS OF ALTERNATIVE MULTI-MODAL PAIN MANAGEMENT OPTIONS TO REDUCE OPIOID USE. THE PROGRAM HAS ESTABLISHED PRESCRIBING STANDARDS FOR OPIOIDS, RESULTING IN A 25 PERCENT REDUCTION IN THE NUMBER OF OPIOID PILLS PER PRESCRIPTION AT SCRIPPS HOSPITALS AND OUTPATIENT CENTERS IN 2019. SCRIPPS ALSO HAS OPENED THREE DRUG TAKE-BACK KIOSKS AT ITS ON-SITE PHARMACIES, OFFERING PATIENTS YEAR-ROUND ACCESS TO DISPOSE OF UNUSED, UNNEEDED OR OUTDATED MEDICATIONS. SOCIAL DETERMINANTS OF HEALTH PER SECTION 2, COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), IN ADDITION TO THE HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA, SOCIAL DETERMINANTS OF HEALTH (SDOH) WERE ALSO IDENTIFIED IN ALL THE COMMUNITY ENGAGEMENT ACTIVITIES. APPROXIMATELY 80 PERCENT OF MODIFIABLE RISKS FOR DISEASES ARE ATTRIBUTABLE TO NON-MEDICAL (UPSTREAM) DETERMINANTS OF HEALTH, SUCH AS HEALTH BEHAVIORS, SOCIOECONOMIC STATUS, AND ENVIRONMENTAL CONDITIONS. TO PREVENT CHRONIC CONDITIONS AND PROMOTE HEALTH, GREATER EMPHASIS SHOULD BE PLACED ON POPULATION HEALTH, WHICH HAS BEEN DEFINED TO FOCUS ON OUTCOMES AS WELL AS ON THE BROADER FACTORS THAT INFLUENCE HEALTH AT A POPULATION LEVEL, INCLUDING MEDICAL CARE SYSTEMS, THE SOCIAL ENVIRONMENT, AND THE PHYSICAL ENVIRONMENT. THE CHNA IDENTIFIED ECONOMIC SECURITY AS A PRIORITY SDOH NEED IN THE SECONDARY DATA ANALYSES AND IN THE COMMUNITY ENGAGEMENT PROCESS. ECONOMIC SECURITY REFERS TO THE ABILITY TO MEET ESSENTIAL FINANCIAL NEEDS SUSTAINABLY, INCLUDING THOSE FOR FOOD, SHELTER, CLOTHING, HYGIENE, HEALTH CARE, AND EDUCATION. ECONOMIC INSECURITY IS ASSOCIATED WITH: - POOR MENTAL HEALTH DAYS - VISITS TO THE ED FOR HEART ATTACKS - ASTHMA - OBESITY - DIABETES - STROKE - CANCER - SMOKING - PEDESTRIAN INJURY ECONOMIC INSECURITY MAY ALSO LEAD TO FOOD INSECURITY, WHICH IS LINKED TO: - FAIR OR POOR HEALTH, ANEMIA, AND ASTHMA IN CHILDREN - MENTAL HEALTH PROBLEMS, DIABETES, HYPERTENSION, HYPERLIPIDEMIA, AND ORAL HEALTH PROBLEMS IN ADULTS - FAIR OR POOR HEALTH, DEPRESSION, AND LIMITATIONS IN ACTIVITIES OF DAILY LIVING IN SENIORS ECONOMIC SECURITY IS ALSO LINKED TO WAGES. - EDUCATIONAL ATTAINMENT IS DIRECTLY RELATED TO ECONOMIC INSECURITY BY WAY OF LOW WAGES AND/OR LIMITED ACCESS TO EMPLOYMENT - IN SAN DIEGO, ADULTS WHO HAD LESS THAN A HIGH SCHOOL DIPLOMA WAS HIGHEST IN SOUTH (21.9%) AND CENTRAL (19.9%) REGIONS. FOOD INSECURITY FOOD INSECURITY IS THE INABILITY TO AFFORD ENOUGH FOOD FOR AN ACTIVE, HEALTHY LIFE. THE HASD&IC 2019 CHNA IDENTIFIED FOOD INSECURITY AND ACCESS TO HEALTHY FOOD AS A SOCIAL DETERMINANT IMPACTING SAN DIEGO'S PRIORITY HEALTH NEEDS. ACCORDING TO THE LATEST RESEARCH FROM THE SAN DIEGO HUNGER COALITION, ALMOST HALF A MILLION SAN DIEGANS, 1 IN 7 RESIDENTS, OR 15 PERCENT OF THE SAN DIEGO COUNTY POPULATION ARE CONSIDERED FOOD INSECURE, AN ECONOMIC AND SOCIAL CONDITION CHARACTERIZED BY LIMITED OR UNCERTAIN ACCESS TO ADEQUATE FOOD. TO PUT THE TOTAL NUMBER OF FOOD INSECURE SAN DIEGANS INTO PERSPECTIVE, IT IS ROUGHLY EQUIVALENT TO THE ENTIRE POPULATIONS OF CHULA VISTA, OCEANSIDE, IMPERIAL BEACH, CORONADO, AND SOLANA BEACH COMBINED. RATES IN IMPERIAL COUNTY ARE EVEN HIGHER, WITH 17% OF THE GENERAL POPULATION SUFFERING FOOD INSECURITY. EVEN MORE ALARMING IS THAT THE RATE OF FOOD INSECURITY AMONG CHILDREN IN IMPERIAL COUNTY IS THE HIGHEST IN CALIFORNIA AT OVER 33%. IN SAN DIEGO COUNTY: - 14% OF PEOPLE EXPERIENCE FOOD INSECURITY, 1 IN 7 PEOPLE - 22% OF CHILDREN ARE IN FOOD INSECURE HOUSEHOLDS, MORE THAN 1 IN 5 CHILDREN - 9% OF SENIORS EXPERIENCE FOOD INSECURITY, 1 IN 11 SENIORS. IN ADDITION, STUDIES DEMONSTRATE THAT HUNGER SIGNIFICANTLY IMPACTS HEALTH. LACK OF ACCESS TO HEALTHY FOOD, OFTEN DUE TO AVAILABILITY AND COST, ARE STRESSORS THAT CONTRIBUTE TO DIABETES, HEART DISEASE, OBESITY, AND OTHER BEHAVIORAL HEALTH ISSUES IN A MYRIAD OF WAYS: - FOOD INSECURE ADULTS WITH DIABETES HAVE HIGHER AVERAGE BLOOD SUGARS. - FOOD INSECURE ADULTS ARE MORE LIKELY TO BE OBESE. - FOOD INSECURITY IS SIGNIFICANTLY MORE PREVALENT IN ADULTS WITH MOOD DISORDERS. - FOOD INSECURITY IS ASSOCIATED WITH INCREASED RISK OF SUICIDAL THOUGHTS AND SUBSTANCE USE IN ADOLESCENTS. - FOOD INSECURE SENIORS HAVE A SIGNIFICANTLY HIGHER LIKELIHOOD OF HEART DISEASE, DEPRESSION AND LIMITED ACTIVITIES OF DAILY LIVING. - FOOD INSECURE ADULTS DELAY BUYING FOOD IN ORDER TO PURCHASE MEDICATIONS. CALFRESH PROGRAM THE CALFRESH PROGRAM, FEDERALLY KNOWN AS THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP), ISSUES MONTHLY ELECTRONIC BENEFITS THAT CAN BE USED TO BUY FOOD AT PARTICIPATING MARKETS AND STORES. IN SAN DIEGO COUNTY, AN ESTIMATED ADDITIONAL 185,000 PEOPLE ARE "FOOD SECURE" BUT RELY ON CALFRESH AND/OR WIC TO SUPPLEMENT THEIR FOOD BUDGET. THIS REPRESENTS 96,000 ADULTS AND 89,000 CHILDREN WHO ARE AT RISK OF FOOD INSECURITY SHOULD THEY LOSE CALFRESH OR WIC BENEFITS. THE TOTAL POPULATION IN SAN DIEGO COUNTY THAT IS EITHER FOOD INSECURE OR FOOD SECURE WITH CALFRESH OR WIC ASSISTANCE IS 671,000 OR 1 IN 5 PEOPLE. FEDERAL REDUCED-PRICE MEALS PROGRAM (FRPM) ACCORDING TO A NEW REPORT RELEASED IN 2019 BY THE SAN DIEGO COUNTY CHILDHOOD OBESITY INITIATIVE, WWW.SDCOI.ORG, THE EFFECT OF POVERTY AND FOOD INSECURITY ON STUDENTS' OVERWEIGHT AND OBESITY RATES CAN PERHAPS MOST PROFOUNDLY BE OBSERVED WHEN LOOKING AT DISTRICTS WITH HIGH CONCENTRATIONS OF STUDENTS ENROLLED IN THE FEDERAL REDUCED-PRICE MEALS PROGRAM (FRPM). ALL STUDENTS CAN PARTICIPATE IN SCHOOL NUTRITION PROGRAMS; HOWEVER, STUDENTS WITH FAMILY INCOMES UNDER 130% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR FREE MEALS, AND THOSE WITH INCOMES BETWEEN 130% AND 185% OF THE POVERTY LEVEL ARE ELIGIBLE FOR LOW-COST (OR "REDUCED PRICE") MEALS. STUDENTS ENROLLED IN THIS PROGRAM NOT ONLY COME FROM LOWER INCOME HOUSEHOLDS BUT ARE ALSO LIKELY TO BE FOOD INSECURE. FIFTY PERCENT, OR HALF OF ALL STUDENTS IN SAN DIEGO COUNTY ARE ENROLLED IN THE FEDERAL REDUCED-PRICE MEALS PROGRAM. SOURCE: CALIFORNIA DEPARTMENT OF EDUCATION. 2018-2019 STUDENT POVERTY FRPM DATA. THE PROGRAMS HIGHLIGHTED BELOW ARE WAYS THAT SCRIPPS HEALTH IS ADDRESSING FOOD INSECURITY; SCREENINGS AND ELIGIBILITY BENEFITS. SCRIPPS HEALTH CALFRESH SCREENINGS AS HEALTH CARE DELIVERY SYSTEMS MOVES TOWARDS A POPULATION HEALTH PARADIGM THAT INCENTIVIZES KEEPING PATIENT'S HEALTHY, HOSPITALS AND CLINICS ARE RECOGNIZING THE SIGNIFICANCE OF ADDRESSING SOCIAL DETERMINANTS OF HEALTH, SUCH AS FOOD INSECURITY (FI). HOSPITALS HAVE BEEN MORE PROACTIVE IN INTERVENING AT SOME LEVEL OF CARE TO AID THE INDIVIDUALS SUFFERING FROM FI AND THEIR ABILITY TO GAIN CONTROL OVER THEIR HEALTH. ACCORDINGLY, FOOD ASSISTANCE PROVIDED BY THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)-KNOWN AS CALFRESH IN CALIFORNIA, SIGNIFICANTLY REDUCES THE RATE AND SEVERITY OF POVERTY THROUGHOUT THE STATE (CALIFORNIA BUDGET & POLICY CENTER, 2018). WHILE SNAP AND WOMEN'S, INFANTS, CHILDREN (WIC) HAVE BEEN SUCCESSFUL IN ASSISTING LOW-INCOME CHILDREN AND THEIR FAMILIES WITH ADDITIONAL FUNDING FOR PURCHASING HEALTHY FOODS, THERE IS EVIDENCE THAT SUGGESTS SCREENING FOR FI IN HEALTHCARE SETTINGS IS THE BEST INDICATOR FOR PATIENTS TO ACCESS FOOD-RELATED ASSISTANCE. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
SCRIPPS HEALTH BEGAN SCREENING FOR CALFRESH IN JUNE 2017 THROUGH THE SUPPORT OF THE PUBLIC RESOURCE SPECIALIST (PRS) TEAM. THE PRS ARE EXPERIENCED STAFF WITH STRONG KNOWLEDGE OF THE COUNTY PROGRAMS. THEY SCREEN ALL UNINSURED PATIENTS WHO HAVE RECEIVED SERVICES AT ANY OF THE FIVE SCRIPPS HOSPITAL FACILITIES. THE IN-HOUSE APPLICATION PROCESS CAN TAKE UP TO 45 MINUTES AS THEY ARE SCREENING FOR MULTIPLE PROGRAMS CONCURRENTLY. ONCE AN APPLICATION HAS BEEN COMPLETED, THE PRS STAFF SUBMITS IT TO THE COUNTY VIA THE HOSPITAL OUTSTATION POINT OF ENTRY (HOPE) PROGRAM. ONCE SUBMITTED, A COUNTY HOPE WORKER IS ASSIGNED AND THE PRS TEAM TRACKS THE APPLICATION, ADVOCATING FOR THE PATIENTS THROUGHOUT THE PROCESS THAT CAN TAKE UP TO 45 DAYS TO RECEIVE AN ELIGIBILITY RESPONSE. IN SOME INSTANCES, HAVING TO GO THROUGH THE APPEAL PROCESS THAT MAY ADD AN ADDITIONAL 30 DAYS. IN DOING SO, THE PRS TEAM HELPS PATIENT'S MANEUVER A COMPLEX APPLICATION PROCESS THAT OTHERWISE MAY DETER THEM FROM SEEKING MUCH NEEDED ACUTE AND PREVENTATIVE CARE. THE TEAM HAS BEEN SUCCESSFUL IN HAVING THE IMPORTANT CONVERSATION ABOUT FOOD INSECURITY WITH 46% OF THE PATIENTS THEY HAVE SCREENED IN THIS PAST FISCAL YEAR. THE CITY HEIGHTS WELLNESS CENTER (CHWC) SCRIPPS MERCY HOSPITAL HAS ESTABLISHED A PARTNERSHIP AT THE CITY HEIGHTS WELLNESS CENTER (CHWC) WITH LA MAESTRA FAMILY CLINIC AND RADY CHILDREN'S HOSPITAL TO ADDRESS SOME OF THE ATTRIBUTING FACTORS TO POOR HEALTH STATUS FOR RESIDENTS. WITH LA MAESTRA SERVING AS THE LEAD AGENCY, SCRIPPS MERCY AND RADY CHILDREN'S HOSPITALS ARE CONTRIBUTING RESOURCES TO SUPPORT OPERATIONAL COSTS OF THE CENTER IN ORDER TO PROVIDE CAPACITY FOR NEEDED COMMUNITY LINKAGES. ELIGIBILITY WORKERS FROM LA MAESTRA FAMILY CLINIC ARE AVAILABLE TO COUNSEL PEOPLE AND ASSIST FILLING OUT APPLICATIONS FOR FOOD STAMP ASSISTANCE. CHWC NOT ONLY PROVIDES THE NEEDED SPACE FOR THE ACTIVITY, BUT ALSO ACTIVELY PARTICIPATES BY DEVELOPING OUTREACH FLYERS, SCHEDULING COMMUNITY RESIDENTS, AND OVERALL COORDINATION FOR THE CLASS. APPLICATIONS AND ASSISTANCE FOR CALFRESH TO SUPPLEMENT FOOD BUDGET AND ALLOW FAMILIES/INDIVIDUALS TO BUY NUTRITIOUS FOOD. SCRIPPS MERCY WIC PROGRAM THE CITY HEIGHTS WELLNESS CENTER IS HOME TO THE SCRIPPS MERCY HOSPITAL-WIC PROGRAM THAT PROVIDES NUTRITION EDUCATION AND COUNSELING, BREASTFEEDING EDUCATION AND SUPPORT AND FOOD VOUCHERS TO PREGNANT AND PARENTING WOMEN, AND CHILDREN 0-5 YEARS OF AGE. FOOD FINDERS - RESCUING FOOD, REDUCING HUNGER SCRIPPS CORPORATE FOOD SERVICE PARTNERED WITH FOOD FINDERS, A MULTI-REGIONAL FOOD BANK AND FOOD RESCUE PROGRAM THAT CONNECTS BUSINESSES TO CHARITABLE INSTITUTIONS IN NEED OF DONATIONS. FOOD FINDERS CONNECTED SCRIPPS WITH INTERFAITH COMMUNITY SERVICES IN ESCONDIDO, WHICH DISTRIBUTES FOOD TO PEOPLE IN NEED. ALL LEFTOVER FOOD FROM SCRIPPS CORPORATE FACILITIES IS PACKAGED, PICKED UP EACH DAY AND TRANSFERRED TO THE SCRIPPS 4S RANCH FOOD AND NUTRITION SERVICES FREEZER FOR STORAGE. THE COST IS MINIMAL, AS SCRIPPS USES THE SAME AMOUNT OF LABOR TO PACKAGE THE FOOD AS IT WOULD TO DISPOSE OF IT, AND UNSOLD "GRAB AND GO" ITEMS ARE ALREADY PACKAGED. INTERFAITH COMMUNITY SERVICES PICKS UP THE FROZEN FOOD TWICE PER WEEK AND TRANSPORTS IT TO ONE OF THEIR FACILITIES TO HELP FEED THE COMMUNITY. BETWEEN FOOD DONATED BY SCRIPPS AND OTHERS, INTERFAITH DISTRIBUTES AN AVERAGE OF 126,000 HOT MEALS AND PACKED LUNCHES AND 23,000 EMERGENCY MEALS, FEEDING APPROXIMATELY 17,000 PEOPLE EVERY YEAR. COOKING FOR HEALTH SCRIPPS CENTER FOR INTEGRATIVE MEDICINE AND BASTYR UNIVERSITY'S MASTER OF SCIENCE IN NUTRITION FOR WELLNESS PROGRAM COLLABORATE ON OFFERING FREE CLASSES THAT TEACH INDIVIDUALS HOW TO MAKE VEGETARIAN AND VEGAN MEALS THAT ARE DELICIOUS AND EASY TO PREPARE. PARTICIPANTS LEARN HOW TO COOK HEALTHY MEALS AND ARE EDUCATED ON WHY INGREDIENTS ARE CHOSEN AND THE HEALTH BENEFITS. THESE COOKING CLASSES FOCUS ON DISEASE PREVENTION, REDUCING OBESITY AND IMPROVING CHRONIC HEALTH ISSUES. FOSTERING VOLUNTEERISM SCRIPPS BELIEVES THAT HEALTH IMPROVEMENT BEGINS WHEN PEOPLE TAKE AN ACTIVE ROLE IN MAKING A POSITIVE IMPACT ON THEIR COMMUNITY. FOR THIS REASON, SCRIPPS SUPPORTS VOLUNTEER PROGRAMS FOR SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS WHO WANT TO MAKE AN EVEN LARGER IMPACT ON THEIR COMMUNITY. SCRIPPS MATCHES THE TALENTS AND INTERESTS OF EMPLOYEES AND PHYSICIANS WITH COMMUNITY NEEDS, SUCH AS MENTORING PARTNERSHIPS WITH LOCAL SCHOOLS AND PROVIDING FREE MEDICAL AND SURGICAL CARE FOR PATIENTS IN NEED. IN ADDITION TO THE FINANCIAL COMMUNITY BENEFIT CONTRIBUTIONS MADE DURING FY19, SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS DONATED A SIGNIFICANT PORTION OF THEIR PERSONAL TIME VOLUNTEERING TO SUPPORT SCRIPPS SPONSORED COMMUNITY BENEFIT PROGRAMS. WITH CLOSE TO 10,191 HOURS, THE ESTIMATED DOLLAR VALUE OF THIS VOLUNTEER LABOR IS $507,887.44*, WHICH IS NOT INCLUDED IN THE SCRIPPS FY19 COMMUNITY BENEFIT PROGRAMS AND SERVICES TOTALS. (*CALCULATION BASED UPON AN AVERAGE HOURLY WAGE FOR THE SCRIPPS HEALTH SYSTEM PLUS BENEFITS.) UNCOMPENSATED HEALTH CARE SCRIPPS CONTRIBUTES SIGNIFICANT RESOURCES TO PROVIDE LOW AND NO-COST HEALTH CARE FOR OUR PATIENTS IN NEED. DURING FY19, SCRIPPS CONTRIBUTED $404,234,464 IN UNCOMPENSATED HEALTH CARE, INCLUDING $14,767,038 IN CHARITY CARE, $377,559,072 IN MEDI- CAL AND MEDICARE SHORTFALL, AND $11,908,354 IN BAD DEBT. SCRIPPS PROVIDES HOSPITAL SERVICES FOR ONE-QUARTER OF THE COUNTY'S UNINSURED PATIENTS. SCRIPPS MERCY HOSPITAL, SAN DIEGO AND SCRIPPS MERCY HOSPITAL, CHULA VISTA PROVIDE 65 PERCENT OF SCRIPPS' CHARITY CARE. THE HEALTH CARE SAFETY NET IN SAN DIEGO COUNTY IS HIGHLY DEPENDENT UPON HOSPITALS AND COMMUNITY HEALTH CLINICS TO CARE FOR UNINSURED AND MEDICALLY UNDERSERVED COMMUNITIES. FINDING MORE EFFECTIVE WAYS TO COORDINATE AND ENHANCE THE SAFETY NET IS A CRITICAL POLICY CHALLENGE. WHILE PUBLIC SUBSIDIES (E.G., COUNTY MEDICAL SERVICES) HELP FINANCE SERVICES FOR SAN DIEGO COUNTY'S UNINSURED POPULATIONS, THESE SUBSIDIES DO NOT COVER THE FULL COST OF CARE. COMBINED WITH MEDI-CAL AND MEDICARE FUNDING SHORTFALLS, SCRIPPS AND OTHER LOCAL HOSPITALS ABSORB THE COST OF CARING FOR UNINSURED PATIENTS IN THEIR OPERATING BUDGETS. THIS PLACES A SIGNIFICANT FINANCIAL BURDEN ON HOSPITALS AND PHYSICIANS. DEMOGRAPHIC PROFILE OF SAN DIEGO COUNTY CURRENT POPULATION DEMOGRAPHICS AND CHANGES IN DEMOGRAPHIC COMPOSITION OVER TIME PLAY A DETERMINING ROLE IN THE TYPES OF HEALTH AND SOCIAL SERVICES NEEDED BY COMMUNITIES. POPULATION SIZE, CHANGE IN POPULATION, RACE AND ETHNICITY, AND AGE OF A POPULATION ARE ALL IMPORTANT IN UNDERSTANDING COMMUNITIES AND ITS RESIDENTS. SAN DIEGO IS THE SECOND MOST POPULOUS COUNTY IN CALIFORNIA AND FIFTH MOST POPULOUS IN THE UNITED STATES. SAN DIEGO HAS: - CLOSE TO 3.3 MILLION RESIDENTS - MAJORITY MINORITY POPULATION - BUSIEST LAND BORDER CROSSING IN THE WORLD - 1 OF EVERY 13 PEOPLE WHO ENTER THE US COME THROUGH SAN YSIDRO. - 70 MILES OF COASTLINE - 16 NAVAL AND MILITARY INSTALLATIONS - 18 FEDERALLY QUALIFIED RECOGNIZED INDIAN RESERVATIONS - A TOTAL OF 4,526 SQUARE MILES, LARGER THAN RHODE ISLAND AND DELAWARE COMBINED. POPULATION: OVER THREE MILLION PEOPLE (3,337,685) LIVE IN THE 4,526 SQUARE MILE AREA OF SAN DIEGO COUNTY (SDC) ACCORDING TO THE U.S. CENSUS BUREAU AMERICAN COMMUNITY SURVEY 2009-13, 5-YEAR ESTIMATES. THE POPULATION DENSITY FOR THIS AREA, ESTIMATED AT 746 PERSONS PER SQUARE MILE, IS GREATER THAN THE NATIONAL AVERAGE POPULATION DENSITY OF APPROXIMATELY 88 PERSONS PER SQUARE MILE. APPROXIMATELY 96.7% OF THE POPULATION LIVES IN AN URBAN AREA COMPARED TO JUST 3.3% LIVING IN RURAL AREAS. POPULATION CHANGE: ACCORDING TO THE U.S. CENSUS BUREAU DECENNIAL CENSUS, BETWEEN 2000 AND 2010 THE POPULATION IN SDC GREW BY 281,480 PERSONS, A CHANGE OF 10.0%. THIS IS SIMILAR TO THE PERCENTAGE POPULATION CHANGE SEEN DURING THE SAME TIME PERIOD IN CALIFORNIA (10.0%) AND THE UNITED STATES (9.7%). A SIGNIFICANT SHIFT IN TOTAL POPULATION OVER TIME IMPACTS THE DEMAND FOR HEALTH CARE PROVIDERS AND THE UTILIZATION OF COMMUNITY RESOURCES. RACE/ETHNICITY: IN THE AMERICAN COMMUNITY SURVEY, DATA FOR RACE AND ETHNICITY ARE COLLECTED SEPARATELY. OF THOSE WHO IDENTIFIED AS NON-HISPANIC (67.7%) IN SDC, THE MAJORITY IDENTIFIED THEIR RACE AS WHITE (70.9%), FOLLOWED BY ASIAN (16.1%), BLACK (7.1%), MULTIPLE RACES (4.5%), NATIVE HAWAIIAN/PACIFIC ISLANDER (0.6%), AND AMERICAN INDIAN/ALASKAN NATIVE (0.5%). OF THOSE WHO IDENTIFIED AS HISPANIC OR LATINO (32.4%) IN SDC, THE MAJORITY ALSO IDENTIFIED THEIR RACE AS WHITE (72.4%), FOLLOWED BY OTHER (19.9%), MULTIPLE RACES (5.1%), AMERICAN INDIAN/ALASKAN NATIVE (1.1%), BLACK (0.8%), ASIAN (0.6%), AND NATIVE HAWAIIAN/PACIFIC ISLANDER (0.1%). |
| FORM 990, PART III, LINE 4A (CONTINUED) |
SAN DIEGO'S UNINSURED THE LACK OF HEALTH INSURANCE IS A SIGNIFICANT BARRIER TO ACCESSING NEEDED HEALTH CARE AND TO MAINTAINING FINANCIAL SECURITY. BETWEEN 2010 AND 2013 UNINSURED RATE WAS RELATIVELY STABLE IN THE UNITED STATES, CALIFORNIA AND IN SAN DIEGO COUNTY. IN THE PAST, GAPS IN THE PUBLIC INSURANCE SYSTEM AND LACK OF ACCESS TO AFFORDABLE PRIVATE COVERAGE LEFT MILLIONS WITHOUT HEALTH INSURANCE, AND THE NUMBER OF UNINSURED AMERICANS GREW OVER TIME, PARTICULARLY DURING ECONOMIC DOWNTURNS. BY 2013, THE YEAR BEFORE THE MAJOR COVERAGE PROVISIONS OF THE AFFORDABLE CARE ACT (ACA) WENT INTO EFFECT, MORE THAN 44 MILLION NONELDERLY INDIVIDUALS LACKED COVERAGE. UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA), MILLIONS OF CALIFORNIANS HAVE GAINED HEALTH COVERAGE. THESE GAINS HAVE COME EITHER THROUGH THE EXPANSION OF MEDICAID (CALLED MEDI-CAL IN CALIFORNIA) TO LOW INCOME ADULTS EARNING UP TO 138% OF THE FEDERAL POVERTY GUIDELINE (FPG), OR THROUGH COVERED CALIFORNIA, THE STATE'S ACA HEALTH INSURANCE MARKETPLACE, WHERE PEOPLE EARNING UP TO 400% FPG CAN PURCHASE SUBSIDIZED INSURANCE COVERAGE. THE MAJOR COVERAGE EXPANSIONS OF THE ACA WERE IMPLEMENTED STARTING IN 2014, AND BY 2016 THE UNINURED RATE AMONG NONELDERLY CALIFORNIANS HAD FALLEN FROM 15.5% TO A HISTORIC LOW OF 8.5%. (THIS PERCENTAGE INCLUDES CHILDREN). KEY FINDINGS SINCE 2010, GENERALLY ALL AGE GROUPS EXPERIENCED A DECLINE IN THE PERCENT UNINSURED FOR BOTH THE COUNTY AND STATE. THE 18-64 YEAR AGE GROUP EXPERIENCED THE GREATEST DECLINE IN NUMBER OF PEOPLE UNINSURED UNDER THE ACA. FINANCIAL ASSISTANCE ASSISTING LOW-INCOME, UNINSURED PATIENTS ASSISTING LOW-INCOME, UNINSURED PATIENTS THE SCRIPPS FINANCIAL ASSISTANCE POLICY IS CONSISTENT WITH THE LANGUAGE OF BOTH STATE (AB774) CALIFORNIA HOSPITAL FAIR PRICING POLICY LEGISLATION AND THE INTERNAL REVENUE CODE (IRC) 501(R) REGULATIONS. THESE PRACTICES REFLECT OUR COMMITMENT TO ASSISTING LOW-INCOME AND UNINSURED PATIENTS WITH DISCOUNTED HOSPITAL CHARGES, CHARITY CARE AND FLEXIBLE BILLING AND DEBT COLLECTION PRACTICES. THESE PROGRAMS ARE AVAILABLE TO EVERYONE IN NEED, REGARDLESS OF THEIR RACE, ETHNICITY, GENDER, RELIGION OR NATIONAL ORIGIN. SCRIPPS MAKES EVERY EFFORT TO IDENTIFY PATIENTS WHO MAY BENEFIT FROM FINANCIAL ASSISTANCE AS SOON AS POSSIBLE AND PROVIDE COUNSELING AND LANGUAGE INTERPRETATION WHEN NEEDED. IN ADDITION, SCRIPPS DOES NOT APPLY WAGE GARNISHMENT OR LIENS ON PRIMARY RESIDENCES AS A WAY OF COLLECTING UNPAID HOSPITAL BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON FAMILY INCOME AND EXPENSES. FOR LOW-INCOME, UNINSURED PATIENTS WHO EARN LESS THAN TWICE THE FEDERAL POVERTY LEVEL (FPL), SCRIPPS FORGIVES THE ENTIRE BILL. FOR THOSE PATIENTS WHO EARN BETWEEN TWO AND FOUR TIMES THE FPL, A PORTION OF THE BILL IS FORGIVEN. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT CHARGED MORE THAN SCRIPPS' DISCOUNTED FINANCIAL ASSISTANCE AMOUNT. FOR 2020, THE DEPARTMENT OF HEALTH AND HUMAN SERVICES DEFINED A FAMILY OF FOUR AT 200 PERCENT FEDERAL POVERTY LEVEL AS $52,400. PROFESSIONAL EDUCATION & HEALTH RESEARCH QUALITY HEALTH CARE IS HIGHLY DEPENDENT UPON HEALTH EDUCATION SYSTEMS AND MEDICAL RESEARCH PROGRAMS. WITHOUT THE ABILITY TO TRAIN AND INSPIRE A NEW GENERATION OF HEALTH CARE PROVIDERS, OR TO OFFER CONTINUING EDUCATION TO EXISTING HEALTH CARE PROFESSIONALS, THE QUALITY OF HEALTH CARE WILL BE GREATLY DIMINISHED. MEDICAL RESEARCH ALSO PLAYS AN IMPORTANT ROLE IN IMPROVING THE COMMUNITY'S OVERALL HEALTH BY DEVELOPING NEW AND INNOVATIVE TREATMENTS. EACH YEAR, SCRIPPS ALLOCATES RESOURCES TO ADVANCE HEALTH CARE SERVICES THROUGH CLINICAL RESEARCH, MEDICAL EDUCATION AND HEALTH PROFESSIONAL EDUCATION. DURING FISCAL YEAR 2019 (OCTOBER 2018 TO SEPTEMBER 2019), SCRIPPS INVESTED $27,907,934 IN PROFESSIONAL TRAINING PROGRAMS AND CLINICAL RESEARCH TO ENHANCE SERVICE DELIVERY AND TREATMENT PRACTICES IN SAN DIEGO COUNTY. THIS SECTION HIGHLIGHTS SOME OF OUR PROFESSIONAL EDUCATION AND HEALTH RESEARCH ACTIVITIES. HEALTH PROFESSIONS TRAINING STUDENT EXPERIENCES WITHIN SCRIPPS SCRIPPS COMMITMENT TO ONGOING LEARNING AND HEALTH CARE EXCELLENCE EXTENDS BEYOND OUR ORGANIZATION. OUR STUDENT PROGRAMS HELP PROMOTE HEALTH CARE CAREERS TO A NEW GENERATION, SHAPE THE FUTURE WORKFORCE AND DEVELOP FUTURE LEADERS IN OUR COMMUNITY. INTERACTING WITH HEALTH CARE PROFESSIONALS IN THE FIELD EXPANDS EDUCATION OUTSIDE THE CLASSROOM. SCRIPPS EMPLOYEES PLAY AN IMPORTANT ROLE AS PRECEPTORS BY INVESTING THEIR TIME TO CREATE A VALUABLE EXPERIENCE FOR THE COMMUNITY. IN FY19, SCRIPPS HOSTED 1,758 STUDENTS WITHIN OUR SYSTEM AND PROVIDED 266,020 DEVELOPMENT HOURS SPANNING NURSING AND ALLIED HEALTH SETTINGS. COLLEGE AND UNIVERSITY AFFILIATIONS SCRIPPS COLLABORATES WITH LOCAL HIGH SCHOOLS, COLLEGES AND UNIVERSITIES TO HELP STUDENTS EXPLORE HEALTH CARE ROLES AND GAIN FIRSTHAND EXPERIENCE AS THEY WORK WITH SCRIPPS PROFESSIONALS. SCRIPPS IS AFFILIATED WITH MORE THAN 110 SCHOOLS AND PROGRAMS, INCLUDING CLINICAL AND NONCLINICAL PARTNERSHIPS. LOCAL SCHOOLS INCLUDE, BUT ARE NOT LIMITED TO, POINT LOMA NAZARENE UNIVERSITY (PLNU), UNIVERSITY OF CALIFORNIA SAN DIEGO (UCSD), CALIFORNIA STATE UNIVERSITY SAN MARCOS (CSUSM), SAN DIEGO STATE UNIVERSITY (SDSU), UNIVERSITY OF SAN DIEGO (USD), MESA COLLEGE, SAN DIEGO CITY COLLEGE, GROSSMONT COLLEGE, PALOMAR COLLEGE AND MIRA COSTA COLLEGE. SCRIPPS IS REGULARLY ACCEPTING NEW PARTNERSHIPS, BASED ON COMMUNITY AND WORKFORCE NEEDS, AND MAINTAINS AN AFFILIATION AGREEMENT COMMITTEE TO REVIEW ALL REQUESTS AND PROVIDE A SYSTEMWIDE APPROACH TO SECURING NEW STUDENTS PLACEMENTS. THIS INTERDISCIPLINARY COMMITTEE REPRESENTS EDUCATION AND DEPARTMENT LEADERSHIP ACROSS THE SCRIPPS SYSTEM ENSURING A PROACTIVE APPROACH TO BUILDING A CAREER PIPELINE FOR TOP TALENT. TO ENSURE STUDENTS FROM HEALTH CARE PROFESSIONS PROGRAMS HAVE ACCESS TO APPROPRIATE EDUCATIONAL EXPERIENCES AT SCRIPPS AND FOSTER A SMOOTH, EFFICIENT PROCESS FOR STUDENT PLACEMENT REQUESTS RECEIPT AND MANAGEMENT, SCRIPPS IS A MEMBER OF THE SAN DIEGO NURSING AND ALLIED HEALTH SERVICE EDUCATION CONSORTIUM AND AMERICAN DATABANK'S COMPLIO ONLINE COMPLIANCE TRACKING SYSTEM. RESEARCH STUDENTS SCRIPPS SUPPORTS GRADUATE RESEARCH FOR MASTERS AND DOCTORAL STUDENT AT UNIVERSITIES WITH AFFILIATION AGREEMENTS. SCRIPPS TALENT DEVELOPMENT OVERSEES THE STUDENT'S PLACEMENT PROCESS. NON-PHYSICIAN STUDENTS WHO CONDUCT RESEARCH AT SCRIPPS REPRESENT A VARIETY OF HEALTH CARE DISCIPLINES, INCLUDING PUBLIC HEALTH, PHYSICAL THERAPY, PHARMACY AND NURSING. IN FY19, SCRIPPS RESEARCH INCLUDED STUDENTS FROM USD, WESTERN GOVERNORS UNIVERSITY, SDSU, PLNU, LOMA LINDA UNIVERSITY AND POSTDOCTORAL PHARMACY RESIDENCY PROGRAMS, INCLUDING THE PGY1 PHARMACY RESIDENCY PROGRAM. HIGH SCHOOL PROGRAMS SCRIPPS IS DEDICATED TO PROMOTING HEALTH CARE AS A REWARDING CAREER, COLLABORATING WITH SEVERAL HIGH SCHOOLS TO OFFER STUDENT'S OPPORTUNITIES TO EXPLORE A ROLE IN HEALTH CARE AND GAIN FIRSTHAND EXPERIENCE WORKING WITH SCRIPPS HEALTH CARE PROFESSIONALS. BELOW IS A SUMMARY OF THE HIGH SCHOOL PROGRAMS SCRIPPS MADE AVAILABLE TO THE COMMUNITY. SCRIPPS HIGH SCHOOL EXPLORATION PROGRAM-HEALTH AND SCIENCE PIPELINE INITIATIVE (HASPI) THIS PROGRAM REACHES OUT TO SAN DIEGO HIGH SCHOOL STUDENTS INTERESTED IN EXPLORING A CAREER IN HEALTH CARE. IN FY19, 25 STUDENTS PARTICIPATED IN THE PROGRAM. DURING THEIR FIVE-WEEK ROTATION, THE STUDENTS VISITED SCRIPPS MERCY CHULA VISTA, SCRIPPS MERCY SAN DIEGO, SCRIPPS MEMORIAL HOSPITAL LA JOLLA, ENCINITAS AND GREEN HOSPITAL. THE STUDENTS WERE ABLE TO VIEW SURGERIES AND SHADOWING HEALTHCARE PROFESSIONALS IN THE EMERGENCY DEPARTMENT, ICU, PHARMACY, URGENT CARE, INTERNAL MEDICINE, PHARMACY, DEFINITIVE OBSERVATION UNIT, AMBULATORY SERVICES, REHAB THERAPY, PATIENT LOGISTICS, LAB AND TRAUMA. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
UNIVERSITY CITY HIGH SCHOOL COLLABORATION UC HIGH SCHOOL AND SCRIPPS PARTNERED TO PROVIDE A REAL-LIFE CONTEXT TO THE SCHOOL'S HEALTH CARE ESSENTIALS COURSE. FOR FY19, 16 STUDENTS WERE SELECTED TO ROTATE THROUGH FIVE DIFFERENT SCRIPPS LOCATIONS, DURING THE SPRING SEMESTER, TO INCREASE THEIR AWARENESS OF HEALTH CARE CAREERS. UC HIGH STUDENTS WERE EXPOSED TO DIFFERENT DEPARTMENTS, EXPLORING CAREER OPTIONS AND LEARNING VALUABLE LIFE LESSON ABOUT HEALTH AND HEALING. YOUNG LEADERS IN HEALTH CARE AN OUTREACH PROGRAM AT SCRIPPS HOSPITAL ENCINITAS, YOUNG LEADERS IN HEALTH CARE TARGETS LOCAL HIGH SCHOOLS' STUDENTS INTERESTED IN EXPLORING HEALTH CARE CAREERS. STUDENTS IN GRADES 9-12 PARTICIPATE IN THE PROGRAM, WHICH PROVIDES A FORUM FOR HIGH SCHOOL STUDENTS TO LEARN ABOUT THE HEALTH CARE SYSTEM AND ITS CAREER OPPORTUNITIES. THE MISSION OF THE YOUNG LEADERS IN HEALTH CARE IS: - TO PROVIDE A FORUM FOR HIGH SCHOOL'S STUDENTS TO LEARN ABOUT THE HEALTH CARE SYSTEM AND ITS BREADTH OF CAREER OPPORTUNITIES. - MENTOR STUDENTS IN THE ACT OF LEADERSHIP GIVING THEM TOOLS TO USE IN THEIR DAILY LIFE CHALLENGES. - PROVIDE A SERVICE PROJECT TO SATISFY HIGH SCHOOL REQUIREMENTS AND MAKE A POSITIVE IMPACT ON THE COMMUNITY. - PROVIDE A VENUE FOR A STUDENT-RUN COMPETITION WHERE EACH SCHOOL PRESENTS A TOPIC IN LINE WITH THE YEAR'S GOAL. THIS COMBINED EXPERIENCE INCLUDES WEEKLY MEETINGS AT LOCAL SCHOOLS FACILITATED BY TEACHERS AND ADVISORS, AS WELL AS MONTHLY MEETINGS AT SCRIPPS HOSPITAL ENCINITAS. THE PROGRAM MENTORS' STUDENTS ON LEADERSHIP AND PROVIDES TOOLS FOR DAILY CHALLENGES. EACH YEAR THE STUDENTS WORK TOWARD A FINAL PRESENTATION BASED ON THEIR COMMUNITY SERVICE PROJECTS RELATED TO HEALTH CARE AND WELLNESS. THE 2019 CLASS TOUCHED A VARIETY OF TOPICS FROM MENTAL ILLNESS TO THE OPIOID CRISIS. MORE THAN 100 STUDENTS, COMMUNITY MEMBERS AND HEALTH CARE SPECIALISTS ATTENDED THE YOUNG LEADER IN HEALTH CARE FINAL MEETING, CULMINATING WITH STUDENT PRESENTATIONS ON TYPES OF CANCER AND TREATMENTS. STUDENTS THAT PARTICIPATE IN THE PROGRAM ARE ELIGIBLE TO APPLY TO THE HIGH SCHOOL EXPLORER SUMMER INTERNSHIP PROGRAM. THIS YEAR'S 2019 YLHC SERVICE PROJECT PRESENTATION AWARDS WERE GIVEN TO: - 1ST PLACE: MISSION VISTA HIGH SCHOOL FOR THEIR PRESENTATION ON EATING DISORDERS - 1ST PLACE: FRANCIS PARKER HIGH SCHOOL FOR THEIR PRESENTATION ON HOLLYWOOD AND MENTAL ILLNESS - 2ND PLACE: CANYON CREST ACADEMY FOR THEIR PRESENTATION ON LEUKEMIA YOUTH EDUCATIONAL PROGRAM ACTIVITIES SCRIPPS IS ALSO DEDICATED TO PROMOTING HEALTH CARE AS A REWARDING CAREER TO POTENTIAL FUTURE CAREGIVERS THROUGHOUT OUR COMMUNITY. THROUGH SEVERAL INTERNSHIPS AND OTHER EDUCATIONAL PROGRAMS, SCRIPPS COLLABORATES WITH HIGH SCHOOLS TO OFFER STUDENTS OPPORTUNITIES TO EXPLORE A ROLE IN HEALTH CARE AND GAIN FIRSTHAND EXPERIENCE WORKING WITH SCRIPPS HEALTH CARE PROFESSIONALS. OUR NURSES AND OTHER CLINICAL AND NON-CLINICAL EMPLOYEES PLAY IMPORTANT ROLES IN THESE EDUCATIONAL EXPERIENCES, AS THE STUDENTS ARE INTERACTING WITH THEM DAILY THROUGH THE PROGRAMS. SCRIPPS CHULA VISTA COMMUNITY BENEFITS SERVICES IMPLEMENTED A WIDE VARIETY OF YOUTH IN HEALTH CAREER ACTIVITIES INCLUDING: CAMP SCRIPPS, MENTORING PROGRAMS, HOSPITAL TOURS, IN-CLASSROOM PRESENTATIONS AND SURGERY VIEWINGS. SCRIPPS FAMILY MEDICINE RESIDENTS ALSO PROVIDE FOOTBALL GAME COVERAGE, SPORT INJURY CLINICS AND PHYSICALS. A TOTAL OF 2,281 YOUTH PARTICIPATED IN THESE PROGRAMS. CAMP SCRIPPS DESIGNED TO INTRODUCE YOUTH TO HEALTH CAREERS, THIS PROGRAM IS A THREE-WEEK CAMP EXPERIENCE TO EDUCATE YOUTH PARTICIPANTS ON THE DUTIES PERFORMED BY HEALTH CARE PROFESSIONALS IN VARIOUS MEDICAL FIELDS. PARTICIPANTS RECEIVE OPPORTUNITIES FOR INTERACTIONS WITH THE HEALTH PROFESSIONALS. CAMP ACTIVITIES INCLUDE TOURS OF HOSPITAL DEPARTMENTS, HANDS-ON ACTIVITIES WITH HEALTH CARE PROFESSIONALS AND PRESENTATIONS ON SPECIFIC HEALTH CAREERS AND/OR HEALTH-RELATED ISSUES. EXAMPLES OF ACTIVITIES INCLUDE VISITS TO THE LABORATORY, RADIOLOGY, NURSING UNITS AND THE CATH LAB. FAMILY MEDICINE RESIDENTS PROVIDE A VARIETY OF PRESENTATIONS AND INTERACTION ACTIVITIES FOR THE YOUTH. SOME OF THESE INCLUDE "DOC 101VISITS TO SPECIFIC HOSPITAL DEPARTMENTS. MENTORING PROGRAM DESIGNED TO HELP HIGH SCHOOL STUDENTS SET A COURSE FOR A SUCCESSFUL CAREER IN HEALTH CARE, PARTICIPANTS ARE PAIRED WITH VARIOUS HEALTH AND SOCIAL SERVICE PROFESSIONALS FOR HOURLY SESSIONS TWICE A WEEK FOR FIVE WEEKS IN THE HOSPITAL SETTING. STUDENTS ARE EXPOSED TO A VARIETY OF DUTIES AND ROLES AND VARIOUS DEPARTMENTS. STUDENTS LEARN FIRST-HAND FROM THEIR MENTORS ABOUT THE PARTICULARS OF THAT DEPARTMENT AND POSITION INCLUDING THE PATH THEY NEED TO TAKE IN ORDER TO ACHIEVE A CAREER GOAL. STUDENTS ALSO RECEIVE PRESENTATIONS ON VARIOUS HEALTH CAREERS AND JOB READINESS. FAMILY MEDICINE RESIDENTS ARE MENTORS FOR THIS PROGRAM AND MEET WITH THE STUDENTS EACH WEEK. STUDENTS WILL SHADOW RESIDENTS DURING ROUNDS AND THROUGHOUT THE EXPERIENCE. HEALTH PROFESSIONALS IN THE CLASSROOM HEALTH CARE PROFESSIONALS, SUCH AS MEDICAL RESIDENTS, DIETICIANS, NURSES AND DOCTORS, ENLIGHTEN STUDENTS ON HEALTH CARE CAREERS AND HEALTH RELATED TOPICS. THESE ARE INTERACTIVE SESSIONS ON NURSING 101, DOC 101, HEALTH AND NUTRITION, STROKE PREVENTION, BREAST HEALTH, TEEN PREGNANCY, SUBSTANCE USE, STDS, HEALTH PROFESSIONS 101 AND MENTAL HEALTH ISSUES THAT IMPACT HIGH SCHOOL STUDENTS. STUDENTS RECEIVE HEALTH CAREER TOOLS/BROCHURES THAT INCLUDE INFORMATION ON EDUCATION REQUIREMENTS, SCHOLARSHIPS AND WAY TO PAY FOR COLLEGE. FAMILY MEDICINE RESIDENTS THROUGHOUT THE YEAR WILL PRESENT IN THE CLASSROOM. SURGERY VIEWING INTERESTED STUDENTS HAVE AN OPPORTUNITY TO OBSERVE ELECTIVE SURGERIES SUCH AS TOTAL KNEE AND HIP REPLACEMENTS. STUDENTS ARE ABLE TO INTERACT AND TO ASK ON THE SPOT QUESTIONS WITH THE SURGEONS AND OTHER OPERATING ROOM STAFF MEMBERS. SCHOOL BASED CLINICS THREE HEALTH CLINICS AT PALOMAR, SOUTHWEST HIGH SCHOOL AND HOOVER HIGH SCHOOL ARE ESTABLISHED FOR MEDICAL RESIDENTS TO GAIN ADDITIONAL SKILLS IN ADOLESCENT MEDICINE AND FOR YOUTH TO GAIN THE KNOWLEDGE, ATTITUDES, AND SKILLS NECESSARY TO PURSUE HEALTH CAREERS. DESIGNED BY STUDENTS, FAMILY MEDICINE RESIDENTS AND FACULTY BASED ON YOUTH NEEDS ASSESSMENT SURVEYS, RESIDENTS AND STUDENTS INTERACT TWICE PER WEEK AT THE CLINIC PROVIDING ADOLESCENT MEDICINE. HEALTH CAREERS PROMOTION AND CONTINUING EDUCATION, SAN DIEGO BORDER AREA HEALTH EDUCATION CENTER (SAN DIEGO BORDER AHEC) THE PRIMARY MISSION OF THE SAN DIEGO BORDER AHEC PROGRAM IS TO BUILD AND SUPPORT A DIVERSE, CULTURALLY COMPETENT PRIMARY HEALTH CARE WORKFORCE IN SAN DIEGO'S MEDICALLY UNDERSERVED COMMUNITIES. DURING THE 2018-2019 FISCAL YEAR THE PROGRAM CONTINUED TO IMPROVE HEALTH CARE ACCESS, EDUCATION, JOB TRAINING AND PLACEMENT FOR YOUTH AND ADULTS IN SOUTHERN SAN DIEGO COUNTY. A PRIMARY FOCUS IS IMPLEMENTING SCHOOL TO HEALTH CAREER ACTIVITIES, INCLUDING MENTORING, CAMPS, JOB SHADOWING, HEALTH EDUCATION CLASSES, HEALTH CHATS, SUPPORT GROUPS, HEALTH FAIRS AND OTHERS. SCRIPPS WHITTIER DIABETES INSTITUTE AND SCRIPPS HUB ACADEMIC RESEARCH CORE (SHARC) THE SCRIPPS HUB ACADEMIC RESEARCH CORE (SHARC) TEAM IS A PARTNERSHIP BETWEEN THE SCRIPPS RESEARCH TRANSLATIONAL INSTITUTE AND SCRIPPS HEALTH (HOUSED IN THE SCRIPPS WHITTER DIABETES INSTITUTE). THE SCRIPPS HUB IS ONE OF 60 SITES AROUND THE COUNTRY THAT ARE SUPPORTED BY THE NIH'S CLINICAL AND TRANSLATIONAL SCIENCE AWARD (CTSA), WITH A FOCUS ON IMPROVING THE PROCESS OF TRANSLATING RESEARCH FROM BENCH-SIDE TO PRACTICE. WITHIN THIS HUB, THE SHARC TEAM AIMS TO SUPPORT TRANSLATIONAL RESEARCH AT SCRIPPS HEALTH AND THE SCRIPPS RESEARCH TRANSLATIONAL INSTITUTE IN THE FOLLOWING WAYS: - RESEARCH NAVIGATION - PROVIDE ASSISTANCE THROUGH THE GRANT PROCESS (FROM PRE- TO POST-AWARD) AND WITH RESEARCH IMPLEMENTATION, ESPECIALLY FOR JUNIOR OR NEW INVESTIGATORS. - STATISTICAL SUPPORT - PROVIDE STATISTICAL SUPPORT FOR DESIGNING THE STUDY, FROM SAMPLE SIZE AND POWER CALCULATIONS THROUGH DATA ANALYSIS AND PRESENTATION. - COMMUNITY ENGAGEMENT - ENCOURAGE BIDIRECTIONAL COMMUNICATION BETWEEN COMMUNITIES AND RESEARCHERS TO FOSTER PARTICIPATION IN RESEARCH, SHARING AND DISCUSSION OF RESEARCH QUESTIONS AND FINDINGS, AND IMPROVE COMMUNITY HEALTH. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
SCRIPPS HEALTH GRADUATE MEDICAL EDUCATION A KEY COMPONENT OF SCRIPPS' MISSION IS TO ADVANCE THE EDUCATION OF PHYSICIANS AND HEALTH CARE PROFESSIONALS AND SPONSOR GRADUATE MEDICAL EDUCATION. BY INVESTING IN THESE AREAS, WE HELP SECURE QUALITY CARE FOR OUR COMMUNITY. SCRIPPS HAS BEEN TRAINING FUTURE PHYSICIANS LONGER THAN ANY OTHER INSTITUTION IN SAN DIEGO. FOR MORE THAN 70 YEARS PHYSICIANS IN SCRIPPS GRADUATE MEDICAL EDUCATION PROGRAMS HAVE HELPED CARE FOR UNDERSERVED POPULATIONS THROUGHOUT THE REGION. SCRIPPS HAS A COMPREHENSIVE RANGE OF GRADUATE MEDICAL EDUCATION PROGRAMS AT SCRIPPS MERCY HOSPITAL, SCRIPPS FAMILY PRACTICE RESIDENCY PROGRAM AND SCRIPPS GREEN HOSPITAL. SCRIPPS GRADUATE MEDICAL EDUCATION PROGRAMS ARE WELL-KNOWN FOR EXCELLENCE, PROVIDE A HANDS-ON CURRICULUM THAT FOCUSES ON PATIENT-CENTERED CARE AND OFFER RESIDENCIES IN A VARIETY OF PRACTICES, INCLUDING INTERNAL MEDICINE, FAMILY MEDICINE, PODIATRY, PHARMACY AND PALLIATIVE CARE. IN FY19, SCRIPPS HAD A TOTAL OF 143 RESIDENTS AND 43 FELLOWS ENROLLED THROUGHOUT THE SCRIPPS HEALTH SYSTEM. MORE DETAILS ON THESE PROGRAMS ARE INCLUDED IN SECTION EIGHT AND NINE OF THE COMMUNITY BENEFIT REPORT. IN ADDITION, SCRIPPS HAS A PHARMACY RESIDENCY PROGRAM WHICH TRAIN RESIDENTS WITH DOCTOR OF PHARMACY DEGREES. UCSD/SCRIPPS HEALTH HOSPICE AND PALLIATIVE MEDICINE FELLOWSHIP PROGRAM THE UCSD/SCRIPPS HEALTH HOSPICE AND PALLIATIVE MEDICINE FELLOWSHIP PROGRAM IS A ONE-YEAR PROGRAM DESIGNED FOR PHYSICIANS WHO WISH TO BECOME SUB-SPECIALISTS AND HAVE A LONG-TERM CAREER IN HOSPICE AND PALLIATIVE MEDICINE. THIS IS A UNIQUE PARTNERSHIP IN WHICH UCSD AND SCRIPPS HEALTH SHARE RESPONSIBILITY FOR THE FELLOWS, WITH TRAINEES SPENDING EQUAL TIME IN BOTH INSTITUTIONS WITH ALL THE BENEFITS OF BOTH INSTITUTIONS. THE FELLOWSHIP PREPARES TRAINEES TO WORK IN A VARIETY OF ROLES, INCLUDING LEADERSHIP POSITIONS IN THE FIELD. GRADUATES HAVE SUCCESSFULLY BECOME HOSPICE MEDICAL DIRECTORS AND PALLIATIVE MEDICINE CONSULTANTS IN OUTPATIENT AND INPATIENT SETTINGS ACROSS THE UNITED STATES. FELLOWS WHO COMPLETE THE UCSD/SCRIPPS HEALTH PROGRAM ARE WELL EQUIPPED TO PRACTICE IN DIVERSE SETTINGS, INCLUDING ACUTE PALLIATIVE CARE UNITS, INPATIENT CONSULTATION, OUTPATIENT CONSULTATION, PATIENTS' HOMES, AND LONG-TERM CARE FACILITIES. |
| FORM 990, PART VI, LINE 11 |
990 REVIEW PROCESS WITH THE GOVERNING BODY THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM WITH THE SUPPORT OF THE CORPORATE FINANCE TEAM WITH INPUT FROM HUMAN RESOURCES, FOUNDATION, AND LEGAL OFFICE. THE FORM 990 WAS REVIEWED BY THE PRESIDENT, LEGAL COUNSEL, CHIEF FINANCIAL OFFICER, AUDIT COMMITTEE, HUMAN RESOURCES AND COMPENSATION COMMITTEE PRIOR TO FILING. IN ADDITION, A FULL COPY OF THE 990 WAS PROVIDED TO THE BOARD OF TRUSTEES VIA EMAIL IN ADVANCE OF FILING FORM 990 WITH THE IRS. |
| FORM 990, PART VI, LINE 12C |
COMPLIANCE POLICY MONITORING WITHIN 60 DAYS OF HIRE AND ANNUALLY THEREAFTER ALL SUPERVISORS AND ABOVE; ALL EMPLOYEES IN THE SUPPLY CHAIN MANAGEMENT DEPARTMENT, AUDIT & COMPLIANCE SERVICES DEPARTMENT, AND CASE MANAGEMENT DEPARTMENT OR FUNCTION; AND ANY OTHER EMPLOYEE WHO IS IN A POSITION TO REFER PATIENTS THAT ARE FEDERALLY FUNDED HEALTHCARE BENEFICIARIES TO OTHER PROVIDERS AND SERVICES; AND OTHERS AS DETERMINED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE WILL BE REQUIRED TO COMPLETE AND SIGN THE CONFLICT OF INTEREST COMMITMENT DISCLOSURE FORM. IT IS THE RESPONSIBILITY OF ANY EMPLOYEE WHO HAS A CHANGE IN OUTSIDE PROFESSIONAL ACTIVITIES, SIGNIFICANT FINANCIAL INTERESTS, OR POTENTIAL OR ACTUAL CONFLICT OF INTEREST, OR COMMITMENT SITUATIONS THAT ARISE DURING THE YEAR TO DISCLOSE THE INFORMATION TO THEIR SUPERVISORS AS SOON AS THE EMPLOYEE BECOMES AWARE OF THE POTENTIAL OR ACTUAL SITUATION CREATING A POSSIBLE CONFLICT OF INTEREST OR CONFLICT COMMITMENT. SUPERVISORS WILL ASSESS THE SITUATION AND REFER TO THEIR BUSINESS UNIT MANAGEMENT AND/OR THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE, AS APPROPRIATE. IN ADDITION, EACH PERSON ENTRUSTED WITH A POSITION OF RESPONSIBILITY IN THE GOVERNANCE AND MANAGEMENT IS REQUIRED TO COMPLETE AND SUBMIT DISCLOSURE STATEMENTS AS FOLLOWS: 1. INITIAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT (INITIAL DISCLOSURES) 2. ANNUAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT 3. SUBSEQUENT OCCURRENCES REPORTING UPON THE OCCURRENCE OF ANY NEW POTENTIAL CONFLICT OF INTEREST ACTUAL OR POTENTIAL CONFLICT DISCLOSURES REGARDING EMPLOYEES ARE REVIEWED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE. DISCLOSURES REQUIRING MITIGATION ARE DISCUSSED WITH THE BUSINESS UNIT CHIEF EXECUTIVE AND EMPLOYEE'S SUPERVISOR. LEGAL COUNSEL REVIEWS EACH BOARD OF TRUSTEES MEETING AGENDA PRIOR TO THE MEETING AND POTENTIAL CONFLICTS OF INTERESTS ARE IDENTIFIED, CONSIDERED AND AN APPROPRIATE COURSE OF ACTION IS DETERMINED BY THE MEMBER AND LEGAL COUNSEL WITH THE INVOLVEMENT OF THE PRESIDENT AND BOARD CHAIR, WHERE APPROPRIATE. COURSE OF ACTION MAY INCLUDE THE CONFLICTED BOARD MEMBER RECUSING THEMSELVES, ABSTAINING FROM VOTING AND/OR READING A STATEMENT INTO THE BOARD MINUTES REGARDING SUCH CONFLICT. AS IT RELATES TO BOARD OF TRUSTEES, WHEN A DETERMINATION IS THAT AN ACTUAL CONFLICT OF INTEREST EXISTS AND A COVERED INDIVIDUAL IS AN "INTERESTED PERSON" UNDER CALIFORNIA LAW, THE TRANSACTION BEING CONSIDERED WILL COMPLY WITH APPLICABLE STATUTORY REQUIREMENTS TO AVOID PARTICIPATION IN THE DECISION MAKING PROCESS BY THE COVERED INDIVIDUAL. THE MINUTES OF BOARD MEETINGS SHALL DOCUMENT ALL RECUSALS FROM DISCUSSION AND VOTING. |
| FORM 990, PART VI, LINES 15A & 15B |
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN PURSUANT TO PROCEDURES REQUIRED BY TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1983 (TEFRA), SCRIPPS HEALTH'S PROCEDURES ARE AS FOLLOWS: THE BOARD OF TRUSTEES REVIEWS EXECUTIVE COMPENSATION FOR OFFICERS AND ALL KEY EMPLOYEES ON AN ANNUAL BASIS UTILIZING COMPARABILITY DATA OBTAINED BY AN EXTERNAL CONSULTANT. IT IS THE PHILOSOPHY OF THE SCRIPPS BOARD OF TRUSTEES TO COMPENSATE THE CORPORATION'S EXECUTIVES FAIRLY RELATIVE TO THE MEDIAN COMPENSATION OF PEER ORGANIZATIONS, CONSIDERING AND MAKING APPROPRIATE ADJUSTMENTS FOR THE COST OF LIVING IN SAN DIEGO, CALIFORNIA AND OTHER RELEVANT FACTORS. TO ACCOMPLISH THIS, THE BOARD HAS ADOPTED A PHILOSOPHY OF TARGETING EXECUTIVE SALARIES AT APPROXIMATELY THE 65TH PERCENTILE OF A NATIONAL PEER GROUP OF ORGANIZATIONS AS DETERMINED THROUGH AN INDEPENDENT OUTSIDE CONSULTANT ENGAGED BY THE BOARD AND WILL RELY ON THEIR RECOMMENDATIONS USING A DATABASE OF INDEPENDENTLY COLLECTED DATA. THE PHILOSOPHY STATES: -FOR PURPOSES OF EXECUTIVE COMPENSATION COMPARISONS, SCRIPPS WILL USE A NATIONAL PEER GROUP OF MEDICAL DELIVERY SYSTEMS OF SIMILAR REVENUE SIZE AND COMPLEXITY. THE PEER GROUP WILL BE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. - SALARIES ARE TARGETED AT APPROXIMATELY THE 65TH PERCENTILE OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. - TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE OF THE PEER GROUP WHEN MAXIMUM LEVEL INCENTIVES ARE PAID FOR ACHIEVEMENT OF MAXIMUM LEVEL OF PREDETERMINED OBJECTIVES AGREED UPON BY THE BOARD. - THE BOARD SELECTS THE 65TH PERCENTILE FOR BASE COMPENSATION OF PEER GROUP ADJUSTED FOR COST OF LIVING OF URBAN WEST COAST MARKET AT THE 50TH PERCENTILE (I.E. THE 50TH PERCENTILE OF CALIFORNIA MARKET IS THE 65TH PERCENTILE OF NATIONAL PEER MARKET AS OUR EXECUTIVE RECRUITMENT MARKET IS NATIONAL). - ANNUALLY, TOTAL CASH COMPENSATION FOR EACH POSITION WILL NOT EXCEED THE BASE SALARY ESTABLISHED FOR THE PERIOD PLUS THE MAXIMUM INCENTIVE PERCENTAGE PAYOUT ALLOWABLE AS DETERMINED BY THE SCRIPPS MANAGEMENT INCENTIVE PLAN APPROVED BY THE BOARD OF TRUSTEES FOR THE RESPECTIVE POSITION. THE REPORT FROM THE EXTERNAL CONSULTANT ENGAGED TO REVIEW EXECUTIVE COMPENSATION IS PRESENTED TO THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ON AN ANNUAL BASIS AND THE MOST RECENT REPORT WAS REVIEWED ON JANUARY 30, 2019 AND MARCH 27, 2019. REVIEW AND DISCUSSION OF SUCH REPORT IS DOCUMENTED IN THE MINUTES. |
| FORM 990, PART VI, LINE 16 |
JOINT VENTURES SCRIPPS HEALTH HAS MAINTAINED A LONG STANDING PRACTICE OF REVIEWING ALL POTENTIAL JOINT VENTURE OR SIMILAR ARRANGEMENTS TO ENSURE THAT CONTRACT TERMS ARE CONSISTENT WITH THE PROTECTION OF ITS TAX-EXEMPT STATUS. |
| FORM 990, PART VI, LINE 19 |
AVAILABILITY OF DOCUMENTS TO THE GENERAL PUBLIC FINANCIAL STATEMENTS ARE POSTED QUARTERLY ON THE DAC (DIGITAL ASSURANCE CERTIFICATION) WEBSITE AND THE MUNICIPAL SECURITIES RULEMAKING BOARD'S (MSRB) ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE IN SATISFACTION OF CONTINUING DISCLOSURE REQUIREMENTS RELATING TO THE ORGANIZATION'S TAX-EXEMPT DEBT ISSUANCES. THE AUDITED FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990, IN ACCORDANCE WITH THE IRS INSTRUCTIONS. SCRIPPS HEALTH'S CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9 |
OTHER CHANGES IN NET ASSETS JOINT VENTURES DISTRIBUTION 1,680,869 OTHER CHANGES IN NET ASSETS 365,281 CHANGE IN VALUE IN DEFERRED GIFTS (904,940) ROUNDING (34,524) ------------ TOTAL 1,106,686 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:PHYS FEES-PROVIDER SVS AGRMENT TOTAL FEES:XXX-XX-XXXX |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:OTHER PURCHASED SVS - NON MED TOTAL FEES:83811926 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:PHYSICIAN FEES TOTAL FEES:58284827 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:PUCHASED MEDICAL SERVICES TOTAL FEES:29464851 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:ALL OTHER FEES FOR SERVICES TOTAL FEES:29503755 |
Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.