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FORM 990 SCHEDULE H PART V, SECTION C:
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCOMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY BENEFITS MISSION STATEMENT BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM'S (BID NEEDHAM) MISSION IS TO PROVIDE SAFE, HIGH-QUALITY, COMMUNITY-BASED HEALTHCARE AND ACCESS TO TERTIARY CARE AS A MEMBER OF BETH ISRAEL LAHEY HEALTH, REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, ETHNICITY, RELIGION, GENDER, GENDER IDENTITY, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, GENETICS OR DISABILITY. THIS COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING BID NEEDHAM'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY; ENGAGING RESIDENTS THROUGHOUT THE HOSPITAL'S SERVICE AREAS IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, INCLUDING ASSESSMENT, PLANNING, IMPLEMENTATION AND EVALUATION. SPECIAL ATTENTION IS FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES; ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO IDENTIFY UNMET HEALTH-RELATED NEEDS AND TO CHARACTERIZE THOSE IN THE COMMUNITY WHO ARE MOST VULNERABLE AND FACE DISPARITIES IN ACCESS AND OUTCOMES; IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN BID NEEDHAM'S SERVICE AREA GEARED TOWARD IMPROVING CURRENT AND FUTURE HEALTH STATUS OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY REMOVING BARRIERS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, STRENGTHENING THE HEALTHCARE SYSTEM AND WORKING TO DECREASE THE BURDEN OF THE LEADING HEALTH ISSUES; PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS SUMMARYDURING THE FISCAL YEAR COVERED BY THIS FILING, BID NEEDHAM PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $456,145 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMBID NEEDHAM FORMED A COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND COMMUNITY BENEFITS LEADERSHIP TEAM IN FY19 TO WORK IN PARTNERSHIP WITH RESIDENTS; COMMUNITY LEADERS; AND CIVIC, SOCIAL AND MEDICAL ORGANIZATIONS IN THE COMMUNITIES THE HOSPITAL SERVES.THE MEMBERSHIP OF BID NEEDHAM'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY POPULATIONS OF BID NEEDHAM'S PROGRAMMATIC ENDEAVORS INCLUDING THOSE FROM DIVERSE RACIAL AND ETHNIC BACKGROUNDS, AGE, GENDER, SEXUAL ORIENTATION AND GENDER IDENTITY, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. SENIOR MANAGEMENT IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY BENEFITS PLAN, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES.
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COMMUNITY HEALTH NEEDS ASSESSMENT
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MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE (IRC) SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN 2019. THAT CHNA WAS APPROVED BY THE BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM BOARD OF TRUSTEES ON SEPTEMBER 5, 2019. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD ON SEPTEMBER 5, 2019, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY (IS) ARE THE CULMINATION OF A YEAR OF PLANNING AND WORKING WITH JOHN SNOW, INC. AND WERE BORNE LARGELY OF BID NEEDHAM'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS COMMONWEALTH ATTORNEY GENERAL'S OFFICE (AGO) AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS WHICH REQUIRE THAT BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY2019 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONSAS NOTED ABOVE, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM COMPLETED ITS LAST ASSESSMENT IN 2019. BID NEEDHAM'S PRIMARY COMMUNITY BENEFITS SERVICE AREA (CBSA) INCLUDES THE TOWNS OF DEDHAM, DOVER, NEEDHAM, AND WESTWOOD. TARGET POPULATIONS FOR BID NEEDHAM'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS AND A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM'S TARGET POPULATIONS FOCUS ON MEDICALLY UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES THROUGHOUT ITS SERVICE AREA, BUT BASED ON THE ASSESSMENT WILL PRIORITIZE CERTAIN DEMOGRAPHIC AND SOCIO-ECONOMIC SEGMENTS OF THE POPULATION THAT HAVE COMPLEX NEEDS OR FACE ESPECIALLY SIGNIFICANT BARRIERS TO CARE, SERVICE GAPS OR ADVERSE SOCIAL DETERMINANTS OF HEALTH THAT PUT THEM AT GREATER RISK, INCLUDING: YOUTH OLDER ADULTS LOW- TO MODERATE-INCOME INDIVIDUALS AND FAMILIES INDIVIDUALS WITH CHRONIC AND COMPLEX CONDITIONSBID NEEDHAM'S PROGRAMS MIRROR THE FIVE CORE PRINCIPLES OUTLINED BY THE PUBLIC HEALTH INSTITUTE IN TERMS OF THE "EMPHASIS ON COMMUNITIES WITH DISPROPORTIONATE UNMET HEALTH-RELATED NEEDS; EMPHASIS ON PRIMARY PREVENTION; BUILDING A SEAMLESS CONTINUUM OF CARE; BUILDING COMMUNITY CAPACITY; AND COLLABORATIVE GOVERNANCE." PROGRAMS DEVELOPED WILL AIM TO ADDRESS AND IMPROVE UPON THE FOLLOWING PRIORITY AREAS: MENTAL HEALTH AND SUBSTANCE USE SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS2019 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSBID NEEDHAM CONDUCTED THIS CHNA PROCESS IN CONJUNCTION WITH BETH ISRAEL DEACONESS MEDICAL CENTER, WHICH SERVED AS THE SOLE MEMBER OF BID NEEDHAM UNTIL MARCH 1, 2019, AS WELL AS WITH BID MILTON AND BID PLYMOUTH, HOSPITALS FOR WHICH THE MEDICAL CENTER ALSO SERVED AS SOLE MEMBER. ALTHOUGH THE PROCESS WAS JOINTLY CONDUCTED, EACH HOSPITAL PRODUCED ITS OWN CHNA AND IMPLEMENTATION STRATEGY (SCHEDULE H, PART V, SECTION B, QUESTIONS 6A AND 6B).THE BID NEEDHAM CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. BID NEEDHAM HIRED JOHN SNOW, INC., TO CONDUCT AND MANAGE THE CHNA PROCESS UNDERTAKEN DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND JSI WORKED CLOSELY WITH BID NEEDHAM COMMUNITY BENEFITS STAFF THROUGHOUT THE PROCESS. THE MOST RECENT CHNA WAS DESIGNED AS A THREE-PHASE PROCESS: PHASE ONE INVOLVED PRELIMINARY ASSESSMENT AND ENGAGEMENT ACTIVITIES, INCLUDING: COLLECTION AND ANALYSIS OF QUANTITATIVE DATA TO CHARACTERIZE COMMUNITY CHARACTERISTICS AND DISEASE BURDEN KEY INFORMANT INTERVIEWS WITH HOSPITAL LEADERSHIP, LOCAL SERVICE PROVIDERS, AND COMMUNITY STAKEHOLDERS AN EVALUATION OF BID NEEDHAM'S CURRENT PORTFOLIO OF COMMUNITY BENEFITS ACTIVITIES PHASE TWO INVOLVED TARGETED ENGAGEMENT ACTIVITIES, INCLUDING: FOCUS GROUPS WITH HOSPITAL LEADERSHIP, CLINICAL PROVIDERS, COMMUNITY STAKEHOLDERS AND RESIDENTS A COMMUNITY MEETING WITH RESIDENTS, SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, AND OTHER COMMUNITY STAKEHOLDERS FROM THE CBSA DISSEMINATION AND ANALYSIS OF A COMMUNITY HEALTH SURVEY TO CAPTURE RESIDENTS' PERCEPTIONS OF BARRIERS TO GOOD HEALTH, LEADING HEALTH ISSUES, VULNERABLE POPULATIONS, ACCESSIBILITY OF HEALTH SERVICES, AND OPPORTUNITIES FOR THE HOSPITAL TO IMPROVE THE SERVICES THEY OFFER TO THE COMMUNITY PHASE THREE INVOLVED A SERIES OF STRATEGIC PLANNING AND REPORTING ACTIVITIES, INCLUDING: MEETINGS WITH THE CBAC AND BIDNEEDHAM'S COMMUNITY BENEFITS LEADERSHIP TEAM (INCLUDING MEMBERS OF THE BOARD OF DIRECTORS) TO PRESENT CHNA FINDINGS, PRIORITIZE COMMUNITY HEALTH ISSUES, IDENTIFY VULNERABLE POPULATIONS, AND DISCUSS POTENTIAL RESPONSES CREATION OF A RESOURCE INVENTORY TO CATALOGUE LOCAL ORGANIZATIONS, SERVICE PROVIDERS, AND COMMUNITY ASSETS THAT HAVE THE POTENTIAL TO ADDRESS IDENTIFIED NEEDS LITERATURE REVIEW OF EVIDENCE-BASED STRATEGIES TO RESPOND TO IDENTIFIED HEALTH PRIORITIES DEVELOPMENT OF FINAL A COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSTHE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS INFORMATION FROM THE DISSEMINATION AND ANALYSIS OF A COMMUNITY HEALTH SURVEY TO CAPTURE RESIDENTS' PERCEPTIONS OF BARRIERS TO GOOD HEALTH, LEADING HEALTH ISSUES, VULNERABLE POPULATIONS, ACCESSIBILITY OF HEALTH SERVICES AND OPPORTUNITIES FOR THE HOSPITAL TO IMPROVE THE SERVICES THEY OFFER TO THE COMMUNITY. QUANTITATIVE DATA FROM A BROAD RANGE OF SOURCES WAS COLLECTED AND ANALYZED TO CHARACTERIZE COMMUNITIES IN BIDNEEDHAM'S CBSA, MEASURE HEALTH STATUS, AND INFORM A COMPREHENSIVE UNDERSTANDING OF THE HEALTH-RELATED ISSUES. SOURCES INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017) MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2017, AND 2018-2019) FBI UNIFORM CRIME REPORTS (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, ANNUAL REPORTS ON BIRTHS (2016) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2017) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY 2013-2017) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018) BETH ISRAEL DEACONESSNEEDHAM: COMMUNITY HEALTH NEEDS ASSESSMENT 2019 TO AUGMENT THE QUANTITATIVE DATA THAT WAS COMPILED FROM MDPH, JSI WORKED WITH THE MASSACHUSETTS HEALTH DATA CONSORTIUM (MHDC) AND THE MASSACHUSETTS CENTER FOR HEALTH INFORMATION AND ANALYSIS (CHIA) TO OBTAIN 2017 INPATIENT HOSPITAL DISCHARGE DATA FOR ALL OF THE MUNICIPALITIES IN BID NEEDHAM'S SERVICE AREA. CHIA AGGREGATES DETAILED HOSPITAL INPATIENT DATA FROM ALL HOSPITALS IN MASSACHUSETTS AND MAKES IT AVAILABLE TO HOSPITALS AND OTHER RESEARCHERS TO UNDERSTAND MORBIDITY, MORTALITY, AND HEALTH SERVICES UTILIZATION TRENDS. THESE DATA ARE MADE AVAILABLE ON AN ANNUAL BASIS AND ALLOW FOR BOTH HOSPITAL-SPECIFIC ANALYSES BASED ON WHERE THE PATIENT WAS HOSPITALIZED AS WELL AS PATIENT ORIGIN ANALYSES BASED ON THE PATIENT'S ADDRESS OF RESIDENTS. RELATED TO THE CHNA ACTIVITIES, THESE DATA WERE USED TO IDENTIFY THE LEADING CAUSES OF ILLNESS FOR ADULTS (18+) BY MUNICIPALITY BASED ON A REVIEW OF SELECTED DIAGNOSTIC CATEGORIES.
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2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS KEY INFORMANT INTERVIEWS
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KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)JSI CONDUCTED 14 KEY INFORMANT INTERVIEWS WITH COMMUNITY STAKEHOLDERS. INTERVIEWEES INCLUDED REPRESENTATIVES FROM PUBLIC HEALTH DEPARTMENTS, LEGISLATORS, CLINICAL PROVIDERS, ELDER SERVICE PROVIDERS, BEHAVIORAL HEALTH PROVIDERS AND FIRST RESPONDERS. KEY INFORMANT INTERVIEWS WERE DONE TO CONFIRM AND REFINE FINDINGS FROM SECONDARY DATA, TO PROVIDE COMMUNITY CONTEXT AND TO CLARIFY NEEDS AND PRIORITIES OF THE COMMUNITY. JSI WORKED WITH BID NEEDHAM TO IDENTIFY A REPRESENTATIVE GROUP OF INTERVIEWEES. INTERVIEWS WERE 30-60 MINUTES LONG AND WERE CONDUCTED BY PHONE USING A STRUCTURED INTERVIEW GUIDE CREATED BY JSI. DETAILED NOTES WERE TAKEN FOR EACH INTERVIEW. APPENDIX A IN THE 2019 CHNA PROVIDES DETAILS ON INTERVIEWEES, INTERVIEW DATES, THE INTERVIEW GUIDE AND A SUMMARY OF FINDINGS.2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)JSI FACILITATED FOUR FOCUS GROUPS WITH HOSPITAL LEADERSHIP, CLINICAL PROVIDERS AND OLDER ADULT RESIDENTS AT THE NEEDHAM SENIOR CENTER. THE NEEDHAM HEALTH DEPARTMENT, WORKING IN COLLABORATION WITH BID NEEDHAM, FACILITATED FOCUS GROUPS WITH THE INTERFAITH CLERGY ASSOCIATION AND THE YOUTH RESOURCE NETWORK (TWO ORGANIZATIONS THAT WORK DIRECTLY WITH UNDERSERVED POPULATIONS IN THE CBSA), AS WELL AS PROVIDERS WHO SERVE OLDER ADULTS. BID NEEDHAM WORKED WITH THE NEEDHAM HEALTH DEPARTMENT TO ENSURE THAT QUESTIONS FOR THE NEEDS ASSESSMENT WERE INCORPORATED INTO THEIR FOCUS GROUP GUIDE. NOTES WERE SHARED BETWEEN THE TWO ORGANIZATIONS TO INFORM ONE ANOTHER'S PROCESSES. FOCUS GROUPS ALLOWED FOR THE COLLECTION OF INFORMATION TO AUGMENT FINDINGS FROM SECONDARY DATA AND KEY INFORMANT INTERVIEWS AND EXPLORATION OF STRATEGIC AND PROGRAMMATIC OPTIONS TO ADDRESS IDENTIFIED HEALTH ISSUES, SERVICE GAPS, AND/OR BARRIERS TO CARE. PARTICIPANTS WERE RECRUITED BY BID NEEDHAM, THE NEEDHAM PUBLIC HEALTH DIVISION AND REPRESENTATIVES FROM HOST ORGANIZATIONS. FOCUS GROUPS WERE APPROXIMATELY 60 MINUTES AND WERE CONDUCTED IN-PERSON USING STRUCTURED INTERVIEW GUIDES. NOTES WERE TAKEN AT EACH SESSION. APPENDIX A INCLUDES SESSION DATES AND A FOCUS GROUP GUIDE. JSI PRESENTED AT A COMMUNITY MEETING AT THE YMCA IN NEEDHAM. THIS EVENT WAS CO-SPONSORED BY THE NEEDHAM PUBLIC HEALTH DIVISION. JSI PRESENTED A SUMMARY OF KEY QUANTITATIVE AND QUALITATIVE DATA FINDINGS FROM THE CHNA AND SOLICITED FEEDBACK AND INPUT FROM COMMUNITY MEMBERS. NOTES WERE TAKEN BY THE NEEDHAM PUBLIC HEALTH DIVISION AND SHARED WITH JSI. THE COMMUNITY MEETING ALLOWED FOR THE CAPTURE OF INFORMATION DIRECTLY FROM COMMUNITY RESIDENTS, REPRESENTATIVES FROM LOCAL COMMUNITY ORGANIZATIONS AND LOCAL SERVICE PROVIDERS. PARTICIPANTS WERE ASKED TO SHARE THEIR REACTIONS TO THE DATA PRESENTED, THEIR THOUGHTS ON COMMUNITY HEALTH NEEDS AND PRIORITIES, BARRIERS TO CARE AND VULNERABLE POPULATIONS. BID NEEDHAM AND THE NEEDHAM PUBLIC HEALTH DIVISION DETERMINED THAT THE YMCA WAS AN APPROPRIATE HOST, A NEUTRAL SPACE AND A TRUSTED COMMUNITY ORGANIZATION THAT OFFERED AMPLE PUBLIC PARKING. TRANSLATION SERVICES AND TRANSPORTATION TO THE EVENT WERE AVAILABLE UPON REQUEST. APPENDIX A INCLUDES A DISCUSSION GUIDE. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSJSI WORKED WITH BID NEEDHAM IN DRAFTING AND FINALIZING THE CHNA REPORT AND IMPLEMENTATION STRATEGY. THESE DOCUMENTS WERE PRESENTED TO THE BOARD OF TRUSTEES, THE AUTHORIZED BODY OF THE HOSPITAL, FOR APPROVAL ON SEPTEMBER 5, 2019. AT THIS MEETING, THE BOARD OF TRUSTEES FORMALLY APPROVED THIS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND THE ASSOCIATED IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY IDENTIFIED PRIORITY AREAS AND DEFINED GOALS, ALONG WITH OBJECTIVES FOR EACH GOAL AND DRAFTED STRATEGIES TO OPERATIONALIZE THESE OBJECTIVES.
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2019 COMMUNITY HEALTH NEEDS ASSESSMENTKEY FINDINGS
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2016 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY
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THE BID NEEDHAM CHNA AND THE ACCOMPANYING IMPLEMENTATION STRATEGY WERE APPROVED BY THE BOARD OF TRUSTEES DURING BID NEEDHAM'S FISCAL YEAR ENDED SEPTEMBER 30, 2016. THESE DOCUMENTS WERE THE CULMINATION OF SEVERAL MONTHS OF WORK AND WERE BORNE LARGELY OUT OF BID NEEDHAM'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THAT PROJECT, SIMILAR TO THE MOST RECENT CHNA AND IMPLEMENTATION STRATEGY NOTED ABOVE, WERE DESIGNED TO FULFILL THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BID NEEDHAM ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BID NEEDHAM, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2016 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONTHE GEOGRAPHICAL FOCUS OF BID NEEDHAM'S 2016 CHNA ENCOMPASSES THE CITY OF QUINCY AND THE TOWNS OF MILTON AND RANDOLPH. TARGET POPULATIONS FOR BID NEEDHAM'S COMMUNITY BID MILTON CONDUCTED THIS CHNA PROCESS IN CONJUNCTION WITH BETH ISRAEL DEACONESS MEDICAL CENTER, WHICH SERVED AS THE SOLE MEMBER OF BID NEEDHAM UNTIL MARCH 1, 2019 AS WELL AS WITH BETH ISRAEL DEACONESS HOSPITAL-MILTON AND BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH HOSPITALS FOR WHICH THE MEDICAL CENTER ALSO SERVED AS SOLE MEMBER. ALTHOUGH THE PROCESS WAS JOINTLY CONDUCTED, EACH HOSPITAL PRODUCED ITS OWN CHNA AND IMPLEMENTATION STRATEGY (SCHEDULE H, PART V, SECTION B, QUESTIONS 6A AND 6B).BID NEEDHAM'S COMMUNITY BENEFITS PRIMARY SERVICE AREA INCLUDES DEDHAM, DOVER, NEEDHAM AND WESTWOOD, WHICH ARE ALL PART OF NORFOLK COUNTY. THE CHNA ANALYSIS FOCUSES ON THIS PRIMARY SERVICE AREA BUT ALSO INCLUDES SECONDARY SERVICE AREA COMPARISONS. BID NEEDHAM'S SECONDARY SERVICE AREA INCLUDES FRAMINGHAM, MEDFIELD, NATICK, NEWTON, NORWOOD, SHARON, WALTHAM AND WELLESLEY. BID NEEDHAM FOCUSES ACTIVITIES TO MEET THE NEEDS OF ALL SEGMENTS OF THE POPULATION WITH RESPECT TO AGE, RACE/ETHNICITY, INCOME, SEXUAL ORIENTATION AND THE BROAD RANGE OF OTHER WAYS THAT POPULATION'S CHARACTERIZE THEMSELVES TO ENSURE THAT ALL RESIDENTS HAVE THE OPPORTUNITY TO LIVE HEALTHY, HAPPY, AND FULFILLING LIVES. HOWEVER, ITS COMMUNITY BENEFITS ACTIVITIES ARE FOCUSED PARTICULARLY ON: YOUTH ADULTS WITH BEHAVIORAL HEALTH AND CHRONIC HEALTH CONDITIONS LOW-INCOME FAMILIES OLDER ADULTS2016 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE CHNA WAS CONDUCTED IN A THREE-PHASED PROCESS BEGINNING WITH A RIGOROUS AND COMPREHENSIVE REVIEW OF QUANTITATIVE AND QUALITATIVE DATA TO CHARACTERIZE COMMUNITY NEEDS, FOLLOWED BY SOLICITING OF COMMUNITY INPUT, AND CONCLUDING WITH A PRIORITY SETTING SESSION THAT DREW FROM THE FINDINGS OF THE FIRST TWO PHASES. IN PHASES ONE AND TWO, THE JSI PROJECT TEAM ACCESSED THE HEALTH-RELATED CHARACTERISTICS OF THE REGION'S POPULATION, INCLUDING DEMOGRAPHIC, SOCIO-ECONOMIC, GEOGRAPHIC, HEALTH STATUS, CARE SEEKING, AND ACCESS TO CARE CHARACTERISTICS. THIS INVOLVED QUANTITATIVE AND QUALITATIVE DATA ANALYSIS, INCLUDING, WHEN POSSIBLE, AN ANALYSIS OF CHANGES OVER TIME USING TREND DATA AND INFORMATION FROM PREVIOUS ASSESSMENTS. COMMUNITY-SPECIFIC HEALTH DATA ANALYSIS. JSI CHARACTERIZED HEALTH STATUS AND NEED AT THE TOWN, ZIP CODE OR CENSUS TRACT LEVEL AND COLLECTED DATA FROM A NUMBER OF SOURCES TO ENSURE A COMPREHENSIVE UNDERSTANDING OF THE ISSUES. THE GOAL DURING PHASE THREE WAS TO REVIEW THE RESULTS, IDENTIFY PRIORITIES, REVIEW EXISTING COMMUNITY BENEFITS ACTIVITIES AND DETERMINE A RANGE OF PROVEN, FEASIBLE AND EVIDENCED-BASED INTERVENTIONS THAT HOSPITALS AND OTHER KEY PROVIDERS BELIEVED WOULD ADDRESS THE ISSUES THAT IDENTIFIED COMMUNITY HEALTH PRIORITIES. ONE OF THE MAJOR GOALS OF THIS PHASE WAS TO DEVELOP A COMMUNITY BENEFITS STRATEGIC FRAMEWORK THAT WOULD CLARIFY COMMUNITY HEALTH PRIORITIES AND IDENTIFY THE RANGE OF HEALTH ISSUES AND SUB-COMPONENTS WITHIN EACH PRIORITY AREA. DRAWING ON THE INFORMATION GATHERED IN PHASES ONE AND TWO, JSI PRESENTED CHNA FINDINGS, REVIEWED BID NEEDHAM'S CURRENT COMMUNITY BENEFITS PROGRAMMING, AND EXPLORED HOW BID NEEDHAM COULD REFINE OR AUGMENT WHAT IT IS CURRENTLY DOING TO BETTER ADDRESS COMMUNITY NEED. THESE STRATEGIC PLANNING ACTIVITIES INVOLVED BID NEEDHAM'S CLINICAL, ADMINISTRATIVE AND SENIOR LEADERSHIP; COMMUNITY SERVICE PROVIDERS; LOCAL PUBLIC HEALTH OFFICIALS; AND OTHER COMMUNITY LEADERS.2016 COMMUNITY HEALTH NEEDS ASSESSMENTMAJOR HEALTH NEEDS AND HOW PRIORITIES WERE DETERMINEDAN UNDERSTANDING OF COMMUNITY NEEDS AND HEALTH STATUS IN BID NEEDHAM'S COMMUNITY BENEFITS SERVICE AREA BEGAN WITH KNOWLEDGE OF THE POPULATION'S CHARACTERISTICS AS WELL AS THE UNDERLYING SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS THAT IMPACTED HEALTH AND HEALTH EQUITY. THIS INFORMATION WAS CRITICAL TO RECOGNIZING DISEASE BURDEN, HEALTH DISPARITIES AND HEALTH INEQUITIES; IDENTIFYING TARGET POPULATIONS AND HEALTH-RELATED PRIORITIES; AND TARGETING STRATEGIC RESPONSES. THIS ASSESSMENT CAPTURED A WIDE RANGE OF QUANTITATIVE AND QUALITATIVE DATA RELATED TO AGE, GENDER, SEXUAL ORIENTATION, RACE/ETHNICITY, INCOME, POVERTY, FAMILY COMPOSITION, EDUCATION, VIOLENCE, CRIME, UNEMPLOYMENT, RECREATIONAL FACILITIES, AND OTHER DETERMINANTS OF HEALTH. THE DATA PROVIDED VALUABLE INFORMATION THAT CHARACTERIZED THE POPULATION AS WELL AS PROVIDED INSIGHTS INTO THE LEADING DETERMINANTS OF HEALTH AND HEALTH INEQUITIES.
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2016 COMMUNITY HEALTH NEEDS ASSESSMENTKEY FINDINGS
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THE FOLLOWING IS A SUMMARY OF KEY FINDINGS RELATED TO COMMUNITY CHARACTERISTICS AND THE SOCIAL, ECONOMIC, AND ENVIRONMENTAL DETERMINANTS OF HEALTH FOR BID NEEDHAM'S COMMUNITY BENEFITS SERVICE AREA. CONCLUSIONS WERE DRAWN FROM QUANTITATIVE DATA AND QUALITATIVE INFORMATION COLLECTED THROUGH INTERVIEWS, A SURVEY, AND A COMMUNITY FORUM. SUMMARY DATA TABLES ARE INCLUDED BELOW. AGE AND GENDER. BID NEEDHAM'S PRIMARY SERVICE AREA HAD A SIGNIFICANTLY LARGER PROPORTION OF OLDER ADULTS (65+) COMPARED TO THE COMMONWEALTH OVERALL AT 14% (19%, DEDHAM; 16%, DOVER; 17%, NEEDHAM; 19%, WESTWOOD).26 OLDER ADULTS HAVE UNIQUE HEALTH NEEDS, AND AN INCREASINGLY AGING POPULATION HAS IMPLICATIONS FOR THE DISTRIBUTION AND TYPES OF MORBIDITY IN THE POPULATION, AS DISCUSSED LATER. IN ADDITION, THREE OF THE TOWNS HAD SIGNIFICANTLY HIGHER YOUTH POPULATIONS (AGE UNDER 18) THAN THE STATE AS A WHOLE AT 21% (31%, DOVER; 27%, NEEDHAM; 28%, WESTWOOD). A COMMON THEME THROUGHOUT INTERVIEWS AND COMMUNITY FORUM WAS THAT OLDER ADULTS AND YOUTH REPRESENTED TWO OF MOST VULNERABLE POPULATIONS IN THE SERVICE AREA. RACE/ETHNICITY, FOREIGN BORN STATUS AND LANGUAGE. THERE IS AN EXTENSIVE BODY OF RESEARCH AND EVIDENCE THAT ILLUSTRATES THE HEALTH DISPARITIES THAT EXIST FOR RACIAL/ETHNIC MINORITIES, FOREIGN-BORN POPULATIONS AND INDIVIDUALS WITH LIMITED ENGLISH LANGUAGE PROFICIENCY. ACCORDING TO THE 2010-2014 ACS, BID NEEDHAM'S SERVICE AREA HAD A RELATIVELY HOMOGENEOUS, WHITE AND NON-HISPANIC POPULATION. ALL TOWNS HAD SIGNIFICANTLY HIGHER NUMBERS OF WHITE, NON-HISPANIC POPULATIONS COMPARED TO THE STATE AS A WHOLE AT 75% (DEDHAM, 82%; DOVER, 84%; NEEDHAM, 87%; WESTWOOD, 89%). ALL TOWNS HAD SIGNIFICANTLY LOWER NUMBERS OF THOSE FOREIGN BORN (WITH THE EXCEPTION OF DEDHAM) AND THOSE WHO SPOKE A LANGUAGE OTHER THAN ENGLISH WHEN COMPARED TO THE STATE OVERALL. INCOME, EDUCATION AND EMPLOYMENT. SOCIO-ECONOMIC STATUS HAS LONG BEEN RECOGNIZED AS A CRITICAL DETERMINANT OF HEALTH. HIGHER SOCIO-ECONOMIC STATUS, AS MEASURED BY INCOME, EMPLOYMENT STATUS, OCCUPATION, AND EDUCATION, IS CLOSELY LINKED TO HEALTH STATUS, OVERALL WELLBEING, AND PREMATURE DEATH. RESEARCH SHOWS THAT COMMUNITIES WITH LOWER SOCIO-ECONOMIC STATUS BEAR A HIGHER DISEASE BURDEN AND HAVE A LOWER LIFE EXPECTANCY. RESIDENTS OF THESE COMMUNITIES ARE LESS LIKELY TO BE INSURED, LESS LIKELY TO HAVE A USUAL SOURCE OF PRIMARY CARE, MORE LIKELY TO USE THE EMERGENCY DEPARTMENT FOR NON-EMERGENT CARE, AND LESS LIKELY TO ACCESS HEALTH SERVICES OF ALL KINDS, PARTICULARLY ROUTINE AND PREVENTIVE SERVICES. MOREOVER, RESEARCH SHOWS THAT CHILDREN BORN TO LOW INCOME FAMILIES ARE, AS THEY MOVE INTO ADULTHOOD, LESS LIKELY TO BE FORMALLY EDUCATED, LESS LIKELY TO HAVE JOB SECURITY, MORE LIKELY TO HAVE POOR HEALTH STATUS, AND LESS LIKELY TO RISE AND MOVE UP TO HIGHER SOCIO-ECONOMIC LEVELS. OVERALL, BID NEEDHAM'S SERVICE AREA HAD A HIGH MEDIAN INCOME COMPARED WITH THE COMMONWEALTH WITH A SIGNIFICANTLY LOWER PROPORTION OF LOW-INCOME POPULATION (THOSE LIVING AT 200% OR BELOW OF THE FEDERAL POVERTY LEVEL. CRIME, VIOLENCE AND COMMUNITY COHESION. CRIME AND VIOLENCE ARE MAJOR ISSUES THAT CAN HAVE INTENSE AND FAR REACHING IMPACTS ON HEALTH STATUS. THESE IMPACTS CAN INCLUDE DEATH, PAGE|18 INJURY, AND ECONOMIC LOSS BUT THEY ALSO INCLUDE EMOTIONAL TRAUMA, ANXIETY, ISOLATION, LACK OF TRUST, AND AN ABSENCE OF COMMUNITY COHESION. OVERALL, ACCORDING TO QUANTITATIVE DATA FROM THE 2013 FBI UNIFORM CRIME REPORTS AND ANECDOTAL INFORMATION FROM THE INTERVIEWEES, CRIME AND VIOLENCE WERE NOT A LEADING CONCERN IN BID NEEDHAM'S SERVICE AREA. UNSTABLE HOUSING AND HOMELESSNESS. AN INCREASING BODY OF EVIDENCE HAS ASSOCIATED HOUSING QUALITY WITH POOR OVERALL HEALTH STATUS AND ILLNESS DUE TO INFECTIOUS DISEASES, CHRONIC ILLNESSES, INJURIES, POOR NUTRITION, SUBSTANCE ABUSE, AND MENTAL HEALTH CONDITIONS. THESE HEALTH ISSUES HAVE ALSO PROVEN TO BE MORE COMMON IN LOW INCOME COHORTS OF THE POPULATION WHO OFTEN STRUGGLE TO DECIDE BETWEEN PAYING FOR SAFE HOUSING, HEALTHY FOOD, NEEDED HEALTH CARE SERVICES, AND OTHER NEEDS. THERE ARE ALSO CLEAR LINKS BETWEEN POOR HOUSING CONDITIONS AND THE ILLNESSES LISTED ABOVE, WHICH CONFOUND AND EXACERBATE OVERALL HEALTH STATUS AND EMOTIONAL WELL-BEING. AT ITS EXTREME ARE THOSE WITHOUT HOUSING, EITHER LIVING ON THE STREET OR IN SOME TRANSIENT HOUSING SITUATION, WHO HAVE BEEN SHOWN TO HAVE SIGNIFICANTLY HIGHER RATES OF ILLNESS AND SHORTER LIFE EXPECTANCY. LACK OF AFFORDABLE HOUSING ALSO HAS AN IMPACT ON POVERTY AND THE ABILITY OF INDIVIDUALS AND FAMILIES TO PAY FOR FOOD AND OTHER ESSENTIAL HOUSEHOLD ITEMS.2016 COMMUNITY HEALTH NEEDS ASSESSMENTMAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEBETH ISRAEL DEACONESS HOSPITAL-NEEDHAM STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED, BID NEEDHAM COMPLETED ITS MOST RECENT CHNA DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. THE 2019 CHNA AND IMPLEMENTATION STRATEGY ARE AVAILABLE UPON REQUEST AND ON THE HOSPITAL'S WEBSITE AT:HTTPS://WWW.BIDNEEDHAM.ORG/ABOUT/COMMUNITY-INVOLVEMENTIN ADDITION, THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016, IS AVAILABLE ON THE HOSPITAL'S WEBSITE AT: HTTPS://WWW.BIDNEEDHAM.ORG/ABOUT/COMMUNITY-INVOLVEMENT. BOTH DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).
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2019 COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDS
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AS PREVIOUSLY NOTED, BID NEEDHAM'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. THAT CHNA AND IMPLEMENTATION STRATEGY WILL INFORM BID NEEDHAM'S COMMUNITY BENEFITS MISSION AND ACTIVITIES FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2019, SEPTEMBER 30, 2020, AND SEPTEMBER 30, 2021. THIS FORM 990 COVERS BID NEEDHAM'S FISCAL YEAR ENDED SEPTEMBER 30, 2019. THE 2016 CHNA AND ACCOMPANYING IMPLEMENTATION STRATEGY WERE APPROVED BY THE BID NEEDHAM BOARD OF TRUSTEES BEFORE SEPTEMBER 30, 2016 AND INFORMED BID NEEDHAM'S COMMUNITY BENEFITS PROCESS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2016; SEPTEMBER 30, 2017; AND SEPTEMBER 30, 2018. AS SUCH, THE ACCOMPLISHMENTS AND ACTIVITIES INCLUDED IN THIS FILING AND REPORTED BELOW RELATE TO THE DOCUMENTS APPROVED AS OF SEPTEMBER 30, 2016. BID NEEDHAM'S IMPLEMENTATION STRATEGY FOR ITS COMMUNITY BENEFITS ACTIVITIES IS PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. FY19 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: RISK FACTORS AND PRIMARY PREVENTIONCANCER, CARDIOVASCULAR DISEASE (HEART DISEASE), CHRONIC LOWER RESPIRATORY DISEASE (COPD), CEREBROVASCULAR DISEASE (STROKE) AND DIABETES ARE THE LEADING CAUSES OF DEATH IN BID NEEDHAM'S PRIMARY SERVICE AREA. INDIVIDUALLY AND COLLECTIVELY, THESE DISEASES HAVE A MAJOR IMPACT ON RESIDENTS, AND TO A LARGE EXTENT, ARE PREVENTABLE. ALL OF THESE CHRONIC CONDITIONS ALSO SHARE COMMON HEALTH RISK FACTORS INCLUDING OBESITY/OVERWEIGHT, LACK OF PHYSICAL EXERCISE, POOR NUTRITION, TOBACCO USE, AND ALCOHOL ABUSE. THERE ARE A NUMBER OF HEALTH AWARENESS, EDUCATION, PREVENTION AND SCREENING ACTIVITIES, CAMPAIGNS, AND INITIATIVES THAT MAY IMPROVE THE SERVICE AREA POPULATION'S HEALTH BY WORKING ON PREVENTION EFFORTS, INCLUDING INCREASING ACCESS TO HEALTHY FOODS AND OPPORTUNITIES FOR PHYSICAL ACTIVITY; REDUCING SMOKING RATES, AND CONTINUED EDUCATION OF MENTAL HEALTH, CANCER, AND CHRONIC DISEASE PREVENTION.KEY: BASELINE 2017, YEAR 1 2018, YEAR 2 2019 GOAL: RAISE AWARENESS AND EDUCATE PUBLIC ON MENTAL HEALTH ISSUES TARGET POPULATION: YOUTH, ADULTS, OLDER ADULTSPROGRAMMATIC OBJECTIVES: 1.1 EDUCATE ON MENTAL HEALTH RISK FACTORS AND HEALTHY BEHAVIORSCOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE RESOURCES FOR MENTAL HEALTH CONFERENCES, EDUCATION EVENTS AND SUPPORT STRUCTURES WITHIN THE COMMUNITYMETRICS AND STATUS UPDATE: NUMBER OF YOUTH, CHILDREN AND ADULTS PARTICIPATING IN EDUCATION EVENTS AND GETTING SUPPORT THROUGH THESE ORGANIZATIONSCOMMUNITY PARTNERS: NEEDHAM PUBLIC SCHOOLS, WESTWOOD CARES, WESTWOOD YOUTH & FAMILY SERVICES, PARENT TALK, RIPPLES OF HOPE, NEEDHAM EDUCATION FOUNDATION, TAKE BACK THE NIGHTGOAL: PROMOTE YOUTH SUBSTANCE PREVENTION AND MENTAL AND EMOTIONAL WELL-BEINGTARGET POPULATION: YOUTH PROGRAMMATIC OBJECTIVES: 2.1 REDUCE STIGMA RELATED TO MENTAL HEALTH AND SUBSTANCE USE ISSUES2.2 DECREASE PROPORTION OF STUDENTS WHO USE OPIOIDS, ALCOHOL, TOBACCO AND OTHER DRUGS2.3 BUILD YOUTH RESILIENCECOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT CURRICULUM BASED EDUCATION, SUBSTANCE-FREE ACTIVITIES, AND SKILL BUILDING METRICS AND STATUS UPDATE: NUMBER OF YOUTH, CHILDREN AND ADULTS PARTICIPATING IN EDUCATION EVENTS AND GETTING SUPPORT THROUGH THESE ORGANIZATIONSCOMMUNITY PARTNERS: SUBSTANCE PREVENTION ALLIANCE OF NEEDHAM (SPAN), STUDENTS ADVOCATING LIFE WITHOUT SUBSTANCE ABUSE (SALSA), NEEDHAM COMMUNITY EDUCATION, NEW YEAR'S NEEDHAM, NEEDHAM PUBLIC SCHOOLS, TOWN OF NEEDHAMGOAL: RAISE AWARENESS AND EDUCATE PUBLIC ON CHRONIC DISEASE PREVENTIONTARGET POPULATION: YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 3.1 EDUCATE ON CHRONIC DISEASE RISK FACTORS AND HEALTHY BEHAVIORS3.2 INCREASE ACCESS TO SCREENINGSCOMMUNITY ACTIVITIES/STRATEGIES: ATTEND AND PROVIDE EDUCATION AT COMMUNITY HEALTH EVENTS WORK WITH PHYSICIANS AND HOSPITAL STAFF TO PROVIDE EDUCATION ABOUT THE IMPORTANCE OF SCREENINGS WITHIN THE HOSPITAL AND DOCTOR'S OFFICES PROVIDE CLINICIAN TALKS & EDUCATION FOR RESIDENTS WITHIN THE COMMUNITYMETRICS AND STATUS UPDATE: NUMBER OF YOUTH, CHILDREN AND ADULTS PARTICIPATING IN EDUCATION EVENTS COMMUNITY PARTNERS: BOSTON JCC, BETH ISRAEL DEACONESS HEALTHCARE, CHARLES RIVER YMCA, TOWNS OF NEEDHAM AND DOVER, BRIARWOOD GOAL: REDUCE TOBACCO AND ALCOHOL USE TARGET POPULATION: YOUTH, ADULTS PROGRAMMATIC OBJECTIVES: 4.1 REDUCE CURRENT NUMBER OF SMOKERSCOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE RESOURCES FOR EDUCATION WITHIN THE COMMUNITY ABOUT THE RISKS OF TOBACCO USEMETRICS AND STATUS UPDATE: NUMBER OF YOUTH AND ADULTS PARTICIPATING IN EDUCATION EVENTS COMMUNITY PARTNERS: SPAN, TOWN OF NEEDHAMGOAL: INCREASE PHYSICAL ACTIVITYTARGET POPULATION: YOUTH, ADULTS, OLDER ADULTSPROGRAMMATIC OBJECTIVES:5.1 INCREASE NUMBER OF CHILDREN AND ADULTS WITH ACCESS TO OPPORTUNITIES FOR PHYSICAL ACTIVITYCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT LOCAL RUNS AND WALKS PROVIDE FUNDING FOR PERSONAL TRAINERS AT LOCAL COUNCIL ON AGINGMETRICS AND STATUS UPDATE: NUMBER OF CHILDREN AND ADULTS PARTICIPATING IN LOCAL EXERCISE ACTIVITIESCOMMUNITY PARTNERS: NEEDHAM TRACK CLUB, SEAN D. BIGGS FOUNDATION, CHARLES RIVER YMCA, CHARLES RIVER CENTER, NEEDHAM COUNCIL ON AGINGGOAL: INCREASE ACCESS TO HEALTHY FOODTARGET POPULATION: YOUTH, ADULTS, OLDER ADULTSPROGRAMMATIC OBJECTIVES:6.1 INCREASE NUMBER OF CHILDREN AND ADULTS WITH ACCESS TO OPPORTUNITIES TO EAT HEALTHYCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT LOCAL FOOD ACCESS PROGRAMS, FOOD BANKS, AND FARM PROGRAMMING PROVIDE EDUCATION ABOUT THE IMPORTANCE OF HEALTHY FOODMETRICS AND STATUS UPDATE: NUMBER OF CHILDREN AND ADULTS OBTAINING ACCESS TO HEALTHY FOODCOMMUNITY PARTNERS: NEEDHAM COMMUNITY FARM, NEEDHAM FARMER'S MARKET, THREE SQUARES RIDE FOR FOOD, GREATER BOSTON FOOD BANK, NOURISHING NEEDHAM, MASS BAY FOOD ACCESSPRIORITY AREA 2: CHRONIC DISEASE MANAGEMENT THERE ARE A BROAD RANGE OF CHRONIC AND INFECTIOUS DISEASES PREVALENT IN BID NEEDHAM'S SERVICE AREA, INCLUDING HEART DISEASE, DIABETES, HYPERTENSION, CANCER AND LYME DISEASE. ALTHOUGH TREATING THESE ILLNESSES REQUIRES A RANGE OF CLINICAL INTERVENTIONS, THERE IS A GREAT DEAL OF OVERLAP WITH RESPECT TO THE POTENTIAL COMMUNITY INTERVENTIONS. POPULATION-LEVEL RESPONSES TO CHRONIC AND INFECTIOUS ILLNESSES ALL REQUIRE COMMUNITY BASED EDUCATION, SCREENING, TIMELY ACCESS TO TREATMENT AND SEAMLESS COORDINATION OF FOLLOW-UP SERVICES. KEY: BASELINE 2017, YEAR 1 2018, YEAR 2 2019GOAL: IMPROVE CHRONIC DISEASE MANAGEMENT TARGET POPULATION: YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE PROPORTION OF ADULTS WITH CHRONIC DISEASE WHO RECEIVE EDUCATION AND TREATMENTCOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE ACCESS TO LIFE-SAVING DEVICES AND PRESCRIPTIONS TO THE COMMUNITY THROUGH SCHOOLS AND EMT'S PROVIDE EDUCATION ON ACCESS , SCREENING AND TREATMENTMETRICS AND STATUS UPDATE: NUMBER OF YOUTH AND ADULTS EDUCATED ON DISEASE MANAGEMENT DISEASE PREVENTION SUPPLIES PROVIDED TO COMMUNITY COMMUNITY PARTNERS: NEEDHAM FIRE DEPARTMENT, NEEDHAM PUBLIC SCHOOLS, FAMILY PROMISE METROWEST, CHARLES RIVER YMCAGOAL: IMPROVE CARE TRANSITIONS FOR THOSE WITH CHRONIC HEALTH CONDITIONS TARGET POPULATION: ADULTS WITH CHRONIC DISEASE, OLDER ADULTSPROGRAMMATIC OBJECTIVES: 2.1 INCREASE PROPORTION OF RECENTLY DISCHARGED ADULTS WITH COORDINATION OF FOLLOW UP AND SUPPORT SERVICES2.2 REDUCE 30-DAY READMISSION RATECOMMUNITY ACTIVITIES/STRATEGIES: PARTNER WITH LOCAL ORGANIZATIONS TO PROVIDE CARE FOR THOSE WITH CHRONIC CONDITIONS PROVIDE SUPPORT FOR ORGANIZATIONS WHO COORDINATE CARE FOR DISCHARGED ADULTS REVIEW READMISSIONS AND IMPLEMENT CHANGES TO ADDRESS PROVIDE EDUCATION AND FOLLOW-UP CARE UPON DISCHARGEMETRICS AND STATUS UPDATE: NUMBER OF ADULTS EDUCATED NUMBER OF ADULTS PROVIDED SERVICES BY LOCAL ORGANIZATIONS READMISSION RATE IMPROVEMENTSCOMMUNITY PARTNERS: CHARLES RIVER CENTER, NEIGHBOR BRIGADE, RELAY FOR LIFE, PATIENT FAMILY ADVISORY COMMITTEEGOAL: INCREASE CHRONIC DISEASE AND CANCER SCREENINGS TARGET POPULATION: ADULTS WITH CHRONIC DISEASE, LOW-INCOME ADULTSPROGRAMMATIC OBJECTIVES: 3.1 INCREASE NUMBER OF ADULTS WHO HAVE BEEN SCREENEDCOMMUNITY ACTIVITIES/STRATEGIES: PARTNER WITH LOCAL ORGANIZATIONS TO PROVIDE SCREENINGS AND EDUCATION ON THE IMPORTANCE OF SCREENINGS PROVIDE COMMUNITY EDUCATION ON CHRONIC DISEASE PREVENTIONMETRICS AND STATUS UPDATE: NUMBER OF ADULTS EDUCATED AND SCREENEDCOMMUNITY PARTNERS: NEEDHAM COUNCIL ON AGING, HEBREW SENIORLIFE, ALZHEIMER'S ASSOCIATION, AVITA OF NEEDHAM, NORTH HILL, FOX HILL, JOG YOUR MEMORY 5K, DOVER COUNCIL ON AGING
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GOAL: PREVENT LYME DISEASE
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TARGET POPULATION: YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 4.1 REDUCE INCIDENCE OF LYME DISEASE COMMUNITY ACTIVITIES/STRATEGIES: PARTNER WITH LOCAL COMMUNITY ORGANIZATIONS TO PROVIDE EDUCATION ON THE RISKS AND PREVENTION OF LYME DISEASE IN DOVERMETRICS AND STATUS UPDATE: NUMBER OF ADULTS AND YOUTH EDUCATED COMMUNITY PARTNERS: CHARLES RIVER SCHOOL, TOWN OF DOVER, DOVER CHURCHPRIORITY AREA 3: BEHAVIORAL HEALTH THE BURDEN OF MENTAL ILLNESS AND SUBSTANCE ABUSE IS SUBSTANTIAL. THESE ISSUES IMPACT ALL SEGMENTS AND AGE GROUPS IN THE POPULATION. HOSPITALIZATION RATES FOR SUBSTANCE ABUSE AND MENTAL HEALTH ARE HIGHER IN MANY OF THE TOWNS WHEN COMPARED TO THE COMMONWEALTH. LARGE PORTIONS OF THE POPULATION ALSO STRUGGLE WITH ALCOHOL ABUSE AND BINGE DRINKING. DESPITE INCREASED COMMUNITY AWARENESS AND SENSITIVITY ABOUT MENTAL ILLNESS AND ADDICTION, THERE IS STILL A GREAT DEAL OF STIGMA RELATED TO THESE CONDITIONS AND THERE IS A GENERAL LACK OF APPRECIATION FOR THE FACT THAT THESE ISSUES ARE OFTEN ROOTED IN GENETICS AND PHYSIOLOGY SIMILAR TO OTHER CHRONIC DISEASES. DURING THE QUALITATIVE INTERVIEWS AND COMMUNITY FORUM, PARTICIPANTS OVERWHELMINGLY IDENTIFIED BEHAVIORAL HEALTH AS THE NUMBER ONE NEED IN ALL OF BID NEEDHAM'S SERVICE AREA.KEY: BASELINE 2017, YEAR 1 2018, YEAR 2 2019GOAL: PROMOTE BEHAVIORAL HEALTH/PRIMARY CARE INTEGRATION TARGET POPULATION: YOUTH, ADULTS, OLDER ADULTSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE NUMBER OF ADULTS SCREENED FOR DEPRESSION AND LINKED TO CARE1.2 INCREASE NUMBER OF PRIMARY CARE PROVIDERS WITH BEHAVIORAL HEALTH INTEGRATIONCOMMUNITY ACTIVITIES/STRATEGIES: WORK WITH LOCAL PRIMARY CARE PHYSICIANS AND MENTAL HEALTH PROVIDERS TO INTEGRATE CARE INCREASE MENTAL HEALTH SCREENING PROVIDE INTEGRATED MENTAL HEALTH SERVICES AT BID NEEDHAMMETRICS AND STATUS UPDATE: NUMBER OF ADULTS SCREENED FOR MENTAL HEALTH NUMBER OF ADULTS SEEN FOR BEHAVIORAL HEALTH CONDITIONSCOMMUNITY PARTNERS: BETH ISRAEL DEACONESS HEALTHCARE, RIVERSIDE COMMUNITY CAREGOAL: REDUCE BURDEN OF OPIOID USE TARGET POPULATION: ADULTS WITH BEHAVIORAL HEALTH CONDITIONS, YOUTHPROGRAMMATIC OBJECTIVES: 2.1 INCREASE CAPACITY OF PROVIDERS TO PREVENT OPIOID USE BY PROVIDING MHA PROVIDER RECOMMENDATIONS2.2 PROVIDE DISPOSAL FOR UNUSED PRESCRIPTIONS 2.3 PROVIDE COMMUNITY SUPPORT FOR AT-RISK RESIDENTSCOMMUNITY ACTIVITIES/STRATEGIES: PARTICIPATE IN LOCAL COMMUNITY CRISIS INTERVENTION TEAM (CCIT) THROUGH WORK OF BID NEEDHAM'S OPIOID TASKFORCE, IMPLEMENT MHA RECOMMENDATIONS FOR PRESCRIBING MAINTAIN PRESCRIPTION DRUG KIOSK AND SHARPS DISPOSAL IN BID NEEDHAM LOBBY PROVIDE SUPPORT TO ORGANIZATIONS WHO OFFER RECOVERY OPTIONSMETRICS AND STATUS UPDATE: OPIOID PRESCRIBING POLICIES IMPLEMENTED POUNDS OF PRESCRIPTION DRUGS COLLECTED DATA PROVIDED TO LOCAL CCITCOMMUNITY PARTNERS: TOWN OF NEEDHAM, NEWTON WELLESLEY HOSPITAL, DODGING ADDICTION FOR AMY, NEW ENGLAND VETERAN'S ASSOCIATION, SHARPS DISPOSAL, BID NEEDHAM OPIOID TASKFORCEGOAL: IDENTIFY THOSE AT RISK AND PROVIDE ENHANCED CARE MANAGEMENT TARGET POPULATION: ADULTS WITH BEHAVIORAL HEALTH CONDITION, YOUTHPROGRAMMATIC OBJECTIVES: 3.1 INCREASE PROPORTION OF ADULTS WITH BEHAVIORAL HEALTH CONDITION WHO ARE LINKED TO APPROPRIATE SERVICES3.2 REDUCE ED/INPATIENT UTILIZATION FOR ALCOHOL AND SUBSTANCE USECOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE EDUCATION AND TRAINING TO PROVIDERS AND RELEVANT ORGANIZATIONS IN THE AREA SUPPORT ORGANIZATIONS WHO PROVIDE BEHAVIORAL HEALTH CARE CONTINUE FUNDING FOR INTERFACE MENTAL HEALTH HOTLINEMETRICS AND STATUS UPDATE: NUMBER OF YOUTH AND ADULTS EDUCATED NUMBER OF YOUTH AND ADULTS PROVIDED SERVICES BY LOCAL ORGANIZATIONS NUMBER OF ADULTS TRAINEDCOMMUNITY PARTNERS: CHNA 18, NEEDHAM PUBLIC LIBRARY, WALKER, NEEDHAM STEPS UP, PLUGGED IN, NEEDHAM YOUTH SERVICES, YOUTH RESOURCE NETWORK, INTERFACE NEEDHAM, INTERFACE MEDFIELD, CIRCLE OF HOPEPRIORITY AREA 4: HEALTHY AGINGTHE SERVICE AREA OF BID NEEDHAM HAS A LARGER POPULATION OF OLDER ADULTS, THUS BID NEEDHAM HAS IDENTIFIED OLDER ADULTS AS A TARGET POPULATION WITH THE OBJECTIVE TO INCREASE QUALITY OF LIFE AS THEY AGE. OLDER ADULTS ARE MUCH MORE LIKELY TO DEVELOP CHRONIC ILLNESSES AND RELATED DISABILITIES SUCH AS HEART DISEASE, HYPERTENSION, AND DIABETES AS WELL AS CONGESTIVE HEART FAILURE, DEPRESSION, ANXIETY, ALZHEIMER'S, PARKINSON'S DISEASE, AND DEMENTIA. MANY EXPERIENCE HOSPITALIZATIONS, NURSING HOME ADMISSIONS, AND LOW-QUALITY CARE AND NEED CARE TRANSITIONS TO DEAL WITH THESE EXPERIENCES. THEY ALSO MAY LOSE THE ABILITY TO LIVE INDEPENDENTLY AT HOME OR NEED MORE SUPPORT TO AGE IN PLACE. KEY: BASELINE 2017, YEAR 1 2018, YEAR 2 2019GOAL: REDUCE FALLS IN THE COMMUNITY TARGET POPULATION: OLDER ADULTSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE AWARENESS OF FALLS PREVENTION STRATEGIES1.2 INCREASE BALANCE TRAINING AND STRENGTH AMONG OLDER ADULTSCOMMUNITY ACTIVITIES/STRATEGIES: WORK WITH LOCAL ORGANIZATIONS AND PHYSICIANS TO PROVIDE BALANCE TRAINING AND FALL PREVENTIONMETRICS AND STATUS UPDATE: NUMBER OF ADULTS EDUCATED ON FALL PREVENTION OR BALANCE TRAININGCOMMUNITY PARTNERS: NEEDHAM COUNCIL ON AGING, BETH ISRAEL DEACONESS HEALTHCAREGOAL: REDUCE ISOLATION OF OLDER ADULTS TARGET POPULATION: OLDER ADULTSPROGRAMMATIC OBJECTIVES: 2.1 DECREASE ISOLATION OF OLDER ADULTSCOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE SPACE AND STAFF FOR VOLUNTEERS TO PREP TRAVELING MEALS FOR HOMEBOUND SENIORS. SUPPORT LOCAL ORGANIZATIONS THAT ARE PROVIDING PROGRAMMING AND SUPPORT FOR SENIORS. ENGAGE LOCAL SENIORS THROUGH A VOLUNTEER PROGRAM THAT PROVIDES SOCIAL INTERACTION AND MEANINGFUL WAYS TO CONTRIBUTE.METRICS AND STATUS UPDATE: MEALS DELIVERED AND RESIDENTS SERVED BY TRAVELING MEALS PROGRAM. NUMBER OF SENIORS ATTENDING OR UTILIZING PROGRAMMING IN THE COMMUNITY. NUMBER OF SENIORS ACTIVELY PARTICIPATING IN VOLUNTEER PROGRAM.COMMUNITY PARTNERS: NEEDHAM COUNCIL ON AGING, NEEDHAM YOUTH & FAMILY SERVICES, NEEDHAM TRAVELING MEALS, SENIOR VOLUNTEER PROGRAMGOAL: SUPPORT OLDER ADULTS AND CAREGIVERS TO AGE IN PLACE TARGET POPULATION: OLDER ADULTS PROGRAMMATIC OBJECTIVES: 3.1 REFER OLDER ADULTS TO EVIDENCE-BASED PROGRAMMING3.2 SUPPORT CAREGIVERS3.3 BUILD PRIMARY CARE AND OTHER COMMUNITY-BASED PROVIDER CAPACITY IN GERIATRIC CARE COMMUNITY ACTIVITIES/STRATEGIES: PARTNER WITH LOCAL COUNCILS ON AGING TO PROVIDE PROGRAMMING AND SUPPORT FOR SENIORS. SUPPORT LOCAL ORGANIZATIONS THAT ARE PROVIDING PROGRAMMING AND SUPPORT FOR CAREGIVERS. COMMUNICATE REGULARLY WITH LOCAL PRIMARY CARE PHYSICIANS TO SHARE RESOURCES AND COMMUNICATION STRATEGIES FOR AGING IN PLACE.METRICS AND STATUS UPDATE: NUMBER OF ADULTS ENGAGED IN PROGRAMMING AND SUPPORT. NUMBER OF CAREGIVERS ENGAGED IN PROGRAMMING AND SUPPORT.COMMUNITY PARTNERS: DEDHAM COUNCIL ON AGING, DOVER COUNCIL ON AGING, NEEDHAM COUNCIL ON AGING, BETH ISRAEL DEACONESS HEALTHCARE, JOG YOUR MEMORY 5KGOAL: INCREASE ACCESS TO PALLIATIVE CARE TARGET POPULATION: OLDER ADULTS PROGRAMMATIC OBJECTIVES: 4.1 INCREASE PROPORTION OF INDIVIDUALS WHO RECEIVE PALLIATIVE CARE SERVICESCOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE SUPPORT TO LOCAL ORGANIZATIONS THAT OFFER PALLIATIVE CARE SERVICES. ENGAGE COMMUNITY TO PLAN FOR END OF LIFE CARE.METRICS AND STATUS UPDATE: NUMBER OF ADULTS PROVIDED PALLIATIVE CARE SERVICES THROUGH PARTNER ORGANIZATIONS.COMMUNITY PARTNERS: VNA HOSPICEGOAL: INCREASE ACCESS TO TRANSPORTATION SERVICESTARGET POPULATION: OLDER ADULTS PROGRAMMATIC OBJECTIVES: 5.1 INCREASE ACCESS TO TRANSPORTATION SERVICES COMMUNITY ACTIVITIES/STRATEGIES: CONTINUE TO PROVIDE FUNDING FOR LOCAL TRANSPORTATION PROGRAMS.METRICS AND STATUS UPDATE: NUMBER OF RIDES GIVEN. NUMBER OF ADULTS WHO WERE GIVEN RIDES.COMMUNITY PARTNERS: NEEDHAM COMMUNITY COUNCILGOAL: IMPROVE CARE TRANSITIONS FOR OLDER ADULTS TARGET POPULATION: OLDER ADULTS WITH RECENT HOSPITALIZATIONSPROGRAMMATIC OBJECTIVES: 6.1 INCREASE PROPORTION OF RECENTLY DISCHARGED OLDER ADULTS WITH COORDINATION OF FOLLOW UP AND SUPPORTIVE SERVICES6.2 REDUCE 30-DAY ED/INPATIENT READMISSIONCOMMUNITY ACTIVITIES/STRATEGIES: REVIEW HOSPITAL READMISSION RATES AND MAKE CHANGES BASED ON FINDINGS. SUPPORT TO LOCAL ORGANIZATIONS THAT PROVIDE RESOURCES AND FOLLOW UP/SUPPORT SERVICES FOR OLDER ADULTS.METRICS AND STATUS UPDATE: NUMBER OF ADULTS ENGAGED IN FOLLOW UP SERVICESCOMMUNITY PARTNERS: WESTWOOD COUNCIL ON AGING, HESSCO
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COMMUNITY PARTNERS
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COMMUNITY PARTNERSBETH ISRAEL DEACONESS HOSPITAL-NEEDHAM IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE: AMERICAN CANCER SOCIETY AVITA OF NEEDHAM CHARLES RIVER CENTER CHARLES RIVER YMCA CHNA 18 CIRCLE OF HOPE DEDHAM COUNCIL ON AGING DEDHAM FIRE DEPARTMENT DEDHAM FOOD PANTRY DEDHAM PUBLIC HEALTH DIVISION DOVER COUNCIL ON AGING DOVER PARKS & RECREATION ELLIE FUND FAMILY PROMISE METROWEST FOX HILL VILLAGE GREAT HALL PERFORMANCE FOUNDATION GREATER BOSTON FOOD BANK GREATER BOSTON JCC HESSCO JOG YOUR MEMORY JOSLIN DIABETES CENTER MASS BAY COLLEGE FOOD RESOURCES NEEDHAM COMMUNITY COUNCIL NEEDHAM COMMUNITY EDUCATION NEEDHAM COMMUNITY FARM NEEDHAM COUNCIL ON AGING NEEDHAM EDUCATION FOUNDATION NEEDHAM EMERGENCY MANAGEMENT NEEDHAM EXCHANGE CLUB NEEDHAM FARMER'S MARKET NEEDHAM FIRE DEPARTMENT NEEDHAM HISTORY CENTER AND MUSEUM NEEDHAM HOUSING AUTHORITY NEEDHAM PARK & RECREATION NEEDHAM POLICE DEPARTMENT NEEDHAM PUBLIC HEALTH DIVISION NEEDHAM PUBLIC SCHOOLS NEEDHAM ROTARY CLUB NEEDHAM STEPS UP NEEDHAM TOUCHDOWN CLUB NEEDHAM TRACK CLUB NEEDHAM TRAVELING MEALS NEIGHBOR BRIGADE NEW ENGLAND VETERAN'S LIBERTY HOUSE NEW YEAR'S NEEDHAM NEWTON NEEDHAM REGIONAL CHAMBER NORTH HILL PARENT TALK PLUGGED IN BAND REACH BEYOND DOMESTIC VIOLENCE RIPPLES OF HOPE RIVERSIDE COMMUNITY CARE SEAN D. BIGGS MEMORIAL FOUNDATION SPRINGWELL SUBSTANCE PREVENTION ALLIANCE OF NEEDHAM (SPAN) THREE SQUARES NEW ENGLAND TOWN OF DEDHAM TOWN OF NEEDHAM TOWN OF WESTWOOD VNA CARE NETWORK WALKER WESTWOOD CARES WESTWOOD COUNCIL ON AGING WESTWOOD PUBLIC HEALTH DIVISION WESTWOOD YOUTH & FAMILY SERVICESCOMMUNITY HEALTH NEEDSOTHER INITIATIVESAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, AS NOTED IN SCHEDULE H, PART V, SECTION B, QUESTION 11, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM IS UNABLE TO ADDRESS ALL NEEDS. DURING THE PERIOD COVERED BY THIS FILING, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM WAS UNABLE TO ADDRESS THE NEED FOR REPRODUCTIVE AND MATERNAL HEALTH AND HOUSING AS IDENTIFIED IN THE CHNA AND THE IMPLEMENTATION STRATEGY BECAUSE OF LIMITED FINANCIAL RESOURCES. IN ADDITION, EFFORTS TO IMPROVE TRANSPORTATION SYSTEMS ARE NOT PART OF THE HOSPITAL'S MISSION AND WHILE THE HOSPITAL SEARCHES FOR WAYS TO IMPROVE TRANSPORTATION, IMPROVING TRANSPORTATION SYSTEMS IS OUTSIDE THE SCOPE OF THE HOSPITAL'S EXPERTISE. FINALLY, THE HOSPITAL WILL CONTINUE TO LOOK FOR OPPORTUNITIES TO INCREASE ACCESS TO SCREENINGS IN THE COMMUNITY.AS NOTED IN DETAIL ABOVE, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IMPLEMENTATION STRATEGY (SCHEDULE H PART VI QUESTION 2).
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 7.35% OF BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. IN ADDITION, THERE ARE ADDITIONAL ACTIVITIES AND EXPENDITURES WHICH BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM CONSIDERS FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. ALTHOUGH THOSE ACTIVITIES ARE NOT QUANTIFIED ON THE BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM SCHEDULE H PER THE INSTRUCTIONS TO THE FORM 990, THOSE ACTIVITIES ARE RELEVANT IN EVALUATING THE TOTAL COMMUNITY BENEFITS PROVIDED. IF BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM HAD INCLUDED THESE IN SCHEDULE H, QUESTION 7, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM WOULD HAVE REPORTED OVER $11,497,413 IN NET EXPENDITURES AT COST, WHICH REPRESENTED APPROXIMATELY 11.30% OF TOTAL EXPENSES INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST FOR THE FISCAL PERIOD COVERED BY THIS FILING. COMMUNITY BENEFITSANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE COMMUNITY BENEFITS ADVISORY COMMITTEE AND BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT: HTTPS://WWW.BIDNEEDHAM.ORG/ABOUT/COMMUNITY-INVOLVEMENT.THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL'S DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE'S DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT THAT BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEBETH ISRAEL DEACONESS HOSPITAL-NEEDHAM'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $694,891 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A. OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. MEDICAID IS A GOVERNMENT INSURANCE PROGRAM FOR INDIVIDUALS WITH LIMITED INCOME AND RESOURCES, AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICAID PROGRAM. PAYMENTS TO HOSPITALS THROUGH THIS GOVERNMENT SPONSORED PROGRAM HAVE NOT KEPT PACE WITH INFLATION AND ALTHOUGH THE PROVISION OF HEALTH CARE TO THESE PATIENTS GENERATED $3,718,911 IN MEDICAID REVENUE THIS WAS LESS THAN THE COST OF CARE PROVIDED BY BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM FOR SUCH SERVICES BY $1,799,019 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 5.7% OR 9,808 OF BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 35.8% OR 62,729 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. THIS TRANSLATED TO AN ADDITIONAL $2,991,063 IN UNCOVERED COST BORNE BY BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM IN PROVIDING CARE TO MEDICARE PATIENTS. AS PREVIOUSLY NOTED, THIS ADDITIONAL BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM COST IS NOT QUANTIFIED IN THE BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM SCHEDULE H.
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BAD DEBTS
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IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $2,858,317 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM SIMILARLY INCURS BAD DEBT LOSSES AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE IN ITS FINANCIAL STATEMENTS. BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM CHARGES FOR THOSE SERVICES WERE $2,858,317 DURING THE FISCAL PERIOD COVERED BY THIS FILING AS REPORTED IN THE FINANCIAL STATEMENTS AND AS REPORTED ON THE BIDMC FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER THE AMOUNT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F, WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR THE SEVEN MONTHS ENDED SEPTEMBER 30, 2019 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH) AND AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP).THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.EMERGENCY CARE ACCESSAS PREVIOUSLY NOTED IN THIS FILING, FOR THE PERIOD COVERED BY THIS FILING, BIDMC SERVED AS THE SOLE MEMBER OF BID NEEDHAM UNTIL MARCH 1, 2019. THE MEDICAL CENTER IS A NATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER AND TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP) IS AN INTEGRALLY RELATED PHYSICIAN PRACTICE OF BIDMC AND IS ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. APHMFP PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE BID NEEDHAM EMERGENCY DEPARTMENT. THESE PHYSICIANS ARE ALL CERTIFIED OR BOARD-ELIGIBLE IN LEVEL 1 TRAUMA. THE BID NEEDHAM DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR.FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE RECEIVED FROM QUALIFYING BETH ISRAEL DEACONESS HOSPITALNEEDHAM PROVIDERS.BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) WHICH APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY THE HOSPITAL'S BOARD PRIOR TO 8/1/2019, AND THESE DOCUMENTS WERE ALL EFFECTIVE AS OF 8/1/2019, THE FIRST DAY OF THE HOSPITAL'S FISCAL YEAR IN WHICH THE HOSPITAL WAS REQUIRED TO BE IN COMPLIANCE WITH THE REGULATIONS PROMULGATED BY THE TREASURY AND RELATED TO IRC SECTION 501(R). FINANCIAL ASSISTANCE POLICYAPPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE (SCHEDULE H PART V SECTION B QUESTION 15).FINANCIAL ASSISTANCE POLICYELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION MAY BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP (SCHEDULE H PART I QUESTIONS 3C).
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FINANCIAL ASSISTANCEPUBLIC ASSISTANCE PROGRAMS
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(SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HER OR HIS CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICYTRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS USING THE HEALTH AND HUMAN SECRETARY GUIDANCE SAFE HARBOR OF 5% OF THE POPULATION OR 1,000 PERSONS, WHICHEVER IS LESS. BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: CHINESE, ENGLISH, RUSSIAN, SPANISH (SCHEDULE H PART V SECTION B QUESTION 16I). FINANCIAL ASSISTANCE POLICYWIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL OR BY MAIL FREE OF CHARGE AND ON THE HOSPITAL'S WEBSITE AT (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT:HTTPS://WWW.BIDNEEDHAM.ORG/WRITABLE/FILES/BIDHN-PLAIN-LANGUAGE-SUMMARY-REVISED-08-2018.DOCX.PDFIN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICYPLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS' APPROVAL UNDER THE FAP WILL APPLY.
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LIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)
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LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLEDLOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAT EXCEED THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED AND FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY AND AFFILIATED HEALTH CARE SYSTEM (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. ON MARCH 1, 2019, THE BETH ISRAEL LAHEY HEALTH SYSTEM WAS FORMED THROUGH THE COMBINATION OF THE HOSPITALS AND OTHER AFFILIATES OF THREE LEGACY HEALTH CARE SYSTEMS BASED PRIMARILY IN EASTERN MASSACHUSETTS, INCLUDING THE FORMER CAREGROUP HEALTH SYSTEM, THE FORMER LAHEY HEALTH SYSTEM, AND THE SEACOAST HEALTH SYSTEM. BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS NOW THE SOLE MEMBER OF THE HOSPITAL AND NINE ADDITIONAL AFFILIATED HOSPITALS. EACH OF THESE ENTITIES MAY HAVE, IN TURN, SERVED AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. THE BILH HEALTH SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. AFFILIATED HEALTH CARE SYSTEMAS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BILH IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. BILH SERVES AS SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). LAHEY CLINIC FOUNDATION SERVES AS THE SOLE MEMBER OF LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER. EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.