| FORM 990, PART I AND PART III, LINE 1 |
FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $3.6 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS OVER HALF A MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF 2,600 AFFILIATED PHYSICIANS AND 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. FULFILLING THE SCRIPPS MISSION DURING THIS FISCAL YEAR, SCRIPPS DEVOTED $431,882,133 TO COMMUNITY BENEFIT PROGRAMS AND SERVICES IN THE AREAS OF UNCOMPENSATED CARE, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND HEALTH RESEARCH. UNCOMPENSATED CARE INCLUDES CHARITY CARE, BAD DEBT, AND MEDI-CAL AND MEDICARE SHORTFALLS. 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. SAN DIEGO COUNTY COMMUNITY DEFINED SAN DIEGO COUNTY HEALTH AND HUMAN SERVICES AGENCY (HHSA) ORGANIZES THEIR SERVICE AREAS INTO SIX GEOGRAPHIC REGIONS DUE TO ITS LARGE GEOGRAPHIC SIZE AND POPULATION. CENTRAL, EAST, NORTH CENTRAL, NORTH COASTAL, NORTH INLAND AND SOUTH. THE DEMOGRAPHICS OF SAN DIEGO REFLECT A DIVERSE POPULATION, WITH CONSIDERABLE VARIATION BETWEEN THE DIFFERENT REGIONS. DEMOGRAPHIC PROFILE OF SAN DIEGO COUNTY 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 RACE, ETHNICITY, AND AGE DISTRIBUTION ARE ALL IMPORTANT FACTORS IN UNDERSTANDING COMMUNITIES AND THEIR HEALTH NEEDS. 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 SAN DIEGO'S UNINSURED LOW-INCOME, UNINSURED, AND UNDEREDUCATED INDIVIDUALS HAVE BEEN FOUND TO BE MOST AT RISK FOR POOR HEALTH STATUS AND HEALTH OUTCOMES. DATA FROM THE AMERICAN COMMUNITY SURVEY (ACS) SHOW HOW THESE INDICATORS IMPACT THE SAN DIEGO COMMUNITY. EVALUATING THESE RISK FACTORS IS IMPORTANT FOR IDENTIFYING COMMUNITIES WITH THE MOST SIGNIFICANT HEALTH NEEDS AND HEALTH DISPARITIES. 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 THE 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% FPL CAN PURCHASE SUBSIDIZED INSURANCE COVERAGE. THE MAJOR COVERAGE EXPANSIONS OF THE ACA WERE IMPLEMENTED STARTING IN 2014 AND BETWEEN 2013 AND 2018, THE UNINSURED RATE FOR CALIFORNIANS UNDER AGE 65 WAS NEARLY HALVED, DROPPING FROM 15.5% TO 8.1% (THIS PERCENTAGE INCLUDES CHILDREN). THE ECONOMIC DOWNTURN CAUSED BY THE CORONAVIRUS PANDEMIC HAS RENEWED ATTENTION ON HEALTH INSURANCE COVERAGE AS MILLIONS HAVE LOST THEIR JOBS AND POTENTIALLY THEIR HEALTH COVERAGE. THE AFFORDABLE CARE ACT (ACA) SOUGHT TO ADDRESS THE GAPS IN OUR HEALTH CARE SYSTEM THAT LEAVE MILLIONS OF PEOPLE WITHOUT HEALTH INSURANCE BY EXTENDING MEDICAID COVERAGE TO MANY LOW-INCOME INDIVIDUALS AND PROVIDING SUBSIDIES FOR MARKETPLACE COVERAGE FOR INDIVIDUALS BELOW 400% OF POVERTY. KEY FINDINGS FOLLOWING THE ACA, THE NUMBER OF UNINSURED NONELDERLY AMERICANS DECLINED BY 20 MILLION, DROPPING TO AN HISTORIC LOW IN 2016. HOWEVER, BEGINNING IN 2017, THE NUMBER OF UNINSURED NONELDERLY AMERICANS INCREASED FOR THREE STRAIGHT YEARS, GROWING BY 2.2 MILLION FROM 26.7 MILLION IN 2016 TO 28.9 MILLION IN 2019, AND THE UNINSURED RATE INCREASED FROM 10.3% IN 2016 TO 10.9% IN 2019 FOR CALIFORNIA AND FROM 10.4% IN 2016 TO 11.3% IN SAN DIEGO COUNTY. 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. SCRIPPS PROVIDES SIGNIFICANT AND GROWING VOLUMES OF EMERGENCY, OUTPATIENT, AND PRIMARY CARE. IN FISCAL YEAR 2020, SCRIPPS PROVIDED 2,519,092 OUTPATIENT VISITS. 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. 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 HELP FINANCE SERVICES FOR SAN DIEGO COUNTY'S UNDERINSURED 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/UNDERINSURED PATIENTS IN THEIR OPERATING BUDGETS. THIS PLACES A SIGNIFICANT FINANCIAL BURDEN ON HOSPITALS AND PHYSICIANS. |
| FORM 990, PART III, LINE 4A |
SCRIPPS MERCY HOSPITAL (INCLUDING SAN DIEGO AND CHULA VISTA CAMPUSES) PROVIDES 56 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. SCRIPPS MERCY HOSPITAL SAN DIEGO AND SCRIPPS MERCY HOSPITAL CHULA VISTA CAMPUSES ARE DESIGNATED BY THE GOVERNMENT AS DISPROPORTIONATE SHARE HOSPITALS, IN REFLECTION OF THE DIVERSITY OF THE POPULATION THEY SERVE. BOTH HOSPITAL 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. 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 https://www.scripps.org/sparkle-assets/documents/scripps-community-health- needs-assessment-2019.pdf 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 4206.64 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. 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. 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. |
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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 IS 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 IS 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. SCRIPPS IS CURRENTLY WORKING WITH THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC) AND THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE TO BUILD A STRATEGIC FRAMEWORK TO PLAN AND IMPLEMENT THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA COMMITTEE IS RE-ENVISIONING HOW BEST TO WORK COLLABORATIVELY IN A VIRTUAL ENVIRONMENT AND CONTINUING TO LOOK AT HEALTH AND SOCIAL NEEDS FROM A HEALTH EQUITY LENS. THE 2022 CHNA IS EXPECTED TO BE FINALIZED IN THE FALL OF 2022. HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES; 2019 COMMUNITY HEALTH NEEDS ASSESSENT PHASE TWO IN JULY 2019, THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC) COMPLETED THE TRIENNIAL COLLABORATE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO IDENTIFY AND PRIORITIZE THE HEALTH NEEDS OF SAN DIEGO COUNTY RESIDENTS, PARTICULARLY THOSE WHO EXPERIENCE HEALTH INEQUITIES. THE CHNA IS MANAGED BY A STANDING CHNA COMMITTEE COMPRISED OF REPRESENTATIVES FROM HOSPITALS, AND HEALTH SYSTEMS AND HEALTH DISTRICTS. HASD&IC CONTRACTED WITH THE INSTITUTE OF PUBLIC HEALTH (IPH) AT SAN DIEGO STATE UNIVERSITY (SDSU) TO CONDUCT THE NEEDS ASSESSMENT. THE CHNA COMMITTEE WORKED WITH IPH TO DISTRIBUTE A FOLLOW-UP SURVEY TO GATHER FEEDBACK ON THE 2019 CHNA FINDINGS THROUGH A PHASE 2 SURVEY. THE SURVEY SOUGHT TO FURTHER EXPLORE FREQUENTLY RECURRING THEMES THAT EMERGED DURING COMMUNITY DISCUSSIONS IN THE 2019 CHNA, INCLUDING: ACCESS TO CARE, STIGMA, IMMIGRATION, AND PUBLIC CHARGE. NOTE: THE PHASE 2 SURVEY WAS DEVELOPED AND DISSEMINATED PRIOR TO THE COVID-19 PANDEMIC TAKING HOLD IN THE SAN DIEGO REGION. THE CHNA COMMITTEE RECOGNIZES THAT COMMUNITIES FACING INEQUITIES ARE DEALING WITH UNPRECEDENTED CHALLENGES AND THE DEVASTATING INCREASE IN NEEDS IS NOT CAPTURED IN THESE FINDINGS. NEARLY 92% OF RESPONDENTS (114 OUT OF 124 RESPONDENTS) AGREED OR STRONGLY AGREED THAT THE HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA REPRESENT THE TOP HEALTH NEEDS OF COMMUNITIES FACING INEQUITIES WITHIN SAN DIEGO COUNTY. MOST SURVEY RESPONDENTS WERE FROM COMMUNITY-BASED ORGANIZATIONS (39.5%), FOLLOWED BY HOSPITALS/HEALTH SYSTEMS (16.1%) AND COMMUNITY RESIDENTS (11.3%). A TOTAL OF 105 SURVEY PARTICIPANTS RESPONDED TO THE QUESTION ABOUT WHERE THEY LIVE OR WORK. OVERALL, 37.4% OF SURVEY RESPONDENTS SERVED ALL REGIONS OF SAN DIEGO COUNTY AND 26.8% LIVED IN OR WORK AT NORTH INLAND. CONCLUSION FOR ADDITIONAL DETAILS, INCLUDING COMMUNITY SUGGESTIONS AND RECOMMENDATIONS TO ADDRESS IDENTIFIED NEEDS, PLEASE SEE THE FULL REPORT ON THE HASD&IC WEBSITE, https://hasdic.org/2019-chna/. 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. SCRIPPS HEALTH IS FOCUSING ON THE STRATEGIES AND INITIATIVES, THEIR MEASURES OF IMPLEMENTATION AND THE METRICS USED TO EVALUATE THEIR EFFECTIVENESS. SCRIPPS MONITORS AND EVALUATES THE STRATEGIES LISTED IN THE IMPLEMENTATION PLAN FOR THE PURPOSE OF TRACKING THE IMPLEMENTATION OF THOSE STRATEGIES AS WELL AS TO DOCUMENT THE ANTICIPATED IMPACT. PLANS TO MONITOR ARE TAILORED TO EACH STRATEGY AND 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 COMMUNITY BENEFIT PROGRAMS IN FISCAL YEAR 2020. 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 FY20. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
SCRIPPS RECUPERATIVE CARE PROGRAMS (RCU) THE SCRIPPS/CITY OF REFUGE RECUPERATIVE CARE SHELTER (RCS) 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. THE CASE MANAGEMENT AND SOCIAL WORK DEPARTMENTS ASSIST WITH A NEEDED SUPPLY OF MEDICATION, APPOINTMENTS, DURABLE MEDICAL EQUIPMENT (DME), SETTING UP HOME HEALTH SERVICES IF NEEDED, AND CONNECTS PATIENTS TO PSYCH AS PART OF THE HOSPITAL DISCHARGE PLAN TO CITY OF REFUGE. CITY OF REFUGE FURTHER SUPPORTS CLIENTS IN MEETING THESE GOALS USING COMMUNITY RESOURCES TO MEET INDIVIDUAL SOCIAL SERVICE NEEDS. SCRIPPS PAYS THE CITY OF REFUGE A DAILY RATE FOR HOUSING AND SERVICES THEY PROVIDE TO THE PATIENTS. THE CITY OF REFUGE PROVIDES A SAFE, SECURE ENVIRONMENT, WITH 24 HOUR SUPERVISION, MEDICATION OVERSIGHT, MEALS, CLOTHING, CASE MANAGEMENT, ASSISTANCE WITH MEDI-CAL, WITH TRANSITION TO MANAGED MEDI-CAL AND DISABILITY APPLICATIONS, REFERRALS TO REHAB AND OTHER PROGRAMS, AND HELP FINDING PERMANENT OR TRANSITIONAL HOUSING USING COUNTY RESOURCES. DME AND OTHER NEEDED SERVICES ARE PROVIDED BY SCRIPPS WHEN FUNDING IS NOT AVAILABLE. ALL PATIENTS ARE CONNECTED TO A MEDICAL HOME, AND PRIMARY CARE IN THE COMMUNITY. PATIENTS WITH PSYCH DISORDERS ARE ESTABLISHED WITH A PSYCHIATRIST IN THE COMMUNITY IF THEY ARE WILLING. PATIENT TRANSPORTATION NEEDS ARE COORDINATED BY CITY OF REFUGE, BUT MAY INCLUDE INSURANCE FUNDED TRANSPORT SERVICES, AND OCCASIONALLY SCRIPPS SHUTTLE, OR USE OF TAXI VOUCHER. THE CITY OF REFUGE BEGAN TAKING PATIENTS ROUTINELY IN OCTOBER OF 2019. THIS YEAR 44 PATIENTS SO FAR HAVE MET THE NEED FOR RCS ADMISSION. AS A GROUP, THE RCS PATIENTS HAD A CUMULATIVE OF 626 HOSPITAL DAYS OF STAY, AN AVERAGE OF 12.6 HOSPITAL DAYS OF STAY, BEFORE GOING TO RCS OCTOBER 2019 TO DATE. THE RCS HAS TAKEN MEDICALLY COMPLEX PATIENTS, INCLUDING THOSE WITH: IV ANTIBIOTICS, WOUND VACS, SKIN GRAFTS, FRACTURES, ABSCESSES, OSTEOMYELITIS, AMPUTATION, 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 AND MANY ARE DIABETIC. PSYCH PROBLEMS ARE COMMON AND OCCASIONALLY THE MAIN ISSUE FOR RCS CLIENTS. OVER 85% OF THIS GROUP WERE EITHER POSITIVE FOR ALCOHOL, DRUGS OR 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 FY20 TOTAL COST SAVINGS FOR SCRIPPS WAS $795,491. - OF RECUPERATIVE CARE SHELTER PATIENTS, 27% HAD STANDARD MEDI-CAL INSURANCE, 9% HPE (HEALTH PRESUMPTIVE ELIGIBILITY) MEDI-CAL, 41% MEDI-CAL HMO'S AND OF THE MANAGED CARE PLANS, MOLINA MEDI-CAL WAS THE HIGHEST UTILIZER. - APPROXIMATELY 30% OF PATIENTS SOUGHT TO SECURE INCOME FROM GOVERNMENT PROGRAMS, SOCIAL SECURITY, AND CA SHORT TERM DISABILITY; SIX TOTAL CLIENTS APPLIED OR RECEIVED INCOME BENEFITS. FOUR HAVE APPLIED AND RECEIVED MEDI-CAL HMO'S WHILE AT THE RCS WITH THE ASSISTANCE OF THEIR CASE MANAGEMENT DEPARTMENT. - THE PROGRAM ASSISTED SCRIPPS MD ANDERSON CANCER CENTER PATIENTS. - RCS ASSISTED TWO PATIENTS IN MAINTAINING THEIR HEALTH AND TRANSITIONED THEM INTO INDEPENDENT LIVING HOMES FOR ADDITIONAL CARE. - EIGHT 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. - TEN PERCENT DID NOT COMPLETE THE PCP APPOINTMENT, YET SEVERAL PATIENTS WERE INTRODUCED TO FHC MENTAL HEALTH SERVICES. - FOLLOWING THEIR STAY AT CITY OF REFUGE: 50% DID NOT RETURN TO THE STREETS, 5% WENT BACK TO THE HOSPITAL AS THEY NEEDED FURTHER TREATMENT. 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, 47 RESIDENTS AND 46 FELLOWS. GME RESIDENTS AND MANY ATTENDING PHYSICIANS MAINTAIN AN EVENING CLINIC AT ST. LEO'S MISSION COMMUNITY CLINIC IN NORTH COUNTY (THIS INITIATIVE WAS PUT ON HOLD IN MARCH DUE TO THE PANDEMIC). 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. 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 APPROXIMATELY 150+ PATIENTS FROM JANUARY-MARCH OF 2020. 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 2020 MISSION BROUGHT OUR 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. TOTAL OF PATIENTS SERVED IN THE JANUARY 2020 MISSION WAS 700. 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 FISCAL YEAR 2020, THE M.O.S.T TEAM SERVED IN ONE OUTREACH MISSION TRIP AS THE SECOND ONE WAS CANCELLED DUE TO THE PANDEMIC. THE TEAM VOLUNTEERED OVER 776 HOURS TO PROVIDE RECONSTRUCTIVE SURGERIES FOR MORE THAN 262 PEOPLE AND 40 PAIRS OF EYEGLASSES WERE DISTRIBUTED. SCRIPPS-SPONSORED AMERICAN RED CROSS BLOOD DRIVES SCRIPPS HEALTH PARTNERED WITH THE AMERICAN RED CROSS IN FISCAL YEAR 2020 TO HOST 13 BLOOD DRIVES; 331 SCRIPPS EMPLOYEES DONATED BLOOD THROUGHOUT THE YEAR. SCRIPPS HEALTH COLLECTED 353 PINTS OF BLOOD (FOR EVERY PINT DONATED 3 LIVES ARE SAVED), WHICH SAVED APPROXIMATELY 1,062 LIVES. SCRIPPS PROMOTED THE BLOOD DRIVES THROUGH OUR SYSTEM WIDE COMMUNICATION CHANNELS AND OUR WELLNESS ALL AROUND YOU CAMPAIGN. SCRIPPS HEALTH COMMUNITY BENEFIT (CB) FUND IN FISCAL YEAR 2020, SCRIPPS HEALTH CONTINUED TO DEEPEN ITS COMMITMENT TO PHILANTHROPY WITH ITS COMMUNITY BENEFIT FUND. OVER THE COURSE OF THE YEAR, IT AWARDED $141,000 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 $4.1 MILLION. PROGRAMS FUNDED DURING FISCAL YEAR 2020 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 IMPORTA |
| FORM 990, PART III, LINE 4A (CONTINUED) |
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 COMMUNITY INFORMATION EXCHANGE 2-1-1 SAN DIEGO SERVES ALL OF SAN DIEGO COUNTY, INCLUDING THE POPULATION SERVED BY SCRIPPS, AS THE REGION'S TRUSTED PRIMARY CONNECTION TO MORE THAN 6,000 COMMUNITY, HEALTH AND DISASTER SERVICES IN MORE THAN 200 LANGUAGES, 24 HOURS A DAY. IN ADDITION, 2-1-1 SAN DIEGO OPERATES A 2-1-1 INFORMATION HOTLINE (CALL CENTER) IN THE SAN DIEGO AND IMPERIAL COUNTY. CALL CENTER SERVICES ARE DESIGNED TO HELP MEMBERS OF THE PUBLIC ("CLIENTS") TO CONNECT WITH COMMUNITY RESOURCES TO ASSIST CLIENTS OBTAIN MEDICAL CARE, MENTAL HEALTH SERVICES, HOUSING, FOOD, CLOTHING, GOVERNMENT BENEFITS, AMONG OTHER THINGS. 2-1-1 SAN DIEGO HAS EXPANDED ITS REFERRAL SERVICES TO INCLUDE DIRECT REFERRAL TO CLIENTS TO COMMUNITY RESOURCES AND ACCESS TO THE COMMUNITY INFORMATION EXCHANGE (CIE) DATABASE. THE CIE IS AN ECOSYSTEM COMPRISED OF MULTIDISCIPLINARY NETWORK PARTNERS THAT USE A SHARED LANGUAGE, A RESOURCE DATABASE, AND AN INTEGRATED TECHNOLOGY PLATFORM TO DELIVER ENHANCED COMMUNITY CARE PLANNING. CARE PLANNING TOOLS ENABLE PARTNERS TO INTEGRATE DATA FROM MULTIPLE SOURCES AND MAKE BI-DIRECTIONAL REFERRALS TO CREATE A SHARED LONGITUDINAL RECORD. BY FOCUSING ON THESE CORE COMPONENTS, A CIE ENABLES COMMUNITIES TO SHIFT AWAY FROM A REACTIVE APPROACH TO PROVIDING CARE TOWARD PROACTIVE, HOLISTIC, PERSON-CENTERED CARE. THE CIE DATABASE SERVES AS A DIRECTORY OF PARTICIPATING PROFESSIONALS, AGENCIES AND BUSINESSES PROVIDING SERVICES THAT RELATE TO THE SOCIAL DETERMINANTS OF HEALTH. THE DATABASE ALSO SERVES AS A SOURCE OF INFORMATION ABOUT THE CLIENT'S SOCIAL DETERMINANTS OF HEALTH AND CURRENT NEEDS AND IS USED TO HELP THE CLIENT ACCESS COMMUNITY RESOURCES SUITABLE TO ADDRESS THOSE NEEDS. 2-1-1 SAN DIEGO HAS PARTNERED WITH SCRIPPS SINCE 2011 TO PROVIDE CARE COORDINATION SERVICES TO CLIENTS IN NEED OF HEALTH NAVIGATION SUPPORT. IN FISCAL YEAR 2020 FUNDING WAS AWARDED TO 2-1-1 SAN DIEGO TO PILOT THE CIE AT THE SCRIPPS MERCY HOSPITAL LOCATION. THIS PROJECT SPECIFICALLY SERVED SCRIPPS MERCY HOSPITAL PATIENTS, FOCUSING ON HOMELESS AND HOUSING INSECURE INDIVIDUALS AND TO ASSIST IN HOSPITAL DISCHARGE PLANNING. COMMUNITY INFORMATION EXCHANGE CIE 2020 SUMMIT SCRIPPS ALSO SPONSORED THE COMMUNITY INFORMATION EXCHANGE (CIE) SUMMIT. THE 2020 SUMMIT WAS HELD VIRTUALLY DUE TO THE IMPACT OF COVID-19. CORE TO THE THEME OF THE CIE SUMMIT, THIS YEAR'S VIRTUAL EVENT: - HOSTED OPEN DISCUSSIONS ON IMPACT OF INEQUITY AND HOW TO LEAD WITH INCLUSION. - EXPLORED COMMUNITY-BASED APPROACHES FOR BUILDING A CIE. - INCORPORATED THOUGHTFUL STRATEGIES FOR ACTIVATING COMMUNITY VOICE. - EMPHASIZED REPRESENTATION OF DIVERSE PERSPECTIVES OF INFORM CIE DESIGN, IMPLEMENTATION AND DATA COLLECTION. 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. IN 2021 THERE WILL BE AN ESTIMATED 187,140 NEW CANCER CASES AND 61,860 CANCER DEATHS, AN INCIDENCE RATE OF 404.6 AVERAGE ANNUAL RATE PER 100,000 AND A DEATH RATE OF 140.3 AVERAGE ANNUAL RATE PER 100,000 IN CALIFORNIA. THE UNITED STATES HAS ONE OF THE HIGHEST RATES OF COVID-19 INFECTION IN THE WORLD, AND AS OF MID-NOVEMBER 2020, 240,000 AMERICANS HAD DIED FROM THE DISEASE. COVID-19 DEATHS ACCOUNT FOR TWO-THIRDS OF THE EXCESS DEATHS IN THE US FROM MARCH THROUGH JULY 2020. INCREASED DEATHS FROM OTHER CAUSES ARE PARTLY DUE TO MISCLASSIFICATION OF DEATHS FROM COVID-19, BUT ALSO BECAUSE OF DISRUPTIONS IN CARE. ADDITIONAL EXCESS MORTALITY FROM OTHER ILLNESSES WILL LIKELY BE PROTRACTED. FOR EXAMPLE, CANCER DEATHS DIPPED DURING THE EARLY MONTHS OF THE PANDEMIC BUT WILL LIKELY REBOUND IN HIGHER NUMBERS THAN EXPECTED IN THE MONTHS AND YEARS TO COME BECAUSE OF DELAYS IN DIAGNOSIS AND TREATMENT. THE IMPACT OF COVID-19 ON CANCER DIAGNOSES AND OUTCOMES AT THE POPULATION LEVEL WILL BE UNKNOWN FOR SEVERAL YEARS BECAUSE OF THE TIME NECESSARY FOR DATA COLLECTION, COMPILATION, QUALITY CONTROL, AND DISSEMINATION. 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 2018, CANCER WAS THE LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY, RESPONSIBLE FOR 23.1 PERCENT OF ALL UNDERLYING CAUSES OF DEATH. - IN 2018, THERE WERE 4,988 DEATHS DUE TO CANCER (ALL SITES), AND AN AGE ADJUSTED DEATH RATE OF 132.18 DEATHS PER 100,000 POPULATION. - ACCORDING TO FINDINGS FROM THE ACS 2021 CANCER FACTS & FIGURES REPORT, SCREENING OFFERS THE ABILITY FOR SECONDARY PREVENTION BY DETECTING CANCER EARLY. IT IS ESTIMATED THAT NEARLY 1.9 MILLION NEW CASES OF CANCER WILL BE DIAGNOSED IN 2021. PROSTATE CANCER IS THE MOST COMMON CANCER AMONG MALES (26%), FOLLOWED BY LUNG (12%) AND COLORECTAL (8%) CANCERS. AMONG FEMALES, BREAST (30%), LUNG (13%), AND COLORECTAL (8%) CANCERS ARE THE MOST COMMON. - ACCORDING TO FINDINGS FROM THE ACS 2021 CANCER FACTS & FIGURES REPORT, CANCER INCIDENCE RATES ARE HIGHER IN MALES THAN IN FEMALES FOR EACH RACIAL/ETHNIC POPULATION, ALTHOUGH RATES ARE VERY SIMILAR IN ASIAN/PACIFIC ISLANDERS. THE HIGHEST INCIDENCE RATES ARE IN BLACKS AMONG MALES AND IN WHITES AMONG FEMALES. ASIAN/PACIFIC ISLANDERS HAVE THE LOWEST RATES IN BOTH SEXES. - 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. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
SCRIPPS HEALTH CURRENTLY CARES FOR ONE-THIRD OF CANCER PATIENTS IN SAN DIEGO. 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. SCRIPPS HEALTH IS COMMITTED TO PROVIDING CARE TO ALL THOSE IN NEED. WE SERVE AN ETHNICALLY AND ECONOMICALLY DIVERSE POPULATION INCLUDING CARING FOR TRADITIONALLY MARGINALIZED AND UNDERSERVED WITH RESPECT TO HEALTH CARE. 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 FISCAL YEAR 2020: 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 CANCER CENTER REGISTERED NURSE NAVIGATOR PROGRAM SCRIPPS PROVIDES 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. SCRIPPS MD ANDERSON CANCER CENTER - OUPATIENT SOCIAL WORKER & LIAISON PROGRAM SCRIPPS PROVIDES SPECIALLY TRAINED ONCOLOGY SOCIAL WORKERS WHO UNDERSTAND THE COMPLEXITIES OF LIVING WITH CANCER AND ARE DEDICATED TO ASSISTING CANCER PATIENTS, ALONG WITH PROVIDING EDUCATION TO HEALTH PROFESSIONALS AND CAREGIVERS. THE SOCIAL WORKERS HELP TO ACCESS THE MOST APPROPRIATE COMMUNITY AND MEDICAL RESOURCES AND PROVIDE SHORT TERM COUNSELING AS WELL AS ASSIST WITH TRANSPORTATION, LODGING AND FINANCIAL CONCERNS. SCRIPPS MD ANDERSON CANCER CENTER- OUTPATINT HEREDITY AND CANCER GENETIC COUNSELING PROGRAM SCRIPPS MD ANDERSON CANCER CENTER GENETIC COUNSELING TEAM HELPS INDIVIDUALS AND THEIR FAMILIES UNDERSTAND THEIR CANCER RISKS SO THAT INDIVIDUALIZED CANCER SCREENING AND RISK REDUCTION PLANS CAN BE DESIGNED. IN ADDITION TO PROVIDING INFORMATION AND GUIDANCE ABOUT GENETIC TESTING, GENETIC COUNSELORS INTERPRET TEST RESULTS, ADVISE FAMILIES ABOUT THEIR OPTIONS AND PROVIDE EDUCATION AND SUPPORT. SCRIPPS MD ANDERSON CANCER CENTER SUPPORT GROUPS THE BEST CANCER CARE INCLUDES MORE THAN MEDICAL TREATMENT. SCRIPPS MD ANDERSON CANCER CARE CENTER OFFERS SUPPORT FOR PEOPLE LIVING WITH CANCERS, INCLUDING BREAST, GYNECOLOGIC AND HEAD AND NECK, AS WELL AS SERVICES TO HELP WITH EMOTIONAL, PSYCHOLOGICAL, FINANCIAL AND LIFESTYLE AS ASPECTS OF CANCER. ALTHOUGH DUE TO COVID-19 MEETINGS WERE SUSPENDED FOR MOST OF THE YEAR AS THERE WAS RESTRICTED ACCESS TO THE HOSPITAL PATIENTS HAD THE ABILITY TO JOIN ONLINE SUPPORT GROUPS OFFERED BY MD ANDERSON CANCER CENTER AS PART OF OUR PARTNERSHIP. THE SESSIONS WERE FACILITATED BY MD ANDERSON SOCIAL WORK COUNSELORS AND PROVIDED AN OPPORTUNITY FOR PATIENTS, FAMILY MEMBERS AND FRIENDS TO MEET OTHERS IN SIMILAR CIRCUMSTANCES, DEVELOP NEW RELATIONSHIPS AND FIND OUT HOW OTHERS COPE DURING THIS TIME OF INCREASED DISTRESS. SCRIPPS MD ANDERSON CANCER CENTER SURVIVORSHIP PROGRAM SCRIPPS MD ANDERSON PATIENTS AND THEIR FAMILIES CAN TAKE PART IN FREE SURVIVORSHIP PROGRAMS THOUGH SAN DIEGO YMCA AND LIVESTRONG FOUNDATION. FOCUSING ON PHYSICAL ACTIVITY AND WELL-BEING, THE PROGRAM HELPS ADULT CANCER SURVIVORS ACHIEVE THEIR HOLISTIC HEALTH GOALS. 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 EVENTS 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. EVENTS WERE HELD ONLINE THIS YEAR TO ENSURE SAFETY AND REDUCE THE SPREAD OF COVID-19. IN PARTNERSHIP WITH MD ANDERSON CANCER CENTER THE FOLLOWING WERE SOME OF THE TOPICS PRESENTED; BUILDING YOUR OWN VISION BOARD AT HOME, HISTORY OF LABYRINTHS, MUSIC AND MINDFULNESS EXERCISE, ANTICANCER LIVING: TRANSFORM YOUR LIFE AND HEALTH WITH THE MIX OF SIX, YOGA BREATHING EXERCISES AND CHAIR YOGA. SCRIPPS MERCY HOSPITAL CHULA VISTA WELL-BEING CANCER SUPORT SERVICES: HEALTHY WOMEN, HEALTHY LIFESTYLES: 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 TOGETHER, 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. DUE TO COVID-19 MANY OF THESE OUTREACH AND EDUCATION PROGRAMS CEASED MID-MARCH 2020 DUE TO LARGE GROUP AND GATHERING RESTRICTIONS; SOME SERVICES WERE ABLE TO TRANSITION TO A VIRTUAL PLATFORM. MUJERES EN ACCION/WOMEN IN ACTION BREAST HEALTH OUTREACH AND EDUCATION THE MUJERES EN ACCIN/WOMEN IN ACTION BREAST HEALTH OUTREACH AND EDUCATION PROGRAM INCREASES BREAST CANCER COORDINATION, BREAST HEALTH EDUCATION, CLINICAL BREAST EXAMINATIONS, AND SCREENING MAMMOGRAPHY SERVICES FOR LATINO AND FILIPINO/ASIAN AND OTHER DIVERSE WOMEN AGES 40 YEARS AND OLDER. THE BREAST CANCER SUPPORT GROUP IS FOR WOMEN GOING THROUGH BREAST CANCER TREATMENT. IT ALLOWS FOR CONFIDENTIAL PEER SUPPORT AND STAFF PROVIDE SUPPORT, EDUCATION, AND RESOURCES TO THESE WOMEN. RESOURCES ARE AVAILABLE AT THE CENTER TO PROVIDE TO PATIENTS SUCH AS WIGS PROSTHESIS, BRAS, HATS, MEDICAL RECORD ORGANIZER BINDER, AND GAS CARDS. THE WELL BEING CENTER OFFERS THIS SUPPORT GROUP TO PROVIDE EMOTIONAL AID, NEW COPING SKILLS, AND ENCOURAGEMENT. GROUP MEMBERS CAN SHARE THEIR PERSONAL EXPERIENCES, HOPES, FEARS, AND STRENGTHS IN A RELAXED SETTING. SCRIPPS MERCY HOSPITAL CHULA VISTA: BREAST HEALTH SERVICES A TOTAL OF 150 WOMEN WERE REFERRED TO CLINICAL BREAST HEALTH SERVICES IN THE COMMUNITY AND SCRIPPS MERCY HOSPITAL CHULA VISTA RADIOLOGY SERVICES. MORE THAN 1,900 SERVICES WERE PROVIDED INCLUDING TELEPHONE REMINDERS, OUTREACH AND EDUCATION ABOUT PREVENTING BREAST CANCER, CASE MANAGEMENT/CARE COORDINATION, PROVIDING LOCAL RESOURCES, ENCOURAGEMENT FOR PATIENTS TO REPEAT EXAM, SENDING CORRESPONDENCE TO PATIENTS AND PROVIDERS, SOCIAL/EMOTIONAL SUPPORT, HOME AND HOSPITAL VISITS, MAILING EDUCATIONAL MATERIAL ON NUTRITION, TREATMENT OPTIONS AND COMMONLY ASKED QUESTIONS AND SUPPLIES (WIGS, BRAS, PROSTHESIS AND MEDICAL RECORD ORGANIZER BINDER). DUE TO COVID-19 BREAST HEALTH SCREENINGS WERE POSTPONED/CANCELLED MID-MARCH 2020. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
SCRIPPS MERCY HOSPITAL CHULA VISTA: CANCER SUPPORT GROUP TOGETHER PROMOTORAS AND CANCER SURVIVORS HOLD A BI-MONTHLY SUPPORT GROUP THAT HELPS INDIVIDUALS COPE WITH LIVING WITH CANCER. GROUP SUPPORT INCLUDING NAVIGATING THE CANCER SYSTEM AND EDUCATIONAL PRESENTATIONS BY LOCAL PROVIDERS ARE OFFERED. A TOTAL OF 190 WOMEN PARTICIPATED IN THE BREAST CANCER SUPPORT GROUP. DUE TO THE COVID-19 THIS SUPPORT GROUP TRANSITIONED TO CONFERENCE CALLS AND VIRTUAL OFFERINGS AND THEREFORE LESS WOMEN PARTICIPATED IN THE SUPPORT GROUP. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD FOR MOST OF THE YEAR AS THERE WAS RESTRICTED ACCESS TO THE HOSPITAL. 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 $8,000 TO RAISE MONEY FOR BREAST CANCER RESEARCH. IN ADDITION, THE SCRIPPS HEALTH TEAM FUNDRAISED $5,000. 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. AMERICAN CANCER SOCIETY CANCER SCTION NETWORK (ACS CAN) SCRIPPS HEALTH PARTICIPATED AND SPONSORED IN A RESEARCH BREAKFAST ON PRECISION MEDICINE, GENOMICS AND CLINICAL TRIALS IN OCTOBER 2019. THESE TOPICS REFLECT CUTTING-EDGE SCIENCE THAT HAS BEEN AT THE FOREFRONT OF BREAKTHROUGHS IN TREATMENT AND WOULD NOT BE POSSIBLE WITHOUT RESEARCH AND DEDICATED SCIENTISTS AND CLINICIANS. THE EVENT BROUGHT TOGETHER MORE THAN 100 LEADERS FROM THE BUSINESS, EDUCATION, GOVERNMENT AND RESEARCH COMMUNITIES TO ADVANCE THE WORK OF ACS CAN. ACS CAN IS A NONPROFIT, NONPARTISAN ADVOCACY AFFILIATE OF THE AMERICAN CANCER SOCIETY. LUNG CANCER RESEARCH FOUNDATION FREE TO BREATHE JAZZ BY THE BAY 5K SCRIPPS PARTICIPATED IN THE LUNG CANCER RESEARCH FOUNDATION FREE TO BREATHE JAZZ FUNDRAISING WALK IN NOVEMBER 2019. THE LUNG CANCER RESEARCH FOUNDATION BUILDS AWARENESS AND FUNDS VITAL RESEARCH PROGRAMS DEDICATED TO IMPROVING LUNG CANCER OUTCOMES. CARDIOVASCULAR DISEASE 'DISEASES OF THE HEART' WERE THE SECOND LEADING CAUSE OF DEATH IN SAN DIEGO COUNTY IN 2018. 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. 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 2018, CEREBROVASCULAR DISEASES INCLUDING STROKE WERE THE FOURTH LEADING CAUSE OF DEATH FOR SAN DIEGO COUNTY OVERALL. - IN 2018, THERE WERE 1,446 DEATHS DUE TO STROKE IN SAN DIEGO COUNTY. THE AGE-ADJUSTED DEATH RATE DUE TO STROKE WAS 37.3 PER 100,000 POPULATION, WHICH WAS HIGHER THAN THE HP2020 TARGET OF 34.8 DEATHS PER 100,000. - IN 2008, THERE WERE 4,655 DEATHS DUE TO DISEASES OF THE HEART IN SAN DIEGO COUNTY. THE AGE-ADJUSTED DEATH RATE DUE TO DISEASES OF THE HEART WAS 120.51 PER 100,000 POPULATION. - IN 2017, THERE WERE 6,078 HOSPITALIZATIONS FOR STROKE IN SAN DIEGO COUNTY, WITH AN AGE-ADJUSTED RATE OF 166.9 PER 100,000 POPULATION, A 7.4% DECLINE FROM 2016. - IN 2017, THERE WERE 2,603 STROKE-RELATED ED VISITS IN SAN DIEGO COUNTY. THE AGE ADJUSTED RATE OF ED VISITS WAS 71.4 PER 100,000. - 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. - 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). - ACCORDING TO 2018 CHIS DATA, AN ESTIMATED 26.3% OF SDC ADULTS WERE OBESE, 11.0% WERE CURRENT SMOKERS, 9.8% REPORTED THAT THEY WERE NOT PHYSICALLY ACTIVE. 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 FISCAL YEAR 2020, SCRIPPS ENGAGED IN THE FOLLOWING HEART HEALTH, STROKE, AND CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT ACTIVITIES. 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. DUE TO COVID-19 THESE CLASSES WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS CARDIAC TREATMENT CENTER GROUP EXERCISE PROGRAMS ARE DESIGNED FOR CARDIOVASCULAR HEALTH IMPROVEMENT. CLASSES INCLUDE TRAINING IN BALANCE, SLOW FLOW YOGA, TAI CHI, FIT BALL, CHAIR YOGA AND MEDITATION, MINDFULNESS, ACUPRESSURE AND BREATH WORK FOR STRESS, MEDITATION AND ARM EXERCISE. THE CARDIAC TREATMENT CENTER ALSO PROVIDES EXERCISE PROGRAMS THAT INCLUDE NUTRITIONAL EDUCATION THROUGH THE PULMONARY CLASS, DIETARY ONE-ON-ONE COUNSELING, NUTRITION CLASS, BREATHING FOR BETTER HEALTH DURING COVID-19 AND THE CARDIAC LIFE PROJECT. THE BETTER BREATHERS PROVIDE ADDITIONAL EDUCATION IN CARDIOVASCULAR HEALTH. DUE TO COVID-19 THESE CLASSES WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. |
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CARDIAC TREATMENT CENTER'S 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. DUE TO COVID-19 THESE CLASSES WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. THIS CLASS WAS OFFERED VIRTUALLY STARTING IN MARCH 2020 DUE TO COVID-19. STUDENT PRECEPTORSHIP 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. DUE TO COVID-19 THE PRECEPTORSHIPS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. COUNTY OF SAN DIEGO LOVE YOUR HEART BLOOD PRESSURE SCREENINGS SCRIPPS PARTNERED WITH THE COUNTY OF SAN DIEGO "LOVE YOUR HEART" BLOOD PRESSURE SCREENINGS AND SERVED OVER 75 INDIVIDUALS. THIS IS AN ANNUAL EVENT WITH A SIMPLE MISSION-HELP PREVENT HEART DISEASE AND STOKE TO REDUCE THE PERCENTAGE OF DEATHS IN SAN DIEGO COUNTY DUE TO CHRONIC DISEASE. ORGANIZATIONS FROM ACROSS THE U.S. AND MEXICO JOIN TO PROVIDE FREE BLOOD PRESSURE SCREENINGS TO THE PUBLIC ON VALENTINE'S DAY. THE LOVE YOUR HEART ANNUAL CAMPAIGN WAS LAUNCHED ON VALENTINE'S DAY 2012 TO ADDRESS THE NEGATIVE IMPACTS OF HEART DISEASE IN THE REGION. PARTNERING ORGANIZATIONS AND BUSINESSES PROVIDE VOLUNTEERS TO CHECK BLOOD PRESSURES, COLLECT DATA, AND HELP PROMOTE THE AVAILABILITY OF BLOOD PRESSURE SITES IN A VARIETY OF LOCATIONS AND SETTINGS TO ENSURE BROAD ACCESSIBILITY. THE INAUGURAL YEAR, 1,000 BLOOD PRESSURE READINGS WERE TAKEN AT THE EVENT. IN 2020, THROUGH THE HELP OF HUNDREDS OF VOLUNTEERS, THERE WERE MORE THAN 56,000 BLOOD PRESSURE READINGS COMPLETED ACROSS 542 SITES IN THE UNITED STATES AND MEXICO. OF THESE, MORE THAN 5,441 HYPERTENSIVE CASES WERE IDENTIFIED AND REFERRED TO URGENT OR EMERGENCY CARE, AS APPROPRIATE. 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. DUE TO COVID-19 THESE SUPPORT GROUPS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. DUE TO COVID-19 THE SUPPORT GROUPS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. EDUCATING WOMEN ABOUT HEART HEALTH SCRIPPS WOMEN'S HEART CENTER IS DEVOTED TO CARING FOR WOMEN AND EDUCATING PATIENTS ABOUT HEART DISEASE PREVENTION. HEART DISEASE IS THE LEADING CAUSE OF DEATH FOR WOMEN IN THE UNITED STATES, KILLING MORE THAN 299,578 WOMEN IN 2017 - OR ABOUT 1 IN EVERY 5 FEMALE DEATHS ACCORDING TO THE CENTER FOR DISEASE CONTROL AND PREVENTION. OUR FEMALE CARDIOLOGISTS FOCUS ON EMPOWERING THEIR PATIENTS AND THE COMMUNITY TO TAKE CARE OF THEIR HEARTS THROUGH EDUCATION, HEALTHY LIFESTYLES AND EXPERT MEDICAL CARE WHEN NEEDED. 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 FISCAL YEAR 2020, SCRIPPS MADE AN $8,500 CONTRIBUTION TO HELP PAY FOR SCREENINGS. IN FISCAL YEAR 2020, SCRIPPS SUPPORTED SCREENING EVENTS AT AREA HIGH SCHOOLS AND SCREENED 1,951 TEENS, IDENTIFYING 27 WITH ABNORMALITIES AND 16 WHO WERE AT RISK. THE OVERALL GOAL WAS TO HOST 6 SCREENINGS PER YEAR AND TO AVERAGE 800 YOUTH PER SCREENING EVENT, HOWEVER, THE NATIONAL HEALTH PANDEMIC CAUSED THE POSTPONING OF THE APRIL, JUNE AND AUGUST SCREENINGS. THE FOLLOWING WERE ADDITIONAL METRICS TRACKED: - TEENS UNINURED: 27% - TEENS WITHOUT A PEDIATRICIAN/FAMILY DOC: 452 - TEENS WHO USE COMMUNITY CLINIC: 446 - AVERAGE PERCENT OF MODERATE TO EXTREMELY LOW HOUSEHOLD INCOME: 69% - ETHNICITY: 53% REPRESENT DIVERSE ETHNICITIES - PARENTS UNAWARE OF SCA IN YOUTH: 57% - PARENTS UNAWARE OF WARNING SIGNS/RISK FACTORS 66% - NUMBER OF YOUTHS SCREENED WHO PARTICIPATE IN SPORTS: 69% - SCRIPPS VOLUNTEERS: 40 - SCRIPPS VOLUNTEER HOURS: 200 THE ERIC PAREDES SAVE A LIFE FOUNDATION - PRESCRIPTION FOR PREVENTION IN PARTNERSHIP WITH SDSU'S INSTITUTE FOR PUBLIC HEALTH AND UC IRVINE, THE ERIC PAREDES SAVE A LIFE FOUNDATION PRODUCED THE FIRST CME/CNE ON INCORPORATING SUDDEN CARDIAC ARREST PREVENTION INTO PRIMARY CARE PRACTICES. STUDIES SHOW CARDIAC CONSIDERATION IS AN OFTEN-OVERLOOKED AREA OF ASSESSMENT. THE TRAINING MODULE REVIEWS SCA WARNING SIGNS, RISK FACTORS AND RECOMMENDED DIAGNOSTIC TESTING PROTOCOL. THE CME DEVELOPMENT WAS DIRECTED AND NARRATED BY DR. JOHN ROGERS, SCRIPPS CARDIOLOGIST AND EP SAVE A LIFE MEDICAL DIRECTOR, AND SCRIPPS HEALTH WAS INSTRUMENTAL IN FACILITATING ENGAGEMENT IN BOTH A FRONT-END NEEDS ASSESSMENT AND IN PARTICIPATION IN THE TRAINING MODULE THROUGH DIRECT COMMUNICATION WITH PCPS. FUNDING SUPPORTED DEVELOPMENT AND PROMOTION OF THE TRAINING MODULE ON A LOCAL, STATE AND NATIONAL LEVEL, IN PARTICULAR WITH THE SAN DIEGO CHAPTER OF THE AMERICAN ACADEMY OF PEDIATRICS. GIVEN EARLY DATA SUGGESTS COVID-19 CAN LEAD TO HEART DAMAGE AND PROFESSIONAL MEDICAL ASSOCIATIONS HAVE RELEASED RECOMMENDATIONS FOR CARDIAC ASSESSMENT OF STUDENT ATHLETES WHO'VE BEEN EXPOSED BEFORE RETURNING TO PLAY, THIS TRAINING SUPPORTS A CRITICAL SKILL SET FOR PCPS. THE SCRIPPS PARTICIPATION IN LIVE CME EVENTS/EARLY NEEDS ASSESSMENT OF TOTAL PARTICIPANTS WAS 45%. 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. DUE TO COVID-19 THE SCREENING EVENTS WERE IMPLEMENTED ON A MUCH SMALLER SCALE AND A TOTAL OF 150 SCREENINGS WERE PROVIDED TO STUDENT ATHLETES THIS YEAR. SU CORAZON, SU VIDA / YOUR HEART, YOUR LIFE COMMUNITY INTERVENTION TO IMPROVE EDUCATION AND AWARENESS OF HEART DISEASE THE YOUR HEART, YOUR LIFE (SU CORAZON, SU VIDA) PROGRAM IS DESIGNED TO HELP PREVENT HEART DISEASE THROUGH EDUCATION AND PROVIDE SUPPORT AND OUTREACH TO THOSE ALREADY LIVING WITH HEART DISEASE AND OTHER RELATED CHRONIC DISEASES SUCH AS DIABETES AND HIGH BLOOD PRESSURE. TOPICS COVERED IN THE CLASSES INCLUDE HEART DISEASE RISK FACTORS, SIGNS OF A HEART ATTACK AND STROKE, LIFESTYLE CHANGES, DIABETES, CHOLESTEROL AND NUTRITION EDUCATION. HEIGHT, WEIGHT, AND BLOOD PRESSURES ARE RECORDED IN THE FIRST AND LAST CLASS TO MEASURE A DIFFERENCE AND IMPACT OF THE LIFESTYLE CHANGES IMPLEMENTED FROM PARTICIPATING IN THE SESSIONS. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
A TOTAL OF 50 COMMUNITY MEMBERS HAVE PARTICIPATED IN THIS EDUCATIONAL SERIES FOR THOSE AFFECTED BY HYPERTENSION, ANGINA, CARDIAC HEART FAILURE OR ANY OTHER HEART HEALTH CONCERNS. ASSESSMENT SURVEY SHOWED WEIGHT (PRE:157 LBS. AND POST:153 LBS.) AND BLOOD PRESSURE (PRE:145/74 AND POST:138/70) AN OVERALL IMPROVEMENT RATE AFTER PARTICIPATING IN THE YOUR HEART, YOUR LIFE SERIES. OVERALL, PARTICIPANTS HAVE MADE A POSITIVE IMPACT FROM THE COURSE BASED ON THE HEALTH ASSESSMENTS. CLASSES WERE CANCELLED MID-YEAR DUE TO COVID-19. 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. DUE TO COVID-19 THESE SUPPORT GROUPS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. SAN DIEGO COUNTY STROKE CONSORTIUM SCRIPPS STROKE PROGRAM PARTICIPATES IN THE SD COUNTY STROKE CONSORTIUM, A COUNTY-WIDE STROKE GROUP, CONSISTING OF SD COUNTY STROKE RECEIVING CENTER STROKE PROGRAM COORDINATORS, STROKE CHAMPIONS AND STROKE LEADERSHIP. ADDITIONALLY, THE MEETING IS ATTENDED BY STROKE PROGRAM MEDICAL DIRECTORS AND SD COUNTY LEADERSHIP. THE STROKE CONSORTIUM SERVES AS A POINT OF CONTACT FOR CONTINUITY OF STROKE CARE IN SAN DIEGO COUNTY. IN THE EARLY MONTHS OF COVID-19 PANDEMIC, A DECLINE IN STROKE HOSPITAL ADMISSIONS WERE REPORTED ACROSS THE NATION. SCRIPPS STROKE PROGRAM SPEARHEADED A REAL-TIME DATA COLLECTION IN COLLABORATION WITH 18 STROKE RECEIVING CENTERS IN SAN DIEGO COUNTY. WHEN THE GROUP CALCULATED A DECREASE IN STROKE CODE ACTIVATIONS BY 30% AS COMPARED TO 2019, SCRIPPS STROKE PROGRAM DEDICATED TIME AND RESOURCES TO LEAD THE EFFORTS TO CREATE AND DISSEMINATE A UNIFIED COMMUNITY MESSAGE URGING SAN DIEGO COUNTY RESIDENTS TO SEEK EMERGENCY TREATMENT WHEN SUFFERING SYMPTOMS OF A STROKE. SCRIPPS STROKE PROGRAM LED A COLLABORATIVE GROUP INCLUDING SAN DIEGO COUNTY EMS, SAN DIEGO REGIONAL AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION, AND THE SAN DIEGO COUNTY STROKE CONSORTIUM IN CREATING A UNITED MARKETING CAMPAIGN. THE SLOGAN "WE ARE HERE FOR YOU. EVERY MINUTE MATTERS" ACCOMPANIED BY A GRAPHIC MESSAGE WAS UTILIZED TO HIGHLIGHT THE IMPORTANCE OF SEEKING EMERGENCY TREATMENT WHEN EXPERIENCING STROKE-LIKE SYMPTOMS. THE SOCIAL MEDIA CAMPAIGN WAS POSTED ON FACEBOOK, TWITTER, INSTAGRAM AND LINKEDIN, WITH A TOTAL OF 26,727 VIEWS. THE COMMUNITY COLLABORATIVE WAS ALSO SUBMITTED FOR CONSIDERATION AT THE 2021 INTERNATIONAL STROKE CONFERENCE. COLLABORATIVE SAN DIEGO COUNTY STROKE CENTER COMMUNITY MESSAGING CAMPAIGN THE SAN DIEGO COUNTY STROKE CONSORTIUM (OF WHICH ALL SCRIPPS HEALTH STROKE PROGRAMS PARTICIPATE) PERFORMED A COLLABORATIVE SD COUNTY STROKE CENTER COMMUNITY MESSAGING CAMPAIGN IN MAY/JUNE DURING THE PANDEMIC. THE GENERAL POINT OF THE CONSORTIUM PROJECT WAS TO REASSURE/REMIND COMMUNITY MEMBERS THE IMPORTANCE OF ACCESSING 911 FOR STROKE SYMPTOMS, TO PRESENT FOR TIMELY CARE, DESPITE THE ONGOING PANDEMIC. SCRIPPS HEALTH STROKE PROGRAM COMMUNITY EVENTS OCEAN KNOLL ELEMENTARY PTA GROUP THE SCRIPPS HEALTH STROKE TEAM PARTICIPATED IN AN EDUCATIONAL EVENT AT OCEAN KNOLL ELEMENTARY SCHOOL IN ENCINITAS, CA ON JANUARY 23, 2020. STROKE TEAM MEMBERS PROVIDED COMMUNITY OUTREACH VIA AN EDUCATIONAL LECTURE TO SCHOOL PARENTS, PTA MEMBERS AND TEACHERS ABOUT BE-FAST (HOW TO RECOGNIZE SYMPTOMS OF STROKE AND CALLING 911 FOR SOMEONE EXHIBITING STROKE SYMPTOMS). THE EVENT WAS HELD AT OCEAN KNOLL ELEMENTARY SCHOOL IN ENCINITAS AND 25 COMMUNITY MEMBERS WERE SERVED. THE EVENT WAS OPEN TO PTA MEMBERS AND STAFF OF OCEAN KNOLL ELEMENTARY SCHOOL. AT&T STROKE SCREENING EVENT WITH AMERICAN HEART ASSOCIATION THE SCRIPPS HEALTH STROKE TEAM COORDINATED AND PARTICIPATED IN A STROKE SCREENING EVENT IN COLLABORATION WITH THE AMERICAN HEART ASSOCIATION TEAM IN SAN DIEGO ON FEBRUARY 7, 2020. STROKE TEAM MEMBERS PROVIDED COMMUNITY OUTREACH VIA STROKE RISK SCREENING AND EDUCATION, STROKE RISK ASSESSMENTS; BLOOD PRESSURE SCREENING, AND BE-FAST EDUCATION (RECOGNITION OF STROKE AND CALLING 911). THE EVENT WAS HELD ON THE AT&T SAN DIEGO CAMPUS AND 70 COMMUNITY MEMBERS WERE SERVED. THE EVENT WAS OPEN TO AT&T EMPLOYEES. RANCHO SANTA FE SENIOR CENTER PARTICIPATION AT THE RANCHO SANTA FE SENIOR CENTER WHERE 20 COMMUNITY MEMBERS WERE SERVED. STROKE TEAM MEMBERS PROVIDED COMMUNITY OUTREACH VIA AN EDUCATIONAL LECTURE TO MEMBERS OF THE SENIOR CENTER AND COMMUNITY MEMBERS REGARDING PHYSIOLOGY OF STROKE, STROKE RISK FACTORS, STROKE PREVENTION, RECOGNITION OF STROKE AND ACCESSING 911. THE EVENT WAS OPEN FOR ALL TO ATTEND, BUT PRIMARILY SERVED RESIDENTS OF RANCHO SANTA FE, CA. MESA COLLEGE THE SCRIPPS HEALTH STROKE TEAM PARTICIPATED IN AN EDUCATIONAL EVENT AT MESA COLLEGE ON MARCH 7, 2020. STROKE TEAM MEMBERS PROVIDED COMMUNITY OUTREACH VIA AN EDUCATIONAL LECTURE TO COLLEGE STUDENTS AND TEACHERS ABOUT BE-FAST (HOW TO RECOGNIZE SYMPTOMS OF STROKE AND CALLING 911 FOR SOMEONE EXHIBITING STROKE SYMPTOMS). THE EVENT WAS HELD AT MESA COLLEGE IN SAN DIEGO CA AND 30 COMMUNITY MEMBERS WERE SERVED. THE EVENT WAS OPEN TO MESA COLLEGE STUDENTS AND STAFF. STROKE AND BRAIN INJURY SUPPORT GROUP AT SCRIPPS MERCY HOSPITAL CHULA VISTA WELL BEING CENTER THE STROKE SUPPORT GROUP IS FOR STROKE AND BRAIN INJURY SURVIVORS, CAREGIVERS, AND LOVED ONES. THE GROUP'S GOAL IS TO EDUCATE AND EMPOWER SURVIVORS. ATTENDEES RECEIVE INFORMATION AND RESOURCES, REINFORCE INNER STRENGTHS, LEARN SELF-CARE STRATEGIES, AND DEVELOP ENCOURAGING PEER RELATIONSHIPS. A TOTAL OF 92 PEOPLE PARTICIPATED IN THE SUPPORT GROUP. DUE TO COVID-19 THE GROUP HAS TRANSITIONED TO CONFERENCE CALL GROUP WHICH HAS IMPACTED THE OVERALL NUMBER OF PARTICIPANTS FOR THE YEAR. BRAINMASTERS: STROKE AND BRAIN INJURY SURVIVORS SUPPORT GROUP IN 2017, SCRIPPS MEMORIAL HOSPITAL ENCINITAS LAUNCHED A PROGRAM TO ADDRESS THE COMMUNICATION CHALLENGES OF STROKE AND BRAIN INJURY SURVIVORS. BRAINMASTERS IS AN IMPROVISATIONAL SPEAKING GROUP FOR ADULTS COPING WITH ACQUIRED BRAIN INJURY. THIS FUN, SUPPORTIVE AND INTERACTIVE GROUP HELPS BRAIN INJURY PATIENTS IMPROVE COMMUNICATION SKILLS, THINK MORE QUICKLY ON THEIR FEET, AND BUILD SELF-CONFIDENCE IN A FRIENDLY, ENCOURAGING ENVIRONMENT. OFFERED AS A COMMUNITY BENEFIT THROUGH SCRIPPS MEMORIAL HOSPITAL ENCINITAS, BRAINMASTERS IS FREE AND OPEN TO THE COMMUNITY. IN FISCAL YEAR 2020, 52 PEOPLE WERE SERVED. 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. 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 2018, THERE WERE 755 DEATHS DUE TO DIABETES IN SAN DIEGO COUNTY OVERALL. THE AGE-ADJUSTED DEATH RATE DUE TO DIABETES WAS 20.5 PER 100,000 POPULATION. - IN 2017, THERE WERE 4,292 HOSPITALIZATIONS DUE TO DIABETES IN SAN DIEGO COUNTY. THE AGE-ADJUSTED RATE OF HOSPITALIZATION WAS 122.9 PER 100,000 POPULATION IN 2017, WHICH WAS SLIGHTLY LOWER THAN THE AGE-ADJUSTED RATE IN 2016 (120.9 PER 100,000 POPULATION). |
| FORM 990, PART III, LINE 4A (CONTINUED) |
- IN 2017, THERE WERE 5,717 DIABETES-RELATED ED DISCHARGES IN SAN DIEGO COUNTY, A 10.6% INCREASE FROM 2016 (5,168 ED DISCHARGES). THE AGE-ADJUSTED RATE OF DIABETES RELATED ED DISCHARGES WERE165.0 PER 100,000 POPULATION IN 2017, WHICH WAS HIGHER THAN THE AGE-ADJUSTED RATE IN 2016 (151.9 PER 100,000 POPULATION). - ACCORDING TO 2018 CHIS DATA, 9.8 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 20.5 PERCENT OF SAN DIEGO COUNTY ADULTS OVER 65 REPORTING THAT THEY HAD EVER BEEN DIAGNOSED WITH DIABETES. - ACCORDING TO 2018 CHIS DATA, 9.8 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 ACCORDING TO THE CDC, NEARLY 10 PERCENT OF THE OVERALL POPULATION IS NOW LIVING WITH DIABETES, AND ANOTHER 45 PERCENT HAS PRE-DIABETES, A PRECURSOR TO TYPE 2 DIABETES. THE COMPLICATIONS RELATED TO DIABETES ARE SERIOUS AND CAN BE REDUCED WITH PREVENTIVE PRACTICES. DIABETES IS A SERIOUS COMMUNITY HEALTH PROBLEM, LEADING TO SCHOOL AND WORK ABSENTEEISM, ELEVATED HOSPITALIZATION RATES, FREQUENT EMERGENCY ROOM VISITS, PERMANENT PHYSICAL DISABILITIES AND SOMETIMES DEATH. SCRIPPS IS MAKING EVERY EFFORT TO HELP PATIENTS AND OUR COMMUNITIES WITH PREDIABETES REVERSE COURSE AND LEAD HEALTHIER LIVES. DURING FISCAL YEAR 2020, SCRIPPS SPONSORED THE FOLLOWING DIABETES MANAGEMENT PROGRAMS AND 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. THE CENTER HAS ADDED CRITICAL CLASSROOM SPACE TO MEET THE HIGH DEMAND FOR SERVICES AND OFFERS A FULL RANGE OF WELLNESS, PREVENTION, DIABETES EDUCATION, AND NUTRITION SERVICES AND ENDOCRINOLOGY SPECIALTY VISITS 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 25 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 FISCAL YEAR 2020, PROJECT DULCE PROVIDED 3,801 DIABETES CARE, RETINAL SCREENINGS AND EDUCATION VISITS FOR LOW INCOME AND UNDERSERVED INDIVIDUALS THROUGHOUT SAN DIEGO. RETINAL SCREENING PROGRAM IT IS ESTIMATED THAT EVERY 24 HOURS, 55 PEOPLE WILL LOSE THEIR VISION BECAUSE 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 FISCAL YEAR 2020, 917 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. DUE TO COVID-19 THE SCREENINGS WERE NOT CONDUCTED FOR MOST OF THE YEAR DUE TO COVID-19. 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. 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 |
| FORM 990, PART III, LINE 4A (CONTINUED) |
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 YEAR-LONG 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. SCRIPPS PROGRAM IS PART OF THE NATIONAL DIABETES PREVENTION PROGRAM, LED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION. THE PROGRAM IS CONSIDERED A MEDICARE BENEFIT FOR PREDIABETIC PATIENTS, AND A DOCTOR'S REFERRAL IS NOT REQUIRED. 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. AFTER A BRIEF PAUSE AT THE START OF THE PANDEMIC, SCRIPPS LAUNCHED A VIRTUAL VERSION OF ITS DIABETES PREVENTION PROGRAM IN WHICH SMALL COHORTS MEET ONLINE ONCE A WEEK FOR THE FIRST FOUR MONTHS, THEN TWICE A MONTH. THE STRUCTURED PROGRAM IS RESEARCH BASED, EFFECTIVE AND PROVIDES THE SUPPORT NEEDED TO MAKE HEALTHY HABITS THAT WILL LAST FOR LIFE. SESSIONS FOCUS ON TOPICS SUCH AS DIET AND EXERCISE, MANAGING STRESS AND OVERCOMING BARRIERS. EACH PARTICIPANT IS ALSO PAIRED WITH A LIFESTYLE COACH WHO HELPS THEM SET AND MEET THEIR GOALS. IN FISCAL YEAR 2020, 1,771 PATIENTS ATTENDED 46 SCRIPPS DPP ORIENTATION SESSIONS. MUCH OF THE EFFORT IS FOCUSED IN THE SOUTH BAY FOR THE LATINO POPULATION, WHICH IS AT HIGHER RISK OF ACQUIRING 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. CLASSES WERE CANCELLED MID-YEAR DUE TO COVID-19. SCRIPPS WHITTIER DIABETES DISTRESS STUDY THE NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES AWARDED A FIVE-YEAR, $3.3 MILLION GRANT IN 2020 TO SCRIPPS WHITTIER DIABETES INSTITUTE TO STUDY THE INTEGRATION OF MENTAL HEALTH SERVICES IN THE CARE OF PATIENTS WITH TYPE 1 DIABETES TO BETTER ADDRESS THE EMOTIONAL DISTRESS THAN OFTEN ACCOMPANIES THE CHRONIC DISEASE. RESEARCHERS AT SCRIPPS WHITTIER WILL USE THE FEDERAL FUNDING TO LAUNCH A LARGE-SCALE, RANDOMIZED, CONTROLLED CLINICAL TRIAL THAT WILL EVALUATE WHETHER THE INTEGRATION OF DIABETES DISTRESS CARE WITH ROUTINE MEDICAL CARE RESULTS IN BETTER MANAGEMENT OF DIABETES AND BETTER HEALTH-RELATED QUALITY OF LIFE. THE STUDY IS A COLLABORATIVE EFFORT THAT CAPITALIZES ON THE COMPLIMENTARY EXPERTISE OF A CLINICAL PSYCHOLOGIST/ENDOCRINOLOGIST PARTNERSHIP. 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. 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. THE RISK FACTORS FOR MANY CHRONIC DISEASES ARE WELL KNOWN. IN PARTICULAR, AN UNHEALTHY DIET, PHYSICAL INACTIVITY AND SUBSTANCE USE HAVE BEEN CITED BY THE WORLD HEALTH ORGANIZATION (http://www.who.int/chp) AS IMPORTANT HEALTH BEHAVIORS THAT CONTRIBUTE TO ILLNESSES SUCH AS CARDIOVASCULAR DISEASE, CANCER, CHRONIC RESPIRATORY DISEASE, DIABETES, AND OTHERS INCLUDING MENTAL DISORDERS AND ORAL DISEASES. - THE HASD&IC AND SCRIPPS 2019 CHNA IDENTIFIED TEN TOP HEALTH AND SOCIAL NEEDS IN SAN DIEGO COUNTY. THESE TEN SOCIAL DETERMINANTS ARE: ACCESS TO CARE, COMMUNITY AND SOCIAL SUPPORT, ECONOMIC SECURITY, EDUCATION, HOMELESSNESS AND HOUSING INSTABILITY, UNINTENTIONAL INJURY AND VIOLENCE, AGING CONCERNS, BEHAVIORAL HEALTH, CANCER AND CHRONIC CONDITIONS. - KEY INFORMANT INTERVIEWS CONDUCTED AS PART OF THE HASD&IC 2019 CHNA SUGGESTED SEVERAL HEALTH IMPROVEMENT STRATEGIES TO ADDRESS THE HEALTH ISSUES IDENTIFIED FOR SAN DIEGO COUNTY. THESE STRATEGIES INCLUDE BEHAVIORAL HEALTH PREVENTION AND STIGMA REDUCTION; EDUCATION ON DISEASE MANAGEMENT AND FOOD INSECURITY; INTEGRATING PHYSICAL AND MENTAL HEALTH CARE; BETTER COORDINATION OF CARE; GREATER CULTURAL COMPETENCE AND DIVERSITY; AND ENGAGEMENT OF PATIENT NAVIGATORS AND CASE MANAGERS IN THE COMMUNITY. - FRUIT/VEGETABLE CONSUMPTION: ACCORDING TO DATA FROM CALIFORNIA HEALTH INTERVIEW SURVEY, 48.3% OF CHILDREN AGE 2 AND OLDER REPORTED CONSUMING LESS THAN FIVE SERVINGS OF FRUITS AND VEGETABLES A DAY COMPARED TO 47.7% IN CALIFORNIA OVERALL. ADULTS AGE 18 AND OVER REPORTED EVEN LESS FRUIT AND VEGETABLE CONSUMPTION. APPROXIMATELY 70.5% OF ADULTS REPORTED EATING THE RECOMMENDED AMOUNT EACH DAY. UNHEALTHY EATING HABITS ARE A SIGNIFICANT CONTRIBUTING FACTOR TO FUTURE HEALTH ISSUES INCLUDING OBESITY AND DIABETES. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
- PHYSICAL INACTIVITY: ACCORDING TO THE CDC'S NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION, 14.9% OF ADULTS AGE 20 AND OLDER SELF-REPORTED THAT THEY PERFORM NO LEISURE TIME PHYSICAL ACTIVITY. HIGHER RATES OF LIMITED LEISURE TIME ACTIVITY WERE REPORTED AT THE STATE AND NATIONAL LEVEL (16.6% AND 22.6% RESPECTIVELY). FOR YOUTH RESULTS OF THE FITNESSGRAM PHYSICAL FITNESS TEST SHOW THAT 29.35% OF CHILDREN IN GRADES 5,7 AND 9 RANKED WITHIN THE "HIGH RISK"NEEDS IMPROVEMENT" ZONES FOR AEROBIC CAPACITY FOR THE 2013-2014 YEAR. THE PERCENTAGE OF CHILDREN THAT ARE NOT IN THE HEALTHY FITNESS ZONE VARIES AMONG ETHNIC GROUPS WITH THE LOWEST BEING NON-HISPANIC ASIANS AT 20.6% AND THE HIGHEST BEING HISPANIC OR LATINOS AT 42.1%. ALTHOUGH THIS IS SMALLER THAN THE STATE AVERAGE OF 36.9%, IT IS STILL CAUSE FOR CONCERN AND MAY LEAD TO SIGNIFICANT HEALTH ISSUES, SUCH AS OBESITY, DIABETES, AND POOR CARDIOVASCULAR HEALTH. - ALCOHOL CONSUMPTION: THE PERCENTAGE OF ADULTS AGE 18 AND OLDER WHO SELF-REPORT HEAVY ALCOHOL CONSUMPTION (DEFINED AS MORE THAN TWO DRINKS PER DAY ON AVERAGE FOR MEN AND ONE DRINK PER DAY ON AVERAGE FOR WOMEN) IS 17.2% IN SAN DIEGO COUNTY ACCORDING TO THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS). BEHAVIORS SUCH AS EXCESSIVE ALCOHOL CONSUMPTION ARE DETRIMENTAL TO FUTURE HEALTH AND MAY ILLUSTRATE OR PRECLUDE SIGNIFICANT HEALTH ISSUES, SUCH AS CIRRHOSIS, CANCER, AND UNTREATED MENTAL AND BEHAVIORAL HEALTH NEEDS. - TOBACCO USAGE: THE BFRSS ALSO REPORTS THAT 12.1% OF ADULTS AGE 18 AND OLDER SELF-REPORTED CURRENTLY SMOKING CIGARETTES SOME DAYS OR EVERYDAY COMPARE TO 18.1% IN THE UNITED STATES, ADJUSTED FOR AGE. TOBACCO USE IS LINKED TO LEADING CAUSES OF DEATH INCLUDING CANCER AND CARDIOVASCULAR DISEASE. - THE HHSA'S LIVE WELL SAN DIEGO (LWSD) 3-4-50 INITIATIVE IDENTIFIED THREE BEHAVIORS (POOR DIET, PHYSICAL INACTIVITY AND TOBACCO USE) THAT CONTRIBUTE TO FOUR CHRONIC CONDITIONS (CANCER, HEART DISEASE/STROKE, TYPE 2 DIABETES AND PULMONARY DISEASES), WHICH RESULT IN MORE THAN 50 PERCENT OF DEATHS WORLDWIDE. IN 2015, 54 PERCENT OF ALL DEATHS IN SDC WERE ATTRIBUTED TO 3-4-50 CONDITIONS. UNDERSTANDING THAT PERSONAL BEHAVIORS PLAY A SIGNIFICANT ROLE IN AN INDIVIDUAL'S OVERALL HEALTH STATUS, SCRIPPS HAS DEVELOPED A SERIES OF PREVENTION AND WELLNESS PROGRAMS THAT HELP PEOPLE TAKE CHARGE OF THEIR OWN, AND THEIR FAMILIES' HEALTH. DURING FISCAL YEAR 2020, SCRIPPS SPONSORED SEVERAL HEALTH BEHAVIOR MODIFICATION EFFORTS: COMMUNITY BASED HEALTH IMPROVEMENT ACTIVITIES COMMUNITY MEMBERS PARTICIPATED IN A VARIETY OF CLASSES, PREVENTION LECTURES AND SUPPORT GROUPS. APPROXIMATELY 1,469 ATTENDED THESE PROGRAMS HELD AT THE CHULA VISTA WELL BEING CENTER. THIS YEAR'S NUMBERS WERE IMPACTED DUE TO THE COVID-19 PANDEMIC. IN PERSON SUPPORT GROUPS, CLASSES, ACTIVITIES WERE CEASED MID-MARCH 2020. THE MAJORITY OF IN-PERSON ACTIVITIES HAVE NOT BEEN ABLE TO RECONVENE DUE TO THE LARGE GROUP RESTRICTIONS AND/OR BEING A VULNERABLE POPULATION DUE TO AGE AND/OR HEALTH CONDITION. A FEW GROUPS HAVE BEEN ABLE TO TRANSITION TO A CONFERENCE CALL OR VIRTUAL PLATFORM TO CONTINUE MEETING. PATIENT COMMUNITY SERVICES SERVICES ARE OFFERED BY WELL BEING CENTER (WBC) STAFF DIRECTLY TO PATIENTS AND THEIR FAMILY TO DECREASE THE RISKS OF READMISSION, KEEPING PATIENTS ON A HEALTHY PATHWAY AND TO INCREASE PATIENT CONTINUITY. SUPPORT SERVICES ARE REFERRAL BASED AND GENERATED THROUGH SCRIPPS ELECTRONIC HEALTH SYSTEM, EPIC. SERVICES AND ASSISTANCE ARE PROVIDED FOR 30 DAYS POST DISCHARGE AND UP TO ONE YEAR TO PATIENTS WITH THE FOLLOWING CONDITIONS: ACUTE MYOCARDIAL INFARCTION (AMI), CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), CHRONIC HEART FAILURE (CHF), PNEUMONIA, CORONARY ARTERY BYPASS GRAFTING (CABG), TOTAL KNEE OR HIP REPLACEMENT, AND COVID-19. WBC STAFF AND SCRIPPS MERCY HOSPITAL CHULA VISTA SOCIAL WORKERS COLLABORATE TO ALSO PROVIDE ONGOING FOLLOW-UP AND SERVICES TO IDENTIFIED SOCIAL WORK PATIENTS. THESE PATIENTS REQUIRE MORE SUPPORT AND RESOURCES (HOUSING/HOMELESSNESS, SENIOR ISSUES, DRUG/ALCOHOL AND MENTAL HEALTH, CANCER) AS DISCHARGED PATIENTS DO NOT CONTINUE TO BE FOLLOWED BY HOSPITAL SOCIAL WORKERS. THIS COLLABORATION ALLOWS FOR HIGH-RISK PATIENTS TO RECEIVE MORE ASSISTANCE. THE GOAL OF PATIENTS PARTICIPATING IN THIS SERVICE POST-DISCHARGE IS TO REDUCE HOSPITAL AND EMERGENCY DEPARTMENT 30-DAY AND 90-DAY READMISSIONS. COMMUNITY PATIENT POST-DISCHARGE SERVICES INCLUDE: HOME VISITS, PHONE CALLS, PROVIDING COMMUNITY AND SOCIAL SERVICE RESOURCES, AND APPLICATION ASSISTANCE (MEDICAL INSURANCE, SDI, HOUSING, SNAP, MAMA'S KITCHEN), AND A REFERRAL TO A LOCAL COMMUNITY CLINIC OR THE SCRIPPS ADVANCED CARE CLINIC. THESE SERVICES ARE CURRENTLY ONLY AVAILABLE AT SCRIPPS MERCY HOSPITAL CHULA VISTA. A TOTAL OF 907 PATIENT REFERRALS HAVE BEEN RECEIVED AND ALL PATIENTS ARE FOLLOWED UP TO ONE YEAR. - 907 PATIENT REFERRALS WERE RECEIVED (30 DAY AND SOCIAL WORK) - 686 PATIENTS WERE CONTACTED/REACHED (THIS INCLUDES 30-DAY FOLLOW UP AND SOCIAL WORK REFERRAL PATIENTS) - 154 PATIENTS - UNABLE TO REACH, DECEASED, DECLINED FOLLOW-UP SERVICES, LANGUAGE BARRIER - 66 PATIENTS WERE READMITTED (SOURCE: CAREGIVER, EPIC) IN ADDITION, STAFF WORK WITH MAMA'S KITCHEN TO PROVIDE FREE, MEDI-CAL COVERED MEDICALLY TAILORED MEALS AND MEDICAL NUTRITION THERAPY FOR DISCHARGED CHF PATIENTS AS PART OF THE PATIENT COMMUNITY SERVICES PROGRAM. THE MAMA'S KITCHEN FREE MEAL PROGRAM LASTS TWELVE WEEKS, WITH MEALS BEING DELIVERED TO THE HOME. STAFF CONTACT PATIENTS POST-DISCHARGE OR AT BEDSIDE BASED ON THE GENERATED REPORT IN EPIC. IF PATIENTS QUALIFY AND ARE INTERESTED, A REFERRAL FORM IS COMPLETED, SIGNED BY A SCRIPPS CLINICIAN, AND THEN SECURELY EMAILED TO MAMA'S KITCHEN. LASTLY, ANOTHER VITAL COMPONENT OF THE PATIENT COMMUNITY SERVICES PROGRAM ARE THOSE PATIENTS THAT ARE PART OF THE CHF EMERGENCY DEPARTMENT PILOT PROGRAM. THIS IS DONE IN COLLABORATION WITH THE SCRIPPS MERCY HOSPITAL CHULA VISTA EMERGENCY DEPARTMENT TO FOLLOW UP WITH CHF PATIENTS WHO WERE IN THE EMERGENCY ROOM BUT DID NOT GET ADMITTED. THIS IS BECAUSE CHF PATIENTS ARE STATISTICALLY MORE LIKELY TO READMIT, THEREFORE WELL BEING CENTER STAFF AND EMERGENCY DEPARTMENT STAFF TAKE MEASURES TO REDUCE THAT LIKELIHOOD. THE PROGRAM ENSURES THAT THESE PATIENTS ARE FOLLOW UP WITH THEIR PROVIDER, TAKE MEDICATIONS AS PRESCRIBED, AND ASSESS THE NEED FOR ADDITIONAL RESOURCES OR OTHER SERVICES. COMMUNITY HEALTH IMPROVEMENT PARTNERS (CHIP) AND RESIDENT LEADERSHIP ACADEMY MODEL SCRIPPS IS A PARTNER WITH CHIP AND COLLABORATIVELY WORKS ON A RESIDENT LEADERSHIP MODEL THAT HAS EMPOWERED 700+ CITIZENS ACROSS THE COUNTY (AND BEYOND) TO AFFECT CHANGE IN A WIDE RANGE OF COMMUNITY HEALTH AREAS SUCH AS PUBLIC SAFETY, ACCESS TO HEALTHY FOODS, AND INCREASED OPPORTUNITIES FOR PHYSICAL ACTIVITY. HEALTH EDUCATION AND SUPPORT GROUPS SCRIPPS EDUCATION AND SUPPORT GROUPS ARE PROVIDED TO SAN DIEGO COUNTY RESIDENTS FOR A WIDE VARIETY OF HEALTH CONCERNS. TOPICS INCLUDE, FALL PREVENTION, STROKE AWARENESS, BLADDER AND PELVIC FLOOR WELLNESS, POSTPARTUM ISSUES, AND GYNECOLOGICAL CANCER. DUE TO COVID-19 ALL EDUCATION AND SUPPORT GROUPS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. OPIOID STEWARDSHIP PROGRAM (OSP) AND BRIDGE PROGRAM ACCORDING TO THE CDC, ANYONE WHO TAKES PRESCRIPTION OPIOIDS CAN BECOME ADDICTED TO THEM, AND ONE IN FOUR ON LONG-TERM OPIOID THERAPY STRUGGLES WITH ADDICTION. IN SAN DIEGO, THE RATE OF DISCHARGE FROM EMERGENCY DEPARTMENTS FOR CHRONIC SUBSTANCE USE INCREASED BY 559% FROM 2014 TO 2016, AND THE RATES OF ED DISCHARGES FOR ACUTE SUBSTANCE USE ROSE AS WELL. HEAVY ALCOHOL CONSUMPTION IS ALSO A PROBLEM IN SAN DIEGO, WITH NEARLY 20% OF ALL ADULTS AGES 18 AND OLDER SELF-REPORTING EXCESSIVE ALCOHOL USE. CAL HOSPITAL COMPARE (CHC), A NONPROFIT ORGANIZATION THAT PROVIDES CALIFORNIANS WITH HOSPITAL PERFORMANCE RATINGS, NAMED ALL FOUR OF SCRIPPS HEALTH'S HOSPITALS TO ITS 2020 OPIOID CARE HONOR ROLL. SCRIPPS IS THE ONLY HEALTH CARE ORGANIZATION IN SAN DIEGO COUNTY TO BE RECOGNIZED ON THE INAUGURAL STATEWIDE LIST. THE 2020 OPIOID CARE HONOR ROLL RECOGNIZES 53 CALIFORNIA HOSPITALS FOR THEIR PROGRESS AND PERFORMANCE IN PROMOTING SAFE AND EFFECTIVE OPIOID USE, PROVIDING TREATMENT FOR PATIENTS WITH OPIOID USE DISORDER AND PROVIDING ACCESS TO NALOXONE TO PREVENT OPIOID OVERDOSES. ACCORDING TO STATE DATA, OVER 2,400 CALIFORNIANS DIED OF AN OPIOID-RELATED OVERDOSE IN 2018. CHC RECOGNIZED SCRIPPS FOR TAKING A VARIETY OF APPROACHES TO ADDRESS OVERUSE OF OPIOIDS AMONG ITS PATIENTS. FOR PATIENTS BEING DISCHARGED FROM AN EMERGENCY DEPARTMENT VISIT OR HOSPITAL STAY, SCRIPPS HAS CREATED EDUCATIONAL VIDEOS THAT IT MAKES AVAILABLE FOR VIEWING AND HAS ALSO SET OPIOID PRESCRIPTION QUANTITY LIMITS AT DISCHARGE. IN ADDITION, SOME SCRIPPS HOSPITAL EMERGENCY DEPARTMENTS HAVE IMPLEMENTED MEDICATION-ASSISTED THERAPY, IN WHICH SPECIALLY LICENSED ER PHYSICIANS CAN ADMINISTER MEDICATIONS AS A BRIDGE FOR PATIENTS WITH OPIOID USE DISORDER UNTIL THEY CAN RECEIVE FURTHER |
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THE OPIOID STEWARDSHIP PROGRAM (OSP) AT SCRIPPS IS COMBATTING THIS NATIONAL EPIDEMIC BY WORKING WITH PHYSICIANS TO DECREASE THE NUMBER OF OPIOIDS PRESCRIBED TO PATIENTS AND EDUCATING PATIENTS ON PAIN MANAGEMENT. THE PROGRAM HAS ESTABLISHED PRESCRIBING STANDARDS FOR OPIOIDS, RESULTING IN A REDUCTION IN THE NUMBER OF OPIOID PILLS PER PRESCRIPTION AT SCRIPPS HOSPITALS AND OUTPATIENT CENTERS. IN ADDITION, 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. CALIFORNIA BRIDGE PROGRAM SCRIPPS HAS RECEIVED STATE GRANTS AT EACH OF ITS SCRIPPS HOSPITALS 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). COMBINED WITH OTHER RECENT GRANTS FOR SCRIPPS OPIOID STEWARDSHIP PROGRAM, SCRIPPS HAS BEEN AWARDED ALMOST $1 MILLION TO HELP PREVENT AND TREAT OPIOID ADDICTION. 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, WHILE MAT AIMS TO REDUCE THE STIGMA OF OPIOID ADDICTION AND INCREASE PROVIDER SUPPORT FOR MEDICATION ASSISTANCE IN TREATING ADDICTION. ALL TOGETHER, THESE STATE PROGRAMS HAVE AWARDED SCRIPPS $935,000. AS PART OF THE GRANT, SCRIPPS NOW HAS BRIDGE COUNSELORS AT TO HELP PATIENTS WITH OPIOID ADDICTION. BRIDGE COUNSELORS ARE CERTIFIED THROUGH THE CALIFORNIA CONSORTIUM OF ADDICTION PROGRAMS AND PROFESSIONALS (CAPP) 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. THE CALIFORNIA BRIDGE GRANT ALSO ENABLED SCRIPPS TO HIRE SUBSTANCE USE DISORDER SERVICE 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. SUDS NURSES EVALUATE PATIENTS WHO MEET CERTAIN CRITERIA AND WORK DIRECTLY WITH THE NURSE AND PHYSICIAN TO ENSURE THE PATIENT IS ADEQUATELY MEDICATED 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, MCALISTER INSTITUTE FOR DETOX BEDS AND THE BETTY FORD CENTER FOR OUTPATIENT CARE. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 2020 LIVE WELL SAN DIEGO VIRTUAL 5K AND FITNESS CHALLENGE SCRIPPS HEALTH JOINED LIVE WELL SAN DIEGO AS A RECOGNIZED PARTNER ON DECEMBER 13, 2016. LIVE WELL SAN DIEGO IS A VISION FOR A REGION THAT IS BUILDING BETTER HEALTH, LIVING SAFELY AND THRIVING. IT ALIGNS THE EFFORTS OF INDIVIDUALS, ORGANIZATIONS AND GOVERNMENT TO HELP ALL 3.3 MILLION SAN DIEGO COUNTY RESIDENTS LIVE WELL. THIS YEAR'S EVENT BROUGHT THOUSANDS OF SAN DIEGANS "TOGETHER" TO CELEBRATE THE 10TH ANNIVERSARY OF THE LIVE WELL SAN DIEGO VISION. THE EVENT HAD 69 TEAMS WORK TOGETHER TO COMPLETE NEARLY 10,000,000 STEPS. AGING CONCERNS ACROSS THE UNITED STATES AND LOCALLY IN SAN DIEGO COUNTY, THE GROWTH IN THE NUMBER AND PROPORTION OF AGING ADULTS OVER THE AGE OF 65 HAS HIT NEW AND UNPRECEDENTED LEVELS IN OUT HISTORY. ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), TWO MAIN FACTORS - LONGER LIFE SPANS AND AGING BOOMERS - WILL "COMBINE TO DOUBLE THE POPULATION OF AMERICANS AGED 65 OR OLDER DURING THE NEXT 25 YEARS TO ABOUT 72 MILLION. BY 2030, OLDER ADULTS WILL ACCOUNT FOR ROUGHLY 20% OF THE U.S. POPULATION." IN 2019, THERE WERE 504,267 RESIDENTS AGES 65 AND OLDER IN SAN DIEGO COUNTY REPRESENTING 15.1% OF THE POPULATION. BETWEEN 2019 AND 2024, IT IS ANTICIPATED THAT SAN DIEGO COUNTY SENIOR POPULATION WILL GROW BY 22.4%. 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 SAN DIEGO IS NOW THE NINTH MOST EXPENSIVE CITY IN THE U.S. (2019). THE ELDER INDEX, DEVELOPED BY UCLA'S CENTER FOR HEALTH POLICY RESEARCH, REPORTS 41% OF SAN DIEGO'S SENIORS DO NOT HAVE ENOUGH INCOME TO PAY FOR BASIC HOUSING, FOOD, HEALTHCARE, AND TRANSPORTATION. MEANWHILE, GOVERNMENT HOUSING PROGRAMS ARE EXPERIENCING EXTREME WAITING LISTS AND INTAKE TOOLS FAIL TO PRIORITIZE THE ELDERLY. THESE FACTORS, COMBINED WITH SAN DIEGO'S HOUSING CRISIS, ARE INTENSIFYING SENIOR HOMELESSNESS, AS EVIDENCED BY SAN DIEGO'S MOST RECENT POINT IN TIME COUNT. IN 2020, 27% OF SAN DIEGO'S UNSHELTERED RESIDENTS WERE 55 YEARS AND OLDER, EQUATING TO MORE THAN 2,000 SENIORS LIVING ON THE STREETS. WITHIN THIS GROUP OF OLDER ADULTS: - 88% OF SENIORS BECAME HOMELESS IN SAN DIEGO - 43% ARE EXPERIENCING HOMELESSNESS FOR THE FIRST TIME - 54% ARE SLEEPING ON THE STREET OR SIDEWALK - 50% ARE MANAGING A CHRONIC CONDITION |
| FORM 990, PART III, LINE 4A (CONTINUED) |
A SUMMARY OF THE MAGNITUDE AND PREVALENCE OF AGING CONDITIONS ARE DESCRIBED BELOW: - THE 2019 HASD&IC AND SCRIPPS CHNA IDENTIFIED AGING CONCERNS 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 2018, 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 2008, THERE WERE 1,461 DEATHS DUE TO ALZHEIMER'S DISEASE IN SAN DIEGO COUNTY OVERALL. THE AGE-ADJUSTED DEATH RATE DUE TO ALZHEIMER'S DISEASE WAS 37.42 PER 100,000 POPULATION - IN 2018, 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 2018, HOSPITALIZATION RATES AMONG SENIORS WERE HIGHER THAN THE GENERAL POPULATION DUE TO CORONARY HEART DISEASE, STROKE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, 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 2017 WERE UNINTENTIONAL INJURIES, FALLS AND COPD/CHRONIC LOWER RESPIRATORY DISEASES. - 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 2017, 69.4% OF THE INFLUENZA HOSPITALIZATIONS AND 75 OF THE 90 INFLUENZA DEATHS IN SDC OCCURRED AMONG RESIDENTS AGES 65 AND OLDER. THE AGE-ADJUSTED RATE OF INFLUENZA DEATH AMONG THIS GROUP WAS 16.2 PER 100,000 POPULATION. - 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). DURING FISCAL YEAR 2020, SCRIPPS ENGAGED IN THE FOLLOWING PROGRAMS AND SERVICES TO MEET THE NEEDS OF THE AGING POPULATION. SCRIPPS ADVANCED CARE CLINIC THE PROGRAM PROVIDES INTENSIVE, PROACTIVE, MEDICAL AND SOCIAL SERVICES TO ADULTS LIVING WITH MULTIPLE CHRONIC DISEASES. UNDERSTANDING THAT DISEASES CAN IMPACT ALL ASPECTS OF A PERSON'S LIFE, THE PROGRAM TREATS NOT JUST MEDICAL ISSUES, BUT ALSO THE PSYCHOSOCIAL, ECONOMIC AND SPIRITUAL ASPECTS OF CARE. THE ADVANCED CARE CLINIC INTERDISCIPLINARY, PATIENT CENTERED TEAM HELPS OPTIMIZE PATIENT HEALTH THROUGH AN EVIDENCE-BASED EXTENSIVIST CLINIC MODEL THAT ASSIST WITH CARE COORDINATION AND PATIENT ADVOCACY ACROSS HEALTH CARE AND HOME SETTINGS. TO DATE 149 PATIENTS HAVE BEEN SERVED, 45% REDUCTION IN HOSPITALIZATIONS, 72% REDUCTION IN 30-DAY READMISSIONS AND 49% REDUCTION IN ED VISIT RATE. IN ADDITION, THE PROGRAM COORDINATES NON-CLINICAL ISSUES. 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 PREVENTION 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 SEPTEMBER 2019 AND JANUARY 2020. 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. VIRTUAL STANDING STRONG FALL PREVENTION WEBINAR AS PART OF NATIONAL FALL PREVENTION AWARENESS WEEK IN SEPTEMBER 2020, SCRIPPS PARTNERED WITH THE COUNTY OF SAN DIEGO HEALTH AND HUMAN SERVICES AND THE SAN DIEGO FALL PREVENTION TASK FORCE ON FREE, VIRTUAL EVENTS TO LEARN MORE ABOUT WHAT INDIVIDUALS CAN DO TO PREVENT FALLS. FALLS ARE THE LEADING CAUSE OF INJURY RELATED EMERGENCY DEPARTMENT VISITS FOR OLDER ADULTS. SCRIPPS HOSTED A TWO-HOUR WEBINAR WITH A PANEL OF SCRIPPS EXPERTS TO PROVIDE SAFETY TIPS, EDUCATION, AND EXERCISES. THE SCRIPPS EVENT SERVED AS THE OFFICIAL KICK-OFF EVENT FOR FALL PREVENTION AWARENESS WEEK WITH 20 PRESENTATIONS DELIVERED VIRTUALLY. http://www.sandiegofallprevention.org/ THE FOLLOWING WERE SOME OF THE TOPICS PROVIDED: - FALL PREVENTION 101 - KEEPING YOUR DAILY BALANCE - UNDERSTANDING AND PREVENTING FALLS FROM THE PERSPECTIVE OF FIRST RESPONDERS - KITCHEN SAFETY IN A COVID-19 WORLD - FALL PREVENTION SCREENING AND GETTING UP SAFELY AFTER A FALL |
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VIRTUAL STANDING STRONG FALL PREVENTION WEBINAR 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 IMPORTANT ASPECT TO HEALTHY LIVING FOR SENIORS PROVIDES EDUCATION ON PREVENTING FALLS THROUGH EXERCISE AND BEING PROACTIVE THROUGH SAFETY MEASURES IN THE HOME. SCRIPPS PHYSICAL THERAPY DEPARTMENT AND PHYSICAL THERAPY SCHOOL VOLUNTEERS PROVIDE FALL RISK ASSESSMENTS. SENIORS MAY ATTEND FROM ALL OVER THE SAN DIEGO COUNTY REGION. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. VIRTUAL STANDING STRONG FALL PREVENTION WEBINAR 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. SCRIPPS WAS CHOSEN AS A PILOT SITE TO TEST A NEW VIRTUAL EDITION OF THE A MATTER OF BALANCE PROGRAM WITH RESULTS BEING USED TO LAUNCH THE NEW VIRTUAL EVIDENCE-BASED VERSION IN JANUARY 2021. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. A TOTAL OF 104 SENIORS HAVE PARTICIPATED IN THESE MONTHLY SESSIONS. THESE PRESENTATIONS INCLUDE A VARIETY OF HEALTH AND AGE-RELATED TOPICS THAT INCLUDE: HEART HEALTH, UNDERSTANDING OSTEOPOROSIS, PARKINSON'S, COLD VS. FLU AND A VARIETY OF PREVENTION AND HEALTHY LIFESTYLE TOPICS. THESE PRESENTATIONS ARE FACILITATED BY VARIOUS HEALTH CARE PROFESSIONS AND RESIDENTS. TOPICS ARE ALL CHOSEN BY THE SENIORS THEMSELVES 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. NO CLASSES WERE HELD AFTER MARCH DUE TO COVID-19. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. 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 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 |
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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 FISCAL YEAR 2020, 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 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. 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. CLASSES WERE CANCELLED IN QUARTER 3 AND 4 DUE TO COVID-19. 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 FOUR-SESSION SERIES IS DESIGNED TO INCREASE KNOWLEDGE AND BEHAVIORS REGARDING A HEALTHY LIFESTYLE. THE SERIES INCLUDES HANDS-ON ACTIVITIES AND DEMONSTRATIONS. THE FOUNDATION OF THIS PROJECT BEGAN IN 2013 WITH A PARTNERSHIP WITH THE PROMISE NEIGHBORHOOD INITIATIVE AND CASTLE PARK ELEMENTARY SCHOOL TO INCREASE EDUCATION AND AWARENESS ABOUT HEALTHY LIFESTYLES AND TO HELP THE STUDENTS PASS THEIR YEARLY PHYSICAL EDUCATION REQUIREMENTS. SCRIPPS HAS CONTINUED TO ENHANCE AND DEVELOP THE SERIES. DURING FY20 THERE WAS A TOTAL OF 275 PARTICIPANTS FROM MAR VISTA, CHULA VISTA AND SOUTHWEST HIGH SCHOOLS AND STUDENTS FROM HEALTH CAREERS OCCUPATIONAL PROGRAM (HCOP) CAMP SCRIPPS. AS A RESULT OF ACTIVITIES, LESSON PLANS AND ADVOCACY FOR HEALTHY LIVING, THE AMOUNT OF PHYSICAL ACTIVITY AND CONSUMPTION OF FRUITS AND VEGETABLES BY THE YOUTH HAS INCREASED. STUDENT RESPONSES VIA THE 5210-ASSESSMENT SURVEY SHOWED PRE-TEST KNOWLEDGE WAS 62.5% AND POST-TEST KNOWLEDGE IMPROVEMENT RATE OF 88.5% AFTER PARTICIPATING IN THE 5210 SESSIONS. DUE TO COVID-19 SOME OF THESE WERE HELD VIRTUALLY. |
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LA MAESTRA FAMILY CLINIC, INC 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. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. A TOTAL OF 248 PEOPLE PARTICIPATED IN TOPS PRIOR TO THE PANDEMIC. 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 AND 50 PEOPLE ATTENDED. THE GROUP STOPPED MEETING IN JANUARY 2020 DUE TO LOW ATTENDANCE OVER THE PAST YEAR. A NEW GROUP STARTED MEETING IN SAN YSIDRO WHICH IS CLOSER TO WHERE THE ATTENDEES RESIDE. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. FOOD HANDLERS TRAINING COURSE SCRIPPS HEALTH PROVIDES THE USE OF A CLASSROOM TO FULL SPECTRUM NUTRITION SERVICES TO PROVIDE A THREE-HOUR COURSE IN SPANISH WHICH PROVIDES CERTIFICATION FOR FOOD HANDLERS AND MEETS REQUIREMENTS OF THE SAN DIEGO COUNTY FOOD HANDLERS ORDINANCE. DUE TO COVID-19 THE COURSES WERE NOT HELD AFTER MARCH DUE TO RESTRICTED ACCESS TO THE HOSPITAL. A TOTAL OF 40 PEOPLE WAS ABLE TO RECEIVE CERTIFICATION PRIOR TO THE PANDEMIC. 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. A SUMMARY OF THE MAGNITUDE AND PREVALENCE OF MATERNAL AND CHILD HEALTH & HIGH-RISK PREGNANCIES ARE DESCRIBED BELOW: - IN 2017, THERE WERE 40,889 LIVE BIRTHS IN SAN DIEGO COUNTY (SDC) OVERALL. SOURCE: COUNTY OF SAN DIEGO, HEALTH AND HUMAN SERVICES AGENCY (HHSA), PUBLIC HEALTH SERVICES, MATERNAL, CHILD, AND FAMILY HEALTH. THE 2017 INFANT MORTALITY RATE WAS 2.3 INFANT DEATHS PER 1,000 LIVE BIRTHS IN THE NORTH INLAND REGION, 3.0 IN THE NORTH COASTAL REGION, 3.3 IN THE EAST REGION, 3.6 IN SDC OVERALL, 4.0 IN THE CENTRAL REGION, 4.3 IN THE NORTH CENTRAL REGION, AND 4.7 IN THE SOUTH REGION. - IN 2017, 149 INFANTS IN SDC DIED BEFORE THEIR FIRST BIRTHDAY. INFANT MORTALITY WAS MORE COMMON AMONG MALE INFANTS (84 DEATHS) THAN FEMALE INFANTS (64 DEATHS). AFRICAN AMERICAN/BLACK INFANTS HAD THE HIGHEST MORTALITY RATE (6.9 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 4.7 DEATHS PER 1,000 LIVE BIRTHS.100 IN ADDITION, 3,423 PRETERM BIRTHS OCCURRED IN SDC DURING 2017. 100,101 COMPARED TO ALL OTHER RACES AND ETHNICITIES, HISPANIC MOTHERS HAD THE HIGHEST TOTAL NUMBER OF BIRTHS (16,593), OF WHICH 8.0% WERE PRETERM. ALTHOUGH BLACK MOTHERS HAD FEWER TOTAL BIRTHS (1,741), THEY EXPERIENCED THE HIGHEST RATE OF PRETERM BIRTHS AMONG ALL RACIAL OR ETHNIC GROUPS (11.3%). SIMILARLY, ALTHOUGH WOMEN AGES 25 TO 39 HAD THE HIGHEST TOTAL NUMBER OF BIRTHS AMONG ALL AGE GROUPS, MOTHERS AGES 40 AND OLDER WERE MORE LIKELY TO GIVE BIRTH PRETERM (15.2% PRETERM BIRTHS AMONG MOTHERS AGES 40 AND OLDER COMPARED TO 8.2% AMONG MOTHERS AGES 25 TO 39). - IN 2017, 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 4.3 FOR A SUMMARY OF MATERNAL AND INFANT HEALTH INDICATORS IN SAN DIEGO COUNTY IN 2017 AND TABLE 4.4 FOR A SUMMARY OF MATERNAL AND INFANT HEALTH INDICATORS BY REGION. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
SCRIPPS HEALTH CONTINUED TO ENHANCE PRENATAL EDUCATION FOR LOW INCOME WOMEN IN SAN DIEGO COUNTY IN FISCAL YEAR 2020. 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 300 SERVICES WERE RECEIVED FOR FIRST TIME MOTHERS INCLUDING: HOME VISITS, REFERRALS RECEIVED, DATA ENTRY, FOLLOW UP PHONE CALLS, PARENTING CLASSES AND OTHER SUPPORT SERVICES. DUE TO COVID -19 THESE CLASSES WERE OFFERED VIRTUALLY AND VIA CONFERENCE CALL. A TOTAL OF 188 UNDUPLICATED PARENTS PARTICIPATED IN PARENTING EDUCATION WORKSHOP SERIES AND 120 SESSIONS WERE PROVIDED. THIS PARTNERSHIP WITH FIRST FIVE AND SOUTH BAY COMMUNITY SERVICES ENDED JUNE 2020. FIRST FIVE HOME VISITS IN COLLABORATION WITH THE MEDICAL RESIDENTS, NEWBORN HOME VISITS ARE PROVIDED TO FIRST-TIME MOMS WHO HAVE DELIVERED AT SCRIPPS MERCY HOSPITAL CHULA VISTA. THE VISIT INCLUDES A COMPREHENSIVE ASSESSMENT COVERING SOCIAL, HEALTH, AND ENVIRONMENTAL ISSUES. FURTHER FOLLOW UP IS PROVIDED TO ASSESS CRITICAL HEALTH BEHAVIORS IDENTIFIED. FOLLOW UP AND SUPPORT SERVICES ARE PROVIDED FOR SIX MONTHS. HOME VISITS CEASED AS OF MARCH 2020 DUE TO COVID-19. BREAST FEEDING SUPPORT GROUP AN EXPERIENCED BREASTFEEDING INSTRUCTOR LEADS THE BREASTFEEDING SUPPORT GROUP AT THE WELL BEING CENTER WITH MOTHERS WHO WOULD LIKE BREASTFEEDING SUPPORT. THEY INTERACT WITH OTHER MOTHERS AND ARE LED BY THE INSTRUCTOR. BABIES ARE WEIGHED AT THE BEGINNING AND END OF GROUP TO ASSESS HOW MUCH MILK THEY ARE GETTING. DUE TO COVID-19 THIS GROUP CONTINUED TO MEET BY CONFERENCE CALL SINCE MARCH 2020. 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 75 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 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. SINCE COVID-19, THIS PROGRAM HAS BEEN OFFERED VIA TELEMEDICINE. 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. DUE TO COVID-19 THE CLINICAL ROTATIONS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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 FY20 THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS FOR 65,655 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. MIRACLE BABIES SCRIPPS HEALTH PARTNERED WITH MIRACLE BABIES ON THEIR VIRTUAL 5K WALK/RUN. THE MISSION OF MIRACLE BABIES IS TO UNIFY FAMILIES WITH THEIR SICK NEWBORNS THROUGH FINANCIAL ASSISTANCE AND SUPPORTIVE SERVICES TO REDUCE PREGNANCY COMPLICATIONS THROUGH PREVENTION, EDUCATION AND RESEARCH. MIRACLE BABIES DIAPER DISTRIBUTION THE MIRACLE BABIES PROGRAM HOSTED SEVERAL DIAPER DISTRIBUTIONS AT CAMPUS POINT. MIRACLE BABIES WAS STARTED BY DR. SEAN DANESHMAND, SCRIPPS CLINIC MEDICAL DIRECTOR OF MATERNAL AND FETAL MEDICINE, TO PROVIDE FINANCIAL AND SUPPORTIVE SERVICES TO PARENTS WITH HOSPITALIZED NEWBORNS RECEIVING TREATMENT IN NEONATAL INTENSIVE CARE UNITS (NICU). THE DISTRIBUTION SERVED MORE THAN 700 FAMILIES. 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 2018, 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. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
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 THAT OCCUR BY ACCIDENT, HOMICIDE, OR SUICIDE DUE TO TRAUMAS OR OVERDOSE, OR UNDIAGNOSED OR SUDDEN UNEXPECTED NATURAL CAUSES. IN 2018, THERE WERE 1,250 DEATHS DUE TO ACCIDENTS/UNINTENTIONAL INJURIES IN SAN DIEGO COUNTY OVERALL. THE AGE-ADJUSTED DEATH RATE DUE TO DIABETES WAS 35.20 PER 100,000 POPULATION. SAN DIEGO COUNTY'S MEDICAL EXAMINER'S OFFICE RELEASE BOTH MID-YEAR STATISTICS COMPARING THE FIRST SIX MONTHS OF 2020 TO 2019 IN ITS 2019 ANNUAL REPORT. LOOKING AT MID-YEAR FIGURES, THE DEPARTMENT INVESTIGATED 1,751 DEATHS THROUGH JUNE THIS YEAR COMPARED TO 1,674 IN THE SAME MONTHS LAST YEAR, A 5% INCREASE. THE MEDICAL EXAMINER'S OFFICE INVESTIGATES DEATHS THAT OCCUR BY ACCIDENT, HOMICIDE, OR SUICIDE DUE TO TRAUMA OR OVERDOSE, OR UNDIAGNOSED OR SUDDEN, UNEXPECTED NATURAL CAUSES. IN CASES WHERE A PERSON DIES A NATURAL DEATH AND IS UNDER A PHYSICIAN'S CARE, THAT PHYSICIAN WILL CERTIFY THE DEATH AND THE PERSON DOES NOT THEN GO TO THE MEDICAL EXAMINER FOR FURTHER INVESTIGATION. - DESPITE IT BEING A PANDEMIC YEAR, IT SHOULD BE NOTED THAT RELATIVELY FEW COVID-19 DEATHS ARE REPRESENTED IN THE MID-YEAR STATISTICS. DEATHS RESULTING FROM CONTAGIOUS DISEASES THAT POSE A RISK TO THE PUBLIC SUCH AS COVID-19 ARE REPORTABLE TO THE MEDICAL EXAMINER BUT ARE CONSIDERED NATURAL DEATHS AND ARE THEREFORE NOT ALWAYS INVESTIGATED FURTHER BY THE DEPARTMENT IF THE PERSON WAS ALREADY UNDER THE CARE OF A PHYSICIAN. THE DEATHS DUE TO COVID-19 THAT THE MEDICAL EXAMINER SEES ARE GENERALLY CASES WHERE THE PERSON HAD NOT SOUGHT ANY TREATMENT FOR THEIR ILLNESS, OR THE DEATH WAS UNEXPECTED. THROUGH JUNE THE DEPARTMENT TESTED 104 DECEDENTS WHO HAD POTENTIAL SYMPTOMS, SIGNS, OR RISK FACTORS FOR COVID-19 AND SEVEN CAME BACK POSITIVE FOR THE VIRUS, A 6.7 POSITIVITY RATE. - IN THE MID-YEAR SNAPSHOT, ACCIDENTAL DEATHS MAKE UP THE LARGEST CAUSE OF CASES, WITH 857 OF 1,751 DEATHS FROM JANUARY THROUGH JUNE. THIS IS AN INCREASE OF 2% COMPARED TO 838 IN THE FIRST SIX MONTHS OF 2019. THE CATEGORY COVERS ANY KIND OF DEATH FROM ACCIDENTAL INJURY OR INTOXICATION, INCLUDING INJURIES FROM FALLS OR CAR CRASHES, ACCIDENTAL DRUG OVERDOSES, INJURIES FROM FIRES OR ENVIRONMENTAL EXPOSURE SUCH AS HYPOTHERMIA OR HYPERTHERMIA, DROWNING, AND OTHER UNINTENTIONAL INJURIES. - WITHIN THE ACCIDENTAL DEATH CATEGORY, UNINTENTIONAL OVERDOSE DEATHS DUE TO ILLICIT DRUGS, PRESCRIPTION MEDICATION AND ALCOHOL TOXICITY INCREASED BY 21% FROM 320 DEATHS IN THE FIRST HALF OF 2019 TO 387 THE FIRST SIX MONTHS OF THIS YEAR. OF THOSE ACCIDENTAL OVERDOSES, FENTANYL-CAUSED DEATHS INCREASED BY 126% COMPARING THOSE SAME SIX MONTHS WHERE THERE WERE 69 DEATHS IN 2019 AND 156 CASES FOR THE FIRST SIX MONTHS OF THIS YEAR. MOST OFTEN, OVERDOSE DEATHS FROM FENTANYL ARE TRACED TO COUNTERFEIT PILLS THAT RESEMBLE OXYCODONE OR ALPRAZOLAM, 2020 SAN DIEGO COUNTY PRESCRIPTION DRUG ABUSE TASK FORCE. - THERE WAS ALSO A DECREASE OF 5% IN NUMBER OF SUICIDES, 198 THIS YEAR COMPARED TO 209 IN THE SAME SIX MONTHS LAST YEAR. FIREARMS WERE THE LEADING METHOD OF DEATH IN 76 OF THE 198 DEATHS BY SUICIDE THIS YEAR. - HOMICIDES INCREASED BY 14% FOR THE FIRST HALF OF THE YEAR, 59 COMPARED TO LAST YEAR'S 52. IN THIS CATEGORY, FIREARMS WERE AGAIN THE LEADING METHOD OF DEATHS, 32 OF THE 59 DEATHS. - FOR ALL OF 2019, ACCIDENTAL DEATHS OVERALL COMPRISED 50% OF ALL DEPARTMENT INVESTIGATIONS. WITHIN THAT CATEGORY, UNINTENTIONAL OVERDOSES FROM DRUGS-BOTH PRESCRIPTION OR ILLEGAL-AND ALCOHOL WERE, AT 39%, THE LEADING CAUSE OF DEATH. ACCIDENTAL FALLS FOLLOWED AT 33% AND THEN TRAFFIC-RELATED FATALITIES AT 19% WERE NEXT AS OUTLINED IN THE DEPARTMENT'S ANNUAL 2019 YEAR-END REPORT. - DEATHS FROM FALLS INCREASED BY 12% WITH 545 CASES IN 2019 COMPARED TO 488 IN 2018. BLUNT HEAD TRAUMA AND HIP/FEMUR FRACTURE WERE THE LEADING CAUSE OF DEATH IN FALLS. TRAFFIC-RELATED DEATHS DECREASED BY 5% FROM 2018 WHICH HAD 316 DEATHS WHILE 2019 SAW 301 DEATHS. 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.SCRIPPS HEALTH CONTINUED TO ADDRESS UNINTENTIONAL INJURY AND VIOLENCE AND 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. DUE TO COVID-19 THIS PROGRAM WAS PUT ON HOLD DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. EVERY 15 MINUTES ALCOHOL CAN BE ATTRIBUTED TO MORE THAN 100,000 DEATHS IN THE U.S. ANNUALLY, INCLUDING 41% OF ALL TRAFFIC FATALITIES. 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. DUE TO COVID-19 CLASSES WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
SAN DIEGO COUNTY LIFEGUARD EDUCATION CONFERENCE IN FISCAL YEAR 2020 SCRIPPS MEMORIAL HOSPITAL LA JOLLA TRAUMA DEPARTMENT HOSTED A VIRTUAL SAN DIEGO COUNTY LIFEGUARD EDUCATION CONFERENCE. SCRIPPS PARTNERED WITH CALIFORNIA STATE PARKS TO HOST AND MODERATE THE VIRTUAL WEBINAR. MORE THAN 100 INDIVIDUALS SIGNED IN FOR THE WEBINAR. 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 VIRTUAL LIFEGUARD EDUCATION CONFERENCE HAS NOW BEEN VIEWED OVER 1,000 TIMES. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. DUE TO COVID-19 THIS EVENT WAS CANCELLED DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. DUE TO COVID-19 THIS EVENT WAS CANCELLED DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. |
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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 - AN ANALYSIS OF MORTALITY DATA IN SAN DIEGO COUNTY FOUND THAT IN 2018, INTENTIONAL SELF-HARM (SUICIDE) WAS THE TENTH LEADING CAUSE OF DEATH. IN 2018, THE AGE-ADJUSTED SUICIDE RATE IN SAN DIEGO WAS 12.63 PER 100,000. RATES WERE HIGHEST AMONG WHITES (19.6), FOLLOWED BY BLACKS (4.06), ASIAN PACIFIC ISLANDERS (7.39) AND HISPANICS (7.56). - AN ANALYSIS OF 2018 MORTALITY DATA FOR SAN DIEGO COUNTY REVEALED ALZHEIMER'S DISEASE AND SUICIDE AS THE THIRD AND TENTH LEADING CAUSES OF DEATH FOR SAN DIEGO COUNTY, RESPECTIVELY. - 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. - IN 2017 THERE WERE 5,882 ED VISITS RELATED TO MOOD DISORDERS IN SAN DIEGO COUNTY, AN 18.2% INCREASE FROM 2013. THIS AGE-ADJUSTED RATE OF ED VISITS FOR MOOD DISORDERS WAS 177.4 PER 100,000 POPULATION. - 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 2017, THERE WERE 998 HOSPITALIZATIONS DUE TO OVERDOSE/POISONING IN SDC. THE AGE-ADJUSTED RATE OF HOSPITALIZATIONS DUE TO OVERDOSE/POISONING WAS 28.4 PER 100,000 POPULATION. - IN 2017, THE AGE-ADJUSTED RATE OF OVERDOSE/POISONING-RELATED ED VISITS IN SDC WAS 172.1 PER 100,000 POPULATION. AGE-ADJUSTED RATES FOR OVERDOSE/POISONING-RELATED ED VISITS WERE HIGHER AMONG MALES, INDIVIDUALS OF OTHER RACE AND INDIVIDUALS AGES 15 TO 24 YEARS IN COMPARISON AMONG GROUP. - 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. 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 2020 REPORT THE NUMBER AND RATE OF PEOPLE WHO DIED BY SUICIDE IN SAN DIEGO COUNTY DROPPED LAST YEAR. IN 2019, THERE WERE 429 DEATHS BY SUICIDE, 36 FEWER THAN THE 465 REPORTED IN 2018. THE ANNUAL REPORT PROVIDES A COMPREHENSIVE LOOK AT SUICIDE IN THE REGION AND BRINGS TOGETHER DATA FROM MULTIPLE SOURCES FOR THE YEARS 2015 THROUGH 2019. |
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AMONG THE REPORT'S FINDINGS: 1. COMPARED WITH 2018, THE COUNTY SUICIDE RATE IN 2019 DECREASED 7.9% FROM 13.9 TO 12.8 PER 100,000 POPULATION, THE LOWEST RATE SINCE 2011. 2. IN CONTRAST, THE RATE OF REGIONAL EMERGENCY DEPARTMENT DISCHARGES DUE TO NON-FATAL SELF-HARM INCREASED 1.7% BETWEEN 2017 AND 2018 (MOST RECENT DATA AVAILABLE). 3. CRISIS CALLS TO THE LOCAL ACCESS AND CRISIS HOTLINE IN 2019 INCREASED 15.5% TO AN UNPRECEDENTED 55% OF ALL CALL VOLUME. 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: 2020 REPORT CARD. https://www.sdchip.org/initiatives/suicide-prevention-council/reports-reso urces/ THE REPORT CARD BRINGS TOGETHER THE MOST RECENT DATA AVAILABLE FROM MULTIPLE SOURCES (FOR THE YEARS 2015 THROUGH 2019) 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. BEHAVIORAL HEALTH 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 FISCAL YEAR 2020, THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM EXPERIENCED A $3.4 MILLION LOSS IN TOTAL OPERATIONS, WITH 2.2 MILLION OF THIS LOSS BEING CAPTURED IN MEDI-CAL/CMS AND CHARITY CARE. - IN FISCAL YEAR 2020, 1.2 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, 626 INQUIRIES HAVE COME IN, 165 OF THESE RESULTED IN QUALIFIED CANDIDATES WITH 101 VOLUNTEERS AND 54 EMPLOYEES THUS FAR. CURRENTLY, THERE ARE A TOTAL OF 24 ACTIVE CANDIDATES: 23 EMPLOYEES AND ONE VOLUNTEER WHO PARTICIPATE IN THIS SUPPORTIVE EMPLOYMENT PROGRAM. THE AVERAGE LENGTH OF EMPLOYMENT FOR THE 54 EMPLOYEES IS 5.4 YEARS, WITH A RANGE OF 2 MONTHS TO 14.7 YEARS. THE CURRENT PAID EMPLOYEES HAVE BEEN EMPLOYED BETWEEN 1.3 YEARS TO 13.4 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 FY20, 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. CLASSES WERE CANCELLED IN MARCH DUE TO COVID-19. 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. SCRIPPS WHITTIER DIABETES DISTRESS STUDY THE NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES AWARDED A FIVE-YEAR, $3.3 MILLION GRANT IN 2020 TO SCRIPPS WHITTIER DIABETES INSTITUTE TO STUDY THE INTEGRATION OF MENTAL HEALTH SERVICES IN THE CARE OF PATIENTS WITH TYPE 1 DIABETES TO BETTER ADDRESS THE EMOTIONAL DISTRESS THAN OFTEN ACCOMPANIES THE CHRONIC DISEASE. RESEARCHERS AT SCRIPPS WHITTIER WILL USE THE FEDERAL FUNDING TO LAUNCH A LARGE-SCALE, RANDOMIZED, CONTROLLED CLINICAL TRIAL THAT WILL EVALUATE WHETHER THE INTEGRATION OF DIABETES DISTRESS CARE WITH ROUTINE MEDICAL CARE RESULTS IN BETTER MANAGEMENT OF DIABETES AND BETTER HEALTH-RELATED QUALITY OF LIFE. THE STUDY IS A COLLABORATIVE EFFORT THAT CAPITALIZES ON THE COMPLIMENTARY EXPERTISE OF A CLINICAL PSYCHOLOGIST/ENDOCRINOLOGIST PARTNERSHIP. 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 150 HOURS WERE SPENT IN THE SCHOOL-BASED CLINICS OFFERING SERVICES FOR ADOLESCENTS TO AN AVERAGE OF 12 STUDENTS PER WEEK. DUE TO COVID-19 THE SCHOOLS WERE CLOSED FOR SEVERAL WEEKS AND THEN TRANSITIONED TO A VIRTUAL SETTING. PATIENT COMMUNITY SERVICES: BEHAVIORAL HEALTH 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. THESE SERVICES WERE OFFERED REMOTELY AS OF MARCH 2020 DUE TO COVID-19. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. DUE TO COVID-19 MEETINGS WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. DUE TO COVID-19 THE MEETINGS WERE NOT HELD IN THE LATER PART OF THE FISCAL YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. 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. THESE MEETINGS WERE CANCELLED MID-YEAR DUE TO COVID-19 AND RESTRICTED ACCESS TO THE HOSPITAL. 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. |
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OPIOID STEWARDSHIP PROGRAM (OSP) CAL HOSPITAL COMPARE (CHC), A NONPROFIT ORGANIZATION THAT PROVIDES CALIFORNIANS WITH HOSPITAL PERFORMANCE RATINGS, HAS NAMED ALL FOUR OF SCRIPPS HEALTH'S HOSPITALS TO ITS 2020 OPIOID CARE HONOR ROLL. SCRIPPS IS THE ONLY HEALTH CARE ORGANIZATION IN SAN DIEGO COUNTY TO BE RECOGNIZED ON THE INAUGURAL STATEWIDE LIST. THE 2020 OPIOID CARE HONOR ROLL RECOGNIZED 53 CALIFORNIA HOSPITALS FOR THEIR PROGRESS AND PERFORMANCE IN PROMOTING SAFE AND EFFECTIVE OPIOID USE, PROVIDING TREATMENT FOR PATIENTS WITH OPIOID USE DISORDER AND PROVIDING ACCESS TO NALOXONE TO PREVENT OPIOID OVERDOSES. ACCORDING TO STATE DATA, OVER 2,400 CALIFORNIANS DIED OF AN OPIOID-RELATED OVERDOSE IN 2018. CHC RECOGNIZED SCRIPPS FOR TAKING A VARIETY OF APPROACHES TO ADDRESS OVERUSE OF OPIOIDS AMONG ITS PATIENTS. FOR PATIENTS BEING DISCHARGED FROM AN EMERGENCY DEPARTMENT VISIT OR HOSPITAL STAY, SCRIPPS HAS CREATED EDUCATIONAL VIDEOS THAT IT MAKES AVAILABLE FOR VIEWING AND HAS ALSO SET OPIOID PRESCRIPTION QUANTITY LIMITS AT DISCHARGE. IN ADDITION, SOME SCRIPPS HOSPITAL EMERGENCY DEPARTMENTS HAVE IMPLEMENTED MEDICATION-ASSISTED THERAPY, IN WHICH SPECIALLY LICENSED ER PHYSICIANS CAN ADMINISTER MEDICATIONS AS A BRIDGE FOR PATIENTS WITH OPIOID USE DISORDER UNTIL THEY CAN RECEIVE FURTHER CARE. 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 REDUCTION IN THE NUMBER OF OPIOID PILLS PER PRESCRIPTION AT SCRIPPS HOSPITALS AND OUTPATIENT CENTERS. SCRIPPS HAS DRUG TAKE-BACK KIOSKS AT ITS ON-SITE PHARMACIES, OFFERING PATIENTS YEAR-ROUND ACCESS TO DISPOSE OF UNUSED, UNNEEDED OR OUTDATED MEDICATIONS. ADDITIONALLY, SCRIPPS PROVIDES A RANGE OF NON-PHARMACEUTICAL PAIN MANAGEMENT THERAPIES, INCLUDING MUSIC AND PET THERAPY, ICE AND HEAT TREATMENT, SPIRITUAL CARE AND MORE. SOCIAL DETERMINANTS OF HEALTH 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) |
THE PUBLIC RESOURCE SPECIALIST (PRS) TEAM SCREEN ALL UNINSURED PATIENTS WHO HAVE RECEIVED SERVICES AT ANY OF THE FIVE SCRIPPS HOSPITAL FACILITIES. SCRIPPS HEALTH BEGAN SCREENING FOR CALFRESH IN JUNE 2017 THROUGH THE SUPPORT OF THE PRS TEAM. THE TEAM HAS BEEN SUCCESSFUL IN HAVING THE IMPORTANT CONVERSATION ABOUT FOOD INSECURITY WITH PATIENTS AND SCREENED A TOTAL OF 1,274 INDIVIDUALS IN FY20. LA MAESTRA FAMILY CLINIC, INC 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. DUE TO COVID-19 CLASSES WERE NOT HELD MOST OF THE YEAR DUE TO RESTRICTED ACCESS TO THE HOSPITAL. SCRIPPS EMPLOYEE FOOD SHARING PROGRAM IN LATE APRIL 2020 EMPLOYEES FROM ACROSS THE SYSTEM BEGAN REACHING OUT ABOUT FOOD RESOURCES FOR COLLEAGUES AT SCRIPPS. AS A RESULT OF THESE MUTUAL CONCERNS THE SCRIPPS EMPLOYEE FOOD SHARING PROGRAM WAS ESTABLISHED, AND FOOD DISTRIBUTION EVENTS WERE HELD ON MAY 23, 2020, JUNE 27, 2020 AND JULY 18, 2020. THE SCRIPPS EMPLOYEE FOOD SHARING PROGRAM SUCCESSFULLY DISTRIBUTED FOOD TO 270 COLLEAGUES WHO FOUND THEMSELVES IN NEED OF ASSISTANCE DURING THIS COVID-19 CRISIS AND 149 VOLUNTEERS PARTICIPATED IN THE DISTRIBUTIONS. EACH OF THESE STAFF MEMBERS RECEIVED MILK, EGGS, BREAD, FRUIT, VEGETABLES, A BOX OF NON-PERISHABLE FOOD AND A FRESHLY PREPARED MEAL FROM COLORS CAF. MANY OF THE RECIPIENTS SHARED WORDS OF THANKS AND GRATITUDE TO THEIR SCRIPPS FAMILY. ONE EVEN NOTED HOW THEY WERE APPRECIATIVE TO WORK FOR "SUCH AN AWESOME ORGANIZATION THAT IS THERE FOR ME WHEN TIMES ARE TOUGH". MANY DEPARTMENTS WORKED COLLABORATIVELY TO MAKE THIS INITIATIVE A SUCCESS SUCH AS HUMAN RESOURCES, FOOD AND NUTRITION SERVICES, AND SECURITY AND FACILITIES TO NAME A FEW. THE SCRIPPS LEADERSHIP ACADEMY ALUMNI ALSO VOLUNTEERED TO HELP PACKAGE AND DISTRIBUTE THE FOOD. MUCH APPRECIATION TO THE EMPLOYEES, PHYSICIANS AND VENDORS WHO DONATED TO THE PROGRAM AS THEIR GENEROSITY HELPED TO MAKE A DIFFERENCE FOR MANY DURING A DIFFICULT TIME. FEEDING SAN DIEGO SCRIPPS MADE A SPONSORSHIP TO FEEDING SAN DIEGO TO ASSIST WITH PANDEMIC COMMUNITY NEEDS OF FOOD INSECURITY. FEEDING SAN DIEGO IS ON A MISSION TO CONNECT EVERY PERSON FACING HUNGER WITH NUTRITIOUS MEALS BY MAXIMIZING FOOD RESCUE. THROUGHOUT THE COVID-19 PANDEMIC, FEEDING SAN DIEGO IS ENSURING THAT HUNDREDS OF CHILDREN, FAMILIES, SENIORS, COLLEGE STUDENTS, MILITARY FAMILIES, VETERANS, AND PEOPLE FACING HOMELESSNESS CAN ACCESS ENOUGH NUTRITIOUS FOOD TO ENDURE THIS DEVASTATING CRISIS. FEEDING SAN DIEGO IS PROVIDING MORE THAN 665,000 MEALS EVERY WEEK DURING THIS PANDEMIC. JACOBS & CUSHMAN SAN DIEGO FOOD BANK SCRIPPS MADE A SPONSORSHIP TO THE JACOBS & CUSHMAN SAN DIEGO FOOD BANK TO ASSIST WITH PANDEMIC COMMUNITY NEEDS OF FOOD INSECURITY. THE JACOBS & CUSHMAN SAN DIEGO FOOD BANK AND ITS NORTH COUNTY FOOD BANK CHAPTER COMPRISE THE LARGEST HUNGER-RELIEF ORGANIZATION IN SAN DIEGO COUNTY. BEFORE THE PANDEMIC IT SERVED ON AVERAGE 350,000 (ABOUT 11% OF THE POPULATION) PEOPLE PER MONTH BY PROVIDING NUTRITIOUS FOOD TO INDIVIDUALS AND FAMILIES IN NEED IN COMMUNITIES THROUGHOUT SAN DIEGO COUNTY. SINCE MID-MARCH, WHEN THE COUNTY DECLARED A STATE OF EMERGENCY, THE FOOD BANK IS NOW FEEDING AN ESTIMATED 600,000 PER MONTH DUE TO SOARING UNEMPLOYMENT AND COVID-19S DEVASTATING IMPACT ON OUR LOCAL ECONOMY. NORTH COUNTY LIFELINE SCRIPPS MADE A SPONSORSHIP TO THE NORTH COUNTY LIFELINE TO ASSIST WITH PANDEMIC COMMUNITY NEEDS. NORTH COUNTY LIFELINE'S MISSION IS TO BUILD SELF-RELIANCE AMONG YOUTHS, ADULTS, AND FAMILIES THROUGH HIGH-QUALITY, COMMUNITY-BASED SERVICES. NORTH COUNTY LIFELINE EXPANDS HOUSING TO VICTIMS OF HUMAN TRAFFICKING, EXPANDS COUNSELING AND BEHAVIORAL HEALTH PROGRAMS FOR ADULTS IN THE CRIMINAL JUSTICE SYSTEM AND PROVIDES SUPPORT FOR FOSTER YOUTH AND HOMELESS YOUTH AND YOUNG ADULTS. TO MEET THE GROWING NEEDS, LIFELINE IMPLEMENTED VIDEO-BASED TELEHEALTH IN MARCH 2020 TO CONTINUE PROVIDING CLINICAL SERVICES, AS WELL AS IN-PERSON SUPPORT. FATHER JOE'S VILLAGE SCRIPPS MADE A SPONSORSHIP TO FATHER JOE'S VILLAGE TO ASSIST WITH PANDEMIC COMMUNITY NEEDS SUCH AS FOOD INSECURITY AND THOSE EXPERIENCING HOMELESSNESS AND POVERTY. FATHER JOE'S WAS ESTABLISHED IN 1950 TO SERVE SAN DIEGANS EXPERIENCING HOMELESSNESS AND POVERTY, FATHER JOE'S VILLAGES HAS GROWN TO INCLUDE A COMPREHENSIVE CAMPUS AND SCATTERED SITE PROGRAMS THAT HOUSE OVER 2,000 PEOPLE NIGHTLY. AT LEAST 7,600 PEOPLE ARE EXPERIENCING HOMELESSNESS EVERY NIGHT IN SAN DIEGO. PEOPLE WHO ARE HOMELESS ARE AT GREATER RISK OF SERIOUS ILLNESS, MENTAL HEALTH ISSUES, SUBSTANCE ABUSE AND VIOLENCE. ALPHA PROJECT SCRIPPS MADE A SPONSORSHIP TO THE ALPHA PROJECT TO ASSIST WITH PANDEMIC COMMUNITY NEEDS SUCH AS FOOD INSECURITY AND THOSE EXPERIENCING HOMELESSNESS AND POVERTY. ALPHA PROJECT'S MISSION IS TO EMPOWER INDIVIDUALS, FAMILIES, AND COMMUNITIES BY PROVIDING WORK, RECOVERY, HOUSING AND SUPPORT SERVICES TO PEOPLE WHO ARE MOTIVATED TO CHANGE THEIR LIVES AND ACHIEVE SELF-SUFFICIENCY. FOUNDED IN 1986 AS A SIMPLE PROJECT OFFERING WORK OPPORTUNITIES FOR HOMELESS MEN, TODAY ALPHA PROJECT OPERATES NUMEROUS PROGRAMS SERVING OVER 4,000 PEOPLE DAILY. THE AGENCY HAS CREATED OVER 600 UNITS OF AFFORDABLE RENTAL HOUSING PROJECTS AND HAS SPONSORED HOME OWNERSHIP PROGRAMS. |
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FULL ACCESS AND COORINDATED TRANSPORTATION (FACT) INC. IN 2019, SCRIPPS ENTERED A PARTNERSHIP WITH A LOCAL NONPROFIT- FACILITATING ACCESS TO COORDINATED TRANSPORTATION (FACT) INC., FOR ON-DEMAND RIDES FOR PATIENTS. SCRIPPS STAFF RELIES ON FACT TO ARRANGE FOR PATIENTS GET TO APPOINTMENTS AND FOR DISCHARGED PATIENTS TO RETURN HOME OR GET TO OTHER FACILITIES. THIS COLLABORATIVE SERVICE HAS QUICKLY PROVED TO BE A RELIABLE, CONVENIENT AND COST-EFFECTIVE SOLUTION TO ONE OF THE DIFFICULT AND EXPENSIVE CHALLENGES IN ACCESSING MEDICAL CARE TRANSPORTATION. IN 2019 SCRIPPS AND FACT CONDUCTED A PILOT PROJECT WHICH STREAMLINED A VARIETY OF MEDICAL TRANSPORTATION OPTIONS THROUGH A SINGLE POINT OF CONTACT AT FACT. THE PILOT PROVIDED RIDES FOR PATIENTS INCLUDING THOSE WHO NEEDED SPECIALIZED VEHICLES OR PERSONAL ASSISTANCE TO COMPLETE THE TRIP. SCRIPPS STAFF USED A SINGLE TELEPHONE NUMBER TO CONTACT STAFF AT FACT, WHO THEN HANDLED THE SELECTION OF THE APPROPRIATE VEHICLE, EQUIPMENT AND PERSONNEL, AND DISPATCHED THE RIDE. THE PILOT RESULTED IN SAVINGS IN PROCESSING TIME, COST OF TRANSPORTATION AND IT PROVIDED THE RIDER WITH A MORE RELIABLE AND CONVENIENT TRANSPORTATION SERVICE. THE PILOT PROJECT WAS PARTLY FUNDED BY A COMMUNITY ENHANCEMENT GRANT AWARDED TO FACT BY THE COUNTY OF SAN DIEGO. SCRIPPS REALIZED A BENEFIT USING FACT TRANSPORT AS A COST SAVINGS RATHER THAN USING TAXI VOUCHERS, AS WELL AS TRIPS THAT COULD TAKE SCRIPPS STAFF A GREAT DEAL OF TIME TO FIND A VENDOR TO DO AS OTHER VENDORS MAY NOT BE ABLE TO DO TRIPS TO THE BORDER OR IMPERIAL COUNTY AS READILY. FACT IS A CLEARINGHOUSE OF SORTS WITH MULTIPLE VENDORS AND THEREFORE SAVES THE STAFF TIME IN FINDING THE APPROPRIATE TRANSPORT AT THE RIGHT TIME. DUE TO THE SUCCESS OF THE PILOT, SCRIPPS AND FACT ENTERED INTO A NEW AGREEMENT IN 2020 THAT WILL PHASE THIS SERVICE TO ALL SCRIPPS HOSPITALS AND ENABLE STAFF TO SCHEDULE RIDES VIA FACT'S CALL CENTER. TRANSPORTATION IS AVAILABLE 7 DAYS A WEEK FOR SCRIPPS DISCHARGED PATIENTS TO ANY LOCATION WITHIN SAN DIEGO AND BEYOND. MOST RIDES BEGIN AND END AT THE CURBSIDE, HOWEVER DOOR THROUGH DOOR RIDES, WHEELCHAIR ACCESSIBLE RIDES AND GURNEY RIDES ARE AVAILABLE ON DEMAND. IN FISCAL YEAR 2020, FACT PROVIDED OVER 400 RIDES FOR SCRIPPS PATIENTS THROUGHOUT SAN DIEGO AND AS FAR AWAY AS IMPERIAL COUNTY. THE FOLLOWING ARE THE DIFFERENT TRANSPORTATION MODALITIES THAT FACT-SD PROVIDES: - AMBULATORY - THE RIDER CAN WALK ALONE TO AND FROM THE VEHICLE - CURB-TO-CURB - THE RIDER WILL BE PICKED UP AND DROPPED OFF AT THE CURB OF THE FACILITY/RESIDENCE - DOOR-TO-DOOR - THE RIDER REQUIRES THE DRIVER TO WALK THEM FROM THE DOOR OF THE FACILITY/RESIDENCE TO THE VEHICLE AND FROM THE VEHICLE TO THE DOOR OF THE FACILITY/RESIDENCE - DOOR-THROUGH-DOOR - THE RIDER REQUIRES THE DRIVER TO COME INSIDE THE FACILITY AND TRANSPORT THEM TO THE VEHICLE, THE DRIVER WILL DROP THEM OFF AT THE DOOR OF THE FACILITY OR RESIDENCE - ACCESSIBLE VEHICLES AND MOBILITY DEVICES - WALKER, CANE, FOLDING WHEELCHAIR, WHEELCHAIR, SCOOTER, AND VEHICLES EQUIPPED WITH RAMP OR LIFT - GURNEY TRANSPORTATION SCRIPPS EMPLOYEE SPONSORED HOLIDAY DRIVES THE HOLIDAYS INSPIRE MANY WITH THE SPIRIT OF GIVING, AND IN A YEAR LIKE NO OTHER, GENEROSITY WAS IN FULL FORCE AT SCRIPPS THROUGHOUT THE HOLIDAY SEASON. ONE IN SIX PEOPLE IN SAN DIEGO COUNTY FACE THE THREAT OF HUNGER EVERY DAY, AND COVID-19 EXACERBATED FOOD INSECURITY (CURRENTLY EXPERIENCING OR AT-RISK OF EXPERIENCING HUNGER) IN SAN DIEGO. THIS YEAR, SCRIPPS HEALTH EMPLOYEES DONATED A TOTAL OF 3,164 POUNDS OF FOOD TO THE JACOBS & CUSHMAN SAN DIEGO FOOD BANK, WHICH PROVIDES EMERGENCY FOOD TO 370,000 CHILDREN AND FAMILIES, ACTIVE-DUTY MILITARY, AND FIXED INCOME SENIORS LIVING IN POVERTY, AND 510 POUNDS OF FOOD FOR FEEDING SAN DIEGO, WHICH COLLECTS AND DISTRIBUTES DONATIONS TO LOCAL PANTRIES OR OTHERS IN NEED. SCRIPPS TEAMS ALSO DONATED CLOTHING, HOUSEHOLD NECESSITIES AND MORE, INCLUDING: - ALPHA PROJECT - AN ESTIMATED TOTAL OF 100 PAIRS OF SHOES AND SOCKS - STANDUP FOR KIDS - HYGIENE AND SNACK PACKS - POLINSKY CHILDREN'S CENTER - TOYS - PROMISES2KIDS - GIFTS FOR FOSTER CHILDREN IN ADDITION, SCRIPPS EMPLOYEES "ADOPTED" SEVERAL FAMILIES IN SAN DIEGO WHO WERE EXPERIENCING A TOUGH YEAR. ONE FAMILY, A SINGLE MOTHER AND HER CHILD, WERE LIVING IN A SHELTER AND HIDING FROM HER ABUSIVE SPOUSE. ANOTHER HAS THREE CHILDREN, INCLUDING A FIVE-YEAR-OLD RECENTLY DIAGNOSED WITH CANCER. EMPLOYEES ALSO CONTINUED THEIR ANNUAL TRADITION OF CREATING GOODIE BAGS FOR CHILDREN WHO COME IN THROUGH THE EMERGENCY DEPARTMENT. DONATED ITEMS INCLUDED PENCILS, STICKERS, NOTEBOOKS, CRAFT ITEMS AND MORE; STAFF MADE MORE THAN 200 BAGS THIS YEAR. 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 FISCAL YEAR 2020, SCRIPPS EMPLOYEES AND AFFILIATED PHYSICIANS DONATED A SIGNIFICANT PORTION OF THEIR PERSONAL TIME VOLUNTEERING TO SUPPORT SCRIPPS SPONSORED COMMUNITY BENEFIT PROGRAMS. WITH CLOSE TO 9,554 HOURS, THE ESTIMATED DOLLAR VALUE OF THIS VOLUNTEER LABOR IS $504,558*, WHICH IS NOT INCLUDED IN THE SCRIPPS FISCAL YEAR 2020 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 FISCAL YEAR 2020, SCRIPPS CONTRIBUTED $394,126,261 IN UNCOMPENSATED HEALTH CARE, INCLUDING $18,335,775 IN CHARITY CARE, $361,998,200 IN MEDI- CAL AND MEDICARE SHORTFALL, AND $13,792,287 IN BAD DEBT. 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 HELP FINANCE SERVICES FOR SAN DIEGO COUNTY'S UNDERINSURED 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/UNDERINSURED PATIENTS IN THEIR OPERATING BUDGETS. THIS PLACES A SIGNIFICANT FINANCIAL BURDEN ON HOSPITALS AND PHYSICIANS. SCRIPPS MERCY HOSPITAL (INCLUDING SAN DIEGO AND CHULA VISTA CAMPUSES) PROVIDES 56 PERCENT OF THE CHARITY CARE WITHIN THE SCRIPPS SYSTEM (REFER TO FIGURE 3.3). 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. SCRIPPS MERCY HOSPITAL SAN DIEGO AND SCRIPPS MERCY HOSPITAL CHULA VISTA CAMPUSES ARE DESIGNATED BY THE GOVERNMENT AS DISPROPORTIONATE SHARE HOSPITALS, IN REFLECTION OF THE DIVERSITY OF THE POPULATION THEY SERVE. BOTH HOSPITAL 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. |
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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 2021, THE DEPARTMENT OF HEALTH AND HUMAN SERVICES DEFINED A FAMILY OF FOUR AT 200 PERCENT FEDERAL POVERTY LEVEL AS $53,000. PUBLIC RESOURCE SPECIALIST TEAM THE PUBLIC RESOURCE SPECIALISTS (PRS) ARE EXPERIENCED STAFF WITH STRONG KNOWLEDGE OF COUNTY PROGRAMS. PRS SCREEN ALL UNINSURED AND UNDERINSURED PATIENTS WHO HAVE RECEIVED SERVICES AT ANY OF THE FIVE SCRIPPS HOSPITAL FACILITIES. THEY OFFER SUPPORT TO PATIENTS AND PROVIDE GUIDANCE ON AVAILABLE FUNDING OPTIONS FOR COUNTY, STATE, AND FEDERAL PROGRAMS. THE PRS TEAM IS RESPONSIBLE FOR SUBMITTING AND MONITORING ALL APPLICATIONS AND FOLLOWING UP WITH APPEALS. IN ADDITION, THEY SERVE AS A TECHNICAL RESOURCE TO CASE MANAGEMENT, SOCIAL WORK, AND OTHER HOSPITAL STAFF WHEN PATIENT FUNDING IMPACTS DISCHARGE PLANNING AND LEVEL OF CARE TRANSFERS. THE PRS TEAM SERVES HOSPITAL PATIENTS BY OFFERING IMMEDIATE TEMPORARY COVERAGE THROUGH THE PRESUMPTIVE ELIGIBILITY PROGRAMS (PE), COVID-19 UNINSURED GROUP AND SUBMITTING INSURANCE AFFORDABILITY APPLICATIONS TO THE COUNTY FOR PROCESSING OF ONGOING BENEFITS. OTHER SERVICES OFFERED ARE ASSISTANCE WITH INITIATING APPLICATIONS WITH DMV, VA, EDD, SOCIAL SECURITY AND MEDI-CAL FOR CAL-FRESH ENROLLMENT. IN FISCAL YEAR 2020, THE PRS TEAM SUCCESSFULLY SUBMITTED AND PURSUED 4,076 APPLICATIONS WITH A 77% APPROVAL RATING. 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 2020 (OCTOBER 2019 TO SEPTEMBER 2020), SCRIPPS INVESTED $27,934,884 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 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 FISCAL YEAR 2020, SCRIPPS ENROLLED A TOTAL OF 160 RESIDENTS AND 46 FELLOWS 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 FELLOWHIPS 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. SCRIPPS CONFERENCE SERVICES AND CONTINUING MEDICAL EDUCATION (CME) SCRIPPS CONFERENCE SERVICES AND CONTINUING MEDICAL EDUCATION (CME) IS COMMITTED TO IMPROVING THE QUALITY OF HEALTH CARE AND ADVANCING THE PRACTICE OF MEDICINE BY PROVIDING EVIDENCE-BASED, UP-TO-DATE AND CLINICALLY RELEVANT CONTINUING MEDICAL EDUCATION COURSES. CME IS REQUIRED FOR MEDICAL CREDENTIALING AND MADE AVAILABLE TO PRACTITIONERS ON A COMMUNITY-WIDE BASIS. SCRIPPS HEALTH IS ACCREDITED BY THE ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION (ACCME) TO PROVIDE AMA PRA CATEGORY 1 CREDIT(S) FOR PHYSICIANS. CREDITS FOR OTHER HEALTH PROFESSIONALS ARE ALSO AVAILABLE. IN FISCAL YEAR 2020 SCRIPPS CONTINUING MEDICAL EDUCATION DEPARTMENT PROVIDED A VARIETY OF COURSES AND CONFERENCES WHICH INCLUDED THE FOLLOWING: SCRIPPS CANCER CARE SYMPOSIUM THE SCRIPPS MD ANDERSON CANCER CENTER'S CANCER CARE SYMPOSIUM TWO-DAY CONFERENCE WAS DESIGNED FOR NURSES, NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS, CLINICAL NURSE SPECIALISTS, AND OTHER HEALTH CARE PROFESSIONALS DEDICATED TO THE FIELD OF HEMATOLOGY/ONCOLOGY WHO PRACTICE IN SETTINGS ACROSS THE CONTINUUM OF CARE. MELANOMA 2020 AS THE INCIDENCE OF MELANOMA CONTINUES TO RISE RAPIDLY IN THE UNITED STATES AND AROUND THE WORLD, THE NEED TO EDUCATE CLINICIANS FROM VARIOUS SPECIALTIES ON THE DISEASE ALSO INCREASES. DURING THE COURSE NATIONALLY RECOGNIZED EXPERTS PRESENTED INFORMATION ON PREVENTION, RISK ASSESSMENT, EARLY DETECTION, GENETIC FACTORS, AND CURRENT AND FUTURE TREATMENT CHOICES FOR MELANOMA PATIENTS. ISSUES CONCERNING SURGICAL MANAGEMENT, ADJUVANT THERAPY, ADVANCED DISEASE THERAPY, AND PERSONALIZING THE COURSE OF TREATMENT FOR INDIVIDUAL PATIENTS WAS DISCUSSED. CLINICAL HEMATOLOGY & ONCOLOGY 2020 THE CLINICAL HEMATOLOGY AND ONCOLOGY CONFERENCE PRESENTED BY SCRIPPS MD ANDERSON CANCER CENTER WAS DESIGNED FOR HEMATOLOGISTS, ONCOLOGISTS, SURGEONS, RADIATION ONCOLOGISTS, INTERNISTS, AND OTHERS DESIRING AN UPDATE IN THESE SPECIALTY AREAS. CARDIOMYOPATHY & CARDIO-ONCOLOGY SYMPOSIUM 2020 THE SCRIPPS CARDIOMYOPATHY AND CARDIO-ONCOLOGY SYMPOSIUM WAS DESIGNED TO PROVIDE A COMPREHENSIVE, CASE-BASED CURRICULUM THAT ADDRESSED IMPORTANT CLINICAL TOPICS RELEVANT TO CARDIOMYOPATHY AND CARDIOVASCULAR HEALTH OF CANCER SURVIVORS. CARDIO-ONCOLOGY IS A GROWING FIELD THAT HAS GREAT IMPORTANCE AS NEWLY DEVELOPED CANCER TREATMENTS IMPROVE CANCER SURVIVAL RATES BUT CAN BE ASSOCIATED WITH CARDIOVASCULAR TOXICITIES. CARDIAC AMYLOIDOSIS, A BURGEONING DISEASE WITH EXCITING NEW TREATMENTS WAS DISCUSSED. 2019 SAN DIEGO DAY OF TRAUMA THE 2019 SAN DIEGO DAY OF TRAUMA REVIEWED THE IMPORTANCE OF BUILDING AN EFFECTIVE TEAM TO PROVIDE THE BEST POSSIBLE CARE FOR PATIENTS WITH LIFE THREATENING INJURIES. NATIONALLY RENOWNED SPEAKERS PRESENTED STATE OF THE ART INTERVENTIONS FOR EMERGENCIES COMMONLY ENCOUNTERED IN THE FIELD. CONFERENCE SPEAKERS INCLUDED SPECIALISTS IN THE FIELDS OF PRE-HOSPITAL CARE, TRAUMA SURGERY, AND CRITICAL CARE. LECTURES, REAL-LIFE CASE PRESENTATIONS, AND INTERACTIVE SESSIONS ENGAGED ATTENDEES AND PROMOTED IMPROVED PATIENT OUTCOMES. |
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CARDIOGENIC SHOCK AND RESUSCITATION SYMPOSIUM THE SCRIPPS CARDIOGENIC SHOCK AND RESUSCITATION SYMPOSIUM COMPREHENSIVE COURSE WAS DESIGNED FOR THOSE WHO CARE FOR PATIENTS WITH CARDIOGENIC SHOCK INCLUDING CARDIOLOGISTS (INTERVENTIONAL AND ADVANCED HEART FAILURE SPECIALISTS), CARDIOTHORACIC SURGEONS, CRITICAL CARE AND EMERGENCY DEPARTMENT PHYSICIANS, AND ADVANCED PRACTICE CLINICIANS. PULMONARY HYPERTENSION (PH) THIS CONFERENCE COVERED ALL FORMS OF PULMONARY HYPERTENSION. EXPERT FACULTY DISCUSSED THE EPIDEMIOLOGY OF PH, HOW PH IS DIAGNOSED, AND THE POOR OUTCOMES ASSOCIATED WITH PH WHEN LEFT UNTREATED. ANNUAL NATURAL SUPPLEMENTS CONFERENCE IT IS IMPORTANT FOR HEALTH CARE PROVIDERS TO RECEIVE TIMELY, EVIDENCE-BASED INFORMATION TO ADDRESS THE RISKS AND BENEFITS OF SUPPLEMENTS WITH THEIR PATIENTS. IN THIS DYNAMIC PARTNERSHIP WITH PATIENTS, PROVIDERS ALSO NEED INFORMATION ABOUT REGULATORY ISSUES, DRUG-NUTRIENT INTERACTIONS, DOSING AND PRODUCT POTENCY. TO ADDRESS THESE NEEDS, FACULTY PRESENTED CLINICALLY RELEVANT INFORMATION ON NATURAL SUPPLEMENTS IN EVIDENCE-BASED PRACTICE, WITH AN EMPHASIS ON DISEASE STATES. PRIMARY CARE SUMMER CONFERENCE (VIRTUAL) SCRIPPS HEALTH'S PRIMARY CARE SUMMER CONFERENCE WAS DESIGNED BY PRIMARY CARE PHYSICIANS FOR PRIMARY CARE PHYSICIANS AND THEIR CARE TEAM AND PRESENTED CONTENT FROM THEIR UNIQUE PERSPECTIVE. 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 FISCAL YEAR 2020, SCRIPPS HOSTED 1,057 STUDENTS WITHIN OUR SYSTEM AND PROVIDED 141,401 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 CONSIDERS 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. SAN DIEGO ORGANIZATION OF HEALTHCARE LEADERS (SOHL) SCRIPPS SPONSORED THE SAN DIEGO ORGANIZATION OF HEALTHCARE LEADERS (SOHL). THIS ANNUAL SUPPORT MAKES IT POSSIBLE TO OFFER MANY QUALITY, COST-EFFECTIVE EDUCATION, PROFESSIONAL DEVELOPMENT AND NETWORKING OPPORTUNITIES TO HEALTHCARE LEADERS AND ASPIRING LEADERS IN SAN DIEGO AND IMPERIAL COUNTIES. DIABETES AND YOU (SAN DIEGO UNIFIED SCIENCE, TECHNOLOGY, ENGINEERING, ARTS AND MATH (STEAM)) THE SCRIPPS WHITTIER DIABETES INSTITUTE (SWDI) JOINED THE "DIABETES & YOU" EVENT HOSTED BY THE SALK INSTITUTE FOR BIOLOGICAL STUDIES AND THE SAN DIEGO UNIFIED SCIENCE, TECHNOLOGY, ENGINEERING, ARTS, AND MATH (STEAM) LEADERSHIP SERIES ON DECEMBER 10. OVER 300 HIGH SCHOOL JUNIORS FROM SIX LOCAL SCHOOLS ATTENDED THIS EVENT, WHICH WAS ALSO LIVESTREAMED TO INCREASE REACH. SWDI WAS INVITED TO BE PART OF THE KEYNOTE SPEAKERS ALONG WITH THE SALK INSTITUTE, DIABETES RESEARCH CONNECTION, AND CHRIS DUDLEY (FORMER NBA PLAYER AND FIRST ONE TO PLAY WITH TYPE 1 DIABETES). TOPICS DISCUSSED INCLUDED THE PREVALENCE OF DIABETES AND PREDIABETES, DISPARITIES AMONG DIFFERENT RACIAL AND ETHNIC GROUPS, THE IMPORTANCE OF DIABETES PREVENTION, AND DISCUSSED RECENT SCIENTIFIC RESEARCH FINDINGS. 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. DURING THEIR FIVE-WEEK ROTATION, THE STUDENTS VISIT SCRIPPS MERCY CHULA VISTA, SCRIPPS MERCY SAN DIEGO, SCRIPPS MEMORIAL HOSPITAL LA JOLLA, ENCINITAS, AND GREEN HOSPITAL. THE STUDENTS VIEW SURGERIES AND SHADOW HEALTHCARE PROFESSIONALS IN THE EMERGENCY DEPARTMENT, ICU, PHARMACY, URGENT CARE, INTERNAL MEDICINE, PHARMACY, AMBULATORY SERVICES, REHAB THERAPY, PATIENT LOGISTICS, LAB AND TRAUMA. THIS INTERNSHIP PROGRAM WAS CANCELLED FOR FISCAL YEAR 2020, DUE TO COVID-19. UNIVERSITY CITY HIGH SCHOOL COLLABORATION UNIVERSITY CITY HIGH SCHOOL AND SCRIPPS PARTNERED TO PROVIDE A REAL-LIFE CONTEXT TO THE SCHOOL'S HEALTH CARE ESSENTIALS COURSE. FOR FISCAL YEAR 2020, 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. THIS INTERNSHIP PROGRAM WAS SUSPENDED AFTER MARCH, DUE TO COVID-19. 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 2020 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. MEETINGS WERE SUSPENDED AFTER MARCH, DUE TO COVID-19. |
| FORM 990, PART III, LINE 4A (CONTINUED) |
YOUTH EDUCATIONAL PROGRAM ACTIVITIES SCRIPPS IS DEDICATED TO BUILDING THE FUTURE PIPELINE OF HEALTH PROFESSIONALS. SCRIPPS IMPLEMENTS A WIDE VARIETY OF YOUTH IN HEALTH CAREER ACTIVITIES. 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 FIRST-HAND EXPERIENCE WORKING WITH SCRIPPS HEALTH CARE PROFESSIONALS. 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. A TOTAL OF 2,505 YOUTH PARTICIPATED IN THESE PROGRAMS AND MORE THAN 75% OF YOUTH ARE ON A TRACK FOR A HEALTH CAREER. DUE TO COVID-19, ALL YOUTH ACTIVITIES (MENTORING, CLASSROOM PRESENTATIONS, HOSPITAL TOURS, SURGERY VIEWINGS) WERE CANCELLED DUE TO SCHOOL CLOSURES. SCRIPPS DISCONTINUED ALL YOUTH PROGRAMS ON AND OFF SITE. DURING THIS TIME STAFF PREPARED AND RECORDED VIDEOS ON A VARIETY OF TOPICS REQUESTED BY THE SWEETWATER SCHOOL DISTRICT TO BE USED FOR VIRTUAL AND DISTANCE LEARNING. CAMP SCRIPPS SUMMER ENRICHMENT PROGRAM DESIGNED TO INTRODUCE YOUTH TO HEALTH CAREERS, THIS PROGRAM DEVELOPED A SIX-WEEK VIRTUAL CAMP EXPERIENCE PROGRAM (JUNE 8, 2020 - JULY 17, 2020) TO EDUCATE YOUTH PARTICIPANTS ON THE DUTIES PERFORMED BY HEALTH CARE PROFESSIONALS IN VARIOUS MEDICAL FIELDS AS WELL AS OTHER PUBLIC HEALTH AND SOCIAL SERVICE TOPICS. PARTICIPANTS PARTICIPATED IN LIVE VIRTUAL CALLS WITH SCRIPPS FAMILY MEDICINE RESIDENTS AND OTHER STAFF. 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 VIRTUAL 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. SURGERY VIEWING INTERESTED STUDENTS HAVE AN OPPORTUNITY TO OBSERVE ELECTIVE SURGERIES SUCH AS TOTAL KNEE AND HIP REPLACEMENTS. STUDENTS CAN INTERACT AND ASK ON THE SPOT QUESTIONS OF SURGEONS. THIS PROGRAM HAS BEEN PLACED ON HOLD DUE TO COVID-19. 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. DUE TO COVID-19, THIS PROGRAM WAS PUT ON PAUSE IN MID-MARCH. HEALTH PROFESSIONS EDUCATION, RESIDENT AND STUDENT TRAINING SCRIPPS MERCY CHULA VISTA WELL BEING CENTER WORKS CLOSELY WITH SCRIPPS FAMILY MEDICINE RESIDENCY PROGRAM TO PROVIDE AND EXPAND COMMUNITY MEDICINE OPPORTUNITIES FOR RESIDENTS TO DELIVER SERVICES, TO PLACE MEDICAL STUDENTS IN COMMUNITY HEALTH ACTIVITIES AND TO COORDINATE COMMUNITY EXPERIENCES FOR VISITING/ROTATING RESIDENTS AND MEDICAL STUDENTS. THE WELL BEING CENTER ALSO COORDINATES AND PROVIDES OPPORTUNITIES FOR INDIVIDUALS TO PARTICIPATE IN HEALTH CAREER TALKS, HEALTH TRAINING COMMUNITY ACTIVITIES AND BALINT SUPPORT GROUPS. A TOTAL OF 843 HEALTH PROFESSIONALS HAVE BEEN TRAINED. THE COVID-19 PANDEMIC BROUGHT SIGNIFICANT CHANGES TO RESIDENT EDUCATION AND PATIENT CARE IN THE SCRIPPS FAMILY MEDICINE RESIDENCY PROGRAM AT SCRIPPS MERCY CHULA VISTA. THE PROGRAM QUICKLY ADAPTED TO MEET THE NEEDS OF SOUTH BAY WITH HIGH RATES OF COVID-19 INFECTION. ALL EDUCATIONAL AND TRAINING CONFERENCES SHIFTED TO VIRTUAL MODALITIES. SOME OF THE RESIDENT EDUCATION INCLUDED PRESENTATIONS AND TOWN HALL STYLE WORKSHOPS THAT ADDRESS PATHOPHYSIOLOGY OF CORONAVIRUS INFECTION IN ADULTS, CHILDREN AND PREGNANT WOMEN, APPROPRIATE PPE USE, TESTING ALGORITHMS, AND HEALTH DISPARITIES IN RELATION TO COVID-19 INFECTIONS. THE RESIDENTS HAVE CONTINUED TO MEET THE NEEDS OF PATIENTS AT THE CLINIC BOTH IN-PERSON AND VIA TELEHEALTH. FAMILY MEDICINE RESIDENTS HAVE PLAYED A SUPPORTING ROLE IN THE CARE OF HOSPITALIZED PATIENTS WITH COVID-19, INCLUDING IN THE ICU AND LABOR AND DELIVERY. INTERNS AND AREA HEALTH EDUCATION SCHOLARS PROGRAM (AHEC) SCRIPPS MERCY HOSPITAL CHULA VISTA WELL BEING CENTER SERVES AS AN INTERNSHIP PLACEMENT SITE FOR BOTH UNDERGRADUATE AND GRADUATE STUDENTS. THIS EDUCATION TRAINING PROGRAM IS DESIGNED TO RAISE THE NUMBERS, TYPES, DIVERSITY AND RETENTION OF PRIMARY HEALTH AND SOCIAL SERVICE CARE PROFESSIONALS WORKING IN UNDERSERVED AREAS. A TOTAL OF NINE STUDENTS COMPLETED THEIR INTERNSHIP. FIELDS OF STUDY INCLUDE UNDERGRAD SOCIAL WORK, UNDERGRAD PUBLIC HEALTH, MASTER'S IN SOCIAL WORK AND MASTER'S IN PUBLIC HEALTH FROM SAN DIEGO STATE UNIVERSITY; FOUR INTERNS ALSO COMPLETED THE AREA HEALTH EDUCATION CENTER SCHOLAR PROGRAM WHICH IS A COMBINATION OF CLINIC AND DIDACTIC ONLINE TRAINING. HEALTH RESEARCH TRAUMA RESEARCH GRADUTE STUDENT INTERNSHIP THE TRAUMA RESEARCH GRADUATE STUDENT INTERNSHIP IS DESIGNED TO PROVIDE STUDENTS IN THE UCSD CLINICAL RESEARCH ENHANCEMENT THROUGH SUPPLEMENTAL TRAINING (CREST PROGRAM) WITH EXPERIENCE IN MANAGING CLINICAL RESEARCH WHILE ALSO PROVIDING THEM WITH OPPORTUNITIES TO APPLY THEIR KNOWLEDGE IN MEDICAL STATISTICS AND EPIDEMIOLOGY TO THE PATIENT POPULATION. STUDENTS LEARN TO CONSTRUCT STUDY SAMPLES, CLEAN DATA, ANALYZE DATA, AND WRITE MANUSCRIPTS FOR SUBMISSION TO MEDICAL JOURNALS. THE ROTATION IS CONDUCTED AT SCRIPPS MERCY HOSPITAL SAN DIEGO. COVID-19 RESEARCH THE FOLLOWING ARE COVID-19 RESEARCH EFFORTS THAT GENERATED GENERALIZABLE KNOWLEDGE AND WERE MADE AVAILABLE TO THE PUBLIC. FROM EDUCATION AND PREVENTION TO RESEARCH NEWS, SCRIPPS IS COMMITTED TO KEEPING THE COMMUNITY UP TO DATE ON THE BATTLE AGAINST COVID-19. PROJECTS ARE BEING LED BY SCRIPPS HEALTH OR CO-LED BY SCRIPPS CLINICAL AND TRANSLATIONAL SCIENCE AWARD (CTSA) SUPPORTED INVESTIGATORS. 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) |
VIRTUAL COMMUNITY TOWN HALLS ON COVID-19 RESEARCH THE SCRIPPS HUB ACADEMIC RESEARCH CORE (SHARC) IS SUPPORTED BY THE CLINICAL AND TRANSLATIONAL SCIENCE AWARD (CTSA) PROGRAM, WHICH IS FUNDED BY THE NATIONAL INSTITUTES OF HEALTH. THE CTSA SEEKS TO SPEED UP THE DEVELOPMENT OF NEW RESOURCES AND TREATMENTS TO HELP IMPROVE THE HEALTH OF INDIVIDUALS AND THE GENERAL PUBLIC. THE SHARC TEAM IS AVAILABLE TO PROVIDE KNOWLEDGE, SKILLS, AND RESOURCES IN COMMUNITY AND COLLABORATION, STATISTICS, AND HOW TO NAVIGATE A RESEARCH GRANT. THE TEAM IS A COLLABORATION BETWEEN THE SCRIPPS RESEARCH TRANSLATIONAL INSTITUTE AND SCRIPPS HEALTH. IN AUGUST, 2020, SCRIPPS HUB ACADEMIC RESEARCH CORE, SCRIPPS RESEARCH AND THE SAN DIEGO COUNTY COVID-19 HEALTH EQUITY TASK FORCE COLLABORATED ON A 3-PART SERIES OF VIRTUAL COMMUNITY TOWN HALLS TO DISCUSS TOPICS SUCH AS THE DISPROPORTIONATE IMPACT OF COVID-19 ON DIVERSE COMMUNITIES, THE IMPORTANCE OF BEING REPRESENTED IN COVID-19 RESEARCH (SUCH AS THE LOCAL VACCINE TRIALS AND PLASMA STUDY, HOW CONTACT TRACING WORKS, AND WHAT COUNTY RESOURCES ARE AVAILABLE TO STAY SAFE AND HEALTHY DURING THIS TIME. OVER 300 COMMUNITY MEMBERS REGISTERED FOR THE SERIES. EACH TOWN HALL (PROVIDED IN ENGLISH, SPANISH, AND TAGALOG) HAD TIME FOR Q&A MODERATED BY THE SAN DIEGO UNION TRIBUNE'S BIOTECH REPORTER. SCRIPPS WHITTIER INSTITUTE FOR DIABETES - DULCE DIGITAL-COVID AWARE (DD-CA) DISCHARGE TEXTING PLATFORM FOR US/MEXICO BORDER HISPANICS WITH DIABETES + COVID-19 THE SCRIPPS WHITTIER INSTITUTE FOR DIABETES RECEIVED GRANT APPROVAL BY THE NATIONAL INSTITUTES FOR HEALTH (NIH) FOR THE "DULCE DIGITAL-COVID AWARE DISCHARGE (DD-CA)" - A TEXTING PLATFORM FOR US/MEXICO BORDER HISPANICS WITH DIABETES AND COVID-19. THE PRIMARY GOAL OF DD-CA IS TO USE A TEXTING PLATFORM TO IMPROVE COMMUNICATIONS TO GUIDE RECENTLY DISCHARGED PATIENTS WITH DIABETES. THE DULCE DIGITAL-COVID AWARE DISCHARGE (DD-CA) PROGRAM AIMS TO IMPROVE GLUCOSE CONTROL AND REDUCE READMISSION RATES AND COVID-19 TRANSMISSION AFTER PATIENTS LEAVE THE HOSPITAL. DD-CA COMBINES CULTURALLY AND LINGUISTICALLY RELEVANT DIABETES AND COVID-19 EDUCATIONAL MESSAGING WITH GLUCOSE MANAGEMENT SUPPORT IN A LOW-COST, EASILY ADOPTABLE PLATFORM TO ADDRESS SPECIFIC BARRIERS IN UNDERREPRESENTED HISPANIC AND LATINO COMMUNITIES. NATIONAL INSTITUTE OF HEALTH (NIH) COMMUNITY ENGAGEMENT ALLIANCE (CEAL) THE NATIONAL INSTITUTES OF HEALTH (NIH) LAUNCHED THE COMMUNITY ENGAGEMENT ALLIANCE (CEAL) AGAINST COVID-19 DISPARITIES TO PROVIDE COVID-19 OUTREACH AND ENGAGEMENT TO RACIAL/ETHNIC MINORITY COMMUNITIES THAT HAVE BEEN DISPROPORTIONATELY IMPACTED BY THE PANDEMIC AND ARE UNDERREPRESENTED IN CLINICAL TRIALS. CEAL'S MISSION IS TO PROVIDE TRUSTWORTHY INFORMATION THROUGH ACTIVE COMMUNITY ENGAGEMENT AND OUTREACH TO THE PEOPLE HARDEST-HIT BY THE COVID-19 PANDEMIC, INCLUDING AFRICAN AMERICANS, HISPANIC/LATINOS AND AMERICAN INDIANS/ALASKA NATIVES, WITH THE GOAL OF BUILDING LONG-LASTING PARTNERSHIPS AS WELL AS IMPROVING DIVERSITY AND INCLUSION IN RESEARCH RESPONSE TO COVID-19. CEAL AWARDS WERE MADE TO ELEVEN DIFFERENT STATEWIDE TEAMS, INCLUDING CALIFORNIA. SCRIPPS HEALTH, REPRESENTED BY THE SCRIPPS HUB ACADEMIC RESEARCH CORE (SHARC) TEAM, HAS PARTNERED WITH THE SAN DIEGO COUNTY COVID-19 EQUITY TASK FORCE TO REACH SAN DIEGO COMMUNITIES AS PART OF THE CALIFORNIA CEAL TEAM AWARD. THE SHARC TEAM HAS PREVIOUSLY PARTNERED WITH THE TASK FORCE TO DELIVER VIRTUAL COMMUNITY TOWN HALLS ON COVID-19 AND WILL CONTINUE TO PROVIDE OUTREACH THROUGH VIRTUAL EVENTS AND SAFELY REDESIGNED HEALTH AND RESOURCE FAIRS TO ASSESS COVID-19 KNOWLEDGE AND PERCEPTIONS ABOUT CLINICAL TRIALS. SUPPORTING THIS NIH-WIDE EFFORT ARE THE NATIONAL INSTITUTE OF MINORITY HEALTH AND HEALTH DISPARITIES (NIMHD) AND THE NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI). CONVALESCENT PLASMA THERPAY STUDY DURING THE EARLY PERIOD OF THE PANDEMIC, SMALL STUDIES SUGGESTED THAT COVID-19 PATIENTS COULD BENEFIT FROM CONVALESCENT PLASMA, WHICH IS BLOOD PLASMA OBTAINED FROM PATIENTS WHO HAVE RECOVERED FROM THE VIRUS AND HAS PROTECTIVE ANTIBODIES. THE MAYO CLINIC IS CONDUCTING A NATIONWIDE CONVALESCENT PLASMA THERAPY STUDY IN WHICH PLASMA DONATED BY RECOVERED PATIENTS IS TRANSFUSED INTO HIGH-RISK OR SEVERELY ILL COVID-19 PATIENTS. ANOTHER MULTICENTER NATIONAL STUDY, PASSITON (PASSIVE IMMUNITY TRIAL FOR OUR NATION), IS A RANDOMIZED STUDY THAT TESTS CONVALESCENT PLASMA IN HOSPITALIZED COVID-19 PATIENTS; ONE GROUP RECEIVES THE PLASMA, WHILE A CONTROL GROUP RECEIVES FLUIDS WITH VITAMINS. SCRIPPS HEALTH IS PARTICIPATING IN BOTH STUDIES. TO LEARN MORE ABOUT THESE STUDIES, VISIT https://www.uscovidplasma.org AND https://passitonstudy.org. COVID RELATED WEBINARS AND MEET THE DOC SESSIONS IN SOUTH BAY SCRIPPS MERCY HOSPITAL CHULA VISTA WELL BEING CENTER PARTNERS WITH CHULA VISTA COMMUNITY COLLABORATIVE (CVCC) TO TRAIN PROMOTORAS ON COVID-19. THE OBJECTIVE IS TO TRAIN PROMOTORAS TO DISSEMINATE INFORMATION ON PREVENTING THE SPREAD COVID-19 SOUTH BAY COMMUNITIES. THE VIRTUAL INTERACTIVE TRAINING SESSIONS WERE RECORDED LIVE AND AVAILABLE FOR LATER VIEWING. PARTICIPANTS INTERESTED IN HELPING SPREAD THE COVID-19 INFORMATION WERE ABLE TO RECEIVE A STIPEND FROM THE GRANT. PARTICIPANTS SHARED INFORMATION WITH FRIENDS AND RELATIVES AND THROUGH THEIR SOCIAL MEDIA PLATFORMS; IN TOTAL, THE TRAINING REACHED MORE THAN 1,000 INDIVIDUALS. FOLLOWING THE TRAINING, SCRIPPS FAMILY PRACTICE RESIDENCY PROGRAM OFFERED FIVE VIRTUAL MEET THE DOC SESSIONS TO THE COMMUNITY. PRESENTATION TITLES INCLUDED COVID-19 AND DISPARITIES, COVID-19: HOW THE VIRUS SPREADS, COVID-19: THE EFFECT IN CHILDREN, AND COVID-19: MASKS AND SYMPTOMS. NEARLY 200 INDIVIDUALS JOINED THE SESSIONS VIRTUALLY TO LEARN ABOUT COVID-19-RELATED TOPICS FROM SCRIPPS MEDICAL RESIDENTS. |
| FORM 990, PART VI, LINE 11B |
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 & COMPLIANCE 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, LINE 15A & 15B |
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCES 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 OF SIMILAR SIZE AND COMPLEXITY, CONSIDERING AND MAKING APPROPRIATE ADJUSTMENTS FOR THE COST OF LIVING IN 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 +4.0% GEOGRAPHIC DIFFERENTIAL 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 +4.0% GEROGRAPHIC DIFFERENTIAL OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. - TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE +4.0% GEOGRAPHIC DIFFERENTIAL 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 +4.0% GEOGRAPHIC DIFFERENTIAL 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 +4.0% GEOGRAPHIC DIFFERENTIAL OF NATIONAL PEER MARKET AS OUR EXECUTIVE RECRUITMENT MARKET IS NATIONAL). - ANNUALLY, TOTAL CASH COMPENSATION FOR EACH POSITION WILL NOT EXCEED THE BASE SALARY ESTABLISHED FOR THE PERIOD PLUS THE MAXIMUM INCENTIVE PERCENTAGE PAYOUT ALLOWABLE AS DETERMINED BY THE SCRIPPS MANAGEMENT INCENTIVE PLAN APPROVED BY THE BOARD OF TRUSTEES FOR THE RESPECTIVE POSITION. THE REPORT FROM THE EXTERNAL CONSULTANT ENGAGED TO REVIEW EXECUTIVE COMPENSATION IS PRESENTED TO THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ON AN ANNUAL BASIS AND THE MOST RECENT REPORT WAS REVIEWED ON DECEMBER 11, 2019, JANUARY 29, 2020, AND MAY 27, 2020. 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 CHANGE IN VALUE OF DEFERRED GIFTS 1,136,702 JOINT VENTURE DISTRIBUTION 974,522 ROUNDING (19,620) --------------- TOTAL 2,091,604 |
| 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:79017571 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:PHYSICIAN FEES TOTAL FEES:60670455 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:PUCHASED MEDICAL SERVICES TOTAL FEES:26363562 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:ALL OTHER FEES FOR SERVICES TOTAL FEES:51593125 |
Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.