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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSMOUNT AUBURN HOSPITAL (MAH) AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF MAH. THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. THE BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE AND THIS BELIEF IS WHAT DRIVES EACH AFFILIATE TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS AND DELIVER THE BEST CARE IN THE COMMUNITIES BILH SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES.MAH COMMUNITY BENEFITS MISSION STATEMENT MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF COMMUNITY MEMBERS BY COLLABORATING WITH COMMUNITY PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE COMMUNITY BENEFITS MISSION IS FULFILLED BY:- INVOLVING MAH'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY;- ENGAGING RESIDENTS THROUGHOUT THE HOSPITAL'S SERVICE AREAS IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, INCLUDING ASSESSMENT, PLANNING, IMPLEMENTATION AND EVALUATION. SPECIAL ATTENTION IS FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES;- ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO IDENTIFY UNMET HEALTH-RELATED NEEDS AND TO CHARACTERIZE THOSE IN THE COMMUNITY WHO ARE MOST VULNERABLE AND FACE DISPARITIES IN ACCESS AND OUTCOMES;- IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN MAH'S SERVICE AREA GEARED TOWARD IMPROVING CURRENT AND FUTURE HEALTH STATUS OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY REMOVING BARRIERS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, STRENGTHENING THE HEALTHCARE SYSTEM AND WORKING TO DECREASE THE BURDEN OF THE LEADING HEALTH ISSUES;- PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND- FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES. COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $1,394,973 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE COMMUNITY BENEFITS TEAM AT MOUNT AUBURN HOSPITAL (MAH) CONSISTS OF THE COMMUNITY HEALTH STAFF, THE DIRECTOR OF SOCIAL WORK AND THE CHIEF OPERATING OFFICER. MAH COMMUNITY HEALTH DEPARTMENT STAFF MET WITH COMMUNITY MEMBERS INCLUDING THOSE WHO WORK IN PUBLIC HEALTH, TO REACH COMMUNITY MEMBERS IN MAH'S TARGET AREA. THIS TEAM MET PERIODICALLY DURING THE FISCAL PERIOD COVERED BY THIS FILING. IN ADDITION, ANNUALLY THE BOARD OF TRUSTEES APPROVES THE COMMUNITY BENEFITS' MISSION STATEMENT AND PLAN. COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R) INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. MAH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER OF 2018. THAT CHNA WAS APPROVED BY THE MAH BOARD OF TRUSTEES IN SEPTEMBER OF 2018. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD IN SEPTEMBER 2018, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY (IS) REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF MAH'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT MAH ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW MAH, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2018 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONAS NOTED ABOVE, MAH COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2018. THE GEOGRAPHICAL FOCUS OF MAH'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES THE CITIES OF ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM, AND WATERTOWN.TARGET POPULATIONS FOR MAH'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS AND A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).MAH'S TARGET POPULATIONS FOCUS ON MEDICALLY-UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN THE ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM, AND WATERTOWN AS FOLLOWS:- RACIAL / ETHNIC MINORITIES- IMMIGRANTS- LOW INCOME POPULATIONS- OLDER ADULTS- LIMITED ENGLISH PROFICIENCY SPEAKERS- LGBTQ2018 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS INFORMATION FROM KEY INFORMANT INTERVIEWS, SURVEYS, FOCUS GROUPS, AND COMMUNITY MEETINGS. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE SIX CITIES AND TOWNS THAT COMPRISE THE MAH CBSA AND WITH A RANGE OF PEOPLE REPRESENTING DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., OLDER ADULTS) (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED OVER 100 PEOPLE.AS NOTED PREVIOUSLY, MAH HIRED JOHN SNOW, INC. AN OUTSIDE FIRM TO CONDUCT AND MANAGE THE CHNA PROCESS UNDERTAKEN DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 (TAX YEAR 2017). THE MAH COMMUNITY HEALTH DEPARTMENT STAFF WORKED CLOSELY THROUGHOUT THE ENTIRE PROCESS WITH STAFF MEMBERS FROM JOHN SNOW INC. IN ORDER TO COMPLETE THE PROJECT. A COMMUNITY BENEFIT ADVISORY COMMITTEE WAS CREATED AT THE BEGINNING OF THE PROCESS WHICH CONSISTED OF OVER 20 COMMUNITY MEMBERS AND/OR COMMUNITY ORGANIZATION REPRESENTATIVES INCLUDING CITY/TOWN PUBLIC HEALTH OFFICIALS.
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THE MOST RECENT CHNA WAS CONDUCTED THROUGH A THREE-PHASED PROCESS.
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THE GOAL OF PHASE I AND PHASE II WAS TO GAIN AN UNDERSTANDING OF HEALTH-RELATED CHARACTERISTICS OF THE REGION'S POPULATION, INCLUDING DEMOGRAPHIC, SOCIO-ECONOMIC, GEOGRAPHIC, HEALTH STATUS, CARE SEEKING, AND ACCESS TO CARE CHARACTERISTICS. THIS INVOLVED QUANTITATIVE AND QUALITATIVE DATA ANALYSIS, INCLUDING, TO THE EXTENT POSSIBLE, AN ANALYSIS OF CHANGES OVER TIME. PHASE I, CATEGORIZED AS PRELIMINARY ASSESSMENT, INVOLVED A RIGOROUS AND COMPREHENSIVE REVIEW OF EXISTING QUANTITATIVE INCLUDING A REVIEW OF US CENSUS DATA AND DATA ON SOCIAL DETERMINANTS OF HEALTH, VITAL STATISTICS INCLUDING DETAIL FROM THE CANCER REGISTRY, COMMUNICABLE DISEASE REGISTRY AND DATA FROM THE BEHAVIORAL RISK FACTOR SURVEY SYSTEM. PHASE I ALSO INCLUDED A SERIES OF INTERVIEWS WITH COMMUNITY STAKEHOLDERS. PHASE II INVOLVED A MORE TARGETED ASSESSMENT OF NEED AND BROADER COMMUNITY ENGAGEMENT ACTIVITIES THAT INCLUDED FOCUS GROUPS WITH HEALTH, SOCIAL SERVICE, AND PUBLIC HEALTH SERVICE PROVIDERS AND CLIENTS, COMMUNITY FORUMS THAT INCLUDED THE COMMUNITY AT-LARGE, AS WELL AS A COMMUNITY HEALTH SURVEY THAT CAPTURED INFORMATION FROM RESIDENTS, SERVICE PROVIDERS, AND OTHER STAKEHOLDERS REGARDING LEADING HEALTH-RELATED PRIORITIES. PHASE III INVOLVED A SERIES OF STRATEGIC PLANNING AND REPORTING ACTIVITIES THAT INVOLVED A BROAD RANGE OF INTERNAL AND EXTERNAL STAKEHOLDERS, THE DEVELOPMENT OF THE CHNA AND IMPLEMENTATION STRATEGY AND CULMINATED IN PRESENTING THE CHNA AND IMPLEMENTATION STRATEGY FOR A VOTE BY THE MAH BOARD OF TRUSTEES.2018 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSJSI CHARACTERIZED HEALTH STATUS AND NEED AT THE TOWN LEVEL. JSI COLLECTED DATA FROM A NUMBER OF SOURCES TO ENSURE A COMPREHENSIVE UNDERSTANDING OF THE ISSUES AND PRODUCED A SERIES OF GEOGRAPHIC INFORMATION SYSTEM (GIS) MAPS WHICH ARE INCLUDED IN THIS REPORT. THE PRIMARY SOURCE OF SECONDARY DATA WAS THROUGH THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH. TESTS OF SIGNIFICANCE WERE PERFORMED, AND STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN MAH'S SERVICE AREA AND THE COMMONWEALTH OVERALL ARE NOTED WHEN APPLICABLE. THE LIST OF SECONDARY DATA SOURCES INCLUDED:- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2009-2013)- BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), (2013-2014 AGGREGATE)- CHIA INPATIENT DISCHARGES (2011-2013)- MA HOSPITAL INPATIENT DISCHARGES (2008-2012)- MA HOSPITAL ED DISCHARGES (2008-2012)- MA CANCER REGISTRY (2007-2011)- MA COMMUNICABLE DISEASE PROGRAM (2011, 2012, 2013)- MASSACHUSETTS VITAL RECORDS (2014)- MASSACHUSETTS BUREAU OF SUBSTANCE ABUSE SERVICES (BSAS) (2013)2018 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)JSI CONDUCTED KEY STAKEHOLDER INTERVIEWS WITH 25 COMMUNITY LEADERS AND STAFF MEMBERS AT MAH. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX B TO THE CHNA WHICH IS POSTED ON THE MAH WEBSITE. (SEE LINK WITHIN THIS SUPPORT TO THE FORM 990 SCHEDULE H). THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN MAH'S SERVICE AREA. INTERVIEWS WERE CONDUCTED ON THE PHONE OR IN PERSON USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING MAJOR HEALTH ISSUES, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS, AND TARGET POPULATIONS.2018 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)JSI CONDUCTED KEY STAKEHOLDER INTERVIEWS WITH 25 COMMUNITY LEADERS AND STAFF MEMBERS AT MAH. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX B TO THE CHNA WHICH IS POSTED ON THE MAH WEBSITE. (SEE LINK WITHIN THIS SUPPORT TO THE FORM 990 SCHEDULE H). THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN MAH'S SERVICE AREA. INTERVIEWS WERE CONDUCTED ON THE PHONE OR IN PERSON USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING MAJOR HEALTH ISSUES, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS, AND TARGET POPULATIONS.JSI CONDUCTED A SERIES OF EIGHT COMMUNITY AND PROVIDER FOCUS GROUPS IN MAH'S SERVICE AREA TO GATHER CRITICAL COMMUNITY INPUT FROM SERVICE PROVIDERS, COMMUNITY LEADERS AND RESIDENTS. STAFF FROM MAH'S COMMUNITY HEALTH DEPARTMENT CONDUCTED AN ADDITIONAL TWO FOCUS GROUPS ON THEIR OWN. THESE FOCUS GROUPS WERE ORGANIZED IN COLLABORATION WITH MAH'S EXISTING COMMUNITY HEALTH PARTNERS TO LEVERAGE THEIR COMMUNITY CONNECTIONS AND TO HELP ENSURE COMMUNITY PARTICIPATION. IN ADDITION, MAH COORDINATED FOUR COMMUNITY FORUMS WHILE JSI LEAD THE DISCUSSIONS WHICH WERE OPEN AND MARKETED TO THE PUBLIC AT-LARGE. THESE FORUMS TOOK PLACE IN ARLINGTON, CAMBRIDGE, WALTHAM, AND SOMERVILLE. MHA MADE EVERY EFFORT TO PROMOTE THESE EVENTS TO THE COMMUNITY AT LARGE IN ORDER TO RECRUIT PARTICIPANTS. DURING THE COMMUNITY FORUMS, JSI DISCUSSED FINDINGS FROM QUANTITATIVE DATA AND POSED A RANGE OF QUESTIONS TO SOLICIT INPUT ON COMMUNITY IDEAS, PERCEPTIONS AND ATTITUDES, INCLUDING: - WHAT ARE THE LEADING SOCIAL DETERMINANTS OF HEALTH (E.G., HOUSING, POVERTY, FOOD ACCESS, TRANSPORTATION, ETC.)?- WHAT ARE THE LEADING HEALTH CONDITIONS (E.G., DIABETES, HYPERTENSION, ASTHMA, RESPIRATORY DISEASE, ETC.)?- WHICH SEGMENTS OF THE POPULATION ARE MOST VULNERABLE (E.G., IMMIGRANTS, LGBTQ, OLDER ADULTS, ETC.)?- WHAT STRATEGIES WOULD BE MOST EFFECTIVE TO IMPROVING HEALTH STATUS AND OUTCOMES IN THESE AREAS?THE MAH ADVISORY COMMITTEE WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEED AND PRIORITIZING THE LEADING HEALTH ISSUES. THE ADVISORY COMMITTEE MET THREE TIMES DURING THE COURSE OF THE ASSESSMENT TO REFINE THE APPROACH, PROVIDE INPUT REGARDING THE ASSESSMENT, AND TO GUIDE THE PRIORITIZATION AND PLANNING PHASE. A FULL LISTING OF ALL COMMUNITY ENGAGEMENT ACTIVITIES IS INCLUDED IN THE CHNA ON THE MAH WEBSITE.2018 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: - REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS.- IDENTIFY MAH'S COMMUNITY BENEFITS PRIORITY POPULATIONS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES.- ANALYZE MAH'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2015 CHNA AND SUBSEQUENT IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY MAH DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2015 (TAX YEAR 2014).- DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 (TAX YEAR 2017).
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2018 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-KEY FINDINGS
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THE KEY PRIORITY POPULATIONS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2018 WERE: RACIAL AND ETHNIC MINORITIES IMMIGRANTS LOW-INCOME POPULATIONS OLDER ADULTS NON-ENGLISH SPEAKERS LGBTQ MAH'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: MENTAL HEALTH: THERE WAS A CLEAR SENTIMENT AMONG KEY INFORMANTS AND FOCUS GROUP/COMMUNITY FORUM PARTICIPANTS THAT MENTAL HEALTH AFFECTS ALL SEGMENTS OF THE POPULATION, FROM CHILDREN AND YOUTH, TO YOUNG AND MIDDLE-AGED ADULTS, TO ELDERS. THERE WAS ALSO A CLEAR SENTIMENT THAT MENTAL HEALTH HAS A DISPROPORTIONATELY HIGHER IMPACT ON RACIAL/ETHNIC MINORITY, IMMIGRANTS, AND LOW INCOME POPULATIONS AS THESE SEGMENTS ARE MORE LIKELY TO BE IMPACTED BY STRESS AND/OR THE TRAUMA ASSOCIATED WITH RACISM AND DISCRIMINATION. SUBSTANCE USE: OPIOID AND PRESCRIPTION DRUG ABUSE IS AT THE FOREFRONT OF OUR NATIONAL AND REGIONAL DIALOGUE, AND THIS WAS CERTAINLY MENTIONED BY INDIVIDUALS OVER THE COURSE OF THIS ASSESSMENT; INDIVIDUALS STRUGGLING WITH THESE ISSUES OFTEN HAVE VERY SERIOUS AND ACUTE NEEDS THAT MUST BE ADDRESSED QUICKLY AND COMPREHENSIVELY. HOWEVER, IT IS IMPORTANT TO NOTE THAT ALCOHOL, MARIJUANA, AND TOBACCO USE, THOUGH CERTAINLY NOT AS HIGH-PROFILE, WERE ALSO IDENTIFIED AS SIGNIFICANT ISSUES FOR LARGE SWATHS OF THE POPULATION IN THE SERVICE AREA.CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS: THE ASSESSMENT'S QUANTITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN MAH'S CBSA HAVE HIGH RATES FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). OF THE SIX TOWNS IN MAH SERVICE AREA, THE CANCER MORTALITY RATE IS SIGNIFICANTLY HIGH IN SOMERVILLE COMPARED TO THE COMMONWEALTH. LOOKING AT THE FOUR LEADING CANCER SITES, SERVICE AREA MORTALITY RATES WERE SIGNIFICANTLY LOWER THAN THE COMMONWEALTH IN SEVERAL MUNICIPALITIES. THE COLORECTAL CANCER MORTALITY RATE WAS SIGNIFICANTLY HIGH IN ARLINGTON COMPARED TO THE COMMONWEALTH OVERALL.HEALTHY AGING: ACCORDING TO QUALITATIVE INFORMATION GATHERED THROUGH INTERVIEWS AND COMMUNITY FORUMS, ELDER HEALTH IS ONE OF THE HIGHEST PRIORITIES FOR THE MAH SERVICE AREA. CHRONIC DISEASE, DEPRESSION, ISOLATION AND FRAGMENTATION OF SERVICES WERE IDENTIFIED AS SOME OF THE LEADING ISSUES FACING THE AREA'S OLDER ADULT POPULATION.SOCIAL DETERMINANTS OF HEALTH: QUANTITATIVE AND QUALITATIVE DATA SHOWED CLEAR GEOGRAPHIC AND DEMOGRAPHIC DISPARITIES RELATED TO THE LEADING SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, HOUSING, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT). THESE ISSUES INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN MAH'S SERVICE AREA. A DOMINANT THEME FROM KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE TREMENDOUS IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS, PARTICULARLY HOUSING, POVERTY, TRANSPORTATION AND FOOD ACCESS, HAVE ON RESIDENTS IN THE SERVICE AREA.HEALTH SYSTEM ISSUES (HEALTH CARE ACCESS): DESPITE THE OVERALL SUCCESS OF THE COMMONWEALTH'S HEATH REFORM EFFORTS, DATA CAPTURED FOR THIS ASSESSMENT SHOWS THAT SEGMENTS OF THE POPULATION, PARTICULARLY LOW INCOME AND RACIALLY/ETHNICALLY DIVERSE POPULATIONS, FACE SIGNIFICANT BARRIERS TO CARE AND STRUGGLE TO ACCESS SERVICES DUE TO LACK OF INSURANCE, COST, TRANSPORTATION, CULTURAL/LINGUISTIC BARRIERS, AND SHORTAGES OF PROVIDERS WILLING TO SERVE MEDICAID INSURED OR LOW INCOME, UNINSURED PATIENTS. AMONG THE SERVICE AREAS SAFETY NET PRIMARY CARE CLINICS, THE UNINSURED RATES RANGE UP TO NEARLY 40%. CHARLES RIVER COMMUNITY HEALTH CENTER, ONE OF MAH'S LEADING COMMUNITY HEALTH / COMMUNITY BENEFITS PARTNERS SERVES THE LARGEST PROPORTION OF UNINSURED PATIENTS OF ANY HEALTH CENTER IN THE COMMONWEALTH. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 WILL INFORM MAH'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2019, SEPTEMBER 30, 2020 AND SEPTEMBER 30, 2021.INTERIM CHANGES AND UPDATES TO IMPLEMENTATION STRATEGY BASED ON NEWLY IDENTIFIED COMMUNITY NEEDS--COVID PANDEMICAS PREVIOUSLY NOTED IN THIS FILING, IRC SECTION 501(R)(3) AND THE PROMULGATED REGULATIONS REQUIRE THAT A TAX-EXEMPT HOSPITAL CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADOPT AN IMPLEMENTATION STRATEGY ADDRESSING COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA AT LEAST ONCE EVERY THREE YEARS. THE PREAMBLE TO THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R)(3) NOTES THAT THE TREASURY AND THE IRS INTENDED FOR THE CHNA AND IMPLEMENTATION STRATEGY REQUIREMENT TO ESTABLISH CONTINUAL FEEDBACK ON CHNA REPORTS AND A HOSPITAL IS REQUIRED TO CONSIDER COMMENTS RECEIVED RELATED TO THE EXISTING CHNA AND IMPLEMENTATION STRATEGY WHEN ENGAGING IN THE NEXT CHNA PROCESS NOT MORE THAN THREE YEARS AFTER ADOPTION. IN ADDITION, FINAL REGULATIONS DO NOT PROHIBIT IMPLEMENTATION STRATEGIES FROM DISCUSSING HEALTH NEEDS IDENTIFIED THROUGH MEANS OTHER THAN A CHNA, PROVIDED THAT THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA ARE ALSO DISCUSSED. FINALLY, THERE IS NOTHING IN THE REGULATIONS THAT PROHIBITS A HOSPITAL FROM UPDATING ITS IMPLEMENTATION STRATEGY BASED ON AN OFF-CYCLE CHANGE TO THE COMMUNITY HEALTH NEEDS THAT ARISE. DURING THE PERIOD COVERED BY THIS FILING, OCTOBER 1, 2019 TO SEPTEMBER 30, 2020, THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY MAH, WERE IMPACTED BY AN UNEXPECTED GLOBAL PANDEMIC. ON JANUARY 9, 2020, THE WORLD HEALTH ORGANIZATION (WHO) ANNOUNCED THE IDENTIFICATION OF A NEW AND NOVEL CORONAVIRUS-RELATED PNEUMONIA IN WUHAN, CHINA. ON JANUARY 21, 2020 THE UNITED STATES CENTER FOR DISEASE CONTROL CONFIRMED THE FIRST CASE OF THIS NEW CORONA VIRUS IN THE UNITED STATES. ON JANUARY 31, 2020, THE WHO ISSUED A GLOBAL HEALTH EMERGENCY AND ON FEBRUARY 3 THE UNITED STATES DECLARED A PUBLIC HEALTH EMERGENCY BECAUSE OF THE COVID-19 VIRUS. ON MARCH 11, 2020, THE WHO DECLARED COVID-19 A PANDEMIC AND TWO DAYS LATER, THE PRESIDENT OF THE UNITED STATES DECLARED COVID-19 A NATIONAL EMERGENCY.THE HEALTH OF THE COMMUNITIES SERVED BY MAH WERE IMPACTED BY THIS UNFORESEEN HEALTH CRISIS AND IN THE ABSENCE OF REGULATORY GUIDANCE TO THE CONTRARY, MAH NEEDED TO QUICKLY REASSESS AND PIVOT TO MEET THE NEW AND PREVIOUSLY UNEXPECTED COMMUNITY NEEDS. AS SUCH, IN RESPONSE TO THE COVID-19 CRISIS MAH'S COMMUNITY BENEFITS STAFF ALONG WITH THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND IN RESPONSE TO COVID, EXPANDED GOALS RELATED TO ACCESS TO CARE AND SOCIAL DETERMINANTS OF HEALTH TARGETED PRIMARILY AT LOW INCOME AND MINORITY POPULATIONS WHO HAVE BEEN DISPROPORTIONATELY IMPACTED BY COVID-19.MAH DEDICATED SIGNIFICANT TIME AND RESOURCES TO RESPOND TO NEEDS RELATED TO COVID-19. MAH WORKED WITH COMMUNITY PARTNERS AND THE HOSPITAL'S STAFF TO EXPAND ACCESS TO TESTING, PERSONAL PROTECTIVE EQUIPMENT, AND ACCESS TO TANGIBLE NEEDS SUCH AS FOOD AND OTHER ITEMS. THE HOSPITAL ALSO WORKED WITH BILH TO DEVELOP AND DISTRIBUTE WRITTEN MATERIALS (IN NINE LANGUAGES) TO THE COMMUNITIES MOST IMPACTED BY COVID-19 TO HELP SLOW THE SPREAD OF THE VIRUS AND DELINEATE WHERE RESIDENTS COULD ACCESS SERVICES AND RESOURCES IN THEIR COMMUNITY. THE ACTIONS TAKEN TOWARD ADDRESSING THESE NEEDS ARE INCLUDED FURTHER IN THIS NARRATIVE SUPPORT ALONG WITH MAH'S DETAILED DESCRIPTION OF ACTIVITIES UNDERTAKEN TO MEET THE COMMUNITY NEEDS.BETH ISRAEL LAHEY HEALTH ("BILH") QUICKLY AND EFFECTIVELY MARSHALLED ITS RESOURCES TO MOUNT A COMPREHENSIVE RESPONSE TO THE COVID-19 PANDEMIC. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS IN PART III FOR FURTHER DETAILS REGARDING BILH'S COVID-19 RESPONSE IN FY20.COMMUNITY HEALTH NEEDS ASSESSMENTMAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEMAH STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, MAH COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2018 (TAX YEAR 2017). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/A9D63E6D-7FD9-4213-881F-F479D4815B06/2018-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDFIN ADDITION TO THE CHNA, MAH COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2018 (TAX YEAR 2017). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/55DA6909-187C-4216-81C5-1574AFF75E9D/2018-COMMUNITY-HEALTH-IMPLEMENTATION-PLAN.PDFIN ADDITION, AS NOTED ABOVE, MAH COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2015 (TAX YEAR 2014). THAT CHNA IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/BB8694B4-B5DB-41BA-9F7A-0F4F83811CF9/NEEDS-ASSESSMENT-2015.PDFFINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING MAH'S FISCAL YEAR ENDED SEPTEMBER 30, 2015 (TAX YEAR 2014) IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBL
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COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDS
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AS NOTED ABOVE, MAH'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018. THAT CHNA AND IMPLEMENTATION STRATEGY INFORMED THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF MAH FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, SEPTEMBER 30, 2020 AND WILL CONTINUE TO INFORM THE HOSPITAL'S COMMUNITY BENEFITS MISSION AND ACTIVITIES FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2021. A SUMMARY OF MAH'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, MAH HAS BEEN STRATEGIC IN IDENTIFYING ITS PRIORITY AREAS IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: REDUCE THE BURDEN OF MENTAL HEALTH (PREVENTION, OUTREACH/IDENTIFICATION, AND RECOVERY SUPPORT)GOAL 1: DECREASE STIGMA ASSOCIATED WITH MENTAL HEALTH GOAL 2: INCREASE ACCESS TO MENTAL HEALTH EDUCATION, SCREENING, REFERRAL, NAVIGATION, AND OTHER SUPPORTIVE SERVICESPRIORITY AREA 2: REDUCE BURDEN OF SUBSTANCE USE/MISUSE (PREVENTION, OUTREACH/IDENTIFICATION, AND RECOVERY SUPPORT)GOAL 1: DECREASE STIGMA ASSOCIATED WITH SUBSTANCE USE / MISUSEGOAL 2: INCREASE ACCESS TO SUBSTANCE USE EDUCATION, SCREENING, REFERRAL, NAVIGATION SUPPORT, TREATMENT, AND RECOVERY SERVICESPRIORITY AREA 3: REDUCE PREVALENCE AND BURDEN OF CHRONIC AND COMPLEX CONDITIONSGOAL 1: INCREASE ACCESS TO HEALTH EDUCATION, SCREENING, AND CHRONIC DISEASE MANAGEMENT GOAL 2: INCREASE ACCESS TO LUNG SCREENING PRIORITY AREA 4: PROMOTE HEALTHY AGING AND ABILITY OF OLDER ADULTS (65+) TO LIVE INDEPENDENTLYGOAL 1: PROMOTE HEALTH AGING AND INDEPENDENT LIVINGGOAL 2: REDUCE FALLS AMONG OLDER ADULTSPRIORITY AREA 5: CROSS-CUTTING ISSUES OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SYSTEM STRENGTHENING/ACCESS TO CARE GOAL 1: PROMOTE HEALTH EQUITY AND REDUCE DISPARITIES FOR THOSE FACING RACISM AND DISCRIMINATION GOAL 2: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WITH LIMITED ENGLISH PROFICIENCY GOAL 3: PROMOTE HEALTH EQUITY FOR LGBTQ POPULATIONS GOAL 4: DEVELOP PARTNERSHIPS WITH LOCAL HOUSING AUTHORITY PROGRAMS GOAL 5: SUPPORT WORKFORCE DEVELOPMENT GOAL 6: SUPPORT TRANSPORTATION EQUITYGOAL 7: PROMOTE HEALTHY EATINGGOAL 8: PROMOTE HEALTH EQUITY AND REDUCE DISPARITIES FOR THOSE FACING RACISM AND DISCRIMINATION GOAL 9: INCREASE ACCESS TO HEALTH INSURANCE AND PUBLIC ASSISTANCE PROGRAMS GOAL 10: PROMOTE RESILIENCE AND EMERGENCY PREPAREDNESS GOAL 11: PROMOTE RESILIENCE AND EMERGENCY PREPAREDNESS PROMOTE CROSS-SECTOR COLLABORATION AND PARTNERSHIPCOMMUNITY HEALTH NEEDS ASSESSMENT APPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)MAH HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES MAH OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES OF THEIR TARGET POPULATIONS THROUGHOUT THEIR PRIORITY NEIGHBORHOODS.MAH HAS BEEN A LEADER IN CREATING A MYRIAD OF COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE THE FOOD ACCESS PROGRAMS SUCH AS ARLINGTON EATS, COMMUNITY HEALTH NETWORK AREA-17 AND PROGRAMS TO ADDRESS RACIAL EQUITY, COLLABORATIONS WITH LOCAL HOUSING AUTHORITIES, DONATIONS TO SUPPORT HIGH NEED POPULATIONS, AND WORKFORCE DEVELOPMENT PROGRAMS. IN FY20, MAH PROVIDED EMERGENCY MEDICAL CARE TO SEXUAL ASSAULT SURVIVORS IN THE EMERGENCY DEPARTMENT. MAH ALSO PROVIDED NEEDED FUNDING TO LOCAL HEALTH DEPARTMENTS TO EXPAND ACCESS TO CARE, AND FUNDS TO LOCAL HOUSING AUTHORITIES TO BRIDGE THE DIGITAL DIVIDE AND ADDRESS FOOD INSECURITY. MAH IS ROOTED IN PROVIDING HEALTHCARE TO POPULATIONS WHO HAVE HISTORICALLY NOT HAD PROPER ACCESS TO CARE. MAH CONTINUES TO EXPAND ACCESS THROUGHOUT THEIR CBSA BY SUPPORTING CHNA 17 AND LOCAL COALITIONS. A FULL UPDATE ON MAH'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.FY20 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: REDUCE THE BURDEN OF MENTAL HEALTH (PREVENTION, OUTREACH/IDENTIFICATION, AND RECOVERY SUPPORT)AS NOTED EARLIER IN THIS UPDATE, THERE WAS A CLEAR SENTIMENT AMONG KEY INFORMANTS AND FOCUS GROUP/COMMUNITY FORUM PARTICIPANTS THAT MENTAL HEALTH AFFECTS ALL SEGMENTS OF THE POPULATION, FROM CHILDREN AND YOUTH, TO YOUNG AND MIDDLE-AGED ADULTS, TO ELDERS. THERE WAS ALSO A CLEAR SENTIMENT THAT MENTAL HEALTH HAS A DISPROPORTIONATELY HIGHER IMPACT ON RACIAL/ETHNIC MINORITY, IMMIGRANTS, AND LOW INCOME POPULATIONS AS THESE SEGMENTS ARE MORE LIKELY TO BE IMPACTED BY STRESS AND/OR THE TRAUMA ASSOCIATED WITH RACISM AND DISCRIMINATION. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE (INCLUDING STIGMA), AND IMPROVE THE QUALITY OF PRIMARY CARE AND SPECIALIZED BEHAVIORAL HEALTH SERVICES. GOAL 1: DECREASE STIGMA ASSOCIATED WITH MENTAL HEALTHPROGRAMMATIC OBJECTIVES: 1.1 INCREASE AWARENESS OF MENTAL ILLNESS AND REDUCE STIGMA 1.2 INCREASE EDUCATIONAL OPPORTUNITIES RELATED TO THE IMPORTANCE AND IMPACT OF SOCIAL DETERMINANTS1.3 PROMOTE MENTAL HEALTH EDUCATION INCREASE ACCESS TO LOW COST HEALTHY FOODS WITH AN EMPHASIS ON PRIORITY POPULATIONS SEGMENTSCOMMUNITY ACTIVITIES/STRATEGIES: ORGANIZE SUPPORT GROUPS FOR THOSE SUFFERING FROM OR RECOVERING FROM MENTAL ILLNESS OR EMOTIONAL DISTRESS SUPPORT COMMUNITY HEALTH NETWORK AREA (CHNA) 17 IN THEIR EFFORTS TO ADDRESS MENTAL ILLNESS IN AFRICAN AMERICAN/BLACK POPULATIONS AND OTHER VULNERABLE SEGMENTS FACING DISCRIMINATION METRICS AND STATUS UPDATE: PROVIDED THREE EIGHT-WEEK LONG SUPPORT GROUPS FOR 29 PARTICIPANTS. PROVIDED FUNDING TO CHNA 17 TO SUPPORT THEIR MISSION OF ADVANCING RACIAL EQUITY AND MENTAL HEALTH.COMMUNITY PARTNERS: NATIONAL COUNCIL ON BEHAVIORAL HEALTH, CHNA 17, LOCAL POLICE AND FIRE DEPARTMENTS, LOCAL DPH, WAYSIDE YOUTH AND FAMILY SERVICESGOAL 2: INCREASE ACCESS TO MENTAL HEALTH EDUCATION, SCREENING, REFERRAL, NAVIGATION, AND OTHER SUPPORTIVE SERVICESPROGRAMMATIC OBJECTIVES: 1.1 INCREASE REFERRAL AND ENGAGEMENT RATES FOR THOSE SCREENED OR IDENTIFIED AS IN NEED OF SERVICES, WITH AN EMPHASIS ON PRIORITY POPULATIONS 1.2 INCREASE ACCESS TO NAVIGATION AND OTHER SUPPORTIVE SERVICES FOR THOSE WITH MENTAL ILLNESS 1.3 INCREASE SUPPORT FOR THOSE AFFECTED BY TRAUMA, DOMESTIC VIOLENCE, AND EMOTIONAL DISTRESS 1.4 INCREASE THE NUMBER OF OLDER ADULTS LIVING INDEPENDENTLY IN THEIR HOMESCOMMUNITY ACTIVITIES/STRATEGIES: ORGANIZE AND FACILITATE PEER SUPPORT GROUP FOR THOSE IN EMOTIONAL DISTRESS OR EXPERIENCING GRIEF ORGANIZE AND SUPPORT MINDFULNESS PROGRAMS FOR COMMUNITY MEMBERS IN RESPONSE TO COVID-19 PROVIDE HEALTH EDUCATION, RAISE AWARENESS AND INCREASE ACCESS TO NEEDED SERVICES BY ORGANIZING EDUCATIONAL EVENTS CONDUCTED BY MEDICAL RESIDENTS IN THE COMMUNITY SOCIAL WORKERS TO ATTEND COMMUNITY MEETINGS WHERE THEY SHARE BEST PRACTICES, IDENTIFY OPPORTUNITIES TO IMPROVE COLLABORATIONS AND OPTIMIZE HEALTH FOR VULNERABLE COMMUNITY MEMBERS. PROVIDE GRANT SUPPORT AND FUNDING FOR LOCAL DPH TO SUPPORT EVIDENCE-BASED PROGRAMS THAT PROMOTE MENTAL HEALTH EDUCATION AND PREVENTION SERVICESMETRICS AND STATUS UPDATE: STAFF TRAINED ON THE EVIDENCED BASED MINDFULNESS BASED STRESS REDUCTION PROGRAM. MAH IS NOW ABLE TO PROVIDE THIS PROGRAM TO COMMUNITY MEMBERS IN FY21. RESIDENT PROGRAM WAS NOT ABLE TO RUN DUE TO COVID-19 IN FY20. SOCIAL WORKERS ATTENDED OVER 50 COMMUNITY MEETINGS TO SHARE BEST PRACTICES AND IMPROVE TRANSITIONS OF PATIENTS FOR OPTIMAL HEALTH. PROVIDED FUNDING TO LOCAL HEALTH DEPARTMENTS TO SUPPORT A SPEAKER SERIES IN BELMONT ON YOUTH MENTAL HEALTH AND RESILIENCE. PROVIDED FUNDING TO LOCAL HEALTH DEPARTMENTS TO SUPPORT A VIRTUAL PROGRAM FOR YOUTH IN SOMERVILLE WHICH DISCUSSED RACIAL EQUITY AND YOUTH MENTAL HEALTH. 24 YOU PARTICIPATED AND RESOURCES WERE PROVIDED FOR ALL HIGH SCHOOL STUDENTS. PROVIDED FUNDING TO INCREASE THE CAPACITY FOR YOUTH MENTAL HEALTH FIRST AID (MHFA) TRAINING. 72 TRAINING UNITS WHICH PROVIDED ACCESS FOR 72 YOUTH WORKERS TO BE TRAINED IN MHFACOMMUNITY PARTNERS: CHNA 17, SCES, YOUTH ON FIRE, AIDS ACTION COMMITTEE, LOCAL DPH DEPARTMENTS, PRO AMBULANCE EMS
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PRIORITY AREA 2: REDUCE BURDEN OF SUBSTANCE USE/MISUSE
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(PREVENTION, OUTREACH/IDENTIFICATION, AND RECOVERY SUPPORT)DURING THE CHNA PROCESS, OPIOID AND PRESCRIPTION DRUG ABUSE WAS MENTIONED THROUGHOUT. IN PARTICULAR, IT WAS NOTED THAT INDIVIDUALS STRUGGLING WITH THESE ISSUES OFTEN HAVE VERY SERIOUS AND ACUTE NEEDS THAT MUST BE ADDRESSED QUICKLY AND COMPREHENSIVELY. MAH TAKES A HOLISTIC APPROACH IN ADDRESSING SUBSTANCE USE DISORDERS AND REACHING PEOPLE WHO ARE IN NEED WITHIN THEIR SERVICE AREA. GOAL 1: DECREASE STIGMA ASSOCIATED WITH SUBSTANCE USE/MISUSEPROGRAMMATIC OBJECTIVES: 1.1 INCREASE AWARENESS OF ISSUES RELATED TO SUBSTANCE USE AND REDUCE STIGMA 1.2 PROMOTE SUBSTANCE USE EDUCATIONCOMMUNITY ACTIVITIES/STRATEGIES:ORGANIZE SUPPORT GROUPS FOR THOSE SUFFERING FROM OR RECOVERING FROM SUBSTANCE USE AND THEIR FAMILIES/CAREGIVERS SUPPORT CHNA-17 IN THEIR EFFORTS TO ADDRESS MENTAL ILLNESS/SUBSTANCE USE IN AFRICAN AMERICAN/BLACK POPULATIONS AND OTHER POPULATIONS FACING DISCRIMINATION METRICS AND STATUS UPDATE:STAFF COLLABORATED WITH THE OUTPATIENT PSYCHIATRIC DEPARTMENT TO CREATE A FAMILY AND FRIENDS OF OPIOID USERS' EDUCATION AND SUPPORT GROUP PROGRAM. A FACILITATOR WAS TRAINED.FUNDING WAS PROVIDED IN WATERTOWN TO SUPPORT A COORDINATED "ERASE THE STIGMA OF SUBSTANCE USE" EVENT AND PANEL DISCUSSION. THIS EVENT REACHED RESIDENTS COMMUNITY WIDE THROUGH CABLE ACCESS NETWORK, YOUTUBE AND WEBSITE POSTINGS OF MATERIALS AND RESOURCES.A RESOURCE BROCHURE WAS CREATED FOR THOSE SEEKING RESOURCES FOR SUBSTANCE USE TREATMENT.COMMUNITY PARTNERS: NATIONAL COUNCIL ON BEHAVIORAL HEALTH, CHNA-17, LOCAL POLICE AND FIRE DEPARTMENTS, LOCAL HEALTH DEPARTMENTS, WAYSIDE YOUTH AND FAMILY SERVICES GOAL 2: INCREASE ACCESS TO SUBSTANCE USE EDUCATION, SCREENING, REFERRAL, NAVIGATION SUPPORT, TREATMENT, AND RECOVERY SERVICESPROGRAMMATIC OBJECTIVES: 1.1 INCREASE AWARENESS OF SUBSTANCE USE / MISUSE 1.2 PROMOTE ACCESS TO SUBSTANCE USE SERVICES1.3 REDUCE INAPPROPRIATE USE OF ED AND OTHER ACUTE CARE SERVICES 1.4 IDENTIFY AND REDUCE BARRIERS TO SUBSTANCE USE SERVICES1.5 INCREASE ACCESS TO PEER SUPPORT GROUPS FOR THOSE IN RECOVERY AND FAMILY MEMBERS OF THOSE IN RECOVERYCOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE GRANT SUPPORT TO LOCAL HEALTH DEPARTMENTS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT PROMOTE SUBSTANCE USE EDUCATION AND PREVENTION SERVICESSOCIAL WORKERS TO ATTEND COMMUNITY MEETINGS WHERE THEY SHARE BEST PRACTICES, IDENTIFY OPPORTUNITIES TO IMPROVE COLLABORATIONS AND OPTIMIZE HEALTH FOR VULNERABLE COMMUNITY MEMBERSPROMOTE AWARENESS AND PARTICIPATION OF THE MIDDLESEX DA OPIOID TASK FORCEMETRICS AND STATUS UPDATE: CREATED A RESOURCE BROCHURE PARTICULARLY FOR THOSE SEEKING RESOURCES FOR SUBSTANCE USE. SOCIAL WORKERS ATTENDED COMMUNITY MEETINGS WHERE THEY SHARED BEST PRACTICES, IDENTIFIED OPPORTUNITIES TO IMPROVE COLLABORATIONS, AND OPTIMIZED HEALTH FOR VULNERABLE COMMUNITY MEMBERS.COLLABORATED WITH THE MIDDLESEX DA TO HOST THE METRO REGION OPIOID TASK FORCE ON AN ONGOING BASIS.COMMUNITY PARTNERS: CHNA 17, SMART RECOVERY, PREVENTION AND RECOVERY CENTER, CASPAR, HEALTHY WALTHAM, CRCHC, NATIONAL COUNCIL ON BEHAVIORAL HEALTH, SUBSTANCE USE STAKEHOLDER TASK FORCE, MIDDLESEX DAPRIORITY AREA 3: REDUCE PREVALENCE AND BURDEN OF CHRONIC AND COMPLEX CONDITIONSTHE ASSESSMENT'S QUANTITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN MAH'S CBSA HAVE HIGH RATES FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). OF THE SIX TOWNS IN MAH SERVICE AREA, THE CANCER MORTALITY RATE IS SIGNIFICANTLY HIGH IN SOMERVILLE COMPARED TO THE COMMONWEALTH. LOOKING AT THE FOUR LEADING CANCER SITES, SERVICE AREA MORTALITY RATES WERE SIGNIFICANTLY LOWER THAN THE COMMONWEALTH IN SEVERAL MUNICIPALITIES. THE COLORECTAL CANCER MORTALITY RATE WAS SIGNIFICANTLY HIGH IN ARLINGTON COMPARED TO THE COMMONWEALTH OVERALL. IN SOME PEOPLE, THESE CONDITIONS HAVE UNDERLYING GENETIC ROOTS THAT ARE HARDER TO COUNTER. HOWEVER, FOR MOST PEOPLE THESE CONDITIONS ARE WIDELY CONSIDERED PREVENTABLE OR MANAGEABLE. ADDRESSING THE LEADING RISK FACTORS IS AT THE ROOT OF A SOUND CHRONIC DISEASE PREVENTION AND MANAGEMENT STRATEGY. GOAL 1: INCREASE ACCESS TO HEALTH EDUCATION, SCREENING, AND CHRONIC DISEASE MANAGEMENT PROGRAMMATIC OBJECTIVES: 1.1 INCREASE THE NUMBER OF ADULTS WHO RECEIVE HEALTH EDUCATION, SCREENING, AND OR REFERRAL FOR DIABETES, HYPERTENSION, ASTHMA, CANCER, AND OTHER CHRONIC/COMPLEX CONDITIONS 1.2 ORGANIZE CANCER EDUCATION, SCREENING, AND REFERRAL EVENTS1.3 ORGANIZE SCREENING EVENTS THAT INCLUDE HEALTH EDUCATION AND REFERRAL FOR SELF-MANAGEMENT SUPPORT FOR PRIORITY POPULATIONS COMMUNITY ACTIVITIES/STRATEGIES: PROVIDE ADULTS WITH HEALTH EDUCATION REGARDING RISK FACTORS AND HEALTHY BEHAVIORS IN SETTINGS CONVENIENT TO VULNERABLE COMMUNITY MEMBERS COLLABORATE WITH COMMUNITY PARTNERS TO PROVIDE CHRONIC DISEASE SELF-MANAGEMENT CLASSES FOR PRIORITY POPULATIONSPROVIDE BLOOD PRESSURE SCREENINGS IN COMMUNITY SETTINGSCONDUCT STROKE EDUCATION IN COMMUNITY SETTINGS AND VIRTUALLYPROVIDE GRANT SUPPORT TO LOCAL HEALTH DEPARTMENTS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT PROMOTE HEALTH EDUCATION, SCREENING, AND CHRONIC DISEASE MANAGEMENT FOR PRIORITY POPULATIONSCOLLABORATE WITH COMMUNITY PARTNERS TO PROVIDE HEALTHY EATING FOR SUCCESSFUL LIVING IN OLDER ADULTS PROGRAMSMETRICS AND STATUS UPDATE: PROVIDED 24 BLOOD PRESSURE CLINICS IN THE COMMUNITY FOR ELDERS.593 ELDERS ATTENDED CLINICS AND RECEIVED EDUCATION ON THE SIGNS AND SYMPTOMS OF HIGH BLOOD PRESSURE AND STROKE.COLLABORATED WITH BELMONT SENIOR CENTER TO PROVIDE A CHRONIC DISEASE SELF-MANAGEMENT CLASS. 10 PARTICIPANTS COMPLETED CLASS.CREATED A FALLS PREVENTION VIRTUAL PRESENTATION PROGRAM THAT WILL NOW BE READY FOR THE FY21.THROUGH THE HERTZSTEIN WELLNESS CENTER PROVIDED FREE ALTERNATIVE THERAPY APPOINTMENTS WHICH INCLUDED REIKI, THERAPEUTIC MUSIC, YOGA AND PAINT BREAK CLASSES. OVER 500 FREE APPOINTMENTS/ENCOUNTERS TOOK PLACE.STROKE NURSE NAVIGATOR PROVIDES ONGOING STROKE EDUCATION AND SUPPORT FOR PATIENTS AND THEIR FAMILIES.COMMUNITY PARTNERS: LOCAL COUNCILS ON AGING, WALTHAM HIGH SCHOOL, CAMBRIDGE LEARNING CENTER, WALTHAM FAMILY SCHOOL, CASPAR, SCES, SCALE, CRCHC, AMERICAN LUNG ASSOCIATION, HEALTHY LIVING CENTER OF EXCELLENCEGOAL 2: INCREASE ACCESS TO LUNG SCREENINGS PROGRAMMATIC OBJECTIVES: 1.1 ORGANIZE CANCER EDUCATION, SCREENING EVENTS. COMMUNITY ACTIVITIES/STRATEGIES: PROVIDE EDUCATION ON LUNG CANCER SCREENING GUIDELINESMETRICS AND STATUS UPDATE: PROVIDED LUNG SCREENING EDUCATION TO CASPAR RESIDENTS IN SOMERVILLE. PROVIDED 1 SESSION FOR 10 RESIDENTS. UNABLE TO PROVIDE ADDITIONAL SESSIONS DUE TO PANDEMICCOMMUNITY PARTNERS: LOCAL COUNCILS ON AGING, WALTHAM HIGH SCHOOL, CAMBRIDGE LEARNING CENTER, WALTHAM FAMILY SCHOOL, CASPAR, SCES, SCALE, CRCHC, AMERICAN LUNG ASSOCIATION, HEALTHY LIVING CENTER OF EXCELLENCEPRIORITY AREA 4: PROMOTE HEALTHY AGING AND ABILITY OF OLDER ADULTS (65+) TO LIVE INDEPENDENTLYOLDER ADULTS ARE MUCH MORE LIKELY TO DEVELOP CHRONIC ILLNESSES AND RELATED DISABILITIES SUCH AS HEART DISEASE, HYPERTENSION AND DIABETES AS WELL AS CONGESTIVE HEART FAILURE, DEPRESSION, ANXIETY, ALZHEIMER'S DISEASE, PARKINSON'S DISEASE AND DEMENTIA. THEY ALSO MAY LOSE THE ABILITY TO LIVE INDEPENDENTLY AT HOME. ACCORDING TO QUALITATIVE INFORMATION GATHERED THROUGH INTERVIEWS AND COMMUNITY FORUMS, ELDER HEALTH IS ONE OF THE HIGHEST PRIORITIES FOR THE MAH SERVICE AREA. CHRONIC DISEASE, DEPRESSION, ISOLATION AND FRAGMENTATION OF SERVICES WERE IDENTIFIED AS SOME OF THE LEADING ISSUES FACING THE AREA'S OLDER ADULT POPULATION.THE FOLLOWING GOALS WERE ESTABLISHED BY THE MAH STEERING COMMITTEE TO RESPOND TO THE CHNA AND THE STRATEGIC PLANNING PROCESS. GOAL 1: PROMOTE HEALTHY AGING AND INDEPENDENT LIVINGPROGRAMMATIC OBJECTIVES: 1.1 INCREASE ACCESS TO LOW COST HEALTHY FOODS FOR VULNERABLE POPULATION SEGMENTS 1.2 INCREASE AWARENESS OF HEALTHY LIFESTYLE CHANGES 1.3 REDUCE ELDER HEALTH ISOLATION1.4 INCREASE ACCESS TO PERSONAL EMERGENCY RESPONSE SERVICESCOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE GRANT SUPPORT LOCAL HEALTH DEPARTMENTS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT PROMOTE HEALTHY AGING AND INDEPENDENT LIVING ORGANIZE HEALTHY EATING FOR SUCCESSFUL LIVING IN OLDER ADULTS EVENTS FOR PRIORITY POPULATIONSENROLL COMMUNITY MEMBERS IN SNAP AND OTHER PUBLIC ASSISTANCE PROGRAMSPROVIDE LOW COST ACCESS TO PERSONAL EMERGENCY RESPONSE SERVICES (LIFELINE)DEVELOP RELATIONSHIPS WITH ELDER SERVING ORGANIZATIONS TO SHARE BEST PRACTICES AND IMPROVE ACCESS TO CARE
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METRICS AND STATUS UPDATE:
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CAREGIVERS SUPPORT GROUP WAS CREATED FOR THOSE WHO CARE FOR A LOVED ONE SUFFERING FROM ALZHEIMER'S DISEASE OR DEMENTIA.THE CARING FOR THE CAREGIVER SUPPORT GROUP MET OVER 20 TIMES IN FY20. OVER 50 PEOPLE PARTICIPATED THROUGHOUT THE YEAR.COLLABORATED WITH WALTHAM COUNCIL ON AGING AND PROVIDED THE HEALTHY EATING FOR SUCCESSFUL LIVING PROGRAM. 12 PARTICIPANTS COMPLETED THE CLASS.OVER 1,000 ELIGIBLE ELDERS AND OR DISABLED ADULTS RECEIVED A PERSONAL EMERGENCY RESPONSE SYSTEM AT BELOW COST.PROVIDED AN OPPORTUNITY WHERE 558 OLDER ADULT VOLUNTEERS GAVE 8,843 HOURS OF SERVICE TO THE HOSPITAL. THE GOAL OF THIS PROGRAM IS TO IMPROVE SELF-WORTH AND SELF CONFIDENCE FOR THE OLDER ADULT POPULATION AS WELL AS REDUCE SOCIAL ISOLATION.CERTIFIED FINANCIAL COUNSELORS HELP PATIENTS AND COMMUNITY MEMBERS ENROLL IN PUBLIC ASSISTANCE PROGRAMSCOMMUNITY PARTNERS: LIVE WELL WATERTOWN, LOCAL COUNCILS ON AGING, LIFELINE SERVICES, WALTHAM CONNECTIONS, ELDER SERVICES TASK FORCE, HEALTHY LIVING CENTER OF EXCELLENCE, LOCAL HEALTH DEPARTMENTSGOAL 2: REDUCE FALLS AMONG OLDER ADULTSPROGRAMMATIC OBJECTIVES: 1.1 REDUCE FEAR OF FALLING1.2 INCREASE CONFIDENCE LEVELS IN OLDER ADULTS1.3 INCREASE ACTIVITY LEVELS COMMUNITY ACTIVITIES/STRATEGIES: PROVIDE FALL PREVENTION EDUCATION TO COMMUNITY MEMBERSMETRICS AND STATUS UPDATE: THE FALLS PREVENTION PROGRAM WAS PAUSED DUE TO COVID-19. A VIRTUAL PROGRAM WAS DEVELOPED THIS YEAR AND IS READY FOR FY21.COMMUNITY PARTNERS: LIVE WELL WATERTOWN, LOCAL COUNCILS ON AGING, LIFELINE SERVICES, WALTHAM CONNECTIONS, ELDER SERVICES TASK FORCE, HEALTHY LIVING CENTER OF EXCELLENCE, LOCAL HEALTH DEPARTMENTSPRIORITY AREA 5: CROSS-CUTTING ISSUES OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SYSTEM STRENGTHENING/ACCESS TO CARE QUANTITATIVE AND QUALITATIVE DATA SHOWED CLEAR GEOGRAPHIC AND DEMOGRAPHIC DISPARITIES RELATED TO THE LEADING SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, HOUSING, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT). THESE ISSUES INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN MAH'S SERVICE AREA. A DOMINANT THEME FROM KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE TREMENDOUS IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS, PARTICULARLY HOUSING, POVERTY, TRANSPORTATION AND FOOD ACCESS, HAVE ON RESIDENTS IN THE SERVICE AREA. MAH TAKES A HOLISTIC APPROACH IN ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH. GOAL 1: PROMOTE HEALTH EQUITY AND REDUCE DISPARITIES FOR THOSE FACING RACISM AND DISCRIMINATION PROGRAMMATIC OBJECTIVES: 1.1 ADDRESS UNDERLYING RACIAL AND INSTITUTIONAL INJUSTICES FOR PRIORITY POPULATIONS BY REDUCING BARRIERS TO HEALTH CARE SERVICES AND DISPARITIES IN HEALTH OUTCOMES FOR PRIORITY POPULATIONS COMMUNITY ACTIVITIES/STRATEGIES: SUPPORT CHNA 17'S WORK TO ADDRESS RACISM, PARTICULARLY WITH RESPECT TO BEHAVIORAL HEALTH SERVICES COLLABORATE WITH CHNA 17 IN ITS EFFORTS TO PROVIDE GRANT OPPORTUNITIES/FUNDING FOR COMMUNITY BASED ORGANIZATIONS TO INCREASE AWARENESS AND BREAK DOWN BARRIERS FOR PRIORITY POPULATIONS METRICS AND STATUS UPDATE: MAH LEADERSHIP SIT ON THE STEERING COMMITTEE FOR CHNA 17.PROVIDED FOUR RACIAL EQUITY GRANTS TO LOCAL ORGANIZATIONS TO REDUCE RACIAL INEQUITIES IN MENTAL HEALTH SERVICES FOR MARGINALIZED POPULATIONS. THIS IS THE 2ND YEAR OF A TWO YEAR GRANT PROGRAM.PROVIDED FINANCIAL SUPPORT TO 12 GRADUATE LEVEL STUDENTS OF COLOR IN THE MENTAL HEALTH. THESE STUDENTS SHARED THEIR LIVED EXPERIENCES WITH YOUTH/HIGH SCHOOLS STUDENTS IN A PROGRAM COORDINATED BY CHNA 17.CHNA 17 GREW FROM 71 TO 97 ACTIVE PARTNERS AND CONNECTIONS ACROSS THE NETWORK. THE NETWORK GREW BY 75% FROM THE PREVIOUS YEAR.COMMUNITY PARTNERS: CHNA-17GOAL 2: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WITH LIMITED ENGLISH PROFICIENCY TARGET POPULATION: RACIAL/ETHNIC MINORITY POPULATIONS, IMMIGRANTS, NON-ENGLISH SPEAKERS, AND OLDER ADULTS AND THE LGBTQ COMMUNITYPROGRAMMATIC OBJECTIVES: 1.1 PROMOTE HEALTH LITERACY FOR COMMUNITY MEMBERS 1.2 PROMOTE HEALTH LITERACY AND CULTURAL SENSITIVITY AT MAH COMMUNITY ACTIVITIES/STRATEGIES: PROVIDE HEALTH EDUCATION TO COMMUNITY PARTNERS, AND OTHER ORGANIZATIONS WHICH WORK WITH THOSE WITH LIMITED ENGLISH PROFICIENCY CONDUCT HEALTH EQUITY/DIVERSITY TRAININGS AT MAH AND INCLUDE OTHER CLINICAL AND NON-CLINICAL PARTNERS, AS POSSIBLE AND APPROPRIATEPROVIDE INTERPRETERS FOR MEDICAL APPOINTMENTS FOR LEP PATIENTS AND/OR THOSE WHO REQUEST MEDICAL INTERPRETATION.CONDUCT HEALTH EQUITY/DIVERSITY TRAININGS AT MAHMETRICS AND STATUS UPDATE: MAH'S HEALTH LITERACY AND HEALTH EDUCATION PROGRAM WAS PUT ON HOLD DUE TO THE PANDEMIC.MEDICAL INTERPRETERS PROVIDED OVER 14,000 INDIVIDUAL ENCOUNTERS EITHER FACE TO FACE, VIDEO OR TELEPHONICALLY. OMMUNITY PARTNERS: SCALE, COMMUNITY LEARNING CENTER, WALTHAM FAMILY SCHOOL, WALTHAM HIGH SCHOOL, CRCHC, CHNA 17GOAL 3: PROMOTE HEALTH EQUITY FOR LGBTQ POPULATIONS PROGRAMMATIC OBJECTIVES: 1.1 REDUCE BARRIERS TO CARE AND DISPARITIES IN HEALTH OUTCOMES COMMUNITY ACTIVITIES/STRATEGIES: PROVIDE OR SUPPORT PROGRAMS AND INITIATIVES TO IMPROVE HEALTH AND WELLBEING OF THE LGBTQ POPULATION CONDUCT HEALTH EQUITY/DIVERSITY TRAININGS AT MAH AND INCLUDE OTHER CLINICAL AND NON-CLINICAL PARTNERS, AS POSSIBLE AND APPROPRIATEMETRICS AND STATUS UPDATE: PROVIDED FUNDING TO AIDS ACTION COMMITTEE OF CAMBRIDGE TO SUPPORT THEIR WORK AND MISSION.ACHED LEADER STATUS FOR THE LGBTQ HEALTHCARE EQUALITY INDEX UNDER THE HUMAN RIGHTS COMMISSION FOR 2020COMMUNITY PARTNERS: YOUTH ON FIRE, SCES, AIDS ACTION COMMITTEE, FENWAY HEALTHGOAL 4: DEVELOP PARTNERSHIPS WITH LOCAL HOUSING AUTHORITIES PROGRAMMATIC OBJECTIVES: 1.1 REDUCE THE IMPACTS OF POVERTY IN INCREMENTAL WAYS BY REDUCING THE HEALTH-RELATED BURDENS AND HEALTH ACCESS BARRIERS FOR THOSE IN PUBLIC HOUSINGCOMMUNITY ACTIVITIES/STRATEGIES: EXPLORE WAYS TO REDUCE /ADDRESS HOUSING INSTABILITY METRICS AND STATUS UPDATE: PROVIDED FUNDING TO LOCAL HOUSING AUTHORITIES IN MAH'S SERVICE AREA.CREATED AND IMPLEMENTED A TRACKING SYSTEM FOR THE LANGUAGE ACCESS PLAN IN ARLINGTON. THIS ALLOWED THE ARLINGTON HOUSING AUTHORITY TO BETTER SERVER THOSE WITH LIMITED ENGLISH PROFICIENCY.PROVIDED FUNDING IN BELMONT FOR TOILETRY GIFT BAGS FOR THOSE LIVING IN ELDERLY/DISABLED HOUSING UNITS. IMPROVED THE HEALTH AND WELLBEING OF RESIDENTS IN CAMBRIDGE BY PURCHASING TWO NEW EXERCISE "NU-STEP" MACHINES AND TRAINING FOR RESIDENTS. PROVIDED FUNDING TO THE CAMBRIDGE HOUSING AUTHORITY TO BRIDGE THE DIGITAL DIVIDE BY PURCHASING COMPUTERS FOR THEIR COMMON ROOM WITH TRAINING AVAILABLE FOR RESIDENTS. THIS IMPROVED DIGITAL LITERACY FOR RESIDENTS. RESIDENTS ARE NOW ABLE TO CONNECT WITH FAMILY MEMBERS DURING THE PANDEMIC AND ALSO USE THE COMPUTERS TO CONNECT TO THE WEB.INCREASED ACCESS TO FRESH PRODUCE FOR WALTHAM HOUSING AUTHORITY RESIDENTS BY PURCHASING A REFRIGERATOR AND FREEZER TO COMPLEMENT THEIR FOOD DISTRIBUTION PROGRAM. COMMUNITY PARTNERS: LOCAL HOUSING AUTHORITIESGOAL 5: SUPPORT WORKFORCE DEVELOPMENTPROGRAMMATIC OBJECTIVES: 1.1 INCREASE TRAINING AND EMPLOYMENT OPPORTUNITIES FOR LOW INCOME, MARGINALIZED SEGMENTS OF THE POPULATIONCOMMUNITY ACTIVITIES/STRATEGIES: ORGANIZE AND SUPPORT MENTORSHIP PROGRAMS FOR YOUTH AND ADULTS TO ENHANCE SKILLS/CAREER ADVANCEMENT PROVIDE WORKFORCE DEVELOPMENT WORKSHOPS AND INTERNSHIPSMETRICS AND STATUS UPDATE: COLLABORATED WITH WATERTOWN HIGH SCHOOL TO SUPPORT THE MED SCIENCE PROGRAM WHICH IS AIMED AT ADDRESSING THE GAP IN STEM EDUCATION. 16 STUDENTS FROM WATERTOWN HIGH ATTENDED PROGRAMMING, WHICH INCLUDED ROTATIONS THROUGHOUT THE HOSPITAL WHICH HIGHLIGHTED SCIENCE AND HEALTH CARE EDUCATION. THIS IS AN EIGHT WEEK ON SITE PROGRAM.MAH'S VOLUNTEER SUMMER PROGRAM WHICH GIVES HIGH SCHOOL STUDENTS AN INTERNSHIP OPPORTUNITY AT THE HOSPITAL WAS CANCELLED DUE TO THE PANDEMIC. COMMUNITY PARTNERS: CAMBRIDGE COMMUNITY LEARNING CENTER, CAMBRIDGE WORKS, SCALE
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GOAL 6: SUPPORT TRANSPORTATION EQUITY
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PROGRAMMATIC OBJECTIVES: 1.1 INCREASE ACCESS TO AFFORDABLE, ACCESSIBLE TRANSPORTATION SERVICES COMMUNITY ACTIVITIES/STRATEGIES: PARTICIPATE IN CAMBRIDGE'S TRANSPORTATION TASK FORCE PROVIDE TRANSPORTATION VOUCHERS TO PRIORITY POPULATIONS (E.G., LOW INCOME, OLDER ADULTS, AND OTHER SEGMENTS)METRICS AND STATUS UPDATE: PROVIDED OVER 3,000 RIDES FREE OF CHARGE TO THOSE WHERE TRANSPORTATION IS A BARRIER TO MEDICAL CARE. PARTICIPATED IN THE CAMBRIDGE TRANSPORTATION TASK FORCE IN ORDER TO MEANINGFULLY DISCUSS AND DECIDE ABOUT HOW TO IMPROVE ACCESS TO TRANSPORTATION, SAFE TRANSPORTATION, ENVIRONMENTALLY RESPONSIBLE TRANSPORTATION AND THE REDUCTION OF HARMFUL ELEMENTS DUE TO TRANSPORTATION MODES. SUPPORTED BELMONT COA THROUGH FUNDING TO PROVIDE 296 RIDES FOR UNDERSERVED ELDERS AND DISABLED PERSONS.COMMUNITY PARTNERS: CITY OF CAMBRIDGE, MBTA, LOCAL COUNCILS ON AGING, METRO CAB COMPANY, SCM TRANSPORTATION SERVICESGOAL 7: PROMOTE HEALTHY EATINGPROGRAMMATIC OBJECTIVES: 1.1 INCREASE ACCESS TO AFFORDABLE, NUTRITIONAL FOODS COMMUNITY ACTIVITIES/STRATEGIES: PARTNER WITH WATERTOWN HEALTH DEPARTMENT TO PROVIDE HEALTHY EATING FOR OLDER ADULTS SUPPORT ENROLLMENT EFFORTS WITH RESPECT TO SNAP AT BOTH MAH AND CHARLES RIVER COMMUNITY HEALTH METRICS AND STATUS UPDATE: COLLABORATED WITH WALTHAM COUNCIL ON AGING AND PROVIDED "HEALTHY EATING FOR SUCCESSFUL LIVING" PROGRAM. 12 PARTICIPANTS COMPLETED CLASS. COLLABORATED WITH THE CAMBRIDGE SNAP MATCH PROGRAM BY PROVIDING FUNDING TO THE SNAP MATCH GRANT WHICH IMPROVED ACCESS TO HEALTHY FOODS FOR LOW INCOME SHOPPERS AT THREE FARMERS MARKETS. 66 LOW INCOME RESIDENTS WERE ABLE TO DOUBLE THEIR PURCHASING POWER. COLLABORATING WITH THE WATERTOWN SCHOOL DEPARTMENT BY PROVIDING FUNDING TO SUPPORT THE SCHOOL NUTRITION DEPARTMENT ALLOWING THEM TO EXPAND ACCESS TO THE FREE MEALS PROGRAM. PROVIDED CHARLES RIVER COMMUNITY HEALTH FUNDING TO SUPPORT 60 FOOD INSECURE FAMILIES WITH GROCERY STORE GIFT CARDS TO SUPPLEMENT THEIR FOOD NEEDS. SUPPORTED THE FOOD BUDGET OF SOMERVILLE HOMELESS COALITION TO HELP INCREASE ACCESS OF HEALTHY FOODS FOR THEIR FOOD DELIVERY SERVICE TO HOUSING AND FOOD INSECURE COMMUNITY MEMBERS.COMMUNITY PARTNERS: CRCHC, LIVE WELL WATERTOWN, WATERTOWN HEALTH DEPARTMENT GOAL 8: PROMOTE HEALTH EQUITY AND REDUCE DISPARITIES FOR THOSE FACING RACISM AND DISCRIMINATION PROGRAMMATIC OBJECTIVES: 1.1 PROVIDE EDUCATION ON HOW TO STOP THE SPREAD OF COVID-19 1.2 SUPPORT ORGANIZATIONS WORKING TO IMPROVE ACCESS TO HEALTHY FOODS COMMUNITY ACTIVITIES/STRATEGIES: CREATE AND DISTRIBUTE EDUCATION MATERIALS PROGRAMMING TO INCREASE ACCESS TO FOODMETRICS AND STATUS UPDATE: CREATED AND DISTRIBUTED "STOP THE SPREAD" WRITTEN AND ONLINE MATERIALS. DISTRIBUTED MATERIALS TO 40 COMMUNITY BASED ORGANIZATIONS ELECTRONICALLY. "STOP THE SPREAD FLYER" TRANSLATED AND PROVIDED IN 10 LANGUAGES. 2,500 COPIES IN VARIOUS LANGUAGES WERE DISTRIBUTED THROUGHOUT MAH'S CBSA. SUPPORTED WALTHAM FIELDS COMMUNITY FARM TO SUPPORT THEIR CHANGING NEEDS TO RESPOND TO THE PANDEMIC TO CONTINUE THEIR LOW INCOME FRESH PRODUCE CSA PROGRAM. THIS SUPPORT PROVIDED THE BOXES NEEDED TO SAFELY DISTRIBUTE THE PRODUCE TO THESE FAMILIES. COLLABORATED WITH HEALTHY WALTHAM TO STRATEGICALLY LOOK FOOD SYSTEMS AND INFRASTRUCTURE AS THE PANDEMIC RESULTED IN OVER 100% INCREASE IN FOOD INSECURE RESIDENTS. THIS FUNDING HELPED TO SUPPORT A COMMUNITY WIDE EFFORT TO ADD AN ADDITIONAL FOOD DISTRIBUTION CENTER FOR COMMUNITY MEMBERS. DISTRIBUTION OF COVID-19 TEST KITS TO VARIOUS COMMUNITY LOCATIONS INCLUDING CRHC AND HELPED WITH TRAINING AND SUPPORT. OVER 500 TEST KITS DONATED AND PPE FOR TESTING. PURCHASED 70 BLOOD PRESSURE KITS FOR PRENATAL WOMEN AT CRCH FOR THE PURPOSE OF HOME CHECKS DURING THEIR VIRTUAL APPOINTMENTS DURING THE PANDEMIC. COMMUNITY PARTNERS: LOCAL HEALTH DEPARTMENTSGOAL 9: INCREASE ACCESS TO HEALTH INSURANCE AND PUBLIC ASSISTANCE PROGRAMSPROGRAMMATIC OBJECTIVES: 1.1 PROVIDE ASSISTANCE TO PRIORITY POPULATIONS AND ENROLL THEM IN HEALTH INSURANCE AND OTHER PUBLIC PROGRAMS COMMUNITY ACTIVITIES/STRATEGIES: SUPPORT ENROLLMENT ASSISTANCE ACTIVITIES TO ASSIST COMMUNITY MEMBERS TO ASSESS ELIGIBILITY AND APPLY FOR PUBLIC ASSISTANCE PROGRAMS.METRICS AND STATUS UPDATE: 3.74 FULL TIME EQUIVALENTS PROVIDE SUPPORT AND ENROLLMENT SERVICES, AT BOTH MAH AND CRCH TO SUPPORT COMMUNITY MEMBERS AND PATIENTS THROUGH ENROLLMENT FOR HEALTH INSURANCE AND PUBLIC ASSISTANCE PROGRAMS.COMMUNITY PARTNERS: CAMBRIDGE COMMUNITY LEARNING CENTER, CRCHC, SCALE, WALTHAM FAMILY SCHOOLGOAL 10: PROMOTE RESILIENCE AND EMERGENCY PREPAREDNESSPROGRAMMATIC OBJECTIVES: 1.1 SUPPORT CITIES/TOWNS TO PROMOTE RESILIENCE AND EMERGENCY PREPAREDNESSCOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE EMERGENCY SERVICES TRAINING TO LOCAL CITY/TOWN POLICE AND FIRE DEPARTMENTS. SERVE AS EMS MEDICAL DIRECTORS FOR CAMBRIDGE, ARLINGTON AND BELMONT MEDICAL DISPATCHERS.METRICS AND STATUS UPDATE: HELD MONTHLY PEER REVIEW SESSIONS PROVIDED BY MAH EMERGENCY DEPARTMENT PHYSICIANS FOR EDUCATIONAL PURPOSES. MAH PHYSICIANS SERVE AS EMS MEDICAL DIRECTORS FOR CAMBRIDGE, WATERTOWN, BELMONT, AND LEXINGTON, MIT EMS AND HARVARD UNIVERSITY EMS. PROVIDED MONTHLY EDUCATION SESSIONS AT LOCAL FIRE DEPARTMENTS WHICH REACH 30 STAFF EACH MONTH. SERVE ON STATE AND REGIONAL EMS ADVISORY BOARDS TO LEND MEDICAL OVERSIGHT TO THE REGION.COMMUNITY PARTNERS: LOCAL HEALTH DEPARTMENTS, PROEMS, MIT EMS, LOCAL POLICE AND FIRE DEPARTMENTSGOAL 11: PROMOTE CROSS SECTOR COLLABORATION AND PARTNERSHIPSPROGRAMMATIC OBJECTIVES: 1.1 COLLABORATE AND PARTNER WITH COMMUNITY-BASED ORGANIZATIONS COMMUNITY ACTIVITIES/STRATEGIES: PARTICIPATE ON CHNA 17 STEERING COMMITTEE PROVIDE FINANCIAL AND PROGRAMMATIC SUPPORT TO CHNA 17 PARTICIPATE IN THE CAMBRIDGE TRANSPORTATION TASK FORCE COLLABORATE WITH THE MIDDLESEX DA OFFICE TO BRING EDUCATION TO HOSPITAL STAFF AND COMMUNITY PARTNERS AROUND SUBSTANCE USE INITIATIVES.METRICS AND STATUS UPDATE: MAH IS AN ACTIVE PARTICIPANT ON THE CHNA 17 STEERING COMMITTEE. FUNDING AND PROGRAMMATIC SUPPORT WAS GIVEN TO CHNA 17. MAH IS AN ACTIVE PARTICIPANT IN THE CAMBRIDGE TRANSPORTATION TASK FORCE. MAH IS AN ACTIVE MEMBER OF THE MIDDLESEX DA'S OPIOID TASK FORCE. MAH HOSTED TWO MEETINGS IN FY20 AND THEN MET VIRTUALLY DUE TO THE PANDEMIC. ATTENDED OVER 50 COMMUNITY AND COALITION MEETINGS THROUGHOUT THE YEAR TO SUPPORT CROSS-SECTOR COLLABORATION.COMMUNITY PARTNERS: WALTHAM CONNECTIONS, HEALTHY WALTHAM, LOCAL POLICE DEPARTMENTS, ELDER SERVING AGENCIES, MIDDLESEX DA, LOCAL SUBSTANCE USE SERVICE PROVIDERS, CITY OF CAMBRIDGE, CITY OF SOMERVILLE
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COMMUNITY PARTNERS
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MAH IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE: ALCOHOL ANONYMOUS AMERICAN CANCER SOCIETY AMERICAN LUNG ASSOCIATION ARLINGTON COUNCIL ON AGING ARLINGTON EATS ARLINGTON HEALTH AND HUMAN SERVICES ARLINGTON HOUSING AUTHORITY ARLINGTON POLICE DEPARTMENT ARLINGTON SCHOOL DEPT. ARLINGTON YOUTH COUNSELING CENTER ARLINGTON YOUTH HEALTH AND SAFETY COALITION BEAVERBROOK STEP BELMONT COUNCIL ON AGING BELMONT DEPARTMENT OF PUBLIC HEALTH BELMONT FIRE DEPARTMENT BELMONT FOOD COLLABORATIVE BELMONT HOUSING AUTHORITY BELMONT POLICE DEPARTMENT CAMBRIDGE COUNCIL ON AGING CAMBRIDGE DEPARTMENT OF PUBLIC HEALTH CAMBRIDGE FAMILY AND CHILDREN SERVICES CAMBRIDGE FIRE DEPARTMENT CAMBRIDGE HEALTH ALLIANCE CAMBRIDGE HOUSING AUTHORITY CAMBRIDGE LEARNING CENTER CAMBRIDGE POLICE DEPARTMENT CASPAR INC. CHARLES RIVER COMMUNITY HEALTH CENTER CITY OF CAMBRIDGE COMMUNITY CONVERSATIONS, SISTER TO SISTER COMMUNITY HEALTH NETWORK AREA 17 (CHNA 17) ELDER SERVICES OF MERRIMACK VALLEY HARVARD DIVINITY SCHOOL HARVARD UNIVERSITY EMS HEALTHY LIVING CENTER OF EXCELLENCE HEALTHY WALTHAM HUMAN SERVICE AGENCY LIFELINE IN HOME SERVICES AT MOUNT AUBURN LIVE WELL WATERTOWN MARINO FOUNDATION MASS. DEPARTMENT OF PUBLIC HEALTH MASSACHUSETTS TRANSIT AUTHORITY METRO CAB OF BOSTON MIDDLESEX COMMUNITY COLLEGE MIDDLESEX DISTRICT ATTORNEY OFFICE MIDDLESEX HUMAN SERVICE AGENCY MINUTEMAN SENIOR SERVICES NAACP NASHOBA LEARNING GROUP NATIONAL COUNCIL FOR BEHAVIORAL HEALTH NEWTON WELLESLEY HOSPITAL ON THE RISE PAINE SENIOR SERVICES PROFESSIONAL AMBULANCE EMS QUIT WORKS SALVATION ARMY OF WALTHAM SCHENDERIAN PHARMACY SCM COMMUNITY TRANSPORTATION SOMERVILLE CAMBRIDGE ELDER SERVICES SOMERVILLE CENTER FOR ADULT LEARNING EXPERIENCE (SCALE) SOMERVILLE COUNCIL ON AGING SOMERVILLE DEPARTMENT OF HEALTH AND HUMAN SERVICES SOMERVILLE HOUSING AUTHORITY SOMERVILLE POLICE DEPARTMENT SPRINGWELL ELDER SERVICES THE CAMBRIDGE HOMES TUFTS UNIVERSITY WALTHAM CHALLENGER PROGRAM WALTHAM CONNECTIONS WALTHAM COUNCIL ON AGING WALTHAM FAMILY SCHOOL WALTHAM FIELDS COMMUNITY FARM WALTHAM HEALTH DEPARTMENT WALTHAM HOUSING AUTHORITY WALTHAM PARTNERSHIP FOR YOUTH WALTHAM POLICE DEPARTMENT WATERTOWN BOYS AND GIRLS CLUB WATERTOWN COUNCIL ON AGING WATERTOWN FIRE DEPT. WATERTOWN HEALTH DEPARTMENT WATERTOWN HIGH SCHOOL WATERTOWN HOUSING AUTHORITY WATERTOWN POLICE DEPARTMENT WAYSIDE YOUTH AND FAMILY SERVICES
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW MAH CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 8.58% OF MAH'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITS ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, MAH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE COMMUNITY BENEFITS ADVISORY COMMITTEE AND BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT: HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH/THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT MAH FILED WITH THE ATTORNEY GENERAL'S OFFICEEMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, MAH IS A GENERAL MEDICAL AND SURGICAL HOSPITAL AND TEACHING HOSPITAL, PROVIDING 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEMAH'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $3,658,988 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, MAH IS ONE OF TEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $3,658,988 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020. OTHER UNCOMPENSATED CHARITY CARE--MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, MAH ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MAH GENERATED $18,585,347 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY MAH FOR SUCH SERVICES BY $7,819,428 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B.MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND MAH PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MAH GENERATED $84,166,989 RELATED TO TREATING MEDICARE PATIENTS. THE REVENUE GENERATED BY PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED THE RELATED COSTS BY $1,896,620. OF THESE AMOUNTS, REVENUE OF $5,708,427 IS RELATED TO THE PROVISION OF INPATIENT PSYCHIATRY AND OUTPATIENT PSYCHIATRY AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES BECAUSE THE COST OF THOSE SERVICES EXCEEDED REVENUES BY $7,297,302. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH MAH CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, MAH HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 4.20%.
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BAD DEBTS
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IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, MAH ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $6,609,898 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH) AND AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP).THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR THE FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2020 INCLUDE THE ACCOUNTS OF: BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. THE FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES.THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.EMERGENCY CARE ACCESSAS PREVIOUSLY NOTED IN THIS FILING, FOR THE PERIOD COVERED BY THIS FILING, BIDMC SERVED AS THE SOLE MEMBER OF MAH. THE MEDICAL CENTER IS A NATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER AND TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP) IS AN INTEGRALLY RELATED PHYSICIAN PRACTICE OF BIDMC AND IS ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. APHMFP PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE MAH EMERGENCY DEPARTMENT. THESE PHYSICIANS ARE ALL CERTIFIED OR BOARD-ELIGIBLE IN LEVEL 1 TRAUMA. THE MAH DEPARTMENT OF EMERGENCY MEDICINE PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, AND 365 DAYS A YEAR.FINANCIAL ASSISTANCE POLICY--INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE MAH IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS MAH FINANCIAL ASSISTANCE POLICY (FAP) IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE FREE AND/OR DISCOUNTED CARE FROM MAH AS WELL AS PROVIDERS WHO FOLLOW MAH'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN MAH AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW MAH'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. MAH DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS, OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY AND THE AMOUNTS GENERALLY BILLED (AGB) CALCULATION IS UPDATED NOT LESS THAN ANNUALLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY, REVISED AUGUST 2020, WERE ADOPTED BY THE HOSPITAL'S BOARD PRIOR TO SEPTEMBER 30, 2017 AND THESE DOCUMENTS WERE ALL EFFECTIVE AS OF OCTOBER 1, 2017, THE FIRST DAY OF THE HOSPITAL'S FISCAL YEAR IN WHICH THE HOSPITAL WAS REQUIRED TO BE IN COMPLIANCE WITH THE REGULATIONS PROMULGATED BY THE TREASURY AND RELATED TO IRC SECTION 501(R). FINANCIAL ASSISTANCE POLICY--APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. THIS INFORMATION IS ALSO INCLUDED IN THE PLAIN LANGUAGE SUMMARY (PLS). IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)
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FINANCIAL ASSISTANCE POLICY--ELIGIBILITY GUIDELINES
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THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE--PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.
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FINANCIAL ASSISTANCE POLICY--TRANSLATIONS
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THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP, APPLICATION FOR FINANCIAL ASSISSTANCE AND HARDSHIP APPLICATION (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: ARMENIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, FRENCH, GREEK, HAITIAN CREOLE, PORTUGUESE RUSSIAN AND SPANISH. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY--WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDES CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE AND/OR DISCHARGE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY--PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE FOLLOWING FINANCIAL ASSISTANCE POLICY (FAP) DOCUMENTS: CREDIT AND COLLECTION POLICY APPLICATION FOR FINANCIAL ASSISTANCE MEDICAL HARDSHIP APPLICATION FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY AS WELL AS ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ARE ADDITIONAL IN THE FOLLOWING LANGUESES: ENGLISH AND ARMENIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, FRENCH, GREEK, HAITIAN CREOLE, PORTUGUESE RUSSIAN AND SPANISH ON THE MAH WEBSITE AT: HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/LIMITATION ON CHARGES--INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED--LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS UPDATED NOT LESS FREQUENTLY THAN ANNUALLY AS REQUIRED PURSUANT TO THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R) AND THE AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS--501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE.
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CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS--HEALTH PROFESSIONS EDUCA
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MOUNT AUBURN HOSPITAL'S CENTRAL LONGSTANDING ACADEMIC FOCUS IS MEDICAL EDUCATION, AND A COMMITMENT TO TEACHING STUDENTS AND TRAINEES IN A RESPECTFUL AND COLLABORATIVE ACADEMIC ENVIRONMENT. THIS COMMITMENT, COUPLED WITH THE INSTITUTION'S WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION, MAKE MAH A TOP CHOICE AMONG STUDENTS AND TRAINEES IN THE HEALTH CARE PROFESSIONS. THE HOSPITAL TRAINS MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, ALONG WITH OTHER ALLIED HEALTH PROFESSIONALS FROM ACROSS THE AREA.MAH HAS SEVERAL RESIDENCY AND FELLOWSHIP PROGRAMS, WITH APPROXIMATELY 50 INTERNAL MEDICINE INTERNS AND RESIDENTS, 12 RADIOLOGY RESIDENTS, 6 PODIATRY RESIDENTS, AND 3 UROGYNECOLOGY FELLOWS DURING MAH'S ACADEMIC YEAR JULY 1, 2019 JUNE 30, 2020 WHICH OVERLAPS WITH A PORTION OF MAH'S FISCAL YEAR ACTIVITIES REPORTED IN THIS FILING. THE HOSPITAL ALSO HOSTS ROTATING RESIDENTS AND FELLOWS IN SURGERY, EMERGENCY MEDICINE, GERIATRICS, GENETICS, OBSTETRICS AND GYNECOLOGY, NEONATOLOGY, AND ANESTHESIA, AND SUPPORTS THE EDUCATION OF MEDICAL STUDENTS FROM HARVARD MEDICAL SCHOOL, AND THE BOSTON UNIVERSITY SCHOOL OF MEDICINE. FINALLY, THE HOSPITAL SERVES AS A TRAINING SITE FOR PHARMACY STUDENTS FROM THE MASSACHUSETTS COLLEGE OF PHARMACY, PHYSICIAN'S ASSISTANT STUDENTS FROM NORTHEASTERN UNIVERSITY, CLINICAL NURSE ANESTHETISTS FROM BOSTON COLLEGE, AND CLINICAL NURSE MIDWIVES FROM MULTIPLE PROGRAMS ACROSS THE NORTHEAST. STAFF PHYSICIANS AT MAH WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF DAILY PATIENT CARE AND A RANGE OF INTERACTIVE EDUCATIONAL EXPERIENCES. AS PART OF THE HOSPITAL'S COMMITMENT TO MEDICAL STUDENT EDUCATION AND LONGSTANDING AFFILIATION WITH HARVARD MEDICAL SCHOOL, MAH IS A CORE SITE FOR THE HARVARD MEDICAL SCHOOL SUB-INTERNSHIP IN MEDICINE; THE HOSPITAL ALSO PARTICIPATES IN THE INTRODUCTORY COURSES IN CLINICAL MEDICINE FOR PRE-CLINICAL HARVARD MEDICAL SCHOOL STUDENTS, AS WELL AS IMMERSIVE TRAINING IN CLINICAL MEDICINE FOR BIOMEDICAL DOCTORAL STUDENTS FROM THE JOINT HARVARD MEDICAL SCHOOL / MASSACHUSETTS INSTITUTE OF TECHNOLOGY'S HEALTH SCIENCES AND TECHNOLOGY PROGRAM. IN ADDITION, THE HOSPITAL HOSTS THIRD-YEAR MEDICAL STUDENTS FROM THE BOSTON UNIVERSITY SCHOOL OF MEDICINE ON THE OBSTETRICS AND NEUROLOGY SERVICES AS WELL AS MEDICAL STUDENTS FROM HARVARD AND OTHER SCHOOLS WHO CHOOSE TO DO SUB-INTERNSHIPS AND SUBSPECIALTY ELECTIVES DURING THEIR THIRD AND FOURTH YEAR.THE MAH INTERNAL MEDICINE TRAINING PROGRAM, THE LARGEST OF ALL MAH RESIDENCIES, OFFERS A THREE-YEAR CATEGORICAL MEDICINE TRACK AND A ONE-YEAR PRELIMINARY MEDICINE TRACK. THE THREE-YEAR CATEGORICAL TRACK PREPARES RESIDENTS FOR CERTIFICATION BY THE AMERICAN BOARD OF INTERNAL MEDICINE AND CAREERS THAT COVER THE FULL SPECTRUM OF OPPORTUNITIES IN BOTH GENERAL INTERNAL MEDICINE AND THE MEDICAL SUB-SPECIALTIES. RESIDENTS ARE ABLE TO TAILOR THEIR 36 MONTHS OF TRAINING TO OBTAIN THE KNOWLEDGE, SKILLS, AND INSIGHT REQUIRED TO PURSUE SUBSEQUENT CAREERS IN PRIMARY CARE OR HOSPITALIST MEDICINE; IN ADDITION, THEY ARE PREPARED TO CONTINUE THEIR TRAINING IN COMPETITIVE SUB-SPECIALTY FELLOWSHIP TRAINING PROGRAMS ACROSS THE COUNTRY. MAH SUPPORTS TRAINEES IN THEIR INTENDED CAREER GOALS THROUGH THE USE OF DEFINED PATHWAYS. THESE PATHWAYS, IN PRIMARY CARE, HOSPITALIST MEDICINE, OR SUB-SPECIALTY MEDICINE, OUTLINE THE MILESTONES THAT THE TRAINEE SHOULD MEET THROUGHOUT THE COURSE OF TRAINING. THE PRELIMINARY MEDICINE INTERNSHIP TRACK OFFERS ONE YEAR OF TRAINING IN MEDICINE FOR PHYSICIANS WHO WILL CONTINUE THEIR TRAINING IN SPECIALTIES OTHER THAN INTERNAL MEDICINE, SUCH AS RADIOLOGY, OPHTHALMOLOGY, ANESTHESIOLOGY, RADIATION ONCOLOGY, NEUROLOGY, DERMATOLOGY, PHYSICAL MEDICINE & REHABILITATION, AND OTHERS. THIS PROGRAM IS HIGHLY SOUGHT AFTER BY TOP STUDENTS FROM MEDICAL SCHOOLS AROUND THE COUNTRY, AND A MAJOR STRENGTH, AS WELL AS A MAJOR ATTRACTION, IS THE FACT THAT THE YEAR IS LARGELY IDENTICAL IN STRUCTURE AND CONTENT TO THE FIRST YEAR FOR PHYSICIANS WHO TRAIN AT MOUNT AUBURN HOSPITAL FOR THREE YEARS IN THE CATEGORICAL INTERNAL MEDICINE TRACK; THE ONLY DIFFERENCE BEING THE QUANTITY OF AMBULATORY MEDICINE EXPERIENCE, AS PRELIMINARY INTERNS ARE NOT ASSIGNED A CONTINUITY CLINIC DURING THEIR YEAR.THE MAH RADIOLOGY RESIDENCY PROGRAM HAS A LONG AND PROUD HISTORY AS AN ELITE PROGRAM AND EXCEPTIONAL PLACE TO TRAIN. RESIDENTS ARE TYPICALLY ASSIGNED IN ONE-MONTH BLOCKS TO ONE OF THE DIFFERENT MODALITIES. EARLY IN TRAINING, RESIDENTS ARE EXPECTED TO READ EXTENSIVELY, MASTER ANATOMY, PARTICIPATE IN THE PROTOCOLLING AND INTERPRETATION OF PATIENT EXAMINATIONS, AND TO PARTICIPATE IN DISCUSSIONS CONCERNING DIAGNOSTIC PROBLEMS. RESIDENTS ADVANCE TO INCREASED LEVELS OF RESPONSIBILITY, AND SOUND JUDGMENT AS A RADIOLOGIST IS ESTABLISHED DURING OVERNIGHT CALL. THREE RESIDENTS ARE CHOSEN EACH YEAR FOR A FOUR-YEAR PROGRAM AND ARE APPOINTED AS CLINICAL FELLOWS AT HARVARD MEDICAL SCHOOL. THE HIGH RATIO OF STAFF RADIOLOGISTS TO RESIDENTS RESULTS IN CLOSE CONTACT BETWEEN THE STAFF AND RESIDENTS THROUGHOUT THE TRAINING PROGRAM. AFTER THE RESIDENT HAS OBTAINED THE NECESSARY FIRM FOUNDATIONS IN THE FUNDAMENTALS OF RADIOLOGY, HE OR SHE IS ENCOURAGED TO TAKE INCREASING RESPONSIBILITY IN BOTH ROUTINE AND SPECIALIZED EXAMINATIONS AND PROCEDURES. THE MAJORITY OF OUR RESIDENTS PURSUE SUBSPECIALTY FELLOWSHIP TRAINING; HOWEVER, THE GOAL OF THE RADIOLOGY RESIDENCY PROGRAM IS TO TRAIN RESIDENTS TO BE FULLY QUALIFIED IN DIAGNOSTIC RADIOLOGY AND SPECIAL PROCEDURES BY THE TIME THEY HAVE COMPLETED THE FOUR-YEAR PROGRAM. GRADUATES HAVE PURSUED CAREERS IN ACADEMIA AND PRIVATE PRACTICE.IN ADDITION TO THE INTERNAL MEDICINE AND RADIOLOGY TRAINING PROGRAMS, MOUNT AUBURN HOSPITAL HAS A NATIONALLY RECOGNIZED TRAINING PROGRAM IN PODIATRY AND IS A SITE FOR OTHER POST-GRADUATE MEDICAL EDUCATION DISCIPLINES. IT IS ALSO A CORE SITE FOR THE BETH ISRAEL DEACONESS MEDICAL CENTER SURGICAL TRAINING PROGRAM. MAH ALSO WELCOMES ROTATING GERIATRIC FELLOWS FROM THE BETH ISRAEL DEACONESS / HARVARD MEDICAL SCHOOL DIVISION ON AGING PROGRAM, AND PEDIATRIC AND NEONATOLOGY RESIDENTS FROM MASSACHUSETTS GENERAL HOSPITAL / CAMBRIDGE HOSPITAL PROGRAM. DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD NET EXPENDITURES OF $7,132,696 REPORTED ON THIS SCHEDULE H RELATED TO MAH'S RESIDENCY PROGRAM AND TO TEACHING OTHER STUDENTS RELATED TO ALLIED HEALTH PROFESSIONS.
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BIDMC-ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY
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(SCHEDULE H, PART VI, QUESTIONS 5 AND 6)COMMUNITY BOARDAS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. ON MARCH 1, 2019, THE BETH ISRAEL LAHEY HEALTH SYSTEM WAS FORMED THROUGH THE COMBINATION OF THE HOSPITALS AND OTHER AFFILIATES OF THREE LEGACY HEALTH CARE SYSTEMS BASED PRIMARILY IN EASTERN MASSACHUSETTS, INCLUDING THE FORMER CAREGROUP HEALTH SYSTEM, THE FORMER LAHEY HEALTH SYSTEM, AND THE SEACOAST HEALTH SYSTEM. BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS NOW THE SOLE MEMBER OF THE HOSPITAL AND NINE ADDITIONAL AFFILIATED HOSPITALS. EACH OF THESE ENTITIES MAY HAVE, IN TURN, SERVED AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. THE BILH HEALTH SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. AFFILIATED HEALTH CARE SYSTEMAS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, MAH IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED.BILH OPERATES AS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. BILH SERVES AS SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). LAHEY CLINIC FOUNDATION SERVES AS THE SOLE MEMBER OF LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER. EACH OF THESE AFFILIATES IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES SERVED BY BILH. EACH OF THESE AFFILIATES MAY ALSO, IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES.FOR THE FISCAL YEAR 2020 THE BILH HOSPITALS NOTED ABOVE PROVIDED CARE TO MEDICAID PATIENTS AT COSTS WHICH EXCEEDED REVENUES BY OVER $86 MILLION AND PROVIDED CARE TO MEDICARE PATIENTS AT COSTS WHICH EXCEEDED REVENUES BY $117 MILLION. IN ADDITION, THE BILH HOSPITALS PROVIDED TOTAL COMMUNITY BENEFITS IN THE NATURE OF DIRECT SERVICES TO THE COMMUNITIES SERVED BY THE BILH NETWORK AS WELL AS FUNDS PROVIDED TO COMMUNITY PARTNERS IN THE AMOUNT OF $93 MILLION BILH HOSPITALS ALSO INCURRED NET COSTS FOR SUBSIDIZED HEALTH SERVICES TO ENSURE THAT CARE WAS AVAILABLE WITHIN THE COMMUNITIES SERVED ACROSS BILH IN THE AMOUNT OF $32 MILLION. FINALLY, BILH HOSPITALS ARE COMMITTED TO PROVIDING RESEARCH TO FURTHER ADVANCE CARE TO BILH PATIENTS AND TO THE GENERAL ADVANCEMENT TO HEALTHCARE TREATMENT BEYOND THE COMMUNITIES IMMEDIATELY SERVED BY BILH AND TO PROVIDING CUTTING EDGE TRAINING TO FUTURE HEALTHCARE PROVIDERS. BILH HOSPITALS INVESTED NET COSTS OF $183 MILLION TOWARD THESE MISSIONS DURING THE FISCAL YEAR COVERED BY THIS FILING.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.