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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) AFFILIATIONMOUNT AUBURN HOSPITAL (MAH) IS A MEMBER OF BETH ISRAEL LAHEY HEALTH (BILH). 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 IS STEADFAST IN ITS COMMITMENT TO IMPROVING THE HEALTH AND WELLBEING OF COMMUNITY MEMBERS, THROUGH COLLABORATION WITH COMMUNITY PARTNERS TO REDUCE BARRIERS TO HEALTH CARE AND TO CONTINUALLY STRIVE TO REDUCE HEALTH DISPARITIES AND HEALTH INEQUITIES FOR THOSE WHO ARE MOST VULNERABLE IN OUR COMMUNITY. WE SEEK TO IDENTIFY CURRENT AND EMERGING HEALTH NEEDS AND ADDRESS THESE NEEDS THROUGH EDUCATION, PREVENTION, TREATMENT AND THE PROMOTION OF HEALTHY BEHAVIORS.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 $7,950,843 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE COMMUNITY BENEFITS TEAM AT MOUNT AUBURN HOSPITAL (MAH) IS LED BY THE DIRECTOR OF COMMUNITY BENEFITS AND CONSISTS OF THE COMMUNITY HEALTH STAFF, THE DIRECTOR OF SOCIAL WORK AND THE CHIEF OPERATING OFFICER. THE DIRECTOR IS SUPPORTED BY THE REGIONAL DIRECTOR OF COMMUNITY BENEFITS WHO IS ACCOUNTABLE TO THE VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS AND THE CHIEF OF DIVERSITY, EQUITY AND INCLUSION OFFICER, ALONG WITH MAH'S PRESIDENT. THESE SENIOR MANAGERS ARE RESPONSIBLE FOR ENSURING THAT COMMUNITY BENEFITS ARE ADDRESSED BY THE ENTIRE ORGANIZATION AND THE NEEDS OF MAH'S HISTORICALLY UNDERSERVED POPULATIONS ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)THE MOST RECENT CHNA WAS CONDUCTED FOR 2021, HOWEVER, ALL OF THE FOLLOWING DATA IS FROM 2018 CHNA.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 JULY OF 2021. THAT CHNA WAS APPROVED BY THE MAH BOARD OF TRUSTEES IN SEPTEMBER OF 2021. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD IN SEPTEMBER 2021, 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.2021 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONAS NOTED ABOVE, MAH COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2021. 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:- BLACK, INDIGENOUS, AND PEOPLE OF COLOR (BIPOC)- IMMIGRANT AND/OR DUAL-LANGUAGE LEARNERS- INDIVIDUALS EXPERIENCING MATERIAL POVERTY- OLDER ADULTS- LGBTQ+2021 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, 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, 2021 (TAX YEAR 2020). THE MAH COMMUNITY HEALTH DEPARTMENT WORKED CLOSELY THROUGHOUT THE ENTIRE PROCESS WITH STAFF MEMBERS FROM JOHN SNOW INC. TO COMPLETE THE PROJECT. MAH'S COMMUNITY BENEFITS ADVISORY COMMITTEE CONSISTS OF OVER 16 COMMUNITY MEMBERS AND/OR COMMUNITY ORGANIZATION REPRESENTATIVES INCLUDING CITY/TOWN PUBLIC HEALTH OFFICIALS AND GUIDED THE CHNA AND IS.
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MAH CONDUCTS ITS CHNAS IN THREE PHASES WHICH ALLOWED MAH TO:
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- COMPILE AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA;- ENGAGE AND INVOLVE KEY STAKEHOLDERS, MAH CLINICAL AND ADMINISTRATIVE STAFF AND THE COMMUNITY AT-LARGE;- DEVELOP A REPORT AND DETAILED STRATEGIC PLAN; AND- COMPLY WITH ALL COMMONWEALTH ATTORNEY GENERAL AND FEDERAL IRS COMMUNITY BENEFITS REQUIREMENTSIT IS IMPORTANT TO NOTE THE FY21 CHNA WAS CONDUCTED ENTIRELY DURING THE COVID-19 PANDEMIC AND EVERY EFFORT WAS MADE TO HEAR FROM A WIDE RANGE OF COMMUNITY MEMBERS. THE COVID 19 PANDEMIC LIMITED OPPORTUNITIES TO ENGAGE PEOPLE IN PERSON AT COMMUNITY SETTINGS. ALL MEETINGS, INTERVIEWS AND FOCUS GROUPS WERE COMPLETED VIA VIDEO CONFERENCING AND PARTICIPANTS WERE ENGAGED IN VIRTUAL ACTIVITIES.2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSMAH RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT ITS CBSA. MAH COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT MAH LEVERAGED INCLUDED:JSI 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 (2015-2019)- FBI UNIFORM CRIME REPORTS (2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, ANNUAL REPORTS ON BIRTHS (2016)- MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SERVICES, (20199)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY 2016-2018)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2018)- MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018)- YOUTH RISK BEHAVIOR SURVEYS (2017 AND 2018)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH COVID-19 DASHBOARD (JANUARY 2021)- CENTER FOR DISEASE CONTROL COVID 19 DASHBOARD (2020)2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)MAH'S CHNA WAS INFORMED BY 23 KEY INFORMANT INTERVIEWS AND 7 FOCUS GROUPS THAT ENGAGED INSTITUTIONAL, ORGANIZATION AND COMMUNITY LEADERS AND FRONT-LINE STAFF ACROSS SECTORS. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES, AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX A OF THE CHNA WHICH IS POSTED ON THE MAH WEBSITE (SEE LINK WITHIN THIS REPORT 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. DUE TO COVID-19, INTERVIEWS WERE CONDUCTED VIRTUALLY AND/OR ON THE PHONE USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING MAJOR HEALTH ISSUES, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS, AND TARGET POPULATIONS. 2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)JSI CONDUCTED A SERIES OF SEVEN COMMUNITY AND PROVIDER FOCUS GROUPS IN MAH'S SERVICE AREA TO GATHER CRITICAL COMMUNITY INPUT FROM SERVICE PROVIDERS, COMMUNITY LEADERS AND RESIDENTS. 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 ONE COMMUNITY FORUM WITH THE PARTNERSHIP AND HELP OF COMMUNITY HEALTH NETWORK AREA 17 (CHNA 17). CHNA 17 IS A COMMUNITY LEAD COALITION IN THE AREA. JSI LEAD THE DISCUSSIONS DURING THE COMMUNITY FORUM, WHICH WAS OPEN AND MARKETED TO THE PUBLIC AT-LARGE. MAH MADE EVERY EFFORT TO PROMOTE THE FORUM TO THE COMMUNITY AT LARGE IN ORDER TO RECRUIT PARTICIPANTS. THE MAH COMMUNITY BENEFITS ADVISORY COMMITTEE WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEED AND PRIORITIZING THE LEADING HEALTH ISSUES. THE COMMUNITY BENEFITS ADVISORY COMMITTEE MET FOUR 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.2021 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 2018 CHNA AND SUBSEQUENT IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY MAH DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2020 (TAX YEAR 2019).- 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).2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGSTHE KEY PRIORITY POPULATIONS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2021, WERE:- BLACK, INDIGENOUS, AND PEOPLE OF COLOR (BIPOC)- IMMIGRANT AND/OR DUAL-LANGUAGE LEARNERS- INDIVIDUALS EXPERIENCING MATERIAL POVERTY- OLDER ADULTS- LGBTQ+
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MAH'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS:
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THE KEY COMMUNITY HEALTH PRIORITIES IDENTIFIED THROUGH THE FY21 CHNA PROCESS WERE:RACIAL EQUITY - A DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND COMMUNITY FORUM WAS RACIAL EQUITY. IT IS IMPORTANT TO UNDERSTAND THAT ACHIEVING RACIAL EQUITY BENEFITS ALL OF SOCIETY. PRIORITIZING THE NEEDS OF CERTAIN POPULATIONS SHOULD NOT BE VIEWED AS NEGLECTING OTHERS, BUT RATHER PRIORITIZING SEEKS TO ADDRESS DISPROPORTIONATE NEEDS, WHICH IN TURN IMPROVES OVERALL ACCESS AND QUALITY OF LIFE FOR EVERYONE. RACISM IS INTERLINKED WITH OTHER SYSTEMIC ISSUES, THEREFORE IN PURSUING RACE-RELATED CONCERNS OTHER HEALTH EQUITY CONCERNS RELATED TO GENDER, AGE, ABILITY, ETC. ARE NOT DEVALUED, BUT RATHER MORE THOROUGHLY ADDRESSED THROUGH AN INTERSECTIONAL APPROACH. MAH IS COMMITTED TO ADDRESSING SYSTEMIC RACISM TO ENSURE THAT THE ROOT CAUSES TO INEQUITIES ARE ADDRESSED IN A COLLABORATIVE AND THOUGHTFUL WAY, ENSURING SUSTAINABILITY AND EFFECTIVE CHANGE.SOCIAL DETERMINANTS OF HEALTH - THE SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY HOUSING, TRANSPORTATION, AND FOOD INSECURITY, HAVE A TREMENDOUS IMPACT ON RESIDENTS WITHIN MAH'S CBSA, ESPECIALLY THOSE WHO ARE LOW TO MODERATE INCOME, AS FOUND DURING THE 2021 CHNA. THE SOCIAL DETERMINANTS OF HEALTH ARE OFTEN THE DRIVERS OF OUR UNDERLYING FACTORS THAT CREATE OR EXACERBATE MENTAL HEALTH ISSUES, SUBSTANCE MISUSE, AND CHRONIC AND COMPLEX CONDITIONS. THESE SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY POVERTY, ALSO UNDERLIE MANY OF THE ACCESS-TO-CARE ISSUES THAT WERE PRIORITIZED IN THE ASSESSMENT: NAVIGATING THE HEALTH SYSTEM (INCLUDING HEALTH INSURANCE), CHRONIC DISEASE MANAGEMENT, AND AFFORDING CARE.MAH IS COMMITTED TO ADDRESSING SOCIAL DETERMINANTS AND BREAKING DOWN BARRIERS TO CARE. THE HOSPITAL WILL CONTINUE TO COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONS TO ENGAGE INDIVIDUALS IN SERVICES, REDUCE FINANCIAL BURDENS, INCREASE ACCESS TO APPROPRIATE PRIMARY AND SPECIALTY CARE SERVICES, AND SUPPORT HEALTHY FAMILIES AND COMMUNITIES. MAH IS ALSO COMMITTED TO STRENGTHENING THE LOCAL WORKFORCE AND EXPLORING OPPORTUNITIES FOR THE HOSPITAL TO ADDRESS LOCAL UNEMPLOYMENT ISSUES.CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS - THE ASSESSMENT'S QUALITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN MAH'S CBSA HAVE HIGH RATES OF MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). HEART DISEASE, STROKE, AND CANCER CONTINUE TO BE THE LEADING CAUSES OF DEATH IN THE NATION AND THE COMMONWEALTH AND PLACE A SIGNIFICANT BURDEN ON COMMUNITIES. APPROXIMATELY SIX IN TEN DEATHS CAN BE ATTRIBUTED TO THESE THREE CONDITIONS COMBINED. IF RESPIRATORY DISEASE (E.G., ASTHMA, COPD) AND DIABETES, WHICH ARE TWO OF THE TOP 10 LEADING CAUSES OF DEATH ACROSS ALL GEOGRAPHIES, ARE INCLUDED, ONE CAN ACCOUNT FOR MOST CAUSES OF DEATH. MANY OF THE RISK FACTORS FOR THESE CONDITIONS ARE THE SAME PHYSICAL INACTIVITY, POOR NUTRITION, OBESITY, AND TOBACCO/ALCOHOL USE. MAH HAS A LONG HISTORY OF WORKING WITH COMMUNITY PARTNERS TO CREATE AWARENESS OF AND EDUCATION ABOUT RISK FACTORS AND THEIR LINKS TO CHRONIC AND COMPLEX HEALTH CONDITIONS. THE HOSPITAL WILL CONTINUE TO SUPPORT PROGRAMS THAT PROVIDE OPPORTUNITIES FOR PEOPLE TO ACCESS LOW-COST, HEALTHY FOODS. BEYOND ADDRESSING THE RISK FACTORS, MAH IS ALSO COMMITTED TO PROVIDING SCREENING AND EDUCATIONAL OPPORTUNITIES, SUPPORTING INDIVIDUALS AND CAREGIVERS THROUGHOUT THE SERVICE AREA TO ENGAGE IN CHRONIC DISEASE MANAGEMENT PROGRAMS AND SUPPORTIVE SERVICES (E.G., INTEGRATIVE THERAPIES, SUPPORT GROUPS), AND PROVIDING LINKS TO CARE.ACCESS TO CARE AND COMMUNITY NAVIGATION - ISSUES REGARDING HEALTH CARE ACCESS, NAVIGATION, AND COMMUNICATIONS CONTINUE TO IMPACT RESIDENTS WITHIN MAH'S CBSA, ESPECIALLY YOUTH, THOSE WITHOUT EASILY ATTAINABLE TRANSPORTATION, AND THOSE LEARNING ENGLISH AS A SECOND LANGUAGE. MANY KEY INFORMANTS AND FOCUS GROUP PARTICIPANTS IDENTIFIED A LACK OF UNDERSTANDING ON THE VARIOUS SERVICES THAT MAH PROVIDES AS WELL AS SOCIAL SERVICES THAT ARE AVAILABLE IN THE HOSPITAL'S CBSA.MAH WILL CONTINUE TO PROMOTE CROSS COMMUNICATION AND INCREASE ACCESS TO COMMUNITY RESOURCE INFORMATION AND NAVIGATION. MENTAL HEALTH AND SUBSTANCE USE DISORDER - AS IT IS THROUGHOUT THE COMMONWEALTH AND THE NATION, THE BURDEN OF MENTAL HEALTH AND SUBSTANCE USE ON INDIVIDUALS, FAMILIES, COMMUNITIES, AND SERVICE PROVIDERS IN MAH'S CBSA IS OVERWHELMING. NEARLY EVERY KEY INFORMANT INTERVIEW AND FOCUS GROUP INCLUDED DISCUSSIONS ON THESE TOPICS. FROM A REVIEW OF THE QUANTITATIVE AND QUALITATIVE INFORMATION, DEPRESSION, ANXIETY/STRESS, AND SOCIAL ISOLATION WERE THE LEADING ISSUES IN THIS DOMAIN. THERE WERE CONCERNS REGARDING THE IMPACT OF DEPRESSION, ANXIETY, AND E-CIGARETTE USE/VAPING ON YOUTH AND SOCIAL ISOLATION AMONG OLDER ADULTS.MAH RECOGNIZES THE IMPORTANCE OF PRIMARY PREVENTION THE HOSPITAL WILL CONTINUE TO WORK WITH COMMUNITY PARTNERS TO OFFER EDUCATIONAL PROGRAMS AROUND MENTAL HEALTH AND SUBSTANCE MISUSE. THE HOSPITAL WILL ALSO PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE ACTIVITIES WITH INTERNAL COLLEAGUES AND EXTERNAL PARTNERS. MAH WILL CONTINUE TO INCREASE ACCESS TO NAVIGATION AND OTHER SUPPORTIVE SERVICES FOR THOSE WITH MENTAL ILLNESS AND OR SUBSTANCE USE. MAH WILL CONTINUE TO PARTNER AND COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONS THAT WORK WITH OLDER ADULTS TO REDUCE SOCIAL ISOLATION AND ENHANCE ACCESS TO SUPPORTIVE SERVICES.THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, WILL INFORM MAH'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2022, SEPTEMBER 30, 2023, AND SEPTEMBER 30, 2024.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, 2021 (TAX YEAR 2020). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/543D4638-5875-495C-84D5-1FE2AC52826F/MAH-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-091721.PDFHTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/2DC40F3C-665B-4B7E-8644-11747505258D/MAH-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-APPENDICES-091721.PDFIN ADDITION TO THE CHNA, MAH COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2021 (TAX YEAR 2020). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/8C59C5FD-3469-4F54-9DD8-9518190B58ED/MAH-COMMUNITY-HEALTH-IMPLEMENTATION-STRATEGY-091721.PDFIN ADDITION, AS NOTED ABOVE, MAH COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2018 (TAX YEAR 2017). THAT CHNA IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/A9D63E6D-7FD9-4213-881F-F479D4815B06/2018-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDFHTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/6C7D75A1-8EA6-4651-A09F-F0B1966E1051/MAH2018CHNA-APPENDICES.PDFFINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING MAH'S FISCAL YEAR ENDED SEPTEMBER 30, 2018 (TAX YEAR 2017) IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/55DA6909-187C-4216-81C5-1574AFF75E9D/2018-COMMUNITY-HEALTH-IMPLEMENTATION-PLAN.PDFEACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).
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SCHEDULE H, PART V, SECTION B, LINE 11
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COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDSAS NOTED ABOVE, MAH'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2021. THAT CHNA AND IMPLEMENTATION STRATEGY INFORM THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF MAH FOR THE FISCAL YEARS ENDING SEPTEMBER 30, 2022, SEPTEMBER 30, 2023, AND WILL CONTINUE TO INFORM THE HOSPITAL'S COMMUNITY BENEFITS MISSION AND ACTIVITIES FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2024. A SUMMARY OF MAH'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 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 HEALTHY 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 ASSESSMENTAPPROACH 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 AND WORKING TO INCREASE SNAP MATCH BENEFITS, PROGRAMS TO ADDRESS RACIAL EQUITY SUCH AS COMMUNITY HEALTH NETWORK AREA 17, COLLABORATIONS WITH LOCAL HEALTH DEPARTMENTS, DONATIONS TO SUPPORT HIGH NEED POPULATIONS, AND HEALTHY AGING PROGRAMS. IN FY21, MAH PROVIDED NEEDED FUNDING TO LOCAL HEALTH DEPARTMENTS TO EXPAND ACCESS TO CARE, AND REGULARLY PURCHASED AND DELIVERED FOOD FOR DISTRIBUTION TO ORGANIZATIONS DISTRIBUTING FOOD TO FOOD INSECURE RESIDENTS.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.FY21 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 40 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, HARVARD DIVINITY SCHOOLGOAL 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: - PROVIDED THREE EIGHT-WEEK LONG SUPPORT GROUPS FOR 40 PARTICIPANTS. - PROVIDED TWO SESSIONS OF THE MINDFULNESS BASED STRESS REDUCTION CLASS. 25 PARTICIPANTS COMPLETED THE COURSE. 100% OF PARTICIPANTS REPORTED RECEIVING SOMETHING OF LASTING VALUE AFTER TAKING THE CLASS. - THE MEDICAL RESIDENT PROGRAM WAS NOT ABLE TO RUN DUE TO COVID-19 IN FY21.- SOCIAL WORKERS ATTENDED OVER 25 COMMUNITY MEETINGS TO SHARE BEST PRACTICES AND IMPROVE TRANSITIONS OF CARE FOR OPTIMAL HEALTH. - PROVIDED FUNDING TO LOCAL HEALTH DEPARTMENTS TO BUILD CAPACITY OF LOCAL HEALTH DEPARTMENTS (OR THEIR DESIGNEE) TO ADDRESS HEATH CONCERNS IDENTIFIED IN THE 2018 CHNA. - PROVIDED BEHAVIORAL HEALTH SERVICES TO 511 PATIENTS ACROSS 7 SITES.COMMUNITY PARTNERS: CHNA 17, SCES, LOCAL HEALTH DEPARTMENTS, LOCAL COUNCILS ON AGING, VARIOUS COMMUNITY GROUPS
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PRIORITY AREA 2:
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REDUCE BURDEN OF SUBSTANCE USE/MISUSE (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. THIS PROGRAM WAS NOT ABLE TO RUN DUE TO COVID RESTRICTIONS. - FUNDING WAS PROVIDED IN WATERTOWN TO CREATE AND PRINT A WATERTOWN CARES BROCHURE TO EDUCATE RESIDENTS ON SUBSTANCE USE RESOURCES IN THE AREA. - DIRECTOR OF COMMUNITY BENEFITS AT MAH IS A MEMBER OF CHNA 17 STEERING COMMITTEE TO HELP STRATEGIZE AND SUPPORT THE WORK OF CHNA 17 TO ADDRESS MENTAL HEALTH IN AFRICAN AMERICAN/BLACK POPULATIONS.COMMUNITY PARTNERS: NATIONAL COUNCIL ON BEHAVIORAL HEALTH, CHNA 17, LOCAL POLICE AND FIRE DEPARTMENTS, LOCAL HEALTH DEPARTMENTSGOAL 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 SERVICES- SOCIAL WORKERS TO ATTEND COMMUNITY MEETINGS WHERE THEY SHARE BEST PRACTICES, IDENTIFY OPPORTUNITIES TO IMPROVE COLLABORATIONS AND OPTIMIZE HEALTH FOR VULNERABLE COMMUNITY MEMBERS PROMOTE AWARENESS AND PARTICIPATION OF THE MIDDLESEX DA OPIOID TASK FORCEMETRICS AND STATUS UPDATE: - PROVIDED GRANT FUNDING TO LOCAL HEALTH DEPARTMENTS TO SUPPORT MENTAL HEALTH AND SUBSTANCE USE THAT PROMOTE SUBSTANCE USE EDUCATION AND PREVENTION SERVICES.- MAH IS A MEMBER OF THE WATERTOWN CARES COALITION. - SOCIAL WORKERS ATTENDED OVER 25 COMMUNITY MEETINGS WHERE THEY SHARED BEST PRACTICES, IDENTIFIED OPPORTUNITIES TO IMPROVE COLLABORATIONS, AND OPTIMIZED HEALTH FOR VULNERABLE COMMUNITY MEMBERS.- PROVIDED A SUBSTANCE USE NAVIGATOR IN THE ED WHO PROVIDES SUPPORT AND CARE TO THOSE WHO SHOW SIGNS OF SUBSTANCE USE IN THE ED. THE NAVIGATOR HELPS WITH TRANSITIONS OF CARE FOR THE PATIENT.- PROVIDED BEHAVIORAL HEALTH SERVICES TO 511 PATIENTS ACROSS 7 SITES.COMMUNITY PARTNERS: CHNA 17, MAH START PROGRAM, MAH PREVENTION AND RECOVERY CENTER, NATIONAL COUNCIL ON BEHAVIORAL HEALTHPRIORITY 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 POPULATIONS- PROVIDE BLOOD PRESSURE SCREENINGS IN COMMUNITY SETTINGS- CONDUCT STROKE EDUCATION IN COMMUNITY SETTINGS AND VIRTUALLY- PROVIDE GRANT SUPPORT TO LOCAL HEALTH DEPARTMENTS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT PROMOTE HEALTH EDUCATION, SCREENING, AND CHRONIC DISEASE MANAGEMENT FOR PRIORITY POPULATIONS- COLLABORATE WITH COMMUNITY PARTNERS TO PROVIDE HEALTHY EATING FOR SUCCESSFUL LIVING IN OLDER ADULTS PROGRAMSMETRICS AND STATUS UPDATE: - CREATED A HEALTHY AGING PROGRAM SERIES OF VIRTUAL PRESENTATIONS GEARED TOWARDS OLDER ADULTS TO ADDRESS HEALTH CONCERNS. A TOTAL OF 198 OLDER ADULTS PARTICIPATED.- 100% OF PARTICIPANTS ATTENDING THE HEALTHY AGING PROGRAMS REPORTED THAT THEY WOULD BE ABLE APPLY WHAT THEY LEARNED IN THE PRESENTATIONS TO IMPROVE THEIR OWN HEALTH AND WELLBEING.- STROKE NURSE NAVIGATOR PROVIDED ONGOING STROKE EDUCATION AND SUPPORT FOR PATIENTS AND THEIR FAMILIES.- FUNDING IN WATERTOWN SUPPORTED A "WALK WITH THE DOC" HEALTH EDUCATION PROGRAM WHERE OVER 30 PEOPLE PARTICIPATED WEEKLY IN THE SPRING AND FALL MONTHS. COMMUNITY PARTNERS: LOCAL COUNCILS ON AGING, LOCAL HEALTH DEPARTMENTS, LIVE WELL WATERTOWNGOAL 2: INCREASE ACCESS TO LUNG SCREENINGS PROGRAMMATIC OBJECTIVES: 1.1 ORGANIZE CANCER EDUCATION, SCREENING EVENTS. COMMUNITY ACTIVITIES/STRATEGIES: - PROVIDED METRICS AND STATUS UPDATE: - PROVIDED A SERIES OF VIRTUAL COMMUNITY HEALTH AND WELLNESS CLASSES GEARED TOWARDS PEOPLE DIAGNOSED WITH CANCER. A TOTAL OF 85 RESIDENTS PARTICIPATED.- PROVIDED FREE MAMMOGRAM SCREENING OPPORTUNITY FOR WOMEN WITHOUT INSURANCE OR LIMITED INSURANCE (CRCH).- UNABLE TO PROVIDE OTHER SCREENING EVENTS SUCH AS LUNG SCREENING DUE TO COVID-19 RESTRICTIONS.COMMUNITY PARTNERS: AMERICAN CANCER SOCIETY, MAH ONCOLOGY DEPARTMENT, CRCH
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PRIORITY AREA 4:
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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 POPULATIONS- ENROLL COMMUNITY MEMBERS IN SNAP AND OTHER PUBLIC ASSISTANCE PROGRAMS- PROVIDE LOW COST ACCESS TO PERSONAL EMERGENCY RESPONSE SERVICES (LIFELINE)- DEVELOP RELATIONSHIPS WITH ELDER SERVING ORGANIZATIONS TO SHARE BEST PRACTICES AND IMPROVE ACCESS TO CAREMETRICS AND STATUS UPDATE: - CAREGIVERS SUPPORT GROUP PROVIDED AND MET 2 TIMES PER MONTH FOR THOSE WHO CARE FOR A LOVED ONE SUFFERING FROM ALZHEIMER'S DISEASE OR DEMENTIA.- OVER 1,000 ELIGIBLE ELDERS AND OR DISABLED ADULTS RECEIVED A PERSONAL EMERGENCY RESPONSE SYSTEM AT BELOW COST.- HOSTED AN ELDER SERVICES PROVIDER MEETING 3 TIMES IN FY21.- CERTIFIED FINANCIAL COUNSELORS HELP PATIENTS AND COMMUNITY MEMBERS ENROLL IN PUBLIC ASSISTANCE PROGRAMS AND PROVIDE FINANCIAL COUNSELING.- PROVIDED CERTIFIED FINANCIAL COUNSELORS AT CRCH TO SERVE THEIR POPULATION.- EXPANDED INTERNET ACCESS IN ARLINGTON BY DISTRIBUTING 10 MOBILE HOT SPOTS TO AREAS WHERE OLDER ADULTS WERE UNABLE TO CONNECT TO THE INTERNET DUE TO FINANCIAL HARDSHIPS. COMMUNITY PARTNERS: LIVE WELL WATERTOWN, LOCAL COUNCILS ON AGING, LIFELINE SERVICES, WALTHAM CONNECTIONS, ELDER SERVICES PROVIDER GROUP, LOCAL HEALTH DEPARTMENTS, CRCHGOAL 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: - PROVIDED A SERIES OF VIRTUAL FALL PREVENTION PRESENTATIONS GEARED TOWARD OLDER ADULTS. OVER 40 PEOPLE PARTICIPATED. -IN SOMERVILLE, PROVIDED THE WEEKLY AGELESS GRACE EVIDENCED BASED PROGRAM TO 32 OLDER ADULTS, 100% OF PARTICIPANTS REPORTED THEY WERE ABLE TO INCREASE THEIR PHYSICAL STRENGTH IN ORDER TO REDUCE THEIR RISK OF FALLING.COMMUNITY PARTNERS: LOCAL COUNCILS ON AGING, SPRINGWELL, SCES, LIFELINE SERVICES, ELDER SERVICES PROVIDER GROUP, 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 SITS ON THE STEERING COMMITTEE FOR CHNA 17.- THROUGH THE WORK OF CHNA 17, 100% OF COALITION MEMBERS REPORTED THEY IMPROVED THEIR SKILLS TO PROMOTE RACIAL EQUITY IN THEIR WORK.- THROUGH THE WORK OF CHNA 17, 94% OF COALITION MEMBERS REPORTED INCREASING THEIR AWARENESS OF RACIAL INEQUITIES IN THEIR COMMUNITY. - PROVIDED FINANCIAL SUPPORT TO 12 GRADUATE LEVEL STUDENTS OF COLOR IN THE MENTAL HEALTH. THESE STUDENTS SHARED THEIR LIVED EXPERIENCES WITH YOUTH/HIGH SCHOOL STUDENTS IN A PROGRAM COORDINATED BY CHNA 17.COMMUNITY PARTNERS: CHNA 17GOAL 2: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WITH LIMITED ENGLISH PROFICIENCY PROGRAMMATIC 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 APPROPRIATE- PROVIDE INTERPRETERS FOR MEDICAL APPOINTMENTS FOR LEP PATIENTS AND/OR THOSE WHO REQUEST MEDICAL INTERPRETATION.- CONDUCT HEALTH EQUITY/DIVERSITY TRAININGS AT MAHMETRICS AND STATUS UPDATE: - PROVIDED A VIRTUAL EDUCATION PROGRAM FOR NAVIGATING THE HEALTH CARE SYSTEM TO 50 ENGLISH LANGUAGE LEARNERS. - 94% OF THOSE PARTICIPATING IN THE NAVIGATING THE HEALTH CARE SYSTEM PROGRAM REPORTED THAT THEY WILL BE ABLE TO TAKE WHAT THEY LEARNED AND USE IT TO HELP THEM NAVIGATE THE HEALTH CARE SYSTEM BETTER AFTER PARTICIPATING IN THE PROGRAM.- MEDICAL INTERPRETERS PROVIDED OVER 15,000 INDIVIDUAL ENCOUNTERS EITHER FACE TO FACE, VIDEO OR TELEPHONICALLY. COMMUNITY PARTNERS: SCALE, COMMUNITY LEARNING CENTER, WALTHAM FAMILY SCHOOL, WALTHAM GOAL 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 Y2Y OF CAMBRIDGE TO SUPPORT THEIR WORK AND MISSION.- ACHIEVED LEADER STATUS FOR THE LGBTQ HEALTHCARE EQUALITY INDEX UNDER THE HUMAN RIGHTS COMMISSION FOR 2021COMMUNITY PARTNERS: Y2Y CAMBRIDGE, FENWAY HEALTH
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GOAL 4 DEVELOP PARTNERSHIPS WITH LOCAL HOUSING AUTHORITIES
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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: - PARTNERED WITH METRO HOUSING BOSTON (MHB) TO IMPROVE AND PROVIDE TRANSITIONAL ASSISTANCE TO PATIENTS WHO ARE HOUSING INSECURE/UNSTABLE- MAH AND MHB AGREED ON A MEMORANDUM OF UNDERSTANDING AND A CONTRACT THAT WILL BEGIN IN FY22 TO START THE CO-LOCATION PROGRAM AT MAH.COMMUNITY PARTNERS: METRO HOUSING BOSTONGOAL 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: - THESE PROGRAMS DID NOT RUN IN FY21 DUE TO THE COVID 19 PANDEMIC.COMMUNITY PARTNERS: GOAL 6: SUPPORT TRANSPORTATION EQUITYPROGRAMMATIC OBJECTIVES: 1.1 INCREASE ACCESS TO AFFORDABLE, ACCESSIBLE TRANSPORTATION SERVICESCOMMUNITY ACTIVITIES/STRATEGIES: - PARTICIPATE IN THE CITY OF 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 1,500 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 ON HOW TO IMPROVE ACCESS TO TRANSPORTATION, SAFE TRANSPORTATION, ENVIRONMENTALLY RESPONSIBLE TRANSPORTATION, AND THE REDUCTION OF HARMFUL ELEMENTS DUE TO TRANSPORTATION MODES.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 FOODSCOMMUNITY ACTIVITIES/STRATEGIES: - PARTNER WITH WATERTOWN HEALTH DEPARTMENT TO PROVIDE HEALTHY EATING FOR OLDER ADULTS - SUPPORT ENROLLMENT EFFORTS WITH RESPECT TO SNAP METRICS AND STATUS UPDATE: - PROVIDED FUNDING TO LOCAL ORGANIZATIONS FOR THE PURPOSE OF INCREASING ACCESS AND CONSUMPTION OF FRESH FOOD TO FOOD INSECURE RESIDENTS. - COLLABORATED WITH THE CAMBRIDGE SNAP MATCH COALITION BY PROVIDING FUNDING WHICH CONTRIBUTED TO AN INCREASE OF 43% OF SNAP MATCH BENEFITS ISSUED TO INDIVIDUALS IN FY21 COMPARED TO FY20 FOR THOSE WHO SHOP AT THE FARMER'S MARKET.- COLLABORATED WITH THE BELMONT FOOD COLLABORATIVE, WHICH CONTRIBUTED TO AN INCREASE IN THEIR SNAP MATCH PROGRAM BY 20% FOR THOSE WHO SHOP AT THE FARMERS MARKET.- COLLABORATED WITH THE WATERTOWN SNAP MATCH PROGRAM, WHICH CONTRIBUTED TO AN INCREASE IN THEIR SNAP MATCH PROGRAM BY 50% FOR THOSE WHO SHOP AT THE FARMERS MARKET.COMMUNITY PARTNERS: CRCHC, LIVE WELL WATERTOWN, WATERTOWN HEALTH DEPARTMENT, WALTHAM FIELDS COMMUNITY FARM, BELMONT FOOD COLLABORATIVE, CAMBRIDGE SNAP MATCH COALITIONGOAL 8: PROMOTE HEALTH EQUITY AND REDUCE DISPARITIES FOR THOSE FACING RACISM AND DISCRIMINATION PROGRAMMATIC OBJECTIVES: 1.1 PROVIDE TEST KITS AND PPE FOR COVID 19 1.2 SUPPORT ORGANIZATIONS WORKING TO IMPROVE ACCESS TO HEALTHY FOODSCOMMUNITY ACTIVITIES/STRATEGIES: - DISTRIBUTE COVID-19 TEST KITS AND PPE- PROGRAMMING TO INCREASE ACCESS TO FOODMETRICS AND STATUS UPDATE: - IN ARLINGTON, PARTNERED WITH ARLINGTON EATS TO INCREASE ACCESS FOR CLIENTS TO THEIR FOOD VOUCHER PROGRAM. THIS PARTNERSHIP PROVIDED OVER 245 HOUSEHOLDS WITH A $15 VOUCHER TO ACCESS FRESH FOOD AND PRODUCE AT THE FARMER'S MARKET.- IN WALTHAM, PARTNERED WITH WALTHAM FIELDS COMMUNITY FARM AND CONTRIBUTED TO THE 100 BOX SHARES OF FRESH PRODUCE DELIVERED WEEKLY DURING THE GROWING SEASON TO HOUSING AUTHORITY NEIGHBORHOODS, WHICH WERE LOW-INCOME. - DISTRIBUTED 2,000 COVID-19 TEST KITS AND PPE TO VARIOUS COMMUNITY LOCATIONS INCLUDING CRHC AND HELPED WITH TRAINING AND SUPPORT. 2,000 TEST KITS DONATED AND PPE FOR TESTING.- IN WATERTOWN 28 VOLUNTEERS TRAINED AND SUPPORTED THE VACCINATION EFFORTS THROUGHOUT THE CITY.COMMUNITY PARTNERS: LOCAL HEALTH DEPARTMENTS, ARLINGTON EATS, WALTHAM FIELDS COMMUNITY FARM, CRCHGOAL 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: - 4 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: CHARLES RIVER COMMUNITY HEALTHGOAL 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 ORGANIZATIONSCOMMUNITY 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.- THE MIDDLESEX DA'S OPIOID TASK FORCE MEETINGS ARE NOW HELD VIRTUALLY SO MAH IS NO LONGER HOSTING THOSE MEETINGS.- ATTENDED OVER 50 COMMUNITY AND COALITION MEETINGS THROUGHOUT THE YEAR TO SUPPORT CROSS-SECTOR COLLABORATION.COMMUNITY PARTNERS: WALTHAM INTERAGENCY NETWORK, HEALTHY WALTHAM, LOCAL POLICE DEPARTMENTS, ELDER SERVING AGENCIES, CITY OF CAMBRIDGE, CITY OF SOMERVILLE, CAMBRIDGE HEALTH ALLIANCE.
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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:AMERICAN CANCER SOCIETY ARLINGTON YOUTH HEALTH AND SAFETY COALITION ARLINGTON COUNCIL ON AGING ARLINGTON EATSARLINGTON FIRE DEPARTMENTARLINGTON HEALTH AND HUMAN SERVICESARLINGTON HOUSING AUTHORITYARLINGTON POLICE DEPARTMENTARLINGTON YOUTH COUNSELING CENTERBELMONT COUNCIL ON AGINGBELMONT DEPARTMENT OF PUBLIC HEALTHBELMONT FIRE DEPARTMENTBELMONT FIRST ARMENIAN CHURCHBELMONT FOOD PANTRYBELMONT HOUSING AUTHORITYBELMONT POLICE DEPARTMENTBILH AT HOMECAMBRIDGE COMMUNITY FOUNDATION CAMBRIDGE COMMUNITY LEARNING CENTERCAMBRIDGE COUNCIL ON AGINGCAMBRIDGE DEPARTMENT OF PUBLIC HEALTHCAMBRIDGE FIRE DEPARTMENTCAMBRIDGE HEALTH ALLIANCE CAMBRIDGE HOUSING AUTHORITYCAMBRIDGE POLICE DEPARTMENTCAMBRIDGE SNAP MATCH COALITIONCASPAR INC.CHARLES RIVER COMMUNITY HEALTH CENTERCITY OF CAMBRIDGECITY OF SOMERVILLECITY OF WALTHAMCOMMUNITY HEALTH NETWORK AREA 17 (CHNA 17) ELDER SERVICES OF MERRIMACK VALLEYFOOD LINK INC.GREATER BOSTON FOOD BANKHARVARD UNIVERSITY EMSHEALTHY LIVING CENTER OF EXCELLENCEHEALTHY WALTHAM HOUSING CORP. OF ARLINGTONLEXINGTON FIRE DEPARTMENTLIFELINE IN HOME SERVICES AT MOUNT AUBURNLIVE WELL WATERTOWNMARINO FOUNDATIONMASS. INSTITUTE OF TECHNOLOGY EMSMASSACHUSETTS BAY TRANSIT AUTHORITY MEADOWGREEN REHABILITATION AND NURSINGMETRO CAB OF BOSTONNEVILLE PLACEPROFESSIONAL AMBULANCE EMS SCHENDERIAN PHARMACY SCM COMMUNITY TRANSPORTATION SOMERVILLE CAMBRIDGE ELDER SERVICES SOMERVILLE CENTER FOR ADULT LEARNING EXPERIENCES (SCALE) SOMERVILLE COUNCIL ON AGING SOMERVILLE HEALTH AND HUMAN SERVICESSOMERVILLE HOMELESS COALITIONSOMERVILLE HOUSING AUTHORITYSOMERVILLE POLICE DEPARTMENTSOMERVILLE STAKEHOLDERS COALITIONSPRINGWELL ELDER SERVICES TOWN OF ARLINGTONTOWN OF BELMONTTOWN OF WATERTOWNWALTHAM CONNECTIONS WALTHAM COUNCIL ON AGING WALTHAM FAMILY SCHOOLWALTHAM FIELDS COMMUNITY FARMWALTHAM HEALTH DEPARTMENTWALTHAM HOUSING AUTHORITYWALTHAM INTERAGENCY GROUPWALTHAM PARTNERSHIP FOR YOUTHWALTHAM POLICE DEPARTMENTWATERTOWN CARESWATERTOWN COUNCIL ON AGINGWATERTOWN FIRE DEPT.WATERTOWN HEALTH DEPARTMENTWATERTOWN HOUSING AUTHORITYWATERTOWN POLICE DEPARTMENTWATERTOWN PUBLIC SCHOOLS 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, 14.10% 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 BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, 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 ATHTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/E063B661-DDE9-42DF-A103-EACC0BDD8296/MAHCOMMUNITYBENEFITATTORNEYGENERALREPORTFY2020.PDFTHERE 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 OFFICE. EMERGENCY 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 $8,141,141 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, 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 $71,673,934 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH ADOPTED AN AMENDED WRITTEN FINANCIAL ASSISTANCE POLICY. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, UNDER THAT POLICY, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CAREMEDICAID 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 ENSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MAH GENERATED $23,892,011 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY MAH FOR SUCH SERVICES BY $9,464,934 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 10.5% OR 32,123 OF MAH'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 43.4% OR 133,004 CASES OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICAID PATIENTS. 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 $128,133,157 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $10,066,462 OF THESE AMOUNTS, REVENUE OF $6,089,723 IS RELATED TO THE PROVISION OF INPATIENT PSYCHIATRY UNIT, OUTPATIENT PSYCHIATRY SERVICE, 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 $6,389,260. 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 5.27%.
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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 $3,483,309 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, 2021 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 BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY 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).
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FINANCIAL ASSISTANCE POLICY APPLYING FOR ASSISTANCE
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THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY TRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 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 INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION 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 HOSPITAL'S APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE MAH FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. - CREDIT AND COLLECTION POLICY- APPLICATION FOR FINANCIAL ASSISTANCE- MEDICAL HARDSHIP APPLICATION- FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN ENGLISH, CHINESE, FRENCH, GREEK, HAITIAN CREOLE, PORTUGUESE, RUSSIAN, SPANISH CAN BE FOUND ON THE MAH WEBSITE AT: HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/
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LIMITATION ON CHARGES INTERNAL REVENUE CODE SECTION 501(R)(5)
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LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. 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. AS NOTED THROUGHOUT THIS FILING MAH IS PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER IN BOSTON AND A SISTER ENTITY OF BIDP. AS PART OF THE SAME NETWORK, THE RESEARCH IN WHICH BIDMC ENGAGES SUPPORTS NOT ONLY THE MISSION AND CARE FOR BIDMC PATIENTS AND COMMUNITIES BUT ALSO HELPS TO IMPROVE PATIENT CARE FOR THE COMMUNITIES OF OTHER BILH AFFILIATES AND BEYOND. THE DETAIL BELOW PROVIDES BACKGROUND ON THE RESEARCH ACTIVITIES AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING.FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHAS NOTED THROUGHOUT THIS FILING MAH IS PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER IN BOSTON AND A SISTER ENTITY OF MAH. AS PART OF THE SAME NETWORK, THE RESEARCH IN WHICH BIDMC ENGAGES SUPPORTS NOT ONLY THE MISSION AND CARE FOR BIDMC PATIENTS AND COMMUNITIES BUT ALSO HELPS TO IMPROVE PATIENT CARE FOR THE COMMUNITIES OF OTHER BILH AFFILIATES AND BEYOND. THE DETAIL BELOW PROVIDES BACKGROUND ON THE RESEARCH ACTIVITIES AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,800 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,400 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 260 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:- ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE - EMERGENCY MEDICINE - MEDICINE - ALLERGY AND INFLAMMATION - CARDIOVASCULAR MEDICINE - CENTER FOR VASCULAR BIOLOGY RESEARCH - CENTER FOR VIROLOGY AND VACCINE RESEARCH - CLINICAL INFORMATICS - CLINICAL NUTRITION - ENDOCRINOLOGY - EXPERIMENTAL MEDICINE - GASTROENTEROLOGY - GENERAL MEDICINE AND PRIMARY CARE - GENETICS - GERONTOLOGY - HEMATOLOGY AND ONCOLOGY - HEMOSTASIS AND THROMBOSIS - IMMUNOLOGY - INFECTIOUS DISEASE - INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGY - MOLECULAR AND VASCULAR MEDICINE - NEPHROLOGY - PULMONOLOGY - RHEUMATOLOGY - SIGNAL TRANSDUCTION - TRANSLATIONAL RESEARCH - TRANSPLANT IMMUNOLOGY-NEONATOLOGY -NEUROLOGY -OBSTETRICS AND GYNECOLOGY -ORTHOPAEDIC SURGERY -PATHOLOGY -PSYCHIATRY -RADIOLOGY -SURGERY - CARDIAC SURGERY - CENTER FOR MINIMALLY INVASIVE SURGERY - NEUROSURGERY - PLASTIC AND RECONSTRUCTIVE SURGERY - VASCULAR SURGERY-TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER REPORTED $241,917,383 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 2.99% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $307,298,416 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX-EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS ON SCHEDULE H, PART I LINE 7H COLUMN D, WHICH, IF INCLUDED IN SCHEDULE H, PART I, LINE 7H COLUMN E CALCULATION, WOULD INCREASE THE NET COMMUNITY BENEFIT REPORTED FROM RESEARCH ACTIVITIES ON THIS SCHEDULE H, PART I, LINE 7H TO 2.21%.
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RESEARCH ENGAGED IN AT THE MEDICAL CENTER
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THE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION, AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H COLUMN E, DEPENDING ON FUNDING SOURCE. COVID-19 VACCINE RESEARCHTHE PERIOD COVERED BY THIS FILING IS THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, DURING WHICH THE COVID-19 PANDEMIC CONTINUED TO DISRUPT LIFE IN THE UNITED STATES AND ACROSS THE GLOBE. RESEARCH CONDUCTED AT BIDMC DURING THIS FISCAL PERIOD HIGHLIGHTS BIDMC'S CONTINUING NATIONAL LEADERSHIP DURING THIS ONGOING PUBLIC HEALTH CRISIS.AS OF LATE JULY 2021, ABOUT 48.5 PERCENT OF AMERICANS, OR ABOUT 159 MILLION PEOPLE, WERE FULLY VACCINATED AGAINST SARS-COV-2, THE VIRUS THAT CAUSES COVID-19. BIDMC IMMUNOLOGIST DAN BAROUCH, MD, PHD, PLAYED AN INSTRUMENTAL ROLE IN DESIGNING AND DEVELOPING ONE OF THE FIRST THREE COVID-19 VACCINES TO COME TO MARKET IN THE UNITED STATES. AS DIRECTOR OF BIDMC'S CENTER FOR VIROLOGY AND VACCINE RESEARCH (CVVR), DR. BAROUCH AND HIS COLLEAGUES BEGAN WORKING ON A COVID-19 VACCINE ON JANUARY 10, 2020, THE SAME NIGHT THAT CHINESE SCIENTISTS RELEASED THE SARS-COV-2 VIRUS'S GENOME. DR. BAROUCH'S TEAM QUICKLY DESIGNED A SERIES OF VACCINE CANDIDATES, EVALUATED IN CLINICAL STUDIES LED BY PRIMARY INVESTIGATOR KATHRYN E. STEPHENSON, MD, MPH, DIRECTOR OF THE CLINICAL TRIALS UNIT AT CVVR.DR. BAROUCH'S INNOVATIVE VACCINE DESIGN NOW THE BASIS OF THE JOHNSON & JOHNSON SINGLE SHOT VACCINE USES A COMMON-COLD VIRUS, CALLED THE ADENOVIRUS, TO DELIVER A SMALL BIT OF THE COVID-19 DNA INTO HOST CELLS, WHERE IT STIMULATES THE BODY TO RAISE IMMUNE RESPONSES AGAINST THE VIRUS. SHOWN TO BE SAFE AND EFFECTIVE, THE COVID-19 VACCINE WAS GRANTED EMERGENCY USE APPROVAL BY THE U.S. FDA IN FEBRUARY 2021.SINCE THEN, BAROUCH AND COLLEAGUES HAVE CONTINUED TO STUDY THE VIRUS' IMPACT ON THE IMMUNE SYSTEM AND HOW THE VACCINES AND THERAPIES DEVELOPED TO PROTECT AGAINST THE ORIGINAL STRAIN OF SARS-COV-2 ARE HOLDING UP AGAINST THE EMERGING VARIANTS. FOLLOWING IS A SUMMARY OUTLINING RESEARCH FROM FISCAL YEAR 2021.A STUDY LED BY BAROUCH AND COLLEAGUES SHED MORE LIGHT ON HOW MOLECULES OF THE IMMUNE AND VASCULAR SYSTEMS INTERACT TO PRODUCE THE EXTENSIVE DAMAGE TO THE LUNG AND VASCULAR TISSUES SEEN IN PATIENTS WITH SEVERE DISEASE. RESEARCHERS CONDUCTED COMPREHENSIVE ANALYSES OF TISSUE AND BLOOD SAMPLES FROM HUMANS AND FROM NON-HUMAN PRIMATES INFECTED WITH COVID-19. THE TEAM'S FINDINGS, PUBLISHED IN THE JOURNAL CELL, HELP DEFINE THE PATHWAYS BY WHICH COVID-19 INDUCES VASCULAR DISEASE AND ALSO POINT TO POTENTIAL THERAPEUTIC TARGETS. "OVERALL, OUR DATA REVEAL THE KEY BIOLOGICAL PROCESSES INVOLVED IN TRIGGERING THE CLOTTING AND VASCULAR DAMAGE OBSERVED WITH SARS-COV-19 INFECTION," SAID BAROUCH. "OUR RESULTS SUGGEST A MODEL IN WHICH CRITICAL INTERACTIONS BETWEEN INFLAMMATORY AND CLOTTING PATHWAYS LEAD TO SEVERE VASCULAR INJURY SEEN IN CRITICALLY ILL PATIENTS WITH COVID-19." IN A PAPER IN THE JOURNAL NATURE, BAROUCH, AND COLLEAGUES ELUCIDATED THE ROLE OF ANTIBODIES AND IMMUNE CELLS IN PROTECTION AGAINST SARS-COV-2, THE VIRUS THAT CAUSES COVID-19, IN RHESUS MACAQUES. "IN THIS STUDY, WE DEFINE THE ROLE OF ANTIBODIES VERSUS T CELLS IN PROTECTION AGAINST COVID-19 IN MONKEYS. WE REPORTTHAT A RELATIVELY LOW ANTIBODY TITER (THE CONCENTRATION OF ANTIBODIES IN THE BLOOD) IS NEEDED FOR PROTECTION," SAID BAROUCH. "SUCH KNOWLEDGE WILL BE IMPORTANT IN THE DEVELOPMENT OF NEXT GENERATION VACCINES, ANTIBODY-BASED THERAPEUTICS, AND PUBLIC HEALTH STRATEGIES FOR COVID-19." IN ANOTHER STUDY IN NATURE, BAROUCH AND COLLEAGUES ALSO TESTED JOHNSON & JOHNSON'S COVID-19 VACCINE IN RHESUS MACAQUES CHALLENGED WITH THE VIRAL VARIANT B.1.351 AND IN RHESUS MACAQUES CHALLENGED WITH THE ORIGINAL STRAIN IDENTIFIED, DESIGNATED WA1/2020. BAROUCH AND COLLEAGUES WHO HELPED DEVELOP JOHNSON & JOHNSON'S SINGLE-SHOT VIRAL VECTOR VACCINE, CALLED AD26.COV2.S REPORT THAT THE VACCINE PRODUCES ROBUST PROTECTION AGAINST BOTH. THE FINDINGS HAVE IMPORTANT IMPLICATIONS FOR THE VACCINE CONTROL OF SARS-COV-2 VARIANTS OF CONCERN. "THE EMERGENCE OF SARS-COV-2 VARIANTS THAT PARTIALLY EVADE NEUTRALIZING ANTIBODIES POSES A THREAT TO THE EFFICACY OF CURRENT COVID-19 VACCINES," SAID BAROUCH, SENIOR AUTHOR OF THE STUDY AND DIRECTOR OF VACCINE AND VIROLOGY RESEARCH AT BIDMC. "HERE WE SHOW THAT THE AD26.COV2.S VACCINE ELICITS HUMORAL AND CELLULAR IMMUNE RESPONSES THAT CROSS-REACT WITH THE B.1.351 VARIANT AND PROTECTS AGAINST THE B.1.351 CHALLENGE IN RHESUS MACAQUES." IN FINDINGS PUBLISHED IN THE NEW ENGLAND JOURNAL OF MEDICINE, BAROUCH'S TEAM REPORTED ON THE DURABILITY OF JOHNSON & JOHNSON'S AD26.COV2.S VACCINE IN HUMANS. THE SINGLE-SHOT VIRAL VECTOR VACCINE DEVELOPED IN PART BY BAROUCH AND COLLEAGUES AT BIDMC WAS ALSO EVALUATED FOR ITS COVERAGE AGAINST THE ALPHA, BETA, GAMMA, DELTA, EPSILON, AND KAPPA SARS-COV-2 VARIANTS. "OUR DATA SHOW THAT THE AD26.COV2.S VACCINE ELICITED DURABLE IMMUNE RESPONSES WITH MINIMAL DECLINE FOR AT LEAST EIGHT MONTHS, THE TIMEFRAME EXAMINED, FOLLOWING IMMUNIZATION," SAID BAROUCH, CORRESPONDING AUTHOR OF THE PAPER AND ALSO PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL. "WE ALSO SHOWED GOOD NEUTRALIZATION COVERAGE OF THE DELTA VARIANT AS WELL AS OTHER VARIANTS." LAST SUMMER, BAROUCH'S TEAM WAS AWARDED $4.9 MILLION IN ANNUAL FUNDING OVER THE NEXT FIVE YEARS TO FIND A CURE FOR HIV. BAROUCH WAS ONE OF TEN PRIMARY INVESTIGATORS TO RECEIVE A 2021 NATIONAL INSTITUTES OF HEALTH (NIH) MARTIN DELANEY COLLABORATORIES FOR HIV CURE RESEARCH AWARD, WHICH AIMS TO EXPEDITE HUMAN IMMUNODEFICIENCY VIRUS (HIV) CURE RESEARCH BY BRINGING TOGETHER RESEARCH PARTNERS IN ACADEMIA, GOVERNMENT, THE PRIVATE SECTOR, AND THE COMMUNITY; COORDINATING COMPLEX RESEARCH STUDIES AND MENTORING THE NEXT GENERATION OF HIV CURE RESEARCHERS. BAROUCH AND COLLEAGUES WILL FOCUS ON UNDERSTANDING THE VIRAL RESERVOIR DORMANT HIV-INFECTED IMMUNE CELLS THAT REMAIN IN THE BODY DESPITE ANTI-RETROVIRAL THERAPY (ART) AND CAN SPRING BACK INTO ACTION IF ART IS INTERRUPTED AND ON DEVELOPING NEW IMMUNOLOGIC STRATEGIES TARGETING THE RESERVOIR TO CONTROL OR ERADICATE HIV INFECTION. WITH MORE THAN 35 MILLION PEOPLE WORLDWIDE LIVING WITH THE VIRUS AND NEARLY 2 MILLION NEW CASES EACH YEAR, HIV REMAINS A MAJOR GLOBAL EPIDEMIC. "THE LATENT VIRAL RESERVOIR IS THE CRITICAL BARRIER FOR THE DEVELOPMENT OF A CURE FOR HIV-1 INFECTION," SAID BAROUCH. "OUR OVERALL HYPOTHESIS IS THAT MULTIPLE IMMUNOLOGIC STRATEGIES WILL NEED TO BE EXPLORED AND COMBINED TO ACHIEVE LONG-TERM, ART-FREE VIROLOGIC CONTROL OR COMPLETE VIRUS ERADICATION. WE'RE VERY GRATEFUL FOR THIS GRANT AND TREMENDOUSLY EXCITED TO SEE THE PROGRESS WE CAN MAKE WITH THIS LONG-TERM SOURCE OF SUPPORT."
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DETAIL ON ADDITIONAL COVID AND NON-COVID RESEARCH EFFORTS
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WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. STUDY FINDS ENTIRE HOUSEHOLD AT INCREASED RISK WHEN POST-SURGICAL PATIENTS REFILL PRESCRIPTION OPIOIDS NEARLY THREE-QUARTERS OF PEOPLE WHO MISUSE OPIOIDS REPORT GETTING THEM WITH OR WITHOUT PERMISSION FROM A FRIEND OR FAMILY MEMBER WHO HAS A PRESCRIPTION. IN A STUDY PUBLISHED IN JAMA SURGERY, PHYSICIAN-SCIENTISTS AT BIDMC SOUGHT TO BETTER UNDERSTAND HOW PRESCRIBING OPIATES TO PATIENTS AFTER SURGERY MAY CONTRIBUTE TO SUBSEQUENT OPIOID MISUSE NOT JUST FOR THE POST-OPERATIVE PATIENT, BUT FOR HOUSEHOLD MEMBERS AS WELL. TO QUANTIFY HOW PRESCRIPTION DURATION AND REFILLS FOR A SURGICAL PATIENT IMPACTED THE RISK FOR MISUSE AND CHRONIC USE IN THEIR FAMILY MEMBERS, CORRESPONDING AUTHOR GABRIEL BRAT, MD, A TRAUMA SURGEON AT BIDMC, AND COLLEAGUES RETROSPECTIVELY EXAMINED DE-IDENTIFIED COMMERCIAL INSURANCE CLAIMS FILED BETWEEN 2008 AND EARLY 2016. AMONG THE 843,531 PATIENT-FAMILY PAIRS IDENTIFIED, THE RESEARCHERS FOUND THE RATES OF OVERALL OPIOID MISUSE (MEASURED BY SUBSEQUENT DIAGNOSTIC CODES) AND CHRONIC USE (MEASURED BY FILLED PRESCRIPTIONS) WERE BOTH LESS THAN ONE PERCENT. HOWEVER, THE RISK OF MISUSE USE ROSE IN HOUSEHOLDS WHERE THE SURGICAL PATIENT OBTAINED REFILLS. THOSE IN HOUSEHOLDS WITH ANY REFILL HAD A 33 PERCENT INCREASED HAZARD OF MISUSE, AND EACH ADDITIONAL REFILL WAS LINKED WITH A 19 PERCENT INCREASE IN HAZARD OF MISUSE BY A FAMILY MEMBER. "OUR DATA SUGGEST THAT THERE ARE SECOND VICTIMS OF OPIOID OVER-PRESCRIBING, THAT THE ADVERSE EFFECTS OF OPIOID PRESCRIPTIONS EXTEND BEYOND THE SURGICAL PATIENT WHO RECEIVED A PRESCRIPTION AND HAVE BROADER IMPLICATIONS FOR THE FAMILY," SAID, BRAT. "IT IS IMPORTANT THAT PRESCRIBERS, PATIENTS, AND THE PUBLIC UNDERSTAND THIS MULTI-FACETED PROBLEM EXTENDS BEYOND THE SURGICAL PATIENT AND HAS BROADER IMPLICATIONS FOR THE FAMILY."NATIONWIDE SPIKE IN CARDIOVASCULAR DEATHS SHOWN TO BE AN INDIRECT COST OF COVID-19 PANDEMICTWO YEARS INTO THE COVID-19 PANDEMIC, MORE THAN ONE MILLION AMERICANS HAVE DIED FROM THE VIRUS. BUT REPORTS DESCRIBE AN INCREASE IN MORTALITY DURING THE PANDEMIC THAT CANNOT BE EXPLAINED BY COVID-19 ALONE. RESEARCHERS LED BY CORRESPONDING AUTHOR RISHI K. WADHERA, MD, MPP, MPHIL, A PHYSICIAN-RESEARCHER AT THE SMITH CENTER FOR OUTCOMES RESEARCH IN CARDIOLOGY AT BIDMC, EVALUATED THE RATE OF U.S. DEATHS DUE TO CARDIOVASCULAR CAUSES DURING THE FIRST 11 WEEKS OF THE COVID-19 PANDEMIC (MID-MARCH TO JUNE 2020) RELATIVE TO THE IMMEDIATELY PRECEDING 11 WEEKS PRE-PANDEMIC. THE TEAM ALSO COMPARED THESE TWO PERIODS OF 2020 TO THE SAME WEEKS IN 2019. THE OBSERVATIONAL STUDY, PUBLISHED IN THE JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (JACC), SUGGESTS THAT PATIENTS MAY HAVE AVOIDED HOSPITALS OUT OF FEAR OF CONTRACTING THE NOVEL CORONAVIRUS AND THAT SOME DIED FROM CARDIOVASCULAR CONDITIONS WITHOUT SEEKING MEDICAL CARE. THE TEAM FOUND A MARKED NATIONWIDE RISE IN CARDIAC DEATHS AFTER THE ONSET OF THE PANDEMIC IN THE U.S. DEATHS DUE-TO ISCHEMIC HEART DISEASES (RELATED TO NARROWING OF THE ARTERIES) AND HYPERTENSIVE (RELATED TO HIGH BLOOD PRESSURE) DISEASES INCREASED BY 11 PERCENT AND 17 PERCENT, RESPECTIVELY, COMPARED TO THE PREVIOUS YEAR. IN CONTRAST, THE RESEARCHERS OBSERVED NO INCREASE IN DEATHS DUE TO OTHER CARDIOVASCULAR CONDITIONS, SUCH AS HEART FAILURE, POTENTIALLY BECAUSE THEY OFTEN DO NOT REQUIRE EMERGENT HOSPITALIZATION FOR POTENTIALLY LIFE-SAVING TREATMENT. DR. WADHERA AND COLLEAGUES SUGGEST THAT THE CANCELLATION OF SEMI-ELECTIVE PROCEDURES AND OUTPATIENT VISITS AS A RESULT OF THE PANDEMIC CONTRIBUTED TO THE INCREASE IN DEATHS BY DELAYING IMPORTANT DIAGNOSTIC TESTING AND LIMITING PATIENTS' ACCESS TO PRESCRIPTION MEDICATIONS. THE STRAIN IMPOSED BY COVID-19 ON SOME HOSPITALS MAY HAVE ALSO LED TO DELAYS IN CARE FOR HOSPITALIZED PATIENTS WITHOUT COVID-19, THE RESEARCHERS ADD. PANDEMIC-RELATED DELAYS IN EMERGENCY SERVICE RESPONSE TIMES AND A REDUCTION IN BYSTANDER CPR RATES ALSO LIKELY CONTRIBUTED TO REDUCED SURVIVAL AFTER CARDIAC ARREST. ADDITIONALLY, BEYOND HEALTHCARE SYSTEM FACTORS, GREATER PSYCHOSOCIAL, COMMUNITY, AND ENVIRONMENTAL STRESS AMID THE PANDEMIC MAY ALSO HAVE PLAYED AN IMPORTANT ROLE. "OVERALL, OUR DATA HIGHLIGHT THE URGENT NEED TO IMPROVE PUBLIC HEALTH MESSAGING TO ENSURE PATIENTS WITH EMERGENT CONDITIONS SEEK AND RECEIVE MEDICAL CARE PARTICULARLY IN REGIONS CURRENTLY EXPERIENCING A SURGE OR RESURGENCE OF COVID 19 CASES," WADHERA SAID. BIDMC RESEARCHERS REVEAL HOW GENETIC VARIATIONS ARE LINKED TO COVID-19 DISEASE SEVERITYMORE THAN 90 MILLION AMERICANS HAVE BECOME INFECTED WITH COVID-19; HOWEVER, PHYSICIANS STILL AREN'T SURE WHY SOME PEOPLE EXPERIENCE MILD TO NO SYMPTOMS WHILE OTHERS BECOME CRITICALLY ILL. RESEARCH LED BY ROBERT E. GERSZTEN, MD, CHIEF OF THE DIVISION OF CARDIOVASCULAR MEDICINE AT BIDMC SHEDS NEW LIGHT ON THE GENETIC RISK FACTORS THAT MAKE INDIVIDUALS MORE OR LESS SUSCEPTIBLE TO SEVERE COVID-19. THE FINDINGS, PUBLISHED IN A LETTER IN THE NEW ENGLAND JOURNAL OF MEDICINE (NEJM), ILLUMINATE THE MECHANISMS UNDERLYING COVID-19, AND POTENTIALLY OPEN THE DOOR TO NOVEL TREATMENTS FOR THE DISEASE. A GROWING BODY OF GENETIC EVIDENCE FROM PATIENTS IN CHINA, EUROPE, AND THE UNITES STATES LINKS COVID-19 OUTCOMES TO VARIATIONS IN TWO REGIONS OF THE HUMAN GENOME, FINDINGS WHICH WERE PUBLISHED IN THE NEJM. BUT THE STATISTICAL ASSOCIATION DOESN'T EXPLAIN HOW THE DIFFERENCES MODULATE DISEASE. TO DO THAT, SCIENTISTS NEED TO UNDERSTAND WHICH PROTEINS THESE SECTIONS OF THE GENOME CODE FOR AND THE ROLE THESE PROTEINS PLAY IN THE BODY IN THE CONTEXT OF DISEASE. OVER THE LAST DECADE, GERSZTEN AND COLLEAGUES HAVE GENERATED JUST SUCH A DATABASE AN IMMENSE LIBRARY OF ALL THE PROTEINS AND METABOLITES ASSOCIATED WITH VARIOUS REGIONS OF THE HUMAN GENOME. WHEN THEY LOOKED UP ONE GENOMIC "HOT SPOT" FOUND TO BE ASSOCIATED WITH COVID-19 DISEASE SEVERITY, THEY QUICKLY REALIZED THAT THE VERY SAME REGION WAS LINKED TO A PROTEIN THAT HAS RECENTLY BEEN IMPLICATED IN THE PROCESS BY WHICH THE SARS-COV-2 VIRUS INFECTS HUMAN CELLS. "GROUPS ARE INCREASINGLY FINDING GENOMIC HOTSPOTS RELATED TO DISEASES, BUT IT'S OFTEN NOT CLEAR HOW THEY IMPACT THE MECHANISMS OF DISEASE," SAID GERSZTEN. "WE LEVERAGED OUR HUGE DATABASE IT'S MORE THAN 100 TERABYTES' WORTH OF DATA TO VERY QUICKLY DETERMINE THAT THE PROTEIN MOST HIGHLY EXPRESSED BY THAT REGION TURNED OUT TO BE A CO-RECEPTOR FOR THE VIRUS THAT CAUSES COVID-19, SUGGESTING THAT THIS MIGHT BE A TARGET FOR THERAPEUTIC INTERVENTIONS. THE SO-CALLED ANTIBODY COCKTAILS CURRENTLY AVAILABLE MOSTLY TARGET THE SPIKE PROTEINS ON THE VIRUS. IN TURN, OUR WORK IDENTIFIES WHICH PROTEINS IN THE HUMAN BODY THAT SARS-COV-2 AND OTHER CORONAVIRUSES LATCH ON TO." RESEARCHERS DEMONSTRATE HOW CHRONIC ALCOHOL CONSUMPTION CAUSES INFLAMMATION IN THE BRAINALCOHOL USE DISORDER IMPACTS MILLIONS OF PEOPLE AROUND THE WORLD, INCLUDING AT LEAST 17 MILLION AMERICANS. NEARLY 100,000 PATIENTS DIE EACH YEAR FROM THE CONSEQUENCES OF CHRONIC DRINKING, WHICH INDUCES ORGAN INJURY THROUGHOUT THE BODY, PARTICULARLY TO THE LIVER AND BRAIN. RESEARCH LED BY GYONGYI SZABO, MD, PHD, HON. SCD, CHIEF ACADEMIC OFFICER OF BIDMC AND BETH ISRAEL LAHEY HEALTH, SHED LIGHT ON THE MECHANISMS BY WHICH CHRONIC ALCOHOL CONSUMPTION CAUSES DAMAGE TO BRAIN CELLS AND CELLS OF THE CENTRAL NERVOUS SYSTEM, WHICH IN TURN POTENTIALLY TRIGGERS ADDICTIVE BEHAVIOR. THE FINDINGS, PUBLISHED IN THE JOURNAL OF NEUROINFLAMMATION, ALSO SUGGEST POSSIBLE TARGETS FOR A THERAPEUTIC APPROACH TO CHRONIC ALCOHOL USE DISORDER. "CHRONIC ALCOHOL EXPOSURE INDUCES A COMPLEX, MULTI-ORGAN RESPONSE WITH ACTIVATION OF A VARIETY OF IMMUNE RESPONSES AND INFLAMMATORY EXPRESSION," SAID SZABO. "OUR DATA IDENTIFIES THE SIGNALING PATHWAY BY WHICH CHRONIC ALCOHOL CONSUMPTION PROMOTES INFLAMMATION IN TISSUES OF THE CENTRAL NERVOUS SYSTEM AND OUR FURTHER ANALYSIS SUGGESTS A STRATEGY FOR BLOCKING THIS ALCOHOL-INDUCED NEUROINFLAMMATION." IN AN EXPERIMENT SZABO AND COLLEAGUES STUDIED THE IMPACT OF CHRONIC ALCOHOL-CONSUMPTION ON VARIOUS REGIONS OF THE BRAIN IN A MOUSE MODEL. THE SCIENTISTS OBSERVED THAT IMMUNE CELLS CALLED MACROPHAGES INVADED THE BRAIN PARENCHYMA (OR TISSUE), PARTICULARLY IN THE HIPPOCAMPUS A REGION OF THE BRAIN CRITICAL TO LEARNING AND MEMORY THAT IS WELL KNOWN TO LOSE VOLUME IN PATIENTS WITH CHRONIC ALCOHOL USE DISORDER. SZABO AND COLLEAGUES POINT OUT THAT, FOR DECADES, SCIENTIFIC DOGMA HELD THAT IMMUNE CELLS COULD NOT REACH THE TISSUES OF THE CENTRAL NERVOUS SYSTEM (CNS). RESEARCHERS SUBSEQUENTLY DEMONSTRATED THE PRESENCE OF IMMUNE CELLS IN CNS TISSUES IN THE SETTING OF DISEASE.
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DETAIL ON ADDITIONAL COVID AND NON-COVID RESEARCH EFFORTS
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GENE EXPRESSION ANALYSIS REVEALED THE SIGNALING PATHWAY BY WHICH ALCOHOL CONSUMPTION PROMOTES NEUROINFLAMMATION. MOREOVER, THE RESEARCHERS ALSO DEMONSTRATED THAT BLOCKING IMMUNE CELL INVASION WITH AN INVESTIGATIONAL DRUG RESTORED SOME LOST BRAIN CELL FUNCTION; HOWEVER, ADMINISTRATION OF THE INVESTIGATIONAL DRUG DID NOT CHANGE THE ALCOHOL CONSUMPTION OR PREFERENCES OF THE LABORATORY ANIMALS. HOSPITALIZED PATIENTS WITH COVID-19 SIX TIMES MORE LIKELY TO DIE THAN PATIENTS HOSPITALIZED WITH INFLUENZA, RESEARCH FINDSCOVID-19 AND INFLUENZA ARE BOTH CONTAGIOUS RESPIRATORY VIRAL DISEASES THAT CAN LEAD TO PNEUMONIA AND ACUTE RESPIRATORY FAILURE IN SEVERE CASES. HOWEVER, DETAILED COMPARISON OF THE EPIDEMIOLOGY AND CLINICAL CHARACTERISTICS OF COVID-19 AND THOSE OF INFLUENZA ARE LACKING. IN A PAPER PUBLISHED IN THE JOURNAL OF GENERAL INTERNAL MEDICINE, PHYSICIAN-RESEARCHERS AT BIDMC ASSESSED THE RELATIVE IMPACT OF COVID-19 ON PATIENTS HOSPITALIZED WITH THE VIRAL INFECTION IN MARCH AND APRIL 2020, VERSUS PATIENTS HOSPITALIZED WITH INFLUENZA DURING THE LAST FIVE FLU SEASONS AT THE MEDICAL CENTER. OVERALL, THE TEAM DEMONSTRATED THAT COVID-19 CASES RESULTED IN SIGNIFICANTLY MORE WEEKLY HOSPITALIZATIONS, MORE USE OF MECHANICAL VENTILATION AND HIGHER MORTALITY RATES THAN INFLUENZA. CORRESPONDING AUTHOR MICHAEL DONNINO, MD, A CRITICAL CARE AND EMERGENCY MEDICINE PHYSICIAN AT BIDMC, AND COLLEAGUES INCLUDED A TOTAL OF 1,634 HOSPITALIZED PATIENTS IN THEIR STUDY, 582 OF WHOM HAD LABORATORY-CONFIRMED COVID-19 AND 1,052 OF WHOM HAD CONFIRMED INFLUENZA. WHILE 174 PATIENTS WITH COVID-19 (OR 30 PERCENT) RECEIVED MECHANICAL VENTILATION DURING THE TWO-MONTH PERIOD, JUST 84 PATIENTS WITH INFLUENZA (OR 8 PERCENT) WERE PLACED ON VENTILATION OVER ALL FIVE SEASONS OF INFLUENZA. LIKEWISE, THE PROPORTION OF PATIENTS WHO DIED WAS MUCH HIGHER FOR COVID-19 THAN FOR INFLUENZA; 20 PERCENT OF ADMITTED PATIENTS WITH COVID-19 DIED IN THE TWO-MONTH PERIOD, COMPARED TO THREE PERCENT OF PATIENTS WITH INFLUENZA OVER FIVE SEASONS. FURTHER ANALYSIS REVEALED THAT HOSPITALIZED PATIENTS WITH COVID-19 TENDED TO BE YOUNGER THAN THOSE HOSPITALIZED WITH INFLUENZA. AMONG PATIENTS REQUIRING MECHANICAL VENTILATION, PATIENTS WITH COVID-19 WERE ON VENTILATION MUCH LONGER A MEDIAN DURATION OF TWO WEEKS COMPARED TO JUST OVER THREE DAYS FOR PATIENTS WITH INFLUENZA. MOREOVER, AMONG PATIENTS REQUIRING MECHANICAL VENTILATION, PATIENTS WITH COVID-19 WERE FAR LESS LIKELY TO HAVE HAD PRE-EXISTING MEDICAL CONDITIONS. "OUR DATA ILLUSTRATE THAT 98 PERCENT OF THE DEATHS OF PATIENTS HOSPITALIZED WITH COVID-19 ARE DIRECTLY OR INDIRECTLY RELATED TO THEIR COVID-19 ILLNESS, WHICH HELPS DEBUNK THE IDEA THAT THE HIGH NUMBER OF U.S. COVID-19 DEATHS ARE AN ARTIFACT OF THE WAY CAUSES OF DEATHS ARE BEING RECORDED," SAID DONNINO. "WE ALSO SHOWED THAT COVID-19 CAUSED A SUBSTANTIAL NUMBER OF PATIENTS WITHOUT MAJOR PRE-EXISTING CONDITIONS TO REQUIRE MECHANICAL VENTILATION, WHICH HAPPENS RARELY IN PATIENTS WITH INFLUENZA," SAID DONNINO. BIDMC RESEARCHERS DEVELOP MODEL TO ESTIMATE FALSE-NEGATIVE RATE FOR COVID-19 TESTS AS OF JUNE 2020, THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) HAD GRANTED EMERGENCY USE AUTHORIZATION FOR MORE THAN 85 DIFFERENT VIRAL DNA TEST KITS OR ASSAYS EACH WITH WIDELY VARYING DEGREES OF SENSITIVITY AND UNKNOWN RATES OF ACCURACY. HOWEVER, WITH NO EXISTING GOLD STANDARD TEST FOR COVID-19, THERE'S LITTLE DATA ON WHICH TO JUDGE THESE VARIOUS TESTS' USEFULNESS. RESEARCHERS AT BIDMC DEVELOPED A MATHEMATICAL MEANS OF ASSESSING TESTS' FALSE-NEGATIVE RATE. THE TEAM'S METHODOLOGY, WHICH ALLOWS AN APPLES-TO-APPLES COMPARISON OF THE VARIOUS ASSAYS' CLINICAL SENSITIVITY, IS PUBLISHED IN THE JOURNAL CLINICAL INFECTIOUS DISEASES. "WE FOUND THAT CLINICAL SENSITIVITIES VARY WIDELY, WHICH HAS CLEAR IMPLICATIONS FOR PATIENT CARE, EPIDEMIOLOGY AND THE SOCIAL AND ECONOMIC MANAGEMENT OF THE ONGOING PANDEMIC," SAID CO-CORRESPONDING AUTHOR JAMES E. KIRBY, MD, DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORIES AT BIDMC. USING DATA FROM MORE THAN 27,000 TESTS FOR COVID-19 PERFORMED AT BETH ISRAEL LAHEY HEALTH HOSPITAL SITES FROM MARCH 26 TO MAY 2, 2020, KIRBY, AND CO-CORRESPONDING AUTHOR RAMY ARNAOUT, MD, DPHIL, ASSOCIATE DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORIES AT BIDMC, AND COLLEAGUES FIRST DEMONSTRATED THAT VIRAL LOADS CAN BE DEPENDABLY REPORTED. "THIS HELPS DISTINGUISH POTENTIAL SUPERSPREADERS, AT ONE EXTREME, FROM CONVALESCENT PEOPLE, WITH ALMOST NO VIRUS, AND THEREFORE LOW LIKELIHOOD OF SPREADING THE INFECTION," ARNAOUT SAID. NEXT, THE RESEARCHERS ESTIMATED THE CLINICAL SENSITIVITY AND THE FALSE-NEGATIVE RATE FIRST FOR THE IN-HOUSE TEST WHICH WAS AMONG THE FIRST TO BE IMPLEMENTED NATIONWIDE AND CONSIDERED AMONG THE BEST IN CLASS. ANALYZING REPEAT TEST RESULTS FOR THE NEARLY 5,000 PATIENTS WHO TESTED POSITIVE ALLOWED THE RESEARCHERS TO DETERMINE THAT THE IN-HOUSE TEST PROVIDED A FALSE NEGATIVE IN ABOUT 10 PERCENT OF CASES, GIVING THE ASSAY A CLINICAL SENSITIVITY OF ABOUT 90 PERCENT. TO ESTIMATE THE ACCURACY OF OTHER ASSAYS, THE TEAM BASED THEIR CALCULATIONS ON EACH TESTS LIMIT OF DETECTION, OR LOD, DEFINED AS THE SMALLEST AMOUNT OF VIRAL DNA DETECTABLE THAT A TEST WILL CATCH 95 PERCENT OR MORE OF THE TIME. ARNAOUT, KIRBY, AND COLLEAGUES DEMONSTRATED THAT THE LIMIT OF DETECTION CAN BE USED AS A PROXY TO ESTIMATE A GIVEN ASSAY'S CLINICAL SENSITIVITY. BY THE TEAM'S CALCULATIONS, AN ASSAY WITH A LIMIT OF DETECTION OF 1,000 COPIES VIRAL DNA PER ML IS EXPECTED TO DETECT JUST 75 PERCENT OF PATIENTS WITH COVID-19, PROVIDING ONE OUT OF EVERY FOUR PEOPLE WITH A FALSE-NEGATIVE. THE TEAM ALSO SHOWED THAT ONE TEST AVAILABLE TODAY MISSES AS MANY AS ONE IN THREE INFECTED INDIVIDUALS, WHILE ANOTHER MAY MISS UP TO 60 PERCENT OF POSITIVE CASES. FIRST-OF-ITS-KIND STUDY FOUND INFANTS OF SOCIALLY VULNERABLE MOTHERS WERE AT HIGHEST RISK OF COVID-19 INFECTIONIN A STUDY PUBLISHED IN JAMA NETWORK OPEN, PHYSICIAN-RESEARCHERS FROM BIDMC, BRIGHAM AND WOMEN'S HOSPITAL, BOSTON CHILDREN'S HOSPITAL AND MASSACHUSETTS GENERAL HOSPITAL REVEALED THAT, WHILE MOTHER-TO-NEWBORN TRANSMISSION OF THE VIRUS IS RARE, NEWBORNS OF EXPECTANT MOTHERS WITH COVID-19 CAN SUFFER INDIRECT ADVERSE HEALTH RISKS AS A RESULT OF WORSENING MATERNAL COVID-19 ILLNESS. EXAMINING NEONATAL OUTCOMES DURING THE FIRST MONTH OF LIFE FOR BABIES BORN AT 11 HOSPITALS THAT REPRESENT APPROXIMATELY 50 PERCENT OF ALL BIRTHS IN MASSACHUSETTS, THE TEAM IDENTIFIED 255 NEONATES DELIVERED BETWEEN MARCH 1 JULY 31, 2020, TO MOTHERS WITH A RECENT POSITIVE SARS-COV-2 TEST RESULT. THE RESEARCHERS USED THE AMERICAN ACADEMY OF PEDIATRICS' NATIONAL REGISTRY FOR SURVEILLANCE AND EPIDEMIOLOGY OF PERINATAL COVID-19 INFECTION COMPLEMENTED BY A MASSACHUSETTS-SPECIFIC REGISTRY. OUT OF THE 255 NEONATES STUDIED, 88.2 PERCENT WERE TESTED FOR SARS-COV-2, AND ONLY 2.2 PERCENT HAD POSITIVE RESULTS. HOWEVER, WHILE INFECTION RATES AMONG NEWBORNS WERE RELATIVELY LOW, WORSENING MATERNAL ILLNESS ACCOUNTED FOR 73.9 PERCENT OF PRETERM BIRTHS. PREMATURE BIRTH CAN OFTEN LEAD TO ACUTE AND CHRONIC COMPLICATIONS, INCLUDING RESPIRATORY DISTRESS, CHRONIC HEALTH PROBLEMS AND DEVELOPMENTAL DISABILITIES. NEWBORNS OF SOCIALLY VULNERABLE MOTHERS, AS DETERMINED USING A TOOL CREATED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION USING RESIDENTIAL ZIP-CODES, WERE AT AN INCREASED RISK FOR TESTING POSITIVE. THE SPECIFIC PATHWAYS BY WHICH SOCIAL VULNERABILITY MIGHT AFFECT MOTHER-TO-CHILD TRANSMISSION OF COVID-19 INCLUDE DIFFERENTIAL ACCESS TO CARE AND CLINICIAN BIAS. DISCRIMINATION MAY ALSO BE A FACTOR IN CHRONIC STRESS, WHICH CAN DIMINISH ANTIVIRAL IMMUNE RESPONSES. "THIS OBSERVATION THAT NEWBORNS OF SOCIALLY VULNERABLE MOTHERS WERE FIVE TIMES MORE LIKELY TO HAVE COVID-19 HIGHLIGHTS THAT HEALTH DISPARITIES ARE VERY COMPLEX AND EXTEND BEYOND RACE, ETHNICITY AND LANGUAGE STATUS," SAID CORRESPONDING AUTHOR ASIMENIA ANGELIDOU, MD, PHD, A NEONATOLOGIST AT BIDMC. "SOCIAL VULNERABILITY LIKELY AFFECTS HEALTH AND IMMUNITY AND OUR STUDY SUPPORTS FURTHER RESEARCH IN THIS AREA. REALLOCATION OF RESOURCES TO SOCIALLY VULNERABLE COMMUNITIES COULD GO A LONG WAY IN DECREASING HUMAN SUFFERING AND ECONOMIC LOSS DURING DISEASE OUTBREAKS." JANUARY 20, 2020SCIENTISTS CREATE FIRST-OF-ITS-KIND 3D ORGANOID MODEL OF THE HUMAN PANCREAS BECAUSE PANCREATIC CANCER IS HIDDEN DEEP WITHIN THE BODY AND OFTEN SYMPTOMLESS, IT'S FREQUENTLY DIAGNOSED AFTER THE DISEASE HAS PROGRESSED TOO FAR FOR SURGICAL INTERVENTION AND/OR HAS SPREAD THROUGHOUT THE BODY. RESEARCH INDICATES THAT EARLIER DETECTION OF PANCREATIC TUMORS COULD QUADRUPLE SURVIVAL RATES; HOWEVER, NO VALIDATED AND RELIABLE TESTS FOR EARLY DETECTION OF PANCREATIC CANCER CURRENTLY EXIST.
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RESEARCHERS AT THE CANCER RESEARCH INSTITUTE AT BIDMC HAVE
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SUCCESSFULLY CREATED THE FIRST THREE-DIMENSIONAL (3D) ORGANOID MODELS OF THE PANCREAS FROM HUMAN STEM CELLS. UNLIKE PREVIOUS PLATFORMS FOR THE STUDY OF PANCREATIC CANCER, THIS FIRST-OF-ITS-KIND ORGANOID MODEL INCLUDES BOTH THE ACINAR AND DUCTAL STRUCTURES THAT PLAY A CRITICAL ROLE IN THE MAJORITY OF PANCREATIC CANCERS. THE NEW RESEARCH PLATFORM WHICH IS NOT EXPECTED TO GUIDE PATIENT CARE AT THIS TIME WILL SHED NEW LIGHT ON THE ORIGINS AND DEVELOPMENT OF PANCREATIC CANCER, AS WELL AS REVEAL POTENTIAL MEANS FOR DISCOVERING MARKERS OF EARLY DIAGNOSIS AND MONITORING THE DISEASE. THE TEAM'S REPORT APPEARS IN CELL STEM CELL. "WE THOUGHT, IF WE HAD A WAY TO USE HUMAN PANCREATIC CELLS TO FORWARD ENGINEER CANCER, WE COULD BEGIN TO UNDERSTAND THE EARLIEST STEPS IN THE DEVELOPMENT OF THIS DISEASE," SAID CORRESPONDING AUTHOR SENTHIL MUTHUSWAMY, PHD, DIRECTOR OF CELL BIOLOGY AT THE CANCER RESEARCH INSTITUTE AT BIDMC. "THIS MODEL COULD ALSO SERVE AS A PLATFORM TO POTENTIALLY DISCOVER BIOMARKERS MEASURABLE CHANGES LINKED TO DISEASE THAT WE HOPE TO USE IN THE CLINIC TO MONITOR CANCER DEVELOPMENT." THE PANCREAS IS A HORMONE-SECRETING ORGAN CONSISTING OF DUCTS AND ACINAR STRUCTURES, OR SACLIKE STRUCTURES THAT STORE PANCREATIC SECRETIONS. UNTIL NOW, SCIENTISTS HAVE NOT BEEN ABLE TO SUCCESSFULLY GROW AND MAINTAIN HUMAN ACINAR STRUCTURES IN THE LAB CHALLENGING THEIR ABILITY TO TEST THE HYPOTHESIS IN A MODEL. RESEARCHERS SUSPECT THAT THE MOST COMMON KIND OF PANCREATIC CANCER ARISES IN THE CELLS LINING ACINAR AND DUCTAL STRUCTURES.THE CULMINATION OF FIVE-PLUS YEARS OF WORK, THE STUDY REPRESENTS THE FIRST TIME RESEARCHERS SUCCESSFULLY GENERATED HUMAN ACINAR CELLS IN CULTURE AND MAINTAINED THEM LONG ENOUGH TO BE ABLE TO USE THEM IN EXPERIMENTS. FINANCIAL BURDENS ASSOCIATED WITH CANCER CARE DISPROPORTIONATELY AFFECTS YOUNG, NON-WHITE PATIENTS WITH GYNECOLOGIC CANCERSTHE COST OF CANCER CARE IN UNITED STATES WAS AN ESTIMATED $183 BILLION IN 2015 AND IS PROJECTED TO RISE BY 30 PERCENT BY 2030, ACCORDING TO THE AMERICAN CANCER SOCIETY. WHILE PRIVATE AND GOVERNMENT INSURANCE MAY COVER MUCH OF THE COST OF CARE, EVEN PATIENTS WITH INSURANCE CAN STRUGGLE TO PAY FOR OFFICE VISIT CO-PAYMENTS, PRESCRIPTION MEDICATIONS OR OTHER CANCER-RELATED EXPENSES. YET LIMITED DATA DESCRIBES HOW FINANCIAL HARDSHIP IMPACTS PATIENT BEHAVIOR AND HOW THAT IN TURN MAY IMPACT PATIENTS' HEALTH. IN A STUDY DESIGNED TO PROVIDE A MORE COMPREHENSIVE PICTURE OF HOW A DIVERSE COHORT OF GYNECOLOGIC CANCER PATIENTS ARE AFFECTED BY FINANCIAL DISTRESS ALSO CALLED "FINANCIAL TOXICITY" IN ACKNOWLEDGMENT OF THE HEALTH HAZARD IT CAN POSE RESEARCHER-PHYSICIANS AT BIDMC AND THE UNIVERSITY OF ALABAMA (UAB) ANALYZED PREVIOUSLY COLLECTED SURVEY DATA OF GYNECOLOGIC ONCOLOGY PATIENTS FROM THEIR RESPECTIVE INSTITUTIONS. THEIR FINDINGS ARE REPORTED IN THE INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER. USING THE COMPREHENSIVE SCORE FOR FINANCIAL TOXICITY (COST) TO MEASURE THE ECONOMIC BURDEN EXPERIENCED BY PATIENTS WITH CANCER, CORRESPONDING AUTHOR KATHARINE M. ESSELEN, MD, MBA, OF THE DIVISION OF GYNECOLOGIC ONCOLOGY IN THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, AND COLLEAGUES ANALYZED PREVIOUSLY COLLECTED SURVEY DATA FROM 308 PATIENTS WITH GYNECOLOGIC CANCER 240 PATIENTS SURVEYED AT BIDMC AND 121 SURVEYED AT UAB. THEY FOUND THAT NEARLY HALF OF PATIENTS WITH GYNECOLOGIC CANCER REPORTED EXPERIENCING MODERATE TO SEVERE FINANCIAL TOXICITY. FURTHER ANALYSIS OF SURVEY DATA REVEALED THAT YOUNGER PATIENTS WERE AT GREATER RISK OF EXPERIENCING FINANCIAL TOXICITY FOR A VARIETY OF REASONS. YOUNGER PATIENTS ARE NOT ELIGIBLE FOR MEDICARE, AND DIAGNOSIS AND TREATMENT MAY IMPACT THEIR ABILITY TO WORK. THEY HAVE ALSO HAD FEWER EARNING YEARS TO ACCUMULATE A FINANCIAL SAFETY NET. PATIENTS REPORTING SEVERE FINANCIAL TOXICITY ACCOUNTED FOR 15 PERCENT OF THOSE SURVEYED. ESSELEN AND COLLEAGUES FOUND THIS GROUP MORE LIKELY TO REPORT CHANGING SPENDING HABITS AND BORROWING MONEY DUE TO THE COSTS OF CANCER CARE. MOST ALARMINGLY, THOSE REPORTING SEVERE FINANCIAL HARDSHIP WERE NEARLY FIVE TIMES MORE LIKELY TO ATTEMPT TO COPE WITH THE HIGH COST OF CARE THROUGH MEDICATION NON-COMPLIANCE. IMMUNOTHERAPY MAY BE EFFECTIVE FOR SUBSET OF PROSTATE CANCER IN RECENT YEARS, CANCER IMMUNOTHERAPY HAS BEEN EFFECTIVE IN TREATING PATIENTS WITH IMMUNOGENIC, OR SO-CALLED "HOT" TUMORS WITH INCREASED LEVELS OF INFLAMMATION AND THE PRESENCE OF IMMUNE CELLS IN AND AROUND THE TUMORS. PROSTATE CANCER, HOWEVER, IS CONSIDERED A "COLD" TUMOR, WITH FEW IMMUNE CELLS RECOGNIZING AND INFILTRATING PROSTATE MALIGNANCIES. ACCORDINGLY, PROSTATE CANCER HAS BEEN FOUND TO RESPOND POORLY TO THE CLASS OF IMMUNOTHERAPIES KNOWN AS IMMUNE CHECKPOINT INHIBITORS. IN PREVIOUS WORK, A TEAM LED BY MEDICAL ONCOLOGISTS AT BIDMC IDENTIFIED A SUBSET OF PROSTATE CANCERS THAT EXHIBITED CHARACTERISTICS MORE TYPICAL OF HOT CANCERS. IN A PAPER APPEARING IN THE JOURNAL CLINICAL CANCER RESEARCH, RESEARCHERS REPORT THAT ABOUT A QUARTER OF LOCALIZED PROSTATE CANCERS MAY DEMONSTRATE THESE IMMUNOLOGIC TRAITS, SUGGESTING THAT A SUBSTANTIAL NUMBER OF PATIENTS WITH PROSTATE CANCER MAY, IN FACT, BENEFIT FROM IMMUNOTHERAPIES. "WE WERE SURPRISED TO FIND ALL THE FEATURES OF MORE TRADITIONALLY IMMUNOGENIC CANCERS IN THESE PROSTATE CANCERS, AND THAT THIS IS NOT A RARE SUBTYPE, OBSERVED IN ABOUT A QUARTER OF HIGH-RISK TUMORS," SAID CO-CORRESPONDING AUTHOR DAVID J. EINSTEIN, MD, A MEDICAL ONCOLOGIST AT BIDMC. "WE'RE INTERESTED IN WHETHER THERE IS A SUBSET OF PATIENTS WITH LOCALIZED PROSTATE CANCER, ESPECIALLY MORE AGGRESSIVE ONES, WHOSE CANCERS MIGHT BE MORE RECOGNIZED BY THE IMMUNE SYSTEM AND THEREFORE MORE TREATABLE WITH IMMUNOTHERAPIES. THESE WOULD ALSO BE SOME OF THE PATIENTS AT GREATEST RISK FOR RELAPSE AND METASTATIC SPREAD." EINSTEIN AND COLLEAGUES, INCLUDING CO-CORRESPONDING AUTHOR STEVEN BALK, MD, PHD, A PHYSICIAN AT BIDMC, FOCUSED ON TWO CHARACTERISTICS THAT MAKE TRADITIONALLY IMMUNOGENIC CANCERS SUSCEPTIBLE TO IMMUNOTHERAPY: PD-L1 EXPRESSION AND T CELL INFILTRATION. PD-L1 IS A PROTEIN INVOLVED IN TUMOR EVASION OF THE IMMUNE SYSTEM. T CELLS ARE THE SENTINELS OF THE IMMUNE SYSTEM, PATROLLING THE BODY FOR POTENTIAL PATHOGENS OR DISEASE. THE RESEARCHERS IDENTIFIED PROSTATE CANCERS THAT HAD BEEN REMOVED FROM PATIENTS, LOOKING FOR THOSE THAT HAD AREAS OF HIGH PD-L1 EXPRESSION AND THEN LOOKED FOR THE PRESENCE OF INFILTRATING T CELLS. NEXT, THE TEAM COMPARED THE T CELL LANDSCAPE IN THE MORE IMMUNOGENIC PROSTATE CANCERS TO THAT OF MORE TYPICAL PROSTATE CANCERS, AS WELL AS TO KIDNEY CANCER, ONE OF THE MOST IMMUNOGENIC TUMOR TYPES. FINALLY, THE TEAM USED DNA SEQUENCING TO COMPARE THE GENETIC PROFILES FROM THESE IMMUNOLOGICALLY HOT AREAS TO THAT OF THE SO-CALLED COLD AREAS IN THE SAME TUMORS, AS WELL AS TO THE GENOMIC LANDSCAPE OF IMMUNOGENIC CANCERS IN GENERAL. THE SCIENTISTS WERE SURPRISED TO LEARN HOW MANY MORE T CELLS INFILTRATED THE IMMUNOGENIC PROSTATE CANCERS COMPARED WITH MORE TYPICAL PROSTATE CANCERS, AND TO OBSERVE ALL THE FEATURES OF MORE TRADITIONALLY IMMUNOGENIC CANCERS LIKE KIDNEY CANCER IN THESE MORE IMMUNOGENIC PROSTATE CANCERS. THEY ALSO NOTED SIGNIFICANTLY MORE LOSS OF SOME KEY TUMOR SUPPRESSOR GENES IN THESE IMMUNOGENIC PROSTATE CANCERS COMPARED WITH TYPICAL PROSTATE CANCER, A DIFFERENCE THAT COULD POTENTIALLY SERVE AS MARKERS TO FIND CANCERS MORE TREATABLE WITH IMMUNOTHERAPIES. AS NOTED THROUGHOUT THIS FILING BIDP IS PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER IN BOSTON AND A SISTER ENTITY OF BIDP. AS PART OF THE SAME NETWORK, THE ACADEMIC TEACHING AND TRAINING IN WHICH BIDMC ENGAGES SUPPORTS NOT ONLY THE BIDMC MISSION, CARE FOR BIDMC PATIENTS AND COMMUNITIES BUT BIDMC'S COMMITMENT TO TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW ALSO HELPS TO IMPROVE PATIENT CARE FOR THE COMMUNITIES OF OTHER BILH AFFILIATES AND BEYOND. THE DETAIL BELOW PROVIDES BACKGROUND ON THE TEACHING ACTIVITIES AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING.
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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GRADUATE MEDICAL EDUCATION 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, 2021 JUNE 30, 2022, 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 YEARS.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 BETWEEN THE PRELIMINARY AND CATEGORICAL TRACKS 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, THEY ARE 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 BOTH 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.
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SCHEDULE H, PART VI, QUESTIONS 5 AND 6
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MAH-ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY OPEN MEDICAL STAFF AND COMMUNITY BOARDTHE 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.AFFILIATED HEALTH CARE SYSTEMAS NOTED BELOW AND THROUGHOUT THIS FILING, MAH IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. AS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL LAHEY HEALTH'S (BILH) MISSION IS TO SUPPORT ITS AFFILIATES AND THOSE AFFILIATES' MISSIONS TO IMPROVE THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY PROVIDING SERVICES TO ITS AFFILIATES WHICH SUPPORT THE DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO ACCESS SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE.BETH ISRAEL LAHEY HEALTH (BILH) IS THE PARENT AND A SUPPORT ORGANIZATION OF THE BILH NETWORK OF AFFILIATES. THE NETWORK COMPRISES AN INTEGRATED HEALTH CARE DELIVERY 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 INCLUDES 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 AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES.DURING THE FISCAL PERIOD COVERED BY THIS FILING, BILH SERVED AS THE SOLE MEMBER 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 HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN) AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER (LHMC). THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. AS A SUPPORT ORGANIZATION OF THESE ENTITIES, BILH PROVIDES CENTRALIZED SERVICES AND SUPPORT TO ITS AFFILIATES IN AREAS SUCH AS MANAGEMENT, STRATEGIC PLANNING, HUMAN RESOURCES AND BENEFITS, DEVELOPMENT AND FUNDRAISING, LEGAL SERVICES, FINANCE, TREASURY, INVESTMENT, INSURANCE, COMPLIANCE AND TAXATION AS WELL AS PATIENT CARE CONTRACTING AND OTHER SERVICES.BILH'S SUPPORT OF ITS AFFILIATES ENABLES THE NETWORK AS A WHOLE TO ACCOMPLISH ITS PRIMARY MISSION OF IMPROVING THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO USE SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE AND BILH IS ACCOMPLISHING THIS GOAL BY PROVIDING SUPPORT TO EACH OF ITS AFFILIATES, PROVIDING AN ORGANIZATIONAL STRUCTURE AND OPERATING MODEL WHICH IS DRIVEN BY FOUR DEEPLY INTERCONNECTED DOMAINS DESIGNED TO ADVANCE MEANINGFUL PARTNERSHIPS ACROSS ORGANIZATIONS, CARE SETTINGS, SPECIALTIES, AND GEOGRAPHIES TO ENSURE BILH PATIENTS RECEIVE THE CARE THEY NEED IN THE COMMUNITIES WHERE THEY LIVE AND WORK.BILH IS DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. BILH IS ACCOMPLISHING THIS MISSION BY PROVIDING SUPPORT TO ITS AFFILIATES WHICH INCLUDE:1. A PHYSICIAN ENTERPRISE THAT ENCOMPASSES THE SYSTEM'S NETWORK OF EMPLOYED PRIMARY CARE AND SPECIALTY PHYSICIANS LOCATED THROUGHOUT OUR REGION;2. A HOSPITAL AND AMBULATORY SERVICES GROUP THAT INCLUDES WORLD-CLASS ACADEMIC MEDICAL CENTERS AND TEACHING HOSPITALS WITH AFFILIATIONS WITH HARVARD MEDICAL SCHOOL AND TUFTS UNIVERSITY SCHOOL OF MEDICINE; LEADING COMMUNITY HOSPITALS; A RENOWNED ORTHOPEDICS HOSPITAL; AND COMPREHENSIVE AMBULATORY CENTERS;3. A POPULATION HEALTH ENTERPRISE THAT EMBRACES A NEW MODEL OF CARE TO IMPROVE THE HEALTH OF ALL THOSE SERVED BY BILH; THE POPULATION HEALTH DOMAIN INCLUDES THE SYSTEM'S CLINICALLY INTEGRATED NETWORK OF AFFILIATED PROVIDERS AND VITAL SERVICES, INCLUDING BEHAVIORAL HEALTH AND HOME CARE SERVICES;4. A ROBUST NETWORK OF ADMINISTRATIVE AND OPERATIONAL SERVICES TO ADVANCE STRATEGIC GOALS, BOTH LOCALLY AND AT THE SYSTEM LEVEL, THAT OFFERS EXPERTISE AND STANDARDIZED RESOURCES BASED ON BEST PRACTICES.BILH BEHAVIORAL HEALTH SERVICESTHE BETH ISRAEL LAHEY HEALTH NETWORK (BILH) IS COMMITTED TO THE BEHAVIORAL HEALTH NEEDS OF THE PATIENTS AND COMMUNITIES SERVICED. BELOW ARE SOME OF ACTIVITIES THAT BILH BEHAVIORAL SERVICES (BILHBS) HAS PROVIDED TO THE PATIENTS AND COMMUNITIES SERVED BY BILH AND ITS AFFILIATED ENTITIES. BILHBS (WHICH INCLUDES THE ACTIVITIES OF BILH'S TAX-EXEMPT AFFILIATE NORTHEAST BEHAVIORAL HEALTH CORP) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS. BILHBS' NETWORK OF BEHAVIORAL HEALTH CARE INCLUDES SERVICES FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TREATMENT TO COMMUNITY-BASED PROGRAMS. SERVICES INCLUDE: - INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT;- EMERGENCY PSYCHIATRIC AND MOBILE EMERGENCY SERVICES TEAMS; - OUTPATIENT MENTAL HEALTH AND ADDICTION TREATMENT;- INDIVIDUAL/COUPLE/FAMILY THERAPY; - MEDICATION ASSISTED TREATMENT PROGRAMS FOR PERSONS WITH OPIOID USE DISORDERS; AND- SCHOOL-BASED AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES.SINCE THE CREATION OF BILH IN MARCH 2019, BILH HAS INVESTED SIGNIFICANTLY IN IMPROVING ACCESS TO BEHAVIORAL HEALTH CARE THROUGH A SYSTEM-WIDE APPROACH TO CARE DELIVERY. FIRST, IT HAS MADE A MULTI-YEAR COMMITMENT TO PROVIDE BEHAVIORAL HEALTH SUPPORT TO ITS EMPLOYED PRIMARY CARE PRACTICES USING AN EVIDENCE-BASED APPROACH KNOWN AS THE IMPACT MODEL. BY THE END OF FY 2021, BILH HAD IMPLEMENTED THE IMPACT MODEL IN 67% OF ITS EMPLOYED PRIMARY CARE PRACTICES AS PART OF ITS COLLABORATIVE CARE PROGRAM IMPLEMENTATION. IN 2021, BILHBS EXPANDED ITS PRIMARY CARE BEHAVIORAL HEALTH INTEGRATION (PCBHI) SERVICES BY INCORPORATING A DSRIP PILOT PROJECT AIMED AT INTERPROFESSIONAL PSYCHIATRIC CONSULTS. THE PCBHI INTERPROFESSIONAL CONSULTATION INCLUDES AN ASSESSMENT AND MANAGEMENT SERVICE IN WHICH A PATIENT'S PRIMARY CARE PROVIDER (PCP) REQUESTS THE OPINION AND/OR TREATMENT ADVICE OF A PSYCHIATRIC CONSULTANT TO ASSIST IN THE DIAGNOSIS AND/OR MANAGEMENT OF THE PATIENT'S BEHAVIORAL HEALTH CONDITION WITHOUT THE NEED FOR THE PATIENT'S FACE-TO-FACE CONTACT WITH THE CONSULTANT. INTERPROFESSIONAL CONSULTATION ENABLES A COMPREHENSIVE ASSESSMENT, ENHANCES PATIENT CARE, REDUCES MISDIAGNOSIS, AND SUPPORTS THE INTEGRATION OF DISCIPLINES IN THE DELIVERY OF CARE. THE PCBHI INTERPROFESSIONAL PSYCHIATRIC CONSULTANTS PROVIDE PCPS WITH ANOTHER AVENUE FOR INTEGRATED CARE. THE IMPLEMENTATION OF PCBHI INTERPROFESSIONAL SERVICES WILL BE OFFERED IN PRACTICES WHERE COLLABORATIVE CARE IS NOT CURRENTLY AVAILABLE. ADDITIONALLY, IN 2021, BILHBS CONTINUED TO OVERSEE THE BILH-WIDE CENTRALIZED BEHAVIORAL HEALTH (BH) BED MANAGEMENT, WHICH SUPPORTS INPATIENT BEHAVIORAL HEALTH BED CAPACITY AND IMPROVING ACCESS TO THESE BEDS, WITH THE PARALLEL GOAL OF REDUCING BOARDING BY BEHAVIORAL HEALTH PATIENTS IN THE EMERGENCY DEPARTMENTS ("EDS"). AS PART OF THE CENTRALIZED BH BED MANAGEMENT, BILH STAFF ENGAGE IN A DAILY HUDDLE WITH REPRESENTATIVES FROM BILH HOSPITALS' EDS AND BEHAVIORAL HEALTH UNITS TO DISCUSS PATIENTS APPROPRIATE FOR TRANSFER TO THE UNIT. THE DAILY HUDDLES HAVE BECOME A FORUM FOR WHICH PARTICIPANTS DISCUSS BEHAVIORAL HEALTH PATIENT VOLUME AND BED CAPACITY ACROSS THE SYSTEM, AS WELL AS DISCHARGE PLANNING AND PLACEMENT OPPORTUNITIES FOR DIFFICULT-TO-PLACE PATIENTS.
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SCHEDULE H, PART VI, QUESTIONS 5 AND 6
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SEPARATELY, IN MARCH 2021, BILHBS LAUNCHED ITS CENTRALIZED BED FINDING TEAM. THIS TEAM IS PART OF OUR CENTRAL CALL CENTER, WHICH CENTRALIZES CALLS TO BILHBS' THREE EMERGENCY SERVICE PROGRAM (ESP) CATCHMENT AREAS REDUCING REDUNDANCIES ACROSS THE AGENCY AND STREAMLINING ALL CALLS TO ONE CENTRAL SERVICE. THIS CENTRALIZED BED FINDING TEAM IS RESPONSIBLE FOR CONDUCTING BED SEARCHES FOR PATIENTS SEEN THROUGH THE ESP AND WHO ARE AWAITING AN INPATIENT PSYCHIATRIC PLACEMENT. THIS TEAM DIRECTLY INCREASES THE AVAILABILITY OF CLINICIANS TO CONTINUE TO SEE PATIENTS IN THE ED AND THE COMMUNITY WHO ARE EXPERIENCING A BEHAVIORAL HEALTH AND/OR CO-OCCURRING SUBSTANCE USE DISORDER CRISIS WHILE OTHER TEAM MEMBERS SEARCH FOR AVAILABLE INPATIENT PLACEMENTS. THIS INITIATIVE SUPPORTS DECREASED RESPONSE TIME TO RESPONDING TO NEW PATIENTS IN CRISIS AND REDUCES ED BOARDING TIME FOR PATIENTS WHO CAN BE SAFELY MANAGED IN THE COMMUNITY.BILHBS SERVES APPROXIMATELY 35,000 UNDUPLICATED INDIVIDUALS ANNUALLY, OFFERING A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS. SERVICES RANGE FROM INPATIENT TO HOME AND COMMUNITY-BASED SERVICES. BILHBS OPERATES OVER 250 BEDS IN 9 FACILITIES FOR CLIENTS REQUIRING ACUTE PSYCHIATRIC CARE, DETOXIFICATION AND RESIDENTIAL STEP-DOWN SERVICES. DURING THE PERIOD COVERED BY THIS FILING, COMMUNITY-BASED SERVICES INCLUDED MOBILE EMERGENCY SERVICES TEAMS IN THREE CATCHMENT AREAS AND HOME-BASED COUNSELING FOR ADULTS, YOUTH AND THEIR FAMILIES. BILHBS ALSO PROVIDED SERVICES IN 63 MIDDLE AND HIGH SCHOOLS, AS WELL AS 9 POLICE DEPARTMENTS.BILHBS ALSO CONTINUES TO IMPROVE ACCESS THROUGH THE URGENT PSYCHOPHARMACOLOGY SERVICES IN BILH'S LOWELL EMERGENCY SERVICES PROGRAM. THIS CLINIC PROVIDES URGENT ACCESS FOR PATIENTS REQUIRING A CHANGE TO THEIR MEDICATIONS. THIS SERVICE IS OFFERED 20 HOURS PER WEEK AND INCLUDES UNINSURED, MEDICAID, AND MEDICARE POPULATIONS, AS WELL AS ANY PERSON IN NEED OF THE SERVICE REGARDLESS OF THE PAYER SOURCE. BILH'S COMMUNITY CRISIS STABILIZATION ("CCS") UNITS IN LAWRENCE AND SALEM, WHICH TYPICALLY CARE FOR PATIENTS WITH MENTAL HEALTH ISSUES, INCREASED THEIR ABILITY TO TREAT PERSONS WITH CO-OCCURRING SUBSTANCE USE DISORDERS. THE CCS UNITS CONTINUE TO BE ABLE TO INDUCT PATIENTS WITH OPIOID USE DISORDER (OUD) ON BUPRENORPHINE AND ARE ALSO ABLE TO MAINTAIN PATIENTS WHO ARE ALREADY ON ANY OF THE THREE FDA APPROVED MEDICATIONS FOR THE TREATMENT OF OUD. THESE UNITS ARE SEEING AN INCREASE IN THE NUMBER OF PATIENTS WITH METHAMPHETAMINE DISORDERS AND HAVE DEVELOPED A PROTOCOL TO MANAGE WITHDRAWAL SYMPTOMS IN THIS POPULATION.BILHBS CONTINUES TO MAINTAIN AND ENHANCE ITS TELEHEALTH PLATFORM AND CLINICAL DELIVERY THROUGH THE USE OF DIGITAL APPLICATIONS ACROSS ALL OF ITS AMBULATORY PROGRAMS. SPECIAL EMPHASIS WAS PLACED ON SPANISH-LANGUAGE ACCESS TO LAWRENCE-BASED PROGRAMS TO ENSURE PATIENTS IN THIS REGION ACCESS LINGUISTICALLY-APPROPRIATE CARE. IN 2021, BILHBS IDENTIFIED IMPROVEMENT OF THE PATIENT EXPERIENCE AS A KEY STRATEGIC PRIORITY. TO THAT END, ALL PROGRAM DIRECTORS ARE EVALUATED AGAINST THIS GOAL AND ARE REQUIRED TO COMPLETE TWO PLAN-DO-STUDY-ACT (PDSA) CYCLES ANNUALLY. PDSA IS A WELL-ESTABLISHED PROCESS IMPROVEMENT FRAMEWORK USED IN HEALTHCARE. PROGRAM DIRECTORS REVIEW PATIENT FEEDBACK TO DEVELOP PILOT INTERVENTIONS, ANALYZE THE RESULTS, AND THEN MAKE ADJUSTMENTS TO THE INTERVENTION. EXAMPLES OF OUTCOMES ACHIEVED THROUGH THE PDSA APPROACH INCLUDE ENHANCING THE PATIENT ENGAGEMENT MODEL FOR THE BEHAVIORAL HEALTH COMMUNITY PARTNERS (BHCP) PROGRAM; IMPROVING PATIENT EXPERIENCES AND ENGAGEMENT IN THE USE OF TELEHEALTH PLATFORMS IN BILHBS' LAWRENCE OUTPATIENT SITE, IMPROVING THE ADMISSION PROCESS IN THE BILHBS GLOUCESTER OPIOID TREATMENT CENTER, REDUCING ADMINISTRATIVE DISCHARGES BY IMPLEMENTING A HARM REDUCTION MODEL, AND IMPROVING EXTERNAL REFERRAL EXPERIENCE AT THE BILHBS HAVERHILL OUTPATIENT AND CHILDREN'S BEHAVIORAL HEALTH INITIATIVES (CBHI) PROGRAMS.
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BETH ISRAEL LAHEY HEALTH'S COVID-19 PANDEMIC RESPONSE
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AS IN THE PRIOR YEAR, BETH ISRAEL LAHEY HEALTH'S ("BILH") HOSPITALS AND OTHER PATIENT CARE ORGANIZATIONS EXPENDED SIGNIFICANT TIME AND RESOURCES ACROSS FY 2021 IN THEIR CONTINUED EFFORTS TO RESPOND TO THE COVID-19 PANDEMIC. IN ADDITION TO PROVIDING COVID-19 TESTING AND TREATMENT, THE HEALTH SYSTEM INITIATED PATIENT AND STAFF VACCINATION EFFORTS IN FY 2021, REACHING OUT TO 1.3 MILLION PATIENTS USING A MULTICHANNEL, MULTILINGUAL APPROACH AND ULTIMATELY DELIVERING OVER 400,000 VACCINE DOSES. THE SYSTEM SUCCESSFULLY UNDERTOOK THESE EFFORTS WHILE ALSO NAVIGATING UNPRECEDENTED FINANCIAL AND OPERATIONAL CHALLENGES STEMMING FROM THE PANDEMIC, INCLUDING ONGOING WORKFORCE DISRUPTION AND A DECLINE IN PATIENT VOLUME DUE TO THE CURTAILMENT OF ELECTIVE SERVICES AND STAFFING CHALLENGES.HIGHLIGHTS OF THE SYSTEM'S PANDEMIC RESPONSE IN FY 2021 INCLUDE:STAFF TESTING, VACCINATION, AND SUPPORT IN NOVEMBER 2020, BILH IMPLEMENTED A PROGRAM TO PROVIDE ITS 36,000 EMPLOYEES WITH ACCESS TO ONSITE, VOLUNTARY, AND FREE-OF-CHARGE COVID-19 PCR TESTING, EVEN IF THEY HAD NO KNOWN EXPOSURE OR SYMPTOMS. IN ADDITION TO SERVING AS AN IMPORTANT ELEMENT TO CONTAIN COMMUNITY SPREAD OF COVID-19, THIS EFFORT BOOSTED BILH STAFF MORALE AND CONFIDENCE DURING THIS CHALLENGING PERIOD. IN DECEMBER 2020, BILH STOOD UP STAFF VACCINATION SITES AT ITS LOCAL HOSPITALS, ULTIMATELY DELIVERING 70,000 VACCINE DOSES TO ITS WORKFORCE IN FY 2021. THE SYSTEM TOOK PROGRESSIVE MEASURES AROUND EMPLOYEE PAID TIME OFF TO SUPPORT VACCINATION EFFORTS AS WELL AS FAMILY CARE NEEDS AND TIME MISSED DUE TO COVID-19 ILLNESS OR TESTING. IN THE SUMMER OF 2021, BILH COMMUNICATED THAT COVID-19 AND FLU VACCINE WOULD BE REQUIRED AS A CONDITION OF EMPLOYMENT; THE COVID-19 VACCINATION DEADLINE WAS SUCCESSFULLY COMPLETED ON OCTOBER 31, 2021. BILH OPERATIONALIZED A CENTRALIZED CALL CENTER TO SUPPORT STAFF WITH SYMPTOM REPORTING, COVID-19 TESTING, AND RETURN-TO-WORK PROCESSES. THE CALL CENTER ENSURED CONVENIENT AND ACCESSIBLE INFORMATION FOR A WORKFORCE SPREAD THROUGHOUT EASTERN MASSACHUSETTS. AT ITS PEAK, THE CENTRALIZED CALL CENTER HANDLED OVER 1,000 PHONE CALLS PER DAY.PATIENT VACCINATION NEARLY IMMEDIATELY UPON RECEIVING VACCINE SUPPLY THAT COULD BE USED FOR PATIENTS, BILH OPENED AND OPERATED 10 VACCINE ADMINISTRATION SITES ACROSS EASTERN MASSACHUSETTS. THE LOCATIONS WERE SELECTED BASED ON SEVERAL CRITERIA, INCLUDING PROXIMITY TO HARD-HIT COMMUNITIES AND EASE OF ACCESS IN TERMS OF TRANSPORTATION. THIS WAS A SIGNIFICANT LOGISTICAL FEAT IN LIGHT OF THE SHIFTING FORECASTS IN VACCINE SUPPLY AND SPECIAL HANDLING REQUIRED FOR THE PFIZER VACCINE. BILH DEVELOPED ITS OWN VACCINATION SCHEDULING TOOL, COVAX, TO SUPPORT STAFF AND PATIENT VACCINATION EFFORTS. THIS TOOL ENABLED BILH TO IDENTIFY PATIENTS ELIGIBLE FOR VACCINATION BASED ON STATE GUIDELINES, SCHEDULE APPOINTMENTS, AND TRACK VACCINATION ACTIVITY. BILH LED A TARGETED CAMPAIGN TO SUPPORT HEALTH EQUITY BY PRIORITIZING FOR VACCINATION BILH PATIENTS WHO RESIDED IN A COMMUNITY OR TOWN IDENTIFIED AS HAVING AMONG THE HIGHEST CUMULATIVE INCIDENCE OF COVID-19 WITHIN THE STATE OF MASSACHUSETTS. BILH ALSO COORDINATED WITH MULTIPLE COMMUNITY HEALTH CENTERS TO PROVIDE THEIR PATIENTS WITH PRIORITY ACCESS TO VACCINATION APPOINTMENTS. DUE TO THESE EFFORTS, BETH ISRAEL DEACONESS CARE ORGANIZATION ("BIDCO"), AN ACCOUNTABLE CARE ORGANIZATION ("ACO") WITHIN BILH, HAD THE HIGHEST COVID-19 VACCINATION RATE FOR MEDICAID MEMBERS AMONG ALL MEDICAID ACOS IN THE STATE. BILH ESTABLISHED THE COVID-19 HEALTH EQUITY ADVISORY COUNCIL ("THE COUNCIL") WITH A GOAL TO ADDRESS HEALTH DISPARITIES BROUGHT ON BY THE PANDEMIC, LANGUAGE BARRIERS, AND OTHER SOCIAL DETERMINANTS OF HEALTH. ITS MEMBERSHIP INCLUDED KEY BILH STAKEHOLDERS AND COMMUNITY HEALTH CENTER CHIEF MEDICAL OFFICERS. AS PART OF ITS RESPONSIBILITY, THE COUNCIL REVIEWED THE SYSTEM'S VACCINE ROLLOUT STRATEGY, INCLUDING THE PATIENT PRIORITIZATION AND SCHEDULING STRATEGY, CALL CENTER MODEL, VACCINE SITE LOCATION AND OPERATING MODEL, AND STAFF RESOURCES TO HELP COMMUNICATE AND ENGAGE WITH PATIENTS ABOUT VACCINE INFORMATION, CONCERNS, AND HESITANCY.TESTING IN FY 2021, BILH PERFORMED OVER 600,000 COVID-19 TESTS ACROSS ITS 10 HOSPITAL LABORATORIES FOR PATIENTS, HEALTHCARE PERSONNEL, AND OTHER PARTNERS, SUCH AS COMMUNITY HEALTH CENTERS AND CORRECTIONAL FACILITIES. IN JANUARY 2021, LAHEY HOSPITAL & MEDICAL CENTER BEGAN TESTING ON HIGH-THROUGHPUT THERMO FISHER INSTRUMENTS, GREATLY INCREASING THE SYSTEM'S CAPACITY FOR SAME-DAY TEST RESULTS. THESE INSTRUMENTS ALSO PROVIDED BACK-UP CAPACITY FOR OTHER LABS IN THE COMMUNITY, WHICH WERE EXPERIENCING HIGH VOLUME. THE THERMO FISHER INSTRUMENTS ADDED THE ABILITY TO RAPIDLY DETECT POTENTIAL COVID-19 VARIANTS (S-GENE DROPOUTS), A PROCESS PREVIOUSLY ONLY AVAILABLE THROUGH THE MASSACHUSETTS STATE LABORATORY. EVENTUALLY, BILH IMPLEMENTED SPECIFIC VARIANT PCR (POLYMERASE CHAIN REACTION) TESTING OF PATIENT SPECIMENS TO IDENTIFY SPECIFIC VARIANTS AND BETTER GUIDE DEVELOPMENT OF INFECTION PREVENTION RECOMMENDATIONS AND APPROPRIATE MONOCLONAL ANTIBODY TREATMENT SELECTION. THE SYSTEM MAINTAINED EIGHT DRIVE-THROUGH COVID-19 TESTING SITES ACROSS EASTERN MASSACHUSETTS TO ENABLE EASY ACCESS FOR PATIENTS AND STAFF, INCLUDING A STATE-SPONSORED "STOP THE SPREAD" SITE IN CHELSEA, MA. BILH PRIMARY CARE MADE POINT-OF-CARE COVID-19 TESTING AVAILABLE TO ITS PATIENTS IN APPROXIMATELY 20 PRACTICE SITES (25% OF TOTAL SITES) SPREAD THROUGHOUT BILH'S SERVICE AREA.
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BETH ISRAEL LAHEY HEALTH'S COVID-19 PANDEMIC RESPONSE
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INFECTION PREVENTION AND PERSONAL PROTECTIVE EQUIPMENT EFFORTS THROUGHOUT FY 2021, BILH INFECTION PREVENTION AND SUPPLY CHAIN STAFF CONTINUED TO PARTNER ON PROCURING PERSONAL PROTECTIVE EQUIPMENT ("PPE") AND OTHER RELATED SUPPLIES AND REPLENISHING BILH'S PANDEMIC SUPPLY WAREHOUSE. THIS ENSURED THE SYSTEM HAD AT LEAST 90 DAYS OF INVENTORY ON HAND FOR THE HIGHEST-UTILIZED PRODUCTS, SUCH AS GLOVES, GOWNS, FACEMASKS, AND EYE AND FACE SHIELDS. IN FY 2021, BILH SUPPLY CHAIN AND INFECTION PREVENTION COORDINATED A RESPIRATOR (N95 OR EQUIVALENT) FIT TESTING PROGRAM WITH A VENDOR TO FIT TEST MORE THAN 20,000 BILH EMPLOYEES TO BOTH DISPOSABLE AND REUSABLE RESPIRATORS. THIS UNIQUE PROGRAM INCORPORATING REUSABLE RESPIRATORS ENSURED THAT BILH STAFF WOULD NOT BE SUBJECT TO FLUCTUATIONS IN SUPPLY CHAIN DURING FUTURE WAVES OF COVID-19 OR OTHER RESPIRATORY VIRAL ILLNESSES AND MITIGATED WASTE RELATED TO DISPOSABLE RESPIRATORY PROTECTION. THROUGHOUT FY 2021, BILH INFECTION PREVENTION DEVELOPED AND UPDATED CLINICAL AND OPERATIONAL GUIDANCE INCLUDING POLICIES, TOOLS, AND EDUCATIONAL MATERIALS TO SUPPORT THE PREVENTION OF TRANSMISSION OF COVID-19. FOR EXAMPLE, BILH INFECTION PREVENTION DEVELOPED STAFF EDUCATION ON COVID-19 PREVENTION TO MEET THE OSHA COVID-19 EMERGENCY TEMPORARY STANDARD FOR USE BY ALL HOSPITAL/BUSINESS UNITS; CREATED SCREENING TOOLS FOR USE AT ALL POINTS OF ENTRY FOR PATIENTS AND VISITORS AND UPDATED CRITERIA AS NEEDED BASED ON LOCAL AND NATIONAL GUIDANCE; AND, UPDATED POLICIES FOR PREOPERATIVE AND PRE-PROCEDURAL TESTING AND PPE.TREATMENT BILH HOSPITALS CONTINUED TO PROVIDE TREATMENT TO ADMITTED PATIENTS WITH COVID-19, USING TREATMENTS AUTHORIZED FOR USE AT THE TIME. LEADERS ACROSS BILH HOSPITALS CONTINUED TO MEET AND SHARE INFORMATION TO ALLOW FOR APPROPRIATE RESOURCE ALLOCATION AND LOAD BALANCING TO ENSURE BILH WAS ABLE TO MEET PATIENT DEMAND. IN FY 2021, BILH BEGAN TO MAKE AVAILABLE TO AMBULATORY PATIENTS COVID-19 THERAPEUTICS (INTRAVENOUS MONOCLONAL ANTIBODIES AND REMDESEVIR) AND PROPHYLAXIS (EVUSHELD), WITH THESE EFFORTS EXPANDING ACROSS 2022.SAFETY NET AFFILIATE SUPPORT IN ORDER TO ENHANCE SITUATIONAL AWARENESS AND THE HEALTH SYSTEM'S UNDERSTANDING OF THE PANDEMIC'S IMPACT ON ITS SAFETY NET AFFILIATES ("SNAS"), BILH INCLUDED ITS SNAS IN DAILY HUDDLES AND INCIDENT COMMAND MEETINGS. THESE COLLABORATIVE FORUMS ENABLED BILH TO PROVIDE TARGETED, CONSISTENT SUPPORT, INCLUDING DISCUSSIONS ON PATIENT TRANSFER AVAILABILITY AND BED CAPACITY ACROSS BILH. THROUGH ITS COMMITMENT TO SUPPORTING LOCAL COMMUNITIES DEVASTATED BY THE PANDEMIC, BILH DONATED $410,000 TO COMMUNITY GROUPS LOCATED IN BROCKTON AND $600,000 TO THE CITY OF CHELSEA TO AID IN ADDRESSING PROBLEMS CREATED OR EXACERBATED BY THE PANDEMIC, INCLUDING TEMPORARY HOUSING FOR EVICTED PATRONS AND FOOD INSECURITY DUE TO LOSS OF INCOME.UNDERPINNING THESE MANY INITIATIVES WERE VARIOUS MULTI-ENTITY, INTERDISCIPLINARY COMMITTEES AND DATA COLLECTION EFFORTS TO ENSURE THAT BILH WAS PROACTIVELY MONITORING THE TRAJECTORY OF THE PANDEMIC AND NIMBLY PLANNING THE SYSTEM'S RESPONSE. THE HEALTH SYSTEM'S EFFORTS SPANNED THE CLINICAL CARE CONTINUUM, FROM PRIMARY CARE TO POST-ACUTE CARE, AS WELL AS BOTH CLINICAL AND ADMINISTRATIVE DEPARTMENTS, FROM INFECTIOUS DISEASE AND NURSING TO HUMAN RESOURCES AND INFORMATION SERVICES. BILH SUCCESSFULLY MARSHALLED ITS RESOURCES THROUGHOUT THE SYSTEM TO SERVE AS ONE OF THE PRIMARY HUBS FOR COVID-19 RELATED CARE IN MASSACHUSETTS.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.