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FORM 990, SCHEDULE H, PART V, SECTION C:
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SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSMOUNT AUBURN HOSPITAL (MAH) AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF MOUNT AUBURN HOSPITAL (MAH). BILH IS A PURPOSE-DRIVEN, VALUES-BASED ORGANIZATION THAT UNITES 38,000 PEOPLE WHO PROVIDE EXCEPTIONAL HEALTH CARE TO EVERYONE WE SERVE.THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND PARTS OF SOUTHERN NEW HAMPSHIRE 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 AND ADDICTION TREATMENT PROGRAMS. THE BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,800 PHYSICIANS AND 39,000 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.BILH'S PURPOSE STATEMENT ARTICULATES THE IMPACT BILH AND EACH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. BILH'S SHARED VALUES GUIDE DAILY EFFORTS, KEEP BILH AND EACH AFFILIATE ALIGNED IN THE PURSUIT OF PURPOSE AND SHOW HOW BILH CARES FOR PATIENTS, EACH OTHER AND OUR COMMUNITIES.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES ONE PERSON AT A TIME THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION, AND EQUITY.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.MAH'S COMMUNITY BENEFITS MISSION IS FULFILLED BY:- INVOLVING MAH STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE THREE-YEAR IMPLEMENTATION STRATEGY;- ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT THE HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION 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 UNDERSTAND UNMET HEALTH-RELATED AND IDENTIFY COMMUNITIES AND POPULATIONS SEGMENTS DISPROPORTIONATELY IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, ECONOMIC AND SYSTEMIC FACTORS;- IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN MAH'S CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED;- 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, HEALTHCARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $1,340,156 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I.
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COMMUNITY BENEFITS LEADERSHIP/TEAM
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MAH'S BOARD OF TRUSTEES ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGHOUT ITS CBSA AND BEYOND. WORLD-CLASS CLINICAL EXPERTISE, EDUCATION AND RESEARCH ALONG WITH AN UNDERLYING COMMITMENT TO HEALTH EQUITY ARE THE PRIMARY TENETS OF ITS MISSION. MAH'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF MAH'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF MAH'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. THE MAH'S COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE DIRECTOR OF COMMUNITY BENEFITS. THE DIRECTOR OF COMMUNITY BENEFITS HAS DIRECT ACCESS AND IS ACCOUNTABLE TO MAH'S PRESIDENT AND THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS, THE LATTER OF WHOM REPORTS DIRECTLY TO THE BILH CHIEF DIVERSITY, EQUITY AND INCLUSION OFFICER. IT IS THE RESPONSIBILITY OF THESE LEADERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF COHORTS WHO HAVE BEEN HISTORICALLY UNDERSERVED ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THE MAH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH MAH'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT MAH'S COMMUNITY BENEFITS MISSION TO IMPROVE 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. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF MAH'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF MAH'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF MAH'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY MAH'S PROGRAMMATIC ENDEAVORS, INCLUDING THOSE FROM DIVERSE RACIAL AND ETHNIC BACKGROUNDS, AGE, GENDER, SEXUAL ORIENTATION AND GENDER IDENTITY, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. MAH'S CBAC MEMBERS INCLUDE:- CARLA BEAUDOIN, DIRECTOR OF DEVELOPMENT, METRO HOUSING BOSTON- CHRISTINE BONGIORNO, DIRECTOR, ARLINGTON HEALTH AND HUMAN SERVICES- LIZ BROWNE, CEO, CHARLES RIVER COMMUNITY HEALTH- RENEE CAMMARATA HAMILTON, DIRECTOR OF THE COMMUNITY HEALTH IMPROVEMENT TEAM, CAMBRIDGE HEALTH ALLIANCE- STACY CARRUTH, PLANNING DIRECTOR, CHNA17- WESLEY CHIN, DIRECTOR, BELMONT HEALTH DEPARTMENT- PATTY CONTENTE, DIRECTOR OF COMMUNITY OUTREACH, HELP, AND RECOVERY, SOMERVILLE POLICE DEPARTMENT- LISA COOK, DIRECTOR, SOMERVILLE CENTER FOR ADULT LEARNING EXPERIENCE- MARY DECOURCEY, DIRECTOR OF COMMUNITY BENEFITS, MOUNT AUBURN HOSPITAL- MICHELLE FEELEY, DIRECTOR, WALTHAM HEALTH DEPARTMENT- NANCY BACCI, DIRECTOR, SOMERVILLE HEALTH AND HUMAN SERVICES- LAURA KURMAN, SENIOR PROGRAM DIRECTOR, WAYSIDE YOUTH AND FAMILY SUPPORT NETWORK- MIKE LIBBY, EXECUTIVE DIRECTOR, SOMERVILLE HOMELESS COALITION- JULIA LONDERGAN, DIRECTOR OF DEVELOPMENT, CAMBRIDGE AND SOMERVILLE PROGRAMS FOR ADDICTION RECOVERY, INC.- MYRIAM MICHEL, EXECUTIVE DIRECTOR, HEALTHY WALTHAM- COLLEEN MORRISSEY, DIRECTOR OF VOLUNTEERS AND SPECIAL PROJECTS, SOMERVILLE CAMBRIDGE ELDER SERVICES- NAVA NIV-VOGEL, DIRECTOR, BELMONT COUNCIL ON AGING- LARRY RAMDIN, DIRECTOR OF PUBLIC HEALTH, TOWN OF WATERTOWN- JACKIE SPENCER, MD, DIRECTOR OF PRIMARY CARE, VA NEW ENGLAND HEALTHCARE SYSTEM- ROBERT TORRES, DIRECTOR OF COMMUNITY BENEFITS, BOSTON REGION, BETH ISRAEL LAHEY HEALTH- STEPHANIE VENIZELOS, MANAGER OF COMMUNITY WELLNESS, TOWN OF WATERTOWN- JOSE WENDEL, DIRECTOR OF POPULATION HEALTH INITIATIVES, CAMBRIDGE PUBLIC HEALTH DEPARTMENTCOMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY (IS OR CHIP) PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. MAH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2022. THAT CHNA WAS APPROVED BY THE MAH BOARD OF TRUSTEES ON SEPTEMBER 13, 2022. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 13, 2022, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE CHNA AND THE ASSOCIATED 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 (CBSA) 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.COMMUNITY HEALTH NEEDS ASSESSMENTPRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, MAH COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF MAH'S MOST RECENTLY COMPLETED CHNA ENCOMPASSES ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN. COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR MAH'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).MAH'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN IN IT'S CBSA, AS FOLLOWS:- LGBTQIA+- LOW-RESOURCED- OLDER ADULTS- RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS- YOUTH
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COMMUNITY HEALTH NEEDS ASSESSMENT - SUMMARY OF APPROACH AND METHODS
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MAH'S CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING MAH'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. MAH'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, STATE AND NATIONAL LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY.BETWEEN OCTOBER 2021 AND FEBRUARY 2022, MAH CONDUCTED 18 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED 3 FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 260 RESIDENTS, AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS. (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 300 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS AND OTHER COMMUNITY PARTNERS.COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - DETAIL OF APPROACH AND METHODSMAH RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR 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:- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020)- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020)- U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021)- BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2019)- MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021)- FBI UNIFORM CRIME REPORTS (2019)- MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021)- MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019)- MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020)- MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018)- ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021)COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, MAH CONDUCTED 18 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, AND OTHER KEY COLLABORATORS THROUGHOUT MAH'S CBSA. 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 REPORT THAT IS POSTED ON MAH'S WEBSITE. 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 CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS.COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)MAH CONDUCTED 3 COMMUNITY FOCUS GROUPS, AND HELD TWO COMMUNITY LISTENING SESSIONS THAT ENGAGED OVER 75 RESIDENTS IN MAH'S CBSA TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS AND LISTENING SESSIONS WERE ORGANIZED IN COLLABORATION WITH THE LOCAL COMMUNITY HEALTH NETWORK AREA 17, A LOCAL COALITION, THE ARLINGTON LGBTQ+ COMMISSION AND SOMERVILLE CENTER FOR ADULT LEARNING EXPERIENCES (SCALE).MAH HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF MAH'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN TWELVE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, CITY AND TOWN AGENCIES, PUBLIC LIBRARIES, AND COMMUNITY EVENTS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE MAH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES. COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - REVIEWING 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 WITH THE MAH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS.- IDENTIFY MAH'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES.- ANALYZE MAH'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2021 CHNA AND SUBSEQUENT 2021 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY MAH DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2021 (TAX YEAR 2020).- 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, 2022 (TAX YEAR 2021).
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COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - KEY FINDINGS
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THE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2022, WERE:- YOUTH AND ADOLESCENTS - OLDER ADULTS- LOW-RESOURCE INDIVIDUALS AND FAMILIES- LESBIAN, GAY, BISEXUAL, TRANSGENDER AND QUEER OR QUESTIONING (LGBTQ) INDIVIDUALS- RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS MAH'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: - EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY.- SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY.- HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, THE MENTAL HEALTH IMPACTS OF RACISM, DISCRIMINATION, AND TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS).- HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.- RACIAL EQUITY. A DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND COMMUNITY FORUMS 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 AND OTHER HEALTH EQUITY CONCERNS RELATED TO GENDER, AGE, ABILITY, ETC. ARE NOT DEVALUED, BUT RATHER MORE THOROUGHLY ADDRESSED THROUGH AN INTERSECTIONAL APPROACH. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM MAH'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2023, SEPTEMBER 30, 2024, AND SEPTEMBER 30, 2025. COMMUNITY HEALTH NEEDS ASSESSMENT - MAKING 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, 2022 (TAX YEAR 2021). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH/IN ADDITION TO THE CHNA, MAH COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH/MAH COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2021 (TAX YEAR 2020). THAT CHNA IS AVAILABLE ON THE MAH WEBSITE AT: HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH/FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING MAH'S FISCAL YEAR ENDED SEPTEMBER 30, 2021 (TAX YEAR 2020) IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH/EACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).
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COMMUNITY HEALTH NEEDS ASSESSMENT - ADDRESSING COMMUNITY HEALTH NEEDS
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(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, MAH'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 AND A SUMMARY OF MAH'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THAT CHNA 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 COMMUNITY HEALTH PRIORITIES 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: RACIAL EQUITY- GOAL 1: PROMOTE HEALTH EQUITY AND REDUCE DISPARITIES FOR THOSE FACING RACISM AND DISCRIMINATION, PARTICULARLY FOR COMMUNITIES OF COLOR PRIORITY AREA 2: MENTAL HEALTH AND SUBSTANCE USE DISORDER- GOAL 1: REDUCE THE IMPACT OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS AMONG RESIDENTS OF MAH'S COMMUNITY BENEFITS SERVICE AREA PRIORITY AREA 3: CHRONIC AND COMPLEX CONDITIONS AND RISK FACTORS- GOAL 1: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, AND REFERRAL SERVICES IN CLINICAL AND NON-CLINICAL SETTINGS - GOAL 2: ENHANCE ACCESS TO SELF-MANAGEMENT AND OTHER SUPPORTIVE SERVICES FOR INDIVIDUALS WITH OR RECOVERING FROM CHRONIC/COMPLEX CONDITIONS AND THEIR CAREGIVERS PRIORITY AREA 4: SOCIAL DETERMINANTS OF HEALTH- GOAL 1: PROVIDE SUPPORTIVE SERVICES FOR THOSE WHO ARE UNSTABLY HOUSED- GOAL 2: IMPROVE ACCESS TO HEALTHY AND NUTRITIOUS FOOD FOR THOSE WHO EXPERIENCE FOOD INSECURITY- GOAL 3: PROMOTE TRANSPORTATION EQUITYPRIORITY AREA 5: ACCESS TO CARE AND COMMUNITY NAVIGATION- GOAL 1: ADDRESS THE SOCIAL DETERMINANTS OF ACCESS TO CARE- GOAL 2: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WHO ARE DUAL-LANGUAGE LEARNERS- GOAL 3: PROMOTE HEALTH EQUITY FOR LGBTQ+ POPULATIONS- GOAL 4: PROMOTE RESILIENCE AND EMERGENCY PREPAREDNESS- GOAL 5: PROMOTE RESILIENCY FOR NEW MOMSCOMMUNITY HEALTH NEEDS ASSESSMENT - APPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)MAH HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES OF THEIR TARGET POPULATIONS THROUGHOUT THEIR SERVICE AREA.MAH HAS BEEN A LEADER IN CREATING A MYRIAD OF COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE FOOD ACCESS PROGRAMS SUCH AS ARLINGTON EATS FRESH BUCKS AND WORKING TO INCREASE SNAP MATCH BENEFITS AT LOCAL FARMER'S MARKETS, PROGRAMS TO ADDRESS RACIAL EQUITY SUCH AS CORE MENTAL HEALTH (CORE MH), DONATIONS TO SUPPORT HIGH NEED POPULATIONS, AND HEALTHY AGING PROGRAMS. IN FY23, MAH CONTINUED ITS COMMUNITY HEALTH GRANT PROGRAM AND SUPPORTED FIVE ORGANIZATIONS WITH GRANT FUNDS. THESE ORGANIZATIONS WORKED ON PROGRAMS WHICH COINCIDED WITH THE FIVE HEALTH PRIORITIES IDENTIFIED IN THE FY22 IS. AS MENTIONED ABOVE, MAH CONTINUES TO PARTNER WITH CORE MH, TO FULFILL ITS MISSION TO PROMOTE HEALTHIER PEOPLE AND COMMUNITIES BY FOSTERING COMMUNITY ENGAGEMENT, ELEVATING INNOVATIVE AND BEST PRACTICES, ADVANCING RACIAL EQUITY, AND SUPPORTING RECIPROCAL LEARNING OPPORTUNITIES TO ADDRESS THE NEEDS OF THOSE MOST IMPACTED BY INEQUITIES.MAH CONTINUED ITS COMMUNITY HEATH GRANT PROGRAM PROVIDING A GRANT OPPORTUNITY TO COMMUNITY-BASED ORGANIZATIONS AND MUNICIPALITIES. FIVE ORGANIZATIONS WERE FUNDED TO WORK ON PROGRAMS THAT HELPED TO INCREASE THEIR CAPACITY TO ADDRESS THE TOP HEALTH CONCERNS IDENTIFIED IN MAH'S MOST RECENT CHNA AND IN THEIR COMMUNITY.THROUGH THE MAH COLLABORATIVE CARE MODEL BEHAVIORAL HEALTH SERVICES WERE PROVIDED TO 1,308 PATIENTS ACROSS TWELVE SITES.RECOGNIZING YOUTH MENTAL HEALTH AS A COMMUNITY HEALTH PRIORITY MAH PARTNERED AND PROVIDED FUNDING TO WAYSIDE YOUTH AND FAMILY SERVICES TO TRAIN YOUTH IN TEEN MENTAL HEALTH FIRST AID. EIGHTEEN YOUTH FROM WATERTOWN HIGH SCHOOL WERE TRAINED. THIS FUNDING ALSO SUPPORTED A HIGH SCHOOL STUDENT SELF-IDENTITY PROJECT TO PROMOTE SELF-CONFIDENCE AND LEADERSHIP SKILLS.MAH PARTNERS WITH METRO HOUSING BOSTON AND COORDINATES ITS CO-LOCATION PROGRAM AT MAH. THIS PROGRAM PROVIDES A COMMUNITY RESOURCE SPECIALIST WHO HELPS TO EASE TRANSITIONS FOR PATIENTS AND TO CONNECT HOUSING UNSTABLE PATIENTS TO A CASE MANAGER. THE CO-LOCATION PROGRAM PROVIDES RESOURCES AND INFORMATION FOR HOUSING UNSTABLE COMMUNITY MEMBERS. NINETY-FIVE INDIVIDUALS RECEIVED A SERVICE OR INTERACTION, WHICH INCLUDED INCREASED KNOWLEDGE OF EVICTION PREVENTION, HOUSING SEARCH STRATEGIES, AND OR FINANCIAL ASSISTANCE PROGRAMS.MAH CONTINUES TO PROVIDE A HEALTH LITERACY EDUCATION PROGRAM. AUDIENCES FOR THIS PROGRAM INCLUDE ENGLISH LANGUAGE LEARNERS AND OLDER ADULTS. THESE PRESENTATIONS HELP PARTICIPANTS NAVIGATE OUR HEALTHCARE SYSTEM AS WELL AS GAIN KNOWLEDGE ON VARIOUS HEALTH AND WELLNESS TOPICS. OVER 140 ENGLISH LANGUAGE LEARNERS PARTICIPATED AND OVER 150 OLDER ADULTS PARTICIPATED IN THIS PROGRAM.MAH CONTINUES TO DEDICATE SIGNIFICANT TIME AND RESOURCES TO RESPOND TO NEEDS RELATED TO COVID-19, SUCH AS FOOD INSECURITY. FOR EXAMPLE, THE HOSPITAL USED ITS' PURCHASING POWER TO PURCHASE AND DELIVER FRESH PRODUCE AND FRESH BREAD TO COMMUNITY FOOD DISTRIBUTION LOCATIONS ON A MONTHLY CYCLE.A FULL UPDATE ON MAH'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.
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FY20 SCHEDULE H - IMPLEMENTATION STRATEGY UPDATE
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PRIORITY AREA 1: EQUITABLE ACCESS TO CAREINDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS ARE AT THE SYSTEM LEVEL, AND STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM-LEVEL ISSUES INCLUDE PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTH CARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE.THERE ARE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FORGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY.GOAL 1: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC AND ECONOMIC BARRIERS.PROGRAMMATIC OBJECTIVES1.1 PROVIDE AND PROMOTE CAREER SUPPORT SERVICES AND CAREER MOBILITY PROGRAMS TO HOSPITAL EMPLOYEES1.2 PROMOTE ACCESS TO HEALTHCARE, HEALTH INSURANCE, PATIENT FINANCIAL COUNSELORS, AND NEEDED MEDICATIONS FOR PATIENTS WHO ARE UNINSURED OR UNDERINSURED1.3 SUPPORT PARTNERSHIPS WITH REGIONAL TRANSPORTATION PROVIDERS AND COMMUNITY PARTNERS TO ENHANCE ACCESS TO AFFORDABLE AND SAFE TRANSPORTATION1.4 PROMOTE EQUITABLE CARE, HEALTH EQUITY, HEALTH LITERACY, AND CULTURAL HUMILITY FOR PATIENTS, ESPECIALLY THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS1.5 PROMOTE RESILIENCY FOR NEW MOMS1.6 SUPPORT CITIES/TOWNS TO PROMOTE RESILIENCE, EMERGENCY CARE AND EMERGENCY PREPAREDNESSCOMMUNITY ACTIVITIES/ STRATEGIES - CAREER AND ACADEMIC ADVISING- HOSPITAL SPONSORED ENGLISH CLASSES- SOCIAL ENTERPRISE YOUTH DEVELOPMENT PROGRAM- HEALTH COVERAGE AND PUBLIC ASSISTANCE ENROLLMENT PROGRAMS AT BOTH MAH AND CHARLES RIVER COMMUNITY HEALTH- FACILITATE THE CONNECTION TO HEALTH CARE BY PROVIDING TRANSPORTATIONS CONNECTIONS AT NO COST WHEN TRANSPORTATION IS A BARRIER TO MEDICAL CARE - HUMAN RIGHTS COMMISSION FOR THE LGBTQ+ HEALTHCARE EQUALITY INDEX STANDARDS- PROVIDE FREE INTERPRETER SERVICES- HEALTH LITERACY AND EDUCATION PROGRAM- PRENATAL AND POSTPARTUM BILINGUAL OUTREACH WORKER PROGRAM- FREE DOULA PROGRAM- BREAST FEEDING EDUCATION AND SUPPORT PROGRAM- EMERGENCY SERVICES TRAINING - COMMUNITY TRAINING FOR EMERGENCY MEDICAL EVENTSMETRICS AND STATUS UPDATE:- IN FY23, THE WORKFORCE DEVELOPMENT TEAM ATTENDED EVENTS AND GAVE PRESENTATIONS ABOUT EMPLOYMENT OPPORTUNITIES TO COMMUNITY PARTNERS. SIXTY-SEVEN EVENTS AND PRESENTATIONS WERE CONDUCTED WITH COMMUNITY PARTNERS ACROSS THE BILH SERVICE AREA.- IN FY23, TWENTY BILH EMPLOYEES ATTENDED CITIZENSHIP CLASSES, 135 BILH EMPLOYEES ATTENDED CAREER DEVELOPMENT WORKSHOPS AND 189 BILH EMPLOYEES ATTENDED FINANCIAL LITERACY CLASSES. MOUNT AUBURN HOSPITAL EMPLOYEES PARTICIPATED IN THESE OFFERINGS.- IN FY23, FIFTY-FOUR COMMUNITY MEMBERS WERE PLACED IN INTERNSHIPS ACROSS BILH HOSPITALS TO LEARN VALUABLE SKILLS. MOUNT AUBURN HOSPITAL PARTICIPATED IN OFFERING THESE INTERNSHIPS. BILH TRAINED A TOTAL OF EIGHTY-NINE COMMUNITY MEMBERS TO PATIENT CARE TECHNICIAN OR NURSING ASSISTANT (30), PHARMACY TECH (16), PERIOPERATIVE LPN (3), MEDICAL ASSISTANT (21), BEHAVIORAL HEALTH ROLES (4) OR INTO THE ASSOCIATE DEGREE NURSING RESIDENCY PROGRAM (15). MOUNT AUBURN HOSPITAL PARTICIPATED IN OFFERING THESE TRAININGS.- MAH OFFERED FREE ENGLISH CLASSES TO EMPLOYEES - THROUGH A PARTNERSHIP WITH MORE THAN WORDS (MTW) IN WALTHAM HELPED FUND THE SOCIAL ENTERPRISE YOUTH DEVELOPMENT PROGRAM:O PROVIDED JOB TRAINING, YOUTH DEVELOPMENT PROGRAMMING, INTENSIVE CASE MANAGEMENT EDUCATION AND EMPLOYMENT COACHING AND INDIVIDUAL ADVOCACY TO APPROXIMATELY 110 YOUNG PEOPLE IN WALTHAM.O LAUNCHED A NEW PROGRAM CALLED THE READINESS PROGRAM TO ENSURE YOUTH HAVE ALL THE STABILIZING FACTORS NEEDED TO BE READY TO ENTER THE HIGH EXPECTATIONS OF THE SOCIAL ENTERPRISE JOB-TRAINING MODEL AT MTW.- MAH FINANCIAL COUNSELORS ASSISTED 954 INDIVIDUALS WITH GOVERNMENT APPLICATION FORMS, INCLUDING HELP WITH HEALTH INSURANCE APPLICATIONS AND OR REFERRING THEM TO GOVERNMENT PROGRAMS AT BOTH MAH AND CHARLES RIVER COMMUNITY HEALTH LOCATIONS.- PROVIDED FIFTY-ONE FREE PRESCRIPTION MEDICATIONS FOR OUR MOST UNDER-RESOURCED POPULATIONS WHO OTHERWISE WOULD NOT BE ABLE TO PAY FOR OR HAVE ACCESS TO MEDICATION WHEN BEING DISCHARGED FROM THE HOSPITAL.- APPROXIMATELY 1,609 RIDES PROVIDED FREE OF CHARGE TO THOSE WHERE TRANSPORTATION IS A BARRIER TO MEDICAL CARE. TRANSPORTATION IS PROVIDED VIA SCM TRANSPORTATION, METRO CAB VOUCHERS AND CHARLIE CARDS DISTRIBUTED.- MAH CONTINUES TO MEET THE STANDARDS OF LEADER STATUS FOR THE HUMAN RIGHT COMMISSION FOR THE LGBTQ+ HEALTHCARE EQUALITY INDEX.- PROVIDED 18,899 INDIVIDUAL ENCOUNTERS EITHER FACE TO FACE, VIDEO, OR TELEPHONIC - IN FY23 MAH PROVIDED SEVEN HEALTH LITERACY EDUCATION PROGRAMS IN THE COMMUNITY AND A TOTAL OF 143 PEOPLE ATTENDED THESE PROGRAMS.O NINETY PERCENT OF PARTICIPANTS REPORTED INCREASING THEIR KNOWLEDGE ABOUT NAVIGATING OUR HEALTH CARE SYSTEM.O SEVENTY-SEVEN PERCENT REPORTED THEY INCREASED THEIR KNOWLEDGE ON HOW TO PREPARE FOR THEIR DOCTOR'S APPOINTMENT.- A LATINA COMMUNITY OUTREACH WORKER IS AVAILABLE TO PRENATAL AND POSTPARTUM PATIENTS TO PROVIDE ACCESSIBILITY HELP WITH RESOURCES AND TO PROVIDE EMOTIONAL SUPPORT IN THE COMMUNITY.- THE LATINA COMMUNITY OUTREACH WORKER PROVIDED OVER 280 WOMEN WITH NAVIGATIONAL AND EMOTIONAL SUPPORT AS WELL AS REFERRALS TO COMMUNITY RESOURCES. THIS INCLUDED OVER 1,500 ENCOUNTERS OF SUPPORT INCLUDING, HELPING WITH GOVERNMENTAL ASSISTANCE PROGRAMS, BIRTH CERTIFICATES, SSI OFFICE VISITS, IMMIGRATION STATUS, BABY'S FIRST APPOINTMENTS, BILLING ISSUES AND HELPING TO PREPARE MOMS FOR APPOINTMENTS AND HOSPITAL FOLLOW-UP VISITS.- PROVIDED A DOULA FOR HISTORICALLY UNDERSERVED POPULATIONS WHO REQUEST THIS SUPPORT DURING BIRTH. A DOULA WAS PROVIDED FOR TWENTY-ONE BIRTHS - THE RATE OF EXCLUSIVE BREAST MILK FEEDING AMONG SPANISH-SPEAKING MOTHERS UPON DISCHARGE IMPROVED FROM THIRTY-FIVE PERCENT TO FORTY-FIVE PERCENT.- MAH PHYSICIANS SERVED AS EMS MEDICAL DIRECTORS TO MIT EMS, HARVARD UNIVERSITY EMS AND PRO AMBULANCE EMS.- THE EMERGENCY DEPARTMENT PROVIDED MONTHLY EDUCATION SESSIONS TO CAMBRIDGE, ARLINGTON, BELMONT WATERTOWN FIRE DEPARTMENTS. AN AVERAGE OF 25 STAFF WERE IN ATTENDANCE EACH MONTH (ALL TOWNS).- SIX SESSIONS OF LIFE THREATENING EMERGENCY - WHAT TO DO WERE PROVIDED TO COMMUNITY ORGANIZATIONS AND MUNICIPAL STAFF. APPROXIMATELY 165 PEOPLE WERE TRAINED.O EIGHTY-FIVE PERCENT OF PARTICIPANTS REPORTED GAINING CONFIDENCE IN HOW TO USE AN AUTOMATED EXTERNAL DEFIBRILLATOR (AED).O EIGHTY-EIGHT PERCENT OF PARTICIPANTS WHO TOOK THE SURVEY REPORTED GAINING CONFIDENCE IN ADMINISTERING CHEST COMPRESSIONS.O EIGHTY-NINE PERCENT OF PARTICIPANTS WHO TOOK THE SURVEY REPORTED THEY LEARNED NEW INFORMATION ABOUT HOW TO IDENTIFY A MEDICAL EMERGENCY.O EIGHTY-NINE PERCENT OF PARTICIPANTS REPORTED THEY ARE MORE LIKELY TO TAKE STEPS SUCH AS ADMINISTERING COMPRESSIONS AND UTILIZING THE AED DURING A MEDICAL EMERGENCY IF THEY HAVE THE OPPORTUNITY.
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PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTH
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THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO HOUSING, FOOD INSECURITY, ECONOMIC INSECURITY, EDUCATION AND OTHER IMPORTANT SOCIAL FACTORS.THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, LISTENING SESSIONS, AND THE MAH COMMUNITY HEALTH SURVEY REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, AND ECONOMIC INSTABILITY.GOAL 1: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENT WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.PROGRAMMATIC OBJECTIVES1.1 PROVIDE COMMUNITY HEALTH GRANTS TO SUPPORT IMPACTFUL PROGRAMS THAT ADDRESS ISSUES ASSOCIATED WITH THE SOCIAL DETERMINANTS OF HEALTH1.2 PARTICIPATE IN MULTI-SECTOR COMMUNITY COALITIONS TO CONVENE STAKEHOLDERS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH 1.3 SUPPORT EDUCATION, SYSTEMS, PROGRAMS, AND ENVIRONMENTAL CHANGES TO INCREASE HEALTHY EATING AND ACCESS TO AFFORDABLE, HEALTHY FOODS 1.4 SCREEN, ASSESS, AND CONNECT PATIENTS WITH HEALTH-RELATED SOCIAL NEEDS1.5 SUPPORT PROGRAMS THAT STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSINGCOMMUNITY ACTIVITIES / STRATEGIES - PROVIDE A COMMUNITY HEALTH GRANT PROGRAM- SUPPORT LOCAL COALITIONS WITH PARTICIPATION AND FUNDING- COMMUNITY FOOD DISTRIBUTION PROGRAM TO PROVIDE FOOD AND OR INCREASE ACCESS TO AFFORDABLE HEALTHY FOODS- PRODUCE PRESCRIPTION PROGRAM- PARTNERSHIPS AND FUNDING SUPPORT TO LOCAL SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) MATCH PROGRAMS AND THE FRESH BUCKS PROGRAM AT LOCAL FARMER'S MARKETS- SOCIAL DETERMINANTS OF HEALTH SCREENING PROGRAM- CO-LOCATION PROGRAM- COMMUNITY HEALTH GRANT PROGRAMS FOCUSING ON HOMELESSNESS PREVENTION AND EVICTION PREVENTIONMETRICS AND STATUS UPDATES: - PROVIDED NINE ORGANIZATIONS FUNDING TO WORK ON IDENTIFIED PROJECTS WHICH REFLECT THE HEALTH PRIORITIES IDENTIFIED IN OUR MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT.- MAH STAFF ATTENDED 52 COMMUNITY COALITION, COMMUNITY BUILDING AND OR COMMUNITY TASK FORCE MEETINGS IN ITS SERVICE AREA. - USING THE HOSPITAL'S PURCHASING POWER, PURCHASED FOOD AND PROVIDED NINE DELIVERIES WHICH INCLUDED 900 DOZEN EGGS AND 900 LOAVES OF WHOLE GRAIN BREAD WHICH WAS DISTRIBUTED TO FOOD INSECURE FAMILIES AND INDIVIDUALS THROUGHOUT THE YEAR. - THROUGH A PARTNERSHIP WITH WALTHAM FIELDS COMMUNITY FARM, COMMUNITY SUPPORTED AGRICULTURE (CSA) SHARES WERE PROVIDED TO THIRTY HOUSEHOLDS. THIS REPRESENTED 4,861 POUNDS OF FRESH PRODUCE TO LOW INCOME MEDICALLY IDENTIFIED FAMILIES. - AT THE WATERTOWN FARMER'S MARKET REACHED APPROXIMATELY TWO HUNDRED RESIDENTS WITH EDUCATIONAL MATERIALS AND TRAININGS INFORMING THEM ABOUT THE SNAP MATCH PROGRAM AND OTHER GOVERNMENT SUBSIDIES. - SNAP MATCH CUSTOMERS INCREASED BY TWENTY-FIVE PERCENT THIS YEAR AT THE WATERTOWN FARMERS MARKET AS COMPARED TO THE PREVIOUS YEAR. - FRESH BUCKS (FOOD VOUCHER PROGRAM) CUSTOMERS INCREASED BY FORTY PERCENT THIS YEAR AT THE ARLINGTON FARMER'S MARKET AS COMPARED TO THE PREVIOUS YEAR.- AT THE BELMONT FARMER'S MARKET, TOTAL SNAP MATCH SHOPPERS AT THIS YEAR'S FARMERS MARKET WAS 263 INDIVIDUALS, AN INCREASE OF TWELVE PERCENT FROM THE PREVIOUS YEAR.- DEVELOPED AND ENHANCED COMMUNITY RESOURCE INFORMATION, ALIGNED WITH OUR IDENTIFIED PRIORITY SDOH: TRANSPORTATION, HOUSING, FOOD INSECURITY AND FINANCIAL INSTABILITY.- A SYSTEM IS NOW IN PLACE TO IDENTIFY PATIENTS WHO CAN BENEFIT FROM COMMUNITY RESOURCES THROUGH A SDOH SCREENING PROCESS AND REFERRED TO COMMUNITY RESOURCES. - THE CO-LOCATION PROGRAM IN PARTNERSHIP WITH METRO HOUSING BOSTON (MHB):O PROVIDED A DEDICATED CASE WORKER WHO MET WITH PATIENTS AND COMMUNITY MEMBERS AND PROVIDED ASSISTANCE AND REFERRALS TO COMMUNITY PROGRAMS AND GOVERNMENTAL ASSISTANCE PROGRAMS. O NINETY-FIVE INDIVIDUALS RECEIVED A SERVICE OR INTERACTION, WHICH INCLUDED INCREASED KNOWLEDGE OF EVICTION PREVENTION, HOUSING SEARCH STRATEGIES AND OR FINANCIAL ASSISTANCE PROGRAMS.O SIX INDIVIDUALS RECEIVED A CONSULTATION THAT RESULTED IN AVOIDING EVICTION FROM THEIR PLACE OF RESIDENCY.- SUPPORTED AND FUNDED Y2Y (YOUTH SHELTER) IN HARVARD SQUARE TO SUPPORT AND STRENGTHEN THEIR CASE MANAGEMENT TEAM VIA IMPROVED TRAINING AND PRACTICES. TEN STUDENT STAFF MEMBERS COMPLETED A DAY-LONG INTENSIVE TRAINING ON CASE MANAGEMENT BEST PRACTICES AND RESOURCES. SIX OF THE TEN CASE MANAGERS WERE RETRAINED AND SERVE AS PEER COACHES.- THROUGH A PARTNERSHIP WITH HOUSING CORPORATION OF ARLINGTON: O THIRTY-NINE FAMILIES HAVE A MORE STABLE SITUATION AND AVOIDED EVICTION BY UTILIZING HOMELESSNESS PREVENTION GRANTS AND REFERRALS TO COMMUNITY RESOURCES. O FIFTY-THREE ADDITIONAL HOUSEHOLDS RECEIVED SOME KIND OF SOCIAL SERVICE SUPPORT, INCLUDING HOUSING SEARCH, SUPPORT NEGOTIATING WITH A LANDLORD REGARDING A RENT INCREASE OR POSSIBLE EVICTION, SIGNING UP FOR SOCIAL SECURITY OR OTHER BENEFITS, DOMESTIC VIOLENCE ASSISTANCE, ACCESSING FREE FURNITURE FOR AN APARTMENT, SIGNING UP FOR RAFT (RENTAL ASSISTANCE THAT IS MORE INTENSIVE THAN WHAT HCA OFFERS FOR THOSE IN A MORE SERIOUS SITUATION), OR GETTING A REFERRAL TO A RANGE OF OTHER SERVICES, SUCH AS MENTAL HEALTH ASSISTANCE OR YOUTH PROGRAMS FOR CHILDREN IN THE HOME. ALL WERE LOW OR (MORE OFTEN) VERY LOW-INCOME.O A NEW TENANT COUNCIL LEADERSHIP GROUP WAS CREATED. SIX HOUSING CORPORATION OF ARLINGTON TENANTS HAVE JOINED THE NEW TENANT COUNCIL LEADERSHIP GROUP. TWENTY-SIX TENANTS HAVE PARTICIPATED IN CIVIC ENGAGEMENT ACTIVITIES INCLUDING GIVING FEEDBACK ON THE TOWN OF ARLINGTON'S MBTA COMMUNITIES DRAFT MAPS, ADVOCATING FOR FUNDING FOR ENERGY RETROFIT IMPROVEMENTS FOR THEIR HOUSING, AND OTHER RELATED ADVOCACY ACTIVITIES.- THROUGH A PARTNERSHIP WITH SOMERVILLE HOMELESS COALITION: O WRAP AROUND CASE MANAGEMENT SERVICES HAVE BEEN PROVIDED TO 109 HOUSEHOLDS.O 108 HOUSEHOLDS HAVE RECEIVED CASE MANAGEMENT SERVICES IN THEIR PRIMARY LANGUAGE.O FIFTY-EIGHT HOUSEHOLDS RECEIVED ASSISTANCE WITH SIGNING UP FOR SNAP OR BENEFITS RECERTIFICATION. AN ADDITIONAL FORTY HOUSEHOLDS RECEIVED ONGOING CASE MANAGEMENT SUPPORT.
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PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USE
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ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19.IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. INTERVIEWEES, FOCUS GROUP, AND COMMUNITY LISTENING SESSION PARTICIPANTS REFLECTED ON THE STIGMA, SHAME, AND ISOLATION THAT THOSE WITH MENTAL HEALTH CHALLENGES FACE THAT LIMIT THEIR ABILITY TO ACCESS CARE AND COPE WITH THEIR ILLNESS.SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES. INTERVIEWEES REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES, INCLUDING MENTAL HEALTH ISSUES AND HOMELESSNESS. INTERVIEWEES ALSO REFLECTED ON THE NEED FOR TRANSITIONAL HOUSING AND OTHER RECOVERY SUPPORT SERVICES.GOAL 1: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE.PROGRAMMATIC OBJECTIVES1.1 ADDRESS THE UNIQUE MENTAL HEALTH NEEDS OF HISTORICALLY UNDERSERVED YOUTH 1.2 PROVIDE ACCESS TO HIGH-QUALITY AND CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE USE SERVICES THROUGH SCREENING, MONITORING, COUNSELING, NAVIGATION, AND TREATMENT1.3 PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE ACTIVITIES INTERNALLY AT MAH AND EXTERNALLY WITH COMMUNITY PARTNERS1.4 ADVOCATE FOR AND SUPPORT POLICIES AND SYSTEMS THAT IMPROVE BEHAVIORAL HEALTH SERVICESCOMMUNITY ACTIVITIES / STRATEGIES - COLLABORATE WITH WAYSIDE YOUTH AND FAMILY SERVICES TO SUPPORT A YOUTH LEADERSHIP PROGRAM FOCUSING ON MENTAL HEALTH- COLLABORATE WITH DE NOVO CENTER FOR JUSTICE AND HEALING (DE NOVO) TO SUPPORT COUNSELING PROGRAMS FOR SURVIVORS OF TORTURE, GENDER-BASED VIOLENCE, WAR CRIMES OR OTHER HUMAN RIGHTS VIOLATIONS- PROVIDE FREE SUPPORT GROUPS- PROVIDE A SUBSTANCE USE NAVIGATOR TO PROVIDE SUPPORT AND CARE TO THOSE PATIENTS IN THE ED WHO SHOW SIGNS OF SUBSTANCE USE DISORDER AND TO HELP WITH CONTINUITY OF CARE- COLLABORATIVE CARE MODEL METRICS AND STATUS UPDATES- WAYSIDE YOUTH AND FAMILY SERVICES:O BUILT A CURRICULUM FOR THE WATERTOWN SELF IDENTITY. PROGRAM WAS LAUNCHED WITH 18 MIDDLE AND HIGH SCHOOL STUDENTS.O TRAINED AND CERTIFIED 18 WATERTOWN YOUTH IN TEEN MENTAL HEALTH FIRST AID.- DE NOVO:O IN FY23 DE NOVO ASSISTED NINETY SURVIVORS THROUGH THE TORTURE TREATMENT PROGRAM.O TWENTY-SEVEN CLIENTS RECEIVED FORENSIC PSYCHOLOGICAL EVALUATION AND IN-COURT TESTIMONY AS NEEDED TO SUPPORT CLIENTS WITH THEIR HUMANITARIAN RELIEF APPLICATIONS.O IN FY23, DE NOVO SUPPORTED 159 CLIENTS WITH CASE MANAGEMENT, COUNSELING SERVICES. THIRTY-SEVEN PERCENT OF THESE RECEIVED SERVICES IN THEIR FIRST LANGUAGE OTHER THAN ENGLISH AND EIGHTY PERCENT RECEIVED THIS SERVICE FOR FREE. OTHERS RECEIVED IT AT LOW COST.- PROVIDED TWO BEREAVEMENT SUPPORT GROUP, EIGHT WEEK LONG SESSIONS FOR COMMUNITY MEMBERS. TWENTY-THREE COMMUNITY MEMBERS ATTENDED.- PROVIDED AN ONGOING SUPPORT GROUP ONCE A MONTH FOR CAREGIVERS TO DROP IN ANYTIME. TEN CAREGIVERS ATTENDED AT LEAST ONE OR MORE CAREGIVER SUPPORT GROUP SESSIONS.- PROVIDED A SUBSTANCE USE NAVIGATOR IN THE EMERGENCY DEPARTMENT (ED) TO PROVIDE SUPPORT AND CARE TO THOSE PATIENTS IN THE ED WHO SHOW SIGNS OF SUBSTANCE USE DISORDER AND TO HELP WITH CONTINUITY OF CARE.- THROUGH OUR COLLABORATIVE CARE MODEL PROVIDED BEHAVIORAL HEALTH SERVICES TO 1,308 PATIENTS ACROSS TWELVE SITES. PRIORITY AREA 4: COMPLEX AND CHRONIC CONDITIONSCHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN MASSACHUSETTS AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.GOAL 1: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.PROGRAMMATIC OBJECTIVES1.1 ENSURE OLDER ADULTS HAVE ACCESS TO COORDINATED HEALTHCARE, SUPPORTIVE SERVICES AND RESOURCES THAT SUPPORT OVERALL HEALTH AND THE ABILITY TO AGE IN PLACE1.2 PROVIDE PREVENTIVE HEALTH INFORMATION, SERVICES, AND SUPPORT FOR THOSE AT RISK FOR COMPLEX AND/OR CHRONIC CONDITIONS AND SUPPORT EVIDENCE-BASED CHRONIC DISEASE TREATMENT AND SELF-MANAGEMENT PROGRAMSCOMMUNITY ACTIVITIES / STRATEGIES - HEALTHY AGING PROGRAM- PROVIDE SUPPORT FOR COMMUNITY MEMBERS WITH CANCER- PROVIDE A FREE BREAST CANCER SUPPORT GROUP- PROVIDE A STROKE NURSE NAVIGATOR- EXECUTE A STROKE AWARENESS CAMPAIGNMETRICS AND STATUS UPDATES- COORDINATED AND PROVIDED FOUR PRESENTATIONS GEARED TOWARDS EDUCATING OLDER ADULTS ON HEALTH TOPICS. A TOTAL OF 152 OLDER ADULTS IN ATTENDANCE. PRESENTATION TOPICS INCLUDED: BRAIN HEALTH, HEALTHY EATING/HEALTHY AGING, AND HEART HEALTH INCLUDING STROKE AWARENESS.- BRAIN HEALTH: O EIGHTY-THREE PERCENT OF PARTICIPANTS REPORTED THEY WILL TAKE LESSONS AND SKILLS LEARNED AND INCORPORATE THEM INTO THEIR WEEKLY ROUTINE.O EIGHTY-SEVEN PERCENT OF PARTICIPANTS REPORTED LEARNING NEW INFORMATION ABOUT KEEPING THEIR BRAINS HEALTHY.O NINETY-THREE PERCENT OF PARTICIPANTS REPORTED THAT THEY LEARNED STRATEGIES TO HELP THEM MAKE CHOICES THAT WILL POSITIVELY IMPACT THEIR OVERALL HEALTH.- HEALTHY EATING/HEALTHY AGING:O EIGHTY-SEVEN PERCENT OF PARTICIPANTS REPORTED LEARNING NEW TIPS AND IDEAS THEY WILL USE WHEN THEY GO GROCERY SHOPPING.O EIGHTY-SEVEN PERCENT OF PARTICIPANTS REPORTED LEARNING NEW TIPS OR IDEAS ABOUT HOW TO SUBSTITUTE HEALTHIER FOODS IN THEIR DIET.- HEART HEALTH:O EIGHTY PERCENT OF PARTICIPANTS REPORTED INCREASED KNOWLEDGE OF THE RISKS OF HEART DISEASE.O SEVENTY-THREE PERCENT OF PARTICIPANTS REPORTED INCREASING THEIR KNOWLEDGE OF THE SIGNS AND SYMPTOMS OF HEART DISEASE.- ORGANIZED A SURVIVORSHIP DAY EVENT IN PERSON WITH FORTY-EIGHT PEOPLE ATTENDING.O NINETY-SEVEN PERCENT OF PARTICIPANTS REPORTED LEARNING SOMETHING OF LASTING VALUE.O NINETY-FIVE PERCENT OF PARTICIPANTS REPORTED THEY WOULD BE ABLE TO TAKE WHAT THEY LEARNED AND APPLY IT TO IMPROVE THEIR OWN HEALTH AND WELLBEING.- PROVIDED A FREE BREAST CANCER SUPPORT GROUP TO THOSE WHO HAVE COMPLETED TREATMENT; THIS GROUP MET TWICE A MONTH THROUGHOUT THE YEAR.- PROVIDED STROKE EDUCATION AND SUPPORT TO OVER 225 PATIENTS AND THEIR FAMILY MEMBERS BY THE STROKE NURSE COORDINATOR.- CREATED A STROKE AWARENESS CAMPAIGN DURING STROKE AWARENESS MONTH.O CREATED AND DEVELOPED A PUBLIC SERVICE ANNOUNCEMENT (VIDEO), DISTRIBUTED STROKE EDUCATION MATERIALS AND CONDUCTED STROKE AWARENESS PRESENTATIONS FOR COMMUNITY MEMBERS.O THE VIDEO IS AVAILABLE IN FIVE LANGUAGES. LANGUAGES INCLUDE ARMENIAN, ENGLISH, HAITIAN CREOLE, PORTUGUESE AND SPANISH. THE VIDEO IS POSTED ON THE HOSPITAL'S WEBSITE AND SHARED WITH OUR COMMUNITY PARTNERS. THE VIDEO WAS AIRED ON LOCAL CABLE NETWORK STATIONS. IT HAS BEEN DISTRIBUTED WIDELY ON SOCIAL MEDIA.O DISTRIBUTED OVER 2,000 STROKE EDUCATIONAL MATERIALS, INCLUDING MAGNETS IN FIVE DIFFERENT LANGUAGES IN ADDITION TO ENGLISH TO VARIOUS COMMUNITY ORGANIZATIONS FOR DISTRIBUTION TO COMMUNITY MEMBERS AND FOR POSTING IN COMMON AREAS.O PROVIDED EIGHT STROKE AWARENESS PRESENTATIONS WITH 127 PEOPLE IN ATTENDANCE.O NINETY-EIGHT PERCENT OF PRESENTATION PARTICIPANTS REPORTED AN INCREASE IN THEIR KNOWLEDGE OF THE RISKS OF HAVING A STROKE.O EIGHTY-NINE PERCENT OF PRESENTATION PARTICIPANTS REPORTED AN INCREASE IN THEIR KNOWLEDGE OF THE SIGNS AND SYMPTOMS OF STROKE.
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PRIORITY AREA 5: RACIAL EQUITY
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RACIAL EQUITY IS THE CONDITION WHERE ONE'S RACIAL IDENTITY HAS NO INFLUENCE ON HOW ONE FARES IN SOCIETY. RACISM AND DISCRIMINATION INFLUENCE THE SOCIAL, ECONOMIC, AND PHYSICAL DEVELOPMENT AMONG BLACK, INDIGENOUS, AND PEOPLE OF COLOR (BIPOC), RESULTING IN POORER SOCIAL AND PHYSICAL CONDITIONS IN THOSE COMMUNITIES TODAY. RACE AND RACIAL HEALTH DIFFERENCES ARE NOT BIOLOGICAL IN NATURE. HOWEVER, GENERATIONS OF INEQUITY CREATE CONSEQUENCES AND DIFFERENTIAL HEALTH OUTCOMES BECAUSE OF STRUCTURAL ENVIRONMENTS AND UNEQUAL DISTRIBUTION OF RESOURCES.GOAL 1: PROMOTE RACIAL EQUITY AND REDUCE DISPARITIES FOR THOSE FACING RACISM AND DISCRIMINATION, PARTICULARLY FOR COMMUNITIES OF COLOR. PROGRAMMATIC OBJECTIVES1.1 WORK IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS TO IDENTIFY AND IMPLEMENT PROJECTS TO PROMOTE RACIAL EQUITY AND IMPROVE OUTCOMES, PARTICULARLY FOR PRIORITIZED POPULATION SEGMENTS1.2 BUILD INTERNAL ORGANIZATIONAL CAPACITY TO UNDERSTAND RACIAL EQUITY AND ENSURE EQUITABLE SERVICES ARE PROVIDED TO ALL1.3 COLLABORATE WITH LOCAL COMMUNITY PARTNERS TO STRENGTHEN THE LOCAL WORKFORCE AND ADDRESS UNDEREMPLOYMENT FOR PRIORITIZED POPULATIONS1.4 ADVOCATE FOR AND SUPPORT POLICIES AND SYSTEMS THAT IMPROVE RACIAL EQUITYCOMMUNITY ACTIVITIES / STRATEGIES - PROVIDE AN OPPORTUNITY FOR GRANT FUNDING TO COMMUNITY ORGANIZATIONS AND MUNICIPALITIES- PROVIDE SUPPORT AND FUNDING TO AFRICANO WALTHAM TO SUPPORT THEIR WORK IN REDUCING MENTAL HEALTH STIGMA TO YOUTH AND FAMILIES INCLUDING COUNSELING TO IMPROVE WELLNESS- PROVIDE SUPPORT AND FUNDING TO WE HEAL OURSELVES WITH LOVE AND EMPOWERMENT (WHOLE) PROGRAM BY SUPPORTING THEIR WORK TO ENGAGE, EDUCATE AND EMPOWER THE BIPOC COMMUNITY WITH COMPREHENSIVE HEALTH RESOURCES- SUPPORT AND PARTNER WITH CORE MH TO HELP BUILD THEIR CAPACITY TO PROMOTE RACIAL EQUITY IN THE MENTAL HEALTH WORKFORCE- PROVIDE SUPPORT AND FUNDING TO TRANSITION HOUSE TO INCREASE THEIR # OF TRAUMA-INFORMED COUNSELORS THAT IDENTIFY AS BIPOC- INCREASE BIPOC REPRESENTATION AMONG NEW LEADERSHIP (DIRECTORS AND ABOVE) AND CLINICAL (PHYSICIANS AND NURSES) HIRES- INCREASE STAFF EDUCATION ON DIVERSITY, EQUITY AND INCLUSION (DEI) PRINCIPLES - WORK WITH BILH DIVERSITY, EQUITY, AND INCLUSION COUNCIL TO EXPAND CONTRACTS WITH DIVERSE SUPPLIERS AND VENDORS- SUPPORT RELEVANT POLICIES WHEN PROPOSEDMETRICS AND STATUS:- AFRICANO WALTHAMO CREATED A TRACKING SYSTEM AT AFRICANO WALTHAM AND ENTERED 200 FAMILIES INTO THE SYSTEM FOR THE PURPOSE OF OVERSEEING MENTAL HEALTH ISSUES AND COUNSELING.O SUCCESSFULLY SERVED FIFTEEN FAMILIES WITH IN-DEPTH SERVICES AND COUNSELING WHICH IMPROVED WELLNESS FOR THESE FAMILIES.- WHOLE:O PROVIDED "JUST BREATH" CAREGIVER SUPPORT GROUP SESSIONS.O HIRED A PROGRAM MANAGER TO OVERSEE OPERATIONAL FUNCTIONS, LEAD IN DEVELOPING EVALUATION PROCESS FOR ALL PROGRAM ACTIVITIES, AND REPRESENT WHOLE AT EXTERNAL COMMUNITY MEETINGS.O PARTNERED WITH BOSTON COLLEGE'S RACISM-BASED VIOLENCE INJURY AND PREVENTION LAB TO OFFER A COMMUNITY EVENT CALLED: "ADDRESSING HOMICIDE VIOLENCE AMONG BLACK EMERGING ADULTS". OVER TWENTY PEOPLE ATTENDED.- CORE MH:O BY THE END OF 2023 PROGRAMMING YEAR, CONVENED THREE EVENTS ON RACIAL EQUITY AND MENTAL HEALTH WITH AN AVERAGE ATTENDANCE OF 15.O PROVIDED RACIAL EQUITY TRAINING. SEVENTY-THREE PERCENT OF PARTICIPANTS IMPROVED THEIR SKILLS TO INCORPORATE RACIALLY EXPLICIT PROGRAMMING, POLICY, OR ORGANIZATIONAL CHANGES WITHIN THEIR WORK ENVIRONMENT.O NINETY-THREE PERCENT OF COALITION MEMBERS HAVE ACCESS TO PROFESSIONAL NETWORKING OPPORTUNITIES THROUGH THE COALITION.- TRANSITION HOUSE:O TRANSITION HOUSE HIRED THREE NEW CLINICIANS, ONE OF WHOM IS A NATIVE PORTUGUESE SPEAKER AND ANOTHER IS A NATIVE SPANISH SPEAKER. THE THIRD CLINICIAN HIRED IS BLACK.O THIRTEEN TRAUMA SURVIVORS WHO IDENTIFIED AS BIPOC ENGAGED IN COUNSELING AND TEN OF THESE CLIENTS HAVE PARTICIPATED IN MORE THAN THREE SESSIONS OF COUNSELING. ALL OF THESE CLIENTS REPORTED BEING SATISFIED WITH THEIR EXPERIENCE WITH THE SEMI-ANNUAL CLIENT SATISFACTION SURVEY.- ACROSS BILH THERE WAS A 25% INCREASE IN BIPOC LEADERSHIP (DIRECTORS AND ABOVE) AND CLINICAL (PHYSICIANS AND NURSES) HIRES OVER FY22.- EIGHT SYSTEM-WIDE DEI TRAININGS WERE CONDUCTED FOR ALL BILH STAFF AND HOSPITALS.- MORE THAN $50 MILLION WAS CONTRACTED TO WOMEN AND MINORITY-OWNED BUSINESS ENTERPRISES (WMBE) IN FY23. THIS IS A 22% INCREASE OVER FY22.- MAH HAS CREATED A DIVERSITY, EQUITY AND INCLUSION COUNCIL TO GUIDE THE HOSPITAL'S EFFORTS TO NURTURE AND SUSTAIN A DIVERSE, EQUITABLE AND INCLUSIVE ORGANIZATIONAL CULTURE AND TO MAKE MEANINGFUL AND LASTING CHANGE FOR OUR PATIENTS, OUR EMPLOYEES AND OUR COMMUNITIES.COMMUNITY PARTNERSMAH 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:- AFRICANO WALTHAM- AMERICAN CANCER SOCIETY - ARLINGTON COUNCIL ON AGING - ARLINGTON EATS- ARLINGTON FIRE DEPARTMENT- ARLINGTON HEALTH AND HUMAN SERVICES- ARLINGTON POLICE DEPARTMENT- ARLINGTON YOUTH COUNSELING CENTER- BELMONT COUNCIL ON AGING- BELMONT DEPARTMENT OF PUBLIC HEALTH- BELMONT FIRE DEPARTMENT- BELMONT POLICE DEPARTMENT- CAMBRIDGE COMMUNITY FOUNDATION - CAMBRIDGE COMMUNITY LEARNING CENTER- CAMBRIDGE COUNCIL ON AGING- CAMBRIDGE DEPARTMENT OF PUBLIC HEALTH- CAMBRIDGE FIRE DEPARTMENT- CAMBRIDGE HEALTH ALLIANCE - CAMBRIDGE POLICE DEPARTMENT- CASPAR INC.- CHARLES RIVER COMMUNITY HEALTH - CITY OF CAMBRIDGE- CITY OF SOMERVILLE- CITY OF WALTHAM- COMMUNITY DAY CENTER OF WALTHAM- CORE MENTAL HEALTH- DE NOVO CENTER FOR JUSTICE AND HEALING- FIRST SOURCE- HARVARD UNIVERSITY EMS- HEALTHY WALTHAM - HOUSING CORP. OF ARLINGTON- KINGDOM EMPOWERMENT CENTER- LEXINGTON FIRE DEPARTMENT- LIFELINE IN HOME SERVICES AT MOUNT AUBURN- LIVE WELL WATERTOWN- MASSACHUSETTS ALLIANCE OF PORTUGUESE SPEAKERS- MASS. INSTITUTE OF TECHNOLOGY EMS- MASSACHUSETTS BAY TRANSIT AUTHORITY - MASSHIRE MNW- METRO CAB OF BOSTON- METRO HOUSING BOSTON- MORE THAN WORDS- PAINE SENIOR SERVICES- PROFESSIONAL AMBULANCE EMS - RAINBOW COMMISSION IN ARLINGTON- SCM COMMUNITY TRANSPORTATION - SOMERVILLE CAMBRIDGE ELDER SERVICES - SOMERVILLE CENTER FOR ADULT LEARNING EXPERIENCES (SCALE) - SOMERVILLE COUNCIL ON AGING - SOMERVILLE HEALTH AND HUMAN SERVICES- SOMERVILLE HOMELESS COALITION- SOMERVILLE POLICE DEPARTMENT- SOMERVILLE STAKEHOLDERS COALITION- SPRINGWELL ELDER SERVICES - TRANSITION HOUSE- TOWN OF ARLINGTON- TOWN OF BELMONT- TOWN OF WATERTOWN- WALTHAM CONNECTIONS - WALTHAM COUNCIL ON AGING - WALTHAM FAMILY SCHOOL- WALTHAM FIELDS COMMUNITY FARM- WALTHAM HEALTH DEPARTMENT- WALTHAM INTERAGENCY GROUP- WALTHAM PARTNERSHIP FOR YOUTH- WALTHAM POLICE DEPARTMENT- WATERTOWN CARES- WATERTOWN COUNCIL ON AGING- WATERTOWN FIRE DEPT.- WATERTOWN HEALTH DEPARTMENT- WATERTOWN POLICE DEPARTMENT- WAYSIDE YOUTH AND FAMILY SERVICES- Y2Y NETWORKAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, MAH IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE MOST RECENT CHNA THAT ARE NOT INCLUDED IN THE IMPLEMENTATION STRATEGY. THOSE NEEDS ARE: ADDRESSING THE DIGITAL DIVIDE (I.E., PROMOTING EQUITABLE ACCESS TO THE INTERNET), SUPPORTING EDUCATION ACROSS THE LIFESPAN, AND STRENGTHENING THE BUILT ENVIRONMENT (I.E., IMPROVING ROADS/SIDEWALKS AND ENHANCING ACCESS TO SAFE RECREATIONAL SPACES/ACTIVITIES). MAH WILL BE UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES.AS NOTED IN DETAIL ABOVE, MAH'S PRIMARY TOOL FOR ASSESSING THE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).
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FORM 990, SCHEDULE H, PART VI, SUPPLEMENTAL INFORMATION
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THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW MAH CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 19.15%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, 2022, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH/THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT MAH FILED WITH THE ATTORNEY GENERAL'S 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 BENEFITS-CHARITY 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 $ 5,577,016 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, MAH IS ONE OF ELEVEN 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 $73,152,852 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, FOR THE PERIOD COVERED BY THIS FILING, 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 CARE-MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, MAH ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT ENSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MAH GENERATED $7,019,957 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY MAH FOR SUCH SERVICES BY $6,974,037 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 13.36%% OR 42,214 OF MAH'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION. 43.83% OR 138,529 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE 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 $96,808,366 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $13,772,710. OF THESE AMOUNTS, REVENUE OF $67,424,843 IS RELATED TO THE PROVISION OF PATIENT CARE IN THE AREAS OF NEUROSCIENCES (INCLUDES DEMENTIA), CARDIOLOGY, HEMATOLOGY/ONCOLOGY, BEHAVIORAL HEALTH, ORTHOPEDICS, GASTROENTEROLOGY, GENERAL SURGERY, OBSTETRICS, GYNECOLOGY AND NEONATOLOGY/NEWBORN SERVICES 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 $20,330,619. 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. BAD DEBTSIN 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. COST FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $7,449,872 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. (BILH) AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 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), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER AND THEIR AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP). FINALLY, EFFECTIVE JULY 1, 2023, BILH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND THREE MONTHS OF EHRI'S ACTIVITY AS WELL AS THREE MONTHS OF EHRI'S AFFILIATES' ACTIVITY, INCLUDING EXETER HOSPITAL, ARE INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF BILH AND AFFILIATES.
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FINANCIAL STATEMENT FOOTNOTES
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PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSREVENUES UNDER THE TRADITIONAL FEE FOR SERVICE MEDICARE AND MEDICAID PROGRAMS ARE BASED PRIMARILY ON PROSPECTIVE PAYMENT SYSTEMS. RETROSPECTIVELY DETERMINED COST-BASED REVENUES UNDER THESE PROGRAMS, WHICH WERE MORE PREVALENT IN EARLIER PERIODS, AND CERTAIN OTHER PAYMENTS, SUCH AS DISPROPORTIONATE SHARE HOSPITAL AND BAD DEBT EXPENSE REIMBURSEMENT, WHICH ARE BASED ON OUR HOSPITALS' COST REPORTS, ARE ESTIMATED USING HISTORICAL TRENDS AND CURRENT FACTORS. COST REPORT SETTLEMENTS UNDER THESE PROGRAMS ARE SUBJECT TO AUDIT BY MEDICARE AND MEDICAID AUDITORS AND ADMINISTRATIVE AND JUDICIAL REVIEW, AND IT CAN TAKE SEVERAL YEARS UNTIL FINAL SETTLEMENT OF SUCH MATTERS IS DETERMINED AND COMPLETELY RESOLVED. THE SYSTEM RECORDS ACCRUALS TO REFLECT THE EXPECTED FINAL SETTLEMENTS ON COST REPORTS. FOR FILED COST REPORTS, THE ACCRUAL IS RECORDED BASED ON THOSE COST REPORTS AND SUBSEQUENT ACTIVITY. THE ACCRUAL FOR PERIODS FOR WHICH A COST REPORT IS YET TO BE FILED IS RECORDED BASED ON ESTIMATES OF WHAT THE SYSTEM EXPECTS TO REPORT ON THE FILED COST REPORTS. AFTER THE COST REPORT IS FILED, THE ACCRUAL MAY NEED TO BE ADJUSTED.THE MAH DEPARTMENT OF EMERGENCY MEDICINE PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, AND 365 DAYS A YEAR.FINANCIAL ASSISTANCE POLICY-INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE MAH IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE FROM MAH AS WELL AS PROVIDERS WHO FOLLOW MAH'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN MAH AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW MAH'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. MAH DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY AN AUTHORIZED BODY AS REQUIRED PURSUANT TO THE IRC SECTION 501(R) TREASURY REGULATIONS EFFECTIVE ON OR ABOUT AUGUST 15, 2020FINANCIAL ASSISTANCE POLICY-APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE 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 AND PORTUGUESE. (SCHEDULE H PART V SECTION B QUESTION 16I)
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FINANCIAL ASSISTANCE POLICY-WIDELY PUBLICIZING AND AVAILABILITY
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COPIES 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 HOSPITALS 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 ARMENIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, FRENCH, GREEK, HAITIAN CREOLE, PORTUGUESE, RUSSIAN AND SPANISH, CAN BE FOUND ON THE MAH WEBSITE AT: HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/LIMITATION ON CHARGES-INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED-LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS 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. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHAS NOTED THROUGHOUT THIS FORM 990, MOUNT AUBURN HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH MOUNT AUBURN HOSPITAL DOES NOT DIRECTLY ENGAGE IN RESEARCH, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC, NEW ENGLAND BAPTIST HOSPITAL AND JOSLIN DIABETES CENTER ALL ENGAGE IN RESEARCH ACTIVITIES DESIGNED TO CARE FOR PATIENTS NOT ONLY AT THESE LOCATIONS, BUT ACROSS THE COMMUNITIES SERVED BY BILH AND BEYOND. ALTHOUGH THE RESEARCH ACTIVITIES OF THESE BILH AFFILIATES ARE NOT QUANTIFIED HERE IN MOUNT AUBURN HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY MOUNT AUBURN HOSPITAL AND BEYOND AND INFORMATION ON THE RESEARCH ENGAGED IN AT BIDMC, A SISTER ENTITY TO MOUNT AUBURN HOSPITAL, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION. TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.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 1,220 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 280 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.
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THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST,
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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 O ALLERGY AND INFLAMMATIONO CARDIOVASCULAR MEDICINEO CENTER FOR VASCULAR BIOLOGY RESEARCHO CENTER FOR VIROLOGY AND VACCINE RESEARCHO CLINICAL INFORMATICSO CLINICAL NUTRITIONO ENDOCRINOLOGYO EXPERIMENTAL MEDICINEO GASTROENTEROLOGYO GENERAL MEDICINE AND PRIMARY CAREO GENETICSO GERONTOLOGYO HEMATOLOGY AND ONCOLOGYO HEMOSTASIS AND THROMBOSISO IMMUNOLOGYO INFECTIOUS DISEASEO INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGYO MOLECULAR AND VASCULAR MEDICINEO NEPHROLOGYO PULMONOLOGYO RHEUMATOLOGYO SIGNAL TRANSDUCTIONO TRANSLATIONAL RESEARCHO TRANSPLANT IMMUNOLOGY- NEONATOLOGY - NEUROLOGY - OBSTETRICS AND GYNECOLOGY - ORTHOPAEDIC SURGERY - PATHOLOGY - PSYCHIATRY - RADIOLOGY - SURGERY O CARDIAC SURGERYO CENTER FOR MINIMALLY INVASIVE SURGERYO NEUROSURGERYO PLASTIC AND RECONSTRUCTIVE SURGERYO VASCULAR SURGERY- TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $320 MILLION IN RESEARCH EXPENSES, MORE THAN $82 MILLION OF WHICH WERE INTERNALLY FUNDED AND REPORTED ON THE BIDMC SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE.RESEARCH ENGAGED IN AT THE MEDICAL CENTERTHE 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. DETAIL ON RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. 1. A POTENTIAL NEW WEAPON IN THE WAR AGAINST SUPERBUGS"THE END OF MODERN MEDICINE AS WE KNOW IT." THAT'S HOW THE THEN-DIRECTOR GENERAL OF THE WORLD HEALTH ORGANIZATION CHARACTERIZED THE CREEPING PROBLEM OF ANTIMICROBIAL RESISTANCE IN 2012. WITHOUT ANTIBIOTICS TO MANAGE COMMON BACTERIAL INFECTIONS, SMALL INJURIES AND MINOR INFECTIONS BECOME POTENTIALLY FATAL ENCOUNTERS. IN 2019, MORE THAN 2.8 MILLION ANTIMICROBIAL-RESISTANT INFECTIONS OCCURRED IN THE UNITED STATES, AND MORE THAN 35,000 PEOPLE DIED AS A RESULT, ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). A REPORT FROM THE UNITED NATIONS ISSUED EARLIER THIS YEAR WARNED THAT NUMBER COULD RISE TO TEN MILLION GLOBAL DEATHS ANNUALLY IF NOTHING IS DONE TO COMBAT ANTIMICROBIAL RESISTANCE.FOR NEARLY 25 YEARS, JAMES KIRBY, MD, DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORY AT BIDMC, HAS WORKED TO ADVANCE THE FIGHT AGAINST INFECTIOUS DISEASES BY FINDING AND DEVELOPING NEW, POTENT ANTIMICROBIALS, AND BY BETTER UNDERSTANDING HOW DISEASE-CAUSING BACTERIA MAKE US SICK. IN A RECENT PAPER PUBLISHED IN PLOS BIOLOGY, KIRBY AND COLLEAGUES INVESTIGATED A NATURALLY OCCURRING ANTIMICROBIAL AGENT DISCOVERED MORE THAN 80 YEARS AGO. USING LEADING-EDGE TECHNOLOGY, KIRBY'S TEAM DEMONSTRATED THAT CHEMICAL VARIANTS OF THE ANTIBIOTIC, CALLED STREPTOTHRICINS, SHOWED POTENCY AGAINST SEVERAL CONTEMPORARY DRUG-RESISTANT STRAINS OF BACTERIA. WHAT'S MORE, THEY SHOWED THE ANTIBIOTIC HAD A THERAPEUTIC EFFECT IN AN ANIMAL MODEL AT NON-TOXIC CONCENTRATIONS."A SINGLE DOSE CLEARED THIS ORGANISM FROM AN INFECTED ANIMAL MODEL WHILE AVOIDING ANY TOXICITY," KIRBY SAID. "IT WAS REALLY REMARKABLE." THE RESEARCHERS ALSO REVEALED THE UNIQUE MECHANISM BY WHICH STREPTOTHRICIN FIGHTS OFF BACTERIAL INFECTIONS. "WE SHOWED THAT NOURSEOTHRICIN ACTS IN A COMPLETELY NEW WAY COMPARED TO ANY OTHER TYPE OF ANTIBIOTIC, BY INHIBITING THE ABILITY OF THE ORGANISM TO PRODUCE PROTEINS IN A VERY SNEAKY WAY," KIRBY EXPLAINED. "WHEN A CELL MAKES PROTEINS, IT MAKES THEM OFF A BLUEPRINT THAT TELLS THE CELL WHAT AMINO ACIDS TO LINK TOGETHER TO BUILD THE PROTEIN. OUR STUDY HELPS EXPLAIN HOW THIS ANTIBIOTIC CONFUSES THE MACHINERY SO THAT THE MESSAGE IS READ INCORRECTLY, AND IT STARTS TO PUT TOGETHER GIBBERISH. ESSENTIALLY THE BACTERIAL CELL GETS POISONED BECAUSE IT'S PRODUCING JUNK."STREPTOTHRICIN'S UNIQUE ACTION IS VERY POWERFUL BECAUSE IT MEANS BACTERIA ARE CURRENTLY HELPLESS AGAINST IT; THAT IS, THERE'S NO ENVIRONMENTAL RESERVOIR OF POTENTIAL RESISTANCE MECHANISMS, KIRBY SAID. THAT GIVES HUMANITY MORE TIME BEFORE PATHOGENS EVOLVE DEFENSE MECHANISMS AGAINST THIS BRAND-NEW CLASS OF ANTIBIOTIC."WE'RE STILL IN THE VERY EARLY STAGES OF DEVELOPMENT, BUT I THINK WE'VE VALIDATED THAT THIS IS A COMPOUND THAT'S WORTH INVESTING IN FURTHER STUDIES TO FIND EVEN BETTER VARIANTS THAT EVENTUALLY WILL MEET THE PROPERTIES OF A HUMAN THERAPEUTIC," KIRBY SAID. 2. SEVERE COVID-19 LINKED WITH MOLECULAR SIGNATURES OF BRAIN AGING, RESEARCHERS FINDSCIENTISTS AT BIDMC FOUND THAT GENE USAGE IN THE BRAINS OF PATIENTS WITH COVID-19 IS SIMILAR TO THOSE OBSERVED IN AGING BRAINS. USING A MOLECULAR PROFILING TECHNIQUE CALLED RNA SEQUENCING TO MEASURE THE LEVELS OF EVERY GENE EXPRESSED IN A PARTICULAR TISSUE SAMPLE, THE SCIENTISTS ASSESSED CHANGES IN GENE EXPRESSION PROFILES IN THE BRAINS OF COVID-19 PATIENTS AND COMPARED THEM TO THOSE CHANGES OBSERVED IN THE BRAINS OF UNINFECTED INDIVIDUALS. THE TEAM'S ANALYSIS, PUBLISHED IN NATURE AGING, SUGGESTED THAT MANY BIOLOGICAL PATHWAYS THAT CHANGE WITH NATURAL AGING IN THE BRAIN ALSO CHANGED IN PATIENTS WITH SEVERE COVID-19.CO-FIRST AND CO-CORRESPONDING AUTHOR MARIA MAVRIKAKI, PHD, AN INSTRUCTOR OF PATHOLOGY AT BIDMC, AND COLLEAGUES ANALYZED A TOTAL OF 54 POSTMORTEM HUMAN FRONTAL CORTEX TISSUE SAMPLES FROM ADULTS 22 TO 85 YEARS OLD. "WE OBSERVED THAT GENE EXPRESSION IN THE BRAIN TISSUE OF PATIENTS WHO DIED OF COVID-19 CLOSELY RESEMBLED THAT OF UNINFECTED INDIVIDUALS 71 YEARS OLD OR OLDER," SAID CO-FIRST AUTHOR JONATHAN LEE, PHD, A POSTDOCTORAL RESEARCH FELLOW AT BIDMC."GIVEN THESE FINDINGS, WE ADVOCATE FOR NEUROLOGICAL FOLLOW-UP OF RECOVERED COVID-19 PATIENTS," SAID SENIOR AND CO-CORRESPONDING AUTHOR FRANK SLACK, PHD, DIRECTOR OF THE INSTITUTE FOR RNA MEDICINE AT BIDMC AND THE SHIELDS WARREN MALLINCKRODT PROFESSOR OF MEDICAL RESEARCH AT HARVARD MEDICAL SCHOOL. "WE ALSO EMPHASIZE THE POTENTIAL CLINICAL VALUE IN MODIFYING THE FACTORS ASSOCIATED WITH THE RISK OF DEMENTIA SUCH AS CONTROLLING WEIGHT AND REDUCING EXCESSIVE ALCOHOL CONSUMPTION TO REDUCE THE RISK OR DELAY THE DEVELOPMENT OF AGING-RELATED NEUROLOGICAL PATHOLOGIES AND COGNITIVE DECLINE."BETTER UNDERSTANDING OF THE MOLECULAR MECHANISMS UNDERLYING BRAIN AGING AND COGNITIVE DECLINE IN COVID-19 COULD LEAD TO THE DEVELOPMENT OF NOVEL THERAPEUTICS TO ADDRESS COGNITIVE DECLINE OBSERVED IN COVID-19 PATIENTS. THE TEAM IS NOW TRYING TO UNDERSTAND WHAT DRIVES THE AGING-LIKE EFFECTS IN THE BRAINS OF COVID-19 PATIENTS.3.. RESEARCH SUGGESTS POLITICAL EVENTS IMPACT SLEEP: STUDY FINDS ASSOCIATION BETWEEN ELECTIONS AND SLEEP, ALCOHOL CONSUMPTION AND OVERALL PUBLIC MOODIN A PAPER PUBLISHED IN THE NATIONAL SLEEP FOUNDATION'S JOURNAL SLEEP HEALTH, RESEARCHERS AT BIDMC SHOWED THAT MAJOR SOCIOPOLITICAL EVENTS CAN HAVE GLOBAL IMPACTS ON SLEEP THAT ARE ASSOCIATED WITH SIGNIFICANT FLUCTUATIONS IN THE PUBLIC'S COLLECTIVE MOOD, WELL-BEING, AND ALCOHOL CONSUMPTION.
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AS PART OF A LARGER STUDY EXPLORING THE SLEEP AND PSYCHOLOGICAL
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REPERCUSSIONS OF THE COVID-19 PANDEMIC, THE TEAM SURVEYED 437 PARTICIPANTS IN THE UNITED STATES AND 106 INTERNATIONAL PARTICIPANTS DAILY BETWEEN OCTOBER 113, 2020 (BEFORE THE ELECTION) AND OCTOBER 30NOVEMBER 12, 2020 (DAYS SURROUNDING THE NOVEMBER 3 U.S. ELECTION). WITH REGARD TO SLEEP, BOTH U.S. AND NON-U.S. PARTICIPANTS REPORTED LOSING SLEEP IN THE RUN-UP TO THE ELECTION; HOWEVER, U.S. RESPONDENTS HAD SIGNIFICANTLY LESS TIME IN BED IN THE DAYS AROUND THE ELECTION. ON ELECTION NIGHT ITSELF, U.S. PARTICIPANTS REPORTED WAKING UP FREQUENTLY DURING THE NIGHT AND EXPERIENCING POORER SLEEP EFFICIENCY.U.S. PARTICIPANTS WHO EVER REPORTED DRINKING ALCOHOL SIGNIFICANTLY INCREASED CONSUMPTION ON THREE DAYS DURING THE ASSESSMENT PERIOD: HALLOWEEN, ELECTION DAY AND THE DAY THE ELECTION WAS CALLED BY MORE MEDIA OUTLETS, SATURDAY, NOVEMBER 7. AMONG NON-U.S. PARTICIPANTS, THERE WAS NO CHANGE IN ALCOHOL CONSUMPTION OVER THE NOVEMBER ASSESSMENT PERIOD.WHEN THE SCIENTISTS LOOKED AT HOW THESE CHANGES IN BEHAVIOR MAY HAVE AFFECTED MOOD AND WELL-BEING OF U.S PARTICIPANTS, THEY FOUND SIGNIFICANT LINKS BETWEEN SLEEP AND DRINKING, STRESS, NEGATIVE MOOD, AND DEPRESSION."THIS IS THE FIRST STUDY TO FIND THAT THERE IS A RELATIONSHIP BETWEEN THE PREVIOUSLY REPORTED CHANGES IN ELECTION DAY PUBLIC MOOD AND SLEEP THE NIGHT OF THE ELECTION," SAID CORRESPONDING AUTHOR TONY CUNNINGHAM, PHD, DIRECTOR OF THE CENTER FOR SLEEP AND COGNITION AT BIDMC. "MOREOVER, IT IS NOT JUST THAT ELECTIONS MAY INFLUENCE SLEEP, BUT EVIDENCE SUGGESTS THAT SLEEP MAY INFLUENCE CIVIC ENGAGEMENT AND PARTICIPATION IN ELECTIONS AS WELL. THUS, IF THE RELATIONSHIP BETWEEN SLEEP AND ELECTIONS IS ALSO BIDIRECTIONAL, IT WILL BE IMPORTANT FOR FUTURE RESEARCH TO DETERMINE HOW PUBLIC MOOD AND STRESS EFFECTS ON SLEEP LEADING UP TO AN ELECTION MAY EFFECT OR EVEN ALTER ITS OUTCOME."4. TARGETED CARE REVERSES RACIAL/ETHNIC HEALTH DISPARITIES IN COLON CANCER SCREENING, RESEARCHERS FINDIN A RETROSPECTIVE REVIEW OF PATIENTS WHO HAD A RECENT PRIMARY CARE VISIT IN A WELL-RESOURCED SAFETY-NET HEALTH SYSTEM SERVING A DIVERSE POPULATION, A TEAM LED BY RESEARCHERS AT BIDMC AIMED TO BETTER DEFINE THE LINKS BETWEEN PATIENTS' SOCIO-DEMOGRAPHIC CHARACTERISTICS AND COLORECTAL SCREENING. EVALUATING SELF-REPORTED FACTORS INCLUDING RACE, ETHNICITY, PREFERRED LANGUAGE, MENTAL HEALTH AND SUBSTANCE USE STATUS, THE TEAM'S MORE GRANULAR ASSESSMENT PROVIDED FINDINGS THAT CONTRADICT TRADITIONAL U.S. HEALTHCARE DISPARITIES, WITH HISPANIC AND SPANISH-SPEAKING PATIENTS SCREENING AT SIGNIFICANTLY HIGHER RATES THAN WHITE AND ENGLISH-SPEAKING PATIENTS. THE COUNTERINTUITIVE FINDINGS, PUBLISHED IN PREVENTIVE MEDICINE, DEMONSTRATE THAT A HEALTHCARE SYSTEM DESIGNED TO PROVIDE EQUAL ACCESS TO SCREENING FOR UNDERSERVED PATIENTS CAN ADDRESS THE DISPARITIES COMMONLY SEEN IN CANCER SCREENING."INVESTMENT INTO A MULTICULTURAL WORKFORCE AND OUTREACH EFFORTS TO UNDERSERVED PATIENTS MAY COUNTERACT SOME OF THE IMPLICIT OR EXPLICIT BIASES SEEN ON HEALTH SYSTEMS THAT HAVE LED TO TRADITIONAL RACIAL/ETHNIC DISPARITIES," SAID SENIOR AUTHOR HEIDI J. RAYALA, MD, PHD, UROLOGIST AT BIDMC. "OUR STUDY SHOWED DIFFERENCES IN ODDS OF SUCCESSFUL SCREENING BASED ON SUB-SECTIONS OF TRADITIONALLY DEFINED ETHNICITIES SUCH AS BREAKING DOWN "HISPANIC" INTO MORE SPECIFIC CULTURES AND BACKGROUNDS AND THAT SUGGESTS THAT FUTURE RESEARCH SHOULD FOCUS ON BETTER UNDERSTANDING INDIVIDUAL CULTURES AND COMMUNITIES, RATHER THAN LUMPING PATIENTS INTO OVERLY LARGE GROUPS."RAYALA AND COLLEAGUES LOOKED AT DE-IDENTIFIED RECORDS OF MORE THAN 22,000 PATIENTS BETWEEN 50- AND 75-YEARS OLD WHO SAW A PRIMARY CARE PHYSICIAN AT CAMBRIDGE HEALTH ALLIANCE (CHA) IN 2018 TO 2019. OF THE 22,000 PATIENTS INCLUDED IN THE STUDY, 16,065 UNDERWENT COLORECTAL SCREENING, AN OVERALL SCREENING RATE OF 73 PERCENT--ON PAR WITH MASSACHUSETTS' OVERALL COLORECTAL SCREENING RATES. HOWEVER, MASSACHUSETTS' NUMBERS REFLECT NATIONAL RACIAL AND ETHNIC DISPARITIES, IN WHICH PEOPLE OF COLOR DO NOT GET SCREENED AS OFTEN AS WHITE PEOPLE, SHOWING A SCREENING RATE OF 56 PERCENT OF HISPANIC INDIVIDUALS AND 68 PERCENT OF BLACK INDIVIDUALS COMPARED TO 76 PERCENT FOR WHITE INDIVIDUALS.IN CONTRAST, AT CHA, HISPANICS HAD THE HIGHEST SCREENING RATES OF 78 PERCENT. RAYALA AND COLLEAGUES FURTHER BROKE OUT PARTICIPANTS BY MORE GRANULAR DEMOGRAPHIC FACTORS, FINDING THE ETHNICITY OF PORTUGUESE/AZOREAN RECEIVED SCREENING AT 79 PERCENT. SPANISH SPEAKERS IN GENERAL HAD THE HIGHEST SCREENING RATE OF NEARLY 80 PERCENT.5. PATIENTS OVERWHELMINGLY PREFER IMMEDIATE ACCESS TO TEST RESULTS, EVEN WHEN THE NEWS MAY NOT BE GOODIN APRIL 2021, NEW FEDERAL RULES WENT INTO EFFECT MANDATING THAT HEALTHCARE PROVIDERS MAKE NEARLY ALL TEST RESULTS AND CLINICAL NOTES IMMEDIATELY AVAILABLE TO PATIENTS. EVIDENCE SUGGESTS THAT PATIENTS MAY GAIN IMPORTANT CLINICAL BENEFITS BY REVIEWING THEIR MEDICAL RECORDS, AND ACCESS THROUGH ELECTRONIC PATIENT PORTALS HAS BEEN ADVOCATED AS A STRATEGY FOR EMPOWERING PATIENTS TO MANAGE THEIR HEALTH CARE AND FOR STRENGTHENING PATIENT-CLINICIAN RELATIONSHIPS. HOWEVER, CONCERNS REMAIN ABOUT THE EFFECTS OF RELEASING TEST RESULTS TO PATIENTS BEFORE CLINICIANS OFFER COUNSEL OR INTERPRETATION.IN A FIRST-OF-ITS-KIND MULTISITE SURVEY OF MORE THAN 8,000 PATIENTS WHO ACCESSED THEIR TEST RESULTS VIA AN ONLINE PATIENT PORTAL ACCOUNT, RESEARCHERS AT BIDMC AND COLLEAGUES FOUND THAT USERS OVERWHELMINGLY SUPPORTED RECEIVING THE RESULTS IMMEDIATELY, EVEN IF THEIR PROVIDER HAD NOT YET REVIEWED THEM. THE FINDINGS, PUBLISHED IN JAMA NETWORK OPEN, SHOWED ONLY A SMALL SUBSET OF PATIENTS REPORTED EXPERIENCING ADDITIONAL WORRY AFTER RECEIVING ABNORMAL TEST RESULTS. IN ADDITION, PRE-COUNSELING BY THE HEALTH CARE TEAM BEFORE TESTS WERE ORDERED WAS LINKED TO REDUCED WORRY AMONG PATIENTS WITH ABNORMAL RESULTS."ONLINE PATIENT PORTALS HAVE EMERGED AS IMPORTANT TOOLS FOR INCREASING PATIENT ENGAGEMENT," SAID CO-SENIOR AUTHOR CATHERINE M. DESROCHES, DRPH, EXECUTIVE DIRECTOR OF OPENNOTES, THE INTERNATIONAL MOVEMENT BASED AT BIDMC FOCUSED ON INCREASING INFORMATION TRANSPARENCY IN HEALTHCARE. "THEY ENABLE PATIENTS TO ACCESS INFORMATION, PARTICIPATE IN MEDICAL DECISION-MAKING AND TO COMMUNICATE WITH CLINICIANS. PRIOR STUDIES PERFORMED BY OPENNOTES INVESTIGATORS ESTABLISHED IMMEDIATE RELEASE OF CLINICAL NOTES AS A RECOMMENDED BEST PRACTICE. HOWEVER, RELEASING TEST RESULTS TO PATIENTS IMMEDIATELY, OFTEN BEFORE A CLINICIAN CAN PROVIDE COUNSELLING AND CONTEXT, WAS YET TO BE STUDIED WIDELY."TO ASSESS PATIENT AND CAREGIVER ATTITUDES AND PREFERENCES RELATED TO RECEIVING TEST RESULTS THROUGH THE PATIENT PORTAL, DESROCHES AND COLLEAGUES DELIVERED SURVEYS TO MORE THAN 43,000 PATIENTS AND CARE PARTNERS WHO ACCESSED THEIR TEST RESULTS VIA AN ONLINE PATIENT PORTAL ACCOUNT BETWEEN APRIL 2021 AND APRIL 2022. WHEN ASKED ABOUT THEIR PREFERENCES FOR CONTACTS ABOUT FUTURE TEST RESULTS, 90 PERCENT OF RESPONDENTS WITH NORMAL RESULTS INDICATED THEY WOULD PREFER RECEIVING THEIR RESULT VIA THE PATIENT PORTAL. THE SURVEY RESULTS SUGGEST THAT PATIENTS RECEIVING NOT NORMAL RESULTS ARE INDEED AT INCREASED RISK FOR WORRY. NEVERTHELESS, MORE THAN 95 PERCENT OF PARTICIPANTS WHO RECEIVED ABNORMAL TEST RESULTS REPORTED PREFERRING TO CONTINUE TO RECEIVE IMMEDIATELY RELEASED RESULTS THROUGH THE PORTAL."RESPONDENTS OVERWHELMINGLY PREFERRED TO RECEIVE TEST RESULTS THROUGH THE PATIENT PORTAL, EVEN IF IT MEANT VIEWING RESULTS PRIOR TO DISCUSSING THEM WITH A HEALTHCARE PROFESSIONAL," SAID CO-AUTHOR LIZ SALMI, COMMUNICATIONS AND PATIENT INITIATIVES DIRECTOR OF OPENNOTES AT BIDMC. "AS HEALTHCARE SYSTEMS CONTINUE TO NAVIGATE THIS NEW ERA OF HEALTH INFORMATION TRANSPARENCY, BALANCING PATIENTS' EXPECTATION OF IMMEDIATE ACCESS TO THEIR INFORMATION WITH THE NEED TO MANAGE INCREASED WORRY IS IMPORTANT."
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6. SHARP RISE IN CARDIOVASCULAR RISK FACTORS AMONG
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YOUNG ADULTS FORESHADOWS PUBLIC HEALTH CRISISIN A STUDY PUBLISHED IN JAMA AND PRESENTED AT THE AMERICAN COLLEGE OF CARDIOLOGY SCIENTIFIC SESSIONS, RESEARCHERS AT BIDMC ANALYZED MORE THAN A DECADE'S WORTH OF DATA TO EXAMINE RATES OF CARDIOVASCULAR RISK FACTORS - SUCH AS HIGH BLOOD PRESSURE, DIABETES, OBESITY AND SMOKING- AMONG US ADULTS FROM 2009 TO MARCH 2020. THE RESEARCHERS OBSERVED A RISE IN HYPERTENSION AND SIGNIFICANT INCREASES IN DIABETES AND OBESITY RATES AMONG YOUNG ADULTS, WITH NO SIGNIFICANT IMPROVEMENT IN CONTROL OF BLOOD PRESSURE OR BLOOD SUGAR. THE SCIENTISTS ALSO OBSERVED SUBSTANTIAL VARIATION IN THESE TRENDS BY RACE AND ETHNICITY."THE ONSET OF CARDIOVASCULAR RISK FACTORS EARLY IN LIFE IS ASSOCIATED WITH A HIGHER RISK OF HEART DISEASE AND ACUTE EVENTS, SUCH AS HEART ATTACK AND STROKE, RESULTING IN THE SUBSTANTIAL LOSS OF QUALITY OF LIFE AND YEARS OF LIFE," SAID CORRESPONDING AUTHOR RISHI K. WADHERA, MD, MPP, MPHIL, SECTION HEAD OF HEALTH POLICY AND EQUITY AT THE SMITH CENTER FOR OUTCOMES RESEARCH IN CARDIOLOGY AT BIDMC. "THEREFORE, THE SUBSTANTIAL RISE IN THE BURDEN OF CARDIOVASCULAR RISK FACTORS AMONG YOUNG ADULTS WILL HAVE MAJOR PUBLIC HEALTH IMPLICATIONS AS THE POPULATION AGES."WADHERA AND COLLEAGUES OBSERVED THAT THE PREVALENCE OF HYPERTENSION INCREASED AND SAW STATISTICALLY SIGNIFICANT INCREASES IN RATES OF DIABETES AND OBESITY DURING THE STUDY PERIOD. THE PERCENTAGE OF YOUNG ADULTS WITH A SMOKING HISTORY WAS HIGH AND DID NOT CHANGE. IN CONTRAST, RATES OF HIGH CHOLESTEROL DECLINED, A DECREASE THE SCIENTISTS SUGGEST REFLECTS GOVERNMENT REGULATION OF THE USE OF TRANS FATTY ACIDS AND OTHER PARTIALLY HYDROGENATED OILS IN PACKAGED CONVENIENCE FOODS AND FAST-FOOD RESTAURANTS.THE RESEARCHERS FOUND SUBSTANTIAL VARIATION IN PREVALENCE OF RISK FACTORS BY RACE AND ETHNICITY. OBESITY SIGNIFICANTLY INCREASED ACROSS ALL RACIAL AND ETHNIC GROUPS EXCEPT BLACK ADULTS. WHILE RATES OF HYPERTENSION INCREASED AMONG MEXICAN AMERICANS AND OTHER HISPANIC ADULTS, BLACK ADULTS EXPERIENCED THE HIGHEST RATES OF HYPERTENSION.THE RESEARCHERS ALSO EXAMINED CARDIOVASCULAR RISK FACTOR TREATMENT AND CONTROL RATES AMONG YOUNG ADULTS. ONLY ABOUT 55 PERCENT OF YOUNG ADULTS WITH HIGH BLOOD PRESSURE RECEIVE TREATMENT FOR THE CONDITION. RATES OF DIABETES TREATMENT WERE ALSO LOW, WITH ONE OUT OF TWO YOUNG ADULTS ON THERAPY FOR THEIR DIABETES. NEARLY HALF OF YOUNG ADULTS ON TREATMENT FOR DIABETES HAD POOR BLOOD SUGAR CONTROL."THE SUBOPTIMAL TREATMENT RATES FOR HIGH BLOOD PRESSURE AND DIABETES ARE CONCERNING AND MAY BE BECAUSE MANY YOUNG ADULTS AREN'T AWARE OF THEIR DIAGNOSIS," SAID WADHERA. "THE RISE IN CARDIOVASCULAR RISK FACTORS THAT WE OBSERVED SHOULD BE A CALL-TO-ACTION TO INTENSIFY PUBLIC HEALTH AND CLINICAL INTERVENTIONS FOCUSED ON THE PREVENTION AND TREATMENT OF CARDIOVASCULAR RISK FACTORS IN YOUNG ADULTS."7. COSTS OF NATURAL DISASTERS SET TO SPIRAL WITH CONTINUED RISE IN CO2 AND GLOBAL TEMPERATURE, STUDY SHOWSIN A PAPER PUBLISHED IN THE JOURNAL OF CLIMATE CHANGE AND HEALTH, MEMBERS OF THE BIDMC FELLOWSHIP IN DISASTER MEDICINE ESTIMATED THAT CLIMATE CHANGE-RELATED NATURAL DISASTERS HAVE INCREASED SINCE 1980 AND HAVE ALREADY COST THE UNITED STATES MORE THAN $2 TRILLION IN RECOVERY COSTS. THEIR ANALYSIS ALSO SUGGESTS THAT AS ATMOSPHERIC CARBON DIOXIDE LEVELS AND THE GLOBAL TEMPERATURE CONTINUE TO RISE, THE FREQUENCY AND SEVERITY OF DISASTERS WILL INCREASE, WITH RECOVERY COSTS POTENTIALLY RISING EXPONENTIALLY."THE UNITED STATES SPENDS A STAGGERING AMOUNT ON COSTS SECONDARY TO NATURAL DISASTERS," SAID SENIOR AUTHOR GREGORY CIOTTONE, MD, DIRECTOR OF THE DISASTER MEDICINE FELLOWSHIP AT BIDMC. "CARBON DIOXIDE LEVELS AND TEMPERATURES HAVE INCREASED OVER THE PAST FOUR DECADES AND ARE STRONGLY POSITIVELY CORRELATED WITH THE NUMBER AND COST OF BILLION-DOLLAR DISASTERS, SUGGESTING THE ANNUAL NUMBER OF EVENTS WILL CONTINUE TO INCREASE ALONG WITH THEIR ECONOMIC BURDEN. MEASURES ARE NEEDED TO MITIGATE THOSE COSTS."TO ASSESS THE RELATIONSHIP BETWEEN RISING CARBON DIOXIDE LEVELS, TEMPERATURES AND THE NUMBER OF DISASTERS COSTING A BILLION DOLLARS OR MORE IN THE UNITED STATES, CIOTTONE AND COLLEAGUES ANALYZED DATA BETWEEN 1980-2021 FROM THE NATIONAL CENTER FOR ENVIRONMENTAL INFORMATION (NCEI). THE TEAM FOUND THAT THE INCREASES IN ATMOSPHERIC CARBON DIOXIDE LEVELS AND TEMPERATURE TIGHTLY LINKED TO EACH OTHER WERE ASSOCIATED WITH INCREASING NUMBERS OF EVENTS PER YEAR, AS WELL AS FATALITIES. AFTER ADJUSTING DOLLAR VALUES FOR INFLATION, THEIR ANALYSIS SHOWED THAT MORE FREQUENT AND MORE SEVERE DISASTERS ARE INCURRING RISING COSTS.AMONG THEIR FINDINGS: FROM 1980-1989, THERE WERE 3 BILLION-DOLLAR EVENTS PER YEAR AND 297 DEATHS PER YEAR, COSTING A TOTAL OF $19.5 BILLION. BY 2010-2019, THE RISE IN CARBON DIOXIDE LEVELS AND TEMPERATURE WERE LINKED WITH 13 ANNUAL EVENTS, 523 ANNUAL DEATHS, AND $89.2 BILLION IN RECOVERY COSTS, A FOURFOLD INCREASE."FRAMING DISASTERS IN THIS ECONOMIC LIGHT CAN BRING MORE ATTENTION AND MOTIVATION FOR CHANGE TO ALTER POLICYMAKERS' DECISIONS," SAID CORRESPONDING AUTHOR VIJAI BHOLA, MD, A GRADUATE OF THE DISASTER MEDICINE FELLOWSHIP AT BIDMC, WHO NOTES THE CURRENT ANALYSIS CAPTURES JUST A FRACTION OF THE COSTS INCURRED BY CLIMATE CHANGE. "THESE COSTS REPRESENT A COMBINATION OF IMMEDIATE AND LONGER-TERM RESTORATION ESTIMATES. WHAT THEY DO NOT REFLECT, HOWEVER, ARE FACTORS SUCH AS DESTRUCTION OF NATURAL RESOURCES OR LOSS OF LIFE, AND THEREFORE THESE NUMBERS SIGNIFICANTLY UNDERESTIMATE THE TRUE COST OF CLIMATE-RELATED DISASTERS."8. RESEARCHERS TEST AI POWERED CHATBOTS MEDICAL DIAGNOSTIC ABILITYIN A RECENT EXPERIMENT PUBLISHED IN JAMA, PHYSICIAN-RESEARCHERS AT BIDMC TESTED ONE WELL-KNOWN PUBLICLY AVAILABLE CHATBOT'S ABILITY TO MAKE ACCURATE DIAGNOSES IN CHALLENGING MEDICAL CASES. THE TEAM FOUND THAT THE GENERATIVE AI, CHAT-GPT 4, SELECTED THE CORRECT DIAGNOSIS AS ITS TOP DIAGNOSIS NEARLY 40 PERCENT OF THE TIME AND PROVIDED THE CORRECT DIAGNOSIS IN ITS LIST OF POTENTIAL DIAGNOSES IN TWO-THIRDS OF CHALLENGING CASES.GENERATIVE AI CHATBOTS ARE POWERFUL TOOLS POISED TO REVOLUTIONIZE CREATIVE INDUSTRIES, EDUCATION, CUSTOMER SERVICE AND MORE. HOWEVER, LITTLE IS KNOWN ABOUT THEIR POTENTIAL PERFORMANCE IN THE CLINICAL SETTING, SUCH AS COMPLEX DIAGNOSTIC REASONING."RECENT ADVANCES IN ARTIFICIAL INTELLIGENCE HAVE LED TO GENERATIVE AI MODELS THAT ARE CAPABLE OF DETAILED TEXT-BASED RESPONSES THAT SCORE HIGHLY IN STANDARDIZED MEDICAL EXAMINATIONS," SAID ADAM RODMAN, MD, MPH, CO-DIRECTOR OF THE INNOVATIONS IN MEDIA AND EDUCATION DELIVERY (IMED) INITIATIVE AT BIDMC. "WE WANTED TO KNOW IF SUCH A GENERATIVE MODEL COULD 'THINK LIKE A DOCTOR, SO WE ASKED ONE TO SOLVE STANDARDIZED COMPLEX DIAGNOSTIC CASES USED FOR EDUCATIONAL PURPOSES. IT DID REALLY, REALLY WELL."TO ASSESS THE CHATBOT'S DIAGNOSTIC SKILLS, RODMAN AND COLLEAGUES USED CLINICOPATHOLOGICAL CASE CONFERENCES (CPCS), A SERIES OF COMPLEX AND CHALLENGING PATIENT CASES INCLUDING RELEVANT CLINICAL AND LABORATORY DATA, IMAGING STUDIES, AND HISTOPATHOLOGICAL FINDINGS PUBLISHED IN THE NEW ENGLAND JOURNAL OF MEDICINE FOR EDUCATIONAL PURPOSES.EVALUATING 70 CPC CASES, THE ARTIFICIAL INTELLIGENCE EXACTLY MATCHED THE FINAL CPC DIAGNOSIS IN 27 (39 PERCENT) OF CASES. IN 64 PERCENT OF THE CASES, THE FINAL CPC DIAGNOSIS WAS INCLUDED IN THE AI'S DIFFERENTIAL A LIST OF POSSIBLE CONDITIONS THAT COULD ACCOUNT FOR A PATIENT'S SYMPTOMS, MEDICAL HISTORY, CLINICAL FINDINGS AND LABORATORY OR IMAGING RESULTS."WHILE CHATBOTS CANNOT REPLACE THE EXPERTISE AND KNOWLEDGE OF A TRAINED MEDICAL PROFESSIONAL, GENERATIVE AI IS A PROMISING POTENTIAL ADJUNCT TO HUMAN COGNITION IN DIAGNOSIS," SAID FIRST AUTHOR ZAHIR KANJEE, MD, MPH, A HOSPITALIST AT BIDMC. "IT HAS THE POTENTIAL TO HELP PHYSICIANS MAKE SENSE OF COMPLEX MEDICAL DATA AND BROADEN OR REFINE OUR DIAGNOSTIC THINKING. WE NEED MORE RESEARCH ON THE OPTIMAL USES, BENEFITS AND LIMITS OF THIS TECHNOLOGY, AND A LOT OF PRIVACY ISSUES NEED SORTING OUT, BUT THESE ARE EXCITING FINDINGS FOR THE FUTURE OF DIAGNOSIS AND PATIENT CARE.""OUR STUDY ADDS TO A GROWING BODY OF LITERATURE DEMONSTRATING THE PROMISING CAPABILITIES OF AI TECHNOLOGY," SAID CO-AUTHOR BYRON CROWE, MD, AN INTERNAL MEDICINE PHYSICIAN AT BIDMC. "FURTHER INVESTIGATION WILL HELP US BETTER UNDERSTAND HOW THESE NEW AI MODELS MIGHT TRANSFORM HEALTH CARE DELIVERY."9. INTEGRATING TECHNOLOGY TO BETTER SUPPORT MENTAL HEALTH CAREOVER THE PAST DECADE, DEMAND FOR MENTAL HEALTH SERVICES HAS RISEN SIGNIFICANTLY, WITH THE NUMBER OF ADULTS RECEIVING PSYCHIATRIC CARE INCREASING BY MORE THAN 12 PERCENT SINCE 2011, ACCORDING TO THE NATIONAL ALLIANCE FOR MENTAL ILLNESS. HOWEVER, A SHORTAGE OF MENTAL HEALTH CLINICIANS MEANS MANY PEOPLE ARE STILL NOT ABLE TO ACCESS THE CARE THEY NEED.
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IN A CASE STUDY PUBLISHED IN NEJM CATALYST, CLINICIAN-INVESTIGATORS
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IN THE DIVISION OF DIGITAL PSYCHIATRY AT BIDMC HIGHLIGHT A MODEL THEY DEVELOPED FOR INTEGRATING DIGITAL TECHNOLOGIES AND BRIEF EVIDENCE-BASED TREATMENT INTO IN-PERSON PSYCHIATRY. KNOWN AS THE DIGITAL CLINIC, THE TEAM'S INNOVATIVE HYBRID CARE MODEL EXPANDS PATIENTS' ACCESS TO HIGHLY EFFECTIVE MENTAL HEALTH CARE WHILE SIGNIFICANTLY DECREASING PATIENT WAIT TIMES AND LENGTH OF TREATMENT. ADDITIONALLY, THE TEAM'S RECENT PILOT STUDY SUGGESTS THAT THIS MODEL MAY YIELD POST-TREATMENT IMPROVEMENTS IN PATIENTS' SYMPTOMS OF DEPRESSION AND ANXIETY THAT ARE COMPARABLE TO, IF NOT BETTER THAN, TRADITIONAL MODELS OF CARE."AS THE SEVERITY OF MENTAL HEALTH CRISES INCREASES, EVIDENCED BY RISING RATES OF DEPRESSION AND ANXIETY ESPECIALLY IN YOUNG PEOPLE, IT'S CRITICAL THAT INNOVATIVE SOLUTIONS ARE DEVELOPED TO INCREASE ACCESS TO HIGH-QUALITY PSYCHIATRIC CARE," SAID SENIOR AUTHOR JOHN TOROUS, MD, MBI, DIRECTOR OF THE DIVISION OF DIGITAL PSYCHIATRY AT BIDMC. "OUR ENCOURAGING FINDINGS SUGGEST THAT WHEN WE TARGET DEPRESSION AND ANXIETY WITH BRIEF, TECHNOLOGY-ENHANCED, EVIDENCE-BASED TREATMENT, OUR PATIENTS CAN OBTAIN MEANINGFUL GAINS."IN A RECENT PILOT STUDY OF 40 ADULT PATIENTS WHO RECEIVED EIGHT WEEKS OF TREATMENT FOR DEPRESSION AND/OR ANXIETY IN THE DIGITAL CLINIC BETWEEN OCTOBER 2022 AND JANUARY 2023, 67 PERCENT OF PATIENTS' MENTAL HEALTH OUTCOMES THAT WERE TARGETED IN TREATMENT REFLECTED CLINICALLY SIGNIFICANT IMPROVEMENT. NOTABLY, 64 PERCENT OF THOSE PATIENT OUTCOMES REFLECTED REMISSION, DEFINED AS HAVING "MILD, MINIMAL OR NO SYMPTOMS" BY THE END OF TREATMENT."THESE OUTCOMES MEET AND EXCEED OUTCOMES FROM LONGER-TERM TREATMENT," SAID TOROUS, WHO ADDED THAT RECENT META-ANALYSES OF MAINLY MAINSTREAM, EVIDENCE-BASED TREATMENTS FOUND REMISSION RATES OF JUST OVER HALF FOR ANXIETY DISORDERS AND ROUGHLY ONE THIRD FOR DEPRESSION. LIKEWISE, STUDIES HAVE SHOWN THAT DIGITAL APPROACHES TO MENTAL HEALTH CAN YIELD IMPRESSIVE RESULTS WHEN PATIENTS CONSISTENTLY ENGAGE WITH THEM, BUT DECADES OF USER-CENTERED DESIGN AND GAMIFICATION HAVE NOT SOLVED THE PROBLEM OF KEEPING PEOPLE REGULARLY INTERACTING WITH THE TECHNOLOGY LONG TERM."WE DESIGNED THE DIGITAL CLINIC TO HARNESS THE STRENGTHS OF BOTH TRADITIONAL AND DIGITAL MENTAL HEALTH CARE," SAID FIRST AUTHOR NATALIA MACRYNIKOLA, PHD, A POSTDOCTORAL RESEARCH FELLOW AT BIDMC. "THE BENEFITS OF HUMAN RAPPORT, THE THERAPEUTIC ALLIANCE, AND A THERAPIST'S ABILITY TO TAILOR EVIDENCED-BASED THERAPEUTIC INTERVENTIONS TO THE NEEDS OF EACH CLIENT ARE TANGIBLE ADVANTAGES OF TRADITIONAL CARE, WHEREAS THE SCALABILITY AND ACCESSIBILITY OF DIGITAL APPROACHES CONFER CLEAR ADVANTAGES THAT SHOULD NOT BE OVERLOOKED."10. NEW NATIONAL STANDARDS FOR NEONATAL INTENSIVE CARE AIM TO ACHIEVE HEALTH EQUITY FOR US NEWBORNSLED BY BIDMC NEONATOLOGIST ANN R. STARK, MD, IN HER CAPACITY AS MEDICAL DIRECTOR OF THE NICU VERIFICATION PROGRAM FOR THE AMERICAN ACADEMY OF PEDIATRICS (AAP), A TEAM OF NEONATAL LEADERS AND EXPERIENCED CLINICIANS HAVE ESTABLISHED NEW STANDARDS FOR LEVELS OF NEONATAL CARE THAT SPECIFY THE PERSONNEL, EQUIPMENT AND SERVICES HOSPITALS NEED TO PROVIDE FOR NEWBORNS AND FAMILIES. BASED ON AAP POLICY, EVIDENCE-BASED LITERATURE AND STANDARDS OF PROFESSIONAL PRACTICE, STANDARDS FOR LEVELS OF NEONATAL CARE: II, III, & IV, APPEARED IN THE AAP'S JOURNAL PEDIATRICS."WE HAVE CREATED THESE STANDARDS WITH A GOAL TO IMPROVE OUTCOMES, INCREASE ACCESS TO CARE, IMPROVE STANDARDIZATION ACROSS ALL LEVELS OF NEONATAL CARE AND ACHIEVE HEALTH EQUITY FOR BABIES ACROSS THE COUNTRY," SAID STARK, "WE WERE CONCERNED THAT FIRST, ALL BABIES SHOULD BE TREATED IN A PLACE WITH APPROPRIATE CARE AND SECOND, THAT THE FACILITY HAS THE PEOPLE AND THE EQUIPMENT THAT ARE APPROPRIATE FOR THEIR DEGREE OF ILLNESS OR IMMATURITY." THE UNITED STATES RANKS 35TH IN NEONATAL MORTALITY AMONG DEVELOPED NATIONS; MORE THAN THREE BABIES OUT OF EVERY 1,000 BABIES DIE WITHIN THEIR FIRST MONTH OF LIFE. MANY FACTORS CONTRIBUTE TO THESE SHOCKING NUMBERS, HOWEVER, EXPERTS AGREE ONE REASON IS THE LACK OF NATIONAL STANDARDS FOR NEONATAL INTENSIVE CARE UNITS (NICUS). WITH PUBLICATION OF THE NEW STANDARDS, AND WHEN PROCESSES ARE IN PLACE, THE AAP PROGRAM WILL BE ABLE TO VERIFY A NEONATAL FACILITY'S COMPLIANCE AND DESIGNATE THAT IT PROVIDES A SPECIFIC LEVEL OF NEONATAL CARE (II, III OR IV). HOSPITALS WILL SUBMIT DATA AND UNDERGO A SURVEY OF THEIR FACILITY. THOSE THAT MEET REQUIREMENTS WILL BE ABLE TO STATE THAT THEY ARE AAP-VERIFIED AT A PARTICULAR LEVEL OF NEONATAL CARE. THE DESIGNATION THEN WILL BE TRANSPARENT TO PHYSICIANS AND FAMILIES DECIDING WHERE TO DELIVER AND/OR SEEK CARE FOR THEIR BABY."PARENTS SHOULD UNDERSTAND THE LEVEL OF NEONATAL CARE AVAILABLE WHERE THEY ARE DELIVERING," SAID STARK. "WHETHER THEY ARE BORN IN URBAN ACADEMIC MEDICAL CENTERS OR RURAL COMMUNITY HOSPITALS, ALL BABIES DESERVE OPTIMAL CARE. ADOPTION OF THE AAP NEONATAL STANDARDS IS A VITAL STEP TOWARD HIGH-QUALITY AND EQUITABLE CARE."CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS - HEALTH PROFESSIONS EDUCATIONMOUNT AUBURN HOSPITAL'S (MAH) CENTRAL LONGSTANDING ACADEMIC FOCUS IS MEDICAL EDUCATION THROUGHA 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, 2022 JUNE 30, 2023 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, OBSTETRICS AND GYNECOLOGY, 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 EAST COAST. STAFF PHYSICIANS AT MAH WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL OR BOSTON UNIVERSITY 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 RESIDENCY WILL CELEBRATE ITS 50TH ANNIVERSARY IN 2024 WHICH ATTESTS TO THE LONGSTANDING COMMITMENT TO MEDICAL EDUCATION AT MAH. 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 CAN 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.
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THE PRELIMINARY MEDICINE INTERNSHIP TRACK OFFERS ONE YEAR OF TRAINING
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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 GIVEN THE RIGOR OF THE TRAINING.. THE MAH RADIOLOGY RESIDENCY PROGRAM HAS A LONGSTANDING HISTORY AS A COMPETITIVE TRAINING PROGRAM. RESIDENTS ARE TYPICALLY ASSIGNED IN ONE-MONTH BLOCKS TO ONE OF THE DIFFERENT IMAGING 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 WITH APPROPRIATE SUPERVISION. 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 THREE-YEAR TRAINING PROGRAM IN PODIATRY WITH TWO RESIDENTS PER YEAR, ADDITIONALLY, MAH IS A SITE FOR OTHER POST-GRADUATE MEDICAL EDUCATION DISCIPLINES INCLUDING NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS IN OBSTETRICS-GYNECOLOGY AND CERTIFIED NURSE MIDWIVES. MAH IS ALSO A CORE SITE FOR THE BETH ISRAEL DEACONESS MEDICAL CENTER SURGICAL TRAINING PROGRAM. DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD NET EXPENDITURES OF $23,541,048 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO MAH'S RESIDENCY PROGRAM AND TO TEACHING OTHER STUDENTS RELATED TO ALLIED HEALTH PROFESSIONS WHICH REPRESENTED 6.01% OF MAH'S TOTAL EXPENSES.ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)OPEN MEDICAL STAFFTHE 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, MOUNT AUBURN HOSPITAL 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 4,800 PHYSICIANS AND 39,000 EMPLOYEES.THE BILH PURPOSE STATEMENT ARTICULATES THE IMPACT THAT EACH BILH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. THESE SHARED VALUES GUIDE EACH ENTITY'S DAILY EFFORTS AND KEEP EACH AFFILIATE ALIGNED IN THE PURSUIT OF THE BILH PURPOSE, SHOWING HOW "WE CARE" FOR PATIENTS, EACH OTHER AND THE COMMUNITIES SERVED.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES ONE PERSON AT A TIME THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BILH WE CARE VALUES:WELLBEING. WE PROVIDE A HEALTH-FOCUSED WORKPLACE AND SUPPORT A HEALTHY WORK-LIFE BALANCE.EMPATHY. WE DO OUR BEST TO UNDERSTAND OTHERS' FEELINGS, NEEDS AND PERSPECTIVES.COLLABORATION. WE WORK TOGETHER TO ACHIEVE EXTRAORDINARY RESULTS.ACCOUNTABILITY. WE HOLD OURSELVES AND EACH OTHER TO BEHAVIORS NECESSARY TO ACHIEVE OUR COLLECTIVE GOALS.RESPECT. WE VALUE DIVERSITY AND TREAT ALL MEMBERS OF OUR COMMUNITY WITH DIGNITY AND INCLUSIVENESS.EQUITY. EVERYONE HAS THE OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL IN OUR WORKPLACE AND THROUGH THE CARE WE PROVIDE.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), JOSLIN DIABETES CENTER 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. EFFECTIVE JULY 1, 2023, BILH ALSO BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND ITS AFFILIATES INCLUDING EXETER HOSPITAL.
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BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES
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FISCAL YEAR ENDED SEPTEMBER 30, 2023THE QUANTIFICATION IN THIS SCHEDULE H PART 1 QUESTION 7 IN THIS FILING REFLECTS ONLY THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST OF MOUNT AUBURN HOSPITAL AND AS NOTED THROUGHOUT THIS FILING, MOUNT AUBURN HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK. BELOW IS ADDITIONAL INFORMATION ON THE FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS ACTIVITIES ACROSS ALL OF THE BILH HOSPITALS. DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED MORE THAN $48 MILLION IN NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST.IN ADDITION TO THE CHARITY CARE REPORTED ABOVE, EACH OF THE BILH HOSPITALS 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, THE COST OF PROVIDING CARE TO MEDICAID PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE RESULTING IN A COMBINED SHORTFALL EXCEEDING $61 MILLION RELATED TO TREATING MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS. PAYMENTS FROM MEDICARE DO NOT COVER THE COST OF SERVICES PROVIDED. ALL BILH HOSPITALS PROVIDE CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICARE PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE, RESULTING IN A COMBINED SHORTFALL EXCEEDING $144 MILLION RELATED TO TREATING MEDICARE PATIENTS. DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED COMBINED COMMUNITY BENEFITS, COMMUNITY HEALTH IMPROVEMENT SERVICES, CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS AS WELL AS COSTS INCURRED RELATED TO SUBSIDIES FOR PRIMARY CARE, BEHAVIORAL HEALTH CARE AND OTHER CARE PROVIDED AT A LOSS TOTALING OVER $88 MILLION. ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $202 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $68 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $134 MILLION WHICH IS AN INVESTMENT IN THE HEALTH SYSTEM OF TOMORROW. RESEARCH ACTIVITIES ACROSS BILH SERVE PATIENT CARE BOTH AT BILH AND BEYOND AS PART OF THE ADVANCEMENT OF SCIENCE. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION AND TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. BIDMC HAS THE LARGEST RESEARCH OPERATIONS ACROSS BILH AND DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $320 MILLION IN RESEARCH EXPENSES, MORE THAN $82 MILLION OF WHICH WERE INTERNALLY FUNDED.FOR ADDITIONAL INFORMATION ON THESE ACTIVITIES AS WELL AS EACH HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY, PLEASE SEE FORM 990 SCHEDULE H FOR EACH OF THE BILH HOSPITALS. ADDITIONAL BILH NETWORK ACTIVITIES - EXPANDING ACCESS AND SERVICES, INCLUDING TO UNDERSERVED PATIENT POPULATIONS IN ORDER TO REDUCE HEALTH INEQUITIES; CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST; BEHAVIORAL HEALTH; COMMUNITY INVESTMENTS - FISCAL YEAR ENDED SEPTEMBER 30, 2023IN ADDITION, AS NOTED FURTHER BELOW, BETH ISRAEL LAHEY HEALTH ("BILH") AND ITS AFFILIATES FOCUSED ON EXPANDING ACCESS AND SERVICES, INCLUDING TO UNDERSERVED PATIENT POPULATIONS IN ORDER TO REDUCE HEALTH INEQUITIES. IN ADDITION, THERE WAS A STRONG FOCUS ON CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST, WHEN APPROPRIATE, AS DEMONSTRATED BY BILH'S EFFORTS TO LEVERAGE COMMUNITY SETTINGS, KEEP CARE WITHIN THE BILH PERFORMANCE NETWORK ("BILHPN"), AND ALLOW PATIENTS TO RECEIVE CARE IN THEIR HOMES. THE FOLLOWING HIGHLIGHTS SPECIFIC EFFORTS DURING THE PERIOD COVERED BY THIS FILING:ACCESS & EXPANSION TO PHARMACY SERVICES- BILH PHARMACY HAS CONTINUED TO EXPAND ITS CONTRACTUAL RELATIONSHIPS, ALLOWING MORE PATIENTS TO UTILIZE ITS PHARMACY FOR THEIR PRESCRIPTIONS. IN FY 2023, BILH PHARMACY SUCCESSFULLY NEGOTIATED ACCESS TO THE POINT32HEALTH SPECIALTY PHARMACY NETWORK AS WELL AS THE WELLSENSE MEDICAID ACCOUNTABLE CARE ORGANIZATION ("ACO") PLAN. EXAMPLES OF BILH PHARMACY'S OTHER EFFORTS TO EXPAND PATIENT ACCESS TO MEDICATIONS INCLUDE: - ENHANCED MEDICATION AUTHORIZATION AND ACCESS SERVICES TO HELP PATIENTS OBTAIN NECESSARY INSURANCE AUTHORIZATIONS AND FIND CO-PAY ASSISTANCE, - EXPANDED THE MEDICATION REFILL CENTER TO ASSIST PATIENTS AND PROVIDERS IN EXPEDITING MEDICATION RENEWALS AND ENSURING PRESCRIBED MEDICATION AND DOSAGE ARE STILL APPROPRIATE, - EXTENDED PATIENT CO-PAY ASSISTANCE PROGRAMS TO THE JOSLIN ADULT DIABETES CLINIC AND NORTHEAST HOSPITAL CORPORATION PATIENTS, AND - EXPANDED CLINICAL PHARMACY SERVICES IN AMBULATORY CLINICS TO HELP MANAGE AND OPTIMIZE PATIENTS' COMPLEX MEDICATION THERAPIES. - BILH PHARMACY ALSO EXPANDED ITS CLINICAL PHARMACY PRESENCE IN CLINICS TO REDUCE THE HEALTH EQUITY GAP IN THE USE OF HIGHLY IMPACTFUL MEDICATIONS TO TREAT PATIENTS WITH DIABETES AND ATHEROSCLEROTIC CARDIOVASCULAR DISEASES BY IMPROVING THEIR BLOOD PRESSURE AND HEMOGLOBIN A1C. INTERVENTIONS CENTERED AROUND PRESCRIBING EVIDENCE-BASED MEDICATIONS, EDUCATING PATIENTS ABOUT THEIR CONDITIONS, AND ENSURING ACCESS TO MEDICATION. INITIAL RESULTS HAVE DEMONSTRATED AN INCREASE IN THE USE OF GLP-1 AGONISTS AND SGLT-2 INHIBITORS BY 32% IN BLACK AND HISPANIC POPULATIONS, AN AVERAGE REDUCTION IN HEMOGLOBIN A1C OF 0.8, AND A DECREASE OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURES OF 7MMHG AND 2MMHG RESPECTIVELY.IMPROVEMENT IN LAB SERVICES- BILH OPTIMIZED THE TRANSPORTATION ROUTES OF COLLECTED LABORATORY SPECIMENS TO TESTING LABORATORIES, ENSURING HIGH STANDARDS FOR TURNAROUND TIMES AND MAXIMUM EFFICIENCY. THIS IS FOUNDATIONAL TO THE SYSTEM'S ABILITY TO CONSOLIDATE TESTING, EXPAND ACCESS TO IN-NETWORK LABORATORY SERVICES WHICH IN TURN GENERALLY REDUCES COST, AND SUPPORT THE PROVISION OF HIGH-QUALITY CARE AND THE CLINICIAN AND PATIENT EXPERIENCE.- FOCUS REMAINED STRONG IN DEVELOPING PHYSICIAN PRACTICE DELIVERY MODELS AND RE-OPENING PATIENT SERVICE CENTERS. THESE EFFORTS ENHANCE COMMUNITY PROVIDERS' ABILITY TO USE BILH LABS AND INCREASE PATIENT ACCESS TO BILH LABS.LEVERAGING IN-NETWORK CARE- BILH OPERATES A TRANSFER CENTER THAT FACILITATES PATIENT ACCESS TO THE APPROPRIATE PLACEMENT OF PATIENT TRANSFERS. WITH THE CREATION OF THE TRANSFER CENTER, BILH HAS BEEN ABLE TO RETAIN PATIENTS WHO MIGHT OTHERWISE HAVE GONE OUTSIDE OF THE SYSTEM. BY EXPANDING ITS FOCUS TO COMMUNITY HOSPITALS, BILH HAS ENHANCED ITS ABILITY TO PLACE PATIENTS, INCLUDING AT LOCATIONS POTENTIALLY CLOSER TO THE PATIENTS' HOMES. - BILHPN OPERATES A CENTRALIZED REFERRAL MANAGEMENT PROGRAM THAT FOCUSES ON PATIENTS SEEKING OUT-OF-NETWORK SPECIALTY CARE AND REDIRECTING THEM TO IN-NETWORK SPECIALTY CARE, WHEN CLINICALLY APPROPRIATE. THROUGHOUT FY 2023, BILHPN REDIRECTED WELL OVER ONE THOUSAND PATIENT VISITS. IN MOST CASES, CARE RETAINED WITHIN BILH RESULTED IN ENHANCED CARE COORDINATION AT A LOWER COST OF CARE.ENABLING PATIENTS TO RECEIVE CARE AT HOME- BILH LAUNCHED ITS HOSPITAL AT HOME PROGRAM IN FY 2023, STARTING WITH LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER. THIS HAS ALLOWED ELIGIBLE PATIENTS TO BE OFFERED CARE IN THE SETTING MOST COMFORTABLE FOR THEM THEIR HOMES WHILE ALSO CUSTOMIZING CARE PLANS AND IMPROVING PATIENTS' MOBILITY EVEN WHILE THEY ARE ACUTELY ILL. - IN FY 2023, BILHPN PUT PROGRAMS IN PLACE TO MANAGE LENGTH OF STAY AT SKILLED NURSING FACILITIES ("SNFS"), REDUCE READMISSIONS, AND DISCHARGE MEDICALLY APPROPRIATE PATIENTS DIRECTLY TO THEIR HOMES WITH HOMECARE SERVICES INSTEAD OF TO A SNF, PROVIDED PATIENTS ARE MEDICALLY STABLE TO RETURN HOME AFTER AN ACUTE CARE STAY AND WILL LIKELY HAVE BETTER OUTCOMES AND LOWER COST OF CARE.
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BEHAVIORAL HEALTH
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- IN FY 2023, BILH BEHAVIORAL SERVICES LAUNCHED ITS COMMUNITY BEHAVIORAL HEALTH CENTER ("CBHC") IN LAWRENCE, MASSACHUSETTS, CONSOLIDATING OUTPATIENT, MOBILE CRISIS INTERVENTION, AND ADULT COMMUNITY CRISIS STABILIZATION SERVICES. THE ESTABLISHMENT OF THE CBHC IS A PART OF THE COMMONWEALTH'S EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES ROADMAP FOR BEHAVIORAL HEALTH REFORM. - IN ADDITION, AS PART OF THE ROADMAP FOR BEHAVIORAL HEALTH REFORM, BILH LAUNCHED AN EMERGENCY SERVICES REDESIGN THAT SHIFTS EMERGENCY EVALUATIONS OUT OF THE EMERGENCY DEPARTMENT ("ED"). BILH BEHAVIORAL SERVICES ALSO EXPANDED ITS ED INTEGRATION EFFORTS TO A TOTAL OF SIX EDS, INCLUDING ADDISON GILBERT HOSPITAL, ANNA JAQUES HOSPITAL, BEVERLY HOSPITAL, LAHEY MEDICAL CENTER-PEABODY, BETH ISRAEL DEACONESS HOSPITAL-MILTON, AND WINCHESTER HOSPITAL.HEALTH EQUITY- BILH AND LAWYERS FOR CIVIL RIGHTS LAUNCHED A MEDICAL-LEGAL PARTNERSHIP TO PROVIDE FREE LEGAL SUPPORT TO LOW-INCOME PATIENTS, BEGINNING AT BETH ISRAEL DEACONESS MEDICAL CENTER. THE COLLABORATION WILL EXPAND BILH'S ABILITY TO ADDRESS HEALTH EQUITY AND EXPAND ACCESS TO HEALTH CARE FOR PATIENTS LIVING IN UNDER-RESOURCED COMMUNITIES.- BILHPN FOCUSED ON REDUCING HEALTH EQUITY DISPARITIES IN DIABETES AND HYPERTENSION MANAGEMENT BY STRATIFYING HEALTH OUTCOMES BY RACE, ETHNICITY AND LANGUAGE; SHARING PERFORMANCE DATA WITH PRIMARY CARE GROUPS; AND IMPLEMENTING CLINICAL INITIATIVES SUCH AS OFF-HOUR CLINICS, HOME BLOOD PRESSURE MONITOR DISTRIBUTION, CONTINUOUS GLUCOSE MONITORING, AND OUTREACH TO PATIENTS WITH HIGHER NEEDS.ONGOING INITIATIVES:ENHANCED ACCESS FOR MASSHEALTH PATIENTS- TO MITIGATE BARRIERS IN ACCESS TO CARE AND INCREASE THE NUMBER OF MASSHEALTH PATIENTS THAT BILH SERVES, THE SYSTEM COMMITTED TO UNIVERSAL NETWORK-WIDE PROVIDER PARTICIPATION IN MASSHEALTH. ALL BILH HOSPITALS AND PROVIDERS EMPLOYED BY BILH OR ON WHOSE BEHALF BILH JOINTLY CONTRACTS PARTICIPATE IN AND/OR HAVE APPLIED TO PARTICIPATE IN SOME FORM OF MASSHEALTH. IN FY 2022, BILH SIGNED A NEW MASSHEALTH ACO CONTRACT WITH BMC HEALTHNET PLAN / WELLSENSE HEALTH PLAN THAT WENT INTO EFFECT IN APRIL 2023. AS PART OF THIS CONTRACT, BILHPN EXTENDED PARTICIPATION TO ALL ELIGIBLE PRIMARY CARE PROVIDERS ("PCPS") WHO WERE NOT OTHERWISE PARTICIPATING IN A MASSHEALTH ACO. PRIOR TO THAT TIME, WHILE ALL ELIGIBLE BILHPN PCPS WERE PARTICIPANTS IN A FORM OF MASSHEALTH, SOME PCPS WERE NOT PREVIOUSLY PARTICIPATING IN A MASSHEALTH ACO. - BILH HAS DEVELOPED, REFINED AND IMPLEMENTED A MULTICULTURAL MARKETING, ADVERTISING, AND OUTREACH PLAN WITH THE PURPOSE OF EXPANDING ACCESS FOR UNDERSERVED POPULATIONS, INCLUDING MASSHEALTH PATIENTS, IN TARGETED BILH SERVICE AREAS. INVESTMENTS IN UNDERSERVED COMMUNITIES- BILH HOSPITALS HAVE CREATED AND MAINTAIN STRONG CONNECTIONS TO A NETWORK OF AFFILIATED HOSPITALS AND HEALTH CENTERS THAT PROVIDE COMMUNITY-BASED CARE TO HISTORICALLY UNDERSERVED POPULATIONS. IN THE REGIONS THAT THEY SERVE, THE SAFETY NET AFFILIATES ("SNAS") AND COMMUNITY CARE ALLIANCE ("CCA") COMMUNITY HEALTH CENTERS ("CHCS") ARE THE CORNERSTONE OF BILH'S DELIVERY SYSTEM REGARDING COMMUNITY-BASED CARE FOR MASSHEALTH AND HISTORICALLY UNDERSERVED PATIENTS. - CCA CHCS INCLUDE BOWDOIN STREET HEALTH CENTER, CHARLES RIVER COMMUNITY HEALTH, THE DIMOCK CENTER, FENWAY HEALTH, AND SOUTH COVE COMMUNITY HEALTH CENTER. - SNAS INCLUDE CAMBRIDGE HEALTH ALLIANCE AND SIGNATURE HEALTHCARE BROCKTON HOSPITAL.- BILH CONTINUES TO INVEST IN THE CCA CHCS AND SNAS, ENABLING THEM TO EXPAND THEIR CAPABILITIES AND CARE FOR MORE HISTORICALLY UNDERSERVED PATIENTS. IN FY 2022, BILH INVESTED OVER $8 MILLION IN ITS CHCS AND SNAS, IN ADDITION TO ENGAGING IN REGIONAL PLANNING AND COLLABORATIVE PROGRAM DEVELOPMENT. THESE INVESTMENTS REPRESENT ONLY A PORTION OF A MUCH LARGER COMMUNITY BENEFITS INVESTMENT PORTFOLIO THAT IS DESCRIBED IN GREATER DETAIL IN THIS AND OTHER BILH NETWORK TAX FILINGS. - BILH CONTINUES TO EXPLORE ADDITIONAL OPPORTUNITIES WITH CHCS IN ESSEX AND MIDDLESEX COUNTIES. FOR EXAMPLE, BILH HAS ESTABLISHED A TELEHEALTH PILOT PROGRAM BETWEEN PHYSICIANS AT ADDISON GILBERT AND BEVERLY HOSPITALS AND PATIENTS AT NORTH SHORE COMMUNITY HEALTH CENTER. 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. ADDICTION SERVICES NORTHEAST BEHAVIORAL HEALTH CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH BEHAVIORAL SERVICES (NBHC OR BILH BS) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS, PROVIDING HIGH-QUALITY MENTAL HEALTH AND ADDICTION TREATMENT. THIS INCLUDES A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TO COMMUNITY-BASED SERVICES. TREATMENT OFFERINGS INCLUDE MOBILE CRISIS TEAMS FOR BEHAVIORAL AND SUBSTANCE-RELATED EMERGENCIES; INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; RESIDENTIAL PROGRAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION CLINICS; AND MEDICATION-ASSISTED TREATMENT PROGRAMS FOR PERSONS WITH OPIOID USE DISORDERS. NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) HAS OVER 250 BEDS IN 9 FACILITIES FOR PATIENTS REQUIRING ACUTE PSYCHIATRIC, DETOXIFICATION AND POST-ACUTE DIVERSIONARY SERVICES. OTHER OFFERINGS INCLUDE MANY COMMUNITY-BASED SERVICES SUCH AS MOBILE EMERGENCY SERVICES TEAMS, SCHOOL AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES. BILHBS SERVES APPROXIMATELY 17,000 INDIVIDUALS ANNUALLY, PROVIDING OVER 380,000 UNITS OF SERVICE, IN A VAST ARRAY OF SETTINGS BASED ON THEIR NEEDS. BECAUSE OF THE COVID-19 EMERGENCY, NBHC WAS FORCED TO RECONFIGURE ITS DELIVERY MODEL FOR MANY SERVICES. WITH MULTIPLE "BRICK AND MORTAR" SITES TEMPORARILY CLOSED DURING THE HEIGHT OF THE PANDEMIC, NBHC OUTFITTED CLINICIANS WITH THE TOOLS NEEDED TO OFFER TELEHEALTH SERVICES. BY THE END OF THE FISCAL YEAR, OF THE TOTAL UNITS OF SERVICE LISTED ABOVE, ALMOST 61,000 WERE DELIVERED VIA TELEHEALTH. IN ADDITION, AS OUTLINED BELOW, NBHC SUPPORTED BILH'S SYSTEM-WIDE RESPONSE TO THE PANDEMIC BY QUICKLY STANDING UP A SHORT-TERM STAY COMMUNITY CRISIS STABILIZATION UNIT ON THE CAMPUS OF AN AFFILIATED ENTITY. BILH BS CONTINUES TO LEVERAGE TELEHEALTH SERVICES TO CONNECT TO COMMUNITIES SERVED ACROSS BILH.NBHC PROVIDED ADDICTION TREATMENT SERVICES WITH MORE THAN 200 INPATIENT AND RESIDENTIAL BEDS, OPERATING 24/7 FOR ADDICTION TREATMENT. ADDICTION TREATMENT INCLUDES BOTH OUTPATIENT AND INPATIENT TREATMENT AND PREVENTION. SUBSTANCE ABUSE COUNSELING AND GROUP THERAPY IS OFFERED FOR BOTH ADULTS AND TEENS, AS ARE A RANGE OF COURT-ORDERED PROGRAMS INCLUDING OPERATING UNDER THE INFLUENCE (OUI) EDUCATION AND EVALUATIONS. MEDICATION-ASSISTED TREATMENT FOR MEN AND WOMEN ADDICTED TO HEROIN OR PRESCRIPTION OPIOIDS IS PROVIDED AT LOCATIONS IN GLOUCESTER AND DANVERS. ACUTE TREATMENT PROGRAMS PROVIDING INPATIENT DETOXIFICATION SERVICES FROM DRUGS AND/OR ALCOHOL IN MEDICAL SETTINGS ARE AVAILABLE AT TREATMENT CENTERS IN DANVERS AND TEWKSBURY. IN FY23 THESE CENTERS SERVED APPROXIMATELY 2,600 PATIENTS. NBHC ALSO PROVIDED POST-DETOXIFICATION RESIDENTIAL SETTINGS AT MULTIPLE LOCATIONS SERVING BOTH MEN AND WOMEN, INCLUDING HART HOUSE IN TEWKSBURY WHICH EXCLUSIVELY SERVES MOTHERS WITH CHILDREN. IN FY23, NBHC'S OUTPATIENT ADDICTION PROGRAMS PROVIDED 196,350 UNITS OF SERVICE, INCLUDING 5,600 VIA TELEHEALTH, WHILE INPATIENT AND RESIDENTIAL PROGRAMS RECORDED 60,327 BED DAYS. AMBULATORY SERVICES BILH BS' AMBULATORY DIVISION SERVES NEARLY 4,300 PATIENTS EVERY YEAR, DELIVERING MORE THAN 108,000 UNITS OF SERVICES IN VARIOUS SETTINGS. MORE THAN 43,000 WERE DELIVERED BY TELEHEALTH AMBULATORY PROGRAMS AND SERVICES OFFERED UNDER THE CHILDREN'S BEHAVIORAL HEALTH INITIATIVE (CBHI) INCLUDING A BROAD RANGE OF COUNSELING AND THERAPY AS WELL AS MORE INTENSIVE TREATMENT MODALITIES. OUTPATIENT MENTAL HEALTH CLINICS IN SALEM, LAWRENCE, GLOUCESTER AND BEVERLY, AND AN OUTREACH CLINIC IN HAVERHILL, ASSIST INDIVIDUALS AND FAMILIES THROUGH PERIODS OF STRESS AND ADJUSTMENT, PROVIDING THERAPY FOR DEPRESSION, ANXIETY, TRAUMA, BIPOLAR DISEASE, AND CHRONIC MENTAL ILLNESS. OUTREACH COUNSELORS OFFER SHORT AND LONG-TERM THERAPY IN HOMES, SCHOOLS, AND OTHER APPROPRIATE COMMUNITY SETTINGS. ALL THERAPY PROGRAMS ARE SUPPORTED BY MEDICATION CLINICS IF THAT IS DETERMINED TO BE AN APPROPRIATE ADJUNCT TO TREATMENT. IN FY23, NBHC DELIVERED 99,419 UNITS OF AMBULATORY SERVICES, SUPPORTED BY 8,432 PSYCHOPHARMACOLOGY VISITS.
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EMERGENCY SERVICES
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THE EMERGENCY SERVICES DIVISION OFFERS EMERGENCY PSYCHIATRIC SERVICES AND INCLUDES THE EMERGENCY SERVICES PROGRAM (ESP) AND COMMUNITY CRISIS STABILIZATION (CCS) INPATIENT PROGRAM. ESP PROVIDES EMERGENCY PSYCHIATRIC ASSESSMENTS AND SUPPORTIVE SERVICES 24/7 IN A VARIETY OF SETTINGS, INCLUDING HOMES, SCHOOLS, OUTPATIENT CLINICS AND HOSPITALS. ESP SERVICES ARE PROVIDED WITHIN THE COMMUNITY AND WITHIN 10 HOSPITALS EMERGENCY DEPARTMENTS (ED) THROUGHOUT THE NORTH SHORE, CAPE ANN AND MERRIMACK VALLEY, INCLUDING 6 NON-BILH EMERGENCY DEPARTMENTS. BILH BS' EMERGENCY PSYCHIATRIC AND MOBILE RESPONSE TEAMS IN LAWRENCE, SALEM AND LOWELL ARE AVAILABLE AROUND THE CLOCK, PROVIDING PSYCHIATRIC ASSESSMENTS AND SUPPORTIVE SERVICES IN VARIOUS SETTINGS. NBHC PROVIDES THESE SERVICES IN CONJUNCTION WITH A LARGE NUMBER OF AREA HOSPITALS, INCLUDING FACILITIES OUTSIDE OF THE BILH UMBRELLA. MOBILE CRISIS CLINICIANS ALSO RESPOND TO SCHOOLS, HOMES AND OUTPATIENT CLINICS, AND NBHC ALSO PROVIDES WALK-IN SERVICES AT THE THREE TEAM LOCATIONS. IN ADDITION TO EMERGENCY EVALUATION, TEAM MEMBERS PROVIDE ONGOING CRISIS COUNSELING UNTIL THE PATIENT IS STABLE AND RELATIONSHIPS ARE ESTABLISHED WITH LONGER-TERM CARE PROVIDERS. THE LAWRENCE AND SALEM LOCATIONS ALSO HOUSE 8-BED COMMUNITY CRISIS STABILIZATION UNITS, WHICH OFFER SHORT-TERM (3-5 DAY) CRISIS BEDS IN LIEU OF HOSPITALIZATION FOR MASSHEALTH, MEDICARE, AND UNINSURED CLIENTS. IN JANUARY 2023, THE STATE OF MASSACHUSETTS IMPLEMENTED BEHAVIORAL HEALTH REDESIGN, WHICH SIGNIFICANTLY IMPACTED OUR EMERGENCY SERVICES TEAMS. BILH BS WAS AWARDED ONE COMMUNITY BEHAVIORAL HEALTH CENTER (CBHC), LOCATED IN LAWRENCE. THE SERVICE AREAS FOR SALEM AND LOWELL WERE TRANSITIONED TO A DIFFERENT VENDOR. HOWEVER, THIS ALLOWED OUR SALEM AND LOWELL TEAMS TO PIVOT INWARD TO SERVICE THE BILH SYSTEM NEEDS. DURING THE FISCAL PERIOD COVERED BY THIS FILING, EMERGENCY SERVICE PROGRAMS HAD 13,502 ENCOUNTERS, 1,895 OF WHICH WERE DONE REMOTELY, AND THE CCS PROGRAMS RECORDED 2,546 BED DAYS. NBHC IS ALSO ON THE FOREFRONT OF EXPANDING TREATMENT FOR OPIOID USE DISORDER (OUD). SEVERAL BILH ORGANIZATIONS HAVE TAKEN STEPS TO ENHANCE CARE FOR PATIENTS WITH OPIOID USE DISORDER (OUD) WHO PRESENT IN EMERGENCY DEPARTMENTS, PARTICULARLY AS THESE PATIENTS TRANSITION FROM THE HOSPITAL TO A LONG-TERM TREATMENT PROGRAM. THE NBHC BRIDGE CLINIC IN GLOUCESTER ACCEPTS PATIENTS REFERRED FROM THE NORTHEAST HOSPITAL CORP (NHC) EMERGENCY DEPARTMENTS AT BOTH BEVERLY HOSPITAL AND ADDISON GILBERT HOSPITAL AND OFFERS CONTINUATION OF MEDICATION ASSISTED TREATMENT AND SUPPORT FROM RECOVERY COACHES. BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH (BID-PLYMOUTH) TREATS PATIENTS WITH OUD THROUGH MEDICATION-ASSISTED TREATMENT IN THE EMERGENCY DEPARTMENT, AND THE HOSPITAL WORKS CLOSELY WITH COMMUNITY PARTNERS TO PROVIDE ONGOING SUPPORT TO PATIENTS. THESE PROGRAMS ARE SIMILAR TO SERVICES AT MOUNT AUBURN HOSPITAL WHICH ALSO OFFERS MEDICATION-ASSISTED TREATMENT IN ITS EMERGENCY DEPARTMENT. PATIENTS CAN THEN BE REFERRED TO THE BRIDGE CLINIC AT MOUNT AUBURN HOSPITAL OR BID-PLYMOUTH FOR CONTINUED OR ADDITIONAL TREATMENT. NORTHEAST HOSPITAL CORPORATION, BID-PLYMOUTH AND MOUNT AUBURN HOSPITALS ARE ALL PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK AND SISTER ENTITIES TO NBHC.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.