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Schedule H, Part V, Section B, Line 3E
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Fairview is committed to transparency and accountability in all we do, including our efforts to assess - and respond to - our community's most pressing health needs. The community benefit work that we do across Fairview must reflect our community's actual needs, not our assumptions about what those needs might or should be. Because we understand that change cannot happen when we work in silos, and it cannot happen in a single year, we grounded our 2021 CHNA process in alignment with our 2018 CHNA needs, existing data, and the voices of community members and community partners. Once we had collected, analyzed, and synthesized the information we received from both primary and secondary data sources, we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. Having a consistent, defined process helps reduce the skewing effect of conscious and unconscious biases and enables us to define priority need areas that reflect our community's top health needs rather than our perception of those needs. We evaluated areas of need based on four broad criteria: -Has this need been voiced by the community? Has this need been vetted by the community? -Does this need align with Fairview's strategies and priorities? -Does this need align with existing public health strategies and community health assessments? -Does this need build upon Fairview's 2018 CHNA priority needs? Our process resulted in the identification of three priority need areas. They are: -Navigating and accessing care and resources -Healing, connectedness, and mental health -Addressing structural racism and barriers to achieving health equity.
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Schedule H, Part V, Section B, Line 5 Facility , 1
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Facility , 1 - University of Minnesota Medical Center. The assessment process and data collection methods we used during this CHNA cycle were different than ever before due to the COVID-19 pandemic. COVID- 19 caused delays in data collection among local, state, and national organizations. As a result of these delays, the U.S. Census Bureau had not yet released finalized data from the 2020 U.S. Census by the time we began the CHNA process. As a result, we used 2015-2019 American Community Survey data. Local public health agencies also were not able to provide updated data as they have in the past. We acknowledge that, due to these setbacks, the data we used is less recent than desired. Additionally, COVID-19 required us to add new safety precautions to our method of gathering community voice data. For example, all conversations and interviews, which had previously been in-person meetings, took place in a virtual format instead. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations. The process included discussions with community benefit and assessment committees, our community advisory council, the HOPE Commission listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Each hospital within Fairview has a community benefit and assessment committee that is involved in the CHNA process throughout the three-year cycle. Each committee is comprised of local community and organizational leaders and staffed by the Fairview Community Advancement department. Community benefit and assessment committees met four times between April and October in 2021, three of which were individual committee meetings and one of which was a system-wide Community Impact Summit that brought all the committees together. Each committee meeting consisted of facilitated discussions through which our team gathered input about top community needs. The Fairview Community Advisory Council, composed of key community leaders and staffed by Community Advancement, reviews the CHNA report and written implementation strategy and recommends it to the Patient Care and Experience Committee of the Fairview Board of Directors for review and adoption. Each member represents the member's respective community, and members represent a broad range of sectors, among them community organizations serving cultural communities, higher education organizations, banks, and a nonprofit electric company. The Community Advisory Council met from May through November 2021 to participate in the CHNA process, give feedback, and ultimately recommend the CHNA and implementation strategy for adoption. The HOPE Commission is a multi-year transformational change effort of M Health Fairview to drive more equitable outcomes and inclusive environments and experiences for our patients, employees, and communities. The Commission conducted a series of listening and learning sessions in 2020 and 2021. The objective was to hold a mirror to Fairview to assess where we are now and how we can make lasting change. Part of being an anti-racist health system is developing a candid understanding of our shortcomings. We particularly sought to hear perspectives and ideas from the most impacted populations: BIPOC employees and patients, front-line workers who care for underserved and marginalized patients, and those patients themselves. A survey was also made available each year to gather insights and suggestions from employees and patients who could not directly participate in a listening and learning session. In 2020, the commission convened 32 virtual listening and learning sessions and two town halls involving more than 1,500 participants across Fairview sites. The sessions focused on employees but included patients and community members as well. In September 2021, the HOPE Commission continued the listening and learning sessions following the same model. In this iteration, however, the focus was primarily on gathering input from patients (and employees as patients). In both 2020 and 2021's listening and learning sessions, the facilitators and note takers reflected the community represented by the session's group to the greatest degree possible. In August and September 2021, Fairview's Community Advancement team conducted a series of interviews with staff members who work with communities. Each conversation followed a consistent interview protocol developed for this purpose, and each interview was captured by means of detailed notes. The goal of these interviews was to draw on staff expertise to gain a deeper understanding of our priority needs and to determine whether there are any emerging needs that we should be considering. Between Aug. 31 and Sept.17, 2021, we conducted 17 interviews. In August 2021, we held two focus groups in partnership with other organizations. We convened the first focus group in partnership with HealthPartners and Allina Health, and the participants were faith community nurses. We convened the second focus group in partnership with the organizations that are a part of the East Side Health and Well-being Collaborative. This meeting's focus was on accessing care and resources for different cultural communities. Fairview also participated in two large surveys. KRC Research conducted a survey around health and health care needs in St. Paul between June 8 and July 7, 2021, and administered it to community members, Fairview employees, patients, and community partners. Responses were received from 294 residents, more than 1,000 employees, 221 patients, and 20 partners. The survey was offered online and by phone and in five languages: English, Spanish, Hmong, Somali, and Karen. Fairview also supported and was a partner organization in Bridge to Health, a survey that assesses the health needs of northern Minnesota residents. The Bridge to Health survey was administered between Aug.28 and Oct. 23, 2020. The geographic areas that were sampled included Aitkin, Carlton, Cook, Itasca, Koochiching, Lake, St. Louis, and Pine counties in Minnesota, as well as Douglas County in Wisconsin. As a foundational part of program planning and evaluation, Community Advancement staff are continuously soliciting feedback from community partners and program participants. We capture this information on an ongoing basis and use it to provide valuable context and drive insights into the needs of the communities we serve. Fairview staff developed standardized tools, processes, instructions, and facilitator, interviewer, and note-taker protocols and training. All primary data was compiled, cleaned, and analyzed. Community conversations lasted various lengths from 30-120 minutes. All community input was captured by a note-taker. The Fairview team contracted with the following groups to support our assessment process: -Loren Blinde, PhD of Writing Power, a copywriter and content strategist, on the writing of the report. -Kristi Fordyce, an independent contractor, for analysis support. -Weber Shandwick, for data collection and analysis of focus groups and stakeholder interviews focused on St. Paul. -KRC Research for the administration and analysis of the St. Paul Community Survey
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Schedule H, Part V, Section B, Line 11 Facility , 1
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Facility , 1 - University of Minnesota Medical Center. Our triennial community health needs assessment (CHNA) process provides an important opportunity to engage with and understand our community, analyze what has changed-for better or worse-since the last assessment, and prioritize together with the community the issues we must urgently address in order to improve wellbeing and resilience. As part of the 2021 CHNA process, we reexamined and built upon the extensive community insights shared during our 2018 CHNA, while also surveying the community for current and emerging needs. Our 2021 CHNA used social determinants of health as a lens through which we frame our understanding of our community's most significant health needs. A social determinants of health lens enable us to identify inequitable distribution of resources and access that negatively impacts health. Through this lens we looked at both qualitative and quantitative data. Quantitative data included data points related to demographics, physical environment, socioeconomic factors, health care and health outcomes. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations. University of Minnesota Medical Center (the medical center) and Masonic Children's Hospital (the children's hospital) has a community advisory committee (CAC) that is involved in the CHNA process. The committee is comprised of local community and organizational leaders, such as local public health, social services organizations, higher education institutions, school districts, and local businesses. The assessment process also included discussions with our community advisory council, the listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Bringing together both the qualitative and quantitative data we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. We prioritized areas of need based on four broad criteria: 1) Has this need been voiced by the community? Has this need been vetted by the community? 2) Does this need align with Fairview's strategies and priorities? 3) Does this need align with existing public health strategies and community health assessments? 4) Does this need build upon Fairview's 2018 CHNA priority needs? The medical center and the children's hospital identified three system-wide priority need areas, and will collaborate with other Fairview hospitals, medical centers, and shared business and clinical services to address these priorities. Our specific response varies by hospital based on the ways in which the priority needs manifest across a given community as well as the partnerships, both ongoing and new, that we have developed to address those needs. 1. Navigating and accessing care and resources. 2. Healing, connectedness, and mental health. 3. Addressing structural racism and barriers to equity. Each priority has a set of anticipated impacts, described in more detail below, and can be found in the University of Minnesota Medical Center and Masonic Children's Hospital CHNA Implementation Strategy Report (2022-2024). We also identified two priority populations that reach across the lifespan and impact from rural to urban. They are racial or ethnic populations experiencing health disparities and people experiencing poverty. For more details about our priority needs and the priority populations as they relate to the medical center and the children's hospital, please see the University of Minnesota Medical Center and Masonic Children's Hospital 2021 Community Health Needs Assessment located at: https://www.fairview.org/our-community-commitment/local-health-needs For more details about our priority needs and the priority populations as they relate to the medical center and the children's hospital, please see the University of Minnesota Medical Center and Masonic Children's Hospital 2021 Community Health Needs Assessments located at: https://www.fairview.org/our-community-commitment/local-health-needs Development of 2022-2024 CHNA Implementation Strategies: As a learning organization that works closely with our community advisory committees and community partners, over the past decades we have gleaned important lessons which have guided us in the development of our Fairview Health Services 2022-2024 implementation strategies. 1. Despite best efforts, health needs and health inequities continue to grow and deepen. 2. Collective action is critical. 3. Transformational change requires sustained and focused commitment. In response to our 2021 community health needs assessment and our lessons learned, all Fairview hospitals and medical centers work collaboratively amongst each other, as well as in partnership with local and statewide organizations to address communities' most pressing needs. To rise to the challenge, we put forth a 10-year vision of increased community health equity and a set of three strategies which will help to address the priority need areas in distinct ways while collectively moving us closer to our vision of increased community health equity. The three strategies are: Strategy 1: Addressing SDOH - Addressing the social determinants of health (SDOH) as well as individual social risks and social needs through the creation and expansion of programs; initiatives; collaborations; research; and policy, system, and environmental work. Strategy 2: Community engagement infrastructure - Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. Strategy 3: Inclusive institution - Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. For this three-year cycle, we are implementing our strategies to work toward distinct anticipated impacts for each priority need and ultimately our 10-year vision of increased community health equity. For more information, the CHNA Implementation Strategy Report outlines the major strategies and actions we will deploy throughout the 2022-2024 assessment cycle as well as the ties between the medical center and the children's hospital CHNA implementation strategies, anticipated impacts, objectives, and key responses. University of Minnesota Medical Center and Masonic Children's Hospital Community Health Needs Assessments Implementation Strategy Reports (2022-2024): https://www.fairview.org/our-community-commitment/local-health-needs Fairview's mission and vision extend beyond traditional healthcare settings, driving a healthier future for the communities we serve. We are currently in the process of standing up three Social Determinants of Health Initiatives. 1) "Food is Medicine" is a Health Initiative to address food insecurity and hunger, for all Fairview patients and community members. 2) " Housing is Health" supports health and affordable housing for all as a foundation for healthy, vibrant communities and inclusive growth. 3) "Connection is Cure" aims to address social isolation and improve community mental health and well-being by strengthening the connection between patients and the healthcare system. These initiatives are key responses that intersect all three priority needs and are also synergistic among themselves.
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Schedule H, Part V, Section B, Line 11 Facility , 2
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Facility , 2 - University of Minnesota Medical Center. Relationship with our partners. Fairview has a long partnership with the University of Minnesota and University of Minnesota Physicians, now represented in the M Health Fairview brand. Together, we offer access to breakthrough medical research and specialty expertise as part of a continuum of care that reaches all ages and health needs. Policy, systems, and environmental change initiatives are implemented across the system (hospitals, clinics, etc.) and in some instances across the M Health Fairview partners to create sustainable and lasting change to advance health equity and community wellbeing. Where indicated, community responses as a part of strategy 2 (Community engagement infrastructure) and strategy 3 (Inclusive institution) represent the work of Fairview in collaboration with the other M Health Fairview partners. Community action plan. The medical center and the children's hospital has an annual action plan that supports our vision of increased community health equity, rolls up to our system CHNA implementation strategies, and addresses priority needs. The Fairview Health Services Community Action Plan details the specific and measurable steps we will take during the year to drive change. Program lists by hospital can be found in the appendix. The System Community Action Plan is updated annually and includes impacts from the prior years. This report is shared with the University of Minnesota Medical Center Community Advisory Committee, the Board of Directors, and is publicly available on the website: https://www.fairview.org/our-community-commitment/local-health-needs Evaluation of Impact. To best evaluate our impact and track progress towards our anticipated impacts, we used a multi-tiered and tailored evaluation approach. We ground our work in understanding core information about our communities. This includes identifying and understanding the community need being addressed, the population or community being impacted, and current and/or potential partners to work with to address the need, and the impacts we anticipate. Community needs are determined in several ways. In addition to being determined through our formal CHNA process, we also respond to emerging needs brought to us by a community partner, public health, or through patient or community data showing significant health disparities. We have standardized several key measures to assess that we are meeting the needs of the CHNA priority populations, focusing our efforts on equity, and participant satisfaction. A subset of established programs and initiatives are set up and supported for deeper evaluation. We have found with the populations we serve; one-size fits all evidence-based approaches are not a good fit for our diverse communities. In response to the unique and differing needs of our community members, our programs have been co-developed in partnership with community, centering the needs of specific populations, and often have unique local tactics. We approach evaluation from a similar perspective by building evaluation approaches informed by our partners, and considering strategies that are culturally and linguistically appropriate and to determine if the programs reflect the values we set out to embody. We are guided by the Centers for Disease Control and Prevention (CDC) model for program evaluation to establish primary outcomes, process measures, and demographics. We evaluate program impact and success from a variety of approaches using both qualitative and quantitative data. For many of the programs described here we are reporting out our reach or outputs through counts on a variety of levels including meeting the rigor required for reporting on grants and contracts. We offer a diverse set of programs that vary the spectrum of low touch and high count or high touch and lower count, or more generally put, the effort and impacts of the programs are not the same. This is a purposeful approach as we want a variety of programs and to "right-size" programs to address the community and population specific needs. We provide outcomes for programs here when we are able, acknowledging not all programs run on a calendar year and analysis may not be complete for some of the programs we do deeper evaluation on. We are currently in the process of building an evaluative approach and capacity for our ten-year vision, increased community health equity, and three social determinants of health initiatives: Housing is Health, Food is Medicine, and Connection is Cure. Part of this evaluative approach is a monthly Social Determinants of Health dashboard. University of Minnesota Medical Center 2023 Implementation Strategy Progress Highlights. The following highlights our implementation strategy work for each of our three priority needs. For a more comprehensive view of what we are doing to impact community needs please see our Fairview Health Services Community Action Plan and for a view of the medical center and the children's hospital's list of programs see the appendices. Fairview Health Services Community Action Plan: https://www.fairview.org/our-community-commitment/local-health-needs In this first three-year CHNA cycle working towards our 2032 vision of increased community health equity the primary way we are directly addressing the three priority needs is through strategy 1 (Addressing SDOH). Through this strategy we create programs and partner with community organizations to address social risk factors, social needs and social determinants of health. Strategy 2 (Engagement infrastructure) and strategy 3 (Inclusive institution) focus on building infrastructure and creating system changes so that we can more effectively respond to these priority needs in the future, as well as any emerging needs.
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Schedule H, Part V, Section B, Line 11 Facility , 3
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Facility , 3 - University of Minnesota Medical Center. STRATEGY 1: Priority Need: Navigating and accessing care and resources. University of Minnesota Medical Center has a variety of programs that work as a part of strategy 1 (Addressing SDOH) to address barriers related to navigating and accessing care and resources. Through this strategy, the medical center and the children's hospital Action Plan programs work towards two anticipated impacts to address this priority need 1) Remove barriers to care by providing community-placed care, co-located services, and navigation supports that address cultural and language barriers. 2) Increased awareness of, knowledge about, and access to healthcare and community-based resources that support opportunities for health and wellbeing. Following is more information on a selection of programs from the system community action plan that are working to meet the two anticipated impacts. Fairview System Key Initiative Highlight. The Community Clinical Care initiative involves multiple community-based clinical programs, including Fairview's Minnesota Immunization Networking Initiative, Blood Pressure and Oral Health Services. All services are multi-sector, community collaborations that provide care and education to the uninsured, under-served, and communities facing health disparities in the greater Twin Cities area. The Community Clinical Care team provides clinical care in trusted community settings at no cost and improves equitable access to vaccines and other services across various populations. The programs ensure a culturally and linguistically appropriate experience in a safe and trusted environment in partnership with over 125 faith-based and grassroots community partners, serving clients at local churches, mosques, temples, schools, community centers, food pantries, and homeless shelters. In 2023 across the system, the community clinical care team provided blood pressure, and oral health services at 180 events, including 97 events in the medical center and children's hospital community, providing 465 blood pressure checks, and 696 dental fluoride applications. Fairview's Minnesota Immunization Networking Initiative (MINI), a multi-sector, community collaboration that initiated the Community Clinical Care approach provides free vaccinations, and education to the uninsured, under-served, and communities facing health disparities in the greater Twin Cities area. In 2023, across the system the team hosted 574 vaccination clinics. There were 7,037 free COVID-19 vaccine doses and 6,428 free flu shots administered. Of those participants who shared their identity, 81% of people who received a COVID-19 vaccine identified as a person of color and 38% indicated a language other than English as their preferred language. In 2023 the Minnesota Immunization Networking Initiative was invited to submit to the New England Journal of Medicine on their approach and successes, with a focus on partnerships with public health. This continues to build the evidence base for community placed and community centered approaches. In the medical center and the children's hospital community specifically, there were 314 MINI clinics at which 4,681 COVID-19 shots and 4,228 flu shots were administered. The Fairview Community Health and Wellness Hub (The Hub) opened in 2022. The hub is a first-of-its-kind center that will address health disparities while providing a range of critical healthcare services and community resources alongside trusted local partners. The Hub provides a variety of services to the community - from primary care to mental healthcare to enrichment options for seniors, food access programs, and community gathering spaces. We bring our own services together with local organizations to make it easier for people to access what they need to thrive. In 2023 we celebrated the 1-year anniversary of the opening of the hub and the Center for Community Health Equity. Through the year, we provided free community gathering space to more than 50 partners and local groups at the Hub. More than 250 community members were reached through cultural healing and community wellness programming delivered in, or partnering with, the Health and Wellness Hub and Center for Community Health Equity. Additionally, we hosted monthly hub Partnership Coordination Meetings, where we deepened partnership opportunities and developed a logic model. The Cultural Broker program was co-developed in 2016 in partnership with Fairview's East Side Health and Well-being Collaborative. Cultural Brokers help bridge cultural gaps through translating for, and supporting individuals and families as they navigate schools, healthcare, and other mainstream systems to ultimately build self-sufficiency. The Cultural Brokers identify with the racial and/or ethnic communities they serve, so they can more easily build trust and can have a greater impact on the communities' health. The program comprises seven Cultural Brokers, who are Fairview employees, located at five respective partner organizations representing different cultural communities: African American, American Indian, Hispanic/Latino, Hmong, and Karen. The Cultural Broker program has one cultural broker that is placed in the community surrounding the medical center and the children's hospital that serves the Hispanic/Latino community, housed in the CLUES Minneapolis location. Across the system, Cultural Brokers served a combined 399 new clients and a total 5,225 encounters. In the medical center and the children's hospital community they served 52 new clients with 572 encounters. Health Commons is a drop-in health and wellness center that began in 2011. It is dedicated to serving those in the Harrison/North Minneapolis neighborhood, Cedar-Riverside neighborhood and in 2023 added a location on the east side of St. Paul. All locations serve highly diverse communities with residents identifying as African American, Asian, Somali, Oromo, Korean, as well as older adults (65+). It is a Fairview-convened program managed in collaboration with other community organizations. The mission of Health Commons is to provide services based on respect, relationship building, hospitality, and collaboration; connecting health and hope for the community to live healthier lives. Services include drop-in hours where a nurse or doctor is available for a one-on-one consultation, massage, aromatherapy, and healthy living classes on topics such as nutrition, exercise, chronic disease, emotional health, physical activity classes such as Zumba and yoga, food distributions and supply giveaways. The services are free of charge and open to the community. Based on a 2023 sample survey of the Cedar Riverside and Harrison/North Minneapolis locations, most (54.8%) participants have been attending Health Commons for 8+ years, almost all are publicly insured (83.3%) and most participants are aged 45-74 (58.5%). Overall participants have experienced a positive impact through the program, 92.9% agree or strongly agree they are more connected to others in the community because of Health Commons, 83.3% say they are more connected to resources, and 57.1% say they are making positive changes toward a healthier lifestyle because of Health Commons. In 2023, there were 11,871 visits to the three Health Commons locations combined, with 11,578 of those visits being to Cedar Riverside and The Living Room in the medical center and the children's hospital community. In 2023 we expanded our work relating to opioid overdose. In response to the increase in drug overdose rates nationally and locally, including those caused by opioids, the community clinical care team partnered with the Steve Rummler Hope Network. The team trained several staff members to become Naloxone educators and helped develop a Spanish and Somali language curriculum to address racial disparities in overdose mortality rates, which are worsening. The training covers how to recognize an opioid overdose; what Naloxone/Narcan is and how it works; how to administer Naloxone to someone experiencing an overdose; and information about Steve's Law/MN's Good Samaritan and Naloxone Law. In total, there were 19 Naloxone trainings where 360 individuals were trained in 2023. In addition, Fairview hosts three low-barrier Naloxone access points (NAPs) at locations across the system. For more information about these and other action plan programs that are addressing the priority need Navigating and Accessing Care and Resources, please see our Fairview Health Services Community Action Plan: https://www.fairview.org/our-community-commitment/local-health-needs
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Schedule H, Part V, Section B, Line 11 Facility , 4
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Facility , 4 - University of Minnesota Medical Center. Priority Need: Addressing Structural Racism and Barriers to Equity. University of Minnesota Medical Center and Masonic Children's Hospital as a part of strategy 1, (Addressing the SDoH), has a variety of programs, events, and community education as a part of the Community Action Plan that work toward the anticipated impact: Develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, to address structural racism and barriers to equity. Fairview system highlights. One of the Fairview social determinants of health initiatives, Food is Medicine, utilizes the knowledge and resources of a large healthcare institution to work towards meeting the immediate needs of our patients, while also transforming the food system into something just, equitable, and sustainable. The initiative aims to 1) Nourish our patients: Advance food security to reduce health disparities and diet-related health conditions. 2) Enrich our communities: Cultivate trusting and engaged partnerships to build and share resources, assets, and capacity. 3) Transform our systems: Nurture just and equitable food systems to ensure health equity. These approaches are framed to increase health equity through focused efforts to serve patients who have been historically marginalized, by providing culturally appropriate food options, and reducing food insecurity in a manner that upholds dignity and empowers the local food system. Clinically, it enables providers to serve patients experiencing food insecurity through a menu of distinct programs comprising an innovative wrap-around approach. One, or more, of the Food is Medicine programs, a selection of which are described below, are available to patients in 43+ clinics and 5 acute sites across the health system. One of the Food is Medicine initiative programmatic responses is Veggie Rx, which distributes fresh, locally grown produce from four farm partners (Hmong American Farmers Association, Sin Fronteras, Naima's Farm and Women's Environmental Institute) via a Community Supported Agriculture (CSA) box. The program offers home delivery to address transportation barriers. In 2023, 20 clinics participated in Veggie Rx across Fairview hospital and medical center communities, four being in the medical center and children's hospital community. Almost one third (29%) of program participants identified as Asian, 20% as Black and 4% as Hispanic/Latino. While just three quarters speak English as a preferred language, 7% had a preferred language of Hmong, 13% Karen, and 2% Spanish. Most participants had public insurance (73%) or were uninsured (1%). Fairview's MarketRx program provides patients with $80 per month to purchase groceries at either the Twin Cities Mobile Market or Fare for All program. The program runs year-round and offers rolling enrollment. Through the year, 195 patients redeemed vouchers for groceries. Additionally, we provided shelf stable immediate need food resource options. MATTERboxes were available in the medical center and the children's hospital community with each box containing enough food to feed a family of four for three days. In 2023 there were 1,900 MATTERboxes distributed at 26 sites across the system. There were also 240 food resource packets distributed that contained information about local food resources along with a grocery gift card to assist with immediate grocery needs. In November of 2023, Fairview and local partners hosted the Harvest at the Hub at the Fairview Community Health and Wellness Hub. The event consisted of a food giveaway with turkeys, fresh produce, and other holiday staples, a community resource fair, a vaccine clinic, and other health and wellbeing services. We served a total of 421 unduplicated households (over twice that of 2022). Another of the Fairview social determinants of health initiatives, Housing is Health initiative is also in response to the priority need Structural Racism and Barriers to Equity. The Housing is Health initiative aims to use the protective power of housing to support patient health and build thriving communities. We approach this initiative with clinically connected programs, supporting community partnerships, contributing time and expertise to collaboratives, and work to impact policy. As an example, Fairview partners with Our Savior's Community Services to provide critical follow-up care and temporary housing for people who are unsheltered after a hospital stay. Patients are referred by the medical center and sheltered at Our Saviors. Additionally, a nurse provides care, and patients receive wrap-around services and social work support. In 2023, 76 patients were provided supports through this program. Also, as a part of Housing is Health, we are proud to have completed inaugural Housing and Health Equity Fellowship hosted by the Greater Minnesota Housing Fund, which aimed to expand community investment by health systems to address the housing crisis in Minnesota. In October 2023, teams from across the system participated in our annual Build Week with Twin Cities Habitat for Humanity, contributing 456 volunteer hours. For more information about the action plan programs that are addressing the priority need Structural Racism and Barriers to Equity please see our Fairview Health Services Community Action Plan. https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Priority Need: Healing, connectedness, and mental health. The medical center and the children's hospital works toward the anticipated impact: develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, address barriers to healing, connectedness and mental health through strategy 1 (Addressing the SDoH) and the Community Action Plan. In response to the priority need, healing, connectedness, and mental health, we have a body of work that makes up the Connection is Cure initiative. Connection is Cure aims to build trust through social connections, centering linguistic and cultural diversity, and bridging silos across our hospital system and communities to transform medical practice. As a part of Connection is Cure, we participated in the Institute for Healthcare improvement trust prototyping network. We were one of eight health care organizations nationwide that are part of a 10-month project to test approaches to improve trust in healthcare systems. Our organization is focusing on a project to identify and remove system level equity barriers for interpreters and patients with limited English proficiency aiming to improve patient outcomes, customer experience, and care team cohesion. Additionally, we are responding to the need healing, connectedness, and mental health with a variety of evidence-based programs, as well as trainings and education sessions. Feeding Hope is a series of virtual one-hour learning sessions focused on positive, hopeful topics that support wellbeing in the general community. This series is offered in partnership with all Fairview's hospitals and medical centers and is open to anyone across all of Fairview's communities. In 2023, across Fairview hospitals and medical centers there were three sessions held with a combined 665 attendees. Healthy Outcomes from Positive Experiences (H.O.P.E.) training is a 60-90-minute training focused on the science of H.O.P.E providing a framework for positive experiences as a mitigating factor in Adverse Childhood Experiences (ACEs) and trauma. In 2023, in the medical center and the children's hospital community. there were four sessions with a total of 156 attendees. The Faith Community Nursing program makes available programs and services to Faith Community Nurses to hold in their congregation. Additionally, $750 mini-grants and provided to Faith community Nurses, as well as resources such as health education materials and resources, and networking opportunities. In 2022 across the system there were 19 mini grants awarded. In the medical center and the children's hospital community, 9 mini grants were awarded to a Faith Community Nurse. Psychological First Aid (PFA) is an evidence-informed training for the broader community as well as professionals. Trainees learn how to support healthy recovery for individuals following a traumatic event, public health emergency, natural disaster, or personal crisis. The curriculum integrates public health, community health and individual psychology by drawing upon skills the trainees probably already have. PFA is a two-hour training. In 2023, in the medical center and the children's hospital community, there were four classes offered with 65 participants attending.
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Schedule H, Part V, Section B, Line 11 Facility , 5
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Facility , 5 - University of Minnesota Medical Center. Refresh and Reset your Resiliency promotes resiliency skills, offers wellness-care tools for mind, body, and spirit, and encourages the development of a personal plan for self-care. In 2023, in the medical center and the children's hospital community, there was one class offered with 21 participants attending. For more information about the action plan programs that are addressing the priority need Structural Racism and Barriers to Equity please see our Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs In addition to strategy 1 (Addressing SDOH) and the programmatic work included on our Action Plans, we are striving to reduce health disparities and increase community health equity through two additional system strategies. While strategy 1 (Addressing SDOH) allows us to directly respond to the three prioritized needs from our community health needs assessment, strategy 2 (Engagement Infrastructure) and strategy 3 (Inclusive institution) focus on building the structures and systems for us do the work more capably. Strategy 2 - Engagement Infrastructure Addressing our three priority needs while also responding to emerging needs requires an infrastructure that supports building and sustaining strong community partnerships and allows for ongoing, trusting exchanges between Fairview and community members. Strategy 2 (Engagement Infrastructure): Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. The anticipated Impacts for this strategy are 1. Build and expand feedback systems for patients and community members; embed process improvement in the health system's response to community voice. 2. Create sustainable structures to convene and engage community voice around addressing social determinants of health. While Fairview boasts an extensive engagement infrastructure already, we continued to bolster and expand thew work we do to expand feedback systems and sustainable convening structures. The M Health Fairview Center for Community Health Equity (the center) was launched in August 2022. The center guides our philosophy around how we gather community voice and who we talk to as we learn how to tie the learnings back into the organization. The 1-year anniversary of the Center for Community Health Equity was celebrated through a 3-day event welcoming over 250 people, where we offered free vaccinations, blood pressure checks, the opportunity to connect and network, and learn more about the work of the center. Throughout the year, we hosted six Center Community Health Equity Work Group meetings to hold strategic discussions on issues of relevance to the center. The work group was comprised of representatives from across the M Health Fairview Joint Clinical Enterprise. We also moved forward the development of a Center for Community Health Equity Model of Community Engagement. The model shares our approach to community engagement, community voice, and community partnerships to advance community health equity. We will utilize this model in 2024 to help guide how we gather feedback and inform our community health needs assessment. Enabling community voice, particularly the voices of priority populations, to influence, and inform the health system, is integral to strategy 2 (Engagement infrastructure). In 2023 we expanded our patient Listening and Learning sessions to host a session for patients who use American Sign Language. Additionally, Fairview hosted 8 Food is Medicine community conversations where we heard from 74 partner organizations to help inform our Food is Medicine approach as well as to convene food partners to increase opportunities for mutual awareness and collaboration. Building our engagement infrastructure involves engaging broadly with community but also building our capacity to engage with complex and intersectional groups. We are building a set of population health equity initiatives, one of which is the Native Health Equity Initiative. As a part of this body of work in 2023, a cohort of employees from across our system began work to advance health equity efforts in partnership with Native Americans and Indigenous communities. We facilitated six sessions to help our employees learn about the historical and current challenges faced by Native communities, connecting with key Native leaders and organizations, and local priority issues including healthcare. The sessions also engaged employees in working to improve experiences and outcomes for our Native patients, employees, and communities. In summer 2023, we co-hosted a "Heal the Healers" Summit with Indigenous Roots Cultural Art Center. The two-day summit welcomed more than 200 attendees for group learning sessions, rituals, seminars, and individual sessions with healers and professionals skilled in traditional healing modalities. Hosted an American Indian and Indigenous focused recruitment event at the Community Health and Wellness Hub. Finally, core to this strategy is building and sustaining trusting partnerships. We continue to support and build on existing engagement infrastructure and support existing collaboratives. Our medical center and children's hospital Community Advisory Committee met through the year to provide input as well as insight and local expertise. We conducted an inventory of the Community Advisory Committee member organizations focus and identified gap areas for expertise and aligned representation with CHNA priority populations. We continue to intentionally recruit participants to expand representation on the committees focusing on these gap areas. Committee members also participated, in addition to other community partners in our annual Community Impact Summit. In the medical center and children's hospital community, we participate in and have leadership roles in collaboratives such as the Minnesota Food Justice Network and the Center for Community Health. We also convene East Side Health and Well-being Collaborative. These are spaces where we do ongoing listening and relationship building with community partners and community members.
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Facility , 6 - University of Minnesota Medical Center. Strategy 3 - Inclusive Institution Strategy 3: Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. The anticipated impacts tied to strategy 3 (Inclusive Institution) are: 1) Build internal and external processes and structures to provide spaces that are safe and welcoming to all, responsive to community needs, and based on a culture of inclusion. 2) Using an antiracist approach, work to identify and eliminate racism by changing systems, organizational structures, policies, practices, and attitudes. 3) Leverage everyday business practices to build community wealth, promoting economic and racial equity and justice. This strategy has been partially operationalized through the HOPE Commission. The work of the HOPE Commission has been to identify foundational and transformational opportunities for our organizations to advance health equity (HE) and promote diversity, equity, and inclusion (DEI). To learn more about the goals, strategies and successes of the HOPE commission please see: The HOPE Commission website: https://mhealthfairview.org/About-Us/health-equity/hope-commission The 2023 HOPE Commission Report: https://www.mhealthfairview.org/-/media/Files/240033-2023-HOPE-Report-R5.pdf This work will continue to be operationalized through various departments across the organization as well as through the Center for Community Health Equity (CCHE). Key achievements in alignment with strategy 3 include the launch of standardized Social Determinants of Health patient screenings (i.e., food security, housing stability) at all ambulatory sites as well as implementation of targeted interventions to improve healthcare disparities which resulted in marked improvement in breast cancer and colon cancer screening rates. There was also improvement in breast cancer screening rates among Karen, Hmong, and Somali patients with 6 mobile mammography events. Additionally, we are building capacity across the system to allow more individuals and teams to participate in the Intercultural Development Inventory (IDI). Operational improvements from the Office of Equity Strategy (OES) include dashboarding and reporting on metrics across the areas of health equity, healthcare equity, and diversity, equity, and inclusion, which will inform the creation of actions plans to reduce any disparities found and create line of sight for progress being made. Fairview is currently enhancing existing data collection and analytics across the institution to uncover and address health disparities. Fairview has successfully enhanced its analytics of Race, Ethnicity and Language (REaL) data across the institution, enabling us to uncover and address health disparities more effectively. With the improved analysis of REaL data, we are now setting Performance Dimension goals specifically aimed at closing these disparities. OES also supported strategic leadership within Human Resources and Customer Experience to incorporate Restorative Justice practices into their Just Culture and patient relations efforts. Additionally, in 2023, various units across the system operationalized systems to embed equity in project development and implementation across various parts of system decision-making. Our anchor strategy works to advance health equity by investing in the social and economic wellbeing of the communities we serve through our everyday business practices. The strategy focuses on local and diverse hiring, purchasing and investing, and serving and leading with trusted community partners. Fairview's Workforce Partnerships team is addressing the social determinants of health by helping people secure employment with family sustaining wages and benefits, become successful in their job, and learn new skills. The team is also focused on inclusive, local hiring, resulting in a healthcare team that represents the communities we serve. Supply Chain leaders launched a Supplier Diversity program, including updated request for proposal language, creating a new webpage, and identifying potential diverse vendors. Fairview also has a robust social corporate responsibility program including employee volunteerism, memberships and affiliations and sponsorships. In 2023 there were five systemwide employee volunteerism events hosted, including Twin Cities Pride. Additionally, Fairview staff sit on boards and/or are members of a diverse set of community organizations. Fairview's sponsorship program is aligned with Fairview's commitment to advancing equity and Fairview's focus on diversity, equity, and inclusion. Within this focus, Fairview awards sponsorships to support local community organizations in the needs and opportunities they have identified. In efforts to increase diversity and trust in clinical trials, the CCHE partnered with Fairview Frontiers to improve representation in a set of clinical trials and hosted a Research Participant Appreciation event that was attended by over 70 research participants. The partnership between Center for Community Health Equity and Fairview Frontiers increased participant representation in a set of clinical trials of those that identified as a race or ethnicity other than white from 15.5% to 33.8%. A paper was published on the partnership and methods used that led to these successes.
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Facility , 7 - University of Minnesota Medical Center. Significant needs not addressed. Prioritizing needs that are the root causes of almost all health disparities allows us to develop upstream strategies that will have a large and lasting impact in our communities. The significant needs we have identified will ultimately be positively impacted by addressing the root causes we have identified as our priority needs. The following needs were not directly addressed because this issue is beyond what the University of Minnesota Medical Center and Masonic Children's Hospital resources can support at this time: Cost of care, insurance and medications, childcare and employment benefits. The following needs were directly not addressed because this issue will be addressed as part of patient care but falls outside of the scope of the CHNA Implementation Strategy: Clinic/hospital hours, limited time spent with provider, limited specialty care.
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Facility , 1 - University of Minnesota Medical Center. The Minnesota Attorney General agreement was used in the determination of the eligibility for financial assistance.
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Facility , 1 - University of Minnesota Medical Center. The organization attaches a summary of the policy to billing invoices and also communicates to patients during admission, financial counseling and collection calls that there is a financial assistance program and that an application can be provided to them. A summary of the Financial Assistance Policy is posted in various locations in the hospital.
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Facility , 1 - University of Minnesota Medical Center. Pursuant to Treas. Reg. Section 1.501(r)-6(c), University of Minnesota Medical Center made reasonable efforts to determine whether an individual was FAP-eligible for care by satisfying the requirements of Section 1.501(r)-6(c)(3).
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Fairview is committed to transparency and accountability in all we do, including our efforts to assess - and respond to - our community's most pressing health needs. The community benefit work that we do across Fairview must reflect our community's actual needs, not our assumptions about what those needs might or should be. Because we understand that change cannot happen when we work in silos, and it cannot happen in a single year, we grounded our 2021 CHNA process in alignment with our 2018 CHNA needs, existing data, and the voices of community members and community partners. Once we had collected, analyzed, and synthesized the information we received from both primary and secondary data sources, we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. Having a consistent, defined process helps reduce the skewing effect of conscious and unconscious biases and enables us to define priority need areas that reflect our community's top health needs rather than our perception of those needs. We evaluated areas of need based on four broad criteria: -Has this need been voiced by the community? Has this need been vetted by the community? -Does this need align with Fairview's strategies and priorities? -Does this need align with existing public health strategies and community health assessments? -Does this need build upon Fairview's 2018 CHNA priority needs? Our process resulted in the identification of three priority need areas. They are: -Navigating and accessing care and resources -Healing, connectedness, and mental health -Addressing structural racism and barriers to achieving health equity.
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Facility , 1 - Fairview Southdale Hospital. The assessment process and data collection methods we used during this CHNA cycle were different than ever before due to the COVID-19 pandemic. COVID- 19 caused delays in data collection among local, state, and national organizations. As a result of these delays, the U.S. Census Bureau had not yet released finalized data from the 2020 U.S. Census by the time we began the CHNA process. As a result, we used 2015-2019 American Community Survey data. Local public health agencies also were not able to provide updated data as they have in the past. We acknowledge that, due to these setbacks, the data we used is less recent than desired. Additionally, COVID-19 required us to add new safety precautions to our method of gathering community voice data. For example, all conversations and interviews, which had previously been in-person meetings, took place in a virtual format instead. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations. The process included discussions with community benefit and assessment committees, our community advisory council, the HOPE Commission listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Each hospital within Fairview has a community benefit and assessment committee that is involved in the CHNA process throughout the three-year cycle. Each committee is comprised of local community and organizational leaders and staffed by the Fairview Community Advancement department. Community benefit and assessment committees met four times between April and October in 2021, three of which were individual committee meetings and one of which was a system-wide Community Impact Summit that brought all the committees together. Each committee meeting consisted of facilitated discussions through which our team gathered input about top community needs. The Fairview Community Advisory Council, composed of key community leaders and staffed by Community Advancement, reviews the CHNA report and written implementation strategy and recommends it to the Patient Care and Experience Committee of the Fairview Board of Directors for review and adoption. Each member represents the member's respective community, and members represent a broad range of sectors, among them community organizations serving cultural communities, higher education organizations, banks, and a nonprofit electric company. The Community Advisory Council met from May through November 2021 to participate in the CHNA process, give feedback, and ultimately recommend the CHNA and implementation strategy for adoption. The HOPE Commission is a multi-year transformational change effort of M Health Fairview to drive more equitable outcomes and inclusive environments and experiences for our patients, employees, and communities. The Commission conducted a series of listening and learning sessions in 2020 and 2021. The objective was to hold a mirror to Fairview to assess where we are now and how we can make lasting change. Part of being an anti-racist health system is developing a candid understanding of our shortcomings. We particularly sought to hear perspectives and ideas from the most impacted populations: BIPOC employees and patients, front-line workers who care for underserved and marginalized patients, and those patients themselves. A survey was also made available each year to gather insights and suggestions from employees and patients who could not directly participate in a listening and learning session. In 2020, the commission convened 32 virtual listening and learning sessions and two town halls involving more than 1,500 participants across Fairview sites. The sessions focused on employees but included patients and community members as well. In September 2021, the HOPE Commission continued the listening and learning sessions following the same model. In this iteration, however, the focus was primarily on gathering input from patients (and employees as patients). In both 2020 and 2021's listening and learning sessions, the facilitators and note takers reflected the community represented by the session's group to the greatest degree possible. In August and September 2021, Fairview's Community Advancement team conducted a series of interviews with staff members who work with communities. Each conversation followed a consistent interview protocol developed for this purpose, and each interview was captured by means of detailed notes. The goal of these interviews was to draw on staff expertise to gain a deeper understanding of our priority needs and to determine whether there are any emerging needs that we should be considering. Between Aug. 31 and Sept.17, 2021, we conducted 17 interviews. In August 2021, we held two focus groups in partnership with other organizations. We convened the first focus group in partnership with HealthPartners and Allina Health, and the participants were faith community nurses. We convened the second focus group in partnership with the organizations that are a part of the East Side Health and Well-being Collaborative. This meeting's focus was on accessing care and resources for different cultural communities. Fairview also participated in two large surveys. KRC Research conducted a survey around health and health care needs in St. Paul between June 8 and July 7, 2021, and administered it to community members, Fairview employees, patients, and community partners. Responses were received from 294 residents, more than 1,000 employees, 221 patients, and 20 partners. The survey was offered online and by phone and in five languages: English, Spanish, Hmong, Somali, and Karen. Fairview also supported and was a partner organization in Bridge to Health, a survey that assesses the health needs of northern Minnesota residents. The Bridge to Health survey was administered between Aug.28 and Oct. 23, 2020. The geographic areas that were sampled included Aitkin, Carlton, Cook, Itasca, Koochiching, Lake, St. Louis, and Pine counties in Minnesota, as well as Douglas County in Wisconsin. As a foundational part of program planning and evaluation, Community Advancement staff are continuously soliciting feedback from community partners and program participants. We capture this information on an ongoing basis and use it to provide valuable context and drive insights into the needs of the communities we serve. Fairview staff developed standardized tools, processes, instructions, and facilitator, interviewer, and note-taker protocols and training. All primary data was compiled, cleaned, and analyzed. Community conversations lasted various lengths from 30-120 minutes. All community input was captured by a note-taker. The Fairview team contracted with the following groups to support our assessment process: -Loren Blinde, PhD of Writing Power, a copywriter and content strategist, on the writing of the report. -Kristi Fordyce, an independent contractor, for analysis support. -Weber Shandwick, for data collection and analysis of focus groups and stakeholder interviews focused on St. Paul. -KRC Research for the administration and analysis of the St. Paul Community Survey
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Facility , 1 - Fairview Southdale Hospital. Our triennial community health needs assessment (CHNA) process provides an important opportunity to engage with and understand our community, analyze what has changed since the last assessment, and prioritize together with the community the issues we must urgently address to improve wellbeing and resilience. As part of the 2021 CHNA process, we reexamined and built upon the extensive community insights shared during our 2018 CHNA, while also surveying the community for current and emerging needs. Our 2021 CHNA used social determinants of health as a lens through which we frame our understanding of our community's most significant health needs. A social determinants of health lens enables us to identify inequitable distribution of resources and access that negatively impacts health. Through this lens we looked at both qualitative and quantitative data. Quantitative data included data points related to demographics, physical environment, socioeconomic factors, health care and health outcomes. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations - racial or ethnic populations experiencing health disparities and persons experiencing poverty. Southdale Hospital has a community advisory committee (CAC) that is involved in the CHNA process. The committee is comprised of local community and organizational leaders, such as local public health, social services organizations, higher education institutions, school districts, and local businesses. The assessment process also included discussions with our community advisory council, listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Bringing together both the qualitative and quantitative data we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. We prioritized areas of need based on four broad criteria: 1) Has this need been voiced by the community? Has this need been vetted by the community? 2) Does this need align with Fairview's strategies and priorities? 3) Does this need align with existing public health strategies and community health assessments? 4) Does this need build upon Fairview's 2018 CHNA priority needs? The Southdale Hospital identified three system-wide priority need areas, and will collaborate with other Fairview hospitals, medical centers, and shared business and clinical services to address these priorities. Our specific response varies by hospital based on the ways in which the priority needs manifest across a given community as well as the partnerships, both ongoing and new, that we have developed to address those needs. The three identified needs are: 1) Navigating and accessing care and resources, 2) Healing, connectedness, and mental health, 3) Addressing structural racism and barriers to equity. Each priority has a set of anticipated impacts, described in more detail below, and can be found in the Southdale Hospital CHNA Implementation Strategy Report (2022-2024). We also identified two priority populations that reach across the lifespan and impact from rural to urban. They are racial or ethnic populations experiencing health disparities and people experiencing poverty. For more details about our priority needs and the priority populations as they relate to the Southdale Hospital, please see the Southdale Hospital 2021 Community Health Needs Assessment. https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Development of 2022-2024 CHNA Implementation Strategies As a learning organization that works closely with our community advisory committees and community partners, over the past decades we have gleaned important lessons which have guided us in the development of our Fairview Health Services 2022-2024 implementation strategies. 1. Despite best efforts, health needs and health inequities continue to grow and deepen. 2. Collective action is critical. 3. Transformational change requires sustained and focused commitment. In response to our 2021 community health needs assessment and our lessons learned, all Fairview hospitals and medical centers worked collaboratively amongst each other, as well as in partnership with local and statewide organizations to address communities' most pressing needs. To rise to the challenge, we put forth a 2032 vision of increased community health equity supported by three strategies to address the priority need areas in distinct ways while collectively moving us closer to our vision of increased community health equity. The three strategies are: Strategy 1: Addressing SDOH - Addressing the social determinants of health (SDOH) as well as individual social risks and social needs through the creation and expansion of programs; initiatives; collaborations; research; and policy, system, and environmental work. Strategy 2: Community engagement infrastructure - Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. Strategy 3: Inclusive institution - Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. For this three-year cycle, we are implementing our strategies to work toward distinct anticipated impacts for each priority need and ultimately our 10-year vision of increased community health equity. For more information, the Southdale Hospital CHNA Implementation Strategy Report outlines the major strategies and actions we will deploy throughout the 2022-2024 assessment cycle as well as the ties between the Southdale Hospital CHNA implementation strategies, anticipated impacts, and key responses. Southdale Hospital Community Health Needs Assessments Implementation Strategy Reports (2022-2024): https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Fairview's mission and vision extend beyond traditional healthcare settings, driving a healthier future for the communities we serve. Significant efforts towards Strategy 1 occurred over the first three years of our ten-year vision, demonstrated through standing up three Social Determinants of Health Initiatives. 1) "Food is Medicine" Using the healing power of food to nourish our patients, enrich our communities, and transform our systems. 2) "Housing is Health" Using the protective power of housing to support patient health and build thriving communities. 3) "Connection is Cure" aims to address social isolation and improve community mental health and well-being by strengthening the connection between patients and the healthcare system. These initiatives are key responses that intersect all three priority needs and are also synergistic among themselves.
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Facility , 2 - Fairview Southdale Hospital. Relationship with our partners. Fairview has a long partnership with the University of Minnesota and University of Minnesota Physicians, now represented in the M Health Fairview brand. Together, we offer access to breakthrough medical research and specialty expertise as part of a continuum of care that reaches all ages and health needs. Policy, systems, and environmental change initiatives are implemented across the system (hospitals, clinics, etc.) and in some instances across the M Health Fairview partners to create sustainable and lasting change to advance health equity and community wellbeing. Where indicated, community responses as a part of strategy 2 (Community engagement infrastructure) and strategy 3 (Inclusive institution) represent the work of Fairview in collaboration with the other M Health Fairview partners. Community action plan. The Southdale Hospital has an annual CHNA action plan that supports our vision of increased community health equity, rolls up to our system CHNA implementation strategies, and addresses priority needs. The Fairview Health Services Community Action Plan details the specific and measurable steps we will take during the year to drive change. Program lists by hospital can be found in the appendix. The System Community Action Plan is updated annually and includes impacts from the prior years. This report is shared with the Southdale Hospital Community Advisory Committee, the Fairview Health Services Board of Directors, and is publicly available on the website: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Evaluation of Impact. To best evaluate our impact and track progress towards our anticipated impacts, we used a multi-tiered and tailored evaluation approach. We ground our work in understanding core information about our communities. This includes identifying and understanding the community need being addressed, the population or community being impacted, and current and/or potential partners to work with to address the need, and the impacts we anticipate. Community needs are determined in several ways. In addition to being determined through our formal CHNA process, we also respond to emerging needs brought to us by a community partner, public health, or through patient or community data showing significant health disparities. We have standardized several key measures to assess that we are meeting the needs of the CHNA priority populations, focusing our efforts on equity, and participant satisfaction. A subset of established programs and initiatives are set up and supported for deeper evaluation. We have found with the populations we serve; one-size fits all evidence-based approaches are not a good fit for our diverse communities. In response to the unique and differing needs of our community members, our programs have been co-developed in partnership with community, centering the needs of specific populations, and often have unique local tactics. We approach evaluation from a similar perspective by building evaluation approaches informed by our partners, and considering strategies that are culturally and linguistically appropriate and to determine if the programs reflect the values we set out to embody. We are guided by the Centers for Disease Control and Prevention (CDC) model for program evaluation to establish primary outcomes, process measures, and demographics. We evaluate program impact and success from a variety of approaches using both qualitative and quantitative data. For many of the programs described here we are reporting out our reach or outputs through counts on a variety of levels including meeting the rigor required for reporting on grants and contracts. We offer a diverse set of programs that vary the spectrum of low touch and high count or high touch and lower count, or more generally put, the effort and impacts of the programs are not the same. This is a purposeful approach as we want a variety of programs and to "right-size" programs to address the community and population specific needs. We provide outcomes for programs here when we are able, acknowledging not all programs run on a calendar year and analysis may not be complete for some of the programs we do deeper evaluation on. We are currently in the process of building an evaluative approach and capacity for our ten-year vision, increased community health equity, and three social determinants of health initiatives: Housing is Health, Food is Medicine, and Connection is Cure. Part of this evaluative approach is a monthly Social Determinants of Health dashboard. Southdale Hospital 2023 Implementation Strategy Progress Highlights. The following highlights our implementation strategy work for each of our three priority needs. For a more comprehensive view of what we are doing to impact community needs please see our Fairview Health Services Community Action Plan and for a view of the Southdale Hospital's list of programs see the appendices. Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs In this first three-year CHNA cycle working towards our 2032 vision of increased community health equity the primary way we are directly addressing the three priority needs is through strategy 1 (Addressing SDOH). Through this strategy we create programs and partner with community organizations to address social risk factors, social needs and social determinants of health. Strategy 2 (Engagement infrastructure) and strategy 3 (Inclusive institution) focus on building infrastructure and creating system changes so that we can more effectively respond to these priority needs in the future, as well as any emerging needs.
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Facility , 3 - Fairview Southdale Hospital. Strategy 1 Priority Need: Navigating and accessing care and resources. Southdale Hospital has a variety of programs that work as a part of strategy 1 (Addressing SDOH) to address barriers related to navigating and accessing care and resources. Through this strategy, the Southdale Hospital Action Plan programs work towards two anticipated impacts to address this priority need 1) Remove barriers to care by providing community-placed care, co-located services, and navigation supports that address cultural and language barriers. 2) Increased awareness of, knowledge about, and access to healthcare and community-based resources that support opportunities for health and wellbeing. Following is more information on a selection of programs from the system community action plan that are working to meet the two anticipated impacts. Fairview System Key Initiative Highlight. The Community Clinical Care initiative involves multiple community-based clinical programs, including Fairview's Minnesota Immunization Networking Initiative, Blood Pressure and Oral Health Services. All services are multi-sector, community collaborations that provide care and education to the uninsured, under-served, and communities facing health disparities in the greater Twin Cities area. The Community Clinical Care team provides clinical care in trusted community settings at no cost and improves equitable access to vaccines and other services across various populations. The programs ensure a culturally and linguistically appropriate experience in a safe and trusted environment in partnership with over 125 faith-based and grassroots community partners, serving clients at local churches, mosques, temples, schools, community centers, food pantries, and homeless shelters. In 2023, across the system, the community clinical care team provided blood pressure, and oral health services at 180 events, including 2 events in the Southdale Hospital community, providing 30 blood pressure checks, and 29 dental fluoride applications. Fairview's Minnesota Immunization Networking Initiative (MINI), a multi-sector, community collaboration that initiated the Community Clinical Care approach provides free vaccinations, and education to the uninsured, under-served, and communities facing health disparities in the greater Twin Cities area. In 2023, across the system the team hosted 574 vaccination clinics. There were 7,037 free COVID-19 vaccine doses and 6,428 free flu shots administered. Of those participants who shared their identity, 81% of people who received a COVID-19 vaccine identified as a person of color and 38% indicated a language other than English as their preferred language. In 2023 the Minnesota Immunization Networking Initiative was invited to submit to the New England Journal of Medicine on their approach and successes, with a focus on partnerships with public health. This continues to build the evidence base for community placed and community centered approaches. In the Southdale Hospital community specifically, there were 8 MINI clinics at which 68 COVID-19 shots and 456 flu shots were administered. The Colon Cancer Prevention program provides community education on colon cancer prevention, outreach, and recruitment of uninsured individuals to have colonoscopy procedures. Communities served are identified based on disparate colorectal cancer screening rates compared to the state rate. Education and outreach are provided by a Community Health Worker (CHW) across multiple community locations. CHW assesses people who indicate interest in having a colonoscopy procedure at no cost based on program criteria: Age 45-75 or in a group at higher risk for colon cancer, do not have medical insurance, and live anywhere in Minnesota. In 2022 there were 25 colonoscopies provided to uninsured community members in the Southdale Hospital community. The Culturally Tailored Education and Outreach Program provides health education sessions on a variety of health topics including COIVD-19 vaccines, COIVD-19 virus, colorectal cancer prevention, cancer prevention, diabetes prevention, heart disease prevention, mental health, Alzheimer's disease, heat-related illness, and other health topics. Education provided to the general Latine community. In partnership with community organizations. In 2023 in the Southdale Community, there were four education sessions with 219 people attending. The Fairview Community Health and Wellness Hub (The Hub) opened in 2022. The hub is a first-of-its-kind center that will address health disparities while providing a range of critical healthcare services and community resources alongside trusted local partners. The Hub provides a variety of services to the community - from primary care to mental healthcare to enrichment options for seniors, food access programs, and community gathering spaces. We bring our own services together with local organizations to make it easier for people to access what they need to thrive. In 2023 we celebrated the 1-year anniversary of the opening of the hub and the Center for Community Health Equity. Through the year, we provided free community gathering space to more than 50 partners and local groups at the Hub. More than 250 community members were reached through cultural healing and community wellness programming delivered in, or partnering with, the Health and Wellness Hub and Center for Community Health Equity. For more information about these and other action plan programs that are addressing the priority need Navigating and Accessing Care and Resources, please see our Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Priority Need: Addressing Structural Racism and Barriers to Equity. Southdale Hospital as a part of strategy 1, (Addressing the SDoH), has a variety of programs, events, and community education as a part of the Community Action Plan that work toward the anticipated impact: Develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, to address structural racism and barriers to equity. Fairview system highlights. One of the Fairview social determinants of health initiatives, Food is Medicine, utilizes the knowledge and resources of a large healthcare institution to work towards meeting the immediate needs of our patients, while also transforming the food system into something just, equitable, and sustainable. The initiative aims to 1) Nourish our patients: Advance food security to reduce health disparities and diet-related health conditions. 2) Enrich our communities: Cultivate trusting and engaged partnerships to build and share resources, assets, and capacity. 3) Transform our systems: Nurture just and equitable food systems to ensure health equity. These approaches are framed to increase health equity through focused efforts to serve patients who have been historically marginalized, by providing culturally appropriate food options, and reducing food insecurity in a manner that upholds dignity and empowers the local food system. Clinically, it enables providers to serve patients experiencing food insecurity through a menu of distinct programs comprising an innovative wrap-around approach. One, or more, of the Food is Medicine programs, a selection of which are described below, are available to patients in 43+ clinics and 5 acute sites across the health system. One of the Food is Medicine initiative programmatic responses is Veggie Rx, which distributes fresh, locally grown produce from four farm partners (Hmong American Farmers Association, Sin Fronteras, Naima's Farm and Women's Environmental Institute) via a Community Supported Agriculture (CSA) box. The program offers home delivery to address transportation barriers. In 2023, 20 clinics participated in Veggie Rx across Fairview hospital and medical center communities. Almost one third (29%) of program participants identified as Asian, 20% as Black and 4% as Hispanic/Latino. While just three quarters speak English as a preferred language, 7% had a preferred language of Hmong, 13% Karen, and 2% Spanish. Most participants had public insurance (73%) or were uninsured (1%). Fairview's MarketRx program provides patients with $80 per month to purchase groceries at either the Twin Cities Mobile Market or Fare for All program. The program runs year-round and offers rolling enrollment. Through the year, 195 patients redeemed vouchers for groceries.
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Facility , 4 - Fairview Southdale Hospital. Additionally, we provided shelf stable immediate need food resource options. MATTERboxes were available in the Southdale Hospital community with each box containing enough food to feed a family of four for three days. In 2023 there were 1,900 MATTERboxes distributed at 26 sites across the system. There were also 240 food resource packets distributed that contained information about local food resources along with a grocery gift card to assist with immediate grocery needs. In November of 2023, Fairview and local partners hosted the Harvest at the Hub at the Fairview Community Health and Wellness Hub. The event consisted of a food giveaway with turkeys, fresh produce, and other holiday staples, a community resource fair, a vaccine clinic, and other health and wellbeing services. We served a total of 421 unduplicated households (over twice that of 2022). Another of the Fairview social determinants of health initiatives, Housing is Health initiative is also in response to the priority need Structural Racism and Barriers to Equity. The Housing is Health initiative aims to use the protective power of housing to support patient health and build thriving communities. We approach this initiative with clinically connected programs, supporting community partnerships, contributing time and expertise to collaboratives, and work to impact policy. As an example, Fairview partners with Our Savior's Community Services to provide critical follow-up care and temporary housing for people who are unsheltered after a hospital stay. Patients are referred by staff at hospital or medical center and sheltered at Our Saviors. Additionally, a nurse provides care, and patients receive wrap-around services and social work support. In 2023, 76 patients were provided supports through this program. Also, as a part of Housing is Health, we are proud to have completed inaugural Housing and Health Equity Fellowship hosted by the Greater Minnesota Housing Fund, which aimed to expand community investment by health systems to address the housing crisis in Minnesota. In October 2023, teams from across the system participated in our annual Build Week with Twin Cities Habitat for Humanity, contributing 456 volunteer hours. For more information about the action plan programs that are addressing the priority need Structural Racism and Barriers to Equity please see our Fairview Health Services Community Action Plan. https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Priority Need: Healing, connectedness, and mental health. Southdale Hospital works toward the anticipated impact: develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, address barriers to healing, connectedness and mental health through strategy 1 (Addressing the SDoH) and the Community Action Plan. In response to the priority need, healing, connectedness, and mental health, we have a body of work that makes up the Connection is Cure initiative. Connection is Cure aims to build trust through social connections, centering linguistic and cultural diversity, and bridging silos across our hospital system and communities to transform medical practice. As a part of Connection is Cure, we participated in the Institute for Healthcare improvement trust prototyping network. We were one of eight health care organizations nationwide that are part of a 10-month project to test approaches to improve trust in healthcare systems. Our organization is focusing on a project to identify and remove system level equity barriers for interpreters and patients with limited English proficiency aiming to improve patient outcomes, customer experience, and care team cohesion. Additionally, we are responding to the need healing, connectedness, and mental health with a variety of evidence-based programs, as well as trainings and education sessions. Feeding Hope is a series of virtual one-hour learning sessions focused on positive, hopeful topics that support wellbeing in the general community. This series is offered in partnership with all Fairview's hospitals and medical centers and is open to anyone across all of Fairview's communities. In 2023, across Fairview hospitals and medical centers there were three sessions held with a combined 665 attendees. The Faith Community Nursing program makes available programs and services to Faith Community Nurses to hold in their congregation. Additionally, $750 mini-grants and provided to Faith community Nurses, as well as resources such as health education materials and resources, and networking opportunities. In 2022 across the system there were 19 mini grants awarded. In the Southdale Hospital Community, 7 mini grants were awarded to a Faith Community Nurse. Healthy Outcomes from Positive Experiences (H.O.P.E.) training is a 60-90-minute training focused on the science of H.O.P.E providing a framework for positive experiences as a mitigating factor in Adverse Childhood Experiences (ACEs) and trauma. In 2023, in the Southdale Hospital community there were two sessions with 93 attendees. Psychological First Aid (PFA) is an evidence-informed training for the broader community as well as professionals. Trainees learn how to support healthy recovery for individuals following a traumatic event, public health emergency, natural disaster, or personal crisis. The curriculum integrates public health, community health and individual psychology by drawing upon skills the trainees probably already have. PFA is a two-hour training. In 2023, in the Southdale Hospital community, there were three classes offered with 71 participants attending. For more information about the action plan programs that are addressing the priority need Structural Racism and Barriers to Equity please see our Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs In addition to strategy 1 (Addressing SDOH) and the programmatic work included on our Action Plans, we are striving to reduce health disparities and increase community health equity through two additional system strategies. While strategy 1 (Addressing SDOH) allows us to directly respond to the three prioritized needs from our community health needs assessment, strategy 2 (Engagement Infrastructure) and strategy 3 (Inclusive institution) focus on building the structures and systems for us do the work more capably.
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Facility , 5 - Fairview Southdale Hospital. Strategy 2 - Engagement Infrastructure Addressing our three priority needs while also responding to emerging needs requires an infrastructure that supports building and sustaining strong community partnerships and allows for ongoing, trusting exchanges between Fairview and community members. Strategy 2 (Engagement Infrastructure): Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. The anticipated Impacts for this strategy are 1. Build and expand feedback systems for patients and community members; embed process improvement in the health system's response to community voice. 2. Create sustainable structures to convene and engage community voice around addressing social determinants of health. While Fairview boasts an extensive engagement infrastructure already, we continued to bolster and expand thew work we do to expand feedback systems and sustainable convening structures. The M Health Fairview Center for Community Health Equity (the center) was launched in August 2022. The center guides our philosophy around how we gather community voice and who we talk to as we learn how to tie the learnings back into the organization. The 1-year anniversary of the Center for Community Health Equity was celebrated through a 3-day event welcoming over 250 people, where we offered free vaccinations, blood pressure checks, the opportunity to connect and network, and learn more about the work of the center. Throughout the year, we hosted six Center Community Health Equity Work Group meetings to hold strategic discussions on issues of relevance to the center. The work group was comprised of representatives from across the M Health Fairview Joint Clinical Enterprise. We also moved forward the development of a Center for Community Health Equity Model of Community Engagement. The model shares our approach to community engagement, community voice, and community partnerships to advance community health equity. We will utilize this model in 2024 to help guide how we gather feedback and inform our community health needs assessment. Enabling community voice, particularly the voices of priority populations, to influence, and inform the health system, is integral to strategy 2 (Engagement infrastructure). In 2023 we expanded our patient Listening and Learning sessions to host a session for patients who use American Sign Language. Additionally, Fairview hosted 8 Food is Medicine community conversations where we heard from 74 partner organizations to help inform our Food is Medicine approach as well as to convene food partners to increase opportunities for mutual awareness and collaboration. At Southdale Hospital, we co-hosted the community conversation with Volunteers Enlisted to Assist People (VEAP), and 8 organizations participated. Building our engagement infrastructure involves engaging broadly with community but also building our capacity to engage with complex and intersectional groups. We are building a set of population health equity initiatives, one of which is the Native Health Equity Initiative. As a part of this body of work in 2023, a cohort of employees from across our system began work to advance health equity efforts in partnership with Native Americans and Indigenous communities. We facilitated six sessions to help our employees learn about the historical and current challenges faced by Native communities, connecting with key Native leaders and organizations, and local priority issues including healthcare. The sessions also engaged employees in working to improve experiences and outcomes for our Native patients, employees, and communities. In summer 2023, we co-hosted a "Heal the Healers" Summit with Indigenous Roots Cultural Art Center. The two-day summit welcomed more than 200 attendees for group learning sessions, rituals, seminars, and individual sessions with healers and professionals skilled in traditional healing modalities. Hosted an American Indian and Indigenous focused recruitment event at the Community Health and Wellness Hub. Finally, core to this strategy is building and sustaining trusting partnerships. We continue to support and build on existing engagement infrastructure and support existing collaboratives. Our Southdale Hospital Community Advisory Committee met through the year to provide input as well as insight and local expertise. We conducted an inventory of the Community Advisory Committee member organizations focus and identified gap areas for expertise and aligned representation with CHNA priority populations. We continue to intentionally recruit participants to expand representation on the committees focusing on these gap areas. Committee members also participated, in addition to other community partners in our annual Community Impact Summit. In the Southdale Hospital community, we participate in and have leadership roles in collaboratives such as the Minnesota Food Justice Network, Interfaith Health Collaborative and the Center for Community Health. These are spaces where we do ongoing listening and relationship building with community partners and community members. The Southdale Colon Cancer Prevention program provides community education on colon cancer prevention, outreach, and recruitment of uninsured individuals to have colonoscopy procedures. Communities served are identified based on disparate colorectal cancer screening rates compared to the state rate. Education and outreach are provided by a Community Health Worker (CHW) across multiple community locations. CHW assesses people who indicate interest in having a colonoscopy procedure at no cost based on program criteria: Age 45-75 or in a group at higher risk for colon cancer, do not have medical insurance, and live anywhere in Minnesota. In 2023 there were 25 colonoscopies provided to uninsured community members in the Southdale Hospital community.
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Facility , 6 - Fairview Southdale Hospital. Strategy 3 - Inclusive Institution Strategy 3: Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. The anticipated impacts tied to strategy 3 (Inclusive Institution) are: 1) Build internal and external processes and structures to provide spaces that are safe and welcoming to all, responsive to community needs, and based on a culture of inclusion. 2) Using an antiracist approach, work to identify and eliminate racism by changing systems, organizational structures, policies, practices, and attitudes. 3) Leverage everyday business practices to build community wealth, promoting economic and racial equity and justice. This strategy has been partially operationalized through the HOPE Commission. The work of the HOPE Commission has been to identify foundational and transformational opportunities for our organizations to advance health equity (HE) and promote diversity, equity, and inclusion (DEI). To learn more about the goals, strategies and successes of the HOPE commission please see: The HOPE Commission website: https://mhealthfairview.org/About-Us/health-equity/hope-commission This work will continue to be operationalized through various departments across the organization as well as through the Center for Community Health Equity (CCHE). Key achievements in alignment with strategy 3 include the launch of standardized Social Determinants of Health patient screenings (i.e. food security, housing stability) at all ambulatory sites as well as implementation of targeted interventions to improve healthcare disparities which resulted in marked improvement in breast cancer and colon cancer screening rates. There was also improvement in breast cancer screening rates among Karen, Hmong and Somali patients with 6 mobile mammography events. Additionally, we are building capacity across the system to allow more individuals and teams to participate in the Intercultural Development Inventory (IDI). Operational improvements from the Office of Equity Strategy (OES) include dashboarding and reporting on metrics across the areas of health equity, healthcare equity, and diversity, equity, and inclusion, which will inform the creation of actions plans to reduce any disparities found and create line of sight for progress being made. Fairview is currently enhancing existing data collection and analytics across the institution to uncover and address health disparities. Fairview has successfully enhanced its analytics of Race, Ethnicity and Language (REaL) data across the institution, enabling us to uncover and address health disparities more effectively. With the improved analysis of REaL data, we are now setting Performance Dimension goals specifically aimed at closing these disparities. OES also supported strategic leadership within Human Resources and Customer Experience to incorporate Restorative Justice practices into their Just Culture and patient relations efforts. Additionally, in 2023, various units across the system operationalized systems to embed equity in project development and implementation across various parts of system decision-making. Our anchor strategy works to advance health equity by investing in the social and economic wellbeing of the communities we serve through our everyday business practices. The strategy focuses on local and diverse hiring, purchasing and investing, and serving and leading with trusted community partners. Fairview's Workforce Partnerships team is addressing the social determinants of health by helping people secure employment with family sustaining wages and benefits, become successful in their job, and learn new skills. The team is also focused on inclusive, local hiring, resulting in a healthcare team that represents the communities we serve. Supply Chain leaders launched a Supplier Diversity program, including updated request for proposal language, creating a new webpage, and identifying potential diverse vendors. Fairview also has a robust social corporate responsibility program including employee volunteerism, memberships and affiliations and sponsorships. In 2023 there were five systemwide employee volunteerism events hosted, including Twin Cities Pride. Additionally, Fairview staff sit on boards and/or are members of a diverse set of community organizations. Fairview's sponsorship program is aligned with Fairview's commitment to advancing equity and Fairview's focus on diversity, equity, and inclusion. Within this focus, Fairview awards sponsorships to support local community organizations in the needs and opportunities they have identified. In efforts to increase diversity and trust in clinical trials, the CCHE partnered with Fairview Frontiers to improve representation in a set of clinical trials and hosted a Research Participant Appreciation event that was attended by over 70 research participants. The partnership between Center for Community Health Equity and Fairview Frontiers increased participant representation in a set of clinical trials of those that identified as a race or ethnicity other than white from 15.5% to 33.8%. A paper was published on the partnership and methods used that led to these successes.
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Facility , 7 - Fairview Southdale Hospital. Significant needs not addressed. Prioritizing needs that are the root causes of almost all health disparities allows us to develop upstream strategies that will have a large and lasting impact in our communities. The significant needs we have identified will ultimately be positively impacted by addressing the root causes we have identified as our priority needs. The following needs were not directly addressed because this issue is beyond what the Southdale Hospital resources can support at this time: Cost of care, insurance and medications, childcare and employment benefits. The following needs were directly not addressed because this issue will be addressed as part of patient care but falls outside of the scope of the CHNA Implementation Strategy: Clinic/hospital hours, limited time spent with provider, limited specialty care.
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Facility , 1 - Fairview Southdale Hospital. The Minnesota Attorney General agreement was used in the determination of the eligibility for financial assistance.
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Facility , 1 - Fairview Southdale Hospital. A summary of the Financial Assistance Policy is posted in various locations in the hospital.
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Facility , 1 - Fairview Southdale Hospital. Pursuant to Treas. Reg. Section 1.501(r)-6(c), Fairview Southdale Hospital made reasonable efforts to determine whether an individual was FAP-eligible for care by satisfying the requirements of Section 1.501(r)-6(c)(3).
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Fairview is committed to transparency and accountability in all we do, including our efforts to assess - and respond to - our community's most pressing health needs. The community benefit work that we do across Fairview must reflect our community's actual needs, not our assumptions about what those needs might or should be. Because we understand that change cannot happen when we work in silos, and it cannot happen in a single year, we grounded our 2021 CHNA process in alignment with our 2018 CHNA needs, existing data, and the voices of community members and community partners. Once we had collected, analyzed, and synthesized the information we received from both primary and secondary data sources, we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. Having a consistent, defined process helps reduce the skewing effect of conscious and unconscious biases and enables us to define priority need areas that reflect our community's top health needs rather than our perception of those needs. We evaluated areas of need based on four broad criteria: -Has this need been voiced by the community? Has this need been vetted by the community? -Does this need align with Fairview's strategies and priorities? -Does this need align with existing public health strategies and community health assessments? -Does this need build upon Fairview's 2018 CHNA priority needs? Our process resulted in the identification of three priority need areas. They are: -Navigating and accessing care and resources -Healing, connectedness, and mental health -Addressing structural racism and barriers to achieving health equity.
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Facility , 1 - Fairview Ridges Hospital. The assessment process and data collection methods we used during this CHNA cycle were different than ever before due to the COVID-19 pandemic. COVID- 19 caused delays in data collection among local, state, and national organizations. As a result of these delays, the U.S. Census Bureau had not yet released finalized data from the 2020 U.S. Census by the time we began the CHNA process. As a result, we used 2015-2019 American Community Survey data. Local public health agencies also were not able to provide updated data as they have in the past. We acknowledge that, due to these setbacks, the data we used is less recent than desired. Additionally, COVID-19 required us to add new safety precautions to our method of gathering community voice data. For example, all conversations and interviews, which had previously been in-person meetings, took place in a virtual format instead. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations. The process included discussions with community benefit and assessment committees, our community advisory council, the HOPE Commission listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Each hospital within Fairview has a community benefit and assessment committee that is involved in the CHNA process throughout the three-year cycle. Each committee is comprised of local community and organizational leaders and staffed by the Fairview Community Advancement department. Community benefit and assessment committees met four times between April and October in 2021, three of which were individual committee meetings and one of which was a system-wide Community Impact Summit that brought all the committees together. Each committee meeting consisted of facilitated discussions through which our team gathered input about top community needs. The Fairview Community Advisory Council, composed of key community leaders and staffed by Community Advancement, reviews the CHNA report and written implementation strategy and recommends it to the Patient Care and Experience Committee of the Fairview Board of Directors for review and adoption. Each member represents the member's respective community, and members represent a broad range of sectors, among them community organizations serving cultural communities, higher education organizations, banks, and a nonprofit electric company. The Community Advisory Council met from May through November 2021 to participate in the CHNA process, give feedback, and ultimately recommend the CHNA and implementation strategy for adoption. The HOPE Commission is a multi-year transformational change effort of M Health Fairview to drive more equitable outcomes and inclusive environments and experiences for our patients, employees, and communities. The Commission conducted a series of listening and learning sessions in 2020 and 2021. The objective was to hold a mirror to Fairview to assess where we are now and how we can make lasting change. Part of being an anti-racist health system is developing a candid understanding of our shortcomings. We particularly sought to hear perspectives and ideas from the most impacted populations: BIPOC employees and patients, front-line workers who care for underserved and marginalized patients, and those patients themselves. A survey was also made available each year to gather insights and suggestions from employees and patients who could not directly participate in a listening and learning session. In 2020, the commission convened 32 virtual listening and learning sessions and two town halls involving more than 1,500 participants across Fairview sites. The sessions focused on employees but included patients and community members as well. In September 2021, the HOPE Commission continued the listening and learning sessions following the same model. In this iteration, however, the focus was primarily on gathering input from patients (and employees as patients). In both 2020 and 2021's listening and learning sessions, the facilitators and note takers reflected the community represented by the session's group to the greatest degree possible. In August and September 2021, Fairview's Community Advancement team conducted a series of interviews with staff members who work with communities. Each conversation followed a consistent interview protocol developed for this purpose, and each interview was captured by means of detailed notes. The goal of these interviews was to draw on staff expertise to gain a deeper understanding of our priority needs and to determine whether there are any emerging needs that we should be considering. Between Aug. 31 and Sept.17, 2021, we conducted 17 interviews. In August 2021, we held two focus groups in partnership with other organizations. We convened the first focus group in partnership with HealthPartners and Allina Health, and the participants were faith community nurses. We convened the second focus group in partnership with the organizations that are a part of the East Side Health and Well-being Collaborative. This meeting's focus was on accessing care and resources for different cultural communities. Fairview also participated in two large surveys. KRC Research conducted a survey around health and health care needs in St. Paul between June 8 and July 7, 2021, and administered it to community members, Fairview employees, patients, and community partners. Responses were received from 294 residents, more than 1,000 employees, 221 patients, and 20 partners. The survey was offered online and by phone and in five languages: English, Spanish, Hmong, Somali, and Karen. Fairview also supported and was a partner organization in Bridge to Health, a survey that assesses the health needs of northern Minnesota residents. The Bridge to Health survey was administered between Aug.28 and Oct. 23, 2020. The geographic areas that were sampled included Aitkin, Carlton, Cook, Itasca, Koochiching, Lake, St. Louis, and Pine counties in Minnesota, as well as Douglas County in Wisconsin. As a foundational part of program planning and evaluation, Community Advancement staff are continuously soliciting feedback from community partners and program participants. We capture this information on an ongoing basis and use it to provide valuable context and drive insights into the needs of the communities we serve. Fairview staff developed standardized tools, processes, instructions, and facilitator, interviewer, and note-taker protocols and training. All primary data was compiled, cleaned, and analyzed. Community conversations lasted various lengths from 30-120 minutes. All community input was captured by a note-taker. The Fairview team contracted with the following groups to support our assessment process: -Loren Blinde, PhD of Writing Power, a copywriter and content strategist, on the writing of the report. -Kristi Fordyce, an independent contractor, for analysis support. -Weber Shandwick, for data collection and analysis of focus groups and stakeholder interviews focused on St. Paul. -KRC Research for the administration and analysis of the St. Paul Community Survey
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Facility , 1 - Fairview Ridges Hospital. Our triennial community health needs assessment (CHNA) process provides an important opportunity to engage with and understand our community, analyze what has changed since the last assessment, and prioritize together with the community the issues we must urgently address to improve wellbeing and resilience. As part of the 2021 CHNA process, we reexamined and built upon the extensive community insights shared during our 2018 CHNA, while also surveying the community for current and emerging needs. Our 2021 CHNA used social determinants of health as a lens through which we frame our understanding of our community's most significant health needs. A social determinants of health lens enables us to identify inequitable distribution of resources and access that negatively impacts health. Through this lens we looked at both qualitative and quantitative data. Quantitative data included data points related to demographics, physical environment, socioeconomic factors, health care and health outcomes. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations - racial or ethnic populations experiencing health disparities and persons experiencing poverty. Ridges Hospital has a community advisory committee (CAC) that is involved in the CHNA process. The committee is comprised of local community and organizational leaders, such as local public health, social services organizations, higher education institutions, school districts, and local businesses. The assessment process also included discussions with our community advisory council, listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Bringing together both the qualitative and quantitative data we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. We prioritized areas of need based on four broad criteria: 1) Has this need been voiced by the community? Has this need been vetted by the community? 2) Does this need align with Fairview's strategies and priorities? 3) Does this need align with existing public health strategies and community health assessments? 4) Does this need build upon Fairview's 2018 CHNA priority needs? The Ridges Hospital identified three system-wide priority need areas, and will collaborate with other Fairview hospitals, medical centers, and shared business and clinical services to address these priorities. Our specific response varies by hospital based on the ways in which the priority needs manifest across a given community as well as the partnerships, both ongoing and new, that we have developed to address those needs. The three identified needs are: 1) Navigating and accessing care and resources, 2) Healing, connectedness, and mental health, 3) Addressing structural racism and barriers to equity. Each priority has a set of anticipated impacts, described in more detail below, and can be found in the Ridges Hospital CHNA Implementation Strategy Report (2022-2024). We also identified two priority populations that reach across the lifespan and impact from rural to urban. They are racial or ethnic populations experiencing health disparities and people experiencing poverty. For more details about our priority needs and the priority populations as they relate to the Ridges Hospital, please see the Ridges Hospital 2021 Community Health Needs Assessment. https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Development of 2022-2024 CHNA Implementation Strategies As a learning organization that works closely with our community advisory committees and community partners, over the past decades we have gleaned important lessons which have guided us in the development of our Fairview Health Services 2022-2024 implementation strategies. 1. Despite best efforts, health needs and health inequities continue to grow and deepen. 2. Collective action is critical. 3. Transformational change requires sustained and focused commitment. In response to our 2021 community health needs assessment and our lessons learned, all Fairview hospitals and medical centers worked collaboratively amongst each other, as well as in partnership with local and statewide organizations to address communities' most pressing needs. To rise to the challenge, we put forth a 2032 vision of increased community health equity supported by three strategies to address the priority need areas in distinct ways while collectively moving us closer to our vision of increased community health equity. The three strategies are: Strategy 1: Addressing SDOH - Addressing the social determinants of health (SDOH) as well as individual social risks and social needs through the creation and expansion of programs; initiatives; collaborations; research; and policy, system, and environmental work. Strategy 2: Community engagement infrastructure - Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. Strategy 3: Inclusive institution - Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. For this three-year cycle, we are implementing our strategies to work toward distinct anticipated impacts for each priority need and ultimately our 10-year vision of increased community health equity. For more information, the Ridges Hospital CHNA Implementation Strategy Report outlines the major strategies and actions we will deploy throughout the 2022-2024 assessment cycle as well as the ties between the Ridges Hospital CHNA implementation strategies, anticipated impacts, and key responses. Ridges Hospital Community Health Needs Assessments Implementation Strategy Reports (2022-2024): https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Fairview's mission and vision extend beyond traditional healthcare settings, driving a healthier future for the communities we serve. Significant efforts towards Strategy 1 occurred over the first three years of our ten-year vision, demonstrated through standing up three Social Determinants of Health Initiatives. 1) "Food is Medicine" Using the healing power of food to nourish our patients, enrich our communities, and transform our systems. 2) "Housing is Health" Using the protective power of housing to support patient health and build thriving communities. 3) "Connection is Cure" aims to address social isolation and improve community mental health and well-being by strengthening the connection between patients and the healthcare system. These initiatives are key responses that intersect all three priority needs and are also synergistic among themselves.
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Facility , 2 - Fairview Ridges Hospital. Relationship with our partners. Fairview has a long partnership with the University of Minnesota and University of Minnesota Physicians, now represented in the M Health Fairview brand. Together, we offer access to breakthrough medical research and specialty expertise as part of a continuum of care that reaches all ages and health needs. Policy, systems, and environmental change initiatives are implemented across the system (hospitals, clinics, etc.) and in some instances across the M Health Fairview partners to create sustainable and lasting change to advance health equity and community wellbeing. Where indicated, community responses as a part of strategy 2 (Community engagement infrastructure) and strategy 3 (Inclusive institution) represent the work of Fairview in collaboration with the other M Health Fairview partners. Community action plan. The Ridges Hospital has an annual CHNA action plan that supports our vision of increased community health equity, rolls up to our system CHNA implementation strategies, and addresses priority needs. The Fairview Health Services Community Action Plan details the specific and measurable steps we will take during the year to drive change. Program lists by hospital can be found in the appendix. The System Community Action Plan is updated annually and includes impacts from the prior years. This report is shared with the Ridges Hospital Community Advisory Committee, the Fairview Health Services Board of Directors, and is publicly available on the website: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Evaluation of Impact. To best evaluate our impact and track progress towards our anticipated impacts, we used a multi-tiered and tailored evaluation approach. We ground our work in understanding core information about our communities. This includes identifying and understanding the community need being addressed, the population or community being impacted, and current and/or potential partners to work with to address the need, and the impacts we anticipate. Community needs are determined in several ways. In addition to being determined through our formal CHNA process, we also respond to emerging needs brought to us by a community partner, public health, or through patient or community data showing significant health disparities. We have standardized several key measures to assess that we are meeting the needs of the CHNA priority populations, focusing our efforts on equity, and participant satisfaction. A subset of established programs and initiatives are set up and supported for deeper evaluation. We have found with the populations we serve; one-size fits all evidence-based approaches are not a good fit for our diverse communities. In response to the unique and differing needs of our community members, our programs have been co-developed in partnership with community, centering the needs of specific populations, and often have unique local tactics. We approach evaluation from a similar perspective by building evaluation approaches informed by our partners, and considering strategies that are culturally and linguistically appropriate and to determine if the programs reflect the values we set out to embody. We are guided by the Centers for Disease Control and Prevention (CDC) model for program evaluation to establish primary outcomes, process measures, and demographics. We evaluate program impact and success from a variety of approaches using both qualitative and quantitative data. For many of the programs described here we are reporting out our reach or outputs through counts on a variety of levels including meeting the rigor required for reporting on grants and contracts. We offer a diverse set of programs that vary the spectrum of low touch and high count or high touch and lower count, or more generally put, the effort and impacts of the programs are not the same. This is a purposeful approach as we want a variety of programs and to "right-size" programs to address the community and population specific needs. We provide outcomes for programs here when we are able, acknowledging not all programs run on a calendar year and analysis may not be complete for some of the programs we do deeper evaluation on. We are currently in the process of building an evaluative approach and capacity for our ten-year vision, increased community health equity, and three social determinants of health initiatives: Housing is Health, Food is Medicine, and Connection is Cure. Part of this evaluative approach is a monthly Social Determinants of Health dashboard. Ridges Hospital 2023 Implementation Strategy Progress Highlights. The following highlights our implementation strategy work for each of our three priority needs. For a more comprehensive view of what we are doing to impact community needs please see our Fairview Health Services Community Action Plan and for a view of the Ridges Hospital's list of programs see the appendices. Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs In this first three-year CHNA cycle working towards our 2032 vision of increased community health equity the primary way we are directly addressing the three priority needs is through strategy 1 (Addressing SDOH). Through this strategy we create programs and partner with community organizations to address social risk factors, social needs and social determinants of health. Strategy 2 (Engagement infrastructure) and strategy 3 (Inclusive institution) focus on building infrastructure and creating system changes so that we can more effectively respond to these priority needs in the future, as well as any emerging needs.
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Facility , 3 - Fairview Ridges Hospital. Strategy 1 Priority Need: Navigating and accessing care and resources. Ridges Hospital has a variety of programs that work as a part of strategy 1 (Addressing SDOH) to address barriers related to navigating and accessing care and resources. Through this strategy, the Ridges Hospital Action Plan programs work towards two anticipated impacts to address this priority need 1) Remove barriers to care by providing community-placed care, co-located services, and navigation supports that address cultural and language barriers. 2) Increased awareness of, knowledge about, and access to healthcare and community-based resources that support opportunities for health and wellbeing. Following is more information on a selection of programs from the system community action plan that are working to meet the two anticipated impacts. Fairview System Key Initiative Highlight. The Community Clinical Care initiative involves multiple community-based clinical programs, including Fairview's Minnesota Immunization Networking Initiative, Blood Pressure and Oral Health Services. All services are multi-sector, community collaborations that provide care and education to the uninsured, under-served, and communities facing health disparities in the greater Twin Cities area. The Community Clinical Care team provides clinical care in trusted community settings at no cost and improves equitable access to vaccines and other services across various populations. The programs ensure a culturally and linguistically appropriate experience in a safe and trusted environment in partnership with over 125 faith-based and grassroots community partners, serving clients at local churches, mosques, temples, schools, community centers, food pantries, and homeless shelters. In 2023, across the system, the community clinical care team provided blood pressure, and oral health services at 180 events, including 2 events in the Ridges Hospital community, providing 11 blood pressure checks, and 28 dental fluoride applications. Fairview's Minnesota Immunization Networking Initiative (MINI), a multi-sector, community collaboration that initiated the Community Clinical Care approach provides free vaccinations, and education to the uninsured, under-served, and communities facing health disparities in the greater Twin Cities area. In 2023, across the system the team hosted 574 vaccination clinics. There were 7,037 free COVID-19 vaccine doses and 6,428 free flu shots administered. Of those participants who shared their identity, 81% of people who received a COVID-19 vaccine identified as a person of color and 38% indicated a language other than English as their preferred language. In 2023 the Minnesota Immunization Networking Initiative was invited to submit to the New England Journal of Medicine on their approach and successes, with a focus on partnerships with public health. This continues to build the evidence base for community placed and community centered approaches. In the Ridges Hospital community specifically, there were 8 MINI clinics at which 62 COVID-19 shots and 179 flu shots were administered. To fill the large gap in the south metro, our Apple Valley Clinic provides space weekly to St. Mary's Health clinics to provide clinical services to uninsured community members. Mary's Health Clinic patients have no Insurance, are ineligible for health insurance and live within 200-250% of Federal Poverty Guidelines. Almost all patients (98%) served identified has Hispanic/Latinx. Fairview Provides logistical and infrastructure support to St Mary's Health clinics to successful provide services. The Colon Cancer Prevention program provides community education on colon cancer prevention, outreach, and recruitment of uninsured individuals to have colonoscopy procedures. Communities served are identified based on disparate colorectal cancer screening rates compared to the state rate. Education and outreach are provided by a Community Health Worker (CHW) across multiple community locations. CHW assesses people who indicate interest in having a colonoscopy procedure at no cost based on program criteria: Age 45-75 or in a group at higher risk for colon cancer, do not have medical insurance, and live anywhere in Minnesota. In 2023 there were 10 colonoscopies provided to uninsured community members in the Ridges Hospital community. The Culturally Tailored Education and Outreach Program provides health education sessions on a variety of health topics including COIVD-19 vaccines, COIVD-19 virus, colorectal cancer prevention, cancer prevention, diabetes prevention, heart disease prevention, mental health, Alzheimer's disease, heat-related illness, and other health topics. Education provided to the general Latine community. In partnership with community organizations. In 2022 in the Ridges Community, there were four education sessions with 219 people attending. The Fairview Community Health and Wellness Hub (The Hub) opened in 2022. The hub is a first-of-its-kind center that will address health disparities while providing a range of critical healthcare services and community resources alongside trusted local partners. The Hub provides a variety of services to the community - from primary care to mental healthcare to enrichment options for seniors, food access programs, and community gathering spaces. We bring our own services together with local organizations to make it easier for people to access what they need to thrive. In 2023 we celebrated the 1-year anniversary of the opening of the hub and the Center for Community Health Equity. Through the year, we provided free community gathering space to more than 50 partners and local groups at the Hub. More than 250 community members were reached through cultural healing and community wellness programming delivered in, or partnering with, the Health and Wellness Hub and Center for Community Health Equity. For more information about these and other action plan programs that are addressing the priority need Navigating and Accessing Care and Resources, please see our Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Priority Need: Addressing Structural Racism and Barriers to Equity. Ridges Hospital as a part of strategy 1, (Addressing the SDoH), has a variety of programs, events, and community education as a part of the Community Action Plan that work toward the anticipated impact: Develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, to address structural racism and barriers to equity. Fairview system highlights. One of the Fairview social determinants of health initiatives, Food is Medicine, utilizes the knowledge and resources of a large healthcare institution to work towards meeting the immediate needs of our patients, while also transforming the food system into something just, equitable, and sustainable. The initiative aims to 1) Nourish our patients: Advance food security to reduce health disparities and diet-related health conditions. 2) Enrich our communities: Cultivate trusting and engaged partnerships to build and share resources, assets, and capacity. 3) Transform our systems: Nurture just and equitable food systems to ensure health equity. These approaches are framed to increase health equity through focused efforts to serve patients who have been historically marginalized, by providing culturally appropriate food options, and reducing food insecurity in a manner that upholds dignity and empowers the local food system. Clinically, it enables providers to serve patients experiencing food insecurity through a menu of distinct programs comprising an innovative wrap-around approach. One, or more, of the Food is Medicine programs, a selection of which are described below, are available to patients in 43+ clinics and 5 acute sites across the health system. One of the Food is Medicine initiative programmatic responses is Veggie Rx, which distributes fresh, locally grown produce from four farm partners (Hmong American Farmers Association, Sin Fronteras, Naima's Farm and Women's Environmental Institute) via a Community Supported Agriculture (CSA) box. The program offers home delivery to address transportation barriers. In 2023, 20 clinics participated in Veggie Rx across Fairview hospital and medical center communities. In Ridges Hospital community there were three clinic sites that offered Veggie Rx serving 47 patients. Almost one third (29%) of all program participants identified as Asian, 20% as Black and 4% as Hispanic/Latino. While just three quarters speak English as a preferred language, 7% had a preferred language of Hmong, 13% Karen, and 2% Spanish. Most participants had public insurance (73%) or were uninsured (1%).
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Facility , 4 - Fairview Ridges Hospital. Fairview's MarketRx program provides patients with $80 per month to purchase groceries at either the Twin Cities Mobile Market or Fare for All program. The program runs year-round and offers rolling enrollment. Through the year, 195 patients redeemed vouchers for groceries. In the Ridges Hospital community there were 28 participants enrolled in MarketRx. Additionally, we provided shelf stable immediate need food resource options. MATTERboxes were available in the Ridges Hospital community with each box containing enough food to feed a family of four for three days. In 2023 there were 1,900 MATTERboxes distributed at 26 sites across the system. There were also 240 food resource packets distributed that contained information about local food resources along with a grocery gift card to assist with immediate grocery needs. In November of 2023, Fairview and local partners hosted the Harvest at the Hub at the Fairview Community Health and Wellness Hub. The event consisted of a food giveaway with turkeys, fresh produce, and other holiday staples, a community resource fair, a vaccine clinic, and other health and wellbeing services. We served a total of 421 unduplicated households (over twice that of 2022). Another of the Fairview social determinants of health initiatives, Housing is Health initiative is also in response to the priority need Structural Racism and Barriers to Equity. The Housing is Health initiative aims to use the protective power of housing to support patient health and build thriving communities. We approach this initiative with clinically connected programs, supporting community partnerships, contributing time and expertise to collaboratives, and work to impact policy. As an example, Fairview partners with Our Savior's Community Services to provide critical follow-up care and temporary housing for people who are unsheltered after a hospital stay. Patients are referred by staff at hospital or medical center and sheltered at Our Saviors. Additionally, a nurse provides care, and patients receive wrap-around services and social work support. In 2023, 76 patients were provided supports through this program. Also, as a part of Housing is Health, we are proud to have completed inaugural Housing and Health Equity Fellowship hosted by the Greater Minnesota Housing Fund, which aimed to expand community investment by health systems to address the housing crisis in Minnesota. In October 2023, teams from across the system participated in our annual Build Week with Twin Cities Habitat for Humanity, contributing 456 volunteer hours. For more information about the action plan programs that are addressing the priority need Structural Racism and Barriers to Equity please see our Fairview Health Services Community Action Plan. https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Priority Need: Healing, connectedness, and mental health. Ridges Hospital works toward the anticipated impact: develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, address barriers to healing, connectedness and mental health through strategy 1 (Addressing the SDoH) and the Community Action Plan. In response to the priority need, healing, connectedness, and mental health, we have a body of work that makes up the Connection is Cure initiative. Connection is Cure aims to build trust through social connections, centering linguistic and cultural diversity, and bridging silos across our hospital system and communities to transform medical practice. As a part of Connection is Cure, we participated in the Institute for Healthcare improvement trust prototyping network. We were one of eight health care organizations nationwide that are part of a 10-month project to test approaches to improve trust in healthcare systems. Our organization is focusing on a project to identify and remove system level equity barriers for interpreters and patients with limited English proficiency aiming to improve patient outcomes, customer experience, and care team cohesion. Additionally, we are responding to the need healing, connectedness, and mental health with a variety of evidence-based programs, as well as trainings and education sessions. Feeding Hope is a series of virtual one-hour learning sessions focused on positive, hopeful topics that support wellbeing in the general community. This series is offered in partnership with all Fairview's hospitals and medical centers and is open to anyone across all of Fairview's communities. In 2023, across Fairview hospitals and medical centers there were three sessions held with a combined 665 attendees. The Faith Community Nursing program makes available programs and services to Faith Community Nurses to hold in their congregation. Additionally, $750 mini-grants and provided to Faith community Nurses, as well as resources such as health education materials and resources, and networking opportunities. In 2022 across the system there were 19 mini grants awarded. In the Ridges Hospital Community, one mini grant was awarded to a Faith Community Nurse. Psychological First Aid (PFA) is an evidence-informed training for the broader community as well as professionals. Trainees learn how to support healthy recovery for individuals following a traumatic event, public health emergency, natural disaster, or personal crisis. The curriculum integrates public health, community health and individual psychology by drawing upon skills the trainees probably already have. PFA is a two-hour training. In 2023, in the Ridges Hospital community, there were two classes offered with 46 participants attending. For more information about the action plan programs that are addressing the priority need Structural Racism and Barriers to Equity please see our Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs In addition to strategy 1 (Addressing SDOH) and the programmatic work included on our Action Plans, we are striving to reduce health disparities and increase community health equity through two additional system strategies. While strategy 1 (Addressing SDOH) allows us to directly respond to the three prioritized needs from our community health needs assessment, strategy 2 (Engagement Infrastructure) and strategy 3 (Inclusive institution) focus on building the structures and systems for us do the work more capably.
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Facility , 5 - Fairview Ridges Hospital. Strategy 2 - Engagement Infrastructure Addressing our three priority needs while also responding to emerging needs requires an infrastructure that supports building and sustaining strong community partnerships and allows for ongoing, trusting exchanges between Fairview and community members. Strategy 2 (Engagement Infrastructure): Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. The anticipated Impacts for this strategy are 1. Build and expand feedback systems for patients and community members; embed process improvement in the health system's response to community voice. 2. Create sustainable structures to convene and engage community voice around addressing social determinants of health. While Fairview boasts an extensive engagement infrastructure already, we continued to bolster and expand thew work we do to expand feedback systems and sustainable convening structures. The M Health Fairview Center for Community Health Equity (the center) was launched in August 2022. The center guides our philosophy around how we gather community voice and who we talk to as we learn how to tie the learnings back into the organization. The 1-year anniversary of the Center for Community Health Equity was celebrated through a 3-day event welcoming over 250 people, where we offered free vaccinations, blood pressure checks, the opportunity to connect and network, and learn more about the work of the center. Throughout the year, we hosted six Center Community Health Equity Work Group meetings to hold strategic discussions on issues of relevance to the center. The work group was comprised of representatives from across the M Health Fairview Joint Clinical Enterprise. We also moved forward the development of a Center for Community Health Equity Model of Community Engagement. The model shares our approach to community engagement, community voice, and community partnerships to advance community health equity. We will utilize this model in 2024 to help guide how we gather feedback and inform our community health needs assessment. Enabling community voice, particularly the voices of priority populations, to influence, and inform the health system, is integral to strategy 2 (Engagement infrastructure). In 2023 we expanded our patient Listening and Learning sessions to host a session for patients who use American Sign Language. Additionally, Fairview hosted 8 Food is Medicine community conversations where we heard from 74 partner organizations to help inform our Food is Medicine approach as well as to convene food partners to increase opportunities for mutual awareness and collaboration. At Ridges Hospital, we co-hosted the community conversation with 360 Communities, and five organizations participated. Building our engagement infrastructure involves engaging broadly with community but also building our capacity to engage with complex and intersectional groups. We are building a set of population health equity initiatives, one of which is the Native Health Equity Initiative. As a part of this body of work in 2023, a cohort of employees from across our system began work to advance health equity efforts in partnership with Native Americans and Indigenous communities. We facilitated six sessions to help our employees learn about the historical and current challenges faced by Native communities, connecting with key Native leaders and organizations, and local priority issues including healthcare. The sessions also engaged employees in working to improve experiences and outcomes for our Native patients, employees, and communities. In summer 2023, we co-hosted a "Heal the Healers" Summit with Indigenous Roots Cultural Art Center. The two-day summit welcomed more than 200 attendees for group learning sessions, rituals, seminars, and individual sessions with healers and professionals skilled in traditional healing modalities. Hosted an American Indian and Indigenous focused recruitment event at the Community Health and Wellness Hub. Finally, core to this strategy is building and sustaining trusting partnerships. We continue to support and build on existing engagement infrastructure and support existing collaboratives. Our Ridges Hospital Community Advisory Committee met through the year to provide input as well as insight and local expertise. We conducted an inventory of the Community Advisory Committee member organizations focus and identified gap areas for expertise and aligned representation with CHNA priority populations. We continue to intentionally recruit participants to expand representation on the committees focusing on these gap areas. Committee members also participated, in addition to other community partners in our annual Community Impact Summit. In the Ridges Hospital community, we participate in and have leadership roles in collaboratives such as the Minnesota Food Justice Network, Interfaith Health Collaborative, and the Center for Community Health. These are spaces where we do ongoing listening and relationship building with community partners and community members. The Ridges Colon Cancer Prevention program provides community education on colon cancer prevention, outreach, and recruitment of uninsured individuals to have colonoscopy procedures. Communities served are identified based on disparate colorectal cancer screening rates compared to the state rate. Education and outreach are provided by a Community Health Worker (CHW) across multiple community locations. CHW assesses people who indicate interest in having a colonoscopy procedure at no cost based on program criteria: Age 45-75 or in a group at higher risk for colon cancer, do not have medical insurance, and live anywhere in Minnesota. In 2023 there were 10 colonoscopies provided to uninsured community members in the Ridges Hospital community.
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Facility , 6 - Fairview Ridges Hospital. Strategy 3 - Inclusive Institution Strategy 3: Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. The anticipated impacts tied to strategy 3 (Inclusive Institution) are: 1) Build internal and external processes and structures to provide spaces that are safe and welcoming to all, responsive to community needs, and based on a culture of inclusion. 2) Using an antiracist approach, work to identify and eliminate racism by changing systems, organizational structures, policies, practices, and attitudes. 3) Leverage everyday business practices to build community wealth, promoting economic and racial equity and justice. This strategy has been partially operationalized through the HOPE Commission. The work of the HOPE Commission has been to identify foundational and transformational opportunities for our organizations to advance health equity (HE) and promote diversity, equity, and inclusion (DEI). To learn more about the goals, strategies and successes of the HOPE commission please see: The HOPE Commission website: https://mhealthfairview.org/About-Us/health-equity/hope-commission This work will continue to be operationalized through various departments across the organization as well as through the Center for Community Health Equity (CCHE). Key achievements in alignment with strategy 3 include the launch of standardized Social Determinants of Health patient screenings (i.e., food security, housing stability) at all ambulatory sites as well as implementation of targeted interventions to improve healthcare disparities which resulted in marked improvement in breast cancer and colon cancer screening rates. There was also improvement in breast cancer screening rates among Karen, Hmong, and Somali patients with 6 mobile mammography events. Additionally, we are building capacity across the system to allow more individuals and teams to participate in the Intercultural Development Inventory (IDI). Operational improvements from the Office of Equity Strategy (OES) include dashboarding and reporting on metrics across the areas of health equity, healthcare equity, and diversity, equity, and inclusion, which will inform the creation of actions plans to reduce any disparities found and create line of sight for progress being made. Fairview is currently enhancing existing data collection and analytics across the institution to uncover and address health disparities. Fairview has successfully enhanced its analytics of Race, Ethnicity and Language (REaL) data across the institution, enabling us to uncover and address health disparities more effectively. With the improved analysis of REaL data, we are now setting Performance Dimension goals specifically aimed at closing these disparities. OES also supported strategic leadership within Human Resources and Customer Experience to incorporate Restorative Justice practices into their Just Culture and patient relations efforts. Additionally, in 2023, various units across the system operationalized systems to embed equity in project development and implementation across various parts of system decision-making. Our anchor strategy works to advance health equity by investing in the social and economic wellbeing of the communities we serve through our everyday business practices. The strategy focuses on local and diverse hiring, purchasing and investing, and serving and leading with trusted community partners. Fairview's Workforce Partnerships team is addressing the social determinants of health by helping people secure employment with family sustaining wages and benefits, become successful in their job, and learn new skills. The team is also focused on inclusive, local hiring, resulting in a healthcare team that represents the communities we serve. Supply Chain leaders launched a Supplier Diversity program, including updated request for proposal language, creating a new webpage, and identifying potential diverse vendors. Fairview also has a robust social corporate responsibility program including employee volunteerism, memberships and affiliations and sponsorships. In 2023 there were five systemwide employee volunteerism events hosted, including Twin Cities Pride. Additionally, Fairview staff sit on boards and/or are members of a diverse set of community organizations. Fairview's sponsorship program is aligned with Fairview's commitment to advancing equity and Fairview's focus on diversity, equity, and inclusion. Within this focus, Fairview awards sponsorships to support local community organizations in the needs and opportunities they have identified. In efforts to increase diversity and trust in clinical trials, the CCHE partnered with Fairview Frontiers to improve representation in a set of clinical trials and hosted a Research Participant Appreciation event that was attended by over 70 research participants. The partnership between Center for Community Health Equity and Fairview Frontiers increased participant representation in a set of clinical trials of those that identified as a race or ethnicity other than white from 15.5% to 33.8%. A paper was published on the partnership and methods used that led to these successes. Significant needs not addressed. Prioritizing needs that are the root causes of almost all health disparities allows us to develop upstream strategies that will have a large and lasting impact in our communities. The significant needs we have identified will ultimately be positively impacted by addressing the root causes we have identified as our priority needs. The following needs were not directly addressed because this issue is beyond what the Ridges Hospital resources can support at this time: Cost of care, insurance and medications, childcare and employment benefits. The following needs were directly not addressed because this issue will be addressed as part of patient care but falls outside of the scope of the CHNA Implementation Strategy: Clinic/hospital hours, limited time spent with provider, limited specialty care.
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Facility , 1 - Fairview Ridges Hospital. The Minnesota Attorney General agreement was used in the determination of the eligibility for financial assistance.
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Facility , 1 - Fairview Ridges Hospital. A summary of the Financial Assistance Policy is posted in various locations in the hospital.
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Facility , 1 - Fairview Ridges Hospital. Pursuant to Treas. Reg. Section 1.501(r)-6(c), Fairview Ridges Hospital made reasonable efforts to determine whether an individual was FAP-eligible for care by satisfying the requirements of Section 1.501(r)-6(c)(3).
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Fairview is committed to transparency and accountability in all we do, including our efforts to assess - and respond to - our community's most pressing health needs. The community benefit work that we do across Fairview must reflect our community's actual needs, not our assumptions about what those needs might or should be. Because we understand that change cannot happen when we work in silos, and it cannot happen in a single year, we grounded our 2021 CHNA process in alignment with our 2018 CHNA needs, existing data, and the voices of community members and community partners. Once we had collected, analyzed, and synthesized the information we received from both primary and secondary data sources, we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. Having a consistent, defined process helps reduce the skewing effect of conscious and unconscious biases and enables us to define priority need areas that reflect our community's top health needs rather than our perception of those needs. We evaluated areas of need based on four broad criteria: -Has this need been voiced by the community? Has this need been vetted by the community? -Does this need align with Fairview's strategies and priorities? -Does this need align with existing public health strategies and community health assessments? -Does this need build upon Fairview's 2018 CHNA priority needs? Our process resulted in the identification of three priority need areas. They are: -Navigating and accessing care and resources -Healing, connectedness, and mental health -Addressing structural racism and barriers to achieving health equity.
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Facility , 1 - Fairview Lakes Regional Medical Ctr. The assessment process and data collection methods we used during this CHNA cycle were different than ever before due to the COVID-19 pandemic. COVID- 19 caused delays in data collection among local, state, and national organizations. As a result of these delays, the U.S. Census Bureau had not yet released finalized data from the 2020 U.S. Census by the time we began the CHNA process. As a result, we used 2015-2019 American Community Survey data. Local public health agencies also were not able to provide updated data as they have in the past. We acknowledge that, due to these setbacks, the data we used is less recent than desired. Additionally, COVID-19 required us to add new safety precautions to our method of gathering community voice data. For example, all conversations and interviews, which had previously been in-person meetings, took place in a virtual format instead. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations. The process included discussions with community benefit and assessment committees, our community advisory council, the HOPE Commission listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Each hospital within Fairview has a community benefit and assessment committee that is involved in the CHNA process throughout the three-year cycle. Each committee is comprised of local community and organizational leaders and staffed by the Fairview Community Advancement department. Community benefit and assessment committees met four times between April and October in 2021, three of which were individual committee meetings and one of which was a system-wide Community Impact Summit that brought all the committees together. Each committee meeting consisted of facilitated discussions through which our team gathered input about top community needs. The Fairview Community Advisory Council, composed of key community leaders and staffed by Community Advancement, reviews the CHNA report and written implementation strategy and recommends it to the Patient Care and Experience Committee of the Fairview Board of Directors for review and adoption. Each member represents the member's respective community, and members represent a broad range of sectors, among them community organizations serving cultural communities, higher education organizations, banks, and a nonprofit electric company. The Community Advisory Council met from May through November 2021 to participate in the CHNA process, give feedback, and ultimately recommend the CHNA and implementation strategy for adoption. The HOPE Commission is a multi-year transformational change effort of M Health Fairview to drive more equitable outcomes and inclusive environments and experiences for our patients, employees, and communities. The Commission conducted a series of listening and learning sessions in 2020 and 2021. The objective was to hold a mirror to Fairview to assess where we are now and how we can make lasting change. Part of being an anti-racist health system is developing a candid understanding of our shortcomings. We particularly sought to hear perspectives and ideas from the most impacted populations: BIPOC employees and patients, front-line workers who care for underserved and marginalized patients, and those patients themselves. A survey was also made available each year to gather insights and suggestions from employees and patients who could not directly participate in a listening and learning session. In 2020, the commission convened 32 virtual listening and learning sessions and two town halls involving more than 1,500 participants across Fairview sites. The sessions focused on employees but included patients and community members as well. In September 2021, the HOPE Commission continued the listening and learning sessions following the same model. In this iteration, however, the focus was primarily on gathering input from patients (and employees as patients). In both 2020 and 2021's listening and learning sessions, the facilitators and note takers reflected the community represented by the session's group to the greatest degree possible. In August and September 2021, Fairview's Community Advancement team conducted a series of interviews with staff members who work with communities. Each conversation followed a consistent interview protocol developed for this purpose, and each interview was captured by means of detailed notes. The goal of these interviews was to draw on staff expertise to gain a deeper understanding of our priority needs and to determine whether there are any emerging needs that we should be considering. Between Aug. 31 and Sept.17, 2021, we conducted 17 interviews. In August 2021, we held two focus groups in partnership with other organizations. We convened the first focus group in partnership with HealthPartners and Allina Health, and the participants were faith community nurses. We convened the second focus group in partnership with the organizations that are a part of the East Side Health and Well-being Collaborative. This meeting's focus was on accessing care and resources for different cultural communities. Fairview also participated in two large surveys. KRC Research conducted a survey around health and health care needs in St. Paul between June 8 and July 7, 2021, and administered it to community members, Fairview employees, patients, and community partners. Responses were received from 294 residents, more than 1,000 employees, 221 patients, and 20 partners. The survey was offered online and by phone and in five languages: English, Spanish, Hmong, Somali, and Karen. Fairview also supported and was a partner organization in Bridge to Health, a survey that assesses the health needs of northern Minnesota residents. The Bridge to Health survey was administered between Aug.28 and Oct. 23, 2020. The geographic areas that were sampled included Aitkin, Carlton, Cook, Itasca, Koochiching, Lake, St. Louis, and Pine counties in Minnesota, as well as Douglas County in Wisconsin. As a foundational part of program planning and evaluation, Community Advancement staff are continuously soliciting feedback from community partners and program participants. We capture this information on an ongoing basis and use it to provide valuable context and drive insights into the needs of the communities we serve. Fairview staff developed standardized tools, processes, instructions, and facilitator, interviewer, and note-taker protocols and training. All primary data was compiled, cleaned, and analyzed. Community conversations lasted various lengths from 30-120 minutes. All community input was captured by a note-taker. The Fairview team contracted with the following groups to support our assessment process: -Loren Blinde, PhD of Writing Power, a copywriter and content strategist, on the writing of the report. -Kristi Fordyce, an independent contractor, for analysis support. -Weber Shandwick, for data collection and analysis of focus groups and stakeholder interviews focused on St. Paul. -KRC Research for the administration and analysis of the St. Paul Community Survey
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Facility , 1 - Fairview Lakes Regional Medical Ctr. Our triennial community health needs assessment (CHNA) process provides an important opportunity to engage with and understand our community, analyze what has changed since the last assessment, and prioritize together with the community the issues we must urgently address to improve wellbeing and resilience. As part of the 2021 CHNA process, we reexamined and built upon the extensive community insights shared during our 2018 CHNA, while also surveying the community for current and emerging needs. Our 2021 CHNA used social determinants of health as a lens through which we frame our understanding of our community's most significant health needs. A social determinants of health lens enables us to identify inequitable distribution of resources and access that negatively impacts health. Through this lens we looked at both qualitative and quantitative data. Quantitative data included data points related to demographics, physical environment, socioeconomic factors, health care and health outcomes. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations - racial or ethnic populations experiencing health disparities and persons experiencing poverty. Lakes Medical Center has a community advisory committee (CAC) that is involved in the CHNA process. The committee is comprised of local community and organizational leaders, such as local public health, social services organizations, higher education institutions, school districts, and local businesses. The assessment process also included discussions with our community advisory council, listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Bringing together both the qualitative and quantitative data we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. We prioritized areas of need based on four broad criteria: 1) Has this need been voiced by the community? Has this need been vetted by the community? 2) Does this need align with Fairview's strategies and priorities? 3) Does this need align with existing public health strategies and community health assessments? 4) Does this need build upon Fairview's 2018 CHNA priority needs? The Lakes Medical Center identified three system-wide priority need areas, and will collaborate with other Fairview hospitals, medical centers, and shared business and clinical services to address these priorities. Our specific response varies by hospital based on the ways in which the priority needs manifest across a given community as well as the partnerships, both ongoing and new, that we have developed to address those needs. The three identified needs are: 1) Navigating and accessing care and resources, 2) Healing, connectedness, and mental health, 3) Addressing structural racism and barriers to equity. Each priority has a set of anticipated impacts, described in more detail below, and can be found in the Lakes Medical Center CHNA Implementation Strategy Report (2022-2024). We also identified two priority populations that reach across the lifespan and impact from rural to urban. They are racial or ethnic populations experiencing health disparities and people experiencing poverty. For more details about our priority needs and the priority populations as they relate to the Lakes Medical Center, please see the Lakes Medical Center 2021 Community Health Needs Assessment. https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Development of 2022-2024 CHNA Implementation Strategies As a learning organization that works closely with our community advisory committees and community partners, over the past decades we have gleaned important lessons which have guided us in the development of our Fairview Health Services 2022-2024 implementation strategies. 1. Despite best efforts, health needs and health inequities continue to grow and deepen. 2. Collective action is critical. 3. Transformational change requires sustained and focused commitment. In response to our 2021 community health needs assessment and our lessons learned, all Fairview hospitals and medical centers worked collaboratively amongst each other, as well as in partnership with local and statewide organizations to address communities' most pressing needs. To rise to the challenge, we put forth a 2032 vision of increased community health equity supported by three strategies to address the priority need areas in distinct ways while collectively moving us closer to our vision of increased community health equity. The three strategies are: Strategy 1: Addressing SDOH - Addressing the social determinants of health (SDOH) as well as individual social risks and social needs through the creation and expansion of programs; initiatives; collaborations; research; and policy, system, and environmental work. Strategy 2: Community engagement infrastructure - Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. Strategy 3: Inclusive institution - Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. For this three-year cycle, we are implementing our strategies to work toward distinct anticipated impacts for each priority need and ultimately our 10-year vision of increased community health equity. For more information, the Lakes Medical Center CHNA Implementation Strategy Report outlines the major strategies and actions we will deploy throughout the 2022-2024 assessment cycle as well as the ties between the Lakes Medical Center CHNA implementation strategies, anticipated impacts, and key responses. Lakes Medical Center Community Health Needs Assessments Implementation Strategy Reports (2022-2024): https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Fairview's mission and vision extend beyond traditional healthcare settings, driving a healthier future for the communities we serve. Significant efforts towards Strategy 1 occurred over the first three years of our ten-year vision, demonstrated through standing up three Social Determinants of Health Initiatives. 1) "Food is Medicine" Using the healing power of food to nourish our patients, enrich our communities, and transform our systems. 2) "Housing is Health" Using the protective power of housing to support patient health and build thriving communities. 3) "Connection is Cure" aims to address social isolation and improve community mental health and well-being by strengthening the connection between patients and the healthcare system. These initiatives are key responses that intersect all three priority needs and are also synergistic among themselves.
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Facility , 2 - Fairview Lakes Regional Medical Ctr. Relationship with our partners. Fairview has a long partnership with the University of Minnesota and University of Minnesota Physicians, now represented in the M Health Fairview brand. Together, we offer access to breakthrough medical research and specialty expertise as part of a continuum of care that reaches all ages and health needs. Policy, systems, and environmental change initiatives are implemented across the system (hospitals, clinics, etc.) and in some instances across the M Health Fairview partners to create sustainable and lasting change to advance health equity and community wellbeing. Where indicated, community responses as a part of strategy 2 (Community engagement infrastructure) and strategy 3 (Inclusive institution) represent the work of Fairview in collaboration with the other M Health Fairview partners. Community action plan. The Lakes Medical Center has an annual CHNA action plan that supports our vision of increased community health equity, rolls up to our system CHNA implementation strategies, and addresses priority needs. The Fairview Health Services Community Action Plan details the specific and measurable steps we will take during the year to drive change. Program lists by hospital can be found in the appendix. The System Community Action Plan is updated annually and includes impacts from the prior years. This report is shared with the Lakes Medical Center Community Advisory Committee, the Fairview Health Services Board of Directors, and is publicly available on the website: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Evaluation of Impact. To best evaluate our impact and track progress towards our anticipated impacts, we used a multi-tiered and tailored evaluation approach. We ground our work in understanding core information about our communities. This includes identifying and understanding the community need being addressed, the population or community being impacted, and current and/or potential partners to work with to address the need, and the impacts we anticipate. Community needs are determined in several ways. In addition to being determined through our formal CHNA process, we also respond to emerging needs brought to us by a community partner, public health, or through patient or community data showing significant health disparities. We have standardized several key measures to assess that we are meeting the needs of the CHNA priority populations, focusing our efforts on equity, and participant satisfaction. A subset of established programs and initiatives are set up and supported for deeper evaluation. We have found with the populations we serve; one-size fits all evidence-based approaches are not a good fit for our diverse communities. In response to the unique and differing needs of our community members, our programs have been co-developed in partnership with community, centering the needs of specific populations, and often have unique local tactics. We approach evaluation from a similar perspective by building evaluation approaches informed by our partners, and considering strategies that are culturally and linguistically appropriate and to determine if the programs reflect the values we set out to embody. We are guided by the Centers for Disease Control and Prevention (CDC) model for program evaluation to establish primary outcomes, process measures, and demographics. We evaluate program impact and success from a variety of approaches using both qualitative and quantitative data. For many of the programs described here we are reporting out our reach or outputs through counts on a variety of levels including meeting the rigor required for reporting on grants and contracts. We offer a diverse set of programs that vary the spectrum of low touch and high count or high touch and lower count, or more generally put, the effort and impacts of the programs are not the same. This is a purposeful approach as we want a variety of programs and to "right-size" programs to address the community and population specific needs. We provide outcomes for programs here when we are able, acknowledging not all programs run on a calendar year and analysis may not be complete for some of the programs we do deeper evaluation on. We are currently in the process of building an evaluative approach and capacity for our ten-year vision, increased community health equity, and three social determinants of health initiatives: Housing is Health, Food is Medicine, and Connection is Cure. Part of this evaluative approach is a monthly Social Determinants of Health dashboard. Lakes Medical Center 2023 Implementation Strategy Progress Highlights. The following highlights our implementation strategy work for each of our three priority needs. For a more comprehensive view of what we are doing to impact community needs please see our Fairview Health Services Community Action Plan and for a view of the Lakes Medical Center's list of programs see the appendices. Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs In this first three-year CHNA cycle working towards our 2032 vision of increased community health equity the primary way we are directly addressing the three priority needs is through strategy 1 (Addressing SDOH). Through this strategy we create programs and partner with community organizations to address social risk factors, social needs and social determinants of health. Strategy 2 (Engagement infrastructure) and strategy 3 (Inclusive institution) focus on building infrastructure and creating system changes so that we can more effectively respond to these priority needs in the future, as well as any emerging needs.
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Facility , 3 - Fairview Lakes Regional Medical Ctr. Strategy 1 Priority Need: Navigating and accessing care and resources. Lakes Medical Center has a variety of programs that work as a part of strategy 1 (Addressing SDOH) to address barriers related to navigating and accessing care and resources. Through this strategy, the Lakes Medical Center Action Plan programs work towards two anticipated impacts to address this priority need 1) Remove barriers to care by providing community-placed care, co-located services, and navigation supports that address cultural and language barriers. 2) Increased awareness of, knowledge about, and access to healthcare and community-based resources that support opportunities for health and wellbeing. Following is more information on a selection of programs from the system community action plan that are working to meet the two anticipated impacts. Fairview System Key Initiative Highlight. The Community Clinical Care initiative involves multiple community-based clinical programs, including Fairview's Minnesota Immunization Networking Initiative, Blood Pressure and Oral Health Services. All services are multi-sector, community collaborations that provide care and education to the uninsured, under-served, and communities facing health disparities in the greater Twin Cities area. The Community Clinical Care team provides clinical care in trusted community settings at no cost and improves equitable access to vaccines and other services across various populations. The programs ensure a culturally and linguistically appropriate experience in a safe and trusted environment in partnership with over 125 faith-based and grassroots community partners, serving clients at local churches, mosques, temples, schools, community centers, food pantries, and homeless shelters. In 2023, across the system, the community clinical care team provided blood pressure, and oral health services at 180 events, including one event in the Lakes Medical Center community, providing 42 blood pressure checks. Fairview's Minnesota Immunization Networking Initiative (MINI), a multi-sector, community collaboration that initiated the Community Clinical Care approach provides free vaccinations, and education to the uninsured, under-served, and communities facing health disparities in the greater Twin Cities area. In 2023, across the system the team hosted 574 vaccination clinics. There were 7,037 free COVID-19 vaccine doses and 6,428 free flu shots administered. Of those participants who shared their identity, 81% of people who received a COVID-19 vaccine identified as a person of color and 38% indicated a language other than English as their preferred language. In 2023 the Minnesota Immunization Networking Initiative was invited to submit to the New England Journal of Medicine on their approach and successes, with a focus on partnerships with public health. This continues to build the evidence base for community placed and community centered approaches. Health UP's mission is to promote a community where all citizens value, have access to, and engage in opportunities that support active and healthy living and a sense of wellbeing. In 2023, as a part of the Health Up collaboration, Fairview and partners hosted one Health Huddles, on "What is the State of Youth in the Forest Lake area?". The Fairview Community Health and Wellness Hub (The Hub) opened in 2022. The hub is a first-of-its-kind center that will address health disparities while providing a range of critical healthcare services and community resources alongside trusted local partners. The Hub provides a variety of services to the community - from primary care to mental healthcare to enrichment options for seniors, food access programs, and community gathering spaces. We bring our own services together with local organizations to make it easier for people to access what they need to thrive. In 2023 we celebrated the 1-year anniversary of the opening of the hub and the Center for Community Health Equity. Through the year, we provided free community gathering space to more than 50 partners and local groups at the Hub. More than 250 community members were reached through cultural healing and community wellness programming delivered in, or partnering with, the Health and Wellness Hub and Center for Community Health Equity. For more information about these and other action plan programs that are addressing the priority need Navigating and Accessing Care and Resources, please see our Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Priority Need: Addressing Structural Racism and Barriers to Equity. Lakes Medical Center as a part of strategy 1, (Addressing the SDoH), has a variety of programs, events, and community education as a part of the Community Action Plan that work toward the anticipated impact: Develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, to address structural racism and barriers to equity. Fairview system highlights. One of the Fairview social determinants of health initiatives, Food is Medicine, utilizes the knowledge and resources of a large healthcare institution to work towards meeting the immediate needs of our patients, while also transforming the food system into something just, equitable, and sustainable. The initiative aims to 1) Nourish our patients: Advance food security to reduce health disparities and diet-related health conditions. 2) Enrich our communities: Cultivate trusting and engaged partnerships to build and share resources, assets, and capacity. 3) Transform our systems: Nurture just and equitable food systems to ensure health equity. These approaches are framed to increase health equity through focused efforts to serve patients who have been historically marginalized, by providing culturally appropriate food options, and reducing food insecurity in a manner that upholds dignity and empowers the local food system. Clinically, it enables providers to serve patients experiencing food insecurity through a menu of distinct programs comprising an innovative wrap-around approach. One, or more, of the Food is Medicine programs, a selection of which are described below, are available to patients in 43+ clinics and 5 acute sites across the health system. One of the Food is Medicine initiative programmatic responses is Veggie Rx, which distributes fresh, locally grown produce from four farm partners (Hmong American Farmers Association, Sin Fronteras, Naima's Farm and Women's Environmental Institute) via a Community Supported Agriculture (CSA) box. The program offers home delivery to address transportation barriers. In 2023, 20 clinics participated in Veggie Rx across Fairview hospital and medical center communities. Specifically in the Lakes Medical Center community there were three sites that enrolled 64 participants. Almost one third (29%) of program participants across the system identified as Asian, 20% as Black and 4% as Hispanic/Latino. While just three quarters speak English as a preferred language, 7% had a preferred language of Hmong, 13% Karen, and 2% Spanish. Most participants had public insurance (73%) or were uninsured (1%).
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Facility , 4 - Fairview Lakes Regional Medical Ctr. Fairview's MarketRx program provides patients with $80 per month to purchase groceries at either the Twin Cities Mobile Market or Fare for All program. The program runs year-round and offers rolling enrollment. Through the year, 195 patients redeemed vouchers for groceries. In the Lakes Medical Center community, there were 73 new participants enrolled. Additionally, we provided shelf stable immediate need food resource options. MATTERboxes were available in the Lakes Medical Center community with each box containing enough food to feed a family of four for three days. In 2023 there were 1,900 MATTERboxes distributed at 26 sites across the system. There were also 240 food resource packets distributed that contained information about local food resources along with a grocery gift card to assist with immediate grocery needs. Lakes Medical Center has a community garden that are available for twenty-five dollars to community members. They are located near the East side of the hospital near the parking lot in locked fenced areas. In 2023 there were 14 garden plots, each taken care of by a community member. Gardeners are harvesting their produce for themselves, their families, and their neighbors. Additionally, through a partnership with Ebenezer (Meadows) 1 plot were provided for Ebenezer residents. In November of 2023, Fairview and local partners hosted the Harvest at the Hub at the Fairview Community Health and Wellness Hub. The event consisted of a food giveaway with turkeys, fresh produce, and other holiday staples, a community resource fair, a vaccine clinic, and other health and wellbeing services. We served a total of 421 unduplicated households (over twice that of 2022). Another of the Fairview social determinants of health initiatives, Housing is Health initiative is also in response to the priority need Structural Racism and Barriers to Equity. The Housing is Health initiative aims to use the protective power of housing to support patient health and build thriving communities. We approach this initiative with clinically connected programs, supporting community partnerships, contributing time and expertise to collaboratives, and work to impact policy. As an example, Fairview partners with Our Savior's Community Services to provide critical follow-up care and temporary housing for people who are unsheltered after a hospital stay. Patients are referred by staff at hospital or medical center and sheltered at Our Saviors. Additionally, a nurse provides care, and patients receive wrap-around services and social work support. In 2023, 76 patients were provided supports through this program. Also, as a part of Housing is Health, we are proud to have completed inaugural Housing and Health Equity Fellowship hosted by the Greater Minnesota Housing Fund, which aimed to expand community investment by health systems to address the housing crisis in Minnesota. In October 2023, teams from across the system participated in our annual Build Week with Twin Cities Habitat for Humanity, contributing 456 volunteer hours. For more information about the action plan programs that are addressing the priority need Structural Racism and Barriers to Equity please see our Fairview Health Services Community Action Plan. https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Priority Need: Healing, connectedness, and mental health. Lakes Medical Center works toward the anticipated impact: develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, address barriers to healing, connectedness and mental health through strategy 1 (Addressing the SDoH) and the Community Action Plan. In response to the priority need, healing, connectedness, and mental health, we have a body of work that makes up the Connection is Cure initiative. Connection is Cure aims to build trust through social connections, centering linguistic and cultural diversity, and bridging silos across our hospital system and communities to transform medical practice. As a part of Connection is Cure, we participated in the Institute for Healthcare improvement trust prototyping network. We were one of eight health care organizations nationwide that are part of a 10-month project to test approaches to improve trust in healthcare systems. Our organization is focusing on a project to identify and remove system level equity barriers for interpreters and patients with limited English proficiency aiming to improve patient outcomes, customer experience, and care team cohesion. Additionally, we are responding to the need healing, connectedness, and mental health with a variety of evidence-based programs, as well as trainings and education sessions. Feeding Hope is a series of virtual one-hour learning sessions focused on positive, hopeful topics that support wellbeing in the general community. This series is offered in partnership with all Fairview's hospitals and medical centers and is open to anyone across all of Fairview's communities. In 2023, across Fairview hospitals and medical centers there were three sessions held with a combined 665 attendees. SPEAC (Substance Prevention Education & Action Coalition) is an organized coalition created to assist Forest Lake and the surrounding community in increasing positive life choices as it relates to alcohol or substance use in the Forest Lake School District. The coalition is designed to highlight scientifically proven, positive narratives through campaigns, events, and community involvement. Fairview provides infrastructure support through staff time serving as the grant director. In 2023 SPEAC was an active coalition with 15 sectors represented & meeting monthly. Twenty-five community conversations were held to provide additional insights to the community and increase SPEAC awareness and finally a student group called RISE student group at FLSD. Lifelines is a comprehensive suicide prevention program that targets the entire school community, providing suicide awareness material for administrators, faculty, staff, parents, and students. Basic information about youth suicide is provided and is primarily directed at helping everyone in the school community recognize when a student is at potential risk of suicide and understand how and where to access help. This research-based program is included in the Substance Abuse and Mental Health Services Administration's (SAMHSA) National Registry of Evidence-Based Programs and Practices. The curriculum is provided by Hazelden-Betty Ford Publishing. In 2023 in the Lakes Medical Center Community there were 6 active school districts. Psychological First Aid (PFA) is an evidence-informed training for the broader community as well as professionals. Trainees learn how to support healthy recovery for individuals following a traumatic event, public health emergency, natural disaster, or personal crisis. The curriculum integrates public health, community health and individual psychology by drawing upon skills the trainees probably already have. PFA is a two-hour training. In 2023, in the Lakes Medical Center community, there were three classes offered with 68 participants attending. For more information about the action plan programs that are addressing the priority need Structural Racism and Barriers to Equity please see our Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs In addition to strategy 1 (Addressing SDOH) and the programmatic work included on our Action Plans, we are striving to reduce health disparities and increase community health equity through two additional system strategies. While strategy 1 (Addressing SDOH) allows us to directly respond to the three prioritized needs from our community health needs assessment, strategy 2 (Engagement Infrastructure) and strategy 3 (Inclusive institution) focus on building the structures and systems for us do the work more capably.
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Facility , 5 - Fairview Lakes Regional Medical Ctr. Strategy 2 - Engagement Infrastructure Addressing our three priority needs while also responding to emerging needs requires an infrastructure that supports building and sustaining strong community partnerships and allows for ongoing, trusting exchanges between Fairview and community members. Strategy 2 (Engagement Infrastructure): Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. The anticipated Impacts for this strategy are 1. Build and expand feedback systems for patients and community members; embed process improvement in the health system's response to community voice. 2. Create sustainable structures to convene and engage community voice around addressing social determinants of health. While Fairview boasts an extensive engagement infrastructure already, we continued to bolster and expand thew work we do to expand feedback systems and sustainable convening structures. The M Health Fairview Center for Community Health Equity (the center) was launched in August 2022. The center guides our philosophy around how we gather community voice and who we talk to as we learn how to tie the learnings back into the organization. The 1-year anniversary of the Center for Community Health Equity was celebrated through a 3-day event welcoming over 250 people, where we offered free vaccinations, blood pressure checks, the opportunity to connect and network, and learn more about the work of the center. Throughout the year, we hosted six Center Community Health Equity Work Group meetings to hold strategic discussions on issues of relevance to the center. The work group was comprised of representatives from across the M Health Fairview Joint Clinical Enterprise. We also moved forward the development of a Center for Community Health Equity Model of Community Engagement. The model shares our approach to community engagement, community voice, and community partnerships to advance community health equity. We will utilize this model in 2024 to help guide how we gather feedback and inform our community health needs assessment. Enabling community voice, particularly the voices of priority populations, to influence, and inform the health system, is integral to strategy 2 (Engagement infrastructure). In 2023 we expanded our patient Listening and Learning sessions to host a session for patients who use American Sign Language. Additionally, Fairview hosted 8 Food is Medicine community conversations where we heard from 74 partner organizations to help inform our Food is Medicine approach as well as to convene food partners to increase opportunities for mutual awareness and collaboration. At Lakes Medical Center, we co-hosted the community conversation with Forest Lake YMCA, and 10 organizations participated. Building our engagement infrastructure involves engaging broadly with community but also building our capacity to engage with complex and intersectional groups. We are building a set of population health equity initiatives, one of which is the Native Health Equity Initiative. As a part of this body of work in 2023, a cohort of employees from across our system began work to advance health equity efforts in partnership with Native Americans and Indigenous communities. We facilitated six sessions to help our employees learn about the historical and current challenges faced by Native communities, connecting with key Native leaders and organizations, and local priority issues including healthcare. The sessions also engaged employees in working to improve experiences and outcomes for our Native patients, employees, and communities. In summer 2023, we co-hosted a "Heal the Healers" Summit with Indigenous Roots Cultural Art Center. The two-day summit welcomed more than 200 attendees for group learning sessions, rituals, seminars, and individual sessions with healers and professionals skilled in traditional healing modalities. Hosted an American Indian and Indigenous focused recruitment event at the Community Health and Wellness Hub. Finally, core to this strategy is building and sustaining trusting partnerships. We continue to support and build on existing engagement infrastructure and support existing collaboratives. Our Lakes Medical Center Community Advisory Committee met through the year to provide input as well as insight and local expertise. We conducted an inventory of the Community Advisory Committee member organizations focus and identified gap areas for expertise and aligned representation with CHNA priority populations. We continue to intentionally recruit participants to expand representation on the committees focusing on these gap areas. Committee members also participated, in addition to other community partners in our annual Community Impact Summit. In the Lakes Medical Center community, we participate in and have leadership roles in collaboratives such as Washington County Mental Health Coalition, CONNECT Washington County, Chisago Age Well Coalition, Chisago County MAPP (Mobilizing for Action through Planning and Partnerships) Committee, Wellspring project, Washington County, Health Up and Substance Prevention Education and Action (SPEAC), Interfaith Health Collaborative and the Center for Community Health. These are spaces where we do ongoing listening and relationship building with community partners and community members.
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Facility , 6 - Fairview Lakes Regional Medical Ctr. Strategy 3 - Inclusive Institution Strategy 3: Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. The anticipated impacts tied to strategy 3 (Inclusive Institution) are: 1) Build internal and external processes and structures to provide spaces that are safe and welcoming to all, responsive to community needs, and based on a culture of inclusion. 2) Using an antiracist approach, work to identify and eliminate racism by changing systems, organizational structures, policies, practices, and attitudes. 3) Leverage everyday business practices to build community wealth, promoting economic and racial equity and justice. This strategy has been partially operationalized through the HOPE Commission. The work of the HOPE Commission has been to identify foundational and transformational opportunities for our organizations to advance health equity (HE) and promote diversity, equity, and inclusion (DEI). To learn more about the goals, strategies and successes of the HOPE commission please see: The HOPE Commission website: https://mhealthfairview.org/About-Us/health-equity/hope-commission This work will continue to be operationalized through various departments across the organization as well as through the Center for Community Health Equity (CCHE). Key achievements in alignment with strategy 3 include the launch of standardized Social Determinants of Health patient screenings (i.e. food security, housing stability) at all ambulatory sites as well as implementation of targeted interventions to improve healthcare disparities which resulted in marked improvement in breast cancer and colon cancer screening rates. There was also improvement in breast cancer screening rates among Karen, Hmong and Somali patients with 6 mobile mammography events. Additionally, we are building capacity across the system to allow more individuals and teams to participate in the Intercultural Development Inventory (IDI). Operational improvements from the Office of Equity Strategy (OES) include dashboarding and reporting on metrics across the areas of health equity, healthcare equity, and diversity, equity, and inclusion, which will inform the creation of actions plans to reduce any disparities found and create line of sight for progress being made. Fairview is currently enhancing existing data collection and analytics across the institution to uncover and address health disparities. Fairview has successfully enhanced its analytics of Race, Ethnicity and Language (REaL) data across the institution, enabling us to uncover and address health disparities more effectively. With the improved analysis of REaL data, we are now setting Performance Dimension goals specifically aimed at closing these disparities. OES also supported strategic leadership within Human Resources and Customer Experience to incorporate Restorative Justice practices into their Just Culture and patient relations efforts. Additionally, in 2023, various units across the system operationalized systems to embed equity in project development and implementation across various parts of system decision-making. Our anchor strategy works to advance health equity by investing in the social and economic wellbeing of the communities we serve through our everyday business practices. The strategy focuses on local and diverse hiring, purchasing and investing, and serving and leading with trusted community partners. Fairview's Workforce Partnerships team is addressing the social determinants of health by helping people secure employment with family sustaining wages and benefits, become successful in their job, and learn new skills. The team is also focused on inclusive, local hiring, resulting in a healthcare team that represents the communities we serve. Supply Chain leaders launched a Supplier Diversity program, including updated request for proposal language, creating a new webpage, and identifying potential diverse vendors. Fairview also has a robust social corporate responsibility program including employee volunteerism, memberships and affiliations and sponsorships. In 2023 there were five systemwide employee volunteerism events hosted, including Twin Cities Pride. Additionally, Fairview staff sit on boards and/or are members of a diverse set of community organizations. Fairview's sponsorship program is aligned with Fairview's commitment to advancing equity and Fairview's focus on diversity, equity, and inclusion. Within this focus, Fairview awards sponsorships to support local community organizations in the needs and opportunities they have identified. In efforts to increase diversity and trust in clinical trials, the CCHE partnered with Fairview Frontiers to improve representation in a set of clinical trials and hosted a Research Participant Appreciation event that was attended by over 70 research participants. The partnership between Center for Community Health Equity and Fairview Frontiers increased participant representation in a set of clinical trials of those that identified as a race or ethnicity other than white from 15.5% to 33.8%. A paper was published on the partnership and methods used that led to these successes. Significant needs not addressed. Prioritizing needs that are the root causes of almost all health disparities allows us to develop upstream strategies that will have a large and lasting impact in our communities. The significant needs we have identified will ultimately be positively impacted by addressing the root causes we have identified as our priority needs. The following needs were not directly addressed because this issue is beyond what the Lakes Medical Center resources can support at this time: Cost of care, insurance and medications, childcare and employment benefits. The following needs were directly not addressed because this issue will be addressed as part of patient care but falls outside of the scope of the CHNA Implementation Strategy: Clinic/hospital hours, limited time spent with provider, limited specialty care.
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Facility , 1 - Fairview Lakes Regional Medical Ctr. The Minnesota Attorney General agreement was used in the determination of the eligibility for financial assistance.
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Facility , 1 - Fairview Lakes Regional Medical Ctr. A summary of the Financial Assistance Policy is posted in various locations in the hospital.
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Facility , 1 - Fairview Lakes Regional Medical Center. Pursuant to Treas. Reg. Section 1.501(r)-6(c), Fairview Lakes Regional Medical Center made reasonable efforts to determine whether an individual was FAP-eligible for care by satisfying the requirements of Section 1.501(r)-6(c)(3).
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Fairview is committed to transparency and accountability in all we do, including our efforts to assess - and respond to - our community's most pressing health needs. The community benefit work that we do across Fairview must reflect our community's actual needs, not our assumptions about what those needs might or should be. Because we understand that change cannot happen when we work in silos, and it cannot happen in a single year, we grounded our 2021 CHNA process in alignment with our 2018 CHNA needs, existing data, and the voices of community members and community partners. Once we had collected, analyzed, and synthesized the information we received from both primary and secondary data sources, we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. Having a consistent, defined process helps reduce the skewing effect of conscious and unconscious biases and enables us to define priority need areas that reflect our community's top health needs rather than our perception of those needs. We evaluated areas of need based on four broad criteria: -Has this need been voiced by the community? Has this need been vetted by the community? -Does this need align with Fairview's strategies and priorities? -Does this need align with existing public health strategies and community health assessments? -Does this need build upon Fairview's 2018 CHNA priority needs? Our process resulted in the identification of three priority need areas. They are: -Navigating and accessing care and resources -Healing, connectedness, and mental health -Addressing structural racism and barriers to achieving health equity.
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Facility , 1 - Fairview Northland Regional Hosp. The assessment process and data collection methods we used during this CHNA cycle were different than ever before due to the COVID-19 pandemic. COVID- 19 caused delays in data collection among local, state, and national organizations. As a result of these delays, the U.S. Census Bureau had not yet released finalized data from the 2020 U.S. Census by the time we began the CHNA process. As a result, we used 2015-2019 American Community Survey data. Local public health agencies also were not able to provide updated data as they have in the past. We acknowledge that, due to these setbacks, the data we used is less recent than desired. Additionally, COVID-19 required us to add new safety precautions to our method of gathering community voice data. For example, all conversations and interviews, which had previously been in-person meetings, took place in a virtual format instead. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations. The process included discussions with community benefit and assessment committees, our community advisory council, the HOPE Commission listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Each hospital within Fairview has a community benefit and assessment committee that is involved in the CHNA process throughout the three-year cycle. Each committee is comprised of local community and organizational leaders and staffed by the Fairview Community Advancement department. Community benefit and assessment committees met four times between April and October in 2021, three of which were individual committee meetings and one of which was a system-wide Community Impact Summit that brought all the committees together. Each committee meeting consisted of facilitated discussions through which our team gathered input about top community needs. The Fairview Community Advisory Council, composed of key community leaders and staffed by Community Advancement, reviews the CHNA report and written implementation strategy and recommends it to the Patient Care and Experience Committee of the Fairview Board of Directors for review and adoption. Each member represents the member's respective community, and members represent a broad range of sectors, among them community organizations serving cultural communities, higher education organizations, banks, and a nonprofit electric company. The Community Advisory Council met from May through November 2021 to participate in the CHNA process, give feedback, and ultimately recommend the CHNA and implementation strategy for adoption. The HOPE Commission is a multi-year transformational change effort of M Health Fairview to drive more equitable outcomes and inclusive environments and experiences for our patients, employees, and communities. The Commission conducted a series of listening and learning sessions in 2020 and 2021. The objective was to hold a mirror to Fairview to assess where we are now and how we can make lasting change. Part of being an anti-racist health system is developing a candid understanding of our shortcomings. We particularly sought to hear perspectives and ideas from the most impacted populations: BIPOC employees and patients, front-line workers who care for underserved and marginalized patients, and those patients themselves. A survey was also made available each year to gather insights and suggestions from employees and patients who could not directly participate in a listening and learning session. In 2020, the commission convened 32 virtual listening and learning sessions and two town halls involving more than 1,500 participants across Fairview sites. The sessions focused on employees but included patients and community members as well. In September 2021, the HOPE Commission continued the listening and learning sessions following the same model. In this iteration, however, the focus was primarily on gathering input from patients (and employees as patients). In both 2020 and 2021's listening and learning sessions, the facilitators and note takers reflected the community represented by the session's group to the greatest degree possible. In August and September 2021, Fairview's Community Advancement team conducted a series of interviews with staff members who work with communities. Each conversation followed a consistent interview protocol developed for this purpose, and each interview was captured by means of detailed notes. The goal of these interviews was to draw on staff expertise to gain a deeper understanding of our priority needs and to determine whether there are any emerging needs that we should be considering. Between Aug. 31 and Sept.17, 2021, we conducted 17 interviews. In August 2021, we held two focus groups in partnership with other organizations. We convened the first focus group in partnership with HealthPartners and Allina Health, and the participants were faith community nurses. We convened the second focus group in partnership with the organizations that are a part of the East Side Health and Well-being Collaborative. This meeting's focus was on accessing care and resources for different cultural communities. Fairview also participated in two large surveys. KRC Research conducted a survey around health and health care needs in St. Paul between June 8 and July 7, 2021, and administered it to community members, Fairview employees, patients, and community partners. Responses were received from 294 residents, more than 1,000 employees, 221 patients, and 20 partners. The survey was offered online and by phone and in five languages: English, Spanish, Hmong, Somali, and Karen. Fairview also supported and was a partner organization in Bridge to Health, a survey that assesses the health needs of northern Minnesota residents. The Bridge to Health survey was administered between Aug.28 and Oct. 23, 2020. The geographic areas that were sampled included Aitkin, Carlton, Cook, Itasca, Koochiching, Lake, St. Louis, and Pine counties in Minnesota, as well as Douglas County in Wisconsin. As a foundational part of program planning and evaluation, Community Advancement staff are continuously soliciting feedback from community partners and program participants. We capture this information on an ongoing basis and use it to provide valuable context and drive insights into the needs of the communities we serve. Fairview staff developed standardized tools, processes, instructions, and facilitator, interviewer, and note-taker protocols and training. All primary data was compiled, cleaned, and analyzed. Community conversations lasted various lengths from 30-120 minutes. All community input was captured by a note-taker. The Fairview team contracted with the following groups to support our assessment process: -Loren Blinde, PhD of Writing Power, a copywriter and content strategist, on the writing of the report. -Kristi Fordyce, an independent contractor, for analysis support. -Weber Shandwick, for data collection and analysis of focus groups and stakeholder interviews focused on St. Paul. -KRC Research for the administration and analysis of the St. Paul Community Survey.
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Schedule H, Part V, Section B, Line 11 Facility , 1
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Facility , 1 - Fairview Northland Regional Hosp. Our triennial community health needs assessment (CHNA) process provides an important opportunity to engage with and understand our community, analyze what has changed since the last assessment, and prioritize together with the community the issues we must urgently address to improve wellbeing and resilience. As part of the 2021 CHNA process, we reexamined and built upon the extensive community insights shared during our 2018 CHNA, while also surveying the community for current and emerging needs. Our 2021 CHNA used social determinants of health as a lens through which we frame our understanding of our community's most significant health needs. A social determinants of health lens enables us to identify inequitable distribution of resources and access that negatively impacts health. Through this lens we looked at both qualitative and quantitative data. Quantitative data included data points related to demographics, physical environment, socioeconomic factors, health care and health outcomes. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations - racial or ethnic populations experiencing health disparities and persons experiencing poverty. Northland Medical Center has a community advisory committee (CAC) that is involved in the CHNA process. The committee is comprised of local community and organizational leaders, such as local public health, social services organizations, higher education institutions, school districts, and local businesses. The assessment process also included discussions with our community advisory council, listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Bringing together both the qualitative and quantitative data we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. We prioritized areas of need based on four broad criteria: 1) Has this need been voiced by the community? Has this need been vetted by the community? 2) Does this need align with Fairview's strategies and priorities? 3) Does this need align with existing public health strategies and community health assessments? 4) Does this need build upon Fairview's 2018 CHNA priority needs? The Northland Medical Center identified three system-wide priority need areas, and will collaborate with other Fairview hospitals, medical centers, and shared business and clinical services to address these priorities. Our specific response varies by hospital based on the ways in which the priority needs manifest across a given community as well as the partnerships, both ongoing and new, that we have developed to address those needs. The three identified needs are: 1) Navigating and accessing care and resources, 2) Healing, connectedness, and mental health, 3) Addressing structural racism and barriers to equity. Each priority has a set of anticipated impacts, described in more detail below, and can be found in the Northland Medical Center CHNA Implementation Strategy Report (2022-2024). We also identified two priority populations that reach across the lifespan and impact from rural to urban. They are racial or ethnic populations experiencing health disparities and people experiencing poverty. For more details about our priority needs and the priority populations as they relate to the Northland Medical Center, please see the Northland Medical Center 2021 Community Health Needs Assessment. https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Development of 2022-2024 CHNA Implementation Strategies As a learning organization that works closely with our community advisory committees and community partners, over the past decades we have gleaned important lessons which have guided us in the development of our Fairview Health Services 2022-2024 implementation strategies. 1. Despite best efforts, health needs and health inequities continue to grow and deepen. 2. Collective action is critical. 3. Transformational change requires sustained and focused commitment. In response to our 2021 community health needs assessment and our lessons learned, all Fairview hospitals and medical centers worked collaboratively amongst each other, as well as in partnership with local and statewide organizations to address communities' most pressing needs. To rise to the challenge, we put forth a 2032 vision of increased community health equity supported by three strategies to address the priority need areas in distinct ways while collectively moving us closer to our vision of increased community health equity. The three strategies are: Strategy 1: Addressing SDOH - Addressing the social determinants of health (SDOH) as well as individual social risks and social needs through the creation and expansion of programs; initiatives; collaborations; research; and policy, system, and environmental work. Strategy 2: Community engagement infrastructure - Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. Strategy 3: Inclusive institution - Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. For this three-year cycle, we are implementing our strategies to work toward distinct anticipated impacts for each priority need and ultimately our 10-year vision of increased community health equity. For more information, the Northland Medical Center CHNA Implementation Strategy Report outlines the major strategies and actions we will deploy throughout the 2022-2024 assessment cycle as well as the ties between the Northland Medical Center CHNA implementation strategies, anticipated impacts, and key responses. Northland Medical Center Community Health Needs Assessments Implementation Strategy Reports (2022-2024): https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Fairview's mission and vision extend beyond traditional healthcare settings, driving a healthier future for the communities we serve. Significant efforts towards Strategy 1 occurred over the first three years of our ten-year vision, demonstrated through standing up three Social Determinants of Health Initiatives. 1) "Food is Medicine" Using the healing power of food to nourish our patients, enrich our communities, and transform our systems. 2) "Housing is Health" Using the protective power of housing to support patient health and build thriving communities. 3) "Connection is Cure" aims to address social isolation and improve community mental health and well-being by strengthening the connection between patients and the healthcare system. These initiatives are key responses that intersect all three priority needs and are also synergistic among themselves.
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Schedule H, Part V, Section B, Line 11 Facility , 2
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Facility , 2 - Fairview Northland Regional Hosp. Relationship with our partners. Fairview has a long partnership with the University of Minnesota and University of Minnesota Physicians, now represented in the M Health Fairview brand. Together, we offer access to breakthrough medical research and specialty expertise as part of a continuum of care that reaches all ages and health needs. Policy, systems, and environmental change initiatives are implemented across the system (hospitals, clinics, etc.) and in some instances across the M Health Fairview partners to create sustainable and lasting change to advance health equity and community wellbeing. Where indicated, community responses as a part of strategy 2 (Community engagement infrastructure) and strategy 3 (Inclusive institution) represent the work of Fairview in collaboration with the other M Health Fairview partners. Community action plan. The Northland Medical Center has an annual CHNA action plan that supports our vision of increased community health equity, rolls up to our system CHNA implementation strategies, and addresses priority needs. The Fairview Health Services Community Action Plan details the specific and measurable steps we will take during the year to drive change. Program lists by hospital can be found in the appendix. The System Community Action Plan is updated annually and includes impacts from the prior years. This report is shared with the Northland Medical Center Community Advisory Committee, the Fairview Health Services Board of Directors, and is publicly available on the website: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Evaluation of Impact. To best evaluate our impact and track progress towards our anticipated impacts, we used a multi-tiered and tailored evaluation approach. We ground our work in understanding core information about our communities. This includes identifying and understanding the community need being addressed, the population or community being impacted, and current and/or potential partners to work with to address the need, and the impacts we anticipate. Community needs are determined in several ways. In addition to being determined through our formal CHNA process, we also respond to emerging needs brought to us by a community partner, public health, or through patient or community data showing significant health disparities. We have standardized several key measures to assess that we are meeting the needs of the CHNA priority populations, focusing our efforts on equity, and participant satisfaction. A subset of established programs and initiatives are set up and supported for deeper evaluation. We have found with the populations we serve; one-size fits all evidence-based approaches are not a good fit for our diverse communities. In response to the unique and differing needs of our community members, our programs have been co-developed in partnership with community, centering the needs of specific populations, and often have unique local tactics. We approach evaluation from a similar perspective by building evaluation approaches informed by our partners, and considering strategies that are culturally and linguistically appropriate and to determine if the programs reflect the values we set out to embody. We are guided by the Centers for Disease Control and Prevention (CDC) model for program evaluation to establish primary outcomes, process measures, and demographics. We evaluate program impact and success from a variety of approaches using both qualitative and quantitative data. For many of the programs described here we are reporting out our reach or outputs through counts on a variety of levels including meeting the rigor required for reporting on grants and contracts. We offer a diverse set of programs that vary the spectrum of low touch and high count or high touch and lower count, or more generally put, the effort and impacts of the programs are not the same. This is a purposeful approach as we want a variety of programs and to "right-size" programs to address the community and population specific needs. We provide outcomes for programs here when we are able, acknowledging not all programs run on a calendar year and analysis may not be complete for some of the programs we do deeper evaluation on. We are currently in the process of building an evaluative approach and capacity for our ten-year vision, increased community health equity, and three social determinants of health initiatives: Housing is Health, Food is Medicine, and Connection is Cure. Part of this evaluative approach is a monthly Social Determinants of Health dashboard. Northland Medical Center 2023 Implementation Strategy Progress Highlights. The following highlights our implementation strategy work for each of our three priority needs. For a more comprehensive view of what we are doing to impact community needs please see our Fairview Health Services Community Action Plan and for a view of the Northland Medical Center's list of programs see the appendices. Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs In this first three-year CHNA cycle working towards our 2032 vision of increased community health equity the primary way we are directly addressing the three priority needs is through strategy 1 (Addressing SDOH). Through this strategy we create programs and partner with community organizations to address social risk factors, social needs and social determinants of health. Strategy 2 (Engagement infrastructure) and strategy 3 (Inclusive institution) focus on building infrastructure and creating system changes so that we can more effectively respond to these priority needs in the future, as well as any emerging needs.
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Schedule H, Part V, Section B, Line 11 Facility , 3
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Facility , 3 - Fairview Northland Regional Hosp. Strategy 1 Priority Need: Navigating and accessing care and resources. Northland Medical Center has a variety of programs that work as a part of strategy 1 (Addressing SDOH) to address barriers related to navigating and accessing care and resources. Through this strategy, the Northland Medical Center Action Plan programs work towards two anticipated impacts to address this priority need 1) Remove barriers to care by providing community-placed care, co-located services, and navigation supports that address cultural and language barriers. 2) Increased awareness of, knowledge about, and access to healthcare and community-based resources that support opportunities for health and wellbeing. Following is more information on a selection of programs from the system community action plan that are working to meet the two anticipated impacts. Fairview System Key Initiative Highlight. The Community Clinical Care initiative involves multiple community-based clinical programs, including Fairview's Minnesota Immunization Networking Initiative, Blood Pressure and Oral Health Services. All services are multi-sector, community collaborations that provide care and education to the uninsured, under-served, and communities facing health disparities in the greater Twin Cities area. The Community Clinical Care team provides clinical care in trusted community settings at no cost and improves equitable access to vaccines and other services across various populations. The programs ensure a culturally and linguistically appropriate experience in a safe and trusted environment in partnership with over 125 faith-based and grassroots community partners, serving clients at local churches, mosques, temples, schools, community centers, food pantries, and homeless shelters. In 2023, across the system, the community clinical care team provided blood pressure, and oral health services at 180 events, including one event in the Northland Medical Center community providing 27 dental varnishes. Fairview's Minnesota Immunization Networking Initiative (MINI), a multi-sector, community collaboration that initiated the Community Clinical Care approach provides free vaccinations, and education to the uninsured, under-served, and communities facing health disparities in the greater Twin Cities area. In 2023, across the system the team hosted 574 vaccination clinics. There were 7,037 free COVID-19 vaccine doses and 6,428 free flu shots administered. Of those participants who shared their identity, 81% of people who received a COVID-19 vaccine identified as a person of color and 38% indicated a language other than English as their preferred language. In 2023 the Minnesota Immunization Networking Initiative was invited to submit to the New England Journal of Medicine on their approach and successes, with a focus on partnerships with public health. This continues to build the evidence base for community placed and community centered approaches. In 2023 in the Northland Medical Center community there were three events where 147 flu shots were administered. The Youth Education Partnerships Programs collaborates with local high schools to host events where students are exposed to healthcare career opportunities including learning new skills, hands-on experiences, and hearing from health care providers. In 2023 Northland Medical center hosted 12 events reaching 157 students. The Fairview Community Health and Wellness Hub (The Hub) opened in 2022. The hub is a first-of-its-kind center that will address health disparities while providing a range of critical healthcare services and community resources alongside trusted local partners. The Hub provides a variety of services to the community - from primary care to mental healthcare to enrichment options for seniors, food access programs, and community gathering spaces. We bring our own services together with local organizations to make it easier for people to access what they need to thrive. In 2023 we celebrated the 1-year anniversary of the opening of the hub and the Center for Community Health Equity. Through the year, we provided free community gathering space to more than 50 partners and local groups at the Hub. More than 250 community members were reached through cultural healing and community wellness programming delivered in, or partnering with, the Health and Wellness Hub and Center for Community Health Equity. For more information about these and other action plan programs that are addressing the priority need Navigating and Accessing Care and Resources, please see our Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Priority Need: Addressing Structural Racism and Barriers to Equity. Northland Medical Center as a part of strategy 1, (Addressing the SDoH), has a variety of programs, events, and community education as a part of the Community Action Plan that work toward the anticipated impact: Develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, to address structural racism and barriers to equity. Fairview system highlights. One of the Fairview social determinants of health initiatives, Food is Medicine, utilizes the knowledge and resources of a large healthcare institution to work towards meeting the immediate needs of our patients, while also transforming the food system into something just, equitable, and sustainable. The initiative aims to 1) Nourish our patients: Advance food security to reduce health disparities and diet-related health conditions. 2) Enrich our communities: Cultivate trusting and engaged partnerships to build and share resources, assets, and capacity. 3) Transform our systems: Nurture just and equitable food systems to ensure health equity. These approaches are framed to increase health equity through focused efforts to serve patients who have been historically marginalized, by providing culturally appropriate food options, and reducing food insecurity in a manner that upholds dignity and empowers the local food system. Clinically, it enables providers to serve patients experiencing food insecurity through a menu of distinct programs comprising an innovative wrap-around approach. One, or more, of the Food is Medicine programs, a selection of which are described below, are available to patients in 43+ clinics and 5 acute sites across the health system. One of the Food is Medicine initiative programmatic responses is Veggie Rx, which distributes fresh, locally grown produce from four farm partners (Hmong American Farmers Association, Sin Fronteras, Naima's Farm and Women's Environmental Institute) via a Community Supported Agriculture (CSA) box. The program offers home delivery to address transportation barriers. In 2023, 20 clinics participated in Veggie Rx across Fairview hospital and medical center communities. Specifically in the Northland Medical Center community there were two sites that enrolled 20 participants. Almost one third (29%) of program participants across the system identified as Asian, 20% as Black and 4% as Hispanic/Latino. While just three quarters speak English as a preferred language, 7% had a preferred language of Hmong, 13% Karen, and 2% Spanish. Most participants had public insurance (73%) or were uninsured (1%).
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Schedule H, Part V, Section B, Line 11 Facility , 4
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Facility , 4 - Fairview Northland Regional Hosp. Fairview's MarketRx program provides patients with $80 per month to purchase groceries at either the Twin Cities Mobile Market or Fare for All program. The program runs year-round and offers rolling enrollment. Through the year, 195 patients redeemed vouchers for groceries. Additionally, we provided shelf stable immediate need food resource options. MATTERboxes were available in the Northland Medical Center community with each box containing enough food to feed a family of four for three days. In 2023 there were 1,900 MATTERboxes distributed at 26 sites across the system. There were also 240 food resource packets distributed that contained information about local food resources along with a grocery gift card to assist with immediate grocery needs. In coordination with seven local churches, Fairview Northland Medical Center nutrition services offers a program called Meals Ala Car. Northland Medical Center prepares healthy meals in the kitchen at Northland, and volunteers deliver those meals to the City of Princeton recipients, targeting senior citizens. The person-to person delivery model provides a social connection to people who might otherwise be isolated, as well as an opportunity for the delivery driver to do a welfare check. In 2023 there were 1,838 meals provided to seniors. In November of 2023, Fairview and local partners hosted the Harvest at the Hub at the Fairview Community Health and Wellness Hub. The event consisted of a food giveaway with turkeys, fresh produce, and other holiday staples, a community resource fair, a vaccine clinic, and other health and wellbeing services. We served a total of 421 unduplicated households (over twice that of 2022). Another of the Fairview social determinants of health initiatives, Housing is Health initiative is also in response to the priority need Structural Racism and Barriers to Equity. The Housing is Health initiative aims to use the protective power of housing to support patient health and build thriving communities. We approach this initiative with clinically connected programs, supporting community partnerships, contributing time and expertise to collaboratives, and work to impact policy. As an example, Fairview partners with Our Savior's Community Services to provide critical follow-up care and temporary housing for people who are unsheltered after a hospital stay. Patients are referred by staff at hospital or medical center and sheltered at Our Saviors. Additionally, a nurse provides care, and patients receive wrap-around services and social work support. In 2023, 76 patients were provided supports through this program. Also, as a part of Housing is Health, we are proud to have completed inaugural Housing and Health Equity Fellowship hosted by the Greater Minnesota Housing Fund, which aimed to expand community investment by health systems to address the housing crisis in Minnesota. In October 2023, teams from across the system participated in our annual Build Week with Twin Cities Habitat for Humanity, contributing 456 volunteer hours. For more information about the action plan programs that are addressing the priority need Structural Racism and Barriers to Equity please see our Fairview Health Services Community Action Plan. https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs Priority Need: Healing, connectedness, and mental health. Northland Medical Center works toward the anticipated impact: develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, address barriers to healing, connectedness and mental health through strategy 1 (Addressing the SDoH) and the Community Action Plan. In response to the priority need, healing, connectedness, and mental health, we have a body of work that makes up the Connection is Cure initiative. Connection is Cure aims to build trust through social connections, centering linguistic and cultural diversity, and bridging silos across our hospital system and communities to transform medical practice. As a part of Connection is Cure, we participated in the Institute for Healthcare improvement trust prototyping network. We were one of eight health care organizations nationwide that are part of a 10-month project to test approaches to improve trust in healthcare systems. Our organization is focusing on a project to identify and remove system level equity barriers for interpreters and patients with limited English proficiency aiming to improve patient outcomes, customer experience, and care team cohesion. Additionally, we are responding to the need healing, connectedness, and mental health with a variety of evidence-based programs, as well as trainings and education sessions. Feeding Hope is a series of virtual one-hour learning sessions focused on positive, hopeful topics that support wellbeing in the general community. This series is offered in partnership with all Fairview's hospitals and medical centers and is open to anyone across all of Fairview's communities. In 2023, across Fairview hospitals and medical centers there were three sessions held with a combined 665 attendees. Lifelines is a comprehensive suicide prevention program that targets the entire school community, providing suicide awareness material for administrators, faculty, staff, parents, and students. Basic information about youth suicide is provided and is primarily directed at helping everyone in the school community recognize when a student is at potential risk of suicide and understand how and where to access help. This research-based program is included in the Substance Abuse and Mental Health Services Administration's (SAMHSA) National Registry of Evidence-Based Programs and Practices. The curriculum is provided by Hazelden-Betty Ford Publishing. In 2023 in the Northland Medical Center Community there were two active school districts. Psychological First Aid (PFA) is an evidence-informed training for the broader community as well as professionals. Trainees learn how to support healthy recovery for individuals following a traumatic event, public health emergency, natural disaster, or personal crisis. The curriculum integrates public health, community health and individual psychology by drawing upon skills the trainees probably already have. PFA is a two-hour training. In 2023, in the Northland Medical Center community, there were two classes offered with 49 participants attending. For more information about the action plan programs that are addressing the priority need Structural Racism and Barriers to Equity please see our Fairview Health Services Community Action Plan: https://www.fairview.org/about/Our-Community-Commitment/Local-Health-Needs In addition to strategy 1 (Addressing SDOH) and the programmatic work included on our Action Plans, we are striving to reduce health disparities and increase community health equity through two additional system strategies. While strategy 1 (Addressing SDOH) allows us to directly respond to the three prioritized needs from our community health needs assessment, strategy 2 (Engagement Infrastructure) and strategy 3 (Inclusive institution) focus on building the structures and systems for us do the work more capably.
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Schedule H, Part V, Section B, Line 11 Facility , 5
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Facility , 5 - Fairview Northland Regional Hosp. Strategy 2 - Engagement Infrastructure Addressing our three priority needs while also responding to emerging needs requires an infrastructure that supports building and sustaining strong community partnerships and allows for ongoing, trusting exchanges between Fairview and community members. Strategy 2 (Engagement Infrastructure): Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. The anticipated Impacts for this strategy are 1. Build and expand feedback systems for patients and community members; embed process improvement in the health system's response to community voice. 2. Create sustainable structures to convene and engage community voice around addressing social determinants of health. While Fairview boasts an extensive engagement infrastructure already, we continued to bolster and expand thew work we do to expand feedback systems and sustainable convening structures. The M Health Fairview Center for Community Health Equity (the center) was launched in August 2022. The center guides our philosophy around how we gather community voice and who we talk to as we learn how to tie the learnings back into the organization. The 1-year anniversary of the Center for Community Health Equity was celebrated through a 3-day event welcoming over 250 people, where we offered free vaccinations, blood pressure checks, the opportunity to connect and network, and learn more about the work of the center. Throughout the year, we hosted six Center Community Health Equity Work Group meetings to hold strategic discussions on issues of relevance to the center. The work group was comprised of representatives from across the M Health Fairview Joint Clinical Enterprise. We also moved forward the development of a Center for Community Health Equity Model of Community Engagement. The model shares our approach to community engagement, community voice, and community partnerships to advance community health equity. We will utilize this model in 2024 to help guide how we gather feedback and inform our community health needs assessment. Enabling community voice, particularly the voices of priority populations, to influence, and inform the health system, is integral to strategy 2 (Engagement infrastructure). In 2023 we expanded our patient Listening and Learning sessions to host a session for patients who use American Sign Language. Additionally, Fairview hosted 8 Food is Medicine community conversations where we heard from 74 partner organizations to help inform our Food is Medicine approach as well as to convene food partners to increase opportunities for mutual awareness and collaboration. At Northland Medical Center, we co-hosted the community conversation with the Women's Environmental Institute, and 13 organizations participated. Building our engagement infrastructure involves engaging broadly with community but also building our capacity to engage with complex and intersectional groups. We are building a set of population health equity initiatives, one of which is the Native Health Equity Initiative. As a part of this body of work in 2023, a cohort of employees from across our system began work to advance health equity efforts in partnership with Native Americans and Indigenous communities. We facilitated six sessions to help our employees learn about the historical and current challenges faced by Native communities, connecting with key Native leaders and organizations, and local priority issues including healthcare. The sessions also engaged employees in working to improve experiences and outcomes for our Native patients, employees, and communities. In summer 2023, we co-hosted a "Heal the Healers" Summit with Indigenous Roots Cultural Art Center. The two-day summit welcomed more than 200 attendees for group learning sessions, rituals, seminars, and individual sessions with healers and professionals skilled in traditional healing modalities. Hosted an American Indian and Indigenous focused recruitment event at the Community Health and Wellness Hub. Finally, core to this strategy is building and sustaining trusting partnerships. We continue to support and build on existing engagement infrastructure and support existing collaboratives. Our Northland Medical Center Community Advisory Committee met through the year to provide input as well as insight and local expertise. We conducted an inventory of the Community Advisory Committee member organizations focus and identified gap areas for expertise and aligned representation with CHNA priority populations. We continue to intentionally recruit participants to expand representation on the committees focusing on these gap areas. Committee members also participated, in addition to other community partners in our annual Community Impact Summit. In the Northland Medical Center, we participate and are active members on collaborations such as Age Friendly Princeton, Princeton Chamber of Commerce, Tiger Community Connections, East Central Regional Transportation Coordinating Council, Rum River Housing and Homelessness Coalition, and "This is Princeton". These are spaces where we do ongoing listening and relationship building with community partners and community members.
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Schedule H, Part V, Section B, Line 11 Facility , 6
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Facility , 6 - Fairview Northland Regional Hosp. Strategy 3 - Inclusive Institution Strategy 3: Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. The anticipated impacts tied to strategy 3 (Inclusive Institution) are: 1) Build internal and external processes and structures to provide spaces that are safe and welcoming to all, responsive to community needs, and based on a culture of inclusion. 2) Using an antiracist approach, work to identify and eliminate racism by changing systems, organizational structures, policies, practices, and attitudes. 3) Leverage everyday business practices to build community wealth, promoting economic and racial equity and justice. This strategy has been partially operationalized through the HOPE Commission. The work of the HOPE Commission has been to identify foundational and transformational opportunities for our organizations to advance health equity (HE) and promote diversity, equity, and inclusion (DEI). To learn more about the goals, strategies and successes of the HOPE commission please see: The HOPE Commission website: https://mhealthfairview.org/About-Us/health-equity/hope-commission The 2023 HOPE Commission Report: https://www.mhealthfairview.org/-/media/Files/240033-2023-HOPE-Report-R5.pdf This work will continue to be operationalized through various departments across the organization as well as through the Center for Community Health Equity (CCHE). Key achievements in alignment with strategy 3 include the launch of standardized Social Determinants of Health patient screenings (i.e. food security, housing stability) at all ambulatory sites as well as implementation of targeted interventions to improve healthcare disparities which resulted in marked improvement in breast cancer and colon cancer screening rates. There was also improvement in breast cancer screening rates among Karen, Hmong and Somali patients with 6 mobile mammography events. Additionally, we are building capacity across the system to allow more individuals and teams to participate in the Intercultural Development Inventory (IDI). Operational improvements from the Office of Equity Strategy (OES) include dashboarding and reporting on metrics across the areas of health equity, healthcare equity, and diversity, equity, and inclusion, which will inform the creation of actions plans to reduce any disparities found and create line of sight for progress being made. Fairview is currently enhancing existing data collection and analytics across the institution to uncover and address health disparities. Fairview has successfully enhanced its analytics of Race, Ethnicity and Language (REaL) data across the institution, enabling us to uncover and address health disparities more effectively. With the improved analysis of REaL data, we are now setting Performance Dimension goals specifically aimed at closing these disparities. OES also supported strategic leadership within Human Resources and Customer Experience to incorporate Restorative Justice practices into their Just Culture and patient relations efforts. Additionally, in 2023, various units across the system operationalized systems to embed equity in project development and implementation across various parts of system decision-making. Our anchor strategy works to advance health equity by investing in the social and economic wellbeing of the communities we serve through our everyday business practices. The strategy focuses on local and diverse hiring, purchasing and investing, and serving and leading with trusted community partners. Fairview's Workforce Partnerships team is addressing the social determinants of health by helping people secure employment with family sustaining wages and benefits, become successful in their job, and learn new skills. The team is also focused on inclusive, local hiring, resulting in a healthcare team that represents the communities we serve. Supply Chain leaders launched a Supplier Diversity program, including updated request for proposal language, creating a new webpage, and identifying potential diverse vendors. Fairview also has a robust social corporate responsibility program including employee volunteerism, memberships and affiliations and sponsorships. In 2023 there were five systemwide employee volunteerism events hosted, including Twin Cities Pride. Additionally, Fairview staff sit on boards and/or are members of a diverse set of community organizations. Fairview's sponsorship program is aligned with Fairview's commitment to advancing equity and Fairview's focus on diversity, equity, and inclusion. Within this focus, Fairview awards sponsorships to support local community organizations in the needs and opportunities they have identified. In efforts to increase diversity and trust in clinical trials, the CCHE partnered with Fairview Frontiers to improve representation in a set of clinical trials and hosted a Research Participant Appreciation event that was attended by over 70 research participants. The partnership between Center for Community Health Equity and Fairview Frontiers increased participant representation in a set of clinical trials of those that identified as a race or ethnicity other than white from 15.5% to 33.8%. A paper was published on the partnership and methods used that led to these successes. Significant needs not addressed. Prioritizing needs that are the root causes of almost all health disparities allows us to develop upstream strategies that will have a large and lasting impact in our communities. The significant needs we have identified will ultimately be positively impacted by addressing the root causes we have identified as our priority needs. The following needs were not directly addressed because this issue is beyond what the Northland Medical Center resources can support at this time: Cost of care, insurance and medications, childcare and employment benefits. The following needs were directly not addressed because this issue will be addressed as part of patient care but falls outside of the scope of the CHNA Implementation Strategy: Clinic/hospital hours, limited time spent with provider, limited specialty care.
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Schedule H, Part V, Section B, Line 13 Facility , 1
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Facility , 1 - Fairview Northland Regional Hosp. The Minnesota Attorney General agreement was used in the determination of the eligibility for financial assistance.
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Schedule H, Part V, Section B, Line 16 Facility , 1
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Facility , 1 - Fairview Northland Regional Hosp. A summary of the Financial Assistance Policy is posted in various locations in the hospital.
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Schedule H, Part V, Section B, Line 20 Facility , 1
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Facility , 1 - Fairview Northland Regional Hospital. Pursuant to Treas. Reg. Section 1.501(r)-6(c), Northland Regional Hospital made reasonable efforts to determine whether an individual was FAP-eligible for care by satisfying the requirements of Section 1.501(r)-6(c)(3).
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Attach to Form 990 or Form 990-EZ.