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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSBETH ISRAEL DEACONESS HOSPITAL-MILTON (BID MILTON) AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF BID MILTON. THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND PARTS OF SOUTHERN NEW HAMPSHIRE AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,900 PHYSICIANS AND 39,000 EMPLOYEES. AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE, AND THIS BELIEF IS WHAT DRIVES EACH AFFILIATE TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS, AND DELIVER THE BEST CARE IN THE COMMUNITIES BILH SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES, AND COMMUNITIES.BILH'S PURPOSE STATEMENT ARTICULATES THE IMPACT BILH AND EACH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. BILH'S SHARED VALUES GUIDE EACH ENTITY'S DAILY EFFORTS AND KEEP EACH AFFILIATE ALIGNED IN THE PURSUIT OF THE BILH PURPOSE, SHOWING HOW "WE CARE" FOR PATIENTS, EACH OTHER, AND THE COMMUNITIES SERVED.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES - ONE PERSON AT A TIME - THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BILH WE CARE VALUES:WELLBEING. WE PROVIDE A HEALTH-FOCUSED WORKPLACE AND SUPPORT A HEALTHY WORK-LIFE BALANCE.EMPATHY. WE DO OUR BEST TO UNDERSTAND OTHERS' FEELINGS, NEEDS AND PERSPECTIVES.COLLABORATION. WE WORK TOGETHER TO ACHIEVE EXTRAORDINARY RESULTS.ACCOUNTABILITY. WE HOLD OURSELVES AND EACH OTHER TO BEHAVIORS NECESSARY TO ACHIEVE OUR COLLECTIVE GOALS.RESPECT. WE VALUE DIVERSITY AND TREAT ALL MEMBERS OF OUR COMMUNITY WITH DIGNITY AND INCLUSIVENESS.EQUITY. EVERYONE HAS THE OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL IN OUR WORKPLACE AND THROUGH THE CARE WE PROVIDE.ADDITIONAL INFORMATION ABOUT THE BILH SYSTEM AND ITS ACCOMPLISHMENTS ARE FURTHER BELOW IN THIS FORM 990 SCHEDULE H NARRATIVE SUPPORT IN THE SECTION NOTED AS "AFFILIATED HEALTH CARE SYSTEM AND ACCOMPLISHMENTS."BID MILTON COMMUNITY BENEFITS MISSION STATEMENT THE MISSION OF BID MILTON IS TO PROVIDE FREE OR LOW-COST PROGRAMS THAT ADDRESS UNMET HEALTH AND WELLNESS NEEDS OF RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE COMMUNITIES IN MILTON, RANDOLPH, AND QUINCY, IN A MANNER SHAPED BY COMMUNITY INPUT, ALIGNED WITH HOSPITAL RESOURCES, AND GUIDED BY OUR OBJECTIVE TO DELIVER HIGH-QUALITY CARE WITH COMPASSION, DIGNITY, AND RESPECT. BID MILTON'S COMMUNITY BENEFITS MISSION IS FULFILLED BY:- INVOLVING BID MILTON STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE THREE-YEAR IMPLEMENTATION STRATEGY;- ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT THE HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES;- ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO UNDERSTAND UNMET HEALTH-RELATED AND IDENTIFY COMMUNITIES AND POPULATIONS SEGMENTS IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, AND ECONOMIC FACTORS;- IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN BID MILTON'S CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED;- PROMOTING HEALTH EQUITY BY ADDRESSING INEQUITIES, AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND- FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTHCARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, BID MILTON PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $354,428 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I.COMMUNITY BENEFITS LEADERSHIP/TEAMBID MILTON'S BOARD OF TRUSTEES ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY BY PROVIDING EXCEPTIONAL, PERSONALIZED HEALTH CARE WITH DIGNITY, COMPASSION, AND RESPECT. BID MILTON'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF BID MILTON'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF BID MILTON'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES.THE BID MILTON COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE MANAGER OF COMMUNITY BENEFITS & COMMUNITY RELATIONS. THE MANAGER HAS DIRECT ACCESS AND IS ACCOUNTABLE TO THE BID MILTON PRESIDENT AND THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS. IT IS THE RESPONSIBILITY OF THESE LEADERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF COHORTS WHO HAVE BEEN HISTORICALLY UNDERSERVED ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THE BID MILTON COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH BID MILTON HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT BID MILTON'S COMMUNITY BENEFITS MISSION TO SERVE ITS PATIENTS COMPASSIONATELY AND EFFECTIVELY, AND TO CREATE A HEALTHY FUTURE FOR THEM, THEIR FAMILIES, AND BID MILTON'S COMMUNITY. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF BID MILTON'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF BID MILTON'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF BID MILTON'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY BID MILTON'S PROGRAMMATIC ENDEAVORS, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. BID MILTON'S CBAC MEMBERS INCLUDE:- KIMBERLY COUGHLIN, DIRECTOR OF NURSING, MILTON PUBLIC SCHOOLS - CATHERINE DENNY, CEO, CHOICE COMMUNITY SUPPORTS - RICK DOANE, EXECUTIVE DIRECTOR, INTERFAITH SOCIAL SERVICES - DR. NANCY DREW, PRIMARY CARE PHYSICIAN, BETH ISRAEL LAHEY HEALTH - EARL FAY, EXECUTIVE DIRECTOR, MILTON HOUSING AUTHORITY - ANGELA FENTON, VICE PRESIDENT OF AMBULATORY & CLINICAL SERVICES, BID MILTON - CLAIRE HOFFMAN, SENIOR PUBLIC HEALTH PLANNER, METROPOLITAN AREA PLANNING COUNCIL - DAVID HYMAN, VICE PRESIDENT OF PHILANTHROPY, BID MILTON - CAROLINE KINSELLA, HEALTH DIRECTOR AND PUBLIC HEALTH NURSE, MILTON BOARD OF HEALTH - VICKI MCCARTHY, RESIDENT, TOWN OF MILTON - EBI OKARA, EDD, BID MILTON BOARD OF TRUSTEES - DAMION OUTAR, COMMUNITY LIAISON, CITY OF QUINCY - LISA SCANLON, DIRECTOR OF COMMUNICATIONS & DEVELOPMENT, BAYSTATE COMMUNITY SERVICES - KRISTEN SCHLAPP, CHIEF OPERATING OFFICER, QUINCY COMMUNITY ACTION PROGRAMS - DEBORAH SCHOPPERLE, MARKETING MANAGER, QUINCY CREDIT UNION - CYNTHIA SIERRA, CHIEF EXECUTIVE OFFICER, MANET COMMUNITY HEALTH CENTER - CHRISTINE STANTON, EXECUTIVE DIRECTOR, MILTON COUNCIL ON AGING - JANICE SULLIVAN, CHIEF OF STRATEGY & COMMUNICATIONS, ASPIRE HEALTH ALLIANCE - KATELYN SZAFIR, VICE PRESIDENT OF OPERATIONS, HALE FAMILY/SOUTH SHORE YMCA - SARA TAN, EXECUTIVE DIRECTOR, ENHANCE ASIAN COMMUNITY ON HEALTH - CHRISTINE TANGISHAKA, RESIDENT, TOWN OF RANDOLPH- MICHELLE TYLER, PLANNER, TOWN OF RANDOLPH
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COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY
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MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT-INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY (IS ) PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. BID MILTON COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2025. THAT CHNA WAS APPROVED BY THE BID MILTON BOARD OF TRUSTEES ON SEPTEMBER 15, 2025. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 15, 2025, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). (SCHEDULE H, PART V, SECTION B, LINE 3)THE CHNA AND THE ASSOCIATED IS REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF BID MILTON'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA (CBSA) WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BID MILTON ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BID MILTON, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA. 2025 COMMUNITY HEALTH NEEDS ASSESSMENT-PRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, BID MILTON COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2025. THE GEOGRAPHICAL FOCUS OF BID MILTON'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENCOMPASSES THE CITY OF QUINCY AND THE TOWNS OF MILTON AND RANDOLPH. COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR BID MILTON'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R). BID MILTON'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES WILL FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF QUINCY, MILTON AND RANDOLPH IN ITS CBSA, AS FOLLOWS: - YOUTH - LOW-RESOURCED POPULATIONS - OLDER ADULTS - RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS - INDIVIDUALS LIVING WITH DISABILITIES2025 COMMUNITY HEALTH NEEDS ASSESSMENT-SUMMARY OF APPROACH AND METHODSBID MILTON'S CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING BID MILTON'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. BID MILTON'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL AND STATE LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, ACCOUNTABILITY, COMMUNITY ENGAGEMENT, AND IMPACT.THIS 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT IS AN INTEGRAL PART OF BID MILTON'S POPULATION HEALTH AND COMMUNITY ENGAGEMENT EFFORTS. IT SUPPLIES VITAL INFORMATION THAT IS APPLIED TO MAKE SURE THAT THE SERVICES AND PROGRAMS THAT BID MILTON PROVIDES ARE APPROPRIATELY FOCUSED, DELIVERED IN WAYS THAT ARE RESPONSIVE TO THOSE IN ITS CBSA, AND ADDRESS UNMET COMMUNITY NEEDS. THIS ASSESSMENT, ALONG WITH THE ASSOCIATED PRIORITIZATION AND PLANNING PROCESSES, ALSO PROVIDES A CRITICAL OPPORTUNITY FOR BID MILTON TO ENGAGE THE COMMUNITY AND STRENGTHEN THE COMMUNITY PARTNERSHIPS THAT ARE ESSENTIAL TO BID MILTON'S SUCCESS NOW AND IN THE FUTURE. THE ASSESSMENT ENGAGED MORE THAN 700 PEOPLE FROM ACROSS THE CBSA, INCLUDING LOCAL PUBLIC HEALTH OFFICIALS, CLINICAL AND SOCIAL SERVICE PROVIDERS, COMMUNITY-BASED ORGANIZATIONS, FAITH LEADERS, GOVERNMENT OFFICIALS, AND COMMUNITY RESIDENTS.BETWEEN JUNE 2024 AND SEPTEMBER 2025, BID MILTON CONDUCTED 15 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED 5 FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, AND 1 COMMUNITY LISTENING SESSION. IN TOTAL, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 700 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS, AND OTHER KEY COMMUNITY PARTNERS2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-DETAIL OF APPROACH AND METHODSBID MILTON RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. BID MILTON COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT BID MILTON LEVERAGED INCLUDED:- BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2021-2022)- CENTERS FOR DISEASE CONTROL GEOSPATIAL RESEARCH, ANALYSIS, AND SERVICES PROGRAM (2018-2022)- CENTERS FOR DISEASE CONTROL AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY (2022)- CENTERS FOR MEDICARE AND MEDICAID SERVICES GEOSPATIAL RESEARCH, ANALYSIS AND SERVICES PROGRAM (2018-2022)- MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021)- FBI UNIFORM CRIME REPORTS (2019)- MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2024)- MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2024)- MASSACHUSETTS DEATH REPORT, COMMUNITY PROFILES (2024)- ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2022, 2023, 2024)- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2019-2023)- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2019-2023)- U.S. DEPARTMENT OF AGRICULTURE: AGRICULTURE MARKETING SERVICE (2023)- U.S. DEPARTMENT OF AGRICULTURE: RETAILER LOCATOR (2024)2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-COMMUNITY INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN JUNE 2024 AND SEPTEMBER 2025, BID MILTON WORKED WITH COLLABORATORS TO CONDUCT 15 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS FROM THE COMMUNITY, INCLUDING REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS, AND OTHERS THROUGHOUT BID MILTON'S CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF COMMUNITY INTERVIEWEES IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON BID MILTON'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN BID MILTON'S CBSA. INTERVIEWS WERE CONDUCTED USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS.
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FOCUS GROUPS AND COMMUNITY FORUMS
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2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)ACROSS ALL FOUR COMPONENTS OF THE CHNA, BID MILTON CONDUCTED 5 COMMUNITY FOCUS GROUPS AND HELD A COMMUNITY LISTENING SESSION THAT ENGAGED PEOPLE IN BID MILTON'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS AND LISTENING SESSIONS WERE ORGANIZED IN COLLABORATION WITH OTHER BETH ISRAEL LAHEY HEALTH (BILH) HOSPITALS.BID MILTON WAS INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF BID MILTON'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN THIRTEEN LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, COMMUNITY EVENTS, AND PUBLIC AND/OR SENIOR HOUSING BUILDINGS TO HELP ENSURE APPROPRIATE REPRESENTATION IN THE CHNA. THE BID MILTON COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES. 2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSTHE BID MILTON'S CBAC WAS ENGAGED AT THE OUTSET OF THE STRATEGIC PLANNING AND REPORTING PHASE OF THE PROJECT. THE CBAC WAS UPDATED ON ASSESSMENT PROGRESS AND WAS PROVIDED THE OPPORTUNITY TO VET AND COMMENT ON PRELIMINARY FINDINGS. THE CBAC THEN PARTICIPATED IN A PRIORITIZATION PROCESS USING A SET OF ANONYMOUS POLLS, WHICH ALLOWED THEM TO IDENTIFY A SET OF COMMUNITY HEALTH PRIORITIES AND POPULATION COHORTS THAT THEY BELIEVED SHOULD BE CONSIDERED FOR PRIORITIZATION AS BID MILTON DEVELOPED ITS IMPLEMENTATION STRATEGY (IS). AFTER PRIORITIZATION WITH THE CBAC, A COMMUNITY LISTENING SESSION WAS ORGANIZED WITH THE PUBLIC-AT-LARGE, INCLUDING COMMUNITY RESIDENTS, REPRESENTATIVES FROM CLINICAL AND SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY-BASED ORGANIZATIONS THAT PROVIDE SERVICES THROUGHOUT THE CBSA. USING THE SAME SET OF ANONYMOUS POLLS, COMMUNITY LISTENING SESSION PARTICIPANTS WERE ASKED TO PRIORITIZE THE ISSUES THAT THEY BELIEVED WERE MOST IMPORTANT. THE SESSION ALSO ALLOWED PARTICIPANTS TO SHARE THEIR IDEAS ON EXISTING COMMUNITY STRENGTHS AND ASSETS, AS WELL AS THE SERVICES, PROGRAMS, AND STRATEGIES THAT SHOULD BE IMPLEMENTED TO ADDRESS THE ISSUES IDENTIFIED. THE CBAC ANALYZED LISTENING SESSION DATA AND INTEGRATED COMMUNITY INPUT INTO THE FINAL PRIORITIZATION. AFTER THE PRIORITIZATION PROCESS, A CHNA REPORT WAS DEVELOPED AND BID MILTON'S EXISTING IS WAS AUGMENTED, REVISED, AND TAILORED. WHEN DEVELOPING THE IS, BID MILTON'S COMMUNITY BENEFITS STAFF RETAINED COMMUNITY HEALTH INITIATIVES THAT WORKED WELL AND ALIGNED WITH THE PRIORITIES FROM THE 2025 CHNA. AFTER DRAFTS OF THE BID MILTON CHNA REPORT AND IS WERE DEVELOPED, THEY WERE SHARED WITH BID MILTON'S SENIOR LEADERSHIP TEAM FOR INPUT AND COMMENT. THE HOSPITAL'S COMMUNITY BENEFITS STAFF THEN REVIEWED THESE INPUTS AND INCORPORATED ELEMENTS, AS APPROPRIATE, BEFORE THE FINAL 2025 CHNA REPORT AND 2026-2028 IS WERE SUBMITTED TO BID MILTON'S BOARD OF TRUSTEES FOR APPROVAL. AFTER THE BOARD OF TRUSTEES FORMALLY APPROVED THE 2025 CHNA REPORT AND ADOPTED 2026-2028 IS, THESE DOCUMENTS WERE POSTED ON BID MILTON'S WEBSITE, ALONGSIDE THE 2022 CHNA REPORT AND 2023-2025 IS, FOR EASY VIEWING AND DOWNLOAD. AS WITH ALL BID MILTON CHNA PROCESSES, THESE DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC WHENEVER REQUESTED, ANONYMOUSLY AND FREE OF CHARGE. IT SHOULD ALSO BE NOTED THAT THE HOSPITAL'S COMMUNITY BENEFITS STAFF HAVE MECHANISMS IN PLACE TO RECEIVE WRITTEN COMMENTS ON THE MOST RECENT CHNA AND IS, ALTHOUGH NO COMMENTS HAVE BEEN RECEIVED SINCE THE LAST CHNA AND IS WERE MADE AVAILABLE2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS--KEY FINDINGSBID MILTON'S PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDING SEPTEMBER 30, 2025, WERE:- YOUTH- LOW-RESOURCED POPULATIONS- OLDER ADULTS- RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS- INDIVIDUALS LIVING WITH DISABILITIESBID MILTON'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: - EQUITABLE ACCESS TO CARE: IN THE CONTEXT OF THE HEALTHCARE SYSTEM, SYSTEMIC FACTORS INCLUDE A BROAD RANGE OF DIFFERENT CONSIDERATIONS THAT INFLUENCE A PERSON'S ABILITY TO ACCESS TIMELY, EQUITABLE, ACCESSIBLE, AND HIGH-QUALITY SERVICES. THERE IS A GROWING APPRECIATION FOR THE IMPORTANCE OF THESE FACTORS AS THEY ARE SEEN AS CRITICAL TO ENSURING THAT PEOPLE CAN FIND, ACCESS, AND ENGAGE IN THE SERVICES THEY NEED, COMMUNICATE WITH CLINICAL AND SOCIAL SERVICE PROVIDERS, AND TRANSITION SEAMLESSLY FROM ONE SERVICE SETTING TO ANOTHER. THE ASSESSMENT GATHERED INFORMATION RELATED TO PERCEPTIONS OF SERVICE GAPS, BARRIERS TO ACCESS (E.G., COST OF CARE, HEALTH INSURANCE STATUS, LANGUAGE ACCESS, CULTURAL COMPETENCE), CARE COORDINATION, AND INFORMATION SHARING.- SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE "THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS." THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO HOUSING, FOOD INSECURITY, ECONOMIC INSECURITY, EDUCATION, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEYS, AND THE LISTENING SESSION REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, AND ECONOMIC STABILITY.- MENTAL HEALTH AND SUBSTANCE USE: ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS; TRAUMA EXPERIENCED BY IMMIGRANTS, MIGRANTS, AND REFUGEES, AND SOCIAL ISOLATION AMONG OLDER ADULTS. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR ASSISTANCE NAVIGATING A COMPLEX BEHAVIORAL HEALTH SYSTEM, AS IT CAN BE OVERWHELMING FOR INDIVIDUALS EXPERIENCING MENTAL HEALTH CHALLENGES. PROVIDING NAVIGATION ASSISTANCE ENSURES PEOPLE CAN ACCESS THE RIGHT SERVICES AT THE RIGHT TIME, IMPROVING CONTINUITY OF CARE AND HEALTH OUTCOMES. YOUTH MENTAL HEALTH WAS A CONCERN IN THE CBSA, INCLUDING THE PREVALENCE OF CHRONIC STRESS, ANXIETY, AND BEHAVIORAL ISSUES. THESE CONDITIONS WERE EXACERBATED THROUGHOUT THE PANDEMIC, BECAUSE OF ISOLATION, UNCERTAINTY, REMOTE LEARNING, AND FAMILY DYNAMICS.- HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN THE COMMONWEALTH, CHRONIC CONDITIONS LIKE CANCER, HEART DISEASE, CHRONIC LOWER RESPIRATORY DISEASE, AND STROKE ACCOUNT FOR FOUR OF THE SIX LEADING CAUSES OF DEATH STATEWIDE, AND IT IS ESTIMATED THAT THERE ARE MORE THAN $41 BILLION IN ANNUAL COSTS ASSOCIATED WITH CHRONIC DISEASE. PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETYTHE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM BID MILTON'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2026, SEPTEMBER 30, 2027, AND SEPTEMBER 30, 2028. BID MILTON'S COMMUNITY BENEFITS ACTIVITIES AND ACCOMPLISHMENTS WHICH ARE REPORTED IN THIS FORM 990 SCHEDULE H WERE INFORMED BY THE HOSPITAL'S PREVIOUS CHNA AND IMPLEMENTATION STRATEGY AND ARE PROVIDED IN MORE DETAIL BELOW.
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PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFITS ACTIVITIES
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AS NOTED THROUGHOUT THIS FORM 990 SCHEDULE H, BID MILTON MOST RECENTLY COMPLETED ITS CHNA DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024) AND THE FIRST YEAR OF ACCOMPLISHMENTS UNDER THAT CHNA AND IMPLEMENTATION STRATEGY (IS) WILL BE REPORTED IN THE FORM 990 FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2026. THE PRIOR CHNA AND IS PROCESS WHICH WAS COMPLETED BY BID MILTON DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 AND INFORMED BID MILTON'S COMMUNITY BENEFITS OPERATIONS AND ACCOMPLISHMENTS REPORTED IN THIS FORM 990. 2022 COMMUNITY HEALTH NEEDS ASSESSMENT-PRIORITY GEOGRAPHY AND COHORTSBID MILTON COMPLETED ITS 2022 ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF BID MILTON'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENCOMPASSES THE CITY OF QUINCY AND TOWNS OF MILTON AND RANDOLPH.COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR BID MILTON'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).BID MILTON'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES WILL FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF QUINCY, MILTON AND RANDOLPH IN ITS CBSA, AS FOLLOWS:- YOUTH- LOW-RESOURCED POPULATIONS- OLDER ADULTS- RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS- INDIVIDUALS WITH DISABILITIES2022 COMMUNITY HEALTH NEEDS ASSESSMENT--SUMMARY OF APPROACH AND METHODSSIMILAR TO BID MILTON'S APPROACH AND METHODS FOR THE CHNA ADOPTED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025, THE BID MILTON'S PRIOR CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING BID MILTON'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. BID MILTON'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, STATE AND NATIONAL LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY. BETWEEN OCTOBER 2021 AND FEBRUARY 2022, BID MILTON CONDUCTED 19 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED THREE FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 500 RESIDENTS, AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS. (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 600 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS AND OTHER COMMUNITY PARTNERS.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-DETAIL OF APPROACH AND METHODSBID MILTON RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. BID MILTON COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT BID MILTON LEVERAGED INCLUDED:- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020)- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020)- U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021)- BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2019)- MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021)- FBI UNIFORM CRIME REPORTS (2019)- MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021)- MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019)- MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020)- MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018)- ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021)
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2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-KEY INFORMANT
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INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, BID MILTON WORKED WITH COLLABORATORS TO CONDUCT 19 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS AND OTHER KEY COLLABORATORS THROUGHOUT BID MILTON' CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON BID MILTON'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN BID MILTON' CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS. 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)BID MILTON CONDUCTED THREE COMMUNITY FOCUS GROUPS AND HELD TWO COMMUNITY LISTENING SESSIONS THAT ENGAGED 77 RESIDENTS IN BID MILTON'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS AND LISTENING SESSIONS WERE ORGANIZED IN COLLABORATION WITH THE SIGNATURE HEALTHCARE BROCKTON HOSPITAL AND OTHER BILH HOSPITALS. BID MILTON HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF BID MILTON'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN TWELVE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, FAITH-BASED COMMUNITIES, COMMUNITY EVENTS AND SENIOR HOUSING FACILITIES TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE BID MILTON COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTS- AS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: - REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS WITH THE BID MILTON COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS.- IDENTIFY BID MILTON'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES.- ANALYZE BID MILTON'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY BID MILTON DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018).- DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021).2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS--KEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDING SEPTEMBER 30, 2022, WERE:- YOUTH - LOW-RESOURCED POPULATIONS - OLDER ADULTS - RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS - INDIVIDUALS WITH DISABILITIESBID MILTON'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: - EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTHCARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY.- SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY.- HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS).- HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.
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COMMUNITY HEALTH NEEDS ASSESSMENT-MAKING THE CHNA AND
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IMPLEMENTATION STRATEGY WIDELY AVAILABLEBID MILTON STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, BID MILTON COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE BID MILTON WEBSITE AT:HTTPS://BIDMILTON.ORG/-/MEDIA/FILES/MILTON/COMMUNITY-BENEFITS/BID MILTON-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2025.PDF. IN ADDITION TO THE CHNA, BID MILTON COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE BID MILTON WEBSITE AT:HTTPS://BIDMILTON.ORG/-/MEDIA/FILES/MILTON/COMMUNITY-BENEFITS/BID MILTON-CHNA-IMPLEMENTATION-STRATEGY-2026-2028.PDFBID MILTON COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THAT CHNA IS AVAILABLE ON THE BID MILTON WEBSITE AT: HTTPS://BIDMILTON.ORG/-/MEDIA/FILES/MILTON/COMMUNITY-BENEFITS/BID-MILTON-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2022.PDF FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING BID MILTON'S FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021) IS AVAILABLE ON THE BID MILTON WEBSITE AT:HTTPS://BIDMILTON.ORG/-/MEDIA/FILES/MILTON/COMMUNITY-BENEFITS/BID-MILTON-CHNA-IMPLEMENTATION-STRATEGY-2023-2025.PDF EACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).COMMUNITY HEALTH NEEDS ASSESSMENT--ADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, BID MILTON'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 BUT IT IS THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY WHICH INFORMED THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF BID MILTON FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024) AND WHICH ARE REPORTED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, BID MILTON HAS BEEN STRATEGIC IN IDENTIFYING ITS COMMUNITY HEALTH PRIORITIES IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH - ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENT WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.PRIORITY AREA 2: CHRONIC AND COMPLEX CONDITIONS- IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.PRIORITY AREA 3: ACCESS TO CARE- PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC AND ECONOMIC BARRIERS. PRIORITY AREA 4: MENTAL HEALTH AND SUBSTANCE USE - PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE ISSUES AND CONDITIONS.
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COMMUNITY HEALTH NEEDS ASSESSMENT-APPROACH TO ADDRESSING HEALTH NEEDS
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(SCHEDULE H, PART V, SECTION B, LINE 11)A FULL UPDATE ON BID MILTON'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.SCHEDULE H-COMMUNITY BENEFITS ACCOMPLISHMENTS - IMPLEMENTATION STRATEGY UPDATEKEY: BASELINE-2023, YEAR 1-2024, YEAR 2-2025PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE THE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO HOUSING, FOOD INSECURITY, ECONOMIC INSECURITY, EDUCATION, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, LISTENING SESSIONS, AND THE BID MILTON COMMUNITY HEALTH SURVEY REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, AND ECONOMIC INSTABILITY. GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.STRATEGIES1. PROVIDE SUPPORT FOR IMPACTFUL PROGRAMS AND COMMUNITY INITIATIVES THAT ADDRESS ISSUES ASSOCIATED WITH THE SOCIAL DETERMINANTS OF HEALTH.2. SUPPORT PROGRAMS THAT STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSING.3. SUPPORT EDUCATION, SYSTEMS, PROGRAMS, AND ENVIRONMENTAL CHANGES TO INCREASE HEALTHY EATING AND ACCESS TO AFFORDABLE, HEALTHY FOODS.4. INCREASE MENTORSHIP, TRAINING, AND EMPLOYMENT OPPORTUNITIES TO INCREASE EMPLOYMENT AND EARNINGS AND INCREASE FINANCIAL SECURITY FOR YOUTH, YOUNG ADULTS, AND ADULTS RESIDING IN THE COMMUNITIES.5. SUPPORT PARTNERSHIPS WITH REGIONAL TRANSPORTATION PROVIDERS AND COMMUNITY PARTNERS TO ENHANCE ACCESS TO AFFORDABLE AND SAFE TRANSPORTATION.6. PARTICIPATE IN MULTI-SECTOR COMMUNITY COALITIONS TO CONVENE STAKEHOLDERS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. INITIATIVES TO ADDRESS THE PRIORITY- EMERGENCY FLEX FUNDING FOR DOMESTIC VIOLENCE SURVIVORS - COMMUNITY GRANT FUNDING FOR INITIATIVES TO ADDRESS ISSUES WITH SOCIAL DETERMINANTS OF HEALTH- RENTAL ASSISTANCE/EVICTION PREVENTION COMMUNITY GRANTS- COMMUNITY SUPPORTED AGRICULTURE (CSA) SHARES TO FOOD PANTRIES- NUTRITIONAL SUPPORTS FOR SENIORS IN AFFORDABLE HOUSING- COMMUNITY TABLE EVENTS- INTERNSHIP PROGRAMS IN MULTIPLE DEPARTMENTS: NURSING, RADIOLOGY, PHARMACY, ETC.- HIGH SCHOOL INTERNSHIP PROGRAM- HEALTHCARE SCHOLARSHIPSMETRICS AND STATUS UPDATE:* BASED ON DATA COLLECTED BETWEEN OCTOBER 1, 2024 AND SEPT 30, 2025- AMOUNT OF COMMUNITY GRANT DOLLARS FOR EMERGENCY FLEX FUNDING AWARDED TO DOVE FOR DOMESTIC VIOLENCE SURVIVORS (BASELINE: $5,000; YEAR 1: $5,000. YEAR 2: $5,000) - NUMBER OF PEOPLE SERVED (BASELINE: 5; YEAR 1:5) AND NUMBER OF CLIENTS PROVIDED WITH ADDITIONAL WRAP AROUND SERVICES (BASELINE: 5; YEAR 1: 5, YEAR 2: 14) - AMOUNT OF COMMUNITY GRANT FUNDING AWARDED TO ADDRESS SOCIAL DETERMINANTS OF HEALTH: (BASELINE: $5,000 ONE-TIME GRANT TO INSTALL NATIONAL FITNESS COURT TO ADDRESS BUILT ENVIRONMENT PROGRAM WAS FUNDED AND IMPLEMENTED FOR ONLY FOR FY23) - AMOUNT OF COMMUNITY GRANT FUNDING AWARDED TO MILTON EARLY CHILDHOOD ALLIANCE TO ADDRESS SOCIAL DETERMINANTS OF HEALTH (BASELINE: $5,000, YEAR 1: $5,000)- BID MILTON'S COMMUNITY HEALTH INITIATIVE - FRIENDLY FOOD PANTRY AMOUNT AWARDED (BASELINE: $20,603; YEAR 1: PROGRAM STAFF LEFT, YEAR 2: $41,206) - NUMBER OF POUNDS OF FOOD DISTRIBUTED (BASELINE: DATA NOT YET AVAILABLE; YEAR 1: 4,617, YEAR 2: METRIC NOT SUBMITTED) - NUMBER OF HOUSEHOLDS SERVED (YEAR 1: 460, YEAR 2: 677)- AMOUNT OF COMMUNITY GRANT FUNDING AWARDED TO THE MAY INSTITUTE TO IMPLEMENT WORKFORCE DEVELOPMENT INITIATIVES FOR YOUTH AND YOUNG ADULTS WITH DISABILITIES (BASELINE: $10,0000; YEAR 1: $10,000, YEAR 2: $10,000) - NUMBER OF STUDENTS PARTICIPATING (BASELINE: 50; YEAR 1: 30, YEAR 2: 35) - PERCENTAGE OF STUDENTS WITH INCREASED IMPROVEMENT IN SOCIAL AND TECHNICAL SKILLS (BASELINE: DATA NOT YET AVAILABLE; YEAR 1: 100% WITH 2 STUDENTS EARNING EMPLOYMENT IN THE COMMUNITY, YEAR 2: 100% IN AT LEAST ONE SKILL AREA)- AMOUNT OF COMMUNITY GRANT FUNDING AWARDED TO SOUTH SHORE ELDER SERVICES TO ADDRESS NON-MEDICAL TRANSPORTATION NEEDS FOR OLDER ADULTS IN (BASELINE: $6,000, YEAR 1: $6,000, YEAR 2: $9,000) - NUMBER OF RIDES PROVIDED: (BASELINE: DATA NOT YET AVAILABLE, YEAR 1: 610 ROUND-TRIP RIDES FOR 181 INDIVIDUALS, YEAR 2: 954 ROUND-TRIP RIDES FOR 395 INDIVIDUALS)- AMOUNT OF COMMUNITY GRANT FUNDING AWARDED TO QUINCY COMMUNITY ACTION PROGRAMS FOR RENTAL ASSISTANCE AND EVICTION PREVENTION (BASELINE: $15,000; YEAR 1: $15,000; YEAR 2: $15,000) - NUMBER OF INDIVIDUALS PREVENTED FROM EXPERIENCING HOMELESSNESS BY PROVIDING RENTAL ASSISTANCE (BASELINE: 15 HOUSEHOLDS FOR A TOTAL OF 25 INDIVIDUALS RECEIVED AN AVERAGE OF $900; YEAR 1: 13 HOUSEHOLDS FOR A TOTAL OF 31 INDIVIDUALS RECEIVED AN AVERAGE OF $923; YEAR 2: 25 HOUSEHOLDS FOR A TOTAL OF 65 INDIVIDUALS RECEIVED AN AVERAGE OF $1,200 ) AND PERCENT OF FAMILIES RECEIVING REFERRALS WHO THEN ENGAGED WITH ONE OR MORE AREA RESOURCES SERVICES (BASELINE:86%; YEAR 1: 100%; YEAR 2: 92% )- AMOUNT OF PRODUCE SUPPLIED TO FOOD PANTRIES (BASELINE: 420LBS.; YEAR 1: 420LBS; YEAR 2: 490LBS)- NUMBER OF MEALS DISTRIBUTED TO OLDER ADULTS (BASELINE: 500; YEAR 1: 500, YEAR 2: 500) - NUMBER OF NUTRITION CONSULTATIONS PERFORMED (BASELINE: 25; YEAR 1:30; YEAR 2: 35) AND NUMBER OF COMMUNAL LEARNING EVENTS (BASELINE: 2 COOKING DEMONSTRATIONS; YEAR 1: 7, YEAR 2: 2).- AMOUNT OF TRANSPORTATION VOUCHERS PROVIDED (BASELINE: $6,414; YEAR 1: $10,242, YEAR 2: $6,186)- NUMBER OF COLLEGE STUDENTS COMPLETING INTERNSHIPS (BASELINE: 4; YEAR 1: 5; YEAR 2: 3); NUMBER OF HOURS COMPLETED (BASELINE: 560; YEAR 1: 2,100, YEAR 2: 2,100); NUMBER OF STUDENTS HIRED FOR POSITIONS (BASELINE: 2; YEAR 1: 1; YEAR 2: 1)- NUMBER OF STUDENTS PARTICIPATING IN HIGH SCHOOL INTERNSHIP PROGRAM (BASELINE: 4; YEAR 1: 4; YEAR 2: 2) AND NUMBER OF HOURS COMPLETED (BASELINE: 200; YEAR 1: 271; YEAR 2: 168) - NUMBER OF JOB SHADOWING AND VOLUNTEER HOURS PROVIDED AT THE HOSPITAL BY AREA TEENAGERS (BASELINE: 500 HOURS; YEAR 1: 453).- NUMBER AND AMOUNT OF HEALTH CARE SCHOLARSHIPS PROVIDED (BASELINE: $500 SCHOLARSHIP PROVIDED TO 1 STUDENT; YEAR 1: $500 SCHOLARSHIP PROVIDED TO 1 STUDENT; YEAR 2: $500 SCHOLARSHIP PROVIDED TO 1 STUDENT)- BILH GOVERNMENT AFFAIRS ADVOCATED, DIRECTLY OR THROUGH THE STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS, FOR BILLS THAT SUPPORTED ACCESS TO SERVICES TO ADDRESS THE ROOT CAUSES OF POOR HEALTH OUTCOMES FOR ALL MASSACHUSETTS RESIDENTS (BASELINE: DATA NOT YET AVAILABLE; YEAR 1: 9; YEAR 2: 12).
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PRIORITY AREA 2: CHRONIC AND COMPLEX CONDITIONS
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CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN MASSACHUSETTS AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY. GOAL: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.STRATEGIES1. ADDRESS BARRIERS TO TIMELY CANCER AND CHRONIC DISEASE SCREENINGS AND FOLLOW-UP CARE THROUGH CULTURALLY APPROPRIATE NAVIGATION AND INNOVATIVE PROGRAMS.2. PROVIDE PREVENTATIVE HEALTH INFORMATION, SERVICES, AND SUPPORT FOR THOSE AT RISK FOR COMPLEX AND/ OR CHRONIC CONDITIONS AND SUPPORT EVIDENCE-BASED CHRONIC DISEASE TREATMENT AND SELF-MANAGEMENT PROGRAMS.3. ENSURE OLDER ADULTS HAVE ACCESS TO COORDINATED HEALTHCARE, SUPPORTIVE SERVICES AND RESOURCES THAT SUPPORT OVERALL HEALTH AND THE ABILITY TO AGE IN PLACE.INITIATIVES TO ADDRESS THE PRIORITY- LUNG CANCER SCREENING PROGRAM- DIABETES SELF-MANAGEMENT CLASSES- MATTER OF BALANCE CLASSES- PALLIATIVE CARE PROGRAM- MEDITATION CLASSESMETRICS AND STATUS UPDATES: - NUMBER OF PATIENTS SCREENED FOR LUNG CANCER (BASELINE: 786; YEAR 1: 917; YEAR 2: 1,148)- NUMBER OF COMMUNITY MEMBERS ENROLLED IN DIABETES SELF-MANAGEMENT COURSES (BASELINE: 8; YEAR 1: 6; YEAR 2: 12); PERCENTAGE OF PARTICIPANTS REPORTING A CHANGE IN BEHAVIOR TO BETTER MANAGE THEIR DIABETES (BASELINE: 80%; YEAR 1: 80%; YEAR 2: 100%) AND NUMBER OF PARTICIPANTS PROVIDED WITH FREE 3-MONTH GYM MEMBERSHIPS TO CONTINUE HEALTHY LIFESTYLE (BASELINE: 2; YEAR 1: 0; YEAR 2: 5)- NUMBER OF COMMUNITY MEMBERS ENROLLED IN MATTER OF BALANCE CLASSES (BASELINE: 8; YEAR 1: DATA NOT YET AVAILABLE, YEAR 2: 26); PERCENTAGE OF PARTICIPANTS REPORTING A DECREASED FEAR OF FALLING AND INCREASED PHYSICAL ACTIVITY LEVELS (BASELINE: 70%; YEAR 1: DATA NOT AVAILABLE; YEAR 2: 60%) AND NUMBER OF PARTICIPANTS PROVIDED WITH FREE 3-MONTH GYM MEMBERSHIPS TO CONTINUE A HEALTHY LIFESTYLE (BASELINE: 6; YEAR 1: 0; YEAR 2: 3) - NUMBER OF PALLIATIVE CARE CONSULTS PERFORMED (BASELINE:108; YEAR 1: 189; YEAR 2: 208) - NUMBER OF PROGRAMS CONDUCTED TO ADDRESS SOCIAL ISOLATION IN OLDER ADULTS (BASELINE: 22 MEDITATION CLASSES AND 14 MUSIC THERAPY CLASSES; YEAR 1: 16 MUSIC THERAPY CLASSES AND 6 COMMUNITY LUNCHEONS; YEAR 2: 16 MUSIC THERAPY CLASSES AND 8 BREAKFASTS) AND NUMBER OF PARTICIPANTS (BASELINE: 15-20 PARTICIPANTS IN EACH CLASS; YEAR 1: 10-15 PARTICIPANTS IN EACH CLASS, 120 PEOPLE FOR LUNCHEONS; YEAR 2: 10-15 PARTICIPANTS IN EACH CLASS, 160 PEOPLE FOR LUNCHEONS)PRIORITY AREA 3: EQUITABLE ACCESS TO CARE INDIVIDUALS IDENTIFIED SEVERAL BARRIERS TO ACCESSING AND NAVIGATING THE HEALTHCARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THE ISSUES STEM FROM HOW THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY.GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AND URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC AND ECONOMIC BARRIERS.STRATEGIES1. PROMOTE EQUITABLE CARE, HEALTH EQUITY, AND HEALTH LITERACY FOR PATIENTS, ESPECIALLY THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS.2. PROMOTE ACCESS TO HEALTH CARE, HEALTH INSURANCE, PATIENT FINANCIAL COUNSELORS, AND NEEDED MEDICATIONS FOR PATIENTS WHO ARE UNINSURED OR UNDERINSURED.3. PROVIDE AND PROMOTE CAREER SUPPORT SERVICES AND CAREER MOBILITY PROGRAMS TO HOSPITAL EMPLOYEES.INITIATIVES TO ADDRESS THE PRIORITY- INTERPRETER SERVICES- FINANCIAL COUNSELORS- PRIMARY CARE SUPPORT- PIPELINE PROGRAMS- CAREER AND ACADEMIC ADVISING - HOSPITAL-SPONSORED COMMUNITY COLLEGE COURSES - HOSPITAL-SPONSORED ENGLISH SPEAKERS OF OTHER LANGUAGES (ESOL) CLASSESMETRICS AND STATUS UPDATES: - NUMBER OF FACE-TO-FACE AND PHONE ENCOUNTERS PERFORMED BY INTERPRETER SERVICES (BASELINE: 9,169 ENCOUNTERS IN 57 LANGUAGES; YEAR 1:12,064 ENCOUNTERS IN 57 LANGUAGES; YEAR 2: 17,386 ENCOUNTERS IN 59 LANGUAGES)- NUMBER OF PEOPLE ASSISTED BY FINANCIAL COUNSELORS AND ENROLLED IN HEALTH INSURANCE (BASELINE: 520, YEAR 1: 124, WITH 1,098 UTILIZING THE HEALTH SAFETY NET; YEAR 2: 149 ASSISTED WITH 1,307 UTILIZING HEALTH SAFETY NET)- NUMBER OF NEW PATIENTS IN MILTON, QUINCY AND RANDOLPH PRIMARY CARE OFFICES (BASELINE: 3,159, YEAR 1: 2,248; YEAR 2: 2,080) - NUMBER OF WORKFORCE DEVELOPMENT EVENTS AND PRESENTATIONS CONDUCTED WITH COMMUNITY PARTNERS (BASELINE: 67, YEAR 1: 33; YEAR 2: 42)- NUMBER OF PIPELINE PROGRAMS OFFERED AT BID MILTON (BASELINE: 2, YEAR 1: 2, YEAR 2: 0)- NUMBER OF EMPLOYEES THAT SUCCESSFULLY COMPLETED CENTRAL STERILE TECH PROCESSING PIPELINE PROGRAM (CPTECH) AND HIRED (BASELINE: 2, YEAR 1: 0, YEAR 2: 0)- NUMBER OF EMPLOYEES THAT ACCESSED CAREER AND ACADEMIC ADVISING SESSIONS (BASELINE: 46, YEAR 1: 1,044 ACROSS BILH, YEAR 2: 831 ACROSS BILH)- NUMBER OF EMPLOYEES ENROLLED IN HOSPITAL-SPONSORED COLLEGE COURSES (BASELINE: 4; YEAR 1: 14 BILH EMPLOYEES ATTENDED CITIZENSHIP CLASSES, 15 BILH EMPLOYEES ATTENDED CAREER DEVELOPMENT WORKSHOPS AND 207 BILH EMPLOYEES ATTENDED FINANCIAL LITERACY CLASSES; YEAR 2: 12 BILH EMPLOYEES ATTENDED CITIZENSHIP CLASSES, 102 BILH EMPLOYEES ATTENDED CAREER DEVELOPMENT WORKSHOPS AND 138 BILH EMPLOYEES ATTENDED FINANCIAL LITERACY CLASSES)- NUMBER OF EMPLOYEES ENROLLED IN ESOL CLASSES AT BID MILTON (BASELINE: 1; YEAR 1: 82 ACROSS BILH; YEAR 2: 126 ACROSS BILH) - NUMBER OF JOB SEEKERS REFERRED TO BILH (BASELINE: 225; YEAR 1: 412; YEAR 2: 306)- NUMBER OF JOB SEEKERS HIRED ACROSS BILH (BASELINE: 70; YEAR 1: 111; YEAR 2: 79)- NUMBER OF COMMUNITY COLLEGE STUDENTS WHO APPLIED AS CERTIFIED NURSING ASSISTANTS AND HIRED (BASELINE: 9, PROGRAM WAS FUNDED AND IMPLEMENTED FOR ONLY FOR FY23)- NUMBER OF PEOPLE TRAINED (BASELINE: 89 COMMUNITY MEMBERS TRAINED ACROSS BILH - PATIENT CARE TECHNICIAN OR NURSING ASSISTANT (30), PHARMACY TECH (16), PERIOPERATIVE LPN (3), MEDICAL ASSISTANT (21) AND BEHAVIORAL HEALTH ROLES (4) AND 15 WERE ENROLLED INTO THE ASSOCIATE DEGREE NURSING RESIDENCY PROGRAM BID MILTON PARTICIPATED IN THESE TRAININGS); YEAR 1: 107 COMMUNITY MEMBERS PLACED IN INTERNSHIPS ACROSS BILH HOSPITALS, 37 INTERNS WERE HIRED PERMANENTLY IN BILH HOSPITALS; YEAR 2: 36 INTERNS HIRED ACROSS BILH).- BILH GOVERNMENT AFFAIRS ADVOCATED, DIRECTLY OR THROUGH THE STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS, FOR BILLS SUPPORTING EQUITABLE HEALTH CARE ACCESS FOR ALL MASSACHUSETTS RESIDENTS (BASELINE: DATA NOT YET AVAILABLE; YEAR 1: 23; YEAR 2: 24).
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PRIORITY AREA 4: MENTAL HEALTH AND SUBSTANCE USE
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ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES ON YOUTH AND YOUNG ADULTS, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. THOSE WHO PARTICIPATED IN THE ASSESSMENT ALSO REFLECTED ON THE STIGMA, SHAME, AND ISOLATION THAT THOSE WITH MENTAL HEALTH CHALLENGES FACE THAT LIMIT THEIR ABILITY TO ACCESS CARE AND COPE WITH THEIR ILLNESS. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH AND ECONOMIC INSECURITY. INTERVIEWEES, FOCUS GROUP, AND LISTENING SESSION PARTICIPANTS ALSO REPORTED THAT ALCOHOL USE IS NORMALIZED, AND USE IS PREVALENT AMONG BOTH ADULTS AND YOUTH.GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE ISSUES AND CONDITIONS.STRATEGIES1. SUPPORT IMPACTFUL PROGRAMS THAT PROMOTE HEALTHY DEVELOPMENT, SUPPORT CHILDREN, YOUTH, AND THEIR FAMILIES, AND INCREASE THEIR RESILIENCE, COPING AND PREVENTION SKILLS.2. BUILD THE CAPACITY OF COMMUNITY MEMBERS TO UNDERSTAND THE IMPORTANCE OF MENTAL HEALTH AND SUBSTANCE USE, AND REDUCE NEGATIVE STEREOTYPES, BIAS, AND STIGMA AROUND MENTAL ILLNESS AND SUBSTANCE USE DISORDERS.3. PARTICIPATE IN MULTISECTOR COMMUNITY COALITIONS TO CONVENE STAKEHOLDERS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES TO INCREASE RESILIENCY, REDUCE YOUTH SUBSTANCE USE, AND PREVENT OPIOID OVERDOSES AND DEATHS.4. PROVIDE ACCESS TO HIGH-QUALITY AND CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE USE SERVICES THROUGH SCREENING, MONITORING, COUNSELING, NAVIGATION, AND TREATMENT.INITIATIVES TO ADDRESS THE PRIORITY- TRAUMA INFORMED SCHOOLS- GETTING THE TEENS OUT- COMMUNITY GRANT FUNDING TO INCREASE RESILIENCE, COPING AND PREVENTION SKILLS- MENTAL HEALTH FIRST AID - COGNITIVE BEHAVIORAL THERAPY (CBT) CLASSES- COALITION INVOLVEMENT- RECOVERY COACHES- COLLABORATIVE CARE MODEL- PRESCRIPTION TAKE-BACK KIOSKMETRICS AND STATUS UPDATES* FY23 INFORMATION IS BASED ON DATA COLLECTED BETWEEN JULY 1, 2021 AND SEPT 30, 2023. A NEW COHORT OF BEHAVIORAL HEALTH GRANTEES RECEIVED 3-YEAR GRANTS THAT BEGAN JANUARY 2024. DATA COLLECTION BEGAN APRIL 2024 AND IS ONGOING.- AMOUNT OF GRANT FUNDING AWARDED TO MILTON PUBLIC SCHOOLS TO IMPLEMENT RESILIENCE, PREVENTION SKILLS AND MENTAL HEALTH PROGRAMS (BASELINE: $12,500; YEAR 1: $12,500; YEAR 2: $5,000) - NUMBER OF STAFF TRAINED TO IMPLEMENT TRAUMA INFORMED SCHOOLS CLASSROOM CURRICULUM (BASELINE:12, YEAR 1:18, YEAR 2: 15) - NUMBER OF 5TH GRADE STUDENTS PARTICIPATING IN BOTVIN LIFE SKILLS TRAINING (BASELINE: 164; YEAR 1: 368) AND CHANGE IN KNOWLEDGE, BEHAVIOR OR SKILLS (BASELINE: 80% REPORTED INCREASED LEARNING AND STRESS COPING MECHANISMS; YEAR 1: 77% REPORTED INCREASED LEARNING AND STRESS COPING MECHANISMS; YEAR 2: PROGRAM ENDED)- IN FY24 GRANT FUNDING PROVIDED BY BILH TO QUINCY PUBLIC SCHOOLS FOR DEVELOPMENT AND IMPLEMENTATION OF COMMUNITY BEHAVIORAL HEALTH NAVIGATOR PROGRAM - NUMBER OF STUDENTS AND FAMILIES REFERRED TO PARTNER MENTAL HEALTH AGENCIES AND QUINCY PUBLIC SCHOOLS STAFF (YEAR 2: 135) - NUMBER OF EDUCATIONAL EVENTS HELD TO INCREASE AWARENESS OF MENTAL HEALTH RESOURCES AND SUPPORTS (YEAR 2: 4) - NUMBER OF PARTICIPANTS REACHED AT EDUCATIONAL EVENTS (YEAR 2: 170)- NUMBER "GETTING THE TEENS OUT" GROUPS CONDUCTED AND NUMBER OF PARTICIPANTS (BASELINE: 12 GROUPS HELD WITH 116 PARTICIPANTS; YEAR 1: 4 GROUPS WITH 90 PARTICIPANTS; YEAR 2: PROGRAM ENDED)- NUMBER OF COMMUNITY MEMBERS TRAINED IN MENTAL HEALTH FIRST AID (BASELINE: 49; YEAR 1: 380; YEAR 2: 146) - NUMBER OF CBT CLASSES (BASELINE: PROGRAM STAFF LEFT; YEAR 1: PROGRAM STAFF LEFT)- AMOUNT OF GRANT FUNDING AWARDED TO THE MILTON COALITION (FORMERLY MILTON SUBSTANCE ABUSE PREVENTION COALITION) (BASELINE: $15,000; YEAR 1: $15,000; YEAR 2: $15,000), NUMBER OF SECTORS REPRESENTED ON COALITION (BASELINE: 14, YEAR 1: 14, YEAR 2:14 AND NUMBER OF ADDITIONAL YOUTH MEMBERS RECRUITED (BASELINE: 5, YEAR 1: 4, YEAR 2: 20) - NUMBER OF BILLS BILH GOVERNMENT AFFAIRS ADVOCATED FOR, DIRECTLY OR THROUGH THE STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS, TO SUPPORT ACCESS TO MENTAL HEALTH AND SUBSTANCE USE SERVICES FOR ALL MASSACHUSETTS RESIDENTS (BASELINE: DATA NOT YET AVAILABLE; YEAR 1: 8; YEAR 2: 10)- NUMBER OF PATIENTS SCREENED AND TRANSFERRED TO TREATMENT BY RECOVERY COACHES (BASELINE: 418 SCREENED, 200 TRANSFERRED TO TREATMENT; YEAR 1: 436 SCREENED, 172 TRANSFERRED TO TREATMENT; YEAR 2: 379 SCREENED, 133 TRANSFERRED TO TREATMENT) - NUMBER OF PATIENTS RECEIVING EMERGENCY PSYCHIATRIC EVALUATIONS FOR PLACEMENT IN AN INPATIENT PSYCHIATRIC UNIT AND/OR CRISIS STABILIZATION UNIT (BASELINE: 571; YEAR 1: 1,027; YEAR 2: 1,872)- NUMBER OF PATIENTS SERVED BY BEHAVIORAL HEALTH CLINICIANS EMBEDDED INTO PRIMARY CARE PRACTICES (BASELINE: 336; YEAR 1: 462; YEAR 2: 584)- AMOUNT OF DISCARDED PRESCRIPTION MEDICATIONS COLLECTED (BASELINE: 23 POUNDS; YEAR 1: 79 POUNDS; YEAR 2: 122 POUNDS)COMMUNITY PARTNERSBID MILTON IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE:- A NEW WAY RECOVERY CENTER- ASIAN AMERICAN SERVICE ASSOCIATION- ASPIRE HEALTH ALLIANCE - BAY STATE COMMUNITY SERVICES - BID MILTON PATIENT FAMILY ADVISORY COUNCIL- BROOKWOOD COMMUNITY FARM- CHOICE COMMUNITY SUPPORTS- CURRY COLLEGE - DOVE, INC- ENHANCE ASIAN COMMUNITIES ON HEALTH- FATHER BILLS & MAINSPRING HOUSE- FRIENDLY FOOD PANTRY- FULLER VILLAGE - GOSNOLD RECOVERY SERVICES- HARBORVIEW RESIDENTS ASSOCIATION- INTERFAITH SOCIAL SERVICES - MANET COMMUNITY HEALTH CENTERS - MAY INSTITUTE- METROPOLITAN AREA PLANNING COUNCIL- MILTON BOARD OF HEALTH - MILTON CHAMBER OF COMMERCE- MILTON COUNCIL ON AGING - MILTON COALITION FORMERLY KNOWN AS MILTON SUBSTANCE ABUSE PREVENTION COALITION - MILTON EARLY CHILDHOOD ALLIANCE- MILTON HOUSING AUTHORITY- MILTON POLICE DEPARTMENT- MILTON PUBLIC LIBRARY- MILTON PUBLIC SCHOOLS - MILTON YOUTH ADVOCATES FOR CHANGE- PARKWAY UNITED METHODIST CHURCH- PARTNERSHIP FOR A HEALTHY MILTON- QUINCY ASIAN RESOURCES- QUINCY BOARD OF HEALTH - QUINCY CHAMBER OF COMMERCE- QUINCY COMMUNITY ACTION PROGRAMS - QUINCY CREDIT UNION- QUINCY FAMILY RESOURCE CENTER- QUINCY PUBLIC SCHOOLS - QUINCY POLICE DEPARTMENT- QUINCY PRIDE- RANDOLPH BOARD OF HEALTH - RANDOLPH COMMUNITY WELLNESS PLAN STEERING COMMITTEE- RANDOLPH COMMUNITY PARTNERSHIP- RANDOLPH EDUCATIONAL COLLABORATIVE- RANDOLPH INTERGENERATIONAL COMMUNITY CENTER- RANDOLPH PUBLIC SCHOOLS- SIMON C. FIREMAN COMMUNITY- SOUTH COVE COMMUNITY HEALTH CENTER- SOUTH SHORE CHAMBER OF COMMERCE- SOUTH SHORE ELDER SERVICES - SOUTH SHORE FOOD BANK- SOUTH SHORE YMCA- WINTER VALLEY- UNQUITY HOUSEAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, BID MILTON IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE MOST RECENT CHNA THAT ARE NOT INCLUDED IN THE IMPLEMENTATION STRATEGY MOST RECENTLY ADOPTED BY BID MILTON DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024) AND WHICH WILL INFORM BID MILTON'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIODS SEPTEMBER 30, 2026, SEPTEMBER 30, 2027 AND SEPTEMBER 30, 2028. NEEDS IDENTIFIED IN THAT CHNA WHICH WILL NOT BE ADDRESSED ARE: STRENGTHENING THE BUILT ENVIRONMENT (I.E. IMPROVING ROADS/SIDEWALKS). BID MILTON IS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES AND BID MILTON'S CBAC AND SENIOR LEADERSHIP TEAM DECIDING THAT THE ISSUE WAS OUTSIDE OF THE ORGANIZATION'S SPHERE OF INFLUENCE AND INVESTMENTS IN OTHERS AREAS WERE BOTH MORE FEASIBLE AND LIKELY TO HAVE GREATER IMPACT. HOWEVER, BID MILTON REMAINS OPEN AND WILLING TO WORK WITH THE OTHER BILH HOSPITALS AND/OR COMMUNITY PARTNERS TO ADDRESS THESE ISSUES.
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IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE PREVIOUS CHNA THAT
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WERE NOT INCLUDED IN THE PREVIOUS IMPLEMENTATION STRATEGY, BOTH OF WHICH GUIDED BID MILTON'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIOD COVERED BY THIS FILING. BID MILTON WAS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES BID MILTON'S CBAC AND SENIOR LEADERSHIP TEAM DECIDING THAT THE ISSUE WAS OUTSIDE OF THE ORGANIZATION'S SPHERE OF INFLUENCE AND INVESTMENTS IN OTHERS AREAS WERE BOTH MORE FEASIBLE AND LIKELY TO HAVE GREATER IMPACT. BID MILTON WAS OPEN TO, WILLING TO AND MAY HAVE WORKED WITH THE OTHER BILH HOSPITALS AND/OR COMMUNITY PARTNERS TO ADDRESS THESE ISSUES AS DESCRIBED IN THIS NARRATIVE SUPPORT TO FORM 990 SCHEDULE H. AS NOTED IN DETAIL ABOVE, BID MILTON'S PRIMARY TOOL FOR ASSESSING THE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW BID MILTON CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H,10.89% OF BID MILTON'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITS--ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, BID MILTON'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT HTTPS://BIDMILTON.ORG/ABOUT/COMMUNITY-BENEFITS-NEEDS.THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT BID MILTON FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, BID-MILTON IS A GENERAL MEDICAL AND SURGICAL HOSPITAL PROVIDING EMERGENCY MEDICAL CARE TO ALL PATIENTS 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR WITHOUT REGARD TO ABILITY TO PAY (SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21).FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS--CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEBID-MILTON'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $880,273 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, BID-MILTON IS ONE OF ELEVEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING FOR THE MASSACHUSETTS HOSPITALS, PAYMENTS TO THE MASSACHUSETTS HEALTH SAFETY NET TRUST, WAS MORE THAN $62 MILLION FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, FOR THE PERIOD COVERED BY THIS FILING, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE. ELIGIBILITY IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CARE--MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, BID-MILTON ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BID-MILTON GENERATED $3,500,300 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY BID-MILTON FOR SUCH SERVICES WHICH RESULTED IN A MEDICAID SHORTFALL OF $1,444,009 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 15.0% OR APPROXIMATELY 33,159 PATIENT ENCOUNTERS OF BID-MILTON'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION. 43.3% OR APPROXIMATELY 95,929 PATIENT CASES OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. IN ADDITION EACH OF THE OTHER BILH HOSPITALS ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM AND AS NOTED ABOVE, PAYMENTS FROM MEDICAID FOR LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ACROSS THE BILH HOSPITALS THE COST OF PROVIDING CARE TO MEDICAID PATIENTS EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE RESULTING IN A COMBINED SHORTFALL OF APPROXIMATELY $104 MILLION RELATED TO TREATING MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND BID-MILTON PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BID-MILTON GENERATED $50,073,667 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE WHICH RESULTED IN A MEDICARE SHORTFALL OF $8,113,634. OF THESE AMOUNTS, REVENUE OF $36,433,048 IS RELATED TO THE PROVISION OF ORTHOPEDICS, OBGYN, UROLOGY, AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES BECAUSE THE COST OF THOSE SERVICES EXCEEDED REVENUES BY $3,661,504. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH BID-MILTON CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, BID-MILTON HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 15.34%.
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BAD DEBTS
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IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, BID-MILTON ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. COSTS FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $260,100 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH) AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 INCLUDE THE ACCOUNTS OF: BETH ISRAEL LAHEY HEALTH (BILH), BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -- MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH, INC. (BID-PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER (JDC), EXETER HEALTH RESOURCES, INC (EHRI), EXETER HOSPITAL (EH), BETH ISRAEL LAHEY HEALTH PHARMACY, THE ENTITIES WHICH COMPRISE, AMONG OTHER OPERATIONS, BETH ISRAEL LAHEY HEALTH CONTINUING CARE AND BETH ISRAEL LAHEY HEALTH MEDICAL GROUP AS WELL AS OTHER ENTITIES FOR WHICH BILH SERVES AS DIRECT OR INDIRECT SOLE MEMBER. THE BILH CONSOLIDATED FINANCIAL STATEMENTS ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) AND THE ENTITIES FOR WHICH HMFP SERVES AS DIRECT OR INDIRECT SOLE MEMBER. SEE FORM 990 SCHEDULE R AND A COPY OF THE AUDITED FINANCIAL STATEMENTS ATTACHED TO THIS FORM 990 FOR ADDITIONAL INFORMATIONFINANCIAL STATEMENT FOOTNOTESBAD DEBTSTHE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSTHE SYSTEM'S PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE SYSTEM EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING MANAGED CARE PAYORS AND GOVERNMENT PROGRAMS), AND OTHERS AND INCLUDE AN ESTIMATE OF VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE SYSTEM BILLS THE PATIENTS AND THIRD-PARTY PAYORS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED AND/OR THE PATIENT IS DISCHARGED FROM THE SYSTEM'S FACILITY.REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. PERFORMANCE OBLIGATIONS ARE DETERMINED BASED ON THE NATURE OF THE SERVICES PROVIDED BY THE SYSTEM. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED (OR ACTUAL) CHARGES. THE SYSTEM BELIEVES THAT THIS METHOD PROVIDES A REASONABLE REPRESENTATION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO INPATIENT SERVICES. THE SYSTEM MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE HOSPITAL, OR COMMENCEMENT OF A PATIENT SERVICE, TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TOTHAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE OR COMPLETION OF THE OUTPATIENT SERVICES. PATIENT ENCOUNTERS AND RELATED EPISODES OF CARE AND PROCEDURES QUALIFY AS DISTINCT GOODS AND SERVICES, PROVIDED SIMULTANEOUSLY TOGETHER WITH OTHER READILY AVAILABLE RESOURCES, IN A SINGLE INSTANCE OF SERVICE, AND THEREBY CONSTITUTE A SINGLE PERFORMANCE OBLIGATION FOR EACH PATIENT ENCOUNTER AND, IN MOST INSTANCES, OCCUR AT READILY DETERMINABLE TRANSACTION PRICES. ALL SERVICES PROVIDED ARE EXPECTED TO RESULT IN CASH FLOWS AND ARE THEREFORE REFLECTED AS NET REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. THE ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS ARE BASED ON CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES AND HISTORICAL CASH COLLECTION EXPERIENCE. DIFFERENCES BETWEEN STANDARD CHARGES AND ESTIMATED TRANSACTION PRICE AREGENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE AND ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. ADJUSTMENTS ARISING FROM A CHANGE IN THE TRANSACTION PRICE WERE NOT SIGNIFICANT DURING THE YEARS ENDED SEPTEMBER 30, FOR 2025 OR 2024.REVENUES UNDER THE TRADITIONAL FEE FOR SERVICE MEDICARE AND MEDICAID PROGRAMS ARE BASED PRIMARILY ON PROSPECTIVE PAYMENT SYSTEMS. RETROSPECTIVELY DETERMINED COST-BASED REVENUES UNDER THESE PROGRAMS, WHICH WERE MORE PREVALENT IN EARLIER PERIODS, AND CERTAIN OTHER PAYMENTS, SUCH AS DISPROPORTIONATE SHARE HOSPITAL AND BAD DEBT EXPENSE REIMBURSEMENT, WHICH ARE BASED ON OUR HOSPITALS' COST REPORTS, ARE ESTIMATED USING HISTORICAL TRENDS AND CURRENT FACTORS. COST REPORT SETTLEMENTS UNDER THESE PROGRAMS ARE SUBJECT TO AUDIT BY MEDICARE AND MEDICAID AUDITORS AND ADMINISTRATIVE AND JUDICIAL REVIEW, AND IT CAN TAKE SEVERAL YEARS UNTIL FINAL SETTLEMENT OF SUCH MATTERS IS DETERMINED AND COMPLETELY RESOLVED. THE SYSTEM RECORDS ACCRUALS TO REFLECT THE EXPECTED FINAL SETTLEMENTS ON COST REPORTS. FOR FILED COST REPORTS, THE ACCRUAL IS RECORDED BASED ON THOSE COST REPORTS AND SUBSEQUENT ACTIVITY. THE ACCRUAL FOR PERIODS FOR WHICH A COST REPORT IS YET TO BE FILED IS RECORDED BASED ON ESTIMATES OF WHAT THE SYSTEM EXPECTS TO REPORT ON THE FILED COST REPORTS. AFTER THE COST REPORT IS FILED, THE ACCRUAL MAY NEED TO BE ADJUSTED.SETTLEMENTS WITH THIRD-PARTY PAYORS FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO AUDITS, REVIEWS OR INVESTIGATIONS ARE CONSIDERED VARIABLE CONSIDERATION AND ARE INCLUDED IN THE DETERMINATION OF THE ESTIMATED TRANSACTION PRICE FOR PROVIDING PATIENT CARE USING THE MOST LIKELY OUTCOME METHOD. THESE SETTLEMENTS ARE ESTIMATED BASED ON THE TERMS OF THE PAYMENT AGREEMENT WITH THE PAYOR, CORRESPONDENCE FROM THE PAYOR AND HISTORICAL SETTLEMENT ACTIVITY, INCLUDING AN ASSESSMENT TO ENSURE THAT IT IS PROBABLE THAT A SIGNIFICANT REVERSAL IN THE AMOUNT OF CUMULATIVE REVENUE RECOGNIZED WILL NOT OCCUR WHEN THE UNCERTAINTY ASSOCIATED WITH THE RETROACTIVE ADJUSTMENT IS SUBSEQUENTLY RESOLVED. ESTIMATED SETTLEMENTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN, OR AS YEARS ARE SETTLED OR ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS.THE SYSTEM IS NOT AWARE OF ANY MATERIAL CLAIMS, DISPUTES, OR UNSETTLED MATTERS WITH ANY PAYORS THAT WOULD AFFECT REVENUES THAT HAVE NOT BEEN ADEQUATELY PROVIDED FOR AND DISCLOSED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. BECAUSE THE LAWS, REGULATIONS, INSTRUCTIONS AND RULE INTERPRETATIONS GOVERNING MEDICARE AND MEDICAID REIMBURSEMENT ARE COMPLEX, SUBJECT TO INTERPRETATION AND CAN CHANGE FREQUENTLY, THE ESTIMATES RECORDED COULD CHANGE BY MATERIAL AMOUNTS.
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CONSISTENT WITH THE SYSTEM'S MISSION, CARE IS PROVIDED TO PATIENTS
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REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES (E.G., COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE SYSTEM EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. PATIENTS WHO MEET THE SYSTEM'S CRITERIA FOR CHARITY CARE ARE PROVIDED CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THE SYSTEM HAS DETERMINED THAT IT HAS PROVIDED SUFFICIENT IMPLICIT PRICE CONCESSIONS FOR THESE ACCOUNTS. PRICE CONCESSIONS, INCLUDING CHARITY CARE, ARE NOT REPORTED AS REVENUE.PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED CO-PAYS, CO-INSURANCE AND DEDUCTIBLES, WHICH VARY IN AMOUNT. THE SYSTEM ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH CO-PAYS, CO-INSURANCE AND DEDUCTIBLES AND FOR THOSE WHO ARE UNINSURED BASED ON HISTORICAL COLLECTION EXPERIENCE AND CURRENT MARKET CONDITIONS. THE DISCOUNT OFFERED TO CERTAIN UNINSURED PATIENTS IS RECOGNIZED AS A CONTRACTUAL ALLOWANCE, WHICH REDUCES NET OPERATING REVENUES AT THE TIME THE SELF-PAY ACCOUNTS ARE RECORDED. THE UNINSURED PATIENT ACCOUNTS, NET OF CONTRACTUAL ALLOWANCES RECORDED, ARE FURTHER REDUCED TO THEIR NET REALIZABLE VALUE AT THE TIME THEY ARE RECORDED THROUGH IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION TRENDS FOR SELF-PAY ACCOUNTS AND OTHER FACTORS THAT AFFECT THE ESTIMATION PROCESS. ALTHOUGH OUTCOMES VARY, THE SYSTEM'S POLICY IS TO ATTEMPT TO COLLECT AMOUNTS DUE FROM PATIENTS, INCLUDING CO-PAYS, CO-INSURANCE AND DEDUCTIBLES DUE FROM PATIENTS WITH INSURANCE, AT THE TIME OF SERVICE WHILE COMPLYING WITH ALL FEDERAL AND STATE STATUTES AND REGULATIONS.OTHER REVENUE INCLUDES CONTRIBUTIONS AND NET ASSETS RELEASED FROM RESTRICTIONS AS WELL AS CAFETERIA AND PARKING INCOME.ADDITIONALLY, PHARMACY SALES AND OTHER CONTRACTS RELATED TO HEALTH CARE SERVICES ARE INCLUDED IN OTHER REVENUE AND CONSIST OF CONTRACTS WHICH VARY IN DURATION AND IN PERFORMANCE. REVENUE IS RECOGNIZED WHEN THE PERFORMANCE OBLIGATIONS IDENTIFIED WITHIN THE INDIVIDUAL CONTRACTS ARE SATISFIED AND COLLECTIONS ARE PROBABLE. OTHER REVENUE FOR THE YEARS ENDED SEPTEMBER 30, 2025 AND 2024 ALSO INCLUDED FUNDING RECEIVED FROM FEDERAL AND STATE SOURCES RELATED TO THE COVID-19 PANDEMIC AMOUNTING TO $21,248 AND $17,500, RESPECTIVELY.FINANCIAL ASSISTANCE POLICY-INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE BID-MILTON IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION AND MAINTAINS A FINANCIAL ASSISTANCE POLICY (FAP) WHICH IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE FREE OR DISCOUNTED CARE FROM BID-MILTON AS WELL AS PROVIDERS WHO FOLLOW BID-MILTON'S FAP. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN BID-MILTON AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW BID-MILTON'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. BID-MILTON DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION OR DISABILITY WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY AN AUTHORIZED BODY AS REQUIRED PURSUANT TO THE IRC SECTION 501(R) TREASURY REGULATIONSFINANCIAL ASSISTANCE POLICY-APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY-ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP.(SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE-PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP,FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED,THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS.IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS,THE HOSPITAL WILL OFFER ALL INDIVIDUALS A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS(INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR,THE CHILDREN'S MEDICAL SECURITY PROGRAM,THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP).SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS.THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN.FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE(WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE),A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR.INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.
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FINANCIAL ASSISTANCE POLICY-TRANSLATIONS
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THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: ENGLISH, HAITIAN CREOLE, SPANISH, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, AND VIETNAMESE (SCHEDULE H PART V SECTION B QUESTION 16I).FINANCIAL ASSISTANCE POLICY-WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FINANCIAL ASSISTANCE POLICY (FAP), CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://BIDMILTON.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE.IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY--PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE BID-MILTON FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. - CREDIT AND COLLECTION POLICY- APPLICATION FOR FINANCIAL ASSISTANCE- MEDICAL HARDSHIP APPLICATION- FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN ENGLISH, HAITIAN CREOLE, SPANISH, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, AND VIETNAMESE CAN BE FOUND ON BID-MILTON WEBSITE AT: HTTPS://BIDMILTON.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE. LIMITATION ON CHARGES--INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED-LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS-501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL HAS NOT ENGAGED IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).THE HOSPITAL MAY DEFER OR REQUIRE PAYMENT BEFORE PROVIDING MEDICALLY NECESSARY SERVICES (OTHER THAN EMERGENCY MEDICAL SERVICES) TO PATIENTS WITH UNPAID BALANCES WHO HAVE FAILED TO PROVIDE REQUESTED INFORMATION FOR PROCESSING A FINANCIAL ASSISTANCE APPLICATION OR WITH RESPECT TO A PAYMENT PLAN. THE HOSPITAL DOES NOT PROVIDE A 30-DAY WRITTEN NOTICE IN ADVANCE OF TAKING SUCH ACTION, AS SUCH NOTICE IS NOT REQUIRED BY THE SECTION 501(R) REGULATIONS. (SCHEDULE H PART V SECTION B QUESTION 20).
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APPLICATION PERIOD
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PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSRESEARCHAS NOTED THROUGHOUT THIS FORM 990, BIDM IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH BIDM DOES NOT DIRECTLY ENGAGE IN RESEARCH, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC),LAHEY CLINIC, NEW ENGLAND BAPTIST HOSPITAL AND JOSLIN DIABETES CENTER ALL ENGAGE IN RESEARCH ACTIVITIES DESIGNED TO CARE FOR PATIENTS NOT ONLY AT THESE HOSPITALS, BUT ACROSS THE COMMUNITIES SERVED BY BILH AND BEYOND. BIDMC HAS THE LARGEST RESEARCH OPERATIONS ACROSS BILH AND DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $398 MILLION IN RESEARCH EXPENSES, APPROXIMATELY $94 MILLION OF WHICH WERE INTERNALLY FUNDED. ALTHOUGH THE RESEARCH ACTIVITIES OF BIDMC AND OTHER BILH AFFILIATES ARE NOT QUANTIFIED HERE IN BIDM'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY BIDM, BILH AND BEYOND. INFORMATION ON THE RESEARCH ENGAGED IN AT BIDMC AND JOSLIN,A SISTER ENTITIES TO BIDM, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION.TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES.THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING.THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE.DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,220 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 280 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY.THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN,HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS.THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION.THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD-RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE,THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:- ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE - EMERGENCY MEDICINE - MEDICINE - ALLERGY AND INFLAMMATION - CARDIOVASCULAR MEDICINE - CENTER FOR VASCULAR BIOLOGY RESEARCH - CLINICAL INFORMATICS - CLINICAL NUTRITION - ENDOCRINOLOGY - EXPERIMENTAL MEDICINE - GASTROENTEROLOGY - GENERAL MEDICINE AND PRIMARY CARE - GENETICS - GERONTOLOGY - HEMATOLOGY AND ONCOLOGY - HEMOSTASIS AND THROMBOSIS - IMMUNOLOGY - INFECTIOUS DISEASE - INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGY - MOLECULAR AND VASCULAR MEDICINE - NEPHROLOGY - PULMONOLOGY - RHEUMATOLOGY - SIGNAL TRANSDUCTION - TRANSLATIONAL RESEARCH - TRANSPLANT IMMUNOLOGY- NEONATOLOGY - NEUROLOGY - OBSTETRICS AND GYNECOLOGY - ORTHOPAEDIC SURGERY - PATHOLOGY - PSYCHIATRY - RADIOLOGY - SURGERY - CARDIAC SURGERY - CENTER FOR MINIMALLY INVASIVE SURGERY - NEUROSURGERY - PLASTIC AND RECONSTRUCTIVE SURGERY - VASCULAR SURGERY- TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $398 MILLION IN RESEARCH EXPENSES, APPROXIMATELY $94 MILLION OF WHICH WERE INTERNALLY FUNDED AND REPORTED ON THE BIDMC SCHEDULE H,PART I,LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE.RESEARCH ENGAGED IN AT THE MEDICAL CENTER:THE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION.BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN THE MEDICAL CENTER'S FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H,PART I,LINE 7H COLUMN E,DEPENDING ON FUNDING SOURCE. DETAIL ON RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. 1. MORE AMERICANS ARE UNAWARE THEY HAVE DIABETES, HIGH BLOOD PRESSURE, CHOLESTEROLIN A NEW REPORT PUBLISHED IN JAMA CARDIOLOGY, HEALTH POLICY EXPERTS AT BIDMC'S RICHARD A. AND SUSAN F. SMITH CENTER FOR OUTCOMES RESEARCH SHOWED THAT MANY U.S. ADULTS ARE UNAWARE THEY HAVE HIGH BLOOD PRESSURE, DIABETES OR HIGH CHOLESTEROL-THREE MAJOR RISK FACTORS FOR CARDIOVASCULAR DISEASE AND DEATH. THE PROPORTION OF AMERICANS UNAWARE THEY HAVE HYPERTENSION HAS RISEN OVER THE PAST DECADE, ESPECIALLY AMONG YOUNGER ADULTS AND WOMEN."YOUNG ADULTS WERE THE MOST LIKELY TO NOT REALIZE THAT THEY HAD HIGH BLOOD PRESSURE, DIABETES, OR HIGH CHOLESTEROL," SAID RISHI WADHERA, MD, MPP, MPHIL, ASSOCIATE DIRECTOR OF THE SMITH CENTER. "IT'S ESPECIALLY CONCERNING THAT ONE IN THREE YOUNG ADULTS WERE UNAWARE OF THEIR HIGH BLOOD PRESSURE, TWO IN FIVE DIDN'T KNOW THEY HAD DIABETES, AND ONE IN FOUR WERE UNAWARE OF HAVING HIGH CHOLESTEROL.THAT'S A MAJOR PUBLIC HEALTH ISSUE."THE ANALYSIS INCLUDED MORE THAN 15,000 ADULTS, MOSTLY MIDDLE-AGED, WHO HAD AT LEAST ONE RISK FACTOR IDENTIFIED THROUGH PHYSICAL EXAMS OR LAB TESTING.THE PROPORTION WITH HYPERTENSION- A CONDITION THAT'S OFTEN SYMPTOMLESS-WHO WERE UNAWARE OF IT ROSE SIGNIFICANTLY OVER THE DECADE-LONG STUDY PERIOD; AWARENESS OF DIABETES AND HIGH CHOLESTEROL DIDN'T CHANGE.BUT WHEN WADHERA AND COLLEAGUES BROKE DOWN THE DATA BY AGE, THE RISE IN HYPERTENSION UNAWARENESS APPEARED ONLY AMONG ADULTS AGES 20 TO 44,WITH NO CHANGE AMONG THOSE OLDER THAN 45.BY SEX, UNAWARENESS ROSE AMONG WOMEN BUT NOT MEN.
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GIVEN DECLINING HEART HEALTH IN YOUNG ADULTS, IT'S CRITICAL THAT
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WE INTENSIFY PUBLIC HEALTH MESSAGING TO THIS GROUP ON THE IMPORTANCE OF SCREENING FOR HIGH BLOOD PRESSURE, DIABETES, AND HIGH CHOLESTEROL," SAID DANIEL JOHNSON, LEAD AUTHOR OF THE STUDY AND RESEARCH FELLOW AT THE SMITH CENTER. "WE NEED TO ADDRESS GAPS IN AWARENESS EARLY IN LIFE TO TO PREVENT THE ONSET OF CARDIOVASCULAR DISEASE, OR WORSE, LATER IN LIFE."STUDY MIMICKING LIFE-THREATENING CONDITION COMMON IN ICU PATIENTS SHOWS POTENTIAL PROTECTIVE ROLE OF IMMUNE CELLSACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) DREW WIDE ATTENTION DURING THE COVID-19 PANDEMIC AS A LEADING CAUSE OF DEATH IN PATIENTS WITH SEVERE CASES. NOW, A PRECLINICAL STUDY FROM BIDMC REVEALS A NOVEL APPROACH TO MITIGATING LUNG DAMAGE CAUSED BY PROLONGED EXPOSURE TO HIGH OXYGEN LEVELS--A CONDITION THAT MIMICS KEY FEATURES OF ARDS, INCLUDING WIDESPREAD INFLAMMATION AND DAMAGE TO THE LUNGS.IN FINDINGS PUBLISHED IN ANESTHESIA AND ANALGESIA, THE INVESTIGATORS DEMONSTRATED THAT A SINGLE ADMINISTRATION OF B CELLS DECREASED THE SEVERITY OF LUNG INJURY, IMPROVED OXYGENATION AND PROMOTED A MORE BALANCED IMMUNE RESPONSE (IMPROVED IMMUNE FUNCTION WITHOUT THE RISK OF RUNAWAY INFLAMMATION) IN A SMALL ANIMAL MODEL OF ARDS. B CELLS ARE A TYPE OF WHITE BLOOD CELL THAT PLAY A CENTRAL ROLE IN THE IMMUNE SYSTEM BY PRODUCING ANTIBODIES, BUT THEY ALSO HELP REGULATE IMMUNE RESPONSES BY COORDINATING WITH OTHER CELLS OF THE IMMUNE SYSTEM AND CALMING EXCESSIVE INFLAMMATION."ARDS DEVELOPS IN AT LEAST ONE IN TEN MECHANICALLY VENTILATED PATIENTS IN THE INTENSIVE CARE UNIT, AND HAS A HIGH MORTALITY RATE," SAID LEAD AUTHOR DUSAN HANIDZIAR, MD, PHD, A POSTDOCTORAL RESEARCH FELLOW IN THE CENTER FOR INFLAMMATION RESEARCH AT BIDMC. "NEW, TARGETED TREATMENTS NEED TO BE DEVELOPED FOR CLINICAL USE, AND WE'RE EXCITED THAT OUR DATA SUGGEST HARNESSING THE FUNCTIONS OF THE B CELL MAY REPRESENT A NOVEL THERAPY FOR ARDS."IN THIS FIRST-OF-ITS-KIND STUDY, HANIDZIAR AND COLLEAGUES SHOWED THAT, IN MICE EXPOSED TO HIGH OXYGEN LEVELS, THE NUMBER OF B CELLS DROPPED SHARPLY IN BOTH THE LUNGS AND THE BLOODSTREAM. ADMINISTERING B CELLS INTRAVENOUSLY 24 HOURS AFTER THE ONSET OF HIGH OXYGEN EXPOSURE, IMPROVED IMMUNE REGULATION, REDUCED HARMFUL INFLAMMATION, AND PARTIALLY RESTORED THE DIVERSITY OF IMMUNE CELLS IN THE ANIMALS' LUNGS."WE'VE KNOWN THAT HIGH OXYGEN LEVELS CAN SEVERELY DISRUPT IMMUNE BALANCE IN THE LUNGS, BUT THIS STUDY SHOWS THAT INFUSING B CELLS CAN HELP CORRECT THAT IMBALANCE AND REDUCE LUNG INJURY," SAID SENIOR AUTHOR SIMON C ROBSON, MD, PHD, DIRECTOR OF THE CENTER FOR INFLAMMATION RESEARCH. "THIS WORK LAYS IMPORTANT GROUNDWORK FOR EXPLORING B-CELL THERAPY AS A POTENTIAL TREATMENT FOR ARDS AND RELATED CONDITIONS."3. MORE THAN HALF OF U.S. ADULTS COULD BENEFIT FROM GLP-1 MEDICATIONS, RESEARCHERS FINDIN AN ANALYSIS OF NATIONAL DATA, RESEARCHERS AT THE RICHARD A. AND SUSAN F. SMITH CENTER FOR OUTCOMES RESEARCH AT BIDMC ESTIMATED THAT 137 MILLION U.S. ADULTS, MORE THAN HALF OF ALL ADULTS, ARE ELIGIBLE FOR SEMAGLUDTIDE FOR WEIGHT LOSS, DIABETES MANAGEMENT, OR PREVENTION OF RECURRENT CARDIOVASCULAR EVENTS. THE FINDINGS, PUBLISHED IN JAMA CARDIOLOGY, UNDERSCORE THE NEED TO INCREASE EQUITABLE ACCESS TO THIS NEW CLASS OF PHARMACEUTICALS.SEMAGLUTIDE, WHICH BELONGS TO A CLASS OF DRUGS KNOWN AS GLP-1 RECEPTOR AGONISTS, IS CURRENTLY APPROVED FOR THE MANAGEMENT OF DIABETES, TREATMENT OF OVERWEIGHT OR OBESITY, AND PREVENTION OF RECURRENT CARDIOVASCULAR DISEASE (E.G., IN PATIENTS WHO HAVE ALREADY EXPERIENCED A HEART ATTACK OR STROKE OR ARE LIVING WITH PERIPHERAL ARTERY DISEASE). ABOUT 15 MILLION ADULTS CURRENTLY TAKE SEMAGLUTIDE. BUT DATA IS RAPIDLY EMERGING ABOUT ITS EFFECTIVENESS FOR OTHER HEALTH CONDITIONS.IVY SHI, MD, WHO IS A RESIDENT IN INTERNAL MEDICINE AT BIDMC, WORKED WITH DHRUV S. KAZI, MD, MS, ASSOCIATE DIRECTOR OF THE SMITH CENTER AND DIRECTOR OF THE CARDIAC CRITICAL CARE UNIT AT BIDMC TO PRODUCE THE ANALYSIS. THEY USED FIVE YEARS' WORTH OF RECENT DATA FROM A LONG-RUNNING SURVEY OF THE U.S. POPULATION RUN BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO IDENTIFY U.S. ADULTS AGED 18 YEARS OR OLDER WHO WOULD BE ELIGIBLE FOR SEMAGLUTIDE TREATMENT BASED ON CURRENTLY APPROVED INDICATIONS.THEY FOUND THAT OF THE 136.8 MILLION US ADULTS ELIGIBLE FOR SEMAGLUTIDE, 35.0 MILLION ADULTS WOULD BE ELIGIBLE FOR THE MEDICATION FOR DIABETES MANAGEMENT, 129.2 MILLION ADULTS FOR WEIGHT LOSS, AND 8.9 MILLION ADULTS FOR SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE. THE SEMAGLUTIDE-ELIGIBLE POPULATION INCLUDES 26.8 MILLION ADULTS COVERED BY MEDICARE, 13.8 MILLION COVERED BY MEDICAID, AND 61.1 MILLION COVERED BY COMMERCIAL INSURANCE."THESE STAGGERING NUMBERS MEAN THAT WE ARE LIKELY TO SEE LARGE INCREASES IN SPENDING ON SEMAGLUTIDE AND RELATED MEDICATIONS IN YEARS TO COME," SAID KAZI. "ENSURING EQUITABLE ACCESS TO THESE EFFECTIVE BUT HIGH-COST MEDICATIONS, AS WELL AS SUPPORTING INDIVIDUALS SO THAT THEY CAN STAY ON THE THERAPY LONG-TERM, SHOULD BE A PRIORITY FOR OUR CLINICIANS AND POLICYMAKERS."4. SKIP THE EXTRA SALT: STUDY SHOWS HEART HEALTHY DIET AND SODIUM REDUCTION LOWER RISK OF HEART DISEASEMOST AMERICANS CONSUME FAR MORE SODIUM THAN RECOMMENDED, WITH THE AVERAGE INTAKE TOPPING 3,400 MILLIGRAMS (MG) PER DAY--WELL ABOVE THE RECOMMENDED FEDERAL GUIDELINE OF 2,300 MG AND THE AMERICAN HEART ASSOCIATION'S GOAL OF 1,500 MG. THE BULK OF AMERICAN'S DAILY SODIUM DOESN'T COME FROM THE SALTSHAKER, BUT FROM PROCESSED AND RESTAURANT FOODS LIKE BREADS, DELI MEATS, AND CANNED SOUPS. HEALTH EXPERTS WARN THIS EXCESS IS FUELING A NATIONAL EPIDEMIC OF HIGH BLOOD PRESSURE, A MAJOR RISK FACTOR FOR HEART DISEASE AND STROKE.A NEW ANALYSIS LED BY INVESTIGATORS AT BIDMC HAS FOUND THAT REDUCING DIETARY SODIUM, OR FOLLOWING THE EVIDENCED-BASED HEART-HEALTHY DASH DIET EACH INDEPENDENTLY LOWERED THE 10-YEAR ESTIMATED RISK OF DEVELOPING ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (ASCVD)--HARDENING OF THE ARTERIES THAT CAN LEAD TO CHEST PAIN, HEART ATTACK OR STROKE--AMONG ADULTS WITH ELEVATED BLOOD PRESSURE BUT NO PRIOR CARDIOVASCULAR DISEASE.MOREOVER, THE COMBINATION OF THE DASH DIET AND REDUCING SODIUM INTAKE HAD ADDITIVE EFFECTS, RESULTING IN THE GREATEST REDUCTION IN ASCVD RISK. THE FINDINGS APPEAR IN THE AMERICAN JOURNAL OF PREVENTIVE CARDIOLOGY."COMPARED TO THE TYPICAL AMERICAN, HIGH-SODIUM DIET, REDUCING SODIUM TO THE RECOMMENDED LEVELS OR EVEN LOWER MARKEDLY DECREASED CARDIOVASCULAR DISEASE RISK SCORES, WITH THE GREATEST EFFECTS AMONG WOMEN, BLACK ADULTS AND PARTICIPANTS WITH BASELINE STAGE II HYPERTENSION," SAID SENIOR AUTHOR STEPHEN P. JURASCHEK, MD. "THESE DATA UNDERSCORE THE NEED FOR STRONGER DIETARY GUIDELINES AND PUBLIC HEALTH INTERVENTIONS THAT CAN BE REALISTICALLY IMPLEMENTED AND SUSTAINED OVER TIME--ESPECIALLY AMONG GROUPS AT HIGHEST RISK."TO EVALUATE THE IMPACT OF SODIUM REDUCTION ON BLOOD PRESSURE--ALONE AND IN COMBINATION WITH THE DASH DIET--JURASCHEK AND COLLEAGUES RANDOMIZED 390 ADULTS WITH ELEVATED BLOOD PRESSURE TO THE DASH DIET AND A TYPICAL AMERICAN DIET.AFTER THE 12-WEEK PERIOD, ANALYSIS REVEALED THAT BOTH THE DASH DIET AND LOWER SODIUM INTAKE INDEPENDENTLY REDUCED PARTICIPANTS' ASCVD RISK SCORES. LOWERING SODIUM INTAKE LED TO MEANINGFUL RISK REDUCTIONS EVEN WHEN NOT MEETING THE MOST AGGRESSIVE TARGETS. BUT THE GREATEST BENEFIT OCCURRED WHEN THE TWO INTERVENTIONS WERE COMBINED.
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5. PRIVATE EQUITY MAY HAVE NEGATIVE EFFECT ON PATIENT CARE, STUDY SHOWS
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IN A PAPER PUBLISHED IN JAMA, BIDMC HEALTH POLICY EXPERTS REPORT THAT PATIENT CARE EXPERIENCE AND STAFF RESPONSIVENESS WORSENED AFTER PRIVATE EQUITY (PE) ACQUISITION OF U.S. HOSPITALS. RISHI WADHERA, MD, MPP, ANJALI BHATLA, MD, AND COLLEAGUES FOUND THAT CARE CONTINUED TO DECLINE WITH EACH ADDITIONAL YEAR AFTER ACQUISITION, SUGGESTING THAT PROFIT-DRIVEN CHANGES MAY COMPOUND OVER TIME."PATIENTS PROVIDE THE MOST IMPORTANT PERSPECTIVE ON WHETHER A HOSPITAL IS PROVIDING GOOD OR BAD CARE, AS THEY HAVE A 360-DEGREE VIEW OF THE ENTIRE CARE EXPERIENCE," SAID WADHERA, ASSOCIATE DIRECTOR OF THE SMITH CENTER FOR OUTCOMES RESEARCH AT BIDMC. "AFTER PRIVATE EQUITY TAKES OVER A HOSPITAL, PATIENT CARE EXPERIENCE SIGNIFICANTLY WORSENS. THAT'S VERY CONCERNING, GIVEN THE SURGE IN PE ACQUISITIONS OF HEALTH CARE FACILITIES OVER THE PAST DECADE."WADHERA AND COLLEAGUES IDENTIFIED 73 U.S. HOSPITALS NEWLY ACQUIRED BY PRIVATE EQUITY AND 293 MATCHED, NON-ACQUIRED HOSPITALS FROM 2008 TO 2019, AND FOUND THAT PATIENTS' OVERALL RATINGS, WILLINGNESS TO RECOMMEND THE HOSPITAL, AND REPORTED STAFF RESPONSIVENESS, DOCTOR AND NURSE COMMUNICATION, AND HOSPITAL ENVIRONMENT ALL WORSENED IN THE THREE YEARS AFTER ACQUISITION."THE RELATIVE DECLINE IN OVERALL PATIENT CARE EXPERIENCE SCORES AFTER PE ACQUISITION WAS LARGE," SAID ANJALI BHATLA, MD, A RESEARCH FELLOW AT THE SMITH CENTER. "POOR PATIENT EXPERIENCES ARE ASSOCIATED WITH SLOWER RECOVERY FROM ILLNESS, MEDICATION NONADHERENCE, AND GREATER HEALTH CARE UTILIZATION.""THE EVIDENCE TO DATE SUGGESTS THAT WHEN PRIVATE EQUITY TAKES OVER A HOSPITAL, THINGS GENERALLY GET WORSE FOR PATIENTS," SAID WADHERA, WHO IS ALSO AN ASSOCIATE PROFESSOR AT HARVARD MEDICAL SCHOOL. "AS PRIVATE EQUITY'S PRESENCE IN HEALTH CONTINUES TO GROW, THERE'S A PRESSING NEED FOR GREATER TRANSPARENCY, MONITORING, AND REGULATORY OVERSIGHT, TO ENSURE THAT PATIENTS ARE PROTECTED."PE INVESTORS SPENT MORE THAN $200 BILLION ON HEALTH CARE ACQUISITIONS IN 2021 ALONE -- $1 TRILLION OVER THE PAST DECADE, PER THE COMMONWEALTH FUND -- YET LITTLE RESEARCH HAS EVALUATED PE'S IMPACT ON THE PATIENT CARE EXPERIENCE.IN AN EARLIER STUDY, WADHERA FOUND THAT PE FIRMS DISPROPORTIONATELY ACQUIRED OUTPATIENT CARDIOLOGY PRACTICES IN WEALTHY COMMUNITIES, OFTEN FLIPPING THEM WITHIN A FEW YEARS -- A PATTERN THAT CAN INCENTIVIZE CARE CHANGES THAT MAXIMIZE PROFIT OVER QUALITY.6. RACIAL DISPARITIES IN PAIN ASSESSMENT EXPOSE AI'S FLAWED BELIEFS ABOUT RACEA STUDY LED BY ADAM RODMAN, MD, MPH, DIRECTOR OF AI PROGRAMS AT BIDMC, REVEALS THAT, RATHER THAN HELPING TO REDUCE RACIAL AND ETHNIC BIASES, AI-DRIVEN CHATBOTS MAY INSTEAD PERPETUATE AND EXACERBATE DISPARITIES IN MEDICINE. THE STUDY APPEARED IN JAMA NETWORK OPEN.IT'S WELL-DOCUMENTED THAT PHYSICIANS UNDERTREAT BLACK PATIENTS' PAIN VERSUS WHITE PATIENTS', A DISPARITY OFTEN ATTRIBUTED TO UNDERASSESSMENT OF THEIR PAIN. AI WAS INITIALLY SEEN AS A WAY TO ELIMINATE SUCH BIASES, WITH DATA-DRIVEN ALGORITHMS EXPECTED TO OFFER OBJECTIVE ASSESSMENTS FREE FROM HUMAN PREJUDICE."THESE MODELS ARE VERY GOOD AT REFLECTING HUMAN BIASES -- AND NOT JUST RACIAL BIASES -- WHICH IS PROBLEMATIC IF YOU'RE GOING TO USE THEM TO MAKE ANY SORT OF MEDICAL DECISION," RODMAN SAID. "IF THE SYSTEM IS BIASED THE SAME WAY HUMANS ARE, IT'S GOING TO SERVE TO MAGNIFY OUR BIASES OR MAKE HUMANS MORE CONFIDENT IN THEIR BIASES."TO INVESTIGATE, RODMAN AND COLLEAGUES REPLICATED A 2016 STUDY IN WHICH 222 MEDICAL STUDENTS AND RESIDENTS RATED PAIN LEVELS FOR TWO MEDICAL VIGNETTES -- ONE DESCRIBING A WHITE PATIENT, ONE BLACK -- ON A 10-POINT SCALE, AND RATED THEIR AGREEMENT WITH FALSE BELIEFS ABOUT RACIAL BIOLOGY, SUCH AS THE INACCURATE BUT WIDESPREAD NOTION THAT BLACK PEOPLE HAVE THICKER SKIN.IN THEIR STUDY, RODMAN'S TEAM APPLIED THE SAME SETUP TO THE AI MODELS GEMINI PRO AND GPT-4 TO SEE HOW THEY WOULD ASSESS PAIN ACROSS RACE AND ETHNICITY AND GAUGE THEIR UNDERSTANDING OF RACIAL BIOLOGY.THE RACIAL DISPARITIES PERSISTED. ACROSS THE BOARD, BLACK PATIENTS WERE UNDERASSESSED FOR THEIR PAIN COMPARED WITH WHITE PATIENTS, REGARDLESS OF WHETHER THE RATER WAS HUMAN OR AI. AS FOR FALSE BELIEFS ABOUT RACIAL BIOLOGY: THE GEMINI PRO AI MODEL EXHIBITED THE HIGHEST PERCENTAGE OF FALSE BELIEFS (24 PERCENT), FOLLOWED BY THE HUMAN TRAINEES (12 PERCENT), AND GPT-4 WITH THE LOWEST (9 PERCENT).AS MORE HOSPITALS AND CLINICS ADOPT AI FOR CLINICAL DECISION SUPPORT, THE FINDINGS SUGGEST CHATBOTS COULD PERPETUATE RACIAL AND ETHNIC BIASES IN MEDICINE, DEEPENING HEALTH CARE INEQUALITIES -- PARTICULARLY IF CONFIRMATION BIAS LEADS PHYSICIANS TO TRUST AI OUTPUTS ONLY WHEN THEY MATCH PRE-EXISTING BELIEFS.7. BIDMC-LED STUDY FINDS MOST CANCER PHYSICIANS-IN-TRAINING FEEL UNDERPREPARED TO ADVISE PATIENTS ABOUT MEDICAL MARIJUANAEVIDENCE SUGGESTS AS MANY AS 40 PERCENT OF ADULTS WITH CANCER TURN TO MARIJUANA -- MORE PROPERLY KNOWN AS CANNABIS -- TO MANAGE SYMPTOMS LIKE PAIN, NAUSEA AND ANXIETY, AND MANY WANT GUIDANCE FROM THEIR PHYSICIANS. YET A NATIONAL STUDY LED BY BIDMC INVESTIGATORS FINDS THAT MOST ONCOLOGISTS-IN-TRAINING, OR FELLOWS, FEEL UNDERPREPARED TO MANAGE THIS INCREASINGLY COMMON ASPECT OF PATIENT CARE."PERSONALIZED, PATIENT-CENTERED CARE STARTS WITH UNDERSTANDING AND COMMUNICATING THE BEST AVAILABLE EVIDENCE," SAID CO-LEAD AUTHOR KIAN TEHRANCHI, MD, A CLINICAL FELLOW IN HEMATOLOGY ONCOLOGY AT BIDMC. "AS MEDICAL CANNABIS BECOMES MORE WIDELY USED AND ACCEPTED, IT'S CRITICAL THAT FELLOWSHIP TRAINING EQUIPS FUTURE ONCOLOGISTS WITH THE KNOWLEDGE THEY NEED TO HAVE INFORMED, THOUGHTFUL CONVERSATIONS AND SUPPORT SHARED DECISION-MAKING WITH THEIR PATIENTS."PUBLISHED IN THE JOURNAL OF CANNABIS RESEARCH, THE STUDY SURVEYED 189 ONCOLOGY FELLOWS ACROSS 40 TRAINING PROGRAMS IN 25 STATES. ABOUT ONE IN FIVE HAD RECOMMENDED MEDICAL CANNABIS TO MORE THAN FIVE PATIENTS IN THE PREVIOUS YEAR. ABOUT A QUARTER HAD RECEIVED PRIOR TRAINING IN MEDICAL CANNABIS, AND THOSE WITH TRAINING WERE TWICE AS LIKELY TO RECOMMEND IT -- AND SIGNIFICANTLY MORE LIKELY TO HOLD INFORMED OPINIONS ABOUT ITS RISKS, BENEFITS, PREFERRED USE, AND WHICH PATIENTS MIGHT BENEFIT MOST.THE FINDINGS UNDERSCORE HOW EVEN BASIC TRAINING BUILDS FELLOWS' CONFIDENCE IN HAVING EVIDENCE-BASED CONVERSATIONS ABOUT CANNABIS USE, DESPITE LIMITED SAFETY AND EFFICACY DATA IN CANCER CARE.THE RESEARCHERS NOTE THAT EVIDENCE IS STRONGEST FOR CANNABIS RELIEVING CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING, WITH LESS SUPPORT FOR OTHER SYMPTOMS LIKE CHRONIC PAIN OR APPETITE LOSS, AND VIRTUALLY NONE FOR ISSUES LIKE DIARRHEA. THEY STRESS THE IMPORTANCE OF TRAINING ON ITS SIDE EFFECTS, DRUG INTERACTIONS, AND RISKS FOR PATIENTS RECEIVING IMMUNOTHERAPY."THIS IS ABOUT PREPARING THE NEXT GENERATION OF CANCER PHYSICIANS TO MEET PATIENTS WHERE THEY ARE," SAID LEAD AUTHOR DEEPA RANGACHARI, MD, DIRECTOR OF GRADUATE MEDICAL EDUCATION & HEMATOLOGY ONCOLOGY FELLOWSHIP PROGRAM DIRECTOR AT BIDMC. "WELL-INFORMED, PATIENT-CENTERED CARE STARTS WITH GIVING OUR TRAINEES THE TOOLS THEY NEED TO ENGAGE IN NUANCED, EVIDENCE-BASED CONVERSATIONS."
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8. COVID-19 EXACERBATED AN ALREADY WIDENING GAP BETWEEN RURAL AND
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URBAN HEART HEALTH OVER LAST DECADEEXISTING SOCIOECONOMIC DISPARITIES LEFT THE U.S. RURAL POPULATION MORE VULNERABLE TO THE DIRECT AND INDIRECT CARDIOVASCULAR EFFECTS OF COVID-19, ACCORDING TO INVESTIGATORS AT BIDMC'S RICHARD A. AND SUSAN F. SMITH CENTER FOR OUTCOMES RESEARCH. IN A STUDY PRESENTED AT THE AMERICAN HEART ASSOCIATION SCIENTIFIC SESSIONS AND PUBLISHED IN THE JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, THE SCIENTISTS SHOWED THAT THE GAP IN HEALTH OUTCOMES BETWEEN RURAL AND URBAN POPULATIONS WIDENED MORE QUICKLY AFTER THE PANDEMIC.RESEARCHERS EVALUATED CARDIOVASCULAR MORTALITY IN THE UNITED STATES FROM 2010 TO 2022, FOCUSING ON THE IMPACT OF THE PANDEMIC ON EXISTING RURAL-URBAN DISPARITIES IN CARDIOVASCULAR HEALTH. PRIOR TO THE PANDEMIC, AGE-ADJUSTED CARDIOVASCULAR DEATH RATES HAD BEEN DECREASING IN URBAN AREAS OF THE UNITED STATES. IN CONTRAST, CARDIOVASCULAR DEATH RATES WERE INCREASING IN RURAL AREAS, DRIVEN LARGELY BY AN ALARMING RISE AMONG YOUNGER ADULTS.THE INVESTIGATORS FOUND THAT FOLLOWING THE ONSET OF THE PANDEMIC, WHILE THERE WAS AN INCREASE IN THE CARDIOVASCULAR MORTALITY RATE IN URBAN AREAS, THERE WAS A STEEPER INCREASE IN RURAL AREAS, PARTICULARLY AMONG RURAL ADULTS AGED 25-64. BY 2022, CARDIOVASCULAR MORTALITY RATES WERE 1.5 TIMES HIGHER IN RURAL COMPARED WITH URBAN AREAS.OTHER STUDIES SUGGEST THAT FOR MANY PEOPLE, RISK FACTORS SUCH AS HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, DIABETES, AND OBESITY WORSENED DURING THE PANDEMIC, AND RURAL AREAS MAY HAVE BEEN MORE SEVERELY AFFECTED DUE TO GREATER INTERRUPTIONS IN ACCESS TO HEALTH CARE. THE PANDEMIC-RELATED SURGE IN SUBSTANCE USE, DEPRESSION, AND SUICIDALITY ALSO DISPROPORTIONATELY IMPACTED RURAL POPULATIONS; THESE "DISEASES OF DESPAIR" CONFER AN INCREASED RISK OF CARDIOVASCULAR EVENTS."DETERIORATING SOCIOECONOMIC CONDITIONS AND HEALTH SYSTEM CHALLENGES THAT WERE EXACERBATED BY THE PANDEMIC MAY HAVE MADE RURAL ADULTS MORE VULNERABLE TO POOR CARDIOVASCULAR OUTCOMES," SAID CORRESPONDING AUTHOR RISHI K. WADHERA, MD, MPP, MPHIL, ASSOCIATE DIRECTOR OF THE SMITH CENTER AT BIDMC. "THERE'S A CARDIOMETABOLIC HEALTH CRISIS HAPPENING IN RURAL AMERICA -- ESPECIALLY AMONG YOUNG ADULTS -- AND IT'S VITAL THAT WE START TACKLING THE UNDERLYING SOCIOECONOMIC CONDITIONS THAT ARE DRIVING THIS PERSISTENT RISE IN CARDIOVASCULAR MORTALITY."9. MPOX VACCINE ANTIBODY RESPONSES WANED WITHIN A YEAR, STUDY SHOWSTHE 2022 OUTBREAK OF MPOX, FORMERLY KNOWN AS MONKEYPOX, MARKED THE FIRST TIME THE VIRUS SPREAD WIDELY ACROSS MULTIPLE COUNTRIES BEYOND ITS HISTORICALLY ENDEMIC REGIONS IN AFRICA. BOSTON REPORTED THE FIRST U.S. CASE IN MAY; BY AUGUST, ALL 50 STATES HAD DOCUMENTED INFECTIONS. SPREAD PRIMARILY THROUGH CLOSE SKIN-TO-SKIN CONTACT, ESPECIALLY DURING SEXUAL ACTIVITY, THE INFECTION MANIFESTS AS FEVER, SWOLLEN LYMPH NODES, AND PAINFUL RASHES OR SORES.TO CONTAIN THE OUTBREAK, PUBLIC HEALTH OFFICIALS PRIORITIZED VACCINATION FOR POPULATIONS AT HIGHER RISK OF EXPOSURE, INCLUDING PEOPLE WHO HAVE NEW OR MULTIPLE SEXUAL PARTNERS; HEALTHCARE WORKERS AND LABORATORY PERSONNEL; AND PEOPLE WHO HAVE TRAVELED TO A COMMUNITY WHERE MPOX HAS BEEN IDENTIFIED.IN A STUDY PUBLISHED IN JAMA, BIDMC RESEARCHERS DEMONSTRATED THAT MPOX ANTIBODY LEVELS DECLINED RAPIDLY AND NEARLY RETURNED TO BASELINE SIX TO 12 MONTHS AFTER RECEIVING THE MPOX VACCINATION. THE FINDINGS SUGGEST THAT PROTECTIVE IMMUNITY MAY WANE IN PREVIOUSLY VACCINATED INDIVIDUALS AND THAT BOOSTING MAY BE REQUIRED TO MAINTAIN ROBUST PROTECTION."IT IS IMPORTANT TO ASSESS THE INFECTION RISK FOR INDIVIDUALS WHO WERE VACCINATED AGAINST THE DISEASE DURING THE 2022 OUTBREAK," SAID CORRESPONDING AUTHOR DAN H. BAROUCH, MD, PHD, DIRECTOR OF THE CENTER FOR VACCINE AND VIROLOGY RESEARCH AT BIDMC."OUR STUDY ALSO HIGHLIGHTS THE IMPORTANCE OF COMPLETING THE RECOMMENDED TWO-DOSE MPOX VACCINE, WHETHER SUBCUTANEOUS OR INTRADERMAL, TO BOOST IMMUNITY -- REGARDLESS OF THE TIME BETWEEN DOSES," SAID LEAD AUTHOR AI-RIS YONEKURA COLLIER, MD, CO-DIRECTOR OF THE CLINICAL TRIALS UNIT AT BIDMC. "IN THIS MPOX OUTBREAK, ENSURING BROAD ACCESS TO THE FULL VACCINE SERIES IS CRUCIAL."10. INVESTIGATIONAL MRNA VACCINE PROTECTED MICE BETTER THAN THE CENTURY-OLD VACCINE -- LIMITING INFECTION AND SLOWING DISEASE SPREADTUBERCULOSIS, AN AIRBORNE BACTERIAL INFECTION, IS ONE OF HUMANITY'S OLDEST FOES AND TODAY THE WORLD'S TOP INFECTIOUS-DISEASE KILLER, CLAIMING 1.2 MILLION LIVES A YEAR. THE ONE AVAILABLE VACCINE PROTECTS YOUNG CHILDREN FROM SEVERE TB BUT DOES LITTLE TO STOP ITS SPREAD AMONG ADOLESCENTS AND ADULTS.NOW, BIDMC SCIENTISTS HAVE CREATED A NEW TB VACCINE CANDIDATE USING NEWLY IDENTIFIED ANTIGENS DELIVERED BY MRNA TECHNOLOGY -- THE SAME APPROACH BEHIND THE RAPID DEVELOPMENT OF COVID-19 VACCINES. THE TEAM, REPORTING IN CELL, PLANS CLINICAL TESTING IN ADULTS, A POTENTIAL ADVANCE IN TB PREVENTION FOR ALL AGE GROUPS."WE SYSTEMATICALLY EVALUATED MULTIPLE POTENTIAL TB VACCINE ANTIGENS TO DEVELOP A NOVEL TB VACCINE CANDIDATE," SAID CORRESPONDING AUTHOR DAN H. BAROUCH, MD, PHD, DIRECTOR OF THE CENTER FOR VIROLOGY AND VACCINE RESEARCH AT BIDMC, WHO CONTRIBUTED TO THE DEVELOPMENT OF JOHNSON & JOHNSON'S COVID-19 VACCINE. "WE USED THE MRNA PLATFORM THAT IS FLEXIBLE, SCALABLE, AND CAN COMBINE MULTIPLE ANTIGENS INTO ONE SHOT."TB LACKS AN OBVIOUS VACCINE TARGET. USING IMMUNE-RESPONSE DATA FROM PEOPLE EXPOSED TO TB, BAROUCH AND COLLEAGUES BUILT A SCREENING PIPELINE TO RANK CANDIDATE ANTIGENS BY IMMUNE RESPONSE, THEN SELECTED TOP CONTENDERS TO DESIGN A TRIVALENT VACCINE -- COMBINING THREE TB ANTIGENS -- TESTED IN AN ANIMAL MODEL."CHOOSING WHICH ANTIGENS TO TARGET IS A SIGNIFICANT CHALLENGE IN TB VACCINE DEVELOPMENT," SAID LEAD AUTHOR SAMUEL J. VIDAL, MD, PHD, A STAFF SCIENTIST IN THE BAROUCH LABORATORY AT BIDMC. "THE THREE ANTIGENS WE CHOSE HAVE NOT PREVIOUSLY BEEN EVALUATED IN CLINICAL TRIALS. OUR TRIVALENT MRNA VACCINE CONCEPT IMPROVED UPON THE CENTURY-OLD BCG SHOT IN ANIMAL MODELS -- IT REDUCED INFECTION RATES, REDUCED BACTERIAL SPREAD, AND LOWERED BACTERIAL LEVELS IN THE LUNGS."THE TRIVALENT VACCINE ANTIGENS ALSO TRIGGERED IMMUNE RESPONSES IN HUMANS EXPOSED TO TB, SUGGESTING THE APPROACH COULD WORK IN PEOPLE."TAKEN TOGETHER, OUR FINDINGS OPEN THE DOOR TO A NEW VACCINE CANDIDATE FOR TB," SAID BAROUCH, WHO IS ALSO A PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL. "WE'RE EXCITED TO BE MOVING THIS NOVEL TB VACCINE CANDIDATE TOWARD CLINICAL TRIALS."RESEARCH AT JOSLIN DIABETES CENTERTHE JOSLIN DIABETES CENTER (JDC), IN CONJUNCTION WITH ITS AFFILIATE THE JOSLIN CLINIC, PROVIDES WORLD CLASS LEADING EDGE PATIENT CARE IN THE SPECIALTY AREA OF DIABETES AND CARING FOR PATIENTS THROUGH A RELENTLESS TEAM OF CLINICIANS, SKILLED HEALTH EDUCATORS, AND ACCESS TO PIONEERING DIABETES RESEARCH. JOSLIN IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND OFFERS A RICH EDUCATIONAL ENVIRONMENT INVOLVING COURSES, LECTURES, FELLOWSHIP OPPORTUNITIES AND CME COURSES. JDC ALSO PROVIDES INFRASTRUCTURE, MANAGEMENT AND SUPPORT SERVICES TO ITS AFFILIATE, THE JOSLIN CLINIC. IN ADDITION, JOSLIN'S MISSION IS NOT ONLY TO PROVIDE OUTSTANDING PATIENT CARE, BUT ALSO TO BRING BEST PRACTICES TO THE LARGER MEDICAL COMMUNITY. JOSLIN ENGAGES IN RESEARCH RELATED TO BETTER UNDERSTANDING DIABETES, HOW TO TREAT IT AND HOW TO HELP PATIENTS MANAGE AND LIVE HEALTHIER LIVES WITH THE DISEASE. JOSLIN DIABETES RESEARCH CENTER IS ONE OF ONLY 16 NIH-DESIGNATED DIABETES RESEARCH CENTERS IN THE UNITED STATES. JOSLIN'S RESEARCH TEAM IS WORLD-RENOWNED AND PASSIONATE ABOUT IMPROVING THE LIVES OF PEOPLE WITH DIABETESMILLIONS OF PEOPLE WITH DIABETES THROUGHOUT THE WORLD BENEFIT DIRECTLY FROM BASIC AND CLINICAL RESEARCH CONDUCTED AT THE CENTER. APPROXIMATELY 300 RESEARCHERS EMPLOYED AT THE JOSLIN DIABETES CENTER ARE WORKING ON VARIOUS ASPECTS OF DIABETES, SEARCHING FOR WAYS TO PREVENT AND TREAT DIABETES IN ALL ITS FORMS AND ULTIMATELY FIND A CURE FOR THE DISEASE.THE RESEARCH ENGAGED IN AT JDC HELPS IMPROVES THE LIVES AT JDC, ACROSS BILH AND IN THE WIDER COMMUNITY BEYOND EASTERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE COMMUNITIES. AS NOTED ABOVE RELATED TO BIDMC, ALTHOUGH JOSLIN'S RESEARCH ACTIVITIES ARE NOT QUANTIFIED HERE IN THIS HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY THIS HOSPITAL, ALL OF BILH AND BEYOND. SOME EXAMPLES OF RESEARCH ENGAGED IN BY JOSLIN DURING THE PERIOD COVERED BY THIS FILING ARE BELOW.
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BRAIN INSULIN SIGNALING IMPACT ON DIABETES AND NEUROLOGICAL DISORDERS
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A STUDY FROM JOSLIN DIABETES CENTER EXPLORES THE ROLE OF INSULIN SIGNALING IN THE BRAIN'S IMMUNE CELLS, AND HOW IT MAY MEDIATE THE RELATIONSHIP BETWEEN TYPE 2 DIABETES AND ALZHEIMER'S DISEASE (AD). THE FINDINGS, PUBLISHED IN PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES, COULD HELP IDENTIFY POTENTIAL TARGETS TO TREAT DIABETES PATIENTS WITH AD."TYPE 2 DIABETES, OBESITY, AND METABOLIC SYNDROME ARE MAJOR CAUSES OF ILLNESS AND DEATH WORLDWIDE, AND INSULIN RESISTANCE, ESPECIALLY BRAIN INSULIN RESISTANCE, FEATURES PROMINENTLY IN ALL THESE CONDITIONS," SAID LEAD AUTHOR WENQIANG CHEN, PHD, INSTRUCTOR OF MEDICINE AT JOSLIN DIABETES CENTER. "A GROWING BODY OF EVIDENCE LINKS INSULIN RESISTANCE WITH INCREASED RISKS OF BRAIN DISORDERS, INCLUDING AD AND DEPRESSION, BUT EXACTLY HOW BRAIN INSULIN RESISTANCE LINKS TO THESE DISEASES REMAINS INCOMPLETELY UNDERSTOOD."TO BETTER UNDERSTAND INSULIN'S ROLE IN THE BRAIN, CHEN AND COLLEAGUES IN THE LAB OF RONALD KAHN, MD, CREATED A MOUSE MODEL IN WHICH THEY COULD "TURN OFF" INSULIN RECEPTORS IN CERTAIN BRAIN CELLS. THESE "KNOCKOUT MICE" GAVE THE SCIENTISTS A PRECISE TOOL TO STUDY HOW SPECIFIC BRAIN CELLS BEHAVE WITHOUT INSULIN'S INFLUENCE.THE JOSLIN INVESTIGATORS LOOKED SPECIFICALLY AT MICROGLIA--THE BRAIN'S RESIDENT IMMUNE CELLS. MOST IMPORTANTLY IN THE CONTEXT OF ALZHEIMER'S, THEY HELP CLEAR AWAY AMYLOID-BETA (A), A STICKY PROTEIN THAT CAN BUILD UP TO FORM THE DAMAGING PLAQUES IN THE BRAIN.THEIR FINDINGS:- MICE WITHOUT INSULIN SIGNALING IN MICROGLIA SHOWED DEPRESSIVE-LIKE BEHAVIORS AND ALTERED SOCIAL INTERACTION- WHEN THESE MICE WERE CROSSED WITH A WIDELY USED ALZHEIMER'S DISEASE MODEL, THE RESULTANT MICE DEVELOPED MORE SEVERE DISEASE- IN THE TEAM'S CELLULAR MODEL OF MICROGLIA LACKING INSULIN RECEPTORS, THE CELLS SHIFTED TO A LESS EFFICIENT WAY OF PRODUCING ENERGY AND BECAME LESS EFFECTIVE AT CLEARING AMYLOID-BETA."OUR FINDINGS POINT TO THE IMPORTANCE OF UNDERSTANDING A CELL TYPE SPECIFIC REGULATION OF INSULIN ACTION AND INSULIN RESISTANCE IN BRAIN HOMEOSTASIS AND DISEASE PATHOGENESIS," SAID SENIOR AUTHOR KAHN, WHO IS ALSO JOSLIN'S CHIEF ACADEMIC OFFICER. "THESE INSIGHTS WILL HELP IDENTIFY THE CELLULAR AND MOLECULAR MECHANISMS UNDERLYING THE LINK BETWEEN TYPE 2 DIABETES AND BRAIN DISORDERS, THUS BRINGING THE POTENTIAL FOR BETTER THERAPEUTICS FOR PATIENTS WITH THESE COMORBID CONDITIONS."JOSLIN SCIENTISTS UNCOVER CLUES TO MYSTERIOUS POST-BARIATRIC COMPLICATIONJOSLIN DIABETES CENTER RESEARCHERS HAVE IDENTIFIED METABOLIC CHANGES THAT MAY EXPLAIN WHY NEARLY 30 PERCENT OF PATIENTS WHO UNDERGO WEIGHT LOSS SURGERY DEVELOP POST-BARIATRIC HYPOGLYCEMIA (PBH). THIS SERIOUS CONDITION OCCURS WHEN THE BODY OVERPRODUCES INSULIN AFTER MEALS, CAUSING DANGEROUS BLOOD SUGAR CRASHES THAT CAN LEAD TO CONFUSION, FAINTING, AND SEIZURES."WHILE SOME PATIENTS CAN MANAGE PBH WITH DIET AND MEDICATION, SEVERE CASES DON'T ALWAYS RESPOND TO TREATMENT--OR EVEN TO REVERSING THE SURGERY," SAID CO-CORRESPONDING AUTHOR MARY-ELIZABETH PATTI, MD, DIRECTOR OF JOSLIN'S HYPOGLYCEMIA CLINIC. "THAT'S WHY FINDING TREATMENT OPTIONS IS SO IMPORTANT."BARIATRIC SURGERIES, SUCH AS GASTRIC BYPASS AND SLEEVE GASTRECTOMY, ARE POWERFUL TOOLS FOR TREATING TYPE 2 DIABETES (T2D), A CONDITION THAT AFFECTS MORE THAN 500 MILLION PEOPLE WORLDWIDE AND INCREASES THE RISK OF HEART DISEASE, KIDNEY FAILURE, AND NERVE DAMAGE. IN SOME INDIVIDUALS, GLUCOSE LEVELS CAN DROP TO LEVELS BELOW NORMAL, OR HYPOGLYCEMIA.IN PREVIOUS STUDIES, PATTI AND COLLEAGUES FOUND THAT PATIENTS WITH PBH HAD SIGNIFICANTLY HIGHER LEVELS OF A HORMONE CALLED FGF19 COMPARED TO POST-SURGICAL INDIVIDUALS WITHOUT HYPOGLYCEMIA. PEOPLE WITH OBESITY TEND TO HAVE LOWER LEVELS OF THIS HORMONE, BUT AFTER BARIATRIC SURGERY, ITS LEVELS RISE--SOMETIMES TOO MUCH.TO UNDERSTAND WHAT TRIGGERS THIS SPIKE IN FGF19, PATTI'S TEAM, WORKING WITH THE LABORATORY OF CO-CORRESPONDING AUTHOR SLOAN DEVLIN, ANALYZED BILE ACIDS--DIGESTIVE COMPOUNDS THAT HELP BREAK DOWN FATS. COMPARING SAMPLES FROM PATIENTS WITH PBH AND INDIVIDUALS WITHOUT THE CONDITION, THEY FOUND DISTINCT DIFFERENCES IN BILE ACID COMPOSITION, SUGGESTING THESE DIFFERENCES MAY BE RESPONSIBLE FOR THE EXCESSIVE INSULIN RESPONSE AND HYPOGLYCEMIA AFTER MEALS.THROUGH A SERIES OF EXPERIMENTS, THE RESEARCHERS MAPPED OUT THE METABOLIC STEPS LIKELY DRIVING PBH. BY IDENTIFYING SPECIFIC PROTEINS INVOLVED IN THE PROCESS, THEY UNCOVERED A POTENTIAL TREATMENT STRATEGY: BLOCKING A TRANSPORTER IN THE GUT RESPONSIBLE FOR SHUTTLING BILE ACIDS FROM INTESTINES INTO BLOOD. BY INHIBITING THIS TRANSPORTER IN MICE, THE RESEARCHERS WERE ABLE TO REDUCE THE BLOOD SUGAR DROP THAT HAPPENS AFTER A MEAL. MORE BROADLY, THIS WORK MAY HAVE IMPLICATIONS FOR PATIENTS STRUGGLING WITH HYPOGLYCEMIA IN OTHER CONTEXTS. THE FINDINGS APPEARED IN NATURE METABOLISM.FIRST-OF-ITS KIND STUDY COMPREHENSIVELY CHARACTERIZED COGNITIVE FUNCTION AND BRAIN PATHOLOGY IN AGING PEOPLE WITH T1DINVESTIGATORS AT JOSLIN DIABETES CENTER HAVE CONDUCTED THE FIRST COMPREHENSIVE CLINICAL CHARACTERIZATION OF COGNITIVE DECLINE IN PEOPLE WITH LONG-DURATION TYPE 1 DIABETES (T1D). PUBLISHED IN JCI INSIGHT, THE STUDY HELPS ANSWER QUESTIONS ABOUT THIS UNDERSTUDIED POPULATION AND HINTS THAT PRESERVING EYESIGHT MAY HELP PREVENT COGNITIVE DECLINE IN PEOPLE WITH T1D."COGNITIVE DYSFUNCTION IS RECOGNIZED AS A POTENTIAL COMPLICATION ASSOCIATED WITH DIABETES, BUT STUDIES HAVE MOSTLY FOCUSED ON TYPE 2 DIABETES OR YOUNGER TYPE 1 POPULATIONS," SAID CORRESPONDING AUTHOR GEORGE KING, CHIEF SCIENTIFIC OFFICER, JOSLIN DIABETES CENTER."DETAILED CLINICAL CHARACTERIZATION OF COGNITIVE DYSFUNCTION IN A LARGE COHORT OF PEOPLE WITH A LONG HISTORY OF LIVING WITH T1D HAS BEEN LIMITED GIVEN THAT LIVING LONGER THAN 55 YEARS WITH THE DISEASE HAS ONLY RECENTLY BECOME POSSIBLE," SAID CO-CORRESPONDING AUTHOR HETAL SHAH, JOSLIN DIABETES CENTER.ENTER THE MEDALISTS: SINCE 1970, JOSLIN HAS AWARDED MEDALS TO MORE THAN 7,000 PEOPLE, KNOWN AS THE MEDALISTS, FOR LIVING WITH THE CONDITION FOR 50 YEARS.KING AND COLLEAGUES RECRUITED MORE THAN 1,000 MEDALISTS WITH TYPE 1 DIABETES. PARTICIPANTS HAD A MEAN AGE OF 66 YEARS AND HAD BEEN LIVING WITH T1D AN AVERAGE OF 53 YEARS.BUT WHEN SHAH, KING AND COLLEAGUES ASSESSED THEIR COGNITIVE FUNCTION AND CONDUCTED BRAIN AND RETINAL IMAGING, THEY FOUND THE MEDALISTS PERFORMED WORSE THAN PEOPLE WITHOUT DIABETES IN MANY CATEGORIES, INCLUDING RECALL AND PSYCHOMOTOR CONTROL. NEUROIMAGING REVEALED THE MEDALISTS HAD LOWER TOTAL BRAIN VOLUME, EQUIVALENT TO NINE YEARS ACCELERATED AGING, THE RESEARCHERS CALCULATED.RETINAL IMAGING REVEALED THAT WORSE COGNITIVE FUNCTION, LOWER BRAIN VOLUMES, AND DIABETIC RETINOPATHY WERE LINKED WITH THE THINNING OF RETINAL TISSUES. TOGETHER, THESE FINDINGS SUGGEST THAT MAINTAINING EYESIGHT COULD BE ONE WAY TO MODIFY THE COURSE OF COGNITIVE DECLINE IN THIS POPULATION."OUR FINDINGS ARE VERY DIFFERENT FROM THOSE REPORTED FOR PEOPLE WITH TYPE 2 DIABETES," SAID KING. "THIS LINK BETWEEN BETTER VISUAL ACUITY AND THE PRESERVATION OF COGNITIVE FUNCTION AND HIGHER BRAIN VOLUMES IS NOVEL AND SUGGESTS A POTENTIAL THERAPEUTIC APPROACH TO PREVENT COGNITIVE DECLINE IN T1D THAT MAY EVEN BE APPLICABLE BEYOND THIS POPULATION TO AGE-RELATED DEMENTIA," SAID SHAH.
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STUDY EXPLORES INSTAGRAM'S ROLE IN YOUNG ADULTS LIVING WITH TYPE 1 DIABETES
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FOR MANY 18- TO 25-YEAR-OLDS WITH TYPE 1 DIABETES (T1D), MANAGING THEIR CONDITION DURING A TIME OF LIFE ALREADY MARKED BY CHANGE AND STRESS POSES A SIGNIFICANT CHALLENGE. FOR THESE SAME YOUNG ADULTS, SOCIAL MEDIA IS A DAILY HABIT, AND A POTENTIAL SOURCE OF SUPPORT. A QUALITATIVE STUDY PUBLISHED IN JMIR DIABETES EXPLORES HOW INSTAGRAM POSTS FOCUSED ON DIABETES MAY AFFECT YOUNG PEOPLE'S SELF-CARE BEHAVIORS AND EMOTIONAL WELL-BEING."OUR RESULTS DEMONSTRATE THAT SOCIAL MEDIA HAS THE POTENTIAL TO PROVIDE SUPPORT TO YOUNG PEOPLE WITH T1D AS WELL AS IMPACT THEIR WELL-BEING BY FOSTERING A SENSE OF COMMUNITY AND INCREASING ACCESS TO INFORMATION ABOUT DIABETES," SAID LEAD AUTHOR TARA MAXWELL, MD, MSHP, FORMERLY AT JOSLIN DIABETES CENTER. "WE ALSO DESCRIBE THE POTENTIAL NEGATIVE EFFECTS OF SOCIAL MEDIA ON DIABETES, SELF-MANAGEMENT, AND EMOTIONAL STATE."IN ONE-ON-ONE VIDEO INTERVIEWS, PARTICIPANTS REACTED TO A CURATED SET OF 10 INSTAGRAM POSTS REFLECTING COMMON DIABETES THEMES. POSTS WERE VIEWED MORE POSITIVELY WHEN THEY WERE MEDICALLY ACCURATE, EMOTIONALLY RELATABLE, AND VISUALLY APPEALING. BUT CONTENT THAT DRAMATIZED THE CONDITION OR IDEALIZED LIFE WITH T1D SOMETIMES UNDERMINED SELF-CARE OR WORSENED EMOTIONAL WELL-BEING.TO BETTER UNDERSTAND HOW SOCIAL MEDIA INFLUENCES PEOPLE WITH T1D, MAXWELL AND COLLEAGUES, INCLUDING SENIOR AUTHOR LORI LAFFEL, MD, MPH, RECRUITED 26 YOUNG ADULTS WHO RECEIVED REGULAR CARE AT JOSLIN AND HAD LIVED WITH T1D FOR AT LEAST A YEAR. WHILE ALL REPORTED DAILY SOCIAL MEDIA USE, MOST SAID THEY ONLY OCCASIONALLY VIEWED DIABETES-RELATED CONTENT AND RARELY POSTED ABOUT THEIR CONDITION THEMSELVES.THE RESEARCHERS ASKED PARTICIPANTS TO DESCRIBE HOW EACH POST MADE THEM FEEL, WHAT IT EMPHASIZED, AND HOW IT MIGHT INFLUENCE THEIR SELF-CARE. SOCIAL MEDIA SERVED TO HIGHLIGHT THE EXISTENCE OF A COMMUNITY OF PEOPLE WITH T1D; PROVIDE DIABETES INFORMATION; POTENTIALLY REINFORCE GOOD HABITS; AND INFLUENCE EMOTIONAL STATE, FOR BETTER OR FOR WORSE."SOCIAL MEDIA MAY NOT NECESSARILY BE GOOD OR BAD FOR YOUNG PEOPLE WITH T1D," SAID LAFFEL. "IT HAS THE POTENTIAL TO FOSTER COMMUNITY, SPARK REFLECTION, SUPPORT SELF-CARE, AND POSITIVELY AFFECT EMOTIONAL WELL-BEING. WITH THOUGHTFUL DESIGN AND MEANINGFUL ENGAGEMENT, SOCIAL MEDIA COULD BE A POWERFUL TOOL FOR IMPROVING OUTCOMES IN THIS POPULATION."FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL EDUCATION AS NOTED THROUGHOUT THIS FORM 990, BIDM IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH BIDM DOES NOT DIRECTLY ENGAGE IN HEALTH PROFESSIONS EDUCATION / GRADUATE MEDICAL EDUCATION, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL AND MOUNT AUBURN HOSPITAL ALL ENGAGE IN EDUCATIONAL ACTIVITIES DESIGNED TRAIN FUTURE PHYSICIANS AND OTHER FUTURE HEALTHCARE PRACTITIONERS. ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $216 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $70 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $145 MILLION WHICH IS AN INVESTMENT IN THE HEALTH SYSTEM OF TOMORROW. ALTHOUGH THE EDUCATIONAL ACTIVITIES OF THESE BILH AFFILIATES ARE NOT QUANTIFIED HERE IN BIDM'S FORM 990 SCHEDULE H, PART I, 7F, AS ALREADY NOTED THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY BIDM AND BEYOND. IN ADDITION, INFORMATION ON THE TEACHING ACTIVITIES AT BIDMC, A SISTER ENTITY TO BIDM, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 63 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 760 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 48 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 57 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS:- ANESTHESIOLOGY- EMERGENCY MEDICINE- EAR, NOSE AND THROAT (OTOLARYNGOLOGY)- INTERNAL MEDICINE- NEUROLOGY- NEUROSURGERY- OBSTETRICS AND GYNECOLOGY- PATHOLOGY- PLASTIC SURGERY - PSYCHIATRY- RADIOLOGY- SURGERY- TRANSITIONAL YEAR- UROLOGYRESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. MORE THAN HALF OF THESE PROGRAMS (47 OF 91) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS:- ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, ANESTHESIA FOR OUTPATIENT SURGERY, CRITICAL CARE MEDICINE, NEUROANESTHESIA, NEURO CRITICAL CARE, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA, PATIENT SAFETY AND QUALITY IMPROVEMENT IN ANESTHESIA, ANESTHESIA MEDICAL EDUCATION, ADVANCED CRITICAL CARE AND ULTRASOUND- DERMATOLOGY: CUTANEOUS ONCOLOGY, DERMATOLOGY RESEARCH FELLOWSHIP IN CLINICAL TRIALS AND OUTCOMES RESEARCH (CLEARS)- EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, MEDICAL EDUCATION IN EMERGENCY MEDICINE- INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOCRINE, DIABETES AND METABOLISM, ADVANCED ENDOSCOPY, ADVANCED INFECTIOUS DISEASE, ADVANCED NEPHROLOGY, CARDIAC MAGNETIC RESONANCE IMAGING, CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GERIATRIC AND DIABETES, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND MEDICAL ONCOLOGY, HEPATOLOGY, HOSPICE AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, STRUCTURAL HEART DISEASE, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY- NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY, NEURO CRITICAL CARE- OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, GYNECOLOGIC ONCOLOGY, MATERNAL FETAL MEDICINE, REPRODUCTIVE ENDOCRINOLOGY, UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY.- PATHOLOGY: BLOOD BANKING/TRANSFUSION MEDICINE, CYTOPATHOLOGY, DERMATOPATHOLOGY, HEMATOPATHOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY CPEP, NEUROPATHOLOGY, SELECTIVE PATHOLOGY - PSYCHIATRY: EARLY PSYCHOSIS, CONSULT LIAISON PSYCHIATRY- RADIOLOGY: DIAGNOSTIC, ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED, MRI, MUSCULOSKELETAL IMAGING (MSK), NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, ADVANCED CROSS-SECTIONAL IMAGING. - RADIATION ONCOLOGY: BRACHYTHERAPY, STEREOTATIC- SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, ACUTE CARE SURGERY, ANTERIOR SEGMENT OPHTHALMOLOGY, COLON AND RECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, HEAD & NECK SURGICAL ONCOLOGY & RECONSTRUCTION, INTERDISCIPLINARY BREAST SURGERY, LYMPHATIC SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, OTOLARYNGOLOGY FELLOWSHIP, PLASTIC SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PLASTIC SURGERY/BREAST RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATED, JOINTS FELLOWSHIP
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ADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS - EXAMPLES
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BELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER:HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMCTHE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HEALTH ALLIANCE, TUFTS MEDICAL CENTER, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL, SOUTH SHORE HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER. INTERNAL MEDICINE EDUCATION AT BIDMCTHE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION. THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR "AMBULATORY BLOCKS" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS. AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD AND FOURTH YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS.JUNIOR AND SENIOR RESIDENCYRESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSESTAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM. RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL "TRACKS" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.TEACHING AS A RESIDENTAS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS: - RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE.- DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS: - DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS. SMALL GROUP PRESENTATIONS: - DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC.- ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS. INTERNAL MEDICINE GLOBAL HEALTH PROGRAMOUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS.PROGRAM OBJECTIVES - INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS - CONTRIBUTE TO THE HEALTH AND WELL-BEING OF POPULATIONS AROUND THE WORLD - ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS - EXPAND RESEARCH OPPORTUNITIES - ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCH
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SITE LOCATIONS
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- BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA. - VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. - ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS. GLOBAL HEALTH TRACK LEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY. HOSPITAL-WIDE GLOBAL HEALTH PROGRAM THE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH. NEUROLOGY EDUCATION AT BIDMCTHE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS. PATHOLOGY EDUCATION AT BIDMCTHE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES. KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES. GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH "RESIDENT-AS-TEACHER" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS. RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE. GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAINING.
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RADIOLOGY EDUCATION AT BIDMC
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THE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL. WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEO-RECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE:- THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR.- FOUR WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR.- ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME.OUR UNIQUE EDUCATIONAL TRACKSCURRENTLY, SIX TRACKS ARE OFFERED:- CLINICAL- EDUCATION- RESEARCH- GLOBAL HEALTH- QUALITY IMPROVEMENT- HEALTH POLICY/HEALTH ECONOMICSEACH OF THESE TRACKS HAS SPECIFIC CURRICULAR OFFERINGS AND EDUCATIONAL GOALS. MOST OF THE TRACKS ARE LINKED TO SPECIFIC EDUCATIONAL ENDEAVORS. FOR EXAMPLE, A RESIDENT SELECTING THE GLOBAL HEALTH TRACK WILL ENROLL IN THE GLOBAL EFFECTIVENESS CURRICULUM OFFERED BY THE HARVARD SCHOOL OF PUBLIC HEALTH AND WILL SPEND TIME ABROAD PROVIDING CLINICAL RADIOLOGY SERVICES AND UNDERTAKING A GLOBAL HEALTH PROJECT. A RESIDENT SELECTING THE EDUCATION TRACK WILL PURSUE ADVANCED TRAINING IN EDUCATIONAL THEORY AND ADULT LEARNING BY PARTICIPATING IN THE HARVARD MACY PROGRAM FOR PHYSICIAN EDUCATORS AND UNDERTAKE AN EDUCATIONAL PROJECT BASED AT BIDMC OR HARVARD MEDICAL SCHOOL. A RESIDENT CHOOSING THE RESEARCH TRACK WILL PARTICIPATE IN GRANT WRITING WORKSHOPS AND DELVE DEEPLY INTO A RESEARCH PROJECT OF THEIR CHOICE.NO MATTER WHICH TRAINING TRACK, THE EXPECTATION IS THAT EVERY RESIDENT WILL HAVE THE OPPORTUNITY TO UNDERTAKE A SUBSTANTIAL PROJECT DURING RESIDENCY THAT WILL CULMINATE IN PRESENTATION AT A NATIONAL MEETING AND/OR PUBLICATION.SURGERY EDUCATION AT BIDMCTHE ROBERTA AND STEPHEN R. WEINER DEPARTMENT OF SURGERY OFFERS EDUCATION OPPORTUNITIES FOR RESIDENTS, FELLOWS AND MEDICAL STUDENTS IN CARDIAC SURGERY, GENERAL SURGERY, NEUROSURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PODIATRY, TRAUMA SURGERY, MINIMALLY INVASIVE SURGERY, UROLOGY, AND VASCULAR SURGERY. RESIDENTS AND FELLOWS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. RESIDENTS AND FELLOWS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSESTAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSESTAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE:- RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB - SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS - COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.
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Attach to Form 990 or Form 990-EZ.