SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
STANFORD HEALTH CARE
 
Employer identification number

94-6174066
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    18,632,501 799,107 17,833,394 0.510 %
b Medicaid (from Worksheet 3, column a) . . . . .     460,543,211 203,453,569 257,089,642 7.340 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     479,175,712 204,252,676 274,923,036 7.850 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     5,469,374   5,469,374 0.160 %
f Health professions education (from Worksheet 5) . . .     94,996,311 19,625,683 75,370,628 2.150 %
g Subsidized health services (from Worksheet 6) . . . .     6,702,150 5,304,928 1,397,222 0.040 %
h Research (from Worksheet 7) .     1,022,613   1,022,613 0.030 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     3,660,481   3,660,481 0.100 %
j Total. Other Benefits . .     111,850,929 24,930,611 86,920,318 2.480 %
k Total. Add lines 7d and 7j .     591,026,641 229,183,287 361,843,354 10.330 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     2,690   2,690  
2 Economic development            
3 Community support     30,095   30,095  
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy     2,500   2,500  
8 Workforce development     117,822   117,822  
9 Other            
10 Total     153,107   153,107  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
109,224,249
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
727,402,478
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
1,239,621,574
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-512,219,096
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 STANFORD HEALTH CARE
300 PASTEUR DRIVE
STANFORD,CA94305
HTTP://STANFORDHEALTHCARE.ORG
070000662 		X X   X     X      
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
STANFORD HEALTH CARE
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTP://STANFORDHEALTHCARE.ORG
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

Financial Assistance Policy (FAP)
STANFORD HEALTH CARE
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTP://STANFORDHEALTHCARE.ORG
b
SAME AS ABOVE
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

STANFORD HEALTH CARE
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
Page 7
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
PART V, SECTION B LINE 5 IN SAN MATEO COUNTY (SMC) AND SANTA CLARA COUNTY (SCC), APPLIED SURVEY RESEARCH (ASR) CONDUCTED THE PRIMARY RESEARCH USING THREE STRATEGIES FOR COLLECTING COMMUNITY INPUT: INTERVIEWS WITH HEALTH EXPERTS, FOCUS GROUPS WITH COMMUNITY LEADERS AND STAKEHOLDERS, AND RESIDENT FOCUS GROUPS. TO PROVIDE A VOICE TO THE COMMUNITY, AND IN ALIGNMENT WITH IRS REGULATIONS, THE FOCUS GROUPS TARGETED RESIDENTS WHO ARE MEDICALLY UNDERSERVED, IN POVERTY, AND OF MINORITY POPULATIONS. ASR CONDUCTED FOCUS GROUPS AND KEY INFORMANT INTERVIEWS IN SAN MATEO AND SANTA CLARA COUNTIES WHICH CENTERED AROUND TWO CORE QUESTIONS. THESE QUESTIONS WERE MODIFIED APPROPRIATELY FOR THE GROUP (PROFESSIONALS OR RESIDENTS): -WHAT ARE THE TOP OR "PRIORITY" HEALTH NEEDS IN THE COMMUNITY THAT ARE NOT BEING WELL-MET NOW (COMPARED TO 2013)? -WHAT ARE THE ISSUES AROUND ACCESS TO HEALTHCARE AND HOW HAS THE AFFORDABLE CARE ACT IMPACTED ACCESS TO HEALTHCARE FOR THE COMMUNITY? FOCUS GROUPS SAN MATEO COUNTY: ASR HELD NINE FOCUS GROUPS IN SMC, PRIMARILY WITH RESIDENTS, AND ONE WITH PROFESSIONALS FROM ORGANIZATIONS THAT SERVE THE FOCUS POPULATION. A TOTAL OF 65 COMMUNITY MEMBERS PARTICIPATED IN THE FOCUS GROUP DISCUSSIONS ACROSS SMC. PARTICIPATING GROUPS INCLUDED: -SEQUOIA WELLNESS CENTER (LOW-INCOME OLDER ADULTS POPULATION) -CARLMONT HIGH SCHOOL (YOUTH POPULATION) -FAIR OAKS ACTIVITY CENTER (LOW-INCOME, SPANISH-SPEAKING OLDER ADULTS POPULATION) -MAPLE STREET SHELTER (HOMELESS ADULTS POPULATION) -EL CENTRO DE LIBERTAD (YOUTH WITH BEHAVIORAL HEALTH ISSUES POPULATION) -PRIDE INITIATIVE AT CONGREGATIONAL CHURCH OF SAN MATEO (LGBTQI POPULATION) -PACIFIC ISLANDER INITIATIVE AT PENINSULA CONFLICT RESOLUTION CENTER (TONGAN/SAMOAN POPULATION) -RAVENSWOOD HEALTH CENTER (MEDICALLY UNDERSERVED POPULATION) -BOYS & GIRLS CLUB OF HALF MOON BAY (COASTSIDE RESIDENTS POPULATION) SANTA CLARA COUNTY: TEN FOCUS GROUPS WERE HELD IN SCC BETWEEN APRIL AND SEPTEMBER 2015. HALF OF THE GROUPS WERE HELD WITH PROFESSIONALS FROM ORGANIZATIONS THAT SERVE THE FOCUS POPULATION, AND HALF WERE HELD WITH RESIDENTS THEMSELVES. SIXTY-EIGHT PROFESSIONALS AND FORTY NON-PROFESSIONAL RESIDENTS PARTICIPATED IN A FOCUS GROUP. THREE OUT OF FIVE FOCUS GROUPS WITH RESIDENTS WERE CONDUCTED IN LANGUAGES OTHER THAN ENGLISH. IN ADDITION TO ANSWERING THE CORE QUESTIONS ABOUT HEALTH PRIORITIES AND ACCESS, ASR ASKED SCC FOCUS GROUP PARTICIPANTS TO SHARE THEIR SUGGESTIONS FOR IMPROVEMENT OF HEALTH, INCLUDING HOW NEW OR EXISTING RESOURCES COULD BEST HELP, AND WHETHER POLICIES COULD BE DEVELOPED TO IMPACT THE NEED. PARTICIPATING GROUPS INCLUDED: -FAMILY CAREGIVER ALLIANCE (FAMILY CAREGIVERS OF OLDER ADULT POPULATION) -DESTINATION HOME (HOMELESS ADULT POPULATION) -COLUMBIA NEIGHBORHOOD CENTER (SPANISH-SPEAKING NEW AND PREGNANT MOTHER POPULATION) -LOS ALTOS HIGH SCHOOL (HIGH SCHOOL YOUTH POPULATION) -COMMUNITY HEALTH PARTNERSHIP (SPANISH-SPEAKING MEDICALLY UNDERSERVED POPULATION) -ALZHEIMERS ASSOCIATION (OLDER ADULT POPULATION) -BEHAVIORAL HEALTH CONTRACTORS ASSOCIATION OF SANTA CLARA COUNTY (MENTAL HEALTH/SUBSTANCE ABUSE POPULATION) -COMMUNITY SOLUTIONS (SOUTH COUNTY RESIDENT POPULATION) -ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT (VIETNAMESE-SPEAKING ADULT POPULATION) INTERVIEWS ASR INTERVIEWED VARIOUS PROFESSIONALS, INCLUDING PUBLIC HEALTH EXPERTS, IN SCC AND SMC WHO EITHER WORK IN THE HEALTH FIELD OR IMPROVE HEALTH AND QUALITY OF LIFE CONDITIONS BY SERVING THOSE FROM IRS-IDENTIFIED HIGH-NEED POPULATIONS AND ALSO COMMUNITY LEADERS OR REPRESENTATIVES. EXPERTS WERE INTERVIEWED IN PERSON OR BY TELEPHONE. IN BOTH COUNTIES, ASR ASKED INFORMANTS TO IDENTIFY THE TOP NEEDS OF THEIR CONSTITUENCIES AND TO GIVE THEIR PERCEPTIONS ABOUT HOW ACCESS TO HEALTHCARE HAS CHANGED IN THE POST-AFFORDABLE CARE ACT ENVIRONMENT. SAN MATEO COUNTY: IN SMC, ASR CONDUCTED 29 KEY INFORMANT INTERVIEWS. IN ADDITION TO THE CORE QUESTIONS ABOUT HEALTH PRIORITIES AND ACCESS DESCRIBED ABOVE, INFORMANTS WERE ASKED TO DISCUSS HOW THE BUILT/PHYSICAL ENVIRONMENT IN SMC IMPACTS HEALTH AND HOW TECHNOLOGY MAY BE USED TO IMPROVE HEALTH. SANTA CLARA COUNTY: ASR INTERVIEWED FIVE SCC EXPERTS FROM VARIOUS ORGANIZATIONS IN THE HEALTH SECTOR. IN ADDITION TO THE CORE QUESTIONS ABOUT HEALTH PRIORITIES AND ACCESS, THEY WERE ASKED TO EXPLAIN WHICH BARRIERS TO GOOD HEALTH OR ADDRESSING HEALTH NEEDS EXIST, AND TO SHARE WHICH SOLUTIONS MAY IMPROVE HEALTH (INCLUDING EXISTING RESOURCES AND POLICY CHANGES). SURVEY (SANTA CLARA COUNTY ONLY) ASR INVITED 65 COMMUNITY LEADERS WITH EXPERTISE IN SERVING THE COMMUNITY TO PARTICIPATE IN AN ONLINE SURVEY. THE SURVEY ASKED PARTICIPANTS TO RANK A LIST OF HEALTH NEEDS IN SANTA CLARA COUNTY AND INVITED THEM TO ADD OTHER NEEDS TO THE LIST. THERE WERE 49 RESPONSES TO THE SURVEY, WHICH REFLECTED A RANGE OF EXPERTISE. PARTICIPANTS ORGANIZATIONS INCLUDED BEHAVIORAL HEALTH AGENCIES, AGENCIES THAT HELP FAMILIES WITH BASIC NEEDS, SCHOOL SYSTEMS, AND OTHER NONPROFIT ORGANIZATIONS. ASR COMBINED THE RESULTS OF THE SURVEY WITH INPUT GATHERED THROUGH FOCUS GROUPS AND INTERVIEWS TO DETERMINE THE COMMUNITYS PRIORITIES.
PART V, SECTION B, LINE 6A -EL CAMINO HOSPITAL -KAISER PERMANENTE - SANTA CLARA, SAN JOSE, SOUTH SAN FRANCISCO AND REDWOOD CITY -LUCILE PACKARD CHILDREN'S HOSPITAL STANFORD HEALTH CARE -O'CONNOR HOSPITAL -SAINT LOUISE REGIONAL -SAN MATEO MEDICAL CENTER -SEQUOIA HOSPITAL -SETON MEDICAL CENTER -SUTTER HEALTH PENINSULA COASTAL REGION
PART V, SECTION B, LINE 6B -UNITED WAY SILICON VALLEY -SAN MATEO COUNTY HEALTH DEPARTMENT -SANTA CLARA COUNTY PUBLIC HEALTH DEPARTMENT
PART V, SECTION B, LINE 7A/10A URL AT WHICH THE CHNA AND IMPLEMENTATION STRATEGY ARE AVAILABLE: HTPPS://STANFORDHEALTHCARE.ORG/ABOUT-US/COMMUNITY-PARTNERSHIPS.HTML
PART V, SECTION B, LINE 11 OF THE 21 HEALTH NEEDS IDENTIFIED BY THE CHNA PROCESS, SHC SELECTED FIVE TO ADDRESS. ACCESS TO CARE, CANCER, INFECTIOUS DISEASE, OBESITY/DIABETES, AND BEHAVIORAL HEALTH. SHC ADDRESSES THESE SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA PROCESS BY PARTNERING WITH FREE- AND COMMUNITY-BASED CLINICS AND OTHER COMMUNITY-BASED ORGANIZATIONS. FOR A DETAILED DESCRIPTION OF SHCS COMMUNITY PARTNERS AND RESOURCES PROVIDED SEE THE IMPLEMENTATION STRATEGY AT HTPPS://STANFORDHEALTHCARE.ORG/ABOUT-US/COMMUNITY-PARTNERSHIPS.HTML THE FOLLOWING FIVE CRITERIA WERE USED TO PRIORITIZE THE 21 HEALTH NEEDS AND DETERMINE, WHICH HEALTH NEEDS WILL BE ADDRESSED BY SHC BETWEEN 2017 AND 2019: -CRITERION 1: CUTS ACROSS BOTH SAN MATEO AND SANTA CLARA COUNTIES (IMPACTS SHCS COMMUNITY) -CRITERION 2: IDENTIFIED AS A PRIORITY HEALTH NEED BY COMMUNITY INPUT -CRITERION 3: SHC HAS THE REQUIRED EXPERTISE AND RESOURCES TO MAKE AN IMPACT -CRITERION 4: MAGNITUDE/SCALE: AFFECTS A LARGE NUMBER OF INDIVIDUALS -CRITERION 5: ALTHOUGH NOT A NEED IN THE GENERAL POPULATION, DISPARITIES OR INEQUITIES EXIST HEALTH NEEDS NOT BEING ADDRESSED: OF THE 21 HEALTH NEEDS IDENTIFIED BY THE CHNA PROCESS, SHC SELECTED FIVE TO ADDRESS. OF THE SIXTEEN OTHER HEALTH NEEDS, THREE ARE INDIRECTLY ADDRESSED THROUGH THE HEALTH INITIATIVES DESCRIBED IN THE IMPLEMENTATION STRATEGY: CEREBROVASCULAR DISEASES, DIET/FITNESS/NUTRITION, AND RESPIRATORY CONDITIONS. THE HEALTH NEEDS LISTED BELOW ARE NOT CURRENTLY ADDRESSED IN THE IMPLEMENTATION STRATEGY. THE REASONS WHY THE NEED IS NOT BEING ADDRESSED INCLUDE -HOUSING: DOES NOT MEET CRITERION 3 -ORAL & DENTAL HEALTH: DOES NOT MEET CRITERION 3 -VIOLENCE & ABUSE: DOES NOT MEET CRITERION 3 OR CRITERION 4 -ALZHEIMERS DISEASE AND DEMENTIA: DOES NOT MEET CRITERION 2 OR 5 -BIRTH OUTCOMES: DOES NOT MEET CRITERION 2 OR 3 -ECONOMIC SECURITY: DOES NOT MEET CRITERION 2 OR 3 -SEXUAL HEALTH: DOES NOT MEET CRITERION 2, 3, OR, 4 -LEARNING DISABILITIES: DOES NOT MEET CRITERION 1, 3, 4, OR 5 -TOBACCO USE: DOES NOT MEET CRITERION 1, 3, 4, OR 5 -TRANSPORTATION AND TRAFFIC: DOES NOT MEET CRITERION 1, 3, 4, OR 5 -ARTHRITIS: DOES NOT MEET ANY CRITERION -CLIMATE CHANGE: DOES NOT MEET ANY CRITERION -UNINTENTIONAL INJURIES: DOES NOT MEET CRITERION 1, 2, 4, OR 5
PART V, SECTION B, LINE 16A-C URL AT WHICH THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY IS AVAILABLE HTTPS://STANFORDHEALTHCARE.ORG/FOR-PATIENTS-VISITORS/BILLING/FINANCIAL-ASS ISTANCE.HTML
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
Page 8
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?5
Name and address Type of Facility (describe)
1 STANFORD EMP HEALTH CLINIC AT QUALCOMM
5535 MOREHOUSE DRIVE
SAN DIEGO,CA92121 		STANFORD EMPL HEALTH CLINIC AT QUALCOMM
2 STANFORD EMP HEALTH CLINIC AT DREAMWORKS
1000 FLOWER STREET
GLENDALE,CA91201 		STANFORD EMPL HEALTH CLINIC AT DREAMWORKS
3 STANFORD EMP HEALTH CLINIC AT CISCO
3571 N 1st Street
San Jose,CA95134 		STANFORD EMP HEALTH CLINIC AT CISCO
4 STANFORD EMP HEALTH CLINIC AT YAHOO
701 FIRST AVENUE
SAN JOSE,CA94089 		STANFORD EMP HEALTH CLINIC AT YAHOO
5 STANFORD EMP HEALTH CLINIC AT QUALCOMM
10155 PACIFIC HEIGHTS BLVD
SAN DIEGO,CA92121 		STANFORD EMP HEALTH CLINIC AT QUALCOMM
6
7
8
9
10
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
Page 9
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 6A IN SAN MATEO AND SANTA CLARA COUNTIES, COMMUNITY INPUT WAS GATHERED IN THE SPRING AND FALL OF 2015 THROUGH INTERVIEWS WITH LOCAL HEALTH EXPERTS, FOCUS GROUPS WITH COMMUNITY LEADERS AND REPRESENTATIVES, AND RESIDENT FOCUS GROUPS. SECONDARY DATA WAS OBTAINED FROM A VARIETY OF SOURCES.
PART I, LINE 7E COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS TOTALED $5,469,374 IN FY16.
PART I, LINE 7F HEALTH PROFESSIONS EDUCATION RESEARCH, EDUCATION AND TRAINING ARE CORE TO SHC'S MISSION. SHC IS THE SETTING FOR TRAINING MEDICAL STUDENTS, RESIDENTS AND FELLOWS FROM THE STANFORD SCHOOL OF MEDICINE AND, AS SUCH, MAKES A SIGNIFICANT CONTRIBUTION TO TRAINING THE NEXT GENERATION OF HEALTHCARE PROVIDERS. IN FY16, SHC CONTRIBUTED MORE THAN $76,393,241 MILLION TO SUPPORT HEALTH RESEARCH, EDUCATION AND TRAINING. OF THIS AMOUNT, OVER $68 MILLION WAS SPENT TO TRAIN MEDICAL RESIDENTS AND INTERNS. IN ADDITION TO TRAINING PHYSICIANS, SHC SUPPORTS THE TRAINING OF OTHER HEALTH PROFESSIONALS. IN FY16, SHC INVESTED NEARLY $7.6 MILLION ON THIS TRAINING. HOSPITAL DEPARTMENTS SUCH AS REHABILITATION SERVICES, NURSING AND CLINICAL LABS PROVIDED CLINICAL ROTATIONS FOR PHYSICAL THERAPY, RESPIRATORY THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, NURSING AND LABORATORY SCIENCE STUDENTS FROM LOCAL COLLEGES AND UNIVERSITIES. IN ADDITION, PHYSICIAN ASSISTANT STUDENTS ARE TRAINED BY SHC PHYSICIAN ASSISTANTS. SHC ALSO PROVIDES A TRAINING GROUND FOR PHARMACY RESIDENTS AND STUDENTS, RADIOLOGY AND NUCLEAR MEDICINE STUDENTS AND PSYCHOLOGY STUDENTS. THE COMMUNITY HEALTH ADVOCACY PROGRAM PROVIDES STANFORD UNDERGRADUATE STUDENTS WEEKLY COURSEWORK FOCUSED ON ADDRESSING THE STRUCTURAL DETERMINANTS OF HEALTH AND FIELD STUDY FOCUSED ON CAPACITY-BUILDING AT LOCAL HEALTH CLINICS AND NON-PROFIT ORGANIZATIONS. IN THE 2015-16 ACADEMIC YEAR, SEVEN STUDENTS DEDICATED 900 HOURS TO THE FOLLOWING SITES AND PROJECTS: SENIOR HEALTH (AVENIDAS), HEALTH CAREERS PROGRAM FOR MIDDLE SCHOOL CHILDREN (BOYS AND GIRLS CLUB), HEALTH EDUCATION FOR INTIMATE PARTNER VIOLENCE SURVIVORS (NEXT DOOR SOLUTIONS FOR DOMESTIC VIOLENCE & HOMEFIRST), AND MOBILE TECHNOLOGY MANAGEMENT OF DIABETES (SAMARITAN HOUSE). STUDENTS ENROLLED IN CLINICAL PASTORAL EDUCATION COME FROM A WIDE RANGE OF RELIGIOUS TRADITIONS, THE MAJORITY OF WHOM ARE PREPARING FOR A CAREER IN CHAPLAINCY OR SEEKING CONTINUING EDUCATION IN THE FIELD OF PASTORAL/SPIRITUAL CARE. UPON COMPLETION OF THE YEAR-LONG PROGRAM, MOST STUDENTS USE THEIR TRAINING AS CLERGY (PASTORS, PRIESTS, RABBIS, CHAPLAINS, ETC.) TO PROVIDE EFFECTIVE SPIRITUAL CARE TO INDIVIDUALS AND FAMILIES FACING HEALTH CHALLENGES AND OTHER HARDSHIPS SUCH AS DEATH, DYING AND BEREAVEMENT. THIS PROGRAM SERVED APPROXIMATELY 7,500 INDIVIDUALS IN FY 2016.
PART I, LINE 7G SUBSIDIZED HEALTH SERVICES STANFORD LIFE FLIGHT IS A STANFORD OPERATED HELICOPTER AIR MEDICAL AND CRITICAL CARE GROUND TRANSPORT PROGRAM AVAILABLE 365 DAYS/YEAR, 24 HOURS/DAY, SERVING NORTHERN CA IN THE TRANSPORT OF CRITICALLY ILL AND INJURED ADULT, PEDIATRIC, AND NEONATAL PATIENTS TO DEFINITIVE CARE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. LIFE FLIGHT TRANSPORTS 73% OF THE PROGRAM'S FLIGHT VOLUME FROM PARTNER HOSPITALS TO STANFORD OR OTHER MAJOR MEDICAL CENTERS, AND THE REMAINING PATIENTS ARE TRANSPORTED DIRECTLY FROM ACCIDENT SCENES OR MEDICAL EMERGENCIES TO TRAUMA CENTERS OR SPECIALTY MEDICAL CENTERS (STROKE, BURNS, ETC.). IN FY 16, LIFE FLIGHT TRANSPORTED 416 ADULT AND PEDIATRIC PATIENTS TO STANFORD HOSPITAL, LUCILE PACKARD CHILDREN'S HOSPITAL, AND OTHER BAY AREA MAJOR MEDICAL CENTERS.
PART I, LINE 7I CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT TOTALED $3,660,481 IN FY16.
PART II COMMUNITY EMERGENCY RESPONSE SHC PLAYS A KEY ROLE IN DISASTER PLANNING FOR THE COMMUNITY. THROUGH THE OFFICE OF EMERGENCY MANAGEMENT (OEM), SHC COLLABORATES WITH LOCAL MUNICIPALITIES, COUNTY GOVERNMENT, AND OTHER HOSPITALS TO COORDINATE PLANNING, MITIGATION, RESPONSE, AND RECOVERY ACTIVITIES FOR EVENTS THAT COULD ADVERSELY IMPACT THE COMMUNITY. THE GOAL OF THESE ACTIVITIES IS TO MINIMIZE THE IMPACT ON LIFE, PROPERTY, AND THE ENVIRONMENT FROM CATASTROPHIC EVENTS SUCH AS PANDEMIC FLU, EARTHQUAKES, AND OTHER DISASTERS. OEM WORKS WITH EMERGENCY MEDICAL SERVICES (EMS) IN BOTH SAN MATEO AND SANTA CLARA COUNTIES ON JOINT DISASTER EXERCISES, DISASTER PLANNING AND MITIGATION, AND BEST PRACTICES. OEM PROVIDES A CRITICAL SERVICE FOR SAN MATEO AND SANTA CLARA COUNTIES' EMS AND OTHER AGENCIES, AS WELL AS THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND OTHER HOSPITALS BY MAINTAINING CACHES OF EMERGENCY MEDICAL EQUIPMENT AND SUPPLIES FOR READY ACCESS AND DEPLOYMENT IN THE CASE OF DISASTER OR EMERGENCIES. OEM PROVIDES REGULAR INVENTORY REVIEW AND 24/7 SECURITY TO ENSURE THAT THESE EMS SUPPLIES ARE SERVICE-READY AT ALL TIMES.
PART III, LINE 2 AND 4 THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL EXPERIENCE AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
PART III, LINE 8 SHC HAS BEEN UTILIZING A COST ACCOUNTING (EPSI) SYSTEM TO MONITOR ITS OPERATION COST. THE SYSTEM SEPARATES THE COST INTO 4 MAJOR CATEGORIES, VARIABLE DIRECT COST, FIXED DIRECT COST, VARIABLE INDIRECT COST AND FIXED INDIRECT COST. THE OVERHEAD COSTS ARE ALLOCATED TO THE REVENUE GENERATED PATIENT CARE COST CENTERS AND INDIVIDUAL PATIENT ACCOUNT BASED ON THE STEP DOWN METHODOLOGY AND VARIOUS STATISTICAL UNITS OF SERVICES. THE COST OF CHARGE RATIO (RCC) FOR MEDICARE PROGRAM IS DETERMINED BY THE TOTAL COST OF SHC DISCHARGED AND FINAL BILLED MEDICARE PATIENTS, INCLUDING ALL 4 COST CATEGORIES MENTIONED ABOVE AND DIVIDED BY THE TOTAL CORRESPONDING DISCHARGED AND FINAL BILLED MEDICARE CHARGES FOR FY 2016. THE AMOUNT OF THE COST FOR PART III, SECTION B LINE 6 IS DETERMINED BY APPLYING THE PAYER SPECIFIC RCC TO ALL CHARGES FOR MEDICARE RELATED PROGRAMS, INCLUDING TRADITIONAL MEDICARE PROGRAM AND MANAGED CARE SENIOR PROGRAMS RESPECTIVELY. SHC'S LARGEST COMMUNITY BENEFIT INVESTMENT IS IN IMPROVING ACCESS TO NEEDED HEALTHCARE SERVICES FOR VULNERABLE COMMUNITY MEMBERS. BENEFITS AND THE SERVICES ARE NOT ONLY PROVIDED TO THE POOR BUT TO THOSE WHO NEED SPECIAL SERVICES AND SUPPORT, WHICH INCLUDES MEDICARE BENEFICIARIES. THUS, TOTAL COMMUNITY BENEFIT EXPENSE INCLUDES UNCOMPENSATED COSTS OF PUBLIC PROGRAM FOR TREATING MEDICARE BENEFICIARIES IN EXCESS OF GOVERNMENT PAYMENTS.
PART III, LINE 9B IT IS THE POLICY OF SHC TO FOLLOW THE STANDARDS AND PRACTICES FOR COLLECTION OF PATIENT DEBT IN ACCORDANCE WITH THE REQUIREMENTS OF CALIFORNIA ASSEMBLY BILL 774. SHC HAS A VARIETY OF OPTIONS FOR PATIENTS FACING FINANCIAL HARDSHIP, INCLUDING UNINSURED DISCOUNTING, NO INTEREST PAYMENT ARRANGEMENTS, AND A CHARITY CARE PROGRAM. PATIENTS WHO APPLY FOR CHARITY CARE AND QUALIFY MAY RECEIVE UP TO 100% FINANCIAL ASSISTANCE. SHC WILL SUSPEND ANY AND ALL COLLECTION ACTIONS IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION, INCLUDING ALL REQUISITE SUPPORTING DOCUMENTATION, IS RECEIVED. SHC DOES NOT ALLOW THEIR COLLECTION AGENCIES TO REPORT DEBT TO CREDIT BUREAUS, GARNISH WAGES, OR FILE LIENS ON PRIMARY RESIDENCES.
PART VI, LINE 2 NEEDS ASSESSMENT: COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) - PROCESS AND METHODS THE SANTA CLARA COUNTY COMMUNITY BENEFIT COALITION, WHICH INCLUDES EIGHT LOCAL NON-PROFIT HOSPITALS, SANTA CLARA COUNTY PUBLIC HEALTH DEPARTMENT, UNITED WAY SILICON VALLEY AND OTHER PARTNERS, AND THE HEALTHY COMMUNITY COLLABORATIVE OF SAN MATEO COUNTY, A COALITION OF SEVEN LOCAL NON-PROFIT HOSPITALS, SAN MATEO COUNTY HEALTH SYSTEM AND OTHER PARTNERS (SEE ACKNOWLEDGEMENTS) BEGAN THE CHNA PROCESS IN 2015 (NEXT CHNA WILL BE COMPLETED IN 2019 IN ALIGNMENT WITH IRS FINAL RULES). THE GOAL WAS TO COLLECTIVELY GATHER COMMUNITY FEEDBACK, UNDERSTAND EXISTING DATA ABOUT HEALTH STATUS AND PRIORITIZE LOCAL HEALTH NEEDS IN EACH COUNTY. IN SAN MATEO AND SANTA CLARA COUNTIES, COMMUNITY INPUT WAS GATHERED DURING THE SPRING AND FALL OF 2015 THROUGH INTERVIEWS WITH LOCAL HEALTH EXPERTS, FOCUS GROUPS WITH COMMUNITY LEADERS AND REPRESENTATIVES, AND RESIDENT FOCUS GROUPS. SECONDARY DATA WAS OBTAINED FROM A VARIETY OF SOURCES. IN LATE 2015 THROUGH EARLY 2016, HEALTH NEEDS WERE IDENTIFIED BY SYNTHESIZING PRIMARY QUALITATIVE RESEARCH AND SECONDARY DATA, AND THEN FILTERING THOSE NEEDS AGAINST A SET OF CRITERIA. NEEDS WERE THEN REVIEWED AND PRIORITIZED BY COUNTYWIDE GROUPS CONSISTING OF MEMBERS OF THE COUNTY COALITIONS AND COMMUNITY LEADERS USING ANOTHER SET OF CRITERIA. THE COALITIONS THEN MET AGAIN TO IDENTIFY THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE HEALTH NEEDS IDENTIFIED THROUGH THE CHNA PROCESS, INCLUDING HOSPITALS, CLINICS AND COMMUNITY-BASED PROGRAMS AND SERVICES.
PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SHC PROVIDES DEDICATED RESOURCES TO PATIENTS THAT APPLY FOR CHARITY CARE AND PROACTIVELY CONDUCTS OUTREACH TO PATIENTS TO INFORM THEM OF THE PROGRAM'S AVAILABILITY AND THEIR POTENTIAL ELIGIBILITY FOR ASSISTANCE. BROCHURES AND SIGNAGE ARE CONSPICUOUSLY DISPLAYED AT ALL CARE DELIVERY LOCATIONS WITH INSTRUCTION ON WHERE TO LOCATE ADDITIONAL INFORMATION ON ELIGIBILITY FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE APPLICATIONS, AND INSTRUCTIONS ON HOW TO APPLY ARE ALSO AVAILABLE ON THE SHC WEBSITE, VIA MAIL, AND IN ALL SHC CARE DELIVERY LOCATIONS.
PART VI, LINE 4 COMMUNITY INFORMATION SHC IS A REGIONAL REFERRAL CENTER FOR AN ARRAY OF ADULT SPECIALTIES, DRAWING PATIENTS FROM THROUGHOUT CALIFORNIA, ACROSS THE COUNTRY, AND INTERNATIONALLY. HOWEVER, A MAJORITY OF SHC'S PATIENTS ARE RESIDENTS OF SAN MATEO AND SANTA CLARA COUNTIES. THEREFORE, FOR PURPOSES OF ITS COMMUNITY BENEFIT PROGRAM INITIATIVES, SHC HAS IDENTIFIED THESE TWO COUNTIES AS ITS TARGET COMMUNITY. SHC MAINTAINS A STRONG COMMITMENT TO THE HEALTH OF ITS COMMUNITY MEMBERS AND DEDICATES CONSIDERABLE RESOURCES TO SUPPORT ITS COMMUNITY PARTNERSHIP PROGRAM. SANTA CLARA COUNTY IN 2015, SANTA CLARA COUNTY HAD APPROXIMATELY 1.9 MILLION RESIDENTS WITH MORE THAN HALF OF THOSE INDIVIDUALS LIVING IN SAN JOSE. THE COUNTY POPULATION WAS 56 PERCENT WHITE, 36 PERCENT ASIAN, 27 PERCENT LATINO/HISPANIC AND 3 PERCENT AFRICAN-AMERICAN AND 0.5 PERCENT PACIFIC ISLANDER. FOREIGN-BORN INDIVIDUALS MAKE UP 37 PERCENT OF COUNTY RESIDENTS. THE LARGEST GROUPS ARE FROM MEXICO AND CHINA (27 PERCENT), FOLLOWED BY VIETNAM AND INDIA (22 PERCENT), AND THE PHILIPPINES (15 PERCENT). IN 2014, SANTA CLARA COUNTY'S MEDIAN INCOME WAS NEARLY $94,000; THE HIGHEST IN THE STATE. DESPITE THE HIGH MEDIAN INCOME LEVEL, 14 PERCENT OF THE COUNTY'S GENERAL POPULATION AND ONE IN TEN OF CHILDREN WERE LIVING BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL), WHICH FOR A FAMILY OF FOUR WAS $24,250 PER YEAR. UNFORTUNATELY, THE FPL DOES NOT TAKE INTO CONSIDERATION LOCAL CONDITIONS SUCH AS COST OF LIVING IN THE SAN FRANCISCO BAY AREA. AS SUCH, THE FAMILY ECONOMIC SELF-SUFFICIENCY STANDARD (FESSS) IS A BETTER ESTIMATE OF ECONOMIC STABILITY IN SANTA CLARA COUNTY. FESSS ESTIMATES THAT AN ANNUAL INCOME OF $90,750 IS NECESSARY FOR A FAMILY OF FOUR (TWO ADULTS AND TWO CHILDREN AGES 3-5) LIVING IN SCC TO MEET THEIR MOST BASIC EXPENSES. WHILE THE CALIFORNIA MINIMUM WAGE INCREASED TO $10 PER HOUR IN JANUARY 2016, THE FESSS ESTIMATE IS EQUIVALENT TO MORE THAN 4 FULL-TIME MINIMUM WAGE JOBS. BY 2030, ONE IN FOUR SANTA CLARA COUNTY RESIDENTS WILL BE OVER THE AGE OF 60. THE FASTEST GROWING SEGMENT OF THIS POPULATION IS 85 YEARS AND OLDER. THE INCREASE OF INDIVIDUALS OVER THE AGE OF 60 WILL HAVE A SIGNIFICANT IMPACT ON THE COUNTY'S ABILITY TO PROVIDE SERVICES TO MEET THE NEEDS OF THIS BURGEONING POPULATION. ADDITIONALLY, ACCORDING TO THE ELDER ECONOMIC SECURITY INDEX (ELDER INDEX), NEARLY HALF OF SCC OLDER ADULTS ARE ECONOMICALLY INSECURE, WITH INCOMES TOO LOW TO MEET THEIR BASIC NEEDS WITHOUT ADDITIONAL ASSISTANCE. 67 PERCENT OF LATINO SENIORS AND 76 PERCENT OF ASIAN SENIORS ARE LIVING IN IMPOVERISHED CONDITIONS, COMPARED WITH 32 PERCENT OF WHITE (NON-LATINO) SENIORS. ADDITIONALLY, FEMALE SENIORS AND SENIORS AGES 75 AND OLDER (ANY GENDER) ARE MORE LIKELY TO EXPERIENCE POVERTY COMPARED TO MALE SENIORS AND THOSE BETWEEN THE AGES OF 65 AND 74. THE MAJORITY OF THE 6,556 PEOPLE COUNTED IN THE 2015 SANTA CLARA COUNTY HOMELESS CENSUS WERE SINGLE INDIVIDUALS OVER THE AGE OF 25 YEARS (73 PERCENT). THIRTEEN PERCENT OF THIS POPULATION WAS UNACCOMPANIED CHILDREN AND TRANSITION-AGE YOUTH UNDER THE AGE OF 25 (CHILDREN AND YOUTH LIVING ON THEIR OWN WITHOUT THE PRESENCE OF A PARENT OR ADULT FAMILY MEMBER). THE SURVEY ALSO FOUND THAT 68 PERCENT OF THOSE INDIVIDUALS CITED INABILITY TO AFFORD RENT AS THE REASON FOR BEING UNSHELTERED AND MORE THAN HALF REPORTED THEY HAD NO WORK OR INCOME. IN COMPARISON TO THE GENERAL POPULATION OF SANTA CLARA COUNTY, A HIGHER PERCENTAGE OF SURVEY RESPONDENTS IDENTIFIED AS HISPANIC OR LATINO (38 PERCENT COMPARED TO 27 PERCENT). A MUCH HIGHER POPULATION OF SURVEY RESPONDENTS IDENTIFIED AS BLACK OR AFRICAN AMERICAN, 18 PERCENT COMPARED TO 3 PERCENT OF THE GENERAL POPULATION. ONLY THREE PERCENT OF HOMELESS RESPONDENTS IDENTIFIED AS ASIAN, COMPARED TO 35 PERCENT OF THE GENERAL POPULATION. SAN MATEO COUNTY SAN MATEO COUNTY (SMC), LOCATED ON THE SAN FRANCISCO PENINSULA, IS MADE UP OF 20 CITIES AND TOWNS. IN 2015, THE COUNTY'S POPULATION WAS ESTIMATED OVER 765,000 WITH 42 PERCENT WHITE, 25 PERCENT HISPANIC/LATINO, 28 PERCENT ASIAN, 3 PERCENT AFRICAN-AMERICAN AND 2 PERCENT NATIVE HAWAIIAN/PACIFIC ISLANDER. IN 2014, THE U.S. CENSUS BUREAU ESTIMATED THAT THE MEDIAN INCOME FOR SMC RESIDENTS WAS $91,421. WHILE THIS MEDIAN INCOME WAS THE THIRD HIGHEST IN CALIFORNIA, 8 PERCENT OF ALL OF SMC INDIVIDUALS LIVED BELOW THE FEDERAL POVERTY LINE (FPL), ONE IN TEN CHILDREN LIVED BELOW FPL, AND 27 PERCENT OF SMC FEMALE HEAD OF HOUSEHOLD FAMILIES WITH CHILDREN UNDER AGE 5 LIVE BELOW FPL. AS WITH SANTA CLARA COUNTY, THE FPL DOES NOT TAKE INTO CONSIDERATION LOCAL CONDITIONS WHEN SETTING FPL. AS SUCH THE FAMILY ECONOMIC SELF-SUFFICIENCY STANDARD (FESSS) IS ALSO A BETTER MEASURE OF POVERTY IN SAN MATEO COUNTY. ACCORDING TO THE 2014 FESSS, A SINGLE PARENT WITH TWO CHILDREN LIVING IN SMC MUST EARN APPROXIMATELY $97,200 ANNUALLY TO MEET THE FAMILY'S BASIC NEEDS; THE EQUIVALENT OF FIVE FULL-TIME MINIMUM-WAGE JOBS IN SMC. ACCORDING TO THE ELDER INDEX, OLDER ADULTS ARE THE FASTEST GROWING POPULATION SEGMENT IN SMC. BY 2040, IT IS EXPECTED THAT THE SENIOR POPULATION WILL NEARLY DOUBLE; GROWING FROM 11 PERCENT IN 2010 TO 21 PERCENT. OLDER ADULTS WILL ALSO EXPERIENCE A SHIFT IN RACIAL AND ETHNIC DIVERSITY IN THE COMING YEARS. THE PERCENTAGE OF WHITE OLDER ADULTS IS PROJECTED TO DECLINE FROM 66 PERCENT IN 2009 TO 48 PERCENT BY 2030, WHILE THE PERCENT OF ASIAN AND HISPANIC OLDER ADULTS WILL GROW BY 12 PERCENT AND 5 PERCENT DURING THAT SAME TIMEFRAME. AFRICAN AMERICANS ARE ESTIMATED TO EXPERIENCE A SMALL DECREASE OF APPROXIMATELY ONE PERCENT. ALSO, PER THE ELDER INDEX, 36 PERCENT OF SENIORS STRUGGLE TO COVER THEIR BASIC EXPENSES BECAUSE THEIR ANNUAL INCOME EXCEEDS FEDERAL POVERTY GUIDELINES AND; THEREFORE, THEY MAY NOT QUALIFY FOR PUBLIC ASSISTANCE PROGRAMS. ADDITIONALLY, OF THOSE WHO LIVE ALONE, 47 PERCENT OF SENIOR WOMEN AND 36 PERCENT OF SENIOR MEN AS WELL AS 30 PERCENT OF SENIOR COUPLES ARE ECONOMICALLY INSECURE.
PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH A MAJORITY OF SHC'S TRUSTEES ARE MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL AND ARE NOT EMPLOYED BY THE HOSPITAL, NOR ARE THEY FAMILY MEMBERS OF PERSONS EMPLOYED BY THE HOSPITAL. SHC EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY IT SERVES WHO WISH TO JOIN THE STAFF, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. EXCESS RECEIPTS FROM SHC'S OPERATIONS ARE DEVOTED TO IMPROVEMENT OF ITS FACILITIES, DEBT SERVICE, MEDICAL TRAINING, AND RESEARCH. SHC HAS USED OPERATIONAL REVENUE TO UPDATE AND EXPAND ITS FACILITIES AND SERVICES, TO IMPROVE SYSTEMS TO ENHANCE QUALITY, TO FUND RESEARCH, AND FOR OTHER PURPOSES TO IMPROVE PATIENT CARE. INVESTMENTS IN VULNERABLE POPULATIONS SHC'S LARGEST COMMUNITY BENEFIT INVESTMENT WAS IN IMPROVING ACCESS TO HEALTH CARE FOR VULNERABLE COMMUNITY MEMBERS. IN FY 2016, SHC CONTRIBUTED NEARLY $281.5 MILLION, 78 PERCENT OF ITS COMMUNITY BENEFIT EXPENDITURES, TO ACTIVITIES SUPPORTING VULNERABLE POPULATIONS (EXCLUDING UNCOMPENSATED MEDICARE). SHC'S UNCOMPENSATED EXPENSE (COST LESS REIMBURSEMENT) FOR MEDI-CAL WAS OVER $257 MILLION. CHARITY CARE FOR UNINSURED AND UNDERINSURED PATIENTS TOTALED NEARLY $18 MILLION. ACTIVITIES FOR VULNERABLE POPULATIONS IN ADDITION TO THE INVESTMENTS IN CHARITY CARE AND UNCOMPENSATED MEDI-CAL, SHC'S CONTRIBUTION TO OTHER COMMUNITY BENEFIT ACTIVITIES FOR VULNERABLE POPULATIONS WAS $6.5 MILLION IN FY 2016. THESE ACTIVITIES PROVIDE ESSENTIAL SERVICES FOR THOSE MOST IN NEED IN OUR COMMUNITIES. SHC SUPPORTED SEVEN COMMUNITY CLINICS AND A TRANSITIONAL MEDICAL UNIT IN A HOMELESS SHELTER AS PART OF ITS IMPROVE ACCESS TO CARE HEALTH INITIATIVE. COMMUNITY PARTNERS INCLUDE CARDINAL FREE CLINICS (ARBOR AND PACIFIC), RAVENSWOOD FAMILY HEALTH CENTER, MAYVIEW COMMUNITY HEALTH CENTER, SAMARITAN HOUSE REDWOOD CITY FREE CLINIC, PENINSULA HEALTHCARE CONNECTION, ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT (AACI) HEALTH CENTER, AND THE MEDICAL RESPITE CENTER AT HOME FIRST'S BOCCARDO REGIONAL CENTER IN SAN JOSE. THE GOAL OF THIS INITIATIVE IS TO BUILD COMMUNITY CAPACITY TO DELIVER QUALITY PRIMARY AND PREVENTIVE HEALTH CARE. CARDINAL FREE CLINICS (CFC), LOCATED IN EAST MENLO PARK AND EAST SAN JOSE, PROVIDES QUALITY, FREE MEDICAL CARE TO LOW-INCOME UNINSURED POPULATIONS, WHILE OFFERING A HANDS-ON LEARNING ENVIRONMENT FOR STANFORD STUDENTS IN COMMUNITY HEALTH, CULTURALLY COMPETENT MEDICINE, AND LEADERSHIP DEVELOPMENT. IN FY 2016, SHC PROVIDED MORE THAN 2,700 FREE LAB AND PATHOLOGY TESTS, INCLUDING CHEMISTRY, HEMATOLOGY, MICROBIOLOGY AND VIROLOGY, AS WELL AS SCREENING FOR DISEASES SUCH AS HEPATITIS B. IN ADDITION TO THE LAB TESTS, SHC PROVIDED FUNDING TO SUPPORT THE CARDINAL FREE CLINICS' TECHNOLOGY INFRASTRUCTURE TO BUILD CAPACITY FOR SERVICES AND TO SUPPORT IMPROVED OPERATIONAL EFFICIENCIES AND PATIENT CARE. WITH EARLIER SHC FUNDING, CFC IMPLEMENTED AN ELECTRONIC MEDICAL RECORD (EMR) SYSTEM IN FY 2011 AND IN 2016 CONTINUED TO REFINE IT, AS WELL AS TO TRAIN STUDENT AND PHYSICIAN VOLUNTEERS ON THE NEW SYSTEM, WITH MORE THAN 175 VOLUNTEERS TRAINED. BUILDING ON THIS WORK, IN FY 2016, CFC WORKED TO MAINTAIN INTERNET CONNECTIVITY TO ENSURE ACCESS TO THE EMR SYSTEM. THE SYSTEM HAS FACILITATED AND ENHANCED LAB ORDERS, REFERRALS TO PRIMARY AND SPECIALTY CARE, CLINIC FLOW, AND CHARTING. THE EMR SYSTEM ALSO PROVIDES EASY ACCESS TO NECESSARY INFORMATION DURING THE WEEK WHEN THE CLINICS ARE NOT OPERATING. ARBOR FREE CLINIC, LOCATED IN MENLO PARK, PROVIDED 407 PATIENT VISITS TO 534 PATIENTS IN FY 2016. MOST OF ARBOR'S CLIENTS (93 PERCENT) ARE UNINSURED; 38 PERCENT ARE UNEMPLOYED; AND 34 PERCENT REQUIRE LANGUAGE INTERPRETATION SERVICES. THE CLINIC SERVES A DIVERSE POPULATION; PRIMARILY ASIAN/PACIFIC ISLANDER, HISPANIC AND WHITE. PACIFIC FREE CLINIC (PFC), LOCATED IN EAST SAN JOSE, PROVIDED 999 PATIENT VISITS TO 407 PATIENTS IN FY 2016. OVER 65% OF PFC PATIENTS ARE VIETNAMESE, AND THE REMAINING ARE MOSTLY LATINO OR OTHER ASIAN/PACIFIC ISLANDER PATIENTS. MOST PFC PATIENTS ARE 45-64 YEARS OLD AND HAVE AT LEAST ONE CHRONIC ILLNESS SUCH AS DIABETES, HYPERTENSION, DYSLIPIDEMIA, OR CHRONIC HEPATITIS B. RAVENSWOOD FAMILY HEALTH CENTER (RFHC) IS AN IMPORTANT COMMUNITY PARTNER. LOCATED IN EAST PALO ALTO, THE HEALTH CENTER PROVIDES PRIMARY CARE TO A DIVERSE, MULTI-ETHNIC, LOW-INCOME POPULATION. DURING SHC'S FISCAL YEAR 2016, RFHC PROVIDED 15,218 UNDUPLICATED LOW INCOME PATIENTS WITH 87,303 MEDICAL, DENTAL, OPTOMETRY, AND BEHAVIORAL HEALTH VISITS. RFHC'S POPULATION INCLUDED 914 UNDUPLICATED HOMELESS PATIENTS THROUGH 2,422 MEDICAL AND 649 DENTAL VISITS. RFHC COLLABORATES WITH SHC ON RESIDENCY EDUCATION FOR PEDIATRICS, CHILD AND ADULT PSYCHIATRY, CARE COORDINATION WITH RFHC PATIENTS WHO ARE SEEN IN THE ED AND/OR ARE HOSPITALIZED, AND DENTAL CARE FOR SPECIAL NEEDS CHILDREN. IN 2010, SHC ESTABLISHED A BRANCH OF THE STANFORD HEALTH LIBRARY AT RFHC TO SERVE THE EAST PALO ALTO COMMUNITY. IN ADDITION TO COMPUTERS, BOOKS AND A MYRIAD OF OTHER RESOURCES, THE LIBRARY HAS A BILINGUAL MEDICAL LIBRARIAN. THE LIBRARIAN NOT ONLY STAFFS THE LIBRARY BUT CONDUCTS RESEARCH ON CONDITION-SPECIFIC HEALTH TOPICS FOR RFHC PATIENTS AND STAFF, AS WELL AS FOR COMMUNITY MEMBERS. IN FY 2016, THE LIBRARIAN ASSISTED IN OVER 2300 INTERACTIONS WITH LIBRARY PATRONS. IN ITS PARTNERSHIP WITH MAYVIEW COMMUNITY HEALTH CENTER, SHC CONTINUED ITS FUNDING FOR INCREASED PROVIDER HOURS AND FOR THE QUALITY IMPROVEMENT OUTCOMES PROJECT FOR MAYVIEW PATIENTS WITH CHRONIC DISEASES, PARTICULARLY DIABETES. THE ADDITIONAL PROVIDER HOURS CONTRIBUTED TOWARD THE PROVISION OF 10,546 ENCOUNTER SERVICES FOR 2,571 PATIENTS AT MAYVIEW'S PALO ALTO CLINIC IN FY2016, AN INCREASE OF 7.4 PERCENT FROM FY2015 (2,393 PATIENTS). OF THE DIABETIC PATIENTS WHO WERE SEEN TWICE IN THE MEASUREMENT YEAR, 84% HAD BLOOD GLUCOSE LEVELS UNDER CONTROL (HBA1C<7). OVER 34 PERCENT OF MAYVIEW'S CLIENTS SEEN AT THIS CLINIC ARE UNINSURED, NEARLY 95 PERCENT ARE LOW-INCOME (BELOW 200 PERCENT OF THE FPL); 45 PERCENT ARE HISPANIC OR LATINO WHITE, 17 PERCENT ARE ASIAN/PACIFIC ISLANDER, AND 26 PERCENT ARE NON-HISPANIC WHITE. SHC COMMITTED MULTI-YEAR FUNDING FOR THE MEDICAL RESPITE PROGRAM (MRP). THE PROGRAM, LOCATED IN A MULTIPURPOSE HOMELESS FACILITY IN SAN JOSE, IS A 20-BED TRANSITIONAL UNIT FOR HOMELESS PATIENTS. IT PROVIDES A SAFE, SUPPORTIVE ENVIRONMENT WHERE HOMELESS PATIENTS CAN BE DISCHARGED FROM ACUTE CARE SETTINGS. THE CENTER PROVIDES SOCIAL SERVICES, SUCH AS HOUSING ASSISTANCE, HEALTH INSURANCE ENROLLMENT ASSISTANCE, FOOD AND CLOTHING, AND JOB TRAINING, IN ADDITION TO CONTINUED MEDICAL CARE. IN FY 2016, 447 HOMELESS PATIENTS WERE REFERRED TO THE MRP. OF THOSE 447, 256 WERE ACCEPTED. THE MOST FREQUENT REASON FOR NOT ACCEPTING PATIENTS WAS "ACUITY TOO HIGH (PATIENT TOO SICK)." A TOTAL OF 118 PATIENTS COMPLETED THE PROGRAM. OF THOSE PATIENTS, 92% WERE ENROLLED IN A MEDICAL HOME, 98% WERE ENROLLED IN SOME TYPE OF HEALTHCARE COVERAGE UPON DISCHARGE, AND 71% WERE PLACED IN SOME TYPE OF HOUSING. IN FY 2016 SHC CONTINUED ITS SUPPORT OF SAMARITAN HOUSE FREE CLINIC OF REDWOOD CITY. THE CLINIC PROVIDED OVER 5,200 PATIENT VISITS SERVING NEARLY 1,000 UNDUPLICATED CLIENTS IN FISCAL YEAR 2016. THE PATIENT POPULATION IS LARGELY HISPANIC (92 PERCENT) AND 99 PERCENT ARE UNINSURED. THE PATIENTS SERVED HAVE VERY LOW INCOMES, FACE LANGUAGE AND CULTURAL BARRIERS, AND ARE LIKELY TO SUFFER FROM MULTIPLE CHRONIC CONDITIONS DUE TO LACK OF PREVENTIVE CARE. ALL MEDICAL PROVIDERS AT THE CLINIC DONATE THEIR TIME AND EXPERTISE PROVIDING SERVICES SUCH AS PRIMARY CARE, DENTISTRY, GYNECOLOGY, BREAST CANCER SCREENINGS, DERMATOLOGY, DIABETIC CARE, ENDOCRINOLOGY, INTERNAL MEDICINE, NEUROLOGY, NEPHROLOGY, ORTHOPEDICS, OPHTHALMOLOGY, OPTOMETRY, PODIATRY, PULMONOLOGY, NUTRITIONAL COUNSELING AND RHEUMATOLOGY. PENINSULA HEALTHCARE CONNECTION (PHC). PENINSULA HEALTHCARE CONNECTION (PHC) IS A NONPROFIT ORGANIZATION THAT PROVIDES COMPREHENSIVE HEALTH, MENTAL HEALTH AND CASE MANAGEMENT SERVICES TO HOMELESS AND LOW-INCOME COMMUNITY MEMBERS, FREE OF CHARGE, AT THEIR STATE LICENSED MEDICAL CLINIC IN PALO ALTO. PHC IS THE ONLY PROVIDER IN NORTHERN SANTA CLARA COUNTY FOCUSED ON HEALTH SERVICES FOR INDIVIDUALS EXPERIENCING HOMELESSNESS. THE GOAL OF PHC IS TO PROMOTE THE OVERALL HEALTH AND WELLNESS OF OUR PATIENTS AND TO PROVIDE ADVOCACY FOR COMMUNITY MEMBERS WHO ARE HOMELESS OR AT RISK OF BECOMING HOMELESS. PHC PROVIDED OVER 1800 MEDICAL AND PSYCHIATRIC VISITS TO OUR PATIENTS IN 2016. THE CLINIC SERVES A DIVERSE POPULATION: 24 PERCENT ARE AFRICAN-AMERICAN, 13 PERCENT ARE ASIAN/PACIFIC ISLANDER, 15 PERCENT ARE HISPANIC, 44 PERCENT ARE WHITE, 4 PERCENT ARE "OTHERTHE MAJORITY OF PATIENTS (65 PERCENT) ARE HOMELESS. ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT (AACI) PROVIDES UNDERSERVED INDIVIDUALS AND FAMILIES IN SANTA CLARA COUNTY WITH CULTURALLY COMPETENT HIGH QUALITY HEALTH, MENTAL HEALTH AND WELLNESS PROGRAMS AND SERVICES. AACI SERVES PREDOMINANTLY LOW-INCOME, FIRST-GENERATION IMMIGRANT, AND LI
PART VI, LINE 5 (CONTINUED) SHC'S EMERGENCY DEPARTMENT REGISTRATION UNIT PARTNERED WITH THE COUNTIES OF SAN MATEO AND SANTA CLARA IN A PROGRAM DESIGNED TO LINK UNINSURED PEDIATRIC PATIENTS TREATED IN THE EMERGENCY DEPARTMENT WITH ASSISTANCE PROGRAMS SUCH AS MEDI-CAL, HEALTHY FAMILIES AND HEALTHY KIDS. THIS PROGRAM RESULTED FROM STUDIES BY EWEN WANG, MD, ASSOCIATE DIRECTOR OF PEDIATRIC EMERGENCY MEDICINE, STANFORD SCHOOL OF MEDICINE, WHICH SHOWED THAT UNINSURED CHILDREN ARE LESS LIKELY TO RECEIVE ROUTINE CARE DUE TO THE FEAR OF FINANCIAL HARDSHIP ON THEIR FAMILIES. IN FY 2016, A TOTAL OF 361 REFERRALS WERE MADE TO COUNTY STAFF. OF THOSE REFERRALS, 128 CHILDREN WERE ENROLLED IN SOME TYPE OF HEALTH INSURANCE PROGRAM. SHC ALSO ASSISTED UNINSURED, LOW-INCOME PATIENTS IN RESEARCHING THEIR HEALTHCARE OPTIONS. SERVICES PROVIDED BY HEALTH ADVOCATES AND DIVERSIFIED HEALTH RESOURCES, AT NO COST TO THE CLIENT, INCLUDED HELPING INDIVIDUALS RESEARCH ELIGIBILITY REQUIREMENTS, IDENTIFY APPROPRIATE HEALTH INSURANCE PROGRAMS, COMPLETE APPLICATIONS, COMPILE REQUIRED DOCUMENTATION, AND FOLLOW UP WITH COUNTY CASE MANAGERS. FOR INDIVIDUALS ELIGIBLE FOR THE VARIOUS PROGRAMS, THIS SERVICE ASSISTS PATIENTS IN OBTAINING COVERAGE FOR MEDICAL NECESSITIES SUCH AS HOSPITAL CARE, PRESCRIPTION DRUGS, AND HOME HEALTH CARE. IN CASES WHERE A PATIENT IS DISCHARGED BUT HAS LIMITED OR NO ABILITY TO PAY FOR NECESSARY MEDICAL ITEMS AND CERTAIN NON-MEDICAL SERVICES, DEPARTMENTS SUCH AS THE SOCIAL WORK AND CASE MANAGEMENT DEPARTMENT PROVIDED FUNDING TO DEFRAY THE COSTS. MEDICAL EQUIPMENT, TRANSPORTATION, TEMPORARY HOUSING, MEDICATIONS AND MEAL ASSISTANCE, AMONG OTHER ITEMS AND SERVICES, ARE FUNDED AND /OR COORDINATED BY THESE HOSPITAL DEPARTMENTS. MINORITY POPULATIONS AN IMPORTANT GOAL OF SHC'S COMMUNITY BENEFIT PROGRAM IS TO REDUCE CANCER HEALTH DISPARITIES. IT IS A GOAL SHC SHARES WITH THE STANFORD CANCER INSTITUTE. IN FY 2016, SHC FUNDED THE FOLLOWING PROJECTS THAT PROVIDED ACCESS TO COMMUNITY-APPROPRIATE CANCER EDUCATION AND SUPPORTIVE SERVICES FOR MINORITIES, WOMEN, AND UNDERSERVED POPULATIONS: -ST. JAMES COMMUNITY FOUNDATION: CULTURALLY COMPETENT, HANDS-ON EDUCATION REGARDING PREPARING HEALTHY FOODS FOR AT-RISK COMMUNITIES, PRIMARILY AFRICAN-AMERICAN, HISPANIC AND PACIFIC ISLANDER -LATINAS CONTRA CANCER: PSYCHOSOCIAL SUPPORT FOR SPANISH-SPEAKING CANCER PATIENTS -HEP B FREE SANTA CLARA: CANCER EDUCATION AND HEPATITIS B SCREENING EDUCATION AND PROMOTION FOR THE CHINESE AND VIETNAMESE COMMUNITIES OF SANTA CLARA COUNTY THE STANFORD MEDICAL YOUTH SCIENCE PROGRAM IS A FIVE-WEEK SCIENCE- AND MEDICINE-BASED ENRICHMENT PROGRAM THAT TAKES PLACE ANNUALLY AND IS OPEN TO LOW-INCOME AND ETHNICALLY DIVERSE HIGH SCHOOL SOPHOMORES AND JUNIORS. THE GOAL OF THE PROGRAM IS TO PROMOTE THE REPRESENTATION OF ETHNIC MINORITY AND LOW-INCOME GROUPS IN THE HEALTH PROFESSIONS. SHC STAFF MENTOR STUDENTS IN A VARIETY OF DEPARTMENTS, INCLUDING ORTHOPEDICS, PHARMACY, LIFE FLIGHT, PHYSICAL THERAPY, EMERGENCY AND OTHERS MENTOR THE STUDENTS. OLDER ADULTS ACCORDING TO ONE REPORT, NEARLY ONE IN FOUR SAN MATEO COUNTY RESIDENTS WILL BE OVER THE AGE OF 65 BY 2030. THE SITUATION IS MUCH THE SAME IN SANTA CLARA COUNTY. BY 2030, MORE THAN ONE IN FOUR COUNTY RESIDENTS WILL BE AGE 60 OR OLDER. SHC PREPARED FOR THIS DEMOGRAPHIC SHIFT BY EXPANDING ITS AGING ADULT SERVICES PROGRAM (AAS) AND OFFERING COMPONENTS OF THAT PROGRAM TO THE COMMUNITY. STANFORD HOME TECHNOLOGY LIFELINE, A PROGRAM OF AAS, IS AN IN-HOME MEDICAL ALERT SERVICE THAT HELPS OLDER ADULTS REMAIN INDEPENDENT BY PROVIDING AN EASY WAY TO SUMMON HELP IN AN EMERGENCY. STANFORD LIFELINE IS ONE OF THE FEW EMERGENCY RESPONSE SERVICES THAT OFFER REDUCED OR SUBSIDIZED RATES TO THOSE IN NEED. IN FY16, 400 FREE OR REDUCED-COST LIFELINE SUBSCRIPTIONS WERE PROVIDED TO LOW-INCOME OLDER ADULTS. SHC'S 2016 COMMUNITY BENEFIT PLAN FOCUSES ON THREE HEALTH INITIATIVES: IMPROVE THE HEALTH AND WELL-BEING OF OLDER ADULTS, IMPROVE ACCESS TO CARE, AND REDUCE CANCER HEALTH DISPARITIES. IN SUPPORT OF THE FIRST INITIATIVE, SHC IMPLEMENTED FIVE EVIDENCE-BASED PROGRAMS, FREE OF CHARGE, AT LOCAL SENIOR CENTERS AND IN LOW-INCOME COMMUNITIES. THOSE PROGRAMS ARE STRONG FOR LIFE, FAREWELL TO FALLS, MATTER OF BALANCE, STEPPING ON, AND CHRONIC DISEASE SELF-MANAGEMENT. AAS'S STRONG FOR LIFE IS A GROUP EXERCISE PROGRAM WHOSE GOALS ARE TO HELP OLDER ADULTS INCREASE STRENGTH, BALANCE AND MOBILITY, AND REDUCE ISOLATION. IN FY 2016, THIS PROGRAM SERVED MORE THAN 195 INDIVIDUALS AT EIGHT SENIOR CENTERS. OF THE EIGHT SENIOR CENTERS, FIVE SERVE PRIMARILY LOW-INCOME OLDER ADULTS. AAS ALSO PROVIDES A PROGRAM CALLED CHRONIC DISEASE SELF-MANAGEMENT, A BEHAVIORALLY ORIENTED PROGRAM THAT TEACHES OLDER ADULTS HOW TO MANAGE THEIR CHRONIC CONDITIONS. PARTICIPANTS LEARN TO DO APPROPRIATE EXERCISES, EAT BETTER, MANAGE STRESS AND PAIN, MANAGE THEIR MEDICATIONS, AND BETTER COMMUNICATE WITH THEIR FAMILIES AND HEALTH CARE PROVIDERS. SHC CONDUCTED THREE, SIX-WEEK WORKSHOPS IN FY 2016. SHC'S TRAUMA SERVICES COMMUNITY OUTREACH AND INJURY PREVENTION STAFF CONTINUED TO OFFER FAREWELL TO FALLS, A BEST-PRACTICE FALL PREVENTION PROGRAM, TO RESIDENTS IN SAN MATEO AND SANTA CLARA COUNTIES. OCCUPATIONAL THERAPISTS PROVIDE HOME VISITS AND REVIEW MULTIPLE RISK FACTORS FOR FALLS. ADDITIONALLY, REGULAR FOLLOW-UP PHONE CALLS ENCOURAGE COMPLIANCE WITH EXERCISE AND OTHER RECOMMENDATIONS. ONE YEAR AFTER THE INITIAL HOME VISIT, THERAPISTS EVALUATE PARTICIPANTS' PROGRESS. THE PROGRAM ENROLLED 314 OLDER ADULTS INTO THE PROGRAM IN FY 2016. SHC'S TRAUMA SERVICES COMMUNITY OUTREACH AND INJURY PREVENTION STAFF PROVIDED SEVERAL NO-COST, EVIDENCE-BASED PROGRAMS TO HELP OLDER ADULTS IN SAN MATEO AND SANTA CLARA. IN FY 2016, FOUR SEVEN-SESSION STEPPING ON PROGRAMS WERE PROVIDED IN SANTA CLARA COUNTY. THE GOAL OF THIS PROGRAM IS TO EMPOWER OLDER ADULTS TO CHANGE BEHAVIORS THAT CAN HELP REDUCE THE RISK OF FALLING. PARTICIPANTS WORK WITH A PHYSICAL THERAPIST ON STRENGTH AND BALANCE EXERCISES, HEAR LECTURES FROM A PHARMACIST AND VISION SPECIALIST, AND PARTICIPATE IN DISCUSSIONS FACILITATED BY AN OCCUPATIONAL THERAPIST. OVER 67 OLDER ADULTS PARTICIPATED AT SIX SITES AND COMPLETED THE STEPPING ON PROGRAM. MATTER OF BALANCE, ANOTHER FREE, EVIDENCE-BASED PROGRAM, IS ALSO PROVIDED BY TRAUMA SERVICES. STAFF WORK WITH OLDER ADULTS IN A GROUP SETTING TO HELP REDUCE THE FEAR OF FALLING. IN EIGHT, TWO-HOUR SESSIONS, PARTICIPANTS LEARN TO VIEW FALLS AS CONTROLLABLE, SET GOALS FOR INCREASING ACTIVITY, LEARN TIPS TO MAKE HOME MODIFICATIONS, AND PRACTICE EXERCISES TO INCREASE STRENGTH AND BALANCE. LAY LEADERS COACH THE SESSIONS, SUPERVISED AND MENTORED BY AN OCCUPATIONAL THERAPIST. TRAUMA SERVICES PROVIDED 13 EIGHT-SESSION MOB CLASSES IN FY 2016 AT SITES IN MENLO PARK, MOUNTAIN VIEW, SUNNYVALE AND BELMONT, REDWOOD CITY, AND SAN CARLOS. IN ADDITION TO THOSE PARTICIPATING IN IN-HOME AND CENTER-BASED FALL PREVENTION PROGRAMS, AN ESTIMATED 1442 OLDER ADULTS WERE REACHED THROUGH EDUCATIONAL PRESENTATIONS AND HEALTH FAIRS BY TRAUMA SERVICES COMMUNITY OUTREACH AND INJURY PREVENTION STAFF. SHC ALSO SUPPORTS THE WORK OF TWO COUNTYWIDE COLLABORATIVES ENGAGED IN IMPROVING THE HEALTH AND WELL-BEING OF OLDER ADULTS WITH FALL PREVENTION EDUCATION: THE SAN MATEO COUNTY FALL PREVENTION TASK FORCE AND THE SANTA CLARA COUNTY FALL PREVENTION TASK FORCE. CONCERNED WITH THE GROWING INCIDENCE OF FALLS AMONG OLDER ADULTS IN SAN MATEO COUNTY, A TASK FORCE OF 50 ORGANIZATIONS REPRESENTING COMMUNITY PROVIDER AGENCIES, HOSPITALS, NONPROFIT ORGANIZATIONS, SENIOR CENTERS AND PRIVATE SERVICE PROVIDERS CAME TOGETHER TO FORM THE SAN MATEO COUNTY FALL PREVENTION TASK FORCE. THE MISSION OF THIS GROUP IS TO DECREASE FALLS AMONG OLDER ADULTS THROUGH ADVOCACY, RESOURCE DEVELOPMENT, AND COMMUNITY EDUCATION. SHC SUPPORTS THE WORK OF THE TASK FORCE WITH STAFF REPRESENTATION AND GRANT FUNDING. THIS PAST YEAR'S ACTIVITIES HAVE INCLUDED CONDUCTING NEEDS ASSESSMENTS WITH MEDICAL PROVIDERS AND HOME-BOUND OLDER ADULTS THROUGH MEALS ON WHEELS AS WELL AS FOCUS GROUPS IN ENGLISH, SPANISH AND CHINESE WITH COMMUNITY-DWELLING OLDER ADULTS. AS A FOUNDING MEMBER OF THE FALLS PREVENTION TASK FORCE IN SANTA CLARA COUNTY, SHC WORKS IN COLLABORATION WITH THE SILICON VALLEY HEALTHY AGING PARTNERSHIP, SANTA CLARA COUNTY PUBLIC HEALTH DEPARTMENT, EMERGENCY MEDICAL SYSTEM, VALLEY MEDICAL CENTER, THE HEALTH TRUST, AND SAN JOS STATE UNIVERSITY TO REDUCE THE RISKS OF FALLS FOR SANTA CLARA COUNTY'S OLDER ADULTS THROUGH ADVOCACY, RESOURCE DEVELOPMENT, AND COMMUNITY AND PROVIDER EDUCATION. FY 2016 ACTIVITIES INCLUDED THE DEVELOPMENT OF A STRATEGIC PLAN, WHICH DIRECTS FUTURE EFFORTS TO OUTREACH TO MEDICAL PROVIDERS AND EXPANDED COMMUNITY OUTREACH DURING FALL PREVENTION AWARENESS MONTH EACH SEPTEMBER.
HEALTH RESEARCH, EDUCATION AND TRAINING HEALTH PROFESSIONS EDUCATION RESEARCH, EDUCATION AND TRAINING ARE CORE TO SHC'S MISSION. SHC IS THE SETTING FOR TRAINING MEDICAL STUDENTS, RESIDENTS AND FELLOWS FROM THE STANFORD SCHOOL OF MEDICINE AND, AS SUCH, MAKES A SIGNIFICANT CONTRIBUTION TO TRAINING THE NEXT GENERATION OF HEALTHCARE PROVIDERS. IN FY16, SHC CONTRIBUTED $ 76,393,241 TO SUPPORT HEALTH RESEARCH, EDUCATION AND TRAINING. OF THIS AMOUNT, OVER $68 MILLION WAS SPENT TO TRAIN MEDICAL RESIDENTS AND INTERNS. IN ADDITION TO TRAINING PHYSICIANS, SHC SUPPORTS THE TRAINING OF OTHER HEALTH PROFESSIONALS. IN FY16, SHC INVESTED MORE THAN $7.6 MILLION ON THIS TRAINING. HOSPITAL DEPARTMENTS SUCH AS REHABILITATION SERVICES, NURSING AND CLINICAL LABS PROVIDED CLINICAL ROTATIONS FOR PHYSICAL THERAPY, RESPIRATORY THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, NURSING AND LABORATORY SCIENCE STUDENTS FROM LOCAL COLLEGES AND UNIVERSITIES. IN ADDITION, PHYSICIAN ASSISTANT STUDENTS ARE TRAINED BY SHC PHYSICIAN ASSISTANTS. SHC ALSO PROVIDES A TRAINING GROUND FOR PHARMACY RESIDENTS AND STUDENTS, RADIOLOGY AND NUCLEAR MEDICINE STUDENTS AND PSYCHOLOGY STUDENTS. BENEFITS FOR VULNERABLE POPULATIONS* $ 281,454,441 MEDICARE (UNCOMPENSATED EXPENSE) $ 512,219,096 BENEFITS FOR THE LARGER COMMUNITY $ 4,148,779 HEALTH RESEARCH, EDUCATION AND TRAINING $ 76,393,241 TOTAL EXCLUDING UNCOMPENSATED EXPENSE OF MEDICARE $ 361,996,461 TOTAL INCLUDING UNCOMPENSATED EXPENSE OF MEDICARE $ 874,215,557 * INCLUDES UNCOMPENSATED COST OF MEDI-CAL, CHARITY CARE, AND SHC COMMUNITY BENEFIT PROGRAMS WHOSE TARGET AUDIENCE IS CATEGORY 1: BENEFITS FOR VULNERABLE POPULATIONS, AND EXCLUDES THE NON-REIMBURSED COST OF MEDICARE.
PART VI, LINE 6 IN MAY 2015, THE HOSPITAL COMMITTEE FOR THE LIVERMORE-PLEASANTON AREAS (VCHS) BECAME AN AFFILIATE OF STANFORD HEALTH CARE (SHC). VCHS PARTNERS WITH SHC TO SERVE THE EAST BAY'S TRI-VALLEY REGION OF LIVERMORE, DUBLIN AND PLEASANTON. VCHS'S FACILITIES IN LIVERMORE, DUBLIN AND PLEASANTON INCLUDE VALLEY MEDICAL CENTER, EMERGENCY SERVICES AND TWO URGENT CARE CENTERS. VCHS ALLOWS SHC TO EXPAND ITS PRESENCE IN THE CRITICAL TRI-VALLEY AREA BY PARTNERING WITH A HIGH QUALITY, HIGH VALUE COMMUNITY HOSPITAL. VCHS WILL PARTICIPATE IN ALL THREE OF SHC'S MISSIONS BY PROVIDING SHC'S LEADING EDGE CLINICAL CARE IN THE VCHS COMMUNITY, TRAINING FUTURE MEDICAL LEADERS THROUGH RESIDENCY ROTATIONS AND OTHER ACADEMIC PURSUITS, AND PROVIDING THE TRI-VALLEY AREA INCREASED ACCESS TO CLINICAL TRIALS FOR LIFE-SAVING TREATMENTS. IN ADDITION, SHC'S GROWING EXPERTISE IN POPULATION AND PRECISION HEALTH WILL BE LEVERAGED TO SERVE THIS COMMUNITY.
PART VI, LINE 7 ALL STATES IN WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: CALIFORNIA
Schedule H (Form 990) 2015
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