Schedule H, Part V, Section B, Line 5-GRADY MEMORIAL HOSPITAL
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GEORGIA STATE UNIVERSITY'S GEORGIA HEALTH POLICY CENTER, WHICH LED THE COLLABORATIVE CHNA PROCESS, INTERVIEWED NEARLY 30 INDIVIDUAL STAKEHOLDERS AND CONDUCTED FOCUS GROUPS AND/OR LISTENING SESSIONS WITH TWO GROUPS OF GRADY PROVIDERS AND NINE GROUPS OF RESIDENTS REPRESENTING FOUR DIFFERENT POPULATIONS. INTERVIEWEES INCLUDED TWO REPRESENTATIVES FROM DEKALB COUNTY BOARD OF HEALTH, PARTNERS FOR HOME, GEORGIA EQUALITY, MERCY CARE HEALTH CENTER FOR THE HOMELESS, KAISER PERMANENTE, CATHOLIC CHARITIES, ATLANTA REGIONAL COMMISSION, UNITED WAY, A VARIETY OF GOVERNMENT OFFICIALS REPRESENTING CITY OF CHAMBLEE, DEKALB COUNTY AND FULTON COUNTY, AMONG OTHERS. FOCUS GROUPS WERE CONDUCTED TO ASSESS THE NEEDS OF FULTON RESIDENTS, DEKALB RESIDENTS, VIETNAMESE SENIORS, LATINOS, CANCER PATIENTS AND PATIENTS WITH BEHAVIORAL HEALTH CONDITIONS.
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Schedule H, Part V, Section B, Line 5-HUGHES SPALDING CHILDRENS HOSPITAL
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HUGHES SPALDING CHILDRENS HOSPITAL IS MANAGED BY CHILDRENS HEALTHCARE OF ATLANTA.
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Schedule H, Part V, Section B, Line 6a-GRADY MEMORIAL HOSPITAL
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GRADY'S CHNA WAS CONDUCTED COLLABORATIVELY THROUGH THE ATLANTA REGIONAL COLLABORATIVE FOR HEALTH IMPROVEMENT (ARCHI). OTHER HOSPITALS THAT PARTICIPATED IN THE 2016 CHNA PROCESS INCLUDE WELLSTAR AND PIEDMONT HEALTHCARE.
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Schedule H, Part V, Section B, Line 6a-HUGHES SPALDING CHILDRENS HOSPITAL
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GRADY'S CHNA WAS CONDUCTED COLLABORATIVELY THROUGH THE ATLANTA REGIONAL COLLABORATIVE FOR HEALTH IMPROVEMENT (ARCHI). OTHER HOSPITALS THAT PARTICIPATED IN THE 2016 CHNA PROCESS INCLUDE WELLSTAR AND PIEDMONT HEALTHCARE.
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Schedule H, Part V, Section B, Line 6b-GRADY MEMORIAL HOSPITAL
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MERCY CARE HEALTH CENTER FOR THE HOMELESS AND KAISER PERMANENTE OF GEORGIA ALSO PARTICIPATED IN ARCHI'S COLLABORATIVE CHNA TO INFORM THEIR ORGANIZATION'S COMMUNITY HEALTH PRIORITIES. ADDITIONALLY, MANY OTHER HEALTH CARE, PUBLIC HEALTH, ACADEMIC, NON-PROFIT AND PHILANTHROPIC ORGANIZATIONS ARE MEMBERS OF ARCHI AND HELPED TO FORM THE 2016 CHNA. SOME OF THESE ORGANIZATIONS INCLUDE ATLANTA REGIONAL COMMISSION, UNITED WAY OF GREATER ATLANTA, CARTER CENTER, CENTERS FOR DISEASE CONTROL AND PREVENTION, GEORGIA DEPARTMENT OF PUBLIC HEALTH, GEORGIA HEALTH POLICY CENTER, AND WHOLESOME WAVE GEORGIA, AMONG OTHERS.
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Schedule H, Part V, Section B, Line 6b-HUGHES SPALDING CHILDRENS HOSPITAL
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MERCY CARE HEALTH CENTER FOR THE HOMELESS AND KAISER PERMANENTE OF GEORGIA ALSO PARTICIPATED IN ARCHI'S COLLABORATIVE CHNA TO INFORM THEIR ORGANIZATION'S COMMUNITY HEALTH PRIORITIES. ADDITIONALLY, MANY OTHER HEALTH CARE, PUBLIC HEALTH, ACADEMIC, NON-PROFIT AND PHILANTHROPIC ORGANIZATIONS ARE MEMBERS OF ARCHI AND HELPED TO FORM THE 2016 CHNA. SOME OF THESE ORGANIZATIONS INCLUDE ATLANTA REGIONAL COMMISSION, UNITED WAY OF GREATER ATLANTA, CARTER CENTER, CENTERS FOR DISEASE CONTROL AND PREVENTION, GEORGIA DEPARTMENT OF PUBLIC HEALTH, GEORGIA HEALTH POLICY CENTER, AND WHOLESOME WAVE GEORGIA, AMONG OTHERS.
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Schedule H, Part V, Section B, Line 11-GRADY MEMORIAL HOSPITAL
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SINCE GRADY'S MOST RECENT CHNA WAS CONDUCTED IN 2016 AND OUR IMPLEMENTATION STRATEGY (IS) WAS ADOPTED AT THE END OF 2016. Listed below are a sample of activities related to the priorities identified in the 2016 CHNA: 1. Improve coordination of care for Grady patients with diabetes, hypertension, prostate cancer, HIV/AIDS and behavioral health conditions. To improve care coordination for high risk patients and reduce unnecessary emergency department utilization, Grady launched the Chronic Care Clinic in 2017. The goal of the program is to engage patients in their care to identify and remove barriers and foster self-management. The multi-disciplinary care team establishes patient-specific care goals, and patients received monthly clinic visits with home visits and telephone follow-ups in between. Patients enrolled in the program have reduced emergency department use and inpatient admissions. Grady partnered with the Atlanta Regional Commission (ARC) and MARTA to address a significant barrier to accessing health care: transportation. Through the Rides to Wellness pilot program, funded by the Federal Transportation Administration, about 200 Grady patients who were missing appointments received six months of free rides on public transportation. Eligible patients also received travel training and assistance with enrolling in MARTA's Paratransit or Reduced Fare programs. As the pilot phase of the program concludes, Grady and the partners are exploring ways of sustaining this critical resource. The Georgia Cancer Center for Excellence at Grady was selected by the Merck Foundation as one of six sites across the nation to participate in the Alliance to Advance Patient-Centered Cancer Care. Through this initiative, Grady has expanded nurse navigation to improve timely access to and coordination of care, began a rigorous patient-centered designation process with Planetree to enhance patient-provider communication and patient engagement, and expanded partnerships with community organizations to strengthen psychosocial and supportive care for patients. Grady has remained committed to community collaboration through the Atlanta Regional Collaborative for Health Improvement (ARCHI). Grady has representation on the Steering Committee and has continued to participate in the diabetes hospital collaborative launched in 2016. Through this effort, Grady is working with Kaiser Permanente, Wellstar and Piedmont Healthcare to implement digital diabetes self-management education (DSME) and coaching. 2. Increase opportunities for all Georgians, with a focus on persons served by Grady Health System, to access healthcare coverage.Grady has engaged a number of resources to assist patients in gaining access to Medicaid and Marketplace health insurance. In 2017, Grady assisted 63 patients with Marketplace insurance enrollment, and submitted about 7,500 Medicaid applications for patients. Through our Food as Medicine Partnership, the Atlanta Community Food Bank and Wholesome Wave Georgia submitted 63 Medicaid applications and 502 SNAP applications on behalf of our patients. 3. Increase patient and community engagement in healthy behaviors to prevent diabetes, hypertension, HIV, unintentional injuries, and homicide. Through a CDC Foundation grant funded by the Robert Wood Johnson Foundation, Grady Memorial Hospital and DeKalb County Police Department are partnering to prevent violence and make communities safer. The Partnership uses the Cardiff Model established in Europe to collect anonymous information on the location and timing of violent events reported at the hospital. Along with existing law enforcement records, they create local maps of where violence occurs, and identify hot spots throughout the county. This information and predictive analysis has been used to develop public health strategies and environmental approaches to address violence in South DeKalb. In 2017, the Injury Prevention Research Center at Emory University, along with Grady Memorial Hospital and collaborators at the University of Michigan, were awarded a five-year, $4 million grant to study metro-Atlanta motor vehicle crashes that result in injuries treated at Grady. The goal of this project, funded by the National Highway Traffic Safety Administration (NHTSA), is to improve vehicle safety and support injury prevention. The Emory/Grady center is one of seven designated Crash Injury Research and Engineering Network (CIREN) centers in the U.S. After successfully launching a Fruit and Vegetable Prescription (FVRx) Program in partnership with Wholesome Wave Georgia in 2016, Grady expanded its commitment to addressing food insecurity. In 2017, the Food as Medicine Partnership was established to bring innovative food and nutrition solutions to Grady patients, staff and community. Grady worked with WWG, Open Hand, and the Atlanta Community Food Bank to create a comprehensive plan, which was approved by Grady's leadership. The plan includes expanding the FVRx program, establishing an onsite food pharmacy, opening a healthy café and farmers market, and strategies to better connect patients with existing resources like SNAP and local food pantries. Several components began in 2017 and the full plan will be implemented throughout 2018 and 2019. Grady continues to partner with the Atlanta Beltline to increase access to safe parks, trails and health education. In 2017, Grady received a Health Grant to support a wellness program for community members. Grady's comprehensive program, Walk the Line, launched in September in collaboration with the opening of the BeltLine's Westside Trail. Walk the Line is a 10 week, healthy lifestyle class targeting African American adults. The lower priorities of Grady's 2016 CHNA-low birth weight, obesity, breast cancer, poverty, and high school education non-attainment-were not included as areas of focus for several reasons. First, Grady already offers a robust women's program to address low birth weight as well as continuously working to improve our services for breast cancer. For the other priorities, Grady does not have the resources or expertise to significantly address these community health needs but these are being supplemented by other ARCHI partners with the appropriate resources and expertise to significantly address those needs.
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Schedule H, Part V, Section B, Line 11-HUGHES SPALDING CHILDRENS HOSPITAL
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INDIRECTLY BENEFITS FROM THE GMHC PLAN.
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Schedule H, Part V, Section B, Line 13-GRADY MEMORIAL HOSPITAL
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Refer to the Financial Assistance Policy attached. Discount Levels with Copayments: Tier 1: Patients with Annual Gross Family Incomes up to 250% of the current Federal Poverty Income Level will be eligible for discounts assuming they meet criteria for financial assistance. Tier 2: Patients with Annual Gross Family Incomes 251% to 400% of the Federal Poverty Income Level will be eligible for discounts assuming they meet criteria for financial assistance. 100% Free Care: Homeless Patients with 0% FPG are exempt from copayments 100% Free Care after Copayment: 0% - 400%
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Schedule H, Part V, Section B, Line 13h-GRADY MEMORIAL HOSPITAL
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REFER TO THE FINANCIAL ASSISTANCE POLICY ATTACHED FOR PROCESS, DEFINITIONS, AND TIER LEVELS OF POLICY. DISCOUNTED CARE WITH COPAYMENTS HAVE VERIFIED INCOME LEVELS FROM 251% TO 400% FEDERAL POVERTY INCOME (FPI) AND HOMELESS WITH 0% FPI QUALIFY FOR FREE CARE UP TO 400% FPI.
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Schedule H, Part V, Section B, Line 13h-HUGHES SPALDING CHILDRENS HOSPITAL
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REFER TO THE FINANCIAL ASSISTANCE POLICY ATTACHED FOR PROCESS, DEFINITIONS, AND TIER LEVELS OF POLICY. DISCOUNTED CARE WITH COPAYMENTS HAVE VERIFIED INCOME LEVELS FROM 251% TO 400% FEDERAL POVERTY INCOME (FPI) AND HOMELESS WITH 0% FPI QUALIFY FOR FREE CARE UP TO 400% FPI.
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Schedule H, Part V, Section B, Line 14-GRADY MEMORIAL HOSPITAL
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Eligibility determination for financial assistance is based on county of residence, gross income, family size and Federal Poverty Level (FPL). PATIENTS ARE ELIGIBLE FOR FREE CARE UP TO 400% OF FPL, AFTER THE COPAYMENT. HOMELESS PATIENTS WITH 0% FPL MAY BE EXEMPT FROM COPAYMENTS. The copayment is driven by the FPL Tier (0-250%) or (251-400%), county of residency and level of care/service.
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Schedule H, Part V, Section B, Line 15-GRADY MEMORIAL HOSPITAL
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The Financial Assistance Program Policy, application and instructions are publicized to include Grady's website. Patients may apply for financial assistance electronically via email, may apply in person, by mail or may qualify at the point of registration through a presumptive automated third-party software.
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Schedule H, Part V, Section B, Line 15e-GRADY MEMORIAL HOSPITAL
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THE FINANCIAL COUNSELORS WILL ADVISE ELIGIBLE PATIENTS VERBALLY AS TO WHERE AND HOW TO APPLY FOR FOOD STAMPS AND DETERMINE IF THEY MEET CRITERIA FOR MEDICAID. SOCIAL WORKERS WILL TYPICALLY PROVIDE INFORMATION REGARDING HOUSING, FOOD STAMPS, AND OTHER SERVICES TO PATIENTS. A FINANCIAL COUNSELOR MAY DETERMINE IF A PATIENT MEETS CRITERIA FOR PRESUMPTIVE MEDICAID, WOMEN'S HEALTH MEDICAID, WOMEN MEDICAID WAVIER, CANCER STATE AID, CRIME VICTIMS COMPENSATION PROGRAM, RIGHT FROM THE START MEDICAID FOR NEWBORNS, EMERGENCY MEDICAL ASSISTANCE - MEDICAID FOR UNDOCUMENTED WOMEN WHO DELIVER THEIR NEWBORNS, PRESUMPTIVE MEDICAID FOR PREGNANT WOMEN, LOW INCOME MEDICAID, ETC., AND COMPLETE THE APPLICATION AS APPROPRIATE. THE FINANCIAL COUNSELOR MAY ALSO REFER A PATIENT TO APPLY FOR MEDICAID WITH THE DEPARTMENT OF FAMILY AND CHILDREN SERVICES GRADY OUTREACH UNIT. GMHC HAS VENDOR PARTNERSHIPS ON CAMPUS WHEREBY REPRESENTATIVES ARE COMPLETING APPLICATIONS FOR ELIGIBLE PATIENTS FOR VARIOUS MEDICAID PROGRAMS, E.G., LOW INCOME MEDICAID, SSI, SSD, ETC. REPRESENTATIVES ARE COMPLETING APPLICATIONS FOR ELIGIBLE PATIENTS FOR VARIOUS MEDICAID PROGRAMS, E.G., LOW INCOME MEDICAID, SSI, SSD, ETC.
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Schedule H, Part V, Section B, Line 15e-HUGHES SPALDING CHILDRENS HOSPITAL
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The FINANCIAL ASSISTANCE PROGRAM POLICY, APPLICATION AND INSTRUCTIONS ARE PUBLICIZED TO INCLUDE CHILDREN'S HEALTHCARE OF ATLANTA WEBSITE. PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE ELECTRONICALLY VIA EMAIL, MAY APPLY IN PERSON, BY MAIL OR MAY QUALIFY AT THE POINT OF REGISTRATION THROUGH A PRESUMPTIVE AUTOMATED THIRD-PARTY SOFTWARE.
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Schedule H, Part V, Section B, Line 16a-GRADY MEMORIAL HOSPITAL
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POLICY (INCLUDES SUMMARY) - HTTPS://WWW.GRADYHEALTH.ORG/FAP/POLICY/
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Schedule H, Part V, Section B, Line 16b-GRADY MEMORIAL HOSPITAL
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APPLICATION - HTTPS://WWW.GRADYHEALTH.ORG/FAP/APPLICATION/
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Schedule H, Part V, Section B, Line 16c-GRADY MEMORIAL HOSPITAL
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SUMMARY - HTTPS://WWW.GRADYHEALTH.ORG/FAP/SUMMARY/
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Schedule H, Part V, Section B, Line 16j-GRADY MEMORIAL HOSPITAL
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IN EARLY 2018, GMHC'S 2014 FORM 990 WAS AUDITED BY THE IRS WITH PARTICULAR EMPHASIS ON SECTION 501r. UPON COMPLETION OF THE AUDIT, GMHC WAS ADVISED TO ADD SOME ADDITIONAL VERBIAGE TO THE FAP AND PLAIN LANGUAGE SUMMARY, WHICH THE ORGANIZATION TOOK THE NECESSARY STEPS TO COMPLY. NO PENALTIES WERE ASSESSED AS THE CHANGES WERE ADVISORY IN NATURE. ALL FUTURE FORM 990 RETURNS WILL CONTAIN THE REQIRED INFORMATION GOING FORWARD.
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Schedule H, Part V, Section B, Line 16j-HUGHES SPALDING CHILDRENS HOSPITAL
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IN EARLY 2018, GMHC'S 2014 FORM 990 WAS AUDITED BY THE IRS WITH PARTICULAR EMPHASIS ON SECTION 501r. UPON COMPLETION OF THE AUDIT, GMHC WAS ADVISED TO ADD SOME ADDITIONAL VERBIAGE TO THE FAP AND PLAIN LANGUAGE SUMMARY, WHICH THE ORGANIZATION TOOK THE NECESSARY STEPS TO COMPLY. NO PENALTIES WERE ASSESSED AS THE CHANGES WERE ADVISORY IN NATURE. ALL FUTURE FORM 990 RETURNS WILL CONTAIN THE REQIRED INFORMATION GOING FORWARD.
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Schedule H, Part V, Section B, Line 20e-GRADY MEMORIAL HOSPITAL
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ADMISSIONS REPRESENTATIVE NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE ON ADMISSION. NONE OF THE ACTIONS LISTED IN LINE 19 ARE FOLLOWED BY GMHC.
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Schedule H, Part V, Section B, Line 22d-GRADY MEMORIAL HOSPITAL
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AFTER INITIAL MEDICAL EVALUATION, FAMILY COMMUNICATES/PROVIDES FINANCIAL PROOF, RESIDENCY INFORMATION, ETC. SO THAT THE ELIGIBILITY REQUIREMENTS FOR FINANCIAL ASSISTANCE ARE MET. THE SLIDING SCALE IS DISCUSSED IN LINE 13A-E.
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