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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY BENEFITS MISSION STATEMENT MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF COMMUNITY MEMBERS BY COLLABORATING WITH COMMUNITY PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING MAH'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY; ENGAGING RESIDENTS THROUGHOUT THE HOSPITAL'S SERVICE AREAS IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, INCLUDING ASSESSMENT, PLANNING, IMPLEMENTATION AND EVALUATION. SPECIAL ATTENTION IS 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 IDENTIFY UNMET HEALTH-RELATED NEEDS AND TO CHARACTERIZE THOSE IN THE COMMUNITY WHO ARE MOST VULNERABLE AND FACE DISPARITIES IN ACCESS AND OUTCOMES; IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN MAH'S SERVICE AREA GEARED TOWARD IMPROVING CURRENT AND FUTURE HEALTH STATUS OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY REMOVING BARRIERS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, STRENGTHENING THE HEALTHCARE SYSTEM AND WORKING TO DECREASE THE BURDEN OF THE LEADING HEALTH ISSUES; PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE 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 SUMMARY MAH CONCENTRATES ITS EFFORTS WITH MEMBERS FROM THE LOCAL COMMUNITY HEALTH NETWORK AREA 17. A COMMUNITY HEALTH NETWORK AREA IS A LOCAL COALITION OF PUBLIC, NON-PROFIT, AND PRIVATE SECTOR ORGANIZATIONS WORKING TOGETHER TO BUILD HEALTHIER COMMUNITIES IN MASSACHUSETTS THROUGH COMMUNITY-BASED PREVENTION PLANNING AND HEALTH PROMOTION RECOMMENDATIONS FROM THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH.DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $1,942,421 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I, COLUMN C. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE COMMUNITY BENEFITS TEAM AT MOUNT AUBURN HOSPITAL (MAH) CONSISTS OF THE COMMUNITY HEALTH STAFF, THE DIRECTOR OF SOCIAL WORK AND THE CHIEF OPERATING OFFICER. MAH COMMUNITY HEALTH DEPARTMENT STAFF MET WITH COMMUNITY MEMBERS INCLUDING THOSE WHO WORK IN PUBLIC HEALTH, TO REACH COMMUNITY MEMBERS IN MAH'S TARGET AREA. THIS TEAM MET PERIODICALLY DURING THE FISCAL PERIOD COVERED BY THIS FILING. IN ADDITION, ANNUALLY THE BOARD OF TRUSTEES APPROVES THE COMMUNITY BENEFITS' MISSION STATEMENT AND PLAN. 2018 COMMUNITY HEALTH NEEDS ASSESSMENTMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE (IRC) 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 IN ACCORDANCE WITH FEDERAL REGULATIONS, IN ORDER MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED.MAH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2018 AND THE CHNA WAS VOTED BY THE MAH BOARD OF TRUSTEES ON SEPTEMBER 30, 2018. THE MAH BOARD OF TRUSTEES ALSO APPROVED THE MOST RECENT IMPLEMENTATION STRATEGY ON SEPTEMBER 30, 2018. MAH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY (IS) WERE THE CULMINATION OF A YEAR OF PLANNING AND WORKING WITH JOHN SNOW INC. AND WAS BORN LARGELY OUT OF MAH'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST VULNERABLE OR DISADVANTAGED. THE PROJECT WAS ALSO DESIGNED TO FULFILL THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT MAH ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW MAH, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENTS, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT.2018 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY2018 COMMUNITY HEALTH NEEDS ASSESSMENT TARGETED GEOGRAPHY AND POPULATIONMAH COMMUNITY BENEFITS ARE AIMED AT SERVING ALL COMMUNITY MEMBERS WHO LIVE ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM, AND WATERTOWN. SPECIAL POPULATIONS INCLUDE COMMUNITY MEMBERS SERVED BY CHARLES RIVER COMMUNITY HEALTH CENTER (CRCHC), THE GEOGRAPHICALLY CLOSEST FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER TO MAH AND FOR PURPOSES OF THE MHA CHNA, REFERED TO AS MAH SERVICE AREA.2018 COMMUNITY HEALTH NEEDS ASSESSMENT SUMMARY OF APPROACH AND METHODSAS NOTED PREVIOUSLY, MAH HIRED JOHN SNOW, INC. AN OUTSIDE FIRM TO CONDUCT AND MANAGE THE CHNA PROCESS UNDERTAKEN DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 (TAX YEAR 2017). THE MAH COMMUNITY HEALTH DEPARTMENT STAFF WORKED CLOSELY THROUGHOUT THE ENTIRE PROCESS WITH STAFF MEMBERS FROM JOHN SNOW INC. IN ORDER TO COMPLETE THE PROJECT. A COMMUNITY BENEFIT ADVISORY COMMITTEE WAS CREATED AT THE BEGINNING OF THE PROCESS WHICH CONSISTED OF OVER 20 COMMUNITY MEMBERS AND/OR COMMUNITY ORGANIZATION REPRESENTATIVES INCLUDING CITY/TOWN PUBLIC HEALTH OFFICIALS.THE MOST RECENT CHNA WAS CONDUCTED THROUGH A THREE-PHASED PROCESS. THE GOAL OF PHASE I AND PHASE II WAS TO GAIN AN UNDERSTANDING OF HEALTH-RELATED CHARACTERISTICS OF THE REGION'S POPULATION, INCLUDING DEMOGRAPHIC, SOCIO-ECONOMIC, GEOGRAPHIC, HEALTH STATUS, CARE SEEKING, AND ACCESS TO CARE CHARACTERISTICS. THIS INVOLVED QUANTITATIVE AND QUALITATIVE DATA ANALYSIS, INCLUDING, TO THE EXTENT POSSIBLE, AN ANALYSIS OF CHANGES OVER TIME. PHASE I, CATEGORIZED AS PRELIMINARY ASSESSMENT, INVOLVED A RIGOROUS AND COMPREHENSIVE REVIEW OF EXISTING QUANTITATIVE INCLUDING A REVIEW OF US CENSUS DATA AND DATA ON SOCIAL DETERMINANTS OF HEALTH, VITAL STATISTICS INCLUDING DETAIL FROM THE CANCER REGISTRY, COMMUNICABLE DISEASE REGISTRY AND DATA FROM THE BEHAVIORAL RISK FACTOR SURVEY SYSTEM. PHASE I ALSO INCLUDED A SERIES OF INTERVIEWS WITH COMMUNITY STAKEHOLDERS. PHASE II INVOLVED A MORE TARGETED ASSESSMENT OF NEED AND BROADER COMMUNITY ENGAGEMENT ACTIVITIES THAT INCLUDED FOCUS GROUPS WITH HEALTH, SOCIAL SERVICE, AND PUBLIC HEALTH SERVICE PROVIDERS AND CLIENTS, COMMUNITY FORUMS THAT INCLUDED THE COMMUNITY AT-LARGE, AS WELL AS A COMMUNITY HEALTH SURVEY THAT CAPTURED INFORMATION FROM RESIDENTS, SERVICE PROVIDERS, AND OTHER STAKEHOLDERS REGARDING LEADING HEALTH-RELATED PRIORITIES. PHASE III INVOLVED A SERIES OF STRATEGIC PLANNING AND REPORTING ACTIVITIES THAT INVOLVED A BROAD RANGE OF INTERNAL AND EXTERNAL STAKEHOLDERS, THE DEVELOPMENT OF THE CHNA AND IMPLEMENTATION STRATEGY AND CULMINATED IN PRESENTING THE CHNA AND IMPLEMENTATION STRATEGY FOR A VOTE BY THE MAH BOARD OF TRUSTEES.
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2018 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS
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DETAIL OF APPROACH AND METHODSJSI CHARACTERIZED HEALTH STATUS AND NEED AT THE TOWN LEVEL. JSI COLLECTED DATA FROM A NUMBER OF SOURCES TO ENSURE A COMPREHENSIVE UNDERSTANDING OF THE ISSUES AND PRODUCED A SERIES OF GEOGRAPHIC INFORMATION SYSTEM (GIS) MAPS WHICH ARE INCLUDED IN THIS REPORT. THE PRIMARY SOURCE OF SECONDARY DATA WAS THROUGH THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH. TESTS OF SIGNIFICANCE WERE PERFORMED, AND STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN MAH'S SERVICE AREA AND THE COMMONWEALTH OVERALL ARE NOTED WHEN APPLICABLE. THE LIST OF SECONDARY DATA SOURCES INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2009-2013) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), (2013-2014 AGGREGATE) CHIA INPATIENT DISCHARGES (2011-2013) MA HOSPITAL INPATIENT DISCHARGES (2008-2012) MA HOSPITAL ED DISCHARGES (2008-2012) MA CANCER REGISTRY (2007-2011) MA COMMUNICABLE DISEASE PROGRAM (2011, 2012, 2013) MASSACHUSETTS VITAL RECORDS (2014) MASSACHUSETTS BUREAU OF SUBSTANCE ABUSE SERVICES (BSAS) (2013)2018 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)JSI CONDUCTED KEY STAKEHOLDER INTERVIEWS WITH 25 COMMUNITY LEADERS AND STAFF MEMBERS AT MAH. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX B TO THE CHNA WHICH IS POSTED ON THE MAH WEBSITE. (SEE LINK WITHIN THIS SUPPORT TO THE FORM 990 SCHEDULE H). THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN MAH'S SERVICE AREA. INTERVIEWS WERE CONDUCTED ON THE PHONE OR IN PERSON USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING MAJOR HEALTH ISSUES, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS, AND TARGET POPULATIONS.2018 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)JSI CONDUCTED A SERIES OF EIGHT COMMUNITY AND PROVIDER FOCUS GROUPS IN MAH'S SERVICE AREA TO GATHER CRITICAL COMMUNITY INPUT FROM SERVICE PROVIDERS, COMMUNITY LEADERS AND RESIDENTS. STAFF FROM MAH'S COMMUNITY HEALTH DEPARTMENT CONDUCTED AN ADDITIONAL TWO FOCUS GROUPS ON THEIR OWN. THESE FOCUS GROUPS WERE ORGANIZED IN COLLABORATION WITH MAH'S EXISTING COMMUNITY HEALTH PARTNERS TO LEVERAGE THEIR COMMUNITY CONNECTIONS AND TO HELP ENSURE COMMUNITY PARTICIPATION. IN ADDITION, MAH COORDINATED FOUR COMMUNITY FORUMS WHILE JSI LEAD THE DISCUSSIONS WHICH WERE OPEN AND MARKETED TO THE PUBLIC AT-LARGE. THESE FORUMS TOOK PLACE IN ARLINGTON, CAMBRIDGE, WALTHAM, AND SOMERVILLE. MOUNT AUBURN MADE EVERY EFFORT TO PROMOTE THESE EVENTS TO THE COMMUNITY AT LARGE IN ORDER TO RECRUIT PARTICIPANTS. DURING THE COMMUNITY FORUMS, JSI DISCUSSED FINDINGS FROM QUANTITATIVE DATA AND POSED A RANGE OF QUESTIONS TO SOLICIT INPUT ON COMMUNITY IDEAS, PERCEPTIONS AND ATTITUDES, INCLUDING: WHAT ARE THE LEADING SOCIAL DETERMINANTS OF HEALTH (E.G., HOUSING, POVERTY, FOOD ACCESS, TRANSPORTATION, ETC.)? WHAT ARE THE LEADING HEALTH CONDITIONS (E.G., DIABETES, HYPERTENSION, ASTHMA, RESPIRATORY DISEASE, ETC.)? WHICH SEGMENTS OF THE POPULATION ARE MOST VULNERABLE (E.G., IMMIGRANTS, LGBTQ, OLDER ADULTS, ETC.)? WHAT STRATEGIES WOULD BE MOST EFFECTIVE TO IMPROVING HEALTH STATUS AND OUTCOMES IN THESE AREAS?THE MAH ADVISORY COMMITTEE WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEED AND PRIORITIZING THE LEADING HEALTH ISSUES. THE ADVISORY COMMITTEE MET THREE TIMES DURING THE COURSE OF THE ASSESSMENT TO REFINE THE APPROACH, PROVIDE INPUT REGARDING THE ASSESSMENT, AND TO GUIDE THE PRIORITIZATION AND PLANNING PHASE. A FULL LISTING OF ALL COMMUNITY ENGAGEMENT ACTIVITIES IS INCLUDED IN THE CHNA ON THE MAH WEBSITE.2018 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: TO REVIEW THE ASSESSMENT PROCESSES MAJOR FINDINGS; TO IDENTIFY MAH'S COMMUNITY BENEFITS PRIORITY POPULATIONS AND COMMUNITY HEALTH PRIORITIES; REVIEW MAH'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE DERIVED FROM THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY WHICH WAS COMPLETED BY MAH DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2015 (TAX YEAR 2014); AND, TO 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, 2018 (TAX YEAR 2017).2018 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - KEY FINDINGSTHE KEY PRIORITY POPULATIONS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2018 WERE: RACIAL AND ETHNIC MINORITIES IMMIGRANTS LOW-INCOME POPULATIONS OLDER ADULTS NON-ENGLISH SPEAKERS LGBTQ THE KEY COMMUNITY HEALTH PRIORITIES IDENTIFIED THROUGH CHNA FY2018 WERE: MENTAL HEALTH SUBSTANCE USE CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS HEALTHY AGING TWO CROSS-CUTTING PRIORITIES INCLUDE: SOCIAL DETERMINANTS OF HEALTH HEALTH SYSTEM ISSUES (HEALTH CARE ACCESS)THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 WILL INFORM MAH'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2019, SEPTEMBER 30, 2020 AND SEPTEMBER 30, 2021.COMMUNITY HEALTH NEEDS ASSESSMENT AND ACTIVITIES REPORTED IN THIS FILINGTHE PREVIOUS NEEDS ASSESSMENT AND ACCOMPANYING IMPLEMENTATION STRATEGY WERE APPROVED BY THE MAH BOARD OF TRUSTEES BEFORE SEPTEMBER 30, 2015 AND INFORMED THE MAH'S COMMUNITY BENEFITS PROCESS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2016, SEPTEMBER 30, 2017 AND SEPTEMBER 30, 2018. AS SUCH, THE ACCOMPLISHMENTS AND ACTIVITIES INCLUDED IN THIS FILING AND REPORTED BELOW RELATE TO THE DOCUMENTS APPROVED AS OF SEPTEMBER 30, 2015. 2015 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYTHE MAH COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP OR IMPLEMENTATION STRATEGY) WHICH WERE APPROVED BY THE MAH BOARD OF TRUSTEES DURING MAH'S FISCAL YEAR ENDED SEPTEMBER 30, 2015 WERE THE CULMINATION OF SEVERAL MONTHS OF WORK AND WERE BORNE LARGELY OUT OF MAH'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST IN NEED. THAT PROJECT, SIMILAR TO THE MOST RECENT CHNA AND IMPLEMENTATION STRATEGY NOTED ABOVE, WERE DESIGNED TO FULFILL THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT MAH ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW MAH, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT.
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2015 COMMUNITY HEALTH NEEDS ASSESSMENT
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TARGETED GEOGRAPHY AND POPULATIONMAH COMMUNITY BENEFITS ARE AIMED AT SERVING ALL COMMUNITY MEMBERS WHO LIVE ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM, AND WATERTOWN. SPECIAL POPULATIONS INCLUDE COMMUNITY MEMBERS SERVED BY CHARLES RIVER (FORMERLY JOSEPH M. SMITH) COMMUNITY HEALTH CENTER (CRCHC) THE CLOSEST FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER AND THE STUDENTS AT CRISTO REY (FORMERLY NORTH CAMBRIDGE CATHOLIC) HIGH SCHOOL. FOR THE PURPOSE OF THIS REPORT THESE COMMUNITIES WILL BE REFERED TO AS MAH COMMUNITIES.THE DECISION OF WHICH CITIES AND TOWNS TO INCLUDE WAS MADE BY REVIEWING MAH PRIMARY DISCHARGE DATA. TOWNS THAT REPRESENTED MORE THAN 5% OF MAH DISCHARGES WERE INCLUDED.2015 COMMUNITY HEALTH NEEDS ASSESSMENT SUMMARY OF APPROACH AND METHODSTHE 2015 CHNA PROCESS WAS CARRIED OUT BY MAH STAFF. THIS DECISION NOT TO HIRE AN OUTSIDE ORGANIZATION WAS MADE AFTER THOUGHTFUL INTERNAL REVIEW AND BASED ON TWO MAIN CRITERIA. FIRST, MAH'S COMMUNITY HEALTH STAFF, IN PARTICULAR THE REGIONAL CENTER FOR HEALTHY COMMUNITIES DEPARTMENT, HAD THE SKILLS REQUIRED TO CONDUCT AN ASSESSMENT OF THIS MAGNITUDE. SECOND, MAH RECOGNIZED THE ADDED VALUE OF HAVING MAH STAFF CONDUCT INTERVIEWS AND LEAD GROUP DISCUSSIONS. THE PERSONAL CONNECTIONS THAT WERE MADE THROUGHOUT THE PROCESS INCREASED UNDERSTANDING BETWEEN COMMUNITY ORGANIZATIONS AND HOSPITAL STAFF. ONCE THIS DECISION WAS MADE APPROVAL FROM MOUNT AUBURN HOSPITAL'S INSTITUTIONAL REVIEW BOARD WAS SOUGHT AND THIS ASSESSMENT WAS APPROVED AS A QUALITY IMPROVEMENT PROJECT. THROUGHOUT THE ASSESSMENT PROCESS MAH MADE AN EFFORT TO CONSIDER THE WORLD HEALTH ORGANIZATION'S DEFINITION OF HEALTH AS NOT ONLY THE PHYSICAL HEALTH OF THE PEOPLE WHO LIVE IN ITS COMMUNITIES BUT ALSO AS THE SPIRITUAL, SOCIAL, PHYSICAL AND EMOTIONAL WELL-BEING OF COMMUNITY MEMBERS AND THE COMMUNITY AS A WHOLE. IMPLICIT IN THIS APPROACH IS AN UNDERSTANDING THAT HEALTH IS NOT DETERMINED SOLELY BY HEALTHCARE BUT ALSO BY THE SOCIAL DETERMINANTS OF HEALTH WHICH INCLUDE SOCIAL SUPPORTS, ENVIRONMENTAL OPPORTUNITIES, POLICIES AND NORMS OF THE COMMUNITY AND BY THE UNDERLYING ECONOMIC FACTORS AND WELL-BEING OF WHERE PEOPLE LIVE. THE PROCESS BEGAN BY BUILDING AN ADVISORY GROUP TO PROVIDE INPUT INTO THE ASSESSMENT PROCESS. OVER 500 COMMUNITY MEMBERS WHO WORK OR LIVE IN MAH COMMUNITIES WERE INVITED TO BE PART OF THIS GROUP. ALTHOUGH IT WAS STRESSED THAT ALL LEVELS OF KNOWLEDGE BOTH LIVED AND LEARNED WERE VALUED SPECIAL EFFORTS WERE MADE TO ENGAGE REPRESENTATIVES FROM LOCAL DEPARTMENTS OF PUBLIC HEALTH AND COMMUNITY HEALTH NETWORK AREA 17. COMMUNITY HEALTH NETWORK AREA 17 IS A COALITION OF PUBLIC, NON-PROFIT AND PRIVATE SECTORS WHO MEET TO THINK TOGETHER ABOUT HOW TO MAKE COMMUNITIES HEALTHIER AND TO SHARE RESOURCES. MOUNT AUBURN HOSPITAL SHARES THE SAME PRIORITY TOWNS OF ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN AS COMMUNITY HEALTH NETWORK AREA 17. ADVISORY GROUP MEMBERS WERE GIVEN INFORMATION ABOUT THEIR ROLE, A TIMELINE FOR MEETINGS AND A DESCRIPTION OF THE WORK THAT MEMBERS WOULD HAVE TO DO DURING AND BETWEEN MEETINGS. THE FINAL ADVISORY GROUP CONSISTED OF 22 MEMBERS REPRESENTING ALL SIX CITIES AND TOWNS. THE ROLES AND RESPONSIBILITIES OF THE ADVISORY GROUP WERE TO: LEARN ABOUT COMMUNITY ASSESSMENT AND HELP DESIGN THE MAH'S ASSESSMENT PROCESS PARTICIPATE IN THE ASSESSMENT AS APPROPRIATE-ANSWER SURVEYS, BE PART OF INTERVIEWS AND ATTEND MEETINGS HELP INVOLVE A BROAD AND DIVERSE GROUP OF RESIDENTS AND OTHER STAKEHOLDERS IN THIS PROCESSTHE ASSESSMENT WAS CONDUCTED IN THREE PHASES. PHASE 1 INCLUDED A REVIEW OF OTHER ASSESSMENTS, A BROAD COMMUNITY SURVEY AND A PILOT OF ASSESSMENT INTERVIEW AND GROUP DISCUSSION INSTRUMENTS. PRELIMINARY DATA GARNERED DURING THIS PHASE WERE PRESENTED TO THE ADVISORY COMMITTEE WHO FINALIZED THE ASSESSMENT INSTRUMENTS AND PROVIDED INPUT FOR PHASE 2. DURING PHASE 2 A COMMUNITY WIDE SURVEY, MORE INTERVIEWS AND A REVIEW OF SECONDARY DATA WERE CONDUCTED. THE ADVISORY GROUP REVIEWED DATA AND PROVIDED INPUT TO THE THIRD PHASE. THE THIRD PHASE BEGAN BY AGAIN INVITING A BROAD BASE OF THE COMMUNITY TO PARTICIPATE IN A COLLABORATIVE GROUP SHARING PROCESS UTILIZING THE WORLD CAF METHODOLOGY. DURING THIS MEETING COMMUNITY MEMBERS ARTICULATED A DEEPER UNDERSTAND ABOUT THE TOP HEALTH ISSUES. OVER 700 INVITATIONS WERE SENT OUT TO ATTEND THIS HALF DAY MEETING. INFORMATION FROM THIS MEETING INFORMED THIS ASSESSMENT AND WILL HELP GUIDE THE CORRESPONDING IMPLEMENTATION PLAN. THE DIRECTOR OF COMMUNITY HEALTH ORGANIZED MEETINGS OF THE ASSESSMENT TEAM, FACILITATED THE DISCUSSIONS, CAPTURED DECISIONS, SHARED THE PROCESS WITH THE LARGER MEMBERSHIP, AND CONNECTED THE HOSPITAL ADMINISTRATION TO THE PROCESS. THE GOAL WAS TO COLLECT QUANTITATIVE AND QUALITATIVE INFORMATION FROM EACH OF THE SIX COMMUNITIES IN ORDER TO CREATE A PROFILE OF HEALTH CONCERNS IN THE MAH COMMUNITIES. THE FOLLOWING PRINCIPLES GUIDED THE DATA COLLECTION.PEOPLE IN OUR COMMUNITIES SEE THE IDENTIFIED HEALTH CONCERN AS A PROBLEM: WE ASKED COMMUNITY MEMBERS WHAT THEY SAW AS IMPORTANT ISSUES, WHAT WAS MOST RELEVANT TO THEIR COMMUNITY MEMBERS AND THEIR LIVES. A WIDE SAMPLE OF COMMUNITY MEMBERS IN ALL SIX COMMUNITIES WAS ASKED TWO QUESTIONS: WHAT CONCERNS YOU MOST ABOUT YOUR COMMUNITY TODAY? WHAT WOULD MAKE YOUR COMMUNITY A BETTER PLACE TO LIVE?THE WAY THESE QUESTIONS WERE PRESENTED AND ASKED WAS CRAFTED SPECIFICALLY TO ALLOW THE ANSWERS TO BE BROAD AND INCLUSIVE OF THE SOCIAL DETERMINANTS OF HEALTH. THE GOAL WAS NOT TO BIAS PEOPLE'S THINKING TOWARD MEDICAL CARE OR ILLNESS. A THIRD QUESTION, "WHAT IS THE ONE THING YOU WOULD LIKE TO IMPROVE ABOUT YOUR HEALTH?" ELICITED COMMUNITY MEMBERS PERSONAL HEALTH CONCERNS. THE 2015 CHNA IDENTIFIED HEALTH CONCERN AFFECTS ALL SIX MAH COMMUNITIES: QUANTITATIVE DATA ABOUT MAGNITUDE AND INCIDENCE OF PROBLEMS WERE REVIEWED. THE FOCUS OF THIS REVIEW WAS TO IDENTIFY COMMON THEMES ACROSS THE MAH COMMUNITIES. THE ADVISORY GROUP CHOSE TO CONDUCT KEY INFORMANT INTERVIEWS OF LEADERS FROM ORGANIZATIONS THAT WOULD BE ALIKE IN EACH TOWN. DEPARTMENTS OF PUBLIC HEALTH, WHICH REPRESENT ALL POPULATIONS, AND COUNCILS ON AGING, WHICH REPRESENT ELDERS, WERE CHOSEN. THE GROUP RECOGNIZED THAT YOUTH SERVING ORGANIZATIONS WERE NOT UNIFORM THROUGHOUT EACH CITY AND TOWN AND RELIED ON A REVIEW OF YOUTH BEHAVIOR RISK SURVEY INFORMATION TO REPRESENT THAT COHORT. THROUGHOUT THIS PROCESS ENGAGED COMMUNITY MEMBERS WERE ASKED TO THINK LOCALLY ABOUT HEALTH CONCERNS AND FOCUS ON DATA PERTAINING TO THE SIX COMMUNITIES.MEASURABLE AND SUSTAINABLE CHANGE CAN BE MADE ON THE IDENTIFIED HEALTH CONCERN IN THREE YEARS: THE MEMBERS OF THE ADVISORY GROUP AND OTHER COMMUNITY MEMBERS WHO PARTICIPATED WERE ASKED TO USE THEIR COLLECTIVE KNOWLEDGE TO DECIDE THIS. A REVIEW OF EVIDENCED BASED PROGRAMS SUCH AS HEALTHY PEOPLE 2020 (HTTP://WWW.HEALTHYPEOPLE.GOV/) AND THE CENTER FOR DISEASE CONTROL'S WINNABLE BATTLES (HTTP://WWW.CDC.GOV/WINNABLEBATTLES/) WAS SHARED WITH THE ADVISORY GROUP AND WILL BE UTILIZED DURING IMPLEMENTATION PLANNING. THERE ARE RESOURCES RELATED TO THE IDENTIFIED HEALTH CONCERN UPON WHICH NEW ACTIVITIES CAN BUILT: THE MEMBERS OF THE ADVISORY GROUP AND OTHER COMMUNITY MEMBERS WHO PARTICIPATED WERE ASKED TO BRAINSTORM TOGETHER AND CREATE A LIST OF COMMUNITY RESOURCES. THE IDENTIFIED HEALTH CONCERN AFFECTS VULNERABLE POPULATIONS: IT WAS DECIDED THAT INVITATIONS TO PARTICIPATE IN THE ASSESSMENT WOULD BE AS BROAD AS POSSIBLE. EVERYONE WAS WELCOME. ORGANIZATIONS WHO SERVE IMMIGRANT POPULATIONS SUCH AS ENGLISH SPEAKERS OF OTHER LANGUAGES (ESOL) AND OTHERS WHO SERVE UNDERSERVED POPULATIONS WERE INCLUDED. THROUGHOUT THE PROCESS PARTICIPANTS WERE ASKED TO CONSIDER AND PRIORITIZE THE NEEDS OF VULNERABLE POPULATIONS.THE GOAL WAS TO COLLECT DATA FROM A VARIETY OF SOURCES IN ORDER TO DEFINE THE MAIN HEALTH CONCERN AND ALSO ARTICULATE WHAT THAT DEFINITION MEANS TO COMMUNITY MEMBERS. DATA CAME FROM FOUR MAIN SOURCES. REVIEW OF CURRENT MAH COMMUNITY BENEFITS PROGRAMMINGBY REVIEWING THE EVALUATION OF THE 2012 IMPLEMENTATION PLAN AND ASKING THE OPINIONS OF KEY STAKEHOLDERS, AN EVALUATION OF CURRENT MAH COMMUNITY BENEFITS PROGRAMMING, INCLUDING A RECOMMENDATION OF WHETHER OR NOT TO CONSIDER CONTINUING THE PROGRAM, WAS COMPLETED.
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QUANTITATIVE DATA: REVIEWING EXISTING SECONDARY DATA
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TO DEVELOP A QUANTITATIVE HEALTH SUMMARY OF MAH COMMUNITIES EXISTING DATA WAS DRAWN FROM THE FOLLOWING SOURCES: CENSUS, AMERICAN COMMUNITY SURVEY 2012 CITY OF CAMBRIDGE ASSESSMENT-2014 MASS CHIP MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH STATUS OF CHILDHOOD WEIGHT IN MASSACHUSETTS 2009-2011 MOUNT AUBURN HOSPITAL EMERGENCY ROOM DATA TUFTS HEALTH PLAN FOUNDATION HEALTHY AGING DATA REPORT 2015 YOUTH BEHAVIOR RISK SURVEYS ARLINGTON (2013-2014), BELMONT (2011-2012), CAMBRIDGE (2013-2014), SOMERVILLE (2013-2014), WALTHAM (2011-2012), AND WATERTOWN (2011-2012) (WHEN POSSIBLE DATA WAS REVIEWED FOR EACH INDIVIDUAL CITY AND TOWN IN THE MAH COMMUNITIES; OTHERWISE, IT WAS REVIEWED AT THE COUNTY OR CHNA LEVEL. QUALITATIVE DATA: INTERVIEWS, GROUPS CONVERSATIONS, SURVEYS AND WORLD CAF THIS ASSESSMENT ATTEMPTED TO SOLICIT BROAD INPUT FROM ALL COMMUNITY MEMBERS. WHENEVER POSSIBLE MAH INCLUDED NEEDS OF THE VUNERABLE POPULATIONS AND/OR INDIVIDUALS OR ORGANIZATIONS SERVING OR REPRESENTING SUCH POPULATIONS. A REVIEW OF THE POPULATION CHARACTERISTICS FOR ALL SIX TOWNS HELPED THE ADVISORY GROUP DECIDE THAT SPECIAL EMPHASIS WOULD BE PLACED ON ELDERLY COMMUNITY MEMBERS. THEY CAME TO THIS CONCLUSION FOR THREE REASONS: ELDERS REPRESENT THE LARGEST GROWING POPULATION OF MAH PATIENTS, THREE OF MAH COMMUNITIES (ARLINGTON, BELMONT AND WATERTOWN) HAVE ELDER POPULATIONS HIGHER THAN STATE AVERAGE AND COUNCILS ON AGING WERE LOCATED IN EACH TOWN PROVIDING A SIMILAR BASE. QUALITATIVE DATA WERE COLLECTED FROM OVER 800 COMMUNITY MEMBERS THROUGH THE FOLLOWING METHODS: KEY INFORMANT INTERVIEWS (25) GROUPS CONVERSATIONS (7) SURVEYS SIX DIFFERENT SURVEYS WERE UTILIZED TO GATHER INFORMATION. O COMMUNITY PAPER SURVEYO ENGLISH AS A SECOND LANGUAGE PROVIDER SURVEYO COLLABORATIONS WITH OTHERS CONDUCTING SURVEYS CHNA 17 YOUTH SUMMIT PARTICIPANTS, N=180 HEALTHY WALTHAM HIGH SCHOOL SURVEY, N=89 COMMUNITY DAY CENTER OF WALTHAM HOMELESS SURVEY, N=100 COMMUNITY ELECTRONIC SURVEY (291) WORLD CAF AFTER INITIAL ANALYSIS OF THE ABOVE DATA SOURCES WAS COMPLETED THE RESULTS WERE PRESENTED TO THE ADVISORY GROUP. WITH THE ADVISORY GROUP CONSENSUS MAH ENGAGED COMMUNITY MEMBERS TO FURTHER DEFINE THE TOP HEALTH CONCERNS. FORTY THREE COMMUNITY MEMBERS MET FOR HALF A DAY AND FOR EACH HEALTH TOPIC THEY FINALIZED A DEFINITION, EXPLORED THE UNDERLYING CAUSES, SHARED WHAT IS CURRENTLY BEING DONE AND SUGGESTED WHAT COULD BE DONE IN THE NEXT THREE YEARS. WRITTEN COMMENTS SOLICITED ON THE 2012 ASSESMENT AND IMPLEMENTATION PLANAS REQUIRED, THE 2012 COMMUNITY HEALTH NEEDS ASSESSMENT AND CORRESPONDING IMPLEMENTATION PLAN WERE POSTED ON THE MAH WEBSITE AND MADE AVAILABLE IN HARD COPY. BOTH REPORTS WERE ALSO SHARED WITH COMMUNITY HEALTH NETWORK AREA 17. COMMUNITY MEMBERS WERE ENCOURAGED TO SHARE THEIR THOUGHTS, CONCERNS OR QUESTIONS2015 COMMUNITY HEALTH NEEDS ASSESSMENT -- MAJOR HEALTH NEEDS AND HOW PRIORITIES WERE DETERMINEDDURING THE DEVELOPMENT OF THE IMPLEMENTATION STRATEGY MAH FIRST REVIEWED THE MASSACHUSETTS ATTORNEY GENERAL'S AND THE INTERNAL REVENUE SERVICE'S GUIDELINES. IN MASSACHUSETTS HOSPITALS ARE ENCOURAGED TO ADDRESS THE FOLLOWING STATEWIDE HEALTH PRIORITIES: SUPPORTING HEALTH CARE REFORM, REDUCING HEALTH DISPARITIES, IMPROVING CHRONIC DISEASE MANAGEMENT AND PROMOTING WELLNESS IN VULNERABLE POPULATIONS. THE INTERNAL REVENUE SERVICE GUIDELINES OUTLINE THE FOLLOWING FEDERAL PRIORITIES: IMPROVING ACCESS TO CARE, ADVANCING MEDICAL KNOWLEDGE, ENHANCING COMMUNITY HEALTH AND RELIEVING OR REDUCING GOVERNMENT BURDEN.NEXT, MAH CONSIDERED THE SAME PRINCIPLES THAT HAD GUIDED THE ASSESSMENT PROCESS: PEOPLE IN MAH COMMUNITIES SEE THE IDENTIFIED HEALTH CONCERN AS A PROBLEM THE IDENTIFIED HEALTH CONCERN AFFECTS ALL SIX MAH COMMUNITIES MEASURABLE AND SUSTAINABLE CHANGE CAN BE MADE ON THE IDENTIFIED HEALTH CONCERN IN THREE YEARS THERE ARE RESOURCES RELATED TO THE IDENTIFIED HEALTH CONCERN UPON WHICH NEW ACTIVITIES CAN BUILT THE IDENTIFIED HEALTH CONCERN AFFECTS VULNERABLE POPULATIONSFINALLY, MAH REVIEWED AN EVALUATION OF CURRENT MAH COMMUNITY BENEFIT PROGRAMING, INCLUDING A RECOMMENDATION OF WHETHER OR NOT TO CONTINUE EACH PROGRAM.PHASES 1 AND 2 INVOLVED COLLECTING COMMUNITY WIDE QUANTITATIVE AND QUALITATIVE DATA AND SHARING RESULTS WITH THE ADVISORY GROUP. THE MAIN HEALTH CONCERNS IDENTIFIED DURING THE ASSESSMENT WERE: OBESITY AND INACTIVE LIVING POOR SELF-MANAGEMENT (AND PREVENTION) OF CHRONIC DISEASE MENTAL HEALTH ISSUES SUBSTANCE ABUSE ACCESS TO HEALTH CARE SERVICES AND SUPPORT OF BROAD PUBLIC HEALTH CONCERNSIN PHASE 3 ENGAGED COMMUNITY MEMBERS PARTICIPATED IN A COLLABORATIVE GROUP SHARING PROCESS UTILIZING THE WORLD CAF METHODOLOGY (HTTP://WWW.THEWORLDCAFE.COM/KEY-CONCEPTS-RESOURCES/WORLD-CAFE-METHOD). DURING THIS MEETING 42 COMMUNITY MEMBERS ARTICULATED A DEEPER UNDERSTANDING OF THE FIRST FOUR IDENTIFIED HEALTH CONCERNS. PARTICIPANTS WERE ASKED TO CONSIDER AND PRIORITIZE THE NEEDS OF VULNERABLE POPULATIONS. THE FOLLOWING QUESTIONS HELPED INFORM THE IMPLEMENTATION PLAN: WHAT ARE THE UNDERLYING CAUSES SURROUNDING THE IDENTIFIED HEALTH CONCERN? WHAT IS CURRENTLY BEING DONE TO ADDRESS THE IDENTIFIED HEALTH CONCERN THAT IS EFFECTIVE? IN OTHER WORDS, WHAT WORKS WELL? WHAT COULD BE DONE IN THE NEXT THREE YEARS TO IMPROVE OR SOLVE THE IDENTIFIED HEALTH CONCERN? WHAT IS ACTUALLY DOABLE? WHAT BARRIERS CURRENT EXIST? IN ADDITION TO ANSWERING THESE QUESTIONS COMMUNITY MEMBERS ARTICULATED THAT THERE WAS SYNERGY BETWEEN THE IDENTIFIED HEALTH CONCERNS A NEED TO ALIGN CURRENT ACTIVITIES ADDRESSING EACH IDENTIFIED HEALTH CONCERN A NEED FOR COMMUNICATION BETWEEN ORGANIZATIONS DOING SIMILAR WORK INCLUDING RESOURCE SHARING LIKELY DISPARITIES AMONG COMMUNITY MEMBERS WHO HAVE LANGUAGE AND CULTURAL BARRIERS AND ARE OF LOWER SOCIO-ECONOMIC STATUS2015 COMMUNITY HEALTH NEEDS ASSESSMENT KEY FINDINGSMAH'S CHNA RESULTED IN THE FOLLOWING KEY FINDINGS RELATED TO COMMUNITY HEALTH NEEDS: OBESITY AND INACTIVE LIVING POOR SELF-MANAGEMENT (AND PREVENTION) OF CHRONIC DISEASE MENTAL HEALTH ISSUES SUBSTANCE ABUSE ACCESS TO HEALTH CARE SERVICES SUPPORT OF BROAD PUBLIC HEALTH CONCERNSCOMMUNITY HEALTH NEEDS ASSESSMENT MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLE MAH STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, MAH COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2018 (TAX YEAR 2017). THAT CHNA IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/1518/2018-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDFTHE APPENDIX TO THAT CHNA IS AVAILABLE ON THE MAH WEBSITE AT: HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/1489/MAH2018CHNA-APPENDICES.PDFIN ADDITION, AS NOTED ABOVE, MAH COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY (CHIP) DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2018 (TAX YEAR 2017). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/1517/2018-COMMUNITY-HEALTH-IMPLEMENTATION-PLAN.PDFIN ADDITION, AS NOTED ABOVE, MAH COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2015 (TAX YEAR 2014). THAT CHNA IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/1118/NEEDS-ASSESSMENT-2015.PDFTHE APPENDIX TO THAT CHNA IS AVAILABLE ON THE MAH WEBSITE AT: HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/744/MAH-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2015-APPENDIX.PDFFINALLY, THE IMPLEMENTATION STRATEGY (CHIP) ASSOCIATED WITH THE CHNA COMPLETED DURING MAH'S FISCAL YEAR ENDED SEPTEMBER 30, 2015 (TAX YEAR 2014) IS AVAILABLE ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/747/MOUNT-AUBURN-HOSPITAL-IMPLEMENTATION-PLAN-2015.PDFEACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST. (SCHEDULE H, PART V, SECTION B, LINE 7A)
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COMMUNITY HEALTH NEEDS ASSESSMENT - ADDRESSING COMMUNITY HEALTH NEEDS
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(SCHEDULE H, PART V, SECTION B, LINE 11).AS NOTED ABOVE, MAH'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018. THAT CHNA AND IMPLEMENTATION STRATEGY WILL INFORM THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF MAH FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2019, SEPTEMBER 30, 2020 AND SEPTEMBER 30, 2021. THIS FORM 990 COVERS MAH'S FISCAL YEAR ENDED SEPTEMBER 30, 2019. THE PREVIOUS NEEDS ASSESSMENT AND ACCOMPANYING IMPLEMENTATION PLAN WERE APPROVED BY THE MAH BOARD OF TRUSTEES BEFORE SEPTEMBER 30, 2015 AND INFORMED THE MAH'S COMMUNITY BENEFIT PROCESS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2016, SEPTEMBER 30, 2017 AND SEPTEMBER 30, 2018. AS SUCH, THE ACCOMPLISHMENTS AND ACTIVITIES INCLUDED IN THIS FILING AND REPORTED BELOW RELATE TO THE DOCUMENTS APPROVED AS OF SEPTEMBER 30, 2018. A SUMMARY OF MAH'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESSES THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY IS PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. FOCUS ON MENTAL HEALTHHERTZSTEIN WELLNESS CENTER THE MISSION OF THE HERZSTEIN WELLNESS CENTER IS TO PROVIDE A SPACE FOR HEALTH, REVITALIZATION, AND HOPE THROUGH EDUCATION AND INTEGRATIVE CARE FOR CANCER PATIENTS, FAMILY AND THEIR CAREGIVERS. MAH OFFERS PROGRAMS THAT ADDRESS THE WHOLE PERSON, INCLUDING PHYSICAL BODY, MIND-BODY CONNECTION, SPIRITUAL VITALITY, AND SOCIAL SUPPORT TO IMPROVE QUALITY OF LIFE, CANCER SURVIVAL, AND CANCER PREVENTION. ACUPUNCTURE, MASSAGE AND REIKKI THERAPY ARE AVAILABLE ON AN INDIVIDUAL BASIS FREE OF CHARGE. THIS PROGRAM IS MANAGED BY THE WELLNESS COORDINATOR. THE HERZSTEIN WELLNESS CENTER PROVIDED OVER 550 APPOINTMENTS FOR MASSAGE THERAPY, ACUPUNCTURE AND REIKKI THERAPY. OTHER PROGRAMS OFFERED ARE PET THERAPY, PAMPER AND PROTECT, GENTLE CHAIR YOGA AND RETURN TO FITNESS. THERE WERE OVER 500 PARTICIPANTS WHO TOOK ADVANTAGE OF THESE PROGRAMS THROUGHOUT THE YEAR.INCREASING CAPACITY OF THE CITY OF CAMBRIDGE TO OFFER MENTAL HEALTH FIRST AID TRAININGMAH PROVIDED A $2,000 GRANT TO THE CITY OF CAMBRIDGE TO HELP THEM INCREASE THEIR CAPACITY TO OFFER MENTAL HEALTH FIRST AID (MHFA) TO STAFF AND COMMUNITY MEMBERS. CAMBRIDGE SENT A STAFF MEMBER TO COMPLETE THE NATIONAL COUNCIL ON BEHAVIORAL HEALTH FACILITATOR TRAINING PROGRAM FOR MHFA. TO DATE OVER 40 STAFF MEMBERS HAVE BEEN TRAINED IN YOUTH MENTAL HEALTH FIRST AID.THE MANY FACES PROJECT - TUFTS UNIVERSITY IN SOMERVILLE MAH SUPPORTED THE MANY FACES PROJECT IN COLLABORATION WITH THE SOMERVILLE HEALTH AND HUMAN SERVICES DEPARTMENT. THIS PROJECT SERVED AS A FOUNDATION FOR GENUINE DIALOGUE ABOUT MENTAL HEALTH. THE MANY FACES PROJECT INCLUDES PORTRAITS, 33 OF INDIVIDUALS ON THE BIPOLAR DISORDER SPECTRUM, 33 OF INDIVIDUALS ON THE SCHIZOPHRENIA SPECTRUM AND 33 INDIVIDUALS WHO LOVE THEM, ALL WITHOUT LABELS. ADDITIONALLY, SCULPTURES DEPICT THE MENTAL HEALTH SPECTRUM, AND PAINTINGS TRANSLATE U.S. CENSUS DATA AND SCIENTIFIC RESEARCH ON MENTAL ILLNESSES IN POIGNANT AND ARTISTIC WAYS. THE MANY FACES PROJECT EXHIBIT WAS OPEN TO THE PUBLIC AND 438 COMMUNITY RESIDENTS VISITED, IN ADDITION TO THE 1,200 STUDENTS AND STAFF. BELMONT PARENT SERIESTHE CITY OF BELMONT RECOGNIZED A NEED TO EDUCATE PARENTS ON THE TOPIC OF TEEN STRESS AND ANXIETY. MAH FUNDED A PARENT SERIES OF INFORMATIONAL PRESENTATIONS WITH BREAKOUT SESSIONS FOR PARENTS AND COMMUNITY MEMBERS. 70 PARTICIPANTS GAINED KNOWLEDGE AND LEARNED STRATEGIES TO HELP THEIR TEENS REDUCE STRESS AND ANXIETY. COLLABORATION WITH COMMUNITY HEALTH NETWORK AREA (CHNA) 17TO INCREASE THE CAPACITY OF COMMUNITY HEALTH NETWORK AREA (CHNA) 17 MAH COLLABORATES WITH CHNA 17 TO HELP SUPPORT AND FULFILL ITS MISSION. CHNA 17'S MISSION IS TO PROMOTE HEALTHIER PEOPLE AND COMMUNITIES BY FOSTERING COMMUNITY ENGAGEMENT, ELEVATING INNOVATIVE AND BEST PRACTICES, ADVANCING RACIAL EQUITY, AND SUPPORTING RECIPROCAL LEARNING OPPORTUNITIES TO ADDRESS THE NEEDS OF THE MOST MARGINALIZED MEMBERS OF OUR COMMUNITIES. MAH PROVIDES FUNDING, TECHNICAL ASSISTANCE AND ACTIVE STEERING COMMITTEE MEMBERSHIP. THIS REPORTING PERIOD, MAH PROVIDED CHNA 17 MENTAL HEALTH AND RACIAL EQUITY GRANTS. THE GOAL OF THE GRANTS IS TO INCREASE ACCESS AND REDUCE RACIAL INEQUITIES IN MENTAL HEALTH SERVICES FOR AFRICAN AMERICANS. IN FY19 THE GRANTS WERE USED TO PLAN EFFECTIVE INITIATIVES FOR FOLLOWING YEARS.SUPPORT GROUPS/BEREAVEMENTTO ADDRESS MENTAL HEALTH, MAH LED A SUPPORT GROUP THAT PROVIDES PEOPLE SPACE, IN A SAFE AND SUPPORTIVE ENVIRONMENT, TO SHARE THEIR FEELINGS AND STORIES WITH OTHERS WHO ARE GOING, OR HAVE GONE, THROUGH THE LOSS OF A LOVED ONE. IT IS OPEN TO ANY ADULT COMMUNITY MEMBER WHO HAS EXPERIENCED THE DEATH OF SOMEONE SIGNIFICANT IN THEIR LIFE. A TOTAL OF 43 COMMUNITY MEMBERS PARTICIPATED IN THREE, EIGHT-WEEK LONG SUPPORT GROUP SESSIONS.FOCUS ON SUBSTANCE USEADDRESSING THE OPIOID EPIDEMICTHE MAH SUBSTANCE USE TASK FORCE PARTNERED WITH THE MIDDLESEX DISTRICT ATTORNEY TO CREATE THE METRO REGION OPIOID TASK FORCE. THIS TASK FORCE WAS FORMED THIS REPORTING PERIOD AND PROVIDES A QUARTERLY MEETING FOR STAFF AND COMMUNITY MEMBERS. THE MEETINGS ARE HELD AT MAH AND THEY PROVIDE THE SPACE FOR EDUCATION, INFORMATION SHARING AND PARTNERSHIP. TO ADDRESS THE GROWING NUMBER OF OVERDOSE PATIENTS IN THE EMERGENCY DEPARTMENT (ED), MAH CREATED AN INTERNAL SUBSTANCE USE TASK FORCE TO EXPLORE HOW THE ED COULD BETTER SUPPORT PATIENTS STRUGGLING WITH SUBSTANCE USE DEPENDENCE. THROUGH THE WORK OF THIS TASK FORCE, MAH CREATED A PROCESS FOR PATIENTS WITH SUBSTANCE USE DEPENDENCE. WHEN PATIENTS LEAVE THE ED, THEY ARE GIVEN A WARM HANDOFF AND ARE SEEN IN THE OUTPATIENT CLINIC. PATIENTS WHO PRESENT IN THE ED WITH AN OVERDOSE ARE GIVEN A THREE-DAY SUPPLY OF SUBOXONE AND ARE THEN SEEN IN THE OUTPATIENT CLINIC FOR FOLLOW-UP. OVER A SHORT PERIOD OF TIME, AND WITH RELATIVELY FEW RESOURCES, THE TASK FORCE ESTABLISHED A BRIDGE CLINIC IN CONJUNCTION WITH THE START (SUBSTANCE TREATMENT AND REFERRAL TEAM) PROGRAM, WITHIN THE DEPARTMENT OF PSYCHIATRY TO IMPROVE TRANSITIONS OF CARE. NARCAN TRAINING IN WALTHAMMAH COLLABORATED WITH THE WALTHAM HEALTH DEPARTMENT AND PROVIDED THEM WITH A $2,000 GRANT THAT THEY USED TO HOST A NARCAN TRAINING AND EXPAND THEIR DISTRIBUTION PROGRAM. IN ADDITION TO HOSTING A NARCAN TRAINING FOR THE COMMUNITY, THE CITY OF WALTHAM PROVIDED ONE ON ONE NARCAN TRAINING AND KITS TO OVERDOSE VICTIMS AND/OR THEIR FAMILIES.SMOKING CESSATION WORKMAH CONTINUED TO PROVIDE THE EVIDENCED-BASED PROGRAM FREEDOM FROM SMOKING TO COMMUNITY MEMBERS. THIS PROGRAM PROVIDES AN OVERVIEW ON HOW TO OVERCOME TOBACCO ADDICTION BY ADDRESSING THE PHYSICAL, MENTAL AND SOCIAL ASPECTS OF ADDICTION. TOPICS INCLUDE MANAGING STRESS, AVOIDING WEIGHT GAIN, DEVELOPING A NEW SELF-IMAGE, HOW TO STAY SMOKE FREE AND MORE. THIS REPORTING PERIOD, MAH COLLABORATED WITH NEWTON WELLESLEY HOSPITAL AND CHARLES RIVER COMMUNITY HEALTH CENTER (CRCH) TO HELP RECRUIT AND SUPPORT THE FREEDOM FROM SMOKING PROGRAM. TWO EIGHT-WEEK SESSIONS WERE OFFERED AT CRCH CENTER. ADDITIONALLY, MAH PROVIDES A TOBACCO SPECIALIST TO THE CAMBRIDGE AND SOMERVILLE PROGRAMS FOR ADDICTION RECOVERY (CASPAR). PARTICIPANTS AT THIS PROGRAM ARE GIVEN THE OPPORTUNITY FOR LUNG SCREENINGS AND TOBACCO CESSATION EDUCATION IS PROVIDED.
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FOCUS ON CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS
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STROKE NAVIGATION AND PREVENTIONMOUNT AUBURN HOSPITAL SUPPORTS A STROKE CERTIFIED NURSE WHO IS A MEMBER OF THE AMERICAN ASSOCIATION OF NEUROLOGICAL NURSES (AANN). THE NURSE PROVIDES STROKE EDUCATION AND AWARENESS SERVICES TO MAH PATIENTS, THEIR FAMILIES AND STAFF. STROKE AND HEART HEALTH EDUCATION WAS PROVIDED IN A VARIETY OF COMMUNITY SETTINGS TO COMMUNITY MEMBERS. MAH PROVIDES ANNUAL COMPETENCY TRAINING FOR THE STAFF AT A LOCAL NURSING FACILITY. THIS EDUCATION WAS PRESENTED TO OVER 200 STAFF AT VARIOUS SKILLED NURSING FACILITIES IN THE COMMUNITY. DURING THIS REPORTING PERIOD MAH COLLABORATED WITH LOCAL PRIVATE EMS, AND LOCAL CITIES AND TOWN FIRE DEPARTMENTS TO PROVIDE STAFF WITH UPDATED INFORMATION AND EDUCATION ABOUT RECOGNIZING THE SIGNS OF A STROKE. MAH TRAINED RESPONDERS TO PERFORMING NATIONAL STROKE ASSESSMENTS AND TO ALERT THE HOSPITAL PRIOR TO ARRIVAL IN ORDER TO PROVIDE PATIENTS WITH EFFICIENT TIME SENSITIVE CARE. OVER 100 EMS STAFF IN THE COMMUNITY HAVE BEEN TRAINED THROUGH THIS PROGRAM. THIS REPORTING PERIOD, THE STROKE EDUCATION PROGRAM AT MAH PARTNERED WITH WALTHAM HIGH SCHOOL TO CREATE THE STROKE AMBASSADOR PROGRAM. STROKE AMBASSADORS CREATED AN EDUCATION CAMPAIGN WHICH TAUGHT STUDENTS AND THEIR FAMILIES TO RECOGNIZE THE SIGNS OF STROKE AND HOW TO RESPOND. 80 STUDENTS REPORTED THAT THEY NOW KNOW HOW TO RECOGNIZE THE SIGNS OF A STROKE. THE STROKE NURSE EDUCATED OVER 70 ELDERS DURING THIS REPORTING PERIOD. 100% OF THE ELDERS WHO RECEIVED TRAINING REPORTED THAT THEY ARE NOW ABLE TO RECOGNIZE THE SIGNS OF A STROKE AND THEY KNOW HOW TO RESPOND TO HELP SAVE A LIFE. MAH PROVIDED STROKE EDUCATION AT A LOCAL SENIOR HEALTH FAIR WHERE THERE WERE OVER 800 PARTICIPANTS.SUPPORT FOR COMMUNITY MEMBERS WITH CANCERMAH WORKS WITH CANCER PATIENTS TO CREATE A SENSE OF SUPPORT, CONFIDENCE, COURAGE, AND COMMUNITY AMONG CANCER PATIENTS. IN ADDITION TO OUR COLLABORATION WITH THE AMERICAN CANCER SOCIETY, MAH HAS GARNERED ITS OWN INTERNAL RESOURCES TO PROVIDE SUPPORT SERVICES FOR COMMUNITY MEMBERS TOUCHED BY CANCER. 80 CANCER SURVIVORS CELEBRATED TOGETHER AT MAH AT OUR "EMBRACING A NEW FUTURE" SURVIVORSHIP DAY HELD IN JUNE TO CELEBRATE SURVIVORS IN OUR COMMUNITY. A LOOK GOOD FEEL BETTER PROGRAM WAS ALSO OFFERED TO COMMUNITY MEMBERS TOUCHED BY CANCER. THIS YEAR MAH FACILITATED A FARM DAY FOR STAFF AND SURVIVORS AND THEIR FAMILIES AT THE WALTHAM FIELDS COMMUNITY FARM. THESE PROGRAMS ARE AIMED AT INCREASING HOPE AND IMPROVED MENTAL HEALTH FOR THOSE AFFECTED BY CANCER.FOCUS ON HEALTHY AGINGFALL PREVENTION IN OLDER ADULTS A MATTER OF BALANCE PROGRAMMOUNT AUBURN HOSPITAL CONTINUED TO OFFER THE EVIDENCE-BASED PROGRAM, A MATTER OF BALANCE, WHICH PROVIDES EDUCATION AND INFORMATION TO ELDERS TO REDUCE THEIR RISK OF FALLING. THIS PROGRAM ADDRESSES OBESITY AND INACTIVE LIVING BY INCORPORATING A LOW IMPACT EXERCISE ROUTINE. CLASSES WERE HELD ONSITE AT THE HOSPITAL AND ARE FREE AND OPEN TO COMMUNITY MEMBERS. 50 ADULTS PARTICIPATED IN CLASSES THIS REPORTING PERIOD AND 100% REPORTED THAT AFTER TAKING THE CLASS THEY FELT MORE COMFORTABLE INCREASING THEIR ACTIVITY LEVELS AND PLAN TO CONTINUE THE EXERCISES ROUTINE.ELDER CARDIOVASCULAR HEALTHTO ADDRESS PREVENTION AND EARLY DETECTION OF ILLNESS, MAH NURSES GO TO COMMUNITY SETTINGS AND PROVIDE FREE BLOOD PRESSURE SCREENINGS. MAH NURSES ALSO TAKE THIS OPPORTUNITY TO TEACH AND REVIEW THE WARNING SIGNS OF HEART ATTACK AND STROKE. THIS REPORTING PERIOD, 80 BLOOD PRESSURE CLINICS WERE PROVIDED, AND 2,000 ELDERS ATTENDED AND RECEIVED EDUCATION ON SIGNS AND SYMPTOMS OF HIGH BLOOD PRESSURE. IN-HOME SERVICES/LIFELINETO ADDRESS ACCESS TO HEALTHCARE MAH PROVIDES PERSONAL EMERGENCY RESPONSE SERVICES (LIFELINE) TO UNDERSERVED ELDERS AND DISABLED ADULTS. MAH WORKS CLOSELY WITH LOCAL AGING SERVICES ACCESS POINT AGENCIES AND PROVIDES THE EMERGENCY RESPONSE SYSTEMS BELOW COST TO OVER 1,000 COMMUNITY MEMBERS WHO ARE IN NEED. THIS PROGRAM ALLOWS OLDER ADULTS STAY AGE SAFELY IN THEIR HOME.FOCUS ON SOCIAL DETERMINANTS OF HEALTHHEALTH EQUITY AND FOOD ACCESSTHIS REPORTING PERIOD, MAH WAS ABLE TO PROVIDE SMALL GRANTS TO SUPPORT HEALTH EQUITY AND FOOD ACCESS FOR THOSE IN NEED. LOCAL FOOD MARKETS, FOOD COLLABORATIVES, AS WELL AS THE WATERTOWN BOYS AND GIRLS CLUB RECEIVED $1,000 EACH TO INCREASE ACCESS AND PROVIDE EDUCATION TO HELP UNDERSERVED RESIDENTS INCREASE THEIR ACCESS TO FRESH FOODS. EACH ORGANIZATION TAILORED A PLAN TO FIT THE NEEDS OF THEIR CONSTITUENTS. MAH WORKED WITH HEALTHY WALTHAM TO PROVIDE FUNDING TO INCREASE HEALTH EQUITY AMONG OLDER ADULTS WITH LIMITED ENGLISH PROFICIENCY. THE GOAL OF THE COLLABORATION IS TO REDUCE SOCIAL ISOLATION BY INCREASING OUTREACH AND OFFERING PROGRAMS AT THE LOCAL SENIOR CENTER. THIS FUNDING SUPPORTED WATERTOWN WELLNESS AND ALLOWED THEM TO INCREASE THEIR PARTICIPATION IN THE SNAP MATCH FARMERS MARKET PROGRAM BY 38%. MAH COLLABORATED WITH ARLINGTONEATS AND SURVEYED THE CHINESE POPULATION TO GAIN KNOWLEDGE ABOUT THEIR NEEDS. AS A RESULT, ARLINGTONEATS WERE ADDED CHINESE LABELS TO ALL OF THE SHELVING AND FOOD PRODUCTS AND TRANSLATED ALL OF THEIR PRINTED MATERIAL TO MANDARIN. THE BELMONT FOOD COLLABORATIVE ADDED FRESH EGGS TO THEIR OFFERINGS FOR SNAP AND WIC RECIPIENTS AND DOUBLE THE PURCHASING POWER FOR LOW-NCOME SHOPPERS AT THE FARMERS MARKET. AT THE BOYS AND GIRLS CLUB OF WATERTOWN COOKING AND NUTRITIONAL CLASSES WERE OFFERED TO TEENS. OVER 40 YOUNG PEOPLE PARTICIPATED IN THE 6-WEEK SERIES, LEARNING HEALTHIER WAYS TO COOK MEALS AND SNACKS. 75% OF THE YOUTH PARTICIPANTS SHOWED UNDERSTANDING AND RETENTION OF THE NUTRITION INFORMATION PRESENTED.REDUCING HEALTH DISPARITIESTHE MAH DISPARITIES COMMITTEE IS FOCUSED ON REDUCING IDENTIFIED HEALTH DISPARITIES. THIS YEAR THE COMMITTEE IDENTIFIED THE LGBTQ+ COMMUNITY AS A PRIORITY POPULATION IN REDUCING HEALTH DISPARITIES FOR PATIENTS AND COMMUNITY MEMBERS. THIS COMMITTEE REVIEWS NATIONAL, LOCAL AND HOSPITAL DATA TO IDENTIFY WHERE INEQUITIES IN HEALTHCARE EXIST. THE COMMITTEE RECOGNIZES THAT BREAKING DOWN BARRIERS FOR ANY PRIORITY POPULATION WILL REDUCE DISPARITIES FOR ALL. THIS YEAR A LGBTQA+ EMPLOYEE RESOURCE GROUP WAS FORMED TO ASSIST IN CREATING A WELCOMING ENVIRONMENT FOR MAH' LGBTQA+ STAFF, AND TO ENSURE THAT EXCELLENT AND COMPASSIONATE CARE IS PROVIDED TO LGBTQA + PATIENTS. THROUGH THE WORK OF THIS COMMITTEE THE HOSPITAL WAS ABLE TO INCORPORATE A NUMBER OF NEW INITIATIVES. THE ABILITY TO RECORD GENDER IDENTITY AND SEXUAL ORIENTATION DATA IN MAH'S NEW ELECTRONIC MEDICAL RECORD WAS COMPLETED. DIGNITY TRAINING WAS PROVIDED FOR ALL EMPLOYEES. ADDITIONALLY, TO CREATE AWARENESS AND IMPROVE INCLUSIVITY, MAH CELEBRATED PRIDE MONTH WITH A SOCIAL MEDIA CAMPAIGN.PATIENT CLOTHING CLOSETMAH SUPPORTS A PATIENT CLOTHING CLOSET THAT IS ACCESSIBLE 24 HOURS A DAY FOR PATIENTS WHO ARE IN NEED OF ADDITIONAL CLEAN CLOTHING UPON DISCHARGE. MAH STAFF DONATE NEW AND USED CLEAN CLOTHES THAT PATIENTS CAN TAKE HOME.
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COLLABORATIONS WITH LOCAL HOUSING AUTHORITIES
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RECOGNIZING THE RELATIONSHIP BETWEEN AFFORDABLE SAFE HOUSING AND HEALTH, THIS REPORTING PERIOD MAH PROVIDED A NON-COMPETITIVE MINI GRANT TO EACH LOCAL HOUSING AUTHORITY IN ITS CBSA. THIS GRANT FUNDING WAS DESIGNATED TO ASSIST IN THE IMPROVEMENT OF HOUSING ACCESS, LIVING CONDITIONS WITHIN BUILDINGS, SAFETY AND TO SUPPORT POLICY CHANGES THAT WILL INCREASE ACCESS TO AFFORDABLE HOUSING. SIX GRANTS OF $2,000 EACH WERE AWARDED TO THE LOCAL HOUSING AUTHORITIES IN THE ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN. IN ARLINGTON THEIR GOAL WAS TO IMPROVE UPON LANGUAGE ACCESS AND REDUCE BARRIERS FOR THOSE WITH LIMITED ENGLISH PROFICIENCY BY PURCHASING AN IPAD AND A LANGUAGE TRANSLATION APPLICATION TO SUPPORT RESIDENTS WITH LIMITED ENGLISH PROFICIENCY.IN BELMONT THEY WERE ABLE TO ENGAGE RESIDENTS IN COMMUNITY EVENTS AND FOSTER A COMMUNITY OF BELONGING. A SERIES OF SOCIAL EVENTS WERE ORGANIZED TO REDUCE SOCIAL ISOLATION AND DEPRESSION ESPECIALLY FOR SENIOR RESIDENTS.CAMBRIDGE COMPLETED THE FIRST PHASE OF A COMMUNITY SURVEY AND ASSESSMENT. THIS INFORMATION WILL INFORM PROPERTY MANAGERS HOW BEST TO ENGAGE RESIDENTS AND IMPROVE CONDITIONS AND EXPERIENCES IN THEIR HOUSING DEVELOPMENT.SOMERVILLE INCREASED THE CAPACITY OF RESIDENTS TO USE ONLINE SERVICES BY PURCHASING A COMMUNITY COMPUTER SYSTEM. RESIDENTS ARE NOW ABLE TO UTILIZE THIS COMPUTER IN THE COMMON AREA OF A RESIDENTIAL BUILDING. THE COMPUTER SYSTEM ALSO EXPANDS INTERNET ACCESS FOR RESIDENTS.WALTHAM IMPROVED THE COMMON AREAS OF THE RESIDENTIAL COMMUNITIES WITH NEW FURNITURE AND COSMETIC UPDATES.WATERTOWN WORKED WITH SIX ELDERLY RESIDENTS AND TWO FAMILY UNITS WHERE HOARDING WAS OCCURRING AND IMPROVED THE SAFETY OF THESE UNITS. THIS PROGRAM ALLOWED PROPERTY MANAGEMENT TO CLEAN UP DANGEROUS UNITS AND ASSIST RESIDENTS. THE SUPPORT GIVEN WILL HELP TO PREVENT FUTURE ISSUES OF HOARDING.DONATION DRIVES TO SUPPORT THE MOST VULNERABLE POPULATIONS IN OUR SERVICE AREAMOUNT AUBURN HOSPITAL COORDINATES AND ORGANIZES A NUMBER OF DONATION DRIVES THROUGHOUT THE YEAR. THE GENEROSITY OF THE HOSPITAL WORKFORCE COMES TOGETHER TO SUPPORT COMMUNITY MEMBERS THROUGH PARTNERSHIPS WITH ORGANIZATIONS WHICH ARE ABLE TO DISTRIBUTE DONATED ITEMS TO THOSE IN NEED. THIS PAST YEAR, THE HOSPITAL COORDINATED THREE HOSPITAL WIDE DONATION DRIVES TO SUPPORT VULNERABLE COMMUNITY MEMBERS. MAH PARTNERED WITH THE CAMBRIDGE POLICE DEPARTMENT TO SUPPORT ITS HOLIDAY GIVING DRIVE FOR SENIORS. THROUGH THE GENEROUS SUPPORT OF EMPLOYEES, THE HOSPITAL DONATED ITEMS TO BE INCLUDED IN OVER 500 GIFT BAGS TO SENIORS FOR THE HOLIDAYS IN PARTNERSHIP WITH THE CAMBRIDGE POLICE DEPARTMENT. THROUGH MAH PARTNERSHIP WITH CASPAR'S EMERGENCY SERVICES CENTER IN CAMBRIDGE, OVER 100 WINTER SCARVES, OVER 100 PAIRS OF MITTENS/GLOVES, OVER 150 HATS, AND OVER150 PAIRS OF SOCKS WERE GENEROUSLY DONATED TO SUPPORT THIS EMERGENCY SHELTER. THE AUGUST FOOD AND TOILETRY DRIVE PROVIDED 15 FULL BAGS OF TOILETRIES, 60 BAGS OF NON-PERISHABLE GROCERIES, 100 LOAVES OF BREAD AND 100 POUNDS OF FRESH PICKED CARROTS WHICH WENT TO SUPPORT WALTHAM COMMUNITY MEMBERS IN NEED. MEDICAL RESIDENTS ALSO ADOPTED A FAMILY DURING THE HOLIDAY SEASON TO PROVIDE HOLIDAY GIFTS AND NECESSITIES.CANCER DISPARITY WORKTO ADDRESS CANCER DISPARITIES IN VULNERABLE POPULATIONS IN PARTICULAR WOMEN AND IMMIGRANTS, MAH PROVIDED HEALTH EDUCATION WHICH INCLUDED HEALTHY LIVING INFORMATION TO WOMEN AT THE WALTHAM FAMILY SCHOOL AND THE CAMBRIDGE LEARNING CENTER. MAH MET WITH THESE ADULT ENGLISH LANGUAGE LEARNERS TO TEACH ABOUT BREAST HEALTH, CANCER PREVENTION AND EARLY DETECTION AS WELL AS HEALTHY LIVING HABITS. FORTY-FIVE WOMEN WERE EDUCATED ABOUT BREAST HEALTH AND CANCER PREVENTION. DIABETES PREVENTION AND EDUCATION WAS ALSO PRESENTED TO 25 IMMIGRANT WOMEN. MAH OFFERED FREE MAMMOGRAPHY SCREENING TO WOMEN FROM CRCHC AND COMMUNITY MEMBERS WHO HAVE LIMITED ACCESS OR COVERAGE. A SPANISH INTERPRETER WAS PRESENT TO TRANSLATE AND IMPROVE UNDERSTANDING OF MATERIAL. MAH CONDUCTED A SERIES OF TOBACCO EDUCATION AND CESSATION SESSIONS WHICH INCLUDED LUNG SCREENING EDUCATION AT CASPAR, A HOMELESS SHELTER FOR MEN IN SOMERVILLE WHO ARE IN TREATMENT FOR SUBSTANCE USE DISORDERS.WORKFORCE DEVELOPMENTMAH WORKS TO INCREASE THE INTEREST AND OPPORTUNITIES FOR COMMUNITY MEMBERS WHO WANT CAREERS HEALTHCARE. PRESENTATIONS AT ENGLISH AS A SECOND OR FOREIGN LANGUAGE CLASSES HELP NON-ENGLISH SPEAKERS UNDERSTAND THE REQUIREMENTS AND FUNCTIONS OF ENTRY LEVEL POSITIONS AND PROVIDES THEM TIPS ON APPLYING FOR JOBS. IN THIS REPORTING PERIOD, EIGHTEEN IMMIGRANT STUDENTS AT THE CAMBRIDGE LEARNING CENTER PARTICIPATED IN THIS PROGRAM. THE WATERTOWN MEDICAL SCIENCE PROGRAM IS ONSITE AT MAH AND GIVES WATERTOWN HIGH SCHOOL STUDENTS AN OPPORTUNITY TO ROTATE THROUGH DIFFERENT DEPARTMENTS AT THE HOSPITAL LEARNING ABOUT THE DIFFERENT DISCIPLINES. IN FY19 TEN STUDENTS PARTICIPATED IN THE TEN-WEEK LONG CAREER PROGRAM. MAH RECOGNIZES THE NEED FOR ADULTS OF ALL PHYSICAL AND DEVELOPMENTAL ABILITIES TO GAIN WORKFORCE SKILLS, AND PARTNERS WITH BEAVERBROOK STEP PROGRAM, INC. AND NASHOBA LEARNING GROUP TO PROVIDE JOB OPPORTUNITIES FOR PEOPLE WITH DISABILITIES. DURING THIS REPORTING PERIOD, SEVEN INDIVIDUALS WERE PLACED IN JOBS AT MAH THROUGH THESE PARTNERSHIPS AND A TOTAL OF 171 HOURS WERE SPENT IN VARIOUS DEPARTMENTS.THE MAH VOLUNTEER DEPARTMENT PROVIDES LOCAL HIGH SCHOOL STUDENTS THE OPPORTUNITY TO PARTICIPATE IN SUMMER INTERNSHIPS. FORTY HIGH SCHOOL STUDENTS PARTICIPATED IN THE FY19 VOLUNTEER SUMMER INTERNSHIP PROGRAM.FOCUS ON ACCESS TO HEALTH CARE TRANSPORTATION AS A BARRIER TO MEDICAL CARETRANSPORTATION IS ALL TOO OFTEN A BARRIER TO MEDICAL CARE. MAH CLINICIANS WORK WITH PATIENTS WHO REQUIRE TRANSPORTATION TO IDENTIFY SOLUTIONS AND WHEN NECESSARY PROVIDE ASSISTANCE. MAH RESPONDS TO COMMUNITY REQUESTS WHERE THERE IS A NEED FOR TRANSPORTATION. OVER 1,500 RIDES FREE OF CHARGE WERE PROVIDED TO THOSE WHERE TRANSPORTATION IS A BARRIER TO MEDICAL CARE.PRENATAL/POST-PARTUM SUPPORT FOR WOMEN AT CHARLES RIVER COMMUNITY HEALTH THE MAH LATINA DOULA PROGRAM HAS BEEN OPERATING FOR OVER EIGHT YEARS SERVING OVER 350 OF OUR MOST VULNERABLE PATIENTS AND THEIR FAMILIES IN THE IMPORTANT MOMENT OF GIVING BIRTH. DOULAS ARE TRAINED PROFESSIONALS WHO PROVIDE CONTINUOUS PHYSICAL, EMOTIONAL AND INFORMATIONAL SUPPORT TO A MOTHER BEFORE, DURING AND SHORTLY AFTER CHILDBIRTH. MAH DOULAS ARE CULTURAL LIAISONS WHO HELP THE LABORING PERSON TO UNDERSTAND THE MEDICAL CULTURE AND ASSIST THE MEDICAL TEAM UNDERSTAND THE FAMILY'S CULTURAL BELIEFS. THERE IS EXCELLENT CLINICAL DATA SHOWING THE BENEFITS OF DOULAS IN DECREASING C-SECTION RATES AND INCREASING PATIENT SATISFACTION. MAH STRIVES TO PROVIDE DOULAS FOR WOMEN WHO HAVE LIMITED RESOURCES AND SUPPORT. THEY ARE OFTEN NON-ENGLISH SPEAKING, UNDOCUMENTED AND/OR HAVE NO PARTNER OR FAMILY WITH THEM IN LABOR. MAH PROVIDED A DOULA FOR TWENTY BIRTHS THIS YEAR. MOST OF MAH'S PATIENTS WHO RECEIVE DOULA SUPPORT THROUGH THE LATINA DOULA PROGRAM RECEIVE PRENATAL CARE AT THE CHARLES RIVER COMMITTEE HEALTH CENTER. THIS PROGRAM PROVIDES A PRENATAL COMMUNITY OUTREACH WORKER WHO HELPS PATIENTS NAVIGATE THE HEALTHCARE SYSTEM AND PROVIDES SUPPORT FOR FAMILIES NAVIGATING AND ENROLLING IN GOVERNMENT BENEFIT PROGRAMS. THE OUTREACH WORKER IS AN IMPORTANT BRIDGE BETWEEN THE HOSPITAL'S SOCIAL WORKERS AND THE BEHAVIORAL HEALTH TEAM. A POST-PARTUM DROP-IN SUPPORT GROUP IS ALSO AVAILABLE TO COMMUNITY MEMBERS. THERE WERE OVER 150 WOMEN WHO PARTICIPATED IN THE POSTPARTUM PROGRAM. ADDITIONALLY, MAH OFFERS INFANT CAR SEATS TO WOMEN WHO WOULD OTHERWISE NOT HAVE A CAR SEAT TO TRANSPORT THEIR NEWBORN SAFELY HOME AFTER DELIVERY.COMMUNITY AND PROFESSIONAL EDUCATION FOR EMERGENCY CAREMAH EMERGENCY ROOM PHYSICIANS WORK WITH LOCAL FIRE DEPARTMENTS AS WELL PRIVATELY OWNED PROFESSIONAL EMS TO INCREASE THEIR CAPACITY TO SERVE COMMUNITY MEMBERS IN NEED OF EMERGENT CARE. OFTEN TIMES MAH'S MOST VULNERABLE COMMUNITY MEMBERS ARE IN NEED OF EMERGENCY CARE. THIS WORK PREPARES OUR LOCAL EMS PROVIDERS TO BRIDGE THE GAP FROM THE COMMUNITY SETTING TO HEALTHCARE AND IMPROVE ACCESS FOR ALL. MAH PROVIDES AN EMS MEDICAL DIRECTOR WHO WORKS WITH AFFILIATED EMS SERVICES TO PROVIDE CREDENTIALING, CONTINUOUS REVIEW/QUALITY ASSURANCE, AND EDUCATION FOR MAH'S AFFILIATED COMMUNITY EMTS AND PARAMEDICS. THIS INVOLVES PROTOCOL REVIEWS, MEDICAL CONTROL, MONTHLY EDUCATION SESSIONS, AND OTHER EDUCATIONAL OPPORTUNITIES. A TOTAL OF 350 EMERGENCY MEDICAL COMMUNITY STAFF PARTICIPATED IN THESE PROGRAMS. MAH ALSO SERVES AS THE EMS MEDICAL DIRECTOR FOR MASSACHUSETTS INSTITUTE OF TECHNOLOGY EMS AND HARVARD UNIVERSITY.
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COALITION BUILDING
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TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE, MOUNT AUBURN HOSPITAL CONTINUES TO SUPPORT A WIDE RANGE OF COMMUNITY GROUPS BY ASSISTING THEM WITH TECHNICAL ASSISTANCE AND PARTICIPATION AT REGULAR MEETINGS. AT COALITION BUILDING MEETINGS STAKEHOLDERS SHARE EXPERIENCES, IDEAS AND BEST PRACTICES. THIS GIVES MAH AN OPPORTUNITY TO LISTEN TO CONCERNS OF THE COMMUNITY IN ORDER TO HELP ALIGN MAH'S COMMUNITY BENEFITS WORK. THESE COALITIONS INCLUDE BUT ARE NOT LIMITED TO W.A.T.E.R., TOWN TASK FORCE, CITY OF CAMBRIDGE CHIP, WALTHAM CONNECTIONS, ARLINGTON HUMAN SERVICES NETWORK, WALTHAM AGENCY GROUP, CAMBRIDGE COMMUNITY STAKEHOLDERS, AND SOMERVILLE COMMUNITY STAKEHOLDERS. THESE MEETINGS REACH MANY COMMUNITY MEMBERS AND ORGANIZATIONS. MAH ALSO HOSTS ELDER SERVICE PROVIDER STAKEHOLDER MEETINGS TO HELP HOSPITAL STAFF IMPROVE SERVICES, LISTEN TO NEEDS AND ALSO TO ENGAGE AGENCIES TO SHARE BEST PRACTICES. HEALTH COVERAGE AND PUBLIC ASSISTANCE ENROLLMENTMAH RECOGNIZES THAT NAVIGATING HEALTH INSURANCE CAN BE OVERWHELMING AND CUMBERSOME. TO ADDRESS ACCESS TO HEALTH CARE, MAH PROVIDES CERTIFIED APPLICATION COUNSELORS (CACS) TO ASSIST COMMUNITY MEMBERS IN APPLYING FOR PUBLIC ASSISTANCE PROGRAMS. MAH'S CACSS WORK DIRECTLY AT CHARLES RIVER COMMUNITY HEALTH CENTER TO AUGMENT THEIR ENROLLMENT STAFF. FIVE CACS SERVE BOTH MAH AND CHARLES RIVER COMMUNITY HEALTH CENTER.MEDICAL INTERPRETER SERVICESTO BRIDGE THE GAP AND IMPROVE ACCESS TO CARE MAH PROVIDES PROFESSIONAL MEDICAL INTERPRETER SERVICES TO NON- ENGLISH SPEAKING, LIMITED-ENGLISH SPEAKING, DEAF, AND HARD OF HEARING PATIENTS. THESE FREE INTERPRETER SERVICES ARE PROVIDED IN A VARIETY OF WAYS: IN-PERSON (FOR BOTH SPOKEN AND AMERICAN SIGN LANGUAGE), OVER-THE-PHONE, USING A PORTABLE SPEAKER PHONE TO CONNECT PATIENTS TO THEIR CARE TEAM WITH AN INTERPRETER, AND WITH A VIDEO REMOTE INTERPRETER SERVICE, USING A COMPUTER TO CONNECT PATIENTS WITH AN INTERPRETER. SERVICES ARE COORDINATED IN A VARIETY OF WAYS TO MEET THE NEEDS OF PATIENTS INCLUDING FULL TIME STAFF, PER-DIEM STAFF, AND AGENCY INTERPRETERS FOR ALL LANGUAGES INCLUDING AMERICAN SIGN LANGUAGE. PROFESSIONAL INTERPRETATION FROM AN OVER-THE-PHONE SERVICE OFFERS ACCESS TO HUNDREDS OF LANGUAGES 24/7. THIS REPORTING PERIOD MAH PROVIDED 14,404 INDIVIDUAL ENCOUNTERS EITHER FACE TO FACE, VIDEO, OR TELEPHONIC ENCOUNTERS. TO INCREASE ACCESS TO INTERPRETER SERVICES, MAH DEPLOYED FOURTEEN INTERPRETER IPADS THROUGHOUT THE HOSPITAL.COMMUNITY PARTNERSTHE HOSPITAL'S COMMUNITY PARTNERS INCLUDE: AIDS ACTION COMMITTEE ALCOHOL ANONYMOUS AMERICAN CANCER SOCIETY AMERICAN LUNG ASSOCIATION ARLINGTON COUNCIL ON AGING ARLINGTON EATS ARLINGTON HEALTH AND HUMAN SERVICES ARLINGTON HOUSING AUTHORITY ARLINGTON POLICE DEPARTMENT ARLINGTON SCHOOL DEPT. ARLINGTON YOUTH COUNSELING CENTER ARLINGTON YOUTH HEALTH AND SAFETY COALITION BEAVERBROOK STEP BELMONT COUNCIL ON AGING BELMONT DEPARTMENT OF PUBLIC HEALTH BELMONT FIRE DEPARTMENT BELMONT FOOD COLLABORATIVE BELMONT HOUSING AUTHORITY BELMONT POLICE DEPARTMENT CAMBRIDGE COUNCIL ON AGING CAMBRIDGE DEPARTMENT OF PUBLIC HEALTH CAMBRIDGE FAMILY AND CHILDREN SERVICES CAMBRIDGE FIRE DEPARTMENT CAMBRIDGE HEALTH ALLIANCE CAMBRIDGE HOUSING AUTHORITY CAMBRIDGE LEARNING CENTER CAMBRIDGE POLICE DEPARTMENT CASPAR INC. CHARLES RIVER COMMUNITY HEALTH CENTER CITY OF CAMBRIDGE COMMUNITY CONVERSATIONS, SISTER TO SISTER COMMUNITY HEALTH NETWORK AREA 17 (CHNA 17) ELDER SERVICES OF MERRIMACK VALLEY HARVARD DIVINITY SCHOOL HARVARD UNIVERSITY EMS HEALTHY LIVING CENTER OF EXCELLENCE HEALTHY WALTHAM HUMAN SERVICE AGENCY LIFELINE IN HOME SERVICES AT MOUNT AUBURN LIVE WELL WATERTOWN MARINO FOUNDATION MASS. DEPARTMENT OF PUBLIC HEALTH MASSACHUSETTS TRANSIT AUTHORITY METRO CAB OF BOSTON MIDDLESEX COMMUNITY COLLEGE MIDDLESEX DISTRICT ATTORNEY OFFICE MIDDLESEX HUMAN SERVICE AGENCY MINUTEMAN SENIOR SERVICES NAACP NASHOBA LEARNING GROUP NATIONAL COUNCIL FOR BEHAVIORAL HEALTH NEWTON WELLESLEY HOSPITAL ON THE RISE PAINE SENIOR SERVICES PROFESSIONAL AMBULANCE EMS QUIT WORKS SALVATION ARMY OF WALTHAM SCHENDERIAN PHARMACY SCM COMMUNITY TRANSPORTATION SOMERVILLE CAMBRIDGE ELDER SERVICES SOMERVILLE CENTER FOR ADULT LEARNING EXPERIENCE (SCALE) SOMERVILLE COUNCIL ON AGING SOMERVILLE DEPARTMENT OF HEALTH AND HUMAN SERVICES SOMERVILLE HOUSING AUTHORITY SOMERVILLE POLICE DEPARTMENT SPRINGWELL ELDER SERVICES THE CAMBRIDGE HOMES TUFTS UNIVERSITY WALTHAM CHALLENGER PROGRAM WALTHAM CONNECTIONS WALTHAM COUNCIL ON AGING WALTHAM FAMILY SCHOOL WALTHAM FIELDS COMMUNITY FARM WALTHAM HEALTH DEPARTMENT WALTHAM HOUSING AUTHORITY WALTHAM PARTNERSHIP FOR YOUTH WALTHAM POLICE DEPARTMENT WATERTOWN BOYS AND GIRLS CLUB WATERTOWN COUNCIL ON AGING WATERTOWN FIRE DEPT. WATERTOWN HEALTH DEPARTMENT WATERTOWN HIGH SCHOOL WATERTOWN HOUSING AUTHORITY WATERTOWN POLICE DEPARTMENT WAYSIDE YOUTH AND FAMILY SERVICES
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COMMUNITY HEALTH NEEDS - OTHER INITIATIVES
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AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, MAH IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. IN ADDITION, WHERE THE HOSPITAL IS UNABLE TO ADDRESS NEEDS BECAUSE OF LIMITED FINANCIAL RESOURCES, THE HOSPITAL EXPLORES A RANGE OF OTHER FUNDING OPPORTUNITIES TO MEET HELP MEET COMMUNITY NEEDS. HOWEVER, IN RESPONSE TO THIS SCHEDULE H, PART V, SECTION B, QUESTION 11, EVEN THOUGH THE TOP HEALTH CONCERNS HAVE ALL BEEN ADDRESSED IN THE IMPLEMENTATION STRATEGY, THERE WERE SOME SPECIFIC NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT INCLUDED IN THE STRATEGY. THE FOLLOWING IDENTIFIED NEEDS WERE NOT ADDRESSED IN THE IMPLEMENTATION STRATEGY: HIGHER RATES OF OBESITY AMONG MINORITY AND LOWER INCOME YOUTH IN CAMBRIDGE, HOARDING AND PERPETUAL CAREGIVING, IMMIGRANT ACCESS TO SERVICES, HOMELESSNESS AFFORDABLE HOUSING, DOMESTIC VIOLENCE, POVERTY/ HUNGER ACCESS TO FOOD, TRANSPORTATION, HIGH INSURANCE CO-PAYMENTS AND DEDUCTIBLES, SEXUAL HEALTH AND GENERAL POPULATION ACCESS TO SERVICES. HOWEVER, AS NOTED WITHIN THIS NARRATIVE, THE HOSPITAL CAN AND DOES PROACTIVELY SUPPORT SOME OF THESE ADDITIONAL COMMUNITY HEALTH NEEDS WITHIN THE BROADER MAH PLAN.AS NOTED IN DETAIL ABOVE, THE MAH'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE 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 MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 10.44% OF MAH'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITS - ANNUAL COMMUNITY BENEFITS REPORTIN ADDITION TO MAH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPLEMENTATION STRATEGY/PLAN (CHIP) WHICH, AS PREVIOUSLY NOTED IN THIS FILING, WERE APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 (TAX YEAR 2017) WHICH IS THE PERIOD COVERED BY THIS FILING, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, MAH PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT WHICH IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL. THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND AT MAH UPON REQUEST. THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT MAH FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, MAH IS A GENERAL MEDICAL AND SURGICAL HOSPITAL AND TEACHING HOSPITAL, PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEMAH'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $4,644,356 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 138% FOR FULL FREE CARE AND 139%-299% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW. SEE ADDITIONAL INFORMATION IN THIS SCHEDULE H NARRATIVE. OTHER UNCOMPENSATED CHARITY CARE - MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, MAH ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MAH GENERATED $22,092,546 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY MAH FOR SUCH SERVICES BY $29,410,648 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND MAH PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MAH GENERATED $101,237,509 RELATED TO TREATING MEDICARE PATIENTS. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH MAH CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFITS, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, MAH HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, MAH ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $7,331,466 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 BENEFITS 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. AND AFFILIATES FOR THE SEVEN MONTHS ENDED SEPTEMBER 30, 2019 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH) AND AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP).THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.EMERGENCY CARE ACCESSMOUNT AUBURN HOSPITAL EMERGENCY DEPARTMENT (ED) IS A FULL-SERVICE ED STAFFED BY PROFESSIONAL NURSES AND PHYSICIANS SPECIALIZING IN EMERGENCY MEDICINE. THE ED'S MISSION IS TO PROVIDE EXPERT EMERGENCY MEDICAL CARE WHILE MAINTAINING COMPASSIONATE CONCERN FOR ALL PATIENTS AND THEIR FAMILIES. THE MOUNT AUBURN HOSPITAL EMERGENCY DEPARTMENT STAFF PHYSICIANS ARE EMERGENCY MEDICINE BOARD CERTIFIED AND ARE ON THE HARVARD SCHOOL FACULTY. THE MAH DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR (SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21).
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FINANCIAL ASSISTANCE POLICY INTERNAL REVENUE CODE SECTION 501(R)(4)
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FINANCIAL ASSISTANCE POLICY PURPOSE MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS. PATIENTS ELIGIBLE FOR MAH FINANCIAL ASSISTANCE WILL ALSO RECEIVE DISCOUNTED CARE FROM PARTICIPATING MAH PROVIDERS.THE HOSPITAL DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) WHICH 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 THE HOSPITAL'S BOARD PRIOR TO SEPTEMBER 30, 2017 AND THESE DOCUMENTS WERE ALL EFFECTIVE AS OF OCTOBER 1, 2017, THE FIRST DAY OF THE HOSPITAL'S FISCAL YEAR IN WHICH THE HOSPITAL WAS REQUIRED TO BE IN COMPLIANCE WITH THE REGULATIONS PROMULGATED BY THE TREASURY AND RELATED TO IRC SECTION 501(R). FINANCIAL ASSISTANCE POLICY APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY TRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1,000 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: SPANISH. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE AT LINKS PROVIDED BELOW IN THIS NARRATIVE (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H). 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).
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FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY
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AS 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 DOCUMENTSFINANCIAL ASSISTANCE POLICY (FAP) (ENGLISH AND SPANISH):HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/1035/FAP-MAH-POLICY.PDFHTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/1037/SPANISH-FAP.PDFTHE AMOUNTS GENERALLY BILLED (AGB) CALCULATION IS ON PAGE 10CREDIT AND COLLECTION POLICY: HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/993/09-08-16-MHA-CC-POLICY.PDFFAP APPLICATION:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/996/MAF-AFAP-VERSION-1-09052016.PDFPLAIN LANGUAGE SUMMARY: HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/1204/1160-ENGLISH-8-10-17.PDFPROVIDER LIST:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/1601/FAP-PROVIDER-LIST-4-2019.PDFADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING CAN BE FOUND ON THE MAH WEBSITE AT:HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/BILLING-POLICIES/HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/LIMITATION ON CHARGES INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00.
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BILLING AND COLLECTIONS 501(R)(6)
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EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS HEALTH PROFESSIONS EDUCATIONMOUNT AUBURN HOSPITAL'S CENTRAL LONGSTANDING ACADEMIC FOCUS IS MEDICAL EDUCATION, AND A COMMITMENT TO TEACHING STUDENTS AND TRAINEES IN A RESPECTFUL AND COLLABORATIVE ACADEMIC ENVIRONMENT. THIS COMMITMENT, COUPLED WITH THE INSTITUTION'S WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION, MAKE MAH A TOP CHOICE AMONG STUDENTS AND TRAINEES IN THE HEALTH CARE PROFESSIONS. THE HOSPITAL TRAINS MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, ALONG WITH OTHER ALLIED HEALTH PROFESSIONALS FROM ACROSS THE AREA.MAH HAS SEVERAL RESIDENCY AND FELLOWSHIP PROGRAMS, WITH APPROXIMATELY 56 INTERNAL MEDICINE INTERNS AND RESIDENTS, 13 RADIOLOGY RESIDENTS, SIX PODIATRY RESIDENTS, AND THREE UROGYNECOLOGY FELLOWS DURING MAH'S ACADEMIC YEAR JULY 1, 2018JUNE 30, 2019, WHICH OVERLAPS WITH A PORTION OF MAH'S FISCAL YEAR ACTIVITIES REPORTED IN THIS FILING. THE HOSPITAL ALSO HOSTS ROTATING RESIDENTS AND FELLOWS IN SURGERY, EMERGENCY MEDICINE, GERIATRICS, GENETICS, OBSTETRICS AND GYNECOLOGY, NEONATOLOGY, AND ANESTHESIA, AND SUPPORTS THE EDUCATION OF MEDICAL STUDENTS FROM HARVARD MEDICAL SCHOOL, TUFTS MEDICAL SCHOOL, AND THE BOSTON UNIVERSITY SCHOOL OF MEDICINE. FINALLY, THE HOSPITAL SERVES AS A TRAINING SITE FOR PHARMACY STUDENTS FROM THE MASSACHUSETTS COLLEGE OF PHARMACY, PHYSICIAN'S ASSISTANT STUDENTS FROM NORTHEASTERN UNIVERSITY, CLINICAL NURSE ANESTHETISTS FROM BOSTON COLLEGE, AND CLINICAL NURSE MIDWIVES FROM MULTIPLE PROGRAMS ACROSS THE NORTHEAST. STAFF PHYSICIANS AT MAH WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. AS PART OF THE HOSPITAL'S COMMITMENT TO MEDICAL STUDENT EDUCATION AND LONGSTANDING AFFILIATION WITH HARVARD MEDICAL SCHOOL, MAH IS A CORE SITE FOR THE HARVARD MEDICAL SCHOOL SUB-INTERNSHIP IN MEDICINE; THE HOSPITAL ALSO PARTICIPATES IN THE INTRODUCTORY COURSES IN CLINICAL MEDICINE FOR PRE-CLINICAL HARVARD MEDICAL SCHOOL STUDENTS, AS WELL AS IMMERSIVE TRAINING IN CLINICAL MEDICINE FOR BIOMEDICAL DOCTORAL STUDENTS FROM THE JOINT HARVARD MEDICAL SCHOOL / MASSACHUSETTS INSTITUTE OF TECHNOLOGY'S HEALTH SCIENCES AND TECHNOLOGY PROGRAM. IN ADDITION, THE HOSPITAL HOSTS THIRD-YEAR MEDICAL STUDENTS FROM THE BOSTON UNIVERSITY SCHOOL OF MEDICINE ON THE OBSTETRICS, PSYCHIATRY AND NEUROLOGY SERVICES AS WELL AS MEDICAL STUDENTS FROM HARVARD AND OTHER SCHOOLS WHO CHOOSE TO DO SUB-INTERNSHIPS AND SUBSPECIALTY ELECTIVES DURING THEIR THIRD AND FOURTH YEAR.THE MAH INTERNAL MEDICINE TRAINING PROGRAM, THE LARGEST OF ALL MAH RESIDENCIES, OFFERS A THREE-YEAR CATEGORICAL MEDICINE TRACK AND A ONE-YEAR PRELIMINARY MEDICINE TRACK. THE THREE-YEAR CATEGORICAL TRACK PREPARES RESIDENTS FOR CERTIFICATION BY THE AMERICAN BOARD OF INTERNAL MEDICINE AND CAREERS THAT COVER THE FULL SPECTRUM OF OPPORTUNITIES IN BOTH GENERAL INTERNAL MEDICINE AND THE MEDICAL SUB-SPECIALTIES. RESIDENTS ARE ABLE TO TAILOR THEIR 36 MONTHS OF TRAINING TO OBTAIN THE KNOWLEDGE, SKILLS, AND INSIGHT REQUIRED TO PURSUE SUBSEQUENT CAREERS IN PRIMARY CARE OR HOSPITALIST MEDICINE; IN ADDITION, THEY ARE PREPARED TO CONTINUE THEIR TRAINING IN COMPETITIVE SUB-SPECIALTY FELLOWSHIP TRAINING PROGRAMS ACROSS THE COUNTRY. MAH SUPPORTS TRAINEES IN THEIR INTENDED CAREER GOALS THROUGH THE USE OF DEFINED PATHWAYS. THESE PATHWAYS, IN PRIMARY CARE, HOSPITALIST MEDICINE, OR SUB-SPECIALTY MEDICINE, OUTLINE THE MILESTONES THAT THE TRAINEE SHOULD MEET THROUGHOUT THE COURSE OF TRAINING. THE PRELIMINARY MEDICINE INTERNSHIP TRACK OFFERS ONE YEAR OF TRAINING IN MEDICINE FOR PHYSICIANS WHO WILL CONTINUE THEIR TRAINING IN SPECIALTIES OTHER THAN INTERNAL MEDICINE, SUCH AS RADIOLOGY, OPHTHALMOLOGY, ANESTHESIOLOGY, RADIATION ONCOLOGY, NEUROLOGY, DERMATOLOGY, PHYSICAL MEDICINE AND REHABILITATION, AND OTHERS. THIS PROGRAM IS HIGHLY SOUGHT AFTER BY TOP STUDENTS FROM MEDICAL SCHOOLS AROUND THE COUNTRY, AND A MAJOR STRENGTH, AS WELL AS A MAJOR ATTRACTION, IS THE FACT THAT THE YEAR IS VIRTUALLY IDENTICAL IN STRUCTURE AND CONTENT TO THE FIRST YEAR FOR PHYSICIANS WHO TRAIN AT MOUNT AUBURN HOSPITAL FOR THREE YEARS IN THE CATEGORICAL INTERNAL MEDICINE TRACK; THE ONLY DIFFERENCE BEING THE QUANTITY OF AMBULATORY MEDICINE EXPERIENCE, AS PRELIMINARY INTERNS ARE NOT ASSIGNED A CONTINUITY CLINIC DURING THEIR YEAR.THE MAH RADIOLOGY RESIDENCY PROGRAM HAS A LONG AND PROUD HISTORY AS AN ELITE PROGRAM AND EXCEPTIONAL PLACE TO TRAIN. RESIDENTS ARE TYPICALLY ASSIGNED IN ONE-MONTH BLOCKS TO ONE OF THE DIFFERENT MODALITIES. EARLY IN TRAINING, RESIDENTS ARE EXPECTED TO READ EXTENSIVELY, MASTER ANATOMY, PARTICIPATE IN THE PROTOCOLLING AND INTERPRETATION OF PATIENT EXAMINATIONS, AND TO PARTICIPATE IN DISCUSSIONS CONCERNING DIAGNOSTIC PROBLEMS. RESIDENTS ADVANCE TO INCREASED LEVELS OF RESPONSIBILITY, AND SOUND JUDGMENT AS A RADIOLOGIST IS ESTABLISHED DURING OVERNIGHT CALL. THREE RESIDENTS ARE CHOSEN EACH YEAR FOR A FOUR-YEAR PROGRAM, AND ARE APPOINTED AS CLINICAL FELLOWS AT HARVARD MEDICAL SCHOOL. THE HIGH RATIO OF STAFF RADIOLOGISTS TO RESIDENTS RESULTS IN CLOSE CONTACT BETWEEN THE STAFF AND RESIDENTS THROUGHOUT THE TRAINING PROGRAM. AFTER THE RESIDENT HAS OBTAINED THE NECESSARY FIRM FOUNDATIONS IN THE FUNDAMENTALS OF RADIOLOGY, HE OR SHE IS ENCOURAGED TO TAKE INCREASING RESPONSIBILITY IN BOTH ROUTINE AND SPECIALIZED EXAMINATIONS AND PROCEDURES. THE MAJORITY OF OUR RESIDENTS PURSUE SUBSPECIALTY FELLOWSHIP TRAINING; HOWEVER, THE GOAL OF THE RADIOLOGY RESIDENCY PROGRAM IS TO TRAIN RESIDENTS TO BE FULLY QUALIFIED IN DIAGNOSTIC RADIOLOGY AND SPECIAL PROCEDURES BY THE TIME THEY HAVE COMPLETED THE FOUR-YEAR PROGRAM. GRADUATES HAVE PURSUED CAREERS IN ACADEMIA AND PRIVATE PRACTICE.IN ADDITION TO THE INTERNAL MEDICINE AND RADIOLOGY TRAINING PROGRAMS, MOUNT AUBURN HOSPITAL HAS A NATIONALLY RECOGNIZED TRAINING PROGRAM IN PODIATRY, AND IS A SITE FOR OTHER POST-GRADUATE MEDICAL EDUCATION DISCIPLINES. IT IS A CORE SITE FOR THE BETH ISRAEL DEACONESS MEDICAL CENTER SURGICAL TRAINING PROGRAM, AND TWO HARVARD-AFFILIATED EMERGENCY MEDICINE PROGRAMS. MAH ALSO WELCOMES ROTATING GERIATRIC FELLOWS FROM THE BETH ISRAEL DEACONESS / HARVARD MEDICAL SCHOOL DIVISION ON AGING PROGRAM, AND PEDIATRIC AND NEONATOLOGY RESIDENTS FROM MASSACHUSETTS GENERAL HOSPITAL / CAMBRIDGE HOSPITAL PROGRAM. DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD NET EXPENDITURES OF $7,913,442 REPORTED ON THIS SCHEDULE H RELATED TO MAH'S RESIDENCY PROGRAM AND TO TEACHING OTHER STUDENTS RELATED TO ALLIED HEALTH PROFESSIONS.
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MOUNT AUBURN HOSPITAL ADDITIONAL INFORMATION
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REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. ON MARCH 1, 2019, THE BETH ISRAEL LAHEY HEALTH SYSTEM WAS FORMED THROUGH THE COMBINATION OF THE HOSPITALS AND OTHER AFFILIATES OF THREE LEGACY HEALTH CARE SYSTEMS BASED PRIMARILY IN EASTERN MASSACHUSETTS, INCLUDING THE FORMER CAREGROUP HEALTH SYSTEM, THE FORMER LAHEY HEALTH SYSTEM, AND THE SEACOAST HEALTH SYSTEM. BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS NOW THE SOLE MEMBER OF THE HOSPITAL AND NINE ADDITIONAL AFFILIATED HOSPITALS. EACH OF THESE ENTITIES MAY HAVE, IN TURN, SERVED AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. THE BILH HEALTH SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. AFFILIATED HEALTH CARE SYSTEMAS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BILH IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM 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, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. BILH SERVES AS SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). LAHEY CLINIC FOUNDATION SERVES AS THE SOLE MEMBER OF LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER. EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES.
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