SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    140,911,724   140,911,724 3.640 %
b Medicaid (from Worksheet 3, column a) . . . . .     144,222,821   144,222,821 3.730 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     285,134,545   285,134,545 7.370 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     528,131   528,131 0.010 %
f Health professions education (from Worksheet 5) . . .     100,398,064 17,814,873 82,583,191 2.130 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     12,878,365   12,878,365 0.330 %
j Total. Other Benefits . .     113,804,560 17,814,873 95,989,687 2.470 %
k Total. Add lines 7d and 7j .     398,939,105 17,814,873 381,124,232 9.840 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
0
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
626,628,526
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
786,945,659
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-160,317,133
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?3Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 DUKE UNIVERSITY HOSPITAL
2301 ERWIN ROAD PRIMARY CAMPUS
DURHAM,NC27710
HTTP://WWW.DUKEHEALTH.ORG
H0015 		X X X X   X X     A
2 DUKE RALEIGH HOSPITAL
3400 WAKE FOREST ROAD PRIMARY
CAMPUS
RALEIGH,NC27609
HTTP://WWW.DUKEHEALTH.ORG
H0238 		X X         X      
3 DUKE REGIONAL HOSPITAL
3643 ROXBORO ROAD
DURHAM,NC27704
HTTP://WWW.DUKEHEALTH.ORG
H0233 		X X         X     A
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
DUKE UNIVERSITYDUKE REGIONAL HOSPITALS
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTP://CORPORATE.DUKEHEALTH.ORG/COMMUNITY
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2020
Page 5
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
DUKE UNIVERSITYDUKE REGIONAL HOSPITALS
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTP://WWW.DUKEHEALTH.ORG
b
HTTP://WWW.DUKEHEALTH.ORG
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
DUKE UNIVERSITYDUKE REGIONAL HOSPITALS
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Page 7
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
DUKE UNIVERSITYDUKE REGIONAL HOSPITALS
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Page 4
Schedule H (Form 990) 2020
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
DUKE RALEIGH HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		2
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTP://CORPORATE.DUKEHEALTH.ORG/COMMUNITY
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2020
Page 5
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
DUKE RALEIGH HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTP://WWW.DUKEHEALTH.ORG
b
HTTP://WWW.DUKEHEALTH.ORG
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Page 6
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
DUKE RALEIGH HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Page 7
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
DUKE RALEIGH HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Page 8
Schedule H (Form 990) 2020
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
NOTE: THIS SCHEDULE H CONTAINS REFERENCES TO DUKE AND DUKE HEALTH WHICH ARE MEANT TO ENCOMPASS FOR THE PURPOSES OF THIS SCHEDULE DUKE UNIVERSITY HEALTH SYSTEM (DUHS), DUKE UNIVERSITY SCHOOL OF MEDICINE, AND DUKE UNIVERSITY SCHOOL OF NURSING. PART V, SECTION B:GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 5: DUKE UNIVERSITY HOSPITAL ("DUH") DUH COLLABORATES WITH THE PARTNERSHIP FOR A HEALTHY DURHAM (THE STATE CERTIFIED HEALTHY CAROLINIANS GROUP) AND THE DURHAM COUNTY HEALTH DEPARTMENT TO CONDUCT THE DURHAM COUNTY COMMUNITY HEALTH ASSESSMENT AND DEVELOPS STRATEGIES TO ADDRESS IDENTIFIED NEEDS. FACULTY AND STAFF OF THE DUKE DIVISION OF COMMUNITY HEALTH AND APPOINTED MEMBERS OF THE DUH SENIOR LEADERSHIP TEAM OFFICIALLY SERVE ON THE PARTNERSHIP FOR A HEALTHY DURHAM COMMITTEES.THE MOST RECENT ASSESSMENT PROCESS CONDUCTED IN CALENDAR YEAR 2017 COMPILED VALID AND RELIABLE INFORMATION ABOUT THE HEALTH OF DURHAM. IT INCLUDED 358 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 3 COMMUNITY LISTENING SESSIONS WITH 42 COMMUNITY MEMBERS. THE SURVEY WAS ALSO CONDUCTED IN PERSON AT GROCERY STORES, LIBRARIES, DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH CLINICS, AND BUS STATIONS. THE COMMUNITY HEALTH ASSESSMENT TEAM - COMPRISED OF MEMBERS REPRESENTING, DUKE UNIVERSITY HEALTH SYSTEM, UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS AND BUSINESSES - WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST. THIS JOINT CHNA AND RELATED IMPLEMENTATION PLAN WAS ADOPTED BY THE DUHS BOARD OF DIRECTORS AND PUBLISHED ON THE DUKE HEALTH WEBSITE IN FISCAL YEAR 2019 (TAX YEAR 2018).GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 6A: DUKE REGIONAL HOSPITAL ("DRH")GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 6B: THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENTGROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 11: THE ASSESSMENT IDENTIFIED FIVE HEALTH PRIORITIES FOR 2018 - 2020: 1. AFFORDABLE HOUSING 2. ACCESS TO HEALTHCARE AND HEALTH INSURANCE3. POVERTY 4. MENTAL HEALTH 5. OBESITY, DIABETES AND FOOD ACCESS ALL OF THE PROGRAMS DESCRIBED IN THE FOLLOWING IMPLEMENTATION PLAN ARE ALIGNED WITH THE FIVE HEALTH PRIORITIES WITH MANY OF THE PROGRAMS ADDRESSING COMBINATIONS OF THE FIVE HEALTH PRIORITIES. A BRIEF EXCERPT FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT DESCRIBING EACH PRIORITY IS INCLUDED IN THIS IMPLEMENTATION PLAN. DUH CONSIDERS THIS DOCUMENT TO BE A "WORKING PLAN" THAT WILL CONTINUE TO EVOLVE OVER THIS THREE YEAR PERIOD IN ORDER TO ENSURE THE EFFICACY OF STRATEGIES INTENDED TO MEET EXPRESSED COMMUNITY HEALTH NEEDS. THIS IMPLEMENTATION PLAN MAY NOTE, BUT DOES NOT CONTAIN DETAILED DESCRIPTIONS OF, THE COMMUNITY HEALTH IMPROVEMENT WORK CARRIED OUT BY OTHER COMPONENTS OF THE LARGER DUKE HEALTH SYSTEM OR DUKE UNIVERSITY. THIS IMPLEMENTATION PLAN IS INTENDED TO HIGHLIGHT DUKE HOSPITAL'S CONTINUALLY EVOLVING ACTIVITIES AND SUPPORT TO IMPROVE HEALTH WITH THE DURHAM COMMUNITY.TOGETHER WITH ITS PARTNERS, DUH ASKS ABOUT AND LISTENS TO CONCERNS, EXPLORES BARRIERS TO CARE, ANALYZES HEALTHCARE UTILIZATION AND COSTS, IDENTIFIES PARTNER NEEDS AND RESOURCES, PLANS/REDESIGNS SERVICES, TRACKS OUTCOMES, AND SHARES ACCOUNTABILITY IN ORDER TO DEVELOP EFFECTIVE PROGRAMS TO IMPROVE THE HEALTH OF THE DURHAM COMMUNITY. AS SUCH THIS IMPLEMENTATION PLAN INCLUDES NEW AND LONG-STANDING PROGRAMS. 1. AFFORDABLE HOUSINGAFFORDABLE HOUSING, AS DEFINED BY HUD (U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT), REQUIRES NO MORE THAN 30% OF A FAMILY'S MONTHLY INCOME. IF A FAMILY SPENDS MORE THAN 30% OF INCOME ON HOUSING, THEY ARE LESS ABLE TO PAY FOR OTHER EXPENSES, SUCH AS FOOD AND HEALTHCARE. THE INCREASED COST BURDEN OF UNAFFORDABLE HOUSING ADDS TO PSYCHOSOCIAL STRESSORS THAT CAN NEGATIVELY IMPACT A FAMILY. RENTERS MAKE UP 40% OF HOUSEHOLDS IN DURHAM, AND ALMOST HALF OF THEM ARE DEFINED AS COST-BURDENED (I.E. PAYING MORE THAN 30% OF THEIR MONTHLY INCOME FOR HOUSING).DUH HAS PARTNERED WITH HABITAT FOR HUMANITY OF DURHAM ON A NUMBER OF HOME BUILDS. ADDITIONALLY, AFFORDABLE HOUSING IS A FOCUS OF DUH AS PART OF THE LARGER DUKE UNIVERSITY. IN 2018, FUNDING FROM DUKE UNIVERSITY AND THE AJ FLETCHER FOUNDATION PROVIDED THE OPPORTUNITY TO DEVELOP TWO ACRES OF PRIME DOWNTOWN DURHAM LAND INTO MULTI-UNIT AFFORDABLE HOUSING. THE DEVELOPMENT BROKE GROUND IN JULY 2019, AND THE MULTI-UNIT HOUSING COMPLEX WAS FINISHED AND OCCUPIED IN 2021. THE LARGER DUKE UNIVERSITY ALSO COMMITTED $3 MILLION WITH THE CITY OF DURHAM TO DEVELOP AN AFFORDABLE HOUSING LOAN FUND. 2. ACCESS TO HEALTHCARE AND HEALTH INSURANCE:ACCESS TO HEALTHCARE IN A COMMUNITY REFERS TO THE ABILITY OF RESIDENTS TO FIND A CONSISTENT MEDICAL PROVIDER FOR THEIR PRIMARY CARE NEEDS, TO FIND A SPECIALTY PROVIDER WHEN NEEDED AND TO BE ABLE TO RECEIVE THAT CARE WITHOUT ENCOUNTERING SIGNIFICANT BARRIERS. ALTHOUGH THERE ARE MANY MEDICAL PROVIDERS, WHICH INCLUDE A NUMBER OF LOW COST AND FREE CLINICS IN DURHAM COUNTY, THERE ARE STILL MANY DURHAM RESIDENTS WHO HAVE TROUBLE ACCESSING CARE WHEN THEY NEED IT. BARRIERS TO OBTAINING HEALTHCARE INCLUDE ISSUES WITH TRANSPORTATION, LANGUAGE BARRIERS, OR DISTRUST OF THE HEALTHCARE SYSTEM. ACCORDING TO THE COMMUNITY HEALTH ASSESSMENT SURVEY, THE TOP REASONS IDENTIFIED BY DURHAM COUNTY RESIDENTS FOR WHY THEY OR SOMEONE IN THEIR HOUSEHOLD COULD NOT ACCESS NECESSARY HEALTHCARE INCLUDED INSURANCE DIDN'T COVER SERVICE, COPAY WAS TOO HIGH, LACK OF INSURANCE, COULDN'T GET AN APPOINTMENT, DIDN'T KNOW WHERE TO GO OR PROVIDER DIDN'T TAKE THEIR INSURANCE.A NUMBER OF LONG-STANDING PROGRAMS SUPPORTED BY DUH SEEK TO INCREASE ACCESS TO CARE FOR UNINSURED, UNDERINSURED, AND/OR VULNERABLE INDIVIDUALS AND FAMILIES. THOSE PROGRAMS INCLUDE:PROJECT ACCESS OF DURHAM COUNTY (PADC): LINKS ELIGIBLE LOW-INCOME, UNINSURED DURHAM COUNTY RESIDENTS TO SPECIALTY MEDICAL CARE FULLY DONATED TO THE PATIENTS BY THE PHYSICIANS, HOSPITALS INCLUDING DUH, LABS, CLINICS AND OTHER PROVIDERS PARTICIPATING IN THE PADC NETWORK.PLANS FOR FY2021: PADC WILL CONTINUE TO FOCUS ON COVID-19 RESPONSE EFFORTS AND PROVIDE AS MANY SPECIALTY SERVICES AS POSSIBLE GIVEN ONGOING COVID-19 DISRUPTIONS/DELAYS.PROGRESS IN FY2021: PADC CONTINUED TO FOCUS ON COVID-19 RESPONSE EFFORTS AND PARTNERED WITH NUMEROUS ORGANIZATIONS TO HELP INDIVIDUALS IMPACTED BY COVID-19. PADC CONTINUED TO LINK AS MANY UNINSURED INDIVIDUALS AS POSSIBLE TO SPECIALTY SERVICES IN SPITE OF DISRUPTIONS/DELAYS THAT CONTINUED AS A RESULT OF COVID-19 IN FY2021.LOCAL ACCESS TO COORDINATED HEALTHCARE (LATCH): WAS INITIATED IN 2002 WITH HEALTHY COMMUNITIES ACCESS PROGRAM (HCAP) FUNDING FROM THE US HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO DUKE'S DIVISION OF COMMUNITY HEALTH, DEPARTMENT OF COMMUNITY AND FAMILY MEDICINE. THE FOUNDING AND SUSTAINING LATCH PARTNERSHIP INCLUDES DUH (WHICH NOW PROVIDES THE MAJORITY OF OPERATING FUNDS), LINCOLN COMMUNITY HEALTH CENTER, THE DURHAM COUNTY DEPARTMENTS OF HEALTH AND SOCIAL SERVICES, EL CENTRO HISPANO, AND A NUMBER OF COMMUNITY-BASED ORGANIZATIONS (CBOS). THROUGH COMMUNITY-BASED, LINGUISTICALLY AND CULTURALLY-RELEVANT CARE MANAGEMENT, LATCH AIMS TO IMPROVE HEALTH KNOWLEDGE AND SELF-CARE, ACCESS TO HEALTH CARE AND HEALTH SERVICES UTILIZATION OUTCOMES AMONG DURHAM COUNTY'S UNINSURED. CARE MANAGEMENT SERVICES INCLUDE: HEALTH SERVICES COORDINATION AND NAVIGATION (MEDICAL, SOCIAL, BEHAVIORAL); POST-HOSPITALIZATION FOLLOW-UP; PATIENT EDUCATION; CHRONIC DISEASE MANAGEMENT; PSYCHO-SOCIAL SUPPORT; ACCESS TO BENEFITS (MEDICAID/SSI/SSDI); BILLS ASSISTANCE; INTERPRETATION/TRANSLATION; AND, TRANSPORTATION COORDINATION. IN PARTNERSHIP WITH OTHER COMMUNITY STAKEHOLDERS-HEALTHCARE AND SOCIAL SERVICE PROVIDERS, LOCAL GOVERNMENT AND COMMUNITY-BASED ORGANIZATIONS-LATCH MONITORS HEALTHCARE TRENDS, IDENTIFIES BARRIERS FACING UNINSURED PATIENTS, AND, WORKING AS A CONSORTIUM, ADDRESSES AND ELIMINATES BARRIERS.
PLANS FOR FY2021: CONTINUE CARE MANAGEMENT SERVICES AND COVID-19 RESPONSE EFFORTS.PROGRESS IN FY2021: LATCH CONTINUED TO PARTNER WITH VARIOUS DUKE AND COMMUNITY ORGANIZATIONS IN COVID-19 RESPONSE EFFORTS DURING FY2021. IN ADDITION, LATCH PROVIDED CARE MANAGEMENT SERVICES TO 772 INDIVIDUALS.THE COMPLEX CHILD PROGRAM (CCP): PROVIDES THE COORDINATION OF MEDICAL AND CO-MANAGEMENT OF MEDICAL CARE FOR CHILDREN WITH MULTIPLE MEDICALLY COMPLEX ISSUES THAT REQUIRE THE INTERACTION WITH MULTIPLE SPECIALISTS. ON AVERAGE THESE CHILDREN WORK WITH 13 SPECIALISTS. BEFORE THE COMPLEX CHILD PROGRAM, CARE COULD SEEM FRAGMENTED AS PATIENTS/FAMILIES HAD NO CENTRAL "QUARTERBACK" HELPING TO OVERSEE THE BIG PICTURE.THROUGH THE CCP PARENTS NOW HAVE DIRECT PHONE ACCESS TO A COMPLEX CARE SERVICE (CCS) PROVIDER OR RN 24/7. THE CCP TEAM WORKS WITH PARENTS TO CREATE A COMPREHENSIVE "COMPLEX CARE PLAN" THAT IS PLACED IN THE CHILD'S MEDICAL RECORD AND GIVEN TO THE PARENTS. IN ADDITION, THE CCP TEAM COORDINATES INPATIENT INTENSIVE CARE TRANSITIONS PRIOR TO DISCHARGE AND CONDUCTS INTENSIVE OUTPATIENT "BETWEEN-VISIT" CONTACTS (PHONE, CLINIC VISITS, AND IN SOME CASES, HOME VISITS). PLANS FOR FY2021: CONTINUE THE CCP SERVING CHILDREN WITH MULTIPLE COMPLEX ISSUES AND THEIR FAMILIES.PROGRESS IN FY2021: AS IN FY2020, CCP CONTINUED TO MAXIMIZE SERVICES TO CHILDREN WITH MULTIPLE MEDICALLY COMPLEX ISSUES AND THEIR FAMILIES.SOUTHERN HIGH SCHOOL (SHS) WELLNESS CENTER: PROVIDES COMPREHENSIVE PRIMARY CARE AND MENTAL HEALTH SERVICES AT SHS TO STUDENTS AT THE SCHOOL AND IS OPEN TO ALL STUDENTS AND STAFF OF DURHAM PUBLIC SCHOOLS. IT IS OPERATED BY DUKE'S DIVISION OF COMMUNITY HEALTH ON BEHALF OF DUH AND CELEBRATED 25 YEARS OF SERVICE IN 2021. DURHAM PUBLIC SCHOOLS CLOSED TO IN-PERSON LEARNING IN MARCH 2020 AS A RESULT OF COVID-19. THE SOUTHERN HIGH SCHOOL WELLNESS CENTER PIVOTED TO PROVIDING TELEHEALTH SERVICES (VIA PHONE AND VIDEO VISITS) IN 2021.
JUST FOR US (JFU): PROVIDES AN IN-HOME CARE PROGRAM FOR LOW-INCOME, FRAIL ELDERLY AND DISABLED. JFU WAS LAUNCHED IN 2002 AS A COLLABORATION OF DUKE, LINCOLN COMMUNITY HEALTH CENTER, DURHAM DEPARTMENT OF SOCIAL SERVICES (DSS), THE LOCAL AREA MENTAL HEALTH ENTITY, AND THE DURHAM HOUSING AUTHORITY. DUH PROVIDES THE MAJORITY OF ONGOING SUPPORT FOR THE PROGRAM. THROUGH JFU, AN INTERDISCIPLINARY TEAM OF PROVIDERS SERVES CLIENTS IN THEIR HOMES, PROVIDING MEDICAL CARE, MANAGEMENT OF CHRONIC ILLNESSES, AND CASE MANAGEMENT. EACH PARTICIPANT RECEIVES A HOME VISIT EVERY 5 WEEKS UNLESS THERE IS AN ACUTE EPISODE OR A HOSPITAL DISCHARGE, FOR WHICH A VISIT IS SCHEDULED IMMEDIATELY. VISITS INCLUDE MEDICATION RECONCILIATION, SOCIAL ISSUES, SUPPORT SERVICES, CHRONIC DISEASE MANAGEMENT, AND POST-HOSPITAL CARE. THE HEALTH CARE TEAM CONSISTS OF A CLINICAL PROVIDER (PA, NP OR MD), OCCUPATIONAL THERAPIST, REGISTERED DIETITIAN, SOCIAL WORKER, PHLEBOTOMIST, AND COMMUNITY HEALTH WORKER. IN LATE DECEMBER 2019, REPORTS OF CARBON MONOXIDE POISONINGS BEGAN AT THE MCDOUGALD TERRACE APARTMENT COMPLEX. BY EARLY JANUARY 2020, THE DURHAM HOUSING AUTHORITY HAD RELOCATED HUNDREDS OF RESIDENTS TO 15 HOTELS ACROSS DURHAM. THE JFU TEAM DEPLOYED TO PROVIDE HEALTH CARE FOR THE RESIDENTS ACROSS THE 15 HOTEL SITES DURING JANUARY AND FEBRUARY. ALMOST ALL OF THE JFU IN HOME VISITS CEASED IN MARCH 2020 AS A RESULT OF COVID-19. AS A RESULT, THE JFU TEAM CONDUCTED FREQUENT WELL-CHECK CALLS AND PROVIDED TELEHEALTH SERVICES (VIA PHONE/VIDEO VISITS).NEIGHBORHOOD/COMMUNITY CLINICS: DUH IN PARTNERSHIP WITH LINCOLN COMMUNITY HEALTH CENTER COLLABORATIVELY OPERATES THREE COMMUNITY HEALTH CLINICS; THE LYON PARK COMMUNITY CLINIC, THE WALLTOWN NEIGHBORHOOD CLINIC AND THE HOLTON WELLNESS CENTER. THE CLINICS WERE DESIGNED TO PROVIDE PRIMARY CARE, HEALTH EDUCATION, AND DISEASE PREVENTION TO THE UNDERSERVED POPULATIONS OF DURHAM. THE CLINICS PROVIDE MEDICAL CARE FOR PERSONS WITH AND WITHOUT HEALTH INSURANCE. THOSE WITHOUT INSURANCE ARE SEEN BASED ON A SLIDING FEE SCALE. NO PATIENT IS DENIED CARE BASED ON INABILITY TO PAY FOR SERVICES. THE LYON PARK CLINIC WAS THE FIRST OF THE COLLABORATIVE NEIGHBORHOOD CLINICS, OPENING ITS DOORS FOR PATIENT CARE IN APRIL 2003. THE WALLTOWN CLINIC OPENED IN JANUARY 2005 AND THE HOLTON CLINIC OPENED IN AUGUST 2009. EACH CLINIC RECEIVED START-UP FUNDS THROUGH A DUKE ENDOWMENT GRANT. CLINICS GENERATE REVENUE THROUGH A CONTRACT WITH LINCOLN COMMUNITY HEALTH CENTER AND RECEIVE SIGNIFICANT SUPPORT FROM DUH. THE CLINICS OPERATE AS FAMILY MEDICINE PRACTICES AND ARE OPEN 5 DAYS A WEEK. STAFFING INCLUDES PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS AND FAMILY PHYSICIANS, WHO SERVE AS SUPERVISING DOCTORS. EACH CLINIC IS SUPPORTED BY NURSING STAFF: CERTIFIED NURSING ASSISTANTS, LICENSED PRACTICAL NURSES, OR CERTIFIED MEDICAL ASSISTANTS AND A STAFF ASSISTANT. THE STAFF ASSISTANT PERFORMS ALL ADMINISTRATIVE TASKS FOR THE CLINIC INCLUDING ANSWERING INCOMING PHONE CALLS, REGISTRATION, SCHEDULING, ETC. PLANS FOR FY2021: THE SOUTHERN HIGH SCHOOL WELLNESS CENTER, JUST FOR US, AND THE NEIGHBORHOOD/COMMUNITY CLINICS HOPE TO RETURN TO PRE-PANDEMIC LEVELS OF CLINICAL ENCOUNTERS OF 13,000+.
PROGRESS IN FY2021: THE SOUTHERN HIGH SCHOOL WELLNESS CENTER, THE MICRO-CLINICS AND JUST FOR US CONTINUED TO ADJUST TO THE IMPACTS OF COVID-19 AND PROVIDED 10,049 IN PERSON AND VIDEO/TELEHEALTH PATIENT VISITS.3. POVERTYPOVERTY HAS A STRONG IMPACT ON HEALTH AND IS AN IMPORTANT CONCERN FOR DURHAM RESIDENTS. RESEARCH NOW SHOWS THAT EVEN THE RISK OF AN ADVERSE CHANGE IN MATERIAL CONDITIONS, ECONOMIC AND HOUSING INSECURITY, AS WELL AS UNINSURED OR UNDERINSURED HEALTH INSURANCE COVERAGE, AFFECT HEALTH OUTCOMES. REASONS FOR THE ASSOCIATION BETWEEN ECONOMIC INSECURITY AND HEALTH INCLUDE THE HEALTH EFFECTS OF STRESS RESULTING FROM ECONOMIC INSECURITY, EFFECTS OF STRESS AND SPENDING LIMITATIONS ON FOOD CONSUMPTION, AND RESTRICTED USE OF HEALTH SERVICES.EFFECTIVE 7/1/2019, DU AND DUHS INCREASED THE MINIMUM WAGE TO $15 PER HOUR FOR ALL EMPLOYEES.SECOND CHANCES: SINCE SEPTEMBER 2018, DUKE NO LONGER REQUIRES JOB APPLICANTS TO DISCLOSE CRIMINAL HISTORY DURING THE APPLICATION PROCESS. THE FOLLOWING PROGRAMS ALSO HELP ADDRESS THE COMMUNITY HEALTH NEED OF POVERTY:SSI/SSDI OUTREACH, ACCESS AND RECOVERY (SOAR): HELPS PATIENTS WHO ARE CHRONICALLY HOMELESS, OR AT RISK OF HOMELESSNESS ACCESS HEALTH INSURANCE, A STABLE INCOME, AND MEDICAL CARE BY ASSISTING THESE INDIVIDUALS IN APPLYING FOR SUPPLEMENTAL SECURITY INCOME (SSI) AND SOCIAL SECURITY DISABILITY INSURANCE (SSDI). THE HOMELESS POPULATION AND THOSE REENTERING THE COMMUNITY FROM AN INSTITUTION FACE NUMEROUS CHALLENGES IN ACCESSING SERVICES. APPROVAL ON INITIAL SSI AND SSDI APPLICATIONS FOR THESE AT-RISK POPULATIONS, WHO HAVE NO ONE TO ASSIST, IS ABOUT 10-15 PERCENT. FOR THOSE WITH MENTAL ILLNESS, SUBSTANCE ABUSE ISSUES, AND/OR CO-COGNITIVE IMPAIRMENT, THE APPLICATION PROCESS IS EVEN MORE DIFFICULT. EVEN WITH ASSISTANCE, THE APPLICATION PROCESS CAN TAKE UP TO SIX MONTHS. THROUGH SOAR, THESE INDIVIDUALS WITH COMPLEX NEEDS ARE PROVIDED CASE MANAGEMENT FOR HOME, HOSPITAL, AND CLINIC VISITS; ARE PROVIDED WITH A STEP BY STEP EXPLANATION AND COMPLETION OF ALL APPLICATIONS FOR FEDERAL DISABILITY BENEFITS; RECEIVE EXPEDITED APPLICATIONS FOR MONTHLY INCOME AND MEDICAID/MEDICARE; AND ARE LINKED TO COMMUNITY RESOURCES. DUKE HOSPITAL CURRENTLY FUNDS TWO SOAR CASE MANAGERS WHO HAVE SUCCESSFULLY HELPED MORE THAN 100 PATIENTS IN THE LAST 3 YEARS. PLANS FOR FY2021: RETURN TO PRE-PANDEMIC LEVELS OF REFERRALS AND COMPLETED APPLICATIONS.
PROGRESS IN FY2021: FY2021 DID NOT BRING THE RELIEF FROM THE COVID-19 PANDEMIC THAT THE WORLD HAD HOPED FOR, BUT THE SOAR PROGRAM WAS ABLE TO SERVICE 20 CASES.BENEFITS ENROLLMENT COUNSELING (BEC): IN FY 16 THE DUKE DIVISION OF COMMUNITY HEALTH LAUNCHED THE BENEFITS ENROLLMENT COUNSELING PROGRAM (BEC) WITH GRANT FUNDING THROUGH THE NATIONAL COUNCIL ON AGING TO HELP SENIORS AND THOSE WITH DISABILITIES AND A LIMITED INCOME FIND AND ENROLL IN ALL THE BENEFIT PROGRAMS FOR WHICH THEY ARE ELIGIBLE. THE GOAL OF THE SERVICE IS TO ENABLE OLDER ADULTS TO ENJOY LIFE AND LIVE INDEPENDENTLY IN THEIR HOMES AND COMMUNITIES FOR AS LONG AS POSSIBLE. FOR THOSE WITH LIMITED INCOME AND RESOURCES, ADDITIONAL SUPPORT CAN BE CRITICAL IN MAINTAINING THEIR HEALTH AND AVOIDING COSTLY HOSPITALIZATIONS. THE BENEFITS PROVIDE CLIENTS SERVED WITH ACCESS TO HEALTHY FOOD, NEEDED MEDICAL CARE AND PRESCRIPTIONS, AS WELL AS OTHER SUPPORTIVE SERVICES. THE BENEFITS ALSO PROVIDE A COMMUNITY ECONOMIC STIMULUS, AS BENEFITS ARE SPENT LOCALLY IN PHARMACIES, GROCERY STORES, UTILITY COMPANIES, AND HEALTH CARE PROVIDERS. TO INCREASE THE REACH OF THE PROGRAM BEYOND GRANT FUNDING, BEC STAFF TRAIN VOLUNTEERS (FROM PARTNER COMMUNITY BASED ORGANIZATIONS AND DUKE) TO ASSIST CLIENTS IN DURHAM, GRANVILLE, AND PERSON COUNTIES. BEC CURRENTLY WORKS WITH 26 DUKE UNDERGRADUATES AND MEDICAL STUDENTS. THESE STUDENTS ENGAGE IN SERVICE, OUTREACH, AND ADVOCACY EFFORTS AS WELL AS BUILD MEANINGFUL INTERGENERATIONAL RELATIONSHIPS.IN 2019 BEC LAUNCHED THE COPE INITIATIVE (COMMUNITY OUTREACH, PREVENTION AND EDUCATION), WHICH OFFERS HEALTH SCREENING AND EDUCATION IN THE COMMUNITY, AND INITIATIVES THAT DIRECTLY ADDRESS GAPS IN SENIOR HUNGER PREVENTION THROUGH TEACHING SELF-SUFFICIENT, SUSTAINABLE GARDENING PRACTICES, AND THE PROVISION OF COOKING CLASSES AT SENIOR CENTERS.PLANS FOR FY2021: CONTINUE COVID-19 RESPONSE ASSISTANCE AND BEC. RETURN TO THE COMMUNITY GARDEN WORK WHEN ALLOWED. PROGRESS IN FY2021: AS COVID-19 CONTINUED TO UPEND NUMEROUS ACTIVITIES, WORK ON THE COMMUNITY GARDEN DID NOT CONTINUE IN 2021. BEC DID ASSIST IN COVID-19 RESPONSE EFFORTS AND CONTINUED TO CONNECT ELIGIBLE INDIVIDUALS TO RESOURCES. BEC ASSISTED 475 INDIVIDUALS WITH AN AVERAGE OF 1.29 APPLICATIONS PER PERSON FOR BENEFIT PROGRAMS. THE TOTAL VALUE OF BENEFITS WAS $1,957,098.4. MENTAL HEALTHMENTAL HEALTH AND SUBSTANCE USE DISORDERS HAVE DIRECT COSTS SUCH AS PREVENTION, TREATMENT, AND RECOVERY SUPPORTS. BUT, THERE ARE ALSO INDIRECT COSTS SUCH AS MOTOR VEHICLE ACCIDENTS, PREMATURE DEATH, COMORBID HEALTH CONDITIONS, DISABILITY, LOST PRODUCTIVITY, UNEMPLOYMENT, POVERTY, SCHOOL DIFFICULTIES, ENGAGEMENT WITH SOCIAL SERVICE, JUVENILE JUSTICE, CRIMINAL JUSTICE SYSTEMS, AND HOMELESSNESS, AMONG OTHER PROBLEMS. DUH PARTNERS WITH AND SUPPORTS A NUMBER OF COLLABORATIVE INITIATIVES TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES AND REDUCE SUBSTANCE ABUSE. DUH CONTINUES TO SERVE AS A KEY PARTNER IN THE FOLLOWING ACTIVITES:* COMMUNITY COALITIONS: DURHAM CRISIS COLLABORATIVE; PARTNERSHIP FOR A HEALTHY DURHAM MENTAL HEALTH COMMITTEE AND DURHAM TOGETHER FOR RESILIENT YOUTH; DURHAM COUNTY LEADERSHIP FORUM ON SUBSTANCE ABUSE AND MENTAL HEALTH.* NALOXONE OUTREACH: PHARMACIES (DUKE SOUTH, CLINIC PHARMACY, MAIN STREET, GURLEY'S, JOSEF'S, & DUKE CANCER SPECIALTY); DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH; DURHAM MOBILE CRISIS UNIT.* PROVIDER EDUCATION: PROVIDER TOOLKITS AND CME EDUCATION; USE OF PAIN AGREEMENTS; USE OF CONTROLLED SUBSTANCE REPORTING SYSTEM (CSRS); CHRONIC PAIN PROVIDER CONSULTATION CALLS.* DIVERSION CONTROL: PERMANENT DROP BOXES IN 5 OF 6 COUNTIES (DURHAM, FRANKLIN, PERSON, GRANVILLE, & VANCE).* CHRONIC PAIN PATIENT SUPPORT: CHRONIC PAIN SELF-MANAGEMENT WORKSHOPS AT LINCOLN COMMUNITY HEALTH CENTER; CHRONIC PAIN MANAGEMENT RESOURCES; KEY COMMUNITY PRESENTATIONS.* COUNTY-WIDE ADVERSE CHILDHOOD EXPERIENCES (ACES) AND COMMUNITY RESILIENCY MODEL (CRM): ACTIVITIES AND TRAINING.
PLANS FOR FY2021: CONTINUE TO SERVE AS A KEY PARTNER IN THE COLLABORATIVE ACTIVITIES WITH THE ABOVE ORGANIZATIONS TO REDUCE SUBSTANCE MISUSE AND INCREASE ACCESS TO MENTAL HEALTH SERVICES.PROGRESS IN FY2021: DURHAM DETENTION CENTER MEDICATION-ASSISTED TREATMENT (MAT) PROGRAM NOW PROVIDES INDUCTION TREATMENT SERVICES (PHASE II OF MAT) FOR INDIVIDUALS WITH SUD (SUBSTANCE USE DISORDER). THEY ALSO RECEIVED APPROVAL FROM THE STATE TO BEGIN AN OPIOID TREATMENT PROGRAM WITHIN THE DETENTION CENTER. THE DETENTION CENTER HAS HIRED A LICENSED CLINICAL ADDICTIONS SPECIALIST (LCAS) AND PEER SUPPORT SPECIALIST TO CONTINUE CARE COORDINATION OF SERVICES.DURHAM DEPARTMENT OF PUBLIC HEALTH BY WAY OF ALLIANCE HEALTH PROVIDED AN OPIOID USE DISORDER (OUD) PROVIDER TRAINING SERIES IN MAY 2021. SEVERAL DUKE PROVIDERS WERE AMONG THE PRESENTERS FOR THE TRAINING. AN UPDATED SUBSTANCE USE DISORDER RESOURCE GUIDE WAS PUT ON THE DURHAM PUBLIC HEALTH'S WEBSITE UNDER THE DJT TASK FORCE SECTION. THIS WAS A COLLABORATION WITH THE DURHAM JOINS TOGETHER (DJT) PREVENTION EDUCATION COMMITTEE.ALLIANCE PURCHASED NALOXONE (NARCAN) AND DISSEMINATED TO PARTNERING ORGANIZATION TO HELP WITH THE SHORTAGE OF NALOXONE ACCESS. ALLIANCE PROVIDED ADDITIONAL FUNDING TO SUPPORT EFFORTS WITH DETENTION CENTER MAT AND PEER SUPPORT SPECIALISTS (PSS) SERVICES.
DUHS SAFE OPIOID TASK FORCE: WAS CREATED TO IMPROVE THE SAFETY OF PAIN MANAGEMENT BY ENCOURAGING CLINICAL PRACTICE STANDARDIZATION, WHERE CLINICALLY APPROPRIATE, WHEN OPIOID THERAPY IS DESIGNATED FOR TREATMENT. THE OPIOID SAFETY TASK FORCE PROVIDES RECOMMENDATIONS FOR THE INITIATION AND MANAGEMENT OF OPIOID THERAPY ACROSS DUKE UNIVERSITY HEALTH SYSTEM (DUHS) TO IMPROVE PERSONAL AND COMMUNITY SAFETY AND REDUCE HARM ASSOCIATED WITH THE HIGH RISK TREATMENTS WHILE ENGAGING PATIENTS IN THEIR OWN CARE. DUH ALONG WITH DUKE REGIONAL AND DUKE RALEIGH HOSPITALS SERVES AS A PIVOTAL PLAYER IN ALL ASPECTS OF THE WORK OF THE TASK FORCE.PLANS FOR FY2021: CONTINUE THE WORK OF THE TASK FORCE.PROGRESS IN FY2021: ACTIVE DUKE MAT PROVIDERS ARE LISTED IN EPIC (DUKE ELECTRONIC HEALTH RECORD) FOR THE SCHEDULING OF PATIENTS REQUIRING MAT SERVICES. THIS GREATLY ENHANCES THE ABILITY TO GET PATIENTS QUICKLY SCHEDULED FOR MAT PROVIDERS.5. OBESITY, DIABETES, AND FOOD ACCESSAS OF 2016, 65% OF ADULTS IN THE PIEDMONT REGION, WHICH INCLUDES DURHAM, WERE OVERWEIGHT OR OBESE. ADDITIONALLY, 12% OF DURHAM HIGH SCHOOLERS WERE OBESE AS OF 2014. OBESITY IS A STRONG CONTRIBUTOR TO DIABETES. IN 2015, 14.1% OF DURHAM COUNTY RESIDENTS AGED 18 YEARS OR OLDER WHO RECEIVED SOME LEVEL OF CARE FROM DUKE HEALTH AND/OR LINCOLN COMMUNITY HEALTH CENTER HAD DIABETES. MANY DISEASES ARE LINKED TO NUTRITION, INCLUDING OBESITY, HYPERTENSION, HIGH CHOLESTEROL, DIABETES, AND SOME CANCERS. FOOD INSECURITY, THE STATE OF BEING WITHOUT RELIABLE ACCESS TO A SUFFICIENT QUANTITY OF AFFORDABLE, NUTRITIOUS FOOD, HAS A LARGE IMPACT ON A PERSON'S DIET. IT IS ESTIMATED THAT 17.9% OF DURHAM RESIDENTS (51,710 PEOPLE) ARE FOOD INSECURE.
BULL CITY FIT: IS A COMMUNITY-BASED WELLNESS PROGRAM AND IS PART OF THE THE LARGER DUKE CHILDREN'S HEALTHY LIFESTYLES PROGRAM. THE HEALTHY LIFESTYLES PROGRAM SEEKS TO ADDRESS WEIGHT-RELATED HEALTH PROBLEMS FOR CHILDREN BY OFFERING CARING PROVIDERS, FAMILY-CENTERED TREATMENT PROGRAMS, HIGHLY TRAINED EDUCATORS AND RESEARCHERS, AND STRONG COMMUNITY PARTNERSHIPS. BULL CITY FIT HELPS IN THIS EFFORT BY OFFERING FREE EVENING AND WEEKEND ACTIVITY SESSIONS FOR THE LARGER COMMUNITY. THESE SESSIONS COVER VARIOUS THEMES THAT ENCOURAGE AND PROMOTE ACTIVE LIVING, SUCH AS FITNESS GAMES, SPORT LESSONS, EXERCISE ROUTINES, SWIMMING, COOKING, AND GARDENING. EACH ACTIVITY IS FACILITATED WITH THE SUPPORT OF ENERGETIC STAFF AND VOLUNTEERS TO CREATE A POSITIVE AND FUN ENVIRONMENT FOR ALL.BULL CITY FIT EMPOWERS THE WHOLE FAMILY TO INCREASE KNOWLEDGE AND PRACTICE OF PHYSICAL ACTIVITY AND HEALTHY EATING; ADDRESS CURRENT WEIGHT-RELATED ILLNESS AND PREVENT CHRONIC DISEASE THROUGH INCREASED ACTIVITY LEVELS; IMPROVE QUALITY OF LIFE BY PROMOTING HEALTHY BEHAVIORS; INCREASE CONFIDENCE, SUPPORT POSITIVE CHANGE, AND BUILD A LIFELONG COMMITMENT TO A HEALTHY LIFESTYLE.PARTNERS INCLUDE: DURHAM PARKS AND RECREATION; DURHAM CITY GOVERNMENT; DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH; EAST DURHAM CHILDREN'S INITIATIVE; LINCOLN COMMUNITY HEALTH CENTER; COMMUNITY NUTRITION PARTNERSHIP; VEGGIE VAN; BLUE POINTE YOGA; DURHAM PUBLIC SCHOOLS; PARTNERSHIP FOR A HEALTHY DURHAM; DUKE SERVICE LEARNING; DUKE FAMILY MEDICINE; DUKE CHILDREN'S HOSPITAL AND THE UNC SCHOOL OF SOCIAL WORK.PLANS FOR FY2021: CONTINUE TO PROVIDE SERVICES VIA ZOOM AND OTHER REMOTE PLATFORMS. RETURN TO IN PERSON ACTIVITIES WHEN ALLOWED.PROGRESS IN FY2021: DUE TO THE ONGOING COVID-19 PRECAUTIONS, SERVICES CONTINUED VIA ZOOM AND OTHER REMOTE PLATFORMS, ALTERNATING BETWEEN FUN COOKING AND FITNESS ACTIVITIES.COVID-19 RESPONSEIN JULY OF 2020 DUKE UNIVERSITY HOSPITAL, THROUGH THE DUKE DIVISION OF COMMUNITY HEALTH, PARTNERED WITH THE DURHAM COUNTY HEALTH DEPARTMENT AND DURHAM PUBLIC SCHOOLS TO OPERATE A COVID-19 TESTING SITE IN EAST DURHAM. THIS AREA CONSISTED OF TWO ZIP CODES EXPERIENCING DURHAM'S HIGHEST BURDEN OF COVID-19. THE TESTING SITE WAS LOCATED AT A TRUSTED SITE, HOLTON WELLNESS CENTER, WHICH IS ONE OF THE DIVISION OF COMMUNITY HEALTH'S CLINICS NOTED EARLIER IN THIS REPORT. THE DURHAM COUNTY HEALTH DEPARTMENT'S CONTACT TRACERS HAD THE ABILITY TO DIRECTLY SCHEDULE TESTING APPOINTMENTS - A UNIQUE FEATURE THAT ENABLED INDIVIDUALS EXPOSED TO COVID-19 TO QUICKLY ACCESS TESTING. INDIVIDUALS WITHOUT APPOINTMENTS WERE ALSO WELCOME TO UTILIZE THE SITE. IT WAS THE FIRST COMMUNITY TESTING SITE IN DURHAM TO OFFER EVENING AND SATURDAY HOURS. THE MAJORITY OF THE SITE'S STAFF WERE BILINGUAL OR BILINGUAL-BICULTURAL. OVER A 9 MONTH PERIOD, MORE THAN 4 THOUSAND PEOPLE WERE TESTED, MOSTLY (94%) ESSENTIAL WORKERS AND PEOPLE OF COLOR. IN ADDITION TO TESTING, THE SITE OFFERED FOOD BOXES THROUGH PARTNERSHIPS WITH THE FOOD BANK, LOCAL FOOD PANTRIES, AND FARMERS' FOODSHARE AND CONNECTIONS TO OTHER RESOURCES TO HELP INDIVIDUALS AND FAMILIES IMPACTED BY COVID-19.
GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 16J: AS PART OF DUHS, DUKE UNIVERSITY HOSPITAL PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZES ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS. PART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER ELECTIVE SERVICES, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 5: DUKE RALEIGH HOSPITAL COLLABORATED WITH ADVANCE COMMUNITY HEALTH, ALLIANCE HEALTH, UNC REX HEALTHCARE, UNITED WAY OF THE GREATER TRIANGLE, WAKE COUNTY HUMAN SERVICES, WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION, WAKEMED HEALTH AND HOSPITALS, AND YOUTH THRIVE TO DEVELOP THE 2019 WAKE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE PROCESS OF DETERMINING THE PRIORITY HEALTH NEEDS FOR THE 2019 WAKE COUNTY CHNA BEGAN WITH THE COLLECTION AND ANALYSIS OF HUNDREDS OF DATA POINTS. ALL INDIVIDUAL DATA MEASURES FROM BOTH PRIMARY (NEW) AND SECONDARY (EXISTING) SOURCES WERE GATHERED, ANALYZED, AND INTERPRETED. IN ORDER TO COMBINE DATA POINTS INTO MORE EASILY DISCUSSABLE CATEGORIES, ALL INDIVIDUAL DATA MEASURES WERE GROUPED INTO SIX CATEGORIES AND TWENTY-ONE CORRESPONDING FOCUS AREAS BASED ON "COMMON THEMES". PRIMARY (NEW) DATA COLLECTION: COMMUNITY MEMBERS PROVIDED INPUT FOR THE ASSESSMENT THROUGH INTERNET-BASED AND TELEPHONE SURVEYS, FOCUS GROUPS, AND AN INTERNET-BASED PRIORITIZATION SURVEY. ADDITIONALLY, KEY LEADERS OF ORGANIZATIONS REPRESENTING BROAD INTERESTS OF THE COMMUNITY PROVIDED INPUT THROUGH AN INTERNET-BASED SURVEY, PARTICIPATION ON THE STEERING COMMITTEE, AND AN INTERNET-BASED PRIORITIZATION SURVEY. THE PROCESS ALSO HAD SIGNIFICANT INPUT AND DIRECTION FROM THE COMMUNITY HEALTH ASSESSMENT TEAM. CONSIDERING ALL OF THESE SOURCES, INPUT FROM NEARLY 5,900 WAKE COUNTY RESIDENTS AND ORGANIZATIONAL LEADERS IS INCLUDED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT. SECONDARY (EXISTING) DATA: KEY SOURCES FOR EXISTING DATA ON WAKE COUNTY INCLUDED NUMEROUS PUBLIC DATA SOURCES RELATED TO DEMOGRAPHICS, SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH, ENVIRONMENTAL HEALTH, HEALTH STATUS AND DISEASE TRENDS, MENTAL/BEHAVIORAL HEALTH TRENDS, AND MODIFIABLE HEALTH RISKS. FURTHER, SOME LOCAL ORGANIZATIONS PROVIDED INTERNAL DATA THAT WERE ALSO INCORPORATED INTO THE ANALYSIS PROCESS.A PRIORITIZATION MATRIX WAS DEVELOPED TO IDENTIFY THE TOP PRIORITIES FOR THE OVERALL COUNTY AND DETERMINE FINDINGS FOR EACH OF THE SERVICE ZONES. THE PRIORITIZATION MATRIX INCLUDED THE FINDINGS FROM THE ANALYSIS OF THE PRIMARY (NEW) AND SECONDARY (EXISTING) DATA WHICH WERE PRESENTED TO THE STEERING COMMITTEE IN OCTOBER 2018 AND TO COMMUNITY MEMBERS DURING THE PRIORITIZATION MEETINGS HELD ON JANUARY 31, 2019 AND VIA THE WWW.WAKEGOV.COM/WELLBEING WEBSITE THROUGH MID-FEBRUARY 2019. ADDITIONALLY, STEERING COMMITTEE MEMBERS WERE PROVIDED THE OPPORTUNITY TO COMPLETE AN INTERNET-BASED SURVEY IN WHICH THEY WERE ASKED TO IDENTIFY THEIR TOP THREE AREAS OF NEED BASED ON THE LIST OF TWENTY-ONE FOCUS AREAS. COMMUNITY MEMBERS WERE ASKED TO PROVIDE THE SAME INFORMATION. THESE VARIOUS DATA COMPONENTS WERE THEN ANALYZED AND THE RESULTS WERE WEIGHTED AS FOLLOWS: SECONDARY (EXISTING) DATA - WEIGHTED 50 PERCENT; PRIMARY (NEW) DATA - WEIGHTED 50 PERCENT IN TOTAL, AS FOLLOWS: FOCUS GROUP FINDINGS, TELEPHONE SURVEY RESULTS, AND INTERNET-BASED COMMUNITY SURVEY RESULTS - WEIGHTED 20 PERCENT; COMMUNITY PRIORITIZATION MEETING RESULTS - WEIGHTED 20 PERCENT; AND, STEERING COMMITTEE PRIORITIZATION SURVEY RESULTS - WEIGHTED 10 PERCENT. THIS JOINT CHNA AND RELATED IMPLEMENTATION PLAN WERE ADOPTED BY THE DUHS BOARD OF DIRECTORS IN FISCAL YEAR 2020 AND PUBLISHED ON THE DUKE HEALTH WEBSITE IN OCTOBER 2020, PRIOR TO THE DECEMBER 31, 2020 DEADLINE PROVIDED IN IRS NOTICE 2020-56. DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 6A: UNC REX HEALTHCARE, WAKEMED HEALTH AND HOSPITALS.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 6B: UNITED WAY OF THE GREATER TRIANGLE, WAKE COUNTY HUMAN SERVICES, ADVANCE COMMUNITY HEALTH, ALLIANCE HEALTH, YOUTH THRIVE, AND THE WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION. DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 11:THE FOLLOWING FIVE PRIORITY AREAS WERE IDENTIFIED FOR 2020-2022:1. TRANSPORTATION OPTIONS AND TRANSIT2. EMPLOYMENT3. ACCESS TO CARE4. MENTAL HEALTH/SUBSTANCE USE DISORDERS5. HOUSING AND HOMELESSNESS
1. TRANSPORTATION OPTIONS AND TRANSIT MANY ASPECTS OF DAILY LIFE REQUIRE THE USE OF TRANSPORTATION SUCH AS EMPLOYMENT, EDUCATION, ACCESS TO NUTRITIONAL FOODS, AND ACCESS TO HEALTHCARE SERVICES AND EACH OF THESE AREAS IMPACTS ONE'S OVERALL HEALTH. THE TRANSPORTATION OPTIONS AND TRANSIT PRIORITY INCLUDES INFORMATION RELATED TO HOW PEOPLE GET AROUND FOR WORK, SCHOOL, AND PLAY AS WELL AS PUBLIC TRANSPORTATION AND OTHER TRANSPORTATION CHOICES. THROUGH THE FOLLOWING ACTIONS, DUKE RALEIGH HOSPITAL WILL WORK COLLABORATELY TO REDUCE BARRIERS TO TRANSPORTATION. * PROVIDE FINANCIAL SUPPORT TO COMMUNITY-BASED ORGANIZATIONS ADDRESSING TRANSPORTATION BARRIERS FOR HEALTHCARE SERVICES. * CONTINUE TO SUPPORT ORGANIZATIONS SUCH AS THE GREATER RALEIGH CHAMBER OF COMMERCE AND MIDTOWN RALEIGH ALLIANCE IN THEIR EFFORTS TO WORK TOWARDS A RELIABLE TRANSPORTATION SYSTEM FOR ALL. * CONTINUE TO IDENTIFY PATIENTS WITH TRANSPORTATION NEEDS AND CONNECT THEM WITH COMMUNITY RESOURCES SUCH AS THE LUNG CANCER INITIATIVE OF NC'S GAS CARD PROGRAM, AMERICAN CANCER SOCIETY'S ROAD TO RECOVERY, THE CARING COMMUNITY FOUNDATION, AND THE NCCARE360 NETWORK.DUKE RALEIGH HOSPITAL SUPPORTED ORGANIZATIONS SUCH AS THE GREATER RALEIGH CHAMBER OF COMMERCE AND MIDTOWN RALEIGH ALLIANCE, WHICH WORK TOWARDS AN ENHANCED TRANSIT AND TRANSPORTATION SYSTEM FOR ALL RESIDENTS. DUKE RALEIGH ALSO PROVIDED $20,000 OF SUPPORT IN FY2021 TO THE LUNG CANCER INITIATIVE OF NC WHICH FUNDS A GAS CARD PROGRAM TO LESSEN THE BURDEN OF LUNG CANCER PATIENTS SEEKING TREATMENT.2. EMPLOYMENT EMPLOYMENT IS ALSO A SOCIAL DETERMINANT OF HEALTH THAT ROSE TO THE TOP OF THE WAKE COUNTY PRIORITIZATION MATRIX. THE EMPLOYMENT PRIORITY INCLUDES INFORMATION RELATED TO HOW MANY PEOPLE HAVE JOBS, WHAT TYPES OF JOBS THEY HAVE, AND WHETHER PEOPLE FEEL THEY CAN GET A GOOD JOB IN WAKE COUNTY. A GOOD-PAYING JOB MAKES IT EASIER FOR WORKERS TO LIVE IN HEALTHIER NEIGHBORHOODS, PROVIDE QUALITY EDUCATION FOR THEIR CHILDREN, SECURE CHILD CARE SERVICES, AND BUY MORE NUTRITIOUS FOOD, ALL OF WHICH AFFECT HEALTH.TO ADDRESS THIS PRIORITY, DUKE RALEIGH HOSPITAL WILL EMPLOY THE FOLLOWING STRATEGY/ACTION ITEMS TO SUPPORT EFFORTS TO INCREASE EMPLOYMENT OPPORTUNITIES:* INCREASE IN MINIMUM WAGE: DUKE UNIVERSITY AND DUKE UNIVERSITY HEALTH SYSTEM INCREASED MINIMUM WAGE TO $15 EFFECTIVE JULY 1, 2019.* JOB GROWTH: AS A RESULT OF THE DUKE RALEIGH HOSPITAL SOUTH PAVILION ADDITION SCHEDULED TO OPEN IN 2021, WE WILL GROW BY A FEW HUNDRED NEW JOBS OVER THE NEXT FIVE YEARS WITH OVER TWO THIRDS OF THESE HIRES TO HAPPEN BY THE END OF FISCAL YEAR 2022. * SUPPORT COMMUNITY: EFFORTS TO PROMOTE ECONOMIC PROSPERITY FOR ALL. THIS INCLUDES CONTINUED COLLABORATION WITH THE GREATER RALEIGH CHAMBER OF COMMERCE AND WAKE COUNTY ECONOMIC DEVELOPMENT BY INVESTING IN THE COMPETITIVE EDGE INITIATIVES AND PARTICIPATING IN THE TRIANGLE DIVERSITY, EQUITY, AND INCLUSIVITY (DEI) ALLIANCE. THIS ALSO INCLUDES COLLABORATING WITH ECONOMIC VITALITY ORGANIZATIONS IN WAKE COUNTY INCLUDING THE CROSBY ADVOCACY GROUP.* PROVIDE OPPORTUNITIES TO PREPARE THE FUTURE HEALTHCARE WORKFORCE. THIS INCLUDES CONTINUED PARTNERSHIP WITH WAKE TECHNICAL COMMUNITY COLLEGE AND WAKE COUNTY PUBLIC SCHOOL SYSTEM (WCPSS). IN FY2020, WE PROVIDED THOUSANDS OF HOURS FOR CLINICAL ROTATIONS FOR STUDENTS OF WAKE TECH'S HEALTH SCIENCES PROGRAMS AS WELL AS ENGAGED WITH WCPSS CAREER ACADEMIES SUCH AS ENLOE HIGH SCHOOL'S MEDICAL BIOSCIENCE ACADEMY.
3. ACCESS TO CARE ACCESS TO CARE WAS INDENTIFIED AS A TOP PRIORITY IN THE 2013 AND 2016 WAKE COUNTY CHNAS AND REMAINS A TOP PRIORITY IN THE 2019 WAKE COUNTY CHNA. THIS PRIORITY INCLUDES HOW AND WHY PEOPLE USE OR DO NOT USE HEALTHCARE, HOW MANY PEOPLE HAVE HEALTH INSURANCE, HOW MUCH HEALTHCARE THERE IS IN THE COMMUNITY, AND HOW MUCH INFORMATION THERE IS ABOUT HEALTHCARE.THE ABILITY TO ACCESS HEALTH SERVICES IS A CRITICAL PUBLIC HEALTH ISSUE, AS PRIMARY AND PREVENTATIVE SERVICES CAN HELP TO PREVENT OR MANAGE CHRONIC ILLNESSES AND THEREFORE IMPROVE THE HEALTH OF THE COMMUNITY. DUKE RALEIGH HOSPITAL IS ACTIVELY ENGAGED IN IMPROVING ACCESS TO HEALTH SERVICES FOR ALL THROUGH STRATEGIC INITIATIVES AND COMMUNITY PARTNERSHIPS. TO ADDRESS THIS PRIORITY DUKE RALEIGH HOSPITAL WILL EMPLOY THE FOLLOWING MAJOR ACTIONS/ACTIVITES: * CONTINUE TO PROVIDE FINANCIAL ASSISTANCE VIA DUKE UNIVERSITY HEALTH SYSTEM'S FINANCIAL ASSISTANCE POLICIES. IN FISCAL YEAR 2021, DUKE RALEIGH HOSPITAL PROVIDED APPROXIMATELY $18.6 MILLION IN CHARITY CARE AT ESTIMATED COST.* SUPPORT COMMUNITY PARTNERS WORKING TO PROVIDE CARE TO UNINSURED POPULATIONS. THIS INCLUDES ORGANIZATIONS SUCH AS ALLIANCE MEDICAL MINISTRY, URBAN MINISTRIES OF WAKE COUNTY, AND PROJECT ACCESS OF WAKE COUNTY. IN FY21, DUKE RALEIGH PROVIDED $30,000 IN FUNDING TO ALLIANCE MEDICAL MINISTRY TO SUPPORT THEIR EFFORTS TO PROVIDE COMPREHENSIVE, COMPASSIONATE AND AFFORDABLE HEALTHCARE TO WORKING, UNINSURED ADULTS IN WAKE COUNTY. BETWEEN FY17-21, DUKE RALEIGH DONATED AND PACKED OVER 4,000 POUNDS OF RICE AND BEANS FOR URBAN MINISTRIES OF WAKE COUNTY'S CLIENT CHOICE PANTRY, WHICH ENGAGED 50+ EMPLOYEES.* CONTINUE TO PROVIDE IN-KIND LAB SERVICES TO URBAN MINISTRIES OF WAKE COUNTY'S OPEN DOOR CLINIC. IN FY2021, DUKE RALEIGH HOSPITAL PROVIDED LAB TESTS IN-KIND FOR URBAN MINISTRIES OF WAKE COUNTY OPEN DOOR CLINIC WORTH MORE THAN $2 MILLION. * CONTINUE TO PROVIDE MONTHLY DIABETES EDUCATION CLASSES AT ALLIANCE MEDICAL MINISTRY IN-KIND.* CONTINUE TO PROVIDE DONATED CARE TO PROJECT ACCESS OF WAKE COUNTY, A PRIVATE, NON-PROFIT PROGRAM THAT CONNECTS ELIGIBLE UNINSURED CLIENTS TO HIGH QUALITY MEDICAL SERVICES. IN FY2021, DUKE RALEIGH HOSPITAL PROVIDED APPROXIMATELY $7.4 MILLION OF DONATED CARE TO PROJECT ACCESS OF WAKE COUNTY CLIENTS.* EXPAND CAPACITY TO CONDUCT SOCIAL SCREENINGS AND SUPPORT LINKAGES TO COMMUNITY RESOURCES. THIS INCLUDES PILOTING NCCARE360 IN FY2021 AS WELL AS WORKING WITH THE DUKE BENEFITS ENROLLMENT CENTER. * CONTINUE TO EXPAND THE DUKE ELDER FAMILY/CAREGIVING TRAINING (DEFT) PROGRAM AT DUKE RALEIGH HOSPITAL. THE DEFT CENTER PROVIDES SKILLS-TRAINING, EDUCATION AND SUPPORT TO CAREGIVERS DISCHARGING HOME AFTER A HOSPITAL STAY. * CONTINUE TO PROVIDE THE HEALTH LITERACY COURSE AS PART OF THE NURSE RESIDENCY CURRICULUM THROUGH OUR CLINICAL EDUCATION DEPARTMENT. IN FY2021, ONE HEALTH LITERACY CLASS WAS TAUGHT AS PART OF THE CURRICULUM WITH A TOTAL OF 155 GRADUATE NURSES EDUCATED.* EXPAND COMMUNITY OUTREACH AND EDUCATION EFFORTS AROUND STROKE, CARDIOVASCULAR DISEASE, DIABETES, CANCER, ORTHOPEDICS, SPORTS MEDICINE AND MORE THROUGH PARTNERING WITH LOCAL ORGANIZATIONS, AGENCIES, AND BUSINESSES. EACH YEAR, DUKE RALEIGH SPONSORS THE MIDTOWN FARMERS MARKET, WHICH PROMOTES A HEALTHY LIFESTYLE AS WELL AS PROVIDES A VENUE FOR DUKE RALEIGH TO SHARE HEALTHY EDUCATION FROM APRIL THROUGH NOVEMBER. IN THE FALL OF 2020, DUKE RALEIGH PROVIDED MORE THAN 1,500 EDUCATION RESOURCES TO EL PUEBLO IN SUPPORT OF THEIR ANNUAL EVENT, Y SIGUE LA FESTA, AND PROVIDED $2,500 IN SPONSORSHIPS IN FY21. DUKE RALEIGH DEVELOPED PROGRAMMING AND PROVIDED FINANCIAL SUPPORT TO INCREASE CHILDREN'S ACCESS TO NUTRITIOUS FOOD. IN FY21, DUKE RALEIGH PROVIDED $2,500 TO MEALS ON WHEELS OF WAKE COUNTY TO SUPPORT A VARIETY OF NEEDS. COVID-19 RESPONSEDUKE RALEIGH PROVIDED OVER 1,300 COVID-19 CARE PACKAGES CONTAINING EDUCATIONAL RESOURCES, MASKS, AND HAND SANITIZER TO COMMUNITY MEMBERS IN ZIP CODE 27604 IN THE SUMMER OF 2020.IN FY2021, DUKE RALEIGH HOSTED 5 COVID-19 VACCINATION EVENTS OFFERED TO MORE THAN 3,000 RESIDENTS ACROSS THE COUNTY WITH A PARTICULAR FOCUS ON LATINX AND AFRICAN-AMERICAN COMMUNITIES, IDENTIFIED AS THE MOST VULNERABLE POPULATIONS IN RELATION TO VACCINATION.4. MENTAL HEALTH/SUBSTANCE USE DISORDERSMENTAL HEALTH/SUBSTANCE USE DISORDERS WAS AN IDENTIFIED PRIORITY IN BOTH THE 2013 AND 2016 WAKE COUNTY CHNAS. WAKE COUNTY HAS EXPERIENCED AN INCREASE IN THE PREVALENCE AND SEVERITY OF MENTAL HEALTH AND SUBSTANCE USE PROBLEMS. THIS PRIORITY INCLUDES MENTAL HEALTH DISEASE (LIKE DEPRESSION, ALZHEIMER'S AND SCHIZOPHRENIA), POOR MENTAL HEALTH DAYS, AND HURTING ONESELF AS WELL AS ALCOHOL, OPIOID, AND ILLEGAL DRUG USE AND DATA RELATED TO OVERDOSES. DUE TO THE SCOPE AND COMPLEXITY OF MENTAL HEALTH AND SUBSTANCE USE, A COLLECTIVE AND COLLABORATIVE APPROACH IS NEEDED. DUKE RALEIGH HOSPITAL WILL CONTINUE TO WORK COLLABORATIVELY AND SUPPORT OPPORTUNITIES TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES AND REDUCE SUBSTANCE USE BY ENGAGING IN THE FOLLOWING MAJOR ACTIONS/ACTIVITIES: * FURTHER DEVELOP BEHAVIORAL HEALTH SERVICE LINE CAPABILITIES AT DUKE RALEIGH HOSPITAL WITH DEDICATED SERVICE LINE LEADERSHIP, ROUNDING NURSES, SOCIAL WORKERS, AND LEVERAGE THE USE OF NCCARE360 RESOURCES. * CONTINUE TO SERVE ON THE FOLLOWING COMMUNITY COALITIONS/WORKGROUPS: NORTH CAROLINA ASSOCIATION (NCHA) BEHAVIORAL HEALTH WORKGROUP, WAKE COUNTY DRUG OVERDOSE PREVENTION COALITION, AND WAKEBROOK COMMUNITY PARTNERSHIP.* CONTINUE TO SUPPORT EFFORTS TO INCREASE COMMUNITY-BASED RESOURCES THROUGH GRANTS AND SPONSORSHIPS. PAST ORGANIZATIONS SUPPORTED HAVE INCLUDED TRIANGLE FAMILY SERVICES AND NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) WAKE COUNTY. * CONTINUE TO PARTICIPATE IN THE DUKE UNIVERSITY HEALTH SYSTEM OPIOID TASK FORCE. THIS TASK FORCE PROVIDES RECOMMENDATIONS FOR THE INITIATION AND MANAGEMENT OF OPIOID THERAPY ACROSS THE HEALTH SYSTEM TO IMPROVE PERSONAL AND COMMUNITY SAFETY AND REDUCE HARM ASSOCIATED WITH THE HIGH RISK TREATMENTS WHILE ENGAGING PATIENTS IN THEIR OWN CARE.* INCREASE CAPABILITIES TO PROVIDE MENTAL HEALTH FIRST AID TRAINING AND INCREASE COMMUNITY AWARENESS.5. HOUSING AND HOMELESSNESSHOUSING AND HOMELESSNESS ARE ALSO SOCIAL DETERMINANTS OF HEALTH THAT ROSE TO THE TOP OF THE WAKE COUNTY PRIORITIZATION MATRIX TO BECOME A PRIORITY AREA FOR THE COUNTY TO FOCUS ON OVER THE COMING YEARS. THE HOUSING AND HOMELESSNESS PRIORITY INCLUDES COST OF HOUSING, HOUSING CHOICES, AND HOW MANY PEOPLE ARE HOMELESS. HEALTHY HOMES PROMOTE GOOD PHYSICAL AND MENTAL HEALTH, AFFECTING THE OVERALL ABILITY OF FAMILIES TO MAKE HEALTHY CHOICES. DUKE RALEIGH HOSPITAL WILL SUPPORT EFFORTS TO INCREASE ACCESS TO SAFE AND HEALTHY HOUSING THROUGH THE FOLLOWING ACTIONS:* EXPAND CAPABILITIES TO IDENTIFY PATIENTS WITH HOUSING/SHELTER NEEDS AND CONNECT THEM WITH COMMUNITY RESOURCES.* SUPPORT EFFORTS TO INCREASE COMMUNITY-BASED ORGANIZATIONS' CAPACITY TO PROVIDE SAFE, QUALITY, AFFORDABLE HOUSING AND SHELTER. IN FY2017-FY2021, DUKE RALEIGH HOSPITAL PROVIDED SUPPORT FOR HABITAT FOR HUMANITY OF WAKE COUNTY THROUGH FINANCIAL CONTRIBUTIONS AND EMPLOYEE VOLUNTEERISM. * CONTINUE SUPPORT FOR TRIANGLE FAMILY SERVICES, WHICH PROVIDES EMERGENCY HOUSING ASSISTANCE, RENTAL ASSISTANCE, AND STREET OUTREACH.* CONTINUE SUPPORT FOR RALEIGH WAKE PARTNERSHIP TO END AND PREVENT HOMELESS (THE PARTNERSHIP) EFFORTS. IN FY2020, DUKE RALEIGH DONATED THERMAL BLANKETS IN SUPPORT.* CONTINUE SUPPORT FOR URBAN MINISTRIES OF WAKE COUNTY, WHICH RUNS THE HELEN WRIGHT CENTER FOR WOMEN, A PROGRAM FOR SINGLE, HOMELESS WOMEN.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 16J: AS PART OF DUHS, DUKE RALEIGH HOSPITAL PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER ELECTIVE SERVICES, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.
GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL: PART V, SECTION B, LINE 5: DUKE REGIONAL HOSPITAL ("DRH") WAS A PARTICIPANT IN THE 2017 DURHAM COMMUNITY HEALTH ASSESSMENT, LED BY PARTNERSHIP FOR A HEALTHY DURHAM. THE ASSESSMENT PROCESS INCLUDED 358 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND THREE COMMUNITY LISTENING SESSIONS WITH 42 COMMUNITY MEMBERS. THE SURVEY WAS ALSO CONDUCTED IN PERSON AT GROCERY STORES, LIBRARIES, DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH CLINICS AND BUS STATIONS. THE COMMUNITY HEALTH ASSESSMENT TEAM COMPRISED OF REPRESENTATIVES FROM DUKE UNIVERSITY HEALTH SYSTEM, UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS, AND BUSINESSES - WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST. THIS JOINT CHNA AND RELATED IMPLEMENTATION PLAN WAS ADOPTED BY THE DUHS BOARD OF DIRECTORS AND PUBLISHED ON THE DUKE HEALTH WEBSITE IN FISCAL YEAR 2019 (TAX YEAR 2018).GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 6A: DUKE UNIVERSITY HOSPITALGROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 6B: THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENTGROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 11: THE ASSESSMENT IDENTIFIED FIVE HEALTH PRIORITIES FOR 2018-2020:1. AFFORDABLE HOUSING2. ACCESS TO HEALTHCARE AND HEALTH INSURANCE3. POVERTY4. MENTAL HEALTH5. OBESITY, DIABETES AND FOOD ACCESSDUKE REGIONAL HOSPITAL CONSIDERS THE DRH COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN DOCUMENT TO BE A "WORKING PLAN" THAT WILL CONTINUE TO EVOLVE OVER THIS THREE-YEAR PERIOD IN ORDER TO ENSURE THE EFFICACY OF STRATEGIES INTENDED TO MEET EXPRESSED COMMUNITY HEALTH NEEDS. THIS IMPLEMENTATION PLAN DOES NOT CONTAIN DESCRIPTIONS OF THE COMMUNITY HEALTH IMPROVEMENT WORK CARRIED OUT BY OTHER COMPONENTS OF DUKE HEALTH OR DUKE UNIVERSITY. THIS IMPLEMENTATION PLAN REPRESENTS ONLY DUKE REGIONAL HOSPITAL'S CONTINUALLY EVOLVING VARIETY OF PROGRAMS AND ACTIVITIES IN THE FIVE PRIORITY AREAS TO IMPROVE HEALTH WITH THE DURHAM COMMUNITY.1 AND 3. AFFORDABLE HOUSING AND POVERTYMINIMUM WAGE: EFFECTIVE 7/1/2019, DU AND DUHS INCREASED THE MINIMUM WAGE TO $15 PER HOUR FOR ALL EMPLOYEES.FILL THAT BUS AND SALVATION ARMY ANGEL TREE: EMPLOYEES HAVE DONATED BINS OF SCHOOL SUPPLIES TO CRAYONS2CALCULATORS AND FILL THAT BUS! CAMPAIGN ANNUALLY SINCE 2015 TO SUPPORT DURHAM PUBLIC SCHOOLS. TEACHERS FROM THE SCHOOLS WITH THE HIGHEST POVERTY LEVELS WERE INVITED TO PICK OUT SUPPLIES NEEDED IN THEIR CLASSROOMS.EACH DECEMBER, EMPLOYEES "ADOPT" 100 CHILDREN FROM DUKE REGIONAL'S SALVATION ARMY ANGEL TREE. CHILDREN IN DURHAM HAVE RECEIVED CLOTHING, BOOKS AND TOYS THANKS TO THE GENEROUS DONATIONS. EXTRA GIFTS ARE ALSO DONATED TO THE SALVATION ARMY FOR OTHER NEEDY FAMILIES IN THE AREA.2021 GOAL: DUKE REGIONAL HOSPITAL WILL AGAIN HOST AT LEAST ONE DRIVE TO BENEFIT UNDERSERVED CHILDREN OR FAMILIES IN OUR COMMUNITY.2021 PROGRESS: DUKE REGIONAL HOSPITAL SUPPORTED CRAYONS2CALCULATOR FILL THE BUS! CAMPAIGN, THE SALVATION ARMY TREE GIFT DRIVE AND A FOOD DRIVE FOR THE NORTH CAROLINA FOOD BANK OF CENTRAL AND EASTERN NC.EDUCATION: DUKE REGIONAL HOSPITAL HAS IDENTIFIED EDUCATION AS A PRIORITY OF ITS COMMUNITY STRATEGY TO HELP PREVENT POVERTY. DUKE REGIONAL HOSPITAL IS COMMITTED TO HELP TRAIN THE HEALTHCARE WORKERS OF THE FUTURE. IN FY20, DRH INVESTED $4.7 MILLION IN TEACHING AND TRAINING HEALTHCARE PROFESSIONALS. DURING FISCAL YEARS 2017 THROUGH 2020, DRH PROVIDED OPPORTUNITIES FOR 70 PRE-HEALTH UNDERGRADUATE STUDENTS FROM LOCAL COLLEGES AND UNIVERSITIES TO SHADOW AND VOLUNTEER ALONGSIDE CLINICAL AND CUSTOMER SERVICE STAFF AS AMBASSADORS IN THE EMERGENCY DEPARTMENT. DRH ALSO PROVIDED AN EIGHT-WEEK JUNIOR VOLUNTEER PROGRAM FOR AREA HIGH SCHOOL STUDENTS TO GAIN CLERICAL AND CUSTOMER SERVICE WORK EXPERIENCES IN A HEALTH CARE SETTING.FY2021 GOAL: DRH WILL CONTINUE THE SAME LEVEL OF SUPPORT.FY2021 PROGRESS: DRH INVESTED $4.7 MILLION IN TEACHING AND TRAINING HEALTHCARE PROFESSIONALS. DUE TO COVID-19, IN-PERSON SHADOWING AND VOLUNTEER OPPORTUNITIES WERE HALTED IN MARCH 2020, BUT THE HOSPITAL CONTINUED TO FIND CREATIVE WAYS TO ENGAGE STUDENTS VIRTUALLY AND WELCOMED CLINICAL STUDENTS BACK TO CAMPUS USING A SLOW AND MEASURED RE-ENTRY OF STUDENTS STARTING IN THE SUMMER OF 2020. SINCE THAT TIME, MORE CLINICAL STUDENTS HAVE RETURNED AND CONTINUE TO FOLLOW ALL DUHS RESTRICTIONS AS NEEDED. CITY OF MEDICINE ACADEMY: DUKE REGIONAL HOSPITAL HAS BEEN A PARTNER WITH CITY OF MEDICINE ACADEMY (CMA) AND DURHAM PUBLIC SCHOOLS SINCE THE PROGRAM'S INCEPTION AT SOUTHERN HIGH SCHOOL IN THE 1990S. IN AUGUST 2011, CMA MOVED TO A NEW FACILITY LOCATED ON THE DUKE REGIONAL CAMPUS. AS PART OF OUR PARTNERSHIP, DUKE REGIONAL HOSPITAL HOSTS STUDENTS FOR CLINICAL ROTATIONS AND INTERNSHIPS, PROVIDES CPR TRAINING AND HOSTS THE ANNUAL SENIOR AWARDS NIGHT IN THE HOSPITAL AUDITORIUM.2021 GOAL: DUKE REGIONAL HOSPITAL WILL CONTINUE ITS PARTNERSHIP WITH CMA.2021 PROGRESS: DUKE REGIONAL CONTINUED TO PARTNER WITH CMA.PROJECT SEARCH: DUKE REGIONAL HOSPITAL WAS THE FIRST HOST HOSPITAL IN THE STATE FOR PROJECT SEARCH, A PARTNERSHIP WITH DURHAM PUBLIC SCHOOLS, OE ENTERPRISES, NORTH CAROLINA VOCATIONAL REHABILITATION AND ALLIANCE BEHAVIORAL HEALTH THAT PROVIDES CAREER DEVELOPMENT EXPERIENCES TO SENIOR HIGH SCHOOL STUDENTS WITH DEVELOPMENTAL DISABILITIES. 2021 GOAL: DUKE REGIONAL HOSPITAL WILL CONTINUE TO SERVE AS A HOST SITE FOR PROJECT SEARCH.2021 PROGRESS: DUKE REGIONAL HOSPITAL CONTINUED TO SERVE AS A HOST SITE FOR PROJECT SEARCH ADDING 7 NEW GRADUATES BRINGING THE TOTAL NUMBER OF GRADUATES TO 77 TO DATE. APPROXIMATELY HALF ARE EMPLOYED IN THE COMMUNITY, WITH THREE GRADUATES WORKING AT DUKE REGIONAL HOSPITAL.
2. ACCESS TO HEALTHCARE AND HEALTH INSURANCE LINCOLN COMMUNITY HEALTH CENTER (LCHC): IS A FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER THAT PROVIDES PRIMARY CARE SERVICES FOR ABOUT 40,000 PATIENTS EACH YEAR. APPROXIMATELY 70 PERCENT OF LCHC PATIENTS ARE UNINSURED AND 84% ARE LIVING AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL. IN ADDITION TO GENEROUS FINANCIAL SUPPORT, DUKE REGIONAL HOSPITAL PROVIDES ENGINEERING, ENVIRONMENTAL, LABORATORY, PHARMACY AND RADIOLOGY SERVICES. THE TOTAL DUKE REGIONAL HOSPITAL CONTRIBUTION TO LCHC IN FY 2021, INCLUDING MONETARY AND IN-KIND SERVICES, WAS $8.1 MILLION.DURHAM COUNTY EMERGENCY MEDICAL SERVICES (EMS): SERVES AS THE PRIMARY PROVIDER OF EMERGENCY AMBULANCE SERVICES AND ALTERNATIVE MEDICAL TRANSPORTATION IN DURHAM COUNTY. IN FY 2021, DUKE REGIONAL HOSPITAL CONTRIBUTED MORE THAN $2.6 MILLION TO THE COUNTY TO SUPPORT DURHAM EMS.PROJECT ACCESS OF DURHAM COUNTY (PADC): COORDINATES SPECIALTY CARE AT NO CHARGE TO UNINSURED AND UNDERINSURED DURHAM RESIDENTS LIVING AT OR BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. THESE RESIDENTS HAVE ACCESS TO PRIMARY HEALTH CARE THROUGH LINCOLN COMMUNITY HEALTH CENTER. DRH HAS PROVIDED OFFICE SPACE AND TECHNOLOGICAL SUPPORT FOR PADC AS WELL AS EPISODES OF CARE FOR PADC PATIENTS.2021 GOAL: CONTINUE A SIMILAR LEVEL OF SUPPORT.2021 PROGRESS: DUKE REGIONAL HOSPITAL CONTINUED TO PROVIDE OFFICE SPACE, TECHNOLOGICAL SUPPORT AND EPISODES OF CARE IN FY2021 UNTIL PROJECT ACCESS RELOCATED TO A NON-HOSPITAL BUILDING. IN DECEMBER 2020, DRH PROVIDED FINANCIAL SUPPORT ($11,667) IN LIEU OF PROVIDING SPACE.FINANCIAL ASSISTANCE: EACH YEAR DUKE REGIONAL HOSPITAL PROVIDES NO-COST OR DISCOUNTED URGENT OR EMERGENT HEALTH CARE SERVICES TO PATIENTS WHO WERE UNABLE TO PAY. IN FY 2021 DUKE REGIONAL PROVIDED $30.5 MILLION (AT ESTIMATED COST) IN FINANCIAL ASSISTANCE.4. MENTAL HEALTHIN 2021, DUKE REGIONAL OPENED THE NEW BEHAVIORAL HEALTH CENTER NORTH DURHAM AND EXPANDED EMERGENCY DEPARTMENT TO PROVIDE MORE COMPREHENSIVE CARE FOR OUR BEHAVIORAL HEALTH PATIENTS. THIS $102.4 MILLION PROJECT EXPANDED THE HOSPITAL'S EMERGENCY ROOM AND CONSOLIDATED INPATIENT, OUTPATIENT, AND EMERGENCY BEHAVIORAL HEALTH SERVICES ON DUKE REGIONAL'S CAMPUS, WITH THE GOAL OF PROVIDING BETTER COORDINATION OF CARE FOR BEHAVIORAL HEALTH PATIENTS IN DURHAM AND REGIONALLY. THE CENTER INCORPORATES MEETING SPACE SPECIALLY DESIGNED TO BE USED BY COMMUNITY-BASED ORGANIZATIONS PROVIDING SERVICES FOR BEHAVIORAL HEALTH PATIENTS AND THEIR FAMILIES.5. OBESITY, DIABETES, AND FOOD ACCESSBEYOND ITS CLINICAL SERVICE LINES IN THE HOSPITAL, DRH COLLABORATES WITH NUMEROUS DURHAM NON-PROFITS AND OTHER ENTITIES WITHIN THE DUKE UNIVERSITY HEALTH SYSTEM THAT ARE SPECIFICALLY FOCUSED ON COMMUNITY-BASED MECHANISMS FOR THE PREVENTION AND TREATMENT OF OBESITY AND DIABETES AND ON ISSUES OF FOOD ACCESS.IN ADDITION TO THE ABOVE ACTIVITIES SPECIFICALLY RELATED TO THE CHNA IDENTIFIED HEALTH PRIORITIES, DUKE REGIONAL HOSPITAL SUPPORTS HEALTH NEEDS OF ITS COMMUNITY IN THE FOLLOWING WAYS:THE LOOK GOOD FEEL BETTER PROGRAM IS A NON-MEDICAL, BRAND-NEUTRAL PROGRAM THAT PROVIDES SUPPORT FOR FEMALE CANCER TREATMENT PATIENTS WHO HAVE EXPERIENCED HAIR LOSS OR OTHER PHYSICAL APPEARANCE CHANGES DUE TO CHEMOTHERAPY OR RADIATION TREATMENTS. FOR MORE THAN A DECADE, DRH HAS SUPPORTED THIS PROGRAM AS A HOST SITE. DUE TO COVID-19, DUKE REGIONAL SPONSORED THE MONTHLY WORKSHOPS IN A VIRTUAL FORMAT DURING FY2021. STROKE SUPPORT: DUKE REGIONAL OFFERS A MONTHLY STROKE SUPPORT GROUP THAT PROVIDES EDUCATION, SUPPORT AND RESOURCES FOR INDIVIDUALS WHO HAVE BEEN AFFECTED BY STROKE. THE SUPPORT GROUP STARTED IN 2006 AND TYPICALLY HOSTS 20-25 PARTICIPANTS A MONTH. DUKE REGIONAL CONTINUED THE MONTHLY STROKE SUPPORT PROGRAM IN A VIRTUAL FORMAT DURING FY2021.COVID-19: WITH STRONG COMMUNITY PARTNERSHIPS, DUKE REGIONAL COORDINATED THE HEALTH SYSTEM EFFORTS TO PROVIDE COVID-19 VACCINATIONS EQUITABLY IN DURHAM BY MANAGING THE DAILY OPERATIONS FOR THE CLINICS FOCUSED ON SERVING OUR MOST VULNERABLE COMMUNITY MEMBERS. THE HOSPITAL OPENED AN ON-SITE CLINIC IN DECEMBER 2020 TO VACCINATE COMMUNITY PROVIDERS AND, ONCE ELIGIBLE, EDUCATORS. IT PARTNERED WITH DURHAM PUBLIC SCHOOLS AND DURHAM COUNTY HEALTH DEPARTMENT IN JANUARY 2021 TO OPEN A VACCINATION SITE AT SOUTHERN SCHOOL OF ENERGY AND SUSTAINABILITY, LOCATED IN ONE OF THE ZIP CODES MOST DISPROPORTIONATELY IMPACTED BY COVID-19. WHEN STUDENTS RETURNED TO CAMPUS IN APRIL 2021, THE HOSPITAL PARTNERED WITH THE CITY OF DURHAM TO MOVE THE CLINIC TO THE OLD WHEELS SKATE PARK. THE HOSPITAL PARTNERED WITH NUMEROUS COMMUNITY ORGANIZATIONS TO BRING "POP-UP OR "MOBILE" VACCINATIONS WHERE THEY WERE MOST NEEDED, CONDUCTING MORE THAN 30 EVENTS IN FY2021. IN TOTAL, THE HOSPITAL DISTRIBUTED MORE THAN 44,000 DOSES OF COVID-19 VACCINE WITH THESE EFFORTS CONTINUING IN FY2022.FUNDRAISING AND OUTREACH: DUKE REGIONAL CONDUCTS A NUMBER OF FUNDRAISING AND OUTREACH ACTIVITIES IN THE DURHAM COMMUNITY AND BEYOND. DUKE REGIONAL EMPLOYEES RAISE FUNDS EACH YEAR FOR CHARITABLE ORGANIZATIONS, INCLUDING DUKE COMMUNITY GIVING, AMERICAN HEART ASSOCIATION HEART WALK, AND MARCH OF DIMES. IN FY2021, DUKE REGIONAL RAISED $29,035 FOR LOCAL CHARITIES. THE HOSPITAL CONTINUES TO PARTNER WITH LOCAL NONPROFITS ON ENDEAVORS THAT EDUCATE OUR COMMUNITY ABOUT HEALTH INITIATIVES AND DISPARATIES AND PROVIDES OFFICE SPACE FOR THE DURHAM COMMUNITY HEALTH COALITION. IN FY2021, DRH PARTNERED WTH THE AMERICAN RED CROSS TO HOST FOUR BLOOD DRIVES, COLLECTING 79 UNITS OF BLOOD.
GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 16J: AS PART OF DUHS, DUKE REGIONAL HOSPITAL PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS.GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITALPART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER ELECTIVE SERVICES, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?7
Name and address Type of Facility (describe)
1 1 - DUKE PTOT MEADOWMONT CHAPEL HILL
801 W BARBEE CHAPEL ROAD SUITE 100
CHAPEL HILL,NC27517 		SPECIALTY
2 2 - DUKE HEALTH CENTER ARRINGDON
5601 ARRINGDON PARK DRIVE
MORRISVILLE,NC27560 		SPECIALTY
3 3 - DUKE IMAGING SERVICES
3700 NW CARY PARKWAY SUITE 120
CARY,NC27513 		INDEPENDENT DIAGNOSTIC TESTING FACILITY
4 4 - HOCK FAMILY PAVILION
4023 NORTH ROXBORO ROAD
DURHAM,NC27704 		HOSPICE
5 5 - DUKE PTOT HILLSBOROUGH
267 SOUTH CHURTON
HILLSBOROUGH,NC27278 		SPECIALTY
6 6 - DUKE PTOT BRIER CREEK
10211 ALM ST
RALEIGH,NC27617 		SPECIALTY
7 7 - DUKE PTOT KNIGHTDALE
162 LEGACY OAKS DR SUITE 1221A
KNIGHTDALE,NC27545 		SPECIALTY
8
9
10
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
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Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 3C: NOT APPLICABLEPART I, LINE 5A, 5B, AND 5C:DUE TO COVID-19, DUKE UNIVERSITY HEALTH SYSTEM (DUHS) DID NOT BUDGET BY SPECIFIC PATIENT REVENUE DEDUCTIONS IN FY2021 TO BE ABLE TO SEPARATELY IDENTIFY THE BUDGET AMOUNT FOR FREE OR DISCOUNTED CARE. INSTEAD, DUHS FORECASTED NET PATIENT REVENUE AND PROVIDED FREE OR DISCOUNTED CARE TO THE MEDICALLY INDIGENT DURING FY2021 REGARDLESS OF BUDGET OR FORECAST CONSIDERATIONS.PART I, LINE 6A:NOT APPLICABLEPART I, LINE 7, COLUMN F:TOTAL GROSS COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES IS 10.3%.PART I, LINE 7:CHARITY CARE AT COST IS DETERMINED USING THE COST-TO-CHARGE CALCULATION FROM WORKSHEET 2, IN ORDER TO CALCULATE THE AMOUNTS REPORTED ON THE TABLE. UNREIMBURSED MEDICAID IS DETERMINED USING A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS.CHARITY CARE, UNREIMBURSED MEDICAID, AND COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDE FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT COSTS PROVIDED BY DUHS' SUPPORT CORPORATIONS, DUKE UNIVERSITY AFFILIATED PHYSICIANS AND DUKE INTEGRATED NETWORK, THAT FILE SEPARATE 990S BUT ARE NOT REQUIRED TO COMPLETE A SCHEDULE H SINCE NOT A HOSPITAL. TOTAL NET COMMUNITY BENEFIT EXPENSES FOR THESE ENTITIES TOTALED $16.9 MILLION IN FY2021.PART II, COMMUNITY BUILDING ACTIVITIES:THESE ACTIVITIES ARE INCLUDED IN DUKE UNIVERSITY HEALTH SYSTEM, INC.'S (DUHS) OPERATING EXPENSES AND ARE NOT TRACKED SEPARATELY FOR COMMUNITY BENEFIT REPORTING PURPOSES.PART III, LINE 1 AND LINE 2:THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) REVISED ITS ACCOUNTING GUIDANCE RELATED TO UNCOMPENSATED CARE IN JUNE 2019 TO REFLECT CHANGES IN BAD DEBT REPORTING RESULTING FROM FINANCIAL ACCOUNTING STANDARDS BOARD ACCOUNTING STANDARDS UPDATE 2014-09, "REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606)" (ASU 2014-09). DUHS ADOPTED ASU 2014-09 ON JULY 1, 2018. UPON ADOPTION OF ASU 2014-09 AND CONSISTENT WITH THE REVISED HFMA STATEMENT NO. 15, THE ESTIMATED UNCOLLECTIBLE AMOUNTS FROM SELF-PAY PATIENTS THAT WERE PREVIOUSLY REPORTED AS BAD DEBT EXPENSE PRIOR TO ADOPTION OF ASU 2014-09 ARE NOW CONSIDERED IMPLICIT PRICE CONCESSIONS DIRECTLY REDUCING NET PATIENT SERVICE REVENUE.DUHS PROVIDED UNCOMPENSATED CARE AT ESTIMATED COSTS IN THE FORM OF IMPLICIT PRICE CONCESSIONS (FORMERLY CONSIDERED BAD DEBT EXPENSE) ASSOCIATED WITH UNCOLLECTIBLE PATIENT ACCOUNTS AT AN ESTIMATED COST OF $29,205,000 IN FISCAL YEAR 2021. DUHS USED THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 TO ESTIMATE COST.PART III, LINE 3:DUHS PRESUMPTIVELY SCREENS ALL UNINSURED PATIENTS AND ALL PATIENTS ENTERING THROUGH THE EMERGENCY DEPARTMENT, REGARDLESS OF INSURANCE STATUS, FOR FINANCIAL ASSISTANCE. WHILE THESE PRESUMPTIVE PROCESSES IDENTIFY A SUBSET OF PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WITHOUT NEEDING DIRECT INPUT FROM THE PATIENT, THOSE WHO DO NOT FALL UNDER THE PRESUMPTIVE SCREENING CRITERIA WILL NEED TO PROVIDE INFORMATION TO QUALIFY FOR FINANCIAL ASSISTANCE UNDER DUHS' FINANCIAL ASSISTANCE POLICY. A PORTION OF IMPLICIT PRICE CONCESSIONS (FORMERLY CONSIDERED BAD DEBT EXPENSE) SHOULD BE INCLUDED AS A COMMUNITY BENEFIT, BUT THE PORTION THAT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY IS INDETERMINABLE BECAUSE OF THOSE PATIENTS WHO FAIL TO APPLY FOR OR PROVIDE INFORMATION NEEDED TO DETERMINE THEIR ELIGIBILITY UNDER THE DUHS FAP. DUHS, INC. FOLLOWS ITS MISSION TO THE COMMUNITY AND PROVIDES EMERGENT SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE ARE REPORTED AS AN IMPLICIT PRICE CONCESSION INSTEAD BECAUSE OF THOSE PATIENTS' INABILITY OR UNWILLINGNESS TO PROVIDE THE NECESSARY DOCUMENTATION REQUIRED TO DETERMINE FINANCIAL ASISTANCE CLASSIFICATION.PART III, LINE 4:PAGES 19-21 IN THE FY2021 AUDITED FINANCIAL STATEMENT FOOTNOTES DESCRIBE IMPLICIT PRICE CONCESSIONS RELATED TO UNINSURED PATIENTS.PART III, LINE 7:TOTAL UNREIMBURSED COSTS ATTRIBUTABLE TO PROVIDING SERVICES UNDER MEDICARE AS REPORTED IN THE JUNE 30, 2021 DUHS CONSOLIDATED FINANCIAL STATEMENTS ARE $412,603,000 AS COMPARED TO $160,317,133 AS REPORTED IN SECTION B, LINE 7 OF SCHEDULE H. THE DUHS TOTAL MEDICARE SHORTFALL OF $412,603,000 IS DERIVED FROM THE COST ACCOUNTING SYSTEM WHICH INCLUDES ALL PAYMENTS AND COSTS ASSOCIATED WITH MEDICARE PATIENTS, WHEREAS THE AMOUNT REPORTED IN SECTION B OF SCHEDULE H IS DERIVED BASED ON IRS INSTRUCTIONS. IRS INSTRUCTIONS SPECIFY THAT ONLY A PORTION OF COSTS ASSOCIATED WITH MEDICARE BENEFICIARIES BE REPORTED ON SCHEDULE H. SIGNIFICANT MEDICARE COSTS EXCLUDED FROM SCHEDULE H DATA INCLUDE THOSE ASSOCIATED WITH MEDICARE PATIENTS COVERED UNDER MANAGED CARE PLANS AND COSTS REIMBURSED THROUGH MEANS NOT REPORTED ON THE COST REPORT.PART III, LINE 8:MEDICARE RATES AND THE NUMBER OF MEDICARE PATIENTS DUHS TREATS ARE NOT NEGOTIATED. MEDICARE DOES NOT FULLY COMPENSATE DUHS FOR THE COST OF PROVIDING CARE TO MEDICARE BENEFICIARIES. DUHS CONTINUES TO SERVE THE MEDICARE POPULATION AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COST OF CARE. THEREFORE, ANY LOSS RELATED TO PROVIDING CARE FOR MEDICARE PATIENTS SHOULD BE CLASSIFIED AS A COMMUNITY BENEFIT. DUHS FOLLOWED THE MEDICARE COST REPORT RULES AND GUIDELINES IN DETERMINING THE COSTS REPORTED ON LINE 6. THESE RULES USE A VARIETY OF DIFFERENT METHODOLOGIES BASED ON THE TYPE OF SERVICE.PART III, LINE 9B:COLLECTION EFFORTS ARE IMMEDIATELY STOPPED FOR PATIENTS WHO SUBMIT A FINANCIAL ASSISTANCE APPLICATION. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT PURSUED USING ANY DEBT COLLECTION PRACTICES.
NEEDS ASSESSMENT: PART VI, LINE 2:DUHS USES SEVERAL MECHANISMS TO ASSESS AND ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. IN DURHAM COUNTY, DUHS AND THE DUKE UNIVERSITY SCHOOL OF MEDICINE FACULTY ARE ACTIVELY INVOLVED IN THE PARTNERSHIP FOR A HEALTHY DURHAM. THE PARTNERSHIP IS A COALITION OF LOCAL ORGANIZATIONS AND COMMUNITY MEMBERS WITH THE GOAL OF COLLABORATIVELY IMPROVING THE PHYSICAL, MENTAL, SOCIAL, HEALTH, AND WELL-BEING OF DURHAM COUNTY'S RESIDENTS. THE NETWORK IS A CERTIFIED HEALTHY CAROLINIANS WORKGROUP. THE PARTNERSHIP EVALUATES COMMUNITY HEALTH CARE INFORMATION, THEN IDENTIFIES AND PRIORITIZES COMMUNITY-IDENTIFIED HEALTH CARE NEEDS AMONG SUBCOMMITTEES THAT FOCUS ON A DURHAM COUNTY HEALTH PRIORITY. SINCE 2002, DUHS' OFFICE OF COMMUNITY HEALTH (FORMERLY KNOWN AS OFFICE OF COMMUNITY RELATIONS) HAS PLAYED A CENTRAL ROLE IN CONDUCTING A DURHAM HEALTH SUMMIT. THIS IS AN EVENT THAT ATTRACTS HUNDREDS OF COMMUNITY MEMBERS, HEALTH OFFICIALS, ELECTED OFFICIALS, AND DUHS EXECUTIVES AND PHYSICIANS TO RAISE AWARENESS OF KEY HEALTH ISSUES IN THE COMMUNITY AND SEEK COLLABORATIVE SOLUTIONS TO THESE ISSUES. THE SUMMIT HAS PRODUCED A NUMBER OF COMMUNITY-DRIVEN HEALTH CARE PROGRAMS AND INITIATIVES, INCLUDING SPECIALTY PROJECT ACCESS, IN WHICH PHYSICIANS WHO PRACTICE AT DUHS FACILITIES AND OTHER DURHAM COUNTY PHYSICIANS OFFER FREE SPECIALTY CARE SERVICES TO RESIDENTS WHO OTHERWISE COULD NOT AFFORD SPECIALTY CARE. DUHS ALSO PLAYS A CENTRAL ROLE IN REGIONAL AND STATE HEALTH CARE SUMMITS USING THE SUMMITS' INFORMATION AND DATA TO ADDRESS THE HEALTH CARE NEEDS OF THOSE BROADER COMMUNITIES.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:PART VI, LINE 3:DUHS EMPLOYS NUMEROUS MEANS TO EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE DUHS CHARITY CARE POLICY. DETAILED INFORMATION IS POSTED ON WWW.DUKEHEALTH.ORG (DUHS' WEBSITE) ALONG WITH HARDCOPY BROCHURES THAT ARE AVAILABLE IN ENGLISH OR SPANISH AT ALL OF OUR PATIENT REGISTRATION LOCATIONS. ALL INPATIENTS AND EMERGENCY DEPARTMENT PATIENTS ARE ALSO PROVIDED WITH A HARDCOPY, ONE-PAGE SUMMARY OF THE WAYS DUHS CAN ASSIST PATIENTS FINANCIALLY. FOR OUTPATIENTS, THIS SAME ONE-PAGE SUMMARY IS PROVIDED ON THEIR FIRST VISIT TO THE INSTITUTION. IN ADDITION, DUHS EMPLOYS FINANCIAL CARE COUNSELORS WHO MEET INDIVIDUALLY WITH PATIENTS WHO HAVE QUESTIONS REGARDING PAYMENT FOR THEIR CARE. DUHS ALSO EMPLOYS MEDICAID ASSISTANCE COUNSELORS WHO SPECIALIZE IN ASSISTING PATIENTS TO APPLY FOR MEDICAID, DISABILITY, AND OTHER FEDERAL, STATE, AND LOCAL PROGRAMS. DUHS ASSISTS BETWEEN 12,000-15,000 PATIENTS IN APPLYING AND BECOMING ELIGIBLE FOR THESE PROGRAMS ANNUALLY. FINALLY, PATIENTS MAY ALWAYS CONTACT DUHS' TOLL FREE CUSTOMER SERVICE NUMBER TO REQUEST INFORMATION ABOUT THEIR BILL OR OBTAIN A CHARITY CARE APPLICATION.COMMUNITY INFORMATION:PART VI, LINE 4:DUHS SERVES A BROAD, CULTURALLY, RACIALLY AND SOCIALLY DIVERSE GEOGRAPHIC AND DEMOGRAPHIC REGION. DUHS' HOME CITY OF DURHAM IS THE CORE, BUT DUHS' REACH EXTENDS INTO THE SURROUNDING RESEARCH TRIANGLE AREA OF NORTH CAROLINA AND THE STATE'S LARGER NORTHERN PIEDMONT REGION, AS WELL AS STATEWIDE, NATIONALLY AND GLOBALLY. DUHS' PRIMARY SERVICE AREA (PSA) IS A 7-COUNTY REGION IN NC THAT INCLUDES ALAMANCE, DURHAM, GRANVILLE, ORANGE, PERSON, VANCE AND WAKE COUNTIES. THIS 7-COUNTY REGION REPRESENTS APPROXIMATELY 18% OF NC'S POPULATION BASED ON FEDERAL FISCAL YEAR (FFY) 2020 DATA. THE WEIGHTED AVERAGE MEDIAN HOUSEHOLD INCOME IN ITS PSA IS $71,807. APPROXIMATELY 67% OF INPATIENT DISCHARGES FROM DUHS FACILITIES IN FFY 2020 WERE PATIENTS FROM ITS PSA. THE POPULATION IN DUHS' PSA IS EXPECTED TO GROW AT A HIGHER RATE OVER THE NEXT 5 YEARS FROM 2020 TO 2025 COMPARED TO NC'S OVERALL EXPECTED POPULATION GROWTH RATE. THE PSA 5-YEAR CAGR IS EXPECTED TO BE 1.8% COMPARED TO THE OVERALL ESTIMATED NC RATE OF 1.1%. DUHS' SECONDARY SERVICE AREA COVERS 15 COUNTIES IN NORTH CAROLINA AND SOUTHERN VIRGINIA WITH A POPULATION OF APPROXIMATELY 2 MILLION. PROMOTION OF COMMUNITY HEALTH:PART VI, LINE 5:DUHS PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A NUMBER OF COMMUNITY BUILDING ACTIVITIES. CENTRAL TO MANY OF THE EFFORTS IS DUHS' OFFICE OF COMMUNITY HEALTH, WHOSE ASSOCIATE VICE PRESIDENT REPORTS DIRECTLY TO DUHS' CEO AND SERVES AS A FULL-TIME LIAISON WITH THE DURHAM COMMUNITY. THE OFFICE SPONSORS AND FACILITATES COMMUNITY EVENTS SUCH AS THE ANNUAL DURHAM HEALTH SUMMIT AND SIMILAR REGIONAL AND STATE HEALTH SUMMITS THAT RAISE AWARENESS OF COMMUNITY HEALTH NEEDS, PROMOTE PREVENTION AND WELLNESS, AND CHART A COURSE FOR SOLVING HEALTH ISSUES AND DISPARITIES. IN ADDITION, THE OFFICE PROVIDES A POINT OF DIRECT CONTACT FOR COMMUNITY MEMBERS WHO HAVE QUESTIONS OR CONCERNS ABOUT COMMUNITY ISSUES OR ABOUT ACCESS TO HEALTH CARE SERVICES. THE OFFICE ALSO PROVIDES DIRECT FINANCIAL SUPPORT TO A VARIETY OF COMMUNITY GROUPS THROUGH THE BUILDING HEALTHY COMMUNITIES GRANTS PROGRAM. THE ASSOCIATE VICE-PRESIDENT AND STAFF SERVE ON A NUMBER OF HEALTH CARE-RELATED COMMUNITY BOARDS AND HEALTH-RELATED COMMITTEES. STAFF FROM THE OFFICE OF COMMUNITY HEALTH AND MEMBERS OF THE DUHS COMMUNITY HEALTH PLANNING GROUP CREATED A FORMAL PRINCIPLES OF COMMUNITY ENGAGEMENT POLICY THAT COMMITS DUHS AND ITS COMMUNITY PARTNERS TO DEVELOPING PROPOSED PROJECTS AND INITIATIVES ON TRUST, RESPECT, DIVERSITY, SAFETY AND COMMUNITY-IDENTIFIED NEEDS. THESE PRINCIPLES HAVE BEEN INCORPORATED INTO COMMUNITY-BASED HEALTH CARE PROJECTS SUCH AS THE DEVELOPMENT OF THE HOLTON WELLNESS CENTER AND DURHAM HEALTH INNOVATIONS, A MULTIDISCIPLINARY COMMUNITY BASED JOINT EFFORT BETWEEN DUHS AND THE DURHAM COMMUNITY THAT FOCUSES ON IMPROVING HEALTH OUTCOMES THROUGH NEW AND CREATIVE APPROACHES TO HEALTH CARE DELIVERY.
IN ADDITION TO COMMUNITY BUILDING ACTIVITIES, DUHS PROMOTES THE HEALTH OF ITS COMMUNITIES IN A NUMBER OF IMPORTANT WAYS. ONE OF DUHS' THREE CONSTITUENT HOSPITALS, DUKE REGIONAL, HAS AN OPEN MEDICAL STAFF AND A HOSPITAL CORPORATION BOARD, WHICH IS A COUNTY APPOINTED BOARD RESPONSIBLE FOR HOSPITAL OVERSIGHT. IN ADDITION, APPROXIMATELY 50 LOCAL LEADERS IN THE DURHAM FAITH COMMUNITY ARE WORKING WITH DUKE HEALTH TO LOOK AT HOW TO ADDRESS THE NEEDS OF THEIR CONGREGATIONS AND COMMUNITIES BY COMBINING THE TRADITIONS OF THE FAITH COMMUNITY WITH THE KNOWLEDGE OF MODERN MEDICINE. MEETINGS ARE HELD TO DETERMINE HOW DUKE HEALTH CAN ASSIST THE FAITH COMMUNITY TO SUPPORT HEALTH MINISTRY ACTIVITIES IN THEIR COMMUNITY AND PLACES OF WORSHIP.DUHS' CEO ALSO HAS A CHANCELLOR'S COMMUNITY HEALTH ADVISORY BOARD TO PROVIDE FEEDBACK ON A VARIETY OF ISSUES, INCLUDING USE OF DUHS RESOURCES, HEALTH SERVICE DELIVERY SYSTEMS AND LONG-RANGE GOALS TO REDUCE HEALTH RISKS AND DISPARITIES IN DURHAM COUNTY. THE BOARD INCLUDES STATE AND LOCAL ELECTED OFFICIALS, NEIGHBORHOOD COUNCILS AND OTHER GRASSROOTS ORGANIZATIONS, POLITICAL GROUPS, LOCAL PHYSICIANS, THE DURHAM PUBLIC SCHOOLS, AMONG OTHERS. DUHS MAINTAINS A BUILDING HEALTHY COMMUNITIES GRANTS COMMITTEE TO REVIEW COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS. DUKE HEALTH PROVIDES VARIOUS OPPORTUNITIES FOR STUDENTS TO INTERACT WITH DIFFERENT HEALTH CARE PROFESSIONALS ACROSS THE SYSTEM. THE OFFICE OF COMMUNITY HEALTH, DRH, AND OTHER KEY COMMUNITY PARTICIPANTS ARE ACTIVE IN A WORKFORCE DEVELOPMENT PROJECT CALLED PROJECT SEARCH. THIS PROGRAM, MODELED AFTER THE PROGRAM AT CINCINNATI CHILDREN'S HOSPITAL, PROVIDES YOUTH WITH DISABILITIES EMPLOYMENT TRAINING AND CAREER OPPORTUNITIES IN THE HEALTHCARE FIELD. THE OFFICE OF COMMUNITY HEALTH WORKS WITH THE DURHAM-ORANGE MEDICAL SOCIETY AND THE DURHAM ACADEMY OF MEDICINE, DENTISTRY AND PHARMACY (AN ASSOCIATION FOR AFRICAN-AMERICAN MEDICAL PROFESSIONALS) TO PROMOTE THE SUCCESS OF THE CITY OF MEDICINE ACADEMY (CMA). THE CMA IS A PUBLIC MAGNET HIGH SCHOOL DESIGNED FOR STUDENTS INTERESTED IN HEALTH CARE CAREERS. FACULTY ARE INVOLVED WITH MENTORING STUDENTS AND CLASSROOM LECTURES. IN ADDITION, THE HEALTH SYSTEM CEO IS WORKING TO HELP THE CMA BECOME THE PREMIER HEALTH SCIENCE HIGH SCHOOL IN NORTH CAROLINA. DUHS IS A KEY PARTICIPANT IN THE ANNUAL BULL CITY FRESH START EVENT. STAFF FROM THE DUKE SCHOOL OF NURSING, DUKE EYE CENTER, AND STAFF AFFILIATED WITH LINCOLN COMMUNITY HEALTH CENTER HEALTHCARE FOR THE HOMELESS CLINIC VOLUNTEER TIME AND RESOURCES AT THIS IMPORTANT EVENT. STUDENTS FROM THE DUKE SCHOOLS OF MEDICINE AND NURSING ENGAGE COMMUNITIES IN DURHAM AND BEYOND IN ACTIVITIES THAT INCLUDE FREE BLOOD PRESSURE SCREENINGS FOR THE HOMELESS, AND IDENTIFYING THE HEALTH CARE NEEDS OF A LOW WEALTH COMMUNITY SCHOOL AND DEVELOPING A CURRICULUM FOR STUDENTS AND PARENTS THAT ADDRESSES THOSE NEEDS.COVID-19 RESPONSE:COVID-19 CONTINUED TO IMPACT OUR COMMUNITY'S HEALTH IN 2021. FORTUNATELY, VACCINATIONS TO PREVENT SERIOUS ILLNESS AND DEATH BECAME AVAILABLE. AT DUKE, WE VACCINATED 153,555 PATIENTS AND TEAM MEMBERS. FOR THE 5,765 PATIENTS WHO NEEDED COVID-19 TREATMENT AT DUKE HOSPITALS, WE COMMITTED OURSELVES TO ACHIEVING EQUITABLE HEALTH OUTCOMES. DUE TO THE IMPACT OF SYSTEMIC RACISM, PEOPLE OF COLOR ARE DISPROPORTIONATELY HOSPITALIZED WITH SEVERE CASES OF COVID-19. BUT ONCE WITHIN OUR WALLS, WE ENSURED THAT THERE WERE NO DISPARITIES IN CARE, TREATMENT, OR OUTCOME AMONG WHITE, AFRICAN AMERICAN, OR LATINX PATIENTS. AT DUKE WE ARE PROUD THAT PATIENTS WHO WERE HOSPITALIZED WITH COVID-19 RECEIVED THE HIGHEST QUALITY CARE.ALL THREE DUHS HOSPITALS PROVIDED EXTENSIVE OUTREACH, STAFFING AND RESOURCES TO ADVANCE EQUITABLE ACCESS TO COVID-19 TESTING AND THE DISTRIBUTION OF VACCINES. BETWEEN AUGUST OF 2020 AND MAY 2021, DUKE UNIVERSITY HEALTH SYSTEM (DUHS) SERVED AS LEAD ENTITY FOR REGION 3 OF THE NC DHHS COVID-19 SUPPORT SERVICES PROGRAM (SSP). LOCAL COMMUNITY BASED ORGANIZATIONS (CBOS) PROVIDED SERVICES ACROSS A 7 COUNTY REGION, INCLUDING DURHAM, FRANKLIN, GRANVILLE, NASH, VANCE, WAKE AND WARREN. DUHS CONTRACTED WITH NOT ONLY ORGANIZATIONS WITH THE BEST OVERALL REACH, BUT ALSO WITH THOSE WHO COULD GENERATE IMPACT WITHIN HIGHLY MARGINALIZED POPULATIONS (HMP) DISPROPORTIONALLY AFFECTED BY THE PANDEMIC. THE ACCOMPLISHMENTS WERE THE RESULT OF AN INTENTIONALITY OF PARTNERSHIPS MADE TO MOST EFFECTIVELY REACH THESE AREAS. AS OF THE PROGRAM'S CONCLUSION, OUR NETWORK OF CBOS SERVED OVER 14,500 FOOD BOXES, OVER 65,000 MEALS AND MORE THAN 13,000 PACKAGES OF COVID-19 SUPPLIES TO HOUSEHOLDS IN OUR 7 COUNTIES. ADDITIONALLY, NEARLY $4 MILLION IN RELIEF PAYMENTS WERE DISPERSED TO JUST UNDER 5,000 HOUSEHOLDS. IN TOTAL THE PROGRAM SERVED 8,199 UNIQUE HOUSEHOLDS REACHING APPROXIMATELY 35 THOUSAND INDIVIDUALS. SURVEY RESULTS INDICATED THAT 88% OF PARTICIPANTS WERE ABLE TO QUARANTINE SAFELY FROM COVID-19 AS A DIRECT RESULT OF THESE SERVICES.ADDITIONAL HOSPITAL-SPECIFIC COVID-19 COMMUNITY RESPONSE ACTIVITIES CAN BE FOUND IN THE RESPECTIVE HOSPITAL PART V, SECTION C SUPPLEMENTAL INFORMATION.AFFILIATED HEALTH CARE SYSTEM ROLES:PART VI, LINE 6:DUHS PROVIDES VIRTUALLY ALL LEVELS OF CARE BEGINNING WITH DUKE UNIVERSITY AFFILIATED PHYSICIANS (DBA DUKE PRIMARY CARE) (DPC). DPC IS A BROAD NETWORK OF COMMUNITY-BASED SERVICES THAT INCLUDE FAMILY MEDICINE, PEDIATRICS, INTERNAL MEDICINE, AND URGENT CARE. THE HOSPITALS PROVIDE ROUTINE INPATIENT AND OUTPATIENT CARE. IN DURHAM COUNTY, DUH AND DRH WORK TOGETHER TO MAXIMIZE FACILITY UTILIZATION PROVIDING ROUTINE AND ADVANCED LEVELS OF CARE. DUH ALSO OPERATES A TRAUMA CENTER WITH AIR AMBULANCE SERVICE. DRAH SERVES THE WAKE COUNTY AREA AS A COMMUNITY HOSPITAL. THE DRAH CAMPUS HAS SEVERAL MEDICAL OFFICE BUILDINGS ENHANCING CONVENIENCE FOR THE PATIENT IN NON-EMERGENT CASES AND PROVIDES STREAMLINED ACCESS TO HIGH-DEMAND PROCEDURES SUCH AS CARDIAC CATHETERIZATION AND RADIOLOGY PROCEDURES. DUHS CONTINUES TO EXPAND ITS AMBULATORY FOOTPRINT TO PROVIDE CARE CLOSE TO PATIENTS' HOMES, EXTEND ACCESS TO NEW COMMUNITIES AND MEET GROWING POPULATION NEEDS EFFICIENTLY AND EFFECTIVELY. DUHS' POPULATION HEALTH MANAGEMENT OFFICE WITHIN DUKE INTEGRATED NETWORK, INC. IS THE CENTRAL ENTITY AT DUKE GUIDING CARE TRANSFORMATION FOR VALUE BASED CARE, INCLUDING CARE MANAGEMENT PROGRAMS AND DEPLOYMENT OF RELATED DATA AND ANALYTICS PROGRAMS, AS WELL AS FOSTERING RELATIONSHIPS WITH PAYERS, COMMUNITY RESOURCES, AND PHYSICIANS WITHIN THE SERVICE AREA. DUHS ALSO OPERATES HOME HEALTH AND HOME INFUSION SERVICES TO TREAT AND CARE FOR PATIENTS IN THE COMFORT OF THEIR HOME. THIS IS OBVIOUSLY PRACTICAL FOR PATIENTS NOT REQUIRING AN INPATIENT STAY BUT IN NEED OF ONGOING CARE AT A SUB-ACUTE LEVEL. FINALLY, HOSPICE PROVIDES PALLIATIVE CARE FOR PATIENTS NOT RESPONDING TO CURATIVE CARE. PAIN MANAGEMENT, SYMPTOM MANAGEMENT, AND PSYCHOLOGICAL AND SPIRITUAL SUPPORT PROVIDE A ROUNDED APPROACH TO COMPASSIONATELY ASSIST TERMINAL PATIENTS AND THEIR FAMILIES WITH THE PROCESS OF DYING. ALL OF THE OPERATING UNITS OF DUHS WORK TOGETHER TO PROVIDE THE RIGHT LEVEL OF CARE FOR THE PATIENT IN THE MOST BENEFICIAL MANNER. IN ADDITION TO THE REACTIVE ACTIVITIES OF DIAGNOSTIC CARE, DUHS ALSO SUPPORTS AND PROMOTES HEALTH AND WELL-BEING AT DUKE HEALTH & FITNESS CENTER, AND DUKE INTEGRATIVE MEDICINE. THESE SERVICES INCLUDE A MEDICALLY-BASED WEIGHT LOSS PROGRAM, MEDICALLY-BASED FITNESS, WELLNESS AND REHABILITATION PROGRAMS.LIST OF ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT:PART VI, LINE 7:NORTH CAROLINA
Schedule H (Form 990) 2020
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