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
2021
Open to Public Inspection
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number

51-0103684
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
 
No
%
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

 

No
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
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
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) . . .
    12,352,059 0 12,352,059 0.510 %
b Medicaid (from Worksheet 3, column a) . . . . .     330,715,188 279,072,889 51,642,299 2.140 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     343,067,247 279,072,889 63,994,358 2.650 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 47 54,089 13,247,640 3,495,300 9,752,340 0.400 %
f Health professions education (from Worksheet 5) . . . 6 1,184 77,095,486 13,670,295 63,425,191 2.620 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) . 1   19,249,661 15,552,330 3,697,331 0.150 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 9   1,567,905 0 1,567,905 0.070 %
j Total. Other Benefits . . 63 55,273 111,160,692 32,717,925 78,442,767 3.240 %
k Total. Add lines 7d and 7j . 63 55,273 454,227,939 311,790,814 142,437,125 5.890 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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 1   85,000 0 85,000  
2 Economic development 2   42,363 0 42,363  
3 Community support 1   105,374 0 105,374 0.010 %
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building 1   5,672 0 5,672  
7 Community health improvement advocacy            
8 Workforce development 1   212,410 0 212,410 0.010 %
9 Other            
10 Total 6   450,819 0 450,819 0.020 %
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
19,560,265
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
1,084,122
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
518,092,905
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
628,301,557
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-110,208,652
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) 2021
Schedule H (Form 990) 2021
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?2Name, 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 and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 CHRISTIANA HOSPITAL
4755 OGLETOWN-STANTON ROAD
NEWARK,DE19718
www.christianacare.org
LICENSE #HSPTL-002
X X   X   X X     A
2 WILMINGTON HOSPITAL
501 WEST 14TH STREET
WILMINGTON,DE19801
www.christianacare.org
LICENSE #HSPTL-001
X X   X   X X     A
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
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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)
A-CHRISTIANA AND WILMINGTON 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):
12
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 21
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 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
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) 2021
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Schedule H (Form 990) 2021
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Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A-CHRISTIANA AND WILMINGTON 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
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
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Part VFacility Information (continued)

Billing and Collections
A-CHRISTIANA AND WILMINGTON 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) 2021
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Schedule H (Form 990) 2021
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Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A-CHRISTIANA AND WILMINGTON 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   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
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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
PART V, SECTION B, LINE 5 (INPUT FROM COMMUNITY) CHRISTIANACARE'S OFFICE OF HEALTH EQUITY SOUGHT THE PARTICIPATION OF A BROAD ARRAY OF INDIVIDUALS TO INFORM THE 2022 CHNA. THIS WAS AN IMPORTANT ASPECT OF THE CHNA PROCESS THAT ALLOWED US TO EXEMPLIFY THE CHRISTIANACARE WAY: WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE, AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. EFFECTIVELY SERVING OUR COMMUNITIES REQUIRES US TO LISTEN AND LEARN SO THAT WE CAN PROVIDE OUR COMMUNITIES WITH WHAT IS IMPORTANT TO THEM. THE CHNA IS A WELCOME OPPORTUNITY TO EXAMINE WHETHER WE ARE MEETING THE NEEDS OF THOSE WE SERVE. WHEN COMPLETING THIS AND PRIOR CHNAS, OUR INTENTION WAS TO HEAR DIRECTLY FROM COMMUNITY MEMBERS AND STAKEHOLDERS. WHILE UNDERTAKING THE 2022 CHNA, COVID-19 CASES WERE REACHING A NEW PEAK IN OUR STATE AND CHRISTIANACARE WAS FORCED TO ISSUE CRISIS STANDARDS OF CARE FOR THE FIRST TIME IN ITS HISTORY. BECAUSE OF THIS, WE DECIDED TO HOST VIRTUAL COMMUNITY MEETINGS TO RECEIVE COMMUNITY INPUT TO PREVENT INCREASED COMMUNITY TRANSMISSION OF COVID-19. OUR PREFERRED FORMAT WOULD HAVE BEEN MEETINGS HELD IN THE COMMUNITY AT ACCESSIBLE LOCATIONS TO PROMOTE COMMUNITY PARTICIPATION, BUT SAFETY HAD TO BE PRIORITIZED. IN ADDITION TO THE COMMUNITY MEETINGS, WE ALSO CONDUCTED INTERVIEWS WITH THE CABINET SECRETARY AND DEPUTY SECRETARY FOR DELAWARE HEALTH AND SOCIAL SERVICES AND THE DIRECTOR FOR THE DELAWARE DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH TO GAIN THEIR PERSPECTIVES ON THE HEALTH OF OUR COMMUNITIES. WE ARE GRATEFUL FOR THE PARTICIPATION OF ALL THOSE WHO SHARED THEIR EXPERIENCE AND PROVIDED INPUT. ALL COMMUNITY MEETINGS FOLLOWED THE SAME FORMAT. SECONDARY DATA WERE PRESENTED INCLUDING A SUMMARY OF UNFAVORABLE COMMUNITY HEALTH INDICATORS. PARTICIPANTS WERE ASKED TO PROVIDE FEEDBACK ON THE SECONDARY DATA ANALYSIS AND IDENTIFY COMMUNITY HEALTH ISSUES THAT WERE MISSING FROM THE DATA. TO CONCLUDE, ALL PARTICIPANTS WERE ASKED TO COMPLETE AN ONLINE SURVEY AND TO IDENTIFY THREE TO FIVE COMMUNITY HEALTH ISSUES THEY CONSIDER TO BE MOST SIGNIFICANT. IN TOTAL, 35 INDIVIDUALS WHO REPRESENTED ORGANIZATIONS INCLUDING DELAWARE HEALTH AND SOCIAL SERVICES, NON-PROFIT ORGANIZATIONS, LOCAL BUSINESSES, HEALTHCARE PROVIDERS, LOCAL POLICYMAKERS, AND SCHOOL SYSTEMS PARTICIPATED IN FOUR VIRTUAL COMMUNITY STAKEHOLDER MEETINGS. THE 2022 CHNA ALSO INCLUDED THE INPUT OF YOUNG DELAWAREANS. CHRISTIANACARE CAREGIVERS WHO PROVIDE REPRODUCTIVE HEALTH EDUCATION TO ADOLESCENTS IN SCHOOLS THROUGHOUT THE STATE PROVIDED THE SECONDARY DATA PRESENTATION TO 110 STUDENTS PARTICIPATING IN THEIR CLASSES AT WILLIAM PENN HIGH SCHOOL IN NEW CASTLE. WE SOUGHT INPUT FROM AND WANTED TO HEAR FROM YOUNG PEOPLE BECAUSE THEY MAKE UP A SIGNIFICANT PART OF OUR COMMUNITY. FINALLY, 45 CHRISTIANACARE CAREGIVERS WHO REPRESENTED ADMINISTRATION, NURSING, CASE MANAGEMENT, SOCIAL SERVICES, PROJECT MANAGEMENT, AND HEALTH EQUITY DEPARTMENTS PARTICIPATED IN AN ADDITIONAL TWO VIRTUAL MEETINGS. WE PROVIDED THEM WITH INFORMATION ABOUT THE CHALLENGES OUR COMMUNITY IS FACING AND GAINED THEIR PERSPECTIVE BASED ON THEIR EXPERIENCES SERVING OUR COMMUNITY. AT CHRISTIANACARE, ALL EMPLOYEES ARE REFERRED TO AS CAREGIVERS REGARDLESS OF THEIR POSITION. THROUGHOUT THIS SECTION, WE WILL REFER TO CAREGIVERS AS OPPOSED TO EMPLOYEES OR STAFF. CHRISTIANACARE CONTRACTED WITH VERIT HEALTHCARE CONSULTING, LLC (VERIT) TO COMPLETE ITS 2022 CHNA. IN COOPERATION WITH CHRISTIANACARE'S OFFICE OF HEALTH EQUITY, VERIT CONDUCTED THE RESEARCH, PRIMARY AND SECONDARY DATA COLLECTION, REVIEW, AND ANALYSIS, TO DEVELOP THE CHNA. -------------------- PART V, SECTION B, LINE 6 (JOINT CHNA) CHRISTIANACARE'S TWO HOSPITAL FACILITIES IN DELAWARE, CHRISTIANA HOSPITAL AND WILMINGTON HOSPITAL, JOINTLY CONDUCTED THEIR CHNA. -------------------- PART V, SECTION B, LINE 7 (CHNA PUBLIC AVAILABILITY) CHRISTIANACARE'S CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/ A PAPER COPY OF THE CHNA IS ALSO AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. -------------------- PART V, SECTION B, LINE 10 (IMP. PLAN PUBLIC AVAILABILITY) CHRISTIANACARE'S CHIP IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY-HEALT H-IMPLEMENTATION-PLAN/ A PAPER COPY OF THE CHIP IS ALSO AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. --------------------
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) IN THE MOST RECENT CHNA, FINALIZED IN JUNE 2022, CHRISTIANACARE IDENTIFIED THE FOLLOWING AS THE COMMUNITY'S MOST SIGNIFICANT NEEDS: - ACCESS TO HEALTH SERVICES - CHRONIC HEALTH CONDITIONS - MATERNAL AND CHILD HEALTH - MENTAL HEALTH AND SUBSTANCE USE DISORDERS - SOCIAL DETERMINANTS OF HEALTH - VIOLENT CRIME CHRISTIANACARE WILL ADDRESS ALL THESE SIGNIFICANT AREAS OF NEED. EXCEPT FOR THE NEWLY ADDED CHRONIC HEALTH CONDITIONS, THESE NEEDS WERE ALSO PRIORITIZED IN 2019. WE WILL CONTINUE TO ADDRESS THESE NEEDS THROUGH PROGRAMMING WE HAVE CREATED, ADAPTED, AND EXPANDED SINCE OUR 2019 CHNA. WHILE UNDERTAKING THIS CHNA, WE WERE FORTUNATE TO LEARN FROM MANY HIGH SCHOOL STUDENTS ABOUT WHAT THEY CONSIDERED TO BE SIGNIFICANT AREAS OF NEED. THE SIGNIFICANT AREAS OF NEED THAT THEY SELECTED MIRRORED THE SELECTIONS OF THE ADULTS WHO PARTICIPATED, WITH TWO ADDITIONAL SIGNIFICANT AREAS OF NEED IDENTIFIED BY MANY OF THE STUDENTS: SEXUALLY TRANSMITTED INFECTIONS AND SMOKING, TOBACCO, AND VAPE PRODUCT USE. CHRISTIANACARE ADDRESSES BOTH THESE AREAS IN ITS SCHOOL-BASED HEALTH CENTERS AND SINCE 1995 HAS BEEN THE RECIPIENT OF A STATE GRANT TO OPERATE THE ALLIANCE FOR ADOLESCENT PREGNANCY PREVENTION (AAPP). AAPP PROVIDES EDUCATION TO STUDENTS THROUGHOUT DELAWARE TO REDUCE THE NUMBER OF TEENS WHO ARE SEXUALLY ACTIVE, CONTRACT AND SPREAD SEXUALLY TRANSMITTED INFECTIONS, BECOME PREGNANT AND BECOME TEEN PARENTS. WHILE WE WILL NOT PRIORITIZE THESE ADDITIONAL AREAS OF NEED IDENTIFIED BY THE TEENS, WE WILL CONTINUE TO ADDRESS THEM THROUGH DIRECT INTERACTION WITH STUDENTS IN THE SCHOOL-BASED HEALTH CENTERS AND THROUGH AAPP PROGRAMMING. ACCESS TO HEALTH SERVICES ON JUNE 2, 2022, THE CHRISTIANACARE BOARD APPROVED A NEW 5-YEAR STRATEGIC PLAN FOR IMPLEMENTATION, WHICH IDENTIFIES OUR ASPIRATIONS, GOALS AND IMPERATIVES. ONE OF THE ASPIRATIONS IS TO RADICALLY SIMPLIFY ACCESS. TO ACCOMPLISH THIS, WE WILL LOOK TO DIGITAL SOLUTIONS TO EASE ACCESS AND REDUCE ADMINISTRATIVE BURDEN AND WORK TOWARDS DEVELOPING A PLAN TO REDUCE ACCESS BARRIERS RELATED TO OUT-OF-POCKET EXPENSE BY USING AUTOMATED PROCESSES. WE ARE COMMITTED TO MAKING CARE MORE CONVENIENT AND AFFORDABLE FOR OUR PATIENTS WHICH WE EXPECT TO IMPROVE ACCESS. WE ALSO RECOGNIZE THAT DIGITAL SOLUTIONS ALONE WILL NOT IMPROVE ACCESS FOR ALL. COMMUNITY-BASED SERVICES REMAIN VITAL TO THE HEALTH OF OUR COMMUNITIES ALONG WITH FINDING INNOVATIVE WAYS TO DELIVER THESE SERVICES. THROUGHOUT THIS NARRATIVE, WE WILL SHARE THE INNOVATIVE WAYS WE ARE SERVING OUR COMMUNITY BY PROVIDING RADICALLY CONVENIENT SERVICE. IN JUNE 2022, CHRISTIANACARE INTRODUCED ITS TWO MOBILE HEALTH SERVICES VANS IN A RIBBON CUTTING CEREMONY IN WILMINGTON'S SOUTHBRIDGE NEIGHBORHOOD. SOUTHBRIDGE IS LOCATED IN THE 19801 ZIP CODE, AN AREA OF HIGH NEED, AND A NEIGHBORHOOD THAT WE INTEND TO CONTINUE TO SERVE THROUGH MOBILE HEALTH SERVICES. THE VANS ARE SUPPORTED BY BARCLAYS WITH A $1 MILLION INVESTMENT AS PART OF ITS COVID-19 COMMUNITY AID PACKAGE. MOBILE HEALTH SERVICES WILL ALLOW US TO BRING CARE TO OUR NEIGHBORS WHO MAY HAVE DIFFICULTY ACCESSING CARE OTHERWISE. IMPORTANTLY, RECEIVING CARE ON THE VAN WILL NOT BE A ONE-TIME EVENT, BUT THE START OF A RELATIONSHIP THAT WILL HELP AN INDIVIDUAL IMPROVE THEIR HEALTH AND WELLNESS. IN SERVICE TO THAT EXPECTATION, WE ARE BEING INTENTIONAL ABOUT WHERE WE PROVIDE MOBILE HEALTH SERVICES. WHILE WE EXPECT TO PROVIDE ONE-TIME SERVICES LIKE VACCINATIONS AND SCREENINGS ON THE VANS, WE WILL ALSO SELECT COMMUNITY LOCATIONS WHERE THE VANS WILL BE REGULARLY STATIONED TO PROVIDE ONGOING PRIMARY CARE AND ACCESS TO SPECIALTY CARE FOR OUR NEIGHBORS. THE COMPLEX CARE AND COMMUNITY MEDICINE DEPARTMENT IS WORKING CLOSELY WITH THE COMMUNITY HEALTH DEPARTMENT TO IDENTIFY AREAS IN THE COMMUNITY WHERE THE VANS SHOULD GO AND THE COMMUNITY ORGANIZATIONS THAT CAN BE PARTNERED WITH TO HOST THE VANS. COMMUNITY PARTNERSHIPS ARE NECESSARY TO ENSURE WE ARE BRINGING SERVICES TO THE COMMUNITY THAT ARE WANTED, NEEDED, AND USED. IT IS ALSO OUR FIRMLY HELD BELIEF THAT COMMUNITY PARTNERSHIPS WILL ENABLE US AND OUR PARTNERS TO BETTER ADDRESS THE VARIED NEEDS OF THOSE WE SERVE. FOR MOST OF FY2022, THE VANS WERE BEING OUTFITTED TO SERVE AS PRACTICES ON WHEELS. IN THE EARLY MONTHS OF FY2023, THE FOCUS HAS BEEN ON DETERMINING WHERE THE VANS SHOULD BE IN THE COMMUNITY AND AT WHAT CADENCE. THE VANS HAVE PROVIDED SERVICES AT A HANDFUL OF COMMUNITY LOCATIONS OVER THE LAST SEVERAL MONTHS AND SINCE NOVEMBER 2022, ONE VAN HAS BEEN ROUTINELY STATIONED OUTSIDE OF THE WILMINGTON HOSPITAL, ALSO LOCATED IN THE HIGH-NEED 19801 ZIP CODE. THIS HAS SERVED AS A FIRST OPPORTUNITY TO PROVIDE PRIMARY CARE SERVICES ON THE VAN. TWO PRIMARY CARE PRACTICES LOCATED IN WILMINGTON HOSPITAL HAVE BEEN SENDING OVERFLOW PATIENTS TO THE VAN WHEN NECESSARY TO ENSURE ACUTE PATIENTS ARE SEEN. WE ARE ALSO PLEASED TO REPORT THAT ON A FEW OCCASIONS, INDIVIDUALS WALKING PAST THE VAN, WITH NO INTENTION OF SEEING A PHYSICIAN, HAVE ENDED UP RECEIVING SERVICES IN THE VAN BECAUSE THEY STOPPED TO TALK WITH THE CAREGIVERS, SHARED HEALTH CONCERNS, AND WERE GIVEN THE OPPORTUNITY TO BE SEEN RIGHT THEN AND THERE. THIS IS EXACTLY THE TYPE OF CONVENIENCE AND MOTIVATION TO ADDRESS HEALTH CONCERNS WE WANT TO PROVIDE OUR NEIGHBORS THROUGH OUR MOBILE HEALTH SERVICES.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) IN ANOTHER EXAMPLE OF PROVIDING RADICAL CONVENIENCE, CHRISTIANACARE OPERATES 23 SCHOOL-BASED HEALTH CENTERS (SBHCS) THROUGHOUT NEW CASTLE COUNTY IN ELEMENTARY, MIDDLE, AND HIGH SCHOOLS. SBHCS OFFER CONVENIENT ACCESS TO HEALTH CARE FOR STUDENTS AND PROVIDE THE OPPORTUNITY TO ADDRESS HEALTH ISSUES AT THE EARLIEST AND MOST PREVENTABLE STAGES. BY VIRTUE OF THEIR ACCESSIBILITY, SBHCS ALSO ADVANCE HEALTH EQUITY IN THE COMMUNITY. IN FY2022, OUR SBHCS SERVED 29,890 STUDENTS AND WE EXPECT THIS NUMBER TO INCREASE AS CHRISTIANACARE HAS OPENED TWO NEW SBHCS IN KUUMBA ACADEMY CHARTER SCHOOL IN WILMINGTON AND ODESSA HIGH SCHOOL IN SOUTHERN NEW CASTLE COUNTY. INACCESSIBLE OR NON-EXISTENT MENTAL HEALTH SERVICES IS A NATIONAL CONCERN THAT IS ALSO HELD AMONG DELAWAREANS. BOTH ADULT AND TEENAGE PARTICIPANTS IN THE 2022 CHNA COMMUNITY MEETINGS IDENTIFIED MENTAL HEALTH AS THE MOST SIGNIFICANT AREA OF NEED IN NEW CASTLE COUNTY. IN RESPONSE TO THE NEED WE ARE SEEING IN THE COMMUNITY, PARTICULARLY AMONG OUR YOUTH, CHRISTIANACARE HAS PRIORITIZED EXPANDING BEHAVIORAL HEALTH SERVICES IN SBHCS IN FY2023. PROVIDING YOUTH WITH THE SERVICES AND THE TOOLS TO ADDRESS THEIR MENTAL HEALTH NEEDS EARLY WILL HELP PREVENT MORE SIGNIFICANT MENTAL HEALTH ISSUES AS THEY GROW OLDER. NEARLY A DECADE AGO, CHRISTIANACARE RECEIVED A GRANT TO HIRE MARKETPLACE GUIDES WHO WOULD ASSIST UNINSURED INDIVIDUALS IN ENROLLING IN THE HEALTH INSURANCE MARKETPLACE. IN THE YEARS SINCE, THAT WORK HAS TRANSFORMED INTO OUR HEALTH GUIDE PROGRAM BASED IN THE WILMINGTON HOSPITAL. THE HEALTH GUIDES CONNECT PATIENTS TO HEALTH CARE SERVICES AND COMMUNITY RESOURCES, AS WELL AS ASSIST WITH HEALTH INSURANCE ENROLLMENT AND PRESCRIPTION ASSISTANCE. IN FY2022, CHRISTIANACARE EXPANDED THE HEALTH GUIDE PROGRAM BY HIRING TWO NEW BILINGUAL HEALTH GUIDES TO SERVE ON-SITE AT TWO ADDITIONAL CHRISTIANACARE PRIMARY CARE PRACTICES, CHRISTIANACARE'S SU CENTRO DE SALUD, WITH PRIMARY CARE AT KIRKWOOD LOCATED IN WILMINGTON AND THE MEDICAL ARTS PAVILION (MAP) LOCATED ON THE NEWARK CAMPUS. THESE ADDITIONAL HEALTH GUIDES WILL ENSURE MORE INDIVIDUALS ARE HELPED IN ACCESSING NEEDED RESOURCES TO RECEIVE CARE AND THAT THOSE WHOSE PRIMARY LANGUAGE IS SPANISH WILL HAVE AN EASIER TIME ACCESSING THOSE SERVICES. IN FY2022, 1,433 INDIVIDUALS RECEIVED ASSISTANCE FROM THE HEALTH GUIDES. THE HEALTH GUIDES ALSO CONNECT PATIENTS TO THE MEDICAL LEGAL PARTNERSHIP (MLP), A COLLABORATION WITH THE DELAWARE COMMUNITY LEGAL AID SOCIETY, INC. (CLASI) WHICH ASSISTS PATIENTS WITH THE MITIGATION OF CIVIL LEGAL HARDSHIPS. CHRISTIANACARE HAS CONTRACTED WITH CLASI SINCE 2015 TO HELP PATIENTS ADDRESS THEIR CIVIL LEGAL NEEDS IN AREAS SUCH AS SAFE HOUSING, PREVENTION OF SUBSIDIZED AND PUBLIC HOUSING EVICTIONS, ASSISTANCE OBTAINING OR PRESERVING INCOME MAINTENANCE AND GOVERNMENT BENEFITS, ACCESS TO SOCIAL SERVICES, APPROPRIATE EDUCATIONAL SERVICES, HEALTH INSURANCE AND ACCESS TO HEALTH CARE. UNDERSTANDABLY, THESE ISSUES PREVENT PATIENTS FROM BEING ABLE TO OBTAIN OR FOCUS ON THEIR HEALTHCARE. WITH THE RESOLUTION OF THESE BARRIERS, PATIENTS CAN PRIORITIZE THEIR HEALTH. THIS PARTNERSHIP HAS BECOME EVEN MORE CRUCIAL SINCE THE PANDEMIC, WHICH HAS EXACERBATED THE INEQUITIES ALREADY FELT BY LOW-INCOME COMMUNITIES IN THE AREAS THE MLP IS ABLE TO REMEDIATE. IN FY2022, 153 PRIMARY CARE PATIENTS WERE REFERRED TO THE MLP WITH 172 DISCRETE LEGAL MATTERS. MOST OF THESE PATIENTS WERE FEMALE WITH CLOSE TO HALF IDENTIFYING AS BLACK OR HISPANIC. THE AVERAGE INCOME OF REFERRED PATIENTS WAS AT 65 PERCENT OF THE FEDERAL POVERTY LEVEL AND ALMOST 50 PERCENT OF THE REFERRED PATIENTS LIVED IN THE CITY OF WILMINGTON. CHRISTIANACARE CONTINUES TO PARTNER WITH CLASI TO PROVIDE THIS SERVICE TO PATIENTS. THE COMMUNITY HEALTH WORKER (CHW) PROGRAM, LIKE THE HEALTH GUIDES AND THE MLP, IS COMMITTED TO HELPING PATIENTS OVERCOME BARRIERS TO GOOD HEALTH. EVEN WHEN PATIENTS ARE CONNECTED TO CARE, OTHER HARDSHIPS IN THEIR LIVES OR CHALLENGES IN COORDINATING COMPLEX MEDICAL CARE CAN DETER ACCESS. THE CHWS SERVE TO PROVIDE THE EMOTIONAL AND INSTRUMENTAL SUPPORT TO HELP PATIENTS OVERCOME THOSE CHALLENGES. CHWS MEET PATIENTS IN THEIR HOMES TO HELP THEM ORGANIZE THEIR MEDICATION OR LEARN A RECIPE; AT THE GYM TO WORK OUT; OR AT THE SOCIAL SECURITY OFFICE TO FILL OUT FORMS. CHWS PROMOTE ACCESS TO HEALTH SERVICES NOT ONLY BY HELPING PATIENTS ADDRESS THEIR HEALTH NEEDS, BUT ALSO BY VIRTUE OF THEIR ACCESSIBILITY. CHRISTIANACARE CHWS SERVE DIFFERENT POPULATIONS WITH AN EVIDENCE-BASED APPROACH. ALL CHWS RECEIVE TRAINING THROUGH PENN MEDICINE'S IMPACT (INDIVIDUALIZED MANAGEMENT FOR PATIENT CENTERED TARGET) MODEL. THE CHWS WORK TO IMPROVE HEALTH OUTCOMES BY ADDRESSING SOCIAL NEEDS, HELPING PATIENTS TO IDENTIFY AND ACHIEVE PATIENT-CENTERED GOALS, AND CONNECTING PATIENTS TO CARE. SUMMARIES OF THE CHW PROGRAMS WILL BE PROVIDED IN THIS SECTION, AND AS WILL BE DEMONSTRATED, OUR CHW INITIATIVE ALSO ADDRESSES OTHER PRIORITIZED AREAS OF NEED. CHRISTIANACARE'S CHWS ARE A BEDROCK OF THE STRATEGY WE EMPLOY TO SUPPORT OUR COMMUNITY. IT EXEMPLIFIES OUR COMMITMENT TO RADICAL ACCESS AND PARTNERING WITH OUR PATIENTS. IN FY2022, OUR CHW INITIATIVE GREW CONSIDERABLY WITH THE ADDITION OF BEHAVIORAL HEALTH, MEDICAID ENGAGEMENT, AND SOCIAL DETERMINANTS OF HEALTH CHWS. BEHAVIORAL HEALTH CHWS CHRISTIANACARE LAUNCHED THE BEHAVIORAL HEALTH CHW PROGRAM IN OCTOBER 2021, WHICH ASSISTS PATIENTS IN INCREASING THEIR INDEPENDENCE AND RESILIENCE. THE 4 BEHAVIORAL HEALTH CHWS ARE EMBEDDED WITHIN CHRISTIANACARE OUTPATIENT BEHAVIORAL HEALTH PRACTICES TO SUPPORT CHILDREN AND ADOLESCENTS AS WELL AS ADULTS WITH MENTAL HEALTH AND/OR SUBSTANCE USE DIAGNOSES FOR UP TO 6 MONTHS. IN FY22, 137 PATIENTS, INCLUDING 40 CHILDREN/ADOLESCENTS, WORKED WITH THESE CHWS.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) EMERGENCY DEPARTMENT CHWS CHRISTIANACARE'S EMERGENCY DEPARTMENT CHW PROGRAM LAUNCHED IN FEBRUARY 2021. EMBEDDED IN THE WILMINGTON HOSPITAL'S EMERGENCY DEPARTMENT, THIS 3-MONTH PROGRAM DELIVERS EPISODIC CARE TO THOSE PATIENTS THAT FREQUENT THE EMERGENCY DEPARTMENT (2 OR MORE VISITS IN THE PRIOR 90 DAYS). THE 2 EMERGENCY DEPARTMENT CHWS MEET PATIENTS AT BEDSIDE AND IN THE COMMUNITY TO CONNECT THE PATIENTS WITH RESOURCES AND PRIMARY CARE AND LONG-TERM SUPPORT. IN FY2022, THIS PROGRAM SERVED 60 INDIVIDUALS. MEDICAID ENGAGEMENT CHWS LAUNCHED IN JUNE 2021, MEDICAID ENGAGEMENT AIMS TO REACH PATIENTS THROUGHOUT THE STATE WHO ARE NEWLY ENROLLED IN DELAWARE MEDICAID TO CONNECT THEM TO PRIMARY CARE SERVICES AND COMMUNITY RESOURCES THAT ADDRESS THEIR SOCIAL DETERMINANTS OF HEALTH. IN FY22, 4 MEDICAID ENGAGEMENT CHWS ATTEMPTED OUTREACH TO 746 PATIENTS. OF THOSE, 98 PATIENTS SCHEDULED A PRIMARY CARE APPOINTMENT, AND 19 PATIENTS UPDATED THEIR PAYER. PRIMARY CARE CHWS CHRISTIANACARE'S PRIMARY CARE CHWS ENGAGE PATIENTS WITH DIABETES, HYPERTENSION, AND/OR HIGH EMERGENCY DEPARTMENT UTILIZATION IN PRIMARY CARE SERVICES. THE 7 PRIMARY CARE CHWS ARE EMBEDDED WITHIN 6 PRIMARY CARE PRACTICES TO DELIVER SERVICES IN A 6-MONTH PROGRAM TO ADULTS WITH MEDICAID INSURANCE. IN FY2022, A PRIMARY CARE CHW BEGAN SERVING A NEW CHRISTIANACARE PRACTICE, SU CENTRO DE SALUD, WITH PRIMARY CARE AT KIRKWOOD AND A SECOND CHW WAS HIRED FOR THE WILMINGTON ADULT MEDICINE PRACTICE TO MEET PATIENT NEED MORE ADEQUATELY. CHWS WERE ALSO TRAINED TO ASSIST PATIENTS WITH SELF-MONITORED BLOOD PRESSURE READINGS. IN TOTAL, 240 PATIENTS WERE SERVED BY THE PRIMARY CARE CHWS IN FY2022. SOCIAL DETERMINANTS OF HEALTH CHWS CHRISTIANACARE'S SOCIAL DETERMINANTS OF HEALTH (SDOH) CHW PROGRAM LAUNCHED IN NOVEMBER 2021. IT WAS DESIGNED TO IMPROVE HEALTH OUTCOMES AND REDUCE LONGSTANDING DISPARITIES IN HEALTH. THIS PROGRAM INCLUDES A?FOCUS ON SCREENING FOR SOCIAL DETERMINANTS OF HEALTH TO IDENTIFY AND ADDRESS THE BARRIERS TO HEALTHCARE. AFTER STEADY EXPANSION DURING FY2022, THERE ARE NOW 4 SDOH CHWS EMBEDDED AT FOUR PRIMARY CARE PRACTICES. THE SDOH CHWS CONDUCT IN-DEPTH PATIENT INTERVIEWS AND SCREENINGS AT PRIMARY PRACTICES FOR PRE-APPOINTMENT PREPARATION AND ANNUAL APPOINTMENTS. THEY IDENTIFY SOCIAL CARE NEEDS AND CONNECT PATIENTS TO COMMUNITY RESOURCES. IN FY2022, 120 PATIENTS WERE SCREENED USING CHRISTIANACARE'S SDOH SCREENING TOOL AND 120 PATIENTS WERE ENROLLED INTO THE SDOH CHW PROGRAM. WOMEN'S HEALTH CHWS CHRISTIANACARE'S WOMEN'S HEALTH CHWS SEEK TO REMOVE BARRIERS TO CARE AND CONNECT PATIENTS TO RESOURCES TO PROMOTE POSITIVE MATERNAL AND INFANT BIRTH OUTCOMES. FIVE WOMEN'S HEALTH CHWS ARE EMBEDDED THROUGHOUT CHRISTIANACARE'S WOMEN'S HEALTH SERVICES INCLUDING INPATIENT, OUTPATIENT, OBSTETRICS (OB) TRIAGE, AND THE NEONATAL INTENSIVE CARE UNIT (NICU). WOMEN'S HEALTH CHWS SERVE PATIENTS OF ALL AGES THROUGHOUT NEW CASTLE AND KENT COUNTY THAT ARE UNINSURED, INSURED WITH MEDICAID, OR ARE MEDICAID-ELIGIBLE WITH ONE OR MORE OF THE FOLLOWING CONDITIONS: CHRONIC DISEASE, MENTAL HEALTH AND/OR SUBSTANCE USE ISSUE(S), LATE OR NO ENTRY TO PRENATAL CARE, HISTORY OF POOR BIRTH OUTCOMES, BMI AT/ABOVE 30, OR ARE AT-RISK FOR BIRTH DEFECTS. SERVICE DELIVERY CONSISTS OF EPISODIC AND LONGITUDINAL CARE DURING THE PERINATAL PERIOD. IN FY2022, THE PROGRAM EXPANDED TO SERVE THE NICU AND OB TRIAGE SERVICES. IN TOTAL, 126 PATIENTS WERE SERVED IN FY2022. SCHOOL-BASED HEALTH CENTER CHWS SEVEN CHWS ARE EMBEDDED WITHIN 21 SCHOOL-BASED HEALTH CENTERS (SBHC) OPERATED BY CHRISTIANACARE. THE CHWS SERVED 1073 STUDENTS IN FY2022 BY CONNECTING THEM AND THEIR FAMILY TO NEEDED RESOURCES SUCH AS CLOTHING, FOOD, TRANSPORTATION, AND UTILITY ASSISTANCE. THEY ALSO ASSISTED STUDENTS IN MEETING THEIR HEALTH NEEDS THROUGH CONNECTION TO PRIMARY CARE PRACTICES, DENTAL SERVICES, AND EYE CARE AS WELL AS HELPING TO ENROLL THEM IN HEALTH INSURANCE. OBTAINING HEALTH INSURANCE WAS THE MOST PROVIDED SERVICE FOLLOWED BY CONNECTION TO A PRIMARY CARE PROVIDER. PEDIATRIC CARE CENTER CHRISTIANACARE ALSO MADE A SIGNIFICANT INVESTMENT TO BETTER SERVE CHILDREN AND THEIR FAMILIES BY OPENING A NEW 14 BED PEDIATRIC CARE CENTER LOCATED IN THE NEWARK CAMPUS. LAUNCHED IN OCTOBER 2021, THE CENTER PROVIDES 24/7 COMBINED SHORT-STAY INPATIENT AND EMERGENCY CARE FOR CHILDREN AND TEENS. THE PEDIATRIC CARE CENTER WILL SIGNIFICANTLY IMPROVE ACCESS TO CARE FOR CHILDREN IN NEW CASTLE COUNTY. DENTAL SERVICES ACCESSING DENTAL SERVICES IS ALSO CHALLENGING FOR MANY COMMUNITY MEMBERS AND CHRISTIANACARE HAS LONG WORKED TO ADDRESS THIS NEED. IN JANUARY 2021, CHRISTIANACARE COMPLETED A TWO-YEAR RENOVATION PROJECT THAT INCREASED THE CLINICAL CAPACITY OF OUR DENTISTRY AND ORAL-MAXILLOFACIAL SURGERY PRACTICES. THE SUCCESS OF THIS EXPANSION WAS SHOWN IN FY2022 WITH A RECORD HIGH NUMBER OF VISITS. CHRISTIANACARE'S DENTAL CLINIC HAS PROVIDED COMPREHENSIVE CARE, INCLUDING ORAL SURGERY, FOR UNINSURED AND UNDERINSURED INDIVIDUALS THROUGHOUT DELAWARE FOR OVER SIXTY YEARS. EVERY FRIDAY, THE DENTAL CLINIC SERVES UNINSURED PEDIATRIC PATIENTS. FEES AT THE CLINIC ARE KEPT AT A REDUCED LEVEL AND ONLY MEDICAID IS ACCEPTED. ANNUALLY, 11,000 PATIENTS ARE SEEN AT THIS CLINIC BY DENTAL RESIDENTS AND VOLUNTEER AND EMPLOYED DOCTORS. THE RESIDENTS SERVING THE DENTAL CLINIC ALSO PROVIDE DENTAL SERVICE IN THE COMMUNITY THROUGH ROTATIONS AT AFFILIATED DENTAL CLINICS AT WESTSIDE FAMILY HEALTHCARE AND DELAWARE TECHNICAL COMMUNITY COLLEGE. CHRISTIANACARE DENTAL RESIDENTS ALSO PROVIDE COMMUNITY OUTREACH. IN APRIL 2022, DENTAL RESIDENTS PROVIDED MOUTH AND THROAT CANCER SCREENINGS ON TWO SEPARATE OCCASIONS AT THE SUNDAY BREAKFAST MISSION. THE SUNDAY BREAKFAST MISSION, LOCATED IN WILMINGTON IN THE 19801 ZIP CODE, PROVIDES EMERGENCY SHELTER TO MEN, WOMEN, AND CHILDREN. CHRISTIANACARE ROUTINELY PARTNERS WITH THIS ORGANIZATION TO PROVIDE SERVICES TO ITS GUESTS. IN APRIL 2022, 53 INDIVIDUALS WERE SCREENED AND FOR THOSE THAT REQUIRED FOLLOW-UP, AN APPOINTMENT WAS SCHEDULED FOR THEM AT THE DENTAL CLINIC.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) CHRONIC HEALTH CONDITIONS IN OUR 5-YEAR STRATEGIC PLAN, CHRISTIANACARE ADOPTED THE ASPIRATION OF ENDING DISPARITIES IN ACCESS, EXPERIENCE, CARE DELIVERY, AND HEALTH OUTCOMES. TO EVEN BEGIN THE WORK OF ENDING DISPARITIES, WE MUST FIRST IDENTIFY DISPARITIES AND THEN DEVELOP EFFECTIVE STRATEGIES TO REDUCE THEM. IN FY2023, WE WILL BUILD SYSTEMS AND PROCESSES TO IDENTIFY AND REDUCE DISPARITIES IN QUALITY MEASURES AND HEALTH OUTCOMES WITH A FOCUS ON CHRONIC DISEASE, CANCER, AND MATERNAL/INFANT HEALTH OUTCOMES. OUR EXPECTATION IS THAT REDUCING DISPARITIES IN THESE AREAS WILL ULTIMATELY IMPROVE HEALTH OUTCOMES. AS DESCRIBED PREVIOUSLY, CHRONIC CONDITIONS ARE AN ELIGIBILITY REQUIREMENT TO PARTICIPATE IN THE PRIMARY CARE AND WOMEN'S HEALTH CHW PROGRAMS. THE CHW WORKS WITH THE PATIENTS TO IMPROVE SELF-MANAGEMENT OF THEIR CHRONIC CONDITIONS. WHILE CHRONIC CONDITIONS ARE NOT A REQUIREMENT TO PARTICIPATE IN EACH CHW PROGRAM, IF A PATIENT HAS A CHRONIC CONDITION, IT WILL BE ADDRESSED BY ANY OF THE CHWS WHO HAVE THE SHARED GOAL OF IMPROVING HEALTH. TO ADDRESS CHRONIC DISEASE OUTCOMES AND FOOD INSECURITY AMONG OUR LOW-INCOME PATIENTS, WE LAUNCHED THE DELAWARE FOOD FARMACY (DFF) IN PARTNERSHIP WITH LUTHERAN COMMUNITY SERVICES IN FEBRUARY 2021. THIS 6-MONTH COMPREHENSIVE FOOD PHARMACY SERVES PRIMARY CARE PATIENTS WITH UNCONTROLLED?HYPERTENSION, DIABETES, AND/OR CONGESTIVE HEART FAILURE. PARTICIPANTS IN THIS PROGRAM RECEIVE WEEKLY MEDICALLY TAILORED GROCERY BOXES DELIVERED TO THEIR HOMES BY LUTHERAN COMMUNITY SERVICES. THE BOXES CONTAIN ENOUGH FOOD FOR THE PATIENT AND THEIR FAMILY MEMBERS TO PREPARE ABOUT 10 MEALS. THE FOOD PROVISIONS ARE GUIDED BY AN EVIDENCE-BASED EATING PLAN. ALONG WITH THE FOOD, PARTICIPANTS MEET EACH WEEK WITH A DFF CHW, WHO ASSISTS THEM WITH GOAL SETTING AND IMPROVING DIETARY KNOWLEDGE AND CULINARY SKILLS. PARTICIPANTS ALSO RECEIVE ADDITIONAL SUPPORT FROM CHRISTIANACARE PHARMACISTS, REGISTERED DIETITIANS, AND BEHAVIORAL HEALTH CONSULTANTS AS WELL AS BLOOD PRESSURE CUFFS, GLUCOSE MONITORS, AND SCALES FOR SELF-MONITORING. THE DFF INCLUDES AN ONGOING ROBUST EVALUATION THAT EXAMINES PRE-TO-POST ENROLLMENT CHANGES IN FOOD INSECURITY AND NUTRITIONAL AND CHRONIC DISEASE OUTCOMES. TWENTY-FOUR HOUR DIETARY RECALLS, PATIENT SURVEYS, AND MEDICAL RECORD DATA ARE BEING USED TO DOCUMENT PROGRAM PROCESS AND OUTCOMES. IN FY2022, 79 PATIENTS PARTICIPATED, AND 198 COMMUNITY MEMBERS WERE FED THROUGH THE DFF. OF THE DFF PARTICIPANTS, 75% WERE FOOD INSECURE, AND THE MAJORITY HAD ONE OR MORE CHRONIC CONDITIONS. A LITTLE MORE THAN HALF OF THE PARTICIPANTS WERE FEMALE AND MOST PARTICIPANTS WERE BLACK/AFRICAN-AMERICAN (70%) WITH ANOTHER 14% IDENTIFYING AS HISPANIC. DEMONSTRATING THE EFFECTIVENESS OF THE PROGRAM, 90% OF THESE PARTICIPANTS LOST WEIGHT. OUTCOMES OF EARLIER DFF PARTICIPANTS, THERE HAVE BEEN A TOTAL OF 95, HAVE ALSO BEEN PROMISING WITH PATIENTS SHOWING INCREASED CALCIUM AND FIBER INTAKE, DECREASES IN HBA1C AND BLOOD PRESSURE, WEIGHT LOSS, AND DECREASES IN ANXIETY AND DEPRESSION. OUR PARTNERSHIP WITH LUTHERAN COMMUNITY SERVICES HAS BEEN A KEY COMPONENT OF THIS PROGRAM'S SUCCESS AND WE LOOK FORWARD TO EXPANDING OUR SUCCESS WITH THEM OVER THE NEXT SEVERAL MONTHS. CHRISTIANACARE IS ACTIVELY ENGAGED IN DEVELOPING A CULTURALLY CENTERED DFF TO OFFER TO OUR SPANISH-SPEAKING PATIENTS. IN THE UPCOMING YEAR, CHRISTIANACARE WILL FURTHER EXPAND THE DFF TO SERVE A TARGETED SUBSET OF PATIENTS IN OUR WOMEN'S HEALTH PRACTICES. THE DFF OPERATES OUT OF CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT, BUT THE PARTICIPATION OF MULTIPLE DEPARTMENTS MAKES THIS PROGRAM AND ITS EXPANSION POSSIBLE. THE DFF DEMONSTRATES CHRISTIANACARE'S COMPREHENSIVE APPROACH TO PROVIDING HOLISTIC AND CONVENIENT CARE THAT RECOGNIZES THE PATIENT AS A WHOLE PERSON. WITH LONG TERM COMMUNITY PARTNER, URBAN ACRES, CHRISTIANACARE ALSO OPERATES A PRODUCE DELIVERY PROGRAM. ADULT PATIENTS LIVING IN NEW CASTLE COUNTY WHO ARE ON MEDICAID OR ARE MEDICAID ELIGIBLE AND HAVE DIABETES, HYPERTENSION, AND/OR NEED FOOD ASSISTANCE ARE ELIGIBLE. THIS 3-TO-6-MONTH WEEKLY DELIVERY PROGRAM IS DESIGNED TO INCREASE PATIENT ACCESS TO THE FRESH PRODUCE NECESSARY TO LIVE A HEALTHIER LIFE. ALONG WITH A BAG OF PRODUCE CONSISTING OF 1 LEAFY GREEN, 2-3 ADDITIONAL VEGETABLES, AND 2-3 FRUITS, PATIENTS ARE ALSO CONNECTED TO SUSTAINABLE FOOD ASSISTANCE PROGRAMS AND RECEIVE EDUCATIONAL MATERIALS ON THE HEALTH BENEFITS OF FRUITS AND VEGETABLES. IN FY2022, 178 PATIENTS WERE SERVED. OF THOSE PATIENTS, 65% WERE FEMALE, 54% WERE BLACK/AFRICAN AMERICAN, AND 19% WERE HISPANIC. THE MEAN AGE OF THESE PATIENTS WAS 57.54.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) MATERNAL AND CHILD HEALTH IN 2015, DELAWARE HAD THE SECOND HIGHEST INFANT MORTALITY RATE AMONG ALL STATES. IN 2020, DELAWARE WAS RANKED 31ST HIGHEST INFANT MORTALITY RATE AMONG THE STATES. THIS IMPROVEMENT WAS THE RESULT OF CONCENTRATED EFFORTS BY STATE AND COMMUNITY AGENCIES AS WELL AS HEALTH SYSTEMS LIKE CHRISTIANACARE WHICH HAS TAKEN A LEADING ROLE IN THIS EFFORT. THE SIGNIFICANT DECREASE IN THE INFANT MORTALITY RATE IS AN ACCOMPLISHMENT TO BE CELEBRATED, BUT THERE IS STILL WORK TO BE DONE TO IMPROVE MATERNAL AND INFANT OUTCOMES, PARTICULARLY DISPARATE OUTCOMES ACROSS RACE AND ETHNICITY. CHRISTIANACARE CONTINUES TO ADDRESS MATERNAL AND CHILD HEALTH WITH EXCEPTIONAL AND INNOVATIVE CLINICAL CARE COMBINED WITH COMMUNITY SUPPORTS LIKE THE HEALTH AMBASSADORS WHICH WILL BE DESCRIBED IN FURTHER DETAIL IN THIS SECTION. WE ALSO ADDRESS SOCIAL DETERMINANTS OF HEALTH BECAUSE WE BELIEVE THAT PROVIDING OUR COMMUNITIES AND NEIGHBORS WITH LIFE RESOURCES WILL HAVE A POSITIVE EFFECT ON HEALTH OUTCOMES INCLUDING THE LONG-TERM IMPACT OF IMPROVING MATERNAL AND INFANT OUTCOMES. AS HAS BEEN DEMONSTRATED THROUGHOUT THIS NARRATIVE, CHRISTIANACARE IS COMMITTED TO REDUCING DISPARITIES, PROVIDING RADICAL CONVENIENCE, AND IMPLEMENTING INNOVATIVE STRATEGIES TO IMPROVE HEALTH OUTCOMES. OVER THE LAST SEVERAL YEARS, CHRISTIANACARE'S WOMEN'S HEALTH DEPARTMENT HAS SUCCESSFULLY IMPLEMENTED THESE OBJECTIVES TO SIGNIFICANTLY IMPROVE MATERNAL AND INFANT HEALTH. POST-PARTUM HYPERTENSION MONITORING--REDUCTION OF DISPARITIES CHRISTIANACARE CLINICAL LEADERS DESIGNED AND IMPLEMENTED A POST-PARTUM HYPERTENSION MONITORING PROGRAM FROM FEBRUARY 2019 THROUGH MAY 2020 TO IMPROVE EARLY DETECTION OF POSTPARTUM HYPERTENSION BY OVERCOMING LOW ATTENDANCE FOR FOLLOW-UP OFFICE VISITS. WOMEN WITH HIGH BLOOD PRESSURE COMPRISED MOST POSTPARTUM READMISSIONS, WITH BLACK WOMEN READMITTED TWICE AS OFTEN AS WHITE WOMEN, BUT ONLY 30% OF PATIENTS ATTENDED POSTPARTUM OFFICE VISITS. THE STUDY TEAM EVALUATED HISTORICAL DATA TO LEARN ABOUT THE BARRIERS ASSOCIATED WITH THE POOR POSTPARTUM OFFICE VISIT RATE. PATIENTS REPORTED CHALLENGES WITH THE TIME AND RESOURCES REQUIRED TO TRAVEL TO APPOINTMENTS, THE EXERTION ASSOCIATED WITH THE EFFORT, AND THE PERCEIVED LOW BENEFIT FROM THE VISIT. TO ADDRESS THESE BARRIERS, CHRISTIANACARE CONNECTED A TARGETED POPULATION OF NEW MOTHERS PRIOR TO HOSPITAL DISCHARGE WITH TWISTLE, A REMOTE PATIENT MONITORING PLATFORM. PATIENTS WHO CONSENTED TO PARTICIPATE IN THE PROGRAM RECEIVED A BRIEF OVERVIEW OF THE PLATFORM AND TUTORIAL ON THE MONITORING EQUIPMENT PRIOR TO HOSPITAL DISCHARGE. THE PROGRAM INCLUDED SENDING EDUCATIONAL MATERIALS AND ASSESSMENT FORMS AUTOMATICALLY TO PATIENTS' CELL PHONES ON A PRESCRIBED SCHEDULE. PATIENTS WITH BLOOD PRESSURE IN THE NORMAL RANGE RECEIVED AUTOMATED REPLIES THAT OFFERED IMMEDIATE REASSURANCE. ABNORMAL READINGS WERE PROMPTLY ROUTED TO THE CARE TEAM FOR FOLLOW-UP. THIS PROCESS PROVIDED AN OPPORTUNITY FOR THE CARE TEAM TO PROACTIVELY TITRATE MEDICATION AND AVOID PATIENTS REQUIRING READMISSION FOR HYPERTENSIVE CRISIS. THIS PROGRAM SUCCESSFULLY REDUCED POSTPARTUM HYPERTENSION READMISSION RATES AND ELIMINATED A LONGSTANDING RACIAL DISPARITY. NOTABLY, 91% OF NEW MOTHERS SUBMITTED AT LEAST ONE BLOOD PRESSURE READING IN THE REMOTE MONITORING PROGRAM, AND 70% OF PATIENTS ENGAGED IN THE FULL 10-DAY PROTOCOL. THE PROGRAM SUCCESSFULLY REDUCED OVERALL POSTPARTUM PATIENT READMISSIONS BY 55%. AMONG BLACK MOTHERS, THE READMISSION RATE DROPPED FROM 61% TO 31%. THIS PROGRAM HAS NOW BECOME STANDARD PRACTICE THROUGHOUT CHRISTIANACARE'S WOMEN'S HEALTH PRACTICES. BASED ON PATIENT FEEDBACK, THE DURATION OF THE MONITORING PROGRAM WAS EXTENDED FROM 10 DAYS TO 42 DAYS. THE ADDITIONAL TIME SUPPORTS EACH PATIENT'S CARE TRANSITION TO THEIR PRIMARY PHYSICIAN OR THE IDENTIFICATION OF A PRIMARY CARE PROVIDER FOR THOSE WITHOUT ONE. PRENATAL AND POSTPARTUM DIABETES MONITORING-REDUCTION OF DISPARITIES WOMEN'S HEALTH CLINICAL LEADERS TACKLED POOR COMPLIANCE WITH POSTPARTUM DIABETES TESTING IN THE SAME MANNER. WOMEN WITH GESTATIONAL DIABETES ARE ASKED TO COMPLETE 2-HOUR GLUCOSE TOLERANCE TEST 6-12 WEEKS POST-DELIVERY. WHILE GESTATIONAL DIABETES RESOLVES AFTER DELIVERY FOR MOST WOMEN, SOME DEVELOP TYPE 2 DIABETES. AS WITH THE PREVIOUSLY DESCRIBED PATIENTS, THE LOGISTICS OF GETTING TO THE DIABETES SCREENING APPOINTMENT PRESENTED MANY CHALLENGES, ESPECIALLY FOR WOMEN FROM LOW-INCOME AND MINORITY COMMUNITIES. TO OVERCOME THOSE BARRIERS, PATIENTS WERE ASKED TO SUBMIT THREE FASTING BLOOD SUGARS AT HOME AND TEXT THE RESULTS. PATIENTS WITH ABNORMAL RESULTS COMPLETED THE 2-HOUR GLUCOSE TOLERANCE TEST AND WERE CONNECTED TO PRIMARY CARE. TEXT-BASED SCREENING FOR POSTPARTUM DIABETES TESTING ACHIEVED IMPROVED COMPLIANCE WITH A 92% INCREASE IN COMPLIANCE RATES COMPARED TO STANDARD SCREENING (25% VERSUS 48%) AND A 213% INCREASE IN THE DETECTION OF TYPE 2 DIABETES (5.4% IN THE STANDARD SCREENING GROUP COMPARED TO 16.9% IN TEXT-BASED SCREENING). ENGAGEMENT WITH TEXT-BASED SCREENING NARROWED THE RACIAL GAP IN CARE WITH A 211% INCREASE IN COMPLIANCE AMONG BLACK WOMEN. IMPROVEMENTS IN COMPLIANCE WITH TEXT-BASED CARE LED TO A 180% HIGHER DIABETES DETECTION AMONG NON-BLACK WOMEN AND A 577% INCREASE AMONG BLACK WOMEN. THESE PROGRAMS DEMONSTRATE HOW DISPARITIES CAN BE EFFECTIVELY ADDRESSED. THESE SUCCESSES WILL INFORM THE WOMEN'S HEALTH DEPARTMENT AS IT PARTNERS WITH THE DELAWARE FOOD FARMACY TO USE FOOD AS MEDICINE TO SERVE HIGH-RISK OBESE PREGNANT PATIENTS. WE LOOK FORWARD TO SHARING INFORMATION ABOUT THIS PROGRAM AS IT PROGRESSES.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) BIRTHING COMPANION CERTIFICATE PARTNERSHIP WITH UNIVERSITY OF DELAWARE CHRISTIANACARE IS ALSO ADDRESSING DISPARITIES IN MATERNAL AND CHILD HEALTH THROUGH ITS COLLABORATION WITH UNIVERSITY OF DELAWARE'S DIVISION OF PROFESSIONAL AND CONTINUING STUDIES AND SCHOOL OF NURSING TO CREATE A BIRTHING COMPANION CERTIFICATE IN THE FALL OF 2021. BIRTH COMPANIONS SUPPORT AND ADVOCATE FOR WOMEN DURING THEIR PREGNANCY, LABOR AND BIRTH, AND AFTER DELIVERY. NURSING STUDENTS PARTICIPATING IN THIS COURSE PROGRAM ARE PROVIDED WITH THE SKILLS THEY NEED TO PURSUE THE REQUIREMENTS OF BECOMING A DOULA. THIS PROGRAM SERVES THE DUAL PURPOSE OF HELPING THE PATIENT AND PROVIDING THE NURSING STUDENT WITH CLINICAL EXPERIENCE AND THE OPPORTUNITY TO WORK CLOSELY WITH PATIENTS WHO MAY BE IN VERY DIFFERENT CIRCUMSTANCES THAN THEIR OWN. THIS WILL GIVE THE PARTICIPATING STUDENTS AN EARLY LESSON IN THE IMPORTANCE OF RECOGNIZING PATIENTS AS A WHOLE PERSON. COMMUNITY HEALTH WORKERS, HEALTHY BEGINNINGS, AND OTHER PROGRAMS TO ADDRESS INFANT MORTALITY AND DISPARITIES CHRISTIANACARE HAS SEVERAL PROGRAMS DESIGNED TO PROMOTE MATERNAL AND CHILDREN'S HEALTH IN A HOLISTIC MANNER. AS DESCRIBED PREVIOUSLY, WOMEN'S HEALTH CHWS ARE EMBEDDED THROUGHOUT CHRISTIANACARE'S WOMEN'S HEALTH SERVICES INCLUDING INPATIENT, OUTPATIENT, OBSTETRICS (OB) TRIAGE, AND THE NEONATAL INTENSIVE CARE UNIT (NICU). THESE CHWS PARTNER WITH PATIENTS TO PROVIDE CONNECTION TO NEEDED SOCIAL AND HEALTH RESOURCES TO ULTIMATELY IMPROVE HEALTH. IN PARTNERSHIP WITH THE DELAWARE DIVISION OF PUBLIC HEALTH, CHRISTIANACARE HAS OFFERED HEALTHY BEGINNINGS FOR OVER A DECADE. CREATED TO ADDRESS DELAWARE'S HIGH INFANT MORTALITY RATE, THIS PROGRAM PROVIDES PRECONCEPTION CARE TO IDENTIFY AND ADDRESS RISKS TO FUTURE PREGNANCY, PREGNANCY PLANNING TO SET THE STAGE FOR A HEALTHY PREGNANCY, AND PRENATAL CARE FROM CONCEPTION TO CHILDBIRTH. HEALTHY BEGINNINGS OFFERS A MULTIDISCIPLINARY TEAM OF DOCTORS, NURSE PRACTITIONERS, NURSE EDUCATORS, SOCIAL WORKERS, RESOURCE MOTHERS, DIETICIANS, AND CASE MANAGERS TO ENSURE THE PATIENT HAS THE CLINICAL AND SOCIAL RESOURCES NEEDED TO ACHIEVE POSITIVE OUTCOMES FOR MOTHER AND BABY AND REDUCE DISPARATE OUTCOMES. IN FY2022, PATIENTS IN THIS PROGRAM RECEIVED THE FOLLOWING SERVICES TO SUPPORT THEIR HEALTH: PERSONAL HEALTH AND WELLNESS, WEIGHT MANAGEMENT, STRESS MANAGEMENT, EMOTIONAL HEALTH TREATMENT, FAMILY PLANNING, CONTRACEPTION, DOMESTIC ABUSE SCREENING, TOBACCO CESSATION, AND HYPERTENSION SCREENING AND TREATMENT. IN FY2022, 1,148 PATIENTS WERE ENROLLED IN HEALTHY BEGINNINGS, OF THOSE, 80.8% WERE BLACK AND 73.9% LIVED-IN HIGH-RISK ZONES (19703, 19720, 19801, 19802, 19804, 19805, 19809). HEALTH AMBASSADORS FOR THE LAST DECADE, THE STATE OF DELAWARE HAS AWARDED CHRISTIANACARE GRANT FUNDING TO SUPPORT ITS HEALTH AMBASSADORS PROGRAM. LIKE THE HEALTHY BEGINNINGS PROGRAM, THE HEALTH AMBASSADORS PROGRAM WAS CREATED IN RESPONSE TO THE HIGH INFANT MORTALITY RATE. HEALTH AMBASSADORS GUIDE FAMILIES ON THE PATH TO GOOD HEALTH. THEY SERVE PREGNANT WOMEN AND FAMILIES WITH CHILDREN AGED 0 TO 5 IN TARGETED HIGH-RISK ZIP CODES TO CONNECT WOMEN AND YOUNG FAMILIES TO HEALTH CARE, SOCIAL SERVICES, HOME VISITING, AND EDUCATIONAL PROGRAMS. THE HEALTH AMBASSADORS ALSO PROMOTE KEY MATERNAL AND CHILD HEALTH MESSAGES INCLUDING THE BENEFITS OF BREASTFEEDING AND THE IMPORTANCE OF SAFE SLEEP. IN FY2022, THE HEALTH AMBASSADORS EXPANDED THEIR REACH BY HIRING A SECOND BILINGUAL HEALTH AMBASSADOR IN JUNE 2022 TO SERVE THE SPANISH SPEAKING COMMUNITY, AS WELL AS PREGNANT AND PARENTING WOMEN WITH SUBSTANCE USE DISORDER RECEIVING TREATMENT AT A SUBSTANCE USE DISORDER TREATMENT CLINIC IN CLAYMONT. FROM JUNE TO NOVEMBER 2022, THE HEALTH AMBASSADORS HAD AN INCREASE IN SERVICES FOR SPANISH SPEAKING FAMILIES BY 40% COMPARED TO THE SAME PERIOD THE PREVIOUS YEAR. THE HEALTH AMBASSADORS WERE ALSO AT THE FOREFRONT OF PROVIDING RELIEF TO FAMILIES IMPACTED BY THE INFANT FORMULA SHORTAGE. THE HEALTH AMBASSADORS PARTNERED WITH THE STATE AND OTHER COMMUNITY ORGANIZATIONS TO COLLECT BABY FOOD AND FORMULA AND HOST A BABY FOOD AND FORMULA DRIVE IN JUNE 2022 FOR FAMILIES IN NEED. WHILE THE CRISIS OF THE INFANT FORMULA SHORTAGE DID ABATE TOWARDS THE END OF 2022, FINDING FORMULA CONTINUES TO BE A CHALLENGE FOR SOME FAMILIES AND THE HEALTH AMBASSADORS PROVIDE THE NEEDED SUPPORT FOR THESE FAMILIES. THE HEALTH AMBASSADORS ALSO PROVIDED FAMILIES WITH 2,882 ESSENTIAL ITEMS SUCH AS FOOD BOXES (227), CAR SEATS (179), PACKAGES OF DIAPERS (640), STROLLERS (27), CLOTHING (160), AND MORE. IN MOST CASES, THE HEALTH AMBASSADORS DELIVERED THESE ITEMS TO THE FAMILY'S HOME. THE HEALTH AMBASSADORS ALSO PROVIDED 625 REFERRALS FOR FAMILIES TO RECEIVE SERVICES SUCH AS HOME VISITING, HOUSING, AND HEALTH INSURANCE. WHILE THERE WAS ALWAYS FREQUENT COMMUNICATION BETWEEN THE WOMEN'S HEALTH CHWS, HEALTH AMBASSADORS, AND HEALTHY BEGINNINGS, IN FY2022, THESE GROUPS BEGAN A WEEKLY HUDDLE TO ENSURE THE HIGH NEEDS PATIENTS THEY SERVE ARE RECEIVING THE MOST EFFECTIVE CARE AND THE NEEDED RESOURCES FOR FAMILIES FROM PRECONCEPTION TO RAISING YOUNG CHILDREN.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) ALLIANCE FOR ADOLESCENTS PREGNANCY PREVENTION (AAPP) SINCE 1995, THE STATE OF DELAWARE HAS ALSO PROVIDED CHRISTIANACARE WITH A GRANT TO OPERATE THE ALLIANCE FOR ADOLESCENTS PREGNANCY PREVENTION (AAPP). AAPP WORKS TO REDUCE THE NUMBER OF TEENS WHO ARE SEXUALLY ACTIVE, BECOME PREGNANT, AND BECOME TEEN PARENTS THROUGH EDUCATIONAL PROGRAMMING OFFERED TO TEENS AND THEIR PARENTS. IN FY2022, CHRISTIANACARE'S AAPP TEAM PROVIDED 500 ADOLESCENTS WITH EDUCATION. AAPP OFFERS THREE COURSES: 1. BE PROUD! BE RESPONSIBLE: A SIX-MODULE CURRICULUM THAT PROVIDES ADOLESCENTS, AGES 13 TO 18, WITH THE KNOWLEDGE, MOTIVATION, AND SKILLS NECESSARY TO CHANGE THEIR BEHAVIORS IN WAYS THAT WILL REDUCE THEIR RISK OF CONTRACTING HIV AND OTHER SEXUALLY TRANSMITTED INFECTIONS. 2. MAKING PROUD CHOICES: AN EIGHT-MODULE CURRICULUM THAT PROVIDES YOUNG ADOLESCENTS, AGES 11 TO 13, WITH THE KNOWLEDGE, CONFIDENCE, AND SKILLS NECESSARY TO REDUCE THEIR RISK OF SEXUALLY TRANSMITTED INFECTIONS (STIS), HIV, AND PREGNANCY. 3. WISE GUYS: A TEN-MODULE PROGRAM DESIGNED TO PREVENT ADOLESCENT PREGNANCY, EMPOWER YOUNG MEN TO RECOGNIZE CHALLENGES THEY MAY FACE IN LIFE, AND GIVE THEM THE TOOLS TO OVERCOME THESE CHALLENGES. SELF-REPORTED PRE-TEST AND POST-TEST KNOWLEDGE, ATTITUDE, AND BEHAVIOR MEASURES BETWEEN SEPTEMBER 2021 AND APRIL 2022 DEMONSTRATED STUDENTS' INCREASED KNOWLEDGE AFTER PARTICIPATING IN BE PROUD! BE RESPONSIBLE! AND MAKING PROUD CHOICES COURSES. DATA FOR WISE GUYS WAS INCOMPLETE, BUT WE EXPECT TO SEE POSITIVE RESULTS IN FY2023. IMPORTANTLY, EVERY STUDENT WAS PROVIDED A SATISFACTION SURVEY AT THE END OF THEIR COURSE AND 94% RATED THE AAPP SERIES AS "EXCELLENT"GOOD6% RATED IT AS "FAIR". 100% OF RESPONDENTS ANSWERED "YES" TO THE QUESTION OF WHETHER THEIR EDUCATOR EXPLAINED THE PROGRAM IN A WAY THEY COULD UNDERSTAND. DELAWARE HEALTHY MOTHER & INFANT CONSORTIUM (DHMIC) CHRISTIANACARE CAREGIVERS ARE ALSO SERVING THE STATE THROUGH COLLABORATIVE EFFORTS SUCH AS THE DELAWARE HEALTHY MOTHER & INFANT CONSORTIUM (DHMIC). DR. DAVID PAUL, CHRISTIANACARE CHAIR OF PEDIATRICS, AGAIN SERVED AS CO-CHAIR OF DHMIC IN FY2022. THE MISSION OF DHMIC IS TO PROVIDE STATEWIDE LEADERSHIP AND COORDINATION OF EFFORTS TO PREVENT INFANT MORTALITY AND TO IMPROVE THE HEALTH OF WOMEN OF CHILDBEARING AGE AND INFANTS THROUGHOUT DELAWARE. CHRISTIANACARE CAREGIVERS ALSO SERVE ON THE DELAWARE MATERNAL MORTALITY REVIEW PANEL WHICH REVIEWS MATERNAL DEATHS AND RECOMMENDS TERTIARY AND SYSTEMIC CHANGES TO REDUCE MORTALITY RATES. MENTAL HEALTH AND SUBSTANCE USE DISORDERS EVEN BEFORE THE CORONAVIRUS PANDEMIC EXACERBATED THE ISSUES OF ACCESS TO BEHAVIORAL HEALTH SERVICES AND BROUGHT INCREASED ATTENTION TO THE BEHAVIORAL HEALTH NEEDS OF VULNERABLE POPULATIONS, OUR COMMUNITY HAD LONG IDENTIFIED MENTAL HEALTH AND SUBSTANCE USE DISORDERS AS A SIGNIFICANT AREA OF NEED. TO ADDRESS THIS AREA OF NEED, CHRISTIANACARE IS WORKING TO PROVIDE MORE ACCESS BY HIRING ADDITIONAL CAREGIVERS AND DEVELOPING AND EXPANDING PROGRAMS. CHRISTIANACARE'S BEHAVIORAL HEALTH TEAM WORKED TOWARDS A GOAL OF HIRING 71 NEW CAREGIVERS IN BOTH CLINICAL AND NON-CLINICAL ROLES TO ADDRESS BEHAVIORAL HEALTH BY THE END OF FISCAL YEAR 2023. IT HAS BEEN A CHALLENGE IN OUR STATE AND NATIONALLY TO FILL BEHAVIORAL HEALTH POSITIONS. CHRISTIANACARE IS NOT IMMUNE TO THOSE CHALLENGES, BUT WE ARE ENCOURAGED BY THE PROGRESS WE HAVE ALREADY MADE. CHRISTIANACARE LAUNCHED A GENDER WELLNESS CLINIC IN OCTOBER 2021 WHICH SERVES ANYONE AGE 13 OR OLDER EXPLORING THEIR GENDER IDENTITY, EXPERIENCING GENDER DYSPHORIA, OR WHO NEEDS EDUCATION AND SUPPORT AROUND SOCIAL AND MEDICAL TRANSITION. A NEW GERIATRIC MENTAL HEALTH PROGRAM IS IN DEVELOPMENT IN COLLABORATION WITH CHRISTIANACARE'S SWANK MEMORY CENTER. THIS PROGRAM WILL BE COMPRISED OF TWO NEW SENIOR PSYCH SOCIAL WORKERS AND A GERIATRIC PSYCHIATRIST. ALSO SET TO LAUNCH THIS YEAR IS THE FIRST EPISODE CLINIC, AN EARLY INTERVENTION MODEL DESIGNED TO CONNECT PATIENTS WITH RESOURCES TO REDUCE INAPPROPRIATE ED VISITS AND READMISSION TO INPATIENT FLOORS. FINALLY, NOW THAT COVID-19 RESTRICTIONS HAVE EASED, WE ARE VERY PLEASED TO RETURN TO OFFERING GROUP THERAPY PROGRAMS FOR ADULTS AND CHILDREN. WE ARE ALSO WORKING TO EXPAND OUR SUBSTANCE USE AND EMBEDDED BEHAVIORAL HEALTH CARE MODELS. EMBEDDED BEHAVIORAL HEALTH CARE INCREASES ACCESS AND EARLY PREVENTION AS WELL AS ENABLES US TO SERVE THE PATIENT HOLISTICALLY BY ADDRESSING THE CONNECTION BETWEEN PHYSICAL AND MENTAL HEALTH. AN ADVANCED PRACTICE CLINICIAN IS NOW EMBEDDED WITHIN PROJECT RECOVERY, CHRISTIANACARE'S OUTPATIENT SUBSTANCE USE DISORDER TREATMENT PROGRAM. WITH THE ADDITION OF TWO NEW BEHAVIORAL HEALTH CONSULTANTS (BHC), SIX WOMEN'S HEALTH PRACTICES ARE NOW SERVED BY BHCS. WE INTEND TO EXPAND EMBEDDED BEHAVIORAL HEALTH INTO NEW PRACTICES THIS YEAR AND WILL BE ABLE TO SHARE THAT PROGRESS NEXT YEAR. IN FY2022, CHRISTIANACARE ALSO LAUNCHED THE BEHAVIORAL HEALTH CHW PROGRAM, AS DESCRIBED IN THE ACCESS TO CARE SECTION. THROUGH THIS PROGRAM, CHWS ARE EMBEDDED IN CHRISTIANACARE'S OUTPATIENT BEHAVIORAL HEALTH SERVICES TO SUPPORT CHILDREN, ADOLESCENTS, AND ADULTS WITH MENTAL HEALTH AND/OR SUBSTANCE USE DIAGNOSES FOR UP TO 6 MONTHS.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) ANOTHER PROGRAM CHRISTIANACARE HAS OPERATED TO ADDRESS SUBSTANCE USE DISORDER IS PROJECT ENGAGE, AN EARLY INTERVENTION AND REFERRAL TO SUBSTANCE USE DISORDER TREATMENT PROGRAM. PEERS IN SUBSTANCE USE DISORDER RECOVERY ENGAGE WITH INPATIENTS AND PATIENTS IN THE EMERGENCY DEPARTMENT WHO ARE STRUGGLING WITH SUBSTANCE USE DISORDER. THE PEERS USE MOTIVATIONAL INTERVIEWING TO EMPOWER EACH PATIENT IN THE DECISION-MAKING PROCESS, ASSISTING THEM TO TAKE THE CRITICAL FIRST STEP TO SEEK HELP FOR THE SUBSTANCE USE DISORDER. PEERS WILL CONNECT THESE PATIENTS TO TREATMENT PROGRAMS AND OTHER COMMUNITY RESOURCES. IN FY2022, PROJECT ENGAGE PEERS HAD A TOTAL OF 2061 ENGAGEMENTS WITH PATIENTS AND MADE 977 REFERRALS TO TREATMENT. CHRISTIANACARE'S PROVISION OF BEHAVIORAL HEALTH SERVICES IN SCHOOL-BASED HEALTH CENTERS IS NOT THE ONLY COMMUNITY-BASED EFFORT BEING UNDERTAKEN TO PROVIDE RADICALLY CONVENIENT SERVICE TO OUR NEIGHBORS. SINCE 2020, CHRISTIANACARE HAS PARTNERED WITH THE NEW CASTLE COUNTY POLICE DEPARTMENT (NCCPD) TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE DISORDER IN THE COMMUNITY. SUPPORTED BY FEDERAL AND STATE GRANT FUNDING, THE UNDERLYING GOALS OF THIS PARTNERSHIP ARE TO DIVERT INDIVIDUALS AWAY FROM THE CRIMINAL JUSTICE SYSTEM AND EMERGENCY DEPARTMENTS WHEN APPROPRIATE AND WORK TO CONNECT INDIVIDUALS TO CARE IN THE COMMUNITY. THREE CHRISTIANACARE CAREGIVERS, TWO MENTAL HEALTH PROFESSIONALS AND A CASE MANAGER, ARE EMBEDDED IN THE POLICE DEPARTMENT'S BEHAVIORAL HEALTH UNIT (BHU) TO ADDRESS MENTAL HEALTH NEEDS IN THE COMMUNITY. SERVING WITH THE POLICE IN A CO-RESPONDER MODEL, THE MENTAL HEALTH PROFESSIONALS RESPOND TO 911 CALLS AND OFFICER REFERRALS WHEN MENTAL ILLNESS IS BELIEVED TO BE A PRIMARY FACTOR FOR POLICE INVOLVEMENT. THEY PROVIDE SUPPORT TO THE COMMUNITY MEMBER AT A TIME OF CRISIS AS WELL AS EDUCATION TO THE OFFICERS ON HOW TO IDENTIFY MENTAL ILLNESS AND PROVIDE ESSENTIAL DE-ESCALATION TACTICS. ONCE THE INITIAL CRISIS HAS BEEN ABATED, THE CASE MANAGER CONTINUES TO WORK TO CONNECT THESE INDIVIDUALS TO THE APPROPRIATE COMMUNITY TREATMENT AND TO ADDRESS ANY SOCIAL NEEDS. IN FY2022, CHRISTIANACARE RECEIVED ADDITIONAL GRANT FUNDING TO EMPLOY ANOTHER MENTAL HEALTH PROFESSIONAL TO BETTER MEET THE NEEDS THE POLICE ARE EXPERIENCING IN THE COMMUNITY. THREE ADDITIONAL CHRISTIANACARE CAREGIVERS SUPPORT THE NCCPD'S HERO HELP PROGRAM WHICH ADDRESSES SUBSTANCE USE DISORDER BY SUPPORTING THOSE SEEKING TREATMENT. THESE CAREGIVERS RESPOND TO NON-FATAL OVERDOSES, PROVIDE OUTREACH IN THE COMMUNITY, WORK WITH INDIVIDUALS TO DEVISE A TREATMENT PLAN AND OBTAIN TREATMENT, PROVIDE ONGOING CASE MANAGEMENT, AND ADDRESS ANY NEEDS INDIVIDUALS MAY HAVE THAT SERVE AS BARRIERS TO OBTAINING TREATMENT. THE INITIAL GRANT FUNDING WHICH ENABLED US TO BEGIN OUR PARTNERSHIP WITH THE POLICE WILL EXPIRE IN OCTOBER 2023. CHRISTIANACARE WILL SEEK ADDITIONAL SUPPORT TO CONTINUE THIS PARTNERSHIP - AND EXPAND IT WITH MORE CAREGIVERS EMBEDDED IN THE NCCPD. THIS PROGRAM ADDRESSES A SIGNIFICANT NEED IN THE COMMUNITY AND ENABLES US TO SERVE OUR COMMUNITY AND THE POLICE. THE NCCPD RECOGNIZES THAT SUBSTANCE USE DISORDER AND MENTAL HEALTH ISSUES ARE OFTEN THE DRIVING FACTORS LEADING TO INVOLVEMENT WITH POLICE. OUR PARTNERSHIP PROVIDES THEM WITH THE SUPPORT TO RESPOND APPROPRIATELY AND IT ALLOWS CHRISTIANACARE TO PROVIDE MORE SERVICES IN THE COMMUNITY. CHRISTIANACARE'S COMMUNITY SUBSTANCE OVERDOSE SUPPORT (SOS), CREATED IN PARTNERSHIP WITH NEW CASTLE COUNTY, PROVIDES OUTREACH TO INDIVIDUALS WITH SUBSTANCE USE DISORDER (SUD) LIVING IN NEW CASTLE COUNTY. SOS ACCEPTS SELF-REFERRALS, INTERNAL REFERRALS FOR CHRISTIANACARE PATIENTS, AND NEW CASTLE COUNTY EMS REFERRALS OF INDIVIDUALS THEY HAVE REVIVED WITH NALOXONE, THE OPIOID OVERDOSE REVERSING MEDICATION, AND TAKEN TO ONE OF CHRISTIANACARE'S EMERGENCY DEPARTMENTS. SOS GOES TO INDIVIDUALS' HOMES OR OTHER COMMUNITY LOCATIONS AND USES MOTIVATIONAL INTERVIEWING TECHNIQUES TO ENCOURAGE THE INDIVIDUAL TO ENTER SUBSTANCE USE DISORDER TREATMENT. IF NEEDED, SOS WILL HELP THE PATIENT ADDRESS ANY BARRIERS TO TREATMENT AND ASSIST THEM WITH ENROLLING IN TREATMENT. SOS ALSO PROVIDES NALOXONE AND TRAINING ON ITS USE AS WELL AS OTHER HARM REDUCTION EDUCATION IN THE COMMUNITY. IN FY2022, SOS DISTRIBUTED 290 NALOXONE KITS OF WHICH 132 WERE REFILLS. THIS DEMONSTRATES THE LIKELIHOOD OF THE NALOXONE BEING USED AS A LIFESAVING MEASURE. SOS ALSO RECEIVED A TOTAL OF 669 REFERRALS. THEY WERE ABLE TO SUCCESSFULLY CONTACT 38% OF THOSE REFERRALS, AND OF THOSE, 9% AGREED TO TREATMENT. IF AN INDIVIDUAL WAS UNWILLING TO GO TO TREATMENT, THEY WERE OFFERED HARM REDUCTION EDUCATION AND NALOXONE AND ENCOURAGED TO CONTACT SOS ONCE THEY WERE READY TO PURSUE TREATMENT. VIOLENCE IN RECOGNITION OF VIOLENCE AS A PUBLIC HEALTH ISSUE, CHRISTIANACARE LAUNCHED A HOSPITAL BASED VIOLENCE INTERVENTION PROGRAM (HVIP), EMPOWERING VICTIMS OF LIVED VIOLENCE (EVOLV), IN FEBRUARY 2021. EVOLV IS DESIGNED TO CREATE A SINGLE CARE TEAM USING EVIDENCE BASED SYNERGISTIC STRATEGIES. EVOLV AIMS TO ADDRESS VIOLENCE AND SUPPORT PATIENTS IMPACTED BY COMMUNITY VIOLENCE IN EFFORTS TO IMPROVE HEALTH AND WELL-BEING AND REDUCE RECIDIVISM OF NEW AND RECURRING INJURIES. PATIENTS WHO HAVE SUFFERED A GUNSHOT WOUND, STAB WOUND, OR VIOLENT BLUNT ASSAULT, ARE RESIDENTS OF NEW CASTLE COUNTY, AND AGED 13 YEARS OR OLDER ARE ELIGIBLE TO PARTICIPATE IN EVOLV. THE LENGTH OF THE PROGRAM IS THREE MONTHS AND PROVIDES THE PATIENT WITH ACCESS TO A DEDICATED SOCIAL WORKER AND COMMUNITY HEALTH WORKER (CHW). EVOLV ASSISTS PATIENTS IN MANY SERVICES POST-DISCHARGE INCLUDING FOLLOW-UP CARE, EDUCATION, EMPLOYMENT, SOCIAL SUPPORT, CONNECTION TO COMMUNITY RESOURCES, LEGAL SUPPORTS, AND IDENTIFYING AND ACHIEVING PATIENT CENTERED GOALS AND OUTCOMES. IN FY2022, EVOLV SERVED 82 PATIENTS AND CONTINUED TO WORK CLOSELY WITH THE TRAUMA DEPARTMENT. FURTHER STRENGTHENING THIS RELATIONSHIP WAS THE COMPLETION OF EVOLV'S INTEGRATION INTO CHRISTIANACARE'S ELECTRONIC HEALTH RECORD. THIS WILL IMPROVE COMMUNICATION BETWEEN EVOLV AND CLINICIANS AS WELL AS DATA TRACKING. EVOLV CLINICAL AND PROGRAM LEADS ALSO SUBMITTED A GRANT PROPOSAL FOR FEDERAL AND STATE FUNDING TO EXPAND THE PROGRAM WITH ADDITIONAL CHWS. AS THEY HAVE DONE SINCE EVOLV WAS BEING DESIGNED, THE EVOLV TEAM CONTINUES TO ENGAGE WITH GOVERNMENT AND COMMUNITY ORGANIZATIONS ADDRESSING VIOLENCE TO ENSURE COHESION IN THEIR EFFORTS TO REDUCE VIOLENCE IN OUR COMMUNITIES, ESPECIALLY IN WILMINGTON. THE TRAUMA DEPARTMENT IS ALSO ADDRESSING VIOLENCE THROUGH EDUCATION. THROUGHOUT THE YEAR, TRAUMA DEPARTMENT CAREGIVERS PROVIDED STOP THE BLEED TRAINING TO COMMUNITY GROUPS AND STUDENTS. STOP THE BLEED IS A NATIONAL AWARENESS CAMPAIGN THAT EMPOWERS BYSTANDERS WITH THE KNOWLEDGE AND TOOLS THEY NEED TO RECOGNIZE AND STOP LIFE-THREATENING BLEEDING. THE TRAUMA DEPARTMENT ALSO REVAMPED STUDENT PROGRAMS ADDRESSING VIOLENCE IT HAD PREVIOUSLY OFFERED TO CREATE A NEW OFFERING FOR STUDENTS THAT REFRAMES GUN VIOLENCE AS A PUBLIC HEALTH ISSUE. STUDENTS DISCUSS THE INDIVIDUAL AND COMMUNITY FACTORS THAT PUT PEOPLE AT RISK FOR GUN VIOLENCE AS WELL AS THE PHYSICAL AND EMOTIONAL IMPACTS OF GUN VIOLENCE. STUDENTS ARE ALSO EMPOWERED WITH INFORMATION TO HELP THEM IDENTIFY THE WARNING SIGNS OF GUN VIOLENCE. STUDENTS IN MIDDLE AND HIGH SCHOOLS THROUGHOUT NEW CASTLE COUNTY RECEIVED THIS EDUCATION.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) SOCIAL DETERMINANTS OF HEALTH CHRISTIANACARE IS COMMITTED TO THE STRATEGY OF ADDRESSING SOCIAL DETERMINANTS OF HEALTH (SDOH) TO IMPROVE HEALTH OUTCOMES. THE CHWS, THE HEALTH GUIDES, THE HEALTH AMBASSADORS, AND THE PEERS WHO COMPRISE THE SOS OUTREACH TEAM ADDRESS CHRISTIANACARE'S DIFFERENT IDENTIFIED AREAS OF NEED, BUT THEY SHARE THE SAME OBJECTIVE OF HELPING INDIVIDUALS OVERCOME THEIR SOCIAL BARRIERS TO GOOD HEALTH. THE DELAWARE FOOD FARMACY AND THE PRODUCE DELIVERY PROGRAM WERE DESIGNED TO SERVE FOOD INSECURE PATIENTS, AND TEXT-BASED BLOOD PRESSURE MONITORING AND SCREENING FOR DIABETES WAS IMPLEMENTED IN WOMEN'S HEALTH TO OVERCOME PATIENT BARRIERS SUCH AS TRANSPORTATION. IN ADDITION TO THE INDIVIDUAL PROGRAMS THAT DIRECTLY ADDRESS SOCIAL DETERMINANTS OF HEALTH, CHRISTIANACARE IS ALSO ADDRESSING SDOH ON A SYSTEMWIDE SCALE. CHRISTIANACARE DESIGNED AND IMPLEMENTED ONE SDOH SCREENING INSTRUMENT TO ADMINISTER TO PATIENTS. TO IMPROVE THE FACILITATION OF THE SDOH SCREENING INSTRUMENT, WE RECENTLY INTRODUCED PATIENT SELF-ADMINISTRATION OF THE SDOH SCREENING INSTRUMENT. ALLOWING PATIENTS TO COMPLETE THE SCREENING ON THEIR OWN WILL INCREASE THE NUMBER OF SDOH SCREENS COMPLETED, IMPROVE EFFICIENCY, AND PROVIDE A BETTER PATIENT EXPERIENCE, AS PATIENTS MAY FEEL MORE COMFORTABLE ENTERING ANSWERS TO QUESTIONS THAT CAN FEEL INVASIVE. WE PUT A GREAT DEAL OF TIME AND RESOURCES INTO CREATING AND OPERATIONALIZING THE SDOH SCREENING INSTRUMENT BECAUSE WE MUST UNDERSTAND THE OBSTACLES THAT STAND IN THE WAY OF OUR PATIENTS IMPROVING THEIR HEALTH. THE SDOH SCREENING WILL ALSO PROVIDE US WITH A BROADER PICTURE OF THE CHALLENGES OUR COMMUNITIES FACE SO THAT WE CAN RESPOND APPROPRIATELY WITH INTERNAL PROGRAMMING AND STRATEGIES THAT ADDRESS THOSE NEEDS AS WELL AS THROUGH COMMUNITY PARTNERSHIPS. IN OUR FY2023 ANNUAL OPERATING PLAN, WE SET THE GOAL OF INCREASING BY 25%, THE PERCENTAGE OF PATIENTS WITH COMPLETE SDOH SCREENS FROM HIGH-RISK COMMUNITIES AS DEFINED IN THE CHNA (HIGH-RISK COMMUNITIES ARE THOSE IN THE 19801, 19802, 19804, 19805, AND 19720 ZIP-CODES). WE WOULD NOT PURSUE SCREENING OUR PATIENTS FOR THEIR SOCIAL NEEDS AS AGGRESSIVELY AS WE HAVE IF WE HAD NO TOOLS TO HELP THEM ADDRESS THOSE NEEDS. TO THAT END, WE PARTNERED WITH UNITE US TO LAUNCH AN ELECTRONIC CARE COORDINATION NETWORK, UNITE DELAWARE, IN LATE 2019. THE UNITE DELAWARE NETWORK CONNECTS SOCIAL SERVICES AND CLINICAL CARE PROVIDERS ACROSS THE STATE. WITH THIS NETWORK, ANY HEALTHCARE PROVIDER OR SOCIAL SERVICE AGENCY CAN HELP AN INDIVIDUAL ADDRESS THE DIVERSE ARRAY OF NEEDS THEY MAY HAVE BY SENDING AN ELECTRONIC REFERRAL ON BEHALF OF THE PATIENT TO THE APPROPRIATE ORGANIZATION. THE SENDER OF THAT REFERRAL WILL BE ABLE TO TRACK WHETHER THAT NEED WAS MET OR NOT AND TAKE ADDITIONAL ACTION IF NEEDED TO HELP THE PATIENT MEET THEIR NEED. UNITE DELAWARE NOW INCLUDES TWO OTHER DELAWARE HOSPITALS AND OVER 200 COMMUNITY-BASED ORGANIZATIONS. CHRISTIANACARE FUNDS THE UNITE DELAWARE PLATFORM BECAUSE WE BELIEVE IT CAN HELP DELAWAREANS THROUGHOUT THE STATE ADDRESS THEIR NEEDS AND IT ALSO PROVIDES BENEFITS AT NO COST TO THE PARTICIPATING COMMUNITY-BASED ORGANIZATIONS THAT PARTICIPATE IN THE NETWORK. IN MAY 2022, UNITE DELAWARE WAS INTEGRATED INTO CHRISTIANACARE'S MEDICAL HEALTH RECORD TO ENABLE EASIER OPERABILITY FOR PROVIDERS TO SEND A REFERRAL IN A CLINICAL SETTING AND SO THE PATIENT'S ENTIRE CARE TEAM CAN HAVE INSIGHT INTO THEIR SOCIAL NEEDS. ANOTHER GOAL OF CHRISTIANACARE'S FY2023 ANNUAL OPERATING PLAN IS TO INCREASE BY 25% THE NUMBER OF REFERRALS CAREGIVERS SEND THROUGH THE UNITE DELAWARE NETWORK ON BEHALF OF PATIENTS IN THE HIGH-RISK COMMUNITIES AS DEFINED IN THE CHNA. HALFWAY INTO FY2023, WE ARE ON TRACK TO MEET BOTH ANNUAL OPERATING PLAN GOALS FOR INCREASED SDOH SCREENING AND UNITE DELAWARE REFERRALS. TRANSPORTATION HAS ROUTINELY BEEN IDENTIFIED AS A BARRIER TO CARE. TO ADDRESS THAT NEED, CHRISTIANACARE PARTNERED WITH ROUNDTRIP TO PROVIDE TRANSPORTATION TO MEDICAL SERVICES FOR ELIGIBLE PATIENTS WHO HAVE A TRANSPORTATION BARRIER. IN 2020, CHRISTIANACARE PILOTED THIS PROGRAM IN TWO DEPARTMENTS AND IN FY2022, WE UNDERTOOK A CONSIDERABLE EXPANSION. THERE ARE NOW EIGHTEEN PARTICIPATING PROGRAMS AND DEPARTMENTS USING ROUNDTRIP TO SERVE PATIENTS WITH TRANSPORTATION BARRIERS. OUR EXPECTATION IS THAT PATIENTS' HEALTH WILL IMPROVE WHEN THE TRANSPORTATION BARRIER IS REMOVED, AND WE EXPECT TO DESIGN AND IMPLEMENT AN EVALUATION TO DEMONSTRATE THAT IN THE COMING MONTHS. IN FY2022, JUST OVER 9,000 RIDES WERE PROVIDED TO PATIENTS THROUGH ROUNDTRIP. AS A HEALTH SYSTEM, WE BELIEVE IT IS NECESSARY TO IDENTIFY AND ADDRESS THE SOCIAL NEEDS OF OUR PATIENTS BECAUSE THE BEST CLINICAL CARE WILL NOT, FOR EXAMPLE, OVERCOME THE POOR HEALTH OUTCOMES OF A DIABETIC PATIENT WHO LIVES IN A FOOD DESERT. THROUGHOUT THIS DOCUMENT, WE HAVE SHARED SUCCESSFUL STRATEGIES WE HAVE EMPLOYED TO ADDRESS SOCIAL NEEDS, AND WE KNOW THAT COMMUNITY PARTNERSHIPS ARE A REQUIREMENT FOR BUILDING UPON THAT SUCCESS. TO SUPPORT COMMUNITY-BASED ORGANIZATIONS WE LAUNCHED THE COMMUNITY INVESTMENT FUND IN DECEMBER 2019. THAT YEAR, WE AWARDED NEARLY $2 MILLION IN FUNDING TO 32 COMMUNITY-BASED ORGANIZATIONS TO ADDRESS THE AREAS OF NEED PRIORITIZED IN THE 2019 CHNA. WE WERE UNABLE TO PROVIDE THIS FUNDING IN FY2021 DUE TO THE FINANCIAL UNCERTAINLY CAUSED BY THE PANDEMIC, BUT IN FY2022, WE PROVIDED 13 ORGANIZATIONS WITH OVER $1 MILLION IN FUNDING TO ADDRESS FOOD INSECURITY AND HOUSING. IN ADDITION TO THE COMMUNITY INVESTMENT FUND, CHRISTIANACARE ALSO PROVIDED A COMBINED $310,000 IN FUNDING TO: - THE DELAWARE COALITION AGAINST DOMESTIC VIOLENCE TO SUPPORT A CHW PROGRAM SERVING SURVIVORS OF DOMESTIC VIOLENCE. - THE WEST END NEIGHBORHOOD HOUSE TO SUPPORT ITS DROP-IN CENTER WHICH SERVES UNACCOMPANIED HOMELESS YOUTH, AGED 18-23, INCLUDING THOSE WHO EXPERIENCED THE FOSTER CARE SYSTEM AND/OR IDENTIFY AS LGBTQ+. - THE WILMINGTON NEIGHBORHOOD CONSERVANCY LAND BANK IN SUPPORT OF ITS LOWER HILLTOP AFFORDABLE HOUSING INITIATIVE TO PROVIDE MORE AFFORDABLE HOUSING OPTIONS TO THE COMMUNITY. - THE ARC OF DELAWARE TO SUPPORT THE DEVELOPMENT OF A STATEWIDE WEBSITE THAT CAN SERVE AS A REPOSITORY OF THE EXISTING SOCIAL AND RECREATIONAL PROGRAMS FOR ADULTS WITH DISABILITIES AND BE THE STARTING POINT OF A COORDINATED EFFORT TO DETERMINE WHAT ADDITIONAL PROGRAMMING IS NEEDED STATEWIDE TO MEET UNADDRESSED NEEDS FOR THIS POPULATION. - DELAWARE TECH COMMUNITY COLLEGE TO ENHANCE THE OFFERINGS OF THE FOUR FOOD CLOSETS OPERATED AT EACH OF ITS CAMPUSES THROUGHOUT DELAWARE FOR THEIR FOOD INSECURE STUDENTS.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) THE ABOVE IS NOT AN EXHAUSTIVE LIST OF THE FUNDING CONTRIBUTED TO COMMUNITY ORGANIZATIONS IN FY2022, BUT IT DEMONSTRATES OUR COMMITMENT TO SUPPORTING THE DIVERSE EFFORTS OF OUR COMMUNITY PARTNERS TO MEET THE NEED OF OUR COMMUNITIES. CHRISTIANACARE IS ALSO INVESTING IN WORKFORCE DEVELOPMENT. FOR THE NEXT FOUR YEARS, CHRISTIANACARE WILL AWARD TEN STUDENTS MERIT-BASED SCHOLARSHIPS OF $12,500 PER YEAR, PER STUDENT, TO ATTEND AN HBCU. THE FOCUS OF THE SCHOLARSHIP PROGRAM WILL BE MINORITY STUDENTS WHO ARE PURSUING A FIELD OF STUDY IN HEALTH CARE. THESE STUDENTS WILL ALSO BE INVITED TO PARTICIPATE IN AN INTERNSHIP PROGRAM AT CHRISTIANACARE. WE MADE THIS COMMITMENT BECAUSE WE RECOGNIZE THE IMPORTANCE OF DIVERSITY IN THE HEALTH CARE FIELD TO IMPROVE PATIENT CARE. CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT ALSO OFFERS YOUTH PROGRAMMING THAT EXPOSES THE PARTICIPANTS, OR SCHOLARS AS WE REFER TO THEM, TO POTENTIAL CAREERS IN THE HEALTH FIELD AND PROVIDES THEM WITH THE SKILLS AND EXPERIENCE TO SUPPORT THEIR DEVELOPMENT INTO YOUNG ADULTS EVEN IF THEY CHOOSE TO TAKE A DIFFERENT PATH. IN FY2022, THE FOLLOWING PROGRAMS WERE OFFERED: BACK 2 BASICS 2.0: THIS PROGRAM, OFFERED IN PARTNERSHIP WITH JOBS FOR DELAWARE GRADS, A SCHOOL-TO-WORK TRANSITIONAL PROGRAM DEDICATED TO HELPING YOUTH REACH ACADEMIC AND ECONOMIC SUCCESS, WAS CREATED IN RESPONSE TO THE CORONAVIRUS PANDEMIC. IT PROVIDES HIGH SCHOOL SCHOLARS WITH THE OPPORTUNITY TO PARTICIPATE IN 12 IMMERSIVE SESSIONS THROUGH A CASE STUDY APPROACH. IN FY2022, 21 SCHOLARS ENROLLED IN THIS PROGRAM. NURSING CAREER COLLABORATIVE: THIS PROGRAM WAS DEVELOPED TO SERVE AS A PATHWAY TO NURSING FOR HIGH SCHOOL SCHOLARS FROM WILLIAM PENN HIGH SCHOOL AND FREIRE CHARTER SCHOOL. THROUGH THE NURSING CAREER COLLABORATIVE, SCHOLARS ARE EDUCATED AND EXPOSED TO THE FIELD AND FUNDAMENTALS OF NURSING. ON THEIR LAST DAY OF THE PROGRAM, SCHOLARS ALSO HAD AN OPPORTUNITY TO SHADOW ON A UNIT WITH A NURSE. IN FY2022, 9 SCHOLARS PARTICIPATED. CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT ALSO OFFERED THE CAMP FRESH PROGRAM FOR THE 15TH YEAR. CAMP FRESH IS AN 8-WEEK SUMMER PROGRAM THAT EXPLORES HEALTH AND WELLNESS WITH 11-18-YEAR OLD YOUTH. CAMP FRESH PROMOTES IMPROVED NUTRITION, MENTAL WELLNESS, INCREASED PHYSICAL ACTIVITY, AWARENESS OF REPRODUCTIVE HEALTH AND IDENTIFYING OPPORTUNITIES FOR PERSONAL, ACADEMIC, AND PROFESSIONAL GROWTH. CAMP FRESH SERVES DELAWARE YOUTH, MOST LIVING IN FEDERALLY RECOGNIZED HIGH-RISK ZIP CODES. YOUTH ARE ELIGIBLE TO ATTEND IF THEIR FAMILY RECEIVES OR IS ELIGIBLE TO RECEIVE MEDICAID. IN THE SUMMER OF 2021, CAMP FRESH TRANSFORMED THE DISRUPTION CAUSED BY THE CORONAVIRUS PANDEMIC INTO AN OPPORTUNITY TO TRY SOMETHING NEW IN THE FORM OF AN 8-WEEK LEADERSHIP PROGRAM, THE CAMP FRESH INFLUENCERS. THE CAMP FRESH INFLUENCER PROGRAM WAS DESIGNED TO PROVIDE YOUTH WITH LEADERSHIP SKILLS AS WELL AS IMPROVE CAMP FRESH THROUGH THEIR PARTNERSHIP. INFLUENCERS PROVIDED THEIR OPINIONS ABOUT CAMP FRESH PROGRAMMING AND MADE RECOMMENDATIONS FOR IMPROVEMENT AND ADVANCEMENT. A TOTAL OF 8 INFLUENCERS COMPLETED THIS PROGRAM. FROM JUNE TO AUGUST 2022, CHRISTIANACARE HOSTED A CAMP FRESH PROGRAM THAT INCORPORATED LESSONS LEARNED FROM THE INFLUENCERS. THERE WERE 24 PARTICIPANTS AND BASED ON FEEDBACK RECEIVED FROM THE INFLUENCERS, THIS WAS THE FIRST TIME THAT CAMPERS AS YOUNG AS 11 YEARS OLD WERE ABLE TO PARTICIPATE. THIS SUMMER ALSO SAW THE EMPLOYMENT OF THE FIRST JUNIOR COUNSELOR WHO HAD BEEN A PREVIOUS CAMP FRESH CAMPER. OTHER FIRSTS WERE STATE RECOGNITION OF CAMP FRESH AS AN EXEMPT SUMMER CAMP PROVIDER AND THE CERTIFICATION OF ALL CAMP FRESH CAREGIVERS IN "SERVSAFE" TO PARTICIPATE IN FOOD PREPARATION AS CAMP FRESH PROVIDES LUNCH, SNACK, AND DINNER FOR ALL CAMPERS. OUTSIDE OF THE SUMMER MONTHS, CAMPERS ARE OFFERED CAMP FRESH 360. PARTICIPANTS OF CAMP FRESH 360 COME TOGETHER TWICE PER MONTH WITH ADDITIONAL HEALTH EDUCATION SESSIONS THAT ARE OFFERED TO YOUTH, THEIR PARENTS/GUARDIANS, FAMILY MEMBERS AND FRIENDS. CHRISTIANACARE ALSO PARTNERS WITH COMMUNITY ORGANIZATIONS OFFERING YOUTH PROGRAMMING TO PROVIDE EXPOSURE TO THE HEALTH CARE FIELD. IN FY 2022, 9 MEDICAL ASSISTANT TRACT SCHOLARS FROM DELCASTLE AND ST. GEORGES TECHNICAL HIGH SCHOOLS CAME TO CHRISTIANACARE FOR THE CO-OP EXPERIENCE. IN APRIL 2022, ABOUT 30 MIDDLE SCHOOL SCHOLARS WHO PARTICIPATE IN THE BRANDYWINE LIFESAVERS CAME TO CHRISTIANACARE'S NEWARK CAMPUS FOR A CAREER EXPO THAT EXPOSED THEM TO VARIOUS NURSING SPECIALTIES. CAREGIVERS SPOKE WITH STUDENTS ABOUT THEIR WORK AND PROVIDED DEMONSTRATIONS. BRANDYWINE SCHOOL DISTRICT NURSES DEVELOPED THE LIFESAVERS PROGRAM TO CREATE A PIPELINE WITH YOUNGER STUDENTS TO GIVE THEM TIME TO LEARN ABOUT POSSIBLE CAREERS IN HEALTH CARE. THE PROGRAM ALSO FOCUSES ITS ATTENTION ON STUDENTS FROM BACKGROUNDS NOT REPRESENTED IN THE NURSING PROFESSION. NURSING STUDENTS FROM THE UNIVERSITY OF DELAWARE ALSO SHADOWED CAREGIVERS IN THE COMMUNITY HEALTH DEPARTMENT TO GAIN EXPOSURE TO THE SOCIAL DETERMINANTS OF HEALTH AND CHRISTIANACARE'S COMMUNITY WORK. THE EXPECTATION IS THAT THIS WILL PROVIDE THESE FUTURE NURSES WITH THE UNDERSTANDING OF THE CHALLENGES THEIR PATIENTS FACE. --------------------
PART V, SECTION B, LINE 13 (ELIGIBILITY FOR PROVIDING DISCOUNTED CARE) FEDERAL POVERTY GUIDELINES ARE NOT USED TO DETERMINE DISCOUNTED CARE. A SELF-PAY DISCOUNT OF 15% IS APPLIED TO ALL UNINSURED PATIENT ACCOUNTS REGARDLESS OF INCOME. PATIENTS WITH INCOME IN EXCESS OF 200% OF THE FEDERAL POVERTY LEVEL WILL RECEIVE A 15% DISCOUNT. --------------------
PART V, SECTION B, LINE 16 (FINANCIAL ASSISTANCE POLICY AVAILABILITY) A COPY OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE ACCESSED AT: HTTPS://CHRISTIANACARE.ORG/US/EN/VISIT-US/FOR-PATIENTS/FINANCIAL-ASSISTANC E-PROGRAM-SUMMARY/FINANCIAL-ASSISTANCE-PROGRAM --------------------
PART V, SECTION B, LINE 20 (ADDITIONAL EFFORTS MADE BEFORE AN ECA) CHRISTIANA CARE HEALTH SERVICES COMMUNICATES IN WRITING ABOUT COLLECTION PLACEMENT AND THE FINANCIAL ASSISTANCE POLICY. --------------------
PART V, SECTION B, LINE 22 (CHARGES FOR FAP-ELIGIBLE INDIVIDUALS) FAP-ELIGIBLE INDIVIDUALS (THOSE WITH INCOME LESS THAN 200% OF FEDERAL POVERTY GUIDELINES) ARE NOT RESPONSIBLE FOR ANY CHARGES. --------------------
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
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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?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
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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 (DES. OF ELIGIBILITY CRITERIA FOR FREE OR DISCOUNTED CARE) CHRISTIANA CARE HEALTH SERVICES, INC.("CHRISTIANACARE") HAS A SELF PAY DISCOUNT PERCENTAGE OF 15% THAT IS APPLIED TO ALL UNINSURED PATIENTS' ACCOUNTS, REGARDLESS OF THE PERSON'S ABILITY TO PAY. THIS DISCOUNT PERCENTAGE IS COMPARABLE TO THAT WHICH IS EXTENDED TO OUR MANAGED CARE COMPANIES. -------------------- PART I, LINE 6A (COMMUNITY BENEFIT ANNUAL REPORT INFORMATION) CHRISTIANACARE HEALTH PREPARED A COMMUNITY HEALTH NEEDS ASSESSMENT AND A COMMUNITY HEALTH IMPLEMENTATION PLAN DURING THE FY2022 TAX YEAR. BOTH DOCUMENTS ARE AVAILABLE AT THE FOLLOWING LINK ON THE CCHS WEBSITE: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-IMPLEMENTATION-PLAN/ -------------------- PART I, LINE 7 (BAD DEBT EXPENSE, COSTING METHODOLOGY USED) IMPLICIT PRICE CONCESSIONS ARE TREATED AS A CONTRA-REVENUE ITEM ON THE STATEMENT OF REVENUE. AS A RESULT, THERE ARE NO BAD DEBT EXPENSES INCLUDED ON FORM 990, PART IX THAT NEED TO BE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES LISTED. THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. --------------------
PART III, SECTION A, LINE 2 (IMPLICIT PRICE CONCESSIONS/BAD DEBT EXPENSE) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE AND RECORDED AS IMPLICIT PRICE CONCESSIONS UNDER ACCOUNTING PRONOUNCEMENT ASC 606). -------------------- PART III, SECTION A, LINE 3 (IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY) THE AMOUNT OF BAD DEBTS (IMPLICIT PRICE CONCESSIONS) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ITS FINANCIAL ASSISTANCE POLICY WAS CALCULATED BASED UPON THE NUMBER OF PRESUMED CHARITY-CARE ELIGIBLE PATIENTS WHO DID NOT COMPLETE THE FAP PAPERWORK DURING THE YEAR. -------------------- PART III, SECTION A, LINE 4 (IMPLICIT PRICE CONCESSION FOOTNOTE) THE TEXT OF THE IMPLICIT PRICE CONCESSION (BAD DEBT EXPENSE) FOOTNOTE CAN BE FOUND ON PAGE 15 OF THE ELECTRONICALLY ATTACHED AUDITED FINANCIAL STATEMENTS. --------------------
PART III, SECTION B, LINE 8 (COSTING METHODOLOGY, MEDICARE SHORTFALL) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON A COST TO CHARGE RATIO. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF CHRISTIANACARE AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, CHRISTIANACARE PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY CHRISTIANACARE TO PROVIDE SUCH SERVICES. AS A RESULT, CHRISTIANA CARE VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. -------------------- PART III, SECTION B, LINE 9B (COLLECTION PRACTICES) CHRISTIANACARE HAS A FINANCIAL ASSISTANCE POLICY THAT IDENTIFIES THE CIRCUMSTANCES FOR WHICH A RESPONSIBLE PARTY WOULD BE EXTENDED A 100% ADJUSTMENT ON ALL MEDICAL BILLS. THE GROSS INCOME THRESHOLD FOR THIS CHARITABLE ADJUSTMENT IS 200% OF THE FEDERAL POVERTY LEVEL AND IT IS BASED ON THE NUMBER OF DEPENDENTS IN THE HOUSEHOLD. THE FINANCIAL ASSISTANCE POLICY FURTHER EXPLAINS THAT ANY UNINSURED PATIENT WHO FAILS TO QUALIFY FOR FINANCIAL ASSISTANCE WOULD BE GRANTED A 15% SELF PAY DISCOUNT. PATIENTS MAY ALSO ESTABLISH INTEREST-FREE MONTHLY PAYMENT ARRANGEMENTS FOR ANY OUTSTANDING BALANCE THAT IS NOT COVERED BY A THIRD PARTY PAYER. AS PART OF THE SELF PAY DUNNING PROCESS, CHRISTIANA CARE MAKES UNINSURED PATIENTS AWARE OF THE FINANCIAL ASSISTANCE PROGRAM WITH THE RELEASE OF OUR FIRST STATEMENT. FOR ALL SUBSEQUENT STATEMENTS, PATIENTS HAVE AN OPPORTUNITY TO CALL OUR CUSTOMER SERVICES DEPARTMENT IF THEY ARE UNABLE TO MAKE PAYMENT IN FULL. IF A PATIENT QUALIFIES FOR A CHARITABLE ADJUSTMENT, THEY ARE EXTENDED THE COURTESY OF AN AUTOMATIC ADJUSTMENT TO THEIR BILLS FOR THE NEXT YEAR AND FOR ONE YEAR PRIOR TO THE DATE A PATIENT'S APPLICATION IS APPROVED. PATIENTS WOULD NEED TO REAPPLY FOR CHARITABLE CONSIDERATION AFTER THE ONE YEAR HAS LAPSED. ALL COLLECTION ACTIONS WOULD CEASE ONCE A PATIENT IS DEEMED ELIGIBLE FOR CHARITY OR ONCE A PATIENT ESTABLISHES AND MAINTAINS A MONTHLY PAYMENT ARRANGEMENT. --------------------
PART VI, LINE 2 (NEEDS ASSESSMENT) AT CHRISTIANACARE, WE ABIDE BY THE CHRISTIANACARE WAY. WE SERVE OUR NEIGHBORS AS EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE, AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. WE PARTNER WITH OUR NEIGHBORS TO PROVIDE THEM WITH SYSTEMS OF CARE THAT THEY VALUE. TO EFFECTIVELY DO THIS, WE MUST LISTEN TO AND LEARN FROM OUR COMMUNITIES CONSISTENTLY. A NEEDS ASSESSMENT CANNOT REPLACE ONGOING TRUSTED PARTNERSHIPS AND A WILLINGNESS TO LISTEN ACTIVELY AND SEEK NEW KNOWLEDGE, TWO OF THE BEHAVIORS THAT GUIDE CHRISTIANACARE CAREGIVERS. MANY OF THE WAYS IN WHICH CHRISTIANACARE ASSESSES THE HEALTH NEEDS OF OUR COMMUNITY HAVE BEEN DESCRIBED IN EARLIER SECTIONS. WE IMPLEMENTED A SYSTEM WIDE SDOH SCREENING INSTRUMENT TO LEARN DIRECTLY FROM OUR PATIENTS ABOUT THEIR CHALLENGES, AND WE PARTNERED WITH UNITE US TO LAUNCH UNITE DELAWARE IN THE STATE WHICH PROVIDES A TOOL TO ADDRESS OUR PATIENTS' NEEDS AS WELL AS INSIGHT INTO THE NEEDS OF DELAWAREANS. FOR EXAMPLE, USE OF THE NETWORK HAS SHOWN THAT HOUSING AND FOOD INSECURITY ARE CONSISTENTLY THE MOST REFERRED NEEDS. THE COMMUNITY INVESTMENT FUND PROVIDES US WITH THE OPPORTUNITY TO LEARN FROM COMMUNITY-BASED ORGANIZATIONS (FOR FY2022, THERE WERE MORE THAN 60 APPLICANTS) ABOUT THE CHALLENGES THEIR COMMUNITIES FACE AND HOW THEY THINK BEST TO ADDRESS THEM. DIRECTLY PARTNERING WITH COMMUNITY ORGANIZATIONS SUCH AS URBAN ACRES, LUTHERAN COMMUNITY SERVICES, AND THE NEW CASTLE COUNTY POLICE DEPARTMENT ALSO PROVIDES INSIGHT INTO OUR COMMUNITY. CHRISTIANACARE ALSO PARTNERED WITH COMMUNITY STAKEHOLDERS AND ORGANIZATIONS TO CREATE SEVERAL GROUPS WHICH PROVIDE US WITH A DIRECT LINE OF CONTACT INTO OUR COMMUNITIES. THE GREATER WILMINGTON COMMUNITY PARTNERSHIP WAS FORMED WITH COMMUNITY PARTNERS IN 2012. INITIALLY CREATED IN PARTNERSHIP WITH HOMELESS SHELTER PROVIDERS TO COLLABORATIVELY ADDRESS THE NEEDS OF HOMELESS INDIVIDUALS, THIS GROUP HAS CONTINUED TO MEET MONTHLY FOR INFORMATION AND RESOURCE SHARING AND THE OPPORTUNITY TO DISCUSS COMMUNITY CHALLENGES. PARTICIPANTS INCLUDE THOSE FROM FAITH-BASED, NON-PROFIT, AND GOVERNMENT ORGANIZATIONS. CHRISTIANACARE CAREGIVERS PLAN AND HOST THE MEETINGS WITH INPUT FROM PARTICIPANTS. THE DELAWARE HEALTH MATERNAL AND INFANT CONSORTIUM CREATED THE WILMINGTON CONSORTIUM TO EDUCATE PROFESSIONALS WORKING WITH FAMILIES WITH CHILDREN FROM BIRTH TO AGE 5. LIKE THE GREATER WILMINGTON COMMUNITY PARTNERSHIP, THE PURPOSE OF THE GROUP IS TO SHARE RESOURCES AND DISCUSS COMMUNITY ISSUES AS THEY RELATE TO FAMILIES WITH YOUNG CHILDREN. CHRISTIANACARE CAREGIVERS CO-CHAIR THE GROUP WHICH MEETS BI-MONTHLY AND PROVIDE THE ADMINISTRATIVE SUPPORT FOR IT TO OPERATE. MEMBERS ARE ALSO ABLE TO SHARE COMMUNITY EVENTS AND RESOURCES WHICH ARE SENT OUT TO ALL MEMBERS IN A WEEKLY EMAIL. THE COMMUNITY ENGAGEMENT ADVISORY COUNCIL, CO-CHAIRED BY CHRISTIANACARE'S CHIEF HEALTH EQUITY OFFICER, WAS FORMED TO PROVIDE CHRISTIANACARE WITH DIRECT CONTACT WITH COMMUNITY LEADERS AND STAKEHOLDERS TO GAIN THEIR PERSPECTIVE ON COMMUNITY NEEDS AND IDENTIFY OPPORTUNITIES IN WHICH BOTH THE COMMUNITY AND CHRISTIANACARE CAN BENEFIT FROM WORKING TOGETHER TOWARDS MUTUAL GOALS. PARTICIPATION BY CHRISTIANACARE LEADERS ON COMMUNITY BOARDS AND COMMITTEES ALSO PROVIDES INSIGHT INTO COMMUNITY NEEDS. THE DELAWARE HEALTHY MOTHER AND INFANT CONSORTIUM, THE VISION COALITION OF DELAWARE, THE DELAWARE BUSINESS ROUNDTABLE, THE DRUG OVERDOSE FATALITY REVIEW COMMISSION, AND AIDS DELAWARE ARE ALL CHAIRED AND CO-CHAIRED BY CHRISTIANACARE CAREGIVERS. CHRISTIANACARE'S PATIENT & FAMILY HEALTH EDUCATION TEAM HAS ALSO BEEN INVOLVED IN A MULTI-YEAR PARTNERSHIP WITH THE UNIVERSITY OF DELAWARE PARTNERSHIP FOR HEALTHY COMMUNITIES AND THE DELAWARE DIVISION OF PUBLIC HEALTH TO CREATE A STRATEGIC PLAN FOR HEALTH LITERACY IN OUR STATE. THIS EFFORT BRINGS TOGETHER EXISTING NETWORKS FROM THROUGHOUT THE STATE IN THE HEALTH, EDUCATION, AND GOVERNMENTAL SECTORS AS WELL AS A CONTRACTED PROJECT WITH PMG CONSULTING TO ASSESS THE BASELINE NEEDS IN THE STATE AND TO GENERATE A STRATEGIC PLAN FOR ONGOING WORK. THIS PARTNERSHIP WILL SERVE TO MAKE CHRISTIANACARE A MORE HEALTH LITERATE ORGANIZATION AS WELL AS BENEFIT ALL DELAWAREANS. OUR PARTICIPATION ALSO ALLOWS US MORE INSIGHT INTO THE CHALLENGES WITHIN OUR COMMUNITY AND THROUGHOUT DELAWARE, AND HOW OUR PARTNERS ARE RESPONDING. --------------------
PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE) FOR FY22 UNINSURED INDIVIDUALS WITH A HOUSEHOLD INCOME GREATER THAN 200% OF THE FEDERAL POVERTY LEVEL WERE ELIGIBLE FOR A STANDARD DISCOUNT OF 15%. EFFECTIVE FEBRUARY 1, 2023, CHRISTIANACARE WILL UPDATE ITS FINANCIAL ASSISTANCE POLICY TO MAKE IT AVAILABLE FOR MORE PATIENTS. THE FINANCIAL ASSISTANCE ELIGIBILITY THRESHOLD WILL BE INCREASED FROM 200% TO 400% OF THE FEDERAL POVERTY LEVEL. PATIENTS FACING CATASTROPHIC COSTS, WHERE THE MEDICAL EXPENSES FOR AN EPISODE OF CARE EXCEED 20% OF THEIR ANNUAL INCOME, CAN NOW APPLY FOR FINANCIAL ASSISTANCE AS WELL. CHRISTIANACARE'S PRESUMPTIVE ELIGIBILITY PROCESS WAS ALSO UPDATED AND CLARIFIED IN THE FINANCIAL ASSISTANCE POLICY TO REDUCE THE BURDEN ON PATIENTS TO SUPPLY SUPPORTING DOCUMENTATION. THE PROCESS FOR CHRISTIANACARE REPRESENTATIVES TO MAKE IMMEDIATE CASE-BY-CASE DETERMINATIONS OF INDIVIDUAL ELIGIBILITY AND ACCEPT ALTERNATIVE QUALIFYING DOCUMENTATION FOR FINANCIAL ASSISTANCE WAS ALSO UPDATED AND STREAMLINED. CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY, ALONG WITH THE FOLLOWING MATERIALS ARE ALSO AVAILABLE ON OUR WEBSITE: HTTPS://CHRISTIANACARE.ORG/US/EN/VISIT-US/FOR-PATIENTS/FINANCIAL-ASSISTANC E-PROGRAM-SUMMARY/FINANCIAL-ASSISTANCE-PROGRAM IN ENGLISH, SPANISH, AND MANDARIN: - A PLAIN LANGUAGE SUMMARY, - THE FINANCIAL ASSISTANCE APPLICATION, - A DESCRIPTION OF THE APPLICATION PROCESS, - THE INCOME SCALES, - THE FINANCIAL ASSISTANCE SERVICE AREA, AND - A LIST OF PARTICIPATING AND NON-PARTICIPATING PROVIDERS. THE FINANCIAL ASSISTANCE PROGRAM IS PUBLICIZED THROUGH PAMPHLETS, SIGNAGE, ONLINE NOTICES ON THE CHRISTIANACARE WEBSITE, AND IN-PATIENT SERVICE AREAS. THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS PROVIDED TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED AND WHO INDICATE THEIR INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES AT INTAKE OR DISCHARGE. BECAUSE THEY ARE THE MOST SPOKEN LANGUAGES BESIDES ENGLISH, APPLICATIONS AND SUPPORTING DOCUMENTS SUCH AS THE PLAIN LANGUAGE SUMMARY ARE ALSO AVAILABLE IN SPANISH, MANDARIN, AND CANTONESE. TRANSLATION ASSISTANCE BY PHONE TO COMPLETE NECESSARY FORMS FOR ANYONE NOT PROFICIENT IN READING, WRITING, OR SPEAKING ENGLISH IS ALSO AVAILABLE MONDAY THROUGH FRIDAY FROM 9 A.M. TO 4 P.M. PATIENTS MAY ALSO CALL PATIENT FINANCIAL SERVICES TO REQUEST INFORMATION AND AN APPLICATION AND TO TALK CONFIDENTIALLY ABOUT THEIR SITUATION. IF CHRISTIANACARE DETERMINES THAT THE PATIENT MAY QUALIFY FOR OTHER COVERAGE, FINANCIAL COUNSELING WILL BE PROVIDED TO ASSIST PATIENTS TO APPLY FOR THE AVAILABLE COVERAGE. CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY WEBPAGE AND PLAIN LANGUAGE SUMMARY ALSO INCLUDES CONTACT INFORMATION OF STATE AND FEDERAL HEALTH INSURANCE RESOURCES FOR THOSE WHO ARE UNINSURED. CHRISTIANACARE'S HEALTH GUIDES ARE ALSO AVAILABLE TO HELP PATIENTS OVERCOME FINANCIAL BARRIERS. THEY ASSIST PATIENTS IN COMPLETING THE CHRISTIANACARE'S APPLICATION FOR FINANCIAL ASSISTANCE AS WELL AS ENROLL IN HEALTH INSURANCE OR APPLY FOR PRESCRIPTION ASSISTANCE OR MEDICAID TO NAME JUST A FEW EXAMPLES. IN FY2022, THE HEALTH GUIDES ASSISTED 50 PATIENTS IN SUBMITTING REQUESTS FOR ADJUSTMENTS TO THEIR MEDICAL BILLS RECEIVED FROM MULTIPLE SOURCES FOR A TOTAL OF $305,141. --------------------
PART VI, LINE 4 (COMMUNITY INFORMATION) WHILE CHRISTIANACARE PROVIDES SERVICES IN FOUR STATES, THE 2022 CHNA DEFINED CHRISTIANACARE'S COMMUNITY AS NEW CASTLE COUNTY, DELAWARE BECAUSE OF THE HIGH PERCENTAGE OF NEW CASTLE COUNTY RESIDENTS AMONG THOSE DISCHARGED FROM CHRISTIANACARE'S TWO DELAWARE HOSPITALS. IN FY2021, 77% OF CHRISTIANA HOSPITAL'S DISCHARGES AND 91% OF WILMINGTON HOSPITAL'S DISCHARGES WERE NEW CASTLE COUNTY RESIDENTS. THE TOTAL POPULATION OF NEW CASTLE COUNTY IN 2021 WAS APPROXIMATELY 553,500 PERSONS. THIS POPULATION IS EXPECTED TO GROW 2.6% FROM 2020 TO 2030. THE POPULATION 65 YEARS OF AGE AND OLDER IS ANTICIPATED TO GROW BY 30.5% DURING THAT TIME. THERE IS CONSIDERABLE VARIATION AMONG SOCIOECONOMIC CONDITIONS IN NEW CASTLE COUNTY. TO ENSURE THESE VARIATIONS WERE NOT OVERLOOKED, THE 2022 CHNA ASSESSED COMMUNITY HEALTH NEEDS IN TWO GEOGRAPHIC AREAS OF NEW CASTLE COUNTY: "COMMUNITY 1" (ZIP CODES 19801, 19802, 19804, 19805, AND 19720) AND "COMMUNITY 2" (ALL OTHER NEW CASTLE COUNTY ZIP CODES). COMMUNITY 1 ACCOUNTED FOR 28% OF CHRISTIANACARE DISCHARGES IN 2021 AND COMMUNITY 2 ACCOUNTED FOR 52% OF CHRISTIANACARE DISCHARGES. IN COMMUNITY 1, APPROXIMATELY 48% OF THE POPULATION IDENTIFIES AS BLACK; IN COMMUNITY 2, THIS STATISTIC IS 17%. APPROXIMATELY 15% OF THE OVERALL POPULATION IN COMMUNITY 1 IDENTIFIES AS HISPANIC; IN COMMUNITY 2, THIS STATISTIC IS ABOUT 8%. THE OVERALL POVERTY RATE IN NEW CASTLE COUNTY HAS BEEN BELOW DELAWARE AND U.S. AVERAGES; HOWEVER, RATES FOR BLACK AND FOR HISPANIC COUNTY RESIDENTS HAVE BEEN SUBSTANTIALLY HIGHER THAN RATES FOR WHITE RESIDENTS. THE POVERTY RATE IN COMMUNITY 1 HAS BEEN MORE THAN DOUBLE THE RATE FOR COMMUNITY 2 (16.8% COMPARED TO 8.3%). LOW-INCOME CENSUS TRACTS ARE MOST PREVALENT IN NEWARK, WILMINGTON AND THROUGHOUT COMMUNITY 1. IN MANY OF THESE CENSUS TRACTS, MORE THAN ONE-HALF OF HOUSEHOLDS ARE "RENT BURDENED," ARE CATEGORIZED AS "HIGH NEED" BY THE DIGNITY HEALTH COMMUNITY NEED INDEXTM (CNI) AND ARE IN THE TOP QUARTILE NATIONALLY FOR "SOCIAL VULNERABILITY" ACCORDING TO THE CENTERS FOR DISEASE CONTROL'S SOCIAL VULNERABILITY INDEX. BECAUSE OF THESE DISPARITIES AMONG NEW CASTLE COUNTY COMMUNITIES, WE HAVE COMMITTED TO HELPING PATIENTS LIVING IN THE HIGH-NEEDS COMMUNITIES OF COMMUNITY 1 ADDRESS THEIR SOCIAL NEEDS THROUGH INCREASED SDOH SCREENING AND RESOURCE REFERRALS THROUGH UNITE DELAWARE. WHILE THE DATA DEMONSTRATE THAT COMMUNITY 2 RESIDENTS ARE NOT AS LIKELY TO HAVE POOR SOCIAL DETERMINANTS OF HEALTH, WE RECOGNIZE THAT THERE ARE CERTAINLY INDIVIDUALS IN THIS AREA FACING CHALLENGES AS WELL. OUR COMMITMENT TO SDOH SCREENING AMONG ALL PATIENTS WILL ENSURE THOSE PATIENTS ARE NOT OVERLOOKED. --------------------
PART VI, LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH) CHRISTIANACARE'S MISSION IS TO SERVE OUR NEIGHBORS AS EXPERT, CARING, PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE AFFORDABLE, AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. WE ARE COMMITTED TO FULFILLING OUR MISSION OF SERVICE TO OUR NEIGHBORS. AS THE LARGEST HEALTH CARE PROVIDER IN A STATE THAT HAS NO SAFETY NET OR PUBLIC HOSPITAL, WE SERVE A SIGNIFICANT PORTION OF THE COMMUNITY'S UNINSURED AND UNDERINSURED POPULATION ALONG WITH A SUBSTANTIAL PORTION OF THE STATE'S MEDICAID POPULATION. IN DEMONSTRATION OF OUR COMMITMENT TO SERVING OUR NEIGHBORS, IN JULY 2019, CHRISTIANACARE ENTERED INTO AGREEMENTS WITH DELAWARE'S TWO LARGEST MEDICAID PAYORS TO WORK WITH BENEFICIARIES IN POPULATION HEALTH CONTRACTS. IN APRIL 2021, CHRISTIANACARE AND HIGHMARK HEALTH ANNOUNCED A JOINT VENTURE THAT WILL CREATE A NEW MODEL OF VALUE-BASED CARE THAT IS CONTINUOUS, AND DATA AND TECHNOLOGY LED. THIS IS PROBLEM-SOLVING DESIGNED TO TAKE COST AND INEFFICIENCIES OUT OF THE SYSTEM. CHRISTIANACARE INCLUDES AN EXTENSIVE NETWORK OF OUTPATIENT SERVICES, HOME HEALTH CARE, URGENT CARE CENTERS, THREE HOSPITALS (1,435 LICENSED BEDS), FREE-STANDING EMERGENCY DEPARTMENT, A LEVEL I TRAUMA CENTER AND A LEVEL III NEONATAL INTENSIVE CARE UNIT, A COMPREHENSIVE STROKE CENTER AND REGIONAL CENTERS OF EXCELLENCE IN HEART AND VASCULAR CARE, CANCER CARE AND WOMEN'S HEALTH. IT ALSO INCLUDES THE PIONEERING GENE EDITING INSTITUTE. CHRISTIANACARE IS A NONPROFIT TEACHING HEALTH SYSTEM WITH MORE THAN 265 RESIDENTS AND FELLOWS. WE ARE CONTINUALLY RANKED BY US NEWS & WORLD REPORT AS A BEST HOSPITAL AND THIS FISCAL YEAR, RANKED BY FORBES AS THE 5TH BEST HEALTH SYSTEM TO WORK FOR IN THE UNITED STATES. WITH OUR UNIQUE, DATA-POWERED CARE COORDINATION SERVICE CAREVIOTM AND A FOCUS ON POPULATION HEALTH AND VALUE-BASED CARE, AS DEMONSTRATED THROUGH OUR JOINT VENTURE WITH HIGHMARK, CHRISTIANACARE IS SHAPING THE FUTURE OF HEALTH CARE. CHRISTIANACARE ALSO PROVIDES SERVICES THAT DELAWAREANS CANNOT FIND ELSEWHERE IN THE STATE SUCH AS AN EPILEPSY MONITORING UNIT, A COMPREHENSIVE PAIN CENTER (WHICH OFFERS EFFECTIVE, NON-OPIOID PAIN TREATMENT STRATEGIES FOR INDIVIDUALS WITH ACUTE AND CHRONIC PAIN), KIDNEY TRANSPLANTS, A LEVEL 2 PEDIATRIC EMERGENCY CARE FACILITY, CAR-T CELL THERAPY, A NEW BREAKTHROUGH TREATMENT FOR HIGHLY RESISTANT B-CELL BLOOD CANCERS, AND PROSTATE EMBOLIZATION (A MINIMALLY INVASIVE OUTPATIENT PROCEDURE PERFORMED BY VASCULAR INTERVENTIONAL RADIOLOGISTS). CHRISTIANACARE ALSO LAUNCHED THE FIRST YOUNG ADULT SURVIVORSHIP TRANSITION PROGRAM IN DELAWARE TO HELP ADOLESCENT AND YOUNG ADULT CANCER SURVIVORS AGED 18 TO 39 TO STAY HEALTHY AFTER CHILDHOOD CANCER. MANY CANCER SURVIVORS HAVE UNMET HEALTH NEEDS BECAUSE OF THEIR TREATMENTS. SIGNIFICANT AND DIVERSE RESEARCH IS ALSO HAPPENING AT CHRISTIANACARE. DURING THE COVID-19 PANDEMIC IN 2020, THERE WAS A 34% INCREASE IN ALCOHOL WITHDRAWAL RATES AMONG HOSPITALIZED PATIENTS AT CHRISTIANACARE, ACCORDING TO A RESEARCH LETTER PUBLISHED IN THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. THIS STUDY IS BELIEVED TO BE THE FIRST TO QUANTIFY THE IMPACT OF THE COVID-19 PANDEMIC ON ALCOHOL WITHDRAWAL AMONG HOSPITALIZED PATIENTS. IN BREAKTHROUGH COLON CANCER RESEARCH, SCIENTISTS AT CHRISTIANACARE'S HELEN F. GRAHAM CANCER CENTER & RESEARCH INSTITUTE HAVE DISCOVERED A LINK BETWEEN TWO KEY SIGNALING PATHWAYS CRUCIAL TO THE DEVELOPMENT AND GROWTH OF COLON CANCER. THE STUDY IS PUBLISHED IN THE JOURNAL PLOS ONE. CHRISTIANACARE IS ALSO PROUD OF ITS INSTITUTE FOR RESEARCH ON EQUITY AND COMMUNITY HEALTH (IREACH), AN EMBEDDED HEALTH RESEARCH INSTITUTE THAT CONDUCTS APPLIED RESEARCH FOCUSED ON ISSUES OF EQUITY AND COMMUNITY HEALTH, POPULATION HEALTH, AND VIRTUAL HEALTH, AND ALSO TRAINS THE NEXT GENERATION OF CLINICAL SCIENTISTS. THE GOAL IS TO BRIDGE THE GAP BETWEEN CLINICAL AND TRANSLATIONAL RESEARCH, ADVANCEMENTS IN THE QUALITY OF CARE, AND IMPROVED POPULATION HEALTH OUTCOMES FOR ALL. CHRISTIANACARE INNOVATIVELY SERVES ITS COMMUNITY THROUGH CAREVIO, AN AWARD-WINNING CARE MANAGEMENT ORGANIZATION SERVING INDIVIDUALS WITH ACUTE, CHRONIC AND COMPLEX HEALTH CARE NEEDS. CAREVIO EARNED ACCREDITATION IN TWO AREAS - CASE MANAGEMENT AND POPULATION HEALTH PROGRAM - THIS FISCAL YEAR FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA), A PRIVATE, NONPROFIT ORGANIZATION DEDICATED TO IMPROVING HEALTH CARE QUALITY. CAREVIO IS THE FIRST NON-HEALTH-PLAN POPULATION HEALTH MANAGEMENT ORGANIZATION IN DELAWARE TO RECEIVE NCQA ACCREDITATION FOR CASE MANAGEMENT AND POPULATION HEALTH. CAREVIO IS A ROBUST INFORMATION TECHNOLOGY PLATFORM THAT HARNESSES REAL-TIME HEALTH DATA FROM ALL AVAILABLE SOURCES. IT USES A PREDICTION ANALYTICS ENGINE TO COORDINATE CARE, IDENTIFY POPULATIONS MOST AT-RISK AND HELP PREVENT THE NEED FOR HOSPITALIZATIONS AND EMERGENCY DEPARTMENT VISITS THROUGH PREVENTIVE CARE AND HOME CARE. CAREVIO HAS NURSE CARE COORDINATORS, SOCIAL WORKERS, CLINICAL PHARMACISTS, RESPIRATORY THERAPISTS, AND MEDICAL DIRECTORS WHO CONNECT WITH PATIENTS BY PHONE, VIDEO, IN-PERSON VISITS, SECURE TEXTS AND E-MAIL TO HELP THEM MANAGE THEIR HEALTH CARE. CHRISTIANACARE IS A FOUNDING PARTNER IN EBRIGHTHEALTH ACO, AN ACCOUNTABLE CARE ORGANIZATION THAT SERVES APPROXIMATELY 50,000 REGIONAL MEDICARE BENEFICIARIES FROM DELAWARE, PENNSYLVANIA, AND MARYLAND. CAREVIO ALSO PROVIDES THE CARE COORDINATION FOR THIS INITIATIVE. CHRISTIANACARE SUPPORTS THE FIRST STATE SCHOOL LOCATED AT WILMINGTON HOSPITAL IN PARTNERSHIP WITH THE RED CLAY CONSOLIDATED SCHOOL DISTRICT AND THE DELAWARE DEPARTMENT OF EDUCATION. CHILDREN AND ADOLESCENTS FROM KINDERGARTEN THROUGH HIGH SCHOOL, WHO WOULD TYPICALLY BE HOMEBOUND WITH SERIOUS ILLNESSES SUCH AS DIABETES, SICKLE-CELL ANEMIA, SEVERE ASTHMA, CANCER, AND ILLNESSES ATTEND SCHOOL WITH THEIR PEERS WHILE RECEIVING NEEDED MEDICAL TREATMENT. THIS PROGRAM IS ONLY ONE OF THREE IN OPERATION NATIONWIDE, AND IT HAS BEEN A STAPLE OF CHRISTIANACARE'S COMMUNITY PROGRAMS SINCE IT BEGAN SERVING ADOLESCENTS IN 1985 AND EXPANDED TO SERVE ELEMENTARY STUDENTS IN 1991. CHRISTIANACARE IS ALSO A MAJOR TEACHING HOSPITAL. CHRISTIANACARE PARTNERS WITH LEADING COLLEGES AND UNIVERSITIES IN THE REGION TO OFFER A ROBUST NURSING EDUCATION PROGRAM AND WITH LOCAL TECHNICAL COLLEGES TO PROVIDE CLINICAL TRAINING FOR TECHNICAL HEALTHCARE CAREERS. CHRISTIANACARE IS COMMITTED TO INSTILLING IN THE STUDENTS IT TEACHES AND MENTORS THE IMPORTANCE OF OUR COMMUNITY'S HEALTH AND WELL-BEING, AND THE NEED TO CONSIDER THE SOCIAL DETERMINANTS OF HEALTH IN ALL WE DO. FINALLY, CHRISTIANACARE IS CONSISTENTLY RECOGNIZED FOR ITS GOOD WORKS THROUGH THE RECEIPT OF NUMEROUS NATIONAL AWARDS. DURING THIS REPORTING PERIOD: - CHRISTIANACARE WAS RECOGNIZED FOR THE 3RD YEAR IN A ROW AMONG THE WORLD'S BEST HOSPITALS BY NEWSWEEK. THE AMERICAN HOSPITAL ASSOCIATION'S INSTITUTE FOR DIVERSITY AND HEALTH EQUITY ALSO NAMED CHRISTIANACARE A 2021 CAROLYN BOONE LEWIS EQUITY OF CARE AWARD HONOREE. THE CAROLYN BOONE LEWIS EQUITY OF CARE AWARD IS AN ANNUAL RECOGNITION OF OUTSTANDING EFFORTS AMONG HOSPITALS AND HEALTH CARE SYSTEMS TO ADVANCE EQUITY OF CARE TO ALL PATIENTS AND TO SPREAD LESSONS LEARNED AND PROGRESS TOWARD DIVERSITY, INCLUSION, AND HEALTH EQUITY. - FORBES MAGAZINE ALSO RANKED CHRISTIANACARE AS ONE OF THE BEST EMPLOYERS FOR DIVERSITY AND INCLUSION IN THE UNITED STATES IN ITS LIST OF BEST EMPLOYERS FOR DIVERSITY 2021. - FOR ITS OUTSTANDING PATIENT PARTICIPATION RATE IN CANCER CLINICAL TRIALS, CHRISTIANACARE'S HELEN F. GRAHAM CANCER CENTER AND RESEARCH INSTITUTE HAS EARNED TOP NATIONAL RANKINGS FROM SEVERAL ORGANIZATIONS OF THE NATIONAL CANCER INSTITUTE. CHRISTIANACARE'S PATIENT PARTICIPATION RATE INTO CANCER CLINICAL TRIALS EACH YEAR IS NEARLY 30% - MORE THAN SEVEN TIMES THE NATIONAL AVERAGE OF 4%. - CHRISTIANACARE EARNED HEALTHGRADES 2021 AMERICA'S 50 BEST HOSPITALS AWARDT AND IS AMONG THE TOP 1 PERCENT OF MORE THAN 4,500 HOSPITALS ASSESSED NATIONWIDE FOR ITS CONSISTENT, YEAR-OVER-YEAR SUPERIOR CLINICAL PERFORMANCE. - CHRISTIANACARE HAS BEEN HONORED AS ONE OF ONLY 89 INSTITUTIONS OUT OF 722 BY THE AMERICAN COLLEGE OF SURGEONS (ACS) CLINICAL CONGRESS FOR ACHIEVING "MERITORIOUS" OUTCOMES IN SURGICAL PATIENT CARE. CHRISTIANACARE'S GOVERNING BODY, ITS BOARD OF DIRECTORS, IS COMPRISED PRIMARILY OF PERSONS WHO RESIDE IN ITS PRIMARY SERVICE AREA, AND MOST OF THE BOARD MEMBERS ARE NOT EMPLOYEES, FAMILY MEMBERS OF EMPLOYEES, OR INDEPENDENT CONTRACTORS OF CHRISTIANACARE. AS DESCRIBED IN THE CHNA AND CHIP, CHRISTIANACARE FINANCIALLY SUPPORTS IMPROVEMENTS IN ACCESSING CARE, COMMUNITY OUTREACH, IMPROVING THE CARE AND OVERALL HEALTH OF OUR NEIGHBORS, AND CONTINUING TO SUPPORT MEDICAL EDUCATION AND RESEARCH. --------------------
PART VI, LINE 6 (AFFILIATED HEALTHCARE SYSTEM INFORMATION) CHRISTIANACARE IS CENTERED ON IMPROVING HEALTH OUTCOMES, MAKING HIGH-QUALITY CARE MORE ACCESSIBLE, AND LOWERING HEALTH CARE COSTS. GUIDED BY OUR VALUES, LOVE AND EXCELLENCE, CHRISTIANACARE HAS GROWN, AND CONTINUES TO GROW, TO MEET THE NEEDS OF OUR COMMUNITY. CHRISTIANACARE HAS AN EXTENSIVE NETWORK OF PRIMARY CARE AND OUTPATIENT SERVICES, HOME HEALTH CARE, URGENT CARE CENTERS, THREE HOSPITALS (1,435 LICENSED BEDS), A FREESTANDING EMERGENCY DEPARTMENT, A LEVEL I TRAUMA CENTER AND A LEVEL III NEONATAL INTENSIVE CARE UNIT, A COMPREHENSIVE STROKE CENTER, AND REGIONAL CENTERS OF EXCELLENCE IN HEART AND VASCULAR CARE, CANCER CARE, AND WOMEN'S HEALTH. CHRISTIANACARE PROVIDES SERVICES THAT DELAWAREANS CANNOT FIND ELSEWHERE IN THE STATE SUCH AS AN EPILEPSY MONITORING UNIT, A COMPREHENSIVE PAIN CENTER, WHICH OFFERS EFFECTIVE, NON-OPIOID PAIN TREATMENT STRATEGIES FOR INDIVIDUALS WITH ACUTE AND CHRONIC PAIN, ADULT KIDNEY TRANSPLANT, AND A LEVEL 2 PEDIATRIC EMERGENCY CARE FACILITY. CHRISTIANACARE IS ALSO ONE OF THE LARGEST COMMUNITY-BASED TEACHING HOSPITALS CONDUCTING RESEARCH IN THE UNITED STATES. WE ARE COMMITTED TO ADVANCING HEALTH AND HEALTH EQUITY THROUGH RESEARCH AND INNOVATION AS DEMONSTRATED THROUGHOUT THIS NARRATIVE AND AS SHOWN BY OUR INSTITUTE FOR RESEARCH ON EQUITY AND COMMUNITY HEALTH. THIS EMBEDDED RESEARCH INSTITUTE CONDUCTS APPLIED RESEARCH FOCUSED ON ISSUES OF EQUITY AND COMMUNITY HEALTH, POPULATION HEALTH, AND VIRTUAL HEALTH, AS WELL AS TRAINING THE NEXT GENERATION OF CLINICAL SCIENTISTS WITH THE GOAL TO BRIDGE THE GAP BETWEEN CLINICAL AND TRANSLATIONAL RESEARCH, ADVANCEMENTS IN THE QUALITY OF CARE, AND IMPROVED HEALTH OUTCOMES FOR ALL. ALONG WITH SERVING OUR PATIENTS AND COMMUNITY THROUGH EXCEPTIONAL CLINICAL SERVICES, TRAINING THE NEXT GENERATION OF HEALTHCARE WORKERS, CONDUCTING ROBUST RESEARCH TO ADVANCE HEALTH OUTCOMES, AND AN UNWAVERING COMMITMENT TO EQUITY, WE ARE ALSO COMMITTED TO PROVIDING AFFORDABLE AND VALUE-BASED CARE. CHRISTIANACARE IS A FOUNDING PARTNER IN EBRIGHTHEALTH ACO, AN ACCOUNTABLE CARE ORGANIZATION THAT SERVES APPROXIMATELY 30,000 REGIONAL MEDICARE BENEFICIARIES FROM DELAWARE, PENNSYLVANIA, AND MARYLAND. CHRISTIANACARE'S CAREVIO PROVIDES THE CARE COORDINATION FOR THIS INITIATIVE. CAREVIO IS ANOTHER EXAMPLE OF CHRISTIANACARE'S AWARD WINNING INNOVATION TO BETTER SERVE INDIVIDUALS. CAREVIO HARNESSES AN INFORMATION TECHNOLOGY PLATFORM THAT IDENTIFIES THE PATIENTS WHO ARE AT HIGHEST RISK AND WHO HAVE SIGNIFICANT CARE NEEDS, INCLUDING THOSE WHO DO NOT REGULARLY ACCESS PRIMARY CARE AND PREVENTIVE SERVICES. UNDERSTANDING WHO IS AT RISK FOR POOR HEALTH ENABLES CLINICIANS TO PROACTIVELY CONTACT THE INDIVIDUAL TO CONNECT THEM TO THE HEALTH SERVICES THEY NEED. IN PERFORMANCE YEAR 2021, THE EBRIGHTHEALTH ACO REDUCED HEALTH CARE SPENDING BY $7 MILLION AND EARNED A QUALITY SCORE OF 82.1%. THIS MARKS THE SIXTH CONSECUTIVE YEAR THAT EBRIGHTHEALTH ACO HAS REDUCED HEALTH CARE COSTS FOR ITS ATTRIBUTED BENEFICIARIES, BRINGING THE CUMULATIVE AMOUNT SAVED TO MORE THAN $44.5 MILLION. CHRISTIANACARE ALSO LAUNCHED ONE OF THE FIRST MEDICAID ACOS IN THE STATE, DELAWARE MEDICAID QUALITY PARTNERS ACO ON JULY 1, 2021. THIS ACO SERVES MORE THAN 18,000 MEDICAID PATIENTS AND LIKE THE EBRIGHTHEALTH ACO, IT WILL ALSO BE SUPPORTED BY CAREVIO. HEALTH EQUITY, CARE STANDARDIZATION, AND SOCIAL DETERMINANTS OF HEALTH ARE AREAS OF FOCUS FOR THIS ACO TO ENSURE PATIENTS ARE SET UP FOR SUCCESS IN ACHIEVING POSITIVE HEALTH OUTCOMES. CHRISTIANACARE'S LEADERSHIP IN THE AREAS OF CLINICAL CARE, INNOVATION, AND RESEARCH CONTRIBUTE TO NATIONAL RECOGNITION. THE FOLLOWING ARE TWO AWARDS WE RECENTLY RECEIVED AMONG MANY. FOR THE 7TH YEAR IN A ROW, THE COLLEGE OF HEALTHCARE INFORMATION MANAGEMENT EXECUTIVES (CHIME) HAS GIVEN CHRISTIANACARE THE "MOST WIRED" DESIGNATION. AMONG THE MORE THAN 38,000 ORGANIZATIONS SURVEYED BY CHIME, CHRISTIANACARE RANKED ABOVE ITS PEERS IN THE CATEGORIES OF ANALYTICS AND DATA MANAGEMENT, POPULATION HEALTH, INFRASTRUCTURE, AND PATIENT ENGAGEMENT. FOR THE 3RD YEAR IN A ROW, HEALTHGRADES NAMED CHRISTIANACARE AS ONE OF AMERICA'S 50 BEST HOSPITALS. CHRISTIANACARE IS AMONG THE TOP 1% OF MORE THAN 4,500 HOSPITALS ASSESSED NATIONWIDE FOR CONSISTENT, YEAR-OVER-YEAR SUPERIOR CLINICAL PERFORMANCE. AS THE LARGEST PRIVATE EMPLOYER IN THE STATE OF DELAWARE, CHRISTIANACARE ALSO STRIVES TO BE A LEADER AMONG OTHER BUSINESSES AND ORGANIZATIONS. IN EARLY 2019, CHRISTIANACARE INCREASED ITS MINIMUM WAGE TO $15 AN HOUR, AND BEGINNING IN JULY 2020, CHRISTIANACARE BEGAN OFFERING 12 WEEKS OF PAID PARENTAL LEAVE FOR ITS CAREGIVERS. IN HONOR OF MARTIN LUTHER KING DAY IN JANUARY 2019, CHRISTIANACARE ALSO PROVIDED A COMMUNITY SERVICE BENEFIT TO ITS CAREGIVERS WHICH PROVIDES THEM WITH PAID COMMUNITY SERVICE TIME, IN ADDITION TO THEIR PAID TIME OFF, TO VOLUNTEER AT CHARITABLE, NON-PROFIT ORGANIZATIONS. IN FY2022, 425 HOURS WERE SPENT IN COMMUNITY SERVICE AT A COST OF OVER $24,000 TO CHRISTIANACARE. FINALLY, CHRISTIANACARE HAS ALSO COMMITTED TO BEING AN ANTI-RACISM ORGANIZATION. THAT COMMITMENT CAN BE FOUND HERE: ANTI-RACISM COMMITMENT - CHRISTIANACARE. CHRISTIANACARE'S CONTINUED GROWTH, ADAPTATION, AND INNOVATION WILL ALWAYS BE DRIVEN BY OUR FOUNDATION OF SERVICE TO OUR COMMUNITY AND ADDRESSING THE NEEDS THEY IDENTIFY. OUR MOST IMPORTANT PARTNERSHIP WILL ALWAYS BE WITH OUR NEIGHBORS. --------------------
PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT) THERE IS NO PRESENT STATE OF DELAWARE REQUIREMENT FOR CHRISTIANACARE TO FILE A COMMUNITY BENEFIT REPORT. CHRISTIANACARE HAS ESTABLISHED A COMMUNITY BENEFIT DEDICATED SECTION ON ITS WEBSITE WHERE THE CHNA AND CHIP CAN BE FOUND, ALONG WITH ARTICLES ABOUT CHRISTIANACARE'S COMMUNITY BENEFIT INITIATIVES AND STORIES. THIS CAN BE ACCESSED AT: https://christianacare.org/us/en/about-us/who-we-are/community-benefit --------------------
Schedule H (Form 990) 2021
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