PART V, SECTION B, LINE 5 (INPUT FROM COMMUNITY)
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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. --------------------
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PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)
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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.
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PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)
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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.
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PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)
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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.
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PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)
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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.
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PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)
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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.
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PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)
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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.
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PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)
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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.
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PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)
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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.
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PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)
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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.
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PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)
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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. --------------------
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PART V, SECTION B, LINE 13 (ELIGIBILITY FOR PROVIDING DISCOUNTED CARE)
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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. --------------------
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PART V, SECTION B, LINE 16 (FINANCIAL ASSISTANCE POLICY AVAILABILITY)
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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 --------------------
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PART V, SECTION B, LINE 20 (ADDITIONAL EFFORTS MADE BEFORE AN ECA)
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CHRISTIANA CARE HEALTH SERVICES COMMUNICATES IN WRITING ABOUT COLLECTION PLACEMENT AND THE FINANCIAL ASSISTANCE POLICY. --------------------
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PART V, SECTION B, LINE 22 (CHARGES FOR FAP-ELIGIBLE INDIVIDUALS)
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FAP-ELIGIBLE INDIVIDUALS (THOSE WITH INCOME LESS THAN 200% OF FEDERAL POVERTY GUIDELINES) ARE NOT RESPONSIBLE FOR ANY CHARGES. --------------------
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