Providence Holy Cross Community Benefit Report 2015 · PDF fileProvidence Holy Cross Medical...

Jim Tehan

Regional Director, Community Partnerships

Providence Health and Services

May 25, 2016

Providence Holy Cross Medical Center

2015 Community Benefit Report and

Implementation Plan Update


2015 Community Benefit Report and Implementation Plan Update

Table of Contents

Executive Summary……………………………………………………...

Page 1

Overview of the Organization……………………………………………

Definition of the Community…………………………………………….

Page 3

Key Findings from 2013 CHNA…………………………………………

Page 4

Community Needs Identified from 2013 CHNA………………………...

Page 6

Priority Needs from 2013 CHNA………………………………………..

Page 7

Status of 2015 Community Benefit Strategies and Metrics……………...

Page 8

Community Benefit 2016 Implementation Strategies and Metrics ……...

Page 14

Economic Inventory of 2015 Community Benefit Activities/Programs…

Page 16

Attachment 1: Providence Holy Cross Medical Center Detailed Listing of Community Benefit

Activities/Programs 2015

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Executive Summary

In December 2013, Providence Holy Cross Medical Center (PHCMC) completed a

comprehensive community health needs assessment of its service area. This assessment process

was initiated back in November 2012 and included a review of both primary and secondary data.

Key informant interviews and focus groups were conducted, along with surveys distributed to

community stakeholders and residents. In addition, several community forums were conducted at

faith-based institutions and schools, in which surveys were done using an electronic automatic

response system. Secondary data included information collected from the L.A. County

Department of Public Health, Truven Analytics, U.S. Bureau of the Census, State of California

Department of Public Health, Local Police and Sheriff Crime Statistics, and Providence Holy

Cross Medical Center CAMIS.

The area studied for the needs assessment included over 830,000 residents living in the

central and northern portions of the San Fernando Valley and the Santa Clarita Valley. Sixteen

communities were included in the assessment area.

While an extensive list of needs and issues were identified from the assessment, a

prioritization process was developed that involved local community leaders to help identify the

top issues. The priority needs/issues include:

- Expanded primary care capacity.

- Obesity prevention programs, including more community based nutrition and physical

activity programs.

- Free, low-cost, and culturally/language appropriate health education programs.

- Diabetes, heart disease, and hypertension prevention and management programs.

- Affordable and accessible mental health services.

This report provides an update on the progress to date in addressing the priority needs/issues

and also provides a listing of the community benefit programs and activities provided by the

Medical Center in 2015.

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Overview of the Organization

Located in Mission Hills, Providence Holy Cross Medical Center (PHCMC) was founded

in 1961 by the Sisters of the Holy Cross to serve a growing population in the San Fernando,

Santa Clarita, and Simi Valley communities. PHCMC is a general acute care hospital that is

currently licensed for 377 beds and has a medical staff consisting of over 600 physicians. In

2011, we celebrated the opening of a 138-bed expansion of PHCMC’s South Tower to meet a

growing need in the northern reaches of the region. The Medical Center offers both inpatient

and outpatient health services, including oncology, cardiology, orthopedics, neurosciences,

rehabilitation services, and women’s and children’s services. The Medical Center is designated

as a Level II Trauma Center and STEMI Receiving Center, and is certified as a Primary Stroke

Center. In 1996, the Medical Center joined Providence Health and Services.

Providence Health and Services, Southern California Region, is a not-for-profit Catholic

health care ministry committed to providing for the needs of the communities we serve —

especially the poor and vulnerable. The region serves the South Bay, Westside and the Greater

San Fernando Valley Area, operating six award-winning medical centers, a comprehensive

network of physician offices, long-term care, home care and hospice, urgent care centers, and

Providence High School. The organization was founded by the Sisters of Providence who have

been serving in the western area of the United States since the mid-1800s and serving the San

Fernando Valley since 1943.

Providence Health and Services’ scope of services includes hospitals, physician clinics,

senior services, supportive housing and many other health and educational services across

Alaska, California, Montana, Oregon, and Washington – with its system office located in

Renton, Washington. Providence Health and Services continues a tradition of caring that the

Sisters of Providence began nearly 160 years ago.

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Definition of the Community

The service area defined for the Providence Holy Cross Medical Center Community

Needs Assessment includes nineteen zip codes and sixteen communities. Approximately

873,788 people currently reside in the area, which includes both wealthy communities and areas

with high levels of poverty and need. The communities studied for the 2013 community needs

assessment included:

91311 Chatsworth 91351 Canyon Country

91321 Newhall 91352 Sun Valley

91326 Porter Ranch 91354 Valencia

91331 Pacoima 91355 Valencia

91340 San Fernando 91381 Stevenson Ranch

91342 Sylmar 91384 Castaic

91343 North Hills 91387 Canyon Country

91344 Granada Hills 91390 Santa Clarita

91345 Mission Hills 91402 Panorama City

91350 Santa Clarita

PHCMC Community Health Needs Assessment Service Area

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Key Findings from 2013 CHNA

Based on a review of both primary and secondary data collected as part of the community

health needs assessment, this section summarizes some of the key information on the PHCMC

service area analyzed as part of the study.

- Males make up 49.98% and females comprise 50.01% of the total population.

- A breakdown of the population of the area by age shows that 22.5% are between the ages

of 0-14, 15.1% are 15-24 years, 29.1% are 25-44 years, 23.7% are 45-64 years, 8.2% are

65-84 years, and 1.4% are 85 and over.

- Within the area targeted for this needs assessment, there were 11,300 births.

- The education level of the population 25 years and above showed that 25% of the

residents did not graduate from high school and 25% have a four year college degree or

graduate degree.

- A breakdown of the population of the area by race shows that 30.4% are Caucasian,

53.2% are Hispanic, 10.7% are Asian, 3.4% are African American, and 2.3% are other

races.

- Approximately 56.2% of the population of the area noted that they speak a language

other than English and 24.7% of the population noted that they speak English less than

very well.

- Of the occupied housing units in the area studied for the needs assessment, approximately

35% were rented and 65% were owned.

- Approximately 15.5% of the population of the area was uninsured.

- Of the two health districts that comprise the area studied for the needs assessment, 24.3%

of adults 18+ years in the East Valley Health District and 13.9% in the San Fernando

Health District reported no regular source of medical care.

- Approximately 23.9% of adults 18+ years in the East Valley Health District and 14.1% in

the San Fernando Health District reported having poor/fair health status.

- The percentage of Adults 18+ years who reported that they could not afford to see a

doctor was 19.9% in the East Valley Health District and 9.4% in the San Fernando Health

District.

- The percentage of children ages 3-17 years that were unable to afford dental care was

10.8% in the East Valley Health District and 12.8% in the San Fernando Health District.

- The percentage of adults 18+ years unable to afford dental care was 35.2% in the East

Valley Health District and 21.1% in the San Fernando Health District.

- The areas with the highest unemployment rate in the zip codes targeted for this study

included 91340 (San Fernando) at 14.5%, 91402 (Panorama City) at 12.8% and 91331

(Pacoima) at 12.6%.

- The zip codes included in this study that had the highest percentage of children living in

poverty included 91402 (Panorama City) at 26.7%, 91343 (North Hills) at 25.0%, and

91331 (Pacoima) at 22.8%.

- The areas studied for this assessment that had the highest percentage of seniors (65+)

living in poverty included 91402 (Panorama City) at 15.2%, 91343 (North Hills) at

13.9%, and 91331 (Pacoima) at 13.6%.

P a g e | 5

- The East Valley Health District had 7.7% of the population 18+ years who are below

300% of the federal poverty level and were homeless or living in a transitional living

situation. In the San Fernando Health District the statistic was 10.1%.

- Within the areas studied for this needs assessment, there were five zip codes that had a

Community Needs Index Score of 4.4 or greater (CNI scores close to 5 indicate areas in

highest need). These zip codes included 91343 (North Hills) at 4.8, 91402 (Panorama

City) at 4.6, 91331 (Pacoima) at 4.6, 91352 (Sun Valley) at 4.6, and 91340 (San

Fernando) at 4.4.

- The major illnesses/diseases present within the area defined for the PHCMC needs

assessment included:

- Hypertension

- Low Back Pain

- Arthritis

- Sinusitis

- Asthma

- Depression and Anxiety

- The leading causes of death in the PHCMC community health needs assessment service

area included:

- Heart Disease (29.0%)

- Cancer (25.3%)

- Other Causes (15.4%)

- Stroke/CVA (5.1%)

- Alzheimer’s Disease (4.8%)

- Approximately 54.7% of adults (18+) in the East Valley Health District and 60.0% of

adults in the San Fernando Health District are obese or overweight.

- Only 38.8% of children (age 6-17 years) in the East Valley Health District and 25.6% of

children in the San Fernando Health District participate in at least one hour of physical

activity seven days per week.

- The percentage of children (age 0-17 years) who eat fast food at least once per week is

44.2 % in the East Valley Health District and 47.3% in the San Fernando Health District.

- The percentage of adults (18+ years) who eat fast food at least once per week is 36.5% in

the East Valley Health District and 34.6% in the San Fernando Health District.

- The percentage of adults (18+ years) who eat at least five or more servings of fruits and

vegetables per day is only 18.8% in the East Valley Health District and 16.8% in the San

Fernando Health District.

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Community Needs Identified from 2013 CHNA

Following are the major needs and issues identified during the community health needs

assessment process through the collection and analysis of primary and secondary data. The

primary data collection tools included surveys and interviews with community stakeholders and

residents.

- Access to affordable primary and specialty care

- Access to affordable dental care

- Access to affordable mental health services

- Obesity prevention

- Safe neighborhoods

- Accessible physical activity programs

- Nutrition education and affordable healthy food options

- Affordable health insurance for adults

- Community case management and resource referral

- Heart disease screening and prevention

- Cancer screening and prevention

- Diabetes prevention and management

- Hypertension prevention and management

- Asthma prevention and management

- Affordable housing and transitional housing

- Substance abuse treatment programs

- Affordable services for a growing senior population

- Free and low cost health education programs

- Teen pregnancy prevention

- Sexually Transmitted Disease prevention

- Stress management programs

- Caregiver resources and support

- Free/low cost health screening services (e.g. mammograms, colonoscopies, etc.)

- Back injury prevention

- Affordable child care and adult day care

- Parenting resources for new parents and grandparents raising grandchildren

- Coordination of existing programs and services

- Expanded primary care capacity

- Culturally and language appropriate health services

P a g e | 7

Priority Needs from 2013 CHNA

Based on a review of the primary and secondary data collected as part of the community

needs assessment process conducted in 2013, a group of community stakeholders (both within

and outside the organization) were invited to review these needs to help the medical center

identify the priority issues. Although Providence Holy Cross Medical Center is not able to

address all of the needs identified in this assessment process, the organization is focused on those

needs/issues where it can bring its expertise and resources to make the best impact on serving the

community. PHCMC partners with other organizations in the community and provides financial

and in-kind resources to address community needs that are included on the list of priorities.

The key needs/issues identified through the assessment and prioritization process

included: (listed in priority order):

- Expanded primary care capacity.

- Obesity prevention programs, including more community based nutrition and physical

activity programs.

- Free, low-cost, and culturally/language appropriate health education programs.

- Diabetes, heart disease, and hypertension prevention and management programs.

- Affordable and accessible mental health services.

This report provides an update on key strategies and measurable metrics used in 2015 to

target these needs/issues (Figure 1, Page 8). The report also highlights the key strategies and

measurable metrics that will be used in 2016 (Figure 2, Page 14).

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Figure 1: Status of 2015 Community Benefit Strategies and Metrics

Providence Holy Cross Medical Center works in partnership with other organizations and community stakeholders to address

the unmet health needs in the area. The Medical Center identified specific multi-year community benefit strategies to direct its

resources to and the following table provides an update on progress made over the past year in meeting the measurable metrics

targeted for 2015.

Priority Need From CHNA 2015 Implementation Strategy Measurable Metrics Status Update

Expand primary care capacity Operationalize the mobile health program

Hire and train the Nurse Practitioner

Nurse practitioner was hired, but the position is currently open.

Confirm the Medical Director Medical Director confirmed.

Complete church/site agreements

Formal agreements signed for eight sites: 1) Valley Crossroads Seventh Day Adventist Church 2) St. Didacus Catholic Church 3) St. Elisabeth Catholic Church 4) St. Patrick’s Catholic Church 5) Our Lady of the Valley Catholic Church 6) St. Mark's Episcopal Church 7) St. Catherine of Siena Catholic Church 8) Canoga Park Presbyterian Church

Install Epic in the department and complete staff training

Epic installed and staff trained

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Expand primary care capacity (continued)

Operationalize the mobile health program (continued)

Develop promotional materials and begin recruiting patients with a target of 3,500 visits in the first year.

In addition to having an appointment line, brochures and flyers were made. 381 patient visits from April 2015 to December 2015.

Rollout the Health Insurance Navigation Project/BIEN (Benefits, Information, Educational Networking)

Develop and finalize curriculum for the classes

BIEN (Benefits, Information, Educational Networking) curriculum was developed. 25 staff and volunteers were trained (ten Providence staff and volunteers from a housing project in Pacoima and local churches).

Conduct 7 sessions of the course series

Due to a lengthy review process, no workshops were conducted in 2015.

Evaluate results to determine impact

P a g e | 1 0


Obesity prevention programs, including more community-based nutrition and physical activity programs

Complete the Nutrition Education and Obesity Prevention (NEOP) program at the churches per the requirements of the grant

Complete NEOP classes at the six churches

Providence arranged with another organization to conduct NEOP classes at ten churches: 1) Our Lady of Peace Catholic Church 2) Iglesia Poder De Dios 3) St. Didacus Catholic Church 4) Our Lady of Perpetual Help Church 5) Church of the Foothills 6) Guardian Angel Catholic Church 7) Canoga Park Presbyterian Church 8) Mired Christian Church 9) St. Mark's Episcopal Church 10) The Salvation Army of San Fernando Valley

Conduct evaluation on the effectiveness of the NEOP project

There was no impact evaluation done in any of the churches as part of the program. However, with some of the nutrition classes, there were evaluations of the program and there was usually an 80% to 90% improvement with knowledge on nutrition by the end of the program.

P a g e | 1 1


Obesity prevention programs, including more community-based nutrition and physical activity programs (continued)

Complete the Nutrition Education and Obesity Prevention (NEOP) program at the churches per the requirements of the grant (continued)

Implement policy component of the NEOP project

There were 109 classes, reaching 1,375 people. A garden was set up at St. Didacus Catholic Church. Healthy food and beverage policies were implemented this year at the Church of the Foothills and St. Didacus Catholic Church. A healthy food and beverage policy at Iglesia Poder De Dios is in the process of being done this year.

Free, low-cost and culturally/language appropriate health education programs

Review curriculum for health education classes offered in the community

Conduct review of the chronic disease classes provided in the community for uniformity and consistency between the outreach programs

A review was conducted.

Update curriculum to include current information

The curriculum was revised and staff received training on the changes.

Expand the base of volunteers working in the community

Complete Latino Health Promoter training in partnership with CDI and the Guadalupe Center

Health Promoter training was not completed in 2015.

Determine options for providing rewards/acknowledgements to volunteers who provide significant time to the outreach programs

Annual recognition receptions are scheduled. Volunteers receive certificates of appreciation.

P a g e | 1 2


Diabetes, heart disease and hypertension prevention and management programs

Evaluate the effectiveness of existing and need for additional support groups

Implement ongoing educational component within the Wellness Support Groups

Additional information regarding hypertension and cholesterol has been integrated into four Wellness Support Groups started by Lorena Soria, RN, CDE. A total of 127 persons attended classes. The classes were on-going for persons with diabetes, hypertension, and/or high blood pressure.

Add two English support groups in the community

No support groups were specifically developed to teach English to community members.

Add a new support group focused on women’s health issues

Two new women's health support groups were added, at Mary Immaculate Catholic Church and Pierce Park Community Center (housing project).

Conduct client surveys with the Faith Community Health Partnership, Latino Health Promoter, and School Nurse Outreach Programs

Develop survey questionnaires to assess which is the best method to provide follow-up communications and the best format to offer educational classes and support groups

Questionnaires developed in collaboration with UCLA research team.

Distribute surveys to a sample of clients served by the program

Surveys distributed to people at the end of health fair events.

Compile, review and summarize results

Analysis of results is pending.

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Affordable and accessible mental health services

Develop the Behavioral Health Outreach Program in partnership with the three Providence Medical Centers

Determine staffing needs and hire staff

Funding was not secured for this program (Behavioral Health Outreach Program).

Train staff using established curriculum

Establish partnership with professionals at the Medical Center to ensure client needs are met

Continue partnership with Tarzana Treatment Center on the development and expansion of the Mental Health Project

Ensure that grant targets are being met and program components are implemented

The partnership with the Tarzana Treatment Center continues for the development and expansion of the Mental Health Project. Grant targets were met and funding was increased. Targets include: 1) Completing a minimum of 2,222 hours of outreach and education activities (We completed over 2,500 hours). 2) Refer 2-4 clients per month for follow-up to the Tarzana Treatment Center (We met our referral target of 25 clients per year).

P a g e | 1 4

Figure 2: Community Benefit 2016 Implementation Strategies and Metrics

Priority Need From CHNA 2016 Implementation Strategy Measurable Metrics

Expanded primary care capacity and access to affordable health coverage

Explore and implement options for wellness visits, immunizations, and screenings (mobile clinic)

Hire and train nurse practitioners

Expand to 4 new sites

Establish baseline wellness visit protocols

Incorporate new health insurance enrollment unit into BIEN project (Benefits, Information, Educational Networking)

Expand to 10 new sites

Provide 1,000 individuals with enrollment assistance

Distribute Satisfaction Surveys

Obesity prevention programs, including more community-based nutrition and physical activity programs

Work in collaboration with Cal State University Northridge's (CSUN) 100 Citizens Program

Implement wellness visits for adults

Evaluate the impact of wellness visits by measuring A1C levels

Identify high-risk adults with chronic conditions, develop physical activity plan, and link to new or existing programs designed to improve physical activity

Monitor and track physical activity levels of adults who participate in 100 Citizens or Providence-sponsored events or programs

P a g e | 1 5

Priority Need From CHNA 2016 Implementation Strategy Measurable Metrics

Free, low-cost and culturally/language appropriate health education programs

Expand workshops (parenting, women’s health, chronic disease management, and others)

Develop a baseline for attendance and the change in knowledge, attitude, and/or behavior by participants

Expand to ten new sites

Continue to expand volunteer base for the Health Promoter Program

Complete Health Promoter training

Distribute Satisfaction Surveys

Diabetes, heart disease and hypertension prevention and management programs

Implement and evaluate Diabetes Self-Management Education (DSME) classes and support groups

Provide DSME classes for 5 cohorts (6 classes per cohort)

Develop a baseline for attendance

Affordable and accessible mental health services

Continue partnership with Tarzana Treatment Center on the development and expansion of the Mental Health Project

Reach grant target of 2,222 hours per year of outreach and education activities

P a g e | 1 6

Economic Inventory of 2015 Community Benefit Activities/Programs

A. Community Benefit Expenditures during 2015

PHCMC Community Benefit activities are classified into three broad expenditure categories

consistent with standards established by the Catholic Health Association: (1) Charity Care, (2)

Community Benefit Services, and (3) Unpaid Costs of Medi-Cal.1 For OSHPD reporting

purposes, we also identify the unpaid costs of Medicare but this statistic is not publicly reported.

Using guidelines developed by the Catholic Hospital Association,2 community benefit services

are further broken down into five broad areas: (1) Community Health Improvement Services, (2)

Health Professions Education, (3) Subsidized Health Services, (4) Cash and In-Kind

Contributions, and (5) Community Benefit Operations. The chart below, summarizes all

community benefit expense for 2015:

2014 2015 2016

Charity Care $9,712,585 $9,205,679

Community Benefit Services $7,819,683 $6,724,151

Unpaid Costs of Medi-Cal $30,350,659 -$15,374,423

TOTAL $47,882,926 $555,408

Unpaid Costs of Medicare $1,987,489 -$5,344,121

Charity Care: Charity care saw a 5.2% drop from 2014, largely due to ACA implementation

and a change in the methodology of calculating charity care by Providence Health and Services

at the system level.

Unpaid Costs of Medi-Cal: Medi-Cal shortfall, the difference between the cost of providing

care and the amount received from Medi-Cal, decreased 150.7% from 2014 to 2015, due to two

factors: (1) there was no provider tax included in 2014 and (2) PHCMC received provider tax

benefits in 2015, thereby dramatically reducing Medi-Cal Shortfall.

Community Benefit Services: Expenditures in the Community Benefit Services category

decreased 14% from $7.8 Million in 2014 to $6.7 Million in 2015. Community Benefit Services

at PHCMC combines five specific elements: Community Health Improvement Services

($1,817,985), Health Professions Education ($279,641), Subsidized Health Services

($4,363,516), Cash and In-Kind Contributions ($189,382), and Community Benefit Operations

($73,627). The drop in expense for preceptorships from $2,616,958 in 2014 to $279,641 in 2015

is the most significant change in expense. Expenses for all Community Benefit Services are

broken out in the detailed report provided in the attachment at the end if this report.

1 OSHPD issued guidance in 2006, notifying hospitals to report Medicare shortfall. Medicare shortfall is not publicly reported as a community benefit expense. 2 A Guide for Planning and Reporting Community Benefit, 2015 Edition, Catholic Health Association of the United States, St Louis, MO, 2015

P a g e | 1 7

B. Number of Individuals Impacted by PHCMC Community Benefit Programs

The number of people who were impacted by Community Benefit Programs decreased

24.4% from 62,068 in 2014 to 46,905 in 2015. While the number of people impacted by Medi-

Cal increased by 16.5% and those impacted by charity care increased by 86.8%, there was a

46.8% decrease in this number for community benefit services. Community-based outreach

programs, namely Faith Community Health Partnership and Latino Health Promoter, account for

much of this change. Prior year statistics reported the number of contacts, visits, appointments,

and/or attendance as opposed to giving an unduplicated number of people served. In addition, as

many of the community-based programs serve residents around the three Providence medical

centers in the San Fernando Valley and the Valley region as a whole, past reporting divided the

number of people served evenly among the three hospitals. In 2015 and going forward, an

attempt is being made to give an unduplicated count and to allocate this statistic based on the

number of people who reside in the service area of the specific Providence facilities. Another

significant difference in the number of people impacted occurred for the Paramedic Base Station.

For 2014, the number of patients in the Emergency Department was counted. For 2015, the

statistic is based on the number of calls and runs that the base station manages.

NUMBER OF INDIVIDUALS IMPACTED, BY COMMUNITY BENEFIT

CATEGORIES

2014 2015 2016

Charity Care 1,014 1,894

Community Benefit Services 41,225 21,919

Medi-Cal 19,829 23,092

TOTAL 62,068 46,905

Strategic Mission Priorities

Consistent with the PHCMC Mission Statement and the Ethical and Religious Directives

for Catholic Healthcare Services, our Community Benefit Plan places a priority on community-

based outreach to the poor and vulnerable. We carefully track the number of individuals

impacted by programs and services provide in underserved communities and seek to leverage

PHCMC resources with private and governmental support.

Community-Based Outreach Programs 2014 2015 2016

Access to Care 2,130 1,500

Faith Community Health Partnership 6,214 1,825

Latino Health Promoter Program 5,571 2,000

Mental Health Outreach N/A 5,000

Mobile Health Program N/A 82

School Nurse Outreach Program 1,168 1,600

Senior Outreach Program 151 167

Tattoo Removal Program 53 225

TOTAL 15,287 12,399

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In this area of community-based outreach programs, the number of people impacted

decreased 18.9% from 15,287 in 2014 to 12,399 in 2015. On an annual basis, there are typically

shifts within programs based either on grant-related funding or program expansion/reduction

based on shifting priorities in our implementation of programs. The lower numbers for the

Access to Care, Faith Community Health Partnership, and Latino Health Promoter programs

account for much of the discrepancy. As explained above, improved methods of documentation

have resulted in a more accurate illustration of the actual number of people impacted, as opposed

to a duplicated visit count. Two new additions to this list of community-based outreach

programs that target underserved populations are the Mental Health Outreach program and the

Mobile Health Program. The Mental Health Outreach program provides outreach, education and

referrals for individuals and families who are dealing with a mental health illness or substance

abuse. The Mobile Health Program was designed to provide high quality medical care to

individuals living at or near poverty who are under or uninsured and have a chronic disease, such

as diabetes, high cholesterol, or high blood pressure. In addition to chronic disease management

and care, the mobile clinic provides wellness visits and links patients to specialist, laboratory,

and imaging services.


Detailed Listing of Community Benefit Activities/Programs

2015

Category Total Expense Net Revenue Net Expense People Served

A. Community Health Improvement Services

Access to Care 342,509 32,329 310,180 1,500

Faith Community Health Partnership 354,367 - 354,367 1,825

Health Resource Center 16,478 - 16,478 45

Latino Health Promoter Program 344,407 40,892 303,515 2,000

Maternal Child Outreach and Education 345,395 - 345,395 N/A

Mental Health Outreach 62,350 33,333 29,017 5,000

Mobile Health Program 61,988 11,802 50,186 82

Post Discharge Pharmacy Medication 6,500 - 6,500 76

School Nurse Outreach Program 99,557 - 99,557 1,600

Senior Outreach Program 122,192 - 122,192 167

Tattoo Removal Program 180,598 - 180,598 225

Total A 1,936,341 118,356 1,817,985 12,520

B. Health Professions Education

Preceptorships 279,641 - 279,641 362

Total B 279,641 - 279,641 362

C. Subsidized Health Services

Paramedic Base Station 391,058 - 391,058 8,719

Trauma Program Physician Fees 3,804,608 - 3,804,608 181

Unreimbursed Psychiatric Care 167,850 - 167,850 137

Total C 4,363,516 - 4,363,516 9,037

E. Cash and In-Kind Contributions

Cash Donations 46,437 - 46,437 N/A

Mother Joseph Fund 142,945 - 142,945 N/A

Total E 189,382 - 189,382 N/A

G. Community Benefit Operations

Community Health Improvement Center 73,627 - 73,627 N/A

Total G 73,627 - 73,627 N/A

Total Community Benefit 6,842,507 118,356 6,724,151 21,919

Attachment 1

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