2011 Community Benefit report

building a community of

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grow

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Table of contents

I. FromtheDeskofGwenMatthews 2

II. Introduction

a. Introduction:WhoWeAre 3 b. CommitmenttoOurCommunity 4

III. Communication&FinancialManagersforCommunityBenefitPlanning&Reporting a. GoverningBoard 5 b. CommunityAdvisoryCouncil 6

IV. CommunityNeedsAssessment 7

V. Strategy/Goals:CommunityBenefitInitiativeandResults

a. Strategy/Goals 16 b. AdditionalCommunityBenefits 19

VI. CommunityBenefitReportForm 25

VII. CommunityBenefitSummary 27

VIII. AdventistHealthPolicy:CommunityBenefitCoordination 28

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“We reflect God’s love to our community by providing physical, mental and spiritual healing.”

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From the Desk of Gwen MatthewsChiefExecutiveOfficer

Whataprivilegeitistobeapartofthiscommunityandespeciallytofeelthepulseofhealthcare.Asalong-timenurse,I’musedtolookingatvitalsigns.

Accesstohealthcareisoneofthebiggestvitalsignsonmyradar. UkiahValleyMedicalCenter(UVMC)iscontinuallyexploringandopeningavenuestoprovidethebestresourcesavailableforthefamiliesweservethroughouta3,700-squaremileservicearea.

Itistruethatweareaninstitution,ahospital,amedicalcenter;butinrealitywearesomuchmore.Weareneighbors,brothers,sisters,mothers,fathers,daughters,sonsandfriends.Weareprovidersandusersofthehealthcarewedeliver.

Wearefamily!

OurmissionistoreflectGod’slovetoourcommunitybyprovidingphysical,mentalandspiritualcare.Wetakethesewordstoheartandhopeyouexperienceitascompassionatecarethrougheachandeveryoneofyourinteractionswithus.

Throughout this report, you will see examples of how UVMC hastakenactionstoworkwithourcommunitypartnerstoprovideactiveandprogressivesupportforsomeofthemostemergenttrendsaffectingour community. We are continually accomplishing this by donating ourtime,talentsandfinancialresources.Iamproudandhumbledtoworkwithsuchagivingandcaringgroupofindividuals…anattitudethatearnedUVMCthe“BestNursingTeam”inthenationduring2011asnamedbyAdvance For Nursesmagazine.

Withthisteamandourcommunitypartnerships,thefutureofhealthcareinourcommunitylooksbright.

Sincerely,

GwenMatthews

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“We are neighbors, brothers, sisters, mothers, fathers, daughters, sons and friends. We are providers and users of the health care we deliver.”

Introduction: Who We Are

From humble beginnings as a small communityhospitalinthe1950s,UVMChasgrowntoastate-of-the-artmedicalcenter,whichispartofAdventistHealth–anorganizationaffiliatedwiththeSeventh-day Adventist church that improves health andwellnessworldwide.

Our mission is to provide balance of physical,mental and spiritual health through preventionand treatment of disease. UVMC brings togetheremployees, physicians and volunteers who arecommittedtomeetingtheneedsofourcommunity.UVMCemploysapproximately700individualswhocollaboratewithourmedical staff (representing27medical specialties). Our 60 volunteers share in awiderangeofserviceactivitiestohelpthehospitalbetterservethecommunity.

UVMC offers 24-hour emergency-trauma care,inpatientandoutpatientsurgical services, intensivecare (with intensivist), specialty consultation viatelemedicine, diagnostic services, family birthcenterwithLevel IINICU, rehabilitation services,health education, advanced wound care including

hyperbaricoxygen therapyandmore.UkiahValleyRural Health Center offers outpatient care in thefollowing specialties: Allergy, Behavioral Health,Cardiology,FamilyPractice,General,Vascular andLaparoscopicSurgery,InternalMedicine,Obstetrics& Gynecology, Oncology, Ophthamology,Orthopedics, Pain Management, Pediatrics andAdolescentCareandUrology.

UVMCemploystechnologythatiswellabovethatfoundinmanyruralsettings.Someofthestate-of-the-art technology and services include a 64-sliceCTscanner,abletodetectvascularandheartdiseasenon-invasively;oneofthemostpowerfulMagneticResonance Imaging (MRI) units in NorthernCalifornia; digital mammography; mobile PET/CTservicesforcancerdetection;Lithotripsy(non-invasiveremovalofkidneystones);Nuclearmedicinediagnostic imaging; Remote Presence Roboticsystem;afamily-orientedbirthingcenterwithspecialcarenurseryandtheAdvancedWoundCenterwithadvancedwoundcaretreatmentincludinghyperbaricoxygentherapychambers.

“From humble beginnings as a small community hospital in the 1950s, UVMC has grown to a state-of-the-art medical center. ”

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Commitment to our Community

MissionWereflectGod’slovetoourcommunitybyprovidingphysical,mentalandspiritualhealing.

Employee FocusWestrivetoprovideeveryteammemberwithpurposeful,worthwhileworkandtohelpthemrecognizethecontributiontheymakepersonally.

Community FocusWecommittobegoodcorporatecitizensthroughcaring,competence,andstewardship.

We will fulfill our Mission by…• beingcompassionatetopatients,theirloved

ones,andeachother;• operatingwithfiscalresponsibilitythereby

ensuringcontinuousservice;• workingtogetherasateam;• providinghigh-quality,technically-advanced

services;• preservingindividualdignity;• protectingconfidentiality;• beingintegraltoourcommunity;• promotingwelllivinginourcommunity;• beingadaptable,innovative,andflexible;• beingexpertlisteners.

“We commit to be good corporate citizens through caring, competence, and stewardship.”

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Communication & Financial Managers for Community Benefit Planning & Reporting

Marketing & Business Development

KeithDobbsAdministrativeDirector707‐463‐7606NickBejaranoMarketingManager707‐463‐7524

Finance

BrandonParkerChiefFinancialOfficer707‐463‐7360ChrisSauderDirector/Controller707‐463‐7636

Decision Support

LaurieWoodDirector707‐463‐7615MaryLoganDecisionSupportAnalyst707‐463‐7615

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Governing BoardTheGoverningBoardatUVMCisinvolvedinstrategicplanningandpolicyapproval.Aspartoftheseresponsibilities,itprovidesmemberswiththemostrecentCommunityHealthStatusReportwhenitispublishedeverytwoyears.MembersareaskedtoapprovetheCommunityBenefitgoalsannually.TheBoardensuresthatthehospital’scommunityserviceroleisinalignmentwiththehospital’smission,vision,andgoals.

TheGoverningBoardatUkiahValleyMedicalCenterincludes:

BillWing,Chairman,SeniorVicePresident,AdventistHealth MarcWoodson,ViceChairman,ExecutiveSecretary,NorthernCaliforniaConferenceofSeventh- dayAdventists GwenMatthews,CEO,UVMC NancyBiggins,Attorney JorgeAllende,MD,ViceChiefofStaff ChanningCornell,LocalBusinessProfessional DonaldCoursey,MD DanniHendricks,CertifiedPublicAccountant ThomasJutzy,DDS MartyLombardi,SeniorVicePresident,SavingsBankofMendocinoCounty JeremyMann,MD DaleMorrison,CMO,MD MargieSalcedo-Rice,Concertmistress,UkiahSymphony DonaldRones,Sr.,RetiredBusinessProfessional LauraWedderburn,MD,ChiefofStaff,UVMC LauraWinkle,MD

TheCommunityBenefitAssessment,PlanandReportarecommunictedatleastannuallytotheGoverningBoardandCommunityAdvisoryCouncilofUkiahValleyMedicalCenterfortheirapprovalandsupport.ThefollowingindividualsparticipateasCommunityBenefitPlannersandReportingManagers:

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MarthaBarra,Vineyard/WineryOwner BobBlanc,RetiredExecutive AllyneBrown,DirectoryofPhilanthropy,UVMC AnilBuhla,Owner,FairfieldInn MelissaBurke,Owner,CreditBureauofUkiah BonnieCarter,CommunityVolunteer MaryLouiseChase,VineyardOwner LynnChevalier,VolunteerDirector,UVMC PaulConrado,VineyardOwner RichardCooper,MendoLakeCreditUnion DianeDaubeneck,Principal,InsuranceServices KeithDobbs,AdministrativeDirector,Marketing Communications,BusinessDevelopment& PhysicianRecruitment,UVMC GuilDye,Owner,KWINE/KMYXRadio EdEversole,EversoleMortuary RonGester,MD,FormerDirectorUVMCEmergency Department JimGoltz,Owner,RetechSystems RichHearney,RetiredMilitary Monte&KayHill,CommunityMembers BrendaHoek,CommunityMember LinHunter,ExecutiveDirector,MCHC PaulJepson,MD,Urologist,UVMC SteveJohnson,Attorney MartyLombardi,SeniorVicePresident,SavingsBankof MendocinoCounty DedeLedford,PropertyManager GwenMatthews,CEO,UVMC JohnMayfield,Consultant CarolMordhorst,Retired(formerDirector,Mendocino CountyPublicHealth) DeborahPardee,CALStarrepresentative MargieSalcedo-Rice,Concertmistress,UkiahSymphony SharonRuddick,Agriculture

TheCommunityAdvisoryCouncil(CAC)iscomprisedofcommunityleadersdedicatedtoimprovinglocalhealthcarebyprovidinginformationandrecommendationstothehospitalregardingcommunityneedsandfundraising.CACmembersalsoactasambassadorsofgoodwillonthehospital’sbehalfthroughoutthecommunityandprovideinputintothehospital’sstrategicplan.TheyaresolicitedfortheiropinionregardinttheCommunityBenefitgoalseachyear.Membersattendbi-monthlymeetings.

TheCommunityAdvisoryCouncilincludes: NeelamSalem,InvestmentCounselor JoanSchlienger,BoardMemberfor MendocinoCountyFoundation FrancineSalem,AssistantPrincipal UkiahHighSchool(retired) DickSelzer,Owner,SelzerRealty AnnThornhill,Retiredteacher HeatherVanHousen,VPofPatientCare, UVMC JimWattenburger,RetiredCALFire RaymondWorster,CertifiedPublic Accountant SteveZuieback,Consultant

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Community Needs Assessment

Executive Summary: Mendocino Community Health Status Report 2010

Mendocino County Health & Human ServicesAgency (HHSA), Community Health ServicesBranch, continues to provide some answers tothe question “How healthy is our community?” inthe Community Health Status Report (CHSR).This eighth biennial report introduces SocialDeterminants of Health and Health Equity andupdatesaselectionofhealth-relatedanddemographicindicators.Traditionalhealthindicatorssuchasbirthrates,deathratesandnumbersof reportedcases forvarious communicable diseases as well as broaderdeterminantsofeconomic,socialandenvironmentalhealtharealsoincluded.Someofthekeyfindingsandpointsofinterestareincludedinthissummary.

What makes us healthy or unhealthy?

Social determinants of health are thefactors embedded in our social and physicalenvironments that impact health either directly

or indirectly and are often beyond the controlof the individual. These include socioeconomicstatus, transportation, education, housing, accessto services, discrimination, and environmentalconditions.

Health inequities arise from health differencesthat result from inequitable distribution ofsocial determinants and are both preventableand unfair. They affect groups of people whohavesystematicallyexperiencedgreaterobstaclesto health based on their racial or ethnic group,socioeconomic status, education and othercharacteristicslinkedtodiscrimination.

While lower income, educational levels and lessaccess to servicesandhealth insurancegenerallytranslate into worse health status and earliermortality, this is often not the case for Latinoimmigrants.ThisiscalledtheLatinoParadox.

“While lower income and educational levels and less access to services and health insurance generally translate into worse health status and earlier mortality, this is often not the case for Latino immigrants. “

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Whenitcomestocountydatabyrace/ethnicityforresidentslivinginpoverty,householdincomeandeducation,itcanbeseenthatresidentsofthewhiteracedobetteroverallthanAmericanIndiansandsomewhatbetterthanHispanics.

Looking at age-adjusted death rates by race/ethnicity,Hispanicshavethelowestdeathratewithwhiteshavingthehighest.Duetosmallnumbersofpopulationanddeaths,AmericanIndiandeathratesareunstableandtrendsnotreliable.

In terms of life expectancy by race/ethnicity, theoppositepatternscanbeseen:HispanicshavethehighestlifeexpectancywithwhitesfollowingandAmerican Indians not reliable (sometimes high,sometimeslow)duetosmallnumbers.

County Health Status

MendocinoCountyiscomparedwiththestateacrossasub-setofhealthstatusindicatorsthathavebeenselectedbytheCentersforDiseaseControlandPrevention(CDC)andtheNationalCenterforHealthStatistics(NCHS)asbasicmeasuresofthehealthofthenationcalledHealthyPeople2010Objectives(HP2010).MendocinoCountyratesfortheseindicatorsarecomparedwiththeHP2010objectivesandwiththeStatefortheperiod2005-2007below:

MendocinoCountyrateswere:

Not significantly different than California deathrates for motor vehicle crash, firearm injury, allcancers, lung cancer, female breast cancer, stroke,infant,anddiabetes;andbirthratestoteensaged15-19andpercentoflow-birth-weightinfants;

SignificantlybetterthanCaliforniadeathratesforcoronary heart disease; were significantly worsethanCaliforniadeathratesforunintentionalinjuryandsuicideandpercentoflateornoprenatalcare;

Met the HP 2010 Objectives for death ratesdue to coronary heart disease, stroke, all cancers,

lungcancerandfemalebreastcancerandinfants,but not for motor vehicle crashes, unintentionalinjuries,suicides,andpercentoflateprenatalcareandpercentoflowbirthweightinfants.

AnotherlookatCountyHealthIndicatorRankingscomesfromtheMobilizingActionTowardCommunityHealth(MATCH)projectfromtheUniversityofWisconsinPopulationHealthInstitute.Healthindicatorsforeachcountyarerankedwithineachstategivinganindicationofhowhealthycountiesareinrelationtoothercountiesinastate.MendocinoCountyhadthefollowingselectedrankingscomparedtootherCaliforniacounties:

Overall health outcomes – 33rd out of 56 healthjurisdictions

Mortality,includingprematuredeath–49thoutof56

Health behaviors, including smoking, obesity,STDs,bingedrinking,etc.–17thoutof56

Clinical care, including insurance coverage,screenings,etc.–21stoutof56

Social & economic factors, includingunemployment, poverty, income inequality, etc. –35thoutof56

Physical environment, including access to healthfoods,airpollution,etc.–14thoutof56

Demographics and Socio-Economic Environment

Demographics

ThepopulationofMendocinoCountyincreasedby20%from1980to1990butonlyby7%from1990to2000.Withapopulationprojectionof93,166in2010,MendocinoCountywouldshowanincreaseof7%from2000to2010.

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Stateestimatesfor2010showthatchildrenandyouthundertheageof18makeup25.7%ofMendocinoCounty’s total population and children under theageof10makeup12.5%ofthepopulation.

2010 estimates indicate the age groups with thelargest populations were the 20-29 year-old groupwith14,049or15%ofthepopulationandthe50-59 year-old group with 13,797 or 14.8% of thepopulation.Residentsover60madeup23%ofthepopulation.

In 2010 estimates, 68.9% of residents wereCaucasian, 20.6% were Hispanic and 6.3% wereAmerican Indian. The Hispanic population isexpectedtoincreaseto24%by2015.

According to the US Census Bureau, AmericanCommunitySurveyfor2008,27.5%ofMendocinoCountyresidentswerehighschoolgraduates,24.9%had some college and 31.4% had a degree beyondhighschool.

Socio-Economic Environment

The countyunemployment rate followed the samedecline as seen in the State rate through 2006withbothbeginning to increase in2007.By2009,Mendocino County rates were at 10.1% with theState rateat12.2%.ByMarch2010,County rateswereat9.7%andCaliforniaat12.6%.

The Census County Bureau estimated that in2008,19%ofMendocinoCountyresidentslivedinpoverty compared to13.3% statewide.Forpersonswith children under 18, the percent’s increased to23.2%forMendocinocomparedto18.5%statewide.

The median household income in 2008 forMendocino County was $43,205 and $61,021 forCalifornia.

Anestimated8,260(9.2%ofthe2008population)residents received public assistance which includesCalWORKS, Foster Care, Welfare to Work andFoodStamps.

Accordingtothe2009MendocinoCountyHomelessCensus,atanyonepoint-in-time,anestimated1,206homelesspeopleareonthestreetsorinemergencyshelters.

Physical EnvironmentHealthy Behaviors, Access to Healthy Food and Physical Activity

AccordingtoCommunityHealthIndicatorSurvey2007, almost three in four Mendocino Countyresidentswereinexcellenttogoodhealth,twoinfivegotmoderatetovigorousphysicalactivity,halfatefive-a-dayfruitsandvegetableswithtwooutoffiveunabletoaffordenoughfood.

The number of persons seeking food stamps inSeptember 2009 was 19,356 (about 11.5% of thepopulation). It is estimated that less than half ofthoseeligibleforfoodstampsreceivethem.

Alcohol Outlets, Tobacco Sales to Minors

The number of retail liquor outlets in the CountycontinuestobealmosttwicethatoftheStatesince1992 (43 county outlets vs. 19 state outlets per10,000residents).

InOctober2009,15%oftobaccoretailerssurveyedintheCountysoldtounderageyouth.

“State estimates for 2010 show that children and youth under the age of 18 make up 25.7% of Mendocino County’s total population and children under the age of 10 made up 12.5% of Mendocino’s population.”

Environmental Health

Between2008and2009,1,248routineinspectionswere conducted by the HHSA EnvironmentalHealth(EH)Division.

A total of 248 public nuisance complaints werelodgedwithEHwith27%involvingsepticsystems,32% involving food facilities and 7% involvingfoodborneillness.

TheRedwoodEmpireHazardousIncidentTeam(REHIT) responded to and oversaw 13 illegaldrugsites:11involvingindoormarijuanagardensandtwoinvolvingmethamphetaminelabs.

A yearly average of 314 animals biting humanswerereportedbetween2004and2008;only twoofthosetestedpositiveforrabies.

ThehighestreportedapplicationforpesticidesinMendocino County is sulfur on grape and pearcrops.Theannualusageofallpesticidesincreasedby44%from2006duetoanincreaseinboardfeetoftreatedlumberin2007.

Availability and Utilization of Health ServicesMedical Facilities, Emergency Medical Service

Health care resources available in MendocinoCounty include: three hospitals, eight FederallyQualified Health Centers and 10 Rural HealthClinics.

AcutecarehospitalizationremainsthemostcostlyformofhealthcareinMendocinoCounty.During2006-2008,almost40%ofallhospitaldischargeswerepaidthroughMedicareandmorethan30%throughMedi-Cal.AdifferentpatternofpaymentisseenforERvisitswherealmost40%werepaidthrough Medi-Cal and almost 20% throughMedicare.Other3rd-partyinsurancecovered23%forhospitalizationand23%forERvisits.

Outpatient services at the two Indian HealthClinics were offered to 5,132 patients in 2008,with over 60% of all patients being AmericanIndian.TheAllianceforRuralCommunityHealth(ARCH)clinicssawatotalof41,283patientsin2008 with 68% seen for medical visits, 25% fordentalvisitsand9.5%formentalhealthvisits.

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In2008,theEmergencyMedicalServicesprograminMendocinoCountylogged11,202requestsforservices by ambulance, an increase of 15% since2006.

Health Insurance Coverage

InMendocinoCounty inJuly2008, therewere20,296 people (22.6% of the total population)enrolledintheMedi-Calprogramand2,505people(2.8%ofthetotalpopulation)wereenrolledintheCountyMedicalServicesProgram(CMSP).

According to the California Health InterviewSurvey (CHIS) 2007, comparing MendocinoCountytotheState,39.9%ofCountyresidentshadjob-basedinsurancecomparedto69.6%statewide;22.2%hadMedi-Calcomparedto15.2%statewide;15.8%wereuninsuredcomparedto14.6%statewide.

According to the Mendocino Children’s HealthInitiative,itwasestimatedthattherewerebetween2,500and3,000uninsuredchildren,someofwhomwereeligibleforMedi-CalortheHealthyFamiliesProgram.Thosenoteligiblefortheseprograms,butstill income eligible, can obtain CalKids coveragethrough Healthy Kids Mendocino. In December2008,387kidswereenrolledinCalKids.

Mental Health Services

For Fiscal Year 2008-2009, the County MentalHealth services and its contractors served 2,736people.Approximately80%ofthechargesfortheseclientswerepaidbyMedi-Cal.

Total“out-of-home”childplacementsin2009were269. Expanded mental health treatment withintheCountyhasreducedthenumberofchildreninplacementandloweredmanyassociatedcosts.

Adultpsychiatricplacementsfor2008were53andpsychiatrichospitalizationswere179.Thenumberof placements has been reduced by improvingcrisis response, providing local support servicesandreturningclientshomeaspromptlyaspossiblerather than into out-of-county placements orhospitalizations.

The Mendocino County Office of Educationprovides the Special Education Local Plan Areas(SELPA) with special services for children withdisabilities,includingmentalhealth.Asof12/1/08,212 children ages 6-18 had been identified with“emotional disturbance” in the school system andreceivedinterventionsbystaff.

Health of Mothers and Infants

BirthratesintheCountyandtheStatecontinuetodecreaseslowlywiththegreatestdecreaseinbirthstowomenofthewhiterace.TotalnumberofbirthsinMendocinoCountywas1,106in2006,1,145in2007 and1,168 in2008.Birth rates by racehaveremainedfairlyconstantforthepastfiveyearswithproportionsfor2008being53%ofbirthstowhite,38%toHispanicand5%toNativeAmericans.

The birth rate (per 1,000 teens) of teenage girlsages15-17inMendocinoCountyvariesfromyearto year but generally dropped through 2002 butrose in 2007 and 2008.The numbers of births toteensdroppedfrom48in2002to29in2006andincreasedto40in2007and35in2008.

The 2-year aggregate infant death rate (per 1,000births) for Mendocino County fluctuated between6.2 for 1999-2000 to ahighof 10.3during2005-2006andisoftenhigherthantheState.

In 2008, low birth weight babies accounted for6.2%ofbirthstoCountyresidents,notsignificantlydifferentfromtheStateratebutanincreasefrom5.8% in 2007.The rise of this indicator is beingcloselymonitoredbyPublicHealth.

Thepercentageofwomenreceivingprenatalcareinthefirsttrimesterhasbeenslowlyrisingfromalowof 58.7% in1999 to69.6% in2008, but remainssignificantlylowerthantheState’s82.9%in2007.

Datafromtheperinatalsubstanceabusescreeningproject for2006-2009of theMendocinoCountyChildandAdolescentHealth (MCAH)programrevealed that 52.5% of women reported usingalcohol or other drugs in the month before theyknewtheywerepregnantdroppingto26.9%aftertheyknewtheywerepregnant.

Health of Children and Adolescents

In FY 2007-2008, 3,994 children received ChildHealth and Disability Prevention (CHDP)preventive health care services, providing regularpreventivehealthassessments and immunizationstoMedi-Caleligiblechildren0-19yearsold.

DuringFY2008-2009,approximately500childrenwithchronicillnessesordisabilitieswereenrolledintheCaliforniaChildren’sServices(CCS)programin Mendocino County and received specializedmedicalcareandrehabilitation.

DatafromtheCaliforniaPhysicalFitnessTestforschool year2008-2009 revealed thatover73%of5th graders, 75% of 7th and 76% of 9th gradersachievedfouroutofsixhealthstandards,anincreasesincelastreported.

According to CHIS 2007, an estimated 84% ofchildrenwerenormalweightforage,69%ofteenswere normal weight, 51% of children ate five ormore fruits & vegetables daily, 61% of teens atefastfoodinpastweek,86%ofchildrenengagedinphysical activity at least three days per week and39%ofteenswerephysicallyactiveeveryday.

From2004through2006,injuriesduetofallsandmotor vehicle accidents accounted for 42% of allnonfatalhospitalizedinjuriestochildrenandyouth0-20yearsold.Injuriesalsoaccountedfor44%ofall deaths to children and youth from 0-20 yearsold.

According to the Child Death Review Team(CDRT)information,13childrenundertheageof18yearsdiedin2008inMendocinoCounty;46%(6)bynaturalcausesand54%(7)byaccident.

“Data from the California Physical Fitness Test for school year 2008-2009 revealed that over 73% of 5th graders, 75% of 7th and 76% of 9th graders achieved four out of six health standards, an increase since last reported.”

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Between 2004 and 2006, the number ofhospitalized,nonfatalsuicideattemptsintheagegroup13-15wasthreeandthenumberofsuicidedeathswasone.However,amuchhighernumberofsuicideattemptsshowupintheEReachyear.

In2008, a totalof1,699childrenwere reportedtotheChildren’sSystemofCare/SocialServicesBranch of HHSA for suspected child abuse orneglect,whichwasadecreaseof15%from2007.

In January 2007, 252 children were in out-of-home placement including 42% in foster care,16%ingrouphomes,and33%inarelative’shome.Morethan3/4thsofthecasesreportedwerefromgeneralneglect.

ResultsfromtheCaliforniaHealthyKidsSurveyof 2006-2008 indicates that 51% of 11th graderespondents reported past 30-day alcohol usewhile83%oftheserespondentsperceivedalcoholusetobeharmful;27%of11thgraderespondentsreported past 30-day marijuana use while 77%reportedperceivedharmfromfrequentmarijuanause.Thesepercentsdecreasedfor8thgradersand7thgraders.

Health of Adults and Older Adults

According to the estimates from the State, thesenior population, 60 and older, in MendocinoCounty increased by almost 26% between 2000and2010.Seniorswereestimatedas22.8%(morethanoneinfive)ofthecountypopulation.

Fallstoseniors65andoveraccountforthelargestnumberofnon-fatalhospitalizedinjuries.Duringthe period 2004-2006, there were 713 nonfatalhospitalized falls of seniors out of 1,080 totalhospitalizations(66%).

AccordingtoCHIS2007,anestimated25%of adultsinMendocinoCountywereobese.

MendocinoCountyadult(ages18-69)felonyandmisdemeanordrug-related arrest ratesper 1,000continuetobeconsistentlyhigherthanStaterates.Adultarrestratesfordriving-under-the-influence(DUI),whicharealsohigherfortheCountythanthe State, were fairly consistent for the CountyandtheStatefrom2001through2005andthenincreasedin2006duetoanincreaseinpatrolsforDUIsinUkiahfrom2006to2007.

Alcohol-related hospitalizations (not includingER data) for Mendocino County averaged 635between 2003 and 2007 while drug-relatedhospitalizationsaveraged530between2003and2007.

Domestic Violence-related calls to lawenforcement in Mendocino County began todecrease in 2005 with 594 calls through 2008with485calls.However,thenumberofarrestsforspousal abuse has remained fairly constant overthepastfiveyearswithanaverageof168peryear,aboutthesameasthelastfive-yearperiod.

In Mendocino County during FY 2008-2009, atotal of 649 elderly and dependent adults werereportedasvictimsofsuspectedabuseandneglect,adecreasefromthe676reportsinFY2007-2008.

“According to the estimates from the State, the senior population, 60 and older, in Mendocino County increased by almost 26% between 2000 and 2010.”

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Infectious Disease

ChlamydiaisthemostfrequentlyreportedSexuallyTransmittedDisease(STD)inMendocinoCounty.Of the 216 reported cases of chlamydia in 2009,32%(almost1/3ofallcases)wereteens.

AtotalofsevenactiveTBcaseswerereportedtotheHealthDepartmentin2008-09.

Atotalof12confirmedcasesofNeisseriameningitiswerereportedtotheHealthDepartmentin2008and2009.

In 2009, four residents died from the H1N1fluvirus.Manyotherresidentswereillwiththevirusbut recovered.At theendof2009,approximately30,000dosesofvaccinehadbeendisseminated.

HepatitisCisthefastestgrowinginfectionintheCountywith945newcasesreportedbetween2005and2009.

As of July 2009, HIV staff in the County hadknowledgeof575individualswithHIVinfectionor AIDS who have used services since 1982. Ofthose,135(24%)areliving.

Intheninth(andlast)yearofoperation(FY2008-2009), the Mendocino County Needle ExchangeProgramhasexchangedover500,000needlesandsyringes.

Chronic Disease

CancerwastheprimarycauseofdeathinMendocinoCountyforthethree-yearperiod2005-2007witharateof163.4per100,000populationcomparedtotheStaterateof159.3forthesametimeperiod.

CoronaryHeartDisease(CHD),oneofthemany“Diseases of the Heart” has historically been thesecond leading cause of death, behind cancer.When adjusted for age and averaged over threeyears,deathratesforCHDwere123.0per100,000for2005-2007 inMendocinoCounty,whichwaslowerthantheStaterateof145.2.

Lung cancer continues to be the most commoncauseofdeathwithfemalebreastcanceradistantsecond.Relatedtothisisthe2007CHISestimateof the population of current smokers: 25% inMendocino,13%statewide.

Forthethree-yearperiod2005-2007,MendocinoCountyhadayearlyaverageof44deathsfromlungcancer,followedbycoloncancerwith18deathsandbreastcancerwith13deaths.

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AccordingtoCHIS2007,anestimated27.7%ofMendocinoCountyresidentshavebeendiagnosedwitharthritis.Related to this is the2007CHISestimateof25%ofMendocinoCountyresidentswhoareobese.

CHIS2007estimates7.5%ofMendocinoCountyresident have been diagnosed with diabetes. In2008,5%ofclientsseenattheARCHclinicsand29%ofclientsseenattheIndianHealthCenterswerediagnosedwithdiabetes.

Deaths from All Causes

Between2005and2007,ayearlyaverageof794residentsofMendocinoCountydied.

All cancer deaths account for 22% of all deathsin2005-2007,whereas,CoronaryHeartDiseaseaccountsfor16.2%ofalldeathsforthesametimeperiod.

Thecompletereportisnowavailable.Checkthepublichealthwebsiteatwww.co.mendocino.ca.us/hhsa/newsletters.htmfor

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Strategy / Goal:Community Benefit Initiative and ResultsGoal: Collaboration with Community Healthcare Resources

During 2011, Ukiah Valley Medical Centeris continuing to provide leadership for a localconsortium referred to as the CUSOC group, anacronymforChronicUsersSystemofCare.UVMCanditsRuralHealthClinic,alongwithMendocinoCommunityHealthClinic,FordStreet(ahomelessshelterandadditionalcounselingservice),MCAVHN(MendocinoCountyAIDS/ViralHepatitisNetwork)and the Mendocino County Sheriff ’s Departmentdevelopedaplan in2010to identifyandassesstheimpactofindividualswhoareintenseusersofhealthcareserviceswithinMendocinocounty.TheCaliforniaMedicalServicesProgram(CMSP)providedagrantto undertake that planning activity which engagedmanyadditionalservicesandcareproviders.CMSPprovides health coverage for low-income, indigentadultsin34primarilyruralCaliforniacounties.TheteamobtainedvoluntaryHIPAA-compliantconsentfrom19individualsandcreatedadatamapofservicesprovidedthemovera22-monthperiod.Fromthatassessmentandplanningeffort,theCUSOCgroupimplementedacasemanagementmodeldesignedtoprovideintensive,focusedassistancetoasmallgroupoffrequentusersofhealthcareandotherservices.

The goal of the collaboration is to develop amanagement system for chronic health care usersthatwouldlowercosts,providebetterandappropriatetreatment,andofferaunifiedmedicalmanagementserviceforthechronicusers.Whileourinitialgroupof19clientshasbeenidentified,ourgoalistohave50participantsduringthisfirstyearandupto200bytheendofyeartwo.TheCUSOCgroupiscommittedto this project and was awarded for a subsequentimplementationgrantbyCMSP. However, all keypartnersmustbringsomethingtothetable(in-kinddonations) as thegrantdoesnot cover all expensesorneeds.

2011 ResultsInthefirstsixmonthsoftheproject,CUSOChadatotalof41clients.Theseclientsarereceivingcasemanagement based on acuity, medical care, andbehavioralhealthordrug/alcoholtreatment.SeveralclientsareincarceratedbutwillbereleasedintotheCUSOC program after completing their sentence.Care management is initiated while in jail. Mostclientsarereferredfromthejail.However,theycanbereferredfromanyagencyaslongastheyare“chronic”usersofcareandareCMSPorCMSP-eligible.

Clients are tracked by The County of MendocinoHomeless Continuum of Care web-based software“Client Track”. This software is used to monitorclients and track services received throughout thesystem.TheCountypaidforfouradditionallicensesfor the first six months as their in-kind donation.

“The goal of CUSOC is to develop a management system for chronic health care users that would lower costs, provide better and appropriate treatment, and offer a unified medical management service for the chronic users.”

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AsaresultofCUSOC,UVMChasseenadecreaseinER/inpatientchargesof$113,894fortheoriginal19membersoveraone-yearspanfrom2010to2011.

Strategy / Goal:Introduction of an Expansion Project for a new Emergency Department and Intensive Care Unit at UVMC

Responding to growing community need for stronglocalemergencyservices,traumacare,andservicesforacutely-ill patients in the service area, UVMC willlaunchafundraisingcampaigntobuildanew20-bayemergency department with trauma bays, isolationarea,twosecuredtreatmentareasforbehavioralhealthpatients, and a specialized area for rape victims.TheIntensiveCareUnit(ICU)willfeatureastate-of-the-art,eight-bedunitdesignedforeasypatienttelemetrymonitoringandspaceforrenalprocedures,ventilators,ultrasound equipment, bladder scanners and multipleIVpumps.Thetotalcostoftheprojectis$22,350,000with$4milliontoberaisedfromemployees,medicalstaffandcommunityfriends.

2011 ResultsUVMCemployeesandphysicianshaveshownextraordinarysupportforthefutureofmedicalcareintheUkiahValleybypledgingmorethan$1milliontotheEmergencyDepartment/TraumaCenterandICU.

Theentirecommunitywillbenefitfromouremployees’and physicians’ generosity and we are most gratefulfortheirsupport.In2011,weraised$836,688innewpledgecommitmentsfortheEDcampaign.Thisbringsourtotalraisedto$1.15milliontowardsthe$4milliongoal.

Strategy / Goal: Coordinated Wellness Program

Building on previous year’s strategies and at therequestofmajoremployersinthecommunity,UVMCplans to develop a coordinated health and wellnessprogram. Currently the medical center offers a rangeof independent programs from various departments.During 2011, UVMC will package a cafeteria-styleprogram where employers can select from a menu ofservices including diabetes education (in English andSpanish), smoking cessation classes, orthopedic andarthritisprograms,occupationalhealthservices,familyandchildrenprograms(suchasbreastfeedingclassesandprenatal programs) and a health-risk assessment.Thistool will allow the medical center to match resourceswithspecificcommunityneed.

Also included will be diagnostic services such aslaboratoryservices,andradiologicalservicesfordetectionand preventive health care including mammography,papsmearsandprostate-specificantigentests.

18

Medical center employees will be engaged in theprogram to help control insurance costs and reducetimeoffforillness.Whilelowerinsurancecostsareanobjective,havingouremployeesandtheirfamiliesmorehealthyistherealgoal.

2011 ResultsUVMCclosedouttheyearwith511participantswhoconducted their Health Risk Assessment (HRA) aspartoftheLivingWellprogram.FromtheirHRA,highriskareashavebeenidentified.Educationalprogramsandincentiveswillbebasedonbringingthehigh-riskemployeesandtheirspousesintothemid-riskcategoryandensuringthatmid-riskparticipantsdonotmovetothehigh-riskcategory.

Return on investment is generally quoted as a $1investmentinwellnessprogramssaves$3inhealthcarecostsperperson.OurUVMCLivingWellprogramgoalsareto:

Further our mission of caring for employees’physical,emotionalandspiritualneeds.

Decreaseemployeeanddependenthealthcarecosts.

Further connect UVMC with our communitythrougheducationaloutreachtoemployeegroups.

Assist with improved management of chronichealthconditionsforemployeesanddependents.

Decrease employee injury rates, workerscompensation and disability costs, missed workdayscausedbyillnessorinjury.

Develop external program offerings to potentiallyincludeaRegionalWellnessConsultation,wellnessprograms for other employers and communityeducationalprograms.

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Additional Community BenefitsSpecial Care Nursery (HHSAAB – Special Populations)

TheUVMCSpecialCareNurseryoffersthecommunityintensivecareservicesforbabiesthatwouldotherwisehavetotravel60–200milestoSantaRosaortheBayArea to receive care. In 2011, we admitted 33 babiesto the NICU, for a total of 134 patient days. RoomandboardwasofferedtothemothersofSpecialCareNurserypatients.

Sexual Assault Response Team (SART) (HHSAAB – Community Safety)

SARTisacollaborativecommunityeffortthatincludeslaw enforcement, medical examiners, the DistrictAttorney’s office, protective services and advocacygroupsworking together to improve the investigationand prosecution of sexual-assault cases, and ensuringappropriate care and treatment of victims. ThroughsupportfromtheSoroptomistInternationalofUkiah,UVMCwasabletoacquireacolposcope.Colposcopesare used during sexual-assault examinations, and canbeinstrumentalinbothassessingapatient’sconditionandprovidingdetailstohelpapprehendandprosecutethosewhoperpetrateviolenceagainstwomen.UVMCcontinues to offer nursing services, space and otherstaffing support to SART and provided 12 SART

exams in 2011 — five adults and seven children. ItalsoprovidesfreeeducationtoSANE(SexualAssaultNurseExaminers).

Under-reimbursed Care (HHSAAB – Access to Care)

Inadditiontotraditionalcharitycare,UVMCprovideshealthcare services to thosewhocanonlypay forpartof their care, either through government assistance orothermeans.Severalyearsago,thehospitalexpandeditscharitycarepolicytoincludepatientswithincomesupto400percentoftheFederalPovertyLevel.

Low-cost Copies of Medical Records (HHSAAB – Access to Care)

The UVMC Health Information ManagementDepartment (Medical Records) frequently providesfreeorlow-costrecordstopatientswhorequestcopiesoftheirinformation.Althoughmostcopiedrecordsarefewer than 50 pages, some can take more than eighthours toproduce. In2011, theMedicalRecords stafffilled1,750patientrequestsfreeofcharge.

Free Notary Services(HHSAAB – Access to Care)

Thehospitalpresident’sassistantisanotarypublicandnotarized107documentsforemployees,medicalstaffandcommunitymembersfreeofchargein2011.

“Several years ago, the hospital expanded its charity care policy to include patients with incomes up to 400 percent of the Federal Poverty Level.”

Leadership Mendocino

UVMCdonated$1,000totheLeadershipMendocinoprogram, which teaches local leaders to learn aboutthe whole county and encourages them to connectwith one another to solve county-wide problems. Inaddition to supporting the program financially, thehospital consistently sponsors individual employees toparticipateintheprogram.

Mendocino College Nursing Program (HHSAAB – Access to Care)

In2011,UVMCprovided$60,000worthoffundingforaclinicalinstructorintheRNprogramatMendocinoCollegetobenefitnursingeducation.Thiscollaborativeeffort recognizes the importance of supporting healthcare education programs that introduce well-trainednursesintothelocalhealthcaresystem.

United Way Day of Caring

OnSeptember14th,25UVMCemployeesparticipatedin the United Way Day of Caring. Day of Caringallowsvolunteerstoexperiencefirst-handtheneedsinourcommunityandthenrolluptheirsleevesandhelp.The experience, which started with a morning rallyandconcludedwithdozensofcompletedprojects, leftvolunteers feeling energized and deeply connected totheircommunity.

American Cancer Society’s Relay for Life

UVMCstaffedafirst aid tent at the event.TheACSis the nationwide community-based voluntary healthorganizationdedicatedtoeliminatingcancerasamajorhealthproblembypreventingcancer, saving lives, anddiminishing suffering from cancer, through research,education,advocacy,andservice.

Free Use of Hospital Conference Rooms

In2011,UVMCoffereditsconferenceroomstovariouscommunitygroupsfornocharge.Thisservicebenefited700 people with more than 222 hours of conferencetimedonated.

Tours of the Hospital for Elementary and High School Students

In2011,UVMCstaffcontinuedthehospital’straditionofprovidinghospitaltourstoschoolchildren.Thetoursfocus on the responsibilities of various departments,the types of positions available in hospitals and theimportanceofteamwork,infectioncontrolandhelpingothers.The tour guide provides students with a smallgift, such as a hospital coloring book. Several schoolsparticipated,servingapproximately60students.

Spiritual Care Department (SCD)

At UVMC, the SCD is involved in counseling, crisisintervention, and yearly holiday food and toy drives.SCD chaplains act as liaisons between the hospitaland the leaders of various religious organizations inMendocino County, and refer patients to appropriatecommunity agencies to meet spiritual, mental, andfinancialneeds.Attimes,thechaplainiscalleduponformediationservicesbetweenmedicalpersonnelandfaithgroupswithdistinctivepractices.In2011,westarteda“HopeforGrievingFamilies”supportgroupforthosethathave lost a childat anyage. Inaddition,UVMCtookpart intheworld-widecandle lightingceremonyforlostchildren.

Volunteer First Aid Stations

UMVC employees voluntarily staff first aid booths atseveralcommunityevents,suchasSouthUkiahRotary’sTriathlon, Ukiah’s Country PumpkinFest and theAmericanCancerSociety’sRelayforLife.

Free and Low Cost Mammograms(HHSAAB – Access to Care)

TocelebrateNationalBreastCancerAwarenessMonth,UVMCprovided25womenwithfreemammogramsandanother63wereprovidedwithlow-costmammogramsduringthemonthofOctober.

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2119

Smoking Cessation Class (HHSAAB – Healthy Lifestyles)

Thesix-weekprogram isbasedon theFreedomfromSmoking Program offered by the American LungAssociation. The program is part of the UVMCcommunity wellness education program. The groupserves approximately 12 people at each of its weeklymeetings.Thementorprogram,guestspeakersandtheon-goingsupportprovidedbytheprogramarequotedas the most helpful aspects of the program for thosewantingtoquit.

Participation in Coordination of Care (HHSAAB – Access to Care)

UVMC leaders worked with other health careprofessionals from community agencies and healthcare organizations to better coordinate the provisionof and the referral to health services. UVMC alsohostedtheEmergencyMedicalCareCouncilmeetings,participatedinpre-hospitalchartreviewforparamedicsandEMTs, and assisted in thequality review for thelocaljail.

Hospital Volunteer Program

The volunteers from UVMC are an active group of50–60dedicatedpeoplewhocollectivelyhavegivenmorethan100,000hoursofserviceovertheyearstothe

community.Mostof thegrouphasvolunteered foratleast15-25years.Volunteersgreetpeopleastheycomeintothehospital,managethegiftshop,deliverflowerstopatientsandaidmanyofthehospital’sdepartmentswith clerical support duties. In 2010, proceeds frombakesalesordonationsfromthevolunteergiftshopwereprovided to St. Mary of the Angels Catholic School,Ukiah Firemen, Ukiah Valley Christmas effort, theMendocinoCountyFarmBureau,DiabetesEducationFund, and our emergency department. In 2010, theyvolunteered more than 10,000 hours to the hospital.Volunteersinthechaplain’sofficedonatedhundredsofhoursofservice.

Licensed Vocational Nurse (LVN)and Registered Nurse (RN) Training(HHSAAB – Access to Care)

Everyyear,UVMCemployeesgivefreeinstructiontocollege nursing students as they train at the hospitaltobecomeLVNsandRNs.LVNinstructionincludesapproximately 720 hours per student for 30 LVNstudents.RNinstructionincludestwoclassesofupto24students,whosecombinedclinical learningtime isapproximately1,700hours.

Inaddition,RNstudentshavetheoptionofdoingtheirseniorpreceptorshipatUVMC,whichis120hourspernurse(10shifts).ExperiencedUVMCnursesspentthistimewiththeseniornursingstudentsgivingthemone-on-oneinstruction.

“Volunteers greet people as they come into the hospital, manage the gift shop, deliver flowers to patients and aid many of the hospital’s departments with clerical support duties.”

Procurement and Donation of Hospital Supplies for Local Schools & Mission Trips

The Materials Management Department donatedmedicalsuppliestotheUkiahAdultSchoolMedicalAssistantandLVNclasses.Italsodonatedsuppliestomedical mission trips, including those to GuatemalaandHaiti.

Publication of Free Health Newsletter

UVMCworkswithCoffeyCommunicationstopublisha free communityhealthnewsletter,HealthScene.ThepublicationissenttohouseholdsinMendocino,Lakeand Northern Sonoma counties, and includes healtharticlesandacalendarofhealthclasses.Thenewsletterispublishedthreetimesayearandismailedtomorethan15,000homesatacostofapproximately$60,000peryear.

Free Education to Emergency Personnel (HHSAAB – Access to Care)

In 2011, the UVMC Emergency Departmentcontinueditstraditionofprovidingfreeeducationtolocal paramedics, firefighters and emergency medicaltechnicians (EMTs). UVMC provides eight-hourpreceptorshipstoapproximately60EMTstudents(40fromtheUkiahAdultSchooland20fromAndersonValleyFireDepartment)and240-hourpreceptorshipstosevenparamedicstudentsfromMendocinoCollege.

UVMC and Me Seminar Series (HHSAAB – Health Lifestyles/Environmental Health)

This program offers free information to communitymembers through seminars and screenings. TopicsrangefrommanagingpaintohowtouseFacebook.Theprogram serves approximately 30 people per monthandprovides access to information andproviders. In2011,wehosted12UVMCandMeevents.

“The Materials Management Department donated medical supplies to the Ukiah Adult School Medical AssistANT and LVN classes. It also donated supplies to medical mission trips, including those to Guatemala and Haiti.”

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Connecting with Focus (CWF)

CWF isUVMC’s versionof speeddating and focusgroup merged into one. At this event we invite ourCommunity Advisory Council members to host andinvitetheircontactstoeachCWFevent.Communitymembers sit at tables while four different presentersrotatetheroominanefforttoinformabouthospitalresourcesandtogetfeedbackastocommunityneeds.Fromthisevent,wehavebeenable togarner severalideasonhowtoshareourserviceswithlocalemployersand community members. In 2011, we hosted 12CWFmeetings.

Public Radio Show on KZYX&Z

TheUVMCmarketingdepartmentscheduledspeakersforabi-monthlyone-hourhealtheducationradioshowinconjunctionwithDr.MarvinTrotter.Annually,24programsonhealth-relatedtopicswerebroadcastatnocharge.ManyofthespeakersareaffiliatedwithUkiahValleyMedicalCenter.

Supporting Health-Related Charities

In 2011, UVMC donated to the Cancer ResourceCenters of Mendocino County, Ukiah ValleyAssociation for Habilitation, Nuestra Casa, theMendocino County Sheriff ’s Activities League, andtheMendocinoCountyAIDSViralNetwork.

Education for Local Students(HHSAAB – Access to Care)

UVMCparticipatedintheSCRUBsclassatthelocalhighschoolbyhavingseveralleaderslectureonvariousaspectsofhealthcare,working inahospital,andthehospital’sroleinthecommunity.

World Diabetes Day

OnNovember14,2011,wehostedaWorldDiabetesDay drive-thru diabetes screening open to ouremployees and local community. UVMC’s diabeteseducation department performed the screening andtested64people,ofwhich10hadelevatedbloodsugarlevels and were offered help through the diabeteseducationprogram.

“CWF is UVMC’s version of speed dating and focus group merged into one.”

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Free Birthing Classes

UVMC offered free birthing classes throughout theyear. A six-week, two-hour course, one-day-a-weekwasoffered12timesduringtheyear.Fasttrackbirthingclasseswerealsoofferedonceamonththroughouttheyear.Theseday-longbirthingclassesaffordedthosewhocouldnotcommittoasix-weekcoursetheopportunitytoparticipate.Theclasscoversallaspectsofpregnancy,signsandstagesof labor, the laborandbirthprocess,optionsforcopingandpainmanagement,newbornandinfantcare,andbreastfeeding.

Diabetes Education and Support Group

Every second Tuesday of the month a free diabeteseducation and support group class was offered.The classes were team-taught by a registered nurseand a registered dietitian. The classes provided anunderstanding of the disease process and evidence-basedtoolstosupportapositivelifestylechange.Guestspeakers also participated discussing subjects fromnutritioneducationtopreventingstrokes.

Bariatric Weight Loss Support Group

OnthefourthThursdayofeverymonth,UVMCofferedaBariatricWeight-LossSupportGroupdesignedforpatients who have undergone bariatric surgery andthose considering the procedure. The support grouplead by a registered dietitian and a medical assistanthelped patients through their weight-loss journeybefore and after surgery, as well as inspiring patientsto continue tobemotivated to reach theirgoals.Thesupportgroupprovidedaplatformforpatientstosharetheirsuccessesandchallengeswithoneanother.

Positive Parenting Classes

Free workshops for parents, caregivers, and childcareproviders were offered the first Thursday of everymonth.Classesweretaughtbyamedicaldoctorwhospecializes in pediatrics and a licensed clinical socialworker.Eachworkshopfocusedonpositivesolutionsto common behavior issues. Childcare was providedfreeofcharge.

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COMMUNITY BENEFIT REPORT FORM – 2011 Return to Community Benefit Coordinator

Hospital ______________________________________________________ Date ___________________________________

Service/Program _____________________________________ Target Population ___________________________________

The service is provided primarily for The Poor Special Needs Group Broader Community

Coordinating Department ____________________________________________________

Contact Person _____________________________________ Phone/Ext __________________________________________

Brief Description of Service/Program _______________________________________________________________________

Caseload ________ Persons Served or _________ Encounters

Names of Hospital Staff Involved Hospital Paid Hours Unpaid Hours Total Hours

Total Hours

1. Total value of donated hours (multiply total hours above by $41.01) _____________

2. Other direct costs _____________ Supplies _____________ Travel Expense _____________ Other _____________ Hospital Facilities Used ___________ hours @ $__________/hour _____________ 3. Value of other in-kind goods and services donated from hospital resources _____________ Goods and services donated by the facility (describe): ___________________ _______________________________________________________________

4. Goods and services donated by others (describe): ___________________________ _____________ ___________________________________________________________________

5. Indirect costs (hospital average allocation ________%) _____________

Total Value of All Costs (add items in 1-5) _______________

6. Funding Sources Fundraising/Foundations _____________ Governmental Support _____________

Total Funding Sources (add items in 6) (_______________)

Net Quantifiable Community Benefit (subtract “Total Funding Sources” from “Total Value of All Costs”) _______________

PLEASE USE OTHER SIDE TO REPORT NON-QUANTIFIABLE COMMUNITY BENEFITS AND HUMAN INTEREST STORIES

NON-QUANTIFIABLE COMMUNITY BENEFIT AND HUMAN INTEREST STORIES

Please fill in the date and complete the lines above the table on other side of worksheet

Who: ________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

What: _______________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

When: _______________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Where: ______________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

How: ________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Additional information may be obtained by contacting: ________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Phone: _______________________ Fax: ____________________ Email: _________________________

PLEASE USE OTHER SIDE TO REPORT QUANTIFIABLE COMMUNITY BENEFITS

 

2625

275 Hospital Drive • Ukiah, CA 95482 • A member of the Northern California Network of Adventist Health

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2827

Facility System-wide Corporate Policy Policy No. AD-04-002-S

Standard Policy Page 1 of 1 Model Policy Department: Administrative Services

Category/Section: Planning Manual: Policy/Procedure Manual

POLICY: COMMUNITY BENEFIT COORDINATION

POLICY SUMMARY/INTENT:

The following community benefit coordination plan was approved by the Adventist Health Corporate President's Council on November 1, 1996, to clarify community benefit management roles, to standardize planning and reporting procedures, and to assure the effective coordination of community benefit planning and reporting in Adventist Health hospitals.

POLICY: COMPLIANCE – KEY ELEMENTS

1. The Adventist Health OSHPD Community Benefit Planning & Reporting Guidelines will be the standard for community needs assessment and community benefit plans in all Adventist Health hospitals.

2. Adventist Health hospitals in California will comply with OSHPD requirements in their community benefit planning and reporting. Other Adventist Health hospitals will provide the same data by engaging in the process identified in the Adventist Health OSHPD Community Benefit Planning & Reporting Guidelines.

3. The Adventist Health Government Relations Department will monitor hospital progress on community needs assessment, community benefit plan development, and community benefit reporting. Helpful information (such as schedule deadlines) will be communicated to the hospitals' community benefit managers, with copies of such materials sent to hospital CFOs to ensure effective communication. In addition, specific communications will occur with individual hospitals as required.

4. The Adventist Health Budget & Reimbursement Department will monitor community benefit data gathering and reporting in Adventist Health hospitals.

5. California Adventist Health hospitals' finalized community benefit reports will be consolidated and sent to OSHPD by the Government Relations Department.

6. The corporate office will be a resource to provide needed help to the hospitals in meeting both the corporate and California OSHPD requirements relating to community benefit planning and reporting.

AUTHOR: Administration APPROVED: AH Board, SLT EFFECTIVE DATE: 6-12-95 DISTRIBUTION: AHEC, CFOs, PCEs, Hospital VPs, Corporate AVPs and Directors REVISION: 3-27-01, 2-21-08 REVIEWED: 9-6-01; 7-8-03

Right where you need us

275 Hospital Drive • Ukiah, CA 95482 • A member of the Northern California Network of Adventist Health