South Bay Needs Assessment

Community Benefit & The Needs Assessment Process--2010 Jim Tehan, Service Area Director Community Partnerships

Community Benefit Services • What is “Community Benefit” ?

• Why do we do it?

• Who Benefits?

• The Needs Assessment Process • The 2010 Priorities • The Cost

What is Community Benefit?

• Medical Center programs/resources that benefit individual patients or local communities.

• Expenditures must follow established national guidelines (CHA).

• Total Service Area expense for 2010 – PH&S definition--$25.1M (charity care + CB Services) – State of California definition--$55.5M (adds MediCal shortfall)

People Impacted in 2010?

• Charity Care • Community Benefit Services Programs in Low income communities Broader Communities Subsidized Health Services Health Professions Training

6,419 54,787 28,459 5,196 20,702 430

• SUBTOTAL (PH&S Definition) • Unpaid Costs of Medi-Cal

• TOTAL COMMUNITY BENEFIT IMPACT

61,206 20,665

81,871 (2010 Statistics)

Why do we do Community Benefit?

• Mission - “…especially the poor and vulnerable…”

• California State law mandates triennial needs assessment and annual update • New IRS Schedule H requirements • Threat to tax exempt status

PLCM History of Community Benefit • Core Components of Community Outreach Programs

– Collaboration—we work with multiple public & private partners – Capacity Building—we use our resources to help partners develop community infrastructure – Direct Service Programs—linked directly to priority needs

• Outreach programs target underserved communities – Southern Area: San Pedro 90731, Wilmington , Harbor City – Northern Area: Torrance 90501, Lawndale, Hawthorne & Gardena

• Our goal is to return value of tax exemption to South Bay communities, consistent with CHA guidelines

How Are We Doing—Big Picture 2008

2009

2010

Value of Tax Exempt Status

$15.1M

$11.1M

$16.7M

Community Benefit Expense

$33.0M

$38.1M

$55.5M

(charity, Medi-Cal shortfall, Community Benefit Services)

Triennial Needs Assessment Process-2010

• Consult collaborative partners – – – –

Los Angeles County, Department of Public Health (LAC) Community Based Organizations School Districts PLCM Governing Board and Mission Committee

• Review Quantitative Data

– Hospital demographics by zip code(income, education, ethnicity,etc.)

– LAC Health Status by region(insured, medical home, chronic conditions etc.)

– CNI Index (1-5 rating) by zip code (consolidates SES, access, housing)

• Seek Local Input

– Local opinion of top health needs (access, education, linkage) – Medical Home/Health status interviews—315 adults

Triennial Needs Assessment Process-2010 • Quantitative data is grouped as follows:

– Group 1—Low need communities – Group 2 –High Need—Northern Communities – Group 3—High Need—Southern/Harbor Communities

• CBO/local stakeholders rank priorities in 3 categories – Access to low cost or free primary care – Wellness Education – Linking people to services

• Top priority in each category drives community outreach objectives for children and adults

Needs Assessment Findings-2010 • Residents of high need communities are:

– less likely to have a medical home – more likely to have a chronic disease – more likely to report their health as “fair” or “poor”

• Zip code statistics highlight disparities across South Bay communities related to demographics, health care access, poverty and social determinants.

(1st stat is for middle income communities; 2nd is high need communities combined)

– – – –

Presence of children: 6.3% v 20.6%; uninsured 18.3% v 29.9% Median Household Income: $47,063 v. $88,934 College/Professional Degree: 11.3% v. 33.5% Uninsured adults: 12.1% v27.3%

Priority Needs for Children Stakeholder Survey Rankings of Top Three Health Care Needs of Children ACCESS

WELLNESS EDUCATION

CONNECTING TO SERVICES

Access to Primary 38.9% Care (accessible and affordable)

Physical Activity/ 30.7% fitness

Affordable health insurance

31.3%

Dental Care

20.4%

Nutrition Education

20.4%

Providers who accept Medi-Cal

26.1%

Optometry

11.3%

Chronic Disease Mgmt after Dx

11.3%

Case mgmt linkage to affordable programs

21.8%

N=34

Priority Needs for Adults Stakeholder Survey Rankings of Top Three Health Care Needs of Adults ACCESS

WELLNESS EDUCATION

CONNECTING TO SERVICES

Access to Primary 34.1% Screening for 25.5% Care (accessible Chronic Conditions & affordable)

Affordable health insurance

Health Screenings 16.3% Chronic Disease Mgmt after Dx

21.6%

Providers who accept 23.7% Medi-Cal

Acute Mental Health

15.2%

Case mgmt linkage to 20.7% affordable programs N=34

15.6% Mental Health Education

34.9%

Priority Needs for Seniors Stakeholder Survey Rankings of Top Three Health Care Needs of Seniors ACCESS

WELLNESS EDUCATION

CONNECTING TO SERVICES

Specialty Medical Service

24.1% Chronic Disease Mgmt after Dx

Elder abuse

21.8% Physical Activity/ 19.1% Cultural and language 27.2% fitness barriers

Home Care/Hospice 14.9% Mental Health & Long Term Care Education

31.0% Case management to 33.8% affordable programs

18.3% Affordable health insurance

20.6% N=34

YOUR Community Health Team PLCM Employees in Local Communities—2012 Expected Results

Access to low cost/free primary care • PFHK—sustain medical care and immunizations to 3,200 uninsured children annually • Children’s Health Insurance Program—cotinue to enroll 800 children annually in Medi-Cal/Healthy Families.

• Vasek Polak Health Clinic low cost, fixed price primary care for 4,000 under and uninsured adults

•

Creating Opportunities for Physical Activity (COPA) • 4,625 students at elementary schools participate in COPA • 225 teachers trained by PLCM in COPA curriculum & Instant Recess • Expected results in 2011-12 130 Teachers and 3,000 children show pre-post improvement in physical activity as measured by SOFIT 25 Collaborative school site events

Diabetes management: GOAL 2012 • 200 adults to complete modified Stanford Self Care Diabetes program • 150 adults complete group visit treatment model at VP Clinic • 300 adults complete prevention module at • Expected Results: Pre-post partner sites improvement in all 3 groups

Community Health Budget Trends Budget $3,056,568

Proposed Budget $2,653,198

2011

2012

Grants

Foundation

Med. Ctrs.

Misc Reimb

8% 14%

38%

Grants

Foundation

Med. Ctrs.

Misc. Reimb

4%

21%

35%

40%

40%

Charity Care Trend: 2008-2010

Community Benefit Services: 2008-2010

Unpaid Costs of Medi-Cal: 2008-2010