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