Community Benefit & the Community Health Needs Assessment (CHNA) Operations Council December 7th, 2012 Dawn Wolff: Director, Strategic Planning Cindy Ortiz:

Community Benefit & the Community Health Needs

Assessment (CHNA)

Operations Council

December 7th, 2012

Dawn Wolff: Director, Strategic Planning

Cindy Ortiz: Administrative Fellow

Jared Vavroch: Manager, Strategic Planning

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What Are We Talking About?

Our Mission: Improve the health and well-being of children.

Our Vision: Be a leader recognized for advancing pediatric health.

Internal Revenue Service (IRS): As a hospital that is organized and operated for charitable purposes (i.e. tax exempt), we must demonstrate that we are following through on our mission.

Community Benefit: Community benefit programs are activities that provide treatment and/or promote health and healing as a response to community needs.

Community Health Needs Assessment: What are those needs? How are they evolving? In the middle of conducting the first pediatric needs assessment in Kansas City.

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Mission, Vision, Values, and Goals

Mission

Improve the health and well-being of children by providing comprehensive family-centered health care, committing to the highest level of clinical and psychosocial care, and exhibiting research, educational and service excellence

Values

Accountability Clinical Excellence Continuous Improvement EmpowermentTransparency Respect Teamwork

Elevate Academic

Profile

E. Enhance the research

capabilities and accomplishments

of CMH and strengthen the quality of the educational experiences

DeliverValue

D. Develop an integrated

pediatric health care system that

demonstrates value, expertise,

and efficiency

Strengthen Market Position

C. Maintain CMH’s market position in the

Metro area and grow it

throughout the region

Improve Performance

B. Improve processes,

increase capacity for innovation and service

excellence, and strengthen

financial position

Demonstrate Quality

Outcomes

A. Demonstrate quality, safety,

and clinical effectiveness

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Vision 2022

Be a national and international leader recognized for

advancing pediatric health and delivering optimal health outcomes through innovation and a high-value,

integrated system of care

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Criteria for Setting Service PrioritiesCriteria Questions to Consider

Revenue/Margin Potential/Cost Does it positively contribute to our financial performance? Does it reflect good stewardship?

Wait Times/Access Does it improve access? Does it allow for an increase in new patients? Does it support “the right patient, in the right place, at the right time”?

Competitive Advantage Does it strengthen CMH’s market position? Does it capitalize on areas of market opportunity? Does it give CMH the ability to stay ahead of competition?

National/Global Program and Recognition Potential

Does it positively impact pediatric health on a broad scale? Does it generate recognized accomplishments in pediatric health?

Uniqueness/No One Else or Few Others Do Does it make CMH a pioneer or early adopter? Does it advance innovation?

Future of Interdisciplinary Healthcare Does it promote a collaborative team practice? Does it improve efficiency? Does it improve effectiveness?

Alignment with Research Areas of Focus Does it advance one of the four research areas of emphasis? - Health Services and Outcomes - Clinical Pharmacology and Therapeutic Innovation - Genomic Medicine - Innovation in Healthcare Delivery

Unmet need consistent with Mission/Vision Does it address an identified need within our defined community? Does it directly impact our Mission or Vision?

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Community Benefit: Survey Descriptions

• Charity Care (Finance & Accounting): Free or discounted health services provided to persons who meet the organization’s criteria for financial assistance and are thereby deemed unable to pay for all or a portion of the services.

• Means Tested Government Program (Finance & Accounting): Means government-sponsored (federal, state or local) health programs where eligibility for benefits or coverage is determined by income or assets.

• Subsidized Health Services (Finance & Accounting): Subsidized health services generally include qualifying programs such as:

– Satellite clinics designed to serve low-income communities

– Home health programs

– Etc.

• Research (Finance & Accounting): Means any study or investigation the goal of which is to create generalizable knowledge made available to the public such as:

– Evaluation of safety and efficacy of interventions for disease;

– Epidemiology, health outcomes, and effectiveness;

– Behavioral or sociological studies related to health, delivery of care, or prevention

– Etc.

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• Community Health Improvement Services (Administrative Fellow & Strategic Planning): means activities or programs carried out or supported for the express purpose of improving community health. Such services may generate nominal patient fees, but generate a low or negative financial return.

• Health Professions Education means educational programs that result in a degree, certificate, or training necessary to be a licensed health professional, or continuing education.

• Community Benefit Operations (Administrative Fellow & Strategic Planning): means activities associated with community health needs assessments as well as community benefit administration.

• Cash and In-kind Contributions (Administrative Fellow & Strategic Planning): means contributions made by the organization to health care organizations and other community groups restricted to one or more of the community benefit activities

• Community Building (Administrative Fellow & Strategic Planning):

– Physical Improvements and Housing (e.g. development or maintenance of parks and playgrounds)

– Environmental Improvements (e.g. Healthy Homes Evaluation)

– Coalition Building (e.g. Weighing In Collaborative)

– Community Health Improvement Advocacy (e.g. efforts to support public health)

Community Benefit: Survey Descriptions

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Community Benefit: An Example

• Program: Family and Friends Flu Shot Clinic

• Survey Category: Community Health Improvement Services

• Description: Family and Friends Flu Shot Clinic offered no cost flu shots to family members and caregivers of our patients.

• Demonstrate Need/Benefit: The Health Department and local drug stores charge $20-$25 for the vaccination. The CDC recommends everyone 6 months and older receive and annual seasonal influenza vaccination.

• Persons Served: 1,616

• Financial Information:

– Employee(s) Involved: Kathy Hulse, multiple RN’s, multiple LPN’s, support staff, pharmacy tech

• Total Hours = 412 Hours

• Total Salary Expense = $10,662

– Supply Expense = $18,219 (e.g. Vaccine, needles, alcohol pads, etc)

– Total Indirect Expense (applied by Finance/Accounting) = $25,311

– Total Offsetting Revenue = $0

– Net Expense = $54,192

Community Benefit: Our Reporting

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What about the Community Health Needs

Assessment (CHNA)?

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CHNA: Our Objectives Objectively identify community health needs and develop implementation strategies to

address them

To be conducted once every three years

Comply with Patient Protection and Affordable Care Act (PPACA) and IRS regulations

Develop an efficient, cost-effective process that identifies current or emerging health

issues that are consistent with the mission of Children’s Mercy Hospital

Enhance our knowledge of the pediatric community

Identify and engage other community resources to address gaps in pediatric health

care

Align Community Benefit with prioritized community health needs in order to work toward:

Improving health status

Reducing the burden of chronic disease

Addressing health disparities

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CHNA: Our Requirements• A written CHNA report (1) and implementation strategy (1) for each state-licensed hospital

facility:

– Two documents for Children’s Mercy Hospital (Main Campus)

– Two documents for Children’s Mercy South

– Describe the process and methods used to conduct the assessment, including sources of data and other information used and analytical methods applied

– Description of how input was taken from people representing the broad interests of the community

Defining community served Input taken from broader community

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CHNA: Our “Community”

Clay County, MO65, 701 patient encounters in Fiscal Year 2011

(10.40% of total encounters)

Wyandotte County, KS59,693 patient encounters in Fiscal Year 2011


Jackson County, MO234,182 patient encounters in Fiscal Year 2011


Johnson County, KS103,696 patient encounters in Fiscal Year 2011


CHNA: Our Approach…

• Community Health Needs Assessment • A final CHNA report with implementation strategies

• Access to dynamic data PRCeasyview.com

• Summary report available to public (w/ benchmarks) Healthforecast.net

Community Health Survey• 25-30 minute telephone survey addressing 140 individual questions to parents, regarding a randomly selected child • 1000 interviews ± 3.1 at 95% confidence (best practice)

• Jackson County, MO = 407 surveys• Clay County, MO = 140 surveys• Johnson County, KS = 334 surveys• Wyandotte County, KS = 119 surveys

Community Health Survey• 25-30 minute telephone survey addressing 140 individual questions to parents, regarding a randomly selected child • 1000 interviews ± 3.1 at 95% confidence (best practice)

• Jackson County, MO = 407 surveys• Clay County, MO = 140 surveys• Johnson County, KS = 334 surveys• Wyandotte County, KS = 119 surveys

Secondary Data• State data• National data• Healthy People 2020• County and State Health Departments

Secondary Data• State data• National data• Healthy People 2020• County and State Health Departments

5 Key Informant Focus Groups• Physicians• Other Healthcare: Public Health, School RN• Social Services: Foundations, United Way, etc.• Community Leaders: Political, Business, etc.• Children’s Mercy Hospital representatives

5 Key Informant Focus Groups• Physicians• Other Healthcare: Public Health, School RN• Social Services: Foundations, United Way, etc.• Community Leaders: Political, Business, etc.• Children’s Mercy Hospital representatives

CHNA: Our Data…

I. Research Phase (Step

1)• Research

IRS/PPACA regulations

• Establish internal CHNA Advisory Committee

• Define our “community” for CHNA purposes

• Establish project plan

II. Planning and

Communication Phase (Step 2)

• Research and interview consulting firms (Professional Research Consultants)

• Develop content for community survey

• Develop invite list and content for Key Informant Focus Groups

III. Project Phase

(Steps 3-5)• Finalize survey

and focus group content

• Complete 1,000 community surveys and 5 focus groups

• Secondary Data (e.g. CDC, HP 2020)

• CHNA Final Reports (2)

IV. Wrap-Up(Steps 6-10)• Board approval

of CHNA report (2) and implementation plans (2)

• Make results widely available to public (i.e. post online)

• Submit to IRS on Form 990

• Complete by July 1, 2013

Community Benefit and CHNA: Our Timeline

Community Health Needs

Assessment

Community Benefit

Community Benefit FY 2011 (Completed)

Community Benefit FY 2010 (Completed)

Community Benefit FY 2012 (Complete by July 1,

2013)

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Community Benefit: What we are asking from you…

• If you have previously reported a Community Benefit program, we will come to you!

– We will schedule a 15-30 minute session to review your program and make sure you have the data, instructions and support to complete your Community Benefit survey for Fiscal Year 2012 (i.e. July 1st, 2011 to June 31st, 2012)

– Please accept and/or propose a different time for our upcoming Microsoft Outlook invitation

• If you have not previously reported a Community Benefit program, but wonder if your program qualifies, please approach us:

– Cindy Ortiz, Administrative Fellow

• Email: [email protected]

• Extension: 56999

– Jared Vavroch, Manager of Strategic Planning:

• Email: [email protected]

• Extension: 44370

mailto:[email protected]

mailto:[email protected]

Documents

Community Benefit & the Community Health Needs Assessment (CHNA) Operations Council December 7th, 2012 Dawn Wolff: Director, Strategic Planning Cindy Ortiz: