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

2 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.

3 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 Mission Values Accountability  Clinical Excellence  Continuous Improvement  Empowerment Transparency  Respect  Teamwork Values Elevate Academic Profile E. Enhance the research capabilities and accomplishments of CMH and strengthen the quality of the educational experiences Elevate Academic Profile E. Enhance the research capabilities and accomplishments of CMH and strengthen the quality of the educational experiences Deliver Value D. Develop an integrated pediatric health care system that demonstrates value, expertise, and efficiency Deliver Value 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 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 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 Demonstrate Quality Outcomes A. Demonstrate quality, safety, and clinical effectiveness Innovation Public Policy Leadership Goals 2017 Vision 2022 Be a national and international leader recognized for leader recognized for advancing pediatric health and delivering optimal health outcomes through innovation and a high-value, integrated system of care Vision 2022 Be a national and international leader recognized for leader recognized for advancing pediatric health and delivering optimal health outcomes through innovation and a high-value, integrated system of care

4 Criteria for Setting Service Priorities

5 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.

6 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

7 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

9 What about the Community Health Needs Assessment (CHNA)?

10 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

11 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

12 CHNA: Our “Community”

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 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 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)

16 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 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 1 st, 2011 to June 31 st, 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 Extension: – Jared Vavroch, Manager of Strategic Planning: Extension: 44370