1. Communities of Care NASCSP Conference Marisue Garganta Director, Community Health Integration Dignity Health, St. Joseph’s Hospital and Medical Center September 11, 2013

2. Setting the Stage Who is your hospital partner? Understanding Hospital's responsibilities The Affordable Healthcare Act Responding to the mission and law Creating Communities of Care Resources 2

3. St. Joseph’s Hospital and Medical Center 3

4. Hospital’s Roles and Responsibilities 4 Nonprofit Requirements Internal Revenue Services – IRS – Form 990 Schedule H 3 year Community Health Needs Assessment 3 year Community Benefit Plan Mission to serve the community Affordable Healthcare Act Investment in community

5. Affordable Health Care Act Health Coverage Medicare Medicaid Subsidies - Assistance Preventive Services Hospital and Providers Community Health Assessments 5

6. Two thirds of the uninsured live in 13 states 6 Uninsured by State <230K230K - 600K 600K - 1.1M 1.1M+ Number of Uninsured 67% of uninsured live in 13 states Source: Census Bureau, Current Population Survey, March 2011 and 2012

7. One fifth of the uninsured live in the top 13 counties and half live in the top 114 counties 7 Uninsured by County 10% of the uninsured live in just 4 counties (LA, Harris, Cook, Miami) 20% of the uninsured live in top 13 counties (Top 4 + Next 9) 50% live in the top 114 counties (3.8% of total counties in the US)

8. All Qualified Health Plans Will Cover These Essential Health Benefits 9/3/2015The Health Insurance Marketplace 101 8 6.Prescription drugs 7.Rehabilitative and habilitative services and devices 8.Laboratory services 9.Preventive and wellness services and chronic disease management 10.Pediatric services, including oral and vision care 1.Ambulatory patient services 2.Emergency services 3.Hospitalization 4.Maternity and newborn care 5.Mental health and substance use disorder services, including behavioral health treatment

9. The Beginning of the Shared Vision and Need “Creating a Healthier and Connected Community” Healthy and Safe Community Environments Clinical and Community Preventive Services Empowered People Elimination of Health Disparities National Prevention Strategy America’s Plan for Better Health and Wellness” (http://www.healthcare.gov/cente r/councils/nphpphc).http://www.healthcare.gov/cente r/councils/nphpphc Prevention Strategy Diagram 9

10. Responding to the mission and law Requirements within Community Benefit Reporting “good works” for IRS Form 990 – Schedule H Improving the health of the community Community Grants Community Investments 10

11. Connecting the Community Health Needs Assessment Identify key areas in Community Health Needs Assessment Review, identify assets and gaps Create initiative to meet your greatest area of need Identify zip codes with Community Needs Index and/or other identified data of greatest need Identify “key” groups of need Identify service areas, departments and/or hospital’s in and outpatient services to be “champions” for work Create a Community of Care 11

12. Grant’s Program as Solution Use grant’s program as a “solution” Filling the gap in services Creating networks of care Integrating best practices in community and hospital Education opportunities – teaching, learning, growing Answering Schedule H – Questions –Did you meet the needs within Community Health Needs Assessment? –If no, than how did you meet it and with whom? Changing the paradigm of care Foundation for the Affordable Healthcare Act 12

13. Investing in the Community 13

14. RESOURCES Affordable Healthcare Act -www.Healthcare.govwww.Healthcare.gov -www.Marketplace.cms.govwww.Marketplace.cms.gov -http://www.healthcare.gov/c enter/councils/nphpphchttp://www.healthcare.gov/c enter/councils/nphpphc Dignity Health -www.DignityHealth.org/Com munityInvestmentswww.DignityHealth.org/Com munityInvestments National Organizations www.chausa.org www.communityhlth.org Healthy Communities http://www.healthycommunitie sinstitute.com Collective Impact http://www.fsg.org/OurApproa ch/CollectiveImpact.aspx 14

15. www.HealthCare.gov 9/3/2015The Health Insurance Marketplace 101 15 Starting October 1, 2013, you will be able to apply through this site Now - Sign up for Email and Text Alerts and Get Ready

16. Marketplace.cms.gov 9/3/2015The Health Insurance Marketplace 101 16 Get the latest resources to help people apply, enroll, and get coverage in 2014

17. QUESTIONS ? Thanks for all you do and for taking the time to be here today! Marisue Garganta Director of Community Health Integration 602.406.6580 Marisue.Garganta@DignityHealth.org