Ellis Hospital D/B/A Ellis Medicine

“Line 11a explanation - a copy of the ellis hospital's 990 was prepared and submitted for review to the chief financial officer. After cfo review was completed, the form 990 was sent to each member of the audit committee for review. After review by the audit committee, a copy of the form 990, including all required schedules, as ultimately filed with the irs, was given to each voting member of ellis' board of trustees, prior to its filing with the irs. After review by the board of trustees, and upon the recommendation of the audit committee, approval is given for filing the return with the irs.”

“Ellis hospital's conflict of interest policy applies to all hospital trustees, officers, employees, medical/dental staff members, directors, managers, appointees with administrative and/or decision-making responsibilities, volunteers or any of these parties' immediate families (collectively called hospital agents). The ellis hospital corporate bylaws require hospital agents and other selected individuals as identified by the vice president, human resources and the corporate compliance officer/director of internal audit (cco), to file a conflict of interest disclosure statement with the hospital on a annual basis. When the statements are completed they are returned to the cco. Upon receipt, the cco will review the disclosure and, if a potential conflict is disclosed, will meet with the hospital agent and/or his/her appropriate supervisor to discuss the disclosure and need for action if any. All statements for trustees are also reviewed by the cco, and if a potential conflict has been disclosed, he/she will meet with the board chairperson to discuss the disclosure and need for action, if any. All potential conflicts involving the board of trustees will be summarized by the cco and reported to the audit committee of the board. This committee will then share this information with the board chairperson. When a potential or actual conflict exists, an interested person may make a presentation to the board or at a committee meeting, but after such presentation, he/she shall leave the meeting during the discussion of, and the vote upon, the transaction or arrangement that could constitute the conflict of interest. The board or committee members shall determine by a majority vote whether the transaction or arrangement is in the hospital's best interest.”

“The current executive compensation plan is in full compliance with all existing rules and regulations applicable to a 501(c) corporation. The following is a summary of each plan: executive compensation plan-the president, and all other senior executivies are governed by our executive compensation program established by the board of trustees. The executive compensation plan is administered also by the executive compensation committee under the direction of the board of trustees. All payments from this program are based on audited results and reviewed by the board of trustees prior to any payments being made. The review of the compensation agreements and gathering of comparability data in determining the reasonableness of compensation follow the procedures described in treasury regulation section 53.4958-6.”

“Corporate compliance policies (including conflicts of interest policy) and audited financial statements are available to the general public via posting on the ellis hospital website: www.ellismedicine.org. In addition, these documents and governing documents are available to the public upon request.”

“Overall, schenectady county residents are slightly more likely than the average new york state resident to have health insurance, to see a doctor, and to see a dentist; and significantly more likely to visit an emergency department for mental health care (see figure 2). The vast majority of primary medical care and dental care for low-income residents is provided by the hometown health fqhc and the community practices of the ellis medical group. Both have achieved recognition by the national committee for quality assurance (ncqa) as patient-centered medical homes (pcmh). Schenectady county city of schenectady new york state population 155,350 (2018) 66,135 (2010) 19,542,209 (2018) persons per square mile 756.6 (2010) 6,135.5 (2010) 411.2 (2010) persons under 18 years 21.6% (2018) 20.7% (2018) 20.9% (2018) persons 65 years and over 16.9% (2018) 13.4% (2018) 15.9% (2018) white alone 78.5% (2018) 59.4% (2018) 69.6% (2018) black or african american alone 12.0% (2018) 20.9% (2018) 17.7% (2018) bachelor's degree or higher (age 25+) 30.8% (2013-17) 22.3% (2013-17) 35.3% (2013-17) median value, owner-occupied housing $164,100 (2013-17) $110,800 (2013-17) $293,000 (2013-17) median household income $61,315 (2013-17) $43,174 (2013-17) $62,765 (2013-17) persons in poverty 12.8% (2018) 21.0% (2018) 14.1% (2086) figure 1: schenectady county, city, and state demographics (source: us census bureau, state and county quickfacts, as accessed april 23, 2019) ----------------------------------------------------------------------- schenectady county new york state adults 18-64 without any health insurance (2016) 91.8% 88.6% adults with regular health care provider (age-adjusted, 2016) 84.6% 83.4% adults who visited dentist w/in 1 year (age-adjusted, 2013-14) 69.7% 69.3% mental disease/disorder primary dx ed visit rate per 10,000 (age-adjusted 2014-16) 235.8 185.4 figure 2: schenectady county insurance, provider, and diagnosis information (source: hcdi, 2019 community health profile)”

“Ellis hospital (d/b/a ellis medicine), the sole remaining provider of acute hospital care in schenectady county, is a voluntary, not-for-profit, community and teaching hospital with 423 licensed beds between two inpatient campuses (ellis hospital and bellevue woman's center), including 52 inpatient mental health beds (see item 4b below). Ellis also operates several primary care and outpatient sites, including two comprehensive outpatient medical campuses (mcclellan street health center in the city of schenectady and medical center of clifton park in southern saratoga county) and an outpatient mental health facility (state street health center). All health care services are provided under a single corporate taxpayer identification number (tin) and a single operating certificate issued by the new york state department of health, the hospital's primary regulator. The hospital is overseen by an 18-member volunteer board of trustees drawn from the community and the medical staff, including five physician trustees. With the mission to "meet the health and wellness needs of our community with excellence," ellis balances state-of-the-art technology and advanced medical procedures with a 133-year tradition of community-based caring and a firm commitment to quality. Ellis has earned numerous recognitions for clinical excellence and community service. Ellis has been a new york state designated stroke center since 2005, and was the first hospital in new york state to receive the american stroke association's (asa) performance achievement award for stroke (in 2006). The ellis stroke center continues as a recipient of the gold/gold plus award (2007-2019), recognized for using the asa's "get with the guidelines" program for improving the quality of care and patient outcomes. The hospital is an accredited bariatric surgery center by the metabolic and bariatric surgery accreditation and quality improvement program (mbsaqip) of the american college of surgeons and the american society of metabolic and bariatric surgery. Additionally, the sleep disorders center is accredited by the american academy of sleep medicine; the belanger school of nursing is accredited by the national league for nursing accrediting commission; the family medicine residency is accredited by both the accreditation council for graduate medical education and the american osteopathic association; five ellis primary care practices in glenville, schenectady and clifton park have achieved national commission on quality assurance (ncqa) "patient-centered medical home" (pcmh) recognition while four others are in progress of achieving recognition; and four primary care practices participate in the federal cms "cpc+" quality program. Ellis has been recognized by the american heart association (aha) as a "fit-friendly worksite and received the aha's "innovation award" for presenting a unique program of health and wellness to employees. Ellis has been awarded blue distinction center designation by blue cross blue shield for cardiac care, bariatric care, knee and hip replacement, and maternity care. Ellis is also a partners in performance excellence gold baldrige award winner, recognized for its dedication and work to create a culture and systems where innovation and performance excellence become the accepted norm. Ellis has also been honored with the five rings award by intellicentrics, inc. For excellence in vendor credentialing and creating a culture of vigilance to make hospitals safer for employees and patients. During recent years, ellis has received community service awards from the chamber of schenectady county ("corporation of the year"), the city mission of schenectady ("partners award," specifically recognizing the hospital's services for the underserved), the schenectady arc ("employer of the year," recognizing the hospital for providing employment, with opportunities for growth and meaningful experience, to individuals with developmental disabilities), the sight society o”

“Ellis serves the community by addressing identified health care priorities; including access to care, and prevention and treatment of chronic diseases; through a variety of programs. Identification of needs includes such mechanisms as the federally required community health needs assessment with its implementation strategy (see schedule h) and the state-mandated triennial community service plan. These plans are built collaboratively through regional and community partnerships. On a regional basis, ellis is a member of the healthy capital district initiative (hcdi) a state-funded health data collection and planning entity which brings together the county public health departments, not-for-profit hospitals, fqhcs, and not-for-profit insurers in the six-county capital region. In both 2013 and 2016, hcdi conducted regional information-gathering exercises to provide the basis for the community health needs assessments (chna) of its member not-for-profit hospitals. These are available here http://www.ellismedicine.org/pages/community-report.aspx and they, as well as preparations for the 2019 chna, are further described in schedule h. Again in 2018, hcdi began preparations for the 2019 chna. These included a formal collaborative planning process, data collection and analysis, and the start of a community survey conducted by telephone. In addition to the federally-required chnas, during 2014 hcdi conducted a comprehensive 11-county greater capital region community health needs assessment (chna) on behalf of two regional health consortia, one of which was led by ellis. That chna, a requirement of the new york state medicaid delivery system reform incentive payment (dsrip) program, covered the specific healthcare needs of the medicaid population. A copy is available here: https://abhealth.us/about/community-needs-assessment/. On a community collaboration basis, ellis partners with schenectady county public health services (scphs), including joint grant applications and joint new york state department of health needs assessments. This includes the schenectady county strategic alliance for health (sah), a county-led, federally-designated and federally-funded collaborative focused on preventing chronic disease and promoting community health. Ellis also provides co-leadership, meeting space, and resources for the schenectady coalition for a healthy community (schc), a community collaborative of about 60 healthcare providers, community-based organizations, and local government agencies. Schc met quarterly during 2018 to discuss community health needs, to monitor progress on ellis' 2016 implementation strategy, and to begin preparations for conducting and presenting the 2019 chna and implementation strategy. Ellis counted 19,193 inpatient discharges and 550,985 outpatient visits during 2018. Ellis has granted discounted rates to all uninsured patients since november 2009. An explanation of ellis bad debt expense can be found on page 12 - 13 on ellis medicine's audited financial statements.”

“Ellis operates a 52-bed (certified and staffed) inpatient mental health unit, along with expanded outpatient services. This is the only inpatient mental health facility in schenectady county, and is one of only two inpatient units in a 16-county region providing services to adolescents. Ellis' mental health services include: inpatient care for adults and adolescents; outpatient child, adolescent, and adult mental health services; crisis intervention, including a 24-hour crisis information hotline; a peer advocacy program; and a support and education group for people with major disorders and their families. Ellis contracts with the schenectady county drug court to provide expedited mental health services to low-level offenders referred by the judicial system, and with the schenectady county correctional facility to provide post-incarceration support services, including peer services. In response to a nationally-studied "schenectady suicide cluster" of teenage african-american females, ellis moved the outpatient child and adolescent mental health clinic to substantially expanded facilities at the ellis mcclellan street health center, where it is co-located with the pediatric and family health centers. The ellis state street health center, which houses the outpatient mental health clinic and a personalized recovery oriented services (pros) service, was opened in 2017. This not only increased the size and improved the quality of facilities for adult outpatient mental health; it also has become part of an informal "medical village," with the mental health facility, a federally qualified health center (fqhc), another large community primary care clinic, and a pharmacy all located within one city block. In 2018, the ellis mental health programs had 1,811 inpatient discharges and 43,529 outpatient visits.”

“The ellis residential and rehabilitation center (errc), an 82-bed long-term skilled nursing facility (snf) and short-stay rehabilitation facility, has been providing long term nursing care since 1989 and short stay rehabilitation services since 2001. Specializing in medically complex cases, errc operates from its renovated facility on the ellis mcclellan street health center campus. The facility provides residents with private rooms and such amenities as a cyber-center, a hair salon, and a roof-top garden. Resident days for 2018 were 28,843.”

“Change in interest in foundation -2,599,490. Pension and postretirement related changes -1,558,820. Yankee alliance tax income -615,198. Alliance for better health care -4,451. Visiting nurse service association of schenectady -5,036,278. Income tax benefit 1,036,000.”

“The process has not changed from the prior year.”

“September 29, 2016 meb (mental health and substance abuse) work group: specific participation in chip/csp projects, reports on projects and opportunities attendees: catholic charities housing office, new choices recovery center, conifer park, schenectady arc, schenectady county public health services, united way of the greater capital region, ellis medicine, community member with suicide prevention expertise september 29, 2016 topics: status of draft chip/csp document, reports from chip/csp work groups, obesity/diabetes, meb (mental health and substance abuse), reports from other work groups, asthma, falls prevention, teen pregnancy, tobacco, report on pich food forum, status of schenectady dsrip projects, next steps/schedule - work groups and full coalition, member updates and information sharing attendees: catholic charities housing office, united way of the greater capital region, new choices recovery center, schenectady arc, conifer park, schenectady county public health services, schenectady county public library, capital district physicians health plan, schenectady community action program, ellis medicine, capital district child care council, bethesda house, capital district tobacco-free community, price chopper, university at albany school of public health, st. Peter's health partners creating healthy schools program, ellis hospital diabetes education program, league of women voters of schenectady, sunnyview rehabilitation hospital, healthy capital district initiative january 10, 2017 topics (diabetes/obesity work group): pich grant updates, work group member updates, hcdi updates, data collection requirements for chip attendees: schenectady county public health services, bethesda house, united way, healthy capital district initiative, ellis hospital, schenectady community action program, price chopper, cornell cooperative extension january 19, 2017 topics (suicide/mental-emotional-behavioral work group): relationship to other community groups, data collection requirements for chip attendees: healthy capital district initiative, schenectady county public health services, catholic charities, conifer park, safe inc., ellis hospital january 19, 2017 topics: presentation on "nuval" healthy foods designation system, overview of healthy schenectady families home visiting program, presentation from capital district tobacco-free communities, work group updates, hcdi updates, update on chip/csp, dsrip update, reorganization of care central health home attendees: healthy capital district initiative, schenectady county public health services, schenectady county suicide prevention, ellis hospital, conifer park, catholic charities housing options, cancer peer education, price chopper, planned parenthood, schenectady county office of senior and long-term care services, capital district physicians health plan, schenectady arc, united way, capital district tobacco-free communities, visiting nurse service of schenectady, healthy schenectady families, schenectady county office of community services, schenectady community action program march 27, 2017 topics (suicide prevention task force): overview of suicide prevention efforts in new york state, data overview, swot analysis, logic model, building and maintaining a coalition attendees: safe inc., planned parenthood, ellis hospital, rehabilitation support services, schenectady county public health services, schenectady county office of community services, scotia-glenville schools, new choices recovery, columbia-greene community college, schenectady city school district, schenectady county community college, burnt hills-ballston lake high school, niskayuna high school, northeast career planning, healthy capital district initiative, schenectady county youth bureau, saratoga county office of community services, columbia-greene public health, solos suicide survivors group april 6, 2017 topics (diabetes/obesity work group): st. Peter's health partners exercise program in schenectady schools (l”

“February 27, 2018 topics: trauma informed work group - survey of needs and resources attendees: schenectady county public health services, ellis hospital, schenectady community action program, city mission of schenectady, schenectady city school district may 24, 2018 topics: potentially establishing a law enforcement assisted diversion (lead) program in schenectady, hometown health centers affiliation discussions, carver community center reestablishment committee, community media services video production discussion, discuss possibility of umatter2 survey for 2019 community health needs assessment attendees: schenectady county public health services, catholic charities, schenectady city school district, bethesda house, capital district physicians health plan, healthy capital district initiative, schenectady inner city ministry, schenectady community action program, ellis hospital, new choices recovery center, miracle on craig street, lead national support bureau, hometown health centers, capital district tobacco free communities, boys and girls club of schenectady, ellis medical group, schenectady county office of community services, schenectady inner city ministry, schenectady county public library, the schenectady foundation, schenectady city mission, community media services june 26, 2018 topics: mission, vision, and goals for trauma-informed community work group attendees: ellis hospital, schenectady county public health services, capital district child care coordination council, prevent child abuse, schenectady community action program, healthy capital district initiative, schenectady county office of community services, alliance for better health, ellis medical group july 19, 2018 topics: schenectady suicide prevention coalition, regional and county-specific mental health equity report, trauma-informed community work group report out, 2019 chna report and next steps, dsrip innovation funds report attendees: healthy capital district initiative, cancer peer education program, new choices recovery center, the schenectady foundation, ellis hospital, capital district child care coordinating council, boys and girls club of schenectady, university at albany school of public health, schenectady county office of senior and long-term care, schenectady community action program, bethesda house, capital district tobacco free communities, catholic charities, schenectady city mission, conifer park, the community builders, prevent child abuse, schenectady county public health services, schenectady county office of community services, catholic charities, capital district physicians health plan july 31, 2018 topics: initiate trauma informed care organizational self-assessment tool (ticosat) survey attendees: ellis hospital, healthy capital district initiative, schenectady county public health services, schenectady community action program, bethesda house, schenectady county office of community services, ywca of northeastern new york august 28, 2018 topics: trauma informed work group - common definition of terms, trauma informed work group - time line for ticosat survey attendees: northern rivers, northeast parent and child society, victims advocacy service of planned parenthood mohawk hudson, ywca of northeastern new york, schenectady county office of community services, ellis hospital, schenectady community action program, schenectady county public health services, healthy capital district initiative, bethesda house, centro civico october 18, 2018 topics: capital region health connections health home - new health home replacing care central, cancer peer education walking program at mohawk harbor, special victims task force, trauma informed community work group report out, opioid grant activities report attendees: ellis hospital, cancer peer education, capital region health connections, the legal project, schenectady county public health services, empower health, catholic charities, capital district center for independence, schenectady in”

“No written comments were received between the website posting of the 2013 chna and implementation strategy in november 2013 and the preparation of the 2016 chna in september 2016. Comments were received, however, during meetings of schc and were used to modify and make mid-course corrections to the overall identification, evaluation, and prioritization of health needs. The most significant comments related to priority modifications so as to be able to take advantage of opportunities which occurred after adoption of the 2013 document. This particularly involved elevation of the priority of food insecurity (initially listed as tier b) as several funding opportunities became available. Greater knowledge of the impact of food insecurity on the overall well-being of individuals and families in schenectady then led to it inclusion as a component in the obesity/diabetes initiative for 2016. Given this experience, ellis sought to more aggressively encourage written comments on the 2016 and 2019 chna and implementation strategy.”

“-in addition to the dpp, ellis diabetes care also offers diabetes self-management education (dsme) programs for individuals already diagnosed with diabetes. They receive referrals from ellis practices but also community based organizations and other medical providers in the community. One of our goals is increase referrals to dsme and increase the number of individuals who follow through on their referral and attend at least one session of dsme. From january 2018 - december 12, 2018, dsme received 641 referrals from all sources. During that same time period, 372 initial dsme sessions were attended. Compared to 2016-2017 data, raw referral numbers stayed very similar, 647 in 2016-2017 and 641 in 2018; however conversion into first visits increased substantially. In 2016-2017, referral to initial visit conversion rate was 26%. In 2018, referral to initial visit conversion rate jumped to 58%. This could be due to a number of factors including providers explaining the program better to their patients at the time of referral and referrals getting scheduled faster. The increased conversion rate means that more patients are getting the benefit of learning management skills for their diabetes. -scphs provided funding through the pich grant to train ellis medicine staff as "lifestyle coaches" to deliver the dpp. Scphs also supported the promotion of the classes through advertisements in the local newspaper and sharing flyers with local partners. The pich grant was able to purchase incentives for the program to help people to continue coming to the program. -ellis medicine provides staff for running both the dpp and dsme programs, both of which are housed in ellis diabetes care. They also provide resources to promote these programs in the community and to their employees. Ellis diabetes care collects all the data that is needed for these programs and monitors progress with referrals. Sunnyview hospital also provides referrals to the dpp and dsme programs. -funding from the community foundation for the greater capital region to support the continued work with food pantries is helpful in keeping momentum for these activities moving forward. The funding supports education for food pantry clients, the purchase of healthier food options, and support from cornell cooperative extension, schenectady county. Ellis medicine's multiple primary care offices and outpatient education services provide direct interface with community members who are food insecure and could benefit from accessing healthy foods at the local food pantries. Ellis care managers also have these interactions with their patients and provide these referrals to community based organizations including food pantries. Cdphp recently started utilizing their care managers to screen for food insecurity and make appropriate referrals based on the outcome. Utilizing the medical community as a point of entry for access to community members who can benefit from various community programs has been a helpful partnership to have. City mission's empower health program has also been instrumental in screening for food insecurity in the community and providing referrals to food pantries as needed. The food pantries are very interested in this work and see the importance of offering healthy options for their clients. Pantries understand that many of their clients are utilizing the pantries on a monthly basis as a part of their food budgeting and thus the food that they receive is a big part of their diets every month. The nutrition expertise that cornell cooperative extension (schenectady county) brings was very important in moving the work with the food pantries forward. Mental health and substance abuse - suicide and mental/emotional/behavioral infrastructure: -the schenectady county office of community services (the local government's mental health unit) and ellis undertook a collaboration to form work groups evaluating mental health needs. -in collaboration with researchers from the schenecta”

“-the ellis pediatric health center received a three-year (extended to four years) $354,500 grant from the new york state office of mental health to implement the healthy steps program supporting at-risk families with children from birth to three years old. The grant enabled hiring a healthy steps specialist who is engaged in expanding awareness of the adverse childhood experiences (aces) concept throughout the community. During 2018, ellis began to explore potential opportunities to sustain the program after the grant terminates in 2020. -the office of community services provided trauma-informed care training two times for schenectady county foster parents, one on march 26, 2018 (15 participants) and one on october 30, 2018 (also 15 participants). Additionally, ocs trained ellis medicine's outpatient adult mental health clinic staff on trauma-informed care and suicide prevention on august 8, 2018; 45 participants attended that training. A trauma-informed care training was hosted by the university at albany school of social welfare on march 12, 2018; 10 people from schenectady county attended. The title was "trauma past trauma present: understanding and applying important skills in trauma informed phase oriented treatment." the trainer was dr. Allison jackson. -schenectady city school district is also engaged in work around trauma, creating trauma-sensitive schools. In may 2018, schenectady high school held a mental health fair in the evening for both students and parents. Numerous community resources were shared and then a screening of the film "resilience" was held with a discussion panel after. Over 100 people attended the event. -the dual recovery task force, led by the office of community services, met a total of nine times during 2018 with an average attendance of 16 individuals. The dual recovery task force includes providers from both mental health and substance abuse, making an important connection for treating those with dual diagnoses. The group had 13 different presentations at their meetings about community resources for those with a dual diagnosis. Programs that presented ranged from outpatient mental health clinics, to harm reduction services and housing. These presentations by community providers are an important step in promoting their programs and making sure the community is aware of all available resources. -in 2018, the trauma informed care workgroups that were established in 2017 merged into one group under the new title of "trauma-informed community workgroup." this group met a total of eight times: february 21 (14 attendees), february 27 (7 attendees), june 22 (5 attendees), june 26 (14 attendees), july 31 (10 attendees), august 28 (15 attendees), october 30 (18 attendees) and november 26 (12 attendees). This group held a brainstorming session in june 2018 to determine a mission, vision, goals and common definitions of trauma language (trauma-informed care, aces, toxic stress, and resilience). One of the goals of the group was to determine a baseline of trauma-informed practices each participating organization is using. This baseline would help determine next steps for training needs of community based organizations. The group decided to utilize coordinated care services, inc.'s tool called the "trauma-informed care organizational self-assessment tool" (tic osat) for each organization. During the fall of 2018, 11 organizations represented on the workgroup completed surveys using the tic osat. The survey divides results into staff and leadership. Leadership at the 11 organizations completed 36 surveys and staff completed 175. The tic osat software generates reports for each organization and an overall report combining all organizations. The workgroup analyzed the results at a meeting in november 2018 and determined that workforce development around trauma-informed care was where the work of the group should start. This will be further explored in 2019. One exciting resource that the group will use, and so”

“-ellis, the schenectady city school district (scsd), and price chopper pharmacy participated in the "school-based asthma management program," which enrolls a small but increasing number of the 1,150 diagnosed asthmatic students in scsd. The program administers albuterol treatments, enabling students to return to class 98.7% of the time. In addition to the in-school component, nearly a third of the students and their parents completed outpatient asthma self-management training sessions through ellis asthma care. -the ellis asthma education program found that "graduates" achieve a 60-70% reduction in emergency department visits over 12 months post-discharge. -a care manager from the ellis-sponsored health home completed a two-day asthma training course. -ellis continued its strong asthma education program, and continued to collaborate with the capital district tobacco free coalition. Informal "suasion" within the community encouraged various smoke-free initiatives; a newly-constructed affordable housing project on albany street in schenectady is smoke-free from the start, and the entire union college campus was smoke-free as of january 1, 2017. Since august 2016, the legal age for the sale of tobacco products in schenectady county is set by local law at 21. Inappropriate emergency department utilization: -ellis led creation of two region-wide health innovations collaborations - a medicare mssp aco ("innovative health alliance of new york" (ihany)) and a medicaid dsrip pps ("alliance for better health" (afbh)) - both with goals of reducing inappropriate hospital utilization. -both collaborations were approved for inauguration in 2015 - the aco on january 1 and the pps on april 1. -ihany adopted the goal of reducing inappropriate hospital emergency department utilization as part of a comprehensive program intending to reduce costs and produce shared savings. Afbhc is required by the state to reduce inappropriate hospital utilization (both emergency department and inpatient) by 25% over a five year period. Ihany was successful in reducing emergency department use by its attributed patients during its first year of operations. Adolescent (teen) pregnancy: -ellis, the schenectady city school district, planned parenthood mohawk hudson, the alliance for positive health (formerly the aids council), and the schenectady teen and adult coalition (stac) worked to consider causes and solutions to the consistently high rates of adolescent pregnancy in certain neighborhoods. -the project engaged adolescents/teenagers in focus group and multiple meetings. A gap in health education at local schools was identified. After most health education teachers had been laid off due to budget cuts, students are receiving no health education classes between 6th grade and 10th grade. Planned parenthood arranged student health education assemblies in 2016 and 2018, and is seeking to reintroduce middle school health classes. -the schenectady foundation's "call to action for schenectady's youth" grant program is providing funding for the "cradle project," a multimedia project that is focusing a lens on schenectady's high rate of teenage pregnancy - the highest in the capital region - and its toll on the community. Dozens of local youth are involved in writing original music and dialog, performing and producing "cradle," a documentary film about teen pregnancy. The cradle project will also include music videos and forums about sexual health and professional development. Arthritis and disability: -as this need was not categorized among the top priorities in the development of the chna, resources were devoted to other higher priority projects. Dental health: -in 2015, ellis received the final payment of a $250,000 "member item" grant from state senator hugh t. Farley which was used to acquire equipment for the pediatric dental program. Ellis dental care now provides expanded services to low-income patients; including the new facilities for pediatric dental surgery”

“Programs for youth and adolescents: -in december 2014, the schenectady foundation hosted a conference entitled "bridges to youths" to better understand the needs of schenectady's youth. -the conference led to the "call to action for schenectady's youth." since its launch, the schenectady foundation has so far invested $770,000 in eight programs with the potential to bring powerful and positive change to schenectady's youth. Call to action for youth is a three-year, $2 million community-wide effort to empower children and teens that face significant barriers to success. Grants include support of scholarships, job training, and sports programs for youth. Community and coalition building: -ellis and scphs continue to lead and participate in numerous community coalitions. These include the schenectady coalition for a healthy community, the schenectady strategic alliance for health, and the healthy capital district initiative. -in addition, during 2014 ellis undertook two major business initiatives promoting broad coalitions of healthcare providers. A medicare shared savings program accountable care organization (mssp aco) partnered three hospital systems, an fqhc, and several community medical practices. A new york state medicaid delivery system reform incentive payment program performing provider system (dsrip pps) partnered the same three hospital systems, two fqhcs, and two large community medical practices, along with more than 50 community agencies. Both were approved by their respective regulators to start operations in 2015. -the mssp aco (innovative health alliance of new york, or ihany) was approved to start operations on january 1, 2015, and the dsrip pps (alliance for better health, or afbh) to begin on april 1, 2015. Each was established as a separate limited liability company (llc) and each undertook to adopt an operating agreement and seat a board of directors. The dsrip pps received scheduled funding from the new york state department of health under a five-year agreement. The mssp aco was funded by capital contributions from the two members of the llc (ellis hospital and st. Peter's health partners), and has not achieved "shared savings." in 2017, ellis withdrew as an equity partner of the mssp aco, but remains a clinical partner. In fall 2017, the federal centers for medicare and medicaid services (cms) approved renewal of ihany's mssp aco agreement for another three years. Community health improvement: -ellis continued programs of community and patient education and support. Health professions education: -ellis, the only hospital in the region to sponsor both physician education and nursing education, continued to provide a broad variety of health professions education programs including the belanger school of nursing, the family medicine residency, the general dental residency, grand rounds and other continuing professional education programs. Ellis also serves as a training and preceptorship site for numerous community-based health professions education programs. Subsidized and free health services: -ellis continued to participate in government insurance programs including medicare and medicaid, while providing reduced rates and charity care for self-pay patients, as detailed in irs form 990, schedule h. Medicare, medicaid, and financial assistance (charity care) covered about two-thirds of inpatient discharges during 2018.”