Cape Cod Healthcare Inc.

“Trustees and officers sit on the boards of the following: cape health insurance company: michael k lauf michael l connors michael g jones bruce johnston robert m birmingham the members of cape cod healthcare, inc.'s board also sit on the boards of cape cod medical office building and emerald physician services, llc (through may 1, 2019), for-profit related organizations.”

“The organization has members/incorporators who elect the organization's trustees.”

“The decisions of the governing body that need approval by its members/incorporators include approval of changes made to the corporation's bylaws and approval when there is a divesting of one of the major affiliates of the organization.”

“The organization's form 990 is reviewed at several levels. The organization engages a public accounting firm to assist in the preparation and review of its form 990 and who signs as paid preparer. Senior management of the organization is responsible for the timely preparation of form 990. The completed form 990 is provided to the finance committee and the entire board in advance of the filing deadline.”

“The organization maintains a conflict of interest policy and regularly and consistently monitors and enforces compliance with this policy. On an annual basis, each trustee, officer and employee at the senior management level completes a conflict of interest disclosure form. The forms are reviewed by cape cod healthcare, inc.'s ("cchc") director of clinical and research compliance who prepares a summary for cchc's compliance officer. Any material interests so disclosed are presented to the corporation's governance committee for review and resolution. All disclosure statements submitted by employees will be reviewed by human resources and/or cchc's director of clinical and research compliance. For any disclosure that is considered substantive the employee's area manager will be consulted to determine if the situation is generally acceptable, requires further examination and possible action or is generally not acceptable. Any action plan created to manage a conflict of interest will be monitored by the employee's area manager or supervisor.”

“The annual process for determining compensation of the organization's ceo, officers, executives and key employees include the following: ceo - compensation will be determined by the compensation committee of the board of trustees, and will include consideration of relevant market data furnished by a disinterested compensation consultant, and a review of job performance. Officers, executives and key employees - officer, executive and key employee compensation will be determined by the ceo and will include consideration of recent relevant market data furnished by a disinterested compensation consultant, and a review of job performance. The ceo's determination of such compensation will be subject to the approval of the compensation committee of the board of trustees. The process and conclusions are documented in the meeting minutes.”

“The organization makes its bylaws, financial statements and conflict of interest policy available to the public upon request. The organization's financial statements are also attached to the annually filed form pc, a publicly disclosed tax-exempt organization filing for the state of massachusetts.”

“With the exception of reporting for visiting nurse association of cape cod, inc., cape cod healthcare, inc. Pays independent contractors on behalf of its affiliates who file as part of a group form 990 as cape cod healthcare, inc. And affiliates.”

“We will be the health service provider of choice for cape cod residents by achieving and maintaining the highest standards in health care delivery and service quality. To do so, we will partner with other health and human service providers as well as invest in needed medical technologies, human resources and clinical services. Above all, we will help identify and respond to the needs of our community. Community benefits mission statement cape cod healthcare, inc., (cchc) through its community benefits initiatives, is committed to enhancing the quality of and access to comprehensive health care services for all residents of cape cod. Through continuous assessment of community needs, coordinated planning and the allocation of resources, this commitment includes a special focus on the unmet needs of the financially disadvantaged and underserved populations. We will take a leadership role in collaborative efforts joining our resources, talent, and commitment with that of other providers, organizations and community members. The community benefits mission statement was affirmed by the cchc community health committee and the board of trustees in 2000 and remains in effect. Target populations 1. Name of target population: individuals managing or at risk of developing chronic and infectious diseases such as cancer, cardiovascular disease, alzheimer's disease and dementia, hepatitis c, diabetes and tick-borne diseases. Basis for selection: aligned with state and national health priorities, barnstable county residents managing chronic diseases are at the greatest risk of declined health and death. Cancer, cardiovascular disease, alzheimer's disease/dementia, hepatitis c, diabetes and tick-borne diseases were identified in the 2017-2019 cape cod hospital and falmouth hospital community health needs assessment report as diseases of concern for the region. 2. Name of target population: residents facing barriers to care due to language, cost, or age, including those who are uninsured or under-insured. Basis for selection: the 2017-2019 cape cod hospital and falmouth hospital community health needs assessment report identified specific target populations that encounter barriers to care or gaps in coverage despite high rates of insured residents in barnstable county. The report specifically identified children ages 0-17 years, individuals lacking year-round employment, seniors living on a fixed income, seasonal workers, and foreign-born residents who do not meet eligibility criteria for mass health enrollment. 3. Name of target population: individuals with mental health disorders, substance use disorders and co-occurring disorders. Basis for selection: access to, and availability of, community-based behavioral health care in barnstable county is an area of concern. This is evidenced by high rates of patients presenting with mental health and substance use disorders in hospital emergency departments. Specific challenges reported by the community and included in the 2017-2019 cape cod hospital and falmouth hospital community health needs assessment report include a shortage of psychiatric providers, wait times for outpatient appointments, limited inpatient treatment options for substance use, and insurance barriers to care. 4. Name of target population: senior population, ages 65 and older. Basis for selection: according to the u.s. Census bureau, american community survey five-year population estimates (2012-2016), nearly 28% of the yearround population in barnstable county is over the age of 65. Increasing consumption of and need for health care services, concerns of social isolation, availability of appropriate housing and transportation, and access to healthy and adequate food were specific challenges identified in the 2017-2019 cape cod hospital and falmouth hospital community health needs assessment report for residents over the age of 65. 5. Name of target population: youth and young adults, ages 15 to 24 years old. Basis for selection:”

“Prevention, screening, detection, and management of chronic and infectious diseases were supported through a variety of cchc community benefits activities. Hospital cancer support services including counseling, support groups, and survivorship activities for patients and caregivers were complimented with a new oncology nutrition program. The successful living fit for you! Cancer wellness program provides free of charge rehabilitation, wellness consultations, exercise, and education services to help adults undergoing cancer treatment manage fatigue, de-conditioning and loss of physical function. Cchc community benefits also provided grants to the cape wellness collaborative and ymca cape cod livestrong program to ensure that patients undergoing and recovering from cancer treatment had access to community-based wellness programs and complementary services such as massage, acupuncture, yoga and nutritional counseling. The cchc integrated cancer committee, comprised of physicians, nurses and support staff, conducted educational campaigns and community outreach events. These events informed youth about the risks of tobacco use and the public about skin cancer prevention, including high-risk screening opportunities. Cchc clinical teams provided disease education, rehabilitation and pathways to chronic disease self- management for individuals living with congestive heart failure, chronic pulmonary diseases, and diabetes. A community benefits grant to the cape cod times needy fund helped with basic needs such as housing and utility payments, transportation, adaptive medical equipment, and child care specifically for individuals managing a chronic disease. A cchc community benefits grant supported the alzheimer's family caregiver support center's expanding free counseling for families and caregivers in outposts across the outer, lower, mid, and upper regions of cape cod. In addition, the organization now hosts concurrent weekly support group meetings for individuals with alzheimer's disease and their caregivers at cape cod hospital. Through a partnership with the umass laboratory of medical zoology, cchc was the only healthcare system in ma to subsidize tick testing for residents within a hospital service area. Cchc also partnered with the cape cod cooperative extension to produce a 10-part online video series titled "tickology" to provide easily accessible community education on tick disease prevention. Cchc infectious disease clinical services is the recipient of federal and state ryan white grant funding to support comprehensive primary medical care and medical case management for individuals with hiv/aids living in barnstable county. Cchc, through partnerships with other local organizations, aligned local efforts to meet national hiv/aids strategy and the massachusetts integrated hiv prevention and care plan to reduce the number of new hiv infections, increase access to care, improve health outcomes for individuals living with hiv/aids, and reduce hiv-related health inequities and disparities. Behavioral health cchc community benefits expanded hospital-based services and collaborations with local federally qualified health centers and behavioral health providers to strengthen regional services and community resources for individuals with mental health and substance use disorders. Cchc's centers for behavioral health joined the ma department of public health and ma department of mental health on the zero suicide initiative to increase suicide prevention and reduce suicide deaths on cape cod. Cchc also provides a community crisis line, staffed by clinicians, offering free and confidential emotional support and referral assistance for individuals in crisis and their families. Cchc community benefits funded a community wide mental health education program through national alliance on mental illness (nami) cape cod, targeting the portuguese population. Cchc community benefits provided grants to three federally qualified health centers o”

“Community organizations to support the quality of life initiative. The initiative provided guest speakers, materials and helpful tools to educate the community about the importance of advance care planning. In addition, cchc community benefits joined a coalition of more than 30 organizations called healthy aging cape cod. Led by barnstable county department of human services, the purpose of the coalition is to undertake regional planning that supports our aging demographic and their families through conversations projects that align local efforts with statewide efforts to build an age and dementia-friendly massachusetts. Healthy parks, healthy people, a program supported through a collaboration between cape cod healthcare, the us national park service, and the cape cod national seashore, continued with its focus on promoting open space for physical activity and wellness. Activities included educational events by cchc physicians and physical therapists, a walking program, and a 5k walk/run for residents and visitors of cape cod. Cchc community benefits grants supported elder suicide prevention trainings through the samaritans of cape cod, hpv vaccination and cervical cancer education for providers, parents and youth by team maureen and chronic disease and mindfulness programs at local family homeless shelters by housing assistance corporation on cape cod. Plans for next reporting year in fy20, cchc community benefits will follow the chna 20-22 goals and strategic implementation plan the priority areas and goals are stated below: 1. Physical health conditions - reduce and prevent the occurrence and severity of chronic and infectious disease in barnstable county through collaborative approaches. 2. Behavioral health - be a leading partner in providing comprehensive regional health services and community resources for individuals with mental health conditions and substance use disorders. 3. Social determinants of health: transportation - work with regional transportation systems to increase access to health care and other health related services in barnstable county. Housing - work with regional partners to ensure that vulnerable populations show improved health indicators through access to stable and quality housing. Healthcare workforce development - work with regional partners to insure our community is served by a strong, adequate healthcare workforce. Food/nutrition - foster regional partnerships to develop a food security assessment process. Workplan elements intended to support achievement of these goals are as follows: 1) the community engagement focus is on involvement, collaboration and empowerment. Intentional modeling and use of common language and definitions, health indicators, smart measures, best practices and learning/knowledge sharing workshops and events will be incorporated in the community benefits processes. 2) the expansion of leadership team(s) and intersections will foster intersectionality of traditional and non-traditional stakeholders. The existing community health committee (cbac) team will include municipal government and public health agent for a town on cape cod. A new internal program committee will be developed to cross-pollinate thought and collective leadership from cchc middle management and the community health initiative counsel will be assembled to focus on social determinants of health and insure alignment and intersection with community health initiative as it relates to determination of need and community engagement. Community benefits programs annual strategic grants program: chronic and infectious disease and prevention program type: community-clinical linkages. Program is part of a grant or funding provided to an outside organization: yes program hashtags: community education, health screening, prevention, support group eohhs focus issue(s) (optional): chronic disease with focus on cancer, heart disease, and diabetes, housing stability/homelessness, mental illness and mental health, su”

“Program in the emergency departments at cape cod hospital and falmouth hospital program type: community-clinical linkages program is part of a grant or funding provided to an outside organization: yes program hashtags: community education, community health center partnership, health professional/staff training, prevention, support group eohhs focus issue(s) (optional): mental illness and mental health, substance use disorders. Don health priorities (optional): built environment, education, social environment. Health issues: social determinants of health-access to health care, social determinants of health-access to transportation, social determinants of health-education/learning, substance addiction-alcohol use, substance addiction-opioid use, substance addiction-substance use. Target population: regions served: county-barnstable - environments served: all - gender: all - race/ethnicity: all - language: all - additional target population status: domestic violence history, incarceration history, lgbt status, refugee/immigrant status, veteran status goal description engage and consult with at least 250 patients with substance use disorders treated in the emergency departments at cape cod hospital and falmouth hospital. Goal status exceeded goal goal description motivate and assist 40% of patients who receive a consultation from the recovery specialist to accept a transfer to treatment or direct referral to treatment prior to discharge from the emergency department. Goal status exceeded goal goal description offer post-discharge follow-up and assistance to patients with substance use disorders who refused services while in the emergency departments. Goal status underway along with extending service for inpatient goal description raise awareness: sud is part of mental health and mental health issues in our behavioral health programs. Goal status ongoing partner name, description and web address gosnold, inc. - www.gosnold.org barnstable county regional substance use council - www.bchumanservices.net/initiatives/regional-substance-use-council/ outer cape health services - www.outercape.org duffy health center - www.duffyhealthcenter.org community health center of cape cod - www.chcofcapecod.org harbor community health center- hyannis - www.hhsi.us/locations/harbor-community-health-center-hyannis/ contact information: mary pumphery cape cod healthcare 297 north street, building 3, 3rd floor hyannis, ma, 02601 phone: 774-470-5506 program description cape cod hospital and falmouth hospital partnered with gosnold, inc. To provide peer-led recovery specialist services in the emergency departments at both hospitals. Recovery specialists have the lived experience of addiction and recovery and engage patients with substance use disorders prior to discharge from the emergency departments. Recovery specialists work as part of the hospital care team with the objective to motivate patients to accept treatment for substance use disorders through a transfer to an inpatient treatment program or direct referrals to outpatient treatment programs. Specialty network for the uninsured and support to federally qualified health centers program type: community-clinical linkages. Program is part of a grant or funding provided to an outside organization: yes program hashtags: community education, community health center partnership, prevention. Eohhs focus issue(s) (optional): chronic disease with focus on cancer, heart disease, and diabetes, housing stability/homelessness, mental illness and mental health, substance use disorders. Don health priorities (optional): built environment, education, social environment. Health issues: other-dental health, other-senior health challenges/care coordination, social determinants of health-access to health care, social determinants of health-homelessness, social determinants of health-uninsured/underinsured, substance addiction-substance use. Target population: regions served: not specified - environments served: all”

“Hospital and falmouth hospital program type: total population or community-wide interventions. Program is part of a grant or funding provided to an outside organization: no program hashtags: community education, prevention. Eohhs focus issue(s) (optional): chronic disease with focus on cancer, heart disease, and diabetes. Don health priorities (optional): education, social environment. Health issues: chronic disease-diabetes, chronic disease-hypertension, chronic disease-osteoporosis, chronic disease-overweight and obesity, chronic disease-pulmonary disease, chronic disease-stroke, health behaviors/mental health-bereavement, health behaviors/mental health-stress management, maternal/child health-child care, maternal/child health-family planning, maternal/child health-menopause, maternal/child health-parenting skills, maternal/child health-reproductive and maternal health, other-senior health challenges/care coordination, social determinants of health-education/learning. Target population: regions served: county-barnstable - environments served: all gender: all age group: all race/ethnicity: all language: all - additional target population status: not specified goal description provide health education and support activities for the community on a continuum of issues including, but not limited to, chronic disease prevention, screening and self-management for conditions such as cancer, heart disease, and diabetes, breastfeeding and parenting, behavioral health, and cultural competency in care. Timeframe: year 3 of 3 goal status education and support activities are ongoing and sustaining and utilization is increasing. Partner name, description and web address american cancer society - www.cancer.org visiting nurses association of cape cod - www.vnacapecod.org ymca cape cod - www.ymcacapecod.org contact information: mary pumphery cape cod healthcare 297 north street, building 3, 3rd floor hyannis, ma, 02601 phone: 774-470-5506 program description at cape cod hospital and falmouth hospital, health education and outreach activities, classes, support groups and services to increase wellness are offered to the community across a few different health areas. From maternity department tours and new parenting classes, to community-based diabetes and stroke education, fall prevention classes, bereavement support groups and advance care planning presentations, the hospitals dedicate clinical staff and resources to support the wellness of barnstable county residents. Community-based interpreter services program type: community-clinical linkages. Program is part of a grant or funding provided to an outside organization: yes program hashtags: prevention. Eohhs focus issue(s) (optional): chronic disease with focus on cancer, heart disease, and diabetes, housing stability/homelessness, mental illness and mental health, substance use disorders,. Don health priorities (optional): built environment, social environment. Health issues: cancer-breast, cancer-cervical, cancer-colorectal, cancer-lung, cancer-multiple myeloma, cancer-other, cancer-ovarian, cancer-prostate, cancer-skin, chronic disease-alzheimer's disease, chronic disease-arthritis, chronic disease-asthma/allergies, chronic disease-cardiac disease, chronic disease-chronic pain, chronic disease-colitis/crohn's disease, chronic disease-diabetes, chronic disease-hypertension, chronic disease-osteoporosis, chronic disease-overweight and obesity, chronic disease-pulmonary disease, chronic disease-sickle cell disease, chronic disease-stroke, health behaviors/mental health-bereavement, health behaviors/mental health-depression, health behaviors/mental health-immunization, health behaviors/mental health-mental health, health behaviors/mental health-physical activity, health behaviors/mental health-responsible sexual behavior, health behaviors/mental health-stress management, infectious disease-hepatitis, infectious disease-hiv/aids, infectious disease-lyme disease, infectious disease-sexually tra”

“Cape cod hospital and falmouth hospital program type: community-clinical linkages. Program is part of a grant or funding provided to an outside organization: no program hashtags: not specified. Eohhs focus issue(s) (optional): chronic disease with focus on cancer, heart disease, and diabetes. Don health priorities (optional): built environment. Health issues: social determinants of health-access to health care. Target population: regions served: county-barnstable - environments served: all gender: all age group: all race/ethnicity: all language: all - additional target population status: disability status. Goal description assist residents who are unable to afford medications to ensure compliance with hospital discharge planning. Goal status ongoing assistance occurs through pharmacies at cape cod hospital and falmouth hospital. Partner name, description and web address cape cod hospital - www.capecodhealth.org falmouth hospital - www.capecodhealth.org contact information: mary pumphery cape cod healthcare 297 north street, building 3, 3rd floor hyannis, ma, 02601 phone: 774-470-5506 program description the prescription assistance program is an initiative of cape cod hospital and falmouth hospital emergency, behavioral health and pharmacy departments as a community benefit assisting uninsured, under-insured and financially disadvantaged patients with no other viable means to pay for medications upon discharge from hospital facilities. Barnstable county tick disease testing and education project program type: total population or community-wide interventions. Program is part of a grant or funding provided to an outside organization: yes program hashtags: community education, health screening, prevention. Eohhs focus issue(s) (optional): n/a. Don health priorities (optional): built environment, education. Health issues: infectious disease-lyme disease. Target population: regions served: county-barnstable - environments served: all gender: all age group: all race/ethnicity: all language: all - additional target population status: not specified. Goal description provide up to 1,500 subsidized tick tests for barnstable county residents. Testing to include: identification of tick species and life stage, high resolution micrographs of tick, assessment of feeding status, and secure private delivery of pathogen testing results. Timeframe: year 3 of 3. Goal status actual tick tests 1,112. Goal description provide county-wide surveillance data for use by medical providers and public health officials. The detection of one or more pathogens in ticks will be reported. Timeframe: year 3 of 3. Goal status provided. Goal description the cape cod extension will develop, produce and release an online series of tick disease education and prevention videos for the public featuring a local epidemiologist. The online videos will be promoted across the county via public locations including schools, libraries, councils on aging and other civic gathering locations. Timeframe: year 3 of 3. Goal status outreach education completed as described. Partner name, description and web address cape cod cooperative extension - www.capecodextension.org umass laboratory of medical zoology - www.tickdiseases.org contact information: mary pumphery cape cod healthcare 297 north street, building 3, 3rd floor hyannis, ma, 02601 phone: 774-470-5506 program description cchc community benefits provided grant funding to subsidize a tick-borne pathogen testing program and expanded tick-borne disease prevention education for residents of barnstable county. Tick-testing and reporting was conducted by the umass laboratory of medical zoology. The cape cod cooperative extension developed, produced and released to the public a 10-part online video series titled "tickology" providing easily accessible community education on tick disease prevention by local epidemiologists. Transportation assistance program for vulnerable populations: cape cod hospital and falmouth hospital (sdoh) pr”

“Cape cod healthcare (sdoh) program type: infrastructure to support cb collaboration. Program is part of a grant or funding provided to an outside organization: yes program hashtags: community education, health professional/staff training, mentorship/career training/internship eohhs focus issue(s) (optional): chronic disease with focus on cancer, heart disease, and diabetes, housing stability/homelessness, mental illness and mental health, substance use disorders. Don health priorities (optional): built environment, education, employment, social environment. Health issues: social determinants of health-education/learning. Target population: regions served: county-barnstable - environments served: all gender: all age group: all race/ethnicity: all language: all - additional target population status: disability status, lgbt status, refugee/immigrant status, veteran status. Goal description cchc staff in various departments will provide clinical oversight and supervision to students engaged in allied health programs and various job-training initiatives in the region. Timeframe: year 2 of 3. Goal status workforce shortage has limited expansion of student supervision. Partner name, description and web address barnstable high school - www.barnstable.k12.ma.us cape cod community college - www.capecod.edu/ cape cod regional technical high school - www.capetech.us ma college of pharmacy and health sciences - www.mcphs.edu the riverview school - www.riverviewschool.org university of massachusetts - www.massachusetts.edu/ upper cape regional technical school - www.uppercapetech.com/ contact information: mary pumphery cape cod healthcare 297 north street, building 3, 3rd floor hyannis, ma, 02601 phone: 774-470-5506 program description - cchc invests in partnerships with local high schools, vocational schools, community colleges, and allied health programs for job training and shadowing and internships with health care providers in various hospital departments including, but not limited to, phlebotomy, radiology, behavioral health, and materials management. Our efforts contributed to regional economic development efforts to increase opportunity for educational attainment and provide experience for individuals to obtain stable, quality, and well-compensated jobs in our region. Food: fish for families (sdoh) program type: total population or community-wide interventions. Program is part of a grant or funding provided to an outside organization: yes program hashtags: community education, health screening, prevention. Eohhs focus issue(s) (optional): chronic disease with focus on cancer, heart disease, and diabetes. Don health priorities (optional): built environment, education, social environment. Health issues: social determinants of health-access to healthy food, social determinants of health-income and poverty, social determinants of health-nutrition. Target population: regions served: barnstable, bourne, brewster, chatham, dennis, eastham, falmouth, harwich, mashpee, orleans, provincetown, sandwich, truro, wellfleet, yarmouth, environments served: all gender: all - age group: all, elderly - race/ethnicity: all language: all, portuguese, spanish - additional target population status: disability status, domestic violence history, incarceration history, lgbt status, refugee/immigrant status, veteran status. Goal description expand the fish for families offerings through four distributions with the cape cod hunger network and the family, pantry of cape cod. Target is four distribution sites. Timeframe: year 1 of 1. Goal status achieved. Goal description provide at least 8000 pounds of seafood at no cost to elderly and economically challenged cape cod residents. Timeframe: year 1 of 1. Goal status exceeded. Actual: 8720 pounds. Goal description create connections between fishing community and hunger network community; increasing support for local seafood. Timeframe: year 1 of 1. Goal status achieved. Partner name, description and web address ca”

“Form 990 part i and part ix fundraising is conducted on behalf of cape cod healthcare, inc. By cape cod healthcare foundation, inc. Certain officers are compensated by cape cod heathcare, inc. Funds raised are reported at cape cod healthcare, inc. And affiliates.”

“Cape cod healthcare, inc.'s volunteers include its trustees.”

“Other changes in net assets or fund balances net assets released from restriction $(2,773,340) transfer to/from affiliates $(3,638,275) change in value of split interest agreement $(79,315) change in value beneficial interest $(399,866) ------------- other changes in net assets $(6,890,796) =============”