Grossmont Hospital Foundation

“Grossmont hospital corporation (fein 33-0449527) has the right to elect directors to grossmont hospital foundation's governing body.”

“Grossmont hospital corporation (fein 33-0449527) approves changes to grossmont hospital foundation's bylaws and approves the election of grossmont hospital foundation board members.”

“The final form 990 is placed on the organization's intranet, prior to the filing date, where it is viewable for comment from all members of the governing body. The review process includes multiple levels of review including key corporate and entity finance department personnel comprised of the director of tax & accounting, vice president of finance, senior vice president and chief financial officer, and entity executive director. Additionally, the organization contracts with ernst & young, an independent accounting firm, for review of the form 990.”

“Grossmont hospital foundation has a written conflict of interest policy which has been reviewed and approved by the grossmont hospital foundation governing board. Grossmont hospital foundation is committed to preventing any participant of the corporation from gaining any personal benefit from information received or from any transaction of sharp. One component of the written conflict of interest policy requires that board members, corporate officers, senior vice presidents and chief executive officer(s) submit a conflict of interest statement annually to legal services/senior vice president of legal services who will review all statements. In addition, all vice presidents and any employees in the purchasing/supply chain, audit and compliance, and case management/discharge planning departments are required to complete an online conflict of interest questionnaire annually that is reviewed by the conflict review committee comprised of employees from sharp's legal, compliance, and internal audit departments. In connection with any transaction or arrangement, which may create an actual or possible conflict of interest, the person shall disclose in writing the existence and nature of his/her financial interest and all material facts. Board members, corporate officers, senior vice presidents, and the chief executive officer(s) shall make such disclosures directly to the chairman of the board, and to the members of the committee with the board designated powers considering the proposed transaction or arrangement. Upon disclosure of the financial interest and all material facts, the board member, corporate officer, senior vice president or the chief executive officer(s) making such disclosures shall leave the board or the committee meeting while the financial interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. In certain instances, such as if someone takes a board seat on a competitor's board of directors or has a role with an organization whereby the information that they may obtain from sharp would put them in a consistent conflict with their two roles, the conflict could call for the individual's removal from the board. The bylaws for the organization provide for the ability to remove directors in accordance with section 5222 of the california corporations code. This can generally be done on a "for cause or a "no cause" basis by the action of the member.”

“The personnel committee of sharp healthcare retains an independent compensation consulting firm to review the total compensation paid to executive management (ceo/president, executive vice president of hospital operations, and senior vice presidents) and compares it to the total compensation paid to similar positions with like institutions. The information is presented to the personnel committee of the board of directors by the independent consultant. The personnel committee is comprised of board members who are not physicians and who are not compensated in any way by the organization. The personnel committee approves the total compensation for the president/chief executive officer and reviews and approves the compensation and compensation salary ranges for the remainder of the executive team. The personnel committee presents its decision to the board of directors. The personnel committee retains minutes of its meetings. The compensation and benefits department engages a third party independent consultant to conduct a compensation study covering officers and key employees. The independent third party compares base salaries to similar positions with like institutions. The information is reviewed by the compensation and benefits department and is presented to the president/chief executive officer, the executive vice president of hospital operations and the appropriate senior vice president for review and approval. The compensation study was last conducted in november/december 2015.”

“Policies are considered proprietary information, however in sharp healthcare's publicly available code of conduct, sharp outlines its conflict of interest policies in a user friendly manner. The annual audited financial statements of the consolidated group are published on the dacbond.com website (www.dacbond.com), are attached to the form 990 filed for each of the sharp hospitals, and are available upon request. The annual audited financial statements include combining schedules which disclose the financial results (balance sheet, statement of operations, statement of changes in net assets) for each entity of the consolidated group. Quarterly financial statements of sharp's obligated group are published on the dacbond.com website (www.dacbond.com).”

“The purpose of this corporation is to provide assistance and support to grossmont hospital corporation in the development of high quality, accessible and affordable inpatient and outpatient services.”

“Grossmont hospital foundation employees' salaries and wages are paid under grossmont hospital corporation's tax id number (ein 33-0449527), and as such are also reported on grossmont hospital corporation's form 990.”

“Uncollectible pledges/return of contribution -8,768.”

“Form 5471 has been filed on behalf of grossmont hospital foundation by sharp healthcare (fein 95-6077327).”

“Sharp healthcare community benefit plan and report fiscal year 2016 section 1 an overview of sharp healthcare sharp team members - both current and those who have come before us - have been making a difference in san diegans' lives for more than 60 years. We have been entrusted with a great responsibility to build on this legacy, and we are honored to do all we can to make sharp the very best it can be. I'm proud that we are always striving to make our patients, their families and our community our highest priorities. - michael w. Murphy, president and chief executive officer, sharp healthcare sharp healthcare (sharp or shc) is an integrated, regional health care delivery system based in san diego, calif. The sharp system includes four acute care hospitals; three specialty hospitals; three affiliated medical groups; 22 medical centers; five urgent care centers; three skilled nursing facilities; two inpatient rehabilitation centers; home health, hospice, and home infusion programs; numerous outpatient facilities and programs; and a variety of other community health education programs and related services. Sharp offers a full continuum of care, including emergency care, home care, hospice care, inpatient care, long-term care, mental health care, outpatient care, primary and specialty care, rehabilitation and urgent care. Sharp also has a knox-keene-licensed care service plan, sharp health plan (shp). Serving a population of approximately 3.2 million in san diego county (sdc), as of september 30, 2016, sharp is licensed to operate 2,084 beds and has more than 2,900 sharp-affiliated physicians and 18,000 employees. Four acute care hospitals: sharp chula vista medical center (343 licensed beds) the largest provider of health care services in sdc's rapidly expanding south bay, sharp chula vista medical center (scvmc) operates the south bay's busiest emergency department (ed) and is the closest hospital to the busiest international border in the world. Scvmc is home to the region's most comprehensive heart program, services for orthopedic care, cancer treatment, women's and infant's services, and the only bloodless medicine and surgery center in sdc. Sharp coronado hospital and healthcare center (181 licensed beds) sharp coronado hospital and healthcare center (schhc) provides services that include acute, sub-acute and long-term care, rehabilitation therapies, joint replacement surgery, and hospice and emergency services. Sharp grossmont hospital (524 licensed beds) sharp grossmont hospital (sgh) is the largest provider of health care services in san diego's east county and has one of the busiest eds in sdc. Sgh is known for outstanding programs in heart care, oncology, orthopedics, rehabilitation, stroke care and women's health. Sharp memorial hospital (656 licensed beds) a regional tertiary care leader, sharp memorial hospital (smh) provides specialized care in trauma, oncology, orthopedics, organ transplantation, cardiology and rehabilitation. Three specialty care hospitals: sharp mary birch hospital for women & newborns (206 licensed beds) a freestanding women's hospital specializing in obstetrics, gynecology, gynecologic oncology and neonatal intensive care, sharp mary birch hospital for women & newborns (smbhwn) delivers more babies than any other hospital in california. Sharp mesa vista hospital (158 licensed beds) as the largest privately operated psychiatric hospital in san diego, sharp mesa vista hospital (smv) is a premier provider of behavioral health services. Sharp mcdonald center (16 licensed beds) sharp mcdonald center (smc) is the only medically supervised substance abuse recovery center in sdc. Offering the most comprehensive hospital-based treatment program in san diego, smc provides services such as addiction treatment, medically supervised detoxification and rehabilitation, day treatment, outpatient and inpatient programs, and aftercare. Collectively, the operations of smh, smbhwn, smv and smc are reported under”

“Pillars of excellence in support of sharp's organizational commitment to transform the health care experience, sharp's pillars of excellence serve as a guide for its team members, providing framework and alignment for everything sharp does. In 2014, sharp healthcare made an important decision regarding these pillars as part of its continued journey toward excellence. Each year, sharp incorporates cycles of learning into its strategic planning process. In 2014, sharp's executive steering and board of directors enhanced sharp's safety focus, further driving the organization's emphasis on its culture of safety and incorporating the commitment to become a high reliability organization (hro) in all aspects of the organization. At the core of hros are five key concepts: o sensitivity to operations o a reluctance to simplify o preoccupation with failure o deference to expertise o resilience applying high-reliability concepts in an organization begins when leaders at all levels start thinking about how the care they provide could become better. It begins with a culture of safety. With this learning, sharp is a seven-pillar organization - quality, safety, service, people, finance, growth and community. The foundational elements of sharp's strategic plan have been enhanced to emphasize sharp's desire to do no harm. This strategic plan continues sharp's transformation of the health care experience, focusing on safe, high-quality and efficient care provided in a caring, convenient, cost-effective and accessible manner. The seven pillars listed below are a visible testament to sharp's commitment to become the best health care system in the universe by achieving excellence in these areas: quality: demonstrate and improve clinical excellence to set industry standards and exceed customer expectations. Safety: keep patients, employees and physicians safe and free from harm. Service: create exceptional experiences at every touch point for customers, physicians and partners by demonstrating service excellence. People: create a values-driven culture that attracts, retains and promotes the best and brightest people, who are committed to sharp's mission and vision. Finance: achieve financial results to ensure sharp's ability to provide quality health care services, new technology and investment in the organization. Growth: achieve consistent net revenue growth to enhance market dominance, sustain infrastructure improvements and support innovative development. Community: be an exemplary community citizen by improving the health and well-being of the community and supporting the stewardship of our environment. Awards below please find a selection of recognitions sharp has received in recent years: in 2013, 2014, and 2016 sharp was recognized as one of the world's most ethical (wme) companies by the ethisphere institute, the leading business ethics think tank. Wme companies are those that truly embrace ethical business practices and demonstrate industry leadership, forcing peers to follow suit or fall behind. Sharp was ranked no. 16 out of 500 large employers on forbes america's best employers 2016 list. Sharp was also given the no. 2 spot on the newcomer's list. Sharp was named "best hospital group" by u-t san diego readers participating in the paper's 2015 "best of san diego" readers poll. In 2016, sharp ranked second in the same category, while smh ranked second for "best hospital and smbhwn and sgh ranked third and fourth. Also in 2016, sharp community medical group (scmg) and srs ranked first and third, respectively, as san diego's "best medical group". In 2016, smh and smbhwn were named on the leapfrog group's top 115 hospitals list recognizing facilities that meet the highest standards of patient safety, care quality and efficiency. Sgh and smh have both received magnet(r) designation for nursing excellence by the american nurses credentialing center (ancc). The magnet recognition program is the highest level of honor bestowed by the ancc and i”

“Shp was ranked a top 100 u.s. Health plan and a top three california health plan based on the national committee for quality assurance's (ncqa) private health insurance rankings 2014-2015, which rated health insurance plans based on clinical quality, member satisfaction and ncqa accreditation survey results. Shp also received the highest level "excellent" accreditation status from the ncqa for the third year in a row (2013-2015). The ncqa awards accreditation status based on compliance with rigorous requirements and performance on healthcare effectiveness data and information set and consumer assessment of healthcare providers and systems (cahps) measures. Shp was also rated highest in california among reporting california health plans for rating of the health plan, rating of health care, rating of personal doctor, and rating of health promotion and education in ncqa's 2015 quality compass/cahps survey, which provides state, regional and national benchmarks as well as individual plan performance. From 2013 to 2016, sharp has ranked in the top 10 of the large employers category as one of the "best places to work" for information technology professionals by the international data group's (idg) computerworld survey. The list is compiled using the following criteria: benefits, training, retention, career development, average salary increases, employee surveys, workplace morale and more. Sgh received a women's choice award(r) as one of america's best hospitals for cancer care in 2015, and one of america's best hospitals for obstetrics in 2016. In 2015, smbhwn received the award as one of america's best hospitals for obstetrics. The women's choice award(r) is a symbol of excellence in customer experience awarded by the collective voice of women. For the third year in a row, and the fourth time in five years, sharp won the top spot in the mega employer category in the san diego association of government's (sandag's) icommute rideshare 2015 challenge. The month-long challenge encouraged the replacement of solo drivers with sustainable carpool, vanpool, bike, walk, or transit commutes. Powered by sandag and in cooperation with the 511 transportation information service, icommute is the transportation demand management program for the san diego region and encourages use of transportation alternatives to help reduce traffic congestion and greenhouse gas emissions. Sharp was named the 2015 medical provider of the year at the international travel & health insurance journal (itij) awards. The itij honors companies that have made an outstanding contribution to the global travel and health insurance industry over the past year. Sharp's global patient services program coordinates patient transfers and evacuations for medical emergencies from around the world to a sharp hospital. Patient access to care programs uninsured patients without the ability to pay and insured patients with inadequate coverage receive financial assistance for medically necessary services through sharp's financial assistance program. Sharp does not refuse any patient requiring emergency medical care. Sharp provides services to help every unfunded patient receiving care in the ed find opportunities for health coverage through pointcare - a team of health coverage experts whose main product is a quick, web-based screening, enrollment and reporting technology designed to provide community members with health coverage and financial assistance options. At sharp, patients use a simple online questionnaire through pointcare to generate personalized coverage options that are filed in their account for future reference and accessibility. The results of the questionnaire allow sharp staff to have an informed and supportive discussion with the patient about health care coverage, and empower them with options. In fy 2016, sharp helped guide approximately 12,300 self-pay patients through the maze of government health coverage programs while ensuring that each patient's dignity was ma”

“In a targeted effort to provide exceptional care for vulnerable populations, since 2013, sharp has participated in the community-based care transitions program (cctp) for medicare fee for service patients. The program began with the san diego care transitions partnership (sdctp) under the health and human services agency, aging & independence services (ais), and included scripps health, palomar health, and university of california san diego (ucsd) health system (11 hospitals with a total of 13 campuses). The program was grant-funded for three years by the centers for medicare and medicaid services to provide comprehensive patient-centered, hospital and community-based services. The goals of cctp included: * improve transition from the inpatient hospital setting to community * improve quality of care * reduce readmissions for high risk beneficiaries * document measurable savings to the medicare program cctp improves transition from hospital to home by providing patients with tools and support that promote knowledge and self-management of their condition. Sharp's transition coaches functioned as facilitators, coaching patients and their caregivers in order to encourage self-management and direct communication between patients, caregivers and providers. The program extended for 30 days per patient and included a hospital visit, a home visit and follow-up phone calls. The cctp program concluded in fy 2016 with the ending of the program's grant funding, and more than 40,000 patients were served collectively through the program. In addition, sharp provides post-acute care facilitation for high-risk patients, including the homeless and patients lacking a safe home environment. Patients may receive services such as assistance with transportation and placement; connections to community resources; and financial support for medical equipment and medications. Schhc, sgh and smh work with the san diego rescue mission (sdrm) to identify homeless patients, or patients who have exhausted other community housing resources, who have a continuing medical need after hospital discharge. Once referred to the sdrm's recuperative care unit, patients receive follow-up medical care through sharp in a safe environment, and may also receive psychiatric care, help scheduling specialty appointments, assistance with calfresh applications, and connections to community resources including programs that support continued sobriety and residential treatment. In addition, a social worker provides referrals for permanent housing and collaborates with st. Vincent de paul village to assist with the ssi application process through hope (homeless outreach programs for entitlement) san diego - an effort to increase access to ssi for people who are homeless or at risk of homelessness. Sharp is committed to providing free of charge medical records to support an ssi claim. Health professions training internships students and recent health care graduates are a valuable asset to the community. Sharp demonstrates a deep investment in these potential and newest members of the health care workforce through internships, financial aid and career pipeline programs. In fy 2016, more than 4,300 student interns dedicated nearly 638,000 hours within the sharp system. Students belonged to a variety of disciplines including nursing, allied health and professional educational programs. Sharp provided education and training programs for nursing students (e.g., critical care, medical/surgical, behavioral health, women's services, cardiac services and hospice) and allied health professions such as rehabilitation therapies (speech, physical and occupational therapy), pharmacy, respiratory therapy, imaging, cardiovascular, dietetics, lab, radiation therapy, surgical technology, paramedic, social work, psychology, business, health information management and public health. Students came from local community colleges such as grossmont college, san diego city college, san diego mesa college (mes”

“In fy 2016, approximately 450 hshmc students - including 280 level i students and 150 level ii students - were supervised for approximately 57,600 hours on sharp campuses. Students rotated through instructional pods in specialty areas, including but not limited to: nursing; emergency services; obstetrics and gynecology (ob/gyn); occupational therapy; physical therapy; behavioral health; pediatrics; medical/surgical; rehabilitation; laboratory services; pharmacy; pathology; radiation oncology; radiology; endoscopy; engineering; nutrition; infection control; pulmonary services; and operations. Students not only had the opportunity to observe patient care, but also received guidance from sharp staff on career ladder development as well as job and education requirements. In may 2016, the hshmc program graduated 153 students in its sixth full class. Each year, sharp reviews and evaluates its collaboration with hshmc, including outcomes of students and graduates, to promote long-term sustainability. Although many hshmc students face financial hardship - the free and reduced-price meal eligibility rate is higher than the averages for sdc and california - the charter school excels in preparing students for high school graduation, college entrance and a future career. In 2016, 90 percent of the hshmc graduating class went on to attend two- or four-year colleges, while 88 percent of students said they wanted to pursue careers in health care. In addition, hshmc has a 100 percent graduation rate, which is higher than california's 82.3 percent state average. Hshmc received the 2016 impact award from the classroom for the future foundation as the most innovative education program in sdc. Each year, classroom for the future foundation awards education programs across sdc in four categories: innovate, inspire, achieve and impact. Hshmc is also a 2016 u.s. News & world report best high schools bronze award winner. The california department of education recognized hshmc as a 2015 california gold ribbon school for its outstanding education programs and practices, and as a title i academic achieving school for demonstrating success in significantly reducing the gap between high- and low-performing students. Hshmc was also recognized with a 2015 model professional learning community at work(tm) award by solution tree for its sustained success in raising student achievement. Professional learning communities are schools and districts in which educators recognize the key to improved learning for students is on-going, job-embedded learning for the adults who serve those students. Hshmc was one in approximately 200 schools and districts in the u.s. And canada, and the first school in sdc, to receive this honor. In addition, hshmc is a 2014 national school safety advocacy council award winner. Lectures and continuing education sharp contributes to the academic environment of colleges and universities throughout san diego. In fy 2016, sharp staff provided hundreds of academic hours in lectures, courses and presentations on numerous college and university campuses. This included guest lectures on health information technology at ucsd and mesa college; advanced health policy at ucsd; diabetes, health literacy and spiritual care in the health care setting at sdsu; advance care planning, physician orders for life-sustaining treatment (polst), hospice, bioethics and goals of care at azusa pacific university (apu), sdsu, california state university san marcos (csusm), university of southern california (usc) and mesa college; spinal cord injury (sci) to physical therapy students at the university of st. Augustine in san marcos; grief, loss and bereavement to psychiatric nursing students from csusm; and a variety of health administration lectures to public health graduate students at sdsu. Sharp's continuing medical education (cme) department is accredited by the accreditation council for continuing medical education to provide continuing medical education, as”

“Beginning in september 2016, the ori expanded its capabilities by adding a full-time post-doctoral clinical psychology fellowship position and a half-time practicum placement for a predoctoral graduate student. Evidence-based practice institute sharp participates in the evidence-based practice institute (ebpi), which prepares teams of staff fellows and mentors to change and improve clinical practice and patient care. This evolution in practice and care occurs through identifying a care problem, developing a plan to solve it and then incorporating this new knowledge into practice. The ebpi is part of the consortium for nursing excellence, san diego, which promotes evidence-based practice in the nursing community. The consortium is a partnership between sharp, scripps health, palomar health, rady children's hospital - san diego, uc san diego health, va san diego healthcare system (vasdhs), elizabeth hospice, plnu, sdsu, apu and usd. Sharp actively supports the ebpi by providing instructors and mentors as well as administrative coordination. The ebpi includes six full-day class sessions featuring group activities, self-directed learning programs outside of the classroom and structured mentorship throughout the program. The ebpi fellows partner with their mentors and participate in a variety of learning strategies. Mentors facilitate the process of conducting an evidence-based practice change and navigating the hospital system to support the fellows through the process of evidence-based practice. Mentors also assist the fellows in working collaboratively with other key hospital leadership personnel. The nine-month program culminated with a community conference and graduation ceremony in november, at which the project results of all ebpi fellows were shared. Thirty fellows graduated from the ebpi program in fy 2016, completing projects that address the following issues in clinical practice and patient care: creating an acute care-friendly environment for altered mental status and high-risk fall patients; the effects of aromatherapy on anxiety in pediatric post-operative patients; implementing a health literacy protocol; debriefing after resuscitation; and bedside pressure mapping for ulcer prevention. Volunteer service sharp lends a hand in fy 2016, sharp continued its systemwide community service program, sharp lends a hand (slah). Sharp team members suggested project ideas that would improve the health and well-being of san diego in a broad, positive way; rely solely on sharp for volunteer labor; and support existing nonprofit initiatives, community activities or other programs that serve sdc. Seventeen projects were selected for fy 2016: san diego blood bank, san diego food bank (food bank), the american diabetes association (ada) tour de cure, the ada step out walk to stop diabetes, the ssubi foundation greening for good project, special olympics, habitat for humanity, feeding san diego (fsd), san diego half marathon, stand down for homeless veterans, life rolls on - they will surf again, i love a clean san diego's coastal cleanup and creek to bay cleanup, and the san diego river park foundation's point loma native plant garden, san diego river garden, coastal habitat restoration and river kids discovery days. More than 2,000 sharp employees, family members and friends volunteered over 6,570 hours in support of these projects. With more than 100,000 walkers across 95 cities nationwide, the ada step out walk to stop diabetes is the signature fundraising walk of the ada. In october 2015, nearly 50 slah volunteers joined the walk in point loma to assist with volunteer check-in, walker registration, t-shirt distribution and the refreshment booth. By volunteering their time, slah participants helped to ensure that more funds go toward the ada's mission to prevent, cure and improve the lives of all people affected by diabetes. Slah volunteers participated in the ada tour de cure 2016 to support the more than 2.4 million san diegans w”

“Slah participated in stand down for homeless veterans, an event sponsored by the veterans village of san diego, to provide community-based social services to veterans without a permanent residence. On seven days in june, approximately 150 volunteers sorted and organized clothing donations and set up the event's clothing tent. During the two-day event in july, which served more than 900 veterans, 120 slah volunteers worked in the clothing tent to find suitable clothes for the homeless veterans. In addition, approximately 70 clinical volunteers - including sharp nurses, doctors, pharmacists and licensed pharmacy technicians - provided medical and pharmaceutical services. The life rolls on foundation is dedicated to improving the quality of life for young people affected by sci. Through the organization's award-winning program, they will surf again, paraplegics and quadriplegics can experience mobility through surfing with support from adaptive equipment and volunteers. In september, an estimated 70 slah volunteers assisted they will surf again with event set-up and breakdown, registration, equipment distribution, lunch service and helping surfers on land and in shallow water. Fsd, part of the feeding america network, is committed to leading the community in the fight against hunger by efficiently providing access to food and nutritious meals. Fsd relies on the generous support of individuals, corporations, foundations and community groups to sustain critical hunger-relief and nutrition programs throughout the region. Every week, the organization feeds more than 63,000 children, families and seniors in need. On seven days in 2016, approximately 340 slah volunteers contributed their time to bag, box and distribute food for fsd. Founded in 2001, the san diego river park foundation is a grassroots nonprofit organization that works to protect the greenbelt from the mountains to the ocean along the 52-mile san diego river. Approximately 60 slah volunteers joined the san diego river park foundation to care for california native plants and trees at the san diego river garden in mission valley in november and the point loma native plant garden in december. Activities included trail maintenance, watering, pruning and other light gardening projects. In january, 30 slah volunteers joined the foundation once again for the coastal habitat restoration event in ocean beach. The team worked to save and restore one of the last remaining coastal dune and wetland habitats in san diego by removing invasive plants and litter, watering and caring for recent plantings and native plants, and providing trail maintenance. In march, more than 40 volunteers participated in the san diego river park foundation's second annual river kids discovery days. This free event provided river education and service events to teach more than 1,000 kids and families about protecting the earth's natural resources. Sharp humanitarian service program in fy 2016, the sharp humanitarian service program funded more than 50 sharp employees in programs that provided health care or other supportive services to underserved or adversely affected populations in haiti, jamaica, mexico, paraguay, peru and other countries throughout the world. A sharp pharmacist participated in two medical missions through the peruvian american medical society (pams), an organization dedicated to providing medical and educational missions throughout peru. During a two-week trip to the city of iquitos through pams' selva in action project, pams specifically provided assistance to villagers living along the rio momon in the amazon jungle. Each day, the mission team served approximately 75 patients in desperate need of medical attention. In addition, in june, the team traveled to the city of tambo in ayacucho, peru, where they provided medical examinations and medications for approximately 75 to 100 villagers daily for one week. Project compassion is a san diego-based medical mission organization that atte”

“Sharp volunteers spend their time within hospitals and out in the community as well as in support of the foundations. On average, more than 1,830 individuals actively volunteered at sharp each month in fy 2016, contributing a total of approximately 273,000 hours of service to sharp and its initiatives throughout the year. This included more than 1,900 auxiliary members and thousands of individual volunteers from the san diego community, including volunteers for sharp's various foundations. More than 17,400 volunteer hours were dedicated to activities such as delivering meals to homebound seniors and assisting with health fairs and events. Table 2 details the average number of active volunteers per month as well as the total number of volunteer service hours provided to each sharp entity, specifically for patient and community support. Table 2: sharp volunteers and volunteer hours - fy 2016 average active volunteers per month: sharp chula vista medical center 374 sharp coronado hospital and healthcare center 70 sharp grossmont hospital 647 sharp hospicecare 76 sharp metropolitan medical campus 632 total 1,799 total volunteer hours: sharp chula vista medical center 51,877 sharp coronado hospital and healthcare center 9,224 sharp grossmont hospital 111,289 sharp hospicecare 11,183 sharp metropolitan medical campus 81,426 total 264,999 in support of sharp's foundations - including the sharp healthcare foundation, grossmont hospital foundation and coronado hospital foundation - volunteers supported various events, such as annual golf tournaments and galas. In addition, sharp offers a systemwide junior volunteer program for high school students interested in giving back to their communities and exploring future health care careers. Program requirements vary, however all require high grade point averages and long-term commitments of at least 100 hours. Junior volunteers serve in a wide range of roles throughout sharp. They enhance patient-centered care through hospitality, such as greeting and escorting patients and families, answering questions, and creating a welcoming and relaxing environment for guests. Through volunteering in the gift shops and thrift store, they learn about merchandising, fundraising and retail sales. On the inpatient units, they are exposed to clinical experiences that provide a glimpse into future careers. In fy 2016, more than 515 high school students contributed a total of 57,770 hours to the junior volunteer program. This included 62 junior volunteers who provided more than 5,860 hours of service at smh and smbhwn; 169 junior volunteers who dedicated nearly 18,000 hours of service at scvmc; and 285 junior volunteers who contributed nearly 34,000 hours of service at sgh. Volunteers on sharp's various entity boards provide program oversight, administration and decision-making regarding financial resources. In fy 2016, nearly 120 volunteers contributed their time to sharp's boards. Sharp employees also donate time as volunteers for the sharp organization, including service on the cabrillo credit union sharp division board, the sharp and children's mri board, the grossmont imaging llc board, and the sharp and uc san diego health's joint venture board, which oversees the operations of their joint liver transplantation and bone marrow transplant programs. This section describes the achievements of various sharp volunteer programs in fy 2016. Sharp hospicecare volunteer programs sharp hospicecare provided various volunteer training opportunities in fy 2016. Hospice volunteers are often working towards a career in the medical field and gain valuable knowledge and experience through volunteering. Volunteers dedicate their time to the hospice organization and those they serve, including companionship to those near the end of life, support for families and caregivers, and help with community outreach. Approximately 80 new hospice volunteers were trained in fy 2016. Volunteers completed an extensive 32-hour training p”

“Since february 2010, the cushman wellness center community health library and the smh volunteer department have offered the health information ambassador program to bring the library's services directly to patients and their families, and empower them to become involved in their health care. The health information ambassadors are hospital volunteers who receive specialized training through the community health library. Once trained, the volunteers ask patients at smh, the smh rehabilitation center and the perinatal special care unit at smbhwn, if they or their family members would like to receive additional resources on their diagnosis. Information requests are brought to the consumer health librarian who then prints consumer-oriented information from quality websites, and returns the information to the patients through the health information ambassadors. Patients or family members who have already conducted their own research are offered online access to a database of reliable health information. Patients and families are welcome to keep in touch with the library after discharge to ensure they have access to quality health information at home. In fy 2016, the health information ambassadors visited approximately 2,000 patient rooms and filled approximately 700 information requests. At smmc, the arts for healing program uses art and music to reduce feelings of fear, stress, pain and isolation among patients facing significant medical challenges and their loved ones. The program brings a variety of activities to patients at their bedside - including painting, beading, creative writing, card-making, seasonal crafts, scrapbooking, quilting, music and theater - to help improve emotional and spiritual health, and promote a faster recovery. The program also engages visitors and members of the community during hospital and community events. Funded completely by donations, arts for healing is led by sharp's spiritual care department and is implemented with help from licensed music and art therapists as well as a team of trained volunteers. At smh, arts for healing typically serves patients who are receiving cancer treatment, recovering from surgery or stroke, awaiting organ transplantation, receiving palliative care, or facing life with newly acquired disabilities following catastrophic events. At smbhwn, arts for healing supports mothers with high-risk pregnancies who are susceptible to stress and loneliness during extended hospital stays prior to childbirth. Music therapy is also provided in the nicu to promote development in premature babies. At smv and smc, arts for healing offers several art and music therapy groups, including groups for patients recovering from drug addiction, patients receiving treatment for mood and anxiety disorders, and older adults receiving treatment for dementia and depression. In fy 2016, arts for healing led art and music activities for hundreds of patients and community members in recognition of various holidays and sharp events, including: saturday with santa, a public event hosted each december by the smh auxiliary; valentine's day; national hospital week in may; cancer awareness week in june; the annual sharp women's health conference; and sharp's annual disaster preparedness expo. Additionally, in collaboration with smmc's social workers and palliative care nurses, arts for healing facilitated the donation of more than 220 blankets and quilts to patients receiving end-of-life care at smh. Seventeen of the blankets were knitted and crocheted by patients at smv's east county outpatient program, an activity that could also reduce anxiety and depression for those crafting and donating the blankets. In fy 2016, 38 volunteers, including students from various colleges and universities, facilitated art activities for patients and their loved ones through arts for healing. Since 2008, more than 83,000 patients, guests and staff have benefitted from the time and talent provided by the arts for healing team. S”

“In august, sgh nurses held their annual backpack drive in collaboration with christie's place, a non-profit that supports women, children and families affected by hiv/aids (human immunodeficiency virus/acquired immunodeficiency syndrome), to prepare children and teens for academic success. Nearly 300 backpacks were filled with school supplies and distributed to youth during a back-to-school party in balboa park. Similarly, the labor and delivery department at smbhwn is committed to the fight against hunger through participation in the international relief team's (irt) fsd's kids project. Based in san diego, irt is a relief organization providing worldwide support that combines both short-term relief efforts and long-term programs to save and change lives. Through fsd's kids, nutritious food is provided to children in the linda vista elementary school nutrition club, a group specifically for children who have been identified as homeless by the school nurse. Every week, labor and delivery team members fill backpacks with nonperishable, nutritious food that can feed a family of four over the weekend. The backpacks are also filled with weekly nutrition-related prizes to encourage students and families to learn and participate in their own nutrition as well as with occasional holiday-related gifts. Since the start of the program in may 2013, the team has dedicated more than 180 weeks of service to filling 4,500 backpacks for approximately 25 elementary school children and their families per school year. More than 467,000 people in sdc face the threat of hunger every day. Each month, the food bank distributes emergency food to approximately 400,000 children and families, active duty military, and fixed income seniors living in poverty. For nearly 10 years now, sharp has supported the food bank's tremendous efforts through a holiday food drive. During the 2015 holiday season, sharp demonstrated its commitment to fighting hunger by hosting a food drive to support the food bank. Through the food drive, team members donated nearly 1,600 pounds of food, which supplied more than 1,300 meals to those in need. All ways green initiative as san diego's largest private employer and leading health care provider, sharp is committed to improving the health of the environment and therefore the communities it serves. Understanding that a healthy environment can influence individual well-being, sharp helps minimize adverse impacts on the environment by creating healthy green practices for its employees, physicians and patients. Sharp promotes a culture of environmental responsibility through education, outreach, and collaboration with san diego earth-friendly businesses to help identify best practices, reduce the cost of green practices, and facilitate the implementation of sustainable initiatives. The all ways green(tm) logo was created in 2009 to brand sharp's environmental activities and communicate sustainability throughout the organization and the san diego community. Sharp's systemwide all ways green(tm) committee is charged with identifying, creating and evaluating opportunities and best practices in five distinct areas: (1) energy efficiency, (2) water conservation, (3) waste minimization, (4) commuter solutions, and (5)sustainable food practices. Sharp's environmental policy serves to guide the organization in identifying and implementing green practices within the health care system. Established green teams at each sharp entity are responsible for developing new programs that educate and motivate employees to conserve natural resources and reduce, reuse and recycle. Energy conservation the u.s. Department of energy information agency states that hospitals and health care facilities account for more than eight percent of the nation's annual energy consumption and generate nearly eight percent of the country's co2 emissions. Unlike other industries, hospitals must operate 24 hours a day, seven days a week, and provide service during power ou”

“In april 2016, sgh virtually eliminated dependency on electrical utility by replacing a 30-year-old cogeneration turbine generator with a new state-of-the-art central energy plant (cep). The cep contains a 52-ton, 4.4-megawatt combustion turbine generator, which generates enough electricity to meet up to 95 percent of sgh's electrical needs and reduces greenhouse gases by up to 90 percent. The cep also converts heat to steam for the operation of medical equipment, space heating and air conditioning. The new cep fully complies with state and local standards for air emissions. Table 3 below highlights sharp's energy conservation projects. Table 3: energy conservation projects by sharp healthcare entity establish energy use baseline: schhc - yes scvmc - yes sgh - yes sharp system services - yes shp - yes smh/smbhwn - yes smv/smc - yes srs - yes energy audits - 2016: schhc - yes scvmc - yes sgh - yes sharp system services - no shp - no smh/smbhwn - yes smv/smc - yes srs - no energy star participation: schhc - yes scvmc - yes sgh - yes sharp system services - no shp - no smh/smbhwn - yes smv/smc - yes srs - no air handler projects: schhc - yes scvmc - no sgh - no sharp system services - no shp - no smh/smbhwn - no smv/smc - yes srs - no cogeneration plant: schhc - no scvmc - no sgh - yes sharp system services - no shp - no smh/smbhwn - no smv/smc - no srs - no evc stations: schhc - no scvmc - yes sgh - no sharp system services - yes shp - no smh/smbhwn - yes smv/smc - no srs - no energy-efficient kitchen/cafe appliances: schhc - yes scvmc - yes sgh - yes sharp system services - yes shp - no smh/smbhwn - yes smv/smc - no srs - no energy-efficient chillers/ motors: schhc - yes scvmc - no sgh - yes sharp system services - yes shp - no smh/smbhwn - yes smv/smc - no srs - no hvac projects: schhc - yes scvmc - yes sgh - yes sharp system services - yes shp - yes smh/smbhwn - yes smv/smc - yes srs - yes light-emitting diode (led) lighting: schhc - yes scvmc - yes sgh - yes sharp system services - yes shp - yes smh/smbhwn - yes smv/smc - yes srs - yes occupancy sensors: schhc - yes scvmc - yes sgh - yes sharp system services - yes shp - yes smh/smbhwn - yes smv/smc - yes srs - yes water conservation according to the epa, hospital water use constitutes seven percent of the total water used in commercial and institutional buildings in the u.s. On any given day, sharp uses an average of 650,000 gallons of water. Of this, approximately 35 percent is used for domestic purposes such as sinks, toilets and showers, while the remaining 75 percent helps cool sharp's buildings, sterilize equipment, prepare food and water the landscape. Below are some of the numerous infrastructure changes and monitoring efforts sharp has implemented to reduce its water consumption: * installation of motion-sensing faucets and toilets in public restrooms * low-flow showerheads and toilets in patient and locker rooms * mist eliminators, micro-fiber mops and other water-saving devices * installation of high-efficiency, low water use dishwashers * installation of water-efficient chillers * water monitoring and control systems * water practice and utilization evaluations * regular rounding to identify leaks * installation of low-water sterile processing equipment to comply with mandatory water restrictions issued for california on april 1, 2015, sharp made significant modifications to its landscape maintenance practices, including adjusting irrigation schedules, properly sizing sprinkler heads, installing water-sensing equipment and drip irrigation systems, xeriscaping, hardscaping, planting succulents and other drought-tolerant plants, and reducing watering times and frequency at all sites. Each year sharp uses over eight million pounds of textiles such as sheets, towels, scrubs and patient gowns. Given the significant amount of laundry generated, sharp selected emerald textiles as its environment-friendly laundry and linen provider. Emerald textiles operates a state-of-t”

“Waste minimization: according to the practice greenhealth healthier hospitals initiative (hhi), hospitals generate an average of 26 pounds of waste per staffed bed each day; approximately 15 percent of this waste is considered hazardous material. Sharp has created a comprehensive waste minimization program to significantly reduce waste at each entity and extend the lifespan of local landfills. Overseen by a systemwide, multi-disciplinary waste minimization committee, the program includes proper waste segregation and enhanced recycling efforts. Sharp was an early adopter in the commitment to waste diversion and now diverts more than 40 percent of waste through recycling, donating, composting, reprocessing, and reusing programs. Sharp's waste minimization efforts have resulted in more than 4.7 thousand tons of waste diverted from the landfill (equivalent to the weight of 12 loaded boeing 747 aircrafts). Sharp made the following achievements in waste minimization in fy 2016: * scvmc and sgh generated nearly 44,000 pounds of green waste through the implementation of green waste recycling. * more than 2.7 million pounds of trash were diverted from the landfill through recycling of non-confidential paper, cardboard, exam table paper, plastic, aluminum cans and glass containers. * approximately 75,000 pounds of surgical instruments were collected, reprocessed and sterilized for further use. * more than 153,000 pounds of plastic and cardboard were diverted from the landfill through the use of reusable sharps containers. * more than 200,000 pounds of surgical blue wrap (recycled at all hospital entities) and disposable privacy curtains (recycled at scvmc) were diverted from the landfill. * sharp continued to collaborate with ssubi is hope, a nonprofit charity organization that collects donated expired (though still safe and usable) medical equipment, to support a health center in rural uganda. Ssubi is hope has collected more than 25 tons of supplies from sharp facilities. * sharp continued to participate in office depot's greeneroffice(tm) delivery service. Through the program, paper bags composed of 40 percent postconsumer recycled material are used in place of small and midsized cardboard boxes. The paper bags are then returned to office depot for reuse. In addition, office depot and sharp have arranged for 30 percent recycled copy paper to be used at all sharp entities. * sharp donated nearly 113,000 pounds of older computer equipment through the technology training foundation of america, an organization that provides donated computers to schools and nonprofit organizations in underserved communities. * sharp employees and hospital visitors donated approximately 150 pairs of eyewear to people in need, both locally and globally, through the lion's club recycle sight program. As a result of its innovative waste minimization efforts, sharp received the recycler of the year award in 2013 and 2015 through the city of san diego environmental services department's waste reduction and recycling awards program. See table 5 for waste diversion rates, and table 6 for specific waste minimization efforts, at sharp in fy 2016. Table 5: sharp healthcare waste diversion - fy 2016 sharp chula vista medical center: recycled waste per year (lbs.) 1,089,472 total waste per year (lbs.) 3,138,051 percent recycled 35% sharp coronado hospital and healthcare center: recycled waste per year (lbs.) 273,929 total waste per year (lbs.) 1,347,238 percent recycled 20% sharp grossmont hospital: recycled waste per year (lbs.) 2,263,496 total waste per year (lbs.) 5,931,577 percent recycled 38% sharp memorial hospital and sharp mary birch hospital for women & newborns: recycled waste per year (lbs.) 2,539,524 total waste per year (lbs.) 7,177,426 percent recycled 35% sharp mesa vista hospital: recycled waste per year (lbs.) 437,214 total waste per year (lbs.) 735,503 percent recycled 59% sharp rees-stealy medical centers: recycled waste per year (lbs.) 1,360,812 to”

“The goal of sharp's food and nutrition best health committee is to promote its food sustainability efforts throughout the health care system and within the greater san diego community. This includes a focus on sharp's mindful food program to provide education and healthy food options to improve the health of sharp's patients, staff, community and environment. The mindful food program includes reducing meat consumption by promoting meatless mondays; increased purchasing of beef and poultry raised without the routine use of antibiotics; color-coded menu labeling to highlight the healthiest food options; participation in community supported agriculture (csa) - a community of individuals who pledge support to a farm operation in order for it to become, either legally or spiritually, the community's farm - to increase the percentage of locally sourced fresh, organic and sustainable food; food composting; increased recycling activities; promotion of sugarless beverages; and use of post-consumer recycled packaging solutions. Additional food sustainability efforts at sharp in fy 2016 are described below: * in august, sharp partnered with the sdrm and the food bank to begin an innovative food recovery program that donates imperfect, yet still edible and safe, food from its kitchens to nearly two dozen hunger relief organizations in sdc. An estimated average of 1,100 pounds of food will be donated to the community each week through the program. Sharp is the first health care system in sdc to donate food to those in need in san diego on such a wide-scale level. * in february, sharp launched a soup stock program which turns previously unused vegetable scraps into soup stock and saves an average of 174 pounds of food each week. * each month, sharp's imperfect produce program purchases an average of 700 pounds of surplus fruits and vegetables that are nutrient-rich and full of flavor but would otherwise be thrown away. * scvmc started a food waste composting program through the otay landfill, joining smh and smv (participants through the miramar greenery site since 2015). Through the program, food waste is processed into a rich compost product and is provided to residents at no charge for volumes of up to two cubic yards. The compost offers several benefits including improving the health and fertility of soil, reducing the need to purchase commercial fertilizers, increasing the soil's ability to retain water and helping the environment by recycling valuable organic materials. In total, sharp's composting efforts have diverted approximately 358,000 pounds of waste from landfills. According to the city of san diego, such waste diversion programs help extend the lifespan of the landfill from 2012 to at least 2022. * sharp's cooking oil recycling program collected 11,824 pounds of oil for conversion into safe biodiesel oil. * schhc, smv and smh continued to operate the first county-approved hospital-based organic gardens. Produce from the gardens is used in meals served at the hospital cafes. * sharp increased purchasing of 100 percent recycled goods at all sites as well as continued its systemwide recycling campaign. * sharp has implemented self-audit checklists to help kitchen teams be mindful of waste between food preparation and cleanup. In recognition of these initiatives, the san diego food system alliance awarded sharp and sodexo the inaugural 2016 emies unwasted food award. Named after the emerson good samaritan food donation act, the award was created to encourage food donation to nonprofit organizations by minimizing liability. Sharp was among five organizations in sdc to receive the award for demonstrating exemplary practices in waste prevention, food donation, and composting and recycling. Sharp is an active member of san diego's nutrition in healthcare leadership team, a subcommittee of the san diego county childhood obesity initiative and facilitated by community health improvement partners (chip). In december 2015, seven sdc hosp”

“To further reduce the number of cars on the road, sharp's commuter solutions subcommittee continuously works to develop innovative accessible programs and marketing campaigns to educate employees on the benefits of ride sharing and other alternative modes of transportation. The committee has overseen the implementation of bike racks and designated car pool spots, as well as a bicycle commuter benefit, which provides employees who bike to work up to $20 per month to use toward qualified costs associated with bicycle purchase, improvement, repair and storage. Sharp participates in sandag's bike to work day each year. In may 2016, sharp employees were among nearly 10,000 san diegans who opted to ride their bike to work. During the event, sharp provided food and beverages at several pit stops located throughout sdc. Furthering sharp's commitment to better commuting solutions for its employees, sharp supplies and supports the hardware and software for nearly 500 employees who are able to efficiently and effectively telecommute to work. These employees work in areas that do not require an onsite presence, such as information technology support, transcription, and human resources. Sharp also provides compressed work schedule options to eligible full-time employees enabling them to complete the basic eighty-hour biweekly work requirement in less than ten workdays, thus reducing commute costs, lowering parking demand, and helping the environment. Sharp's ongoing efforts to promote alternative commute choices in the workplace has led to recognition as a sandag icommute diamond award winner consistently between 2001 and 2010, and again from 2013 through 2016. Education, communication and community outreach sharp conducted the following environmental community education and outreach activities in fy 2016: * sharp shared e-newsletters with employees throughout the year to highlight the organization's recycling efforts and accomplishments, as well as to provide reminders for proper workplace recycling, carpooling, and energy and water conservation. * in april 2016, sharp held its annual systemwide all ways green(tm) earth week celebration, including earth fairs at each sharp hospital and system office. During the fairs, employees learned how to help preserve the planet and its precious resources. Many of sharp's key vendor partners participated in the fairs to help raise awareness of various green initiatives at sharp. * sharp continued to participate in sdg&e's major customer advisory panel and health care collaborative to provide input and education relating to energy reliability, fees and cost structure and their impacts on the health care environment. * in partnership with the county, sharp hosted a complimentary community workshop on pharmaceutical waste management to educate medical providers, pharmacy and hospital personnel, and other participants about safe and proper pharmaceutical waste disposal, including pharmaceutical waste liability, regulatory compliance and cost-effective disposal strategies. * sharp provided confidential paper shredding through shred-it(r), a secure paper shredding and document destruction service, at sharp's annual disaster expo. * sharp's corporate office location served as a drop-off location during national drug take back day, a day dedicated to curbing prescription drug theft and abuse by providing safe, convenient and responsible methods of drug disposal. * sharp continued to participate in san diego's gathering of green teams with other san diego business leaders to identify and discuss sustainable best practices that can be replicated across industries. * sharp continued to participate in san diego county's hazmat stakeholder meetings to discuss best practices for medical waste management with other hospital leaders in sdc. * scvmc is a member of the city of chula vista's clean business program, demonstrating its commitment to reducing energy use, water use and waste, and purchasing more sustainable”

“Through participation in the u.s. Department of health & human services public health emergency hospital preparedness program (hpp) grant, sharp created the sharp healthcare hpp disaster preparedness partnership. The partnership includes scvmc, schhc, sgh, smh, srs urgent care centers and clinics, san diego's ronald mcdonald house, rady children's hospital, scripps mercy hospital chula vista, kaiser hospital, alvarado hospital, paradise valley hospital, uc san diego health, palomar health, the council of community clinics, naval air station north island/naval medical services, san diego county sheriffs, marine corps air station miramar fire department and fresenius medical centers. The partnership seeks to continually identify and develop relationships with health care entities, nonprofit organizations, law enforcement, military installations and other organizations that serve sdc and are located near partner health care facilities. Through networking, planning, and the sharing of resources, trainings and information, the partners will be better prepared for a collaborative response to an emergency or disaster affecting sdc. Sharp supports safety efforts of california and the city of san diego through maintenance and storage of a county decontamination trailer at sgh to be used in response to a mass decontamination event. Additionally, all sharp hospitals are prepared for an emergency with backup water supplies that last up to 96 hours in the event the system's normal water supply is interrupted. In september, sharp hosted its fifth annual disaster preparedness expo to educate san diego residents on effective disaster preparedness and response in the event of an earthquake, fire, power outage or other emergency. Held at balboa park, the free event provided approximately 500 community members with a variety of disaster exhibitors, demonstrations and displays, as well as education on personal and family disaster planning, and confidential document shredding from shred-it. In recent years, global endemic events had the potential to impact public health in the local san diego community. Sharp continues to partner with community agencies, sdc public health services and first responders to develop protocols, provide joint trainings, and establish safe treatment methods and locations. This allows for the continued delivery of uninterrupted care to the community in the face of public health threats. Employee wellness: sharp best health sharp recognizes that improving the health of its team members benefits the health of the broader community. Since 2010, the sharp best health employee wellness program has created wellness initiatives to improve the overall health, happiness and productivity of sharp's workforce. Sharp best health encourages team members to incorporate healthy habits into their lifestyles and supports them on their journey to attain their personal health goals. Each sharp hospital as well as srs has a dedicated best health committee that works to promote wellness at their individual work site. Team members are encouraged to participate in on-site fitness classes, meditation workshops, micro-stretch breaks, and relaxation and stress management workshops. In addition, sharp best health offers web-based resources to help team members stay fit and healthy, including interactive blogging, recipes, as well as education on biometric screenings, health risk assessments, mindfulness, healthy eating and active lifestyle development. Since 2013, sharp best health has offered annual employee health screenings to raise awareness of important biometric health measures and help team members learn how to reduce their risk of related health issues. In fy 2016, more than 10,000 employees received health screenings for blood pressure, cholesterol, body mass index (bmi), blood sugar and tobacco use. Sharp best health hosted a variety of wellness programs and events in fy 2016 for its employees, family and friends, including walking and hi”

“* education and training of community health care professionals * student and intern supervision and support * collaboration with local schools to promote interest in health care careers * cancer education, patient navigation services and participation in clinical trials * women's and prenatal health services and education * meeting the needs of new mothers and their loved ones * mental health and substance abuse education and support for the community highlights of community benefit provided by sharp in fy 2016 the following are examples of community benefit programs and services provided by sharp hospitals and entities in fy 2016. * unreimbursed medical care services included uncompensated care for patients who are unable to pay for services, and the unreimbursed costs of public programs such as medi-cal, medicare, san diego county indigent medical services, civilian health and medical program of the u.s. Department of veterans affairs (champva), and tricare - the regionally managed health care program for active-duty, national guard and reserve members, retirees, their loved ones and survivors; and unreimbursed costs of workers' compensation programs. This also included financial support for on-site workers to process medi-cal eligibility forms. * other benefits for vulnerable populations included van transportation for patients to and from medical appointments; flu vaccinations and services for seniors; financial and other support to community clinics to assist in providing and improving access to health services; project help; project care; meals on wheels; contribution of time to stand down for homeless veterans, the san diego food bank (food bank), and feeding san diego (fsd); financial and other support to the sharp humanitarian service program; and other assistance for vulnerable and high-risk community members. * other benefits for the broader community included health education and information, and participation in community health fairs and events addressing the unique needs of the community, as well as providing flu vaccinations, health screenings and support groups to the community. Sharp collaborated with local schools to promote interest in health care careers and made its facilities available for use by community groups at no charge. Sharp executive leadership and staff also actively participated in numerous community organizations, committees and coalitions to improve the health of the community. See appendix a for a listing of sharp's involvement in community organizations. In addition, the category included costs associated with planning and operating community benefit programs, such as community health needs assessments and administration. * health research, education and training programs included education and training programs for medical, nursing and other health care students and professionals, as well as supervision and support for students and interns, and time devoted to generalizable health-related research projects that were made available to the broader health care community. Economic value of community benefit provided in fy 2016 in fy 2016, sharp provided a total of $319,497,417 in community benefit programs and services that were unreimbursed. Table 8 displays a summary of unreimbursed costs based on the categories specifically identified in sb 697. In fy 2015 the state of california and the centers for medicare and medicaid services approved a medi-cal hospital fee program for the time period of january 1, 2014 through december 31, 2016. This resulted in an increased reimbursement of $164.2 million and an assessment of a quality assurance fee and pledge totaling $103.1 million in fy 2016. The net impact of the program totaling $61.1 million reduced the amount of unreimbursed medical care service for the medi-cal population. This reimbursement helped offset prior years' unreimbursed medical care services, however the additional funds recorded in fy 2016 understate the true unreimbursed medica”

“Table 10 includes a summary of unreimbursed costs for each sharp hospital entity based on the categories specifically identified in sb 697. For a detailed summary of unreimbursed costs of community benefit provided by each sharp entity in fy 2016, see tables presented in sections 4 through 5. Table 10: fy 2016 detailed economic value of sb bill 697 categories note: table shows estimated fy 2016 unreimbursed costs and is presented by sharp healthcare entity and by sb 697 category. Economic value is based on unreimbursed costs. Sharp chula vista medical center: medical care services - $59,362,219 other benefits for vulnerable populations - $318,613 other benefits for the broader community - $248,531 health research, education and training programs - $875,760 total estimated fy 2016 unreimbursed costs - $60,805,123 sharp coronado hospital and healthcare center medical care services - $13,346,669 other benefits for vulnerable populations - $32,822 other benefits for the broader community - $64,013 health research, education and training programs - $347,546 total estimated fy 2016 unreimbursed costs - $13,791,050 sharp grossmont hospital: medical care services - $95,687,226 other benefits for vulnerable populations - $850,000 other benefits for the broader community - $627,388 health research, education and training programs - $1,299,472 total estimated fy 2016 unreimbursed costs - $98,464,086 sharp mary birch hospital for women & newborns: medical care services - $5,455,562 other benefits for vulnerable populations - $51,104 other benefits for the broader community - $300,746 health research, education and training programs - $320,862 total estimated fy 2016 unreimbursed costs - $6,128,274 sharp memorial hospital: medical care services - $122,118,736 other benefits for vulnerable populations - $828,317 other benefits for the broader community - $549,428 health research, education and training programs - $1,721,704 total estimated fy 2016 unreimbursed costs - $125,218,185 sharp mesa vista hospital and sharp mcdonald center: medical care services - $13,742,304 other benefits for vulnerable populations - $608,878 other benefits for the broader community - $213,934 health research, education and training programs - $450,583 total estimated fy 2016 unreimbursed costs - $15,015,699 sharp health plan: medical care services - $- other benefits for vulnerable populations - $12,733 other benefits for the broader community - $58,774 health research, education and training programs - $3,493 total estimated fy 2016 unreimbursed costs - $75,000 all entities: medical care services - $309,712,716 other benefits for vulnerable populations - $2,702,467 other benefits for the broader community - $2,062,814 health research, education and training programs - $5,019,420 total estimated fy 2016 unreimbursed costs - $319,497,417 section 3 community benefit planning process an exceptional community citizen listens to their community's needs, barriers to service and vision of their future and helps them translate that into a reality through advocacy, outreach and action. - lisa mills, business development specialist, sharp mesa vista hospital for the past 20 years, sharp healthcare (sharp) has based its community benefit planning on findings from its triennial community health needs assessment (chna) process. Chna findings are used in combination with the expertise in programs and services of each sharp hospital, as well as knowledge of the populations and communities served by those hospitals, to provide a foundation for community benefit program planning and implementation. Methodology to conduct the 2016 sharp healthcare community health needs assessments sharp has been a longtime partner in the process of identifying and responding to the health needs of the san diego community. Since 1995, sharp has participated in a countywide collaborative that includes a broad range of hospitals, health care organizations and community agencies to conduct a trienni”

“Study area defined for the purposes of the collaborative hasd&ic 2016 chna, the study area is the entire county of san diego due to a broad representation of hospitals in the area. With more than three million residents, sdc is socially and ethnically diverse. Information on key demographics, socioeconomic factors, access to care, health behaviors, and the physical environment can be found in the full hasd&ic 2016 chna report at: http://hasdic.org. As the study area for both the collaborative hasd&ic 2016 and sharp 2016 chnas cover sdc, the hasd&ic 2016 chna process and findings significantly informed sharp's chna process/findings, and as such, are described as applicable throughout sharp's chnas. For complete details on the hasd&ic 2016 chna process, please visit the hasd&ic website or contact lindsey wade, vice president, public policy at hasd&ic at [email protected]. For the collaborative hasd&ic 2016 chna process, the iph employed a rigorous methodology using both community input and quantitative analysis to provide a deeper understanding of barriers to health improvement in sdc. The 2016 chna process began with a comprehensive scan of recent community health statistics in order to validate the regional significance of the top four health needs identified in the hasd&ic 2013 chna. Quantitative data for both the hasd&ic 2016 chna and sharp 2016 chnas included 2013 oshpd demographic data for hospital inpatient, emergency department (ed), and ambulatory care encounters to understand the hospital patient population. Clinic data was also gathered from oshpd and incorporated in order to provide a more holistic view of health care utilization in sdc. Additional variables analyzed in the 2016 chna processes are included in table 11 below; variables were analyzed at the zip code level wherever possible. Table 11: data variables in the hasd&ic and sharp 2016 chnas * hospital utilization: inpatient discharges, ed and ambulatory care encounters * community clinic visits * demographic data (socio-economic indicators) * mortality and morbidity data * regional program data (childhood obesity trends and community resource referral patterns) * social determinants of health and health behaviors (education, income, insurance, physical environment, physical activity, diet and substance abuse) based on the results of the community health statistics scan and feedback from community partners received during the 2016 chna planning process, a number of community engagement activities were conducted across sdc, as well as specific to sharp patents, in order to provide a more comprehensive understanding of identified health needs, including their associated sdoh and potential system and policy changes that may positively impact them. In addition, a detailed analysis of how the top health needs impact the health of san diego residents was conducted. The number and type of community engagement activities conducted as part of the collaborative hasd&ic 2016 chna, including key informant interviews, facilitated discussions with care coordinators (community partner discussions), and community resident input through a health access and navigation survey, are outlined below. Hasd&ic 2016 chna community engagement activities: * 3 behavioral health discussions * 19 key informant interviews * 87 community partner discussion participants * 91 hhsa regional live well surveys * 235 health access & navigation surveys in addition, sharp contracted with iph to collect additional community input through three primary methods: facilitated discussions, key informant interviews, and the health access and navigation survey with patients and community members. This input focused on behavioral health, cancer, cardiovascular health, diabetes, high-risk pregnancy, senior health and the needs of highly vulnerable patients and community members. In addition, sharp conducted specific outreach to community promoters, and members of sharp's patient family advisory councils - commu”

“Section 4 sharp grossmont hospital fy 2016 community benefit program highlights sharp grossmont hospital (sgh) provided $98,464,086 in community benefit in fy 2016. See table 20 for a summary of unreimbursed costs based on the categories identified in senate bill (sb 697). Table 20: economic value of community benefit provided - sharp grossmont hospital - fy 2016 note: the table shows estimated fy 2016 unreimbursed costs and the data is presented by sb 697 category and by programs and services included in sb 697 category medical care services: shortfall in medi-cal, financial support for on-site workers to process medi-cal eligibility forms - $31,616,312 note: methodology for calculating shortfalls in public programs is based on sharp's payor-specific cost-to-charge ratios, which are derived from the cost accounting system, offset by the actual payments received. Shortfall in medicare - $55,040,735 note: methodology for calculating shortfalls in public programs is based on sharp's payor-specific cost-to-charge ratios, which are derived from the cost accounting system, offset by the actual payments received. Shortfall in san diego county indigent medical services - $202,469 shortfall in champva/tricare1 - $1,242,332 note: methodology for calculating shortfalls in public programs is based on sharp's payor-specific cost-to-charge ratios, which are derived from the cost accounting system, offset by the actual payments received. Charity care - $6,466,509 note - charity care reflects the unreimbursed costs of providing services to patients without the ability to pay for services at the time the services were rendered. Bad debt -$1,118,869 note - bad debt reflects the unreimbursed costs of providing services to patients without the ability to pay for services at the time the services were rendered. Other benefits for vulnerable populations: patient transportation, project help and other assistance for the needy - $850,000 note: unreimbursed costs may include an hourly rate for labor and benefits plus costs for supplies, materials and other purchased services. Any offsetting revenue (such as fees, grants or external donations) is deducted from the costs of providing services. Unreimbursed costs were estimated by each department responsible for providing the program or service. Other benefits for the broader community: health education and information, health screenings, health fairs, flu vaccinations, support groups, meeting room space, donations of time to community organizations and cost of fundraising for community events - $627,388 note: unreimbursed costs may include an hourly rate for labor and benefits plus costs for supplies, materials and other purchased services. Any offsetting revenue (such as fees, grants or external donations) is deducted from the costs of providing services. Unreimbursed costs were estimated by each department responsible for providing the program or service. Health research, education and training programs: education and training programs for students, interns and health care professionals - $1,299,472 note: unreimbursed costs may include an hourly rate for labor and benefits plus costs for supplies, materials and other purchased services. Any offsetting revenue (such as fees, grants or external donations) is deducted from the costs of providing services. Unreimbursed costs were estimated by each department responsible for providing the program or service. Total - $98,464,086 key highlights: * unreimbursed medical care services included uncompensated care for patients who were unable to pay for services; the unreimbursed costs of public programs such as medi-cal, medicare and champva/tricare; and financial support for on-site workers to process medi-cal eligibility forms. In fy 2015 the state of california and the centers for medicare and medicaid services approved a medi-cal hospital fee program for the time period of january 1, 2014 through december 31, 2016. This resulted in an increased reimbursemen”

“Description of community health in sdc's east region in 2015, 100 percent of children ages 0 to 11 and 100 percent of children ages 12 to 17 had health insurance, meeting the healthy people 2020 (hp2020) national targets for health insurance coverage. 91.3 percent of adults ages 18 to 64 had health insurance - failing to meet the hp2020 targets. See table 21 for a summary of key indicators of access to care, and table 22 for data regarding eligibility for medi-cal. In the east region in 2015, 13.0 percent of adults ages 18 to 64 did not have a usual source of care and 12.1 percent of these adults had health insurance. In addition, 31.2 percent reported fair or poor health outcomes. Further, 43.4 percent living at 200 percent below the federal poverty level (fpl) reported as food insecure. Table 21: health care access in sdc's east region, 2015 current health insurance coverage children 0 to 11 years: rate - 100% year 2020 target - 100% children 12 to 17 years: rate - 100% year 2020 target - 100% adults 18 to 64 years: rate - 91.3% year 2020 target - 100% regular source of medical care: children 0 to 11 years: rate - 100% year 2020 target - 100% children 12 to 17 years: rate - 59.4% year 2020 target - 100% adults 18 to 64 years: rate - 87.0% year 2020 target - 89.4% not currently insured: adults 18 to 64 years: rate - 8.7% source: 2014-2015 california health interview survey (chis) table 22: medi-cal (medicaid) eligibility, among uninsured in sdc's east region (adults ages 18 to 64 years), 201535 medi-cal eligible - 7.9% not eligible - 92.1% source: 2014-2015 chis in 2013, cancer and heart disease were the top two leading causes of death in sdc's east region. See table 23 for a summary of leading causes of death in the east region. For additional demographic and health data for communities served by sgh, please refer to the sgh 2016 chna at http://www.sharp.com/about/community/community-health-needs-assessments table 23: leading causes of death in sdc's east region, 2013 malignant neoplasms number of deaths - 908 percent of total deaths - 23.8% diseases of heart number of deaths - 877 percent of total deaths - 23.0% alzheimer's disease number of deaths - 250 percent of total deaths - 6.6% chronic lower respiratory diseases number of deaths - 235 percent of total deaths - 6.2% cerebrovascular diseases number of deaths - 201 percent of total deaths - 5.3% accidents (unintentional injuries) number of deaths - 193 percent of total deaths - 5.1% diabetes mellitus number of deaths - 120 percent of total deaths - 3.1% chronic liver disease and cirrhosis number of deaths - 68 percent of total deaths - 1.8% intentional self-harm (suicide) number of deaths - 67 percent of total deaths - 1.8% essential (primary) hypertension and hypertensive renal disease number of deaths - 64 percent of total deaths - 1.7% all other causes number of deaths - 830 percent of total deaths - 21.8% total deaths number of deaths - 3,813 percent of total deaths - 100.0% source: county of san diego health and human services agency (hhsa), public health services, epidemiology & immunization services branch community benefit planning process in addition to the steps outlined in section 3: community benefit planning process regarding community benefit planning, sgh: * incorporates community priorities and community input into its strategic plan and develops service line-specific goals * estimates an annual budget for community programs and services based on community needs, previous years' experience and current funding levels * prepares and distributes a monthly report of community activities to its board of directors, describing community benefit programs provided, such as education, screenings and flu vaccinations * prepares and distributes information on community benefit programs and services through its foundation and community newsletters * consults with representatives from a variety of departments to discuss, plan and implement community activities priorit”

“Rationale * the sgh 2016 chna continued to identify cardiovascular disease (including cerebrovascular disease/stroke) as one of six priority health issues affecting members of the communities served by sgh. * the hasd&ic 2016 chna continued to identify cardiovascular disease (including cerebrovascular disease/stroke) as one of the top four priority health issues for community members in sdc. * according to data presented in the sgh 2016 chna, high blood pressure, high cholesterol and smoking are all risk factors that could lead to cardiovascular disease and stroke. About half of all americans (49 percent) have at least one of these three risk factors. Additional risk factors include alcohol use, obesity, physical inactivity, poor diet, diabetes and genetic factors. * in 2013, cerebrovascular disease (stroke) was the fifth leading cause of death for sdc's east region. * in 2013, there were 201 deaths due to cerebrovascular diseases in sdc's east region. The regions' age-adjusted death rate due to cerebrovascular disease was 37.4 per 100,000 population. This rate was the highest among all sdc regions and higher than the overall sdc age-adjusted death rate due to cerebrovascular disease of 33.1 per 100,000 population. * in 2013, there were 1,312 hospitalizations due to stroke in sdc's east region. The regions' age-adjusted rate of hospitalizations for stroke was 250.3 per 100,000 population, which is the highest among all sdc regions as well as higher than the overall sdc age-adjusted rate of 203.9 per 100,000 population. * in 2013, there were 256 stroke-related ed visits in sdc's east region. The age-adjusted rate of visits was 48.4 per 100,000 population. This rate has been decreasing since 2010. * according to the 3-4-50: chronic disease in san diego county 2010 report, if no changes are made in risk behavior, based on current disease rates, it is projected that by the year 2020 the total number of deaths from heart disease and stroke will both increase by 38 percent. * according to data presented in the hhsa 2014 livewell community health assessment, east region residents were more likely to be obese, to smoke tobacco, to regularly eat fast food, and to binge drink than residents of other regions, all which are risk factors for stroke. * according to the 2012 hhsa report titled critical pathways: the disease continuum, the most common risk factors associated with stroke include physical inactivity, tobacco use, alcohol or drug use, poor nutrition, poor medical care, stress, depression, high cholesterol and diabetes. * the national institute of neurological disorders and stroke (ninds) reports that 25 percent of people who recover from their first stroke will have another stroke within five years (ninds, 2016). Objective * provide stroke education, support and screening services for the east region of sdc fy 2016 report of activities note: sgh is recognized with advanced certification by the joint commission as a primary stroke center and was recertified in june 2014. The program is nationally recognized for its outreach, education and thorough screening procedures, as well as documentation of its success rate. Sgh is a recipient of the american heart association (aha)/american stroke association's (asa) get with the guidelines(r) (gwtg)-stroke gold plus quality achievement award for excellence in stroke care as well as the target: stroke honor roll elite designation. The aha/asa's gwtg is a national effort focused on ensuring that evidence-based therapies are used to improve outcomes for stroke patients. The aha/asa's target: stroke honor roll designation focuses on improving the timeliness of intravenous tissue plasminogen activator (iv t-pa) administration to eligible patients. In fy 2016, the sgh stroke center conducted 11 education and screening events in sdc's east region, providing more than 500 community members with information about stroke risk factors, warning signs, and appropriate interventions including arrival a”

“Fy 2017 plan sgh stroke center will do the following: * participate in stroke screening and education events in the east region of sdc * provide education for individuals with identified stroke risk factors * offer a stroke support group in conjunction with the hospital's outpatient rehabilitation department * participate with other sdc hospitals in the san diego county stroke consortium * continue to provide data to the sdc stroke registry * provide at least one physician speaking event around stroke care and prevention * provide stroke education and screenings at the sharp women's health conference identified community need: heart and vascular disease education and screening rationale references the findings of the sgh 2016 chna, hasd&ic 2016 chna or the most recent sdc community health statistics unless otherwise indicated. Rationale * the sgh 2016 chna continued to identify cardiovascular disease as one of six priority health issues affecting members of the communities served by sgh. * the hasd&ic 2016 chna continued to identify cardiovascular disease as one of the top four priority health issues for community members in sdc. * data analysis in the 2016 chnas revealed a higher rate of hospital discharges due to cardiovascular disease in more vulnerable communities within sdc's east region (e.g., el cajon, jacumba, etc.) (dignity health, sangis, office of statewide health planning and development (oshpd) & speedtrack inc., 2015). * a cardiovascular health key informant interview conducted as part of the sgh 2016 chna process identified the following important issues facing cardiology patients: access to care, obtaining medications, understanding diet, understanding symptoms, and communicating their needs to providers. * the key informant interview identified the following as effective strategies for cardiology patients: taking time to teach patients about their disease and self-management; building relationships with patients; providing educational materials; backline (a text messaging service connecting patients and providers) numbers for providers; education for general practitioners; and including a trained addictions specialist on the team. * in addition, the cardiovascular health key informant interview identified the following risk factors for heart disease: diabetes, lack of social support, substance use disorders, financial issues, transportation, and lack of health education. Addiction is of particular concern, as almost all sgh cardiology patients under age 55 have substance use issues. * according to the sgh 2016 chna, high blood pressure, high cholesterol and smoking are all risk factors that could lead to cardiovascular disease and stroke. * in 2013, heart disease was the second leading cause of death for sdc's east region. * in 2013, there were 626 deaths due to coronary heart disease in sdc's east region. The region's age-adjusted death rate due to heart disease was 112.8 per 100,000 population. This was higher than the sdc overall age-adjusted death rate of 101.1 deaths per 100,000 population as well as the hp2020 target of 108.2 deaths per 100,000 population. * in 2013, there were 1,180 hospitalizations due to coronary heart disease in sdc's east region. The rate of hospitalization for heart disease was 222.7 per 100,000 population, which is higher than sdc's overall age-adjusted rate of 201.6 per 100,000 population. * in 2013, there were 243 coronary heart disease ed discharges in sdc's east region. The age-adjusted rate of ed discharges was 45.8 per 100,000 population, which is the highest in the county, and higher than sdc's overall age-adjusted average of 32.1 per 100,000 population. * according to the california health interview survey (chis), in 2015 12.1 percent of adults living in sdc's east region indicated that they were ever diagnosed with heart disease, which is higher than sdc overall at 8.9 percent. * the 2015 chis results showed that 33.7 percent of adults living in sdc's east region had ever”

“Throughout the year, sgh provided expert speakers on heart disease and heart failure at professional conferences and events. This included sgh's seventh annual heart and vascular conference in november, where more than 400 health care professionals received education on advances in cardiovascular care. In november and may, sgh participated in the ninth and 10th semiannual meetings of southern california voice (vascular outcomes improvement collaborative), which included more than 40 regional vascular physicians, nurses, epidemiologists, scientists and research personnel working together to collect and analyze vascular data in an effort to improve patient care. Sgh shared its expertise on the use of data processes to improve outcomes, compliance to standards, and care. Sgh also shared its expertise on data retrieval and analysis processes at the society for vascular surgery's 2016 vascular annual meeting in washington, d.c. In addition, sgh presented on its processes for prescribing appropriate medications at discharge and obtaining long-term follow-up data on patients at the southern california vascular surgical society annual meeting. Sgh continued to participate in programs to improve the care and outcomes of individuals with heart and vascular disease. To help improve care for acutely ill patients in sdc, sgh provided data on stemi (st elevation myocardial infarction or acute heart attack) to the county of san diego ems. Sharp healthcare also hosted the quarterly county of san diego ems county advisory council for stemi at sharp's corporate office (spectrum). Additionally, sgh provided its peripheral vascular disease rehabilitation program to provide education and coaching on exercise, diet and medication to keep patients - particularly low-income patients - at the highest functional level. The program is funded in part by donations contributed to the sgh foundation, to help defray the cost for patients with limited resources. Sgh's cardiac team is committed to supporting future health care leaders through active participation in student training and internship programs. In fy 2016, the team mentored more than 30 students from azusa pacific university (apu), san diego state university (sdsu), university of california, san diego (ucsd), grossmont college, national university and western university of health sciences, including students with an interest in a career as a nurse or cardiovascular technician. Fy 2017 plan sgh will do the following: * provide a free monthly chf class and support group * provide free bimonthly heart and vascular risk factor education classes * provide cardiac and vascular risk factor education and screening at community events * provide one cardiac health lecture and a cardiovascular expo for community members * continue to participate in the open versus endovascular repair of popliteal arteryaneurysm trial for popliteal aneurysm patients * pursue additional research opportunities to benefit patients and community members * offer educational speakers to the professional community on topics such as performance improvements in chf and acute myocardial infarction, and cardiovascular treatment options, as invited * provide a conference on heart and vascular disease for community physicians and other health care professionals in october 2016 * continue to provide student learning opportunities identified community need: diabetes education, prevention and support rationale references the findings of the sgh 2016 chna, hasd&ic 2016 chna or the most recent sdc community health statistics unless otherwise indicated. Rationale * the sgh 2016 chna continued to identify type 2 diabetes as one of six priority health issues for community members served by sgh. * the hasd&ic 2016 chna continued to identify type 2 diabetes as one of the top four priority health issues for community members in sdc. * data analysis in the 2016 chnas revealed a higher rate of hospital discharges due to diabetes in more vulnerable com”

“Objectives * provide diabetes education, prevention and support in the east region of sdc * collaborate with community organizations and projects to provide diabetes education to sdc's vulnerable populations * participate in local and national professional conferences to share best practices in diabetes treatment and control with the broader health care community fy 2016 report of activities the sgh diabetes education program is recognized by the american diabetes association (ada) for meeting national standards for excellence and quality in diabetes education. The program provides individuals with the skills needed to successfully self-manage their diabetes and live a long, healthy life and includes blood sugar monitoring, medications and insulin pump training. Small group and one-on-one classes are also offered. In fy 2016, the sgh diabetes education program provided four on-site pre-diabetes classes teaching more than 30 community members about risk factors, and nutrition and lifestyle tools for prevention. At the sharp women's health conference, shc and srs diabetes education programs provided diabetes risk assessments using the ada's diabetes risk test questionnaire as well as offered resources on pre-diabetes, diabetes management and nutrition to approximately 1,000 attendees. Through fundraising and team participation, the shc diabetes education program also continued to support the ada's step out walk to stop diabetes held in october at the naval training center park in point loma. The shc diabetes education program continued to collaborate with family health centers of san diego (fhcsd) to provide diabetes education to fhcsd diabetes patients at multiple sites, including those in sdc's east region, through fhcsd's diabetes management care coordination project (dmccp). Dmccp provides fhcsd diabetes patients with weekly group health and nutrition education, healthy cooking demonstrations, physical activity including zumba classes, one-on-one support from a nurse practitioner and encourages peer support and education from project "graduates" to current patients/project enrollees in english and spanish. The project monitors enrollees' a1c and blood glucose levels and physical activity, and has proven successful outcomes in lowering and maintaining these levels. In fy 2016, the shc diabetes education program provided a diabetes lecture to 50 community members at the fhcsd lemon grove site. Topics included nutrition, physical activity, diabetes mellitus, self-management and goal setting. The shc diabetes education program continued to provide diabetes education to food insecure adults enrolled in the fsd diabetes wellness project, a collaboration between ucsd's student-run free clinic project, the third avenue charitable organization (taco) and baker elementary school in southeast san diego. The diabetes wellness project screens adult clinic patients with type 2 diabetes for food insecurity, and provides them with ongoing medical treatment and diabetes management through the clinic. In addition, fsd provides diabetes wellness food boxes to project participants, in conjunction with a monthly diabetes and nutrition education course as well as calfresh/supplemental nutrition assistance program (snap) outreach. Through the project, the shc diabetes education program provided diabetes and nutrition education to more than 300 community members at both the taco and baker elementary school sites. Approximately 200 participants are enrolled in the diabetes wellness project, and evaluation will include pre- and post-assessment surveys for the patients regarding diabetes control, an a1c blood test, and other metrics. In further efforts recognizing the connection between access to healthy food and its impact on chronic health conditions such as diabetes, throughout the year the shc diabetes education program actively supported superfood drive - a san diego-based organization that focuses on improving the health of food insecure populat”

“Fy 2017 plan the sgh diabetes education program will do the following: * conduct diabetes education at various community venues in sdc's east region * continue to collaborate with fhcsd to provide and expand education to their diabetes patients through the dmccp * continue to provide gestational services and resources to underserved pregnant women - both at the hospital and in collaboration with community clinics * conduct monthly diabetes prevention classes * continue to foster relationships with community clinics to provide education and resources to community members * continue to participate in ada's step out walk to stop diabetes * keep current on resources to provide community members support with diabetes treatment and prevention - particularly language and culturally appropriate resources * continue to participate in local and national professional conferences to share best practices in diabetes treatment and control with the broader health care community * conduct educational outpatient and inpatient symposiums for health care professionals * explore additional collaborations with fsd to assist and educate food insecure community members identified community need: health education, screening and support for seniors rationale references the findings of the sgh 2016 chna, hasd&ic 2016 chna or the most recent sdc community health statistics unless otherwise indicated. Rationale * the sgh 2016 chna continued to identify senior health as one of six priority health issues for community members served by sgh. * the hasd&ic 2016 chna continued to identify dementia and alzheimer's disease among the top 15 priority health conditions seen in sdc hospitals. * as part of sharp's 2016 chnas, discussions held with social workers and nurses from sharp's senior health centers identified the following challenges to improving the health of seniors in sdc: access to care issues due to aging, decreased driving or loss of support system; difficulty purchasing medications due to financial issues, lack of transportation or lack of motivation; difficulty understanding medical instructions; inability to recognize a health problem exists; memory issues; and the perception that health issues and loneliness are a normal part of aging. * as part of the sgh 2016 chna, discussions with nurses and social workers at sharp's senior health centers identified the following barriers to senior health in sdc: access to care issues due to aging, decreased driving or loss of support system; difficulty purchasing medications due to financial issues, lack of transportation or lack of motivation; difficulty understanding medical instructions; inability to recognize a health problem exists; memory issues; and the perception that health issues and loneliness are a normal part of aging. * sharp senior health discussions held as part of the sgh 2016 chna process identified the most common health-related issues or needs as: anxiety; cardiac disease; cognitive impairment and dementia; depression; diabetes; psychosis and chronic mental illness (specific to the population served by the downtown senior health center); hypertension; increased need for caregivers; isolation, contributing to poor diet, bad habits, and depression; loss of purpose; and substance abuse, particularly for prescription drugs. * seniors participating in the sgh 2016 chna health access and navigation survey prioritized the following barriers to accessing health care: understanding health insurance, including confusing terms; knowing where to go for care, especially understanding when to use the ed, urgent care and primary care; using health insurance, including understanding health care costs/bills and knowing what services are covered; getting health insurance; and follow-up care, including understanding next steps and finding available appointments. * in 2015, sdc's east region had 63,901 residents over the age of 65, comprising 14.4 percent of the total regional population. This proportion is hi”

“* according to a report from the national alliance for caregiving and the aarp titled caregiving in the u.s. 2015, an estimated 34.2 million adults have provided unpaid care to an adult age 50 or older in the past 12 months. In addition, 60 percent of unpaid caregivers are female, and nearly one in 10 caregivers are ages 75 or older (aarp and the national alliance for caregiving, 2015) * the economic value of family caregiving for older adults in the u.s. Was estimated to be $470 billion in 2013. It is estimated that u.s. Businesses lose over $25 billion annually due to lost productivity and absenteeism related to family caregiving among full-time working caregivers (aarp, 2015). * about six in 10 caregivers assist with medical/nursing tasks for their loved one, and 42 percent of these caregivers are performing those tasks without any preparation. According to caregiving in the u.s. 2015, 84 percent of caregivers report that they could use more information or help on caregiving topics. The top four topics of concern to caregivers are keeping their loved one safe at home; managing their own emotional or physical stress; making end-of-life decisions; and managing their loved ones' challenging behaviors (aarp and the national alliance for caregiving, 2015). * the university of california, los angeles (ucla) center for health policy research conducted a study highlighting the plight of california's "hidden poor," finding 772,000 seniors who live in the gap between the fpl and the elder economic security standard. The highest proportion of seniors living in this gap includes renters, latinos, women, and grandparents raising grandchildren (padilla-frausto, & wallace, 2015). Objectives * provide a variety of senior health education and screening programs * produce and mail quarterly activity calendars to community members * provide daily telephone reassurance/welfare check calls to ensure the safety of homebound seniors and disabled adults in sdc's east region * in collaboration with community partners, offer seasonal flu vaccination clinics at convenient locations for seniors and high-risk adults in the community * serve as a referral resource to additional support services in the community for senior residents in sdc's east region * provide education and community resources to caregivers * maintain and grow partnerships with community organizations to expand community outreach and provide community members with updated information on available services and resources fy 2016 report of activities sharp senior resource centers meet the unique needs of seniors and their caregivers by connecting them - through email, phone and in-person consultations - to a variety of free and low-cost programs and services. The sharp senior resource centers' compassionate staff and volunteers provide personalized support and clear, accurate information regarding health education and screenings, community referrals and caregiver resources. In fy 2016, the sgh senior resource center developed and mailed quarterly calendars of its programs and services to more than 6,900 households in sdc's east region, as well as distributed approximately 4,000 vials of life - small vinyl sleeves that can be magnetically placed on a refrigerator to provide emergency personnel with critical medical information for seniors and disabled people. In fy 2016, the sgh senior resource center provided nearly 50 free health education programs at the sgh campus, the grossmont healthcare district conference center and several community sites in sdc's east region, reaching more than 1,100 community members. Professionals with expertise in a variety of areas presented programs, including physical therapy, psychology, nutrition, nursing, cardiology, advance care planning (acp), audiology, speech therapy, neuroradiology, and law, as well as by experts from community organizations. Educational topics included diet and fitness for a healthy heart, diabetes, healthy eating, senior services”

“Throughout fy 2016, the sgh senior resource center participated in as well as hosted health fairs and events throughout sdc's east region. Through these events, the sgh senior resource center provided blood pressure screenings as well as educational resources to nearly 2,100 community seniors and caregivers. Locations included the lakeside community center, fletcher hills recreation center, mission del magnolia mobile home park in santee, cameron's mobile estates in santee, johnson & johnson employee health fair, waterford terrace retirement community, jewish family service of san diego's college avenue center, la vida real, sonrise community church in santee, grossmont center, monte vista village, sgh and the mcgrath family ymca in spring valley. In addition, the sgh senior resource center served lesbian, gay, bisexual and transgender (lgbt) seniors at the san diego lgbt community center's (the center's) senior resource fair, where they provided blood pressure checks, vials of life, and caregiver and community resources. The sgh senior resource center also provided vials of life as well as health and community resources for seniors and caregivers at the sharp women's health conference held at the sheraton san diego hotel and marina. The sgh senior resource center continued to coordinate the notification of availability and provision of seasonal flu vaccines in selected community settings. Seniors, caregivers and high-risk adults with limited access to care were alerted through activity reminders, collaborative outreach conducted by the flu clinic site, sharp.com and paper and electronic newspaper notices. In fy 2016, the sgh senior resource center provided more than 650 seasonal flu vaccinations at 11 community sites to high-risk adults with limited access to health care resources, including seniors without transportation, those with chronic illnesses and caregivers. Sites included senior centers, community centers, churches, the salvation army, the sgh campus, senior nutrition sites and food banks. In september and october, the sgh senior resource center offered flu shots and caregiver resources to approximately 150 community members at the senior transportation and wellness expos at the la mesa community center, which highlighted transportation and safety information for seniors and caregivers. In addition to providing flu vaccinations at these sites, the sgh senior resource center provided its activity calendars detailing upcoming community events and programs, including blood pressure and flu clinics, health screenings, vials of life, community senior programs and telephone reassurance calls. At the food banks, the sgh senior resource center provided vaccines not only to seniors, but also to pregnant women and high-risk community members, many of whom were uninsured or had limited access to transportation. Throughout the year, the sgh senior resource center maintained active relationships with organizations that enhance professional networking in sdc's east region and provide quality programming for seniors. Organizations included the caregiver coalition of san diego (the caregiver education committee), the aging and disability resource connection, ecan, ecssp and meals on wheels greater san diego east county advisory board. Fy 2017 plan sgh senior resource center will do the following: * provide resources and support to address relevant concerns of community seniors and caregivers through in-person and phone consultations * provide community health information and resources through educational programs, monthly blood pressure clinics and at least five health screenings * collaborate with sharp experts and community partners to provide approximately 35 seminars that focus on issues of concern to seniors * provide six additional community presentations for senior services and caregiving * participate in 20 community health fairs and events targeting seniors * collaborate with the east county ymca, county of san diego ais a”

“* in 2013, 23 percent of all cancer deaths in sdc's east region were due to lung cancer, nine percent to colorectal cancer, six percent to female breast cancer, five percent to prostate cancer, and one percent to cervical cancer (livewell san diego, 2013). * in 2013, the age-adjusted death rates for colorectal, lung, and cervical cancer were higher in the east region than the age-adjusted death rates for these cancers in sdc overall. * by 2018, total cancer cases in sdc are expected to grow by 11.7 percent (california cancer registry, 2013; truven health analytics market discovery planning). * according to the american cancer society (acs) cancer statistics center, in 2016 there will be an estimated 26,730 new cases of breast cancer and 4,400 breast cancer deaths for females in california. * in 2013, the age-adjusted mortality rate of breast cancer in the east region was 19.7 per 100,000 population. In sdc overall, the rate was 20.1 per 100,000 population. This falls slightly below the hp2020 target of 20.7 breast cancer deaths per 100,000 women. * according to the cdc, from 2009-2013, sdc had an age-adjusted breast cancer incidence rate of 128.3 per 100,000 population. This is higher than the incidence rates for the same period in california or the u.s. (121.4 and 123.3, respectively). * according to the 2015 susan g. Komen for the cure(r) san diego affiliate community profile report, in sdc there were 46.1 late-stage cases of breast cancer per 100,000 women, exceeding the hp2020 target of 42.1 cases per 100,000 women. It is expected that sdc will take approximately five years to meet the hp2020 target. * according to the 2015 susan g. Komen for the cure(r) san diego affiliate community profile report, breast cancer mortality rates for african american women were the highest in sdc in 2013, at 27.7 deaths per 100,000. This exceeded the mortality rate for caucasian (23.9), latina (17.3), and asian/pacific islander (13.2). * the study findings from the 2015 susan g. Komen for the cure(r) san diego affiliate community profile report indicate a critical need for culturally competent outreach, especially for hispanic, middle eastern, and african american women. (susan g. Komen, 2015). * according to the 2015 susan g. Komen for the cure(r) san diego affiliate community profile report, approximately 81.9 percent of women in sdc between the ages of 50 and 74 reported having a mammogram in the past two years, exceeding the hp2020 target of 81.1 percent for breast cancer screenings. * according to a 2014 report from the acs, california cancer facts & figures, screening offers the ability for secondary prevention by detecting cancer early. Regular screening that allows for the early detection and removal of precancerous growth is known to reduce mortality for cancers of the cervix, colon, and rectum. Five-year relative survival rates for common cancers are 93 to 100 percent if they are discovered before having spread beyond the organ where the cancer began. * the american society of clinical oncology (asco) emphasizes the importance of patient navigators as part of a multidisciplinary oncology team with the goal of reducing mortality among underserved patients. Some of the tasks a patient navigator may assist with include: psychosocial support; assistance with treatment decisions; assistance with insurance issues; arrangement of transportation; coordination of additional services (i.e., fertility preservation); and tracking of interventions and outcomes. The navigator works with the patient across the care continuum, ensuring coordination and efficiency of care, and removal of barriers to care (asco, 2016). * according to the national institutes of health (nih), clinical trials are part of clinical research and are at the heart of all medical advances. Clinical trials look at new ways to prevent, detect or treat disease, with the goal to determine the safety and efficacy of a new test. Clinical trials also examine other aspects of care,”

“A variety of free support groups reached approximately 1,200 community members impacted by cancer. Offered twice per month, the breast cancer support group allowed women in all stages of breast cancer - from recent diagnosis to treatment to cancer survivor - to share experiences and discover coping strategies. The lung cancer support group was offered monthly to meet the educational and emotional needs of people living with or caring for someone with lung cancer. The group, provided encouragement and hope in a safe environment as well as an opportunity to explore important issues that arise when coping with any phase of treatment. The weekly art and chat support group offered cancer patients, survivors and their loved ones a combination of chat and relaxing drawing methods to increase focus, creativity, self-confidence and personal well-being. Two new support groups were offered by the sgh cancer in fy 2016, including a monthly man cave support group for men with cancer as well as a monthly knitting and crocheting support group for cancer patients and their loved ones to help promote relaxation, increase dexterity and cognitive skills, and manage pain. Furthering its support for those with cancer, the sgh cancer center continued to provide the wall of hope and inspiration - a special art installation created in 2015 for patients and visitors to write words of wisdom, advice and encouragement to those with cancer. The sgh cancer center continued to host educational classes at no cost for patients and community members facing cancer. Through the monthly survivorship lunch and learn series, community members, patients and families were invited to hear local experts speak about a unique cancer-related topic each month, such as coping with chemo brain, sexuality, adjusting to life after cancer, stress management, the role of genetics in cancer, and clinical trials - and participate in a question-and-answer session while enjoying a complimentary lunch. The series reached more than 10 individuals per session in fy 2016. The sgh cancer center also provided meeting space for the acs' look good...feel better classes, which teach women techniques to manage the appearance-related side effects of cancer treatment (e.g., hair loss, etc.) and boost self-confidence. Classes include a complimentary makeup kit and instruction from a licensed beauty professional on makeup application, skin care, and wearing wigs and headwear. Six classes were offered at the sgh cancer center in fy 2016, reaching approximately 36 women. Throughout the year, the sgh cancer center offered free workshops for patients and community members. This included free monthly advance care planning workshops provided in collaboration with sharp's acp program. Led by a trained acp facilitator, the workshops provided more than 40 community members with an overview of the acp process, basic tools to help define their personal health care choices, communication tips to begin the conversation with loved ones, and guidance with completing an advance health care directive. The sgh cancer center also offered a workshop focused on relaxation and quieting the mind to help cancer patients and their loved ones manage the stress, anxiety and difficult emotions that may accompany a cancer diagnosis. New in fy 2016, a managing sleep and fatigue workshop offered patients and their family members strategies to help relax, improve sleep and manage persistent fatigue, which is a common side effect both during and after cancer treatment. Also new in fy 2016, a chemo brain workshop: improving memory and concentration was offered to patients experiencing memory problems related to chemotherapy and other cancer treatments. The workshop provided more than 40 community members with tips and strategies to help manage and improve memory during and after cancer treatment. To help guide and support patients and their families before, during and after the course of treatment, the sgh cancer center team off”

“Two genetics counselors assist patients and family members at sgh and smh through risk assessment, counseling, genetics testing for personal and family history of cancer, and referrals for high-risk patients. From january 2015 to december 2016, the genetics counselors dedicated more than 3,100 hours to genetics counseling, including approximately 390 consultations and nearly 800 referrals. During this time period, there was a 60 percent increase in the number of referrals and a 61 percent increase in new patient consultations. The sgh cancer center's certified dietitian assists patients receiving radiation therapy or combined radiation and chemotherapy who are at high-risk for malnutrition. This most often includes patients with head and neck, esophageal, lung, pancreatic and pelvic cancers - including some cervical and rectal. In fy 2016, the dietitian provided one-on-one nutrition assessments, education and follow-up to more than 130 patients. The sgh cancer center conducts oncology clinical trials to support the discovery of new and improved treatments to help individuals overcome cancer and to enhance scientific knowledge for the larger health and research communities. In fy 2016, the sgh cancer center screened nearly 30 patients for participation in oncology clinical trials. As a result, 18 patients were enrolled in cancer research studies while more than 60 patients continued to receive follow-up care through the studies. In fy 2016, clinical trials focused on multiple types of cancer, including breast, lung, neurological, prostate, lymphomas and more. In fy 2016, the sgh cancer center supported learning opportunities for community physicians and other health care professionals through participation in a professional conference titled advances and controversies in melanoma and other skin cancers conference at the rancho bernardo inn - a free, conference sponsored by shc to promote strategies for skin cancer prevention and early cancer detection. The sgh cancer center provided cancer resources to approximately 90 attendees at the event. Fy 2017 plan the sgh cancer center will do the following: * continue to provide cancer education, resources and demonstrations on breast self-exams at community health fairs and events * continue to provide a free biweekly breast cancer support group for women in all stages of breast cancer * provide free community support groups, including a group for community members with lung cancer and their caregivers, a group for men with cancer, and an art-themed group * continue to host a free monthly lunch and learn educational series for cancer patients, survivors and their loved ones * provide six look good...feel better classes to help female cancer patients manage appearance-related side effects of cancer treatment * continue to provide ongoing personalized education, information, support and guidance to cancer patients and their loved ones as they move through the continuum of care * provide education and resources to the community with patient navigators for breast, colon, brain and gynecologic cancers as well as cancer patients with complex care needs * continue to connect individuals to services and community resources to assist them in managing their illness * in collaboration with the sharp acp program, continue to provide an advance care planning workshop to assist patients and community members with cancer, and their loved ones, in completing an advance directive * screen and enroll cancer patients in clinical trials for research studies * provide educational information on cancers and available treatments through community residents and community physician lectures * provide internships to nu radiation therapy students * offer a multi-session couples communication workshop on legacy planning including creating a life story and ethical will * offer a daylong workshop on medical cannabis * provide support groups and education for the chaldean and middle-eastern communities * provide a”

“* according to the cdc's 2016 breastfeeding report card, 58.5 percent of mothers in california were breastfeeding at six months, while only 24.8 percent were exclusively breastfeeding at six months (cdc, 2016). * according to the cdc's 2016 breastfeeding report card, breastfeeding provides many known benefits for infants, children, and mothers. The early postpartum period is a critical time for establishing and supporting breastfeeding, and women may need support from health care providers, family members and employers. * data show that mothers who experience more supportive practices (such as early breastfeeding initiation and limited supplementation) are more likely to breastfeed exclusively in the hospital and beyond. In california, 94 percent of mothers begin breastfeeding in the hospital, but 27 percent also feed their infants formula during their stay. In-hospital lactation support is crucial to mothers' breastfeeding success following discharge (california wic association and uc davis human lactation center, a policy update on california breastfeeding and hospital performance, 2016). * the american academy of pediatrics (aap) recommends that babies be exclusively breastfed for approximately the first six months of life, followed by continued breastfeeding with complementary foods for one year or longer (aap, 2012). * according to 2015 chis data, 36 percent of women ages 18 to 65 years in sdc's east region were obese (body mass index (bmi) > 30), which is higher than sdc overall (22.3 percent). * according to the california health care almanac, being overweight increases the risk of complications during pregnancy. In 2014, about one in four california mothers was obese or morbidly obese prior to pregnancy, and an additional one in four was overweight (california health care foundation (chcf), 2016). * according to a study in the jama, one in seven women have depression in the year after they give birth (jama, 2013). * according to the cdc, maternal health conditions that are not addressed before pregnancy can lead to complications for the mother and the infant. Several health-related factors known to cause adverse pregnancy outcomes include uncontrolled diabetes around the time of conception, maternal obesity, maternal smoking during pregnancy and maternal deficiency of folic acid (cdc, 2015). * contributing factors associated with preterm birth include maternal age, race, socioeconomic status, tobacco and alcohol use, substance abuse, stress, high blood pressure, prior pre-term births, carrying more than one baby, infection and late prenatal care (cdc, 2015). Objectives * conduct outreach and education activities for women on a variety of health topics, including prenatal care and parenting skills * demonstrate best practices in breastfeeding and maternity care, and provide education and support to new mothers on the importance of breastfeeding * collaborate with community organizations to help raise awareness of women's health issues and services, as well as to provide low-income and underserved women in the san diego community with critical prenatal services * participate in professional associations related to women's services and prenatal health and disseminate research fy 2016 report of activities in fy 2016, the sgh women's health center provided education, outreach and support to help meet the unique needs of women, mothers and newborns throughout the community. Free support groups assisted women and families with the challenges and adaptations of having a newborn. Offered twice per week, the breastfeeding support group provided a comfortable environment to discuss the joys and challenges of breastfeeding as well as tips to improve breastfeeding success at home. Facilitated by rn lactation consultants, the group served more than 15 attendees per session in fy 2016, including fathers who were welcome to attend. A weekly postpartum support group, led by the sgh women's health center's social workers, supported appr”

“Staff contributed their expertise in breastfeeding measurement to a report developed by uc san diego's lactation supportive environments initiative titled breastfeeding measurement in the outpatient electronic health record: current practices and future possibilities. The report became available for distribution in april 2016. In addition, in 2015, the sgh prenatal clinic joined the breastfeeding-friendly community health centers project (bfchc) - an initiative of sdc's live well san diego and funded through a grant from the first 5 commission of san diego. Through the bfchc collaboration, the sgh prenatal clinic was selected out of six participating clinics as the pilot clinic to help establish baby-friendly usa guidelines around breastfeeding during the prenatal period and after discharge, and support other prenatal clinics in achieving baby-friendly usa standards. Though the pilot program ended in 2016, sgh continues its collaboration in the bfchc to ensure sustainability of the model. Sgh delivers more than 800 babies from community clinics each year. The sgh prenatal clinic offers a variety of prenatal support for high-risk and underserved women in sdc. Throughout fy 2016, sgh prenatal clinic midwives provided in-kind help at neighborhood health centers in el cajon to support the underserved population in sdc's east region. This included approximately 1,570 hours of care for pregnant women five days per week. The sgh prenatal clinic also continued to participate in the california department of public health (cdph) comprehensive perinatal services program to offer comprehensive prenatal clinical and social services to low-income, low-literacy women with medi-cal benefits. Services included health education, nutritional guidance, and psychological and social issue support as well as translation services for non-english-speaking women. Nutrition classes were offered as part of this effort in order to reduce the number of women who reach gestational diabetic criteria. Women with a current diabetes diagnosis were referred to the sgh diabetes education program, while those with nutrition issues were referred to an sgh rd or the sgh diabetes education program as appropriate. At-risk women with elevated bmis received education and glucometers in order to measure their blood sugar and prevent the development of gestational diabetes. In addition, education on gestational diabetes was provided to pregnant members of the community. The sgh women's health center continued its partnership with vista hill parentcare to assist drug-addicted patients with psychological and social issues during pregnancy. These approaches have been shown to reduce both lbw rates and health care costs in women and infants. The sgh women's health center also provided women with referrals to a variety of community resources, including, but not limited to, california teratogen information service (ctis), wic, and the sdc public health nurse. In fy 2016, the sgh women's health center participated in and partnered with several community organizations and advisory boards for maternal and child health, including the local chapter of the association of women's health, obstetric and neonatal nurses (awhonn); wic; ctis; partnership for smoke-free families; san diego county breastfeeding coalition advisory board; the beacon council's patient safety collaborative; acnl; the regional perinatal care network; perinatal safety collaborative; american association of critical-care nurses - clinical scene investigator academy; and the public health nurse advisory board. The sgh women's health center also recently joined the california maternal quality care collaborative to improve morbidity and mortality in women as well as the california perinatal quality care collaborative to improve antibiotic stewardship in the nicu. Fy 2017 plan sgh will do the following: * provide free breastfeeding, postpartum and new parent support groups * provide parenting education classes * partic”

“* according to the cdc, some of the leading causes of preventable death include obesity-related conditions, such as heart disease, stroke, type 2 diabetes, and certain types of cancer. Between 2011 and 2014, 36.5 percent of americans were obese (cdc, 2015). * some of the risk factors for developing osteoporosis include body size, family history, age, sex hormone deficiencies, diet low in calcium and vitamin d, certain medications, physical inactivity, smoking and excessive alcohol use (nih, 2014). * according to the cdc, more than 95 percent of hip fractures are caused by a fall. Three-quarters of all falls are experienced by women, who are more likely to have osteoporosis, which causes weakened bones that are more likely to break (cdc, 2016). Objectives * provide a variety of health and wellness education and services at events and sites throughout the community * offer health and wellness education to the community through various media outlets fy 2016 report of activities throughout fy 2016, sgh participated in community events, offered presentations at neighborhood sites, and partnered with local media sources to educate community members about a variety of health and wellness topics. In may, staff from a range of hospital departments participated in sharp's annual women's health conference, where they offered wellness education and services to approximately 1,000 attendees. This included nutrition education, healthy food samples, and a presentation on intuitive eating from an sgh rd. At the conference, sgh also provided more than 300 community members with osteoporosis heel screenings, education on calcium and vitamin d requirements, and exercise tips for osteoporosis treatment and prevention. In fy 2016, sgh rd's provided more than 520 community members with nutrition handouts and healthy food samples, as well as answered nutrition-related questions at a health fair at sempra/sdg&e and sgh's heart health expo. In addition, in january, an sgh rd presented on eating well in the new year to approximately 60 community members at the sgh and smh senior resource centers. Sgh helped increase awareness about current news and trends impacting the health and safety of community members through television interviews on kusi news, kpbs and cw6 as well as through various radio stations and printed articles in the san diego union-tribune, the east county californian and east county gazette. Information was shared through these outlets by a bereavement counselor, acp specialist, infectious disease specialist, clinical lab scientist, chef and hospital physicians from a variety of specialties, including emergency medicine, urology, cardiology, and oncology. Topics included, but were not limited to, coping with grief during the holidays; kidney injuries; a new study that shows heart attack patients are younger and more obese; the importance of acp and completing an advance directive; knowing whether to choose the doctor's office, urgent care or the emergency room; heart health; the zika virus; the importance of vaccinations; the importance of managing hypertension at home; the increase in meth related issues in sdc; debunking common myths and misperceptions about donating blood; skin and breast cancer awareness and prevention; thanksgiving cooking tips, recipes and how to incorporate leftovers into new dishes; and eating healthier in the new year. Fy 2017 plan sgh will do the following: * continue to provide health and wellness offerings to community members at a variety of community events and other sites * continue to provide health and wellness education through local news sources identified community need: prevention of unintentional injuries rationale references the findings of the sgh 2016 chna, hasd&ic 2016 chna or the most recent sdc community health statistics unless otherwise indicated. Rationale * the hasd&ic 2016 chna continued to identify unintentional injury as one of the top priority health conditions seen in sdc hospitals.”

“Objective * offer an injury and violence prevention program for children, adolescents and young adults in sdc's east region fy 2016 report of activities in fy 2016, thinkfirst/sharp on survival participated in approximately 16 programs, serving nearly 1,700 elementary, middle and high school students in sdc's east region. The programs consisted of one- to two-hour classes covering topics such as the modes of injury, disability awareness, and the anatomy and physiology of the brain and spinal cord. The programs included personal testimonies from individuals with traumatic brain injury (tbi) or sci, known as voices for injury prevention (vips). Schools were offered additional opportunities for learning through a variety of lesson plans, including information on physical rehabilitation and careers in health care as well as disability awareness panels to meet the needs of specific class curricula. Specifically, elementary school students learned about the importance of using booster seats and helmets, proper pedestrian safety and safe practices while on the playground, and at-risk teens learned about the consequences of reckless driving, violence and poor decision making. With the partnership and financial support of the health and science pipeline initiative (haspi), the thinkfirst/sharp on survival program offered a variety of services to haspi teachers. These included classroom presentations, small assemblies and the opportunity to participate in a half-day tour of the smh rehabilitation center designed specifically for students interested in pursuing careers in health care. In total, more than 300 haspi students from schools in sdc's east region benefited from thinkfirst/sharp on survival education in fy 2016. Additionally, in fy 2016, thinkfirst/sharp on survival presented on injury prevention, tbi, sci and disability awareness to more than 1,200 college students in sdsu's disability in society courses. Fy 2017 plan thinkfirst/sharp on survival will do the following: * with funding support from grants, provide educational programming and presentations for local schools and organizations * using grant funding, increase community awareness of thinkfirst/sharp on survival through attendance and participation at community events and health fairs * as part of the haspi partnership, continue to evolve program curricula to meet the needs of health career pathway classes * grow partnership with haspi through participation in conferences, round table events and collaboration on letters of support for various funding opportunities * continue to provide booster seat education to elementary school children and their parents with funding support from grants * continue to provide college students with injury prevention education through sdsu's disability in society course and public health classes * explore further opportunities to provide education to health care professionals and college students interested in health care careers * as appropriate and with funding, continue to explore opportunities to utilize additional thinkfirst/sharp on survival curricula to serve varied populations throughout sdc's east region * as funding allows, explore educational opportunities on the basics of fall prevention for older adults * expand the reach of haspi tours to calexico and other imperial county areas identified community need: support during the transition of care process for high-risk, underserved and underfunded patients rationale references the findings of the sgh 2016 chna, hasd&ic 2016 chna or the most recent sdc community health statistics unless otherwise indicated. Rationale * as part of the sgh 2016 chna process, discussions with sharp's community-based care transitions program (cctp)/ cti staff identified the following strategies for improving the health of sdc's vulnerable, high-risk, or medically underserved patients: coaching; education about their disease and the health care system; education tailored to specific cultural and lingu”

“Objectives * connect high-risk, underfunded patients and community members to local resources and organizations for low-cost medical equipment, housing options and follow-up care * assist economically disadvantaged individuals through transportation and financial assistance for pharmaceuticals * collaborate with community organizations to provide services to chronically homeless individuals * through the cti pilot, provide high-risk, under and unfunded patients with health coaching, support and resources that address sdoh to ensure a safe transition home and maintained health and safety fy 2016 report of activities in fy 2016, sgh continued to provide post-acute care facilitation for high-risk patients, including individuals who were homeless or without a safe home environment. Individuals received referrals to and assistance from a variety of local resources and organizations. These groups provided support with transportation, placement, medical equipment, medications, outpatient dialysis and nursing home stays. Sgh referred high-risk patients, families, and community members to churches, shelters and other community resources for food, safe shelter and other resources. For unemployed, uninsured and underinsured patients, or for those who simply cannot afford the expense of a wheelchair, walker or cane due to a fixed income, sgh has committed to improving access to dme for high-risk patients upon discharge. Sgh case managers and social workers actively recruited dme donations from the community, providing more than 100 dme items to patients in need in 2016. To assist economically disadvantaged individuals, sgh provided more than $171,500 in free medications, transportation, lodging and financial assistance through its project help funds. These funds assisted more than 6,200 individuals in fy 2016. In addition, sgh pharmacists assisted more than 440 economically disadvantaged patients with more than 2,180 outpatient prescriptions valued at approximately $230,000. In addition, sgh continued to collaborate with community organizations to provide services to chronically homeless patients. Through its collaboration with the sdrm, sgh discharged chronically homeless patients to the sdrm's recuperative care unit. This program allows chronically homeless patients to receive follow-up care through sgh in a safe space, and also provides psychiatric care, substance abuse counseling and guidance from the sdrm's programs in order to help these patients get back on their feet. Beginning in 2014, sgh piloted a cti program for its high-risk, vulnerable populations, including, medi-cal, medi-cal pending/ presumptive, self-pay, no-pay, refugee populations, homeless and medicare a or b only patients. Modeled after the countywide community care transitions program established by cms to serve the medicare fee-for-service patient population at risk for readmission, the cti program provides 30-day coaching by an rn or medical social worker at no cost to vulnerable patients who are identified through a comprehensive risk assessment tool. The assessment tool evaluates patients for multiple factors including isolation, co-occurring health issues, food insecurity, behavioral health issues, and other conditions that impact their health and safety. The project team is a collaborative effort between various team members across sharp, including nurses, case managers, disease specialists as well as team members of shc community benefit, patient financial services (pfs), sgh's senior resource center, and others. The team ensures that vulnerable patients are connected with community resources and support to safely transition home, and keep them safe and healthy in the community. Partnerships with community organizations connect these patients to critical social services upon discharge, and have included fsd, food bank, 2-1-1, fhcsd, various churches, and refugee and other social support organizations. This outreach is critical for sustaining vulnerable patien”

“Cti patients referred to 2-1-1 are assessed on a variety of measures such as housing, nutrition, primary care, health management, social support, activities of daily living, ambulance use, transportation, income and employment. The risk assessment tool has identified the top needs as housing, food assistance and primary care services. The cti pilot and partnership with 2-1-1 has demonstrated a positive impact thus far. Since the inception of the partnership in march 2016, 51 patients have been referred to 2-1-1 and 21 patients have completed the program. For those patients, a 95 percent decrease in vulnerability and a 10 percent readmit rate of patients has been observed. Of the patients that were referred to 2-1-1 and completed the program from march to july, 2016 (n=21): * 17 percent decreased vulnerability regarding activities of daily living * 46 percent decreased vulnerability regarding ambulance use * 33 percent decreased vulnerability regarding health management * 25 percent decreased vulnerability regarding housing * 39 percent decreased vulnerability regarding income/employment * 31 percent decreased vulnerability regarding nutrition * 33 percent decreased vulnerability regarding primary care * 50 percent decreased vulnerability regarding social support * 27 percent decreased vulnerability regarding transportation follow-up surveys with patients who have completed the program reveal that, 100 percent of the patients agreed that the resources and information provided by 2-1-1 helped their situation and 69 percent felt confident or very confident in their care plan to manage their health. In recognition of its innovative care approach and tremendous results, sgh's cti program was selected to be highlighted by the health research and educational trust/robert wood johnson foundation's culture of health learning collaborative, which spotlights successful hospital-community organization partnerships to improve community health. Cti has also been recognized locally with the calfresh outreach partner and community collaborator award by the san diego hunger coalition's calfresh outreach task force. Fy 2017 plan sgh will do the following: * continue to provide post-acute care facilitation to high-risk patients * continue and expand the dme donations project to improve access to necessary medical equipment for high-risk patients who cannot afford dme * continue to administer project help funds to those in need * continue to collaborate with community organizations to provide medical care, financial assistance, and psychiatric and social services to chronically homeless patients * continue to provide high-risk, medi-cal and unfunded patients with cti health coaches and connection to resources, including resources to combat food insecurity, housing, and other sdoh * maintain and strengthen partnerships with fsd and 2-1-1 to strengthen the services of the cti program and support expansion of the program * explore opportunities to improve communication with community clinics identified community need: health professions education and training, and collaboration with local schools to promote interest in health care careers rationale references the findings of the sgh 2016 chna, hasd&ic 2016 chna or the most recent sdc community health statistics unless otherwise indicated. Rationale * according to the 2013 sdc healthcare shortage areas atlas from the hhsa, sdc is one of 27 counties in california listed as a registered nurse (rn) shortage area. * the 2014 labor market analysis by the san diego workforce partnership (sdwp) indicated that the occupations with the largest supply gaps were nursing assistants, home health aides, physician's assistants, clinical laboratory scientists, and laboratory technicians. * according to the sdwp, health care specialty occupations were expected to increase employment by 12 percent (7,466 jobs) between 2013 and 2018 in sdc. The top six growing health care occupations in 2014 were rns, home health aides”

“Fy 2016 report of activities sgh continued to collaborate with the grossmont union high school district (guhsd) in the health-careers exploration summer institute (hesi), providing high school students with opportunities for classroom instruction, job shadowing, observations and limited hands-on experiences. In fy 2016, 16 students shadowed staff for two weeks in a variety of hospital specialties, including women's health, laboratory, pulmonary, interventional radiology, pre- and post-operative surgery, the progressive care unit, radiology, pharmacy, supply chain/distribution, nutrition, infection control, the surgical waiting area/concierge, occupational and physical therapy, and the catheterization and hyperbaric laboratories. At the conclusion of the program, students presented their experiences as case studies to family members, educators and hospital staff. Those completing the program received high school credits equal to two summer school sessions. New in fy 2016, sgh provided three lectures to hesi students on the following topics: the sharp experience/patient experience at sgh, the importance of infection control in the hospital, and injury prevention and the importance of proper body mechanics to avoid injury. Sgh also continued its participation in the health sciences high and middle college (hshmc) program in fy 2016, providing early professional development for 180 students in ninth through 12th grades. Students spent approximately 23,600 hours shadowing staff in various areas throughout the hospital, including but not limited to progressive care units, food and nutritional services, oncology, acute care medical-surgical nursing, sterile processing, supply distribution, engineering, occupational and physical rehabilitation, endoscopy, women's health, cardiology, pharmacy, medical intensive care unit, surgical intensive care unit, the concierge as well as srs family practice, podiatry, specialty areas, and primary care. In addition, sgh staff provided students instruction on educational requirements, career ladder development and job requirements. At the end of the academic year, sgh staff provided the students, their loved ones, community leaders and hospital mentors with a symposium that showcased the lessons learned throughout the program. Throughout the academic year, sgh provided more than 950 students from colleges and universities throughout san diego with various placement and professional development opportunities. More than 730 nursing students spent nearly 64,700 hours at sgh, including time spent both in clinical rotations and individual preceptor training, while more than 215 ancillary students spent more than 50,100 hours on the sgh campus. Academic partners included alliant university; apu; california northstate university; california state university fresno; california state university long beach; california state university northridge; california state university san marcos; casa loma college; chamberlain college; concorde career college; emsta college; florida international university; grand valley state university; grossmont college; grossmont health occupations center; loma linda university; national university; palomar college; pima medical institute; point loma nazarene university (plnu); san diego city college; san diego mesa college; sdsu; southwestern college; touro university; university of new hampshire; university of phoenix; ucsd; university of san diego; university of southern california; university of st. Augustine; university of the pacific; villanova university; western university; and westmed college. In addition, sgh offered professional development lectures to 30 plnu students on nutrition. Further, the sgh cancer center provided internships to two national university radiation therapy students. Lastly, in july, the sgh cancer center shared best practices with staff members from borrego health - centro medico el cajon, including providing optimal care for breast cancer patients a”

“* other benefits for the broader community included a variety of end-of-life support for seniors, families, caregivers and veterans in the san diego community, such as education, support groups and outreach at community health fairs and other events. Sharp hospicecare staff actively participated in community boards, committees and civic organizations, including san diego county coalition for improving end-of-life care (sdcceolc), caregiver coalition of san diego, san diego county hospice-veteran partnership (hvp), california hospice and palliative care association (chapca), national hospice and palliative care organization (nhpco), southern caregiver resource center (scrc), san diego regional home care council (sdrhcc), san diego community action network (sandi-can), north county community action network (norcan), south county action network (socan), east county senior service providers (ecssp), san diego chapter of the hospice and palliative nurses association (hpna), san diego physician orders for life-sustaining treatment (polst) coalition/san diego coalition for compassionate care (sdccc), and san diego county medical society bioethics commission. See appendix a for a listing of sharp's involvement in community organizations in fy 2016. The category also incorporated costs associated with community benefit planning and administration, including community health needs assessments. * health research, education and training programs included time devoted to education and training for health care professionals, student and intern supervision and generalizable health-related research projects that were made available to the broader health care community. Definition of community sharp hospicecare is located at 8881 fletcher parkway in la mesa, zip code 91942. Sharp hospicecare provides comprehensive end-of-life hospice care, specialized palliative care and compassionate support to patients and families throughout sdc. For shc's 2016 community health needs assessment (chna) process, the dignity health/truven health community need index (cni) was utilized to identify vulnerable communities within the county. The cni identifies the severity of health disparity for every zip code in the united states of america (u.s.) based on specific barriers to health care access, including education, income, culture/language, insurance and housing. As such, the cni demonstrates the link between community need, access to care, and preventable hospitalizations. According to the cni, communities served by sharp hospicecare with especially high need include, but are not limited to, east san diego, city heights, north park, the college area, and downtown san diego. Description of community health in sdc in 2015, 96.7 percent of children ages 0 to 11, 94.9 percent of children ages 12 to 17, and 88.9 percent of adults ages 18 to 64 had health insurance - failing to meet the healthy people 2020 (hp2020) national targets39 for health insurance coverage. See table 24 for a summary of key indicators of access to care and table 25 for data regarding medi-cal eligibility. In sdc in 2015, 15.6 percent of adults ages 18 to 64 did not have a usual source of care and 12.3 percent of these adults had health insurance. In addition 22.5 percent reported fair or poor health outcomes. Further, 45.2 percent of adults ages 18 to 64 living at 200 percent below the federal poverty level (fpl) reported as food insecure. Table 24: health care access in sdc, 2015 current health insurance coverage: children 0 to 11 years rate - 96.7% year 2020 target - 100% children 12 to 17 years: rate - 94.9% year 2020 target - 100% adults 18 to 64 years: rate - 88.9% year 2020 target - 100% regular source of medical care: children 0 to 11 years: rate - 95.1% year 2020 target - 100% children 12 to 17 years: rate - 84.6% year 2020 target - 100% adults 18 to 64 years: rate - 84.4% year 2020 target - 89.4% not currently insured: adults 18 to 64 years: rate - 11.1% source: 2014-2015 california”

“Rationale * in sharp's 2016 chnas, senior health was identified as one of the priority health issues for community members served by sharp. * as part of sharp's 2016 chnas, discussions held with social workers and nurses from sharp's senior health centers identified the following challenges to improving the health of seniors in sdc: access to care issues due to aging, decreased driving or loss of support system; difficulty purchasing medications due to financial issues, lack of transportation or lack of motivation; difficulty understanding medical instructions; inability to recognize a health problem exists; memory issues; and the perception that health issues and loneliness are a normal part of aging. * information presented by the institute of medicine (iom) indicates that improving the quality and availability of medical and social services for patients may contribute to a more sustainable care system, in addition to improving quality of life through the end of life. The u.s. Population is rapidly aging and becoming increasingly culturally diverse which increases the need for responsive, patient-centered care. Current limitations to effective end-of-life care include barriers in access to care that disadvantage certain groups, and misalignment between the services patients and families need and those they are able to obtain (iom, 2014). * seniors are at high risk for developing chronic illnesses and related disabilities, and chronic conditions are the leading cause of death among older adults (cdc and merck company foundation, 2007). Significant health issues for seniors include obesity, diabetes mellitus, stroke, chronic lower respiratory diseases, influenza and pneumonia, mental health issues (including dementia and alzheimer's disease), cancer, and heart disease (san diego association of governments, 2014). Nationwide, about 80 percent of seniors are living with at least one chronic condition, while 50 percent of seniors have two or more chronic conditions, thus increasing their need for care (county of san diego health and human services agency (hhsa), 2013; cdc, 2016). * those caring for a close relative, such as a spouse or parent, are at a much greater risk of declining health as a result of caregiving (national alliance on caregiving & aarp, 2015). One in three caregivers of someone age 50 or older says a health care provider, such as a doctor, nurse, or social worker, has asked about what was needed to care for their recipient, while only 16 percent say a health care provider has asked what they need to care for themselves. In addition, one in four caregivers report it is very difficult to get affordable care services in their loved one's community to help with their care (pew research center, 2010). * in sdc overall, there were 416,568 residents (13.0 percent of the sdc population) aged 65 years or older in 2015. Between 2015 and 2020 sdc's senior population is expected to grow by 22.0 percent. * in 2014, there were an estimated 3.4 million family caregivers in california, according to the family caregiver alliance. * according to a report from the national alliance for caregiving and aarp titled caregiving in the u.s. 2015, an estimated 34.2 million adults have provided unpaid care to an adult age 50 or older in the past 12 months. Sixty percent of unpaid caregivers are female, and nearly one in 10 caregivers are age 75 or older (aarp and the national alliance for caregiving, 2015). * about six in 10 caregivers assist with medical/nursing tasks for their loved one, and 42 percent of these caregivers are performing those tasks without any preparation. According to caregiving in the u.s. 2015, 84 percent of caregivers report that they could use more information or help on caregiving topics, with 87 percent of high burden caregivers indicating this need. The top four topics of concern to caregivers are keeping their loved one safe at home; managing their own emotional or physical stress; making end-of-life decisions”

“In march, sharp hospicecare participated in the smh senior resource center's free community conference titled caring for the caregiver, held at the point loma community presbyterian church. The conference educated approximately 25 seniors and family caregivers about the emotional issues of caregiving, how to address behaviors and improve communication with someone with dementia, proper transfer and lift techniques, and when to consider hospice care. In april and may, sharp hospicecare partnered with schhc and the smh and sgh senior resource centers to provide three aging conferences for community seniors and their families. Titled life's transitions: changing health care needs through the years, the conferences were held at the point loma community presbyterian church, the la mesa community center and the coronado public library. The free conferences provided approximately 300 community members with education from sharp hospicecare leadership and other community health experts on how to approach aging from a healthier perspective with an alert mind, vitality and a plan for the future. In september, sharp hospicecare and socan hosted the live stronger longer: conference for seniors and caregivers at the kimball senior center in national city. The free conference provided approximately 125 seniors and their caregivers with valuable information on how to care for themselves and their loved ones. The event included a variety of community resource agencies, free flu shots, and presentations on topics such as asking your doctor the right questions, completing an advance health care directive (advance directive), detecting fraud, developing healthy eating habits, getting fit at any age, and managing depression. In addition, the scrc offered free respite care to seniors in their homes while their loved ones attended the conference. Sharp hospicecare partnered with the caregiver coalition of san diego and other community organizations to provide several conferences throughout sdc for approximately 300 community members who are providing care for a friend or family member. Conferences included navigating the insanity of caregiving held at st. Paul's plaza in chula vista; don't get spooked by the aging process held at the temple adat shalom in poway; the art of caregiving held at temple solel in cardiff by the sea; protecting yourself and your loved ones held at st. Paul's plaza senior community in chula vista; let's talk dementia: finding the balance in caregiving held at the la mesa community center; and challenges in the art of caregiving held at the first united methodist church of san diego. The free conferences included resource booths as well as speakers on a variety of caregiving topics, including alzheimer's disease; senior housing and care options; how to handle grief, fear, illness and loss in a spiritual way; how to have a positive experience as a caregiver; legal and financial planning; reducing caregiver stress; managing difficult conversations; acp; protecting against elder abuse, theft and scams; legal and financial dementia care planning; caring for your loved one's personal needs; and self-care. Sharp hospicecare participated in numerous other community health fairs and events throughout the year, including the sharp senior resource center annual senior health and safety fair, college avenue senior center health fair, spring into healthy living at the mcgrath family ymca, st. Paul's senior services health fair, sharp women's health conference, sharp coronado hospital community open house, tour de cure, ecssp's 17th annual senior health fair at sonrise community church in santee, senior expo at the la mesa community center, healthfair saturday at grossmont center, celebrando latinas women's conference, dr. Daramola's health fair; san diego gas & electric (sdg&e) employee wellness fair, senior health fair at lakeside community center, quality of life fair, aging & independence services (ais) 2016 aging summit; and the sou”

“In november, sharp hospicecare participated in finding the balance in caregiving: caring for veterans, an educational seminar presented by the caregiver coalition of san diego and the city of la mesa. Held at the la mesa community center, the free event provided approximately 100 attendees with resource booths and educational presentations on caring for veterans and their caregivers. Sharp hospicecare honored the nation's veterans at various ceremonies and events in fy 2016. In august, sharp hospicecare participated in the hvp's keep the spirit of `45 alive event at the veterans museum and memorial center in balboa park. The annual ceremony is part of a nationwide commemoration and celebration of the end of world war ii and those who sacrificed their lives. In december, sharp hospicecare joined community members and local end-of-life care organizations in the annual wreaths across america wreath-laying ceremony at ft. Rosecrans to commemorate the vietnam war and honor the men and women who served as well as their families. As part of the whv program, sharp hospicecare celebrated patients who served in the u.s. Military in honor of veteran's day in november 2015 by holding 55 flag ceremonies from november 7 through 14. During the ceremonies, fellow veterans presented the patients with a u.s. Flag that was flown on the u.s.s. Midway aircraft carrier. In honor of the 75th anniversary of the attack on pearl harbor, sharp hospicecare wrote and mailed 150 thank-you notes to local veterans. Sharp hospicecare continued its wig donation program in fy 2016. Through the program, sharp hospicecare receives new, unused wigs from manufacturers, cleans and styles the wigs, and donates them to individuals experiencing hair loss due to cancer treatment and other illnesses. Sharp hospicecare team members offer private wig appointments for community members to select their wig and receive personalized wig fitting, styling and maintenance instructions. Surplus wigs are donated to other departments throughout sharp, including cancer patients at smh and the douglas & nancy barnhart cancer center at scvmc. In fy 2016, 25 community members received free wigs from sharp hospicecare, with a total donation of 175 wigs. Fy 2017 plan sharp hospicecare will do the following: * continue to collaborate with a variety of local networking groups and community-oriented agencies to provide education and resources for community members on advanced illness management and end-of-life care * collaborate with schhc and the sharp senior resource centers to host three free aging conferences, reaching 100 community members per conference * continue to support the needs of military veterans and their families through the provision of education and resources at veteran-oriented community events and collaboration with local and national organizations advocating for quality end-of-life care for veterans * achieve whv level iii partners to develop and strengthen relationships with va medical centers and other veteran organizations and community hospices * begin working towards whv level iv partners to increase access and improve quality of care for veterans in the community * continue to provide a wig donation program identified community need: advance care planning education and outreach to community members and health care professionals rationale references the findings of sharp's 2016 chnas, hasd&ic 2016 chna or the most recent sdc community health statistics unless otherwise indicated. Rationale * the shc 2016 chnas identify care at the end of life as a critical issue for the senior population. * discussions held with sharp cancer patient navigators as part of sharp's 2016 chnas indicated the following major challenges to helping oncology patients: difficulty of having end-of-life conversations, which may be due to cultural variation, or lack of physician experience with palliative care; and few individuals having an advance directive. * according to the iom, there is a”

“Objectives * provide education, engagement and consultation for community members on acp and polst * educate community health care professionals on acp and polst * empower community members to make informed health care decisions fy 2016 report of activities shc offers a free and confidential acp program to support community members as they consider their future health care options. Facilitated by sharp hospicecare, the acp program empowers adults of any age and health status to explore and document their beliefs, values and goals as they relate to health care. The program consists of three stages. Stage one, community engagement, focuses on bringing awareness to healthy community members about the importance of acp. This stage includes basic education and resources, identification of an appropriate health care agent, and completion of an advance directive. Stage two, disease-specific outreach, focuses on education for community members with a progressive chronic illness, including decline in functional status, co-morbidities, potential for hospitalization and caregiver issues. With a goal of anticipating future needs as health declines, this stage focuses on developing a written plan that identifies goals of care, and involves the health care agent and loved ones. The third stage, late-life illness outreach, targets those with a disease prognosis of one year or less. Under these circumstances, specific or urgent decisions must be made and converted into medical orders that will guide the health care provider's actions and be consistent with goals of care. The focus of this stage is to assist the individual or appointed health care agent with navigating complex medical decisions related to immediate life-sustaining or prolonging measures, including completion of the polst form, a legal document designed for individuals with advanced progressive or terminal illness that specifies care preferences in an emergency medical situation. Since 2014, shc has offered the sharp healthcare advance directive to guide the public in outlining their health care decisions. The document is publicly available on sharp's website in both english and spanish, and uses easy-to-read language to describe what an advance directive is and how and why to complete one. The form allows individuals to put their health care wishes into writing and to appropriately sign the advance directive. With this signature, the advance directive becomes a legal document that can be used as a tool for health care decision-making. Additional contact information is provided for community members who are interested in speaking with a sharp acp facilitator. Throughout fy 2016, the sharp acp team provided more than 140 phone and in-person consultations to community members seeking guidance with identifying their personal goals of care and health care preferences, appointing an appropriate health care agent, and completing an advance directive. In addition, the team engaged more than 2,000 community members and caregivers in education on acp and polst at a variety of community sites, including health fairs, senior centers, homecare agencies, churches and seminars. Audiences included, but were not limited to, elk's lodge senior health and resource fair; san ysidro senior center; norman park senior center; ramona library; national city public library; san diego continuing education - cesar chavez campus; senior gifford clinic at the university of california, san diego (ucsd) health fair; san diego lgbt community center; casa familiar community development agency; center for community solutions; all souls episcopal church; veterans education and resource fair; december nights; sdg&e employee wellness fair; salvation army; silver crest senior residence; glenner memory care center chula vista; st. Pauls' senior services; fairbanks square senior apartments; rachel's women's center; san diego pace (program of all-inclusive care for the elderly); california state retirees; alpine commu”

“Beginning in fy 2016, the sharp hospicecare acp team joined san diego health connect, county ais, health services advisory group, emergency medical services, and various health care providers in sdc to ensure that community members have access to advance directive and polst forms in emergency situations through the san diego healthcare information exchange - a countywide program that securely connects health care providers and patients to private health information exchanges. In addition, the sharp hospicecare acp team participates in an initiative funded by the california health care foundation (chcf) - and supported by the cccc and california emergency medical services authority (emsa) - to create an electronic polst registry (polst eregistry). When a paper polst form is not readily available during an emergency, the patient's care may be hindered or conflict with their wishes. The polst eregistry will improve access to critical information through a cloud-based registry for completed polst forms to be securely submitted and retrieved. Fy 2017 plan sharp hospicecare will do the following: * continue to provide free acp and polst education and outreach to community members through phone and in-person consultations * collaborate with community organizations to provide educational classes and events to raise community awareness of acp * in collaboration with sdccc and sdcceolc, provide community events to promote the importance of acp in honor of nhdd * continue to provide acp education and outreach to local, state and national health care professionals * continue to serve as a community resource regarding the end of life option act * continue to collaborate with community partners to provide community members with access to advance directive and polst forms through the san diego healthcare information exchange * participate in the chcf's polst eregistry initiative with cccc and emsa identified community need: health professions and student education and training, and volunteer training rationale references the findings of sharp's 2016 chnas, hasd&ic 2016 chna or the most recent sdc community health statistics unless otherwise indicated. Rationale * according to the 2013 sdc healthcare shortage areas atlas from the hhsa, sdc is one of 27 counties in california listed as a registered nurse (rn) shortage area. * direct-care workers in california are responsible for providing 70 to 80 percent of the paid hands-on long-term care for older adults or those living with disabilities or other chronic conditions (eldercare workforce alliance, 2014-15). * the san diego workforce partnership (sdwp) recommends programs that provide volunteer experiences to high school and postsecondary students, as on-the-job training could provide real world experience for workers. Programs that target underrepresented groups and disadvantaged students could help increase the number of culturally competent health care workers (sdwp, 2011). * a march 2014 report from the california hospital association (cha) titled critical roles: california's allied health workforce follow-up report emphasizes the importance of local hospitals providing clinical training for nurses and allied health professionals, as well as programs to support mentoring and hospital work experience for interns and high school students. In the coming decades, such programs will have a tremendous impact on the lives of individuals, families and communities as a result of dedicating time and resources to the thousands of interns and high school students who gain valuable work experience and career exposure by spending time in california hospitals. * the u.s. Bureau of labor statistics (bls) projects that the demand for home health aides will grow 38.1 percent from 2014 to 2024. Older individuals often have health problems and need help with daily activities. As the u.s. Population ages, the demand for home health aides will continue to increase (bls, 2014). * in their 2014 occupational outlo”

“Each year, the sharp acp team supports san diego's future health care workforce through lectures and professional training opportunities. In fy 2016, the team provided one-on-one supervision to students from the university of san diego, national university and the university of california, irvine. The acp team also provided introductory education on acp, polst, hospice, bioethics and goals of care to more than 400 students, including nursing students from azusa pacific university, sdsu, and california state university san marcos (csusm); social work students from university of southern california; san diego mesa college students; and advanced placement psychology students at valhalla high school. In addition, the sharp hospicecare bereavement team presented on grief, loss and bereavement to psychiatric nursing students from csusm, while, in april, sharp hospicecare joined the csusm institute for palliative care to provide a being mortal film screening and post-film discussion panel on beginning end-of-life discussions for approximately 50 students, staff and faculty. Sharp hospicecare leadership provided education, training and outreach to local, state and national health professionals throughout the year. These efforts sought to guide industry professionals in achieving person-centered, coordinated care through the advancement of innovative hospice and palliative care initiatives. Audiences included cape cod healthcare quality of life management summit; chapca; delaware valley accountable care organization conference; bit third annual world congress of geriatrics and gerontology; rainbow hospice care; outcome resources pharmacy benefit management solutions; the annual assembly of the american academy of hospice and palliative medicine and hpna; winneshiek medical center palliative care conference; cccc annual summit; csusm institute for palliative care and sdccc palliative care across the continuum conference; harvard law school; and caregiver coalition of san diego. Presentation topics included palliative care economics, advanced illness management, geriatric frailty, prognostication, delirium and treatments, acp and polst. Sharp hospicecare leadership continued to serve on the board, and as a state hospice representative, for the nhpco and chapca in fy 2016. In august, sharp hospicecare leadership received the dorris a. Howell md, award for advancing palliative care in recognition of their achievements in and contributions to improving palliative care in the community. In june, sharp hospicecare participated in sharp healthcare's continuing education conference titled advanced illness management: an integrated approach across the continuum of care. The free conference educated approximately 100 physicians, nurses, social workers, chaplains, bereavement counselors, other interested health care providers and community members on what advanced illness management means in today's health care environment, tools to facilitate improved care coordination and planning, and communication strategies to help guide difficult conversations. In addition, sharp hospicecare provided education, resources and support at the sharp healthcare osteopathic medicine conference, sharp healthcare pulmonary conference and sgh seventh annual heart and vascular conference; sharp hospicecare continued to provide volunteer training opportunities in fy 2016. Hospice volunteers are often working towards a career in the medical field. In addition to gaining knowledge and experience through volunteering, hospice volunteers provide valuable support to hospice organizations and those they serve, including companionship to those near the end of life, family and caregiver support, and community outreach. Sharp hospicecare trained approximately 80 new volunteers in fy 2016. In addition, 13 teenagers were trained through sharp hospicecare's teen volunteer program while volunteer opportunities were extended to 17 premedical students from point loma nazarene univers”

“* according to a 2013 study published in the journal of palliative medicine (jpm), many caregivers may benefit from bereavement support, as 12 to 40 percent of caregivers experience poor psychological outcomes, including depression and complicated grief, six months to one year following loss. Targeting services to caregivers at risk for poor psychological well-being following loss may facilitate effective use of hospice bereavement services (jpm, 2013). * according to a 2014 study published in the journal of hospice and palliative nursing (jhpn), family caregiver descriptions of bereavement adaptation revealed significant themes related to social support in bereavement, including support from professional health care providers, both for themselves and their family member during palliative and hospice care. Risk factors for poor bereavement adaptation included length of time in the caregiver role; loss of an adult child; loss of spouse; and history of multiple losses (jhpn, 2014). Objectives * provide bereavement education, resources, counseling and support to community members who have lost loved ones * provide individuals and their families referrals to community services * provide the memory bear program to support community members who have lost loved ones fy 2016 report of activities throughout fy 2016, sharp hospicecare offered a variety of bereavement service options to help grieving community members learn effective ways to cope with the loss of a loved one. Services included professional bereavement counseling for individuals and families as well as free community education, support groups and monthly newsletter mailings. In fy 2016, sharp hospicecare devoted more than 2,700 hours to home, office and phone counseling with patients and their loved ones, providing them with bereavement counseling services from licensed clinical social workers with specific training in grief and loss. Sharp hospicecare's bereavement counselors also provided referrals to community counselors, mental health services, and other bereavement support services and community resources as needed. Sharp hospicecare continued to offer the healing after loss and the widow's and widower's bereavement support groups, reaching more than 180 community members in fy 2016. Offered quarterly, the groups consisted of eight-week sessions facilitated by skilled mental health care professionals specializing in the needs of the bereaved. The healing after loss support group focused on practical concerns of adults who are grieving the loss of a loved one. Weekly themes included introduction to the grief process; strategies for coping with grief; communicating with family and friends; experiencing anger in grief; guilt, regret and forgiveness; differentiating natural grief and depression; use of ceremony and ritual to promote healing; and who am i now?/what does healing look like?. The widow's and widower's support group helped address concerns of men and women who have lost their spouse. Participants were able to share their emotional challenges and learn coping skills from group members in similar life situations. In fy2016, sharp hospicecare offered support to adults grieving the loss of a parent through two remembering our parents classes. Held at the all souls' episcopal church in point loma in april and at the grossmont healthcare district conference center in may, the classes helped more than 50 attendees to recognize the scope of their loss, allow time to grieve, maintain their own health, and honor their parent as mother's day and father's day approached. Other bereavement presentations in fy 2016 included grief, healing and self care for residents at lohar lodge nursing home and good grief: the truth about grief, healing, and how to provide meaningful support at the sharp women's health conference. Sharp hospicecare supported approximately 100 community members grieving the loss of a loved one during the 2015 holiday season. In november, sharp hospicecar”

“* california association of physician groups * california board of behavioral health sciences * california college san diego * california maternal quality care collaborative * california department of public health * california dietetic association, executive board * california emergency medical services authority * california health care foundation * california health information association * california hospice and palliative care association * california hospital association center for behavioral health * california hospital association * california hospital association emergency management advisory committee * california library association * california perinatal quality care collaborative * california state university san marcos * california teratogen information service * caregiver coalition of san diego * caring hearts medical foundation * center for community solutions * check your mood committee * chelsea's light foundation * chicano federation of san diego county * community health improvement partners (chip) behavioral health work team * chip health literacy task force * chip independent living association advisory board and peer review advisory team * chip suicide prevention work team * chula vista chamber of commerce * chula vista police foundation * city of chula vista wellness program * city of san diego * city of san diego park & recreation - therapeutic recreation services disabled services advisory council * combined health agencies * community center for the blind and visually impaired * community emergency response team * consortium for nursing excellence, san diego * coronado fire department * coronado public library * coronado safe (student and family enrichment) * coronado senior center planning committee * council of women's and infants' specialty hospitals * county of san diego emergency medical services * cvs minuteclinics * cycle eastlake * downtown san diego partnership * east county action network * east county senior service providers * emergency nurses association, san diego chapter * employee assistance professionals association * emsta college * family health centers of san diego * feeding san diego * gary and mary west senior wellness center * girl scouts san diego * girls with goals * greater san diego east county advisory board * grossmont college * grossmont health occupations center * grossmont healthcare district * grossmont imaging llc board * grossmont union high school district * health care communicators board * health insurance counseling and advocacy program * health sciences high and middle college (hshmc) * helen woodward animal center * home start, inc. * hospital association of san diego and imperial counties (hasd&ic) * hasd&ic community health needs assessment advisory group * hshmc board * hunger advocacy network * i love a clean san diego * inner city action network * international association of eating disorders professionals * the jacobs & cushman san diego food bank * kiwanis club of chula vista * la maestra community health centers * la mesa lion's club * la mesa park and recreation foundation board * las damas de san diego international nonprofit organization * las patronas * las primeras * life rolls on foundation * lightbridge hospice community foundation * march of dimes * meals on wheels greater san diego * mended hearts * mental health america * mental health first aid program - mha of san diego * miracle babies * mri joint venture board * national active and retired federal employees association * national alliance on mental illness * national association of neonatal nurses * national association of hispanic nurses, san diego chapter * national hospice and palliative care organization * national institute for children's health quality * national kidney foundation * national university * neighborhood healthcare * north san diego business chamber * pacific arts movement * peninsula shepherd senior center * perinatal safety collaborative * perinatal social work clust”