Sharp Chula Vista Medical Center

“Pablo velez and richard king were directors on the governing board of the san diego imaging-chula vista joint venture. Director walter olsen, m.d., is a partner in the medical group that owns 50% of the san diego imaging-chula vista joint venture. Directors steve brozinsky, m.d. And errol korn, m.d. Have a business relationship. Directors hugo barerra, m.d., walter olsen, m.d. And philip zentner, m.d. Have a business relationship. Director chris lewis has a business relationship with scott mcmillin. Director chris lewis has a business relationship with hugo barrera. Director chris lewis has a business relationship with lourdes valdez.”

“Sharp healthcare (fein 95-6077327) is the sole member of sharp chula vista medical center.”

“Sharp healthcare, as the sole member of the corporation, has the right to elect and remove most board members.”

“Sharp healthcare, as the sole member of the corporation, has the right to elect and remove most board members. Sharp healthcare also retains the approval rights afforded members for certain significant transactions (e.g. Dissolution or sale or transfer of all or substantially all of the assets).”

“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 accounting & tax, vice president of finance, senior vice president and chief financial officer, and entity chief financial officer. Additionally, the organization contracts with ernst & young, an independent accounting firm, for review of the form 990.”

“Sharp chula vista medical center has a written conflict of interest policy which has been reviewed and approved by the sharp chula vista medical center governing board, and this policy has been adopted by all sharp healthcare entities. Sharp chula vista medical center 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 2013.”

“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).”

“Independent contractors are paid under sharp healthcare's tax identification number (95-6077327) and are reported on sharp healthcare's tax return”

“To establish, operate and maintain a hospital or hospitals and related, associated and complimentary facilities and services, such as, but not limited to, skilled nursing, extended care, outpatient care, home care, and other health care programs, activities, services and facilities; to carry on wellness and health education and training activities, programs and services; to engage in activities designed to promote the general health of the community; and, generally to do anything and everything necessary, expedient or incidental to the foregoing.”

“Tax exempt bonds are issued for the sharp healthcare obligated group. As a result, the tax exempt bond balances are reported on the sharp healthcare return (ein 95-6077327). This organization's allocated portion is included in part x, line 25.”

“Tax exempt bonds are issued for the sharp healthcare obligated group. As a result, the tax exempt bond balances are reported on the sharp healthcare return (ein 95-6077327) and this organization has reported zero on form 990, part x, line 20 and has reported the allocated balance on line 25.”

“Change in minimum pension liability -2,872,532.”

“Form 5471 has been filed on behalf of sharp chula vista medical center by sharp healthcare (fein 95-6077327).”

“Fiscal year 2014 community benefits report section 1 an overview of 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; two affiliated medical groups; 21 medical clinics; five urgent care facilities; 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, 2014, sharp is licensed to operate 2,087 beds, and has approximately 2,600 sharp-affiliated physicians and nearly 17,000 employees. Four acute care hospitals: sharp chula vista medical center (343 beds) the largest provider of health care services in san diego's rapidly expanding south bay, sharp chula vista medical center (scvmc) operates the region'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, women and infants and the only bloodless medicine and surgery center in sdc. Sharp coronado hospital and healthcare center (181 beds) sharp coronado hospital and healthcare center (schhc) provides services that include sub-acute and long-term care, rehabilitation therapies, joint replacement surgery, and hospice and emergency services. Schhc is the largest provider of total joint surgeries in all of sdc. Sharp grossmont hospital (536 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, orthopedics, rehabilitation, robotic surgery, stroke care and women's health. Sharp memorial hospital (656 beds) a regional tertiary care leader, sharp memorial hospital (smh) provides specialized care in trauma, oncology, orthopedics, organ transplantation, cardiology and rehabilitation. Smh houses san diego's largest emergency and trauma center. Three specialty care hospitals: sharp mary birch hospital for women & newborns (206 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 private hospital in california. Sharp mesa vista hospital (149 beds) the largest private freestanding psychiatric hospital in california, sharp mesa vista hospital (smv) is a premier provider of behavioral health services. Sharp mcdonald center (16 beds) sharp mcdonald center (smc) is san diego county's only licensed chemical dependency recovery hospital. Collectively, the operations of smh, smbhwn, smv and smc are reported under the not-for-profit public benefit corporation of smh, and are referred to herein as the sharp metropolitan medical campus (smmc). The operations of sharp rees-stealy medical centers (srs) are included within the not-for-profit public benefit corporation of sharp, the parent organization. The operations of sgh are reported under the not-for-profit public benefit corporation of grossmont hospital corporation. Mission statement it is sharp's mission to improve the health of those it serves with a commitment to excellence in all that it does. Sharp's goal is to offer quality care and services that set community standards, exceed patients' expectations and are provided in a caring, convenient, cos”

“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 now 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: demonstrate and improve clinical excellence to set industry standards and exceed customer expectations. Keep patients, employees and physicians safe and free from harm. Create exceptional experiences at every touch point for customers, physicians and partners by demonstrating service excellence. Create a values-driven culture that attracts, retains and promotes the best and brightest people, who are committed to sharp's mission and vision. Achieve financial results to ensure sharp's ability to provide quality health care services, new technology and investment in the organization. Achieve consistent net revenue growth to enhance market dominance, sustain infrastructure improvements and support innovative development. Be an exemplary community citizen by making a difference in the community and supporting the stewardship of our environment. Awards sharp has received the following recognition: sharp is a recipient of the 2007 malcolm baldrige national quality award, the nation's highest presidential honor for quality and organizational performance excellence. Sharp was the first health care system in california and eighth in the nation to receive this recognition. Sharp was recognized as one of the 2013 world's most ethical (wme) companies by the ethisphere institute, the leading business ethics think-tank. The list highlights companies that outperform industry peers when it comes to ethical behavior. The 2013 wme companies are those that truly embrace ethical business practices and demonstrate industry leadership, forcing peers to follow suit or fall behind. Sharp was the only company in san diego named to the list. Sharp was named the no. 1 "best integrated health care network" in california and no. 12 nationally by modern healthcare magazine in 2012. The rankings are part of the "top 100 most highly integrated healthcare networks (ihn)," a survey conducted by health care data analyst ims health. This was the 14th consecutive year that sharp placed among the top in the state. Sharp healthcare was named "best hospital group" by u-t san diego readers participating in the paper's 2014 "best of san diego" readers poll, and sharp rees-stealy medical group was named "best medical group" in 2014. Sgh was named "best hospital," while smh and smbhwn were ranked second and fourth "best hospitals." sgh and smh have both received magnet 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 is accepted nationally as the gold standard in nursing excellence. Smh was re-designated in march 2013. Sharp was named one of the nation's "most wired" health care systems from 2012 to 2014, as well as from 1999 to 2009, by hospitals & health networks magazine's annual most wired survey and benchmark study. "most wired" hospitals are committed to using technology to enhance quality of care for both patients and staff. In july 2010, smh was named the "most beautiful hospital in america" by soliant health, one of the largest medical staffing companies in the country. With over 10,000 votes from visitors to the soliant health website, smh was”

“Sharp provides services to help every unfunded patient received in the emergency department (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 shc staff to have an informed and supportive discussion about health care coverage with the patient, empowering them with options. From the inception of the program in fy 2010 through september 2014, sharp helped guide approximately 70,200 self-pay patients through the maze of government health coverage programs while maintaining the patient's dignity throughout the process. In january, 2014 sharp hospitals implemented an onsite process for real-time medi-cal eligibility determinations (presumptive eligibility). Sharp was the first hospital system in san diego county to provide these services, and secured this benefit for 9,500 unfunded patients in the ed during fy 2014. In anticipation of covered california's roll out, 28 members of sharp's registration staff completed the state's certified enrollment counselor certification to better assist both patients and the general community navigate the covered california website (coveredca.com) and plan enrollment. In addition, three sharp hospitals scvmc, sgh, and smh qualify as covered entities for the 340b drug pricing program administered by the health resources and services administration (hrsa). Hospital participation in the 340b drug pricing program permits the purchase of outpatient drugs at reduced prices. The savings from this program are used to offset patient care costs for sharp's most vulnerable patient populations, as well as to assist patient access to medications through the patient assistance team. The patient assistance team works hard to help those in need of assistance gain access to free or low-cost medications. Patients are identified through usage reports, or referred through case management, nursing, physicians or even other patients. If eligible, uninsured patients are offered assistance, which can help decrease readmissions resulting from lack of medication access. The team members research all options available, including programs offered by drug manufacturers, grant-based programs offered by foundations, copay assistance and other low-cost alternatives. Sharp also continues to offer clearbalance a specialized loan program for patients facing high medical bills. Through this collaboration with san diego-based csi financial services, both insured and uninsured patients have the opportunity to secure small bank loans in order to pay off their medical bills in low monthly payments as low as $25 per month preventing unpaid accounts from going to collections. Through this program, sharp provides a more affordable alternative for patients struggling to resolve their hospital bills. In addition, sharp provides post-acute care facilitation for high-risk patients, including the homeless and patients lacking a safe home environment. Patients receive assistance with transportation and placement; connections to community resources; and financial support for medical equipment and medications, as well as outpatient dialysis and nursing home stays. Through collaboration with the san diego rescue mission, schhc, sgh and smh discharge their chronically homeless patients to the rescue mission's recuperative care unit, where patients not only receive follow-up medical care through sharp in a safe environment, but also receive psychiatric care, substance abuse counseling and guidance to help get them off the street. Community health screenings sharp's dedication to improving community health ext”

“Sharp mesa vista hospital nursing students 330 nursing group hours 25,457 nursing precepted hours 3,128 ancillary students 34 ancillary hours 16,524 total students 364 total hours 45,109 sharp hospicecare nursing students 96 nursing group hours 0 nursing precepted hours 768 ancillary students 1 ancillary hours 80 total students 97 total hours 848 sharp healthcare nursing students 368 nursing group hours 0 nursing precepted hours 55,730 ancillary students 197 ancillary hours 42,531 total students 565 total hours 98,261 health sciences high and middle college since 2007, sharp has been an industry partner with charter school health sciences high and middle college (hshmc) to provide students broad exposure to health care careers. Through this partnership, hshmc students connect with sharp team members through job shadowing to explore real world application of their school-based knowledge and skills. This collaboration prepares high school students to enter health, science and medical technology careers in the following five career pathways: biotechnology research and development, diagnostic services, health informatics, support services and therapeutic services. The hshmc program began in 2007 with students on the campuses of sgh and smh, and expanded to include smv and smbhwn in 2009, schhc in 2010, and scvmc in 2011. Hshmc students also devote time to various srs sites in san diego. New in fy 2014, hshmc students began their experience with a systemwide orientation to sharp healthcare and their upcoming job-shadowing activities. Throughout fy 2014, nearly 400 hshmc students were supervised for thousands of hours on various sharp campuses, where they rotated through instructional pods in specialty areas such as nursing, obstetrics and gynecology (ob/gyn), occupational therapy, physical therapy, behavioral health, surgical intensive care unit (sicu), medical intensive care unit (micu), imaging, rehabilitation, laboratory services, pharmacy, engineering, pulmonary services, cardiac services and operations. The 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. Hshmc students earn high school diplomas, complete college entrance requirements and have opportunities to earn community college credits, degrees or vocational certificates. Even with many of hshmc students facing financial hardship the free and reduced price meal (frpm) 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 2014, 91 percent of the hshmc graduating class went on to attend two- or four-year colleges, while 82 percent of students said they wanted to pursue careers in health care. In addition, hshmc has a 99 percent graduation rate, higher than california's 80 percent state average, as well as an academic performance index score of 827, exceeding the state's goal of 800. In addition, hshmc is a u.s. News & world report "best high schools" bronze award winner, a national school safety advocacy council award-winning school and is recognized by the california department of education as a title i academic achievement award winner and a california distinguished school. Each year, sharp healthcare reviews and evaluates the collaboration with hshmc to promote long-term sustainability. Lectures and continuing education sharp contributes to the academic environment of many colleges and universities in san diego. In fy 2014, sharp staff provided hundreds of academic hours in lectures, courses and presentations on numerous college and university campuses throughout san diego. Through the delivery of a variety of guest lectures, including pharmacy practice lectures, health information technology lectures at mc and usd, nutrition lectures at plnu, and a variety of health administration lectures to public health graduat”

“The ori has made it a priority to seek guidance and expertise from the local and national academic community on how to effectively conduct outcomes research, with the aim of improving patient and community health. This networking has resulted in collaborative research partnerships with investigators at national university (nu) and sdsu. In addition, the ori student research intern program offers advanced nursing and public health students an opportunity to learn about and become involved in outcomes research. Since its inception in 2011, the ori has successfully graduated nine interns. Interns have presented ori-sponsored posters throughout san diego to educate students on the importance of research to develop evidence-based practice. In order to develop and promote best practices across the health care community, the ori has conducted numerous research studies to identify the benefit and outcomes of quality patient care. This includes recently completed feasibility studies examining: * the association of perfect adherence to heart failure quality care measures for hospitalized patients with readmission and mortality rates * sharp hospicecare's transitions chronic disease management program influence on advanced heart failure patient care patterns, including regular and acute care utilization (ed use, overall hospitalization rates) and costs * the association of a 90-day remote-monitoring program with acute care utilization (including readmission rates and use of ed) for underserved heart failure and chronic obstructive pulmonary disease (copd) patients compared to a similar but untreated patient sample * the predictive capacity of evidence-based and sharp physician-identified clinical factors for identifying patients at risk for poor blood sugar control when hospitalized the ori has developed educational presentations that foster awareness of the importance of research for improving health outcomes; provide information on ori study results; and provide practical information about research designs and methods to the greater health care research community. The ori has also presented peer-reviewed abstracts of its research results and provided lectures to the health care community on innovative research designs. Ori presentations have been delivered at the heart failure society of america, the council for advancement of nursing science, the society for obstetric anesthesia and perinatology, the association of california nurse leaders and the american association of colleges of nursing. Evidence-based practice institute sharp participates in the evidence-based practice institute (ebpi), which prepares teams of staff fellows (interprofessional staff) 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 of nursing excellence, san diego, which promotes evidence-based practice in the nursing community. The consortium is a partnership between scvmc, sgh, smbhwn, smh, scripps health, palomar health, rady children's hospital san diego, uc san diego health system, va san diego healthcare system and elizabeth hospice, as well as plnu, sdsu, azusa pacific university (apu) and usd. Sharp actively supports the ebpi by providing instructors and mentors, as well as administrative coordination. The san diego ebpi includes six full-day class sessions featuring group activities, self-directed learning programs outside of the classroom and structured mentorship provided 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”

“Habitat for humanity believes that every man, woman and child should have a decent, safe and affordable place to live. From january through may, nearly 100 slah volunteers joined this volunteer labor organization dedicated to building and repairing houses all over the world. During the effort, volunteers worked alongside construction professionals to complete a home for a selected family in need. In april, 20 slah volunteers helped keep the decks of the legendary uss midway aircraft carrier clean during the uss midway foreign object damage (fod) walk-down. Walking in the footsteps of sailors who have served our country, volunteers used hand tools and vacuums to clear the carrier decks and prevent debris from getting sucked into and damaging the aircraft engines. The special olympics program provides free, year-round sports training and competitions for children and adults with intellectual disabilities. It uses sports as an opportunity for physical fitness, social interaction, community involvement and empowerment. In april, nearly 30 slah volunteers attended the special olympics, providing competition assistance in running and long jump events and serving the athletes lunch. In support of waste reduction for a healthier environment, approximately 50 slah volunteers participated in sharp healthcare's community waste collection events in october and april. Through the events, community members and employees recycled 330 pounds of pharmaceutical waste, nearly 12 bins of electronic waste and more than 530 gallons of shredded paper documents. Volunteers assisted the attending collection agencies with set-up, clean-up, traffic control, and guiding event visitors. Sharp humanitarian service program in fy 2014, the sharp humanitarian service program funded 52 sharp employees in service programs that provide health care or other supportive services to underserved or adversely affected populations including haiti, guatemala, peru, west africa and other vulnerable areas. Sharp employees volunteered with humanitarian organizations, including project compassion. This nonprofit, multi-denominational medical mission organization is dedicated to the physical and spiritual needs of people and provides free medical care in communities with little to no care available. In addition, the organization builds clinics and churches, and provides assistance to orphanages. In july 2014, sharp team members participated in project compassion's medical mission trip to cameroon, west africa, where they provided education and physical therapy care to approximately 1,500 impoverished community members. In may 2014, a sharp team member led a three-week medical mission trip to haiti. The team included 12 nursing and pre-med students with plnu's loveworks program, which conducts mission trips across the world. The team also collaborated with heart to heart international, a nonprofit organization committed to improving global health with initiatives that connect people and resources to communities in need. The team worked in mobile clinics in 11 different rural mountain villages in southeast haiti, as well as a downtown port-au-prince clinic, where clinic visits are typically twice per month. Over the three weeks, the team triaged thousands of community members ranging from infants to the elderly. The team assessed patients for health conditions, dispensed prescribed medication and provided education regarding medication management and diet. The experience was not only special and rewarding for the sharp team member, but also for the students, as it further enhanced their skills, confidence and passion for the health care field. Through sharp's humanitarian service program, another sharp team member took a medical mission trip to peru serving as a nurse in several of the shanty towns outside of lima. Health care providers set up tents to treat people of all ages who were without access to health care. Because several community members were treated for parasites,”

“Sharp volunteers spend their time within hospitals, in the community, and in support of the sharp healthcare foundation, grossmont hospital foundation and coronado hospital foundation. Sharp employees also donate time as volunteers for the sharp organization. Sharp employees also volunteer their time for the cabrillo credit union sharp division board, the sharp and children's mri board, the ucsd medical center/sharp bone marrow transplant program board, and the grossmont imaging llc board. Volunteers on sharp's auxiliary boards and the various sharp entity boards volunteer to provide program oversight, administration and decision making regarding financial resources. In fy 2014, 125 community members contributed their time to sharp's boards. This section describes various sharp volunteer programs, as well as their achievements in fy 2014. Sharp hospicecare volunteer programs in fy 2014, sharp hospicecare provided extensive training for nearly 70 new volunteers. Because volunteers are often considering a career in the medical field, they gain important knowledge and experience. They learn how to provide valuable services to the hospice organizations, including companionship to those near the end-of-life, support for families and caregivers and help with community outreach. Before being with patients and providing administrative support activities, hospice volunteers go through an extensive, 32-hour training program to confirm their understanding of and commitment to hospice care. In fy 2014, sharp hospicecare also trained five teenagers through its teen volunteer program. Through the program, teens are assigned special projects in the office or patient assignments at sharp hospicecare's lakeview and parkview homes. The teens provide simple acts of kindness such as sitting with patients, listening to their stories, providing grooming and hygiene tasks and being a comforting presence by just holding their hand. Three nursing students from plnu also volunteered at sharp hospicecare in fy 2014, offering assistance to family caregivers in private homes. The sharp hospicecare memory bear program supports community members who have lost a loved one. Through the program, volunteers created teddy bears out of the garments from those who have passed on. The bears serve as special keepsakes and permanent reminders of the grieving family member's loved one. In fy 2014, sharp hospicecare volunteers devoted approximately 3,200 hours to handcraft more than 800 bears for approximately 400 families. Sharp hospicecare recognized its volunteers by providing a monthly support group to enhance their education and training as volunteers, and by acknowledging their valuable contribution during national volunteer month and national hospice month. Sharp hospicecare furthers its volunteer efforts through the 11th hour program, a special program to ensure that no patient dies alone. Through this program, patients at the end-of-life without family members by their side are accompanied by a sharp hospicecare volunteer. During their final moments, the volunteer sits with and comforts the patient by holding their hand, reading softly to them and simply being present. In addition, families who are present with their dying loved one may prefer the company of a volunteer to help them feel comfortable as their loved one passes away. Sharp metropolitan medical campus (smh, smbhwn, smv) volunteer programs to help serve and comfort patients without family or friends to support them during their hospital stay, smh created the community care partner (ccp) program. This unique program hand-selects and trains hospital volunteers to become community care partners (ccps). The ccps act as companions to provide comfort and help keep patients safe by notifying medical staff as needed a task that is usually performed by a family member or friend, but often overlooked for patients who lack a companion. The ccps provide patients with company and support, share common interests”

“In collaboration with social workers and palliative care nurses, arts for healing also facilitated the donation of nearly 180 blankets and quilts to patients receiving end-of-life care at smh. Eighteen of the blankets were knitted and crocheted by patients at smv's east county outpatient program, an activity that could also help reduce anxiety and depression from the patients making and donating the blankets. In fy 2014, 50 volunteers, including several students from plnu and mc, supported arts for healing by facilitating art activities for patients and their loved ones. Arts for healing also provided music at several hospital and systemwide events, including sharp's disaster preparedness expo at the spectrum corporate office in september. Since the inception of the program in 2007, more than 50,000 patients, guests and staff have benefitted from the time and talent provided by the arts for healing group. In fy 2014, smh and smbhwn brought the junior volunteer program to high school students interested in future health care careers. The program is open to 10th through 12th grade students, ages 15 years or older who maintain a minimum grade point average (gpa) of 3.25 for two full semesters. New volunteers are placed either as guest ambassadors at the concierge desk or in the upscale gift shop or boutiques. The junior volunteers enhance the patient-centered services of staff by greeting and escorting patients and families, answering visitors' questions and baking cookies to create aromatherapy and a relaxing environment for patients and visitors. Through volunteering in the gift shop or boutiques, junior volunteers learn about merchandizing and retail sales while also helping to raise funds for the smh auxiliary. After completing a six-month, 100-hour commitment, 11th and 12th grade volunteers have the opportunity to earn promotions into clinical units based on their good attendance, professional communication and high level of productivity. In fy 2014, 110 junior volunteers provided more than 7,800 hours of service to the program. In fy 2015, smh and smbhwn plan to continue expanding opportunities for the junior volunteer program. Other sharp volunteer efforts in fy 2014, sharp staff donated their time and passion to a number of unique initiatives, underscoring sharp's commitment to the health and welfare of san diegans. Below are just a few examples of how sharp employees participated in the community. Sgh's engineering department volunteered in a number of initiatives in fy 2014, including this bud's for you, a program that delivers flowers hand-picked from the campus' abundant gardens to unsuspecting patients and their loved ones. The sgh landscape team grows, cuts, bundles and delivers colorful bouquets each week, bringing an element of natural beauty to patients and visitors of both the hospital and sharp's hospice homes. The team also regularly offers single-stem roses in a small bud vase to passers-by. In fy 2014, the team delivered a daily average of eight to 10 vases of flowers to patient rooms, with as many as 20 vases or more during peak flower season and upon additional requests. In its fourth year, this bud's for you has become a natural part of the landscape team's day, an act that is simply part of what they do to enhance the experience of visitors to the hospital. The engineering department further extends the spirit of caring through sodexo cares cheers bouquets. During their work day, the engineers keep an eye out for patients or visitors that appear to need encouragement or cheer. With help from sodexo, the hospital's food service, housekeeping and engineering vendor, a bouquet of balloons, ribbon, a teddy bear or sodexo football, plus an inspirational quote are quickly assembled. The gift is delivered to bring the patient or visitor comfort and joy while at the hospital. The sgh engineering department, landscape team, sgh auxiliary and local businesses collaborated to bring the shirt off our backs program t”

“Established green teams at each entity are responsible for developing new programs that educate and motivate sharp employees to conserve natural resources and reduce, reuse and recycle. Sharp has also partnered with key vendors and community organizations to identify and develop new programs and initiatives to help achieve its environmental goals. Sharp also participates in san diego's gathering of green teams, a group of teams from a variety of local businesses who meet quarterly to share innovative sustainability solutions. Sharp's environmental policy serves to affirm its commitment to improving the health of the environment and therefore the communities it serves. According to the u.s. Epa, health care ranks as the country's second most energy intensive industry. Furthermore, 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 carbon dioxide (co2) emissions. Unlike other industries, hospitals must operate 24 hours a day, seven days a week, and must provide service during power outages, natural disasters and other emergencies. The epa estimates that 30 percent of the health care sector's current energy use could be reduced without sacrificing quality of care through a shift toward energy efficiency and use of renewable energy sources. Sharp has responded to the need for hospitals to conserve energy and reduce carbon emissions by implementing numerous green initiatives. Some of those include: retro-commissioning of heating, ventilation and air conditioning (hvac) systems; lighting retrofits; pipe insulations; infrastructure control initiatives; occupancy sensor installation; energy audits; and energy-efficient motor and pump replacements. In addition, in 2013 sharp implemented a computer power management program which enables computers and monitors to go into a low-power sleep mode after a period of inactivity. Since its implementation, the program has been installed on 14,500 computers and has resulted in annual energy savings of 1.2 million kilowatt-hours (kwh). The initiative earned sharp a certificate of recognition from the epa in 2013. Sharp's energy-saving initiatives are driven by its energy conservation guideline to help manage energy utilization practices throughout the system. Since 2009, these initiatives have reduced the system's energy consumption by more than 17 million kwh and 200,440 natural gas therms (unit of heat energy). As a result of its lighting retrofits alone, sharp has saved approximately 3.9 million kwh, resulting in annual energy costs savings of more than $500,000. In total, sharp's energy initiatives have reduced the system's carbon footprint equal to the removal of almost 17,000 metric tons of co2 each year. In may, sharp was named as san diego's healthcare 2014 energy champion by sdg&e in recognition of its commitment to the innovative programs it has implemented to reduce its carbon footprint. Furthering its dedication to energy efficiency, sharp healthcare participates in sdg&e's major customer advisory panel, a group of sdg&e's largest customers who meet quarterly to receive energy updates from sdg&e and provide feedback on important regional energy issues. All sharp entities participate in the epa's es database and monitor their es scores on a monthly basis. Es is an international standard for energy efficiency created by the epa. Buildings that are certified by es must earn a 75 or higher on the epa's energy performance scale, indicating that the building performs better than at least 75 percent of similar buildings nationwide without sacrifices in comfort or quality. According to the epa, buildings that qualify for the es typically use 35 percent or less energy than buildings of similar size and function. As a result of sharp's commitment to superior energy performance and responsible use of natural resources, schh”

“Sharp also recognizes earth day and america recycles day. Each year emails are sent out that highlight sharp's recycling efforts and accomplishments, and offer reminders for proper workplace recycling, carpooling and energy and water conservation. In april 2014, sharp held its fifth annual systemwide all ways green earth week event, including all ways green fairs at each sharp entity. During the fairs, employees learned how they can contribute to recycling, waste minimization, healthy eating practices and other sustainability efforts. Many of sharp's key vendor partners participated in the fairs to help raise awareness of green initiatives and how sharp healthcare is involved in those programs. In october 2013 and april 2014, sharp hosted two free community waste collection events where community members and employees recycled 330 pounds of pharmaceutical waste, nearly 12 bins of electronic waste and more than 530 gallons of shredded paper documents. The impact of sharp's waste reduction programs has been significant. In fy 2014, sharp facilities diverted over 7.5 million pounds of waste from local landfills, which equates to an overall recycling rate of 37 percent. This included, but was not limited to 111,608 pounds of waste diverted through utilization of reusable sharps and pharmaceutical waste containers at schhc and smmc, as well as systemwide recycling of 270,464 pounds of hazardous and universal waste (e.g., batteries, solvents and fluorescent light bulbs), and 39,784 pounds of waste diverted through surgical device reprocessing. In the coming year, sharp has a system goal of diverting 7.6 million pounds of waste from local landfills. Table 3 presents the waste diversion rates at sharp healthcare in fy 2014. Table 3: sharp healthcare waste diversion fy 2014 sharp chula vista medical center recycled waste per year (lbs.) 773,131 total waste per year (lbs.) 2,665,343 percent recycled 29% sharp coronado hospital and healthcare center recycled waste per year (lbs.) 252,848 total waste per year (lbs.) 1,335,244 percent recycled 18% sharp grossmont hospital recycled waste per year (lbs.) 1,761,515 total waste per year (lbs.) 4,703,949 percent recycled 37% sharp memorial hospital and sharp mary birch hospital for women and newborns recycled waste per year (lbs.) 2,006,597 total waste per year (lbs.) 6,450,334 percent recycled 34% sharp mesa vista hospital recycled waste per year (lbs.) 257,739 total waste per year (lbs.) 555,811 percent recycled 46% sharp rees-stealy medical centers recycled waste per year (lbs.) 1,158,209 total waste per year (lbs.) 2,743,139 percent recycled 42% sharp corporate sites recycled waste per year (lbs.) 1,329,075 total waste per year (lbs.) 2,154,748 percent recycled 92% total sharp healthcare recycled waste per year (lbs.) 7,539,114 total waste per year (lbs.) 20,608,568 percent recycled 37% according to the intergovernmental panel on climate change, agriculture is responsible for 13.5 percent of greenhouse gas emissions worldwide. Sharp is committed to making eco-friendly food choices to minimize its environmental footprint. This includes a systemwide focus on its sustainable mindful food program to provide education and healthy food options designed to improve the health of sharp's patients, staff, community and environment. In collaboration with sodexo, sharp's food service vendor, sharp's mindful program includes meatless mondays, wellness menus, community supported agriculture (csa) fresh produce, food composting, increased recycling activities, the promotion of sugarless beverages, the use of post-consumer recycled packaging solutions and increased local and organic food purchases which are approaching 65 percent at some entities. In addition, smh, smv, and schhc created the first county-approved organic gardens and use the produce from these gardens in the meals served at the hospital cafes. Sharp has implemented many other sustainable food practices including the use of green-label kitch”

“To further reduce the number of cars on the road sharp's commuter solutions sub-committee continuously works to develop new programs and marketing campaigns to educate employees on the benefits of ride sharing. The committee has overseen the implementation of bike racks and designated car pool spots, as well as adding a bicycle commuter benefit, which each year gives employees who bike to work up to $20 per month to use for qualified costs associated with bicycle purchase, improvement, repair and storage. Sharp furthered its support of green transportation through several bike to work initiatives in fy 2014. This included two bike to work day events during which sharp employees opted to ride their bike to work in place of driving. Sharp also participated in the fifth annual icommute bike to work 2014 corporate challenge for the entire month of may (national bike month), competing with similar-sized organizations for the highest percentage of bike ridership for the month. In june, sharp promoted national dump the pump day to employees by sharing special promotions from icommute, such as vanpool discounts and gift card drawings, for individuals who pledged to "dump the pump" and make greener transportation choices. Furthering the commitment to better commuting solutions for its employees, sharp supplies and supports the hardware and software for more than 200 employees so that they 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. Table 4 highlights the all ways green efforts at sharp entities. Going forward, sharp remains committed to the all ways green initiative and will continue to investigate opportunities to reduce its carbon footprint. Sharp's all ways green committee continues to work with system employees, physicians and corporate partners to develop new and creative ways to reduce its impact on the environment and meet the goal of being an outstanding community citizen through environmental responsibility. Table 4: all ways green initiatives by sharp entity fy 2014 schhc *energy efficiency - update elevators/ chillers - energy audits - energy-efficient chillers/motors - es award hvac projects - lighting retrofits *water conservation - drip irrigation - drought-tolerant plants and bark-covered ground - electronic faucets - evaluation of water utilization practices - hardscaping - landscape water reduction systems - mist eliminators *waste minimization - single-serve paper napkin and plastic cutlery dispensers - reusable sharps containers - single-stream recycling - surgical instrument reprocessing *education and outreach - earth week activities - environmental policy - green team - no smoking policy - organic farmer's market - organic gardens - recycling education - ride share promotion scvmc *energy efficiency - energy audits - energy-efficient chillers/motors - es participation and award eligible - hvac projects - lighting retrofits *water conservation - drip irrigation - drought-tolerant plants and bark-covered ground - electronic faucets - evaluation of water utilization practices - hardscaping - landscape water reduction systems - mist eliminators *waste minimization - compactor renovation - electronic cafe menus - single-stream recycling - surgical instrument reprocessing *education and outreach - earth week activities - environmental policy - green team - no smoking policy - organic farmer's market - recycling education - ride share promotion sgh *energy efficiency - energy audits - es participation - hvac projects - lighting retrofits - retro-commissioning *water conservation - drip irrigation - drought-tolerant plants and bark-covered ground - electronic faucets - evaluation of water utilization practices - hardscaping - landscape water reduction systems - mist eliminators *waste minimization - electronic cafe menus - single-serve paper napkin and plastic cu”

“Sharp's disaster preparedness team offered disaster trainings to first responder and health care providers across sdc. This included a standardized, on-scene federal emergency management training for hospital management entitled, nims (national incident management system)/ ics (incident command system)/ hics (hospital incident command system), and a start (simple triage and rapid treatment) triage/ jump start triage class to train emergency responders at all levels to triage a large volume of trauma victims within a short period of time. In march, sharp's disaster team participated in the 2014 mass rescue operations exercise (mro) at the san diego mission bay lifeguard headquarters. During the exercise, the san diego lifeguards, u.s. Coast guard, american red cross (arc), multiple response agencies, uc san diego health system, palomar health and sharp healthcare engaged in a maritime emergency simulation designed to practice and improve communication, water rescue, helicopter support and emergency medical services (ems) handoff of victims. In july, sharp hosted the 5th annual disaster partnership conference at its spectrum office location. The conference was attended by approximately 100 health care providers, county emergency personnel, sharp healthcare employees and community members and included speakers from sdc hospitals plus a review of lessons learned during an active shooter response exercise. In september, sharp's disaster leadership presented to more than 900 california hospital staff, state and local officials, and key preparedness and response partners at the california hospital association's (cha) 9th annual disaster planning for california hospitals conference in sacramento, california. Presentations aimed at helping hospitals strengthen their disaster planning efforts, including how to develop a perinatal evacuation plan. Sharp's disaster leadership donated their time to multiple state and local organizations and committees in fy 2014. This included the southern california earthquake alliance, the county of san diego emergency medical care committee (emcc) disaster operations and the county of san diego healthcare disaster council, a group of representatives from sdc hospitals, other health care delivery agencies, county officials, fire agencies, law enforcement, arc and others who meet monthly to share best practices for emergency preparedness. Sharp's disaster leadership also served on the statewide medical health exercise work group that designed training materials for the 2014 california statewide medical health training and exercise program through the california department of public health (cdph) and the emergency medical services authority (emsa). The program is designed to guide local emergency outlets in developing, planning and conducting emergency responses. Furthermore, sharp disaster leadership is part of the san diego patient tracking committee, which is in the process of designing a countywide family assistance center (fac) to aid community members in finding their loved ones during a disaster event. Sharp supports safety efforts of the state and the city through maintenance and storage of a county decontamination trailer at sgh, to be used in response to a mass decontamination event. Sharp has also arranged for the prospective storage of 24 state hospital ventilators at three sharp hospitals. Additionally, all sharp hospitals are prepared for an emergency with backup water supplies that last up to 96 hours in the event that the system's normal water supply is interrupted. As part of its participation in the u.s. Department of health & human services (dhhs) public health emergency hospital preparedness program (hpp) grant, sharp continued its involvement in the sharp healthcare hpp disaster preparedness partnership (the 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 hospi”

“In addition, each sharp hospital as well as srs has a dedicated best health committee, which works to promote employee wellness in different ways for their team members. For instance, in fy 2014, more than 700 sharp team members attended the annual wellness fair at scvmc. Organized by scvmc's best health committee, the event provided an inviting atmosphere for employees to improve wellness of the mind, body and spirit. Educational resources included employee safety, cancer awareness, physical therapy and weight management, as well as bone density screenings and a nutrition booth that offered healthy food samples. At smh, the best health committee provided a best health wellness cart, led by members of the committee and a physical therapist. The cart navigated throughout the smh campus and provided team members with healthy food and wellness tips, such as how to perform stretch breaks and other healthy ideas. Sharp best health added healthy vending machine options on all hospital campuses, as well as healthy food items in each cafeteria and retail area. Sharp best health also conducts a semi-annual food and nutrition survey at each sharp hospital and corporate office location to assess employee satisfaction of the organization's cafeteria food and customer service, including requests for feedback and suggestions for improvement. Additionally, in september, sharp best health supported fresh fruit and vegetable month through the five-a-day challenge, a 21-day initiative designed to motivate sharp team members to increase their daily consumption of fruits and vegetables. In collaboration with sodexo and specialty produce, sharp best health offers the green grocers delivered to you program at more than 15 sharp sites. Through the green grocers program, seasonally available, locally grown and organic produce can be selected online and delivered to the workplace twice a month. The program provides a convenient method for employees and their families to incorporate more fruits and vegetables into their diet. Along with supporting employee health, the purchase of locally grown produce helps support local farmers and the san diego community. Since january 2014, sharp team members have ordered approximately 17,024 pounds of produce through the green grocers program. Sharp best health also provides a free nutrition education series to employees and family members designed to help sharp team members develop healthier eating habits. The program includes live workshops with cooking demonstrations from registered dietitians, educational videos and blog posts. More than 30 nutrition classes were offered to sharp employees and their families by sharp best health in fy 2014. Offsite activities like hiking and walking clubs are also available to sharp team members, family and friends. In fy 2014, sharp best health organized 12 systemwide hikes with more than 80 attendees. Beginning in fy 2013, sharp best health has offered annual health screenings to sharp employees in order to raise awareness of important biometric health measures and help team members understand how to reduce their risk of related health issues. Screenings are completed in less than 15 minutes and include indicators for blood pressure, body mass index (bmi), blood sugar, tobacco use and cholesterol. In fy 2014, more than 9,400 sharp employees participated in the screening effort, and more than 2,300 employees reduced their risk levels in at least one screening metric when compared to fy 2013 screening results. A variety of post-screening resources and tools are available for sharp employees and their family members, including a free health coach and classes on diabetes, heart disease, smoking cessation, healthy weight and eating, physical activity and stress management. As a fun incentive for completing their health screening, sharp best health provided employees with a fitbit zip wireless pedometer that tracks steps, distance and calories, and syncs these statistics to compute”

“* mental health and substance abuse education for the community highlights of community benefit provided by sharp in fy 2014 the following are examples of community benefit programs and services provided by sharp hospitals and entities in fy 2014. * 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 department of veterans affairs (champva), and tricare the regionally managed health care program for active-duty and service members, 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 and habitat for humanity; 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; made sharp facilities available for use by community groups at no charge; and executive leadership and staff 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 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 2014 in fy 2014, sharp provided a total of $354,271,459 in community benefit programs and services that were unreimbursed. Table 1 displays a summary of unreimbursed costs based on the categories specifically identified in sb 697. Table 1: total economic value of community benefit provided sharp healthcare overall fy 2014 *medical care services shortfall in medi-cal $129,446,653 shortfall in medicare $160,841,853 shortfall in san diego county indigent medical services $10,547,826 shortfall in champva/tricare $2,664,033 shortfall in workers' compensation $167,061 charity care and bad debt $41,362,966 *other benefits for vulnerable populations patient transportation and other assistance for the needy $2,340,135 *other benefits for the broader community health education and information, support groups, health fairs, meeting room space, donations of time to community organizations and cost of fundraising for community events $2,090,478 *health research, education and training programs education and training programs for students, interns and health care professionals $4,810,454 total $354,271,459 table 2 shows a listing of these unreimbursed costs provided by each sharp entity. Table 2: total economic value of community benefit provided by sharp healthcare entities fy 2014 estimated fy”

“In this endeavor, sharp collaborated with the hospital association of san diego and imperial counties (hasd&ic), the institute for public health (iph) at san diego state university (sdsu) and sdc hospital systems including: kaiser foundation hospital, san diego; palomar health; rady children's hospital; scripps health; tri-city medical center and uc san diego health system. The complete report of this collaborative process the hasd&ic 2013 chna is available for public viewing at http://www.hasdic.org. The results of this collaborative process significantly informed the 2013 chnas for each sharp hospital, and individual hospital assessments were further supported by additional data collection and analysis and community outreach specific to the primary communities served by each sharp hospital. Additionally, in accordance with federal regulations, the sharp memorial hospital (smh) 2013 chna also includes needs identified for communities served by sharp mary birch hospital for women & newborns (smbhwn), as the two hospitals share a license, and report all utilization and financial data as a single entity to the office of statewide health planning and development (oshpd). As such, the smh 2013 chna summarizes the processes and findings for communities served by both hospital entities. The 2013 chnas for each sharp hospital help inform current and future community benefit programs and services, especially for high-need community members. This section describes the general methodology employed for sharp healthcare's 2013 chnas. Data collection and analysis as the study area for both the collaborative hasd&ic 2013 chna and the sharp 2013 chnas cover sdc, the hasd&ic 2013 chna process and findings significantly informed sharp's chna process and as such, are described as applicable throughout the various chna reports. For complete details on the hasd&ic 2013 chna process, please visit the hasd&ic website at: http://www.hasdic.org. For the hasd&ic 2013 chna process, the iph employed a rigorous methodology using both community input (primary data sources) and quantitative analysis (secondary data sources) to identify and prioritize the top health conditions in sdc. These health needs were prioritized based on the following criteria: * has a significant prevalence in the community * contributes significantly to the morbidity and mortality in sdc * disproportionately impacts vulnerable communities * reflects a need that exists throughout sdc * can be addressed through evidence-based practices by hospitals and health care systems quantitative data (secondary sources) for both the hasd&ic 2013 chna and the individual sharp hospital chnas included 2011 calendar year hospital discharge data at the zip code level, health statistics from the san diego county health and human services agency (hhsa), the u.s. Census bureau, the centers for disease control and prevention and others. The variables analyzed are included in table 1 below, and were analyzed at the zip code level wherever possible: table 1: variables analyzed in the hasd&ic and sharp healthcare 2013 chnas *secondary data variables - inpatient hospitalizations by cause - emergency department visits by cause - demographic data (socio-economic indicators) - mortality data - regional disease-specific health data (county hhsa) - self-reported health data (california health interview survey) - specialized health data /reports (various) recognizing that health needs differ across the region and that socioeconomic factors impact health outcomes, both hasd&ic's 2013 chna and sharp's 2013 chna processes utilized the dignity health/truven community need index (cni) to identify communities in sdc with the highest level of health disparities and needs. Residents in five of these high-need neighborhoods across sdc were asked to provide input in a community forum setting. For the hasd&ic 2013 chna, iph conducted primary data collection through three methods: an online community health leader/health ex”

“Sharp entities reviewed their 2013 chnas and used these assessments to help determine priority needs for the communities served by their hospitals. In identifying these priorities, sharp entities also considered the expertise and mission of its programs and services, in addition to the needs of the unique, ever-changing demographics and health topics that comprise sharp's service area and region. Steps completed to prepare an annual community benefit report on an annual basis, each sharp hospital performs the following steps in preparation of its community benefit report: * establishes and/or reviews hospital-specific objectives taking into account results of the entity chna and evaluation of the entity's service area and expertise/services provided to the community * verifies the need for an ongoing focus on identified community needs and/or adds new identified community needs * reports on activities conducted in the prior fiscal year fy 2014 report of activities * develops a plan for the upcoming fiscal year, including specific steps to be undertaken fy 2015 plan * reports and categorizes the economic value of community benefit provided in fy 2014, according to the framework specifically identified in sb 697 * reviews and approves a community benefit plan * distributes the community benefit plan and report to members of the sharp board of directors and each of the sharp hospital boards of directors, highlighting activities provided in the prior fiscal year as well as specific action steps to be undertaken in the upcoming fiscal year ongoing commitment to collaboration in support of its ongoing commitment to working with others on addressing community health priorities to improve the health status of sdc residents, sharp executive leadership, operational experts and other staff are actively engaged in the national american hospital association, statewide california hospital association, hasd&ic, and other local collaboratives such as combined health agencies and the community health improvement partners behavioral health work team. Section 4 sharp chula vista medical center fy 2014 community benefit program highlights sharp chula vista medical center (scvmc) provided a total of $66,364,211 in community benefit in fy 2014. See table 1 for a summary of unreimbursed costs based on the categories specifically identified in sb 697. Table 1: economic value of community benefit provided sharp chula vista medical center fy 2014 senate bill 697 category programs and services included in senate bill 697 category estimated fy 2014 unreimbursed costs *medical care services shortfall in medi-cal - $22,397,944 shortfall in medicare - $33,244,497 shortfall in san diego county indigent medical services - $1,420,298 shortfall in champva/tricare - 544,467 shortfall in workers' compensation - $144,811 charity care and bad debt - $7,166,383 *other benefits for vulnerable populations project help, patient transportation, and other assistance for the needy - $310,178 *other benefits for the broader community health education and information, health screenings, flu vaccinations, support groups, meeting room space and donations of time to community organizations - $225,236 *health research, education and training programs education and training programs for students, interns and health care professionals - $910,397 total - $66,364,211 key highlights: * unreimbursed medical care services included uncompensated care for patients who were unable to pay for services; unreimbursed costs of public programs such as medi-cal, medicare, san diego county indigent medical services; and financial support for onsite workers to process medi-cal eligibility forms. * other benefits for vulnerable populations included insulin and other diabetes treatment for underserved, uninsured individuals to care for their diabetes at home; van transportation for patients to and from medical appointments; project help that provides funding for medications, transportation and oth”

“Table 3: medi-cal (medicaid)/healthy families eligibility, among uninsured in sdc's south region (adults ages 18 to 64 years), 2011 description/rate medi-cal eligible - 5.5% healthy families eligible - 0.0% not eligible - 94.5% source: 2011-2012 chis heart disease and cancer were the top two leading causes of death in the county's south region. See table 4 for a summary of leading causes of death in the south region. For additional demographic and health data for communities served by scvmc, please refer to the scvmc 2013 chna at http://www.sharp.com/about/community/community-health-needs-assessments table 4: leading causes of death in sdc's south region, 2012 cause of death number of deaths percent of total deaths diseases of heart 689 25.1% malignant neoplasms 655 23.9% cerebrovascular diseases 141 5.1% alzheimer's disease 133 4.8% diabetes mellitus 127 4.6% chronic lower respiratory diseases 109 4.0% accidents (unintentional injuries) 104 3.8% chronic liver disease and cirrhosis 50 1.8% influenza and pneumonia 41 1.5% essential (primary) hypertension and hypertensive renal disease 38 1.4% all other causes 656 23.9% total deaths 2,730 100.0% 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 regarding community benefit planning, scvmc: * incorporates community priorities and community relations into its strategic plan * estimates an annual budget for community programs and services based on community needs, previous years' experience and current funding levels * hosts a monthly community relations committee, composed of representatives from a variety of hospital departments, to discuss, plan and implement community outreach activities priority community needs addressed in community benefit report scvmc 2013 chna through the scvmc 2013 chna, the following priority health needs were identified for the communities served by scvmc (in alphabetical order): * behavioral health (mental health) * cancer * cardiovascular disease * diabetes, type 2 * obesity * senior health (including end-of-life care) in alignment with these identified needs, the following pages detail programs that specifically address cardiovascular disease (as part of education and screening activities), cancer, diabetes and senior health (as part of education and screening activities). Through its social services staff, scvmc provides comprehensive behavioral health services to safety net patients. Individuals who present in the emergency department (ed) with severe mental illness receive a psychiatric evaluation team (pet) assessment and are provided mental health placement and given information and resources as needed. Scvmc's social services also provide ongoing counseling, crisis intervention and debriefing for patients. Staff is placed as needed throughout the hospital and at birch patrick skilled nursing facility. Scvmc provides around-the-clock social services both onsite and on-call. Beyond these clinical services, scvmc lacks the resources to comprehensively address community education and support in behavioral health. Consequently, these issues are addressed through the programs and services provided through sharp mesa vista hospital and sharp mcdonald center, which are the major providers of behavioral health and chemical dependency services in sdc. Scvmc provides general nutrition and exercise education for obesity, as well as programs that address a healthy lifestyle as part of care for heart disease, cancer, diabetes and other issues influenced by healthy weight and exercise. In addition, sharp rees-stealy clinics throughout sdc provide structured weight management and health education programs to community members, such as smoking cessation and stress management; long-term support for weight management and fat loss; and personalized weight-loss programs. Through further analysis of s”

“* the same report identified the following barriers for san diego community members in accessing breast health care: lack of awareness and knowledge; financial barriers including insurance, transportation and childcare; emotional factors such as fear, denial and stigma; and cultural barriers. Findings from the study also proposed the following recommendations from stakeholders and breast cancer survivors: increased advocacy and education; increased funding for services, particularly transportation and screening; and increased knowledge and training for providers. * according to the acs, a total of 1,665,540 new cancer cases and 585,720 cancer deaths were projected to occur in the u.s. In 2014. California was projected to have the most new cancer cases (171,730) and the highest number of deaths (57,950) (january, 2014). * according to the centers for disease control and prevention (cdc), cancer survivors face many physical, psychological, social, spiritual and financial issues at diagnosis, during treatment and for the remainder of their lives. Breast cancer patient navigation, an intervention that addresses barriers to quality standard care, provides individualized assistance to patients, cancer survivors and their families. Objective * provide cancer education, support services, and patient navigation to the community fy 2014 report of activities scvmc is certified by the american college of surgeons commission on cancer (coc) as a community hospital cancer program. Scvmc is also a certified breast center by the national accreditation program for breast centers (napbc) and a lung cancer alliance screening center of excellence. In fy 2014, scvmc hosted three free cancer-related health seminars and two community cancer expos, one in english and one in spanish. Through these events, approximately 140 community members received screenings or education about awareness and prevention of various cancers, including ovarian, uterine, prostate, cervical, breast, colorectal and lung. There was also education on smoking cessation. Scvmc offered a seminar on colorectal cancer in spanish, and two seminars on lung cancer, one in english and one in spanish. In addition, the hospital collaborated with las damas de san diego and clinica medica de la mora to provide two screening events breast and cervical cancer to more than 50 community members in february and may. Las damas de san diego and clinica medica de la mora partner to provide cancer screening services for women through registration in every woman counts, a state program that pays for their screenings and care. The screenings provided 48 clinical breast exams, 35 mammograms and 37 pap smears. Going forward, scvmc seeks to strengthen its partnership with las damas de san diego and clinica medica de la mora, and offer patients and community members access to medical care, resources, education, financial assistance and prevention and screening programs. The douglas & nancy barnhart cancer center at scvmc offers a free monthly wellness series on yoga, healthy eating and other issues for patients, their families and those in the community. In addition, in fy 2014 those newly diagnosed with breast cancer were invited to attend quarterly meet the pathologist presentations. These 90-minute educational presentations by a scvmc pathologist provided detailed, personal information about the attendee's diagnosis by reviewing their pathology report and explaining it in layman's terms. These presentations reached 16 community members in fy 2014. In fy 2014, scvmc conducted cancer support groups in response to community needs. This included weekly breast cancer support groups in english and spanish, a monthly men's cancer support group and a monthly cancer caregiver support group for those caring for individuals battling any type of cancer. These meetings reached nearly 300 individuals. The hospital utilized grant funding from the susan g. Komen breast cancer foundation to conduct additional communi”

“* in 2012, there were 127 deaths due to diabetes in sdc's south region. The region's age-adjusted death rate due to diabetes was 28.6 per 100,000 population, higher than sdc's overall age-adjusted diabetes death rate of 20.4 deaths per 100,000. * in 2012, there were 882 hospitalizations due to diabetes in sdc's south region. The rate of hospitalization was 186.3 per 100,000 population, the second highest rate in sdc, and also higher than the age-adjusted rate of hospitalization for sdc overall of 133.2 per 100,000 population. * in 2012, there were 909 diabetes-related ed visits in sdc's south region. The rate of ed visits was 192.0 per 100,000 population. The south region diabetes-related ed rate was the second highest in sdc, and higher than the age-adjusted diabetes-related ed visit average of 142.6 per 100,000 population for sdc overall. * according to the california health interview survey (chis) in 2011, 11 percent of adults ages 18 and up in sdc's south region indicated that they were ever diagnosed with diabetes, higher than sdc overall at 7.8 percent. * according to the 3-4-50 chronic disease 2010 report from the county's health and human services agency (hhsa), the most common risk factors associated with type 2 diabetes include being overweight or obese, physical inactivity, smoking, hypertension and abnormal cholesterol. (note: two out of three americans are now overweight or obese.) * in 2012, according to the american diabetes association (ada), the prevalence of diabetes in the u.s. Was 29.1 million, or 9.3 percent of the population. The incidence of diabetes in 2012 was 1.7 million new diagnoses. * the 2014 national diabetes statistics report from the cdc reports that there are 21 million people in the u.s. Diagnosed with diabetes. * according to the ada, in 2012, the total cost of diagnosed diabetes in the u.s. Was $245 billion, with $176 billion in direct medical costs and $69 billion in reduced productivity. Objective * provide diabetes education and screening in the south region of sdc fy 2014 report of activities note: the scvmc diabetes education program is recognized by the ada and meets national standards for excellence and quality in diabetes education. In fy 2014, the scvmc diabetes education program conducted five blood glucose screenings at hospital sites and offsite locations, screening nearly 160 community members. As a result of these screenings, seven individuals were identified with elevated blood glucose levels and were referred to follow-up resources. Of those individuals with elevated blood glucose levels, two did not have pre-existing cases of diabetes. Screenings were held at locations in the south bay community, including the cycle eastlake & eastlake half marathon, chula vista chamber of commerce mixer and the chula vista chamber of commerce trade show. As part of these screening efforts, the scvmc diabetes education program provided education, screenings and outreach for women in the south bay. At the scvmc women's heart expos, held in july and august, the scvmc diabetes education program provided approximately 250 women in the community with health education and resources. The july expo targeted spanish-speaking women in the community and covered topics such as diabetes prevention and management, nutrition, exercise, weight loss and lipid control. From these expos, more than 70 women were screened and 11 women were identified with elevated blood glucose levels. In recognition of november's american diabetes month, the scvmc diabetes education program provided resources to community members through a variety of media sources. A sharp nurse provided a live facebook chat, as well as a live spanish radio broadcast on the la invasora radio network. There was education on various topics on diabetes and nutrition, including eating healthy during the holidays and making healthy choices. There were approximately 50 attendees for the live facebook chat and thousands of listeners for the radio int”

“* according to 2011 data from the chis, the self-reported obesity rate for adults (ages 18 and older) in sdc's south region was 26.6 percent, higher than the self-reported obesity rate of 22.1 percent for sdc overall. * also in 2011, 11.3 percent of adults (ages 18 and older) in sdc's south region self-reported eating at fast-food restaurants four or more times each week (chis, 2011). * according to the cdc, obesity increases the risk of many health conditions, including the following: coronary heart disease, stroke, high blood pressure, type 2 diabetes, various cancers, high total cholesterol, high levels of triglycerides, liver and gallbladder disease, sleep apnea and respiratory problems, osteoarthritis, mental health conditions and reproductive health complications such as infertility (cdc, 2011). * 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. The cdc reports that approximately 34.9 percent of u.s. Adults are obese. * in 2011, the leading causes of death among senior adults ages 65 years and older in sdc were heart disease; cancer; alzheimer's disease; stroke; chronic lower respiratory diseases; diabetes; influenza and pneumonia; unintentional injuries; hypertension and hypertensive renal disease; chronic liver disease and cirrhosis; parkinson's disease; and intentional self-harm. * in 2011, 97,647 seniors ages 65 and over were hospitalized in sdc. Seniors in sdc's south region experienced higher rates of hospitalization and ed visits for falls, coronary heart disease, stroke, diabetes, influenza, pneumonia and chronic obstructive pulmonary disease, when compared to sdc overall. * in sdc's south region in 2012, the number of arthritis-related hospitalizations totaled 1,205, which is a rate of 254.6 per 100,000 population. * in sdc's south region in 2012, females had a higher hospitalization discharge rate for arthritis-related diagnoses than males. * according to the national institutes of health (nih), more than 52 million people in the u.s. Either already have osteoporosis or are at high risk due to low bone mass. In addition to the financial costs, osteoporosis takes a toll in terms of reduced quality of life for many people who suffer fractures. * in sdc's south region in 2012, there were 479 low birth weight (lbw) births, which translate to 6.0 percent of total births for the south region. Additionally, in 2012 there were 75 very low birth weights (vlbw) in the south region, or 0.9 percent of births. * there were 904 hospitalizations due to maternal complications in sdc's south region in 2012. The region's age-adjusted rate was 379.8 per 100,000 population, which is higher than the actual rate for sdc overall (319.9 per 100,000 population). * in 2012, among adults 65 and older in the south region, there were 113 deaths, 763 hospitalizations, and 185 discharges for strokes. * the total number of deaths from stroke in sdc in 2012 was 1,003, or a rate of 31.9 per 100,000 population. Objectives * provide health education classes, support groups and screening activities for the community, with a focus on health issues identified through the chna * participate in community-sponsored events and support nonprofit health organizations fy 2014 report of activities in fy 2014, scvmc participated in numerous community health fairs and events serving more than 1,500 community members. Events included cycle eastlake & eastlake half marathon, caring hearts health fair, bonitafest, celebrando latinas conference at the hilton san diego bayfront, campeonata sudamericano de futbol (copa) soccer tournament, walk a day in someone else's shoes expo, the american heart association (aha) heart & stroke walk, a day for women's heart health expo, chula vista chamber mixer, chula vista chamber trade show and the susan g. Komen race for the cure at balboa park. Scvmc provided a variety of health services during”

“In fy 2014, scvmc hosted two women's heart health expos one in english and another in spanish. These half-day events reached more than 130 community members and provided physician- and nurse-led cardiac education, including nutrition, heart health, healthy food and exercise. Screenings were also provided for blood pressure, cholesterol, bmi, glucose and bone density. Scvmc also participated in the annual sharp women's health conference, where they provided a breast model to demonstrate how to perform a breast self-exam, distributed a variety of health education materials and conducted balance and bone density screenings for approximately 250 attendees. Throughout the year, scvmc women's health services offered free weekly breastfeeding support groups. Groups were held twice a week in order to serve working mothers, and were led by the hospital's lactation educators. Sessions were offered in english and spanish and provided education, support and guidance to more than 630 breastfeeding mothers and their babies. In october, scvmc women's health services provided its 12th annual fall baby parade to more than 40 mothers in the community. The parade provided mothers from the breastfeeding support groups with the opportunity to dress their infants in costumes and celebrate with other mothers in the community. In addition, scvmc women's health services collaborated with babies "r" us in chula vista to provide seminars in both english and spanish. The seminars were held twice a month at babies "r" us and included topics such as breastfeeding and baby care basics. These hour-long classes reached more than 100 couples in fy 2014. Scvmc women's services was also actively involved in the san diego county breastfeeding coalition, association of women's health, obstetric and neonatal nurses (awhonn) and the regional perinatal system (rps). In fy 2014, scvmc provided coordination, support and related fundraising activities for various nonprofit organizations in the community, including the san diego immunization coalition, south bay community services, san diego science alliance, family health centers of san diego, combined health agencies, chula vista kiwanis, chula vista chamber of commerce, chula vista veterans home support foundation, las primeras, san diego human dignity foundation, rotary club of chula vista and billy's kids. Fy 2015 plan scvmc will do the following: * provide a variety of educational resources and health screenings at community health fairs and events * provide community outreach on stroke education and prevention including two stroke screenings or education events in the south bay * provide education for individuals with identified stroke and osteoporosis risk factors, including residents at the veterans home of california, chula vista * conduct two half-day comprehensive heart health seminars with health screenings in english and spanish * conduct health education classes on a variety of topics on the scvmc campus * conduct quarterly blood drives * continue to assist community nonprofit organizations through coordination, support and fundraising activities * continue to reach out to underserved communities to provide education and community resources on health issues * participate with other sdc hospitals in the san diego county stroke consortium and continue to provide data to the sdc stroke registry 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 scvmc 2013 community health needs assessment or the most recent sdc community health statistics unless otherwise indicated. Rationale * according to the 2013 healthcare shortage areas atlas from the county of san diego health and human services agency (hhsa), sdc is one of 28 counties in california listed as a registered nurse (rn) shortage area. * the demand for rns and other health care personnel in the u.s. Will increase due to”

“Through affiliations with san diego state university (sdsu), point loma nazarene university (plnu), university of san diego (usd), university of california san diego (ucsd), azusa pacific university (apu), southwestern college (swc), grossmont college (gc) and other colleges and universities, scvmc provided training, leadership and facilities for more than 900 nursing and other health care students. Nursing programs ranged from associate degrees to master of science degrees in nursing. In fy 2014, nursing students received nearly 61,000 preceptor hours at scvmc. The hospital also hosted eight first-year postgraduate pharmacy residents, 38 pharmacy students in advanced pharmacy practice experience rotations, and 10 pharmacy tech students. In addition, scvmc conducted 31 interviews, provided professional education lectures on pharmacy administration and provided an open house to 42 pharmacy residency candidates. In total, scvmc provided nearly 1,900 hours of supervision, lectures and support to pharmacy students in fy 2014. Scvmc also participated in sharp hospicecare's 5th annual resource and education expo at college avenue baptist church. The theme of the expo was law, ethics and advocacy in health care and scvmc provided palliative care and hospice materials to approximately 150 community health care professionals. In addition, scvmc provided a lecture at usd on palliative care to five students and one instructor. In may, scvmc welcomed students from nearly a dozen chula vista elementary schools to the third annual robotics day. The students were members of smart mind robotics, an after-school program that encourages interest in science, technology, engineering and math. The students learned about robotic surgery and were able to simulate a procedure in an operating room. The students also enjoyed the opportunity to maneuver the da vinci si hd surgical system and speak with the medical staff. In fy 2014, scvmc continued its participation in the health sciences high and middle college (hshmc) program. This partnership provides students with early professional development and promotes interest in health care careers through hospital internships. In fy 2014, 36 students choose from a variety of hospital specialties to shadow based on their personal interests, including pharmacy, radiology/oncology, pathology, nursing, respiratory, laboratory, bloodless medicine, medical/surgical, catheterization laboratory, operating room (or), ed and patient financial services. Scvmc also continued to foster student interest in health care careers by providing four hospital tours for high school students from the sweetwater union high school district (suhsd): san ysidro high school, southwest high school, sweetwater adult school and otay ranch high school. Approximately 15 students participated in each tour. Two additional tours were conducted for more than 75 students from abroad including a tour of the scvmc ed and or, as well as a tour of the entire hospital that included lectures on emergency services and pharmacy. Fy 2015 plan scvmc will do the following: * continue to provide intern and professional development opportunities to health-profession students throughout sdc * in collaboration with suhsd and other organizations, continue to promote student interest in health care careers by providing hospital tours * continue participation in the hshmc program providing tours, job shadowing, mentorship and additional department rotations for high school students identified community need: access to primary care and behavioral health services for low-income, medically uninsured and underserved patients rationale references the findings of the scvmc 2013 community health needs assessment or the most recent sdc community health statistics unless otherwise indicated. Rationale * community health leaders participating in the hasd&ic 2013 chna process strongly aligned and recommended further work in access to care, health insurance and care manageme”

“In fy 2014, scvmc continued to provide specialized programming to help establish medical homes for low-income, medically uninsured and underserved patients in the south bay who are managed by scvmc hospitalists. The program provided access and timely referrals to primary care and behavioral health services for safety net patients. It also helped them to establish medical homes at community clinics, including chula vista family health centers (cvfhc). In fy 2014, scvmc referred approximately 500 patients (an average of 10 per week) to cvfhc, either through scheduled appointments or as walk-ins. Scvmc provided care and resources to support safety net patients that suffered from chronic conditions so that they could better manage their pain, diseases and overall health care. Scvmc provided safety net patients with resources for affordable medications through low-cost generic prescriptions available at costco and walmart. The program provided additional pharmaceutical assistance via discount cards for select medications available through sharp's pharmacy assistance program and other resources. In addition, scvmc provided comprehensive behavioral health services to safety net patients through scvmc social services staff. Individuals who presented in the ed with severe mental illness received a pet assessment and were provided mental health placement, information and resources as needed. In fy 2014, 3,057 social service interventions, including behavioral health interventions, were conducted throughout the ed, an increase of 12 percent over the previous year. Of these interventions, more than 100 family conferences were conducted an increase of 32 percent from the previous year as well as more than 70 psychosocial assessments, and more than 875 staff consultations. More than 315 patients were seen for counseling, more than 80 patients were evaluated for substance abuse and more than 340 individuals received information and referral resources. Nearly 300 individuals were also assessed due to suicidal or homicidal ideations. They were provided with outpatient resources or mental health treatment placement, which is an increase of 43 percent from the previous year. Scvmc also continued programming for safety net patients who frequent the ed that establishes outpatient treatment plans collaboratively with the patients. It also added a numerical identifier to their accounts so that social service referrals could be more easily triggered if the patient returns to the ed. Scvmc's specialized programming established a higher standard of care delivery for nurses and doctors that handle exceptionally vulnerable patients. Utilization of the ed as a source of primary care by such vulnerable populations has decreased dramatically due to the increased establishment of medical homes, and thus has improved access to and quality of care for these community members. To assist economically disadvantaged individuals, scvmc provided more than $28,600 in free medications, transportation and financial assistance through its project help funds. Additionally, during fy 2014, scvmc provided financial assistance to a variety of post-acute care services, such as housing fees for homeless patients at the recuperative care facility run by the san diego rescue mission, as well as durable medical equipment necessary for a safe discharge for unfunded patients. Fy 2015 plan scvmc will do the following: * continue to collaborate with local community clinics to provide referrals and establish appointments for low-income, underserved and uninsured individuals in the south bay; collaboration to include scvmc case management * continue to provide safety net patients with opportunities for education on the proper use of the ed, as well as help them establish medical homes; target approximately 500 patients per year, depending on ed volume * continue to explore new funding opportunities for programs that assist safety net patients to establish a medical home * continue to”

“* chip suicide prevention work team * chip independent living association (ila) advisory board and peer review advisory team * chula vista chamber of commerce * chula vista community collaborative * chula vista family health center * chula vista rotary * city of chula vista wellness program * coalition to transform advanced care (ctac) * combined health agencies * community emergency response team (cert) * consortium for nursing excellence, san diego * coronado chapter of rotary international * coronado fire department * council of women's and infants' specialty hospitals (cwish) * cycle eastlake * downtown san diego partnership * east county senior service providers (ecssp) * el cajon fire department * emergency nurses association, san diego chapter * employee assistance professionals association * emsta college * family health centers of san diego (fhcsd) * gardner group * gary and mary west senior wellness center * girl scouts of san diego imperial council, inc. * grossmont college (gc) * grossmont healthcare district * grossmont union high school district (guhd) * health care communicators board * health insurance counseling and advocacy program (hicap) * health volunteers overseas * heart to heart international * helen woodward animal center * helix charter high school * helps international * home of guiding hands * hospice-veteran partnership (hvp) * hospital association of san diego and imperial counties (hasd&ic) * hasd&ic community health needs assessment advisory group * health sciences high and middle college (hshmc) board * i love a clean san diego * international association of eating disorders professionals (iaedp) * international lactation consultants association (ilca) * international relief team (irt) * ioamai medical ministries * jewish family service of san diego * jewish federation of san diego county jewish senior services council * john brockington foundation * journal for nursing care quality editorial board * kaplan college advisory board * kiwanis club of chula vista * komen latina advisory council * komen race for the cure committee * la maestra family clinics * la mesa lion's club * la mesa park and recreation foundation board * las patronas * las primeras * march of dimes * meals-on-wheels * medical library group of southern california and arizona * mended hearts * mental health america (mha) * mental health coalition * miracle babies * mri joint venture board * national alliance on mental illness (nami) * national association of neonatal nurses (nann) * national association of hispanic nurses (nahn), san diego chapter * national hospice and palliative care organization (nhpco) * national initiative for children's healthcare quality (nichq) * national kidney foundation * national university (nu) * neighborhood healthcare community clinic * north county health project * nurseweek * pacific arts movement (pac-arts, formerly the san diego asian film foundation) * partnership for smoke-free families * peninsula shepherd senior center * perinatal safety collaborative * perinatal social work cluster * planetree board of directors * professional oncology network (pon) * project care * project compassion * public health nurse advisory board * recovery innovations california * regional perinatal system (rps) * residential care council * safety net connect * san diego community action network (sandi-can) * san diegans for healthcare coverage * san diego association of diabetes educators * san diego association of directors of volunteer services * san diego black nurses association * san diego blood bank * san diego brain injury foundation * san diego community care transitions partnership (sdcctp) * san diego center for children * san diego city college * san diego city parks and recreation * san diego council on suicide prevention * san diego county breastfeeding coalition * san diego county coalition for improving end-of-life care (sdcceol) * san diego county council on aging (sdccoa) * san diego county eme”