CaliforniaHospitalMedicalCenter

Community Benefit Report 2008

Community Benefit Plan 2009

Table of Contents

Executive Summary3

Mission Statement

CHW Mission Statement13

CHMC Mission Statement13

Organizational Commitment14

Community

Definition of Community17

Community Needs and Assets Assessment Process21

Community Benefit Planning Process

Developing the Hospital’s Community Benefit Report and Plan34

Planning for the Uninsured/Underinsured Patient Population94

Plan Report and Update including Measurable Objectives and Timeframes95

Program Digests

Type 2 Diabetes Prevention, Screening, and Intervention Program97

HopeStreetFamilyCenter Early Head Start Program 104

HopeStreetFamilyCenter Family Literacy Program112

Health Ministry Program120

Healthy Eating Lifestyle Program124

Para Su Salud127

HopeStreetFamilyCenterSchool Readiness Program130

Community Benefit and Economic Value138

Report – Classified Summary of Unsponsored Community Benefit Expense

Communication Plan

Attachments

Charity Care Policy

Community Needs Index, Map of the Community

Executive Summary

Primary Service Area:City of Los Angeles, including downtown, central and
south Los Angeles

Facility Type:Not for profit

Total Licensed Beds:316

Number of Employees:1,186 (meets community requirements for Major Employer)

Year Established:1887

Ethnic Mix of Patients:67% Hispanic; 20% African American;
6% Caucasian; 6% Asian; 1% other

Payer Mix of Patients:65.7% Medi-Cal, 14.3% Medicare; 16.3% HMO/PPO;

5% Self-Pay

Annual Emergency Services48,708 Emergency Services visits

Statistics:33% Medi-Cal Emergency Services visits

20% Indigent Care Emergency Services visits

President:Mark A. Meyers

(213) 742-5778 (phone) | (213) 765-4078 (fax)

Senior Vice President David Mauss

Business Development:(213) 742 5693 (phone) | (213) 742 6405 (fax)

City Council Representative:Jan Perry, Council District 9

CountySupervisor:Gloria Molina, District 1

Assembly Member:Fabian Nunez (D), Assembly District 46

State Senator:Gil Cedillo (D), Senate District 22

Congressional Representative:Lucille Roybal-Allard (D), Congressional District 33

Hospital Services:Emergency and Trauma Services

Obstetrics, Neonatal Intensive Care, Pediatrics,

Medical/Surgical Services, Critical Care,

Orthopedics, Skilled Nursing, Cancer Care

Community Benefit Programs:Health Ministry Program; Para Su Salud Program; Healthy Eating Lifestyle Program; Type 2 Diabetes Prevention, Screening and Intervention Program; Community Dental Partnership; Hope Street Family Center Early Head Start Program; Hope Street Youth Center;School ReadinessProgram;Child Development Center; Early Childhood Center; Early Care & Education Center; Family Childcare Network; Central High School; Pico Union Family PreservationNetwork; Nurse Family Partnership; Responsible Fatherhood Program; Healthy Marriage Program; Los Angeles Best Babies Network’s Center for Healthy Births.

Since 1887 CaliforniaHospital has been at the heart of downtown and active in caring for our downtown and inner city communities. The 316-bed private, non-profit hospital is a leader in acute care services and in the development of innovative programs that make a difference in both the local community and the medical profession.

  • The J. Thomas McCarthy Center for Emergency Services is the only full-service, 24-hour emergency department in central Los Angeles, serving more than 45,000 patients per year.
  • In December 2004, CHMC opened its Level II Trauma Center—the first new trauma center to open in more than a decade and one of only 13 in Los AngelesCounty. CHMC’s trauma team is ready 24 hours a day, 7 days a week, and cares for an average of more than 185 patients per month. These patients span a diversity of ages and walks of life, and require life-saving care following severe car crashes and industrial or other accidents. The availability of trauma care at CaliforniaHospital is critical for those who live in, work in, or visit the greater Los Angeles area.
  • High quality, cost-effective, state-of-the-art cancer care is provided by the DonaldP.LokerCancerCenter.
  • The Keith P. Russell Women's Health Center provides complete gynecological and obstetrical services, including a birthing center featuring nurse midwives and birthing tubs for water births.
  • A comprehensive prenatal program, Babies First/Primeros Pasitos offers expectant mothers friendly and efficient service in a relaxed setting, leading up to labor and delivery.
  • Para Su Salud (For Your Health) aims to increase the enrollment and retention of eligible residents in health insurance programs, especially Medi-Cal and Healthy Families.
  • The Hope Street Family Center works to (a) enhance the overall development of children, (b) strengthen the economic and social self-sufficiency and stability of families, and (c) enhance the local service delivery network of agencies serving young children and families.
  • TheHopeStreetFamilyCenter (HSFC) impressive list of awards:

2002American Hospital Association’s NOVA Award Winner. This award recognizes

collaborative projects aimed at improving the health status of communities.

2002 Selected as a Model School Readiness site by the Pathways Mapping Initiative of Harvard Medical School and the Annie E. Casey Foundation. “HSFC illustrates how an array of health, education, early childhood and social services can be blended into a coherent strategy for improving child and family outcomes.”

2004Received the Communities of Excellence Award on behalf of Central Los Angeles from the Federal Interagency Coordinating Council. The Communities Can! Award honors HSFC’s commitment to making sure that all children and families, especially those with or at risk for disabilities, have the services and supports they need to develop, flourish, and be valued members of the community and that those services are family-centered and culturally-competent.

2006HSFC’s Early Head Start program was selected by the U.S. Substance Abuse and Mental Health Services Administration as a model for innovative services for young children and families. HSFC successfully integrates behavioral health into primary care for pregnant women and families with young children.

HIGHLIGHTS OF MAJOR COMMUNITY BENEFITS PROGRAMS IN FY08

  • In July 2007 the HopeStreetFamilyCenter received a grant from California Department of Education, Child Development Division to establish a classroom for 20 four-year-olds at the new Early Care and EducationCenter, located at the Mercy Housing Development across the street from CHMC’s campus. The Prekindergarten and Family Literacy Program will enable children to receive high-quality services to prepare them for success as learners in kindergarten and beyond and their parents to learn how to be active partners in the education of their children, with an emphasis on promoting their young children’s pre-reading and school readiness skills. Through a partnership with the Los AngelesUnifiedSchool District, parents will also have the opportunity to improve their own literacy skills through English-as-a Second-Language and adult basic education instruction.
  • In August 2007 theHope Street Family Center’s School Readiness Programwas selected by First 5 LA to participate in their Sustainability Project which supports providers in developing and implementing plans to sustain high-quality outcomes for children ages 0-5 years in Los AngelesCounty. It includes monthly workshops and follow-up support by first 5 LA staff and Sustainability Project consultants. The goal is to build providers’ capacity to plan for sustainability, and to successfully pursue funding and other resources. The Project trains teams from community-based organizations serving children and their families within Los AngelesCounty. The sustainability team from HSFC consisted of Vickie Kropenske, Richard Hume, Laura Diaz, Sherrie Segovia, and Maria Avila. Monthly workshops walked the team through each step of the sustainability planning process with the ultimate goal of creating a comprehensive sustainability plan. HSFC’s Sustainability Plan was presented in June 2008 at a Resource Forum to a group of leaders from local foundations, County offices, and other nonprofit organizations.
  • In September 2007 M. Lynn Yonekura, M.D. participated with Kate Lorig, PhD on an Audio Conference and Community Benefits 101 Workshop for the Catholic Health Association of the United States entitled Chronic Disease Management: An Evidence-Based Approach That Works. Dr. Lorig described the Chronic Disease Self Management Program and the evidence that it works. Dr. Yonekura discussed the implementation of the CDSMP at CHMC and the telephone survey of CHMC participants documenting at 50% reduction in hospitalizations and a 80% decrease in ER visits in the year after program participation compared to the year prior to program participation.
  • In October 2007 Los Angeles Best Babies Network was selected by First 5 LA to participate in the same Sustainability Project described above. Their sustainability team consisted of Carolina Reyes, M. Lynn Yonekura, Janice French, Deborah Munoz, and Joseph Hobbs. They also presented their Sustainability Plan in June 2008 at the Resource Forum.
  • In October 2007 the HopeStreetFamilyCenter was awarded a five year grant from the U.S. Department of Health and Human Services, Administration for Children and Families, Office of Head Start to initiate and sustain a Healthy Marriage Program, targeting parents who participate in or are eligible for Head Start or Early Head Start services. The program will help parents and couples achieve and maintain nurturing and healthy marital relationships, which, in turn, will strengthen the family unit and support the creation of a home environment where children can thrive. Parents will have the opportunity to participate in classes to build their communication, conflict management, parenting, and relationship skills; develop positive social support networks with other parents; enjoy structured weekend retreats; and access services to address healthcare, mental health, and social service issues that are jeopardizing their marriages and family stability.
  • In October 2007 Dr. Carolina Reyes, Executive Director of Los Angeles Best Babies Network, spoke at the Second National Summit on Preconception Health and Health Care. Her presentation was entitled “Building Sustainable Networks to Provide Interconception care and Reduce Disparities”.
  • First 5 LA approved $125 million for the Prenatal-Three focus area which included plans for a universal home visitation program for all new parents in Los AngelesCounty. This is based on three basic premises: 1) the health of parents is important to the growth and development of young children; 2) the time during fetal development through age three is the most critical developmental period of life; and that 3) the primary relationships between parents and infants are the foundation of social and emotional health and development. These factors provide the foundation for school readiness for children. In November 2007 the Los Angeles Best Babies Network was commissioned to provide an implementation plan fora pilot of a universal home visitation program, entitled Welcome, Baby! based on a framework provided by First 5 LA staff and provide an assessment of feasibility and scalability of this program if adopted countywide. First 5 LA wanted to build on their current investment in developing a vibrant Network of providers who share in the mission of improving health and well-being of mothers, families, and children.
  • In December 2007 President Mark Meyers awarded seven recipients $15,000 each through the CHW Community GrantsProgram at a luncheon at the California Club. The Community Grants Program is sponsored by CHMC and its parent company, Catholic Healthcare West. Through this program, CHMC partners with other nonprofit organizations working to improve the health status and quality of life of local communities. The grants provide services to underserved populations and address specific community needs delineated in our Community Needs Assessment. The following causes and their sponsoring organizations received the grants:
  • Mental Health Services for the Uninsured: The 1736 FamilyCrisis Center is providing an innovative school-based intern training program for master’s-level counselors working toward licensure. The proposed program will increase the capacity to serve the mental health needs of the community, particularly for persons who need but cannot afford services or have no insurance.
  • Mental Health Services for Homeless Families: Beyond Shelter’s grant will support group and individual counseling to an estimated 90 homeless parents and 15-20 at-risk children from South Los Angeles. these families also have access to a broad range of additional social and human services through Beyond Shelter’s Neighborhood Resource Centers.
  • Community Yoga Classes: Immanuel Presbyterian Church was awarded funding for its Community Yoga Classes. This proposal builds upon a highly successful and unique pilot program that demonstrated effectiveness in reducing adult stress, promoting weight loss and improving emotional well-being.
  • First Steps Program: Los Angeles Child Guidance Clinic’s grant will help fund its First Steps Program. First Steps provides early intervention mental health services for at-risk families raising infants and toddlers on limited resources in Central and South Los Angeles, where intense stressors negatively impact the healthy development of children.
  • The Hope Street Youth Circus: Opportunities Team’s grant will support the Hope Street Youth Circus, a supervised after-school program that involves 40 youth, ages 7-18, who attend CHMC’s HopeStreetYouthCenter. Twice weekly circus training sessions provide physical activity, fitness training, and skill development. The Youth Circus performs at a variety of public venues around Los Angeles.
  • Red Shield After School Program: The Salvation Army was awarded funding for its Red Shield After School Program, which provides supervised, safe and structured academic and recreational activities for children ages 6-12 and teens ages 13-17 during the critical after-school hours.
  • Psychosocial Support for Cancer Patients at CHMC’s DonaldP.LokerCancerCenter: The Wellness Community-West Los Angeles was awarded funding for its Psychosocial Support Program for Cancer Patients at CHMC’s DonaldPLokerCancerCenter. The Wellness Community provides two psychosocial support groups each week for cancer patients and their families, with one group in English and one in Spanish. A licensed psychotherapist facilitates the groups which help cancer patients learn to better manage feelings of anxiety and uncertainty about their disease. Participants develop new coping skills and support one another in managing the day-to-day challenges that accompany a life-threatening illness.
  • In December 2007, CHMC received a three-year grant from the UniHealth Foundation for the Community Dental Partnership. Responding to recent studies linking periodontal disease and chronic diseases such as diabetes and cardiovascular diseases, as well as preterm births, the CDP will offer free periodontal care at Eisner Pediatric and FamilyMedicalCenter’s dental clinic for uninsured adults with diabetes. The program will also provide access to discounted basic dental care, dental health education, care coordination for patients between their dental provider and their primary care physician and establish a loan program with favorable terms to help patients purchase critical but expensive dental care not covered by the grant.
  • In January 2008, the Chronic Disease Management Consortium consisting of CHMC, Good Samaritan Hospital, HuntingtonMemorialHospital, and the National Health Foundation received a planning grant from the Good Hope Medical Foundation for its Heart HELP Program, a cardiovascular health promotion/ cardiovascular disease prevention program. This program will provide outreach education and screening for risk factors, smoking cessation classes, and five weekly 2-hr workshops.
  • California Hospital Medical Center was named the Official Hospital for the 23rd Annual Los Angeles Marathon held on March 2, 2008. Under the leadership of CHMC more than 300 doctors, nurses, paramedics and firefighters worked to ensure the safety of 25,000 runners and one million spectators at the 23rd Annual Los Angeles Marathon. The event is the largest marathon held in California, the fourth largest in the country and the seventh largest in the world. Eight medical aid stations along the race route and two mobile emergency hospitals at the finish line served those who gave their all along the course that covered most of the city. “We did our best to anticipate as many scenarios as possible, from blisters and bruises to dehydration, broken bones and heart attacks,” said CHMC Emergency Nursing Director Sarah Stevens. The medical teams saw about 500 cases reporting minor injuries, with very few needing treatment and stabilization for stress fractures, asthma, and heat exhaustion or transfer to local emergency rooms. In addition to CHMC’s volunteer nursing and physician staff, this meant recruiting and coordinating a team of 140 highly trained family medicine doctors, emergency and trauma specialists, and orthopedists, as well as skilled physician assistants, nurse practitioners, intensive care and emergency room nurses from other medical facilities including cross town rivals USC and UCLA. It also meant months of preparation, including weekly medical strategy meetings with the leadership of the Los Angeles Fire Department, marathon organizers, and hospital and academic administrators, working with suppliers for medical and pharmaceutical equipment, transportation, and communications, as well as consulting with other medical race directors across the country. In the end, marathon organizers complimented the medical staff as having provided the most comprehensive coverage in the race’s history. “As medical providers, it’s our job to make race day a safe and healthy celebration for the city of Los Angeles,” said LA Marathon Medical Commissioner and CHMC Medical Staff Member Maureen Strohm, M.D. “We all worked diligently to provide the best outcomes possible for those seeking medical attention. It’s one more way CaliforniaHospital says, ‘We’re here for you, Los Angeles.’”
  • In April 2008 the HopeStreetFamilyCenter was awarded a grant from the Atlas Family Foundation to implement Phase I of the Integrated Behavioral Health Training Program at HSFC. This program will create a model for providing paraprofessionals and professionals (including physicians, nurses, social workers, and child development educators) with training in the mental health assessment of infants, toddlers, and their families.