2023-08-14T13:17:12-05:00 2022-09-30 366055558 GRANT THORNTON LLP 75 STATE ST BOSTON MA 02019 990 2021-10-01 042791396 BERKSHIRE MEDICAL CENTER INC BERK 4134472508 725 NORTH STREET PITTSFIELD MA 012014109 SCOTT ST GEORGE CFO 4134473366 2023-08-14 1 SCOTT ST GEORGE 999009999 ERIN COUTURE P01390492 6177237900 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DARLENE RODOWICZ 725 NORTH STREET PITTSFIELD MA 012014109 653653907 0 X WWW.BERKSHIREHEALTHSYSTEMS.ORG X 1983 MA TO ADVANCE HEALTH & WELLNESS OF OUR COMMUNITY IN A WELCOMING, INCLUSIVE, & PERSONALIZED ENVIRONMENT. 22 19 3716 89 1226667 1225667 1993447 2934577 593096263 632203414 35427323 14662166 1305364 1594590 631822397 651394747 0 0 0 0 283250237 283357464 0 0 131858 271482975 316510400 554733212 599867864 77089185 51526883 782927301 688226708 242071297 189375195 540856004 498851513 X THE MISSION OF BERKSHIRE MEDICAL CENTER IS TO ADVANCE HEALTH AND WELLNESS FOR EVERYONE IN OUR COMMUNITY IN A WELCOMING, INCLUSIVE, AND PERSONALIZED ENVIRONMENT. 0 0 491634765 579862095 OPERATE AN ACUTE CARE GENERAL HOSPITAL AND MEDICAL EDUCATIONAL FACILITY, AND TO DELIVER THE HIGHEST QUALITY PATIENT CENTERED CARE IN A LEARNING ENVIRONMENT. TOTAL PATIENT DAYS FOR THE YEAR ARE 61,340, TOTAL LAB PROCEDURES 1,690,942, TOTAL RADIOLOGY PROCEDURES 177,707, TOTAL REHAB VISITS 53,735. HOURS OF OPERATION 24/HRS 365/DAYS PER YEAR. 34785832 41389349 OPERATION OF AN EMERGENCY DEPARTMENT AND TRAUMA CARE CENTER AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. TOTAL VISITS FOR THE YEAR 59,588. ED IS IN OPERATION 24 HRS/DAY 365 DAYS/YEAR. 14301096 8300726 VISITING NURSE PROGRAM ALLOWING FOR THE CARE AND REHABILITATION OF PATIENTS IN THEIR OWN HOME ENVIRONMENT. TOTAL VISITS FOR THE YEAR 51,462 DETAILED AS FOLLOWS SKILLED NURSING 28,081 HOME HEALTH AIDE 2,141, REHAB 20,825, AND SOCIAL SERVICE 415. HOURS OF OPERATION 7 DAYS/WEEK 8AM-9PM WITH A NURSE ON CALL 24 HOURS. 3325845 2651244 OPERATE A SUBSTANCE ABUSE CENTER PROVIDING THE HIGHEST QUALITY OF PATIENT CARE. TOTAL PATIENT DAYS FOR THE YEAR 6,657. PROGRAM OPERATES 24 HRS/DAY 365 DAYS/YEAR. 3325845 2651244 544047538 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 204 0 1 3716 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 22 19 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA NY X X SCOTT ST GEORGE 4134473366 725 NORTH STREET PITTSFIELD MA 012014109 DARLENE RODOWICZ PRESIDENT/TRUSTEE TERM BEGAN 1/1/22 25.00 25.00 X X 0 605131 46484 RICHARD ALCOMBRIGHT TRUSTEE 1.00 2.00 X 0 0 0 THOMAS O ANDREWS TRUSTEE 1.00 2.00 X 0 0 0 ALFRED A BARBALUNGA TRUSTEE 1.00 2.00 X 0 0 0 ALEC R BELMAN MD TRUSTEE/PHYSICIAN TERM BEGAN 1/22 1.00 49.00 X 0 366654 50317 JOHN L BISSELL TRUSTEE/VICE CHAIR 1.00 2.00 X X 0 0 0 BRONLY S BOYD TRUSTEE 1.00 2.00 X 0 0 0 ALBERT BRAVO DPM TRUSTEE 1.00 2.00 X 0 0 0 TIMOTHY BURKE TRUSTEE 1.00 2.00 X 0 0 0 ROBERT P CELLA JR MD TRUSTEE 1.00 2.00 X 0 0 0 EDITH KIT DOBELLE TRUSTEE 1.00 2.00 X 0 0 0 DAVID HALL TRUSTEE 1.00 2.00 X 0 0 0 LETICIA SEHAYNES TRUSTEE 1.00 2.00 X 0 0 0 EDMUND HORNSTEIN DO TRUSTEE 1.00 2.00 X 192314 0 0 JAMES G KOLESAR TRUSTEE 1.00 2.00 X 0 0 0 JOHN A LOIODUCE MD TRUSTEE/PHYSICIAN TERM BEGAN 1/22 1.00 49.00 X 0 0 0 DAVID MORESI TRUSTEE 1.00 2.00 X 0 0 0 BARTON D RASER TRUSTEE/CHAIR 1.00 2.00 X X 0 0 0 CAROLE G SIEGEL TRUSTEE 1.00 2.00 X 0 0 0 ERWIN A STUEBNER JR MD TRUSTEE 1.00 2.00 X 0 0 0 ANAKATINA CORDON SUFFISH TRUSTEE/TERM BEGAN 08/22 1.00 2.00 X 0 0 0 JULIANNE BOYD TRUSTEE 1.00 2.00 X 0 0 0 JOSEPH C THOMPSON TRUSTEE/TERM ENDED 1/22 1.00 2.00 X 0 0 0 DAVID PHELPS TRUSTEE/PRESIDENT TERM ENDED 1/1/22 25.00 25.00 X X 0 1137632 51452 BRIAN BURKE MD TRUSTEE/PHYSICIAN TERM END 12/21 1.00 49.00 X 0 197521 36053 MICHAEL MCINERNEY MD TRUSTEE/PHYSICIAN TERM ENDED 12/21 1.00 49.00 X 0 293833 44064 SCOTT ST GEORGE TREASURER 37.00 13.00 X 0 518004 11639 CHERYL M BOUDREAU CLERK 19.00 21.00 X 0 122003 18346 MICHAEL MCHUGH MD CHAIRMAN-E.D. MEDICINE 50.00 0.00 X 502455 0 46729 ANDREW MANZER CHIEF OPERATING OFFICE 50.00 0.00 X 502575 0 42827 TONY MAKDISI MD HOSPITALIST 50.00 0.00 X 591444 0 45474 ROBIN BURNS-LAMBERT MD ANESTHESIOLOGIST 50.00 0.00 X 567757 0 45299 RAYMOND GARY SOHL MD ANESTHESIOLOGIST 50.00 0.00 X 543532 0 45768 SEETHA MUTHAVARAPU MD HOSPITALIST 50.00 0.00 X 515914 0 45783 BARANI MAYIL VAGANAN MD GASTROENTEROLOGIST 50.00 0.00 X 513708 0 39700 3929699 3240778 569935 453 1 1 0 SHIELDS PHARMACY OF THE BERKSHIRE PO BOX 844023 BOSTON MA 022844023 PHARMACY CONSULTANT 5603087 FASTAFF LLC PO BOX 911452 DENVER CO 802911452 CONTRACTED LABOR 2806897 MEDTIGO STAFFING LLC PO BOX 397 DOVER MA 02030 CONTRACTED LABOR 2784600 QUEST DIAGNOSTICS PO BOX 844226 BOSTON MA 022844226 CONTRACTED LABOR 2609133 AHSA PO BOX 670529 DALLAS TX 752670529 CONTRACTED LABOR 1468931 34 2153548 781029 99660 2934577 PATIENT SERVICES REVENUE 622000 522904714 522904714 OTHER ANCILLARY 622000 102796818 102796818 LAB REVENUE 621510 3265970 3265970 HEALTH PROMO EDUCATION 611710 1785024 1785024 PSYCH PROF SERVICES 621112 1450888 1450888 632203414 5556782 1226667 4330115 634836 564137 70699 70699 70699 10795825 4582 1695023 0 9100802 4582 9105384 9105384 CAFETERIA INCOME 722514 1523891 1523891 1523891 651394747 632203414 1226667 15030089 1184640 1184640 218755000 216363837 2338633 52530 8469835 8254212 215623 35863219 35289408 573811 19084770 18779414 305356 45760031 45760031 43265 43265 93348 93348 30625711 29994431 631280 301743 296423 4820 500 6982843 6871117 111726 525256 516852 8404 485281 477516 7765 521100 521100 34745879 34192153 553726 5262673 5178470 84203 PATIENT RELATED SUPPLY 164954035 162215443 2670344 68248 EQUIPMENT RENTAL/PURCHA 11546696 11082227 464469 BAD DEBT 9635237 9635237 5027302 4336433 680289 10580 599867864 544047538 55688468 131858 13545 14596 157777644 103657235 193004 297880 52355377 51325537 15834951 17597427 13852607 15289308 2417168 3046981 704695700 524139003 193273759 180556697 276388683 254588901 41740004 35268918 29080559 26583228 782927301 688226708 62352196 67565877 219435 396924 55026720 49561200 3817520 0 124472946 68033674 242071297 189375195 X 501052147 462881749 39803857 35969764 540856004 498851513 782927301 688226708 X 51526883 -68091711 -25439663 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 43265 43265 0 PART II-B, LINE 1: LOBBYING ACTIVITIES EXPENDITURES BERKSHIRE MEDICAL CENTER PAYS ANNUAL MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE MASSACHUSETTS HOSPITAL ASSOCIATION (MHA). A PORTION OF THESE DUES ARE USED BY THE AHA AND THE MHA TO CONDUCT LOBBYING ACTIVITIES TO INCREASE THE BUDGET FOR MEDICARE AND MEDICAID FOR THE FYE 9/30/2022. CALCULATION OF THE LOBBYING FEE PORTION OF THE ANNUAL DUES ARE AS FOLLOWS: MHA LOBBYING FEES OF $26,933 ARE 14.15% OF THE $190,343 ANNUAL DUES. AHA LOBBYING FEES OF $16,332 ARE 27.29% OF THE $59,844 ANNUAL DUES. 35358308 -3740481 -14000 -20393 31583433 30131752 5235776 -8500 -720 35358308 28399191 1747061 -5500 -9000 30131752 27603974 818464 -6500 -16747 28399191 26030698 1590967 -14000 -3692 27603974 0.24960 0.75040 0 0 9937161 9937161 290914365 192536424 98377941 373803409 312901117 60902292 30040765 18701462 11339303 180556697 INDEX FUND, LARGE BLEND 35268918 C 35268918 DUE TO THIRD PARTIES 25429303 DEFERRED COMPENSATION 7895324 WORKERS COMP STOP LOSS LIABILITY 439000 AMOUNT DUE TO AFFILIATE 31029879 ASSET RETIREMENT ACCRETION 2423201 LEASE LIABAILTY 816967 68033674 X PART V, LINE 4: THE ORGANIZATION HOLDS, INVESTS AND/OR UTILIZES ENDOWMENT FUNDS IN ACCORDANCE WITH ANY EXPRESSED WISH OF THE DONOR OF THOSE FUNDS. TO THE EXTENT THAT THE DONOR INSTRUCTIONS ALLOW THE EXPENDITURE OF THE ENDOWMENT FUNDS, THEY ARE EXPENDED FOR HEALTHCARE SERVICES PURPOSES SUCH AS FREE CARE AND SCHOLARSHIPS, CONSISTENT WITH THE TAX EXEMPTION OF THE ORGANIZATION. PART X, LINE 2: THE FINANCIAL ACTIVITIES OF BERKSHIRE MEDICAL CENTER, INC. ARE INCLUDED WITHIN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES AND SUPPLEMENTARY FINANCIAL INFORMATION FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021. THOSE FINANCIALS INCLUDE THE FOLLOWING FIN-48 FOOTNOTE: "THE HEALTH SYSTEM FOLLOWS THE ACCOUNTING GUIDANCE FOR UNCERTAINTIES IN INCOME TAX POSITONS, WHICH REQUIRES THAT A TAX POSITION BE RECOGNIZED OR DERECOGNIZED BASED ON A "MORE LIKELY THAN NOT" THRESHOLD. THE HEALTH SYSTEM HAS DETERMINED THAT THERE ARE NO SUCH POSITIONS, INDIVIDUALLY OR IN THE AGGREGATE, THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS." 1 1 X 1 X 1 X 1 1 1 0 1 1 782294 68967 713327 0.00120 90094832 70678142 19416690 0.03290 8843533 12545952 99720659 83293061 20130017 0.03410 5263776 2437106 2826670 0.00480 13112349 5195343 7917006 0.01340 18053353 13067641 4985712 0.00840 0 0 332882 0 332882 0.00060 36762360 20700090 16062270 0.02720 136483019 103993151 36192287 0.06130 521407 27443 493964 0.00080 521407 27443 493964 0.00080 1 9635237 177768116 280744776 -102976660 X 1 1 1 1 BERKSHIRE MEDICAL CENTER 725 NORTH STREET PITTSFIELD MA 01201 WWW.BERKSHIREHEALTHSYSTEMS.ORG VQKK X X X X BERKSHIRE MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 1 0 1 X SEE PART V SECTION C X 1 19 1 SEE PART V SECTION C 0 1 X 150.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE PART V SECTION C X SEE PART V SECTION C X SEE PART V SECTION C X X X X X X 1 X 0 X X X 1 X 0 0 BERKSHIRE MEDICAL CENTER PART V, SECTION B, LINE 5: THE BMC CHNA HAD ITS TRIANNUAL ASSESSMENT IN 2021 WHICH DIRECTED OUR EFFORTS FOR THIS REPORTING PERIOD OUR FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR 2021 RELIES HEAVILY UPON SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH FRAMEWORK AND THE ROBERT WOOD JOHNSON FOUNDATION'S COUNTY HEALTH RANKINGS TO ANALYZE AND PRIORITIZE THE FACTORS THAT CONTRIBUTE TO THE HEALTH OF A POPULATION. OUR ASSESSMENT INCLUDED THE EVALUATION OF PUBLICLY AVAILABLE DATA, FINDINGS FROM LOCAL ORGANIZATION REPORTS, AND FEEDBACK COLLECTED FROM FOCUS GROUPS AND SURVEYS. WE DEVELOPED OUR THREE-YEAR IMPLEMENTATION PLAN BASED ON THE 2021 CHNA. THE FOLLOWING IS A SUMMARY OF THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2021 CNHA, ORGANIZED INTO THREE OVERARCHING CATEGORIES:HEALTH CONDITIONS AND OUTCOMESCOMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTHBARRIERS TO ACCESSING QUALITY CAREHEALTH OUTCOMES AND BEHAVIORSCHRONIC DISEASE WITH A FOCUS ON CANCER, HEART DISEASE, AND DIABETESBERKSHIRE COUNTY HAS THE HIGHEST RATE OF PREMATURE DEATH IN THE COMMONWEALTH OF MASSACHUSETTS, ACCORDING TO THE ROBERT WOOD JOHNSON FOUNDATION'S COMMUNITY HEALTH RANKINGS (2021). RESIDENTS REPORT A HIGHER RATE OF POOR MENTAL HEALTH DAYS THAN THE STATE OVERALL, AND HAVE HIGHER RATES OF SMOKING (19%), OBESITY (27%) AND EXCESSIVE DRINKING (26%), ALL OF WHICH CONTRIBUTE TO HIGHER RATES OF CHRONIC DISEASE WITHIN THE COMMUNITY. MORE THAN 20% OF THE POPULATION IS OVER THE AGE OF 65, MAKING THE COMMUNITY HIGHLY SUSCEPTIBLE TO THE VARIETY OF INCREASED HEALTH ISSUES THAT ACCOMPANY AGING.MENTAL ILLNESS AND MENTAL HEALTH, INCLUDING SUICIDE PREVENTION AND TREATMENTIN ADDITION TO THE HIGH LEVEL OF REPORTED POOR MENTAL HEALTH DAYS IN THE BERKSHIRE COMMUNITY, RATES OF SUICIDE ARE AMONG THE HIGHEST IN THE STATE AT 17.4 PER 100,000. A RECENT SURVEY OF YOUTH REVEALED A SIMILARLY HIGH LEVEL OF SUICIDAL BEHAVIORS WITH BETWEEN 14-17% OF YOUTH STATING THAT THEY HAD PLANNED A SUICIDE ATTEMPT IN THE PAST 12 MONTHS AND 7-11% OF YOUTH HAVING ATTEMPTED SUICIDE IN THE PAST 12 MONTHS.SUBSTANCE USE DISORDERSBERKSHIRE COUNTY'S RATE OF SUBSTANCE USE HAS SKYROCKETED, AS EVIDENCED BY THE NEARLY 200% INCREASE IN OVERDOSE DEATHS IN THE PAST 10 YEARS. BERKSHIRE COUNTY ALSO REPORTS THE SECOND-HIGHEST RATE OF PREGNANT WOMEN WHO USED OPIOIDS DURING PREGNANCY.COVID-19 TESTING AND VACCINATIONBHS CONTINUES TO PROVIDE THE MAJOR INFRASTRUCTURE SUPPORTING THE COMMUNITY'S RESPONSE TO THE COVID-19 PANDEMIC. DURING THE HEALTH SYSTEM'S FISCAL YEAR ENDED 09/30/2021, BHS PERFORMED MORE THAN 160,000 COVID TESTS AND CARED FOR MORE THAN 500 HOSPITALIZED COVID-19 PATIENTS. COMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTHIMPROVING COMMUNITY SAFETYBERKSHIRE COUNTY RANKS 10TH OF 14 COUNTIES IN THE STATE FOR VIOLENT CRIMES, BUT 3RD IN THE STATE FOR HOMICIDE RISK AT 2.36 PER 100,000 PEOPLE.CREATING INITIATIVES TO IMPROVE SOCIAL DETERMINANTS OF HEALTHA VARIETY OF SOCIAL AND ECONOMIC ISSUES CONVERGE ON BERKSHIRE COUNTY TO CREATE SIGNIFICANT CHALLENGES THAT CAN IMPACT THE HEALTH OF ITS RESIDENTS. BERKSHIRE COUNTY FOLLOWS SUFFOLK AND HAMPDEN COUNTY, RANKING 3RD IN THE STATE (TIED WITH BRISTOL COUNTY) FOR PREVALENCE OF FOOD INSECURITY (9.9%). BERKSHIRE COUNTY HOUSING STOCK IS SIGNIFICANTLY OLDER THAN THE REST OF THE STATE, WITH MORE THAN 45% OF ALL HOUSING BEING BUILT BEFORE 1950, AS OPPOSED TO ONLY 37% FOR THE REST OF THE STATE. THE COUNTY'S MEDIAN HOUSEHOLD INCOME IS AT LEAST 25% LOWER THAN THE STATE AVERAGE AND A HIGHER NUMBER OF CHILDREN UNDER 18 LIVE BELOW THE POVERTY LEVEL (13.9%).BARRIERS TO ACCESSING QUALITY CAREINCREASING INSURANCE ENROLLMENTGIVEN THE AGE AND ECONOMIC DEMOGRAPHIC OF THE COUNTY, MORE THAN 45% OF BERKSHIRE RESIDENTS ARE HEAVILY RELIANT ON PUBLIC SOURCES OF FINANCING FOR ACCESS TO HEALTH CARE. NEARLY 3.0% ARE UNINSURED. ENHANCING THE HEALTHCARE WORKFORCETHE REGION'S SIGNIFICANT RELIANCE ON GOVERNMENT-REIMBURSED SERVICES CAN HAVE A DIRECT INFLUENCE ON LOCALLY AVAILABLE PROGRAMS AND SERVICES. BHS CONTINUES TO FACE STAFFING CHALLENGES, LIKE THOSE EXPERIENCED ACROSS THE NATION AND IS EXPLORING CAREER TRAINING PROGRAMS THAT CAN SIMULTANEOUSLY HELP TO REDUCE CLINICIAN SHORTAGES AND HELP TO RAISE MEDIAN INCOME LEVELS THROUGH STRONG EMPLOYMENT OPPORTUNITIES FOR BERKSHIRE RESIDENTS.CONTINUED ON SCHEDULE O BERKSHIRE MEDICAL CENTER PART V, SECTION B, LINE 6A: FAIRVIEW HOSPITAL BERKSHIRE MEDICAL CENTER PART V, SECTION B, LINE 11: BERKSHIRE MEDICAL CENTER (BMC) REGULARLY ASSESSES THE HEALTH NEEDS OF BERKSHIRE COUNTY RESIDENTS AS PART OF THE STRATEGIC PLANNING PROCESS AND COMMUNITY BENEFITS PROGRAMMING. BMC COMPILED THE BERKSHIRE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT USING THE EVALUATION OF PUBLICLY AVAILABLE DATA, FINDINGS FROM LOCAL ORGANIZATION REPORTS, AND FEEDBACK COLLECTED FROM FOCUS GROUPS AND SURVEYS. THIS DATA, IN CONJUNCTION WITH THE MASSACHUSETTS FOCUS AREAS AND PRIORITIES, WAS USED TO DETERMINE OUR ANNUAL COMMUNITY BENEFIT PRIORITIES. THE INTENT IS TO BROADLY IDENTIFY THE MAJOR TRENDS IN HEALTH STATUS AND OUR COMMUNITY'S HEALTH NEEDS WITH AN UNDERSTANDING OF THE FACTORS THAT ARE LIKELY TO AFFECT THE POPULATION OF BERKSHIRE COUNTY. THE FRAMEWORK OF THIS PLAN SPANS FISCAL YEARS 2021-2024. THE OBJECTIVES OF THE CHNA ARE TO: TO GATHER STATISTICALLY VALID INFORMATION ON THE HEALTH STATUS OF THE RESIDENTS OF BERKSHIRE COUNTY TO DEVELOP ACCURATE COMPARISONS TO STATE AND NATIONAL BENCHMARKS OF HEALTH AND QUALITY OF LIFE MEASURES TO PROVIDE TRENDING INFORMATION FOR THE FUTURE TO IDENTIFY KEY AREAS OF SIGNIFICANT COMMUNITY NEEDS AND VULNERABLE POPULATIONS TO UTILIZE FINDINGS FOR COMMUNITY BENEFIT AND HOSPITAL PLANNING WHILE DEMOGRAPHIC, SOCIOECONOMIC AND HEALTH STATUS INDICATORS PROVIDE AN EFFECTIVE MEANS OF IDENTIFYING POTENTIAL NEEDS AND/OR PROBLEMS, SUCH A BROAD-BASED VIEW CANNOT IDENTIFY ALL OF THE HEALTH AND HUMAN SERVICE PROBLEMS FACING A COMMUNITY. THIS IS RATHER ONE STEP OF MANY IN AN ON-GOING PROCESS OF COLLECTING AND DISSEMINATING HEALTH STATUS INFORMATION SO THAT, WORKING TOGETHER WE ADDRESS MOST OF THE IDENTIFIED HEALTH NEEDS OF OUR COMMUNITY AND HELP TO ENSURE BETTER OUTCOMES FOR ALL THE PEOPLE LIVING IN BERKSHIRE COUNTY. ADDITIONALLY, AN IMPORTANT PART OF THIS PROCESS IS TO IDENTIFY PREEXISTING PROGRAMS AND RESOURCES IN THE COMMUNITY TO AVOID DUPLICATION OF EFFORTS AND SILOED WORK. WE KNOW THAT COLLABORATING WITH OUR PARTNERS WE CAN BUILD A STRONGER MORE RESILIENT COMMUNITY THAT CAN ADDRESS MOST OF OUR COMMUNITY NEEDS. WHEN PARTNER ORGANIZATIONS ARE ALREADY ADDRESSING A PRIORITY HEALTH NEED, BMC MAY NOT PROVIDE DIRECT SERVICE OR FUNDS HOWEVER SUPPORTS THAT PROGRAM BY PROVIDING REFERRALS, CONNECTIONS, DATA, AND/OR OTHER MODALITIES OF SUPPORT. BASED ON THIS APPROACH, MOST OF THE IDENTIFIED HEALTH NEEDS ARE BEING ADDRESSED BY BMC OR PARTNER ORGANIZATIONS. COMMUNITY BENEFIT AND ACCESS COMMITTEE:AS A STANDING COMMITTEE OF THE BOARD OF TRUSTEES - ITSELF MADE UP OF COMMUNITY VOLUNTEERS, THIS COMMITTEE IS RESPONSIBLE FOR UNDERSTANDING THE HEALTH NEEDS AND BARRIERS TO CARE IN OUR SERVICE AREA. THE COMMITTEE OVERSEES THE COMMUNITY BENEFIT PROCESS OF THE ORGANIZATION, INCLUDING HEALTH NEEDS ASSESSMENTS, DETERMINING TARGET POPULATIONS AND PRIORITIES, DEVELOPMENT OF THE COMMUNITY BENEFITS PLAN AND EVALUATING PERFORMANCE AGAINST GOALS AND OBJECTIVES. THE COMMITTEE IS COMPRISED OF PEOPLE FROM THE BOARD OF TRUSTEES AND THE COMMUNITY AT LARGE. THE BMC COMMUNITY BENEFITS AND ACCESS COMMITTEE REVIEWS AND DISCUSSES COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, AND COMMUNITY NEEDS AND OUTCOMES. THE COMMITTEE FORMALLY REVIEWS ANY UPDATES TO COMMUNITY NEEDS AND REAFFIRMS PRIORITIES ANNUALLY AND COMPLETES A COMPREHENSIVE NEEDS ASSESSMENT EVERY THREE YEARS. THROUGHOUT THE YEAR, INTERNAL COMMUNITY BENEFITS AND PROGRAM LEADERS MEET TO COORDINATE THE COMMUNITY BENEFIT PLAN AND PROGRAMS. DUE TO THE COVID-19 PANDEMIC THIS COMMITTEE DID NOT MEET AS MANY OF THE PARTICIPANTS HAD COMPETING PRIORITIES. OUR COMMUNITY BENEFIT AND ACCESS COMMITTEE ALSO INCURRED CHANGES IN ITS LEADERSHIP STRUCTURE.BMC IS THE ONLY HEALTH SYSTEM IN BERKSHIRE COUNTY AND THEREFORE WE ASSUME A SIGNIFICANT LEADERSHIP ROLE IN ADDRESSING THE PRIORITIES IDENTIFIED IN THE CHNA. WE ARE FORTUNATE TO WORK COLLABORATIVELY WITH MANY COMMUNITY ORGANIZATIONS. BERKSHIRE MEDICAL CENTER HAS A STRONG REPUTATION AS A LEADER AND COLLABORATOR IN MEETING COMMUNITY HEALTH NEEDS THROUGH ITS ONGOING COMMUNITY BENEFIT PROGRAMS AND SERVICES. BMC PLANS TO PROVIDE COMMUNITY BENEFIT PROGRAMS IN RESPONSE TO THE HEALTH NEEDS IDENTIFIED IN THE 2021-2024 COMMUNITY HEALTH NEEDS ASSESSMENT. THESE INCLUDE, BUT ARE NOT LIMITED TO, HEALTH EDUCATION PROGRAMS, SCREENINGS, SUPPORT GROUPS, MENTAL HEALTH SERVICES, AND OTHER COMMUNITY HEALTH IMPROVEMENT SERVICES AND ACCESS TO CARE THROUGH SEVERAL LEVERAGED SOURCES (GRANTS). BMC UNDERSTANDS THAT THE NEEDS OF THE COMMUNITY ARE FLUID AND MAY CHANGE WITH CIRCUMSTANCE AND TIME, IN RESPONSE STRATEGIES MAY ALSO CHANGE, AND PROGRAMS MAY BE ADDED OR ELIMINATED DURING THE 2021-2024 TIMEFRAME. LISTED BELOW ARE THE HOSPITAL'S FY21 STRATEGIC PRIORITY HEALTH NEEDS, AND HOW EACH IS ADDRESSED. THE FY21 PRIORITY HEALTH NEEDS ARE UPDATED FROM THE TRIANNUAL FY21 CHNA. BMC HAS IDENTIFIED THE FOLLOWING PRIORITY NEEDS AREAS: BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER, CHRONIC CONDITIONS AND INFECTIOUS DISEASE, ACCESS TO CARE, SOCIAL ECONOMIC, AND WORKFORCE DEVELOPMENT. THESE PRIORITY NEEDS ARE LISTED BELOW WITH SUPPLEMENTATION OF WHAT IS BEING DONE BY THE HOSPITAL REGARDING EACH NEED. PLEASE NOTE, THE LISTS ARE NOT EXHAUSTIVE BUT ARE INTENDED TO PROVIDE AN OVERVIEW. BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER:SUBSTANCE USE/ OPIOIDS - BMC HAS INPATIENT SUBSTANCE USE TREATMENT PROGRAMS, INCLUDING THE MCGEE RECOVERY CENTER, A DETOX PROGRAM, AND OUR CLINICAL STABILIZATION SERVICES UNIT, WHICH GIVES THOSE IN RECOVERY THE OPPORTUNITY TO STAY, UP TO 30 DAYS, IN A SAFE SETTING THAT AIDS IN LONG-TERM RECOVERY. BMC ALSO PARTNERS WITH THE BRIEN CENTER FOR SUBSTANCE USE SERVICES IN PROVIDING ACCESS TO OUTPATIENT PROGRAMS TO ENHANCE TREATMENT FOR ADDICTION. THE SUBSTANCE USE TREATMENT CLINIC DEVELOPED IN 2019 IS PROVIDED BY A MEDICATION ASSISTED TREATMENT (MAT) CERTIFIED NURSE PRACTITIONER AND REGISTERED NURSE WHO PROVIDE TREATMENTS RELATED TO ALL FORMS OF SUBSTANCE USE DISORDERS AND PRACTICE USING THE HARM REDUCTION MODEL OF CARE. CARE INCLUDES SUPPORT, MEDICATIONS INCLUDING INDUCTIONS, ORAL, SUBLINGUAL, INJECTABLE AND TRANSDERMAL FORMULATIONS. COORDINATES CARE WITH THE PATIENT'S PRIMARY CARE PHYSICIAN AND SOCIAL SERVICES. THE GOAL OF THE PROGRAM IS TO HELP MANAGE THEIR SUBSTANCE USE DISORDER, REDUCE EMERGENCY DEPARTMENT UTILIZATION, AND REDUCE INPATIENT AND OBSERVATION ADMISSIONS. THE PROVIDERS ARE BOTH CERTIFIED RECOVERY COACHES. RECRUITMENT FOR OTHER POSITIONS SUCH AS COMMUNITY HEALTH WORKER/RECOVERY COACH AND MEDICAL ASSISTANT HAS BEEN CHALLENGING. MENTAL HEALTH-DEPRESSION, SUICIDE - THE BMC DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL HEALTH PROVIDES ANNUAL FREE DEPRESSION SCREENINGS IN THE COMMUNITY, PARTNERS WITH THE BRIEN CENTER FOR MENTAL HEALTH AND SUBSTANCE USE SERVICES ON OUTPATIENT PROGRAMS AND PROVIDES AN EMPLOYEE ASSISTANCE PROGRAM TO COMPANIES IN THE COMMUNITY TO AID IN RESPONDING TO MENTAL HEALTH ISSUES. CHRONIC CONDITIONS & INFECTIOUS DISEASECANCER - IN ADDITION TO PROVIDING COMPREHENSIVE HEMATOLOGY AND RADIATION ONCOLOGY SERVICES THROUGH THE BMC CANCER CENTER, BMC HAS COMMUNITY PROGRAMS ENCOURAGING AND PROMOTING CANCER SCREENING, SUCH AS COLONOSCOPY, MAMMOGRAPHY, AND LUNG CANCER. FOR COLONOSCOPY AND MAMMOGRAPHY, BMC ALSO PROVIDES PATIENT ASSISTANCE FUNDS TO HELP THOSE AT RISK TO PAY FOR POTENTIAL HIGH CO-PAYS FOR THESE PREVENTION SCREENINGS. CARDIOVASCULAR HEALTH - BERKSHIRE MEDICAL CENTER PROVIDES COMPREHENSIVE CARDIOVASCULAR HEALTH SERVICES THROUGH OUR PHYSICIAN PRACTICES. THE WELLNESS AT WORK PROGRAM PROVIDES CARDIOVASCULAR SCREENINGS FOR BUSINESSES AND EMPLOYEES. AS WELL AS FREE COMMUNITY BLOOD PRESSURE SCREENINGS. DIABETES - BMC HAS A DIABETES EDUCATION PROGRAM THAT WORKS WITH PEOPLE DIAGNOSED WITH PRE-DIABETES, AND TYPE 1 AND 2 DIABETES, PROVIDING ONE-ON-ONE COUNSELING AND SUPPORT, INCLUDING ACCESS TO NUTRITION SERVICES. INFECTIOUS DISEASE - BMC'S INFECTION PREVENTION AND CONTROL DEPARTMENT WORKS BOTH IN THE HOSPITAL AND IN THE COMMUNITY TO CURB INFECTIOUS DISEASE, INCLUDING COVID-19, INFLUENZA, LYME DISEASE, AND MANY OTHERS. STROKE/BLOOD PRESSURE - BMC IS A DEDICATED STROKE CENTER AND REGULARLY PROVIDES COMMUNITY LECTURES AND PROGRAMS THAT EDUCATE RESIDENTS ON THE RISK FACTORS AND WARNING SIGNS FOR STROKE, AND HOW TO RESPOND. SEXUALLY TRANSMITTED DISEASE/ INFECTION - BMC'S INFECTION PREVENTION AND CONTROL DEPARTMENT WORKS BOTH IN THE HOSPITAL AND IN THE COMMUNITY TO CURB INFECTIOUS DISEASE, INCLUDING INFLUENZA, LYME DISEASE, AND MANY OTHERS. BERKSHIRE HARM REDUCTION PROGRAM EMBRACES AN APPROACH THAT FOCUSES ON HELPING PEOPLE WHO USE DRUGS REDUCE THEIR HIGH-RISK BEHAVIOR AND THE HARM ASSOCIATED WITH DRUG USE.CONTINUE ON SCHEDULE O PART V, SECTION B LINE 7A THE HOSPITAL'S 2021 CHNA REPORT IS AVAILABLE ON THE HOSPITAL WEBSITE, HTTPS://WWW.BERKSHIREHEALTHSYSTEMS.ORG/PROGRAMS-AND-SERVICES/COMMUNITY-WELLNESS/CLICK ON THE LINK FOR COMMUNITY BENEFIT REPORT BMC FY 2021 PART V SECTION B LINE 10A THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE ON THE HOSPITAL WEBSITE,HTTPS://WWW.BERKSHIREHEALTHSYSTEMS.ORG/PROGRAMS-AND-SERVICES/COMMUNITY-WELLNESS/CLICK ON THE LINK FOR COMMUNITY BENEFIT REPORT BMC FY 2021. PART V SECTION B LINE 16A THE HOSPITAL'S FAP IS AVAILABLE ON THE HOSPITAL WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/ABOUT/POLICIES-AND-NOTICES, SELECT FINANCIAL ASSISTANCE POLICY DROP DOWN BOX, SELECT DOCUMENT "FINANCIAL ASSISTANCE POLICY - BERKSHIRE HEALTH SYSTEMS". PART V SECTION B LINE 16B THE HOSPITAL'S FAP APPLICATION IS AVAILABLE ON THE HOSPITAL WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/ABOUT/POLICIES-AND-NOTICES, SELECT FINANCIAL ASSISTANCE POLICY DROP DOWN BOX, THEN SELECT THE DOCUMENT "FINANCIAL ASSISTANCE APPLICATION". PART V SECTION B LINE 16C THE HOSPITAL'S PLAIN LANGUAGE SUMMARY OF THE FAP IS AVAILABLE ON THE HOSPITAL WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/ABOUT/POLICIES-AND-NOTICES, SELECT FINANCIAL ASSISTANCE POLICY DROP DOWN BOX, THEN SELECT THE DOCUMENT "PLAIN LANGUAGE SUMMARY OF FINANCIAL ASSISTANCE POLICIES". PART I, LINE 7: THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINES 7A, 7B, & 7C HAS BEEN CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AS COMPUTED USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINE 7G HAS BEEN CALCULATED USING A COST ACCOUNTING METHOD. PART I, LINE 7G: OUR COMMUNITY BENEFITS WHICH ARE SUBSIDIZED ARE THE SUBSTANCE ABUSE UNIT, CLINICAL STABILIZATION SERVICES, RENAL DIALYSIS SERVICES, AND THE INPATIENT PYSCHIATRIC UNIT. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $9,635,237 ATTRIBUTABLE TO PATIENT ACCOUNTS HAS BEEN EXCLUDED FROM THE COMPUTATION OF ALL COMMUNITY BENEFIT EXPENSE SHOWN IN PART I, LINE 7, COLUMN F. PART I, LINE 6A FAIRVIEW HOSPITAL AND BERKSHIRE MEDICAL CENTER EACH FILE A SEPARATE COMMUNITY BENEFITS REPORT WITH THE STATE OF MASSACHUSETTS. BMC'S FISCAL YEAR 2021 COMMUNITY BENEFITS REPORT CAN BE ACCESSED AT HTTPS://MASSCHARITIES.MY.SITE.COM/FILINGSEARCH/S/DETAIL/A095E000009HDTMAA0 PART II, COMMUNITY BUILDING ACTIVITIES: WORKFORCE DEVELOPMENT $493,964: RECRUITMENT OF STAFF PART III, LINE 2: THE HOSPITAL REPORTS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE AMOUNTS BASED UPON ACTUAL WRITE-OFF'S, A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS AND TRENDS. PART III, LINE 4: FOOTNOTE 2 (PROVISION FOR BAD DEBT) TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SUPPLEMENTARY FINANCIAL INFORMATION OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES (INCLUDING BERKSHIRE MEDICAL CENTER) FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021 ARE LISTED ON PAGE 13 UNDER "PATIENT ACCOUNTS RECEIVABLE". PART III, LINE 8: THE AMOUNT REPORTED ON LINE 6, PART III WAS DETERMINED USING THE COST ALLOCATION METHODOLOGY USED FOR THE MEDICARE COST REPORTS. THE LOSS ON MEDICARE ACTIVITY AS REPORTED IN PART III, LINE 7 IS A COMMUNITY BENEFIT BECAUSE IT IS THE MISSION OF BERKSHIRE MEDICAL CENTER TO PROVIDE HIGH QUALITY HEALTH CARE TO RESIDENTS OF BERKSHIRE COUNTY REGARDLESS OF THEIR ABILITY TO PAY. THE COST TO PROVIDE SERVICES TO MEDICARE BENEFICIARIES OFTEN EXCEEDS THE REIMBURSEMENT FOR SUCH SERVICES. ELDERLY PATIENTS ARE AMONG THE MOST NEEDY IN OUR COMMUNITY AND PROVIDING SERVICES TO THEM CLOSE TO HOME IMPROVES THE QUALITY OF THEIR CARE, INCREASES ACCESS AND ENHANCES HEALTH AND WELLNESS FOR THIS POPULATION. SERVICES SUCH AS EMERGENCY CARE, CARDIAC SERVICES, PSYCHIATRIC CARE, RENAL DIALYSIS AND WOUND CARE SERVICES ARE AMONG THOSE THAT PROVIDE A SIGNIFICANT BENEFIT TO THE FRAIL ELDERLY. THE BREADTH OF ACUTE AND AMBULATORY SERVICES PROVIDED BY BMC MEANS THAT THE MEDICARE BENEFICIARIES IN OUR COUNTY DO NOT HAVE TO LEAVE THE COUNTY FOR MOST SERVICES. PART III, LINE 9B: POPULATIONS EXEMPT FROM COLLECTION ACTIVITIESTHE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS:A. PATIENTS ENROLLED IN A STATE HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN, "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID.1. PLEASE NOTE THAT BMC MAY SEEK COLLECTION ACTION AGAINST ANY PATIENT ENROLLED IN THE ABOVE MENTIONED PROGRAMS FOR THEIR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM.2. BMC MAY ALSO INITIATE BILLING OR COLLECTION FOR A PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT FAILS TO PROVIDE PROOF OF SUCH PARTICIPATION. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM, (INCLUDING RECEIPT OR VERIFICATION OF SIGNED APPLICATION) BMC SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES. 3. BMC MAY CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED OR EXPIRED. HOWEVER, ONCE A PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN COMMONWEALTH CARE PROGRAMS, BMC WILL CEASE COLLECTION ACTIVITY FOR SERVICES, PREVIOUSLY BILLED, THAT NOW FALL INTO THE ELIGIBILITY PERIOD. 4. BMC MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE.5. BMC WILL NOT UNDERTAKE COLLECTION ACTION AGAINST AN INDIVIDUAL THAT HAS BEEN APPROVED FOR MEDICAL HARDSHIP UNDER THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM WITH RESPECT TO THE AMOUNT OF THE BILL THAT EXCEEDS THE MEDICAL HARDSHIP CONTRIBUTION.B. BMC DOES NOT GARNISH A PATIENT'S OR THE PATIENT'S GUARANTOR'S WAGES OR EXECUTE A LIEN ON THE PATIENT'S OR THE PATIENT'S GUARANTOR'S PERSONAL RESIDENCE OR MOTOR VEHICLE. C. BMC AND ITS AGENTS SHALL NOT CONTINUE COLLECTION OR BILLING ON A PATIENT WHO IS A MEMBER OF A BANKRUPTCY PROCEEDING EXCEPT TO SECURE ITS RIGHTS AS A CREDITOR IN THE APPROPRIATE ORDER. PART VI, LINE 2: COMMUNITY BENEFITS MISSION STATEMENT:FURTHERING OUR CHARITABLE PURPOSE, THE BERKSHIRE MEDICAL CENTER'S (BMC) COMMUNITY BENEFIT MISSION IS TO IDENTIFY, PRIORITIZE AND INVEST IN OUR COMMUNITY'S HEALTH NEEDS BY PURSUING NEEDED INITIATIVES AND PROGRAMS. THE COMMUNITY BENEFIT GOALS INCLUDE SATISFYING UNMET NEEDS IN THE BERKSHIRES AND IMPROVING THE HEALTH STATUS OF OUR COMMUNITY WITH A PARTICULAR FOCUS ON ACCESS TO HEALTHCARE AND "AT RISK" POPULATIONS. RECOGNIZING THE VALUE OF BMC'S PARTNERSHIP WITH OUR COMMUNITY, BMC WILL SEEK INPUT AND MEANINGFUL COLLABORATION IN OUR EFFORT TO MEET COMMUNITY NEED. BMC WILL OUTLINE IN AN ANNUAL COMMUNITY BENEFIT PLAN, THE PRIORITIES TO BE ADDRESSED AND THE INITIATIVES TO BE FUNDED.BMC AND FAIRVIEW HOSPITAL ARE BOTH PART OF BERKSHIRE HEALTH SYSTEMS AND THEREFORE WORK TOGETHER TO MEET COMMUNITY NEED. COMMUNITY BENEFIT AND ACCESS COMMITTEE:AS A STANDING COMMITTEE OF THE BOARD OF TRUSTEES - ITSELF MADE UP OF COMMUNITY VOLUNTEERS, THIS COMMITTEE IS RESPONSIBLE FOR UNDERSTANDING THE HEALTH NEEDS AND BARRIERS TO CARE IN OUR SERVICE AREA. THE COMMITTEE OVERSEES THE COMMUNITY BENEFIT PROCESS OF THE ORGANIZATION, INCLUDING HEALTH NEEDS ASSESSMENTS, DETERMINING TARGET POPULATIONS AND PRIORITIES, DEVELOPMENT OF THE COMMUNITY BENEFITS PLAN AND EVALUATING PERFORMANCE AGAINST GOALS AND OBJECTIVES. THE COMMITTEE IS COMPRISED OF PEOPLE FROM THE BOARD OF TRUSTEES AND THE COMMUNITY AT LARGE AND MEETS MONTHLY THOUGH OUT THE YEAR. COMMUNITY BENEFITS LEADERSHIP/TEAM:THE BHS COMMUNITY BENEFITS AND ACCESS COMMITTEE MEETS TO DISCUSS COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, COMMUNITY NEEDS AND OUTCOMES. IN 2021 THE COMMUNITY BENEFIT AND ACCESS COMMITTEE DID NOT MEET DUE TO THE COVID-19 PANDEMIC. COMMUNITY BENEFITS MEETINGS:THE BHS COMMUNITY BENEFITS AND ACCESS COMMITTEE MEETS TO DISCUSS COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, COMMUNITY NEEDS AND OUTCOMES. IN 2022 THE COMMUNITY BENEFIT AND ACCESS COMMITTEE DID NOT MEET DUE TO THE COVID-19 PANDEMIC. THE COMMUNITY BENEFIT AND ACCESS COMMITTEE IS CURRENTLY BEING RESTRUCTURED. COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)BMC HAS UTILIZED AN ACTIVE COMMUNITY NEEDS ASSESSMENT AS PART OF ITS COMMUNITY BENEFIT PROCESS SINCE 1996. THE COMMUNITY NEEDS ASSESSMENT IS UPDATED ANNUALLY, WITH A COMPLETE ASSESSMENT DONE EVERY THREE YEARS. THE LAST CHNA WAS COMPLETED IN THE FALL OF 2021. BMC UTILIZED ALL AVAILABLE CLINICAL, HEALTH STATUS, DEMOGRAPHIC, AND SOCIO-ECONOMIC DATA AVAILABLE TO FORM THE FOUNDATION OF OUR NEEDS ASSESSMENT. IN ADDITION, WE GATHERED AVAILABLE QUALITATIVE DATA FROM OUR MANY ADVISORY GROUPS, COMMUNITY FORUMS, SURVEYS, AND FOCUS GROUPS. THE WELLNESS AND OUTREACH PROGRAMS ALSO SUPPLEMENT OUR UNDERSTANDING OF THE HEALTH STATUS OF OUR COMMUNITY, HEALTH RISK FACTORS, AND BARRIERS TO HEALTH AND HEALTH CARE. THE FEEDBACK GATHERED INPUT ON SPECIFIC ACTIONS THAT COULD BE TAKEN AT AN INDIVIDUAL, FAMILY, AND ORGANIZATIONAL LEVEL AS WELL AS IDENTIFYING GAPS IN SERVICE IN ADDITION TO PRIORITIZING THE MOST IMPORTANT NEEDS FOR THE COMMUNITY. WE HAVE CONVENED THIS COMMUNITY GROUP AT LEAST ANNUALLY TO REVIEW DATA, CONFIRM PRIORITIES, DISCUSS NEEDS, AND WORK TOGETHER TO ADDRESS THE IDENTIFIED PRIORIES AND NEEDS. THE NEEDS DATA, ALONG WITH STATE PRIORITIES ARE USED TO DETERMINE OUR ANNUAL COMMUNITY BENEFIT PRIORITIES. IN ITS PLANNING, BMC LOOKS FOR OPPORTUNITIES TO MAKE BETTER AND MORE EFFECTIVE USE OF EXISTING RESOURCES AND PROVIDERS, AS WELL AS TO IDENTIFY GAPS IN SERVICE AND SEEKS OUT AVAILABLE GRANTS TO FACILITATE MEETING COMMUNITY NEED. BMC WORKS WITH INTERNAL RESOURCES AND COMMUNITY AND REGIONAL PARTNERS, WITH THE HELP OF EVIDENCED BASED OR BEST PRACTICE PROGRAMS, TO DEVELOP AND IMPLEMENT PROGRAMS AND INITIATIVES TO MEET COMMUNITY NEED. DATA SOURCESCOMMUNITY FOCUS GROUPS, HOSPITAL DATA, CONSUMER AND ADVISORY GROUPS, INTERVIEWS, MASS CHIP, PUBLIC HEALTH PERSONNEL, SURVEYS, OTHER - HEALTHYPEOPLE.GOV; DEPARTMENT OF PUBLIC HEALTH BUREAU OF FAMILY AND COMMUNITY HEALTH INJURY REPORT; COUNTY HEALTH RANKINGS, DEPARTMENT OF PUBLIC HEALTH PRESCRIPTION MONITORING PROGRAM DATA; PHYSICIAN MANPOWER DATA; WORKFORCE NEEDS DATA; WELLNESS AT WORK DATA; EMERGENCY DEPARTMENT/TRAUMA REGISTRY; BERKSHIRE UNITED WAY; NORTHERN BERKSHIRE COMMUNITY COALITION, BERKSHIRE REGIONAL PLANNING COMMISSION; AND YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM DATA. GOALS: STATEWIDE PRIORITIES AS PART OF OUR PLANNING PROCESS, BHS INCORPORATES THE MASSACHUSETTS STATEWIDE PRIORITIES AND THE MA DEPARTMENT OF PUBLIC HEALTH PRIORITIES TO GUIDE THE INVESTMENTS FUNDED BY THE DETERMINATION OF NEED PROCESS AS PART OF OUR LOCAL ASSESSMENT, PRIORITIES AND INITIATIVES. THE COMMONWEALTH'S PRIORITIES ARE: CHRONIC DISEASE (WITH A FOCUS ON CANCER, HEART DISEASE, & DIABETES), HOUSING STABILITY/HOMELESSNESS, MENTAL ILLNESS & MENTAL HEALTH, AND SUBSTANCE USE DISORDERS. THE DEPARTMENT OF PUBLIC HEALTH'S PRIORITIES ARE: BUILT ENVIRONMENT, SOCIAL ENVIRONMENT, HOUSING, VIOLENCE, EDUCATION AND EMPLOYMENT COMMUNITY BENEFIT TARGET POPULATIONS:CHILDREN/ADOLESCENTS OLDER ADULTS MEDICALLY UNDERSERVED COMMUNITY BENEFIT PRIORITIES:BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER CHRONIC CONDITIONS & INFECTIOUS DISEASE ACCESS TO CARE SOCIAL ECONOMIC WORKFORCE DEVELOPMENT COMMUNITY PARTNERSBEACON RECOVERY COMMUNITY CENTER, BERKSHIRE AHEC, BERKSHIRE BOUNTY, BERKSHIRE BREAST HEALTH TEAM, BERKSHIRE COMMUNITY ACTION COUNCIL, BERKSHIRE COMMUNITY PROVIDERS, BERKSHIRE COUNTY BOARDS OF HEALTH, BERKSHIRE COUNTY COURT SYSTEM, BERKSHIRE COUNTY FIRE DEPARTMENTS, BERKSHIRE COUNTY REGIONAL EMERGENCY OPERATIONS PLANNING COMMITTEE, BERKSHIRE COUNTY REGIONAL HOUSING AUTHORITY, BERKSHIRE COUNTY REGIONAL PLANNING COMMISSION, BERKSHIRE COUNTY SHERIFF'S OFFICE, BERKSHIRE DISTRICT ATTORNEY OFFICE, BERKSHIRE EMERGENCY NURSE'S ASSOCIATION, BERKSHIRE FACILITIES SERVICES, BERKSHIRE FALLON HEALTH COLLABORATIVE, BERKSHIRE IMMIGRANT CENTER, BERKSHIRE OB-GYN, BERKSHIRE OPIOID ADDICTION PREVENTION COLLABORATIVE (BOAPC), BERKSHIRE UNITED WAY, BERKSHIRE YOUTH DEVELOPMENT PROJECT, BOARDS OF HEALTH: TRI-TOWN HEALTH DEPARTMENT, BERKSHIRE COUNTY BOARDS OF HEALTH AND PITTSFIELD HEALTH DEPARTMENT, THE BRIEN CENTER FOR MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES, CHILD CARE OF THE BERKSHIRES, CLINICAL SUPPORT OPTIONS, COMMUNITY HEALTH PROGRAMS, EDUCATIONAL INSTITUTIONS (LOCAL SCHOOL DISTRICTS, BERKSHIRE COMMUNITY COLLEGE, MASSACHUSETTS COLLEGE OF LIBERAL ARTS, WILLIAMS COLLEGE, UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL), ELDER SERVICES OF BERKSHIRE COUNTY/ SENIOR CENTERS/COUNCILS ON AGING/RVSP/SHINE, FOOD BANK OF WESTERN MA, GREYLOCK FEDERAL CREDIT UNION, HOME-CARE AGENCIES, INNOVATIVE CARE PARTNERS, JUVENILE AND ADULT PROBATION, KEENAN HOUSE, LOCAL BUSINESS COMMUNITY, LOCAL EMERGENCY MANAGEMENT SERVICES/PITTSFIELD POLICE DEPARTMENT, LOCAL HIRING AGENCIES, LOCAL SHELTERS, FOOD PANTRIES, DAY PROGRAMS, ETC., MCGEE RECOVERY CENTER, MOTHER'S IN RECOVERY, NORTHERN BERKSHIRE COMMUNITY COALITION, PHYSICIAN AND SPECIAL PROVIDER OFFICES, RECREATIONAL (BERKSHIRE BOYS AND GIRLS CLUB, BERKSHIRE FAMILY YMCA, BERKSHIRE SOUTH), REGIONAL PAIN COLLABORATIVE, SERVICENET, THINK FIRST, VOLUNTEERS IN MEDICINE, WIC (WOMEN, INFANTS, AND CHILDREN), ZERO SUICIDEPROGRAM PLANNING AND EVALUATIONTHE COMMUNITY HEALTH NEEDS ASSESSMENT IS USED TO FOCUS OUR COMMUNITY BENEFIT PROGRAM AND INITIATIVE PLANNING AS WELL AS TO MONITOR RESULTS AND REPRIORITIZE FOR FUTURE EFFORTS. PART VI, LINE 3: BMC PROMINENTLY ADVERTISES THROUGHOUT THE COMMUNITY, AT ALL OF ITS FACILITIES, AND ON ITS WEBSITE ITS ADVOCACY FOR ACCESS PROGRAM. THE GOAL OF THIS PROGRAM IS TO ASSIST THE UNINSURED AND UNDERINSURED IN BERKSHIRE COUNTY IN ACCESSING VARIOUS FEDERAL, STATE, OR LOCAL PROGRAMS THAT CAN PAY FOR HEALTHCARE SERVICES, AS WELL AS INFORM PATIENTS ABOUT OTHER AVENUES THEY CAN ACCESS TO RECEIVE HEALTHCARE SERVICES AT NO COST. ADVOCACY FOR ACCESS HELPS REDUCE THE PERCEPTION THAT AN INABILITY TO PAY FOR HEALTHCARE IS A BARRIER TO RECEIVING CARE. ADVOCACY FOR ACCESS STAFF FACILITATE THE APPLICATION AND ENROLLMENT PROCESS OF INDIVIDUALS AND FAMILIES WHO LIVE IN MASSACHUSETTS INTO QUALIFIED HEALTH PLANS THROUGH THE MARKETPLACE AND/OR OTHER HEALTH INSURANCE PROGRAMS SUCH AS MEDICAID AND CHIP, AND ASSIST QUALIFIED INDIVIDUALS IN MAKING INFORMED DECISIONS ON THE SELECTION OF A HEALTH PLAN. THE STAFF RECOGNIZES THAT MANY OF THESE STATE AND FEDERAL PROGRAMS CAN BE COMPLEX AND CONFUSING, AND THEIR GOAL IS TO MAKE THE HEALTH INSURANCE ENROLLMENT PROCESS AS SIMPLE AS POSSIBLE FOR THE PATIENT. WHEN AN INDIVIDUAL OR FAMILY'S CIRCUMSTANCES CHANGE, THE ADVOCACY STAFF CAN ASSIST IN UPDATING THE APPROPRIATE AGENCY.ADVOCACY FOR ACCESS ASSISTS THOUSANDS OF PEOPLE EACH YEAR ACCESS HEALTH INSURANCE OR OTHER COVERAGE PROGRAMS TO AID THEM IN ADDRESSING THEIR HEALTHCARE NEEDS.IN ADDITION TO THE ADVOCACY FOR ACCESS PROGRAM, BERKSHIRE HEALTH SYSTEMS HAS AN INTERNAL FINANCIAL ASSISTANCE PROGRAM THAT IS AVAILABLE TO UNINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC ASSISTANCE THROUGH THE STATE OR WHO ARE NOT MASSACHUSETTS RESIDENTS.INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS IS OFFERED TO OUR PATIENTS IN THE FOLLOWING MANNER:NOTICES OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS ARE POSTED THROUGHOUT THE HOSPITAL, SPECIFICALLY IN ALL SERVICE DELIVERY AREAS, IN FINANCIAL COUNSELING OFFICES THROUGHOUT THE CLINICAL CAMPUSES, IN ALL BERKSHIRE FACULTY SERVICES PHYSICIAN PRACTICES, AND ELECTRONICALLY ON BMC'S WEBSITE WWW.BERKSHIREHEALTHSYSTEMS.ORG. APPOINTMENTS CAN BE MADE WITH THE ADVOCACY FOR ACCESS APPLICATION COUNSELORS WHO CAN ASSIST PATIENTS SUBMIT AN ELECTRONIC APPLICATION VIA WWW.MAHEALTHCONNECTOR.ORG FOR STATE FINANCIAL ASSISTANCE PROGRAMS. APPLICATION COUNSELOR ARE ALSO AVAILABLE DAILY TO MEET WITH PATIENTS WHO PRESENT AT THE OFFICE WITHOUT AN APPOINTMENT.AT PRE-REGISTRATION, SELF-PAY PATIENTS ARE OFFERED AN APPOINTMENT WITH THE ADVOCACY FOR ACCESS PROGRAM OFFICE ALONG WITH AN EXPLANATION OF THE SERVICE.BROCHURES ARE DISTRIBUTED AT ALL ACCESS POINTS INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS WITH PHONE NUMBERS TO CONTACT ADVOCACY FOR ACCESS TO SET UP AN APPOINTMENT. STATEMENTS MAILED TO PATIENTS WHO HAVE A SELF-PAY BALANCE WILL HAVE A MESSAGE INDICATING THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE AND THE PHONE NUMBERS TO CONTACT ADVOCACY FOR ACCESS FOR ADDITIONAL INFORMATION. ALL PATIENT STATEMENTS HAVE A MESSAGE ON THE BACK OF THE STATEMENT INDICATING THE AVAILABILITY OF FINANCIAL ASSISTANCE. PART VI, LINE 4: BERKSHIRE COUNTY IS THE MOST WESTERN OF THE 14 COUNTIES IN MASSACHUSETTS. WITH ABOUT 12% OF THE TOTAL LAND MASS IN MASSACHUSETTS, AND ONLY 2% OF THE POPULATION, BERKSHIRE COUNTY IS THE SECOND MOST RURAL COUNTY IN THE STATE. THE BERKSHIRES RUN ALONG THE NEW YORK BORDER FROM VERMONT IN THE NORTH TO CONNECTICUT IN THE SOUTH AND ENCOMPASSES MOST OF THE MOUNTAIN RIDGE THAT SEPARATES THE HUDSON AND CONNECTICUT RIVER VALLEYS. ELEVATIONS RANGE FROM 500 FEET IN THE RIVER VALLEYS TO 3500 FEET AT MOUNT GREYLOCK.THE SOCIODEMOGRAPHIC CHARACTERISTICS OF BERKSHIRE COUNTY:SEX AND AGE TOTAL POPULATION 125,927 MALE 48.5% FEMALE 51.5%MEDIAN AGE (YEARS) 47.2 YRS. UNDER 5 YEARS 4.2% 5-19 YEARS 15.7% 20-64 YEARS 56.9% 65 YEARS AND OVER 23.2%RACE AND ETHNICITY ONE RACE 96.3% WHITE 89.9% BLACK OR AFRICAN AMERICAN 2.7% AMERICAN INDIAN AND ALASKA NATIVE 0.3% ASIAN 1.7% NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER 0.0% SOME OTHER RACE 1.6%TWO OR MORE RACES 3.7%HISPANIC OR LATINO (OF ANY RACE) 5.0% NOT HISPANIC OR LATINO 95.0% NOT HISPANIC OR LATINO, WHITE ALONE 87.7%THE COUNTY IS COMPRISED OF THREE DISTINCT SUB-REGIONS: NORTH, SOUTH, AND CENTRAL WHICH FORM THE OVERALL COUNTY PROFILE OF A LARGELY RURAL AREA WITH SMALL URBAN, AGRARIAN, AND POST-INDUSTRIAL TOWNS AND CITIES. WHILE TIED TOGETHER ECONOMICALLY, SOCIALLY, AND POLITICALLY, EACH SUB-REGION REFLECTS A DEGREE OF SOCIAL AND ECONOMIC DIFFERENCES, PRIMARILY DUE TO THE 50-MILE LENGTH OF THE COUNTY FROM NORTH TO SOUTH. BERKSHIRE COUNTY'S POPULATION, ACCORDING TO THE 2020 CENSUS, IS 129,026, WITH POPULATION LARGELY CONCENTRATED IN THE COUNTY'S TWO CITIES-PITTSFIELD (43,927) AND NORTH ADAMS (12,961).SINCE THE CLOSURE OF THE FORMER NORTH ADAMS REGIONAL HOSPITAL IN 2014, BERKSHIRE MEDICAL CENTER AND BERKSHIRE HEALTH SYSTEMS STABILIZED ACCESS TO CRITICAL SERVICES FIRST AND THEN PROCEEDED TO ADD ADDITIONAL SERVICES TO MEET COMMUNITY NEED AND ACCESS EFFORTS. THIS WORK CONTINUES AND HAS BEEN SUPPORTED WITH THE HELP OF MANY LOCAL ORGANIZATIONS, ELECTED OFFICIALS, AND GOVERNMENT AGENCIES. THE BERKSHIRES IS A NATIONALLY RECOGNIZED YEAR-ROUND TOURIST DESTINATION, KNOWN FOR ITS CULTURAL OFFERINGS AND OUTDOOR RECREATION. BOASTING AWARD-WINNING ART MUSEUMS, HISTORICAL DESTINATIONS, AND THEATRES ALONGSIDE SCENIC HIKING, BIKING, AND SKIING, THE BERKSHIRES HAS BEEN A HOLIDAY DESTINATION FOR BOSTON AND NEW YORK RESIDENTS FOR HUNDREDS OF YEARS AND IS HOME TO MANY SEASONAL RESIDENTS. THE COUNTY IS TRADITIONALLY DIVIDED INTO THREE REGIONS: NORTH, CENTRAL, AND SOUTH. IT TAKES ABOUT TWO HOURS TO DRIVE FROM THE TOWN OF SHEFFIELD IN THE SOUTH TO WILLIAMSTOWN IN THE NORTH. THERE IS NO COUNTY GOVERNMENT, AND ALL LOCAL SERVICES ARE THE RESPONSIBILITY OF EACH OF THE COUNTY'S 32 TOWNS AND CITIES. THE COMMONWEALTH OF MASSACHUSETTS FUNDS A COUNTY SHERIFF'S DEPARTMENT, DISTRICT ATTORNEY'S OFFICE, THE COURT SYSTEM, AND REGISTRY OF DEEDS. EACH AREA OF THE COUNTY IS SERVICED BY A REGIONAL EMERGENCY PLANNING COMMITTEE (REPC).BERKSHIRE COUNTY'S POVERTY RATE MIRRORS THAT OF THE STATE, HOWEVER, THE COUNTY HAS A SLIGHTLY INCREASED RATE OF POVERTY AMONG MINORS (UNDER 18 YEARS OLD). MEDIAN HOUSEHOLD INCOME FOR THE REGION IS AT LEAST 25% LOWER THAN THE STATE AVERAGE.POVERTY: PERCENTAGE OF ALL PEOPLE WHOSE INCOME IN THE PAST 12 MONTHS IS BELOW THEPOVERTY LEVEL: BERKSHIRE COUNTY 9.7% MASSACHUSETTS 9.8%POVERTY UNDER 18 YEARS: BERKSHIRE COUNTY 13.9% MASSACHUSETTS 12.2%INCOME: MEDIAN HOUSEHOLD INCOME: BERKSHIRE COUNTY $62,166 MASSACHUSETTS $84,385 MEDIAN NONFAMILY INCOME: BERKSHIRE COUNTY $36,294 MASSACHUSETTS $48,876DATA SOURCE US CENSUS BUREAU,ACS 5-YEAR ESTIMATES, 2020THE EDUCATION PROFILE OF COUNTY RESIDENTS REFLECTS THE ECONOMIC AND POPULATION DEMOGRAPHIC:THE EDUCATION LEVEL OF BERKSHIRE COUNTY RESIDENTS LARGELY MIRRORS THAT OF MASSACHUSETTS, SURPASSING THE STATE IN THE PERCENTAGE OF INDIVIDUALS WHO HAVE GRADUATED FROM HIGH SCHOOL AND HAVE AT LEAST SOME COLLEGE, OR AN ASSOCIATE DEGREE. BERKSHIRE COUNTY HAS A SIGNIFICANTLY SMALLER POPULATION OF BACHELOR'S EDUCATED RESIDENTS THAN THE STATE OVERALL (35.3% VS. 44.5%)A TOTAL OF 7.5% OF INDIVIDUALS OVER THE AGE OF 5 SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THIS FIGURE HAS BEEN RISING CONSISTENTLY, INDICATING THE GROWTH OF IMMIGRANT POPULATIONS. BHS LANGUAGE SERVICE ENCOUNTERS REVEAL A SIMILAR TREND, WITH A HIGHER AVERAGE NUMBER OF REQUESTS FOR LANGUAGE SUPPORT SERVICES IN 2021.THE CONNECTION BETWEEN EDUCATION AND INCOME CAN BE A SIGNIFICANT DETERMINANT IN HEALTH STATUS, AS IT CAN RELATE TO FOOD SECURITY, HOUSING, BEHAVIORAL HEALTH CHOICES, AND GENERAL FEELING OF WELL-BEING. THE CUMULATIVE IMPACT OF THIS TRANSITION HAS HAD A SIGNIFICANT IMPACT ON THE FABRIC OF THE COMMUNITY. TRADITIONAL SUPPORT SYSTEMS OF FAMILY, SCHOOLS, AND RELIGION HAVE BEEN CHALLENGED BY THESE DEVELOPMENTS:ALCOHOL AND DRUG ABUSE ARE SIGNIFICANT ISSUES. COUNTY RESIDENTS ARE ADMITTED INTO SUBSTANCE USE TREATMENT AT A FAR GREATER RATE THAN THE STATE AVERAGE.IN 2016, SUICIDE RATES IN BERKSHIRE COUNTY WERE 11.8 AND CONTINUE TO BE HIGHER THAN THE STATE RATE OF 9.2 PER 100,000 POPULATION. (CHNA)FROM 2012 TO 2016 THE VIOLENT CRIME RATE PER 100,00 POPULATION INCREASED BY 95% IN NORTH ADAMS (705.3 TO 1375.2) AND 85.6% IN PITTSFIELD'S (425.7 TO. 790.1). HOWEVER, DURING THE SAME PERIOD MASSACHUSETTS, OVERALL, HAD A DECREASE OF 7.1% (405.5 TO 376.9). (CITY DATA)COMMUNITY PARTNERS NORTHERN BERKSHIRE COMMUNITY COALITION, THE BERKSHIRE YOUTH DEVELOPMENT PROJECT, BERKSHIRE UNITED WAY, AND THE RAILROAD STREET YOUTH PROJECT WITH THE SUPPORT OF BHS, CONDUCTED A COUNTY-WIDE PREVENTION NEEDS ASSESSMENT SURVEY IN 2021. THERE ARE SOME DIFFERENCES BETWEEN THE COUNTY, FOR EXAMPLE ALCOHOL USE IS MORE LIKELY IN CENTRAL COUNTY AND CIGARETTES ARE MORE LIKELY IN SOUTH COUNTY WHERE SUICIDAL IDEATION IS MORE LIKELY IN NORTH COUNTY. AMONG ADOLESCENTS, ALCOHOL, MARIJUANA, AND TOBACCO APPEAR TO BE THE MOST PREVALENT SUBSTANCES BEING USED. (CHNA) CONTINUED ON SCHEDULE O PART VI, LINE 5: THE GOVERNING BODY OF BERKSHIRE MEDICAL CENTER (BMC) CONSISTS OF COMMUNITY VOLUNTEERS, PHYSICIAN REPRESENTATIVES OF THE HOSPITALS' MEDICAL STAFF AND, AND THE CHIEF EXECUTIVE OFFICER. THE COMMUNITY VOLUNTEERS ARE ELECTED FOR TERMS OF UP TO THREE YEARS, ARE SUBJECT TO TERM LIMITS AND REPRESENT A WIDE SPECTRUM OF COMMUNITY INTERESTS-INCLUDING SOCIAL SERVICE PROVIDERS, LOCAL BUSINESS LEADERS, FINANCIAL PROFESSIONALS, CONSUMER ADVOCATES AND EDUCATIONAL LEADERS. MOST COMMITTEES OF THE BOARD OF TRUSTEES INCLUDE ADDITIONAL COMMUNITY REPRESENTATIVES. BHS MAINTAINS A PATIENT AND FAMILY COUNCIL TO PROVIDE INPUT AND ADVICE ON A WIDE RANGE OF SERVICE TOPICS.THE MEDICAL STAFF OF BHS IS OPEN TO ALL PHYSICIANS WHO MEET CLINICAL AND PATIENT SERVICE CRITERIA, ALTHOUGH CERTAIN HOSPITAL-BASED SERVICES-RADIOLOGY, ANESTHESIA, EMERGENCY DEPARTMENT AND PATHOLOGY-ARE FUNCTIONALLY CLOSED BECAUSE OF THE WAY THOSE DEPARTMENTS ARE STRUCTURED.BMC REGULARLY EXPENDS PERSONNEL AND FINANCIAL RESOURCES IN SUPPORT OF COMMUNITY INITIATIVES THAT PROMOTE IMPROVEMENTS IN COMMUNITY HEALTH AND WELL-BEING AND FOR WHICH IT DOES NOT EXPECT REIMBURSEMENT. THE HOSPITAL UTILIZES SURPLUS FUNDS FOR CAPITAL IMPROVEMENTS AND TO MAINTAIN ACCESS TO PATIENT SERVICES AND EXPAND ACCESS POINTS OF CARE AND SERVICES THAT SUPPORT COMMUNITY BENEFIT PRIORITIES TO PATIENTS THROUGHOUT THE COMMUNITY. THE BERKSHIRE COUNTY COMMUNITY HAS LONG LABORED UNDER A CRITICAL PHYSICIAN SHORTAGE IN VARIOUS SPECIALTIES AND BHS HAS IN RECENT YEARS EXPENDED SIGNIFICANT PERSONNEL TIME AND FINANCIAL RESOURCES IN RECRUITING PHYSICIANS TO THE AREA AS DIRECT EMPLOYEES OF BHS OR ITS AFFILIATES. MOREOVER, BMC HAS, IN APPROPRIATE WAYS, PROVIDED SUBSTANTIAL ASSISTANCE TO COMMUNITY MEDICAL PRACTICES TO RECRUIT AND SUPPORT THE PRACTICE START-UP OF NEW PHYSICIANS IN NEEDED SPECIALTIES. THE HEALTH SYSTEM IS ALSO FACING CRITICAL SHORTAGES IN VARIOUS AREAS OF NURSING AND HEALTHCARE. AS DISCUSSED AT GREATER LENGTH IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), BMC CONTINUALLY GOES ABOVE AND BEYOND TO SUPPORT THE HEALTH OF THE COMMUNITY THROUGH EXTENSIVE COMMUNITY OUTREACH PROGRAMS AND SUPPORT, COMPREHENSIVE, COMMUNITY-BASED INITIATIVES TO ADDRESS SUCH DIVERSE HEALTHCARE CHALLENGES AS DIABETES, HYPERTENSION AND HEART FAILURE, SMOKING CESSATION, FALLS PREVENTION, AND CHRONIC PAIN MANAGEMENT/NARCOTICS USE AND DIVERSION, AND ACCESS TO CARE.EXAMPLES OF BMC PROMOTING THE HEALTH OF THE COMMUNITY IN FY21 INCLUDES BUT IS NOT LIMITED TO:DONATED FUNDS TO COMMUNITY EVENTS, LOCAL SPORTS TEAMS, ORGANIZATIONS, AND INITIATIVESHOSTED SEVERAL COMMUNITY EVENTS INCLUDING A SUPPORT GROUPS AND COMMUNITY EDUCATION, BMC INDEPENDENCE DAY RUN, BERKSHIRES 150, FOOD SERVICE DONATION TO HOMELESS SHELTERS MEDICAL STUDENTS PROVIDING HEALTH EDUCATION AT COMMUNITY EVENTSMEMBERS OF THE WELLNESS PROGRAM AND MANAGEMENT TEAM PROVIDING BLOOD PRESSURE SCREENINGS, HEALTH EDUCATION, ENVIRONMENTAL CLEAN UPS, AND OTHER COMMUNITY VOLUNTEERISMOFFERED COMMUNITY PARTNERS FREE ACCESS TO COMMUNITY HEALTH WORKER TRAINING PROGRAMPROVIDED JOURNEY TO HEALTH, A SERIES OF CLASSES ON HEALTH AND WELLBEING WITH PRESENTATIONS DELIVERED BY DOCTORS, NURSES, DIETITIANS, AND SOCIAL WORKERSSUPPORTED A WIDE VARIETY OF COMMUNITY ORGANIZATIONS AND INITIATIVES INCLUDING HEALTH RELATED ORGANIZATIONS SUCH AS THE BRIEN CENTER (MENTAL HEALTH AND ADDICTION TREATMENT), THE ELIZABETH FREEMAN CENTER (RAPE AND SEXUAL ASSAULT SUPPORT), HILLCREST EDUCATIONAL CENTERS (EDUCATION FOR YOUTH WITH DEVELOPMENTAL DISABILITIES), AND THE DARE PROGRAM (DRUG-RESISTANCE PROGRAM FOR KIDS)SUPPORTED SIGNIFICANT COMMUNITY EDUCATIONAL AND CULTURAL INSTITUTIONS IN OUR AREA INCLUDING BERKSHIRE COMMUNITY COLLEGE, BERKSHIRE THEATRE GROUP, MASSACHUSETTS COLLEGE OF LIBERAL ARTS, THE PITTSFIELD PARADE COMMITTEE, GIRLS INC., AND COMMUNITY ACCESS TO THE ARTSASSISTED COMMUNITY AGENCIES WITH NALOXONE AND EDUCATION PART VI, LINE 6: BMC IS A PART OF AN INTEGRATED, NON-PROFIT HEALTHCARE SYSTEM THAT INCLUDES (A) A TEACHING HOSPITAL, (B) A CRITICAL ACCESS COMMUNITY HOSPITAL, (C) A LARGE, MULTISPECIALTY FACULTY PRACTICE ORGANIZATION, (D) A HOME HEALTH AGENCY AND (E), BY CONTRACT AND CLOSE COORDINATION, A NON-PROFIT SENIOR CARE ORGANIZATION THAT INCLUDES SUB-ACUTE SERVICES IN REHABILITATION AND LONG TERM CARE FACILITIES, ASSISTED LIVING FACILITIES, HOSPICE CARE SERVICES, SENIOR DAY CARE AND OTHER ELDERCARE SERVICES. BMC ENGAGES IN HEALTHCARE NEEDS ASSESSMENT AND PLANNING ON A SYSTEM-WIDE BASIS, WITH A GOAL OF A SEAMLESS TRANSITION OF PATIENT-CENTERED CARE ACROSS THE SPECTRUM OF SERVICES OFFERED BY EACH OF THE SYSTEM'S COMPONENT ENTITIES. BMC, ALONG WITH ITS AFFILIATES, CONTINUES TO DEVELOP INTEGRATED CLINICAL AND INFORMATION SYSTEMS ACROSS THE ENTIRE ORGANIZATION SO AS TO RENDER CARE EFFICIENTLY, EFFECTIVELY AND CONSISTENTLY AT EVERY CARE SITE. THE BMC AFFILIATES SUCH, AS THE PHYSICIAN FACULTY PRACTICE, ARE FULLY INTEGRATED INTO OUR COMMUNITY BENEFIT PROCESS AND SUPPORT THE ORGANIZATION'S PRIORITIES BY HONORING OUR FREE CARE GUIDELINES AND IN ENGAGING IN SPECIFIC PROGRAMS AND INITIATIVES DESIGNED TO MEET COMMUNITY NEED. PART VI, LINE 7, REPORTS FILED WITH STATES MA 0 0 0 0 0 0 0 0 0 DAVID PHELPS TRUSTEE/PRESIDENT TERM ENDED 1/1/22 0 1090852 0 0 0 46780 0 13050 0 38402 0 1189084 0 0 DARLENE RODOWICZ PRESIDENT/TRUSTEE TERM BEGAN 1/1/22 0 542023 0 0 0 63108 0 12083 0 34401 0 651615 0 0 TONY MAKDISI MD HOSPITALIST 578514 0 9996 0 2934 0 12800 0 32674 0 636918 0 0 0 ROBIN BURNS-LAMBERT MD ANESTHESIOLOGIST 562286 0 0 0 5471 0 12517 0 32782 0 613056 0 0 0 RAYMOND GARY SOHL MD ANESTHESIOLOGIST 535412 0 0 0 8120 0 8453 0 37315 0 589300 0 0 0 SEETHA MUTHAVARAPU MD HOSPITALIST 504277 0 8871 0 2766 0 13050 0 32733 0 561697 0 0 0 BARANI MAYIL VAGANAN MD GASTROENTEROLOGIST 464055 0 47345 0 2308 0 13050 0 26650 0 553408 0 0 0 MICHAEL MCHUGH MD CHAIRMAN-E.D. MEDICINE 420735 0 65041 0 16679 0 13050 0 33679 0 549184 0 0 0 ANDREW MANZER CHIEF OPERATING OFFICE 451448 0 0 0 51127 0 12275 0 30552 0 545402 0 0 0 SCOTT ST GEORGE TREASURER 0 480696 0 0 0 37308 0 895 0 10744 0 529643 0 0 ALEC R BELMAN MD TRUSTEE/PHYSICIAN TERM BEGAN 1/22 0 347321 0 16696 0 2637 0 13050 0 37267 0 416971 0 0 MICHAEL MCINERNEY MD TRUSTEE/PHYSICIAN TERM ENDED 12/21 0 265072 0 21779 0 6982 0 10724 0 33340 0 337897 0 0 BRIAN BURKE MD TRUSTEE/PHYSICIAN TERM END 12/21 0 191950 0 0 0 5571 0 8955 0 27098 0 233574 0 0 EDMUND HORNSTEIN DO TRUSTEE 0 0 0 0 192314 0 0 0 0 0 192314 0 0 0 PART II IN REFERENCE TO FORM 990, PART VII AND SCHEDULE J PART II, NO COMPENSATION IS PAID BY THE FILING ENTITY TO ANY DIRECTOR (TRUSTEE) FOR HIS OR HER ROLE AS DIRECTOR (TRUSTEE). THE OFFICERS OF THE FILING ENTITY ARE COMPENSATED FOR THEIR ROLES AS OFFICERS. PHYSICIANS WHO SERVE AS DIRECTOR (TRUSTEE) ARE COMPENSATED FOR THEIR ROLES AS PHYSICIANS. COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY THE INDEPENDENT VOLUNTEER GOVERNING BODY OF BERKSHIRE HEALTH SYSTEMS, INC. (PARENT ORGANIZATION OF THE FILING ENTITY), BASED ON PERFORMANCE REVIEWS AND COMPARISON TO INDEPENDENTLY ESTABLISHED, REGIONALLY APPROPRIATE BENCHMARKS FOR SIMILAR POSITIONS IN SIMILARLY SIZED HEALTHCARE ORGANIZATIONS, AS VERIFIED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS SET IN ACCORDANCE WITH GOVERNING-BODY ESTABLISHED PRINCIPLES BASED ON COMPARABLE BENCHMARK IDENTIFIED BY SUCH INDEPENDENT CONSULTANTS. IN THE REPORTING YEAR, THE GOVERNING BODY TARGETED TOTAL COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 60TH PERCENTILE OF APPROPRIATE. A MDFA BHS SERIES I 043431814 57584YP94 2021-08-03 58923326 REFUND SERIES G BONDS 0 0 0 A 58923326 844443 58078883 2021 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 X 1 99660 FAIR MARKET VLAUE 0 1 0 PART I, COLUMN (B): ORGANIZATION RECEIVED ONE CONTRIBUTION OF PUBLICLY TRADED STOCK. FORM 990, PART VI, SECTION A, LINE 6 BERKSHIRE HEALTH SYSTEMS, INC. IS THE SOLE CORPORATE MEMBER OF BERKSHIRE MEDICAL CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES IS COMPOSED OF THE INCUMBENT MEMBERS OF THE BOARD OF TRUSTEES OF BERKSHIRE HEALTH SYSTEMS, INC. FORM 990, PART VI, SECTION B, LINE 11B BHS WILL MAKE THE FORMS 990 FOR BHS AND AFFILIATES AVAILABLE TO THE MEMBERS OF THE RESPECTIVE GOVERNING BODIES FOR THEIR REVIEW BY (A) SENDING COPIES TO THEM PHYSICALLY OR ELECTRONICALLY, OR (B) NOTIFYING THE MEMBERS THAT THE FORMS 990 CAN BE ACCESSED BY A SECURE WEB-BASED FOLDER BEFORE THEY ARE FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY REQUIRING ALL MEMBERS OF THE GOVERNING BODY AND ALL OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST (A) ANNUALLY AND (B) AS POTENTIAL CONFLICTS ARISE. THE EXECUTIVE COMMITTEE OF THE GOVERNING BODY IS CHARGED WITH REVIEWING POTENTIAL CONFLICTS OF INTEREST INVOLVING MEMBERS OF THE GOVERNING BODY OR THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION. THE PRESIDENT AND CHIEF EXECUTIVE OFFICER IS CHARGED WITH REVIEWING POTENTIAL CONFLICTS OF INTEREST INVOLVING ANY OTHERS. OFFICERS (INCLUDING THE PRESIDENT AND CHIEF EXECUTIVE OFFICER), KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES ARE NOT PERMITTED TO HAVE MATERIAL CONFLICTS OF INTEREST. THE DISINTERESTED MEMBERS OF THE GOVERNING BODY ARE CHARGED WITH DETERMINING WHETHER A CONFLICT EXISTS IN THE CASE OF MEMBERS OF THE GOVERNING BODY AND HOW THE AFFECTED MEMBER IS TO ABSTAIN FROM ACTION THAT MAY BE INFLUENCED BY HIS OR HER CONFLICT OR POTENTIAL CONFLICT, INCLUDING BY (A) NOT VOTING OR (B) NOT VOTING AND LEAVING THE ROOM OR (C) LEAVING THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE CHIEF EXECUTIVE OFFICER IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY THE INDEPENDENT, VOLUNTEER, BHS GOVERNING BODY, BASED ON PERFORMANCE REVIEWS AND COMPARISON TO INDEPENDENTLY ESTABLISHED, REGIONALLY APPROPRIATE BENCHMARKS FOR SIMILAR POSITIONS IN SIMILARLY SIZED HEALTHCARE ORGANIZATIONS, AS VERIFIED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS SET IN ACCORDANCE WITH GOVERNING BODY-ESTABLISHED PRINCIPLES BASED ON COMPARABLE BENCHMARK IDENTIFIED BY SUCH INDEPENDENT CONSULTANTS. IN THE REPORTING YEAR, THE GOVERNING BODY TARGETED TOTAL COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 60TH PERCENTILE OF APPROPRIATE BENCHMARKS. THE ORGANIZATION FOLLOWED THIS PROCESS FOR THE TAX YEAR BEING REPORTED. FORM 990, PART VI, SECTION C, LINE 18 BERKSHIRE MEDICAL CENTER, INC'S FORM 990 REPORT IS AVAILABLE ON THE FOLLOWING WEBSITES: GUIDESTAR AT WWW.GUIDESTAR.ORG OFFICE OF THE MA ATTORENY GENERAL AT WWW.CHARITIES.AGO.STATE.MA.US/CHARITIES/ FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AT THE OFFICE OF (A) THE CHIEF FINANCIAL OFFICER AND (B) THE VICE PRESIDENT AND GENERAL COUNSEL AT 725 NORTH STREET, PITTSFIELD MA 01201. FORM 990, PART XI, LINE 9: EQUITY TRANSFER -25,439,663. SCHEDULE H PART V SECTION B LINE 5 CHRONIC CONDITIONS CHRONIC HEALTH CONDITIONS REMAIN PRIORITIZED NEEDS. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), CARDIOVASCULAR DISEASE, AND OTHER CHRONIC CONDITIONS THAT ARE ALSO RISK FACTORS FOR HEART DISEASE - DIABETES AND OBESITY - ALSO SHOW DISPARITIES, WITH HIGHER RATES AMONG BLACK RESIDENTS. ANOTHER CHRONIC CONDITION, ALZHEIMER'S DISEASE, APPEARS TO HAVE BEEN AFFECTED BY COVID-19, WITH THE U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) REPORTING THAT THERE WERE 16% MORE DEATHS FROM THIS AND OTHER FORMS OF DEMENTIA IN 2020 COMPARED TO THE PRIOR FIVE-YEAR AVERAGE. CANCER HOSPITAL ADMISSION RATES DECREASED ACROSS THE SERVICE AREA. THE SERVICE AREA SAW AN INCREASE IN RESIDENTS AGED 65 AND OLDER LIVING IN THE AREA, AND ADVANCED AGE (65 AND OLDER) IS A RISK FACTOR FOR CANCER. ACCESS TO PHYSICAL ACTIVITY AND A HEALTHY DIET CONTRIBUTE TO HEALTH AND WELL-BEING, AND YOUTH AND ADULTS ARE NOT GETTING THE RECOMMENDED INTAKE OF FRUITS AND VEGETABLES AND LEISURE-TIME PHYSICAL ACTIVITY. BERKSHIRE COUNTY HAS THE HIGHEST RATE OF PREMATURE DEATH UNDER AGE 75 IN MASSACHUSETTS, WITH BLACK RESIDENTS IN BERKSHIRE COUNTY DISPROPORTIONATELY IMPACTED BY PREMATURE DEATH. HOUSING AND HOMELESSNESS AFFORDABLE, ACCESSIBLE, AND SUPPORTIVE HOUSING IS A KEY CONTRIBUTOR TO HEALTH, AND COVID-19 HAS CONTRIBUTED TO HOUSING CHALLENGES. SEVERAL KEY INFORMANT INTERVIEWS FOR THIS REPORT IDENTIFIED SAFE AND AFFORDABLE HOUSING AS ONE OF THE TOP HEALTH-RELATED CONCERNS. MORE THAN ONE IN FOUR (26%) OF HOUSEHOLDS IN THE SERVICE AREA QUALIFY AS HOUSING-COST BURDENED, MEANING THEY SPEND 30% OR MORE OF THEIR INCOME ON HOUSING. UNAFFORDABLE HOUSING CORRELATES WITH A GREATER-THAN-AVERAGE PREVALENCE OF HOMELESSNESS - A SITUATION THAT HAS WORSENED OVER THE PAST DECADE. THE PANDEMIC HAS CORRELATED WITH A GENERAL INCREASE IN HOUSING PRICES THAT HAS MOVED HOMEOWNERSHIP - A COMMON VEHICLE FOR WEALTH-GENERATION - OUT OF REACH FOR MANY. THE SHORT-TERM MIGRATION OF NEW YORK AND BOSTON RESIDENTS TO THE COUNTY TO ESCAPE THE PANDEMIC FURTHER IMPACTED HOUSING AFFORDABILITY AND ACCESS. A RECENT RISE IN INTEREST RATES HAS MADE HOMEOWNERSHIP EVEN LESS ATTAINABLE. TRANSPORTATION AFTER HOUSING, TRANSPORTATION WAS THE SECOND MOST PRESSING ISSUE IDENTIFIED BY KEY INFORMANTS AND PUBLIC HEALTH OFFICIALS IN BERKSHIRE COUNTY. RELIABLE TRANSPORTATION IS A CRITICAL PART OF DAILY LIFE, ALLOWING INDIVIDUALS TO GO TO WORK, TRAVEL TO THE GROCERY STORE, AND GET TO MEDICAL APPOINTMENTS. TRANSPORTATION TO GET TO MEDICAL APPOINTMENTS IS A PARTICULARLY DIFFICULT ISSUE FOR CHILDREN AND ADULTS LIVING WITH DISABILITIES, OLDER ADULTS, AND LIMITED-INCOME POPULATIONS. APPROXIMATELY ONE IN TEN (9%) OF SERVICE AREA RESIDENTS REPORT NOT HAVING ANY ACCESS TO A VEHICLE. THE COVID-19 PANDEMIC EXACERBATED PROBLEMS OF ACCESS TO TRANSPORTATION. ACCORDING TO A REPORT BY THE BUREAU OF LABOR STATISTICS, THE PRICE OF USED CARS INCREASED BY 41% IN THE 12 MONTHS BETWEEN JANUARY 2021 AND JANUARY 2022. FUEL COSTS HAVE INCREASED BY 47% OVER THE SAME INTERVAL. THIS MEANS THAT RELIABLE TRANSPORTATION HAS BECOME LESS AFFORDABLE FOR MANY. PRIORITY POPULATIONS THIS CHNA IDENTIFIED MANY INEQUITIES IN PRIORITIZED HEALTH NEEDS AMONG YOUTH, OLDER ADULTS, AND MEDICALLY UNDERSERVED INDIVIDUALS. ALSO, THOSE WHO ARE BLACK OR LATINO/A/E EXPERIENCE FURTHER INEQUITIES, AS THEY OR THEIR FAMILIES HAVE A LOWER MEDIAN INCOME THAN WHITE RESIDENTS, MAKING IT HARDER FOR THEM TO AFFORD BASIC NEEDS AND TO ACCESS QUALITY HEALTH CARE. THEY ALSO EXPERIENCE FRAGMENTATION OF CARE, INDIVIDUAL AND SYSTEMIC RACISM WITHIN HEALTH CARE INSTITUTIONS, AND LACK OF CARE THAT IS CULTURALLY AND LINGUISTICALLY APPROPRIATE. THE PANDEMIC EXACERBATED EXISTING INEQUITIES. THERE WERE HIGHER RATES OF INFECTION AND DEATH IN BERKSHIRE COUNTY RELATIVE TO SOME OF THE OTHER WESTERN MASSACHUSETTS COUNTIES. NATIONAL TRENDS INDICATE THAT OLDER ADULTS, COMMUNITIES OF COLOR, AND THOSE WITH LIMITED MEANS SUFFERED HIGHER RATES OF BOTH INFECTION AND DEATH. BASED ON NATIONAL STUDIES, THE PANDEMIC-INDUCED UPHEAVAL IN THE ECONOMY AND THE SHIFT TO REMOTE SCHOOLING DISPROPORTIONATELY HARMED WOMEN OF COLOR AND CAUSED DISRUPTIONS IN EDUCATION FOR YOUTH. THE PANDEMIC ALSO HAD SIGNIFICANT EFFECTS ON MENTAL HEALTH. LGBTQIA+ YOUTH, YOUTH WITH DISABILITIES, AND OLDER ADULTS EXPERIENCED HIGH RATES OF DEPRESSION AND ANXIETY DURING COVID-19 COMPARED TO OTHER GROUPS. MEDICALLY UNDERSERVED INDIVIDUALS EXPERIENCE COMPLEX HEALTH NEEDS THAT OFTEN HAVE ROOTS IN SYSTEMIC BARRIERS. THESE INCLUDE HIGH RATES OF SUBSTANCE USE, MENTAL ILLNESS, CHRONIC DISEASE, AND INFECTIOUS DISEASE - WHICH OFTEN CO-OCCUR. THIS POPULATION IS DISPROPORTIONATELY COMPOSED OF PEOPLE WITH LIMITED INCOMES, IMMIGRANTS, AND INDIVIDUALS OF COLOR. IMMIGRANTS WERE ALSO AT GREATER RISK FOR COVID-19 INFECTION AND DEATH. ADDITIONALLY, THEY FACE BARRIERS DUE TO THE STIGMA ASSOCIATED WITH BEING AN IMMIGRANT, AND DISCRIMINATION IN ACCESSING HOUSING AND EMPLOYMENT. IN SUM, FOR SO MANY FACETS OF HEALTH AND HEALTH CARE, COVID-19 DEEPENED INEQUITIES. VIRTUALLY EVERY PRIORITIZED HEALTH NEED WAS AFFECTED BY THE PANDEMIC, AND PEOPLE WITH ONE OR MORE MARGINALIZED IDENTITIES OFTEN FELT THE COMPOUNDING EFFECTS. SCHEDULE H, PART V SECTION B LINE 11 OBESITY - BERKSHIRE MEDICAL CENTER HAS SEVERAL PROGRAMS FOCUSED ON REDUCING OBESITY AMONG BOTH YOUTH AND ADULT POPULATIONS. OPERATION BETTER START (OBS) IS A UNIQUE PROGRAM THAT WORKS WITH FAMILIES AND CHILDREN TO PROVIDE NUTRITIONAL GUIDANCE AND EXERCISE PROGRAMS. OBS PARTNERS WITH LOCAL PEDIATRICIANS AND THE PUBLIC SCHOOLS TO REACH AT RISK YOUTH AND FAMILIES. BMC WELLNESS AT WORK PROVIDES LOCAL BUSINESSES WITH TARGETED WELLNESS PROGRAMS FOR EMPLOYEES TO REDUCE OBESITY AND OTHER CO-MORBIDITIES. TOBACCO USE/ NICOTINE DEPENDENCE- THIS NEED IS ADDRESSED BY BMC THROUGH "HYPNOSIS FOR QUITTING SMOKING", BEAT THE PACK (OFFERED TO EMPLOYEES), TOBACCO CESSATION EDUCATION AND, REFERRALS TO OTHER TOBACCO CESSATION PROGRAMS. ADDITIONALLY, OTHER COMMUNITY ORGANIZATIONS AND PROGRAMS THAT ARE ON THE FOREFRONT OF ADDRESSING THIS NEED INCLUDE: BERKSHIRE AHEC, TRI-TOWN HEALTH DEPARTMENT, MAKE SMOKING HISTORY THROUGH MASSACHUSETTS DPH, AND QUIT TO WIN THROUGH FALLON HEALTH. BMC REFERS TO THESE PROGRAMS FOR TOBACCO AND NICOTINE CESSATION EFFORTS. ACCESS TO CARE ACCESS FOR UNDER AND UNINSURED - BMC'S ADVOCACY FOR ACCESS PROGRAM CONNECTS THOUSANDS OF PEOPLE IN OUR COMMUNITY TO HEALTH INSURANCE OPTIONS AVAILABLE THROUGH MASSHEALTH AND OTHER PROGRAMS. ENHANCING ACCESS AND THE HEALTHCARE WORKFORCE - THE REGION'S SIGNIFICANT RELIANCE ON GOVERNMENT-REIMBURSED SERVICES CAN HAVE A DIRECT INFLUENCE ON LOCALLY AVAILABLE PROGRAMS AND SERVICES. BHS CONTINUES TO FACE STAFFING CHALLENGES, LIKE THOSE EXPERIENCED ACROSS THE NATION AND IS EXPLORING CAREER TRAINING PROGRAMS THAT CAN SIMULTANEOUSLY HELP TO REDUCE CLINICIAN SHORTAGES AND HELP TO RAISE MEDIAN INCOME LEVELS THROUGH STRONG EMPLOYMENT OPPORTUNITIES FOR BERKSHIRE RESIDENTS. SOCIAL ECONOMIC COMMUNITY DEVELOPMENT/ ENGAGEMENT - BMC WORKS IN COLLABORATION WITH NUMEROUS COMMUNITY ORGANIZATIONS ON PROGRAMS THAT ARE AIMED AT IMPROVING COMMUNITY DEVELOPMENT, SOME OF OUR PARTNERS INCLUDE: NORTHERN BERKSHIRE COMMUNITY COALITION, THE BERKSHIRE UNITED WAY, LOCAL SENIOR CENTERS, CITY GOVERNMENT IN PITTSFIELD AND NORTH ADAMS, AND MORE. EMERGENCY PREPAREDNESS - WORKING IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS, INCLUDING LOCAL FIRE AND POLICE DEPARTMENTS, EMS PROVIDERS, REGIONAL EMERGENCY RESPONSE COMMITTEES AND THE COUNTY BOARDS OF HEALTH ASSOCIATION, BMC HAS A COMPREHENSIVE EMERGENCY PREPAREDNESS PROGRAM. THIS PROGRAM WORKS TO IMPROVE RESPONSE TO POTENTIAL COMMUNITY EMERGENCIES THROUGH REGULAR TABLETOP AND LIVE-ACTION DRILLS. BMC'S EMERGENCY OPERATIONS ALSO HAS PLANS IN PLACE FOR RESPONSE TO A WIDE VARIETY OF POTENTIAL EMERGENCIES, INCLUDING MASS CASUALTY, ELECTRICAL OUTAGES, FLOODING, SNOW/ICE STORM, AND MANY OTHERS. HEALTHCARE DISPARITIES - BMC ACTIVELY WORKS TO REDUCE HEALTH DISPARITIES IN THE COMMUNITY THROUGH EXPANDED ACCESS TO PRIMARY CARE AND SPECIALTY SERVICES, RECRUITMENT OF HEALTHCARE PROFESSIONALS WITH VARIED BACKGROUNDS AND LANGUAGE COMPETENCY, AND A DEDICATED TRANSLATION SERVICE THAT CAN PROVIDE PATIENTS WITH ACCESS TO CARE USING THEIR OWN LANGUAGE, WITH PROFESSIONAL HEALTH INTERPRETERS AND/OR ACCESS TO ELECTRONIC SERVICES THAT CAN PROVIDE INTERPRETATION. NUMEROUS COMMUNITY EFFORTS ARE ALSO USED TO REACH AS MANY AS POSSIBLE IN THE COMMUNITY, INCLUDING COMMUNITY HEALTH WORKERS THAT CAN HELP COMMUNITY MEMBERS OVERCOME BARRIERS SUCH AS TRANSPORTATION, FOOD INSECURITY, HOUSING, TELEPHONE ACCESS, AND MUCH MORE. MATERNAL/CHILD HEALTH - BMC HAS NUMEROUS PROGRAMS DESIGNED TO AID NEW MOTHERS AND NEWBORNS IN ATTAINING OPTIMAL HEALTH DURING AND AFTER PREGNANCY, INCLUDING PRE-NATAL CLASSES AND CLASSES FOR NEW PARENTS. IN ADDITION, THE BERKSHIRE NORTH WOMEN, INFANTS, AND CHILDREN'S PROGRAM, OPERATED BY BMC, PROVIDES ACCESS TO NUTRITIONAL SERVICES AND HEALTHY FOOD OPTIONS, AND OPERATION BETTER START PROVIDES FAMILY SERVICES THAT CAN HELP THE NEWBORN AND FAMILY TO MAINTAIN A HEALTHY LIFESTYLE. SAFETY/ VIOLENCE PREVENTION -BMC SECURITY COLLABORATES WITH MANY COMMUNITY AGENCIES ON SUBSTANCE ABUSE PREVENTION AND TREATMENT AND WORKS REGULARLY WITH AREA POLICE DEPARTMENTS AS WELL AS THE BERKSHIRE COUNTY HOUSE OF CORRECTION TO ENSURE SAFETY OF THE HOSPITAL ENVIRONMENT AND THE SURROUNDING COMMUNITY. SOCIAL DETERMINANTS OF HEALTH- BMC UNDERSTANDS THAT SOCIOECONOMIC STATUS, EDUCATION, EMPLOYMENT, HOUSING, FOOD SECURITY, TRANSPORTATION AND SOCIAL PROTECTIVE FACTORS, ALL HAVE AN IMPACT ON THE PHYSICAL AND MENTAL WELLBEING OF THE POPULATION, INCLUDING THE CIRCUMSTANCES PEOPLE FIND THEMSELVES IN, AND IN MANY CASES THE LIFE CHOICES THEY MAKE OR ARE FORCED TO MAKE DUE TO SOCIAL OR ENVIRONMENTAL CONDITIONS. MANY OF BERKSHIRE COUNTY'S COMMUNITY ORGANIZATIONS DO AN OUTSTANDING JOB AT ADDRESSING THESE NEEDS ALREADY. BMC COLLABORATES WITH THESE ORGANIZATIONS AND HAS PLANS TO INCREASE PARTNERSHIP OVER THE NEXT YEAR TO FURTHER REDUCE SDOH BARRIERS. BERKSHIRE HEALTH SYSTEMS RECEIVED FUNDING FROM MA HEALTH TO PROVIDE EMERGENCY FOOD TO FACING FOOD ACCESS DIFFICULTIES OR INSECURITY DURING THE COVID-19 PANDEMIC AND DEVELOPED A GROCERY DELIVERY PROGRAM (GDP). IN 2021, THE GROCERY DELIVERY PROGRAM HAS CONTINUED AS A FLEXIBLE SERVICES PROGRAM. THE MTM AND GDP ARE OPERATIONALIZED IN COLLABORATION WITH THE BERKSHIRE COUNTY HOUSE OF CORRECTION. ADOLESCENT AND YOUTH PREGNANCY - BERKSHIRE UNITED WAY TAKES THE LEAD ON EFFORTS TO PROVIDE INFORMATIONAL AND EDUCATIONAL PROGRAMS TO YOUTH AND ADOLESCENTS TO REDUCE THE RATE OF PREGNANCY IN TEENS. BERKSHIRE MEDICAL CENTER WORKS IN COLLABORATION WITH THIS COMMUNITY PARTNER BY PARTICIPATING ON COMMITTEES, SHARING DATA, AND RESOURCES. WORKFORCE DEVELOPMENT ACCESS TO MEDICAL PROFESSIONALS - BMC HAS AN INTENSIVE PHYSICIAN AND PROVIDER RECRUITMENT PROGRAM, WHICH HAS SUCCEEDED IN SEVERAL PROFESSIONALS TO THE REGION YEARLY, PARTICULARLY IN AREAS OF CRITICAL NEED, SUCH AS: PRIMARY CARE, NEUROSURGERY AND NEUROLOGY, ORTHOPEDIC SURGERY, ENDOCRINOLOGY, AND OTHERS. THIS INCLUDES NOT ONLY PHYSICIANS, BUT ALSO NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS. TRAININGS FOR HEALTHCARE PROFESSIONALS, ALLIED HEALTHCARE WORKERS AND COMMUNITY HEALTH WORKERS- BMC SUPPORTS ITS EMPLOYEES TO ATTEND TRAININGS AND CERTIFICATIONS IN APPLICABLE AREAS, EXAMPLES OF THESE TRAININGS INCLUDE BRIDGES OUT OF POVERTY, COMMUNITY HEALTH WORKER CERTIFICATION, MENTAL HEALTH FIRST AID, MEDICAL ASSISTANT TRAINING, PHLEBOTOMY CERTIFICATION ETC. BY INVESTING IN OUR EMPLOYEES AND SUPPORTING OUR PARTNERS WE CAN BETTER SERVE THE NEEDS OF OUR COMMUNITY AT LARGE. SCHEDULE H, PART VI LINE 4 COMMUNITY INFORMATION CONTINUED: IN MASSACHUSETTS, THE RISK FOR SUICIDE MORTALITY AND MORBIDITY VARIES SIGNIFICANTLY BY REGION. MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH IDENTIFIED BERKSHIRE COUNTY AS A REGION WITH YOUTH SUICIDE RATES/SUICIDAL BEHAVIORS INCLUDING RATES OF NON-FATAL SELF-INFLICTED INJURY HIGHER THAN THOSE IN THE STATE AND NATION. YOUTH BEHAVIOR NORTH 2021(N=482) CENTRAL 2021(N=831) SOUTH 2021(N=314) ALCOHOL USE 31.50% 37.50% 36.90% CIGARETTE USE 6.80% 9.30% 10.10% E-CIGARETTE USE 22.00% 26.10% 17.20% MARIJUANA USE 21.00% 27.30% 17.30% PLANNED SUICIDE IN LAST 12 MONTHS 17.20% 14.10% 15.20% ATTEMPTED SUICIDE IN LAST 12 MONTHS 7.70% 10.40% 8.00% DATA SOURCE: BERKSHIRE COUNTY PREVENTION NEEDS ASSESSMENT, 2021 OPIOIDS AND PRESCRIPTION DRUGS OVER THE PAST SEVERAL YEARS, USE OF DRUGS, PARTICULARLY OPIOIDS AND PRESCRIPTION DRUGS HAS EMERGED AS A GROWING BEHAVIORAL HEALTH ISSUE. BETWEEN 2010 AND 2020, THE NUMBER OF OPIOID-RELATED OVERDOSE DEATHS IN THE COUNTY INCREASED FROM 4 TO 56, A DRAMATIC SPIKE OF NEARLY 200%. OPIOID USAGE APPEARS TO BE MORE PREVALENT IN THE CENTRAL AND NORTHERN REGIONS OF BERKSHIRE COUNTY, AS EVIDENCED BY A HIGHER OVERDOSE RATE IN THOSE REGIONS. (HTTPS://WWW.MASS.GOV/DOC/OPIOID-RELATED-OVERDOSE-DEATHS -BY-COUNTY-NOVEMBER-2021/DOWNLOAD) IN AN ATTEMPT, TO AIDE IN THE REDUCTION OF OPIOID-RELATED OVERDOSE DEATHS MANY LOCAL PHARMACIES ARE CARRYING NASAL NARCAN THAT CAN BE PROVIDED WITHOUT A PHYSICIAN'S PRESCRIPTION. ADDITIONALLY, PATIENTS OR THEIR FRIENDS OR FAMILY WHO ARE BROUGHT TO ANY OF THE BERKSHIRE COUNTY EMERGENCY DEPARTMENT WITH AN OPIOID OVERDOSE ARE PROVIDED WITH NASAL NARCAN UPON DISCHARGE INFANT AND PERINATAL CARE AND CONTROLLED SUBSTANCES AS OPIOID USE HAS INCREASED IN OUR COMMUNITY, SO HAS THE USE OF OPIOIDS IN WOMEN OF CHILD-BEARING AGE. BABIES BORN TO MOTHERS WHO HAVE USED OPIOIDS DURING PREGNANCY ARE AT RISK FOR NEONATAL ABSTINENCE OR WITHDRAWAL, WHICH CAN HAVE BOTH SHORT-TERM AND LONG-TERM SIDE EFFECTS. ALTHOUGH RATES DECREASED BETWEEN 2020 AND 2021, BERKSHIRE COUNTY STILL HAD THE SECOND-HIGHEST RATE OF MOTHERS WHO USED OPIOIDS DURING PREGNANCY AND THE SECOND-HIGHEST RATE OF BABIES BORN WITHDRAWING FROM OPIOIDS IN THE STATE OF MASSACHUSETTS. IN BRISTOL COUNTY, MOTHERS WHO USED OPIOIDS OR BENZODIAZEPINES DURING PREGNANCY DECREASED 22% BETWEEN 2020 AND THE FIRST EIGHT MONTHS OF 2021 (FROM 11.2% TO 8.7%). IN BERKSHIRE COUNTY, THE HIGHEST RATE OF MOTHERS WHO USED OPIOIDS OR BENZODIAZEPINES DURING PREGNANCY DECREASED 53% (FROM 7.9% TO 3.7%). HTTPS://WWW.MASS.GOV/DOC/NEWBORN-AND-MATERNAL-SUBSTANCE-EXPOSURE -SURVEILLANCE-NOVEMBER-2021/DOWNLOAD) COVID-19 IN BERKSHIRE COUNTY: ON MARCH 6, 2020, BERKSHIRE MEDICAL CENTER REPORTED THE FIRST INPATIENT CASE OF COVID-19 IN THE COMMONWEALTH OF MASSACHUSETTS. SINCE THEN, BHS HAS BEEN ON THE LEADING EDGE OF COVID RESPONSE FOR TESTING, TREATMENT, AND VACCINATION, WORKING QUICKLY AND EFFICIENTLY TO SUPPORT THE NEEDS OF THE BERKSHIRE COMMUNITY DURING THE ONGOING PUBLIC HEALTH EMERGENCY. IN 2020, BERKSHIRE HEALTH SYSTEMS ESTABLISHED A COVID CALL CENTER AND OPENED OUTDOOR TESTING SITES IN NORTH ADAMS, PITTSFIELD, AND GREAT BARRINGTON. IN 2021 BHS OPENED PERMANENT TESTING SITES IN NORTH ADAMS, PITTSFIELD, AND GREAT BARRINGTON AND BEGAN PROVIDING COVID-19 VACCINATIONS AT ALL THREE OF THESE SITES. IN ADDITION TO OUR STAND-ALONE SERVICES, BHS WORKED WITH THE BERKSHIRE VACCINE COLLABORATIVE TO VACCINATE TENS OF THOUSANDS OF COMMUNITY MEMBERS THROUGH LARGE-SCALE PUBLIC HEALTH CLINICS. 2019 COUNTY HEALTH RANKINGS THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE AND THE ROBERT WOOD JOHNSON FOUNDATION DEVELOPED THE "COUNTY HEALTH RANKINGS" TO HELP COMMUNITIES UNDERSTAND WHAT INFLUENCES HOW HEALTHY RESIDENTS ARE AND HOW LONG THEY WILL LIVE. THE RANKINGS LOOK AT A VARIETY OF MEASURES THAT AFFECT HEALTH SUCH AS THE RATE OF PEOPLE DYING BEFORE AGE 75, HIGH SCHOOL GRADUATION RATES, ACCESS TO HEALTHIER FOODS, AIR POLLUTION LEVELS, INCOME, RATES OF SMOKING, OBESITY AND TEEN BIRTHS. COUNTIES IN EACH OF THE 50 STATES ARE RANKED ACCORDING TO SUMMARIES OF A VARIETY OF HEALTH MEASURES. THOSE HAVING HIGH RANKS, E.G., 1 OR 2, ARE CONSIDERED TO BE THE "HEALTHIEST." COUNTIES ARE RANKED RELATIVE TO THE HEALTH OF OTHER COUNTIES IN THE SAME STATE ON THE FOLLOWING SUMMARY MEASURES: SUMMARY HEALTH OUTCOMES & HEALTH FACTORS RANKINGS COUNTIES RECEIVE TWO SUMMARY RANKS: 1. HEALTH OUTCOMES: RANKINGS ARE BASED ON AN EQUAL WEIGHTING OF ONE LENGTH OF LIFE MEASURE (MORTALITY) AND FOUR QUALITIES OF LIFE MEASURES (MORBIDITY). 2. HEALTH FACTORS: RANKINGS ARE BASED ON WEIGHTED SCORES OF FOUR TYPES OF FACTORS: I. HEALTH BEHAVIORS II. CLINICAL CARE III. SOCIAL AND ECONOMIC IV. PHYSICAL ENVIRONMENT OUT OF THE FOURTEEN COUNTIES OF MASSACHUSETTS, BERKSHIRE COUNTY RANKED: * HEALTH OUTCOMES: 13TH * HEALTH FACTORS: 11TH * HEALTH BEHAVIORS: 8TH * CLINICAL CARE: 5TH * SOCIAL AND ECONOMIC: 11TH * PHYSICAL ENVIRONMENT: 12TH WORKSITE WELLNESS PROGRAM: THE BERKSHIRE HEALTH SYSTEMS (BHS) WORKSITE WELLNESS PROGRAM IS A COMPREHENSIVE PROGRAM DEVELOPED FOR BHS EMPLOYEES, SPOUSES AND COMMUNITY AT LARGE. THE PROGRAM PROVIDES HEALTH RISK ANALYSES, SCREENINGS AND A RANGE OF PROGRAMS TO SUPPORT HEALTHY LIFESTYLES AND TO HELP REDUCE HEALTH COVERAGE COSTS THROUGHOUT BERKSHIRE COUNTY. THE WELLNESS INTEGRATIVE MODEL FOCUSES ON CREATING POSITIVE, SUSTAINABLE LIFESTYLE CHANGE BY FOSTERING PHYSICAL, MENTAL AND EMOTIONAL WELLNESS. IN 2021, BHS WELLNESS OFFERED MANY SERVICES TO EMPLOYEES AND EXTERNAL COMPANIES USING A VIRTUAL ENVIRONMENT WHILE CONTINUING WORK WITH HEALTH LIVING WORKSHOPS, IMPROVING RESILIENCY, FINANCIAL WELLNESS, TOBACCO TREATMENT AND ACCESS TO MENTAL HEALTH WITH AN APPLICATION CALLED TALKSPACE. HEALTH AND CLINICAL INDICATORS: ADDITIONAL HEALTH INFORMATION THAT HELPS DEPICT THE PROFILE OF BERKSHIRE COUNTY INCLUDES: HEART DISEASE MORTALITY AGE ADJUSTED ANNUAL DEATH RATES PER 100,000 IN BERKSHIRE COUNTY (291.1) IS ABOVE THE STATE (254.4) AND BELOW THE NATIONAL AVERAGE (317.4). (CHNA) THE LEADING CAUSES OF CANCER DEATHS IN BERKSHIRE COUNTY ARE LUNG, BREAST, PROSTATE, COLORECTAL AND PANCREATIC. OVERALL, CANCER DEATH RATES IN BERKSHIRE COUNTY HAVE BEEN STEADY SINCE 2000. THE TOTAL CANCER AGE-ADJUSTED DEATH RATE IS HIGHER (152.9) THAN THE STATE AVERAGE IN 2015-2019 OF 146.9. (CHNA) OUTCOME MEASURES FOR SUBSTANCE ABUSE IN 2019 INCLUDE 1,978 ADMISSIONS TO DETOX, 858 ADMISSIONS TO CLINICAL STABILIZATION SERVICES (CSS), 716 ADMISSIONS TO JONES 2, AND 482 ADMISSIONS TO JONES 3. DIABETES IS ONE OF THE MULTIPLE CONDITIONS CONSIDERED TO BE RELATED TO CARDIOVASCULAR DISEASE. 2021 DATA FROM COUNTY HEALTH RANKINGS SHOWS THAT BERKSHIRE COUNTY HAS THE SECOND-HIGHEST PREVALENCE OF DIABETES IN THE STATE OF MASSACHUSETTS AT 10.7%. (BERKSHIRE COUNTY, MA / DATA USA) SMOKING IS AN ADDICTION THAT CAN CONTRIBUTE TO MULTIPLE MEDICAL CONDITIONS, FROM CARDIOVASCULAR DISEASE TO CANCER. DATA FROM THE 2021 COUNTY HEALTH RANKINGS SHOWS THAT BERKSHIRE COUNTY HAS THE SECOND-HIGHEST PREVALENCE OF SMOKING IN THE STATE OF MASSACHUSETTS AT 19%. (ADULT SMOKING IN MASSACHUSETTS & COUNTY HEALTH RANKINGS & ROADMAPS). WORKFORCE SHORTAGES AND ACCESS TO CARE: BERKSHIRE COUNTY RANKS 5TH OF 14 COUNTIES IN THE STATE FOR CLINICAL CARE AND ACCESS. THOUGH THE COUNTY PRESENTS WELL IN TERMS OF PROVIDER TO PATIENT RATIOS, PATIENTS FREQUENTLY STRUGGLE WITH APPOINTMENT AVAILABILITY AND TRANSPORTATION TO AND FROM HEALTHCARE LOCATIONS. BHS CONTINUES TO FACE STAFFING CHALLENGES, LIKE THOSE EXPERIENCED ACROSS THE NATION. TO ADDRESS THESE ISSUES, BHS HAS BEGUN TO CREATE CAREER TRAINING PROGRAMS, PARTICULARLY IN NURSING AREAS, THAT CAN SIMULTANEOUSLY HELP TO REDUCE CLINICIAN SHORTAGES AND IMPROVE EMPLOYMENT OPPORTUNITIES FOR BERKSHIRE RESIDENTS. (CHNA) BERKSHIRE HEALTH SYSTEMS INC 725 NORTH ST PITTSFIELD MA 01201 042442944 PARENT CORP MA 501 (C)(3) 12B-II N/A 0 FAIRVIEW HOSPITAL 725 NORTH ST PITTSFIELD MA 01201 042133860 ACUTE CARE MA 501 (C)(3) 3 N/A 0 BERKSHIRE FACULTY SERVICES INC 725 NORTH ST PITTSFIELD MA 01201 042995053 PHYSICIAN SVC MA 501 (C)(3) 12B-II N/A 0 BHS MANAGEMENT SERVICES INC 725 NORTH ST PITTSFIELD MA 01201 222755258 MANAGEMENT MA 501 (C)(3) 12B-II N/A 0 TRI-STATE MEDICAL MANAGEMENT CORP 725 NORTH STREET PITTSFIELD MA 01201 042913352 REAL ESTATE MANAGEMENT MA FAIRVIEW HOSPITAL C 1.00000 1 BERKSHIRE ORTHOPAEDIC ASSOCIATES PC 24 PARK STREET PITTSFIELD MA 01201 043017240 HEALTH SERVICES MA N/A C 0 BERKSHIRE FAMILY PRACTICE ASSOCIATES PC 20 ELM ST PITTSFIELD MA 01201 842155335 HEALTH SERVICES MA N/A C 0 BERKSHIRE APOTHECARY INC 725 NORTH STREET PITTSFIELD MA 01201 843975327 RETAIL PHARMACY MA BERKSHIRE MEDICAL CENTERINC C 1.00000 1 BERKSHIRE EAR NOSE THROAT AND AUDIOLOGY PC 510 NORTH ST 10 PITTSFIELD MA 01201 222683819 HEALTH SERVICES MA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 1