2019-11-12T09:40:06-06:00 2018-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2018-01-01 111631788 JAMAICA HOSPITAL MEDICAL CENTER JAMA 7182066291 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 MOUNIR DOSS EXECUTIVE VP & CFO 7182066291 2019-11-11 1 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2019-11-10 209.59.242.22 2019-11-11 10:13:53 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F9BA0E82A6D947CC92540FBC56E8B73643681DA5 2018 2020-01-14 16:20:31Z MOUNIR DOSS 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 580397212 0 X WWW.JAMAICAHOSPITAL.ORG X 1934 NY THE JAMAICA HOSPITAL IS AN ACUTE CARE FACILITY SERVING THE PUBLIC. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT REDUCED RATES. 13 11 3929 318 40373 988661 29275067 91016210 455031378 456985596 3909669 5213913 24999504 25530664 513215618 578746383 0 0 0 0 342709977 352386194 0 0 0 205138023 210754896 547848000 563141090 -34632382 15605293 186960570 229338844 253372858 280147582 -66412288 -50808738 X THE JAMAICA HOSPITAL IS AN ACUTE CARE FACILITY SERVING THE PUBLIC. ITS SERVICES INCLUDE ACUTE, MEDICAL REHABILITATION, TRAUMA BRAIN INJURY, HOSPICE UNIT, A LEVEL 1 TRAUMA CENTER, AND PSYCHIATRIC CARE. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT DISCOUNTED AMOUNTS LESS THAN ESTABLISHED RATES. 0 0 500991263 481602328 JAMAICA HOSPITAL IS A 408-BEDS INCLUDING BASSINETS, FULLY ACCREDITED COMMUNITY TEACHING HOSPITAL WITH A LARGE NETWORK OF COMMUNITY-BASED AMBULATORY CARE CENTERS. JHMC OFFERS A FULL ARRAY OF ACUTE INPATIENT REHABILITATION AND MENTAL HEALTH SERVICES, THE LARGEST VOLUNTARY HOSPITAL AMBULANCE FLEET SERVING THE CITY'S 911 SYSTEM AND A LEVEL 1 TRAUMA CENTER. 500991263 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 849 9 1 3929 1 1 1 0 0 0 0 0 0 0 1 0 X 13 11 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X MOUNIR DOSS 7182066291 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 X ANTHONY DIMARIA MD SECRETARY 1.00 42.00 X X 0 252116 44318 ANTHONY J MAZZO TRUSTEE 1.00 2.00 X 0 0 0 ANTONIETTA MORISCO MD TRUSTEE 1.00 2.00 X 0 0 0 DOUGLAS W SINGER TRUSTEE 1.00 2.00 X 0 0 0 GEOFFREY DOUGHLIN MD THIRD VICE CHAIRMAN 40.00 2.00 X X 470318 0 45044 GERALDINE M CHAPEY PHD TRUSTEE 1.00 2.00 X 0 0 0 HON ARCHIE SPIGNER ASSISTANT SECRETARY 1.00 2.00 X X 0 0 0 HON TIMOTHY J DUFFICY TRUSTEE 1.00 2.00 X 0 0 0 JOSEPH A FERRARA ASSISTANT TREASURER 1.00 2.00 X X 0 0 0 JOSEPH LIANA TRUSTEE 1.00 2.00 X 0 0 0 NEIL FOSTER PHILLIPS CHAIRMAN 1.00 2.00 X X 0 0 0 PHILIPPA L KARTERON TRUSTEE 1.00 2.00 X 0 0 0 ROBERT W KOOP 2ND VICE CHAIRMAN/TREASURE 1.00 2.00 X X 0 0 0 BRUCE FLANZ PRESIDENT & CEO 30.00 35.00 X 983842 631552 43659 MOUNIR DOSS EXEC. VICE PRESIDENT & CFO 30.00 35.00 X 720425 376688 43659 WILLIAM LYNCH EXEC. VICE PRESIDENT & COO 40.00 1.00 X 529992 0 43659 ALAN ROTH CHARIMAN FAMILY PRACTICE 40.00 X 478200 0 43659 MANZAR SASSANI VP FINANCE 40.00 X 481937 0 43659 ROBERT SOLOMON RADIOLOGIST 40.00 X 452757 0 41338 SABIHA RAOOF CHAIRPERSON RADIOLOGY 40.00 X 653237 0 45044 SCOTT TREPETA RADIOLOGIST 40.00 X 485882 0 36682 5256590 1260356 430721 704 0 1 0 MARTIN CLEARWATER & BELL 220 E 42ND ST NEW YORK NY 10017 LEGAL SERVICE 3319724 NEURO AXISNEUROAXIS NEUROSURGICAL ASSOC PO BOX 345 GREENVALE NY 11548 PHYSICIAN ASSOICATES/PHYSICIANS & SURGEO 1235000 NEW YORK PRESBYTERIAN HOSPITAL 525 EAST 68TH STREET STE 156 NEW YORK NY 10021 MEDICAL SERVICES 1210754 ARAMARK MANAGEMENT SERVICES 2300 WARRENVILLE ROAD DOWNERS GROVE IL 60515 HOUSEKEEPING FOR BUILDING AND APPAREL SE 877755 NIGHTHAWK RADIOLOGY SERVICES 25983 NETWORK PLACE CHICAGO NY 60673 X-RAY READING SERVICES 596401 17 451881 90170792 393537 91016210 NET PATIENT REVENUE 621400 376403151 376403151 CAPITATION REVENUE 621400 47756709 47756709 PROFESSIONAL COMPONENT 621400 23440411 23440411 PHARMACY 621400 6885958 6885958 TEACHING AND EDUCATION 611600 2499367 2499367 456985596 180340 180340 1237373 1197000 40373 40373 40373 5043430 251237 24957 236137 5018473 15100 5033573 5033573 179842 451881 192735 -12893 -12893 REIMBURSEMENT FOR SERVICES PROVID 900099 17509764 17509764 EARNINGS FROM JOINT VENTURES 900099 3386368 3386368 MANAGEMENT FEE 900099 3000000 3000000 1607052 720600 886452 25503184 578746383 481602328 40373 6087472 2881890 2536482 345408 259454552 227801096 31653456 18040979 16660188 1380791 48048889 43670912 4377977 23959884 21143411 2816473 4044998 4044998 360350 316387 43963 141241 141241 55958803 53944298 2014505 80600 70767 9833 1392409 1222535 169874 4629199 4064437 564762 6960322 5985487 974835 148817 148817 3386300 3386300 10563655 10563655 13105777 11532400 1573377 MEDICAL SUPPLIES 42372927 42372927 BAD DEBT EXPENSE 41180071 38443373 2736698 CHARGE BACK 10241468 5093424 5148044 UBIT TAX 3500 3073 427 16184459 12031294 4153165 563141090 500991263 62149827 0 304558 20654876 58639561 68229824 4860009 4391738 887846 1550852 300490859 258151483 40305795 42339376 32703 32381 20011520 21277376 61918578 70862421 186960570 229338844 104653147 92397717 1080468 1072856 13654962 41219198 133984281 145457811 253372858 280147582 X -66412288 -50808738 -66412288 -50808738 186960570 229338844 X 15605293 -1170 -573 X X 0 1 X 1 1 1 X 0 0 0 0 0 0 1 141241 0 0 141241 0 PART II-B, LINE 1: JAMAICA HOSPITAL MEDICAL CENTER IS A MEMBER OF TWO ASSOCIATIONS OF WHICH SOME OF THEIR DUES ARE ALLOCATED TO GRASS ROOTS LOBBYING IN REGARD TO THEIR NEEDS IN SERVICING AND PROVIDING HEALTHCARE TO THE GENERAL PUBLIC. GREATER NY HOSPITAL ASSOCIATION DUES: $20,200; HEALTHCARE ASSOCIATION OF NEW YORK STATE: $15,110; 1199 HEALTH EDUCATION $105,931. 1018049 1018049 101207532 85673650 15533882 6995487 5584810 1410677 165269104 155445925 9823179 26000687 11447098 14553589 42339376 INVESTMENT IN NHP HOLDINGS 158113 C JHMC HEALTHFIRST 21119263 C 21277376 DUE FROM THIRD PARTY PAYORS 8307415 DUE FROM RELATED PARTIES 4233536 INSURANCE RECEIVABLE 25450272 ASSETS LIMITED OR RESTRICTED TO USE 164765 SECURITY DEPOSITS 64271 WORKERS COMENSATION DEPOSITS 399291 HF RETAINED PAYMENTS 32242871 70862421 DUE TO THIRD PARTY 8138881 CAPITAL LEASE OBLIGATIONS 9608958 MALPRACTICE INSURANCE 105946992 WORKERS COMPENSATION LIABILITY 20980910 ACCURED PAYROLL AND RELATED BENEFITS 782070 145457811 X 748998018 -1170 -18751619 -18752789 767750807 -189004424 -189004424 578746383 710962517 189004997 189004997 521957520 41183570 41183570 563141090 PART X, LINE 2: JAMAICA HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -18,748,119. UBIT TAX -3,500. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES -192,735. K-1 ACTIVITY NOT ON BOOKS 573. CAPTION EXPENSES -187,615,262. RENTAL EXPENSES -1,197,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES 192,735. RENTAL EXPENSES 1,197,000. CAPITATION EXPENSE 187,615,262. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 41,180,070. UBIT TAX 3,500. GOLF OUTING 125615 90107 35508 5777 52211 ANNUAL GALA 506108 361774 144334 4150 15370 107377 1000 6850 631723 451881 179842 9927 15370 159588 1000 6850 192735 -12893 1 1 1 X 1 X 1 1 1 0 1 1 19530272 12689616 6840656 0.01210 219395070 178094557 41300513 0.07330 238925342 190784173 48141169 0.08540 1354820 1354820 0.00240 81672911 20153149 61519762 0.10920 111035108 81388036 29647072 0.05260 194062839 101541185 92521654 0.16420 432988181 292325358 140662823 0.24960 1 18748119 46164570 37421655 8742915 X 1 1 1 1 JAMAICA HOSPITAL MEDICAL CENTER 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 WWW.JAMAICAHOSPITAL.ORG X X X X PHYSICAL MEDICAL REHABILITATION, PSYCHIATRIC SVC, HOSPICE, AMBULATORY CARE JAMAICA HOSPITAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X WWW.JAMAICAHOSPITAL.ORG 1 16 1 HTTP:JAMAICAHOSPITAL.ORG/INDEX.PHP/COMMUNITYSERVICEPLAN 0 1 X 100.000000000000 300.000000000000 X X X X X 1 1 X X X X 1 X WWW.JAMAICAHOSPITAL.ORG X WWW.JAMAICAHOSPITAL.ORG X WWW.JAMAICAHOSPITAL.ORG X X X X 1 X 0 X X 1 X 0 0 JAMAICA HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 5: ACCESSIBILITY TO HEALTHCARE REMAINS A CONCERN FOR SOME RESIDENTS IN JAMAICA HOSPITAL MEDICAL CENTER'S (JHMC) SERVICE AREA, AS 12.9% OF EAST NEW YORK RESIDENTS, 6.6% OF JAMAICA RESIDENTS, AND 18.6% OF SOUTHWEST QUEENS RESIDENTS HAVE REPORTED THAT THEY HAVE NOT BEEN ABLE TO RECEIVE MEDICAL CARE WITHIN THE PAST YEAR WHEN THEY NEEDED IT. THE PERCENTAGES OF EAST NEW YORK AND SOUTHWEST QUEENS RESIDENTS WHO WERE UNABLE TO ACCESS HEALTHCARE SERVICES WERE HIGHER THAN THOSE OBSERVED IN QUEENS OVERALL (10.1%) OR NYC OVERALL (9.6%). REASONS FOR A PERSON'S INABILITY TO RECEIVE NEEDED MEDICAL SERVICES RANGE FROM APPOINTMENT AVAILABILITY TO FINANCIAL MEANS (INCLUDING INSURANCE AND MEDICAID/MEDICARE COVERAGE). INDEED, THE EFFECTS OF POVERTY ON HEALTHCARE ACCESSIBILITY AND THE ABILITY TO OBTAIN NUTRITIOUS FOOD AS PART OF MAINTAINING A HEALTHY LIFESTYLE, ARE OBSERVED IN THE COMMUNITIES THAT JAMAICA HOSPITAL SERVES.OBESITY, SMOKING, AND THE NEED FOR ADDITIONAL BEHAVIORAL HEALTH SERVICES WERE PRIORITY HEALTH ISSUES HIGHLIGHTED IN THE DATA ANALYSES THAT JAMAICA HOSPITAL CONDUCTED FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THESE HEALTH CONCERNS WERE ALSO IDENTIFIED BY RESIDENTS OF THE COMMUNITIES OF JAMAICA AND EAST NEW YORK, WHO TOOK PART IN FOCUS GROUPS AND SURVEYS AS PART OF THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE'S (DOHMH) TAKE CARE NEW YORK (TCNY) 2020 INITIATIVE. ON THE TCNY 2020 SURVEYS, EAST NEW YORK RESIDENTS ALSO NAMED PHYSICAL ACTIVITY AS A HEALTH ISSUE, UNDERSCORING THE NEED FOR MORE EXERCISE PROGRAMS AND EDUCATIONAL OPPORTUNITIES TO HELP RESIDENTS MAINTAIN A HEALTHY WEIGHT. JAMAICA RESIDENTS COMMENTED THAT BINGE DRINKING WAS A CONCERN, WHICH SPEAKS TO THE NEED FOR BEHAVIORAL HEALTH SERVICES IN THIS COMMUNITY. BREASTFEEDING, WHICH LOWERS THE RISK OF DEATH FROM INFECTIOUS DISEASES IN A CHILD'S FIRST TWO YEARS OF LIFE, AND CAN ALSO REDUCE THE RISK OF CHILDHOOD OBESITY AS WELL AS THE RISK OF A WOMAN DEVELOPING BREAST OR OVARIAN CANCER , IS STILL NOT PRACTICED AS OFTEN IN PARTS OF JAMAICA OR EAST NEW YORK AS IT IS IN NEW YORK CITY OVERALL. JAMAICA HOSPITAL HAS FOCUSED ON IMPROVING RATES OF EXCLUSIVE BREASTFEEDING AMONG THE WOMEN DISCHARGED FROM ITS BIRTHING CENTER, AS WELL AS AMONG MOTHERS IN THE COMMUNITY, AND HOPES TO SOON BE DESIGNATED AS A BABY FRIENDLY HOSPITAL FOR OFFERING AN OPTIMAL LEVEL OF CARE FOR INFANT FEEDING AND MOTHER/BABY BONDING. SMOKING AND SECONDHAND SMOKE, AS WELL AS HOUSEHOLD/OUTDOOR AIR POLLUTION, WERE IDENTIFIED AS ONGOING COMMUNITY HEALTH CONCERNS THAT ARE CORRELATED WITH CHRONIC DISEASE, SUCH AS ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), AS WELL AS CANCER. RESPONDING TO THE NEEDS OF THE COMMUNITY, JAMAICA HOSPITAL HAS FOCUSED ON IMPROVING TOBACCO CESSATION RATES AND HAS BEEN AWARDED GOLD STAR STATUS FROM THE NYC DOHMH'S TOBACCO-FREE HOSPITALS CAMPAIGN IN RECOGNITION OF ITS SMOKING CESSATION PROGRAMMING AND SUCCESSES. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $18,748,119. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIESJAMAICA HOSPITAL'S PROGRAMS SUPPORT TAKE CARE NEW YORK IN THE FOLLOWING WAYS:HAVE A REGULAR DOCTOR OR OTHER HEALTH CARE PROVIDER: JAMAICA'S AMBULATORY CARE SERVICES ARE DESIGNED TO PROMOTE CONTINUITY OF CARE BY ALLOWING PATIENTS TO CHOOSE A PHYSICIAN WHO WILL BE DESIGNATED AS THEIR PRIMARY CARE PROVIDER. IN ADDITION TO ON-CAMPUS AMBULATORY CARE SERVICES, THERE ARE TWELVE CENTERS CONVENIENTLY LOCATED THROUGHOUT JAMAICA'S SERVICE AREA. EVENING AND WEEKEND HOURS ALLOW RESIDENTS ACCESS FOR THOSE WHO FIND IT DIFFICULT TO SEEK CARE ON WEEKDAYS. THE DESIGNATED PROVIDER IS RESPONSIBLE FOR ENSURING THAT HIS/HER PATIENTS ARE GIVEN AGE APPROPRIATE SCREENING, IMMUNIZATION AND EDUCATION. THE HOSPITAL HAS IMPLEMENTED AN ELECTRONIC MEDICAL RECORD, HAS ENHANCED ITS HEALTH PROMOTION EFFORTS VIA AUTOMATIC REMINDERS TO PHYSICIANS WHEN A PATIENT IS DUE FOR A TEST OR PROCEDURE.BE TOBACCO-FREE: IN 2012 THE HOSPITAL JOINED THE NEW YORK CITY TOBACCO-FREE HOSPITALS CAMPAIGN, WHICH IS TARGETING STAFF AND PATIENTS, WITH A COMPREHENSIVE, EVIDENCE-BASED SERIES OF INITIATIVES.KNOW YOUR HIV STATUS: THE HOSPITAL PROVIDES HIV COUNSELING AND TESTING WITH STAFF THAT ROUTINELY PERFORMS THIS FUNCTION IN BOTH EMERGENCY DEPARTMENT AND CLINICS. THE HOSPITAL'S AMBULATORY CARE CENTER IS DESIGNATED BY THE NEW YORK STATE DEPARTMENT OF HEALTH AS AN HIV PRIMARY MEDICAL CARE PROVIDER. PATIENTS WHO ARE HIV POSITIVE ARE CARED FOR IN THIS FACILITY AND REFERRED TO OTHER COMMUNITY SERVICE PROGRAMS FOR SUPPORTIVE SERVICES AS NECESSARY. THE HOSPITAL APPLIED AND WAS APPROVED FOR A GRANT IN THE SPRING 2010 FROM THE NEW YORK STATE DEPARTMENT OF HEALTH (NYSDOH) TO PROVIDE HIV/STI PREVENTION FOR WOMEN AND YOUNG PEOPLE.GET HELP FOR DEPRESSION: JAMAICA HOSPITAL'S MEDICAL PROVIDERS INCORPORATE DEPRESSION SCREENING DURING ROUTINE MEDICAL EXAMINATIONS AND ONGOING CARE. CHILDREN AND ADULTS NEEDING FURTHER SERVICES ARE REFERRED TO JAMAICA'S FULL SERVICE PSYCHIATRY DEPARTMENT OR OTHER COMMUNITY PROGRAMS. LIVE FREE OF DEPENDENCE ON ALCOHOL AND DRUGS: DURING ROUTINE MEDICAL EXAMINATIONS PATIENTS ARE SCREENED FOR ALCOHOL AND DRUG USE AND GIVEN PREVENTIVE COUNSELING AND, AS NECESSARY, TREATMENT OPTIONS ARE DISCUSSED, INCLUDING FLUSHING HOSPITAL, JAMAICA'S AFFILIATE, WHICH OFFERS BOTH IN-PATIENT AND OUT-PATIENT TREATMENT FOR CHEMICAL DEPENDENCY.GET CHECKED FOR CANCER: REFERRALS FOR OTHER CANCER SCREENINGS, SUCH AS BREAST CANCER, ARE PART OF THE HOSPITAL'S ROUTINE PROTOCOLS. THE HOSPITAL PARTICIPATES IN THE QUEENS HEALTHY LIVING PARTNERSHIP WHICH PROVIDES FREE CANCER SCREENING AND TREATMENTS FOR THE UNINSURED. THE HOSPITAL EMPLOYS A COLONOSCOPY SCREENING PATIENT NAVIGATOR TO DECREASE CANCELLATIONS DUE TO POOR PREPARATION AND NO SHOWS AND TO PROVIDE OUTREACH SERVICES TO INCREASE THE NUMBER OF PATIENTS RECEIVING COLONOSCOPY SCREENING.GET THE IMMUNIZATIONS YOU NEED: THE HOSPITAL PARTICIPATES IN THE NYC'S VACCINE FOR CHILDREN PROGRAM (VFC) PROVIDING IMMUNIZATIONS TO CHILDREN UP TO 19 YEARS OF AGE AGAINST CHILDHOOD DISEASES AND INFLUENZA TO ELIGIBLE CHILDREN INCLUDING THOSE WITHOUT HEALTH COVERAGE SEEN IN OUR AMBULATORY CARE NETWORK. INFLUENZA VACCINE IS OFFERED TO ADULTS DURING RECOMMENDED VACCINATION MONTHS. HAVE A SAFE AND HEALTHY HOME: ANTICIPATORY GUIDANCE ON SAFETY IN THE HOME IS PROVIDED BY THE HOSPITAL'S PEDIATRIC, FAMILY MEDICINE AND REHABILITATION PROFESSIONALS. AT HEALTH FAIRS IN THE COMMUNITY, FIRE, HOME AND AUTOMOTIVE SAFETY INFORMATION IS ROUTINELY MADE AVAILABLE TO ATTENDEES.HAVE A HEALTHY BABY: THE HOSPITAL FOLLOWS PRENATAL CARE GUIDELINES ADOPTED BY THE NEW YORK STATE DEPARTMENT OF HEALTH. THE HOSPITAL OPERATES A WOMEN, INFANT AND CHILDREN (WIC) PROGRAM FUNDED BY THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH PROVIDES FOOD VOUCHERS AND EDUCATION TO LOW INCOME PREGNANT WOMEN AND CHILDREN UP TO AGE FIVE. THE HOSPITAL WILL BE IMPLEMENTING A CENTERING PREGNANCY PROGRAM WITH THE HELP OF A MARCH OF DIMES GRANT AND IS DEVELOPING AN AGGRESSIVE BREAST FEEDING PROMOTION PROGRAM IN CONCERT WITH THE NEW YORK CITY DEPARTMENT OF HEALTH & MENTAL HYGIENE.JAMAICA HOSPITAL'S PUBLIC HEALTH EFFORTS ARE CONSTANTLY CHANGING WITH THE NEEDS OF ITS COMMUNITY. THE ABOVE LISTING DOES NOT INCLUDE ALL PROGRAMS, SOME OF WHICH ARE FUNDED BY GRANTS SUCH AS THE SCHOOL HEALTH PROGRAM PRIMARILY FUNDED BY NEW YORK STATE DEPARTMENT OF HEALTH WHICH OPERATES IN TWO ELEMENTARY SCHOOLS AND A CAMPUS MAGNET SCHOOL CONSISTING OF FOUR HIGH SCHOOLS. IN ADDITION, CLINICAL DEPARTMENTS OFTEN INITIATE THEIR OWN PREVENTION ACTIVITIES WITH THEIR PATIENTS AND WITHIN THE COMMUNITY. LASTLY, THE HOSPITAL PROVIDES HUNDREDS OF FREE HEALTH SCREENINGS AND OUTREACH EFFORTS EACH YEAR FOR A VARIETY OF DISORDERS. PART III, LINE 4: FINANCIAL STATEMENTS BAD DEBT & CHARITY CARE FOOTNOTE:JAMAICA PROVIDES CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A MATTER OF POLICY, JAMAICA PROVIDES SIGNIFICANT AMOUNTS OF PARTIALLY OR TOTALLY UNCOMPENSATED PATIENT CARE. FOR ACCOUNTING PURPOSES, SUCH UNCOMPENSATED CARE IS TREATED AS CHARITY CARE. JAMAICA PROVIDES CHARITY CARE FOR THE DIFFERENCE BETWEEN ITS CUSTOMARY CHARGES AND THE DISCOUNTED RATES GIVEN TO PATIENTS IN NEED OF FINANCIAL ASSISTANCE. SINCE PAYMENT OF THIS DIFFERENCE IS NOT SOUGHT, CHARITY CARE ALLOWANCES ARE NOT REPORTED AS REVENUE. REMAINING UNCOLLECTED BALANCES AFTER CHARITABLE ALLOWANCES FOR THESE PATIENTS ARE CATEGORIZED AS BAD DEBTS. THE ESTIMATED COSTS OF PROVIDING CHARITY SERVICES ARE BASED ON A CALCULATION WHICH APPLIES A RATIO OF COSTS TO CHARGES TO THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS. JAMAICA'S FINANCIAL ASSISTANCE POLICY ENSURES THAT ANY PATIENT THAT HAS BEEN DEEMED TO BE UNINSURED THROUGH BASIC FINANCIAL SCREENING WILL BE ENTITLED TO A GLOBAL CHARITABLE DISCOUNT FOR EMERGENT (NEW YORK STATE ("NYS") RESIDENTS) AND/OR MEDICALLY NECESSARY SERVICES (RESIDES IN JAMAICA'S PRIMARY SERVICE AREA). THE GLOBAL CHARITABLE DISCOUNT WILL BE BASED ON THE CURRENT APPLICABLE MEDICAID - DEPENDING ON THE SERVICE PROVIDED. THE GLOBAL DISCOUNTS FOR UNINSURED PATIENTS ARE BASED ON THE PREMISE THAT JAMAICA SERVES A LOW-INCOME, UNDER-INSURED POPULATION - AS SUPPORTED BY PUBLIC STATISTICS - AND THAT UNINSURED PATIENTS LIVING IN THIS COMMUNITY WILL GENERALLY NOT BE ABLE TO PAY THEIR BILL IN ITS ENTIRETY. AFTER THE GLOBAL CHARITABLE DISCOUNT IS APPLIED, PATIENTS DEMONSTRATING ADDITIONAL FINANCIAL NEED MAY BE EXTENDED SLIDING SCALE DISCOUNTS UNDER THE CHARITY CARE POLICY. ADDITIONALLY, FOR COVERED SERVICES THERE ARE NO LIMITS ON FINANCIAL ASSISTANCE BASED ON THE MEDICAL CONDITION OF THE APPLICANT.COSTING METHODOLOGY FOR CALCULATING LINES 2 & 3:BAD DEBT EXPENSE IS ESTIMATED BASE ON AGING OF THE ACCOUNTS RECEIVABLE AND GETS ADJUSTED BASE ON ACTUAL WRITE OFF. ACTUAL ACCOUNT WRITE OFF IS AS FOLLOW: PATIENTS WHO ARE ENTITLED TO FINANCIAL ASSISTANT ARE GIVEN DISCOUNT BASE ON OUR CHARITY CARE POLICY (MEDICAID RATE) IF THE PATIENT DOESN'T PAY THE BALANCE OF THEIR ACCOUNT AFTER RECEIVING 3 BILLS THEN THE ACCOUNT BALANCE GETS TRANSFER TO THE COLLECTION AGENCY. IF THE COLLECTION AGENCY CAN'T COLLECT AFTER EXHAUSTING THEIR EFFORT THEN THE ACCOUNT GETS RETURNED AS UNCOLLECTIBLE AND HOSPITAL WRITE OFF THE ACCOUNT AS BAD DEBT. PART III, LINE 8: LINE 5 MEDICARE REVENUE AND LINE 6 MEDICARE ALLOWABLE COSTS ARE FROM HOSPITAL COST REPORT THAT GETS FILED WITH MEDICARE EVERY YEAR. COST METHODOLOGY THAT IS USED TO CALCULATE MEDICARE ALLOWABLE COST IS RATIO OF COST TO CHARGES BASE ON MEDICARE GUIDELINES. MEDICARE ALLOWABLE COST ON LINE 6 DOESN'T INCLUDE COST OF RESIDENCY PROGRAM AND SUPERVISORY PHYSICIAN COST WHICH IS OVER $60 MILLION. EXCLUSION OF THESE COSTS RESULTED IN THE SURPLUS ON LINE 7. PART III, LINE 9B: THE HOSPITAL OFFERS INSTALLMENT PLANS FOR THE PAYMENT OF OUTSTANDING BALANCES FOR PATIENTS APPROVED FOR FINANCIAL AID. THE HOSPITAL DOES NOT MANDATE THAT THE MONTHLY INSTALLMENT PAYMENT ARRANGEMENT EXCEED 10% OF THE APPLICANT'S GROSS MONTHLY INCOME OR AN INTEREST RATE THAT EXCEEDS THE RATE FOR A 90-DAY SECURITY ISSUED BY THE US DEPARTMENT OF TREASURY, PLUS 0.5%. THERE IS NO ACCELERATOR OR SIMILAR CLAUSE UNDER WHICH A HIGHER RATE OF INTEREST IS TRIGGERED WHEN A PATIENT MISSES MAKING A PAYMENT. THE HOSPITAL INCLUDES A WRITTEN NOTICE ON PATIENTS' BILLS AND STATEMENTS AT LEAST 30 DAYS PRIOR TO REFERRING THE ACCOUNT TO COLLECTION. THE HOSPITAL REQUIRES THAT ANY COLLECTIONS AGENCIES WITH WHICH THEY CONTRACT FOLLOW THE FINANCIAL ASSISTANCE POLICIES OF THE HOSPITAL. THE HOSPITAL DOES NOT FORCE THE SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE TO COLLECT ON AN OUTSTANDING BILL. COLLECTION IS PROHIBITED AGAINST ANY PATIENT WHO WAS ELIGIBLE FOR MEDICAID AT THE TIME SERVICES WERE RENDERED. FINALLY, THE CONTRACTED COLLECTIONS AGENCIES MUST OBTAIN THE HOSPITAL'S WRITTEN CONSENT BEFORE COMMENCING A LEGAL ACTION. PART VI, LINE 2: JAMAICA HOSPITAL MEDICAL CENTER (JHMC) ADDRESSED THE 5 UPDATED PRIORITY AREAS IDENTIFIED BY THE NEW YORK STATE DEPARTMENT OF HEALTH IN ITS PREVENTION AGENDA 2013-2018: 1) PREVENT CHRONIC DISEASE; 2) PROMOTE A HEALTHY AND SAFE ENVIRONMENT; 3) PROMOTE HEALTHY WOMEN, INFANTS, AND CHILDREN; 4) PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE; AND 5) PREVENT HIV, STDS, VACCINE PREVENTABLE DISEASES AND HEALTHCARE-ASSOCIATED INFECTIONS. WITHIN EACH PRIORITY AREA, JAMAICA HOSPITAL ANALYZED AND SUMMARIZED DATA RELEVANT TO "FOCUS AREAS" (E.G., "REDUCE OBESITY AND "REDUCE ILLNESS, DISABILITY, AND DEATH RELATED TO TOBACCO USE AND SECONDHAND SMOKE EXPOSURE" ARE FOCUS AREAS FOR THE PREVENT CHRONIC DISEASES PRIORITY). DATA WERE PRIMARILY OBTAINED FROM THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE'S (NYC DOHMH) 2015 COMMUNITY HEALTH PROFILES AND COMMUNITY HEALTH SURVEYS (EPIQUERY); THE NEW YORK STATE DEPARTMENT OF HEALTH'S DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PROGRAM'S CLINICAL METRICS AND PERFORMANCE DATA; COMMUNITY-WIDE SURVEYS THAT WERE ADMINISTERED AS PART OF DATA COLLECTION FOR THE 2014 QUEENS COMMUNITY NEEDS ASSESSMENT (CNA); AND FOCUS GROUPS THAT WERE CONVENED BY THE NYC DOHMH IN NEIGHBORHOODS ACROSS THE CITY'S FIVE BOROUGHS AS PART OF NEW YORK CITY'S TAKE CARE NEW YORK (TCNY) 2020 INITIATIVE. COMMUNITY CONSULTATIONS WERE HELD IN NEIGHBORHOODS THROUGHOUT NYC TO VOTE ON LOCAL PRIORITIES IDENTIFIED BY THE NYC HEALTH DEPARTMENT FOR THE TCNY 2020 INITIATIVE. THE SOUTHWEST QUEENS TCNY 2020 COMMUNITY CONSULTATION WAS HELD ON DECEMBER 2, 2015; THE EAST NEW YORK TCNY 2020 COMMUNITY CONSULTATION WAS HELD ON DECEMBER 3, 2015, AND THE JAMAICA TCNY 2020 COMMUNITY CONSULTATION WAS CONVENED ON FEBRUARY 6, 2016; THESE THREE COMMUNITY CONSULTATIONS WERE HELD WITHIN JAMAICA HOSPITAL'S PRIMARY SERVICE AREA. TCNY 2020'S FOUR OBJECTIVES (1. CREATE HEALTHIER NEIGHBORHOODS; 2. SUPPORT HEALTHY LIVING; 3. PROMOTE HEALTHY CHILDHOODS; 4. INCREASE ACCESS TO QUALITY CARE) ARE ALIGNED WITH THE FIVE PRIORITY AREAS OF NEW YORK STATE'S PREVENTION AGENDA.NYC HAS DIFFERENT WAYS OF DESCRIBING AND CATEGORIZING NEIGHBORHOODS, WHICH IS RELEVANT TO HOW COMMUNITY HEALTH DATA ARE ANALYZED AND PRESENTED. NEIGHBORHOODS ARE TYPICALLY DEFINED ACCORDING TO EITHER NYC COMMUNITY DISTRICTS OR UNITED HEALTH FUND NEIGHBORHOODS. THERE ARE 59 NYC COMMUNITY DISTRICTS, WHICH WERE ESTABLISHED BY LOCAL LAW IN 1975. UNITED HEALTH FUND (UHF) NEIGHBORHOODS CONSIST OF 34 NEIGHBORHOODS, MADE UP OF ADJOINING ZIP CODE AREAS, DESIGNATED TO APPROXIMATE NYC COMMUNITY PLANNING DISTRICTS. JAMAICA HOSPITAL'S PRIMARY SERVICE AREA HAS TRADITIONALLY BEEN DEFINED AS COVERING THE QUEENS NEIGHBORHOODS OF JAMAICA AND SOUTHWEST QUEENS (SWQ), AS WELL AS THE BROOKLYN NEIGHBORHOOD OF EAST NEW YORK (ENY). THESE NEIGHBORHOODS, AS DEFINED BY THE UHF (AN INDEPENDENT, NONPROFIT, HEALTH SERVICES RESEARCH AND PHILANTHROPIC ORGANIZATION), DO NOT CORRESPOND EXACTLY TO DISTINCT COMMUNITY DISTRICTS,.MOST OF THE CHARTS IN THIS REPORT REFLECT JAMAICA HOSPITAL'S SERVICE AREA DATA FROM THE NYC DOHMH'S COMMUNITY HEALTH PROFILES AND COMMUNITY HEALTH SURVEYS. BECAUSE THE COMMUNITY HEALTH PROFILE DATA ARE ORGANIZED BY COMMUNITY DISTRICT, AND THE COMMUNITY HEALTH SURVEY DATA ARE ORGANIZED BY UNITED HEALTH FUND NEIGHBORHOOD, JAMAICA HOSPITAL HAS USED BOTH WAYS TO DESCRIBE NEIGHBORHOODS. ADDITIONALLY, DSRIP DATA WERE AGGREGATED INTO UHF NEIGHBORHOODS AND ANALYZED TO BETTER CAPTURE AND DESCRIBE JHMC'S SERVICE AREA.NYS PREVENTION AGENDA PRIORITY AREA 1: PREVENT CHRONIC DISEASESFOCUS 1: REDUCE OBESITYMORE ADULTS (18+) RESIDING WITHIN JHMC'S SERVICE AREA (JAMAICA, SWQ, AND ENY NEIGHBORHOODS) ARE DEFINED AS BEING OBESE THAN IN QUEENS AND NYC OVERALL. THE PERCENTAGE OF OBESE ADULTS ROSE FROM 2013 TO 2014. OBESITY IS LINKED TO CHRONIC CONDITIONS AND DISEASES SUCH AS HIGH BLOOD PRESSURE, HEART DISEASE, DIABETES, AND STROKE.RESIDENTS WITHIN JHMC'S SERVICE AREA REPORTED HAVING ENGAGED IN SOME TYPE OF EXERCISE ROUTINE (PHYSICAL ACTIVITIES OR EXERCISES SUCH AS RUNNING, CALISTHENICS, GOLF, GARDENING, OR WALKING FOR EXERCISE) AS FREQUENTLY AS RESIDENTS OF QUEENS AND NYC OVERALL. THESE DATA ARE ENCOURAGING, HOWEVER, THEY DO NOT DESCRIBE THE INTENSITY OR DURATIONS OF EXERCISE ACTIVITIES. ACCORDING TO THE CENTERS FOR DISEASE CONTROL, ADULTS REQUIRE AT LEAST 150 MINUTES OF MODERATE-INTENSITY AEROBIC ACTIVITY OR 75 MINUTES OF HIGH-INTENSITY AEROBIC ACTIVITY PER WEEK, COMBINED WITH 2 OR MORE DAYS A WEEK THAT WORK ALL MAJOR MUSCLE GROUPS (LEGS, HIPS, BACK, ABDOMEN, CHEST, SHOULDERS, AND ARMS). OVER A THIRD OF KEY INFORMANT INTERVIEWS, SURVEY PARTICIPANTS, AND FOCUS GROUP RESPONDENTS HIGHLIGHTED OBESITY AS A HEALTH CONCERN ON THE 2014 QUEENS COMMUNITY NEEDS ASSESSMENT (CNA). ADDITIONALLY, THE QUEENS CNA POINTS TO DIFFERENCES IN HEALTH NEEDS AND BEHAVIORS BASED ON NEIGHBORHOOD AND/OR POPULATION GROUPS. THE QUEENS CNA REVEALED THAT HEALTH NEEDS VARY WITH CULTURAL/NEIGHBORHOOD DIFFERENCES, AS, FOR EXAMPLE, AFRICAN AMERICAN AND CARIBBEAN POPULATIONS IN JAMAICA CONSIDERED OBESITY TO BE A PRESSING ISSUE, ALONG WITH LIMITED ACCESS TO HEALTHY FOODS AT LOCAL STORES. ASIANS WHO PARTICIPATED IN THE QUEENS CNA, HOWEVER, DID NOT CITE OBESITY AS AN ISSUE, AND REPORTED EASY ACCESS TO HEALTHY FOODS.RESOURCES: JAMAICA HOSPITAL STRIVES TO HELP ITS COMMUNITY MEMBERS REDUCE OBESITY AND EMPOWER THEM TO MAKE HEALTH-CONSCIOUS NUTRITION DECISIONS. THE HOSPITAL'S SERVICES INCLUDE NUTRITIONISTS AND DIABETES EDUCATORS, WHO ASSIST PATIENTS WITH DEVELOPING HEALTHY EATING HABITS AND REACHING WEIGHT MANAGEMENT GOALS. THE HOSPITAL OFFERS THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) APPROVED NATIONAL DIABETES PREVENTION PROGRAM (NDPP) CLASSES AT REGULAR INTERVALS FOR PRE-DIABETICS PATIENTS. JAMAICA HOSPITAL OFFERS A MONTHLY SUPPORT GROUP THAT CONSISTS OF INTERACTIVE SESSIONS THAT AIM TO EDUCATE DIABETIC PATIENTS WITH LIFESTYLE AND PROFESSIONAL RECOMMENDATIONS FROM OUR HIGHLY QUALIFIED PHYSICIANS, THERAPISTS, PODIATRISTS, DIETICIANS, AND OTHER CLINICAL SPECIALISTS. JAMAICA HOSPITAL PARTICIPATED IN THE NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE'S "HEALTHY HOSPITAL FOOD INITIATIVE" TO CREATE A HEALTHIER FOOD ENVIRONMENT THROUGH SUCH ACTIVITIES AS MEETING STANDARDS FOR STOCKING VENDING MACHINES WITH HEALTHY FOODS AND BEVERAGES AND OFFERING HEALTHY CHOICES IN THE HOSPITAL CAFETERIA. BREASTFEEDING IS ENCOURAGED BY JAMAICA HOSPITAL'S STAFF AS ANOTHER HEALTHY MEANS OF HELPING POSTPARTUM MOTHERS TO SHED WEIGHT GAINED DURING PREGNANCY AND POTENTIALLY REDUCING THE RISK OF PEDIATRIC OBESITY FOR THEIR CHILDREN.IN ADDITION TO JAMAICA HOSPITAL'S NUTRITIONISTS AND DIABETES EDUCATORS, THERE ARE 56 ENDOCRINE/DIABETES PHYSICIANS IN QUEENS. THE NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE OFFERS A "HEALTH BUCKS" PROGRAM, THROUGH WHICH FRESH FRUITS AND VEGETABLES CAN BE PURCHASED AT ALL FARMERS' MARKETS IN NYC. THE HOSPITAL DISTRIBUTES HEALTH BUCKS TO PATIENTS IN ITS NDPP. TWO FARMERS' MARKETS ARE FOUND IN JHMC'S SERVICE AREA. QUEENS HOSPITAL CENTER FARMERS' MARKET, JAMAICA'S DOWN TO EARTH FARMERS' MARKET, AND JAMAICAL HOSPITAL STARTED ITS OWN FARMERS' MARKET IN 2018.FOCUS 2: REDUCE ILLNESS, DISABILITY, AND DEATH RELATED TO TOBACCO USE AND SECONDHAND SMOKE EXPOSUREHIGHER PERCENTAGES OF SWQ AND ENY RESIDENTS SMOKE CIGARETTES THAN QUEENS OR NYC RESIDENTS. TOBACCO CESSATION EFFORTS REMAIN A PRIORITY IN JHMC'S COMMUNITY.MORE RESIDENTS OF SWQ AND ENY REPORT BEING EXPOSED TO SECONDHAND SMOKE ON A DAILY BASIS, COMPARED WITH RESIDENTS OF QUEENS AND NYC, OVERALL. THE 2014 SECONDHAND SMOKE EXPOSURE RATES FOR SWQ AND ENY ARE ALMOST DOUBLE THAT OF QUEENS OVERALL. SECONDHAND SMOKE IS KNOWN TO CAUSE CANCER, EVEN IN INDIVIDUALS WHO DO NOT SMOKE, AND IS LINKED TO RESPIRATORY CONDITIONS SUCH AS ASTHMA AND BRONCHITIS.NYC COMMUNITY HEALTH SURVEY SMOKING DATA ARE SUPPORTED BY QUEENS CNA INFORMANT DATA AND HIGHLIGHT THE NEED FOR SMOKING CESSATION SERVICES. PART VI, LINE 3: CHARITY CARE POLICYPOLICY: TO PROVIDE ACCESS TO GOVERNMENT ASSISTANCE APPLICATIONS AND/OR FINANCIAL AID FOR THE QUALIFIED UNINSURED.PURPOSE: TO PROVIDE ACCESSIBLE AND AFFORDABLE CARE TO UNINSURED PATIENTS AND TO IDENTIFY METHODS BY WHICH PATIENTS AND/OR FAMILY MEMBERS ARE NOTIFIED OF THE JAMAICA HOSPITAL MEDICAL CENTER FINANCIAL AID POLICY.PROCEDURE: NOTIFICATION TO PATIENTS:JAMAICA HOSPITAL MEDICAL CENTER DEVELOPED AND HAS PUBLICLY AVAILABLE A CLEAR AND UNDERSTANDABLE WRITTEN SUMMARY OF ITS FINANCIAL ASSISTANCE POLICIES AND ENSURES THAT EVERY PATIENT IS MADE AWARE OF THE EXISTENCE OF THE POLICIES. THE HOSPITAL HAS A 24-HOUR EMERGENCY DEPARTMENT AND NOTIFIES PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE DURING THE INTAKE AND REGISTRATION PROCESS THROUGH THE POSTING OF CONSPICUOUS AND LANGUAGE APPROPRIATE INFORMATION, AND THROUGH INFORMATION ON ALL BILLS AND STATEMENTS SENT TO PATIENTS. IN ADDITION, THE HOSPITAL POSTS THE FINANCIAL ASSISTANCE SUMMARY ON ITS WEBSITE. THE SUMMARY OF POLICIES INCLUDES THE SPECIFIC INCOME LEVELS USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE, A DESCRIPTION OF THE PRIMARY SERVICE AREA OF THE HOSPITAL, AND INFORMATION ABOUT HOW PATIENTS CAN APPLY FOR ASSISTANCE.ADDITIONALLY, THE HOSPITAL REQUIRES CONTRACTED OUTSIDE COLLECTIONS AGENCIES TO, WHEN APPROPRIATE; PROVIDE INFORMATION TO PATIENTS ABOUT HOW TO APPLY FOR FINANCIAL ASSISTANCE. CHANGES IMPACTING COMMUNITY HEALTH/PROVISION OF CHARITY CARE/ACCESS TO SERVICES:THE HOSPITAL CONTINUES TO FACE EXTRAORDINARY FINANCIAL CHALLENGES INCLUDING FEDERAL AND STATE BUDGET CUTS, INCREASES IN THE UNINSURED, AND DWINDLING THIRD-PARTY REIMBURSEMENT RATES. SIMULTANEOUSLY, THE HOSPITAL HAS HAD A DRAMATIC INCREASE IN ITS EMERGENCY AND INPATIENT LOAD DUE TO NEARBY HOSPITAL CLOSINGS. POLICY: TO PROVIDE ACCESS TO GOVERNMENT ASSISTANCE APPLICATIONS AND/OR FINANCIAL AID FOR THE QUALIFIED UNINSURED. PURPOSE: TO PROVIDE ACCESSIBLE AND AFFORDABLE CARE TO UNINSURED PATIENTS AND TO DEFINE THEIR RESPONSIBILITY TO CONTRIBUTE TO THEIR CARE BASED ON THEIR ABILITY TO PAY. PROCEDURE: ELIGIBILITY:JAMAICA HOSPITAL MEDICAL CENTER FINANCIAL ASSISTANCE POLICY ENSURES THAT ANY PATIENT THAT HAS BEEN DEEMED TO BE UNINSURED THROUGH BASIC FINANCIAL SCREENING WILL BE ENTITLED TO A GLOBAL CHARITABLE DISCOUNT FOR EMERGENT (NYS RESIDENTS) AND/OR MEDICALLY NECESSARY SERVICES (RESIDES IN HOSPITAL'S PRIMARY SERVICE AREA). THE GLOBAL CHARITABLE DISCOUNT WILL BE BASED ON THE CURRENT APPLICABLE MEDICAID RATE - DEPENDING ON THE SERVICE PROVIDED. ADDITIONALLY, FOR COVERED SERVICES THERE ARE NO LIMITS ON FINANCIAL ASSISTANCE BASED ON THE MEDICAL CONDITION OF THE APPLICANT. THE HOSPITAL ALSO PROVIDES ADDITIONAL FINANCIAL ASSISTANCE TO PATIENTS WITH INCOMES BELOW 300% FPL. TO BE POTENTIALLY ELIGIBLE FOR ADDITIONAL FINANCIAL ASSISTANCE, A PATIENT MUST BE UNINSURED OR HAVE EXHAUSTED THEIR HEALTH INSURANCE BENEFITS AND MUST BE DEEMED INELIGIBLE FOR ANY OTHER GOVERNMENT ASSISTANCE PROGRAM BY THE FINANCIAL COUNSELING OFFICE OF THE HOSPITAL. THOSE PATIENTS WHO ARE POTENTIALLY ELIGIBLE AND PROVIDE PROOF THAT THEIR INCOME IS BELOW 300% FPL CAN QUALIFY FOR ADDITIONAL FINANCIAL ASSISTANCE. THE LEVEL OF ADDITIONAL ASSISTANCE WOULD BE DEPENDENT ON HOW LOW THEIR INCOME IS. THERE IS NO RESOURCE TEST FOR FINANCIAL AID ELIGIBLE PATIENTS. PLEASE NOTE THAT CERTAIN ELECTIVE SERVICES ARE EXCLUDED FROM THIS PROGRAM SUCH AS NON-MEDICALLY NECESSARY COSMETIC SERVICES AND SELF-IMPROVEMENT SERVICES.CO-PAYS AND DEDUCTIBLES ARE NOT COVERED UNDER THE PROGRAM. PATIENTS WHO DO NOT HAVE INSURANCE, AND; CHOOSE NOT TO FILE FOR ADDITIONAL CHARITABLE ASSISTANCE; ARE UNCOOPERATIVE; OR WHO ARE UNABLE TO BE LOCATED WILL HAVE THE GLOBAL CHARITABLE DISCOUNT APPLIED TO THEIR ACCOUNT(S). NO FURTHER DISCOUNTING WILL BE MADE AVAILABLE TO PATIENTS IN THESE CATEGORIES UNLESS APPROVED VIA THE APPEALS PROCESS. ANCILLARIES ARE NOT INCLUDED IN DISCOUNTING EXTENDED TO THESE PATIENTS' ACCOUNTS.JAMAICA HOSPITAL MEDICAL CENTER ALLOWS FOR ALL RESIDENTS OF NEW YORK STATE TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE FOR EMERGENCY HOSPITAL SERVICES. FOR ANY MEDICALLY NECESSARY, NON-EMERGENT MEDICAL CARE, THE POLICY ALLOWS FOR RESIDENTS OF THE HOSPITAL'S PRIMARY SERVICE (AS DEFINED BY THE COMMISSIONER OF THE DEPARTMENT OF HEALTH), TO BE ELIGIBLE TO RECEIVE FINANCIAL ASSISTANCE. POLICY: TO PROVIDE ACCESS TO GOVERNMENT ASSISTANCE APPLICATIONS AND/OR FINANCIAL AID FOR THE QUALIFIED UNINSURED. PURPOSE: TO DEFINE WHAT SERVICES ARE COVERED UNDER THE JAMAICA HOSPITAL MEDICAL CENTER FINANCIAL AID POLICY BASED ON NEW YORK STATE MANDATORY GUIDELINES. PROCEDURE: SERVICES COVERED: JAMAICA HOSPITAL MEDICAL CENTER PROVIDES FINANCIAL ASSISTANCE FOR ALL MEDICALLY NECESSARY AND THERAPEUTICALLY BENEFICIAL SERVICES AND PROCEDURES, AND ALL EMERGENCY HOSPITAL SERVICES INCLUDING EMERGENCY TRANSFERS PURSUANT TO THE FEDERAL EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA).POLICY: TO PROVIDE ACCESS TO GOVERNMENT ASSISTANCE APPLICATIONS AND/OR FINANCIAL AID FOR THE QUALIFIED UNINSURED.PURPOSE: TO PROVIDE ACCESSIBLE AND AFFORDABLE CARE TO UNINSURED PATIENTS AND TO DEFINE THEIR RESPONSIBILITY TO CONTRIBUTE TO THEIR CARE BASED ON THEIR ABILITY TO PAY. PROCEDURE: APPLICATION, APPROVAL, AND APPEAL:JAMAICA HOSPITAL MEDICAL CENTER FINANCIAL ASSISTANCE POLICY ALLOWS PATIENTS TO APPLY FOR ADDITIONAL FINANCIAL ASSISTANCE UP TO 90 DAYS AFTER INPATIENT DISCHARGE OR RECEIPT OF OUTPATIENT SERVICES. THE HOSPITAL REQUIRES APPLICANTS TO SUBMIT FINANCIAL DOCUMENTS TO SUPPORT THEIR APPLICATION. THE POLICY ALLOWS 20 DAYS FOR PATIENTS TO SUBMIT ADDITIONAL DOCUMENTS AND INFORMATION NEEDED TO COMPLETE AN APPLICATION. FINANCIAL ASSISTANCE APPLICANTS ARE NOT REQUIRED TO PAY THEIR HOSPITAL BILL(S) WHILE THE APPLICATION FOR ASSISTANCE IS BEING CONSIDERED AND A DETERMINATION MADE. DESIGNATED HOSPITAL STAFF ASSISTS PATIENTS IN THE APPLICATION PROCESS, INCLUDING UNDERSTANDING THE POLICIES AND PROCEDURES. PATIENTS APPLYING FOR FINANCIAL ASSISTANCE ARE REQUIRED TO COOPERATE WITH THE REQUIREMENTS OF THE APPLICATION, SUCH AS PROVIDING INFORMATION AND DOCUMENTATION NECESSARY TO RENDER A DECISION ON THE APPLICATION. TO QUALIFY FOR ADDITIONAL FINANCIAL ASSISTANCE, HOSPITAL POLICY REQUIRES A PATIENT TO FIRST APPLY FOR MEDICAID OR ANOTHER INSURANCE PROGRAM, IF, IN THE JUDGMENT OF THE HOSPITAL, THE PATIENT MAY BE ELIGIBLE FOR MEDICAID OR ANOTHER HEALTH INSURANCE PROGRAM.THE HOSPITAL PROVIDES APPLICATION FORMS IN THE PRIMARY LANGUAGES OF PATIENTS SERVED BY THE HOSPITAL.DECISIONS REGARDING FINANCIAL ASSISTANCE APPLICATIONS ARE MADE BY THE HOSPITAL WITHIN 30 DAYS OF RECEIPT OF A COMPLETED APPLICATION. WHENEVER A MEDICAID APPLICATION IS ALSO BEING SUBMITTED ON BEHALF OF THE FINANCIAL AID APPLICANT, A FINANCIAL AID DECISION WILL BE RENDERED WITHIN 30 DAYS OF A MEDICAID DENIAL. THE DECISION IS PROVIDED TO THE PATIENT IN WRITING AND INCLUDES THE METHOD BY WHICH THE PATIENT CAN APPEAL A DENIAL. THE FINANCIAL ASSISTANCE DENIAL LETTERS EXPLAINS THE APPEALS PROCESS TO RE-EVALUATE DENIED APPLICATIONS; IF, OR WHEN, AN APPEAL IS REQUESTED. PART VI, LINE 4: JAMAICA HOSPITAL'S PRIMARY SERVICE AREA WAS DETERMINED BY ANALYZING STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS) DISCHARGE DATA AT THE ZIP CODE LEVEL. THE UHF NEIGHBORHOODS WITH THE HIGHEST VOLUMES OF PATIENTS WERE DETERMINED TO BE THE PRIMARY SERVICE AREA. THE TOTAL (PRIMARY AND SECONDARY) SERVICE AREA COLLECTIVELY ACCOUNTS FOR APPROXIMATELY 85% OF THE HOSPITAL'S TOTAL INPATIENT CASES. THE PRIMARY SERVICE AREA ACCOUNTS FOR 79% OF THE CASES.THERE ARE GAPS IN PRIMARY MEDICAL CARE AND MENTAL HEALTH CARE ACROSS QUEENS, WHICH ARE ALSO EVIDENT IN JAMAICA HOSPITAL'S SERVICE AREA. QUEENS HAS SEVEN NEIGHBORHOODS THAT ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS (MUA) BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA); THIS DESIGNATION IS BASED ON FOUR FACTORS: THE RATIO OF PRIMARY MEDICAL CARE PHYSICIANS PER 1,000 POPULATION, INFANT MORTALITY RATE, PERCENTAGE OF THE POPULATION WITH INCOMES BELOW THE POVERTY LEVEL, AND PERCENTAGE OF THE POPULATION AGE 65 OR OVER. THE KINGS COUNTY SERVICE AREA MUA, WHICH CONTAINS EAST NEW YORK, AND THE QUEENS SERVICE AREA MUA, WHICH CONTAINS PARTS OF JAMAICA, COVER JAMAICA HOSPITAL'S SERVICE AREA. SOUTH JAMAICA, A NEIGHBORHOOD WITHIN JAMAICA HOSPITAL'S PRIMARY SERVICE AREA, ALSO IS A DESIGNATED MUA. SOUTH JAMAICA IS ALSO DESIGNATED AS A PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) BY HRSA, MEANING THERE ARE FEWER PRIMARY CARE PROFESSIONALS THAN ARE NECESSARY TO ACCOMMODATE THE POPULATION LIVING IN THAT AREA. CENSUS TRACTS WITHIN SOUTH JAMAICA ARE ALSO DESIGNATED AS MENTAL HEALTH HPSAS, MEANING THERE ARE FEWER MENTAL HEALTH CARE PROFESSIONALS THAN ARE NECESSARY TO ACCOMMODATE THE POPULATION LIVING IN THOSE AREAS. WITHIN JAMAICA HOSPITAL'S SERVICE AREA, THERE ARE TWO FACILITIES (JOSEPH P. ADDABBO FAMILY HEALTH CENTER AND PROJECT SAMARITAN HEALTH SERVICES) THAT RECEIVED MENTAL HEALTH HPSA DESIGNATION BECAUSE THEY PROVIDE MENTAL HEALTH SERVICES TO AN AREA OR POPULATION GROUP DESIGNATED AS HAVING A SHORTAGE OF MENTAL HEALTH PROFESSIONALS AND HAVE INSUFFICIENT CAPACITY TO MEET THE PSYCHIATRIC NEEDS OF THE AREA OR POPULATION GROUP. JAMAICA: WITH A POPULATION OF MORE THAN 308,000, JAMAICA IS THE LARGEST NEIGHBORHOOD IN JAMAICA HOSPITAL'S SERVICE AREA. MORE THAN HALF OF JAMAICA'S RESIDENTS ARE BLACK (53%) AND 20% IDENTIFY AS HISPANIC/LATINO (REGARDLESS OF RACE). SIXTEEN PERCENT OF JAMAICA'S RESIDENTS ARE ASIAN AND 12% OF JAMAICA'S RESIDENTS ARE WHITE. ALMOST A THIRD OF JAMAICA'S RESIDENTS RECEIVE MEDICAID AND 12% RECEIVE MEDICARE. POVERTY AND ITS EFFECTS ON HEALTH, PARTICULARLY ON MENTAL/BEHAVIORAL HEALTH AND NUTRITION, ARE OF SIGNIFICANCE IN JAMAICA. WHEREAS MORE THAN A THIRD (35%) OF QUEENS RESIDENTS HAVE INCOMES AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, MOST (78%) QUEENS CNA SURVEY RESPONDENTS FROM JAMAICA REPORTED THAT THEY WERE LIVING BELOW THE FEDERAL POVERTY LEVEL AND, AND 62% REPORTED THAT IN THE LAST YEAR THEY SOMETIMES WORRIED ABOUT NOT HAVING ENOUGH TO EAT. OVERALL, 53% OF QUEENS CNA SURVEY RESPONDENTS REPORTED THAT THEY WORRIED ABOUT NOT HAVING ENOUGH TO EAT. QUEENS CNA SURVEY RESPONDENTS FROM JAMAICA ALSO REPORTED THEY HAVE MORE LIMITED AVAILABILITY OF HEALTHY FOODS. SURVEY RESPONDENTS IN JAMAICA WHO PARTICIPATED IN THE QUEENS COMMUNITY NEEDS ASSESSMENT WERE MORE LIKELY TO REPORT THAT HIV WAS A HEALTH CONCERN (26.4%, COMPARED TO 11% FOR THE FULL QUEENS SAMPLE) AND WERE MORE LIKELY TO REPORT HAVING ASTHMA (19% COMPARED TO 11% FOR THE FULL QUEENS SAMPLE). OVERWEIGHT AND OBESITY RATES WERE HIGHER IN JAMAICA (53%) COMPARED TO 44% FOR THE FULL SAMPLE OF QUEENS CNA SURVEY RESPONDENTS. ALMOST A THIRD (28%) OF QUEENS CNA SURVEY RESPONDENTS REPORTED THAT HEALTH EDUCATION OR PROGRAMS ON DOMESTIC VIOLENCE WERE NEEDED IN THEIR COMMUNITY, HOWEVER 44% OF JAMAICA RESPONDENTS INDICATED THAT DOMESTIC VIOLENCE PROGRAMMING IS NECESSARY. THESE DOMESTIC VIOLENCE SURVEY DATA ARE SUPPORTED BY THE INJURY ASSAULT HOSPITALIZATION RATE DATA SHOWN IN THIS JAMAICA HOSPITAL CHNA (PAGE 17). THAT IS, THE INJURY ASSAULT HOSPITALIZATION RATE WAS HIGHER FOR QUEENS COMMUNITY DISTRICT 12 (JAMAICA) THAN IT WAS FOR QUEENS AND NYC OVERALL. COMMUNITY DISTRICT PRIORITIES FOR JAMAICA, AS IDENTIFIED IN THE TAKE CARE NEW YORK 2020 COMMUNITY CONSULTATIONS, INCLUDE SMOKING, DRUG OVERDOSE DEATHS, CONTROLLED HIGH BLOOD PRESSURE, BINGE DRINKING, AND THE HIGH SCHOOL GRADUATION RATE. THE CITY DOHMH ADDED ADDITIONAL PRIORITIES BASED ON THE LOCAL DATA FOR THESE PROBLEMS: CHILD-CARE SLOTS, UNMET MEDICAL NEED AND SUGARY DRINKS.SOUTHWEST QUEENS: THE TOTAL RESIDENT POPULATION OF SOUTHWEST QUEENS IS APPROXIMATELY 283,000 . ALMOST A THIRD OF SOUTHWEST QUEENS RESIDENTS ARE HISPANIC/LATINO (33%; REGARDLESS OF RACE) OR WHITE (35.6%). TWELVE PERCENT OF SOUTHWEST QUEENS RESIDENTS ARE BLACK AND 23% OF SOUTHWEST QUEENS RESIDENTS ARE ASIAN. SIXTEEN PERCENT OF RESIDENTS OF SOUTHWEST QUEENS RECEIVE MEDICARE AND 27% OF RESIDENTS RECEIVE MEDICAID. SOUTHWEST QUEENS GENERALLY FARES COMPARABLY TO QUEENS ON THE WHOLE AND DOES NOT STAND OUT ON MOST MEASURES OF CHRONIC DISEASE PREVALENCE. HOWEVER, IN THE NYC COMMUNITY HEALTH PROFILES, COMMUNITY DISTRICT 10 RANKED THE HIGHEST (#13 OUT OF 59 COMMUNITY DISTRICTS ) AMONG ALL OF THE NEIGHBORHOODS INCLUDED IN THE QUEENS CNA FOR SELF-REPORTED DIABETES PREVALENCE, INDICATING THAT DIABETES IS A CONCERN IN SOUTHWEST QUEENS. THERE WAS NOT A BREAK OUT FOR SOUTHWEST QUEENS IN THE TCNY 2020 COMMUNITY CONSULTATIONS REPORT, AS ONLY COMMUNITY DISTRICTS THAT HAD AT LEAST 10 VOTES IN THE RANKING OF THEIR PRIORITIES WERE INCLUDED IN THE QUEENS TCNY 2020 REPORT. TCNY 2020 COMMUNITY CONSULTATION PRIORITIES FOR SOUTHWEST QUEENS ARE LIKELY THOSE THAT WERE NAMED FOR QUEENS OVERALL, NAMELY: AIR QUALITY, CONTROLLED HIGH BLOOD PRESSURE, OBESITY, PHYSICAL ACTIVITY, AND UNMET MENTAL HEALTH NEED. EAST NEW YORK: EAST NEW YORK (ENY), WITH A TOTAL RESIDENT POPULATION OF ALMOST 188,000, IS A DIVERSE COMMUNITY. MORE THAN HALF OF ENY RESIDENTS ARE BLACK (57%) AND 39% IDENTIFY AS HISPANIC/LATINO (REGARDLESS OF RACE). SLIGHTLY LESS THAN 5 PERCENT OF ENY RESIDENTS ARE ASIAN AND 14% OF ENY RESIDENTS ARE WHITE. TWELVE PERCENT OF ENY RESIDENTS RECEIVE MEDICARE AND 37% RECEIVE MEDICAID.WITHIN THE QUEENS SERVICE AREA DEFINED IN THE QUEENS CNA, EAST NEW YORK HAS THE HIGHEST RATE OF CLASS C SERIOUS HOUSING VIOLATIONS (101.1 PER 1,000 RENTAL UNITS), ALMOST DOUBLE THE RATES OF THOSE FOUND IN JAMAICA (51.34/1,000 RENTAL UNITS) AND NYC OVERALL (53.79/1,000 UNITS), AND ALMOST FOUR TIMES THE RATE IN SOUTHWEST QUEENS (26.5 - 34.6/1,000 RENTAL UNITS). THESE CLASS C ("IMMEDIATELY HAZARDOUS") CONDITIONS REQUIRE CORRECTION WITHIN 24 HOURS OF AN OWNER RECEIVING A VIOLATION NOTICE FROM THE NYC HOUSING PRESERVATION AND DEVELOPMENT AND INCLUDE ISSUES SUCH AS INADEQUATE SUPPLY OF HEAT AND HOT WATER, RODENTS, AND PEELING LEAD PAINT IN DWELLINGS WHERE A CHILD UNDER AGE 7 RESIDES. THE HIGH RATE OF SERIOUS HOUSING VIOLATIONS OBSERVED IN EAST NEW YORK MAY BE RELEVANT TO THE HIGH RATE OF ASTHMA HOSPITALIZATIONS (POTENTIALLY AVOIDABLE INPATIENT DISCHARGES, OR PQI) FOR MEDICAID BENEFICIARIES AGED 18-39 (155.9 PER 100,000) IN EAST NEW YORK. BY COMPARISON, THE PQI ASTHMA HOSPITALIZATION RATES FOR THE SAME AGE GROUP OF RESIDENTS WHO RECEIVE MEDICAID BENEFITS ACROSS QUEENS, NYC, AND NYS ARE 77.2, 160.82, AND 134.52 DISCHARGES PER 100,000, RESPECTIVELY. SIMILARLY, CHILDREN IN EAST NEW YORK WHO ARE MEDICAID BENEFICIARIES HAVE HIGHER RATES OF ASTHMA HOSPITALIZATIONS (557 DISCHARGES PER 100,000) THAN PEDIATRIC MEDICAID BENEFICIARIES IN ADJOINING SOUTHWEST QUEENS (299 DISCHARGES PER 100,000) AND QUEENS OVERALL (230 DISCHARGES PER 100,000). COMMUNITY DISTRICT PRIORITIES FOR EAST NEW YORK, AS IDENTIFIED IN THE TAKE CARE NEW YORK 2020 COMMUNITY CONSULTATIONS, INCLUDE SMOKING, PHYSICAL ACTIVITY, CONTROLLED HIGH BLOOD PRESSURE, OBESITY, AND UNMET MENTAL HEALTH NEED. PART VI, LINE 5: SELECTION OF PREVENTION AGENDA PRIORITIESJAMAICA HOSPITAL'S PRIORITIES ARE IN LINE WITH THE PRIORITIES IDENTIFIED BY THE NYS PREVENTION AGENDA AS WELL AS NEW YORK CITY'S TAKE CARE NEW YORK 2020. ALTHOUGH JHMC COULD HAVE SELECTED OTHER INITIATIVES TO HIGHLIGHT IN ITS PREVENTION AGENDA, BASED UPON COMMUNITY HEALTH STATISTICS AND CONSUMER NEEDS/UTILIZATION SURVEYS, ITS RESOURCES AND CAPABILITIES ARE BEST SUITED TO FOCUS ON:- DECREASING TOBACCO USE WITHIN THE COMMUNITY, AND- INCREASING RATES OF EXCLUSIVE BREASTFEEDING AMONG MOTHERS IN THE SERVICE AREA JHMC ELECTED TO ADDRESS THESE TWO PARTICULAR HEALTH NEEDS SINCE THEY WILL MAKE A SIGNIFICANT IMPACT ON THE COMMUNITY'S HEALTH AND CREATE SUSTAINABLE QUALITY OF LIFE IMPROVEMENTS. BECAUSE OF ITS CURRENT AND PAST EFFORTS ON THESE TWO PRIORITIES, JAMAICA HOSPITAL EARNED A GOLD STAR FOR ITS ACCOMPLISHMENTS WITH NYC'S TOBACCO-FREE HOSPITAL CAMPAIGN; AND IS IN THE FINAL PHASE OF BEING DESIGNATED AS A BABY FRIENDLY HOSPITAL. THE HOSPITAL HAS INCORPORATED COMMUNITY INPUT INTO ITS SELECTION OF PRIORITIES, AS DESCRIBED IN DETAIL IN THE SECTION ON DATA SOURCES AND COMMUNITY INPUT. AT ITS MEETING ON SEPTEMBER 12, 2016, JAMAICA'S COMMUNITY ADVISORY BOARD AGREED WITH THE ABOVE PRIORITIES, AND ON NOVEMBER 28, 2016 THE HOSPITAL'S BOARD OF TRUSTEES APPROVED THE PLAN.THE HOSPITAL HAS WORKED ON MANY OTHER PREVENTION ACTIVITIES, AND HAS PARTNERED WITH THE CITY DOHMH ON TAKE CARE NEW YORK (TCNY) 2016, OTHER GOVERNMENT AGENCIES, AND COMMUNITY-BASED ORGANIZATIONS (CBOS), IMPLEMENTING A VARIETY OF EVIDENCE-BASED INTERVENTIONS, IN ADDITION TO TOBACCO CESSATION AND EXCLUSIVE BREASTFEEDING:- ADOPTING THE HEALTHY HOSPITAL FOOD INITIATIVE.- TRACKING AND REPORTING THE BLOOD PRESSURE CONTROL SCORES OF PATIENTS IN THE HOSPITAL AMBULATORY FOOTPRINT.- SUPPORTING AND PROMOTING THE NATIONAL DIABETES PREVENTION PROGRAM (NDPP) FOR OVERWEIGHT AND OBESE ADULTS WITH PRE-DIABETES OR WOMEN WITH HISTORY OF GESTATIONAL DIABETES.- ENSURING ROUTINE OFFERING OF HIV TESTING IN EMERGENCY DEPARTMENTS AND ALL OUTPATIENT CLINICS.- REDUCING THE PERCENT OF HIV INFECTED PATIENTS WITH DETECTABLE VIRAL LOADS.- IMPLEMENTING HOME-BASED FALLS RISK ASSESSMENTS AND INTERVENTIONS IN THE HOMES OF OLDER ADULTS, DEPLOYING DOHMH TOOLS.- PROMOTING APPROPRIATE AND JUDICIOUS PRESCRIBING OF OPIOID ANALGESICS.- SUPPORTING THE TRAINING AND CERTIFICATION OF PRIMARY CARE PRACTICES TO PRESCRIBE BUPRENORPHINE.- ADOPTING SCREENING, BRIEF INTERVENTION AND REFERRAL TO TREATMENT (SBIRT) FOR ALCOHOL AND DRUG USE IN OUTPATIENT AND EMERGENCY DEPARTMENT SETTINGS.- ENGAGING PATIENTS WITH FIRST EPISODE PSYCHOSIS INTO QUALITY OUTPATIENT CARE.CURRENTLY THE HOSPITAL IS PARTNERING WITH THE CITY DOHMH ON ITS TCNY 2020 AGENDA, WHICH HAS FOUR OBJECTIVES, EACH WITH SEVERAL INDICATORS OF PROGRESS. THESE OBJECTIVES ARE ALIGNED WITH THE STATE'S PREVENTION AGENDA PRIORITIES, DESCRIBED IN DETAIL ABOVE, AS WELL AS THE DSRIP PROJECTS THAT THE HOSPITAL IS IMPLEMENTING. THE HOSPITAL DEVOTES CONSIDERABLE RESOURCES TO MOST OF THE CITY AND STATE PREVENTION OBJECTIVES DESCRIBED BELOW WITH A FEW EXCEPTIONS WHERE THE HOSPITAL WOULD HAVE NO AGENCY, SUCH AS DECREASING THE JAIL POPULATION, INCREASING HOMES WITH NO MAINTENANCE DEFECTS AND OTHERS THAT GOVERNMENT AGENCIES AND CBOS ARE BETTER SUITED TO ADDRESS. TCNY 20201. PROMOTE HEALTHY CHILDHOODS (ALIGNED WITH NYS PRIORITY: PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN)THE FIRST INDICATOR IS BABIES BORN IN BABY FRIENDLY HOSPITALS. THE HOSPITAL IS WELL ON ITS WAY TO BEING DESIGNATED AS A BABY FRIENDLY HOSPITAL. THE SECOND INDICATOR IS TEENAGE PREGNANCY. REDUCING TEENAGE PREGNANCY IS A VERY HIGH PRIORITY FOR THE HOSPITAL. THE HOSPITAL IS PROVIDING LONG ACTING CONTRACEPTIVES FOR ALL AGE GROUPS, INCLUDING ADOLESCENTS IN ITS AMBULATORY CARE CENTER (ACC), AND IN ITS SCHOOL-BASED HEALTH CENTER IN A LOCAL HIGH SCHOOL. CITY GOVERNMENT AND COMMUNITY-BASED ORGANIZATIONS ARE BETTER SUITED TO WORK TOWARDS IMPROVEMENT IN THE OTHER TWO INDICATORS: OPENINGS IN CHILD CARE CENTERS AND HIGH SCHOOL GRADUATION.2. CREATE HEALTHIER NEIGHBORHOODS (ALIGNED WITH NYS PRIORITY: PROMOTE A HEALTHY AND SAFE ENVIRONMENT)THE HOSPITAL IS WORKING ON SEVERAL OF THE INDICATORS UNDER THIS OBJECTIVE, INCLUDING FALL-RELATED HOSPITALIZATIONS BY THOROUGH DOCUMENTATION AND ANALYSIS OF FALLS PATIENTS AND REFERRAL TO EVIDENCE-BASED FALLS PREVENTION PROGRAMS IN THE COMMUNITY, AIR QUALITY BY VIRTUE OF ITS WORK ON TOBACCO CESSATION, CHILDREN'S VISITS TO EMERGENCY DEPARTMENTS FOR ASTHMA BY BEING PART OF THE QUEENS ASTHMA COALITION AND BY WORKING ON DSRIP PROJECT 3.D.III - EVIDENCE-BASED ASTHMA MANAGEMENT IN COLLABORATION WITH ITS PARTNERS IN THE ACP PPS TO MAKE SURE PATIENTS ARE PROPERLY DIAGNOSED, HAVE AN ASTHMA ACTION PLAN, AND ONGOING HEALTH COACHING. CITY GOVERNMENT AND COMMUNITY-BASED ORGANIZATIONS ARE BETTER SUITED TO WORK TOWARDS THE OTHER FOUR INDICATORS: ASSAULT HOSPITALIZATIONS, HOMES WITH NO MAINTENANCE DEFECTS, JAIL POPULATION, AND SOCIAL COHESION.3. SUPPORT HEALTHY LIVING (ALIGNED WITH NYS PRIORITY: PREVENT CHRONIC DISEASE)PATIENT NAVIGATORS, NUTRITIONISTS, DIABETES EDUCATORS, SOCIAL WORKERS AND THERAPISTS SUPPORT PHYSICIANS AND OTHER PROVIDERS IN EDUCATING AND COACHING PATIENTS ON MAKING LIFE STYLE CHANGES RELATED TO ALL THE INDICATORS UNDER THIS OBJECTIVE: OBESITY, SUGARY DRINKS, PHYSICAL ACTIVITY, SODIUM INTAKE, SMOKING, BINGE DRINKING AND OVERDOSE DEATHS. REDUCING TOBACCO USE HAS BEEN COVERED EXTENSIVELY IN THIS REPORT. BESIDES ADDRESSING NUTRITION AND EXERCISE ON AN INDIVIDUAL BASIS WITH PATIENTS, THE HOSPITAL PROMOTES HEALTHY EATING IN THE COMMUNITY. TWO OUTPATIENT REGISTERED DIETITIANS HOSTED A FARMER'S MARKET TOUR ON NOVEMBER 18, 2016. EDUCATIONAL MATERIALS WERE DISTRIBUTED ALONG WITH 2-3 HEALTH BUCKS (PER FAMILY), RECIPES FROM THE CORNELL COOPERATIVE EXTENSION, AND MAPS OF NYC FARMERS' MARKETS.4. INCREASE ACCESS TO QUALITY CARE (ALIGNED WITH NYS PRIORITY: PROMOTE MENTAL HEALTH AND SUBSTANCE ABUSE AND PREVENT HIV AND STDS VACCINE PREVENTABLE DISEASES AND HEALTHCARE ASSOCIATED INFECTIONS)THE HOSPITAL IS WORKING ON SEVERAL OF THE INDICATORS UNDER THIS OBJECTIVE, INCLUDING UNMET MENTAL HEALTH NEED BY DEPLOYING DEPRESSION CARE MANAGERS IN ITS FAMILY MEDICINE CENTER, AND EVENTUALLY IN ALL OF ITS ACCS, TO IDENTIFY, TREAT AND REFER PATIENTS TO BEHAVIORAL HEALTH CARE AS NEEDED. CURRENTLY PROVIDERS IN ALL OF THE HOSPITAL'S AMBULATORY CARE SITES PERFORM DEPRESSION SCREENING ON ALL ADULTS, ADOLESCENTS AND PRE-NATAL PATIENTS, AND MAKE REFERRALS AS NECESSARY. THE HOSPITAL IS CONTINUING TO ADDRESS ANOTHER INDICATOR - UNMET MEDICAL NEED BY ITS PLAN TO ALMOST DOUBLE ITS ON-CAMPUS AMBULATORY CARE CAPACITY, THEREBY DRAMATICALLY REDUCING WAIT TIMES FOR APPOINTMENTS TO ENCOURAGE PATIENTS TO TAKE ADVANTAGE OF COMPREHENSIVE PREVENTIVE AND PRIMARY HEALTH CARE. CONTROLLED HIGH BLOOD PRESSURE IS RECEIVING ADDED ATTENTION THROUGH DSRIP PROJECTS 3.B.I AND 3.C.I - EVIDENCE-BASED CARDIOVASCULAR MANAGEMENT AND DIABETES CARE - FOR ALL PATIENTS IN PARTNERSHIP WITH THE ACP PPS. THE HOSPITAL CONTINUES TO TRY TO AFFECT NEW HIV DIAGNOSES AND HIV VIRAL SUPPRESSION INDICATORS BY OFFERING HIV TESTING AND EXTENSIVE COUNSELING TO AMBULATORY, EMERGENCY AND INPATIENTS, AND REFERRAL FOR FOLLOW UP CARE IN THE HOSPITAL'S HIV CLINIC.MANY PREVENTION ACTIVITIES ARE UNDERTAKEN BY THE HOSPITAL, SOME OF THEM DOCUMENTED IN THIS SECTION AND OTHERS DOCUMENTED IN THE NARRATIVES FOR EACH OF THE FIVE NYS PREVENTION AGENDA PRIORITY AREAS. STAFF IN MANY AREAS OF THE HOSPITAL HAVE TAKEN IT UPON THEMSELVES TO DEVELOP PREVENTION AND EDUCATION PROGRAMS FOR PATIENTS AND COMMUNITY RESIDENTS, OFTEN IN PARTNERSHIP WITH LOCAL CBOS AND GOVERNMENT AGENCIES. THE HOSPITAL PLACES A HIGH VALUE ON THE IMPORTANT WORK OF PREVENTION, COMMUNITY OUTREACH AND EDUCATION. THESE ACTIVITIES WILL NOT ONLY REDUCE DISEASE AND DISABILITY WITHIN OUR COMMUNITY, BUT WILL ALSO ENABLE THE HOSPITAL TO PROSPER UNDER VALUE-BASED PAYMENT ARRANGEMENTS.IMPLEMENTATION PLAN AND PROGRESS REPORT 2018THE CHARTS ON THE FOLLOWING PAGES OUTLINE GOALS, OBJECTIVES, IMPLEMENTATION PLANS AND 2016 ACHIEVEMENTS FOR THE HOSPITAL'S TWO PREVENTION AGENDA PRIORITIES:- PREVENT CHRONIC DISEASES - FOCUS 2: TOBACCO CESSATION- PROMOTE HEALTHY WOMEN, INFANTS, AND CHILDREN - FOCUS 1: BREASTFEEDING PART VI, LINE 7, REPORTS FILED WITH STATES NY PART VI, LINE 2, ASSESSMENT OF COMMUNITY HEALTH NEEDS CONTINUED: OTHER HEALTH RESOURCES IN JHMC'S PRIMARY SERVICE AREAIN ADDITION TO JAMAICA HOSPITAL MEDICAL CENTER, QUEENS HOSPITAL CENTER (A MEMBER OF THE NEW YORK CITY HEALTH + HOSPITALS) SERVES A SIMILAR SERVICE AREA. IN ADDITION, THERE ARE 25 HRSA- SUPPORTED FEDERALLY QUALIFIED HEALTH CENTERS (FQHC) OR LOOK-ALIKES (AS OF MAY 2016) IN QUEENS COUNTY. THE FOLLOWING FQHCS PROVIDE PRIMARY AND/OR SPECIALTY HEALTHCARE SERVICES TO THE COMMUNITIES WITHIN JAMAICA HOSPITAL'S PRIMARY SERVICE AREA: - COMMUNITY HEALTHCARE NETWORK, INC.- CARE FOR THE HOMELESS- DAMIAN FAMILY CARE CENTERS (DOING BUSINESS AS PROJECT SAMARITAN HEALTH SERVICES) - HOUSING WORKS HEALTH SERVICES - JOSEPH P. ADDABBO FAMILY HEALTH CENTER - SUNSET PARK HEALTH COUNCIL, INC. NYS PREVENTION AGENDA PRIORITY AREA 1: PREVENT CHRONIC DISEASESFOCUS 1: REDUCE OBESITYMORE ADULTS (18+) RESIDING WITHIN JHMC'S SERVICE AREA (JAMAICA, SWQ, AND ENY NEIGHBORHOODS) ARE DEFINED AS BEING OBESE THAN IN QUEENS AND NYC OVERALL. THE PERCENTAGE OF OBESE ADULTS ROSE FROM 2013 TO 2014. OBESITY IS LINKED TO CHRONIC CONDITIONS AND DISEASES SUCH AS HIGH BLOOD PRESSURE, HEART DISEASE, DIABETES, AND STROKE.RESIDENTS WITHIN JHMC'S SERVICE AREA REPORTED HAVING ENGAGED IN SOME TYPE OF EXERCISE ROUTINE (PHYSICAL ACTIVITIES OR EXERCISES SUCH AS RUNNING, CALISTHENICS, GOLF, GARDENING, OR WALKING FOR EXERCISE) AS FREQUENTLY AS RESIDENTS OF QUEENS AND NYC OVERALL. THESE DATA ARE ENCOURAGING, HOWEVER, THEY DO NOT DESCRIBE THE INTENSITY OR DURATIONS OF EXERCISE ACTIVITIES. ACCORDING TO THE CENTERS FOR DISEASE CONTROL, ADULTS REQUIRE AT LEAST 150 MINUTES OF MODERATE-INTENSITY AEROBIC ACTIVITY OR 75 MINUTES OF HIGH-INTENSITY AEROBIC ACTIVITY PER WEEK, COMBINED WITH 2 OR MORE DAYS A WEEK THAT WORK ALL MAJOR MUSCLE GROUPS (LEGS, HIPS, BACK, ABDOMEN, CHEST, SHOULDERS, AND ARMS). OVER A THIRD OF KEY INFORMANT INTERVIEWS, SURVEY PARTICIPANTS, AND FOCUS GROUP RESPONDENTS HIGHLIGHTED OBESITY AS A HEALTH CONCERN ON THE 2014 QUEENS COMMUNITY NEEDS ASSESSMENT (CNA). ADDITIONALLY, THE QUEENS CNA POINTS TO DIFFERENCES IN HEALTH NEEDS AND BEHAVIORS BASED ON NEIGHBORHOOD AND/OR POPULATION GROUPS. THE QUEENS CNA REVEALED THAT HEALTH NEEDS VARY WITH CULTURAL/NEIGHBORHOOD DIFFERENCES, AS, FOR EXAMPLE, AFRICAN AMERICAN AND CARIBBEAN POPULATIONS IN JAMAICA CONSIDERED OBESITY TO BE A PRESSING ISSUE, ALONG WITH LIMITED ACCESS TO HEALTHY FOODS AT LOCAL STORES. ASIANS WHO PARTICIPATED IN THE QUEENS CNA, HOWEVER, DID NOT CITE OBESITY AS AN ISSUE, AND REPORTED EASY ACCESS TO HEALTHY FOODS.RESOURCES: JAMAICA HOSPITAL STRIVES TO HELP ITS COMMUNITY MEMBERS REDUCE OBESITY AND EMPOWER THEM TO MAKE HEALTH-CONSCIOUS NUTRITION DECISIONS. THE HOSPITAL'S SERVICES INCLUDE NUTRITIONISTS AND DIABETES EDUCATORS, WHO ASSIST PATIENTS WITH DEVELOPING HEALTHY EATING HABITS AND REACHING WEIGHT MANAGEMENT GOALS. THE HOSPITAL OFFERS THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) APPROVED NATIONAL DIABETES PREVENTION PROGRAM (NDPP) CLASSES AT REGULAR INTERVALS FOR PRE-DIABETICS PATIENTS. JAMAICA HOSPITAL OFFERS A MONTHLY SUPPORT GROUP THAT CONSISTS OF INTERACTIVE SESSIONS THAT AIM TO EDUCATE DIABETIC PATIENTS WITH LIFESTYLE AND PROFESSIONAL RECOMMENDATIONS FROM OUR HIGHLY QUALIFIED PHYSICIANS, THERAPISTS, PODIATRISTS, DIETICIANS, AND OTHER CLINICAL SPECIALISTS. JAMAICA HOSPITAL PARTICIPATED IN THE NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE'S "HEALTHY HOSPITAL FOOD INITIATIVE" TO CREATE A HEALTHIER FOOD ENVIRONMENT THROUGH SUCH ACTIVITIES AS MEETING STANDARDS FOR STOCKING VENDING MACHINES WITH HEALTHY FOODS AND BEVERAGES AND OFFERING HEALTHY CHOICES IN THE HOSPITAL CAFETERIA. BREASTFEEDING IS ENCOURAGED BY JAMAICA HOSPITAL'S STAFF AS ANOTHER HEALTHY MEANS OF HELPING POSTPARTUM MOTHERS TO SHED WEIGHT GAINED DURING PREGNANCY AND POTENTIALLY REDUCING THE RISK OF PEDIATRIC OBESITY FOR THEIR CHILDREN.IN ADDITION TO JAMAICA HOSPITAL'S NUTRITIONISTS AND DIABETES EDUCATORS, THERE ARE 56 ENDOCRINE/DIABETES PHYSICIANS IN QUEENS. THE NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE OFFERS A "HEALTH BUCKS" PROGRAM, THROUGH WHICH FRESH FRUITS AND VEGETABLES CAN BE PURCHASED AT ALL FARMERS' MARKETS IN NYC. THE HOSPITAL DISTRIBUTES HEALTH BUCKS TO PATIENTS IN ITS NDPP. TWO FARMERS' MARKETS ARE FOUND IN JHMC'S SERVICE AREA. QUEENS HOSPITAL CENTER FARMERS' MARKET AND JAMAICA'S DOWN TO EARTH FARMERS' MARKET.FOCUS 2: REDUCE ILLNESS, DISABILITY, AND DEATH RELATED TO TOBACCO USE AND SECONDHAND SMOKE EXPOSUREHIGHER PERCENTAGES OF SWQ AND ENY RESIDENTS SMOKE CIGARETTES THAN QUEENS OR NYC RESIDENTS. TOBACCO CESSATION EFFORTS REMAIN A PRIORITY IN JHMC'S COMMUNITY.MORE RESIDENTS OF SWQ AND ENY REPORT BEING EXPOSED TO SECONDHAND SMOKE ON A DAILY BASIS, COMPARED WITH RESIDENTS OF QUEENS AND NYC, OVERALL. THE 2014 SECONDHAND SMOKE EXPOSURE RATES FOR SWQ AND ENY ARE ALMOST DOUBLE THAT OF QUEENS OVERALL. SECONDHAND SMOKE IS KNOWN TO CAUSE CANCER, EVEN IN INDIVIDUALS WHO DO NOT SMOKE, AND IS LINKED TO RESPIRATORY CONDITIONS SUCH AS ASTHMA AND BRONCHITIS.NYC COMMUNITY HEALTH SURVEY SMOKING DATA ARE SUPPORTED BY QUEENS CNA INFORMANT DATA AND HIGHLIGHT THE NEED FOR SMOKING CESSATION SERVICES. RESOURCES: JAMAICA HOSPITAL HAS OBTAINED GOLD STAR STATUS FROM THE NYC TOBACCO-FREE HOSPITALS CAMPAIGN FOR ITS TOBACCO CESSATION WORK WITH OUTPATIENTS, INPATIENTS, AND EMPLOYEES. IN 2015, THE HOSPITAL ASSESSED 93% OF 38,776 OUTPATIENTS; ALL OUTPATIENTS WHO REQUIRED CESSATION INTERVENTIONS RECEIVED THEM. THE HOSPITAL IS ENABLED TO MAKE ELECTRONIC REFERRALS FROM ITS ELECTRONIC HEALTH RECORD SYSTEM DIRECTLY TO THE NEW YORK STATE QUIT LINE. JAMAICA HOSPITAL'S RESPIRATORY THERAPISTS AND PATIENT NAVIGATORS WITH CERTIFICATION IN SMOKING CESSATION COUNSELING EDUCATE AND COUNSEL PATIENTS AND COMMUNITY MEMBERS ON A ONE-TO-ONE BASIS AND IN GROUP SETTINGS. PHYSICIANS CONDUCT A MANDATED 5-QUESTION ASSESSMENT OF ALL PATIENTS TO SCREEN FOR TOBACCO USAGE AND GAUGE READINESS TO QUIT. JAMAICA HOSPITAL HAS ENLISTED SEVERAL COMMUNITY-BASED ORGANIZATIONS AS PARTNERS IN PROMOTING TOBACCO-FREE LIVING, AND IS SEEKING MORE PARTNERS TO EXTEND THE PROGRAM'S REACH TO AS MANY PEOPLE AS POSSIBLE. JHMC RECEIVED A TWO-YEAR GRANT FROM THE NYC DEPARTMENT OF HEALTH TO CONTINUE ITS TOBACCO CESSATION PROGRAMMING AND OBTAIN EXPERT CONSULTATION FROM PREVENTION PARTNERS (IN NORTH CAROLINA), WHICH HAS DEVELOPED A PATIENT QUIT-TOBACCO SYSTEM.IN ADDITION TO JAMAICA HOSPITAL'S COMMUNITY-BASED EFFORTS AND PROGRAMMING AIMED AT REDUCING TOBACCO USE, THERE ARE THREE OTHER HOSPITAL-BASED TOBACCO CESSATION PROGRAMS (FLUSHING HOSPITAL; QUEENS HOSPITAL; ELMHURST HOSPITAL ) IN QUEENS.FOCUS 3: INCREASE ACCESS TO HIGH QUALITY CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT IN BOTH CLINICAL AND COMMUNITY SETTINGSJAMAICA RESIDENTS, AS WELL AS RESIDENTS OF QUEENS OR NYC OVERALL, ARE LESS LIKELY TO REGULARLY TAKE MEDICATIONS TO MANAGE THEIR HBP THAN SWQ OR ENY RESIDENTS. UNCONTROLLED HBP CAN LEAD TO DAMAGE TO THE HEART AND CORONARY ARTERIES AS WELL AS STROKE. HIGHER RATES OF STROKE-RELATED HOSPITALIZATIONS WERE OBSERVED IN BROOKLYN CD 4 & 5 (ENY) AND IN QUEENS CD 12 (JAMAICA), RELATIVE TO OTHER COMMUNITY DISTRICTS, QUEENS, AND NYC OVERALL. HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, AND SMOKING ARE THE MAJOR RISK FACTORS FOR STROKE. STROKE IS A LEADING CAUSE OF LONG-TERM DISABILITY.THE 2014 QUEENS COMMUNITY NEEDS ASSESSMENT (CNA) INCLUDED KEY INFORMANT INTERVIEWS AND FOCUS GROUP RESPONDENTS THAT ALSO HIGHLIGHTED OBESITY AS A HEALTH CONCERN AMONG QUEENS RESIDENTS, PARTICULARLY AS IT RELATES TO INCREASED RISK OF DIABETES, HEART ATTACK, AND STROKE. CONSISTENT WITH THE COMMUNITY HEALTH SURVEY DATA SHOWN IN THE "PERCENTAGE OF ADULTS NOT TAKING HIGH BLOOD PRESSURE MEDICATION" GRAPH ON THE PREVIOUS PAGE, WHERE JAMAICA RESIDENTS HAD A HIGHER PERCENTAGE OF ADULTS NOT TAKING HBP MEDICATION, JAMAICA RESIDENTS NAMED "HIGH BLOOD PRESSURE" AS A PRIORITY HEALTH ISSUE IN THE TCNY 2020.RESOURCES: JAMAICA HOSPITAL IS A NEW YORK STATE DEPARTMENT OF HEALTH-DESIGNATED STROKE CENTER. IT RECEIVED THE 2015 AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S "GET WITH THE GUIDELINES" STROKE GOLD QUALITY ACHIEVEMENT AWARD . JHMC EARNED THE AWARD BY MEETING SPECIFIC QUALITY ACHIEVEMENT MEASURES FOR THE DIAGNOSIS AND TREATMENT OF STROKE PATIENTS, WHICH INCLUDES AGGRESSIVE USE OF MEDICATIONS AND RISK-REDUCTION THERAPIES. THE HOSPITAL IS PART OF ADVOCATE COMMUNITY PROVIDERS PERFORMING PROVIDER SYSTEM (ACP PPS) WHICH IS IMPLEMENTING DSRIP PROJECT 3.B.I., EVIDENCE-BASED CARDIOVASCULAR MANAGEMENT, WHICH WILL STANDARDIZE A PATIENT-CENTERED APPROACH TO PATIENTS WHO HAVE OR ARE AT RISK FOR CARDIOVASCULAR DISEASE. IN ADDITION, THE HOSPITAL IS IMPLEMENTING PROJECT 3.C.I. EVIDENCE-BASED SERVICES FOR DIABETES CARE. PART VI, LINE 2, ASSESSMENT OF COMMUNITY HEALTH NEEDS CONTINUED: IN ADDITION TO JAMAICA HOSPITAL'S CARDIOLOGY, FAMILY MEDICINE, PULMONARY MEDICINE, AND CARE MANAGEMENT SERVICES, THE QUEENS SERVICE AREA (AS DEFINED IN THE QUEENS CNA) HAS 361 CARDIO/PULMONARY PHYSICIANS AND 56 ENDOCRINE/DIABETES PHYSICIANS.JAMAICA RESIDENTS ARE LESS LIKELY TO RECEIVE REGULAR COLORECTAL SCREENINGS THAN RESIDENTS OF OTHER NEIGHBORHOODS OR IN QUEENS OR NYC OVERALL. REGULAR SCREENING, STARTING AT AGE 50, IS CRUCIAL TO PREVENTING COLORECTAL CANCER.WOMEN RESIDING WITHIN SWQ AND JAMAICA ARE SLIGHTLY LESS LIKELY TO RECEIVE BIANNUAL MAMMOGRAMS THAN WOMEN RESIDING IN ENY, QUEENS OVERALL, AND NYC. TIMELY DETECTION OF BREAST CANCER WITH SCREENING MAMMOGRAPHY ENABLES EARLIER TREATMENT THAT CAN POTENTIALLY PREVENT THE CANCER'S SPREAD. WOMEN RESIDING WITHIN JHMC'S SERVICE AREA ARE RECEIVING CERVICAL SCREENINGS COMPARABLE TO WOMEN RESIDING IN QUEENS AND NYC OVERALL. THE PERCENTAGE OF WOMEN RECEIVING CERVICAL SCREENINGS INCREASED BETWEEN 2012 AND 2013 ACROSS ALL GEOGRAPHIES. TIMELY DETECTION OF CERVICAL CANCER WITH PAP SCREENING ENABLES EARLIER TREATMENT THAT CAN POTENTIALLY PREVENT THE CANCER'S SPREAD. KEY INFORMANTS AND FOCUS GROUP RESPONDENTS WHO PROVIDED DATA TO THE 2014 QUEENS COMMUNITY NEEDS ASSESSMENT (CNA) INDICATED THAT CANCER IS AN ADDITIONAL HEALTH CONCERN FOR QUEENS RESIDENTS. CULTURALLY-BASED AND LANGUAGE DIFFERENCES CAN IMPEDE ACCESS TO CARE; A KEY INFORMANT INTERVIEW INCLUDED IN THE QUEENS CNA GAVE AN EXAMPLE OF ARAB WOMEN THAT MAY TRY TO HIDE A BREAST CANCER DIAGNOSIS FROM THEIR FAMILIES AND THEIR COMMUNITY OUT OF FEAR THAT THEIR DAUGHTERS MAY NOT BE ABLE TO MARRY (IF THE CANCER IS GENETICALLY-LINKED) IF THEIR HEALTH INFORMATION IS KNOWN. RESOURCES: JAMAICA HOSPITAL'S WOMEN'S HEALTH CENTER HAS A MULTILINGUAL AND MULTIDISCIPLINARY STAFF OF OBSTETRICIANS, GYNECOLOGISTS, SURGEONS, TECHNICIANS, AND RADIOLOGISTS, AND OFFERS BREAST CANCER SCREENING (MAMMOGRAPHY), PREVENTION, AND TREATMENT; COLPOSCOPY; AND GYN ONCOLOGY. THE HOSPITAL OFFERS MORE THAN FOUR HOURS PER WEEK OF EXTENDED HOURS FOR MAMMOGRAMS, INCLUDING EVENING AND WEEKEND HOURS, TO ACCOMMODATE PATIENTS' SCHEDULES. JHMC OFFERS MAMMOGRAPHY SERVICES FROM 8 AM UNTIL 8 PM MONDAY THROUGH FRIDAY AND FROM 8 AM UNTIL 4 PM ON SATURDAYS. WOMEN'S HEALTH IS OPEN AND OFFERS MAMMOGRAPHY UNTIL 7 PM ON TUESDAYS AND THURSDAYS. JAMAICA HOSPITAL'S DIVISION OF GASTROENTEROLOGY CONSISTS OF BOARD-CERTIFIED GASTROENTEROLOGISTS WHO PROVIDE HIGH QUALITY AND EXPERT CARE TO PATIENTS, INCLUDING COLORECTAL SCREENINGS USING COLONOSCOPY AND ENDOSCOPY. JAMAICA HOSPITAL'S ONCOLOGY DIVISION OFFERS CONSULTATIONS FOR BOTH INPATIENTS AND OUTPATIENTS DIAGNOSED WITH CANCER AND FEATURES AN AMBULATORY CHEMOTHERAPY UNIT. THE HOSPITAL'S PALLIATIVE CARE SERVICES, CONSISTING OF A TEAM OF ATTENDING PHYSICIANS, PALLIATIVE CARE FELLOWS, AND A LICENSED CLINICAL SOCIAL WORKER, ARE AVAILABLE TO SUPPORT PATIENTS WITH ADVANCED OR TERMINAL ILLNESSES. THE HOSPITAL ALSO OPERATES AN INPATIENT HOSPICE UNIT.IN ADDITION TO JAMAICA HOSPITAL'S ONCOLOGY DIVISION AND PALLIATIVE CARE SERVICES, THE QUEENS SERVICE AREA (AS DEFINED IN THE QUEENS CNA) HAS 103 ONCOLOGY PHYSICIANS, EIGHT HOSPICE PROGRAMS, AND FIVE OTHER PROGRAMS OFFERING PALLIATIVE CARE.NYS PREVENTION AGENDA PRIORITY AREA 2: PROMOTE A HEALTHY AND SAFE ENVIRONMENTFOCUS 1: OUTDOOR AIR QUALITY / BUILT ENVIRONMENT ALTHOUGH THE NEW YORK CITY COMMUNITY AIR SURVEY* (RELEASED APRIL 2016) REPORTS THAT AIR POLLUTION (E.G., LEVELS OF PM2.5 (FINE PARTICULATE MATTER), NO2 (NITROGEN DIOXIDE), & NO (NITRIC OXIDE)) HAS GENERALLY DECREASED IN NYC SINCE 2009, HIGHER CONCENTRATIONS OF AIR POLLUTANTS AND PERCENTAGES OF HOUSING WITH MAINTENANCE DEFECTS WERE OBSERVED IN BROOKLYN CDS 4 & 5 (ENY) RELATIVE TO OTHER COMMUNITY DISTRICTS, QUEENS, AND NYC OVERALL. *HTTP://WWW1.NYC.GOV/ASSETS/DOH/DOWNLOADS/PDF/ENVIRONMENTAL/COMM-AIR-SURVEY-08-14.PDFOUTDOOR AND HOUSEHOLD AIR POLLUTION ARE ENVIRONMENTAL HEALTH HAZARDS THAT ARE LINKED TO PREMATURE DEATH ATTRIBUTABLE TO RESPIRATORY DISEASES, CANCER, AND CARDIOVASCULAR DISEASES. AS PREVIOUSLY SHOWN IN THE CIGARETTE SMOKING AND SECONDHAND SMOKE EXPOSURE GRAPHS, AIR POLLUTION DUE TO CIGARETTE SMOKE IS A HEALTH CONCERN IN NYC AND IN JAMAICA HOSPITAL'S COMMUNITIES.RESOURCES: JAMAICA HOSPITAL IS PART OF THE ASTHMA COALITION OF QUEENS (FORMED IN 2012), IN WHICH ORGANIZATIONS WORK TOGETHER TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE WITH ASTHMA BY ENGAGING PATIENTS, FAMILIES, HEALTHCARE PROVIDERS, INSTITUTIONS AND THE COMMUNITY. JAMAICA HOSPITAL'S DIVISION OF PULMONARY MEDICINE OFFERS A WIDE VARIETY OF SERVICES TO HELP DIAGNOSE AND TREAT PATIENTS WITH LUNG DISEASE, SUCH AS ASTHMA. THE HOSPITAL'S DIVISION OF ALLERGY AND IMMUNOLOGY FOCUSES ON THE DIAGNOSIS AND LONG-TERM TREATMENT OF ALLERGIC AND IMMUNOLOGIC CONDITIONS, SUCH AS ASTHMA. JAMAICA HOSPITAL'S PATIENT NAVIGATORS WERE TRAINED TO CONDUCT GROUP COUNSELING IN THE "FREEDOM FROM SMOKING" PROGRAM BY THE AMERICAN LUNG ASSOCIATION.IN ADDITION TO JAMAICA HOSPITAL'S RESOURCES, NEW YORK-PRESBYTERIAN/QUEENS ALSO OFFERS A PEDIATRIC ASTHMA CENTER.FOCUS 2: INJURIES, VIOLENCE, AND OCCUPATIONAL HEALTHHIGHER RATES OF ASSAULT-RELATED HOSPITALIZATIONS WERE OBSERVED IN BROOKLYN CD 4 & 5 (ENY) RELATIVE TO OTHER COMMUNITY DISTRICTS, QUEENS, AND NYC OVERALL. ACCORDING TO NEW YORKERS AGAINST GUN VIOLENCE, HOSPITAL VISITS FOR GUN-RELATED INJURIES FROM 2008-2010 COST NYC $118 MILLION, COMPARED TO $91 MILLION IN THE REST OF NYS. RESEARCH* SHOWS THAT STRICTER STATE FIREARM LEGISLATION IS ASSOCIATED WITH LOWER DISCHARGE RATES FOR NONFATAL GUNSHOT INJURIES.*E.G., SIMONETTI ET. AL. AM J PUBLIC HEALTH. 2015 AUGUST; 105(8): 1703-1709ALTHOUGH THE ASSAULT-RELATED HOSPITALIZATION RATE HAS DECREASED ACROSS QUEENS FROM 52 HOSPITALIZATIONS PER 100,000 POPULATION (2008-2010 SPARCS DATA) TO 43 HOSPITALIZATIONS PER 100,000 (2011-2013 SPARCS DATA) AND MEETS THE NEW YORK STATE PREVENTION AGENDA 2013-2018'S GOAL OF 43 HOSPITALIZATIONS PER 100,000 POPULATION, IT REMAINS AN ISSUE IN JAMAICA HOSPITAL'S SERVICE AREA. MORE THAN TWELVE PERCENT OF QUEENS CNA RESPONDENTS INDICATED THAT VIOLENCE/INJURY PREVENTION WAS A HEALTH CONCERN IN THEIR COMMUNITY.HIGHER RATES OF FALL-RELATED HOSPITALIZATIONS AND DEATHS WERE OBSERVED IN SOUTHWEST QUEENS RELATIVE TO JAMAICA, EAST NEW YORK, AND QUEENS OVERALL.FALLS WERE THE NUMBER ONE CAUSE OF INJURY IN JAMAICA HOSPITAL'S REGISTRY OF TRAUMA PATIENTS. JAMAICA HOSPITAL'S IN-HOUSE DATA FOR FALL-RELATED INJURIES REVEALED THAT 2,512 PATIENTS PRESENTED AT THE HOSPITAL FOR FALLS BETWEEN AUGUST 1, 2013 AND JULY 31, 2015; 59.6% OF THESE WERE CATEGORIZED AS "TRAUMATIC" FALLS, MEANING THEY MET THE TRAUMA CRITERIA FOR THE SEVERITY OF INJURY. OVER A THIRD OF NON-TRAUMATIC FALLS WERE SUSTAINED FROM SLIPPING, TRIPPING, OR TUMBLING, AND ALMOST 20% OF THESE FALLS WERE SUSTAINED FROM FALLING OFF OR TRIPPING ON STEPS. MOST TRAUMATIC FALLS INJURIES OCCURRED AT HOME (41%) AND ALMOST A QUARTER OF TRAUMATIC FALLS INJURIES OCCURRED ON THE STREET OR HIGHWAY. THE MAJORITY (62%) OF TRAUMA FALLS PATIENTS WERE 55 YEARS OR OLDER. MOST ELDERLY TRAUMA FALLS PATIENTS WERE FEMALE (55.5%). AMONG ELDERLY TRAUMATIC FALLS PATIENTS, MOST FALLS (WHEN THE HEIGHT OF THE FALL WAS KNOWN) OCCURRED WHILE PATIENTS WERE STANDING, INDICATING THAT PATIENTS HAD DIFFICULTY MAINTAINING BALANCE.RESOURCES: JAMAICA HOSPITAL MEDICAL CENTER IS DESIGNATED AS A LEVEL 1 TRAUMA CENTER THAT IS AVAILABLE 24 HOURS A DAY, 7 DAYS PER WEEK, AND INCLUDES TRAUMA, ORTHOPEDIC, AND NEURO SURGEONS AS WELL AS PHYSICIANS FROM A RANGE OF FIELDS INCLUDING EMERGENCY MEDICINE, RADIOLOGY, ANESTHESIOLOGY, INTENSIVE CARE, AND REHABILITATION MEDICINE. JAMAICA HOSPITAL REGULARLY SPONSORS RESEARCH RELATED TO INJURY-PREVENTION AND IMPROVING CLINICAL AND BEHAVIORAL OUTCOMES OF PATIENTS WHO HAVE SUSTAINED INJURIES DUE TO ACCIDENTS OR VIOLENT EVENTS. FOR EXAMPLE, TWO OF JAMAICA HOSPITAL'S OCCUPATIONAL THERAPISTS PRESENTED A RESEARCH POSTER (2015 ) OUTLINING LEADERSHIP ROLES WHICH OCCUPATIONAL THERAPISTS WORKING IN TRAUMA CENTERS CAN TAKE TO INCREASE INJURY PREVENTION PROGRAMMING. IN 2015, JAMAICA HOSPITAL RECEIVED A GOVERNOR'S TRAFFIC SAFETY COMMITTEE GRANT TO CONDUCT A PROJECT ENTITLED "SAFER STREETS QUEENS," IN WHICH THE HOSPITAL CATALOGUES DATA FROM EMERGENCY DEPARTMENT PATIENTS TO INFORM THE NYS DEPARTMENT OF TRANSPORTATION ABOUT DANGEROUS ROAD AND TRAFFIC CONDITIONS TO HELP PREVENT ACCIDENTS AND RESULTING INJURIES. JAMAICA HOSPITAL HAS ADAPTED A SCREENING TOOL FOR ASSESSING INJURIES FROM THE NYC DOHMH'S DIVISION FOR THE AGING (DFTA) AND REFERS PATIENTS TO EVIDENCE-BASED FALLS-PREVENTION PROGRAMS WHEN INDICATED. PART VI, LINE 2, ASSESSMENT OF COMMUNITY HEALTH NEEDS CONTINUED: IN ADDITION TO JAMAICA HOSPITAL'S LEVEL 1 TRAUMA CENTER, REGIONAL TRAUMA CENTER, SERVICES ARE AVAILABLE WITHIN QUEENS AT REGIONAL TRAUMA CENTERS AT ELMHURST HOSPITAL AND NEW YORK-PRESBYTERIAN/QUEENS. JHMC REFERS SENIOR CITIZENS WHO ARE TREATED FOR FALL-RELATED INJURIES TO SENIOR CITIZEN CENTERS THAT PROVIDE CLASSES, SUCH AS STAY ACTIVE AND INDEPENDENT FOR LIFE (SAIL) AND TAI CHI FOR ARTHRITIS, THAT ARE DESIGNED TO PROMOTE HEALTHY EXERCISE HABITS, STRENGTHEN JOINTS, INCREASE STABILITY, AND REDUCE THE LIKELIHOOD OF FALLS. THERE ARE FIVE SENIOR CITIZEN CENTERS OFFERING EVIDENCE-BASED FALLS PREVENTION PROGRAMMING IN EAST NEW YORK (COMMUNITY DISTRICT 5, BROOKLYN). JAMAICA (QUEENS COMMUNITY DISTRICTS 8, 12, & 13) HAS 12 SENIOR CITIZEN CENTERS OFFERING THESE PROGRAMS, INCLUDING THREE SITES FOR JAMAICA SERVICE PROGRAMS FOR OLDER ADULTS (JSPOA). SOUTHWEST QUEENS (QUEENS COMMUNITY DISTRICTS 9 & 10) HAS THREE SENIOR CITIZEN CENTERS OFFERING FALL-PREVENTION PROGRAMS, INCLUDING TWO SERVICES NOW FOR ADULT PERSONS (SNAP) SITES.NYS PREVENTION AGENDA PRIORITY AREA 3: PROMOTE HEALTHY WOMEN, INFANTS, AND CHILDREN FOCUS 1: MATERNAL AND INFANT HEALTHMOTHERS RESIDING IN QUEENS CD 12 (JAMAICA) AS WELL AS BROOKLYN CD 5 (ENY) WERE LESS LIKELY TO RECEIVE TIMELY PRENATAL CARE THAN MOTHERS IN OTHER NEIGHBORHOODS SERVED BY JHMC, AS WELL AS QUEENS OR NYC OVERALL. ACCORDING TO THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION, BABIES BORN TO MOTHERS WHO RECEIVED NO PRENATAL CARE ARE THREE TIMES MORE LIKELY TO BE BORN AT LOW BIRTH WEIGHT, AND FIVE TIMES MORE LIKELY TO DIE, THAN THOSE WHOSE MOTHERS RECEIVED PRENATAL CARE. MORE INFANTS BORN TO MOTHERS RESIDING IN QUEENS CDS 9 AND 12 (JAMAICA) WERE EXCLUSIVELY BREASTFED WITHIN FIVE DAYS POSTNATALLY. DATA ARE PROMISING, AS INCREASES IN BREASTFEEDING BETWEEN 2012 AND 2013 WERE SEEN IN MOST CDS WITHIN JHMC'S SERVICE AREA, PARTICULARLY IN QUEENS CDS 9 (SWQ), 10 (SWQ), & 12 (JAMAICA). BREASTFEEDING CONFERS NUMEROUS HEALTH PROTECTIONS UPON INFANTS AND MOTHERS ALIKE. FOR EXAMPLE, BREASTFED CHILDREN ARE LESS LIKELY TO CONTRACT A NUMBER OF DISEASES LATER IN LIFE, INCLUDING JUVENILE DIABETES, MULTIPLE SCLEROSIS, HEART DISEASE, AND CANCER BEFORE THE AGE OF 15. BREASTFEEDING MOTHERS ARE LESS LIKELY TO DEVELOP OSTEOPOROSIS LATER IN LIFE, ARE ABLE TO LOSE WEIGHT GAINED DURING PREGNANCY MORE EASILY, AND HAVE REDUCED RISK OF BREAST, UTERINE, AND OVARIAN CANCERS.FOCUS 2: REPRODUCTIVE, PRECONCEPTION, AND INTER-CONCEPTION HEALTHTEEN MOTHERS RESIDING IN QUEENS CD 10 AND 12 (JAMAICA) AND BROOKLYN CD 5 (ENY) HAD HIGHER PERCENTAGES OF LOW BIRTH WEIGHT BABIES THAN THE OTHER NEIGHBORHOODS THAT JHMC SERVES, AS WELL AS QUEENS AND NYC OVERALL. THE TEEN BIRTH RATE IN BROOKLYN CD 4 (BUSHWICK) IS THE 6TH HIGHEST AMONG THE 59 NYC CD'S.DATA PUBLISHED IN THE QUEENS CNA (WHICH WERE OBTAINED FROM THE NEW YORK STATE DEPARTMENT OF HEALTH PERINATAL DATA PROFILES 2010-2012) INDICATE THAT RATES OF LATE OR NO PRENATAL CARE HAVE INCREASED SINCE 2010 AND ARE STILL RELATIVELY HIGHER AMONG THE NEIGHBORHOODS THAT JHMC SERVES, PARTICULARLY JAMAICA (9.1%) AND EAST NEW YORK (9%), COMPARED WITH NYC OVERALL (7.0%), AND NEW YORK STATE OVERALL (5.6%). IN ZIP CODE 11436 (JAMAICA), 12.3% OF BIRTHS WERE TO MOTHERS WHO RECEIVED LATE OR NO PRENATAL CARE; THIS WAS THE SECOND HIGHEST PERCENTAGE AMONG ALL OF THE ZIP CODES IN QUEENS BETWEEN 2011-2013. RESOURCES: JAMAICA HOSPITAL RECOGNIZES THAT SUPPORTING BREASTFEEDING IS AN IMPORTANT PUBLIC HEALTH ISSUE. THE HOSPITAL DISCHARGED 570 EXCLUSIVELY BREASTFEEDING MOTHERS (37%) IN 2015 AND IS IN THE FINAL PHASE OF SEEKING "BABY-FRIENDLY" HOSPITAL DESIGNATION, A GLOBAL INITIATIVE LAUNCHED BY THE WORLD HEALTH ORGANIZATION (WHO) AND THE UNITED NATIONS CHILDREN'S FUND (UNICEF). JAMAICA HOSPITAL'S STAFF ARE DEDICATED TO BREASTFEEDING TRAINING EFFORTS SO THEY CAN SHARE THEIR KNOWLEDGE WITH THE COMMUNITY; ALL PEDIATRIC PROVIDERS AND MOST OBSTETRICS (98%) AND FAMILY MEDICINE (85%) PROVIDERS HAVE COMPLETED THE RECOMMENDED BREASTFEEDING TRAINING. JAMAICA HOSPITAL MEDICAL CENTER OFFERS A WEEKLY BREASTFEEDING EDUCATION PROGRAM TO PATIENTS AND COMMUNITY MEMBERS AT ITS WOMEN'S HEALTH CENTER. THE BREASTFEEDING PROGRAM, WHICH IS ALSO AVAILABLE IN SPANISH, IS TAUGHT BY A CERTIFIED MIDWIFE AND IS INTENDED TO FAMILIARIZE MOTHERS-TO-BE WITH PROPER BREASTFEEDING TECHNIQUES.JAMAICA HOSPITAL IS A NEW YORK STATE DEPARTMENT OF HEALTH-DESIGNATED LEVEL 3 PERINATAL CENTER, MEANING THAT IT CARES FOR PATIENTS REQUIRING INCREASINGLY COMPLEX CARE AND OPERATES A NEONATAL INTENSIVE CARE UNIT (NICU). FOR THE PAST FOUR YEARS, JHMC HAS MAINTAINED AN ACTIVE CENTERINGPREGNANCY PROGRAM, WHICH FACILITATES SUPPORT GROUPS AND PRENATAL VISITS FOR PREGNANT WOMEN PARTICIPATING IN THE PROGRAM. IN 2015, THE MARCH OF DIMES REACHED OUT TO JAMAICA HOSPITAL TO IMPLEMENT "HEALTHY BABIES ARE WORTH THE WAIT," WHICH EXPANDED THE CENTERINGPREGNANCY PROGRAM BY INCORPORATING EVIDENCE-BASED PREMATURE BIRTH PREVENTION EDUCATION THAT IMPROVES PARTICIPANTS' KNOWLEDGE OF FACTORS CONTRIBUTING TO PREMATURE BIRTHS AND ENCOURAGES PREGNANT WOMEN TO SEEK PRENATAL CARE. JHMC'S WOMEN, INFANTS, AND CHILDREN (WIC) PROGRAM PROVIDES NUTRITION EDUCATION, BREASTFEEDING SUPPORT, REFERRALS, AND A VARIETY OF NUTRITIOUS FOODS TO LOW-INCOME PREGNANT, BREASTFEEDING OR POSTPARTUM WOMEN, INFANTS AND CHILDREN UP TO AGE FIVE TO PROMOTE AND SUPPORT GOOD HEALTH. JAMAICA HOSPITAL ALSO OPERATES A SCHOOL-BASED HEALTH CENTER PROGRAM AT CAMPUS MAGNET HIGH SCHOOL (CAMBRIA HEIGHTS, QUEENS), AND AT TWO LARGE ELEMENTARY SCHOOLS [PS 223 IN JAMAICA AND PS (Q) 155 IN SOUTH OZONE PARK].IN ADDITION TO JAMAICA HOSPITAL'S DIVISION OF MATERNAL-FETAL MEDICINE/OBSTETRICAL UNIT, THERE ARE SEVEN HOSPITALS WITHIN QUEENS OFFERING MATERNITY SERVICES, THERE ARE FOUR OTHER HOSPITALS IN QUEENS THAT ARE LEVEL 3 PERINATAL CENTERS . AS OF MAY 2016, ONLY ONE HOSPITAL IN QUEENS (QUEENS HOSPITAL CENTER) HAS RECEIVED A "BABY-FRIENDLY" HOSPITAL DESIGNATION. EIGHT OTHER HOSPITALS OR AGENCIES PROVIDE WIC SERVICES WITHIN QUEENS. WIC SERVICES ARE ALSO AVAILABLE AT TWO LOCATIONS IN EAST NEW YORK (BROOKDALE HOSPITAL AND EAST NEW YORK DIAGNOSTIC & TREATMENT CENTER). CENTERINGPREGNANCY DOES NOT CURRENTLY LIST OTHER SITES IN QUEENS OTHER THAN JAMAICA HOSPITAL.NYS PREVENTION AGENDA PRIORITY AREA 4: PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSEFOCUS 1: PROMOTE MENTAL, EMOTIONAL, AND BEHAVIORAL WELL-BEINGPERCENTAGES OF ADULTS WHO HAVE EXPERIENCED CLINICAL DEPRESSION ARE LOWER WITHIN THE NEIGHBORHOODS SERVED BY JHMC, COMPARED WITH NYC OVERALL. ACCORDING TO ANALYSES IN THE NYC HEALTH PROVIDER PARTNERSHIP'S 2014 QUEENS COMMUNITY NEEDS ASSESSMENT, ENY AND JAMAICA HAVE HIGH NUMBERS OF MEDICAID BENEFICIARIES WHO HAVE MENTAL HEALTH CONDITIONS (PREDOMINANTLY DEPRESSION/ MOOD DISORDER) AND USE EMERGENCY DEPARTMENT SERVICES.THE RATE OF PSYCHIATRIC HOSPITALIZATIONS IS HIGHER IN BROOKLYN CD 5 (ENY), RELATIVE TO OTHER NEIGHBORHOODS AND QUEENS AND NYC OVERALL. BEHAVIORAL HEALTH DISCHARGES HAVE HIGHER READMISSION RATES. MEDICATION NONADHERENCE, SUBSTANCE USE, AND LACK OF ENGAGEMENT IN TIMELY AND ADEQUATE OUTPATIENT SERVICES ARE THREE KEY FACTORS IN BEHAVIORAL HEALTH HOSPITAL READMISSIONS.FOCUS 2: PREVENT SUBSTANCE ABUSE AND OTHER MENTAL EMOTIONAL BEHAVIORAL DISORDERSSIMILAR TO NYC OVERALL, HIGHER PERCENTAGES OF BINGE DRINKING WERE REPORTED IN SWQ, COMPARED TO OTHER NEIGHBORHOODS IN JHMC'S SERVICE AREA. BINGE DRINKING IS LINKED TO MANY HEALTH PROBLEMS, SUCH AS ALCOHOL POISONING, UNINTENTIONAL (E.G., CAR CRASHES, FALLS) AND INTENTIONAL (E.G., DOMESTIC VIOLENCE, FIREARM INJURIES, AND SEXUAL ASSAULT) INJURIES, LIVER DISEASE, AND NEUROLOGICAL DAMAGE.SUBSTANTIALLY HIGHER RATES OF ALCOHOL- AND DRUG-RELATED HOSPITALIZATIONS ARE OBSERVED IN BROOKLYN CDS 4 AND 5 (ENY), RELATIVE TO OTHER COMMUNITIES SERVED BY JHMC AND QUEENS OR NYC OVERALL. THIS IS A SIMILAR PATTERN SEEN FOR INJURY ASSAULT RATES WITHIN JHMC'S COMMUNITIES. FOCUS 3: STRENGTHEN MENTAL HEALTH SERVICES INFRASTRUCTURERESIDENTS OF SWQ WERE MORE LIKELY TO RECEIVE FOLLOW-UP MENTAL HEALTH TREATMENT WITHIN 7 OR 30 DAYS OF HOSPITAL DISCHARGE THAN ENY OR JAMAICA RESIDENTS, OR QUEENS OR NYC RESIDENTS ON THE WHOLE. HOWEVER, DSRIP GOALS THAT WERE ESTABLISHED TO REDUCE AVOIDABLE HOSPITAL USE INCLUDE ENSURING THAT AT LEAST 74.2% OF DISCHARGED PATIENTS RECEIVE MENTAL HEALTH TREATMENT WITHIN 7 DAYS POST-DISCHARGE AND AT LEAST 88.2% OF DISCHARGED PATIENTS RECEIVE MENTAL HEALTH SERVICES WITHIN 30 DAYS POST-DISCHARGE. PART VI, LINE 2, ASSESSMENT OF COMMUNITY HEALTH NEEDS CONTINUED: THESE LOCAL, NEIGHBORHOOD DATA MIRROR NATIONAL FINDINGS THAT HIGHLIGHT THE PREVALENCE OF CO-OCCURRENCE OF DRUG-RELATED, MENTAL HEALTH- RELATED, AND INJURY-RELATED DIAGNOSES AMONG ALCOHOL-RELATED ED VISITS AND HOSPITALIZATIONS. QUEENS CNA SURVEY RESPONDENTS AND FOCUS GROUPS ALSO PRIORITIZED THE GAP IN MENTAL HEALTH SERVICES. DEPRESSION, ANXIETY, AND ALCOHOL AND SUBSTANCE ABUSE WERE ISSUES THAT THE QUEENS CNA RESPONDENTS SPECIFICALLY MENTIONED. THESE DATA HIGHLIGHT THE NEED FOR MORE TIMELY MENTAL HEALTH SERVICES IN JHMC'S COMMUNITIES.RESOURCES: JHMC'S MENTAL HEALTH SERVICES, INCLUDING ITS LARGE MENTAL HEALTH OUTPATIENT SERVICE, ITS AFFILIATED OUTPATIENT ADVANCED CENTER FOR PSYCHOTHERAPY, ITS PSYCHIATRIC EMERGENCY DEPARTMENT, AND CPEP PROGRAM, PROMOTE THE COORDINATION OF MENTAL HEALTH CARE, INCLUDING INCREASING DEPRESSION SCREENING RATES AND PROVIDING APPROPRIATE AND TIMELY TREATMENT WHEN INDICATED. JAMAICA HOSPITAL'S HEALTHCARE PROVIDERS CONDUCT DEPRESSION SCREENINGS (PATIENT HEALTH QUESTIONNAIRE 2, OR, PHQ-2) AT ALL PRIMARY CARE VISITS AND ADDITIONAL SCREENINGS (PATIENT HEALTH QUESTIONNAIRE 9, OR, PHQ-9) AS INDICATED. MOTHERS WHO GIVE BIRTH AT JAMAICA HOSPITAL COMPLETE A MATERNAL DEPRESSION SCREENING PRIOR TO BEING DISCHARGED; IF INDICATED, MOTHERS RECEIVE INTERVENTION SERVICES TO TREAT POSTPARTUM DEPRESSION. THE HOSPITAL IS ALSO IMPLEMENTING ACP PPS DSRIP PROJECT 3.A.I., INTEGRATION OF PRIMARY CARE AND BEHAVIORAL HEALTH; AND NOW OFFERS PRIMARY CARE IN ITS MENTAL HEALTH CENTER. A DEPRESSION CARE MANAGER PROVIDES SCREENING AND COUNSELING IN ITS FAMILY MEDICINE CENTER, AND THERE ARE PLANS TO EXPAND THIS SERVICE TO ALL OUTPATIENT CENTERS.TO ACCOMMODATE THE HIGH DEMAND, THE HOSPITAL HAS REQUESTED AND RECEIVED CONTINGENT NYSDOH APPROVAL TO PERMANENTLY ADD SIX PSYCHIATRY BEDS, WHICH HAD BEEN ADDED IN 2013 ON A TEMPORARY BASIS AT THE REQUEST OF NEW YORK STATE OFFICE OF MENTAL HEALTH (NYSOMH).IN ADDITION TO JAMAICA HOSPITAL'S MENTAL HEALTH SERVICES, THE QUEENS SERVICE AREA (AS DEFINED IN THE QUEENS CNA) HAS 336 PSYCHIATRISTS, PSYCHIATRIC EMERGENCY SERVICES [THREE COMPREHENSIVE PSYCHIATRIC EMERGENCY PROGRAMS (CPEP), ONE CRISIS INTERVENTION PROGRAM, AND THREE HOME BASED CRISIS INTERVENTION PROGRAMS)], INPATIENT UNITS AT SIX GENERAL CARE AND TWO STATE PSYCHIATRIC HOSPITALS, AND OUTPATIENT SERVICES [INCLUDING EIGHT ASSERTIVE COMMUNITY TREATMENT PROGRAMS (ACT) AND 52 CLINIC TREATMENT PROGRAMS]. THERE ARE ALSO 34 LICENSED RESIDENTIAL TREATMENT PROGRAMS IN CONGREGATE, APARTMENT AND SINGLE ROOM RESIDENCES; THESE PROGRAMS ARE PARTICULARLY BENEFICIAL FOR PERSONS WITH A HISTORY OF REPEATED PSYCHIATRIC HOSPITALIZATIONS, HOMELESSNESS, INVOLVEMENT WITH THE CRIMINAL JUSTICE SYSTEM, AND CO-OCCURRING SUBSTANCE ABUSE. JAMAICA HOSPITAL REFERS PATIENTS WHO NEED INPATIENT SUBSTANCE AND/OR ALCOHOL ABUSE TREATMENT TO A 30-BED CHEMICAL DEPENDENCY UNIT LOCATED AT FLUSHING HOSPITAL, ITS SISTER HOSPITAL WITHIN THE MEDISYS HEALTH NETWORK. OTHER SUBSTANCE AND ALCOHOL ABUSE TREATMENT FACILITIES LOCATED WITHIN QUEENS INCLUDE THREE HOSPITALS THAT PROVIDE OUTPATIENT WITHDRAWAL SERVICES, TWO HOSPITALS THAT PROVIDE DETOXIFICATION SERVICES, AND FIVE HOSPITALS THAT PROVIDE OUTPATIENT REHABILITATION SERVICES.NYS PREVENTION AGENDA PRIORITY AREA 5: PREVENT HIV, STDS, VACCINE PREVENTABLE DISEASES AND HEALTH-CARE ASSOCIATED INFECTIONSFOCUS 1: PREVENT HIV AND STDPLWHA IN JAMAICA (AND QUEENS OVERALL) ARE LESS LIKELY TO BE ENGAGED IN CARE THAN PLHWA IN OTHER NEIGHBORHOODS OR IN NYC OVERALL. WHILE ALMOST 80% OF PLWHA RESIDING IN ENY AND NYC ARE ENGAGED IN CARE, THE GOAL IS TO MEET OR EXCEED 91.8% ACROSS NYS. ENGAGING IN AND MAINTAINING HIV/AIDS CARE IS PARAMOUNT TO ACHIEVING VIRAL SUPPRESSION, HELPING PLWHA TO LIVE HEALTHIER, LONGER LIVES, AND PREVENTING HIV TRANSMISSION TO OTHER PEOPLE.AS OF DECEMBER 31, 2013, THERE WERE MORE THAN 8,000 PEOPLE LIVING WITH HIV/AIDS IN JAMAICA HOSPITAL'S SERVICE AREA (EAST NEW YORK, SOUTHWEST QUEENS, AND JAMAICA), WHICH IS MORE THAN THE NUMBER OF PEOPLE LIVING WITH HIV/AIDS STATEWIDE IN 25 OF THE 50 STATES. KEY INFORMANTS WHO PARTICIPATED IN THE QUEENS CNA HAVE ASSERTED THAT WHILE FUNDING FOR HIV/AIDS SERVICES FOCUSES ON MEDICAL MANAGEMENT, THE SUPPORT SERVICES NECESSARY FOR PLWHA ARE DIFFICULT TO OBTAIN. AS PLWHA ARE ABLE TO MANAGE THEIR ILLNESSES WITH EFFECTIVE TREATMENTS, ASSISTANCE WITH OBTAINING ENTITLEMENTS (E.G., MEDICAID, FOOD STAMPS/SNAP), AFFORDABLE HOUSING, AND JOBS BECOMES MORE IMPORTANT. RESOURCES: JAMAICA HOSPITAL'S AMBULATORY CARE CENTER (ACC) IS DESIGNATED BY NYS DOH AS AN HIV PRIMARY MEDICAL CARE PROVIDER, AND OFFERS TESTING ANNUALLY TO PATIENTS AGES 13 64 IN BOTH THE EMERGENCY DEPARTMENT AND CLINICS. FOR MANY YEARS, THE HOSPITAL HAS HELD A NYS GRANT TO PROVIDE SCREENINGS, COUNSELING, AND RISK-REDUCTION INTERVENTIONS TO AT-RISK WOMEN IN THE HOSPITAL CLINICS. IN ADDITION TO JAMAICA HOSPITAL'S DIVISION OF INFECTIOUS DISEASE SERVICES, THE QUEENS SERVICE AREA (AS DEFINED IN THE QUEENS CNA) HAS 49 INFECTIOUS DISEASE PHYSICIANS. THERE ARE THREE HOSPITALS IN QUEENS THAT ARE LICENSED AS AIDS CENTERS (ELMHURST HOSPITAL, QUEENS HOSPITAL CENTER, AND NEW YORK-PRESBYTERIAN/QUEENS). QUEENS ALSO HAS 25 AGENCIES WITH 180 SERVICE SITES THAT OFFER HIV RELATED SERVICES, INCLUDING RYAN WHITE AND CDC PREVENTION PROGRAMS. THESE SERVICES INCLUDE HIV PREVENTION AND OUTREACH EFFORTS SUCH AS SEXUAL AND BEHAVIORAL HEALTH FOR HIV PREVENTION, CONDOM DISTRIBUTION, HARM REDUCTION, TESTING AND LINKAGE TO CARE, AND SYRINGE EXCHANGE.FOCUS 2: PREVENT VACCINE PREVENTABLE DISEASESTEENAGED GIRLS (13-17) RESIDING IN BROOKLYN CD 4 (BUSHWICK) WERE MORE LIKELY TO RECEIVE HPV VACCINATIONS THAN THEIR COUNTERPARTS IN OTHER AREAS SERVED BY JHMC. THE HPV VACCINE PROTECTS AGAINST CANCERS CAUSED BY HPV, WHICH IS A VERY COMMON VIRUS; NEARLY 80 MILLION PEOPLEABOUT ONE IN FOURARE CURRENTLY INFECTED IN THE US. ABOUT 14 MILLION PEOPLE, INCLUDING TEENS, BECOME INFECTED WITH HPV EACH YEAR. FLU SHOT VACCINATION PERCENTAGES WERE LOWER IN ALL OF JHMC'S NEIGHBORHOODS COMPARED TO NYC OVERALL AND LOWER THAN THE NYS AVERAGE FOR 2014-2015 (48.6%)*, WHICH HAS INCREASED BY ONLY 7% OVER THE PAST 6 YEARS. THE HEALTHY PEOPLE 2020 GOAL IS TO ACHIEVE 70% FLU VACCINATION COVERAGE.* CENTERS FOR DISEASE CONTROL'S 2014-15 STATE, REGIONAL, AND NATIONAL VACCINATION REPORT.RESOURCES: JAMAICA HOSPITAL MANDATES STAFF VACCINATIONS FOR COMMUNICABLE AND VACCINE-PREVENTABLE ILLNESSES, SUCH AS INFLUENZA. INFLUENZA VACCINATION RATES FOR TOTAL HEALTHCARE STAFF AT JAMAICA HOSPITAL WERE 87% BETWEEN 2014 AND 2015. THE HOSPITAL MAINTAINS RECOMMENDED AGE-RELATED VACCINATION PROTOCOLS, SUCH AS THE AMERICAN ACADEMY OF PEDIATRICS' IMMUNIZATION SCHEDULE FOR INFANTS AND CHILDREN AND THE AMERICAN GERIATRICS SOCIETY'S IMMUNIZATION GUIDELINES FOR OLDER ADULTS (E.G., FOR SHINGLES, INFLUENZA VACCINES).IN ADDITION TO JAMAICA HOSPITAL'S VACCINATION RESOURCES, LOW-TO-NO-COST IMMUNIZATION CLINICS ARE AVAILABLE IN QUEENS. CHILDREN CAN GET WALK-IN IMMUNIZATION SERVICES AT THE NEW YORK CITY HEALTH + HOSPITALS CORPORATION CHILD HEALTH CLINIC (JACKSON HEIGHTS, NY). ADULTS CAN GET COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING LOW OR NO-COST IMMUNIZATIONS, AT ELMHURST HOSPITAL CENTER (ELMHURST, QUEENS). PART VI, LINE 5, PROMOTION OF COMMUNITY HEALTH CONTINUED: 2018 UPDATEPRIORITY 1: DECREASE TOBACCO USE WITHIN THE COMMUNITYSUCCESSES:- THE HOSPITAL HAS BEEN VERY ACTIVE IN OFFERING OUTREACH AND EDUCATIONAL EVENTS RELATED TO SMOKING CESSATION, HAVING HELD 22 EVENTS TO-DATE. THESE EVENTS REACHED 266 PEOPLE, OF WHOM 161 WERE REFERRED TO A SMOKING CESSATION PROGRAM. THIRTY-SEVEN SIGNED UP FOR A SMOKING CESSATION PROGRAM AT THE HOSPITAL.- THERE IS AT LEAST ONE PATIENT NAVIGATOR AT EACH OF THE HOSPITAL'S AMBULATORY CARE SITES WHO IS TRAINED AS A FREEDOM FROM SMOKING (FFS) FACILITATOR- SMOKING CESSATION COUNSELING PROMPTS WERE INTRODUCED INTO THE EPIC EHR AT DISCHARGE FOR ALL INPATIENT SMOKERS, RESULTING IN 100% COUNSELING COMPLIANCE- THE EHR WAS UPDATED TO INCLUDE EMERGING ELECTRONIC NICOTINE DELIVERY SYSTEMS, SUCH AS E-CIGARETTES, VAPORIZERS AND HOOKA PENS.- THE HOSPITAL CONTINUES TO OFFER SMOKING CESSATION COUNSELING AND MEDICATION FREE OF CHARGE TO ALL EMPLOYEES.- HOSPITAL STAFF PHYSICIAN CONTINUES TO PARTICIPATE IN A NYS QUITLINE PHYSICIAN TASK FORCE, ASSISTING WITH REVIEW OF QUITLINE MARKETING MATERIALS AND OUTREACH COMMUNICATIONS TO HEALTHCARE PROVIDERS, WITH THE ULTIMATE GOAL OF FACILITATING CHANGES IN HOW NY STATE HEALTH SYSTEMS OFFER TOBACCO CESSATION SERVICES.CHALLENGES- SOME EMPLOYEES REMAIN RELUCTANT TO DISCLOSE THEIR SMOKING ADDICTION, FEARING HEALTH INSURANCE RATE INCREASES OR OTHER WORKPLACE RESTRICTIONS, EVEN THOUGH THESE RESTRICTIONS HAVE NOT BEEN IMPOSED. THIS LIMITS DISTRIBUTION OF AVAILABLE BENEFITS AND INTERVENTIONS.- MANY PHYSICIANS CONSIDER TOBACCO CONTROL INTERVENTIONS AND OTHER PREVENTIVE CARE MEASURES AS NOT INTEGRAL TO THEIR ROUTINE PATIENT CARE ENCOUNTERS. PROVIDERS REPORT THAT THE MANY MANDATORY ASSESSMENTS THAT MUST BE PERFORMED AT EACH ENCOUNTER LEAVE LITTLE OR NO TIME TO ADDRESS TOBACCO USE.- NEED FOR CONSTANT REPETITION ABOUT THE HEALTH RISKS OF SMOKING AND THE BENEFITS OF QUITTING. SMOKERS WILL DECIDE TO QUIT SMOKING ONLY WHEN THEY ARE PSYCHOLOGICALLY READY. THEREFORE, IT IS IMPORTANT THAT THEIR MEDICAL PROVIDERS DISCUSS THE ISSUE WITH THEM AS OFTEN AS POSSIBLE, AND ADDRESS ANY LINGERING OBSTACLES THAT MAY HOLD THEM BACK.- DIFFICULTY ENGAGING COMMUNITY PHYSICIANS TO TAKE ADVANTAGE OF THE SMOKING CESSATION SERVICES AVAILABLE IN OUR NETWORK.- THE MULTITUDE OF PSYCHOSOCIAL ISSUES AFFECTING MANY PATIENTS WITH BEHAVIORAL HEALTH ISSUES. SMOKING CESSATION OFTEN IS NOT A PRIORITY GIVEN THE OTHER PRESSING ISSUES INCLUDING HOMELESSNESS, UNEMPLOYMENT, AND FOOD INSECURITY. IN ADDITION THESE PATIENTS MAY BE SELF-MEDICATING BY SMOKING.- COMBATING SMOKING HABITS AGAINST THE POWERFUL TOBACCO INDUSTRY IS A WORK IN PROGRESS. MASSIVE SPREAD OF E-CIGARETTES WITH ITS DECEPTIVE ADVERTISING REQUIRES NEW AND FLEXIBLE RESPONSE FROM HEALTH CARE PROVIDERS. WE WILL CONTINUE TO SEEK THE MOST EFFECTIVE WAYS TO CONVEY THE MESSAGE OF WELL-KNOWN TOBACCO RELATED HEALTH HAZARDS TO OUR PATIENTS AT EVERY STEP OF THEIR CARE AS WELL AS TO THE SURROUNDING COMMUNITIES.NEW YORK STATE PRIORITY AREA: PREVENT CHRONIC DISEASESFOCUS AREA 2: REDUCE ILLNESS, DISABILITY AND DEATH RELATED TO TOBACCO USE AND SECONDHAND SMOKE EXPOSURE.GOAL #2.2: PROMOTE TOBACCO USE CESSATION, ESPECIALLY AMONG LOW SOCIOECONOMIC STATUS (SES) POPULATION AND THOSE WITH POOR MENTAL HEALTH.JHMC PRIORITY 1: DECREASE TOBACCO USE WITHIN THE COMMUNITYGOAL 1: ELIMINATE TOBACCO USE ON HOSPITAL CAMPUS.ACHIEVEMENTS YEAR TO DATE - OFFER COUNSELING AND MEDICATION TO ALL SMOKERS FREE OF CHARGE. ALL EMPLOYEES WHO IDENTIFIED THEMSELVES AS SMOKERS RECEIVED SMOKING CESSATION COUNSELING.OUTCOME OBJECTIVE - TRAIN ALL PATIENT NAVIGATORS IN SMOKING CESSATION.ACHIEVEMENTS YEAR TO DATE - TWENTY-FIVE OF THE 33 PATIENT NAVIGATORS ARE FREEDOM FROM SMOKING (FFS) FACILITATORS. PLANS ARE UNDERWAY TO SCHEDULE TRAININGS TO ENSURE THAT ALL NEWLY HIRED NAVIGATORS ARE FULLY TRAINED TO PROVIDE TOBACCO CESSATION COUNSELING.OUTCOME OBJECTIVE - ACHIEVE AND MAINTAIN STANDARDS FOR NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE GOLD STAR STATUS.ACHIEVEMENTS YEAR TO DATE - ALL STANDARDS HAVE BEEN UPHELD, INCLUDING EMPLOYEE POLICIES, AS WELL AS PROCEDURES FOR ASSESSMENT, COUNSELING AND MEDICATION ADMINISTRATION.GOAL 2: GENERAL MEDICAL/SURGICAL PATIENTS AGED 13 AND ABOVE INCREASE ASSESSMENTS, INTERVENTIONS, AND NUMBER OF QUITTERS.OUTCOME OBJECTIVE - DECREASE SMOKING PREVALENCE AMONG PATIENTS.NOTE: NYS SMOKING PREVALENCE TARGET OF 12.3% FOR ADULTS AND 20% AMONG LOW SES ADULTS (USING MEDICAID COVERAGE AS A PROXY).ACHIEVEMENTS AS OF OCTOBER 21, 2018 OUTPATIENT (OP) = 8.9%, COMPARED TO 17.4% IN 2017INPATIENT (IP) = 18.8%, COMPARED TO 18.5% IN 2017MEDICAID OP = 9.8%MEDICAID IP = 22.4%OUTCOME OBJECTIVE - ACHIEVE 95% OR GREATER ASSESSMENT RATE FOR OUTPATIENTS AND INPATIENTS. ACHIEVEMENTS AS OF OCTOBER 21, 2018 OP = 92.2%, COMPARED TO 90% IN 2017IP = 95.4% COMPARED TO 94.7% IN 2017OUTCOME OBJECTIVE - INCREASE COUNSELING RATE FOR RETURNING OUTPATIENT SMOKERS TO 85% OR GREATER; 65% OR GREATER FOR INPATIENTS.NOTE: THE BASIC INTERVENTION IS COUNSELING. OTHER POSSIBLE INTERVENTIONS INCLUDE EDUCATIONAL MATERIALS, PRESCRIPTIONS FOR MEDICATIONS, AND/OR REFERRAL FOR SMOKING CESSATION CLASSES/SUPPORT.ACHIEVEMENTS AS OF OCTOBER 21, 2018 ALL OP = 100%ALL IP = 100%MEDICAID OP =100%MEDICAID IP =100%OUTCOME OBJECTIVE - INCREASE PRESCRIPTIONS FOR SMOKING CESSATION BENEFITS AMONG MEDICAID AND MEDICAID MANAGED CARE SMOKERS. NOTE: NYS BENEFIT USE TARGET OF 41% FOR MEDICAID MANAGED CARE ENROLLEES.ACHIEVEMENTS AS OF OCTOBER 21, 2018 MEDICAID IP = 32%MEDICAID OP = 9%OUTCOME OBJECTIVE - DOCUMENT AND TRACK USE OF NYS QUITLINE.ACHIEVEMENTS AS OF OCTOBER 21, 2018 ABOUT 88 SMOKERS WERE REFERRED TO THE NYS QUITLINE.GOAL 3: BEHAVIORAL HEALTH (BH) PATIENTS ABOVE AGE 13INCREASE ASSESSMENTS, INTERVENTIONS, AND NUMBER OF QUITTERS.OUTCOME OBJECTIVE - DECREASE SMOKING PREVALENCE AMONG BH PATIENTS.NOTE: NYS SMOKING PREVALENCE TARGET OF 24% AMONG ADULTS WHO REPORT POOR MENTAL HEALTH.ACHIEVEMENTS AS OF OCTOBER 21, 2018 OP = 19.1%, ALMOST THE SAME AS LAST YEARIP = 43%, DOWN BY ALMOST 4 POINTS FROM LAST YEAROUTCOME OBJECTIVE - ACHIEVE 75% OR GREATER ASSESSMENT RATE OF OUTPATIENTS AND 95% OR GREATER OF INPATIENTS.ACHIEVEMENTS AS OF OCTOBER 21, 2018 OP = 89.8% IP = 95%OUTCOME OBJECTIVE - ACHIEVE 90% OR GREATER COUNSELING RATE FOR OUTPATIENTS AND INPATIENTS.NOTE: THE BASIC INTERVENTION IS COUNSELING. OTHER INTERVENTIONS FOR BH PATIENTS INCLUDE PRESCRIPTIONS FOR MEDICATION, FOLLOW-UP COUNSELING AND PROVISION OF EDUCATIONAL MATERIALS.ACHIEVEMENTS AS OF OCTOBER 21, 2018 OP = 100%. MEDICAID OP = 100%IP = 100%MEDICAID OP = 100%OUTCOME OBJECTIVE - INCREASE PRESCRIPTIONS FOR SMOKING CESSATION BENEFITS AMONG BH MEDICAID AND MEDICAID MANAGED CARE PATIENTS.NOTE: NYS BENEFIT USE TARGET OF 41% FOR MEDICAID MANAGED CARE ENROLLEES.ACHIEVEMENTS AS OF OCTOBER 21, 2018 MEDICAID IP = 53%MEDICAID OP = 37.6%GOAL 4: PROVIDE TOBACCO CESSATION EDUCATION TO COMMUNITY RESIDENTS AND PROVIDERS.OUTCOME OBJECTIVE - INCREASE NUMBER OF PROVIDERS ENGAGED CONCERNING TOBACCO CESSATION RESOURCES AND TECHNIQUES.ACHIEVEMENTS YEAR TO DATE - PLAN TO INTRODUCE INFORMATION ABOUT THE HOSPITAL'S SMOKING CESSATION RESOURCES TO ALL PHYSICIANS DURING THEIR APPLICATION FOR ADMITTING PRIVILEGES AND FOR BIANNUAL RENEWAL.OUTCOME OBJECTIVE - INCREASE THE NUMBER OF COMMUNITY EDUCATIONAL EVENTS THAT COVER TOBACCO CESSATION, IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS AND OFFER FFS CLASSES AND ABBREVIATED QUIT PROGRAMS IN AS MANY LANGUAGES AS POSSIBLE.ACHIEVEMENTS YEAR TO DATE - TWENTY-TWO EDUCATIONAL OUTREACH EVENTS DREW 266 PEOPLE; EDUCATIONAL MATERIALS WERE DISTRIBUTED AND ATTENDEES WERE URGED TO SIGN UP FOR QUIT SMOKING PROGRAMS. ONE HUNDRED AND SIXTY-ONE WERE REFERRED TO A SMOKING CESSATION PROGRAM, AND 37 SIGNED UP FOR A HOSPITAL CLASS. FOUR SMOKING CESSATION CLASSES WERE HELD WITH A TOTAL OF TEN ATTENDEES, OF WHOM SIX QUIT OR CUT DOWN AT THIS TIME CLASSES ARE ONLY HELD IN ENGLISH. ONE MORE CLASS WILL BE HELD IN 2018. PART VI, LINE 5, PROMOTION OF COMMUNITY HEALTH CONTINUED: PRIORITY 2: INCREASE RATES OF EXCLUSIVE BREASTFEEDING IN THE SERVICE AREASUCCESSES:- MAINTAINED DESIGNATION AS A BABY FRIENDLY USA HOSPITAL SINCE DESIGNATION IN MAY 2017.- JHMC CELEBRATED ITS ONE-YEAR ANNIVERSARY IN OCTOBER 2018 AS THE FIRST HOSPITAL IN QUEENS TO OFFER A MILK DEPOT. SINCE ITS INCEPTION, ELEVEN MOTHERS HAVE DONATED 397 GALLONS OF BREAST MILK. THE MILK DEPOT IS A SAFE LOCATION WHERE WOMEN APPROVED BY THE NEW YORK MILK BANK (NYMB) CAN DONATE THEIR EXCESS BREAST MILK TO BE DISTRIBUTED BY NYMB TO MOTHERS WHO ARE UNABLE TO BREASTFEED THEIR PREMATURE BABIES OR INFANTS WITH WEAKENED IMMUNE SYSTEMS.- EXPANDED THE BREASTFEEDING VOLUNTEER PEER COUNSELOR PROGRAM, ENABLING ALMOST 90% OF MOTHERS TO RECEIVE INDIVIDUAL BREASTFEEDING SUPPORT WHILE IN THE HOSPITAL TO DELIVER THEIR BABIES. - MAINTAINED VITAL CONNECTIONS WITH A WIDE NETWORK OF COMMUNITY BASED ORGANIZATIONS (CBOS) THAT PROVIDE SERVICES TO NEW AND EXPECTANT MOTHERS. THESE CBOS MAKE INDIVIDUALIZED AND MEANINGFUL CONNECTIONS WITH OUR PATIENTS CONCERNING BREASTFEEDING AND PARENTING SUPPORT.CHALLENGES:- DATA FOR INFANT FEEDING PRACTICES WAS NOT BEING CAPTURED IN THE DATA FIELD DEVELOPED BY THE EMR BUILD TEAM SO SIGNIFICANT UNDERREPORTING OF THIS MEASURE TOOK PLACE. IT WAS DETERMINED THAT THE REVISED TEMPLATES WERE CUMBERSOME AND PROVIDERS CHOSE TO USE THEIR OWN FORMATS FOR DOCUMENTATION. A WORK GROUP WAS FORMED TO REDESIGN THE TEMPLATES AND RECOMMENDED CHANGES HAVE BEEN IMPLEMENTED IN THE EHR.- INCREASING THE PERCENTAGE OF MOTHERS WHO HAVE SKIN-TO-SKIN CONTACT AFTER CESAREAN-SECTION BIRTH.- INCREASING THE PERCENTAGE OF MOTHERS WHO ARE EXPRESSING MILK FOR THEIR INFANTS IN THE NICU IN THE FIRST SIX HOURS AFTER DELIVERY.- IDENTIFYING AND HELPING MOTHERS TO OVERCOME THE SOCIOECONOMIC CHALLENGES, AND FAMILY PRESSURE NOT TO BREASTFEED, WHICH FACE OUR EXPECTANT AND NEW MOTHERS, SO THAT THEY CAN FOCUS ON AND ACHIEVE THEIR BREASTFEEDING GOALS.- INCREASING THE NUMBER OF PROVIDERS OF OUTPATIENT PEDIATRIC CARE WHO FOCUS ON SUPPORTING MOTHERS IN BREASTFEEDING THEIR BABIES.NEW YORK STATE PRIORITY AREA: PROMOTING HEALTHY WOMEN, INFANTS AND CHILDREN FOCUS AREA 1: MATERNAL AND INFANT HEALTH INCREASE THE PROPORTION OF BABIES WHO ARE BREASTFED. GOAL #2: INCREASE EXCLUSIVE BREASTFEEDINGJHMC PRIORITY 2: INCREASING RATES OF EXCLUSIVE BREASTFEEDING IN THE SERVICE AREA GOAL 1: EXCLUSIVE BREASTFEEDING (BF) AT DISCHARGE FOR AS MANY PATIENTS AS CLINICALLY POSSIBLE.OUTCOME OBJECTIVE ACHIEVE EXCLUSIVE BF RATE AT DISCHARGE OF 41%.NOTE: NYS TARGET OF 48.1%.ACHIEVEMENTS AS SEPTEMBER 30, 2018 - EXCLUSIVE BF RATE = 39% (537 OF 1374 PATIENTS)OUTCOME OBJECTIVE REDUCE EXCLUSIVE BF DISPARITY BETWEEN MEDICAID AND NON-MEDICAID ENROLLEES.NOTE: NYS DISPARITY TARGET OF 0.66. (EQUALITY WOULD EQUAL 1.0)ACHIEVEMENTS AS SEPTEMBER 30, 2018 - EXCLUSIVE BF DISPARITY RATE = 0.97OUTCOME OBJECTIVE ACHIEVE SKIN-TO-SKIN CONTACT FOR NEWBORN BABIES: - VAGINAL BIRTHS = 95% - C-SECTION BIRTHS = 86%ACHIEVEMENTS AS SEPTEMBER 30, 2018 SKIN-TO-SKIN CONTACT: - VAGINAL BIRTHS = 97% (873 OF 904 PATIENTS) - CESAREAN BIRTHS = 78% (422 OF 538 PATIENTS)OUTCOME OBJECTIVE ACHIEVE ROOMING-IN FOR 90% OF NEWBORNS.ACHIEVEMENTS AS SEPTEMBER 30, 2018 ROOMING-IN RATE = 96% (1444 OF 1504 PATIENTS)SKIN OUTCOME OBJECTIVE ACHIEVE 95% OR GREATER TRAINING RATE IN RECOMMENDED BF EDUCATION: - MEDICAL PROVIDERS - MATERNAL/CHILD NURSESACHIEVEMENTS AS SEPTEMBER 30, 2018 BF TRAINING RATE = 100%.OUTCOME OBJECTIVE RECEIVE AND ADMINISTER PASTEURIZED HUMAN MILK FROM THE MILK BANK TO SERVE OUR NICU PATIENTS IN 2018.ACHIEVEMENTS AS SEPTEMBER 30, 2018 THE HOSPITAL HAS BEGUN TO EXPLORE THE POSSIBILITY; HOWEVER, THIS ENDEAVOR WILL TAKE MORE THAN A YEAR TO ACCOMPLISH AS WE LEARNED FROM ATTENDING THE "DONOR HUMAN MILK WORKSHOP" SPONSORED BY MORGAN STANLEY CHILDREN'S HOSPITAL OF NEW YORK PRESBYTERIAN, JULY 2018.GOAL 2: BABY FRIENDLY USA DESIGNATION OUTCOME OBJECTIVE MAINTAIN BABY FRIENDLY USA DESIGNATION.ACHIEVEMENTS YEAR TO DATE - DATA IS SUBMITTED QUARTERLY TO BABY FRIENDLY USA ON BREASTFEEDING INITIATION AND EXCLUSIVE BREASTFEEDING RATE AT DISCHARGE.NOW IN ANNUAL QUALITY IMPROVEMENT (AQI) PHASE. AUDIT TOOLS SPECIFIED BY BABY FRIENDLY USA ARE UTILIZED FOR CLINICS AND HOSPITAL. DATA SUBMITTED WITH TARGETED QUALITY IMPROVEMENT PLAN, OCTOBER 2018.GOAL 3: EXCLUSIVE BREASTFEEDING AT 3 AND 6 MONTHS FOR AS MANY PATIENTS AS CLINICALLY POSSIBLEOUTCOME OBJECTIVE INCREASE EXCLUSIVE BF RATES AT 3 AND 6 MONTHS FOR THE HOSPITAL'S WELL BABIES.NOTE: HEALTHY PEOPLE 2020 TARGET3 MONTHS: 46.2%6 MONTHS: 25.2%ACHIEVEMENTS YEAR TO DATE - A MEASURABLE DATA FIELD WAS IMBEDDED IN EPIC PEDIATRIC WELL CHILD TEMPLATES SO PROVIDERS COULD EASILY DOCUMENT NUTRITION INFORMATION DURING WELL CHILD ENCOUNTERS. PEDIATRIC PROVIDERS WERE NOT USING THESE TEMPLATES, PREFERRING TO USE THEIR OWN FORMAT, SO THE DATA COULD NOT BE CAPTURED. A GROUP REVISED AND SIMPLIFIED THE TEMPLATES TO GAIN ACCEPTANCE OF ALL PROVIDERS.OUTCOME OBJECTIVE TRAIN ALL PEDIATRICIANS AND FAMILY MEDICINE PHYSICIANS IN BF.ACHIEVEMENTS YEAR TO DATE - 100% TRAINED.GOAL 4: INCREASE KNOWLEDGE OF COMMUNITY RESIDENTS AND PROVIDERS ABOUT THE BENEFITS OF BREASTFEEDINGOUTCOME OBJECTIVE INCREASE ADOPTION OF BREASTFEEDING FRIENDLY PRACTICE (BFFP) STANDARDS BY COMMUNITY PROVIDERS.ACHIEVEMENTS YEAR TO DATE - PLANS UNDERWAY FOR AN INTERACTIVE, EDUCATIONAL PROGRAM FOR PEDIATRICIANS, FAMILY MEDICINE PROVIDERS AND COMMUNITY PHYSICIANS IN THE SECOND QUARTER 2019.OUTCOME OBJECTIVE INCREASE PARTICIPATION IN BF EDUCATION AND SUPPORT SERVICES.ACHIEVEMENTS YEAR TO DATE WIC PROGRAM ACTIVITIES INCLUDED WEEKLY FACILITATED PRENATAL GROUP DISCUSSIONS ATTENDED BY 414 WOMEN, AND DISTRIBUTION OF EDUCATIONAL MATERIAL AT TWO OUTREACH EVENTS. HOSPITAL PROGRAM ACTIVITIES INCLUDED WEEKLY AND MONTHLY CLASSES RELATED TO CHILDBIRTH AND BREASTFEEDING, WHICH DREW APPROXIMATELY 500 WOMEN; REFERRAL OF 264 WOMEN TO HEALTHY START'S HOME VISITATION PROGRAM; PARTICIPATED IN BACK TO SCHOOL DRIVE AND HEALTH FAIR IN AUGUST. X X X X 0 0 0 0 0 0 0 0 0 ANTHONY DIMARIA MD SECRETARY 0 242516 0 0 0 9600 0 13024 0 31617 0 296757 0 0 GEOFFREY DOUGHLIN MD THIRD VICE CHAIRMAN 470318 0 0 0 0 0 13750 0 31617 0 515685 0 0 0 BRUCE FLANZ PRESIDENT & CEO 838159 631552 0 0 145683 0 13750 0 30232 0 1027824 631552 0 0 MOUNIR DOSS EXEC. VICE PRESIDENT & CFO 686714 376688 0 0 33711 0 13750 0 30232 0 764407 376688 0 0 WILLIAM LYNCH EXEC. VICE PRESIDENT & COO 516828 0 0 0 13164 0 13750 0 30232 0 573974 0 0 0 ALAN ROTH CHARIMAN FAMILY PRACTICE 475878 0 0 0 2322 0 13750 0 30232 0 522182 0 0 0 MANZAR SASSANI VP FINANCE 468773 0 0 0 13164 0 13750 0 30015 0 525702 0 0 0 ROBERT SOLOMON RADIOLOGIST 449193 0 0 0 3564 0 13750 0 27911 0 494418 0 0 0 SABIHA RAOOF CHAIRPERSON RADIOLOGY 653237 0 0 0 0 0 13750 0 31617 0 698604 0 0 0 SCOTT TREPETA RADIOLOGIST 484640 0 0 0 1242 0 13750 0 23255 0 522887 0 0 0 SCHEDULE J, PART II: THE AMOUNT IN COLUMN B(III) FOR BRUCE FLANZ INCLUDES PAYMENTS FOR SUPLEMENTAL LIFE AND DISABILITY INSURANCE. FORM 990, PART VI, SECTION A, LINE 6 MEDISYS HEALTH NETWORK IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A MEDISYS HEALTH NETWORK, AS THE SOLE MEMBER CAN APPOINT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED (FORM 990), IS PREPARED BY OUTSIDE ACCOUNTANT AND REVIEWED INTERNALLY BY MANAGEMENT, AT WHICH TIME IT IS CONSIDERED THE FINAL DRAFT. THE FINAL DRAFT OF THE FORM 990 IS PRESENTED TO THE TRUSTEES VIA EMAIL AND OR A BOARD MEETING. ONCE THE REVIEW OF THE FORM 990 HAS BEEN COMPLETED TO THE BOARD'S SATISFACTION, IT IS FINALIZED AND SUBSEQUENTLY FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY BY EMPLOYEES THAT SATISFY THE CRITERIA TO BE CONSIDERED AN "INTERESTED PERSON" IS SUBMITTED UPON HIRING AND ANNUALLY THEREAFTER. THE COMPLIANCE OFFICERS REVIEW THE SUBMISSIONS FOR CONFLICTS AND REPORTS THEM TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION POLICY - THE BOARD OF MEDISYS HEALTH NETWORK HAS CREATED AN INDEPENDENT COMPENSATION COMMITTEE WHOSE CHARGE IS TO REVIEW AND APPROVE THE COMPENSATION OF ALL INDIVIDUALS WHO MEET THE REQUIREMENTS OF A DISQUALIFIED PERSON FOR INTERMEDIATE SANCTION. THIS COMMITTEE IS EMPOWERED TO APPROVE COMPENSATION FOR ALL ENTITIES WITHIN THE MEDISYS HEALTH NETWORK SYSTEM. THE COMMITTEE HAS RETAINED AN INDEPENDENT COMPENSATION CONSULTANT TO APPLY ITS STANDARD METHODOLOGY FOR DETERMINATION OF APPROPRIATE EXECUTIVE COMPENSATION AND BENEFIT LEVELS FOR EXECUTIVES. IT IS POLICY TO TARGET THE TOTAL COMPENSATION (BASE SALARY, INCENTIVE COMPENSATION AND BENEFITS) OF EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE FOR SIMILARLY SITUATED EXECUTIVES IN CONSULTATION WITH AN INDEPENDENT COMPENSATION CONSULTANT IN A MANNER THAT COMPLIES WITH THE INTERMEDIATE SANCTION REGULATIONS AND OTHER FEDERAL AND STATE LAWS AND REGULATIONS. THE COMMITTEE SHALL APPROVE BASE SALARIES FOR EXECUTIVES AND ANY DISQUALIFIED INDIVIDUALS BASED UPON THE AMOUNTS PAID TO SIMILARLY SITUATED EXECUTIVES WITHIN THE RELEVANT MARKETPLACE, WITH POSSIBLE ADJUSTMENTS MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. THE CEO SHALL RECOMMEND TO THE COMPENSATION COMMITTEE ANY ADJUSTMENTS TO THE BASE SALARIES OF EXECUTIVES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, COLUMN C: MANAGEMENT HAS IN THE PREPARATION OF ITS FORM 990 REVIEWED PERSONNEL IN THE INSTITUTION TO SEE IF ANYONE MEETS THE CRITERIA ESTABLISHED TO BE CONSIDERED A "KEY EMPLOYEE" FOR IRS PURPOSES. IT IS THE CONTENTION OF MANAGEMENT THAT NO EMPLOYEE FULFILLS ANY OF THE SITUATIONS UNDER THE RESPONSIBILITY TEST ESTABLISHED BY THE IRS TO MEET TITLE OF KEY EMPLOYEE. THEREFORE, PART VII OF FORM 990 DOES NOT HAVE ANY INDIVIDUALS WHO WOULD BE CONSIDERED A "KEY EMPLOYEE". FORM 990, PART VII, SECTION A, LINE 1B: ANTHONY DIMARIA, M.D., RECEIVED COMPENSATION FOR THE PERFORMANCE OF SERVICES TO THE JAMAICA HOSPITAL NURSING HOME WORKING ABOUT 40 HOURS PER WEEK. ANTHONY DIMARIA, M.D., DID NOT RECEIVE COMPENSATION AS A TRUSTEE FOR JAMAICA HOSPITAL MEDICAL CENTER, MEDISYS HEALTH NETWORK, OR THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND TREATMENT CENTER FOR EACH OF WHICH HE WORKED ABOUT 1 HOUR PER WEEK. GEOFFREY DOUGHLIN M.D., RECEIVED COMPENSATION FOR THE PERFORMANCE OF SERVICES TO THE JAMAICA HOSPITAL MEDICAL CENTER AS THE CHAIRMAN OF EMERGENCY MEDICINE WORKING ABOUT 40 HOURS PER WEEK. GEOFFREY DOUGHLIN M.D., DID NOT RECEIVE COMPENSATION AS A TRUSTEE FOR JAMIACA HOSPITAL MEDICAL CENTER, THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND TREATMENT CENTER OR MEDISYS HEALTH NETWORK FOR EACH OF WHICH HE WORKED ABOUT 1 HOUR PER WEEK. FOR BRUCE FLANZ, PRESIDENT & CEO, MOUNIR DOSS, EXECUTIVE VICE PRESIDENT & CFO, THE HOURS REPORTED BELOW REFLECT THE TOTAL TIME WORKED AS OFFICERS FOR ALL OF THE RELATED ORGANIZATIONS SHOWN ON SCHEDULE R. TOTAL COMPENSATION IS REPORTED ON EACH ENTITY'S FORM 990. COST ALLOCATION AMONG THE ENTITIES IS PERFORMED CONSISTENTLY WITH ACCOUNTING RULES AND APPLICABLE COST ALLOCATION METHODOLOGIES. ESTIMATED NUMBER OF HOURS WORKED PER WEEK FOR RELATED ORGANIZATIONS IS AS FOLLOWS: MEDISYS HEALTH NETWORK - 10 HOURS PER WEEK FLUSHING HOSPITAL MEDICAL CENTER - 15 HOURS PER WEEK JAMAICA HOSPITAL MEDICAL CENTER - 30 HOURS PER WEEK OTHER RELATED ENTITIES LISTED ON SCHEDULE R - 10.0 HOURS PER WEEK FORM 990, PART XI, LINE 9: PARTNERSHIP BOOK TO TAX DIFFERENCE -573. FORM 990, PART XII, LINE 2C: THE OVERSIGHT AND SELECTION PROCESSES DID NOT CHANGE FROM THE PRIOR YEAR. 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