2018-11-08T14:09:41-06:00 2017-12-31 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2017-01-01 941105628 KAISER FOUNDATION HOSPITALS % CHIEF ACCOUNTING OFFICER KAIS 5102716611 ONE KAISER PLAZA 15L OAKLAND CA 94612 ALFONSE UPSHAW VICE PRESIDENT TAX 5102716611 2018-11-06 ROBERT W FRIZ P00438748 2673303000 155.201.188.33 23522320183125000027 2018-11-08 P 6CFBC1E470B119DB9F0B0C745D98B714AAF1A9A1 4C4C4B9893EC382B44A01CC035730476DEEC612F 2017 2019-02-21 02:37:17Z Bernard J Tyson ONE KAISER PLAZA 15L OAKLAND CA 94612 36971306958 false X www.kp.org X 1948 CA to provide high-quality, affordable health care services to improve the health of our members and the communities we serve. 14 13 83083 10993 736510 0 133605188 133030190 22933954169 24245322520 1148256480 1748745817 35962972 39622965 24251778809 26166721492 65959661 180945294 0 0 8087586455 8438687895 0 0 0 13822272617 14376980733 21975818733 22996613922 2275960076 3170107570 44703206468 51507506504 23345473549 26616949182 21357732919 24890557322 X TO PROVIDE HIGH-QUALITY, AFFORDABLE HEALTH CARE SERVICES TO IMPROVE THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE. false false 19716664610 6834967 23146146124 Provides hospital and medical care, training and charity care. Kaiser foundation hospitals (KFH) provides hospital, medical and surgical care, including emergency services, extended care and home health care without regards to age, sex, race, religion or national origin or the ability to pay. KFH educates and trains medical students, physicians and other health care professionals and promotes scientific research and medical and nursing education in order to improve care for our members and our community. KFH directly invests in improvements in community health by working to increase access for the underserved, disseminating care improvements, altering the social determinants of health and educating to improve health. 1641233563 0 992979971 Medicaid and Other Government Sponsored Programs. Kaiser Foundation Hospitals (KFH) is committed to improving medical care for beneficiaries of Medicaid and other government sponsored programs, not only for Kaiser Foundation Health Plan, Inc. members, but also within the communities we serve. At the end of 2017, nearly 621,000 individuals were receiving access to inpatient and emergency care at KFH's facilities under Medicaid managed care programs in the states of California, Hawaii, Oregon, and Washington. More than 159,000 individuals were receiving treatment under the Children's Health Insurance Program (CHIP). In addition, KFH provided health care on a fee-for-service basis for Medicaid beneficiaries who were not enrolled as Kaiser Foundation Health Plan, Inc. members. 200071370 0 15071498 Charity Care (Medical Financial Assistance and Charitable Health Coverage). Kaiser Foundation Hospitals (KFH) provides charity care to low-income vulnerable patients through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) Programs. KFH offers financial assistance through the MFA program to help families and individuals with a demonstrated financial need pay for all or part of the cost of emergency or medically necessary care provided in Kaiser Permanente facilities and/or by Kaiser Permanente providers. In 2017, this program assisted approximately 180,000 qualifying applicants, including nearly 31,000 patients who were not covered by a product offered by Kaiser Foundation Health Plan, Inc. The CHC programs offer regular Kaiser Foundation Health Plan membership at minimal cost to low income families who are not eligible for other public or privately sponsored coverage. Over 23,000 patients were receiving access to comprehensive health care through these programs at the end of 2017. See part iii, line 4a-d description 444350921 174110327 91124927 22002320464 true true false true false false false false false false true true false false true false false true false false true true false false false false true true true true true true true false false false false false false false true false false false false false true true true true false false true X 2982 0 true 83083 true true true true AR BR CJ CI CH CO EZ GH GR HU false false false false false false false false X 14 13 false false true true false false false true true false false true true true true true true true true false CA GA OR X X CHIEF ACCOUNTING OFFICER 5102716611 ONE KAISER PLAZA 15L OAKLAND CA 94612 X Ramon F Baez Director 2.0 3.0 X 0 216956 0 David Barger Director 2.0 5.0 X 0 129258 0 Regina M Benjamin MD MBA Director 3.0 5.5 X 0 195085 0 Jeffery E Epstein Director 3.0 5.5 X 0 209793 0 Leslie S Heisz Director 2.0 3.0 X 0 221011 0 David F Hoffmeister Director 4.0 5.5 X 0 228956 0 Judith A Johansen JD Director 3.0 6.0 X 0 245223 0 Kim J Kaiser Director 2.4 5.6 X 0 229212 0 Edward Y W Pei Director 3.0 4.5 X 0 227488 18000 Margaret E Porfido JD Director 2.0 4.0 X 0 273015 0 Richard Shannon MD Director 2.0 3.5 X 0 190000 18000 Cynthia A Telles PHD Director 3.0 4.5 X 0 233956 0 Bernard Tyson Chairman & CEO 15.0 35.0 X X 0 10709503 5373250 Eugene Washington MD Director 3.0 4.0 X 0 193495 0 Gregory Adams EVP, Group President 15.0 35.0 X 0 3042495 3546643 Mary Barnes Region President - Hawaii 50.0 0.0 X 0 1071569 29603 Anthony Barrueta SVP, Government Relations 25.0 25.0 X 0 1354413 396224 Kristin Bear Assistant Secretary 17.0 33.0 X 0 346012 142273 Vanessa Benavides SVP, Chief Comp & Priv Officer 20.0 30.0 X 0 923294 190921 Charles Bevilacqua SVP, HP Products, Svc & Admin 10.0 40.0 X 0 1521557 308111 Maryann Bodayle Assistant Secretary 22.0 28.0 X 0 172364 48189 William Caswell Interim Regional President -HI 40.0 10.0 X 0 1509573 146401 Bechara Choucair SVP,Community Health & Benefit 25.0 25.0 X 0 955689 188323 Charles Columbus SVP, Chief HR Officer 25.0 25.0 X 0 1857813 336076 Patrick Courneya EVP, Chief Medical Officer 22.5 27.5 X 0 1220085 630555 Richard Daniels EVP, CIO 2.0 48.0 X 0 1814409 146709 Sandra Golze Assistant Secretary - NCAL 25.0 25.0 X 0 374649 220377 Bernice Gould Assistant Secretary 20.0 30.0 X 0 211923 119722 Kimberly Horn Regional President - MAS 0.0 50.0 X 0 1459825 687515 Kathryn Lancaster EVP & CFO 15.0 35.0 X 0 2834247 889086 Janet Liang Regional President - NCAL 25.0 25.0 X 0 1461682 541446 R Roland Lyon Regional President - Colorado 5.0 45.0 X 0 891176 364965 Andrew Mcculloch Regional President - Northwest 25.0 25.0 X 0 4160783 167915 Thomas Meier SVP, Corporate Treasurer 18.0 32.0 X 0 1125095 191167 Julie Miller-Phipps Regional President - SCAL 25.0 25.0 X 0 1518610 295129 Susan Mullaney Regional President - WA 0.0 50.0 X 0 1454292 246464 Janet O'Hollaren INTERIM REGIONAL PRESIDENT- NW 0.0 50.0 X 0 522090 361570 Donald Orndoff SVP, NFS 14.0 36.0 X 0 974157 230435 Wade Overgaard SVP, Health Plan Ops - CA 10.0 40.0 X 0 1471370 277717 Frank Richardson Assistant Secretary - HI 25.0 25.0 X 0 311997 141313 Rochelle Roth Assistant Secretary 10.0 40.0 X 0 235364 200790 Jacqueline Sellers Assistant Secretary 25.0 25.0 X 0 287588 171076 James Simpson REGIONAL PRESIDENT - GA 5.0 45.0 X 0 1444464 353119 Arthur Southam EVP, Health Plan Operations 5.0 45.0 X 0 3230890 776312 Paul Swenson SVP & Chief Strategy Officer 5.0 45.0 X 0 1472354 284884 Alfonse Upshaw SVP,Corporate Controller & CAO 15.0 35.0 X 0 839199 168061 Cesar Villalpando SVP, Enterprise Shared Svcs 25.0 25.0 X 0 816812 210779 Ruth Williams-Brinkley Regional President - Northwest 25.0 25.0 X 0 48611 35651 John Yamamoto Assistant Secretary 25.0 25.0 X 0 669177 225971 Philip Young Assistant Secretary 25.0 25.0 X 0 479379 191476 Hong-Sze Yu VP, Brd & Corp Gov & Asst Secy 14.5 35.5 X 0 330937 179627 Mark Zemelman SVP, General Counsel & Secy 18.0 32.0 X 0 2447915 221897 Chandrika Bhalla SVP, CFO - NCAL 25.0 25.0 X 0 779587 191209 Christopher Boyd SVP & Area Mgr - Santa Clara 50.0 0.0 X 0 632895 177306 Greg Christian SVP, Area Manager - Fontana 50.0 0.0 X 0 562704 230422 Judith Coffey SVP & Area Mgr - Marin/Sonoma 50.0 0.0 X 0 637106 161370 Jeffrey Collins SVP & Area Manager - Roseville 50.0 0.0 X 0 770925 213404 Mark Costa SVP, Area Mgr - Orange County 50.0 0.0 X 0 639865 206561 George Disalvo SVP, CFO - SCAL 25.0 25.0 X 0 1420963 162314 Elizabeth Finley SVP, Area Manager - San Diego 50.0 0.0 X 0 662857 272995 Deborah Friberg SVP & Area Mgr -Central Valley 50.0 0.0 X 0 377996 68663 Corwin Harper SVP & Area Mgr - Napa/Solano 50.0 0.0 X 0 598381 212935 Gerald Mccall SVP Operations 50.0 0.0 X 0 994274 236988 Colleen Mckeown SVP & Area Mgr - Diablo 50.0 0.0 X 0 983379 235524 Christine Robisch SVP, CHIEF ADMIN. OFFICER 50.0 0.0 X 0 829570 299425 Michael Rowe SVP, CFO - NCAL 25.0 25.0 X 0 1309546 347371 Nirav Shah SVP, COO Clinical Operations 50.0 0.0 X 0 916509 33959 Lisa L Caplan SVP, Care Delivery Tech Svcs 50.0 0.0 X 0 834768 215791 Diane Comer SVP, Bus Info Officer - HP 50.0 0.0 X 0 925448 221072 Wendy L Lee SVP, Corp Svcs & Digital Tech 50.0 0.0 X 0 863025 236154 Kathleen Marie Scheirman SVP, Application Svcs Group 50.0 0.0 X 0 876602 184232 Michael Sutten SVP, Info Technology & CTO 50.0 0.0 X 0 1090728 182163 George Halvorson Chairman 0.0 0.0 X 0 28956 25716 J Neal Purcell Director 0.0 0.0 X 0 48745 0 Raymond Baxter SVP, CB Research & Hlth Policy 0.0 0.0 X 0 1025489 0 Jerry Fleming SVP, Health Reform Implement 0.0 0.0 X 0 370330 72706 Daniel Garcia SVP, Chief Compliance Officer 0.0 0.0 X 0 593429 0 Marilyn Kawamura Region President - MAS 0.0 0.0 X 0 209165 0 Deborah Stokes SVP,Corporate Controller & CAO 0.0 0.0 X 0 165396 0 Nancy Wollen SVP, Chief Operating Officer 0.0 0.0 X 0 449497 89911 Carlos Zaragoza Assistant Secretary 0.0 0.0 X 0 163976 0 Victoria Zatkin VP, Off of Brd & Corp Gov Svcs 0.0 0.0 X 0 105278 0 Edward Glavis SVP & Area Mgr - Roseville 0.0 0.0 X 0 114090 0 Thomas Hanenburg SVP & Area Mgr - GSAA 50.0 0.0 X 0 720222 156632 Nathaniel Oubre VP, CA MediCal, CHIP & CHC 50.0 0.0 X 0 556983 231876 Max Villalobos COO - North County 50.0 0.0 X 0 560409 198792 Vita Willett SVP, Area Manager - Riverside 50.0 0.0 X 0 584228 337796 0 82770131 24477029 29891 true true false CARDINAL HEALTH 5426 LANDERS RD SHERWOOD AR 72117 CONSULTING SERVICES 415238091 BARPELLAM INC 27777 FRANKLIN RD SOUTHFIELD MI 48034 WORKFORCE MANAGEMENT 367031517 COGNIZANT TECHNOLOGY SOLUTIONS 500 FRANK W BURR BLVD TEANECK NJ 07666 DIGITAL TECHNOLOGY 145010090 WORLD WIDE TECHNOLOGY INC 60 WELDON PKWY MARYLAND HEIGHTS MO 63043 IT DATA MGMT SVCS 137645457 BLACKSTONE CONSULTING INC 11726 SAN VICENTE BLVD LOS ANGELES CA 90049 CONSULTING SERVICES 124885688 276 X 854880 95380546 36794764 133030190 HOSPITAL SERV REV 622110 20641417541 20641417541 NON-PLAN & IND REV 622110 649027695 649027695 OTHR PRGM SERV REV 622110 2635635470 2634799707 835763 MEDICARE PAYMENTS 622110 319241814 319241814 24245322520 1378114772 -4725296 1382840068 0 0 1781885 1781885 0 1781885 1781885 11158140209 17076302 10777988233 26597233 380151976 -9520931 370631045 370631045 0 0 0 0 0 0 0 0 0 CAFETERIA 722310 23100229 23100229 PARKING GARAGES 812930 10572974 458166 10114808 KP VENTURES 900099 4167877 4167877 37841080 26166721492 24244486757 736510 1788468035 179587682 179587682 1181500 1181500 176112 176112 0 0 691183 652187 38996 0 6177952524 5829396375 348556149 805266412 759833794 45432618 1027672581 969691948 57980633 427105195 403008192 24097003 0 1246813 1246813 1210981 1210981 0 0 86221668 86221668 0 4391852 4391852 361416370 341025488 20390882 968339604 913706500 54633104 0 266696629 251649775 15046854 16489644 15559309 930335 0 13615491 13615491 702796693 663145351 39651342 0 1010461540 953451943 57009597 81190662 76609937 4580725 PURCHASED MEDICAL SERVICES 3972490418 3972490418 BASIC CONTRACTUAL PAYMENTS 3004186078 3004186078 MEDICAL & OTHER SUPPLIES 2236301719 2110130999 126170720 PURCHASED NON-MEDICAL SVC 480456896 453349824 27107072 1169467675 1103487052 65980623 22996613922 22002320464 994293458 0 X 287517486 189273579 0 0 0 0 878294178 613829020 0 0 0 0 2433475334 2624092353 438648688 463786153 375252902 458529277 35636024121 17976844786 17228429696 17659179335 15552369237 21190841573 6804679191 7608898024 0 0 0 0 704539756 699077190 44703206468 51507506504 2704578264 3188750041 0 0 2829888 240159500 5533423519 9365288192 0 0 0 0 0 0 0 0 15104641878 13822751449 23345473549 26616949182 X 0 0 41319391 54349820 21316413528 24836207502 21357732919 24890557322 44703206468 51507506504 X 3170107570 1382413346 -1019696513 X false true X true true true X false false false false false false false false true 1418 1418 false SCHEDULE C, PART II-B, LINE 1(i) LOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES The Organization is a member of the Kaiser Permanente Medical Care Program and participated and benefited from lobbying activities conducted at the regional and national level for the benefit of its enrolled members and for the health care industry as a whole. As an organization generally exempt from income tax under Internal Revenue Code Section 501(c)(3), Kaiser Foundation Hospitals ("Health Plan") has a policy prohibiting internal involvement in any political campaigns. This policy is closely monitored for compliance. During the year this Organization may have made comments or statements concerning legislation which may affect the health care industry. Health Plan may have engaged in telephone conversations and/or written letters to various federal, state, and local officials regarding matters which affected the healthcare industry as a whole. The amount of time and money involved in the activities is detailed on lines a through i. Health Plan has several employees and/or may retain a professional consultant to represent Health Plan's interests in various legislative and regulatory bodies and from time-to-time to keep informed of Federal and State legislation having an impact on Health Plan's charitable activities as an exempt Health Maintenance Organization. These individuals attempt to ensure that proposed legislation and enacted laws are compatible with the Interest of Health Plan and its members by performing the following activities: - Collecting, analyzing and distributing within the Organization, public and private policy recommendations regarding proposed legislation that affect the operation of Health Plan and its ability to provide quality health and medical care services to its members in a cost effective environment. - Providing appropriate informational materials to legislators and to their staffs that pertain to matters of common interest in the health care community and in the not-for-profit community. - Also by preparing written and oral testimony, these individuals appear at legislative hearings, monitor legislative proceedings and meet with legislators and/or their staffs regarding issues pertinent to the mission of Health Plan. Those individuals appearing at such hearings and meetings for and on behalf of Health Plan often are representing the interests of common interest groups as well as the interests of the members of Health Plan. - Other employees and officers perform services by delivering speeches at various public and private functions and in serving as faculty in healthcare related educational programs throughout the community. 977996046 977996046 23802033095 10975768748 12826264347 275925467 201858351 74067116 3656200927 2723934150 932266777 6923868586 4075283537 2848585049 17659179335 ABSOLUTE RETURN FUNDS 2163551361 F PRIVATE EQUITY FUNDS 4687895083 F RISK PARITY FUNDS 757451580 F 7608898024 0 DUE TO RELATED ENTITIES 5980740999 RESERVE FOR WORKERS COMP RISKS 435179253 RESERVE FOR PROF/PUBLIC LIAB 230490700 COMMERCIAL PAPER 768026402 POST RETIREMENT LIABILITIES 5673659243 OTHER LONG-TERM LIABILITIES 469305503 OTHER CURRENT LIABILITIES 82104294 BROKER PAYABLES 183245055 13822751449 Schedule D, Part X ASC 740 Footnote: The organization's financial statements do not include a footnote under ASC 740. true South America Investments 502238000 East Asia and the Pacific Investments 1723604000 Europe (Including Iceland and Greenland) Investments 789878000 Middle East and North Africa Investments 28728000 South Asia Investments 25738000 Sub-Saharan Africa Investments 23697000 Central America and the Caribbean Investments 5301613000 8395496000 8395496000 North America RSCRH GRANT 146112 East Asia and the Pacific RSRCH GRANT 30000 2 true false true false true false true true X true X 350. false true true true false true true 200071370 15071498 184999872 0.00800 1594232511 947038899 647193611 0.02810 47001053 45938072 1062981 0.00000 1841304934 1008048469 833256464 0.03610 41070048 41070048 0.00180 124977472 18667353 106310119 0.00460 104193074 72457574 31735500 0.00140 174110327 174110327 0.00760 444350921 91124927 353225994 0.01540 2285655855 1099173396 1186482458 0.05150 true 343146223 280780034 384124560 -103344526 X true true 42 1 KAISER FDN HOSPITAL - LOS ANGELES 4867 SUNSET BLVD LOS ANGELES CA 90027 http://www.kp.org 9300077 X X X X X A 2 KAISER FDN HOSPITAL- SAN DIEGO(ZION) 4647 ZION AVE SAN DIEGO CA 92120 http://www.kp.org 0800062 X X X X X A 3 KAISER FDN HOSP - SUNNYSIDE MED CTR 10180 SOUTHEAST SUNNYSIDE RD CLACKAMAS OR 97105 http://www.kp.org 1073 X X X X D 4 KAISER FOUNDATION HOSPITAL - FONTANA 9961 SIERRA AVE FONTANA CA 92335 http://www.kp.org 2400159 X X X X X A 5 KAISER FOUNDATION HOSPITAL- ROSEVILLE 1600 Eureka Rd Roseville CA 95661 http://www.kp.org 030000052 X X X X X A 6 KAISER FDN HOSPITAL - SANTA CLARA 700 LAWRENCE EXPRESSWAY SANTA CLARA CA 95051 http://www.kp.org 070000661 X X X X X A 7 KAISER FOUNDATION HOSPITAL - OAKLAND 275 W MACARTHUR BLVD OAKLAND CA 94611 http://www.kp.org 140000052 X X X X X A 8 KAISER FOUNDATION HOSPITAL - DOWNEY 9333 IMPERIAL HIGHWAY DOWNEY CA 90242 http://www.kp.org 930000078 X X X X X A 9 KAISER FOUNDATION HOSPITAL - HONOLULU 3288 MOANALUA RD HONOLULU HI 96819 http://www.kp.org OHCA#31-H X X X X E 10 KAISER FDN HOSPITAL - SAN FRANCISCO 2425 GEARY BLVD SAN FRANCISCO CA 94115 http://www.kp.org 220000188 X X X X X A 11 KAISER FOUNDATION HOSPITAL - ANAHEIM 3340 E LA PALMA AVE ANAHEIM CA 92806 http://www.kp.org 0600091 X X X X X A 12 KAISER FOUNDATION HOSPITAL - VALLEJO 975 SERENO DR VALLEJO CA 94589 http://www.kp.org 110000026 X X X X X A 13 KAISER FDN HOSPITAL- SOUTH SACRAMENTO 6600 BRUCEVILLE RD SOUTH SACRAMENTO CA 95823 http://www.kp.org 030000228 X X X X X A 14 KAISER FDN HOSPITAL - WALNUT CREEK 1425 S MAIN ST WALNUT CREEK CA 94596 http://www.kp.org 140000290 X X X X X A 15 KAISER FDN HOSPITAL - SACRAMENTO 2025 MORSE AVE SACRAMENTO CA 95825 http://www.kp.org 030000052 X X X X X A 16 KAISER FOUNDATION HOSPITAL- RIVERSIDE 10800 MAGNOLIA AVE RIVERSIDE CA 92505 http://www.kp.org 2500327 X X X X X B 17 KAISER FOUNDATION HOSPITAL - ONTARIO 2295 S VINEYARD AVE ONTARIO CA 91761 http://www.kp.org 240000159 X X X X X A 18 KAISER FDN HOSPITAL - SAN LEANDRO 2500 MERCED ST SAN LEANDRO CA 94577 http://www.kp.org 550002678 X X X X X A 19 KAISER FOUNDATION HOSPITAL - SAN JOSE 250 HOSPITAL PARKWAY SAN JOSE CA 95119 http://www.kp.org 070000117 X X X X X A 20 KAISER FDN HOSPITAL - BALDWIN PARK 1011 BALDWIN PARK BLVD BALDWIN PARK CA 91706 http://www.kp.org 9300920 X X X X X B 21 KAISER FOUNDATION HOSPITAL - IRVINE 6640 ALTON PARKWAY IRVINE CA 92618 http://www.kp.org 06000091 X X X X X A 22 KAISER FDN HOSPITAL - SOUTH BAY 25825 S VERMONT AVE HARBOR CITY CA 90710 http://www.kp.org 9300079 X X X X X A 23 KAISER FDN HOSPITAL - SANTA ROSA 401 BICENTENNIAL WAY SANTA ROSA CA 95403 http://www.kp.org 110000213 X X X X X A 24 KAISER FDN HOSPITAL - WOODLAND HILLS 5601 DE SOTO AVE WOODLAND HILLS CA 91367 http://www.kp.org 9300358 X X X X X B 25 KAISER FOUNDATION HOSPITAL - MODESTO 4601 DALE RD MODESTO CA 95356 http://www.kp.org 030000393 X X X X X A 26 KAISER FOUNDATION HOSPITAL - FRESNO 7300 N FRESNO ST FRESNO CA 93720 http://www.kp.org 040000384 X X X X X A 27 KAISER FDN HOSPITAL - REDWOOD CITY 1100 VETERANS BLVD REDWOOD CITY CA 94063 http://www.kp.org 220000021 X X X X X A 28 KAISER FDN HOSPITAL - PANORAMA CITY 13652 CANTARA ST PANORAMA CITY CA 91402 http://www.kp.org 9300080 X X X X X B 29 KAISER WESTSIDE MEDICAL CENTER 2875 NW STUCKI ROAD HILLSBORO OR 97124 http://www.kp.org 14-1472 X X X X D 30 KAISER FDN HOSPITAL - W LOS ANGELES 6041 CADILLAC AVE LOS ANGELES CA 90034 http://www.kp.org 9300081 X X X X X B 31 KAISER FOUNDATION HOSPITAL- VACAVILLE 1 QUALITY DR VACAVILLE CA 95688 http://www.kp.org 550001207 X X X X X A 32 KAISER FOUNDATION HOSPITAL - ANTIOCH 4501 SAND CREEK RD ANTIOCH CA 94531 http://www.kp.org 550000614 X X X X X A 33 MAUI MEMORIAL MEDICAL CENTER 221 Mahalani Street Wailuku HI 96793 mauihealthsystem.org 3-H X X X C 34 KAISER FDN HOSP - SOUTH SAN FRANCISCO 1200 EL CAMINO REAL SOUTH SAN FRANCISCO CA 94080 http://www.kp.org 220000022 X X X X X A 35 KAISER FDN HOSPITAL - SAN RAFAEL 99 MONTECILLO RD SAN RAFAEL CA 94903 http://www.kp.org 110000357 X X X X X A 36 KAISER FOUNDATION HOSPITAL - RICHMOND 901 NEVIN ST RICHMOND CA 94801 http://www.kp.org 140000052 X X X X X A 37 KAISER FOUNDATION HOSPITAL - FREMONT 39400 PASEO PADRE PARKWAY FREMONT CA 94538 http://www.kp.org 140000053 X X X X X A 38 KAISER FDN HOSPITAL - MORENO VALLEY 27300 IRIS AVE MORENO VALLEY CA 92555 http://www.kp.org 550000810 X X X X X B 39 KAISER FOUNDATION HOSPITAL - MANTECA 1777 W YOSEMITE AVE MANTECA CA 95336 http://www.kp.org 030000393 X X X X X A 40 KULA HOSPITAL 100 Keokea Place Kula HI 96790 mauihealthsystem.org 25-H X X X X C 41 LANAI COMMUNITY HOSPITAL 628 SEVENTH STREET LANAI CITY HI 96763 mauihealthsystem.org 28-H X X X X C 42 KAISER FDN HOSPITAL - SAN DIEGO 9455 CLAIREMOMT MESA BLVD SAN DIEGO CA 92123 http://www.kp.org 080000062 X X X X X A A-30 Facilities - See Part V Sec C false false true X X X X X X X X X 16 true true true true X http://www.kp.org/chna X true 16 true http://www.kp.org/chna false true X 350. 0. X true true X X X X true X http://www.kp.org/mfa/ X http://www.kp.org/mfa/ X http://www.kp.org/mfa/ X X X X X X X true X false X X X X true X false false B-6 FACILITIES - SEE PART V SEC C false false true X X X X X X X X X 16 true true false true X http://www.kp.org/chna X true 16 true http://www.kp.org/chna false true X 350. 0. X true true X X X X true X http://www.kp.org/mfa/ X http://www.kp.org/mfa/ X http://www.kp.org/mfa/ X X X X X X X true X false X X X X true X false false C-3 Facilities - See Part V Sec C false true false false true X 250. 0. X true true X X X X true X https://www.mauihealthsystem.org/ X https://www.mauihealthsystem.org/ X www.mauihealthsystem.org X X X X X X X true X false X X X X true X false false D-2 Facilities See Part V Sec C false false true X X X X X X X X X 16 true true true true X http://www.kp.org/chna X true 16 true http://www.kp.org/chna false true X 300. 0. X true true X X X X true X http://www.kp.org/mfa/ X http://www.kp.org/mfa/ X http://www.kp.org/mfa/ X X X X X X true X false X X X X X true X false false E-1 Facility See Part V Sec C false false true X X X X X X X X X 16 true true true true X http://www.kp.org/chna X true 16 true http://www.kp.org/chna false true X 400. 0. X true true X X X X true X http://www.kp.org/mfa/ X http://www.kp.org/mfa/ X http://www.kp.org/mfa/ X X X X X X X true X false X X X X X true X false false A, 1, KFH - LOS ANGELES EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, non-traditional stakeholders representing affordable housing development, banking, business, community capital development, disaster preparedness, government real estate, land use, property management, public utility and transportation also provided input. LINE 6A: Cedars-Sinai Medical Center LINE 6B: ChapCare Medical and Dental Health Center, the Hollywood Chamber of Commerce, and The Wellness Center LINE 11: A. Access to Care Support the provision of high quality health care (including preventive services and specialty care) for underserved populations. As part of the largest non-profit health system, KFH Los Angeles participates in government-sponsored programs for low-income individuals (i.e. Medi-Cal Managed Care and Medi-Cal Fee-For-Service), provides access and comprehensive health care to low-income individuals and families who do not have access to public or private health coverage through charitable health coverage, and provides financial assistance to low-income individuals who receive care at KFH facilities and cant afford medical expenses and/or cost sharing. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to share information about what works in improving access to health care for the underserved. Leverage Kaiser Permanente assets to drive coverage and access to health care for the underserved; Build the capacity of the primary care workforce and improve appropriate utilization of health care services. - KFH-Los Angeles will continue to support Eisner Pediatric & Family Medical Center with the engagement of KFH-Los Angeles Pediatric Community Fellow and residents and by providing specialty care consults and services to un/underinsured pediatric patients (15 -20 patients per year). - To address access to care for the homeless and underserved population, KFH-Los Angeles radiologists will continue to read over 2,000 x-rays from the JWCH Wesley Health Center Clinic annually. - KFH-Los Angeles will continue to support KHEIR Community Clinics primary and specialty care hub by having physician specialists (Dermatology, Ophthalmology, Sleep Medicine, Neurology) and Internal Medicines Community Medicine Fellows and residents volunteer their time. B. Obesity/HEAL/Diabetes Support programs that improve referral of patients to evidenced-based health promotion programs that teach self-management and empowerment techniques for chronic disease management and prevention. Support multi-level, multi component initiatives in school settings to produce significant and measurable impact on the health of students, staff and teachers in K-12 schools within communities. Examples for these strategies include: - KFH-Los Angeles Family Medicine and Pediatrics Community Medicine Fellows continued participation in obesity/overweight and diabetes prevention at Belmont and Hollywood Highs Wellness Centers and help develop STEM-related curriculum to other local LAUSD schools. - KFH-Los Angeles Pediatric and Family Medicine Community Medicine Fellows participation in Belmont and Hollywood Highs Student Wellness Councils to promote healthy eating active, living practices and policies within a school environment and surrounding school community by the provision of health education materials. - Thriving Schools Initiative, a community based effort to improve healthy eating, physical activity and school climate in K-12 schools in Kaiser Permanentes service areas, primarily through a focus on policy, systems and environmental changes that support healthy choices and a positive school climate. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to build the field of healthy eating and active living. For example, KFH-Los Angeles partnership pilot program with The Wellness Center at the Historic General Hospital (LAC+USC) to provide free healthy eating cooking classes and diabetes/overweight prevention health education to members and non-members living in East Los Angeles. Leverage Kaiser Permanente assets to drive community health, including healthy eating and active living and champion organizational practice changes within Kaiser Permanente that promote health. C. Mental and Behavioral Health Support place-based and multi-sector collaborative efforts that support mental health and behavioral health. As an example, KFH-Los Angeles Community Benefit Manager will continue to participate in the Executive Committee of the East Hollywood/Los Feliz Homeless Coalition (ELFH), the Saban Community Clinic Strategic Planning Committee and in other homeless collaboratives such as: Hollywood4WRD and the Los Angeles County Department of Mental Healths Hollywood Health Neighborhood. Support integration of health care with community-based mental health services. One way KFH Los Angeles will address this strategy is to consider the possibility of providing Kaiser Permanente Health Education classes related to mental and behavioral health to community members at KFH Los Angeles Medical Center Campus, Medical Office Buildings, and in community settings. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to share information about what works in improving behavioral and mental health and to build the field. KFH-Los Angeles will continue to partner with JWCH Wesley Health Center to support the Emergency Department Embedded Homeless Navigator to link homeless individuals to primary, mental health, behavioral health and other homeless supportive services. In addition, KFH-Los Angeles will continue to provide funding to support the integration of health care with community-based community clinics and provide health education materials and/or classes to community partners engaged in the identification and prevention of mental health illness. Leverage Kaiser Permanente assets to drive community health and champion organizational practice changes within Kaiser Permanente that promote mental and behavioral health. D. Sexually Transmitted Infections Support programs that improve referral of patients to evidence-based health promotion programs that teach self-management and empowerment techniques for STI/HIV management and prevention. KFH-Los Angeles will continue to promote and provide community health education materials, resources and technical training (as appropriate) to community clinics, mental health/counseling centers, and community-based organizations to promote healthy living and the prevention and treatment of sexually-transmitted diseases and/or HIV. Support the provision of high quality health care including preventive services and specialty care for underserved populations. - KFH-Los Angeles will continue to engage its Pediatrics, Family Medicine and Internal Medicine Community Medicine Fellows and residents with community clinics and school-based Wellness Centers to promote healthy lifestyles, including responsible sexual health and prevention of sexually transmitted infections/HIV to at risk youth. - Through its local grant-making and sponsorships, KFH-Los Angeles will continue to support community-based organizations and/or community clinics serving the LGBTQ individuals, homeless youth and adults, and other at-risk populations. Community partners include but not limited to: Latino Equality Alliance, The LGBT Center, TransLatin@ Coalition, Bienestar Human Services, The Wall/Las Memorias, AIDS Project Los Angeles, Planned Parenthood Los Angeles, CHAPCare, Covenant House, St. Johns Well Child & Family Center, Saban Community Clinic, JWCH Wesley Health Center). The health needs that KFH Los Angeles does not intend to directly address are: asthma, cancer, cardiovascular disease, community safety and oral health. A majority of these needs were deemed to be of relatively lower need. Additionally, existing community resources were also considered, and KFH Los Angeles will focus on health needs that can be most effectively addressed given the assets available. The core planning team was involved in this process and these needs were deemed to have lower magnitude and severity ratings. Finally, during the CHNA process, community members ranked health needs, and asthma, cancer, safety, cardiovascular disease, and oral health were in the bottom half of the final list of priori A, 2, KFH-SAN DIEGO (ZION) & A, 42 KFH-SAN DIEGO PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members through the use of key informant interviews, discussions/focus groups, and surveys. Individuals with the knowledge, information, and expertise relevant to the health needs within the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, when applicable, other individuals with expertise of local health needs were consulted. LINE 6A: Kaiser Foundation Hospital - San Diego, Palomar Health, Palomar Medical Center, Palomar Health Downtown Campus, Pomerado Hospital, Rady Children's Hospital , Rady Children's Hospital - San Diego, Scripps Health, Scripps Memorial Hospital La Jolla, Scripps Mercy Hospital, Scripps Green Hospital, Scripps Memorial Hospital Encinitas, Scripps Mercy Hospital Chula Vista, Sharp HealthCare, Sharp Chula Vista Medical Center, Sharp Coronado Hospital, Sharp Grossmont Hospital, Sharp Mary Birch Hospital , Sharp McDonald Center, Sharp Memorial Hospital, Sharp Mesa Vista Hospital, Tri-City Medical Center, Tri-City Medical Center, UCSD Medical Center, UCSD Thornton Hospital, UCSD Hillcrest. LINE 6B: 2-1-1 San Diego, San Diego County Health and Human Services Agency, Resident Leadership Academy, North County Health Services, Palomar Health Community Action CounciL - TODAY Program. LINE 11: A. Obesity/Diabetes Long-term Goal All Community Members eat healthy and move more as part of daily life. Intermediate Goals - Improve access to opportunities for physical activity in the community. - Improve access to healthy food options in the community. - Improve linkages between health care services and community-level services. Strategies - Support multi-level, multi-component initiatives in community settings to support access to healthy, affordable food and activity-promoting environments. - Support local governments, schools and/or community based organizations to provide healthy food options (including accessible drinking water) and to adopt healthy food policies, including procurement practices. - Support local governments, schools and/or community based organizations to enroll community members into available food programs, most importantly Afresh and the Supplemental Food Program for Women, Infants, and Children (WIC); Promote use of Cal Fresh and WIC benefits at farmer's markets for purchasing fresh fruits and vegetables. - Support policies that prioritize underserved neighborhoods for park investments and encourage communities to use parks to their full potential. Expected Outcomes - Adoption and implementation of policies and environments that increase availability and enable access to healthy food (including fresh produce and safe drinking water) and/or physical activity. - Reduced availability and marketing of unhealthy foods and beverages, including sugar-sweetened beverages. - Increased enrollment and use of federal food programs. - Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to collaborate and to promote policy, system and environmental change. B. Cardiovascular Disease Long-term Goal Improve cardiovascular health and quality of life through prevention, detection, and treatment of risk factors for heart attack and stroke. Intermediate Goals - Improve clinical system processes to enable the delivery of quality health care services that address CVD. - Improve linkages between health care services and community-level services to address CVD. - Improve patient access to CVD preventive services including affordable medications and behavioral counseling and support. - Improve access to healthy eating and physical activity opportunities among those with or at risk of CVD. Strategies - Support programs that improve referral of patients to evidence-based health promotion programs that teach self-management and empowerment techniques for chronic disease management and prevention. - Support new and improved policies and environments that support active transportation and physical activity (e.g. safe pedestrian bicycle routes). - Increase healthy eating and active living among vulnerable populations by supporting programs that focus on wellness and promote healthy food choices and exercise. - Support community based initiatives that promote cardiovascular screenings, health and wellness checkup and increase care management related to patient care for vulnerable populations. Expected Outcomes - Improved referrals and coordination between healthcare providers and community resources and programs to address the medical and social needs of at-risk CVD patients. - Improved clinical systems and processes to support CVD population health management (panel management, team based-care, QI infrastructure, data-based decision making, supportive leadership and culture). - Adoption and implementation of policies and environments that increase availability and enable access to healthy food (including fresh produce and safe drinking water) and/or physical activity. - Improved patient assessment and care for chronic conditions (obesity, diabetes, and/or heart disease) and social non-medical needs by healthcare providers. - Improved referrals and coordination between healthcare providers and community resources and programs. - Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to collaborate and to promote policy, system and environmental change. C. Behavioral/Mental Health Long-term Goal All community members have optimal levels of mental health and well-being and access to high quality mental and behavioral health care services when needed. Intermediate Goals - Improve the knowledge, capacity and infrastructure of health care, organizations and communities to address mental and behavioral health. - Promote positive mental health by fostering community cohesion and social and emotional support. Strategies - Support community based initiatives that promote positive mental health by fostering community connection to one's neighbors and participation in local activities and create access to safe local public spaces where people can congregate. - Support integration of healthcare with community-based mental health services, such as: increase patient navigators and case managers who can help patients access services, strengthening of referral networks, and/or co-location of services between primary care and mental health providers. - Support school and youth development organizations in learning about and addressing mental and behavioral health, including suicide prevention and trauma-informed care. - Enhance access to high quality substance abuse treatment including medication-assisted treatments to decrease the burden of addiction and promote resiliency and recovery. Expected Outcomes - Increased access (availability and affordability) of mental and behavioral health services in healthcare and community settings. - Improved screening and identification of mental and behavioral needs among patients. - Improved referrals and coordination between healthcare providers and community resources and programs. - Improved community cohesion, networks and social support. - Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to address mental and behavioral health. The 2016 KFH San Diego CHNA process focused on compiling additional data--both primary and secondary--to better understand and confirm the priority Health Needs first identified in 2013. Through the CHNA process, stakeholders affirmed that Obesity, Diabetes, Cardiovascular Disease and Behavioral/Mental Health persisted as the most pressing Health Needs in 2016. At the same time, stakeholders recommended that Obesity and Diabetes be combined into one Health Need, and that Behavioral/Mental Health become the first priority. Therefore, in 2016, there were no Health Needs considered by the Implementation Strategy Engagement Team (ISET) committee that were subsequently excluded from the KFH San Diego Community Benefits Implementation Strategy. LINE 13A: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. LINE 13H: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. KFHP MEMBERS WHO HAVE A DEDUCTIBLE MUST HAVE INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD D, 3, Kaiser Sunnyside Med Ctr Explanations PART V, SECTION B. ********************************************************************** LINE 5: Community input from across the primary and secondary service areas was incorporated into the CHNA process to identify and prioritize health needs. KPNW staff accounted for community input as part of the CHNA process in the following ways: - Identifying existing sources of primary data/community input (within 3 years prior to CHNA). - Participating in a regional collaboratives community health assessment process. - Conducting 29 community listening sessions and collecting 3000 surveys through the collaborative. - Community input informed the CHNA process across the KPNW region, but the sources and methodology varied across the primary and secondary hospital service areas. Line 6a: KFH Westside and KFH Sunnyside conducted a joint CHNA. Both KFH hospitals share the same primary service area. line 6b: KFH Hospitals helped found and has participated in the development of Healthy Columbia Willamette, a collaborative effort including 15 area hospitals and health systems as well as four county health departments and two Coordinated Care Organizations (CCOs) Healthy Columbia Willamette was formed to support member organizations in responding to the new ACA federal requirements and to catalyze the collective efforts of health and public health leaders in the Portland metropolitan area to have coordinated and meaningful impact on the health of the region. KPNW Community Benefit staff contributes to the on-going assessment efforts of Healthy Columbia Willamette to expand Kaiser Permanentes community partnerships and improve community health in the Northwest region. Members of Healthy Columbia Willamette collaborative: - Adventist Medical Center - Legacy Health System (5 hospitals) - Oregon Health & Science University - PeaceHealth Southwest Medical Center - Providence Health (4 hospitals) - Tuality Community Hospital - Health Share of Oregon (CCO) - Familycare (CCO) - Clackamas County Public Health Division - Clark County Public Health Department - Multnomah County Health Department - Washington County Public Health Division Line 11: KFH hospitals prioritized and selected five health needs to address throughout our service area. Listed below are the five selected needs followed by a high-level description of the strategies we are currently implementing. For a full description of all of KFH hospitals health improvement strategies, please refer to the Implementation Strategy report. A. Access to care KFH Hospitals are primarily addressing access to care through Medicaid, Medical Financial Assistance, Charitable Health Coverage, and Community Access programs, as well as through grant funding to Safety Net clinics and contracted hospitals. B. Nutrition and physical activity related chronic disease KFH Hospitals are primarily addressing chronic disease through regional collaborations promoting healthy eating active living (HEAL) policies and behaviors, and a healthy food access grant initiative, and by awarding grants to community organizations that promote HEAL clinical and community activities. C. Oral health KFH Hospitals are primarily addressing oral health through Dental Medicaid, Dental Financial Assistance, and Charitable Health Coverage programs, as well as the through participation in an oral health funders collaborative and an oral health grant initiative providing supporting local organizations that provide oral health prevention and treatment services. D. Mental health KFH Hospitals are primarily addressing mental health through behavioral health grants and grant initiatives that support both prevention and treatment efforts in adult and school-aged children as well as partnering with Oregon Childrens theater to deliver Kaiser Permanentes Educational Theatre Program which serves children grades K-12 with programming to support health and well-being. E. Maternal and infant health KFH Hospitals are primarily addressing maternal and infant health through providing perinatal care through community access programs, awarding grants to programs that improve perinatal health or provide teen pregnancy prevention, and through collaborations to support and promote breastfeeding. The remaining prioritized health needs will not be addressed because using the criteria described previously, they were not ranked as highly as Nutrition and Physical Activity-related Chronic Disease, Maternal and Infant Health, Access to Health Care, Oral Health, and Mental Health. The region has a unique set of resources and capacity to dedicate to the five selected health needs. In addition, there are other strong community partners and networks who are currently addressing the needs below. The needs that will not be addressed are: - Economic security - Cancer - Tobacco use - Sexually transmitted disease - Injury line 13a: KP provides a 100% discount to all charity eligible patients regardless of whether they are uninsured or underinsured. The discount amount is not adjusted based on income level. line 13h: A patient of any household income level with incurred out-of-pocket medical and pharmacy expenses excluding medical insurance premiums for eligible services over a 12 month period greater than or equal to 10% of their annual household income is eligible for charity care. Line 16G: In 2018, KFH, through its ongoing internal compliance process, discovered that the direct website address (URL) where copies of the financial assistance policy (FAP), FAP application form, and plain language summary of the FAP (PLS) may be obtained was inadvertently not included on the billing statements for two of its forty-one hospital facilities, KFH Sunnyside and Westside Medical Center, as a result of a system update that impacted the billing statements. Upon discovery in February 2018, the billing statements for these two facilities were promptly updated (by March 2018) to include the URL. The billing statements otherwise provided patients with all other required information regarding the FAP for each facility and how to obtain information about the program or assistance in applying for financial assistance. Further, at all times the URL was made known to patients by including the URL on the PLS and providing the PLS to patients at intake or discharge as well as with at least one billing statement. KFH has also implemented processes to provide additional review for the content of billing statements following a system update. Line 16J: The FAP program materials are available on the KP website at www.kp.org//mfa/nw Line 20E: 1) Provided written notice on all patient statements informing patients that MFA is available for those who qualify. 2) Provided the PLS with first patient billing statement. A, 4, KFH - FONTANA EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided through the use of key informant interviews, focus groups, and/or surveys. Individuals with knowledge, information, and/or expertise relevant to the health needs of the community were consulted, including representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, non-traditional stakeholders representing business, chamber of commerce, community-based organizations, economic development, educational institutions, financial institutions, government, public safety, transportation and utility were also involved in providing input. Line 6a: Ontario Line 6b: Community Vital Signs Line 11: A. Mental and Behavioral Health Support evidence-based and promising family and youth development programs in school settings focused on conflict resolution, violence/bullying, mentoring, trauma, and/or suicide prevention. Programs can include 1) student assistance programs (Screening, Assessment, Referral, and Treatment-SAR, Positive Behavioral Interventions & Support; Trauma -Informed Care), 2) direct delivery of services, and 3) parenting education, social support to parents, and encouragement of positive parent-child interactions. KFH-Fontana will address mental health issues among youth by collaborating with the Fontana Unified School District, where the Kaiser Permanente Child and Adolescent Psychiatry staff and SCPMG residents will provide therapy to high school students to address Adverse Childhood Experiences. Support integration of healthcare with community-based mental health services, such as training of health care providers to identify mental and behavioral health needs, patient navigators who can help patients access services, strengthening of referral networks, and/or co-location of services between primary care and mental health providers. KFH-Fontana will address mental health issues by providing grant support to El Sol Neighborhood Center to enable promotores de salud to educate the broader community about the issue, link to services, and stress the importance of seeking care in San Bernardino. Support prevention efforts to increase community awareness and educate youth and adults about the dangers of substance abuse, prescription drugs (including sharing, proper disposal, unintentional overdose, etc.) across school districts and universities. KFH-Fontana will address mental health issues by partnering with the Fontana Unified School District, where the Kaiser Permanente Chemical Dependency Recovery Program and the SCPMG Adolescent Chemical Dependency Ph.D Coordinator will provide substance abuse education by speaking with adolescents and their parents and linking them to substance abuse community resources. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to share information about what works in improving behavioral and mental health and to build the field. KFH-Fontana will address mental health issues by collaborating with the National Alliance on Mental Illness (NAMI) San Bernardino Chapter through grant funding support. KFH-Fontana will also explore the opportunity to provide hospital conference room space to NAMI to hold Family Support meetings for those living with a mental health disorder at no cost to community. B. Economic Security Support educational attainment programs focused on: 1) High School dropout prevention; 3) Mentoring for students at-risk, homeless, foster care; 4) College enrollment; 5) Health care workforce pipeline 5) Science, Technology, Engineering, and Mathematics (STEM). KFH-Fontana Human Resources liaison is member of the Inland Health Professions Coalition, which brings K-12, community college and university faculty, hospital and health care agency representatives, county office of education staff, and professional organization and community agency representatives together to identify and facilitate solutions to the educational, social and environmental barriers to enable a seamless health pipeline. Support employment programs focused on: 1) Employment skills development, education, and training through career-employment bridge programs, transitional employment programs (time-limited, subsidized, paid jobs) as a bridge to unsubsidized employment, on-the-job training. KFH-Fontana will address economic security issues by partnering with the San Bernardino City Unified School District, where Kaiser Permanente Human Resources Director will provide Employment Workshops to parents of students from Arroyo High School to facilitate career exploration, writing a cover letter/resume, including job search techniques. Support programs that focus on 1) Shelter/housing for homeless; 2) rapid re-housing or 3) tenant-based rental assistance for low-income families to create a path to more housing options, to include intake of all needs, case management, and follow -up. KFH-Fontana will address economic security by providing grant support to homeless service providers from throughout San Bernardino County. Participate and support a countywide cross-sector Housing Policy Council to focus on affordable housing and community development issues. KFH-Fontana serves on the San Bernardino County Interagency Council on Homelessness, where a nonprofit hospital is represented for the first time. Support cities, schools, community based organizations to provide healthy food options (including fruits/vegetables, accessible drinking water) and to adopt healthy food policies, including procurement practices. Enroll community members into available food programs (i.e. Cal Fresh and Supplemental Food Program for Women, Infants, and Children (WIC)). KFH-Fontana will address economic security by providing grant support to Healthy Cities to set up and accept Cal Fresh and WIC benefits to enable community to obtain fresh fruits and vegetables at Farmer's Markets. Support community-based organizations and networks to build their capacity to advance economic security. KFH-Fontana Community Benefit liaison is member of the High Desert Food Collaborative, which will ensure 30 food providers create synergy, communication channels to mutually tap into coordinated equipment/distribution resources, share food surplus, share best practices and explore opportunities for joint funding to better respond to the food security needs in the High Desert Region. Support efforts to assess upstream social and basic needs and coordinate with community based organizations. KFH-Fontana will address economic security issues by partnering with social service, housing, transportation, and food security nonprofits to screen low income residents in response to non-medical social needs and link to basic needs through the Kaiser Permanente Health Leads Program. C. Access to Care Support the provision of high quality health care (including preventive services and specialty care) for underserved populations. As part of the largest non-profit health system, KFH-Fontana participates in government-sponsored programs for low-income individuals (i.e. Medi-Cal Managed Care and Medi-Cal Fee-For-Service), provide access and comprehensive health care to low-income individuals and families who do not have access to public or private health coverage through charitable health coverage, and provide financial assistance to low-income individuals who receive care at KP facilities and can't afford medical expenses and/or cost sharing. Explore opportunities between hospitals and safety net community clinic providers to reduce hospital readmissions (follow up appointments to community clinics upon discharge). KFH-Fontana Community Benefit liaison is member of the Community Clinic Association of San Bernardino County, which supports community clinics to efficiently deliver culturally appropriate quality healthcare to the medically indigent, underserved, uninsured and/or underinsured. Support solutions that address the health care needs of people who do not qualify for low-cost or no-cost health insurance such as a) outreach, enrollment, and retention efforts to increase access to health care coverage and b) use of Community Health Workers to connect residents to medical homes, onboarding / orientation for new patient members, including education about patient centered medical home concept and how to access clinical preventive services. KFH-Fontana will address access to care by providing grant support to SAC Health Systems, Bloomington Community Health Center, Lestonnac Free Clinic, Al Shifa Free Clinic, and Well of Healing Mobile Medical Clinic. Support the provision of high quality healthcare (including preventive services and specialty care) for underserved populations including education on use of A, 5, KFH - ROSEVILLE EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from the local public health department as well as leaders, representatives, and members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. Primary data collection began with interviews with hospital service representatives and interviews of area health experts such as public health and social service representatives. The primary data collected from the first phase of interviews, including initial analysis of socio-demographic data, identified Focus Communities within the KFH-Roseville service area. These identified Focus Communities were then used to help inform a second phase of data collection which included additional key informant interviews and Focus Groups with medically-underserved, low-income and minority populations where additional data collection was needed. Line 6a: - Dignity Health: Mercy General Hospital, Mercy Hospital of Folsom, Mercy San Juan Medical Center, Methodist Hospital of Sacramento, Sierra Nevada Memorial Hospital, Woodland Memorial Hospital. - Kaiser Permanente of Greater Sacramento: KFH Roseville, KFH Sacramento, KFH South Sacramento. - Sutter Health Sacramento Sierra Region: Sutter Auburn Faith Hospital, Sutter Center for Psychiatry, Sutter Davis Hospital, Sutter Medical Center - Sacramento, Sutter Roseville Medical Center). - UC Davis Health System. Line 6b: Numerous partner organizations contributed to the CHNA. In particular, the following local health departments contributed data that were used in the CHNA reports: El Dorado County Health and Human Services Agency; Placer County Health and Human Services; Sacramento County Health and Human Services; and Yolo County Health and Human Services. Over 35 organizations assisted the KFH-Roseville CHNA process through participation in key informant interviews or focus groups. Line 11: As part of the Kaiser Permanente integrated health system, KFH Roseville has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems - Address federal, state, or local public health priorities - Leverage or enhance public health department activities - Advance increased general knowledge through education or research that benefits the public - Otherwise would not become the responsibility of government or another tax-exempt organization KFH Roseville is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Roseville welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Roseville will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. Access to Care Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low income and vulnerable populations. - Develop a diverse, well-trained health care workforce that provides culturally sensitive health care. Strategies - Provide high-quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and can't afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For Example, - Participate in Medi-Cal Managed care. - Provide subsidized health care coverage to children (18 & under) in low-income families (up to 300% FPL) who lack access to other sources of coverage. - Provide Medical Financial Assistance. - Participate in Placer Community Health Initiative to strengthen Placer County's public health system through conducting health assessments, developing improvement plans, and supporting strategic planning. - Provide grants for transportation to medical appointments. - Support organizations that provide navigation to free and reduced cost services for specialty care. - Provide physician and KP staff volunteers at events that provide surgical, specialty, and diagnostic services to low-income, uninsured people. - Support population health management approaches that Improve health outcomes for safety net patients with diabetes and hypertension. - Support community health centers and public hospital organizations to participate successfully in waiver and demonstration programs moving from fee for service to capitation. - Provide grants for a behavioral health navigation program to help clients access services. - Provide grants for programs to connect frequent users of the Emergency Department with case management support services and community resources. - Implement health care workforce pipeline programs to introduce diverse, underrepresented school age youth and college students to health careers. - Support successful recruitment and retention efforts to address workforce shortages in the health care safety net. Expected Outcomes Access - Increase in the number of low-income patients who receive health care services/coverage. - Increase in the number of low-income patients that enroll in health care coverage programs. Capacity of healthy systems - Increase in the quality of care provided by safety net providers through PHASE protocol. - Improve capacity of health systems to provide population health management. - Increased integration of primary and specialty health care services. - Improved capacity of safety net providers to assuming capitated risk. Social non-medical services - Increase in referrals and coordination to social non-medical services. - Increased enrollment and participation in public benefit programs. Workforce - Increase in the number of people from underrepresented groups enrolling in education and job training programs. - Increase in the number of culturally and linguistically competent and skilled healthcare providers. B. Healthy Eating Active Living Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g. obesity, diabetes, CVD). Intermediate Goals - Improve healthy eating among residents in low income, under-resourced communities. - Increase physical activity among residents in low income, under-resourced communities. Strategies - Increase access to healthy, affordable foods, including fresh produce, and decrease access to u 2016 Needs Not Selected and Rationale A. Disease Prevention and Management Disease Prevention and Management was a lower priority compared to other needs during the IS prioritization processes. It scored lower than the selected needs on ability to leverage organizational assets and feasibility. Some of the HEAL and Behavioral Health strategies will address disease prevention (obesity, heart disease, stroke, diabetes). B. Pollution-free Environments Pollution-free Environments was a low priority compared to other needs in both the CHNA and IS prioritization processes. It scored low on all criteria used during prioritization. C. Affordable and accessible transportation Transportation was a low priority compared to other needs in both the CHNA and IS prioritization processes. There is a lack of internal and external resources to leverage in this area. It scored low on all criteria used during prioritization. D. Basic Needs (Economic Security) Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Roseville. Economic security was a low priority compared to other needs in the IS prioritization process. It scored low in CHNA prioritization, KP expertise and feasibility and lower than the selected needs in existing or promising approaches and ability to leverage organizational assets. While KFH Roseville did not select this need, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL A, 6, KFH - Santa Clara EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: The Coalition contracted with Applied Survey Research (ASR) to conduct the primary research. Community input was provided by a broad range of community members through the use of key informant interviews, focus groups and surveys. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. In all, ASR gathered community input from 162 individuals through a survey, focus groups, and individual interviews. In all, ASR solicited input from over 120 community leaders and representatives of various organizations and sectors. These representatives either work in the health field or improve health conditions by serving those from the target populations. Multiple community leaders participated from each of these types of agencies: - Santa Clara County Public Health Department and Behavioral Health Services - Santa Clara Valley Medical Center (County) clinics - Hospitals and healthcare systems- Health insurance providers - Mental/behavioral health or violence prevention providers - School systems - Nonprofit community-based organizations serving children, youth, seniors, parents, immigrants, those experiencing homelessness, and those suffering from dementia, mental health and substance use disorders. Many of these leaders and representatives participated in key informant interviews or focus groups, and others participated in an online survey. Line 6a: - El Camino Hospital - Kaiser Permanente South Bay (Santa Clara and San Jose Kaiser Foundation Hospitals) - Lucile Packard Children's Hospital Stanford - O'Connor Hospital - Stanford Health Care - Saint Louise Regional Hospital - Santa Clara County Public Health Department - Sutter Health Line 6b: The Coalition includes partners representing the Santa Clara County Public Health Department, the Hospital Council of Northern & Central California, and the Palo Alto Medical Foundation (PAMF). Line 11: As part of the Kaiser Permanente integrated health system, KFH Santa Clara has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Santa Clara is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Santa Clara welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Santa Clara will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. BEHAVIORAL HEALTH Long-term Goal All community members experience social/emotional health and wellbeing and have access to high-quality behavioral health care services when needed. Intermediate Goals - Expand prevention and support services for mild to moderate behavioral health conditions. - Decrease stigma associated with seeking behavioral health services among vulnerable and diverse populations. - Develop a diverse, well-trained behavioral health care workforce that provides culturally sensitive behavioral health care. - Increase access to culturally and linguistically appropriate behavioral health services for vulnerable and low-income populations. Strategies Prevention strategies: - Provide screening and identification related to behavioral health needs among low-income, vulnerable, and uninsured populations and connect them with the appropriate services or support. - Support opportunities to prevent and reduce the misuse of drugs and alcohol. - Provide access to programs, services or environments that evidence suggests improves overall social/emotional wellness. Destigmatization strategies: - Support opportunities to reduce stigma through education and outreach in school, community and workforce settings. Workforce strategies: - Support the recruitment, hiring and retention of a diverse, culturally competent behavioral health care workforce in the clinical and community-based settings. - Increase access to training and education for diverse populations currently underrepresented in the behavioral health care workforce. Access strategies: - Provide high-quality behavioral health care to Medi-Cal participants. - Promote integration of care between primary and behavioral health care. - Improve navigation to appropriate care within the health care system and support services in the community. - Increase the capacity to respond appropriately to individuals and/or communities that have experienced trauma and/or violence. Examples: - Provide grants for programs providing early childhood screening for developmental delays and behavioral problems. - Provide grants to addiction education or programs for youth to prevent and reduce the misuse of alcohol, tobacco, and marijuana use. - Provide grants to support substance abuse prevention and treatment programs for youth and families and aggression-reducing programs focused on skill-building. - Provide grants for behavioral health programs for homeless families. - Partner with community-based organizations to support behavioral health programs, services, and environments that reduce stress, anxiety, and/or depression. - Partner with Santa Clara County Public Health Department on trauma & violence. - Support community health workers who assist community members with obtaining appropriate services. - Provide KP's Educational Theater, programming that provides education in schools on health and wellness. - Mental health training program participants rotate through community clinics and other community based organizations to provide behavioral health services and training. Expected Outcomes Prevention: - Increased enrollment in programs to improve social/emotional wellness. - Increased screening for behavioral health needs. - Increased participation in drug and alcohol prevention programs. Destigmatization: - Increase in help-seeking behavior for accessing behavioral health care. Workforce: - Increase in the number of culturally and linguistically competent and skilled behavioral healthcare providers. - Increase in the number of people from underrepresented groups enrolling in education and job training programs. Access: - Increase in the number of low-income patients who receive behavioral health care services. - Increased integration of primary and behavioral health care services. - Improved access to quality care for youth, families and communities experiencing violence. B. COMMUNITY AND FAMILY SAFETY Long-term Goal All community members live in safe environments and individuals who are victims or at-risk of violence have the support they need. Intermediate Goals - Improve safety in communities with high rates of violence. - Support prevention and early intervention efforts targeting youth that promote positive youth development and that focus on youth assets and resilience. - Improve safety in families through family violence prevention, screening and treatment efforts. - Improve the quality of responsive care and services for youth and families experiencing violence and/or trauma to break the cycle of violence. Strategies Community safety strategies: - Increase availability of safe parks and public spaces. - Build social cohesion in neighborhoods and community. - Improve law enforcement and community relations. - Promote public understanding of violence as a public health issue. Preve 2016 Needs Not Selected and Rationale The Contributions Committee was careful to recommend a set of health needs that could make an impact in the community: Behavioral Health, Community and Family Safety, Health Care Access and Delivery, and Healthy Eating, Active Living. Therefore, the remaining health needs for this area (listed below in alphabetical order) will not be addressed by KFH Santa Clara, because these needs did not meet the criteria to the same extent that the chosen needs did, and more specifically for the following reasons. A. Birth Outcomes Improving the well-being of mothers, infants, and children is an important public health goal. The topic area of birth outcomes addresses a wide range of conditions, health behaviors, and health systems indicators that affect the health, wellness, and quality of life of women, children, and families. The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality preconception (before pregnancy) and interconception (between pregnancies) care. Birth outcomes were not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. KFH Santa Clara is better positioned to address this need from a prevention standpoint via healthcare access and delivery strategies and via strategies related to healthy eating and active living. B. Cancer Cancer is the second most common cause of death in the United States. Behavioral and environmental factors play a large role in reducing the nation's cancer burden, along with the availability and accessibility of high-quality screening. KFH Santa Clara is better positioned to address drivers of cancer via strategies related to healthy eating and active living, and ethnic disparities in cancer incidence and mortality rates via healthcare access and delivery strategies. C. Cardiovascular (Heart /Stroke) Nationally, more than one in three adults (81.1 million) lives with one or more types of cardiovascular disease. In addition to being the first and third leading causes of death in the U.S., heart disease and stroke result in serious illness and disability, decreased quality of life, and hundreds of billions of dollars in economic loss every year. KFH Santa Clara is better positioned to address drivers of these needs via strategies related to healthy eating and active living. Kaiser Permanente believes that strategies intended to address the community's healthy eating and active living needs have the potential to decrease cardiovascular disease and stroke in the community as well. D. Communicable Diseases (Non-Sexually-Transmitted Infections) Communicable diseases remain a major cause of illness, disability, and death. Various public health agencies closely monitor communicable diseases to identify outbreaks and epidemics, provide preventive treatment and/or targeted education programs, and allocate resources effectively. Relatively few community resources were identified to address communicable diseases, providing fewer opportunities for leverage. This need is already being monitored and addressed by the county public health department. KFH Santa Clara believes that certain healthcare access and delivery strategies, such as screenings and vaccinations, have the potential to decrease communicable diseases in the community as well. E. Dementia & Alzheimer's Disease Alzheimer's disease is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Several factors determine the risk of developing dementia, including age and family history. Dementia and Alzheimer's disease were not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. Also, there were not many evidence-based strategies identified to address the need. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. KFH Santa Clara is better positioned to address this need from an early intervention standpoint via healthcare access and delivery strategies. F. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Santa Clara. While KFH Santa Clara did not select this need because the Contributions Committee believed it was much less feasible to address given the resources available, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Additionally, health care providers such as KFH Santa Clara have no control over the cost of housing in a thriving economy. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. G. Learning Disabilities Learning disabilities include attention deficit disorder (ADD) and attention deficit-hyperactivity disorder (ADHD), and identification on the autism spectrum. ADHD affects 3-7% of American children and often continues into adulthood, making it the most common developmental disorder. Learning disabilities were not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. Also, there were not many evidence-based strategies identified to address the need. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. KFH Santa Clara is better positioned to address this need from an early intervention standpoint via healthcare and non-medical social services access strategies. H. Respiratory Conditions Respiratory conditions include asthma, chronic obstructive pulmonary disorder (COPD), and others. Asthma in particular is considered a significant public health burden and its prevalence has been rising since 1980. Respiratory conditions were not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. Also, there were not many evidence-based strategies identified to address the need. In addition, few evidence-based strategies were identified that could be applied to this health need. KFH Santa Clara is better positioned to address asthma management via healthcare access and delivery strategies. I. Sexual Health Data indicate that rates of sexually-transmitted infections (STIs) and teen births in Santa Clara County are similar to California. However, disparities are pervasive and screening rates for HIV and other STIs are lower than the state. Communicable diseases such as sexually transmitted infections are closely monitored by various public health agencies to identify outbreaks and epidemics, provide preventive treatment and/or targeted education programs, and allocate resources effectively. Sexual health was not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. This need is already being monitored and addressed by the county public health department. KFH Santa Clara believes that certain healthcare access and delivery strategies, such as screenings and vaccinations, as well as increased cultural competency among providers, have the potential to improve sexual health in the community as well. J. Unintentional Injuries Unintentional injuries are defined as those that are not purposely inflicted. The most common unintentional injuries result from falls, motor vehicle crashes, poisonings, and drownings. Although most unintentional injuries are predictable and preventable, they are a major cause of premature death and lifelong disability. Unintentional injuries were not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. KFH Santa Clara is better positioned to address this need from a prevention standpoint via strategies related to active living. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10 A, 7, KFH - OAKLAND EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: The Hospitals contracted with Applied Survey Research (ASR) to conduct the primary research. Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. In all, ASR consulted with 39 professional community representatives of various organizations and sectors through 21 key informant interviews and two focus group (which included 18 participants). These representatives either work in the health field or improve health conditions by serving those from the target populations. In the list below, the number in parentheses indicates the number of participants from each sector. - County and City Public Health (8) - Other health centers or systems (9) - Mental/Behavioral health or violence prevention providers (6) - School system representatives (2) - City or county government representatives (1) - Nonprofit agencies providing basic needs (2) - Other nonprofit agencies serving children, seniors, veterans, and/or families (11) line 6a: - John Muir Health - Kaiser Foundation Hospital - Antioch - Kaiser Foundation Hospital - Walnut Creek - Kaiser Foundation Hospital - Richmond - Kaiser Foundation Hospital - Fremont - Kaiser Foundation Hospital - San Leandro - St. Rose Hospital - San Ramon Regional Hospital - Stanford Health Care - ValleyCare - UCSF Benioff Children's Hospital Oakland - Washington Hospital Healthcare System Line 6b: While there was no formal collaboration between the Hospitals and other organizations, the Hospitals invited representatives from the public health departments of the City of Berkeley, County of Alameda, and the County of Contra Costa to one of its first joint meetings. These representatives presented local public health data and shared about local efforts to improve health outcomes. The Hospitals discussed these issues with these public health representatives and increased their knowledge of the health needs in their respective communities. Line 11: As part of the Kaiser Permanente integrated health system, KFH Oakland has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Oakland is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Oakland welcomes future opportunities to enhance their strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Oakland will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. ACCESS TO CARE AND COVERAGE Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low-income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low-income and vulnerable populations. - Develop a diverse, well-trained health care workforce that provides culturally sensitive health care. Strategies Access strategies: - Provide high-quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and can't afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity of health systems strategies: - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social non-medical services strategies: - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. Workforce strategies: - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For example: - Participate in Medi-Cal Managed care. - Participate in Medi-Cal Fee for Service. - Provide subsidized health care coverage to children (18 & under) in low-income families (up to 300% FPL) who lack access to other sources of coverage. - Provide Medical Financial Assistance. - Support effort to improving health care access and utilization - Fund programs and/or providers to improve access to care for chronic health conditions (i.e. asthma, diabetes, comorbidities). - Fund programs and/or organizations to conduct targeted outreach and screening for chronic unmanaged health conditions specific to geographic area. - Fund safety net providers (e.g., community clinics) to expand & improve primary care access, navigation, & services. - Fund programs and/or organizations via local grants to provide case management and social services at health care centers. - Participate in Healthy Richmond Collaborative and Oakland and West Contra Costa Clinic Consortium. - Participate in Community Health Center Network (CHCN), a partnership of community health centers committed to enhancing our ability to provide comprehensive, quality health care in a manner respectful of community traditions and values. - Partner with Operation Access, a nonprofit dedicated to providing access to free surgery and specialty care, to enable KP medical volunteers to provide free outpatient consultations, specialty care, and same-day surgery appointments to uninsured patients. - Support via regional grants population health management approaches that improve health outcomes for safety net patients with diabetes and hypertension. - Support community health centers and public hospital organizations to participate successfully in waiver and demonstration programs moving from fee for service to capitation. - Support screening for social non-medical service needs and referrals to community services. - Support pilot demonstration projects with faith-based organizations to connect caregivers and patients with end of life planning and other services. - Support pathway programs to increase the diversity of the healthcare workforce by providing mentorship, academic enrichment, leadership development, and career exposure to disadvantaged and minority youth. - Support via programs that prepare under-represented students for success in the medical school application process. - Support successful recruitment and retention efforts to address workforce shortages in the health care safety net. - Implement health care workforce pipeline programs to introduce diverse, under-represented school age youth and college students to health E. Economic Security Long-term Goal All community members have access to the basic needs necessary to thrive. Intermediate Goals - Increase access to safe, quality affordable housing and support services for the most vulnerable populations affected by homelessness and housing displacement. - Increase opportunities for education, training and employment for vulnerable and low-income populations. - Increase enrollment in and use of public benefit programs among vulnerable and low-income populations, including social non-medical services. - Improve community revitalization and economic health. Strategies Housing and support strategy: - Support innovative solutions to develop affordable, sustainable housing to increase availability and decrease displacement for low and moderate income families Education, training & employment strategies: - Increase availability of job training programs for high risk populations. - Improve educational attainment and college readiness among youth from educationally disadvantaged backgrounds. - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. Connection to services strategies: - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low income populations. - Increase and systematize access to needed social non-medical services. - Increase access to safe, affordable transportation to promote access to necessary services (Active transportation/HEAL). Community revitalization strategy: - Provide support to improve economic outcomes for communities. For example: - Participate in Oakland Thrive Council which preserves and protects affordable housing. - Partner with community college districts and workforce coalitions on strategies to address academic success of youth from educationally disadvantaged backgrounds at the Regional and State level. - Participate in collaboratives of local health care institutions, community colleges, workforce development organizations, and chambers of commerce to support the pipeline and hiring of diverse populations in health care. - Support non-profit housing developers who are exploring innovative solutions to the affordable housing shortage. - Support the connection of residents in affordable housing to a range of critical health and human services. - Support programs that provide access to job training programs for high-risk populations. - Support organizations focused on improving academic success of youth from educationally disadvantaged backgrounds. - Support organizations who work with re-entry population to help them successfully access jobs. - Support pathway programs to increase the diversity of the healthcare workforce by providing mentorship, academic enrichment, leadership development, and career exposure to disadvantaged and minority youth. - Support programs that prepare underrepresented students for success in the medical school application process. - Support successful recruitment and retention efforts to address workforce shortages in the health care safety net. - Support Market Match to provide incentives for CalFresh users to purchase produce at farmers markets. - Support the development and use of innovative technology to decrease barriers to enrollment in CalFresh. - Support programs that provide financial literacy support. - Implement a paid summer internship program for underserved high school students at KP medical centers and administrative offices. - Implement KP health care workforce pipeline programs to introduce diverse, underrepresented school age youth and college students to health careers. - Provide KP workforce training programs to train current and future health care providers, including physicians, mental health practitioners, physical therapy, pharmacy, nurses, and allied health professionals, with the skills and linguistic and cultural competence to meet the health care needs of diverse communities. - Explore social impact investing opportunities in service of promoting affordable housing. - At the institutional level, support vendors that hire under/unemployed residents in specific communities and provide living wages and benefits. - Explore implementing policies and standards at the institutional level to procure supplies and services from diverse vendors. - Build capacity of small businesses to be able to contract with KP in target neighborhoods/populations. - At the institutional level, target recruitment activities in underrepresented or lower socio-economic communities, focused primarily on working with local organizations to educate the community on hiring practices and jobs available. - At the institutional level, focus efforts on local hiring. Expected Outcomes - Increased availability and utilization of affordable housing. - Increased enrollment and completion of education and job training programs. - Improved educational outcomes. - Increase in number of culturally and linguistically competent and skilled healthcare providers. - Increased enrollment and participation in public benefit programs. - Increase in referrals and coordination between healthcare providers and social non-medical services. - Improved transportation access to necessary services. Additional Community Benefit Priorities In addition to addressing the selected health needs described above, Kaiser Permanente, as an integrated health care delivery system, dedicates resources that target broader health system needs and upstream determinants of health. Kaiser Permanente deploys dedicated research expertise to conduct, publish, and disseminate high-quality epidemiological and health services research to improve the health and medical care throughout our communities. Access to reliable data is a significant need of the overall health care system and can also be implemented in service of the identified health needs. Deploying a wide range of research methods contributes to building general knowledge for improving health and health care services, including clinical research, health care services research, and epidemiological and translational studies on health care that are generalizable and broadly shared. Conducting high-quality health research and disseminating its findings increases awareness of the changing health needs of diverse communities, addresses health disparities, and improves effective health care delivery and health outcomes in diverse populations disproportionally impacted by heath disparities. Research projects encompass epidemiologic and health services studies as well as clinical trials and program evaluations. They cover a wide range of topics including cardiovascular disease, cancer, diabetes, substance abuse, mental health, maternal and child health, women's health, health care delivery, health care disparities, pharmaco-epidemiology, and studies of the impact of changing health care policy and practice. 2016 Needs Not Selected and Rationale The Contributions Committee was careful to choose a set of health needs to address that best met all of the selection criteria and for which KFH Oakland could make an impact in the community. The Contributions Committee thought it was feasible to address the health needs listed above, given its local community benefit resources and, in the case of Economic Security for Oakland, the clear and substantial local commitment to addressing the need. The remaining health needs did not meet the criteria to the same extent as the chosen needs did; therefore, KFH Oakland does not plan to address them at this time. They are listed below in alphabetical order. A. Asthma Although Asthma was not selected as a standalone top priority, the Contributions Committee agreed to address asthma under Healthcare Access and Delivery. Asthma is a chronic inflammatory disorder of the airways characterized by episodes of reversible breathing problems due to airway narrowing and obstruction. These episodes can range in severity from mild to life threatening. Asthma affects people of every race, sex, and age; however, significant disparities in asthma morbidity and mortality exist, in particular for low-income and minority populations. Asthma was not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. Kaiser Permanente in the East Bay is better positioned to address asthma management via healthcare access and delivery strategies. B. Cancer Although cancer was not selected as standalone top priority, the Contributions Committee agreed to address cancer under Health Access and Delivery. Cancer the second most common cause of death in the United States. Behavioral and environmental factors play a large role in reducing the nations cancer burden, along with the availability and accessibility of high-quality screening. Cancer wa A, 8, KFH - DOWNEY EXPLANATIONS PART V, SECTION B. ********************************************************************** Line 5: Community input was provided through the use of key informant interviews, focus groups, and/or surveys. Individuals with knowledge, information, and/or expertise relevant to the health needs of the community were consulted, including representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, non-traditional stakeholders representing business, chamber of commerce, community-based organizations, economic development, educational institutions, financial institutions, government, public safety, transportation and utility were also involved in providing input. Line 6a: PIH Health Hospital - Downey and PIH Health Hospital - Whittier Line 6b: Cerritos College Health Clinic, Ernie Pyle Elementary School, Bellflower, Interfaith Food Center, Santa Fe Springs, Kaiser Permanente Watts Counseling and Learning Center, My Friends House, Partnership for Healthier Communities Collaborative, Plaza de la Raza, TLC Collaborative, Downey Unified School District Line 11: A. Access to Care Support the provision of high quality health care including preventive services and specialty care for underserved populations (i.e. Medi-Cal Managed Care and Medi-Cal Fee-For-Service), provide access and comprehensive health care to low-income individuals and families who do not have access to public or private health coverage through charitable health coverage, and provide financial assistance to low-income individuals who receive care at KFH facilities and cant afford medical expenses and/or cost sharing. Support the development of community-based organizations, leaders, and networks, and build their capacity to advance equity and improve access to health care. Support policies and programs that improve the ability of health care organizations to access upstream factors and coordinate with community-based preventive services. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to share information about what works in improving access to health care for the underserved. KFH Downey will address access to care by partnering with Caring Connections, a nonprofit serving Bellflower Unified School District. KFH Downey Public Affairs Representative is a member of the Caring Connections collaborative which ensures that children and families gain access to medical care regardless of insurance status or ability to pay. Leverage Kaiser Permanente assets to drive coverage and access to health care for the underserved, build the capacity of the primary care workforce and improve appropriate utilization of health care services. KFH Downey Director of Human Resources is a member of the Southeast Los Angeles County Workforce Development Board where she provides expertise on local programs and policies that impact the evolving needs of the healthcare workforce. B. Obesity/HEAL/Diabetes Support multi-level, multi-component initiatives in community settings to support access to healthy, affordable food and activity-promoting environments (HEAL Zones). KFH Downey Community Benefit Manager is a founding member of the Healthy Downey initiative which aims to align school and city based healthy eating and active living efforts in the community of Downey. Support multi-level, multi-component activities in school settings to produce a significant and measurable impact on the health of students, staff and teachers in K-12 schools within communities served by Kaiser Permanente. The Thriving Schools Initiative is a community based effort to improve healthy eating, physical activity and school climate in K-12 schools in Kaiser Permanentes service areas, primarily through a focus on policy, systems and environmental changes that support healthy choices and a positive school climate. Support programs that improve referral of patients to evidenced-based health promotion programs that teach self-management and empowerment techniques for chronic disease management and prevention. Leverage Kaiser Permanente assets to drive community health, including healthy eating and active living and champion organizational practice changes within Kaiser Permanente that promote health. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to build the field of healthy eating and active living. KFH Downey Community Benefit Manager serves as a member of the Partnership for Healthy Communities (PHC) coalition, which is made up of representatives from the Los Angeles County Department of Public Health, PIH Health, Interfaith Food Center and staff from the cities of Cerritos, Artesia, Bellflower and Whittier. PHC has a team of 21 trained promotores who are implementing evidence based healthy eating curriculums at nonprofits and through Parks and Recreation programs in all four cities involved. C. Mental Health Support school and youth development organizations in learning about and addressing mental and behavioral health including suicide prevention and trauma-informed care. KFH Downey will address mental health by providing educational programming and resources (such as bully prevention), through programs such as the KP Educational Theatre, to local schools. Support the development of community-based organizations, leaders, and networks, and build their capacity to advance equity and reduce stigma surrounding mental and behavioral health. KFH Downey will address mental health by partnering with True Lasting Connections (TLC) Family Resource Center (FRC) in Downey. KFH Downey Public Affairs Director has served for eight years on the advisory board for this FRC who focuses on providing uninsured and underinsured youth access to mental health services. Leverage Kaiser Permanente assets to drive community health and champion organizational practice changes within Kaiser Permanente that promote mental and behavioral health. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to share information about what works in improving behavioral and mental health and to build the field. D. Community Safety/Violence Prevention Support the adoption of evidence-based and promising family and youth development programs, such as the provision of trauma-informed care, conflict resolution program, and mentoring programs that focus on keeping youth positively engaged in school and the community. Support policies and programs that improve the delivery of services for youth and adults returning to the community from incarceration. KFH Downey collaborates with Black Coffee, a social enterprise based in KFH Downey service area dedicated to providing job training, employment and mentoring to men re-entering the community from incarceration. KFH Downey purchases and serves Black Coffee in our hospital cafeteria. Leverage KP assets, including organizational practices, to promote community safety and prevent violence in communities. KFH Downeys Associate Executive Director of the Kaiser Permanente Watts Counseling and Learning Center serves as a member of the Watts Gang Taskforce whose primary function is to eliminate gang violence, and coordinate resources and services in the Watts Community to help youth stay gang free and in school. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to build the field of community health (including promoting best practices in trauma-informed care). E. Sexually Transmitted Infections Promote and encourage STI education, condom use, abstinence, testing and treatment for patients and their partners. Support school and youth development organizations in learning about and addressing STD prevention. KFH Downey will address sexual health by providing educational programming and resources (such as STI awareness), through programs such as the KP Educational Theatre, to local schools. The health needs that KFH Downey does not intend to directly address are: asthma, cardiovascular disease, oral health, preventive practices, substance abuse and teen pregnancy. For the most part these needs were deemed to be of relatively lower need based on the defined criteria. Taking existing community resources into consideration, KFH Downey has selected to concentrate on those health needs that we can most effectively address given our assets. While this Implementation Strategy Report responds to the CHNA and Implementation Strategy requirements in the Affordable Care Act and IRS Notices, it is not exhaustive of everything we do to enhance the health of our communities. KFH-Downey will look for collaboration opportunities that address needs not E, 9, KFH - HONOLULU EXPLANATIONS PART V, SECTION B. ********************************************************************** Line 5: Key Informants were chosen by the Healthcare Association of Hawaii Advisory Committee through a structured nomination and selection process, which followed a thorough review of the preliminary core indicator data. Key informant interviews were conducted by local consultants, Storyline Consulting. Following is a list of the key informants: Kurt Akamine, Garden Isle Rehabilitation & Healthcare Center Marc Alexander, Hawaii Community Foundation Gino Amar, Kohala Hospital Maile Ballesteros, Stay At Home Healthcare Services Joy Barua, Kaiser Permanente Hawaii Dan Brinkman, Hawaii Health System Corporation, East Hawaii Region Rose Choy, Sutter Health Kahi Mohala Behavioral Health Kathy Clark, Wilcox Memorial Hospital R. Scott Daniels, State Department of Health Thomas Driskill, Spark M. Matsunaga VA Medical Center Tom Duran, CMS Laurie Edmondson, North Hawaii Community Hospital Lynn Fallin, State Department of Health Brenda Fong, Kohala Home Health Care of North Hawaii Community Andrew Garrett, Healthcare Association of Hawaii Beth Giesting, State of Hawaii, Office of the Governor Kenneth Graham, North Hawaii Community Hospital George Greene, Healthcare Association of Hawaii Robert Hirokawa, Hawaii Primary Care Association Mari Horike, Hilo Medical Center Janice Kalanihuia, Molokai General Hospital Lori Karan, MD; State Department of Public Safety Darren Kasai, Kula and Lanai Hospitals Nicole Kerr, Castle Medical Center Peter Klune, Hawaii Health Systems Corporation, Kauai Region Tammy Kohrer, Wahiawa General Hospital Jay Kreuzer, Kona Community Hospital Tony Krieg, Hale Makua Eva LaBarge, Wilcox Memorial Hospital Greg LaGoy, Hospice Maui, Inc. Leonard Licina, Sutter Health Kahi Mohala Behavioral Health Wesley Lo, Hawaii Health Systems Corporation, Maui Region Lorraine Lunow-Luke, Hawaii Pacific Health Sherry Menor-McNamara, Chamber of Commerce of Hawaii Lori Miller, Kauai Hospice Pat Miyasawa, Shriners Hospitals for Children - Honolulu Ramona Mullahey, U.S. Department of Housing and Urban Development Jeffrey Nye, Castle Medical Center Quin Ogawa, Kuakini Medical Center Don Olden, Wahiawa General Hospital Ginny Pressler, MD, State Department of Health Sue Radcliffe, State Department of Health, State Health Planning and Development Agency Michael Robinson, Hawaii Pacific Health Linda Rosen, MD, Hawaii Health Systems Corporation Nadine Smith, Ohana Pacific Management Company Corinne Suzuka, CareResource Hawaii Brandon Tomita, Rehabilitation Hospital of the Pacific Sharlene Tsuda, The Queen's Medical Centers Stephany Vaioleti, Kahuku Medical Center Laura Varney, Hospice of Kona Cristina Vocalan, Hawaii Primary Care Association John White, Shriners Hospitals for Children - Honolulu Rachael Wong, State Department of Human Services Betty J. Wood, Department of Health Barbara Yamashita, City and County of Honolulu, Department of Community Services Ken Zeri, Hospice Hawaii Line 6a: Castle Medical Center Kahi Mohala Behavioral Health Kapiolani Medical Center for Women and Children Kuakini Medical Center Pali Momi Medical Center Rehabilitation Hospital of the Pacific Shriners Hospitals for Children Straub Clinic & Hospital The Queen's Medical Center The Queen's Medical Center - West Oahu Wahiawa General Hospital Line 6b: The Healthcare Association of Hawaii led the statewide effort. Line 11: The two health needs that KFH Honolulu plans to address are Access to Care and Exercise, Nutrition and Weight/Diabetes. As part of the Kaiser Permanente integrated health system, KFH Honolulu has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Honolulu is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Honolulu welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Honolulu will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. The remaining prioritized health needs for Honolulu will not be addressed by KFH Honolulu because they were not ranked as highly as Exercise, Nutrition, Weight and Diabetes, and Equitable Access to Health Services. KFH Honolulu has unique resources and capacity to dedicate to the two chosen health needs, and a number of the strategies developed to address the chosen health needs will impact the other health needs that were not selected in this Implementation Strategy. Additionally, many of the specific health needs identified through the CHNA can be addressed by strategies implemented under the needs selected to address. In addition, there are other strong community partners who are currently addressing these needs below: - Mental Health and Mental Disorders - Cardiovascular Disease and Stroke - Substance Abuse, including Tobacco - Oral Health - Prevention and Safety, including Violence/Injury Prevention - Maternal, Infant and Fetal Health - Respiratory Diseases, including Asthma - Cancers - Immunizations and Infectious Diseases, including HIV/AIDS/STDs The implementation strategy can be found at: https://share.kaiserpermanente.org/wp-content/uploads/2013/10/KFH-HI-IS-Re port.pdf line 13a: KP provides a 100% discount to all charity eligible patients regardless of whether they are uninsured or underinsured. The discount amount is not adjusted based on income level. line 13h: A patient of any household income level with incurred out-of-pocket medical and pharmacy expenses for eligible services over a 12 month period greater than or equal to 15% of their annual household income is eligible for charity care. Line 16J: THE FAP PROGRAM MATERIALS ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG/MFA/HAWAII Line 20E: You may qualify for Kaiser Permanente's Medical Financial Assistance Program if you cannot pay for medically necessary care and meet specific income requirements. Please contact Patient Financial Services or visit our website at kp.org/mfa/Hawaii for an application and detailed program information, including how we determine the Accounts Generally Billed adjustment (Amt Gen Billed Adj). A, 10, KFH - SAN FRANCISCO EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. SFHIP screened 43 published community health assessments completed between 2012 and 2015 to identify gaps in primary data available. Twenty-one of the assessments were included in the data analysis. This review informed the selection of community partners and target populations for community input. The SFHIP identified target populations for which there was limited secondary data or limited data from other assessments as described above. The target populations are listed below. Community conversations with members of these groups included low-income, minority and medically underserved residents: - Formerly incarcerated - Transitional age youth - Seniors - Latinos - Middle Eastern and Arab residents - African American mothers - Filipinos - LGBT - Native Americans - Veterans Using the SFHIP member relationships, community-based organizations representing or serving the target populations were asked to host a community conversation with residents about their health needs. SFDPH staff facilitated 11 community conversations using the Technology of Participation techniques for focused conversations and consensus development. SFDPH staff compiled the themes and identified health needs from the 11 community conversations for inclusion in the CHNA and in the 29 SFDPH Social Determinant of Health and Health Outcome reports. The Health Need In addition to the input from public health experts who serve on SFHIP, two formal key informant interviews with SFDPH staff were conducted, including the County Population Health Branch Director. Key informants were asked about their highest health issue concerns for vulnerable San Franciscans, the top health needs in San Francisco and community assets to protect and enhance. Line 6a: - Chinese Hospital - Dignity Health - Saint Francis Memorial Hospital - Dignity Health - St. Marys Medical Center - Kaiser Permanente KFH San Francisco - Sutter Health - California Pacific Medical Center - University of California San Francisco Medical Center line 6b: SFHIP participants included: - APA Family Support Services - Asian Pacific Islander Health Parity Coalition - San Francisco Community Clinic Consortium - Chicano/Latino/Indigena Health Equity Coalition - Instituto Familiar de la Raza - Bayview Hunters Point Foundation for Community Improvement - San Francisco Human Services Network - San Francisco Unified School District - San Francisco Mayors Office - African American Community Health Equity Coalition - Rafiki Wellness - CAL Insurance and Associates, Inc. - Metta Fund - The San Francisco Foundation - Interfaith Coalition for Immigrants Rights - San Francisco Interfaith Council - San Francisco Department of Public Health - University of California, San Francisco Community Engagement Partners: - Advancing Justice of the Asian Law Caucus - African American Art and Cultural Center - CARECEN - Filipino American Development Foundation - Instituto Familiar de la Raza/Asociacin Mayab - Larkin Street Youth - LGBT Center - Native American Health Center - On Lok 30th Street Senior Center - Swords to Plowshares - Transitions Line 11: As part of the Kaiser Permanente integrated health system, KFH San Francisco has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH San Francisco is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH San Francisco welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH San Francisco will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. Behavioral Health Long-term Goal All community members experience social emotional health and wellbeing and have access to high quality behavioral health care services when needed. Intermediate Goals 1. Expand prevention and support services for mild to moderate behavioral health conditions. 2. Decrease stigma associated with seeking behavioral health services among vulnerable and diverse populations. 3. Develop a diverse, well trained behavioral health care workforce that provides culturally sensitive behavioral health care. 4. Increase access to culturally and linguistically appropriate behavioral health services for vulnerable and low-income populations. Strategies Prevention strategies: - Provide screening and identification related to behavioral health needs among low-income, vulnerable, and uninsured populations and connect them with the appropriate services or support. - Support opportunities to prevent and reduce the misuse of drugs and alcohol. - Provide access to programs, services and environments that evidence suggests reduce stress, anxiety and depression. Destigmatization strategies: - Support opportunities to reduce stigma through education and outreach in school, community and workforce settings. Workforce strategies: - Support the recruitment, hiring and retention of a diverse, culturally competent behavioral health care workforce in the clinical and community-based settings. - Increase access to training and education for diverse populations currently underrepresented in the behavioral health care workforce. Access strategies: - Provide high-quality medical care to Medi-Cal participants. - Promote integration of care between primary and behavioral health care. - Improve navigation to appropriate care within the health care system and support services in the community. - Increase the capacity to respond appropriately to individuals and/or communities that have experienced trauma and/or violence. For example: - Provide grants to programs at schools and community-based organizations that identify behavioral health needs and connect individuals to services, including programs to help people avoid and recover from substance abuse; programs that support mindfulness, stress reduction, peer support, and a trauma-informed approach to care; and programs that increase access to and from primary and behavioral health care. - Partner with the San Francisco Unified School District, the San Francisco Department of Public Health, and the San Francisco Human Services Network to identify persons with behavioral health needs and the best services to address those needs. - Support depression screening and follow-up as part of population health management initiatives. - Support the use and adoption of screening tools for risk of exposure to trauma - Conduct outreach to underrepresented populations to support entering behavioral health professions. - Support the capacity of clinics, schools and other community-based organizations to provide trauma-informed care. Expected Outcomes Prevention - Increased enrollment in programs to improve social/emotional wellness. - Increased screening for behavioral health needs. - Increased participation in drug and alcohol prevention programs Destigmatization - Increase in help seeking behavior for accessing behavioral health care. Workforce - Increase in the number of culturally and linguistical 2016 Needs Not Selected and Rationale A. Housing Stability Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH San Francisco. In San Francisco, the discussion focused on Housing Stability and Homelessness which are driven by housing costs and availability of good paying jobs. While KFH San Francisco did not select this need because of the challenges of addressing a need this large given limited resources, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to transition the homeless to stable housing, promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. B. Safety and violence prevention Safety and Violence Prevention was not ranked as highly as the selected needs. In addition, the Community Benefit Advisory Committee (CBAC) recognized that there are other strong community partners who are currently addressing or are better suited to address Safety and Violence Prevention. While this Implementation Strategy Report responds to the CHNA and Implementation Strategy requirements of the Affordable Care Act and IRS notices, it is not exhaustive of everything we do to enhance the health of our communities. KFH San Francisco will look for collaboration opportunities that address needs not selected where it can appropriately contribute to addressing those needs. In addition, as KFH San Francisco develops specific implementation strategies and grant criteria, it will acknowledge the connection of housing stability, safety and violence prevention to the selected priority health needs. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL. A, 11, KFH - ANAHEIM EXPLANATIONS PART V, SECTION B. ********************************************************************** Line 5: Local stakeholders participated in focus groups or key informant interviews. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, other individuals with expertise of local health needs were consulted. In order to increase the diversity of community input, and to acknowledge the growing diversity of Orange County, Asian-Pacific Islander community organization representatives, members from the Arab-American community, and members from the Latino community were included as well. Additionally, other non-traditional stakeholders representing behavioral health, business community, child and family services, economic instability organizations, OC STEM Initiative, and alcohol drug education and prevention also provided input. Line 6a: Memorial Care, St. Jude Medical Center, St. Joseph's Medical Center, Hoag Memorial Hospital, and University of California, Irvine. Line 6b: Orange County Health Care Agency, Orange County Health Improvement Plan (OCHIP) work groups Line 11: A. Mental and Behavioral Health Support school and youth development organizations in learning about and addressing (through sharing of teen assessment tool) mental and behavioral health, including suicide prevention and trauma-informed care. KFH-Anaheim intends to share teen assessment tool as a partnership between Kaiser Permanente and the Coalition of Community Health Centers, Orange County Department of Education and other community based organizations to better address teen mental and behavioral health. Support policies and programs that address early child development and toxic stress, including positive parenting and violence-free homes (Raise, OCDE, Thriving Schools, OC FJF youth violence prevention). KFH-Anaheim intends to address mental health by collaborating with Cal State Fullerton's Center for Healthy Neighborhoods and other nonprofit organizations through participation on the advisory board to provide expertise regarding parenting classes, early childhood education and teen mental health concerns. Support the development of community-based organizations, leaders, and networks, and build their capacity to advance equity and reduce stigma surrounding mental and behavioral health. KFH-Anaheim community benefit liaison is a member of the behavioral health work group of the Health Improvement Partnership of Orange County. The goal of this work group is to increase the proportion of residents who experience emotional and mental wellbeing and reducing alcohol and drug misuse in Orange County. Leverage KP assets to drive community health and champion organizational practice changes within KP that promote mental and behavioral health. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to share information about what works in improving behavioral and mental health and to build the field. B. Obesity/Heal/Diabetes Support new and improved policies and environments that support active transportation and physical activity (e.g. safe pedestrian bicycle routes). Support multi-level, multi-component initiatives in community settings to support access to healthy, affordable food and activity-promoting environments. An example of an initiative for this strategy is the Healthy Eating Active Living (HEAL) Zones. HEAL Zones are multi-year, place-based investments that support policy, advocacy and/or system changes in communities. This initiative aims to lower the prevalence of obesity and overweight by increasing access to fresh fruit, vegetables, and healthy beverages and increasing safe places to play and be physically active. Support multi-level, multi component initiatives in school settings to produce a significant and measurable impact on the health of students, staff and teachers in K-12 schools within communities. An example for this strategy is the Thriving Schools Initiative, a community based effort to improve healthy eating, physical activity and school climate in K-12 schools in Kaiser Permanente's service areas, primarily through a focus on policy, systems and environmental changes that support healthy choices and a positive school climate. Support new and improved policies and environments that support active transportation and physical activity (e.g. safe pedestrian bicycle routes). KFH-Anaheim Community Benefit liaison is a member of the active transportation subcommittee of the Alliance for a Healthy Orange County. The goal of this work is to identify and build support for active transportation and find sources of funding at the local, state and federal level for Orange County's active transportation projects and programs to promote healthy communities. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to build the field of healthy eating and active living. Leverage KP assets to drive community health, including healthy eating and active living and champion organizational practice changes within KP that promote health. KFH-Anaheim community medicine fellow and Orange County Family Medicine Residents provide direct and guidance for the diabetes self-management program run by Latino Health Access. C. Economic Security Expand efforts to increase access to permanent housing with supportive services for homeless individuals and families to help them maintain stability and self-sufficiency. Support local governments, schools and/or community based organizations that increase economic security for individuals and families by expanding opportunities for employment, education and workforce pipeline. An example of this is KFH-Anaheim recruitment services liaison will continue to serve as a member of the City of Anaheim workforce investment board to share knowledge regarding healthcare jobs of the future, participate on focus groups and serve on the workforce evaluation subcommittee. In addition, KFH-Anaheim recruitment services liaison will continue to partner with Vital Link to coordinate an expert panel and review of Orange County MA and LVN programs (ROP, private and community college) curriculum as well as provide expert speakers at large events. Support local governments, schools and/or community based organizations to provide healthy food options (including accessible drinking water) and to adopt healthy food policies, including procurement practices. Leverage KP assets to drive community health and champion organizational practice changes within Kaiser Permanente that improve economic security. This will be accomplished by contributing toward supplier diversity in the community to address economic security by implementing policies and standards to procure supplies and services from a diverse set of providers; working with vendors to support sub-contracting with diverse suppliers/service providers; working with community-based workforce development programs to support a pipeline for diverse suppliers/service provides; and building the capacity of target neighborhoods/populations. D. Access to Care Provide training for medical professionals to improve the delivery care infrastructure and/or implement new models of care provision to improve the capacity of the primary care workforce. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to share information about what works in improving access to health care for the underserved. An example of this is Health Funders Partnership of Orange County's Health and Wellness Committee, a collaborative between KFH-Anaheim and Irvine and other health care organizations in Orange County. The aim of this partnership is to support local community health centers with health and wellness programs, such as Integrative Medicine, which will improve access to mental and behavioral health services for low-income patients. Participate in government-sponsored programs for low-income individuals (i.e. Medi-Cal Managed Care and Medi-Cal Fee-for-Service). Provide heavily subsidized health care coverage. Provide Medical Financial Assistance (i.e. Charity Care). Leverage KP assets to drive coverage and access to healthcare for the underserved, build the capacity of the primary care workforce and improve appropriate utilization of healthcare services. Support the provision of high quality health care (including preventive services and specialty care) for underserved populations. As part of the largest non-profit health system, KFH - Anaheim participates in government-sponsored programs for low-income individuals (i.e. Medi-Cal Managed Care and Medi-Cal Fee-For-Service), provide access and comprehen A, 12, KFH - VALLEJO EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members and leaders provided community input through key informant interviews and focus groups. The consultant team interviewed individuals who were identified as having valuable knowledge, information, and expertise relevant to the health needs of the community. Interviewees included representatives from the local public health department as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Other individuals from various sectors with expertise of local health needs were also consulted. A total of 18 key informant interviews were conducted for the Napa County CHNA. Because the KFH-Vallejo service area also includes Benicia and Vallejo, two cities in Solano County, the 18 Napa County interviews were considered alongside primary data that were collected in Solano County by Valley Vision for the Solano County CHNA. Four interviews (including group interviews) conducted with Benicia and Vallejo residents and stakeholders for the Solano County CHNA, and were included in the analysis because the KFH-Vallejo service area includes these two cities. Additionally, four focus groups were conducted throughout Napa County. These groups were intentionally sampled to reach specific subpopulations of the county that were identified as having worse health outcomes or at risk for having worse health outcomes than the general population in Napa County. These subpopulations included youth county-wide, as well as residents in American Canyon and Calistoga. Focus groups were monolingual, conducted in either English or Spanish. Two additional focus groups conducted in Solano County by Valley Vision were also considered in this analysis because they included residents from Benicia and Vallejo, which are part of the KFH-Vallejo service area. line 6a: Kaiser Foundation Hospital-Vallejo collaborated with St. Joseph Health Queen of the Valley Medical Center and St. Helena Hospital on data collection and interpretation for Napa County. Line 6b: The Napa County hospitals, in partnership with the following organizations, made up the Napa County CHNA Advisory Group: - Napa County Health and Human Services Agency - Live Healthy Napa County Line 11: As part of the Kaiser Permanente integrated health system, KFH Vallejo has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Vallejo is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Vallejo welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Vallejo will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources are described below for each selected health need. Strategies in bold are those recommended by the Contributions Committee to direct community benefit support and investments. A. Healthy Eating/Active Living Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g. obesity, diabetes, CVD). B. Intermediate Goals - Improve healthy eating among residents in low-income, under-resourced communities. - Increase physical activity among residents in low-income, under-resourced communities. Strategies Healthy eating strategies - Increase access to healthy, affordable foods, including fresh produce, and decrease access to unhealthy food. - Increase access to free, safe drinking water. - Reduce access to and appeal of sugar sweetened beverages. - Increase enrollment in and use of federal food programs. Physical activity strategies - Increase access to safe parks and public spaces. - Increase opportunities for active transportation. - Increase access to physical activity opportunities in the community. - Increase access to physical activity opportunities in schools, and utilize schools as forums for educational sessions (e.g. convening assemblies). For example: - Provide grants for food banks, nutritious cooking classes for youth and healthy eating programs for seniors - Provide grants for advocacy effort and education about the health risks of sugar-sweetened beverages. - Provide grants for programs that support physical activity among youth. - Deploy physicians and clinicians to speak/educate community members on nutrition and physical activity. - Participate in Live Healthy Napa County (LHNC), a public-private partnership that provides Napa County residents with education and resources to drive health and wellness. - Support local restaurants and caterers that meet healthy food guidelines. - Provide Kaiser Permanente's Educational Theater, programming that provides education in schools on health and wellness. Expected Outcomes Healthy eating - Increased consumption of fruits and vegetables. - Increased consumption of water. - Decreased consumption of sugar sweetened beverages (SSBs). - Increased enrollment and participation in federal food programs. Physical activity - Increased use of parks and public spaces. - Increased walking and biking to school and work. - Increased physical activity. B. Access to Health Care Services Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low-income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low-income and vulnerable populations. Strategies Access strategies - Provide high quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and cannot afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity of health system strategies - Increase capacity of systems and individuals to adopt population health management, addressing socio-economic, ethnic and cultural needs, as well as barriers like housing and transportation. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social non-medical service strategies - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. Workforce strategies - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For example: - Provide subsidized health care coverage to children (18 & under) in low-income families (up to 300% FPL) who lack access to other sources of coverage. - Provide grants for programs that support children's enrollment in and use of health insurance coverage. - Provide grants for programs that support promoters and/or community health workers to help patients navigate the health care system. - Partner with local community colleges on programs to improve ac 2016 Needs Not Selected and Rationale KFH Vallejo has unique resources, expertise, and capacity to dedicate to the four chosen health needs. The remaining health needs prioritized in the 2016 CHNA will not be addressed by KFH Vallejo because the facility has chosen to concentrate resources in health need areas where Kaiser Permanente can align with existing local and regional efforts, and maximize the impact of organizational resources. A number of community partners have undertaken initiatives to address the additional health needs as outlined below. While this Implementation Strategy Report responds to the CHNA and Implementation Strategy requirements in the Affordable Care Act and IRS Notices, it is not exhaustive of everything we do to enhance the health of our communities. KFH Vallejo will look for collaboration opportunities that address needs not selected where it can appropriately contribute to addressing those needs. The needs that will not be addressed are: A. Cancers Cancers will not be directly addressed by KFH Vallejo through implementation strategies because the Contributions Committee assigned this health need a low score with respect with to CHNA prioritization, existing county funding, and ability to leverage community assets. However, KFH Vallejo anticipates indirectly addressing this need through strategies aimed to address Access to Care and Coverage and Healthy Eating/Active Living, as these health needs are interrelated. For example, providing high quality medical care to Medi-Cal participants and supporting outreach, enrollment, retention and appropriate utilization of health care coverage programs will increase access to preventative care and screenings, as well as treatment for individuals with cancer. Because healthy eating and an active lifestyle are directly correlated with a decreased risk of cancer, KFH Vallejo also intends to address cancer prevention by increasing access to healthy, affordable foods, decreasing access to unhealthy food and sugar-sweetened beverages, and increasing opportunities for physical activity in the community and in schools. B. Education While KFH Vallejo did not select this need, we understand that the causes are broad, and the solutions extend beyond specific communities across the region, and state. Progress in educational attainment and education quality requires partnering with non-traditional partners, beyond health care providers. To achieve the greatest impact and maximize use of its resources, KFH Vallejo chose to address other health needs in this implementation plan. C. Economic and Housing Security Economic and Housing Security, defined principally by community residents as deep concerns about housing costs, the need for well-paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Vallejo. Although the Contributions Committee ranked Economic and Housing Security high with respect to criteria such as disparities/equity and CHNA prioritization, this health need was ranked low with respect to KP expertise, feasibility, and ability to leverage community assets. Ultimately, KFH Vallejo did not select this need because our expertise is stronger in other areas and thus we may be better positioned to leverage our resources to affect positive change towards other health needs. However, we understand that the causes of poverty and housing instability are complex, and collaborative partnerships are needed to address this health need. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL. A, 13, KFH - SOUTH SACRAMENTO EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. Primary data collection began with interviews with hospital service representatives and interviews of area health experts such as public health and social service representatives. The primary data collected from the first phase of interviews, including initial analysis of socio-demographic data, identified Focus Communities within the KFH-South Sacramento service area. These identified Focus Communities were then used to help inform a second phase of data collection which included additional key informant interviews and Focus Groups with medically-underserved, low-income and minority populations where additional data collection was needed. Line 6a: - Dignity Health: Mercy General Hospital, Mercy Hospital of Folsom, Mercy San Juan Medical Center, Methodist Hospital of Sacramento, Sierra Nevada Memorial Hospital, Woodland Memorial Hospital - Kaiser Permanente of Greater Sacramento: KFH South Sacramento, KFH Sacramento, KFH Roseville - Sutter Health Sacramento Sierra Region: Sutter Auburn Faith Hospital, Sutter Center for Psychiatry, Sutter Davis Hospital, Sutter Medical Center - Sacramento, Sutter Roseville Medical Center) - UC Davis Health System Line 6b: Numerous partner organizations contributed to the CHNA. In particular, the following local health departments contributed data that were used in the CHNA reports: El Dorado County Health and Human Services Agency; Placer County Health and Human Services; Sacramento County Health and Human Services; and Yolo County Health and Human Services. Over 37 organizations assisted the KFH-South Sacramento CHNA process through participation in key informant interviews or focus groups. Line 11: As part of the Kaiser Permanente integrated health system, KFH South Sacramento has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities - Leverage or enhance public health department activities - Advance increased general knowledge through education or research that benefits the public - Otherwise would not become the responsibility of government or another tax-exempt organization KFH South Sacramento is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH South Sacramento welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH South Sacramento will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. Access to Care Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low income and vulnerable populations. - Develop a diverse, well-trained health care workforce that provides culturally sensitive health care. Strategies - Provide high-quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and can't afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For Example, - Participate in Medi-Cal Managed care. - Provide subsidized health care coverage to children (18 & under) in low -income families (up to 300% FPL) who lack access to other sources of coverage. - Provide Medical Financial Assistance. - Provide grants to increase access to health insurance coverage and health care services. - Participate in Healthy Partners Program, which provides primary and preventative health care services to low-income, undocumented adults residing in Sacramento County. - Support organizations that provide navigation to free and reduced cost services for specialty care. - Provide grants for youth substance abuse outreach and risk reduction. - Provide Regional Health Education classes and materials. - Support population health management approaches that improve health outcomes for safety net patients with diabetes and hypertension. - Support community health centers and public hospital organizations to participate successfully in waiver and demonstration programs moving from fee for service to capitation. - Support programs to promote integration of care between primary and specialty care. - Provide grants to increase coordination of youth and family services by providing a single point of access and assistance to address the social, emotional, health and academic needs of students. - Provide grants for programs to connect frequent users of the Emergency Department with case management support services and community resources. - Implement health care workforce pipeline programs to introduce diverse, underrepresented school age youth and college students to health careers. Expected Outcomes Access - Increase in the number of low-income patients who receive health care services/coverage. - Increase in the number of low-income patients that enroll in health care coverage programs. Capacity of healthy systems - Increase in the quality of care provided by safety net providers through PHASE protocol. - Improve capacity of health systems to provide population health management. - Increased integration of primary and specialty health care services. - Improved capacity of safety net providers to assuming capitated risk. Social non-medical services - Increase in referrals and coordination to social non-medical services. - Increased enrollment and participation in public benefit programs. Workforce - Increase in the number of people from underrepresented groups enrolling in education and job training programs. - Increase in the number of culturally and linguistically competent and skilled healthcare providers. B. Healthy Eating Active Living Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g. obesity, diabetes, CVD). Intermediate Goals - Improve healthy eating among residents in low income, under-resourced communities. - Increase physical acti 2016 Needs Not Selected and Rationale A. Disease Prevention and Management Disease Prevention and Management was a lower priority compared to other needs in IS prioritization processes. It scored lower than the selected needs on ability to leverage organizational assets and feasibility. Some of the HEAL and Behavioral Health strategies will address disease prevention (obesity, heart disease, stroke, diabetes). B. Pollution-free Environments Pollution-free Environments was a low priority compared to other needs in both the CHNA and IS prioritization processes. It scored low on all criteria used during prioritization. C. Affordable and accessible transportation Transportation was a low priority compared to other needs in both the CHNA and IS prioritization processes. It scored low on all criteria used during prioritization. D. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH South Sacramento. Economic security was a low priority compared to other needs in the IS prioritization process. It scored low in CHNA prioritization, KP expertise and feasibility and lower than the selected needs in existing or promising approaches and ability to leverage organizational assets. While KFH South Sacramento did not select this need, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. Line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL. A, 14, KFH - WALNUT CREEK EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: The Hospitals contracted with Applied Survey Research (ASR) to conduct the primary research. Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. In all, ASR gathered community input from 55 individuals through focus groups and individual interviews. In all, ASR consulted with 21 professional community representatives of various organizations and sectors through 15 key informant interviews and one focus group (which included six participants). These representatives either work in the health field or improve health conditions by serving those from the target populations. In the list below, the number in parentheses indicates the number of participants from each sector. - County Public Health (2) - Other health centers or systems (7) - Mental/Behavioral health or violence prevention providers (2) - School system representatives (8) - City or county government representatives (1) - Other nonprofit agencies serving children, seniors, veterans, and/or families (1) Line 6a: - John Muir Health - Kaiser Foundation Hospital - Antioch - Kaiser Foundation Hospital - Walnut Creek - Kaiser Foundation Hospital - Oakland - Kaiser Foundation Hospital - Richmond - Kaiser Foundation Hospital - Fremont - Kaiser Foundation Hospital - San Leandro - Stanford Health Care - ValleyCare - San Ramon Regional Hospital - St. Rose Hospital - UCSF Benioff Children's Hospital Oakland - Washington Hospital Healthcare System Line 6b: While there was no formal collaboration between the Hospitals and other organizations, the Hospitals invited representatives from the public health departments of the City of Berkeley, County of Alameda, and the County of Contra Costa to one of its first joint meetings. These representatives presented local public health data and shared about local efforts to improve health outcomes. The Hospitals discussed these issues with these public health representatives and increased their knowledge of the health needs in their respective communities. Line 11: As part of the Kaiser Permanente integrated health system, KFH Walnut Creek has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Walnut Creek is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Walnut Creek welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Walnut Creek will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. HEALTH CARE ACCESS AND DELIVERY Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low-income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low-income and vulnerable populations. - Develop a diverse, well-trained health care workforce that provides culturally sensitive health care. Strategies Access strategies: - Provide high-quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and can't afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity of health system strategies: - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social non-medical service strategies: - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. Workforce strategies: - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. Examples: - Provide grants for promotores/peer educator programs to connect monolingual non-English-speaking community members to healthcare. - Provide grants to connect low-income families and individuals to healthcare via free clinics. - Provide grants that support integration via the out-posting of behavioral health staff to primary care community clinics. - Collaborate with the East and Central County Access Action Team and the Access to Care Stakeholders group on issues of healthcare access in the community. - Participate in Medi-Cal Managed Care and Medi-Cal Fee for Service. - Provide subsidized health care coverage to children (18 & under) in low-income families (up to 300% FPL) who lack access to other sources of coverage. - Provide Medical Financial Assistance. - Provide physician and KP staff volunteers at events that provide surgical, specialty, and diagnostic services to low-income, uninsured people. - Support rotation of residents and trainees in community health centers. Expected Outcomes Access: - Increase in the number of low-income patients who receive health care services/coverage. - Increase in the number of low-income patients that enroll in health care coverage programs. Capacity of health systems: - Increase in the quality of care provided by safety net providers through PHASE protocol. - Improved capacity of health systems to provide population health management. - Increased integration of primary and specialty health care services. - Improved capacity of safety net providers to assuming capitated risk. Social non-medical services: - Increase in referrals and coordination to non-medical social services. - Increased enrollment and participation in public benefit programs. Workforce: - Increase in the number of people from underrepresented groups enrolling in education and job training programs. - Increase in the number of culturally and linguistically competent and skilled healthcare providers. B. HEALTHY EATING ACTIVE LIVING Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g., obesity, diabetes, cardiovascular disease). Intermediate Goals - Improve healthy eating among residents in low-income, under-resourced communities. - Increase physical activity among residents in low-income, under-resourced communities. Strategies Healthy eating strategies: - Increase access to healthy, affordable foods, including fresh produce, and decrease access to unhealthy food. - 2016 Needs Not Selected and Rationale The Contributions Committee was careful to choose a set of health needs that best met all of the selection criteria and for which KFH Walnut Creek could make an impact in the community. The Contributions Committee thought it was feasible to address a total of three health needs given its local Community Benefit resources. The remaining health needs did not meet the criteria to the same extent as the chosen needs did; therefore, KFH Walnut Creek does not plan to address them at this time. They are listed below in alphabetical order. A. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Walnut Creek. While KFH Walnut Creek did not select this need because the Contributions Committee believed it was much less feasible to address given the resources available, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. B. Oral health Oral health is essential to overall health. Oral diseases, from cavities to oral cancer, cause pain and disability. Barriers that can limit a person's use of preventive oral health interventions and treatments include: limited access to and availability of dental services; lack of awareness of the need for care; cost; and fear of dental procedures. KFH Walnut Creek did not select this need because the Contributions Committee believed it was less feasible to address this need than the selected health needs. Also, there are relatively few evidence-based practices that have been identified to ameliorate it, Kaiser Permanente has only moderate expertise in this topic, and there are relatively few Kaiser Permanente regional assets available to leverage for it. C. Violence and abuse Violence and intentional injury contribute to poorer physical health for victims, perpetrators, and community members. Crime in a neighborhood causes fear, stress, unsafe feelings, and poor mental health. Witnessing and experiencing violence in a community can cause long-term behavioral and emotional problems in youth. KFH Walnut Creek did not select this need because it was of much lower community priority than the selected health needs, and the Contributions Committee believed it was less feasible to address this need than the selected health needs. Also, there are not many evidence-based practices that have been identified to ameliorate it, Kaiser Permanente has only moderate expertise in this topic, and there are not many Kaiser Permanente regional assets available to leverage for it. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL. A, 15, KFH - SACRAMENTO EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from the local public health department as well as leaders, representatives, and members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. Primary data collection began with interviews with hospital service representatives and interviews of area health experts such as public health and social service representatives. The primary data collected from the first phase of interviews, including initial analysis of socio-demographic data, identified Focus Communities within the KFH-Sacramento service area. These identified Focus Communities were then used to help inform a second phase of data collection which included additional key informant interviews and Focus Groups with medically-underserved, low-income and minority populations where additional data collection was needed. Primary data were collected from May 2015-November 2015. Line 6a: - Dignity Health: Mercy General Hospital, Mercy Hospital of Folsom, Mercy San Juan Medical Center, Methodist Hospital of Sacramento, Sierra Nevada Memorial Hospital, Woodland Memorial Hospital - Kaiser Permanente of Greater Sacramento: KFH Sacramento, KFH South Sacramento, KFH Roseville - Sutter Health Sacramento Sierra Region: Sutter Auburn Faith Hospital, Sutter Center for Psychiatry, Sutter Davis Hospital, Sutter Medical Center - Sacramento, Sutter Sacramento Medical Center) - UC Davis Health System Line 6b: Numerous partner organizations contributed to the CHNA. In particular, the following local health departments contributed data that were used in the CHNA reports: El Dorado County Health and Human Services Agency; Placer County Health and Human Services; Sacramento County Health and Human Services; and Yolo County Health and Human Services. Over 40 organizations assisted the KFH-Sacramento CHNA process through participation in key informant interviews or focus groups. Line 11: As part of the Kaiser Permanente integrated health system, KFH Sacramento has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities - Leverage or enhance public health department activities - Advance increased general knowledge through education or research that benefits the public - Otherwise would not become the responsibility of government or another tax-exempt organization KFH Sacramento is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Sacramento welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Sacramento will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. Access to Care Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low income and vulnerable populations. - Develop a diverse, well-trained health care workforce that provides culturally sensitive health care. Strategies - Provide high-quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and can't afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For Example, - Participate in Medi-Cal Managed care. - Provide subsidized health care coverage to children (18 & under) in low -income families (up to 300% FPL) who lack access to other sources of coverage. - Provide Medical Financial Assistance. - Provide grants to increase access to health insurance coverage and health care services. - Participate in Healthy Partners Program, which provides primary and preventative health care services to low-income, undocumented adults residing in Sacramento County. - Support organizations that provide navigation to free and reduced cost services for specialty care. - Provide grants for youth substance abuse outreach and risk reduction. - Provide Regional Health Education classes and materials - Support population health management approaches that improve health outcomes for safety net patients with diabetes and hypertension. - Support community health centers and public hospital organizations to participate successfully in waiver and demonstration programs moving from fee for service to capitation. - Provide grants to improve navigation to obtain services (e.g. promotores). - Support programs to promote integration of care between primary and specialty care. - Provide grants for programs to connect frequent users of the Emergency Department with case management support services and community resources. - Implement health care workforce pipeline programs to introduce diverse, underrepresented school age youth and college students to health careers. - Support KP Pals Program at Thomas Edison Institute, which provides 5th grade students with ongoing communication with a healthcare professional mentor. Expected Outcomes Access - Increase in the number of low-income patients who receive health care services/coverage. - Increase in the number of low-income patients that enroll in health care coverage programs. Capacity of healthy systems - Increase in the quality of care provided by safety net providers through PHASE protocol. - Improve capacity of health systems to provide population health management. - Increased integration of primary and specialty health care services. - Improved capacity of safety net providers to assuming capitated risk. Social non-medical service - Increase in referrals and coordination to social non-medical services. - Increased enrollment and participation in public benefit programs. Workforce - Increase in the number of people from underrepresented groups enrolling in education and job training programs. - Increase in the number of culturally and linguistically competent and skilled healthcare providers. B. Healthy Eating Active Living Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g. obesity, diabetes, CVD). Intermediate Goals - Improve healthy eating among residents in low income, under-resourced communities. - Increase physical activity among residents in lo 2016 Needs Not Selected and Rationale A. Disease Prevention and Management Disease Prevention and Management was a lower priority compared to other needs during the IS prioritization processes. It scored low on CHNA prioritization and lower than the selected needs on ability to leverage organizational assets and feasibility. Some of the HEAL and Behavioral Health strategies will address disease prevention (obesity, heart disease, stroke, diabetes). B. Pollution-free Environments Pollution-free Environments was a low priority compared to other needs in both the CHNA and IS prioritization processes. It scored low on all criteria used during prioritization. C. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Sacramento. Economic security was a low priority compared to other needs in the IS prioritization process. It scored low in KP expertise and feasibility and lower than the selected needs in existing or promising approaches and ability to leverage organizational assets. While KFH Sacramento did not select this need, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. Line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL. B, 16, KFH - RIVERSIDE EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was solicited from stakeholders that represented broad interests in the community, including, the health care sector (e.g. hospitals, clinics and providers), mental health, nonprofit and community-based organizations (e.g. grassroots, food pantries, coalitions), county and city agencies and programs (e.g. public health department, city planners, school districts), public health experts and professionals, social service providers (e.g. family assistance, children services, domestic violence) and academic institutions (e.g. colleges and universities). Local stakeholders participated in focus groups or key informant interviews to discuss health needs, health barriers, and health assets in their respective community. Line 6a: KFH-Moreno Valley Line 11: Health Need 1: Access to Care Access to Care Long-Term Goal All community members have access to timely, coordinated, high quality health care from a trained and diverse workforce. Access to Care Intermediate Goals - Increase coverage and access to comprehensive, quality health care services for low income and uninsured populations. - Improve the capacity of health care systems to provide quality health care services, including the social and non-medical needs of their patients. - Improve the capacity of the primary care workforce to meet community needs. - Enhance individuals' utilization of the community based health delivery system. Access to Care Strategies - Support targeted outreach, enrollment, and retention efforts to increase access to health care coverage, particularly among communities of color and immigrant populations, where disparities in both access to care and health care coverage is greatest. - Develop solutions that address the health care needs of people who do not qualify for low-cost or no-cost health insurance, including but not limited to undocumented individuals. - Support policies and programs that improve ability of the health care organizations to assess upstream factors and coordinate with community based preventive services. - Improve the quality improvement (QI) infrastructure of health care organizations by supporting capacity to use data, leadership training, business operations and through other infrastructure building strategies - Provide training for medical providers on the provision of culturally competent care to diverse populations. - Reduce barriers to access to care by providing language interpretation, transportation, non-traditional access points, and/or other supportive services. - Support policies and programs that improve public understanding of the health care delivery system and the onboarding and orientation for new patient members. Access to Care Resources and Partners - Community Health Care Access (formerly Community Surgery Day) for uninsured residents in partnership with community clinics. - Family Medicine Residency Program. - Partners such as the Riverside University Health System, local FQHCs, community clinics, and more. Access to Care Expected Outcomes - Enrollment continues to rise, especially in low-income communities and communities of color. - Individuals who do not qualify for low-cost or no-cost health insurance (e.g., undocumented individuals) have at least one option for seeking medical treatment. - Increased referrals and coordination between health care providers and community-based efforts. - Increased efforts to address health predictors and other upstream factors in community outreach. - Health care organizations have increased opportunities for professional development and infrastructure improvements, especially in areas relating to data analysis, leadership training, and business operations. - There is an increase in the number of medical providers who receive continuing education in providing culturally competent care. - Increased availability of medical care in preferred language, utilizing qualified interpreter services. - Multiple low-cost transportation options are available when traveling to-and-from care. - Increased number of patients accessing care at non-traditional access points. - Greater public understanding of the health care system and coverage options. - New patient members are successfully onboarded and understand their benefits. Health Need 2: Obesity/Diabetes/HEAL Obesity/Diabetes/HEAL Long-Term Goal All community members eat healthy and move more as part of daily life. Obesity/Diabetes/HEAL Intermediate Goals - Improve access to opportunities for physical activity in the community - Improve access to healthy food options in the community - Improve linkages between health care services and community-level services Obesity/Diabetes/HEAL Strategies - Support new and improved policies and environments that support active transportation and physical activity (e.g. safe pedestrian bicycle routes) - Support policies that prioritize underserved neighborhoods for park investments and encourage communities to use parks to their full potential - Support local governments, schools and/or community based organizations to provide healthy food options (including accessible drinking water) and to adopt healthy food policies, including procurement practices - Support local governments, schools and/or community-based organizations to enroll community members into available food programs such as WIC, Cal Fresh, etc. - Promote use of Cal Fresh and WIC benefits at farmer's markets for purchasing fresh fruits and vegetables - Support programs that improve referral of patients to evidence-based health promotion programs that teach self-management and empowerment techniques for chronic disease management and prevention - Support collaboration between health care providers and community-level services to support patients' needs related to upstream determinants of health, such as access to healthy food at local grocery stores and addressing violence-free neighborhoods - Support programs-particularly evidence-based programs-that address diabetes prevention, education, and self-management Obesity/Diabetes/HEAL Resources and Partners - HEAL Zone Initiative - Thriving Schools Initiative - Pediatric Obesity Champion - Partners such as local cities, coalitions, collaboratives, foundations, after-school programs for children, and many more Obesity/Diabetes/HEAL Expected Outcomes - Increased options are available for safe active transportation - The number of people using active transportation has increased - Existing parks are improved to encourage greater use - Local organizations adopt and implement policies and environments that increase availability and encourage consumption of nutritious foods - Reduced unhealthy food consumption in participating organizations - Increased availability of free, clean drinking water across the community and in schools - Increased enrollment of eligible individuals into federal food programs - Increased use of federal food program benefits at farmers' markets - Increased consumption of fruits and vegetables among those receiving federal food program benefits - Increased number of available evidence-based health promotion programs are available in the community at no-or-low cost - Increased attendance at health promotion programs - Improved feelings of self-efficacy and ability to prevent/manage chronic disease - Increased number of people with diabetes who take a self-management course - Increased ability of people with diabetes to manage their blood sugar levels and avoid serious diabetic complications - Improved referrals and coordination between health care providers and community-based resources/programs - Increased collaboration between health care providers and non-traditional partners (e.g., police, local merchants, etc.) Health Need 3: Mental Health Mental Health Long-Term Goal All community members have optimal levels of mental health and well-being and access to high quality mental and behavioral health care services when needed. Mental Health Intermediate Goals - Improve the knowledge, capacity and infrastructure of health care, organizations and communities to address mental and behavioral health - Promote positive mental health by fostering community cohesion and social and emotional support Mental Health Strategies - Support integration of health care with community-based mental health services, such as: training of health care providers to identify mental and behavioral health needs, patient navigators who can help patients access services, strengthening of referral networks, and/or co-location of services between primary care and mental health providers. - Support school and youth development organizations in learning about and addressing mental and behavioral health, including suicide prevention and trauma-informed care. - Enhance access to high quality substance abuse treatment including medication-assisted treatments to decrease the burden of addiction and promote resiliency an A, 17, KFH - ONTARIO EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided through the use of key informant interviews, focus groups, and/or surveys. Individuals with knowledge, information, and/or expertise relevant to the health needs of the community were consulted, including representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, non-traditional stakeholders representing business, chamber of commerce, community-based organizations, economic development, educational institutions, financial institutions, government, public safety, transportation and utility were also involved in providing input. Line 6a: KFH-Fontana Line 6b: Community Vital Signs Line 11: A. Mental and Behavioral Health Long-term Goal Increase the number of community members that have optimal levels of mental health/well-being and access to quality mental and behavioral health services Intermediate Goals - Improve the knowledge, capacity and infrastructure of health care, organizations and communities to address mental and behavioral health - Promote positive mental health by fostering community cohesion and social and emotional support - Prevent and reduce violence Strategies - Support 1) Evidence-based and promising family and youth development programs in school setting (i.e. conflict resolution, violence/bullying, mentoring, suicide prevention); 2) Student assistance programs (Screening, Assessment, Referral, and Treatment-SART); Positive Behavioral Interventions & Support; Trauma -Informed Care; 3) Direct delivery of services; 4) Parenting education, social support to parents, and encouragement of positive parent-child interactions. Example resources and partnerships include: Ontario - Montclair Unified School Districts and the Kaiser Permanente Chemical Dependency Recovery Program. - Support integration of healthcare with community-based mental health services (training of health care providers to identify mental and behavioral health needs, patient navigators who can help patients access services, strengthening of referral networks, and/or co-location of services between primary care and mental health providers) if grant is proposed from specific organizations including National Alliance on Mental Illness (NAMI) and DBH. Example resources and partnerships include: San Bernardino County Behavioral Health Dr. Ahiba, a physician who is also connected with the NAMI. - Support prevention efforts to increase community awareness and educate youth and adults about the dangers of substance abuse, prescription drugs (including sharing, proper disposal, unintentional overdose, etc.) across school districts and universities. Example resources and partnerships include: Ontario Unified School Districts and the Kaiser Permanente Chemical Dependency Recovery Program. Expected Outcomes - Increased access (availability and affordability) of mental and behavioral health services in school and community settings. - Increased screening and identification of mental and behavioral needs in High Schools. - Improved schools and community cohesion and social support - Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to address mental and behavioral health. B. Economic Security Long-term Goal Increase the number of community members experience improved economic security, including access to employment, educational and housing opportunities and other factors that influence health, including access to affordable fresh food. Intermediate Goals - Improve the availability and the quality of affordable housing - Prevent displacement and homelessness - Improve employment opportunities - Reduce food insecurity in the community - Increase education attainment Strategies - Support 1) Career and bridge training/educational opportunities to participate in postsecondary education and obtain employment; 2) Transitional employment programs (time-limited, subsidized, paid jobs) as a bridge to unsubsidized employment; 3) Youth apprenticeship programs that provide high school students with professional opportunities that combine academic and on-the-job training/mentorship. Example resources and partnerships include: San Bernardino County Vital Signs and Kaiser Permanente Human Resources Employment Workshops. - Support 1) Efforts to increase access to permanent housing with supportive services for homeless individuals/families to help them maintain stability and self-sufficiency; 2) Rapid re-housing combined with crisis intervention, needs assessment, case management; 3)Tenant-based rental assistance programs to low-income families for more housing options. Example resources and partnerships include: Homeless Service Provider Collaborations and the Kaiser Permanente Social Medicine Department. - Participate and support a countywide cross-sector Housing Policy Council to focus on affordable housing and community development issues. Example resources and partnerships include: The Interagency Council on Homelessness and Kaiser Permanente Public Affairs - Support cities, schools, community based organizations to 1)Provide healthy food options (including fruits/vegetables, accessible drinking water) and to adopt healthy food policies, including procurement practices; 2) Enroll community members into available food programs (i.e. Cal Fresh and Supplemental Food Program for Women, Infants, and Children (WIC)); Promote use of Cal Fresh and WIC benefits at farmer's markets for purchasing and promote fresh fruits and vegetables as healthy food choices. Example resources and partnerships include: Healthy Cities and Kaiser Permanente Nutrition and Food Services - Support community-based organizations and networks to build their capacity to advance economic security. Example resources and partnerships include: High Desert Food Collaborative and Kaiser Permanente Public Affairs - Support efforts to assess upstream social and basic needs and coordinate with community based organizations. Example resources and partnerships include: Health Leads and Kaiser Permanente Regional Program. - Support: 1) Career academies, small learning communities within high schools that focus on specific vocational fields; 2) Dropout prevention programs; 3) Mentoring programs for at-risk students, homeless or youth in foster care; 4) Targeted programs to increase college enrollment, with strong parental engagement; 5) Health care workforce pipeline programs to introduce diverse, underrepresented school age youth and college students to health careers; 5) Support STEM education programs/opportunities focused on science, technology, engineering or mathematics; an interdisciplinary and applied approach coupled with real-world, problem-based learning and exposure. Example resources and partnerships include: Inland Empire Pipeline Convergence and Kaiser Permanente Hippocrates Circle Program. Expected Outcomes - Increased self-sufficiency - Decreased percentage of individuals with no high school diploma - Increased educational attainment - Increased number of people employed - Decreased number of people becoming homeless C. Access to Care Long-term Goal Increase the number of community members have access to timely, coordinated, high quality health care from a trained and diverse workforce. Intermediate Goals - Increase coverage and access to comprehensive, quality health care services for low income and uninsured populations - Improve the capacity of healthcare systems to provide quality healthcare services, including the social and non-medical needs of their patients. - Improve the size and capacity of the primary care workforce to meet community needs. - Enhance individuals' utilization of the community based health delivery system Strategies - Explore opportunities between hospitals and community health providers to reduce hospital readmissions (follow up appointments to community clinics upon discharge). Example resources and partnerships include: Community Clinic Association of San Bernardino County and Kaiser Permanente Public Affairs. - Support solutions that address the health care needs of people who do not qualify for low-cost or no-cost health insurance such as 1) Outreach, enrollment, and retention efforts to increase access to health care coverage; 2) Encourage and integrate use of Community Health Workers to connect residents to medical homes and sign them up for insurance; onboarding / orientation for new patient members, including education about patient centered medical home concept and how to access clinical preventive services. Example resources and partnerships include: El Sol Promotoras and admitting staff in emergency departments who are aware of alternative community resources. - Train new physicians (i.e., Graduate Me A, 18, KFH - SAN LEANDRO EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: The Hospitals contracted with Applied Survey Research (ASR) to conduct the primary research. Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. In all, Applied Survey Research (ASR) gathered community input from 54 individuals through focus groups and individual interviews. In all, ASR consulted with 44 professional community representatives of various organizations and sectors through 18 key informant interviews and three focus groups (which included 26 participants). These representatives either work in the health field or improve health conditions by serving those from the target populations. In the list below, the number in parentheses indicates the number of participants from each sector. - County Public Health (5) - Other health centers or systems (11) - Mental/Behavioral health or violence prevention providers (12) - School system representatives (2) - City or county government representatives (3) - Nonprofit agencies providing basic needs (11) Line 6a: - John Muir Health - Kaiser Foundation Hospital - Antioch - Kaiser Foundation Hospital - Walnut Creek - Kaiser Foundation Hospital - Oakland - Kaiser Foundation Hospital - Richmond - Kaiser Foundation Hospital - Fremont - Kaiser Foundation Hospital - San Leandro - St. Rose Hospital - San Ramon Regional Hospital - Stanford Health Care - ValleyCare - UCSF Benioff Children's Hospital Oakland - Washington Hospital Healthcare System Line 6b: While there was no formal collaboration between the Hospitals and other organizations, the Hospitals invited representatives from the public health departments of the City of Berkeley, County of Alameda, and the County of Contra Costa to one of their first joint meetings. These representatives presented local public health data and shared about local efforts to improve health outcomes. The Hospitals discussed these issues with these public health representatives and increased their knowledge of the health needs in their respective communities. Line 11: As part of the Kaiser Permanente integrated health system, KFH San Leandro has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH San Leandro is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH San Leandro welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH San Leandro will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. HEALTHY EATING ACTIVE LIVING Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g., obesity, diabetes, cardiovascular disease). Intermediate Goals - Improve healthy eating among residents in low-income, under-resourced communities. - Increase physical activity among residents in low-income, under-resourced communities. Strategies Healthy eating strategies: - Increase access to healthy, affordable foods (including fresh produce), and decrease access to unhealthy food. - Increase access to free, safe drinking water. - Reduce access to and appeal of sugar sweetened beverages. - Increase enrollment in and use of federal food programs. Physical activity strategies: - Increase access to safe parks and public spaces. - Increase opportunities for active transportation. - Increase access to physical activity opportunities in the community. - Increase access to physical activity opportunities in schools. Examples: - Provide grants to increase access to affordable, healthy foods in schools, workplaces, community settings, and programs that serve low-income persons. - Implement Thriving Schools, an initiative that targets resources to schools in low income neighborhoods to improve the health and wellness of students and employees through improved nutrition, increased physical activity, and access to health care. - Participate in the Alameda County Building Blocks Collaborative and other coalitions to support policies that promote healthy eating and encourage access to affordable, healthy foods. - Provide grants for use of promotores (i.e., peer educators) through safety net clinics to assist with enrollment in SNAP. - Provide grants to food banks and other local nonprofit organizations in underserved neighborhoods to assist in SNAP enrollment. - Partner with local safety net clinics and faith-based organizations on SNAP enrollment. - Participate in coalitions to support evidence-based, community-driven advocacy efforts to influence infrastructure and policies that increase the use of safe public spaces. - Support institutional healthy food procurement. - Support programs and policies in schools that maximize opportunities for physical activity throughout the day, including through our Thriving Schools initiative. - Provide KP's Educational Theater, programming that provides education in schools on health and wellness. Expected Outcomes Healthy eating: - Increased consumption of fruits and vegetables. - Increased consumption of water. - Decreased consumption of sugar sweetened beverages (SSBs). - Increased enrollment and participation in federal food programs. Physical activity: - Increased use of parks and public spaces. - Increased walking and biking to school and work. - Increased physical activity. B. BEHAVIORAL HEALTH Long-term Goal All community members experience social/emotional health and wellbeing and have access to high-quality behavioral health care services when needed. Intermediate Goals - Expand prevention and support services for mild to moderate behavioral health conditions. - Decrease stigma associated with seeking behavioral health services among vulnerable and diverse populations. - Develop a diverse, well-trained behavioral health care workforce that provides culturally sensitive behavioral health care. - Increase access to culturally and linguistically appropriate behavioral health services for vulnerable and low-income populations. Strategies Prevention strategies: - Provide screening and identification related to behavioral health needs among low-income, vulnerable, and uninsured populations and connect them with the appropriate services or support. - Support opportunities to prevent and reduce the misuse of drugs and alcohol. - Provide access to programs, services or environments that evidence suggests improves overall social/emotional wellness. Destigmatization strategies: - Support opportunities to reduce stigma through education and outreach in school, community and workforce settings. Workforce strategies: - Support the recruitment, hiring and retention of a diverse, culturally competent behavioral health care workforce in the clinical and community-based settings. - Increase access to training and education for diverse populations currently underrepresented in the behavioral health care workforce. Access strategies: - Provide high-quality behavioral health care to Medi-Cal participants. - Promote integration of care between primary and behavioral health care. - Improve nav 2016 Needs Not Selected and Rationale The Contributions Committee was careful to recommend a set of health needs that could make an impact in the community: Healthy Eating, Active Living, Behavioral Health, Community and Family Safety, and Health Care Access and Delivery. Therefore, the remaining health needs for this area (listed below in alphabetical order) will not be addressed by KFH San Leandro, because these needs did not meet the criteria to the same extent that the chosen needs did, and more specifically for the following reasons. A. Asthma Asthma is a chronic inflammatory disorder of the airways characterized by episodes of reversible breathing problems due to airway narrowing and obstruction. These episodes can range in severity from mild to life threatening. Asthma affects people of every race, sex, and age; however, significant disparities in asthma morbidity and mortality exist, in particular for low-income and minority populations. Asthma was not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. In addition, few evidence-based strategies were identified that could be applied to this health need. KFH San Leandro is better positioned to address asthma management via healthcare access and delivery strategies. B. Cancer Cancer is the second most common cause of death in the United States. Behavioral and environmental factors play a large role in reducing the nation's cancer burden, along with the availability and accessibility of high-quality screening. Cancer was not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. KFH San Leandro is better positioned to address drivers of cancer via strategies related to healthy eating and active living, and ethnic disparities in cancer incidence and mortality rates via healthcare access and delivery strategies. C. Cardiovascular Disease/Stroke Nationally, more than one in three adults (81.1 million) lives with one or more types of cardiovascular disease. In addition to being the first and third leading causes of death in the U.S., heart disease and stroke result in serious illness and disability, decreased quality of life, and hundreds of billions of dollars in economic loss every year. KFH San Leandro is better positioned to address drivers of these needs via strategies related to healthy eating and active living. Kaiser Permanente believes that strategies intended to address the community's healthy eating and active living needs have the potential to decrease cardiovascular disease and stroke in the community as well. D. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH San Leandro. While KFH San Leandro did not select this need because the Contributions Committee believed it was much less feasible to address given limited resources, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. E. Infectious Disease Infectious diseases remain a major cause of illness, disability, and death. Various public health agencies closely monitor infectious diseases to identify outbreaks and epidemics, provide preventive treatment and/or targeted education programs, and allocate resources effectively. Infectious Disease was not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. This need is already being monitored and addressed by the county public health department. KFH San Leandro believes that certain healthcare access and delivery strategies, such as screenings and vaccinations, have the potential to decrease infectious disease in the community as well. F. Maternal and Child Health Improving the well-being of mothers, infants, and children is an important public health goal. The topic area of maternal and child health addresses a wide range of conditions, health behaviors, and health systems indicators that affect the health, wellness, and quality of life of women, children, and families. The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality preconception (before pregnancy) and interconception (between pregnancies) care. Maternal/child health was not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. KFH San Leandro is better positioned to address this need from a prevention standpoint via healthcare access and delivery strategies and via strategies related to healthy eating and active living. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL. A, 19, KFH - SAN JOSE EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: The Coalition contracted with Applied Survey Research (ASR) to conduct the primary research. Community input was provided by a broad range of community members through the use of key informant interviews, focus groups and surveys. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. In all, ASR gathered community input from 162 individuals through a survey, focus groups, and individual interviews. In all, ASR solicited input from over 120 community leaders and representatives of various organizations and sectors. These representatives either work in the health field or improve health conditions by serving those from the target populations. Multiple community leaders participated from each of these types of agencies: - Santa Clara County Public Health Department and Behavioral Health Services - Santa Clara Valley Medical Center (County) clinics - Hospitals and healthcare systems- Health insurance providers - Mental/behavioral health or violence prevention providers - School systems - Nonprofit community-based organizations serving children, youth, seniors, parents, immigrants, those experiencing homelessness, and those suffering from dementia, mental health and substance use disorders Many of these leaders and representatives participated in key informant interviews or focus groups, and others participated in an online survey. line 6A: - El Camino Hospital - Kaiser Permanente South Bay (Santa Clara and San Jos Kaiser Foundation Hospitals) - Lucile Packard Childrens Hospital Stanford - OConnor Hospital - Stanford Health Care - Saint Louise Regional Hospital - Santa Clara County Public Health Department - Sutter Health Line 6B: The Coalition includes partners representing the Santa Clara County Public Health Department, the Hospital Council of Northern & Central California, and the Palo Alto Medical Foundation (PAMF). Line 11: As part of the Kaiser Permanente integrated health system, KFH San Jos has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH San Jose is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH San Jos welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH San Jose will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. BEHAVIORAL HEALTH Long-term Goal All community members experience social/emotional health and wellbeing and have access to high-quality behavioral health care services when needed. Intermediate Goals - Expand prevention and support services for mild to moderate behavioral health conditions. - Decrease stigma associated with seeking behavioral health services among vulnerable and diverse populations. - Develop a diverse, well-trained behavioral health care workforce that provides culturally sensitive behavioral health care. - Increase access to culturally and linguistically appropriate behavioral health services for vulnerable and low-income populations. Strategies Prevention strategies: - Provide screening and identification related to behavioral health needs among low-income, vulnerable, and uninsured populations and connect them with the appropriate services or support. - Support opportunities to prevent and reduce the misuse of drugs and alcohol. - Provide access to programs, services or environments that evidence suggests improves overall social/emotional wellness. Destigmatization strategies: - Support opportunities to reduce stigma through education and outreach in school, community and workforce settings. Workforce strategies: - Support the recruitment, hiring and retention of a diverse, culturally competent behavioral health care workforce in the clinical and community-based settings. - Increase access to training and education for diverse populations currently underrepresented in the behavioral health care workforce. Access strategies: - Provide high-quality behavioral health care to Medi-Cal participants. - Promote integration of care between primary and behavioral health care. - Improve navigation to appropriate care within the health care system and support services in the community. - Increase the capacity to respond appropriately to individuals and/or communities that have experienced trauma and/or violence. Examples: - Provide grants for programs providing early childhood screening for developmental delays and behavioral problems. - Provide grants to addiction education or programs for youth to prevent and reduce the misuse of alcohol, tobacco, and marijuana use. - Provide grants to support substance abuse prevention and treatment programs for youth and families and aggression-reducing programs focused on skill-building. - Provide grants for behavioral health programs for homeless families. - Partner with community-based organizations to support behavioral health programs, services, and environments that reduce stress, anxiety, and/or depression. - Partner with Santa Clara County Public Health Department on trauma & violence. - Provide KPs Educational Theater, programming that provides education in schools on health and wellness. - Mental health training program participants rotate through community clinics and other community based organizations to provide behavioral health services and training. Expected Outcomes Prevention: - Increased enrollment in programs to improve social/emotional wellness. - Increased screening for behavioral health needs. - Increased participation in drug and alcohol prevention programs. Destigmatization: - Increase in help-seeking behavior for accessing behavioral health care. Workforce: - Increase in the number of culturally and linguistically competent and skilled behavioral healthcare providers. - Increase in the number of people from underrepresented groups enrolling in education and job training programs. Access: - Increase in the number of low-income patients who receive behavioral health care services. - Increased integration of primary and behavioral health care services. - Improved access to quality care for youth, families and communities experiencing violence. B. COMMUNITY AND FAMILY SAFETY Long-term Goal All community members live in safe environments and individuals who are victims or at-risk of violence have the support they need. Intermediate Goals - Improve safety in communities with high rates of violence. - Support prevention and early intervention efforts targeting youth that promote positive youth development and that focus on youth assets and resilience. - Improve safety in families through family violence prevention, screening and treatment efforts. - Improve the quality of responsive care and services for youth and families experiencing violence and/or trauma to break the cycle of violence. Strategies Community safety strategies: - Increase availability of safe parks and public spaces. - Build social cohesion in neighborhoods and community. - Improve law enforcement and community relations. - Promote public understanding of violence as a public health issue. Prevention and early intervention strategies: - Increase availability of education, job training and enrichment programs for 2016 Needs Not Selected and Rationale The Contributions Committee was careful to recommend a set of health needs that could make an impact in the community: Behavioral Health, Community and Family Safety, Health Care Access and Delivery, and Healthy Eating, Active Living. Therefore, the remaining health needs for this area (listed below in alphabetical order) will not be addressed by KFH San Jose, because these needs did not meet the criteria to the same extent that the chosen needs did, and more specifically for the following reasons. A. Birth Outcomes Improving the well-being of mothers, infants, and children is an important public health goal. The topic area of birth outcomes addresses a wide range of conditions, health behaviors, and health systems indicators that affect the health, wellness, and quality of life of women, children, and families. The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality preconception (before pregnancy) and interconception (between pregnancies) care. Birth outcomes were not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. KFH San Jose is better positioned to address this need from a prevention standpoint via healthcare access and delivery strategies and via strategies related to healthy eating and active living. B. Cancer Cancer is the second most common cause of death in the United States. Behavioral and environmental factors play a large role in reducing the nation's cancer burden, along with the availability and accessibility of high-quality screening. KFH San Jose is better positioned to address drivers of cancer via strategies related to healthy eating and active living, and ethnic disparities in cancer incidence and mortality rates via healthcare access and delivery strategies. C. Cardiovascular (Heart /Stroke) Nationally, more than one in three adults (81.1 million) lives with one or more types of cardiovascular disease. In addition to being the first and third leading causes of death in the U.S., heart disease and stroke result in serious illness and disability, decreased quality of life, and hundreds of billions of dollars in economic loss every year. KFH San Jose is better positioned to address drivers of these needs via strategies related to healthy eating and active living. Kaiser Permanente believes that strategies intended to address the community's healthy eating and active living needs have the potential to decrease cardiovascular disease and stroke in the community as well. D. Communicable Diseases (Non-Sexually-Transmitted Infections) Communicable diseases remain a major cause of illness, disability, and death. Various public health agencies closely monitor communicable diseases to identify outbreaks and epidemics, provide preventive treatment and/or targeted education programs, and allocate resources effectively. Relatively few community resources were identified to address communicable diseases, providing fewer opportunities for leverage. This need is already being monitored and addressed by the county public health department. KFH San Jose believes that certain healthcare access and delivery strategies, such as screenings and vaccinations, have the potential to decrease communicable diseases in the community as well. E. Dementia & Alzheimer's Disease Alzheimer's disease is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Several factors determine the risk of developing dementia, including age and family history. Dementia and Alzheimer's disease were not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. Also, there were not many evidence-based strategies identified to address the need. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. KFH San Jose is better positioned to address this need from an early intervention standpoint via healthcare access and delivery strategies. F. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH San Jose. While KFH San Jose did not select this need because the Contributions Committee believed it was much less feasible to address given the resources available, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Additionally, health care providers such as KFH San Jos have no control over the cost of housing in a thriving economy. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. G. Learning Disabilities Learning disabilities include attention deficit disorder (ADD) and attention deficit-hyperactivity disorder (ADHD), and identification on the autism spectrum. ADHD affects 3-7% of American children and often continues into adulthood, making it the most common developmental disorder. Learning disabilities were not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. Also, there were not many evidence-based strategies identified to address the need. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. KFH San Jose is better positioned to address this need from an early intervention standpoint via healthcare and non-medical social services access strategies. H. Respiratory Conditions Respiratory conditions include asthma, chronic obstructive pulmonary disorder (COPD), and others. Asthma in particular is considered a significant public health burden and its prevalence has been rising since 1980. Respiratory conditions were not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. Also, there were not many evidence-based strategies identified to address the need. In addition, few evidence-based strategies were identified that could be applied to this health need. KFH San Jose is better positioned to address asthma management via healthcare access and delivery strategies. I. Sexual Health Data indicate that rates of sexually-transmitted infections (STIs) and teen births in Santa Clara County are similar to California. However, disparities are pervasive and screening rates for HIV and other STIs are lower than the state. Communicable diseases such as sexually transmitted infections are closely monitored by various public health agencies to identify outbreaks and epidemics, provide preventive treatment and/or targeted education programs, and allocate resources effectively. Sexual health was not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. This need is already being monitored and addressed by the county public health department. KFH San Jose believes that certain healthcare access and delivery strategies, such as screenings and vaccinations, as well as increased cultural competency among providers, have the potential to improve sexual health in the community as well. J. Unintentional Injuries Unintentional injuries are defined as those that are not purposely inflicted. The most common unintentional injuries result from falls, motor vehicle crashes, poisonings, and drownings. Although most unintentional injuries are predictable and preventable, they are a major cause of premature death and lifelong disability. Unintentional injuries were not a high priority of the community (i.e., the prioritization score was much lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. KFH San Jose is better positioned to address this need from a prevention standpoint via strategies related to active living. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS EL B, 20, KFH - BALDWIN PARK EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided through the use of key informant interviews, focus groups, and/or surveys. Individuals with knowledge, information, and/or expertise relevant to the health needs of the community were consulted, including representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, non-traditional stakeholders representing business, chamber of commerce, community-based organizations, economic development, educational institutions, financial institutions, government, public safety, transportation and utility were also involved in providing input. Line 6a: Citrus Valley Health Partners three campuses (Citrus Valley Medical Center-Inter-Community Campus in Covina; Citrus Valley Medical Center-Queen of the Valley Campus in West Covina; and Foothill Presbyterian Hospital in Glendora) and hospice (Citrus Valley Hospice in West Covina) Line 11: A. Obesity/HEAL/Diabetes KFH-Baldwin Parks long-term goal for addressing Obesity/HEAL/Diabetes is that all community members eat healthy and move more as a part of daily life. It aims to visualize this goal by organizing its strategies around the following strategic priorities (or intermediate goals): - Improve access to opportunities for physical activity in the community. - Improve access to healthy food options in the community. - Improve linkages between health care services and community-level services. These priorities have guided the development of the following core strategies to address Obesity/HEAL/Diabetes in the community. A large sub-set of these strategies are aligned with the Los Angeles County Community Health Improvement Plan (CHIP) and will enable greater collaboration with public health and community health partners in addressing this health need. Support new and improved policies and programs that support active transportation and physical activity (e.g. safe pedestrian bicycle routes and violence prevention initiatives that create safe schools and communities). Support programs and policies that prioritize underserved neighborhoods for park investments and encourage communities to use parks to their full potential. Support local governments, schools and/or community based organizations to provide healthy food options (including accessible drinking water) and to adopt healthy food policies, including procurement practices. Support local governments, schools and/or community-based organizations to enroll community members into available food programs, most importantly CalFresh and the Supplemental Food Program for Women, Infants, and Children (WIC); Promote use of CalFresh and WIC benefits at farmer's markets for purchasing fresh fruits and vegetables. KFH-Baldwin Park partners with Southland Farmers Market Association in holding a farmers market every Friday on the medical center campus. The Farmers Market is available to the broad community (including patients and staff). This partnership enables the use of CalFresh and WIC benefits for the purchase of fresh fruits and vegetables as healthy food choices. KFH-Baldwin Park partners with Baldwin Park and West Covina Unified School Districts in implementing the Garden Gourmets program for low-income fourth grade students at nine (9) participating elementary schools. Students are taught to harvest their own vegetables and fresh herbs and encouraged to make healthy choices when purchasing food from local vendors. In addition, the hands on activities in the gardens (KP Baldwin Park Community Garden and Hurst Ranch in West Covina) and use of healthy recipes directly align with their science and health curriculums implemented in the classroom. Support multi-level, multi component initiatives in school settings to produce significant and measurable impact on the health of students, staff and teachers in K-12 schools within communities. An example for this strategy is the Thriving Schools Initiative, a community-based partnership to improve healthy eating, physical activity and school climate in K-12 schools in Kaiser Permanentes service areas, primarily through a focus on policy, systems and environmental changes that support healthy choices and a positive school climate. Support programs that improve referral of patients to evidence-based health promotion programs that teach self-management and empowerment techniques for chronic disease (obesity, diabetes, and/or heart disease) management and prevention. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to build the field of healthy eating and active living. Leverage KP assets to drive community health, including healthy eating and active living and champion organizational practice changes within KP that promote health. Successful implementation of these strategies is expected to contribute to the following set of outcomes in the community: Adoption and implementation of policies and programs that increase availability and enable access to healthy food (including fresh produce and safe drinking water) and/or physical activity. Reduced availability and marketing of unhealthy foods and beverages, including sugar-sweetened beverages. Increased enrollment and use of federal food programs. Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to collaborate and to promote policy, system and environmental change. Improved patient assessment and care for chronic conditions (obesity, diabetes, and/or heart disease) and social non-medical needs by healthcare providers. B. Access to Care KFH-Baldwin Parks long term goal for addressing Access to Care is that all community members have access to timely, coordinated, high quality health care from a trained and diverse workforce. It aims to visualize this goal by organizing its strategies around the following strategic priorities (or intermediate goals): Increase coverage and access to comprehensive, quality health care services for low income and uninsured populations. Enhance individuals' utilization of the community based health delivery system. Improve the capacity of healthcare systems to provide high quality healthcare services, including the social and non-medical needs of their patients. These priorities have guided the development of the following core strategies to address access to care in the community. A large sub-set of these strategies are aligned with the Los Angeles County Community Health Improvement Plan (CHIP) and will enable greater collaboration with public health and community health partners in addressing this health need. Support targeted outreach, enrollment, and retention efforts to increase access to health care coverage, particularly among communities of color and immigrant populations, where disparities in both access to care and health care coverage is greatest. Support the provision of high quality healthcare (including preventive services and specialty care) for underserved populations. KFH Baldwin Park aims to address access to care by a) partnering with the East Valley Community Health Center (EVCHC) through the KP Care Night program, where once a month, KFH-Baldwin Park physicians and nurse practitioners provide no-cost primary care services to uninsured and underinsured residents of the San Gabriel Valley, b) partnering with nine school districts in the San Gabriel Valley for the Every Childs Healthy Option (ECHO) Program, where various KFH-Baldwin Park departments including Emergency Room, Pediatrics, Vision Essentials, and Pharmacy provide uninsured children in grades K-12 with year-round, no-cost access to urgent care services (i.e. fractures, breaks, infections, etc) and any follow up appointments and services (i.e. glasses, medication) affiliated with their initial visit at the medical center are also covered. In addition, as part of the largest non-profit health system, KFH-Baldwin Park participates in government-sponsored programs for low-income individuals (i.e., Medi-Cal Managed Care and Medi-Cal Fee-For-Service), provides access and comprehensive health care to low-income individuals and families who do not have access to public or private health coverage through charitable health coverage, and provides financial assistance to low-income individuals who receive care at KFH facilities and cant afford medical expenses and/or cost sharing. Support infrastructure improvements that can support the integration of clinical care with mental/behavioral health, oral health, vision and other health services. Reduce barriers to access to care by providing language interpretation, transportation, non-traditional access points, and/or other supportive services. Support partnerships and net A, 21, KFH - IRVINE EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Local stakeholders participated in focus groups or key informant interviews. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, other individuals with expertise of local health needs were consulted. In order to increase the diversity of community input, and to acknowledge the growing diversity of Orange County, Asian-Pacific Islander community organization representatives, members from the Arab-American community, and members from the Latino community were included as well. Additionally, other non-traditional stakeholders representing behavioral health, business community, child and family services, economic instability organizations, OC STEM Initiative, and alcohol drug education and prevention also provided input. line 6A: Memorial Care, St. Jude Medical Center, St. Joseph's Medical Center, Hoag Memorial Hospital, and University of California, Irvine. Line 6b: Orange County Health Care Agency, Orange County Health Improvement Plan (OCHIP) work groups. Line 11: A. Mental and Behavioral Health Support school and youth development organizations in learning about and addressing (through sharing of teen assessment tool) mental and behavioral health, including suicide prevention and trauma-informed care. KFH-Irvine intends to share teen assessment tool as a partnership between Kaiser Permanente and the Coalition of Community Health Centers, Orange County Department of Education and other community based organizations to better address teen mental and behavioral health. Support policies and programs that address early child development and toxic stress, including positive parenting and violence-free homes (Raise, OCDE, Thriving Schools, OC FJF youth violence prevention). Support the development of community-based organizations, leaders, and networks, and build their capacity to advance equity and reduce stigma surrounding mental and behavioral health. KFH-Irvine community benefit liaison is a member of the behavioral health work group of the Health Improvement Partnership of Orange County. The goal of this work group is to increase the proportion of residents who experience emotional and mental wellbeing and reducing alcohol and drug misuse in Orange County. Leverage KP assets to drive community health and champion organizational practice changes within KP that promote mental and behavioral health. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to share information about what works in improving behavioral and mental health and to build the field. B. Obesity/HEAL/Diabetes Support new and improved policies and environments that support active transportation and physical activity (e.g. safe pedestrian bicycle routes). KFH-Irvine Community Benefit liaison is a member of the active transportation subcommittee of the Alliance for a Healthy Orange County. The goal of the active transportation subcommittee is to identify and build support for active transportation and find sources of funding at the local, state and federal level for Orange County's active transportation projects and programs to promote healthy communities. Support multi-level, multi-component initiatives in community settings to support access to healthy, affordable food and activity-promoting environments. Support multi-level, multi component initiatives in school settings to produce a significant and measurable impact on the health of students, staff and teachers in K-12 schools within communities served by Kaiser Permanente. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to build the field of healthy eating and active living. Leverage KP assets to drive community health, including healthy eating and active living and champion organizational practice changes within KP that promote health. C. Economic Security Expand efforts to increase access to permanent housing with supportive services for homeless individuals and families to help them maintain stability and self-sufficiency. Support local governments, schools and/or community based organizations that increase economic security for individuals and families by expanding opportunities for employment, education and workforce pipeline. An example of this is KFH-Irvine recruitment services liaison will continue to serve as a member of the Orange County Business Council workforce development committee to share knowledge regarding healthcare jobs of the future, participate on focus groups and participate as a guest speaker on work force development expert panels. KFH-Irvine liaison will continue to meet with community based organizations, such as Working Wardrobes, to provide expertise in mock interviews, resume writing and presentations such as the values of hiring a Veteran. Support local governments, schools and/or community based organizations to provide healthy food options (including accessible drinking water) and to adopt healthy food policies, including procurement practices. Leverage KP assets to drive community health and champion organizational practice changes within Kaiser Permanente that improve economic security. D. Access to Care Provide training for medical professionals to improve the delivery care infrastructure and/or implement new models of care provision to improve the capacity of the primary care workforce. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to share information about what works in improving access to health care for the underserved. An example of this is Health Funders Partnership of Orange County's Health and Wellness Committee, a collaborative between KFH-Anaheim and Irvine and other health care organizations in Orange County. The aim of this partnership is to support local community health centers with health and wellness programs, such as Integrative Medicine, which will improve access to mental and behavioral health services for low-income patients. Kaiser Permanente liaison serves as a funder on the collaborative as well as providing community expertise in participating in formation of initiatives for community clinics to improve access to care. In addition, KFH-Irvine intends on addressing access to care by involving Kaiser Permanente service line leaders in the community to provide diversity training for community based organizations, specifically around health care equality and measures to address disparities in healthcare for African Americans. Leverage KP assets to drive coverage and access to healthcare for the underserved, build the capacity of the primary care workforce and improve appropriate utilization of healthcare services. Support the provision of high quality health care (including preventive services and specialty care) for underserved populations. As part of the largest non-profit health system, KFH - Irvine participates in government-sponsored programs for low-income individuals (i.e. Medi-Cal Managed Care and Medi-Cal Fee-For-Service), provide access and comprehensive health care to low-income individuals and families who do not have access to public or private health coverage through charitable health coverage, and provide financial assistance to low-income individuals who receive care at KFH facilities and cannot afford medical expenses and/or cost sharing. Participate in government-sponsored programs for low-income individuals (i.e. Medi-Cal Managed Care and Medi-Cal Fee-for-Service). Provide heavily subsidized health care coverage. Provide Medical Financial Assistance (i.e. Charity Care). The remaining prioritized health needs not addressed by KFH-Irvine because they demonstrated lower 'Need,'Feasibility' include Housing, Substance Abuse/Use, Oral/Dental Health, Cancer, Cardiovascular Disease, Alzheimer's, Suicide, Maternal & Child Health and HIV/AIDS. While the Implementation Strategy Report responds to the CHNA and Implementation Strategy requirements in the Affordable Care Act and IRS Notices, it is not exhaustive of everything we do to enhance the health of our communities. KFH-Irvine will look for collaboration opportunities that address needs not selected where it can appropriately contribute to addressing those needs, or where needs align with current strategy and priorities. Line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. Line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES O A, 22, KFH - SOUTH BAY EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, non-traditional stakeholders representing anchor institutions/significant employers (e.g., DIRECTV, Edison, Sam's Club), chamber of commerce, civic leaders, educational. Line 6a: Dignity Health St. Mary Medical Center, Long Beach Memorial, Miller Children's & Women's Hospital Long Beach, and Community Hospital Long Beach Line 6b: The Children's Clinic and the City of Long Beach Department of Health and Human Services. Line 11: A. Access to Care Develop solutions that address the health care needs of people who do not qualify for low-cost or no-cost health insurance, including but not limited to undocumented individuals. KFH-Harbor City will provide Charitable Care and Coverage and grants to nonprofit organizations offering health coverage outreach and enrollment services. Support policies and programs that improve the ability of health care organizations to assess upstream factors and coordinate with community based preventative services. KFH-Harbor City will provide funding support to FQHCs/Community Health Centers to provide employment and housing assistance, and enrollment in CalFresh for underserved populations. Support infrastructure improvements that can support the integration of clinical care with mental/behavioral health, oral health, vision, and other health services. To address the integration of clinical care, KFH-Harbor City will award grants to nonprofit organizations and FQHCs/Community Health Centers that provide mental and dental health services. Provide training for medical providers on the provision of culturally competent care to diverse populations (including homeless). KFH-Harbor City will identify Continuing Medical Education (CMEs), symposiums or in-service training and learning opportunities for FQHCs/Community Health Centers to participate. Support the provision of high quality health care (including preventive services and specialty care) for underserved populations. As part of the largest non-profit health system, KFH-Harbor City participates in government-sponsored programs for low-income individuals (i.e. Medi-Cal Managed Care and Medi-Cal Fee-For-Service), provide access and comprehensive health care to low-income individuals and families who do not have access to public or private health coverage through charitable health coverage, and provide financial assistance to low-income individuals who receive care at KFH facilities and can't afford medical expenses and/or cost sharing. Leverage KP assets to drive coverage and access to healthcare for the underserved, build the capacity of the primary care workforce and improve appropriate utilization of healthcare services. KFH-Harbor City coordinates annual Community Surgery and Colonoscopy Screening Days in partnership with FQHCs (Harbor Community Clinic; Harbor City Family Health Care; The Children's Clinic, Serving Children and Their Families; and Wilmington Community Clinic). Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to share information about what works in improving access to health care for the underserved. B. Economic Security Expand efforts to increase access to permanent housing with supportive services for homeless individuals and families to help them maintain stability and self-sufficiency. KFH-Harbor City's Community Benefit Manager and Physician Champion will participate on a hospital subcommittee of the Harbor City Coalition to End Homelessness to share best practices, resources and training opportunities to serve the homeless population. Support policies that increase economic security for individuals and families by expanding opportunities for employment. KFH-Harbor City will identify a local leader (Human Resources Director) to partner with the Harbor City Workforce Investment Board to recruit and hire individuals in the communities KFH-Harbor City serves. Support local governments, schools, and/or community based organizations to enroll community members into available food programs, most importantly Cal Fresh and Supplemental Food Program for Women, Infants, and Children (WIC); Promote the use of Cal Fresh and WIC benefits at farmer's markets for purchasing fresh fruits and vegetables. In partnership with City of Los Angeles, KFH-Harbor City will establish a Farmer's Market at Ken Malloy Park in Harbor City and offer enrollment in supplemental food programs such as Women Infants and Children (WIC) and Cal Fresh at the existing KFH-Harbor City Farmer's Market. Leverage KP assets to drive community health and champion organizational practice changes within Kaiser Permanente that improve economic security. KFH-Harbor City will partner with local vocational schools, community colleges, workforce investment boards, local hiring halls or community-based workforce development programs to create career pipeline programs in target communities with high rates of unemployment and poverty. C. Injury and Violence Prevention Support the adoption of evidence-based and promising family and youth development programs, such as the provision of trauma-informed care, conflict resolution programs, and mentoring programs that focus on keeping youth positively engaged in school and the community. KFH-Harbor City's Hippocrates Circle Program will assign physician mentors to middle school students to encourage them to enter the health care field; connecting Kaiser Permanente's Educational Theatre Program conflict resolution and anti-bullying performances to local schools. Additionally, KFH-Harbor City's Chief Operating Officer will serve as a member of the advisory board for California State University Dominguez Hills Male Success Alliance Program, which matches professional mentors, provides career guidance and mock interviews for college students and afterschool programs for youth. Support policies and programs that increase diversion from incarceration for low-level offenses among youth and adults, particularly those that result from substance abuse or mental health needs. KFH-Harbor City to provide grants to nonprofit organizations offering school-based diversion programs, namely: Centinela Youth Services' Reducing Violence in Schools through Mediation; Long Beach Bar Association's Short Stop Juvenile Crime Diversion Program; and the California Conference for Equality and Justice, Restorative Justice Programs in Schools and Community. Support new and improved policies and environments that increase the availability and use of safe public spaces, such as parks. In partnership with the City of Los Angeles Parks and Recreation Department, KFH-Harbor City will convene nonprofit and community-based organizations in the Harbor City-Harbor Gateway area to engage youth in positive programs and activities at Los Angeles County Ken Malloy Park to reduce violence in the community. Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to build the field of community health (including promoting best practices in trauma-informed care). KFH-Harbor City will identify a leader to participate in stakeholder convenings and activities hosted by the City of Long Beach in support of Safe Long Beach Violence Prevention Plan and its initiatives aimed at reducing violence, increasing awareness, and providing resources and assistance. Leverage KP assets to drive community health, including violence prevention; champion organizational practice changes within KP that create safe schools and communities. D. Mental and Behavioral Health Support place-based and multi-sector collaborative efforts that support mental health and behavioral health. KFH-Harbor City will identify and recruit physician volunteers to participate in the Mental Health America's homeless innovations program, a "street medicinecollaborative approach to providing medical and mental health services to homeless individuals in Long Beach. Support school and youth development organizations in learning about and addressing mental and behavioral health, including suicide prevention and trauma-informed care. KFH-Harbor City physicians and LCSWs will be identified to speak at parent and youth workshops offered by Behavioral Health Services on various topics such substance abuse and gender identity. Support the development of community-based orga A, 23, KFH - SANTA ROSA EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members and leaders through key informant interviews and focus groups. Individuals identified by the CHNA Collaborative as having valuable knowledge, information, and expertise relevant to the health needs of the community were interviewed. Interviewees included representatives from the local public health department, as well as members of medically underserved, low-income, chronically diseased, and minority populations. Other individuals from various sectors with expertise of local health needs were also consulted. A total of 21 key informant interviews were conducted during this needs assessment. Additionally, five focus groups were conducted throughout Sonoma County, reaching 64 residents. These groups were intentionally sampled to reach residents in specific geographic regions identified as areas of high concern in the Portrait of Sonoma County report. These subpopulations included residents in Petaluma, the Boyes Hot Springs in Sonoma Valley, Cloverdale, Roseland in Southwest Santa Rosa, and the Russian River area. Focus groups were monolingual, and the language of facilitation was selected to encourage participation from the target population for each conversation. The SC CHNA Collaborative worked closely with community organizations to ensure that the location and language of facilitation selected was appropriate and convenient for residents in each community. Groups in Cloverdale and the Boyes Hot Springs in Sonoma Valley were conducted in Spanish; all others were conducted in English. Community partners provided invaluable assistance in recruiting and enrolling focus group participants. Many individuals who participated in focus groups identified as leaders, representatives, or members of medically underserved, low-income, chronically diseased, and minority populations. line 6a: Sonoma County's primary hospitals (KFH-Santa Rosa, St. Joseph Health-Sonoma County, Sutter Health) worked in collaboration with partners from Sonoma County District Hospitals, including Healdsburg Health District, Palm Drive Health Care District, and Sonoma Valley Hospital, to complete a county wide CHNA. Line 6b: Representatives from the primary hospitals, joined by representatives from Sonoma County Department of Health Services, formed the 2016 Sonoma County Community Health Needs Assessment Collaborative. Line 11: As part of the Kaiser Permanente integrated health system, KFH Santa Rosa has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Santa Rosa is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Santa Rosa welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Santa Rosa will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. Healthy Eating Active Living Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g. obesity, diabetes, CVD). Intermediate Goals - Improve healthy eating among residents in low income, under-resourced communities. - Increase physical activity among residents in low income, under-resourced communities. Strategies Healthy eating strategies - Increase access to healthy, affordable foods, including fresh produce, and decrease access to unhealthy food. - Increase access to free, safe drinking water. - Reduce access to and appeal of sugar sweetened beverages. - Increase enrollment in and use of federal food programs. Physical activity strategies - Increase access to safe parks and public spaces. - Increase opportunities for active transportation. - Increase access to physical activity opportunities in the community. - Increase access to physical activity opportunities in schools. For Example - Grant funding for food distribution programs. - Grant funding for physical activity programs in parks and the community. - Support programs that promote school-based physical activity as well as school wellness policy development and implementation. - Participate in collaborative with health care and educational institutions to procure healthy food - Provide KP's Educational Theater, programming that provides education in schools on health and wellness. - Support sustainable food distributors by purchasing locally produced fruits and vegetables. - Support local restaurants and caterers that meet healthy food guidelines. - Host farmers markets at KP facilities. Expected Outcomes Healthy eating - Increased consumption of fruits and vegetables. - Increased consumption of water. - Decreased consumption of sugar sweetened beverages (SSBs). - Increased enrollment and participation in federal food programs Physical activity - Increased use of parks and public spaces. - Increased walking and biking to school and work. - Increased physical activity. B. Access to Care and Coverage Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low income and vulnerable populations. - Develop a diverse, well trained health care workforce that provides culturally sensitive health care. Strategies Access strategies - Provide high-quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and can't afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity of health system strategies - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social non-medical service strategies - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low income populations. Workforce strategies - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For Example: - Provide grant funding for community health centers, clinics, and coalitions. - Support programs that expand use of patient navigators, promotores or community application assisters. - Provide grant funding for pathway programs to increase the diversity of the healthcare workforce by providing mentorship, academic enrichment, leadership development, and career exposure to disadvantaged and minority youth. - Provide subsidized health care coverage to children (18 & under) in low-income families (up to 300% FPL) who lack access to other sources of coverage. - Partner with existing organizations and collaboratives focus 2016 Needs Not Selected and Rationale KFH Santa Rosa has unique resources, expertise, and capacity to dedicate to the four chosen health needs. The remaining health needs prioritized in the 2016 CHNA will not be addressed by KFH Santa Rosa because the facility has chosen to concentrate resources in health need areas where Kaiser Permanente can align with existing local and regional efforts, and maximize impact of organizational resources. A number of community partners have undertaken initiatives to address the needs, below. While this Implementation Strategy Report responds to the CHNA and Implementation Strategy requirements in the Affordable Care Act and IRS Notices, it is not exhaustive of everything we do to enhance the health of our communities. KFH Santa Rosa will look for collaboration opportunities that address needs not selected where it can appropriately contribute to addressing those needs. The needs that will not be addressed are: A. Access to Education Access to Education is an important issue in Sonoma County, particularly in early childhood. In selecting to focus on Early Childhood Development, KFH Santa Rosa intends to support innovative solutions to providing increased access to education in early childhood, such as increasing access to high quality early learning opportunities and supporting early childhood workforce development. Therefore, KFH Santa Rosa chose not to address Access to Education separately. B. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Santa Rosa. Although the Contributions Committee ranked Economic and Housing Security high with respect to criteria such as disparities/equity and CHNA prioritization, this health need was ranked low with respect to KP expertise, feasibility, and existing or promising practices. Ultimately, KFH Santa Rosa did not select this need because our expertise is stronger in other areas and thus we may be better positioned to leverage our resources to affect positive change towards other health needs. However, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. C. Oral Health In Sonoma County, oral health is an important issue that is driven in part by lack of access to dental insurance coverage or inadequate utilization of dental care. KFH Santa Rosa does not have extensive expertise in the field of oral health, and instead intends to explore opportunities to increase residents' access to health insurance, which in turn may increase access to dental health care, as well as support residents in eating healthier diets, which addresses some of the causes and impact of poor oral health outcomes. Therefore, KFH Santa Rosa chose not to address Oral Health as a separate priority area. D. Violence and Unintentional Injury Violence and Unintentional Injury, while a concern in Sonoma County, was the lowest ranked health need in the CHNA prioritization process. Further, the causes of violence and injury are broad, and the solutions extend beyond specific communities across the Region, and State. To achieve the greatest impact and maximize use of its resources, KFH Santa Rosa chose to address higher-priority health needs. KFH Santa Rosa intends to explore opportunities to support residents in accessing behavioral health resources, support effective connections to social services, and help prepare community residents to be successful in seeking jobs and careers, in order to address both the causes and impact of violence and injury. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL. B, 24, KFH - WOODLAND HILLS EXPLANATIONS PART V, SECTION B. ************************************************************************** LINE 5: Community input was provided by a broad range of community members through the use of key informant interviews, focus groups, and/or surveys. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. Additionally, Valley Care Community Consortium's (VCCC) long-established partnerships and collaboration with organizations and county departments was advantageous to identifying representatives who serve within various sectors of the communities of KFH-Woodland Hills. These representatives included community residents, political representatives, county departments, educators, health providers and providers, and business leaders. Line 6a: Simi Valley Hospital, Community Memorial Health System, St. John's Regional Medical Center, and Ventura County Medical Center Line 11: Financial Well-Being Long-term Goal All community members experience improved economic security, including access to employment, educational and housing opportunities and other factors that influence health, including access to affordable fresh food. Intermediate Goals - Prevent displacement and homelessness. - Improve employment opportunities. - Reduce food insecurity in the community. Strategies - Expand efforts to increase access to permanent housing with supportive services for homeless individuals and families. - Support policies that increase economic security for individuals and families by expanding opportunities for employment. - Support the development of culturally relevant and multi-generational community resident's leadership and build their capacity to advance equity and improve economic security. - Support policies that increase economic security by expanding educational opportunities for individuals and their families. Expected Outcomes - Increase access to education opportunities. - Increase access to employment opportunities and workforce training. Healthy Eating Active Living Long-term Goal All Community Members eat healthy and move more as part of daily life. Intermediate Goals - Improve access to opportunities for physical activity in the community - Improve linkages between health care services and community-level services. Strategies - Support the development of culturally relevant and multi-generational community resident leadership and build their capacity to advance equity and prevent obesity/promote healthy eating and active living. - Support local governments, schools and/or community based organizations to provide healthy food options (including accessible drinking water) and to adopt healthy food policies that are community driven. - Support new and improved community driven policies and environments that support increased physical activity. Expected Outcomes - Adoption and implementation of policies and environments that increase availability and enable access to physical activity. - Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to collaborate and to promote policy, system and environmental change. - Improved referrals and coordination between healthcare providers and community resources and programs. Access to Care Long-term Goal All community members have access to timely, coordinated, high quality health care from a trained and diverse workforce. Intermediate Goals - Improve the capacity of the primary care workforce to meet community needs. - Improve the capacity of healthcare systems to provide quality healthcare services, including the social and non-medical needs of their patients. Strategies - Support the provision of high quality healthcare (including preventive services, specialty care and integrative medicine) for underserved populations. - Reduce barriers to quality, culturally appropriate care by providing language and literacy interpretation, transportation, non-traditional access points, and/or other supportive services. - Support the development of culturally relevant and multi-generational community resident's leadership and build their capacity to advance equity and improve access to healthcare. Expected Outcomes - Enhanced care integration of clinical, mental, dental, vision and complementary health strategies. - Safety net partners are engaged in a public policy agenda to create conditions that support the health of low-income and underserved individuals and that advance equity, improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to address access to healthcare. Social and Emotional Support Long-term Goal All community members have optimal levels of mental health and well-being and access to high quality mental and behavioral health care services when needed. Intermediate Goals - Improve the knowledge, capacity and infrastructure of health care, organizations and communities to address mental and behavioral health. - Promote positive mental health by fostering community cohesion and social and emotional support. Strategies - Enhance access to high quality substance abuse prevention and treatment, including integrated assistance therapies, to promote resiliency and recovery from addiction. - Support community based initiatives that promote social and emotional wellbeing by fostering community connections. - Support the development of culturally relevant and multi-generational community resident leadership and build their capacity to advance equity and reduce stigma surrounding mental and behavioral health. Expected Outcomes - Increased access (availability and affordability) of mental and behavioral health services in healthcare and community settings. - Improved screening and identification of mental and behavioral needs among patients. - Improved referrals and coordination between healthcare providers and community resources and programs. The remaining prioritized health needs for the Woodland Hills MCA will not be addressed by KFH-Woodland Hills because they demonstrated lower 'Need,'Feasibility' than the selected health needs using the aforementioned strategy grid methodology. The selected health needs (Access to Care, Diabetes/Obesity, Economic Security, Mental/Behavioral Health) demonstrate relatively higher levels of magnitude, severity, and disproportionate impact among vulnerable populations. There are strong community partners mobilizing around these issues and KFH-Woodland Hills has unique resources and capacity to dedicate to work focused on these health needs. The needs that will not be addressed for Woodland Hills are: 1. Cancers Although cancer is a leading cause of death in the United States, the rate of death due to cancer is notably lower in the Woodland Hills MCA (rate of 143.11 per 100,000 population) relative to the state (157.1 per 100,000 population). Furthermore, the incidence of breast, prostate, and lung cancers in this area are lower than rates in the state and nationwide. Alcohol consumption and tobacco usage, which have significant impact on cancer, are additionally lower in the Woodland Hills MCA than the state. 2. Heart Disease and Stroke The prevalence of heart disease is lower in the service area (6.08%) than in the state (6.30%). Furthermore, the rates of both mortality by ischemic heart disease and mortality by stroke are notably lower in the Woodland Hills service area than in the state. While this Implementation Strategy Report responds to the CHNA and Implementation Strategy requirements in the Affordable Care Act and IRS Notices, it is not exhaustive of everything we do to enhance the health of our communities. KFH-Woodland Hills will look for collaboration opportunities that address needs not selected where it can appropriately contribute to addressing those needs. Line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. Line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. KFHP MEMBERS WHO HAVE A DEDUCTIBLE MUST HAVE INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME TO BE ELIGIBLE FOR CHARITY CARE. Line 16j: THE FAP PROGRAM MATERIALS ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/SCALWWW.KP.ORG//MFA/SCAL A, 25, KFH - MODESTO EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members through the use of key informant interviews, focus groups, and/or surveys. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from local public health departments as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. A community survey was administered to 2,927 residents of San Joaquin County in the participants self-identified dominant language (English or Spanish) or verbally in other languages (Hmong or Cambodian). Approximately 10% of surveys were administered in Spanish. The survey was available online and in a paper version. Among all respondents, 19.2% were under age 25 and 7.2% were over age 60. Respondents were 71.7% female, 43.0% identified as Latino, and 26.6% spoke Spanish at home. A total of 34 individuals identified by the Core Planning Group as having valuable knowledge, information, and expertise were interviewed. Interviewees included representatives from the local public health department, as well as leaders, representatives, and members of medically underserved, low-income, minority populations, and those with a chronic disease. Other individuals from various sectors with expertise in local health needs were also consulted. To maximize resources and strengthen relationships, all interviews were conducted by members of the Core Planning Group. Additionally, 29 focus groups were conducted throughout the County, reaching 348 residents. To maximize resources and leverage relationships with community groups and residents, these groups were facilitated by local volunteers who had been trained by MIG staff. Community partners provided invaluable assistance in recruiting and enrolling focus group participants. Individuals who participated in focus groups included leaders, representatives, or members of medically underserved, low-income, chronically diseased, and minority populations. Participants also represented a breadth of geographic regions, racial/ethnic subpopulations, and age categories. Line 6A: The core Planning group consisted of the following organizations: - Community Medical Centers - Community Partnership for Families of San Joaquin - Dameron Hospital Association - Dignity Health-St. Joseph's Medical Center - First 5 San Joaquin - Health Net - Health Plan of San Joaquin - San Joaquin County Public Health Services - Sutter Tracy Community Hospital Line 6B: The other partner organizations that are members of the San Joaquin County Community Health Assessment Committee and participated in the assessment include: Community Partnership for Families, First 5 San Joaquin, Community Medical Centers, Inc., San Joaquin County Public Health Services, Health Net of California, Health Plan of San Joaquin, Scan Health Plan, San Joaquin County Office of Education, National Alliance on Mental Illness (NAMI), Catholic Charities, California Center for Public Health Advocacy, Lao Family Community Empowerment, Inc., St. Mary's Dining Room, Wallach & Associates, San Joaquin County Behavioral Health Services, Community Development, City of Stockton, Delta Health Care, El Concilio, City of Tracy Parks and Recreational Services, Tracy Unified School District, Counseling and More, Journey Christian Church, Reich's Pharmacy, City of Tracy City Council, Child Abuse Prevention Council, Stockton City Council, San Joaquin County Probation, Emergency Food Bank San Joaquin, Family Resource & Referral, San Joaquin County Data Co-Op, Regional Transit Division, County Office of Education, People and Congregations Together (PACT), University of the Pacific, Business Council of San Joaquin County, Asian-American Chamber of Commerce, San Joaquin Hispanic Chamber of Commerce, League of Women Voters of San Joaquin County, UC Cooperative Extension, San Joaquin County Housing Authority, Aging and Community Services, San Joaquin Council of Governments, and Business Forecasting Center. Line 11: As part of the Kaiser Permanente integrated health system, KFH Modesto has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Modesto is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Modesto welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Modesto will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. Access to Care and Coverage Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low income and vulnerable populations. - Develop a diverse, well trained health care workforce that provides culturally sensitive health care. Strategies Access - Provide high quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at Kaiser Permanente facilities and cant afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity and Health Systems Management - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social Non-medical Services - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. Workforce - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For example: - Provide subsidized health care coverage to children (18 & under) in low-income families (up to 300% FPL) who lack access to other sources of coverage. - Provide Medical Financial Assistance. - Fund community-based organizations to provide health care coverage outreach, enrollment and retention, especially for undocumented populations. - Support diabetes prevention/management for adults and pregnant women. - Fund community clinics to provide behavioral health services (peer groups, promotoras), especially for Spanish speaking and Hmong populations. - Support organizations that provide navigation to free and reduced cost services for specialty care. - Support community-based organization staff to assist individuals/families with health system navigation. - Fund 211 for information & referral on primary, specialty and behavioral health care services. - Collaborate with Modesto City Schools, Stanislaus Union School 2016 Needs Not Selected and Rationale A. CVD/Stroke CVD/Stroke was not perceived as a high priority by the community. Many of the Obesity/HEAL/Diabetes and Access to Care strategies will address cardiovascular disease and stroke prevention. In addition, there are many existing programs that address this need; KFH Modesto and other area hospitals conduct ongoing CVD/Stroke prevention, education and screening as part of their clinical and outreach activities. B. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Modesto. KFH Modesto did not select this need because the facility alone does not have the resources to make a meaningful contribution to address economic security. While KFH Modesto did not select this need, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments in community infrastructure and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. C. Violence/Injury Prevention Violence/injury prevention was categorized as a low priority during the multi voting process conducted to prioritize health needs during the CHNA, and this need was not identified as a priority need during the CHNA community input process. This need will be addressed in part by strategies conducted under Behavioral Health. D. Asthma Asthma was categorized as low priority during the multi voting process conducted to prioritize health needs during the CHNA. KFH Modesto perceives limited ability to leverage organizational assets to address asthma. E. Cancers Cancers were categorized as a medium priority during the multi voting process conducted to prioritize health needs during the CHNA. Cancer prevention is addressed in part through Kaiser Permanente's strategies under Obesity/HEAL/Diabetes and Access to Care. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. Line 13H: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL A, 26, KFH - FRESNO EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members through the use of key informant interviews, focus groups, and surveys. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from local public health departments as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. Community input was collected through surveys, focus groups, and key informant interviews in each of the four counties that comprise the KFH Fresno service area (Fresno, Kings, Tulare and Madera Counties). The goal of soliciting community input was to gather the communitys perspective on the priority health needs for each county and any community assets or resources available to address those needs. All three methodologies focused on the same set of questions which asked about the biggest health, social and economic problems facing the community, obstacles to a healthy environment, behaviors that affect health, and barriers that make it hard to access health care. Community input validated a health need when at least two points were assigned using the criteria outlined for each methodology. LINE 6A: - Adventist Health/Central Valley Network - Community Medical Centers - Coalinga Regional District Hospital - Kaweah Delta Medical Center - Madera Community Hospital - Saint Agnes Medical Center - Sierra View Medical Center - Tulare Regional Medical Center - Valley Childrens Hospital Line 6B: Fresno Metro Ministry, a nonprofit established in 1970 with a mission to advocate for the health and well-being of the community, and Centro La Familia Advocacy Services, a nonprofit working to empower low income people to access life sustaining resources through education, training and social services, were contracted to assist with the community outreach efforts. In addition, the Madera County Department of Public Health assisted with the outreach efforts in Madera County. Line 11: As part of the Kaiser Permanente integrated health system, KFH Fresno has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities - Leverage or enhance public health department activities - Advance increased general knowledge through education or research that benefits the public - Otherwise would not become the responsibility of government or another tax-exempt organization KFH Fresno is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Fresno welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Fresno will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. Access to Care and Coverage Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low income and vulnerable populations. - Develop a diverse, well-trained health care workforce that provides culturally sensitive health care. Strategies Access - Provide high quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at Kaiser Permanente facilities and cant afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity and Health Systems Management - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social Non-medical Services - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. Workforce - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For example: - Participate in Medi-Cal Managed Care and Medi-Cal Fee for Service - Provide subsidized health care coverage to children (18 & under) in low-income families (up to 300% FPL) who lack access to other sources of coverage. - Support targeted outreach and enrollment for specific populations for programs for which they are eligible. - Fund community-based organization to assist homeless people with obtaining health care coverage. - Partner with California School Based Health Alliance to support school based health center model dissemination to provide access to services on school campuses. - Support organizations that provide navigation to free and reduced cost services for specialty care. - Provide physician and Kaiser Permanente staff volunteers at events that provide surgical, specialty, and diagnostic services to low-income, uninsured people. - Support population health management approaches that Improve health outcomes for safety net patients with diabetes and hypertension. - Provide access to Kaiser Permanente expertise related to population health management via trainings and consultation. - Support community health workers who assist community members with obtaining appropriate services. - Fund school based health center model to link students to non-medical services. - Fund program to provide internships for low-income youth at local health centers, medical centers and hospitals. - Partner with UCSF Fresno Doctors Academy and UCSF/CSU Fresno Health Care Opportunities program to expand participation of Kaiser Permanente providers. - Provide workforce training programs to train current and future health care providers, including physicians, mental health practitioners, physical therapy, pharmacy, nurses, and allied health professionals, with the skills and linguistic and cultural competence to meet the health care needs of diverse communities. - Support rotation of residents and trainees in community health centers. Expected Outcomes Access - Increase in the number of low-income patients who receive health care services/coverage. - Increase in the number of low-income patients that enroll in health care coverage programs. Capacity of Health Systems - Increase in the quality of care provided by safety net providers through PHASE protocol. - Improved capacity of health systems to provide population health management. - Increased integration of primary and specialty health care services. - Improved capacity of safety net providers to assuming capitated risk. Social non-medical Services - Increase in referrals and coordination to non-medical social services. - Increased enrollment and participation in public benefit programs. Workforce - Increase in the number of people from underrepresented groups enrolling in education and job training programs. - Increase in the number of culturally and linguistically competent and skilled healthcare providers. B. Healthy Eating and Active Living (HEAL) Long-term Goal All community mem 2016 Needs Not Selected and Rationale A. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Fresno. KFH Fresno did not select this need because the facility alone does not have the resources to make a meaningful contribution to address economic security. While KFH Fresno did not select this need, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. B. Asthma Although asthma was categorized as a high priority during the CHNA prioritization process, KFH Fresno perceives limited ability to leverage organizational assets to address asthma. Asthma will be addressed in part through strategies implemented under Access to Care and Coverage. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. Line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL. A, 27, KFH - REDWOOD CITY EXPLANATION PART V, SECTION B. ********************************************************************** LINE 5: The HCC contracted with Applied Survey Research (ASR) to conduct the primary research. Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. In all, ASR gathered community input from 103 individuals through focus groups and individual interviews. In all, ASR consulted with 38 professional community representatives of various organizations and sectors through 29 key informant interviews and one focus group (which included nine participants). These representatives either work in the health field or improve health and quality of life conditions by serving those from IRS-identified high-need populations. In the list below, the number in parentheses indicates the number of participants from each sector. - San Mateo County Public Health Department (1) - San Mateo County Health & Hospital System (5) - San Mateo County Supervisors or Commissioners (3) - Other San Mateo County employees (3) - Nonprofit agencies (22) - Faith-based leaders (2) - Business sector (2) Line 6a: - Dignity Health Sequoia Hospital - Hospital Consortium of San Mateo County - Kaiser Permanente, San Mateo Area - Lucile Packard Childrens Hospital Stanford - Peninsula Health Care District - Seton Medical Center and Seton Coastside, part of Verity Health System - Stanford Health Care - Sutter Health Mills-Peninsula Health Service Line 6b: The HCC also includes members outside of the hospitals. These organizations are the San Mateo County Health Department and the San Mateo County Human Services Agency. Line 11: As part of the Kaiser Permanente integrated health system, KFH Redwood City has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Redwood City is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Redwood City welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Redwood City will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. HEALTHY EATING ACTIVE LIVING Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g., obesity, diabetes, cardiovascular disease). Intermediate Goals - Improve healthy eating among residents in low-income, under-resourced communities. - Increase physical activity among residents in low-income, under-resourced communities. Strategies Healthy eating strategies: - Increase access to healthy, affordable foods (including fresh produce), and decrease access to unhealthy food. - Increase access to free, safe drinking water. - Reduce access to and appeal of sugar sweetened beverages. - Increase enrollment in and use of federal food programs. Physical activity strategies: - Increase access to safe parks and public spaces. - Increase opportunities for active transportation. - Increase access to physical activity opportunities in the community. - Increase access to physical activity opportunities in schools. Examples: - Provide grants for programs that offer nutrition education and/or make healthy food available to low-income children, youth, and/or adults, such as food banks, distribution sites, and CalFresh enrollment work. - Collaborate with San Mateo Public Health Department to promote public health policy aimed at increasing access and availability of healthy foods and decreasing access and advertising of unhealthy foods and beverages. - Partner with community-based organizations to increase accessibility to farmers markets (new and/or existing) and to increase the use of EBT (Electronic Benefits Transfer) for SNAP (Supplemental Nutrition Assistance Program) for fresh fruits and vegetables. - Provide grants for programs that assist individuals in enrolling and/or using federal food programs. - Support programs and policies in schools that maximize opportunities for physical activity throughout the day, including through our Thriving Schools initiative. - Provide KPs Educational Theater, programming that provides education in schools on health and wellness. - Support local restaurants and caterers that meet healthy food guidelines. - Design new KP facilities in ways that promote active transportation, whenever possible. Expected Outcomes Healthy eating: - Increased consumption of fruits and vegetables. - Increased consumption of water. - Decreased consumption of sugar sweetened beverages (SSBs). - Increased enrollment and participation in federal food programs. Physical activity: - Increased use of parks and public spaces. - Increased walking and biking to school and work. - Increased physical activity. B. BEHAVIORAL HEALTH Long-term Goal All community members experience social/emotional health and wellbeing and have access to high-quality behavioral health care services when needed. Intermediate Goals - Expand prevention and support services for mild to moderate behavioral health conditions. - Decrease stigma associated with seeking behavioral health services among vulnerable and diverse populations. - Develop a diverse, well-trained behavioral health care workforce that provides culturally sensitive behavioral health care. - Increase access to culturally and linguistically appropriate behavioral health services for vulnerable and low-income populations. Strategies Prevention strategies: - Provide screening and identification related to behavioral health needs among low-income, vulnerable, and uninsured populations and connect them with the appropriate services or support. - Support opportunities to prevent and reduce the misuse of drugs and alcohol. - Provide access to programs, services or environments that evidence suggests improves overall social/emotional wellness. Destigmatization strategies: - Support opportunities to reduce stigma through education and outreach in school, community and workforce settings. Workforce strategies: - Support the recruitment, hiring and retention of a diverse, culturally competent behavioral health care workforce in the clinical and community-based settings. - Increase access to training and education for diverse populations currently underrepresented in the behavioral health care workforce. Access strategies: - Provide high-quality behavioral health care to Medi-Cal participants. - Promote integration of care between primary and behavioral health care. - Improve navigation to appropriate care within the health care system and support services in the community. - Increase the capacity to respond appropriately to individuals and/or communities that have experienced trauma and/or violence. Examples: - Provide grants to local community-based organizations, community agencies, community stakeholder groups, and/or teen health centers that focus on providing mental health screening and treatment programs. - Provide grants to support substance abuse prevention and treatment programs for youth and families. - Provide grants to support therapeutic interventions for adolescents (e.g., cognitive-behavioral therapy and Mindfulness-Based Stress 2016 Needs Not Selected and Rationale The Community Benefit Advisory Committee (CBAC) was careful to choose a set of health needs that best met all of the selection criteria and on which KFH Redwood City could make an impact in the community. The CBAC thought it was feasible to address a total of three health needs given its local community benefit resources. The remaining health needs did not meet the criteria to the same extent as the chosen needs did; therefore, KFH Redwood City does not plan to address them at this time. They are listed below in alphabetical order. A. Alzheimer's disease and dementia Alzheimer's disease is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Several factors determine the risk of developing dementia, including age and family history. KFH Redwood City did not select this need because it was of much lower community priority than the selected health needs, and the CBAC believed it was less feasible to address this need than the selected health needs. Also, there are not many local community assets available to leverage, and there are relatively few evidence-based practices that have been identified to ameliorate it. B. Birth outcomes Improving the well-being of mothers, infants, and children is an important public health goal. Data indicators that measure progress in the topic area of birth outcomes include low birthweight, infant mortality, teen births, breastfeeding, and access to prenatal care. Overall, birth outcomes in San Mateo County meet Healthy People 2020 (HP2020) targets and are similar to California. KFH Redwood City did not select this need because it was of much lower community priority than the selected health needs, and the CBAC believed it was less feasible to address this need than the selected health needs. C. Cancer Cancer is the second most common cause of death in the United States. Behavioral and environmental factors play a large role in reducing the nation's cancer burden, along with the availability and accessibility of high-quality screening. KFH Redwood City did not select this need because it was of somewhat lower community priority than the selected health needs, and the CBAC believed it was less feasible to address this need than the selected health needs. Also, there are not many local community assets available to leverage for it, and there are relatively few evidence-based practices that have been identified to ameliorate it. D. Cardiovascular Disease Nationally, more than one in three adults (81.1 million) lives with one or more types of cardiovascular disease. In addition to being the first and third leading causes of death in the U.S., heart disease and stroke result in serious illness and disability, decreased quality of life, and hundreds of billions of dollars in economic loss every year. KFH Redwood City did not select this need because it was of somewhat lower community priority than the selected health needs, and there are not many local community assets available to leverage for it. E. Climate change Maintaining a healthy environment is central to increasing quality of life and years of healthy life. Globally, almost 25% of all deaths and the total disease burden can be attributed to environmental factors. KFH Redwood City did not select this need because it was of much lower community priority than the selected health needs, and the CBAC believed it was much less feasible to address this need than the selected health needs. Also, there are very few local community assets and Kaiser Permanente regional assets available to leverage for it, Kaiser Permanente has little expertise in it, and there are few evidence-based practices that have been identified to ameliorate it. F. Communicable diseases Communicable diseases remain a major cause of illness, disability, and death. Various public health agencies closely monitor communicable diseases to identify outbreaks and epidemics, provide preventive treatment and/or targeted education programs, and allocate resources effectively. KFH Redwood City did not select this need because it was of lower community priority than the selected health needs, and the CBAC believed it was less feasible to address this need than the selected health needs. Also, there are very few local community assets available to leverage for it, and there are relatively few evidence-based practices that have been identified to ameliorate it. G. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Redwood City. While KFH Redwood City did not select this need because the CBAC believed it was much less feasible to address this need, given the resources available, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Additionally, health care providers such as KFH Redwood City have no control over the cost of housing in a thriving economy. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. H. Respiratory conditions Respiratory conditions include asthma, chronic obstructive pulmonary disorder (COPD), and others. Asthma in particular is considered a significant public health burden and its prevalence has been rising since 1980. KFH Redwood City did not select this need because it was of lower community priority than the selected health needs, and the CBAC believed it was less feasible to address this need than the selected health needs. Also, there are very few local community assets available to leverage for it, and there are relatively few evidence-based practices that have been identified to ameliorate it. I. Transportation and traffic In the U.S. in 2010, 3.9 million motor vehicle crashes killed and injured nearly 33,000 people, at an estimated cost to the U.S. economy of $242 billion. Vehicle exhaust is a known risk factor for heart disease, stroke, asthma, and cancer. KFH Redwood City did not select this need because it was of lower community priority than the selected health needs, and the CBAC believed it was much less feasible to address this need than the selected health needs. Also, there are not many local community assets and very few Kaiser Permanente regional assets available to leverage for it, Kaiser Permanente has little expertise in it, and there are few evidence-based practices that have been identified to ameliorate it. J. Unintentional injuries Unintended injuries are defined as those that are not purposely inflicted. The most common unintended injuries result from falls, motor vehicle crashes, poisonings, and drownings. Although most unintended injuries are predictable and preventable, they are a major cause of premature death and lifelong disability. KFH Redwood City did not select this need because it was of much lower community priority than the selected health needs, and the CBAC believed it was much less feasible to address this need than the selected health needs. Also, there are very few local community assets and relatively few Kaiser Permanente regional assets available to leverage for it, Kaiser Permanente does not have great expertise in it, and there are few evidence-based practices that have been identified to ameliorate it. K. Violence and abuse Violence and intentional injury contribute to poorer physical health for victims, perpetrators, and community members. Crime in a neighborhood causes fear, stress, unsafe feelings, and poor mental health. Witnessing and experiencing violence in a community can cause long-term behavioral and emotional problems in youth. Although there are some ethnic disparities in county statistics on violence and abuse, by almost all measures these issues have been trending down in San Mateo County. For this reason, and because it was of lower community priority, KFH Redwood City did not select this need. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP B, 28, KFH - PANORAMA EXPLANATIONS PART V, SECTION B. ************************************************************************ Line 5: Community input was provided by a broad range of community members through the use of key informant interviews, focus groups, and/or surveys. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. Line 6a: Valley Presbyterian Hospital and Northridge Hospital Medical Center Line 11: A. Access to Care Long-term Goal All community members have access to timely, coordinated, high quality health care from a trained and diverse workforce. Intermediate Goals - Enhance individuals' utilization of the community-based health delivery system. - Improve the capacity of health care systems to provide quality healthcare services, including the social and non-medical needs of their patients. - Improve the capacity of the primary care workforce to meet community needs. Strategies - Support the provision of high quality health care including preventive services and specialty care for underserved populations. - Support policies and programs that improve ability of the health care organizations to assess upstream factors and coordinate with community-based preventive services. - Support infrastructure improvements that can support the integration of clinical care with mental/behavioral health, oral health, vision and other health services. - Improve the quality improvement (QI) infrastructure of health care organizations by supporting capacity to use data, leadership training, business operations and through other infrastructure building strategies. - Support policies and programs that improve the delivery care infrastructure and/or implement new models of care provision to improve the capacity of the primary care workforce. Expected Outcomes - Reduced barriers that impede an individual's ability to seek and obtain health care, and comply with medical treatment regimes. - Improved referrals and coordination between health care providers and community resources and programs. - Enhanced care integration of clinical, mental, dental, vision and complementary health strategies. - Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to address access to health care. B. Economic Security Long-term Goal All community members experience improved economic security, including access to employment, educational and housing opportunities and other factors that influence health, including access to affordable fresh food. Intermediate Goals - Improve employment opportunities. - Reduce food insecurity in the community. Strategies - Support plans and policies that expand the supply of affordable housing for low-income families. - Support the development and implementation of plans to remove or remediate lead paint. - Expand efforts to increase access to permanent housing with supportive services for homeless individuals and families to help them maintain stability and self-sufficiency. - Support local governments, schools and/or community based organizations to provide healthy food options (including accessible drinking water) and to adopt healthy food policies, including procurement practices, - Support local governments, schools and/or community-based organizations to enroll community members into available food programs, most importantly Cal Fresh and the Supplemental Food Program for Women, Infants, and Children (WIC); Promote use of Cal Fresh and WIC benefits at farmer's markets for purchasing fresh fruits and vegetables. - Support communities (schools, childcare, retailors, etc.) in adopting nutrition policies and practices, including those that limit children's exposure to unhealthy food and beverage marketing. Expected Outcomes - Adoption and implementation of policies and environments that increase availability and enable access to affordable housing, healthy food, and reduction in lead paint. - Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to address access the social determinants of health. C. Obesity/HEAL/Diabetes Long-term Goal All community members eat healthy and move more as part of daily life. Intermediate Goals - Improve access to opportunities for physical activity in the community. - Improve access to healthy food options in the community. - Improve linkages between health care services and community-level services. Strategies - Support new and improved policies and environments that support active transportation and physical activity (e.g. safe pedestrian bicycle routes). - Support policies that prioritize underserved neighborhoods for park investments and encourage communities to use parks to their full potential. - Support local governments, schools and/or community based organizations to provide healthy food options (including accessible drinking water) and to adopt healthy food policies, including procurement practices. - Support collaboration between health care providers and community-level services to support patients' needs related to upstream determinants of health, such as access to healthy food at local grocery stores. - Support multi-level, multi component initiatives in school settings to produce a significant and measurable impact on the health of students, staff and teachers in K-12 schools within communities served by Kaiser Permanente (Thriving Schools Initiative). Expected Outcomes - Adoption and implementation of policies and environments that increase availability and enable access to healthy food (including fresh produce and safe drinking water) and/or physical activity. - Improved referrals and coordination between health care providers and community resources and programs. - Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to collaborate and to promote policy, system and environmental change. D. Mental Health and Behavioral Health Long-Term Goal All community members have optimal levels of mental health and well-being and access to high quality mental and behavioral health care services when needed. Intermediate Goals - Improve the knowledge, capacity and infrastructure of health care, organizations and communities to address mental and behavioral health. - Promote positive mental health by fostering community cohesion and social and emotional support. Strategies - Support integration of healthcare with community-based mental health services, such as: training of health care providers to identify mental and behavioral health needs, patient navigators who can help patients access services, strengthening of referral networks, and/or co-location of services between primary care and mental health providers. - Support school and youth development organizations in learning about and addressing mental and behavioral health, including suicide prevention and trauma-informed care. - Support prevention efforts to increase community awareness and educate youth and adults about the dangers of prescription drugs (including sharing, proper disposal, unintentional overdose, etc.) - Support policies and programs that address early child development and toxic stress, including positive parenting and violence-free homes. Expected Outcomes - Increased access (availability and affordability) of mental and behavioral health services in health care and community settings. - Improved referrals and coordination between health care providers and community resources and programs. - Improved community cohesion, networks and social support. - Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to address mental and behavioral health. E. Oral Health Long-term Goal Reduce oral health disease and advance overall health through increasing access and improving the prevention and management of oral health across the lifespan. Intermediate Goals - Improve the quality of the oral health care delivery system, focusing on patient-centered care. - Improved oral health policies and programs that increase preventive care and expand services. Strategies - Support infrastructure and capacity building of FQHCs to improve access to quality oral health services. - Support the maintenance and expansion of clinic and community linkages with government, school, and community programs. - Support the integration of oral health into clinical care delivery models. - Support partnerships and networks that sustain and scale change and lift up priorities, evidence and experience of communities, and to build the fie D, 29, KAISER WESTSIDE MED CTR EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input from across the primary and secondary service areas was incorporated into the CHNA process to identify and prioritize health needs. KPNW staff accounted for community input as part of the CHNA process in the following ways: - Identifying existing sources of primary data/community input (within 3 years prior to CHNA). - Participating in a regional collaboratives community health assessment process. - Conducting 29 community listening sessions and collecting 3000 surveys through the collaborative. - Community input informed the CHNA process across the KPNW region, but the sources and methodology varied across the primary and secondary hospital service areas Line 6a: KFH Westside and KFH Sunnyside conducted a joint CHNA. Both KFH hospitals share the same primary service area. Line 6b: KFH Hospitals helped found and has participated in the development of Healthy Columbia Willamette, a collaborative effort including 15 area hospitals and health systems as well as four county health departments and two Coordinated Care Organizations (CCOs) Healthy Columbia Willamette was formed to support member organizations in responding to the new ACA federal requirements and to catalyze the collective efforts of health and public health leaders in the Portland metropolitan area to have coordinated and meaningful impact on the health of the region. KPNW Community Benefit staff contributes to the on-going assessment efforts of Healthy Columbia Willamette to expand Kaiser Permanentes community partnerships and improve community health in the Northwest region. Members of Healthy Columbia Willamette collaborative: - Adventist Medical Center - Legacy Health System (5 hospitals) - Oregon Health & Science University - PeaceHealth Southwest Medical Center - Providence Health (4 hospitals) - Tuality Community Hospital - Health Share of Oregon (CCO) - Familycare (CCO) - Clackamas County Public Health Division - Clark County Public Health Department - Multnomah County Health Department - Washington County Public Health Division Line 11: KFH hospitals prioritized and selected five health needs to address throughout our service area. Listed below are the five selected needs followed by a high-level description of the strategies we are currently implementing. For a full description of all of KFH hospitals health improvement strategies, please refer to the Implementation Strategy report. A. Access to care KFH Hospitals are primarily addressing access to care through Medicaid, Medical Financial Assistance, Charitable Health Coverage, and Community Access programs, as well as through grant funding to Safety Net clinics and contracted hospitals. B. Nutrition and physical activity related chronic disease KFH Hospitals are primarily addressing chronic disease through regional collaborations promoting healthy eating active living (HEAL) policies and behaviors, and a healthy food access grant initiative, and by awarding grants to community organizations that promote HEAL clinical and community activities. C. Oral health KFH Hospitals are primarily addressing oral health through Dental Medicaid, Dental Financial Assistance, and Charitable Health Coverage programs, as well as the through participation in an oral health funders collaborative and an oral health grant initiative providing supporting local organizations that provide oral health prevention and treatment services. D. Mental health KFH Hospitals are primarily addressing mental health through behavioral health grants and grant initiatives that support both prevention and treatment efforts in adult and school-aged children as well as partnering with Oregon Childrens theater to deliver Kaiser Permanentes Educational Theatre Program which serves children grades K-12 with programming to support health and well-being. E. Maternal and infant health KFH Hospitals are primarily addressing maternal and infant health through providing perinatal care through community access programs, awarding grants to programs that improve perinatal health or provide teen pregnancy prevention, and through collaborations to support and promote breastfeeding. The remaining prioritized health needs will not be addressed because using the criteria described previously, they were not ranked as highly as Nutrition and Physical Activity-related Chronic Disease, Maternal and Infant Health, Access to Health Care, Oral Health, and Mental Health. The region has a unique set of resources and capacity to dedicate to the five selected health needs. In addition, there are other strong community partners and networks who are currently addressing the needs below. The needs that will not be addressed are: - Economic security - Cancer - Tobacco use - Sexually transmitted disease - Injury Line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL Line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. Line 16G: In 2018, KFH, through its ongoing internal compliance process, discovered that the direct website address (URL) where copies of the financial assistance policy (FAP), FAP application form, and plain language summary of the FAP (PLS) may be obtained was inadvertently not included on the billing statements for two of its forty-one hospital facilities, KFH Sunnyside and Westside Medical Center, as a result of a system update that impacted the billing statements. Upon discovery in February 2018, the billing statements for these two facilities were promptly updated (by March 2018) to include the URL. The billing statements otherwise provided patients with all other required information regarding the FAP for each facility and how to obtain information about the program or assistance in applying for financial assistance. Further, at all times the URL was made known to patients by including the URL on the PLS and providing the PLS to patients at intake or discharge as well as with at least one billing statement. KFH has also implemented processes to provide additional review for the content of billing statements following a system update. Line 16j: THE FAP PROGRAM MATERIALS ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG/MFA/NW Line 20e: 1) Provided written notice on all patient statements informing patients that MFA is available for those who qualify. 2) Provided the PLS with first patient billing statement. with first patient billing statement. B, 30, KFH - WEST LOS ANGELES PART V, SECTION B. ********************************************************************** Line 5: Community input was provided by a broad range of community members through the use of key informant interviews, focus groups, and/or surveys. Individuals with knowledge, information, and/or expertise relevant to the health needs of the community were consulted, including representatives from state, local, tribal, or other regional governmental public health departments (or equivalent agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, other individuals with expertise in local health needs were consulted where applicable. Line 6a: Cedars-Sinai Medical Center, University of California Los Angeles (UCLA) Medical Center, and Saint Johns Health Center Line 11: A. Access to Care Long Term Goal All community members have access to timely, coordinated, high quality health care from a trained and diverse workforce. Strategic Priorities (intermediate goals): - Increase coverage and access to comprehensive, quality health care services for low income and uninsured populations. - Improve the capacity of healthcare systems to provide quality healthcare services, including the social and non-medical needs of their patients. - Improve the capacity of the primary care workforce to meet community needs. Strategies: Coverage and Access - Support targeted outreach, enrollment, and retention efforts to increase access to health care coverage, particularly among communities of color and immigrant populations, where disparities in both access to care and health care coverage are greatest - Support the provision of high quality healthcare (including preventive services and specialty care) for underserved populations including the reduction of barriers to accessing care Capacity of Healthcare Systems - Support policies and programs that improve the ability of the healthcare organizations to assess upstream factors and coordinate with community-based preventive services Capacity of Primary Care Workforce - Support educational programs to reduce system barriers to improve the capacity of the primary care workforce. Outcomes: - Improved referrals and coordination between healthcare providers and community resources and programs - Reduced barriers that impeded individuals ability to seek and obtain health care - Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to address access to healthcare B. Economic Security Long Term Goal All community members experience improved economic security, including access to employment, educational and housing opportunities and other factors that influence health, including access to affordable fresh food. Strategic Priorities (intermediate goals) - Improve the availability and quality of affordable housing - Prevent displacement and homelessness - Improve employment opportunities - Reduce food insecurity in the community Strategies: Affordable Housing - Support plans, programs, and policies that promote access to affordable housing for low-income residents and prevents displacements. Displacement and Homelessness - Support efforts to increase access to permanent housing with supportive services for homeless individuals and families to help them maintain stability to self-sufficiency. Employment - Supports policies and programs that increase economic security for individuals and families by expanding opportunities for employment and increasing workers income Food Insecurity - Support local governments, schools and/or community based organizations to enroll community members into available food programs, most importantly Cal Fresh and the Supplemental Food Program for Women, Infants, and Children (WIC); Promote use of Cal Fresh and WIC benefits at farmer's markets for purchasing fresh fruits and vegetables C. Mental Health and Behavioral Health (Including Substance Abuse) Long Term Goal All community members have optimal levels of mental health and well-being and access to high quality mental and behavioral health care services when needed. Strategic Priorities (intermediate goals) - Improve the knowledge, capacity and infrastructure of health care, organizations and communities to address mental and behavioral health - Promote positive mental health by fostering community cohesion and social and emotional support Strategies: Knowledge, Capacity and Infrastructure - Support integration of healthcare with community-based mental health services such as: training of health care providers to identify mental and behavioral health needs, patient navigators who can help patients access services, strengthening of referral networks, and/or co-location of services between primary care and mental health providers. - Increase Access to high quality mental health services to low income populations by supporting community based organizations and schools and removing barriers to care. - Support prevention efforts to increase community awareness and educate youth and adults about the dangers of prescription drugs (including sharing, proper disposal, unintentional overdose, etc.) and substance abuse. Violence and Mental Health - Support the adoption of evidence-based and promising family and youth development programs, such as the provision of trauma-informed care, conflict resolution programs, and mentoring programs that focus on keeping youth positively engaged in school and the community, including suicide prevention Outcomes: - Increased access (availability and affordability) of mental and behavioral health services in healthcare and community settings - Improved screening and identification of mental and behavioral needs among patients. - Improved referrals and coordination between healthcare providers and community resources and programs - Improved capacity, readiness and effectiveness of community-based organizations, community leaders and residents to address mental and behavioral health. D. Obesity/HEAL/Diabetes Long-Term Goal All Community Members eat healthy and move more as part of daily life. Strategic Priorities (intermediate goals) - Improve access to opportunities for physical activity in the community - Improve access to healthy food options in the community - Improve linkages between health care services and community-level services Strategies: Physical Activity - Support policies and programs that promote physical activity Healthy Food - Support local governments, schools and/or community based organizations to provide healthy food and water and to adopt health food policies Clinic to Community Integration - Support evidence-based health promotion programs that teach self-management and empowerment techniques for chronic disease management and prevention. Outcomes: - Adoption and implementation of policies and environments that increase availability and enable access to healthy food (including fresh produce and safe drinking water) and/or physical activity - Reduced availability and marketing of unhealthy foods and beverages, including sugar-sweetened beverages - Improved patient assessment and care for chronic conditions (obesity, diabetes, and/or heart disease) and social non-medical needs by healthcare providers. - Improved referrals and coordination between healthcare providers and community resources and programs Line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. Line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. KFHP MEMBERS WHO HAVE A DEDUCTIBLE MUST HAVE INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME TO BE ELIGIBLE FOR CHARITY CARE Line 16j: THE FAP PROGRAM MATERIALS ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/SCAL A, 31, KFH - VACAVILLE EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Primary data were collected from May 2015-November 2015. Community input was provided by a broad range of community members through the use of key informant interviews, focus groups, and surveys. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from the local public health department as well as leaders, representatives, or members of medically underserved, low income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. Line 6a: - Kaiser Permanente: Kaiser Permanente Vacaville Medical Center - NorthBay Healthcare: NorthBay Medical Center - Sutter Health Sacramento Sierra Region: Sutter Solano Medical Center Line 6b: The Solano Coalition for Better Health and the Solano County Public Health Department were both active contributors to the CHNA Collaborative. In addition, numerous partner organizations contributed to the CHNA. Over 15 organizations assisted the KFH-Vacaville CHNA process through participation in key informant interviews or focus groups. Line 11: As part of the Kaiser Permanente integrated health system, KFH Vacaville has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Vacaville is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Vacaville welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Vacaville will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grant-making, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources are described below for each selected health need. Strategies in bold are those recommended by the Contributions Committee to direct community benefit support and investments. A. Healthy Eating/Active Living Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g. obesity, diabetes, CVD). Intermediate Goals - Improve healthy eating among residents in low-income, under-resourced communities. - Increase physical activity among residents in low-income, under-resourced communities. Strategies Healthy eating strategies - Increase access to healthy, affordable foods, including fresh produce, and decrease access to unhealthy food. - Increase access to free, safe drinking water. - Reduce access to and appeal of sugar sweetened beverages. - Increase enrollment in and use of federal food programs. Physical activity strategies - Increase access to safe parks and public spaces. - Increase opportunities for active transportation. - Increase access to physical activity opportunities in the community. - Increase access to physical activity opportunities in schools. For example: - Provide grants for food banks, nutritious cooking classes for youth and healthy eating programs for seniors - Provide grants for advocacy effort and education about the health risks of sugar-sweetened beverages. - Provide grants for programs that support physical activity among youth. - Provide grants for programs that promote physical activity in school curricula. - Deploy physicians and clinicians to speak/educate community members on nutrition and physical activity. - Partner with the Food-Ag-Nutrition Network and the Solano Coalition for Better Health to improve access to health food in Solano County - Support local restaurants and caterers that meet healthy food guidelines. - Provide Kaiser Permanentes Educational Theater, programming that provides education in schools on health and wellness. Expected Outcomes Healthy eating - Increased consumption of fruits and vegetables. - Increased consumption of water. - Decreased consumption of sugar sweetened beverages (SSBs). - Increased enrollment and participation in federal food programs. Physical activity - Increased use of parks and public spaces. - Increased walking and biking to school and work. - Increased physical activity. B. Access to Care and Coverage Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low-income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low-income and vulnerable populations. Strategies Access strategies - Provide high quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and cant afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity of health system strategies - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social non-medical service strategies - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. Workforce strategies - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For example: - Provide grants for programs that support enrollment in affordable insurance coverage options. - Provide grants for programs that support healthy aging, especially programs that leverage technology and communications tools to make education about aging readily attainable. - Provide grants for programs that support a network of services for children and families (e.g., family resource centers). - Provide Medical Financial Assistance to patients that cant afford the cost of care - Provide subsidized health care coverage to children in low-income families who lack access to other sources of coverage. - Support rotation of residents and trainees in community health centers. - Participate in collaboratives of local health care institutions, community colleges, workforce development organizations, and chambers of commerce to support the pipeline and hiring of diverse populations within health care. Expected Outcomes Access - Increased number of low-income patients who receive health care services/coverage provided by KP. - Increased number of low-income patients that enroll in health care coverage programs. - Increased use of preventative medical services by low utilizers. Capacity of healthy systems - Increased quality of care provided by safety net providers through PHASE protocol. - Improved capacity of health systems to provide population health management. - Increased integration of primary and specialty health care services. - Improved capacity of safety net providers to assuming capitated risk. Social non-medical services - Increased referrals and coordination between healthcare providers and social non-medical services. - Increased enrollment and participation in public benefit p 2016 Needs Not Selected and Rationale KFH Vacaville has unique resources, expertise, and capacity to dedicate to the four chosen health needs. The remaining health needs prioritized in the 2016 CHNA will not be addressed by KFH Vacaville because the facility has chosen to concentrate resources in health need areas where Kaiser Permanente can align with existing local and regional efforts, and maximize the impact of organizational resources. A number of community partners have undertaken initiatives to address the additional health needs as outlined below. While this Implementation Strategy Report responds to the CHNA and Implementation Strategy requirements in the Affordable Care Act and IRS Notices, it is not exhaustive of everything we do to enhance the health of our communities. KFH Vacaville will look for collaboration opportunities that address needs not selected where it can appropriately contribute to addressing those needs. The needs that will not be addressed are: A. Disease Prevention, Management, and Treatment Disease Prevention, Management, and Treatment refers to clinical treatment and management of chronic and infectious diseases such as cancer, heart disease, and STIs. In implementation planning, KFH Vacaville decided to partially address this need through strategies aimed to address Access to Care and Coverage, as these two health needs are interrelated. By investing in programs that will improve navigation to obtain access to appropriate care within the health care system, and by providing high quality care to Medi-Cal patients, KFH Vacaville will support chronic disease management and early screening for diseases. B. Affordable and Accessible Transportation Transportation needs identified in the KFH Vacaville service area are related to other issues addressed in this implementation plan, including community safety and access to health care. While KFH Vacaville did not select this need, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Progress in achieving affordable and accessible transportation may require partnering with non-traditional partners, beyond health care providers. To achieve the greatest impact and maximize use of its resources, KFH Vacaville chose to address other health needs in this implementation plan. To the extent that access to transportation is identified as a key barrier to obtaining needed access to physical and behavioral health care, KFH Vacaville may address elements of this need as a method to improve access to preventative care and treatment. C. Economic and Housing Security Economic and Housing Security, defined principally by community residents as deep concerns about housing costs, the need for well-paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Vacaville. Although the Contributions Committee ranked Economic and Housing Security high with respect to criteria such as disparities/equity and CHNA prioritization, this health need was ranked low with respect to KP expertise, feasibility, and ability to leverage community assets. Ultimately, KFH Vacaville did not select this need because our expertise is stronger in other areas and thus we may be better positioned to leverage our resources to affect positive change towards other health needs. However, we understand that the causes of poverty and housing instability are complex, and collaborative partnerships are needed to address this health need. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions that promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. Line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL A, 32, KFH - ANTIOCH EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: The Hospitals contracted with Applied Survey Research (ASR) to conduct the primary research. Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. In all, ASR gathered community input from 28 individuals through focus groups and individual interviews. In all, ASR consulted with 10 professional community representatives of various organizations and sectors through four key informant interviews and one focus group (with 6 participants). These representatives either work in the health field or improve health conditions by serving those from the target populations. In the list below, the number in parentheses indicates the number of participants from each sector. - County and City Public Health (8) - Mental/Behavioral health or violence prevention providers (1) - Other nonprofit agencies serving children, seniors, veterans, and/or families (1) Line 6a: - John Muir Health - Kaiser Foundation Hospital - Antioch - Kaiser Foundation Hospital - Walnut Creek - Kaiser Foundation Hospital Oakland - Kaiser Foundation Hospital - Richmond - Kaiser Foundation Hospital Fremont - Kaiser Foundation Hospital - San Leandro - St. Rose Hospital - San Ramon Regional Hospital - Stanford Health Care ValleyCare - UCSF Benioff Childrens Hospital Oakland - Washington Hospital Healthcare System Line 6b: While there was no formal collaboration between the Hospitals and other organizations, the Hospitals invited representatives from the public health departments of the City of Berkeley, County of Alameda, and the County of Contra Costa to one of their first joint meetings. These representatives presented local public health data and shared about local efforts to improve health outcomes. The Hospitals discussed these issues with these public health representatives and increased their knowledge of the health needs in their respective communities. Line 11: As part of the Kaiser Permanente integrated health system, KFH Antioch has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Antioch is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Antioch welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Antioch will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. HEALTH CARE ACCESS AND DELIVERY Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low-income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low-income and vulnerable populations. - Develop a diverse, well-trained health care workforce that provides culturally sensitive health care. Strategies Access strategies: - Provide high-quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and cant afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity of health system strategies: - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social non-medical service strategies: - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. Workforce strategies: - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. Examples: - Provide grants for promotores/peer educator programs to connect monolingual non-English-speaking community members to healthcare. - Provide grants to connect low-income families and individuals to healthcare via free clinics. - Provide grants that support integration via the out-posting of behavioral health staff to primary care community clinics. - Collaborate with the East and Central County Access Action Team and the Access to Care Stakeholders group on issues of healthcare access in the community. - Participate in Medi-Cal Managed Care and Medi-Cal Fee for Service. - Provide subsidized health care coverage to children (18 & under) in low-income families (up to 300% FPL) who lack access to other sources of coverage. - Provide Medical Financial Assistance. - Provide physician and KP staff volunteers at events that provide surgical, specialty, and diagnostic services to low-income, uninsured people. - Support rotation of residents and trainees in community health centers. Expected Outcomes Access: - Increase in the number of low-income patients who receive health care services/coverage. - Increase in the number of low-income patients that enroll in health care coverage programs. Capacity of health systems: - Increase in the quality of care provided by safety net providers through PHASE protocol. - Improved capacity of health systems to provide population health management. - Increased integration of primary and specialty health care services. - Improved capacity of safety net providers to assuming capitated risk. Social non-medical services: - Increase in referrals and coordination to non-medical social services. - Increased enrollment and participation in public benefit programs. Workforce: - Increase in the number of people from underrepresented groups enrolling in education and job training programs. - Increase in the number of culturally and linguistically competent and skilled healthcare providers. B. HEALTHY EATING ACTIVE LIVING Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g., obesity, diabetes, cardiovascular disease). Intermediate Goals - Improve healthy eating among residents in low-income, under-resourced communities. - Increase physical activity among residents in low-income, under-resourced communities. Strategies Healthy eating strategies: - Increase access to healthy, affordable foods, including fresh produce, and decrease access to unhealthy food. - Increase access to free, safe drinking water. - Reduce access to and appeal of sugar sweetened beverages. - Increase enrollment in and use of federal 2016 Needs Not Selected and Rationale The Contributions Committee was careful to choose a set of health needs that best met all of the selection criteria and for which KFH Antioch could make an impact in the community. The Contributions Committee thought it was feasible to address a total of three health needs given its local Community Benefit resources. The remaining health needs did not meet the criteria to the same extent as the chosen needs did; therefore, KFH Antioch does not plan to address them at this time. They are listed below in alphabetical order. A. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Antioch. While KFH Antioch did not select this need because the Contributions Committee believed it was much less feasible to address given the resources available, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. B. Oral health Oral health is essential to overall health. Oral diseases, from cavities to oral cancer, cause pain and disability. Barriers that can limit a person's use of preventive oral health interventions and treatments include: limited access to and availability of dental services; lack of awareness of the need for care; cost; and fear of dental procedures. KFH Antioch did not select this need because the Contributions Committee believed it was somewhat less feasible to address this need than the selected health needs. Also, there are relatively few evidence-based practices that have been identified to ameliorate it, Kaiser Permanente has only moderate expertise in this topic, and there are relatively few Kaiser Permanente regional assets available to leverage for it. C. Unintentional injuries Unintended injuries are defined as those that are not purposely inflicted. The most common unintended injuries result from falls, motor vehicle crashes, poisonings, and drownings. Although most unintended injuries are predictable and preventable, they are a major cause of premature death and lifelong disability. KFH Antioch did not select this need because it was of lower community priority than the selected health needs, and the Contributions Committee believed it was much less feasible to address this need than the selected health needs. Also, there are few local community assets and very few Kaiser Permanente regional assets available to leverage for it. D. Violence and abuse Violence and intentional injury contribute to poorer physical health for victims, perpetrators, and community members. Crime in a neighborhood causes fear, stress, unsafe feelings, and poor mental health. Witnessing and experiencing violence in a community can cause long-term behavioral and emotional problems in youth. KFH Antioch did not select this need because it was of much lower community priority than the selected health needs, and the Contributions Committee believed it was less feasible to address this need than the selected health needs. Also, there are not many evidence-based practices that have been identified to ameliorate it, Kaiser Permanente has only moderate expertise in this topic, and there are not many Kaiser Permanente regional assets available to leverage for it. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. Line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL C, 33, MAUI MEMORIAL MEDICAL CENTER EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 2: ON JULY 1, 2017, MAUI MEMORIAL MEDICAL CENTER, MAUI MEMORIAL MEDICAL CENTER OUTPATIENT CLINIC, KULA HOSPITAL, AND LANAI COMMUNITY HOSPITAL BECAME PART OF MAUI HEALTH SYSTEM, WHICH IS AFFILIATED WITH KAISER PERMANENTE. THESE FACILITIES WILL CONTINUE TO OPERATE AS VITAL COMMUNITY HOSPITALS, OPEN TO EVERYONE REGARDLESS OF HEALTH COVERAGE. LINE 13A: KP/MHS PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. LINE 13H: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 15% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. LINE 16J: THE FAP PROGRAM MATERIALS ARE AVAILABLE ON THE MHS WEBSITE AT WWW.MAUIHEALTHSYSYEM.ORG/MEDICAL-FINANCIAL-ASSISTANCE A, 34, KFH - SOUTH SAN FRANCISCO EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: The HCC contracted with Applied Survey Research (ASR) to conduct the primary research. Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. In all, ASR gathered community input from 127 individuals through focus groups and individual interviews. In all, ASR consulted with 53 professional community representatives of various organizations and sectors through 29 key informant interviews and two focus groups (which included 24 participants total). These representatives either work in the health field or improve health and quality of life conditions by serving those from IRS-identified high-need populations. In the list below, the number in parentheses indicates the number of participants from each sector. - San Mateo County Public Health Department (1) - San Mateo County Health & Hospital System (5) - San Mateo County Supervisors or Commissioners (3) - Other San Mateo County employees (4) - Nonprofit agencies (34) - Faith-based leaders (2) - Business sector (3) - Private practice (1) Line 6a: - Dignity Health Sequoia Hospital - Hospital Consortium of San Mateo County - Kaiser Permanente, San Mateo Area - Lucile Packard Childrens Hospital Stanford - Peninsula Health Care District - Seton Medical Center and Seton Coastside, part of Verity Health - System Stanford Health Care - Sutter Health Mills-Peninsula Health Service line 6b: The HCC also includes members outside of the hospitals. These organizations are the San Mateo County Health Department and the San Mateo County Human Services Agency. Line 11: As part of the Kaiser Permanente integrated health system, KFH South San Francisco has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop, and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities - Leverage or enhance public health department activities - Advance increased general knowledge through education or research that benefits the public - Otherwise would not become the responsibility of government or another tax-exempt organization KFH South San Francisco is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH South San Francisco welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH South San Francisco will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. HEALTHY EATING ACTIVE LIVING Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g., obesity, diabetes, cardiovascular disease). Intermediate Goals - Improve healthy eating among residents in low-income, under-resourced communities. - Increase physical activity among residents in low-income, under-resourced communities. Strategies Healthy eating strategies: - Increase access to healthy, affordable foods, including fresh produce, and decrease access to unhealthy food. - Increase access to free, safe drinking water. - Reduce access to and appeal of sugar sweetened beverages. - Increase enrollment in and use of federal food programs. Physical activity strategies: - Increase access to safe parks and public spaces. - Increase opportunities for active transportation. - Increase access to physical activity opportunities in the community. - Increase access to physical activity opportunities in schools. For example: - Provide grants to programs that support access to healthy food through home-delivered meals, healthy retail projects, farmers markets, and garden-based education; and to programs that support physical activity in the community and at schools. - Provide grants to programs that encourage walking and biking, physical activity for older adults, and increase the percentage of students who meet Healthy Fitness Zone standards for aerobic capacity. - Participate in collaborative with health care and educational institutions to procure healthy food - Provide grants to support the development of active transportation policies and practices. - Provide KPs Educational Theater, programming that provides education in schools on health and wellness. Expected Outcomes Healthy eating: - Increased consumption of fruits and vegetables. - Increased consumption of water. - Decreased consumption of sugar sweetened beverages (SSBs). - Increased enrollment and participation in federal food programs. Physical activity: - Increased use of parks and public spaces. - Increased walking and biking to school and work. - Increased physical activity. B. ACCESS TO CARE AND COVERAGE Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low-income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low-income and vulnerable populations. - Develop a diverse, well-trained health care workforce that provides culturally sensitive health care. Strategies Access strategies: - Provide high-quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and cant afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity of health systems strategies: - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social non-medical services strategies: - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. Workforce strategies: - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For example: - Provide grants to programs that help low-income communities with health disparities prevent and manage cancer and chronic diseases, provide culturally-appropriate care navigation and connection to medical homes, and provide community-based case management and support services for homeless residents. - Partner with the San Mateo Healthy Communities Collaborative, a coalition of the countys nonprofit hospitals and public health department, to coordinate efforts to address the identified health needs of vulnerable residents. - Provide grants that support pathway programs to increase the diversity of the healthcare workforce by providing mentorship, academic enrichment, leadership development, and career exposure to disadvantaged and minority youth - Provide subsidized health car 2016 Needs Not Selected and Rationale The Community Benefit Advisory Committee (CBAC) chose a set of health needs that best met all of the selection criteria and for which KFH South San Francisco could make an impact in the community. The CBAC thought it was feasible to address a total of three health needs given its local community benefit resources, understanding that many of the remaining health needs could be addressed through strategies of the top three needs. The remaining health needs did not meet the criteria to the same extent as the chosen needs did. They are listed below in priority order. A. Violence and abuse Violence and intentional injury contribute to poorer physical health for victims, perpetrators, and community members. Crime in a neighborhood causes fear, stress, unsafe feelings, and poor mental health. Witnessing and experiencing violence in a community can cause long-term behavioral and emotional problems in youth. Although there are some ethnic disparities in county statistics on violence and abuse, by almost all measures these issues have been trending down in San Mateo County. KFH South San Francisco did not select this need because it was of lower community priority than the selected health needs, and strategies under Behavioral Health can address the causes and consequences of violence and abuse. B. Cardiovascular Disease Nationally, more than one in three adults (81.1 million) lives with one or more types of cardiovascular disease. In addition to being the first and third leading causes of death in the U.S., heart disease and stroke result in serious illness and disability, decreased quality of life, and hundreds of billions of dollars in economic loss every year. KFH South San Francisco did not select this need because it was of somewhat lower community priority than the selected health needs, and the strategies under Healthy Eating / Active Living have been shown to prevent and reduce the risk of CVD/Stroke. C. Birth outcomes Improving the well-being of mothers, infants, and children is an important public health goal. Data indicators that measure progress in the topic area of birth outcomes include low birthweight, infant mortality, teen births, breastfeeding, and access to prenatal care. Overall, birth outcomes in San Mateo County meet Healthy People 2020 (HP2020) targets and are similar to California. KFH South San Francisco did not select this need because it was of lower community priority than the selected health needs, and the CBAC believed it was less feasible to address this need than the selected health needs. D. Cancer Cancer is the second most common cause of death in the United States. Behavioral and environmental factors play a large role in reducing the nation's cancer burden, along with the availability and accessibility of high-quality screening. KFH South San Francisco did not select this need because it was of somewhat lower community priority than the selected health needs, and some of the strategies under Access to Care can address it. E. Communicable diseases Communicable diseases remain a major cause of illness, disability, and death. Various public health agencies closely monitor communicable diseases to identify outbreaks and epidemics, provide preventive treatment and/or targeted education programs, and allocate resources effectively. KFH South San Francisco did not select this need because it was of lower community priority than the selected health needs, and strategies under Access to Care can address it. F. Transportation and traffic In the U.S. in 2010, 3.9 million motor vehicle crashes killed and injured nearly 33,000 people, at an estimated cost to the U.S. economy of $242 billion. Vehicle exhaust is a known risk factor for heart disease, stroke, asthma, and cancer. KFH South San Francisco did not select this need because it was of lower community priority than the selected health needs, and the CBAC believed it was much less feasible to address this need than the selected health needs. Also, there are not many local community assets and very few Kaiser Permanente regional assets available to leverage for it, and Kaiser Permanente has little expertise in it. G. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH South San Francisco. While KFH South San Francisco did not select this need because the CBAC believed it was much less feasible to address given the resources available, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. H. Alzheimer's disease and dementia Alzheimer's disease is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Several factors determine the risk of developing dementia, including age and family history. KFH South San Francisco did not select this need because it was of much lower community priority than the selected health needs, and some of the strategies under Access to Care and Behavioral Health can address it. I. Respiratory conditions Respiratory conditions include asthma, chronic obstructive pulmonary disorder (COPD), and others. Asthma in particular is considered a significant public health burden and its prevalence has been rising since 1980. KFH South San Francisco did not select this need because it was of lower community priority than the selected health needs, and the CBAC believed it was less feasible to address this need than the selected health needs. Also, strategies under Access to Care can focus on persons with these conditions. J. Unintentional injuries Unintended injuries are defined as those that are not purposely inflicted. The most common unintended injuries result from falls, motor vehicle crashes, poisonings, and drownings. Although most unintended injuries are predictable and preventable, they are a major cause of premature death and lifelong disability. KFH South San Francisco did not select this need because it was of much lower community priority than the selected health needs, and the CBAC believed it was much less feasible to address this need than the selected health needs. Also, there are few local community assets and very few Kaiser Permanente regional assets available to leverage for it, and Kaiser Permanente has only moderate expertise in it. K. Climate change Maintaining a healthy environment is central to increasing quality of life and years of healthy life. Globally, almost 25% of all deaths and the total disease burden can be attributed to environmental factors. KFH South San Francisco did not select this need because it was of much lower community priority than the selected health needs, and the CBAC believed it was much less feasible to address this need locally than the selected health needs. Kaiser Permanente is addressing environmental concerns through national policies focusing on energy use, water conservation, transportation, etc. Line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL A, 35, KFH - SAN RAFAEL EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members and leaders through key informant interviews and focus groups. Individuals identified by the Marin County CHNA Collaborative as having valuable knowledge, information, and expertise relevant to the health needs of the community were interviewed. Interviewees included representatives from the local public health department as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Other individuals from various sectors with expertise of local health needs were also consulted. A total of 20 key informant interviews were conducted during this needs assessment. Additionally, eight focus groups were conducted throughout Marin County. These groups were intentionally sampled to reach specific subpopulations of the county that were identified as high-risk populations by the Marin County CHNA Collaborative. These subpopulations included youth, adults in recovery from substance abuse, individuals experiencing homelessness, and residents in Marin City, Novato, San Geronimo, Canal, and West Marin. Focus groups were monolingual, conducted in either English or Spanish. Community partners provided invaluable assistance in recruiting and enrolling focus group participants. Many individuals who participated in focus groups identified as leaders, representatives, or members of medically underserved, low-income, chronically diseased, and minority populations. Line 6a: As has been done in Marin since 1996, Marin County's hospitals (Marin General, Novato Community Hospital, and KFH-San Rafael) worked in collaboration to complete a county-wide CHNA. Representatives from these institutions, joined by representatives from Marin County Health and Human Services and HMP, formed the 2016 Marin County CHNA Collaborative. line 6b: - Healthy Marin Partnership - Marin County Health and Human Services Line 11: As part of the Kaiser Permanente integrated health system, KFH San Rafael has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities - Leverage or enhance public health department activities - Advance increased general knowledge through education or research that benefits the public - Otherwise would not become the responsibility of government or another tax-exempt organization KFH San Rafael is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH San Rafael welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH San Rafael will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. Strategies mentioned below are those recommended by the Contributions Committee to direct community benefit support and investments. A. Healthy Eating Active Living Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g. obesity, diabetes, CVD). Intermediate Goals - Improve healthy eating among residents in low income, under-resourced communities. - Increase physical activity among residents in low income, under-resourced communities. Strategies Healthy eating strategies - Increase access to healthy, affordable foods, including fresh produce, and decrease access to unhealthy food. - Increase access to free, safe drinking water. - Reduce access to and appeal of sugar sweetened beverages. - Increase enrollment in and use of federal food programs. Physical activity strategies - Increase access to safe parks and public spaces. - Increase opportunities for active transportation. - Increase access to physical activity opportunities in the community. - Increase access to physical activity opportunities in schools. For Example - Grant funding for countywide food recovery and distribution in Marin; healthy eating education programs; and wellness policy and program implementation in schools. - Partner with Healthy Marin Partnership, HEAL Zone 2.0, and the Community Health Initiative of the Petaluma Area to collaboratively address healthy eating active living. - Grant funding for school-based physical activity programs and wellness policy and program implementation in schools. - Participate in Marin County of Education's County-wide Wellness Initiative. - Provide KP's Educational Theater, programming that provides education in schools on health and wellness. - Support sustainable food distributors by purchasing locally produced fruits and vegetables. - Support local restaurants and caterers that meet healthy food guidelines. - Host farmers markets at KP facilities. Expected Outcomes Healthy eating - Increased consumption of fruits and vegetables. - Increased consumption of water. - Decreased consumption of sugar sweetened beverages (SSBs). - Increased enrollment and participation in federal food programs Physical activity - Increased use of parks and public spaces. - Increased walking and biking to school and work. - Increased physical activity. B. Access to Care and Coverage Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low income and vulnerable populations. - Develop a diverse, well trained health care workforce that provides culturally sensitive health care. Strategies Access strategies - Provide high-quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and can't afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity of health system strategies - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social non-medical service strategies - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low income populations. Workforce strategies - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For Example - Participate in Medi-Cal Managed care and Medi-Cal Fee for Service. - Provide subsidized health care coverage to children (18 & under) in low-income families (up to 300% FPL) who lack access to other sources of coverage. - Provide grant funding for: programs that expand the use of patient navigators, promotores or community application assisters, in clinic and community settings. - Provide physician and KP staff volunteers at events that provide surgical, specialty, and diagnostic services to low-income, uninsured people. - National Facility Services in-kind consultation on design and construction for safety net capital projects. - Provide input and expertise to education and community partners to inform curricula, training and health career ladder/pipeline programs. - Partner 2016 Needs Not Selected and Rationale KFH San Rafael has unique resources, expertise, and capacity to dedicate to the four chosen health needs. The remaining health needs prioritized in the 2016 CHNA will not be addressed by KFH San Rafael because the facility has chosen to concentrate resources in health need areas where Kaiser Permanente can align with existing local and regional efforts, and maximize impact of organizational resources. A number of community partners have undertaken initiatives to address the needs, below. While this Implementation Strategy Report responds to the CHNA and Implementation Strategy requirements in the Affordable Care Act and IRS Notices, it is not exhaustive of everything we do to enhance the health of our communities. KFH San Rafael will look for collaboration opportunities that address needs not selected where it can appropriately contribute to addressing those needs. The needs that will not be addressed are: A. Economic and Housing Insecurity Economic and Housing Insecurity, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH San Rafael. KFH San Rafael did not select this need because our expertise is stronger in other areas and thus we may be better positioned to leverage our resources to affect positive change towards other health needs. However, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. B. Oral Health Oral Health, while a concern in Marin County, was the second-lowest ranked health need. Further, KFH San Rafael does not have extensive expertise in the field of oral health. To achieve the greatest impact and maximize use of its resources, KFH San Rafael chose to address higher-priority health needs. KFH San Rafael intends to explore opportunities to increase residents' access to health insurance, which in turn may increase access to dental health care, as well as support residents in eating healthier diets, which addresses some of the causes and impact of poor oral health outcomes. C. Violence and Injury Violence and Injury, while a concern in Marin County, was the lowest ranked health need. Further, the causes of violence and injury are broad, and the solutions extend beyond specific communities across the Region, and State. To achieve the greatest impact and maximize use of its resources, KFH San Rafael chose to address higher-priority health needs. KFH San Rafael intends to explore opportunities to support residents in accessing behavioral health resources, support effective connections to social services, and help prepare community residents to be successful in seeking jobs and careers, in order to address both the causes and impact of violence and injury. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL A, 36, KFH - RICHMOND EXPLANATIONS, PART V, SECTION B. ********************************************************************** LINE 5: The Hospitals contracted with Applied Survey Research (ASR) to conduct the primary research. Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. In all, ASR consulted with 39 professional community representatives of various organizations and sectors through 21 key informant interviews and two focus group (which included 18 participants). These representatives either work in the health field or improve health conditions by serving those from the target populations. In the list below, the number in parentheses indicates the number of participants from each sector. - County and City Public Health (8) - Other health centers or systems (9) - Mental/Behavioral health or violence prevention providers (6) - School system representatives (2) - City or county government representatives (1) - Nonprofit agencies providing basic needs (2) - Other nonprofit agencies serving children, seniors, veterans, and/or families (11) Line 6a: - John Muir Health - Kaiser Foundation Hospital - Antioch - Kaiser Foundation Hospital - Walnut Creek - Kaiser Foundation Hospital - Oakland - Kaiser Foundation Hospital - Richmond - Kaiser Foundation Hospital - Fremont - Kaiser Foundation Hospital - San Leandro - St. Rose Hospital - San Ramon Regional Hospital - Stanford Health Care - ValleyCare - UCSF Benioff Children's Hospital Oakland - Washington Hospital Healthcare System Line 6b: While there was no formal collaboration between the Hospitals and other organizations, the Hospitals invited representatives from the public health departments of the City of Berkeley, County of Alameda, and the County of Contra Costa to one of its first joint meetings. These representatives presented local public health data and shared about local efforts to improve health outcomes. The Hospitals discussed these issues with these public health representatives and increased their knowledge of the health needs in their respective communities. Line 11: As part of the Kaiser Permanente integrated health system, KFH Richmond each has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Richmond is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Richmond welcomes future opportunities to enhance their strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Richmond each will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. ACCESS TO CARE AND COVERAGE Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low-income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low-income and vulnerable populations. - Develop a diverse, well-trained health care workforce that provides culturally sensitive health care. Strategies Access strategies: - Provide high-quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at KP facilities and can't afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity of health systems strategies: - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social non-medical services strategies: - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. Workforce strategies: - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For example: - Participate in Medi-Cal Managed care. - Participate in Medi-Cal Fee for Service. - Provide subsidized health care coverage to children (18 & under) in low-income families (up to 300% FPL) who lack access to other sources of coverage. - Provide Medical Financial Assistance. - Support effort to improving health care access and utilization - Fund programs and/or providers to improve access to care for chronic health conditions (i.e. asthma, diabetes, comorbidities). - Fund programs and/or organizations to conduct targeted outreach and screening for chronic unmanaged health conditions specific to geographic area. - Fund safety net providers (e.g., community clinics) to expand & improve primary care access, navigation, & services. - Fund programs and/or organizations via local grants to provide case management and social services at health care centers. - Participate in Healthy Richmond Collaborative and Oakland and West Contra Costa Clinic Consortium. - Participate in Community Health Center Network (CHCN), a partnership of community health centers committed to enhancing our ability to provide comprehensive, quality health care in a manner respectful of community traditions and values. - Partner with Operation Access, a nonprofit dedicated to providing access to free surgery and specialty care, to enable KP medical volunteers to provide free outpatient consultations, specialty care, and same-day surgery appointments to uninsured patients. - Support via regional grants population health management approaches that improve health outcomes for safety net patients with diabetes and hypertension. - Support community health centers and public hospital organizations to participate successfully in waiver and demonstration programs moving from fee for service to capitation. - Support screening for social non-medical service needs and referrals to community services. - Support pilot demonstration projects with faith-based organizations to connect caregivers and patients with end of life planning and other services. - Support pathway programs to increase the diversity of the healthcare workforce by providing mentorship, academic enrichment, leadership development, and career exposure to disadvantaged and minority youth. - Support via programs that prepare under-represented students for success in the medical school application process. - Support successful recruitment and retention efforts to address workforce shortages in the health care safety net. - Implement health care workforce pipeline programs to introduce diverse, under-represe 2016 Needs Not Selected and Rationale The Contributions Committee was careful to choose a set of health needs that best met all of the selection criteria and for which KFH Richmond could make an impact in the community. The Contributions Committee thought it was feasible to address the health needs listed above, given its local community benefit resources and, in the case of Economic Security for Oakland, the clear and substantial local commitment to addressing the need. The remaining health needs did not meet the criteria to the same extent as the chosen needs did; therefore, KFH Richmond does not plan to address them at this time. They are listed below in alphabetical order. A. Asthma Although Asthma was not selected as a standalone top priority, the Contributions Committee agreed to address asthma under Healthcare Access and Delivery. Asthma is a chronic inflammatory disorder of the airways characterized by episodes of reversible breathing problems due to airway narrowing and obstruction. These episodes can range in severity from mild to life threatening. Asthma affects people of every race, sex, and age; however, significant disparities in asthma morbidity and mortality exist, in particular for low-income and minority populations. Asthma was not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. Kaiser Permanente in the East Bay is better positioned to address asthma management via healthcare access and delivery strategies. B. Cancer Although cancer was not selected as standalone top priority, the Contributions Committee agreed to address cancer under Health Access and Delivery. Cancer is the second most common cause of death in the United States. Behavioral and environmental factors play a large role in reducing the nation's cancer burden, along with the availability and accessibility of high-quality screening. Cancer was not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. Kaiser Permanente in the East Bay is better positioned to address drivers of cancer via strategies related to healthy eating and active living, and ethnic disparities in cancer incidence and mortality rates via healthcare access and delivery strategies. C. Economic Security Economic Security, defined by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Richmond. KFH Richmond did not select this need because it is much less feasible to address locally than the other selected health needs given the resources required to have an impact. However, we understand that the causes are broad, and the solutions can extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities regionally to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. D. Infectious diseases Infectious diseases remain a major cause of illness, disability, and death. Various public health agencies closely monitor infectious diseases to identify outbreaks and epidemics, provide preventive treatment and/or targeted education programs, and allocate resources effectively. Infectious diseases were not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. This need is already being monitored and addressed by the county public health department. Kaiser Permanente in the East Bay believes that certain healthcare access and delivery strategies, such as screenings and vaccinations, have the potential to decrease infectious disease in the community as well. E. Sexually-Transmitted Infections Sexually- transmitted infections are diseases that are primarily transmitted through direct sexual contact with an infected individual or their discharge (such as blood or semen). They include HIV/AIDS, syphilis, chlamydia, gonorrhea, and genital herpes. Communicable diseases such as sexually transmitted infections are closely monitored by various public health agencies to identify outbreaks and epidemics, provide preventive treatment and/or targeted education programs, and allocate resources effectively. Sexually-transmitted infections were not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. This need is already being monitored and addressed by the county public health department. Kaiser Permanente in the East Bay believes that certain healthcare access and delivery strategies, such as screenings and vaccinations, have the potential to decrease sexually-transmitted infections in the community as well. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL A, 37, KFH - FREMONT EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: The Hospitals contracted with Applied Survey Research (ASR) to conduct the primary research. Community input was provided by a broad range of community members through the use of key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. In all, ASR gathered community input from 54 individuals through focus groups and individual interviews. In all, ASR consulted with 44 professional community representatives of various organizations and sectors through 18 key informant interviews and three focus groups (which included 26 participants). These representatives either work in the health field or improve health conditions by serving those from the target populations. In the list below, the number in parentheses indicates the number of participants from each sector. - County Public Health (5) - Other health centers or systems (11) - Mental/Behavioral health or violence prevention providers (12) - School system representatives (2) - City or county government representatives (3) - Nonprofit agencies providing basic needs (11) Line 6a: - John Muir Health - Kaiser Foundation Hospital - Antioch - Kaiser Foundation Hospital - Walnut Creek - Kaiser Foundation Hospital - Oakland - Kaiser Foundation Hospital - Richmond - Kaiser Foundation Hospital - Fremont - Kaiser Foundation Hospital - San Leandro - St. Rose Hospital - San Ramon Regional Hospital - Stanford Health Care - ValleyCare - UCSF Benioff Children's Hospital Oakland - Washington Hospital Healthcare System Line 6b: While there was no formal collaboration between the Hospitals and other organizations, the Hospitals invited representatives from the public health departments of the City of Berkeley, County of Alameda, and the County of Contra Costa to one of their first joint meetings. These representatives presented local public health data and shared about local efforts to improve health outcomes. The Hospitals discussed these issues with these public health representatives and increased their knowledge of the health needs in their respective communities. Line 11: As part of the Kaiser Permanente integrated health system, KFH Fremont has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities. - Leverage or enhance public health department activities. - Advance increased general knowledge through education or research that benefits the public. - Otherwise would not become the responsibility of government or another tax-exempt organization. KFH Fremont is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Fremont welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Fremont will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. HEALTHY EATING ACTIVE LIVING Long-term Goal All community members eat better and move more as part of daily life in order to prevent and reduce the impact of chronic conditions (e.g., obesity, diabetes, cardiovascular disease). Intermediate Goals - Improve healthy eating among residents in low-income, under-resourced communities. - Increase physical activity among residents in low-income, under-resourced communities. Strategies Healthy eating strategies: - Increase access to healthy, affordable foods (including fresh produce), and decrease access to unhealthy food. - Increase access to free, safe drinking water. - Reduce access to and appeal of sugar sweetened beverages. - Increase enrollment in and use of federal food programs. Physical activity strategies: - Increase access to safe parks and public spaces. - Increase opportunities for active transportation. - Increase access to physical activity opportunities in the community. - Increase access to physical activity opportunities in schools. Examples: - Provide grants to increase access to affordable, healthy foods in schools, workplaces, community settings, and programs that serve low-income persons. - Support Thriving Schools, an initiative that targets resources to schools in low income neighborhoods to improve the health and wellness of students and employees through improved nutrition, increased physical activity, and access to health care. - Participate in the Alameda County Building Blocks Collaborative and other coalitions to support policies that promote healthy eating and encourage access to affordable, healthy foods. - Provide grants for use of promotores (i.e., peer educators) through safety net clinics to assist with enrollment in SNAP. - Provide grants to food banks and other local nonprofit organizations in underserved neighborhoods to assist in SNAP enrollment. - Participate in coalitions to support evidence-based, community-driven advocacy efforts to influence infrastructure and policies that increase the use of safe public spaces. - Support institutional healthy food procurement. - Provide KP's Educational Theater, programming that provides education in schools on health and wellness. - Design new KP facilities in ways that promote active transportation, whenever possible. Expected Outcomes Healthy eating: - Increased consumption of fruits and vegetables. - Increased consumption of water. - Decreased consumption of sugar sweetened beverages (SSBs). - Increased enrollment and participation in federal food programs. Physical activity: - Increased use of parks and public spaces. - Increased walking and biking to school and work. - Increased physical activity. B. BEHAVIORAL HEALTH Long-term Goal All community members experience social/emotional health and wellbeing and have access to high-quality behavioral health care services when needed. Intermediate Goals - Expand prevention and support services for mild to moderate behavioral health conditions. - Decrease stigma associated with seeking behavioral health services among vulnerable and diverse populations. - Develop a diverse, well-trained behavioral health care workforce that provides culturally sensitive behavioral health care. - Increase access to culturally and linguistically appropriate behavioral health services for vulnerable and low-income populations. Strategies Prevention strategies: - Provide screening and identification related to behavioral health needs among low-income, vulnerable, and uninsured populations and connect them with the appropriate services or support. - Support opportunities to prevent and reduce the misuse of drugs and alcohol. - Provide access to programs, services or environments that evidence suggests improves overall social/emotional wellness. Destigmatization strategies: - Support opportunities to reduce stigma through education and outreach in school, community and workforce settings. Workforce strategies: - Support the recruitment, hiring and retention of a diverse, culturally competent behavioral health care workforce in the clinical and community-based settings. - Increase access to training and education for diverse populations currently underrepresented in the behavioral health care workforce. Access strategies: - Provide high-quality behavioral health care to Medi-Cal participants. - Promote integration of care between primary and behavioral health care. - Improve navigation to appropriate care within the health care system and support services in the community. - Increase the capacity to respond appropriately to individuals and/or communities that have experienced trauma 2016 Needs Not Selected and Rationale The Contributions Committee was careful to recommend a set of health needs that could make an impact in the community: Healthy Eating, Active Living, Behavioral Health, Community and Family Safety, and Health Care Access and Delivery. Therefore, the remaining health needs for this area (listed below in alphabetical order) will not be addressed by KFH Fremont, because these needs did not meet the criteria to the same extent that the chosen needs did, and more specifically for the following reasons. A. Asthma Asthma is a chronic inflammatory disorder of the airways characterized by episodes of reversible breathing problems due to airway narrowing and obstruction. These episodes can range in severity from mild to life threatening. Asthma affects people of every race, sex, and age; however, significant disparities in asthma morbidity and mortality exist, in particular for low-income and minority populations. Asthma was not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. In addition, few evidence-based strategies were identified that could be applied to this health need. KFH Fremont is better positioned to address asthma management via healthcare access and delivery strategies. B. Cancer Cancer is the second most common cause of death in the United States. Behavioral and environmental factors play a large role in reducing the nation's cancer burden, along with the availability and accessibility of high-quality screening. Cancer was not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. KFH Fremont is better positioned to address drivers of cancer via strategies related to healthy eating and active living, and ethnic disparities in cancer incidence and mortality rates via healthcare access and delivery strategies. C. Cardiovascular Disease/Stroke Nationally, more than one in three adults (81.1 million) lives with one or more types of cardiovascular disease. In addition to being the first and third leading causes of death in the U.S., heart disease and stroke result in serious illness and disability, decreased quality of life, and hundreds of billions of dollars in economic loss every year. KFH Fremont is better positioned to address drivers of these needs via strategies related to healthy eating and active living. Kaiser Permanente believes that strategies intended to address the community's healthy eating and active living needs have the potential to decrease cardiovascular disease and stroke in the community as well. D. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Fremont. While KFH Fremont did not select this need because the Contributions Committee believed it was much less feasible to address this need given limited resources, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure, and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. E. Infectious Disease Infectious diseases remain a major cause of illness, disability, and death. Various public health agencies closely monitor infectious diseases to identify outbreaks and epidemics, provide preventive treatment and/or targeted education programs, and allocate resources effectively. Infectious Disease was not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. This need is already being monitored and addressed by the county public health department. KFH Fremont believes that certain healthcare access and delivery strategies, such as screenings and vaccinations, have the potential to decrease infectious disease in the community as well. F. Maternal and Child Health Improving the well-being of mothers, infants, and children is an important public health goal. The topic area of maternal and child health addresses a wide range of conditions, health behaviors, and health systems indicators that affect the health, wellness, and quality of life of women, children, and families. The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality preconception (before pregnancy) and interconception (between pregnancies) care. Maternal/child health was not a high priority of the community (i.e., the prioritization score was lower) compared to other needs. In addition, relatively few community resources were identified, providing fewer opportunities for leverage. KFH Fremont is better positioned to address this need from a prevention standpoint via healthcare access and delivery strategies and via strategies related to healthy eating and active living. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL B, 38, KFH - MORENO VALLEY EXPLANATIONS PART V, SECTION B. ************************************************************************ LINE 5: Community input was solicited from stakeholders that represented broad interests in the community, including, the health care sector (e.g. hospitals, clinics and providers), mental health, nonprofit and community-based organizations (e.g grassroots, food pantries, coalitions), county and city agencies and programs (e.g. public health department, city planners, school districts), public health experts and professionals, social service providers (e.g. family assistance, children services, domestic violence) and academic institutions (e.g. colleges and universities). Local community stakeholders participated in focus groups or key informant interviews to discuss health needs, health barriers, and health assets in their respective community. Stakeholders with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from state, local, tribal, or other regional governmental public health departments (or equivalent department or agency) as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. LINE 6A: KFH-Moreno Valley collaborated with KFH-Riverside. LINE 11: Health Need 1: Access to Care Access to Care Long-Term Goal All community members have access to timely, coordinated, high quality health care from a trained and diverse workforce. Access to Care Intermediate Goals - Increase coverage and access to comprehensive, quality health care services for low income and uninsured populations - Improve the capacity of health care systems to provide quality health care services, including the social and non-medical needs of their patients. - Improve the capacity of the primary care workforce to meet community needs. - Enhance individuals' utilization of the community based health delivery system Access to Care Strategies - Support targeted outreach, enrollment, and retention efforts to increase access to health care coverage, particularly among communities of color and immigrant populations, where disparities in both access to care and health care coverage is greatest - Develop solutions that address the health care needs of people who do not qualify for low-cost or no-cost health insurance, including but not limited to undocumented individuals. - Support policies and programs that improve ability of the health care organizations to assess upstream factors and coordinate with community based preventive services - Improve the quality improvement (QI) infrastructure of health care organizations by supporting capacity to use data, leadership training, business operations and through other infrastructure building strategies - Provide training for medical providers on the provision of culturally competent care to diverse populations. - Reduce barriers to access to care by providing language interpretation, transportation, non-traditional access points, and/or other supportive services. - Support policies and programs that improve public understanding of the health care delivery system and the onboarding and orientation for new patient members Access to Care Resources and Partners - Community Health Care Access (formerly Community Surgery Day) for uninsured residents in partnership with community clinics - Family Medicine Residency Program - Partners such as the Riverside University Health System, local FQHCs, community clinics, and more. Access to Care Expected Outcomes - Enrollment continues to rise, especially in low-income communities and communities of color - Individuals who do not qualify for low-cost or no-cost health insurance (e.g., undocumented individuals) have at least one option for seeking medical treatment - Increased referrals and coordination between health care providers and community-based efforts - Increased efforts to address health predictors and other upstream factors in community outreach - Health care organizations have increased opportunities for professional development and infrastructure improvements, esp. data analysis, leadership training, and business operations - There is an increase in the number of medical providers who receive continuing education in providing culturally competent care - Increased availability of medical care in preferred language, utilizing qualified interpreter services - Multiple low-cost transportation options are available when traveling to-and-from care - Increased number of patients accessing care at non-traditional access points - Greater public understanding of the health care system and coverage options - New patient members are successfully onboarded and understand their benefits Health Need 2: Obesity/Diabetes/HEAL Obesity/Diabetes/HEAL Long-Term Goal All Community Members eat healthy and move more as part of daily life. Obesity/Diabetes/HEAL Intermediate Goals - Improve access to opportunities for physical activity in the community - Improve access to healthy food options in the community - Improve linkages between health care services and community-level services Obesity/Diabetes/HEAL Strategies - Support new and improved policies and environments that support active transportation and physical activity (e.g. safe pedestrian bicycle routes) - Support policies that prioritize underserved neighborhoods for park investments and encourage communities to use parks to their full potential - Support local governments, schools and/or community based organizations to provide healthy food options (including accessible drinking water) and to adopt healthy food policies, including procurement practices - Support local governments, schools and/or community-based organizations to enroll community members into available food programs such as WIC, Cal Fresh, etc. - Promote use of Cal Fresh and WIC benefits at farmer's markets for purchasing fresh fruits and vegetables - Support programs that improve referral of patients to evidence-based health promotion programs that teach self-management and empowerment techniques for chronic disease management and prevention. - Support collaboration between health care providers and community-level services to support patients' needs related to upstream determinants of health, such as access to healthy food at local grocery stores and addressing violence-free neighborhoods - Support programs-particularly evidence-based programs-that address diabetes prevention, education, and self-management. Obesity/Diabetes/HEAL Resources and Partners - HEAL Zone Initiative - Thriving Schools Initiative - Pediatric Obesity Champion - Partners such as local cities, coalitions, collaboratives, foundations, after-school programs for children, and many more. Obesity/Diabetes/HEAL Expected Outcomes - Increased options are available for safe active transportation - The number of people using active transportation has increased - Existing parks are improved to encourage greater use - Local organizations adopt and implement policies and environments that increase availability and encourage consumption of nutritious foods - Reduced unhealthy food consumption in participating organizations - Increased availability of free, clean drinking water across the community and in schools - Increased enrollment of eligible individuals into federal food programs - Increased use of federal food program benefits at farmers' markets - Increased consumption of fruits and vegetables among those receiving federal food program benefits - Increased number of available evidence-based health promotion programs are available in the community at no-or-low cost - Increased attendance at health promotion programs - Improved feelings of self-efficacy and ability to prevent/manage chronic disease - Increased number of people with diabetes who take a self-management course - Increased ability of people with diabetes to manage their blood sugar levels and avoid serious diabetic complications - Improved referrals and coordination between health care providers and community-based resources/programs - Increased collaboration between health care providers and non-traditional partners (e.g., police, local merchants, etc.) Health Need 3: Mental Health Mental Health Long-Term Goal All community members have optimal levels of mental health and well-being and access to high quality mental and behavioral health care services when needed. Mental Health Intermediate Goals - Improve the knowledge, capacity and infrastructure of health care, organizations and communities to address mental and behavioral health - Promote positive mental health by fostering community cohesion and social and emotional support Mental Health Strategies - Support integration of health care with community-based mental health services, such as: training of health care providers to identify mental and behavioral health needs, pati A, 39, KFH - MANTECA EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 5: Community input was provided by a broad range of community members through the use of key informant interviews, focus groups, and/or surveys. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from local public health departments as well as leaders, representatives, or members of medically underserved, low-income, and minority populations. Additionally, where applicable, other individuals with expertise of local health needs were consulted. A community survey was administered to 2,927 residents of San Joaquin County in the participant's self-identified dominant language (English or Spanish) or verbally in other languages (Hmong or Cambodian). Approximately 10% of surveys were administered in Spanish. The survey was available online and in a paper version. Among all respondents, 19.2% were under age 25 and 7.2% were over age 60. Respondents were 71.7% female, 43.0% identified as Latino, and 26.6% spoke Spanish at home. A total of 34 individuals identified by the Core Planning Group as having valuable knowledge, information, and expertise were interviewed. Interviewees included representatives from the local public health department, as well as leaders, representatives, and members of medically underserved, low-income, minority populations, and those with a chronic disease. Other individuals from various sectors with expertise in local health needs were also consulted. To maximize resources and strengthen relationships, all interviews were conducted by members of the Core Planning Group. Additionally, 29 focus groups were conducted throughout the County, reaching 348 residents. To maximize resources and leverage relationships with community groups and residents, these groups were facilitated by local volunteers who had been trained by MIG staff. Community partners provided invaluable assistance in recruiting and enrolling focus group participants. Individuals who participated in focus groups included leaders, representatives, or members of medically underserved, low-income, chronically diseased, and minority populations. Participants also represented a breadth of geographic regions, racial/ethnic subpopulations, and age categories. Line 6a: The core Planning group consisted of the following organizations: - Community Medical Centers - Community Partnership for Families of San Joaquin - Dameron Hospital Association - Dignity Health - St. Joseph's Medical Center - First 5 San Joaquin - Health Net - Health Plan of San Joaquin - San Joaquin County Public Health Services - Sutter Tracy Community Hospital Line 6b: The other partner organizations that are members of the San Joaquin County Community Health Assessment Committee and participated in the assessment include: Community Partnership for Families, First 5 San Joaquin, Community Medical Centers, Inc., San Joaquin County Public Health Services, Health Net of California, Health Plan of San Joaquin, Scan Health Plan, San Joaquin County Office of Education, National Alliance on Mental Illness (NAMI), Catholic Charities, California Center for Public Health Advocacy, Lao Family Community Empowerment, Inc., St. Mary's Dining Room, Wallach & Associates, San Joaquin County Behavioral Health Services, Community Development, City of Stockton, Delta Health Care, El Concilio, City of Tracy Parks and Recreational Services, Tracy Unified School District, Counseling and More, Journey Christian Church, Reich's Pharmacy, City of Tracy City Council, Child Abuse Prevention Council, Stockton City Council, San Joaquin County Probation, Emergency Food Bank San Joaquin, Family Resource & Referral, San Joaquin County Data Co-Op, Regional Transit Division, County Office of Education, People and Congregations Together (PACT), University of the Pacific, Business Council of San Joaquin County, Asian-American Chamber of Commerce, San Joaquin Hispanic Chamber of Commerce, League of Women Voters of San Joaquin County, UC Cooperative Extension, San Joaquin County Housing Authority, Aging and Community Services, San Joaquin Council of Governments, and Business Forecasting Center. Line 11: As part of the Kaiser Permanente integrated health system, KFH Manteca has a long history of working internally with Kaiser Foundation Health Plan, The Permanente Medical Group, and other Kaiser Foundation Hospitals, as well as externally with multiple stakeholders, to identify, develop and implement strategies to address the health needs in the community. These strategies are developed so that they: - Are available broadly to the public and serve low-income individuals. - Reduce geographic, financial, or cultural barriers to accessing health services, and if they ceased would result in access problems. - Address federal, state, or local public health priorities - Leverage or enhance public health department activities - Advance increased general knowledge through education or research that benefits the public - Otherwise would not become the responsibility of government or another tax-exempt organization KFH Manteca is committed to enhancing its understanding about how best to develop and implement effective strategies to address community health needs and recognizes that good health outcomes cannot be achieved without joint planning and partnerships with community stakeholders and leaders. As such, KFH Manteca welcomes future opportunities to enhance its strategic plans by relying on and building upon the strong community partnerships it currently has in place. KFH Manteca will draw on a broad array of strategies and organizational resources to improve the health of vulnerable populations within our communities, such as grantmaking, in-kind resources, collaborations and partnerships, as well as several internal KFH programs. The goals, outcomes, strategies, and examples of resources planned are described below for each selected health need. A. Access to Care and Coverage Long-term Goal All community members have access to high quality, culturally and linguistically appropriate health care services in coordinated delivery systems. Intermediate Goals - Increase access to comprehensive health care services for low income and vulnerable populations. - Improve the capacity of health care systems to provide quality health care services. - Increase access to social non-medical services that support health for low income and vulnerable populations. - Develop a diverse, well -trained health care workforce that provides culturally sensitive health care. Strategies Access - Provide high quality medical care to Medi-Cal participants. - Provide access to comprehensive health care coverage to low-income individuals and families. - Provide financial assistance to low-income individuals who receive care at Kaiser Permanente facilities and can't afford medical expenses and/or cost sharing. - Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. - Increase access to primary and specialty care. Capacity and Health Systems Management - Increase capacity of systems and individuals to adopt population health management. - Increase capacity of systems to participate in value-based care. - Improve navigation to obtain access to appropriate care within the health care system. - Promote integration of care between primary and specialty care, including behavioral health care. Social Non-medical Services - Increase and systematize access to needed social non-medical services. - Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low-income populations. Workforce - Increase access to training and education for diverse populations currently underrepresented in the health care workforce. - Support the recruitment, hiring and retention of a diverse, culturally competent health care workforce in the clinical and community based settings. For example: - Participate in Medi-Cal Managed Care and Medi-Cal Fee for Service - Partner with Healthier Communities Coalition (HCC), San Joaquin Hospital, and Community Medical Centers to increase access to quality care for Medi-Cal recipients, particularly for migrant and Pacific Islander populations. Support targeted outreach and enrollment for specific populations for programs for which they are eligible. - Collaborate with Catholic Charities on disseminating promotoras model in San Joaquin County. - Partner with California School Based Health Alliance to support school based health center model dissemination to provide access to services on school campuses. - Support organizations that provide navigation to free and reduced cost services for specialty care. - Support population health management approaches that improve health outcomes for safety net patients with diabetes and hypertension. - Provide access to Kaiser Pe 2016 Needs Not Selected and Rationale While there is an important relationship between education and health, this need was not selected to address as KFH Manteca does not have the experience or organizational assets to leverage to make a meaningful contribution to addressing education. Furthermore, other organizations in the community are working to address this need. A. Youth growth and development Youth growth and development refers to the healthy physical, social, and emotional development of young people and lays a foundation for physical and mental/behavioral health and chronic disease prevention. KFH Manteca has limited organizational expertise or resources to leverage in this area and other agencies in the service area are addressing this need. B. Economic Security Economic Security, defined principally by community residents as deep concerns about housing costs, the need for good paying jobs, and affordable public transportation, was identified in each of the communities served by KFH Manteca. KFH Manteca did not select this need locally because the facility alone does not have the resources to make a meaningful contribution to address economic security. While KFH Manteca did not select this need, we understand that the causes are broad, and the solutions extend beyond specific communities across the Region, and State. Investments into community infrastructure and solving the crisis of affordable housing requires many non-traditional partners, beyond health care providers. Kaiser Permanente intends to explore opportunities to support innovative solutions to promote affordable housing, prepare community residents to be successful in seeking jobs and careers, and support effective connections to social services, to address both the causes and impact of economic security. C. Violence and injury This need will be addressed in part by strategies conducted under Behavioral Health. KFH Manteca does not have the same expertise as it has in the other selected health need areas and other agencies are implementing strategies to prevent violence and injury. D. Access to housing While access to housing is important to overall health and well being, access to housing was ranked as a moderate priority in the CHNA report. KFH Manteca does not have sufficient local resources or to leverage in this area. Housing is a component of overall economic security and will likely be addressed by Kaiser Permanente's overall commitment as an organization to addressing this important need. E. Oral health KFH Manteca does not offer dental services and does not have oral health expertise in house. Oral health scored next to last in the CHNA analysis of secondary data (in terms of severity, disparities, impact, and ability to intervene on a prevention level). F. Asthma/air quality Asthma/air quality scored lowest of all health needs in the CHNA analysis of secondary data (in terms of severity, disparities, impact, and ability to intervene on prevention level). KFH Manteca perceives limited ability to leverage organizational assets to address asthma. line 13a: KP PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. Line 13h: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 10% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. THIS CRITERIA MAY APPLY FOR SPECIFIC PRODUCTS / BENEFITS. Line 16J: THE FAP PROGRAM MATERIALS FOR NORTHERN CALIFORNIA REGION ARE AVAILABLE ON THE KP WEBSITE AT WWW.KP.ORG//MFA/NCAL C, 40, KULA HOSPITAL EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 2: ON JULY 1, 2017, MAUI MEMORIAL MEDICAL CENTER, MAUI MEMORIAL MEDICAL CENTER OUTPATIENT CLINIC, KULA HOSPITAL, AND LANAI COMMUNITY HOSPITAL BECAME PART OF MAUI HEALTH SYSTEM, WHICH IS AFFILIATED WITH KAISER PERMANENTE. THESE FACILITIES WILL CONTINUE TO OPERATE AS VITAL COMMUNITY HOSPITALS, OPEN TO EVERYONE REGARDLESS OF HEALTH COVERAGE. LINE 13A: KP/MHS PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. LINE 13H: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 15% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. LINE 16J: THE FAP PROGRAM MATERIALS ARE AVAILABLE ON THE MHS WEBSITE AT WWW.MAUIHEALTHSYSYEM.ORG/MEDICAL-FINANCIAL-ASSISTANCE C, 41, LANAI COMMUNITY HOSPITAL EXPLANATIONS PART V, SECTION B. ********************************************************************** LINE 2: ON JULY 1, 2017, MAUI MEMORIAL MEDICAL CENTER, MAUI MEMORIAL MEDICAL CENTER OUTPATIENT CLINIC, KULA HOSPITAL, AND LANAI COMMUNITY HOSPITAL BECAME PART OF MAUI HEALTH SYSTEM, WHICH IS AFFILIATED WITH KAISER PERMANENTE. THESE FACILITIES WILL CONTINUE TO OPERATE AS VITAL COMMUNITY HOSPITALS, OPEN TO EVERYONE REGARDLESS OF HEALTH COVERAGE. LINE 13A: KP/MHS PROVIDES A 100% DISCOUNT TO ALL CHARITY ELIGIBLE PATIENTS REGARDLESS OF WHETHER THEY ARE UNINSURED OR UNDERINSURED. THE DISCOUNT AMOUNT IS NOT ADJUSTED BASED ON INCOME LEVEL. LINE 13H: A PATIENT OF ANY HOUSEHOLD INCOME LEVEL WITH INCURRED OUT-OF-POCKET MEDICAL AND PHARMACY EXPENSES FOR ELIGIBLE SERVICES OVER A 12 MONTH PERIOD GREATER THAN OR EQUAL TO 15% OF THEIR ANNUAL HOUSEHOLD INCOME IS ELIGIBLE FOR CHARITY CARE. LINE 16J: THE FAP PROGRAM MATERIALS ARE AVAILABLE ON THE MHS WEBSITE AT WWW.MAUIHEALTHSYSYEM.ORG/MEDICAL-FINANCIAL-ASSISTANCE 11 KAISER PERMANENTE POST ACUTE CARE CENTER 1440 168TH AVE SAN LEANDRO CA 94578 SKILLED NURSING MENTAL HEALTH CENTER 765 W COLLEGE ST LOS ANGELES CA 90012 MENTAL HEALTH SUNNYBROOK SURGICAL CENTER 10180 SOUTHEAST SUNNYSIDE RD CLACKAMAS OR 97015 AMBULATORY SURGERY CENTER FOR HEALTH RESEARCH 3800 N INTERSTATE AVE PORTLAND OR 97227 RESEARCH CENTER INTERSTATE SURGICAL CENTER 3500 N INTERSTATE AVE PORTLAND OR 97227 AMBULATORY SURGERY SANTA CLARA PHF 3840 HOMESTEAD RD SANTA CLARA CA 95051 MENTAL HEALTH SKYLINE SURGICAL CENTER 5135 SKYLINE ROAD SOUTH SALEM OR 97306 AMBULATORY SURGERY BROOKSIDE RESIDENTIAL TREATEMENT CENTER 10180 SOUTHEAST SUNNYSIDE RD PORTLAND OR 97015 INPATIENT MENTAL HEALTH SVCS KULA HOSPITAL - 35N 100 KEOKEA PLACE KULA HI 96790 SKILLED NURSING & INTERMEDIATE CARE FACILITY KULA HOSPITAL - IMR-7 100 KEOKEA PLACE KULA HI 96790 IMMEDIATE CARE FACILITY FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES LANAI COMMUNITY HOSPITAL 43-N 628 SEVENTH STREET LANAI CITY HI 96763 SKILLED NURSING AND INTERMEDIATE CARE FACILITY 1 - Part I Line 3c ********************************************************************** There are three distinct eligibility criterion for free care under KPs medical financial assistance policy; (1) means tested (income-based), (2) high medical expenses and (3) situations where the patient has been prequalified. Means-tested: A patient of a household income less than or equal to KFHs means testing criteria as a percentage of the Federal Poverty Guidelines (FPG) is eligible for financial assistance. Note: Assets are not used in income-based criteria. High Medical Expenses: A patient of any household income level with incurred out-of-pocket medical and pharmacy expenses for eligible services over a 12 month period greater than or equal to KFHs high medical expense criteria as a percentage of annual household income is eligible for financial assistance. Prequalification: A patient is presumed to meet the program eligibility criteria and is not required to provide personal, financial and other information to verify financial status when he or she: 1. Is enrolled in a Community MFA (CMFA) program to which patients have been referred and prequalified through (1) federal, state or local government, (2) a partnering community-based organization, or (3) at a KFH sponsored community health event, or 2. Is enrolled in a KP Community Benefit program designed to support access to care for low-income patients and prequalified by designated KFH/HP personnel, or 3. Is enrolled in a credible means-tested health coverage program (e.g., Medicare Low Income Subsidy Program), or 4. Was granted a prior medical financial assistance award within the last 30 days. 1 - Part I Line 7 ********************************************************************** The losses attributed to providing charity care (medical financial assistance and charitable health coverage) and participation in select government or community sponsored health coverage programs are calculated using a cost-based methodology for patients in those programs. The cost-based loss is generated through the standard systems used to report on market segments for KFHP/KFH's commercial business lines. In order to calculate the percentages reported in column (f) bad debt was excluded. 1 - Part III Line 4 ********************************************************************** The financial statements do not include a footnote related to bad debt expense. However, on the financial statements, the bad debt expense is included in the patient service revenue. Patient services revenue is included in copays, deductibles, fees, and other revenue in the statement of operations and is recognized as services are rendered. Bad debt expense related to patient services revenue is calculated based on historical bad debt experience and recorded as an offset to patient services revenue (net of contractual allowances, charity care, and discounts). 1 - Part III Line 8 ********************************************************************** None of the amounts reported on Part III, line 7 has been treated as community benefit. The Medicare hospital cost reports are the source document to capture the Medicare revenue and Medicare allowable costs. To determine the direct costs, the cost report takes inputs from the general ledger by hospital location and applies a step-down methodology to allocate overhead costs. The costs are then passed through additional cost report computations to determine allowable Medicare costs. The total allowable Medicare cost is subtracted from the total revenue by region to determine the Medicare surplus or shortfall. 1 - Part III Line 9b ********************************************************************** When a patient/guarantor indicates an inability to pay (charity care), the patient/guarantor will be evaluated for charity care in accordance with established criteria outlined in the Medical Financial Assistance (MFA) Program. In addition, outside collection agencies will cancel and return on a retrospective basis any accounts that either would have qualified or now qualify for charity care according to the criteria outlined in the MFA Program. 2 - needs assessment ********************************************************************** IN CALIFORNIA, HAWAII, AND OREGON, EACH KFH MEDICAL CENTER IS REQUIRED TO CONDUCT A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS. THE ASSESSMENTS MAY BE CONDUCTED INDIVIDUALLY BY EACH HOSPITAL OR IN COLLABORATION WITH OTHER HOSPITALS, COMMUNITY-BASED AGENCIES AND PUBLIC SERVICE ORGANIZATIONS. EACH NEEDS ASSESSMENT PROVIDES A SUMMARY OF THE NEEDS ASSESSMENT PROCESS UNDERTAKEN INCLUDING THE METHODOLOGIES AND DATA SOURCES UTILIZED, INDIVIDUALS AND ORGANIZATIONS CONSULTED, A COMPLETE LISTING OF THE NEEDS IDENTIFIED AND DESCRIPTION OF THE METHOD USED TO PRIORITIZE NEEDS FOR INCLUSION IN THE INDIVIDUAL COMMUNITY BENEFIT PLANS. THE MOST RECENT NEEDS ASSESSMENTS WERE COMPLETED IN 2016. 3 - patient education of eligibility for assistance ********************************************************************** IN CALIFORNIA, HAWAII, AND OREGON, INFORMATION REGARDING ASSISTANCE IS WIDELY AVAILABLE THROUGHOUT THE FACILITIES TO ALL PATIENTS WHICH INCLUDES BOTH HEALTH PLAN MEMBERS AND THE GENERAL PUBLIC. INFORMATION REGARDING THE AVAILABILITY OF KAISER PERMANENTE'S MEDICAL FINANCIAL ASSISTANCE PROGRAM (MFAP) IS POSTED IN THE EMERGENCY DEPARTMENTS, AND ADMITTING AREAS OF ALL KAISER PERMANENTE HOSPITALS. THE POSTED INFORMATION CONTAINS CONTACT INFORMATION FOR FURTHER ASSISTANCE. KAISER PERMANENTE ADMISSION AND DISCHARGE STAFF ARE ALSO A SOURCE OF INFORMATION FOR PATIENTS THAT EXPRESS FINANCIAL HARDSHIP OR REQUEST MEDICAL FINANCIAL ASSISTANCE. THIS STAFF CAN PROVIDE A COPY OF THE FINANCIAL ASSISTANCE POLICY SUMMARY OR CONNECT A PATIENT WITH A FINANCIAL COUNSELOR WHO CAN ASSIST PATIENTS IN DETERMINING ELIGIBILITY FOR GOVERNMENT PROGRAMS OR THE MFAP. PATIENT DISCHARGE PACKETS ALSO INCLUDE A COPY OF THE MFAP POLICY SUMMARY. IN ADDITION, MFAP INFORMATION, INCLUDING THE POLICY, POLICY PLAIN LANGUAGE SUMMARY AND APPLICATION, CAN ALSO BE FOUND ON THE PUBLICLY ACCESSIBLE KP FINANCIAL ASSISTANCE WEBSITE. ALL PATIENT BILLING STATEMENTS INCLUDE INFORMATION THAT FINANCIAL ASSISTANCE IS AVAILABLE AS WELL AS WHERE TO GET ADDITIONAL INFORMATION OR ASSISTANCE. THE MFAP POLICY PLAIN LANGUAGE SUMMARY IS ALSO INCLUDED WITH THE FIRST HOSPITAL BILLING STATEMENT TO ALL PATIENTS. THE PROGRAM POLICY, POLICY PLAIN LANGUAGE SUMMARY, AND APPLICATION ARE AVAILABLE WITHOUT CHARGE IN ENGLISH AS WELL AS ALL THE LANGUAGES THAT MEET THE LIMITED ENGLISH PROFICIENCY POPULATION CRITERIA (LESSER OF 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY). LANGUAGES SUPPORTED INCLUDE, BUT ARE NOT LIMITED TO SPANISH, CHINESE, JAPANESE, KOREAN, LAOTIAN, TAGALOG, RUSSIAN, FARSI AND VIETNAMESE. 4 - community information ********************************************************************** KFH SERVES COMMUNITIES IN CALIFORNIA, HAWAII, AND OREGON. THE COMMUNITIES WE SERVE ARE DIVERSE AND INCLUDE BOTH LESS POPULOUS AND DENSELY POPULATED CITIES AND COUNTIES. OUR COMMUNITIES ARE DIVERSE IN MANY WAYS INCLUDING INCOME, RATE OF UNINSURED, HIGH SCHOOL GRADUATION AND LIMITED ENGLISH PROFICIENCY. OUR FACILITIES AND THE PEOPLE WHO WORK WITHIN THEM ARE LOCATED WITHIN, AND ARE PART OF OUR COMMUNITIES. KFH owns and operates 41 licensed hospitals, including five licensed hospitals with multiple campuses in California, Hawaii and Oregon. In California, KFH medical centers are located in the cities of Anaheim, Antioch, Baldwin Park, Downey, Fontana, Fremont, Fresno, Harbor City, Irvine, Los Angeles, Manteca, Modesto, Moreno Valley, Oakland, Ontario, Panorama City, Redwood City, Richmond, Riverside, Roseville, Sacramento, San Diego, San Francisco, San Jose, San Leandro, San Rafael, Santa Clara, Santa Rosa, South Sacramento, South San Francisco, Vacaville, Vallejo, Walnut Creek, West Los Angeles, and Woodland Hills. In Hawaii, the Moanalua Medical Center is located in the City of Honolulu on the island of Oahu. In Oregon, the Sunnyside Medical Center is located in the City of Clackamas and Kaiser westside medical center in Hillsboro. Ncal scal Hawaii nw ---- ---- ------ -- Total population in area (mil)* 12.4 22.4 1.4 3.4 Median Household Income**** $81,354 $56,990 $60,499 $50,789 below 100% fpl* 13.7% 16.36% 10.8% 14.47% w/o public or private health ins* 9.26% 14.38% 2.0% 9.75% Limited English Proficiency* 16.37% 20.45% 12.64% 6.74% High School Graduation Rate** 84.3%** 82.3%** 81.5%**^ 77.2**^ Unemployment Rate (%)*** 3.6% 3.9% 2.0% 3.8% (SOURCE: US CENSUS 2010 AMERICAN COMMUNITY SURVEY S2701, CPO3, AND DP03 LIMITED TO APPROXIMATE KAISER SERVICE AREAS (MSA) IN EACH OF THE 4 REGIONS. (INCLUDES THE ENTIRE STATE OF HAWAII) * US CENSUS BUREAU, AMERICAN COMMUNITY SURVEY: 2012-16 ** CALIFORNIA DEPARTMENT OF EDUCATION; 2014-2015. **^ US Department of Education, EDFacts; Accessed via DATA.GOV. Additional data analysis by CARES. 2014-15. *** US DEPARTMENT OF LABOR, BUREAU OF LABOR STATISTICS: 2017 - JUNE **** KAISER PERMANENTE UTILITY FOR CARE DATA ANALYSIS, ESRI 2016, HOUSEHOLD-WEIGHTED MEDIAN OF HOUSEHOLD INCOME MEDIANS FOR THE BLOCK GROUPS IN KP'S REGIONAL SERVICE AREAS (PREVIOUSLY REPORTED AS MEMBER-WEIGHTED MEDIAN OF MEDIAN HOUSE HOLD INCOME) ***** US CENSUS BUREAU, AMERICAN COMMUNITY SURVEY. 2012-16 KAISER PERMANENTE'S COMMITMENT TO THE COMMUNITY AND PROMOTION OF COMMUNITY HEALTH Since our beginnings, we have been committed to helping shape the future of health care. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. KFH is committed to the belief that good health is a fundamental right shared by all, and we recognize that good health extends beyond the doctor's office and the hospital. Like our approach to medicine, our work in the community takes a prevention-focused, evidence-based approach. We go beyond traditional corporate philanthropy or grant-making to leverage financial resources with medical research, physician expertise, and clinical practices. Historically, we have focused our investments in three areas-Health Access, Healthy Communities, and Health Knowledge-to address critical health issues in our communities. For many years, we have worked collaboratively with other organizations to address serious public health issues such as obesity, access to care, and violence. We have conducted Community Health Needs Assessments (CHNA) to better understand each community's unique needs and resources. The CHNA process informs our community investments and helps us develop strategies aimed at making long-term, sustainable change-and it allows us to deepen the strong relationships we have with other organizations that are working to improve community health. THE KFHP/KFH BOARD HAS A STANDING COMMUNITY BENEFIT COMMITTEE OF THE BOARD OF DIRECTORS TO OVERSEE THE PROGRAM-WIDE COMMUNITY BENEFIT PROGRAM. KAISER PERMANENTE ALSO HAS A NATIONAL EXECUTIVE OF KFHP AND KFH TO LEAD KAISER PERMANENTE'S COMMUNITY BENEFIT PROGRAM AS A FULL-TIME ASSIGNMENT. BECHARA CHOUCAIR, MD IS THE SENIOR VICE PRESIDENT FOR COMMUNITY HEALTH AND BENEFIT, AND CHIEF COMMUNITY HEALTH OFFICER REPORTING TO THE CEO AND CHAIRMAN OF THE BOARD. 5 - promotion of community health ********************************************************************** KFH's principal purpose is to provide hospital, medical, and surgical care, including emergency services, extended care and home health care to members of the public without regard to age, sex, race, religion or national origin, or to the individual's ability to pay. KFH SHARES THE KAISER PERMANENTE MISSION, OF PROVIDING AFFORDABLE HIGH QUALITY HEALTH CARE TO OUR MEMBERS, AND IMPROVING THE HEALTH OF OUR MEMBERS AND THE COMMUNITIES WE SERVE. KFH's general community benefits include: Emergency departments - KFH operates full-time emergency departments in each of its 41 licensed hospitals, including five licensed hospitals with multiple campuses in California, Hawaii, and Oregon. Emergency medical services are available to all individuals regardless of their ability to pay. Care provided to all patients - Hospital care is provided to individuals with health care coverage from any private or government-sponsored health plan, insured and uninsured referrals from safety net and other public health partnerships, and uninsured patients admitted through the emergency department. Open Medical Staff Privileges - Staff privileges in the hospitals are available to community practitioners who are not affiliated with a Permanente Medical Group. Reinvestment of Surplus Revenues - KFHP pays KFH for hospital services and surplus revenues are reinvested IN THE furtherance OF THE EXEMPT PURPOSE, for capital replacement or expansion of facilities and equipment, debt amortization, improvement in patient care and services, and other community benefit services including charity care, medical education and research. In addition, KFH is committed to operating to intentionally protect and preserve the environment and scarce resources. Poor environmental quality contributes to disease and economic insecurity. Kaiser Foundation Hospitals has therefore committed itself to protecting and improving the natural environment as a key component of our mission to improve healthcare quality and affordability. To fulfill this commitment, Kaiser Foundation Hospitals maintains a structure for environmental stewardship that enables the organization to continuously improve its environmental performance. This structure includes clearly defined roles, responsibilities, plans and routines, and has resulted in five organization-wide focus areas that have been selected based on their ability to have the most impact on the environmental forces that shape environmental- and human-health: 1. Finding safe alternatives to harmful industrial chemicals 2. Responding to climate change 3. Promoting sustainable farming and food choices 4. Reducing, reusing, and recycling to eliminate waste 5. Conserving water In each of these focus areas, Kaiser Foundation Hospitals has established ambitious goals, implemented initiatives, achieved measurable improvements, and regularly reported progress to our Board of Directors, our staff, and the communities we serve. 6 - affiliated health care system ********************************************************************** Kaiser Permanente is a not for profit, integrated health care delivery system comprised of Kaiser Foundation Hospitals, Kaiser Foundation Health Plan, and The Permanente Medical Groups. For more than 70 years, Kaiser Permanente has been dedicated to providing high-quality, affordable health care services and to improving the health of our members and the communities we serve. Kaiser Foundation Hospitals (KFH) and Kaiser Foundation Health Plan, Inc. (KFHP), with its five principal operating tax-exempt subsidiary health plans-Kaiser Foundation Health Plan of Colorado; Kaiser Foundation Health Plan of Georgia, Inc.; Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.; Kaiser Foundation Health Plan of the Northwest; and Kaiser Foundation Health Plan of Washington, are nonprofit corporations that are part of the integrated health care delivery system known as the Kaiser Permanente Medical Care Program or "Kaiser Permanente." Kaiser Permanente is an integrated health care delivery system that combines the provision and financing of health care services. People who elect to enroll in a Kaiser Permanente health plan receive a full range of prepaid health care services, including hospital care, professional care in hospitals and physicians' offices, x-ray and laboratory services, physical therapy, emergency, ambulance transportation, preventive services, health education and certain prescribed drugs. More comprehensive drug coverage is also provided through a separate coverage rider. Persons enroll in Kaiser Permanente through KFHP or one of the Health Plan subsidiaries ("Health Plan"). Health Plan provides and arranges comprehensive health care services for members on a predominantly prepaid basis and fulfills its contractual obligations to group and individual members by contracting with KFH, in CA, HI, and OR based regions, and a Permanente Medical Group to provide the required health care services. KFHP and KFH are separate corporations governed by identical boards of directors. KFH accepts responsibility to provide or arrange necessary hospital services and facilities for Health Plan members. KFH owns and operates 41 licensed hospitals, including five licensed hospitals with multiple campuses in California, Hawaii and Oregon. KFHPW owns and operates 1 licensed hospital. KFH and KFHPW provide emergency and in-patient services to all persons in the community regardless of membership or ability to pay. Staff privileges are available on a nondiscriminatory basis to physicians in the communities served. KFH also contracts with other community hospitals to provide hospital services to members for specialized care and other services. 7 - state filing of community benefit report ********************************************************************** KFH annually prepares and submits a Consolidated Community Benefit Plan to the California Office of Statewide Health Planning and Development in compliance with Health and Safety Code Section 127340 et seq. The consolidated plan includes a hospital-specific community benefit plan for each individual medical center campus in California. KFH also annually prepares and submits a comprehensive Community benefit report to the Department of Human Services, Office for Oregon Health Policy and Research for the Sunnyside Medical Center located in the City of Clackamas. true 1736 Family Crisis Center 2116 Arlington Ave Los Angeles CA 90018 953989251 501(c)(3) 10000 Project Support 18 Reasons 3150 18th St 315 San Francisco CA 94110 453059509 501(c)(3) 20000 Project Support 5 Acrs - The Boys & Grls Aid Soc of LA Cty 760 W Mountain View St Altadena CA 91001 951647810 501(c)(3) 10000 Project Support A Better Way - Berkeley 3200 Adeline St Berkeley CA 94703 931190792 501(c)(3) 98000 Project Support A Community of Friends 3701 Wilshire Blvd Los Angeles CA 90010 954203106 501(c)(3) 17000 Project Support A New Way of Life Re-Entry Project 9512 S Central Ave Los Angeles CA 90002 954782503 501(c)(3) 10000 Project Support A Place Called Home 2830 S Central Ave Los Angeles CA 90011 954427291 501(c)(3) 10000 Project Support AAA Comprehensive Healthcare Inc 7451 Lanker Blvd North Hollywood CA 91605 270735908 501(c)(3) 10000 Project Support ABC Unified School District 16700 Norwalk Blvd Cerritos CA 90703 952380644 Government or P 15000 Project Support Abode Services 40849 Fremont Blvd Fremont CA 94538 943087060 501(c)(3) 47569 Project Support Active Children Portland 7931 NE Halsey St 201 Portland OR 97213 452474481 501(c)(3) 15000 Project Support Adaptive Physical Education 1455 Madison Ave Redwood City CA 94061 463037547 501(c)(3) 10000 General Operating Support Adelante Mujeres 2030 Main St A Forest Grove OR 97116 030473181 501(c)(3) 50000 Project Support Adelante Youth Alliance 805 N Madison Ave Pasadena CA 91104 154819333 501(c)(3) 19700 Conference Support Adolescent Counseling Services Inc 643 Bair Island Rd Redwood City CA 94063 530192551 501(c)(3) 10000 General Operating Support Affordable Living for the Aging 2029 Century Park E Los Angeles CA 90067 953301874 501(c)(3) 94500 Event Support\Annual Fundraiser Afghan Coalition 39155 Liberty St D460 Fremont CA 94538 943398311 501(c)(3) 30000 Project Support Aids Community Action Foundation 273 9th St 2nd Fl San Francisco CA 94103 900171830 501(c)(3) 10000 Project Support AIDS Project Los Angeles Inc 611 S Kingsley Dr Los Angeles CA 90005 953842506 501(c)(3) 12300 Event Support\Annual Fundraiser Aircraft Carrier Hornet Foundation Pier 3 Alameda Point Alameda CA 94501 943226801 501(c)(3) 15000 Project Support Airport Marina Counseling Service 7891 La Tijera Blvd Los Angeles CA 90045 952224149 501(c)(3) 10000 Project Support Airway Science for Kids PO Box 4142 Portland OR 97208 943163800 501(c)(3) 20000 Project Support Al Wooten Jr Youth&Adult Cultural-Edu Ctr 9106 S Western Ave Los Angeles CA 90047 954295918 501(c)(3) 10000 Project Support Alameda County Board of Supervisors 16355 E 14th St San Leandro CA 94578 946000501 Government or P 2636500 Project Support Alameda Health Consortium 101 Callan Ave 300 San Leandro CA 94577 510189590 501(c)(3) 134250 Project Support Alameda Health System Foundation 350 Frank Ogawa Plz 900 Oakland CA 94607 943103136 501(c)(3) 263500 Event Support\Cultural Event Alameda Point Collaborative 677 West Ranger Ave Alameda CA 94501 943361464 501(c)(3) 8000 General Operating Support Alano Club of Portland 909 NW 24th Ave Portland OR 97210 930370227 501(c)(3) 15000 Project Support Albert Schweitzer Fellowship Inc 330 Brookline Ave Boston MA 02215 131982786 501(c)(3) 45000 General Operating Support Alcott Center for Mental Health Services 1433 S Robertson Blvd Los Angeles CA 90035 953392564 501(c)(3) 10000 Project Support Alexander Montgomery Foundation 105 Seminary Rd San Anselmo CA 94960 813850170 501(c)(3) 90000 Project Support All Hands Raised 2069 NE Hoyt St Portand OR 97232 931149789 501(c)(3) 15000 Project Support Alliance for a Healthier Generation Inc 2525 SW 1st Ave 120 Portland OR 97201 272028308 501(c)(3) 270000 Project Support Al-Shifa Clinic Inc 2034 B Mallory St San Bernardino CA 92407 330855769 501(c)(3) 70000 General Operating Support Alternatives in Action 3666 Grand Ave A Oakland CA 94610 943210413 501(c)(3) 34000 Event Support\Cultural Event Alum Rock Counseling Center Inc 777 North First St 444 San Jose CA 95112 237367637 501(c)(3) 118000 Project Support Always Knocking Inc 4001 Sumner Ln Carmichael CA 95608 264635991 501(c)(3) 20000 Project Support Alzheimers Disease Association of Kern Cty 4203 Buena Vista Rd Bakersfield CA 93311 770017561 501(c)(3) 10000 Project Support Alzheimer's San Diego 6632 Convoy Court San Diego CA 92111 475534541 501(c)(3) 10000 Project Support Alzhs Disease & Rlted Disorders Assoc OC 2515 McCabe Way 200 Irvine CA 92614 953702013 501(c)(3) 7500 Event Support\Annual Fundraiser Amanecer Comm Counseling Svc an NFP 1200 Wilshire Blvd Los Angeles CA 90017 953076578 501(c)(3) 10000 Project Support Ambulatory Surgery Access Coalition 1119 Market St 400 San Francisco CA 94103 943180356 501(c)(3) 411900 General Operating Support Amer Rnd Table to Abolish Homelessness 5 Park St Boston MA 02108 270176858 501(c)(3) 10000 Conference Support America SCORES Bay Area 1610 Harrison St San Francisco CA 94103 481272959 501(c)(3) 25000 Project Support American Cancer Society Inc 1001 Marina Village Pkwy Alameda CA 94501 131788491 501(c)(3) 17900 Event Sponsor American Diabetes Association Inc 611 Wilshire Blvd Los Angeles CA 90017 131623888 501(c)(3) 22685 Event Support\Annual Fundraiser American Heart Association Inc 4600 Campus Dr Irvine CA 92617 135613797 501(c)(3) 257744 Event Support\Dinner American National Red Cross 1663 Market St San Francisco CA 94103 530196605 501(c)(3) 269300 Other;Event Support\Annual Fundraiser Antelope Valley Boys and Girls Club 45404 N Division St Lancaster CA 93535 954290055 501(c)(3) 10000 Project Support Antelope Valley College Foundation 3041 West Ave K Lancaster CA 93536 954398700 501(c)(3) 12000 General Operating Support Antelope Valley Community Clinic 45104 10th St West Lancaster CA 93534 260574826 501(c)(3) 22400 Event Support\Annual Fundraiser Antelope Valley Partners for Health 44226 10th St West Lancaster CA 93534 470957404 501(c)(3) 19339 Project Support Apple Tree Dental California Inc 430 N El Camino Real San Mateo CA 94401 943390196 501(c)(3) 15000 General Operating Support AREA AGENCY ON AGING 400 Contra Costa St Vallejo CA 94590 942742309 501(c)(3) 10000 Project Support Arrowhead United Way 646 North D St San Bernardino CA 92401 951934586 501(c)(3) 10000 Project Support Arts & Cultural Foundation of Antioch 510 G St Antioch CA 94509 680479175 501(c)(3) 16250 Project Support Arts Council of Kern 1330 Truxton Ave B Bakersfield CA 93301 953098602 501(c)(3) 10000 Project Support Ashby Village Inc 1821 Catalina Ave Berkeley CA 94707 272174330 501(c)(3) 150000 Project Support Asian American Drug Abuse Program Inc 2900 S Crenshaw Blvd Los Angeles CA 90016 952848695 501(c)(3) 10000 Project Support Asian Americans Adv Justice Los Angeles 1145 Wilshire Blvd Los Angeles CA 90017 953854152 501(c)(3) 9200 Event Support\Dinner Asian Americans for Community Involvement 2400 Moorpark Ave 300 San Jose CA 95128 942292491 501(c)(3) 40000 Project Support Asian and Pacific Islander Wellness Center 730 Polk St 4th Fl San Francisco CA 94109 943096109 501(c)(3) 8000 Event Support\Annual Fundraiser Asian Art Museum Foundation Of SF 200 Larkin St San Francisco CA 94102 941704765 501(c)(3) 88750 Event Support\Cultural Event Asian Health & Service Center 3430 SE Powell Blvd Portland OR 97202 931192100 501(c)(3) 95353 Project Support Asian Health Services 101 8th St 100 Oakland CA 94607 942235908 501(c)(3) 158700 Capital Fund Support Asian PA Amer PA Assoc Com Edu Fdn 4000 Truxel Rd3 Sacramento CA 95834 550849384 501(c)(3) 9950 Project Support Asian Pacific American Network of Oregon 2788 SE 82nd Ave203 Portland OR 97266 800252850 501(c)(3) 100000 Project Support Asian Pacific Health Care Venture Inc 4216 Fountain Ave Los Angeles CA 90029 954177752 501(c)(3) 8000 Project Support Asian Pacific Youth Leadership Project 3064 Mill Oak Way Sacramento CA 95833 943167910 501(c)(3) 7760 Other;Event Support\Annual Fundraiser Assistance League of San Bernardino 580 West 6th St San Bernardino CA 92410 956065105 501(c)(3) 75000 Project Support Autism Tree Project Inc 2845 Nimitz Blvd C San Diego CA 92106 710942573 501(c)(3) 12000 Project Support Avance Schools Inc 115 N Ave 53 Los Angeles CA 90042 203082187 501(c)(3) 24000 Project Support Axis Community Health Inc 4361 RailRd Ave Pleasanton CA 94566 942232394 501(c)(3) 40000 Project Support Baldwin Park Charitable Relief Foundation 14403 E Pacific Ave Baldwin Park CA 91706 475435073 501(c)(3) 7000 Project Support Baldwin Park Unified School District 3699 N Holly Ave Baldwin Park CA 91706 956000213 Government or P 22530 Project Support Basic Rights Education Fund PO Box 40625 Portland OR 97240 931266613 501(c)(3) 20000 Project Support Battle Ground HealthCare 11117 NE 189th St Battle Ground WA 98604 273148590 501(c)(3) 21000 Project Support Bay Area Black United Fund Inc 1212 BRdway 640 Oakland CA 94612 942602958 501(c)(3) 90000 Project Support Bay Area Women Against Rape 470 27th St Oakland CA 94612 942300454 501(c)(3) 40000 Project Support Bear Valley Unified School District 42271 Moonridge RD Big Bear Lake CA 92315 956006065 Government or P 15000 Project Support Being Alive People w AIDS Action Coalition 7531 Santa Mon Bl West Hollywood CA 90046 954137742 501(c)(3) 8000 Project Support Beneficent Technology Inc DBA Benetech 480 California Ave Palo Alto CA 94306 770555413 501(c)(3) 50000 Project Support Benicia Community Action Council 480 MILITARY EAST BENICIA CA 94510 680294153 501(c)(3) 10000 Project Support Berkeley Community Health Project 2339 Durant Ave Berkeley CA 94704 941697002 501(c)(3) 20000 Project Support Big Brothers Big Sisters Columbia NW 1827 NE 44th Ave100 Portland OR 97213 931303640 501(c)(3) 35000 Project Support Big Sunday 6111 Melrose Ave Los Angeles CA 90038 421765317 501(c)(3) 9250 Event Support\Annual Fundraiser Bill Wilson Center 3490 The Alameda Santa Clara CA 95050 942221849 501(c)(3) 25000 Project Support Black Parent Initiative (BPI) 2915 NE MLK Blvd Portland OR 97212 205686374 501(c)(3) 20000 Project Support Black Women For Wellness 4340 11th Ave Los Angeles CA 90008 954624707 501(c)(3) 32500 Project Support Blanchet House of Hospitality 310 NW Glisan St Portland OR 97209 936031009 501(c)(3) 15000 Project Support Boldly Me 39843 Paseo Padre PkwyG Fremont CA 94538 454796086 501(c)(3) 6640 Event Support\Annual Fundraiser Borland Free Clinic 3500 Borland Rd Tualatin OR 97062 461070038 501(c)(3) 6000 Project Support Borrego Community Health Foundation 4343 Yaq Pass Rd Borrego Springs CA 92004 330440021 501(c)(3) 25000 Project Support Boys & Girls Clb of Burbank and Grtr E Vly 2244 N Buena Vista St Burbank CA 91504 954485745 501(c)(3) 8000 Project Support Boys & Girls Clb of Grtr Redlands 1251 Clay ST Redlands CA 92373 956187083 501(c)(3) 10000 Project Support Boys & Girls Club of Fontana 7723 Almeria Ave Fontana CA 92335 330443344 501(c)(3) 15000 Project Support Boys & Girls Club of Hollywood 850 N Cahuenga Blvd Los Angeles CA 90038 951775142 501(c)(3) 8000 Project Support Boys & Girls Club of Southwest County 28790 Pujol St Temecula CA 92590 330475756 501(c)(3) 20000 Project Support Boys & Girls Club of Tracy Inc 753 W Lowell Ave Tracy CA 95376 680028682 501(c)(3) 40000 Project Support Boys & Girls Club of W San Gabriel Vly 328 S Ramona Ave Monterey Park CA 91754 952782501 501(c)(3) 15000 Project Support Boys & Girls Clubs North San Mateo County 201 W Orng Av South San Francisco CA 94080 941497000 501(c)(3) 22247 Event Support\Annual Fundraiser Boys & Girls Clubs of Fresno County 540 North Augusta St Fresno CA 93701 941149171 501(c)(3) 45918 Project Support Boys & Girls Clubs of Metro Los Angeles 800 S Figueroa St Los Angeles CA 90017 810851473 501(c)(3) 7500 Project Support Boys & Girls Clubs of San Francisco 380 Fulton St San Francisco CA 94102 941156608 501(c)(3) 15000 Project Support Boys & Girls Clubs of Silicon Valley 518 Valley Way Milpitas CA 95035 941294898 501(c)(3) 25000 Project Support Boys & Girls Clubs of the Peninsula 401 Pierce Rd Menlo Park CA 94025 941552134 501(c)(3) 20000 General Operating Support Boys and Girls Club of Carson 1950 E 220th St102 Carson CA 90810 330475452 501(c)(3) 10000 Project Support Boys and Girls Clubs of Santa Monica Inc 1220 Lincoln Blvd Santa Monica CA 90401 951890706 501(c)(3) 10000 Project Support Breathe California of Sacramento 909 12th St 100 Sacramento CA 95814 941641240 501(c)(3) 20000 Project Support Brentwood School 100 S Barrington Pl Los Angeles CA 90049 951426236 501(c)(3) 12500 Board Matching Gift Bridge to Home SCV 23752 Newhall Av Santa Clarita CA 91321 954587823 501(c)(3) 7000 Project Support Bright Prospect 1460 East Holt Ave74 Pomona CA 91767 522363234 501(c)(3) 15000 Project Support Brighter Beginnings 2727 Macdonald Ave Richmond CA 94804 942949749 501(c)(3) 82500 Project Support Buddhist Tzu Chi Medical Foundation 3898 N Ann Ave Fresno CA 93727 954457939 501(c)(3) 80000 Project Support Buena Horace Mann K-8 Community School 3351 23rd St San Francisco CA 94110 943033872 501(c)(3) 25000 Project Support Building A Generation 932 W Cypress Ave Redlands CA 92375 542104001 501(c)(3) 15000 Project Support CA Aquatic Therapy & Wellness Center Inc 6801 Long Beach Blvd Long Beach CA 90805 952382016 501(c)(3) 10000 Project Support CA Bicycle Coalition Education Fund 1017 L St 288 Sacramento CA 95814 680417507 501(c)(3) 9430 Conference Support CA Consortium For Urban Indian Health Inc 1016 Lincoln Blvd San Francisco CA 94129 204878959 501(c)(3) 125000 General Operating Support CA Court Appointed Special Advocate Assoc 663 13th St 200 Oakland CA 94612 680163010 501(c)(3) 150000 Project Support CA Parntng Institute DBA Child Parent Inst 3650 Standish Ave Santa Rosa CA 95407 942541640 501(c)(3) 20000 Project Support CA Partnership for Safe Communities 825 Washington St200 Oakland CA 94607 453127566 501(c)(3) 200000 Project Support Cajon Valley Union School District 750 East Main St El Cajon CA 92020 956000428 501(c)(3) 10000 Project Support Cal State Bakersfield Foundation 9001 Stockale Hwy Bakersfield CA 93311 952643086 501(c)(3) 12000 Project Support Calico Center 524 Estudillo Ave San Leandro CA 94577 943256781 501(c)(3) 28790 Project Support California Association of Food Banks 1624 Franklin St 722 Oakland CA 94612 680392816 501(c)(3) 200000 Conference Support California Community Foundation 221 South Figueroa St Los Angeles CA 90012 953510055 501(c)(3) 20025000 General Operating Support California Coverage and Health Initiatives 1107 9th St 601 Sacramento CA 95814 474034471 501(c)(3) 10000 Event Support\Awards Ceremony California Exposition & State Fair 1600 Exposition Blvd Sacramento CA 95815 946032535 Government or P 56796 Project Support California Food Policy Advocates Inc 1970 BRdway 760 Oakland CA 94612 943163142 501(c)(3) 125000 Project Support California Health Collaborative 1680 W Shaw Ave Fresno CA 93711 942862660 501(c)(3) 70000 Project Support California Living Museum Foundation 1300 17th St Bakersfield CA 93301 770420446 501(c)(3) 8000 Project Support California Pan-Ethnic Health Network 1221 Preserv Prk Wy Oakland CA 94612 943306223 501(c)(3) 175000 General Operating Support California Primary Care Association 1231 I St 400 Sacramento CA 95814 943215565 501(c)(3) 325000 Conference Support California School Based Health Alliance 1203 Preserv Prk Wy Oakland CA 94612 943201896 501(c)(3) 175000 Project Support California WIC Association 3120 Freeboard Dr West Sacramento CA 95691 680271696 501(c)(3) 100000 Project Support Camarena Health 344 E Sixth St Madera CA 93638 942503904 501(c)(3) 50000 Project Support CAMBRIDGE PUBLIC HEALTH COMMISSION 1493 Cambridge Street Cambridge MA 02139 043167608 501(c)(3) 39631 PassThrough Fed Proj Caminar 2600 S El Camino Real San Mateo CA 94403 941639389 501(c)(3) 145000 Event Support\Annual Fundraiser Canal Alliance 91 LARKSPUR ST San Rafael CA 94901 942832648 501(c)(3) 25000 Project Support CANCER PREVENTION INSTITUTE 2201 Walnut Avenue Fremont CA 94538 237427232 501(c)(3) 154141 PassThrough Fed Proj Cancer Support Community 530 Hampshire Rd Westlake Village CA 91361 770205691 501(c)(3) 20000 Project Support CAPACES Leadership Institute 356 Young St Woodburn OR 97071 452771253 501(c)(3) 10000 Project Support Care Harbor 18436 Hawthorne Blvd204 Torrance CA 90504 272984870 501(c)(3) 50000 Event Support\Health Fair Caregivers Vlntrs Assisting the Elderly 1765 Goodyear Ave 205 Ventura CA 93003 770081692 501(c)(3) 20000 Project Support CASA of Clackamas County 421 High St 108 Oregon City OR 97045 931105205 501(c)(3) 9375 Project Support CASA of Los Angeles 201 Centre Plaza Dr Monterey Park CA 91754 953890446 501(c)(3) 11000 Project Support Casa Pacifica Ctrs for Children and Fmls 1722 S Lewis Rd Camarillo CA 93012 770195022 501(c)(3) 20000 Project Support Cascade Aids Project Inc 520 NW Davis St 215 Portland OR 97209 930903383 501(c)(3) 15000 Project Support Catholic Char of the Diocese of Oakland 433 Jefferson St Oakland CA 94607 942677202 501(c)(3) 115537 Project Support Catholic Char of the Diocese of Santa Rosa 987 Airway Court Santa Rosa CA 95403 942479393 501(c)(3) 52000 Project Support Catholic Charities of Los Angeles Inc 3250 Wilshire Blvd Los Angeles CA 90010 951690973 501(c)(3) 19200 Project Support Catholic Charities of Oregon 2740 SE Powell Blvd 5 Portland OR 97217 930386801 501(c)(3) 10000 Project Support Catholic Charities of Santa Clara County 2625 Zanker Rd San Jose CA 95134 942762269 501(c)(3) 37500 Project Support Catholic Charof the Diocese of Stockton 400 12th St 4 Modesto CA 95354 941629114 501(c)(3) 150000 Project Support Causa Oregon 700 Marion St NE Salem OR 97301 611590160 501(c)(3) 10000 Project Support Center for AIDS ResearchEducation & Svcs 1500 21st St Sacramento CA 95811 680162903 501(c)(3) 50000 Project Support Center for Community Solutions 4508 Mission Bay Dr San Diego CA 92109 956379598 501(c)(3) 10000 Project Support Center For Elders Independence 510-17th St 400 Oakland CA 94612 943123446 501(c)(3) 30000 Project Support Center for Human Development 901 Sunvalley Blvd 220 Concord CA 94520 942520840 501(c)(3) 7450 Event Support\Health Fair Center for Human Services 2000 W Briggsmore Ave I Modesto CA 95350 941725620 501(c)(3) 75000 Project Support Center for Living and Learning 14549 Archwood St221 Van Nuys CA 91405 954406897 501(c)(3) 20330 Project Support Center for Oral Health 309 E 2nd St Pomona CA 91766 943000350 501(c)(3) 75000 Project Support Center for the Pacific Asian Family Inc 3424 Wilshire Blvd Los Angeles CA 90010 953532351 501(c)(3) 12750 Event Support\Annual Fundraiser Centinela Valley Union HS District 14901 S Inglewood Ave Lawndale CA 90260 956000539 Government or P 7500 Project Support Centinela Youth Services Inc 11539 Hawthorne Blvd Hawthorne CA 90250 953821576 501(c)(3) 10000 Project Support Central City Community Health Center 5233 E Beverly Blvd Los Angeles CA 90022 954492570 501(c)(3) 20000 Project Support Central City Concern Inc 232 NW 6th Ave Portland OR 97209 930728816 501(c)(3) 1348334 Project Support Central Unified School District 5650 W Escalon Ave Fresno CA 93722 770559747 Government or P 59237 Project Support Central Valley Health Network Inc 1451 River Park Dr Sacramento CA 95815 680429643 501(c)(3) 125000 General Operating Support Centro Binacional para el DIO Inc 744 N Abby St Fresno CA 93701 770337939 501(c)(3) 15000 Project Support Centro Community Partners 825 Washington St 228 Oakland CA 94607 452992960 501(c)(3) 24500 Project Support Centro Latino Americano 944 W 5th Ave Eugene OR 97402 930638731 501(c)(3) 10000 Project Support Cesar Chavez Foundation 316 West 2nd St 600 Los Angeles CA 90012 952466747 501(c)(3) 9400 Event Support\Annual Fundraiser Chapa-De Indian Health Program Inc 11670 Atwood Rd Auburn CA 95603 942583156 501(c)(3) 50000 Project Support Charles Drew Univ of Med & Science 1731 East 120th St Los Angeles CA 90059 956151774 501(c)(3) 24541 Event Support\Awards Ceremony Child & Family Center 21545 Ctre Pte Pkwy Santa Clarita CA 91350 953941342 501(c)(3) 15000 Project Support Child Abuse Council of Sacramento 4700 Roseville Rd North Highlands CA 95660 942833431 501(c)(3) 30000 Project Support Child Advocates of San Bernardino County 851 S Mt Vernon Ave 7A Colton CA 92324 330362613 501(c)(3) 25000 Project Support Child Care Coord Coun of San Mateo Cty 330 Twin Dolphin Dr Redwood City CA 94065 942226587 501(c)(3) 15000 General Operating Support Child Haven Inc 801 Empire St Fairfield CA 94533 942907687 501(c)(3) 30000 Project Support Children & Nature Network 808 14TH AVE SE MINNEAPOLIS MN 55414 141959018 501(c)(3) 85000 Project Support Children's Cancer Association 1200 NW Naito Pkwy 140 Portland OR 97209 931181662 501(c)(3) 15000 Project Support Childrens Dental Foundation 455 East Columbia St Long Beach CA 90806 952111124 501(c)(3) 85000 Project Support Children's Fund Incorporated 348 W Hosp Ln San Bernardino CA 92408 330193286 501(c)(3) 20000 Project Support Children's Hospital & Research Center 747 52nd St Oakland CA 94609 940382330 501(c)(3) 29500 Project Support Children's Network of Solano County 827 Missouri St 5 Fairfield CA 94533 680014506 501(c)(3) 30000 Project Support Chinatown Service Center 767 N Hill St 200 Los Angeles CA 90012 952918844 501(c)(3) 9350 Event Support\Annual Fundraiser Christian Community Placement Center 4890 32nd Ave SE Salem OR 97317 943112571 501(c)(3) 20000 Project Support Christian Counseling Service of E Valley 101 East Redlands Blvd Redlands CA 92373 330063237 501(c)(3) 10000 Project Support City of Carson 701 E Carson St Carson CA 90745 952513547 Government or P 7500 General Operating Support City of Concord 1950 Parkside Dr Concord CA 94519 946000315 Government or P 10000 Project Support City of Folsom Parks & Recreation 50 Natoma St Folsom CA 95630 946000334 Government or P 10000 Project Support City of Fremont 39155 Liberty StE500 Fremont CA 94537 946027361 Government or P 30968 Project Support City of Glendale Comm Svcs & Parks 613 East BRdway 120 Glendale CA 91206 956000714 Government or P 10000 General Operating Support City of Madera 205 West 4th St Madera CA 93637 946000365 Government or P 50000 Project Support City of Menifee 29714 Haun Rd Menifee CA 92586 943439857 Government or P 25000 Project Support City of Moreno Valley 14075 Frederick St Moreno Valley CA 92553 330076484 Government or P 20000 Project Support City of Oakland 250 Frank Ogawa Plz 3315 Oakland CA 94612 946000384 Government or P 557250 Project Support City of Perris 101 North D St Perris CA 92570 956000761 Government or P 25000 Project Support City of Portland Oregon 1001 SW 5th Ave 5th Fl Portland OR 97204 936008836 Government or P 150000 Project Support City of Redwood City 400 DUANE ST 125 Redwood City CA 94062 946001116 Government or P 30000 Project Support City of Rialto 150 S Palm Ave Rialto CA 92376 956000768 Government or P 10000 General Operating Support City of Richmond California 3201 Leona Ave Richmond CA 94804 946000403 Government or P 75000 Project Support City of Riverside 3900 Main St Riverside CA 92522 956000769 Government or P 12230 Conference Support City of Sacramento 915 I St 5th Floor Sacramento CA 95814 946000410 Government or P 509250 General Operating Support City of San Jose 200 E Santa Clara St San Jose CA 95113 946000419 Government or P 75000 Project Support City of Selma 1710 Tucker St Selma CA 93662 946000431 Government or P 10000 Project Support City of Yucaipa 34272 Yucaipa Blvd Yucaipa CA 92399 330383731 Government or P 10000 Project Support City Year Inc 1875 Conn Ave NW Washington DC 20009 222882549 501(c)(3) 100000 Project Support Clackamas County 2051 Kaen Rd 367 Oregon City OR 97045 936002286 Government or P 82616 Project Support Clackamas Education Service District 13455 SE 97th Ave Clackamas OR 97015 936000229 Government or P 53150 Project Support Clackamas Volunteers in Medicine 700 Molalla Ave Oregon City OR 97045 371621141 501(c)(3) 8000 Project Support Clark County Food Bank 6502 NE 47th Ave Vancouver WA 98661 911307564 501(c)(3) 15000 Project Support Clark County Mural Society 1601 E 4th Plain Blvd Vancouver WA 98666 201348169 501(c)(3) 60000 Project Support Clark County Public Health PO Box 9825 Vancouver WA 98666 916001299 Government or P 83333 Project Support Clinicas de Salud Del Pueblo Inc 1166 K St Brawley CA 92227 952657324 501(c)(3) 25000 Project Support Clinicas del Camino Real Inc 1040 Flynn Rd Camarillo CA 93012 952977147 501(c)(3) 75000 Project Support Cntrl Amer Resource Ctr Carcen of CA 2845 West 7th St Los Angeles CA 90005 953867724 501(c)(3) 24635 General Operating Support Cntrl Coast Yng Mens Christian Association 27 Sudden St Watsonville CA 95076 770202335 501(c)(3) 10000 Project Support Centro de Salud La Comun de San Ysidro Inc 1275 30th St San Diego CA 92154 952801772 501(c)(3) 30000 Project Support Coal for Humane Immigrant Rights of LA 2533 W Third St101 Los Angeles CA 90057 954421521 501(c)(3) 12000 Event Support\Annual Fundraiser Coal of Orange County Community Clncs 515 N Cabrillo Park Dr Santa Ana CA 92701 952900725 501(c)(3) 225000 Project Support Coalition of Communities of Color 221 NW Second Ave 303 Portland OR 97218 474448490 501(c)(3) 10000 Project Support Code For America Labs Inc 155 9th St San Francisco CA 94103 271067272 501(c)(3) 200000 Project Support Comm Actn Ptnrship of San Bernardino Cty 696 S Tippec Ave San Bernardino CA 92408 952376882 501(c)(3) 25000 Project Support Comm Alliance w Fmly Farmers Foundation PO Box 363 Davis CA 95617 942914745 501(c)(3) 95000 Project Support Comm Asset Dev Redefining Edu 8410 S BRdway Los Angeles CA 90003 264753821 501(c)(3) 10000 Project Support Comm Chaplaincy dba US Crisis Care 2500 Marconi Ave 210 Sacramento CA 95821 200241444 501(c)(3) 22000 Project Support Comm Child Care Coord Coun of Alameda Cty 22351 City Center Drive Hayward CA 94541 237218859 501(c)(6) 31500 Project Support Comm Child Care Coun of Sonoma County 131 A Stony Cir 300 Santa Rosa CA 95401 942274620 501(c)(3) 42100 Event Support\Annual Fundraiser Comm Clinic Assoc of LA County 700 S Flower St 3150 Los Angeles CA 90017 954576023 501(c)(3) 246180 Conference Support Comm Coal For Sub Abus Prev and Treatment 8101 S Vermont Ave Los Angeles CA 90044 954298811 501(c)(3) 12140 Event Support\Health Fair Comm Health Assoc Inland Southern Reg 621 E Carnegie Dr San Bernardino CA 92408 300666184 501(c)(3) 225000 General Operating Support Comm Settlement Assoc of Riverside 4366 Bermuda Ave Riverside CA 92507 950642985 501(c)(3) 25000 Project Support Community Action Board of Santa Cruz Cty 406 Main St 207 Watsonville CA 95076 942523780 501(c)(3) 40000 Project Support Community Action Marin 29 Mary St San Rafael CA 94901 946136365 501(c)(3) 22400 Responsive Community Action of Napa Valley 2310 Laurel St 1 Napa CA 94559 941610851 501(c)(3) 15000 Project Support Community Action Partnership of Sonoma Cty 141 Stony Circle 210 Santa Rosa CA 95401 941648949 501(c)(3) 25000 Project Support Community Against Sexual Harm 3101 1st Ave Sacramento CA 95817 461498182 501(c)(3) 20000 Project Support Community Agencies for Caring Connections 16703 S Clark Ave Bellflower CA 90706 330953881 501(c)(3) 15000 Project Support Community Alliance of Tenants 2710 NE 14th Ave Portland OR 97212 311571929 501(c)(3) 30000 Project Support Community Awareness and Treatment Services 1171 Mission St San Francisco CA 94103 942335626 501(c)(3) 25000 Project Support Community Bridges 236 Santa Cruz Ave Aptos CA 95003 942460211 501(c)(3) 15000 Project Support Community Clinic Consortium 3720 Barrett Ave Richmond CA 94805 200782029 501(c)(3) 377000 Project Support Community Cycling Center 1805 NE 2nd Ave Portland OR 97212 931127186 501(c)(3) 15000 Project Support Community Family Guidance Center 10929 South St208B Cerritos CA 90703 953083776 501(c)(3) 20000 Project Support Community Foundation Of The Napa Valley 3299 Claremont Way 2 Napa CA 94558 680349777 501(c)(3) 5010000 Project Support Community Foundation Sonoma County 1030 Apollo Way Santa Rosa CA 95407 465607272 501(c)(3) 95000 Project Support Community Health Alliance of Pasadena 455 West Montana St Pasadena CA 91103 954536824 501(c)(3) 350000 Project Support Community Health Awareness Council 590 W El Cam Real Mountain View CA 94040 942223670 501(c)(3) 30000 Project Support Community Health Center Network Inc 101 Callan Ave 300 San Leandro CA 94577 943253662 501(c)(3) 165000 Project Support Community Health Councils Inc 3731 Stocker Ave 201 Los Angeles CA 90008 954487664 501(c)(3) 8867 Conference Support Community Health Initiative Napa County 2140 Jefferson St D Napa CA 94559 251924934 501(c)(3) 100000 General Operating Support Community Health Partners PO Box 2853 Longview WA 98632 912016542 501(c)(3) 28000 Project Support Community Health Partnership 1401 Parkmoor Ave 200 San Jose CA 95126 770352645 501(c)(3) 340000 Project Support Community Health Systems Inc 22675 Aless Blvd Moreno Valley CA 92553 330056551 501(c)(3) 20000 Project Support Community House on BRdway 1105 BRdway Longview WA 98632 943067129 501(c)(3) 15000 Project Support Community Housing Partnership 20 Jones St 200 San Francisco CA 94102 943112338 501(c)(3) 24645 Event Support\Annual Fundraiser Community Initiatives 2560 9th St 211 Berkeley CA 94710 943255070 501(c)(3) 31980 Conference Support Community Integration Services Inc 10100 Balboa Blvd Granada Hills CA 91344 202300297 501(c)(3) 8000 Project Support Community Link Capital Region 8001 Folsom Blvd Sacramento CA 95826 941201196 501(c)(3) 50000 Project Support Community Matters 120 Stony Point Rd Santa Rosa CA 95401 680369720 501(c)(3) 10000 Project Support Community Medical Centers Inc (EIP) 7210 Murray Drive Stockton CA 95210 942437106 501(c)(3) 125000 Project Support Community Partners 1000 NAlameda St240 Los Angeles CA 90012 954302067 501(c)(3) 306111 Project Support Community Recovery Resources 730 Sunrise Ave Bldg200 Roseville CA 95661 942275091 501(c)(3) 20000 Project Support Compass Family Services 49 Powell St 300 San Francisco CA 94102 941156622 501(c)(3) 20000 Project Support Compassion Connect 12135 SE Lincoln St Portland OR 97216 262304524 501(c)(3) 15000 Project Support Comprehensive Comm Hlth Ctrs Inc 801 S Chevy Chase Dr 20 Glendale CA 91205 421553807 501(c)(3) 10000 Project Support Concordia University 2811 NE Holman St Portland OR 97211 930391563 501(c)(3) 59064 Project Support Constructing Hope Pre-Apprenticeship Prog 405 NE Church St Portland OR 97211 931155647 501(c)(3) 20000 Project Support Contra Costa Child Care Council 1035 Detroit Ave 200 Concord CA 94518 942383037 501(c)(3) 70840 Project Support Contra Costa Childrens and Families 1485 Civic Court 1200 Concord CA 94520 680474731 Government or P 95000 Project Support Contra Costa Crisis Center PO BOX 3364 Walnut Creek CA 94598 941747227 501(c)(3) 50000 Project Support Contra Costa Family Justice Alliance 256 24th St Richmond CA 94804 474082871 501(c)(3) 200000 Project Support Contra Costa Health Services 597 Center Ave200 Martinez CA 94553 946000509 Government or P 30000 Project Support Cope Family Center 707 Randolph St Napa CA 94559 942322399 501(c)(3) 30000 Project Support CORA 2211 Palm Ave San Mateo CA 94403 942481188 501(c)(3) 17500 General Operating Support Coro Southern California Inc 1000 N Alameda St Los Angeles CA 90012 954274561 501(c)(3) 9200 Event Support\Awards Ceremony Council of Community Clinics 7535 Metropolitan Drive San Diego CA 92108 953008850 501(c)(3) 225000 General Operating Support County of Alameda Family Justice Center 470 27th St Oakland CA 94612 261141080 501(c)(3) 99875 Project Support County of San Mateo 222 West 39th Ave San Mateo CA 94403 946000532 Government or P 165000 Project Support County of Santa Cruz Hlth Svcs Agency 1080 Emeline Ave Santa Cruz CA 95060 946000534 Government or P 20000 Project Support County of Sonoma Dept of Hlth Svcs 3313 Chanate Drive Santa Rosa CA 95404 946000539 Government or P 95000 Project Support County of Yolo Health Department 25 N Cottonwood St Woodland CA 95695 946000548 Government or P 50000 Project Support Court Appointed Spec Advc of Kern County 1717 Columbus St Bakersfield CA 93305 770344298 501(c)(3) 10000 General Operating Support Covenant House California 1325 N Western Ave Los Angeles CA 90027 133391210 501(c)(3) 80000 Project Support Cowlitz County Health Department 207 Fourth Ave N Kelso WA 98626 916001310 Government or P 82802 Project Support Cristo Rey San Jose High School 1390 Five Wounds Ln San Jose CA 95116 462594689 501(c)(3) 30000 Project Support CruzMed Foundation Inc 1975 Soquel Dr 215 Santa Cruz CA 95065 452774675 501(c)(3) 10000 Project Support CSU Dominguez Hills Phil Fdn 1000 East Victoria St Carson CA 90747 473097839 501(c)(3) 10000 Project Support CSU Fresno Foundation 2345 E San Ramon Fresno CA 93740 946003272 501(c)(3) 24955 Project Support CSU Fullerton Aux Services Corp 1121 N St College Bl Fullerton CA 92831 952081258 501(c)(3) 40000 Project Support CSU Northridge Foundation 18111 Nordhoff St Northridge CA 91330 956196006 501(c)(3) 33000 Project Support CSULA Auxiliary Services Inc 5151 State Univ Dr Los Angeles CA 90032 954016653 501(c)(3) 8770 Event Support\Annual Fundraiser CSUSB Philanthropic Foundation 5500 Univ Pkwy San Bernardino CA 92407 452255077 501(c)(3) 10000 Project Support Cthlc Char San Bernardino & Riverside Cty 1450 North D St San Bernardino CA 92405 953516461 501(c)(3) 25000 Project Support Ctr for Individual and Family Counseling 5445 Lrel Cny Bl North Hollywood CA 91607 510204566 501(c)(3) 10000 Project Support Curry Senior Center 333 Turk St San Francisco CA 94102 237362588 501(c)(3) 9330 Event Support\Annual Fundraiser DANA-FARBER CANCER INSTITUTE 450 Brookline Avenue Boston MA 02215 042263040 501(c)(3) 358025 PassThrough Fed Proj Day One 175 N Euclid Ave Pasadena CA 91101 954172246 501(c)(3) 10000 Project Support De La Salle North Catholic High School 7528 N Fenwick Ave Portland OR 97217 931287554 501(c)(3) 9000 Project Support Delta Health Care and Mgmt Svcs Corp 4662 Precissi Ln 200 Stockton CA 95207 942529117 501(c)(3) 98000 Project Support Department of Health & Human Services 8600 Rockville Pike Bethesda MD 20894 520821668 Government or P 150000 General Operating Support Desarrollo Familiar Inc 205 39th St Richmond CA 94805 942751073 501(c)(3) 98000 Project Support Diamond Bar High School Wellness Center 21400 Pathfinder Rd Diamond Bar CA 91765 956003446 Government or P 13775 Project Support Didi Hirsch Psychiatric Service 4760 S Sepulveda Blvd Culver City CA 90230 951816023 501(c)(3) 10000 Project Support Dientes Community Dental Care 5300 Soquel Ave 103 Santa Cruz CA 95062 770311752 501(c)(3) 21500 Project Support Discovery Counseling Center 16275 Monterey RD C Morgan Hill CA 95037 912153275 501(c)(3) 20000 Project Support Diversity In Health Training Institute 1900 Embarcadero Cv 305 Oakland CA 94606 352432876 501(c)(3) 130000 Project Support Dixon Family Services 155 North Second St Dixon CA 95620 680041829 501(c)(3) 20000 Project Support Domestic Violence Interv Collaborative 111 N Market St1015 San Jose CA 95113 721592492 501(c)(3) 10000 Project Support Downey Unified School District 13220 Bellflower Blvd Downey CA 90242 956006586 Government or P 16800 Event Support\Annual Fundraiser Downtown Womens Center 442 S San Pedro S Los Angeles CA 90013 311597223 501(c)(3) 97858 Project Support Dress for Success Oregon 1532 NE 37th Ave Portland OR 97232 931250115 501(c)(3) 15000 Project Support E San Gabriel Valley Coal for the Homeless 1345 Turn Cny Rd Hacienda Heights CA 91745 954508436 501(c)(3) 12500 Project Support Earth Island Institute Inc 2150 Allston Way 460 Berkeley CA 94704 942889684 501(c)(3) 120000 Project Support East Bay Agency for Children 303 Van Buren Ave Oakland CA 94610 941358309 501(c)(3) 191600 Project Support East Bay Asian Local Dev Corp 1825 San Pablo Ave 200 Oakland CA 94612 510171851 501(c)(3) 100000 Project Support East Bay Bicycle Coalition 466 Water St Oakland CA 94607 942585652 501(c)(3) 18000 Project Support East Bay College Fund 2030 Franklin St 210 Oakland CA 94612 542103707 501(c)(3) 7500 Event Support\Cultural Event East Bay Community Foundation 200 Frank Ogawa Plz Oakland CA 94612 946070996 501(c)(3) 77000000 Project Support East Oakland Youth Development Center 8200 International Blvd Oakland CA 94621 237334590 501(c)(3) 152500 Project Support Easter Seals Bay Area 391 Taylor Blvd Pleasant Hill CA 94523 943120231 501(c)(3) 9250 Project Support Eco Urban Gardens 4647 Kingswell Ave Los Angeles CA 90027 474933807 501(c)(3) 8000 Project Support Ecumenical Ministries of Oregon 0245 SW Bancroft St B Portland OR 97239 930625359 501(c)(3) 10000 Project Support Eden I&R Inc 570 B St Hayward CA 94541 942339050 501(c)(3) 50000 Project Support Eden Youth & Family Center 680 West Tennyson Rd Hayward CA 94544 942442586 501(c)(3) 104700 Project Support EduCare Foundation 16134 Wyandotte St Van Nuys CA 91406 954285350 501(c)(3) 10000 Project Support Education Outside 135 Van Ness Ave San Francisco CA 94102 460590185 501(c)(3) 25000 Project Support Educational Service District 112 2500 NE 65th Ave Vancouver WA 98661 910847188 Government or P 50000 Project Support El Centrito Family Learning Centers 450 South K St 111 Oxnard CA 93030 311652255 501(c)(3) 20000 Project Support El Centro de Amistad Inc 566 South Brand Blvd San Fernando CA 91340 953498639 501(c)(3) 12000 Project Support El Centro de Libertad 500 Allerton St Redwood City CA 94062 943189174 501(c)(3) 10000 General Operating Support El Centro Del Pueblo 1157 Lemoyne St Los Angeles CA 90026 953187780 501(c)(3) 10000 Project Support El Monte Emergency Resources Association 10900 Mulhall St El Monte CA 91731 956097318 501(c)(3) 8500 Project Support El Nido Family Centers 10200 Sep Blvd Mission Hills CA 91345 953186429 501(c)(3) 21000 Project Support ElderHelp of San Diego 3860 Calle Fortunada San Diego CA 92123 952880426 501(c)(3) 8000 Project Support Elders in Action 1411 SW Morrison St290 Portland OR 97205 931168567 501(c)(3) 12500 Project Support Elevate Your GAME 2019 E 120th St Los Angeles CA 90059 680533404 501(c)(3) 20000 Project Support Elevating Soulciety 16335 E 14th St San Leandro CA 94578 800184767 501(c)(3) 150000 Project Support Elica Health Centers 1860 Howe Ave 440 Sacramento CA 95825 371424390 501(c)(3) 50000 Project Support Elk Grove Food Bank Services 9820 Dino Dr 140 Elk Grove CA 95624 383664737 501(c)(3) 25000 Project Support Elk Grove Unified School District 9510 Elk Gr-Flor Rd Elk Grove CA 95624 946002501 Government or P 44440 Project Support Emerald Cities Collaborative Inc 1140 Conn Ave NW Washington DC 20036 270920269 501(c)(3) 125000 Project Support Emergency Food Bank 7 West Scotts Ave Stockton CA 95203 680002165 501(c)(3) 10000 Project Support Encompass Community Services 380 Encinal St 200 Santa Cruz CA 95060 237275290 501(c)(3) 98000 Project Support Encoreorg PO Box 29542 San Francisco CA 94129 943274339 501(c)(3) 10000 Project Support Environmental Health Coalition 2727 Hoover Ave National City CA 91950 953798792 501(c)(3) 15000 Project Support Episcopal Community Services 401 Mi of Cars Wy National City CA 91950 951945256 501(c)(3) 10000 Project Support Eric Paredes Save A Life Foundation 2514 Jamacha Rd 502 El Cajon CA 92019 800636157 501(c)(3) 11500 Project Support Esperanza Community Housing Corporation 3655 South Grand Ave Los Angeles CA 90007 954230345 501(c)(3) 14800 Event Support\Annual Fundraiser ESSENTIA INSTITUTE OF RURAL HEALTH 502 E 2nd Street Duluth MN 55805 271291124 501(c)(3) 33109 PassThrough Fed Proj Essential Access Health 3600 Wilshire Blvd Los Angeles CA 90010 952564024 501(c)(3) 370000 General Operating Support Facing History and Ourselves 300 Frank H Ogawa Plz269 Oakland CA 94612 042761636 501(c)(3) 8500 Project Support Fairfield Community Services Foundation PO Box 147 Fairfield CA 94553 680344658 501(c)(3) 15000 Project Support Faith In Action 3303 Whitemarsh Ln Fairfield CA 94534 680431992 501(c)(3) 15000 Project Support Familias en Accion 2710 NE 14th Ave Portland OR 97212 931284335 501(c)(3) 21000 Project Support Family Alliance for the Mentally Ill 7545 N Del Mar Ave 105 Fresno CA 93711 770319190 501(c)(3) 48962 Project Support Family Assistance Ministries 1030 Calle Negocio San Clemente CA 92673 330864870 501(c)(3) 20000 Project Support Family Foundations Counseling Services 2610 W Shaw Ln 104 Fresno CA 97311 273301215 501(c)(3) 98000 Project Support Family Giving Tree 606 Valley Way Milpitas CA 95035 770284682 501(c)(3) 22250 Project Support Family Health Care Ctrs of Gtr LA Inc 6501 S Gar Av Bell Gardens CA 90201 951641454 501(c)(3) 20000 Project Support Family Health Centers of San Diego Inc 823 Gateway Center Way San Diego CA 92102 952833205 501(c)(3) 75000 Project Support Family HealthCare Network 305 E Center Ave Visalia CA 93291 942525145 501(c)(3) 75000 Project Support Family Justice Center Sonoma County 2755 Mendocino Ave Santa Rosa CA 95403 453160831 Government or P 95000 Project Support Family Res & Referral Ctr of San Joaquin 509 W Weber Ave 101 Stockton CA 95203 941691503 501(c)(3) 90000 Project Support Family Service Agency of San Bernardino 1669 North E St San Bernardino CA 92405 951641436 501(c)(3) 15000 Other Family Service Agency of the Central Coast 104 Walnut Ave 208 Santa Cruz CA 95060 941716354 501(c)(3) 10000 Project Support Family Service Association 21250 Box Spr Rd Moreno Valley CA 92557 951803694 501(c)(3) 50000 Project Support Family Support Services of the Bay Area 401 Grand Ave 500 Oakland CA 94610 943108205 501(c)(3) 97500 Event Support\Annual Fundraiser Farmers Market Fund 240 N BRdway 129 Portland OR 97227 453804465 501(c)(3) 15000 Project Support FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH 350 Community Drive Manhasset NY 11030 112673595 501(c)(3) 27238 PassThrough Fed Proj Filipino Advocates for Justice 310 8th St 309 Oakland CA 94607 942218907 501(c)(3) 5917 General Operating Support First 5 Alameda County 1115 Atlantic Ave Alameda CA 94501 830383617 Government or P 17600 Project Support First African Methodist Episcopal Church 530 37th St Oakland CA 94609 237010426 501(c)(3) 20000 Project Support First Place for Youth 426 17th St 100 Oakland CA 94612 943341034 501(c)(3) 75000 Project Support First Step Communities 350 Crestridge Ln Folsom CA 95630 352537631 501(c)(3) 12900 Project Support FISH of Cowlitz County 1526 Commerce Ave Longview WA 98632 237452250 501(c)(3) 12100 Project Support west contra costa county Flourish Agenda 1714 Franklin St 321-100 Oakland CA 94612 330488726 501(c)(3) 97500 Project Support Fndrs Ntrk for Smart Growth & Livable Comm 1500 San Remo Ave Coral Gables FL 33146 571173613 501(c)(3) 25000 General Operating Support Folk-Time Inc PO Box 33260 Portland OR 97292 931222522 501(c)(3) 15000 Project Support Folsom Cordova Unified School District 1965 Birkmont Dr Rancho Cordova CA 95742 946002505 Government or P 25000 Project Support Food Bank of Contra Costa and Solano 4010 Nelson Ave Concord CA 94520 942418054 501(c)(3) 155500 Project Support Food In Need of Distribution Inc 83-775 Citrus Ave Indio CA 92201 330006007 501(c)(3) 20000 Project Support FOOD Inc 3403 E Central Ave Fresno CA 93725 770320851 501(c)(3) 105000 Project Support Food Literacy Center 2973 Third Ave Sacramento CA 95817 453973268 501(c)(3) 24999 Project Support Foodbank of Southern California 1444 San Francisco Ave Long Beach CA 90813 953557056 501(c)(3) 12500 Project Support Foodwhat Incorporated FoodWhat 1156 High St Santa Cruz CA 95064 812590280 501(c)(3) 10000 Project Support Foothill AIDS Project 233 West Harrison Ave Claremont CA 91711 330341665 501(c)(3) 22500 Project Support Foothill Family Service 2500 E Foothill Blvd Pasadena CA 91107 951690990 501(c)(3) 26000 Event Support\Annual Fundraiser Foothill Family Shelter Inc 1501 W Ninth St D Upland CA 91786 330341818 501(c)(3) 20000 Project Support Foothill Unity Center Inc 415 W Chestnut Ave Monrovia CA 91016 954310817 501(c)(3) 18000 Project Support Foothill-De Anza Comm Colleges Fdn 12345 El Mon Rd Los Altos Hills CA 94022 943258220 501(c)(3) 50000 Project Support Foundation for Clovis Schools 1450 Herndon Ave Clovis CA 93611 770140576 501(c)(3) 50000 Project Support Foundation for Healthy Generations 419 Third Ave West Seattle WA 98119 916186093 501(c)(3) 45000 Project Support Foundation for Students Rising Above PO Box 29174 San Francisco CA 94129 810615887 501(c)(3) 64750 Event Support\Annual Fundraiser FRED HUTCHINSON CANCER RESEARCH CTR 1100 Fairview Ave North Seattle WA 98109 237156071 501(c)(3) 165574 PassThrough Fed Proj Free Clinic of Southwest Washington 4100 Plomondon St Vancouver WA 98661 911707542 501(c)(3) 48000 Project Support Fresh Approach 5060 Commercial CircleC Concord CA 94520 262438206 501(c)(3) 92500 Project Support Fresh Lifelines for Youth Inc (FLY) 568 Valley Way Milpitas CA 95035 522234595 501(c)(3) 30000 Project Support Fresh Producers Inc 420 I St 5 Sacramento CA 95814 208747234 501(c)(3) 24000 Project Support Fresno Center for New Americans 4879 E Kings Canyon Rd Fresno CA 93727 770280265 501(c)(3) 15000 Project Support Fresno Healthy Communities Access Partners 3845 N Clark St 105 Fresno CA 93726 204210175 501(c)(3) 15000 Project Support Fresno Interdenomin Refugee Ministries 1940 N Fresno St Fresno CA 93703 770357297 501(c)(3) 150000 Project Support Fresno Metropolitan Ministry 4270 N Blackstone Ave Fresno CA 93726 942181848 501(c)(3) 70000 Project Support Fresno Unified School District 1833 E St Fresno CA 93721 946002206 Government or P 33000 Project Support Fresno United Neighborhoods 1515 E Divisadero St Fresno CA 93721 770348220 501(c)(3) 30000 Project Support Friends For Youth Inc 1741 BRdway Redwood City CA 94402 942961034 501(c)(3) 10000 General Operating Support Friends of Creston Chld's Dental Clin PO Box 86368 Portland OR 97286 320300896 501(c)(3) 20000 Project Support Friends of Peralta Hacienda Hist Park PO Box 7172 Oakland CA 94601 943317442 501(c)(3) 35000 Project Support Friends of the Los Angeles Free Clinic 8405 Beverly Blvd Los Angeles CA 90048 953433824 501(c)(3) 13500 Event Support\Dinner Friends of Zenger Farm 11741 SE Foster Rd Portland OR 97266 931269630 501(c)(3) 96073 Project Support Future Leaders of America 450 S K St 205 Santa Barbara CA 93030 770071036 501(c)(3) 20000 Project Support Garfield Health Center 210 N Garfield Ave Monterey Park CA 91754 760733752 501(c)(3) 7500 Project Support Gay & Lesbian Center of Bakersfield 902 18th St Bakersfield CA 93301 453709449 501(c)(3) 15000 Project Support Gay and Lesbian Comm Svcs Ctr of OC 1605 N Spurgeon St Santa Ana CA 92701 952934041 501(c)(3) 40000 Project Support GEISINGER CLINIC 100 N Academy Ave Danville PA 17822 236291113 501(c)(3) 7430 PassThrough Fed Proj Girl Scouts of Northern California 1650 Harbor Bay Pkwy 100 Alameda CA 94502 941551410 501(c)(3) 30000 Project Support Girls Inc of W Contra Costa Cty 260 BRdway Richmond CA 94804 510172193 501(c)(3) 20000 Project Support Girls Inc of Northwest Oregon 4800 SW Macadam Ave309 Portland OR 97239 542073930 501(c)(3) 15000 Project Support Girls Incorporated of Alameda County 510 16th St Oakland CA 94612 941558073 501(c)(3) 14200 Event Support\Cultural Event Girls on the Run - Bay Area 3543 18th St 31 San Francisco CA 94110 710890558 501(c)(3) 15000 Project Support Girls On The Run Napa Valley Incorporated 3299 Claremont Way 6 Napa CA 94558 550906534 501(c)(3) 20000 Project Support Girls on the Run of Los Angeles County 556 S Fair Oaks Ave Pasadena CA 91105 205115367 501(c)(3) 8000 Project Support Give Every Child A Chance 322 Sun West Place Manteca CA 95337 680399384 501(c)(3) 45000 Project Support Glendale Community Free Health Clinic 134 N Kenwood St Glendale CA 91206 870732681 501(c)(3) 10000 General Operating Support Global Center For Success Inc 1055 Azuar Drive Vallejo CA 94592 710896807 501(c)(3) 18000 Project Support Global Education Fund PO Box 548 Boulder CO 80306 841437310 501(c)(3) 5667 Board Matching Gift Global Family Care Network Inc 3535 Union Ave Bakersfield CA 93305 208346599 501(c)(3) 20000 Project Support Golden Gate National Parks Conservancy 201 Fort Mason San Francisco CA 94123 942781708 501(c)(3) 150000 Project Support Golden Valley Health Centers 737 West Childs Ave Merced CA 95341 942196086 501(c)(3) 50000 Project Support Gordon J Lau School Parents Club 950 Clay St San Francisco CA 94108 943196467 501(c)(3) 20000 Project Support Gospel Center Rescue Mission Inc 445 S San Joaquin St Stockton CA 95203 941375835 501(c)(3) 75000 Project Support Greenlining Institute 360 14th St 2nd Fl Oakland CA 94612 943173571 501(c)(3) 8950 Conference Support Grntmkrs Concrn w Immigrants and Refugees PO Box 1100 Sebastopol CA 95473 202559651 509(a)(1) 250000 Project Support Groceryships 3655 S Grand Ave 210 Los Angeles CA 90007 464312265 501(c)(3) 10000 Project Support GROUP HEALTH COOPERATIVE (KP Washington) 1730 Minor Avenue Seattle WA 98101 910511770 501(c)(3) 1923461 PassThrough Fed Proj Gtr Hayward Area Rec & Park Fdn 1099 E St Hayward CA 94541 942901655 509(a)(1) 75000 Project Support Guide Dogs for the Blind 32901 SE Kelso Rd Boring OR 97009 941196195 501(c)(3) 15000 Project Support H LEE MOFFITT CANCER CENTER AND RESEARCH 12902 Magnolia Drive Tampa FL 33612 592451713 501(c)(3) 11134 PassThrough Fed Proj Hacienda La Puente Unified School District 15959 E Gale Ave City of Industry CA 91745 952623262 Government or P 10000 Project Support Happy Hollow Corporation 1300 Senter Rd San Jose CA 95112 237219471 501(c)(3) 15000 Project Support Harbor Area Gang Alternatives 309 W Opp St Wilmington CA 90744 330322451 501(c)(3) 23500 Project Support Harbor Community Clinic Inc 593 W 6th St San Pedro CA 90731 237103245 501(c)(3) 10000 Project Support Harbor Gateway Boys & Girls Club 1220 West 256th St Harbor City CA 90710 330450797 501(c)(3) 16000 Project Support Harm Reduction Services 2800 Stockton Blvd Sacramento CA 95817 680300656 501(c)(3) 25000 Project Support HARVARD PILGRIM HEALTH CARE INC 133 Brookline Avenue Boston MA 02215 042452600 501(c)(3) 218755 PassThrough Fed Proj Hathaway-Sycamores Child & Family Svcs 840 N Ave 66 Los Angeles CA 90042 951691005 501(c)(3) 84250 Project Support Haven Hills Inc 7112 Owensmouth Ave Canoga Park CA 91305 953196247 501(c)(3) 12167 Project Support Hayward Sisters Hospital 27200 Calaroga Ave Hayward CA 94545 941668344 501(c)(3) 3000000 General Operating Support Hayward Unified School District 24411 Amador St Hayward CA 94544 941693499 Government or P 24950 Project Support Health Care Integrated Services 2600 N Central Ave B1 Compton CA 90222 770505602 501(c)(3) 7500 General Operating Support Health Care Without Harm 12355 Sunrise Valley Dr Reston VA 20191 522358837 501(c)(3) 126500 Project Support Health Career Connection 300 Frank Ogawa Plz243 Oakland CA 94612 251904312 501(c)(3) 90000 Project Support Health Education Council 3950 Indst Blvd West Sacramento CA 95691 680249296 501(c)(3) 180500 Project Support Health Professions Education Foundation 2020 W El Camino Ave Sacramento CA 95833 680178150 501(c)(3) 500000 Project Support HEALTH RESEARCH INC PO Box 2966 Buffalo NY 14240 141402155 501(c)(3) 898829 PassThrough Fed Proj Healthier Kids Foundation 4040 Moorpark Ave 100 San Jose CA 95117 770545774 501(c)(3) 22290 Project Support HEALTHPARTNERS INSTITUTE 8170 33rd Ave South Minneapolis MN 55440 411670163 501(c)(3) 178316 PassThrough Fed Proj Healthy Aging Association 3500 Coffee Rd 19 Modesto CA 95355 770546574 501(c)(3) 30000 Project Support Healthy Community Forum - Gtr Sac Region 8928 Volunteer Ln220 Sacramento CA 95826 680377256 501(c)(3) 132500 Project Support Healthy Cooking with Kids Inc 180 Olive Branch Court Benicia CA 94510 453957719 501(c)(3) 90000 Project Support Healthy Smiles Mobile Dental Foundation 4186 W Swift Ave 108 Fresno CA 93722 770530538 501(c)(3) 542000 Project Support HENRY FORD HEALTH SYSTEM FUND ACCOUNTING 1 Ford Place 2F Detroit MI 48202 381357020 501(c)(3) 242670 PassThrough Fed Proj Hidden Genius Project Inc 2934 Telegraph Ave Oakland CA 94609 460689949 501(c)(3) 15000 Other;Event Support\Cultural Event Hidden Harvest Corporation 85711 Peter Rabbit Ln Coachella CA 92236 330821743 501(c)(3) 15000 Project Support Hillsides 815 Colorado Blvd300 Los Angeles CA 90041 951644002 501(c)(3) 25650 Event Support\Annual Fundraiser Hinds Hospice 2490 W Shaw Ave101 Fresno CA 93711 770071360 501(c)(3) 20394 Project Support Hispanas Org for Political Eq - CA 634 S Spring St Los Angeles CA 90014 954718409 501(c)(3) 22200 Conference Support Hlth Imprv Pship of Santa Cruz County 1800 Green Hills Rd Scotts Valley CA 95066 010826156 501(c)(3) 20000 Project Support Hollywood Community Housing Corporation 5020 San Mon Bl Los Angeles CA 90029 954198215 501(c)(3) 10000 Project Support Hollywood Farmers Market 1907 NE 45th Ave Portland OR 97213 911796737 501(c)(3) 15000 Project Support Hollywood Police Activities League 1358 N Wilcox Ave Los Angeles CA 90028 954596172 501(c)(3) 8000 General Operating Support Home Ownership For Pers Emp Inc 21231 Hawthorne Blvd Torrance CA 90240 330618316 501(c)(3) 10000 Project Support Homeboy Industries 130 W Bruno St Los Angeles CA 90012 954800735 501(c)(3) 20000 Event Support\Annual Fundraiser HomeFirst Services of Santa Clara County 507 Valley Way Milpitas CA 95035 942684272 501(c)(3) 30000 Project Support Homeless Prenatal Program Inc 2500 18th St San Francisco CA 94110 943146280 501(c)(3) 24950 Event Support\Annual Fundraiser Homeless Services Center 115B Coral St Santa Cruz CA 95060 770126783 501(c)(3) 15368 Project Support Hope Of The Valley Rescue Mission 11134 Sep Blvd Mission Hills CA 91345 272053273 501(c)(3) 10000 Project Support House of Ruth Inc 599 N Main St Pomona CA 91768 953276033 501(c)(3) 27780 Project Support Huckleberry Youth Programs Inc 3310 Geary Blvd San Francisco CA 94118 941687559 501(c)(3) 133750 Project Support Human Options Inc 5540 Trabuco Rd 100 Irvine CA 92620 953667817 501(c)(3) 40000 Project Support Humanidad Therapy & Education Services 95 Montgomery St 112 Santa Rosa CA 95404 463725156 501(c)(3) 12000 Project Support Hunger Action Los Angeles 961 S Mariposa Ave Los Angeles CA 90006 205142259 501(c)(3) 83300 General Operating Support Hurtt Family Health Clinic Inc One Hope Drive Tustin CA 92782 330906866 501(c)(3) 15400 Project Support ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI One Gustave L Levy Pl New York NY 10029 136171197 501(c)(3) 19994 PassThrough Fed Proj ICF Center For Cross-Border Philanthropy 2525 N Ave National City CA 91950 261640148 501(c)(3) 18000 Project Support Illumination Foundation 2691 Richter Ave 107 Irvine CA 92606 711047686 501(c)(3) 17650 Project Support Immigrant & Refugee Community Organization 10301 NE Glisan St Portland OR 97220 930806295 501(c)(3) 10000 Project Support IMPACT ASSESSMENT 2166 Avenida De La Playa La Jolla CA 92037 953649615 FOR PROFIT 20183 PassThrough Fed Proj Impact Northwest PO Box 33530 Portland OR 97292 930557964 501(c)(3) 15000 Project Support Imperial Beach Community Clinic 949 Palm Ave Imperial Beach CA 91933 237209592 501(c)(3) 20000 Project Support Imtasik Family Counseling Services Inc 6809 Indiana Ave Riverside CA 92506 465525893 501(c)(3) 55000 Project Support Indian Health Center of Santa Clara Valley 1333 Meridian Ave San Jose CA 95125 942476242 501(c)(3) 20000 Project Support INDIANA UNIVERSITY 980 Indiana Ave Indianapolis IN 46202 351955872 501(c)(3) 9829 PassThrough Fed Proj INDIVIDUALS NOW INC SOCIAL ADV FOR YOUTH 2447 Summerfield Rd Santa Rosa CA 95405 941711490 501(c)(3) 20000 Project Support Info Line of San Diego County 3860 Calle Fortunada San Diego CA 92123 331029843 501(c)(3) 10000 Project Support Init For A Competitive Inner City Inc 56 Warren St 300 Roxbury MA 02119 133772904 501(c)(3) 150000 Project Support Inland Caregiver Resource Center 1430 East Cooley Dr 124 Colton CA 92324 330460833 501(c)(3) 25000 Project Support Inland Empire United Way 9644 Hermosa Ave Rancho Cucamonga CA 91730 330502676 501(c)(3) 25000 Project Support Inland Valley Council of Churches 1753 N Park Ave Pomona CA 91768 952674837 501(c)(3) 25000 Project Support InnerCity Struggle 530 South Boyle Ave Los Angeles CA 90033 272133211 501(c)(3) 8000 Project Support Innovative Services NW 9414 NE Fourth Plain Rd Vancouver WA 98662 910782136 501(c)(3) 15000 Project Support Insure the Uninsured Project 1107 9th St 1025 Sacramento CA 95814 274159194 501(c)(3) 150000 Project Support Integrated Recovery Network 2010 Wilshire Blvd Los Angeles CA 90057 273493736 501(c)(3) 84000 Project Support Interface Children and Family Services 4001 Mission Oaks Blvd Camarillo CA 93012 952944459 501(c)(3) 20000 Project Support Interfaith Food Center 11819 Burke St Santa Fe Springs CA 90670 953889152 501(c)(3) 10000 Project Support International Association for Human Values 708 Tramway Dr Milpitas CA 95035 522178069 501(c)(3) 20000 Project Support International Pre-Diabetes Center Inc 14500 Roscoe Blvd Panorama City CA 91402 471341290 501(c)(3) 8500 Project Support International Rescue Committee Inc 5348 University Ave San Diego CA 92105 135660870 501(c)(3) 15500 Project Support Jacobs & Cushman San Diego Food Bank 9850 Distribution Ave San Diego CA 92121 204374795 501(c)(3) 15000 Project Support Jacob's Heart Chld Cancer Supp Svcs 680 West Beach St Watsonville CA 95076 680413822 501(c)(3) 10000 Project Support Janus Youth Programs Inc 707 NE Couch St Portland OR 97232 237345990 501(c)(3) 14993 Project Support Jefferson Union High School District 2780 Juni Serra Blvd Daly City CA 94015 943083772 501(c)(3) 32765 Event Support\Annual Fundraiser Jewish Community Free Clinic 50 Montgomery Dr Santa Rosa CA 95404 943386103 Government or P 20000 Project Support Jewish Family & Community Svcs East Bay 2484 Shattuck Ave 210 Berkeley CA 94706 943250304 501(c)(3) 20000 Project Support Jewish Family Service of the Desert 490 S Farrell Drive Palm Springs CA 92262 330613083 501(c)(3) 25000 Project Support Jewish Fmly & Chlds Svc of Long Beach 3801 E Willow St Long Beach CA 90815 952273033 501(c)(3) 12500 Project Support John F Kennedy University 2702 Clayton Rd 100 Concord CA 94519 941610694 501(c)(3) 49605 Project Support JOHNS HOPKINS UNIVERSITY 615 North Wolfe Street Baltimore MD 21205 520591656 501(c)(3) 207688 PassThrough Fed Proj J-Sei Inc 1285 66th St Emeryville CA 94608 942496799 501(c)(3) 24000 Project Support Jurupa Area Recreation and Park District 4810 Pedley Rd Jurupa Valley CA 92509 330105732 501(c)(3) 24000 Project Support JWCH Institute Inc 5650 Jillson St Commerce CA 90040 952289916 501(c)(3) 13500 Event Support\Dinner K to College 7730 Pardee Ln Oakland CA 94621 510671019 501(c)(3) 1518700 Project Support Kainos Home & Training Ctr for the Dev Dis 3631 Jefferson Ave Redwood City CA 94062 237408490 501(c)(3) 10000 General Operating Support KAISER FOUNDATION HEALTH PLAN OF COLORADO 10065 E Harvard Ave Denver CA 80231 840591617 501(c)(3) 965321 PassThrough Fed Proj Keaton Raphael Memorial for Neuroblastoma 2260 Douglas Blvd140 Roseville CA 95661 680406980 501(c)(3) 10000 Project Support Kennedy King Memorial College Schl Fnd 532 Eagle Nest Drive Martinez CA 94553 941677726 501(c)(3) 19755 Project Support Kern County Chld and Families Commiss 2724 L St Bakersfield CA 93301 770529128 501(c)(3) 10000 Project Support Kern Partnership for Children and Families 100 E California Ave BAKERSFIELD CA 93307 205536572 Government or P 18000 Project Support Kern Valley Hospital Foundation 6412 Laurel Ave Lake Isabella CA 93240 330176789 501(c)(3) 16000 Project Support Kidpower Teenpower Fullpower International PO Box 1212 Santa Cruz CA 95061 770226712 501(c)(3) 28000 General Operating Support Kids Community Clinic of Burbank 400 W Elmwood Ave Burbank CA 91506 954791296 501(c)(3) 20000 Project Support KidsFirst 124 Main St Roseville CA 95678 680195225 501(c)(3) 29750 Project Support Kingdom Causes Bellflower 16429 Bellflower Blvd Bellflower CA 90706 954849998 501(c)(3) 120000 Project Support Kitchens for Good 404 Euclid Ave San Diego CA 92114 463278605 501(c)(3) 10000 Project Support Korean Hlth Edu Infor & Research Center 3727 West 6th St Los Angeles CA 90020 954074660 501(c)(3) 8880 Event Support\Dinner KVIE Inc 2030 W El Camino Ave Sacramento CA 95833 941421463 501(c)(3) 10000 Project Support LA Family Housing Corporation 7843 Lanker Blvd North Hollywood CA 91605 953920560 501(c)(3) 12500 Event Support\Annual Fundraiser LA Works Inc 570 West Ave 26 Los Angeles CA 90065 954329727 501(c)(3) 20000 Event Support\Annual Fundraiser LA Brthrhood Crus - Black United Fund Inc 200 E Slauson Ave Los Angeles CA 90011 952543819 501(c)(3) 20750 Event Support\Cultural Event La Clinica De La Raza Inc PO Box 22210 Oakland CA 94623 941744108 501(c)(3) 285400 Project Support LA Ctrs for Alcohol and Drug Abuse 11015 Blmfld Ave Santa Fe Springs CA 90670 237110152 501(c)(3) 25000 Project Support La Luz Bilingual Center 17560 Greger St Sonoma CA 95476 680228235 501(c)(3) 20000 Project Support La Maestra Family Clinic Inc 4060 Fairmount Ave San Diego CA 92105 330473171 501(c)(3) 30000 Project Support LA River Revitalization Corp 525 S Hewitt St Los Angeles CA 90013 272245545 501(c)(3) 9350 Event Support\Annual Fundraiser Laguna Beach Community Clinic 362 Third St Laguna Beach CA 92651 952637633 501(c)(3) 15000 Project Support Larkin St Youth Services 134 Golden Gate Ave San Francisco CA 94102 942917999 501(c)(3) 40000 Project Support LA's Best 200 N Spring St Los Angeles CA 90012 954311058 501(c)(3) 114480 Event Support\Annual Fundraiser Latino Community Foundation 235 Montgomery St San Francisco CA 94104 810564400 501(c)(3) 358140 Project Support Latino Leadership Council 2945 Bell Rd 274 Auburn CA 95603 270970476 501(c)(3) 30000 Project Support Latino Network 410 NE 18th Ave Portland OR 97232 731675402 501(c)(3) 38104 Project Support Lava Mae 1015 Fillmore St San Francisco CA 94115 810832318 501(c)(3) 200000 Project Support Lavender Youth Recreation and Info Ctr 127 Collingwood St San Francisco CA 94114 943227296 501(c)(3) 20000 Project Support Leadership for Urban Renewal Network Inc 553 S Clarence St Los Angeles CA 90033 270584116 501(c)(3) 38200 Conference Support Learning Enrichment After-Sch Prgm Inc 1310 N La Brea Ave A Inglewood CA 90302 201734414 501(c)(3) 10000 General Operating Support Leaven Program 2220 Boynton Ave A Fairfield CA 94533 263653717 501(c)(3) 45000 Project Support Legacy LA Youth Development Corporation 1350 N San Pablo St Los Angeles CA 90033 010960970 501(c)(3) 7000 Project Support Legal Aid Society of San Mateo County 330 Twin Dolphin Dr Redwood City CA 94065 941451894 501(c)(3) 10000 General Operating Support Leland Stanford Junior University 326 Galvez Street Stanford CA 94305 941156365 501(c)(3) 12912 Board Matching Gift Lemonade - A Yoga Program 3649 Taraval St San Francisco CA 94116 455015338 501(c)(3) 20000 Project Support LGBTQ Community Center Fund 4115 N Mississippi Ave Portland OR 97217 200038065 501(c)(3) 30000 Project Support License to Freedom 131 Avocado Ave El Cajon CA 92020 201057775 501(c)(3) 10000 Project Support LIFE Courses Inc 440 Grand Ave 207 Oakland CA 94610 454177065 501(c)(3) 10000 Project Support Life Lab Science Program 1156 High St Santa Cruz CA 95064 942778848 501(c)(3) 10000 Project Support Life Skills Training & Edu Prgs Inc 4041 Bridge St Fair Oaks CA 95628 330720982 501(c)(3) 10000 Project Support LifeMoves 181 Constitution Drive Menlo Park CA 94025 770160469 501(c)(3) 60000 General Operating Support LifeWorks Of Sonoma County 1200 College Ave Santa Rosa CA 95404 680375462 501(c)(3) 18000 Project Support Lighthouse Counseling&Family Resource Ctr 427 A St 400 Lincoln CA 95648 352252834 501(c)(3) 29750 Project Support Lincoln Child Center 1266 14th St Oakland CA 94607 941156501 501(c)(3) 100500 Event Support\Annual Fundraiser Links Foundation Inc 1200 Mass Ave NW Washington DC 20005 521170830 501(c)(3) 27500 Event Support\Workforce/Knowledge Dissemination Live Oak School District 984-1 Bostwick Ln Santa Cruz CA 95062 946002633 501(c)(3) 25475 Conference Support Livermore Area Rec and Park District 4444 East Ave Livermore CA 94550 946000849 Government or P 20000 Project Support Livermore Valley Joint Unified School Dist 685 E Jack London Blvd Livermore CA 94550 942175582 Government or P 20000 Project Support Livingston Community Health 1140 Main St Livingston CA 95334 941719656 501(c)(3) 50000 Project Support Loaves and Fishes of Contra Costa 835 Ferry St Martinez CA 94553 680018077 501(c)(3) 34250 Event Support\Annual Fundraiser Loma Linda University 24951 N Circle Drive Loma Linda CA 92350 951816009 501(c)(3) 159052 Conference Support Los Angeles Alliance for a New Economy 464 Lucas Ave 202 Los Angeles CA 90017 954459427 501(c)(3) 8250 Event Support\Annual Fundraiser Los Angeles Center for Law and Justice 5301 Whittier Blvd Los Angeles CA 90022 952690540 501(c)(3) 8600 Event Support\Awards Ceremony Los Angeles Child Development Center 2014 Sawtelle Blvd Los Angeles CA 90025 953222295 501(c)(3) 10000 Project Support Los Angeles Christian Health Centers 202 W 1st St 4-0435 Los Angeles CA 90012 954315734 501(c)(3) 17150 Event Support\Annual Fundraiser Los Angeles County Comm Dev Fdn 700 West Main St Alhambra CA 91801 770469732 501(c)(3) 10000 Project Support Los Angeles County-USC Med Ctr Fdn Inc 1200 N State St 1008 Los Angeles CA 90033 954192908 501(c)(3) 10000 General Operating Support Los Angeles Education Partnership 202 W 1st St 06-0410 Los Angeles CA 90012 953909218 501(c)(3) 370803 Project Support Los Angeles LGBT Center 1625 N Schrader Blvd Los Angeles CA 90028 953567895 501(c)(3) 10000 Project Support Los Angeles Neighborhood Land Trust 1541 Wilshire Blvd Los Angeles CA 90017 383687836 501(c)(3) 83200 Event Support\Annual Fundraiser Los Angeles Trade Tech College Fdn 400 W Washington Blvd Los Angeles CA 90069 953813527 501(c)(3) 9650 Event Support\Annual Fundraiser Los Angeles Unified School District 2660 Ruth Swiggett Dr Los Angeles CA 90032 956001908 501(c)(3) 9886 Project Support Los Angeles Urban League 3450 Mount Vernon Dr Los Angeles CA 90008 951691288 Government or P 12000 Event Support\Annual Fundraiser Lower Columbia School Gardens PO Box 785 Longview WA 98632 464549009 501(c)(3) 15000 Project Support MACLA 510 S First St San Jose CA 95113 770251774 501(c)(3) 8000 Event Support\Cultural Event Madera County Food bank 225 South Pine St 101 Madera CA 93637 770513488 501(c)(3) 10000 Project Support MAGEE-WOMENS RESEARCH INST AND FIN DEPT 3339 Ward Street Pittsburgh PA 15213 251462312 501(c)(3) 25627 PassThrough Fed Proj Magical Bridge Foundation 654 Gilman St palo alto CA 94301 812377796 501(c)(3) 95000 Project Support Mano a Mano 2921 Saddle Club St SE1009 Salem OR 97317 930992858 501(c)(3) 10000 Project Support Manteca Unified School District 2271 W Louise Ave Manteca CA 95337 941054800 501(c)(3) 52500 Project Support March of Dimes Foundation 101 Montgomery St San Francisco CA 94104 131846366 Government or P 65750 Project Support Marin Center for Independent Living 710 Fourth St San Rafael CA 94901 942605669 501(c)(3) 22200 Project Support Marin County Office of Education 1111 Las Gallinas Ave San Rafael CA 94903 946022431 501(c)(3) 20000 Project Support Marion County Health Department 3180 Center St NE Salem OR 97301 936002307 Government or P 83333 Project Support MARSHFIELD CLINIC RESEARCH 1000 North Oak Avenue Marshfield WI 54449 390452970 Government or P 91336 PassThrough Fed Proj Marthas Pantry 5701 MacArthur Blvd Vancouver WA 98661 383794358 501(c)(3) 6000 Project Support Martin Luther King Jr Freedom Center 12500 Campus Dr BldgD OAKLAND CA 94619 943390034 501(c)(3) 110500 Event Support\Cultural Event Mary's Mercy Center Inc 641 Roberds Ave San Bernardino CA 92411 330632426 501(c)(3) 10000 General Operating Support MASSACHUSETTS GENERAL HOSPITAL 399 Revolution Drive Somerville MA 02145 042697983 501(c)(3) 45140 PassThrough Fed Proj Maternal and Child Health Access 1111 W Sixth St Los Angeles CA 90017 954555879 501(c)(3) 92500 Project Support Maven Project PO Box 156781 San Francisco CA 94115 465370676 501(c)(3) 10000 Project Support Mayo Clinic 200 First Street SW Rochester MN 55905 416011702 501(c)(3) 8423 Board Matching Gift MayView Community Health Center 270 Grant Ave Palo Alto CA 94306 942239648 501(c)(3) 30000 Project Support McAlister Inst for Treatment and Edu Inc 1400 Johnson St 101 El Cajon CA 92020 953140767 501(c)(3) 10000 Project Support Meals on Wheels of San Francisco Inc 1375 Fairfax Ave San Francisco CA 94124 941741155 501(c)(3) 24050 Event Support\Annual Fundraiser Meals On Wheels of Solano County 95 Marina Center Suisun City CA 94585 942453452 501(c)(3) 30000 Project Support Medical Education Cooperation with Cuba 1814 Franklin 820 Oakland CA 94612 311603765 501(c)(3) 50000 Project Support Medical Missions Adventures 11540 Bonham Ave Lakeview Terrace CA 91342 043661520 501(c)(3) 10000 Project Support Medshare International 2937 Alvarado St San Leandro CA 94577 582433968 501(c)(3) 209550 General Operating Support MEMORIAL SLOAN KETTERING CANCER CENTER 633 3rd Ave New York NY 10017 131624182 501(c)(3) 27582 PassThrough Fed Proj Mend-Meet Each Need with Dignity 10641 N San Fernando Rd Pacoima CA 91331 237306337 501(c)(3) 18925 Event Support\Annual Fundraiser Menifee Valley Boys & Girls Club 26301 Garbani Rd Menifee CA 92584 462167670 501(c)(3) 25000 Project Support Mental Health America of Los Angeles 200 Pine Ave 400 Long Beach CA 90802 951881491 501(c)(3) 23000 Project Support Mental Health Assoc of San Mateo County 2686 Spring St Redwood City CA 94063 946034112 501(c)(3) 15000 General Operating Support Mentis 709 Franklin St Napa CA 94559 941236934 501(c)(3) 50000 General Operating Support Mentoring in Medicine & Science Inc 2201 BRdway LL13 Oakland CA 94608 273263074 501(c)(3) 90000 Project Support Mercy House Living Centers 807 N Garfield St Santa Ana CA 92701 330315864 501(c)(3) 20000 Project Support Metropolitan Public Defender Svcs Inc 630 SW Fifth Ave 500 Portland OR 97204 930591637 501(c)(3) 99000 Project Support Mexican American Legl Defense and Edu Fnd 634 S Spring St Los Angeles CA 90014 741563270 501(c)(3) 14150 Event Support\Dinner MFI Recovery Center 5870 Arlington Ave 103 Riverside CA 92504 952833715 501(c)(3) 25000 Project Support MICHIGAN STATE UNIVERSITY 426 Auditorium Rd East Lansing MI 48824 386005984 501(c)(3) 13819 PassThrough Fed Proj Micronesian Islander Community PO Box 18606 Salem OR 97305 900663871 501(c)(3) 15000 Project Support MID-ATLANTIC PERMANENTE 2101 E Jefferson St Rockville MD 20852 521196226 FOR PROFIT 70215 PassThrough Fed Proj Mid-Peninsula Boys & Girls Club Inc 450 Martin St Daly City CA 94014 941431583 501(c)(3) 15000 Project Support MIKE Program 9155 SW Barnes Rd 219 Portland OR 97225 450520604 501(c)(3) 15000 Project Support Mindful Schools 1260 45th St Emeryville CA 94608 273261154 501(c)(3) 75000 Project Support Mission Edge San Diego 4005 Camino del Rio S San Diego CA 92108 272938491 501(c)(3) 20000 Project Support MLK Jr Community Health Foundation 1680 E 120th St Los Angeles CA 90059 454433505 501(c)(3) 24400 Event Support\Luncheon Molding HeartsOrg 16000 Yucca St Hesperia CA 92345 263863657 501(c)(3) 15000 General Operating Support Momentum Alliance 221 NW 2nd Ave Portland OR 97209 454176224 501(c)(3) 10000 Project Support Momentum for Mental Health 438 N White Rd San Jose CA 95127 941496052 501(c)(3) 10000 Project Support Montclair Community Foundation 5111 Benito St Montclair CA 91763 264180900 501(c)(3) 20000 Other Monument Crisis Center 1990 Market St Concord CA 94520 412111171 501(c)(3) 20750 Event Support\Annual Fundraiser Monument Impact 1760 Clayton Rd Concord CA 94520 943370919 501(c)(3) 20000 Project Support Moses House Ministries 15180 Anacapa Rd Victorville CA 92392 330568537 501(c)(3) 10000 Project Support Mothers Club Family Learning Center 980 N Fair Oaks Ave Pasadena CA 91103 237275324 501(c)(3) 8700 Event Support\Annual Fundraiser Mountain Comm Boys & Girls Club Inc 607 Forest Shade Rd Crestline CA 92325 330653707 501(c)(3) 10000 Project Support Mountain Health & Community Services Inc 31115 Hwy 94 Campo CA 91906 330164420 501(c)(3) 20000 Project Support Museum of the African Diaspora 685 Mission St San Francisco CA 94605 943338239 Government or P 125000 Project Support MUSLIM EDUCATIONAL TRUST INC PO Box 283 Portland OR 97207 931151949 501(c)(3) 10000 Project Support Mutual Assist Network of Del Paso Heights 811 Grand AveA3 Sacramento CA 95838 680332694 501(c)(3) 40000 Project Support My Sister's House 5770 Freeport Blvd48 Sacramento CA 95818 680464114 501(c)(3) 20000 Project Support NAMI ACS dba NAMI Alameda County South 4974 Omar St Fremont CA 94538 461028709 501(c)(3) 30000 Project Support NAMI California 1851 Heritage Ln 150 Sacramento CA 95815 942676057 501(c)(3) 13850 Conference Support NAMI Santa Clara County 1150 S Bascom Ave 24 San Jose CA 95128 942430956 501(c)(3) 50000 Project Support NAMI Sonoma County 182 Farmers Ln 202 Santa Rosa CA 95405 680041644 501(c)(3) 16000 Project Support NAMI-Ventura County 5251 Verdugo Rd K Camarillo CA 93011 770037450 501(c)(3) 8155 Project Support Napa County Bi-National Health Alliance 1100 Trancas St 300 Napa CA 94558 237221695 501(c)(3) 100000 Project Support Napa County Health and Human Svcs Agency 2751 Napa Val Corp Dr Napa CA 94558 946000525 501(c)(3) 25000 Project Support Napa Emergency Women's Services 1141 Pear Tree Ln 220 Napa CA 94558 942745889 Government or P 20000 Project Support Napa Solano SaneSart 1141 Pear Tree Ln 220 napa CA 94558 680285816 501(c)(3) 42000 General Operating Support Narika 1904 Franklin St Oakland CA 94612 943162871 501(c)(3) 26500 Project Support National Coalition of 100 Black Women P O Box 24231 Oakland CA 94623 943298877 501(c)(3) 7500 Project Support National Hispanic Health Foundation 1216 Fifth Ave Rm 457 New York NY 10029 260051902 501(c)(3) 9320 Event Support\Awards Ceremony National Medical Fellowships Inc 347 Fifth Ave 510 New York NY 10016 010963657 501(c)(3) 14000 Event Support\Awards Ceremony Nehemiah Community Foundation 1321 Garden Hwy Sacramento CA 95833 680449972 501(c)(3) 15000 Project Support Neighborhood Healthcare 425 N Date St Escondido CA 92025 952796316 501(c)(3) 20000 Project Support Neighborhood Homework House 777 East Alosta Blvd Azusa CA 91702 954713600 501(c)(3) 7000 Project Support Neighborhood House Inc 7780 SW Capitol Hwy Portland OR 97219 930386875 501(c)(3) 15000 Project Support Neighborhood Housing Svcs of LA County 3926 Wilshire Blvd Los Angeles CA 90010 953938955 501(c)(3) 10000 General Operating Support New Haven Unified School District 725 Whipple Rd Union City CA 94587 941717886 501(c)(3) 40000 Project Support New Hope Free Clinic Inc 760 E Stuart Ave Redlands CA 92375 462473576 Government or P 15000 General Operating Support New Horizons Caregivers Group 3129 S Hac Bl Hacienda Heights CA 91745 753132090 501(c)(3) 8000 Project Support New Horizons Serv Ind With Special Needs 15725 Parthenia St North Hills CA 91343 951862084 501(c)(3) 9500 Project Support Niroga Institute 111 Fairmount Ave Oakland CA 94611 202620278 501(c)(3) 185000 Project Support NO CA INST RESEARCH AND ED 4150 Clement St San Francisco CA 94121 943084159 501(c)(3) 158572 PassThrough Fed Proj Nor & Sth of Mkt Adult Day Hlth Care Corp 930 Fourth St San Francisco CA 94158 942915039 501(c)(3) 25000 Project Support North by Northeast Community Health Center 714 NE Alberta St Portland OR 97211 721618287 501(c)(3) 61115 Project Support North County Community Services 1557 Grand Ave C San Marcos CA 92078 237071474 501(c)(3) 12000 Project Support North County Health Project Inc 150 Valpeda Rd San Marcos CA 92069 952847102 501(c)(3) 27500 Project Support North County Lifeline Inc 3142 Vista Way 400 Oceanside CA 92056 952794253 501(c)(3) 105000 Project Support North East Medical Services 1520 Stockton St San Francisco CA 94133 941722562 501(c)(3) 15000 Project Support Northeast Valley Health Corporation 1172 N Maclay Ave San Fernando CA 91340 237120632 501(c)(3) 12626 Project Support Northern California Center for Well-Being 101 Brookwood Ave A Santa Rosa CA 95404 931144835 501(c)(3) 32180 Event Support\Awards Ceremony Northwest Family Services 6200 SE King Rd Portland OR 97222 930841022 501(c)(3) 25000 Project Support Northwest Housing Alternatives 2316 SE Willard St Milwaukie OR 97222 930814473 501(c)(3) 15000 Project Support NORTHWESTERN UNIVERSITY 750 N Lake Shore Drive Chicago IL 60611 362167818 501(c)(3) 95052 PassThrough Fed Proj Novato Youth Center 680 Wilson Ave Novato CA 94947 941735064 501(c)(3) 20000 Project Support Oak Grove Institute Foundation Inc 24275 Jefferson Ave Murrieta CA 92562 330470446 501(c)(3) 25000 Project Support Oakland Adult Education 4521 Webster St Oakland CA 94609 946000385 501(c)(3) 40000 Project Support Oakland California Youth Outreach Inc 3700 East 12th St Oakland CA 94601 274707108 Government or P 49995 Project Support Oakland Military Institute Coll Prep Acad 3877 Lusk St Oakland CA 94608 912073068 501(c)(3) 19600 Other;Event Support\Luncheon Oakland Museum of California 1000 Oak St Oakland CA 94607 453138892 501(c)(3) 56000 Event Support\Cultural Event Oakland Police Activities League 9600 Sunnyside St Oakland CA 94603 942826718 501(c)(3) 24000 Project Support Oakland Public Education Fund 581 61st St Oakland CA 94609 432014630 501(c)(3) 8500 Project Support Oakland School for the Arts 530 18th St Oakland CA 94612 680463892 501(c)(3) 20000 Project Support Odd Fellow- Rebekah Chlds Home of CA 290 IOOF Ave Gilroy CA 95020 941167402 501(c)(3) 40000 Project Support Okizu Foundation 83 Hamilton Dr 200 Novato CA 94949 680291178 501(c)(3) 6500 Event Support\Cultural Event Olive Crest 555 Technology Ct 300 Riverside CA 92507 952877102 501(c)(3) 25000 Project Support On Lok Day Services 225 30th St San Francisco CA 94131 943101464 501(c)(3) 19925 Event Support\Annual Fundraiser On The Move 780 Lincoln Ave Napa CA 94558 753149095 501(c)(3) 103223 Project Support One House of Peace PO Box 14351 Portland OR 97293 263664835 501(c)(3) 15000 Project Support One in Long Beach Inc 2017 E 4th St Long Beach CA 90814 953523149 501(c)(3) 12995 General Operating Support One Step a la Vez 421 Sespe Ave Fillmore CA 93015 454604852 501(c)(3) 8155 Project Support OneOC 1901 E 4th St 100 Santa Ana CA 92705 952021700 501(c)(3) 165000 Project Support Ontario-Montclair School District 950 West D St Ontario CA 91762 956002267 501(c)(3) 10000 Project Support Ontario-Montclair Schools Foundation 950 West D St Ontario CA 91762 900716973 Government or P 10000 Project Support Open Heart Kitchen of Livermore Inc 1141 Catalina Dr 137 Livermore CA 94550 943396038 501(c)(3) 30780 Event Support\Annual Fundraiser Open Paths Counseling Center 5731 W Slauson Ave Culver City CA 90230 953221061 501(c)(3) 10000 Project Support Operation USA 7421 Beverly Blvd Los Angeles CA 90036 953504080 501(c)(3) 50000 General Operating Support Optimal Hospice Foundation 1315 Boughton Drive Bakersfield CA 93308 953334909 501(c)(3) 12000 Project Support Orangewood Foundation 1575 E 17th St Santa Ana CA 92705 953616628 501(c)(3) 40000 Other Oregon Children's Foundation DBA SMART 101 SW Market St Portland OR 97201 931051724 501(c)(3) 15000 Project Support Oregon Childrens Theatre Company 1939 NE Sandy Blvd Portland OR 97232 931029151 501(c)(3) 15000 Project Support Oregon College Of Oriental Medicine 75 NW Couch St Portland OR 97209 930845182 501(c)(3) 15000 Project Support Oregon Community Warehouse Inc 3969 NE MLK Jr Blvd Portland OR 97212 931310582 501(c)(3) 20000 Project Support Oregon Food Bank Inc 7900 NE 33rd Drive Portland OR 97211 930785786 501(c)(3) 15000 Project Support Oregon Oral Health Coalition 9140 SW Pioneer CtE Wilsonville OR 97070 300449673 501(c)(3) 30000 Project Support Oregon Primary Care Association 310 SW 4th Ave 200 Portland OR 97204 930877986 501(c)(3) 98692 Project Support Oregon Public Health Institute 310 SW 4th Ave 900 Portland OR 97204 931259522 501(c)(3) 157703 Project Support Oregon School-Based Health Alliance 310 SW 4th Ave905 Portland OR 97204 364588657 501(c)(3) 135000 Project Support Pacific Region Oasis 4005 Crenshaw Blvd Los Angeles CA 90008 134242159 501(c)(3) 10000 Project Support Pacific University 2043 College Way Forest Grove OR 97116 930386892 501(c)(3) 32000 Project Support Pajaro Valley Community Health Trust 85 Nielson St201 Watsonville CA 95076 941149702 501(c)(3) 34000 Event Support\Health Fair Pajaro Valley Prevention & Students Assist 335 East Lake Ave Watsonville CA 95076 770269322 501(c)(3) 95000 Project Support Pajaro Valley Unified School District 294 Green Valley Rd Watsonville CA 95076 770375541 501(c)(3) 50000 Project Support Parent Resource Center 811 5th St Modesto CA 95351 770324466 Government or P 15000 Project Support Parent Teacher Home Visit Project Inc 2411 15th St A Sacramento CA 95818 510477445 501(c)(3) 24000 Project Support Partners In Care Foundation Inc 732 Mott St 150 San Fernando CA 91340 953954057 501(c)(3) 10000 Event Support\Dinner Partnership for Children and Youth 1330 BRdWAY 601 Oakland CA 94612 043653529 501(c)(3) 150000 Project Support Partnerships for Trauma Recovery 1936 University Ave 191 Berkeley CA 94704 473948973 501(c)(3) 24500 Project Support Pasadena Senior Center 85 E Holly St Pasadena CA 91103 952085393 501(c)(3) 23296 Conference Support Pasadena-Foothill Valley YWCA 50 N Hill 301 Pasadena CA 91106 951644059 501(c)(3) 11200 Event Support\Annual Fundraiser PATH Ventures 340 North Madison Ave Los Angeles CA 90004 201892523 501(c)(3) 7500 Project Support Pathways Volunteer Hospice 4645 Woodruff Ave Lakewood CA 90713 330241726 501(c)(3) 24000 Project Support Patterson Joint Unified School District 510 Keystone Blvd Patterson CA 95363 582207430 501(c)(3) 50000 Project Support PDI Surgery Center 1380 19th Hole Drive Windsor CA 95492 343012430 501(c)(3) 20000 Project Support Peace Over Violence 1015 Wilshire Blvd Los Angeles CA 90017 510179305 501(c)(3) 14960 Event Support\Annual Fundraiser Pediatric and Family Medical Center 1530 S Olive St Los Angeles CA 90015 951690966 501(c)(3) 100000 Project Support Peninsula Conflict Resolution Center 1660 S Amphlette Blvd San Mateo CA 94402 770144000 501(c)(3) 10500 Event Support\Annual Fundraiser Peninsula Family Connections 220 Twin Dolphin Dr Redwood City CA 94065 943315163 501(c)(3) 10000 General Operating Support Peninsula Family Service 24 Second Ave San Mateo CA 94401 941186169 501(c)(3) 10000 General Operating Support Petaluma People Services Center 1500 Petaluma BlvdS Petaluma CA 94952 942271299 501(c)(3) 16250 Event Support\Annual Fundraiser Philanthropic Ventures Foundation 1222 Presv Park Way Oakland CA 94612 943136771 501(c)(3) 50000 Project Support Physician Medical Forum 13323 Campus Drive Oakland CA 94619 300086728 501(c)(3) 90000 Project Support Placer County Office of Education - Auburn 360 Nevada St Auburn CA 95603 946002096 501(c)(3) 19260 Project Support Placer Food Bank 8284 Industrial Ave Roseville CA 95678 941740316 Government or P 100000 Project Support Planned Parenthood Los Angeles 400 West 30th St Los Angeles CA 90007 952408623 501(c)(3) 25000 Project Support Planned Parenthood Mar Monte Inc 1691 The Alameda San Jose CA 95126 941583439 501(c)(3) 27300 General Operating Support Planned Parenthood Shasta Diablo Inc 2185 Pacheco St Concord CA 94520 941575233 501(c)(3) 38750 Event Support\Cultural Event Planting Justice 3463 San Pablo Ave Oakland CA 94608 270334905 501(c)(3) 75000 Project Support Playworks Education Energized 380 Washington St Oakland CA 94607 943251867 501(c)(3) 232900 Project Support Pln Parenthood Pasa & S Gabriel Vly Inc 2333 Lake Ave 2nd Floor Altadena CA 91001 951916050 501(c)(3) 20850 Project Support Plz de Cultura y Arte Foundation 501 North Main St Los Angeles CA 90012 753059288 501(c)(3) 8170 Event Support\Annual Fundraiser Police Activities League of Vancouver WA 605 E Evergreen Blvd Vancouver WA 98661 912072283 501(c)(3) 20000 Project Support Portland After-School Tennis & Education 7519 N Burlington Ave Portland OR 97203 931256066 501(c)(3) 20000 Project Support Portland Leadership Foundation 809 N Russell 203 Portland OR 97227 264224606 501(c)(3) 30000 Project Support Portland Public Schools (PPS) 501 N Dixon St Portland OR 97227 936000830 501(c)(3) 57000 Project Support Portola Family Connection Center 2565 San Bruno Ave San Francisco CA 94134 943213689 Government or P 20000 Project Support Portuguese Org for Social Svc & Opp 1115 E Santa Clara St A San Jose CA 95116 510187655 501(c)(3) 25000 Project Support Positive Alt Rec Teambuilding Impact Prgm 2576 Gumdrop Dr Lake Balboa CA 91406 760832431 501(c)(3) 15000 Project Support Positive Results Corporation 1128 W Gardena Blvd Gardena CA 90247 954455668 501(c)(3) 20000 Project Support Postpartum Health Alliance 16935 W Bernardo Dr San Diego CA 92127 680306790 501(c)(3) 8000 Project Support Poverello House 412 F St Fresno CA 93726 770007985 501(c)(3) 60000 Project Support Prevention Institute 221 Oak St Oakland CA 94607 943282858 501(c)(3) 6776 Conference Support Project Access Now 714 SW 20th Pl Portland OR 97205 208928388 501(c)(3) 260798 Project Support Project Access Inc 2100 W Orangewood Ave 230 Orange CA 92868 330834635 501(c)(3) 25000 Project Support Project Angel Food 922 Vine St Los Angeles CA 90038 954115863 501(c)(3) 40000 Event Support\Annual Fundraiser Project Return Peer Support Network 6055 E Washington Blvd Commerce CA 90040 272318836 501(c)(3) 6000 Project Support Project Sister Family Services 363 S Park Ave 303 Pomona CA 91766 237116161 501(c)(3) 25000 Project Support Protestant Epi Church in the Diocese of LA 840 Echo Park Ave Los Angeles CA 90026 951684078 501(c)(3) 50000 Project Support PSU Foundation Portland State University PO Box 751 RSP Portland OR 97207 481278529 501(c)(3) 262500 Project Support Public Health Advocates 2201 BRdway 604 Oakland CA 94612 954723901 501(c)(3) 200000 Project Support Public Health Institute 555 12th St 10th Fl Oakland CA 94607 941646278 501(c)(3) 860000 Project Support Puente de la Costa Sur 620 North St Pescadero CA 94060 371484262 501(c)(3) 10000 General Operating Support ROADS Foundation Inc 121 S Long Beach Blvd Compton CA 90221 450572757 501(c)(3) 20000 Project Support Radio Bilingue Inc 5005 E Belmont Ave Fresno CA 93727 942472322 501(c)(3) 24520 Project Support Rafiki Coalition for Health and Wellness 601 Cesar Chavez St San Francisco CA 94124 943098879 501(c)(3) 15000 Project Support Rainbow Services Ltd 453 W 7th St San Pedro CA 90731 953855705 501(c)(3) 10000 Project Support Rancho Los Amigos Foundation Inc 7601 E Imperial Hwy Downey CA 90242 953849600 501(c)(3) 9250 Event Support\Annual Fundraiser Rape Trauma Services 1860 El Camino Real Burlingame CA 94010 943215045 501(c)(3) 15000 Project Support Raphael House of San Francisco Inc 1065 Sutter St San Francisco CA 94109 943141608 501(c)(3) 10000 Project Support Reach Out West End 1126 West Foothill Bvld Upland CA 92716 952642747 501(c)(3) 10000 Conference Support Reading and Beyond 4670 E Butler Ave Fresno CA 93702 770508471 501(c)(3) 15000 Project Support REAP INC PO Box 3442 Portland OR 97208 931315162 501(c)(3) 20000 Project Support Redwood Community Health Coalition 1310 Redwood Way 135 Petaluma CA 94954 943220029 501(c)(3) 388000 Project Support Redwood Empire Food Bank 3990 Brickway Blvd Santa Rosa CA 95403 680121855 501(c)(3) 29400 Event Support\Annual Fundraiser Regents of the UC at San Diego 9500 Gilman Dr MC 0857 La Jolla CA 92093 956006144 501(c)(3) 75000 Project Support REGENTS OF THE UNIVERSITY OF MICHIGAN 3003 S State Street Ann Arbor MI 48109 386006309 501(c)(3) 40035 PassThrough Fed Proj REGENTS OF THE UNIVERSITY OF MINNESOTA 106 Pleasant St Minneapolis MN 55455 416007513 501(c)(3) 94788 PassThrough Fed Proj Regents UCLA 10889 Wilshire Blvd Los Angeles CA 90095 956006143 501(c)(3) 1393567 Project Support Regional Parks Foundation 2950 Peralta Oaks Court Oakland CA 94605 237011877 501(c)(3) 165000 Project Support ReImagine Mack Rd Foundation 7833 Center Pkwy Sacramento CA 95823 464193875 501(c)(3) 75000 Project Support Renaissance Entrepreneurship Center 275 5th St San Francisco CA 94103 942793122 501(c)(3) 75000 Project Support Rescue Mission Alliance 15572 7th St Victorville CA 92395 237278002 501(c)(3) 20000 Project Support RESEARCH FOUNDATION STATE UNIV OF NY 402 Crofts Hall Buffalo NY 14260 141368361 501(c)(3) 16823 PassThrough Fed Proj Returning Veterans Project 833 SE Main Mailbox 122 Portland OR 97214 204034255 501(c)(3) 15000 Project Support Reynolds School District 1204 NE 201st Ave Fairview OR 97024 938000836 501(c)(3) 20000 General Operating Support Richland School District 331 N Shafter Ave Shafter CA 93263 956002546 Government or P 15000 General Operating Support Rio Vista CARE Inc PO Box 576 Rio Vista CA 94571 680063763 501(c)(3) 22000 Project Support River to Coast Children's Services 16300 First St Guerneville Ca CA 95446 942378459 501(c)(3) 15000 Project Support Riverside Area Rape Crisis Center 1845 Chicago Ave A Riverside CA 92507 953245057 501(c)(3) 15000 Project Support Robert F Kennedy Inst of Com & Family Med 544 N Avalon Blvd 309 Wilmington CA 90744 330531975 501(c)(3) 12500 Project Support Roberts Family Development Center 770 Darina Ave Sacramento CA 95815 680470557 501(c)(3) 34500 Event Support\Cultural Event Ronald McDonald House Char of Southern Cal 4560 Fountain Ave Los Angeles CA 90029 953167869 501(c)(3) 17200 Event Support\Annual Fundraiser RotaCare Bay Area Inc 514 Valley Way Milpitas CA 95035 770328723 501(c)(3) 60000 Project Support Rubicon Programs Inc 24100 Amador St 3rd Fl Hayward CA 94544 942301550 501(c)(3) 56750 Other;Event Support\Annual Fundraiser Rural Community Assistance 3120 Freeboard Dr West Sacramento CA 95691 942512284 501(c)(3) 25000 Project Support RUSH UNIVERSITY MEDICAL CENTER 1653 W Congress Parkway Chicago IL 60612 362174823 501(c)(3) 16760 PassThrough Fed Proj Ryse Inc 205 41st St Richmond CA 94805 260692904 501(c)(3) 11380 Other;Event Support\Cultural Event S Alameda Cty Comite de Raza Mental Hlth 22366 Fuller Ave Hayward CA 94541 942297155 501(c)(3) 30000 Project Support SAC Health System 250 S G St San Bernardino CA 92410 330664371 501(c)(3) 10000 Project Support Sac Reg Coalition to End Homelessness 1331 Garden Hwy 100 Sacramento CA 95833 463175193 501(c)(3) 24500 Project Support Sacramento Children's Home 2750 Sutterville Rd Sacramento CA 95820 941156588 501(c)(3) 20000 Project Support Sacramento City Unified School District 5735 47th Ave Sacramento CA 95824 946002491 501(c)(3) 148000 Project Support Sacramento Cottage Housing Inc 1500 NORTH A St SACRAMENTO CA 95811 680322086 Government or P 10000 Project Support Sacramento Loaves and Fishes 1351 No C St Sacramento CA 95813 680189897 501(c)(3) 25000 Project Support Sacramento Native American Health Center 2020 J St Sacramento CA 95811 204287737 501(c)(3) 50000 Project Support Sacramento Neighborhood Housing Services 2411 Alhambra Blvd Sacramento CA 95817 680118032 501(c)(3) 20000 Project Support Sacred Heart Community Service 1381 South First St San Jose CA 95110 237179787 501(c)(3) 20000 Project Support Safe Passages 250 Frank Ogawa Plz 6306 Oakland CA 94612 204535835 501(c)(3) 100000 Project Support Safe Routes to School National Partnership PO Box 44328 Fort Washington MD 20749 462694434 501(c)(3) 500000 Project Support Saint Rest Baptist Church 1550 E Rev Ches Rigg Ave Fresno CA 93706 770009944 501(c)(3) 75000 Project Support SAJE 152 West 32nd St Los Angeles CA 90007 931226092 501(c)(3) 10000 Project Support Salem Free Clinics 1300 BRdway St NE 104 Salem OR 97301 203549992 501(c)(3) 43000 Project Support Salem Harvest Inc PO Box 483 Salem OR 97308 453043885 501(c)(3) 8000 Project Support Salem Hospital PO Box 140001 Salem OR 97309 930579722 501(c)(3) 2021190 General Operating Support Salem-Keizer Coalition for Equality 3850 Portland Rd NE 100 Salem OR 97301 651203900 501(c)(3) 80000 Project Support Salud Para La Gente Inc 195 Aviation Way Watsonville CA 95076 942705747 501(c)(3) 95000 Project Support Samaritan Counseling Center 1126 W Foothill Blvd 110 Upland CA 91786 953160005 501(c)(3) 25000 Project Support Samaritan House 4031 Pacific Blvd San Mateo CA 94403 237416272 501(c)(3) 30000 Project Support Samuel Dixon Family Health Center Inc 25115 W Av Stanford Valencia CA 91355 954278726 501(c)(3) 18000 Project Support San Bern County Sexual Asslt Svcs Inc 444 N Arrwhd Ave San Bernardino CA 92401 953543081 501(c)(3) 25000 General Operating Support San Bernardino City Uni School Dist 747 N Mnt View Ave San Bernardino CA 92410 952285577 501(c)(3) 42404 Project Support San Diego American Indian Health Center 2602 First Ave 105 San Diego CA 92103 953397369 Government or P 75000 Project Support San Diego Hunger Coalition 4305 University Ave San Diego CA 92105 300507718 501(c)(3) 75000 Project Support San Diego Unified School District 2875 Ocean View Blvd San Diego CA 92113 956002781 501(c)(3) 24432 Project Support San Diego Youth Services 3255 Wing St San Diego CA 92110 952648050 Government or P 15000 Project Support San Fernando Community Hospital 732 Mott St 100 San Fernando CA 91340 510142144 501(c)(3) 10000 General Operating Support San Francisco Child Abuse Prevention Ctr 1757 Waller St San Francisco CA 94117 942455072 501(c)(3) 25000 Project Support San Francisco Community Clinic Consortium 2720 Taylor St 430 San Francisco CA 94133 942897258 501(c)(3) 313500 Project Support San Francisco General Hospital Foundation 2789 25th St 2028 San Francisco CA 94110 943189424 501(c)(3) 229250 Project Support San Francisco -Marin Food Bank 900 Penn Ave San Francisco CA 94107 943041517 501(c)(3) 105000 Project Support San Francisco Parks Alliance 1663 Mission St San Francisco CA 94103 237131784 501(c)(3) 170000 Project Support San Gabriel Unified School District 408 Junipero Serra Dr San Gabriel CA 91776 956000777 501(c)(3) 9000 Project Support San Joaquin County Office of Education 2922 Transworld Drive Stockton CA 95206 680006282 501(c)(3) 75000 Project Support San Joaquin General Hospital 500 W Hospital Rd French Camp CA 95231 946000531 Government or P 165000 Project Support San Jose Children's Discovery Museum 180 Woz Way San Jose CA 95110 942870828 Government or P 85000 Project Support San Leandro Unified School District 895 East 14th St 200 San Leandro CA 94577 946002608 501(c)(3) 98000 Project Support San Mateo County Sheriff's Act League 3151 Edison Way Redwood City CA 94063 450617342 Government or P 20000 General Operating Support San Mateo Police Activities League 200 Franklin Pkwy San Mateo CA 94403 311593896 501(c)(3) 15200 Event Support\Annual Fundraiser San Pablo Economic Development Corporation 13830 San Pablo Ave D San Pablo CA 94806 275395012 501(c)(3) 36000 Project Support Sanctuary of Hope 4003 W Adams Blvd Los Angeles CA 90018 273273118 501(c)(3) 10000 General Operating Support Santa Clara City Library Fdn & Friends 2635 Homestead Rd Santa Clara CA 95051 912125234 501(c)(3) 12000 Project Support Santa Clara County 70 WEST HEDDING St SAN JOSE CA 95110 946000533 501(c)(3) 170000 Project Support Santa Clarita Valley Boys and Girls Club 24909 Newhall Ave Newhall CA 91321 952572622 Government or P 7000 Project Support Santa Cruz Community Health Centers 125 Water St A2 Santa Cruz CA 95060 237428303 501(c)(3) 90000 Project Support Santa Cruz Lesbian And Gay Comm Ctr 1117 Soquel Ave Santa Cruz CA 95062 770212967 501(c)(3) 10000 Project Support Santa Monica-Malibu Education Foundation 1645 16th St Santa Monica CA 90404 953787674 501(c)(3) 10000 Project Support Santa Rosa City Schools 211 Ridgway Ave Santa Rosa CA 95401 680180139 501(c)(3) 66000 Project Support Santa Rosa Community Health Centers 3569 Round Barn Circle Santa Rosa CA 95403 680365296 Government or P 599500 Event Support\Annual Fundraiser Santa Rosa Junior College District 1501 Mendocino Ave Santa Rosa CA 95401 946033759 501(c)(3) 12000 Project Support Satellite Affordable Housing Associates 1835 Alcatraz Ave Berkeley CA 94703 943186770 Government or P 20000 Project Support School Health Clinics of Santa Clara Cty 6840 Via Del Oro 210 San Jose CA 95119 770031679 501(c)(3) 30000 Project Support Scotts Valley Counseling Center 5523 Scotts Val Dr Scotts Valley CA 95066 453159860 501(c)(3) 10000 Project Support SD LGBT Comm Ctr 3909 Centre St San Diego CA 92103 237332048 501(c)(3) 25000 Project Support Sec Hvst Food Bnk of San Cl & San Mat Ctys 4001 N 1st St San Jose CA 95134 942614101 501(c)(3) 148000 Project Support Sec Hvst Food Bnk of San Joaq & Stnsl Cty 704 E Industrial Park Dr Manteca CA 95337 680376587 501(c)(3) 10000 Project Support Second Harvest Food Bank Santa Cruz County 800 Ohlone Pkwy Watsonville CA 95076 770326685 501(c)(3) 76220 Event Support\Annual Fundraiser Self Enhancement Inc 3920 N Kerby Ave Portland CA 97239 931086629 501(c)(3) 50000 Project Support Seneca Family Of Agencies 6925 Chabot Rd Oakland CA 94618 942971761 501(c)(3) 98000 Project Support Senior Support of the Tri-Valley 5353 Sunol Blvd Pleasanton CA 94566 203225569 501(c)(3) 15000 Project Support Seniors First 12183 Locksley Ln205 Auburn CA 95602 680430154 501(c)(3) 40940 Project Support SEPULVEDA RESEARCH CORP 16111 Pulmmer Street Sepulveda CA 91343 954246275 501(c)(3) 25318 PassThrough Fed Proj Serving Kids Hope 2100 W Alton Ave 2 Santa Ana CA 92704 471518476 501(c)(3) 20000 Project Support SF Bay Area Chap of the Ntl Black MBA Asc 2163 Aldengate 275 Hayward CA 94545 943154540 501(c)(3) 14400 Project Support SF Court Appointed Special Advocate Prog 2535 Mission St San Francisco CA 94110 943039028 501(c)(3) 24715 Event Support\Annual Fundraiser Shane's Inspiration 15213 Burbank Blvd Sherman Oaks CA 91411 954760497 501(c)(3) 75000 Project Support Share Our Selves Corporation 1550 Superior Ave Costa Mesa CA 92627 953222316 501(c)(3) 20000 General Operating Support Sharefest Community Development Inc 638 S Beacon St 700 San Pedro CA 90731 205651596 501(c)(3) 12500 Project Support Shelter Inc of Contra Costa County PO Box 5368 Concord CA 94524 680117241 501(c)(3) 25000 Project Support Shelter Partnership Inc 520 S Grand Ave Los Angeles CA 90071 953976214 501(c)(3) 13750 Event Support\Annual Fundraiser ShelterCare 499 West 4th Eugene OR 97401 237115003 501(c)(3) 295468 Project Support Sierra Health Foundation 1321 Garden Hwy210 Sacramento CA 95833 455282243 501(c)(3) 75000 Project Support Sierra Vista Child & Family Services 100 Poplar Ave Modesto CA 95354 942158023 501(c)(3) 144114 Project Support Silicon Valley Bicycle Coalition 96 N Third St375 San Jose CA 95112 770338658 501(c)(3) 35000 Project Support Soil Born Farm Urban Agriculture Project 2140 Chase Drive Rancho Cordova CA 95670 200774693 501(c)(3) 41500 Conference Support Solano Coalition for Better Health 744 Empire St 210 Fairfield CA 94533 943189914 501(c)(3) 40000 Project Support Solano County Office of Education 5100 Business Center Dr Fairfield CA 94534 946002197 Government or P 41032 Project Support Solano Family & Children's Council 421 Executive Court N Fairfield CA 94534 942369308 Government or P 20000 Project Support Solutions For At Risk Youth 579 Willow Ct Benicia CA 94510 680479787 501(c)(3) 24000 Project Support Somos Mayfair 370-B S King Rd San Jose CA 95116 770499813 501(c)(3) 20000 Project Support Sonoma County Regional Parks Foundation 2300 County Center Dr Santa Rosa CA 95403 680421813 501(c)(3) 75000 Project Support Soroptimist House of Hope Inc 13525 C Azl Wy Desert Hot Springs CA 92240 953652725 501(c)(3) 10000 Project Support SOSMentor 23622 Calabasas Rd Calabasas CA 91302 954722980 501(c)(3) 34700 Event Support\Annual Fundraiser South Asian Network Inc 18173 Pioneer Blvd I Artesia CA 90701 330608166 501(c)(3) 7500 Event Support\Annual Fundraiser South Central Family Health Center 1111 E Vernon Ave Los Angeles CA 90011 953877793 501(c)(3) 17000 Project Support South Central Scholars Foundation 1414 S Grand Ave Los Angeles CA 90015 202820261 501(c)(3) 10000 Project Support South County Community Health Center Inc 1885 Bay Rd East Palo Alto CA 94303 943372130 501(c)(3) 10000 General Operating Support South Hayward Parish 27287 Patrick Ave Hayward CA 94544 942250549 501(c)(3) 15000 Project Support South West Community Health Center 7754 SW Capitol Hwy Portland OR 97219 743050497 501(c)(3) 23000 Project Support Southern California Education Fund 515 W 27th St Los Angeles CA 90007 953713168 501(c)(3) 10000 Project Support Southern California Grantmakers 1000 N Alameda St Los Angeles CA 90012 952831058 501(c)(3) 9550 Conference Support Span-Spk Unity Cou of Alameda County Inc 1900 Fruitvale Ave 2A Oakland CA 94601 941670490 501(c)(3) 500000 General Operating Support Spark SF Public Schools 135 Van Ness Ave San Francisco CA 94102 474568396 501(c)(3) 15000 Event Support\Dinner Special Needs Network Inc 4401 Crenshaw Blvd Los Angeles CA 90043 050617904 501(c)(3) 10000 Project Support Special Olympics Northern California Inc 3480 Buskirk Ave Pleasant Hill CA 94523 680363121 501(c)(3) 60000 General Operating Support Special Olympics Southern California 1600 Forbes Way 200 Long Beach CA 90810 954538450 501(c)(3) 8500 Event Support\Dinner Special Service for Groups Inc 905 E 8th St Los Angeles CA 90021 951716914 501(c)(3) 59000 Project Support SPIRITT Family Services 8000 Painter Ave Whittier CA 90602 952852683 501(c)(3) 20000 Project Support SPOON Foundation 135 SE Main St201 Portland OR 97214 260712302 501(c)(3) 15000 Project Support St Francis Center of Redwood City 151 Buckingham Ave Redwood City CA 94063 943052056 501(c)(3) 10000 General Operating Support St Level Health Project 3125 East 15th St Oakland CA 94601 562324355 501(c)(3) 50000 Project Support St Anne's Maternity Home 155 N Occidental Bl Los Angeles CA 90026 951691306 501(c)(3) 8000 Project Support St Francis Center 1835 S Hope St Los Angeles CA 90015 954479271 501(c)(3) 10000 Project Support St John's Program for Real Change 2443 Fair Oaks Blvd Sacramento CA 95825 680132934 501(c)(3) 20000 Project Support St Johns Well Child and Family Ctr Inc 808 W 58th St Los Angeles CA 90037 954067758 501(c)(3) 13600 Event Support\Annual Fundraiser St Joseph's Medical Center of Stockton 1800 North California St Stockton CA 95204 510432777 501(c)(3) 3600000 Project Support St Mary's Dining Room 545 W Sonora St Stockton CA 95203 942687280 501(c)(3) 50000 Project Support St Vincent de Paul of Contra Costa County 2210 Gladstone Drive Pittsburg CA 94565 941448577 501(c)(3) 40000 Project Support St Vincent de Paul Society 503 Giuseppe Ct 8 Roseville CA 95678 680205405 501(c)(3) 30000 Project Support St Vincent de Paul Village Inc 3350 E St San Diego CA 92102 330492302 501(c)(3) 18000 Project Support Stand Up Placer 11115 B Ave Auburn CA 95603 942578871 501(c)(3) 26750 Event Support\Cultural Event Stand for Families Free of Violence 1410 Danzig Plz Concord CA 94520 942476576 501(c)(3) 101150 Project Support Stanisl Mult-Cultural Comm Hlth Coal 601 S MLK Dr Modesto CA 95351 311751288 501(c)(3) 50000 Project Support StarVista 610 Elm St 212 San Carlos CA 94070 943094966 501(c)(3) 30148 Event Support\Annual Fundraiser Step Up on Second St Inc 1328 Second St Santa Monica CA 90401 954109386 501(c)(3) 100000 General Operating Support Stepping Higher Inc 7373 University Ave 201 La Mesa CA 91942 010819805 501(c)(3) 10000 Project Support Sth Cal Assoc of Nonprof Housing Inc 501 Shatto Pl Los Angeles CA 90020 954019655 501(c)(3) 8600 Conference Support Sth Cal Center for Nonprofit Management 1000 N Alameda St Los Angeles CA 90012 953357253 501(c)(3) 10000 Conference Support Stiles Hall 2400 Bancroft Way Berkeley CA 94704 941156636 501(c)(3) 75000 Project Support Store to Door 7730 SW 31st Ave Portland OR 97219 943105555 501(c)(3) 17000 Project Support Student Health Svcs Support Fund 333 S Beaudry Ave Los Angeles CA 90017 954262448 501(c)(3) 256300 Project Support Students Run America 5252 Crebs Ave Tarzana CA 91356 954430502 501(c)(3) 9500 Project Support Sunnyvale Community Services 725 Kifer Rd Sunnyvale CA 94086 941713897 501(c)(3) 40000 Project Support Susan G Komen Breast Cancer Foundation 2817 McGaw Irvine CA 92614 330487943 501(c)(3) 20400 Project Support Sust Econ Enterprises Of LA 6255 W Sunset Blvd Los Angeles CA 90028 954597000 501(c)(3) 11500 Event Support\Annual Fundraiser THE Clinic Inc 3834 S Western Ave Los Angeles CA 90062 237351622 501(c)(3) 10000 Project Support Take Wings Foundation 762 Fulton St San Francisco CA 94102 710877586 501(c)(3) 8500 Event Support\Cultural Event Taking the Reins 3919 1/2 Rigali Ave Los Angeles CA 90039 954688657 501(c)(3) 7500 Project Support Tarzana Treatment Center Inc 18646 Oxnard St Tarzana CA 91356 942219349 501(c)(3) 12000 General Operating Support The Abundant Table 1012 W Ventura Blvd Camarillo CA 93010 262243787 501(c)(3) 8332 Project Support The Achievable Foundation 5901 Green Valley Cir Culver City CA 90230 954552419 501(c)(3) 15000 Event Support\Health Fair The Alameda County Com Food Bnk Inc 7900 Edgewater Drive Oakland CA 94621 942960297 501(c)(3) 143500 Project Support The Bread Project 1555 Park Ave Unit B Emeryville CA 94608 943363920 501(c)(3) 30000 Project Support The CA Conference for Eq & Justice Inc 3711 Long Beach Blvd Long Beach CA 90807 542178438 501(c)(3) 20100 Event Support\Cultural Event The CA Health Care Safety- Net Institute 70 Washington St 215 Oakland CA 94607 942970752 501(c)(3) 571025 General Operating Support The Catalyst Foundation 44758 Elm Ave Lancaster CA 93534 770357456 501(c)(3) 12000 Project Support The Center at Blessed Sacrament 6636 Selma Ave Los Angeles CA 90028 203022534 501(c)(3) 20000 Project Support The Children's Book Bank 1915 NE 7th Ave Portland OR 97212 261600475 501(c)(3) 15000 Project Support The Cleo Eulau Ctr dba Ack Alliance 2483 Old Midfld Way Mountain View CA 94043 770393676 501(c)(3) 35000 General Operating Support The Davis St Community Center Incorporated 3081 Teagarden St San Leandro CA 94577 943121699 501(c)(3) 9500 Event Support\Annual Fundraiser;Other The Env Justice Coalition for Water 909 12th St Sacramento CA 95814 202539559 501(c)(3) 20000 Project Support The Escondido Community Child Dev Ctr 819 W 9th Ave Escondido CA 92025 953264143 501(c)(3) 10000 Project Support The Gathering Inn 201 Berkeley Ave Roseville CA 95678 841657746 501(c)(3) 50000 Project Support The Intertwine Alliance 2100 SW River Pkwy 450 Porltand OR 97201 452629474 501(c)(3) 50000 Project Support The Latina Center 3701 Barrett Ave Richmond CA 94805 680470904 501(c)(3) 24840 Project Support The Leukemia & Lymphoma Society 101 Montgomery St San Francisco CA 94104 135644916 501(c)(3) 19250 Project Support The Mindful Project 124 Washington Ave B Richmond CA 94801 475066819 501(c)(3) 80000 Project Support The Oregon Community Foundation 1221 SW Yamhill 100 Portland OR 97205 237315673 501(c)(3) 24500 Project Support The Regents of the University of CA 2150 Shattuck Ave 300 Berkeley CA 94704 946002123 501(c)(3) 97000 Project Support The Roman Cath Bishop of San Bernardino 15512 Sixth St Victorville CA 92395 953293901 501(c)(3) 10000 Project Support The Salvation Army 586 East Wigeon Way Suisun City CA 94585 941156347 501(c)(3) 81200 Event Support\Annual Fundraiser The Sheriffs Community Impact Program 2350 Northrop Ave Sacramento CA 95825 273457087 501(c)(3) 24000 Project Support The Tech Museum of Innovation 201 South Market St San Jose CA 95113 942864660 501(c)(3) 50000 Project Support The Teen Project Inc 8140 Sunland Blvd Sun Valley CA 91352 300421837 501(c)(3) 10000 Project Support The Trust For Public Land 101 Montgomery Str San Francisco CA 94102 237222333 501(c)(3) 195000 Project Support The Tucker Maxon Oral School 2860 SE Holgate Blvd Portland OR 97202 930391592 501(c)(3) 15000 Project Support The Young Artists Conservatory of Music 500 Davis St Vacaville CA 95688 202734913 501(c)(3) 24000 Project Support Thessalonika Family Services 38950 Mesa Rd Temecula CA 92592 953551068 501(c)(3) 25000 Project Support Think Dignity 3525 30th St San Diego CA 92104 331146733 501(c)(3) 24000 Project Support THINK Together 550 Valley Way Milpitas CA 95035 330781751 501(c)(3) 102500 Project Support Thriving in Place 832 Folsom St San Francisco CA 94107 473219728 501(c)(3) 15000 Project Support Tiburcio Vasquez Health Center Inc 22331 Mission Blvd Hayward CA 94541 237118361 501(c)(3) 75000 Project Support TIdes Center PO Box 29907 San Francisco CA 94129 943213100 501(c)(3) 593262 Project Support Tierra del Sol Foundation 9919 Sunland Blvd Sunland CA 91040 952671260 501(c)(3) 10000 Project Support Time for Change Foundation 1255 E Highland Av San Bernardino CA 92405 522405277 501(c)(3) 10000 Event Support\Awards Ceremony TLCS Inc 650 Howe AveBldg400-A Sacramento CA 95825 942777955 501(c)(3) 34880 Project Support Toberman Neighborhood Center Inc 131 N Grand Ave San Pedro CA 90731 951643387 501(c)(3) 10000 Project Support TransFormCA 436 14th St 600 Oakland CA 94612 721521579 501(c)(3) 75000 Project Support Tri-City Health Center 40910 Fremont Blvd Fremont CA 94538 237255435 501(c)(3) 49300 Event Support\Health Fair Trillium Family Services Foundation 3415 SE Powell Blvd Portland OR 97202 930386966 501(c)(3) 15000 Project Support Tri-Valley Anti-Poverty Collaborative PO Box 2467 Livermore CA 94551 474672151 501(c)(3) 20000 Project Support TRUSTEES OF THE UNIVERSITY OF PENSYLVANIA 3451 Walnut Street Philidelphia PA 19104 231352685 501(c)(3) 25024 PassThrough Fed Proj Turning Point Foundation 557 East Thompson Blvd Ventura CA 93001 770213467 501(c)(3) 20000 Project Support Uncommon Good 211 W Foothill Blvd Claremont CA 91711 954792792 501(c)(3) 10000 General Operating Support Union Station Homeless Services 825 E Orange Grove Blvd Pasadena CA 91104 953958741 501(c)(3) 19000 Event Support\Annual Fundraiser United African American Minist Act Coun 404 Euclid Ave 390 San Diego CA 92114 330959000 501(c)(3) 10000 Project Support United Samaritans Foundation 220 S BRdway Turlock CA 95380 770393321 501(c)(3) 35000 Project Support United States Veterans Initiative 800 W 6th St 1505 Los Angeles CA 90017 954382752 501(c)(3) 54090 Event Support\Dinner United Way of Fresno County 4949 E Kings Canyon Rd Fresno CA 93727 941156514 501(c)(3) 50000 Project Support United Way of Santa Cruz County 4450 Capitola Rd 106 Capitola CA 95010 941422471 501(c)(3) 70000 Project Support United Way of the Bay Area 550 Kearny St 1000 San Francisco CA 94108 941312348 501(c)(3) 99300 Project Support United Way of the Stanislaus Area 422 McHenry Ave Modesto CA 95354 941212129 501(c)(3) 130000 Project Support United Way of Ventura County 4001 Mission Oaks Blvd Camarillo CA 93012 951945833 501(c)(3) 350000 Responsive UNIVERSITY OF ALABAMA AT BIRMINGHAM 1530 3rd Ave S Birmingham AL 35294 630649108 501(c)(3) 157164 PassThrough Fed Proj UNIVERSITY OF CALIFORNIA - SAN FRANCISCO 3333 California St San Francisco CA 94115 946036493 501(c)(3) 1260072 PassThrough Fed Proj UNIVERSITY OF CALIFORNIA DAVIS 1850 Research Park Drive Davis CA 95618 946036494 501(c)(3) 308413 PassThrough Fed Proj THE UNIVERSITY OF CHICAGO PRESS 6030 S Ellis Chicago IL 60637 362177139 501(c)(3) 116583 PassThrough Fed Proj UNIVERSITY OF COLORADO 13001 East 17th Ave Aurora CO 80045 846000555 501(c)(3) 31743 PassThrough Fed Proj UNIVERSITY OF FLORIDA HEALTH 219 Grinter Hall Gainsville FL 32611 591943502 501(c)(3) 15928 PassThrough Fed Proj UNIVERSITY OF MASSACHUSETTS WORCESTER 55 Lake Ave North Worcester MA 01655 043167352 501(c)(3) 201297 PassThrough Fed Proj UNIVERSITY OF NORTH CAROLINA 104 Airport Drive Chapel Hill NC 27599 566001393 501(c)(3) 75001 PassThrough Fed Proj UNIVERSITY OF PITTSBURGH 123 University Place Pittsburgh PA 15213 250965591 501(c)(3) 50888 PassThrough Fed Proj University of Southern California 1149 S Hill St Los Angeles CA 90015 951642394 501(c)(3) 75000 Project Support UNIVERSITY OF TENNESSEE 910 Madison Ave Memphis TN 38163 626001636 501(c)(3) 24101 PassThrough Fed Proj UNIVERSITY OF TEXAS 7000 Fannin Houston TX 77030 741761309 501(c)(3) 79561 PassThrough Fed Proj University of the Pacific 3200 Fifth Ave Sacramento CA 95817 941156266 501(c)(3) 84999 Project Support UNIVERSITY OF WASHINGTON 4333 Brooklyn Avenue NE Seattle WA 98195 916001089 501(c)(3) 77494 PassThrough Fed Proj UpValley Family Centers of Napa Valley 1500 Cedar St Calistoga CA 94515 800023012 501(c)(3) 20000 Project Support Urban Comm Act Proj dba Health to Hope 2880 Hulen Place Riverside CA 92057 043656147 501(c)(3) 25000 Project Support Urban Compass 11100 S Central Ave Los Angeles CA 90059 202438382 501(c)(3) 15000 Project Support Urban Habitat Program 2000 Franklin St Oakland CA 94612 200275424 501(c)(3) 90000 Project Support Urban Life Ministries Incorporated 4391 El Cajon Blvd San Diego CA 92105 272778158 501(c)(3) 20000 Project Support Urban Tilth 31 Maine Ave Richmond CA 94804 204124161 501(c)(3) 36616 Project Support Vacaville Neighborhood Boys & Girls Club 100 Holly Ln Vacaville CA 95688 134223488 501(c)(3) 25000 Project Support Vallejo City Unified School District 665 Walnut Ave Vallejo CA 94592 680111380 Government or P 51371 Project Support Valley Community Healthcare 6801 Cdwtr Cny Av North Hollywood CA 91605 237050082 501(c)(3) 22250 Event Support\Annual Fundraiser Valley Economic Development Center 5121 Van Nuys Blvd Van Nuys CA 91403 953139419 501(c)(3) 10000 Project Support Valley Family Center 302 S Brand Blvd San Fernando CA 91340 954105054 501(c)(3) 10000 Project Support Valley Health Team Inc 21890 W Colorado Ave San Joaquin CA 93660 942217261 501(c)(3) 324928 Project Support Valley Village 20830 Sherman Way Winnetka CA 91306 237314159 501(c)(3) 15000 Project Support VCCool 1150 N Ventura Ave 101 Ventura CA 93001 262180702 501(c)(3) 8155 Project Support Venice Community Housing Corporation 720 Rose Ave Venice CA 90291 954200761 501(c)(3) 10000 Project Support Venice Family Clinic 604 Rose Ave Venice CA 90291 952769432 501(c)(3) 98500 Event Support\Annual Fundraiser Verde 6899 NE Columbia Blvd A Portland OR 97218 203685723 501(c)(3) 50000 Project Support Via Care Community Health Center 607 S Atlantic Blvd Los Angeles CA 90022 800699156 501(c)(3) 10000 Project Support Victor Valley College Dist Fdn Inc 18422 Bear Valley Rd Victorville CA 92395 510141667 501(c)(3) 25000 Responsive VIP Community Mental Health Center Inc 1721 Griffin Ave Los Angeles CA 90031 300017808 501(c)(3) 10000 Project Support Virginia Garcia Memorial Foundation PO Box 6149 Aloha OR 97007 912077840 501(c)(3) 65000 Project Support Vision To Learn 11611 San Vic Bl Los Angeles CA 90049 453457853 501(c)(3) 50000 Project Support Vision Y Compromiso 1000 N Alameda St Los Angeles CA 90012 320071651 501(c)(3) 175000 Project Support Vista Hill Foundation 8910 Clrmnt Mesa Bl San Diego CA 92123 951944230 501(c)(3) 16000 Project Support Voices for Children 2851 Meadow Lark Drive San Diego CA 92123 953786047 501(c)(3) 10000 Project Support Volunteer Center of Sonoma County Inc 153 Stony Circle 101 Santa Rosa CA 95401 941751375 501(c)(3) 50000 Project Support Volunteer Centers of Santa Cruz County 1740 17th Ave Santa Cruz CA 95062 941702678 501(c)(3) 10000 Project Support Volunteers in Medicine - San Francisco 4877 Mission St San Francisco CA 94112 262593712 501(c)(3) 29800 Project Support Volunteers In Medicine Clinic 2260 Marcola Rd Springfield OR 97477 931276816 501(c)(3) 28000 Project Support Volunteers of America 3910 SE Stark St Portland OR 97214 930395591 501(c)(3) 30000 Project Support WalkSanDiego 1111 Sixth Ave 402 San Diego CA 92101 460505205 501(c)(3) 77000 Project Support Wall-Las Memorias Project 5619 Monte Vista St Los Angeles CA 90042 954468225 501(c)(3) 8200 General Operating Support Walnut Ave Family & Women's Center 303 Walnut Ave Santa Cruz CA 95060 941186197 501(c)(3) 19000 Project Support Washington State University PO Box 641025 Pullman WA 99164 916001108 Government or P 87287 Project Support Watts Healthcare Corporation 10300 Compton Ave Los Angeles CA 90002 753046480 501(c)(3) 33502 Project Support WEAVE Incorporated 1900 K St Sacramento CA 95811 942493158 501(c)(3) 20000 Project Support Weingart Center Association 566 S San Pedro St Los Angeles CA 90013 956054617 501(c)(3) 10000 General Operating Support Well in the Desert 588 Rosa Parks Rd Palm Springs CA 92262 330694580 501(c)(3) 25000 Project Support Well of Healing Mobile Medical Clinic 7625 East Ave Fontana CA 92336 330831503 501(c)(3) 20000 General Operating Support WellSpace Health 777 12th St 250 Sacramento CA 95814 941713704 501(c)(3) 475768 Project Support West Angeles Comm Dev Corp 6028 Crenshaw Blvd Los Angeles CA 90043 954486925 501(c)(3) 10000 Project Support West County Community Services 16390 Main St Guerneville CA 95446 942277740 501(c)(3) 25000 Project Support West County Health Centers Inc 14045 Mill St Guerneville CA 95446 237310613 501(c)(3) 250000 Capital Fund Support West Covina Unified School District 1717 W Merced Ave West Covina CA 91790 956003481 Government or P 11415 Project Support WestCoast Children's Clinic 330 E 12th St 259 Oakland CA 94601 942553319 Government or P 150000 Project Support Western University of Health Sciences 309 E 2nd St Pomona CA 91766 953127273 501(c)(3) 75000 Project Support Westminster Free Clinic 5560 Napoleon Ave Oak Park CA 91377 770563241 501(c)(3) 20000 Project Support Westside Community Services 1153 Oak St San Francisco CA 94117 941164909 501(c)(3) 10000 Event Support\Dinner Westside Family Health Center 1711 Ocean Park Blvd Santa Monica CA 90405 952931931 501(c)(3) 19000 Project Support Whittier Area First Day Coalition 12426 Whittier Blvd Whittier CA 90602 931141844 501(c)(3) 10000 Project Support Wilmington Community Clinic 1009 N Avalon Blvd Wilmington CA 90744 953137803 501(c)(3) 12500 Event Support\Dinner WIND Youth Services 8001 Folsom Blvd Sacramento CA 95826 237348227 501(c)(3) 30000 Project Support WINDS Foundation Inc 14082 Baker St Westminister CA 92683 271404608 501(c)(3) 10000 Project Support Wise & Healthy Aging 1527 4th St 2nd fl Santa Monica CA 90401 952788014 501(c)(3) 38900 Event Support\Annual Fundraiser Women Against Gun Violence 10401 Venice Blvd Los Angeles CA 90034 954738754 501(c)(3) 9580 Event Support\Annual Fundraiser Women Crowned In Glory Corporation 7120 Hayvenhurst Ave Van Nuys CA 91406 954808038 501(c)(3) 8155 Project Support Women Helping Women 1800 E McFadden Ave Santa Ana CA 92705 330576900 501(c)(3) 50000 Project Support Womens Breast Cancer Resource Center 27645 Jefferson Ave Temecula CA 92590 330951216 501(c)(3) 16000 Project Support Women's Empowerment 1590 N A St Sacramento CA 95811 030520643 501(c)(3) 10000 Project Support Womens Foundation Of California 510 16th St Oakland CA 94612 942752421 501(c)(3) 53440 Conference Support Woodland Action Center 736 Davidson Ave Woodland WA 98674 912105285 501(c)(3) 15000 Project Support Working Wardrobes for a New Start 1851 Kettering St Irvine CA 92614 330669145 501(c)(3) 35400 Project Support WorldWideWomen Foundation 100 Tiburon Blvd Mill Valley CA 94941 352534984 501(c)(3) 9000 Other;Conference Support YALE UNIVERSITY 47 College Street New Haven CT 06520 060646973 501(c)(3) 71367 PassThrough Fed Proj YMCA of San Diego County 3601 Arey Drive San Diego CA 92154 952039198 501(c)(3) 10000 Project Support YMCA of San Francisco 50 California St San Francisco CA 94111 940997140 501(c)(3) 45000 Project Support YMCA of Silicon Valley 80 Saratoga Ave Santa Clara CA 95051 941156318 501(c)(3) 50000 Project Support YMCA of the East Bay 322 Harbour Way 10 Richmond CA 94801 941156317 501(c)(3) 134500 Project Support Yng Mens Christ Assoc of Burbank CA 321 E Magnolia Blvd Burbank CA 91502 951664139 501(c)(3) 8000 Project Support Yng Mens Christ Assoc of Gtr Long Beach 5835 E Carson St Lakewood CA 90713 951663396 501(c)(3) 20000 Project Support Yng Men's Christ Assoc of Metropolitan LA 11531 Downey Ave Downey CA 90277 951643352 501(c)(3) 96000 Project Support Yolo County Childrens Alliance 600 A St Y Davis CA 95616 680526185 501(c)(3) 100000 Project Support Yolo Healthy Aging Alliance 600 A St C Davis CA 95616 461075195 501(c)(3) 10000 Project Support Young & Healthy 136 W Peoria St Pasadena CA 91103 954527969 501(c)(3) 5500 Event Support\Annual Fundraiser Youth ALIVE 3300 Elm St Oakland CA 94609 943143254 501(c)(3) 138600 Project Support Youth Leadership Institute 910 Irwin St San Rafael CA 94901 680184712 501(c)(3) 30000 Project Support Youth Outside 436 14th St 1209 Oakland CA 94612 800565914 501(c)(3) 150000 Project Support Youth Policy Institute 6464 Sunset Blvd Los Angeles CA 90028 521278339 501(c)(3) 20000 Project Support Youth Radio 1701 BRdway Oakland CA 94612 943180825 501(c)(3) 222500 Project Support Youth Speaks Inc 1663 Mission St San Francisco CA 94103 912134499 501(c)(3) 26100 Event Support\Cultural Event Youth Uprising 8711 MacArthur Blvd Oakland CA 94605 203321544 501(c)(3) 307500 Project Support YWCA of San Diego County 1012 C St San Diego CA 92101 951661119 501(c)(3) 10000 Project Support YWCA of San Gabriel Valley 943 N Grand Ave Covina CA 91724 951641967 501(c)(3) 11000 Project Support ZERO BREAST CANCER 30 N San Pedro Rd San Rafael CA 94903 680386016 501(c)(3) 46850 PassThrough Fed Proj 1085 5 Scholarships 587 1181500 SCHEDULE I, PART I, LINE 2 Grantees are required to submit a final report that describes progress towards goals, impact to date, as well as financial accounting for how funds were used. true true false false false false false true false Gregory Adams EVP, Group President 0 1049401 0 1616205 0 376889 0 3517776 0 28867 0 6589138 0 0 Ramon F Baez Director 0 204500 0 0 0 12456 0 0 0 0 0 216956 0 0 Mary Barnes Region President - Hawaii 0 317207 0 611781 0 142581 0 13250 0 16353 0 1101172 0 0 Anthony Barrueta SVP, Government Relations 0 458177 0 633570 0 262666 0 375259 0 20965 0 1750637 0 177089 Raymond Baxter SVP, CB Research & Hlth Policy 0 0 0 676852 0 348637 0 0 0 0 0 1025489 0 331848 Kristin Bear Assistant Secretary 0 224693 0 116173 0 5146 0 124717 0 17556 0 488285 0 0 Vanessa Benavides SVP, Chief Comp & Priv Officer 0 391760 0 437497 0 94037 0 172275 0 18646 0 1114215 0 86809 Regina M Benjamin MD MBA Director 0 187000 0 0 0 8085 0 0 0 0 0 195085 0 0 Charles Bevilacqua SVP, HP Products, Svc & Admin 0 558377 0 777537 0 185643 0 285847 0 22264 0 1829668 0 124859 Chandrika Bhalla SVP, CFO - NCAL 0 420443 0 341106 0 18038 0 165398 0 25811 0 970796 0 0 Maryann Bodayle Assistant Secretary 0 151515 0 18654 0 2195 0 38051 0 10138 0 220553 0 0 Christopher Boyd SVP & Area Mgr - Santa Clara 0 386112 0 223224 0 23559 0 153483 0 23823 0 810201 0 0 Lisa L Caplan SVP, Care Delivery Tech Svcs 0 372450 0 423365 0 38953 0 204736 0 11055 0 1050559 0 0 William Caswell Interim Regional President -HI 0 503757 0 363713 0 642103 0 125073 0 21328 0 1655974 0 424433 Bechara Choucair SVP,Community Health & Benefit 0 486899 0 150000 0 318790 0 167564 0 20759 0 1144012 0 0 Greg Christian SVP, Area Manager - Fontana 0 367602 0 174393 0 20709 0 204801 0 25621 0 793126 0 0 Judith Coffey SVP & Area Mgr - Marin/Sonoma 0 351811 0 239985 0 45310 0 137502 0 23868 0 798476 0 0 Jeffrey Collins SVP & Area Manager - Roseville 0 397347 0 276446 0 97132 0 188322 0 25082 0 984329 0 56942 Charles Columbus SVP, Chief HR Officer 0 566222 0 980775 0 310816 0 300458 0 35618 0 2193889 0 263974 Diane Comer SVP, Bus Info Officer - HP 0 371312 0 514143 0 39993 0 197749 0 23323 0 1146520 0 0 Mark Costa SVP, Area Mgr - Orange County 0 370278 0 229615 0 39972 0 184044 0 22517 0 846426 0 0 Patrick Courneya EVP, Chief Medical Officer 0 518855 0 657633 0 43597 0 610234 0 20321 0 1850640 0 0 Richard Daniels EVP, CIO 0 725531 0 1040625 0 48253 0 113239 0 33470 0 1961118 0 0 George Disalvo SVP, CFO - SCAL 0 533322 0 611188 0 276453 0 142465 0 19849 0 1583277 0 193426 Jeffery E Epstein Director 0 202000 0 0 0 7793 0 0 0 0 0 209793 0 0 Elizabeth Finley SVP, Area Manager - San Diego 0 375174 0 200299 0 87384 0 251926 0 21069 0 935852 0 0 Jerry Fleming SVP, Health Reform Implement 0 0 0 42033 0 328297 0 72706 0 0 0 443036 0 323172 Deborah Friberg SVP & Area Mgr -Central Valley 0 196616 0 162900 0 18480 0 56575 0 12088 0 446659 0 0 Daniel Garcia SVP, Chief Compliance Officer 0 0 0 537870 0 55559 0 0 0 0 0 593429 0 45739 Edward Glavis SVP & Area Mgr - Roseville 0 0 0 25000 0 89090 0 0 0 0 0 114090 0 82282 Sandra Golze Assistant Secretary - NCAL 0 132508 0 214499 0 27642 0 209266 0 11111 0 595026 0 0 Bernice Gould Assistant Secretary 0 175937 0 33715 0 2271 0 109987 0 9735 0 331645 0 0 George Halvorson Chairman 0 0 0 0 0 28956 0 25716 0 0 0 54672 0 17874 Thomas Hanenburg SVP & Area Mgr - GSAA 0 449548 0 230924 0 39750 0 132652 0 23980 0 876854 0 0 Corwin Harper SVP & Area Mgr - Napa/Solano 0 343408 0 150563 0 104410 0 185148 0 27787 0 811316 0 71218 Leslie S Heisz Director 0 204500 0 0 0 16511 0 0 0 0 0 221011 0 0 David F Hoffmeister Director 0 217000 0 0 0 11956 0 0 0 0 0 228956 0 0 Kimberly Horn Regional President - MAS 0 582580 0 851203 0 26042 0 656818 0 30697 0 2147340 0 0 Judith A Johansen JD Director 0 230667 0 0 0 14556 0 0 0 0 0 245223 0 0 Kim J Kaiser Director 0 216667 0 0 0 12545 0 0 0 0 0 229212 0 0 Marilyn Kawamura Region President - MAS 0 0 0 0 0 209165 0 0 0 0 0 209165 0 204199 Kathryn Lancaster EVP & CFO 0 896255 0 1578456 0 359536 0 868611 0 20475 0 3723333 0 Wendy L Lee SVP, Corp Svcs & Digital Tech 0 360131 0 390267 0 112627 0 213093 0 23061 0 1099179 0 75920 Janet Liang Regional President - NCAL 0 749954 0 668436 0 43292 0 511444 0 30002 0 2003128 0 0 R Roland Lyon Regional President - Colorado 0 486619 0 306884 0 97673 0 337370 0 27595 0 1256141 0 49723 Gerald Mccall SVP Operations 0 473914 0 401723 0 118637 0 206249 0 30739 0 1231262 0 22350 Andrew Mcculloch Regional President - Northwest 0 253998 0 1067227 0 2839558 0 152671 0 15244 0 4328698 0 2174291 Colleen Mckeown SVP & Area Mgr - Diablo 0 379663 0 198795 0 404921 0 214304 0 21220 0 1218903 0 316494 Thomas Meier SVP, Corporate Treasurer 0 415802 0 569121 0 140172 0 161620 0 29547 0 1316262 0 32787 Julie Miller-Phipps Regional President - SCAL 0 775317 0 538030 0 205263 0 274104 0 21025 0 1813739 0 0 Susan Mullaney Regional President - WA 0 481871 0 677978 0 294443 0 216652 0 29812 0 1700756 0 0 Janet O'Hollaren INTERIM REGIONAL PRESIDENT- NW 0 377410 0 124794 0 19886 0 337107 0 24463 0 883660 0 0 Donald Orndoff SVP, NFS 0 425896 0 521871 0 26390 0 198216 0 32219 0 1204592 0 0 Nathaniel Oubre VP, CA MediCal, CHIP & CHC 0 308312 0 186809 0 61862 0 212568 0 19308 0 788859 0 Wade Overgaard SVP, Health Plan Ops - CA 0 547681 0 773035 0 150654 0 246132 0 31585 0 1749087 0 3341 Edward Y W Pei Director 0 214000 0 0 0 13488 0 18000 0 0 0 245488 0 0 Margaret E Porfido JD Director 0 254167 0 0 0 18848 0 0 0 0 0 273015 0 0 J Neal Purcell Director 0 11000 0 0 0 37745 0 0 0 0 0 48745 0 20937 Frank Richardson Assistant Secretary - HI 0 218969 0 81211 0 11817 0 114131 0 27182 0 453310 0 0 Christine Robisch SVP, CHIEF ADMIN. OFFICER 0 412949 0 307199 0 109422 0 283926 0 15499 0 1128995 0 70606 Rochelle Roth Assistant Secretary 0 130910 0 81317 0 23137 0 186070 0 14720 0 436154 0 0 Michael Rowe SVP, CFO - NCAL 0 605284 0 680986 0 23276 0 321006 0 26365 0 1656917 0 0 Kathleen Marie Scheirman SVP, Application Svcs Group 0 414303 0 439717 0 22582 0 161791 0 22441 0 1060834 0 0 Jacqueline Sellers Assistant Secretary 0 185684 0 74361 0 27543 0 157570 0 13506 0 458664 0 0 Nirav Shah SVP, COO Clinical Operations 0 448192 0 363669 0 104648 0 13250 0 20709 0 950468 0 0 Richard Shannon MD Director 0 190000 0 0 0 0 0 18000 0 0 0 208000 0 0 James Simpson REGIONAL PRESIDENT - GA 0 437730 0 592170 0 414564 0 327996 0 25123 0 1797583 0 91191 Arthur Southam EVP, Health Plan Operations 0 922115 0 1690487 0 618288 0 742216 0 34096 0 4007202 0 245168 Deborah Stokes SVP,Corporate Controller & CAO 0 0 0 156115 0 9281 0 0 0 0 0 165396 0 0 Michael Sutten SVP, Info Technology & CTO 0 400903 0 521644 0 168181 0 154323 0 27840 0 1272891 0 24333 Paul Swenson SVP & Chief Strategy Officer 0 598720 0 582757 0 290877 0 256387 0 28497 0 1757238 0 166466 Cynthia A Telles PHD Director 0 222000 0 0 0 11956 0 0 0 0 0 233956 0 0 Bernard Tyson Chairman & CEO 0 1436935 0 7978527 0 1294041 0 5335702 0 37548 0 16082753 0 Alfonse Upshaw SVP,Corporate Controller & CAO 0 378040 0 311757 0 149402 0 141409 0 26652 0 1007260 0 98416 Max Villalobos COO - North County 0 336073 0 161161 0 63175 0 179914 0 18878 0 759201 0 53078 Cesar Villalpando SVP, Enterprise Shared Svcs 0 286752 0 499438 0 30622 0 197165 0 13614 0 1027591 0 0 Eugene Washington MD Director 0 193000 0 0 0 495 0 0 0 0 0 193495 0 0 Vita Willett SVP, Area Manager - Riverside 0 367591 0 194002 0 22635 0 317292 0 20504 0 922024 0 0 Nancy Wollen SVP, Chief Operating Officer 0 0 0 76648 0 372849 0 54789 0 35122 0 539408 0 0 John Yamamoto Assistant Secretary 0 341726 0 243696 0 83755 0 200009 0 25962 0 895148 0 18538 Philip Young Assistant Secretary 0 282789 0 180142 0 16448 0 165852 0 25624 0 670855 0 0 Hong-Sze Yu VP, Brd & Corp Gov & Asst Secy 0 225517 0 88592 0 16828 0 155892 0 23735 0 510564 0 0 Carlos Zaragoza Assistant Secretary 0 0 0 114383 0 49593 0 0 0 0 0 163976 0 37869 Victoria Zatkin VP, Off of Brd & Corp Gov Svcs 0 0 0 20815 0 84463 0 0 0 0 0 105278 0 81430 Mark Zemelman SVP, General Counsel & Secy 0 577508 0 1031758 0 838649 0 190188 0 31709 0 2669812 0 556159 Schedule J, Part I, Line 3 METHODS USED TO ESTABLISH COMPENSATION OF CEO/EXECUTIVE DIRECTOR: THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THE METHODS DESCRIBED BELOW TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF A RELATED ORGANIZATION. SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS: Nirav Shah $ 89,400 Nancy Wollen 338,460 LISTED PERSONS PARTICIPATED IN ARRANGEMENTS ENTITLING THEM TO SEVERANCE BENEFITS IN THE EVENT OF TERMINATION BY THE ORGANIZATION WITHOUT CAUSE OR DUE TO JOB ELIMINATION. DEPENDING ON POSITION LEVEL, TENURE, AND TERMINATION REASON, SEVERANCE BENEFITS PAYABLE UNDER THESE ARRANGEMENTS PROVIDE FOR PAY AND HEALTH BENEFITS CONTINUATION PLUS PAYMENT OF ACCRUED OBLIGATIONS. IN ADDITION, FOR SOME OF THE LISTED PERSONS, SEVERANCE BENEFITS PAYABLE INCLUDE PRORATED INCENTIVE AWARDS FOR PERFORMANCE PERIODS NOT YET ENDED. NONE OF THE LISTED PERSONS PARTICIPATED IN ARRANGEMENTS ENTITLING THEM TO CHANGE-OF-CONTROL PAYMENTS. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS: Gregory Adams $ 325,791 Mary Ann Barnes 116,452 Anthony Barrueta 222,051 Charles Bevilacqua 162,240 William Caswell 510,463 Jeffrey Collins 73,296 Charles Columbus 263,974 George Disalvo 233,501 Elizabeth Finley 49,331 Jerry C. Fleming 323,172 Edward Glavis 35,663 Corwin Harper 86,685 Marilyn Kawamura 13,196 Kathryn Lancaster 309,860 Wendy L. Lee 93,126 R. Roland Lyon 74,917 Gerald Mccall 86,822 Andrew McCulloch 2,806,490 Colleen Mckeown 383,137 Thomas Meier 97,965 Julie Miller-Phipps 151,668 Nathaniel Oubre 43,389 Wade Overgaard 124,888 Christine Robisch 88,758 James Simpson 111,182 Arthur Southam 568,315 Paul Swenson 243,792 Bernard Tyson 789,552 Alfonse Upshaw 129,022 Max Villalobos 55,732 John Yamamoto 65,932 Victoria Zatkin 81,430 Mark Zemelman 773,564 SOME OF THE PARTICIPANTS LISTED IN SCHEDULE J, PART II PARTICIPATED IN NONQUALIFIED SUPPLEMENTAL RETIREMENT PLANS. UNDER THESE PLANS, THE ORGANIZATION MAKES ANNUAL CONTRIBUTIONS TO A NOTIONAL ACCOUNT ON BEHALF OF EACH PARTICIPANT. CONTRIBUTIONS VARY BY POSITION, LEVEL AND PAY, AND VEST OVER TIME BASED ON AGE AND/OR SERVICE. PARTICIPANT ACCOUNTS ARE CREDITED WITH A FIXED RATE OF INTEREST, INVESTED IN AVAILABLE MUTUAL FUNDS OR A COMBINATION OF BOTH. CERTAIN OFFICERS ACCRUE A BENEFIT THAT VESTS BASED ON AGE AND SERVICE AND TARGETS A PERCENTAGE OF FINAL AVERAGE PAY LESS PRIOR PLAN OFFSETS. UNVESTED AMOUNTS ARE SUBJECT TO RISK OF FORFEITURE. Schedule J, Part I, Line 7 Non-fixed payments: THE ORGANIZATION PROVIDED NON-FIXED PAYMENTS TO SOME OF THE PERSONS LISTED. PAYMENTS WERE MADE UNDER INCENTIVE PLANS, BASED ON ATTAINMENT OF ORGANIZATIONAL PERFORMANCE GOALS AND INDIVIDUAL PERFORMANCE, DESIGNED TO SUPPORT THE ORGANIZATION'S MISSION TO PROVIDE HIGH-QUALITY, AFFORDABLE CARE AND IMPROVE THE HEALTH OF ITS MEMBERS AND THE COMMUNITIES IT SERVES. Schedule J, Part II, Column F AMOUNTS INCLUDED IN SCHEDULE J, PART II, COLUMN F INCLUDE AMOUNTS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION, AS WELL AS, DISTRIBUTIONS FROM A 457(B) PLAN THAT WERE PREVIOUSLY REPORTED AS REPORTABLE COMPENSATION IN ACCORDANCE WITH FORM 990 INSTRUCTIONS. A 2003 CALIFORNIA STATEWIDE CMNTYS DEV AUTH 521598225 130911RW2 2003-08-06 213060000 PAR REFUNDING CHFFA 83,85,93 SER C false false false B 2004 CALIFORNIA STATEWIDE CMNTYS DEV AUTH 680164610 130911WF3 2004-03-30 1600000000 FINANCE HEALTH CARE FACILITIES false false false C 2006 CSCDA CHFFA Variable 521643828 13033FK74 2006-06-08 600000000 FINANCE HEALTH CARE FACILITIES false false false D 2008 CALIFORNIA STATEWIDE CMNTYS DEV AUTH 680164610 130795SZ1 2008-05-01 500000000 PAR REFUNDING 04A-D ARS BONDS& 04H false false false A 60000000 0 213060000 0 0 0 0 0 0 0 213060000 0 true false true true B 800000000 0 1639884612 0 88159219 0 6375000 10073543 0 1535276850 0 0 2009 false false true true C 0 0 602245616 0 5674726 0 0 0 0 596570889 0 0 2009 false false true true D 237500000 0 500000000 0 0 0 0 0 0 0 500000000 0 true false true true A 0 B false true true false true false 0 false false false true C false true true false true false 0 false false false true D false true true false true false 0 false false false true A false true true false 0 false 0 false true B false true true false 0 false 0 true true C false true true false 0 false 0 false true D false true true false 0 false 0 false true A true B true C true D true PART I: 2006 CSCDA / CHFFA Variable have multiple issuers and therefore multiple EIN numbers. The EIN number reported matched the reported CUSIP. PART II, LINE 1: We will continue to report the 2009 put rolls of the 2008C and 2002E bonds as the current outstanding debt, with the amount of premium from their sales shown in Part II, Line 1, "Amount of bonds retired". PART II, LINE 3: Difference between total proceeds (Part II Line 3) and issue price (Part I), for all applicable bond issues, is due to interest earned on the construction fund. PART III, LINES 4 AND 5: At bond-financed facilities, there is 0% private use reported due to a policy of maintaining adequate equity contributions at each facility. PART IV, LINE 2C: BOND ISSUER NAME: 2004 CALIFORNIA STATEWIDE CMNTYS DEV AUTH REBATE DATE COMPUTATION WAS PERFORMED: 01/14/2009 BOND ISSUER NAME: 2002 CALIFORNIA STATEWIDE CMNTYS DEV AUTH REBATE DATE COMPUTATION WAS PERFORMED: 11/27/2012 A 2009 CALIFORNIA STATEWIDE CMNTYS DEV AUTH 680164610 130795D38 2009-06-03 1638437048 FINANCE HEALTH CARE FACILITIES false false false B 2002 CALIFORNIA STATEWIDE CMNTYS DEV AUTH 680164610 130911LD0 2009-06-01 99996058 REOFFERING OF 2002E CSCDA (PREMIUM false false false C 2008 CALIFORNIA STATEWIDE CMNTYS DEV AUTH 680164610 130795TP2 2009-05-29 149996162 REOFFERING OF 2008C CSCDA (PREMIUM false false false D 2012 CALIFORNIA STATEWIDE COMNTYS DEV AUTH 680164610 1307955G8 2012-04-18 1007791119 FINANCE HEALTH CARE FACILITIES false false false A 609030000 0 1639188993 0 71262216 0 0 0 0 1567926777 0 0 2011 false false true true B 2716058 0 99996058 0 0 0 0 0 0 0 99996058 0 true false true true C 3131162 0 149996162 0 0 0 0 0 0 0 149996162 0 true false true true D 100000000 0 1007791119 0 0 0 0 0 0 1007791119 0 0 2014 false false true true A false true true false true false 0 false false false true B false true true false true false 0 false false false true C false true true false true false 0 false false false true D false true true false true false 0 false false false true A false true true false 0 false 0 false true B false true true false 0 false 0 false true C false true true false 0 false 0 false true D false true true false 0 false 0 false true A true B true C true D true A 2017 CALIFORNIA HEALTH FACILITIES FINANCING AUTH 521643828 13032UMQ8 2017-05-03 1528834768 REFUNDING OF PROJECTS (2002C,2011, false false false B 2017 CALIFORNIA HEALTH FACILITIES FINANCING AUTH 521643828 13032UMP0 2017-05-03 812493279 FINANCE HEALTH CARE FACILITIES false false false A 0 0 1528834768 0 0 0 41768 0 0 0 1528793000 0 true false true true B 0 0 812511867 0 0 0 0 0 0 812511867 0 0 false false false true A false true true false true false 0 false false false true B false true true false true false 0 false false false true A false true true false 0 false 0 false true B false true false false 0 false 0 false true A true B true ANGELA PATRICIA BENNAGE FAM. Mbr OF Fmr Key Empl. 154400 COMPENSATION false KIM B KURTH FAMILY MEMBER OF OFFICER 191587 COMPENSATION false CAROL MCMENAMY FAMILY MEMBER OF KEY EMPLOYEE 153423 COMPENSATION false JOSHUA SCRUGGS FAM. Mbr OF Fmr Key Empl. 106985 COMPENSATION false CHRIS ZIPPERT FAMILY MEMBER OF KEY EMPLOYEE 84788 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 5793318 BUSINESS TRANSACTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 7488011 BUSINESS TRANSACTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 2169756 BUSINESS TRANSACTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 182096 BUSINESS TRANSACTION false FORM 990, PART V, LINE 4B - FOREIGN COUNTRIES CONTINUED INDIA INDONESIA ISRAEL JAPAN KENYA REPUBLIC OF KOREA MALAYSIA NIGERIA PAKISTAN PHILIPINES POLAND TAIWAN THAILAND TURKEY URUGUAY FORM 990, PART VI, LINE 1A The Executive Committee, composed of the Directors that are the chairs of the Board's other standing committees, has authority to act for the Board between meetings except it has no authority to: a. Fill vacancies on the Board or the Committee; b. Fix the compensation of Directors for serving on the Board or any committee; c. Adopt, amend or repeal Bylaws; d. Amend or repeal any resolution of the Board which by its express terms cannot be amended or repealed by the Executive Committee; e. Appoint committees of the Board or appoint the members thereof; or f. Approve any aspect of a transaction involving the company when a Director has a material financial interest in that transaction, except as expressly provided by the law. FORM 990, PART VI, LINE 4 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: The Bylaws of the corporation were amended in 2017 with the following significant changes: On March 17, 2017, Article D, Sections D-7 and D-9 were amended to reflect that the Executive Vice President and Group President instead of the Executive Vice President and Chief Financial Officer shall perform the duties of the President in the absence or disability of the President. On June 15, 2017, Article E, Sections E-8.C.3.a and b were amended to reflect that the Charter of the Finance Committee was amended to (a) increase the Board approval threshold for all land purchases and (b) exclude routine facility lease renewals with no material changes from requiring Board approval. On September 8, 2017, Article E, Section E-10.B.3.a was amended to reflect that the Charter of the Quality and Health Improvement Committee was amended to update the name of The Joint Commission as an accrediting body. On December 1, 2017, Article E, Sections E-8.C.3.a, b and e were amended to reflect that the Charter of the Finance Committee was amended to increase the Board approval threshold for all capital expenditures, property and equipment leases, and purchase, sale and closure of subsidiaries or lines of business. FORM 990, PART VI, LINE 5 DIVERSION OF ASSETS THEFT OF COMPUTER EQUIPMENT VALUED AT $1.1 MILLION DOLLARS. MATTER HAS BEEN REFERRED TO LAW ENFORCEMENT. ADDITIONAL PROCUREMENT AND INVENTORY CONTROLS WERE IMPLEMENTED. PHYSICAL SECURITY WAS UPGRADED TO ENSURE ADEQUATE SECURITY MEASURES. TRAINING WAS PROVIDED. DEPARTMENT MONITORING AND INTERIM REPORTING WAS IMPLEMENTED. FORM 990, PART VI, LINE 11B Form 990 Review Process: 1. Key information necessary for the preparation of the tax return is obtained and/or confirmed with internal sources including regional finance, executive compensation, community benefits, treasury, government relations, and legal. 2. Prior to finalization, the return is reviewed by an external tax advisor. 3. Once signed by an external tax advisor, the return and underlying data are reviewed by an officer or a member of management designated by an officer for signature and filing. 4. Copies are then provided to board members prior to filing. FORM 990, PART VI, LINE 12C COMPLIANCE ENFORCEMENT A. REGULARLY AND CONSISTENTLY MONITORS COMPLIANCE WITH THE CONFLICTS OF INTEREST POLICY - KAISER PERMANENTE REGULARLY MONITORS COMPLIANCE WITH THE CONFLICTS OF INTEREST POLICY IN 3 KEY WAYS: A1. THE KAISER PERMANENTE COMPLIANCE HOTLINE IS AVAILABLE TO ALL EMPLOYEES AND VENDORS TO REPORT ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. ALL CALLS ARE ANSWERED BY A THIRD PARTY AND PROVIDED TO KAISER PERMANENTE'S NATIONAL COMPLIANCE OFFICE FOR REVIEW AND APPROPRIATE ACTION. EMPLOYEES CAN REPORT ANONYMOUSLY. RETALIATION IS PROHIBITED. REPORTS OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST ARE GENERATED AND INVESTIGATIONS ARE CONDUCTED AS REQUIRED AND INFORMATION IS TRACKED AND TRENDED TO DETERMINE IF ADDITIONAL GUIDANCE IS REQUIRED TO AVOID OR MANAGE CONFLICTS OF INTEREST. COMPLIANCE HOTLINE REPORTS ARE PROVIDED FOR REVIEW AND ACTION TO THE KAISER FOUNDATION HEALTH PLAN/HOSPITALS BOARDS OF DIRECTORS ANNUALLY. A2. THE NATIONAL COMPLIANCE OFFICE AND INTERNAL AUDIT SERVICES ANNUALLY REVIEW THE DIRECTORS', OFFICERS', KEY EMPLOYEES', AND EXECUTIVES' ANNUAL CONFLICTS OF INTEREST QUESTIONNAIRE DISCLOSURES AND PROVIDE DIRECTION ON ANY INVESTIGATIONS REQUIRED. INVESTIGATIONS ARE DOCUMENTED, TRACKED AND TRENDED TO DETERMINE IF ADDITIONAL CONTROLS OR EDUCATION IS REQUIRED. IN ADDITION, CONFLICTS OF INTEREST QUESTIONNAIRE REPORTS ARE PROVIDED FOR REVIEW AND ACTION TO THE KAISER FOUNDATION HEALTH PLAN/HOSPITALS BOARDS OF DIRECTORS ANNUALLY; AND A3. ANNUALLY, AS A COMPONENT OF THE EXTERNAL AUDIT, AN OUTSIDE CERTIFIED PUBLIC ACCOUNTING FIRM REVIEWS THE ANNUAL CONFLICTS OF INTEREST QUESTIONNAIRES PROCESS COMPLETED BY DIRECTORS, OFFICERS, KEY EMPLOYEES, AND EXECUTIVES, AND ACTIONS TAKEN AS A RESULT OF THE DISCLOSURES. THE RESULTS OF THE ANNUAL AUDIT, INCLUDING ANY FINDINGS IN THIS AREA ARE PRESENTED TO THE KAISER FOUNDATION HEALTH PLAN/HOSPITALS AUDIT AND COMPLIANCE COMMITTEE. B. REGULARLY AND CONSISTENTLY ENFORCES COMPLIANCE WITH THE CONFLICTS OF INTEREST POLICY - TO ENSURE CONSISTENCY IN THE ENFORCEMENT OF THE POLICY KAISER PERMANENTE USES THE FOLLOWING STEPS AS A GENERAL GUIDELINE: B1. REPRESENTED EMPLOYEES ARE SUBJECT TO ANY CORRECTIVE/DISCIPLINARY ACTION PROVISIONS DESCRIBED IN SPECIFIC REGIONAL/NATIONAL COLLECTIVE BARGAINING AGREEMENTS AND/OR ORGANIZATIONAL POLICIES AND PRACTICES. B2. KAISER PERMANENTE NOTIFIES EMPLOYEES OF THE NATIONAL HUMAN RESOURCES POLICY NO. 14. CORRECTIVE/DISCIPLINARY ACTION POLICY DURING NEW EMPLOYEE ORIENTATION AND IN ANNUAL COMPLIANCE TRAINING. B3. IN THE EVENT THAT IT IS NECESSARY TO DISCIPLINE ANY EMPLOYEE BECAUSE OF, BUT NOT LIMITED TO, FAILURE TO COMPLY WITH APPLICABLE LEGAL/REGULATORY REQUIREMENTS, KAISER PERMANENTE POLICIES AND PROCEDURES, OR THE PRINCIPLES OF RESPONSIBILITY, OR FOR UNSATISFACTORY PERFORMANCE OR MISCONDUCT, COACHING/COUNSELING AND/OR CORRECTIVE/DISCIPLINARY ACTION MAY INCLUDE, BUT IS NOT LIMITED TO: - ORAL DISCUSSION AND/OR WARNING BY THE EMPLOYEE'S IMMEDIATE SUPERVISOR OR HIGHER LEVEL MANAGER TO CORRECT THE PROBLEM; - WRITTEN NOTICE, WITH OR WITHOUT FINAL WARNING; - PAID OR UNPAID SUSPENSION, WITH OR WITHOUT FINAL WARNING; - TERMINATION OF EMPLOYMENT. FORM 990, PART VI, LINE 15A/B COMPENSATION DETERMINATION THE EXECUTIVE COMPENSATION PROGRAM AS ADMINISTERED BY KAISER FOUNDATION HEALTH PLAN, INC. IS DESIGNED TO RECRUIT, RETAIN AND MOTIVATE QUALIFIED SENIOR MANAGEMENT PERSONNEL. SENIOR MANAGEMENT PERSONNEL HAVE A SIGNIFICANT IMPACT ON THE STRATEGIC AND POLICY DIRECTION AND RESULTS OF THE ORGANIZATION. THEREFORE, THE EXECUTIVE COMPENSATION PROGRAM IS, TO A SIGNIFICANT DEGREE, PERFORMANCE-BASED. THE COMPENSATION PROGRAM IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND THE MANAGEMENT COMMITTEE ON COMPENSATION. PRIOR TO PAYMENT, ALL PROGRAMS AND PAYMENTS TO THE CEO, EXECUTIVE DIRECTOR, AND TOP MANAGEMENT OFFICIALS (EXECUTIVES) ARE REVIEWED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND THE MANAGEMENT COMMITTEE ON COMPENSATION. BASE PAY FOR EXECUTIVE POSITIONS IS ESTABLISHED AT A LEVEL COMPARABLE TO THE RELEVANT MARKET. IN ADDITION, OTHER COMPONENTS OF THE COMPENSATION PROGRAM BEAR 'AT-RISK' FEATURES DESIGNED TO FOCUS ON STRATEGICALLY IMPORTANT PERFORMANCE GOALS AND TO ASSIST IN ATTRACTING AND RETAINING TOP PERFORMERS. THE EXECUTIVE COMPENSATION PROGRAM IS TARGETED TO BE COMPETITIVE TO THE COMPARABLE EXTERNAL MARKET IN WHICH THE ORGANIZATION COMPETES FOR EXECUTIVE LEADERSHIP. EVALUATION OF COMPARABLE PAY DATA IS PERFORMED BY AN INDEPENDENT COMPENSATION, BENEFIT & HUMAN RESOURCES CONSULTING FIRM. THE COMPENSATION PROGRAM FOCUSES ON OBJECTIVES IN THE AREAS OF QUALITY OF MEMBER CARE AND SERVICE, MEMBERSHIP GROWTH, FINANCIAL SOUNDNESS, AND THE COMMUNITY AND SOCIAL MISSION OF THE ORGANIZATION. FORM 990, PART VI, LINE 18 Forms 990 are available on www.guidestar.org. FORM 990, PART VI, LINE 19 Public Inspection Copy: Governing documents, conflict of interest policy are available upon request as disclosed to other regulatory bodies. Financial Statements are on file with the state regulatory agency. Combined data is published for Kaiser Foundation Health Plan Inc. and subsidiaries and Kaiser Foundation Hospitals and Subsidiaries with independent auditors' report. To request copies contact: Vice President, Communication Kaiser Foundation Health Plan and Hospitals One Kaiser Plaza, 18th floor Oakland, CA 94612 FORM 990, PART VII, SECTION A, COLUMN B Hours for Related Organization: Individuals who are both officers and members of Boards of Directors work full time as employees as well as fulfill their board assignment. All officers work full time in their employee capacity. Full time work may require in excess of the traditional 40 hour week. Given the integrated nature of our organization, employees may provide support for various Kaiser Permanente companies. The average hours per week reported for the filing organization and related organizations was estimated. FORM 990, PART XI, LINE 9 Other Changes in Net Assets or Fund Balances: Change in donated capital $ 13,030,429 Change in inter-regional transfer (4,311,781) Change in dividends 2,776,729 Restricted Grants - CO 2,772,171 Change in pension and other retirement liabilities (1,559,574,010) Book tax difference in sub income (684,661) OTTI losses (318,819,079) Gain/loss on sale on investment - Book 1,225,265,665 Gain/loss on sale on investment - Tax (380,151,976) ------------------ TOTAL $ (1,019,696,513) FORM 990, PART III, LINES 4A-4D Legal Affiliation with Kaiser Foundation Health Plan, Inc. and its Subsidiaries Kaiser Foundation Hospitals (KFH) and Kaiser Foundation Health Plan, Inc. (KFHP, Inc.) and its four principal operating subsidiaries are separate corporations governed by identical boards of directors. KFH accepts responsibility to provide or arrange necessary inpatient services and facilities for members of health plans administered by KFHP, Inc. KFH owns and operates licensed hospitals in California, Hawaii and Oregon. These facilities provide emergency and inpatient services to all persons in the community, regardless of membership or ability to pay. Staff privileges are available on a nondiscriminatory basis to physicians in the communities served. KFH also contracts with other community hospitals to provide services to members for specialized care and other services. Kaiser Foundation Hospitals' Commitment to the Community: KFH's mission is to provide hospital, medical, and surgical care, including emergency services, extended care, and home health care to the public without regard to age, sex, race, religion, or national origin, or to the individual's ability to pay. KFH strives for excellence in serving its patients through market-leading performance in quality and service. As a nonprofit organization, Kaiser Foundation Hospitals is committed to improving the health of the communities beyond the population of patients served by its facilities. Annual investments in a range of Community Benefit programs are a fundamental embodiment of the organization's ongoing commitment to improve the general wellbeing within the broader community. These investments result in intentional, planned, measurable, and accountable benefits intended to address many of the health challenges faced at the individual, local, state, and national levels. The Affordable Care Act (ACA) enacted in 2010 codifies responsibilities that nonprofit hospital organizations such as KFH must satisfy in order to maintain their qualification as tax-exempt entities. One responsibility involves conducting a Community Health Needs Assessment (CHNA) at least once every three years at every licensed hospital facility. Kaiser Foundation Hospitals has completed similar needs assessments for many years to identify the needs and resources that guide our Community Benefit spending. The new federal legislation provides an opportunity to revisit assessment and planning processes with an eye toward enhancing compliance, transparency, efficiency, and utilization of emerging technologies. KFH's most recent CHNA process was undertaken in 2016. In 2016, KFH conducted a Community Health Needs assessment at each of its licensed hospital facilities. The primary needs which were identified in the prior CHNA were addressed between 2014 and 2016 with the assistance of a comprehensive set of Implementation Strategies (IS) for every facility. The IS reports describe the needs which each KFH facility has chosen to prioritize and the reasons why other needs are not being addressed during each three-year cycle. A full set of the CHNA assessments by facility as well as the related Implementation Strategy reports can be found at www.kp.org/chna. In 2007, the board of directors of Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals refined the focus of the organizations' Community Benefit programs and established the following four priority areas which have come to be known as "Streams of Work": A. Care and Coverage for Low-Income People - Creates and supports programs that lower the financial barriers for the under- and uninsured. B. Community Health Initiatives - Seeks to measurably improve the health of the communities we serve. Designs, delivers, and sustains long-term programs that engage communities in work to improve conditions in their neighborhoods. C. Safety Net Partnerships - Builds partnerships with community clinics, local health departments, and public hospitals. Provides funding, technical assistance, dissemination of care management and quality improvements technology to help improve care and expand treatment capacity for vulnerable populations. D. Developing and Disseminating Knowledge - Improves health care by sharing our knowledge - educating practitioners, advancing research, empowering consumers and informing policymakers about evidence-based care and health. In addition to Streams of Work above, KFH also made contributions to benefit the communities served in the following areas: E. Other Community Benefit Investments - support Community Benefit activities and programs beyond the national streams of work, including the administrative expenses of regional Community Benefit departments dedicated to supporting the organization's Community Benefit programs and services and coordinating related initiatives. F. Environmental Stewardship - protecting and improving the natural environment is a key component of KFH's mission to improve the health of the community it serves. Although costs associated with this initiative is not included in the dollars reported as Community Benefit investments, efforts in this area contributes to advancing a broader vision emphasizing healthy people and healthy environments while also improving health care quality and affordability. The following are details of the Community Benefit activities provided by Kaiser Foundation Hospitals: In 2017, Kaiser Foundation Hospitals expended approximately $1.2 billion (at cost, net of $1.1 billion of related revenues) to support Community Benefit activities. The following summarizes many of the signature Community Benefit programs and services grouped according to the national Streams of Work. A. Care and Coverage for Low-Income People Improving health care access for those with limited incomes and resources is fundamental to Kaiser Foundation Hospitals' mission. In 2017, the organization invested approximately $833 million (at cost, net of $1.0 billion of related revenues) to address the financing and delivery of health care for populations vulnerable due to socio-economic status, illness, ethnicity, age, or other factors. Program beneficiaries (under- and uninsured) received free or discounted care in a KFH facility. A.1. Charitable Care (Medical Financial Assistance and Charitable Health Coverage Programs) Kaiser Foundation Hospitals provides charity care to low-income vulnerable populations through the Medical Financial Assistance (MFA) and Charitable Health Coverage (CHC) programs. In 2017, KFH spent approximately $185 million (at cost, net of $15 million of related revenues) to support under- and uninsured patients treated in KFH facilities located in California, Hawaii, and Oregon. A.1.1. Medical Financial Assistance (MFA) Program Kaiser Foundation Hospitals' Medical Financial Assistance program provides financial assistance for emergency and medically necessary services, medications, and supplies to patients with a demonstrated financial need. Patients must receive health care services at facilities operated by Kaiser Foundation Hospitals and/or from a Kaiser Permanente provider. Eligibility is based upon prescribed levels of income to patients who have exhausted other private and public sources of support. In 2017, KFH provided $184.5 million (at cost, net of $300 thousand in related revenues) of services under this program. At KFH, patients who are eligible for medical financial assistance, but do not receive an MFA award, are not charged more than amounts generally billed. Contracted collection agency practices are aligned with the organization's social values and IRC section 501(r). Additionally, any patient experiencing financial hardship due to high medical expenses relative to their income level may qualify for the program under KP's high medical expense criteria. Eligibility for high medical expenses exists when the patient's incurred out-of-pocket medical and pharmacy expenses over the previous 12-month period is equal to or exceeds 10% of annual income. High medical expenses can apply to any income level. A.1.1.1. MFA Program Offered in California In California, KFH covers 100% of the out of pocket costs incurred by eligible patients. In 2017, KFH patients in California received full forgiveness for over 102,600 inpatient days of care under the MFA program. A.1.1.2. MFA Program Offered in Hawaii In Hawaii, KFH covers 100% of the out of pocket costs incurred by eligible patients. In 2017, KFH patients in Hawaii received full forgiveness for over 9,000 inpatient days of care under the MFA program. A.1.1.3. In July 2017, KFH assumed management of Maui County community hospitals and associated clinics from the state of Hawaii. In Maui, KFH covers 100% of the out of pocket costs incurred by eligible patients. A.1.1.4. MFA Program Offered in Oregon and Washington In Oregon and Washington, KFH covers 100% of the out of pocket costs incurred by eligible patients. In 2017, KFH patients in Oregon and Washington received full forgiveness for over 33,300 inpatient days of care under the MFA program. The MFA program in Oregon and Washington also covers full or partial expenses for dental services if applicants meet qualifying guidelines. KFH's Northwest region has known for 40 years that dental care is a crucial component of total health. Research has shown that dental care combined with medical care improves health outcomes for members and the bottom line for insurers. Patients without dental insurance regularly present to the medical system with acute dental problems. The overall medical system is not designed to handle these kinds of emergencies, but increased coordination between dental and medical care systems could lead to improved care, reduced costs, and better quality measure in all systems. To participate in this program, the patient must have annual gross household income no greater than 200 percent of the Federal Poverty Guidelines. Patients are only eligible for Dental Financial Assistance every other year. In, 2017 approximately 520 people received dental financial assistance. A.1.1.5. Community Medical Financial Assistance (CMFA) The MFA program also includes support for community based initiatives, known as Community Medical Financial Assistance (CMFA) programs. CMFA programs are designed to broaden access to health care within the community and help KFH fulfill its objectives to reduce the financial barriers that limit access to care for qualified low income populations. KFH participates in several programs in collaboration with Kaiser Foundation Health Plan, Inc. and community-based organizations to provide charity care services to low income uninsured patients at its facilities or from Permanente providers. Patients are referred to the community MFA programs by one of the community-based organizations. The community-based organization takes responsibility for pre-screening each patient to make sure they meet the eligibility criteria. The following are descriptions of a few of the programs offered under community MFA: A.1.1.5.1 Operation Access Thirteen Kaiser Permanente Northern California Region hospitals participate in Operation Access, a nonprofit organization that mobilizes a network of medical volunteers, hospitals, facilities, and referring community clinics to provide the uninsured with donated outpatient surgeries and procedures that significantly improve their health, ability to work, and quality of life. Some the most common procedures performed include hernia repairs, biopsies, and cyst excisions. A.1.1.5.2. Mission Cataract USA Kaiser Permanente's Rancho Cordova Medical Offices participate in Mission Cataract, a national program that offers free cataract surgery to people of all ages who have no means to pay. It was started in 1991 by Frederick A. Richburg, MD, Medical Director of Valley Eye Institute in Fresno, California, and expanded in 1992 to include six eye surgeons who offered free surgeries throughout California. The goal of Mission Cataract USA is to eradicate blindness due to cataracts and bring as many people as possible from blindness to useful productive lives. A.1.1.5.3. KP Soars KP SOARS provides services to uninsured patients from La Clinica de la Raza in Vallejo, California, to address breast care, gastroenterology, cardiology and orthopedic needs. Based on each individual patient's treatment plan, related services are covered, including diagnostics and in-patient hospitalization. Patients are screened for medical need and financial eligibility by La Clinica de la Raza. The program is based on a joint agreement between KFH and Kaiser Foundation Health Plan, Inc., The Permanente Medical Group, and La Clinica de la Raza. A.1.2. Charitable Health Coverage (CHC) Program Charitable Health Coverage (CHC) is a unique approach to caring for low-income uninsured persons in the community. Eligible participants receive a regular Kaiser Foundation Health Plan, Inc. membership card and access to the full range of services and providers at Kaiser Foundation Hospital facilities - a much better alternative to a potentially costly emergency room visit or hospitalization. KFH's CHC programs have a long history of making a real difference in the lives of low-income people who might otherwise have no permanent medical home. In 2017, more than 23,000 low-income adults and children who were not eligible for other public or privately sponsored coverage received access to health care through facilities operated by Kaiser Foundation Hospitals in California and Oregon. KFH contributed approximately $500 thousand (at cost, net of $14.8 million of related revenues) to provide subsidized care to these underserved populations in 2017. A.1.2.1. CHC Programs Offered in California A.1.2.1.1. Community Health Care Program (Northern California) and Child Health Program (Southern California) The Community Health Care Program and Child Health Program provide comprehensive medical, pediatric dental and prescription coverage to low income individuals with household income up to 300% of the Federal Poverty Level Guidelines who do not have any access to public or private coverage. Both programs focus on children under the age of 19. However, in the Fresno service area, the Health Plan has extended the age limit up to age 25 as a pilot program. The California CHC programs provide a 100% premium subsidy and also provide 100% cost sharing support for covered services provided at Kaiser Permanente facilities. California CHC members are enrolled in the Health Plan's standard platinum level off exchange plan. A.1.2.1.2. Healthy San Francisco KFH provided access to approximately 700 KFHP, Inc. members participating in the Healthy San Francisco program at the end of 2017. Healthy San Francisco is a program created by the City and County of San Francisco to make health care services accessible and affordable for uninsured residents living on a combined family income at or below 500% of the Federal Poverty Level. It is available for all San Francisco residents, regardless of immigration or employment status, or pre-existing medical conditions. While this program is not an insurance plan, it does provide access to primary care, preventive services, and hospitalization within the city and county of San Francisco. A.1.2.2. CHC Program Offered in Oregon A.1.2.2.1. The Child Health Plan Child Health Program Plus provides comprehensive medical, pediatric dental and prescription coverage to low income individuals up to age 19 with household income up to 350% of the Federal Poverty Level Guidelines who do not have any access to public or private coverage. This program is open to students in school districts that the Health Plan has partnered with. Child Health Program Plus provides a 100% premium subsidy and also provides 100% cost sharing support for covered services provided at Kaiser Permanente facilities. Child Health Program Plus members are enrolled in the Health Plan's standard gold level off exchange plan. A.2. Participation in Medicaid and Other Government-Sponsored Programs Kaiser Foundation Hospitals has a long history of providing access to low- and moderate-income individuals as a nonprofit organization. In 2017, Kaiser Foundation Hospitals provided medical services valued at $647 million (at cost, net of $947 million of related revenues) to individuals participating in government-sponsored programs in California, Hawaii, Oregon, and Washington. Improving access to care for vulnerable populations is fundamental to KFH's social mission to improve the health of communities served and consistent with the obligations of a tax exempt organization. The Affordable Care Act has had a far-reaching impact on the landscape of government-sponsored programs, as these options have become a key source of health coverage for a significant portion of the American population. KFH has responded to this challenge by developing organizational strategies to enable individuals whose coverage is changing - due to personal or financial circumstances - to continue to obtain medical care at facilities owned by the organization. Realized and anticipated growth in the organization's Medicaid offerings closely aligns with and supports KFH's core mission, tax exempt status, credibility in state and federal policy arenas, and community health needs focusing on access to care. A.2.1. Government-Sponsored Programs in California Highlights of the government-sponsored health care coverage programs supported by KFH in California include: A.2.1.1. Medicaid/Medi-Cal Managed Care KFH provided access to inpatient care for over 700,000 Medicaid/Medi-Cal managed care members in Northern and Southern California through various local and state government entities. Approximately $538 million (at cost, net of $560 million of related revenues) was invested in this program in 2017. Prior to 2014, KFH provided health care services to members participating in the federal- and state-funded Children's Health Insurance Program (CHIP) offered by Kaiser Foundation Health Plan, Inc. California administers its CHIP program as part of Medicaid. Member counts and expenditures are included above. A.2.1.2. Medicaid/Medi-Cal Fee-for-Service KFH provided subsidized care on a fee-for-service basis to over 215,000 Medi-Cal patients who were not enrolled as members of Kaiser Foundation Health Plan, Inc. This accounted for approximately $81 million (at cost, net of $312 million of related revenues) of inpatient services provided by KFH in 2017. A.2.2. Government-Sponsored Programs in Hawaii Highlights of the government-sponsored health care coverage programs supported by KFH in Hawaii include: A.2.2.1. QUEST QUEST is a Medicaid managed care program run by Hawaii's Department of Human Services. The state administers the QUEST program and pays Kaiser Foundation Health Plan, Inc. to provide medical services. KFH provides access to the organization's health care facilities in connection with the QUEST program on the islands of Oahu and Maui. In 2017, KFH cared for approximately 27,000 individuals enrolled in QUEST and expended approximately $9.2 million (at cost, net of $36 million of related revenues) on subsidized medical care services. A.2.2.2. Medicaid Fee-for-Service Kaiser Foundation Hospitals provides services on a fee-for-service basis in states not participating in the Medicaid managed care program or for individuals/populations not enrolled in managed care. In 2017, KFH in Hawaii contributed $2.7 million (at cost, net of $1.6 million of related revenues) towards subsidized care for Medicaid patients who were not enrolled in the Kaiser Foundation Health Plan QUEST program. A.2.2.3. Children's Health Insurance Program (CHIP) The Children's Health Insurance Program provides health insurance coverage to children with family income up to twice the federal poverty guideline for Hawaii under Title XXI of the Social Security Act. CHIP is one of several aid categories under the QUEST program. More than 3,300 children enrolled in this program were cared for at KFH facilities in Hawaii at a total expense of $769 thousand (at cost, net of $844 thousand of related revenues) in 2017. A.2.3. Government-Sponsored Programs in Oregon and Washington Highlights of the government-sponsored health care coverage programs supported by KFH in Oregon and Washington include: A.2.3.1. Medicaid Managed Care Programs in Oregon and Washington Kaiser Foundation Hospitals supports Medicaid managed care programs in the states of Oregon and Washington. In 2017, KFH expended approximately $11 million (at cost, net of $76 million of related revenues) in the Northwest region to subsidize care under Medicaid. The following describe the programs and target populations: A.2.3.1.1. Health Share of Oregon In 2011, Oregon passed House Bill 3650. This bill set the stage for transforming the care people receive through the Oregon Health Plan (OHP), Oregon's Medicaid program, and began the process of establishing local coordinated care organizations (CCOs) to serve OHP members and improve the way care is delivered. Kaiser Foundation Health Plan, Inc. has joined Tuality Healthcare, CareOregon, and Providence Health Services to form the largest Coordinated Care Organization in the State. Kaiser Foundation Hospital provides inpatient care services to the KFHP, Inc. members of this program which serves families in Clackamas, Multnomah, and Washington counties. A.2.3.1.2. Washington Apple Health Care In Washington State, the Medicaid program is called Apple Health. Kaiser Foundation Hospitals provides services to eligible participants who reside in either Clark or Cowlitz counties through a subcontract with Molina Healthcare Apple Health (Medicaid), a fully-capitated state program managed by the Washington State Health Care Authority (HCA). A.2.3.2. Medicaid Fee-for-Service KFH provided $5.6 million (at cost, net of $5.6 million of related revenues) in subsidized care to Medicaid fee-for-service patients living in the states of Oregon and Washington in 2017. These services were billed to the Medicaid program on behalf of non-affiliated patients receiving medical attention in KFH facilities. When a Medicaid patient receives services from Kaiser Foundation Hospitals under this program, these expenses are recorded as non-capitated services and billed to the Medicaid program on a fee-for-service basis. A.2.3.3. Child Health Insurance Program (CHIP) In both Oregon and Washington, KFH provides health care services to members of KFHP, Inc.'s Child Health Insurance Program. The program provides health insurance to children whose family income is between 200% and 300% of the federal poverty level, and who are not eligible for Medicaid. In both states, the program is governed by the Medicaid contract, and offers the same benefits. KFH incurred net losses of $80.6 thousand (at cost, net of $170 thousand of related revenues) under this program in 2017. A.3. Care and Coverage Investments in the Community In 2017, Kaiser Foundation Hospitals donated approximately $24.1 million to nonprofit and community-based organizations to improve access to health care for low-income families and individuals. The following are a few examples of the contributions made in this area: A.3.1. City of Sacramento's Pathways to Health and Home Program The City of Sacramento received $1 million to support the Pathway to Health and Home program, a program connecting and stabilizing homeless Medi-Cal patients to health, housing, and social services. By providing outreach and engagement (2,000 individuals), case management (1,000 enrollees), and housing supports (500 enrollees) to the target population annually beginning in 2018, the program ultimately aims to reduce ER visits, inpatient utilization, 30-day readmissions by 5% in 2018 and 10% in 2019. A.3.2. Operation Access (OA) Kaiser Foundation Hospitals provided $400 thousand to support the Operation Access program. The program will expand access to specialty and diagnostic care and services for the uninsured in nine Bay Area counties through the coordination of donated medical services from its volunteer and hospital network. This funding is a two-year grant to provide a total of $800 thousand. B. Community Health Initiatives (CHI) The Community Health Initiatives (CHI) strategy aims to improve the health of individuals, families, and communities by addressing the social, economic, and environmental determinants of health. Research supports the central premise that excellent medical care alone is insufficient to generate health. Evidence underscores the importance of changing community environments as a critical community health strategy. Guided by this evidence, Kaiser Foundation Hospitals supports comprehensive initiatives that focus on policy and environmental changes to promote healthy eating and active living (HEAL), community safety, economic stability, and social and emotional wellness. Two of the primary programs supported within the CHI Stream of Work include: Healthy Eating, Active Living (HEAL) and Obesity Prevention Healthy eating, active living has been and continues to be a compelling focus for Kaiser Foundation Hospital's work, as obesity continues to be a significant and pervasive public health problem. Despite encouraging signs of obesity rates leveling off in recent years, substantial racial and ethnic disparities continue to exist. Also, through a focus on healthy eating and active living, Kaiser Foundation Hospitals can have a marked impact on a wide range of health conditions including pre-diabetes, diabetes, cardiovascular disease and several cancers that are affected by these behaviors. Finally, a focus on nutrition, physical activity and weight management are highly aligned with Kaiser Foundation Hospital's clinical expertise in this area, including a prevention orientation and a number of existing programs and partnerships. Wherever possible, KFH supports a concentration of multiple strategies that enable sustainable change towards healthy eating and active living lifestyles. These include policies and practices to reduce the availability and consumption of sugar-sweetened beverages, encourage the establishment of safe spaces, promote active transportation policies that support equitable public transit, and create connections between health clinics and community resources. Thriving Schools Thriving Schools is an initiative to improve healthy eating, physical activity, and social and emotional wellness in K-12 schools within Kaiser Foundation Hospital's geographic service areas. Thriving Schools efforts focus on policy, systems, and environmental changes that make the healthy choice the easy choice. Interventions aim to create a culture of health on school campuses to spur individual behavior change targeting students, teachers, and staff. In 2017, KFH spent approximately $69 million to support Community Health Initiatives that addressed needs underscored by recent Community Health Needs Assessments - obesity and related conditions, economic security, violence/injury prevention, climate and health, and transportation and built environment. B.1. CHI Investments in the Community Kaiser Foundation Hospitals' investments in the CHI Stream of Work during 2017 included the following: B.1.1. East Oakland Youth Development Center's Pathway to College and Career program In 2017, KFH provided $150,000 to the East Oakland Youth Development Center's Pathway to College and Career Program. This program provides youth of color, ages 13 to 24, with a comprehensive program that supports their academic achievement, school engagement, college access and persistence, and provides opportunities for youth to gain meaningful work experience that builds leadership and employment skills. The expected results include 180 participants in a program to increase their high school graduation rates, college entrances and graduations. In addition to provide work opportunities for youth to develop skills, knowledges, and confidences to succeed in the workplace. B.1.2. Stagg High Alliance for Resilience Education and Support (SHARES) In 2017, Delta Health Care received $98,000 for the SHARES program. Through SHARES, Delta Health Care will address the unmet trauma-related mental health needs of students and staff at Stagg High School. SHARES will provide campus-based, trauma-focused mental health services to students and staff and establish a trauma-informed campus culture. The program is expected to provide 1,550 students/teachers/staff education on effects of trauma, and to provide 90 teens and 20 teachers/staffs campus-based trauma-focused mental health therapy. The expected result is decrease in risky behaviors and better functioning at school/home for program participants. B.1.3. Alameda County Community Food Bank In 2017, the Alameda County Community Food Bank received support of $75,000 from KFH to increase CalFresh (food stamps) enrollment of vulnerable and low income populations. This program will increase efficiencies, streamline processes, and improve customer service related to CalFresh application and assistance. The expected outcome is to conduct 350 CalFresh enrollment clinics, prescreen 7,000 people for CalFresh eligibility, and to submit 4,500 applications on behalf on eligible clients. B.1.4. San Diego Hunger Free Coalition In 2017, KFH awarded $75,000 in grant funds to San Diego Hunger Free coalition, a coalition of agencies, to end hunger in San Diego through an interwoven safety net of food assistance resources. The results to date are: report evaluating child nutrition program activities in the San Diego school districts and launching new youth meal programs at 6 sites providing nutritious meals to over 800 youths. B.1.5. Jade District Community Space and Affordable Housing Development In 2017, KFH awarded $70,000 in grant funds to the Asian Pacific American Network of Oregon (APANO) for the Jade District Community Space and Affordable Housing Development project. This project would create a permanent community space and offices for APANO on the ground floor of a new 48 unit affordable housing development at the heart of the Jade District. This would provide a safe space both for Oregon's fast growing Asian Pacific Islander community as well as local residents of one of the most diverse neighborhoods in the state. The space will provide a center for building community, supporting the arts, and social services that will improve community health outcomes through a social determinants of health lens. This neighborhood is currently a Kaiser HEAL initiative project. C. Safety Net Partnerships Kaiser Foundation Hospitals is committed to building partnerships with the institutions that serve on the front lines of health care for the uninsured and underserved. By providing support to community health centers, public hospitals, and local health departments, KFH helps them deliver care and treatment to the most vulnerable in our communities. KFH is dedicated to investing in communities and promoting good health for the communities served. As such, Safety Net Partnership (SNP) initiatives aim to strengthen the system of community clinics, public hospitals, and health departments to promote access to high quality care for the uninsured and underserved vulnerable populations. KFH also focuses on improving access to health services and the transformation of care delivery to meet the challenges of the ever evolving performance expectations and revenue design. Efforts to improve access and transform care include work on: increasing access to specialty care services; increasing the utility of health information technology in safety net settings; addressing mental health and wellness, improving population outcomes and eliminating health disparities. KFH also supports innovative efforts to bring both health care and support services closer to underserved populations through partnerships with school based health centers and community clinics. Investments in Safety Net Partnerships target the following strategic focus areas: I. Care Delivery Transformation II. Capacity Building III. Clinic-Community Integration IV. Policy, Systems, and Environmental Change V. Create and Spread Knowledge VI. Total Health In 2017, KFH spent approximately $68 million to support Safety Net Partnerships as access to affordable quality care and health disparities amongst vulnerable populations were identified as significant and pervasive barriers to health in the 2017 Community Health Needs Assessments in the communities that KFH hospitals served. The following are examples of initiatives funded in accordance with the objectives of the Safety Net Partnerships Stream of Work during the year. C.1. Safety Net Partnerships Investments in the Community C.1.1. California Primary Care Association (CPCA) In 2017, KFH provided a grant of $150,000 to the California Primary Care Association (CPCA). CPCA supports its member community health centers through education, training, and advocacy to ensure compliance with federal program requirements and to serve their low-income, underserved, and diverse patients. By participating in projects such as this, KFH's resources contribute to provide training and assistance to the low-income, underserved, and diverse population. C.1.2. Quality Improvement and Population Health: PHASE Program KFH issued a series of grants to support safety net clinics in adopting "Preventing Heart Attacks and Strokes Everyday" (PHASE) into clinical guidelines and care management protocols, leveraging KFH's evidence-based practices. KFH Northern California Community Health continues and has expanded its signature program, PHASE, to support the safety net's capacity to implement chronic care management program designed to reduce cardiovascular disease, increase capacity for reporting utilization and quality measures using HEDIS, and building system capacity for managing population health. The majority of the grants will continue support for safety net health care organizations already using PHASE, to help them increase the number of patients enrolled in the program and expand the program's scope to treat other conditions, such as hypertension. Other grants will help health care safety net organizations adopt team-based care models and make technical improvements that are foundational for implementing chronic care programs such as PHASE, and support evaluation and training efforts. D. Developing and Disseminating Knowledge The Developing and Disseminating Knowledge Stream of Work supports activities that improve health care by sharing knowledge, educating practitioners, advancing research, empowering consumers and informing policymakers about evidence-based care and health. Kaiser Foundation Hospitals spent $153 million (at cost, net of $91 million of related revenues) in 2017 to support programs and services associated with the development and dissemination of knowledge. D.1. Medical Research Programs Kaiser Permanente (KP), the largest nonprofit integrated health system in the United States, has a long history of conducting health research related to both prevention and treatment of disease that benefits both its members and the communities that it serves. Kaiser Permanente's research efforts are core to the organization's mission to improve population health, and its commitment to continued learning. Through studies conducted at Kaiser Permanente's seven regional research centers and in collaboration with three national research infrastructure centers, collectively called Kaiser Permanente Research, Kaiser Permanente researchers study critical health issues including: cancer, cardiovascular conditions, diabetes, behavioral and mental health, and health care delivery improvement. Kaiser Permanente Research is broadly focused on three themes: . Understanding health risks . Addressing patients' needs and improving health outcomes . Informing policy and practice to facilitate the use of evidence-based care Kaiser Permanente is uniquely positioned to do research due to its rich, longitudinal, electronic clinical databases that capture virtually complete health care delivery, payment, decision-making and behavioral data in detail to support primary, secondary and tertiary clinical care across inpatient, outpatient and emergency department settings for more than 10 million geographically and demographically diverse members and non-members. D.1.1. National Research Program The Division of Research in Northern California, Department of Research and Evaluation in Southern California, and Centers for Health Research in Oregon and Hawaii are four of eight regional centers. Kaiser Permanente Research also includes the Kaiser Foundation Research Institute (KFRI) which is a national program established to administer and support research at Kaiser Permanente. Research projects conducted by this collaborative team have yielded findings that affect not only the practice of medicine within the area served by KFH, but also for society-at-large. The following are descriptions of the entities providing support at the national level. D.1.1.1. Kaiser Foundation Research Institute (KFRI) The Kaiser Foundation Research Institute (KFRI) is a national program established in 1958 to administer and support research at Kaiser Permanente. KFRI's responsibilities include: overseeing and maintaining Kaiser Permanente's relationship with federal granting agencies, including ensuring financial compliance, providing contract negotiation services for all regions, overseeing Kaiser Permanente's Human Research Participant Protection Program Research through the National Compliance in Research Support Program, and which promotes responsible research conduct; and partnering with clinical trials' stakeholders across Kaiser Permanente to ensure quality and compliance through the clinical trials program. D.1.1.2. The Center for Effectiveness and Safety Research (CESR) The Center for Effectiveness & Safety Research enhances opportunities to answer questions about which interventions work best for whom across all of KP's regional centers by investing in the ongoing development of a common data model, convening researchers and organizational leaders at an annual meeting and via webinars, and by conducting research. The center routinely partners with investigators in KP's regional research centers and with selected operational analytical groups. D.1.1.3. The Utility for Care Data Analysis (UCDA) The Utility for Care Data Analysis (UCDA) was created to ensure that analysts and researchers throughout Kaiser Permanente can fully realize the analytical potential of Kaiser Permanente's electronic medical record systems, HealthConnectT (KPHC) and other Kaiser Permanente enterprise-wide information systems. This allows experts to compile and compare clinical and utilization data from across KP regions, to assess patterns in health, health care delivery, and clinical quality, among other uses. UCDA has developed tools for using geographic information systems and conducting geospatial analysis, enrichment of data for research, support for a variety of Program-level analytic activities, and analytic support for Community Benefit including the Community Health Needs Assessments. D.1.1.4. The Kaiser Permanente Research Bank The Kaiser Permanente Research Bank is a research resource designed to help the organization better understand how people's health is affected by their genes, behaviors and the environment. It allows researchers to use DNA and other health information voluntarily provided by a diverse cross-section of KP members to study how genetic and environmental factors affect health, and look for new ways to diagnose, treat and prevent certain diseases. KP has set a goal to collect data from a total of 500,000 participants from all eight regions, which would make it one of the world's largest and most diverse repositories of genetic, environmental and health data. To date, more than 300,000 members from seven geographic regions have participated in biobanking efforts. D.1.2. Regional Research Centers D.1.2.1. The Division of Research - Northern California The Division of Research was established in 1961. DOR's program is built on a base of rigorous epidemiologic investigation in a large, well-characterized population and has made major contributions in risk factor identification, prevention, and drug safety. New areas of inquiry include the role of genes and the environment in health, the use of health informatics, the management of chronic conditions, and delivery science to enhance specialty care. In 2017, KFH invested $15.5 million in medical research for The Division of Research - Northern California. Number of investigators: 49 Number of support staff: 598 Number of journal publications in 2017: 390 Number of clinical trials in 2017: 358 Number of active studies (clinical trials and non-clinical trials) in 2017: 476 Number of proposals submitted in 2017: 246 Top research areas: . Behavioral health and aging . Cancer . Cardiovascular and metabolic conditions . Health care delivery and policy . Infectious diseases . Women's and Children's Health . Vaccine Study Center D.1.2.1.1. Major Areas of Funded Research The following are examples of research projects conducted by KFH investigators at the Division of Research in Northern California in 2017: D.1.2.1.1.1. Spotlight on Understanding Risk - Breast Cancer Survivors Benefit from Vitamin D, Social Ties Two studies of breast cancer survivors by Division of Research scientists showed lower risks of disease recurrence and mortality among women with higher levels of vitamin D in their blood, as well as those with more social ties. The first study, published in JAMA Oncology, found that women with higher vitamin D levels in their blood following a breast cancer diagnosis had significantly better long-term outcomes. The second study, published in the American Cancer Society journal Cancer, found that women with invasive breast cancer who were socially isolated were significantly more likely to die from breast cancer or have a disease recurrence than socially integrated women. Primary Funding Provided By: National Cancer Institute D.1.2.1.1.2. Spotlight on Improving Patient Outcomes - For Patients with Positive Fecal Screening Test, Sooner is Better The risk of colorectal cancer increased significantly when colonoscopy was delayed by more than nine months following a positive fecal screening test, according to a large Kaiser Permanente study published in the Journal of the American Medical Association. This study provides strong evidence that a colonoscopy should be performed within several months of a positive fecal screening test. The fecal immunochemical test, known as FIT, screens for colorectal cancer by detecting small amounts of blood in the stool. When blood is detected, gastroenterologists perform a colonoscopy to detect and possibly remove cancerous or pre-cancerous polyps before there are any symptoms. Primary Funding Provided By: National Cancer Institute D.1.2.1.1.3. Spotlight on Translating Research into Policy & Practice - Surgery Program Significantly Improves Outcomes A comprehensive Enhanced Recovery After Surgery program implemented in Kaiser Permanente's 20 Northern California medical centers resulted in a one-third relative reduction in postoperative complication rates and a 21 percent reduction in opioid prescribing rates. A study of the program, published in JAMA Surgery, also showed decreased hospital mortality among colorectal resection patients and increased rates of home discharge over discharge to skilled nursing facilities among hip fracture patients. Primary Funding Provided By: Gordon & Betty Moore Foundation, The Permanente Medical Group, Kaiser Foundation Health Plan D.1.2.2. The Department of Research and Evaluation - Southern California The Department of Research & Evaluation was established in 1963, and focuses on conducting research with real-world implications and translating findings into practice. The department is expanding and building scientific expertise in new research areas, including health services and implementation science. This helps the organization to bridge the gap between research and practice and to understand how provide better care for members, and the communities from which they come from. In 2017, KFH invested approximately $9 million in medical research for The Department of Research and Evaluation - Southern California. Number of investigators: 27 Number of support staff: 362 Number of journal publications in 2017: 153 Number of clinical trials in 2017: 468 Number of active studies (clinical trials and non-clinical trials) in 2017: 915 Number of proposals submitted in 2017: 175 Top research areas: . Cancer . Cardiovascular diseases . Diabetes . Health services research and implementation science . Obesity . Vaccine safety and effectiveness . Maternal and infant health D.1.2.2.1. Major Areas of Funded Research The following are examples of research projects conducted by investigators at the Department of Research and Evaluation in Southern California in 2017: D.1.2.2.1.1. Spotlight on Understanding Risk - Androgen deprivation and early-stage prostate cancer Men with localized prostate cancer who received androgen deprivation therapy were at higher risk of heart failure than men who did not receive this therapy. Researchers followed a cohort of 7,637 men diagnosed with localized prostate cancer between 1998 and 2008 who were initially under active surveillance. Nearly 30% were treated with androgen deprivation therapy. Researchers followed them for up to 12 years after diagnosis. Among the key findings from this research: For men with localized prostate cancer, androgen deprivation therapy was associated with an 81% increased risk of heart failure in men without pre-existing cardiovascular disease. Primary Funding Provided By: National Cancer Institute, Kaiser Permanente D.1.2.2.1.2. Spotlight on Improving Patient Outcomes - Kaiser Permanente's successful approach to safer opioid prescribing Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated in our system, which included addressing the use of opioid painkillers. Clinical data demonstrated that chronic pain was not effectively managed with high dose opioids and that these drugs had significant risks associated with them. Research was published in 2017 that describes the elements of KPSC's intervention, outlines the implementation process, reports on short- and intermediate-term outcomes, and discusses how this initiative could be adopted by other health care systems. The various efforts to reduce opioid prescribing included prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination with electronic health records. Reductions were observed in all the tracked outcomes including a 30% reduction in prescribing opioids in high doses. Primary Funding Provided By: Centers for Disease Control & Prevention D.1.2.2.1.3. Spotlight on Implementing Findings in Policy and Practice - Reducing antibiotic prescriptions through physician education and intervention Physicians at Kaiser Permanente in Southern California reduced the odds of prescribing an antibiotic for sinusitis by 22% using computer alerts to inform doctors when antibiotics may not be the best course of treatment. During an 8-month period (September 2014 through April 2015), the study tracked nearly 22,000 initial acute sinusitis encounters in adults at primary and urgent care offices. A key finding of this research was that clinical decision support was associated with a 22% decrease in antibiotic use after the intervention. Researchers also found that the intervention was associated with a substantial decrease in acute sinusitis diagnoses. Primary Funding Provided By: KP Southern California, Care Improvement Research Team D.1.2.3. The Center for Health Research Northwest The Center for Health Research - Northwest (CHR-NW) has been a leader in the field of health research since its founding in 1964. As the research landscape has shifted over that time, CHR-NW has adapted and cultivated new strengths, while remaining true to its guiding mission of advancing knowledge to improve health. Our close affiliation with the Kaiser Permanente Northwest health plan, hospitals, and medical group allows us to conduct studies with real patients and healthcare providers in real-world settings. KP Northwest enrolls over 600,000 health plan members and more than 270,000 dental members in Oregon and Southwest Washington. The Center's research covers a broad range of topics including cancer, diabetes, cardiovascular disease, obesity, health disparities, population health management, mental health and substance abuse, maternal and child health, evidence-based medicine and policy, shared decision making, genetics, and oral health (in collaboration with the KP Northwest Dental Care Program, the only program of its kind in Kaiser Permanente). In 2017, KFH invested $6.5 million in medical research for The Center for Health Research - Northwest Number of investigators: 36 Number of support staff: 229 Number of journal publications in 2017: 167 Number of clinical trials in 2017: 170 Number of active studies (clinical trials and non-clinical trials) in 2017: 395 Number of proposals submitted in 2017: 173 Top research areas: . Vaccine Safety & Effectiveness . Genetics & Genomics . Mental Health & Substance Abuse . Cancer . Women's Health . Patient Reported Measures (including Social Determinants) . Predictive Analytics D.1.2.3.1. Major Areas of Funded Research The following is an example of a research project conducted by KFH investigators at the Centers for Health Research in the Northwest in 2017: D.1.2.3.1.1. Spotlight on Understanding Risk - Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force The objective of this report was to systematically review the evidence on the benefits and harms of behavioral counseling for the primary prevention of cardiovascular disease in adults without known cardiovascular risk factors to inform the US Preventive Services Task Force. The main outcomes studied were cardiometabolic health and intermediate outcomes, behavioral outcomes, and harms related to interventions. There was no evidence of greater incidence of serious adverse events, injuries, or falls in intervention vs control participants. Diet and physical activity behavioral interventions for adults not at high risk for cardiovascular disease result in consistent modest benefits across a variety of important intermediate health outcomes across 6 to 12 months, including blood pressure, low-density lipoprotein and total cholesterol levels, and adiposity, with evidence of a dose-response effect, with higher-intensity interventions conferring greater improvements. There is very limited evidence on longer-term intermediate and health outcomes or on harmful effects of these interventions. Primary Funding Provided By: National Institute of Mental Health D.1.2.4. The Center for Health Research Hawaii The Center for Health Research - Hawaii was established in 1999 and is specially attuned to the health issues of the local population, which suffers disproportionately from several chronic diseases, primarily diabetes and heart disease. Hawaii probably has the world's most ethnically diverse population. Japanese and Caucasians constitute about a quarter of the population. Native Hawaiians and other Pacific Islander populations are about 20%, Filipinos about 12%, Chinese about 8%, and other groups-mostly Southeast Asian and Korean-make up the balance. This mix of cultures, lifestyles, and practices creates a challenging and fascinating environment for research on cultural issues and on the mixing of cultures. Health plan members constitute about 18-20% of the state's population and are demographically like the rest of the state. Kaiser Permanente Hawaii participates in both Medicaid and Medicare programs and has good representation in both groups. In 2017, KFH invested $1.7 million in medical research conducted by The Center for Health Research - Hawaii Number of investigators: 3 Number of support staff: 29 Number of journal publications in 2017: 20 Number of clinical trials in 2017: 36 Number of active studies (clinical trials and non-clinical trials) in 2017: 71 Number of proposals submitted in 2017: 18 Top research areas: . Cancer . Chronic Disease (e.g., Diabetes) . Mental Health . Patient Safety D.1.2.4.1. Major Areas of Funded Research The following is an example of a research project conducted by KFH investigators at the Centers for Health Research in Hawaii in 2017 in collaboration with the Center for Health Research in the Northwest: D.1.2.4.1.1. Spotlight on Understanding Risk - The Impact of Race and Ethnicity on Rates of Return to Psychotherapy for Depression There are many limitations with the evidence base for the role of race and ethnicity in continuation of psychotherapy for depression. The study sample consisted of 242,765 patients at least 18 years old from Kaiser Permanente Hawaii and five other healthcare systems in the Mental Health Research Network (MHRN) who had a new episode of psychotherapy treatment for depression between 1/1/2010 and 12/31/2013. Provider and healthcare system variation were stronger predictors of patient return to psychotherapy than race and ethnicity. More research is needed to understand why providers and healthcare systems determine psychotherapy return rates for patients of all racial and ethnic groups. Primary Funding Provided By: Mental Health Research Network (National Institute of Mental Health). D.2. Health Sciences and Medical Libraries KFH actively supports medical libraries and other health resource and information dissemination services. These programs give medical staff and the greater professional community access to health-related research conducted within and outside of KFH. Medical libraries participated in an inter-loan system with other community hospitals, supported students in training and education programs to conduct literature searches, and conducted searches for community clinics and other community-based organizations on advances in medical treatment, clinical protocols and new development on specific health issues. In 2017, the $515 thousand invested in health sciences and medical libraries in California, Hawaii, and Oregon assisted users in completing thousands of requests for general knowledge and literature searches for research purposes. One example of the resources available to the community is the KFH libraries in Oregon. There are two library locations in the region, each supporting the local community, students, residents, and KP members. The services provided include in-depth research, answering reference questions, providing consumer health information, document delivery and providing access to resources to support professional certifications. All are invited to check out books from the consumer health and health sciences book collections. Each library has a dedicated community computer that is available to the public. These computers are used daily by volunteers, interpreters, student interns, family members of patients, KP members and the community. Library staff advises patrons of all skill and reading levels about how to access appropriate health information and resources online. KFH Library services available to the community have been specifically promoted at Community Benefit grantee convenings and through the Community Benefit Manager of Contributions, Community Engagement & Community Relations, who connects organizations applying for funding to the libraries for support. The KFH Libraries in Oregon also support Community Benefit initiatives such as the Community Giving Campaign and KFH Northwest Pride BRG activities, and in 2017, started a program collecting and distributing donated reading materials for patients and their visitors. D.3. Educational Theatre Programs (ETP) For 30 years, the Educational Theatre program has been using live theatre, music, comedy, and drama to inspire children, teens, and adults to make healthier choices and better decisions about their well-being. KFH's award-winning programs are as entertaining as they are educational and were developed with the advice of teachers, parents, students, health educators, medical professionals, and professional theatre artists. Professional actors who are also trained health educators deliver all performances and workshops. The programs share health information and develop individual and community knowledge about leading healthier lives. Programs are presented free of charge to schools and the general community. In addition to performances and classroom workshops, ETP supplies schools and organizations with supplementary educational materials including workbooks, parent and teacher guides, and student wallet cards. All materials are designed to reinforce the messages presented in our programs. ETP performances are localized to suit local cultures, norms, and audience on a regular basis. The 2017 productions focused heavily on healthy eating and active living, nutrition, and mental health, depending on the health priorities of the area as identified in their respective Community Health Needs Assessments. The Educational Theatre Program offers a wide repertoire of programs for students from grade K to 12 and families that address literacy promotion, healthy eating active living, conflict resolution and violence prevention, adolescent bullying prevention, sexually transmitted disease prevention, and family oriented workshops that introduce parents and families to the concepts their students learned and are encouraged to make changes to become healthier families. KFH in California, Northwest (Oregon, Washington) spent approximately $6.8 million to provide approximately 250,000 children and adults the opportunity to view or participate in performances, workshops, and other educational interactions offered during 2017. D.4. Health Professional Training and Education In 2017, KFH spent approximately $106 million (at cost, net of $18.7 million in related revenues) to provide continuing medical education to healthcare professionals affiliated with colleges and universities and other health care providers. D.4.1 Graduate Medical Education KFH provides training and education for medical residents and interns in the interest of educating the next generation of physicians. The nationally acclaimed program attracts some of the top medical school graduates in the United States and serves as a national model by exposing future health care providers to an integrated health care delivery system. Residents are offered the opportunity to serve a large, culturally diverse patient base in a setting with sophisticated technology and information systems, established clinical guidelines and an emphasis on preventive and primary care. In 2017, KFH contributed $82 million (at cost, net of $18.7 million of related revenues) to educate independent and affiliated interns and residents in California, Hawaii, Oregon, and Washington. The majority of medical residents are studying within the primary care medicine areas of family practice, internal medicine, OB/GYN, pediatrics, preventive medicine, and psychiatry. As a part of receiving training in a Kaiser Foundation Hospital setting, exposure to understanding culturally competent care is heavily emphasized. To further understand barriers to receiving health care in the community, KFH also offers a one-year Community Medicine Fellowship in Southern California. These are full-time positions where fellows may work in multiple community settings, providing direct care, exploring connections in personal professional goals for community service, and identifying opportunities for systems-based improvements. In addition, in the Northwest region, KFH Sunnyside's Department of Graduate Medical Education provides training resources for medical residents and fellows from institutions who rotate within primary care medicine areas and specialty. D.4.2. Nurse Practitioner and Other Non-Physician Training Programs During 2017, KFH spent approximately $24 million on training and education programs for nurse practitioners, nurses, radiology and sonography technicians, physical therapists, post-graduate psychology and social work students, pharmacists, and other non-physician health professionals. The following are descriptions of training programs offered: D.4.2.1. Kaiser Permanente School of Allied Health Sciences (KPSAHS) The Kaiser Permanente School of Allied Health Sciences (KPSAHS), located in Richmond, California, was originally established in 1989 as a radiology program in response to the severe shortage of radiology technologists. Due to the continued national shortage of medical imaging and therapy workforce, KPSAHS expanded the school to include 18-month programs in sonography, nuclear medicine and radiation therapy. In addition, the school provides courses in anatomy and physiology and advanced/basic phlebotomy. D.4.2.2. Community College Partnerships In Southern California, KFH partners with community colleges as a clinical affiliate for radiologic technology, diagnostic medical sonography (ultrasound), and/or nuclear medicine. Students officially enrolled in these programs complete a clinical internship as an integral part of the curriculum. D.4.2.3. Community Rehabilitation Education The Community Rehabilitation Education Program is directed toward advancing the practice of Occupational therapy, Physical therapy and Speech therapy by providing evidence-based, state of the art course work for rehabilitation professionals in Northern California. Each year educational needs are identified and local and nationally known speakers are brought to Northern California for weekend conferences and hands on laboratory sessions. We work to impact quality of care in the northern California community through greater opportunities for training. D.4.2.4. Pharmacy Residency Programs Through the pharmacist residency programs in California, licensed pharmacists gain additional experience and training in the provision of pharmaceutical care and administrative pharmacy services in an integrated managed care organization during a one- or two-year postgraduate education and training program. These programs enable residents to improve their clinical knowledge and skills while enhancing continuity of patient care in a wide range of ambulatory, intermediate and hospital settings. D.4.2.5. Physical Therapy Residency Program The Physical Therapy Residency Program provides education in the specialty area of physical therapy. This program offers physical therapy residency positions at non-KFH facilities in southern California. Program graduates are able to sit for board certification examinations in physical therapy, and apply to participate in a physical therapy fellowship program. D.4.2.6. School of Anesthesia for Nurses The Kaiser Permanente School of Anesthesia for Nurses, founded in 1972, helped pioneer graduate-level education for nurse anesthetists. In partnership with California State University Fullerton, the school offers a two-year sequential academic and clinical graduate program for nurses with a baccalaureate degree. Students earn a Master's of Science in nursing with a clinical specialty in anesthesia. In 2012, the Kaiser School of Anesthesia/California State University Fullerton was ranked by U.S. News and World Report's "Best Graduate Schools 2009" as one of the top nurse anesthesia programs in the nation. In Southern California Region, the school has partnered medical centers, hospitals, military hospitals and universities to provide additional clinical rotation opportunities for students. Scholarships for students are available through National Black Nurses Association and American Association of Nurse Anesthetists Foundation. In California Region, the school has a partnership with Loma Linda University and Samuel Merritt University to provide distance learning for students statewide. D.4.2.7. Delores Jones Nursing Scholarship Program The Delores Jones Nursing Scholarship Program provides financial assistance for students enrolled in any California nursing program to encourage and support them to become registered nurses or to pursue advanced nursing degrees. Scholarships are based primarily on financial need, grade point average, and are awarded in several categories including academic excellence in pre-licensure, graduate studies, and doctoral programs. D.5. Self-Sufficiency Programs KFH provided community-based programs and services to low-income residents and students through learning centers and youth employment programs. In 2017, KFH spent $7.7 million to support the following programs. D.5.1 Watts Counseling and Learning Center (WCLC) Since 1967, Watts Counseling and Learning Center (WCLC) has a valuable community resource for low-income, inner-city families in South Los Angeles. WCLC provides mental health and counseling services, educational assistance for children with learning disabilities, and a state-licensed and nationally accredited preschool program. In addition, WCLC operates several outreach programs, including Kids Can Cope support groups (for children whose siblings or parents have cancer), pre-employment training for high school youth, and scholarships for high school students, and training for graduate social work interns from local universities. D.5.2. Youth Employment Programs Several Youth Employment programs offered in California focus on providing underserved diverse students with meaningful employment experiences in the health care field. Educational sessions and motivational workshops introduce them to the possibility of pursuing a career in health care while enhancing job skills and work performance. These programs serve as a pipeline for the organization and community-at-large, enhancing the future diversity of the health care workforce. Programs include: . KP INROADS College Internship Program . Health Care Career College Internship Program . Kaiser Permanente Southern California Internship Program - Apothecary Circle Program . Kaiser Permanente LAUNCH Internship Program E. Other Community Benefit Investments In 2017, Kaiser Foundation Hospitals spent over $26 million to support Community Benefit activities and programs beyond the national streams of work. This included the administrative expenses of regional Community Benefit departments dedicated to supporting the organization's Community Benefit programs and services and coordinating related initiatives. The following is an example of programs funded in this area. E.1. Tumor Board and Cancer Registry KFH spent $1.4 million to support the Tumor Board and Cancer Registry in the Northwest and Hawaii regions. Besides being a statistical database utilized by clinicians and researchers within the regions, the registry submits statistics to the National Cancer Data Base annually. The Cancer Program, which oversees the registry, is surveyed for accreditation every three years by the American College of Surgeons Commission on Cancer. E.2. Kaiser Permanente Community Fund (KPCF) It is often the social, political, and economic conditions in communities that have the potential to create or inhibit health. These systems have to be aligned in such a way that they maximize opportunity for people if they are to contribute to long-term health. The Kaiser Permanente Community Fund at Northwest Health Foundation (KPCF) has been at the forefront of this movement in the Northwest region for more than a decade. By making thoughtful investments in our communities, KPCF has helped bring together organizations working across different sectors of society, building their capacity to collaborate and serve in the best interest of communities so that individuals and families can truly thrive. In 2017, KPCF initiated the UnWind program with a focused investment in developing a cohort of community leaders ready to address the challenges in their communities with innovative, life-giving solutions. A strong emphasis is being placed on supporting leaders coming from communities of color. Through a series of intentional retreats, self-care learnings, and relationship-building opportunities offered over the two years, UnWind hopes to cultivate a people-powered movement of community leaders whose vision, skill, and insight can bring about a vibrant, healthy future for Northwest residents. F. Environmental Stewardship A stable and non-toxic environment contributes to health and wellness. Safeguarding and healing the natural environment is therefore a key component of Kaiser Permanente's multifaceted efforts to improve the total health of our members and the communities we serve. Kaiser Permanente maintains a governance structure for environmental stewardship that steers actions across our organization to detoxify the ways in which healthcare is delivered while catalyzing environmental improvement throughout society. This structure includes clearly defined roles, responsibilities, plans and routines, and has resulted in five organization-wide focus areas that have been selected based on their ability to have the most impact on the forces that shape environmental- and human-health: . Responding to climate change . Promoting sustainable farming and food choices . Reducing, reusing, and recycling to eliminate waste . Finding safe alternatives to harmful industrial chemicals . Conserving water In each of these focus areas, Kaiser Permanente has established ambitious goals (including a 2025 target to remove more greenhouse gases from the atmosphere than we emit); implemented initiatives; achieved measurable improvements; and regularly reported progress to our Board of Directors, our staff, and the communities we serve. F.1. Performance Metrics During 2017, key performance indicators for Kaiser Foundation Hospitals environmental programs in California, Oregon, Washington, and Hawaii, including KP Information Technology included: F.1.1. Reduced our greenhouse gas emissions associated with routine use of anesthetic agents by over 8,000 metrics tons of carbon dioxide equivalent, compared to our 2014 baseline. F.1.2. Purchased or contracted to purchase over 450 million kilowatt-hours of renewable power (including over 15 million kilowatt-hours of electricity generated by solar panels hosted at our facilities). F.1.3. Improved our energy use intensity (kBtu/rentable square foot) by 6% (not including data centers) compared to our 2010 baseline, and improved the Power Usage Effectiveness of our national data centers by 25% compared to our 2008 baseline. F.1.4. Provided meals to patients containing at least 491,000 pounds of sustainably produced meat and poultry. F.1.5. Responsibly reused, recycled or composted over 27,000 tons of materials. F.1.6. Reduced our overall water use by more than 123 million gallons compared to our 2013 baseline, while improving our water use intensity (gallons/rentable square foot) by 12% (not including data centers). 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