Title: Holy Cross Hospitals Community Benefit Plan and FY05 Annual Work Plan
1Holy Cross Hospitals Community Benefit Plan and
FY05 Annual Work Plan
- Approved by the Holy Cross Hospital Board of
Trustees - October 14, 2004
2Holy Cross Hospitals Community Benefit
PlanContents
- Holy Cross Hospitals Community Benefit Plan,
including the annual work plan, articulates
overarching strategic - objectives and annual initiatives for meeting
identified community healthcare needs. The focus
of this plan is on promoting - access and improving community health deploying
resources toward that end and involving the
community. The plan - provides methods for reporting and evaluation.
- Contents Page
- Executive summary of Holy Cross Hospitals
community benefit ministry......3 - I. Statements of commitment to community
benefit.7 - II. Identification of unmet community healthcare
needs and link to Holy Cross Hospitalsstrategic
priorities and mission commitments.....
...8 - III. Description of fit of community benefit plan
within overall planning process...16 - IV. Methods for evaluation.
........23 - V. FY04 accomplishments
25 - VI. Annual work plan for FY05.
.28 - Data Supplement..
..32 -
3Executive Summary of Holy Cross Hospitals
Community Benefit Ministry
- The overarching goal of Holy Cross Hospitals
community benefit ministry is to ensure access
and improve health status, especially for the
most vulnerable and underserved, and to be a
leader in community service - Holy Cross Hospitals community benefit ministry
is rooted in our identity and is an integral part
of our mission our commitment is evidenced by - written statements (e.g., mission and role
operating plan target for community benefit), - organizational structures (e.g.,
interdepartmental CEO Review Committee on
Community Benefit Mission and Planning Committee
of the board of trustees), - policies (e.g., charity care policy
comprehensive coverage by hospital and
hospital-based physicians), and - the allocation of institutional resources (e.g.,
9.7 million in FY04) - Holy Cross Hospitals community benefit
activities focus on access and community health
improvement especially for women and children
seniors and racial, ethnic and linguistic
minorities - We leverage our strengths and match our strategic
priorities to identified community needs - We strive to maintain our leadership position in
community benefit activity and monitor and
evaluate our progress through integrated
management and governance processes - We provided 9.6 million in community benefit
activity during FY04
4Executive Summary (cont.)
- We work in partnership with community
organizations for example - Our parish nurse program has relationships with
36 faith communities plus 10 under development - Our senior fit program is offered in partnership
with Kaiser Permanente, Montgomery County
Department of Recreation, and Maryland National
Capital Parks and Planning Commission during
FY05, we are partnering with the National Council
on the Aging to carry out an impact study - We have an exclusive Maternity Partnership
program with Montgomery County Department of
Health and Human Services, which served 1,596
uninsured women during FY04 - During FY04, we expanded our partnership with
Montgomery County around ethnic health promotion.
With grant funding from the State of Maryland,
Minority Office and Technical Assistance
Cigarette Restitution Fund, the Community
Ministries of Rockville, and CASA of Maryland
will partner with us to provide technical
assistance and train 30 ethnic health promoters - We have partnered with the Housing Opportunities
Commission of Montgomery County, Montgomery
County Department of Health and Human Services,
and the State of Marylands Department of Aging
to provide our senior source in a Section 8,
Housing and Opportunities senior housing facility
adjacent to the Elizabeth House in Silver Spring
5Executive Summary (cont.)
- During FY04, our accomplishments included
- Improved access
- Provided 6.3 million in charity care (5.3
million at cost) and raised the income level for
charitable assistance - Provided prenatal and obstetrical care to 1,596
maternity partnership admissions and secured
additional supplemental funding for FY04 and
removal of the cap on the number of
county-funded enrollees going forward - Opened Holy Cross Health Center at Montgomery
College - Increased the number of foreign and sign language
interpretations - Increased the number of parish nurse screenings,
visitations, and newsletter mailings - Referred 48 uninsured patients to 23 specialty
physicians - Provided clinical breast examinations, diagnostic
studies, and links to treatment for medically
underserved women who are ineligible for county
cancer control programs - Reached targeted populations
- Seniors Increased participation in senior
exercise programs - Women/Children Increased participation in
perinatal programs - Racial and Ethnic Minorities Increased
participation in ethnic health promotion program - Improved monitoring via better data collection
- Provided leadership
- Selected for national longitudinal study on the
impact of senior exercise programs - Became project director in a partnership to build
ethnic health promotion capacity in the county - Initiated conversation with county hospital CEOs
about additional hospital-owned primary care
health centers
6Executive Summary (cont.)
- During FY05, we plan to
- Create a plan to improve data collection and
analysis and improve our ability to meet language
needs - Monitor bilingual capacity by unit and recruit
bilingual clinical and non-clinical staff in
areas of high interpretation demand - Open Holy Cross Hospital Senior Source in Silver
Spring - Work with Montgomery County hospital CEOs and
Montgomery County government to create additional
hospital-owned primary care capacity - Participate in the National Council on the
Agings longitudinal study on the impact of
senior exercise - In-service emergency center, hospitalists, and
applicable units/departments regarding the health
centers services and continue to understand
relationship of health center visits to emergency
center use - Secure additional outside grant funding
- Serve as project director for State of Maryland
Cigarette Restitution Grant, Minority Office and
Technical Assistance grant to train 30 ethnic
health promoters
7I. Statements of Commitment to Community
BenefitHoly Cross Hospitals community benefit
ministry is rooted in our identity as a Catholic
healthcare provider and is an integral part of
our mission our commitment is evidenced by
written statements, organizational structures,
policies, programs, and especially the allocation
of institutional resources
- The overarching goal of Holy Cross Hospitals
community benefit ministry is to ensure access
and improve health status, especially for the
most vulnerable and underserved, and to be a
leader in community service - Holy Cross Hospital is committed to a program of
community benefit through our mission and role to
be the most trusted provider of healthcare
services, with special emphasis on access for the
vulnerable and underserved (especially women
children seniors and racial, ethnic and
linguistic minorities) and improvements in health
status - We have established and improved explicit charity
care policies and procedures, and we encourage
physician and employee participation in providing
services for the needy and the broader community - Key elements of our charity care policy are
active communication, comprehensive coverage of
services provided by the hospital and
hospital-based physicians, and a six month period
of eligibility - We work to assess eligibility for public programs
and provide enrollment support - We participate with other organizations in the
community to leverage community resources toward
mutual goals - We have established leadership accountability and
an organizational infrastructure for ongoing
planning, budgeting, implementation, and
evaluation of community benefit activities, which
are integrated into our multi-year strategic and
annual operating planning processes
8II. Identification of Unmet Community
Healthcare Needs and Link to Holy Cross
Hospitals Strategic Priorities and Mission
CommitmentsHoly Cross Hospital obtains
information about needs in our service area in a
variety of ways
- Through participation in a variety of coalitions,
committees, partnerships and panels - Employees contributed 2,293 leadership hours in
the community - From our own internal patient data, and from
purchased and publicly available data on the
market, demographics and health service
utilization - From residents in our service area
- Through available needs assessments and reports
- Program Prioritization to Control Chronic
Diseases in African American Faith-Based
Communities, April 2004 - Community Ministries of Rockville Health Project
Focus Groups Report, April 2004 - National Healthcare Disparities Report, U.S.
Department of Health and Human Services, Agency
for Healthcare Research and Quality, July 2003 - Blueprint for Latino Health in Montgomery County
Maryland, 2002-2006 - Improving the Health of Our Community, Montgomery
County, Maryland, 2002 Progress Report - A Report on the Needs of Low Income Seniors,
Montgomery County, Maryland, June 2002 - Institute of Medicine Report, Unequal Treatment
What Healthcare Providers Need to Know about
Racial and Ethnic Disparities in Health Care,
March 2002 - Montgomery County Community Health Improvement
Plan, July 2001 - Community Health Indicators for the Washington
Metropolitan Region, June 2001 (A Regional Report
from the Metropolitan Washington Public Health
Assessment Center) - Primary Care Coalition Enhancement of Safety Net
Providers Final Report (December 12, 2000)
9The two most recent reports provide
affirmation about what we have been doing
- Faith-based Communities Study
- Larger African American congregations are an
effective vehicle by which health promotion
messages can diffuse however, the leadership
must be provided with skills to assess health
needs before selecting programs most beneficial
to their congregations Mechanisms by which small
congregation leaders can participate need
development - Community Ministries of Rockville Report
- Most pressing needs identified by medical
providers, caregivers and recipients - Regarding Health Conditions Asthma and
respiratory disease cancer diabetes
hypertension/cardiovascular disease mental
health oral health obesity substance abuse - Regarding the Health Care System Access to
health care complicated and gruesome system
expensive health care help with medications - Regarding Case Management and Customer Service
Efficient case management and customer service
help to navigate the system cultural
competence/language appropriate services - Regarding Health Services Information/prevention
infant care/care for children long-term care - Regarding Infrastructure and Equipment More
community clinics - Regarding Supportive Services More hours of
availability transportation
10As a leader, Holy Cross Hospital sometimes
identifies and responds to community needs before
the needs are identified in available needs
assessments
- The Senior Fit exercise program was developed
seven years ago by Holy Cross Hospital in
partnership with Kaiser Permanente, Montgomery
County Department of Recreation, and the Maryland
National Capital Parks and Planning in Prince
Georges County - Three years after its development, the program
was identified as a recommended strategy by
Montgomery County in its July 2001 Needs
Assessment - During FY03, the National Council on the Aging in
a national competition judged Senior Fit to be
one of 10 award-winning national programs - During FY04, the National Council on Aging
selected Senior Fit as one of only three programs
nationally to participate in a longitudinal study
to measure the impact of fitness activities on
the health and quality of life of older
participants during FY05 - The Parish Nurse program, developed in 1993, was
a pioneer in preventive health services and
promotion in partnership with faith communities - Our program was the first in the area and is a
widely replicated model we have partnered with
36 faith communities with over 70,000 members in
Montgomery County, Prince Georges County, and
the District of Columbia, with 10 additional
congregational relationships under development - Holy Cross Hospital continues to serve as a
local, regional and national model and resource
for others
11Leadership (cont.)
- The ethnic health promoter program began during
2002 with funding from Montgomery County through
the Cigarette Restitution Fund and matched by
Holy Cross Hospitals community benefit fund - This approach has been identified by experts in
community health as powerful and Holy Cross
Hospital is at the forefront locally - During FY05, Holy Cross Hospital will serve as
the project director on a grant funded by the
State of Maryland, Minority Office and Technical
Assistance to build capacity in ethnic health
promotion and cancer control and tobacco
prevention with key partners Montgomery Countys
African American Health Program, Latino Health
Initiative, and the Asian American Cancer
Program community-based organizations CASA of
Maryland, and Community Ministries of Rockville - During FY04, Holy Cross Hospital took the lead
and engaged the Montgomery County hospital chief
executive officers in a conversation about
creating additional community health centers
funded by the hospitals and in part by Montgomery
County - An outline of the Montgomery County hospitals
response to serve the uninsured has been
developed a position paper will be developed and
follow-up will take place with key
representatives of Montgomery County government
to talk about implementation and shared financing
12Demographic analysis (detail is included in
attached data supplement) reveals that areas
close to the hospital have a large number of
people who are...
- Poor
- Child-bearing age
- Elderly
- Racially and ethnically diverse
- Limited English speaking
13To select outreach priorities, Holy Cross
Hospital linked identified community healthcare
needs to our strengths and own mission commitments
- Needs Identified in Montgomery County
- and Valid in Prince Georges County
- Infant mortality
- Asthma
- Colorectal cancer
- Cardiovascular disease
- Diabetes
- HIV/AIDS
- Identified barriers to access
- Financial access
- Geographic access
- Cultural access
- Identified need to improve data, especially
cultural
- Holy Cross Hospitals Strategic Priorities
- Women/children
- Cancer
- Cardiac
- Seniors
- Holy Cross Hospitals Mission Commitments
- Access, especially for vulnerable and underserved
- Outreach to targeted populations
- Demonstrated improvements in health status
Identified priority health problems based on
substantial racial or ethnic disparity county
rate higher than state rate and/or county rate
higher than national rate targeted by Healthy
People 2010, Community Health Improvement Plan
2001 and 2002 Progress Report
14We developed a set of principles to help
determine our highest priorities and guide our
decision making about community benefit
- Be focused on geographically close (vs. distant)
locations, especially in the core area - Meet Holy Cross Hospitals strategic focus and
identified community need - Women/children (particularly infant mortality,
asthma) - Cancer (particularly in racial and ethnic
minorities) - Cardiovascular disease (particularly in racial
and ethnic minorities) - Seniors (particularly cardiovascular disease,
obesity and diabetes) - Meet Holy Cross Hospitals overall commitment to
access and identified community need - Financial access (particularly charity care
policy) - Geographic access (particularly offsite locations
including Piccard Clinic and Health Center 20
senior exercise sites 36 parish nursing sites) - Cultural access (particularly multicultural
access program and ethnic health promotion
program) - Meet Holy Cross Hospitals commitment to health
status improvement and build upon our strengths - Have measurable outcomes and be integrated with
planning and budgeting - Reflect partnership
15After reviewing the range of information about
community need, we have concluded that identified
community needs are consistent with our overall
strategic plan
- The priorities identified in earlier needs
assessments remain valid - The community benefit plan is an extension of the
strategic plan, with particular emphasis on our
mission commitments of access and health status
improvements to leverage our strengths, it links
to clinical priorities as well - Ongoing community outreach efforts will respond
to emerging unmet community healthcare needs,
especially as identified through our ethnic
health promotion program
16III. Description of Fit of Community Benefit
Plan within Overall Planning ProcessThe
Community Benefit Plan is a key planning document
in Holy Cross Hospitals portfolio of plans
- Holy Cross Hospitals strategic plan is the key
planning document that provides the vision and
multi-year direction for accomplishing our
mission within our environment and focuses on - working with physicians to grow volume
(especially through program development in six
programmatic areas women and children cancer
care seniors emergency surgery, and cardiac
services), - ensuring our ability to grow (through strategies
in key areas workforce, efficiency,
philanthropy, information, and facility), - providing the best possible outcome in a safe and
caring environment (through nursing excellence,
patient safety, quality and patient
satisfaction), and - demonstrating commitment to community health
improvement (through financial access targeted
outreach leadership/advocacy and
monitoring/evaluation) - The community benefit plan includes statements of
organizational commitment identification of
unmet community needs a description of the fit
of the plan within the overall planning process
methods for evaluation and an annual work plan
based on accomplishments achieved to date. The
community benefit plan receives the same level of
senior management attention and governance
oversight as the organizations budget, human
resources plan, and quality plan. - The annual operating plan highlights special
fiscal year initiatives for achieving specific
organizational targets in community benefit,
growth, human resources, budget and finance,
quality and service, philanthropy, and facility.
17Holy Cross Hospitals planning process integrates
community benefit planning within the overall
strategic and operating planning processes
MISSION AND ROLE Most trusted provider high
quality and efficiency access outreach and
health status improvements caring spirit
ENVIRONMENT Population,
utilization, births, uninsured, physicians,
workforce, quality (safety, clinical
outcomes, satisfaction), costs, rate regulation
VISION Working with physicians to grow volume,
with a particular emphasis on developing complex
services Ensuring our ability to grow Providing
the best possible outcome in a safe and caring
environment Demonstrating our commitment to
community health improvement
STRATEGIC PLAN Growth
Ability to Grow
Quality Community Health Program market
Workforce Evidence-based
practice Financial access development
Efficiency Nursing
excellence Targeted outreach Physician relations
Fundraising Patient safety
Facility
Patient satisfaction
Information systems
ANNUAL OPERATING PLAN includes select initiatives
and annual targets from
Community Benefit
Budget and Finance
Quality and Service
Human Resources
Growth
Facility
Philanthropy
Human Resources Plan
Capital and Operating Budget Info. Sys. Plan
Performance Improvement Plan Plan for Nursing
Excellence
Strategic Plan Growth Plan Phys. Dev. Plan
Master Facility Plan
Fund Development Plan
Community Benefit Plan / Annual Target
Key Planning Documents
Holy Cross Hospital Community Benefit Plan and
FY05 Annual Work Plan
17
18Mission and Role Statement Holy Cross
Hospitals planning process begins with our
mission, which guides all that we do
- We serve together in Trinity Health, in the
spirit of the Gospel, to heal body, mind and
spirit, to improve the health of our communities,
and to steward the resources entrusted to us - Respect
- Social justice
- Compassion
- Care of the poor and underserved
- Excellence
- Holy Cross Hospital of Silver Spring exists to
support the health ministry of Trinity Health and
to be the most trusted provider of healthcare and
related services in our area through - The high quality and efficiency of the services
we provide in partnership with our physicians and
others - The accessibility of those services to people
living within our service area, especially the
most vulnerable and underserved - The breadth of our community outreach and our
demonstrated commitment to improve health status,
and - The friendly, caring spirit we extend to every
individual
19Environment Holy Cross Hospital pursues its
mission in the context of the environment
- The population in the market that we serve has
grown the past few years and is expected to
continue to grow and become more diverse both
racially and ethnically. - Inpatient and outpatient utilization rates have
been rising nationally and locally. We
anticipate use rates will continue to grow,
although the pace of growth will slow. - The number of births in the area will continue to
increase, with a high rate of births to immigrant
women. - The problem of the uninsured will continue for at
least the current planning horizon. - Holy Cross has a very large medical staff. These
physicians will continue to practice at multiple
hospitals and to seek ways to be more efficient
when in the hospital to allow more time for
office visits. - Clinical workforce shortages will continue to
exist. Holy Cross will continue to have a very
diverse workforce. - Quality (safety, clinical outcomes and
satisfaction) will continue to be an important
source of differentiation and increasingly will
be monitored by regulatory bodies, purchasers and
the public. - Costs to deliver high quality care will continue
to rise, particularly driven by labor and
pharmaceutical costs. - Rate regulation will remain in effect at least
through the current planning horizon.
20VisionHoly Cross Hospital will succeed in its
environment and accomplish its mission of
becoming the most trusted provider of healthcare
and related services in our area by...
- Working with physicians to grow volume, with a
particular emphasis on developing selected
complex services - program and market development
- physician relations
- Ensuring our ability to grow
- workforce effectiveness and commitment
- efficiency of our people and processes
- fundraising
- facility
- information systems
- Providing the best possible outcome in a safe and
caring environment - evidence-based practice
- nursing excellence
- patient safety
- patient satisfaction
- Demonstrating our commitment to community health
improvement - financial access
- targeted outreach
- leadership
- monitoring and evaluation
21Three-Year Strategic PlanThe FY04-06 strategic
plan outlines four broad community health
strategies, which are the overarching objectives
of the FY05 community benefit annual work plan
- FY04-06 community health strategies
- Provide general financial access to the poor and
vulnerable - Do so in accordance with our mission and charity
care policy - Target populations for special outreach,
especially in the core market area, in
partnership with others enhance geographic and
cultural access and improve health status - Increase access to primary care for uninsured and
underinsured people and address use of emergency
department for urgent/primary care by uninsured
people - Increase capabilities to understand and meet
needs of diverse patient population - Maintain leadership/advocacy position in
community benefit activity - Increase advocacy regarding the uninsured
- Increase role as a resource for health
information - Monitor and evaluate progress
22Annual Operating PlanHoly Cross Hospitals
FY05 operating plan (the second year of our
three-year planning horizon) identifies a
specific organizational target for community
benefit
- Community benefit target
- Improve data collection to establish a baseline
related to interpretation needs, set improvement
target and meet it - Special initiative for FY05
- Targeting Racial and Ethnic Minorities and
Cultural Access - Evaluate and respond to special needs of our
diverse population special focus on meeting
language difficulties
23IV. Methods for EvaluationHoly Cross Hospital
has developed specific methods for monitoring and
evaluating progress toward community benefit
objectives
- The annual hospital budgeting process includes a
charity care target and designated operating
funds for the Community Benefit Fund, community
health, parish nursing, OB/GYN clinic, the Holy
Cross Health Center at Montgomery College,
multicultural services, and the senior source - The interdepartmental CEO Review Committee on
Community Benefit develops the community benefit
plan, including the annual work plan and monitors
progress on a quarterly basis the senior
management team reviews progress semi-annually - The Mission and Planning Committee of the board
of trustees provides governance oversight and
monitors selected community benefit performance
indicators on a quarterly basis - The Community Benefit Plan, including the annual
work plan, is presented for full board of
trustees discussion and approval in October of
each year a subset of the community benefit
performance indicators are shared with the board
of trustees on a quarterly basis
24Evaluation MethodologyEvaluation of Holy Cross
Hospitals community benefit plan is integrated
into seniormanagement and governance oversight
processes
ANNUAL OPERATING PLAN includes select initiatives
and annual targets from
Community Benefit
Budget and Finance
Quality and Service
Human Resources
Growth
Facility
Philanthropy
Human Resources Plan
Capital and Operating Budget/ Info. Sys. Plan
Performance Improvement Plan/Plan for
Nursing Excellence
Strategic Plan / Growth Plan/Phys.Dev. Plan
Master Facility Plan
Fund Development Plan
Community Benefit Plan / Annual Target
Key Planning Documents
Management
Governance
24
Holy Cross Hospital Community Benefit Plan and
FY05 Annual Work Plan
25V. FY04 AccomplishmentsProgress on last
years initiatives sets the stage for the FY05
work plan
- During FY04 (and compared to FY03), our
accomplishments included - Improved access
- Provided 6.3 million in charity care (5.3
million at cost), an increase of 18 percent and
972,000 - Raised the income level for charitable assistance
at Holy Cross Hospital to 300 percent of poverty
from 200 percent of poverty and secured
hospital-based physician participation - Provided prenatal, obstetrical and newborn care
to 1,596 maternity partnership admissions (a 12
percent increase from 1,431) with 85 entering in
the first and second trimesters, and secured an
additional 211,000 in supplemental funding for
FY04 and removal of the cap on the number of
county-funded enrollees going forward - Opened Holy Cross Health Center at Montgomery
College on February 2, 2004 and saw 400 patients
during the first five months of operation - Improved the collection of registration data on
racial, ethnic, and linguistic minorities by
altering the registration screens to reflect
Census categories, primary language, and need for
an interpreter - Reported 8,683 foreign and sign language
interpretations, an increase of 73 percent from
5,017 - Increased the number of parish nurse screenings
to 320 from 200, the number of visitations to 150
from 100, and the number of newsletter mailings
to 1,200 from 1,105 - Referred 48 uninsured patients to 23 specialty
physicians (with 31 physicians participating in
the safety net) primarily through the ethnic
health promotion program, community health
outreach, Cancer Education Day, and
Back-to-Health (Spine) Day - Provided clinical breast examinations, diagnostic
studies (i.e., mammograms, ultrasounds, and MRI),
and links to treatment (i.e., surgery, oncology
and radiation therapy) for medically underserved
women who are ineligible for county cancer
control programs with additional financial
support from Maryland Regional Cancer Care and
Susan G. Komen Breast Cancer Foundation
26 FY04 Accomplishments (cont.)
- Reached targeted populations
- Seniors
- Enrolled 5,464 participants in senior exercise
programs with 46,045 encounters (an increase from
5,213 and 42,739 respectively) - Oversaw renovation of space in a Housing
Opportunities Commission site in Silver Spring,
and planned for the relocation of our senior
source activities to Silver Spring from Bethesda - Women/Children
- Enrolled 9,469 participants in perinatal
programs, an increase of 10 percent increase and
824 participants from 8,645 - Served as health resource by registering 1,200
parents for our parent e-newsletter, the highest
in the country and an increase from 200 - Racial and Ethnic Minorities
- We increased the number of participants in our
ethnic health promotion program to 10,984 from
3,325, with 72 percent and 7,873 participants of
targeted ethnic origin the number of screenings
increased to 1,092 from 73 and the number of
teachings increased to 500 from 77 - Increased community health outreach grant funding
38 percent to 313,000 from 226,000
27 FY04 Accomplishments (cont.)
- Improved monitoring
- Data collection maintained and improved for range
of community benefit activities, including
Maternity Partnership, registrations by primary
language, interpretations, senior exercise
programs, community health programs, perinatal
programs, parish nursing programs, and ethnic
health promotion - Established data collection systems for Holy
Cross Health Center at Montgomery College - Provided leadership
- Selected by the National Council on the Aging as
one of only three sites nationally to participate
in a longitudinal study on the impact of senior
exercise programs and received Institutional
Review Board approval to proceed - Increased the number of parish nursing
relationships to 46 churches (including 36
established relationships and 10 under
development (and added our first Hispanic
congregation to 12 African American
congregations) with the number of church members
increasing to 87,000 from 70,000 - Became project director in a partnership with
county government and community based
organizations to build capacity and cultural
competence, facilitated by ethnic health
promoters under a state-funded grant - Initiated conversation with Montgomery County
hospital CEOs about additional hospital-owned
primary care health centers - Need more/continued work on
- Re-application for Foster McGaw award the
application process strengthened our ability to
quantify major activities and demonstrate
integration of community benefit with hospital
governance, management and operations - Developing better charity care monitoring to
track applications and improve understanding of
charity care profile - Development of health status indicators to be
monitored
28VI. FY05 Annual Work Plan 1. Provide
general financial access to the poor and
vulnerable and do so in accordance with our
mission and charity care policy
- Priorities to be addressed Financial Access and
Women/Children - Initiatives
- Ensure financial access through the charity care
program, especially the ob/gyn clinic and the
health center at Montgomery College - Track charity care applications, approvals, and
referrals to other programs and improve
understanding of charity care profile
(participants, inpatient/outpatient mix, service
line, and referral source) - Review impact of ethnic health promotion program
on enhancing access and links to treatment - Work with Holy Cross Hospital physicians and
Project Access to improve access to specialty
physician safety net
292. Target populations for special outreach,
especially in the core market area, in
partnership with others enhance geographic and
cultural access and improve health status
- Priorities to be addressed Uninsured and
Racial/Ethnic Minorities, Geographic and Cultural
Access - Seniors, Cancer and Cardiac
- Operating Plan Item
- Create a plan to improve data and improve our
ability to meet language needs and enhance
cultural access - Establish a monthly reporting system on
non-English registrations, identified need for
interpreter, and number of interpretations
provided Analyze baseline data and improve data
collection process Improve understanding of
hospital and community demographics Review best
practices on data collection and meeting language
needs Assess current capability and determine
gaps and methods for closing the gaps - Establish multidisciplinary committee to focus on
this issue engage foreign born physicians - Identify and enroll key clinical individuals,
including physicians, in Command Spanish course - Develop methods to monitor interpretation demands
and bilingual capacity by unit Recruit bilingual
staff (clinical and non-clinical) in areas of
high interpretation demand - Other Initiatives
- Open Holy Cross Hospital Senior Source in Silver
Spring - In-service emergency center, hospitalists, and
applicable hospital units and departments
regarding health center capabilities and
services pursue additional funding and full time
provider relationships - Identify opportunities to leverage Parish Nursing
relationships - Develop plan to carry out research related to
health center, parish nursing, ethnic health
promotion, and senior fit as described in
Certificate of Need for open heart surgery - Review restricted and unrestricted funds for
community benefit and establish plan for
expenditure - Create four new Senior Fit sites for the National
Council on the Aging Impact Study
303. Maintain leadership/advocacy position in
community benefit activity
- Priorities to be addressed Overall Commitment
to Access and Identified Community Need and
Reflect Partnership - Initiatives
- Lead conversation with Montgomery County hospital
CEOs and key individuals to plan for additional
primary care health centers in Montgomery County
sponsored by the hospitals and supported in part
by the County - Explore and consider innovations in charity care
reimbursement under Marylands rate system to
encourage improvements in access - Serve as project director for Minority Outreach
and Technical Assistance grant to train 30 ethnic
health promoters with community partners - Re-submit qualified application for Foster McGaw
Prize - Explore partnering with area baccalaureate
nursing schools clinical rotations on two levels
1) perinatal education (e.g., program
development and teaching), and 2) addressing the
unmet needs in the community (e.g., health
screening, health fairs, education and awareness)
314. Monitor and evaluate progress
- Priorities to be addressed Measurable Outcomes
- Initiatives
- Continue to improve monitoring of health center
activity, especially with respect to emergency
department use - Explore better methods of ensuring house-wide
participation in quarterly community benefit data
collection effort hold in-service explore
automation or web-based approach to data
collection - Write and print FY04 Community Benefit Report
understand differences in community benefit
activity compared with FY03 understand
expectations for first year peer reporting in
Maryland and submit report - Participate in National Council on the Agings
longitudinal study on senior exercise and report
progress and results - Explore new software tool and develop methods to
improve data collection on parish nursing and
community health activities and ascertain
improvements in health status and consistency
with current methods - Establish charitable gifts and grants policy and
comply with review process as determined for
outreach grants - Evaluate performance toward goals of outreach
grants - Maintain CEO Review, operating plan, and board
monitoring and evaluation processes and develop
new or alternative performance indicators as
needed
32Data Supplement
33Holy Cross Hospital serves a four-area market in
Montgomery and Prince Georges Counties (with 56
of patients residing in the core service area and
the Northern Prince Georges County service area)
Montgomery Referral
Core
Northern Prince Georges
Primary Service Area
Prince Georges Referral
Patient Origin
Washington D.C.
Core (45)
Northern Prince Georges (11)
Prince Georges Referral (10)
Montgomery Referral (18)
Source Inforum
33
Holy Cross Hospital Community Benefit Plan and
FY05 Annual Work Plan
34Demographic analysis reveals that Areas close to
the hospital generally have a greater number of
poor households
Number of Households with Income the top 10 ZIP codes are in our primary service
area
Number of Medicaid, Charity, and Self Pay
Discharges 6 of the top 10 ZIP codes are in our
primary service area
Source Inforum (2002 Demographic Data from
Claritas)
35Areas close to the hospital generally have a
greater number of seniors and women of
childbearing age
Number of Seniors (Ages 65) 5 of the top 10 ZIP
codes are in our primary service area
Number of Women of Childbearing Years (Ages
18-44) 5 of the top 10 ZIP codes are in our
primary service area
Source Inforum (2002 Demographic Data from
Claritas)
35
36 Montgomery and Prince Georges Counties are
racially diverse
White Population 1 of the top 10 ZIP codes is in
our primary service area
Black Population 1 of the top 10 ZIP codes is in
our primary service area (3 of the ZIP codes in
Montgomery Co. with the greatest number of
African Americans are in our core market area)
Source Inforum (2002 Demographic Data from
Claritas)
36
37 Areas close to the hospital have the highest
numbers of foreign born and linguistic minorities
Number of Foreign Born 6 of the top 10 ZIP codes
are in our primary service area
Number that Speak Limited English 7 of the top 10
ZIP codes are in our primary service area
Source U. S. Census Bureau (Census 2000,
Summary File 3, QT-P15)
37
Holy Cross Hospital Community Benefit Plan and
FY05 Annual Work Plan
38 Areas near the hospital are ethnically diverse,
with the highest numbers of Hispanic persons
Hispanic Population 7 of the top 10 ZIP codes are
in our primary service area
Source Inforum (2002 Demographic Data from
Claritas)
39 Non-English Speaking Inpatient Registrations in
Montgomery and Prince Georges Counties
FY03 Inpatient Registrations
FY04 Inpatient Registrations
39
Source Clinstar
40 Non-English Speaking ED Registrations in
Montgomery and Prince Georges Counties
FY03 ED Registrations
FY04 ED Registrations
40
Source Clinstar
41Healthcare needs identified in Montgomery
County are valid in Prince Georges County as
well -- especially racial and ethnic disparities
- Infant Mortality Rate Deaths per 1,000 births
- Prince Georges County - 12.6
- Montgomery County - 6.5
- Washington, DC - 13.6
- US average - 7.2
- Healthy People 2010 Target - 4.5
- Adults, 50 and Older, Having a Fecal Occult Blood
Test in Past 2 Years () - Prince Georges County - 29
- Montgomery County - 42
- Washington, DC - 41
- US average - 35
- Healthy People 2010 Target - 50
- Coronary heart disease Age-Adjusted Death Rate
(per 100K) - Prince Georges County - 228
- Montgomery County - 142
- Washington, DC - 213
- US average - 216
- Healthy People 2010 Target - 166
- Diabetes-related DeathsAge-adjusted Death Rate
(per 100K) - Prince Georges County - 120
- Montgomery County - 60
- Washington, DC - 99
- US average - 75
- Healthy People 2010 Target - 45
Note Although Montgomery Countys rates are
better that the US average and/or Healthy People
target in some cases, the County
selected these priorities based on racial and
ethnic disparities
Source Community Health Indicators for the
Washington Metropolitan Region,
Metropolitan Washington Public Health Assessment
Center, June 2001
41
Holy Cross Hospital Community Benefit Plan and
FY05 Annual Work Plan
42Holy Cross Hospital offers clinical and outreach
programs beyond the Silver Spring campus but
focuses nearby
Clinical and Outreach Services in Montgomery and
Prince Georges Counties and the District of
Columbia
Montgomery County
Rockville
?
Bethesda
Prince Georges County
District of Columbia
?
Holy Cross Hospital
?
Parish Nurse Program
?
Senior Fit
?
Holy Cross Off Site Locations
42
Holy Cross Hospital Community Benefit Plan and
FY05 Annual Work Plan