4A (Expenses $ 16196209450 including grants of $ 1786662463) (Revenue $ 13738381873)
SEE SCHEDULE O

THE GENERAL HOSPITAL CORPORATION
PART V, SECTION B, LINE 5: IN EACH COLLABORATIVE, PARTICIPANTS ENGAGED COMMUNITY ORGANIZATIONS, LOCAL OFFICIALS, SCHOOLS, HEALTH CARE PROVIDERS, BUSINESS, FAITH COMMUNITIES, AND COMMUNITY RESIDENTS, IN AN APPROXIMATELY YEAR-LONG PROCESS, ABOUT THE UNIQUE LOCAL CONDITIONS, TO BETTER UNDERSTAND THE HEALTH ISSUES THAT MOST AFFECT COMMUNITIES AND THE ASSETS AVAILABLE TO ADDRESS THEM. THE KEY METHODS OF THE CHNA INCLUDED: PRIMARY DATA COLLECTION VIA MULTILINGUAL (SIX LANGUAGES) COMMUNITY SURVEYS WITH 1,895 TOTAL RESPONDENTS TO; 33 FOCUS GROUPS WITH 334 COMMUNITY RESIDENTS; AND 91 KEY INFORMANT INTERVIEWS WITH ORGANIZATIONAL, GOVERNMENT, AND COMMUNITY LEADERS. REVIEW OF SECONDARY DATA FROM MULTIPLE CITY, STATE, AND NATIONAL SOURCES INCLUDING THE U.S. CENSUS, THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, THE BOSTON PUBLIC HEALTH COMMISSION, AND THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS). RIGOROUS DATA ANALYSIS, INCLUDING REVIEWING DIFFERENCES AMONG CERTAIN POPULATIONS, SPECIFICALLY YOUTH AND ELDERLY, AS WELL AS BY RACE AND ETHNICITY.

THE BRIGHAM AND WOMEN'S HOSPITAL, INC
"PART V, SECTION B, LINE 5: PRIMARY DATA COLLECTION FOR THE BCCC WAS LED BY THE COMMUNITY ENGAGEMENT WORK GROUP (CEWG), WHICH INCLUDED 24 MEMBERS REPRESENTING A RANGE OF ORGANIZATIONS. FROM OCTOBER 2021 TO MARCH 2022, CEWG MEMBERS AND THEIR PARTNERS CONDUCTED 29 VIRTUAL AND IN-PERSON FOCUS GROUP DISCUSSIONS WITH A TOTAL OF 309 RESIDENTS. SOME FOCUS GROUPS WERE CONDUCTED IN LANGUAGES OTHER THAN ENGLISH, INCLUDING SPANISH, CHINESE, AND VIETNAMESE. THE FOCUS GROUPS ENGAGED A BROAD RANGE OF INDIVIDUALS INCLUDING YOUNG PEOPLE, OLDER ADULTS, PERSONS WITH DISABILITIES, UNDER-RESOURCED INDIVIDUALS AND FAMILIES, LGBTQIA+ POPULATIONS, RACIALLY/ETHNICALLY DIVERSE POPULATIONS, LIMITED-ENGLISH SPEAKERS, IMMIGRANT AND ASYLEE COMMUNITIES, FAMILIES AFFECTED BY INCARCERATION AND/OR VIOLENCE, AND VETERANS. IN ADDITION TO FOCUS GROUPS, BCCC CONDUCTED 62 KEY INFORMANT INTERVIEWS. KEY INFORMANTS WERE LEADERS AND STAFF FROM MANY SECTORS INCLUDING PUBLIC HEALTH, HEALTH CARE, BEHAVIORAL HEALTH, THE FAITH COMMUNITY, IMMIGRANT SERVICES, HOUSING ORGANIZATIONS, ECONOMIC DEVELOPMENT, COMMUNITY DEVELOPMENT, RACIAL JUSTICE ORGANIZATIONS, SOCIAL SERVICE ORGANIZATIONS, EDUCATION, COMMUNITY COALITIONS, THE BUSINESS COMMUNITY, CHILDCARE CENTERS, ELECTED GOVERNMENT OFFICES, AND OTHERS. TO NOTE, THE BCCC USES THE TERM ""RESIDENTS"" TO REFER TO PARTICIPANTS IN FOCUS GROUPS, INTERVIEWS, AND COMMUNITY LISTENING SESSIONS. THIS REPORT HAS ADOPTED THE SAME LANGUAGE WHEN REFERENCING PRIMARY DATA FROM THE BCCC REPORT. AFTER COMPLETION, CEWG MEMBERS SUMMARIZED KEY THEMES FROM THEIR DISCUSSIONS. THESE SUMMARIES WERE ANALYZED TO IDENTIFY COMMON THEMES AND SUB-THEMES ACROSS POPULATION GROUPS AND THE UNIQUE CHALLENGES AND PERSPECTIVES IDENTIFIED BY POPULATIONS AND SECTORS, WITH AN EMPHASIS ON DIVING DEEP INTO THE ROOT CAUSES OF INEQUITIES. FREQUENCY AND INTENSITY OF TOPIC SPECIFIC DISCUSSIONS WERE KEY INDICATORS USED TO EXTRACT MAIN THEMES."

NORTH SHORE MEDICAL CENTER, INC.
PART V, SECTION B, LINE 5: THE 2022 CHNA WAS DEVELOPED USING THREE DATA SOURCES: 1) SECONDARY DATA (E.G., FROM THE HOSPITAL AND HEALTH SYSTEM, U.S. CENSUS BUREAU, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH) PROVIDED DEMOGRAPHIC DATA, AS WELL AS INFORMATION ABOUT THE HEALTH AND BEHAVIORAL HEALTH OF RESIDENTS, AND THE SOCIAL DETERMINANTS OF HEALTH AFFECTING THEM. 2) EIGHT FOCUS GROUPS WERE CONDUCTED ONLINE WITH 51 COMMUNITY LEADERS WITH EXPERIENCE IN/WITH COMMUNITY HEALTH CENTERS; HEALTH CARE ADVOCACY AND PUBLIC HEALTH; ELDER SERVICES; YOUTH SERVICES; MENTAL HEALTH AND SUBSTANCE USE DISORDERS; IMMIGRANT SERVICES; HOUSING; AND FOOD SECURITY. THE HOUR-LONG GROUPS WERE CONDUCTED VIA ZOOM AND UTILIZED A SEMI-STRUCTURED INTERVIEW GUIDE. THE DATA WERE ANALYZED FOR COMMON AND DIVERGENT THEMES AND ILLUSTRATIVE QUOTES. 3) A COMMUNITY SURVEY WAS ADMINISTERED BETWEEN JULY 28 THROUGH AUGUST 19 AND AVAILABLE IN MULTIPLE LANGUAGES: ENGLISH, SPANISH, PORTUGUESE (EUROPEAN AND BRAZILIAN), HAITIAN CREOLE, CHINESE (MANDARIN/CANTONESE), ARABIC, RUSSIAN, AND KHMER/CAMBODIAN. DATA FROM 686 RESPONSES WERE ANALYZED USING EXCEL AND SPSS (STATISTICAL PACKAGE FOR SOCIAL SCIENCE).

NEWTON-WELLESLEY HOSPITAL
PART V, SECTION B, LINE 5: THE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH AND EXAMINED HEALTH IN ITS BROADEST CONTEXT. THIS WAS ONLY POSSIBLE DUE TO THE RELATIONSHIP-BUILDING WITH COMMUNITY PARTNERS THAT NWH HAS BEEN DEDICATED TO FOR YEARS. IN 2017, NWH STARTED THE NEWTON-WELLESLEY COLLABORATIVE FOR HEALTHY FAMILIES AND COMMUNITIES (NOW CALLED THE NWH COMMUNITY COLLABORATIVE) TO BRING SERVICES AND RESOURCES DIRECTLY TO COMMUNITIES IN NEED IN THE NWH SERVICE AREA, AND TO LIFT UP VOICES OF COMMUNITY LEADERS TO IMPROVE ACCESS TO QUALITY HEALTHCARE. FOLLOWING THE 2018 CHNA-CHIP PROCESS, THE NWH COMMUNITY COLLABORATIVE, UNDER THE COMMUNITY BENEFITS LEADERSHIP GUIDANCE, FORMED EIGHT COUNCILS OVER THE DURATION OF THE NEXT FEW YEARS AROUND THE FOCUS AREAS IDENTIFIED BY THE 2018 CHNA. EACH COUNCIL HAS APPROXIMATELY 20 MEMBERS AND INCLUDES NWH HEALTH CARE PROVIDERS, COMMUNITY PARTNERS, AND VOLUNTEER COMMUNITY MEMBERS; AND HAVE LEADERSHIP FROM A COMMUNITY CHAIR AND HOSPITAL CHAMPION. THE EIGHT COUNCILS ARE: CARDIOVASCULAR COUNCIL DOMESTIC AND SEXUAL ABUSE COUNCIL ELDER CARE COUNCIL MATERNITY SERVICES COUNCIL PALLIATIVE CARE COUNCIL THE RESILIENCE COUNCIL SUBSTANCE USE SERVICES COUNCIL WORKFORCE DEVELOPMENT COUNCIL EACH COUNCIL MEETS THREE TIMES PER YEAR TO ADDRESS COMMUNITY NEEDS AND IMPLEMENT COMMUNITY HEALTH PRIORITIES, INFORMED BY PREVIOUS 2018 AND 2021 CHIP STRATEGIES AND 2018 AND 2021 CHNA DATA. IN PARTICULAR, THE HEALTH OF WALTHAM RESIDENTS WAS A PRIORITY AREA IN THE 2018 CHIP, SO PARTNERSHIPS BETWEEN COMMUNITY-BASED ORGANIZATIONS IN WALTHAM AND NWH HAVE BEEN BUILDING SINCE THEN. A SILVER LINING OF THE COVID-19 PANDEMIC HAS BEEN A STRENGTHENING OF THESE PARTNERSHIPS, DUE TO THE URGENT NEED FOR COLLABORATION BETWEEN COMMUNITIES AND HEALTHCARE AND SERVICE PROVIDERS DURING THIS HISTORIC TIME. FOR THE 2022 CHNA-SIP, ADDITIONAL PERSPECTIVES FROM THE SERVICE AREA COMMUNITIES WERE SOUGHT TO GUIDE THE PROCESS. ELEVEN COMMUNITY LEADERS AND ADVOCATES WERE ENGAGED TO WORK ALONGSIDE THE ESTABLISHED 22 MEMBERS OF THE NWH COMMUNITY BENEFITS COMMITTEE (CBC) TO PROVIDE STRATEGIC OVERSIGHT OF THE CHNA-SIP PROCESS. TOGETHER, THE COMMUNITY BENEFITS COMMITTEE PLUS (CBC+) COMPRISES COMMUNITY STAKEHOLDERS FROM THE HOSPITAL SERVICE AREA AND NWH STAFF AND ADMINISTRATORS INVOLVED IN STRATEGIC PLANNING AND COMMUNITY BENEFITS EFFORTS. THE CBC+ GUIDED SEVERAL PARTS OF THE ASSESSMENT INCLUDING HELP DESIGNING THE CHNA METHODOLOGY, RECOMMENDING SOURCES OF SECONDARY DATA, SERVING AS TRUSTED COMMUNITY ORGANIZERS FOR RECRUITING PARTICIPANTS FOR FOCUS GROUPS AND INTERVIEWS, AND VOICING THE NEEDS AND STRENGTHS OF THEIR COMMUNITIES DURING THE PRIORITIZATION PROCESS.

BRIGHAM AND WOMEN'S FAULKNER HOSPITAL
"PART V, SECTION B, LINE 5: FOR THE 2022 CHNA-CHIP, BWFH PARTICIPATED IN THE BOSTON CHNA-CHIP COLLABORATIVE (""THE COLLABORATIVE OR ""BCCC""), A JOINT INITIATIVE BRINGING MULTIPLE STAKEHOLDERS TOGETHER TO ASSESS THE TOP PRIORITY COMMUNITY HEALTH ISSUES IN BOSTON AND IDENTIFY OPPORTUNITIES FOR SHARED IMPLEMENTATION. PARTICIPANTS INCLUDE COMMUNITY MEMBERS, COMMUNITY ORGANIZATIONS, COMMUNITY HEALTH CENTERS, THE BOSTON PUBLIC HEALTH COMMISSION, AND CONFERENCE OF BOSTON TEACHING HOSPITAL (COBTH) MEMBERS. THE COLLABORATIVE CONDUCTED 62 INTERVIEWS WITH BOSTON ORGANIZATIONS AND COMMUNITY LEADERS. THESE REPRESENTED A CROSS-SECTION OF SECTORS TO IDENTIFY AREAS OF ACTION AND PERSPECTIVES ON THE COMMUNITY. THESE INTERVIEWEES INCLUDED LEADERS AND STAFF FROM PUBLIC HEALTH, HEALTH CARE, BEHAVIORAL HEALTH, THE FAITH COMMUNITY, IMMIGRANT SERVICES, HOUSING ORGANIZATIONS, ECONOMIC DEVELOPMENT, COMMUNITY DEVELOPMENT, RACIAL JUSTICE ORGANIZATIONS, SOCIAL SERVICE ORGANIZATIONS, EDUCATION, COMMUNITY COALITIONS, THE BUSINESS COMMUNITY, CHILDCARE CENTERS, ELECTED GOVERNMENT OFFICES, AND OTHERS. ALSO FACILITATED WERE 29 FOCUS GROUPS WITH A DIVERSE CROSS-SECTION OF COMMUNITY MEMBERS AND REVIEWED SECONDARY DATA. ADDITIONALLY, COLLABORATIVE MEMBERS CONDUCTED FOUR 90-MINUTE VIRTUAL COMMUNITY LISTENING SESSIONS IN JANUARY 2022. A TOTAL OF 122 COMMUNITY MEMBERS PARTICIPATED IN THESE FOUR SESSIONS. THESE SESSIONS OCCURRED MID-WAY INTO THE CHNA PROCESS AND PROVIDED AN OPPORTUNITY TO GATHER FEEDBACK AND INSIGHTS ON PRELIMINARY DATA FINDINGS AND POTENTIAL PRIORITIES AT THIS POINT IN TIME. DURING THESE SESSIONS, COLLABORATIVE MEMBERS SHARED PRELIMINARY THEMES FROM FOCUS GROUPS, INTERVIEWS, AND THE REVIEW OF SECONDARY DATA. THE PARTICIPANTS DISCUSSED THEIR REACTIONS AND FEEDBACK TO THESE PRELIMINARY FINDINGS IN SMALL GROUPS AND IDENTIFIED AREAS THAT WERE THEIR HIGHEST PRIORITY FOR ACTION. TO COMPLEMENT THIS DATA, WITH BRIGHAM AND WOMEN'S HOSPITAL, THERE WERE NINE ADDITIONAL KEY INFORMANT INTERVIEWS, EIGHT DISCUSSION GROUPS AND WRITTEN INPUT FROM SIX KEY INFORMANTS FROM THE BWFH COMMUNITY. HOSPITAL SPECIFIC PATIENT DATA AND OTHER SECONDARY SOURCES WERE ALSO REVIEWED TO HELP PROVIDE THE MOST EXTENSIVE AND FULL ASSESSMENT OF INFORMATION. LASTLY AS PART OF OUR TARGETED COMMUNITY ENGAGEMENT, BWFH AND MASS GENERAL HOSPITAL CONDUCTED A COMMUNITY HEALTH CONVENIENCE SURVEY, WITH 494 RESPONDENTS, TO GATHER ADDITIONAL INFORMATION ABOUT TOP HEALTH CONCERNS, COVID IMPACTS AND CHALLENGES, BARRIERS TO HEALTHCARE AND MOBILE HEALTH CARE. THE FOLLOWING ARE THE PARAMETERS OF THE SURVEY: ADMINISTERED IN PERSON (ANONYMOUS PAPER SURVEY) AT BWFH EVENTS AND ON-LINE USING REDCAP TRANSLATED INTO SPANISH, PORTUGUESE, HAITIAN CREOLE, TRADITIONAL CHINESE, AND SIMPLIFIED CHINESE CONVENIENCE SAMPLING ONLINE SURVEY PROMOTED THROUGH MGH CCHI SOCIAL MEDIA ACCOUNTS (FACEBOOK AND INSTAGRAM) AND IN THE COMMUNITY BY BWFH STAFF SURVEY ADMINISTRATION FROM JANUARY 15, 2022-MARCH 25, 2022 14 QUESTIONS TOTAL, 4 OPEN-ENDED, 6 DEMOGRAPHIC QUESTIONS"

THE MCLEAN HOSPITAL CORPORATION
PART V, SECTION B, LINE 5: DUE TO MCLEAN'S HIGHLY SPECIALIZED MISSION AND SERVICES, AS WELL AS WHERE MCLEAN PATIENTS AT ALL LEVELS OF CARE LIVE IN MASSACHUSETTS, WE RELY ON COMMUNITY, REGIONAL AND STATE-WIDE PUBLIC HEALTH AND COMMUNITY NEEDS ASSESSMENTS AND FEEDBACK FROM THE COMMUNITY HEALTH NETWORK AREA 17 (CHNA 17) WHICH SERVES THE COMMUNITIES OF ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN.

THE SPAULDING REHABILITATION HOSPITAL
PART V, SECTION B, LINE 5: IN FY22, AN INTERNAL WORKING GROUP CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF A CONTINUOUS QUALITY IMPROVEMENT APPROACH TO COMMUNITY BENEFIT PLANNING. THE ASSESSMENT INVOLVED A REVIEW OF PATIENT DATA FROM THE PAST FISCAL YEAR, FY21 (OCTOBER 1, 2020 SEPTEMBER 30, 2021); DATA FROM THE CENSUS, AMERICAN COMMUNITY SURVEY DATA, AND MASSACHUSETTS BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (BRFSS); INFORMATION RELATED TO THE CENTER FOR DISEASE CONTROL AND PREVENTION'S (CDC) HEALTHY PEOPLE 2030 (HP2030). THE PATIENT AND COMMUNITY DATA WERE USED IN FORMULATING THE COMMUNITY BENEFIT PRIORITIES, GOAL, OBJECTIVES, AND TARGET COMMUNITIES AND TO OUTLINE THE PROGRESS MADE IN THE 2018 CHNA.

REHABILITATION HOSPITAL OF THE CAPE
PART V, SECTION B, LINE 5: SPAULDING CAPE COD'S 2022 CHNA RELIED UPON DATA FROM THE FOLLOWING SOURCES: PATIENT DATA: DE-IDENTIFIED DATA OF PATIENTS WHO RECEIVED CARE AT SPAULDING CAPE COD'S INPATIENT AND OUTPATIENT SITES WHO WERE DISCHARGED BETWEEN OCTOBER 1, 2020 AND SEPTEMBER 30, 2021 (FISCAL YEAR 2021) WERE ANALYZED TO INFORM SELECTION OF THE HOSPITAL'S TARGET COMMUNITY AND VULNERABLE POPULATIONS. U.S. CENSUS DATA: THE 2020 U.S. CENSUS AND AMERICAN COMMUNITY SURVEY DATA WERE USED TO UNDERSTAND THE DEMOGRAPHICS AND NEEDS RELATED TO THE SOCIAL DETERMINANTS OF HEALTH IN THE TARGET COMMUNITIES. KEY INFORMANT INPUT: STAKEHOLDERS WHO HAVE EXPERTISE AND INVOLVEMENT WITH TARGET POPULATIONS AND RELEVANT COMMUNITY ORGANIZATIONS MET AS AN ADVISORY COUNCIL TO PROVIDE INPUT ON PRIORITY AREAS.

SPAULDING HOSPITAL-CAMBRIDGE, INC.
PART V, SECTION B, LINE 5: IN FY 21, AN INTERNAL WORKING GROUP AT SPAULDING HOSPITAL CAMBRIDGE CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF A CONTINUOUS QUALITY IMPROVEMENT APPROACH TO COMMUNITY BENEFIT PLANNING. THIS YEAR'S ASSESSMENT WAS MORE CHALLENGING DUE TO THE CHANGES WE HAVE EXPERIENCED WITH OUR INPATIENT POPULATIONS AND THE INABILITY TO PROVIDE OUR COMMUNITY BENEFIT PROGRAMS DUE TO THE COVID PANDEMIC. THIS YEARS' ASSESSMENT UTILIZED A COLLABORATIVE AND DYNAMIC APPROACH TO REVIEW AVAILABLE SPAULDING HOSPITAL CAMBRIDGE DATA (FY 2021), A REVIEW OF PUBLICLY AVAILABLE HEALTH AND DEMOGRAPHIC DATA INCLUDING THE CITY OF CAMBRIDGE COMMUNITY HEALTH ASSESSMENT (JULY 2020) AND THE MASS GENERAL BRIGHAM SYSTEM PRIORITIES. BASED ON THE ASSESSMENT FINDINGS THE WORKING GROUP REFINED THE COMMUNITY BENEFIT AGENDA FROM 2019. GIVEN THE SPECIALTY NATURE OF THE CARE PROVIDED AND THE BROAD GEOGRAPHIC REACH OF OUR PATIENTS, WE DEFINE OUR PRIMARY COMMUNITY SERVED BEYOND OUR IMMEDIATE GEOGRAPHIC LOCATION BUT INSTEAD ON OUR SPECIFIC PATIENT POPULATIONS: THOSE PERSONS WITH COMPLEX AND CHRONIC HEALTH CONDITIONS AND PERSONS LIVING WITH DISABILITY. BOTH QUANTITATIVE AND QUALITATIVE DATA WERE COLLECTED FOR THE COMMUNITY HEALTH ASSESSMENT TO HELP IDENTIFY MAJOR ASPECTS OF THE COMMUNITY THAT IMPACT THE HEALTH OF ITS PRIORITY POPULATIONS. THE DATA WERE EVALUATED THROUGH A SOCIAL DETERMINANTS OF HEATH LENS, BY CONSIDERING THE ECONOMIC, ENVIRONMENTAL, AND SOCIAL FACTORS THAT INFLUENCE HEALTH. THE PROGRAMS AND INITIATIVES IDENTIFIED BY THE WORKING GROUP SUPPORT THE OVERALL NEEDS IDENTIFIED BY THE HEALTH ASSESSMENT AND DESCRIBED PROGRESS MADE IN THE FY 19 BEFORE THE COVID PANDEMIC PLACED MANY OF OUR COMMUNITY BENEFIT PROGRAMS ON HOLD.

NANTUCKET COTTAGE HOSPITAL
PART V, SECTION B, LINE 5: THIS CHNA SEEKS TO IDENTIFY AND PRIORITIZE PERSISTENT AND EMERGING COMMUNITY HEALTH NEEDS ON NANTUCKET ISLAND. THE ASSESSMENT UTILIZES THE WORLD HEALTH ORGANIZATION SOCIAL DETERMINANTS OF HEALTH FRAMEWORK, DEFINING HEALTH IN THE BROADEST SENSE AND RECOGNIZING NUMEROUS FACTORS AT MULTIPLE LEVELS, INCLUDING: LIFESTYLE BEHAVIORS INCLUDING ACTIVE LIVING AND HEALTHY EATING HABITS CLINICAL CARE INCLUDING ACCESS TO MEDICAL AND BEHAVIORAL HEALTH SERVICES AS WELL AS INSURANCE COVERAGE SOCIAL AND ECONOMIC FACTORS INCLUDING POVERTY, UNEMPLOYMENT AND ACCESS TO AFFORDABLE HOUSING, AND THE PHYSICAL ENVIRONMENT INCLUDING AIR AND WATER QUALITY. THE PROCESS OF GATHERING THE QUALITATIVE AND QUANTITATIVE DATA INVOLVED A COMBINATION OF DIRECT COMMUNITY OUTREACH THROUGH PUBLIC TOWN HALLS, SURVEYS, AND A ROBUST SERIES OF STAKEHOLDER INTERVIEWS. THE STAKEHOLDER INTERVIEWS TARGETED CIVIC LEADERS, COMMUNITY ADVOCATES, AND HEALTHCARE PROVIDERS, EMPHASIZING COLLECTING FEEDBACK ABOUT THE COMMUNITY ISSUES FACING OUR MOST VULNERABLE RESIDENTS. INTERVIEWEES WERE ASKED TO IDENTIFY KEY HEALTH NEEDS, POPULATIONS IMPACTED MOST HEAVILY BY THESE KEY HEALTH NEEDS, PERCEIVED BARRIERS TO ADDRESSING NEEDS, AND SUGGESTIONS FOR ADDRESSING THESE NEEDS MOVING FORWARD.

MARTHA'S VINEYARD HOSPITAL
PART V, SECTION B, LINE 5: BASED UPON THE CHNA PLAN DEVELOPED BY THE CAC AT ITS MAY 31, 2022 MEETING, THE CHNA METHODOLOGY INVOLVED THE FOLLOWING DATA SOURCES AND METHODS. (1) A REVIEW OF SECONDARY DATA FROM PUBLICLY AVAILABLE STATE AND FEDERAL SOURCES (E.G., U.S. CENSUS BUREAU, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH), AS WELL AS MVH'S OWN DATA. THE SECONDARY DATA REVIEW PROVIDED INFORMATION ABOUT THE DEMOGRAPHICS OF RESIDENTS, HEALTH AND BEHAVIORAL HEALTH RISKS AND CONDITIONS, AND SOCIAL DETERMINANTS OF HEALTH AFFECTING THEM. THE MOST RECENTLY AVAILABLE DATA SOURCES WERE USED WHENEVER POSSIBLE (E.G., THE 2021 AMERICAN COMMUNITY SURVEY VERSUS THE 2020 CENSUS) TO PROVIDE ESTIMATES CLOSER TO THE CURRENT REALITY ON THE ISLAND. HOWEVER, OLDER SOURCES WERE USED WHEN MORE RECENT DATA WERE NOT AVAILABLE. FOR EXAMPLE, CENSUS DATA FOR THE INDIVIDUAL COMMUNITIES WITHIN THE TARGET AREA AND FOR SOME VARIABLES DISCUSSED IN THIS REPORT ARE ONLY AVAILABLE FOR TIME PERIODS EARLIER THAN 2021. (2) THE MARTHA'S VINEYARD COMMUNITY SURVEY WAS ADMINISTERED PRIMARILY AS AN ONLINE SURVEY IN ENGLISH AND PORTUGUESE WITH SOME SURVEYS COMPLETED IN HARD COPY. THE SURVEY WAS ADMINISTERED BETWEEN JULY 18, 2022 AND AUGUST 12, 2022 AND RECEIVED 455 RESPONSES. THE MAJORITY OF RESPONDENTS (N=432 OR 94.9%) REPORTED THAT ENGLISH IS THEIR PRIMARY LANGUAGE WHILE 23 (5.1%) INDICATED THAT PORTUGUESE IS THEIR PRIMARY LANGUAGE.2 YEAR-ROUND RESIDENTS COMPRISED (N=362) 79.5% OF SURVEY RESPONDENTS. QUANTITATIVE DATA ANALYSIS WAS CONDUCTED USING EXCEL AND SPSS AND OPEN-TEXT RESPONSES WERE REVIEWED FOR COMMON AND DIVERGENT THEMES. KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH 18 REPRESENTATIVES FROM A RANGE OF ORGANIZATIONS ON THE ISLAND WHO COULD OFFER PERSPECTIVES ON THE ISLAND'S HEALTH NEEDS IN GENERAL, AS WELL AS EXPERTISE ON SPECIFIC POPULATIONS AND/OR HEALTH ISSUES. THE INTERVIEWS WERE UP TO 60 MINUTES LONG, CONDUCTED VIA TELEPHONE, AND USED A SEMI-STRUCTURED INTERVIEW TOOL. THE INTERVIEW DATA WERE REVIEWED FOR COMMON AND DIVERGENT THEMES AND TO IDENTIFY ILLUSTRATIVE QUOTES ABOUT THE MAJOR ISSUES AFFECTING THE HEALTH OF ISLAND RESIDENTS.

COOLEY DICKINSON HOSPITAL, INC.
"PART V, SECTION B, LINE 5: THE 2019 CHNA UPDATES THE PRIORITIZED COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2016 CHNA. THE PRIORITIZED HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA INCLUDE COMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTH, BARRIERS TO ACCESSING CARE, AND HEALTH BEHAVIORS AND OUTCOMES. WE ALSO PROVIDE CONTEXT FOR THE ROLE THAT SOCIAL POLICIES AND THE PRACTICES OF SYSTEMS HAVE ON HEALTH OUTCOMES. ASSESSMENT METHODS INCLUDED: 1) ANALYSIS OF SOCIAL, ECONOMIC, AND HEALTH QUANTITATIVE DATA FROM THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, THE U.S. CENSUS BUREAU, THE COUNTY HEALTH RANKING REPORTS, THE MASSACHUSETTS HEALTHY AGING COLLABORATIVE, SOCIAL EXPLORER, AND A VARIETY OF OTHER DATA SOURCES; 2) ANALYSIS OF FINDINGS FROM 12 FOCUS GROUPS, 45 INTERVIEWS WITH KEY INFORMANTS (INCLUDING WITH LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS), 10 COMMUNITY CHATS CONDUCTED BY THE CONSULTANT TEAM AND THE REGIONAL ADVISORY COUNCIL (RAC) AS PART OF THIS CHNA, AND A MEETING OF THE CDHC COMMUNITY BENEFITS ADVISORY COUNCIL; 3) THE EXPERIENCES OF COMMUNITY MEMBERS WHO GAVE INPUT IN FOCUS GROUPS OR KEY INFORMANT INTERVIEWS IN OTHER REGIONS WERE OCCASIONALLY CONSIDERED RELEVANT TO THIS SERVICE AREA AND WERE INCLUDED; AND 4) REVIEW OF EXISTING ASSESSMENT REPORTS PUBLISHED SINCE 2016 THAT WERE COMPLETED BY COMMUNITY AND REGIONAL AGENCIES SERVING HAMPSHIRE COUNTY. THE ASSESSMENT FOCUSED ON COUNTY-LEVEL DATA AND SELECT COMMUNITY-LEVEL DATA AS AVAILABLE. GIVEN DATA CONSTRAINTS, THE FOLLOWING COMMUNITIES WERE IDENTIFIED FOR THE MAJORITY OF THE COMMUNITY LEVEL DATA ANALYSES: AMHERST, EASTHAMPTON, AND NORTHAMPTON. OTHER COMMUNITIES WERE INCLUDED AS DATA WAS AVAILABLE AND ANALYSIS INDICATED AN IDENTIFIED HEALTH NEED FOR THAT COMMUNITY. SOME OF THE DATA SOURCES SUPPLIED DATA IN RATES (E.G. RATES PER 100,000 OF THE POPULATION), INCLUDING THE MAIN SOURCE OF DATA FOR HEALTH OUTCOMES, THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH. CREATING RATES ALLOWS US TO COMPARE OUTCOMES FROM GEOGRAPHIES THAT MIGHT BE DRASTICALLY DIFFERENT IN SIZE OR POPULATION, FOR EXAMPLE, THE STATE OF MASSACHUSETTS AND THE TOWN OF HATFIELD. IF ALL WE COULD REPORT WAS THE NUMBER OF PEOPLE HOSPITALIZED, FOR EXAMPLE, IT WOULD NOT BE POSSIBLE TO COMPARE HOW HATFIELD IS DOING COMPARED TO THE STATE. FOR EXAMPLE, IF 38 PEOPLE IN A TOWN OF ABOUT 3,300 (HATFIELD) WERE HOSPITALIZED IN ONE YEAR FOR CARDIOVASCULAR DISEASE, THE RATE IS 748 PER 100,000. IF OVER 92,000 PEOPLE ACROSS THE APPROXIMATELY 6.9 MILLION PEOPLE IN THE STATE OF MASSACHUSETTS WERE HOSPITALIZED FOR THE SAME THING IN ONE YEAR, THE RATE IS 1,216 PER 100,000. THUS, WE CAN SEE THAT THE TOWN OF HATFIELD HAD A LOWER RATE OF HOSPITALIZATION. COMMUNITY HEALTH NEEDS ASSESSMENTS ARE REQUIRED TO IDENTIFY ""VULNERABLE POPULATIONS"". WE USE THE TERM ""PRIORITY POPULATIONS"". TO THE EXTENT POSSIBLE GIVEN DATA AND RESOURCE CONSTRAINTS, PRIORITY POPULATIONS WERE IDENTIFIED USING QUALITATIVE AND QUANTITATIVE INFORMATION. QUALITATIVE DATA INCLUDED FOCUS GROUP FINDINGS, INTERVIEWS, INPUT FROM OUR REGIONAL ADVISORY COMMITTEE AND COMMUNITY BENEFITS ADVISORY COMMITTEES, AND COMMUNITY OUTREACH. WE USED QUANTITATIVE DATA TO IDENTIFY PRIORITY POPULATIONS BY DISAGGREGATING BY RACE/ETHNICITY; AGE WITH A FOCUS ON CHILDREN/YOUTH AND OLDER ADULTS; AND LGBTQ (LESBIAN/GAY/BI-SEXUAL/TRANSGENDER/QUEER) POPULATIONS."

WENTWORTH-DOUGLASS HOSPITAL
PART V, SECTION B, LINE 5: COMMUNITY HEALTH NEEDS WERE IDENTIFIED BY COLLECTING AND ANALYZING DATA FROM MULTIPLE SOURCES. CONSIDERING A VAST ARRAY OF INFORMATION IS IMPORTANT WHEN ASSESSING COMMUNITY HEALTH NEEDS, TO ENSURE THE ASSESSMENT CAPTURES A WIDE RANGE OF FACTS AND PERSPECTIVES AND TO INCREASE CONFIDENCE THAT SIGNIFICANT COMMUNITY HEALTH NEEDS HAVE BEEN IDENTIFIED ACCURATELY AND OBJECTIVELY. STATISTICS FOR NUMEROUS COMMUNITY HEALTH INDICATORS WERE ANALYZED, INCLUDING DATA PROVIDED BY LOCAL, STATE, AND FEDERAL GOVERNMENT AGENCIES, LOCAL COMMUNITY SERVICE ORGANIZATIONS, AND WENTWORTH-DOUGLASS. COMPARISONS TO BENCHMARKS WERE MADE WHEREVER POSSIBLE. THIS CHNA ALSO INCORPORATED FINDINGS FROM OTHER RECENTLY CONDUCTED, RELEVANT STATE AND COUNTY HEALTH ASSESSMENTS. IN ADDITION, THE CHNA DEVELOPMENT PROCESS ALSO INCLUDED DATA OBTAINED IN PARTNERSHIP WITH THE UNIVERSITY OF NEW HAMPSHIRE SURVEY CENTER. THE SURVEY CENTER CONDUCTED A WEB AND TEXT-BASED COMMUNITY HEALTH ASSESSMENT SURVEY WITH 519 PARTICIPANTS FROM WDH'S SERVICE AREA. THIS DATA WAS USED TO SUPPLEMENT VERIT'S DATA ANALYSIS. INPUT FROM 42 INDIVIDUALS, FROM 25 INTERNAL AND EXTERNAL ORGANIZATIONS, REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY WAS TAKEN INTO ACCOUNT THROUGH KEY INFORMANT INTERVIEWS. INTERVIEWEES INCLUDED: INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; LOCAL PUBLIC HEALTH DEPARTMENTS; AGENCIES WITH CURRENT DATA OR INFORMATION ABOUT THE HEALTH AND SOCIAL NEEDS OF THE COMMUNITY; REPRESENTATIVES OF SOCIAL SERVICE ORGANIZATIONS; AND LEADERS, REPRESENTATIVES, AND MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS.

MASSACHUSETTS EYE & EAR INFIRMARY
PART V, SECTION B, LINE 5: THE 2022 MASS. EYE AND EAR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) RELIED UPON THE FOLLOWING DATA SOURCES: (1) SECONDARY DATA: FOR MOST MASSACHUSETTS HOSPITALS, COMMUNITY-LEVEL DATA AVAILABLE THROUGH THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH AND BOSTON PUBLIC HEALTH COMMISSION ARE USEFUL IN UNDERSTANDING THE SPECIFIC HEALTH NEEDS OF COMMUNITIES AND THOSE IN WHICH DISPARITIES EXIST. THESE DATA ARE TYPICALLY USED TO SELECT VULNERABLE COMMUNITIES AND POPULATIONS AND TO TARGET SERVICES TO ADDRESS PARTICULAR HEALTH ISSUES AND DISPARITIES. BECAUSE NEITHER THE BOSTON PUBLIC HEALTH COMMISSION NOR THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH COLLECT AND REPORT DATA ON VISION, HEARING AND OTHER HEAD AND NECK CONDITIONS IN MASSACHUSETTS COMMUNITIES, MASS. EYE AND EAR RELIED ON THE FOLLOWING SOURCES TO INFORM ITS 2022 CHNA: PATIENT DATA: MOST GENERAL HOSPITALS SELECT PRIORITY COMMUNITIES WITHIN THEIR EXISTING SERVICE AREA AS THE FOCUS OF THEIR CHNA. AS A PROVIDER OF SPECIALTY CARE TO PATIENTS FROM AROUND THE WORLD, ACROSS THE U.S., AND ALL AREAS OF MASSACHUSETTS, MASS. EYE AND EARS' SERVICE AREA IS MORE EXPANSIVE. WITH THE EXCEPTION OF THE MISSION HILL NEIGHBORHOOD OF BOSTON, WHERE MASS. EYE AND EAR'S LONGWOOD FACILITY IS LOCATED, THE HOSPITAL RELIED UPON ANALYSIS OF 12 MONTHS OF ITS OWN (DE-IDENTIFIED) PATIENT DATA TO BETTER UNDERSTAND THE POPULATION SERVED BY THE HOSPITAL AND DEFINE ITS TARGET COMMUNITY. BETWEEN MARCH 1, 2020 AND FEBRUARY 28, 2021, 146,557 PATIENTS UTILIZED SERVICES AT MASS. EYE AND EAR'S MAIN CAMPUS AND ITS LONGWOOD FACILITY. THESE DATA PROVIDED A REPRESENTATIVE SAMPLE OF PATIENTS WHO UTILIZED SERVICES AT MASS. EYE AND EAR'S MAIN CAMPUS AND ITS LONGWOOD FACILITY. U.S. CENSUS DATA: THE 2022 CHNA UTILIZED THE MOST RECENTLY AVAILABLE U.S. CENSUS AND AMERICAN COMMUNITY SURVEY DATA TO UNDERSTAND THE DEMOGRAPHICS AND NEEDS RELATED TO THE SOCIAL DETERMINANTS OF HEALTH IN THE TARGET COMMUNITIES. ALONG WITH MASS. EYE AND EAR'S OWN PATIENT DATA, CENSUS DATA WERE USED TO IDENTIFY VULNERABLE POPULATIONS. HEALTHY PEOPLE 2030: WHILE LOCAL AND STATE PUBLIC HEALTH DATA WERE NOT AVAILABLE TO INFORM THE MASS. EYE AND EAR CHNA, THE U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION'S HEALTHY PEOPLE 2030 OBJECTIVES OFFER INSIGHT INTO THE HIGHEST PRIORITY PUBLIC HEALTH ISSUES. THE OBJECTIVES ARE EVIDENCE-BASED, USING THE MOST RECENTLY AVAILABLE PUBLIC HEALTH DATA, AND INFORMED BY SUBJECT MATTER EXPERTS FROM AROUND THE COUNTRY. THE SENSORY AND COMMUNICATIONS OBJECTIVES IDENTIFY COMMUNITY HEALTH NEEDS RELATED TO VISION, HEARING, BALANCE, TASTE, AND SMELL.1 (2) KEY INFORMANT INTERVIEWS AND SURVEYS: INTERVIEWS WERE CONDUCTED BY TELEPHONE WITH 14 INTERNAL AND EXTERNAL STAKEHOLDERS WHO HAVE EXPERTISE AND EXPERIENCE WITH SPECIFIC POPULATIONS AND/OR HEALTH ISSUES. CONDUCTED BY PHONE, THE INTERVIEWS WERE UP TO 60 MINUTES LONG AND EMPLOYED A SEMI-STRUCTURED INTERVIEW TOOL CREATED SPECIFICALLY FOR THE CHNA. QUALITATIVE DATA WERE ANALYZED TO IDENTIFY COMMON AND DIVERGENT THEMES AND ILLUSTRATIVE QUOTES THAT SERVED TO ELUCIDATE MAJOR THEMES. EIGHT OF THE KEY INFORMANTS ALSO RESPONDED TO AN ONLINE SURVEY TO DESCRIBE THE POPULATIONS WITH WHICH THEY WORK AND THE NEEDS AND BARRIERS TO CARE THEY SEE AMONG THEM.

THE GENERAL HOSPITAL CORPORATION
PART V, SECTION B, LINE 6A: MASS GENERAL BRIGHAM BOSTON AND NORTH SUFFOLK REGIONAL COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IN 2022, THE MASS GENERAL BRIGHAM HOSPITALS IN BOSTONMASSACHUSETTS GENERAL HOSPITAL, BRIGHAM AND WOMEN'S HOSPITAL, AND BRIGHAM AND WOMEN'S FAULKNER HOSPITALPARTICIPATED IN TWO COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) ALONG WITH OTHER HOSPITALS, HEALTH CENTERS, COMMUNITY-BASED ORGANIZATIONS, COMMUNITY RESIDENTS, AND COMMUNITY STAKEHOLDERS: BOSTON CHNA/CHIP COLLABORATIVE NORTH SUFFOLK PUBLIC HEALTH COLLABORATIVE COVERING CHELSEA, REVERE, AND WINTHROP THE COMMUNITY HEALTH NEEDS PRIORITIZED IN BOTH CHNAS ARE: HOUSING ECONOMIC MOBILITY AND INCLUSION MENTAL AND BEHAVIORAL HEALTH, INCLUDING SUBSTANCE USE DISORDER (SUD) ACCESS TO CARE AND SERVICES THE BOSTON AND NORTH SUFFOLK COLLABORATIVE CHIPS DEFINED GOALS, OBJECTIVES AND STRATEGIES TO IMPACT THESE PRIORITIZED HEALTH NEEDS. THIS MASS GENERAL BRIGHAM BOSTON AND NORTH SUFFOLK REGIONAL CHIP ADOPTS THESE GOALS, OBJECTIVES AND STRATEGIES AND FURTHER OUTLINES ADDITIONAL STRATEGIES TARGETING RACIAL AND ETHNIC HEALTH INEQUITIES THAT DISPROPORTIONATELY IMPACT COMMUNITIES OF COLOR, WITH A FOCUS ON CARDIOMETABOLIC DISEASE AND SUBSTANCE USE DISORDER (SUD) BASED ON THE EXCESS DEATHS ATTRIBUTABLE TO THESE CONDITIONS FOR BLACK RESIDENTS. ALONG WITH THE MASS GENERAL BRIGHAM SYSTEM STRATEGIES, OUR BOSTON HOSPITALS ALSO EMPLOY LOCALLY DIRECTED EFFORTS IN SUPPORT OF THE BOSTON AND NORTH SUFFOLK COLLABORATIVES. ADDITIONAL COMMUNITY HEALTH NEEDS MAY BE IDENTIFIED BY EACH HOSPITAL'S CHNA AND PRIORITIZED BY ITS COMMUNITY ADVISORY BOARD. TAKING THE STRATEGIES DEFINED BY THE COLLABORATIVES' CHIPS AND COMBINING THEM WITH THE MGB SYSTEM AND HOSPITAL STRATEGIES RESULTS IN A BROADER SPECTRUM OF EFFORTS AND INITIATIVES THAT WILL MORE SIGNIFICANTLY IMPACT COMMUNITY HEALTH OUTCOMES. WHILE THE COLLABORATIVES ARE INCLUSIVE OF BOSTON, CHELSEA, REVERE, AND WINTHROP, THE TARGET COMMUNITIES FOR OUR HOSPITALS ARE: BRIGHAM AND WOMEN'S FAULKNER (BWFH): HYDE PARK, JAMAICA PLAIN, ROSLINDALE, WEST ROXBURY BRIGHAM AND WOMEN'S HOSPITAL (BWH): DORCHESTER, JAMAICA PLAIN, MATTAPAN, MISSION HILL, ROXBURY MASSACHUSETTS GENERAL HOSPITAL (MGH): CHARLESTOWN, CHELSEA, REVERE MGB PRIORITY COMMUNITIES (MGB): BOSTON, CHELSEA, REVERE, LYNN, SALEM EACH ENTITY IS REQUIRED TO DEFINE TARGET COMMUNITIES AS PART OF THE CHNA PROCESS, AND EFFORTS MAY OVERLAP ACROSS NEIGHBORHOODS AND COMMUNITIES.

THE BRIGHAM AND WOMEN'S HOSPITAL, INC
"PART V, SECTION B, LINE 6A: THE BOSTON CHNA-CHIP COLLABORATIVE CONDUCTED ITS SECOND CITYWIDE COLLABORATIVE ASSESSMENT THE COLLABORATIVE IS COMPRISED OF EVERY BOSTON TEACHING HOSPITAL, THE BOSTON PUBLIC HEALTH COMMISSION, COMMUNITY HEALTH CENTERS, AND COMMUNITY-BASED ORGANIZATIONS THE CONFERENCE OF BOSTON TEACHING HOSPITALS (COBTH) ACTED AS THE ""BACKBONE ORGANIZATION, PROVIDING INFRASTRUCTURE SUPPORT, WITH TWO WORK GROUPS LEADING THE COMMUNITY ENGAGEMENT PROCESS AS A MEMBER OF THE BOSTON COLLABORATIVE STEERING COMMITTEE, MGH HELPED GUIDE THE ENTIRE PROCESS, INCLUDING DATA GATHERING, ANALYSIS, PRIORITIZATION, AND STRATEGY DEVELOPMENT IN NORTH SUFFOLK (CHELSEA, REVERE, AND WINTHROP), THE NORTH SUFFOLK PUBLIC HEALTH COLLABORATIVE (NSPHC) CONDUCTED ITS SECOND REGIONAL INTEGRATED COMMUNITY HEALTH NEEDS ASSESSMENT (ICHNA) THE CITY AND TOWN LEADERS FORMED THE NSPHC TO INCREASE THEIR COLLECTIVE IMPACT ON IMPROVING HEALTH LIKE BOSTON, THE COLLABORATIVE IS MADE UP OF AREA HOSPITAL SYSTEMS, HEALTH CENTERS, LOCAL HEALTH DEPARTMENTS, AND COMMUNITY-BASED ORGANIZATIONS MGH CO-LED THE NORTH SUFFOLK CHNA PROCESS, OVERSEEING DATA COLLECTION, ANALYSIS, AND REPORTING ADDITIONALLY, MGH PROVIDED TECHNICAL SUPPORT FOR THE DESIGN OF FOCUS GROUPS, KEY INFORMANT INTERVIEWS, AND SURVEY QUESTIONS."

BRIGHAM AND WOMEN'S FAULKNER HOSPITAL
"PART V, SECTION B, LINE 6A: FOR THE 2022 CHNA-CHIP, BWFH PARTICIPATED IN THE BOSTON CHNA-CHIP COLLABORATIVE (""THE COLLABORATIVE OR ""BCCC""), A JOINT INITIATIVE BRINGING MULTIPLE STAKEHOLDERS TOGETHER TO ASSESS THE TOP COMMUNITY HEALTH ISSUES IN BOSTON AND ITS UNIQUE NEIGHBORHOODS AND IDENTIFY OPPORTUNITIES FOR SHARED IMPLEMENTATION. PARTICIPANTS INCLUDE COMMUNITY MEMBERS, COMMUNITY ORGANIZATIONS, COMMUNITY HEALTH CENTERS, THE BOSTON PUBLIC HEALTH COMMISSION, AND CONFERENCE OF BOSTON TEACHING HOSPITAL (COBTH) MEMBERS. THE COLLABORATIVE CONDUCTED 62 INTERVIEWS WITH BOSTON ORGANIZATIONS AND COMMUNITY LEADERS, FACILITATED 29 FOCUS GROUPS WITH A DIVERSITY OF COMMUNITY MEMBERS, AND REVIEWED SECONDARY DATA. ADDITIONALLY, BWFH AND MASS GENERAL HOSPITAL CONDUCTED A COMMUNITY HEALTH SURVEY, WITH 494 RESPONDENTS, TO GATHER ADDITIONAL INFORMATION ABOUT COMMUNITY HEALTH CONCERNS AND COVID IMPACTS. TO COMPLEMENT THE DATA, BWFH WITH BRIGHAM AND WOMEN'S HOSPITAL, THERE WERE NINE KEY INFORMANT INTERVIEWS CONDUCTED, EIGHT DISCUSSION GROUPS AND WRITTEN INPUT FROM SIX KEY INFORMANTS SPECIFICALLY FROM THE BWFH COMMUNITY. ADDITIONALLY, WE REVIEWED HOSPITAL SPECIFIC PATIENT DATA AND OTHER SECONDARY SOURCES. THIS EXTENSIVE DATA COLLECTION PROVIDED RICH INFORMATION FOR THE ASSESSMENT."

COOLEY DICKINSON HOSPITAL, INC.
"PART V, SECTION B, LINE 6A: COOLEY DICKINSON HEALTH CARE (CDHC) IS A MEMBER OF THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS (""COALITION""). THE COALITION IS A PARTNERSHIP BETWEEN EIGHT NON-PROFIT HOSPITALS/HEALTH PLAN IN WESTERN MASSACHUSETTS: BAYSTATE MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, BAYSTATE WING HOSPITAL, COOLEY DICKINSON HEALTH CARE, MERCY MEDICAL CENTER, SHRINERS HOSPITALS FOR CHILDREN SPRINGFIELD, AND HEALTH NEW ENGLAND, A LOCAL HEALTH INSURER WHOSE SERVICE AREAS COVERS THE FOUR COUNTIES OF WESTERN MASSACHUSETTS. THE COALITION FORMED IN 2012 TO BRING HOSPITALS WITHIN WESTERN MASSACHUSETTS TOGETHER TO SHARE RESOURCES AND WORK IN PARTNERSHIP TO CONDUCT THEIR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) AND ADDRESS REGIONAL NEEDS."

THE GENERAL HOSPITAL CORPORATION
PART V, SECTION B, LINE 6B: MASS GENERAL BRIGHAM BOSTON AND NORTH SUFFOLK REGIONAL COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IN 2022, THE MASS GENERAL BRIGHAM HOSPITALS IN BOSTONMASSACHUSETTS GENERAL HOSPITAL, BRIGHAM AND WOMEN'S HOSPITAL, AND BRIGHAM AND WOMEN'S FAULKNER HOSPITALPARTICIPATED IN TWO COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) ALONG WITH OTHER HOSPITALS, HEALTH CENTERS, COMMUNITY-BASED ORGANIZATIONS, COMMUNITY RESIDENTS, AND COMMUNITY STAKEHOLDERS: BOSTON CHNA/CHIP COLLABORATIVE NORTH SUFFOLK PUBLIC HEALTH COLLABORATIVE COVERING CHELSEA, REVERE, AND WINTHROP THE COMMUNITY HEALTH NEEDS PRIORITIZED IN BOTH CHNAS ARE: HOUSING ECONOMIC MOBILITY AND INCLUSION MENTAL AND BEHAVIORAL HEALTH, INCLUDING SUBSTANCE USE DISORDER (SUD) ACCESS TO CARE AND SERVICES THE BOSTON AND NORTH SUFFOLK COLLABORATIVE CHIPS DEFINED GOALS, OBJECTIVES AND STRATEGIES TO IMPACT THESE PRIORITIZED HEALTH NEEDS. THIS MASS GENERAL BRIGHAM BOSTON AND NORTH SUFFOLK REGIONAL CHIP ADOPTS THESE GOALS, OBJECTIVES AND STRATEGIES AND FURTHER OUTLINES ADDITIONAL STRATEGIES TARGETING RACIAL AND ETHNIC HEALTH INEQUITIES THAT DISPROPORTIONATELY IMPACT COMMUNITIES OF COLOR, WITH A FOCUS ON CARDIOMETABOLIC DISEASE AND SUBSTANCE USE DISORDER (SUD) BASED ON THE EXCESS DEATHS ATTRIBUTABLE TO THESE CONDITIONS FOR BLACK RESIDENTS. ALONG WITH THE MASS GENERAL BRIGHAM SYSTEM STRATEGIES, OUR BOSTON HOSPITALS ALSO EMPLOY LOCALLY DIRECTED EFFORTS IN SUPPORT OF THE BOSTON AND NORTH SUFFOLK COLLABORATIVES. ADDITIONAL COMMUNITY HEALTH NEEDS MAY BE IDENTIFIED BY EACH HOSPITAL'S CHNA AND PRIORITIZED BY ITS COMMUNITY ADVISORY BOARD. TAKING THE STRATEGIES DEFINED BY THE COLLABORATIVES' CHIPS AND COMBINING THEM WITH THE MGB SYSTEM AND HOSPITAL STRATEGIES RESULTS IN A BROADER SPECTRUM OF EFFORTS AND INITIATIVES THAT WILL MORE SIGNIFICANTLY IMPACT COMMUNITY HEALTH OUTCOMES. WHILE THE COLLABORATIVES ARE INCLUSIVE OF BOSTON, CHELSEA, REVERE, AND WINTHROP, THE TARGET COMMUNITIES FOR OUR HOSPITALS ARE: BRIGHAM AND WOMEN'S FAULKNER (BWFH): HYDE PARK, JAMAICA PLAIN, ROSLINDALE, WEST ROXBURY BRIGHAM AND WOMEN'S HOSPITAL (BWH): DORCHESTER, JAMAICA PLAIN, MATTAPAN, MISSION HILL, ROXBURY MASSACHUSETTS GENERAL HOSPITAL (MGH): CHARLESTOWN, CHELSEA, REVERE MGB PRIORITY COMMUNITIES (MGB): BOSTON, CHELSEA, REVERE, LYNN, SALEM EACH ENTITY IS REQUIRED TO DEFINE TARGET COMMUNITIES AS PART OF THE CHNA PROCESS, AND EFFORTS MAY OVERLAP ACROSS NEIGHBORHOODS AND COMMUNITIES.

THE BRIGHAM AND WOMEN'S HOSPITAL, INC
"PART V, SECTION B, LINE 6B: THE BOSTON CHNA-CHIP COLLABORATIVE CONDUCTED ITS SECOND CITYWIDE COLLABORATIVE ASSESSMENT THE COLLABORATIVE IS COMPRISED OF EVERY BOSTON TEACHING HOSPITAL, THE BOSTON PUBLIC HEALTH COMMISSION, COMMUNITY HEALTH CENTERS, AND COMMUNITY-BASED ORGANIZATIONS THE CONFERENCE OF BOSTON TEACHING HOSPITALS (COBTH) ACTED AS THE ""BACKBONE ORGANIZATION, PROVIDING INFRASTRUCTURE SUPPORT, WITH TWO WORK GROUPS LEADING THE COMMUNITY ENGAGEMENT PROCESS AS A MEMBER OF THE BOSTON COLLABORATIVE STEERING COMMITTEE, MGH HELPED GUIDE THE ENTIRE PROCESS, INCLUDING DATA GATHERING, ANALYSIS, PRIORITIZATION, AND STRATEGY DEVELOPMENT IN NORTH SUFFOLK (CHELSEA, REVERE, AND WINTHROP), THE NORTH SUFFOLK PUBLIC HEALTH COLLABORATIVE (NSPHC) CONDUCTED ITS SECOND REGIONAL INTEGRATED COMMUNITY HEALTH NEEDS ASSESSMENT (ICHNA) THE CITY AND TOWN LEADERS FORMED THE NSPHC TO INCREASE THEIR COLLECTIVE IMPACT ON IMPROVING HEALTH LIKE BOSTON, THE COLLABORATIVE IS MADE UP OF AREA HOSPITAL SYSTEMS, HEALTH CENTERS, LOCAL HEALTH DEPARTMENTS, AND COMMUNITY-BASED ORGANIZATIONS MGH CO-LED THE NORTH SUFFOLK CHNA PROCESS, OVERSEEING DATA COLLECTION, ANALYSIS, AND REPORTING ADDITIONALLY, MGH PROVIDED TECHNICAL SUPPORT FOR THE DESIGN OF FOCUS GROUPS, KEY INFORMANT INTERVIEWS, AND SURVEY QUESTIONS."

BRIGHAM AND WOMEN'S FAULKNER HOSPITAL
"PART V, SECTION B, LINE 6B: FOR THE 2022 CHNA-CHIP, BWFH PARTICIPATED IN THE BOSTON CHNA-CHIP COLLABORATIVE (""THE COLLABORATIVE OR ""BCCC""), A JOINT INITIATIVE BRINGING MULTIPLE STAKEHOLDERS TOGETHER TO ASSESS THE TOP COMMUNITY HEALTH ISSUES IN BOSTON AND ITS UNIQUE NEIGHBORHOODS AND IDENTIFY OPPORTUNITIES FOR SHARED IMPLEMENTATION. PARTICIPANTS INCLUDE COMMUNITY MEMBERS, COMMUNITY ORGANIZATIONS, COMMUNITY HEALTH CENTERS, THE BOSTON PUBLIC HEALTH COMMISSION, AND CONFERENCE OF BOSTON TEACHING HOSPITAL (COBTH) MEMBERS. THE COLLABORATIVE CONDUCTED 62 INTERVIEWS WITH BOSTON ORGANIZATIONS AND COMMUNITY LEADERS, FACILITATED 29 FOCUS GROUPS WITH A DIVERSITY OF COMMUNITY MEMBERS, AND REVIEWED SECONDARY DATA. ADDITIONALLY, BWFH AND MASS GENERAL HOSPITAL CONDUCTED A COMMUNITY HEALTH SURVEY, WITH 494 RESPONDENTS, TO GATHER ADDITIONAL INFORMATION ABOUT COMMUNITY HEALTH CONCERNS AND COVID IMPACTS. TO COMPLEMENT THE DATA, BWFH WITH BRIGHAM AND WOMEN'S HOSPITAL, THERE WERE NINE KEY INFORMANT INTERVIEWS CONDUCTED, EIGHT DISCUSSION GROUPS AND WRITTEN INPUT FROM SIX KEY INFORMANTS SPECIFICALLY FROM THE BWFH COMMUNITY. ADDITIONALLY, WE REVIEWED HOSPITAL SPECIFIC PATIENT DATA AND OTHER SECONDARY SOURCES. THIS EXTENSIVE DATA COLLECTION PROVIDED RICH INFORMATION FOR THE ASSESSMENT."

COOLEY DICKINSON HOSPITAL, INC.
"PART V, SECTION B, LINE 6B: COOLEY DICKINSON HEALTH CARE (CDHC) IS A MEMBER OF THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS (""COALITION""). THE COALITION IS A PARTNERSHIP BETWEEN EIGHT NON-PROFIT HOSPITALS/HEALTH PLAN IN WESTERN MASSACHUSETTS: BAYSTATE MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, BAYSTATE WING HOSPITAL, COOLEY DICKINSON HEALTH CARE, MERCY MEDICAL CENTER, SHRINERS HOSPITALS FOR CHILDREN SPRINGFIELD, AND HEALTH NEW ENGLAND, A LOCAL HEALTH INSURER WHOSE SERVICE AREAS COVERS THE FOUR COUNTIES OF WESTERN MASSACHUSETTS. THE COALITION FORMED IN 2012 TO BRING HOSPITALS WITHIN WESTERN MASSACHUSETTS TOGETHER TO SHARE RESOURCES AND WORK IN PARTNERSHIP TO CONDUCT THEIR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) AND ADDRESS REGIONAL NEEDS."

WENTWORTH-DOUGLASS HOSPITAL
PART V, SECTION B, LINE 6B: THE HOSPITAL'S MOST RECENT CHNA WAS CONDUCTED WITH WENTWORTH-DOUGLASS PHYSICIAN CORP (WDPC)/WENTWORTH HEALTH PARTNERS, A RELATED 501(C) (3) ENTITY.

THE GENERAL HOSPITAL CORPORATION
PART V, SECTION B, LINE 11: BASED ON BOTH BOSTON AND NORTH SUFFOLK'S COMMUNITY HEALTH NEEDS ASSESSMENT DATA, HOSPITAL PATIENT DATA, AND PUBLIC HEALTH DATA REVEALING THE LEADING CAUSES OF MORTALITY, MGH HAS UPDATED ITS COMMUNITY HEALTH PRIORITIES TO REFLECT AREAS THAT WE FEEL WE AS A HOSPITAL AND SYSTEM CAN MAKE MEASURABLE IMPACT. MGH'S PRIMARY FOCUS FOR ITS CHNA/CHIP IS TO IMPLEMENT STRATEGIES THAT WILL ACHIEVE RACIAL AND ETHNIC HEALTH EQUITY. WE WILL WORK TO ACHIEVE THIS GOAL BY ENSURING ACCESS TO TRADITIONAL AND INNOVATIVE HIGH-QUALITY AND EFFECTIVE CLINICAL PREVENTIVE SERVICES, WHILE AT THE SAME TIME WORKING UPSTREAM TO PROMOTE HEALTH AND WELLNESS IN COMMUNITY SETTINGS. THIS WILL ENTAIL WORKING ON SOCIAL DETERMINANTS OF HEALTH/UPSTREAM APPROACHES TO DISEASE PREVENTION, NAMELY 1) HOUSING AND 2) ECONOMIC/FINANCIAL STABILITY & MOBILITY, WHICH INCLUDES EDUCATION AS HIGHLIGHTED IN SURVEY AND FOCUS GROUP DATA AND 3) FOOD/NUTRITION SECURITY, WHICH WAS HIGHLIGHTED OVER THE PANDEMIC. HOUSING, FOOD AND EMPLOYMENT ARE FOUNDATIONS FOR GOOD HEALTH, AND WE WILL WORK WITH OTHERS TO ADDRESS THE INEQUITIES THAT EXIST TO ACHIEVE THESE BASIC NEEDS. BECAUSE OF OUR LONG-STANDING COMMITMENT TO KEEPING OUR PATIENTS AND COMMUNITIES SAFE, WE WILL CONTINUE TO ADDRESS 4) VIOLENCE AND SAFETY, PARTICULARLY HELPING PATIENTS EXPERIENCING INTIMATE PARTNER VIOLENCE OR COMMUNITY VIOLENCE, AND WE WILL WORK TO PREVENT NEEDLESS HARM THROUGH GUN VIOLENCE THROUGH EDUCATION AND ADVOCACY. AS ALWAYS, WE WILL CONTINUE TO HELP COMMUNITIES AND PATIENTS' 5) ACCESS AND NAVIGATE TREATMENT AND OTHER SERVICES, PARTICULARLY PREVENTATIVE SERVICES AND SOCIAL SUPPORTS THAT CAN HELP INDIVIDUALS REACH THEIR POTENTIAL. AS A HOSPITAL AND SYSTEM, WE HAVE AN OBLIGATION TO ADDRESS THE DISEASES MOST PREVALENT AND DESTRUCTIVE TO INDIVIDUALS AND COMMUNITIES. WITH A RENEWED INTEREST, WE WILL FOCUS OUR EFFORTS ON 6) MENTAL HEALTH, 7) SUBSTANCE USE AND 8) CARDIOMETABOLIC DISEASE, THE LEADING CAUSES OF MORTALITY, THROUGH MORE CREATIVE, COORDINATED, AND TARGETED APPROACHES AND WORKING IN COLLABORATION WITH OTHERS, WE CAN REDUCE THE LEADING CAUSES OF MORTALITY THAT FACE OUR COMMUNITIES AND HELP COMMUNITIES AND PATIENTS THRIVE. WE WILL DO THIS BY TARGETING EFFORTS IN EARLY LIFE, WITH YOUTH AND THROUGH ADULTHOOD, SPANNING THE LIFE COURSE.

THE BRIGHAM AND WOMEN'S HOSPITAL, INC
PART V, SECTION B, LINE 11: THE FOLLOWING 5 COMMUNITY HEALTH PRIORITY AREAS WERE APPROVED BY THE BWH COMMUNITY ADVISORY COMMITTEE AND ADOPTED BY THE BWH BOARD COMMITTEE FOR DIVERSITY, INCLUSION, HEALTH EQUITY AND COMMUNITY HEALTH IN JULY 2022: FINANCIAL STABILITY AND MOBILITY RESIDENTS OF BWH'S PRIORITY NEIGHBORHOODS FACE BARRIERS TO FINANCIAL STABILITY AND THESE ARE DISPROPORTIONATELY EXPERIENCED BY RESIDENTS OF COLOR. MISSION HILL, ROXBURY, AND DORCHESTER THAN HAD HIGHER RATES OF POVERTY COMPARED TO BOSTON OVERALL THERE ARE AND HIGHER RATES OF ADULT RESIDENTS WITHOUT A HIGH SCHOOL DIPLOMA IN ROXBURY. INCOME LOSS REPORTED DURING THE PANDEMIC WAS NOTABLY HIGHER FOR LATINO AND BLACK RESIDENTS. INCOME LOSS REPORTED DURING THE PANDEMIC WAS NOTABLY HIGHER FOR LATINO AND BLACK RESIDENTS IN BOSTON. COMMUNITY MEMBERS SHARED THE CONSIDERABLE CHALLENGE TO MAKE ENDS MEET AMID RISING COSTS. HOUSING CONCERNS INCLUDED LACK OF STABLE AND AFFORDABLE HOUSING, RISING COSTS, HIGHER RATES OF EVICTION, DISPLACEMENT, AND OVERCROWDING. IN MOST BWH PRIORITY COMMUNITIES, RESIDENTS ARE COST-BURDENED AND THE HIGH COST OF HOUSING HAS ALSO RESULTED IN THE DISPLACEMENT OF LOCAL RESIDENTS WHO ARE COMPELLED TO RELOCATE TO REDUCE HOUSING COSTS. MENTAL AND BEHAVIORAL HEALTH MENTAL HEALTH CONCERNS AND ACCESS TO MENTAL HEALTH CARE WAS A PRIMARY ISSUE OF CONCERN. THE STRESS AND EMOTIONAL TOLL OF THE PANDEMIC WAS A PROMINENT THEME WITH SPECIFIC CONCERNS CITED FOR YOUNG PEOPLE AND OLDER ADULTS WHO WERE ISOLATED FROM FAMILY AND FRIENDS. THE LACK OF CULTURALLY-COMPETENT TREATMENT WAS NOTED AS A CRITICAL SERVICE GAP. THE DRAMATIC INCREASE IN OPIOID-RELATED OVERDOSE FOR BLACK AND HISPANIC RESIDENTS IN MASSACHUSETTS IN RECENT YEARS IS AN ISSUE OF SIGNIFICANT CONCERN. PHYSICAL HEALTH AND WELLNESS SEVERAL CONCERNS RELATED TO OVERALL PHYSICAL HEALTH AND WELLNESS AROSE, INCLUDING MOST NOTABLY, CHRONIC DISEASE, FOOD INSECURITY, AND ACCESS TO CULTURALLY APPROPRIATE HEALTH CARE. IN ADDITION, THE RACIAL AND ETHNIC DIFFERENCES IN MORTALITY AND PREMATURE MORTALITY REFLECT THE ONGOING EFFECT OF SYSTEMIC AND STRUCTURAL RACISM ON HEALTH OUTCOMES. IT IS CRITICAL TO NOTE THE SIGNIFICANT IMPACT THE COVID-19 PANDEMIC HAD ON NUMEROUS AREAS RELATED TO PHYSICAL HEALTH AND WELLNESS. VIOLENCE AND TRAUMA COMMUNITY VIOLENCE EMERGED AS AN IMPORTANT THEME WITH MANY RESPONDENTS FROM DORCHESTER, MATTAPAN AND ROXBURY REPORTING SAFETY CONCERNS IN THEIR NEIGHBORHOODS. DATA INDICATE THAT VIOLENCE DISPROPORTIONATELY IMPACTING COMMUNITIES OF COLOR AND IMPACTING PREMATURE MORTALITY.

NORTH SHORE MEDICAL CENTER, INC.
PART V, SECTION B, LINE 11: THE 2022 CHNA AFFIRMED THE PRIORITIES IDENTIFIED IN THE 2021 CHNA AND ADDRESSED IN THE 2021 CHIP, WHILE INTRODUCING NEW ISSUES RELATED TO EXISTING THEMES AND ONE NEW COMMUNITY HEALTH THEME. THE 2022 CHNA THEMES AND RELATED ISSUES ARE AS FOLLOWS. BEHAVIORAL HEALTH, A PRIORITY IN THE 2021 CHIP, ENCOMPASSES THE ISSUES OF MENTAL HEALTH, SUBSTANCE USE DISORDERS (SUD), GAPS IN TREATMENT, STIGMA, AND VIOLENCE (DOMESTIC VIOLENCE, CHILD ABUSE/NEGLECT, ELDER ABUSE/NEGLECT). THE 2022 CHNA IDENTIFIED THE NEED FOR HARM REDUCTION CONVERSATIONS IN THE HOSPITAL WITH ACTIVE USERS AND THOSE WITH PAIN MANAGEMENT ISSUES. HEALTH CARE ACCESS, ALSO A PRIORITY ADDRESSED IN THE 2021 CHIP, INVOLVES NEEDS RELATED TO THE ACCESSIBILITY OF SERVICES, HEALTH INSURANCE AND COST, CARE COORDINATION AND NAVIGATION, AND ORAL HEALTH SERVICES. THE 2022 CHNA IDENTIFIED OPPORTUNITIES TO EXPAND ACCESS BY ENHANCING SALEM HOSPITAL'S PARTNERSHIP WITH THE LOCAL COMMUNITY HEALTH CENTERS AND EXPANDING MOBILE HEALTH SERVICES. CULTURALLY SENSITIVE CARE WAS DEFINED IN THE 2021 CHNA AND CHIP AS THE DELIVERY OF CULTURALLY SENSITIVE CARE AND SERVICES IN MULTIPLE LANGUAGES. THESE CONTINUING NEEDS CALL FOR FURTHER INVESTMENT IN OUTREACH TO AND ENGAGEMENT OF DIVERSE COMMUNITIES AND VULNERABLE POPULATIONS. SOCIAL DETERMINANTS OF HEALTH, INCLUDING INEQUITIES RELATED TO HOUSING, FOOD/NUTRITION, TRANSPORTATION, BROADBAND AND CELL SERVICE, CHILDCARE, AND EDUCATION, WERE ADDRESSED IN THE 2021 CHIP. THESE NEEDS PERSIST AND, FOR MANY, HAVE WORSENED IN 2022. WORKFORCE: THE 2022 CHNA ADDS A NEW THEME IN UNDERSTANDING THE HEALTH-RELATED NEEDS IN THE PRIORITY COMMUNITIES. LABOR SHORTAGES ARE CAUSING EXTENSIVE WAIT LISTS AND TIMES AND SEVERELY LIMITING ACCESS TO HEALTH AND BEHAVIORAL HEALTH CARE. GIVEN THE DEMOGRAPHIC MAKE-UP OF THE COMMUNITIES, INCREASING DIVERSITY OF THE WORKFORCE TO MEET THESE NEEDS IS PARAMOUNT. IN A SEPTEMBER 13, 2022 MEETING, THE CAHAC REVIEWED THE CHNA FINDINGS AND MGB'S SYSTEM FOCUS ON CARDIOMETABOLIC DISEASE AND SUDS AND ADOPTED THE FIVE PRIORITIES AND RELATED ISSUES DESCRIBED ABOVE. AFTER REVIEWING THE CHNA RESULTS, THE CAHAC DETERMINED THAT THE 2023-2025 CHIP WILL CONTINUE TO FOCUS ON ITS EIGHT PRIORITIES COMMUNITIES AND DEVELOP STRATEGIES THAT WILL ACHIEVE RACIAL AND ETHNIC HEALTH EQUITY BY ADDRESSING THE NEEDS OF SEVERAL UNDERSERVED AND VULNERABLE POPULATIONS, INCLUDING SENIORS, YOUTH, THOSE WITH HEARING IMPAIRMENTS AND OTHER DISABILITIES, UNDOCUMENTED IMMIGRANTS, NON-ENGLISH SPEAKING INDIVIDUALS, HOMELESS POPULATIONS, THE TRANSGENDER COMMUNITY, PEOPLE RE-ENTERING THE COMMUNITY FROM JAIL/PRISON, AND PEOPLE DEALING WITH MENTAL HEALTH CONCERNS AND SUBSTANCE USE DISORDERS.

NEWTON-WELLESLEY HOSPITAL
PART V, SECTION B, LINE 11: AS MASS GENERAL BRIGHAM DEVELOPS AND IMPLEMENTS PROGRAMMING AND SUPPORTS THAT WILL REDUCE DISPARITIES IN HEALTH OUTCOMES FOR THE TWO SYSTEM PRIORITIES, OUR EFFORTS WILL FOCUS ON THE HIGHEST NEED COMMUNITIES ACROSS OUR HOSPITAL PRIORITY NEIGHBORHOODS. WE WILL ALSO CONTINUE TO SUPPORT LOCALLY IDENTIFIED PRIORITIES AT THE HOSPITAL LEVEL. COMMUNITY PRIORITIES FOR ACTION PRIORITIZATION ALLOWS ORGANIZATIONS TO TARGET AND ALIGN RESOURCES, LEVERAGE EFFORTS, AND FOCUS ON ACHIEVABLE STRATEGIES AND GOALS FOR ADDRESSING PRIORITY NEEDS. THROUGH A SYSTEMATIC, ENGAGED APPROACH THAT IS INFORMED BY DATA, PRIORITIES ARE IDENTIFIED THROUGH AN ITERATIVE PROCESS TO FOCUS PLANNING EFFORTS. THIS SECTION DESCRIBES THE PROCESS AND OUTCOMES OF THE NWH CHNA PRIORITIZATION PROCESS.FROM THIS DISCUSSION, THE FOLLOWING PRIORITIES WERE SELECTED: HOUSING AFFORDABILITY MENTAL HEALTH & SUBSTANCE USE ACCESS TO QUALITY CARE, WITH A FOCUS ON: CHRONIC DISEASE PREVENTION AND MANAGEMENT OF INTEGRATION OF SERVICES AND HEALTHCARE TRANSPORTATION IT WAS RECOMMENDED THAT ALL PRIORITIES BE ADDRESSED WITH THE FOLLOWING CROSS-CUTTING STRATEGIES: HEALTH AND RACIAL EQUITY WORKFORCE DEVELOPMENT SUSTAINED COMMUNITY ENGAGEMENT AND EMPOWERMENT FINALLY, ALL PRIORITIES SHOULD SPECIFICALLY CONSIDER THE SPECIAL NEEDS OF THE COMMUNITIES' MOST VULNERABLE POPULATIONS: OLDER ADULTS YOUTH IMMIGRANTS PEOPLE OF COLOR

BRIGHAM AND WOMEN'S FAULKNER HOSPITAL
PART V, SECTION B, LINE 11: BRIGHAM AND WOMEN'S FAULKNER HOSPITAL USED A COLLABORATIVE PLANNING PROCESS TO IDENTIFY AND REAFFIRM THE PRIORITIES IN WHICH WE WILL WORK WITH RESIDENTS AND ACROSS ALL SECTORS IN THE COMMUNITY TO ADDRESS. IDENTIFIED AND REAFFIRMED PRIORITIES FOR BRIGHAM AND WOMEN'S FAULKNER HOSPITAL AND THE COLLABORATIVE THE PRIORITIZATION PROCESS WAS CENTERED ON THE DATA FROM THIS 2022 CHNA AND THE CURRENT CHIP WHICH HAS FIVE MAIN PRIORITY AREAS (FOUR FOR THE COLLABORATIVE) AND AN OVERARCHING CENTRAL FOCUS OF ACHIEVING RACIAL AND ETHNIC HEALTH EQUITY: 1: HOUSING- FOCUS ON AFFORDABILITY, QUALITY, HOMELESSNESS, OWNERSHIP AND DISPLACEMENT 2: FINANCIAL SECURITY AND MOBILITY - FOCUS ON JOBS, EMPLOYMENT, INCOME, EDUCATION, AND WORKFORCE TRAINING 3: BEHAVIORAL HEALTH - FOCUS ON MENTAL HEALTH AND SUBSTANCE USE 4: ACCESSING SERVICES FOCUS ON HEALTHCARE, TRANSPORTATION, LANGUAGE, HEALTHY AND NUTRITIOUS FOOD AND SOCIAL SERVICES 5: CHRONIC DISEASE AND HEALTHY LIVING - FOCUS ON CARDIOMETABOLIC DISEASE, FITNESS AND WELLNESS FOR ALL

THE MCLEAN HOSPITAL CORPORATION
PART V, SECTION B, LINE 11: PRIORITIES - MCLEAN'S IMPROVEMENT PLAN WILL BE INFORMED BY THESE PRIORITIZED NEEDS IDENTIFIED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT. FOCUSING ON PEOPLE AND FAMILIES AFFECTED BY PSYCHIATRIC ILLNESS AND SUBSTANCE USE DISORDERS ACROSS EASTERN AND CENTRAL MASSACHUSETTS, ENCOMPASSING CHNA 17 SERVICE AREAS AND MIDDLEBOROUGH, THE CHIP WILL INCLUDE: IMPROVING MENTAL HEALTH ACCESS AND CAPACITY THROUGH INNOVATIVE PROGRAMS AND BETTER COORDINATION DECREASING LENGTHS OF STAY IN HOSPITAL EMERGENCY DEPARTMENTS AND MEDICAL/SURGICAL UNITS FOR PATIENTS WITH MENTAL/BEHAVIORAL HEALTH NEEDS ADDRESSING THE NEEDS OF UNDERSERVED COMMUNITIES WITH RESIDENTS PREDOMINATELY WITH HISTORICALLY MARGINALIZED IDENTITIES SUPPORTING SCHOOLS (K-12 AND INSTITUTIONS OF HIGHER EDUCATION) AS THEY SUPPORT STUDENTS AND FAMILIES CARING FOR UNINSURED AND UNDERINSURED STRENGTHENING BEHAVIORAL HEALTH WORKFORCE TO ADDRESS ACCESS AND QUALITY EXPANDING PUBLIC EDUCATION AND ENGAGEMENT TO REDUCE STIGMA AND PROMOTE MENTAL HEALTH WELLNESS AND RESILIENCY.

THE SPAULDING REHABILITATION HOSPITAL
PART V, SECTION B, LINE 11: MASS GENERAL BRIGHAM (MGB) COMMUNITY HEALTH LEADS THE MGB SYSTEM-WIDE COMMITMENT TO IMPROVE THE HEALTH AND WELL-BEING OF RESIDENTS IN THE MGB PRIORITY COMMUNITIES MOST IMPACTED BY HEALTH INEQUITIES. IN ADDITION TO THE PRIORIES EACH HOSPITAL IDENTIFIES THAT ARE UNIQUE TO ITS COMMUNITIES, MGB HAS IDENTIFIED TWO SYSTEM-LEVEL PRIORITIES: CARDIOMETABOLIC DISEASE AND SUBSTANCE USE DISORDER. THESE PRIORITIES EMERGED FROM A REVIEW OF HOSPITAL-LEVEL DATA AND PREVALENT TRENDS IN POPULATION HEALTH STATISTICS THAT SHOW BLACK AND HISPANIC INDIVIDUAL ARE DISPROPORTIONATELY AFFECTED BY DISPARITIES IN HEALTH OUTCOMES AND EXCESS DEATHS RELATED TO THESE CONDITIONS. MGB EFFORTS WITHIN THESE TWO AREAS WILL AIM TO REDUCE RACIAL AND ETHNIC DISPARITIES IN OUTCOMES, WITH THE GOAL OF IMPROVING LIFE EXPECTANCY. HOSPITALS ACROSS MGB ARE CONDUCTING CHNAS AT THIS TIME TO ALIGN WITH MGB EFFORTS TO HAVE ALL HOSPITALS ON THE SAME THREE-YEAR CYCLE TO UTILIZE SYSTEM-WIDE EFFORTS TO ADDRESS HEALTH INEQUITIES.PRIORITY AREA OBJECTIVE ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH - TO INCREASE OPPORTUNITIES FOR EDUCATIONAL AND PROFESSIONAL ADVANCEMENTIMPROVING ACCESS TO CARE - TO REDUCE BARRIERS TO HEALTH CARE PROMOTING WELLNESS AND PREVENTING INJURY AND DISEASE - TO INCREASE WELLNESS AND PREVENT INJURY AND DISEASE, ESPECIALLY FOR CHILDREN, SENIORS, AND THOSE WITH DISABILITIESIMPROVING THE SOCIAL ENVIRONMENT AND OPPORTUNITIES FOR THOSE WITH DISABILITIES - TO DECREASE ISOLATION AND INCREASE SOCIAL-EMOTIONAL SUPPORT FOR PEOPLE WITH DISABILITIES OTHER PRIORITIES IDENTIFIED BY THE COMMUNITY - TO PROVIDE RESOURCES, AS APPROPRIATE AND AVAILABLE, TO SUPPORT COMMUNITY PRIORITIES THAT FALL OUTSIDE THE OTHER COMMUNITY BENEFIT PRIORITY AREAS.

REHABILITATION HOSPITAL OF THE CAPE
PART V, SECTION B, LINE 11: RESULTS FROM OUR ASSESSMENT INDICATE THAT SPAULDING CAPE COD IS VERY MUCH A COMMUNITY-BASED HOSPITAL, SERVING MAINLY CAPE COD (BARNSTABLE COUNTY) AND, TO A LESSER DEGREE, PLYMOUTH COUNTY. OUR INPATIENT POPULATION IS ELDERLY. THE COMBINATION OF ADVANCED AGE, AN ACUTE ADMISSION SUPERIMPOSED ON CHRONIC COMORBIDITIES, AND VARIED LEVELS OF SUPPORT AT TIME OF DISCHARGE PLACE MANY OF OUR PATIENTS AT RISK. GIVEN SPAULDING CAPE COD'S MISSION, CATCHMENT AREA, AND PATIENT CHARACTERISTICS IDENTIFIED DURING OUR COMMUNITY HEALTH NEEDS ASSESSMENT, WE WILL BE FOCUSING ON THE NEEDS OF BARNSTABLE AND PLYMOUTH COUNTY RESIDENTS, PARTICULARLY THE ELDERLY AND PERSONS LIVING WITH A DISABILITY. OUR PRIORITIES WILL INCLUDE ADDRESSING SOCIAL DETERMINANTS OF HEALTH, IMPROVING ACCESS TO CARE, PROMOTING HEALTH AND WELLNESS OF THE COMMUNITY, AND REDUCING IMPACTS OF CHRONIC DISEASE AND DISABILITY.

SPAULDING HOSPITAL-CAMBRIDGE, INC.
PART V, SECTION B, LINE 11: CRITERIA FOR PRIORITIZATION TO DETERMINE THE PRIORITIES FOR COMMUNITY HEALTH NEEDS, THE FOLLOWING CRITERIA WERE USED: (1) BURDEN AND URGENCY OF THE COMMUNITY HEALTH NEED, (2) EQUITY, (3) IMPACT, (4) FEASIBILITY: AND (5) POTENTIAL FOR COLLABORATION A. ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH: SPAULDING IS COMMITTED TO ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH, INCLUDING CHRONIC UNEMPLOYMENT FOR PEOPLE WITH DISABILITIES, THE UNDEREMPLOYMENT OF COMMUNITY MEMBERS WITH SOCIOECONOMIC LIMITATIONS TO FURTHER EDUCATION AND THE NEED FOR TRANSITIONAL HOUSING FOR THE HOMELESS. A. TRANSITION WELLNESS CENTER THE TRANSITIONAL WELLNESS CENTER WAS DEVELOPED IN 2020 TO SUPPORT THE HOMELESS POPULATION IN CAMBRIDGE WHO WERE BEING DISPLACED DUE TO THE COVID RESTRICTIONS IMPACTING SHELTER CAPACITY. THE CITY OF CAMBRIDGE APPROACHED SPAULDING TO RENOVATE VACANT HOSPITAL SPACE TO PROVIDE A 58-BED HOMELESS SHELTER. THE SHELTER WAS OPENED IN DECEMBER 2020 AND PROVIDES HOUSING AND TRANSITIONAL SERVICES FOR BOTH MALE AND FEMALE RESIDENTS UNDER A CONTRACT WITH THE CITY OF CAMBRIDGE AND BAY COVE. TO SUPPORT THE NEEDS OF THESE RESIDENTS THE SPAULDING EMPLOYEES CREATED THE SPAULDING CLOSET WHICH IS A DONATION CENTER FOR RESIDENTS TO OBTAIN CLOTHING AND PERSONAL CARE ITEMS. B. WORKFORCE DEVELOPMENT: DURING THE COVID PANDEMIC ALL WORKFORCE DEVELOPMENT PROGRAMS WERE CANCELLED BUT SPAULDING IS IN THE PROCESS OF REESTABLISHING OUR COMMITMENT TO SUPPORT THE EDUCATIONAL AND PROFESSIONAL GROWTH OPPORTUNITIES FOR THOSE DISADVANTAGED COMMUNITIES. JEWISH VOCATIONAL SERVICES (JVS) BOSTON JVS IS ONE OF THE LARGEST AND MOST IMPACTFUL WORKFORCE DEVELOPMENT ORGANIZATIONS IN NEW ENGLAND. SPAULDING CAMBRIDGE PARTNERS WITH JVS TO EMPOWER INDIVIDUALS FROM DIVERSE COMMUNITIES TO FIND EMPLOYMENT AND BUILD CAREERS, WHILE PARTNERING WITH EMPLOYERS TO HIRE, DEVELOP, AND RETAIN PRODUCTIVE WORKFORCES. SPAULDING HAS PARTNERED WITH JVS FOR PCA TRAINING COHORTS SINCE 2017 BUT THE PROGRAM TOOK A HIATUS DURING COVID. THE PROGRAM WAS REINSTITUTED IN JAN 2022 AND REMAINS AN ACTIVE PARTNER WITH SPAULDING. B. ACCESS TO CARE: TO REDUCE BARRIERS TO HEALTH CARE, THE SPAULDING CAMBRIDGE COMMUNITY BENEFIT PROGRAM PLANS TO SUPPORT FREE CARE PATIENTS IN NEED. ALTHOUGH IT IS DIFFICULT TO ANTICIPATE THE PAYERS AND COVERAGE ASSOCIATED WITH PATIENTS WHO MAY NEED SUCH ASSISTANCE IN THE YEAR AHEAD, SPAULDING CAMBRIDGE ASSUMES THE COST OF NON-COVERED SERVICES MAY BE COMPARABLE TO THOSE OF FY20 (~$1.056M) C. PROMOTING WELLNESS AND PREVENTING INJURY AND DISEASE TO INCREASE WELLNESS AND PREVENT INJURY AND DISEASE, SPAULDING IS COMMITTED TO CONTINUING THE CURRENT AND DEVELOPING ADDITIONAL PROGRAMS TO ADDRESS THE NEEDS OF THOSE WITH DISABILITIES AND CHRONIC ILLNESS. A. EXERCISE FOR PEOPLE WITH DISABILITIES (EXPD) EXPD IS AN EXAMPLE OF A PROGRAM THAT PROVIDES SUITABLE EXERCISE ACTIVITIES FOR HEALTH LEISURE AND SPORT FOR PEOPLE WITH DISABILITIES SUCH AS SPINAL CORD INJURY, CEREBRAL PALSY, MULTIPLE SCLEROSIS, AND PERIPHERAL NEUROPATHY. THE EXPD PROGRAM IS OVERSEEN BY EXERCISE PHYSIOLOGISTS, WHO ARE TRAINED IN KEEPING INDIVIDUALS WITH CHRONIC DISEASES AS FIT AND HEALTHY AS POSSIBLE USING AEROBIC CONDITIONING AND STRENGTH TRAINING. THE PROGRAM WAS REOPENED IN JAN 2021 AFTER THE COVID PANDEMIC. D. IMPROVING THE SOCIAL ENVIRONMENT AND OPPORTUNITIES FOR THOSE WITH DISABILITIES ADVOCACY WITH AND ON BEHALF OF PEOPLE WITH DISABILITIES IS CORE TO THE MISSION OF SPAULDING REHABILITATION NETWORK. TO DECREASE ISOLATION AND INCREASE SOCIAL-EMOTIONAL SUPPORT FOR PERSONS WITH DISABILITIES AND THOSE STRUGGLING WITH SUBSTANCE ABUSE, SPAULDING IS COMMITTED TO PROVIDING BOTH PROGRAMS AND FREE ACCESSIBLE MEETING SPACE ON CAMPUS. GROUPS THAT WE HAVE SUPPORTED INCLUDE ALCOHOLICS ANONYMOUS, LEARN TO COPE, EATING DISORDER ANONYMOUS AND THE MID CAMBRIDGE NEIGHBORHOOD ASSOCIATION.

NANTUCKET COTTAGE HOSPITAL
PART V, SECTION B, LINE 11: ENHANCE OVERALL WELLNESS FOR THE NANTUCKET COMMUNITY THROUGH THE IMPLEMENTATION OF AN EFFECTIVE AND COLLABORATIVE BEHAVIORAL HEALTH SYSTEM:STRATEGIES: EDUCATE ALL EMPLOYERS (E.G., SMALL AND LARGE EMPLOYERS, BUILDER'S ASSOCIATION, CHAMBER OF COMMERCE), ON NANTUCKET AND IMPLEMENT EMPLOYEE ASSISTANCE PROGRAMS TO RECOGNIZE AND REFER HIGH RISK EMPLOYEES. EXPAND EDUCATION ABOUT SUICIDE RISK BY ASSESSING AND ENHANCING SIGNS OF SUICIDE (SOS) PROGRAM IN NANTUCKET SCHOOLS. REDUCE THE STIGMA SURROUNDING SUICIDAL THOUGHTS BY IMPLEMENTING AN EVIDENCED-BASED PEER-TO-PEER PROGRAM FOR THE REDUCTION OF SUICIDE IN THE MIDDLE AND HIGH SCHOOL (E.G., INCORPORATE IN EXISTING HEALTH EDUCATION OR ESTABLISH A HIRED POSITION). ESTABLISH A FULL-SERVICE MOBILE CRISIS UNIT. INCREASE THE AVAILABILITY TO ACCESS NEEDED BEHAVIORAL HEALTH SERVICES.BY 2020, DECREASE THE NEED FOR EMERGENCY EVALUATION FOR MENTAL HEALTH AND SUBSTANCE USE DISORDERS BY 10% PER YEAR: STRATEGIES: EDUCATE ALL EMPLOYERS (E.G., SMALL AND LARGE EMPLOYERS, BUILDER'S ASSOCIATION, CHAMBER OF COMMERCE), ON NANTUCKET AND IMPLEMENT EMPLOYEE ASSISTANCE PROGRAMS TO RECOGNIZE AND REFER HIGH RISK EMPLOYEES. EXPAND EDUCATION ABOUT SUICIDE RISK BY ASSESSING AND ENHANCING SIGNS OF SUICIDE (SOS) PROGRAM IN NANTUCKET SCHOOLS. REDUCE THE STIGMA SURROUNDING SUICIDAL THOUGHTS BY IMPLEMENTING AN EVIDENCED-BASED PEER-TO-PEER PROGRAM FOR THE REDUCTION OF SUICIDE IN THE MIDDLE AND HIGH SCHOOL (E.G., INCORPORATE IN EXISTING HEALTH EDUCATION OR ESTABLISH A HIRED POSITION). ESTABLISH A FULL-SERVICE MOBILE CRISIS UNIT. INCREASE THE AVAILABILITY TO ACCESS NEEDED BEHAVIORAL HEALTH SERVICES.

MARTHA'S VINEYARD HOSPITAL
PART V, SECTION B, LINE 11: MASS GENERAL BRIGHAM COMMUNITY HEALTH LEADS THE MASS GENERAL BRIGHAM SYSTEM-WIDE COMMITMENT TO IMPROVE THE HEALTH AND WELL-BEING OF RESIDENTS IN OUR PRIORITY COMMUNITIES MOST IMPACTED BY HEALTH INEQUITIES. MASS GENERAL BRIGHAM'S COMMITMENT TO THE COMMUNITY IS PART OF A $30 MILLION PLEDGE TO FUND PROGRAMS AIMED AT DISMANTLING RACISM AND OTHER FORMS OF INEQUITY THROUGH A COMPREHENSIVE RANGE OF APPROACHES INVOLVING OUR HEALTH CARE DELIVERY SYSTEM AND COMMUNITY HEALTH INITIATIVES. WHILE NOT REQUIRED TO CONDUCT A CHNA UNDER CURRENT REGULATIONS, MASS GENERAL BRIGHAM'S BELIEF IN THE CRITICAL IMPORTANCE OF SYSTEM-WIDE, POPULATION-LEVEL APPROACHES RESULTED IN OUR DECISION TO HAVE EVERY HOSPITAL CONDUCT A 2022 CHNA. HAVING ALL OUR HOSPITALS ON THE SAME THREE-YEAR CYCLE WILL PROVE INVALUABLE IN OUR EFFORTS TO ELIMINATE HEALTH INEQUITIES BY IDENTIFYING SYSTEM-WIDE PRIORITIES THAT REQUIRE SYSTEM-LEVEL EFFORTS. IN ADDITION TO THE PRIORITIES EACH HOSPITAL IDENTIFIES THAT ARE UNIQUE TO ITS COMMUNITIES, MASS GENERAL BRIGHAM IDENTIFIED TWO SYSTEM-LEVEL PRIORITIES: CARDIOMETABOLIC DISEASE AND SUBSTANCE USE DISORDER. THESE PRIORITIES EMERGED FROM A REVIEW OF HOSPITAL-LEVEL DATA AND PREVALENT TRENDS IN POPULATION HEALTH STATISTICS. OUR EFFORTS WITHIN THESE PRIORITIES WILL AIM TO REDUCE RACIAL AND ETHNIC DISPARITIES IN OUTCOMES, WITH THE GOAL OF IMPROVING LIFE EXPECTANCY.

COOLEY DICKINSON HOSPITAL, INC.
PART V, SECTION B, LINE 11: SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTHSOCIAL ENVIRONMENT ALZHEIMER'S DISEASE AND DEMENTIA FOCUS: SOCIAL ISOLATION AND LONELINESS POPULATION: OLDER ADULTS GOAL: INCREASE OPPORTUNITIES FOR SOCIAL CONNECTIONS THROUGH COLLABORATION WITH COMMUNITY-BASED ORGANIZATIONS ACCESS TO HEALTHY FOOD, TRANSPORTATION, AND PLACES TO BE ACTIVE FOCUS: ACCESS TO HEALTHY FOOD POPULATION: LOWER INCOME IN AMHERST, EASTHAMPTON, NORTHAMPTON, AND OTHER COMMUNITIES GOAL: INCREASE OPPORTUNITIES TO ACCESS AFFORDABLE, FRESH, HEALTHY FOOD THROUGH COLLABORATION WITH COMMUNITY-BASED ORGANIZATIONS AND PROJECTS BARRIERS TO ACCESSING QUALITY HEALTH CARE TRANSPORTATION FOCUS: TRANSPORTATION TO MEDICAL APPOINTMENTS, FOOD ACCESS, AND SOCIAL EVENTS POPULATION: RURAL OLDER ADULTS GOAL: HELP SUPPORT THE HILLTOWN EASY RIDE THROUGH THE PROVISION OF FUNDING TO A COMMUNITY-BASED ORGANIZATION LACK OF CARE COORDINATION FOCUS: AGE-FRIENDLY HEALTH CARE INITIATIVE POPULATION: OLDER ADULTS GOAL: TRAIN PROVIDERS IN THE SERIOUS ILLNESS CONVERSATION MODEL FOCUS: HEALTH CARE FOR VETERANS POPULATION: VETERANS AND MILITARY FAMILIES GOAL: OPTIMIZE USE OF ELECTRONIC MEDICAL RECORD FOR SCREENING AND REFERRALS GOAL: TRAINING FOR PROVIDERS TO BETTER UNDERSTAND UNIQUE NEEDS OF VETERANS NEED FOR INCREASED CULTURALLY SENSITIVE CARE HEALTH LITERACY AND LANGUAGE BARRIERS FOCUS: LANGUAGE ACCESS THROUGH MEDICAL INTERPRETER SERVICES POPULATION: PATIENTS WITH LIMITED ENGLISH PROFICIENCY RECEIVING SERVICES AT A FEDERALLY QUALIFIED HEALTH CENTER GOAL: HELP MITIGATE BARRIERS TO ACCESS TO HEALTH CARE SERVICES FOR HEALTH CENTER PATIENTS 2019-2022 COOLEY DICKINSON COMMUNITY HEALTH IMPLEMENTATION PLAN FOCUS: TRAINING AND COMMUNITY CAPACITY BUILDING SUCH THAT NON-PROFIT HEALTH AND SOCIAL SERVICE BOARDS AND LEADERS REFLECT THE POPULATION: PEOPLE OF THE GLOBAL MAJORITY AND NON-PROFIT HEALTH AND SOCIAL SERVICE ORGANIZATIONS GOAL: INCREASE THE NUMBER OF PEOPLE OF THE GLOBAL MAJORITY SERVING ON NON-PROFIT BOARDS AS WELL AS THE CULTURAL COMPETENCY OF NON-PROFIT BOARDS FOCUS: SYSTEM DEVELOPMENT TO ENSURE ACCESS TO CULTURALLY APPROPRIATE SERVICES FOR LGBTQ RESIDENTS POPULATION: LGBTQ ADULTS AND YOUTH GOAL: INCREASE ORGANIZATIONAL EFFECTIVENESS PROVIDING HEALTH CARE TO LGBTQ RESIDENTS FOCUS: INFORMATION & REFERRAL POPULATION: SPANISH SPEAKING RESIDENTS GOAL: ENSURE ACCESS TO SERVICES THROUGH COLLABORATION WITH A COMMUNITY-BASED ORGANIZATION TO PROVIDE HEALTH AND SOCIAL SERVICE INFORMATION AND REFERRAL THAT IS BILINGUAL SPANISH .

WENTWORTH-DOUGLASS HOSPITAL
PART V, SECTION B, LINE 11: NINE SIGNIFICANT COMMUNITY HEALTH NEEDS WERE IDENTIFIED THROUGH THIS ASSESSMENT. THESE SIGNIFICANT HEALTH NEEDS ARE AS FOLLOWS, IN ALPHABETICAL ORDER: 1. ACCESS TO PRIMARY CARE SERVICES; 2. ACCESS TO LONG TERM SERVICES AND SUPPORTS;3 3. CHRONIC DISEASE; 4. FINANCIAL BARRIERS TO CARE; 5. MENTAL HEALTH; 6. OBESITY AND PHYSICAL INACTIVITY; 7. ORAL HEALTH; 8. SOCIAL DETERMINANTS OF HEALTH; AND 9. SUBSTANCE USE DISORDERS. THESE SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY SERVED BY WDH WERE IDENTIFIED BASED ON ANALYSES OF SECONDARY DATA, PRIMARY DATA RECEIVED THROUGH INTERVIEWS WITH INTERESTED PARTIES, AND ASSESSMENTS PRODUCED BY PUBLIC HEALTH DEPARTMENTS. CATEGORIES OF COMMUNITY HEALTH NEEDS ARE TOPIC AREAS CONSISTENT WITH THE NEW HAMPSHIRE COMMUNITY BENEFITS REPORTING GUIDE, DECEMBER 20204 AND HEALTHY PEOPLE 2020 AND HEALTHY PEOPLE 2030, TEN-YEAR NATIONAL HEALTH OBJECTIVES OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. DETAILS ARE SUMMARIZED BELOW, WITH DESCRIPTIONS OF TOPICS BASED ON INFORMATION FROM HEALTHY PEOPLE 2020, HEALTHY PEOPLE 2030, THE CENTERS FOR DISEASE CONTROL AND PREVENTION.5, 6 IN ADDITION, MASS GENERAL BRIGHAM ALSO IDENTIFIED CARDIOMETABOLIC DISEASE AND SUBSTANCE USE DISORDER AS SIGNIFICANT HEALTH NEEDS. SIGNIFICANT NEEDS CAN IMPACT ALL RESIDENTS, IRRESPECTIVE OF DEMOGRAPHIC CHARACTERISTICS. WHILE EVERY COMMUNITY CAN EXPERIENCE NEED, THE FOLLOWING POPULATION GROUPS MAY BE ESPECIALLY VULNERABLE TO THE SIGNIFICANT NEEDS IDENTIFIED FOR THIS CHNA: 1. CHILDREN AND YOUTH; 2. OLDER ADULTS; 3. LGBTQIA+7 INDIVIDUALS; 4. RACIAL/ETHNIC MINORITIES; AND 5. LOW-INCOME RESIDENTS. NOTE: THE COVID-19 PANDEMIC HAD AN IMMEDIATE IMPACT ON THE WORLD SINCE ITS EMERGENCY IN LATE 2019. TESTING, VACCINATING, AND TREATMENT OPTIONS HAVE EVOLVED, YET THE PANDEMIC CONTINUE TO EXACERBATE NUMEROUS HEALTH-RELATED NEEDS WITHIN THE COMMUNITY. AS COVID-19 PREVENTION AND MANAGEMENT OPTIONS HAVE IMPROVED, THIS CHNA RECOGNIZES THE IMPACT OF COVID-19 ON SIGNIFICANT NEEDS WITHIN THE COMMUNITY. SHOULD THE PANDEMIC WORSEN, IT WOULD BE APPROPRIATE TO EVALUATE THE POTENTIAL CONSIDERATION OF COVID-19 AS A SEPARATE SIGNIFICANT COMMUNITY NEED.

MASSACHUSETTS EYE & EAR INFIRMARY
PART V, SECTION B, LINE 11: THE CBAC DECIDED THE 2023 CHIP SHOULD ADDRESS THE CLINICAL PRIORITIES OF VISION, HEARING, BALANCE, AND HEAD AND NECK CANCERS (PARTICULARLY SKIN CANCERS) AND ADDRESS THE PRIMARY BARRIERS TO CARE FACED BY SENIORS, CHILDREN, RACIALLY/ETHNICALLY DIVERSE COMMUNITIES, AND THOSE WITH LOW SES. THE CBAC MEMBERS BELIEVE THE CHIP SHOULD MAXIMIZE EXISTING COMMUNITY PARTNERSHIPS TO ADDRESS THE CLINICAL PRIORITIES AND OVERCOME BARRIERS THAT PRIORITY POPULATIONS FACE IN ACCESSING CARE. IN PARTICULAR, THE GROUP DISCUSSED THE NEED FOR GREATER OUTREACH TO DIVERSE COMMUNITIES TO BUILD TRUST, EXTEND SERVICES IN THE COMMUNITY, AND OFFER EDUCATION TO IMPROVE HEALTH LITERACY AND UNDERSTANDING OF THE HEALTH SYSTEM. ADDITIONALLY, THE CBAC DISCUSSED THE NEED FOR IMPROVED MECHANISMS TO ENSURE FOLLOW-UP CARE IS PROVIDED AFTER A PROBLEM IS DETECTED VIA SCREENING. CLINICAL PRIORITIES HEARING VISION BALANCE HEAD AND NECK CANCERS (PARTICULARLY SKIN CANCERS)IMPROVING ACCESS TO CARE INSURANCE/COST TRANSPORTATION DIFFICULTY ACCESSING, UNDERSTANDING, AND NAVIGATING HEALTH SYSTEM DUE TO LANGUAGE, HEALTH LITERACY, AND TRUST ISSUESMASS. EYE AND EAR'S SENIOR LEADERSHIP REVIEWED THE CBAC'S RECOMMENDATIONS AND APPROVED THE CHNA AND ITS CONCLUSIONS.

PART V, SECTION B - LINES 7 AND 10:
THE GENERAL HOSPITAL CORPORATIONHTTPS://WWW.MASSGENERAL.ORG/COMMUNITY-HEALTH/CCHI/ASSESSMENTSTHE BRIGHAM AND WOMEN'S HOSPITAL, INC.HTTPS://WWW.BRIGHAMANDWOMENS.ORG/ABOUT-BWH/COMMUNITY-HEALTH-EQUITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENTNORTH SHORE MEDICAL CENTER, INC.HTTPS://SALEM.MASSGENERALBRIGHAM.ORG/COMMITMENT_TO_COMMUNITYNEWTON-WELLESLEY HOSPITALHTTPS://WWW.NWH.ORG/ABOUT-US/COMMUNITY-HEALTH-ASSESSMENTBRIGHAM AND WOMEN'S/FAULKNER HOSPITALHTTPS://WWW.BRIGHAMANDWOMENSFAULKNER.ORG/ABOUT-BWFH/COMMUNITY-HEALTH-AND-WELLNESS/DEFAULTTHE MCLEAN HOSPITAL CORPORATIONHTTPS://WWW.MCLEANHOSPITAL.ORG/ABOUT/COMMUNITY-HEALTH-ASSESSMENTSPAULDING REHABILITATION HOSPITAL CORPORATIONHTTPS://SPAULDINGREHAB.ORG/ABOUT/COMMUNITY-INVOLVEMENTREHABILITATION HOSPITAL OF THE CAPE AND ISLANDS CORPORATIONHTTPS://SPAULDINGREHAB.ORG/ABOUT/COMMUNITY-INVOLVEMENTSPAULDING HOSPITAL CAMBRIDGE, INC.HTTPS://SPAULDINGREHAB.ORG/ABOUT/COMMUNITY-INVOLVEMENTNANTUCKET COTTAGE HOSPITALHTTPS://NANTUCKETHOSPITAL.ORG/ABOUT-US/ABOUT-NANTUCKET-COTTAGE-HOSPITAL/COMMUNITY-OUTREACH/MARTHA'S VINEYARD HOSPITALHTTPS://MVHOSPITAL.ORG/ABOUT-MARTHAS-VINEYARD-HOSPITAL/REPORTS/COOLEY DICKINSON HOSPITAL, INC.HTTPS://WWW.COOLEYDICKINSON.ORG/ABOUT-US/COMMITMENT-TO-COMMUNITY/BENEFITING-OUR-COMMUNITY/WENTWORTH-DOUGLASS HOSPITALHTTPS://WWW.WDHOSPITAL.ORG/WDH/ABOUT-WDH/GIVING-BACKMASSACHUSETTS EYE & EAR INFIRMARYHTTPS://WWW.MASSEYEANDEAR.ORG/ABOUT/OUTREACH

PART V, LINE 16A-C:
URLS FOR FINANCIAL ASSISTANCE POLICIES:HTTPS://WWW.MASSGENERALBRIGHAM.ORG/EN/PATIENT-CARE/PATIENT-VISITOR-INFORMATION/FINANCIAL-ASSISTANCE

PART V, SECTION B - LINE 11:
PLEASE SEE THE CHNAS AND IMPLEMENTATION STRATEGIES FOR EACH OF THE HOSPITAL FACILITIES AT THE APPLICABLE URL LISTED IN PART V, SECTION B.

PART I, LINE 6A:
MASS GENERAL BRIGHAM HOSPITALS (EXCEPT WENTWORTH-DOUGLASS HOSPITAL) FILE THEIR ANNUAL COMMUNITY BENEFIT REPORT WITH THE ATTORNEY GENERAL OF MASSACHUSETTS.HTTPS://MASSAGO.ONBASEONLINE.COM/MASSAGO/1801CBS/ANNUALREPORT.ASPXTHE WENTWORTH DOUGLASS COMMUNITY BENEFIT REPORT WHICH IS FILED WITH THE NEW HAMPSHIRE DEPARTMENT OF JUSTICE IS FOUND ON ITS WEBSITE AT:HTTPS://WWW.WDHOSPITAL.ORG/DOWNLOAD_FILE/VIEW/3946/7870

PART I, LINE 3C:
PART I, LINE 3C: AFFILIATED ENTITIES ARE TAX-EXEMPT ENTITIES, WHOSE UNDERLYING MISSION IS TO PROVIDE SERVICES TO ALL IN NEED OF MEDICAL CARE. PATIENTS REQUIRING URGENT OR EMERGENT SERVICES SHALL NOT BE DENIED THOSE SERVICES BASED ON THEIR INABILITY TO PAY. MASS GENERAL BRIGHAM POST-ACUTE CARE AND BEHAVIORAL HEALTH HOSPITALS WILL WORK WITH PATIENTS WHO HAVE A DEMONSTRATED FINANCIAL NEED TO PROVIDE FINANCIAL ASSISTANCE TO THOSE PATIENTS SEEKING CARE IN THOSE SETTINGS.

PART I, LINE 7:
PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES DO INCLUDE COSTS ASSOCIATED WITH PHYSICIAN CLINICS. THESE AMOUNTS TOTALED $10,291,976 FOR THE FISCAL PERIOD.PART I, LINE 7, COLUMN (F): THERE WAS $ 461,457 OF BAD DEBT EXPENSE SUBTRACTED FROM TOTAL EXPENSES FOR PURPOSES OF CALCULATING THE PERCENTAGE COLUMN.PART I, LINE 7: THE AMOUNTS REPORTED ON THE CHARITY CARE AND OTHER COMMUNITY BENEFITS TABLE ARE CALCULATED USING THE BEST AVAILABLE DATA USING A COST ACCOUNTING SYSTEM OR A COST TO CHARGE RATIO. IN MOST CASES, A COST ACCOUNTING SYSTEM WAS USED AND THE SYSTEM ADDRESSES ALL PATIENT SEGMENTS AND DIRECTLY ASSIGNS COSTS TO INDIVIDUAL SERVICES.

PART II, COMMUNITY BUILDING ACTIVITIES:
"MASS GENERAL BRIGHAM' HOSPITALS ARE WORKING TO DEVELOP A PROCESS TO QUANTIFY THE EXPENDITURES ASSOCIATED WITH THE VARIOUS COMMUNITY BUILDING ACTIVITIES TO BE REPORTED IN PART II. BELOW IS A DESCRIPTION OF SOME OF THESE ACTIVITIES THAT TOOK PLACE DURING THE REPORTING PERIOD. COMMUNITY CARE VANS:OUR COMMUNITY CARE VANS ARE DESIGNED TO EXPAND ACCESS TO HEALTH CARE SERVICES ACROSS THE DIVERSE COMMUNITIES IN THE GREATER BOSTON AREA SERVED BY MASS GENERAL BRIGHAM:MASS GENERAL BRIGHAM'S MOBILE MEDICAL COMMUNITY CARE VANS BRING A BROAD MENU OF MOBILE MEDICAL SERVICES, INCLUDING SCREENINGS AND INTERVENTIONS FOR CHRONIC HEALTH ISSUES LIKE HYPERTENSION, DIABETES, AND SUBSTANCE USE DISORDERS. THE COMMUNITY CARE VANS, ORIGINALLY DEPLOYED DURING THE HEIGHT OF THE COVID-19 PANDEMIC, ARE STAFFED WITH MULTILINGUAL AND MULTICULTURAL CLINICIANS AND SUPPORT STAFF TO BETTER CONNECT WITH THE COMMUNITIES SERVED BY MASS GENERAL BRIGHAM.IN JANUARY OF 2021, MASS GENERAL BRIGHAMLAUNCHED A FLEET OF COMMUNITY CARE VANSIN OUR LOCAL COMMUNITIES HIT HARDEST BY THE COVID-19 PANDEMIC, PROVIDING COVID TESTING, VACCINES, AND RELIABLE HEALTH INFORMATION TO PATIENTS AND RESIDENTS. INFORMATION AND RESOURCES WERE PROVIDED IN A VARIETY OF LANGUAGES ALONG WITH CARE KITS CONTAINING ITEMS LIKE MASKS AND HAND SANITIZER. AS OF MAY 2022, THE COMMUNITY CARE VANS HAD ADMINISTERED MORE THAN 17,900 VACCINES TO COMMUNITY RESIDENTS. TO ADDRESS SOCIAL DETERMINANTS OF HEALTH, PATIENTS ARE SCREENED FOR ISSUES RELATED TO HOUSING, ACCESS TO HEALTHY FOOD, AND PERSONAL SAFETY, AND CONNECTED WITH RELEVANT RESOURCES.NOW, AS COVID-19 TRANSITIONS FROM AN ACUTE PANDEMIC TO A MORE ENDEMIC STATE, THE MASS GENERAL BRIGHAM MOBILE MEDICAL COMMUNITY CARE VANS WILL ALSO EVOLVE TO MEET PEOPLE WHERE THEY ARE.WORKFORCE DEVELOPMENT:MASS GENERAL BRIGHAM WORKFORCE DEVELOPMENT (WFD), A DIVISION OF HUMAN RESOURCES AND COMMUNITY HEALTH, IS COMMITTED TO ENSURING A HIGHLY QUALIFIED AND DIVERSE PIPELINE OF HEALTH CARE PROFESSIONALS, WHILE PROVIDING ECONOMIC OPPORTUNITY WITHIN THE COMMUNITIES WE SERVE. WFD ASSISTS STAFF, MANAGEMENT AND LEADERSHIP WITH PROGRAM DEVELOPMENT, PLANNING AND FUNDING PROCUREMENT. WFD STRIVES TO CREATE CAREER PIPELINES AND PATHWAYS FOR YOUTH, COMMUNITY RESIDENTS AND CURRENT EMPLOYEES WITH THE DUAL GOAL OF PROVIDING CAREER AND ECONOMIC OPPORTUNITY WHILE RESPONDING TO MASS GENERAL BRIGHAM'S NEED FOR A HIGHLY QUALIFIED, DIVERSE WORKFORCE.THE WORKFORCE DEVELOPMENT PROGRAM ALSO PROVIDES CAREER/SKILLS GROWTH OPPORTUNITIES FOR EMPLOYEES THROUGH ACADEMIC AND CAREER COACHING/NAVIGATION AND SUPPORTIVE, ACCESSIBLE AND AFFORDABLE COLLEGE PROGRAMS OFFERED IN PARTNERSHIP WITH MULTIPLE INSTITUTIONS OF HIGHER LEARNING. IN ORDER TO ENSURE EQUITABLE ACCESS FOR ALL OF OUR COLLEAGUES, THE WFD TEAM HAS PILOTED AND SUSTAINED MULTIPLE, INNOVATIVE, FLEXIBLE STRATEGIES AND PARTNERSHIPS THAT OFFER EMPLOYEES THE OPTION TO ACCESS EDUCATIONAL OPPORTUNITIES ONLINE, ON THEIR OWN TIME, AND AT THEIR OWN PACE.ENVIRONMENTAL SUSTAINABILITY:MASS GENERAL BRIGHAM WAS NAMED A RECIPIENT OF THE COMMONWEALTH ENVIRONMENTAL LEADERSHIP AWARD BY THE ENVIRONMENTAL LEAGUE OF MASSACHUSETTS (ELM). THE AWARD WAS PRESENTED AT ELM'S EARTH NIGHT, AN EVENT TO HONOR THE RECIPIENTS AND BUILD THE RELATIONSHIPS THAT WILL HELP MASSACHUSETTS LEAD THE NATION IN ADDRESSING THE SCALE AND URGENCY OF OUR ENVIRONMENTAL CHALLENGES. MASS GENERAL BRIGHAM WAS RECOGNIZED AS AN INDUSTRY LEADER IN SUSTAINABLE HEALTH CARE DELIVERY. ""WE ARE HONORED TO HAVE BEEN RECOGNIZED FOR OUR WORK TO MINIMIZE OUR IMPACT ON THE ENVIRONMENT. MASS GENERAL BRIGHAM IS COMMITTED TO REDUCING THE HARMFUL IMPACTS OF CLIMATE CHANGE AND CREATING HEALTHIER ENVIRONMENTS FOR OUR PATIENTS, EMPLOYEES, AND COMMUNITIES,"" SAID NIYUM GANDHI, CHIEF FINANCIAL OFFICER AND TREASURER OF MASS GENERAL BRIGHAM.THE HEALTH SECTOR IS RESPONSIBLE FOR APPROXIMATELY 8.5% OF CARBON EMISSIONS IN THE UNITED STATES, WHICH ARE THE LEADING CAUSE OF GLOBAL CLIMATE CHANGE. AS AN INDUSTRY LEADER IN SUSTAINABLE HEALTHCARE DELIVERY, MASS GENERAL BRIGHAM HAS REDUCED GREENHOUSE GAS EMISSIONS BY ABOUT 60% SINCE 2008. CURRENTLY 80% OF MASS GENERAL BRIGHAM'S ELECTRICITY COMES FROM RENEWABLE SOURCES, AND THE SYSTEM STRIVES TO ACHIEVE CARBON NEUTRALITY BY 2025. EARLIER THIS YEAR, MASS GENERAL BRIGHAM LAUNCHED THE CLIMATE AND SUSTAINABILITY LEADERSHIP COUNCIL (CSLC). ITS PURPOSE IS TO DEVELOP SYSTEMWIDE GOALS FOR EMISSION-REDUCTION TARGETS, INFORM SYSTEMWIDE SUSTAINABILITY PRACTICES AND INITIATIVES AND IDENTIFY OPPORTUNITIES FOR SYNERGY WITH OTHER MASS GENERAL BRIGHAM PRIORITIES. IN RECOGNITION OF CLIMATE CHANGE AS A PUBLIC HEALTH ISSUE, MASS GENERAL BRIGHAM IS THE ONLY HEALTHCARE SYSTEM IN THE COUNTRY WITH FOUR MEDICAL DIRECTORS FOR SUSTAINABILITY. MASS GENERAL BRIGHAM'S EFFORTS INCLUDE INITIATIVES THAT RANGE FROM INTEGRATING CLIMATE-HEALTH AND HEALTH CARE SUSTAINABILITY INTO RESIDENT TRAINING, MINIMIZING FOOD WASTE AS PART OF THE COOL FOOD PLEDGE, AND DESIGNING CARBON NEUTRAL BUILDINGS. THE SYSTEM HAS ALSO MADE IT A PRIORITY TO ADVOCATE FOR POLICIES AND PROGRAMS AT THE LOCAL, STATE, AND FEDERAL LEVELS THAT ARE AIMED AT BUILDING A HEALTHIER, MORE SUSTAINABLE, AND MORE EQUITABLE FUTURE."

PART III, LINE 2:
THE PATIENT LIABILITY IS REDUCED BY ALL PAYMENTS AND INSURANCE CONTRACTUAL ADJUSTMENTS. PREVIOUSLY APPLIED PATIENT DISCOUNTS ARE REVERSED PRIOR TO PLACEMENT IN BAD DEBT IF THE PATIENT DOES NOT PAY AFTER THE PRESCRIBED COLLECTION PROCESS OR IF THE PATIENT RENEGES ON A PREVIOUSLY AGREED PAYMENT SCHEDULE.

PART III, LINE 4:
TEXT OF BAD DEBT FOOTNOTE FROM AFS: (IN THOUSANDS OF DOLLARS)IN ADDITION TO CHARITY CARE AND INADEQUATE FUNDING FROM THE MEDICAID AND MEDICARE PROGRAMS, THERE ARE SIGNIFICANT LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENT FOR SERVICES RENDERED OR INSURED PATIENTS WHO FAIL TO REMIT CO-PAYMENTS AND DEDUCTIBLES AS REQUIRED UNDER THE APPLICABLE HEALTH INSURANCE ARRANGEMENT. THE ESTIMATED COST OF PROVIDING THESE SERVICES WAS APPROXIMATELY $73,165 AND $66,215 FOR 2022 AND 2021, RESPECTIVELY.

PART III, LINE 8:
ALL COSTS REPORTED ON THE MEDICARE COST REPORT HAVE BEEN DETERMINED IN ACCORDANCE WITH MEDICARE COST-FINDING PRINCIPLES. COSTS ALLOCABLE TO MEDICARE PATIENTS ARE LIMITED TO CERTAIN SERVICES AND DERIVED IN A NUMBER OF WAYS, INCLUDING AVERAGE COST PER DAY TIMES MEDICARE DAYS AND RATIO OF COST TO CHARGES APPLIED TO CHARGES FOR ANCILLARY SERVICES PROVIDED TO MEDICARE BENEFICIARIES. THE DETERMINATION OF ALLOWABLE COSTS VIA THE MEDICARE COST REPORT EXCLUDES THE COST AND REVENUE ASSOCIATED WITH CERTAIN SERVICES, LIMITS THE COSTS RECOGNIZED FOR OTHER SERVICES AND EXCLUDES CERTAIN COSTS OF DOING BUSINESS. IN ADDITION, THE MEDICARE COST REPORT METHODOLOGY DOES NOT ALLOCATE COSTS TO MEDICARE BENEFICIARIES AS PRECISELY AS COST ACCOUNTING SYSTEMS, WHICH, FOR EXAMPLE, ACCOUNT FOR THE MORE INTENSIVE NURSING CARE MEDICARE BENEFICIARIES OFTEN REQUIRE.LOSSES ON THE PROVISION OF CARE TO MEDICARE PATIENTS SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE THEY REPRESENT A DIRECT SUBSIDY BY HOSPITALS TO THE FEDERAL GOVERNMENT TO COVER THE COST OF CARE IN EXCESS OF MEDICARE REIMBURSEMENT. PROVIDING CARE FOR THE ELDERLY AND DISABLED AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD BECAUSE ACCESS TO CARE IS ONE OF THE MOST IMPORTANT WAYS WE CAN SERVE OUR COMMUNITIES. THIS SUBSIDY HELPS TO MAKE THAT ACCESS POSSIBLE.

PART III, LINE 9B:
PATIENTS PROTECTED FROM COLLECTION ACTION. THE HOSPITAL WILL TAKE REASONABLE STEPS TO ENSURE THAT NO COLLECTION ACTIONS, INCLUDING TELEPHONE CALLS, STATEMENTS OR LETTERS, ARE INITIATED FOR THOSE PATIENT BALANCES THAT MAY BE EXEMPT FROM COLLECTION ACTION BY REGULATION, INCLUDING PATIENTS DETERMINED TO BE A LOW INCOME PATIENT BY THE OFFICE OF MEDICAID (EXCEPT FOR DENTAL-ONLY LOW INCOME PATIENTS), OR ENROLLED IN MASSHEALTH, CHILDREN'S MEDICAL SECURITY PLAN (CMSP) WITH A MAGI FAMILY INCOME EQUAL TO OR LESS THAN 300% OF THE FPG, EMERGENCY AID TO THE ELDERLY, DISABLED, AND CHILDREN (EAEDC), AND HEALTH SAFETY NET (FULL OR PARTIAL) EXCEPTING DEDUCTIBLES AND COPAYMENTS DETERMINED BY THOSE PROGRAMS TO BE A PATIENT RESPONSIBILITY, AND COPAYMENTS FROM ANY THIRD-PARTY PAYER EXCEPT MEDICARE.. IF IT IS DETERMINED THAT A PATIENT WAS ENROLLED IN ONE OF THOSE CATEGORIES, THEN ALL COLLECTION ACTIONS (EXCEPT APPLICABLE CO-PAYMENTS AND HSN DEDUCTIBLES) WITH THE PATIENT WILL BE CLOSED FOR SERVICES THAT OCCURRED DURING THE PATIENT'S PERIOD OF ELIGIBILITY. COLLECTION ACTIONS WILL ALSO CEASE FOR AS LONG AS THE PATIENT IS DETERMINED TO BE LOW INCOME IF THE BALANCE IS FROM A PERIOD WHEN THE PATIENT WAS NOT ENROLLED IN A QUALIFYING PROGRAM. THE HOSPITAL MAY CONTINUE TO SEND LETTERS REQUESTING INFORMATION OR ACTION BY THE PATIENT TO RESOLVE COVERAGE AND/OR ELIGIBILITY ISSUES WITH A PRIMARY PAYER, WORKERS COMPENSATION PROGRAM OR TO OBTAIN ANY THIRD PARTY LIABILITY OR MVA CARRIER INFORMATION.

PART VI, LINE 2:
MASS GENERAL BRIGHAM HAS A SYSTEM-WIDE STRATEGY TO IMPROVE PATIENT OUTCOMES AND EXPERIENCE, WHICH IS SUPPORTED BY OUR HISTORICAL AND ONGOING COMMITMENT TO DIGITAL HEALTH AND DATA ANALYTICS, POPULATION HEALTH, AND OUTPATIENT CARE. WE SEEK WAYS TO DELIVER CARE IN SUBURBAN SETTINGS THROUGH DEVELOPING COMMUNITY-BASED CARE CENTERS THAT OFFER PRIMARY AND BEHAVIORAL HEALTH CARE, AS WELL AS SPECIALTY AND SURGICAL SERVICES.TO FULLY UNDERSTAND THE RANGE OF NEEDS OF PATIENTS, MASS GENERAL BRIGHAM CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS. THESE STUDIES ARE AIMED AT IDENTIFYING THE MOST PRESSING SOCIAL, ECONOMIC AND HEALTH ISSUES IN THE SERVICE AREA BY AIMING TO:SYSTEMATICALLY IDENTIFY THE HEALTH-RELATED NEEDS, STRENGTHS, AND RESOURCES OF THE SERVICE AREA TO INFORM FUTURE PLANNINGUNDERSTAND THE CURRENT HEALTH STATUS OF RESIDENTS WITHIN THE SERVICE AREA, AS WELL AS SUB-POPULATIONS WITHIN THEIR SOCIAL CONTEXTENGAGE THE COMMUNITY TO HELP DETERMINE COMMUNITY NEEDS AND SOCIAL DETERMINANT OF HEALTH NEEDSIN ADDITION, ALL OF MASS GENERAL BRIGHAM'S MEMBER INSTITUTIONS CONDUCT CHNAS OF THEIR OWN, AT MINIMUM, EVERY 3 YEARS.SEE CHNAS FOR EACH HOSPITAL FACILITY AS REPORTED ON SCHEDULE H, PART V AS WELL AS THE COMMUNITY BENEFIT REPORTS FOUND AT THE MASSACHUSETTS ATTORNEY GENERAL: HTTPS://MASSAGO.HYLANDCLOUD.COM/203CBS/ANNUALREPORT.ASPX

PART VI, LINE 3:
FINANCIAL COUNSELING SERVICESTHE HOSPITAL WILL SEEK TO IDENTIFY PATIENTS WHO MAY BE UNINSURED OR INADEQUATELY INSURED IN ORDER TO PROVIDE COUNSELING AND ASSISTANCE. THE HOSPITAL WILL PROVIDE FINANCIAL COUNSELING TO THESE PATIENTS AND THEIR FAMILIES, INCLUDING SCREENING FOR ELIGIBILITY FOR OTHER SOURCES OF COVERAGE, SUCH AS STATE PROGRAMS AND OTHER GOVERNMENT PROGRAMS (INCLUDING TO THE EXTENT POSSIBLE, MEDICAID PROGRAMS IN STATES OTHER THAN MASSACHUSETTS OR NEW HAMPSHIRE), AND PROVIDING INFORMATION REGARDING ALL ACCEPTABLE METHODS OF PAYMENT OF THE HOSPITAL BILL. THE HOSPITAL WILL ENCOURAGE PATIENTS WHO ARE POTENTIALLY ELIGIBLE FOR COVERAGE FROM STATE PROGRAMS OR OTHER GOVERNMENT PROGRAMS TO APPLY FOR COVERAGE AND SHALL ASSIST THE PATIENT IN APPLYING FOR BENEFITS. MA RESIDENTS MAY ALSO APPLY FOR AND BE APPROVED FOR COVERAGE BY THE HSN FOR CO-INSURANCE OR DEDUCTIBLES NOT COVERED BY THEIR PRIMARY INSURANCE PLAN. THE HOSPITAL WILL POST A NOTICE (SIGNS) OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS AND DESCRIBE WHERE TO GO TO FOR ASSISTANCE IN THE FOLLOWING LOCATIONS: 1. INPATIENT, CLINIC, EMERGENCY DEPARTMENT, AND COMMUNITY HEALTH CENTER ADMISSION AND/OR REGISTRATION AREAS; 2. FINANCIAL COUNSELING WAITING AREAS 3. CENTRAL ADMISSION/REGISTRATION AREAS THAT ARE OPEN TO PATIENTS 4. BUSINESS OFFICE WAITING AREAS THAT ARE OPEN TO PATIENTS. SIGNS WILL BE TRANSLATED INTO OTHER LANGUAGES TO THE EXTENT THAT THE LANGUAGE IS THE PRIMARY LANGUAGE OF MORE THAN 10% OF RESIDENTS IN THE HOSPITAL'S SERVICE. SIGNS WILL GENERALLY BE POSTED IN ENGLISH AND SPANISH. POSTED SIGNS WILL BE CLEARLY VISIBLE AND LEGIBLE TO PATIENTS VISITING THESE AREAS. SIGNAGE WILL ALSO INCLUDE INSTRUCTIONS ON ACCESS TO TRANSLATION SERVICES FOR PATIENTS WHO HAVE OTHER LANGUAGE NEEDS. STANDARD NOTICES WILL BE PROVIDED TO ALL PATIENTS AT THE TIME OF THEIR INITIAL REGISTRATION WITH MASS GENERAL BRIGHAM. THESE NOTICES WILL ALSO BE MADE WIDELY AVAILABLE THROUGHOUT ALL MASS GENERAL BRIGHAM HOSPITAL CREDIT & COLLECTION POLICY JANUARY 1, 2020 13 HOSPITALS AND HEALTH CENTERS AND ROUTINELY OFFERED TO EXISTING PATIENTS WHENEVER THEY ARE EXPECTED TO HAVE AN OUT-OF-POCKET LIABILITY. COMPLETE COPIES OF THIS POLICY AND THE MGB UNINSURED PATIENT DISCOUNT AND FINANCIAL ASSISTANCE POLICY WILL ALSO BE MADE AVAILABLE TO PATIENTS AS REQUIRED. BOTH POLICIES WILL ALSO BE POSTED ON THE INTERNET AT WWW.PARTNERS.ORG/PATIENTBILLING WITH LINKS TO THE HOMEPAGES OF ALL HOSPITAL ENTITIES IN READILY IDENTIFIABLE LOCATIONS.

PART VI, LINE 4:
MASS GENERAL BRIGHAM IS COMMITTED TO WORKING WITH COMMUNITY RESIDENTS AND ORGANIZATIONS TO MAKE MEASURABLE, SUSTAINABLE IMPROVEMENTS IN THE HEALTH STATUS OF UNDERSERVED POPULATIONS. AS A SYSTEM, MASS GENERAL BRIGHAM MAKES A SIGNIFICANT COMMITMENT TO COMMUNITY HEALTH. THROUGH INITIATIVES THAT INCLUDE ACCESS TO HEALTH CARE, PREVENTION, AND WORKFORCE DEVELOPMENT, MASS GENERAL BRIGHAM AND ITS HOSPITALS ARE MAKING A DIFFERENCE IN THE COMMUNITIES IN WHICH WE LIVE AND WORK. MASS GENERAL BRIGHAM HAS A DEEP COMMITMENT TO COMMUNITY HEALTH CENTERS. SINCE ITS FOUNDING IN 1994, MASS GENERAL BRIGHAM AND ITS HOSPITALS HAVE PROVIDED MORE THAN $83M TO ENSURE THAT HEALTH CENTERS HAVE THE SPACE AND TECHNOLOGY THEY NEED TO PROVIDE PATIENTS WITH EXCELLENT CARE.

PART VI, LINE 5:
THE HOSPITALS INCLUDED IN THE MASS GENERAL BRIGHAM SYSTEM HAVE GOVERNING BODIES THAT ARE COMPRISED OF COMMUNITY LEADERS WHO ARE GUIDED BY THE MISSION TO DELIVER EXCELLENCE IN PATIENT CARE, ADVANCE THAT CARE THROUGH INNOVATIVE RESEARCH AND EDUCATION AND IMPROVE THE HEALTH AND WELL-BEING OF THE DIVERSE COMMUNITIES SERVED.SURPLUS FUNDS ARE USED TO FURTHER THE ORGANIZATION'S TAX-EXEMPT MISSIONS OF PATIENT CARE, EDUCATION AND RESEARCH.

PART VI, LINE 6:
MASS GENERAL BRIGHAM IS ONE OF THE LARGEST CHARITABLE DIVERSIFIED HEALTH CARE SERVICES ORGANIZATIONS IN THE UNITED STATES, ESTABLISHED IN 1994 BY AN AFFILIATION BETWEEN THE BRIGHAM MEDICAL CENTER, INC., NOW KNOWN AS BRIGHAM, INC., AND THE MASSACHUSETTS GENERAL HOSPITAL IN ORDER TO CREATE AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. MASS GENERAL BRIGHAM CURRENTLY OPERATES TWO TERTIARY AND SEVEN COMMUNITY ACUTE CARE HOSPITALS, HOSPITALS SPECIALIZING IN INPATIENT AND OUTPATIENT SERVICES IN BEHAVIORAL HEALTH, REHABILITATION MEDICINE AND OPHTHALMOLOGY AND OTOLARYNGOLOGY, A HOME HEALTH AGENCY, A NURSING HOME AND A PHYSICIAN NETWORK WITH APPROXIMATELY 7,200 EMPLOYED AND AFFILIATED PRIMARY CARE AND SPECIALTY CARE PHYSICIANS. MASS GENERAL BRIGHAM ALSO OPERATES A NON-PROFIT MANAGED CARE ORGANIZATION AND A FOR-PROFIT INSURANCE COMPANY THAT PROVIDE HEALTH INSURANCE PRODUCTS AND ADMINISTRATIVE SERVICES TO THE MASSACHUSETTS MEDICAID PROGRAM (MASSHEALTH), CONNECTORCARE (A STATE SUBSIDIZED PROGRAM FOR ADULTS WHO MEET INCOME AND IMMIGRATION GUIDELINES) AND COMMERCIAL POPULATIONS. MASS GENERAL BRIGHAM MAINTAINS THE LARGEST NON-UNIVERSITY-BASED, NON-PROFIT, PRIVATE MEDICAL RESEARCH ENTERPRISE IN THE UNITED STATES; ITS HOSPITALS ARE PRINCIPAL TEACHING AFFILIATES OF THE MEDICAL AND DENTAL SCHOOLS OF HARVARD UNIVERSITY; AND IT OPERATES A GRADUATE LEVEL PROGRAM FOR HEALTH SCIENCES.WITH APPROXIMATELY 53,300 FULL-TIME EQUIVALENT EMPLOYEES (FTES), MASS GENERAL BRIGHAM IS ONE OF THE LARGEST PRIVATE EMPLOYERS IN THE COMMONWEALTH OF MASSACHUSETTS. MASS GENERAL BRIGHAM INCORPORATED AS THE PARENT CORPORATION OF THE MASS GENERAL BRIGHAM SYSTEM, PROVIDES A NUMBER OF SERVICES FOR ITS AFFILIATES, INCLUDING CLINICAL AFFAIRS, COMMUNITY BENEFITS, FINANCE, HUMAN RESOURCES, INFORMATION SYSTEMS, INTERNAL AUDIT, INVESTMENTS, LEGAL, MARKETING, MATERIALS MANAGEMENT, REAL ESTATE, RESEARCH ADMINISTRATION, STRATEGIC PLANNING AND TREASURY. THE FINANCE COMMITTEE OF THE INSTITUTION'S BOARD OF DIRECTORS OVERSEES CENTRALIZED OPERATING AND CAPITAL BUDGET, DEBT MANAGEMENT AND BUSINESS PLANNING PROCESSES FOR THE INSTITUTION AND ALL OF ITS AFFILIATES. CASH AND INVESTMENTS ARE MANAGED CENTRALLY UNDER POLICIES DEVELOPED BY THE INVESTMENT COMMITTEE OF THE INSTITUTION'S BOARD OF DIRECTORS AND REVIEWED BY THE FINANCE COMMITTEE. THE INSTITUTION ALSO COORDINATES THE RESEARCH AND MEDICAL EDUCATION PROGRAMS OF ITS AFFILIATES.

PART VI, LINE 7, REPORTS FILED WITH STATES
MA,NH

PART VI, LINE 7: STATE OF FILING COMMUNITY BENEFIT REPORT:
EACH OF THE HOSPITALS THAT COMPRISE THE MASS GENERAL BRIGHAM SYSTEM HAS A COMMUNITY BENEFIT PLANNING AND SERVICE DELIVERY STRUCTURE. EACH OF THESE ENTITIES (EXCEPT THE THREE REHABILITATION FACILITIES LISTED IN PART V, SECTION A) HAS FILED SEPARATE COMMUNITY BENEFIT REPORTS WITH ATTORNEY GENERAL OF THE COMMONWEALTH OF MASSACHUSETTS AND THE NEW HAMPSHIRE DEPARTMENT OF JUSTICE IN THE CASE OF WENTWORTH-DOUGLASS HOSPITAL.