4A (Expenses $ 17260087 including grants of $ 2994) (Revenue $ 20666922)
THE ORGANIZATION FORMERLY KNOWN AS ANGEL MEDICAL CENTER, INC. PROVIDES QUALITY MEDICAL HEALTHCARE SERVICES TO PEOPLE IN ITS SERVICE AREA REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE ORGANIZATION, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES. THE ORGANIZATION FURTHER RECOGNIZES THAT ITS MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND EDUCATION. TO THIS END, THE ORGANIZATION PROVIDES FREE CARE, SUBSIDIZED CARE, AND CARE AT BELOW COST TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. HEALTHCARE ACTIVITIES AND SCREENINGS, PROGRAMS AND EDUCATION TO SUPPORT THE COMMUNITY'S HEALTH ARE ALSO PROVIDED EACH YEAR.

ANGEL MEDICAL CENTER, INC.:
"PART V, SECTION B, LINE 4: CHNA TAX YEAR THE ORGANIZATIONS LAST CHNA WAS CONDUCTED IN TAX YEAR 2015. IN ACCORDANCE WITH IRC SECTION 501(R)(3)(D)(4), ""A HOSPITAL ORGANIZATION IS NOT REQUIRED TO MEET THE REQUIREMENTS OF SECTION 501(R)(3) WITH RESPECT TO A HOSPITAL FACILITY IN A TAXABLE YEAR IF, BEFORE THE END OF THAT TAXABLE YEAR, THE HOSPITAL ORGANIZATION TRANSFERS ALL OWNERSHIP OF THE HOSPITAL FACILITY TO ANOTHER ORGANIZATION OR OTHERWISE CEASES ITS OPERATION OF THE HOSPITAL FACILITY OR THE FACILITY CEASES TO BE LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED AS A HOSPITAL BY A STATE."" DUE TO THE SALE OF THE HOSPITAL FACILITY DURING THE CURRENT 2018 TAX YEAR, THE ORGANIZATION DID NOT CONDUCT A NEW CHNA. ANGEL MEDICAL CENTER, INC.: PART V, SECTION B, LINE 5: THE ORGANIZATION PARTNERED PREDOMINANTLY WITH THE MACON COUNTY PUBLIC HEALTH, HIGHLANDS-CASHIERS HOSPITAL, MOUNTAINWISE OF MACON COUNTY AND WNC HEALTHY IMPACT. IN 2015, MACON COUNTY PUBLIC HEALTH CONVENED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) STEERING COMMITTEE COMPRISED OF VARIOUS COMMUNITY STAKEHOLDERS TO HELP GUIDE LOCAL DATA COLLECTION EFFORTS. BASED ON FEEDBACK FROM THE CHNA GROUP, IT WAS DETERMINED THAT CONCERNS AND ISSUES RAISED FROM COMMUNITY LEADERS AND VULNERABLE POPULATIONS WOULD BE ESSENTIAL TO PROVIDE CONTEXT FOR THE RESEARCH AND STATISTICAL ANALYSIS. IN ORDER TO HEAR THESE DIVERSE COMMUNITY PERSPECTIVES, THE CHNA STEERING COMMITTEE DETERMINED THAT LISTENING SESSIONS AND KEY INFORMANT INTERVIEWS WERE THE BEST METHOD TO COLLECT LOCAL PRIMARY DATA. KEY INFORMANT SURVEY PARTICIPANTS: EXECUTIVE DIRECTOR OF CARENET, EXECUTIVE DIRECTOR OF REACH, SUPERINTENDENT OF MACON COUNTY SCHOOLS, HEALTH DIRECTOR OF MACON COUNTY PUBLIC HEALTH, COUNTY COMMISSIONER OF MACON COUNTY, EXECUTIVE DIRECTOR COMMUNITY CARE CLINIC HIGHLANDS, DIRECTOR OF MACON COUNTY SENIOR SERVICES, DIRECTOR OF MACON COUNTY SOCIAL SERVICES, DIRECTOR OF MACON PROGRAM FOR PROGRESS. THE 12 LISTENING SESSIONS CONDUCTED: LOW INCOME (FRANKLIN), LOW INCOME (HIGHLANDS), THE LATINO COMMUNITY, SENIOR CITIZENS, THOSE AFFECTED WITH MENTAL ILLNESS, CAREGIVERS, YOUTH FROM FRANKLIN AND NANTAHALA. (HIGHLANDS), THE LATINO COMMUNITY, SENIOR CITIZENS, THOSE AFFECTED WITH MENTAL ILLNESS, CAREGIVERS, YOUTH FROM FRANKLIN AND NANTAHALA."

ANGEL MEDICAL CENTER, INC.:
PART V, SECTION B, LINE 6A: REGIONAL PARTNERSHIP: ANGEL MEDICAL CENTER'S COLLABORATIVE COMMUNITY HEALTH IMPROVEMENT EFFORT IS ALSO SUPPORTED BY A COMPREHENSIVE PARTNERSHIP WITH OTHER REGIONAL HOSPITALS AND LOCAL HEALTH DEPARTMENTS. THIS INITIATIVE, KNOWN AS WNC HEALTHY IMPACT, REPRESENTS 16 COUNTIES ACROSS THE WESTERN NORTH CAROLINA REGION WORKING COLLABORATIVELY TO IMPROVE COMMUNITY HEALTH. INFORMATION ABOUT THIS INNOVATIVE REGIONAL COLLABORATION, COUNTY-WIDE COMMUNITY HEALTH ASSESSMENTS, AND OVERALL REGIONAL FINDINGS, ARE MADE WIDELY AVAILABLE TO THE PUBLIC AT WWW.WNCHEALTHYIMPACT.COM.

ANGEL MEDICAL CENTER, INC.:
PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED WITH THE FOLLOWING NON-HOSPITAL FACILITIES: MACON COUNTY PUBLIC HEALTH, MOUNTAINWISE OF MACON COUNTY AND WNC HEALTHY IMPACT.

ANGEL MEDICAL CENTER, INC.:
PART V, SECTION B, LINE 7A: ORGANIZATION'S WEBSITE: HTTPS://MISSIONHEALTH.ORG/OUR-COMMITMENT-TO-YOU/COMMUNITY-INVESTMENT/OUR-C

ANGEL MEDICAL CENTER, INC.:
PART V, SECTION B, LINE 11: ENGAGED 384 LOCAL PARTICIPANTS IN PASSPORT TO WELLNESS PROGRAM, INCLUDING HEALTH FAIRS, SCREENINGS, FALL RISK ASSESSMENTS, ADVANCED DIRECTIVE ASSISTANCE, FREEDOM FROM SMOKING PROGRAM, SAFETY PROGRAMMING IN PARTNERSHIP WITH LOCAL POLICE, WEIGHT SEMINAR WITH FRANKLIN HEALTH & FITNESS, GROCERY GAMES SCAVENGER HUNT, AND MACON YOUR HEART BEAT 5K. PARTNERED TO CREATE MULTI-SECTOR COMMUNITY TASK FORCE TO EXPLORE MORE OPTIONS FOR EXERCISE OPPORTUNITIES. - INCREASED PHYSICAL ACTIVITY OPPORTUNITIES WITH WALK ON THE GREENWAY PROGRAM, WEEKLY COMMUNITY WALKING GROUP WITH 30-MINUTE GUIDED WALKS, AND ADDITIONAL FITNESS STATIONS AVAILABLE ONCE A MONTH. - PARTNERED WITH REACH OF MACON COUNTY TO ASSESS STAFF KNOWLEDGE RELATED TO SUPPORTING SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT, AND IDENTIFIED OPPORTUNITIES FOR ADDITIONAL TRAINING. - PROVIDED TAILORED CURRICULUM ON SUPPORTING SURVIVORS, BASED ON ASSESSMENT, AND OFFERED TO STAFF THROUGH SEVERAL MODES OF COMMUNICATION, INCLUDING TOWN HALL MEETINGS, ONLINE AND IN PERSON TRAININGS. - AMC STAFF INVITED TO 3 INTERAGENCY CROSS-TRAINING PROGRAMS RELATED TO DOMESTIC VIOLENCE AND SEXUAL ASSAULT TO HELP UNIFY COMMUNITY RESPONSE. - REPRESENTED HOSPITAL ON COMMUNITY TASK FORCE TO ADDRESS WORKSITE WELLNESS AND HELPING BUSINESSES WORK TOWARD A HEALTHY WORKPLACE. THERE ARE NO SIGNFICANT IDENTIFIED NEEDS WHICH ARE NOT BEING ADDRESSED.

ANGEL MEDICAL CENTER, INC.:
PART V, SECTION B, LINE 15E: THE ORGANIZATION'S STAFF WORK IN COLLABORATION WITH THE PATIENT AND APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED OF HEALTH CARE SERVICES TO DETERMINE AVAILABLE FUNDING SOURCES. PART V, PART B, LINE 10A HTTPS://MISSIONHEALTH.ORG/WP-CONTENT/ UPLOADS/2018/04/2013-ANGEL-MEDICAL-CENTER -IMPLEMENTATION-STRATEGY.PDF PART V, PART B, LINE 16A HTTPS://MISSIONHEALTH.ORG/WP-CONTENT/UPLOADS /2018/05/FINASSDISCOUNT_POLICY_04.PDF PART V, PART B, LINE 16B HTTPS://MISSIONHEALTH.ORG/WP-CONTENT/UPLOADS /2018/05/PATIENT_FINANCIAL_ASSISTANCE_PAGE.PDF

PART I, LINE 7:
THE NCHA ANDI REPORTS WERE USED WHICH ARE BASED ON THE IRS GUIDELINES TO DERIVE A COST-TO-CHARGE RATIO USED IN THE CALCULATION OF COMMUNITY BENEFIT EXPENSE AT COST.

PART II, COMMUNITY BUILDING ACTIVITIES:
WORKFORCE DEVELOPMENT: VOLUNTEERS FROM NURSING AND ALLIED HEALTH DEPARTMENTS PARTICIPATE ANNUALLY IN A PROGRAM WITH THE LOCAL HIGH SCHOOL AND COMMUNITY COLLEGE THAT ALLOWS STUDENTS FROM HEALTH OCCUPATIONS CLASSES TO OBSERVE AND LEARN FROM ACTUAL EXPERIENCE RATHER THAN JUST CLASS ROOM ACTIVITIES.

PART III, LINE 2:
THE ORGANIZATION USES A COST TO CHARGE RATIO TO ESTIMATE BAD DEBT.

PART III, LINE 3:
THE ORGANIZATION USES THE COST TO CHARGE RATIO APPLIED TO BAD DEBTS RECLASSIFIED TO CHARITY CARE AS OF THE MOST RECENT DATE AVAILABLE AFTER YEAR END.

PART III, LINE 8:
PER THE INSTRUCTIONS, THE MEDICARE COST REPORT IS THE BASIS FOR CALCULATING THE COSTS USING ALLOWABLE COSTS RELATED TO THE REVENUE REPORTED.

PART III, LINE 9B:
"PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AND OTHER CHARITY CARE ARE NOTIFIED USING THE PROCESS DESCRIBED IN THE EDUCATION OF PATIENTS' ELIGIBILITY IN PART VI, ON LINE 3. MISSION'S STATED POLICY WITH RESPECT TO FINANCIAL ASSISTANCE: ""MISSION HOSPITAL WILL MAKE EVERY EFFORT TO THOROUGHLY SCREEN ALL PATIENTS THAT ARE UNINSURED OR UNDERINSURED IN AN EFFORT TO IDENTIFY A SOURCE OF FINANCIAL SPONSORSHIP. ONLY AFTER A FINAL DETERMINATION IS MADE THAT THE PATIENT IS NOT ELIGIBLE FOR ANY SOURCE OF FUNDING TO COVER THE MEDICAL EXPENSES WILL THE ACCOUNT BE ELIGIBLE FOR CONSIDERATION OF FINANCIAL ASSISTANCE."" AFTER THE NOTIFICATIONS AND PROCESSES REFERENCED ABOVE HAVE BEEN COMPLETED, STANDARD DEBT COLLECTION POLICIES ARE IN EFFECT FOR THE PORTION OF THE BILL FOR WHICH THE PATIENT IS RESPONSIBLE."

PART V, PART B, LINE 16C
HTTPS://MISSIONHEALTH.ORG/WP-CONTENT/UPLOADS /2018/03/FINASSISTPLAIN_LANGUAGE_SUMMARY_4.PDF

PART VI, LINE 3:
THE CURRENT INDIGENT CARE POLICY IS POSTED AT THE REGISTRATION AREAS. PATIENTS ARE ENCOURAGED TO SPEAK WITH A PATIENT COUNSELOR TO SEEK FINANCIAL ASSISTANCE.

PART VI, LINE 4:
ANGEL MEDICAL CENTER SERVES MACON COUNTY, NC WITH A POPULATION OF APPROXIMATELY 34,732, 28.2% OF WHICH ARE OVER THE AGE 65, 16.4% OF WHICH ARE BELOW POVERTY LEVEL AND 4.8% OF WHICH ARE UNEMPLOYED. THE AVERAGE ANNUAL HOUSEHOLD INCOME IS ALMOST $39,593. THE ETHNIC DEMOGRAPHICS OF THE AREA INCLUDE 7.3% HISPANIC POPULATION, 1.6% AFRICAN AMERICAN POPULATION AND OTHER MINORITY POPULATIONS TOTALING 2.1%. THESE STATISTICS ARE ACCORDING TO THE US CENSUS BUREAU AND THE EMPLOYMENT SECURITIES COMMISSION OF NC.

PART VI, LINE 5:
SEE PROGRAM SERVICES ACCOMPLISHMENTS ON PAGE 2 OF THE 990.

PART VI, LINE 6:
ANC HEALTHCARE, INC. (FKA MISSION HEALTH SYSTEM) IS THE PARENT ORGANIZATION FOR THE CHARITABLE ORGANIZATIONS OF MISSION HOSPITAL, INC.; MISSION HEALTH SYSTEM FOUNDATION, INC.; ANC MISSION MEDICAL ASSOCIATES, INC; ANC BLUE RIDGE HOSPITAL, INC.; ANC MCDOWELL HOSPITAL, INC.; ANC ANGEL MEDICAL CENTER,INC.; ANC TRANSYLVANIA COMMUNITY HOSPITAL, INC.; ANC HIGHLANDS-CASHIERS HOSPITAL, INC. AND MOUNTAIN CARE, INC. (FKA COMMUNITY CAREPARTNERS, INC.) THE SYSTEM'S MISSION IS TO OPERATE AN INTEGRATED HEALTH CARE SYSTEM FOR THE BENEFIT OF THE RESIDENTS OF WESTERN NORTH CAROLINA. MISSION HOSPITAL, INC. IS A REGIONAL INTEGRATED HEALTH FACILITY PROVIDING SUPERIOR CARE AND SERVICE TO PATIENTS AND THEIR FAMILIES THROUGH A FULL CONTINUUM OF INTEGRATED SERVICES, EDUCATION, AND RESEARCH. IT SERVES AS A TRAUMA CENTER TO PEOPLE OF WESTERN NORTH CAROLINA AND THE SURROUNDING COUNTIES. ANC MISSION MEDICAL ASSOCIATES' MISSION IS TO PROVIDE PHYSICIAN SERVICES IN PREDOMINANTLY RURAL AREAS THAT ARE INSUFFICIENTLY SERVED, THEREBY IMPROVING THE HEALTH CARE OF THE GENERAL PUBLIC. IN MANY CASES THIS INVOLVES RECRUITING AND PLACING PRIMARY CARE PHYSICIANS, AS WELL AS PEDIATRIC AND ADULT SPECIALTY SERVICES CLOSE TO WHERE PEOPLE LIVE AND WORK. ANC BLUE RIDGE HOSPITAL SERVES AS A COMMUNITY HOSPITAL IN MITCHELL, YANCEY AND SURROUNDING COUNTIES. ANC MCDOWELL HOSPITAL SERVES AS A COMMUNITY HOSPITAL IN MCDOWELL AND THE SURROUNDING COUNTIES. MISSION HEALTH SYSTEM FOUNDATION, INC. SUPPORTS THE MISSION AND PROGRAMS OF MISSION HOSPITAL, INC. AND ANC HEALTHCARE, INC. (MISSION HEALTH SYSTEM, INC.) AND OTHER ORGANIZATIONS THAT ARE TAX EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND WORKS TO BENEFIT THE COMMUNITY AND REGION SERVED BY THE ENTITIES LISTED ABOVE. ANC ANGEL MEDICAL CENTER, INC. SERVES AS A COMMUNITY HOSPITAL IN MACON AND SURROUNDING COUNTIES. ANC TRANSYLVANIA COMMUNITY HOSPITAL, INC. SERVES AS A COMMUNITY HOSPITAL IN TRANSYLVANIA AND SURROUNDING COUNTIES. ANC HIGHLANDS-CASHIERS HOSPITAL, INC. SERVES AS A COMMUNITY HOSPITAL FOR JACKSON AND MACON AND SURROUNDING COUNTIES. MOUNTAINCARE, INC. OPERATES AN INPATIENT FACILITY FOR ACUTE REHABILITATION LOCATED IN ASHEVILLE, NORTH CAROLINA, AND PROVIDES A WIDE VARIETY OF POST-ACUTE CARE SERVICES TO RESIDENTS OF WESTERN NORTH CAROLINA, INCLUDING REHABILITATION, HOME HEALTH, ADULT CARE, AND HOSPICE AND PALLIATIVE CARE. MSJHS AND CCP JOINT DEVELOPMENT COMPANY DBA ASHEVILLE SPECIALTY HOSPITAL OPERATES AN INPATIENT FACILITY FOR LONG-TERM ACUTE CARE.

PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT:
NC

PART VI, LINE 2:
"MACON COUNTY IS A DIVERSE MIXTURE OF MOUNTAIN LIVING, SMALL CITY HUSTLE, RURAL LANDSCAPES AND HIGH TECH POTENTIAL. APPROXIMATELY 34,000 COUNTY RESIDENTS RESIDE ACROSS 519 SQUARE MILES, MOST OF THEM MOUNTAINOUS AND SPARSELY INHABITED. IN ADDITION, 46% OF THIS AREA INCLUDE FEDERAL LANDS THAT LIE WITHIN THE NANTAHALA FOREST AND ARE OVERSEEN BY THE US FOREST SERVICE. THE COUNTY'S LARGEST NATURAL WATER SUPPLY IS THE CULLASAJA RIVER. THERE IS A SLIGHTLY HIGHER PROPORTION OF FEMALES TO MALES IN MACON COUNTY WHICH IS CONSISTENT WITH REGION AND STATE-WIDE DATA. THE COUNTY HAS A MEDIAN AGE SEVERAL YEARS OLDER THAN THE REGIONAL MEAN AND THE STATE AVERAGE MEDIAN AGE. THIS, AND PROJECTED GROWTH OF POPULATION OVER THE AGE OF 65 OVER THE NEXT TWO DECADES, FIT WITH THE REGIONAL CHARACTERISTIC OF A SIGNIFICANTLY LARGE POPULATION OF SENIOR CITIZENS AND THE ISSUES THAT ACCOMPANY THIS POPULATION. MACON COUNTY HAS SIGNIFICANTLY LOWER PROPORTIONS OF ALL MINORITY RACIAL GROUPS THAN THE WNC REGION AND NC AS A WHOLE. HOWEVER, THE COUNTY IS HOME TO A HIGHER PROPORTION OF ETHNIC HISPANICS OR LATINOS THAN THE WNC AVERAGE. THE POPULATION IN EACH MAJOR AGE GROUP AGE 65 AND OLDER IN MACON COUNTY IS PROJECTED TO INCREASE BETWEEN 2010 AND 2030. THE PROPORTION OF THE POPULATION AGE 85 AND OLDER WILL APPROXIMATELY DOUBLE IN THAT PERIOD; THE POPULATION AGE 75-84 WILL INCREASE BY 46%. BY 2030, PROJECTIONS ESTIMATE THERE WILL BE MORE THAN 10,250 PERSONS AGE 65 AND OVER IN MACON COUNTY. ADDITIONAL SOCIOECONOMIC AND DEMOGRAPHIC DATA CAN BE FOUND IN THE MACON COUNTY WEBSITE: WWW.MACONNC.ORG DATA COLLECTION PROCESS THE FOLLOWING SECTION DESCRIBES HOW DATA WAS OBTAINED, COMPILED AND ANALYZED IN OUR ASSESSMENT PROCESS. WNC HEALTHY IMPACT: WNC HEALTHY IMPACT IS A PARTNERSHIP AND COORDINATED PROCESS BETWEEN HOSPITALS AND HEALTH DEPARTMENTS IN WESTERN NORTH CAROLINA TO IMPROVE COMMUNITY HEALTH. AS PART OF A LARGER, AND CONTINUOUS, COMMUNITY HEALTH IMPROVEMENT PROCESS, THESE PARTNERS ARE COLLABORATING TO CONDUCT COMMUNITY HEALTH (NEEDS) ASSESSMENTS ACROSS WESTERN NORTH CAROLINA WWW.WNCHEALTHYIMPACT.COM. ANGEL MEDICAL CENTER IS ALSO INVOLVED IN THIS REGIONAL/LOCAL VISION HENDERSON, JACKSON, MACON, MADISON, MCDOWELL, MITCHELL, POLK, RUTHERFORD, SWAIN, TRANSYLVANIA AND YANCEY. CORE DATASET COLLECTION: THE DATA REVIEWED AS PART OF OUR COMMUNITY'S HEALTH NEEDS ASSESSMENT CAME FROM THE WNC HEALTHY IMPACT REGIONAL CORE SET OF DATA. WNC HEALTHY IMPACT'S CORE REGIONAL DATASET INCLUDES SECONDARY (EXISTING) AND PRIMARY (NEWLY COLLECTED) DATA COMPILED TO REFLECT A COMPREHENSIVE LOOK AT HEALTH. THE FOLLOWING DATA SET ELEMENTS AND COLLECTION ARE SUPPORTED BY WNC HEALTHY IMPACT DATA CONSULTING TEAM, A SURVEY VENDOR, AND PARTNER DATA NEEDS AND INPUT: - A COMPREHENSIVE SET OF PUBLICALLY AVAILABLE SECONDARY DATA METRICS WITH OUR TARGET POPULATION COMPARED TO THE OTHER WNC REGIONS AS ""PEER"". - SET OF MAPS ACCESSED FROM COMMUNITY COMMONS AND NC CENTER FOR HEALTH STATISTICS. - TELEPHONE SURVEY OF A RANDOM SAMPLE OF ADULTS IN THE COUNTY SEE THE MACON COUNTY LOCAL COMMUNITY HEALTH ASSESSMENTS FOR MORE DETAILS ON THE REGIONAL DATA COLLECTION METHODOLOGY - MACON COUNTY WEBSITE: WWW.MACONNC.ORG ADDITIONAL COMMUNITY-LEVEL DATA: IN FEBRUARY 2015, MACON COUNTY PUBLIC HEALTH CONVENED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) STEERING COMMITTEE COMPRISED OF VARIOUS COMMUNITY STAKEHOLDERS TO HELP GUIDE LOCAL DATA COLLECTION EFFORTS. BASED ON FEEDBACK FROM THE CHNA GROUP, IT WAS DETERMINED THAT CONCERNS AND ISSUES RAISED FROM COMMUNITY LEADERS AND VULNERABLE POPULATIONS WOULD BE ESSENTIAL TO PROVIDE CONTEXT FOR THE RESEARCH AND STATISTICAL ANALYSIS. IN ORDER TO HEAR THESE DIVERSE COMMUNITY PERSPECTIVES, THE CHNA STEERING COMMITTEE DETERMINED THAT LISTENING SESSIONS AND KEY INFORMANT INTERVIEWS WERE THE BEST METHOD TO COLLECT LOCAL PRIMARY DATA. GAPS IN AVAILABLE INFORMATION: WHILE THIS ASSESSMENT IS QUITE COMPREHENSIVE, IT CANNOT MEASURE ALL POSSIBLE ASPECTS OF HEALTH IN THE COMMUNITY, NOR CAN IT ADEQUATELY REPRESENT ALL POSSIBLE POPULATIONS OF INTEREST. IT MUST BE RECOGNIZED THAT THESE INFORMATION GAPS MIGHT LIMIT THE ABILITY COMPREHENSIVELY ASSESS THE COMMUNITY'S HEALTH NEEDS. FOR EXAMPLE, CERTAIN POPULATION GROUPS (SUCH AS THE HOMELESS, INSTITUTIONALIZED PERSONS OR THOSE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH OR SPANISH) ARE NOT REPRESENTED IN THE SURVEY DATA. OTHER POPULATION GROUPS (FOR EXAMPLE, PREGNANT WOMEN, LESBIAN/GAY/BISEXUAL/TRANSGENDER RESIDENTS, UNDOCUMENTED RESIDENTS AND MEMBERS OF CERTAIN RACIAL/ETHNIC OR IMMIGRANT GROUPS) MIGHT NOT BE REPRESENTED IN NUMBERS SUFFICIENT FOR INDEPENDENT ANALYSIS. IN TERMS OF CONTENT, THIS ASSESSMENT WAS DESIGNED TO PROVIDE A COMPREHENSIVE AND BROAD PICTURE OF THE OVERALL COMMUNITY'S HEALTH. HOWEVER, THERE ARE A GREAT NUMBER OF MEDICAL CONDITIONS THAT ARE NOT SPECIFICALLY ADDRESSED IN THIS SURVEY. Community Input: THROUGHOUT THE COLLABORATIVE HEALTH NEEDS ASSESSMENT PROCESS IN OUR COMMUNITY, INPUT WAS OBTAINED IN A NUMBER OF WAYS. SEE BELOW FOR A LIST OF THE ORGANIZATIONS THAT PROVIDED INPUT INTO THIS PROCESS, THE PERIOD OF TIME THEY WERE INVOLVED, HOW THEIR INPUT WAS OBTAINED, AND THE NATURE AND EXTENT OF THEIR INPUT. MACON COUNTY COMMUNITY INPUT IS LED BY THE MOUNTAINWISE LEADERSHIP TEAM. THIS PUBLIC AND PRIVATE HEALTHCARE PARTNERSHIP IS COMPRISED OF MORE THAN TWENTY-FIVE COMMUNITY LEADERS WHO REVIEWED SURVEY RESULTS, GUIDED THE PRIORITIZATION PROCESS AND DETERMINED TOP PRIORITIES TO BE ADDRESSED BY EACH OF THREE TASK FORCES. THROUGH THIS TEAM, COMMUNITY MEMBERS AND LEADERS, REPRESENTATIVES OF PUBLIC HEALTH, HOSPITALS, HUMAN SERVICE ORGANIZATIONS, CHURCHES, SCHOOLS AND BUSINESSES WORK TOGETHER TO COLLABORATIVELY ORGANIZE AND MOBILIZE RESOURCES. OUR COLLABORATIVE HEALTH NEEDS ASSESSMENT PROCESS SOLICITED AND TOOK INTO ACCOUNT INPUT FROM THE FOLLOWING: PUBLIC HEALTH DEPARTMENT: IN THE COLLABORATIVE ASSESSMENT PROCESS FOR OUR COMMUNITY, THE MACON COUNTY PUBLIC HEALTH CENTER IS A KEY PARTNER. THEY PROVIDED COORDINATION FOR THE LOCAL PROCESS THAT WE HELP SUPPORT AND PARTNER TO IMPLEMENT. MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS OUR PROCESS INCLUDED INPUT REGARDING THE NEEDS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN TWO WAYS. (1) AS PART OF OUR COLLABORATIVE DATA COLLECTION EFFORT, A COMMUNITY-WIDE TELEPHONE SURVEY WAS CONDUCTED TO BETTER UNDERSTAND THE SPECIFIC HEALTH INFLUENCE HEALTH ARE INCLUDED IN THE FULL COMMUNITY HEALTH ASSESSMENTS FOR EACH COUNTY IN OUR COMMUNITY. THE COLLABORATIVE LOCAL ASSESSMENTS INCLUDE A BASIC REVIEW OF TRENDS AND PROGRESS AND CHANGES IN HEALTH STATUS FOR THE BROAD COMMUNITY. THESE ASSESSMENTS ALSO INCLUDE DETAILS ON POPULATIONS AT RISK OR FACING HEALTH DISPARITIES IN OUR COMMUNITY. HEALTH ISSUES PROCESS: TO IDENTIFY THE SIGNIFICANT HEALTH ISSUES IN OUR COMMUNITY, OUR KEY PARTNERS REVIEWED DATA AND DISCUSSED THE FACTS AND CIRCUMSTANCES OF OUR COMMUNITY. WE USED THE FOLLOWING CRITERIA TO IDENTIFY SIGNIFICANT HEALTH ISSUES: -COUNTY DATA DEVIATES NOTABLY FROM THE REGION, STATE OR BENCHMARK -SIGNIFICANT DISPARITIES EXIST -DATA REFLECTS A CONCERNING BURDEN, SCOPE OR SEVERITY -SURFACED AS A PRIORITY COMMUNITY CONCERN IDENTIFIED ISSUES THE FOLLOWING HEALTH ISSUES WERE SURFACED THROUGH THE ABOVE SURVEY PROCESS: -CHRONIC DISEASE: THIS INCLUDES HEART DISEASE, DIABETES, CEREBROVASCULAR DISEASE (I.E. STROKE), CANCER AND CHRONIC LOWER RESPIRATORY DISEASE. -OBESITY: THIS INCLUDES OBESITY RATES OF CHILDREN AGES 0-5, 6-12 & 13-18 AND ADULTS AGE 19 AND UP. -TEEN PREGNANCY: THIS INCLUDES TEENS THAT BECAME PREGNANT UNDER AGE 19. -SUBSTANCE ABUSE: THIS INCLUDES NOT ONLY THOSE WHO USE DRUGS BUT ALSO THOSE WHO ENABLE DRUG USE BEHAVIORS ALONG WITH THE NEED FOR DRUG USE PREVENTION EFFORTS. -INTIMATE PARTNER VIOLENCE: THIS INCLUDES SEXUAL ASSAULT AND DOMESTIC VIOLENCE. -TOBACCO: THIS INCLUDES TOBACCO USE DURING PREGNANCY AND THE NEED FOR TOBACCO POLICIES (TOBACCO-FREE PLACES). -SOCIAL DETERMINANTS OF HEALTH: THIS INCLUDES ECONOMIC DEVELOPMENT AND AFFORDABLE HOUSING."