St. Joseph Health System – Humboldt County

Fiscal Year 2009 COMMUNITY BENEFIT REPORT

EXECUTIVE SUMMARY

Required by CA OSHPD, TX DSHS

Our Mission

To extend the healing ministry of Jesus in the tradition of the Sisters of St. Joseph of Orange by con-tinually improving the health and quality of life of people in the communities we serve.

Our Vision

We bring people together to provide compassionate care, promote health improvement and create healthy communities.

Our Values

The four core values of St. Joseph Health System -- Service, Excellence, Dignity and Justice -- are the guiding principles for all we do, shaping our interactions with those whom we are privileged to serve.

Who We Are and What We Do

St. Joseph Health System-Humboldt County (SJHS-HC) began with a vision when a congregation of nine teaching Sisters responded to the flu epidemic of 1918. The Sisters went into the homes of the sick to provide practical nursing care, introducing these educators to the need for services that would effec-tively address the health care needs of the area. In 1920, the Sisters opened St. Joseph Hospital in Eureka and in 1957 they expanded their ministry 20 miles south to open Redwood Memorial Hospital in Fortuna. The commitment these nine Sisters brought to Humboldt County in 1918 continues today and is further defined by their vision- to bring people together to provide compassionate care, promote health improve-ment and create healthy communities.

St. Joseph Hospital (SJE) consists of two campuses in Eureka, employing 1,062 individuals. The full ser-vice acute care hospital is one of the most advanced in Northern California and is the leader in furnishing health care to the North Coast. The services provided include open heart surgery, interventional cardiol-ogy, total joint replacements, complex eye surgery, pediatric care, urgent care and a full range of women and children health care. SJE offers comprehensive oncology care through an accredited cancer program, as well as Emergency Medicine Board certified physicians for the hospital’s full service emergency room. The hospital provides the community with both an outpatient surgery center and an outpatient imaging center. All of these services will be enhanced when, in 2011, the new patient tower on the SJE campus is completed and opened for services

The General Hospital campus is located only a few blocks from SJE and offers the community a Medi-cal Rehabilitation Center, Occupational Medicine, Outpatient Laboratory Services, Sleep Disorder Center and Outpatient Rehabilitation services. The campus also houses many of the support services needed by SJHS-HC, including patient accounts, clinical education, the SJHS-HC Foundation offices and Paso a Paso’s educational programs for Latino families.

Redwood Memorial Hospital (RMH) is a critical access hospital providing a full range of 24 hour emer-gency services and an accredited cancer program and employment for 218 individuals. RMH adopted a patient centered, family centered holistic care model and has received recognition as a high achieving hospital in patient survey databases.

SJHS-HC identifies the entire community as one with disproportionate unmet needs and sets communi-ty benefit activities and priorities for the most isolated, underserved members of the region. These activi-ties include addressing the unmet needs of the growing Latino population with the educational programs of Paso a Paso, providing community specific resource centers in six locales throughout the county and partnering with like organizations to expand SJHS-HC reach to populations who have defined health ac-cess needs.

St. Joseph Hospital provided $14,511,000 of community benefit services in FY 2009, a 10.5% increase from FY 2008. During the same time period, Redwood Memorial Hospital, a critical access facility, pro-vided $5,256,000, equal to the support provided the community in FY 2008.

Organizational Structure and Community Involvement

SJHS-HC is comprised of both SJE and RMH who are over seen by mirror Boards of Trustees. The Board of Trustees has established a Community Benefit Committee to guide and participate in planning, devel-opment, implementation and evaluation of programs to improve the health of the community served. The Community Benefit Committee follows the guidelines established in the Advancing the State of the Art of Community Benefits and the Board of Trustee has approved by-laws, charter and policies defining/delineating processes for activity selection,

Financial Assistance Policy

Our mission is to provide quality care to all our patients, regardless of ability to pay. We believe that no one should delay seeking needed medical care because they lack health insurance. That is why St. Joseph Health System has a Patient Financial Assistance Program that provides free or discounted services to eligible patients.

Access to necessary care is never affected by whether financial resources are available and medically necessary care is provided to the extent SJHS-HC can reasonably care for the patient. Eligibility for finan-cial assistance is determined solely by the patient’s ability to pay and not on any other factor.

In FY 2009, SJE provided $1,992,000 in charity care and RMH provided $737,000.

Community Plan Priorities

• The Community Resource Centers continue to provide the conduit for SJHS-HC to provide outreach throughout Humboldt County. Located in 6 distinct areas of the community, the centers provide support and resources to the communities they serve – as defined by each community. In FY 09, the centers pro-vided food resources to 4,853 individuals, oversaw the summer lunches and weekend food distribution for 290 children on free and reduced school lunch programs, and sponsored three bike rodeos for 257 underserved children.

• Paso a Paso provided education and training to parents of both RMH and SJE through classes on positive discipline, child birth education, breast feeding and car seat safety to 2,100 Latino parents and their children.

• SJHS-HC partnered with organizations and businesses to outreach to families/individuals to address increased access to health insurance for children, food resources and safe exercise

• SJHS-HC successfully partnered with Open Door Community Health Center to assure the continua-tion of clinic operations for the rural, isolated region of Willow Creek.

Who We Are and What We Do

St. Joseph Health System – Humboldt County is committed to addressing the unmet needs of our com-munity and to strengthen our work, we partner with local communities and community organizations, going out into each to improve the quality of life of the people living there.

• St. Joseph Health System – Humboldt County sponsors community resource centers in Blue Lake, Rio Dell, Loleta, Eureka, Fortuna and Willow Creek. Each community served by a center is distinct and each center is organized to meet the needs of their defined populations. The Eureka Center is located in Old Town and primarily serves the homeless. The center is provides almost 300 homeless with a mailing ad-dress. The address is used for social security checks, legal paperwork, communication with families and routine information that those with homes take for granted. Four of the centers are in schools, partner-ing with education to provide assistance for low income students. The centers are in rural underserved schools and act as advocates for homeless students, provide needed school supplies and clothing, assist parents to obtain health insurance, schedule appointments with the Mobile Medical Office for students/families and coordinate after school snacks, weekend food backpacks and food/commodities distribu-tion. The final center is located in rural Willow Creek and shares a space with the Open Door Federally Qualified Health Center. This center provides the same services as the others, including access to pharma-ceutical assistance programs, free fax, telephone and e-mail, gas vouchers for medical and social service appointments and addressing individual needs.

• Paso a Paso, a program developed to provide child birth education for Latina mothers, has expanded to provide the only child birth, parenting, lactation, and positive discipline classes for the area’s grow-ing Spanish speaking families. Public Health, First Five Humboldt, Mobile Medical Offices, and the New Comers Center are all partnering with Paso a Paso. In FY 2009, Paso a Paso worked with 534 undupli-cated individuals. Those parents who attended the prenatal classes progressed from an average of 69% on the pretest to 98% on the post. Ninety five percent of the babies born to Paso a Paso moms were born of normal birth weight. One hundred per cent of the moms breast fed during early postpartum (compared to national average of 66% for Hispanic women), 69% at six months (29%), and 40% at one year (19%). In a thank you note to the staff, a young mother reported her husband lost his job during her pregnancy and they were not sure how they would be able to provide for their needs of their child. ‘Thanks to the Paso a Paso program, our situation got better. The staff visited us and helped us with things that once seemed impossible for us to deal with. Now, our baby girl is with us and we have all the supplies we need. Thank you for being the light at the end of our tunnel.’

• St. Joseph Health System-Humboldt County actively participates on two community-wide collabora-tions to address health care access (Healthy Kids Humboldt) and to address obesity. (Humboldt County Activity and Nutrition) The two collaboratives include Redwood Community Action Agency, Public Health, Mental Health, Department of Health and Human Services, Food for People, the Co-Op, Farmers Collab-orative, First Five Humboldt, North Coast Funders Network, Community Health Alliance, Humboldt State University, Board of Supervisors, Cities of Arcata and Eureka, and Humboldt County Office of Education. Representatives from these organizations meet monthly to assure outreach to the underserved popula-tion to enroll children in health insurance, their families in food stamps and assure that partners are working together without duplication of efforts. The collaboratives have resulted in One-E Application for children’s insurance which enrolled 300 children, two community catalyst fairs to define activities that are occurring to address exercise/nutrition concerns and five mini-grant projects to pilot and test programs that if successful, can be duplicated throughout the region.

• St. Joseph Health System – Humboldt County partnered with Open Door Community Health Cen-ter to successfully obtain federally qualified health clinic status for the Willow Creek Community Health Center. Willow Creek was a department of St. Joseph’s Hospital and it became clear that, in order to

survive as a free standing clinic, obtaining FQHC status was imperative. Open Door had ten FQHC clinics throughout the SJHS-HC region and was approached and invited to partner to continue the clinic services in this rural isolated area. Open Door applied for FQHC status and SJHS-HC continued to support the clin-ic until the status and the transfer of assets was completed in December of 2008. SJHS-HC handed over all assets of the clinic, book value of over $300,000, and Open Door hired all staff to continue to provide the over 10,000 medical and 2,500 dental visits for the Willow Creek area without a disruption in care.

Overview of Community Needs and Assets Assessment

St. Joseph Health System-Humboldt County completed a Community Needs/Assets Assessment in 2008 and has set the community benefit program services according to the identified priorities of the citi-zens of the services delivery area. The assessment found a growing concern of citizens and organizations alike on the problems of obesity, lack of exercise, and the increase in poor health outcomes that relate to food insecurity and poor nutrition. FY 2009 faced a tremendous economic downturn in the community, resulting in an even greater concern for food insecurity and access to proper nutrition. Local businesses have closed and the two main department stores for the local mall have gone out of business, increasing the unemployment rate to over 11% for the region. From 1999 to April of 2009, the unemployment for the region had averaged 6%, showing the tremendous problems the economic down turn has placed on the local communities. The Food Bank has reported that they now see many individuals at their food distributions who in the past were those that volunteered to help with the distributions or donated the food. Citizens who never had envisioned requiring safety net programs are now active recipients.

With almost 3,600 square miles, Humboldt County is the largest and most populous of the North Coast counties. Roughly 80% of the county is designated as National and State parks and timber land, leaving the population of 132,821 spread out county-wide on only 20% of the land. The density of population is 35 citizens per square mile in comparison to the State of California’s definition that 52 citizens per square mile equals rural. The population density is not consistent with over 50 citizens per square mile in some areas and only 10 in others. The area unemployment rate of over 11% is also not consistent, with some communities having a rate of over 20% and some less than 5%.

The poverty rate for the region is very high with 16.9% of all citizens living below the national poverty rate. The children of the region have an even greater rate, with over 22% of the total living in poverty. The local schools offering free and reduced lunches for the students continue the regional imbalance in rates, with some rural schools at over 85% of the student population and others less than 10%.

In January of 2009, the Humboldt Housing and Homeless Coalition conducted a comprehensive count of homeless people in the County. The total number of adult homeless was 1,497 and they were accom-panied by 416 children. The City of Eureka had the highest concentration of homeless with 723 adults and 262 children (51.5%), followed by Arcata with 219 adults and 44 children (13.7%) and Fortuna with 130 adults and 51 children (9.5%). The remaining 25.3% were scattered throughout the county.

The vast majority of the homeless are single people with no children, with only 11% of homeless adults being single parents accompanied by a child and an additional 9% of homeless adults were part of a couple with children. Among the homeless adults, 39% self reported alcohol issues, 37% self reported drug issues, 54% self reported mental health issues, 47% self reported physical disabilities and 18% self reported they are victims of domestic violence.

The major transportation accesses are Highway 101, running north to south, and 299, running east to west. The majority of the population centers are along the 101 corridor, including the three largest cities of Eureka, Arcata and Fortuna. These communities comprise almost 42% of the total population and are home to the majority of health care, community and social services. The remaining 58% of the county

population must travel to these communities for services, an often difficult process in a county that aver-ages over 36 inches of annual rain fall, is comprised of mountainous roads and isolated communities and has the highest gas prices of all of California.

The prevalence of very low food security (Very low food security is a measure of severe insecurity result-ing in reduced food intake, disrupted eating patterns or hunger) is more than double the prevalence in California. The California Center for Rural Policy conducted a Rural Health Information Survey in 2006 and respondents with very low food security were significantly more likely to report poor health and depression compared to respondents without very low food security. Households with incomes below the Federal Poverty Level (FPL) were clearly disadvantaged with 29% reporting very low food security compared to 1.1% of those at 300% of the FPL. Respondents with children living in their home were 1.6 times more likely to report very low food security and the most rural communities had up to 25% of the respondents reporting the same.

There is an association between food insecurity and obesity or overweight in adults and children. Food insecurity reaches into the schools where children living in food insecure households tend to have poor cognitive, academic and psychosocial outcomes. CCRP found the younger the respondent, the more likely they were to report very low food security with 18% of those 18-29 experiencing it compared to 0.8% of respondents 80 years or over. Research suggests that food insecurity is related to increased risk for health problems such as obesity as mentioned, but also diabetes, heart disease and high blood pres-sure.

Currently only 50% of those eligible for food stamps in Humboldt County are enrolled in the pro-gram. These 50% are spending more than $1 million per month at local stores and farmer’s markets. This money benefits the nutrition of the community and keeps people employed and farmers working in their fields. The economic impact of food stamps is that for every dollar spent in Humboldt County creates between $1.73 and $1.84 in economic activity. If the other 50% of those eligible for food stamps were enrolled in the program, an additional $1.84 million in revenue would be generated through out the county, as well as the improvement in nutrition for the eligible families.

Whites constitute the largest ethnic group in the county at 86.9%, followed by Hispanics at 8.4%, Na-tive American at 6%, Asians at 2% and Blacks at 1.1%.

Organizational Structure and Community Involvement

SJHS-HC has a mirror Board of Trustees for both St. Joseph and Redwood Memorial Hospitals. The board designates a Community Benefit (CB) Committee to guide and participate in the planning, de-velopment, implementation and evaluation of community benefit activities. The Committee, chaired by a Trustee, follows the guidelines of the Advancing the State of the Art of Community Benefit and has board approved by-laws, charter and policies. The BOT receives monthly written reports of CB activities and verbal reports from the Trustee Chair, who carries recommendations to them for programs and initia-tives approved by the CB Committee.

The Vice President of Mission Integration (VP of MI) is a member of the CB Committee and is the representative between the Committee and the Executive Leadership Team. The VP of MI provides the Committee with support from management and assures the SJHS-HC CB Plan is in alignment with the SJHS-HC Strategic Plan. The VP of MI attends the strategic planning sessions of the BOT and provides the CB Committee and the Regional Director of Community Benefit (RDCB) with access to the strategic plan. The RDCB is an active participant on the Area Management Team, a team that reviews and supports the SJHS-HC Strategic Plan.

The CB Committee membership includes representatives from community non-profits, who provide direct input into the formation of the CB Plan.

Financial Assistance Policy

We believe that as a Catholic health service organization, SJHS has a social responsibility and moral obligation to make quality health services accessible to the medically poor. We further believe all persons have a right to an adequate level of health care and that the provision of health care for those who re-quire it is an obligation of justice as well as charity or mercy (A Vision of Value, 1986, Rev. 1991).

Our mission is to provide quality care to all our patients, regardless of ability to pay. We believe that no one should delay seeking needed medical care because they lack health insurance. That is why St. Joseph Health System has a Patient Financial Assistance Program that provides free or discounted services to eligible patients.

Humboldt County has a large population of individuals who qualify for the Patient Financial Assistance Program due to the low per capita income of $17,203 and a Federal Poverty Level (FPL) for housing assis-tance for the county set at $17,800. The policy states that patients at or below 300% of the FPL will not pay more than Medicare would typically pay on average for a similar episode of service. This applies to all necessary hospital inpatient, outpatient and emergency services. It is estimated that up to 90% of all the county residents will qualify for assistance under this policy.

In FY 09, St. Joseph Hospital provided $1,992,000 in charity care to 7,7076 patients and Red-wood Memorial Hospital provided $737,000 to 2,612 patients.

FY 09 – FY 11 Community Benefit Plan: FY 09 Progress Initiative/Program: Increase physical activity and healthful eating for communities served by SJHS-HC Community Resource Centers

Key Community Partners: Food for People, Humboldt County Office of Education, Law Enforcement, Rotarians

Unmet Health-Related Group: School students who qualify for free and reduced lunches

Goal: Improve the health of school aged children through increased access to healthful foods and physical activities

How will we measure success? FY 2009 Strategy 1: Rural CRCs will sponsor food distributions for low income children/familiesStrategy 1 Measure: 4,853 families obtained food from distributions at centers in FY 09

Strategy 2: Sponsor fitness events at three low income schoolsStrategy 2 Measure: Fitness events were sponsored at Rio Dell, Blue Lake and Loleta Elementary Schools

Strategy 3: Increase backpack for kids distribution pointsStrategy 3 Measure: Food for People partnerships increased distribution to nine sites, including the Homeless Shelter. Two of the sites are sponsored 100% by rotary clubs.

FY 2009 Accomplishments: The partnership with Food for People and the Community Resource Centers continues to be one tool for the distribution of healthy foods to children and their families. The center coordinators pick up the food at the Food for People location in Eureka and deliver it to the isolated rural locations of Humboldt County. The CRCs are a distribution site for commodities, home delivered senior brown bags, meal tickets, food stamp enrollment, weekend back packs for the children and summer lunches. SJHS-HC partnered with the Serenity Inn homeless shelter on food distribution for the families and children, resulting in Food for People opening a summer lunch program and back pack program at this location

FY 2010• Strategy 1: One new/underserved rural site will have an established food distribution site by January 2010

with at least monthly food distributions• Strategy 2: SPARKS after school program will be established in two rural schools by January 2010, with

attendance by at least 75% of after school children• Strategy 3: SPARKS after school sites will include after school nutritional snacks in partnership with school,

Food for People and Boys and Girls Clubs, 100% of the time

FY 09 – FY 11 Community Benefit Plan: FY 09 Progress Initiative/Program: Healthful Food Distributions

Key Community Partners: Willow Creek Health Center, Food for People, City of Blue Lake, North Coast Funders Network, UPS, Senior Resource Center

Unmet Health-Related Group: Isolated low income

Goal: Improve the health of low income individuals through increased access to healthful foods

How will we measure success? FY 2009 Strategy 1: Provide summer lunches for low incomeStrategy 1 Measure: WC CRC provided summer lunches for 60 unduplicated students

Strategy 2: Pick up and deliver needed food to isolated community members on a monthly basisStrategy 2 Measure: 12 home bound seniors and 129 Blue Lake citizens received delivery of healthful food with 95% verbally reporting maintaining personal health status

FY 2009 Accomplishments: The Regional Director of Community Benefit actively participated in fund raising for the summer youth activities and food distributions. Rio Dell, Blue Lake and Willow Creek were summer lunch sites, with age appropriate physical activity provided. Blue Lake and Willow Creek coordinators pick up, distribute and monitor commodities and food for their communities, including the delivery of food to isolated seniors and the homebound and the maintenance of food pantries within each center.Food for People relies on the services of the North Coast Funders Network and the Community Resource Centers, and also utilizes the Senior Resource Center to make the lunches and when available, local UPS drivers to deliver them to isolated areas. All of these partners working together make this program successful.

FY 2010• Strategy 1: Loleta Elementary will be a new site for the 2009 summer lunch program, with the CRC

coordinator picking up, distributing and monitoring the lunches of at least 15 students, 3 times per week. The coordinator will also be the lead in the delivery and distribution of commodities with community partners at the Loleta Community Church

• Strategy 2: The Regional Director will actively participate on the Food Stamp task force, assuring training for all SJHS-HC outreach staff on Food Stamp enrollment and access to Food Stamp on line applications at all outreach locales

FY 09 – FY 11 Community Benefit Plan: FY 09 Progress Initiative/Program: Bike Rodeos

Key Community Partners: City Parks and Recreation, Humboldt County Schools, Cal. Highway Patrol, local service clubs

Unmet Health-Related Group: Isolated rural commu-nities of Humboldt County

Goal: Improve the health of students through increased physical activities

How will we measure success? FY 2009 Strategy 1: Sponsor bike rodeos for students of Rio Dell and Loleta, including free safety equipment for all ‘graduates’

Strategy 1 Measure: All participating students (137) had safety checks and all that were without helmets and safety equipment (99) were provided proper equipment. Children were taught proper use of helmet and 96% were able to immediately don helmet correctly.

Strategy 2: Educate Blue Lake children and families on bike safety through a bike rodeoStrategy 2 Measure: All participating students (120) had safety checks and all that needed safety equipment and/or helmets (30) were provided them. All children were able to safely put on helmets.

FY 2009 Accomplishments: Humboldt County students rely on bicycles as a primary method of transportation in rural communities, often on poorly maintained roads and streets. The parents of the children are often not able to afford proper fitting bikes or safety equipment or helmet, and it common to see children riding hand me down bikes with hand me down helmets, if there are helmets. Local service clubs and law enforcement agencies are active participants in the CRC bike rodeos, assisting with the purchase/distribution of properly fitting helmets and inspecting all bikes for safety. Volunteers not only do safety inspections but also do adjustments to ill fitting, improperly maintained bikes. The success of the bike rodeos and the enjoyment the children have while participating in them is an important activity of the centers who work with the children of their communities.

FY 2010• Strategy 1: There will be at least three bike rodeos in 2010, with all equipment inspected for safety,

adjusted when needed and each child attending will leave with a proper fitting bike helmet.

FY 09 – FY 11 Community Benefit Plan: FY 09 Progress Initiative/Program: Back Pack Program for Students

Key Community Partners: Food for People, Humboldt County Office of Education, UPS drivers, CRC, Rotarians, North Coast Funders Network

Unmet Health-Related Group: Students eligible for free and reduced lunches

Goal: Improve access to healthful foods during weekends, holidays and summer vacations

How will we measure success? FY 2009 Strategy 1: Weekend backpacks of healthful foods will be handed out weekly at Willow Creek, Rio Dell and Blue Lake community resource centersStrategy 1 Measure: 90 children received weekly backpacks during the school year from the three CRC sites.

Strategy 2: Summer lunches will be provided to the students of the above locationsStrategy 2 Measure: 129 students received summer lunches at the three CRC locations

FY 2009 Accomplishments: Humboldt County continues to focus on transporting food to the children of our communities. The weekend backpack program began 3 years ago at three sites and with the assistance of local Rotary clubs, the program grew to 9 sites in 2009. Sites are being sponsored by Rotary clubs who provide all the work to pick up the food, fill the backpacks, sponsor the school site and deliver the full backpacks each week. The cost of the program for one child per year is $260 and one Rotary club sponsored 70 children per week at a school where the free and reduced lunch rate is 92% of all enrolled students. The North Coast Funders Network has worked closely with the schools and Food for People and is very actively attempting to expand the ‘food stamp’ program to enable the families to increase the access to healthful foods for all family members.

FY 2010• Strategy 1: Partner with Humboldt County Office of Education to provide education on nutrition, healthful

eating in conjunction with the Healthy 4 Life/SPARKS after school programs at two local schools. • Strategy 2: Actively participate on the Safety Net Funder group and the North Coast Funders Network to

leverage funds for at least three safety net services, including access to healthful foods, in FY 2010.

FY 09 – FY 11 Community Benefit Plan: FY 09 Progress Initiative/Program: Paso a Paso

Key Community Partners: Humboldt County Public Health Department, First Five Humboldt, Eureka Adult Education, Newcomers Center, Maternal Child and Adolescent Health, Mobile Medical Office

Unmet Health-Related Group: Community members with language/cultural barriers to service/care access

Goal: Improve the broad understanding of child birth, new parenting challenges, and access to health and community resources among Latino women and families

How will we measure success? FY 2009 Strategy 1: Provide linguistically appropriate prenatal classes/parenting classesStrategy 1 Measure: Attendees at the classes improved their knowledge from an average of 69% score on the pretest to an average of 98% on the post test, surpassing the 80% score target

Strategy 2: Provide education on BMI and the dangers of childhood obesityStrategy 2 Measure: 100% of the parents taking the pretest did not know what BMI was or the importance of monitoring it, and after the class, 80% understood what it was and the importance of it.

FY 2009 Accomplishments: The accomplishment of Paso a Paso can best be surmised by quoting a thank you note received from one new mother – this note shows the scope of care the program provides the families, beyond the education that is taught in the classroom.‘Things were going well during my pregnancy and then my husband lost his job. Every passing day, we worry more and more about our situation. Sometimes we worry all night long about what to do because our baby girl was about ready to be born and we didn’t have any supplies for her. Thanks to the Paso a Paso program, our situation got better. The staff visited us and helped us with things that once seemed impossible for us to deal with. Now, our baby girl is with us and we have all the supplies we need. Thank you for being the light at the end of our tunnel.’

FY 2010• Strategy 1: There will be a part time Spanish speaking social worker hired to work directly with the families/

staff to address social issues, facilitate educational groups and streamline application assistance to safety net programs for participants. The social worker will be trained in food stamp and health insurance access for families and will become a certified application assistant for both.

FY 09 – FY 11 Community Benefit Plan: FY 09 Progress Initiative/Program: Healthy Kids Humboldt

Key Community Partners: Department of Health and Human Services, Humboldt County Public Health Department, First Five Humboldt, McLean Foundation, Humboldt Area Foundation, Community Health Alliance, Humboldt County Office of Education

Unmet Health-Related Group: Low income children without access to health insurance

Goal: Rural families will have access to health care coverage for their children

How will we measure success? FY 2009 Strategy 1: Partner with Healthy Kids Humboldt to provide outreach at all CRC locations through trained application assistantsStrategy 1 Measure: Access to assistance is available at all CRC locations with trained application assistants available to enroll children in insurance products

Strategy 2: Partner with Rio Dell and Loleta schools to assure 100% of families have the opportunity to enroll their children in health insurance optionsStrategy 2 Measure: Community Health Alliance, and CRCs, Rio Dell and Loleta schools provided information and follow up to 100% of the families that reported to the school their children did not have health insurance

FY 2009 Accomplishments: Healthy Kids Humboldt addresses the access needs of Humboldt County children through monthly coalition meetings (co-chaired by SJHS-HC), fund raising strategies and outreach/education. The highlight of the program was the agreement of the coalition to adopt One- E app which provides for ‘one application’ shopping for families to apply for Healthy Families, Cal Kids and Medi Cal – and receive assistance from the program for which they are eligible.

FY 2010• Strategy 1: Advocate with North Coast Funders Network partners for continued financial support for the

growing number of uninsured children and funds to cover 2009 $17K+ deficit and improving understanding of rural provider access points

• Strategy 2: Participate on Dental Advisory Group to increase access points for children and families in need of dental care, attending 90% of the meetings and sharing information obtained with 100% of CB staff in all programs

FY 09 – FY 11 Community Benefit Plan: FY 09 Progress Initiative/Program: Increase Activity and Nutrition throughout Humboldt County

Key Community Partners: Food for People, Humboldt County Office of Education, RCAA, Hum PAL, Department of Health and Human Services, Public Health, Co-op, First Five Humboldt, Community Health Alliance, North Coast Funders Network

Unmet Health-Related Group: Low income, high food insecurity families

Goal: Families/individuals will have increased access to education and resources on use of healthful food and exercise

How will we measure success? FY 2009 Strategy 1: SJHS-HC will partner with at least 4 community organizations to outreach to families/individuals to address increased healthful foods and exerciseStrategy 1 Measure: 9 community safety net organizations were awarded funding from SJHS-HC Care for the Poor funds to provide food and exercise programs for low income individuals

Strategy 2: SJHS-HC will actively participate on Humboldt County Activity and Nutrition Coalition to increase community awareness of healthful foods and safe exerciseStrategy 2 Measure: SJHS-HC participated in 90% of HumCan activities, three HumCan subcommittees and assured the implementation of 5 pilot projects and one community wide forum on healthful foods and exercise

FY 2009 Accomplishments: SJHS-HC worked closely with the safety net programs in 2009, those programs that provide food, shelter and clothing for the under served. The partners in HumCan and those of the North Coast Funders Network addressed emerging needs of the organizations when the dramatic spikes in individuals/families seeking assistance continued to increase. The economic conditions of the county continue to be of concern to SJHS-HC and as these conditions continue, SJHS-HC will continue to address needs with the funding network partnerships established over the past years.

FY 2010• Strategy 1: Evaluate the distribution of the Care for the Poor funds, improve RFP process to meet safety net

program needs and assure funding to at least 4 community partners• Strategy 2: Participate in the planning, advocacy and formal presentations for the Healthy Eating Active

Living, California Cities symposium, advocating with elected officials from three county area for policy writing to address nutrition/activity needs of low income citizens

FY 09 – FY 11 Community Benefit Plan: FY 09 Progress Initiative/Program: Willow Creek Family Health Center/Dental Clinic

Key Community Partners: Open Door Community Health Center

Unmet Health-Related Group: Rural isolated region within Humboldt County

Goal: The medical and dental services provided to underserved and the community of Willow Creek will continue to be available under a federally qualified health care delivery system and/or patient access to physician services

How will we measure success? FY 2009 Strategy 1: Assist Open Door Community Health Center in obtaining federally qualified health care status for the Willow Creek clinicsStrategy 1 Measure: Open Door Community Health Center received FQHC status for the Willow Creek Clinic in December of 2008

Strategy 2: Transition the services, staff and equipment to Open Door Community Health CenterStrategy 2 Measure: 95% of the staff, all the equipment and all services were transferred to Open Door for the continuation of all services at the WC clinic site

FY 2009 Accomplishments: The Willow Creek clinic is now a FQHC resource for the patients of the WC area. The partnership between SJHS-HC and Open Door to obtain the FQHC status included weekly meetings between staff of both entities, meetings with Open Door, SJHS-HC and Willow Creek staff, and the transition from SJHS-HC of all assets to Open Door. The initial difficulties expressed by WC staff were alleviated by Open Door’s willingness to work with SJHS-HC and accept not only staff seniority credits but also to pay each staff member at least the amount they were being paid from SJHS-HC. The clinic literally closed on a Friday as a department of SJHS-HC and reopened on Monday as a FQHC site of the Open Door Community Health network with the same staff, the same services and the same excellent care for the community.

FY 2010• Strategy 1: Partner with Open Door Community Health Center dental clinic to provide dental exams and

treatment to all students at Blue Lake and Loleta Elementary Schools

Other Community Benefit Initiatives and Programs Program Name: Donations of supplies, medications, housing

Key Community Partners: Emergency Medical Transportation, Open Door Community Health Center, North Coast Clinic Network, American Cancer Society

Target Audience: Rural isolated regions and citizens of Humboldt County

Goal: The medical and dental services provided to underserved and the community of Willow Creek will continue to be available under FQHC status and patient access to physician services

How will we measure success? Services will continue to be available in the rural isolated community of Willow Creek through Open Door Community Health Center

Accomplishments The SJHS-HC Willow Creek Community Health Center closed on a Friday and the center reopened on Monday under the ownership of the Open Door Community Health Center. The transition was accomplished through the donation of over $300,000 of equipment, remodeling, supplies and medications. SJHS-HC assisted Open Door Community Health Center in completing the application for FQHC status for Willow Creek and, once that was granted, SJHS-HC determined it was to the best interest of all the patients at the clinic to make the transfer of all equipment, supplies and medications as seamless as possible. In exchange, Open Door accepted all clinic staff, including the physician, allowing them to maintain years of seniority and benefits.

Other Community Benefit Initiatives and Programs Program Name: Intern programs for health careers

Key Community Partners: Humboldt State University, Touro, College of the Redwoods, Eureka High School, Humboldt County Office of Education

Target Audience: Rural isolated Humboldt County

Goal: Increase the capacity of residents to partner with community organizations to bring positive economic growth to the area

How will we measure success? Internships will be available at both ministries to provide nurses and allied professionals access to mentoring

Accomplishments Staff from St. Joseph and Redwood Memorial Hospital provided mentoring to students from Humboldt State University, College of the Redwoods, Eureka High School, Touro and Humboldt County Office of Education. Mentoring occurred in the nursing departments, rehabilitation unit, imaging centers, lab, community resource center and through the Care Transition team. There were 464 individuals mentored at St. Joseph and 549 at Redwood Memorial. Redwood Memorial statistics included the social work student., AmeriCorps and Department of Health and Human Services workers assigned to the Community Resource Centers.

Other Community Benefit Initiatives and Programs Program Name: Community Resource Centers

Key Community Partners: Humboldt County Office of Education, Food for People, Cities of Blue Lake and Rio Dell, Willow Creek Open Door Community Clinic, Department of Health and Human Services

Target Audience: Rural isolated Humboldt County

Goal: Increase the health of low income individuals throughout rural Humboldt County by increasing access to healthful food, physical activity and support from community organizations

How will we measure success? Community Resource Centers will be located in rural, isolated communities throughout Humboldt County

Accomplishments The St. Joseph Health System-Humboldt County acts as sponsors of the Community Resource Centers in Blue Lake, Eureka, Fortuna, Rio Dell, Loleta and Willow Creek. These centers address the individual needs of the community they serve, as defined by the communities where they are located. The centers do not duplicate efforts of other non-profits but work closely with like organizations to address the defined needs. The coordinators of each center participate in community activities, lending the support of SJHS-HC to the community efforts to address problems. The centers are often the primary source for services for families – including food stamp applications, access to pharmaceutical assistance, enrollment into health insurance for children, food pantries, commodities etc.

Other Community Benefit Initiatives and Programs Program Name: Physician Trauma Services

Key Community Partners: FQHC clinics, primary physician offices, emergency medical transporters.

Target Audience: Uninsured patients of the ER and Urgent Care

Goal: The medical and dental services provided to underserved and the community of Willow Creek will continue to be available under a FQHC delivery system and/or patient access to physician services

How will we measure success? Low income patients will have access to appropriate physician services when seen through the emergency room or the urgent care center

Accomplishments There were 15,638 underserved patients seen in the emergency room and urgent care clinic through access to physicians covered by this community benefit initiative. This represents 24.5% of all patients seen in these venues. The health care of the underserved was met by these physicians when the patient’s primary care physician office or clinic was unavailable.