Community Benefits Report 2015

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Inside this issue...What are C ommunity Benefits?........................................................................2 Community Benefits By the Numbers Fiscal Year 2015: July 1, 2014 through June 30, 2015

Enhance Health of the C ommunity .....................................................................4 Getting Active Healthy Habits and Health Education Partnering to Do More

Improve Access to Health Care Services ...........................................................10 Physician Recruitment Partnering to Address Primary Care Access Community Paramedicine Pilot Program

Advance Medical or Health Knowledge ...............................................................12

Patients By the Numbers ..............................................................................12

Volunteer C ommunity Boards .........................................................................13

November 2015Dear Friends,

It is our pleasure to present to you our 2015 “Community Benefits Report.” As we hope you will see, Enloe Medical Center is committed to improving the health status of our region by providing quality community education and health screenings, and by ensuring that everyone has access to needed health care regardless of insurance type or ability to pay. In addition to those direct programs, we continue to partner with local agencies to address the top issues identified in our most recent Community Health Needs Assessment: tobacco use, drug and alcohol abuse, and comprehensive mental health services. And we are proud of our collaboration with Butte Community College, Chico State University and other institutions of higher learning to train our next generation of health care professionals.

We hope you enjoy the contents of this report. Thank you for your support.

Sincerely,

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Mike Wiltermood President/Chief Executive Officer

Eric Larrabee Chair of the Enloe Board of Trustees

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What are C ommunity Benefits?Community Benefits are programs or activities designed to promote health and healing, provide treatment and respond to the changing health needs of a community. In 2013, Enloe Medical Center partnered with other health care organizations throughout Butte County to identify the most pressing health needs of our community. Since that time, we have worked with community partners to address the needs identified. A Community Benefit must respond to an identified community need and meet at least one of the following:■ Enhance health of the community■ Improve access to health care services■ Advance medical or health knowledge■ Relieve or reduce the burden of government or other community efforts

Community Benefits By the NumbersAs the focus of our community outreach efforts evolves to include better ways of working together to improve the health outcomes of the communities we serve, Enloe Medical Center is looking for more and more ways to improve the health of individuals throughout our region. By investing in Community Benefits programs designed to “inspire a healthier you,” we hope to contribute to better well-being in all its forms.Enloe Medical Center is committed to organized and sustainable Community Benefits programs providing:■ Free and discounted care to those unable to afford health care■ Care to low-income beneficiaries of Medicaid and other indigent care programs■ Services designed to improve community health and increase access to health care

Traditional Charity Care 6,170 $3,254,175

Bad Debt 19,150 $2,848,995

Medicare 65,425 $45,202,396

Medi-Cal/CMSP 67,755 $41,082,361 Community Education & Service 394,159 $2,669,534

Subsidized Health Services 9,695 $1,164,455

Persons Served Community Benefit with Medicare Shortfall

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Fiscal Year 2015 July 1, 2014 through June 30, 2015

Without Medicare

Shortfall

Persons Served

Expense

Offsetting Revenue

Net Community

Benefit

% of

Expense

% of Net Revenue

Traditional Charity Care 6,170 $3,254,175 - $3,254,175 0.7% 0.6%

Bad Debt 19,150 $2,848,995 - $2,848,995 0.7% 0.7%

Unpaid Costs of Medi-Cal 67,755 $103,855,350 $62,772,989 $41,082,361 9.4% 8.1%

Community Education & Service 394,159 $2,724,695 $55,161 $2,669,534

Subsidized Health Services 9,695 $2,542,941 $1,378,486 $1,164,455

Total 496,929 $115,226,156 $64,206,636 $51,019,520

Charity

Bad Debt

Medicare

Medi-Cal/

CMSP

Subsidized Health

Services

Persons Served (Count of Names) 2,238 10,105 18,289 25,653 6,064

Persons Served (Count of Encounters) 6,170 19,150 65,425 67,755 9,695

With Medicare

Shortfall

Persons Served

Expense

Offsetting Revenue

Net Community

Benefit

% of

Expense

% of Net Revenue

Traditional Charity Care 6,170 $3,254,175 - $3,254,175 0.7% 0.6%

Bad Debt 19,150 $2,848,995 - $2,848,995 0.7% 0.7%

Medicare 65,425 $221,212,538 $176,010,142 $45,202,396 10.3% 8.9%

Medi-Cal/CMSP 67,755 $103,855,350 $62,772,989 $41,082,361 9.4% 8.1%

Community Education & Service 394,159 $2,724,695 $55,161 $2,669,534

Subsidized Health Services 9,695 $2,542,941 $1,378,486 $1,164,455

Total 562,354 $336,438,694 $240,216,778 $96,221,916

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Getting ActivePhysician engagement and physical activity come together in our Walk with a Doc program. Each month, a doctor from a different health spe-cialty shares how exercise can impact health, from strengthening bones and joint health with simple weight-bearing exercise, to improving heart health by gradually increasing duration and intensity, then embarks on a walk through a local park with participants. Participating doctors were:■ Brock Cummings, MD - Orthopedic Surgeon ■ Deron Ludwig, MD - Bariatric Surgeon ■ Scott Nichols, MD - Psychiatrist ■ David Woods, MD - Ophthalmologist ■ Peter Magnusson, MD - Cardiovascular Specialist ■ Michael Fealk, DO - Colorectal Surgeon ■ Corey McNamee, MD - Emergency Physician ■ Ivan Liang, MD - Emergency Physician ■ Paramjit Singh, MD - Neurologist ■ Jeffrey Lobosky, MD - Neuro Surgeon

New this year was Enloe’s Heart & Sole: Run for Wellness. More than 400 people participated in either a one-mile walk or 5k fun run. After the run, participants enjoyed healthy snacks, free health screenings and education about topics ranging from helmet safety for kids to nutrition, weight loss and women’s health. This untimed run with two distances to choose from, encouraged participants of all ages and abilities to participate. For some, crossing the finish line represented months of practice, for others it was their first experience going the distance.

Enhance Health of the C ommunityThis past year, health care professionals throughout Enloe Medical Center have been engaging in a variety of community outreach projects. Our licensed staff work side-by-side with students from Butte College and California State University, Chico to mentor the next generation of qualified caregivers and ensure the region’s access to quality health care for years to come. We continue to partner with local agencies to address ongoing concerns around mental health, tobacco use, and alcohol and drug abuse - some of the top issues identified in our most recent Community Health Needs Assessment. And we are proud to support existing programs designed to engage individuals and families in healthy lifestyle activities that can lead to lifelong healthy habits. We have been inspired over the past year by those of you we see taking charge of your health in new ways. Whether you are learning healthy eating tips to minimize your risk of diabetes, or exercising to improve your joints and heart health, these small changes make a big impact. And this is just the beginning.

Healthy Habits and Health Education

Education and support for lifestyle changes that can impact chronic conditions prevalent among Butte County residents continues to be a focus for our community outreach programs. Giving individuals the resources and tools they can use to lower common risk factors for diabetes, heart health, and obesity, among others, leads to an overall healthier population.

As a Baby Friendly hospital, our Mother & Baby Care Center supports new moms in initiating infant feeding and mother-baby bonding. Enloe’s Mother & Baby Education Center also offers breastfeeding classes for expectant moms and support from specially trained lactation consultants when baby arrives. Even with all that, there are times when a new mom isn’t able to produce her own breast milk and a medically vulnerable newborn may require donated breast milk. In August 2014, in celebration of World Breastfeeding Month, Enloe partnered with Mothers’ Milk Bank to host a Community Milk Drive. The drive raised awareness of the process of safe breast milk donation and reinforced the health benefits of breastfeeding, including reducing the incidence of sudden infant death syndrome and lowering a child’s risk of childhood obesity and juvenile onset diabetes.

Enloe Medical Center’s annual Community Wellness Expo brought together health care professionals from throughout the organization, as well as a number of community partners who share our mission for well- being. This free event offered participants the opportunity to not only get a free flu shot and safely dispose of unused medications, but also to engage in activities encompassing health for the mind, body and spirit.Guests were treated to freshly picked apples, healthy cooking demonstrations, and aromatherapy. Our younger guests enjoyed a healthy plate art activity teaching them about good nutrition, as well as the kids’ physical activity station. Medicare and Medi-Cal enrollment information was made available to help increase access to health care, and participants were given the opportunity to voice their opinion of the most pressing health issues facing Butte County. Nearly 800 flu vaccines were administered and more than 700 free health screenings were conducted, including: ■ Abdominal Aortic Aneurysm Screening■ Blood Pressure Screening ■ Depression Screening■ Diabetes Risk Assessment■ Flexibility Testing■ Grip Strength

Physicians and other health care professionals visited a number of community and service organizations to talk about health as part of our revitalized Speakers Bureau. Topics included:■ Alcohol poisoning and how to address highly intoxicated persons in public■ The emotional and psychological impact of eating habits and how they impact obesity, diabetes and other

chronic conditions■ Women’s heart health and the latest technological advances in treating heart disease■ Update on the Affordable Care Act

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■ Metabolic Testing■ Pulmonary Function Screening■ Pulse Oximetry ■ Sleep Apnea Screening■ Step Test■ Stroke Risk Assessment

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Advanced Cardiovasular Life SupportThroughout the year, Enloe’s Education Center provides Advanced Cardiovasular Life Support (ACLS) classes for health care professionals. In fiscal year 2015, more than 220 individuals participated in the certification courses.

In addition, the Education Center partnered with Butte County EMS to bring awareness and education of proper lifesaving techniques to the public. In attempt to make learning CPR fun, a team of volunteers visited Chico’s Thursday Night Market with CPR training dummies, performing hands-on demonstrations in proper CPR technique to the tune of “Staying Alive.”

Education and demonstrations for hands-only CPR and use of an automated external defibrillator were also provided at our annual Community Wellness Expo and The Gateway Science Museum.

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Support Groups

Living with an illness or chronic disease can be difficult and sometimes isolating. Support groups can offer valuable information and comfort. ■ ALS Support■ A.W.A.K.E. (sleep apnea)■ Bariatric Buddies■ Bereavement Suppot■ Cancer Support

Butte County EMS Out in the C ommunityAmbulance crews provided free standby service at local events, including:• Almond Bowl• Almond Bowl Run• Chico Criterion• Durham High School Football• Growing Healthy Children• Public Safety Day• PV High School Football• Run for Food• Stonyford Rodeo• Suicide Prevention Walk• Walk MS-Chico• Walk to End Alzheimer’s• Wings of Eagles

■ Diabetes■ Fibromyalgia■ Head Trauma■ Healthy Hearts■ Huntington Disease

■ Ostomy Support■ Second Wind Pulmonary■ Multiple Sclerosis (MS)■ Stroke

Healthy Habits and Health Education (continued )

Diabetes continues to be a concern for Butte County residents, with nearly 9 percent of adults age 20 and older having been diagnosed with this chronic condition. While diabetes is influenced by genetic factors, obesity or being overweight is a leading risk factor for diabetes, along with high blood pressure and a sedentary lifestyle. In an attempt to address these modifiable risk factors, Enloe Medical Center held several events.

In November, renowned diabetes expert Richard Aguilar, MD, came to Chico for a presentation aimed at those already diagnosed with Type 2 diabetes. Nearly a hundred people attended that event, Simplifying Diabetes, during which Dr. Aguilar discussed what he calls the “diabetes train,” the continuing progression of diabetes that can be slowed with proper management, but can never be reversed. He shared tangible information participants could use to manage their disease through nutrition, exercise, and medication.

In support of the American Diabetes Association’s Diabetes Alert Day, our Diabetes Services team hosted a Diabetes Alert Screening Day in March during which they conducted free blood glucose screenings for the public. Armed with their blood sugar number, participants were encouraged to explore educational booths to learn more about what those numbers mean.

Pre-diabetes is a condition in which an individual’s blood glucose levels are higher than normal, but not yet high enough to warrant a diagnosis of Type 2 diabetes. In California, it is estimated that approximately 11.4 million people have pre-diabetes. In April, Enloe Medical Center launched a quarterly Pre-Diabetes Class aimed at reaching these individuals. The class covers strategic ways to use diet, exercise and realistic goal-setting to lower the risk of elevating blood sugar levels into the diabetes range.

Drop the DrugsWith drug induced death rates at an alarming level in Butte County (36 deaths per 100,000 population, compared with the Healthy People 2020 national objective of no more than 11.3), reducing access for inappropriate use of medications continues to be a focus. For years, Enloe Medical Center partnered with the Butte County Sheriff ’s Office and Drug Enforcement Administration (DEA) for the spring National Prescription Drug Take-Back Day. This year, due to changing regulations with the DEA, Enloe partnered with the Butte County Department of Public Works for safe disposal of collected medications to ensure the program continued. During the spring collection, 266 pounds of over-the-counter and prescription drugs were collected, effectively eliminating possible misuse.In addition, Enloe partnered with Chico Police and the Butte County Department of Public Works to offer a second opportunity for safe medication disposal as part of our annual Community Wellness Expo in October.

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C ommunity Blood Drives & Free Flu Clinics Enloe Medical Center partnered with BloodSource to hold five Community Blood Drives in fiscal year 2015, collecting more than 140 pints of blood. According to BloodSource, approximately one out of every seven people entering the hospital needs blood, and one donation has the potential to save as many as three lives.Fall is the start of flu season and once again Butte County Public Health provided vaccine enabling us to offer a number of free flu clinics. In total, Enloe administered more than 3,200 flu vaccines.

Chico Area Recreation & Parks District Healthy Aging Summit & Senior ExpoThe Healthy Aging Summit & Senior Expo brings together community resources for area seniors. Representative from Enloe’s Outpatient Therapy Services, HomeCare and Cardiac Rehabilitation Program participated in the event, offering free health screenings and education. Participants had fun testing their balance with the Wii Fit, learned nutrition tips for a healthy heart and more.

Growing Healthy Children Run/Walk The annual Growing Healthy Children Run/Walk brought out more than 300 kids and their families to participate in the one-mile walk or 5k fun run. After the run, families were treated to fresh fruit and water, and at a number of educational booths, kids learned about healthy living while having fun - all free for families. Making healthy living fun is the first step to instilling life-long habits of exercise and good nutrition.

Partnering To Do MoreWhen we work together, amazing things can happen. That is why Enloe Medical Center is pleased to partner with other non-profit organizations throughout our region to address many of the health issues facing area families. Community collaborations like the Healthy Aging Summit & Senior Expo, Growing Healthy Children Run/Walk, and Dia del Campesino are good examples of coming together to inspire health among traditionally underserved populations.

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Hispanic Resource Council Dia del CampesinoDia del Campesino (Farm Worker’s Day) is a community event hosted annually by the Hispanic Resource Council. Representatives from Enloe’s Cardiac Rehabilitation Program, Diabetes Services and Behavioral Health provided education and free health screenings to address some of the chronic health conditions prevalent among the Hispanic population. In addition, kids were engaged in fun activities to learn about healthy eating.

Smoke-Free, Drug-Free Night in City Plaza

Smoking is a leading modifiable risk factor for heart disease and stroke. That’s why we partnered with the California Health Collaborative and Downtown Chico Business Association for their annual Smoke-Free, Drug-Free Night. Representatives from Enloe’s Stroke and Cardiac and Pulmonary Rehabilitation Programs interacted with the community, offering free blood pressure screenings and stroke risk assessments. The Future of Alzheimer’s DiseaseMore than 200 people attended this presentation, hosted in partnership with the Alzheimer’s Association, for families and caregivers facing Alzheimer’s disease. Presenting physicians Joel Rothfeld, MD, PhD (Neurologist and member of Enloe’s Medical Staff ) and Geoffrey Kerchner, MD, PhD (Assistant Professor, Department of Neurology & Neurological Sciences; Director of Research, Stanford Center for Memory Disorders; Stanford University School of Medicine) shared information about the causes of dementia, symptoms and risk factors for Alzheimer’s disease, plus the latest research and therapies available.

More Supported Programs• Ability First

Youth Sports Camp• American Foundation

for Suicide Prevention: Out of the Darkness Walk

• American Junior Golf Association

• Assisted Living Collaborative of Chico

• Butte County Sheriff ’s Search & Rescue Team

• Catalyst: Youth Empowered Conference

• Chico Chamber of Commerce• Chico High School:

Sports Boosters & Sober Grad Night

• Chico Little League• Chico Performances• Drop the Drugs:

National Prescription Drug Take-Back Day

• Durham High School: Sober Grad Night

• Girls on the Run of Butte County

• Making Strides Against Breast Cancer

• National MS Society: Walk MS-Chico

• Pleasant Valley High School: Sports Boosters & Sober Grad Night

• Relay for Life• Run for Food• Stonewall Alliance:

Chico Aids Run/Walk• Wings of Eagles

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Improve Access to Health Care ServicesEnloe Medical Center’s Century Project began in 2007. In 2012, the Magnolia Tower opened, doubling the size of the existing Medical Center. In 2015, we opened the second phase of our new Emergency Department - bringing the space to 25,000 sq.ft., with 39 beds - thus completing the Century Project construction. In recent years, as access to primary health care continues to challenge our region, we’ve seen an increase in the number of patients seeking care in our Emergency Department. In fiscal year 2013, we saw 45,699 patients in our emergency room. In fiscal year 2015, that number had increased nearly 23 percent to 56,033 emergency room visits.The investment made to nearly triple the size of the original emergency department has allowed us to accommodate the growing volume of patients by streamlining workflows, adding new physicians, physician shifts and staff, including mid-level practitioners to help with patient triage and reducing wait times.

P hysician Recruitment

Access to primary and specialty care physicians continues to challenge the region. According to the latest County Health Rankings data, Butte County has one primary care physician (PCP) per 1,497 residents. In fiscal year 2015, we recruited three new PCPs to the area - two Family Practice doctors and one Internist - and added a new Obstetrics & Gynecology specialist and one Prompt Care doctor to our medical staff.In total, Enloe Medical Center dedicated $764,243 to bringing 18 new physicians in 11 different medical specialties to the region.

■ Anesthesiology ■ Emergency Medicine ■ Family Practice ■ Hospitalist Medicine

Partnering to Address Primary Care Access

To further address the shortage of primary care coverage in our area, Enloe Medical Center has been working with Ampla Health, Northern Valley Indian Health, Immediate Care, Premiere Primary Care and other provider groups to bring more primary care physicians to the area and to care for the community.

C ommunity Paramedicine Pilot Program

In early 2015, Butte County EMS established one of 12 Community Paramedicine pilot programs in the state. The team of nine paramedics received specialized training, including 140 hours of didactic and 80 hours of clinical training in preparation for a July launch of the program. Community paramedicine is an emerging field in health care in which paramedics operate outside their customary emergency response and transport roles to facilitate more appropriate use of emergency care resources or enhance access to primary care for medically underserved populations. The Butte County program is designed specifically to follow up with patients recently discharged home from Enloe Medical Center with a diagnosis of heart attack or heart failure. Within 72 hours of discharge, a community paramedic follows-up by phone with identified patients, asking a series of questions to determine the individual’s health status and whether special services are needed to avoid the potential for an unnecessary ambulance transport or emergency room visit. Services provided by a community paramedic may include: ■ Home visits and safety assessments■ Facilitating transportation to a pharmacy or follow-up cardiology appointment■ Help with understanding or accessing medications

■ Internal Medicine■ Obstetrics & Gynecology■ Ophthalmology ■ Oral & Maxillofacial Surgery

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■ Ortho-Trauma ■ Prompt Care ■ Radiology

Advance Medical or Health KnowledgeIn fiscal year 2015, Enloe Medical Center provided nearly a million dollars towards educating the next generation of health care providers and advancing the knowledge of physicians, nurses and other health care professionals. The Enloe Education Center offers a wide array of symposiums, review and specialty courses throughout the year to enhance the knowledge of health care professionals. Among the continuing medical education topics addressed this year were diabetes, prescription drug abuse and the maternal safety bundle. Other Continuing Education topics included:■ Trauma ■ Emergency Medicine■ Pulmonary Medicine■ Neurological Medicine■ Critical Care

In addition, more than 2,200 health care professionals - including physicians, nurses, technicians and others - participated in Ground Rounds, Tumor Boards and Case Reviews.

More than 40 physical therapy interns from seven different states participated in Clinical Rotations at Enloe’s Rehabilitation Center; and 70 fourth semester nursing students from Butte College completed a Quality Management Rotation as part of their leadership training.The Rural Northern California Clinical Simulation Center - a collaboration between Enloe Medical Center, Feather River Hospital, CSU, Chico and Butte College - provided specialized training in a clinical setting for an average of 180 students monthly, as well as continuing education for hospital staff. Recruiting and education efforts at middle and high schools throughout the region include career fairs, job shadowing, ROP programs and more. Additionally, students from Butte College and CSU, Chico participate in community health programs, working side-by-side with health care professionals, providing health screenings and education for underserved or at-risk populations.

Patients By the Numbers

179Heart Surgeries

438Rehabilitation Inpatients

500Trauma Activations

723FlightCare Transports

752Behavioral Health Inpatients

1,533Deliveries

14,223Same Day Surgeries

14,935Patients Seen for Diabetes

56,033Emergency Room V isits

230,129Total Patients Served

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■ Colorectal Cancer■ Bariatrics■ Wound Management ■ Diabetes

Enloe Foundation Board of Directors

Mark Kimmelshue, ChairMelisse Larrabee, Vice ChairMichael Dailey, SecretaryScott ChalmersChristie ChryslerKenneth N. DerucherLiz FlemingLaverna HubbardTom HughesSandy KalinowskiEric LarrabeeMichael MarksTom MartinSusan R. MinasianMike O’DonnellNicole PlottelConnie Rowe, VP-Patient Care ServicesPatti SouzaRichard SteinJim Stevens

Enloe Medical Center Board of Trustees

Eric Larrabee, ChairCarol Huston, DPA, Vice ChairJack Sterling, SecretaryDenise AdamsCarrie AldenCindy Bennington-FoorWilliam CarriereCraig DuncanMatthews D. Jackson, Sr.Mark Kimmelshue, Ex OfficioTom LandoJeffrey Lobosky, MDSean Maiorano, DO, Ex OfficioForrest Olson, MDMark Schwabe, MD, Ex OfficioMonroe Sprague, MDMike Wiltermood, Ex Officio

Enloe Medical CenterVolunteers Board

Ronnie Campbell, PresidentPam deMello, President-ElectHelen Deatsch, VP-RecruitmentCasey Sohnrey, VP-Special EventsCarol Moreland, Assistant VP-Special EventsMaureen Duquette, Gift Shop LiaisonJackie Carley, Finance LiaisonAnne Marie Madsen, Member at LargeBev Silliman, Member at LargeRoseanna Galindo-Kuhn, Director-Volunteer ServicesCarol Linscheid, VP-Human Resources

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Volunteer Community Boards

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