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We’re in Your Neighborhood! 
UMassMemorial 
Health Care 
Community Benefits Report 2013
It has been a year and a half since I assumed the role of president and CEO of UMass Memorial 
Health Care, Inc. During th...
UMassMemorial 
Health Care 
Community Benefits Mission 
UMass Memorial Health Care is committed to improving the health st...
A Road Map for 
Worcester neighborhoods
Community health improvement plan update 
First completed in 2012 through a joint effort co-led by 
UMass Memorial, the Ci...
pediatric chronic 
disease management 
4 UMass Memorial Health Care
an inNOVATIVE partnership 
IN-HOME ASTHMA EDUCATION 
infestations. Referred by school nurses—a unique aspect of 
this prog...
VIOLENCE AND 
INJURY PREVENTION
A SUCCESSFUL STRATEGY 
goodS FOR guns 
Michael Hirsh, MD, surgeon-in-chief of UMass 
Memorial Children’s Medical Center an...
cooking matters 
Cooking Matters®, an interactive course developed by 
Share Our Strength to fight hunger and poverty, emp...
HEALTHY EATING AND ACTIVE LIVING 
A NUTRITIONAL FOCUS 
Cooking Matters® was offered in response to 
neighborhood residents...
a neighborhood effort 
access to healthy food 
UMass Memorial Health Care supports a range of efforts 
in distressed, food...
Great Brook 
Valley 
Bell Pond 
Backyard and Community 
Gardens, and Worcester 
Veggie Mobile Stops 
Elm Park 
Rt 
290 
Rt...
a positive approach 
YOUTH development 
HOPE Coalition Youth Worker Training Institute (YWTI) 
This 15-week course is desi...
A 20-year collaboration 
worcester youth center 
When a group of youths was arrested for loitering and 
disturbing the pea...
Great Brook 
Valley 
Bell Pond 
Care Mobile Stops 
and Affiliated Schools 
Elm Park 
Rt 
290 
Rt 
9 
Shrewsbury Street 
Rt...
UMass memorial ronald mcdonald care mobile 
schools (see map). Children receive screenings, fluoride 
treatments and seala...
access to health care 
16 UMass Memorial Health Care
A COMMON LANGUAGE 
Elder Semi-Urgent Care 
As baby boomers reach age 65, seniors account for the 
fastest growing sector o...
A HEALTHY COMMUNITY 
a focus on public health 
Wing Memorial Hospital 
To improve access to care as well as monitor and ed...
reducing health care disparities 
hepatitis screening and treatment 
Hepatitis C (HCV) is transmitted through blood-to-blo...
our system supports a variety of community and neighborhood initiatives 
Access to Care 
• Oral health and primary care at...
UMass Memorial Health Care System 
Wing Memorial Hospital Marlborough Hospital 
Licensed Beds 
System Total 
1,083 
Health...
UMass Memorial Health Care is a not-for-profit health care system in 
Central New England with nearly 2,000 physicians and...
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2013 UMass Memorial Community Benefits Report

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The hospitals of UMass Memorial Health Care work with their respective communities to address identified needs of the medically underserved. Each hospital offers a number of community benefits programs that link our vast clinical and community resources to overcome barriers to accessing care and addressing health disparities. Our 2013 Community Benefits Report highlights some of these programs that meet the needs of vulnerable populations.

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2013 UMass Memorial Community Benefits Report

  1. 1. We’re in Your Neighborhood! UMassMemorial Health Care Community Benefits Report 2013
  2. 2. It has been a year and a half since I assumed the role of president and CEO of UMass Memorial Health Care, Inc. During this time, our hospitals have completed a community health needs assessment and are working with their respective communities to address identified needs of the medically underserved. Improving the health of the community requires addressing the complex social factors that impact health and people’s ability to make healthy choices. In today’s era of health care reform, we must incorporate population and public health strategies into our approach along with transforming how we deliver care. Developing innovative models that link our vast clinical and community resources are key to overcoming barriers to accessing care and addressing health disparities. As such, all of our health care entities continue to work closely with their local public health departments and a broad range of community partners to achieve the greatest collective impact in improving health outcomes. Most recently, UMass Memorial Medical Center and the Worcester Division of Public Health convened stakeholders to complete a grant application to the Massachusetts Prevention and Wellness Trust Fund (PWTF). As a result, Worcester was selected as one of nine communities in the state to receive PWTF funding for innovative interventions that use clinical/community links to reduce preventable conditions and health care costs. We are thrilled that as a result of the PWTF award our Pediatric Asthma Home Visiting Pilot project will be expanded to schools across the City of Worcester where the rate of asthma-related emergency room visits for children ages 0 to 19 is double that of the state. As we move forward, community health improvement and prevention efforts such as these are crucial to our mission of addressing health care disparities in the most patient- and family-centered, cost-effective manner. I look forward to sharing our progress with you in the coming year. System Hospitals UMass Memorial Medical Center Patrick Muldoon, FACHE, President and CEO Mónica Lowell, Vice President, Community Relations Clinton Hospital Sheila Daly, RN, MS, CPHQ, President and CEO Rosa Fernandez-Peñaloza, Manager, Community Benefits/Interpreter Services HealthAlliance Hospital Deborah Weymouth, FACHE, President and CEO Kelli Rooney, Interim Director, External Affairs and Marketing “ Developing innovative models that link our vast clinical and community resources are key to overcoming barriers to Marlborough Hospital Steve Roach, President and CEO Mary Ann Stein, Director, Volunteer Services and Community Outreach Wing Memorial Hospital and Medical Centers Charles Cavagnaro III, MD, President and CEO Teresa Grove, Director of Development, Marketing and Public Relations accessing care and addressing health disparities. ” Inside the Report 1. UMass Memorial Community Benefits 3. Community Health Improvement Plan (CHIP) 5. In-Home Asthma Education Pilot 7. Goods for Guns 8. Cooking Matters 9. Healthy Eating and Active Living 10. Access to Healthy Food 11. Backyard Gardening 12. Youth Development 13. Worcester Youth Center 14. Improving Access 15. UMass Memorial Ronald McDonald Care Mobile 17. Elder Semi-Urgent Care 18. Focus on Public Health 19. Hepatitis Screening and Treatment 20. Community and Neighborhood Initiatives Inside Back Cover: UMass Memorial Health Care System dear friends and Colleagues, Eric W. Dickson, MD, MHCM, FACEP President and CEO UMass Memorial Health Care, Inc. Cover: View of Bell Hill neighborhood and UMass Memorial Hospital
  3. 3. UMassMemorial Health Care Community Benefits Mission UMass Memorial Health Care is committed to improving the health status of all those it serves and to addressing the health problems of the poor and other medically underserved populations. In addition, nonmedical conditions that negatively impact the health and wellness of our community are a priority. WHAT ARE Community Benefits? Community Benefits are programs and services provided by not-for-profit hospitals to improve community health. They are designed to respond to identified community needs and address health disparities among disadvantaged and vulnerable populations. Community Benefits are not provided for marketing purposes and must meet at least one of the following criteria: • Improve access to health care services • Enhance the health of the community • Advance medical or health knowledge • Relieve or reduce the burden of government or other community efforts In 2013, UMass Memorial Health Care contributed nearly $154.0 million to positively impact the health and well-being of the communities we serve. Our Community Benefits contributions support charity care, subsidized health services, education of health professionals, community-based programming and partnerships. In addition, almost $6.9 million in other non-Community Benefits expenses were absorbed through bad debt write-offs and Medicare shortfalls. Community Benefits Total $154.0 Million Subsidized Health Services $10.0 M Health Professions Education $74.5 M Contributions Associated with Charity Care $64.8 M Community Health Programs Partnerships, Donations, Community Building $4.7 M 2013 Other Significant Expenses Total $6.9 Million Bad Debt* $4.6 M Medicare Shortfall** $2.3 M * Bad debt: Expenses for receivables that can no longer be collected and are written off. ** Medicare shortfall: Net loss incurred for the cost of providing services to Medicare patients versus income received from the Medicare program. Community Benefits Report 2013 1 1
  4. 4. A Road Map for Worcester neighborhoods
  5. 5. Community health improvement plan update First completed in 2012 through a joint effort co-led by UMass Memorial, the City of Worcester Division of Public Health and Common Pathways, the Greater Worcester Community Health Improvement Plan (CHIP) is structured around five principal “domains” with specific, measurable objectives and an overarching mission of making Worcester and the region “the healthiest in New England by 2020.” Initial efforts included a Community Health Needs Assessment (CHA) of the City of Worcester and the outlying towns of Shrewsbury, Millbury, West Boylston, Leicester and Holden and involved the collection and analysis of data from multiple primary and secondary sources including key informant interviews. An online survey to which more than 1,300 individuals responded was also used. In total, approximately 1,745 individuals representing a range of populations and institutions including neighborhoods, youth, immigrants, seniors, government, philanthropy, education, social services and health care provided input. In 2013, the first annual update of the CHIP was released at a press conference attended by approximately 100 community members and stakeholders. The revised report was developed using key findings from the CHA and a detailed literature review to assess and select appropriate data-driven priority goals, objectives and strategies. Progress was made in reevaluating goals to be challenging yet realistic; fine-tuning measurements of success to reflect regional, state and national trends; and refocusing or, in some cases, eliminating strategies to more accurately address targeted outcomes. The CHIP is a roadmap for the future health of the region and intended to be a living document that will be reassessed annually. By design, the UMass Memorial Community Benefits Plan aligns with the report to maximize collective impact. The original CHIP, the 2013 update and the CHA are all available on the UMass Memorial website*. *See http://www.umassmemorialhealthcare.org/umass-memorial-medical- center/patients-visitors/community-benefits-programs/ community-health-needs-assessment “ The five identified Priority Areas will be referred to as ‘Domain Areas’ to reflect their equal importance: Healthy Eating/Active Living; Behavioral Health; Primary Care/Wellness; Violence/Injury Prevention; and Health Equity/Health Disparities.” –Derek Brindisi, Director of Public Health, City of Worcester Prevention and Wellness GRANT AWARD grant partners The PWTF grant is funded through Chapter 224 of the Acts of 2012 Massachusetts Health Care Reform to lower costs and make quality, affordable care a reality. Grant strategies address preventable health conditions using evidence-based and -informed program policy and system change. PWTF Asthma Intervention Grant Partners: City of Worcester Health Department Edward M. Kennedy Community Health Center Family Health Center of Worcester UMass Memorial Plumley Village Health Services UMass Memorial Pediatric Primary Care UMass Memorial Pediatric Pulmonology UMass Memorial Office of Clinical Integration Worcester Community Legal Aid Worcester Head Start Program Worcester Public Schools Building on the CHIP, the City of Worcester was selected as one of nine communities in Massachusetts to receive a 2013 Prevention and Wellness Trust Fund (PWTF)* grant. UMass Memorial and the Worcester Division of Public Health convened and led a group of diverse community partners through an application process that targets improving health outcomes for chronic conditions while reducing health care costs. The award will bring more than $7 million over 30 months for three citywide interventions: pediatric asthma, hypertension and falls prevention. Worcester’s strong collaborative effort is serving as a leading example for public health initiatives on a state and national level. *www.mass.gov/eohhs/gov/departments/dph/ programs/community-health/prevention-and-wellness Community Benefits Report 2013 3 1
  6. 6. pediatric chronic disease management 4 UMass Memorial Health Care
  7. 7. an inNOVATIVE partnership IN-HOME ASTHMA EDUCATION infestations. Referred by school nurses—a unique aspect of this program—parents and students meet at home with a known and trusted UMass Memorial community health worker (CHW). “It’s important to provide family-centered care in the context of home and culture,” continued Dr. Nazarian. “If we focus solely on medication, we may overlook something. A culturally competent CHW is an effective liaison to a child’s home, school and medical home.” Parents may keep asthmatic children at home due to cold weather, lack of transportation to pick up inhalers or caring for a young baby at home. When they gain awareness that asthma is controllable and their child can participate more fully at school, they become more invested in a management plan. “We have to be proactive about asthma, and addressing it only at an annual physical isn’t the best option,” added Dr. Nazarian. “We need to see children more often and focus on education and prevention. By engaging school nurses and in-home CHWs to reiterate the message, we provide a multi-pronged approach that works for these families who have so many competing priorities for basic needs.” In 2014, the asthma pilot will be expanded under the Prevention and Wellness Trust Fund grant (see page 3) to include a clinical care team comprised of a provider champion, a clinical care manager and community health workers. The pediatric pulmonology department will work closely with school nurses. Asthma Pilot Program Partners Belmont Street Community School UMass Memorial Plumley Village Health Services UMass Memorial Pediatric Primary Care Worcester Community Legal Aid “Asthma is a common condition that affects about 10 percent of our patients,” said UMass Memorial pediatric primary care physician Beverly Nazarian, MD. “It’s serious for children living in low-income housing because they may be exposed to more triggers and parents cannot make changes to their rented home. Based on successful evidence-based programs elsewhere, we piloted an approach coordinated through a local school that includes legal assistance as well as in-home visits to identify triggers, provide appropriate cleaning and bedding supplies, and connect families to asthma education and other resources.” One area of need, just two blocks from the hospital’s Memorial Campus, is Belmont Street Community School (BSCS) where principal Susan Proulx, EdD, wanted to address the high rate of absenteeism among asthmatic students. Located in a highly diverse, distressed neighborhood with a large Latino population, BSCS serves students who live in public housing and old housing stock. Asthma is prevalent because in addition to common triggers like cigarette smoke, pets and pollen, there are more insidious problems: mold, dust mites, mice and roach “ Our collaborative effort identifies students, acquires parental consent, and conducts visits to identify possible environmental causes. ” – Susan Proulx, EDD, Principal, Belmont Street Community School Emergency Room Pediatric Respiratory Visits Worcester Massachusetts (Per 100,000, ages 0-19) Community Benefits Report 2013 5 1
  8. 8. VIOLENCE AND INJURY PREVENTION
  9. 9. A SUCCESSFUL STRATEGY goodS FOR guns Michael Hirsh, MD, surgeon-in-chief of UMass Memorial Children’s Medical Center and the Division of Pediatric Surgery and Trauma, speaks passionately when remembering a friend and medical colleague who was killed by a teen with a handgun in 1981. “That event was seminal in putting me on the path to prevent gun violence. I know that the gun is a coveted object protected by our Bill of Rights, but along with that right is the responsibility to store it properly. In 2010, of 31,000 gun deaths nationwide, 12,000 were homicides and 19,000 suicides. Recent research by the Harvard School of Public Health also reveals that in the last five years, rifles were involved in more than half of teen suicides. We have to look at the gun as a vector—in the same way that the mosquito was a vector for yellow fever that killed troops during the Spanish American War—that quickly changes personal and interpersonal conflict into lethal violence.” Goods for Guns, in conjunction with the Worcester Police Department and part of a more comprehensive injury prevention agenda, is a buyback program that removes weapons from homes and the streets. Coupled with the spirit of the December holiday season, owners exchange guns for gift certificates that can be redeemed in local grocery stores. Buyback events have been more successful here than in cities where cash is distributed. “Worcester has the lowest rate of penetrating trauma—by knife or gun—of any city in Massachusetts. Our track record makes the point, but sometimes money speaks loudest,” continued Dr. Hirsh. “Since 2002, 2,396 weapons have been retrieved, two-thirds of which are handguns or semi-automatic weapons. Supported in part by UMass Memorial, we have paid $53 per gun, or about $127,000, which is less than the cost of treating just four gunshot victims. While we are pleased with our collection effort, the problem remains. As Acting Commissioner of Public Health for the City of Worcester, I can’t be complacent about it. We have made it part of the Community Health Improvement Plan and use it to have difficult conversations. If we make people aware and responsible, tragedies will be averted.” “ We have to look at the gun as a vector . . . that quickly changes personal and interpersonal conflict into lethal violence. ” –Michael Hirsh, MD, surgeon-in-chief of UMass Memorial Children’s Medical Center and the Division of Pediatric Surgery and Trauma program goals To teach safe gun storage To distribute free trigger locks To promote home gun safety Goods for guns partners UMass Memorial Medical Center Wegman’s Worcester Division of Public Health Worcester Office of the District Attorney Worcester Police Department Guns Retrieved Since 2002 (Total = 2,396) Semi-Automatic/ Automatic 884 Pistols/ Revolvers 913 Long Guns 599 Community Benefits Report 2013 7 1
  10. 10. cooking matters Cooking Matters®, an interactive course developed by Share Our Strength to fight hunger and poverty, empowers low-income families to stretch their food budget and serve healthy meals at home. With funding from UMass Memorial, the series of six classes for adults—team-taught by a volunteer chef and nutrition educator—focused on food shopping, meal preparation, budgeting and nutrition at five community sites in Worcester. “We use an evidence-based curriculum structured on the United States Department of Agriculture Dietary Guidelines for Americans and MyPlate,” said Alicia McCabe, Massachusetts State Director. “Our priority is mothers with babies and young children. Parents are recruited, not referred, by partner organizations and we adapt the course to include what they want to learn. We respect that participants make choices and decide what works best for them in their own lives.” Everyone receives a cookbook and kitchen tools, and is involved in meal preparation every week. Families also take home groceries to replicate recipes. The first class emphasizes a balanced diet. Participants read nutrition fact labels, prepare recipes using a variety of food groups and talk about kitchen safety—food handling and knife use. The following week, they look at whole grains, fruits and vegetables, and how to incorporate them more often in their family meals. Week three addresses sources of lean protein, healthy fat and calcium. The importance of breakfast, making healthy choices away from home, and ways to add flavor without salt round out the fourth class. A field trip to the grocery store is scheduled in week five where the group talks about store layout, unit pricing, and how to make meals within budget. The course concludes with a discussion of beverages and exercise. Healthy cooking is a major contributor to a healthy life, and sharing this knowledge with families on a budget is an important preventive measure against obesity. The kitchen classroom offers a safe space to acquire new skills, explore different foods and make favorite recipes healthier. “It’s one thing to say that squash is healthy, or expect that on your advice someone is going to use limited dollars to buy it,” observed Ms. McCabe. “The challenge is to make it appealing to them, their family and even their picky four-year-old.” 8 UMass Memorial Health Care
  11. 11. HEALTHY EATING AND ACTIVE LIVING A NUTRITIONAL FOCUS Cooking Matters® was offered in response to neighborhood residents who identified cooking classes as an area of interest during the Community Health Improvement Plan process (see page 3). Nearly 60 individuals participated, impacting about 135 family members. Sites included YWCA, Plumley Village Health Services, South Worcester Neighborhood Center, YOU, Inc. Teen Living Program and Worcester Head Start. key factors for Obesity • Food insecurity and hunger are highly correlated with overweight and obesity. • Hunger and poor nutrition impair children’s development and learning. • Without supermarkets, neighborhoods rely on convenience stores that offer lower-quality, less nutritional food at higher prices. Promoting CityWide Physical Activity Wheels to Water In collaboration with the City of Worcester, this summer activity served 1,422 youth, provided 2,554 swimming lessons and created jobs for 144 teens. Free transportation and a nourishing meal are also important components of the program. 1,422 Youth participated in Wheels to Water activities After-school and summer exercise for the underserved UMass Memorial supports summer and after-school programs at Belmont Community School, where 93 percent of students receive free or reduced lunch and lack access to fitness and sports opportunities. A total of 137 elementary school students participated throughout the year. Addressing high rates of obesity among Asian youth More than 170 youth took part in MyPlate nutrition workshops and Southeast Asian Coalition (SEAC) dance and exercise activities. Annually serving 2,000 people of all ages, SEAC also offers English language classes, job training and a connection to the UMass Memorial Care Mobile. Community Benefits Report 2013 9 1
  12. 12. a neighborhood effort access to healthy food UMass Memorial Health Care supports a range of efforts in distressed, food-insecure neighborhoods to improve nutrition among vulnerable populations and increase access to healthy food. Plumley Village Community Garden Established at a public housing site in May 2011, the garden is planted annually and maintained by approximately 24 families. Grant Square Urban Agriculture Launched in 2010, this Bell Hill neighborhood garden is made possible through a partnership with the Regional Environmental Council (REC). UMass Memorial funding employs five inner-city youths and leverages additional money for seven more youth positions. Expanded from 10 to 20 beds in FY13, REC’s YouthGrow garden supplies produce to its Veggie Mobile (see map) and farmers’ markets, that are also supported by the hospital. Funding doubles food stamp values at Bell Hill Veggie Mobile stops. Clinton Hospital and WHEAT Partnership To address hunger locally, Clinton Hospital partnered with Morrison Health Care Food Services and WHEAT Community Services, an organization that helps people to secure essential needs such as food, housing and workforce assistance. WHEAT serves hot, nutritious meals free of charge to 60 to 80 residents monthly in its café and refers clients to the hospital for health insurance and SNAP (food stamps) enrollment. Worcester Food & Active Living Policy Council (WFALPC) UMass Memorial is a strong supporter of WFALPC, which convenes the Community Health Improvement Plan Healthy Eating & Active Living Work Group and the Childhood Obesity Sub-Group targeting healthy weight and healthy eating efforts. The group focuses on policy and advocacy to promote healthy eating. “ Having a vegetable garden in the back of my house is the most wonderful experience for our family and an excellent project for Bell Hill.” Yanet Slovan, Worcester, MA (photo right) 10 UMass Memorial Health Care
  13. 13. Great Brook Valley Bell Pond Backyard and Community Gardens, and Worcester Veggie Mobile Stops Elm Park Rt 290 Rt 9 Shrewsbury Street Rt 190 Downtown Rt 290 Green Island backyard gardening Tatnuck Square Columbus Park South Worcester Quinsigamond Village Rt 390 Rt 290 Backyard gardens are springing up in a food-insecure Worcester neighborhood where access to fresh vegetables is limited by lack of a supermarket and transportation. Even the terrain presents a challenge. “Bell Hill is just that, a steep hill that makes it difficult for residents to carry groceries from store to home,” said Ana Rodriguez, community liaison, UMass Memorial Community Relations. “Backyard gardening is part of our strategy to combat obesity and encourage healthy eating. I knocked on doors to recruit families who agreed to water and weed the garden, and at the end of summer, share homegrown produce with neighbors. Immediately, six families signed up and more were on a waiting list. Worcester Technical High School built the raised bed gardens and the City of Worcester provided fresh soil. Families selected what they wanted to grow.” A barrier to backyard gardening in Bell Hill is soil contamination— specifically lead from exterior paint on old housing stock. While gardening is done in raised beds, dust blown from the surrounding area, even in small yards, can make vegetables unsafe to eat. Therefore, soil testing is required at all home sites before gardens are established. “This project is an ideal extension to a successful community garden we started in nearby Grant Square Park through a partnership with UMass Memorial and the City,” added Amanda Debrusk, backyard garden assistant, of Regional Environmental Council (REC), a grassroots organization for environmental health and food justice. “By the end of summer 2014, we will have 20 backyard gardens in Bell Hill. REC staff and volunteers, with help from the Worcester Carpenters Union, will build the 4' by 12' boxes, offer free plants and be available for advice on methods and techniques. We build relationships and community through this food sharing effort.” “We want to use the beds year-round by planting fall crops, like garlic, for harvest in the spring,” said Ms. Rodriguez. “The community gardens are amazing and have inspired people to have one at their own home. All of the families from our pilot program will continue to garden next year because of the beautiful fresh produce that can be found right in their backyard.” Map Key: Backyard and community gardens Veggie Mobile stops Community Benefits Report 2013 111
  14. 14. a positive approach YOUTH development HOPE Coalition Youth Worker Training Institute (YWTI) This 15-week course is designed to enhance the knowledge, skills and networks of front-line youth workers by increasing their understanding of risk factors, effective planning, program development and self-evaluation. YWTI is offered in collaboration with Clark University and was developed based on a needs assessment conducted among youth and executive directors of youth-serving agencies. This educational opportunity empowers youth workers to be more effective in delivering services to high-risk youth. HOPE now partners with Clark University to offer credit to youth workers who take Institute courses. HOPE Coalition Substance Abuse Task Force Peer leaders of this youth-adult partnership—created to reduce youth violence and substance abuse and promote adolescent mental health—co-chair the Youth Substance Abuse Prevention Task Force with the Worcester Division of Public Health to reduce alcohol, drug and tobacco use, which resulted in a city ordinance banning tobacco sales from pharmacies. HOPE organizes “Kick-Butt” and lobbying campaigns to discourage smoking. Worcester Education Collaborative (WEC) Working to ensure Worcester public school students are prepared to succeed, WEC aims to reduce school suspensions and improve educational attainment and graduation rates. A published white paper “Not Present, Not Accounted For” supports WEC’s holistic approach to reduce the use of out of school suspensions. Training programs were held for parents, students and the community. YouthConnect (formerly YouthNet) On average, 250 at-risk middle school youth participate daily in YouthConnect summer recreational, educational and cultural activities at Boys & Girls Club of Worcester, Friendly House, Girls Inc., Worcester Youth Center, YOU, Inc., YMCA, YWCA and the Massachusetts Society for the Prevention of Cruelty to Children. Neighborhood programs reduce violence and substance abuse, and include a healthy eating component. Healthy Options for Prevention and Education (HOPE) Coalition Art Initiative Building on the Coalition’s 2012 Social Norms campaign and in collaboration with the Worcester Art Museum, peer leaders encouraged youth to express themselves positively through art. Artwork focused on substance abuse was shared on social media, and was displayed at the City of Worcester CHIP report-out, the Massachusetts Organization for Addiction Recovery annual meeting and the city’s Town Hall meeting on underage drinking, marijuana use and prescription drugs. Building Brighter Futures With Youth Since 2005, UMass Memorial’s youth job initiative for high school students provides summer and year-round employment in many Medical Center departments. Working with the City of Worcester, Worcester Community Action Council and other agencies, 60 participants are selected and matched to placements that offer valuable on-the-job experience. 250 At-risk middle school youth participate daily in YouthConnect activities 12 UMass Memorial Health Care
  15. 15. A 20-year collaboration worcester youth center When a group of youths was arrested for loitering and disturbing the peace in the early 1990s, a grassroots effort sprang up to address violence and the lack of youth development opportunities in Worcester. The idea? To create a free, safe drop-in center where teens and young adults could make lasting, positive life choices. During three years of planning, the City Manager’s office reached out to UMass Memorial Medical Center as a key community partner for the financial support needed to launch a fledgling organization. The result was the establishment of the Worcester Youth Center (WYC) in 1994 as “not just a place to go, but a place to go further.” Samuel Martin, executive director, describes this 20- year commitment as the “first aid” that was needed in its formative years. “UMass Memorial stepped to the plate and funded salaried staff who could lead and develop the center, as well as create meaningful activities for youth. If it hadn’t been for the hospital, we wouldn’t have survived.” Expanding services with a larger building in 2008, WYC is, today, more education- and job-focused. “While we’re still “ UMass Memorial stepped to the plate and funded salaried staff who could lead and develop the center, as well as create meaningful activities for youth. ” ... C.H.I.P. provides an approach that is structured –Samuel Martin, executive director and specific enough to guide decisions and flexible enough to respond to new health challenges.” committed to the original idea as a place for adolescents who have nowhere else to go, we have moved toward more organized programming,” said Mr. Martin. “Our high school equivalency program is a failsafe for those who are displaced from school—who were pushed out, dropped out, or whose life just got in the way.” Additional emphasis is being placed on youth community leadership, individualized mental health services, violence prevention and work-based training. As WYC and UMass Memorial celebrated the culmination of a two-decade partnership, Mr. Martin reflected, “In the short term, we look to maintain a strong correlation between our programs and what society demands of young people. When we started, it was easier for someone with a high school diploma to land a job. Those days are gone and technology is driving this change. Youth are good consumers of technology, but we also want them to have the curiosity and drive to, some day, fully participate in this new economy. We want to serve youth and meet their present and future needs. In the long term, the sky is the limit.” YOUTH EMPLOYMENT City of Worcester Youth Office The office coordinates employment and pre-employment training for youth ages 12 to 21. Working with the state-funded YouthWorks summer program, more than 700 meaningful job placements for young people were created at nonprofits and local businesses in 2013. UMass Memorial leadership has helped Worcester youth job programs to collectively secure annual funding. Health Career Expo UMass Memorial, the University of Massachusetts Medical School, Worcester Public Schools, Boys & Girls Club and the City of Worcester Youth Opportunities Office hosted this annual event at The College of the Holy Cross. About 60 providers from a range of health professions and 14 area colleges participated. Nearly 600 high school students took part in this program that exposes students to careers in the health care industry. Photo (above): Eric W. Dickson, MD, UMass Memorial president and CEO, congratulates executive director Samuel Martin on Worcester Youth Center’s 20th anniversary. Community Benefits Report 2013 131
  16. 16. Great Brook Valley Bell Pond Care Mobile Stops and Affiliated Schools Elm Park Rt 290 Rt 9 Shrewsbury Street Rt 190 Rt 290 Downtown Green Island Worcester Tatnuck Square Columbus Park South Worcester Quinsigamond Village Rt 390 Rt 290 improving access Wellness Education at Belmont Street Community School UMass Memorial holds monthly Parent/Teacher Organization meetings at this Worcester elementary school in the Bell Hill neighborhood to connect parents to needed health and prevention resources. Experts from the clinical system speak about nutrition, oral health, asthma, behavioral disorders and other chronic conditions. Central Massachusetts Oral Health Initiative To address the high rate of tooth decay among children due to the lack of fluoride in the Worcester water supply, UMass Memorial coordinates the region’s oral health initiative. Working to ensure the provision of preventive dental services in public and charter schools, the collaboration of a broad range of community stakeholders includes Edward M. Kennedy Community Health Center, Family Health Center of Worcester, Quinsigamond Community College, Massachusetts Department of Public Health, Massachusetts College of Pharmacy and Worcester Public Schools. Plumley Village Health Services (PVHS) A satellite family clinic serving the needs of low-income public housing residents, PVHS is the medical home of 1,400 primarily Latino families. Approximately 80 percent of its 3,000 patients are covered by Medicaid. The clinic manages an on-site Wellness Center offering health and community engagement programs, including a garden initiative, fitness and cooking classes. A community health worker conducts home visits to identify and address complex social factors that adversely affect patient health. PVHS is an integral part of the UMass Memorial pediatric asthma home visiting pilot program (see page 5). Worcester Free Clinics Coalition This coalition comprised of providers, focuses on opportunities to better serve vulnerable populations that are attracted to Worcester’s network of free clinics. In collaboration with students from the University of Massachusetts Medical School, the group conducted an assessment to increase understanding of health care needs. An electronic medical record option was explored to improve communication among clinics. Sara Connor, UMass Memorial Care Mobile manager, co-leads the coalition. Map Key: Care Mobile stops Worcester Public Schools Photo: James Broadhurst, MD, medical director of the UMass Memorial Ronald McDonald Care Mobile, examines a young patient. 14 UMass Memorial Health Care
  17. 17. UMass memorial ronald mcdonald care mobile schools (see map). Children receive screenings, fluoride treatments and sealants, and as needed, a hygienist makes referrals to two community health centers for follow-up. “Severely decayed teeth can be the source of other illness,” added Ms. Connor. “Dental pain negatively affects children’s ability to learn, but they might not know to tell someone about a toothache. We can cover them with antibiotics until they get to a dental clinic, keeping them out of the emergency room, and ideally helping them to participate more fully in the classroom.” There is more to health care than how it is traditionally defined. An experienced outreach worker connects families to resources that include, but are not limited to food, housing or domestic violence prevention. “The Care Mobile is an open door that helps bridge barriers to health care,” continued Ms. Connor. “When families connect to our very caring health care professionals in a welcoming space, good health becomes a group effort. I am proud of that.” CARE MOBILE services and community outreach Through partnerships with local organizations, the Care Mobile educates the community about the importance of primary care at these and other community events: Lutheran Social Services National Night Out Plumley Village Health Fair Southeast Asian Coalition Festival Star of Jacob Evangelical Church UHAI African Women’s Health Fair Developing A brand new UMass Memorial Ronald McDonald Care Mobile rolled out in July 2012. It brings consistent, dependable medical and dental care to low-income Worcester neighborhoods with its bright and expanded user-friendly spaces and state-of-the-art equipment. “Think of it as a medical and dental office on wheels, instead of a truck, and one gets a sense of how complicated it is to run a mobile clinic,” said Sara Connor, FNP, manager. “We also drive to 10 community outreach events. It’s a working clinic wherever it goes. While checking BMI and blood pressures at community health fairs, the staff is constantly evaluating people ‘on the fly’ for medical or dental needs, and if they require immediate attention, we can provide it.” Now in its thirteenth year, the program focuses on children and their families. Outreach to the Worcester Public Schools Adult Learning Center and English language classes at Lutheran Social Services makes parents aware of the schedule and how to get started in the preventive care system. The Care Mobile meets people in their neighborhood. Its dental program is affiliated with 22 “ The Care Mobile is an open door that helps bridge barriers to health care. ” –Sara Connor, care mobile manager and family nurse practitioner The Care Mobile serves medically underserved populations who cannot access or are not connected to care, thereby minimizing unnecessary visits to emergency rooms and increasing the likelihood of establishing a medical home. 3,010 patients 22 Worcester Public and Charter Schools 10 city neighborhoods 4,389 sealants 4,217 fluoride varnish applications 1,451 pediatric oral health screenings 10 community outreach events Insurance enrollment assistance Referral to other social support resources Vietnamese Elder Day Care YWCA Young Parents Program Worcester Latino Festival Worcester Public Schools Parent and Guardian Expo Community Benefits Report 2013 151
  18. 18. access to health care 16 UMass Memorial Health Care
  19. 19. A COMMON LANGUAGE Elder Semi-Urgent Care As baby boomers reach age 65, seniors account for the fastest growing sector of the general population and, according to the 2010 census, represent 11.6 percent of Worcester residents. This statistic demands consideration, as seniors often encounter more barriers to accessing medical and dental care due to physical immobility and lack of transportation, particularly in low-income areas. Through a relationship with the Worcester Housing Authority (WHA), UMass Memorial conducts on-site urgent medical evaluations at seven public housing sites and two Latino-centric nonprofit community clinics—Centro Las Americas, a social services provider, and Hector Reyes House, a men’s substance abuse recovery home. Matilde Castiel, MD, hospital internist and executive director of Reyes House, serves more than 400 ethnically diverse residents and sees about 60 patients every week. While largely focused on triage for acute medical conditions, such as possible stroke or heart attack, Dr. Castiel doesn’t turn anyone away. “Patients who see me for urgent care often present with chronic problems that need attention and management as well: diabetes, hypertension, pulmonary disease and asthma, hepatitis, substance abuse “ UMass Memorial subsidizes this important service because these people would not go to a doctor otherwise. ” xxxxxxx Meals were served through –Matilde Castiel, MD, hospital internist Wheels to Water On-Site Urgent Care Belmont Tower Apartments Centro Las Americas Curran Terrace Elm Park Tower Apartments Hector Reyes House Lafayette Place Lincoln Park Tower Apartments Pleasant Tower Apartments Webster Square Towers Wellington Apartments and mental health issues. It’s a matter of noticing what else might be going on. “UMass Memorial subsidizes this important service because these people would not go to a doctor otherwise. Lack of transportation is a major obstacle for my patients, but the inability to understand and be understood in a medical setting also makes them feel uncomfortable. My assistant and I are Hispanic and we speak Spanish to most of our patients. By offering services where they live, particularly in large housing developments, we can lower costs as well as provide the care they really need.” Ultimately, going to the emergency room isn’t always appropriate or the best option for a patient’s health, and education can make a difference in lowering the frequency of such visits for elders and vulnerable populations. The hospital’s partnership with WHA is very effective in getting the word out by advertising services through its programs, and by offering a video and a printed package of information when people move into housing. Together with WHA, we serve some of Worcester’s most vulnerable people in a language they understand. Access to Care/Wellness Domain Work Group Promoting access to medical and oral health care and reducing the prevalence of chronic disease, emergency room utilization, infant mortality, preventable hospitalizations and readmissions emerged as key areas of focus in the Greater Worcester Community Health Improvement Plan (CHIP, see page 3) Working on these priorities, UMass Memorial convenes the CHIP Access to Care/ Wellness Domain Work Group. Community Benefits Report 2013 171
  20. 20. A HEALTHY COMMUNITY a focus on public health Wing Memorial Hospital To improve access to care as well as monitor and educate seniors who have or are at risk for diabetes and hypertension, Wing Memorial provides monthly screening clinics at the Belchertown Senior Center. The staff additionally offers educational programs on nutrition and healthy eating for people with diabetes at the Monson and Palmer Senior Centers. A total of 265 elderly patients were served by these programs. Marlborough Hospital Promoting heart health among seniors, Marlborough Hospital presented “Know Your Heart” sessions at the New Horizons Retirement Community. Including topics such as exercise for seniors, preventive medicine, heart tests and treatments, the programs were attended by 60 people. The hospital also conducted cholesterol and glucose screenings at a senior health fair visited by approximately 500 people. HealthAlliance Hospital An “As We Age” Health Expo, presented by HealthAlliance and attended by 150 people, was held at Montachusett Home Care in Leominster, a not-for-profit agency established to assist elders and disabled persons to remain safely in their own homes and prevent unnecessary nursing home placement. Youth Mental Health Peer leaders from the Healthy Options for Prevention and Education (HOPE) Coalition developed a model to include mental health counselors with staff at the Boys & Girls Club, Worcester Youth Center and YouthConnect. Targeting the stigma and barriers associated with mental health services, the program served 800 youth through one-on-one counseling, therapeutic groups and crisis intervention delivered by the Massachusetts Society for the Prevention of Cruelty to Children. Insurance & SNAP (Food Stamps) Enrollment Assistance While health insurance is required for Massachusetts residents, approximately four percent remain uninsured resulting in a significant need for continued insurance enrollment assistance. UMass Memorial Health Care and its affiliates— HealthAlliance, Clinton, Marlborough and Wing Memorial— helped 13,547 patients and members of the general public to apply for health insurance, SNAP (food stamps) and Women, Infants & Children (WIC) nutrition vouchers. The Commissioner of Public Health UMass Memorial’s close partnership with the City of Worcester Division of Public Health creates a framework for preventive community-based programs for vulnerable groups, promoting public policy and the greatest collective impact through collaborative programs and initiatives. As part of a mission to promote health and address disparities among underserved populations, the hospital financially supports the public health commissioner position. 13,547 People assisted with insurance and SNAP (food stamps) enrollment systemwide 18 UMass Memorial Health Care
  21. 21. reducing health care disparities hepatitis screening and treatment Hepatitis C (HCV) is transmitted through blood-to-blood encounters such as sharing needles, transfusions and sexual contact. The virus leads to cirrhosis and hepatic carcinoma, and is the number one reason for liver transplant. According to the Centers for Disease Control, it infects more than 3.2 million Americans and about 100,000 Massachusetts residents live with chronic HCV. Three percent move toward end stage liver disease each year. For patients co-infected with HIV, hepatitis B, or who abuse alcohol or drugs, end stage disease arrives more quickly and requires more complex treatment. “It is a dormant epidemic and people should be tested,” said UMass Memorial infectious disease specialist Mireya Wessolossky, MD. “Most won’t know they have it until it may be too late. Two populations are at increased risk: users of cocaine or other substances; and patients who were transfused prior to 1992. Men engaging in sex with other men and baby boomers are also at risk.” At Hector Reyes House, a men’s residential substance abuse treatment program for Latinos, many residents have a history of drug use and are HCV positive. “Initially, patients were referred from Reyes House to my hospital clinic,” continued Dr. Wessolossky. “But after teaching house residents about infectious diseases I thought, why not hold monthly office hours, too? By going where the need is, I have significantly decreased the number of no-shows, good cultural match.” Dr. Wessolossky evaluates patients, hears their stories, orders tests and looks for additional risk factors. HCV medication is more than 90 percent effective but costly, making longer-term lifestyle changes necessary for recovery. Therefore, patients must be truly ready to undergo treatment. They learn about treatment goals, commit to a full course of medication, and return for ongoing post-treatment counseling because they are not immune to new infection. “As a community, we want to eradicate diseases that are costly not only from a financial perspective, but also the personal toll it takes on individuals,” said Dr. Wessolossky. “I see all patients as human beings first. If I can provide care in a more convenient setting, that positive feeling is going to continue to resonate with them emotionally.” “ As a community, we want to eradicate diseases that are costly not only from a financial perspective, but also the ... C.H.I.P. provides personal an toll approach it takes that on individuals. is structured ” and specific enough to guide decisions and flexible enough to respond to new health challenges.” – infectious disease specialist Mireya Wessolossky, MD and because my native language is Spanish, it’s a Who should be tested for Hepatitis C? (From the Center for Disease Control) • Baby boomers (born 1945 to 1965) • Current and past injection drug users • Those treated for blood clotting problems before 1987 • Blood transfusion or organ transplant patients before 1992 • Long-term dialysis patients • Those with abnormal liver tests or liver disease • Health care and public safety workers • Those infected with HIV 8,744 The average number of new HCV infections each year since 2002 (From the Massachusetts Department of Public Health) Community Benefits Report 2013 191
  22. 22. our system supports a variety of community and neighborhood initiatives Access to Care • Oral health and primary care at community health centers • UMass Memorial Ronald McDonald Care Mobile • YMCA Men’s Health & Families Program • Elder medical services at Worcester Housing Authority and Centro Las Americas • Southeast Asian Coalition • Health insurance enrollment • Plumley Village Health Services • Hector Reyes House • Akwaaba African Free Clinic • Outreach education programs • UHAI African Women Organization Bell Hill Healthy Community Outreach and Revitalization • Crime Watch and Bell Hill Task Force meetings • Family health and support services at two schools • Increased availability of fresh produce Chronic Disease • Pediatric Asthma Home Visiting Program Coalition-Building Efforts • Central Massachusetts Oral Health Initiative • Common Pathways • North County Minority Collaboration for Community Development & Health Equity Literacy • Reach Out & Read • Health literacy outreach • YWCA Teen Parent Program • Worcester Education Collaborative Obesity and Healthy Weight • Wheels to Water • Belmont Street Community School exercise programs • Plumley Village Path to Wellness • Act FRESH campaign • Community gardens • Regional Environmental Council mini-farmers market and Veggie Mobile • Food pantries and SNAP food stamp enrollment • Community nutrition, education, outreach and screenings Programs Enhancing Community Health • Injury prevention programs • City of Worcester Commissioner of Public Health • Public health nursing program, Belchertown • Palmer Senior Center nurse • Smoking cessation education programs Youth At Risk • Building Brighter Futures With Youth • HOPE Coalition • Workforce and mentoring programs • Health career scholarship fund • YouthNet violence prevention • Worcester Youth Center • Career Expo at the Boys & Girls Club • City of Worcester Youth Opportunities Office • Mental health services at community sites • Worcester Youth Training Institute Other Contributions • American Heart Association • Community-based support groups • Central Massachusetts Walk for Homelessness • Advocacy for health care access 20 UMass Memorial Health Care
  23. 23. UMass Memorial Health Care System Wing Memorial Hospital Marlborough Hospital Licensed Beds System Total 1,083 HealthAlliance Hospital Our Community Benefits Partners • Advocacy groups • Medically underserved populations • Neighborhood groups • State and local government officials • State and local health departments • The City of Worcester • Community health centers • Schools and community-based organizations Hospital Admissions (including newborns) System Total 57,581 Emergency Room Visits System Total 260,716 ★ ★ ★ ★ ★ ★ Outpatient Visits System Total 1,052,673 Clinton Hospital UMass Memorial Medical Center ★ Plumley Village Health Services Barre Family Health Center Care Mobile 7,612 Patient Visits Life Flight 472 Flights Active Medical Staff System Total 1,628 ABOUT OUR SYSTEM Photo Credits Unless otherwise noted, all photos were provided by UMass Memorial Community Benefits; Kim Reckert, photographer. • Front Cover: View of Belmont Hill, Worcester, MA, Dany Pelletier, photographer • Page 2: View of downtown Worcester, Dany Pelletier, photographer • Page 4, 5: In-Home Asthma Education, Dany Pelletier, photographer • Page 6: Michael Hirsh, MD, Courtesy of UMass Medical School • Page 8: Cooking Matters classes, Courtesy of Alicia McCabe, Massachusetts State Director | No Kid Hungry® • Page 9: Cooking Matters class, Dany Pelletier, photographer • Page 11: Backyard Gardens, Dany Pelletier, photographer • Page 12: Youthreach Program artists. Courtesy of the Worcester Youth Center • Page 13: Worcester Youth Center, Dany Pelletier, photographer • Page 14: Care Mobile, UMass Memorial Health Care • Page 16: Robert Kneschke, photographer, Dreamstime.com • Page 17: Dr. Castiel, Tammy Woodard, photographer • Page 18: Care Mobile, Courtesy of UMass Memorial Health Care • Page 19: Dr. Wessolossky, Courtesy of UMass Memorial Health Care • Back Cover: Inside the Care Mobile, Courtesy of UMass Memorial Health Care • Largest not-for-profit health care system in Central New England • Largest provider to the uninsured outside Boston • Only Safety Net Provider in Central New England and the 4th largest in the Commonwealth • Supports a dedicated financial benefits program that connects the medically underserved and uninsured populations to health insurance and other services Photo (left): Kids cool off at Christoforo Colombo Park in Worcester, part of the Wheels to Water summer program.
  24. 24. UMass Memorial Health Care is a not-for-profit health care system in Central New England with nearly 2,000 physicians and more than 13,000 employees. Our member hospitals, all fully accredited, are: • Clinton Hospital • HealthAlliance Hospital • Marlborough Hospital • UMass Memorial Medical Center • Wing Memorial Hospital and Medical Centers UMassMemorial Health Care UMass Memorial Health Care, Biotech One, 365 Plantation Street, Worcester, MA 01605 Tel: 508-334-1000 www.umassmemorial.org

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