Prioritization Process

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Healthy Montgomery Hospital Workgroup March 2, 2015 1/30/2015 1

Prioritization Process Goal: Purposeful activities that meet identified communityhealth needs and improve health status and quality of life. Hospital Programs & Activities Identified Community Health Priorities Improved Health Status & Quality of Life Community defined based on (source: Catholic Health Association): Primary service area Secondary service area Patient categories (e.g., general population, children-only or rehabilitation-only) Areas and populations served by hospital s community benefit programs Example: Suburban Hospital Formula for Calculating Community Benefit Service Area: a) The top 20 zip codes from which Hospital ED visits originate b) The top 20 zip codes from which Hospital inpatients originate c) The top 25 zip codes for Hospital Charity Care cases d) The top 10 zip codes for Hospital Community Benefit Activities 1/30/2015 2

FY15 Methodology Comparisons Similarities Differences Timeline Healthy Montgomery Priorities Data Sources IRS Guidelines Variation of Hospital Priorities CBSA Zip Codes CBSA Formula Implementation Plan Strategies Input from Public Health Experts and Stakeholders Hospital Board Approval of CHNA 1/30/2015 3

Adventist HealthCare Mission: We demonstrate God s care by improving the health of people and communities through a ministry of physical, mental and spiritual healing. Adventist HealthCare Shady Grove Medical Center CBSA Adventist HealthCare Washington Adventist Hospital CBSA

Approach & Methodology: Approach & Methodology: SGMC and WAH Data Sources/Community Input -Primary, secondary (HM, ACS, Census, SHIP, etc.), and hospital data -Input from local public health experts and stakeholders (Advisory Board, Community Partnerships) Partners -Multiple community groups and clinics, including Montgomery County DHHS, Asian American Health Initiative, Pan Asian Clinic, Lung Cancer Alliance, Montgomery Cares, Mercy Health Center, Muslim Community Clinic Utilizing Healthy Montgomery -To help identify and prioritize focus areas, and as a data source Implementation Plan -Advisory board and hospital leadership prioritized identified needs -1 or 2 focus areas selected for each hospital, to align with mission and strategy

Adventist HealthCare Shady Grove Medical Center Health Priorities Cancer Diabetes

Adventist HealthCare Washington Adventist Hospital Health Priorities Behavioral Health Influenza

CHNA ing Timeline FY12 (July 2011 June 2012) FY13 (July 2012 June 2013) FY14 (July 2013 June 2014) FY15 (July 2014 June 2015) FY16 (July 2015 June 2016) FY17 (July 2016 June 2017) FY18 (July 2017 June 2018) FY19 (July 2018 June 2019) FY20 (July 2019 June 2020) FY21 (July 2020 June 2021) Conduct CHA 3-year CHA cycle Conduct CHA 3-year CHA cycle 3 year Summary Summary Implementation Strategy Conduct CHA 3-year CHA cycle Conduct Conduct CHA CHA Implementation Strategy Last updated 3/14/2014 by JLR

Holy Cross Health We, Holy Cross Health and Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. We carry out this mission in our communities through our commitment to be the most trusted provider of health care services. Holy Cross Hospital Community Benefit Service Area Holy Cross Germantown Hospital Community Benefit Service Area

Approach & Methodology Holy Cross Health identifies unmet community health care needs in our community in a variety of ways. We collaborate with other healthcare providers to support Healthy Montgomery, Montgomery County's community health improvement process. The majority of our data is obtained from Healthy Montgomery documents, the Healthy Montgomery website, community conversations and the priority setting process. We use available reports and assessments such as Community Health Need Index, County Health Rankings and Roadmaps and other needs assessments from non-profit organizations in Montgomery and Prince George s County We conduct an extensive analysis of demographics, health indicators and social determinants of health of the communities we serve, including hospital specific readmission data and prevention quality indicators. We seek expert guidance from a panel of external participants with expertise in the needs of our community.

Holy Cross Health Health Priorities Holy Cross Health adopted the HM top-ranked priority areas and the three overarching themes. Demographic analysis from Holy Cross Health's needs assessment also reveals that the senior population of Montgomery and Prince George s Counties is growing at an unprecedented rate, increasing the need for senior services such as housing and health care. In an effort to be proactive in meeting the growing needs of this population we have included seniors as a priority focus in addition to the priorities set by Healthy Montgomery. We focus our community benefit activities on the most vulnerable and underserved individuals and families, including women/children, seniors, and racial, ethnic and linguistic minorities. 1. Maternal/Infant Health 2. Seniors 3. Cardiovascular Health 4. Obesity 5. Diabetes 6. Behavioral Health 7. Cancers Based on Healthy Montgomery priorities and overarching themes.

Holy Cross Health CHNA ing Timeline CHNA ing Timeline FY11 (July 2010 June 2011) FY12 (July 2011 June 2012) FY13 (July 2012 June 2013) FY14 (July 2013 June 2014) FY15 (July 2014 June 2015) FY16 (July 2015 June 2016) FY17 (July 2016 June 2017) FY18 (July 2017 June 2018) FY19 (July 2018 June 2019) FY20 (July 2019 June 2020) Conduct CHNA 3-year CHNA cycle 3-year CHNA cycle Conduct CHNA 3-year CHA cy Multi-year Implementation Strategy Multi-year Implementation Strategy Multi-year Implementation Strat Amend CHNA w/ new HM Data Board Approves Conduct CHNA Amend CHNA w/ new HM Data Board Approves New 3-year CHNA cycle Multi-year Implementation Strategy

MedStar Montgomery Medical Center A proud member of MedStar Health, is dedicated to enhancing our community's health & well-being by offering high quality, compassionate and personalized care.

Approach & Methodology Community Health Needs Assessment Survey Primary and Secondary Hospital Data Hospital utilization data assessed with emphasis on charity care Percent of serviced uninsured/insured population Highest serviced area (zip code) Most common diagnosed health conditions Healthy Montgomery Healthy Montgomery provides data through their website including, disparities dashboards and county demographics. Implementation Plan Community Benefit Advisory Task Force Determine areas of focus Develop implementation strategy Determine impact measures Partnering Organizations Community Health Partners of Aspen Hill, Millian Methodist Church, Proyecto Salud Clinic, Holy Cross Aspen Hill Clinic, Longwood Community Center, Mid county Community Center, American Lung Association, MedStar Visiting Nurse Association.

MedStar Montgomery Health Priorities Vulnerable populations: Persons not well integrated into the health care system because of ethnic, cultural, economic, geographic, or health characteristics. MedStar Montgomery Medical Center s community health needs assessment reveals a focus on low-income residents and underserved seniors linked to risk factors of developing chronic disease. 1. Cancer 2. Diabetes 3. Heart Disease 4. Overweight/Obesity Based on Healthy Montgomery priorities and overarching themes.

CHNA ing Timeline FY12 (July 2011 June 2012) FY13 (July 2012 June 2013) FY14 (July 2013 June 2014) FY15 (July 2014 June 2015) FY16 (July 2015 June 2016) FY17 (July 2016 June 2017) FY18 (July 2017 June 2018) FY19 (July 2018 June 2019) FY20 (July 2019 June 2020) FY21 (July 2020 June 2021) Conduct CHA 3-year CHA cycle Conduct CHA 3-year CHA cycle Summary Conduct CHA 3-year CHA cycle Conduct CHA Summary CHA: Published by June 30 of indicated fiscal year : Presents outcomes to ATF of activities completed in prior fiscal year; Published by December of indicated fiscal year Summary : Presents outcomes via website of prior 3-year CHA cycle; Published by December of indicated fiscal year

Suburban Hospital Mission: To improve health with skill and compassion

Approach & Methodology Data Collection Implementation Strategy Improved Health Status & Quality of Life

Suburban Hospital Health Priorities Healthy Montgomery priorities and overarching themes.

CHNA ing Timeline FY12 (July 2011 June 2012) FY13 (July 2012 June 2013) FY14 (July 2013 June 2014) FY15 (July 2014 June 2015) FY16 (July 2015 June 2016) FY17 (July 2016 June 2017) FY18 (July 2017 June 2018) FY19 (July 2018 June 2019) FY20 (July 2019 June 2020) FY21 (July 2020 June 2021) Conduct CHNA 3-year CHA cycle Conduct CHNA 3-year CHA cycle 3-year CHA cycle Conduct CHNA

Summary 1/30/2015 21

Planning for the Future Up-to-date data Follow guidelines from IRS (expertise to assist hospitals in meeting guidelines) Facilitate community conversations Share best practices of evaluations and outcomes based on identified priorities, technical support on completed CHNA of hospitals Integrate Hospitals input on steering committee agendas; address issues Continue to evolve and develop steering committee membership to represent all sectors of Montgomery County (private sector, grassroots, community members, etc.). Utilize the resources of the hospitals, specifically during work plan development-think about what the hospitals are already doing. 1/30/2015 22

Implementation Plan: Diabetes & Cardiovascular Health 1/30/2015 23

Adventist Healthcare- Shady Grove Medical Center Pre-Diabetes Classes Health Priority Diabetes Informational Sessions at Mobile Med Holy Cross Hospital Diabetes Prevention Program Group Lifestyle Balance OB/GYN Gestational Diabetes Education Classes MedStar Montgomery Medical Center Diabetes Education and Nutrition School: Health education on selfmanagement of the disease, which includes an adequate diet, regular physical activity and daily control of glucose levels. Suburban Hospital Mobile Med/NIH Endocrine Clinic at Suburban Hospital; Financialand in-kind support to local clinics Core Measures Adults with diabetes ER visits for diabetes Diabetes Schools at Proyecto Salud; Support Groups, Nutrition Counseling Services; Nutrition Seminars Adventist HealthCare- Washington Adventist Hospital Pre-Diabetes Classes Diabetes Support Group

Adventist HealthCare- Shady Grove Medical Center Health Priority Monthly Blood Pressure Testing at Damascus & Rockville Senior Center Holy Cross Hospital Senior Fit, a free 45-minute multi-component, age appropriate exercise class at various geographically accessible locations in Mont. & PG County Stanford University s Chronic Disease Self-Management Program, two and a half hour workshop, once a week, for six weeks, in community settings such as senior centers, churches, libraries and hospitals MedStar Montgomery Medical Center Conduct heart disease-related education programs and screenings events in the Aspen Hill/Bel Pre region Senior Exercise: A fitness active aging group exercise class, designed to help older adults maintain their cardiovascular health. Suburban Hospital Mobile Med/NIH Heart Clinic at Suburban Hospital Project Access & Catholic Charities HeartWell Program Re-admission Initiative Core Measures Heart disease mortality Stroke mortality High blood pressure prevalence Adventist HealthCare Washington Adventist Hospital Love Your Sweetheart Healthy Living Lecture Series

Healthy Montgomery Priorities 1/30/2015 26