Communities of CareNASCSP Conference

Marisue GargantaDirector, Community Health IntegrationDignity Health, St. Joseph’s Hospital and Medical Center

September 11, 2013

Setting the Stage

•Who is your hospital partner?

•Understanding Hospital's responsibilities

•The Affordable Healthcare Act

•Responding to the mission and law

•Creating Communities of Care

•Resources

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St. Joseph’s Hospital and Medical Center

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Hospital’s Roles and Responsibilities

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•Nonprofit Requirements

• Internal Revenue Services – IRS – Form 990 Schedule H

• 3 year Community Health Needs Assessment

• 3 year Community Benefit Plan

• Mission to serve the community

• Affordable Healthcare Act

• Investment in community

Affordable Health Care Act

•Health Coverage

•Medicare

•Medicaid

•Subsidies - Assistance

•Preventive Services

•Hospital and Providers

•Community Health Assessments5

Two thirds of the uninsured live in 13 states

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Uninsured by State

<230K 230K - 600K

600K - 1.1M

1.1M+

Number of Uninsured

67% of uninsured live in 13 states

Source: Census Bureau, Current Population Survey, March 2011 and 2012

One fifth of the uninsured live in the top 13 counties and half live in the top 114 counties

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Uninsured by County

10% of the uninsured live in just 4 counties (LA, Harris, Cook, Miami)

20% of the uninsured live in top 13 counties(Top 4 + Next 9)

50% live in the top 114 counties (3.8% of total

counties in the US)

All Qualified Health Plans Will Cover These Essential Health BenefitsAll Qualified Health Plans Will Cover These Essential Health Benefits

04/20/23 The Health Insurance Marketplace 101 8

6. Prescription drugs

7. Rehabilitative and habilitative services and devices

8. Laboratory services

9. Preventive and wellness services and chronic disease management

10. Pediatric services, including oral and vision care

1. Ambulatory patient services

2. Emergency services

3. Hospitalization

4. Maternity and newborn care

5. Mental health and substance use disorder services, including behavioral health treatment

The Beginning of the Shared Vision and Need“Creating a Healthier and Connected Community”

Healthy and Safe Community Environments

Clinical and Community Preventive Services

Empowered People

Elimination of Health Disparities

National Prevention Strategy America’s Plan for Better Health and Wellness” (http://www.healthcare.gov/center/councils/nphpphc).

Prevention Strategy Diagram

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Responding to the mission and law

Requirements within Community Benefit

• Reporting “good works” for IRS Form 990 – Schedule H

• Improving the health of the community

• Community Grants

• Community Investments

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Connecting the Community Health Needs Assessment

Identify key areas in Community Health Needs Assessment

Review, identify assets and gaps

Create initiative to meet your greatest area of need

Identify zip codes with Community Needs Index and/or other identified data of greatest need

Identify “key” groups of need

Identify service areas, departments and/or hospital’s in and outpatient services to be “champions” for work

Create a Community of Care

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Grant’s Program as Solution

Use grant’s program as a “solution”

• Filling the gap in services

• Creating networks of care

• Integrating best practices in community and hospital

• Education opportunities – teaching, learning, growing

• Answering Schedule H – Questions

– Did you meet the needs within Community Health Needs Assessment?

– If no, than how did you meet it and with whom?

• Changing the paradigm of care

• Foundation for the Affordable Healthcare Act

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Investing in the Community

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RESOURCES

Affordable Healthcare Act

- www.Healthcare.gov

- www.Marketplace.cms.gov

- http://www.healthcare.gov/center/councils/nphpphc

Dignity Health- www.DignityHealth.org/

CommunityInvestments

National Organizations

•www.chausa.org

•www.communityhlth.org

Healthy Communities

http://www.healthycommunitiesinstitute.com

Collective Impact

http://www.fsg.org/OurApproach/CollectiveImpact.aspx

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www.HealthCare.govwww.HealthCare.gov

04/20/23 The Health Insurance Marketplace 101 15

Starting October 1, 2013, you will be able to apply

through this site

Now - Sign up for Email and Text Alerts

and Get Ready

Marketplace.cms.govMarketplace.cms.gov

04/20/23 The Health Insurance Marketplace 101 16

Get the latest resources to help people

apply, enroll, and get

coverage in 2014

QUESTIONS?Thanks for all you do and for taking the time to be here today!

Marisue Garganta

Director of Community Health Integration

602.406.6580

Marisue.Garganta@DignityHealth.org